GOOD AFTERNOON. UM WE WON'T
FORMALLY START THE MEETING UNTIL
I HAVE A REPUBLICAN MEMBER UP
HERE. AS YOU CAN SEE, UM I HAVE
pPRESENT. SO WHAT I DO WANT TO
MAKE YOU HAVE SOME ANNOUNCEMENTS
WE TYPICALLY MAKE BEFORE THE
HEARING, SO I'M GOING TO GO
AHEAD AND DO THAT NOW. AH AND
THEN WHEN WE HAVE A REPUBLICAN
HERE WILL ACTUALLY GO AHEAD AND,
WELL, WE ALSO NEED TO SENATOR TO
PRESENT A BILL. WE DO HAVE A
SENATOR. SO THAT'S A GOOD START.
SO ANYWAY, LET ME GO AHEAD WITH
OUR ANNOUNCEMENTS. UM WELL.
THANK YOU VERY MUCH FOR BEING
HERE TODAY. THIS IS THE ASSEMBLY
HEALTH COMMITTEE HEARINGS ARE
LAST SCHEDULED HEARING OF THE
YEAR. UM WE SEEK TO PROTECT THE
RIGHTS OF ALL WHO PARTICIPATE IN
THE LEGISLATIVE PROCESS SO THAT
WE CAN HAVE EFFECTIVE
DELIBERATION ON CRITICAL ISSUES
FACING CALIFORNIA. IN ORDER TO
FACILITATE THE GOAL OF THIS
HEARING. WE WILL NOT PERMIT
CONDUCT THAT DISRUPTS, DISTURBS
OR OTHERWISE IMPEDES THE ORDERLY
CONDUCT OF LEGISLATIVE
PROCEEDINGS ARE WITNESSES WILL
BE TESTIFYING IN PERSON. WE
ALLOWED TO MAIN WITNESSES FOR A
MAXIMUM OF THREE MINUTES EACH.
WE WILL HAVE A SPECIAL ORDER OF
BUSINESS AT THREE P.M. TODAY FOR
ITEM NUMBER ONE SB 13 38 BY
SENATOR UMBERG. FOR THIS BILL.
WE WILL ALLOW TO WITNESSES FOR A
TOTAL OF 10 MINUTES FOR EACH
SIDE. THAT IS 10 MINUTES FOR
SUPPORT AND 10 MINUTES FOR
OPPOSITION AND 10. FOR THOSE WHO
FEEL LIKE THEY ARE SOMEWHERE IN
BETWEEN. EFFECTIVELY CALLED
TWEENERS. AFFECTIONATELY CALLED. ADDITIONAL TESTIMONY WILL ALSO
BE IN PERSON AND LIMITED TO NAME
POSITION ORGANIZATION IF THEY
REPRESENT ONE. WE WILL TAKE SP
14 73 BY SENATOR PAN IMMEDIATELY
AFTER SP 13 38 TO ACCOMMODATE A
WITNESS, UM, WHICH IS ACTUALLY
DARK. DR MARK GOLLY, OUR
SECRETARY FOR HEALTH AND HUMAN
SERVICES. WE APPRECIATE YOUR
COOPERATION. WE HOPE AUTHORS AND
STAKEHOLDERS ARE RESPECTFUL OF
THE PROCESS. THE CONSENT
CALENDAR. I'M JUST GONNA WAIT ON
THAT UNTIL WE ACTUALLY UNTIL WE
ACTUALLY HAVE A REPUBLICAN
MEMBER, AND THEN I'LL MAKE AN
ANNOUNCEMENT ABOUT THAT. SO HANG
TIGHT. PLAY CARDS. CHECK YOUR
EMAIL. AYE.
OKAY WE WILL GO AHEAD AND GET
STARTED HERE. UM MR BIGELOW HAS
JOINED US SO WELL. OUR RULES OF
OUR COMMITTEE WILL GO AHEAD AND
GET STARTED. SO WE HAVE A
CONSENT CALENDAR TODAY. THE
FOLLOWING BILLS ARE PROPOSED FOR
CONSENT FOR TODAY'S HEARING. ANY
MEMBER OF THE COMMITTEE MAY
REMOVE A BILL FROM CONSENT. THE
PROPOSED CONSENT CALENDAR.
INCLUDES ITEM NUMBER TWO SB 11
91 BY SENATOR BATES ITEM NUMBER
SEVEN SP 8 42 BY SENATOR DODD. I
DON'T NUMBER EIGHT SP 9 29 BY
SENATOR EGGMAN. ITEM NUMBER NINE
SB. 11,000 03. YEAH 1003 BY
SENATOR EGGMAN OR WHY THAT WAS
SO DIFFICULT ITEM NUMBER 13 SB 3
67 BY SENATOR HER. TATO REMEMBER
19 CENTS. SB 11 80 BY DR PAN.
ITEM NUMBER 22 SB 13 39 BY DR
PAN AND ITEM NUMBER 24 SP 1500
BY THE HEALTH COMMITTEE. WE HAVE
A SUBSTITUTE MEMBER ASSEMBLY
MEMBER, DR AKILA WEBER WILL BE
WILL BE REPLACING THE DEMOCRATIC
VACANCY FOR TODAY'S COMMITTEE
HEARING. REMOVED FROM THE
AGENDA. SB 9 58 BY SENATOR
LIMÓN. SP SET I SPEAK SP 9 39
AND SB 4 43. WERE PULLED FROM
TODAY'S HEARING AT THE REQUEST
OF THE AUTHORS, THAT IS SP 9 39
. PAN S BEFORE 43 BY SENATOR
HERZBERG PULLED FROM TODAY'S
HEARING AT THE REQUEST OF THE
AUTHORS.
OKAY WE'LL GO AHEAD AND I WAS
JUST GOING TO GIVE A FEW MINUTES
TO IN CASE PEOPLE WERE LEAVING
ANOTHER WERE PEOPLE HERE FOR
BILLS. SO SENATOR BECKER. WOULD
YOU LIKE TO COME FORWARD? WE'VE
GOT YOU'VE GOT, UH, FEW BILLS
BEFORE US.
THANK YOU, MR CHAIR MEMBERS CAN
I DO SB 13 46 1ST. SURE THAT'S
FINE. THANK YOU FOR ALLOWING ME
TO PRESENT THIS BILL WHEN I
THANK YOUR STAFF, FOR ALL THE
INCREDIBLE WORK ON THIS BILL AND
FOR WORKING WITH MY STAFF IN THE
BILL SPONSORS, I DO ACCEPT THE
COMMITTEE AMENDMENTS OUTLINED IN
THE ANALYSIS. UNUSED MEDICATION
WORTH BILLIONS OF DOLLARS ENDS
UP IN OUR GARBAGE EVERY YEAR.
INSTEAD OF DISPOSING OF UNUSED
MEDICATION STATES WTH
REPOSITORY PROGRAMS MAY DONATE
IT. OVER 10. YEARS AGO, SANTA
CLARA COUNTY BECAME THE FIRST
COUNTY IN THE STATE TO STEP UP.
AND SET A REPORT REPOSITORY
PROGRAM IN PLACE. CLARA'S
PROGRAM RECEIVES UNUSED,
UNOPENED UNEXPIRED MEDICATION
FROM LICENSED HEALTHCARE
FACILITIES. AND DISPENSES THEM
AT NO COST TO PATIENTS WITH A
VALID PRESCRIPTION. SB 13 46
PROVIDES OPERATIONAL FLEXIBILITY
AND ELIMINATES TASKS THAT DO NOT
ENHANCE A PROGRAM. LESSONS
UNNECESSARY RECORDKEEPING
REQUIREMENTS REMOVES OVERLY
STRINGENT INVENTORY
REQUIREMENTS. THE BILL HAS BEEN
NARROWED TO A PILOT PROGRAM FOR
THREE BARRIER COUNTIES, AND
WE'VE MADE OTHER MODIFICATIONS.
WHICH IS EXPLAINING THE TYPES OF
ELIGIBLE DONORS AND REPACKAGING
TRANSFER REQUIREMENTS, WHICH
WILL BENEFIT FUTURE. A COUNTIES
AND I HOPE THIS QUICKLY BECOMES
MODEL ONCE PEOPLE SEE WHAT'S
REALLY POSSIBLE. I BELIEVE THIS
WILL HELP INCREASE IN OTHER
ENTITIES THAT OPERATE A
VOLUNTARY DRUG REPOSITORY
PROGRAM. MY OFFICE AND SPONSORS
ARE CONTINUE TO WORK WITH BOARD
OF PHARMACY TO ADDRESS THEIR
CONCERNS. THIS BILL IS CO
SPONSORED BY SANTA CLARA COUNTY
AND SERUM. RESPECTFULLY ASK FOR
IT. I VOTE AND WE HAVE OUR
WITNESSES HERE TODAY FROM BOTH
SENATE CLARE COUNTY AND FROM
SERUM. THANKS. PLEASE GO AHEAD.
I'M A PHARMACIST FROM SANTA
CLARA COUNTY. CENA BUILD 13 46 6
OF US THAN ADMINISTRATIVE AND
OPERATIONAL BURDENS FACED BY
PARTICIPATING ENTITIES THAT
OPERATE A MEDICATION DONATION
AND WE DISTRIBUTION PROGRAM. THE
CHANGES SOUGHT WILL INCREASE
PROGRAM EFFECTIVENESS WITH THE
INTENT TO EXPEND AVAILABILITY OF
THE PROGRAM BEYOND ONLY ONE
LOCATION IN OUR COUNTY AND TO
HELP OTHER COUNTIES ESTABLISHED
ONE OF THEIR OWN. THE COUNTY OF
SANTA CLARA COUNTY HEALTH SYSTEM
IS A FULLY INTEGRATED AND
COMPREHENSIVE HEALTH CARE
DELIVERY SYSTEM THAT OFFERS
HEALTH SERVICES TO MEDICAL
BENEFICIARIES AND OTHER
VULNERABLE MEMBERS OF OUR
COMMUNITY IN 2010, THE COUNTY
ESTABLISHED THE FIRST DEDICATED
DRUG DONATION PHARMACY IN
CALIFORNIA, THE BETTER HEALTH
PHARMACY, WHICH AIMS TO INCREASE
MEDICATION ACCESS FOR ALL AND
SERVICE PATIENTS WHO CANNOT
AFFORD THE MEDICATIONS. IT
RECEIVES A NEWS AND OPEN AND
UNEXPIRED MEDICATIONS FROM
LICENSED HEALTHCARE FACILITIES
AND DISPENSES THEIR DRUGS TO
PATIENTS WHO HAVE A VALID
PRESCRIPTION AT NO COST SINCE
AUGUST 2015 THROUGH THE END OF
JANUARY, 2022 THE PHARMACY HAS
DISPENSED OVER 152,000
PRESCRIPTIONS AND SAVE THE
COUNTER APPROXIMATELY $8.5
MILLION AND DRUG COSTS. DESPITE
ITS EFFECTIVENESS, IT IS ONLY
OFFER IN ONE LOCATION IN OUR
COUNTY. THE BETTER HEALTH
PHARMACY OPERATES AS A
STANDALONE FACILITIES. IT
DISTRIBUTES DONATED MEDICATIONS
THAT HAS RECEIVED ADMINISTRATIVE
AND OPERATIONAL REQUIREMENTS
LIMIT THE EXPANSION OF THE
PROGRAM TO THE COUNTY'S OTHER
PHARMACY LOCATIONS AND
DISCOURAGE MORE. ENTITIES FROM
PARTICIPATING IN THE PROGRAM.
SENATE BILL 13 46 WERE DRESSED,
CUMBERSOME BURDENS AND
INEFFICIENT OPERATIONAL
REQUIREMENTS, SUCH AS OVERLY
STRINGENT INVENTORY CONDITIONS.
IF I DRESS OR COUNTY COULD
ESTABLISH THE PROGRAM THAT OTHER
COUNTY PHARMACY LOCATIONS WHICH
WOULD IMPROVE ACCESS TO
MEDICATION FOR VULNERABLE AND
MEDICALLY INDIGENT PATIENTS. THE
BOARD OF PHARMACY HAS EXPRESSED
OPPOSITION TO THE BILL. THE
COUNTY OR CO SPONSOR SERUM AND
THE OTHER STAFF ARE ON OUR AN
ONGOING DISCUSSION IN AN EFFORT
TO ADDRESS THESE CONCERNS. THANK
YOU FOR THE TIME TODAY. THANK
YOU. NEXT WITNESS, PLEASE.
PLEASE JUST PUSH THE BUTTON
THERE. THE THANK YOU. THANK YOU.
CHAIRPERSON WOULD AND MEMBERS OF
THE COMMITTEE I'M GEORGE WONG,
ONE OF THE CO FOUNDERS OF SERUM
, WHERE A NATIONAL NONPROFIT
WITH A MISSION TO HELP CONNECT
SAFE, UNUSED MEDICATION WITH
FAMILIES IN NEED. FOR OVER THE
LAST 10 YEARS WE HAVE ASSISTED
IN OPERATIONALIZED DRUG DONATION
PROGRAMS AROUND THE COUNTRY,
INCLUDING THE PROGRAM HERE IN
CALIFORNIA AND PROVIDED EXPERT
ADVICE ON OVER 20 BILLS AND
REGULATIONS AROUND THE COUNTRY.
WE ENTHUSIASTICALLY SUPPORT. SB
13 46 CURRENT LAW RESTRICTS
PROGRAM EXPANSION AND EFFICIENCY
INADVERTENTLY LIMITING THE
NUMBER OF ELIGIBLE PATIENTS
BEING SERVED. BECAUSE EXISTING
REQUIREMENTS PLACE UNNECESSARY
BURDENS ON THE ENTITIES LIKE
BETTER HEALTH PHARMACY THAT
RECEIVING DISPENSE DONATED
MEDICINE WE STARTED WITH WE
ASSIST WITH PROGRAMS IN MANY
OTHER STATES THAT HAVE
SUCCESSFUL DONATION PROGRAMS
THAT EMPLOY LESS ONEROUS
REQUIREMENTS AND CALIFORNIA'S
BUT AT THE SAME TIME MAINTAIN
HIGH LEVELS OF SAFETY. WE ASK
FOR YOUR SUPPORT FOR SP 13 46
BECAUSE THIS LEGISLATION WILL
INCREASE EFFECT IN THIS INCREASE
THE NUMBER OF ENTITIES ELECTING
TO OPERATE A PROGRAM REDUCE
HEALTH CARE COSTS IN THE
ENVIRONMENTAL IMPACT OF
PHARMACEUTICAL WASTE. MOST
IMPORTANTLY, EXPAND ACCESS TO NO
COST MEDICATIONS FOR ELIGIBLE
PATIENTS SO THAT THEY CAN BE
HEALTHY. THANK YOU FOR
CONSIDERING. THANK YOU VERY
MUCH, UM OTHERS IF THERE ARE
OTHERS IN OUR CHAMBER HERE WHO
WOULD LIKE TO EXPRESS SUPPORT?
PLEASE FEEL FREE TO COME FORWARD
TO THE MICROPHONE, WHICH IS UP
THERE. IF NOT, WE'LL BRING IT
BACK ARE THERE IS THERE ARE
THERE WITNESSES AND OPPOSITION
TO THE BILL OR ANY REGISTERED
WITNESS? WE DON'T HAVE ANY THAT
I'M AWARE OF. ANYONE IN THE
CHAMBER IN OPPOSITION TO THE
BILL. SEE NO ONE WILL BRING IT
BACK TO THE COMMITTEE FOR
QUESTIONS OR COMMENTS ANY
QUESTIONS OR COMMENTS OF THE
AUTHOR. A NONE OF THE BILL DOES
ENJOY DO PASS RECOMMENDATIONS.
SENATOR WE DON'T HAVE A QUORUM,
SO WE'RE OPERATING AS A
SUBCOMMITTEE, WOULD YOU LIKE TO
CLOSE? THANK YOU RESPECTFULLY
ASK WHEN I VOTED THE APPROPRIATE
TIME. THANK YOU. THANK YOU TO
YOUR WITNESSES, SO ARE YOU
PREPARED TO MOVE BACK TO SB 7 71
NOW? YEP. OKAY. GREAT. UM. I
WILL PRESENT SB 771. THIS BILL
WOULD MAINTAIN A PREGNANT
PERSON'S ABILITY IN CONSULTATION
WITH THEIR DOCTOR TO UTILIZE ALL
AVAILABLE PRENATAL SCREENING
SERVICES. THIS WILL ALLOW THEM
TO MAKE INFORMED DECISIONS ABOUT
THEIR HEALTH AND HEALTH OF THE
NEWBORN. AS POSSIBLE. THE MOST
MOST INFORMED DECISIONS AS
POSSIBLE. SPECIFICALLY THIS BILL
CREATES AN OPT OUT PROGRAM FOR
THE CALIFORNIA DEPARTMENT OF
HEALTH PROPOSED PRENATAL
SCREENING PROGRAM THAT IS SET TO
ROLL OUT IN SEPTEMBER OF THIS
YEAR. WELL THE FIXED PROPOSED IN
MY BILL IS SIMPLE, ALLOWING
PREGNANT INDIVIDUALS TO OPT OUT
OF THE PROGRAM AND HAVE THE
GENETIC SCREENING COVERED BY
INSURANCE OR MEDICAL THE SAME AS
IT IS TODAY. THIS OPPOSITE OPT
OUT. IT'S ABSOLUTELY ESSENTIAL
TO ADDRESS. UNFORTUNATELY ACCESS
ISSUES THAT WILL BE CREATED.
UNFORTUNATELY TBH CDP HS
PROPOSAL WILL LEAD TO SERIOUS
PROBLEMS, PARTICULARLY AMONG THE
MOST VULNERABLE IN CALIFORNIA.
WITHOUT AN OPT OUT COVERED BY
INSURANCE R MEDICAL PREGNANT
INDIVIDUALS WHO WISH TO HAVE
ACCESS TO THE FULL PANEL, WHICH
IN EXT SCREENING AS RECOMMENDED
AND ORDERED BY THE O B G Y N
WE'LL HAVE TO PAY OUT OF POCKET
FOR ANY TESTS OUTSIDE OF THE
PROGRAM, EVEN IF RECOMMENDED BY
THEIR DOCTOR. WHICH MEANS THAT
THE VAST MAJORITY OF PREGNANT
PEOPLE WILL NOT HAVE ACCESS TO
FULL PANEL SCREENING AND THE
IMPORTANT INFORMATION THAT
PROVIDES SIMPLY BECAUSE THEY
CANNOT AFFORD IT. JUST A COUPLE
OF THINGS. QUESTIONS HAVE BEEN
RAISED ABOUT FALSE POSITIVES,
WHICH COULD LEAD TO UNNECESSARY
ANXIETY AND UNNECESSARY NUMBER
OF THE MORE INVASIVE DIAGNOSTIC
TESTS. I'D LIKE TO ADDRESS THIS.
FIRST OFF THE SCREEN TESTS DO%
NOT IN FACT, HAVE AN INCREASED
RATE OF FALSE POSITIVES. TO THE
CONTRARY, THEY HAVE THE SAME
RATE OF FALSE POSITIVES AS THE
MORE INVASIVE GENETIC SCREENING
TESTS RELIED ON FOR THE PAST 40
YEARS. WHEN YOU THINK ABOUT
MATERNAL ANXIETY FOR A MOMENT, I
CANNOT THINK OF ANYTHING MORE
ANXIETY INTO SEEM THAN HAVING
YOUR TRUSTED G Y N RECOMMEND A
FULL PANEL SCREENING BASED ON
THEIR FAMILIARITY WITH YOUR
GENERIC AND HEALTH HISTORY. AND
BEING DENIED THE ABILITY TO GET
THAT FULL PANEL BECAUSE THE
STATE OF CALIFORNIA HAS MADE A
PUBLIC POLICY DECISION THAT ONLY
THOSE WITH FINANCIAL MEANS TO
PAY OUT OF POCKET KIND OF ACCESS
TO THESE IMPORTANT SCREENING
TESTS. THIS IS ABOUT MEDICAL
MEDICAL CARIBBEAN DECIDED BY
MEDICAL CARE PROVIDERS RATHER
THAN ARBITRARY LINE IN THE SAND.
WITH ME TODAY IS LATELY RE
LICENSE PRENATAL GENETIC
COUNSELOR TO TESTIFY AND
SUPPORT. AND LIBBY SANCHEZ WITH
ACTIVE WHO'S AVAILABLE TO ANSWER
ANY TECHNICAL QUESTIONS,
RESPECTFULLY ASK FOR AND I VOTE
AND I THINK IN ADVANCE DR WEBBER
FOR HER HELP WITH THIS BILL, AND
, UH WE'LL BE AVAILABLE.
PROBABLY FOR QUESTIONS AS WELL.
I'D IMAGINE. THANK YOU. THANK
YOU. PLEASE GO AHEAD. THANK YOU
FOR THE OPPORTUNITY TO SPEAK
TODAY. MY NAME IS LILA RE. I'M A
LICENSED PRENATAL GENETIC
COUNSELOR. I'VE WORKED FOR THE
PAST 30 YEARS OF PRIMARILY IN
SACRAMENTO. I COUNSEL WOMEN WITH
HIGH RISK PREGNANCIES AND THOSE
AT RISK FOR GENETIC DISEASE. I
AM HERE TO SPEAK ABOUT WHY ASK B
. 771 IS NECESSARY AFTER
SEPTEMBER 19TH THIS YEAR,
CALIFORNIA WOMEN WILL BE LIMITED
TO SCREENING THEIR PREGNANCY FOR
ONLY THREE FETAL CONDITIONS
BECAUSE OF PLANNED CHANGES. TO
THE CALIFORNIA PRENATAL
SCREENING PROGRAM, OR PNS
PROGRAM. SP 771 WILL ALLOW
CALIFORNIA WOMEN TO OPT OUT OF
THE PROGRAM AND ENABLE THEM TO
SEEK MORE THOROUGH TEST OPTIONS
WIDELY USED THROUGHOUT THE USA
AND THE DEVELOPED WORLD. SB 771
WILL ALLOW PREGNANT WOMEN AND
THEIR FAMILIES TO BE PROTECTED
AGAINST HARM BY MISSED
DIAGNOSES. IN SEPTEMBER. THE
PIANIST PROGRAM WILL BE
SWITCHING TO A DIFFERENT TEST
METHOD. HOWEVER THE TEST PLAN
ONLY OFFERS A PARED DOWN VERSION
PROVIDING RISK ASSESSMENT FOR
THREE FETAL CONDITIONS, WHEREAS
WITHIN INDEPENDENT LABS
SCREENING FOR ADDITIONAL FETAL
CHROMOSOME ABNORMALITY
CONDITIONS IS USED. CALIFORNIA
WOMEN ARE ENTITLED UNDER STATE
LAW TO THE STANDARD OF CARE, AND
THE PNS PLAN DOES NOT MEET THE
STANDARD OF CARE AVAILABLE FOR
THE PAST NINE YEARS VIA SEVERAL
INDEPENDENT LABORATORIES. VILLA
CARDIO FACIAL SYNDROME, OR VCF,
FOR SURE, IS ONE OF THE
CONDITIONS NOT SLATED TO BE
SCREENED FOR BY THE NEW PNS
TEST, AND I WANT TO HIGHLIGHT
THIS CONDITION. PRESIDENT AND
ONE IN 2000 BIRTHS. IT IS TWO
TIMES MORE COMMON THAN TRISOMY
13, WHICH WILL BE SCREENED FOR
APPROXIMATELY 7% 70% OF BABIES
WITH VCS WILL HAVE A SERIOUS
HEART DEFECT. WHEN THE NDP S
BLOOD TEST RESULTS INDICATE A
HIGH RISK FOR VCF. ADDITIONAL
TESTS AND CONSULTATIONS CAN BE
DONE ON THE PREGNANT WOMAN AND
WHEN A POSITIVE DIAGNOSIS IS
MADE BEFORE BIRTH, THE MOTHER
CAN HAVE A PLANNED DELIVERY AT A
HIGH RISK CENTER WITH IMMEDIATE
ACCESS TO A HEART SURGEON. THE
PARENTS CAN ALSO LEARN MORE
ABOUT THE CONDITION AS THESE
BABIES CAN ALSO HAVE CLEFT
PALATE, CALCIUM AND IMMUNE
PROBLEMS. I HAVE HAD TWO
DIFFERENT PATIENTS WHO DIDN'T
KNOW THAT THEIR BABY HAD A HEART
DEFECT BEFORE DELIVERY. WHOSE
BABIES DIED WAITING FOR
TRANSPORT, ONE FROM A RURAL
CENTER AND ONE FROM A HOME BIRTH
. UM, THEY DIDN'T MAKE IT TO THE
HIGHER LEVEL HOSPITAL PASSING SB
771 WILL PROVIDE ALL CALIFORNIA
WOMEN WITH THE OPTION OF THE
STATE OF THE ART AND I PT TEST,
NOT A STRIPPED DOWN VERSION.
ALLOWING FOR PARODY SO THAT ALL
WOMEN EVEN THOSE OF LOWER
SOCIOECONOMIC STATUS CAN ACCESS
THIS BROADER SCREENING. WITH NO
OPT OUT OPTION ONLY THOSE WHO
CAN PAY CASH FOR A SECOND TEST
WOULD RECEIVE THE ADDITIONAL
EXPANDED SCREENING. IT WILL
PROTECT CALIFORNIA BASED LABS
OPERATING OUTSIDE OF THE STATE
AND I P T PROGRAM FROM HAVING A
LAYOFF. POTENTIALLY THOUSANDS OF
EMPLOYEES WITHOUT SB 771 PER
STATE REGULATIONS 65 23. THESE
BUSINESSES WILL BE PREVENTED
FROM RUNNING BLOOD SAMPLES. FROM
CALIFORNIA WOMEN DECREASING
THEIR NUMBER OF TESTS. IT WILL
GIVE ADDITIONAL SAFEGUARDS FOR
THE HEALTHY DELIVERY OF MOMS AND
BABIES WITH KNOWN FETAL
CHROMOSOME ABNORMALITIES,
ESPECIALLY IN REMOTE AREAS. IT
WILL PROTECT OBI PROVIDERS FROM
MEDICAL LEGAL LIABILITY BY
ALLOWING THE PROVIDERS TO
PROVIDE THE BEST EXPANDED
SCREENING THAT THEY AND THEIR
PATIENT DECIDE IS WARRANTED. AND
IT WILL SAFEGUARD THE OBI
PROVIDERS, TIME WORKLOAD AND
ACCURACY BY NOT HAVING AN ORDER
TO SEPARATE TESTS APPEARED DOWN
AND EXPANDED TEST ON THE SAME
PATIENT. THANK YOU, UM. YOU HAVE
JUST THE ONE WITNESS AND SOMEONE
AVAILABLE FOR TECHNICAL
QUESTIONS. YES THANK YOU VERY
MUCH. UM OTHERS IN SUPPORT. JUST
YOUR NAME POSITION. WHY WAS HE
POSITION SUPPORT BUT NAME AND
ORGANIZATION? IF YOU REPRESENT
ONE, PLEASE. MR CHAIR AND
MEMBERS LARA FITZGERALD ON
BEHALF OF CALIFORNIA LIFE
SCIENCES AND STRONG SUPPORT.
THANK YOU. THANK YOU. GOOD
AFTERNOON CHRISTIE FILE ON
BEHALF OF THE CALIFORNIA
CLINICAL LABORATORY ASSOCIATION
IN STRONG SUPPORT YOU. BRIAN
SPENCER ON BEHALF OF THE
AMERICAN COLLEGE OF O B. G Y INS
DISTRICT NINE AND SUPPORT. THANK
YOU. DO WE HAVE OPPOSITION TO
THE BILL? WITNESSES AND
OPPOSITION. WHEN DO WE HAVE
ANYBODY IN THE CHAMBER WHO WOULD%
LIKE TO SPEAK IN OPPOSITION OF
THE BELT? BRING IT BACK TO THE
COMMITTEE FOR QUESTIONS OR
COMMENTS FROM THE COMMITTEE. GOT
YOUR WEAPON. THANK YOU. CHAIR
THANK YOU VERY MUCH FOR BRINGING
THIS BILL FORWARD. UM. YOU KNOW,
I CANNOT, UM, OVERSTATE THE
IMPORTANCE OF THIS BILL. SIZE
AND G Y N SOMEONE WHO HAS BEEN
SAYING AND REFERRING PATIENTS TO
GENETIC COUNSELORS TO TRY TO
FIGURE OUT WHAT THE BEST TEST IS
BASED ON THEIR MEDICAL HISTORY,
THEIR PARTNERS MEDICAL HISTORY,
THEIR FAMILY'S MEDICAL HISTORY.
AND WHILE I AM VERY HAPPY THAT
WE WILL NOW BE EXPANDING THE
BENEFIT OF AN I P T SCREENING
FOR ALL PREGNANT CALIFORNIANS,
AS WE SHOULD. IT SHOULD NOT BE
AT THE EXPENSE OF MAKING SURE
THAT WOMEN ARE ABLE TO GET THE
FULL GAMUT OF TESTING THAT THAT
THEY NEED. THE OTHER THING THAT
I'VE FOUND VERY CONCERNING.
ABOUT WHAT WILL BE HAPPENING IS
JUST THE. THE LIMITATION ON
WHICH LABS WILL BE ABLE TO OFFER
IS KIND OF PRENATAL TESTS. I'M
VERY, VERY, VERY, VERY CONCERNED
ABOUT IT. AND I'VE SPOKEN WITH,
YOU KNOW THE CALIFORNIA
DEPARTMENT OF PUBLIC HEALTH
ABOUT THIS BECAUSE UM, FOR
PEOPLE WHO LIVE IN RURAL AREAS
OR IN INNER CITIES. HOW ARE THEY
GOING TO BE ABLE TO KNOW THAT
THEIR LAB IS CONTRACTED TO RUN
THESE TESTS? UM WHAT EXTRA
BURDEN ARE WE PLACING ON THESE
PATIENTS? WHEN WE TALK A LOT
MORE. WE'VE BEEN TALKING FOR THE
LAST FEW YEARS ABOUT ACCESS
ACCESS ACCESS. THIS IS
POTENTIALLY LIMITING ACCESS TO,
UH TO OUR PREGNANT PATIENTS. AND
SO, UM, AGAIN AS AN O B G Y N. I
CANNOT STRESS THE IMPORTANCE OF
THIS BILL. I KNOW WHEN THESE
REGULATIONS CAME OUT A LOT OF O
B G. Y N TRIED TO MEET WITH THE
DEPARTMENT OF PUBLIC HEALTH TO
KIND OF RESOLVE THIS SO WE
WOULDN'T HAVE TO GO THROUGH THIS
LEGISLATIVE PROCESS AND
UNFORTUNATELY, THAT DIDN'T
HAPPEN. BUT UM, THIS IS A BILL
TO ENSURE THE HEALTH AND SAFETY
OF ALL OF OUR PREGNANT PATIENTS
AND OUR FUTURE RESIDENTS. LITTLE
ONES, CALIFORNIA SO THANK YOU SO
VERY MUCH FOR CHAMPION AND
CARING THIS BILL. THANK YOU.
THANK YOU, DR WEBBER ANYONE
ELSE? I HAVE SOME COMMENTS. I
JUST WANT TO SAY SENATOR I WON'T
BE VOTING ON THIS BILL TODAY. UM
ACTUALLY, THE COMMITTEE
RECOMMENDATION IS A NUN. UM THE
LEGISLATURE AND THE GOVERNOR
APPROVED THE TRANSITION TO THE
CELL FREE DNA SCREENING FOR
PREGNANT INDIVIDUALS AS PART OF
THE 20. 2020 21 2022 BUDGET. THE
CLINICAL LABORATORIES WERE AGAIN
GIVEN THE OPPORTUNITY RAISED
THEIR ISSUES IN ASSEMBLY SUB ONE
WHICH I SIT ON ON MARCH 23RD
2022, BUT THIS DID NOT CHANGE
THE OUTCOME OF THE TRANSITION.
MAYBE CLEAR. CHANGES TO THE
PRENATAL SCREEN PROGRAM DOES NOT
PREVENT PROVIDERS FROM ORDERING
ADDITIONAL TESTS. DEPARTMENT OF
PUBLIC HEALTH HAS EVEN POSTED
THIS ON THEIR WEBSITE. THE STATE
WILL JUST NOT PAY FOR THOSE
ADDITIONAL TESTS. WHEN WE
APPROVED THE TRANSITION TO SELF
CELL FREE DNA SCREENING, WE TOOK
A POLICY AND FISCAL CHOICE TO
COVER CELL FREE DNA TESTING FOR
ALL PREGNANT INDIVIDUALS. E PH.
ALSO CONDUCTED STAKEHOLDER
ENGAGEMENT PRIOR TO EVEN
INTRODUCING THIS CHANGE IN THE
BUDGET. A MATTER OF POLICY. I
DON'T THINK WE SHOULD EXPECT THE
STATE TO PAY FOR ALL TYPES OF
NON INVASIVE PRENATAL TESTS, AS
THIS BILL REQUIRES, ESPECIALLY
WHEN THE FOOD AND DRUG
ADMINISTRATION ITSELF CAME OUT
WITH A SAFETY GUIDANCE WARNING
PATIENTS AND HEALTHCARE
PROVIDERS ABOUT THE RISKS OF
FALSE POSITIVES OR FALSE RESULTS
. BASED ON WITH THESE AND I PT
TESTS BILL ALSO LACKS PROVISION
ON PATIENT FOLLOW UP, WHICH IS
CRITICAL, ESPECIALLY WHEN THERE
ARE POSITIVE RESULTS. JUST
MANDATING TESTING IS NOT ENOUGH
FOR MY PERSPECTIVE. I WILL NOT
BE VOTING ON THE BILL TODAY.
WITH THAT YOU MAKE CLOTHES.
WELL, THANK YOU. UM I THINK, UM
, BOTH OF YOUR COMMENTS, YOU
KNOW, JUST TO JUST A COUPLE
QUICKTHINGS. UM YOU KNOW, I
THINK THAT THIS WAS NOT THE
PREFERRED PATH. YOU HAVE TO COME
UP FORWARD WITH A BILL AT THIS
TIME. UM, BUT I THINK AS IT WAS
INDICATED A B G Y N CLINICAL
LABS AND OTHERS. UM HAVE SPENT A
LOT OF TIME WITH BPH ON THIS
ISSUE, AND, UM, YOU KNOW, WOULD
WE'RE NOT MAKING HEADWAY AND
FELT LIKE THERE'S NOT A LOT OF
GOOD FAITH DISCUSSIONS THERE. SO
THAT'S REALLY WHY WE'RE HERE AT
THIS POINT, YOU KNOW, IN TERMS
OF FALSE POSITIVES OF THE
EVIDENCE THAT WE'VE SEEN SHOWS
THAT THERE ARE NOT, THERE ARE NO
HIGHER DEGREE OF FALSE
POSITIVES. FROM FROM THESE
ADDITIONAL TESTS. UM AGAIN. I
WANT TO APPRECIATE HOW TO WEBER
FOR HER COMMENTS IN HER
EXPERIENCE ON THIS APPRECIATE
THE TIME YOU'VE YOU'VE SPENT ON
THIS ISSUE. UM BUT I THINK WHEN
YOU LOOK AT THE PROGRESS OF
EVIDENCE WE WANT TO MAKE SURE
THAT ALL WOMEN REGARDLESS OF
FINANCIAL ABILITY TO PAY YOU
HAVE ACCESS TO THESE TESTS
WITHOUT RESPECTFULLY ASK FOR AN
I VOTED THE APPROPRIATE TIME.
WELL, THANK YOU. THAT WILL GO
AHEAD AND MOVE ON TO OUR NEXT
PRESENTER. WE'RE STILL LACKING A
QUORUM. SENATOR CORTEZ.
YOU HAVE TWO BILLS BEFORE US
SENATOR WE HAVE 999 AND 11 84. I
DO. THANK YOU, MR CHAIR. UM
MEMBERS.
I'M PLEASED TO PRESENT SP 9 99,
CO SPONSORED BY SOME OF THE
STATE RECOVERY CENTER IN THE
CALIFORNIA CONSORTIUM OF
ADDICTION PROGRAMS AND
PROFESSIONALS WITH SUPPORT FROM
THE ADDICTION TREATMENT,
ADVOCACY COUNCIL COALITION,
SOBER AFRICA FREE SOLUTIONS AND
MANY MORE. SP 999 WILL ENSURE
THAT CALIFORNIA'S SUFFERING FROM
MENTAL HEALTH AND SUBSTANCE USE
DISORDERS ARE ABLE TO RECEIVE
THE APPROPRIATE LEVEL OF
TREATMENT AND CARE THAT'S
NECESSARY FOR FULL AND LASTING
RECOVERY. DESPITE EXISTING LAW,
SOME. HEALTH PLANS AND
DISABILITY INSURERS ARE STILL
USING INAPPROPRIATE UTILIZATION
REVIEW PRACTICES TO AVOID PAYING
FOR CARE. AS A RESULT, MEDICALLY
NECESSARY TREATMENT DAYS THAT
ARE RECOMMENDED IN COMPLIANCE
WITH GENERALLY ACCEPTED
STANDARDS OF TREATMENT. OR
SOMETIMES ARBITRARILY DENIED SP
999 WILL REMEDY THIS BY
ESTABLISHING UTILIZATION REVIEW
CRITERIA FOR HEALTH PLANS AND
DISABILITY INSURERS THAT WILL
PROTECT PATIENT ACCESS TO TIMELY
REVIEW DECISIONS. AND ENSURE
THAT A HEALTH CARE PROVIDER WITH
SIMILAR EDUCATION, TRAINING AND
EXPERIENCE IN THE RELEVANT
DIAGNOSIS IS CONDUCTING EUROPE
WITH UTILIZATION REVIEWS. BY
APPLYING THE APPROPRIATE
CLINICAL AND UTILIZATION REVIEW
CRITERIA TO SUBSTANCE USE
DISORDER TREATMENT. WE CAN SAVE
LIVES BY COMBATING OVERDOSE,
DEATHS AND SUICIDE, AMONG OTHER
THINGS, I WOULD LIKE TO THANK
THE COMMITTEE AND CHAIR WE'RE
PROPOSING AMENDMENTS RELATED
SPECIFICALLY TO SUBDIVISION CAVE
, THE BILL THAT WE WILL BE
TAKING, AND MOREOVER, I'M VERY,
VERY APPRECIATIVE OF THE SHARES
TÌM. PROFESSIONAL COURTESY AND
IN THAT OF THE COMMITTEE STAFF
TO WORK THROUGH SOME DIFFICULT,
SOMETIMES COMPLEX ISSUES, BUT I
THINK WE'RE THERE AND I WOULD
RESPECTFULLY ASK FOR YOUR I
VOTE. BUT TODAY WITH ME HIS
BRYCE DOUGHERTY, REPRESENTATIVE
OF SUMMIT, THE STATE RECOVERY
CENTER. AND SUSIE. WHO WILL
OTHERWISE REMAIN ANONYMOUS.
OTHER THAN THE FACT THAT SHE'S
AN ALUMNA, PATIENT TO SPEAK IN
SUPPORT. THANK YOU SO MUCH.
THANK YOU VERY MUCH. PLEASE,
PLEASE GO AHEAD. YES UH, BRYCE
DOUGHERTY ON BEHALF OF SOME OF
THE STATE RECOVERY CENTER, PROUD
SPONSORS OF THE BILL. THIS
LEGISLATION BUILDS ON
LEGISLATION FROM 2020 THAT WAS
STRONGLY SUPPORTED FROM THIS
COMMITTEE. SB 8 55 BY SENATOR
WIENER. WHICH COMPLETELY
RETOOLED AND REFORMATTED THE
MENTAL HEALTH PARITY ACT AND IT
AND IT PUT TOGETHER IN A
PARTICULAR MANNER. BOTH MENTAL
HEALTH AND SUBSTANCE USE
DISORDER CARE. THAT LEGISLATION
ALSO POINTED TO GENERALLY
ACCEPTED STANDARDS AND PEER
REVIEWED CLINICAL CRITERIA FOR
MAKING DETERMINATIONS ON
TREATMENT. AND WHEN WE'RE
TALKING ABOUT TREATMENT IN THIS
SPACE, WE'RE TALKING ABOUT THE
LEVEL OF CARE THAT THE PATIENT
NEEDS. OF STAY AND
OTHER MEDICALLY NECESSARY
TREATMENTS WHEN IT COMES TO
ADDICTION TREATMENT, WHICH HAS
BEEN DOCUMENTED AS A BRAIN
DISORDER. THE GUIDE GUIDELINE
CRITERIA IS THE AMERICAN SOCIETY
OF ADDICTION MEDICINE. ALTHOUGH
THAT IS THE LAW OF THE LAND
SINCE 2020. WHAT WE'RE FINDING
IS A LOT OF THESE HEALTHCARE
PROVIDERS THAT ARE USING THAT
CRITERIA HAVE NO EXPERIENCE IN
ADDICTION. THEY'RE NOT FAMILIAR
WITH THE GUIDELINES AND WE HAVE
HEALTH CARE PROVIDERS OUT OF
STATE. THEY'RE DOING UTILIZATION
REVIEW AND ARBITRARILY
CAPRICIOUSLY DENYING CARE. UM AS
YOU CAN IMAGINE SOMEBODY WHO'S
SUFFERING FROM ADDICTION AND WHO
NEEDS TO STAY IN A 28 DAY
PROGRAM. IS ILL EQUIPPED TO
INDEPENDENTLY FUNCTION. AFTER
ONLY FIVE DAYS OF TREATMENT. WE
HAVE HORRENDOUS EXAMPLESOF
WHERE HEALTH PLANS AND INSURERS
BY WAY OF CONTRACTING ENTITIES
THAT THEY USE FOR UTILIZATION
REVIEW WILL ONLY TELL A PATIENT
THAT YOU'RE AN ADDICT ON MONDAY,
WEDNESDAY, FRIDAY AND SUNDAY. WE
WILL COVER THOSE DAYS, BUT WE
WON'T COVER YOUR RESIDENTIAL
TREATMENT ON TUESDAYS, THURSDAYS
AND SATURDAYS. THAT'S AKIN TO
SOMEBODY HAVING CANCER OR HAVING
RENAL FAILURE AND ONLY BEING
TOLD THAT THEY WILL GET
CHEMOTHERAPY OR DIALYSIS
TREATMENT A COUPLE DAYS A WEEK
AND THOSE OTHER DAYS OF THE
MONTH OR THE WEEK. YOU DON'T
HAVE THAT AFFLICTION. UM THIS
ACTIVITY WAS HIGHLIGHTED IN 2014
BY 60 MINUTES ON A SPECIAL THAT
THEY DID CALLED DENIED. WE COVER
THAT AND WE COVER ALL OTHER
ISSUES RELATED TO SOME OF THE
DENIALS. WE'RE SEEING UP AND
DOWN THE STATE. AT THE WEBSITE
THAT WE CREATED, WHICH IS
FRIENDS OF SB 999 .ORG AND
ENCOURAGE YOU TO GO THERE TO
FIND OUT MORE RESOURCES ON THE
SITUATION, AND THE BOTTOM LINE
IS, YOU KNOW, WE THINK THIS IS
SOMEWHAT OF A CRUEL ILLUSION. WE
SPEND A LOT OF TIME. TRYING TO
PROVIDE COVERAGE FOR INDIVIDUALS
FOR MEDICALLY NECESSARY
TREATMENT. AND THE CREW ILLUSION
IS SOMEBODY WHO'S IN THIS SORT
OF SITUATION COME TO FIND OUT
THAT THEY HAVE COVERAGE, BUT
THEY DON'T HAVE ACCESS TO THAT
COVERAGE. THIS BILL GO A LONG
WAY TO RECTIFY THAT PROBLEM, AND
WE STRONGLY URGE YOUR I VOTE.
THANK YOU. THANK YOU VERY MUCH.
AND PLEASE GO AHEAD. HI GOOD
AFTERNOON. MY NAME IS SUSIE. I
HAVE MORE THAN NINE MONTHS OF
CONTINUOUS SOBRIETY. I AM A 53
YEAR OLD BOOKKEEPER AND ACCOUNT
FOR OUR FAMILY BUSINESS. A SMALL
AUTO REPORT REPAIR CENTER IN
CONTRA COSTA COUNTY. OUR
BUSINESS OFFERS OUR EMPLOYEES
MEDICAL INSURANCE, AND WE HAVE A
SMALL GROUP ANTHEM BLUE CROSS P
P O PLAY ON THAT HAS SUBSTANCE
ABUSE BEEN ABUSE BENEFITS. THE
PLAN IS REGULATED BY THE D. M. H
C. ON SEPTEMBER 18TH 2021 I
ENTER SUMMIT STATE RECOVERY IN
ORDER TO DEAL WITH A LONG
HISTORY OF OPIOID USE DUE TO
CHRONIC PAIN. AND ALSO SELF
MEDICATING WITH ALCOHOL AND
DEPRESSION AND ANXIETY. THE
AMOUNT THAT. ANTHEM WOULD
REIMBURSE FOR EACH DAY OF TREEM
ABUSE TREATMENT WAS MUCH LESS
THAN SO MUCH CHARGES. I BORROWED
MONEY FROM MY PARENTS AND FOR
TREATMENT. ID DETOX FOR FIVE
DAYS AND BEGAN TREATMENT AFTER
11 DAYS OF RESIDENTIAL TREATMENT
FACILITY APPLIED FOR SEVEN
ADDITIONAL DAYS. WHICH TO MY
GREAT SURPRISE THOSE DAYS WERE
DENIED. MY THERAPIST SAID THAT
ACCORDING TO THE A S, A M GUIDES
FOR ADDICTIONS, ADDICTION
TREATMENT. I NEEDED THOSE
ADDITIONAL DAYS AS I WAS AT HIGH
RISK FOR RELAPSE. THE FIRST
ANTHEM DOCTOR TO DENY MY
TREATMENT WAS SCOTT GORDON. HE
HAS A FAMILY DOCTOR WITH A
CALIFORNIA LICENSE, BUT HE IS
NOT AN ADDICTION SPECIALTY ISTS.
NEITHER IS DR ROBERT GORNEY, THE
PSYCHIATRIST FROM ANTHEM WHO
CONFIRMED DR GORDON'S DENIAL. I
KNOW THIS BECAUSE THEY SEE US AM
DOCTOR REVIEWED BOTH DENIALS AND
THE DOCTORS MISSED ALL THE
REASONS THAT I NEEDED TO REMAIN
IN TREATMENT ACCORDING TO A S A
M CRITERIA. BY THE WAY, IT SEEMS
DR GORDON AND DR GORNY DENY ALL
THE TIME SUMMIT AND 50 OTHER
CALIFORNIA FACILITIES. KEEP
SCORE. DOCTOR DR. GORDON HAS
100% DENIAL RATE. AND DR
GORDON'S CORNEAS TONIGHT.
ALRIGHT, IS 92% UM, PLEASE VOTE
FOR US P 999, WHICH REQUIRES
ANTHEM OF CALIFORNIA AND OTHER
INSURANCE COMPANIES TO USE
QUALIFIED ADDICTION DOCTORS IN
ORDER TO, UM. EARN THEIR LIVING
DENYING NECESSARY TREATMENT.
PLEASE TELL ANTHEM TO REIMBURSE
ME. THANK YOU. OTHERS IN SUPPORT
THE MICROPHONE. JUST YOUR NAME
AND ORGANIZATION. IF YOU
REPRESENT ONE, PLEASE. I AM ANNE
LAURENCE ZINI WITH AMERICAN
ADDICTION CENTERS, AND I
COMPLETELY SUPPORT THIS, BILL.
THANK YOU. CODY BOILS ON BEHALF
OF CALIFORNIA CONSORTIUM OF
ADDICTION PROGRAMS AND
PROFESSIONALS AND SUPPORT OF THE
BILL.THANK YOU. EDDIE VARGAS ON
BEHALF OF RECOVERY ADVOCACY
PROJECT AND WE TOTALLY SUPPORT
THIS BILL. QUÊ UM. WITNESSES AND
OPPOSITION TESTIMONY IN
OPPOSITION. PLEASE COME ON UP.
MR CHAIR MEMBER, STEPHANIE
WATKINS ON BEHALF OF THE
ASSOCIATION OF CALIFORNIA LIFE
AND HEALTH INSURANCE COMPANIES.
FIRST, WE'D LIKE TO THANK THE
COMMITTEE AS WELL AS THE AUTHOR
FOR TAKING THE MOST RECENT
AMENDMENTS THINK THEY GO A LONG
WAY TO ADDRESS SOME OF OUR
CONCERNS. UNFORTUNATELY, WE ARE
STILL OPPOSED TO THE BILL TODAY.
MENTAL HEALTH IS A KEY COMPONENT
TO PERSONS OVERALL WELL BEING,
AND HEALTH INSURANCE PROVIDERS
REMAIN STEADFAST IN OUR EFFORT
TO PROVIDE SAFE AND EVIDENCE
BASED BEHAVIORAL HEALTH ON PAR
WITH MEDICAL AND SURGICAL CARE.
WE BELIEVE THERE IS MORE WE MUST
DO TO MEET THE EVER INCREASING
TREATMENT NEEDS OF THOSE
SUFFERING FROM ADDICTION AND
MENTAL HEALTH AND REMAIN
RESOLUTE IN OUR COMMITMENT TO DO
SO. THAT BEING SAID. WE ARE
CONCERNED WITH THE OVERARCHING
RESTRICTIONS THAT THE BILL PUTS
IN PLACE REGARDING UTILIZATION
MANAGEMENT. SB 999 PROPOSES TO
SET IN PLACE. A NEW PROCESS,
WHICH WOULD LIMIT WHO IS ALLOWED
TO CONDUCT UTILIZATION REVIEWS,
BUT WE UNDERSTAND THE IMPORTANCE
OF ENSURING QUALIFIED PHYSICIANS
AND SPECIALISTS PERFORM THESE
REVIEWS AND CLOSELY FOLLOW THE
CURRENT GUIDELINES SET FORTH BY
BOTH THE DEPARTMENT OF INSURANCE
AS WELL AS THE DEPARTMENT OF
MANAGED HEALTH CARE. EXISTING
LAW CLEARLY SPECIFIES THAT NO
INDIVIDUAL OTHER THAN A LICENSED
PHYSICIAN OR LICENSED HEALTH
CARE PROFESSIONAL WHO IS
COMPETENT TO EVALUATE THE
SPECIFIC CLINICAL ISSUES
INVOLVED IN THE HEALTH CARE
SERVICES REQUESTED BY THE
PROVIDER. THEY DENY, MODIFY OR
PERMITTED TO REQUEST. FOR THOSE
REASONS, AND I WOULD JUST LIKE
TO PREFACE THAT THE DEPARTMENT
OF IT MANAGED CARES ISSUED
RECENTLY. UM REGULATIONS
ADDRESSING THIS AS WELL AS
IMPLEMENTATION OF EIGHT BY FIVE,
WHICH HAS BEEN A HUGE
UNDERTAKING. THEY'RE VERY, VERY
SPECIFIC RECOMMENDATIONS WITHIN
THAT THAT REQUIRE US TO PROVIDE
, UM VERY DETAILED INFORMATION
REGARDING THE CLINICAL SPECIALTY
THAT CLINICAL GUIDELINES THAT
WERE WERE USED. THE SUMMARY OF
THE REASONS FOR DEVIATING FROM
CRITERIA LISTED IN THE RULES. A
SUMMARY OF THE PLANS CLINICAL
REASONS FOR ITS DECISION. THIS
ALONG WITH THE REQUIREMENT THAT
PLANS DEMONSTRATE AT THE REQUEST
OF THE DEPARTMENT. THAT THEY ARE
MAKING MENTAL HEALTH AND SUDS
DETERMINATIONS PURSUANT TO THE
HEALTH AND SAFETY CODE
REQUIREMENTS AS WELL AS THOSE
REGARDING DEPARTMENT OF
INDUSTRIAL RELATIONS WERE
CONCERNED THAT THESE
RESTRICTIONS THAT ARE INCLUDED
IN THE BILL MAY LIMIT OUR
ABILITY TO DO UTILIZATION
MANAGEMENT. FOR THOSE REASONS.
WE REMAIN OPPOSED TO THE BILL,
BUT WE DO LOOK FORWARD TO
CONTINUING CONVERSATIONS AND
ENSURING THAT 855 IS PUT IN
PLACE THAT THE REGULATIONS ARE
ADOPTED AND ADDITIONAL. CRITERIA
AND CLINICAL GUIDANCE IS GIVEN
TO OUR MEMBERS. THANK YOU BEFORE
WE MOVE TO OUR NEXT WITNESS. WE
HAVE A QUORUM, SO WE'RE GOING TO
HAVE OUR SECRETARY TAKE ROLL.
WOULD WALDRON CURRY ARAMBULA.
BIGELOW. CARILLO. FLORA.
MAIENSCHEIN MAZE. MCCARTHY.
CAESARIAN RIVAS. RODRIGUEZ.
SANTIAGO. WEBER. WE HAVE A
CORNER, SO WE HAVE A QUORUM. SO
THAT'S THAT'S A REALLY IMPORTANT
THING. SO THANK YOU. NEXT
WITNESS, PLEASE. GOOD AFTERNOON
. THANK YOU, MR CHAIR MEMBERS OF
THE COMMITTEE JET HAMPTON WITH
THE CALIFORNIA ASSOCIATION OF
HEALTH PLANS ARE REGRETTABLY
HERE IN OPPOSITION SP 999, WHICH
WOULD CREATE IN NEW, DISTINCT
AND COMPLICATED LEGALIZATION
MANAGEMENT PROCESS FOR MENTAL
HEALTH SERVICES, DESPITE THE
PRESENCE OF EXISTING LAWS AND
REGULATIONS ADDRESSING THE ISSUE
I WOULD LIKE TO THANK THE AUTHOR
AND THE COMMITTEE STAFF FOR THE
PRODUCTIVE CONVERSATIONS THAT
WE'VE HAD ON THIS BILL TODAY.
I'LL JUST SAY IN THE INTEREST OF
TIME AND THE LONG AGENDA TODAY,
I WOULD, UM, JUST ALIGN MY
COMMENT WITH MY COLLEAGUE
STEPHANIE WATKINS FROM A CLICK,
AND AS WE SHARE THE CONCERNS
AROUND NOT ONLY HOW THIS BILL
WOULD INTERACT WITH EXISTING
STATUTORY AND REGULAR REGULATORY
REQUIREMENTS PURSUANT TO SP 55,
BUT ALSO SHARE THE CONCERNS
AROUND SOME OF THE CLEAR THE
CLINICAL PERIOD APPEAR LANGUAGE
EXISTING IN THE BILL, SO AGAIN
AN INTERESTING TIME WITH ALIGN
MY COMMENTS WITH MY COLLEAGUE
AND REGRETTABLY OPPOSED TO THE
BILL. THANK YOU VERY MUCH OTHERS
IN OPPOSITION, JUST YOUR NAME
AND ORGANIZATION IF YOU
REPRESENT JOHN WINGER ON BEHALF
OF AMERICA'S HEALTH INSURANCE
PLANS WERE ALSO OPPOSED. OKAY.
ANYONE ELSE? THE NUMBER WILL
BRING IT BACK TO THE COMMITTEE
QUESTIONS OR COMMENTS ANY
QUESTIONS OR COMMENTS FROM THE
COMMITTEE. SEEN AND WOULD YOU
LIKE TO? WOULD YOU LIKE TO CLOSE
SENATOR? THANK YOU, MR CHAIR AND
AGAIN. UM I DIDN'T EMPHASIZE
THAT MUCH IN MY OPENING, BUT, UM
EVERY STEP OF THE WAY WE WORKED
WITH SENATOR WIENER, THE AUTHOR
OF 8 55. YOU CAN IMAGINE HIS
CONCERN. HAVING WORKED SO HARD
ON THAT BILL WITH THIS COMMITTEE
AND OTHERS TO MAKE SURE THAT WE
DIDN'T UNWIND ANYTHING THERE.
THIS REALLY DOES JUST BUILD ON
IT TO MAKE SURE THAT WE HAVE
KNOWLEDGEABLE FOLKS WHO ARE
MAKING THESE DECISIONS. AND WITH
THAT, I WOULD RESPECTFULLY ASK
FOR YOUR I VOTE. THANK YOU.
THANK YOU HAVE EMOTION ANYWHERE
FROM THE COMMITTEE. MOTION BY
MISS AGGER CURRY, A SECOND BY DR
WEBBER. EMOTION IS DO PASS AS
AMENDED TO APPROPRIATIONS. MADAM
SECRETARY PLEASE CALL THE ROLL.
I WOULD I. ALDRIN. WALDEN I GOT
CURRY CURRY. I ARAMBULA.
BIGELOW. BIGELOW NÓ CARILLO.
CARILLO I FLORA. FLOOR AND THAT
VOTING MAIENSCHEIN. MAZE. MAY
NOT VOTING MCCARTY NAZARIAN.
PRIEBUS RODRIGUEZ RODRIGUEZ I
SANTIAGO WEBER. HOWEVER, I. 6 TO
1. YOU HAVE SIX VOTES WILL LEAVE
THE BILL ON CALL. UM AND THANK
YOU AND THANK YOU TO YOUR
WITNESSES. THANK YOU VERY MUCH.
ALL RIGHT. THANK YOU AGAIN, MR
CHAIR. AND IF IT'S UM A TIMELY
I'LL GO AHEAD AND PROCEED WITH
SENATE BILL 707. WE DON'T. 77 WE
HAVE 11 4 GRABBED THE WRONG. YOU
TRY IT. IS IT 11 84 AIRPLANE?
BILL, IS IT WOULD PROBABLY BE A
LOT EASIER IF IT WAS, UM THANK
YOU. 11 80 FOUR'S BEFORE US
APOLOGIZE TO GET THROUGH. I
MEAN, ALL IDENTICAL WHITE
BINDERS IN MY BANK. NOW YOU'RE
THREE. OKAY NOW THEY GOT THE
APOLOGIES OUT OF THE WAY. UM
AGAIN. PLEASED TO PRESENT THIS
BILL. SB 11 84 TO ENSURE
CALIFORNIA STUDENTS GET THE
BEHAVIORAL SUPPORT THEY NEED UM
, IN MY HOME DISTRICT, SANTA
CLARA COUNTY AS A COUNTY
SUPERVISOR FOR A NUMBER OF
YEARS, I WAS PROUD TO PIONEER
SOMETHING CALLED SCHOOLING
SERVICES PROGRAM USING MENTAL
HEALTH SERVICES ACT MONEY THAT
CONNECTS STUDENTS AND FAMILIES
TO COUNTY. MENTAL HEALTH
COUNSELING, CASE MANAGEMENT,
PUBLIC HEALTH SERVICES ON
DISTRICT AND SCHOOL SITE
CAMPUSES THROUGH THIS CHOOL
LINKED PROCESS IN CURRENTLY THAT
PROGRAM IN THAT PARTICULAR
COUNTY SERVES OVER 200 SCHOOLS
ACROSS 15 DIFFERENT SCHOOL
DISTRICTS IN A SINGLE COUNTY.
THE SUCCESS OF THAT PROGRAM WE
BELIEVE, CAN GUIDE THE FRAMEWORK
OF SCHOOL BASED MENTAL HEALTH
SERVICES STATEWIDE AND GIVEN THE
INVESTMENTS THAT WE'RE ALL
MAKING THIS LEGISLATORS AND
CURRENTLY IN THE STATE IN MNTAL
HEALTH SERVICES, FOCUSED ON THAT
POPULATION AND FOCUSED ON OUR
SCHOOLS. UM THIS IS AN IMPORTANT
BILL. SB 11 84 WOULD DEFINE IN
CALIFORNIA LAW WHAT A SCHOOL
BASE R SCHOOL LINK SERVICES
COORDINATOR IS AS THOSE
INDIVIDUALS OR ENTITIES WITH A
PUPIL PERSONNEL SERVICES
CREDENTIAL. LOCATED ACTUALLY ON
A SCHOOL CAMPUS WERE UNDER
CONTRACT BY COUNTY BEHAVIORAL
HEALTH PROVIDER TO ENSURE THAT
THESE COORDINATORS CAN BETTER
REFER BOTH STUDENTS AND FAMILIES
TO MENTAL HEALTH TREATMENT AND
CARE ESSENTIALLY BACK AND FORTH
BETWEEN THE COUNTY AND THE
SCHOOL DISTRICT. BETWEEN 2000
AND SEVEN AND 2014. THE SUICIDE
RATE FOR CHILDREN AGED 10 TO 14
MORE THAN DOUBLED. SUICIDE IS
NOW THE SECOND LEADING CAUSE OF
DEATH FOR INDIVIDUALS BETWEEN
THE AGES OF 10 AND 24. COVID 19
, AS WE ALL KNOW, HAS ONLY
EXACERBATED THESE ISSUES. WE
MUST MEET STUDENTS WHERE THEY
ARE. ON THEIR SCHOOL CAMPUSES.
AND THAT'S WHAT THIS BILL IS
TRYING TO HELP FACILITATE WITH
ME TODAY, OR LYDIA, BORN OF THE
CALIFORNIA SCHOOL NURSES
ORGANIZATION TO SPEAK IN SUPPORT
, AS WELL AS LEE ANGELA REID OF
THE CALIFORNIA ASSOCIATION OF
SCHOOL COUNSELORS. AGAIN. THANK
YOU, AND I RESPECTFULLY ASK FOR
YOUR VOTE. THANK YOU. PLEASE GO
AHEAD. PUSH THE BUTTON THERE. IF
YOU DON'T MIND, IT'S AUDI IS
OKAY. THANK YOU. SORRY, AND I
SAW THE BLUE LIGHT. LYDIA ONE,
REPRESENTING CALIFORNIA SCHOOL
NURSES ORGANIZATION. WE ARE THE
PROFESSIONAL ORGANIZATION FOR
CREDENTIAL SCHOOL NURSES IN THE
STATE OF CALIFORNIA. PRIMARY THE
MICROPHONE CLOSER OR SPEAKING,
OKAY, WE ARE THE PRIMARY. HEALTH
PROFESSIONAL WITHIN CALIFORNIA'S
K 12 SYSTEM, AND WE STRIVE TO
ASSURE ALL CHILDREN ARE IN
SCHOOL HEALTHY AND READY TO
LEARN. MORE THAN 25% OF CHILDREN
. ADOLESCENTS HAVE CHRONIC
HEALTH CONDITIONS SUCH AS
ASTHMA. IT'S EASIER DISORDERS,
DIABETES AND POOR ORAL HEALTH.
THE CDC ESTIMATES. 20% OF
CHILDREN HAVE MENTAL HEALTH
DISORDERS, OFTEN A COLD
MORBIDITY OF CHRONIC HEALTH
CONDITIONS. LET ME SAY THAT
AGAIN, OFTEN A CO MORBIDITY OF
CHRONIC HEALTH CONDITIONS.
MENTAL HEALTH IS PHYSICAL
HEALTH. SCHOOL NURSES ARE
UNIQUELY QUALIFIED TO SERVE IN
THE ROLE OF SCHOOL LINK SERVICES
COORDINATOR WE PROVIDE
ASSESSMENT, COUNSELING AND
EDUCATION TO STUDENTS AND THEIR
PARENTS. BUT ALSO INTERACT WITH
THEIR PRIVATE HEALTHCARE
PROVIDERS. THE LEVEL OF
EXPERTISE PROVIDES IMPORTANT AND
ACCURATE HEALTH INFORMATION IN
CASE MANAGEMENT SERVICES FOR
BOTH PHYSICAL AND MENTAL HEALTH
ISSUES, WHILE ASSURING TIMELY
ACCESS TO CRITICAL SERVICES. THE
SCHOOL LINKED COORDINATOR WILL
SERVE AS THE PRIMARY LIAISON
BETWEEN THE STUDENT THE PARENTS
, SCHOOL STAFF AND HEALTH CARE
PROVIDERS. IT IS ESSENTIAL
STUDENTS RECEIVE SUPPORT. AND
MANAGING THEIR CHRONIC
CONDITIONS SO THEY CAN BE
PRESENT AND ENGAGED IN SCHOOL.
WE ASK FOR YOUR SUPPORT, AND I'M
PLEASED TO RESPOND TO ANY
QUESTIONS. THANK YOU. NEXT
WITNESS, PLEASE. MM MR CHAIR AND
MEMBERS LEE ANGELA REID ON
BEHALF OF THE CALIFORNIA
ASSOCIATION OF SCHOOL COUNSELORS
. THERE'S CURRENTLY A
COMMUNICATION GAP HAMPERING
CREDENTIAL, SCHOOL BASED MENTAL
HEALTH PROFESSIONALS AND
LICENSED COMMUNITY BASED MENTAL
HEALTH PROFESSIONALS FROM
SHARING VITAL INFORMATION ABOUT
STUDENTS WHO ARE RECEIVING
COUNSELING SERVICES. THIS IS DUE
TO THE DIFFERENCES BETWEEN HIPPA
AND FERPA. REGULATIONS. SB 11 84
WILL RESOLVE THIS ISSUE AND OPEN
THE DOOR TO VITAL COMMUNICATION
BETWEEN SCHOOL BASED AND
COMMUNITY BASED PROFESSIONALS.
BETTER FOR ALL STUDENTS. SCHOOL
COUNSELORS FROM THE FIELD. TELL
US THAT EVEN THE SHARING OF THE
SIMPLEST OF INFORMATION IS
DIFFICULT, LIKE VERIFYING THAT A
STUDENT ATTENDED AN APPOINTMENT.
FOUR ON THE OTHER HAND, IF A
STUDENT'S BEHAVIOR OR ANOTHER
MEASURABLE INDICATOR HAS
IMPROVED THE SHARED GIVEN THE
LAUNCH OF THE COMMUNITY SCHOOL
MODEL STATEWIDE, THIS BILL IS
MORE VITAL NOW THAN EVER. WE
ENCOURAGE YOUR I VOTE AND THANK
YOU FOR YOUR CONSIDERATION.
THANK YOU VERY MUCH. ARE THERE
OTHERS IN THE AUDIENCE IN
SUPPORT OF THE BILL? NO ONE IS
THEIR OPPOSITION TO THE BILL.
OPPOSITION WITNESSES ANYONE IN
THE CHAMBER IN OPPOSITION TO THE
BILL. NO ONE BRING BACK TO THE
COMMITTEE YOUR QUESTIONS OR
COMMENTS FROM THE COMMITTEE.
