GOOD AFTERNOON. THIS IS THE
ASSEMBLY BUDGET SUBCOMMITTEE
NUMBER ONE ON HEALTH AND HUMAN
SERVICES. TODAY'S HEARING IS OUR
FIRST REGULAR SUB ONE HEARING
COVERING HEALTH ISSUES FOR THE
YEAR. FOR THOSE OF YOU WHO
ALREADY KNOW WE'VE ALREADY HAD
OUR FIRST SUB ONE HUMAN SERVICES
HEARING ON FEBRUARY 22ND OF THIS
YEAR, FOLLOWED BY A JOINT
INFORMATIONAL HEARING WITH THE
HEALTH COMMITTEES ON MENTAL
HEALTH ON FEBRUARY 28TH. TODAY'S
HEARING WILL BE FOCUSED ON
PUBLIC HEALTH AND EMERGENCY
MEDICAL SERVICES. WE ARE MAKING
ONE SIGNIFICANT CHANGE TO THE
AGENDA, WHICH IS TO MOVE SEVERAL
ITEMS TO NON DISCUSSION. FOR
THESE ISSUES. THERE WILL BE NO
PRESENTATION OR DISCUSSIONS OF
THE PROPOSALS. AS USUAL WITH NON
DISCUSSION ITEMS. WE WILL
WELCOME PUBLIC COMMENT ON THEM
AT THE END OF THE HEARING,
SHOULD THERE BE ANY THE
FOLLOWING ISSUES WILL BE MOVED
TO NON DISCUSSION. ISSUES. FOR
16 18, 19 AND 24 THROUGH 30. I
ALSO WANT TO REMIND EVERYONE
THAT PUBLIC COMMENT ON ALL
ISSUES ON THE AGENDA WILL BE
TAKEN AT THE END OF THE HEARING
AFTER THE LAST ISSUE HAS BEEN
PRESENTED. WE WILL FIRST TAKE
PUBLIC COMMENT FROM INDIVIDUALS
HERE IN THE HEARING ROOM,
FOLLOWED BY PUBLIC COMMENTS FROM
INDIVIDUALS WHO ARE ON THE
PHONE. THE PUBLIC. COMMENT CALL
IN NUMBER IS ON THE
SUBCOMMITTEE'S WEBSITE. IT WILL
ALSO BE ON THE LIVESTREAM SCREEN
WENT PUBLIC COMMENT HAS STARTED
, AND I WILL ALSO SHARE IT RIGHT
NOW. THE PHONE NUMBER IS 87769.
AND THE ACCESS CODE IS 13151.
WITH THAT. LET US BEGIN PANEL
ONE WITH DR THOMAS ARAGON,
DIRECTOR AND STATE PUBLIC HEALTH
OFFICER WITH THE CALIFORNIA
DEPARTMENT OF PUBLIC HEALTH. WHO
WILL BE PROVIDING THE ANNUAL
STATE OF PUBLIC HEALTH. DR
ARAGON. BEFORE WE BEGIN, WE WILL
ESTABLISH QUORUM. ARAMBULA. HERE
LONNIE'S HERE. JACKSON
PATTERSON. RAMOS RUBIO. I WOULD
. WHEN YOU'RE READY, DOCTOR
ARROGANT. THANK YOU. GOOD
AFTERNOON CHAIR AND MEMBERS. I
AM DR TOMAS ARAGON, STATE PUBLIC
HEALTH OFFICER AND DIRECTOR OF
THE CALIFORNIA DEPARTMENT OF
PUBLIC HEALTH. IT'S AN HONOR TO
BE HERE TODAY TO PRESENT ON THE
STATE OF PUBLIC HEALTH IN
CALIFORNIA. AT C D PH. OUR
MISSION IS TO ADVANCE THE HEALTH
AND WELL BEING OF CALIFORNIA'S
DIVERSE PEOPLES AND COMMUNITIES.
AND THE VISION THAT ALL
CALIFORNIANS ENJOY HEALTHY
COMMUNITIES WITH THRIVING
FAMILIES AND INDIVIDUALS. HEALTH
IS NOT THE ABSENCE OF DISEASE OR
INJURY. IT IS A STATE OF
COMPLETE PHYSICAL, MENTAL AND
SOCIAL WELL BEING. THE INSTITUTE
OF MEDICINE DEFINED PUBLIC
HEALTH AS WHAT WE AS A SOCIETY
COLLECTIVELY DO TO ASSURE THE
CONDITIONS IN WHICH PEOPLE CAN
BE HEALTHY. PUBLIC HEALTH IS OUR
COLLECTIVE ENDEAVOR TO PROTECT,
PROMOTE AND IMPROVE THE HEALTH
OF OUR COMMUNITIES.
UNFORTUNATELY THE FIELD OF
PUBLIC HEALTH IS OFTEN
MISUNDERSTOOD AND SOMETIMES
CONFUSED WITH HEALTHCARE. WHICH
IS THE PROVISION OF MEDICAL
SERVICES. HERE IS THE PUBLIC
HEALTH APPROACH. IT HAS FOUR
PILLARS, FIRST ECOLOGICAL,
SOCIAL OR EQUAL SOCIAL FOR
SHORT. THE RELATIONSHIP OF
PEOPLE WITH THEIR FAMILY,
NEIGHBORHOOD AND SOCIAL NETWORKS
AND WITH THEIR ENVIRONMENT. IN
OTHER WORDS, HEALTH HAPPENS
WHERE PEOPLE LIVE, WORK, LEARN,
PLAY AND PRAY. THINK OF COVID 19
PANDEMIC AND IT'S WIDESPREAD
IMPACTS. THINK OF HEALTH IMPACTS
FROM CLIMATE CHANGE. THE SECOND
PILLAR IS LIFE COURSE AND
INTERGENERATIONAL PROCESSES.
THINK OF ADVERSE CHILDHOOD
EXPERIENCES AND TOXIC STRESS AND
THE INTERGENERATIONAL
TRANSMISSION OF THE SOCIAL AND
BIOLOGICAL EFFECTS OF ADVERSITY
AND TRAUMA. THIRD EQUITY AND
HEALTH EQUITY, THINK OF LOW
INCOME COMMUNITIES AND ESSENTIAL
WORKERS WITH HIGHER RATES OF
COVID 19 EXPOSURE, ILLNESS,
HOSPITALIZATION AND DEATH. THINK
OF DISPROPORTIONATE IMPACTS OF
VIOLENCE AND MENTAL ILLNESS ON
COMMUNITIES OF COLOR, ESPECIALLY
BLACK AFRICAN AMERICANS. FOURTH
PREVENTION FOCUS, ESPECIALLY
PRIMARY PREVENTION. THINK OF
LAWS, REDUCING AVAILABILITY OF
TOBACCO PRODUCTS AND EXPOSURE TO
SECONDHAND SMOKE. THINK OF
SMARTER STREET DESIGN, VEHICLE
STANDARDS, SEATBELTS, CHILD
SAFETY SEATS AND ROBUST SAFE
MOBILITY OPTIONS TO REDUCE ROAD
FATALITIES. WELL WHAT HAVE WE
ACCOMPLISHED OVER THE LAST 20
YEARS, PUBLIC HEALTH HAS
CONTRIBUTED TO SIGNIFICANT
IMPROVEMENT IN HEALTH AND WELL
BEING OF ALL GROUPS. IN
CALIFORNIA, FOR EXAMPLE. THE
DEATH RATE FOR LUNG CANCER HAS
DECREASED BY 57% SINCE 2001
THANKS TO COMPREHENSIVE TOBACCO
CONTROL EFFORTS, CREATING A
SOCIAL AND LEGAL CONTEXT IN
WHICH TOBACCO IS LESS DESIRABLE,
ACCEPTABLE AND ACCESSIBLE. THE
HIV DEATH RATE DECREASED BY 71%
BETWEEN 2001 AND 2021 FOR ALL
GROUPS AND BY 73% FOR BLACK
INDIVIDUALS. BIRTH RATES AMONG
ADOLESCENTS DECREASED BY 78%
BETWEEN 2020 20 DUE TO IMPROVED
ACCESS TO PUBLIC HEALTH
PREVENTION STRATEGIES, INCLUDING
COMPREHENSIVE SEXUAL HEALTH,
EDUCATION, CLINICAL SERVICES AND
PROMOTION OF HEALTHY
RELATIONSHIPS AND COMMUNICATION
PRACTICES. DESPITE DECLINES IN
MORTALITY FOR ALL GROUPS AND IN
CALIFORNIA, SIGNIFICANT RACIAL
AND ETHNIC HEALTH DISPARITIES
CONTINUE. FOR EXAMPLE, OVERALL
LIFE EXPECTANCY IS 10 TO 12
YEARS LESS FOR BLACK INDIVIDUALS
COMPARED TO THE GROUP WITH THE
HIGHEST LIFE LIFE EXPECTANCY,
WHICH IS ASIANS. THE RATE FOR
ALCOHOL RELATED DEATHS IS 14
TIMES HIGHER FOR AMERICAN,
INDIAN AND ALASKAN NATIVE
INDIVIDUALS COMPARED TO ASIAN
INDIVIDUALS AND AS 1/4 LEADING
CAUSE OF DEATH FOR THIS GROUP.
THE PREGNANCY. ASSOCIATED
MORTALITY RATE IS 3.5 TIMES
HIGHER AMONG BLACK WOMEN THAN
AMONG WHITE WOMEN. THE HIV STD
DEATH RATE IS 11 TIMES HIGHER
FOR BLACK INDIVIDUALS THAN ASIAN
INDIVIDUALS. PUBLIC HEALTH WORKS
TO REDUCE THESE DISPARITIES BY
INFORMING POLICIES THAT ADDRESS
THE UNDERLYING SOCIAL,
ENVIRONMENTAL AND BEHAVIORAL
DRIVERS OF HEALTH AND BY
REGULATING SELECTED SECTORS WITH
HIGH IMPACTS ON HEALTH. FOR
EXAMPLE, WE LICENSED, CERTIFIED
AND INSPECT OVER 12,000 HEALTH
FACILITIES ACROSS THE STATE.
EQUITY IS A FOUNDATIONAL GUIDING
PRINCIPLE AND PUBLIC HEALTH
BASED ON THEIR NEEDS. EVERY
CALIFORNIAN SHOULD HAVE THE
RESOURCES AND OPPORTUNITIES TO
BE HEALTHY AND TO THRIVE. THIS
REQUIRES PRIORITIZING INVESTMENT
IN COMMUNITIES WITH CONTINUING
HEALTH INEQUITIES. TODAY
CALIFORNIA FACES SOME OF THE
TOUGHEST PUBLIC HEALTH
CHALLENGES IN DECADES. THESE
CHALLENGES INCLUDE COVID 19
CHRONIC DISEASES LIKE
CARDIOVASCULAR DISEASE AND
ALZHEIMER'S DISEASE, MENTAL
ILLNESS AND SUBSTANCE USE
DISORDER, FIREARM RELATED DEATH
AND INJURY AND HEALTH IMPACTS
FROM CLIMATE CHANGE. CITY PH IS
BUILDING CAPACITY TO TACKLE
THESE PUBLIC HEALTH PRIORITIES.
CLIMATE CHANGE IS A MAJOR FORCE
IMPACTING THE PUBLIC'S HEALTH.
AFFECTING ALL ASPECTS OF OUR
HEALTH AND WELL BEING ACROSS
AFFECTING ACCESS TO CLEAN AIR,
WATER, FOOD, SHELTER AND
PHYSICAL SAFETY. HEAT WAVES,
DROUGHTS, WILDFIRES AND WILDFIRE
SMOKE. FLOODS RESULTING
ILLNESSES, INJURIES AND DEATHS
AS WELL AS LOSS OF LIVELIHOODS,
CONTRIBUTING TO UNEMPLOYMENT,
POVERTY AND HOUSING, INSTABILITY
, DIRECT AND INDIRECT EFFECTS
INCREASED CHRONIC AND INFECTIOUS
DISEASES, MENTAL HEALTH
CHALLENGES AND HEAT AND SMOKE
RELATED ILLNESSES. THE IMPACTS
HAVE THE GREATEST TOLL ON THE
HEALTH. OF THOSE WHO ARE ALREADY
EXPERIENCING HEALTH, SOCIAL AND
ECONOMIC INEQUITIES. PUBLIC
HEALTH MONITORS, POPULATION,
HEALTH IMPACTS AND PARTNERS WITH
STATE AND LOCAL GOVERNMENTS AND
THE PRIVATE SECTOR TO EMBED THE
PUBLIC HEALTH APPROACH AND
EFFORTS TO ADDRESS ADDRESS THESE
CHALLENGES. LIFE EXPECTANCY
STEADILY INCREASED FOR 20 YEARS
PRIOR TO 2020, BUT DUE TO
IMPACTS OF COVID 19 PANDEMIC, WE
EXPERIENCED A SHARP DROP IN LIFE
EXPECTANCY IN 2021 COVID 19 WAS
THE LEADING CAUSE OF DEATH. AND
YEARS OF LIFE LOST WITH OVER
43,000 CALIFORNIANS LOSING THEIR
LIFE TO COVID, 19 AND 2021
MILLIONS MORE EXPERIENCED SEVERE
ILLNESS, HOSPITALIZATION,
DISRUPTION TO EDUCATION AND WORK
, SOMETIMES LOSS OF JOBS OR
HOUSING. COVID 19 HIGHLIGHTED
AND EXACERBATED EXISTING HEALTH
INEQUITIES. COVID 19 DEATH RATE
WAS SIGNIFICANTLY HIGHER FOR
NATIVE HAWAIIANS AND PACIFIC
ISLANDERS, BLACKS AND LATINOS
COMPARED TO THE OVERALL STATE
RATE. LOW INCOME COMMUNITIES
SUFFERED DISPROPORTIONATELY.
THEY LIVE IN CROWDED CONDITIONS
, WORK IN ESSENTIAL FRONTLINE
JOBS AND HAD MORE EXPOSURE TO
COVID 19. THEY HAD LESS ACCESS
TO RESOURCES, CREATING GAPS IN
HEALTH CARE, INFORMATION,
HOUSING AND ECONOMIC SECURITY.
THROUGH OUR COLLECTIVE ACTIONS,
PROVIDING TESTING, VACCINATION
TREATMENT AND PUBLIC HEALTH
GUIDANCE. CASES HOSPITALIZATIONS
AND DEATHS DROPPED SIGNIFICANTLY
BETWEEN 2020 AND 2021. 2022
COVID 19 DROPPED TO THE THIRD
LEADING CAUSE OF DEATH. NOW IN
2023. WE HAVE REACHED THE LOWEST
LEVELS SINCE THE SINCE THE PRE
PANDEMIC PERIOD, ENABLING
ACTIVITIES OF DAILY LIFE TO
RESUME MORE SAFELY. COVID 19
WILL REMAIN WITH US FOR THE
FORESEEABLE FUTURE, INCLUDING
THE UNCERTAIN BURDEN OF LONG
COVID. USING USING LESSONS
LEARNED FROM THE PANDEMIC. THE
CALIFORNIA SMARTER PLAN ENABLES
US TO MANAGE COVID 19 TODAY AND
PREPARE FOR A FUTURE SURGES AND
VARIANTS AS WELL AS RESPOND TO
EMERGING INFECTIOUS DISEASES
LAST YEAR CITY PH LEVERAGE COVID
COVID RESPONSE INFRASTRUCTURE
AND THE SMARTER PLAN TO RESPOND
TO THE M POX OUTBREAK. WE WERE
ABLE TO ACTIVATE SYSTEMS FOR
SURVEILLANCE VACCINATION AND
TREATMENT TO HIGHLY IMPACTED
COMMUNITIES. 14 DAY AVERAGE CASE
RATES HAVE FALLEN FROM MORE THAN
90 PER DAY IN AUGUST, 2022 TO
LESS THAN ONE CASE PER DAY NOW.
CD PH DISTRIBUTED VACCINES AND
ANTIVIRAL TREATMENTS STATEWIDE
SUPPORTED VACCINATION EVENTS AND
PROVIDED DISEASE PREVENTION
MESSAGES. OVER 300,000 VACCINE
DOSES HAVE BEEN ADMINISTERED TO
MORE THAN 180,000 PEOPLE WITH
OVER 116,000 PERSONS RECEIVING
TWO DOSES. AGAIN AT THE END OF
2022. WE LEVERAGE OUR COVID
RESPONSE INFRASTRUCTURE TO
ADDRESS THE SIMULTANEOUS SURGE
OF COVID 19 INFLUENZA AND RSV.
WE TRACKED AT THESE LEVELS AND
THE REAL TIME AND PROJECTED
IMPACTS ON THE HEALTH CARE
SYSTEM CITY CREATE CD PH
PROVIDED DATA TO LOCAL PARTNERS
AND POLICYMAKERS TO GUIDE THE
RESPONSE TO THIS TRIPLE DES
MICK. THE GOVERNOR'S 2023 BUDGET
PROPOSAL CONTINUES INVESTMENTS
TO SUPPORT THE STATE'S EFFORT TO
PROTECT AGAINST COVID 19 AND
OTHER PUBLIC HEALTH THREATS.
CALIFORNIA'S POPULATION IS
GROWING OLDER BY 2031 IN FOUR
CALIFORNIANS WILL BE OVER THE
AGE OF 60. ISCHEMIC HEART
DISEASE AND ALZHEIMER'S DISEASE
CONTINUE TO BE THE TOP LEADING
CAUSES OF DEATH FOR CALIFORNIANS
. CARDIOVASCULAR DISEASE
CONTRIBUTED TO THE MOST DEATHS
IN 2021. THIS CONDITION. GROUP
INCLUDES ISCHEMIC HEART DISEASE,
STROKE, HYPERTENSIVE HEART
DISEASE, ALL OF WHICH ARE THE
TOP FIVE LEADING CAUSES OF DEATH
DURING THE PANDEMIC PERIOD.
RATES OF ISCHEMIC HEART DISEASE
INCREASED COUNTERING A LONG TERM
TREND OF DECLINE. FROM 2021. THE
DATA SHOWS THAT WE HAVE WE WE'VE
HAD A LITTLE BIT OF A TURN DOWN
IN THAT TREND RETURNING TO PRIOR
TRENDS, WHICH IS GOOD. MOST
CARDIOVASCULAR DISEASES CAN BE
PREVENTED BY ADDRESSING
BEHAVIORAL RISK FACTORS SUCH AS
TOBACCO USE, UNHEALTHY DIET AND
OBESITY, PHYSICAL ACTIVITY,
HARMFUL ALCOHOL CONSUMPTION.
HOWEVER RECOGNIZING THAT DEEPLY
ROOTED SOCIAL AND ECONOMIC
INEQUITIES ARE THE DRIVERS OF
MANY HEALTH BEHAVIORS. PUBLIC
HEALTH INFORMS POLICIES THAT
IMPROVE COMMUNITY CONDITIONS SO
ALL PEOPLE CAN ENJOY SAFE,
WALKABLE NEIGHBORHOODS AND
ACCESS TO HEALTHY FOODS AND
AFFORDABLE HOUSING. DEATHS FROM
ALZHEIMER DISEASE HAVE MORE THAN
DOUBLED SINCE 2000 AND ABOUT ONE
IN 10. ADULTS IN CALIFORNIA
EXPERIENCE SUBJECTIVE COGNITIVE
DECLINE OR MEMORY LOSS. CDP CDP
PH COLLABORATES WITH
STAKEHOLDERS STAKEHOLDERS TO
SUPPORT THE MASTER PLAN FOR
AGING TO PREVENT AND PREPARE FOR
THE GROWING NUMBER OF ALZHEIMER
CASES AND FORGE A PATH FORWARD.