QUESTIONS OR COMMENTS, QUESTIONS
OR COMMENTS. WE HAVE A MOTION BY
MISS A GEAR CURRY, A SECOND BY
MR RODRIGUEZ BILL, AND DOORS
THAT DO PASS RECOMMENDATION FROM
THE CHAIR AND THE MOTION IS DO
PASS. THANK YOU. VERY SWEETLY
ASKED FOR I VOTE. THANK YOU,
SENATOR. MADAM SECRETARY. PLEASE
CALL THE ROLL. I WALDRON
AGUIAR-CURRY AGUIAR-CURRY. AYE,
ARAMBULA. BIGELOW. BIGELOW NÓ
CARILLO CARILLO I FLORA. FLOOR
AND THAT VOTING. MAIENSCHEIN
MAIZE, MAIZE. I MCCARTY NAZARIAN
, REBUS RODRIGUEZ. RODRIGUEZ I
SANTIAGO. WEBER. 5 TO 151 WILL
LEAVE THAT BILL ON CALL. OKAY.
THANK YOU AGAIN. THANK YOU,
SENATOR. WHILE WE ARE WAITING
FOR ANOTHER SENATOR TO ATTEND
HERE, UM, WOULD ANYONE LIKE WHAT
COULD WE COULD WE GET A MOTION
ON THE CONSENT CALENDAR? THE
CONSENT COUNTER INCLUDES SB ITEM
NUMBER TWO SB 11 91 ITEM NUMBER
SEVEN. SB 8 42 REMEMBER EIGHT SB
9 29. AND ITEM NUMBER NINE SB
1003. ITEM NUMBER 13 SP 3 67
ITEM NUMBER 19 SB 11 80 REMEMBER
22 SB 13 39 AS AN ITEM NUMBER 24
SB 1500. I MEAN, JUST FOR OTHER
MEMBERS WHO ARE OR OTHERS WHO
MAY BE ARRIVING. UM WE'LL GO
AHEAD. LET'S GO AHEAD AND VOTE
ON THIS AND I'LL HAVE ANOTHER
ANNOUNCEMENT. WOULD, WOULD I,
WALDRON. AGUIAR-CURRY
AGUIAR-CURRY. AYE, ARAMBULA.
BIGELOW BIGELOW. I CARILLO. FOR
YOU. I FLORA FLORA, I
MAIENSCHEIN MAZE. MEANS I
MCCARTY NAZARIAN, RIVAS
RODRIGUEZ RODRIGUEZ I, SANTIAGO
WEBER. 7 TO 070. SO EVEN THE
CONSENT CALENDAR IS ON CALL, SO
UM. IT WAS CLOSE. WE ACTUALLY
HAD A QUORUM AND THEY WERE ALL
HERE FOR A WHILE, SO I'M JUST AS
ONCE AGAIN ANOTHER ANNOUNCEMENT
JUST ON EARLIER SOMETHING FROM
EARLIER. SB 9 58 BY SENATOR
LIMÓN WAS REMOVED FROM THE FROM
THE AGENDA. SP 9 39 BY SENATOR
PAN AND SP 4 43. BY SENATOR
HERZBERG. THOSE BILLS WERE
REMOVED BY THE AUTHORS FROM THE
AGENDA. SO UM, WE HAVE A COUPLE
OF BILLS THAT HAVEN'T HAD
MOTIONS. UM REMEMBER THREE SP
771 ANYONE? MOVE THE BILL.
MOTION WAS A MOTION BY A SEMI
MARIA. YOUR CAREER, I THINK WAS
THE SECOND BY MR MAYS. IS THAT
CORRECT? THANK YOU. THE MOTION
IS DUE PASS TO APPROPRIATIONS.
SECRETARY. PLEASE CALL THE ROLL.
WOULD NOT VOTING WOULD NOT
VOTING. WALDRON. EDGAR CURRY,
EDGAR CARILLO. AYE, ARAMBULA.
BIGELOW. BIGELOW, NOT VOTING
CARILLO. FOR YOU. I FLORA. LARA?
AYE, MAIENSCHEIN. MAIZE, MAIZE,
I MCCARTY. NAZARIAN RIVAS
RODRIGUEZ. RODRIGUEZ NOT VOTING.
SANTIAGO WEBER. 4 TO 0. BILL HAS
FOUR VOTES WILL LEAVE THAT BILL
ON CALL AND THEN ITEM NUMBER UM
FOUR SP 13 46. BUT MOTION BY MR
BIGELOW, SECOND BY MS MS HAGAR
CURRIE. THE MOTIONS DO PASS AS A
MANITOU, APPROPRIATIONS
SECRETARY. PLEASE CALL THE ROLL.
YES. ITEM NUMBER FOUR SP 13 46
MR SENATOR BECKER. WOULD, WOULD
I, WALDRON. AGUIAR-CURRY
AGUIAR-CURRY. AYE, ARAMBULA.
BIGELOW. BIGELOW. I CARILLO.
CARILLO I FLORA FLORA. I
MAIENSCHEIN AMAZED. AMAZIGH
MCCARTY NAZARIAN. LUZ RIVAS
RODRIGUEZ. RODRIGUEZ I, SANTIAGO
WEBER. 7 TO 070. THAT BILL IS ON
CALL, SO WE ARE AS CAUGHT UP AS
WE COULD POSSIBLY BE SO WE WAIT.
THANK YOU.
UM YEAH, I GUESS WE MISS CAREER
YOU'D LIKE TO I'LL ENTERTAIN
YOUR VOTE CHANGE. PLEASE GO
AHEAD. WHAT BILL? UH SP SEVEN
MISS CARILLO SP 771 FROM I TO
NOT VOTING. OKAY. THANK YOU.
REAL. I'M NOT VOTING ON SB 771.
MR BIGELOW, DID YOU MR BIGELOW,
DID YOU WANT TO MAKE A CHANGE?
6320.
WE MIGHT AS WELL HOURS JUST
WAITING. WE CAN, UH GO THROUGH,
UM NOT SURE WHAT WE HAVE YOU ON
OR DON'T HAVE YOU ON SO BUT
WE'LL GO TO THE CONSENT
CALENDAR. PLEASE OPEN THE ROLL
CALL ACTUALLY LIFT THE CALL.
CALL THE ABSENT MEMBERS.
WALDRON. ARAMBULA MAIENSCHEIN
MCCARTHY, MISSOURIAN, REBUS
SANTIAGO, REB WEBER WEBER. I 80
IS 802 CONSENT CALENDAR HAS
PASSED. UM I DON'T NUMBER THREE.
I THINK WE'VE ALREADY WE'VE
ALREADY VOTED ON. BUT NO. ITEM
NUMBER FOUR. I'M SORRY. ITEM
NUMBER THREE. SB 771, PLEASE
LIFT THE CALL. CALL THE ABSENT
MEMBERS. WALDRON. ARAMBULA
MAIENSCHEIN MCCARTY, NAZARIAN
RIVAS. SANTIAGO WEBER. WEBER.
AYE. 4 TO 0. THANK YOU. THAT'S
40 REMEMBER FOUR. UM ITEM NUMBER
FOUR. SB 13 46. PLEASE LIFT THE
CALL CALLED THE ABSENT MEMBERS.
WALDRON. ARAMBULA MAIENSCHEIN.
MCCARTY NAZARIAN RIVAS. SANTIAGO
WEBBER WEBBER, I LET'S 8080 THAT
BILL IS OUT. WE'LL LEAVE THE
ROLE OPEN FOR OTHERS TO ADD ON
TO REMEMBER FIVE SP 999 PLEASE
LIFT THE CALL CALL THE ABSENT
MEMBERS. I'M SORRY. WE'VE GOT
YOU ON 999. EXCUSE ME, AND WE
HAVE YOU ON 11 84 OKAY. SB 11
84. PLEASE LIFT THE CALL. CALL
THE ABSENT MEMBERS. WALDRON
ARAMBULA MAIENSCHEIN. MCCARTHY
NAZARIAN RIVAS, THIAGO WEBER
HOWEVER, I. 6161 SO WE'LL LEAVE
THAT BILL ON CALL. SO OUR HAS
CAUGHT UP AS WE CAN BE. THANK
YOU.
JUST JUST A THOUGHT THAT YOU
KNOW FOR THOSE. THERE'S ANY
SENATORS OUT THERE LURKING, UM
ANYWHERE ON OUR AGENDA. UM WE DO
HAVE A SPECIAL ORDER OF BUSINESS
AT THREE. SO THIS WOULD BE A
REALLY GOOD OPPORTUNITY IN
WHATEVER ORDER TO COME IN AND
PRESENT A BILL OR TO JUST
ANYTHING AS LONG AS THE HEALTH
COMMITTEE BILL. AND ON OUR
AGENDA.
SO IN LIEU OF PLAYING CARDS,
WE'RE GONNA OPEN THE ROLL UP FOR
THE VICE CHAIR TO BE ABLE TO ADD
ONTO VOTES SO UM THE PLEASE.
OPEN THE ROLL CALL FOR THE
CONSENT CALENDAR. WALDRON
WALDRON. AYE. AH! ARAMBULA
MAIENSCHEIN MCCARTHY, NAZARIAN
RIVAS. SANTIAGO. 9090 OKAY. AT
THIS POINT, WE'RE GOING TO STOP
THAT WE HAVE A SENATOR. YES, YOU
ARE. YOU ARE. THANK YOU,
SENATOR. MHM. IT IS GENTLEMEN OF
THE JURY. HOW IS EVERYBODY?
THANK YOU, MR CHAIRMAN. WELCOME,
PLEASE. SENATE BILL 10 14. THE
IMPORTANT BILL. SB 10 14. LET ME
FIRST ACCEPT THE AMENDMENTS.
CRAFTED BY. YOUR COMMITTEE IN
COORDINATION WITH ALL THE REST
OF US, AND I WANT TO THANK CHAIR
. THIS IS NOT LIKE PULLING
TEETH. THIS IS WAS EASY. OKAY? I
APPRECIATE IT. THANK YOU SO
MUCH. IT'S HARD WORK. IT TAKES A
LOT OF WORK TO MAKE THESE BILLS
BETTER. AND I APPRECIATE
EXPERTISE FROM THOSE FOLKS THAT
YOU HAVE AS PART OF YOUR TEAM.
THE RATE OF HEALTHCARE COVERAGE
. WE ALL WANT EVERYBODY TO HAVE
GOOD HEALTH CARE COVERAGE, BUT
THE RATE OF HEALTHCARE COVERAGE
HAS RISEN AMONG CALIFORNIA'S
HISTORIC LEVELS. IT'S REALLY
BEEN QUITE EXTRAORDINARY. THERE
HAS BEEN AN UNBELIEVABLE
IMPLEMENTATION OF THE AFFORDABLE
CARE ACT. AN ADDITIONAL STATE
POLICIES THAT WE'VE DONE
ELIMINATING BARRIERS FOR MEDICAL
ENROLLMENT. AND WE CAN PROUDLY
SAY, I THINK ALL OF US AS
MEMBERS OF THIS GOVERNMENT THAT
WERE LEADING THE NATION IN
PROVIDING UNIVERSAL ACCESS. BUT
HERE'S THE RUB. AND HERE'S THE
REASON WHY I'M HERE TODAY.
UNIVERSAL COVERAGE IS
MEANINGLESS IF IT DOES NOT
TRANSLATE INTO TANGIBLE
BENEFITS, ESPECIALLY ARE MOST
VULNERABLE. FEDERALLY QUALIFIED
HEALTH CENTERS OR COMMUNITY
CLINICS, AS WE LIKE TO CALL
THEM. ARE THE SCENT ARE CENTRAL
TO OUR MISSION IN DELIVERING
QUALITY HEALTHCARE IN CALIFORNIA
. SO MANY COMMUNITIES DON'T HAVE
THE BIG FANCY SHMANCY HOSPITALS
ALL THIS TYPE OF STUFF. A LOT OF
PEOPLE GET THEIR CARROT
COMMUNITY CLINICS. AND UM, THESE
ARE THE BACKBONES, I SAY OF THE
SAFETY NET AND OFFER SERVICES TO
ALL PATIENTS. REGARDLESS AND I
STRESS THIS REGARDLESS OF THEIR
ABILITY TO PAY. CALIFORNIA. YOU
PROBABLY KNOW THIS, MR CHAIRMAN,
BECAUSE YOU'RE THE CHAIR OF THE
HEALTH COMMITTEE. HAS MORE THAN
800 FEDERALLY QUALIFIED HEALTH
CENTERS OPERATED BY OVER 180
PUBLIC AND NOT FOR PROFIT
ORGANIZATIONS THROUGHOUT OUR
STATE THAT PROVIDE THIS PRIMARY
PRIMARY CARE THAT REFERRED TO
DENTAL CARE. UM AND BEHAVIORAL
HEALTH SERVICES TO MEDICALLY
UNDERSERVED COMMUNITIES. UM
UNINSURED INDIVIDUALS AD
MEDICAL AND OUR MEDICAL
POPULATION. THESE FEDERALLY
QUALIFIED HEALTH CENTERS SERVED
NEARLY SIX MILLION CALIFORNIANS
. I DIDN'T DO THE NUMBERS, BUT
I'M SURE THAT'S LARGER THAN MOST
STATES IN THE UNION. SIX MILLION
CALIFORNIANS PER YEAR AND
MEDICAL RECIPIENTS MAKE UP 60.3%
OF ALL OF THE PATIENTS. IN FACT
, CLINICS PROVIDE CARE TO ONE
THIRD OF ALL MEDICAL
PARTICIPANTS IN OUR STATE. SO
WITH THIS CONTINUED GROWTH OF
THE SAFETY NET, AND THANKS TO
THE LEADERSHIP OF THIS
ADMINISTRATION, THIS GOVERNOR
GAVIN NEWSOM, THE NUMBER IS ONLY
GROWING IS GOING TO GROW AND
CLINICS ARE UNDER EXTRAORDINARY
PRESSURE TO RAPIDLY INCREASE
THEIR CAPACITY TO MEET THIS
DEMAND. MEMBERS OF THIS
COMMITTEE ON SURPRISINGLY,
CLINICS ARE SEVERELY UNDER
RESOURCED. IT'S HARD TO BELIEVE
, BUT THEY ARE SEVERELY UNDER
RESOURCED, ESPECIALLY ESPECIALLY
COMPARED TO PROVIDERS OPERATING
OUTSIDE OF THE SAFETY NET.
CLINICS FACE CRIPPLING WORKFORCE
SHORTAGES AND INCREASINGLY HIGH
TURNOVER RATES AMONG THEIR
CAREGIVERS. IN FACT, CALIFORNIA
PRIMARY CARE ASSOCIATION WHO IS
OPPOSED TO THIS BILL, REPORTED A
MEDIAN TURNOVER. COMEDIAN
TURNOVER OF 18.2% IN THERE TO
2021 SURVEY UP FROM 7.6. IN THE
PREVIOUS YEAR. IT'S HARD TO
OPERATE A CLINIC AT WITH THAT
LEVEL OF TURNOVER, AND SO THIS
IS A TIME WHEN CLINICS NEED TO
RETAIN WORKERS BUT NEED TO BE
NOT ONLY THE NEED TO RETAIN
WORKERS BUT NEED TO BE STAFFING
UP MEMBERS AND IN CREATE WITH
THE INCREASED DEMAND FOR CARE.
THE NUMBER ONE BARRIER TO
RECRUITMENT AND RETENTION IS
COMPETITION AMONG OTHER HEALTH
CARE PROVIDERS FOR WORKERS.
CLINIC SALARIES ARE MUCH LOWER
THAN THOSE PAID FOR BY COMPETING
PROVIDERS AND WORKERS ARE
INCREASINGLY DISSATISFIED WITH
THEIR WORKPLACE CONDITIONS. WHAT
DOES THIS MEAN? WHAT DOES THIS
MEAN FOR US IN TERMS OF
PROVIDING A SYSTEM THAT WORKS
FOR ALL CALIFORNIANS, CROSSROADS
CLINICS ARE AT A CROSSROADS WHEN
IT'S INCREASINGLY DIFFICULT TO
HIRE AND RETAIN STAFF TO SERVE
PATIENTS TO MEET THE MISSIONS TO
EXPAND CARE. IN ADDITION,
INADEQUATE CLINICAL STAFFING
MEANS LONGER, WAIT TIMES AND
DIMINISHED CARE, WHICH MEANS
PATIENTS ARE SLIPPING THROUGH
THE CRACKS. WHAT DOES IT ALSO
MEAN? IT MEANS THAT THESE
CHALLENGES JUST SET UP FURTHER
SET US FURTHER BACK. IN OUR
MISSION TO ACHIEVE GREATER
HEALTH EQUITY DELAYS AND HAVE A
DEVASTATING AND LONG TERM IMPACT
ON OUR COMMUNITIES THAT HAVE THE
LEAST ABILITY TO SHOULDER THE
BURDENS AND PARTICULARLY THE
CHILDREN WERE SO IMPACTED. SO
HOW DOES WHAT YOU HAVE BEFORE
YOU SOLVE THIS PROBLEM? WHAT ARE
WE TRYING TO DO TO SOLVE THIS
PROBLEM? AND DOES THIS DO SO?
WELL THE MEASURE BEFORE YOU
TODAY IN CONJUNCTION WITH WHAT?
ASSEMBLY MEMBER? UH CARILLO HAS
BEEN DOING PRESENTS AN
OPPORTUNITY TO ADDRESS THE
LONGSTANDING WORKFORCE SHORTAGES
AND ENSURES WE CAN DELIVER
QUALITY HEALTH CARE FOR OUR MOST
VULNERABLE. IT CREATES AN
OPTIONAL AND I STRESS OPTIONAL
NEW PROGRAM A NEW TOOL IN
GOVERNMENT CREATIVE. TOOL IN
YOUR GOVERNMENT, WHICH CLINICS
CAN TAP INTO WHO DESPERATELY
NEED THE RESOURCES. IT ALLOCATES
FUNDS ALLOCATED FUNDS WILL ALLOW
CLINICS TO HIRE AND RETAIN
CAREGIVERS AND INCREASED
TRAINING AND INCREASED CAPITAL
INVESTMENT. FUNDS WILL BE USED
TO PAY CLINIC WORKERS A MINIMUM
WAGE OF $25 AN HOUR I REPEAT A
MINIMUM WAGE OF $25 AN HOUR,
WHICH HELP WILL ATTRACT AND
RETAIN WORKERS. NOW LET'S KEEP
IN MIND THAT L. A COUNTY, THE
COUNTY THAT I'M FROM IN ORDER TO
AFFORD A MODEST TWO BEDROOM
APARTMENT, YOU NEED TO BE
EARNING A MINIMUM WAGE OF $39 AN
HOUR. THAT'S NOT I SUSPECT THE
CASE IN OTHER PARTS OF THE STATE
REPRESENTED BY MEMBERS HERE. BUT
IT'S A LOT OF MONEY AND WE'RE
ONLY INCREASING IT TO $25 AN
HOUR. THIS MEASURE ENCOURAGES
COLLABORATION BETWEEN CLINICS,
WORKERS AND PATIENTS FOR
RECRUITMENT AND TRAINING
PROGRAMS, AND THESE PARTNERSHIPS
WILL FOCUS ON CREATING PATHWAYS.
FOR HEALTH CARE CAREERS IN
CLINICS. IMPORTANTLY THIS BILL
ALLOWS ALSO INCLUDES APPROPRIATE
GUARDRAILS TO ENSURE THE FUNDS
ARE DIRECTED TOWARDS IMPROVING
CARE AND INVESTING IN OUR
CLINICS, WORKFORCE. NOW THE
THING THAT I THINK IS SO
IMPORTANT IS THAT SO OFTEN IT'S
BEEN A GREAT FRUSTRATION OF MINE
IS THAT GOVERNMENT COMES ALONG
AND SAYS, WELL, WE'RE GOING TO
DO THIS AND WE'RE GOING TO PAY
FOR THIS. AND THEN AFTER THEY
SAY THEY'RE GOING TO PAY FOR IT,
YOU GO OUT. YOU HIRE THE PEOPLE
UP, AND THEN IT TAKES TWO YEARS
TO GET PAID. AND YOU CAN'T
AFFORD IT. YOU CAN'T TAKE THE ON
THE GOVERNMENT PROGRAM. WHAT
THIS SAYS THIS BILL SAYS, IS
THAT YOU DON'T HAVE TO. YOU
DON'T HAVE TO START PAYING $25
AN HOUR UNTIL YOU GET THE MONEY
FROM THE GOVERNMENT. WE'RE
PUTTING THE MONEY UP FRONT. IT'S
BRILLIANTLY DESIGNED IN THAT
RESPECT. YOU DON'T HAVE CLINICS
THAT OFTEN HAVE THESE CHALLENGES
ON THE ONE HAND TO THEN SAY, OH,
NOW YOU'RE PAYING THESE PEOPLE,
BUT I DON'T HAVE THE CASH FLOW
TO PAY IT. WE GIVE YOU THE CASH
FLOW UP FRONT AND THEN YOU ONCE
YOU GET THE CASH FLOW, THEN YOU
PAY THE $25 AN HOUR. WE'LL
LIKELY HEAR FROM THE CLINICS IN
OPPOSITION THAT THE REAL PROBLEM
WITH CLINICS BUDGET SHORTFALLS
IS DUE TO LOW MEDICAL
REIMBURSEMENT RATES. PROBABLY
TRUE TO SOME EXTENT, BUT I DON'T
DOUBT THAT MEDICAL IS
UNDERFUNDED AND EVERY STEP OF
THE WAY. THERE'S NO QUESTION
ABOUT THAT MEMBERS. BUT THAT'S
EXACTLY WHY WE SHOULD BE
THINKING OF EVERY CREATIVE NEW
TOOL THAT WE COULD POSSIBLY
CREATE. TO PROVIDE SUPPLEMENTAL
DOLLARS INTO THE CLINICS
PROGRAM. THIS PROVIDES THAT ONE
MECHANISM AND BY STRENGTHENING
THE CLINICS WORKFORCE TO IMPROVE
WAGES AND BENEFITS. WE
STRENGTHEN CLINICS CAPACITY TO
IMPROVE CARE FOR OUR MOST
VULNERABLE POINT THAT I MADE IN
THE BEGINNING, I MAKE NOW AGAIN
AND I WILL MAKE IT THE END OF
THIS BECAUSE THAT'S WHAT WE'RE
TRYING TO DO WITH OUR
GOVERNMENT. WE HAVE HERE TODAY.
JIM MARACAS ST JOHN'S WELL, WELL
CHILD AND FAMILY CENTER AND
NORMAN AGUILAR FROM S. C I U 7
21, A MEMBER TO SPEAK IN SUPPORT
OF THIS VERY IMPORTANT MEASURE,
AND I THANK YOU SO MUCH MEMBERS.
AND CHAIRMAN FOR THE TIME,
PLEASE. THANK YOU FOR YOUR
WITNESSES. PLEASE, PLEASE COME
ON UP. HAVE A SEAT.
A LITTLE BUTTON THERE. IT SAYS,
M I C ON IT IF YOU WANT TO PUSH
THAT. WHAT. THANK YOU. THANK
YOU. GOOD MORNING. MY NAME IS
JIM MAJA. I'M THE PRESIDENT AND
CEO OF SAINT JOHN'S COMMUNITY
HEALTH, WHICH IS A FEDERALLY
QUALIFIED HEALTH CENTER IN SOUTH
CENTRAL LOS ANGELES. WHERE THE
LARGEST HEALTHCARE PROVIDER IN
SOUTH LA AND EAST L. A WE SERVE
OVER 475,000 PATIENT VISIT
ANNUALLY. BEFORE WE TALK ABOUT
HOUSE SP 10 14 WILL STRENGTHEN
OUR CLINICS IN THE FUTURE. I
WANT TO BRING US BACK TO WHAT
THIS IS ALL ABOUT FIXING THE
WRONGS THAT HAVE PUT QUALITY
HEALTHCARE OUT OF THE REACH. FOR
LOW INCOME COMMUNITIES,
PARTICULARLY COMMUNITIES OF
COLOR. COMMUNITY CLINICS EMERGED
FROM THE CIVIL RIGHTS MOVEMENT
AND THE WAR ON POVERTY. TO
ADDRESS THE SYSTEMIC INEQUITIES
IN HEALTH CARE. THE FOUNDER OF
THAT MOVEMENT OF THE COMMUNITY
HEALTH CENTER MOVEMENT, DR JACK
GEIGER FOCUS ON COMMUNITY HEALTH
, FIGHTING POVERTY AND BUILDING
SOCIAL JUSTICE AS KEY FACTORS.
IN THE MISSION OF HEALTH
CENTERS. I BRING UP OUR HISTORY
BECAUSE WITHOUT ACTION AND
INCREASED INVESTMENT IN OUR
CLINICS, CALIFORNIA IS
UNDERMINING OUR PROGRESS AND
DEEPENING DISPARITIES TO CARE.
THE PATIENTS WHO COME TO OUR
CLINICS OR JUST AS DESERVING OF
QUALITY CARE AS THOSE WHO CAN
AFFORD TO GO TO PRIVATE
HOSPITALS OR LARGER HEALTHCARE
SETTINGS. BUT THE WAY THINGS ARE
COMMUNITY CLINICS ARE SIMPLY
UNABLE TO COMPETE WITH OTHER
HEALTH CARE PROVIDERS FOR
WORKERS, ESPECIALLY THOSE WHO
PAY OUR HIGHER SALARIES. THIS
PROBLEM WORSENED BY THE PANDEMIC
AND THE SKYROCKETING COST OF
LIVING IS JEOPARDIZING CARE TO
PATIENTS WHO CAN LEAST AFFORD
THE SHOULDER THE BURDEN. WITHOUT
ENOUGH MEDICAL ASSISTANCE. CASE
MANAGERS, BENEFITS COUNSELORS
AND OTHER ESSENTIAL STAFF.
PATIENTS ARE HAVING TO WAIT
LONGER TO BE SEEN OR REFER TO
PROVIDERS THAT ARE FURTHER AWAY
FROM THEIR HOMES AND COMMUNITIES
. AND DURING COVID 19. IT WAS
THESE COMMUNITY CLINIC WORKERS
WHO ARE ON THE FRONT LINES EVERY
DAY. AT SAINT JOHN'S ALONE. WE
VACCINATED CLOSE TO A HALF A
MILLION PEOPLE IN SOUTH LOS
ANGELES. SB 10 14 NOT ONLY
ENSURES THAT OUR CLINICS CAN
HIRE AND TRAIN THE BEST IT
INVESTS IN THE HEALTHCARE HEROES
WHO HAVE CARRIED OUR CLINICS
THROUGH THE WORST CRISIS. OF OUR
GENERATION AND MAKES FUNDS
AVAILABLE TO ALL CLINICS SO THAT
WE CAN ATTRACT THE TALENT AND
EXPERTISE THAT WE NEED AND THAT
THE LARGER HEALTHCARE EMPLOYERS
ARE ABLE TO DRAW ON WITH HIGHER
SALARIES. IT CREATES LABOR
MANAGEMENT COOPERATION
COMMITTEES THAT THAT OUR
PARTNERSHIPS BETWEEN WORKERS
MANAGEMENT AND PATIENT ADVOCATES
THAT CAN WORK COLLABORATIVELY TO
IMPROVE PATIENT CARE. I WANT TO
THANK CHAIR WOULD SENATOR
HERZBERG, UM, FEAR AND YOUR
MEMBERS OF THIS COMMITTEE FOR
YOUR LEADERSHIP AND COMMITMENT
TO HEALTH, EQUITY AND JUSTICE. I
ALONG WITH CEOS AND PRESIDENTS
OF HEALTHCARE CENTERS FROM
ACROSS THE STATE. URGE YOU TO
PASS. SB 10 14. THANK YOU. THANK
YOU. NEXT WITNESS, PLEASE. THANK
YOU SHARE WITH AND COMMITTEE
MEMBERS. MY NAME IS NORMAN
MILLAR. I AM A HEALTH EDUCATOR
AT NORTHEAST VALLEY HEALTH
CORPORATION IN BANGLADESH. HERE
IN SUPPORT OF SB 10 14. I AM AN
IMMIGRANT IN A REFUGEE, SO I
UNDERSTAND HOW IMPORTANT
COMMUNITY CLINICS ARE IN GETTING
CULTURALLY SENSITIVE HEALTH
CARE. AS A HEALTH EDUCATOR. I
HELP PATIENTS NAVIGATE, UH,
VARIETY OF HEALTH SERVICES,
INCLUDING HIV PREVENTION AND
OTHER HEALTH PROGRAMS. NEARLY
75% OF ALL OUR PATIENTS ARE
CLINICS ACROSS THE SAN FERNANDO
IN SANTA CLARITA. VOLLEYS ARE
LATINOS IN 85% ARE PEOPLE OF
COLOR. WE NEED MORE HEALTH
EDUCATORS IN MORE HEALTHCARE
PROVIDERS, BUT OUR CLINICS HAVE
A STRUGGLE TO RECRUIT AND RETAIN
EXPERIENCES IN QUALIFYING
HEALTH. WORKERS. WE. CLINIC
WORKERS HAVE BEEN CALLED HEROES
DURING THE PANDEMIC, BUT MANY OF
US HAVE NO CHOICE BUT TO LEAVE
THIS WORK SO WE CAN AFFORD TO
PAY OUR BILLS. THE MOST PAINFUL
RESULT OF OUR CLINICS NOT HAVING
ENOUGH FUNDING FOR WORKERS IS
THAT OUR PATIENTS ARE SUFFERING.
EVERYONE DESERVES TO HAVE ACCESS
TO HEALTH CARE AND NOT TO WAIT
FOR HOURS FOR YOUR APPOINTMENT,
OR 2 TO 3 WEEKS JUST TO GET ONE.
WITH S B 10 14 CLINICS WILL HAVE
MORE RESOURCES TO TRAIN AND KEEP
QUALIFIED STEPS TO SERVE IN
COMMUNITIES THAT ARE MOST IN
NEED. SB 14 GIVES CLINICS THE
ONE THING IT NEEDS MOST MORE
HANDS TO SERVE THOSE WHO COME TO
US FOR CARE. TODAY WE NEED YOUR
HANDS HELP SERVE OUR
COMMUNITIES. PLEASE HELP US.
BILL OUR PRIMARY CARE SAFETY NET
AND PASSED SB 10 14 THANK YOU SO
MUCH. THANK YOU VERY MUCH OTHERS
IN SUPPORT. COMING FORWARD. JUST
YOUR NAME. UH AND ORGANIZATION.
IF YOU REPRESENT ONE, PLEASE. MR
CHAIR MEMBER SARAH FLOCKS ON
BEHALF OF APPS ME IN SUPPORT. MR
CHAIR MEMBERS MATT BROUGHT ON
BEHALF OF THE CALIFORNIA SCHOOL
EMPLOYEES ASSOCIATION AND
SUPPORT THANK YOU. HELLO CHAIR
AND MEMBERS. CHRISTOPHER SANDINO
WITH THE CALIFORNIA HAWAII AND
PROUD SUPPORT. THANK YOU. ALICIA
WALKER, MEDICAL ASSISTANT TO AT
LIFELONG MEDICAL CARE IN
OAKLAND, CALIFORNIA AND I'M IN
SUPPORT OF SB 10 14. MORNING
TANYA BRASHEARS. I REPRESENT
LOCAL 7 21, WHAT'S HEALTHCARE
CORPORATION NUTRITIONIST AND
CERTIFIED BREASTFEEDING
COUNSELOR. THANK YOU. THANK YOU.
MY NAME IS KYLE A WILSON. I'M A
MENTAL HEALTH ADMINISTRATOR. I
WAS STOCKLAND HEALTH CENTER, AND
I'M HERE IN SUPPORT OF SB 10 14.
MY NAME IS BUT HE SAWARA I'M, A
MEDICAL ASSISTANT AT SANTA ROSA
COMMUNITY HEALTH. AND I AM IN
SUPPORT OF A SPEED 10 14. THANK
YOU. I PATIENT. I SUPPORT SB 10
14. THANK YOU. MY NAME IS GARY
PO. I'M NOT REACHED COORDINATOR
AT ST JOHN'S COMMUNITY HEALTH
CLINIC, AND I AM SUPPORTIVE. SB
10 14. THANK YOU. HELLO MY NAME
IS JESSICA ALVARADO. I'M A
MEDICAL ASSISTANT FOR ST JOHN'S
WORT CHILD CENTER, AND I'M HERE
TO SUPPORT SB 10 14. HI MY NAME
IS CARL ORTEGA S E I U H W I
REPRESENT. AFTERNOON MY NAME IS
SHARON BROOKS BOY AT THE PATIENT
THAT ACCESSES THE MEDICAL SYSTEM
. I AM HERE IN SUPPORT OF SENATE
BILL 10 14. THANK YOU. HELLO MY
NAME IS LAKISHA. CAN'T I AM A
MEDICAL ASSISTANT AND I WORKED
FOR FAMILIES TOGETHER OF ORANGE
COUNTY IN THE CITY OF TUSTIN.
AND I SUPPORT SB 10, 15 OR SORRY
10 14. I WORK FOR SAINT GENERAL
CHILD FAMILY CENTER AND I
SUPPORT SB 10 14 YOU THANK YOU.
HI MY NAME IS PEGGY HERNANDEZ,
MEDICAL ASSISTANT AT SAINT
JOHN'S COMMUNITY HEALTH CLINIC,
AND I SUPPORT THE SB 10 14.
THANK YOU. HI MY NAME IS VALERIE
PEOPLE FROM HERE TO SUPPORT SB
10 14. I WORK AT THE WISE
HEALTHCARE FOUNDATION OF MY
FELLOW BOTANIST AND ALSO AS CI
YOU REMEMBER LOCAL 7 TO 1. THANK
YOU. GOOD AFTERNOON. MY NAME IS
MARIA HOLDER FROM THE WHITE CELL
CENTER. I WORKED THERE FOR 28
YEARS AND I'M HERE. WE HERE TO
SUPPORT SB 10 14. THANK YOU.
EVERYBODY I'M K TEMPLETON. I
WORK AT THE LGBT CENTER LOCATED
IN HOLLYWOOD. I ALSO SUPPORT 10
14. OH MY NAME IS MARCELA
RODRIGUEZ. I'M THE HEALTH
EDUCATOR AT THE WAT SALE CENTER
IN LOS ANGELES. AND I SUPPORT SV
FOR 10 14. THANK YOU. GOOD
AFTERNOON. MY NAME IS TINA DIP.
I'M WORKING FROM ASIAN HEALTH
SERVICES AND OAKLAND AND I'M
COMMITTEE, HEALTH ADVOCATES AND
ALSO, I'M S E I U 10 21. I'M
LIKE ALAMEDA COUNTY AREA WHERE I
SUPPORT TENT. 14. THANK YOU.
THANK YOU. HI MY NAME IS JESSICA
AND THERE'S A WORK AT HIGHLAND
HOSPITAL IN OAKLAND. UM AND I
SUPPORT SB 10 14. THANK YOU.
HELLO MY NAME IS VERONICA ROSE
SALAS AND I WORK FOR HEALTH.
RIGHT? 3 60 LOCAL S C I U 7 TO 1
AND I SUPPORT SB 10 14. THANK
YOU. HELLO MY NAME IS MOIST. I
WORKED FOR CITY AND COUNTY OF
TIME IN CISCO JAIL HEALTH
SERVICES AND I AM SUPPORTIVE. SB
10 14. THANK YOU. THANK YOU. YOU
HAVE TO KNOW WHEN I'M BRANDON
DAWKINS ON THE VICE PRESIDENT OF
ORGANIZING FOR S E I U LOCAL 10
TO 1. I'M ALSO A HEALTH WORKER
FOR THE SAN FRANCISCO DEPARTMENT
OF PUBLIC HEALTH, AND I'M HERE
IN SUPPORT OF SB 10 14. GOOD
AFTERNOON. MY NAME IS CASSANDRA
HAWKINS. I WORK AT THE S WEST
OAKLAND HEALTH COUNCIL, AND I'M
HERE IN SUPPORT OF SB 10 14.
THANK YOU. HELLO MY NAME IS
SHELLEY BUTLER. I WORK AT WATCH
HEALTH CARE. I'M IN A SUPPORT OF
SB 10 14. THANK YOU ALL VERY
MUCH. THANK YOU. GOOD AFTERNOON
. MY NAME IS ANGELA. ME ON I AM
YOUR DENTAL SCHEDULE ER FOR OUT
WATER, CALIFORNIA AND I AM HERE
TO SUPPORT SB 10 14. THANK YOU.
THANK YOU. ANYONE ELSE? WHAT ONE
OF THOSE CAPES. I WOULD IMAGINE
, SENATOR IF YOU REQUEST ONE. OR
YOU WILL GET ONE OF THOSE CAPES.
SO THANK YOU. THANK YOU, UM
OPPOSITION WITNESSES AND
OPPOSITION TO SB 10 14. IF THERE
ARE PLEASE COME FORWARD.
WHENEVER YOU'RE READY. THANK YOU
. GOOD AFTERNOON. CHAIRMAN WOULD
MEMBERS OF THE COMMITTEE MY NAME
IS VERNITA TODD I'M A RESIDENT
OF LA MESA, CALIFORNIA AND I
CURRENTLY SERVE AS THE VICE
PRESIDENT AND CHIEF STRATEGY
OFFICER. FLOOR. SANDY CEDRONE
HEALTH, A LARGE FEDERALLY
QUALIFIED HEALTH CENTER. EXCUSE
ME IN SAN DIEGO COUNTY. I DO
APPRECIATE THE OPPORTUNITY TO
SPEAK WITH YOU TODAY. ABOUT OUR
STRONG OPPOSITION TO SB 10 14 A
BILL THAT LEADS 93% OF FEDERALLY
QUALIFIED HEALTH CENTERS AND
THEIR COMMUNITIES BEHIND OUR
OPPOSITION. SB 10 14 IS SIMPLE
AND BASED ON TWO BASIC FRONTS,
THE MATH AND THE MODEL.
REGARDING THE MATH, FOR EXAMPLE,
IT JUST DOESN'T ADD UP. AT SANDY
CEDO HEALTHY INITIAL COST OF
IMPLEMENTING A $25 MINIMUM WAGE
IS $12 MILLION. WITH ADDITIONAL
DECOMPRESSION OF SKILLED AND
UNSKILLED PAYROLL COSTS, MAKING
IT EXTRA CONSERVATIVELY. THIS
MOVEMENT COULD COST $1.5 BILLION
FOR ALL F Q S IN CALIFORNIA. THE
STATE'S PORTION WAS TOUTED AT
ABOUT 400 MILLION YET TODAY ONLY
A MYSTERY $75 MILLION EXIST IN
THE BUDGET. IT JUST DOESN'T ADD
UP, ESPECIALLY IF THE TRUE GOAL
IS INCREASING QUALITY AND
PRESERVING THE SAFETY NET
WORKFORCE. INCIDENTALLY WE
BELIEVE THE HCS COULD MAKE THESE
CHANGES SUSTAINABLE WITH THE
SIGN OF A PIN OR A FEW
KEYSTROKES, BUT THAT WOULD PUT
THE BURDEN ON THE STATE AND NOT
ON HEALTH CENTERS. WE DO HEAR
OFTEN THAT IT'S VOLUNTARY, AND
IT'S OPTIONAL. BUT IS IT OUR
CHOICE TO NOT UNIONIZE IS
PORTRAYED AS CHOOSING NOT TO
BELIEVE IN PAYING OUR WORKERS
MORE MONEY. AT LEAST THAT'S WHAT
THE ORGANIZERS ARE TELLING OUR
EMPLOYEES OUTSIDE OF OUR CLINIC
DOORS. THAT SEEMS LIKE A FALSE
EQUIVALENCY. WHY WOULD WE
UNDERTAKE A STRATEGY THAT'S
UNSUSTAINABLE? THE MODEL R F Q S
HAVE GOVERNING BOARDS REQUIRED.
51% PATIENT MAJORITY WHO ARE
REPRESENTATIVE OF THE
COMMUNITIES THEY SERVE. THESE
ARE THE PEOPLE WHO STEWARD OUR
HEALTH CENTERS THROUGH PANDEMIC
WHO AGONIZED OVER LAYOFFS AND
TERMINATIONS, AND WE'RE
DETERMINED TO BRING OUR STAFF
BACK. THEY DO THIS WHILE KEEPING
THE SUSTAINABILITY OF THE WHOLE
AS THEIR FUNCTION. INSERTING LMC
CS DISRUPTS THIS AUTHORITY.
THEY'RE NOT REPRESENTATIVE, AND
THEY'RE NOT MINDFUL OF ALL THE
THINGS THAT WE HAVE TO DO. AT
SANDY SAID ROW STANDING IN
PARTNERSHIP WITH THE STATE, THE
STATE HAS 14 MILLION MEDICAL
BENEFICIARIES. FQ HCFC FQ HCS
SERVES 7.2 MILLION OF THEM. WE
WANT TO SUCCEED WITH YOU. WE
HAVE MEDICAL, DENTAL,
BEHAVIORAL, HEALTH, RURAL URBAN
MEDICAL STUDENTS RESIDENCY
PROGRAMS, ALL OF THOSE WIC
PROGRAMS THAT WE'RE TRYING TO
SERVE THESE VULNERABLE
COMMUNITIES. ALL TOTAL 109,000
PATIENTS, 500,000 VISITS AND
2348 EMPLOYEES. IF WE MAKE THIS
OPTIONAL CHOICE, WHAT WILL WE
CUT TO KEEP OUR BUDGET?
RESPECTFULLY URGE A NO VOTE ON
SENATE BILL 10 14. THANK YOU.
PAIGE CAN YOU HEAR ME? YES OKAY
. GOOD. UM MY NAME IS MARCO
LIZARRAGA. AND I AM THE
EXECUTIVE DIRECTOR OF LIKE
OPORTO, CAMPESINA, THE
CALIFORNIA WE'RE STATEWIDE
ORGANIZATION SERVING THE FARM
WORKERS. WE CURRENTLY HAVE ABOUT
82 OFFICES THROUGHOUT THE STATE
, AND WE ARE LOCATED IN EVERY
ONE OF THE 32 MOST SIGNIFICANT
AGRICULTURAL COMEDIES. THE
NETWORK THAT I REPRESENT 1ST 140
, 53,000 PEOPLE AND 55,000 OF
THOSE ARE FARM WORKERS ON AN
AVERAGE YEAR. WE SERVE THE FARM
WORKER. PRIMARILY WITH
EMPLOYMENT AND TRAINING, BUT WE
HAVE MEETING OTHER SERVICES,
WHICH INCLUDE THE PLACEMENT,
EDUCATION, HOUSING AND OTHER
SUPPORTIVE SERVICES WE OPPOSE
HAS BEEN 10 14 BECAUSE BY
STATINGTHAT TO RECEIVE THE
FUNDING THE CLINICS OR THE FUH
CHEESE QUALIFIED HEALTH CENTERS.
HAVE TO PARTICIPATE IN THE LABOR
MANAGEMENT COOPERATION COMMITTEE
EXCLUSIVE ABOUT 93% OF THE
CLINICS. OF FEDERALLY QUALIFIED
HEALTH CENTERS HAVE A PATIENT
MAJORITY BOARD AND IN SOME
INSTANCES, A FARMWORKER MAJORITY
BOARD. THESE BOARDS ARE
SPECIALIZED IN SERVING THEIR
RURAL POOR BY IDENTIFYING THEIR
SPECIFIC MEDICAL NEEDS AND
INVESTING RESOURCES IN THESE
AREAS AS 10 14 TAKES AWAY THAT
DISCRETION FROM THESE BOARDS
THAT HAVE A FARMWORKER MAJORITY
AND GIVES IT TO A LABOR
MANAGEMENT COOPERATION
COMMITTEE. WHICH DO NOT HAVE THE
EXPERTISE TO SERVE THE RURAL
POOR. IT'S BEEN TEMPERED 14
BENEFITS FEDERAL QUALIFIED
HEALTH CENTERS THAT ARE IN SOME
URBAN AREAS. AND EXCLUDES RURAL
AREAS AND THE MAJORITY OF THE
URBAN AREAS. ALSO WE SERVED MANY
COMMUNITIES THROUGH AN APPLE
VALLEY THROUGH SUN ALL MY
THROUGH IMPERIAL VALLEY,
COACHELLA VALLEY SALINAS VALLEY.
THE CENTRAL VALUE FRESNO.
INCLUDING SACRAMENTO. I
RESPECTFULLY ASK FOR A NO VOTE.
THANK YOU. ARE THERE OTHERS IN
OPPOSITION TO THE BILL, PLEASE
COME FORWARD. JUST YOUR NAME ND
ORGANIZATION IF YOU REPRESENT
ONE. GOOD AFTERNOON CHAIR AND
MEMBERS, ALEJANDRO SOLIS ON
BEHALF OF THE FOLLOWING
COMMUNITY GROUPS ALSO VALLEY, A
MONASTERY COMMUNITY COUNSELING
SERVICES. FARMWORKER INSTITUTE
OF EDUCATION AND LEADERSHIP
DEVELOPMENT FIELD. ASSOCIATION
IMMIGRANT IS GUATEMALA TACOS ALL
IN OPPOSITION TO SP 4, 10 14.
THANK YOU. THANK YOU. AND WE
HAVE CALIFORNIA HUMAN
DEVELOPMENT CENTER FOR
EMPLOYMENT AND TRAINING. MENCIUS
IN OPPOSITION TO SB 10 14. THANK
YOU. I'M AMERICAN MARTINEZ ON
BEHALF OF RODEOS. CONSIDER THE
COUNTY GUATEMALA. GUATEMALA
TECOS IMMIGRANT OPPOSITION TO SB
10 14. THANK YOU. HELLO IDA
DONNIE DARKO ON BEHALF OF
CALIFORNIA HEALTH PLUS ADVOCATES
AND THE CALIFORNIA PARTNERSHIP
FOR HEALTH OPPOSED UNLESS
AMENDED. THANK YOU. WHEN I
STARTED THIS FERNANDO PRESIDENT%
AND CASA DEL TACO AND OPPOSITION
LAPTOP WEST, I SAID, CUT OFF!
THANK YOU. CINDY HILLARY ON
BEHALF OF THE CALIFORNIA MEDICAL
ASSOCIATION. OPPOSING LESS
AMENDED. THANK YOU. THANK YOU.
MR CHAIRMAN MEMBERS DUNCAN
MCFEATTERS, REPRESENTING
ULTIMATE HEALTH SERVICES. THANK
YOU. ANYONE ELSE? SEE, NO ONE
WILL BRING IT BACK TO THE
COMMITTEE FOR QUESTIONS OR
COMMENTS FROM THE COMMITTEE, DR
WEBBER GOOD AFTERNOON AFTERNOON
, EVERYONE. THANK YOU SO MUCH.
UM, I DO HAVE A COUPLE OF
QUESTIONS. I MEAN, ARE FEDERALLY
QUALIFIED HEALTH CENTERS DO SUCH
IMPORTANT WORK IN OUR
COMMUNITIES. I MEAN, THEY'RE
REALLY THERE, TOO. FILL IN THE
GAPS FOR THE PEOPLE THAT OFTEN
NEED MEDICAL SERVICES. THE MOST
, UM, THEY'RE THERE TO DO
PREVENTATIVE CARE THERE THERE,
TOO. MANAGE PATIENTS WHEN THE
SPECIALISTS ARE SO FAR AWAY THAT
THEY CAN'T GET TO THEM. I MEAN,
EVEN IN IN CITIES LIKE MINE IN
SAN DIEGO, WE COUNT ON OUR
FEDERALLY QUALIFIED HEALTH
CENTERS FOR A LOT FOR A LOT OF
OUR UNDERSERVED PATIENTS, SO
UNDERSTANDING THE IMPORTANCE OF
WHAT THEY DO AND THEIR
SIGNIFICANCE AND, YES, MEDICAL
REIMBURSEMENT RATES ARE WAY TOO
LOW. IT IS SOMETHING THAT WE
HAVE TO ADDRESS HERE. WITHIN THE
STATE OF CALIFORNIA, BUT
UNDERSTANDING THAT WHY WOULD WE
TIE THIS PROGRAM INTO THE
REQUIREMENT TO PARTICIPATE. IN
AN L. M C. C WHY ARE WE LINKING
THAT? WHY IS THAT A REQUIREMENT
FOR THIS FOR THESE FUNDS? I
THINK THE ANSWER THE QUESTIONS.
FIRST OF ALL, IT'S YES, IT'S
LINKED IN TERMS OF REQUIRED THE
FUNDS. THE PROGRAM IS VOLUNTARY
, SO YOU DON'T HAVE TO DO
OTHERWISE, I WOULD SUGGEST AND
IT WITH RESPECT TO SOME OF THE
OPPOSITION OF THE MORE RURAL
AREAS. I THINK HE MADE THE WRONG
ASSUMPTION. I'LL GET TO THE CORE
OF YOUR ISSUE AND SECOND THAT
SOMEHOW YOU HAVE TO HAVE LIKE
EACH ONE PER CLINIC. IT'S NOT
THE CASE THAT COULD BE REGIONAL
NUMBER ONE AND THEY'RE NOT, YOU
KNOW, AND SO IN THE FOLKS ARE
NOT ALL UNIONIZED. THE OTHER
FOLKS THAT ARE PART OF THIS I
THINK THE NOTION IS UM, IN TERMS
OF DELIVERING SERVICES YOU WHEN
YOU LOOK AT THIS, YOU'VE GOT
REPRESENTATIVES WHO ARE IN THE
CLINICS OR FRONTLINES RIGHT
WHERE THE ORGANIZED LABOR OR
OTHERWISE, AND THEY PARTICIPATE
IN PROVIDE ADVICE AND COUNSEL IN
TERMS OF ADDING AN ADDITIONAL
VOICE TO THE DOCTORS AND THE
ADMINISTRATORS AND EVERYBODY
ELSE THAT MAKES THOSE THOSE
DECISIONS RIGHT? AND SO WHAT? WE
WHAT YOU'RE SAYING HERE IS.
LOOK, YOU KNOW, OKAY, WE'VE GOT
A VERY SIGNIFICANT PROBLEM THAT
PEOPLE UNDERPAID. WE HAVE A VERY
IMPORTANT DELIVERY SERVICE FOR
YOU KNOW FOR HEALTH IN
UNDERSERVED COMMUNITIES WHERE
THIS IS, AS YOU KNOW, DR. THIS
IS CRITICALLY IMPORTANT AND WE
THINK THAT HAVING, UM WORKERS
NOT ALL UNIONIZED ISN'T REQUIRED
. HAVE A VOICE. IT DOESN'T. THE
THING THAT'S MISUNDERSTOOD IS
TWO THINGS THAT I'VE HEARD IN
THE OPPOSITION. I THINK OUR
MISUNDERSTANDING THIS IS ONE
THAT SOMEHOW YOU HAVE TO HAVE
EACH ONE FOR EACH CLINIC THAT
COULD BE COOPERATIONS AMONG
REGIONS. SO WHEN YOU HAVE RURAL
AREAS, YOU MIGHT HAVE A DOZEN
CLINICS THEY CAN COME TOGETHER
IN AN AREA JUST WITH THE LAW
SAYS HERE IS THAT THE COMMITTEE
CONSISTS OF REPRESENTATIVES OF
THE CLINICS LOCATED IN THE STATE
, YOU KNOW NOT NOT TO BE
UNIONIZED DON'T HAVE TO BE FROM
FROM THERE, BUT I THINK IT'S
ABOUT GIVING THEM A VOICE. AND I
THINK YOU KNOW WHEN YOU ONE OF
THE GREAT CHALLENGES THAT WE
FIND IN GOVERNMENT ALL OVER THE
PLACE, AND I'VE SEEN THIS
EXPERIENCE OF MYSELF. IS THAT WE
DON'T LISTEN TO THE FOLKS ON THE
FRONT LINES, THE OTHER PEOPLE
THAT ARE PROVIDING THE SERVICES
TO ASK YOU TO PUT FOLKS IN TO
HELP, YOU KNOW, GIVE GUIDANCE
AND ADVICE. YOU HAVE TO TAKE THE
ADVICE. THEY DON'T AFFECT THE
MANAGEMENT OF THE ORGANIZATION.
BUT IT'S ADDING THAT DIMENSION
WHICH WE THINK IS IMPORTANT IN
TERMS OF DELIVERY OF SERVICES,
ALONG WITH THE $25 AN HOUR, IT
DOESN'T HAVE TO BE GIVEN UNTIL
THREE MONTHS AFTER YOU RECEIVE
THE MONEY CRITICAL POINT. HOPE
THAT HELPS YOU UNDERSTAND THE
LEAST MY POINT OF VIEW. NO I, UM
I COMPLETELY AGREE WITH HAVING
WORKERS VOICES AT THE TABLE AND
I COMPLETELY AGREE WITH PEOPLE
UNIONIZING IF THEY CHOOSE TO.
I'M JUST NOT UNDERSTANDING WHY
WE'RE LINKING THIS MONEY TO THE
REQUIREMENT FOR THE FOR THE
UNIONIZATION, WHICH IS A PART OF
THE L M. C C. BECAUSE I THINK
YOU CAN. YOU CAN HAVE WORKERS AT
THE TABLE WITHOUT HAVING THAT
REQUIREMENT FOR UNIONIZATION, SO
I JUST DIDN'T I JUST IN MY HEAD.
I JUST DON'T SEE WHY WE'RE
TRYING TO LINK IT TO THE OTHER
QUESTION THAT I HAVE IS, UM I
GUESS THE DEALS AROUND THE MATH
THAT WAS BROUGHT UP. SO UM. IF
THIS IS SOMETHING THAT HAS TO BE
ALLOCATED THROUGH THE THROUGH
OUR FUNDS THROUGH THE BUDGETARY
PROCESS. LET'S SAY THAT, YOU
KNOW, WE'VE GOT 75 MILLION AND
THERE'S A MIRACLE THAT WE DO GET
A BILLION THIS YEAR. LET'S JUST
SAY THAT OKAY. WHAT HAPPENS NEXT
YEAR? I MEAN, AND THEN YOU'VE
HIRED PEOPLE AT A $25 A RATE OR
YOU CAN'T LIKE, TAKE THEIR
SALARIES BACK. SO THEN YOU HAVE
TO START CUTTING RESOURCES.
THAT'S RIGHT. DO I THINK YOU
KNOW, UH, SOMEBODY REMEMBER
CARILLO IS DOING THE BUDGET
REQUEST. WE HAVE 75 MILLION SO
FAR IN MY EXPERIENCE IN IN THIS
PROCESS THAT THERE'S PROBABLY
GOING TO BE A BUDGET BILL JR.
WHERE THEY WILL BE CONTINUED
NEGOTIATIONS ON THESE THINGS.
BUT IF YOU LOOK AT AT BUDGETING
THROUGHOUT CALIFORNIA, RIGHT, WE
HAVE THIS PROBLEM EVERYWHERE. WE
HAVE IT AT THE UNIVERSITIES THAT
AREN'T SUBJECT TO PROP 98. EVEN
WITH PROPER 98 WITH THE MONEY
GOES DOWN. WE HAVE A HORRIBLE
SYSTEM OR UP AND DOWN. THE ISSUE
OF SYNC. ONE TIME BUDGET FUNDING
91% OF THIS BUDGET, I BELIEVE IN
MY RECOLLECTION IS CORRECT FROM
READING THE GOVERNOR GOVERNORS
BRIEFING DOCUMENTS ARE ONE TIME
DOLLARS. SO WE HAVE ALL THIS
MONEY. IT'S ONE TIME MONEY. WHAT
HAPPENS WITH THE PARKS? WHAT
HAPPENS WITH FOSTER CARE WHAT
HAPPENS WITH ALL OF THESE OTHER
THINGS? WE HAVE THE SAME
CHALLENGE? ARE WE AS
POLICYMAKERS GOING TO SAY WELL,
LET'S WE'VE GOT THIS HORRIBLE
SITUATION, OR ARE WE GOING TO
COME AND TRY TO PUSH AND COME UP
WITH EVERY WAY POSSIBLE WITH
CREATIVE WAYS TO MAKE STUFF
HAPPEN? AND TO HANDLE PEOPLE WHO
ARE SICK TODAY? YES THAT'S A
PROBLEM. YES MEDICAL RATES ARE
LOW TAX RATES GO DOWN. WE'RE
GOING TO BE EVEN WORSE SHAPE. IF
THE DOWNTURN HAPPENS THAT I'VE
BEEN THROUGH A FEW OF THEM IN MY
TIME AROUND THIS CAPITAL, IT'S
PRETTY UGLY. AND SO, YOU KNOW, I
THINK THAT THE ANSWER TO THE
QUESTION IS THE SECOND PIECE OF
IT IS. I THINK IT'S IMPORTANT
UNDERSTAND IS WHAT WE'RE TRYING
TO DO. IN ADDITION, THE GOAL
HERE WAS WITH ASSEMBLYWOMAN. UH
CARILLO WAS 400 MILLION IN THE
BUDGET REQUESTS. MARRIED WITH
THIS BILL, WHICH WOULD THEN HELP
US LEVERAGE. ANOTHER 600 MILLION
GOING TO YOUR BILLION DOLLARS
FOR FEDERAL DOLLARS. WE HAVE A
GOOD RELATIONSHIP WITH THE
FEDERAL ADMINISTRATION. AT LEAST
FOR NOW. I HOPE THE GROUP'S
GOING ON THAT WAY. AND WE FIGHT
THE FIGHT, BUT I DON'T THINK
THAT WE MAKE DECISIONS IN
GOVERNMENT BECAUSE WE DON'T HAVE
THE LONG TERM REVENUE STREAM.
ALTHOUGH IT'S A CRITICALLY
IMPORTANT POINT THAT YOU RAISE
AND THE LAST THING I WANT TO
SHARE IS THAT 93% THAT WAS
MENTIONED WITH RESPECT TO THE
OPPOSITION IF I COULD, DOCTOR DR
ASSEMBLYWOMAN, YOU'RE BOTH DR
PAN MAKES THIS CONTRACTOR SO, UM
, BUT ANY EVENT THE IT'S ALL
VOLUNTARY, RIGHT? AND OBVIOUSLY
IF YOU RUN OUT OF MONEY, YOU RUN
OUT OF MONEY, BUT WE'RE TRYING
TO GET AS MANY PEOPLE HIRED AT
$25 AN HOUR AS POSSIBLE TO HELP
AS MANY PEOPLE AS POSSIBLE AND
HOPEFULLY IF WE CAN MAKE A
WONDERFUL SHOWING THAT IT'S
WORKING IN THE IMPACT ON THE
COMMUNITY IS GREAT. WE'VE GOT A
BASIS TO CONTINUE THIS AND
HOPEFULLY MAKE IT EVEN GO A
LITTLE HIGHER BECAUSE WHAT I
TOLD YOU, AT LEAST IN THE
COMMUNITY THAT I REPRESENT LOS
ANGELES THAT'S NOT ENOUGH TO
AFFORD A TWO BEDROOM APARTMENT.
I DEFINITELY APPRECIATE THE
EFFORT AND I APPRECIATE YOU
ANSWERING MY QUESTIONS TODAY. UM
I AM CONCERNED ABOUT WHAT WOULD
THE FUTURE TAKE? BECAUSE YES, WE
WANT TO IMPROVE THINGS TODAY,
BUT WE ALSO WANT TO MAKE SURE
THAT WE HAVE THE ABILITY FOR
THOSE THINGS TO BE LONG LASTING.
AND YOU KNOW, I AM CONCERNED
WITH THE FACT I GUESS YOU'VE
ASKED HER FOR 400 MILLION, BUT
WE'VE GOT 75. SO FAR. THESE
DISCUSSIONS ABOUT WHAT OUR
FINANCIAL FUTURE IS IN
CALIFORNIA IS NOT NECESSARILY AS
BRIGHT AS WE WOULD LIKE IT TO
BE. UM AND SO I'M JUST CONCERNED
ABOUT WHAT WOULD HAPPEN TO OUR
FEDERALLY QUALIFIED HEALTH
CENTERS IF THEY'VE HIRED THESE
UM INDIVIDUALS AT A HIGHER RATE
, AND THEN WE DON'T HAVE THE
FUNDS NEXT YEAR OR WE DON'T GET
ALL THE FUNDS THIS YEAR. YEAH
WHAT WOULD HAPPEN MORE? JUST AS
IMPORTANTLY TO THOSE COMMUNITIES
THAT THEY SERVE, AND ONE MORE
THING HERE IS YOUR QUESTION.
BACK IN 2000 OR 2000 AND ONE UM. WE WE AS A CARCASS OF THIS OF
YOUR HOUSE MADE A PRAYER. WE HAD
THREE PRIORITIES. ONE OF OUR
PRIORITIES WAS CLINICS,
COMMUNITY CLINICS, SAME KIND OF
REASON AND AT THAT TIME WE ASKED
GOVERNOR, UM TO GIVE US $50
MILLION AND WE GOT IT.
UNFORTUNATELY ONE TIME RIGHT? WE
HELP PEOPLE WE HELP THE
COMMUNITY. WE WEREN'T ABLE TO DO
IT BECAUSE THE FOLLOWING YEAR WE
HAD A DOWNTURN, BUT WE GOT $50
MILLION PER COMMUNITY CLINICS,
WHICH WAS A GREAT THING, AND SO
IT IS CHALLENGING. I DON'T
DISAGREE WITH YOU. BUT HOPEFULLY
I WOULD SUGGEST THAT IF THIS IS
PROVEN TO BE EFFECTIVE, UM THAT
THIS BECOMES A BIGGER PRIORITY
AS WE GO FORWARD AS WE SHOW THAT
WE CAN SERVE THE COMMUNITY, VERY
COST EFFECTIVE MANNER. ON THE
FRONT. AND PEOPLE THAT NEEDED.
THE MOST. THAT'S HELPFUL. THANK
YOU SO MUCH FOR ANSWERING MY
QUESTIONS AND INDULGING ME. OF
COURSE I YOU KNOW, I HOLD OUR
FEDERALLY QUALIFIED HEALTH
CENTERS TO THE UTMOST RESPECT.
TRAINED IN COMMUNITY CLINIC.
COMMUNITY HAS. AND I WORKED IN
COMMUNITY HOSPITALS. IT DOES
SPEAK VOLUMES TO ME, THOUGH,
THAT MY AREA. SAN DIEGO IS AN
OPPOSITION TO THIS BILL, AND SO
I JUST URGE YOU TO CONTINUE TO
WORK WITH THEM TODAY. I CANNOT
SUPPORT IT. UM, BUT I DO YOU
KNOW? GOD AND THANK YOU SO MUCH
FOR WORKING WITH THEM. THANK YOU
KINDLY. HEY MISS WALDRON'S YOU
HAVE A QUESTION, COMMENT. JUST
JUST A COMMENT. REALLY? UM MY
DISTRICT IS VERY RURAL. IN FACT
, AND I KNOW I'VE SAID THIS
BEFORE IT CONTAINS TWO OF THE
LOWEST INCOME CENSUS TRACTS IN
THE NATION. WOW, I ALSO MY NEW
DISTRICT WITH REDISTRICTING
INCLUDES LA MESA, AND I'M VERY
FAMILIAR TO SEND YOUR SEED YOUR
HEALTH AS WELL AS THE GOOD WORK.
YOU DO. UM WE'VE DONE A LOT OF
SUPPORT FOR FARM WORKERS IN MY
DISTRICT CURRENTLY AND WHEN I
WAS ON THE CITY COUNCIL IN
ESCONDIDO UM AND WHAT WE SAW
WITH COVID. THEY IMPACTS TO THE
HEALTH CLINICS AS WELL AS FARM
WORKERS AND LOW WAGE WORKERS. UM
WE'RE VERY MUCH IMPACTED. WHEN
WE LOOK AT RURAL AND THESE LOW
INCOME COMMUNITIES, ESPECIALLY
THAT I REPRESENT THERE'S MANY
CHALLENGES, INCLUDING FOOD
SHORTAGE, UNEMPLOYMENT. UM LOTS
OF HEALTH DISPARITIES THAT WE
TALKED ABOUT A LOT AND ARE
MAINLY SERVED BY THE FQ HCS. UM,
SO MY CONCERN IS THAT WE'RE
GOING TO CREATE A BIGGER HEALTH
DISPARITY BECAUSE A LOT OF THIS
FUNDING WILL GO TO AREAS LIKE L
. A AND FRANCISCO ETCETERA. AND
IF THERE WAS A WAY THAT FUNDING
COULD GO TO ALL OF THEM WITHOUT
THESE CAVEAT OF HAVING TO
UNIONIZE, I THINK IT WOULD BE
MORE FAIR. GETTING THE TRAINING
THAT'S NEEDED GETTING THE
SUPPORT THAT'S NEEDED TO THE FQ
HCS ALL ALL OVER, ESPECIALLY IN
THE RURAL LOW INCOME AREAS.
THANK YOU. ANYONE ELSE HERE?
CARRIE? SURE, JUST QUICK LIKE.
LITTLE FRUSTRATED BECAUSE I WAS
HOPING, HOPING I WOULD SEE CPC A
IN MY OFFICE TO CLARIFY SOME
QUESTIONS THAT I HAD BUT
NEVERTHELESS IS THE. SITUATED CS
HAVE BEEN INCREDIBLE IN MY
DISTRICT, AND I'VE ALWAYS
SUPPORTED THEM. UM I UNDERSTAND
YOUR MATH. MATH IS GOOD. IT'S
TERRIFYING OF WHAT'S GOING COULD
HAPPEN. BUT I'M GOING TO HAVE A
LITTLE BIT OF HOPE HERE. THAT
THE SENATOR WILL CONTINUE TO
WORK WITH YOU ALL. UM AND
HOPEFULLY GET SOME MORE FUNDING.
I'M GOING TO, UM, SUPPORT YOU
TODAY. HOWEVER UH, IF WE CAN'T
GET THIS CLEANED UP BEFORE IT
COMES TO THE FLOOR. I WOULD
PROBABLY RECONSIDER SENATOR
OKAY, ANYONE ELSE? UM. JUST A
COMMENT, UM, SO IN MY DISTRICT,
WHICH IS A RURAL DISTRICT AS
WELL, UM, ABOUT HALF OF THE
HEALTHCARE DELIVERED TO MY
CONSTITUENTS COMES TO FEDERALLY
QUALIFIED HEALTH CENTERS OR
RURAL CLINICS. UM. ONE OF THE
BIGGEST CHALLENGES WE FACE IS
OUR AROUND PROVIDERS, DENTISTS,
PHYSICIANS. AH MENTAL HEALTH
PROVIDERS, UM AND SO WITHOUT
THOSE KEY PROVIDERS, YOU CAN'T
NECESSARILY HAVE THE ABILITY TO
HIRE ADDITIONAL SUPPORT STAFF,
SO WHEN I GO TO THE CLINICS, AS
I DID JUST A COUPLE OF WEEKS AGO
AND MET WITH THE DENTIST AT THE
CLINIC, SAID ONE A BIG
CHALLENGES IS IT'S JUST ME, HE
SAYS. WE NEED TWO MORE OF ME.