SEVERAL CONDITIONS OTHER THAN
COVID 19 SHOW SUBSTANTIAL
INCREASES IN DEATH RATES OVER
THE PAST TWO YEARS. THESE
INCLUDE DEATHS RELATED TO
ALCOHOL. ROAD INJURY AND DRUG
OVERDOSE. DRUG OVERDOSE HAS BY
FAR CAUSED THE LARGEST INCREASE
, WITH DEATHS INCREASING BY OVER
200% BETWEEN 2011 AND 2021. THIS
BEGAN WITH A 63% INCREASE IN THE
PRE PANDEMIC PERIOD. THIS
INCREASE SERVES DRAMATICALLY
DURING THE PANDEMIC PERIOD, WITH
AN ADDITIONAL 79% INCREASE IN
JUST TWO YEARS AND OVER 10,000
DEATHS IN 2021. IN 2019 DRUG
OVERDOSE DEATHS OVERTOOK
ISCHEMIC HEART DISEASE AS A TOP
CAUSE OF YEARS OF LIFE LOST
BETWEEN 2019 AND 2021. THERE WAS
ALSO A 38% INCREASE IN HOMICIDES
AFTER MANY YEARS OF DECREASING
OR LEVEL RATES. THIS WAS
PRIMARILY DRIVEN BY AN INCREASE
IN FIREARM RELATED HOMICIDES.
EXPOSURE TO GUN VIOLENCE,
TRAUMATIZES SURVIVORS AND
COMMUNITIES IMPACTING MENTAL
HEALTH AND SOCIAL WELL BEING.
MANY PUBLIC HEALTH CHALLENGES
START IN EARLY LIFE AMONG
CHILDREN, YOUTH AND YOUNG ADULTS
IMPACTING THEIR LIFE COURSE
TRAJECTORY OF PHYSICAL, MENTAL
AND EMOTIONAL HEALTH AND WELL
BEING. CHILDREN AND YOUTH ARE
DEALING WITH UNPRECEDENTED
CHALLENGES DUE TO COVID 19 PACK
TEMIC AS THE SEPTEMBER 2022
ALMOST 38,000 OF CALIFORNIA'S
CHILDREN UNDER 18 HAD LOST A
PARENT OR CAREGIVER DUE TO COVID
19. THIS TYPE OF LOSS HAVE LOST
HAS LONG TERM HEALTH
CONSEQUENCES. AND CONTRIBUTE TO
ADVERSE CHILDHOOD EXPERIENCES OR
RACES. TOXIC TOXIC STRESS OVER
TIME FROM ACES CAN ALTER BRAIN
DEVELOPMENT AND EFFECTS AFFECT
OUR BODY'S RESPONSE RESPONSES TO
STRESS. ACES ACES ARE LINKED TO
CHRONIC HEALTH PROBLEMS, MENTAL
HEALTH ISSUES AND SUBSTANCE
MISUSE AND ADULTHOOD. IN
CALIFORNIA, ABOUT SIX IN 10.
ADULTS EXPERIENCE AT LEAST 1/8
BEFORE THE AGE OF 18 PUBLIC
HEALTH WORKS WITH THE DEPARTMENT
OF SOCIAL SERVICES AND THE
OFFICE OF THE SURGEON GENERAL TO
PROMOTE POLICIES THAT PREVENT
ACES AND BUILD SAFE, STABLE,
NURTURING RELATIONSHIPS AND
ENVIRONMENTS THROUGH PROGRAMS
LIKE HOME VISITING MENTAL HEALTH
CONDITIONS AFFECT MORE THAN HALF
OF US PEOPLE OVER THEIR LIFETIME
AND COULD CONTRIBUTE TO WORSE
OVERALL HEALTH AND RISK OF DEATH
BY SUICIDE. IN CALIFORNIA,
SEVERE MENTAL ILLNESS AND
SUBSTANCE USE DISORDERS HAVE A
SIGNIFICANT IMPACT ON YOUNG
ADULTS WITH MOOD DISORDERS AND
SCHIZOPHRENIA AS A 1ST AND 3RD
LEADING CAUSE OF
HOSPITALIZATIONS, RESPECTIVELY.
FOR CALIFORNIANS AGES 15 TO 24.
MENTAL HEALTH CONDITIONS ARE THE
SECOND LEADING CAUSE OF YEARS OF
YEARS, LIVED WITH DISABILITY FOR
CALIFORNIANS AND THE LEADING
CAUSE FOR CHILDREN BETWEEN THE
AGES OF 5 TO 14, EMPHASIZING THE
NEED TO STRENGTHEN PREVENTION,
EARLY IDENTIFICATION AND
COMPASSIONATE CARE. UNTREATED
MENTAL HEALTH PROBLEMS OR
SUBSTANCE USE AND ADDICTION CAN
RESULT IN INJURY AND PREMATURE
DEATH. IN 2021 OVER 4000
CALIFORNIANS DIED BY SUICIDE,
THE OVERALL NUMBER OF SUICIDE
DEATHS HAS DECREASED SINCE 2018
BECAUSE OF THE DECREASES IN
OLDER PERSONS. IN CONTRAST,
SUICIDE AND SELF HARM ARE AMONG
THE TOP FIVE CAUSES OF DEATH FOR
15 TO 44 YEAR OLD AND RATES HAVE
BEEN RISING IN RECENT YEARS
AMONG BLACKS AND LATINO
CALIFORNIANS, HOSPITALIZATIONS
AND EMERGENCY DEPARTMENT VISITS
FOR MENTAL HEALTH RELATED
CONDITIONS. OR HIGHER AMONG
BLACK INDIVIDUALS THAN FOR ANY
OTHER RACE OR ETHNIC GROUP.
AMONG ASIA'S 15 TO 24 MOOD
DISORDERS IS THE LEADING CAUSE
OF HOSPITALIZATION. I'VE ALREADY
MENTIONED THAT POINT EARLIER.
THE GOVERNOR'S PROPOSED BUDGET
DEMONSTRATES STEADFAST
COMMITMENT TO ADVANCING THE
HEALTH AND WELL BEING OF ALL
CALIFORNIA, CALIFORNIA'S
COMMUNITIES WHILE PRIORITIZING
THE MOST VULNERABLE THROUGH
CRITICAL INVESTMENTS IN THE
BEHAVIORAL HEALTH SYSTEM, SOCIAL
SAFETY NET SYSTEM AND PUBLIC
HEALTH INFRASTRUCTURE. RECENT
PUBLIC HEALTH EFFORTS CAME TO
PREVENT ADDICTION OVERDOSE
THROUGH HARM REDUCTION
STRATEGIES, PUBLIC AWARENESS,
EDUCATION, RECOVERY AND SUPPORT
SERVICES, AS WELL AS INNOVATIVE
APPROACHES TO MAKE NALOXONE AND
FENTANYL TEST STRIPS WIDELY
AVAILABLE. THE CALIFORNIA YOUTH
BEHAVIORAL HEALTH INITIATIVE AND
INTERDEPARTMENTAL COLLABORATIVE
EFFORT TO TRANSFORM THE
BEHAVIORAL HEALTH SYSTEM TO BE
RESPONSIVE TO THE CURRENT NEEDS
OF YOUTH AND CALIF YOUTH AND
CHILDREN. CITY PH IS LEADING AN
EDUCATIONAL CAMPAIGN TO
NORMALIZE SEEKING SUPPORT FOR
MENTAL HEALTH CHALLENGES AND TO
DE STIGMATIZE BEHAVIORAL, HEALTH
AND COMMUNITIES. THE BUDGET
PROVIDES FOR CORE PUBLIC HEALTH
INFRASTRUCTURE THROUGH THE
FUTURE OF PUBLIC HEALTH
INITIATIVE. THE STATE INVESTED
$300 MILLION TO MODERNIZE STATE
AND LOCAL PUBLIC HEALTH
INFRASTRUCTURE AND TRANSITION TO
A MORE RESILIENT SYSTEM.
CENTERED ON EQUITY. WE ARE
BUILDING OUR CAPACITY AND
CAPABILITIES AND LONG TERM
STRATEGIC PLANNING AND POLICY
DEVELOPMENT. WORKFORCE
DEVELOPMENT. DATA MODERNIZATION
, DATA SCIENCE AND DECISION
INTELLIGENCE. EMERGENCY
PREPAREDNESS AND RESPONSE
HEALTHCARE PARTNERSHIPS TO
IMPROVE POPULATION HEALTH
MANAGEMENT. COMMUNITY ENGAGEMENT
AND PARTNERSHIPS AND RECRUITMENT
AND RETENTION OF DIVERSE
WORKFORCE THAT REFLECTS THE
COMMUNITIES WE SERVE. THIS
FUNDING FUNDING IS ALREADY AT
WORK, WITH MANY NEW STAFF HIRED
ACROSS THE STATE TO SUPPORT THIS
TRANSFORMATION. CD PH IS AN
AGENCY WITH OVER 220 PROGRAMS
AND OVER 4000 STAFF. BUT PUBLIC
HEALTH IS WHAT WE DO
COLLECTIVELY. TO ENSURE THE
CONDITIONS. IN WHICH EVERY
CALIFORNIAN CAN BE HEALTHY AND
THRIVE. THANK YOU FOR YOUR
LEADERSHIP AND SUPPORT. THANK
YOU, DR HARRIGAN FOR THE ANNUAL
STATE OF THE STATE ON PUBLIC
HEALTH. I WILL NOW BRING IT UP
TO THE DIOCESE AND SEE IF THERE
ARE ANY MEMBERS WHO HAVE
QUESTIONS. DR JACKSON. THANK YOU
VERY MUCH, AND THANK YOU VERY
MUCH FOR THE REPORT. I MEAN,
CLEARLY THERE ARE A LOT OF RED
FLAGS WHEN IT COMES TO THE STATE
OF OUR PUBLIC HEALTH HERE IN
CALIFORNIA. UM MY FIRST QUESTION
IS, OF COURSE WE'VE DEALT WITH
THE PANDEMIC AND, OF COURSE,
MONKEYPOX AS WELL. UH CALIFORNIA
BEGAN TO SEE PANDEMICS OR OTHER
PUBLIC HEALTH EMERGENCIES HAPPEN
MORE OFTEN IN CALIFORNIA. YES SO
THE PROCESS OF REALLY PANDEMIC.
IT'S REALLY A GLOBAL PROCESS,
CORRECT THE GROWING POPULATION
AND ENCROACHMENT TO AREAS WHERE
VIRUSES LIVE BECAUSE THEY'RE
USUALLY ZOONOTIC. THEY COME FROM
ANIMALS MOST OFTEN, SO THERE'S
ALWAYS THERE'S ALWAYS
INTRODUCTION OF VIRUSES INTO THE
HUMAN POPULATION. SO UH, THE
ANSWER. UNFORTUNATELY, THE
ANSWER IS YES. YEAH BECAUSE WE
SHOULD BE EXPECTING UH UM MORE
PUBLIC HEALTH EMERGENCIES OVER
TIME. UM OBVIOUSLY, WE
IDENTIFIED. MANY GAPS DURING
COVID 19 IN TERMS OF NOT ONLY
PUBLIC HEALTH, BUT HOW WE
ORGANIZE OURSELVES AS A SOCIETY.
UM WHAT ARE SOME WEAKNESSES AND
GAPS? UH THAT WE SAW AND COVID
THAT STILL EXIST TODAY THAT YOU
THINK WE REALLY NEED TO MAKE
SURE THAT WE ADDRESS UM BEFORE
THE NEXT ONE COMES I THINK I
THINK THE GAP WAS, I WOULD SAY
THE PRIMARY GAP WE HAD WITH THE
EXISTING HEALTH INEQUITIES THAT
WE HAD BEFORE THE PANDEMIC
BECAUSE WHEN THE VIRUS CAME THE
PEOPLE WHO ARE THE MOST IMPACTED
WITH THOSE THAT LIVED IN CROWDED
HOUSING AND HAD UNDERLYING
CHRONIC CONDITIONS HAD LIMITED
ACCESS TO HEALTH CARE, SO THOSE
EXISTING INEQUITIES WERE
AMPLIFIED BY THE PANDEMIC. IT
JUST IT JUST REALLY REVEALED
WHAT ALREADY EXISTED, SO WE
REALLY NEED TO DO A LOT MORE
THERE. UM, AND THEN FROM A
PUBLIC HEALTH PERSPECTIVE. WE
NEED TO CONTINUE OUR INVESTMENTS
IN PREPARING EMERGENCY
PREPAREDNESS. I'VE BEEN IN
PUBLIC HEALTH LONG ENOUGH TO SEE
THE WAXING AND WANING OF
INVESTMENTS FOR PUBLIC HEALTH
PREPAREDNESS. AND SO WE HAVE TO
JUST CONTINUE TO MAKE SURE IT'S
WHEN THINGS CALM DOWN, PEOPLE
SORT OF, YOU KNOW, LOSE INTEREST
IN PREPAREDNESS. IT'S REALLY
IMPORTANT TO CONTINUE THEM. I
MEAN, AND OBVIOUSLY, WHEN YOU
TALK ABOUT THE UH UM. UM RISE,
OF COURSE. COVID LOVED UH,
DIABETES. COVID LOVED AH!
HYPERTENSION HIGH BLOOD PRESSURE
, RIGHT? ALL THOSE THINGS ALL
THOSE THINGS ARE PERSONAL
BEHAVIORS. AH THAT YOU'VE
OUTLINED IN THIS REPORT. WHAT
WHAT? WHAT CAN WE DO BETTER TO
MAKE SURE THAT PEOPLE ARE UM
THAT SOME OF THESE TRENDS GO
INTO THE OPPOSITE DIRECTION. SO
YOU CAN SEE WE MADE. FOR EXAMPLE
, PROGRESS IN TOBACCO, WHICH IS
A PERSONAL BEHAVIOR, BUT IT'S
REALLY IT'S REALLY DRIVEN BY THE
SOCIAL ENVIRONMENT THAT YOU FIND
YOURSELF. SO IF YOU IF YOU HAVE
EASY ACCESS IF YOU WERE TO SEE
ADVERTISING FOR TOBACCO, WE
SYSTEMATICALLY DEALT WITH
TOBACCO IN SUCH A WAY THAT WE
REDUCE THE DEMAND AND SMOKING
WENT DOWN DRAMATICALLY. SO
ALTHOUGH IT ULTIMATELY IT DOES
SEEM LIKE IT'S A PERSONAL
BEHAVIOR. IT'S REALLY DRIVEN BY
SOCIAL NORMS AND THE SOCIAL
NORMS AND THE ENVIRONMENT ARE
THE ONES THAT WE SHAPE AND BUILD
. AND SO THERE'S A SAYING THAT
WE HAVE MAKE THE HEALTHY CHOICE
THE EASY CHOICE AND SO THEY'RE
REALLY COMES FROM US WORKING ON
SYSTEMS POLICIES AND IN THE
ENVIRONMENT TO MAKE THE HEALTHY
CHOICE, TOO EASY CHOICE. FOR
PEOPLE BEING BE FEELING FREE TO
EXERCISE IN YOUR COMMUNITY, FOR
EXAMPLE, SO TOBACCO IS ONE OF
THOSE THINGS THAT WAS VERY
PREVALENT AT ONE POINT, RIGHT,
BUT WE CONTINUE TO SEE SOME
DECREASES CORRECT. WHAT WHAT IS
THE NEXT THING WE SHOULD BE
GOING AFTER? SO THERE'S A
THERE'S A DIFFERENT THINGS THAT
WELL, I'M DRINKING MY SODA. UH
FIRST THING I NOTICED WHEN I
WALKED IN THE ROOM. UM I DIDN'T
SAY THERE WAS AN HYPOCRISY
INVOLVED IN THESE QUESTIONS. I
YOU KNOW, I THINK, UM, I WOULD
SAY THAT THE APPROACH THAT, UM
HHS IS TAKING WHICH IS A VERY
HOLISTIC APPROACH, TAKING A LIFE
COURSE AND INTER GENERAL
GENERATIONAL APPROACH, REALLY
FOCUSING ON EARLY LIFE EVENTS
AND STRESSES THAT THAT REALLY
CAUSES YOUR TRAJECTORY FOR A LOT
OF THE THINGS THAT WE'RE SEEING.
SO, UM, WE KNOW, FOR EXAMPLE,
EARLY LIFE TRAUMA IMPACTS YOUR
BRAIN, YOUR BODY AND YOUR
BEHAVIORS FOR THE REST OF YOUR
LIFE. SO A LOT OF THESE THINGS
THAT WE'RE SEEING ARE REALLY
EXPOSURES THAT HAPPENED EARLY ON
IN THE COMMUNITY WHERE PEOPLE
ARE MORE VULNERABLE, ESPECIALLY
WHEN THEY'RE YOUNG. SO I WOULD
SAY THAT WE WOULD I WOULD. I
WOULD SAY THAT THAT'S REALLY
THAT. THAT'S THE WHOLE AREA.
BEHAVIORAL, HEALTH AND MENTAL
HEALTH IS REALLY THE FRONTIER
FOR PUBLIC HEALTH. OFTENTIMES
HISTORICALLY, WE'VE DIVIDED,
PHYSICAL AND MENTAL WHEN IT'S
REALLY IS ONE AND IT REALLY
STARTS IN HEALTH IS PRODUCED IN
THE COMMUNITY, AND WE HAVE TO.
WE HAVE TO FIGURE OUT HOW TO HOW
TO SUPPORT THAT PROCESS IN THE
COMMUNITY. SO DO YOU SUPPORT
UNIVERSAL SCREENINGS FOR
CHILDREN FOR ACES? ABSOLUTELY
YES. I SHOULD TELL YOU THAT. MY
WIFE IS A FIRST GRADE TEACHER
FOR ALMOST 30 YEARS AND, UH, I
CAN TELL YOU THAT WE SHE SEES
THE EFFECTS OF ADVERSITY AND
EARLY AGES BECAUSE THEY COME
UNPREPARED TO LEARN, AND THEY
HAVE TO. THEY HAVE TO LEARN A
LOT OF THE SKILLS EARLY ON, SO
YES, SCREEN IS ABSOLUTELY
IMPORTANT, NOT JUST IN THE
HEALTHCARE SETTING, BUT ALSO IN
SCHOOLS AND OTHER SETTINGS WHERE
WE'RE TOUCHING. UH, KIDS WHEN
THEY'RE WHEN THEY'RE YOUNG. AND
THEN FINALLY, MY LAST QUESTION.
UH, I MEAN, OBVIOUSLY IS, UM,
YOU KNOW, DO YOU BELIEVE THAT
CALIFORNIA IS AND A MENTAL
HEALTH CRISIS? I WOULD SAY, I
WOULD SAY, UM, I THINK IF YOU
LOOK, I WOULD SAY THE UNITED
STATES IS IN THE MENTAL HEALTH
CARE AND THIS IS A PROBLEM
REALLY CROSSED ACROSS THE UNITED
STATES. NO TALKING ABOUT THE
DATA. UM AND I YES, I WOULD SAY.
WE ARE. WE ARE IN THE CRISIS. WE
ARE IN A CRISIS. JUST GIVEN THAT
THE NUMBERS THAT WERE OUT. THESE
ARE EARLY INDICATORS WE SEE
TRENDS GOING UP. I THINK WE HAVE
TO TREAT IT LIKE A CRISIS AND
REALLY BE FOCUSED. AND I THINK
WE ARE WE ARE FOCUSED AND
THEY'RE NOT WITHIN WITHIN DPH.
BUT WITHIN THE AGENCY. THERE'S A
LOT OF INVESTMENT AND FOCUSED ON
FOCUS ON THIS AREA. AND THEN
FINALLY, DO YOU BELIEVE THAT
RACISM IS A PUBLIC HEALTH
CRISIS? UM I BELIEVE THAT RACISM
IS AN ONGOING ONGOING CRISIS
THAT WE'VE WE'VE HAD. IT'S ONE
OF THESE THINGS WHERE I THINK
SOMETIMES, UH, PEOPLE FEEL LIKE
OH, THINGS HAVE GOTTEN BETTER.
BUT THEY HAVEN'T SOME ASPECTS.
WE CAN SEE THIS RIGHT NOW IN THE
UNITED STATES WHEN WE SEE THE
BLATANT DISCRIMINATION AGAINST
PEOPLE OF COLOR. SO I WOULD SAY
YES, WE DO. WE DO. WE DO HAVE A
CRISIS THAT WE HAVE TO CONTINUE
TO ADDRESS. SO FOR US EQUITY IS
A CORE PRINCIPLE IN WHAT WE DO,
AND WE'RE ON THAT JOURNEY TO
REALLY TRANSFORM OUR SYSTEMS TO
SYSTEMATICALLY ADDRESSED
DISCRIMINATION, RACISM AND
EQUITY FOR ALL EQUITY ISSUES
ACROSS OTHER DIMENSIONS OF
DISCRIMINATION. THANK YOU VERY
MUCH. MR CHAIR. BRING IT BACK UP
TO THE CHAIR. UM I'M GONNA
FOLLOW UP FIRST. I WANT TO
APPRECIATE THE IMPROVEMENTS
WE'VE MADE OVER THE LAST SEVERAL
DECADES. PRIMARILY I WANTED TO
CALL OUT IF I COULD. THE BIRTH
RATES AMONG ADOLESCENTS THAT
HAVE DECREASED BY 78% IN THE
LAST TWO DECADES, COMING FROM
ONE OF THOSE COMMUNITIES WHERE
WE HAD HIGH TEAM PREGNANCIES, IT
HAS BEEN PUBLIC HEALTH
STRATEGIES THAT HAVE MADE
SIGNIFICANT IMPROVEMENTS IN
COMMUNITIES LIKE MINE, BUT I'D
LIKE TO DRILL INTO SOME OF THE
AREAS OVER THE LAST COUPLE OF
YEARS WHERE WE SEEM TO HAVE
STRUGGLED. YOU IDENTIFIED THAT
IT WAS ALCOHOL, WROTE INJURY AND
DRUG OVERDOSES THAT HAVE
INCREASED 200% IN THE LAST
DECADE. BUT SPECIFICALLY YOU
SAID THAT IT INCREASED 79% IN
JUST TWO YEARS AND NOW HAS OVER
10,000 DEATHS, WHICH WERE
REPORTED IN 2021. SO I'M
WONDERING HOW YOU CAN HELP TO
FRAME IT IN THE SAME WAY YOU
JUST DESCRIBED. HOW DO WE MAKE
THE HEALTHY CHOICE? EASY CHOICE
HERE. HOW DO WE ADDRESS MANY OF
THE ALCOHOL, ROAD INJURIES AND
DRUG OVERDOSES THAT WE'RE
SEEING? YEAH THAT'S A REALLY
GOOD. THAT'S AN INCREDIBLY GOOD
QUESTION IN EACH OF THEM ARE ARE
VERY, VERY DIFFERENT. UM AND
I'LL JUST START WITH JUST DRUG
DRUG OVERDOSE. WE KNOW AND
THERE'S REALLY BEEN THIS IF YOU
IF YOU HAVE BEEN FOLLOWING THE
OPIOID OVERDOSE OVERDOSE
EPIDEMIC, THERE REALLY HAVE BEEN
DIFFERENT, DIFFERENT ERRORS, AND
WE SAW THE ERROR WITH PRIMARILY
PRESCRIPTION DRUGS AND HEROIN.
WE'RE NOW WE'RE SEEING NOW.
FENTON FENTANYL AND FENTANYL IS
ENDS UP AND NOT JUST OPIATES
OPIOID DRUGS, BUT THEY END UP IN
OTHER DRUGS. SO THERE THERE YOU
CAN BE. YOU MIGHT BE THINKING
YOU'RE TAKING YOU'RE TAKING, UM
, A XANAX PILL, AND IT MAY
CONTAIN FENTANYL AND THIS IS
REALLY TRANSFORMED. IT'S MADE IT
MUCH MORE DIFFICULT IF YOU IF
YOU IF YOU PUT ON YOUR PUTTING
YOUR COVID LENSES, IT'S ALMOST
AS IF THE ABBOT JUST LIKE THE
VARIANCE HAVE EVOLVED. THE
EPIDEMIC HAS EVOLVED. TO HIGHER
POTENCY, OPIOID DRUGS THAT ARE
INCREDIBLY ADDICTIVE AND ALSO
DEADLY. AND SO THEN OUR
STRATEGIES REALLY HAVE TO CHANGE
. AND SO IT'S NOT JUST A MATTER
OF HAVING THE EARLY LIFE EVENTS
ARE IMPORTANT. BUT ALSO YOU HAVE
THESE EVENTS WHERE YOU'RE AT
RISK FOR OVERDOSE. SO YOU HAVE
TO HAVE THE ABILITY TO IF YOU IF
YOU THINK YOU MIGHT HAVE
FENTANYL TO BE ABLE TO TEST FOR
IT HAVE HAVE A LOT IN THE LOCK
STONE AVAILABLE. SO HAVING THOSE
SYSTEMS IN PLACE ARE REALLY
CRITICAL AND THEN HAVING ACCESS
TO TREATMENT, SO PEOPLE HAVE TO
BE ABLE TO HAVE EARLY, EASY
ACCESS TO TREATMENT FOR OPIOID
ADDICTION. AND SO THOSE ARE
THOSE ARE AREAS THAT, UM, AGENCY
IS WORKING ON TO ADDRESS. HAVING
YOUNG CHILDREN SOMETHING THAT
KEEPS ME UP LATE AT NIGHT IS
THINKING ABOUT THE AMOUNT OF
FENTANYL OVERDOSES THAT WE'RE
SEEING IN COMMUNITIES ALL OVER
OUR STATE. UM ON THE NEXT TOPIC
I'D LIKE TO ADDRESS IS
CALIFORNIANS WHO DIED BY SUICIDE
IN YOUR REPORT. YOU HIGHLIGHTED
BOTH YOUNG BLACK AND LATINO
CALIFORNIANS. BUT THE CDC HAS
ALSO ADDED BOTH FEMALE AND LGBT
Q YOUTH AS BEING DISAGGREGATED
AND AT PARTICULAR RISK, AND I'M
WONDERING IF YOU CAN COMMENT OF
CALIFORNIA'S SEEING THAT SAME
DAY. UM I WOULD HAVE TO LOOK AT
THE DATA AGAIN. I DIDN'T. I'LL
HAVE TO FOLLOW UP. I'LL HAVE TO
FOLLOW UP ON THAT. FINALLY IF I
CAN, JUST REPRESENTING THE
COMMUNITY THAT I DO WAS HOPING
YOU COULD COMMENT REGARDING
SYPHILIS AS FRESNO COUNTY HAS
THE HIGHEST CONGENITAL SYPHILIS
IN OUR STATE AND WONDERING IF
YOU CAN COMMENT ON SPECIFIC
STRATEGIES THAT MAY HELP US TO
ADDRESS THAT. YES SO, UM, YOU
KNOW THE PROBLEM THAT YOU KNOW
THE AND THE PROBLEM WITH
CONGENITAL SYPHILIS IN THAT
POPULATION. IT'S A COMPLEX
SOCIAL. IT'S A COMPLEX SOCIAL
PROBLEM. WE HAVE SORT OF A
COMBINATION OF POVERTY. DRUG SEX
FOR DRUGS AND OTHER OTHER
SERVICES, SORT OF REALLY CAUSING
PEOPLE NOT TO BE NOT TO BE
DIAGNOSED AND BECOMING PREGNANT
AND THEN NOT HAVING PRENATAL
CARE. AND THEN, OF COURSE,
DELIVERING A CHILDHOOD
CONGENITAL SYPHILIS, SO THIS IS
REALLY AN IMPORTANT IMPORTANT
PROBLEM. WE DO HAVE OUR STAFF
SPECIFICALLY FOCUSING ON THAT. I
DON'T HAVE THE DETAILS WITH ME
AT THE MOMENT, BUT I CAN MAKE
SURE THAT WE PUT THAT TOGETHER
FOR YOU AND PROVIDED I
APPRECIATE THAT, AND I DIDN'T
EXPECT YOU TO HAVE ALL 4000
EMPLOYEES READY OR 220 PROGRAMS
RIGHT? BUT IT IS IT IS. IT'S A
PROBLEM THAT WHERE WE ARE, WE
ARE FOCUSED ON IT. FOR THE FOR
THE REASONS THAT I JUST
MENTIONED WITH THAT I WOULD LIKE
TO THANK VERY MUCH DOCTOR
ARROGANT AND WE WILL NOW MOVE ON
TO ISSUE TWO. OKAY. THANK YOU.
OUR SECOND ISSUE IS ON THE
EMERGENCY MEDICAL SERVICES DATA
RESOURCES SYSTEM BUDGET CHANGE
PROPOSAL, WE WILL HAVE TWO
PRESENTERS ON THIS PANEL. UH
FIRST WE'LL BEGIN WITH LORNA,
BABY DEPUTY DIRECTOR FOR THE
PROJECT MANAGEMENT DIVISION AND
THE OFFICE OF SYSTEMS
INTEGRATION AND RICK TRUSSELL,
CHIEF OF ADMINISTRATION WITH. WE
BEGIN WITH MISS EVIE. GOOD
AFTERNOON, MR CHAIR AND
HONORABLE COMMITTEE MEMBERS.
THANK YOU FOR HAVING ME HERE
TODAY. THE OFFICE OF SYSTEMS
INTEGRATION IS REQUESTING 1.13
MILLION IN FISCAL YEAR 23 24
EXPENDITURE AUTHORITY FOR SIX
LIMITED TERM POSITIONS TO
PROVIDE PROJECT MANAGEMENT, THE
SCHOOL AND PROCUREMENT SERVICES
TO THE EMERGENCY MEDICAL
SERVICES AUTHORITY IN SUPPORT OF
THE CALIFORNIA AMS DATA RESOURCE
SYSTEM PROJECT, KNOWN AS CEDARS.
THE PROPOSED CEDAR CEDARS
PROJECT IS INTENDED TO CREATE
LINKS BETWEEN VARIOUS HEALTH
INFORMATION EXCHANGE SYSTEMS TO
INCREASE DATA INTEROPERABILITY
BETWEEN HOSPITALS, M S AGENCIES
AND HEALTHCARE ORGANIZATIONS.
CEDARS IS ENVISIONED TO PROVIDE
A SOLUTION THAT WILL ALLOW FOR
THE AGGREGATION AND ANALYSIS OF
VMS DATA TO ENSURE THAT PATIENTS
RECEIVE THE APPROPRIATE CARE BY
QUALIFIED MÁS PROFESSIONALS. AND
HOW IS THE DATA REPOSITORY FOR
INFORMATION ON ALL E M S
TRANSPORT WITHIN CALIFORNIA?
THIS IS NEEDED TO DRIVE QUALITY
ASSURANCE TO ENSURE THAT
CALIFORNIA AMS IS ALIGNED WITH
NATIONAL STANDARDS AND BEST
PRACTICES AND ALLOW FOR BETTER
INFORMED AND DATA DRIVEN POLICY
DECISIONS. THE CEDARS PROJECT IS
CURRENTLY IN STAGE. TWO
ALTERNATIVES ANALYSIS OF THE
CALIFORNIA DEPARTMENT OF
TECHNOLOGY PROJECT APPROVAL
LIFECYCLE OR PAL PROCESS THE PAL
PROCESSES CURRENTLY TARGETED FOR
COMPLETION. INTERVIEW 2024. THE
OVERSIGHT RESOURCES REQUESTED
WILL ENSURE ALL STAGES OF THE
PAL PROCESS OR MANAGE CONSISTENT
WITH PROJECT MANAGEMENT AND
PROCUREMENT, BEST PRACTICES AND
WITHIN A COLLABORATIVE AND
TRANSPARENT GOVERNANCE FRAMEWORK
TO ENSURE INCLUSION OF
STAKEHOLDER GROUPS TO ACHIEVE
THE ENVISIONED GOALS. UH,
OBJECTIVES AND OUTCOMES. AND I
WILL TAKE A PAUSE THERE FOR ANY
QUESTIONS, MR. CHAIR, MR
TRUSSELL. YES SIR. UM GOOD
AFTERNOON, MR CHAIR. MEMBERS OF
THE COMMUNITY. RICHARD TRUSSELL
, CHIEF OF ADMINISTRATION AT THE
E. M S AUTHORITY. WHICH WE REFER
TO AS AMAZON, AS REQUESTED, WILL
PROVIDE. A BRIEF OVERVIEW OF EMS
IS PROPOSED BUDGET AND THE TWO
SPECIFIC TRAILER BILL PROPOSALS
CURRENTLY UNDER CONSIDERATION BY
THE COMMITTEE, THE GOVERNOR'S
BUDGET FOR FISCAL YEAR 23 24,
INCLUDES AM I MISSING SOMETHING?
I BELIEVE YOU'RE ON ISSUE. THREE
IF YOU CAN SPEAK TO ISSUES, TOO.
ISSUE THREE IS THE OVERSIGHT OF
THE BUDGET. CORRECT YES, BUT
WE'RE STILL ON ISSUE TWO. OH I
HAVE NO COMMENTS ON THAT. OKAY
NINA, BACK WITH THE DEPARTMENT
OF FINANCE DEPARTMENT OF
FINANCE. CHINA HONG. NO FURTHER
COMMENTS, ELIO. WHO OWNS LEO. WE
HAVE NO CONCERNS WITH THIS
PROPOSAL. THANK YOU. WE WILL
BRING IT UP TO THE DIOCESE TO
SEE IF THERE ARE ANY MEMBERS
QUESTIONS. SEEING NONE. WE WILL
UM, THANK YOU VERY MUCH AND MOVE
NOW ONTO ISSUE. THREE APOLOGIES
. OKAY GOVERNOR'S BUDGET FOR
FISCAL YEAR 23 24 INCLUDES
EXPENDITURE AUTHORITY AND THE
AMOUNT OF 53.7 MILLION AND 114
PERMANENT POSITIONS. THIS IS A
REDUCTION OF APPROXIMATELY 100
AND 21 MILLION OVER LAST YEAR'S
BUDGET AND IS PRIMARILY THE
RESULT. REDUCTION OF 100 MILLION
IN REIMBURSEMENT AUTHORITY AND
$21 MILLION IN VARIOUS ONE TIME
APPROPRIATIONS. OF THE 53 POINT.
7,000,030 53.0.5 MILLION, OR 57%
IS DELEGATED TO STATE OPERATIONS
AND 23.2 MILLION OR 43% TO LOCAL
ASSISTANCE. STATE OPERATIONS.
FUNDING OF 30.5 MILLION IS 54%
GENERAL FUND, 18% SPECIAL FUND
16% REIMBURSEMENTS AND 1 12%
FEDERAL LOCAL ASSISTANCE.
FUNDING OF 23.2 MILLION IS 48%
REIMBURSEMENTS. 48% GENERAL
FUND. 3% FEDERAL AND 1% SPECIAL
FUNDS. ISSUE NUMBER FIVE. IF
THERE ARE NO QUESTIONS, I'LL
MOVE ON ISSUE. STAY ON ISSUE
THREE IF WE CAN WE WILL NOW GO
TO SALINA NOR ALLEY WITH THE
DEPARTMENT OF FINANCE GENERALLY,
DEPARTMENT OF FINANCE NOTHING
FURTHER TO ADD. OH WILL OWNS
ELIO NOTHING FURTHER. WE WILL
NOW BRING IT UP TO THE DIOCESE
TO SEE IF THERE ARE ANY MEMBERS
QUESTIONS. SEEING NONE. WE WILL
NOW MOVE ON TO ISSUE FIVE.
NUMBER FIVE IS THE CALIFORNIA
PULSE HE REGISTRY ACT TRAILER
BILL LANGUAGE. IS PROPOSING THE
STRIKETHROUGH STATUTORY
REQUIREMENTS TO INTEGRATE THE
ADVANCED HEALTH HEALTH CARE
DIRECTIVE REGISTRY INTO THE
PULSE REGISTRY. THE PORTS FORM
IS A MEDICAL ORDER SIGNED BY
BOTH THE PATIENT AND PHYSICIAN,
NURSE PRACTITIONER OR
PHYSICIAN'S ASSISTANT THAT GIVES
SERIOUSLY ILL PATIENTS MORE
CONTROL OVER THEIR CARE BY
SPECIFYING THE TYPE OF MEDICAL
TREATMENT THEY WISH TO RECEIVE
TOWARDS THE END OF LIFE. CHAPTER
143 STATUTES OF 2021 ASSEMBLY
BILL 1 33 ENACTED THE CALIFORNIA
POLLS E REGISTRY ACT ON JULY
27TH 2021, WHICH REQUIRES EMC TO
ESTABLISH A STATEWIDE ELECTRONIC
PULSE REGISTRY SYSTEM FOR THE
PURPOSE OF COLLECTING PATIENT
PULSE INFORMATION AND PROVIDING
REAL TIME ELECTRONIC ACCESS TO
THE FORM BY EMS AND MEDICAL
PROVIDERS. MAYBE 1 33 ALSO
REQUIRES THAT INCORPORATE THE
HCG REGISTRY ESTABLISHED
PURSUANT TO PART FIVE OF
DIVISION 4.7 OF THE PROBATE CODE
AND OVERSEEN BY THE SECRETARY OF
STATE INTO THE E PULSE REGISTRY.
EXISTING LAW REQUIRES HAMZA TO
INCORPORATE THE ADVANCED
HEALTHCARE DIRECTORY AND ANZUS
PHYSICIAN ORDERS FOR LIFE
SUSTAINING TREATMENT REGISTRY AS
THERE IS NO EXISTING ELECTRONIC
REGISTRY FOR THE H C D
INTEGRATION OF THIS DATA INTO
THE ELECTRONIC REGISTRY IS NOT
FEASIBLE WITHOUT SIGNIFICANT
DELAYS. THE IMPLEMENTATION OF
THE PULSE REGISTRY. AND
ADDITIONAL RESOURCES.