WHEN I MEET WITH THE DOCTORS,
IT'S JUST ME. WE NEED TWO MORE
OF ME. AND SO WHAT? I'M GOING TO
SUPPORT YOUR BILL TODAY, BUT
THIS DOESN'T ADDRESS ONE OF THE
REAL REASONS. THAT WE HAVE
CHALLENGES IN DISPARITY IS THAT
WE CAN'T GET THE PROFESSIONAL
PROVIDER OR THE HIGHER LEVEL
PROVIDER THAT THAT OVERSEE. UM
ALL THE INCREDIBLY IMPORTANT
PEOPLE THAT PROVIDE SERVICES IN
THE SUPPORT IN A SUPPORTING ROLE
AS WITHOUT THOSE KEY PROVIDERS,
IT'S REALLY DIFFICULT. TO
COMPLETELY STAFFED CLINICS AND I
, YOU KNOW, I DON'T KNOW IF
THAT'S HAPPENING IN ANOTHER MAN,
YOU KNOW OTHEROTHER PARTS OF
THE STATE, BUT IT'S TOUGH TO GET
DOCTORS CLINICS, AND IT'S TOUGH
TO GET DENNIS AND DENTAL
HYGIENISTS AND UM, THAT THAT ARE
PROVIDING PRIMARY CARE TO FOLKS
SO I WILL SUPPORT YOUR BILL
TODAY. UM UM, BUT I M THAT IS
THE CHALLENGES ARE NOT ARE
DIFFERENT BASED ON THE GEOGRAPHY
AND THE ECONOMICS OF THE AREAS
THROUGHOUT THE STATE. IT'S A BIG
, VERY, VERY DIVERSE STATE. SO
WHAT MIGHT WORK GREAT FOR YOU IN
LOS ANGELES? I DIDN'T DO DIDDLY
FOR ME IN THE NORTH COAST.
BECAUSE OF THE DIFFERENCE IN THE
DIFFERENCE IN THE CHALLENGES WE
FACE. SO WOULD YOU LIKE TO
CLOSE? THANK YOU, UM I WANT TO
START OUT BY DRESSING DIDDLY
BECAUSE YOU KNOW, BASICALLY BY
ME, MAKING THE POINT OF $39 AN
HOUR IN LOS ANGELES. YOU KNOW, I
DON'T KNOW WHAT WHAT? $25 AN
HOUR HELPS WITH FOLKS IN THE
COMMUNITIES THAT YOU REPRESENT,
BUT I SUSPECT IT'S PROBABLY
BETTER THAN LOS ANGELES. SO AT
LEAST IT'S WE'RE NOT GOING AS
FAR AS WE SHOULD. BECAUSE IF IT
WAS ME, I'D GO TO BILLION
DOLLARS AN HOUR. UM BUT BUT I
WANT TO SEE THIS THING AND
YOU'RE RIGHT. IT'S KIND OF A
CHICKEN AND EGG PROBLEM, MR
CHAIRMAN. WHAT DO WE DO? WE DO.
WE DON'T HAVE PEOPLE WHO WORK IN
CLINICS BECAUSE THEY'RE NOT
THERE. WE SEE WHAT THE TURNOVER
RATE IS. I GAVE YOU THAT DATA ON
MY OPENING. WE SEE WE GOT THIS
SIGNIFICANT PROBLEM. WE SEE THAT
WE HAVE UM, THESE CLINICS BEING
HUGELY IMPORTANT THAT WE ALL SEE
IN OUR RESPECTIVE COMMUNITIES
FROM BEING THERE AND
REPRESENTING THEM IN PROVIDING
THE SERVICES AND THERE'S A
NUMBER OF COMPONENTS WOULD
PROVIDE THE CHALLENGES OF WHAT
WE'RE TRYING TO ACCOMPLISH. AND
WHAT WE'RE DOING IN THIS BILL IS
TO AT LEAST TRY TO GET ENOUGH
MONEY ON THE TABLE TO GET FOLKS
TO WORK. AND MAYBE AS A RESULT
OF HAVING MORE FOLKS BECAUSE
MAYBE YOU KNOW IT'S THE DOCTORS.
YOU GUYS COME IN, AND YOU DON'T
HAVE ASSISTANCE AND PEOPLE TO
HELP YOU AND DO ALL THE OTHER
WORK. CRITICAL TO THE
FUNCTIONING OF THE CLINIC. AND
SO WHAT'S THE DIFFERENCE? IF YOU
HAVE AN EXTRA DOCTOR OR AN EXTRA
DENTIST, OR YOU KNOW,
PROFESSIONAL, SO IT IS THE
ARCHITECTURE OF THE LARGER
PROBLEM. I THINK WHAT'S
IMPORTANT HERE? IS THAT WE'RE
ADDRESSING AND I THINK A NEW
WAY. YES, IT'S A LITTLE
DIFFERENT. UM BUT BUT THAT THAT
IS AT LEAST A GIANT STEP
FORWARD, AND I DO AGREE THAT WE
NEED A LOT MORE DOUGH. A LOT
MORE MONEY, AND I WISH THAT THEY
WE WERE ABLE TO STRIKE AN
AGREEMENT THAT WE HAD MORE
MONEY. AND FOR THOSE WHO KNOW
ME, THEY KNOW THAT I'M NOT GOING
TO STOP AND THEY KNOW THE
ASSEMBLY CAREER IS NOT GOING TO
STOP AND WE'RE GOING TO CONTINUE
TO MAKE THIS CASE BECAUSE WE
THINK IT'S A JUST CASE. BECAUSE
DOLLAR FOR DOLLAR THE BENEFITS
OF THESE COMMUNITY CLINICS IN
TERMS OF PROVIDING HEALTH CARE
SERVICES TO FOLKS IS JUST
NOTHING LESS THAN EXTRAORDINARY
. SO WE THINK IT'S A RIGHT IN
JUST CAUSE. UM AND WE THINK THAT
THE IDEA OF HAVING WORKERS
PARTICIPATE IN THE LARGER
DECISIONS IS A GOOD THING AND
AGAIN, YOU KNOW, ONE OF THE
REASONS WHY I DECIDED TO CARRY
THIS BILL. AND I JUST CLOSE
HERE. I MADE THIS POINT BEFORE,
BUT I'M ALWAYS FRUSTRATED BY
THESE RED THINK GOVERNMENT
PROGRAMS THAT SAY WE'RE GOING TO
DO THIS, AND WE'RE GOING TO DO
THAT. BUT THEN YOU NEVER GET THE
MONEY. IT'S HORRIBLE. YOU DON'T
HAVE TO START PAYING PEOPLE
UNTIL THREE MONTHS AFTER YOU GET
THE MONEY. YOU DON'T HAVE TO
START PUTTING TOGETHER THE
COOPERATION WITH THE LABOR
COMMITTEES UNTIL AFTER YOU GET
THE MONEY, SO IT DOESN'T AT
LEAST HARM PEOPLE. AND FOR THOSE
THAT ARE UNIONIZED OR NOT
UNIONIZED. IT DOESN'T HOW YOU
HAVE TO DO SO YOU HAVE TO WORK
WITH PEOPLE WHO HAPPEN TO BE A
MEMBER OF THE UNION. OKAY BUT
BALANCE THAT AGAINST THE
COMMUNITY BENEFIT BALANCE THAT
AGAINST THE BENEFIT TO EACH OF
THE WORKERS WHO NOW CAN HAVE A
DECENT WAGE TO BE ABLE TO WORK
IN THESE CONDITIONS THAT HAVE
BEEN RIDICULOUSLY HARD DURING
THE PANDEMIC. WITH THAT I ASK
FOR YOUR VOTE. THANK YOU VERY
MUCH. SENATOR WE HAVE A MOTION
BY MR RODRIGUEZ. DO WE HAVE A
SECOND? I WILL. SECOND. THE BILL
. UM MADAM SECRETARY OF THE
MOTION IS DUE PASS AS AMENDED TO
APPROPRIATIONS AND SECRETARY
PLEASE CALL THE ROLL. WOULD
WOULD I? WALDRON, WALTER NÓ.
AGUIAR-CURRY AGUIAR-CURRY. AYE,
ARAMBULA. BIGELOW. CARILLO. FOR
A. MAIENSCHEIN MAZE. MCCARTY,
NAZARIAN RIVAS RODRIGUEZ.
RODRIGUEZ? AYE. SANTIAGO WEBER.
WHETHER OR NOT VOTING. 321 BILL
IS 31 WILL LEAVE THE BILL ON
CALL. UM WE WILL NOW BE MOVING
INTO OUR SPECIAL ORDER OF
BUSINESS. AS WITH PEOPLE
GATHERING, LIKE TO JUST SENATOR
AMBURG HAVE MADE COMING UP. WELL
DR GHALI AS WELL, IT'S GOING TO
MAKE. I JUST WANT TO MAKE SOME
COMMENTS HERE BRIEFLY. SO TODAY
IS LIKELY THE LAST ASSEMBLY
HEALTH COMMITTEE OF THE YEAR AND
I'D LIKE TO TAKE A MOMENT TO
REFLECT ALL THE GOOD WORK THAT
WE HAVE DONE THIS YEAR AND IN
PAST YEARS THAT HAVE MADE THIS
POSITION OF BEING THE CHAIR SO
REWARDING PROVIDING ALL
CALIFORNIANS WITH ACCESS TO
QUALITY. AFFORDABLE HEALTH CARE
HAS BEEN MY GUIDING LIGHT.
COULDN'T DO THIS WORK WITHOUT
THE AMAZING STAFF THAT I HAVE.
IT'S TRULY A TEAM EFFORT. AND I
THINK THAT EVEN DURING CRUNCH
TIMES, WE GET IT DOWN WITH A LOT
OF HUMOR AND ONLY A TINY BIT OF
DRAMA. OUR CONSULTANTS WORK FOR
THE HOUSE. SUPPORTING ALL THE
OFFERS, UH, WHEN THE OBJECTIVE
EVALUATION OF LEGISLATION JUST
MENTION SOME OF THE WORK WE'VE
DONE TOGETHER SCOTT BAIN, WHO
YOU DON'T SEE UP HERE TODAY. UM
UM, PROBABLY HE'S REINVENTING
MEDICAL AS WE SPEAK. I SUSPECT,
UM, TO SAY THAT SCOTT
UNDERSTANDS THE INTRICACIES OF
GOVERNMENT PROGRAMS IS TRULY AN
UNDERSTATEMENT. IF ANYONE EVER
TRIED TO PULL THE WOOL OVER
SCOTT'S EYES, YOU HAVE NO DOUBT
EXPERIENCE FAILURE. CALIFORNIANS
HAVE BENEFITED FROM ALL HIS WORK
. ALL THIS WORK THROUGH IT,
INCLUDING HIS TIRELESS WORK ON
THE IMPLEMENTATION OF CALLUM
CALLUM. CHRISTINE MONOPOLY IS
OUR HEALTH INSURANCE AND MEDICAL
PRIVACY GURU. TOGETHER WE WORKED
ON LEGISLATION TO LEVERAGE THE
BY BROADENING SUBSIDIES, MAKING
COVERAGE MORE AFFORDABLE AND
LOOKED FORWARD TO CREATE A
STATEWIDE HEALTH INFORMATION
EXCHANGE. LARA FLYNN TAKES ON A
GOOD DEAL OF LEGISLATION
COVERING ISSUES THAT HAVE THE
POTENTIAL TO ABOUT PASSION AND
CONTROVERSY BY MANY PEOPLE.
WE'VE MADE SIGNIFICANT PROGRESS
ON IMPROVING CARE FOR RESIDENTS
AND SKILLED NURSING FACILITIES,
PROTECTING A WOMAN'S RIGHT TO
CHOOSE PROTECTING END OF LIFE
DECISIONS AND FIGHTING YOUTH,
TOBACCO AND VAPING USE AND MUCH
MORE. JUDY BABCOCK. COVERS
ISSUES THAT ARE VERY IMPORTANT
TO SOME OF OUR MOST VULNERABLE
CALIFORNIANS. TOGETHER. WE'VE
ADVANCED ACCESS TO MENTAL
HEALTH. SUBSTANCE USE DISORDER
PROGRAMS BETTER REGULATED
OPIOIDS THROUGH E PRESCRIBING
ADDED ACCESS TO NALOXONE
EVALUATED THE PARTICULARS AND
CHALLENGES OF APPLYING THE
LETTERMAN'S PETRUS SHORT ACT.
WE'RE GONNA TALK A. LITTLE BIT
ABOUT THAT TODAY. I THINK ROSE
PALMA, NO CHIEF CONSULTANT.
OVERSEES ALL OF THESE EFFORTS
AND HAS TAKEN ON SOME OF THE
MOST ç
DRUG PRICING, UNIVERSAL HEALTH
CARE, PUBLIC HEALTH VACCINES
REGULATION OF PRESCRIPTION
BENEFIT MANAGERS. AND ALL
PLAYERS, ALL PAYER CLAIMS
DATABASE AND LAST, CERTAINLY NOT
THE LEAST SHE HAS SPENT MORE
THAN A YEAR ACTUALLY, MORE THAN
TWO YEARS NOW, WORKING WITH ME
ON THE OFFICE OF HEALTH CARE
AFFORDABILITY. SOMETHING WE
SHOULD BE VERY PROUD OF.
ULTIMATELY, I HOPE WHEN WE VOTE
FOR IT HMM. AND OF COURSE LAST
AND CERTAINLY NOT LEAST, UM, TO
MY LEFT HERE. THANK YOU, PADDY
RODGERS, ALL THE PREPARATION AND
WORK AND ORGANIZATION. YOU DO
HEAR APPLAUSE OUT THERE. YEAH
I'M GONNA GIVE YOU A CHANCE TO
DO THAT. UM UH, YOU'RE EDITING
YOUR EDITING SUPPORT AND YOUR
KNOWLEDGE OF ALL THE INS AND
OUTS OF THE SYSTEM. AND WHEN I
GET LOST UP HERE AND LOOK TO YOU
WITH THIS HORRIBLE, SHOCKED.
LOOK AT MY FACE OF WHAT THE HECK
NEXT YOU'RE ALWAYS CALM. YOU
KNOW WHAT? YOU KNOW WHAT THE
NEXT STEP IS, AND I APPRECIATE
THAT. AND MARSHALL MARSHALL. YOU
DON'T SEE HERE. HE HELPS US SET
UP AND HELPS US TAKE IT AWAY AND
HE'S HE'S THERE ALL THE TIME.
MARSHALL YOUR SUPPORT SUPPORT
YOUR COLUMN DEMEANOR. YOUR
WILLINGNESS TO HANDLE ALL THE
DUTIES THAT ARE REQUIRED MUCH
APPRECIATED ALL THE STAFF. AND
THOSE OTHER OF OTHER COMMITTEES
HAVE MADE MY ABILITY TO SHARE
THIS CAMILLA COMMITTEE COMMITTEE
. UM AND DO MY BEST WORK. I'M
GRATEFUL FOR ALL YOU FOR YOUR
EXPERTISE AND DEDICATION. THE
ASSEMBLY IS LUCKY TO HAVE ALL OF
YOU AND THIS COMMITTEE HEARS
MORE BILLS THAN ANY OTHER
COMMITTEE EXCEPT FOR
APPROPRIATIONS. AND THESE ARE
ALL SIGNIFICANT POLICY
COMMITTEE. BILLS HERE. I JUST
WANT TO THANK YOU, MY STAFF, THE
STAFF EVERYONE FOR THE
OPPORTUNITY TO WORK WITH YOU. UM
AND LET'S CONTINUE WORKING. SO
WITH THAT, THANK YOU. I DID THAT
NOW BECAUSE WE GET TO THE END OF
THE NIGHT HERE, LIKE EIGHT
O'CLOCK. THERE'S NOT GOING TO BE
ANYBODY OUT THERE. SO UM I
APPRECIATE IT. SO WITH THAT,
SENATORUMBERG, PLEASE. THE
FLOOR IS YOURS. THANK YOU. THANK
YOU, MR CHAIR AND MEMBERS. LET
ME JOIN THE CHORUS WITH RESPECT
TO THE ACCOLADES. UH CONSIDERING
YOUR STAFF. THANK YOU. AND THANK
IN PARTICULAR JUDY BADCOCK FOR
THE HARD WORK ON THIS EXTREMELY
IMPORTANT, BILL. I HAVE THE
PLEASURE TODAY OF PRESENTING SB
13 38 WITH MY JOINT AUTHOR
SENATOR EGGMAN, WHICH CREATES
THE COMMUNITY ASSISTANCE
RECOVERY AND EMPOWERMENT
PROGRAM. UH, THIS MEASURE IS
MOVING, UH AND IT IS IMPROVING.
IT PASSED THE SENATE WITH THE
UNANIMOUS BIPARTISAN VOTE. UM
AND IT IS A FRAMEWORK SPONSORED
BY THE GOVERNOR TO DELIVER
BEHAVIORAL HEALTH SERVICES TO
THE MOST SEVERELY IMPAIRED AND
IMPACT OF CALIFORNIANS. QUEEN
SEVEN AND 12,000 INDIVIDUALS,
BUT LET ME MAKE SURE THAT I
UNDERLINE THIS. WHILE THERE MAY
BE 7 TO 12,000 INDIVIDUALS THE
IMPACT OF THOSE WITH
SCHIZOPHRENIA AND SEVERE MENTAL
ILLNESS AS WELL BEYOND THOSE 7
TO 12,000 HARD TO RICHIE
INDIVIDUALS THAT INCLUDE THE
FAMILIES, THE COMMUNITY IT
IMPACTS LITERALLY HUNDREDS OF
THOUSANDS OF CALIFORNIANS TOO
OFTEN THOSE WITH SEVERE MENTAL
ILLNESS, LANGUAGE AND
HOMELESSNESS ARE INCARCERATION.
WITHOUT TREATMENT THEY
DESPERATELY NEED. THIS PROGRAM
IS A RESPONSE TO THE URGENT NEED
FOR PROVIDING THAT FRAMEWORK
THAT COMPREHENSIVE CARE,
MEDICATION AND HOUSING WE
RECOGNIZE THOSE ARE REALLY
IMPORTANT, PROVIDING ADEQUATE
HOUSING, PROVIDING ADEQUATE
PROFESSIONAL CARE REALLY
IMPORTANT IN TERMS OF REACHING
THOSE WHO ARE SEVERELY MENTALLY
ILL. UM THE JOURNEY FOR A FAMILY
WITH A FAMILY MEMBER WHO IS
MENTALLY ILL IS ONE OF
TREMENDOUS CONCERN. TREMENDOUS
ANXIETY. THE WHOLE FAMILY, UM,
IN MY OWN LIVED EXPERIENCE. I
HAVE LOOKED FOR A LOVED ONE AT
THREE IN THE MORNING WHEN WE
COULDN'T SLEEP BECAUSE WE DIDN'T
KNOW WHERE THAT PERSON WAS, UM
AND REALLY JUST LOOKING
ANYWHERE, ALMOST JUST TO DEAL
WITH OUR OWN ANXIETY. GETTING A
CALL. AND BEING GRATEFUL. IT'S
FROM THE POLICE VERSUS FROM
ANOTHER GOVERNMENTAL
INSTITUTIONS. UM WORRYING ABOUT
MEDICATION, WORRYING ABOUT
SOMEONE WHO BELIEVES THAT
THEY'RE FINE WHEN WE RECOGNIZE
THEY'RE REALLY NOT FINE. IT IS A
TREMENDOUS TREMENDOUS CHALLENGE
TO REACH THOSE IN THEIR FAMILIES
TO PROVIDE SUPPORT. LET ME JUST
MAKE IT CLEAR WHAT CARE COURT IS
AND IS NOT. IT IS A FRAMEWORK
FOR RECOVERY IS A FRAMEWORK FOR
STABILIZATION. IT IS NOT
CONSERVATIVE SHIP. IN FACT, IT
IS SOMETHING THAT WE HOPE. WOULD
MAKE SURE THAT WE DON'T PUT AS
MANY CALIFORNIANS INTO
CONSERVATORSHIP. IT IS TO MAKE
SURE THAT CONSERVATIVE SHIP IS A
LAST RESORT AND ABSOLUTELY LAST
RESORT. IT DOESN'T CREATE A
POWER TO ARREST. THIS IS IN THE
CIVIL COURTS. IT IS NOT A
CRIMINAL COURT, UM, CARE COURT
PARTICIPANTS CANNOT BE FORCED TO
PARTICIPATE. LAW ENFORCEMENT
WILL NOT ARREST THEM. IT DOES
NOT INVOLVE SECURE FACILITIES.
WHAT IT DOES DO IT DOES PROVIDE
PRIORITY IN TERMS OF HOUSING. IT
DOES PROVIDE A COURT AND I
REALIZED THAT THE COURT SETTING
CAN BE INTIMIDATING. IT'S
INTIMIDATING TO ME AND I'VE BEEN
THERE HUNDREDS AND HUNDREDS OF
TIMES AND THAT'S OUR CHALLENGE
TO MAKE SURE THAT IT IS NOT
INTIMIDATING. MAKE SURE WE'VE
TRAINED THE COURT PERSONNEL TO
MAKE SURE THAT THEY CAN
ADEQUATELY DEAL WITH THOSE WHO
ARE SUFFERING SEVERE MENTAL
ILLNESS. UM, THERE HAVE BEEN
SOME AMENDMENTS TAKEN. OF LATE.
I'LL JUST DESCRIBE THOSE IN
BRIEF. FIRST OF ALL THE
IMPLEMENTATION DATE HAS BEEN
MOVED. UH IT HAS BEEN MOVED FOR
THE FIRST COHORT OF COUNTIES TO
JULY ONE OF 2023 TO THE SECOND
COHORT OF COUNTIES. REPRESENTING
THE REMAINING POPULATION OF
STATE THAT WILL BEGIN NO LATER
THAN JULY. 1 2024 UM WE HAD
TALKED EARLIER ABOUT HAVING A
PUBLIC DEFENDER PARTICIPATE.
THAT'S PROBABLY THE WRONG UM THE
WRONG GROUP OF INDIVIDUALS TO
HELP SUPPORT AND NOW IT WILL BE
MOVED TO LEGAL AID WILL BE A
LEGAL AID ATTORNEY THAT WILL BE
ASSIGNED TO SUPPORT THOSE THAT
ARE IN CARE COURTS AND THE ROLE
OF SUPPORTER FAMILY MEMBER. WHAT
HAVE YOU THAT IS NOT IN LIEU OF
A COUNCIL. IT IS IN ADDITION TO
COUNSEL WE'LL ALSO BE COLLECTING
DATA AND EVALUATING THE PROGRAM
SO IMPORTANT WITH GOVERNMENTAL
PROGRAMS TO MAKE SURE THAT WE
WON COLLECT, WHO'S BEING
BASICALLY WHO'S IN CARE COURT.
WAS REPORTING THOSE INTO
CHARACTER COURT AND HOW
EFFECTIVE ARE WE AND ADDRESSING
THE CONCERNS THAT THIS IS ALL
ABOUT? I'M VERY FORTUNATE. AS I
SAID AT THE OUTSET, THEY HAVE
SENATOR EGGMAN HERE WITH ME. I
MAY HAVE TO LEAVE BECAUSE AS YOU
KNOW, THERE ARE MANY THINGS
GOING ON TODAY IN THE
LEGISLATURE, UM, AND ALSO AS
WITNESSES, DR GALLEY VICTORY OF
HEALTH AND HUMAN SERVICES AND
MARK SAWYER, SOCIAL ORKER IN
THE HOMELESS COORDINATOR FOR THE
CITY OF WEST SACRAMENTO. GOOD
AFTERNOON FRIENDS. NICE TO BE
BACK HERE WITH YOU AGAIN TODAY.
UM I JUST WANTED TO JUST GET UP
BRIEFLY. I THINK SENATOR HAMBURG
HAS DONE A GOOD JOB OF GOING
OVER THINGS. UM AND THIS IS THIS
IS NOT UNFAMILIAR TO YOU. WE'VE
BEEN TALKING ABOUT THIS CARE
COURT FOR A WHILE NOW. UM AND AS
YOU KNOW, I WAS HERE LAST WEEK
WITH MY EIGHT BILL PACKAGE. YOU
MAY KNOW THAT I GOT A COUPLE OF
THOSE HELD UP ALONG THE WAY.
THANK YOU ALL VERY MUCH FOR
HEARING THEM IN HERE, SO I THINK
THIS BECOMES EVEN MORE IMPORTANT
AS WE CONTINUE TO LOOK FOR.
REALLY UM, REPAIRING OUR SYSTEM.
AND AS WE ALL KNOW, WHEN WE WENTINTO THE PANDEMIC, WE HAD A
CRISIS, AND IT CERTAINLY HAS
JUST BECOME WORSE THROUGHOUT THE
PANDEMIC. WHAT IS NOT ACCEPTABLE
AS A STATUS QUO AND THAT YOU
KNOW WHEN AND AT SOME POINT
WE'LL HAVE TO HAVE A DIFFERENCE
WITH SOME OF THE OPPOSITION THAT
THE STATUS QUO IS NOT OKAY. UM
AND WE CAN DO MORE THAN ONE
THING AT ONCE. DO WE NEED MORE
DATA? ALWAYS DO WE NEED UM MORE
FUNDING ALWAYS. BUT DO WE ALSO
NEED AND DO WE HAVE IN FRONT OF
US AN OPPORTUNITY TO PROVIDE AND
TO REACH MANY OF THOSE WHO HAVE
BEEN ON UNREACHABLE IN MANY
RESPECTS. UM IN ADDITION TO WHAT
AND WHAT WE KNOW, AND, UM IS
THAT THE LONGER PEOPLE ARE ON
THE STREETS, THE MORE
COMPLICATED THEIR HEALTH
CONDITIONS ARE THE LONGER THAT
THEIR PSYCHOSIS HAS BEEN
UNTREATED, THE LONGER THAT THEIR
PHYSICAL HEALTH HAS BEEN
UNTREATED. THE MORE COMPLICATED
THEIR THEIR THEIR RECOVERY IS,
WHICH REALLY IS THE POINT TO BE
ABLE TO RECOVER PEOPLE TO A
POSSIBLE, ABLE TO LIVE
INDEPENDENTLY. BUT TO REALLY BE
ABLE TO AGAIN, UM AND AS I
TALKED ABOUT THE WHOLE CONTINUUM
OF CARE, THIS WILL BE ANOTHER
ONRAMP. I'D LIKE TO THINK OF IT
AS A AS THE FRONTAGE ROAD
SOMETIMES BECAUSE OUR SYSTEM IS
KIND OF BUILT AROUND A CRISIS.
IF YOU'RE IF YOU'RE AT THE POINT
WHERE YOU'RE IN IN REALLY DIRE
NEED AND SOMETIMES CAN'T MAKE
YOUR DECISIONS YOURSELF. YOU ARE
IN A CRISIS, AND THAT'S THE WAY
OUR SYSTEM IS DESIGNED. BUT
THESE ISSUES ARE CHRONIC. THERE
ARE CHRONIC ISSUES. SO THIS IS A
WAY TO BE ABLE TO BRING THOSE
FOLKS IN WHO MAY NOT NECESSARILY
BE IN SOMEBODY WHO WOULD BE HELD
AGAINST THEIR WILL IN AN L. P S
HEARING. BUT IT IS SOMEBODY WHO
CLEARLY HAS BEEN IN AND OUT AND
IN AND OUT OF OUR OF OUR SYSTEM
HAS CYCLED REPEATEDLY THROUGH
HAS BEEN IN AND OUT OF JAIL MANY
TIMES, AND THIS IS ANOTHER WAY
TO BE ABLE TO BRING THOSE FOLKS
IN A VERY SLIM AMOUNT OF PEOPLE.
A VERY UM IDENTIFIED DEMOGRAPHIC
. UM AND I BELIEVE THIS IS
IMPORTANT. I BELIEVE THIS IS THE
TIME AND I BELIEVE THE PUBLIC
EXPECTS AND SHOULD DEMAND BETTER
OF US, AND I THINK THAT THE
ADMINISTRATION HAS PUT FORTH A
SOLID PLAN. I CAN'T SAY ENOUGH
POSITIVE THINGS ABOUT DR GALLEY
AND HIS COMMITMENT TO THIS AND
THIS ISSUE. AS I KNOW, ALL OF
YOU ARE COMMITTED TO REALLY
IMPROVING THE LIVES OF OUR MOST
VULNERABLE CALIFORNIANS. THANK
YOU VERY MUCH, DOCTOR EGGMAN.
WITH YOUR PERMISSION, MR CHAIR
TURNED OVER TO DR GALLEY. THANK
YOU. THANK YOU VERY MUCH. SO AS
WE MENTIONED, THE BEGINNING WILL
HAVE 10 MINUTES OR TESTIMONY FOR
WITNESSES IN SUPPORT, 10 MINUTES
IN OPPOSITION AND THEN 10
MINUTES OF, UM TWEENERS FOR LACK
OF BETTER DESCRIPTION. SO
WHENEVER YOU'RE READY, DOCTOR
GALLEON. THANK YOU SO MUCH FOR
BEING HERE WITH US. YEAH. THANK
YOU VERY MUCH DOCTOR WOULD
MEMBERS OF THE COMMITTEE
SENATORS EMBURGH, EGGMAN AND
MARC FOR JOINING ME HERE TODAY?
UH IT'S A REAL PRIVILEGE TO BE
HERE. I JUST WANT TO TAKE A
MINUTE TO ECHO AND THANK THE
COMMITTEE FOR ALL OF YOUR
TREMENDOUS WORK AND IN AREAS
AFFECTING AND IMPACTED BY OUR
AGENCY. WE'RE GRATEFUL FOR YOUR
LEADERSHIP AND COMMITMENT TO
CALIFORNIANS. AND THIS IS AN
ISSUE THAT I KNOW IT'S HARD.
IT'S COMPLICATED. BUT I ALSO
BELIEVE IT'S SOMETHING WHERE WE
MUST ACT AND MUST MOVE FORWARD.
AND AS SENATOR EDMUND SAID,
WE'VE BEEN TALKING ABOUT THIS
FOR QUITE SOME TIME. THE
CHALLENGES THE OPPORTUNITIES THE
FRAMEWORK THAT IS CARE COURT AND
I WANT TO SPEND A LITTLE BIT OF
TIME FOCUSED ON TWO WORDS. I
SPENT LAST WEEK'S JUDICIARY
HEARING FOCUSED ON WHICH WAS
PRIORITIZATION AND
ACCOUNTABILITY. AND I'VE HAD THE
PRIVILEGE BECAUSE AS WITH
ANYTHING THAT JUST COMPLEX AND
HARD AS THIS, YOU SPEND A LOT OF
TIME SPEAKING TO FOLKS ON THE
OTHER SIDE OF AN ISSUE, AND MANY
OF THOSE FOLKS ARE PEOPLE THAT
I'VE WORKED CLOSELY WITH WHETHER
IT'S THE OFFICE OF DIVERSION AND
REENTRY IN L A OR HOMELESSNESS
ISSUES IN LOS ANGELES, REALLY
WORKING TO FIGURE OUT SOLUTIONS
FOR THE OFTEN OVERLOOKED OFTEN
THE MOST VULNERABLE AND ONE
RESOUNDING COMMENT THAT MANY OF
THOSE INDIVIDUALS SHARERS, THEY
SAY, WELL, OF COURSE, PART OF
THIS THAT WE LIKE IS THE
ACCOUNTABILITY. ON OUR
GOVERNMENT ENTITIES TO MAKE SURE
THAT WE SERVE THIS POPULATION
WELL. AND SO I WANT TO FOCUS
THAT THE QUESTION AROUND
PRIORITIZATION AND
ACCOUNTABILITY AS ONE THAT I
THINK IS DOABLE HERE IN
CALIFORNIA. AND I SAY THAT NOT
BECAUSE WE'VE JUST CRUNCHED THE
DATA AND LOOKED AT IT WE KNOW
TODAY. THAT ARE COUNTIES AND OUR
SERVICE PROVIDERS. UP AND DOWN
THE STATE ARE DOING TREMENDOUS
WORK FOR VULNERABLE
CALIFORNIANS. AND THE ABILITY TO
FOCUS ON WHAT WE ESTIMATE IS 7
TO 12,000 INDIVIDUALS WITH A SET
OF CLINICAL CRITERIA. NOT A
POTENTIAL FOR CLINICAL CRITERIA
BUT EVALUATED DIAGNOSED
CRITERIA. FOR HEALTH AND SAFETY
IS AT RISK. THOSE 7 TO 12,000
PEOPLE. I BELIEVE UP AND DOWN
THE STATE WE CONSERVE AND
PRIORITIZE. I UNDERSTAND THE
WORD PRIORITIZATION MAY MEAN
THAT WE ARE'T ABLE TO DO
EVERYTHING THAT WE MAY WISH WE
COULD. IT MAY MEAN THAT THE HARD
WORKING DEDICATED STAFF AND SOME
PLACES WILL NEED TO TURN THEIR
FOCUS TO THIS POPULATION. THAT
CERTAIN RESOURCES THAT ALREADY
FEEL SCARCE CAN BE FOCUSED HERE
ON THIS POPULATION. BUT AS I'VE
SAID BEFORE, AH, ISSUES OF
HOMELESSNESS HAVE MANY FACES.
THIS IS BUT 11 OF THE MOST HEART
WRENCHING DIFFICULT TO SEE WHEN
SO SICK INDIVIDUALS WHO ARE
VULNERABLE ON THE STREETS OFTEN
BUT NOT ALWAYS. UM AREN'T
GETTING THE CARE THAT THEY NEED.
WE MUST ACT. SO I'LL JUST REMIND
YOU THAT THROUGH THE PANDEMIC
THROUGH EFFORTS LIKE PROJECT
ROOM KEY AND HOME KIWI IN
CALIFORNIA HOUSED 50,000.
CALIFORNIANS. SO WE CAN DO THIS
TODAY. LOCAL COUNTY BEHAVIORAL
HEALTH IS SERVING OVER 350,000
ADULTS WITH SERIOUS MENTAL
ILLNESS ON A DAILY BASIS OVER
75,000 INDIVIDUALS. IN FULL
SERVICE PARTNERSHIP TODAY
WE KNOW THAT PROBABLY OVER THIS
CALENDAR YEAR THAT WE'RE GOING
TO SEE NEARLY 5000 INDIVIDUALS
DIAGNOSED OR WHERE A DOUBT IS
DECLARED IN THEIR FELONY
PROCEEDINGS ENTER THE FELONY.
HIGHEST T PROGRAM, AND THAT
DOESN'T COUNT THOUSANDS MORE WHO
ARE MISDEMEANOR. IT'S IN THE
SAME INCOMPETENT TO STAND TRIAL
PROGRAM, SO WE KNOW THAT ACROSS
THE STATE WHEN WE'RE FOCUSED ON
THIS POPULATION THAT WE CAN TAKE
THE RESOURCES IN OUR COUNTIES
AND SERVED THIS POPULATION WELL.
SO AS WE TALK ABOUT THE DEARTH
OF PLACEMENTS, THE DEARTH OF
STAFF THE DEARTH OF ABILITY TO
REALLY CARE AND MANAGE FOR THIS
POPULATION. I'LL REMIND US TWO
THINGS. CALIFORNIA HAS DONE THIS
BEFORE WE'VE STEPPED UP. FOR THE
MOST VULNERABLE THE MOST
OVERLOOKED MANY, MANY TIMES AND
WE CAN DO IT AGAIN. AND IN MANY
WAYS WE'RE DOING IT ALREADY FOR
SOME OF THESE INDIVIDUALS, JUST
NOT IN THE COMPREHENSIVE WAY
THAT CARE COURT IS ASKING SO
WHEN I THINK ABOUT WHAT IS THE
POTENTIAL OF THIS PROGRAM, I
DON'T WANT TO DISMISS HOW HARD
HAVING A FRAMEWORK LIKE CARE
COURT WILL BE IN MANY AREAS.
THIS IS A TOUGH ISSUE. THIS IS
ONE THAT I THINK OUR STATE HAS
GRAPPLED WITH, UH MANY, MANY
TIMES. BUT BY PROMOTING THIS
PATHWAY, MAKING IT AVAILABLE.
HOLDING OURSELVES ACCOUNTABLE,
PRIORITIZING THIS POPULATION
THAT WE COULD SEE MEANINGFUL
CHANGE FOR A POPULATION THAT
DESPERATELY NEEDS IT. AND HELP
US MAKE THE CALIFORNIA FOR ALL
THAT. I THINK WE ALL STRIVE TO
CREATE HERE IN CALIFORNIA CLOSER
REALITY, SO WITH THAT, I WANT TO
TURN IT OVER TO MARK TO SHARE
SOME OTHER WORDS. THANK YOU.
PLEASE GO AHEAD. THANK YOU.
THANK YOU. GOOD AFTERNOON CHAIR
AND MEMBERS. MY NAME IS MARK
SAWYER AND I AM A SOCIAL WORKER
AND THE HOMELESS COORDINATOR FOR
THE CITY OF WEST SACRAMENTO
SPENT THE ENTIRETY OF MY CAREER
WORKING WITH HOMELESS ADULTS,
MANY WITH SERIOUS MENTAL ILLNESS
WITHIN A FEW MILES OF THIS
BUILDING. THANK YOU FOR ALLOWING
ME TO SPEAK THIS AFTERNOON AND
SUPPORT OF CARE COURT. I'VE
WORKED IN HOMELESS SERVICES FOR
OVER 15 YEARS AND A HUGE PART OF
MY PASSION FOR SOCIAL WORK AND
WORKING WITH OTHERS COMES FROM
MY OWN LIVED EXPERIENCE WITH
ADDICTION, MENTAL HEALTH AND
HOMELESSNESS. MY LATE
ADOLESCENCE AND EARLY ADULTHOOD
OR IMPACTED GREATLY BY THOSE
TRUTHS AND BECAUSE OF THE HELP I
RECEIVED ALONG THE WAY. FROM
BOTH INDIVIDUALS AND
INSTITUTIONS HAVE BECOME
EMBOLDENED TO WORK WITH OTHERS.
I HAVE BEEN A CLIENT MYSELF AND
DRUG DIVERSION, PROP 36 DRUG
COURT AND ULTIMATELY FAMILY
COURT WHERE I WAS REDEFINED
REUNIFYING WITH MY SON. THESE
INTERVENTIONS WERE ABSOLUTELY
PARAMOUNT IN MY AND MY FAMILY'S
SUCCESS, AND WITHOUT THEM, I
SHUDDER TO THINK WHERE I WOULD
BE TODAY. AS I ENTERED THE
SOCIAL WORK FIELD. I NEVER SHIED
AWAY FROM THE IMPORTANCE OF
COURT. COLLABORATIVE EFFORTS
WERE MULTIPLE AGENCIES WITH
DIFFERENT PERSPECTIVES WORK
TOGETHER ON A CASE. IN MY
OPINION, THIS IS ALWAYS
BENEFICIAL TOWARDS THE CLIENT
AND CREATES AN ENVIRONMENT TO
IMPROVE OUTCOMES. INTERVENING IN
IT. AN UNMANAGEABLE ITTY IS AN
ACT OF COMPASSION, AND I HAVE
TRIED TO INCORPORATE THAT IN MY
PROFESSIONAL LIFE AS MUCH AS I
CAN, AS I FIRMLY BELIEVE, IN THE
MERCY OF ASSERTIVE INTERVENTIONS
FOR THOSE IN CRISIS.
PARTICULARLY THOSE EXPERIENCING
HOMELESSNESS AND WITHIN THAT
GROUP, THOSE EXPERIENCING
PSYCHOSIS. NO ONE SHOULD HAVE TO
WAIT UNTIL THEY ARE INCARCERATED
OR INSTITUTIONALIZED TO GET
ACCESS TO NECESSARY SERVICES AND
SUPPORT. I HAVE WORKED ALONG THE
FULL CONTINUUM OF HOMELESS
SERVICES AS A COUNSELOR AS A AT
A RESIDENTIAL TREATMENT CENTER
FOR MEN WITH CO OCCURRING
DISORDERS RECENTLY RELEASED FROM
A FROM INCARCERATION AS A CASE
MANAGER WORKING WITH CHRONICALLY
HOMELESS ADULTS WITH SME. AS A
CRISIS CLINICIAN AND FINALLY IN
MY CURRENT POSITION FOR THE CITY
OF WEST SACRAMENTO. WHERE I AM
DOING STREET AND ENCAMPMENT,
OUTREACH CASE MANAGEMENT AND
MOST RECENTLY OVERSEEN PROJECT
ROOM KEY PROJECT HOME KEY AND NO
PLACE LIKE HOME PERMANENT,
SUPPORTIVE HOUSING DEVELOPMENT.
THROUGHOUT MY CAREER, IT HAS
BEEN THOSE SUFFERING FROM
SERIOUS MENTAL ILLNESS THAT HAVE
AFFECTED ME THE MOST WATCHING
INDIVIDUALS SUFFER WHILE IN THE
THROES OF UNTREATED MENTAL
ILLNESS HAS BEEN IMPACTFUL AND
AS A SOCIAL WORKER. I HAVE TRIED
TO COME UP WITH SOLUTIONS TO
HELP IMPROVE THEIR QUALITY OF
LIFE. THIS IS NO EASY TASK AND
CAN BE QUITE DAUNTING, BUT
NEVERTHELESS, WE MOVE FORWARD
WITH THE ULTIMATE GOAL OF
IMPROVING THE LIVES OF THOSE WE
HAVE THE OPPORTUNITY TO SERVE IN
THIS WORK I'VE COME TO KNOW AND
CARE ABOUT MANY PEOPLE
EXPERIENCING HOMELESSNESS.
HOMELESSNESS IS BRED BY AND
BREEDS TRAUMA. EVERYONE IMPACTED
BY HOMELESSNESS IS WORTHY OF
GOOD WORK, BUT NONE OF OUR
RESIDENTS ARE MORE AT RISK THAN
THOSE WHO STRUGGLE WITH
SCHIZOPHRENIA AND OTHER
PSYCHOTIC DISORDERS. THEY ARE
VICTIMIZED REGULARLY,
PHYSICALLY, SEXUALLY, MENTALLY
AND FINANCIALLY. THIS
VICTIMIZATION OFTEN LEADS TO
HOSPITALIZATION, WORSENING OF
SYMPTOMS AND ULTIMATELY, IN SOME
CASES, DEATH. I BELIEVE THE
SOLUTIONS TO THESE PROBLEMS WE
FACE IS BY EVER EXPANDING OUR
TOOLBOX WITH INTERVENTIONS AT%
BOTH THE MICRO AND MACRO LEVEL.
I AM A BELIEVER IN CORRESPONDING
TO ENCAMPMENTS AND BUILDING
REPORT THROUGH CONTINUOUS
OUTREACH, PROVIDING SUPPORT AND
ENCAMPMENTS. AND HELPING THOSE
NAVIGATOR SYSTEM THAT CAN BE
DIFFICULT TO ACCESS. I BELIEVE
IN PROVIDINGLOW TO NO BARRIERS
, SHELTERS THAT ALLOW PEOPLE,
PETS AND POSSESSIONS TO RECEIVE
IMMEDIATE RESPITE. MODELS LIKE
PROJECT ROOM KEY AND HOME KEY.
COME TO MIND AND I BELIEVE OUR
GREAT MOVE IN THE RIGHT
DIRECTION AS HIS PERMANENT
SUPPORTIVE HOUSING, WHICH IS
ANOTHER MODEL THAT I'VE USED IN
MY PROFESSIONAL CAREER, AND I
BELIEVE IT IS ABSOLUTELY WE
SHOULD SOMETHING WE SHOULD
CONTINUE TO CULTIVATE AND
EXPAND. BUT DESPITE ALL OF THESE
GREAT STRIDES, WE STILL NEED
MORE TOOLS. AND I'D JUST LIKE TO
POINT OUT NOW THAT CARE COURT IS
NOT NEEDED FOR ALL, BUT IT IS
ESSENTIAL FOR SOME CARE COURT
WOULD GIVE THOSE OF US ON THE
STREETS CARING FOR THE
UNSHELTERED WITH SME AN
ADDITIONAL TOOL TO PREVENT
INCARCERATION, CONSERVATORSHIP
AND DEATH. I HAVE SEEN THE VALUE
OF ADDING SERVICES AND HOUSING
OPTIONS, AND I AGREE THAT WE
NEED MORE OF ALL OF THAT. BUT I
FIRMLY BELIEVE THAT CHARACTER
COURT WILL SAVE LIVES AS WE
CONTINUE TO BUILD MORE HOUSING
AND MAKE MORE SERVICES
AVAILABLE. FROM MY FROM MY
PERSPECTIVE, CARE COURT
REPRESENTS AN ACT OF MERCY, NOT
PERSECUTION. MY HOPE IS THAT
CARE COURT IS SOMETHING OUTREACH
SOCIAL WORKERS, SUCH AS MYSELF
HAVING OUR TOOLBOX IN THE NEAR
FUTURE. THANK YOU FOR YOURTIME
AND YOUR THOUGHTFUL
CONSIDERATION. THANK YOU VERY
MUCH. AT THIS POINT, OTHERS IN
SUPPORT, PLEASE COME FORWARD.
JUST THE NAME YOUR NAME AND
ORGANIZATION. IF YOU REPRESENT
ONE. THANK YOU, MR CHAIRMAN AND
MEMBERS MOIRA TOP HERE ON BEHALF
OF SAN DIEGO MAYOR TODD GLORIA
IN THE CITY OF SAN DIEGO AND
ALSO THE ORANGE COUNTY BUSINESS
COUNCIL. BOTH IN SUPPORT. THANK
YOU. GOOD AFTERNOON, MR CHAIR
AND MEMBERS OF THE COMMITTEE,
SHARON GONZALVES ON BEHALF OF
THE ITIES OF BAKERSFIELD.
CARLSBAD CORONA, RANCHO PALOS
BIRTHDAYS. REDWOOD CITY IN SANTA
ROSA IN SUPPORT. THANK YOU.
pCHECKER WITH THE LOS ANGELES
AREA CHAMBER OF COMMERCE AND
SUPPORT ANTHONY MOLINA BEHALF ON
BEHALF OF THE CALIFORNIA
ASSOCIATION OF CODE ENFORCEMENT
OFFICERS AND SUPPORT THANK YOU.
THANK YOU. HELLO CHAIR MEMBERS.
KILLIAN CIRINCIONE ON BEHALF OF
THE LEGAL CALIFORNIA CITIES WITH
THE SUPPORT OF AMENDED POSITION
TO ADDRESS CONCERNS REGARDING
IMPLEMENTATION, WE LOOK FORWARD
TO SEEING YOU KNOW AMENDMENTS.
THANK YOU. THANK YOU. MADELINE
COOPER WITH NIELSEN MERKSAMER ON
BEHALF OF THE COUNTY OF SAN
DIEGO IN SUPPORT. THANK YOU.
THANK YOU. LEAH BURROWS ON
BEHALF OF CALIFORNIA HOSPITAL
ASSOCIATION AND SUPPORT THANK
YOU, MR CHAIR MEMBERS, DOUG
SUPERS ON BEHALF OF THE
CALIFORNIA PROFESSIONAL
FIREFIGHTERS AND SUPPORT THANK
YOU. THANK YOU, MR CHAIR AND
MEMBERS COREY HAS SHED ON BEHALF
OF THE STEINBERG INSTITUTE AND
SUPPORT. THANK YOU. ALEX TORRES
ON BEHALF OF THE BARRIER BAY
AREA COUNCIL AND OUR 300 MEMBERS
IN SPORT. QUÊ. GOOD AFTERNOON
CHAIR AND MEMBERS IS KIRK
BLACKBURN ON BEHALF OF THE CITY
OF SANTEE AND SUPPORT QUÊ NICOLE
WARD LEMAN ON BEHALF OF THE CITY
OF ONTARIO AND SUPPORT BRIAN SAP-ON BEHALF OF THE SAN DIEGO
HOUSING COMMISSION AND SUPPORT
YEAH. SYLVIA SO LEASH ON BEHALF
OF THE CITY AND COUNTY OF SAN
FRANCISCO AND ALSO ON BEHALF OF
THE CITY OF SANTA MONICA AND THE
CITY OF BEVERLY HILLS AND STRONG
SUPPORT. THANK YOU. THANK YOU.
MR CHAIRMAN MEMBERS BRIAN LONDON
ON BEHALF OF THE NATIONAL
ALLIANCE ON MENTAL ILLNESS AND
SUPPORT. ALLISON MONROE, ALAMEDA
COUNTY FAMILIES ADVOCATING FOR
THE SERIOUSLY MENTALLY ILL ALONG
WITH A COUPLE OF MOMS OF
PEOPLE'S SCHIZOPHRENIA, WHO
DIDN'T UNDERSTAND THAT THEY
COULDN'T CALL INTO THIS HEARING
TODAY. WE SUPPORT THIS BILL.
THANK YOU. THANK YOU. GOOD
AFTERNOON, PATRICK ESPINOSA ON
BEHALF OF SAN DIEGO COUNTY
DISTRICT ATTORNEY SUMMER STEP IN
AND SUPPORT. YEP. MILLIONS OF
MONTE CALIFORNIA TRAVEL
ASSOCIATION AND SUPPORT THANK
YOU VERY MUCH ANYONE ELSE. AND
NO ONE WILL GO TO OPPOSITION.
PLEASE. WE MAY HAVE QUESTIONS
FOR YOU. DR GALLEY. IF YOU'RE
ABLE TO STICK AROUND, I DON'T
BUT WE'LL GO TO OUR OPPOSITION.
NOW. PLEASE COME FORWARD. MHM.
PLEASE. THERE'S A BUTTON ON
THERE THE MICROPHONE BUTTON IF
YOU JUST PUSH THAT MM. GOOD DAY.
MY NAME IS THE SANTA WA BOYKIN.
I AM E R NURSE WHO SPECIALIZES
IN ACUTE PSYCHIATRIC CARE. I AM
ALSO THE CO FOUNDER OF THE ANTI
POLICE TERROR PROJECT AND ALSO A
CO CREATOR OF MENTAL HEALTH
FIRST, WHICH IS APPEAR AND
COMMUNITY RUN CRISIS RESPONSE
SYSTEM THAT'S RUN ON VOLUNTEER
POWER. I WOULD LIKE TO START BY
SAYING OUR LIVES ARE PAYING. OUR
STORIES ARE NOT PLATFORMS ON
WHICH FOLKS CAN BUILD POLITICAL
CAREERS NOR PAD THE POCKETS OF
NON PROFITS. WE ARE CLEAR NOW,
MORE THAN EVER MORE THAN EVER
THAT SCARCITIES SCARCITY OF
RESOURCES IS MANUFACTURED AND
BUILT ON A FOUNDATION OFWHITE
SUPREMACY, PATRIARCHY AND
EXTRACTIVE CAPITALISM. IT IS
DISTURBINGLY OBVIOUS THAT THE
REAL FUNCTION OF THIS BILL IS TO
FURTHER EMBED THE JUDICIAL
SYSTEM AND THE PRESENT
INDUSTRIAL COMPLEX INSIDE OF OUR
HEALTH CARE SYSTEM. WITH THAT,
OUT OF THE WAY. THIS LEGISLATION
THIS PIECE OF LEGISLATION
DISHONESTLY USES WORDS LIKE
VOLUNTARY AND GRADUATION WHEN IN
FACT, WHAT WE ARE TALKING ABOUT
IS COERCION AND INTIMIDATION.
AND I BELIEVE I HEARD SOMEONE
USED THE WORD INTIMIDATE. IT'S
TRUE. IN THE SAME WAY THAT
CALIFORNIA COUNTIES ARE
ENCOURAGED TO PARTICIPATE. BUT
THEN, IF THEY DON'T THEY'RE FINE
. THAT SOUNDS LIKE COERCION AND
NOT BEING VOLUNTARY. THIS
LEGISLATION HAS TOKENIZED THE
SAD STORIES OF FAMILIES OF
CALIFORNIANS WHO ARE DESPERATE
TO GET THEIR PEOPLE HOUSING AND
ALSO CARE. THIS BILL REQUIRES
REQUIRES THAT THE PATIENT SHOWS
UP FOR TREATMENT, BUT IT DOES
NOT REQUIRE THAT THE STATE IN
FACT, PROVIDE HOUSING. HMM. THIS
BILL AIMS TO SUPPORT THOSE WHO
SUFFER FROM THE POSITIVE
SYMPTOMS OF SCHIZOPHRENIC
SPECTRUM DISORDERS AND OTHER
PSYCHOTIC DISORDERS, WHICH MEANS
THAT THESE ARE THE FOLKS THAT
ARE EXPERIENCING AUDITORY.
VISUAL HALLUCINATIONS, SOMETIMES
DELUSIONS THAT INTERFERE WITH
THEIR ACTIVITIES OF DAILY
LIVING, AND THOSE CAN BE
CLASSIFIED AS EXACERBATED
PERCEPTIONS. SO FOR FOLKS WHO
ARE UNHAPPY HOUSED BLACK PEOPLE
, BROWN PEOPLE, FOLKS WHO ARE
DEALING WITH SUBSTANCE USE.
THOSE PERCEPTIONS ARE IN FACT
REAL RIGHT. THEY ARE, IN FACT
BEING PURSUED SURVEILLED RIGHT.
WE ARE ASKING THEM IN A
TRAUMATIZED STATE TO ENGAGE IN A
SYSTEM THAT HAS ALREADY
TRAUMATIZED THEM THAT THEY
ALREADY DO. THAT THEY ALREADY
DON'T TRUST EVEN WHEN THEY COME
INTO THE HOSPITALS, AND
IMMEDIATELY THE DOCTORS AND
NURSES. ALL OF US ARE IN A PLACE
TO HARM THEM, AND WE HAVE TO BE
CAREFUL ABOUT THAT RELATIONSHIP
. WHAT WE'RE TELLING THEM IS
THAT WE WOULD RATHER DRAG HIM
INTO COURT THAT, IN FACT, CANNOT
PROVIDE HOUSING EVEN IF IT'S
KIND OF PROMISED RIGHT RATHER
THAN JUST PROVIDE THE HOUSING
THE MONEY THAT'S GOING TO GO
INTO THE INFRASTRUCTURE. TO
BUILD THIS CARE COURT SYSTEM
COULD SIMPLY BUY HOUSING FOR
THOSE 7 TO 12,000. PEOPLE
BECAUSE THE ROOT CAUSES THAT
THEY RUN HOUSED AND THEY'RE
UNABLE, NOT UNWILLING, UNABLE TO
COMPLY WITH THESE TREATMENT
PLANS. SO AS A NURSE WHAT I KNOW
LOGISTICALLY WHAT HAPPENED ON
THE GROUND. IS THE CARE WORKER
LIKELY WILL BE TRAINED TO CALL
POLICE WHEN PEOPLE ARE NOT
PARTICIPATING IN THEIR CARE PLAN
, AND THEY'LL END UP IN AN
EMERGENCY ROOM. WE CURRENTLY ARE
HOUSING PEOPLE FOR DAYS UP TWO
WEEKS. TRYING TO GET THEM ACUTE
BED AND THE REASON WHY THAT'S
HAPPENING IS BECAUSE MOST PLACES
WILL NOT TAKE THEM UNLESS
THEY'RE MEDICALLY CLEARED, AND
WE HAVE TO DO THAT. AND I KNOW
IT'S LIKE, OH, WELL, WE'RE NOT
GOING TO SEND HIM TO THE
HOSPITAL, BUT YOU ABSOLUTELY ARE
UNFORTUNATELY GOING THROUGH ER
AND THEN THROUGH INPATIENT
PROGRAM IS THE FASTEST WAY TO
GET OUTPATIENT OR INPATIENT
TREATMENT. SO I UNDERSTAND THAT
THIS BILL IS SUPER SENTIMENTAL,
AND IT SOUNDS LIKE IT'S GONNA
WORK BUT THE DAY TO DAY DEALING
WITH THE SAME POPULATION, THE
SAME FOLKS COMING IN AND OUT OF
THE ER SITTING THERE FOR WEEKS.
SOMETIMES MONTHS, FOLKS THAT ARE
HARD TO PLACE. AND WE'RE
TRAUMATIZING THEM WERE
TRAUMATIZING THEM FURTHER. SO TO
SAY, NOW GO STAND IN FRONT OF A
JUDGE. CIVIL OR NOT. RIGHT IT'S
NOT OUR PATIENTS THAT ARE BROKEN
. THE SYSTEM IS BROKEN, DRAGGED
THE FOR PROFIT HOSPITALS DRAGGED
THE FOR PROFIT. MENTAL HEALTH
CORPORATIONS DRAGGED THEM INTO
CIVIL COURT. AND WATCH THE
RESOURCES MAGICALLY APPEAR. GOOD
AFTERNOON. MY NAME IS ERIC
HARRIS. I'M THE DIRECTOR OF
PUBLIC POLICY AT DISABILITY
RIGHTS, CALIFORNIA. WE ARE
CALIFORNIA'S PROTECTION AND
ADVOCACY AGENCY. WE UPHOLD AND
PROTECT THE RIGHTS OF MILLIONS
OF PEOPLE WITH DISABILITIES AND
PRIORITIZE THE NEEDS OF
MARGINALIZED COMMUNITIES. I AM
HERE TO STRONGLY èHASIZE
OPPOSITION TO CARE COURT. UNDER
SB 13 38. MY COMMENTS ALSO
UNDERSCORE THE FEAR AND CONCERNS
OF PEOPLE WITH MENTAL HEALTH
DISABILITIES. AUTONOMY AND CIVIL
LIBERTIES DO NOT EXIST IN THE
SYSTEM. WHERE THERE ARE
CONSEQUENCES FOR NOT FOLLOWING A
COURT ORDER. AS A BLACK MAN WHO
WAS A WHEELCHAIR USER. I AM A
LIFELONG DISABILITY RIGHTS
ADVOCATE. I AM COMMITTED TO THE
INTEGRATION AND LIBERTIES OF
PEOPLE WITH DISABILITIES AND
HAVE BEEN RECOGNIZED TO DO SO.
IN 2021. I WAS APPOINTED TO BE
CO CHAIR OF CALIFORNIANS
DISABILITY AND AGING COMMUNITY
LIVING ADVISORY COMMITTEE. THE
COMMITTEE'S PURPOSE IS ROOTED IN
BOTH THE HOMESTEAD SUPREME COURT
DECISION OF 1999, THE
ANNIVERSARY OF WHICH WAS JUST
THIS LAST WEEK. AND IN
CALIFORNIA'S VALUES OF
INCLUSION, ACCESS AND EQUITY. IN
2020. I WAS APPOINTED TO BUY
GOVERNOR NEWSOM TO THE
CALIFORNIA STATE INDEPENDENT
LIVING COUNCIL. THIS COUNCIL
SERVES TO MAXIMIZE OPPORTUNITIES
FOR PEOPLE WITH DISABILITIES WHO
DESIRE TO LIVE INDEPENDENTLY. IN
MY ROLES AS AN ADVOCATE AND AS
AN APPOINTED ADVISER. I CAUTION
YOU CARE COURT DOES NOT UPHOLD
THESE CALIFORNIA VALUES FOR ITS
RESIDENTS WITH DISABILITIES.
CARE COURT DOES NOT ABIDE BY
HOUSING FIRST PRINCIPLES. THE
ANSWER TO ENDING HOMELESSNESS.
INSTEAD IT THREATENS THE
FUNDAMENTAL CONSTITUTIONAL
RIGHTS AND SETS US BACK TO THE
DARK AGES BEFORE THE U. S.
SUPREME COURT'S LANDMARK
DECISION OF OLMSTEAD. BEFORE
OLMSTEAD. IT WAS PREFERRED TO
SEGREGATE AND INSTITUTIONALIZED
PEOPLE WITH DISABILITIES. WE
KNOW THAT THE FUNDING THAT HAS
BEEN ALLOCATED FOR THIS PURPOSE
$65 MILLION IS ONLY A STARTING
POINT TO WHAT ULTIMATELY COULD
BE A MONUMENTAL AMOUNT OF MONEY.
7 TO 12,000 IS THE TARGET NUMBER
OF PEOPLE THAT THIS BILL HOPES
TO ADDRESS, BUT WE KNOW THAT
THERE COULD BE COUNTLESS OTHERS
THAT WILL BE DIRECTLY AND
INDIRECTLY IMPACTED BY. IT'S BY
ITS EFFECT. AS WITH THE THREAT
TO REPRODUCTIVE RIGHTS CARE
COURT WILL BE A DEVASTATING STEP
TOWARD A RACING THE RIGHTS AND
LIBERTIES OF PEOPLE WITH
DISABILITIES WHO HAVE FOUGHT IN
COURT COURTHOUSES IN CAPITALS
THROUGHOUT THE THROUGHOUT THE
COUNTRY. IN TODAY'S LEGAL
LANDSCAPE, WHERE INDIVIDUAL
RIGHTS ARE AT RISK OF BEING LOST
DOWN A SLIPPERY SLOPE. WE NEED
TO BE VERY CAREFUL NOT TO ENACT
NEW SYSTEMS AND PROGRAMS THAT
THREATENED THOSE RIGHTS. CARE
COURT WILL STRIP THE
CONSTITUTION. CONSTITUTIONAL
RIGHTS OVEN HOUSED PEOPLE WITH
DISABILITIES. WE AS CALIFORNIANS
NEED TO STAY CONSISTENT IN OUR
VALUES AND MAKE SURE PEOPLE CAN
EXERCISE AUTONOMY OVER THEIR
HEALTH CHOICES, WHETHER IT BE
MENTAL HEALTH CARE CHOICES OR
REPRODUCTIVE RIGHTS. WE ALSO
NEED TO BE MINDFUL OF THE
DISPARITIES AND RACISM THAT HARM
PEOPLE IN OUR SYSTEMS. THE
PEOPLE MOST LIKELY TO BE PLACED
IN CARE COURT WILL BE BLACK,
INDIGENOUS, LATIN X AND OTHER
PEOPLE OF COLOR. BLACK PEOPLE
REPRESENT OVER 30% OVEN HOUSED
PEOPLE LIKE NEXT PEOPLE
REPRESENT OVER 30% OVEN HOUSED
PEOPLE AND, UNFORTUNATELY, THE
FASTEST GROWING DEMOGRAPHIC IN
THE HOUSE LIST COMMUNITY. AND
FOR BLACK MEN, WE ARE MOST
LIKELY TO BE MISDIAGNOSED AND
OVER, DIAGNOSED WITH
SCHIZOPHRENIA AND OTHER
PSYCHOTIC DISORDERS BASED ON OUR
HISTORY OF RACISM AND
DISCRIMINATION THAT STILL EXISTS
AS AND IS ENFORCED TODAY. AND
THE SPECIFIC MENTAL HEALTH
DIAGNOSES ARE THE MAIN
ELIGIBILITY CRITERIA FOR CARE
COURT. ON JUNE 1ST 2022, THE
CALIFORNIA REPARATIONS TASK
FORCE ISSUED A GROUNDBREAKING
REPORT FOR THIS LEGISLATURE. THE
REPARATIONS REPORT DETAILS THE
LONG HISTORY OF HOW BLACK PEOPLE
ARE MOST OFTEN MISDIAGNOSED
FORCED INTO AN APPROPRIATE
TREATMENT. EXCLUDED FROM HOUSING
AND DISCRIMINATED AGAINST WITH
POLICIES JUST LIKE THESE. THE
REPORT ALSO STATES THAT EVEN
TODAY BLACK CALIFORNIANS ARE ARE
DISCRIMINATED AGAINST IN HARMED
AND THE HEALTH CARE SYSTEM AND
IN THE MENTAL HEALTH TREATMENT
SYSTEM. THE REPORT EMPHASIZES
THAT THE LEGISLATURE NEEDS TO BE
AWARE OF THIS HISTORY AND
PRESENT AND PRESENT HARM TO
BLACK CALIFORNIANS. BECAUSE THE
CIVIL LEGAL SYSTEM WHERE SUCH
DISCRIMINATORY TYPICAL SUCH
DISCRIMINATION TYPICALLY IS
RESOLVED AND HAS UNFORTUNATELY
BEEN THE SYSTEM TO UNJUSTLY
SUBJUGATE BLACK CALIFORNIANS TO
THESE BROKEN SYSTEMS. THE SAME
CIVIL SYSTEM LEGAL SYSTEM WOULD
BE USED IN CARE COURT, BOTH IN
THE SENATE AND THE ASSEMBLIES,
JUDICIARY COMMITTEES. MANY
LEGISLATORS HAVE STATED. WE HAVE
CONCERNS WITH THIS BILL, BUT
TRUST THAT AS IT MOVES THROUGH
THE PROCESS THAT IT WILL GET
BETTER AND VOTED YES. LET ME
TELL YOU. WERE THERE TO BE
JUSTICE. WE BETTER BE 100% SURE
THERE ARE NO CONCERNS BEFORE
CODIFYING ANY NEW COURT SYSTEM
THAT TAKES EVEN ONE PERSON'S
LIBERTY. THIS CANNOT BE A TRIAL
OR A TEST PROGRAM HERE. COURT
WILL ONLY INFLICT HARM FOR
GENERATIONS IF CODIFIED INTO A
COURT SYSTEM WIELDED AGAINST OUR
MOST MARGINALIZED INDIVIDUALS.
DISABILITY RIGHTS, CALIFORNIA
AND OVER 40 OTHER ORGANIZATIONS
ARE TELLING THE ADMINISTRATION
SENATOR UMBERG AND SENATOR
EDMUND THIS MESSAGE. NO WE DO
NOT WANT CARE COURT DRC URGES
YOUR NO VOTE ON SB 1338 THANK
YOU. THANK YOU VERY MUCH. OTHERS
IN OPPOSITION COMING TO THE
MICROPHONE. JUST YOUR NAME AND
ORGANIZATION. IF YOU REPRESENT
ONE, PLEASE. GOOD AFTERNOON.
GLENN BACCHUS FOR A C L U
CALIFORNIA ACTION IN OPPOSITION
WAS ASKED TO READ THESE OTHER
ORGANIZATIONS INTO THE RECORD,
PLEASE. SAN FRANCISCO PUBLIC
DEFENDER'S OFFICE DRUG POLICY
ALLIANCE. ALAMEDA COUNTY
HOMELESS ACTION CENTER AND NEXT
GEN. CALIFORNIA THANK YOU. THANK
YOU. GOOD AFTERNOON, VICTORIA
WONG ON BEHALF OF THE ELLA BAKER
CENTER FOR HUMAN RIGHTS IN
OPPOSITION TO THIS BILL. AND SHE
REMEMBERS, WHICH WERE RODRIGUEZ
, BUT NIELSEN MARKS MORE ON
BEHALF OF BRANDON CONTRA COSTA
COUNTIES. WE CURRENTLY DO NOT
HAVE AN OPPOSED POSITION BUT
REMAIN. THANK YOU. HELLO, CHAIR
AND MEMBERS. CHRISTOPHER SANDINO
FROM THE CALIFORNIA HAWAII CP
AND RESPECTFUL OPPOSITION. THANK
YOU. GOOD AFTERNOON. SHARON
MEMBERS RONALD COLMAN HERE ON
BEHALF OF THE CALIFORNIA PAN
ETHNIC HEALTH NETWORK. ALSO
HERE, RESPECTFULLY OPPOSING.