ELIMINATING THE REQUIREMENT FOR
NZ TO INCORPORATE THE H C D
REGISTRY INTO THE PULSE. THE
REGISTRY WILL ALLOW THE PULSE
THE REGISTRY TO BE IMPLEMENTED
IN A TIMELY MANNER. DEPARTMENT
OF FINANCE. GENERALLY DEPARTMENT
OF FINANCE NOTHING FURTHER TO
ADD. WE HAVE NO CONCERNS WITH
THIS PROPOSAL WILL BRING IT UP
TO THE DIETS TO SEE IF THERE ARE
ANY MEMBERS QUESTIONS. I WILL
KEEP IT HERE AT THE CHAIR IF I
CAN I'M GOING TO DRILL IN A
LITTLE BIT INTO THIS ONE. I'D
LIKE TO UNDERSTAND HOW MANY
FORMS THE HCG REGISTRY CURRENTLY
CONTAIN AND HOW MUCH RESOURCES
WOULD BE NEEDED TO CONVERT THEM
OVER TO ELECTRONIC FORMS. UM
BASED ON EARLY DISCUSSIONS WITH
SECRETARY OF STATE THERE'S
APPROXIMATELY 10,000 FORMS THAT
THEY HAVE ON FILE THERE.
CURRENTLY WE DO NOT. WE ARE
CURRENTLY ESTIMATING THE
RESOURCES NEEDED TO MAKE THAT
TRANSITION OF THOSE FORMS TO
ELECTRONIC AND WE NEED TO DO
FURTHER DISCOVERY ON THAT
PROCESS DOESN'T NOT CREATE
CONFUSION TO HAVE TWO SEPARATE
REGISTRIES AND POTENTIALLY LEAD
TO PROVIDERS, REFERRING TO
OUTDATED DOCUMENTS IN THIS
POSITION RIGHT NOW IS THAT IT
CREATES NO MORE CONFUSION THAN
ALREADY EXISTS TODAY WITH THE
DIFFERENCE BETWEEN THE TWO
FORMS, I WILL SAY AS ONE OF
THOSE FRONT LINE PROVIDERS.
THERE IS SIGNIFICANT CONFUSION,
WHICH IS WHY I BELIEVE IT WAS
IMPORTANT FOR US TO CREATE A
REGISTRY IN THE FIRST PLACE.
AND, UM I GUESS WHAT I'M TRYING
TO UNDERSTAND IS I DON'T WANT TO
DELAY THE POLLS E REGISTRY FROM
GETTING ONLINE AS QUICKLY AS
POSSIBLE. BUT WOULD LIKE US TO
CONSIDER HOW WE CAN ALSO CREATE
AN ELECTRONIC REGISTRY
EVENTUALLY FOR AGE CD AND WOULD
LIKE TO BE ABLE TO WORK WITH THE
ADMINISTRATION TO FIGURE OUT HOW
LONG AND HOW EXPENSIVE THAT
WOULD BE. WOULD YOU BE AMENABLE
OR SUPPORTIVE, TOO? FOLLOWING UP
ON THAT INFORMATION, YES, WOULD
BE AMENABLE TO FOLLOWING UP ON
THAT INFORMATION WITH THAT WE
WILL DR JACKSON. YOU KNOW, MY
ONLY CONCERN WAS THERE. IT
SEEMED AS THOUGH WE WERE, UM UM
MAKING THIS CHANGE THE STATUTORY
CHANGE AND DEFINITELY LIKE THEY
DIDN'T SEEM LIKE THERE WAS A
TIMELINE IN WHICH OKAY IF YOU
NEED TO DO THIS FOR THE POST, UM
THEN, BY WHAT TIME DO WE EXPECT
THE LAW TO COME BACK INTO EFFECT
SO THAT WE CAN STILL FINISH THE
JOB? AND BY WHEN DO WE SEE US
DOING SO? CURRENTLY WE ARE IN
THE DISCOVERY PHASE OF THAT
PROCESS. MHM RIGHT NOW. WE DO
NOT HAVE A DEFINITIVE DATE, BUT
WE CAN GET BACK TO YOU IN THAT
PROCESS IS COMPLETE, WOULD JUST
HATE TO SUPPORT THIS. AND THEN
NOW WE FORGET ALL ABOUT IT
BECAUSE WE HAVE A THOUSANDS
ISSUES THAT WE HAVE TO DEAL
WITH. SO I MEAN AT THIS CURRENT
PROPOSAL, I WOULDN'T BE IN
SUPPORT OF THIS. UM I THINK THAT
WE NEED TO HAVE JUST MORE OF A
LONG TERM PLAN SO WE CAN
UNDERSTAND. HOW WE CAN GET BOTH
DONE. RIGHT AND SO, LOOKING
FORWARD TO MORE DISCUSSION ON
THAT. THANK YOU. THANK YOU. THE
THIRD STEP QUESTION WITHIN THE
AGENDA REGARDING, UM, AMENDING
THE LAW TO STATE THAT THE
INTEGRATION OF THE TWO REGISTRY
SHALL OCCUR WHEN RESOURCES
BECOME AVAILABLE WILL MOST
LIKELY BE THE DIRECTION THAT
THIS COMMITTEE TAKES AND WOULD
LIKE TO BE ABLE TO WORK WITH THE
ADMINISTRATION TO FIGURE OUT THE
COST AND TIMELINE.
ASSEMBLYMEMBER'S RUBIO JUST HAVE
TO, UM DR JACKSON'S COMMENTS
WERE USED TO GETTING THAT
STANDARD ANSWER. WE'RE WORKING
ON IT, AND, UM, QUITE FRANKLY,
IT'S YOU KNOW, OBVIOUSLY, UH, IT
HAS TO BE REALLY FRUSTRATING FOR
YOU AS WELL AS FOR US TO KEEP
GETTING THE SAME ANSWER OVER AND
OVER AGAIN. SO YOU KNOW, I DO
WOULD SUGGEST THAT TO DR JACKSON
AND DR ARAMBULA IS POINT THAT WE
HAVE SOME DEFINITIVE ANSWERS
BECAUSE THE FACT THAT YOU KNOW,
WE COME IN AND ASK THESE
QUESTIONS LIKE OH, WE'RE WORKING
ON IT. WHAT DOES THAT MEAN? ARE
YOU WORKING ON IT? ONE DAY A
WEEK. ARE YOU WORKING ON A ONE
DAY A MONTH? ONE DAY A YEAR?
IT'S A BIG DIFFERENCE, UM, TO
SAY I'M WORKING ON IT. AND THEN
YOU KNOW AGAIN ONE DAY VERSUS
YOU KNOW, ONE DAY A WEEK VERSUS
ONE DAY A YEAR IS A HUGE
DIFFERENCE. SO IF WE CAN GET A
LITTLE BIT MORE SPECIFIC AS TO
WHAT I'M WORKING OR WERE WORKING
ON, IT MEANS UNDERSTOOD. THANK
YOU. WE WILL THANK VERY MUCH
THIS PANEL AND THEN WE WILL NOW
MOVE ON TO ISSUE SIX. MY NAME IS
GENERALLY AND I'M WITH THE
DEPARTMENT OF FINANCE AND WILL
BE PRESENTING ON THIS ISSUE. THE
EMERGENCY MEDICAL SERVICES
AUTHORITY PROPOSES TO REMOVE THE
MEDICAL DOCTOR REQUIREMENT AS A
PART OF THE ELIGIBILITY CRITERIA
TO SERVE AS THE DEPARTMENT'S
DIRECTOR AND HAVE A CHIEF
MEDICAL OFFICER OF THE
DEPARTMENT WHO SHALL BE
APPOINTED BY THE GOVERNOR.
EXISTING LAW REQUIRES EMC'S
DIRECTOR TO BE A LICENSED
PHYSICIAN AND SURGEON WITH
SUBSTANTIAL EXPERIENCE IN THE
PRACTICE OF EMERGENCY MEDICINE.
THE ELIGIBLE CANDIDATE POOL AND
MADE IT MORE CHALLENGING TO
RECRUIT FOR THIS ROLE IN THE
PAST. THEREFORE REMOVING THE MD
REQUIREMENT FOR MP'S DIRECTOR
WILL ASSIST THE DEPARTMENT WITH
TAPPING INTO A BROADER CANDIDATE
POOL WHILE AT THE SAME TIME
FOCUSING ON THE APPROPRIATE
SKILL SET REGARDING PUBLIC
ADMINISTRATION. UNLESS THERE ARE
ANY QUESTIONS. I WILL NOW
ADDRESS THE QUESTIONS INCLUDED
IN THE AGENDA. ADDRESS THE
QUESTIONS THAT ARE ON THE
AGENDA, PLEASE. THE FIRST IS
REGARDING THE NEED FOR
ADDITIONAL FUNDING. THE
ADMINISTRATION IS EVALUATING THE
NEED FOR ADDITIONAL FUNDING, AND
ANY REQUESTS FOR ADDITIONAL
FUNDING WILL BE SUBMITTED
THROUGH THE SPRING BUDGET
PROCESS. SECOND REGARDING ANY
CONCERNS, RECRUITING A CHIEF
MEDICAL OFFICER. IT IS
HISTORICALLY BEEN CHALLENGING TO
RECRUIT AN MD WITH EXPERIENCE IN
EMERGENCY MEDICINE AND SKILL SET
TO LEAD A STATE DEPARTMENT.
THEREFORE THE ADMINISTRATION
BELIEVES THAT WOULD BOTH AN EMC
DIRECTOR AND CHIEF MEDICAL
OFFICER, WE WILL BE ABLE TO
RECRUIT FROM A BROADER CANDIDATE
POOL AND RECRUIT INDIVIDUALS
WITH THE NECESSARY SKILL SETS
CRITICAL TO OVERSEEING THE
DEPARTMENT. ELIO. WE HAVE NO
CONCERNS WITH THIS PROPOSAL.
BRING IT UP TO THE DIOCESE FOR
ANY MEMBERS, QUESTIONS. YOU'RE
SEEING NONE. ASSEMBLYMEMBER'S
ALANA'S JUST REAL QUICK. WHY IS
THIS A TRAILER BILL AND NOT A
POLICY BILL? WE BELIEVE THAT
THIS IS A TRAILER BILL IN ORDER
TO ADVANCE DISCUSSIONS. UM BUT I
WOULD HAVE TO DEFER TO THE
DEPARTMENT ON WHY THIS WAS
INTRODUCED AS A TRAILER BILL. I
THINK WE HAVE TO HIT THE BUTTON.
UH YOU COULD SHOULD. IT SHOULD
BE ACTIVE NOW, UM, LITTLE
DEPARTMENT OF FINANCE. I WOULD
ALSO KNOW, GIVEN QUESTION ONE
REGARDING A BUDGET PROPOSAL. ONE
OF THE OUTSTANDING QUESTIONS WAS
WHETHER THERE WOULD BE A
RESOURCE NEED ASSOCIATED WITH
THIS REQUEST. HENCE THE
SUBMISSION OF A TRAILER BILL
INSTEAD OF A POLICY BILL. WE
WILL THANK VERY MUCH THIS PANEL
. WE WILL NOW MOVE ON TO ISSUE
SEVEN IN THE DEPARTMENT OF
PUBLIC HEALTH. THANK YOU. THANK
YOU. ISSUE SEVEN IS AN OVERVIEW
OF THE CALIFORNIA DEPARTMENT OF
PUBLIC HEALTH BUDGET BEING
PRESENTED BY BRENDAN, NEW YEAR'S
CHIEF DEPUTY DIRECTOR OF
OPERATIONS AT SEA, DPH. MR NUNEZ
. THANK YOU. CHAIR MEMBERS.
BRANDON NUNES, CHIEF DEPUTY FOR
OPERATIONS AT THE DEPARTMENT. IS
THAT BETTER? PERFECT. UM THE
AGENDA DOES A REALLY GOOD JOB OF
PROVIDING THE OVERVIEW OF OUR
BUDGET, SO I'LL KIND OF HIT SOME
HIGHLIGHTS AND THEN WE HAVE
MEMBERS OF OUR TEAM TO DISCUSS
SOME OF THE OTHER ISSUES THAT
ARE IN THE AGENDA TODAY. UM BUT
AS FAR AS OVERVIEWS GOES FOR 23
24, OUR DEPARTMENT HAS A BUDGET
OF 5.5 BILLION, AND THAT'S GOING
TO SUPPORT OUR SIX CENTERS AND
VARIOUS DIVISIONS AND OFFICES.
UM BROKEN DOWN. WE HAVE ABOUT A
BILLION DOLLARS COMING TO US
FROM GENERAL FUND ROUGHLY 2.2
BILLION COMING TO US IN FEDERAL
FUNDS AND THEN 2.3 BILLION
COMING TO US IN THE FORM OF
ROUGHLY 50 DIFFERENT SPECIAL
FUNDS. IT'S ALSO BROKEN DOWN BY
TWO BILLION FOR OUR STATE OPS
SUPPORT AS WELL AS 3.5 BILLION
THAT GOES FOR LOCAL ASSISTANCE
FOR OUR LOCAL HEALTH
JURISDICTIONS AND OTHER LOCAL
ASSISTANCE PROGRAMS. UM, THE
AGENDA POINTS OUT THAT THERE IS
A DECREASE OF OUR BUDGET BETWEEN
22 23 23 24 OF ROUGHLY 1.4
BILLION OR 20% I JUST WANTED TO
HIGHLIGHT REAL QUICKLY THAT THIS
ISN'T THE RESULT OF BUDGET
REDUCTIONS OR ANYTHING LIKE
THAT. IT'S PRIMARILY THE RESULT
OF ONE TIME FUNDING THAT WAS
PROVIDED IN 22 23. THERE WAS
NATURALLY GOING TO FALL OFF IN
23 24. THE LARGEST OF THIS, AS
YOU MAY ALL RECALL COVID SUPPORT
THAT WAS PROVIDED IN THE 22 23
BUDGET OF ROUGHLY 1.7 BILLION.
THAT NUMBER NOW FOR 23 24 IS
ROUGHLY 176 MILLION THAT SPREAD
OVER ABOUT 100 MILLION FOR OUR
COVID RESPONSE SUPPORT AS WELL
AS ABOUT 75 FOR OUR NEW, SMARTER
PLAN INITIATIVE. UM, THERE WAS
ALSO YOU MAY RECALL IN 22 23, A
NUMBER OF DIFFERENT GENERAL FUND
INVESTMENTS THAT WERE MEANT TO
BE ONE TIME. YOUR AGENDA ON PAGE
25, I BELIEVE DOES A REALLY GOOD
JOB OF INVENTORYING WHAT THOSE
ONE TIME GENERAL FUND ITEMS ARE
FOR, AND THAT'S PRIMARILY THE
CHANGE FOR OUR GENERAL FUND IS
AS ONE TIMES. UM WE'RE HAPPY TO
SAY THAT THE INVESTMENT FOR
FUTURE PUBLIC HEALTH IS DR
ARROGANT MENTIONED OF 300
MILLION REMAINS IN THE BUDGET.
ROUGHLY 100 MILLION COMING OUR
DEPARTMENT. AND 200 MILLION
GOING TO OUR LOCAL HEALTH
JURISDICTIONS. UM WE DO HAVE
SOME ISSUES IN OUR BUDGET
RELATED TO THE ADMINISTRATIVE
ADMINISTRATIONS PROPOSAL TO
ADDRESS THE BUDGET GAP,
PRIMARILY IN TWO AREAS. UM, THE
FIRST IS RELATED TO OUR PUBLIC
HEALTH WORKFORCE. WE HAD SOME
INVESTMENTS THAT WERE MADE LAST
YEAR. AND THERE'S ROUGHLY A $50
MILLION REDUCTION TO PUBLIC
HEALTH WORKFORCE, UM, FOR THINGS
SUCH AS TRAINING, WORKFORCE
DEVELOPMENT AND THE LIKE OF
ABOUT 50 MILLION, AND THAT'S
THAT REDUCTION SPREAD OVER A
FOUR YEAR PERIOD, ROUGHLY FIVE
MILLION IN CURRENT YEAR AND
ROUGHLY 21 MILLION IN BUDGET
YEAR AND BUDGET YEAR PLUS ONE
AND THEN BALANCED BY A FEW
MILLION IN THE BUDGET YEAR, PLUS
TWO UM WE ALSO HAVE AN ISSUE
RELATED TO OUR CLIMATE AND
HEALTH RESILIENCE PLANNING
REDUCTION THAT WAS PUT IN LAST
YEAR'S BUDGET. THE DIFFERENCE
WITH THIS PARTICULAR REDUCTION
IS THIS IS ONE OF THE
ADMINISTRATION'S TRIGGER
REDUCTIONS. SO TO THE EXTENT WE
ARE BUILDING THE 24 BUDGET, AND
THERE IS FUNDING THAT'S
AVAILABLE IN JANUARY 24 THIS
WOULD BE A TRIGGER REDUCTION
THAT WOULD BE RESTORED. UM AND
THEN, FINALLY, OVER THE COURSE
OF OUR HEARINGS. THERE'S GOING
TO BE A NUMBER OF DIFFERENT
INVESTMENTS THAT WE TALKED TO
YOU ABOUT. THERE'S ROUGHLY 14
MILLION THAT'S INCLUDED IN OUR
BUDGET RELATED TO ABOUT 15
PIECES OF LEGISLATION THAT
PASSED LAST YEAR. WE HAVE ABOUT
A 3.2 MILLION AUGMENTATION FROM
OUR TOBACCO TAX REVENUES FROM
PROP 56 99 THAT ARE GOING TO
SUPPORT OUR TOBACCO CESSATION
PROGRAMS. AND THEN FINALLY, WE
HAVE ABOUT A $200 MILLION
INCREASE IN THE CURRENT YEAR AND
ABOUT A $240 MILLION INCREASE IN
BUDGET YEAR TO SUPPORT OUR
PUBLIC ASSISTANCE PROGRAMS SUCH
AS OUR WOMEN, INFANTS AND
CHILDREN AIDS DRUG ASSISTANCE
PROGRAM, UM AND JAR GENETIC
DISEASE SCREENING PROGRAM.
THAT'S A HIGH LEVEL SUMMARY. WE,
OF COURSE, HAVE OUR TEAM TO
DISCUSS THE NUMBER OF ISSUES
THAT ARE IN THE BUDGET. UM, BUT
THAT'S A KIND OF A HIGH LEVEL
FOR US. DEPARTMENT OF FINANCE.
GOOD AFTERNOON. NICK MILLS
DEPARTMENT FINANCE NOTHING
FURTHER TO ADD. UH WILL OWNS L
09 FURTHER. DAD WILL BRING IT UP
TO THE DIET TO SEE IF THERE WERE
ANY MEMBER QUESTIONS WILL HOLD
THE QUESTIONS REGARDING THE
PUBLIC HEALTH WORKFORCE UNTIL
ISSUED 12. WELL, THANKS VERY
MUCH. THIS PANEL WILL NOW MOVE
ON TO ISSUE EIGHT. ISSUE EIGHT
AND NINE ARE VERY CLOSELY
RELATED. SO IF YOU CAN PLEASE
PRESENT THEM TOGETHER. ISSUE
EIGHT. IS AN OVERVIEW OF THE
BUDGET ADJUSTMENTS TO FUNDING
FOR THE STATE'S RESPONSE TO
COVID AN ISSUE NINE IS THE COVID
BUDGET CHANGE PROPOSAL FOR 23
24. MELISSA REYES. LS IS THE
ASSISTANT. ASSISTANT DEPUTY
DIRECTOR OF THE EMERGENCY
PREPAREDNESS OFFICE. THAT CED PH
. CAN YOU PLEASE BEGIN? GOOD
AFTERNOON CHAIR AND MEMBERS.
THANK YOU FOR HAVING ME HERE
TODAY I'LL START WITH A BRIEF
OVERVIEW OF THE BUDGET
ADJUSTMENTS AND THEN RESPOND TO
THE QUESTIONS. THE CALIFORNIA
DEPARTMENT OF PUBLIC HEALTH HAS
RECEIVED A BUDGET ADJUSTMENT,
REFLECTING A REDUCTION OF $614
MILLION FOR COVID 19 RESPONSE
ACTIVITIES IN THE CURRENT STATE
FISCAL YEAR. 22 23 CD PH PLANS
TO REDUCE SPENDING IN MANY AREAS
OF THE COVID 19 RESPONSE,
INCLUDING PUBLIC TESTING
ACTIVITIES, THERAPEUTICS AND
STATE OPERATIONS SUPPORT.
ADDITIONALLY CD PH NO LONGER
ANTICIPATES UTILIZING THE $250
MILLION EMERGENCY CONTINGENCY
FUND. THAT WAS AUTHORIZED FOR
SPENDING IN 22 23. UM, AND NOW
WILL PROVIDE AN UPDATE OF WHAT
COVID 19 LOOKS LIKE CURRENTLY IN
CALIFORNIA. THE COVID CASE,
AVERAGE AND CASE RATES HAVE BEEN
PLATEAU KHÔNG OVER THE LAST FEW
WEEKS. HOSPITALIZATIONS AND
COVID RELATED EMERGENCY
DEPARTMENT VISITS ARE ALSO
PLATEAU NG DEATHS ARE DECREASING
AND REMAIN LOW. HOWEVER THERE IS
A LAG OF ABOUT FOUR WEEKS FOR
DEATHS. THE OVERALL HOSPITAL
BURDEN OF COVID 19 AND FLEW
DURING THE PAST WINTER HAS BEEN
SIMILAR TO A SERIOUS FLU SEASON
, SUCH AS THE LAST SEVERE ONE
THAT WE HAD IN 2017 AND 18. C D
PH WILL CONTINUE TO MONITOR
CASES AND HOSPITALIZATIONS AND
IS WORKING WITH FEDERAL AND
LOCAL PARTNERS TO SHIFT
SURVEILLANCE STRATEGIES TO
IMPROVE OUR OVERALL RESPIRATORY
SURVEILLANCE, INCLUDING FLU RSV
AND COVID 19. CD PH WILL
CONTINUE TO DISTRIBUTE TEST KITS
AS NEEDED FOR OUTBREAKS AND HIGH
RISK SETTINGS CONTINUE
ALLOCATING AND DISTRIBUTING
VACCINES, THERAPEUTICS AND PPE
AND MAINTAIN SITUATIONAL
AWARENESS AND PROVIDE TECHNICAL
ASSISTANCE TO OUR LOCAL
PARTNERS. PUBLIC HEALTH WILL
FOCUS ON AT RISK POPULATIONS,
WHILE MANY SERVICES WILL
TRANSITION TO THE HEALTH CARE
DELIVERY SYSTEM. AND WE'LL
CONTINUE TO AIM TO PROVIDE A
SAFETY NET FOR AN AND
UNDERINSURED LIKE WE DO WITH
MANY OTHER DISEASES. AND NOW
I'LL GO INTO THE AREAS THAT WERE
REDUCING FOR THE CURRENT YEAR.
WE PLAN TO REDUCE TESTING BY
APPROXIMATELY $200 MILLION.03
TRANSITIONING THE STATE
LABORATORY TESTING NETWORK THAT
PROVIDES PCR TESTING TO ANTIGEN
TESTING BY THE END OF THE FIRST
QUARTER IN 2023. PURCHASES OF
ANTIGEN TEST KITS WILL DECREASE
FROM $5 MILLION PER MONTH TO
APPROXIMATELY $3 MILLION. WE ARE
ALSO ABLE TO ORDER TEST KITS
FROM THE CDC FOR FREE. STATE
SUPPORTED MOBILE AND TO END
TESTING SITES AT SCHOOLS ARE
RAMPING DOWN AND WE'LL STOP BY
THE END OF THE CURRENT YEAR.
THERE WILL BE A REDUCTION IN
THERAPEUTICS BY APPROXIMATELY
$40 MILLION, PRIMARILY AND
REDUCING SAFETY NET GRANTS BY
ABOUT 50 TO 60. THE THERAPEUTICS
MEDIA CAMPAIGN WILL DECREASE BY
75% WHICH IS 27 MILLION, DOWN TO
SEVEN MILLION. AND ACCESS TO A
TELEHEALTH VENDOR FOR THOSE MOST
DISCONNECTED TO HEALTHCARE WILL
BE REDUCED BY 75% FROM EIGHT
MILLION DOWN TO TWO MILLION.
DISTRIBUTION OF ORAL ANTIVIRALS
ALLOCATED TO CALIFORNIA FROM THE
FEDERAL GOVERNMENT WILL CONTINUE
UNTIL PRODUCTS GO TO
COMMERCIALIZATION. AND REGARDING
CASE INVESTIGATION, CONTACT
TRACING AND EXPOSURE.
NOTIFICATION THE CALIFORNIA
NOTIFY SYSTEM WILL REDUCE
ACTIVITIES TO THOSE SUPPORTED BY
GENERAL FUNDS APPROPRIATED IN
THE CURRENT YEAR. THE NUMBER OF
COVID 19 COMMUNICABLE DISEASE
CASE, INVESTIGATORS WILL
DECREASE AS WELL AS THE NUMBER
OF STAFF WHO PROVIDE TRAINING,
EVALUATION AND TECHNICAL
ASSISTANCE FOR CASE
INVESTIGATION TO STATE AND LOCAL
STAFF. MOST OF THE ONGOING
ACTIVITIES IN THIS AREA ARE
SUPPORTED BY FEDERAL FUNDS
THROUGH JUNE OF 2024. AND MOVING
INTO VACCINATIONS. THE STAFFING
SUPPORT FOR VACCINATIONS IS
BEING REDUCED AND RESOURCES WILL
BE PRIORITIZED FOR FALL EFFORTS
AND SUPPLEMENTED WITH FEDERAL
IMMUNIZATION FUNDING. POP UP
CLINICS ARE BEING REDUCED THIS
SPRING AND FALL AND RESOURCES
WILL BE PRIORITIZED FOR FALL
EFFORTS AND EQUITY APPROACH TO
REDUCE DISPARITIES, GAPS,
INCLUDING AUGMENTATION OF BACK
TO SCHOOL CLINICS AND FALL
BOOSTERS FOR FLU AND COVID 19.
CALIFORNIA WILL CONTINUE TO
COLLECT DATA ON ADMINISTERED
VACCINATIONS. DATA QUALITY
EFFORTS WILL CONTINUE, BUT WITH
REDUCED STAFFING. WESTERN STATES
. SCIENTIFIC SAFETY REVIEW
WORKGROUP HAS CONCLUDED, AND WE
WILL CONTINUE TO FOLLOW CDC FDA
ADVISORY GROUP RECOMMENDATIONS
AS WE DID PRIOR TO THE PANDEMIC.
AND DISTRIBUTION OF COVID
VACCINES TO PROVIDERS ENROLLED
IN MY CALVE AX WILL CONTINUE
UNTIL COMMERCIALIZATION. AND
RESOURCES WILL SUPPORT ONGOING
EFFORTS TO INCREASE ACCESS TO
VACCINES FOR CHILDREN AND
VACCINES FOR ADULTS RESOURCES.
AND FINALLY, WITH STATE
OPERATIONS. FUNDING FOR THE
PUBLIC CALL CENTER WILL BE
REDUCED THE OVERALL STATE
OPERATION SUPPORT WILL SCALE
DOWN. HOWEVER WE WILL CONTINUE
OUR WAREHOUSING OPERATIONS TO
DISTRIBUTE TEST KITS AND OTHER
MEDICAL COUNTERMEASURES. NOW FOR
QUESTION TWO REGARDING
VACCINATION RATES FOR PATIENTS
AND STAFF AT SKILLED NURSING
FACILITIES. ONGOING DATA ON
COVID 19 VACCINATION COVERAGE IS
REPORTED BY CALIFORNIA SNIFFS TO
THE CENTER FOR MEDICARE AND
MEDICAID. AND AS OF FEBRUARY
29TH 2023 88% OF RESIDENTS IN
CALIFORNIA SNIFFS HAVE RECEIVED
THEIR PRIMARY SERIES. 58% HAVE
RECEIVED AT LEAST ONE BOOSTER
DOSE. 95% OF STAFF IN CALIFORNIA
, SNIFFS HAVE RECEIVED THEIR
PRIMARY SERIES. WELL, 45% HAVE
RECEIVED AT LEAST ONE BOOSTER
DOSE. CD PH CONTINUES TO CONDUCT
OUTREACH, SHARE UPDATED
INFORMATION AND PROVIDE
TECHNICAL ASSISTANCE TO SNIFFS
AND OTHER STATE AND LOCAL
PARTNERS TO ENSURE ACCESS TO
COVID 19 VACCINE. AS AN EXAMPLE
. SEE DPH PRODUCED TOOL KITS AND
OTHER MATERIALS SPECIFICALLY
FIRST SNIFFS. AND FINALLY FOR
QUESTION THREE POPULATIONS AT
HIGHEST RISK OF SEVERE DISEASE
AND OR HOSPITALIZATION CONTINUE
TO BE THE ELDERLY. THOSE WITH
IMMUNO COMPROMISE THOSE WITH
UNDERLYING MEDICAL CONDITIONS,
AND WE CONTINUE TO SEE EQUITY
DISPARITIES IN OUR COMMUNITIES
OF COLOR. TREATMENT CAN GREATLY
REDUCE THE RISK OF
HOSPITALIZATION FOR THESE
VULNERABLE POPULATIONS, WHICH IS
WHY WE LAUNCHED OUR TREATMENT
CAMPAIGN AND CONTINUE TO
RESOURCE TELEHEALTH TREATMENT
ACCESS AND ARE WORKING WITH
HEALTHCARE SYSTEMS TO IMPROVE
TREATMENT UTILIZATION.
DEPARTMENT OF FINANCE GENERALLY,
DEPARTMENT OF FINANCE NOTHING
FURTHER TO ADD. PEOPLE WILL OWNS
A LOW WE HAVE NO CONCERNS WITH
THE 22 23 BUDGET ADJUSTMENTS
BRING IT UP TO THE DIOCESE FOR
ANY MEMBERS, QUESTIONS. SEEING
NONE. I WILL KEEP IT WITH THE
CHAIR JUST FOR A SECOND. AM I
RIGHT THAT YOU STATED THAT THERE
WERE NO CONTINGENCY FUNDS USED
OUT OF THE 250 MILLION IN LAST
YEAR'S BUDGET, THAT'S CORRECT.
AND YET WE'RE ASKING FOR ANOTHER
50 MILLION AND THIS YEAR'S
BUDGET TO START DESPITE IT BEING
A TOUGH BUDGET YEAR. THAT'S
CORRECT JUST IN THE EVENT THAT
THINGS SHOULD PROGRESS WITH
COVID LIKE THAT. WE WERE NOT
EXPECTING UM, SO MAYBE, OR MAY
NOT BE USED HIGHLIGHT A $50
MILLION REDUCTION THAT CAME
WITHIN PUBLIC HEALTH WORKFORCE
WITHIN ISSUE NUMBER, 12. THAT
MANY OF US HAVE CONCERNS ABOUT
AND WILL POINT TO THE FACT THAT
THESE CONTINGENCY FUNDS WERE NOT
USED IN THE PAST. WE'LL ASK
DEPARTMENT OF FINANCE WHAT
HAPPENS TO THOSE CONTINGENCY
FUNDS THAT WERE APPROPRIATED TO
PUBLIC HEALTH? THOSE $250
MILLION THE 250 MILLION WILL
REVERT BACK TO THE GENERAL FUND.
UM WITH THAT? I WILL. THANKS
VERY MUCH. THIS PANEL WE WILL
NOW MOVE ON TO ISSUE TIM. ISSUE
10 IS THE COVID 19 WEBSITE,
TRANSITION AND INFORMATION
TECHNOLOGY RESOURCES, BCP. WE
WILL BEGIN WITH JOHN RUSSELL,
WHO WAS THE DEPUTY DIRECTOR FOR
INFORMATION TECHNOLOGY SERVICES
DIVISION AT THE C D PH. WELCOME
AND PLEASE BEGIN. THANK YOU, MR
CHAIR. CITY PH LAUNCHED THE
COMPANY. EXCUSE ME. DPH LAUNCHES
A COMPREHENSIVE, USER FRIENDLY
COVID-19 WEBSITE. TO PROVIDE THE
PUBLIC SERVICE. SERVICE
ANNOUNCEMENTS, STEPS PEOPLE CAN
TAKE TO STAY HEALTHY RESOURCES
AVAILABLE CALIFORNIANS IMPACTED
BY THE OUTBREAK AND DATA
ANALYTICS DASHBOARDS TO BOOST
COVID-19 AWARENESS. THE CREATION
AND MAINTENANCE OF THE COVID 19
WEBSITE. WAS A DIRECT REQUEST
FROM THE GOVERNOR DURING THE
PANDEMIC. THE SITE WAS DEVELOPED
IN PARTNERSHIP WITH THE
CALIFORNIA DEPARTMENT OF
TECHNOLOGY. AND THE OFFICE OF
DATA AND INNOVATION WHO BUILT
AND HOSTED THE SITE. IN APRIL
2022. THE DEPARTMENT OF
TECHNOLOGY REQUESTED CD PH TO
TAKE OWNERSHIP OF THE SITE C D
PH HAS SINCE TAKEN OWNERSHIP.
YOU'RE ASKING FOR THREE LIMITED
TERM POSITIONS AND 900,000
ANNUALLY FOR FISCAL YEAR 23 24
24 25 25 26, WHICH INCLUDES
LICENSING AND OPERATING COSTS.
DEPARTMENT OF FINANCE GENERALLY
NOTHING FURTHER TO ADD. HELLO.
WE HAVE NO CONCERNS WITH THIS
PROPOSAL. BRING IT UP TO THE
DIASPORA. ANY MEMBERS QUESTIONS
SEEING NONE. WE WILL THANK YOU
AND MOVE ON TO ISSUE 11. ISSUE
11 IS THE MAINTENANCE AND
OPERATIONS OF THE INFECTIOUS
DISEASE DATA SYSTEM FOR THE
SMARTER PLAN IMPLEMENTATION,
BCP. JAMES WATT IS THE ASSISTANT
DEPUTY DIRECTOR OF THE CENTER
FOR INFECTIOUS DISEASE THAT SEED
PH AND TESTIFYING REMOTELY. CAN
WE WELCOME YOU? AND WILL YOU
PLEASE BEGIN? GOOD AFTERNOON, MR
CHAIRMAN AND MEMBERS. THANK YOU
VERY MUCH. CAN YOU HEAR ME? ALL
RIGHT. WE CAN HEAR YOU, BUT WE
CAN'T SEE. OH, THERE YOU ARE.
PLEASE BEGIN. ALRIGHT. THANK YOU
VERY MUCH. MY NAME IS DR JAMES
WADDEN. I'M AN ASSISTANT DEPUTY
DIRECTOR IN THE CENTER FOR
INFECTIOUS DISEASES AT THE
CALIFORNIA DEPARTMENT OF PUBLIC
HEALTH. CD PH REQUESTS $74.4
MILLION IN GENERAL FUND IN 2023
24 FOR THE MAINTENANCE AND
OPERATIONS OF CRITICAL
INFECTIOUS DISEASE DATA SYSTEMS
ESTABLISHED DURING THE COVID 19
PANDEMIC. THESE SYSTEMS WILL
CONTINUE TO SUPPORT THE STATE'S
EMERGENCY PREPAREDNESS AND
RESPONSE EFFORTS. DISEASE
CONTROL FOR COVID, 19 AND
DISEASE CONTROL WORK FOR OTHER
INFECTIOUS DISEASES. THIS
FUNDING WILL SUPPORT MAINTENANCE
AND OPERATIONS OF TWO IMPORTANT
SYSTEMS. THE CALIFORNIA COVID
REPORTING SYSTEM, OR C. CRS
WHICH HAS BEEN RENAMED SAPPHIRE.
AND CAL CONNECT THE STATE SYSTEM
FOR DISEASE INVESTIGATION AND
CONTACT TRACING AS WELL AS I T
INFRASTRUCTURE AND SECURITY
COSTS. I WILL BRIEFLY DESCRIBE
THOSE THREE ITEMS. FIRST CD PH
REQUESTS. $30.9 MILLION AND 2023
24 FOR MAINTENANCE AND
OPERATIONS OF SAPPHIRE, WHICH
STANDS FOR THE SURVEILLANCE AND
PUBLIC HEALTH INFORMATION
REPORTING AND EXCHANGE. SAPPHIRE
IS A CORE ELEMENT OF THE SYSTEM
THAT CD PH USES TO COLLECT DATA
ON ALL REPORTABLE DISEASES.
SAPPHIRE ENABLES CD PH TO
RECEIVE ELECTRONIC DATA MESSAGES
FROM LABORATORIES AND OTHER DATA
SUBMITTERS. THIS SYSTEM IS
CRITICAL TO DISEASE PREVENTION
AND CONTROL EFFORTS FOR COVID,
19 AND OTHER INFECTIOUS DISEASES
, AS WELL AS PREPAREDNESS FOR
FUTURE PANDEMIC AND EMERGENCY
RESPONSE. MORE THAN 350 DATA.
SUBMITTERS ARE CONNECTED
DIRECTLY TO THIS SYSTEM AND ARE
SUBMITTING RESULTS ON BEHALF OF
THOUSANDS OF ENTITIES. UM.
SAPPHIRE PROVIDES EFFICIENT AND
CONSISTENT FLOW OF ELECTRONIC
MESSAGES TO CD PH. AND IN
ADDITION, THESE RESOURCES WILL
SUPPORT INTEGRATION AND CRITICAL
DATA EXCHANGE BETWEEN SAPPHIRE
AND OTHER CORE CD PH SYSTEMS,
INCLUDING CAL READY AND CAL
CONNECT. CD PH RECEIVED AN
APPROPRIATION OF $26.3 MILLION
IN 22 23 TO PROVIDE M AND O FOR
ONE YEAR TO SUPPORT AND OPERATE
THE SYSTEM. THIS ONE YEAR
FUNDING STRATEGY WAS DESIGNED TO
ALLOW CD PH TO OBTAIN UPDATED M
AND O COSTS THROUGH A RE
COMPETITION FOR THE SYSTEM. IN
2022 C D PH ENGAGED IN A NEW
CHALLENGE BASED PROCUREMENT
PROCESS, RESULTING IN A CONTRACT
WITH THE NEW VENDOR. THE
TRANSITION BETWEEN THE OLD AND
NEW VENDOR WAS COMPLETED BY
DECEMBER 31ST AND WE ARE NOW
REQUESTING MAINTENANCE AND
OPERATIONS FUNDING OR 2023 24.