EDDIE VARGAS FOR RECOVERY
ADVOCACY PROJECT AND WITHOUT
STRONGER HOUSING, FIRST
INFRASTRUCTURE. WE CANNOT
SUPPORT THIS. POSSUM INS WITH
THE DEPRESSION AND BIPOLAR
SUPPORT ALLIANCE STRONGLY
OPPOSED TO ANY LEGISLATION,
WHICH WOULD IMPLEMENT THIS CARE
COURT PROPOSAL. THANK YOU. QUÊ.
GOOD AFTERNOON CHAIR AND
COMMITTEE MEMBERS. KAREN VICKERY
WITH MENTAL HEALTH AMERICA OF
CALIFORNIA AND THE CALIFORNIA
YOUTH EMPOWERMENT NETWORK. IN
STRONG OPPOSITION. THANK YOU.
GOOD AFTERNOON. STACEY HERE ON
MOTO, REPRESENTING BOTH ANY SW
THE NATIONAL ASSOCIATION OF
SOCIAL WORKERS, CALIFORNIA
CHAPTER AND RAMCO. THE RACIAL
AND ETHNIC MENTAL HEALTH
DISPARITIES COALITION BOTH IN
OPPOSITION. THANK THANK YOU.
GOOD AFTERNOON, MR CHAIR MEMBERS
ANYA LOLLAR ON BEHALF OF THE
PUBLIC INTEREST LAW PROJECT AND
THE NATIONAL HOUSING LAW PROJECT
IN OPPOSITION. GOOD AFTERNOON
CHAIR MEMBERS CYNTHIA CASTILLO
ON BEHALF OF WESTERN CENTRAL ON
POVERTY AND STRONG OPPOSITION.
GOOD AFTERNOON, MARIE CASTALDI
ON BEHALF OF HOUSING CALIFORNIA
AND THE CORPORATION FOR
SUPPORTIVE HOUSING AND
OPPOSITION. THANK YOU. NHNG MY
NAME IS RITA GUTHRIE. I'M A
DISABILITY RIGHTS ATTORNEY
ADVOCATE IN STRONG OPPOSITION.
MEMBERS. MATTHEW GALLAGHER, ON
BEHALF OF COWBOYS IS ALSO IN
STRONG OPPOSITION. THANK YOU.
THANK YOU ANYONE ELSE? ONE
THERE. ANY GROUPS IN BETWEEN
ACTUALLY CALLED TWEENERS. WILL
ALLOW 10 MINUTES FOR AND SO.
FIRST COUPLE UP HERE OR GOING TO
GET THE CHANCE. THERE'S MORE
TIME WILL ALLOW OTHERS SO. OKAY?
OKAY? GOOD AFTERNOON CHAIR WOULD
MEMBERS. THANK YOU FOR THE
OPPORTUNITY TO PROVIDE THE
COUNTY PERSPECTIVE ON THE
CHARACTER CARE ACT TODAY. I'M
CHUCK WASHINGTON. AND I HAVE THE
HONOR TO SERVE. AS A LOCAL
ELECTED PUBLIC SERVANT FOR
NEARLY 25 YEARS, NOW, FIRST AS
MAYOR IN MARIETTA AND THEN TO
MUKALLA. AND NOW AS A MEMBER OF
THE RIVERSIDE COUNTY BOARD OF
SUPERVISORS. TODAY. OF THE NOUR
SPEAKING ON BEHALF ABOUT 58
COUNTIES AS FIRST VICE PRESIDENT
OF THE CALIFORNIA STATE
ASSOCIATION OF COUNTIES SACK.
FIRST I WANT TO EXPRESS OUR
COLLECTIVE GRATITUDE FOR YOUR
GOVERNOR NEWS YOURS AND GOVERNOR
NEWSTANDS INVESTMENTS IN
HOUSING. HOMELESS SERVICES AND
BEHAVIORAL HEALTH PLACEMENTS.
COUNTIES ARE USING THE FUNDING.
CREATE SAFE PLACES TO LIVE,
PROVIDE VITAL SERVICES TO OUR
NEIGHBORS ARE UNHAPPY, HOUSED
AND LIVING WITH SEVERE
BEHAVIORAL HEALTH CONDITIONS. WE
ALSO UNDERSTAND AND SHARE THE
AUTHORS AND GOVERNORS DESIRE TO
DEVELOP NEW SOLUTIONS TO PREVENT
INDIVIDUALS AND BECOMING
HOMELESS. AND CYCLING IN AND OUT
OUR CRIMINAL JUSTICE AND HEALTH
CARE SYSTEM. AND I'M HERE. AND
I'M HERE BEFORE YOU TO SAY THAT
COUNTIES WILL CONTINUE TO OFFER
THE EXPERTISE AND HELP WITH THE
DEVELOPMENT. OF THE CARE ACT,
HOWEVER. WE RECOGNIZE THAT TIME
IS SHORT. BUT THAT SAID MY
COLLEAGUES AND COUNTLESS MY
COLLEAGUES IN COUNTIES ACROSS
THE STATE STILL SHARE
SIGNIFICANT CONCERNS REGARDING
RESOURCES. NOT JUST AS IT
RELATES TO FUNDING BUT ALSO
COUNTY CAPACITY. AND
ACCOUNTABILITY. AS WRITTEN. THIS
BILL INCLUDES A HOST OF NEW
RESPONSIBILITIES AND OBLIGATIONS
FOR COUNTIES. BUT THERE'S NO
GUARANTEE OF ONGOING FUNDING. IT
WILL LIKELY REQUIRE HUNDREDS OF
MILLIONS OF DOLLARS TO DO IT
RIGHT. AND WE'RE DEALING WITH
ARE MOST VULNERABLE. CUTTING
CORNERS OR FAILING TO SUPPORT
THE ACTUAL COST COULD HAVE
SEVERE CONSEQUENCES. TO PUT AN
EVEN FINER POINT ON IT. BETWEEN
2020 AND 2021. MORE PEOPLE MOVED
MY COUNTY, RIVERSIDE COUNTY THAN
ANY OTHER COUNTY IN THE COUNTRY.
WITH THE SINGLE EXCEPTION. A
MIRACLE TO COUNTY, ARIZONA. BUT
DESPITE THE EXPONENTIAL GROWTH
IN THE NUMBER OF RESIDENTS.
BEHAVIORAL HEALTH FUNDING FOR
SERVICES AND INFRASTRUCTURE HAS
NOT KEPT UP. AND NOW THERE'S
MORE PRESSURE THAN EVER. BEFORE
ON OUR LOCAL BEHAVIORAL HEALTH
SYSTEMS, WHICH ARE FACING MORE
CLIENTS. WITH SKYROCKETING NEEDS
FOR GREATER GREATER ARRAY OF
SERVICES AS WELL AS AN EXTREME
WORKFORCE SHORTAGE. WHILE SOME
COUNTIES ARE BETTER POSITIONED
THAN OTHERS. IT IS DIFFICULT TO
IMAGINE HOW WITH ANY UNCERTAIN
CASE WITH WITH AN UNCERTAIN
CASELOAD AND NO GUARANTEE OF
SUSTAINABLE RESOURCES, ANY
COUNTY OR MANAGED TO EFFECTIVELY
IMPLEMENT THE CARE ACT AS IT IS
CURRENTLY WRITTEN. ANOTHER TOP
CONCERN. FOR COUNTIES IS THE
PROPOSED SANCTIONS AND THE HARM
THEY COULD CAUSE TO THE VERY
ENTITIES. COUNTIES THAT ARE
RESPONSIBLE FOR CASE MANAGEMENT
AND SERVICES. THE THREAT OF
SANCTIONS AND RECEIVERSHIP
CERTAINLY CAUSES A CHILLING
EFFECT AMONG MY COLLEAGUES,
COLLEAGUES. WE HAVE HERE.
COUNTIES WILL BE REQUIRED TO
PLAY THE MOST CRITICAL ROLE IN
THE NEW CARE COURTS. IT WON'T BE
PROVIDED THE TOOLS AND RESOURCES
. WE ARE IN DIRE NEED TO BE
SUCCESSFUL. IT'S LIKELY WILL
RESULT. AND FAILURE FOR THE
PROCEEDINGS AND HEARTBREAKINGLY
FOR RESPONDENTS. ADDING
SANCTIONS ON TOP, WE'LL HOBBLE
COUNTIES, WHICH ARE NOT SOLELY
RESPONSIBLE. FOR THE CURRENT
HOUSING CRUNCH. AND WILL HARM
THE VARIOUS SERVICES, WHICH THE
CARE ACT DEPENDS. I COULD GO ON
ABOUT VARIOUS CONCERNS REGARDING
CAPACITY. FUNDING. WORKFORCE AND
HOUSING. I'VE HEARD FROM MY
COLLEAGUES IN COUNTIES, LARGE
AND SMALL. AND THE CHANGES
NECESSARY SIX SUCCESS AT THE
LOCAL LEVEL. I WILL INSTEAD
SIMPLY ASKED THAT THE COMMITTEE
AND GOVERNOR CLOSELY REVIEW THE
COMPREHENSIVE AMENDMENTS. AND
TECHNICAL CONCERNS COUNTIES HAVE
PROVIDED SINCE THE UNVEILING OF
THIS PROPOSAL. TO CLOSE THE CARE
ACT IS PROMISING. BUT THE TERM
PROMISE INTO MEASURABLE OUTCOMES
. WE NEED COLLABORATION AND
PARTNERSHIP BETWEEN THE STATE.
CITIES. ADVERSE GROUP OF
COMMUNITY PARTNERS WITH THE
ENTITIES MOST RESPONSIBLE FOR
IMPLEMENTATION OUR COUNTIES I
CANNOT SAY THIS ENOUGH. THE
SUCCESS OF THE CARE ACT IS ONLY
POSSIBLE. IF THE STATE
GUARANTEES THAT THOSE OF US ON
THE GROUND AT THE TIME RESOURCES
CAPACITY AND SUPPORT REQUIRED.
UNFORTUNATELY THE CURRENT
VERSION OF SP 13 38. LACKS THAT
GUARANTEE AND FAILS TO ADDRESS
GUARANTEED HOUSING OPTIONS
NONETHELESS. I ASSURE YOU. THE
COUNTIES CAN BUILD ON OUR
EXPERTISE AND SUCCESS IN
REACHING THOSE WITH THE MOST
SEVERE NEEDS. WAS SUFFICIENT
INVESTMENTS, ACCESSIBLE HOUSING
AND ONGOING SUPPORT FOR
WORKFORCE AND SERVICES, HOWEVER
, AS DRAFTED SB 13 38 ULTIMATELY
LEAVES COUNTIES INCREDIBLY
CONCERNED. AND PERPLEXED AS TO
HOW SUCCESS CAN BE ACHIEVED. I
RESPECTFULLY URGE THE
LEGISLATURE AND ADMINISTRATION
TO HEAR OUR PLEAS BECAUSE
THERE'S NOTHING MORE WE WANT.
GOING TO SEE THIS WORK. THANK
YOU FOR THE OPPORTUNITY TO SHARK
COUNTY CONCERNS. THANK YOU.
SUPERVISOR WASHINGTON. GOOD
AFTERNOON, SHERWOOD REMEMBERS.
MY NAME IS PHOEBE BELL, AND I'M,
THE BEHAVIORAL HEALTH DIRECTOR
FROM NEVADA COUNTY, AS WELL AS
THE PRESIDENT OF THE CALIFORNIA
BEHAVIORAL HEALTH DIRECTORS
ASSOCIATION. MY TEAM OF COUNTY
STAFF AND OUR COMMUNITY BASED
CONTRACTORS HAVE DEDICATED OUR
LIVES TO CONNECTING INDIVIDUALS
WITH SERIOUS MENTAL ILLNESS AND
SUBSTANCE USE DISORDERS, THE
SERVICES AND SUPPORT FOR OUR
COMMUNITY MEMBERS WHO ARE
UNHAPPY HOUSED. THIS WORK IS
VITAL AND WE ARE DEEPLY
PASSIONATE ABOUT IT. IN NEVADA
COUNTY ARE POINT IN TIME COUNT
VARIES A BIT YEAR EVERY YEAR,
DEPENDING ON IF THERE'S A
SNOWSTORM WHEN WE'RE COUNTING,
ETCETERA, BUT WHAT WE DO KNOW IS
THAT SINCE THE PANDEMIC BEGAN,
OUR NUMBERS HAVE INCREASED. THIS
IS DUE TO MUCH TIGHTER HOUSING
STOCK RENTS SOARING TO
UNPRECEDENTED LEVELS. AND ALSO
THE IMPACTS OF FIRES IN NORTHERN
CALIFORNIA, WHICH HAVE DISPLACED
RESIDENTS AND DESTROYED HOUSING.
IN FACT, IN OUR RECENT COUNT IN
NEVADA COUNTY, WE FOUND 200
PEOPLE WHO ENTERED INTO
HOMELESSNESS THIS LAST YEAR,
TWICE THE RATE WE'VE SEEN IN
PREVIOUS COUNTS. IN ANY GIVEN
YEAR. WE ALSO KNOW THAT ABOUT
HALF OF OUR POPULATION
IDENTIFIED IN THE COUNT ALSO
SUFFERS WITH SOME DEGREE OF
MENTAL ILLNESS OR SUBSTANCES
DISORDER AS THEY IDENTIFY
THEMSELVES. AND THIS IS WHERE WE
COME INTO THE PICTURE. THE WORK
OF CONNECTING ON HOUSED FOLKS
WHO ARE STRUGGLING WITH MENTAL
ILLNESS OR SUBSTANCE USE TO
RESOURCES TAKES DEDICATION AND
SKILL. ONE STUDY FOUND THAT IT
TYPICALLY TAKES AROUND 40
TOUCHES PER CLIENT TO GET THEM
TO SAY YES. YES TO ACCEPTING
SUPPORT AND TREATMENT AND
SERVICES. THIS IS INTENSIVE AND
COSTLY WORK, BUILD ON SMALL
TOUCHES AND CONSISTENCY
ESSENTIAL TOWARDS BUILDING A
RELATIONSHIP BASED ON TRUST. AS
THE PREVIOUS SPEAKER, SPOKE TO
LITTLE OF IT IS REIMBURSABLE
THROUGH MEDICAL OR OTHER
INSURANCE TYPES. HOWEVER WE KNOW
IT IS EFFECTIVE FROM OUR YEARS
OF DOING THIS WORK. OFTEN THE
PUBLIC POINTS TO THE SMALL
NUMBERS OF INDIVIDUALS
ULTIMATELY CONSERVED UNDER
ALTERNATIVE MODELS SUCH AS
LAURA'S LAW, WHICH WAS STARTED
IN NEVADA COUNTY. AS A SIGN THAT
WE HAVE NOT DONE OUR JOB WHEN IN
FACT THE OPPOSITE IS TRUE.
THEY'RE GETTING OUR CLIENTS TO
YES, VOLUNTARILY AND HAVING
FEWER CONSERVATIVES AS A MARKER
OF THE PROGRAM'S SUCCESS. I'M
PROUD THAT WE'VE BEEN ABLE TO
REDUCE INVOLUNTARY TREATMENT FOR
OUR CLIENTS BY PARALYZING
INTENSIVE ENGAGEMENT AND
UPSTREAM OUTPATIENT SERVICES IN
NEVADA COUNTY. AND WHILE OUR
PRIMARY MISSION IS TREATMENT, WE
ALSO KNOW THAT HOUSING IS
ESSENTIAL TO HEALING TO EVERY
BEHAVIORAL HEALTH DIRECTOR
THROUGHOUT CALIFORNIA HAS HAD TO
LEARN HOW TO BECOME A LANDLORD
LIAISON, A REAL ESTATE DEVELOPER
AND HOUSING FINANCE EXPERT AS
WELL. WE SURVEYED OUR MEMBERS
AND FOUND THAT ONE PROGRAM MODEL
IN A SINGLE YEAR. THROUGH THAT
MODEL COUNTY BEHAVIORAL HEALTH
DIRECTION AGENCIES SUCCESSFULLY
ENGAGED AROUND 14,000 HOMELESS
HOMELESS INDIVIDUALS INTO
TREATMENT. WE SUCCEEDED IN
HOUSING ABOUT HALF OF THOSE
FOLKS, BUT THAT MEANT NEARLY
8000. OTHERS REMAINED ON HOUSED
WHILE ENGAGED IN THIS HIGHLY
INTENSIVE FORM OF TREATMENT.
THEY WERE UNHAPPY BECAUSE THEY
COULDN'T PASS CREDIT CHECKS OR
THEY HAD CRIMINAL JUSTICE
HISTORIES OR THE MYRIAD OTHER
REASONS PEOPLE HAVE A HARD TIME
GETTING INTO HOUSING OR, AS IS
THE CASE IN MY COMMUNITY BECAUSE
THEY'RE WAITING FOR HOUSING THAT
SIMPLY DID NOT EXIST. WE HAVE
OUR CLIENTS AT? YES YES. I'M
ENGAGED IN TREATMENT. YES I WANT
HOUSING AND WERE UNABLE TO HOUSE
THEM. UNDERSTAND THE URGENCY OF
THIS PUBLIC HEALTH EMERGENCY. WE
SEE FIRST HAND HOW LIVING ON SSE
WITH A SIGNIFICANT MENTAL HEALTH
DISABILITY WILL MAKE YOU MORE
VULNERABLE TO BECOMING HOMELESS
AND HOW THE TRAUMA OF LIFE ON
THE STREETS WILL LEAD TO NEW OR
WORSE, BEHAVIORAL HEALTH
CONDITIONS, PARTICULARLY
SUBSTANCE USE DISORDERS. BUT WE
DESPERATELY LACK OR ADDITIONAL
RESOURCES TO KEEP UP WITH THE
INFLUX OF NEWLY HOMELESS
INDIVIDUALS, YEAR TO YEAR AND
THE HOUSING TO SUPPORT THEM.
WELL, WE APPRECIATE THE PROGRESS
. WE'VE MADE HIM WORKING ON
AMENDMENTS WITH THE
ADMINISTRATION, THE AUTHORS AND
THE COMMITTEE. SEVERAL KEY
ISSUES REMAIN. FIRST WE CAN'T
MISTAKE THEN WE TALK ABOUT
PRIORITIZATION WE'RE REALLY
SAYING IS THAT COUNTY SHOULD
DIRECT RESOURCES AWAY FROM OTHER
PROGRAMS AND SERVICES TO ADDRESS
THE CONCERNS OF CARE COURT
PARTICIPANTS. AIRPORTS INTENDED
TO ADDRESS HOMELESSNESS, BUT IT
CREATES A NEW ENTRY POINT FOR
INDIVIDUALS WITH PRIVATE
INSURANCE TO TAKE RESOURCES,
INCLUDING TREATMENT AND EVEN
HOUSING SLOTS AHEAD OF LOW
INCOME CLIENTS WHO ARE ALREADY
VOLUNTARILY ENGAGED. WE ALSO
BELIEVE THAT THE NEW ELIGIBILITY
CRITERIA SIGNIFICANTLY EXPANDS
THE POPULATION. THIS PROPOSAL
WILL APPLY TO WELL BEYOND THE 7
TO 12,000 ESTIMATES. AND WE KNOW
THAT WITHOUT ADDITIONAL
RESOURCES AND WITH THE
SIGNIFICANT THREAT OF SANCTIONS
WILL HAVE NO CHOICE BUT TO
DIVERT RESOURCES AWAY FROM
EVIDENCE BASED INTERVENTIONS
THAT WORK TO SAVE THE LIVES OF
THOUSANDS OF CLIENTS. WE SERVE
THROUGHOUT THE STATE. THE
SUICIDE RATES AND OPIOID DEATHS
AT AN ALL TIME HIGH. WE CANNOT
AFFORD TO TAKE A ZERO SUM
APPROACH TO POLICY MAKING. WE
MUST FULLY FUND THIS INITIATIVE
AND ENSURE THAT THE HOUSING
RESOURCES ARE IN PLACE IN MY
COMMUNITY. THEY'RE NOT HERE
TODAY. VOUCHERS IN HAND SHOVELS
AND GROUND. WE WAIT WITH THE
KNOWLEDGE, SKILLS AND PASSION TO
DELIVER ON THIS PROMISE. THANKS.
THANK YOU VERY MUCH ARE THERE
OTHERS IN BETWEEN JUST YOUR NAME
AND ORGANIZATION. IF YOU
REPRESENT ONE NICOLE WARDIMAN ON
BEHALF OF THE ORANGE COUNTY
BOARD OF SUPERVISORS IN A
SUPPORT IF AMENDED TO ADDRESS
COUNTING POSITION. OKAY. THANK
YOU. GOOD AFTERNOON, MR CHAIR
AND MEMBERS CARON LING ON BEHALF
OF THE BOARDS OF SUPERVISORS IN
KERN, SAN LUIS OBISPO. DON
NORTON, NEVADA BEAUTY, TULARE,
FRESNO AND SOLANO AND CONCERNS
WITH CONCERNS. YOU KNOW,
BRILLIANTLY OUTLINED BY THE TWO
WITNESSES, HARRY. THANK YOU.
THANK YOU. THE NEW NON SHOOTS.
SO ON BEHALF OF THE 700,000
MEMBERS OF S E I U S. C I U
CALIFORNIA WERE ALSO IN BETWEEN
OUR POSITION BUT LOOK FORWARD TO
CONTINUING WORKING WITH THE
AUTHOR ADMINISTRATION. THANK
YOU. DEVON ANDERSON ON BEHALF OF
THE SAN MATEO COUNTY BOARD OF
SUPERVISORS. ALSO WITH THE
CONCERNS POSITION. THANK YOU.
THANK YOU. KELLY BROOKS ON
BEHALF OF THE URBAN SORRY. I
FEEL LIKE YOU CAN'T HEAR ME
KELLY BROOKS ON BEHALF OF THE
URBAN COUNTIES OF CALIFORNIA,
THE ROYAL COUNTY REPRESENTATIVES
OF CALIFORNIA AND THE COUNTY
WELFARE DIRECTORS ASSOCIATION.
ALL WITH CONCERNS POSITIONS.
THANK YOU. THANK YOU. GOOD
AFTERNOON TIWARI RANDY ON BEHALF
OF THE CALIFORNIA ALLIANCE, A
CHILD AND FAMILY SERVICES AND
THE CALIFORNIA ASSOCIATION OF
ALCOHOL AND DRUG PROGRAM
EXECUTIVES WITH CONCERNS. THANK
YOU. THANK YOU. ANYONE ELSE? NO.
ONE BRING IT BACK TO THE
COMMITTEE FOR QUESTIONS AND
COMMENTS OF THE COMMITTEE WHO
WOULD LIKE TO START. THANK YOU,
SENATOR. THANK YOU, SENATOR FOR
BRINGING THIS BILL FORWARD. AND
YOU KNOW, WE'RE ALL AWARE OF, UM
THE CALIFORNIA IS FACING A
HOMELESS CRISIS. AND THIS
POINTED OUT IN JANUARY 2020 THAT
WE HAVE. CALIFORNIA HAS 28% OF
THE NATION'S HOMELESS POPULATION
OVER 160 HUMAN BEINGS OUT THERE.
YOU KNOW, WE HAVE SO MANY
SUPPORTIVE SERVICES INVEST IN
LARGE SUMS OF MONEY EVERY YEAR.
AND WE'VE CREATED A MULTI AGENCY
HOMELESS COUNCIL. AND YET THE
PROMISE PER THE PROBLEM STILL
PERSISTS. AND I COMMEND YOU
SENATOR AND SENATOR UMBERG
SUPPORTERS THE GOVERNOR FOR
SEEKING NEW APPROACH. WE CANNOT
REST UNTIL WE MAKE REAL
PROGRESS. WHICH IS WHY I SAY
NINE, IS A CO AUTHOR. AND ALSO
ACKNOWLEDGED THERE'S STILL SO
MUCH MORE WORK TO DO. AND AS
WE'VE HEARD FROM THE OPPOSITION
, UM I UNDERSTAND THE CONCERNS
AND I REALLY APPRECIATE THEIR
TESTIMONY TODAY. BUT I CAN'T
WAIT. AND I'M PLENTY OF MY
COLLEAGUES FEEL LIKE WE CAN'T
WAIT. BUT THERE'S A COUPLE OF MY
CHIEF CONCERNS THAT ARE STILL
REMAINING. ONE SUFFICIENT
RESURCES MUST ACCOMPANY THE
IMPLEMENTATION. THERE MUST BE A
THOUGHTFUL PHASE IN FOR
JURISDICTIONS WILL FACE
CHALLENGES TO IMPLEMENT THIS
PROGRAM. ALTHOUGH WE HAVE
COMMITTED BILLIONS TO HOUSING
THE IN HOME SUFFICIENT HOUSING
RESOURCES ARE CRITICAL FOR THIS
TO SUCCEED. AND PENALTIES UNDER
THE BILL MUST BE RESERVED FOR
THOSE WHO HAVE TRULY FAILED TO
SINCERELY ATTEMPT TO MAKE THE
REQUIREMENTS. UM I WANTED TO
ALSO ACKNOWLEDGE THE GENTLEMAN
THAT CAME FROM WEST SACRAMENTO.
I HAD THE OPPORTUNITY TO GO OUT
TO THEIR LATEST HOMELESS SITE,
AND I JUST AND THE HOMES THAT
ARE BEING PROVIDED IN WEST
SACRAMENTO. THAT IS STATE OF THE
ART. PEOPLE SHOULD GO SEE WHAT
THEY HAVE DONE OUT THERE BECAUSE
WE DO KNOW THERE ARE GREAT
PROGRAMS THAT ARE OUT THERE. WE
DON'T HEAR ABOUT HIM ENOUGH, BUT
I JUST WANT TO COMMEND YOU ON
WHAT YOU'RE DOING. FOR YOUR
COMMUNITY, AND I WILL CONTINUE
TO BE SUPPORTIVE OF WHATEVER
YOU'RE DOING WITH SACRAMENTO. I
DO ENCOURAGE THE AUTHORS TO WORK
DILIGENTLY WITH THE STAKEHOLDERS
ON ISSUES I'VE OUTLINED AND VERY
INTENTIONALLY TO SPECIFICALLY
AVOID ANY IMPLEMENTATION THAT
WILL DISPROPORTIONATELY AFFECT
STIGMATIZED OR PENALIZED THOSE
FROM THE COMMUNITIES WHO HAVE
STRUGGLED MORE MOST DURING THIS
CRISIS. THANK YOU SO MUCH FOR
BRINGING THIS FORWARD AND LOVE
TO SEE US GET THIS ACROSS THE
FINISH LINE, BUT WE'RE GOING TO
HAVE EVERYONE IN THIS ROOM USED
TO PARTICIPATE AND MAKE SURE
IT'S SUCCESSFUL. THANK YOU, SAM.
REMEMBER? THANK YOU. WALDRON.
THANK YOU, MR CHAIR AND AUTHOR.
AUTHORS, BUT ONE PRESENT ONE.
NOT AT THIS TIME. UM MENTAL
HEALTH AND HOMELESSNESS HAS BEEN
AN ISSUE THAT WE'VE BEEN TALKING
ABOUT SINCE WE GOT HERE IN THE
LEGISLATURES AND HAS BEEN TALKED
ABOUT BEFORE US. WE'VE SEEN THE
CRISIS LOAD. UM, AND WE'VE BEEN
TRYING TO ADDRESS IT. AS SINCE
WE SINCE WE GOT HERE AS I
MENTIONED, BUT YOU KNOW, WHEN I
FIRST HEARD ABOUT THE CARE COURT
PROPOSAL, I WAS REALLY EXCITED
BECAUSE I THOUGHT YOU KNOW WHAT
WE'VE BEEN TALKING ABOUT FOR A
DECADE BASICALLY MAY COME TO
FRUITION IF IT'S DONE RIGHT. UM
BRINGING ALL THE DIFFERENT
SYSTEMS TOGETHER IN THE
CONTINUUM OF CARE PACKAGE THAT
MIGHT ACTUALLY WORK. UM YOU KNOW
, IT'S NOT A PERFECT PROPOSAL BY
ANY MEANS. I DON'T THINK ANY OF
OUR BILLS ARE PERFECT, BUT IT'S
PROVIDES A FIRST STEP TO MAKE
ACTIONABLE CHANGES THAT CAN
ADDRESS THIS HOMELESSNESS AND
BEHAVIORAL HEALTH CRISIS THAT WE
WITNESS ON OUR STREETS. AND
GETTING PEOPLE CONNECTED TO CARE
EARLIER. IS REALLY SOMETHING
THAT WE'VE STRUGGLED WITH, YOU
KNOW, INSTEAD OF LETTING IT GO
AND GO AND YEARS WE SEE THE SAME
PEOPLE AND AS WAS MENTIONED
CYCLING IN AND OUT OF JAIL OR
CYCLING IN AND OUT OF
FACILITIES. UM SO IT'S MOST
IMPORTANT THAT CARE COURT DOES
RECOGNIZE THE CONTINUUM OF CARE
AND GETTING PEOPLE IN EARLY AND
WILL ALLOW PEOPLE WITH UNTREATED
MENTAL ILLNESS TO CREATE AN
INDIVIDUALIZED PLAN. WITH THE
CARE TEAM TO GET THEM THOSE
SUPPORTIVE SERVICES THAT THEY
NEED. UM MOST IMPORTANTLY, IT
DOESN'T ADDRESS THE ISSUE IN THE
VACUUM. YOU KNOW, WE'VE TRIED
HOUSING. WE'VE TRIED. SOME
MENTAL HEALTH SERVICES. WE TRIED
SUBSTANCE USE. WE TRIED ALL
THESE THINGS, SOMETIMES A LITTLE
BIT TOGETHER, SOMETIMES
SEPARATE. BUT I THINK THE
WRAPAROUND SERVICES IS GOING TO
BE THE CRITICAL PART. BUT AS MY
COLLEAGUE MENTIONED GETTING THE
SUFFICIENT FUNDING ONGOING WILL
BE IMPORTANT. ALSO FOR THE
HOUSING PART OF IT. AND THE
ACCOUNTABILITY IS DR GALLEY HAD
TALKED ABOUT ACCOUNTABILITY IS
GOING TO BE THE KEY, BECAUSE AS
WE GO INTO IT, IT'S A BIG
PROGRAM. AND ALL EYES ARE GOING
TO BE ON WHAT WE'RE DOING.
BECAUSE CALIFORNIA ISN'T THE
ONLY STATE THAT IS EXPERIENCING
HOMELESS THIS SO YOU KNOW, WE
NEED TO BE READY TO PIVOT. IF
SOMETHING'S NOT WORKING. WE NEED
TO KNOW EARLY ENOUGH. IF IT'S
NOT, UH AND IF WE SEE SOMETHING
THAT COULD BE ADDRESSED TO BE
ABLE TO ADDRESS IT SO THAT WE'RE
NOT TOO BUREAUCRATIC THAT WE
CAN'T DO THAT. UM I THINK IT'S
SOMETHING THAT WE COULD BE
SUCCESSFUL OUT OF IT'S DONE
RIGHT? IT COULD BE A GREAT
MODEL. FOR OTHER STATES AS WELL
. SO IT'S THE START. THIS
LEGISLATURE NEEDS TO CREATE MORE
ACCESS TO MENTAL HEALTH PROGRAMS
AND SUPPORT CALIFORNIANS IN
THEIR TIME OF NEED. SO I'M
EXCITED TO SUPPORT THIS TANK.
THANK YOU, MR MCCARTHY. YES, UH
THANK YOU. BACK. I KNEW YOU
WOULD HAVE ANSWERED. SO UM, YOU
KNOW, THIS IS A BIG ISSUE THAT
WE SPENT THE FALL TALKING ABOUT
WITH OUR HEARING. I WOULD. AND
IT'S SOMETHING I THINK
UNIVERSALLY THE LEGISLATION THE
GOVERNMENT THINKS WHEN YOU DO
THINGS DIFFERENTLY, THE STATUS
QUO IS NOT WORKING. AND I KNOW
IT'S DANGEROUS TO PUT PEOPLE IN
THE POTS OF HOMELESS. ACTION AND
MENTALLY ILL BECAUSE BECAUSE
OBVIOUSLY NOT ALL HOMELESS, HAVE
MENTAL ILLNESS OR SEVERE MENTAL
ILLNESS. NOT ALL SEVERE MENTALLY
ILL HOMELESS. BUT THERE IS A
CORRELATION OF PEOPLE OUT THERE.
AND WE SEE THOSE PEOPLE MORE
THAN PEOPLE WHO HAVE SERIOUS,
MENTAL, UM, HEALTH. DISORDERS
AND HER LIVING AT HOME WITH THE
FAMILY. YOU DON'T SEE THEM AS
MUCH THE BREAKDOWN IN OUR
STREETS AND NO, WE ALL SEE THIS
OUT THERE IN THE OPEN. JUST FOUR
HOURS AGO, OUR COUNTY DID OUR
ALMOST POINTING COUNT. POINT
TIME, AND IT'S LIKE, YOU KNOW,
9000. DOUBLE WHERE IT WAS A
COUPLE YEARS AGO. MORE HOMELESS
HERE THAN IN SAN FRANCISCO. SO
LIKE WE'VE HAD AN EXPLOSION HERE
AND THIS IS NOT GOING TO SOLVE
ARE HOMELESS PROBLEM. BUT TO
IGNORE THE FACT THAT THERE ARE
SOME PEOPLE WHO AREN'T GETTING
THE TREATMENT THAT UM, THEY NEED
AND NOT TO BE TAKEN. MR THIS IS
THAT. CALIFORNIA SHOULD HAVE A
RESPONSIBILITY TO OFFER CERTAIN
PEOPLE. TREATMENT AND HOUSING
AND THE INDIVIDUAL SHOULD HAVE
AN OBLIGATION TO SAY YES. WE'RE
SAYING IS, IF YOU DON'T WE'RE
GOING TO STEP IN AND BE I GUESS
THE ADULT IN THE ROOM. AND I GET
THAT'S KIND OF THE PREMISE OF
THIS NOT CONSERVATORSHIP OF THIS
UNIQUE PROCESS THROUGH THIS CARE
COURT. SO I THINK THE ONE
QUESTION THAT THE OPPOSITION
HANGS ON TO AND THAT I GUESS WE
HAVE IS WHAT HAPPENS I KNOW IN
THE BILL THAT SAYS THAT COUNTIES
SHOP, UM DEVELOP SERVICES AND
HOUSING AND PRIORITIES FOR
PEOPLE WITHIN THIS POPULATION.
SO WHAT HAPPENS IF SOMEBODY GOES
THROUGH THIS IN MY SIMPLE LAYMAN
TERMS GOES THROUGH. THE CARE
COURT PROCESS AND IS ADJUDICATED
AS SOMEBODY WHO OUGHT TO BE
RECEIVING SOME OF THIS TREATMENT
AND WE'RE SAYING HEY, IN
CALIFORNIA. WE WERE SAYING YOU
SHALL RECEIVE IT. YOU MUST
RECEIVE IT OR THERE'S A
CONSEQUENCE. WHAT HAPPENS TO
THAT PERSON? IF IT'S NOT THERE.
WHAT I THINK THAT'S THE
OVERARCHING ISSUES. HOW WOULD
YOU ADDRESS THAT? UM THANK YOU
VERY MUCH, UH, ASSEMBLY MEMBER,
UM WHEN YOU SAID THE PERSON IS
OBLIGATED THAN TO ACCEPT. I
THINK WHAT WE'RE ALSO SAYING IS
IN WHICH IN WHICH RIGHTLY WHY
THE COUNTIES ARE OPPOSED. WE'RE
NOT JUST SAYING THE PERSON HAS
THE OBLIGATION TO ACCEPT WE'RE
SAYING THE SYSTEM HAS THE
OBLIGATION TO TREAT RIGHT? AND
WHICH IS WHY AND SO EMPEROR TO
THE OPPOSITION WHO KEEPS TALKING
ABOUT HOUSING FIRST, AND IF
WE'RE NOT OFFERING HOUSING, THIS
ISN'T REAL. THAT'S WHAT WE'RE
SAYING THAT PART OF THE COUNTY'S
PLAN, WHICH IS WHY THE COUNTIES
ARE YOU KNOW, NOT AS IN FAVOR
ARE TWEENERS, IF YOU WILL IS
BECAUSE WE'RE NOT JUST SAYING
THE PERSON HAS THE OBLIGATION TO
ACCEPT. WE'RE SAYING THE SYSTEM
AS THE COUNTIES THE COURTS ALSO
HAVE THE OBLIGATION TO SERVE SO
I WOULD SAY THAT DIFFERENTIATES,
UM 11 LITTLE COMPONENT THAT YOU
TALKED ABOUT. UM I WOULD. I
WOULD SAY THAT THE BILL LAYS OUT
IF SOMEONE IS THEY WOULD JUST GO
THROUGH THE REGULAR PROCESS
RIGHT THEN THEY WOULD PROBABLY
REFER TO THE LPS PROCESS IF
THEIR IF THEIR SYMPTOMS ARE SO
BAD THAT IT LEADS TO THE CRISIS.
BUT THERE IS NOTHING IN HERE
THAT SENDS SOMEBODY TO PRISON.
THERE'S NOTHING IN HERE THAT
SEND SOMEBODY TO JAIL, IT IS
WOULD BE SOMEBODY'S OWN BEHAVIOR
THAT WOULD THAT WOULD
PRECIPITATE THAT. SO LET'S LET'S
LET'S FOCUS ON A HYPOTHETICAL WE
HAD THE INDIVIDUAL. COURT FROM
WEST SACRAMENTO. CAN YOU SPEAK
INTO THE MIKE? BECAUSE IT'S
GOING TO BE HARD TO SEE ME.
SORRY. WE HAD THE INDIVIDUAL
EARLIER FROM WEST SACRAMENTO. SO
LET'S SAY YOLO COUNTY DEVELOPS
THIS SYSTEM FOR PEOPLE THAT ARE
TAG IN THIS AND I THINK THAT
LONGER NUMBERS ARE GOING TO BE
STAGGERING NÓ AND SO AS A
HYPOTHETICAL FOR ONE INDIVIDUAL.
IF THERE IS NOT, UM, CAPACITY
FOR THE INDIVIDUAL WHAT HAPPENS
CAPACITY IN THE SYSTEM? THEN
THERE'S THE SYSTEMS HELD
ACCOUNTABLE. NOT THAT INDIVIDUAL
BECAUSE WITH THE WITH THE WITH
THE COUNTIES WILL HAVE TO DO IS
CREATE THAT CARE PLAN, RIGHT?
THEY HAVE TO CREATE THE PLAN.
THIS IS WHAT IN COLLABORATION
WITH THE PERSON IN COLLABORATION
WITH THE SUPPORTER, AND THAT
SUPPORTER NOW CAN EITHER BE, UM
, A FAMILY MEMBER OR SOMEBODY
ELSE OR SOMEBODY THAT THE CARE
THE CARE ACT WILL PROVIDE, AND
IT WOULD ALSO WILL ALSO BE THAT
LEGAL AID PERSON. AND THEN IN
ANYBODY'S SOMETHING LIKE A CPS
FAMILY, YOU KNOW, WE'RE GOING TO
CREATE A PLAN, SO YOU CREATE
THAT PLAN. AND THEN THE COURT
SAYS THAT'S THE PLAN. OKAY,
THAT'S THAT'S A GOOD PLAN.
THAT'S NOT A PLAN BECAUSE PART
OF THAT PLAN. IS FOR HOUSING.
PART OF THAT PLAN IS FOR
HOUSING. AND SO THAT AND THE
COUNTIES GOT TO FIND IT
SOMEWHERE, AND I THINK THAT'S
WHAT THEY'RE SAYING. WE DON'T
HAVE ENOUGH AS IT IS AND RIGHT
AND WE ALL KNOW THAT THE
COUNTIES HAVE BEEN THERE. I
MEAN, WE'VE SEEN THE REPORTS
FROM MH ESSAY THERE. THERE'S YOU
KNOW BILLIONS. STILL IN SOME OF
THAT FUNDING, AND WE UNDERSTAND
THAT IT TAKES A WHILE TO PLAN TO
GET THE HOUSING BUT FOR
OPERATION ROOM CARE HOME KEY. I
MEAN, THERE ARE THOSE PLACES
AVAILABLE, WHICH IS WHY WENDELL
DOCTOR, GALLI SAYS. WE ARE GOING
TO PRIORITIZE BECAUSE WE'RE
GOING TO SAY THESE FOLKS NEED TO
GET SOMEWHERE SAFE. AS PART OF
THAT PLAN. SO IF THERE IS A
JUDGMENT FROM THE CARE COURT.
I'M NOT SURE THAT THE RIGHT
TERMS HERE AND SOMEONE'S
ADJUDICATES AS YES. HARCOURT
WORTHY. NECESSITATES THIS TYPE
OF. THE COUNTY WOULD BE
OBLIGATED TO HAVE THAT.
TREATMENT FOR INDIVIDUAL AND
THEY WILL TRIAGE AND PUT PEOPLE
OUT OF THE WAY. MAKE THAT PERSON
THE TOP OF THE LIST. THAT'S
CORRECT. THAT'S CORRECT. NO ONE
WOULD SLIP THROUGH THE CRACKS,
AND I GUESS THAT'S THE ANSWER TO
THE OPPOSITION WHO SAYS THAT
PEOPLE WOULD HAVE THIS AS A
LABEL AND THEN WE WOULDN'T HAVE
THE SERVICES AND TREATMENT FOR
THEM. I WOULD SAY WHAT THE
OPPOSITION PRESENTED IS OUR
SYSTEM RIGHT NOW, PEOPLE IN AND
OUT OF THE ER IN AND OUT OF
JAILS IN AND OUT WITH
MISDIAGNOSIS BECAUSE IT'S TOO
HOT. IT'S HARD. THIS IS A VERY
DIFFICULT DEMOGRAPHIC TO TREAT
AN INCREDIBLY DIFFICULT AND
AGAIN WHEN PEOPLE TALK ABOUT
HOMELESS, IT'S NOT JUST WHERE
WE'RE NOT TALKING ABOUT
EVERYBODY WHO'S HOMELESS. WE'RE
TALKING ABOUT PEOPLE WITH A VERY
SPECIFIC DIAGNOSTIC CRITERIA TO
MEET, UH, THAT AGAIN THAT WE ALL
KNOW, OR THE VERY, VERY, VERY
MOST DIFFICULT TO TREAT. SO I
DON'T THINK IT'S GONNA BE A TON
OF 7 TO 12 IS WHAT THE, UM 1000
SO, YES, BUT THOSE PEOPLE WOULD
THEN BE PRIORITIZED. AND YES,
SOMETIMES I HAD TO SOMEBODY ELSE
WHO MAY BE, UM, HAVE BEEN
WAITING. BUT IT IS WE'RE NOT
THINKING THAT, ESPECIALLY IN
NEVADA COUNTY HAS DONE A
FANTASTIC JOB WITH A OT WHERE IT
STARTED IN NEVADA COUNTY WITH
LAURA'S LAW, UM, WE'RE NOT
ANTICIPATING THAT THERE'S GOING
TO BE THE 7 TO 12,000 PEOPLE
THERE, ESPECIALLY THE BETTER A
COUNTY HAS DONE AND BEING ABLE
TO TREAT THESE FOLKS WHO ARE AND
I WILL SAY THERE ARE ALREADY IN
OUR COMMUNITIES RIGHT? THESE
PEOPLE ARE ALREADY THEORETICALLY
SERVED. BY OUR SYSTEMS. AND WHAT
WE'VE HEARD IS NO, THEY'RE NOT
BECAUSE IT'S REALLY, REALLY.
IT'S VERY, INCREDIBLY DIFFICULT
AND EXPENSIVE. AGAIN MEMBERS OF
HOW MANY BILLIONS OF DOLLARS ARE
WE GOING TO CONTINUE TO THROW AN
ISSUE WITHOUT TAKING REALLY
CONCRETE STEPS? I WOULD JUST AS
PEOPLE KNOW BY WAS A PROFESSOR
OF SOCIAL WORK, AND THAT'S WHAT
I WOULD SAY TO MY BY MY STUDENTS
ALL THE TIME. YOU HAVE TO HAVE
MORE TOOLS IN YOUR TOOLBOX. IF
THE ONLY TOOL YOU HAVE IS A
HAMMER AND EVERYTHING LOOKS LIKE
A NAIL, AND WE KNOW THAT'S NOT
TRUE THAT PEOPLE ARE COMPLEX, UH
AND COMING WITH ALL KINDS OF
TRAUMA TO THEM, SO IT'S THE IT'S
THE SYSTEM THAT WILL BE HELD
ACCOUNTABLE. TO THE CARE. MR
MAYS. THANK YOU, MR CHAIR. I
JUST WANTED TO START OFF BY
SAYING HELLO TO MY GOOD FRIEND
SUPERVISOR CHUCK WASHINGTON.
IT'S GREAT TO SEE YOU HERE, UM
AND REPRESENTING NOT JUST
RIVERSIDE COUNTY. BUT ALL THE
ALL THE COUNTIES AND I CAN
UNDERSTAND THE POSITION THAT YOU
TAKE ON THIS REPRESENTING ALL
THE COUNTIES. UM AND
UNDERSTANDING THAT THERE DOES
NEED TO BE THE RESOURCES. THE
STATE NEEDS TO PROVIDE THE
RESOURCES. BUT I SEE THIS AS, UH
, ONE OF THE MOST MONUMENTAL
PIECES OF PUBLIC POLICY THAT THE
STATE OF CALIFORNIA HAS HAS
PROPOSED ONE OF THEM, MAYBE NOT
THE PRIMARY BUT ONE OF THEM IN
THE LAST EIGHT YEARS THAT I HAVE
THAT I HAVE SERVED, AND I
HAVEN'T DONE A WHOLE LOT OF
PRAISING OF THE ADMINISTRATION.
UM OVER THE LAST COUPLE OF
YEARS, BUT I DO THINK THIS IS AN
INSTANCE AND WHEN YOU SEE THE
NUMBER OF SUPPORTERS AND THE
NUMBER OF OPPOSITION THAT ARE
VERY SINCERE IN THEIR SUPPORT
AND THEIR OPPOSITION THAT I
THINK WE GOT IT JUST ABOUT
RIGHT. MAYBE NOT PERFECT, BUT WE
GOT IT. JUST ABOUT RIGHT. I
THINK THE BALANCE HERE BETWEEN
UM UH, CIVIL LIBERTIES AND AT
THE SAME TIME AS YOU SAY, DOCTOR
EGGMAN. THAT OBLIGATION TO SERVE
. UM, I'VE TOLD THIS STORY MANY
TIMES THAT I'VE HAD A FAMILY
MEMBER WHO IS PARANOID
SCHIZOPHRENIC WHO HAD HOUSING
HAD A SMALL HOUSE OUT IN THE
MIDDLE OF THE MOJAVE DESERT.
THAT HE OWNED. BUT WHEN HE
STOPPED TAKING HIS MEDICATION,
HE VERY QUICKLY, UM, TORE OUT
ALL THE ELECTRICAL. UM UH, PUT
TO THE REFRIGERATOR MICROWAVE ON
THE GROUND BECAUSE YOU STARTED
HEARING FROM THE CIA, FBI AND
ALL THIS. WE'VE HEARD THIS STORY
A STORY BEFORE. UM AND IT'S ONLY
A MATTER OF TIME BEFORE HE ENDED
UP LIVING UNDERNEATH AN
UNDERPASS. AND THE TRUTH IS AS A
SOCIETY AS A SYSTEM. WE FAILED
THEM. AND AS YOU SAID, A DOCTOR
EGGMAN, UH, WHAT THE OPPOSITION
SAID. TODAY IS THE CURRENT
SYSTEM THAT WE HAVE, AND WE ARE
FAILING THESE PEOPLE. THERE'S
GOTTA BE A WAY TO BE ABLE TO
BALANCE THOSE CIVIL LIBERTIES
AND AT THE SAME TIME UH, THAT
MAKING SURE THAT WE ARE, UH,
OBLIGED AS WE SHOULD BE TO SERVE
THESE PEOPLE THAT WE HAVEN'T
BEEN DOING A VERY GOOD JOB A JOB
OF AND IT IS IMPACTING OUR STATE
AND IMMEASURABLE WHAT WAYS AND
SO I'M GONNA JUST SAY THIS IS A
FANTASTIC PIECE OF PUBLIC POLICY
. UM I AM, UH, WILDLY SUPPORTIVE
OF IT. IT IS NOT PERFECT. BUT
IT'S CERTAINLY IS THE BEST OF
ALL THE DIFFERENT OPTIONS THAT
WE'VE SEEN. AND SO I'LL BE
SUPPORTING IT TODAY. QUÊ ANYONE
ELSE, MISS CARILLO? THANK YOU.
THANK YOU. MR CHAIR. AND I WANT
TO THANK ALL OF THE FOLKS THAT,
UM TESTIFIED TODAY, BOTH IN
SUPPORT AND OPPOSITION. I GREW
UP IN THE CITY OF LOS ANGELES. I
GREW UP IN THE DISTRICT THAT I
ACTUALLY REPRESENT. AND YOU KNOW
FOR A LONG TIME. MY MY MOM
DIDN'T KNOW HOW TO DRIVE. AND SO
I GREW UP USING WHAT WAS THEN
THE R T A SYSTEM ARTERY SYSTEM,
WHICH IS NOW THE M T A SYSTEM.
AND WE GO FROM THE EAST SIDE OF
LOS ANGELES TO THE WEST SIDE
WHERE SHE WORKED, AND WE PASSED
DOWNTOWN. AND I REMEMBER AS A
LITTLE GIRL THINKING, WHY ARE
THERE SO MANY PEOPLE ON THE
STREETS WE WOULD PASS THROUGH
SKID ROW. SKID ROW, WHICH IS THE
EPICENTER OF OUR OWN HOUSE
COMMUNITY WITH A LOT OF MENTAL
HEALTH CHALLENGES IS GROUND
ZERO. ACROSS THE NATION, THE
BIGGEST ON HOUSE POPULATION.
WITH LOTS OF NEED IN THE ENTIRE
UNITED STATES. IT BORDERS MY
DISTRICT. IT'S ACTUALLY PART OF
THE CURRENT, UM, CURRENT MEMBER
THAT'S IN THIS COMMITTEE AS
WELL, WHO REPRESENTS THAT AREA,
AND IT IS IT IS INCREDIBLY
PROFOUND TO LOOK AND TO SEE AND
TO FEEL I'VE GONE ON MY OWN.
EVEN BEFORE I WAS ELECTED TO
HELP OUT TO PASS OUT FOOD, TOO.
GIVE OUT SLEEPING BAGS, AND
THERE WERE MOMENTS WHERE I FELT
UNSAFE. DIDN'T KNOW WHETHER I
YOU KNOW WAS OKAY OR NOT. MY
SISTER WORKS WITH, UM, HOUSED
YOUTH. TRYING TO FIND THEM.
PLACEMENT ALSO, UH, YOU KNOW, IN
SKID ROW WHERE SHE FIRST
STARTED, SO THERE ARE SEVERAL OF
US THAT HAVE TRIED TO DO
MONUMENTAL. THINGS ARE LITTLE
THINGS TO TRY TO HELP. AND EVEN
THEN, I WONDERED. HOW DID IT GET
THIS WAY? SO YOU KNOW AS A JUST
AS A WE OFTEN CAN LOOK AT
HISTORY TO TRY TO FIGURE OUT
WHERE IT IS THAT WE FAILED AND
HOW WE CAN IMPROVE UPON
SOMETHING SOMETHING THIS WAS,
YOU KNOW, I THINK BACK OF, UM
WHAT HAPPENED TO MENTAL HEALTH
MENTAL HEALTH HOSPITALS ACROSS
THE STATE OF CALIFORNIA,
SHUTTING THEM DOWN UNDER THE
REAGAN ADMINISTRATION AND WHAT
HAPPENED YEARS LATER, WHEN
GOVERNOR REAGAN BECAME PRESIDENT
REAGAN. AND IF I MAY, MR CHAIR I
WANT TO READ SOMETHING FROM THE
L A TIMES DATED MARCH 22ND 1987.
AH! THAT'S OKAY. OKAY THANKS.
THE TITLE OF THIS, UM REPORT IS
CALIFORNIA GOOD AIMS BAD RESULTS
AND AGAIN IT'S MARCH 22ND 1987,
AND IT'S SPECIFIC TO THE 1967
LPS ACT. THE CALIFORNIA
LEGISLATURE PASSED THE LETTERMAN
PETRUS SHORT ACT. WHICH HAD AS
THEY SAID GOOD AIMS AND BAD
RESULTS. AND ONE INDIVIDUAL WHO
IS A MENTAL HEALTH PROFESSIONAL
WHO HELPED DRAFT THE ORIGINAL
LEGISLATION, AND I QUOTE SAID IN
OUR SEAL TO MOVE PEOPLE OUT OF
VERY RESTRICTIVE, VERY INHUMANE
PLACES. WE FORGOT THAT THERE WAS
A WHOLE VARIETY OF SUPPORTS THAT
WERE BEING PROVIDED BY
INSTITUTIONS. AND WE NEGLECTED
TO FIND ADEQUATE WAYS TO
REPLICATE THEM. WE HAD A
SIMPLISTIC NOTION THAT BASICALLY
WHAT YOU COULD DO IS TAKE PEOPLE
OUT OF INSTITUTIONS, MOVE THEM
INTO THE COMMUNITY AND PROVIDE
OUTPATIENT MENTAL HEALTHCARE.
BUT WHAT WE FORGOT IS THAT
INSTITUTIONS PROVIDE PEOPLE
SHELTER, FOOD, HEALTHCARE AND A
WHOLE VARIETY OF OTHER BASIC
HUMAN NEEDS AND QUOTE. THIS IS
19. WHAT YEAR DID I SAY? 1987
FOR A LAW THAT HAD PASSED 20
YEARS EARLIER. AND HERE WE ARE
DECADES LATER DECADES LATER,
STILL TRYING TO SOLVE WHERE LPS
FELL SHORT. AND I UNDERSTAND THE
ADVOCATES THAT WANT TO SAY, YOU
KNOW YOU DON'T WANT TO INFRINGE
UPON SOMEONE'S CIVIL LIBERTIES.
BUT WHEN AN INDIVIDUAL IS UNABLE
TO CARE FOR THEM THEMSELVES IS A
DANGER TO THEMSELVES AND TO
OTHERS. WHERE ARE WE? AS A
SOCIETY TO JUST LET THEM BEYOND
THE STREETS ON THEIR OWN. WE
HAVE SEEN ENCAMPMENTS CONTINUE
TO GROW. WE HAVE SEEN THE LACK
OF SERVICES. WE HAVE SEEN THE
LACK OF URGENCY TO ADDRESS THIS
ISSUE. AND WHILE THERE MAY NOT
BE ONE, COMPLETE, FULL, PERFECT
ANSWER. WE CANNOT ALLOW FOR THE
ISSUE TO CONTINUE. AND SO I DO
HAVE MY OWN PERSONAL
RESERVATIONS. BUT I ALSO BELIEVE
THAT WE CAN AND SHOULD DO
SOMETHING AND ACT WITH URGENCY
TO BE ABLE TO SUPPORT
INDIVIDUALS WHO NEED THE MOST
CARE AND ULTIMATELY ANSWER. WITH
THE 1967 PIECE OF LEGISLATION,
KNOWN AS THE LPS ACT HAS FAILED
TO CONTINUOUSLY DO FOR DECADES
NOW. AND SO I WILL BE SUPPORTING
YOUR BILL, AND I HOPE THAT AS IT
MOVES FORWARD, WE FIND THE
FUNDING NECESSARY FOR THE COURTS
. WE FIND THE FUNDING NECESSARY
FOR HOUSING. WE FIND THE FUNDING
NECESSARY TO ADDRESS THE
CHALLENGING ISSUES OF MENTAL
HEALTH. RESOURCES AND 100%
WRAPAROUND SERVICES FOR THOSE
THAT NEEDED I HAVE BEEN
ADVOCATING PERSONALLY SINCE I
GOT ELECTED FOR THE RETROFITTING
OF THE GENERAL, GENERAL COUNTY
HOSPITAL AND ALI COUNTY. THIS
IS, YOU KNOW. HUGE BUILDING THAT
HAS BEEN VACATED THAT CAN SERVE
AS A AS A PLACE AND WHERE PEOPLE
CAN HAVE WRAPAROUND CARE CAN
HAVE SERVICES CAN HAVE
ASSISTANCE CAN HAVE HOUSING. CAN
HAVE A PLACE BECAUSE OF WHAT WE
LACK CURRENTLY IS SPACE AND
HOUSING AND REAL ESTATE AND ALL
OF THESE DIFFERENT CHALLENGES.
WE CERTAINLY HAVE THOSE SPACES
NOW. AND SO WHILE WE MOVE THIS
FORWARD, WE SIMULTANEOUSLY HAVE
TO FOLLOW UP ON ALL THE
DIFFERENT PARALLELS IN HOW WE AT
THE END OF THE DAY HELP PEOPLE
GET OFF THE STREET. IN A HUMANE
AND DIGNIFIED MANNER IN AFFORD
THEM. THE MEDICAL ATTENTION AND
RESOURCES THAT THEY NEED. THANK
YOU VERY MUCH. THANK YOU VERY
MUCH, REMEMBER, AND FOR ALL YOUR
CONTINUED WORK AND EFFORT.
ANYONE ELSE? HEY, COMES BACK TO
ME. UM. FIRST OF ALL, THANK YOU
, SENATOR HAMBURG, SENATOR
EDMUND FOR CHAMPIONING THIS
BILL, AND THANK YOU, DR GHALI.
AH! VERY MUCH FOR YOUR
LEADERSHIP AND TRYING TO ADDRESS
THIS DIFFICULT ISSUE. I THINK
WITH EACH ITERATION OF THE BILL,
IT IS IMPROVED. BUT THERE'S
STILL WORK THAT CAN BE DONE.
THERE'S OUR WORK IS REALLY NEVER
DONE. UM THERE'S NO DOUBT THAT
THE BEHAVIORAL HEALTH SYSTEM IN
CALIFORNIA HAS TO BE MORE
EFFECTIVE AND SERVING THE NEEDS
OF OUR CITIZENS SUFFERING. FROM
SEVERE MENTAL ILLNESS DESPITE
THE BEST OF INTENTIONS TOO OFTEN
, OUR EFFORTS FAIL THOSE WE
INTEND TO SERVE, UM LACK OF
HOUSING, LACK OF PSYCHIATRIC
BEDS. AN ISSUE I KNOW THAT IS
NEAR AND DEAR TO YOUR HEART, UH,
LACK OF CARE COORDINATION
BETWEEN SYSTEMS OF CARE FROM LPS
TO COMMUNITY BASED CARE OR FROM
JAILS TO COMMUNITY BASED CARE
AND ON I REFLECT BACK ON A
COUPLE OF THINGS. UM UH, ONE, UM
, GOING TO MY COUNTY JAIL? UM,
AND MEETING WITH THE WITH THE
UNDERSHERIFF IN CHARGE OF THE
JAIL AND TALKING ABOUT SOME OF
THE CHALLENGES THEY HAVE. AND HE
SAID. YOU KNOW, ONE OF THE
THINGS WE REALLY LACK HERE IS A
REAL IS COORDINATION. UM UH, HE
SAYS TOO OFTEN ON A FRIDAY WE'LL
GET A RELEASE ORDER FOR SOMEONE.
WE KNOW WHO HAS MENTAL ILLNESS
OR SUBSTANCE ABUSE ISSUES. AND
WE KNOW THEY'RE GOING TO BE BACK
REALLY QUICKLY BECAUSE THERE'S
NO WARM HANDOFF. THERE'S NO
COORDINATION THERE. THE COURTS
SAY IT'S TIME TO GO. IT'S FRIDAY
AFTERNOON, THAT PERSON ENDS UP
ON THE STREET. THEY HAVE NOWHERE
TO GO. THERE'S NO NO ONE TO HELP
THEM AND WE REPEAT THE CYCLE.
IT'S AND IT GOES ON AND ON. ALSO
REFLECT ON UM, SENATOR WICKER. I
DON'T REMEMBER THE BILL, BUT I
REMEMBER THE DESCRIPTION OF THIS
TALKING ABOUT PERSON. IN THE
TENDERLOIN WHO WAS TAKEN TO AN
EMERGENCY ROOM 150 TIMES IN ONE
YEAR, 100 AND 50 TIMES. STRESS
ON RMS SYSTEM. UM SEEN BY PEOPLE
OF THE PUBLIC WHO WAS CLEARLY
UNABLE TO CARE FOR HIMSELF. AND
THAT'S ACCEPTABLE. I DON'T THINK
SO. UM AND THESE ARE THE KINDS
OF THINGS THAT THAT THAT
HAPPENED ON A REGULAR BASIS. YOU
KNOW, AT THE HEART OF THIS BILL,
THE WAY I UNDERSTAND IT. IS THAT
WE'RE ASKING COUNTIES TO
PRIORITIZE. AND GET CARE TO THE
PEOPLE WHO NEED IT. THE MOST NOW
I'VE BEEN HERE EIGHT YEARS. I'VE
BEEN SEVEN YEARS AS THE CHAIR OF
THIS COMMITTEE. I HAVE NEVER,
EVER HEARD A COUNTY SAY THANK
YOU. THAT'S MORE THAN ENOUGH
MONEY TO DO WHAT WE NEED TO DO
EVER. UM HAS ANYBODY EVER HEARD
THAT FROM A CITY OR A COUNTY?
NO, THERE'S ALWAYS GOING TO BE
THE DESIRE FOR MORE. UM WE'RE
ASKING. I THINK IN THIS BILL,
PRIORITIZE, PRIORITIZE,
PRIORITIZE, AND THAT'S THE
THAT'S THE BOTTOM LINE. UM EVEN
BEFORE WE ENDURE THE COVID 19
PANDEMIC AND OUR OUR BEHAVIORAL
HEALTH SYSTEM WAS STRETCHED TO
NEAR MAXIMUM CAPACITY. COVID IS
ONLY EXACERBATED THAT SYSTEM
SITUATION, STRESSING OUR SYSTEM
NEARLY TO THE BREAKING POINT,
AND IN SOME, SOME WOULD ARGUE IT
IS THE BREAKING POINT. WHICH IS
WHY WE'RE HERE TODAY. WE SAID
THAT COVID FIRST HIT THAT
TSUNAMI OF BEHAVIORAL HEALTH
WHEN, WHEN COVID FIRST HIT THAT
TSUNAMI OF BEHAVIORAL HEALTH
WOULD LAG THE PANDEMIC BY ABOUT
12 TO 18 MONTHS. UM WE'RE SEEING
THAT NOW WITH MENTAL ILLNESS,
DRUG USE, HOMELESSNESS AND,
FRANKLY HOPELESSNESS ON THE
RISE. I SAY THIS BECAUSE WHILE
THE COMMITTEE ANALYSIS OUTLINES
A NUMBER OF SUGGESTIONS FOR YOU
TO CONSIDER AFRICARE COURT AS
THE BILL MOVES FORWARD, I WANT
TO SPECIFICALLY ADDRESS ONE UM,
THAT OF COUNTY PREPAREDNESS AND
A MORE REALISTIC PHASE IN
PERIOD. I KNOW THE
ADMINISTRATION IS COMMITTED TO
GETTING THIS PROGRAM OFF THE
GROUND AS SOON AS POSSIBLE, AND
I APPLAUD EVERYONE FOR THAT. UM
AND IT'S SUGGESTED A TWO PHASE
IMPLEMENTATION. BUT TO ME THAT
ISN'T NEARLY SUFFICIENT TIME FOR
COUNTIES TO ADDRESS THE MYRIAD
OF ISSUES RELATED TO SUCCESSFUL
IMPLEMENTATION. NOT ALL COUNTIES
ARE CREATED EQUAL. UM WE DON'T
WANT THIS TO BE A PIECEMEAL
PROGRAM. WE NEEDED TO BE
COORDINATED WELL AMONG ALL
PARTIES, THE COURTS, THE
GUARDIANS, THE HOUSING ENTITIES
, THE BEHAVIORAL HEALTH AGENCIES
, LEGAL SERVICE ORGANIZATIONS
AND FACILITIES FOR THOSE NEEDING
IN PATIENT CARE. THE LAST THING
WE NEED IS TO IMPLEMENT YET
ANOTHER SYSTEM OF CARE THAT
FAILS TO DELIVER ON HIS
PROMISES. I HOPE THAT DURING
RECESS, YOU'LL REACH OUT
DIRECTLY TO THE COUNTIES TO
DEVELOP A REFINED IMPLEMENTATION
PLAN THAT ALLOWS HIM TO, UM
DEMONSTRATE THEIR READINESS TO
FULLY IMPLEMENT THE PROGRAM.
MANY COUNTIES, ESPECIALLY RURAL
ONES, AND I KNOW YOU KNOW THAT.
WELL, SENATOR, UM AND THAT I'M
MOST FAMILIAR WITH ARE WOEFULLY
UNPREPARED FOR THIS AND ENDEAVOR
EVEN IF THEY HAD THE MONEY. THEY
LACKED THE TECHNICAL EXPERTISE.
THEY LACK THE WORKFORCE. THEY
LACK SO MUCH, UM, ON TOP OF THAT
UNPREPAREDNESS THEIR FACE WITH
SANCTIONS AND RECEIVER SHIPS
THAT COULD VERY WELL UNDERMINE
THE GOOD THEY ARE CURRENTLY
DOING IN THAT AREA. ONE OF THE
THINGS I TALK ABOUT WHICH I FIND
OFTEN MEETS WITH DEAF EARS IS
THAT WE DO SO MUCH THAT IS ONE
SIZE FITS ALL IN THIS BUILDING.
WE ABSOLUTELY NEED FLEXIBILITY
WITH SOME COUNTIES IN PARTICULAR
THAT MAYBE DOING A FABULOUS JOB
TO ACTUALLY JUST THINK OF ALL
THE LITTLE STEPS AND THINGS WE
PUT IN FRONT OF PEOPLE. AND IT
IS REALLY, REALLY CHALLENGING
THE TECHNICAL ASSISTANCE THAT
MIGHT BE REQUIRED JUST TO COMPLY
WITH THAT. IF COUNTIES ARE DOING
GOOD THINGS WE NEED TO WE NEED.
WE NEED TO EMBRACE THAT. WE NEED
TO, YOU KNOW, SUPPORT THAT AND
HOPEFULLY WE CAN SEE SUCCESS. IN
THAT WAY. EVERYONE WOULD LIKE TO
SEE CARE COURT SUCCEED. I THINK
ONE OF THE THINGS THAT WE'VE SO
FRUSTRATED WITH HIS THAT AND
IT'S THE DEFINITION OF UTILITY
DOING THE SAME THING OVER AND
OVER AND OVER AGAIN AND
EXPECTING DIFFERENT RESULTS.