AS PART OF THE TRANSITION, THE
SYSTEM WAS RENAMED SAPPHIRE TO
RECOGNIZE THAT IT RECEIVES DATA
FOR ALL REPORTABLE CONDITIONS,
NOT JUST COVID 19. SECONDLY PPH
REQUEST $39.7 MILLION FOR 22 23
24 FOR MAINTENANCE AND
OPERATIONS OF CAL CONNECT. HOW
CONNECTORS CALIFORNIA SYSTEM FOR
CASE AND OUTBREAK INVESTIGATION
, CONTACT TRACING, MONITORING OF
EXPOSED INDIVIDUALS AND
COMMUNICATION WITHIN AFFECTED
PERSONS. CONNECT WAS DEVELOPED
DURING THE COVID 19 PANDEMIC AND
HAS NOW BEEN EXPANDED TO SUPPORT
THE IMPACTS. RESPONSE HAS ALSO
BEEN UTILIZED FOR MONITORING
PERSONS EXPOSED TO AVIAN
INFLUENZA AND EBOLA VIRUS
DISEASE. CD PH PLANS TO LEVERAGE
THE CAL CONNECT FUNCTIONALITY TO
ADDRESS OTHER PRIORITY
CONDITIONS THAT REQUIRE CASE
INVESTIGATION AND CONTACT
TRACING, SUCH AS TUBERCULOSIS.
HIV SYPHILIS, PERINATAL,
HEPATITIS B AND MEASLES. CD PH
RECEIVED AN APPROPRIATION OF
$39.6 MILLION IN 22 23 TO
PROVIDE ONE YEAR OF EM ENOUGH
FUNDING FOR CAL CONNECT. THE ONE
YEAR FUNDING STRATEGY, AS WITH
SAPPHIRE, WAS DESIGNED TO ALLOW
CD PH TO OBTAIN UPDATED COSTS
THROUGH A RE COMPETITION IN 2022
C D PH CARRIED OUT A NEW
PROCUREMENT PROCESS, RESULTING
IN A NEW CONTRACT WITH THE
EXISTING VENDOR. THIRD TO
SUPPORT DATA SYSTEM,
MODERNIZATION EFFORTS. CD PH
REQUEST $3.8 MILLION FOR
LICENSING, MAINTENANCE AND
SUPPORT OF THE INFRASTRUCTURE
AND SECURITY PROTOCOLS NEEDED TO
SUPPORT PUBLIC HEALTH
SURVEILLANCE AND RESPONSE
SYSTEMS AND DEPARTMENTAL DATA,
INCLUDING CONFIDENTIAL PROTECTED
HEALTH INFORMATION. THE FUNDING
REQUESTED IS NEEDED TO MAINTAIN
AND OPERATE CD PH TECHNOLOGY
INFRASTRUCTURE AND ITS CURRENT
STATE SUPPORT CRITICAL PUBLIC
HEALTH SERVICES STATEWIDE,
PREPARE FOR RESPOND TO FUTURE
PUBLIC HEALTH EMERGENCIES AND TO
LEVERAGE THE TECHNOLOGY
DEVELOPED FOR COVID 19 TO
ADDRESS OTHER CONDITIONS THAT
IMPACT THE PEOPLE OF CALIFORNIA.
THANK YOU. AND IF SHALL I GO
AHEAD AND ADDRESS THE TWO
QUESTIONS THAT WERE INCLUDED IN
THE AGENDA? MR. WHAT? THANK YOU
. UM SO THE FIRST QUESTION WAS
TO EXPLAIN THE CONNECTION
BETWEEN THIS PROPOSAL AND LAST
YEAR'S BCP ENTITLED DISEASE
SURVEILLANCE, READINESS RESPONSE
, RECOVERY AND MAINTENANCE OF IT
OPERATIONS. AS I INDICATED, UM
OR FISCAL YEAR 22 23. WE
REQUESTED ONE YEAR OF FUNDING
FOR THE CCR S AND CAL CONNECTS
SYSTEMS. SO THAT WE COULD
CONDUCT RE COMPETITIONS FOR BOTH
SYSTEMS, UM, RESULTING IN
UPDATED COSTS. AS I SAID, THOSE
COMPETITIONS WERE DONE, AND NOW
WE'RE REQUESTING CONTINUATION OF
MAINTENANCE AND OPERATION COSTS.
AND THEN THE SECOND QUESTION
WAS, WHAT IS THE TOTAL COST AND
TIMELINE OF THIS PROJECT? THESE
TWO SYSTEMS ARE IN MAINTENANCE
AND OPERATIONS AND ARE PLANNED
TO BE AN ONGOING PART OF THE CPH
PORTFOLIO OF IT. SYSTEMS USED TO
MONITOR AND CONTROL REPORTABLE
DISEASES. THE C D PH WILL REFINE
FUTURE COST ESTIMATES AS THE IT
STRATEGIC PLANNING PROCESS IN
THE DEPARTMENT PROCEEDS IN
CONJUNCTION WITH THE FUTURE OF
PUBLIC HEALTH PLANNING. THANK
YOU. DEPARTMENT OF FINANCE AND
RALLY NOTHING FURTHER TO ADD.
ELIO WE HAVE NO CONCERNS WITH
THIS PROPOSAL. I WILL BRING IT
BACK UP TO THE DIOCESE. REMEMBER
QUESTIONS DOCTOR WOULD YEAH,
THANK YOU. MY QUESTION IS, DOES
THIS CAL CONNECT IS THIS SYSTEM
ALSO USED FOR SURVEILLANCE OF
VECTOR LIKE VECTOR CONTROL, LIKE
MOSQUITOES AND OTHER VECTORS? UM
NO. THE CALCULATION SYSTEM IS
NOT USED FOR SURVEILLANCE OF
VECTORS PER SE, AND, UM, WE
HAVEN'T USED IT, OR WE HAVEN'T
PROJECTED TO USE IT FOR
SURVEILLANCE OF VECTOR BORNE
DISEASES. WE'VE BEEN
PRIORITIZING THOSE CONDITIONS
THAT ARE, UM, WHERE THERE'S A
HEAVY COMPONENT OF CASE
INVESTIGATION AND CONTACT
TRACING. UM. AS PART OF OUR
USUAL PUBLIC HEALTH RESPONSE. SO
I GUESS MY QUESTION IS. WHERE DO
YOU WHAT SYSTEM DO YOU USE FOR
TRACING FOR VECTOR CONTROL.
THERE IS SIGNIFICANT TRACING
INVOLVED IN THAT. UM, SO IT
SEEMS LOGICAL THAT MIGHT FIT
HERE. SO WHERE ARE YOU? TRACKING
AND, UH, INVESTIGATING VECTORS.
UM WE HAVE A COUPLE OF SYSTEMS
THAT WE USE FOR THAT. SO WE WORK
IN PARTNERSHIP WITH UC DAVIS. UM
TO OPERATE A COMPREHENSIVE
VECTOR SURVEILLANCE SYSTEM THAT
IS MONITORING THE VECTORS
THEMSELVES. UM SO THAT IS
MOSQUITOES AND OTHER SYSTEMS
WHERE WE TRACK UM VECTOR BORNE
VIRUSES. UM SO THAT SYSTEM IS IN
PLACE FOR THE VECTORS. AND THEN
WE USE THE ALREADY SYSTEM TO
MONITOR CASES OF HUMAN DISEASE
ASSOCIATED WITH VECTOR BORNE
VIRUSES. SO DO YOU DO YOU ALSO
WORK WITH LIKE THE LOCAL
MOSQUITO VECTOR CONTROL
DISTRICTS? DO THEY? ARE THEY
FEEDING INTO THE SAME SYSTEM?
YES, THEY ARE. AND WE DO. SO I.
YOU KNOW, THIS IS A THIS IS A
PRETTY ROBUST SYSTEM. WHY? WHAT
I MEAN WE'VE GOT A MOSQUITO
ISSUE THAT'S BEEN BREWING FOR
LACK OF A BETTER DESCRIPTION. UM
SINCE FOR THE LAST 10 YEARS,
THAT'S STARTING TO REAR. ITS
UGLY HEAD, UH, AND BE BECOME A
BIGGER PROBLEM. UM SO WHY? WHY
WOULDN'T WHY WOULDN'T THOSE
ISSUES BE HERE? YOU TALK ABOUT
INFLUENZA YOU TALK ABOUT YOU
HAVE AN AVIAN INFLUENZA. EBOLA
OTHER INFECTIOUS ENTITIES. WHY
WOULDN'T YOU PUT THEM ALL IN THE
SAME IN THIS IN A SIMILAR IN THE
SAME SYSTEM. WHY WOULD YOU PUT
IT IN? GREAT QUESTION, UM, WITH
THE CAMP CONNECT SYSTEM HAS IS.
IT'S LIKE A TOOL BOX THAT HAS A
SET OF, UM, RESOURCES THAT WE
CAN USE FOR DIFFERENT INFECTIOUS
DISEASES SO DEPENDING ON THE
DISEASE AND CONTROL STRATEGIES,
UM WE CAN USE. RESOURCES THAT
ARE AVAILABLE IN IN DIFFERENT
SYSTEMS. AS I MENTIONED WE HAVE
A THE SYSTEM WITH èC GAVE US IS
REALLY DESIGNED TO SPECIFICALLY
TRACK VECTOR BORNE DISEASES, SO
THAT'S OUR PRIMARY FOCUS. THEIR
UM HOW CONNECT TOOLS HAVE BEEN
VERY USEFUL FOR COVID 19 FOR MPX
AND THE OTHER CONDITIONS THAT
YOU MENTIONED. IF WE NEEDED
THEM. WE CERTAINLY COULD. BUT AT
THIS POINT UM UH, ROLLOUT IS
PLANNED FOR OTHER DISEASES THAT
ARE MORE ALIGNED WITH THE CAL
CONNECT TO A BOX. UM AND WE HAVE
OTHER SYSTEMS THAT ARE
SPECIFICALLY DESIGNED FOR VECTOR
BORNE DISEASES. OKAY. ONE FINAL
QUESTION. I'M SORRY. I JUST
DON'T MEAN TO MHM BEAT UP INSECT
DOWN HERE, BUT, UM BUT, UH. IS
THERE SOME THRESHOLD BY WHICH
SOMETHING RISES TO GET? ELIGIBLE
FOR CAL CONNECT. I MEAN, I DON'T
KNOW THAT WE HAVE THAT MANY
CASES OF EBOLA IN THIS STATE,
BUT I THINK WE HAVE A LOT OF
VECTOR CONTROL VECTOR VECTOR
RELATED ILLNESS IN THE STATE, SO
IT'S STILL A LITTLE APPRECIATE
THAT WE'VE GOT A SYSTEM WITH
DAVIS. BUT I JUST DON'T
UNDERSTAND WHY WE WOULDN'T WANT
TO HAVE EVERYTHING MORE
CENTRALIZED. DR ARROGANT I'LL
MAYBE MAYBE I CAN CLARIFY, SO
THE DIFFERENCE IS WITH COVID
INFLUENZA THEIR PERSON TO PERSON
TRANSMISSIBLE. AND SO THAT'S
REALLY SORT OF THE KEY THING. SO
THESE ARE COMMUNICABLE DISEASES
, PERSON TO PERSON. AND THE
CHALLENGES THAT WE HAVE IS THAT
PEOPLE WORK IN ONE COUNTY. UM
THEY GET, LET'S SAY THEY GET
INFECTED IN ONE COUNTY AND WORK
IN ANOTHER COUNTY AND JUST PUT
ALL THAT TOGETHER AND YOU HAVE
THIS COMPLEX SOCIAL NETWORK OF
TRANSMISSION, AND SO IT'S REALLY
HARD FOR THE COUNTIES TO, UM DO
CONTACT TRACING AND CASE
INVESTIGATION OF ABOUT COMPLEX
TRANSMISSION IF THEY'RE NOT
CONNECTED TO CAL CONNECTS LOCALE
CONNECTS, OPERATES AT THIS HIGH
LEVEL AND ALLOWS ALL THAT
COMPLEX CONTACT TRACING IN CASE
INVESTIGATION TO HAPPEN, IN
CONTRAST TO MOSQUITO BORNE
PATHOGEN, IF YOU BECOME
INFECTED, YOU DON'T TRANSMIT
THAT TO SOMEBODY ELSE. SO THAT'S
THE BIGGEST DIFFERENCE IS REALLY
THE CASE INVESTIGATION AND
CONTACT TRACING FOR PERSON TO
PERSON COMMUNICABLE DISEASES.
THANK YOU. STDS IS ANOTHER
REALLY GOOD EXAMPLE OF THAT HIV,
ETCETERA. I WILL BRING IT BACK
UP TO THE CHAIR. MR WATT ARE
THESE ONE TIME FUNDS 74.4
MILLION FOR THE MAINTENANCE AND
OPERATIONS. YES THERE FOR ONE
YEAR, SO I'M I UNDERSTOOD WHY
THEY WERE ONE TIME FUNDS LAST
YEAR AS WE WERE GOING THROUGH A
PROCUREMENT. BUT I'M QUESTIONING
SINCE WE PLAN ON STANDING UP
THESE SYSTEMS WHY WE AREN'T
PLANNING ON ONGOING FUNDING. FOR
THESE SYSTEMS, AND I'M HOPING
YOU CAN COMMENT ON IT. SURE
THAT'S RELATED TO OUR BROADER, I
T S STRATEGY WORK. AND UM, I
THINK JOHN RUSSELL IS THERE WHO
CAN RESPOND TO THAT QUESTION.
SURE SO THE TERMS OF BOTH THESE
CONTRACTS ARE THREE YEARS M AND
O WITH TWO YEAR OPTIONAL YOU
SPEAK INTO THE MIC A LITTLE BIT.
UH BOTH IN TERMS OF THESE
CONTRACTS ARE THREE YEAR M AND A
WITH TWO YEAR OPTIONAL YEARS FOR
A TOTAL OF FIVE YEARS. LAST
YEAR'S REQUEST WAS LIMITED TO
THE CURRENT YEAR ONLY AND CD PH
WAS SUBMITTED ANOTHER BCP IN THE
FALL OF ONGOING FUNDING OF
CONTINUATION. WE DON'T WANT TO
CONTINUE TO FUND THESE WITHOUT
UNDERSTANDING THE TOTAL STRATEGY
OF THE FUTURE OF PUBLIC HEALTH
AND HAVE IT GO AND BUILD SILO
SYSTEMS AGAIN. WE'D LIKE TO PUT
IT ALL TOGETHER. ALMOST. WE
SOLIDIFY THAT STRATEGY GOING
FORWARD SO WE CAN BUILD A GOOD
FOUNDATION FOR SURVEILLANCE
ITSELF, WITH COURT CAPABILITIES
GOING FORWARD. THANK YOU WITH
THAT. WE WILL NOW MOVE ON TO
ISSUE 12. ISSUE 12 IS THE
PROPOSED PUBLIC HEALTH WORKFORCE
INVESTMENT REVERSION TO BE
PRESENTED BY SUSAN FINALLY. WHO
IS THE CHIEF DEPUTY DIRECTOR OF
HEALTH QUALITY AND EMERGENCY
RESPONSE AT CD PH, MISS.
FINALLY. YEAH GOOD AFTERNOON
CHAIR AND MEMBERS. I THINK IN
TERMS OF THE QUESTIONS ON THIS
PROPOSAL, FIRST OF ALL SAY WE
WERE PRIORITIZING THE ONGOING
300 MILLION FOR FUTURE OF PUBLIC
HEALTH. I'LL TURN IT OVER TO
FINANCE IN TERMS OF WHY THIS
REDUCTION SALES DEPARTMENT OF
FINANCE, UM, DUE TO DECLINING
STATE REVENUE. THE BUDGET
PROPOSALS, REDUCING A PORTION OF
FUNDING INCLUDED IN THE 22
BUDGET ACT FOR PUBLIC HEALTH
WORKFORCE INVESTMENTS. THIS
REDUCTION IS CONSISTENT WITH THE
ADMINISTRATION'S OVERALL
APPROACH TO ADDRESSING THE
BUDGETARY PROBLEMS THROUGH
DELAYS OR REDUCTIONS OF SOME
SPENDING IN THE NEAR TERM. WHERE
FEASIBLE, THE GOVERNOR'S BUDGET
PRIORITIZES ONGOING COMMITMENTS
APPROVED IN PREVIOUS BUDGETS.
THAT INCLUDES PUBLIC HEALTH,
INFRASTRUCTURE AND STAFFING
RESOURCES, SUCH AS 300 MILLION
ONGOING FOR STAYING LOCAL HEALTH
DEPARTMENTS, SIGNIFICANT PORTION
OF WHICH IS FOR NEW STAFF. AS
WELL AS ONGOING WORKFORCE AND UP
SKILLING PROGRAMS INCLUDED IN
THE 21ST CENTURY PUBLIC HEALTH
DBCP APPROVED IN THE 22 BUDGET
ACTS. MS FANELLI, CAN I HAVE YOU
GO THROUGH A BIT MORE OF THE BCP
AND UNDERSTANDING WHAT EFFECT
THIS WOULD HAVE PLEASE ON PUBLIC
HEALTH. WORKFORCE INVESTMENTS.
SURE SO THIS MONEY WAS INTENDED
TO FUND A NUMBER OF DIFFERENT
PROGRAMS, INCLUDING PATHWAYS,
WHICH IS A PIPELINE PROGRAM. UM,
THE KELLY I ASKED FELLOWS
PROGRAM, THE CAREER LADDER AND
UP. SKILLING PROGRAM, PUBLIC
HEALTH MICROBIOLOGISTS AND OUR
LAB LABORATORY DIRECTOR TRAINING
AND SO, WITH THESE REDUCTIONS,
WE ARE ABLE TO HONOR THE
COMMITMENTS OF THIS FIRST YEAR.
UM AND WE CAN PROVIDE MORE
DETAIL. IN TERMS OF THE NUMBER
OF PEOPLE WE CAN TRAIN IN EACH
OF THESE SEPARATE PROGRAMS,
HOWEVER, AS WE LOOK FORWARD,
MOST OF THE DOLLARS THAT ARE
MOST OF THESE PROGRAMS THAT ARE
CURRENTLY BEING SUPPORTED BY
THESE WORKFORCE DEVELOPMENT
FUNDS AS WELL AS SOME OF OUR
COVID FUNDING AND MAYBE SMALL
BITS OF FUNDING FROM PREVENTION
BLOCK GRANT AND FROM OUR PUBLIC
HEALTH EMERGENCY PREPAREDNESS
PROGRAM. MOST OF THESE WOULD GO
AWAY AT THE END OF NOT ONLY THIS
CURRENT YEAR, BUT SOME OF THE
PROGRAMS RUN INTO THE BUDGET
HERE, SO THESE REDUCTIONS WOULD
, IN EFFECT AND THESE PROGRAMS.
CAN YOU RESPOND TO THE QUESTIONS
ON PAGE 44 1ST ONE IS TO PROVIDE
AN ASSESSMENT OF THE PUBLIC
HEALTH WORKFORCE. AND ARE WE
MORE OR LESS PREPARED FOR THE
NEXT PANDEMIC? AND SO I WOULD
SAY, YOU KNOW, THE PANDEMIC
CERTAINLY POINTED OUT GAPS IN
PUBLIC HEALTH INFRASTRUCTURE. UM
AND IT'S A CHALLENGING QUESTION
TO SAY ARE WE BETTER PREPARED
FOR THE NEXT PANDEMIC. I THINK
ON THE ONE HAND, WE HAVE
DEVELOPED A GREAT DEAL OF
EXPERTISE AND PROMISING
PRACTICES THROUGHOUT THE
PANDEMIC. THINGS LIKE ARE MORE
EFFECTIVE MEDIA CAMPAIGNS AND
COMMUNICATION STRATEGIES. UM
THINGS LIKE ADDRESSING MIS AND
DISINFORMATION. THAT'S OUT.