WELL WE'RE DONE WITH THAT. AND
THAT'S WHY THIS PROPOSAL IS HERE
. SO I APPLAUD THE
ADMINISTRATION. I APPLAUD YOU
SENATORS FOR BRINGING THIS
FORWARD. IS IT PERFECT? I
HAVEN'T SEEN ANYTHING PERFECT IN
THIS BUILDING. JUST LIKE
COUNTIES HAVING CITIES HAVEN'T
GOT ENOUGH MONEY, YOU KNOW, SO
THAT'S JUST THE WAY THIS THAT'S
THE WAY THIS PROCESS WORKS. BUT
THE BEAUTY OF THIS IS WE CAN
BUILD UPON THIS. WE CAN MOVE
FORWARD. AND AS THIS GOES
FORWARD, WE CAN MAKE THIS SYSTEM
BETTER AND BETTER AND BETTER
OVER TIME. SO UM, UM, WE HAVE A
MOTION. UM UM, BELIEVED BY
ASSEMBLYMEMBER'S AGUIAR-CURRY, A
SECOND BY MS WALDRON. AH, WOULD
YOU LIKE TO CLOSE? CHALLENGES
VERY BRIEF, BUT THANK YOU,
EVERYBODY FOR THEIR, UM, FOR
THEIR CONVERSATION. THANK
EVERYBODY FOR THEIR LONGTIME
COMMITMENT. THIS IS NOBODY'S NEW
TO THIS AGAIN, THANKS TO THE
ADMINISTRATION. MM BECAUSE
ASSEMBLYMEMBER'S I THINK THEY
WERE SO FRUSTRATED WITH OUR
CONTINUED ATTEMPTS TO TRY TO FIX
THE LPS SYSTEM, UM, THAT WE
CONTINUE TO RUN UP AGAINST A
BRICK WALLS WITHIN THE
ADMINISTRATION REALLY DECIDED WE
NEED TO FIND ANOTHER WAY TO BE
ABLE TO REACH THESE FOLKS WHO
ARE SO INCREDIBLY DIFFICULT TO
REACH AND SO INCREDIBLY ILL.
JUST ANOTHER STORY FROM FROM SAN
FRANCISCO. JUST A COUPLE OF DAYS
AGO, MAN WAS DEAD ON THE STREET
FOR OVER 11 HOURS. PEOPLE JUST
CONTINUE TO STEP OVER HIM
BECAUSE I JUST THOUGHT THAT WAS
JUST ANOTHER DAY THAT HE WAS
THERE, BUT THIS TIME HE WAS
DECEASED. THAT'S WHAT THAT IS.
WHAT IS OCCURRING RIGHT NOW, AND
THAT IS WHAT THIS BILL IS
DESIGNED TO DO. THEN TO THE
ISSUE OF HOUSING. WE WILL
CONTINUE TO WORK ON THAT. BUT
AGAIN, THERE IS NOT A ONE SIZE
FITS ALL FOR SO SOMEONE UNDER
MEDICATION AND CARE MIGHT BE
ABLE TO COME HOME. OR SOMEONE
THAT WOULDN'T HAVE BEEN SAFE
BEFORE. SO THERE IS GOOD.
THERE'S GOT TO BE A VARIATION
AND THE ABILITY TO BE ABLE TO
NOT JUST SAY WE'RE GETTING ALL
THIS MONEY FOR HOUSING AND TO
THINK EVERYBODY'S GOING TO GO
INTO THAT, UM, WE KNOW THIS
NEEDS TO BE INDIVIDUALIZED. AND
AGAIN THIS IS, I THINK SOMETHING
THAT COUNTIES THE LOCAL
ADMINISTRATION, THE LEGISLATURE,
THE JUDICIAL BRANCH. WE'RE ALL
WORKING ON THIS TOGETHER AND
SAYING THIS IS THE TIME IS THE
MOMENT AND I ASK FOR YOUR VOTE.
THANK YOU. AND I'LL JUST ADD ONE
OTHER THING. AND BECAUSE YOU YOU
YOU MENTIONED THIS AND THEN
THAT'S DATA IS REALLY, REALLY
IMPORTANT. WE HAVE TO GET DATA.
SO WE UNDERSTAND WHAT'S WORKING.
WHAT'S NOT WORKING SO THAT WE
CAN REACT AND BUILD UPON THAT?
WE WE KNOW THE LPS SYSTEM RIGHT
NOW IN CALIFORNIA, WHICH IS WHY
YOU AND I ARE BOTH WORKING ON
BILLS RELATED TO DATA THE
OUTCOME OF THE HEARING WE HAD
LAST DECEMBER THAT WE JUST DON'T
KNOW. WE DON'T KNOW HOW MANY
PEOPLE ARE PICKED UP ON A 51 50
DON'T KNOW. WE KNOW HOW LONG
THERE THERE. WE DON'T KNOW HOW
MANY REPEATS. WE DON'T KNOW THAT
INFORMATION. AND SO WE'RE
OPERATING IN A VACUUM, AND SO AS
THIS PROGRAM WAS FORWARD, AND AS
WE MOVE FORWARD WITH HELPING WE
NEED WILL NEED MORE DATA AND TO
BE ABLE TO REACT TO THAT DATA AS
WELL. SO WE DO HAVE A MOTION AND
A SECOND. THE MOTION IS DUE PASS
AS AMENDED TO APPROPRIATIONS.
MADAM SECRETARY, PLEASE CALL THE
ROLL. WOULD WOULD I? WALDRON
WALDRON, I AGUIAR-CURRY COREY. I
ARAMBULA. BIGELOW. CARILLO.
CARILLO. AYE, LARA. MAIENSCHEIN. MAIZE MAIZE. I MCCARTY
MCCARTHY. I NAZARIAN LUZ RIVAS
RODRIGUEZ. RODRIGUEZ EYES
SANTIAGO SANTIAGO I WEBBER.
HOWEVER, I. EXCUSE ME. UM OF
YOU'RE OUT OF ORDER. YOU ARE OUT
OF ORDER. YOU ARE OUT OF ORDER.
YOU ARE OUT OF ORDER. PLEASE
PLEASE DESIST. YOU'RE OUT OF
ORDER. LIKE YOU TO LEAVE NOW,
PLEASE. YOU ARE OUT OF ORDER.
THANK YOU. THANK YOU THE VOTE
MADAM SECRETARY 090. THE BILL IS
OUT. WE'LL LEAVE THE ROLE OPEN
FOR OTHERS TO ADD ON. WE WILL GO
AHEAD. UM I SEE. UM, SENATOR
PAN. I'M SORRY. AND DR GHALI FOR
14 73. I BELIEVE.
WHENEVER YOU'RE READY, SIR.
THANK YOU. THANK YOU, MR CHAIR
MEMBERS. UM FIRST OF ALL, I WANT
TO SAY THAT ACCEPT AMENDMENTS TO
AN URGENCY AND ADDRESS TECHNICAL
ASSISTANCE. AH, FROM THE
DEPARTMENTS OF INSURANCE AND
DEPARTMENTS MANAGE HEALTHCARE.
UM SO AGAIN, I'M PLEASED TO
PRESENT SB 14 73 PART OF THIS
BILL IS CODE CLEANUP RELATED TO
OPEN ENROLLMENT PERIODS, AND THE
OTHER PART ASPECT OF THIS BILL
IS TO SUPPORT TESTED TREAT
MEETING SOMEONE WHO TEST
POSITIVE FOR COVID 19 OF
APPROPRIATE FOR PATIENTS WHO
RECEIVED TREATMENT AND TESTING
LOCATION OR SOON AFTER, IN ORDER
TO GET THE INFECTION QUICKLY
UNDER CONTROL. THE TIMING
BETWEEN SYMPTOM ONSET AND
MEDICAL CARE IS KEY. WHICH IS
WHY I TESTED TREAT IS SO
CRITICAL. THIS BILL ENSURES THAT
PERSONS STATE REGULATED HEALTH
INSURANCE WILL COVER THE
THERAPEUTIC AND ADMINISTRATION
WITHOUT COST SHARING
ORGANIZATION MANAGEMENT. RIGHT
NOW. MOST OF THE THERAPEUTICS
ARE FEDERALLY FUNDED, BUT SOME
POINT PLAN WILL BEGIN WOULD BE
NEGOTIATING FUNDING THOSE COSTS
. THAT JABBER REPORT INDICATES
THAT THIS BILL COULD RESULTIN
REDUCED HOSPITALIZATIONS FROM
FEWER INPATIENT VISITS YOUR
EMERGENCY AND FEWER EMERGENCY
DEPARTMENT VISITS. ONE OF US
UTILIZE DRUGS. PAXIL ID
PIXELATED REDUCES
HOSPITALIZATIONS AND THE
UNVACCINATED UNDER 65 BY 85% OF
COURSE, THIS IS NO SUBSTITUTE
FOR ACCELERATION, BUT WE
CERTAINLY WOULD WE WANT TO AGAIN
CONTINUE TO SAVE LIVES. AS
MENTIONED IN THE ANALYSIS. THERE
ARE AMENDMENTS NOW RESPECTFULLY
REQUEST THAT THE COMMITTEE TO
ADOPT THAT ADDS AN URGENCY
CLAUSE AS I MENTIONED BEFORE WE
TOOK THOSE SPELL, SO, UM THIS
BILL ALSO CLEANS UP SOME
PROVISIONS FROM SB 5 10 FROM
LAST YEAR THAT REQUIRES PLANS TO
COVER COVID 19 VACCINATIONS AND
TESTING. AND I THINK YOU HAVE
THAT IN YOUR ANALYSIS, BUT I'M
PLEASED TO HAVE SECRETARY GOLLY
HERE TO TESTIFY AND SUPPORT AND
BETH FELT HOW TO ACCESS. THANK
YOU. THANK YOU. PLEASE GO AHEAD,
SIR. THANK YOU, DOCTOR WOULD AND
MEMBERS OF THE COMMITTEE THANK
YOU, DOCTOR PAN FOR YOUR PUTTING
THIS FORWARD AS THE GOVERNOR.
SMARTER PLAN HAS LAID OUT SINCE
FEBRUARY. CALIFORNIA IS MOVING
FORWARD WITH OUR EYE ON COVID,
UH, WE HAVE, THANKFULLY, COME
THROUGH SOME OF THE WORST
SURGES. AND REALLY DONE THINGS
TO LEAN IN AND SAVE LIVES IN THE
SMARTER PLAN LAYS OUT A
COMMITMENT TO THE BASICS OF
COVID AND FRANKLY, SO MANY
INFECTIOUS DISEASES, WHICH ARE
FOCUSING ON THOSE THINGS THAT WE
CAN DO. A CITIZENS TO AVOID
GETTING INFECTED WHEN POSSIBLE,
BUT ALSO FOCUSING ON
VACCINATIONS TESTING. AND NOW,
WITH THE ADVENT OF TREATMENT
THAT IS MORE WIDELY AVAILABLE,
MENTIONED PACK SLOVIN. OTHER
ANTIVIRALS FOR OTHER POPULATIONS
, MAKING SURE THAT THE
CRITICALITY OF CONNECTING THAT
TO POSITIVE TESTS CONFIRMED
SYMPTOMS THAT INDIVIDUALS GET
ONTO THOSE MEDICATIONS QUICKLY.
AND THIS BILL ENSURES THAT THE
BARRIERS TO CARE THAT WE'VE
WIDELY EXPERIENCED NOT JUST
THROUGH COVID. BUT OTHER HEALTH
CARE ISSUES THAT PEOPLE FACE
WHETHER THAT'S ACCESS TO
IMMEDIATE AVAILABILITY OF A
MEDICATION SUCH AS PACKS LOADED
AVAILABILITY TO NO COST SHARING.
AND THE ABILITY TO GET IT RIGHT
AWAY. I THINK IT'S CRITICAL AS,
UH, DR PAM MENTIONED LIVES HAVE
BEEN SAVED. PEOPLE'S ILLNESSES
HAVE BEEN SHORTENED. HAVE BEEN
ABLE TO RETURN TO WORK. TAKE
CARE OF THEIR FAMILIES DO THINGS
THAT I THINK CALIFORNIA'S EXPECT
THE STATE TO BE LOOKING OUT FOR
THEM TO DO SO. WE SUPPORT. UH
THIS THIS BILL, I THINK IT
FURTHERS THE SMARTER PLAN IN
DEEP AND IMPORTANT WAYS. AND AT
OVER 140 STATE SPONSORED TESTING
SITES ACROSS OUR STATE, NOT JUST
IN URBAN BUT IN MANY RURAL AREAS
. THAT TEST TO TREAT PROGRAM IS
ALIVE AND WELL AND CAN BE
AVAILABLE BECAUSE OF THIS
LEGISLATION TO MORE AND MORE
CALIFORNIANS WITHOUT A CONCERN
AROUND COST AND ACCESS. THANK
YOU. THANK YOU, DR GHALI. BEST
CAPELLAN BEHALF. HEALTH ACCESS
CALIFORNIA. WE'RE PLEASED TO BE
HERE AND SUPPORT. I WILL LEAVE
THE CLINICAL PIECES O THE TWO
PHYSICIANS AND SAY THAT WE ARE
VERY PLEASED TO BE SUPPORTING
THIS BILL, WHICH WILL ASSURE
THAT WHEN PEOPLE GET THAT CARE,
THEY WILL NOT BE EXPOSED TO
SURPRISE MEDICAL BILLS, EVEN IF
THEY'RE OUT OF NETWORK, AND WE
APPRECIATE WORKING WITH THE
AUTHOR ON THAT. WE'RE ALSO VERY
APPRECIATIVE TO CODIFY IN STATE
LAW, THE ABILITY OF PEOPLE TO
ENROLL AND COVERED CALIFORNIA
THROUGH THE END OF JANUARY, ONE
OF THE BAD THINGS THAT HAPPENED
IN THE PRIOR FEDERAL
ADMINISTRATION WAS THE ATTEMPTED
TO CUT OFF ENROLLMENT AT
DECEMBER. 15TH. WAS REALLY THE
THING EVERYBODY WANTS TO DO
BETWEEN THANKSGIVING CHRISTMAS
IS SIGN UP FOR HEALTH INSURANCE
. UM WE DIDN'T ALLOW THAT TO
HAPPEN. IN CALIFORNIA. WE MADE
SURE THAT PEOPLE HAD A GOOD
MONTH AFTER THE NEW YEAR TO SIGN
UP FOR COVERAGE. THIS BILL WOULD
CONTINUE THAT AND WE'RE PLEASED
TO BE IN SUPPORT. QUÊ OTHERS IN
SUPPORT. JUST YOUR NAME AND
ORGANIZATION IF YOU REPRESENT
ONE. SEE NO ONE. I SEE
OPPOSITION LOOMING. OR LURKING.
I'M NOT REALLY SURE LURKING
LOOMING WHATEVER. IN THE US
YEAH. IN THE OPPOSITION. UM
THANK YOU, MR CHAIRMAN MEMBERS
NICK LOUISA'S ON BEHALF OF THE
CALIFORNIA ASSOCIATION OF HEALTH
PLANS IN RESPECTABLE OPPOSITION.
TO S P 14 73, YOU KNOW, WE
CERTAINLY APPRECIATE THE
TESTIMONY OF THE AUTHOR. AND UM
YOU KNOW THE SECRETARY'S
COMMENTS RELATED TO THE NEED TO
COVER THERAPEUTICS AND FOR
CALIFORNIANS TO HAVE ACCESS TO
THOSE UM, THERAPEUTICS AS
THEY'RE AVAILABLE. CALIFORNIA'S
HEALTH PLANS ARE STRONGLY
COMMITTED TO THE HEALTH AND WELL
BEING OF OUR ENROLLEES, OF
COURSE, AND YOU KNOW, WE FEEL
LIKE WE'VE BEEN GOOD PARTNERS
WITH THE STATE THROUGHOUT THE
PANDEMIC. INDEED YOU KNOW, PLANS
WERE PROACTIVELY ELIMINATING THE
SHARE OF COST FOR COVID 19
DIAGNOSTIC TESTING AND TREATMENT
PRIOR TO THE FEDERAL MANDATE
ALONG THOSE LINES. HOWEVER, THE
TEMPORARY FEDERAL HEALTH
EMERGENCY THAT REQUIRES HEALTH
PLANS TO REIMBURSE PROVIDERS FOR
BOTH IN NETWORK AND OUT OF
NETWORK TESTING AND SERVICES,
YOU KNOW WAS DONE WITH THE
EXPECTATION AT LEAST AT THIS
REQUIREMENT WOULD BE LIFTED ONCE
THE FEDERAL EMERGENCY EXPIRES.
UM SB 14 73, HOWEVER, REQUIRES
HEALTH PLANS TO CONTINUE
REIMBURSING OUT OF NETWORK
PROVIDERS FOR COVID 19 TESTING
ETCETERA FOR ENTIRE FOR AN
ENTIRE YEAR AFTER THE EXPIRATION
OF THE FEDERAL PUBLIC HEALTH
EMERGENCY. AND THIS IS
CONCERNING TO THE PAYERS, HEALTH
PLANS, YOU KNOW, DUE TO THE
FRAUD, WASTE AND ABUSE
ASSOCIATED WITH OUT OF NETWORK
COVID RELATED SERVICES. YOU
KNOW, WE HAVE SEEN UNSCRUPULOUS
ENTITIES AND INDIVIDUALS THAT
ARE REGRETTABLY EXPLOITING
VULNERABLE CALIFORNIA FOR
ONIONS. THAT ARE SEEKING ACCESS
TO COVID TESTING, MANY OF THEM
FALSELY POSING AS LEGITIMATE
HEALTHCARE CLINICS AND
PROVIDERS. AND MANY OF THESE BAD
ACTORS HAVE SUBMITTED MEDICALLY
UNNECESSARY. COVID TEST FOR
REIMBURSEMENT TO THE TUNES OF
MILLIONS OF DOLLARS. TO THE JUNE
OF MILLIONS OF DOLLARS. EXCUSE
ME, AND, YOU KNOW, WELL, YOU
KNOW, THERE HAVE BEEN ATTEMPTS
BY THE STATE, INCLUDING THE
ATTORNEY, GENERAL DEPARTMENT AND
HEALTHCARE, ETCETERA TO TRY AND
TRY TO REIN IN THESE BAD ACTORS.
UNFORTUNATELY, YOU KNOW, THE
PROBLEM PERSISTS. AND YOU KNOW,
THIS HAS BEEN DEMONSTRATED IN
THE MEDIA AS WELL. FOR EXAMPLE,
ONE COMPANY WAS ACCUSED OF
EXPLOITING THE CORONAVIRUS
TESTING BOOM, AND THIS IS A
QUOTE FROM THE ARTICLE TO READ
MILLIONS BY HANDING OUT HUNDREDS
OF FAKE TEST RESULTS TO KEEP UP
WITH DEMAND WHILE CHARGING THE
HEALTH PLANS 100 AND $95 PER
TEST. UM AND THEN YOU KNOW, WE,
UH, PLANS OBVIOUSLY STRIVE TO
PROVIDE THE BEST HEALTHCARE
POSSIBLE TO THEIR ENROLLEES. BUT
YOU KNOW, SP 14 73 WILL BE
INCREASING PREMIUMS AND,
ACCORDING TO THE INDEPENDENT
ANALYSIS OF THE BILL ON THOSE
PREMIUMS WILL GO UP. TO THE TUNE
OF $40 MILLION. WE THINK THAT
COULD BE AN UNDERESTIMATE. UH IT
DOESN'T APPEAR THAT YOU'RE BURP
ACTUALLY EXAMINE THE
DIFFERENTIAL BETWEEN YOU KNOW,
UH, TESTING COSTS. ANOTHER COSTS
, UH, IN NETWORK VERSUS OUT OF
NETWORK, SO THAT THAT THAT COULD
BE SOMETHING THAT, UM YOU KNOW,
WE LOOK AT MOVING FORWARD. SO,
FOR THE REASONS STATED ABOVE,
YOU KNOW, WE'VE JUST THINK IT'S
UM IRRESPONSIBLE FOR THE STATE
TO EXTEND THE REQUIREMENT TO
REIMBURSE OUT OF NETWORK TESTING
SITES AND PROVIDERS FOR AN
ENTIRE YEAR AFTER THE PUBLIC
HEALTH EMERGENCY EXPIRES. AND
FOR THAT REASON WE'RE OPPOSED TO
14 73. THANK YOU. OTHERS IN
OPPOSITION. ONE ELSE. SEE NO ONE
WILL BRING IT BACK TO THE
COMMITTEE. DID YOU? WERE YOU?
CAN'T BE. YOU'RE WELCOME TO COME
TO THE MICROPHONE AND. THANK
YOU. CHAIR. HIGH CHAIR AND SHE
REMEMBERS MY NAME IS SHARON A
LOT AND I AM IN STRONG
OPPOSITION OF THE SPILL. THANK
YOU. THANK YOU. ONE ELSE. BRING
IT BACK TO THE COMMITTEE FOR
QUESTIONS OR COMMENTS ANY
QUESTIONS OR COMMENTS. OH I SEE.
NO I SEE NO ONE. NO FURTHER
QUESTIONS. WE HAVE A MOTION BY
DR ARAMBULA, SECOND BY DR WEBBER
SEEM TO BE SURROUNDED BY DOCTORS
TODAY, UM, MOTION WOULD BE DO
PASS AS AMENDED TO
APPROPRIATIONS. WOULD YOU LIKE
TO CLOSE? DOCTOR RESPECTFULLY
ASKED FOR AND I VOTE. THANK YOU.
THANK YOU. UM AND SECRETARY
PLEASE CALL THE ROLL. WOULD I
WOULD I? WALDRON WALDRON. NO
AGUIAR-CURRY. ARAMBULA.
ARAMBULA. AYE, BIGELOW. CARILLO.
FLORA MAIENSCHEIN MAZE, MCCARTY
NAZARIAN. LUZ RIVAS RODRIGUEZ
RODRIGUEZ. I SANTIAGO HOWEVER.
WEBER I, FOR ONE FOR ONE WILL
LEAVE THAT BILL ON CALL. THANK
YOU.
UM THANK YOU VERY MUCH. DOCTOR
PAN. WOULD YOU LIKE TO CONTINUE?
YOU HAVE ROLLING THEN AT LEAST
ONE OTHER BILL BEFORE US TODAY.
I'M JUST KIDDING. YOU HAVE
SEVERAL? YES. UP TO THE CHAIR.
SO, UM OTHER THAT I BELIEVE.
PLEASE PLEASE GO AHEAD. OK?
THANK YOU. ALL RIGHT. AND IF WE
START RUNNING A LITTLE LONG, I
KNOW SENATOR PORTANTINO HAS A
WITNESS THAT MAY HAVE TO FLY OUT
AND I DON'T KNOW HOW WE HANDLE
THAT IF YOU CHOOSE TO CHOOSE,
JUST STEP ASIDE FOR SENATOR
PORTANTINO. I'M SURE HE WON'T.
HE WON'T COMPLAIN, BUT THAT'S
THAT'S UP TO YOU. ALL RIGHT,
WELL, WE'LL KEEP ROLLING HERE
AND THEN IF IT'S LOOKS LIKE SO
SP 2 50 FIRST OF ALL, I WANT TO
THANK THE COMMITTEE STAFF FOR
THE ANALYSIS AND WORKING WITH
THE BILL. SPONSORS ON AMENDMENTS
DESCRIBE AND COMMENT NINE IN THE
ANALYSIS. I'LL ACCEPT THE
AMENDMENTS IN THE MARKUP. SO
AGAIN THE I'M PROUD TO PRESENT
SP 2 50, WHICH IS INTENDED TO
EASE AND MINISTRY OF BURDENS FOR
HEALTHCARE PROVIDERS AND THEIR
PATIENTS, FREEING UP TIME AND
EXPENSE, WHICH ULTIMATELY
IMPROVES CARE FOR PATIENTS.
NATIONAL SURVEYS CONDUCTED IN
RECENT YEARS, SUPPORT THE BELIEF
THAT THE PRIOR AUTHORIZATION
BURDEN IS SUBSTANTIAL, WITH COST
ESTIMATES TO THE U. S.
HEALTHCARE SYSTEM OF 23 TO 31
BILLION EACH YEAR. UM OR
APPROXIMATELY AROUND. 84,000 PER
FULL TIME EQUIVALENT POSITIONS.
I THINK ABOUT EACH DOCTOR HAVING
TO PAY APPROXIMATELY 80 SOME
OVER $80,000 A YEAR AND EXPENSES
TO DEAL WITH PRIOR
AUTHORIZATIONS. STUDIES SHOW
THAT PRIOR AUTHORIZATION DELAYS
, UH, TREATMENT FOR PATIENTS AND
FOR MANY PRIOR AUTHORIZATIONS,
THERE'S A HIGH RATE OF OVERTURNS
AFTER THE INITIAL DENIALS, WHICH
MEANS IS THAT WE GO THROUGH THIS
WHOLE PROCESS AND THEN IN THE
END, THEY SAID, OH, OKAY. FINE,
BUT WE HAD TO SPEND ALL THIS
TIME AND EFFORT AND BY THE WAY,
SOMETIMES THEY DON'T ANSWER THE
PHONES AT NIGHT AND OTHER TYPES
OF THINGS. SO BASICALLY,
PATIENTS ARE WAITING TO FIND OUT
WHETHER THEY CAN GET CARE. SO IT
OFF CAN DO. YOU CAN DO LITTLE TO
CONTROL COSTS INSTEAD CREATES
UNNECESSARY ADMINISTRATIVE
BURDENS OF DELAYS. THE CARE. SO
WHAT'S THE HOW DO WE WANT TO
ADDRESS THIS? WELL, WE'RE NOT
SAYING THAT PRIORITIZATION CZAR
ENTIRELY, YOU KNOW INAPPROPRIATE
TO TRY TO ADDRESS UTILIZATION,
BUT INSTEAD, SB 2 50 WOULD
CREATE A GOLD CARD PROCESS. FOR
HEALTHCARE PROVIDERS WHO HAVE A
RECORD OF GAINING APPROVALS FOR
PRIOR AUTHORIZATION REQUESTS
FROM HEALTH PLANS. INSURERS, SO
YOU KNOW IF THERE'S A BAD ACTOR
YOU KNOW, WE THAT'S THE PERSON
YOU NEED TO CHECK ON. BUT IF
SOMEONE CONDEMNS DEMONSTRATES
THAT THEY ARE ACTUALLY THEIR
THEIR AUTHORIZATIONS, THEY'RE
CONSTANTLY BEING APPROVED. THEN
WE SHOULD NOT BE MAKING THEM GO
THROUGH THIS AND CONTINUING TO
IMPOSED THAT EXPENSE. AND
CLEARLY THAT'S THAT YOU'RE NOT
GOING TO BE CATCHING. YOU'RE NOT
CATCHING A BAD ACTOR THERE AT
THAT POINT IN TIME, SO AND
AGAIN. I WANT TO THANK THE
COMMITTEE FOR THE AMENDMENTS,
WHICH NARROWED THE BILL IN THE
SCOPE. AND I HAVE WITNESSES
SUPPORT BRIAN BRANDON MARTY FROM
THE CALIFORNIA MEDICAL
ASSOCIATION, AND DR JOAN BIANCA
ROBERTS. THAT'S FINE SUPPORT.
THANK YOU. THANK YOU. PLEASE GO
AHEAD. THANK YOU, MR CHAIR AND
MEMBERS OF THE COMMITTEE BRANDON
MARCHI WITH THE CALIFORNIA
MEDICAL ASSOCIATION. WE'RE PROUD
SPONSORS OF SB 2 50. I WANT TO
START BY THANKING YOU, MR CHAIR
IN YOUR COMMITTEE FOR WORKING
WITH US TO AMEND THE BILL. UH
AND REFINE THIS CRITICAL PIECE
OF LEGISLATION. SB 2 50 TAKES
EXCUSE ME BUILDS OFF OF THE WORK
STARTED IN 2019 BY
ASSEMBLYMEMBER'S RODRIGUEZ WITH
A B 12 68 AND TAKES A
COMPREHENSIVE APPROACH TO
REFORMING THE GROWING PROBLEM OF
PRIOR AUTHORIZATION IN OUR
HEALTH CARE SYSTEM. IN A 2021
PHYSICIANS SURVEYED, THE
AMERICAN MEDICAL ASSOCIATION
FOUND THAT ON AVERAGE PHYSICIANS
COMPLETE 41 PRIOR AUTHORIZATIONS
PER WEEK, TAKING APPROXIMATELY
TWO WORKING DAYS OUT OF THE WEEK
TO COMPLETE. WHICH IS TIME
BETTER SPENT ACTUALLY SEEING
PATIENTS AND PROVIDING CLICK
CARE. FURTHERMORE DESPITE
AGREEMENTS AND STATEMENTS FROM
PLANS AND INSURERS, SAYING THAT
THEY WILL WORK COLLABORATIVELY
COLLABORATIVELY EXCUSE ME TO
IMPROVE THE PRIOR AUTHORIZATION
PROCESS. 84% OF HIS PHYSICIAN'S
REPORT THAT PRIOR AUTH
REQUIREMENTS HAVE INCREASED OVER
THE LAST FIVE YEARS. NOT
DECREASED. BUT ULTIMATELY THE
PATIENT IS THE ONE THAT IS
HARMED BY THIS INTRUSIVE PROCESS
. 34% OF PHYSICIANS REPORT THAT
PRIORITIZATION HAS LED TO A
SERIOUS ADVERSE EVENT FOR A
PATIENT. 91% SAY THAT IT HAS HAD
A NEGATIVE IMPACT ON A PATIENT'S
CLINICAL OUTCOME AND 93% REPORT
CARE DELAYS BECAUSE OF PRIOR
AUTHORIZATION REQUIREMENTS.
MEMBERS SP 2 50 WILL IMPROVE
PATIENT OUTCOMES INCREASED
ASSETS, ACCESS TO CARE AND
CONTROL COSTS WITHOUT THE STATE
HAVING TO INVEST A SINGLE DOLLAR
IN THE HEALTH CARE DELIVERY
SYSTEM. EACH OF US BE TWO
FIFTIES COMPONENTS ARE NECESSARY
TO STREAMLINE A PROCESS THAT HAS
LED TO SIGNIFICANT DELAYS. BY
INCLUDING PHYSICIANS IN THE
DEVELOPMENT OF A PLANS PRIOR
AUTHORIZATION CRITERIA. THE
CRITERIA WILL MORE ACCURATE,
ACCURATELY REFLECT EVIDENCE
BASED MEDICAL PRACTICE STANDARDS
AND CLINICAL GUIDELINES. THE END
RESULT WILL BE FEWER PRIOR
AUTHORIZATIONS ATTACHED TO
STANDARD OF CARE TREATMENTS AND
SERVICES. THE ONE YEAR EXEMPTION
IN SP 2 50 WILL ALLOW A
PHYSICIAN TO PRACTICE MEDICINE
WITHOUT UNNECESSARY DELAYS FROM
A HEALTH PLAN. THE EXEMPTION IS
BASED OFF ON THE TREATING
PHYSICIANS UTILIZATION AND AS
APPROPRIATELY BALANCED BY
ALLOWING A HEALTH PLAN TO
CONDUCT A REVIEW OF THE
PHYSICIANS UTILIZATION DURING
THAT ONE YEAR PERIOD. AND TAKE
ACTION. IF A PHYSICIAN IS FOUND
TO BE ACTING FRAUDULENTLY, OR
HAS A PATTERN OF MISUSE. IF THEY
NO LONGER MEET THE 90% THRESHOLD
. THE PHYSICIAN MAY APPEAL THE
DECISION, AND AN ADDITIONAL
REVIEW MAY TAKE PLACE AND THEY
WOULD HAVE TO PRACTICE WITH
PRIOR AUTHORIZATION AGAIN UNTIL
THEY MEET THAT 90% THRESHOLD.
PATIENT SORIES COLLECTED BY CMA
AND SHARED ON TWITTER GIVE AN
AGONIZING NARRATIVE ABOUT THE
HORROR THAT IS PRIOR
AUTHORIZATION. ANYTHING FROM
PLANS DENYING CANCER DIAGNOSTIC
IMAGING SERVICES TO DELAYING
PATIENT ACCESS TO INSULIN
MEDICATION FOR DIABETIC PATIENTS
TO SUDDEN DENIALS OF MEDICATIONS
PATIENTS HAVE BEEN ON FOR
MONTHS, IF NOT YEARS. HERE WITH
ME TO SHARE HER AND HER PATIENTS
EXPERIENCES WITH PRIORITIZATION
IS DR JOAN BIANCA ROBERTS. THANK
YOU FOR YOUR TIME TODAY. I
RESPECTFULLY REQUEST YOUR VOTE
ON THIS IMPORTANT MEASURE.
PLEASE GO AHEAD. THANK YOU, MR
CHAIR AND COMMITTEE. I'M SO GLAD
TO BE SPEAKING TODAY TO SHARE
SOME EXPERIENCES THAT MY
PATIENTS AND I HAVE HAD IN
REGARDS TO DELAYING CARE DUE TO
PRIOR AUTHORIZATIONS AND A STAND
HERE AND SUPPORT OF SB 2 50. SO
I'M A FAMILY PHYSICIAN HERE IN
SACRAMENTO, AND THERE HAVE BEEN
MANY CIRCUMSTANCES THAT MY
PATIENTS HAVE HAD ADVERSE
OUTCOMES DUE TO DELAYS. I'M JUST
GOING TO SHARE A FEW. SO I HAVE
ONE PATIENT THAT I'VE BEEN
MANAGING A DIABETES FOR SEVERAL
YEARS WHOSE DIABETES WAS OUT OF
CONTROL AND WORKED VERY CLOSELY
WITH THE ENDOCRINOLOGIST AND
CLINICAL PHARMACISTS AS WELL AS
MY OTHER TEAM MEMBERS, AND WE
HAVE BEEN ABLE TO GET THE
PATIENT'S DIABETES CONTROLLED.
THIS YEAR, THE HEALTH PLAN
DECIDED TO CHANGE THE FORMULARY
, SO THE PATIENT'S MEDICATIONS
ARE NO LONGER ON THE PLAN.
UNFORTUNATELY UM, THE PATIENT
HAS NOT BEEN ABLE TO GET THEIR
MEDICATIONS EACH MONTH UNLESS WE
FILL OUT PAPERWORK OVER AND OVER
AND OVER AGAIN WHERE WE SHOW
WHAT'S BEEN TRIED AND FAILED.
AND WHY WE ARE TREATING THE
PATIENT WITH THIS MEDICATION AND
EACH TIME EACH MONTH IT DOES GET
APPROVED, BUT IT DOES TAKE A LOT
OF RESOURCES, AND THERE HAVE
BEEN SIGNIFICANT DELAYS TO THE
POINT THAT ONE TIME WHEN THE
PATIENT WASN'T ABLE TO GET THE
MEDICATION AUTHORIZED QUICKLY.
THEY DID END UP IN THE EMERGENCY
ROOM TO REQUIRE CARE FOR HIGH
LEVELS OF BLOOD SUGAR. AN
EMERGENCY MEDICAL CARE HAVE
ANOTHER PATIENT WHO I'VE BEEN
MANAGING FOR EMPHYSEMA, AND WHEN
A PATIENT HAS EMPHYSEMA, THERE'S
A SHORT WINDOW PERIOD FOR WHEN
THEY COME IN WITH MILD SYMPTOMS,
AND WE CAN TREAT THEM WITH THE
STANDARD OF CARE, WHICH IS
STEROIDS, ANTIBIOTICS AND, UM,
INHALERS. AND UNFORTUNATELY ONE
OF MY PATIENTS WAS HAVING MILD
SYMPTOMS, AND I SENT IN THE
PRESCRIPTIONS TO TREAT WITH THE
STANDARD OF CARE, AND THE
MEDICATIONS WERE NOT APPROVED BY
THEIR THEIR INSURANCE AND
REQUIRED PRIOR AUTHORIZATION. I
DID NOT KNOW THE PATIENT DIDN'T
GET THEIR MEDICATIONS AS THE
PATIENT WAS VERY ILL AND DID NOT
CALL OR HAVE THE ABILITY TO TELL
US THAT THEY WERE MISSING THE
MEDICATIONS, AND THEN WE CALLED
A FEW DAYS LATER, THE PATIENT
WAS NOT DOING WELL AND ENDED UP
IN THE EMERGENCY ROOM AND ENDED
UP HAVING TO HAVE ICU LEVEL
CARE. AND THEN ON A MORE
PERSONAL LEVEL WHEN MY
GRANDMOTHER WAS PASSING AWAY
FROM DEMENTIA, AND WAS NOT YET,
UM, APPROVED FOR HOSPICE, SHE
HAD A LOT OF PAIN DUE TO BED
SORES AND OTHER CONDITIONS THAT
WERE IMPACTING HER ABILITY TO
HAVE QUALITY OF CARE AT THE END
OF HER LIFE. HER PRIMARY CARE
PHYSICIAN TRIED TO SEND IN A
NARCOTIC PAIN MEDICATIONS TO
HELP RELIEVE THE SUFFERING, AND
WE HAD TO WAIT A FEW DAYS FOR
PRIOR AUTHORIZATION TO HAVE THIS
MEDICATION APPROVED, AND IT WAS
AGONIZING AS A FAMILY MEMBER AS
A PHYSICIAN TO WATCH HER DIE.
AND HAVE PAIN WHILE WE WERE
WAITING FOR A PRIOR
AUTHORIZATION. I URGE FOR YOUR I
VOTE ON THIS BILL. THANK YOU
VERY MUCH OTHERS IN SUPPORT.
JUST YOUR NAME ORGANIZATION IF
YOU REPRESENT ONE KIM STONE
STONE ADVOCACY ON BEHALF OF THE
CALIFORNIA ORTHOPEDIC
ASSOCIATION IN SUPPORT. THANK
YOU. THANK YOU. GRACE DOUGHERTY
ON BEHALF OF THE CALIFORNIA
SOCIETY OF ANESTHESIOLOGISTS,
THE CALIFORNIA ACADEMY OF FAMILY
PHYSICIANS AND STRONG SUPPORT.
THANK YOU. THANK YOU. LADY BORN
REPRESENTING MARINE ACADEMY OF
PEDIATRICS, CALIFORNIA DIVISION.
WE'RE IN SUPPORT. THANK YOU. T
MADDEN REPRESENT THE CALIFORNIA
CHAPTER OF THE AMERICAN COLLEGE
OF CARDIOLOGY AND THE CALIFORNIA
RHEUMATOLOGY ALLIANCE AND
SUPPORT QUÊ CONSCIENCE CAN
BEHALF OF THE CALIFORNIA SOCIETY
OF DERMATOLOGY AND DERMATOLOGIC
SURGERY AND SUPPORT ALEX CON ON
BEHALF OF THE CALIFORNIA CHRONIC
CARE COALITION AND STRONG
SUPPORT. THANK YOU. STEPHEN
SCHULTZ WITH THE ARTHRITIS
FOUNDATION IN SUPPORT. THANK
YOU. MOLLY ROPES AND WITH
PLANNED PARENTHOOD, AFFILIATES
OF CALIFORNIA AND SUPPORT THANK
YOU. AND RYAN SPENCER ON BEHALF
OF THE CALIFORNIA PODIATRIC
MEDICAL ASSOCIATION AND SUPPORT
THANK YOU. UM, GONNA GUESS
THERE'S OPPOSITION TO THIS BILL.
PLEASE COME ON FORWARD.
GOOD AFTERNOON MEMBERS. AND BILL
BARCELONA, EXECUTIVE VICE
PRESIDENT FOR GOVERNMENT AFFAIRS
WITH AMERICA'S PHYSICIAN GROUPS.
WE REPRESENT THE CALIFORNIA
DELEGATED MODEL. OF
APPROXIMATELY 200 MEDICAL GROUPS
THAT TAKE FINANCIAL RISK AND
RESPONSIBILITY FOR THE LIVES OF
THEIR PATIENTS. WE ARE
RESPECTFULLY IN OPPOSITION TO
THIS MATTER. FOR A VARIETY OF
REASONS. UNFORTUNATELY, THIS
IN WHICH WE MANAGE
OR RISK BEARING PHYSICIAN GROUPS
ACROSS CALIFORNIA IN THE H M O
MODEL. AND THE REASON WHY, UM
THAT OCCURS IS THAT THE PREMISE
BEHIND THE CALIFORNIA DELEGATED
MODEL IS THAT THE GROUP TAKES A
CAPITATED PAYMENT, WHICH IS A
BUDGET. FOR THE MONTHLY CARE OF
THE PATIENT. AND THEN HAS THE
FLEXIBILITY TO MANAGE ITS
NETWORK PHYSICIANS. FOR THAT
CARE, AND SO THEY ARE DESIGNED
TO PRACTICE POPULATION HEALTH
MANAGEMENT. UM THIS BILL. WOULD
UNDERMINE THE ABILITY OF OUR
CHIEF MEDICAL OFFICERS IN THESE
RISK BEARING GROUPS. TO CONTINUE
TO MANAGE. THE PHYSICIANS
DOWNSTREAM AND THE NETWORKS. AND
THAT, OF COURSE, UNDERMINES THE
DELEGATED MODEL AND ITS ABILITY
TO CONTROL COSTS AND TO IMPROVE
CARE IN THE STATE. UM AND THAT
IS THE BASIS FOR OUR OPPOSITION.
UM THE SECOND BASIS, WHICH I
THINK IS MOST IMPORTANT IS THE
ADMINISTRATIVE BURDEN AT THIS
PUTS ON THE GROUPS TO DO CHART
REVIEW. UM IN A STATISTICALLY
UNCERTAIN MANNER. UM, AND WOULD
REQUIRE US TO HAVE CLINICIANS.
DEVOTE FULL TIME EACH WEEK TO
ONGOING CHART REVIEW. WE DID
SOME BACK OF THE ENVELOPE MATH
ON THIS. ACCORDING TO THE TERMS
OF THE RECENTLY AMENDED BILL
THAT WE RECEIVED THIS AFTERNOON.
AND. TO REVIEW 20 FILES FOR EACH
OF OUR NETWORK PHYSICIANS IN A
1000 PHYSICIAN GROUP. WE WOULD
HAVE TO COMMIT 10 FULL TIME
CLINICIANS 40 HOURS A WEEK, 52
WEEKS A YEAR. TO CONTINUE TO
MEET THE CRITERIA UNDER THIS
BILL. AND THAT'S FRANKLY
UNACCEPTABLE BECAUSE THAT TAKES
PEOPLE AWAY FROM PATIENT CARE.
AND IT DIMINISHES THE OUTCOMES
THAT WE CAN ACHIEVE IN IN THESE
CAPITATED DELEGATED GROUP, SO
WITHOUT ALL CLOSE. UM AND I
RESPECTFULLY ASK FOR YOUR NO
VOTE. THANK YOU. THANK YOU, MR
CHAIR AND MEMBERS NICK LOUISE
OSAN BEHALF OF THE CALIFORNIA
ASSOCIATION OF HEALTH PLANS WERE
IN OPPOSITION AS WELL. JUST BY
WAY OF BACKGROUND MEMBERS.
ACCORDING TO A RECENT NATIONAL
SURVEY ABOUT 90% OF PHYSICIANS
HAVE SAID THEY HAVE SEEN A
CASCADE OF UNNECESSARY TESTS,
TREATMENTS OR PROCEDURES THAT
BRING HARM TO THE PATIENT,
EITHER PHYSICALLY OR
FINANCIALLY. IN SP 2 50 BY
EFFECTIVELY ELIMINATING A PLANS
ABILITY TO EXERCISE MEANINGFUL
CHECKS AND BALANCES IN THE
HEALTH CARE SYSTEM WILL MAKE
THAT PROBLEM WORSE. THIS MEANS
MORE MEDICALLY UNNECESSARY
SERVICES WITH LITERAL LITTLE OR
NO BENEFIT TO THE PATIENT. MORE
UNNECESSARY TESTING AND SCANS,
WHICH LEADS TO UNNECESSARY
RADIATION EXPOSURE, IN SOME
CASES, WHICH CAN CAUSE NEEDLESS
STRESS AND ANXIETY ON A PATIENT.
IT COULD ALSO LEAD TO HIGHER
BRAND NAME DRUGS BEING
PRESCRIBED WHEN LOWER COST
ALTERNATIVES ARE AVAILABLE AND
MORE ALL OF THIS IS AVOIDED WHEN
WE FOCUS ON DELIVERING THE RIGHT
CARE AT THE RIGHT TIME TO THE
RIGHT PERSON. SB 2 50 TURNS OUR
CURRENT MODEL OF MANAGED CARE ON
HIS HEAD, INCREASING COSTS IN
LEADING TO BAD PATIENT OUTCOMES.
MEMBER IS THE ONLY STATE THAT IS
IMPLEMENTED. A POLICY LIKE THIS
IS TEXAS. I KNOW THE SPONSORS OF
THIS BILL WANT CALIFORNIA TO
TAKE TEXAS LEAD ON THIS MATTER
THAT CALIFORNIA USUALLY DOESN'T
TAKE ITS CUES FROM THE LONE
START STATE ON MATTERS OF PUBLIC
POLICY. IN ANY CASE, THE
EXPERIENCE IN TEXAS HAS BEEN
HIGHLY PROBLEMATIC. ACCORDING TO
OUR COUNTERPARTS IN THAT STATE,
THE IMPLEMENTATION OF THE SPILL
HAS BEEN A TOTAL MESS. THAT'S A
QUOTE. UM AND THE CARRIERS IN
TEXAS ESTIMATE THAT THE PREMIUM
IMPACT UM WOULD BE ABOUT A
BILLION DOLLARS PER YEAR AS A
RESULT OF THAT LEGISLATION WHEN
IT ACTUALLY GETS ENACTED. IT WAS
SUPPOSED TO BE ENACTED AT THE
BEGINNING OF THIS YEAR. AND THEY
HAVEN'T BEEN ABLE TO GET IT OFF
THE GROUND. AS OF YET, WE DON'T
KNOW WHAT THE COST OF THIS BILL
WOULD BE IN CALIFORNIA, SP 2 50
WASN'T REFERRED TO THE
CALIFORNIA HEALTH BENEFITS
REVIEW PROGRAM FOR ANALYSIS, AS
IT SHOULD HAVE BEEN, SO WE WERE
KIND OF FLYING BLIND BLIND ON A
MAJOR POLICY SHIFT HERE. BUT IN
CLOSING, I WOULD JUST SAY THAT
SP 2 50 PREVENTS MY MEMBERS FROM
ENSURING THE HIGHEST QUALITY OF
CARE AND PREVENTING WASTEFUL
MEDICAL SPENDING. UM, I WOULD
ALSO JUST ADD ACTUALLY, AS MY
FINAL COMMENT FOR REAL THIS
TIME. THAT THE AMERICAN
AMERICA'S HEALTH INSURANCE PLANS
AND THE AMERICAN MEDICAL
ASSOCIATION, UM CAME TO A
CONSENSUS STATEMENT ON IMPROVING
THE PRIOR AUTHORIZATION PROCESS
. SO THE FEDERAL MEDICAL
ASSOCIATION THE FEDERAL TRADE
ASSOCIATION WITH THE PLANS CAME
UP WITH SOME PRINCIPLES AND A
STATEMENT ON THIS, UM YOU KNOW,
ACTIONS HAVE BEEN TAKEN BY
CARRIERS NATIONALLY IN THE FIVE
AREAS OF THE CONSENSUS STATEMENT
, AND YOU KNOW, A HIP IS
CURRENTLY DOING SOME REVIEW IN
THAT AREA TO GET A BETTER GRASP
OF WHAT'S GOING ON THERE. IN
CASE YOU DON'T UNDERSTAND WHY
THE SPONSORS OF THIS BILL ARE
KIND OF, YOU KNOW, MUGGING THEIR
WAY INTO THE PICTURE OR PHOTO
BOMBING THAT PROCESS, YOU KNOW,
YOU KNOW, WITH SP 2 50. SO WE
ASKED FOR YOUR NO VOTE. THANK
YOU. THANK YOU VERY MUCH. WE'LL
BRING IT BACK TO THE COMMITTEE.
I'M SORRY. NEVER MIND. FORGET
ADDITIONAL OPPOSITION IF JUST
YOUR NAME AND ORGANIZATION. MY
APOLOGIES. MR CHAIR MEMBERS.
JOHN WINGER ON BEHALF OF
AMERICA'S HEALTH INSURANCE PLANS
IN OPPOSITION. MR CHAIR MEMBER,
STEPHANIE WATKINS ON BEHALF OF
THE ASSOCIATION OF CALIFORNIA
LIFE AND HEALTH INSURANCE
COMPANIES ALSO POST. ALISON REMY
ON BEHALF OF THE PHARMACEUTICAL
CARE MANAGEMENT ASSOCIATION, A
POST. MR CHAIRMAN SCOTT WEST ON
BEHALF OF THE TAFT HARTLEY TRUST
FUNDS, THE STATE ASSOCIATIONOF
ELECTRICAL WORKERS. THE
CALIFORNIA STATE PIPE TRADES IN
THE WESTERN STATES COUNCIL OF
SHEET METAL WORKERS IN
OPPOSITION. THANK YOU. THANK
YOU. ANYONE ELSE? NOW WE'LL
BRING IT BACK TO THE COMMITTEE.
ANY QUESTIONS OR COMMENTS, MR
FLORA? THANK YOU. THANK YOU,
SENATOR FOR BRINGING THIS
FORWARD, BUT I AM CURIOUS. ARE
THERE ANY OTHER STATES WITH HIS
GOLD KARTING STANDARD AS IT
RELATES TO MEDICAID. RELATE TO
MEDICAID. ARE THERE ANY OTHER?
UM THIS IS APPLIED TO ANY OTHER
MEDICAID PROGRAM IN ANY ANYWHERE
ELSE IN THE COUNTRY. THESE KIND
OF STANDARDS. MAYBE I'LL PASS
THAT ON TO THE SPONSOR STAND.
ASSEMBLYMEMBER'S I DON'T BELIEVE
AS OF RIGHT NOW. ANY LAW IN ANY
OTHER STATE HAS PASSED AS IT
RELATES TO THEIR MEDICAID
PROGRAM. BUT THE AMENDMENTS
TAKEN IN THE COMMITTEE TODAY SAY
THAT IT IS APPLICABLE TO
MEDICAID ONLY TO THE EXTENT THAT
FEDERAL LAW ALLOWS IT TO BE.
CREATE THAT. THANK YOU. ANYONE
ELSE? UM I'M SORRY. GOOD. MR AND
MISS WALDRON'S SO, THIS BILL, I
SPENT MORE TIME ON THIS BILL AND
PROBABLY MOST OF THE OTHERS,
BECAUSE,UM, THE ISSUES THAT I
SEE ON BOTH SIDES. I MEAN, I'VE
BEEN A HUGE ADVOCATE OF
REFORMING THE PRIOR
AUTHORIZATION PROCESS FOR SINCE
I GOT HERE RUNNING BILL AFTER
BILL TRYING TO FIGURE OUT A WAY
SUPPORTING OTHER MEMBERS BILLS
THAT HAVE COME FORWARD. UM YEAH.
JUST HAVING PERSONAL EXPERIENCES
AND THE FAMILY WITH THIS ISSUE
DELAYED CARE AND THINGS LIKE
THAT. MY BROTHER BEING A DOCTOR,
UM HE HAS TO HIRE. STAFF HE HAS
AT LEAST 2 TO 4 PEOPLE ON STAFF
WHO SPEND ALL THEIR TIME JUST
DEALING WITH PRIORITIZATION. UM
SO I UNDERSTAND THAT IT'S AN
ISSUE AND IT'S AN ADMINISTRATIVE
BURDEN ON BOTH SIDES,
REGARDLESS. SO, UM. I GUESS.
DOES THIS BILL DEAL WITH
MEDICAID? I MEAN, JUST WHAT YOU
SAID, JUST AS FEDERAL LAW WOULD
ALLOW. BECAUSE I WAS READING IT.
IT WAS NOT DIRECTED IT, DECAL. I
MEAN, THIS BILL IS NOT JUST FOR
MEDICAID PROGRAMS, BUT CLEARLY,
YOU KNOW, THE MEDICAID PROGRAM
IS A FEDERAL STATE PARTNERSHIPS.
AND SO, OF COURSE, WE NEED TO BE
SURE THAT IT'S CONSISTENT WITH
FEDERAL LAW SO THAT WE DON'T
CREATE A PROBLEM WITH OUR YOU
KNOW THE MATCHING FUNDS AND SO
FORTH. WE GET FROM CMS FOR
MEDICAID PROGRAM, BUT I DO WANT
TO RECOGNIZE AND APPRECIATE.
YOUR LEADERSHIP AND ADVOCACY
AROUND PRIOR AUTHORIZATION AND
SAID, YOU KNOW YOU YOU TALKED TO
YOUR BROTHER WHO'S A PHYSICIAN
AND THE FACT THAT HE HAS TO HIRE
SO MANY STAFF TO DEAL WITH THIS
, AND AS I CITED, YOU KNOW,
THERE'S A HUGE EXPENSE PER
POSITION TO DEAL WITH
PRIORITIZATION. I WOULD ALSO
MAKE NOTE, AND I CERTAINLY
APPRECIATE THE OPPOSITION'S
TESTIMONY. BUT IF THEY'RE SAYING
IT'S SUCH A BURDEN TO ACTUALLY
REVIEW THESE AN ARTIST, SEE
WHETHER A PHYSICIAN GET GOLD
CARD. SHOULDN'T HAVE BEEN USING
THAT SAME EFFORT IN MAKING THE
DECISION ABOUT THE AUTHORIZATION
ITSELF, RIGHT? THERE'S PATIENTS
ON THE LINE RIGHT PATIENTS ARE
WAITING TO GET CARE THAT A
PHYSICIAN IS RECOMMENDING. AND
WE'RE WAITING FOR THE INSURANCE
COMPANY. THAT ISN'T THAT THAT'S
A BURDEN THAT CERTAINLY THE
HEALTH PLANS, BY THE WAY, CHOSE
THEMSELVES TO IMPOSE. THERE'S NO
REQUIREMENT FOR HELPING TO PUT A
PRIOR AUTHORIZATION SYSTEM, SO
THAT'S THE HEALTH AND DECIDE
THAT THEY FEEL THAT THAT'S AN
EXPENSE THAT THEY WANT TO OCCUR.
AND IN ORDER TO, I GUESS. MAKE
IT SO THAT IT'S MUCH HARDER FOR
PHYSICIANS TO BE ABLE TO CARE
FOR THEIR PATIENTS AND PROVIDE
THE CARE NOW I ADMIT THERE ARE
BAD ACTORS, AND THAT'S WHY
THAT'S BEEN PLACED. BUT WHEN YOU
SOMEONE'S PROVEN THEMSELVES TO
BE A GOOD ACTOR, WHY WOULD WE
CONTINUE TO TRY TO, YOU KNOW,
CREATE THAT ONGOING COSTS AND
DELAYS AND AGAIN REALLY COMES
DOWN TO THE PATIENT, RIGHT? THE
DELAY. THAT'S THE PATIENT
SITTING THERE. BUT THE DOCTORS
ARE SAYING WE STILL ARE WAITING
FOR THE YEAR FROM YOUR INSURANCE
COMPANY BEFORE WE KNOW THAT THIS
IS GOING TO BE GETTING PAID FOR.
AND SO WE CAN'T PROVIDE THE CARE
RIGHT NOW. AND THAT'S THAT'S THE
REAL PROBLEM. BUT, YEAH, I
REALLY APPRECIATE YOUR ADVOCACY.
ONE OF THE BIGGER ISSUES THAT
I'VE SEEN IS PEOPLE WHO HAVE
BEEN ON A PROTOCOL AND THEN ALL
OF A SUDDEN FOR SOME REASON,
THEY'RE NOT. OR THERE'S A DELAY
EVEN THOUGH IT'S BEEN THAT WAY
OR THE PRICE GOES UP. THE LATEST
ONE WAS THE PRICE, ALL OF A
SUDDEN JUMPED JUMPED UP WHEN IT
HAD BEEN COVERED BEFORE AND YOU
KNOW, ONCE AGAIN THAT CAUSES A
DELAY BECAUSE THEN YOU'RE
WAITING LIKE IN THE CASE IN MY
FAMILY WAS A WEEK. AND IT WAS
RIGHT AT THE POINT WHERE YOU
KNOW THEY'RE NOT GETTING IT AND
ALL OF A SUDDEN THEY GET IT, AND
THEN THEY HAVE TO PAY $50 TO
OVERNIGHT IT BECAUSE IT WAS THAT
URGENT SO IT'S A TOUGH IT'S A
TOUGH BILL. UM I'M GOING TO
SUPPORT IT TODAY, BUT I GET BOTH
SIDES AND MAYBE THERE'S SOME WAY
TO HELP. THE OPPOSITION WORK
THROUGH SOME OF THE
ADMINISTRATIVE ISSUES. ANYONE
ELSE? JUST SOME SOME COMMENTS
AND ACTUALLY, ACTUALLY A
QUESTION FOR THE OPPOSITION. SO
SPECIFICALLY, MR LOUISE OWES
FROM THE FROM THE INSURANCE PLAN
PERSPECTIVE, SO YOUR OPPOSITION
IS BASED ON LARGELY ON.
PERCEIVED INCREASES IN COST. SO
DO YOU HAVE? CAN YOU ELABORATE
ON THAT? A LITTLE BIT MORE?
THANK YOU, MR CHAIR. YOU KNOW,
AS AS I STATED, WE DON'T HAVE AN
INDEPENDENT FISCAL ANALYSIS ON
THIS BILL. SO IT'S HARD FOR ME
TO, YOU KNOW, PEG AN ACTUAL
DOLLAR AMOUNT ASSOCIATED WITH
THIS BILL. UM YOU KNOW, BEYOND
THE REGULATORY COSTS THAT HAVE
BEEN IDENTIFIED BY THE
APPROPRIATIONS COMMITTEES AND
SUCH, YOU KNOW. YOU KNOW, AS I
STATED, WE DO HAVE EXPERIENCE IN
OTHER STATES. THE CLOSEST STATE
THAT IS EMULATED. THIS POLICY IS
TEXAS AND THE CARRIERS ARE
ESTIMATED ABOUT A BILLION DOLLAR
PREMIUM IMPACT AND PER YEAR NOW
GRANTED, YOU KNOW, THAT IS THAT
IS THAT IS A SELF ATTESTED
NUMBER, BUT I THINK THE POINT I
WAS TRYING TO MAKE IS THAT YOU
KNOW, THIS IS A BILL THAT IS
GOING TO HAVE A PREMIUM IMPACT
BECAUSE PART OF THE PRIOR
AUTHORIZATION PROCESS MUCH OF IT
IS AROUND. YOU KNOW, PATIENT
SAFETY ISSUES IS THE PERSON
GETTING THE RIGHT CARE AT THE
RIGHT TIME. ONLY ABOUT 15% OF
PRIOR AUTHORIZATIONS. UM EXCUSE
ME. ONLY ABOUT 15% OF SERVICES
ACTUALLY REQUIRE PRIOR
AUTHORIZATION, SO WE'RE NOT, YOU
KNOW, I THINK THERE'S THIS
MISNOMER AROUND AROUND PRIOR
AUTH THAT YOU KNOW, EVERYTHING
HAS TO GO THROUGH THE GAUNTLET
OF, YOU KNOW, UTILIZATION
MANAGEMENT IF YOU WILL, BUT IT'S
A PRETTY SMALL PERCENTAGE OF
PROCEDURES. PART OF THAT PROCESS
IS AGAIN EFFICACY. BUT THERE IS
A COST COMPONENT TO IT AS WELL.
ESPECIALLY WHEN WE'RE TALKING
ABOUT. UM UM, UH, YOU KNOW, UH,
PHARMACEUTICALS, YOU KNOW, ARE
WE GOING TO USE A BRAND NAME
WHEN THERE'S A GENERIC
AVAILABLE? THAT WOULD BE ONE
EXAMPLE. SO WE DO THINK THAT
THIS WILL INCREASE. COSTS UM, I
WISH THIS HAD BEEN REFERRED, YOU
KNOW, FOR AN INDEPENDENT
ANALYSIS BY THE CALIFORNIA
BENEFIT REVIEW PROGRAM. THANK
YOU. THIS IS A THIS IS A TOUGH
ONE. YOU KNOW, I'LL BE HONEST
WITH YOU AND I HAD A LOT OF BACK
AND FORTH ON THIS ONE. I THINK I
PRACTICED DENTISTRY FOR 27 YEARS
AND YES, I WOULD GET VERY
FRUSTRATED WITH
PREAUTHORIZATION. AT TIMES AND
THEN OTHER TIMES. IT WAS AN
IMPORTANT TOOL FOR MY PATIENTS,
BECAUSE OFTENTIMES I WOULD BE
ASKED, IS THIS A COVERED BENEFIT
AND OFTEN TOLD THAT THE ONLY WAY
TO BE INSURANCE A COVERED
BENEFIT IS FOR US TO DO A
PREAUTHORIZATION AND THEY'D WANT
TO KNOW WHAT IS IT GOING TO
COST? AT THE END OF THE DAY, AND
SO IT WAS A TOOL AT TIME, AND
SOMETIMES IT WAS FRUSTRATING
BECAUSE I KNEW IT WOULD BE A
COVERED BENEFIT. UH BASED ON MY
CLINICAL EXPERIENCE OF YEARS.
AND YET WE STILL GO THROUGH THAT
PROCESS. SO UM, I DON'T THINK
WE'D BE HERE. TODAY IN THIS
DISCUSSION WERE IT NOT FOR THE
FACT THAT THE COST OF HEALTH
CARE IS SO HIGH? I MEAN, THAT'S
THAT'S THE REALITY OF THIS. AND
SO I BELIEVE THE
PREAUTHORIZATION. UH THE PROCESS
IS A WAY TO GET OUR ARMS AROUND
AND TRY TO UNDERSTAND. IS THAT
CARE APPROPRIATE? IS THAT
NECESSARY OR WE JUST CHURNING? I
DON'T ALWAYS KNOW. I THINK OF
MYSELF WHEN I WAS PRACTICING
DENTISTRY, AND I'M NOT GOING TO
SPEAK FOR DOCTORS, BUT I THINK,
UH, BUT I THINK SOMETIMES THERE
IS THIS PERCEPTION. OH, DON'T
WORRY ABOUT YOUR INSURANCE WILL
COVER THAT. VERSUS IS THIS TEST
ABSOLUTELY POSITIVELY NEEDED FOR
THE DIAGNOSIS, OR ARE WE JUST
COVERING ALL BASES ALL POSSIBLE
BASES REGARDLESS, REGARDLESS OF
COST, AND SO I SAY ALL THIS
BECAUSE IT IS IT IS A
COMPLICATED ISSUE. UM IT'S A
IT'S A IT'S A CHALLENGING ISSUE.
UM AND BUT IT REALLY GOES BACK
TO THE FACT THAT THE COST OF
HEALTH CARE IS SO EXPENSIVE. SO,
UM. IT'LL BE INTERESTING TO SEE
IF THIS IS IMPLEMENTED IF IT CAN
BE IMPLEMENTED BECAUSE WE'VE
HEARD THAT TEXAS IS STRUGGLING
TO IMPLEMENT THIS, UM I AM GOING
TO SUPPORT IT TODAY. UM AND BUT
IT IS IT DOES COME WITH IT DOES
COME WITH CHALLENGES. I WOULD
LOVE WHO ARE PRE AUTHORIZATION
PROCESS AS A MEDICAL CONSUMER TO
ACTUALLY KNOW WHAT A PROCEDURE
IS GOING TO COST, BUT I NEVER
GET TO HEAR THAT. I KNOW WHEN I
HAD A KNEE OPERATION. UM I GOT
TO HEAR THAT THAT THAT IT WAS
APPROVED, BUT I DIDN'T KNOW WHAT
IT WAS GOING TO COST. I DIDN'T
KNOW WHAT THE HOSPITALIZATION
WAS GOING TO COST. I DIDN'T KNOW
WHAT THE MEDICATIONS WE'RE GOING
TO COST. FOR DENTAL PROCEDURE I
KNEW AS I GOT THAT FEEDBACK FROM
UPFRONT, AND SO, UM, I THINK
THAT IS A MISSING PIECE OF THE
PUZZLE. UM, WE'VE ACTUALLY HAD
HOSPITALS OUT THERE THAT ARE NOW
UNDER A MANDATE TO PROVIDE YOU
KNOW WHAT COST MIGHT BE AND
MANY, AND MANY OF THEM ARE
ACTUALLY IGNORING THAT. IGNORING
FEDERAL LAW. THAT'S PRETTY
DISAPPOINTING. SO UM, IT WAS A
LOT OF WORDS THERE A LITTLE BIT
AND MAYBE A LITTLE PENT UP
FRUSTRATION. UM, BUT, UM, THERE
IS EMOTION FOR THE BILL. YES.
I'M SORRY, MR SANTIAGO. A
SECOND. WE HAVE EMOTION BY DR
ARAMBULA SECOND BY, UM MR
SANTIAGO. DR PAM, WOULD YOU LIKE
TO CLOSE? THANK YOU. AND AGAIN.
I WANT TO THANK YOU AND YOUR
COMMITTEE STAFFER WITH WORKING
WITH MY OFFICE AND SPONSORS ON
THIS BILL. UM YOU KNOW, AS A
PHYSICIAN, AND ACTUALLY MY
WIFE'S A DENTIST, SO I HAVE SOME
FAMILIARITY WITH DENTAL PRACTICE
AND DENTAL BILLING. AND THERE
ARE CERTAINLY SOME SIGNIFICANT
DIFFERENCES AND AS A RESIDENCY
DIRECTOR. I TRAINED THEATRIC
RESIDENTS. WE SPENT A LOT OF
TIME TALKING ABOUT YOU KNOW,
DOING THINGS RIGHT QUALITY,
RIGHT? RIGHT PLACE RIGHT TIME,
ETCETERA, NOT OVER. ORDERING
TESTS AND SO FORTH. AND, UM. YOU
KNOW PART OF WHAT THE CORE OF
THIS BILL IS THAT WE'RE NOT
SAYING BAND PRIOR AUTHORIZATION.
THAT SAME BAND PRIOR
AUTHORIZATION WE'RE SAYING IS
THAT IF YOU PROVE YOURSELF AS
BEING A POSITION OR OTHER
PROVIDER WHO DOES DO THINGS THE
RIGHT TIME FOR THE RIGHT THE
RIGHT THING AT THE RIGHT TIME
AND YOU HAVE THAT RECORD AND YOU
HAVE TO. I THINK IT'S 90% RIGHT.
YOU HAVE TO SHOW THAT YOU'RE
OVER AND OVER AND OVER AGAIN
THAT YES, YOU'RE APPROVED.
VALLAPUDUA PROVE TO PROVE TO
PROVE TO PROVE AT SOME POINT IN
TIME. WHAT'S THE REASON FOR ALL
THE EXCESS OVERHEAD AND WORK
RIGHT TO TELL YOU THAT? NOT
ONLY, OF COURSE YOU YOUR PATIENT
HAS TO WAIT. THE OTHER THING IS
, IS THAT I JUST I ALSO JUST
WANT TO CITE THIS BECAUSE I KNOW
OFTENTIMES, YOU KNOW, CERTAINLY
WE WANT TO TRY TO KEEP THE
HEALTHCARE COSTS DOWN.
APPRECIATE YOUR LEADERSHIP CHAIR
WOULD IN THIS SO I KNOW
WORKFORCE ISSUES. SO STUDIES ON
PRIMARY CARE PHYSICIANS AND
PRIMARY CARE PHYSICIAN SHOW THAT
PRIMARY CARE PHYSICIANS ARE
SPENDING APPROXIMATELY ONLY 28%
OF THEIR TIME DOING CLINICAL
WORK. I APPRECIATE THE CENTRAL
SIMILAR AND DR RAINBOW AND
NODDING HIS HEAD BECAUSE WE ALL
ALL THOSE OF US WHO ARE ON THE
FRONT LINES NOW HOW MUCH TIME WE
SPEND DOING THIS OVERHEAD STUFF?
WE COULD ACTUALLY DOUBLE OUR
PRIMARY CARE WORKFORCE IF WE
ACTUALLY REDUCED THE OVERHEAD
WORK FOR DR PRIMARY CARE DOCTORS
TO UNDER 50% NOT DOWN TO LIKE
FIVE OR 10. JUST GET IT UNDER
50% AND THEN WE WOULD ACTUALLY
DOUBLE OUR PRIMARY CARE
WORKFORCE PRACTICALLY THAT'S THE
COST THAT THINGS LIKE PRIOR
AUTHORIZATION IS CAUSING. WHEN
YOU'RE MAKING PHYSICIANS WHO
HAVE ALREADY DEMONSTRATED TO
DOING THE RIGHT THING AT THE
RIGHT TIME, PROVIDING GOOD CARE
, MAKING THEM HAVE TO JUMP OVER
THESE HOOPS OVER AND OVER AGAIN.
AND OF COURSE, WE'RE GOING TO DO
IT BECAUSE WE DON'T TAKE CARE OF
OUR PATIENTS. AND OF COURSE,
THERE'S A COST TO THE PATIENT
BECAUSE THAT'S THE MOST
IMPORTANT THING. SO YOU KNOW, I
DON'T WANT YOU TO BE SO AND
THEY'RE LIKE, OH, WELL, POOR
DOCTORS. IT'S REALLY ABOUT THE
PATIENTS IN THE END, BUT THERE
IS AN OVERHEAD COST TO THAT.
RIGHT. SO WE'RE TRYING TO
RECRUIT DOCTORS WERE TRYING TO
RECRUIT OTHER PEOPLE, THE
PRIVATE CARE, AND YET THEY'RE
ONLY SPENDING 28% OF THE TIME
DOING CLINICAL WORK. THAT'S A
PROBLEM. AND THAT'S ALSO A
PROBLEM THAT DRIVES UP COSTS AND
THINK ABOUT IF THEY'RE NOT WHAT
YOU KNOW WHAT? WHAT ARE WE
PAYING FOR? FOR THE OTHER REDDIT
REST OF THE TIME, RIGHT? THAT'S
A COST TO SO AGAIN REALLY
APPRECIATE SUPPORT. UM SHERWOOD.
THANK YOU SO MUCH FOR WORKING
WITH ME IN THE SPONSORS, AND I
REALLY APPRECIATE THAT YOUR
EXPRESSION OF SUPPORT. I
RESPECTFULLY ASK, AND I, BUT
THANK YOU. AND BEFORE WE DO, I
JUST WANT TO SAY ONE OF AND I
DON'T EVER DO THIS SO, BUT I BUT
I HAVE I FEEL COMPELLED TO, UM
THIS IS FASCINATING. WE HAVE THE
CALIFORNIA MEDICAL ASSOCIATION
ON ONE SIDE. WE HAVE HEALTH
PLANS. WE ALSO HAVE AMERICANS
PHYSICIAN GROUP THERE. AND THEY
JUST TALKED ABOUT THE INCREDIBLE
WORKLOAD THAT THIS MIGHT CAUSE
ADMINISTRATIVE BURDEN THAT THIS
MIGHT CAUSE FOR THEIR PHYSICIANS
. SO BECAUSE OF THE WAY THIS
THIS BILL MIGHT BE IMPLEMENTED,
SO I JUST POINT THAT OUT. I'M
NOT CHANGING MY POSITION OR
ANYTHING. BUT I JUST POINT OUT
THE FASCINATING MIX OF THINGS WE
HAVE BEFORE US HERE IN THIS
PARTICULAR BILL, SO, UM WITH
THAT WE HAVE A MOTION BY DR
ARAMBULA. SECOND BY MR SANTIAGO
. MOTION IS DUE PASS AS AMENDED
TO APPROPRIATIONS AND MADAM
SECRETARY, PLEASE CALL THE ROLL.
WOULD I? WALDRON WALDER, NIAGARA
CURRY. ARAMBULA ARAMBULA. AYE,
BIGELOW. CARILLO. CARILLO I
FLORA. FOR A NO MAIENSCHEIN.
MAZE. MCCARTY. NAZARIAN RIVAS
RODRIGUEZ. SANTIAGO. SANTIAGO, I
WEBER. 51 WILL LEAVE THE BILL ON
CALL AND DR PAN, PLEASE EXCUSE
ME FOR THIS. I AM GOING TO ASK
MR RAZ O TO PRESENT A BILL FOR
SENATOR GONZALEZ. SHE GOT CAUGHT
UP IN THE CARE COURT. THINKSO.
UM SO SHE WAS HERE. UM AND SO
I'M GOING TO ASK YOUR INDULGENCE
ON THAT SHE WOULD HAVE BEEN NEXT
IN ORDER. UM, SO IF THAT'S OKAY.
OKAY PRESENTING FOR SOMEONE WHO
WAS A SENATOR WHO IS SICK YET?
NO, I UNDERSTAND. I ALSO AND
AGAIN. THANK YOU. AND UH, SO I
THINK, UH, PORTANTINO DOES HAVE
SOMEONE WHO AND THEN HE ALSO HAD
A WITNESS WHO THAT'S THAT'S WHY
I TRIED TO GET THESE TWO BILLS
OUT OF IT. BUT AGAIN. THANK YOU,
MR CHAIR AND HAPPY TO HAVE
SENATOR PORTANTINO GO AFTER MR
RAZ O IF SENATOR DURAZO, IF
YOU'RE OKAY WITH THAT, SENATOR
ARE YOU OKAY WITH SENATOR
PORTANTINO GOING AFTER HIM? IS
SENATOR DURAZO? THAT'S FINE,
OKAY. YOU'RE THE CHAIR. SO THANK
THANK YOU VERY MUCH. I'M LOOKING
FORWARD TO PRESENTING THE REST
OF MY BILLS. THANK YOU. THANK
YOU. SO, SENATOR ROSCOE SORRY.
SURE. SANITARY AS OH, THANK YOU
VERY MUCH FOR PRESENTING SENATOR
GONZALEZ IS BILL THANK YOU, MR
SANTIAGO. WE HAVE A MOTION BY MR
SANTIAGO. SECOND BY MS CARILLO.
YES. THANK YOU, MR CHAIR AND
MEMBERS. I WANT TO BEGIN BY
SAYING THAT WE ARE ACCEPTING THE
CORRECTION AMENDMENTS AS LAID
OUT IN THE COMMITTEE. ANALYSIS
JUST SAID I'M HERE TO PRESENT ON
BEHALF OF SENATOR SENATOR
GONZALEZ. THIS BILL WILL
MODERNIZE THE CALIFORNIA RETAIL
FOOD CODE. CAL CODE. TO BE
INCLUSIVE OF SIDEWALK FOOD
VENDORS. IT WILL BRING THOUSANDS
OF MICRO ENTREPRENEURS INTO A
MORE EQUITABLE AND WELL
REGULATED FOOD ECONOMY. ALSO
ENHANCING CRITICAL HEALTH AND
FOOD SAFETY REGULATION. THE
RECENT AMENDMENTS RESTRUCTURE
THE BILL IN ACCORDANCE WITH
FEEDBACK FROM THE COMMITTEE
STAFF AND ARE A RESULT OF
WORKING DILIGENTLY WITH LOCAL
FOOD SAFETY PROFESSIONALS. TO
REMOVE THEIR OPPOSITION AND
ENSURE THAT THE BILL ENHANCES
FOOD SAFETY. SIDEWALKS STREET,
UM FOOD VENDORS ARE A STAPLE IN
CALIFORNIA'S COMMUNITIES. THEY
ARE PART OF A VERY VIBRANT FOOD,
CULTURE AND THE LOCAL ECONOMY
THAT MAKES MY DISTRICT AND ALL
OF CALIFORNIA VERY UNIQUE.
HOWEVER UNDER THE EXISTING
RESTRICTIONS IN CAL CODE, IT IS
NEARLY IMPOSSIBLE. FOR SIDEWALK
FOOD VENDORS T ATTAIN A LOCAL
HEALTH PERMIT TO VENT FOOD.
THESE VENDORS ARE FACED WITH A
COMBINATION OF INACCESSIBLE,
PERMITTING PROCEDURES,
EXORBITANT COSTS, INCOMPATIBLE
EQUIPMENT AND DESIGN STANDARDS,
AS WELL AS PUNITIVE ENFORCEMENT
MEASURES. MANY OF THESE VENDORS
ARE LOW INCOME AND PUNITIVE IN
FORCE MINT MEASURES THAT LIMIT
CONSIDERATION FOR THEIR ABILITY
TO PAY. IN A SYSTEM THAT
HISTORICALLY HAS PUSHED THEM
INTO THE SHADOWS, FURTHER
CRIMINALIZES VENDORS AND KEEPS
THEM IN THIS ENDLESS CYCLE OF
POVERTY. THIS BILL CREATES A
DEFINITION FOR COMPACT FOOD
MOBILE FOOD OPERATION. TO BETTER
INCORPORATE SIDEWALK FOOD
VENDORS INTO CAL CODE MAKES
SMALL CHANGES TO THE MICRO AND
ENTERPRISE HOME KITCHEN
OPERATIONS AND THE COTTAGE FOOD
OPERATION LAWS. TO ALLOW
SIDEWALK FOOD VENDORS TO ACCESS
EXISTING PROGRAMS. THIS BILL
ALSO ADDRESSES ADDITIONAL
BARRIERS IN CAL CODE THAT
INCLUDE SIDEWALK VENDORS AND CAN
BE SPECIFICALLY DETAILED. BY
BILL SPONSORS IF NEEDED. I WANT
TO EMPHASIZE THAT BY REDUCING
THE BARRIERS TO OBTAIN A PERMIT
, MORE SIDEWALK VENDORS WILL
PARTICIPATE IN THE LOCAL
PERMITTING PROCESS THAT
INCORPORATES BETTER FOOD SAFETY.
EDUCATION AND SANITATION CONTROL
, TESTIFYING IN SUPPORT OF THIS
MEASURE TODAY, I HAVE LYNETTE
ROBINSON AND EULALIA AALIYAH.
CHAVEZ TO SPEAK ABOUT THEIR
EXPERIENCES AND ALSO HAVE PUBLIC
COUNCIL AND WESTERN CENTER
REPRESENTATIVES TO ASSIST WITH
TECHNICAL QUESTIONS. THANK YOU
VERY MUCH. PLEASE PUSH THE
BUTTON THERE. THE MICROPHONE
BUTTON. THANK YOU. HELLO. GOOD
AFTERNOON, EVERYONE. I AM THE
OWNER, THE CEO AND OPERATOR OF
MY STARTUP AND GROWING COMPANY,
AND I DO SO SUPPORT SB 972,
BECAUSE WHEN I GO TO WORK EVERY
DAY I DON'T JUST CLOCK IN. I
PHYSICALLY BUILD MY BUSINESS
STRUCTURE. I WORKED THROUGH THE
DAY AND THEN I BREAK IT DOWN AT
THE END, AND I GLADLY DO IT
AGAIN EVERY DAY. AS AN
ENTREPRENEUR, AS WE 972 WILL
SERVE AS A CLEAR AND CONCISE
PATH TO PROPER PERMITTING FOR
VENDORS SUCH AS MYSELF. PASSING
THIS BILL WILL SHOW THAT THE
WORKING CLASS WILL SHOW THE
WORKING CLASS AND THE LOW INCOME
COMMUNITY DOES HAVE THE SUPPORT
ESCAPE FINANCIAL TRAPS. AND THAT
THEY CAN PROSPER. THE ETHICS AND
DEDICATION AND GREAT THAT
SITTING BEFORE YOU TODAY UM IT'S
WHAT FEEDS AND SUSTAINS MY
LIVELIHOOD. INCREASING FINES AND
FEES. THEIR SCARE TACTICS AT
THAT, DEEPLY OR UNNECESSARY. IT
COMES ACROSS AS A DESIRE TO
SQUEEZE OUT ENTREPRENEURS OF
COLOR, SUCH AS MYSELF FROM
CERTAIN AREAS. IT'S AN
UNCOMFORTABLE FEELING. STREET
VENDING IS GROWING IN POPULARITY
JUST AS RESTAURANTS AND FOOD
TRUCKS ONCE DID. SB 972 IS
SORELY NEEDED TO GUIDE VENDORS
TO RECEIVING THE PROPER PERMITS
SO WE CAN SHOW THAT WE ARE
HOLDING OURSELVES ACCOUNTABLE
AND RESPONSIBLE. AND TODAY I
IMPLORE YOU. TO CONSIDER THE
IMPACT OF HIGH FEES AND FINES ON
THIS GROWING BUSINESS BASE. IF
WE WERE ABLE TO AFFORD THOUSANDS
OF DOLLARS IN FEES AND FINES,
WHY WOULDN'T WE JUST PAY FOR THE
PERMITS INSTEAD? AGAIN I SUPPORT
SB 972. AND I'M ASKING YOU TO
HELP US HELP OURSELVES SO WE CAN
CONTINUE TO PROVIDE YOUR
FAVORITE FESTIVAL FOODS ACROSS
THE STATE BY VOTING. YES. AGAIN?
YES, ONSET 972. QUÊ. THANK YOU.
THANK YOU. WHEN I START I'M
GONNA INTERPRET FROM MONGOLIA.
SO SHE'S GOING TO READ IT ALL IN
SPANISH, AND THEN I'LL READ IT
IN ENGLISH. QUÊ WHEN I STARTED
SENORES. ASAMBLEÍSTA REGULARLY
CARRIES EVEN THE DOOR AND
BERLANTI THE TAMALES ANGLE
MERCADO COMIDA GUATEMALA TAKEN
LOOSE ANGELUS. ESTÁ SKIN ESTATE
HOMES, CAR ADELANTE. I'M NEVER
SEE THAT. OPPORTUNITY AREA AND
TO PREVENT Ó. CRIMINALISTS. AS
WE DEFEATED BARRELS SALARY THÄU
COMIDA. NOT INTO ME THAT MALTA'S
LOTS AHEAD OF THIS IN SECONDS.
PERMISO VERANO SEPARATED. YOUR
TAXES INVESTIGATION PROCESS OF
OFFICIAL LOSS, CARLOS GRANDES.
IN ENGLAND. S MASCARO. THE
LOCATION GÓMEZ. OR THE
COMMITTEE. SENORES ASSEMBLIES
FOR FABER ESTÁ. AGGREGATE AREA.
MALTA'S SARDO DÍAS MALTA, MALTA
, OUR DINERO. BUT MAESTRO
PERMISO CARLITO! MUST BE VIENTO.
BICYCLE LLORENTE, CARLOS. AND S
SEVEN TITLES. THEN OPPORTUNITY
PRESERVE RESPECT. PRESENT THING.
CRIMINAL ASSAD. MUCHAS GRACIAS.
THANK YOU. GOOD AFTERNOON.
ASSEMBLYMEMBER'S MY NAME. MY
NAME IS EULALIA, A STREET VENDOR
AND SOUTH TAMALES AT THE FAMOUS
GUATEMALAN FOOD MARKET IN LOS
ANGELES. THIS HAS BEEN MY JOB
FOR THE LAST 15 YEARS. AND
THROUGH THIS JOB, MY HUSBAND AND
I HAVE BEEN ABLE TO RAISE OUR
THREE DAUGHTERS, ONE WHO HAS
JUST GRADUATED FROM COLLEGE. MY
WORK HAS GIVEN US A LOT OF
OPPORTUNITY, AND I'M VERY PROUD
. SO I WONDER WHY AM I STILL
TREATED LIKE A CRIMINAL? IT IS
VERY DIFFICULT TO SEE. THE
HEALTH DEPARTMENT ARRIVED WITH
THE SHERIFF'S THEY THROW OUR
FOOD AWAY. THEY INTIMIDATE US,
AND THEY GIVE US HIGH FINES.
THESE AGENTS TELL US GET YOUR
PERMITS, BUT THAT'S IMPOSSIBLE.
I PAY TAXES HAVE INVESTIGATED
THE PROCESS FOR GETTING PERMITS,
AND IT'S VERY, VERY DIFFICULT.
THE CARDS. THEY OFFER US THE
CARDS THEY OFFER US ARE VERY
LARGE, AND THEY DON'T FIT ON THE
SIDEWALKS. THE COST OF THE
COMMISSARY SPACE IS MORE THAN I
THAN WHAT I EARNED IN ONE MONTH.
I WANT TO WORK WITHOUT FEAR OF
BEING FINED OR HAVING MY WORK
THROWN AWAY. ASSEMBLYMEMBER'S
PLEASE DO NOT SUPPORT PROPOSALS
THAT WOULD ADD FINES OR CAUSES
MORE DEBT. FINES AND FINES WILL
NOT ALLOW US TO SAVE MONEY FOR
OUR PERMITS OR FOR OUR CARTS.
THE TIME WE ARE THE TIMES WE ARE
LIVING NOW, THINGS ARE VERY
EXPENSIVE. THE COST OF FOOD THE
COST OF RENT. EVERYTHING IS
EXPENSIVE. AND THAT'S WHY I
ASKED YOU TO VOTE YES, ON SB 972
AND GIVE US A CHANCE TO GROW OUR
SMALL BUSINESSES WITHOUT
CRIMINALIZATION AND WITHOUT
FINES. THANK YOU. THANK YOU.
OTHERS IN SUPPORT. JUST YOUR
NAME AND ORGANIZATION IF YOU
REPRESENT ONE. GOOD AFTERNOON,
MR CHAIR MEMBERS, CHRISTOPHER
SANCHEZ, A POLICY ADVOCATE THE
WESTERN CENTER IN LONG POVERTY,
PROBABLY A CO SPONSOR OF THIS
MEASURE. BIXEL IQUITOS ON BEHALF
OF THE CITY OF LOS ANGELES. AND
SUPPORT THANK YOU. I GET
AFTERNOON LYRIC KILCHER WITH
INCLUSIVE ACTION FOR THE CITY OF
PROUD SPONSOR OF SB 9 17. YEAH.
HELLO ANNA MATTHEWS AT THE
WESTERN CENTER ON LAW AND
POVERTY. WE STAND IN STRONG
SUPPORT OF THIS BILL. THANK YOU.
THANK YOU. GOOD AFTERNOON AS
STEPHANIE YELLOW BUS PEREZ WITH
INCLUSIVE ACTION, PROUD CO
SPONSOR OF THIS BILL, PLEASE
VOTE. YES, THANK YOU. MARCEL
DOUGLAS OF LAMAR, PART
REPRESENTATIVE FROM L. A LEGAL
ASSISTANCE AND LAMARCHE PARK
VILLAGE RENDERS AND I SAY
YESTERDAY'S BILL. GOOD AFTERNOON
, ALMA LOPEZ, DIRECTOR OF BROWN
ISSUES IN SUPPORT OF THIS BILL.
GOOD AFTERNOON. VANESSA MERINO
FROM WOODLAND, CALIFORNIA WITH
BROWN ISSUES AND SUPPORT OF SB 9
72. MEAN HOMBRES ANA MARTINEZ DE
LOS ANGELES. SO YOU ORGANISM
ADORA, THE CHURLA OLA S EVENT.
NOT AFFECT YOUR HUMBLE AUNTIES,
GRACIE. THANK YOU. CRUZ. OTHER
CHILDREN TO BINGO DELACY TODAY,
SO THANK YOU. ROBIN SALAS, EVEN
THE CHAIR LAND. IT'S A SATURDAY
THANK YOU. HELLO GOOD EVENING.
MY NAME IS MIRIAM SAMARA. I'M A
STREET VENDOR AND THE CITY OF
COMMERCE AND WE WOULD LIKE YOU
TO SUPPORT US BY SAYING YES AND
SB 9 72. THANK YOU. AFTERNOON MY
NAME IS MIGUEL. UNCLE PEREZ. UM
I AM A STREET VENDOR. I WANT
YOUR SUPPORT. YES TO BE. 1972
THANK YOU. HYAH! CELEBRATE
CHECKER WITH THE LOS ANGELES
CHAMBER OF COMMERCE AND STRONG
SUPPORT. THAT'S NOT ASKING.
THAT'S HOW CALIFORNIA AND
SUPPORT QUÊ. GOOD AFTERNOON.
DOUG SMITH WITH PUBLIC COUNCIL
PROUD CO SPONSOR AND STRONG
SUPPORT. RITA MEDINA, DEPUTY
DIRECTOR OF STATE POLICY AND
ADVOCACY WITH CHEERED LIKE PROUD
CO SPONSOR QUÊ. GOOD AFTERNOON.
MY NAME IS JUAN ESPINOZA. EQUAL
JUSTICE WORKS FELLOW WITH PUBLIC
COUNCIL PROUD CO SPONSOR. THANK
YOU. HERE AND MEMBERS. CAT
DEBERG WITH THE HEALTH OFFICERS
ASSOCIATION OF CALIFORNIA, ALSO
REPRESENTING MY COLLEAGUES AT
THE CALIFORNIA ASSOCIATION OF
ENVIRONMENTAL HEALTH
ADMINISTRATORS. WE ARE REMOVING
OUR OPPOSITION. TODAY. WE WANT
TO THANK THE AUTHOR AND THE
SPONSORS. AND I KNOW EVERYONE
THINKS COMMITTEE STAFF. BUT
COMMITTEE SEVERALLY DID GO GO
ABOVE AND BEYOND THIS TIME.
THANK YOU. QUÊ NORTHERN ASPECT
WITH THE COUNTY HEALTH
EXECUTIVES ASSOCIATION OF
CALIFORNIA ECHO THE REMARKS MADE
BY MY COLLEAGUE FROM THE
CALIFORNIA ASSOCIATION OF
ENVIRONMENTAL HEALTH
ADMINISTRATORS. THANK YOU. THANK
YOU. ANYONE ELSE? NO ONE IS
THERE. IS THERE ANY OPPOSITION
TO THE BILL? WE JUST HAD SOME
OPPOSITION REMOVED SO WE MIGHT
HAVE SOME OPPOSITION. PLEASE
COME FORWARD.
THANK YOU. CHAIR AND MEMBERS. MY
NAME IS AMELIA ZAMANI. UM AND I
AM HERE ON BEHALF OF THE
CALIFORNIA TRAVEL ASSOCIATION,
WHERE THE ADVOCACY ORGANIZATION
REPRESENTING THE TRAVEL AND
TOURISM INDUSTRY IN CALIFORNIA.
WE ARE RESPECTFULLY AND
REGRETTABLY IN AN OPPOSING LESS
AMENDED POSITION AT THIS TIME.
HOW TRAVELS MEMBERSHIP INCLUDES
ATTRACTIONS THAT EXPERIENCE HIGH
VOLUMES OF UNPERMITTED VENDING,
SUCH AS FISHERMAN'S WHARF AND
PIER 39 IN SAN FRANCISCO. SANTA
CRUZ, BOARDWALK, SANTA MONICA
PIER AND BALBOA PARK IN BELMONT
PARK IN SAN DIEGO. CAL TRAVEL
MEMBERS TAKE IMMENSE PRIDE IN
THE EXPERIENCES AND SERVICES
THEY PROVIDE VISITORS AND STREET
FOOD IS AN INTEGRAL PART OF MANY
OF OUR COMMUNITIES. PLEASE
UNDERSTAND. WE ARE NOT OPPOSED
TO VENDING AND ARE SUPPORTIVE OF
MANY ASPECTS OF SP 972,
ESPECIALLY REDUCING IMPOSSIBLE
EQUIPMENT REQUIREMENTS NECESSARY
TO OBTAIN HEALTH PERMITS TO VENT
FOOD SAFELY. HOWEVER WE ARE
OPPOSED TO REDUCING THE ALREADY
LIMITED TOOLS LOCAL AUTHORITIES
HAVE FOR ENFORCING VENDING
ORDINANCES. SINCE THE ENACTMENT
OF SB 946 AND 2019 HIGH TOURISM
DESTINATIONS HAVE EXPERIENCED A
CONCENTRATION OF UNPERMITTED
VENDORS SELLING FOOD DRINKS,
ALCOHOL, CANNABIS PRODUCTS,
UNLICENSED MERCHANDISE, AND, IN
SOME CASES, STOLEN GOODS. YES,
MANY OF THESE ACTIVITIES ARE
ALREADY ILLEGAL. THIS
CONCENTRATION OF UNPERMITTED
COMMERCIAL ACTIVITY OFTEN
INTERFERES WITH THE ABILITY OF
VISITORS AND RESIDENTS FROM
EXCESS ACCESSING OUR BEACHES,
PIERS, BOARDWALKS AND BUSINESS
DISTRICTS. DESPITE OUR LOCAL
GOVERNMENT'S BEST EFFORTS TO
CORRECT THESE PROBLEMS THROUGH
LOCAL VENDING ORDINANCES,
OVERCROWDING AND UNSAFE FOOD
PRACTICES PERSIST. ENFORCEMENT
IS A CHALLENGE DUE TO LIMITED
CITY RESOURCES AT AND AS I'M
TOLD BY MY MEMBERS ENFORCEMENT
SENSE THAT ADMINISTRATIVE FEES
DO NOT DETERTHE REPEAT
OFFENDERS FROM SELLING THEIR
GOODS, BLOCKING THE RIGHT OF WAY
OR IMPROPERLY DISPOSING OF
WASTE. WE BELIEVE THIS BILL GOES
TOO FAR AND REDUCING BARRIERS TO
PERMITTING WITHOUT ENSURING
LOCAL AUTHORITIES HAVE THE TOOLS
NECESSARY TO GO AFTER
INDIVIDUALS WHO REPEATEDLY DO
NOT OR WILL NOT COMPLY WITH THE
LAW. FOR THIS REASON, WE REMAIN
IN OPPOSING LESSON AND POSITION.
WE HOPE WE CAN CONTINUE WORKING
ON THIS ISSUE TO ENSURE AN
ACCESSIBLE STREET VENDING
PROGRAM THAT PROTECTS BOTH
VENDORS AND VISITORS. THANK YOU.
QUÊ OTHERS IN OPPOSITION. MR
CHAIR AND MEMBER SYLVIA SALAS
SHAH HERE ON BEHALF OF THE CITY
OF SANTA MONICA. WE ARE ACTUALLY
IN A TWEENER POSITION. UM I
WOULD JUST NOTE THAT WE, THE
CITY STRONGLY SUPPORTS THE
STREAMLINING OF THE PERMITTING
PROCESS FOR SIDEWALK VENDORS.
AND WE CURRENTLY WERE ONE OF THE
FIRST CITIES IN THE STATE TO
IMPLEMENT SB 946. WE HAVE OVER
100 PERMITTED VENDORS IN THE
CITY. HOWEVER, WE DO HAVE
SERIOUS CONCERNS WITH THE
ENFORCEMENT SCHEME IN THE BILL.
WE FEEL THAT THIS WOULD FURTHER
DISADVANTAGE OUR CITIES. MANY
PERMITTED VENDORS WERE FOLLOWED
FOLLOWING THE ESTABLISHED RULES
AND SO THANK YOU VERY MUCH FOR
YOUR CONSIDERATION. THANK YOU.
ANYONE ELSE? AND I WANT TO BRING
IT BACK TO THE COMMITTEE
QUESTIONS OR COMMENTS FROM THE
COMMITTEE. MISS KOREA. THANK
YOU, MR CHAIR. JUST A FEW
COMMENTS IN ESPANOL, SENORA
CAPITAL. IF THERE IS A CASA YES
. ON GRAN OR GO CAÑADA. SOBRE
PIZZA IMPORTANT THAT STEP
PERSONAL MENTE. I WANTED TO SAY
THANK YOU. TO OUR WITNESS WHO IS
HERE AND FOR YOU KNOW, WELCOMING
HER TO OUR STATE CAPITAL. THIS
IS THE PEOPLE'S HOUSE, AND WE
SHOULD ALL BE WELCOMING AND
ENCOURAGING OF ALL OF THE ALL
VENDORS ACROSS THE STATE, BUT OF
COURSE, ALL WORKERS ACROSS THE
STATE OF CALIFORNIA SO WELCOME.
AND I WANT TO THANK SENATOR LARA
SO AS WELL AS SENATOR GONZALEZ
FOR BRINGING THIS IMPORTANT
PIECE OF LEGISLATION FORWARD.
I'M A PROUD CO AUTHOR. AND I
THINK THAT WE NEED TO DO
EVERYTHING WE POSSIBLY CAN TO
ENSURE THAT OUR COUNTY
DEPARTMENTS OF HEALTH HAVE THE
RESOURCES NECESSARY TO IMPLEMENT
THE NECESSARY PERMITS, BUT THAT
THEY'RE ALSO LISTENING TO THE
WORKERS ON THE GROUND. AND THAT
ULTIMATELY, YOU KNOW, WE ARE
RESPECTFUL IN THE PROCESS AND
THAT I KNOW THAT THERE ARE SOME
CONVERSATIONS RELATED TO BRICK
AND MORTAR. BUSINESSES WHO ARE
ALSO IMPACTED. BUT AT THE END OF
THE DAY, HOW DO WE HELP FAMILIES
ACHIEVE THE AMERICAN DREAM? THE
CALIFORNIA DREAM AND I'M SO GLAD
TO HEAR YOU KNOW THAT, UH, THE
TESTIMONIES WERE ALSO ABOUT
PROVIDING UPWARD MOBILITY FOR
FAMILIES ACROSS THE STATE OF
CALIFORNIA. AND CONGRATULATIONS
ON HAVING, UH, YOUR DAUGHTER
GRADUATE FROM FROM COLLEGE AND
ALSO TO OUR OUR OTHER WITNESS
FOR BRINGING YOUR BUSINESS
FORWARD AND SHARING THE
IMPORTANCE. OF WHAT IT IS THAT
YOU DO TO PROVIDE AN EXPERIENCE
TO ALL OF THOSE THAT THAT
SUPPORT YOUR BUSINESS. I KNOW
THAT I REPRESENT THE CITY OF LOS
ANGELES. UH, PROBABLY REPRESENT
DODGER STADIUM. AND EVERY TIME
YOU KNOW WHEN THERE'S A GAME AND
WE GO OUTSIDE, THERE'S STREET
VENDORS THAT ARE PROVIDING OUR
OUR WONDERFUL DODGER DOGS, MR
CHAIR, WHICH YOU DON'T
EXPERIENCE AND SAN FRANCISCO
GIANTS. FRANCISCO PERHAPS. UH,
GIANT DOGS. FELT WE HAVE A
FRIENDLY RIVALRY HERE. BUT AT
THE END OF THE DAY, YOU KNOW, UM
WE ALL WANT TO EXPERIENCE OUR
CITIES AND PART OF WHAT MAKES
CALIFORNIA SO BEAUTIFUL AND EVEN
A PLACE LIKE LOS ANGELES OR SAN
FRANCISCO OR OAKLAND OR SAN
DIEGO. IS THE ABILITY TO
EXPERIENCE THE FOOD, THE CULTURE
, THE PEOPLE, AND THAT'S WHAT
MAKES US AN AMAZING STATE. SO
I'M PROUD TO BE A CO AUTHOR, AND
THANK YOU TO ALL OF YOU THAT
HAVE TRAVELED ACROSS THE STATE
TO BE HERE. UM AND AGAIN THANK
YOU FOR THE PRESENTATION. THANK
YOU, UM, ANYONE ELSE? NOW WHAT
WE DO HAVE A MOTION BY MR
SANTIAGO. A SECOND BY MS CARILLO
MOTION IS DUE PASS AS AMENDED TO
APPROPRIATIONS. AND OR DURAZO,
WOULD YOU LIKE TO CLOSE? THANK
YOU VERY MUCH FOR ALL OF YOUR
COMMENTS, AND WE WANT TO MOVE
FORWARD AND MAKE SURE THAT ALL
OF THIS HAS PUT TOGETHER IN A
WAY THAT WORKS BEST. FOR OUR
COMMUNITIES FOR TOURISTS. I GO
TO SANTA MONICA PIER QUITE
OFTEN, AND I THINK IT'S PART OF
THE EXCITEMENT AND PART OF THE
EXPERIENCE THERE. WHAT ARE
STREET VENDORS DO SO
RESPECTFULLY ASK FOR YOUR VOTE.
THANK YOU VERY MUCH. MADAM
SECRETARY, PLEASE CALL THE ROLL.
WOULD I WOULD I. WALDRON.
AGUIAR-CURRY AGUIAR-CURRY. AYE,
ARAMBULA. BIGELOW CARILLO. V
FLORA MAIENSCHEIN. MAZE.
MCCARTHY. NAZARIAN RIVAS
RODRIGUEZ. SANTIAGO. SANTIAGO, I
WEBER HOWEVER, I. 40 OR ZERO
WILL LEAVE THE BILL ON CALL
MEMBERS OUT SOMEWHERE. THANK
YOU. THANK YOU, MR CHAIR.
SENATOR PORTANTINO. THE LAST ONE
WAS FIVE ZEROS. IT'S STILL ON
CALL, THOUGH.
WHENEVER YOU'RE READY, SIR.
THANK YOU, MR CHAIR. I HAVE TWO
BILLS THAT SHOULD GO QUICKLY,
AND I APPRECIATE DR PAN FOR
LETTING ME CUT THE LINE. UM I'D
LIKE TO, UH. BEGIN BY THANKING
ASSEMBLYMEMBER'S CRISTINA GARCIA
FOR BEING A PRINCIPAL CO AUTHOR
WITH ME ON THIS BILL, UM SHE HAS
ALWAYS SHARED HER PERSONAL
PERSPECTIVE, AND IT'S BEEN A
VALUABLE PARTNER. SP 974 WILL
HELP PROVIDE COVERAGE FOR
MEDICALLY NECESSARY DIAGNOSTIC
BREAST IMAGING WITHOUT IMPOSING
COST SHARING. THIS INCLUDES
DIAGNOSTIC BREAST IMAGING AFTER
AN ABNORMAL MAMMOGRAM RESULTS.
AS WELL AS DIAGNOSTIC BREAST
IMAGING FOR WOMEN WITH GENETIC
RISK FACTORS ASSOCIATED WITH
BREAST CANCER. BREAST CANCER IS
THE SECOND LEADING CAUSE OF
DEATH AMONG WOMEN. HOWEVER EARLY
DETECTION OF BREAST CANCER
DRASTICALLY INCREASES THE RATES
OF SURVIVAL. OR MAMMOGRAMS.
SCREENING DETECT 80 TO 90% OF
BREAST CANCERS IN WOMEN WHO HAVE
NOT YET MANIFESTED PHYSICAL
SYMPTOMS. SUCH SUCH SCREENINGS
CANNOT ALWAYS ADEQUATELY DETECT
BREAST CANCER. WOMEN WHO RECEIVE
ABNORMAL RESULTS. UM WHO OR WHO
HAVE GENETIC RISK FACTORS
GENETIC RISK FACTORS ASSOCIATED
WITH BREAST CANCER, INCLUDING
FAMILY HISTORY ARE KNOWN GENETIC
MUTATIONS OFTEN NEED TO UNDERGO
FOLLOW UP TESTING. UM, TO ENSURE
THAT WE CAN FIND AND DETECT
THEIR CANCERS. OUR WOMEN ARE
REQUIRED TO PAY FOR THIS OUT OF
POCKET EXPENSE. FOLLOWING UP THE
INITIAL TEST, WHICH CAN COST
HUNDREDS OF AND THOUSANDS OF
DOLLARS. SUCH COSTS CAUSED MANY
WOMEN TO DELAY OR AVOID GETTING
THESE APPOINTMENTS.
UNFORTUNATELY THE LONGER IT
TAKES TO DETECT THE CANCER, THE
HIGHER THE CHANCES WERE ARE TO
BE UNSUCCESSFUL. EARLY DETECTION
IS THE KEY. WHICH IS WHY MAKING
SURE THAT THESE FOLLOW UP IMAGES
ARE, UM PAID FOR. THIS IDEA WAS
BROUGHT TO ME BY MY WITNESS GUY
IN A CHICKEN WHO BROUGHT THE
ISSUE TO MY ATTENTION, AS HAS
PERSONAL EXPERIENCE. AND SO
SHE'S HERE TO TESTIFY AND
SUPPORT AS HIS RYAN SPENCER.
FROM THE AMERICAN COLLEGE OF
ASKED PATRICIANS AND
GYNECOLOGISTS AND OBVIOUSLY
APPROPRIATE WOULD ASK FOR AN I
VOTE WHEN APPROPRIATE. THANK
YOU. PLEASE GO AHEAD. HMM. THANK
YOU, MR CHAIR AND COMMITTEE
MEMBERS. MY NAME IS GAIANEH
POSSESSION OF UNEASE, AND I'M, A
RESIDENT OF GLENDALE, CALIFORNIA
ORIGINALLY, UM PRESENTED THE
NEED FOR SP NINE. SP 974 BECAUSE
OF MY OWN EXPERIENCE OF BEING
CHARGED FOR A PROCEDURE THAT WAS
PART OF MY PREVENTATIVE CARE OR
SO I THOUGHT, WHEN I QUESTIONED
THIS WITH MY INSURANCE REP THE
SHE SAID. YOU NEED TO GO CHANGE
THE LAW. THAT MOMENT I STARTED
RESEARCHING AND REALIZED THE
NEED TO IN FACT, MAKE A CHANGE,
WHICH IS WHEN I TURNED TO
SENATOR PORTANTINO SP 974 IS THE
KIND OF FORWARD THINKING
LEGISLATION CALIFORNIA NEEDS. TO
SAVE LIVES WITH EARLY BREAST
CANCER DETECTION WITH DIAGNOSTIC
IMAGING. HELPING NOT JUST WOMEN
WHO ARE AFFECTED, BUT THEIR
FAMILIES AND FRIENDS WHO
SURROUND THEM. AFTER AN INITIAL
MAMMOGRAM WHEN A WOMAN WHEN A
WOMAN IS TOLD THAT SHE HAS TO
HAVE A MORE ADVANCED SCREENING.
IT'S SCARY AND STRESSFUL, IN
ADDITION TO THE ANXIETY OF
TESTING TO SEE AN UNEXPECTED
BILL, AND THEN THE BURDEN OF HOW
TO PAY FOR IT. ISN'T IS AWFUL
AND UNNECESSARY. WOMEN,
ESPECIALLY NOW IN CALIFORNIA.
KNOW THAT. CAN KNOW THAT THEIR
HEALTH MATTERS AND THAT YOU MADE
SURE THEY ONLY HAVE TO MAKE AN
APPOINTMENT TO GET THEIR
MAMMOGRAM WITHOUT WORRYING ABOUT
HOW TO PAY FOR IT OR HAVING TO
SAVE UP FOR IT WITH KRISH
CRUCIAL TIME PASSING I'VE SHARED
THIS WITH MY COMMUNITY. MY
COLLEAGUES, FRIENDS AND ACROSS
THE BOARD, MEN AND WOMEN. UM
DIFFERENT POLITICAL AFFILIATIONS
HAVE GIVEN RESOUNDING APPROVAL.
THANK YOU TO SENATOR PORTANTINO
AND ALL THOSE WHO HAVE SUPPORTED
THIS BILL. ON BEHALF OF ALL THE
WOMEN OF CALIFORNIA. I
RESPECTFULLY ASK FOR YOUR I
VOTE. THANK YOU. MR SPENCER.
RIGHT. SPENCER ON BEHALF OF THE
AMERICAN COLLEGE OF O B. G. Y N
S DISTRICT NINE. WE ARE THE
SPONSORS OF THIS MEASURE. I
REALLY DON'T HAVE ANYTHING ELSE
TO ADD. THAT WAS BEST
ENCAPSULATED BY THE WITNESS TO
MY LEFT AND SAW JUST SIMPLY ASK
FOR YOUR VOTE. THANK YOU. GREAT.
THANK YOU. OTHERS IN SUPPORT.
JUST YOUR NAME AND ORGANIZATION
IF YOU REPRESENT ONE. TWO MEN
REPRESENT THE CALIFORNIA SOCIETY
OF PLASTIC SURGEONS AND SUPPORT. BRANDON MARCHI WITH THE
CALIFORNIA MEDICAL ASSOCIATION
IN SUPPORT. THANK YOU. MOLLY
ROBSON WITH PLANNED PARENTHOOD
AFFILIATES OF CALIFORNIA IN
SUPPORT. WE WERE TOP ON BEHALF
OF BIO COM CALIFORNIA AND
SUPPORT ALEX CON CALIFORNIA
CHRONIC CARE COALITION AND
STRONG SUPPORT. TRAIN A LARGE
PLASTER COUNTY. UM AVATAR, UH,
SPEAKING FOR LABORATORY
PROFESSIONALS AND STRONG SUPPORT
OF THIS SPILL. THANK YOU FOR
BRINGING THIS SPILL FORWARD. WE
REALLY APPRECIATE THAT. UM
SOMETHING FOR WOMEN. THANK YOU.
THANK YOU. ANYONE ELSE? SAY NO
ONE WILL GO TO OPPOSITION AS
THEIR OPPOSITION TO THIS BILL.
SEEN. NONE WILL BRING IT BACK TO
THE COMMITTEE FOR QUESTIONS OR
COMMENTS ANY QUESTIONS OR
COMMENTS FROM THE COMMITTEE. I
JUST WANT TO THANK YOU VERY MUCH
FOR BRINGING THIS FORWARD, YOU
KNOW? WHO YOU WOULD HAVE EVER
THOUGHT YOU'D BE DOING SOMETHING
LIKE THIS. I'LL BET BUT YOU ARE
GOING TO HELP SO MANY WOMEN, AND
, UM I REALLY APPRECIATE YOU
DOING THIS. HECK, YEAH. LET'S
GET THIS ONE THROUGH. THANK YOU.
OKAY SO WE HAVE A MOTION BY MR
SANTIAGO, A SECOND BY MS
AGUIAR-CURRY EMOTIONS DO PASS TO
APPROPRIATIONS. WOULD YOU LIKE
TO CLOSE SENATOR? JUST YOU HEARD
A BROAD COALITION OF HEALTHCARE
PROVIDERS WHO WERE SUPPORTIVE.
AND AS THE FATHER OF TWO
DAUGHTERS RESPECTFULLY ASK FOR
MY VOTE. THANK YOU VERY MUCH.
MADAM SECRETARY, PLEASE CALL THE
ROLL. WOULD, WOULD I, WALDRON
WALDRON, I AGUIAR-CURRY
AGUIAR-CURRY. AYE, ARAMBULA.
BIGELOW. CARILLO. FLORA
MAIENSCHEIN. MAY'S MCCARTHY.
NAZARIAN RIVAS RODRIGUEZ.
SANTIAGO. SANTIAGO. I WEBBER
WEBBER. AYE. 5 TO 050. WE'LL
LEAVE THAT BILL ON CALL. AND MY
SECOND WILL EVEN BE QUICKER.
OKAY. THANK YOU. THERE'S SOMEONE
MOVING IT ALONG FOR YOU THERE,
SENATOR. THANK YOU. SO WE HAVE
FOLKS TO COME UP FOR ALL OF THEM
ARE CATCHING FLIGHTS, AND I
APPRECIATE AGAIN DOCTOR PEN AND
EVERYONE FOR ACCOMMODATING MY
OUT OF TOWN WITNESSES. THANK YOU
, MR CHAIR AND COMMITTEE MEMBERS
. UM, I'M PRESENTING, UM SP 9 87
TODAY AND I WOULD LIKE TO START
BY THANKING YOUR STAFF FOR
WORKING WITH MY STAFF. UH AND
THE SPONSORS ON THIS BILL, UM SP
9 87 IS IMPORTANT IN THE
CALIFORNIA CANCER CARE EQUITY
ACT, WHICH WOULD GIVE MEDICAL
BENEFICIARIES WHO HAVE BEEN
DIAGNOSED WITH COMPLEX CANCER
ELIGIBLE. TO REQUEST REFERRAL TO
A NATIONAL CANCER INSTITUTE
DESIGNATED COMPREHENSIVE CANCER
CENTER AND N C. I DESIGNATED C C
C. LOTS OF LOTS OF, UH, DALLAS.
I MEAN CONSONANTS SITE
AFFILIATED WITH A N C. I
COMMUNITY ONCOLOGY RESEARCH
PROGRAM OR A QUALIFYING ACADEMIC
CANCER CENTER. AH! INEFFECTIVELY
DEFINED AS A CEDAR SINAI MEDICAL
CENTER. UNFORTUNATELY THERE ARE
SIGNIFICANT DISPARITIES IN
CANCER PATIENTS ACCESS TO THIS
SPECIALIZED CARE WE'VE SEEN
DURING THE PANDEMIC. THERE'S
BEEN A HOST OF DISPARITIES THAT
HAVE BEEN HIGHLIGHTED. CANCER
TREATMENT IS ANOTHER ONE OF
THOSE WHERE OUR MEDICAL PATIENTS
JUST DON'T GET THE CARE THEY
NEED AND THAT'S WHAT THIS BILL
WOULD RECTIFY. SB 97, THE CANCER
CARE EQUITY ACT WILL IMPROVE
CANCER CARE ACCESS AND
ULTIMATELY IMPROVE CANCER CARE
OUTCOMES. FOR MANY OF THEM THE
EGGS, UNDERSERVED COMMUNITIES
TODAY I HAVE A DOCTOR JOSEPH
ALVAREZ FROM THE GREAT CITY OF
HOPE IN THIS 25TH STATE SENATE
DISTRICT AND MIRON AGNES FOR
FROM THE CALIFORNIA BLACK HEALTH
NETWORK. AND OBVIOUSLY
APPROPRIATELY RESPECTFULLY.
ASPIRIN. I VOTE WHEN
APPROPRIATE. THANK YOU. PLEASE
GO AHEAD. CHAIRMANWOULD AND
MEMBERS OF THE COMMITTEE. I'M
JOE ALVAREZ. I MEAN,
HEMATOLOGIST, A PROFESSOR OF
HUMAN COLLAGEN AT CITY OF HOPE
COMPREHENSIVE CANCER CENTER. FOR
THE PAST 25 YEARS. I'VE WORKED
AS A CLINICIAN WHO CARES FOR
PATIENTS WITH THE MOST
AGGRESSIVE CANCER TYPES THAT
EXIST. CANCER WILL AFFECT 39% OF
ALL CALIFORNIANS OVER THE COURSE
OF THEIR LIFETIME. AND THANKS TO
ADVANCES IN CANCER CARE
TREATMENTS IN A GROWING
PORTFOLIO OF CLINICAL TRIALS,
PATIENTS ARE LIVING LONGER,
BETTER QUALITY LIVES OVER THE
LAST 30 YEARS, THE DURATION OF
MY CAREER. CANCER MORTALITY HAS
DROPPED BY 31% THANKS TO THESE
KINDS OF RESEARCH TRIALS AND
CARE. UNFORTUNATELY TOO MANY
PATIENTS IN CALIFORNIA DO NOT
GET TIMELY ACCESS TO CARE THAT
COULD HAVE SAVED THEIR LIVES.
RECENT UC IRVINE STUDY SHOWED
THAT LESS THAN HALF OF PATIENTS
IN CALIFORNIA AFFECTED BY CANCER
RECEIVED CARE THAT CORRESPONDED
TO OPTIMAL CARE GUIDELINES. AND
THERE BEING A MEDICAL
BENEFICIARY WAS AN INDEPENDENT
AND STATISTICALLY SIGNIFICANT
RISK FACTOR FOR NOT GETTING
GUIDELINES CONCORDANT CARE. SB
987. THE CALIFORNIA CHARACTER
CANCER CARE EQUITY ACT WAS
CREATED TO MAKE OUR SYSTEM FAIR
BY IMPROVING ACCESS BY THE MOST
VULNERABLE MEMBERS OF OUR
SOCIETY TO THE BREATH OF LIFE
SAVING EXPERTISE, CLINICAL
TRIALS AND INNOVATIVE
TREATMENTS. THAT CAN TRANSFORM
PATIENT OUTCOMES FOR THE BETTER.
SB 987 IS HIGHLY FOCUSED UPON
THE MEDICAL BENEFICIARIES WITH
THE MOST ADVANCED MOST LIFE
THREATENING TYPES OF CANCER FOR
WHOM BROADLY AVAILABLE
TREATMENTS ARE LIKELY TO BE AN
EFFECTIVE FOR THESE PATIENTS,
SPEEDY ACCESS TO INNOVATIVE
TREATMENTS AND CLINICAL TRIALS
DELIVERED BY CLINICIANS AND
RESEARCH PHYSICIANS AND OUR
STATE'S TOP CANCER CARE CENTERS
REPRESENTS THEIR BEST CHANCE TO
SURVIVE CANCER. ACCESS EQUALS
WHAT CHANCE FOR LIFE. AS OUR
NATION AS OUR STATE RATHER LEADS
OUR NATION, BY EXAMPLE, AND
EXTENDING HEALTH CARE COVERAGE
TO ALL CALIFORNIANS. WE SHOULD
FURTHER LEAD THE NATION BY
ENSURING THAT COVERAGE
TRANSLATES INTO LIFE SAVING
ACCESS TO THE KINDS OF CARE THAT
ALL PATIENTS AND THEIR FAMILIES
DESERVE. ALL OF THEM NEED. I
STRONGLY URGE YOU TO SUPPORT SB
987. THANK YOU. THANK YOU VERY
MUCH. GOOD AFTERNOON CHAIR AND
MEMBERS, UM, BEHALF OF THE
CALIFORNIA BLACK HOLES NETWORK.
I'M HERE IN SUPPORT OF SB 9. 87
PORTANTINO CALIFORNIA CANCER
CARE EQUITY ACT. MY NAME IS
MARINA CONIFER. I'M THE MANAGER
OF POLICY AND LEGISLATIVE
AFFAIRS AND SEE BHN SP 987 GIVES
MEDICAL ENROLLEES WITH A COMPLEX
COUNTER DIAGNOSIS. THE OPTION TO
RECEIVE CANCER CARE THROUGH THE
DESIGNATED CANCER CENTERS.
ACCORDING TO THE DEPARTMENT OF
HEALTH CARE SERVICES. DATA OVER
60% OF MEDICAL PATIENTS ARE
BLACK OR BROWN. AND
UNFORTUNATELY, CALIFORNIANS
ENSURED WITH MEDICAL SUFFER WITH
WORSE THAN AVERAGE OUTCOMES FOR
SEVERAL CANCER DIAGNOSIS,
INCLUDING LUNG AND BREAST
CANCER. MOST BLACK AND BROWN,
CALIFORNIA AND LEAVING
COMMUNITIES WITH BARRIERS TO
HEALTH EQUITY DUE TO SYSTEMATIC
RACIST POLICIES LIKE REDLINING.
34% OF CANCER. DEATH AMONG ALL U
S ADULTS AGED 25 TO 74 COULD BE
PREVENTED IF SOCIOECONOMIC
DISPARITIES WERE ELIMINATED.
ACCORDING TO THE. AMERICAN
CANCER SOCIETY. BLACK PEOPLE
HAVE THE HIGHEST DEATH RATE AND
SHORTEST SURVIVAL OF ANY RACIAL
ETHNIC GROUP IN THE UNITED
STATES FOR MOST CONCERTS. BLACK
WOMEN ARE 41% MORE LIKELY TO DIE
FROM BREAST CANCER THAN WHITE
WOMEN. THE GOOD NEWS IS,
ACCORDING TO NIH PATIENTS
RECEIVING CARE FROM DESIGNATED
SPECIALISTS, SO A 53% REDUCTION
THE ODDS OF EARLY MORTALITY TBH
IN BELIEFS. SP 987 WOULD GIVE
MEDICAL PATIENTS WITH THE
COMPLEX CANCER DIAGNOSIS ACCESS
TO ONCOLOGY SPECIALISTS,
INNOVATIVE TREATMENTS, CUTTING
ITS CLINICAL TRIALS. ENTER A
PIECE. IMPROVED THEIR HEALTH
OUTCOMES AND REDUCE MORTALITY.
FOR THOSE REASONS. WE URGE
MEMBERS OF THIS COMMITTEE TO
PLEASE VOTE YET ON SP NINE H
SEVEN THANK YOU FOR YOUR TIME.
THANK YOU VERY MUCH OTHERS IN
SUPPORT. JUST YOUR NAME AND
ORGANIZATION IF YOU REPRESENT
ONE GOOD AFTERNOON, LINDA WAY
WITH WESTERN CENTER ON LAW AND
POVERTY IN SUPPORT. JIM KNOX
WITH AMERICAN CANCER SOCIETY
CANCER ACTION NETWORK, A CO
SPONSOR AND STRONG SUPPORT.
THANK YOU. JENNIFER SNYDER ON
BEHALF OF THE CALIFORNIA LIFE
SCIENCES IN SUPPORT. AND FRED
NOWHERE, REPRESENTING STANFORD.
HEALTH CARE AND SUPPORT. THANK
THANK YOU. WE WERE TAP ON BEHALF
OF BIOCON, CALIFORNIA AND
SUPPORT. THANK YOU. ALEX CON
CALIFORNIA CHRONIC CARE
COALITION CO SPONSOR AND STRONG
SUPPORT. OKAY, THANK YOU. HI.
SARAH HUCKLE WITH THE UNIVERSITY
OF CALIFORNIA WERE NOT YET IN
SUPPORT. BUT WE'RE WORKING
CLOSELY WITH THE AUTHOR AND
SPONSORS AND LOOK FORWARD TO
GETTING THERE SOON. THANK YOU.
THEIR OPPOSITION TO THE BILL.
POSITION.
BUTTON PLACE. THANK YOU. MY
APOLOGIES, MR CHAIR. GOOD
AFTERNOON. UM IT WOULD MEMBERS
OF THE COMMITTEE JET HAMPTON,
THE CALIFORNIA ASSOCIATION OF
HEALTH PLANS. WE CURRENTLY HAVE
OPPOSED POSITION ON THIS BILL. I
THINK IT OBVIOUSLY GOES WITHOUT
SAYING THAT WE CERTAINLY
APPRECIATE THE INTENT OF THE
BILL AND ENSURE AND ENSURING
THAT ACCESS TO A BENEFICIARY
WITH COMPLEX CANCER TREATMENT IS
CRITICAL. I WILL SAY THAT WE ARE
STILL REVIEWING THE AMENDMENTS
OUTLINED IN THE COMMITTEE
ANALYSIS. HOWEVER THEY DO SEEM
TO ADDRESS THE MAJORITY, IF NOT
ALL OF OUR, UM, ANY CONCERNS
WITH THE BILL. UM SO WE WOULD
LIKE TO THANK THE AUTHOR, THE
SPONSORS AND THE COMMITTEE STAFF
FOR WORKING WITH US. AND LOOK
FORWARD TO REEVALUATING OUR
POSITION ON THE BILL ONCE THE
AMENDMENTS ARE IN PRINT. THANK
YOU. THANK YOU VERY MUCH. IS
THERE ANYONE ELSE IN OPPOSITION?
ANY OTHER? SEEN NONE WILL COME
BACK TO THE COMMITTEE QUESTIONS
OR COMMENTS FROM THE COMMITTEE.
WE HAVE A MOTION BY MR SANTIAGO
. MISS. MISS DR WEBBER. EXCUSE
ME. OH, YOU'RE SECONDING THAT
OKAY, OKAY. UM I REALLY JUST
WANT TO THANK YOU FOR BRINGING
THIS BILL FORWARD. UM, YOU KNOW,
AS SOMEONE WHO'S MY FATHER AND
MY BROTHER. BOTH HAD CANCER. AT
THE SAME TIME. I UNDERSTAND THE
IMPORTANCE OF NOT ONLY EARLY
INTERVENTION BUT ALSO ALL OF THE
OTHER RESOURCES THAT, UM MANY OF
THESE CI DESIGNATED PLACES HAVE
AS FAR AS RESEARCH NEWER
MEDICATIONS. NEWER TECHNOLOGIES
, UM AND SO WHILE SOME PEOPLE
YOU KNOW, LIKE MY FAMILY WE WERE
IN SAN DIEGO WENT THROUGH THAT
WENT TO THE CITY OF HOPE IN LOS
ANGELES AND YOU KNOW, THAT
REALLY TRULY SAVED MY BROTHER'S
LIFE. NOT EVERYONE HAS THAT
OPPORTUNITY. UM, BUT THEY SHOULD
SO THANK YOU VERY MUCH FOR
BRINGING THIS BILL FORWARD.
THANK YOU, UM, HAVE EMOTION BY
MR SANTIAGO IS SECOND BY DR
WEBBER MOTION DO PASS AS AMENDED
TO APPROPRIATIONS. WOULD YOU
LIKE TO CLOSE SENATOR PORTANTINO
. I WOULD LIKE TO THANK CITY OF
HOPE FOR SPONSORING THIS. FROM
THE GREAT 25TH STATE
SENATE-DISTRICT. AND
RESPECTFULLY ASK FOR AN I VOTE.
THANK YOU. THANK YOU VERY MUCH,
SENATOR. MADAM SECRETARY. PLEASE
CALL THE ROLL. WOULD I? WALDRON
WALDRON, I AGUIAR-CURRY
AGUIAR-CURRY. AYE, ARAMBULA.
BIGELOW CARILLO. FLORA
MAIENSCHEIN MAZE. MCCARTY
NAZARIAN RIVAS RODRIGUEZ.
SANTIAGO. SANTIAGO, I WEBER.
HOWEVER I HAVE 200 WILL LEAVE
THE BILL ON CALL. THANK YOU. NOW
GO BACK TO SENATOR PAN, STARTING
WITH ITEM NUMBER 15 SB 8 38. I'M
GOING TO ASK THE VICE CHAIR TO
TAKE OVER FOR A FEW MINUTES. IT
DOESN'T MIND. MY TAKING OVER FOR
THIS. THIS BILL. THAT WOULD BE
GREAT. THANK YOU. MHM HM, 15
DOCTOR PAN SB 838. THANK YOU,
MADAM CHAIR AND ACTUALLY, MAYBE
BEFORE I BEGIN, I AND I KNOW
THAT THE CHAIR STEPPING DOWN FOR
A MOMENT. UH I TOO WANTED JUST
SORT OF JOIN MY VOICE TO HIS AND
HIS PREVIOUS ACKNOWLEDGEMENT OF
THE ASSEMBLY HEALTH COMMITTEE
STAFF AS A FORMER CHAIR OF THE
ASSEMBLY HEALTH COMMITTEE. I,
TOO HAD THE PRIVILEGE AND HONOR
OF WORKING WITH MANY OF THE
STAFF AND SO AND I KNOW HOW MUCH
YOU ADVOCATE FOR STAND FOR THAT.
YOU KNOW THE ASSEMBLY AND FOR
THE PEOPLE OF CALIFORNIA, SO I
JUST WANTED TO BE SURE, I ADDED
ON TO OUR CHAIR WOOD AND HIS HIS
WONDERFUL ACKNOWLEDGEMENT OF THE
STAFF AND TWO WANTED TO JOIN MY
VOICE TO HIS AS A FORMER CHAIR
OF THE ASSEMBLY HEALTH
COMMITTEE. SO SO, THANK YOU. SO
I'M PLEASED TO NOW PRESENT SB 8
38. UM WHICH IS A BILL THAT, UM. TO ACTUALLY SURE THAT WE HAVE
A BOTH A DOLLAR SUPPLIES WELL AS
AH, LOW COST SUPPLY OF INSULIN
AS WELL AS OTHER MEDICATIONS.
FOR THE PEOPLE OF CALIFORNIA AS
WE ALL KNOW, PRESCRIPTION DRUGS
OFFER WIDE RANGING BENEFITS,
THEY REDUCED THE NEED FOR HEALTH
CARE SERVICES. THEY IMPROVE
QUALITY OF LIFE. THEY EXTEND
LIFE. BUT UNFORTUNATELY THEY'RE
NOT ALWAYS ACCESSIBLE BECAUSE OF
HIGH PRICES AND THAT COULD
REDUCE PATIENT ACCESS AND
CONTRIBUTE TO HIGHER SPENDING
AND STRAINING BUDGETS. IN FACT,
IN 2020 20 WE PASSED THANKS TO
YOUR SUPPORT. SB 8 52, WHICH
REQUIRED THE CALIFORNIA HEALTH
AND HUMAN SERVICES AGENCY TO
PARTNER WITH A DRUGMAKER TO
MANUFACTURE GENERIC DRUGS. AH
THE NEWS. UM, ADMINISTRATION HAS
BEGUN THIS WORK AND IT'S CLEAR
THAT IS NOW A PATH TO CALIFORNIA
LABELED INSULIN. SO THIS BILL,
UH, FURTHERS THAT WORK BY
EXPLICITLY REQUIRING THE
DEVELOPMENT OF AN INSULIN
PRODUCT AND ESTABLISHMENT OF A
CALIFORNIA BASED MANUFACTURING
FACILITY FOR GENERICS. THIS
POLICY IS MORE IMPORTANT THAN
EVER IS. THE PANDEMIC HAS
BROUGHT THE LIGHT GLARING GAPS
AND SUPPLIES OF ESSENTIAL LIFE
SAVING DRUGS, MEDICAL EQUIPMENT
SUPPLIES AND SETTING UP THE
STRUCTURE IN THE STATE OF
CALIFORNIA. AS IT WITH ITS OWN
DRUG MAKING CAP. UH, DRUG
MANUFACTURING CAPACITY WILL HELP
THE STATE PREPARE FOR THE NEXT
PANDEMIC AS WELL. THIS REALLY IS
ABOUT BEING SURE THAT
CALIFORNIANS HAVE A RELIABLE
SUPPLY OF AFFORDABLE, UH,
MEDICATIONS IN WHATEVER
CIRCUMSTANCE AND TO HAVE THAT
CAPACITY AVAILABLE TO US
EXPECTEDLY ASKED WHEN I VOTE,
PLEASED TO HAVE AS WITNESSES AND
SUPPORT DAVID AS A VETO FROM THE
AARP AND PEOPLE FROM HEALTH
ACCESS CALIFORNIA THANK YOU. ONE
CHAIR. TÌM. HOW'S THAT GREAT
GOOD AFTERNOON CHAIR AND
MEMBERS. MY NAME IS DAVID
AZEVEDO, ASSOCIATE STATE
DIRECTOR, ASSOCIATE DIRECTOR FOR
ADVOCACY FOR AARP, CALIFORNIA
HERE SPEAKING ON BEHALF OF OUR
3.3 MILLION MEMBERS ACROSS THE
STATE IN SUPPORT OF SB 838.
WHICH ENHANCES CALIFORNIA'S
ABILITY TO MANUFACTURE GENERICS,
INCLUDING INSULIN. IN 2020. AARP
CALIFORNIA ALSO SUPPORTED SB
582852, WHICH CREATED THE OFFICE
OF DRUG CONTRACTING AND
MANUFACTURING IN THE CALIFORNIA
HEALTH AND HUMAN SERVICES
AGENCY. WE SUPPORT SB 838 FOR
THE SAME REASONS. SB 838 WILL
INCREASE COMPETITION, LOWER
PRICES AND ADDRESS SHORTAGES IN
THE MARKET FOR GENERIC
PRESCRIPTION DRUGS. AARP
BELIEVES THAT ALL CALIFORNIANS
SHOULD HAVE ACCESS TO AFFORDABLE
LIFE SAVING DRUGS. WE'RE
FIGHTING HARD TO ENACT REFORMS
THAT HELP LOWER PRESCRIPTION
DRUG PRICES AND PROVIDE RELIEF
TO OLDER AMERICANS STRUGGLING TO
AFFORD VITAL MEDICATIONS. FOR
EXAMPLE, RIGHT NOW, OUR TOP
NATIONAL PRIORITY IS TO ENACT
FEDERAL LEGISLATION THAT WILL
ENABLE MEDICARE NEGOTIATION AND
LOWER PRESCRIPTION DRUG PRICES.
AARP SUPPORTS 838 BECAUSE PRICES
OF GENERIC DRUGS ARE
SIGNIFICANTLY LOWER THAN BRAND
NAME DRUGS. SOMETIMES AS MUCH AS
85% LOWER THE AVERAGE OLDER
AMERICAN TAKES 4.5 PRESCRIPTION
DRUGS ON A DAILY BASIS, SO THIS
REALLY MATTERS. AMERICANS PAY
AMONG THE HIGHEST DRUG PRICES IN
THE WORLD, AND WE HAVE HEARD
FROM MANY AARP MEMBERS HERE IN
CALIFORNIA AND ACROSS THE
COUNTRY WHO HAVE TOLD US THEY
HAVE HAD TO CHOOSE BETWEEN
PURCHASING GROCERIES AND TAKING
MEDICINE. TO MANAGE LIFE
THREATENING CONDITIONS.
MEANWHILE BRAND NAME DRUG PRICES
CONTINUE TO INCREASE AT RATES
THAT FAR EXCEED THE OVERALL RATE
OF INFLATION. IN FACT, THE
AVERAGE ANNUAL COST OF
PRESCRIPTION DRUG TREATMENT
INCREASED ALMOST 58% BETWEEN
2012 AND 2017. WHILE THE ANNUAL
INCOME FOR AMERICANS INCREASED
BY ONLY 13.3. THE TIME IS NOW
FOR CALIFORNIA TO TAKE ACTION
AND ONCE AGAIN LEAD THE NATION
BY PASSING SB 838. WE URGE THIS
COMMITTEE TO SUPPORT THIS
CRITICAL LEGISLATION. THANK YOU.
BETH CAPELL ON BEHALF OF HEALTH
ACCESS CALIFORNIA I'D LIKE TO
ECHO THE COMMENTS OF MY
COLLEAGUE FROM AARP AND SAY THAT
THIS APPLIES TO ALL CALIFORNIA
CONSUMERS, NOT JUST THOSE WHO
ARE ELIGIBLE TO BE A RP MEMBERS
. WE WERE VERY EXCITED WHEN WE
HEARD THE ORIGINAL PROPOSAL TO
CREATE CALIFORNIA DRUG
MANUFACTURING CAPACITY. THERE'S
LOTS OF DRUG MANUFACTURING IN
THIS STATE. WE HAVE A CONSUMER
BASE OF 40 MILLION CALIFORNIANS.