THERE ARE STATEWIDE VACCINATION
CAMPAIGN WITH OVER 80 MILLION
SHOTS ADMINISTERED IN A VERY
SHORT PERIOD OF TIME ARE
PREDICTIVE ANALYTICS AND
MODELING TEAMS ARE HOSPITAL AND
HEALTHCARE FACILITIES IMPROVED
IMPROVED OUR SURGE STRATEGIES
WITH MANY LESS AND LEARNS AND
PLANS DEVELOPED, WHICH WILL HELP
US IN THE LONG RUN. WE WILL
LEVERAGE THOSE LESSONS LEARNED
ABOUT SCALING UP EXISTING
FACILITIES RATHER THAN BUILDING
ALTERNATIVE CARE SITES AND SOME
OF THE OTHER EFFORTS WE HAD.
WE'VE LEVERAGED TECHNOLOGY
PLATFORMS SO THAT WE'RE MORE
EFFICIENT AND QUICKLY CAN
CAPTURE AND ANALYZE DATA. WE'VE
IMPROVED AND ENHANCED OUR
ABILITY TO QUICKLY DISTRIBUTE
BETTER MEDICAL COUNTERMEASURES,
MAINTAINING OUR WAREHOUSE WITH
PHARMACEUTICAL CAPABILITIES,
SUCH AS TEMPERATURE CONTROL AND
SECURE STORAGE ARE WILL BE
ESSENTIAL TO CONTINUING THAT. WE
HAVE NAVIGATED AND RESPOND. IT
RESPONDED TO MANY SUPPLY CHAIN
CHALLENGES. WE PUT SYSTEMS IN
PLACE THAT THAT OUR STAFF ARE
MORE EFFECTIVE AND EFFICIENT,
SUCH AS REPORTING TEMPLATES AND
STANDARDIZING CALLS. WE HAVE
IDENTIFIED SOME GAPS IN STATE
STAFF, SOME OF WHICH HAVE BEEN
FILLED IN THE PAST YEAR THROUGH
CONTRACTS AND ARE WORKING TO ADD
SOME OF THESE NEW SKILLS TO OUR
PERMANENT STAFF, USING LARGELY
OUR FUTURE OF PUBLIC HEALTH
FUNDING AND SOME CONTINUING
FEDERAL FUNDS FOR THE NEXT YEAR.
ON THE OTHER HAND, HAVING ENOUGH
TRAINED STAFF WAS AND CONTINUES
TO BE CHALLENGING. THE STRESS OF
THE PANDEMIC HAS MEANT A LOSS OF
STAFF AT THE STATE HEALTH
DEPARTMENT AND OUR LOCAL HEALTH
JURISDICTIONS, INCLUDING
LEADERSHIP POSITIONS, WHICH
AREN'T EASY TO BRING BACK OUR
LOCAL PARTNERS. I'M SURE WE'LL
TALK IN THE NEXT SESSION ABOUT
THE TURNOVER OF HEALTH OFFICERS
AND HEALTH DIRECTORS AND THE
IMPACT THAT THAT HAS HAD WILL
CONTINUE TO USE OUR FUTURE OF
PUBLIC HEALTH FUNDING OUR
FEDERAL FUNDS FOR THE NEXT YEAR.
AND THE WORKFORCE DEVELOPMENT
FUNDING THAT WE DO HAVE TO BUILD
. UM AND RETAIN STAFF AND BUILD
A PIPELINE FOR PUBLIC HEALTH.
THE THIRD QUESTION IS, ARE THERE
FEDERAL FUNDS AVAILABLE TO
BACKFILL THE REDUCTION? VERY
LIMITED FEDERAL FUNDS. THE
FEDERAL FUNDS WE HAVE FOR COVID
THAT HAVE BEEN SUPPORTING SOME
OF THESE EFFORTS LIKE ON
MICROBIOLOGIST TRAINING THOSE
EXPIRE AT THE END OF JUNE OF
2024, THEIR LIMITED
ACCESSIBILITY. WE'RE USING SOME
OF THOSE TO AUGMENT THE PROGRAMS
NOW, SO I WOULD SAY THERE'S VERY
LIMITED FEDERAL FUNDS, LEO YES.
SO WILL OWENS. L. A. L. WE WERE
JUST NOTE TO THE LEGISLATURE
THAT MAY WISH TO EVALUATE HOW OF
REDUCTION IN PUBLIC HEALTH
WORKFORCE, UM, MAY IMPACT ITS
BROADER GOALS AS FAR AS SHARING
OF PUBLIC HEALTH INFRASTRUCTURE
, WE NOTED IN OUR RECENT POST
ABOUT HEALTHCARE WORKFORCE MORE
BROADLY THAT THE FOCUS ON BUDGET
SOLUTIONS FOR LIMITED TERM
GENERAL FUND AUGMENTATIONS IS
PRUDENT, GIVEN THE STATE'S
CURRENT BUDGET SITUATION. UM
HOWEVER, THE LEGISLATURE MAY
WISH TO ENSURE THAT THE
GOVERNMENT'S PROPOSED SOLUTIONS
DON'T IMPEDE LEGISLATIVE
PRIORITIES OR DISRUPT EXISTING
PROGRAMS AND TO THE DEGREE THAT
THIS PUBLIC HEALTH WORKFORCE
REDUCTION MAY DO THAT, UM
THERE'S A VERY REAL CHANCE THAT
THAT THIS BUDGET SOLUTION MAY
UNDERCUT THOSE BROADER
LEGISLATIVE EFFORTS THAT HAVE
BEEN PASSED IN RECENT YEARS.
THANK YOU. I WILL BRING IT UP TO
THE DIOCESE FOR ANY MEMBER OF
QUESTIONS, BEGINNING WITH DR
JACKSON AND DR WOOD. THANK YOU
VERY MUCH. I'M REMINDED OF THE
REPORTS THAT WE CONTINUE TO SEE.
OBVIOUSLY. CALIFORNIA WILL BE
FACING MORE FREQUENT PANDEMICS
AND PUBLIC HEALTH EMERGENCIES. I
DON'T I'M NOT SURE. WELL, I KNOW
FOR SURE THIS IS NOT SOMETHING
THAT I AM SUPPORTIVE OF, UM I
THINK THAT YOU KNOW, EVERY TIME
I'M GOING TO A BUDGET HEARING
NOW I GET FLASHBACKS OF WHEN MY
PAYCHECK CAME IN, AND I WONDERED
WHERE THE HECK DID MY MONEY GO?
AND I WAS SHORT AND I HAD TO
DECIDE WHETHER I WANTED TO GET
RID OF SHOWTIME OR WHETHER I PAY
MY ELECTRICITY BILL. UM I'M NOT
SAYING IT WASN'T EASY ANSWER AND
EASY ANSWER FOR ME, BUT THE IDEA
IS, I CHOSE THE ELECTRICITY BILL
, AND UNFORTUNATELY, AS I SEE
THE BUDGET, UM I STILL SEE A LOT
OF HBO AND SHOWTIME IN THE
BUDGET. UM, I STILL SEE SOME FAT
IN THE BUDGET THAT I THINK WE
CAN RE PRIORITIZE FOR SOMETHING
AS CENTRAL AND IMPORTANT AS
PUBLIC HEALTH. ESPECIALLY AS IT
RELATES TO OUR WORKFORCE. UM AND
SO I'M MORE THAN HAPPY TO
CONTINUE TO DIALOGUE AND FIND
OUT WHERE IF THIS IS A WELL,
WHERE YOU GONNA CUT KIND OF
QUESTION. UM I'M MORE THAN HAPPY
TO PROVIDE A LIST OF WHERE WE
SHOULD BE CUTTING IN ORDER TO BE
ABLE TO DO THESE THINGS, BUT I
THINK THIS IS SOMETHING THAT, UH
, I THINK IT WOULD BE BAD PUBLIC
POLICY, BAD BUDGETING FOR THE
PUBLIC TO BE TO AGREE TO SUCH
CUTS. THANK YOU VERY MUCH.
DOCTOR WOULD YEAH, I AGREE WITH
DR JACKSON. I HAVE REAL PROBLEMS
WITH THIS. WE FOUGHT HARD A
COUPLE OF YEARS AGO AND ON
WORKFORCE OF BUDGETING AND
INFRASTRUCTURE FOR PUBLIC
HEALTH. AND WE'RE TOLD TO WAIT A
YEAR, WHICH WE DID. AND NOW WE
GOT RESOURCES AND THE BUTTON THE
CURRENT BUDGET AND NOW SOME OF
THAT IS GOING TO GO AWAY AND
WE'RE LOOKING AT POTENTIALLY
LOSING THAT FOR THE FUTURE. UM I
CAN'T THINK OF ANY WORST WAY TO
BE PREPARED FOR THE NEXT
PANDEMIC THAN CUTTING. OUR
WORKFORCE TRAINING PROGRAMS IN
OUR WORKFORCE. INVESTMENTS. UM
WE WERE ALREADY STRUGGLING WITH
WORKFORCE IN PUBLIC HEALTH
BEFORE THE PANDEMIC. WE'VE HAD
SIGNIFICANT BURN OUT IN A COUPLE
OF MY COUNTY'S. WE'VE HAD
MULTIPLE PUBLIC HEALTH DIRECTORS
, HUGE TURNOVER IN STAFF, AND SO
THE IDEA OF NOT CONTINUING TO
FUND WORKFORCE IS I USE THIS
PHRASE ALL THINK IT'S PENNY WISE
AND POUND FOOLISH. I JUST DON'T
IT DOESN'T MAKE ANY SENSE TO ME
. AND SO WE HAD TO FIND SOME
OTHER WAY TO DO THIS. IT JUST
DOESN'T MAKE SENSE. I SAT IN
2017 ON A WORKFORCE COMMISSION
FOR THE CALIFORNIA HEALTHCARE
FOUNDATION. WE IDENTIFIED THAT
WE NEEDED INVESTMENT OVER 10
YEARS OF $3 BILLION IN HEALTH
CARE WORKFORCE THREE. BILLION
DOLLARS. THAT'S $300 MILLION A
YEAR AND THAT'S JUST TO KIND OF
GET US UP WHERE WE NEED TO BE.
PUBLIC HEALTH WORKFORCE WAS A
PART OF THE DISCUSSION THERE, SO
I'M SORRY. WE GOT TO FIND
ANOTHER WAY TO DO THIS. I
COULDN'T SUPPORT THIS. THANK
YOU. I WILL NOW BRING IT UP TO
THE CHAIR AND WILL REMIND US OF
DR ARROGANCE, WORDS AT THE
BEGINNING ABOUT THE WAXING AND
WANING INTEREST WITHIN PUBLIC
HEALTH AND THE NEED FOR US TO
INVEST INTO PREPAREDNESS. AND
WANT TO COME BACK TO HOW WE HELP
TO MAKE THIS THE HEALTHY CHOICE
, THE EASY CHOICE AND SO I WOULD
LIKE TO ASK AGAIN REGARDING THE
CONTINGENCY FUNDING SINCE WE
DIDN'T USE ANY OF THE 5200 AND
50 MILLION IN LAST YEAR'S BUDGET
FOR CONTINGENCY FUNDING. WHY WAS
IT THE PRUDENT CHOICE FOR US TO
BUDGET FOR 50 MILLION IN THIS
YEAR'S BUDGET FOR CONTINGENCY
FUNDING? WHILE AT THE SAME TIME
STRIPPING 50 MILLION FROM PUBLIC
HEALTH WORKFORCE, HOPING YOU CAN
EXPLAIN THAT. OF WHAT FINANCE
ANSWER THAT ONE. THANK YOU, MR
CHAIR. UM YOU KNOW, WE
ACKNOWLEDGE FROM THE
ADMINISTRATION THAT THESE ARE
VERY HARD DECISIONS TO CONSIDER
, AS MY COLLEAGUE PREVIOUSLY
MENTIONED WE ARE MAINTAINING THE
300 MILLION ONGOING WHICH FOLKS
WILL RECALL INCLUDES, UM 200
MILLION FOR LOCAL HEALTH
JURISDICTIONS, OF WHICH 70% MUST
BE USED FOR STAFFING, SO WE ARE
MAINTAINING A SIGNIFICANT PUBLIC
HEALTH STAFFING INVESTMENT IN
THE ONGOING BUT YOU KNOW, AS WE
MENTIONED THE ADMINISTRATION
AIMED TO BALANCE ADDRESSING
REVENUE SHORTFALLS, WHILE ALSO
MAINTAINING OUR COMMITMENT TO
INVESTING IN OUR STATE'S PUBLIC
HEALTH INFRASTRUCTURE, SO WE
CONTINUE TO MAINTAIN THIS
PRIORITY. UM AND WE BELIEVE WE
STRUCK THE BEST BALANCE AND
COMPROMISE BETWEEN MAKING A
DIFFICULT CUT WHILE STILL
MAINTAINING A VERY IMPORTANT
INVESTMENT IN PUBLIC HEALTH.
THANK YOU. ALL ELEVATE IF I CAN
THAT MANY OF THOSE INVESTMENTS
WERE FOR CURRENT STAFF AND
WEREN'T FOR ADDRESSING THE
BURNOUT AND LOSS OF STAFF THAT
WE'VE BEEN SEEING. AND SO MANY
OF THE PATHWAY AND PIPELINE
PROGRAMS ARE IMPORTANT, WHICH IS
WHY THE LEGISLATURE FELT SO
INCLINED TO INVEST THESE DOLLARS
IN THE LAST BUDGET YEAR. THAT
WOULD LIKE TO CONTINUE THOSE
CONVERSATIONS WITH THE
ADMINISTRATION'S AS WE FINALIZE
OUR BUDGET, BUT HOPE YOU HEAR
THE SUPPORT WE HAVE FOR
CONTINUED PUBLIC HEALTH
INVESTMENTS AS WE MUST BE
PREPARED WITH THE WORK FORCE FOR
TOMORROW. WITH THAT WE WILL
THANK DOCTOR WOULD THANK YOU, MR
CHAIR, AND JUST JUST ONE COMMENT
HERE, AND THIS IS I'M LOOKING AT
THE CALIFORNIA PUBLIC PUBLIC.
HEALTH PATHWAYS, TRAINING COURT
, AND, UM, THINKING THINKING
ABOUT THAT YOU HAVE A WORKFORCE
PATHWAY. FOR EARLY CAREER PUBLIC
PROFESSIONALS, HEALTH
PROFESSIONALS FROM DIVERSE
BACKGROUNDS AND
DISPROPORTIONATELY AFFECTED
COMMUNITIES. NOW, OFTENTIMES
THESE FOLKS GO BACK TO THOSE
COMMUNITIES AND WE SAW DURING
COVID SOME OF OUR MOST
VULNERABLE COMMUNITIES WHERE THE
WERE REALLY DIFFICULT TO GET OUR
ARMS AROUND WERE FOR WORKFORCE
AND HOW WE HOW WE COMMUNICATE ON
VACCINATIONS AND TESTING AND ALL
OF THAT. AND YET THAT'S ONE OF
THOSE THINGS WERE GOING TO CUT.
FOR THE FUTURE THAT JUST FEELS
IT JUST IT DOESN'T MAKE ANY
SENSE FROM MY PERSPECTIVE. SO I
JUST WANT TO HIGHLIGHT THAT ONE
BECAUSE SOME OF OUR MOST
UNDERSERVED, DIFFICULT
CHALLENGING COMMIT COMMUNITIES,
UM YEAH, AND I'LL JUST SAY,
HAVING MET SOME OF THE PEOPLE IN
OUR PATHWAYS PROGRAM. IT'S AN
INCREDIBLE PROGRAM THAT PEOPLE
COMING IN HAVE BEEN YEAH, FROM
VERY DIVERSE BACKGROUNDS, AND
WE'VE BEEN ABLE TO SUPPORT THAT
WITH SOME OF OUR COVID DOLLARS
AND, UM IT'S BEEN AN INCREDIBLE
GROUP OF PEOPLE. AND MY THESE
THEY GO BACK TO THE COMMUNITIES
IN GENERAL THAT THEY THAT THEY
COME FROM OFTEN. I MEAN, NOT OUR
IN IN GENERAL, I CAN'T. I CAN'T
CHARACTERIZE THAT. BUT I DO KNOW
THAT YOU KNOW, FROM EXPERIENCE
THAT PEOPLE THAT GO INTO THAT
COME FROM CERTAIN COMMUNITIES
TEND TO GO BACK TO HAVE TIES TO
THOSE COMMUNITIES HOME FAMILY.
YOU KNOW THAT KIND OF THING, AND
SO ANYWAY, THANK YOU. WITH THAT
WE WILL THANK VERY MUCH THIS
PANEL AND WILL NOW MOVE ON TO
ISSUE 13. ISSUE 13 AS AN
OVERSIGHT ISSUE ON THE STATE'S
PANDEMIC RESPONSE, EMERGENCY
PREPAREDNESS AND PUBLIC HEALTH
INFRASTRUCTURE. WE WILL BEGIN
WITH SUSAN, FINALLY, CHIEF
DEPUTY DIRECTOR FOR THE HEALTH
QUALITY AND EMERGENCY RESPONSES
TO SEED PH, MISS. FINALLY. SURE
SO I'M JUST GONNA GO SORT OF
RIGHT TO THE QUESTIONS ON THE
ASSESSMENTS OF OUR STRENGTHS AND
WEAKNESSES IN PUBLIC HEALTH
INFRASTRUCTURE AND EMERGENCY
PREPAREDNESS. I THINK OUR
STRENGTHS ONE I WOULD PUT UP
THERE THE DEVELOPMENT AND MEAN
MAINTENANCE OF OUR PUBLIC HEALTH
AND MEDICAL RESPONSE STRUCTURE.
THROUGH OUR WITH OUR LOCAL
PARTNERS. THE DEVELOPMENT OF OUR
REGIONAL TEAM AS WELL. REGIONAL
DISASTER MEDICAL HEALTH
SPECIALISTS, ALONG WITH OUR
MOHAWK PROGRAM, MEDICAL HEALTH
OPERATIONAL AREA COORDINATORS
HAS REALLY BEEN, YOU KNOW, NOT
ONLY HELPFUL FOR COVID, BUT FOR
EVERY MEDICAL AND HEALTH
RESPONSE. UM ALTHOUGH WE'VE HAD
CATEGORICAL FUNDING THAT HAS LED
TO SPECIALIZED STAFF AND
SPECIFIC DISEASES, PUBLIC HEALTH
ISSUES, I THINK WE'VE RECOGNIZED
THE NEED FOR MORE GENERALISTS
WHO CAN BE SHIFTED INTO RESPONSE
ROLES ACROSS DIFFERENT KINDS OF
EVENTS, AND OVER THE PAST FEW
YEARS, WE HAVE BEEN ABLE TO
CROSS TRAIN MANY STAFF THAT, UM
, YOU KNOW, WE WANT TO RETAIN
AND ARE USING SOME OF THE
DOLLARS THAT WE'RE GETTING TO DO
JUST THAT. WE'VE INCREASED THE
NUMBER OF SUBJECT MATTER EXPERTS
WHO CONTINUE TO WORK AT THE
NATIONAL LEVELS AS EXPERTS IN
THEIR FIELDS THAT TODAY. WORK
REALLY PREPARES THEM FOR
EMERGENCY RESPONSE. EXAMPLES
INCLUDE THINGS LIKE OUR VACCINE
INFRASTRUCTURE. INFECTIOUS
DISEASES ARE HOSPITAL ACQUIRED
INFECTIONS GROUP. ENVIRONMENTAL
HEALTH AND INDUSTRIAL HYGIENISTS
AND MATERNAL AND CHILD HEALTH.