TOO MANY OF WHOM NEED DRUGS TO
MANAGE THEIR CONDITIONS AND KEEP
THEM HEALTHY AND AVOID DEATH. MM
WE ARE ALSO, WE'RE VERY PLEASED
TO SEE DOCTORS PANS ORIGINAL
POLICY BILL THAT WE THINK
IMPROVED THE ADMINISTRATION'S
PROPOSAL AND WE THINK THIS BILL
DOES AS WELL. ADDING INSULIN TO
THE DRUGS THAT WOULD BE
MANUFACTURED AS TARGETING ONE OF
THE HIGHEST COST ONE OF THE
DRUGS WHOSE COSTS HAVE INCREASED
THE MOST OVER THE LAST 10 OR 20
YEARS, SO CREATING THIS DRUG
MANUFACTURING CAPACITY AT THE UM
, DIRECTION OF THE STATE OF
CALIFORNIA AND PARTNERSHIP WITH
THE DRUG MANUFACTURER MAKES
SENSE TO US, AND WE THINK WE'LL
GIVE CALIFORNIA'S MUCH MORE
AFFORDABLE DRUGS MUCH MORE
AFFORDABLE ACCESS TO DRUGS AND
REDUCE THE UNDERLYING COST OF
DRUGS. FOR THOSE REASONS, WE'RE
PLEASED TO BE IN SUPPORT OF THE
BILL. ARE THERE OTHER WITNESSES
IN SUPPORT? GOOD EVENING, LINDA
WAY WITH WESTERN CENTER ON LAW
AND POVERTY IN SUPPORT. MADAM
CHAIR MEMBER SARAH FLOCKS ON
BEHALF OF AFSCME IN SUPPORT. ON
ASK YOU. THAT'S YOU, CALIFORNIA
AND SUPPORT. OKAY ARE THERE ANY
WITNESSES IN OPPOSITION? PLEASE
COME FORWARD. THING. NONE. AH!
IT'S INTERESTING. OKAY, UM. BACK
TO THE COMMITTEE. ANY QUESTIONS,
COMMENTS? LOTION. AND DR PAN, IF
YOU WOULD LIKE TO CLOSE. UM SO
FIRST OF ALL, I JUST WANT TO
ACKNOWLEDGE AND THANK GOVERNOR
NEWSOM IS ADMINISTRATION FOR HIS
LEADERSHIP. WE REALLY THRILLED
WHEN HE FIRST PROPOSED IN THE
BUDGET SEVERAL YEARS AGO, AND OF
COURSE THE WE WERE WORKING ON
THIS POLICY ISSUE AS WELL IN THE
SENATE, SO AND DOING THAT BILL
AND THE AND THE CONTINUING
PARTNERSHIP THAT'S BEEN GOING ON
SO THAT WE CAN ACTUALLY BRING
THIS TO EXECUTION. SO I'M VERY
PROUD THAT WE HAVE FUNDING IN
THIS STATE BUDGET THAT'S GOING
TO GET US GOING, AND THIS BILL
IS SORT OF A COMPANION TO THAT
AS WELL. AND SO I'M LOOKING
FORWARD TO CALIFORNIANS HAVING
ACCESS TO AFFORDABLE, RELEVANT
SUPPLY OF INSULIN. UH BECAUSE OF
BOTH THIS BILL AND THE BUDGET
ALLOCATION AND AGAIN REALLY
APPRECIATE ALL THE PARTNERSHIP
WITH THE ASSEMBLY AS WELL, TO
MAKE THIS HAPPEN AS WELL. SO
THANK YOU. RESPECTFULLY ASK MY
VOTE. SO WE HAVE A MOTION AND A
SECOND MOTION IS DUE PASS TO
APPROPRIATIONS. MADAM SECRETARY,
PLEASE CALL THE ROLL. I WOULD I
. WALDRON NIAGARA CURRY CURRY. I
ARAMBULA BIGELOW CARILLO. FLORA.
MAIENSCHEIN MAZE. MCCARTY
NAZARIAN RIVAS RODRIGUEZ
SANTIAGO SANTIAGO, I WEBER
WEBER. AYE. 50. 50 WILL LEAVE
THAT BILL ON CALL. THANK YOU.
THANK YOU. EXCEPT SP 9 44. YES.
RIGHT. THANK YOU. AND MR CHAIR
MEMBERS. SB 944 IS THE IS THE
FOLLOW UP TO THE BUDGET TRAILER
BILL FROM LAST YEAR. THAT TASK
COVERED CALIFORNIA COME UP WITH
OPTIONS, REDUCING COST SHARING
AND PLANS AVAILABLE THROUGH
COVERED CALIFORNIA. THIS BILL
WOULD HAVE COVERED CALIFORNIA
ELIMINATE DEDUCTIBLES AND
SUBSTANTIALLY REDUCED COST
SHARING WITH THE MOST GENEROUS
APPLICATION TO LOW INCOME
POPULATIONS. I AM IN WORKING
PARTNERSHIP WITH YOU. TERRIBLE
WOULD, UH, WHO HAS A MIRROR
VERSION OF THIS BILL THAT WE
ALSO ARE HEARING IN THE SENATE
COMMITTEE ON HEALTH AND IN
SUPPORT OF THE BILL? UH WE HAVE
THE SPONSORS AND OTHERS BETH
COUPLE FROM HEALTH ACCESS
CALIFORNIA AND ANDREA RIVERA
FROM THE CALIFORNIA PAN ETHNIC
HEALTH NETWORK. THERE IS A
QUESTION ABOUT THE EXTENT TO
WHICH FEDERAL FUNDING FOR
PREMIUM ASSISTANCE ACROSS
SHARING ASSISTANCE WILL BE
AVAILABLE IN 2023 THE BILL, THE
BUDGET BILL WOULD USE THE 304
MILLION TO REINSTATE THE STATE
SUBSIDIES BUT ALSO ALLOWS A
CONTINGENCY THAT THE FUNDS BE
USED REDUCED COST SHARING. IF
THE FEDERAL PREMIUM SUBSIDIES
ARE NOT EXTENDED AS A RESULT OF
, UH, WITH ARPAIO EXPIRING, SO
HOPEFULLY THAT WILL HAPPEN AT
THE FEDERAL LEVEL TO CONGRESS TO
TAKE ACTION. BUT WITH THAT
RESPECTFULLY ASKED FOR AN I
VOTE. THANK YOU. THANK YOU
WITNESSES. S COUPLE ON BEHALF OF
HEALTH ACCESS CALIFORNIA.
PLEASED TO BE HERE IS THE
SPONSOR OF THIS AND OF YOUR
MEASUREMENTS, DOCTOR WOULD UM,
1.8 MILLION CALIFORNIANS ARE
ENROLLED IN COVERED CALIFORNIA
TODAY, ALMOST ALL OF THEM
RECEIVING FEDERAL SUBSIDIES TO
PAY FOR PREMIUMS AND SOME HELP
WITH COPAYS AND DEDUCTIBLES, BUT
THE DEDUCTIBLE FOR THE BASIC
SILVER PRODUCT. HAS INCREASED
FROM $2000 IN 2000 AND 2014 TO
ALMOST $5000 NEXT YEAR. THINK
ABOUT IT. MOST OF THE PEOPLE AND
COVERED CALIFORNIA MAKE LESS
THAN $50,000 A YEAR AND WE'RE
ASKING THEM TO SPEND 10% OF
THEIR INCOME IF THEY END UP IN
THE HOSPITAL. THERE'S BEEN A LOT
OF WORK BY THE COVERED
CALIFORNIA STAFF AND BY YOUR
STAFF'S ON THE ISSUE OF
PROVIDING PEOPLE ADDITIONAL
ASSISTANCE ON COST SHARING. IF
WE ARE FORTUNATE ENOUGH THAT THE
FEDERAL GOVERNMENT EXTENDS THE
FEDERAL SUBSIDIES AND COVERED
CALIFORNIA HAS ALREADY ADOPTED A
PLAN THAT WOULD ALLOW CONSUMERS
UP TO 600% OF POVERTY TO HAVE
ZERO DEDUCTIBLES AND WOULD LOWER
OTHER COST SHARING FOR MANY OF
THEM. AND AS DR PAN SAID, IF THE
FEDERAL GOVERNMENT DOES NOT ACT
IN TIME THAN THE CALIFORNIA
SUBSIDIES WOULD GO TO REDUCING
PREMIUMS, SO WE ASK FOR YOUR
SUPPORT. THANK YOU. THANK YOU.
PLEASE GO AHEAD. GOOD AFTERNOON
CHAIR AND MEMBERS ANDREA RIVERA
ON BEHALF OF THE CALIFORNIA PAN
ETHNIC HEALTH NETWORK. COVERED
COVERED CALIFORNIA SERVES MANY
LOW INCOME AND MIDDLE INCOME
HOUSEHOLDS THROUGHOUT THE STATE
, MANY OF WHOM BELONG TO
COMMUNITIES OF COLOR. BY THE END
OF JANUARY, 2022, THE AGENCY
EXPERIENCED A RECORD HIGH OPEN
ENROLLMENT WITH NEARLY 1.7
MILLION SIGNED UP FOR
COMPREHENSIVE HEALTH CARE
COVERAGE. AT THE SAME TIME,
CALIFORNIA STARTED TO MAKE
PROGRESS AND CLOSING HEALTH
EQUITY GAPS BY CUTTING THE
UNINSURED RATE AMONG LATINOS AND
HALF AND CUTTING THE UNINSURED
RATES AMONG ASIAN PACIFIC
ISLANDER IN AFRICAN AMERICAN
COMMUNITIES BY TWO THIRDS.
HOWEVER DESPITE THESE SUCCESSES
, THE REALITY IS THAT A VERY
LARGE EQUITY GAP CONTINUES TO
REMAIN UNADDRESSED, AND THAT'S
AFFORDABILITY ASSISTANCE. SP 9
44 WOULD ALLEVIATE COST BURDENS
ON COVERED CALIFORNIA ENROLLEES
PRIMARILY AND PARTICULARLY FOR
COMMUNITIES OF COLOR. BY
REDUCING COST SHARING AND
THEREFORE ALLOWING MANY
CALIFORNIANS TO PAY FOR BASIC
HEALTHCARE SERVICES. THIS IS
ESPECIALLY IMPORTANT IN A TIME
WHEN RISING OUT OF POCKET COSTS
HAVE CREATED SYSTEMIC BARRIERS
TO ACCESSIBLE HEALTHCARE.
EXCESSIVE COST SHARING HITS
PEOPLE HARDEST WHEN THEY DO NOT
HAVE MUCH IN SAVINGS, THE LEGACY
OF RACIAL INJUSTICE AND WEALTH
AND EQUITY MEANS THAT BY PART
CALIFORNIANS HAVE LESS IN
SAVINGS AND LESS AND FAMILY
RESOURCES COMPARED TO OTHERS. SP
9 44 WOULD BEGIN TO ELIMINATE
BARRIERS TO AFFORDABLE
HEALTHCARE COVERAGE AND DESPITE
BEST EFFORTS CONTINUE TO AND
DESPITE THE BEST EFFORTS
CONTINUE TO POSE CHALLENGES FOR
THE REMAINING UNINSURED
POPULATION IN THE STATE. AS WE
RECOVER FROM THE PUBLIC HEALTH
EMERGENCY. WE CANNOT AFFORD TO
REVERT TO THE SYSTEMS THAT
EXPOSED CRITICAL GAPS IN OUR
SOCIAL SAFETY NETS. SP 9 44 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 9 44. THANK YOU
VERY MUCH OTHERS IN SUPPORT. MR
CHAIR AND MEMBERS BRANDON MARCH
WITH THE CALIFORNIA MEDICAL
ASSOCIATION AND SUPPORT THANK
YOU. HI MARGUERITE CASILLAS AND
REPRESENTING THE NATIONAL
MULTIPLE SCLEROSIS SOCIETY. AND
I AM A PERSON WITH M S IN
SUPPORT. LINDA WAY WITH WESTERN
CENTER ON LAW AND POVERTY IN
SUPPORT. THANK YOU. MR CHAIRMAN
MEMBERS MATT BROUGHT ON BEHALF
OF CSKA AND SUPPORT. THANK YOU.
THANK YOU. MOLLY ROBSON WITH
PLANNED PARENTHOOD, AFFILIATES
OF CALIFORNIA AND SUPPORT THANK
YOU. TWO MEN REPRESENT THE
CALIFORNIA CHAPTER OF THE
AMERICAN COLLEGE OF EMERGENCY
EFFICIENCY AND SUPPORT. THANK
YOU. ALEX CON CALIFORNIA CHRONIC
CARE COALITION AND STRONG
SUPPORT. THANK YOU. IS THERE
ANYONE IN OPPOSITION? TESTIMONY
IN OPPOSITION. SEE, NO ONE WILL
BRING IT BACK TO THE COMMITTEE
QUESTIONS OR COMMENTS FROM THE
COMMITTEE. WHAT FEW OF US THERE
ARE. WELL WE'RE HAPPY IF SOMEONE
MOVED THE BILL. YEAH. THE MOTION
BY MISS AGUILAR. CURIOUS SECOND.
I'M SORRY. DR WEBBER. WOULD YOU
HAVE A QUESTION, MISS WALDRON?
JUST A QUICK QUESTION. UM, DOES
DOES THIS BILL COVER? ALSO
DENTAL. COVERAGE. AS FAR AS THE
COPAYS AND DEDUCTIBLE. IF I
LEAVE IF I MAY, MR CHAIR UM YES
COVERS PEDIATRIC DENTAL COVERAGE
, WHICH IS AN ESSENTIAL HEALTH
BENEFIT. UNFORTUNATELY ADULT
DENTAL IS STILL AN OPTIONAL
BENEFITS. COVERED CALIFORNIA
DOES ALLOW PEOPLE TO BUY DENTAL
, BUT IT'S IN IN ADDITION TO SO
THERE, BUT FOR PEDIATRIC YES.
OKAY? ANYONE ELSE COMING? SO WE
HAVE A MOTION BY MISS A GEAR.
CURRY'S SECOND BY DR WEBBER S
MOTIONS DO PASS THROUGH
APPROPRIATIONS. WOULD YOU LIKE
TO CLOSE? THANK YOU, SHERWOOD
AND AGAIN APPRECIATE YOUR
LEADERSHIP IS ALL I KNOW. YOU
HAVE YOUR COMPANION BILL. COMING
UP TOMORROW. JUST WANTED AGAIN
REITERATE THE TESTIMONY FROM MY
SPONSORS. YOU KNOW THE SILVER
PLAN, WHICH IS THAT WHICH IS
SORT OF THE BASIC, YOU KNOW, WE
HAVE. WE HAVE A BRONZE PLAN, BUT
THEY'RE SILVER PLANTS. SORT OF
LIKE THE FIRST TIER FOR THE IT
AND DEDUCTIBLES $4750 RIGHT.
IT'S ALMOST $5000. AND SO WE
THINK ABOUT IT RIGHT? WE HEARD
TESTIMONIAL SUPPORT FROM THEM. M
S SOCIETY. PRACTICE CARE
COALITION, RIGHT. SO IMAGINE
YOU'RE A PERSON OF THE CHRONIC
DISEASE AND YOU NEED MEDICATION.
TO FEED YOUR CHRONIC DISEASE TO
KEEP IT UNDER CONTROL. 4007 AND
$50. OR YOU GET ANY SUPPORT OR
HELP FOR THAT? THAT'S A PROBLEM.
THAT MEANS YOU'RE NOT TAKING
YOUR MEDICATION FOR MAYBE WHO
KNOWS? MONTH TWO MONTHS, THREE
MONTHS BEFORE YOU SAVE THAT MUCH
MONEY. AND THAT'S WHY WE NEED TO
PROVIDE FAMILIES AND PEOPLE WITH
HELP. YOU KNOW, WE HAVE 40% OF
CALIFORNIANS HAVE A CHRONIC
CONDITION. NOT NECESSARILY ALL
OF THEM NECESSARILY REQUIRE
MEDICATION, KEEPING THEM CONTROL
, BUT A LOT OF THEM DO SO
CERTAINLY THERE'S
HOSPITALIZATIONS AND OTHER
THINGS AND EFFECTIVELY STOPPED
INTERN MEDICINE. MAYBE THEY'LL
USE THE DEDUCTIBLE AND
HOSPITALIZATIONS ER VISITS. BUT
YOU KNOW, THERE'S AN OPPORTUNITY
HERE TO AGAIN TRY TO HELP
PEOPLE. WHO NEED THE CARE TO
STAY HEALTHY TO KEEP UP THEIR
ACTIVITIES DAILY LIVING
SOMETIMES, UNFORTUNATELY, YOU
KNOW, ALSO TO EXTEND THEIR LIFE.
I MEAN, THAT'S IF YOU STOP
TAKING YOUR MEDICATION OF A
CHRONIC CONDITION. NOT ONLY
COULD YOU BE HOSPITALIZED, YOU
COULD EVEN POTENTIALLY, YOU
KNOW? EXCEPT FOR SERIOUS INJURY
OR OR DEATH. AND SO THAT'S WHY
IT'S SO IMPORTANT. WE PROVIDE
THESE SUBSIDIES THAT WE TRY TO
ELIMINATE DEDUCTIBLE. I
CERTAINLY HOPE CONGRESS PASSES
AND EXTENDS IS THE AMERICAN
WRITTEN THAT THAT PORTION OF THE
AMERICAN RESCUE ACT SO THAT WE
CAN COMMIT THESE FUNDS TO THAT,
OTHERWISE, WE'RE GONNA HAVE TO
DID IT TO US. THE PREMIUMS, BUT
UM YOU KNOW, DEDUCTIBLES REALLY
OUR PROBLEM BECAUSE IT'S A
CERTAINLY EXTREMELY LARGE
BARRIER TO CARE. AND IT DOESN'T
REALLY. I MEAN, WAS IT ABOUT IT
DOESN'T REALLY REDUCE. I MEAN,
REDUCES UTILIZATION, BUT IT'S
YOU KNOW, WE TALKED AND AGAIN. I
APPRECIATE SHERWOOD YOU
MENTIONED ISSUES AROUND. YOU
KNOW THE RIGHT THING. YOU KNOW
THE RIGHT MEDICINE. WE DON'T
WANT PEOPLE TO OVERUSE. IS IT
THE RIGHT THING AT THE RIGHT
TIME, RIGHT? AND I'M NOT SURE
HOW DEDUCTIBLE INSURERS
DEDUCTIBLE. BE SURE THAT WE'RE
ACTUALLY DETERRING UNNECESSARY
USE. ACTUALLY WOULD DETERMINE
MORE THAN NECESSARY USE. SO
AGAIN REALLY APPRECIATE. UM YOUR
LEADERSHIP CHAIR, WOOD AND THIS
ISSUE PROUD TO PARTNER WITH YOU
AND, YOU KNOW, CARRYING A MIRROR
BILLS AND AGAIN, RESPECTFULLY
ASKING MY VOTE. AND THEY'RE
LOOKING FORWARD THAT HOPEFULLY
RELATIVE OUR LEGISLATION. WE
WILL BE ABLE TO PROVIDE THAT
ASSISTANCE TO PEOPLE IN COVERED
CALIFORNIA. THANK YOU. THANK YOU
VERY MUCH, UM, MOTION IS DO PASS
THROUGH APPROPRIATIONS. MADAM
SECRETARY, PLEASE CALL THE ROLL
. WOULD WOULD I? WALDRON
WALDRON, I AGUIAR-CURRY HAGAR
CURRIE. I ARAMBULA. BIGELOW
CARILLO LARA MAIENSCHEIN. MAY'S
MCCARTY NAZARIAN. RIVAS
RODRIGUEZ SANTIAGO HOWEVER.
HOWEVER, I. 40 BILL HAS FOUR
VOTES WILL LEAVE THE BILL ON
CALL. THANK YOU. I THINK IT'S 10
33. YES, PLEASE. ALL RIGHT.
THANKS VERY MUCH. HERE MEMBERS.
UM SB 10 33 REQUIRES COMMERCIAL
HEALTH PLANS TO ESTABLISH
STANDARDS FOR THE COLLECTION OF
DEMOGRAPHIC AND HEALTH RELATED
SOCIAL NEEDS. DATA FROM
CALIFORNIA IS ENROLLED IN
COMMERCIAL HEALTH INSURANCE.
THESE DATA IMPROVEMENT STANDARDS
WILL ALLOW FOR STATE LEADERS,
CONSUMER ADVOCATES AND STATE
COMMITTEE STAKEHOLDERS TO
IDENTIFY AND ADDRESS RACIAL,
ETHNIC AND GENDER DISPARITIES,
HELP IMPROVE THE QUALITY OF CARE
AND ENABLE CALIFORNIA TRULY
BEGAN TO RESOLVE ISSUES THAT
IMPACT POPULATION HEALTH FOR
COMMUNITIES OF COLOR AND OTHER
HISTORICALLY EXCLUDED GROUPS.
THIS BUILDS UPON THE IMPORTANT
WORK BEING DONE BY COVERED
CALIFORNIA, AS WELL AS THE
DEPARTMENT MANAGED HEALTH CARE
THROUGH ITS NEW FOR NEWLY FORMED
HEALTH, EQUITY AND QUALITY
COMMITTEE. RECENT AMENDMENTS
HAVE BEEN TAKEN TO ADDRESS
CONCERNS FROM DENTAL PLANS
REGARDING HEALTH EQUITY
ACCREDITATION. THE BILL NOW
CLARIFIES THAT NATIONAL
ACCREDITATION WILL BE REQUIRED
ONLY IF AND WHEN IT EXISTS FOR
SPECIALIZED HEALTH PLANS. WELL I
AM SYMPATHETIC TO THE ARGUMENT
THAT NATIONAL ACCREDITATION MAY
NOT EASILY TRANSLATE TO DENTAL
PLANS. CURRENTLY, WE MUST ENSURE
THAT WHEN IT DOES APPLY, WE'RE
DOING ALL WE CAN TO ADDRESS
DISPARITIES AND INEQUITIES IN
HEALTH CARE SETTINGS, AND I KNOW
HAREWOOD IS A DENTIST. THEY KNOW
THAT THAT'S NOT A VALUE THAT YOU%
SHARE. AH THESE AMENDMENTS ALLOW
FOR SPECIALIZED HEALTH PLANS
LIKE DENTAL PLANS TO DEVELOP AND
IMPLEMENT ANNUAL QUALITY
IMPROVEMENT PLAN SPECIFIC TO
HEALTH, EQUITY AND DISPARITY
REDUCTION GOALS UNTIL SUCH TIME
AS NATIONAL ACCREDITATIONS
APPROPRIATE FOR THEM TO OBTAIN.
I WOULD MAKE KNOWS CHAIR OF THE
ASIAN PACIFIC ISLANDER
LEGISLATIVE CAUCUS. THIS IS A
PRIORITY BILL FOR OUR CAUCUS,
ESPECIALLY GIVEN THE FACT THAT
WE HAVE TREMENDOUS DISPARITIES
WITHIN OUR COMMUNITY. AND TOO
OFTEN, THOSE ARE MASKED. WHEN
THERE ISN'T DATA COLLECTION TO
ALLOW US TO DISAGGREGATE THE
INFORMATION THE DATA, UH AND BE
SURE THAT PEOPLE CAN GET THEIR
NEEDS MET. SO AGAIN, THIS BILL
HAS EARNED UNANIMOUS SUPPORT SO
FAR AND RESPECTFULLY ASK FOR AN
I VOTE. THANK YOU. THANK YOU
VERY MUCH. WITNESSES, PLEASE.
GOOD AFTERNOON, ANDREA RIVERA ON
BEHALF OF THE CALIFORNIA PEN.
ETHNIC HEALTH NETWORK PEN IS THE
PROUD SPONSOR OF SB 10 33, WHICH
WILL ENSURE THAT CALIFORNIA HAS
ENFORCEABLE STATEWIDE STANDARDS
FOR DEMOGRAPHIC DATA COLLECTION
TO IDENTIFY AND THEN REDUCE RACE
SPACE DISPARITIES IN HEALTH
CARE. IN 2000 AND THREE
CALIFORNIA PASSED THE HEALTHCARE
LANGUAGE ASSISTANCE ACT. NOT
ONLY WAS THIS LEGISLATION THE
FIRST OF ITS KIND IN THE COUNTRY
, IT REQUIRED HEALTH PLANS AND
SPECIALIZED HEALTH PLANS TO
BEGIN COLLECTING. DEMOGRAPHIC
INFORMATION TO ASSESS A
PATIENT'S NEEDS FOR LANGUAGE
ASSISTANT SERVICES AND TO BEGIN
TRACKING HEALTH AND EQUITIES.
HOWEVER 20 YEARS LATER, THE
COMPLETENESS OF DATA COLLECTED
BY PLANS VERY SUBSTANTIALLY
ACROSS LINES OF BUSINESS. AND
WHILE MEDICAL ALSO EXPERIENCES
ITS OWN CHALLENGES, WITH LACK OF
GRANULAR INFORMATION. COMMERCIAL
COVERAGES EVEN FURTHER BEHIND. A
SPEECH AND 33 WOULD REQUIRE THE
DEPARTMENT OF MANAGED HEALTH
CARE TO LEAD A REGULATORY
STAKEHOLDER PROCESS THAT WOULD
UTILIZE FEDERAL EQUITY GUIDANCE
STANDARDS AS WELL AS INCORPORATE
BEST PRACTICES. THE DESIGN
UPDATED STATEWIDE STANDARDS FOR
COMMERCIAL HEALTH PLANS AND
INSURERS. AND UPDATING THE
STANDARDS SP 10 33 WOULD BUILD
ON EXISTING LEGISLATION AND
REQUIRE PLANS TO BEGIN
COLLECTING MORE GRANULAR
INFORMATION ON SEXUAL
ORIENTATION, GENDER IDENTITY.
DISABILITY STATUS, RACE AND
ETHNICITY, AS WELL AS THE SOCIAL
DETERMINANTS OF HEALTH.
ADDITIONALLY PLANS WOULD BE
REQUIRED TO ESTABLISH HOW THEY
WILL TACKLE DISPARITIES BY
MEETING NATIONALLY HEALTH EQUITY
ACCREDITATION STANDARDS WHERE
APPLICABLE THE LACK OF INDUSTRY
WIDE STANDARDS HAS CREATED A
BARRIER FOR HEALTH PLANS AND
COVERED CALIFORNIA, PARTICULARLY
AND IDENTIFYING AND ADDRESSING
DISPARITIES. IN FACT, VERY DATA
QUALITY HAS SEVERELY HINDERED
THE AGENCY'S ABILITY TO HOLD
PLANS ACCOUNTABLE. BASED ON A
COMMISSIONED REPORT IN 2000 AND
19. MANY COMMERCIAL PLANS RELY
ON SAMPLE SIZES THAT ARE SO
SMALL THAT THE AGENCY HAS
DIFFICULTIES ACCURATELY
COMPARING PERFORMANCES. ON
QUALITY AND EQUITY GOALS ACROSS
PLANS. INCOMPLETE DATA DOES NOT
ALLOW FOR THE STATE ADVOCATES,
COMMUNITY MEMBERS OR EVEN THE
VERY SAME PLANS AND INSURERS
THAT ARE COLLECTING THIS
INFORMATION TO UNDERSTAND HOW WE
CAN APPROPRIATELY ALLOCATE
RESOURCES TO COMMUNITIES WHO
STILL FACE BARRIERS TO BEING
HEALTHY. WE URGENTLY I VOTE ON
SB 10 33. THANK YOU. GOOD
AFTERNOON CHAIR AND MEMBERS JOSE
TORRES ON BEHALF OF HEALTH
ACCESS CALIFORNIA, THE STATEWIDE
HEALTHCARE CONSUMER ADVOCACY
COALITION AND SUPPORTER OF SB 10
33. IN ORDER TO ADDRESS HEALTH
DISPARITIES. WE NEED HIGH
QUALITY DATA WITHIN OUR HEALTH
CARE SYSTEM. SB 10 33 WOULD HELP
WITH THAT. SB 10 33 ENSURES THAT
CALIFORNIA HAS ENFORCEABLE
STATEWIDE STANDARDS. FOR
DEMOGRAPHIC DATA COLLECTION.
WITH THIS DATA, WE WOULD BE ABLE
TO IDENTIFYAND PROPERLY
ADDRESSED HEALTH DISPARITIES
WITHIN COMMUNITIES UNDER
COMMERCIAL PLANS. THIS BILL
BUILDS UPON. THE EXISTING DATA
REQUIREMENTS ALREADY IN PLACE.
THESE CURRENT REQUIREMENTS ONLY
GO SO FAR. AS HEALTH PLAN DATA
QUALITY AND COLLECTION PROCESS
IS VERY SUBSTANTIALLY WITHIN
COMMERCIAL COVERAGE AND ARE
LAGGING BEHIND BOTH MEDICAL AND
MEDICARE. THE LACK OF
ENFORCEABLE STATEWIDE STANDARDS
WITHIN DATA COLLECTION HAS
GREATLY AFFECTED HOW WE CAN
RESPOND AND ADDRESS HEALTH
DISPARITIES. THIS IS SEEN IN
COVERED CALIFORNIA. THIS IS SEEN
IN COVERED CALIFORNIA'S ABILITY
TO MEASURE AND HOLD HEALTH PLANS
ACCOUNTABLE FOR IMPROVING HEALTH
OUTCOMES AND REDUCING
DISPARITIES. THEIR EFFORTS HAVE
BEEN HINDERED, ESPECIALLY WITHIN
GETTING ACCURATE STATISTICAL
DATA FOR A P I AND L G B T Q
PLUS COMMUNITIES. WE NEED THIS
DATA TO IDENTIFY DISPARITIES
THAT EXIST WITHIN COMMUNITIES
AND THESE ENFORCEABLE STANDARDS
ARE NEEDED FOR THE COMPLETE AND
ACCURATE COLLECTION OF DATA BY
BY RACE, ETHNICITY, LANGUAGE,
SEXUAL ORIENTATION, GENDER
IDENTITY. DISABILITY STATUS AND
HEALTH RELATED SOCIAL NEEDS. WE
DO HOPE THAT MEMBERS TODAY CAN
SUPPORT THIS BILL WITH AN I
VOTE, AND I THANK YOU FOR YOUR
TIME. THANK YOU VERY MUCH OTHERS
IN SUPPORT. LINDA WAY WITH
WESTERN CENTER ON LAW AND
POVERTY IN SUPPORT. THANK YOU.
MARGUERITE CASILLAS,
REPRESENTING THE NATIONAL
MULTIPLE SCLEROSIS SOCIETY. I AM
A PERSON WITH MS AND SUPPORT QUÊ
NICOLE WARD ULLMAN ON BEHALF OF
THE CHILDREN'S PARTNERSHIP AND
SUPPORT. THANK YOU. KELLY BROOKS
ON BEHALF OF THE CALIFORNIA
ASSOCIATION OF PUBLIC HOSPITALS
AND HEALTH SYSTEMS AND SUPPORT.
MELISSA SAID GUN WITH THE
SOUTHEAST ASIA RESOURCE ACTION
CENTER IN SUPPORT THANK YOU. ALI
ROBSON WITH PLANNED PARENTHOOD
AFFILIATES OF CALIFORNIA AND
SUPPORT QUÊ IS THERE ANY
OPOSITION TO THE BILL?
GOOD EVENING ALMOST THAT
AFTERNOON, BUT IT IS EVENING, MR
CHAIRMAN AND MEMBERS CHRISTIE
WEEKS ON BEHALF OF THE
CALIFORNIA ASSOCIATION OF DENTAL
PLANS. WE DO HAVE AN OPPOSED
UNLESS AMENDED POSITION AND
WANTED TO REGISTER THAT AS WE
ARE. OBVIOUSLY GETTING LATE IN
THE PROCESS. UM WE HAVE HAD VERY
PRODUCTIVE CONVERSATIONS WITH
THE SPONSOR AND DO APPRECIATE
THE AMENDMENTS THAT HAVE BEEN
TAKEN. THE DENTAL PLANS ARE NOT
AT ALL OPPOSED TO THE GOAL OF
THE BILL. THE CHALLENGE THAT
WE'RE WORKING THROUGH IS REALLY
OPERATIONAL SINCE THE PARADIGM
THAT'S IN PLACE FOR THE MEDICAL
PLANS TO COLLECT. A LOT OF THIS
IS JUST A LITTLE BIT DIFFERENT
FROM THE DENTAL PLANS. AND THERE
IS A D MHC PROCESS THAT IS
UNDERWAY. THAT DOESN'T INCLUDE
DENTAL PLANS, AND SO WE HAVE
OFFERED ADDITIONAL AMENDMENTS.
WE THINK WE CAN GET THERE AND
LOOK FORWARD TO CONTINUING THE
CONVERSATION. THANK YOU VERY
MUCH. IS THERE ANYONE ELSE IN
OPPOSITION?
SO SERENA LODGE. I JUST WANT TO
GREET THE SPEAKER BECAUSE SHE,
UM DEFINITELY, UM. I WOULD BE
INGREDIENTS WITH THAT. SO, UM ON
A SECOND, SHE SAID. THANK YOU.
ANYONE ELSE? NO ONE WILL BRING
IT BACK TO THE COMMITTEE
QUESTIONS OR COMMENTS FROM THE
COMMITTEE. NONE IS THERE A
MOTION SECOND MOTION BY MISS
AGUILAR CURIOUS SECOND BY MR
MCCARTHY MOTION WOULD BE DO PASS
THROUGH APPROPRIATIONS. DR PAM,
WOULD YOU LIKE TO CLOSE? I
APPRECIATE THE CONTINUING
DIALOGUE WITH THE DENTAL PLANS.
I THINK THE IDEA THE GOAL IS TO
BE SURE WE HAVE APPROPRIATE DATA
SO WE CAN IDENTIFY BOTH NOT ONLY
IDENTIFIED. WE KEEP TALKING
ABOUT IDENTIFYING HEALTH, YOU
KNOW RACIAL, ETHNIC GENDER
DISPARITIES, BUT ALSO THEN TO
ACTUALLY CLOSE THEM AND
ELIMINATE THEM. SO APPRECIATE
THE CONTINUING DIALOGUE AND
AGAIN RESPECT THE ASPIRIN,
EITHER. THANK YOU. YOU VERY
MUCH. MADAM SECRETARY. PLEASE
CALL THE ROLL. WOULD WOULD I
WALDRON? WALDRON I GOT CURRY
CURRY I ARAMBULA BIGELOW.
BIGELOW NÓ CARILLO. FLORA
MAIENSCHEIN MAZE MCCARTHY
MCCARTHY, I NAZARIAN RIVAS
RODRIGUEZ SANTIAGO WEBER.
HOWEVER, I 5 TO 1. 51 WILL LEAVE
THAT BILL ON CALL AS WELL. THANK
YOU. I'M MOVING ON TO ITEM
NUMBER 20 SB 12 34. THANK YOU.
SO I'M PLEASED TO PRESENT SP. I
GUESS 1234 12 34, WHICH REQUIRES
THE FAMILY PACK PROGRAM TO
COVERS S T I SCREENING, SEXUALLY
TRANSMITTED INFECTION, SCREENING
AND TREATMENT SERVICES FOR
INCOME ELIGIBLE PATIENTS,
REGARDLESS OF THE REASON FOR
VISITING PROVIDER UNTREATED STDS
CAN HAVE SERIOUS LONG TERM
EFFECTS, INCLUDING INFERTILITY,
BLINDNESS, CERVICAL CANCER,
NEGATIVE AND NEGATIVE. MATERNAL
AND CHILD HEALTH OUTCOMES ARE
FAMILY PACK COVERS STD SERVICES.
IT'S ONLY WITHIN THE CONTEXT OF
A FAMILY PLANNING VISIT PEOPLE
WHO AREN'T AT RISK FOR
EXPERIENCING OR CAUSING
UNINTENDED PREGNANCY AREN'T
ELIGIBLE FOR FAMILY PACKED
SERVICES. THE SALES TAX PROGRAM
, HOWEVER, AS A NETWORK OF MORE
THAN 2000, CULTURALLY COMPETENT
PROVIDERS WHO ARE WELL TRAINED
TO DELIVER US T SERVICES AND THE
SCOPE OF THE S D I EPIDEMIC
RICARD'S ACTION NOW. COVID 19
PANDEMIC HAS EXACERBATED RATES
IN CALIFORNIA ACROSS THE COUNTRY
TO CRISIS LEVELS. BUT THIS WAS
AN ONGOING TREND EVEN PRIOR TO
THIS AS WELL, UH, WITH THAT,
RESPECTFULLY ASK FOR AN I VOTE.
PLEASED TO HAVE TOMMY MARTIN
FROM EQUALITY, CALIFORNIA.
TESTIFYING IN SUPPORT. THANK
YOU. YOU PLEASE GO AHEAD. PLEASE
PUSH THE BUTTON. IF YOU DON'T
MIND. THANK YOU. CHAIR AND
COMMITTEE MEMBERS, UH, TOMMY
MARTIN ON BEHALF OF EQUALITY
CALIFORNIA, ONE OF THE CO
SPONSORS OF THIS BILL, AND WE
JOINED THIS EFFORT BECAUSE A
SENATOR PAN MENTIONED THE LGBTQ
PLUS COMMUNITY EXPERIENCES.
SEVERE NEGATIVE HEALTH
DISPARITIES IN MANY WAYS,
INCLUDING WITH STD RATES. MANY
REASONS FOR THESE DISPARITIES,
REASONS THAT OFTEN IMPEDE ACCESS
, UM AND CREATE CONFIDENTIALITY
CONCERNS FOR LGBTQ, PLUS
PATIENTS, YOUTH AND COMMUNITIES
OF COLOR. REALLY IMPORTANT FOR
OUR COMMUNITY, THE CALIFORNIA
STD CONTROL BRANCH, FOR EXAMPLE
, REPORTS THAT MEN WHO HAVE SEX
WITH MEN CONSTITUTE MORE THAN
HALF OF REPORTED MALE GONORRHEA
CASES JUST A FEW YEARS AGO. WE
ALSO KNOW THAT MORE THAN HALF OF
ALL STS IN CALIFORNIA ARE
EXPERIENCED, UH BY YOUTH BETWEEN
THE AGES OF 15 AND 24. WE ALL
RECOGNIZE THAT THE PANDEMIC HAS
ONLY EXACERBATED STD RATES AND
LONGSTANDING HEALTH DISPARITIES.
OF COURSE, CALIFORNIA HAS MADE
IMPORTANT STRIDES AND EXPANDING
HEALTHCARE ACCESS. BUT WE NEED
TO CLOSE REMAINING COVERAGE GAPS
THAT ARE DRIVING S T U. S. T. I
RATES AND DISPARITIES. BECAUSE
THE FAMILY PACKED PROGRAM CANNOT
CURRENTLY SERVE PEOPLE WHO ARE
NOT NOT AT RISK OF UNINTENDED
PREGNANCY. THIS LEAVES MANY LOW
INCOME LGBTQ, PLUS CALIFORNIANS
WITH NO OTHER PATHWAY TO FREE S
T I COVERAGE. AS WE HEARD IN
TESTIMONY DURING A PRIOR
COMMITTEE HEARING, AND L G B T Q
. PLUS PERSON MIGHT BE GRANTED
ACCESS TO THIS COVERAGE ONE DAY
AND BE DENIED THE NEXT JUST
BECAUSE OF WHO THEY ARE, WHICH
CAUSES HARMFUL LAPSES IN CARE.
SO THE STRUCTURAL INEQUITY
REQUIRES THE UPDATE THAT SP 1234
WOULD PROVIDE TO ENSURE THAT
CALIFORNIANS HAVE ACCESS TO
ESSENTIAL AND TIME SENSITIVE
SERVICES. THANK YOU. THANK YOU
VERY MUCH OTHERS IN SUPPORT.
FRANK SPENCER ON BEHALF OF THE
AMERICAN COLLEGE OF O B. G Y N S
DISTRICT NINE AND SUPPORT HERE.
KELLY BROOKS ON BEHALF OF THE
COUNTY HEALTH EXECUTIVES
ASSOCIATION OF CALIFORNIA IN
SUPPORT. CINDY HILLARY ON BEHALF
OF THE CALIFORNIA MEDICAL
ASSOCIATION AND SUPPORT MOLLY
ROBSON WITH PLANNED PARENTHOOD,
AFFILIATES OF CALIFORNIA AND
STRONG SUPPORT, ALSO ISSUING
SUPPORT FOR A PLOT HEALTH AND
ESSENTIAL ACCESS HEALTH. THANK
YOU. OR ANYONE IN OPPOSITION TO
THE BILL. NO ONE WILL BRING IT
BACK TO THE COMMITTEE FOR
QUESTIONS OR COMMENTS. DR WEBBER
THANK YOU. THANK YOU. CHAIR. SO
I AM FAMILIAR WITH FAMILY
PLAQUE. UM I'M VERY GRATEFUL
THAT WE HAVE THAT IN CALIFORNIA
SPECIFICALLY FOR THE
CONFIDENTIALITY CLAUSE SO THAT
OUR ADOLESCENTS CAN BE COVERED,
UM, WITHOUT IT, NECESSARILY
HAVING BEING BUILT TO THEIR
PARENTS, UM AND ALSO FOR WOMEN
EXPERIENCING DOMESTIC VIOLENCE,
AND THEY DON'T WANT THEIR, UM OR
SPOUSES TO KNOW THAT THEY'RE
EITHER GETTING CONTRACEPTION OR
, UM, YOU KNOW THAT THEY'D SEEN
A PROVIDER FOR REPRODUCTIVE
HEALTH SERVICES. SO I JUST HAVE
A QUESTION, BECAUSE, UM THERE IS
SOMETHING IN HERE THAT SAYS THAT
TO NOTIFY FAMILY PACK PROVIDERS
WHEN 50% AND 75% OF THE
AVAILABLE FUNDS HAVE BEEN
EXPENDED. SO UM, IS THERE. WHEN
WE EXPAND THE NUMBER OF PEOPLE
WHO HAVE ACCESS TO THIS SERVICE
. ARE WE RISKING POTENTIALLY
LOSING THE FUNDS TO HELP THOSE
THAT WE NEEDED TO SERVE, WHICH
IS WHY THE FUND WAS CREATED IN
THE FIRST PLACE. I JUST DON'T
WANT TO DO THIS. AND THEN THOSE
WHO NEED REPRODUCTIVE HEALTH
CARE SERVICES WILL NO LONGER BE
ABLE TO GET THEM. I HAVE NOT
HEARD FROM, UM FROM ANYONE THAT
THERE'S A CONCERN THAT THE MONEY
WOULD RUN OUT OR WOULD GET THAT
THEY WOULDN'T THAT WE WOULD NOW
HAVE TO REDUCE SERVICES FOR
PEOPLE WHO ARE CURRENTLY ON
FAMILY PACKED RIGHT? IT IS, YOU
KNOW, IT'S A FEDERAL PROGRAM
WHERE WE CAN GET MATCHING FUNDS
AND SO FORTH, SO I HAVE NOT
HEARD OF ANY LIMITATION TO FROM
ANYONE. AND IN THAT REGARD, UM
AND I THINK IF YOU SEE THE
PEOPLE WHO SUPPORT THE BILL,
MANY OF THEM, OF COURSE, ALSO
USE FAMILY PACKED FUNDS TO PAY
FOR SERVICES FOR ANY POPULATIONS
AS WELL. SO I HAVE NOT SOUTH. NO
ONE'S INDICATED TO ME AND I HAVE
NOT FOUND ANYONE THAT SOMEONE
WHO'S YOU KNOW, UH AT SOME
FAMILIAR THE PROGRAM, NOT IN THE
CLINICAL SENSE AS MUCH AS YOU
HAVE, DR WEBBER, BUT, UH, YOU
KNOW, SORT OF, FROM THE STATE'S
PERSPECTIVE THAT THAT'S A
PROBLEM. WE CAN CERTAINLY LOOK
INTO IT AGAIN AND SEE WHETHER
THERE'S ANYTHING BUT SO FAR HAVE
NOT. I'M NOT AWARE OF ANY RED
FLAGS THAT THAT THAT THAT
CONCERN BEING A ONE THAT PEOPLE
ARE HAVE RAISED OKAY? YEAH WELL
AND AGAIN. IT JUST MADE ME THINK
WHEN IT WHEN IT TALKS ABOUT THE
REQUIREMENT FOR 50% AND 75% OF
THE FUNDS. WHEN THOSE HAVE BEEN
USED THAT YOU HAVE TO INFORM
PROVIDERS OF FAMILY PACKED
BECAUSE I DEFINITELY DON'T WANT
TO USE FAMILY PACK FUNDS. AND
HAVE THEM. GONE AND SO PATIENTS
THAT NEED IT WON'T BE ABLE TO
USE IT. SO MY CONSULTANT JUST
REMINDED ME THAT THE AMENDMENTS
ACTUALLY DELETE THE COST CAP.
I'M SORRY. THE AMENDMENTS DELETE
THE COST CAP, SO THAT'S NO
LONGER AN ISSUE. SO YOU'RE
STATING THAT WE WILL ALWAYS HAVE
THE FUNDS FOR FAMILY PACK, SO
THERE'S NOT AN ISSUE OF LIKE
THERE'S A CERTAIN NUMBER OF FINE
FUNDS IN A POOL. AND ONCE WE'VE
USED THOSE WE DON'T HAVE. SO
WHAT HAPPENS IS THAT, OF COURSE,
FAMILY PACT IS A STATE FEDERAL,
RIGHT? SO WE HAVE A FEDERAL
MATCH. AND SO OF COURSE WE HAVE
TO PUT IN THE STATE. PART OF THE
MONEY IN THERE, AND SO THAT THAT
WOULD BE THE MAIN LIMITATION ON
THE WHOLE PROGRAM IS IF WE SAY
WE'RE ONLY GOING TO SPEND EXTRA
$100 AND STATE SO AND I BELIEVE
THAT GAP HAS BEEN REMOVED. SO
GOOD BYE BYE BYE. THIS COMMITTEE
. ACTUALLY YES. AMENDMENTS WAS
ACTUALLY WAITING FOR YOU TO. I
DIDN'T HEAR THAT. YOU ACCEPTED
THE AMENDMENTS. YES OF COURSE.
WE ARE ACCEPTING YOUR
AMENDMENTS. NOW THE CAP, WHICH
HAS BEEN DELETED. BY THE
ACCEPTANCE OF OKAY, SO BECAUSE
AGAIN, UM I WAS SUPPORTED, BUT
I'M VERY CONCERNED ABOUT THE
POSSIBILITY OF THE REASON WHY
FAMILY PACT WAS ESTABLISHED,
WHICH WAS TO MAKE SURE THAT
PEOPLE HAVE ACCESS TO
REPRODUCTIVE HEALTH CARE. UM I
WOULD HATE TO SEE US LIMITING
THAT BECAUSE WE ARE EXPANDING.
THE POOL OF PEOPLE WHO ARE NOW
TRYING TO RECEIVE THESE SERVICES
FOR FREE. I GUESS I WOULD JUST
SAY IS THAT CERTAINLY IN NO WAY
DO WE WANT TO ENDANGER SERVICES
FOR PEOPLE, BUT I ALSO JUST WANT
TO EMPHASIZE AGAIN THAT, UM THAT
THAT YOU KNOW, WE HAVE A WHOLE
GROUP OF PEOPLE WHO ALSO CAN'T
GET SERVICES. AND UH, SO I DON'T
THINK YOU KNOW. WE'RE NOT TRYING
TO MAKE A TRADE OFF HERE AND
AGAIN. UH, CERTAINLY, I HAVE
NOT. UH AND IN FACT, THIS IS NOT
THE FIRST TIME I'VE CARRIED THIS
POLICY. SO IT WAS PART OF
ANOTHER BILL BEFORE. NOW WE'RE
DOING AS A STANDALONE THAT THAT
HAS AN ISSUE THAT'S BEEN RAISED
WHERE PEOPLE HAVE SAID WAIT A
MINUTE FAMILY PACK MONEY WOULD
NOW EITHER BE LIMITED OR
UNAVAILABLE FOR PEOPLE WHO
ACTUALLY NEED IT FOR
REPRODUCTIVE SERVICES SO THAT
THAT'S NEVER COME UP BEFORE AS A
CONCERN AND AGAIN, IF YOU SEE
WHO WHO'S SUPPORTING THE BILL.
THESE ARE ALSO THE SAME
ORGANIZATIONS THAT OFTEN ARE
ACTUALLY GETTING REIMBURSED FROM
FAMILY PACK FOR THE SERVICES
THEY PROVIDE FOR REPRODUCTIVE
HEALTH AS WELL. SO THEY'RE NOT
RAISING THAT CONCERN AS WELL.
BUT CERTAINLY WE CAN. I CAN HAVE
MY STAFF LOOK INTO IT AGAIN AND
BE SURE THAT THAT'S NOT AN ISSUE
BUT THAT THAT'S NEVER COME UP,
AND I WAS NEVER AWARE THAT THAT
WOULD BE AN ISSUE BEFORE, BUT I
APPRECIATE YOU RAISING IT. SO WE
WANT TO BE SURE WE DO I AGREE
WITH YOU. WE DO NOT WANT TO BE
LIMITING REPRODUCTIVE CARE. I
APPRECIATE THAT AND I'LL HAVE MY
STAFF REACHED OUT TO YOUR STAFF
TO GET THAT INFORMATION BECAUSE
I JUST KNOW HOW VERY IMPORTANT
IT IS FOR. UM ARE TEENS AS
YOU'VE NOTED, YOU KNOW, RST HIGH
RATES ARE HIGHEST IN 15 TO 24
YEAR OLDS FOR THEM TO BE ABLE TO
COME IN AND GET THAT TREATMENT
THAT TESTING AND TREATMENT AND
ALSO YOU KNOW FOR PEOPLE WHO
ARE, UM INTERESTED IN GETTING
CONTRACEPTION, ESPECIALLY OUR
TEENS AND MAY NOT BE ABLE TO
TALK TO THEIR PARENTS ABOUT IT.
SO THANK YOU. THANK YOU. ANY
ANYONE ELSE? DO WE HAVE A MOTION
OR PARDON? OKAY YOU SAID OKAY.
OKAY. WE HAVE AN OKAY. MOTION
HAVE A SECOND. SECOND. THAT WAS
THAT WAS A SECOND MISS. THANK
YOU. SO WE WENT OKAY IN A
SECOND. UM SO, UM, THE MOTION
WOULD BE DO PASS AS AMENDED TO
APPROPRIATIONS AND THANK YOU FOR
THIS BILL. UM AND IF YOU'RE
TAKING CO AUTHORS, I'D LOVE TO
BE ADDED AS A CO OPERATIVES BILL
EXPLOSION OF C I S HAS HAS BEEN
REALLY, REALLY DRAMATIC. UM, AND
ANYTHING THAT CHALLENGES. ACCESS
TO PEOPLE TRYING TO GET CARE IS
PROBLEMATIC. SO THANK YOU FOR
BRINGING THE BILL FORWARD. UM
WOULD YOU LIKE TO CLOSE THANK
YOU. AND AGAIN, I THINK IT YOU
KNOW, WE DEFINITELY WANT TO BE
SURE THAT WE'RE NOT LIMITING
ACCESS TO ANY FOR REPRODUCTIVE
SERVICES. BUT ALSO JUST KEEP IN
MIND. WE HAVE MANY PEOPLE WHO
AREN'T ABLE TO GET TREATMENT,
WHICH THIS BILL AVAILED
THEMSELVES UP, AND SO, YOU KNOW,
PARTICULAR LGBTQ COMMUNITY AND
SO I THINK WE CAN TAKE CARE OF
BOTH. AND THIS BILL WILL ALLOW
US TO DO THAT. EXPECTEDLY ASKING
WHEN I VOTE. THANK YOU VERY
MUCH. MADAM SECRETARY. PLEASE
CALL THE ROLL. WOULD WOULD I?
WALDRON WALDRON, I AGUIAR-CURRY
AGUIAR-CURRY. AYE, ARAMBULA.
BIGELOW. BIGELOW NÓ. CARILLO.
FLORA MAIENSCHEIN MAZE, MCCARTY
CAESARIAN. RIVAS RODRIGUEZ
SANTIAGO WEBER. HOWEVER I WERE
TO 1 TO 1 WILL LEAVE THAT BILL
ON CALL WITH A MYRIAD OF OTHER
BILLS ON A CALL TODAY. UM SO YOU
HAVE ONE MORE BILL THIS EVENING
, DOCTOR PAN SP 12 96. THANK
YOU. CHAIR WOOD AND
ASSEMBLYMEMBER'S. I'M PLEASED TO
PRESENT SB 12 96, WHICH TAKES
THE NECESSARY STEPS TO EMPOWER
CALIFORNIA TO RAPIDLY DETECT AND
RESPOND TO EMERGING VIRAL
THREATS. AND YOU KNOW THE COVID
19 PANDEMIC EXPOSED THE LACK OF
ORGANIZED VIRAL SURVEILLANCE,
VIRAL SURVEILLANCE CAPACITY IN
BOTH UNITED STATES AND
CALIFORNIA. AND THIS DEFICIT
PUTS US BEHIND OUR PEER NATIONS
, WHERE THEY WERE ABLE TO MORE
QUICKLY IDENTIFY AND MORE
RAPIDLY RESPOND TO EMERGING
VARIANTS DURING THE PANDEMIC.
THIS SHORTCOMING IS PARTICULARLY
UNACCEPTABLE, GIVEN HOW
CALIFORNIA IS HOME TO WORLD
CLASS VIRAL SURVEILLANCE,
GENOMIC SEQUENCING FACILITIES.
AS A LEADER IN BIOTECH IN THE
WORLD. UNFORTUNATELY OUR STATE'S
VIRAL SURVEILLANCE LABS ARE
SILOED AND DISJOINTED, LACK REAL
TIME COMMUNICATIONS THAT WOULD
BE NECESSARY TO ENABLE AN
EFFECTIVE STATEWIDE VIRAL
SURVEILLANCE NETWORK. IMPROVE
OUR VIRAL SURVEILLANCE NETWORK.
SB 12 96 WILL DIRECT SEED PH TO
EVALUATE CALIFORNIA'S CURRENT
VIRAL SURVEILLANCE CAPACITIES
AND AFTER THE VALUATION CD PH
QUIRED TO ESTABLISH THE
CENTRAL VIRAL SURVEILLANCE HUB.
COMMUNICATION WITH VIRAL
SURVEILLANCE LABS ALL ACROSS THE
STATE. THE MONITORING RESPOND TO
VIRAL THREATS. LASTLY CPH WILL
BE REQUIRED TO PUBLISH THE VIRAL
GENETIC SEQUENCE OF ANY NEW
VIRAL THREATS IDENTIFIES ON ITS
WEBSITE SO THAT SCIENTISTS CAN
IMMEDIATELY BEGIN USING THE
VIRAL SEQUENCES TO IDENTIFY
POSSIBLE TREATMENTS. SB 12 96
WORDS PER CALIFORNIA ENSURE
TIMELY AND EFFECTIVE RESPONSES
TO NEW VIRUS OR VARIANTS WOULD
MAKE NOTE THAT CERTAINLY COVID
WILL NOT BE THE LAST VIRUS STILL
REAR ITS UGLY HEAD. UM THIS BILL
IS PASSED THROUGH THE SENATE
WITHOUT OPPOSITION. I
RESPECTFULLY ASK FOR YOUR VOTE,
AND I'M PLEASED TO HAVE AH,
SARAH HUCKABEE FROM THE
UNIVERSITY OF CALIFORNIA HERE TO
TESTIFY AND SUPPORT. THANK YOU.
PLEASE GO AHEAD. THANK YOU. GOOD
EVENING CHAIR WOOD AND MEMBERS.
I'M SARAH HUCKLE ON BEHALF OF
THE UNIVERSITY OF CALIFORNIA.
OVER THE PAST TWO YEARS. WE'VE
BEEN IN A STATE OF PERPETUAL
EMERGENCY WITH THE REACTIVE
STRATEGY TO THE NEW COVID
VARIANTS OR HEALTHCARE SYSTEMS
AND COMMUNITIES MUST NOW
TRANSITIONED TO A NEW NORMAL
WHERE COVID IS TREATED AS ONE OF
MANY ENDEMIC VIRUSES AND PREPARE
OURSELVES FOR THE NEXT PANDEMIC.
/C BELIEVES DR PANS BILL
ESTABLISHING A VIRAL
SURVEILLANCE HUB HELP ACHIEVE
THIS THROUGH THE EARLY DETECTION
OF FUTURE VARIANTS AND VIRAL
THREATS, ALLOWING PUBLIC HEALTH
SYSTEMS TIME TO PREPARE AND
REACT. YOU SEE IS ENDORSING THIS
IDEA BECAUSE SEVERAL OF OUR
CAMPUSES ARE ALREADY UTILIZING
THIS DATA DRIVEN APPROACH
THROUGH COMPREHENSIVE WASTEWATER
TESTING, AND WE HOPE OTHERS
ACROSS CALIFORNIA AND THE WORLD
WILL DO THE SAME. WASTEWATER
SURVEILLANCE SERVES AS AN EARLY
WARNING SYSTEM AND CAN BE USED
TO SET THRESHOLDS FOR PROACTIVE
PUBLIC HEALTH MEASURES. IN FACT
, THIS CONCEPT WAS INCLUDED IN
GOVERNOR NEWSOM'S SMARTER PLAN
RELEASED EARLIER IN FEBRUARY.
OUR DATA SHOW THAT WASTEWATER
SURVEILLANCE ACCURATELY PREDICTS
COVID COVERED TRANSMISSION WITH
A 123 WEEK WARNING, DEPENDING ON
THE VARIANT. WE KNOW THIS DATA
DRIVEN APPROACH WILL HELP
MITIGATE THE SPREAD OF COVID AT
ALL TIMES, BUT ESPECIALLY WHEN
WE KNOW A NEW WAVE IS
FORTHCOMING. C LOOKS FORWARD
TO CONTINUING OUR PARTNERSHIP
WITH THE STATE AND OTHER PUBLIC
HEALTH AND RESEARCH LABORATORIES
TO IDENTIFY AND SEQUENCE VIA NEW
VIRAL THREATS. THANK YOU, DOCTOR
PAN AND WE URGE YOUR I VOTE.
THANK YOU VERY MUCH OTHERS IN
SUPPORT. VIDEO BORN REPRESENTING
HEALTH OFFICERS ASSOCIATION, AS
WELL AS THE AMERICAN ACADEMY OF
PEDIATRICS, BOTH IN SUPPORT.
THANK YOU. KELLY BROOK SONYA FOR
THE COUNTY HEALTH EXECUTIVES
ASSOCIATION OF CALIFORNIA, ALSO
IN SUPPORT. THANK YOU. IS THERE
ANYONE IN OPPOSITION? NO ONE
WILL BRING IT BACK TO THE
COMMITTEE QUESTIONS OR COMMENTS
FROM THE COMMITTEE. I'M SORRY.
I'M SORRY. MY APOLOGIES. QUICK
ON THE DRAW HERE. IT'S MAYBE
ABLE TO HAVE LISA MINUTE. SURE
YOUR FUTURE WILL ALLOW THAT
ABSOLUTE HI. HI. UH GOOD EVENING
CHAIR. WOODS AND TWO REMEMBERS.
MY NAME IS TRINA WATCH BEFORE
SPEAKING ON BEHALF OF LABORATORY
PROFESSIONALS AND AS A MEMBER OF
STAND UP SACRAMENTO APPRECIATE
THIS WELL THOUGHT OUT ANALYSIS
AND SP 12 96 DOCTOR PEN HAS BEEN
DOING HIS HOMEWORK. I DO NOT
CLAIM TO BE AN EXPERT ON CHEN
DYNAMIC. EXCUSE ME GENOMIC
SEQUENCING, ALTHOUGH THIS IS THE
SCIENTIFIC METHOD TO DETECT
COMPLEX DISEASES AND THEIR
CAUSES. THAT WE USE. I WOULD ASK
THE COMMITTEE TO ABSTAIN FROM
VOTING ON THIS BILL TODAY. TO
ALLOW FURTHER ANALYSIS. AND
OPPOSITIONAL EXPERTS. TO WEIGH
IN. MAYBE AN EXPERT FROM
HOMELAND SECURITY. OR. AN EXPERT
IN GENOMIC, SKINNY GENOMIC
SEQUENCING DUE TO INVOLVING THIS
IS FROM THE BILL INVOLVING OTHER
OUTSIDE ENTITIES TO CONDUCT NEXT
GENERATION SEQUENCING AND
ANALYSIS. DUE TO THE SENSITIVITY
OF PROTECTING DATA SHARING.
INCLUDING ALSO, WE WILL BE WHO
WILL BE FUNDING THIS. IN
CALIFORNIA AFFORD BILLIONS OF
DOLLARS ON THIS HUB PROJECT. SO
WITH THAT SAID. WE NEED TO HAVE
MORE DISCUSSIONS ON THE
FRAMEWORK OF THIS BILL. SO
CALIFORNIANS CAN ONCE AGAIN
BEGIN TO TRUST THE SCIENCE
COMMUNITY. SO I THANK YOU. CHAIR
WOODS IN AND THIS COMMITTEE. AND
GIVING ME THE TIME TO SPEAK.
THANK YOU. THANK YOU. I WOULD,
UM. BRING IT BACK TO THE
COMMITTEE QUESTIONS OR COMMENTS.
I WOULD JUST SAY THAT THE BILL'S
BEEN IN PRINT FOR QUITE A WHILE.
SO THERE WAS THERE IS
OPPORTUNITY IF OTHERS CHOSE TO,
UM, TO APPROACH US WITH
OPPOSITION. EVEN IF THE
DEPARTMENT OF HOMELAND SECURITY
HAD OPPOSITION. WE WOULD LOVE TO
HEAR ABOUT THAT. BUT WE DID NOT.
WE DID NOT. AND WE HAVE NOT. WE
HAVE WE'VE RESPONDED TO WHAT WE
HAVE BEEN WAS BEEN PROVIDED TO
US. AND THAT'S WHY THE BILL IS
BEFORE US IN THE CURRENT STATE.
UM SO LOOKING FOR A MOTION OR
MOTION BY DR WEBBER, A SECOND BY
MS AGUILAR CURRY. MOTION WOULD
BE DO PASS THROUGH
APPROPRIATIONS. DR PAM WOULD YOU
LIKE TO CLOSE? I APPRECIATE THE
SUPPORT FROM THE SCIENTIFIC,
MEDICAL AND PUBLIC HEALTH
COMMUNITY FOR THIS BILL. THIS IS
ABOUT BEING SURE WE HAVE A GOOD
EARLY WARNING SYSTEM. I
RESPECTFULLY ASK FOR AN I VOTE.
THANK YOU VERY MUCH. DOCTOR PAN
. UM AND WE'LL GO AHEAD AND HAVE
MADAM SECRETARY. PLEASE CALL THE
ROLL. WOULD WOULD I, WALDRON
WALDRON, I AGUIAR-CURRY
AGUIAR-CURRY. AYE, ARAMBULA.
BIGELOW. BIGELOW, NOT VOTING.
CARILLO. FLORA MAIENSCHEIN MAZE.
MAYS I'M MCCARTY NAZARIAN RIVAS
RODRIGUEZ SANTIAGO. ARAMBULA?
AYE. WEBER. HOWEVER, I. 6 TO 0.
WE HAVE SIX VOTES WILL LEAVE
THAT BILL ON CARBON BEFORE YOU
GO. PLEASE. UM JUST LIKE TO TAKE
A MOMENT TO RECOGNIZE YOU, DR.
PAM THANK YOU, UM, YOUR PASSION
, YOUR COURAGE AND YOUR
ACCOMPLISHMENTS. UM, THIS IS
YOUR LAST YEAR IN THE
LEGISLATURE. UM YOU'LL BE
CHAIRING SENATE HEALTH TOMORROW
LIKELY FOR THE LAST TIME,
ALTHOUGH WE NEVER KNOW IN THIS
BUSINESS OR MAYBE AN EMERGENCY
HEARING OF SOME SORT, BUT, UM,
BUT AS A LONGTIME PEDIATRICIAN,
YOU BROUGHT YOUR WEALTH. YOUR
KNOWLEDGE ABOUT HEALTHCARE AND
MEDICINE TO EVERY DISCUSSION. UM
YOU'VE BEEN A FIERCE DEFENDER OF
SCIENCE, UH, AND OF HEALTHY AND
SAFE PRACTICES AND PROTOCOLS AS
WE'VE WORKED THROUGH THE COVID
PANDEMIC. UM YOU'VE BEEN A
SUPPORTER AND SOMETIMES
SIGNIFICANT ADVERSARY OF MY WORK
. BUT IN THE END, WE BOTH HAVE
THE SAME GOALS IN MIND, UM, TO
MAKE CALIFORNIANS HEALTHIER.
SAFER AND HAPPIER. I WISH YOU
THE BEST AS YOU CONTINUE TO DO
GOOD WORK FOR THE HEALTH AND
BENEFIT FOR ALL OF US. THANK YOU
VERY MUCH. DOCTOR, PAM. WELL,
THANK THANK YOU, DOCTOR WOULD
JUST SAY BRIEFLY, BECAUSE I
GUESS YOU HAVE A CHANCE TO SAY A
LITTLE MORE TOMORROW AGAIN.
THANK YOU FOR YOUR LEADERSHIP
AND HOPEFULLY, WE HAVEN'T REALLY
BEEN ADVERSARIES AS MUCH AS
WE'VE HAD DIFFERENCES OF OPINION
. THERE YOU GO. OKAY BUT WE
THINK WE HAVE WE SHARE THE SAME
VALUES AND GOALS. SO THANK YOU.
SO MUCH FOR YOUR LEADERSHIP. AND
THANK YOU FOR THE
ACKNOWLEDGMENT. THANK YOU. THANK
YOU, DR PAM. YEAH. OKAY, MR
WIENER. HAVE. AS SOME OF THE END
OF THE ALPHABET. I KNOW WHAT
THIS IS LIKE, UM YOU HAVE THE
FINAL THREE BILLS OF HAVING
WORSE THAN I DO. I THINK I DO.
BUT MAYBE NOT IN I MEAN, ANYWAY
. SOMETIMES SCOTT WILL COMES
ALONG AND I CAN BE THE SECOND TO
LAST. NOT QUITE THE CABOOSE
THEN, OKAY? HEY DO YOU WANT ME
TO GO IN A PARTICULAR ORDER? YOU
CAN. HOW ABOUT, UH, LET'S START
IN NUMERICAL ORDER 2 TO 5. GREAT
UM SO COLLEAGUES, SP TWO D FIVE,
IS CLEAN UP LEGISLATION TO
CENTER BUILT TO 21, WHICH I
AUTHORED LAST YEAR IN THE
LEGISLATURE PASSED. WITH STRONG
BIPARTISAN SUPPORT. AH THANK
YOU, MADAM VICE CHAIR FOR FLOOR
MANAGING THAT BILL, UH, TO
ENSURE TIMELY ACCESS TO FOLLOW
UP MENTAL HEALTH APPOINTMENTS.
WE WORKED WITH THE DEPARTMENT OF
MANAGED HEALTH CARE. AND OTHER
STAKEHOLDERS ON SOME NEED TO
CLEAN UP, MAKE SURE THERE WERE
NO LOOPHOLES IN THE LEGISLATION
AND I RESPECTFULLY ASK FOR YOUR
VOTE. UM, AND IT ISN'T AUTHOR
BILL. VERY WELL, THEN IT'S A YOU
SAID IT IS AN AUTHOR SPONSORED
BILL. YES, I HAVE NO NO
WITNESSES FOR YOU. I THINK THIS
COUPLE IS HERE FOR ONE OF MY
OTHER OH, YOU'RE ON FOR THIS
ONE. OKAY? SORRY. SHE BEGS TO
DIFFER. OKAY ALRIGHT, MISS
COUPLE. PEOPLE'S HEALTH ACCESS.
PLEASED TO BE HERE AND SUPPORT.
UM THIS IS A TECHNICAL CLEANUP
BILL, BUT IT'S TAKEN A LOT MORE
WORK THAN MOST TECHNICAL CLEANUP
BILLS. WE ARE PLEASED TO BE HERE
IN SUPPORT. THANK YOU VERY MUCH
. UM ARE THERE OTHERS IN SUPPORT
OF THIS COMPLICATED TECHNICAL
CLEANUP BILL? IS THERE ANYONE IN
OPPOSITION? SO YOU KNOW ONE.
BRING IT BACK TO THE COMMITTEE
FOR QUESTIONS OR COMMENTS ANY
QUESTIONS OR COMMENTS THE
COMMITTEE WE HAVE A MOTION
SEARCH OF IT. SECOND ARE YOU
SAYING AND SO WE HAVE A MOTION
BY DR ARAMBULA, SECOND BY MS
AGUILAR CURRY OF THE MOTION IS
DUE PASS TO APPROPRIATIONS.
WOULD YOU LIKE TO CLOSE SENATOR?
RESPECTFULLY ASK FOR MY VOTE.
THANK YOU VERY MUCH. UM ADAM,
CHIEF CONSULTANT, WOULD YOU
PLEASE CALL THE ROLL? WOULD
WOULD I, WALDRON. NOT VOTING,
NOT VOTING CURRY. AGUIAR-CURRY
AYE ARAMBULA ARAMBULA. AYE,
BIGELOW. BIGELOW, NOT VOTING
CARILLO. LARA. MAIENSCHEIN MAZE.
MATE, I MCCARTY THE SYRIAN.
RIVAS RODRIGUEZ SANTIAGO WEBER.
HAVE FOUR VOTES THAT WILL LEAD
THE BILL ON CALL. WE'VE GOT A
LOT OF MEMBERS THAT SIMPLY
AREN'T HERE. THANK YOU, UH,
TERROR NEXT SP 8 53 SO
COLLEAGUES. FIRST OF ALL, I
WOULD LIKE TO BEGIN BY ACCEPTING
THE COMMITTEE AMENDMENTS LISTED
IN THE AND ACTUALLY, UM, YOU
KNOW, I JUST REALIZED MR
CHAIRMAN IN SP TO DO FIVE. THERE
ARE AMENDMENTS AND WHICH I AM
ACCEPTING THANK YOU FOR HELPING
US OUT AND PEOPLE NEED TO DO A
NEW MOTION. WE THINK WE THINK
YOU DID THAT. YOU ACCEPT THE
AMENDMENTS. OKAY OKAY. WE'LL
JUST CLARIFYING THAT. WHERE. WE
MOVED IT AS DO PASS AS AMENDED.
A WONDERFUL THANK YOU. YES SO
ANYWAY, BACK TO US SO TECHNICAL
THAT WE'RE ALL LOST IN THE
TECHNICALITIES OF WHAT WE'RE
DOING HERE. SO BACK TO SP 53
ALSO ACCEPT THE COMMITTEE'S
AMENDMENTS. UM THIS BILL, WHICH
WILL EXPAND CONTINUITY OF CARE
UM, EXCUSE ME, UM, SPF 531 FOR
THE PATIENTS CAN ACCESS
CRITICALLY IMPORTANT. MEDICATION
AND AVOID A LAPSE IN TREATMENT.
THE BILL REQUIRES HEALTH PLANS
AND INSURERS TO CONTINUE TO
COVER PREVIOUSLY PRESCRIBED
MEDICATION. INCLUDING THE DOSE
AND DOSAGE FORM. AND EXPANDS
DURING THE PENDENCY OF AN APPEAL
, AND IT EXPANDS CALIFORNIA'S
PROHIBITION ON NONMEDICAL
SWITCHING TO INCLUDE DOSE AND
DOSAGE FORM. MANY CALIFORNIANS
EXPERIENCING CHRONIC ILLNESS
RELY ON PRESCRIPTION MEDICATIONS
TO LIVE FUNCTIONAL LIVES OR EVEN
SURVIVE. SOME CHRONIC ILLNESSES
, FOR EXAMPLE, INFLAMMATORY
BOWEL DISEASE, UM, HAVE A
LIMITED NUMBER OF TREATMENTS
AVAILABLE. UM WE NEED TO MAKE
SURE THAT WHEN PEOPLE HAVE BEEN
PRESCRIBED MEDICATION THEY CAN
CONTINUE. AND THEN, WHEN A
HEALTH PLAN DENIES THAT
CONTINUANCE THEY CAN BE COVERED
DURING THE APPEAL. AND IF A NEW
FORM OF DOSE DOZING COMES, UH,
INTO BEING THAT'S MORE EFFECTIVE
. WE WANT TO MAKE SURE THAT THAT
IS COVERED AS WELL. RESPECTFULLY
ASKED FOR AN I VOTE AND WITH ME
TODAY, TESTIFY ARE VERONICA
BLANK. KADO AND RYAN SPENCER.
OKAY, THANK YOU. LET'S GO AHEAD.
GOOD EVENING, AND THANK YOU, MR
CHAIR AND MEMBERS OF THE HEALTH
COMMITTEE. MY NAME IS VERONICA
BLANK. KADO AND I HAVE LIVED
WITH CRONES DISEASE FOR THE LAST
17 YEARS, WHICH IS MORE THAN
HALF OF MY ENTIRE LIFE. IN 2015
. I COLLAPSED AT WORK AND WAS
RUSHED TO THE HOSPITAL WITH AN
ABSCESS THE SIZE OF A GRAPEFRUIT
IN MY ABDOMEN. ONE OF THE MANY
COMMON COMPLICATIONS OF CHRONIC
DISEASE. WILD HOSPITALIZED. MY
DOCTOR RECOMMENDED I SWITCHED
MEDICATIONS FROM REMICADE TO
HUMIRA. BOTH DRUGS WHICH FALL
UNDER THE SCOPE OF THIS BILL
BEING PRESENTED TODAY. I'VE
TAKEN HUMIRA FOR ALMOST SEVEN
YEARS. NOW IT HAS SINGLE
HANDEDLY SAVED MY LIFE. BUT IT
TOOK ALMOST EIGHT MONTHS TO GET
THAT PRESCRIPTION APPROVED
BECAUSE THE DOSE PRESCRIBED TO
ME BY MY DOCTOR WAS CONSIDERED
OFF LABEL. AND THE ASSOCIATED
APPEAL PROCESS WAS A GARGANTUAN
FEET, ESPECIALLY FOR A
CHRONICALLY ILL 25 25 YEAR OLD.
WITHIN THAT EIGHT MONTH TIME
PERIOD THAT I SPENT MOSTLY ON
MEDICATED. MY SYMPTOMS RETURNED
WITH A VENGEANCE, AND I WAS
FORCED TO UNDERGO SURGERY. THE
SECOND ONE, I WOULD HAVE THUS
FAR. I'LL NEVER KNOW IF HAVING
ACCESS TO HUMIRA SOONER COULD
HAVE SPARED ME THAT SECOND
SURGERY. LIKE I MENTIONED HUMIRA
SAVED MY LIFE, AND IT TOOK MANY
VARIATIONS OF DOSES AND
FREQUENCIES FOR THAT TO HAPPEN.
ALMOST ALL OF THEM CONSIDERED
OFF LABEL AND NEARLY ALL OF THEM
REQUIRING A LENGTHY PRIOR
AUTHORIZATION, APPEAL AND
APPROVAL PROCESS. IT WAS THIS
TIME THAT GAVE MY DISEASE THE
OPPORTUNITY TO HOLD ME HOSTAGE
ONCE AGAIN. THIS BILL WILL
ENSURE THAT MY DAUNTING
EXPERIENCE DOES NOT BECOME THE
STATUS QUO AND GIVE THESE LIFE
CHANGING MEDICINES THE PLATFORM
THAT THEY NEED TO DO WHAT
THEY'RE INTENDED TO DO. SAVE
LIVES LIKE MINE. I'M HONORED TO
BE A PART OF THIS NOBLE PROCESS
TOWARDS PRESCRIPTION DRUG
COVERAGE REFORM AND I URGE YOU
TO VOTE YES, ON THIS BILL. THANK
YOU FOR THE OPPORTUNITY TO SHARE
MY EVERY PERSONAL STORY TODAY
AND FOR YOUR TIME AND ATTENTION
TOWARDS MAKING THE FEAR OF
APPEALS PROCESS FOR THE MILLIONS
OF PEOPLE WITH IRRITABLE BOWEL
DISEASE NO LONGER A REALITY.
THANK YOU. RENT SPENCER ON
BEHALF OF THE CALIFORNIA SORRY,
RYAN SPENCER HAVE THE CROHN'S
AND CLYDE IS FOUNDATION. THE
SPONSORS OF THIS MEASURE,
UNFORTUNATELY, OTHER WITNESS DR
CDVA ABBASI, A GASH IN OLOGISTS
SPECIALIZE IN THE PLAN. NATORI
BOWEL DISEASE. IBD IS NOT ABLE
TO ATTEND TODAY, SO I'LL BE
PROVIDING PORTIONS OF HER
TESTIMONY. FIRST SET EXAMPLES OF
HOW EIGHT SB 853 WILL HELP
PATIENTS ACROSS ALL FIELDS OF
MEDICINE. IBD IS A CHRONIC
AUTOIMMUNE CONDITION. THE
RESULTS IN INFLAMMATION OF THE
INTESTINAL TRACT, WHICH CAN LEAD
TO SYMPTOMS OF SEVERE ABDOMINAL
PAIN, ABNORMAL BOWEL MOVEMENTS
AND BOWEL OBSTRUCTIONS AND
CANCER. POSITIONS CONTROL THIS
DISEASE WITH MEDICATIONS THAT
MODULATE THE IMMUNE SYSTEM. AND
I'VE LEARNED IN RECENT YEARS THE
CONSEQUENCES PATIENTS WILL
EXPERIENCE IF THEY DO NOT
RECEIVE THE RIGHT MEDICATION AT
THE RIGHT DOSE AT THE RIGHT
TIME. DR BASSEY HAS WITNESSED
HER PATIENTS GO THROUGH LENGTHY
. WE AUTHORIZATION APPEALS
PROCESSES, BUT THEY'RE STABLE
MEDICATIONS, RESULTING IN MISSED
DOSES THAT FURTHER RESULT IN
COMPLICATIONS, INCLUDING
RECURRENT SYMPTOMS LEADING TIME
OFF WORK. VISITS TO THE URGENT
CARE AND EMERGENCY DEPARTMENT.
DURING THAT TIME, SOME OF
PATIENTS HAVE DEVELOPED
ANTIBODIES TO THE MEDICATION,
RENDERING INEFFECTIVE AND
REQUIRING A SWITCH TO A
DIFFERENT MEDICATIONS, WHICH MAY
OR MAY NOT WORK FOR THEM. AND
FINALLY, WHEN SHE HAS HAD SHE'S
HAD A FEW PATIENTS DEVELOP A
SEVERE FLARE IN THEIR DISEASE
REQUIRE HOSPITALIZATIONS AND
EVEN SURGERY ON THE GI TRACT. SB
53 ALLOWS YOUR PATIENT
PROTECTIONS FROM COMPLICATIONS
DUE TO DELAYS IN THEIR STABLE
THERAPIES ARE FOCUSES IBD. A
BILL LIKE THIS WOULD PROTECT ALL
PATIENTS AND FIELDS AND
MEDICINES AND FILL THE MEDICINE,
INCLUDING ONCOLOGY RHEUMATOLOGY
IN DERMATOLOGY. AND IS SUPPORTED
BY A RANGE OF PATIENT
ORGANIZATIONS. PROVIDERS. THANK
YOU AND WE ASK FOR YOUR SUPPORT.
THANK YOU VERY MUCH OTHERS IN
SUPPORT, PLEASE. HI I'M
MARGUERITE CASILLAS,
REPRESENTING THE NATIONAL
MULTIPLE SCLEROSIS SOCIETY. AND
I AM A PERSON WITH M S IN STRONG
SUPPORT. THANK YOU. HARMONY WAS
MILICIC GUY FOR THE CALIFORNIA
ASSOCIATION OF ORTHODONTISTS
STRONG THANK YOU. GRANT AND
MARCH WITH THE CALIFORNIA
MEDICAL ASSOCIATION AND SUPPORT. TWO MEN REPRESENT THE
CALIFORNIA RHEUMATOLOGY ALLIANCE
AND THE CALIFORNIA CHAPTER OF
THE AMERICAN COLLEGE OF
CARDIOLOGY AND SUPPORT. THANK
YOU. STEPHEN SCHULTZ WITH THE
ARTHRITIS FOUNDATION IN SUPPORT.
JENNIFER SNYDER ON BEHALF OF THE
CALIFORNIA LIFE SCIENCES AND
SUPPORT. ALEX CON CALIFORNIA
CHRONIC CARE COALITION AND
STRONG SUPPORT. THANK YOU VERY
MUCH. ANYONE ANYONE ELSE? SEE?
NO ONE WILL GO TO OPPOSITION.
GOOD EVENING, MR CHAIR MEMBERS
OF THE COMMITTEE JED HAMPTON
HERE WITH THE CALIFORNIA
ASSOCIATION OF HEALTH PLANS.
REGRETTABLY WE ARE IN OPPOSITION
SP 8 53 I WISH WOULD REQUIRE
HEALTH PLANS AT COVERAGE, NINE
MEDICATION OR DOSAGE OF
MEDICATION OR A DOSAGE FORM OF
THE MEDICATION DURING THE
DURATION OF THE APPEALS PROCESS.
I WOULD LIKE TO THANK THE AUTHOR
AND THE SPONSORS AND THE
COMMITTEE STAFF AND WE HAVE HAD
SOME THOUGHTFUL CONVERSATIONS ON
THIS BILL TO DATE. HOWEVER
UNFORTUNATELY WE ARE STILL
OPPOSED TO THE BILL TODAY.
HEALTH PLANS RELY UPON SEVERAL
CRITICAL UTILIZATION MANAGEMENT
PROTOCOLS TO ENSURE THAT
PATIENTS RECEIVE THE RIGHT CARE
AT THE RIGHT TIME FROM THE RIGHT
PROVIDER. I KNOW WE'VE HEARD A
LOT ABOUT THAT TODAY, UM, WITH
THESE PROTOCOLS ARE CRITICALLY
IMPORTANT TO PROMOTING SAFE
EFFECTIVE, AFFORDABLE CARE FOR
OUR PLAN ENROLLEES PRIOR
AUTHORIZATION STEP THERAPY.
PROTOCOLS ARE PARTICULARLY
IMPORTANT FOR PRESCRIPTION DRUG
COVERAGE, CONSIDERING THE
POTENTIAL FOR ABUSE AND
ADDICTION, AS WELL AS THE HIGH
COST OF THESE DRUGS.
UNFORTUNATELY FROM OUR
PERSPECTIVE, SPF 53 WOULD
BROADLY DISMANTLE EXISTING
UTILIZATION MANAGEMENT PROCESSES
FOR PRESCRIPTION DRUGS. AH SPF
53 EFFECTIVELY NEGATES OUR
ABILITY TO ENSURE CLINICALLY
APPROPRIATE USE FOR PRESCRIPTION
DRUGS AND MAY ALSO ENCOURAGE THE
USE OF EXPENSIVE SPECIALTY AND
BRAND NAME DRUGS. WHEN A GENERIC
OR LOWER COST BRAND EQUIVALENT
IS AVAILABLE IN A CLINICALLY
APPROPRIATE ADDITIONALLY, WE ARE
CONCERNED ABOUT SOME POTENTIAL
SAFETY ISSUES AT THIS BILL MAKER
, UM MAY CREATE FOR OUR
ENROLLEES. IT'S REALLY IMPORTANT
TO NOTE THAT WHEN A PLAN CHOOSES
TO LIMIT OR DENY A DRUG OR A
SPECIFIC DOSE OF A DRUG OR A
DOSAGE FORM. UH IT'S ALMOST
ALWAYS FOR SAFETY REASONS.
SPECIFIC REASONS INCLUDE
POTENTIAL ABUSE OR OVERUSE.
INCONSISTENT USE WITH FDA
APPROVED LABELING. OR TO PREVENT
USES AT DOSES THAT HAVE NOT BEEN
STUDIED OR SHOWN TO BE
EFFICACIOUS. I DO KNOW THAT THE
BILL OBVIOUSLY IS FOCUSED, YOU
KNOW, HASN'T IBD FOCUS AND
CERTAINLY APPRECIATE THAT.
HOWEVER THIS BILL IS NOT LIMITED
TO THE DRUGS THAT TREAT YOU KNOW
ONE OR TWO OR THREE SPECIFIC
CONDITIONS. IT IS. IT IS
EXPANSIVE AND COVERS ALL
PRESCRIPTION DRUGS, WHICH IS
PART OF THE REASON FOR THE
CONCERN. OH WE ARE ALSO
CONCERNED ABOUT THE DRAMATIC
INCREASE IN COSTS FOR HEALTH
CARE DELIVERY THAT THIS BILL MAY
CREATE, AS YOU KNOW, THE BILL IS
ANALYZED BY TO BURP AND WILL
INCREASE PREMIUMS ON CALIFORNIA
RATEPAYERS BY $75 MILLION, AS
WELL AS AN ADDITIONAL 10
MILLION. IN ADDITIONAL COST
SHARING. SO FOR THESE REASONS,
WE BELIEVE THAT CALIFORNIA IS
RIGHTLY FOCUSED ON ACHIEVING
THIS, UM, THIS AFFORDABLE
COVERAGE HERE IN THE STATE, AND
UNFORTUNATELY FOR THESE REASONS,
WE ARE OPPOSED TO S P 53 OVING
FORWARD, BUT I WOULD LIKE TO
THANK THE AUTHOR AGAIN FOR
CONTINUING TO WORK WITH US.
THANK YOU. THANK YOU. MR CHAIR
MEMBER, STEPHANIE WATKINS ON
BEHALF OF THE ASSOCIATION OF
CALIFORNIA LIFE AND HEALTH
INSURANCE COMPANIES AND THE
INTEREST OF TIME I KNOW IT'S
LATE. I'D LIKE TO ECHO MANY OF
MY COLLEAGUES COMMENTS AND JUST
HIGHLIGHT. I THINK WE'VE SEEN
SEVERAL BILLS HERE TODAY TO
DISCUSS UTILIZATION MANAGEMENT.
I THINK IN GENERAL, OUR CONCERN
IS THE NARRATIVE THAT IT'S
REALLY INTENDED TO BE PUNITIVE
OR TO RESTRICT ACCESS. AND TRULY
, IT IS ABOUT ENSURING THAT
PATIENTS HAVE THE ACCESS TO THE
RIGHT DRUGS AT THE RIGHT TIME,
THE RIGHT SERVICES AND TO ENSURE
THE SAFETY AND EFFICACY OF THOSE
SERVICES THAT ARE PROVIDED. I
THINK WE ARE CONCERNED THAT THE
INCREASE IN DOSAGE UM I KNOW WE
HAD SOME EARLY CONVERSATIONS
WITH THE AUTHOR'S OFFICE ABOUT
ENSURING THAT IF SOMETHING IS
DISAPPROVED, BASED ON CONCERN OF
SAFETY OF THE PATIENT THAT THAT
MAY BE TAKEN IN A DIFFERENT
PERSPECTIVE, OR LOOKED AT
DIFFERENTLY. UNFORTUNATELY THE
BILL TODAY DOES STILL EXEMPT. UM
THE PRIOR AUTHORIZATION PROCESS
DURING THAT APPEALS PROCESS AND
ALSO LIKE TO POINT OVER THE LAST
DECADE. OUR MEMBERS HAVE WORKED
CLOSELY WITH COMMITTEE STAFF
ABOUT WAYS TO SPEED UP THE
PROCESS. THERE'S A 24 AND 72
HOUR PROCESS FOR PRIOR
AUTHORIZATION FOR THE USE OF
PRESCRIPTION DRUGS. WE ALSO
MOVED TO A SINGLE FORM PROCESS
SO THAT PROVIDERS COULD MORE
EASILY APPLY FOR PRIOR
AUTHORIZATION FOR THOSE DRUGS,
SO UNFORTUNATELY, TODAY WE ARE
OPPOSED TO THIS MEASURE. WE DO
LOOK FORWARD TO CONTINUING THOSE
CONVERSATIONS, THOUGH IT THE
BUILD MOVES FORWARD AS WE ARE.
SINCERELY CONCERNED ABOUT THE
SAFETY OF PATIENTS, ESPECIALLY
IF SOMETHING IS DENYING BASED ON
SAFETY REASONS. THANK YOU.
OTHERS IN OPPOSITION. MR CHAIR
MEMBERS. JOHN WINGER ON BEHALF
OF AMERICA'S HEALTH INSURANCE
PLANS ALSO OPPOSED. OKAY. THANK
YOU VERY MUCH. ANYONE ELSE? YOU
KNOW, WE'LL BRING IT BACK TO THE
COMMITTEE QUESTIONS OR COMMENTS
ANY QUESTIONS OR COMMENTS FROM
THE COMMITTEE FOR THE AUTHOR? DR
WEBBER. THANK YOU. CHAIR. I JUST
WANT TO THANK THE AUTHOR FOR
BRINGING THIS BILL FORWARD. UM,
YOU KNOW, AS A PRACTICING
PHYSICIAN UM, GETTING
AUTHORIZATIONS.
PREAUTHORIZATIONS IS VERY
CHALLENGING, NOT ONLY FOR ME,
BUT ALSO FOR THE PATIENTS THAT
HAVE TO WAIT. AND WAIT AND WAIT.
AND I THINK YOU KNOW, UM YOU
KNOW WHEN WE TALK ABOUT THE
RIGHT DRUGS AT THE RIGHT TIME,
UM A LOT OF TIMES THAT THAT IS A
DISCUSSION BETWEEN THE PATIENT
AND IS HER PROVIDER. UM AND, UM
I HAVE PERSONALLY NEVER HAD A
DRUG DENIED FOR SAFETY REASONS.
OFTENTIMES IT'S A COST ISSUE. UM
OR SOMETHING ELSE, AND I THINK
THAT THE PROVIDER WOULD NOT
PRESCRIBE SOMETHING BECAUSE
WE'RE TALKING ABOUT LICENSED
PEOPLE HERE IN CALIFORNIA THAT
WOULD PURPOSELY BE UNSAFE FOR A
PATIENT, SO I JUST WANT TO THANK
YOU FOR BRINGING THIS. THIS BILL
FOR IT. IT IS DEFINITELY GOING
TO HELP OUT OUR PATIENTS AND OUR
PROVIDERS HERE IN CALIFORNIA.
THANK YOU VERY MUCH ANYONE ELSE?
WE DO HAVE A MOTION BY DR
ARAMBULA AND WE HAVE A SECOND I
CAN'T BY DR WEBBER. UM MOTION
WOULD BE DO PASTOR
APPROPRIATIONS. UH SENATOR
WIENER. WOULD YOU LIKE TO CLOSE
? THANK YOU. I APPRECIATE IT. I
JUST WANT TO REALLY JUST CRYSTAL
CLEAR. THIS IS THE TWO PARTS OF
BILL. IT'S YOU'RE ALREADY TAKING
MEDICATION, AND IT NEEDS TO BE
REAUTHORIZED AND THE HEALTH PLAN
DOESN'T REAUTHORIZE IT. SHOULD
YOU THEN HAVE TO GO? OFF OF THAT
DRUG. OR HOWEVER MANY MONTHS IT
TAKES TO RESOLVE THE APPEAL AND
THE BILL SAYS NO. THEY HAVE TO
CONTINUE TO COVER IT UNTIL THE
APPEAL IS OVER. AND THEN IF YOU
HAVE A DIFFERENT KIND OF DOSAGE
OR DOSAGE FORM, THAT'S A IT IS
NOW CREATED THAT YOU WERE ON A
PATCH. BUT NOW THERE'S AN
INJECTION AND YOUR DOCTOR THINKS
THAT OF THE SAME DRUG DOCTOR
THINK IT'S MORE EFFECTIVE. UM
I'M GONNA GO. I'M GONNA GO WITH
THE DOCTOR, AND THAT'S WHAT THE
BILL DOES. AND I RESPECTFULLY
ASK FOR AN I VOTE. THANK YOU
VERY MUCH. SENATOR WIENER MET
MOTION IS DO PASS THROUGH
APPROPRIATIONS. MADAM SECRETARY,
PLEASE CALL THE ROLL. WOULD,
WOULD I, WALDRON. ALTERNATE
VOTING AGUIAR-CURRY COREY I
ARAMBULA ARAMBULA. AYE, BIGELOW.
PICCOLO NOT VOTING. CARILLO
CARILLO? AYE FLORES. FLOOR IS
NOT VOTING MAIENSCHEIN. MAZE.
AMAZIGH MCCARTY MCCARTHY, I
NAZARIAN NAZARIAN I RAPIST RIVAS
IRODRIGUEZ. RODRIGUEZ I,
SANTIAGO WEBER. HOWEVER, I. AND
ZERO BILL HAS 10 VOTES AT BILLS
OUT OF COMMITTEE. THAT'S THE
FIRST ONE OUT OF COMMITTEE AND
SEVERAL HOURS WE'LL REJOICE IN
THAT AND MOVE ON TO THE FINAL
BILL OF THE EVENING, SENATOR
WIENER A B S. B 8 58. THANK YOU
VERY MUCH, MR CHAIR, AND I ALSO
WANT TO START BY, UM, ACCEPTING
THE COMMITTEE'S AMENDMENTS. SO
THANK YOU. UM AND OF COURSE, ONE
OF THE AMENDMENTS WERE MAKING TO
THE BILL IS MAKING THE 25,000
COP AS OPPOSED TO A MINIMUM. SO
COLLEAGUES SP 858 IS LONG
OVERDUE, A LONG OVERDUE UPDATING
OF THE PENALTIES, UH, FOR HEALTH
PLANS THAT VIOLATE STATE LAW. UM
CURRENTLY THE MAXIMUM, UH,
PROVIDE MAXIMUM FINE. PROVIDE
ELATION. UH IS $2500 AND THAT
WAS SET. WHEN I WAS A CHILD, AND
I'M GETTING UP THERE. AND SO IT
WAS A LONG TIME AGO. AH MORE
THAN 40 YEARS, I BELIEVE. AND SO
IT'S TIME TO UPDATE THE REALLY
SPECIFIC IT'S OKAY. BUT IF YOU
WANT TO, THAT'S FINE, OKAY.
THERE WE GO. UM HA HA! AND SO
THIS WILL BRING IT UP TO A
MINUTE MAXIMUM WITH THE
AMENDMENTS AND MAXIMUM 25,000.
YOU KNOW, WE WANT TO MAKE SURE
WE PASS GO THROUGH THIS
COMMITTEE. LAWS TO SET THE
STANDARDS FOR HEALTH PLANS SO
THAT PEOPLE CAN GET THE
COVERAGE. WHICH YOU'RE ENTITLED,
AND PEOPLE CAN GET THE TREATMENT
TO WHICH THEY'RE ENTITLED. AND
WE WANT THE HEALTH PLANS TO
FOLLOW THE LAW JUST TO BE CLEAR.
OVERWHELMINGLY THE HEALTH PLANS
DO FOLLOW THE LAW, BUT SOMETIMES
THEY DON'T AND THERE'S SOME
PLANS THAT TAKE EXTRA LIBERTY
AND WE WANT TO MAKE SURE THAT
THESE FINES ARE NEVER VIEWED AS
A COST OF DOING BUSINESS. THEY
NEED TO BE HIGH ENOUGH THAT THEY
DISSUADE THE VIOLATION. SO IT'S
THIS IS JUST MODERNIZING THE
PENALTY STRUCTURE AND I
RESPECTFULLY ASK FOR YOUR I
VOTE. WITH ME TODAY ARE MISS
COUPLE IS BACK, UM, AS WELL AS
JASMINE HICKS. THANKS. PLEASE GO
AHEAD. HI. GOOD EVENING. THANK
YOU. MY NAME IS JASMINE HICKS
AND I'M THE MOTHER OF TWO
DAUGHTERS INTO 32,013. MY ELDEST
WAS DIAGNOSED WITH MULTIPLE
SERIOUS MENTAL ILLNESSES. KAISER
OFFERED US A FEW PAMPHLETS AND
SENT US HOME. THAT SAME YEAR,
GMHC CITED KAISER FOR SYSTEMIC
VIOLATIONS OF CALIFORNIA'S
MENTAL HEALTH PARITY ACT AND
OTHER LAWS. THEY WERE FINED $4
MILLION. A DROP IN THE BUCKET
COMPARED TO THEIR REPORTED
PROFITS THAT YEAR OF 2.7
BILLION. IN 2019, MY DAUGHTER'S
SUICIDAL IDEATIONS GREW
ALARMING. WE BEGAN PLEADING WITH
KAISER FOR THERAPY AND HELP WE
WERE TOLD THERE WERE NO
THERAPIST AVAILABLE. SINCE THEN,
SHE'S TRIED TO KILL HERSELF
TWICE. TWICE ON LIFE SUPPORT IN
THE ICU. IN THE LAST 20 MONTHS.
SHE'S BEEN HOSPITALIZED SIX
TIMES. AND EVERY TIME SHE'S BEEN
DISCHARGED WITH NO FOLLOW UP
SERVICES OR AFTER IN SPITE OF
THE SEVERITY OF HER MENTAL
HEALTH CHALLENGES AND REPEATED
APPEALS FOR SERVICES. KAISER HAS
INFORMED US THAT THEY HAVE NO
AVAILABLE MENTAL HEALTH
PROFESSIONALS ON STAFF AND THEIR
CONTRACTED THERAPISTS OR BOOK
SOLID. THEIR TREATMENT PROGRAMS
HAVE STAGNANT WAIT LISTS. KAISER
PSYCHIATRIST ONLY COMES IN ON
MONDAYS, SO IT TAKES MONTHS FOR
US TO GET AN APPOINTMENT. EVEN
SO, WE'VE BEEN LUCKY. MY
DAUGHTER'S ALIVE, BUT I DON'T
KNOW HOW LONG I'LL BE ABLE TO
SAY THAT IN SPITE OF HER MEDICAL
HISTORY, SHE STILL NEEDS HELP,
AND WE STILL CAN'T GET IT MUCH
LIKE THE COST BENEFIT ANALYSIS
FOR DID WHILE DEVELOPING THE
DEADLY PINTO. WITH THE PENALTIES
AS THEY STAND. IT IS CHEAPER FOR
KAISER TO PAY ANTIQUATED FINES
THAN TO DO WHAT THEY'RE LEGALLY
REQUIRED TO DO. PSAS TELL ME TO
GET HELP. IF I NEED IT. WE'RE
TRYING. WE'VE BEEN TRYING FOR
YEARS. WITH THIS BILL, YOU WILL
BE TELLING KAISER. THAT BUSINESS
AS USUAL IS NO LONGER OKAY.
INCREASED FINES WON'T FIX
EVERYTHING, BUT IT MIGHT GIVE MY
DAUGHTER AND THOUSANDS OF OTHERS
THE CARE NEEDED TO HAVE A HAPPY,
HEALTHY FUTURE INSTEAD OF ENDING
UP. ASSAD AND ALL TOO COMMON
STATISTICS. I URGE YOU TO
APPROVE THIS LONG OVERDUEREFORM
OUR STATE'S ENFORCEMENT SYSTEM.
THANK YOU. YOU PEOPLE AND THEY
HAVE HEALTH ACCESS CALIFORNIA
HERE IS SPONSOR OF THIS MEASURE.
WHEN THAT $4 MILLION FINE WAS
LEVIED AGAINST KAISER. IT WAS
ONE OF THE LARGEST FOUND THAT IT
EVER BEEN LEVIED. BUT WE HAD
QUESTIONS. WE HAD QUESTIONS
BECAUSE KAISER AS MILLIONS OF
ENROLLEES IN BILLIONS IN
REVENUE. AND $4 MILLION WAS FAR
LESS THAN THE HARM DONE TO THIS
FAMILY. AND OTHER CONSUMERS LIKE
THEM. AND LESS THAN THE COST TO
KAISER TO PROVIDE TIMELY ACCESS
TO CARE. SO WE LOOKED AT THE
FINE STRUCTURE AND CREATED THIS
BILL TO UPDATE IT. YOU'VE HEARD
THAT WE'VE TAKEN AMENDMENTS
TODAY. THAT MAKE THE BILL
SOMEWHAT MORE MODEST, BUT THAT
FUNDAMENTAL FACT THAT WHEN THIS
PENALTY WAS THE ORIGINAL PENALTY
WAS PUT IN PLACE GAS WAS 59
CENTS. IT'S TIME TO UPDATE THESE
PENALTIES. IT'S TIME TO CHANGE
THE LAW, SO PEOPLE LIKE JASMINE
AND HER FAMILY. NEVER GO THROUGH
THIS AGAIN. THANK YOU. YEAH.
OTHERS IN SOME FOUR. TIM MADDEN
REPRESENT THE CALIFORNIA CHAPTER
OF THE AMERICAN COLLEGE OF
EMERGENCY PHYSICIANS AND STRONG
SUPPORT. THANK YOU. LINDA WAY
WITH WESTERN CENTER ON LAW ON
POVERTY AND SUPPORT. THANK YOU.
OPPOSITION.
THANK YOU, MR CHAIR AND MEMBERS
NICK LOUISA'S ON BEHALF OF THE
CALIFORNIA ASSOCIATION OF HEALTH
PLANS, REGRETTABLY, IN
OPPOSITION TO SB 8 58. UM AS IT
EXISTS IN PRINT TODAY, WE DO
WANT TO ACKNOWLEDGE THAT
SUBSTANTIAL AMENDMENTS ARE BEING
TAKEN DURING THIS COMMITTEE
HEARING. WE HAVE A COPY OF THOSE
AMENDMENTS. THOSE ARE OUT FOR
REVIEW BY OUR MEMBERSHIP. WE'VE
HAD A GOOD OPEN DOOR POLICY SET
OF DISCUSSIONS WITH THE AUTHOR'S
OFFICE AND THE SPONSORS. SO UM,
YOU KNOW, TO THE EXTENT WE GET
FEEDBACK FROM OUR MEMBERS, YOU
KNOW WE'D LOVE TO CONTINUE THAT
OPEN DOOR POLICY IS PART OF OUR
DISCUSSIONS OVER THIS BILL. UM
BUT STICKING TO THE BILL IN
PRINT, YOU KNOW, JUST TO EXPLAIN
OUR OPPOSITION TO IT. UM YOU
KNOW, WE HEARD SOME PRETTY
COMPELLING TESTIMONY FROM THE
SUPPORTERS. I THINK I SAID THIS
IN A PRIOR HEARING. I MEAN, YOU
KNOW, WE'RE ALL MADE OUT OF THE
SAME STUFF. YOU KNOW, WE'VE ALL
HAD FRIENDS AND FAMILY MEMBERS
THAT HAVE INTERACTED WITH THE
SYSTEM, PARTICULARLY, YOU KNOW,
THE MENTAL HEALTH. UM SYSTEM OF
CARE IN HIS STATE. SOMETIMES
IT'S GREAT. SOMETIMES IT'S NOT
SO GREAT. YOU KNOW WHEN IT'S NOT
SO GREAT, OBVIOUSLY, YOU KNOW,
THAT'S PROBLEMATIC. UM BUT YOU
KNOW, THE FUNDAMENTAL BASIS OF
OUR OPPOSITION TO THIS BILL IS
THAT YOU KNOW WHETHER IT'S A
MENTAL HEALTH ISSUE OR OTHER
HEALTH ISSUES. YOU KNOW, WE'RE
NOT GOING TO FIND AND PENALIZE
OUR WAY INTO A BETTER HEALTH
CARE SYSTEM. AND YOU KNOW, WITH
RESPECT TO MENTAL HEALTH
SERVICES. A LOT OF THE PROBLEM
IS REALLY WORKFORCE DEVELOPMENT
ISSUE. UM, AND YOU KNOW, WE ARE
HAPPY THAT THE AUTHOR OF THIS
BILL IS KIND OF ACKNOWLEDGE THAT
THROUGH THROUGH HIS BILL PACKAGE
THIS YEAR, AND I KNOW HE'S
WORKING ON THE ISSUE, BUT YOU
KNOW, THE THAT THAT IS ONE OF
THE CORE ISSUES. I'M HERE. I'M
HAVING SAID THAT, UM YOU KNOW
THE BILL IN PRINT? YOU KNOW, WE
BELIEVE IS EXCESSIVE FROM OUR
OPINION. UM WE ARE GOING TO
REVIEW THE AMENDMENTS. WE'LL GET
BACK TO THE AUTHOR. WE'LL GET
BACK TO THE COMMITTEE TO SEE IF
THAT CHANGES OUR POSITION. WE
MAY CONTINUE TO OPPOSE THE BILL.
WE MAY HAVE OTHER OTHER
COMMENTS, BUT, UM YOU KNOW, WE'D
LIKE TO CONTINUE THE DISCUSSION
MOVING FORWARD IF THE BILL MOVES
OUT OF COMMITTEE TODAY, UM AND
SO, BUT YOU KNOW, THE BILL AND
PRINT WERE IN OPPOSITION. THANK
YOU VERY MUCH. THANK YOU. ARE
THERE OTHERS IN OPPOSITION
ANYONE ELSE? SEE, NO ONE WILL
COME BACK TO THE COMMITTEE FOR
QUESTIONS OR COMMENTS. DR
WEBBER. THANK YOU CHAIR. SO I
HAVE A I HAVE A QUESTION. THANK
YOU SO MUCH FOR BRINGING THIS
BILL FORWARD. UM SO HOW WOULD
THIS BILL IMPACT? UM YOUR
WITNESS'S STORY AND THANK YOU SO
MUCH FOR BEING HERE TODAY AND
TELLING US YOUR STORY. IT'S VERY
PERSONAL, AND YOU KNOW, BUT WE
DEFINITELY APPRECIATE IT. SO HOW
WOULD THIS BILL IMPACT HER THE
OBVIOUSLY THERE'S. FIRST OF ALL,
BECAUSE THERE'S NO SILVER
BULLET. UM, BUT IN TERMS OF THIS
WILL CREATE A STRONGER INCENTIVE
FOR HEALTH PLANS TO FOLLOW THE
LAW. AND SO WE HAVE MENTAL
HEALTH PARITY. IN CALIFORNIA AND
THAT WE STRENGTHEN THAT A COUPLE
OF YEARS AGO WITH SB 85. AH AND
HEALTH PLANS ARE REQUIRED. TO
TREAT MENTAL HEALTH THE SAME AS
PHYSICAL HEALTH. UH YOU KNOW, IF
YOU HAVE A BROKEN BONE AND YOU
GO, UH, TO THE TREATMENT, THE
HEALTH PLAN HAS TO PAY FOR YOUR
TREATMENT. UM, AND UNFORTUNATELY
THERE'S BEEN A THIS APPROACH,
NOT JUST BY THE HEALTH PLANS.
IT'S THERE IS A SOCIETAL PROJECT
. MENTAL HEALTH IS DIFFERENT.
JUST DEAL WITH IT. SUCK IT UP,
BE STRONGER, AND SO THE IDEA OF
MENTAL HEALTH PARODY, AS YOU
KNOW IS TO SAY NO, IT'S THE SAME
DISEASE BUT A DISEASE OF THE
BRAIN. AND UH, HAVING MUCH
HIGHER FINES. UM, FRANKLY. HAS
ADJUSTING THEM. FOR THE LAST 40
PLUS YEARS. WILL MAKE IT LESS
LIKELY THAT A HEALTH PLAN WILL
SAY WE'RE GOING TO NOT REALLY
COVER MUCH MENTAL HEALTHCARE PAY
THE FINES CHEAPER TO PAY THE
FINES, AND SO THIS WILL MAKE IT
SO IT IS NO LONGER CHEAPER JUST
TO PAY THE FINES. UM SO I GUESS
USING HER EXAMPLE WHAT WOULD
WHAT SHOULD HAVE BEEN THE
OUTCOME BECAUSE WE ALL KNOW THAT
UM, WE HAVE A SHORTAGE OF
PROVIDERS HERE IN CALIFORNIA.
AND UNFORTUNATELY WE HAVEN'T
EVEN GREATER SHORTAGE OF MENTAL
HEALTH PROVIDERS. SO YEAH, IT BE
LIKE YOU KNOW THEY THAT KAISER
SHOULD HAVE REFERRED HER OUT OF
THE NETWORK. YEAH. I MEAN, THERE
ARE, UH WE DO HAVE A MENTAL
HEALTH WORKFORCE SHORTAGE. UM
AND I'VE WERE HAD ANOTHER BILL A
FEW WEEKS AGO, AND THIS
COMMITTEE HAS BEEN 9 64. BUT I
ALSO THINK IT'S NOT THE CASE
THAT THAT THAT THAT THAT
SHORTAGE IS EVERYTHING RIGHT?
THAT'S ONE FACTOR, BUT WE ALSO
SYSTEMICALLY. I THINK THERE IS
THIS APPROACH WHILE MENTAL IT'S
EXPENSIVE, AND SO WE DON'T WANT
TO. INVEST IN IT FOR WHAT'S
NEEDED, AND SO SOMETIMES NOT
ENOUGH. PROVIDERS ARE HIRED OR
THEY'RE NOT BEING PAID WELL
ENOUGH SO THEY'RE NOT BEING
RETAINED. SO THERE ARE IT'S A
COMPLICATED ISSUE, BUT I DON'T
AGREE WITH THE NOTION THAT MEANS
THAT WE CAN SPLIT EVERYTHING ON
THE WORKFORCE SHORTAGE. THERE'S
NOTHING ELSE THAT THE THAT THE
PLANS CAN DO. THERE ARE OTHER
THINGS. THAT THEY CAN DO, UM,
AND TO BE ABLE TO PROVIDE MENTAL
HEALTH CARE. YOU KNOW, JUST
SPEAKING FROM MY EXPERIENCE IS
EXTREMELY HARD TO FIND A MENTAL
HEALTH CARE PROVIDER FOR MY
PATIENTS. UM AND IT IS OFTEN
TIMES DUE TO A WORKFORCE
SHORTAGE. I MEAN, WE'RE ALSO NOT
HAVING A RESIDENTS GO INTO, YOU
KNOW, UM, PSYCHIATRY RESIDENCY,
SO I JUST UM JUST WONDERING HOW. IT WOULD IMPACT HER STORY. BUT
THANK YOU IF I MAY ADD THE BILLS
, OF COURSE NOT JUST ABOUT
MENTAL HEALTH KIND OF COVERED
WITH. QUÊ ANY ANYONE ELSE? ANY
OTHER QUESTIONS? JUST JUST A
COMMENT. FIRST OF ALL, THANK YOU
. AND WE DO HAVE A MOTION BY DR
ARAMBULA. SO I'M IN SEARCH OF A
SECOND IF THERE'S A SECOND
SECOND BY MR MCCARTY. UM FIRST
OF ALL, THANK YOU FOR BRINGING
BRINGING THE BILL FORWARD. SO UM
AND YOU KNOW, IT IS INTERESTING
THAT THOSE PENALTIES HAD NOT
BEEN ADJUSTED OVER THE YEARS AND
I LOOK, I I'M NOT I DON'T WANT
TO. I DON'T WANT TO. DON'T WANT
TO BE IMPOSING PENALTIES ALL THE
TIME. THAT'S NOT THE PURPOSE OF
THIS AND WENT THROUGH A LOT OF
DISCUSSIONS IN TRYING TO DEVELOP
THE OFFICE OF HEALTH CARE
AFFORDABILITY AND A LOT OF IT
CAME BACK TO PENALTIES AND WE RE
PENALIZED IN SIGHT. WHAT WE
REALLY WANT. IS SOMETHING SORT
OF A HAMMER A LITTLE BIT TO
CHANGE BEHAVIOR. UM WE DON'T
WANT ANYBODY TO BE PENALIZED. WE
WANT THEM TO DO WHAT THEY'RE
SUPPOSED TO DO. SO YOU KNOW, AS
I THINKING, THINKING, WHAT ABOUT
DR WEBBER'S QUESTION? KAISER IS
UNIQUE. IT IS A PLAN. THEIR
PROVIDER NETWORK AND THEIR
HOSPITAL. AND SO IF YOU ARE A
PLAN YOU HAVE NETWORK AND YOU
HAVE POSTED THERE SHOULD BE
NETWORK ADEQUACY REQUIREMENTS
THERE. AND IT APPEARS THAT IN
THIS PARTICULAR CASE, UM MAYBE,
AND I'M NOT. I DON'T KNOW THE
PARTICULARS OF THIS CASE, BUT
THEY HAVE A PLAN. UM AND FOR
WHATEVER REASON, THE NETWORK
WASN'T ABLE TO SUPPLY THE
SERVICE THAT WAS CRITICAL TO
THIS FAMILY, AND, UM, IT IS
FRUSTRATING AND WE HAVE WORKED
ON THE OVER THE YEARS ON A
VARIETY OF THINGS TRYING TO
EXPAND THE ABILITY OF MARRIAGE
AND FAMILY THERAPIST TO BE ABLE
TO PROVIDE CARE THAT'S OF
CLINICAL AT A COMPARABLE
SERVICES THAT LICENSED CLINICAL
SOCIAL WORKER HAS PROVIDES, AND
WE RUN INTO OPPOSITION THERE
BECAUSE OF THE TURF BATTLES OVER
THAT, BUT WE'RE DESPERATELY
TRYING TO FIND WAYS ALLOWED
PEOPLE. THE PRACTICE THEIR CRAFT
PRACTICE THEIR THEIR ABILITY TO
PROVIDE SERVICES AT THE HIGHEST
LEVEL POSSIBLE BECAUSE OF THE
CRITICAL SHORTAGE THAT WE HAVE
HERE, SO, UM SO THE REASON WE
DID THE UP TO, UM, AMENDMENT IN
THE BILL IS THAT IT'S NOT
NECESSARILY THAT EVERY EVERY
VIOLATION OR WOULD BE WOULD BE A
EGREGIOUS, UM, ABSOLUTELY
EGREGIOUS. AND SO WE DO WANT THE
OVERALL GOAL OF PENALTIES IS TO
CHANGE BEHAVIOR. THAT'S THAT'S
WHAT WE WANT TO DO. AND I DON'T
YOU KNOW THE MONEY MEANS VERY,
VERY, VERY LITTLE. FROM MY
PERSPECTIVE. IF THE BEHAVIOR
DOESN'T CHANGE, SO I CAN
GUARANTEE YOU IF THESE PENALTIES
ARE IN PLACE. AND IT DOESN'T
CHANGE THE BEHAVIOR. WE'RE
PROBABLY GOING TO COME BACK AND
REVISIT THE PENALTIES AGAIN
UNLESS SOMEBODY ELSE GIVES US
ANOTHER SOLUTION BECAUSE THEY'RE
OBVIOUSLY WORKFORCE IS SOMETHING
THAT'S GOING TO TAKE AWHILE TO
TAKE EFFECT. BUT THE WHEN YOU'RE
PAYING FOR A PLAN, AND YOU CAN'T
GET THE SERVICE THAT IS A PART
OF YOUR CONTRACT WITH US.
ESSENTIALLY YOU HAVE A CONTRACT
WITH THE PLAN. YOU'RE PAYING THE
PLAN TO PROVIDE YOU SERVICES AND
THEIR YOU'RE BEING TOLD WE DON'T
HAVE ANYBODY TO PROVIDE THAT
SERVICE. UM PRETTY SURE I DIDN'T
PRETTY SURE YOU WEREN'T OFFERED
A PARTIAL REFUND FOR YOUR
PREMIUM FOR THAT PROVIDED
SERVICE AND INDEED, YOU KNOW,
YOU'VE EXPERIENCED A LOT OF A
LOT OF HARDSHIP BECAUSE OF YOUR
DAUGHTER BEING HOSPITALIZED
MULTIPLE TIMES AND STILL NOT
BEING ABLE TO GET THE ADEQUATE
CARE SO IT'S FRUSTRATING. AND I
KNOW SENATOR WEINER DOESN'T DO
THIS LIGHTLY. THESE ARE HE
BRINGS EXPERIENCE. HE BRINGS HE
BRINGS, UM A LOT OF THOUGHT TO
THESE BILLS, AND SO I AM
SUPPORTING THE BILL TODAY. UM, I
APPRECIATE YOU BRINGING IT
FORWARD. UH THE BILL. WE HAVE A
MOTION FROM, UH WAS IT, DR
ARAMBULA? AND THEN? UM MR
MCCARTHY. THAT'S WHY I WAS ON MY
NOTES ARE GETTING I'M LOW BLOOD
SUGAR HERE AT THIS POINT, UM,
AND THE MOTION WOULD BE DO PASS
AS AMENDED TO APPROPRIATIONS.
AND WOULD YOU LIKE TO CLOSE
SENATOR, I'LL MR CHILD IF I MAY.
I'LL TAKE YOUR COMMENTS AS MY
CLOTHES AND I RESPECTFULLY ASK
FOR AND I VOTE. THANK YOU.
THANKS VERY MUCH. I APPRECIATE
IT. MADAM SECRETARY. PLEASE CALL
THE ROLL. WOULD WOULD I WALDRON?
WALDRON NO AGUIAR-CURRY
AGUIAR-CURRY. AYE ARAMBULA
ARAMBULA. AYE, BIGELOW BIGELOW
NÓ CARILLO. CARILLO I FLORA OR
NO MAIENSCHEIN. MAIN TRAIN I
MADE. HE'S NOT VOTING MCCARTY
MCCARTHY, I MISSOURIAN.
NAZARIAN. I REBUS. RIVAS I
RODRIGUEZ RODRIGUEZ I SANTIAGO
PEPPER. WEBER. AYE. 10 TO 3 10
VOTES YOUR BILLS OUT. THANK YOU
VERY MUCH. THANK YOU. OKAY?
REMEMBERS. LET'S GO TO THE TOP
OF THE FILE. WE STILL HAVE ONE
MEMBER WHO WAS IN COMMITTEE
SOMEWHERE. OR TO BELIEVE THERE'S
STILL COMMITTEES. MEETING. THIS
POINT, BUT APPARENTLY THERE ARE
SO, UM, HE FINDS HIS WAY BACK AT
SOME POINT, BUT FOR THE OTHER 14
OF US HERE, WE'RE GOING TO GO
THROUGH THE FILE AND HOPEFULLY
DO THIS ONE TIME. EXCEPT FOR THE
TIME THAT I GO THROUGH IT WITH
THE OTHER MEMBER. OKAY. ITEM
NUMBER ONE. PLEASE THIS IS SP 13
38 BY SENATOR UMBERG, PLEASE
LIFT THE CALL. CALL THE ABSENT
MEMBERS ARAMBULA. ARAMBULA. AYE,
BIGELOW. BIGELOW, NOT VOTING.
FLORA. LARA. I MAIENSCHEIN
MAIENSCHEIN. AYE NAZARIAN.
NAZARIAN. I RIVAS. RIVAS. AYE.
14 0 BILL HAS 14 VOTES. THAT
BILL IS OUT OF COMMITTEE. THE
CONSENT CALENDAR, WHICH IS ITEM
NUMBER 279. EIGHT. THAT WOULD BE
EIGHT AND 9 13, 1922 AND 24.
PLEASE UH, OPEN THE ROLL CALL
THE ABSENT MEMBERS. ARAMBULA.
ARAMBULA. AYE, MAIENSCHEIN.
MAIENSCHEIN I MCCARTNEY
MCCARTHY. I NAZARIAN NAZARIAN. I
RIVAS. RIVAS SANTIAGO. 14 0 14 0
ITEM NUMBER THREE SP 7 71 BY
SENATOR BECKER PLEASE LIFT THE
CALL. CALL THE ABSENT MEMBERS,
WALDRON. WALTER AND I ARAMBULA.
THEY'RE NOT VOTING. ARAMBULA,
NOT VOTING. MAIENSCHEIN BEEN
TRYING TO I. MCCARTHY MCCARTHY,
I NAZARIAN. NAZARIAN, NOT
VOTING. RIVAS. LUZ RIVAS. AYE.
SANTIAGO. THAT'S 88 TO 0. BILL
HAS EIGHT VOTES THAT BUILDS OUT
ITEM NUMBER 10 SB 13 46, PLEASE.
I'M SORRY, NUMBER FOUR. I DON'T
KNOW. SO I CAN'T EVEN I CAN'T
EVEN READ NUMBERS ANYMORE. SO UM
, ITEM NUMBER FOUR SB 13 46,
PLEASE LIFT THE CALL ALL THE
ABSENT MEMBERS. WALDRON. WALTER
AND I ARAMBULA. ARAMBULA? AYE.
MAIENSCHEIN MAIENSCHEIN I
MCCARTY MCCARTHY. I NAZARIAN
MISSOURI AND I RE BUS RIVAS I
SANTIAGO. ZERO. 14 0 ITEM NUMBER
FIVE SP 999 BY SENATOR CORTEZ,
PLEASE LIFT THE CALL AND CALL
THE UPSET MEMBERS. ARAMBULA.
ARAMBULA? AYE. MAIENSCHEIN
MAIENSCHEIN. AYE MCCARTHY
MCCARTHY I NAZARIAN NAZARIAN AND
I RIVAS. RIVAS EYES SANTIAGO. 11
TO 1 11 TO 1 ITEM NUMBER SIX SP
11 84 BY SENATOR CORTEZ, PLEASE
LIFT THE CALL. CALL THE ABSENT
MEMBERS, WALDRON. SP 11 84
WALDRON NO. ARAMBULA. ARAMBULA?
AYE. MAIENSCHEIN MAIENSCHEIN,
AYE MCCARTHY. BACARDI I NAZARIAN
MISERY AND I RIVAS PREVIOUS
SANTIAGO. 11 2 TO 11 TO TWO ITEM
NUMBER 10. SB 9 72 BY SENATOR
GONZALEZ, PLEASE LIFT THE CALL.
CALL THE ABSENT MEMBERS,
WALDRON. WALDRON NO. ARAMBULA
ARAMBULA. AYE, BIGELOW. BIGELOW,
NOT VOTING. LARA. LARA, NOT
VOTING MAIENSCHEIN. MAIENSCHEIN
I MADE MAZE. I MCCARTY MCCARTHY
I NAZARIAN MISERY AND I, RIVAS
RIVAS, I RODRIGUEZ RODRIGUEZ.
AYE. 12 TO 1 JUST 12 TO 1. ITEM
NUMBER, 12 SO JUST EVERYBODY WHO
WASN'T HERE. ITEM NUMBER 11 SP
443 SENATE, HERTZBERG WAS PULLED
BY THE AUTHOR. I DON'T REMEMBER
12. SB 10 14 BY SENATOR
HERZBERG, PLEASE LIFT THE CALL.
CALL THE ABSENT MEMBERS.
ARAMBULA ARAMBULA. AYE, BIGELOW.
BIGELOW NÓ CARILLO. CARILLO I
FLORA. SB 10 14 ITEM NUMBER 12.
FLORA NO MAIENSCHEIN
MAIENSCHEIN. I'M ACES. HE'S NOT
VOTING MCCARTHY MCCARTHY, I
NAZARIAN. LUZ RIVAS RIVAS I
SANTIAGO. NAZARIAN. HI, HARRY
AND I. 93. THAT'S 93. THAT BILL
IS OUT. ITEM NUMBER 14. SB 2 50.
PLEASE LIFT THE CALL. CALL THE
ABSENT MEMBERS CURRY. I GET
KOREA. I BIGELOW BIGELOW NÓ.
MAIENSCHEIN MAIENSCHEIN I MADE.
MAY IS NOT VOTING MCCARTY
MCCARTHY, I NAZARIAN. NAZARIAN I
RIVAS RIVAS. I RODRIGUEZ.
RODRIGUEZ. I WEBER HOWEVER, I.
12 TO 2 12 TO REMEMBER 15 SB 8
38 BY DR PAN. PLEASE LIFT THE
CALL. CALL THE ABSENT MEMBERS.
ARAMBULA ARAMBULA. AYE, BIGELOW.
BIGELOW NÓ CARILLO. I HAVE NEVER
15 SB 8 38. CARILLO I FLORA.
FLOOR AND HAVE VOTING
MAIENSCHEIN MAIENSCHEIN I MADE
AMAZIGH MCCARTY MCCARTHY, I
NAZARIAN NAZARIAN I RIVAS RIVAS
RODRIGUEZ RODRIGUEZ. AYE.
WALDRON VOTE CHANGE ADRIN.
WALTER AND I TO NOT VOTING NOT
VOTE IN. 13 TO 1 13 VOTES 13 TO
1. I DIDN'T NUMBER 16 SP 9 39
WAS PULLED BY DR PAM WAS PULLED
BY THE AUTHOR. ITEM NUMBER 17.
SB 9 44, PLEASE LIFT THE CALL.
CALL THE OPPOSITE MEMBERS.
ARAMBULA ARAMBULA. AYE, BIGELOW.
BIGELOW NÓ CARILLO. SB 9 44.
CARILLO I FLORA. LARA NÓ
MAIENSCHEIN MAIENSCHEIN I MADE
MAISIE MCCARTY MCCARTHY I
NAZARIAN NAZARIAN I REBUS RIVAS.
I RODRIGUEZ RODRIGUEZ. I
SANTIAGO. SPOKE TO 12 TO 2 ITEM
NUMBER 18 SB 10 33 BY SENATOR
PAN, PLEASE LIFT THE CALL. CALL
THE ABSENT MEMBERS ARAMBULA.
ARAMBULA? AYE. CARILLO CARILLO I
FLORA. FLORA NO MAIENSCHEIN
MAIENSCHEIN I MADE HE'S NOT
VOTING NAZARIAN. MISSOURI AND I,
RIVAS RIVAS. I RODRIGUEZ
RODRIGUEZ I SANTIAGO. 11 2 TO 11
TO TWO ITEM NUMBER 20 SB. 1234
BY DR PAN, PLEASE LIFT THE CALL.
CALL THE ABSENT MEMBERS
ARAMBULA. ARAMBULA? AYE.
CARILLO. CARILLO I FLORA. LARA,
NOT VOTING MAIENSCHEIN.
MAIENSCHEIN I MAY MAY'S NOT
VOTING MCCARTHY MCCARTHY I
NAZARIAN. NAZARIAN AND I, RIVAS
RIVAS. I RODRIGUEZ RODRIGUEZ I
SANTIAGO. 11 AND 1 11 TO 1 ITEM
NUMBER 21 SP 12 96 BY DR PAN,
PLEASE LIFT THE CALL CALLED THE
ABSENT MEMBERS CARILLO. CARILLO
I FLORA. FLORA. I MAIENSCHEIN.
MAIENSCHEIN I MCCARTY MCCARTHY.
I NAZARIAN. NAZARIAN I RIVAS
RIVAS I RODRIGUEZ RODRIGUEZ
SANTIAGO. 13 0 13 TO 0 ITEM
NUMBER 23 SB 14 73 PLEASE LIFT
THE CALL. CALL THE OPPOSITE
MEMBERS. I WAS STRUCK BY DR PAN.
AGUIAR-CURRY AGUIAR-CURRY. AYE.
BIGELOW. BIGELOW NÓ CARILLO.
CARILLO I FLORA FLORA. NO
MAIENSCHEIN MAIENSCHEIN I MADE I
MEAN, IT'S NOT VOTING MCCARTHY
MCCARTHY, I NAZARIAN. NAZARIAN.
I RIVAS. REVIS I SANTIAGO. IN
THE 3 10 TO 3 ITEM NUMBER 25 SP
9 74 BY SENATOR PET PORTANTINO.
THESE LIFT THE CALL CALL THE
ABSENT MEMBERS ARAMBULA.
ARAMBULA. AYE, BIGELOW. PICCOLO
NOT VOTING CARILLO CARILLO I
FLORA. LARA NOT VOTING
MAIENSCHEIN MAIENSCHEIN I MADE
AMAZIGH MCCARTHY MCCARTHY I
NAZARIAN NAZARIAN. I RIBAS.
PRIEBUS? AYE. RODRIGUEZ.
RODRIGUEZ? AYE. SANTIAGO HERE.
ALREADY VOTED ON THAT ONE. 13 0
13 0. THANK YOU. ITEM NUMBER 26
SB 9 87 BY SENATOR PORTANTINO
PLEASE LIFT THE CALL. CALL THE
ABSENT MEMBERS. ARAMBULA
ARAMBULA. AYE, BIGELOW. BIGELOW
NÓ CARILLO. CARILLO I FLORA
LARA. AYE, MAIENSCHEIN.
MAIENSCHEIN I MADE AMAZIGH
MCCARTY MCCARTHY. I NAZARIAN
NAZARIAN. I RIVAS. RIVAS
IRODRIGUEZ. RODRIGUEZ? AYE. 14 0
. I'M SORRY. 14 1 14 1. THANK
YOU REMEMBER 27 SB? BIGELOW NO
TO NOT VOTING. 14 00. OKAY THANK
YOU. REMEMBER 27 SB 2 25 BY
SENATOR WIENER, PLEASE LIFT THE
CALL. CALL THE OPPOSITE MEMBERS,
CARILLO. SB 2 25 ITEM NUMBER 27.
CARILLO? AYE. LARA. LARA. I
MAIENSCHEIN MAIENSCHEIN I
MCCARTY. NAZARIAN. NAZARIAN I
RIVAS RIVAS. I RODRIGUEZ
RODRIGUEZ I SANTIAGO SANTIAGO, I
WEBER. WALDRON WILDER AND I FROM
NOT VOTING TÔI.
12 00. I DON'T REMEMBER 28 SB 8
53 BY SENATOR WIENER, PLEASE
OPEN THE ROLE AND CALL THE
OPPOSITE MEMBERS. MAIENSCHEIN
SANTIAGO. SANTIAGO, I 11 TO 0.
THANK YOU. ITEM NUMBER 20. GOT
YOU ON THAT ONE? YEAH AND ITEM
NUMBER 29. SB 8 58 BY SENATOR
WIENER, PLEASE OPEN THE ROLL.
CALL THE ABSENT MEMBERS, TIAGO.
SANTIAGO. I 11-3 11-3. OKAY
WE'VE BEEN THROUGH THE ENTIRE
ORDER AND WE'LL GO BACK AND ADD
ON MEMBER AT ON. START AT THE
TOP.
SO IT'S 13 TO 1.
12 TO 1 ON. SP 838 CORRECTION ON
THE CALL OUT ON SP 3838 ITEM
NUMBER 15 12 TO 1. OKAY, SO NOW
WE'LL GO BACK TO THE TOP OF THE
ORDER. UM ALL IN THE ABSENT
MEMBERS. ITEM NUMBER ONE SP 13
38 BY SENATOR HAMBURG PLEASE
OPEN THE ROYAL CALLED THE ABSENT
MEMBER, ABSENT MEMBERS OR NO
ABSENT MEMBERS. CONSENT
CALENDAR. SANTIAGO. SANTIAGO I
15 0 15 0 ITEM NUMBER THREE. SB
771. PLEASE CALL THE ABSENT
MEMBERS. SANTIAGO SANTIAGO. I 9
TO 0. ITEM NUMBER FOUR. SB 13 46
. PLEASE CALL THE ABSENT MEMBER
SANTIAGO SANTIAGO. I 15 0 15 0
ITEM NUMBER. FIVE SP 9 99
CORTEZ, PLEASE. ALL THE ABSENT
MEMBER THIAGO SANTIAGO. I 12 TO
1 OF ONE ITEM NUMBER SIX. SB 11
. 84 CORTEZ. PLEASE CALL THE
ABSENT MEMBER SANTIAGO.
SANTIAGO. I 12 222. ITEM NUMBER
SEVEN SP 8 42 THAT'S ON THE
CONSENT CALENDARS STOP. DANGER
TAIL NUMBER 10 AS MONTANA WE'VE
GOT YOU ON 10. AND 12. 12. 10 14
ITEM. REMEMBER 12 SB 10 14,
PLEASE OPEN THE ROLL CALL THE
ABSENT MEMBER. SANTIAGO.
REMEMBER 12. THANK YOU CHECK OUT
I TEND TO 3 TO 3. ITEM NUMBER 14
SB 2 50, PLEASE OPEN THAT WE GOT
YOU ON THAT ONE. 15 15. 16 IS,
UM SEVEN OR 17. ADAM 75 NUMBER
17 SP 9 44 BY SENATOR PAN PLEASE
OPEN THE ROYAL CALLED THE ABSENT
MEMBER SANTIAGO ON TIAGO. I 13
2. I DON'T KNOW 18. MONDAY. 18
OR NOT. SB 10 33 BY SENATOR PAN,
PLEASE OPEN THE ROLL CALL THE
OPPOSITE MEMBER SANTIAGO.
SANTIAGO I 12 TO. ITEM NUMBER 20
SP 12 34 DR PAN, PLEASE OPEN THE
ROLL CALL THE ABSENT MEMBER.
SANTIAGO. SANTIAGO. I 12-1 12-1.
ITEM NUMBER. 21 PLEASE OPEN THE
ROLE CALLED THE ABSENT MEMBER.
THAT'S SP 12 96 BY DR PAN.
SANTIAGO SANTIAGO. I 14 0 14 0.
LEAVE FOR ITEM NUMBER, OKAY?
NEVER MIND. NEVER ITEM NUMBER 23
SP 14 73 BY DR PAN, PLEASE OPEN
THE ROLL CALL THE ABSENT MEMBER
SANTIAGO SANTIAGO. I 11-3 11 TO
3, AND I BELIEVE THAT IS IT. YOU
DID? YEAH. SPEAK YEAH, AND IT
WAS ITEM NUMBER 12 SP 10 14.
YEAH. LEAVE THAT CONCLUDES THAT
CONCLUDES IT. OKAY? THAT
CONCLUDES THE HEARING OF THE
HEALTH COMMITTEE. THANK YOU ALL
VERY MUCH.