OUR WEAKNESSES WITH DECLINING
PREPAREDNESS AND RESPONSE OVER
FUNDS OVER THE PAST YEARS WERE
MUCH MORE LIMITED IN THE NUMBER
OF RESPONSE STAFF THAT WE HAVE
THROUGH THESE FEDERAL DOLLARS,
UM AND OUR ABILITY TO SCALE FOR
MULTIPLE OR LARGE DISASTERS. AS
WE SEE, YOU KNOW, WERE ACTIVATED
NEARLY EVERY DAY FOR SOME KIND
OF A RESPONSE. AND SO I THINK
THAT DOES JUST LEND ITSELF TO,
YOU KNOW, MAKING SURE THAT WE
HAVE TRAINED STAFF AND THAT WE
ARE ABLE TO USE THE DOLLARS THAT
WE'RE GETTING FOR FUTURE PUBLIC
HEALTH TO CONTINUE TO BUILD THAT
AGAIN THAT INCREASING NUMBER AND
FREQUENCY AND SEVERITY OF
EMERGENCIES IS CHALLENGING. UM,
COMMUNICATIONS TEAMS NEED TO BE
EXPANDED TO ADDRESS THE MANY
DEMANDS FOR INFORMATION ACROSS
THE VARIETY OF PLATFORMS, AND
SOME OF THOSE ARE REALLY NEW
THINGS. AND SO I THINK WE'VE
RECOGNIZED THAT SOME OF OUR GAPS
REALLY ARE AND THOSE KINDS OF
THINGS THAT WE HAVE NOT HAD TO
DO IN THE PAST THAT THEY ARE NEW
SKILLS AND NEW COMPLEX PROBLEMS
THAT WE'RE DEALING WITH. SO I
DON'T KNOW IF YOU WANT TO LET
THE OTHERS RESPOND TO THAT, OR
YOU WANT ME TO GO THROUGH ON THE
INVESTMENTS, THE UPDATES ON THE
IMPLEMENTATION OF THE 300
MILLION SORT OF WRAPPED TOGETHER
THROUGH YOUR PROPORTIONS. OKAY
SURE. SO UM, THE FIRST YEAR OF
THE FUTURE OF PUBLIC HEALTH
FUNDING HAS REALLY BEEN ABOUT
FILLING ARE CRITICAL STATE AND
LOCAL HEALTH DEPARTMENT
POSITIONS WITH DIVERSE
REPRESENT. NATIVE AND HIGHLY
QUALIFIED STAFF. SO FOR STATE
OPERATIONS, WE'VE PRIORITIZED
HIRING BY ADDING ADDITIONAL
RESOURCES WITHIN OUR HR
DEPARTMENT. WE HAVE USED LEAN TO
STREAMLINE OUR HIRING PROCESS.
WE HAVE SET UP A TEAM TO ASSIST
PROGRAMS AND PREPARING THE NEED
OF PAPERWORK. IN ADDITION, WE
ARE RECRUITING A NEW WAYS,
INCLUDING ADDITIONAL ADVERTISING
SITES AND GROUPING INTERVIEWS
FOR MULTIPLE POSITIONS WITHIN
SPECIFIC CLASSIFICATION. THERE'S
BEEN A STRONG START AND
CONTINUED MOMENTUM FOR THE
PUBLIC HEALTH WORKFORCE
EXPANSION, BOTH THE STATE AND
LOCAL LEVEL OF EXCEEDING OR
HIGHER HAVE EXCEEDED OUR HIRING
TARGETS FOR THE FIRST TWO
QUARTERS WITH OVER 700 NEW
PUBLIC HEALTH STAFF HIRED
STATEWIDE THROUGHOUT THIS
INVESTMENT. WE'VE WE'VE HIRED
ABOUT ROUGHLY 40% OF OUR 404
POSITIONS, AND WE'RE ON TRACK AT
THE STATE TO HIRE 80% OF OUR
STAFF IN THE CURRENT FISCAL YEAR
. WE'VE INVESTED FUNDING IN A
NUMBER OF WORKFORCE AREAS,
INCLUDING LEAN TRANSFORMATION,
TRAUMA, RESPONSIVE TRAINING,
IMPROVING INTERNAL
COMMUNICATIONS AND MANY EFFORTS
TOWARDS RECRUITMENT AT THE LOCAL
LEVEL. UM THEY'VE HIRED NEARLY
50% OF THE PER CHECKED IT 1200
POSITIONS AND SO VERY IMPRESSED
BY THAT, AND WITH ALL THE
CHALLENGES AND HIRING WE'VE
WE'RE CONTINUING AN AGGRESSIVE
FOCUS ON RECRUITMENT, CONDUCTING
CAMPAIGNS TO ADDRESS HARD TO
FILL CLASSIFICATIONS AND
STRENGTHENING OUTREACH TO
IMPROVE WORKFORCE DIVERSITY.
WE'VE WORKED WITH SEVERAL NEW,
UM, WE'VE WORKED TO REORGANIZE
SEVERAL OF OUR OFFICES AND
REALLY ENABLING WAVES OF HIRING
. OUR EFFORTS HAVE ALSO REQUIRED
THE ESTABLISHMENT OF TWO NEW
OFFICES, WHICH WERE APPROVED BY
HR IN DECEMBER, INCLUDING THE
OFFICE OF POLICY AND PLANNING
AND THE REGIONAL PUBLIC HEALTH
OFFICE. WE HAVE ALREADY HIRED
THE DEPUTY DIRECTOR. FOR THE
OFFICE OF POLICY AND PLANNING
AND ARE ACTUALLY ABOUT TO
INTERVIEW FOR THE DEPUTY
DIRECTOR FOR THE REGIONAL POP UP
PUBLIC HEALTH OFFICE. UM, AND
SEVERAL POSITIONS HAVE BEEN
HIRED INTO THESE OFFICES AND
RECRUITMENT CONTINUES. AS PART
OF THEIR SCOPE. THESE OFFICES
ARE COORDINATING CENTRAL
MONITORING FOR PERFORMANCE
TRACKING AND SUPPORT FOR
IMPLEMENTATION FOR THIS
INVESTMENT AS PART OF THE LEAN
TRANSFORMATION. WE HAVE LAUNCHED
NEW STRUCTURES AND SYSTEM
IMPROVEMENT EFFORTS, CPH
RELEASED A CONTINUANCE
IMPROVEMENT PLAN TO BOOST THE
DEPARTMENT'S AGILITY AND
RESPONSIVENESS AND ADDRESSING
COMPLEX PUBLIC HEALTH CHALLENGES
. WE'VE LAUNCHED THE LEAN
IMPROVEMENT PROJECTS FOR HIRING
CONTRACTING AND REGULATIONS
PACKAGES AT THE LOCAL LEVEL. CPH
ISSUED A GUIDANCE DOCUMENT ALL
JURISDICTIONS WHICH WE CONTINUE
TO AMEND A AS WE MAKE CHANGES TO
WHAT'S ALLOWABLE WITH THESE
FUNDS. 60 OF THE 61
JURISDICTIONS HAVE RECEIVED
THEIR ADVANCE PAYMENTS. ONE HAS
OPTED NOT TO YOU. 100% OF THE
JURISDICTIONS HAVE DEVELOPED
DETAILED WORK PLANS AND SUBMIT
IT QUARTERLY UPDATES ON
EXPENDITURES, HIRING IN PROGRESS
TOWARDS MEETING THEIR OBJECTIVES
. LH DAYS REPORT EXPANDING THEIR
WORKFORCE IN MULTIPLE PRIORITY
PUBLIC HEALTH AREAS, INCLUDING
INFECTIOUS DISEASES, CHRONIC
DISEASE, COMMUNITY HEALTH,
FAMILY HEALTH AND ENVIRONMENTAL
HEALTH, AND L. HJ'S PRIORITY
COMMITMENTS INCLUDE USING
FUNDING TO PROMOTE EQUITABLE
OUTCOMES AND PREVENTION AND
HEALTH PROMOTION IN THEIR
COMMUNITIES. AND I WOULD JUST
SAY THAT AS WE LOOK TO THE
FUTURE OF ACCOUNTABILITY
MEASURES FOR THE FUTURE OF
PUBLIC HEALTH WE'RE LOOKING AT
WHERE WE HAVE PLANNED INVESTMENT
AREAS, BOTH OF THE STATE AND
LOCAL LEVEL, AND WE'RE WORKING
WITH OUR LOCAL PARTNERS TO
ESTABLISH STATEWIDE METRICS,
WHICH WILL BE USED ISSUED PRIOR
TO THE START OF THE NEW FISCAL
YEAR. THE FOCUS OF THESE METRICS
WILL BE TO REFLECT PROGRESS ON
ADDRESSING GAPS AND POOR BOOK
POOR YEAH. AND CORE PUBLIC
HEALTH INFRASTRUCTURE. IMPROVING
CAPACITY TO DELIVER TO DELIVER
FOUNDATIONAL PUBLIC HEALTH
SERVICES, CONTRIBUTING TO LONG
TERM IMPROVEMENTS IN POPULATION
, HEALTH OUTCOMES, AND WE'VE
ALREADY BEGUN THAT WORK WITH OUR
LOCAL PARTNERS AND WILL CONTINUE
TO MEET WITH THEM, SO I'LL STOP.
THERE ARE NEXT SPEAKER IS
CHRISTINE SAYYAD, OR WHO IS THE
ASSISTANT DIRECTOR OF POLICY
PLANNING AND PERFORMANCE AT CD?
PH. PLEASE BEGIN. THANK YOU
CHAIR AND IT'S SIMPLY MEMBERS.
SO UM, THE QUESTION I WILL
ANSWER IS, ARE WE OR OR WILL WE
BE MORE PREPARED FOR THE NEXT
PANDEMIC OR NEXT PUBLIC HEALTH
CRISIS THAN WE WERE BEFORE COVID
THE COVID PANDEMIC? THE ANSWER
IS, YES, BUT THAT'S DEPENDENT ON
OUR ABILITY TO RETAIN STAFF TO
BETTER INTEGRATE AND UPGRADE OR
DATA SYSTEMS. AND OUR ONGOING
FUTURE OF PUBLIC HEALTH FUNDING.
BUILDING ON THE LESSONS LEARNED
FROM COVID RESPONSE. WE ARE
TRYING TO UPDATE AND BROADEN OUR
DATA SYSTEMS TO ACCOMMODATE NEW
THREATS. UM TRAIN OUR STAFF TO
WORK ACROSS MULTIPLE INFECTIOUS
DISEASES AND EXPAND OUR
PREPAREDNESS AND RESPONSE
INFRASTRUCTURE. MUCH OF OUR
FUNDING FOR THIS WORK WILL BE
FEDERALLY FUNDED, WILL WORK WITH
FEDERALLY FUNDED IN THE CURRENT
YEAR BUDGET YEAR, AND MOST OF
THOSE FUNDS WE ANTICIPATE WILL
END BY JUNE 2024. SO THE
INVESTMENTS FROM THE FUTURE
PUBLIC HEALTH IS CRITICAL TO THE
SUFFER. HOW HOW WILL THE STATE
MEASURE PROGRESS? AND HOW WILL
WE KNOW WE'RE WE'RE BETTER
PREPARED. WE ARE REVIEWING EACH
OF THE RESPONSE AREAS TO
IDENTIFY BEST PRACTICES AND
LESSONS LEARNED AND
OPPORTUNITIES FOR ADDITIONAL
PREPAREDNESS WORK. CITY PH WILL
PRIORITIZE OUR WORK THAT NEEDS
TO BE DONE TRACKING PROGRESS IN
COMPLETING THE ACTION ITEMS
DEVELOPING OUR OBJECTIVES AND
KEY RESULTS FRAMEWORK. WERE
ALREADY ABLE TO RESPOND. WE WERE
ALL READY ABLE TO RESPOND TO M
PARKS MUCH MORE QUICKLY, UM,
WITH RESOURCES IN THE COMMUNITY
TO VACCINATE MORE RAPID TESTING
CAPACITY AND UPDATING SYSTEMS
LIKE CAL CONNECT TO HELP WITH
INVESTIGATIONS. WE'LL CONTINUE
TO DO ANNUAL EXERCISES AND DO
RESPONSE TRAINING, TRACKING THE
NUMBER OF PEOPLE ABLE TO FILL
VARIOUS RESPONSE ROLES. BUILDING
ON OUR GAINS AND INFECTIOUS
DISEASE SURVEILLANCE RESOURCES
TO BE BROADER THAN COVID. UM
THAT IS OUR, UM, COMMITMENT AND
TO CONTINUE TO SUPPORT SMALL
SEGMENT OF MODELING TEAM, THE
CALL CENTER. CORE THAT CAN BEGIN
RESPONSE AND OPTIONS FOR SCALING
UP IN PRE TRAINING DATA SYSTEMS
AND OTHERS WERE EXPANDING OUR
COMMUNICATIONS CAPACITY. AND
WE'RE COLLABORATING WITH
MULTIPLE ACADEMIC PARTNERS TO
INCORPORATE INFORMATION AND
LESSONS LEARNED FROM THIS
PANDEMIC TO INFORM ALGORITHMS,
PROJECTIONS AND OTHER EVIDENCE
BASED WORK TO INFORM FUTURE
INFECTIOUS DISEASE EMERGENCIES
AND PANDEMIC RESPONSE AND
PANDEMIC POLICIES AND RESPONSE.
CD PH AND LOCAL HEALTHCARE
SUCCESS JURISDICTIONS ARE
WORKING CLOSELY TO TRACK
PROGRESS AND THE IMPACT OF
CRITICAL PUBLIC HEALTH
INFRASTRUCTURE INVESTMENT. WE
ARE MEASURING ACCOUNTABILITY
FOCUSED ON EFFICIENT
IMPLEMENTATION. WE'RE LOOKING AT
RAPID DISSEMINATION, WE MEASURED
A RAPID DISSEMINATION OF LOCAL
ASSISTANCE, FUNDS MONITORING
STATE AND LOCAL PROGRESS ON
EXPENDITURE. WE'RE TRACKING
METRICS RELATED TO HIRING,
RECRUITMENT AND OUTREACH AND
PROCESSING TIMES. WE'RE LOOKING
TO, UM, PROGRESS AND INSTITUTING
SYSTEMS AND PROCESS IMPROVEMENTS
. AND WE'RE LOOKING AT OUR
OUTCOMES AND IMPACT. WE'RE
ADDRESSING GAPS IN CORE PUBLIC
HEALTH INFRASTRUCTURE, AND WE'RE
IMPROVING PUBLIC HEALTH,
FOUNDATIONAL SERVICES AND
POPULATION HEALTH OUTCOMES.
THANK YOU. NEXT. WE HAVE JULIE
NAGASAKI, Ó. NOT SURE IF THEY
HAVE ANY COMMENTS. AND MY
COLLEAGUES. THANK YOU. THANK YOU
. OUR NEXT SPEAKER IS OUSSAMA.
OKAY TÂM, DIRECTOR OF STATE
POLICY AT PUBLIC HEALTH
ADVOCATES. CAN YOU PLEASE BEGIN?
GOOD AFTERNOON. MR CHAIR
REMEMBERS. MY NAME IS SALMAN
MOGHADAM. AND I'M THE DIRECTOR
OF STATE POLICY AND PUBLIC
HEALTH ADVOCATES. PUBLIC HEALTH
ADVOCATES. WE BELIEVE THAT
PREPARATION FOR FUTURE
EMERGENCIES SHOULD BE A TOP
PRIORITY. I FREQUENTLY POSED
THIS QUESTION TO PEOPLE. IF I
WERE TO TRANSPORT YOU TO 2018
AND ASK IN A COUPLE OF YEARS,
THERE WILL BE A NOVEL VIRUS THAT
SWEEPS THE WORLD AND WHO WOULD
BE MOST HARMED. WHAT WOULD YOU
ANSWER? BE? EVERYONE IN THIS
ROOM COULD ACCURATELY PREDICT
THAT LOW INCOME PEOPLE, PEOPLE
OF COLOR, OLDER PEOPLE AND
MEDICALLY VULNERABLE PEOPLE WERE
GOING TO BE AT THE HIGHEST RISK
FOR GETTING THE DISEASE AND
SUCCUMBING TO IT. AND THAT THE
IMPACT WOULD LIKELY BE
COMPOUNDED BY OTHER FACTORS THAT
MADE THEM HIGH HIGH RISK IN THE
FIRST PLACE. WE COULD HAVE
PREDICTED. THAT ALL ALL OF THAT
WITHOUT EVEN KNOWING WHAT THE
DISEASE WAS, AND THIS BRINGS ME
TO KEY LESSON NUMBER ONE. THE
PATTERNS OF COMMUNITY
VULNERABILITY ARE WELL KNOWN.
WHICH MEANS THAT THERE WERE
OPPORTUNITIES FOR PREVENTION
THAT WE DID NOT TAKE ADVANTAGE
OF WITH COVID 19. COVID 19 AS
DEVASTATING AS IT WAS ON THE
GLOBAL SCALE PROVIDERS PROVIDED
US ALL WITH A WIDE VARIETY OF
LEARNINGS. WE NOW HAVE AN
OPPORTUNITY TO PREPARE SO THAT
WE DO NOT REPEAT THE SAME
MISTAKES IN THE FUTURE. BECAUSE
THERE WERE NEVER INEVITABLY BE
FUTURE EMERGENCIES. THE ANSWER
TO THE QUESTION OF ARE WE OR
WILL WE BE MORE PREPARED FOR THE
NEIGHBOR? NEXT PUBLIC HEALTH
CRISIS IS THIS IF WE AREN'T
ALREADY PLANNING FOR THE NEXT
CRISIS, THE ANSWER IS NO. IF WE
ARE WAITING FOR IT TO HAPPEN TO
ALLOCATE RESOURCES, DEVELOP
INFRASTRUCTURE AND HIRE STAFF
AGAIN, THE ANSWER IS NO. LUCKILY
AS I'VE MENTIONED THE SHORTFALLS
OF THE COVID 19 RESPONSE HAVE
BEEN WELL DOCUMENTED, DOCUMENTED
BY STATE AND LOCAL HEALTH
DEPARTMENTS AND COMMUNITY
PARTNERS. SO WE CAN BE MORE
PREPARED. IF WE HEED THE LESSONS
FROM COVID 19. WHICH BRINGS ME
TO KEY LESSON NUMBER TWO. WE
MUST START THE RESPONSE NOW.
BEFORE THE STATE BEGINS THE
USUAL PROCESS OF ENDING
TEMPORARY COVID 19 STAFF
REASSIGNMENTS THE STAFF SHOULD
HELP DEVELOP EMERGENCY RESPONSE
PLANS THAT DRAW ON THE LESSONS
THEY LEARNED. THESE STATE AND
LOCAL STAFF SHOULD BE TASKED
WITH DEVELOPING RESPONSE PLANS
FOR KNOWN EMERGENCY THREATS TO
PUBLIC HEALTH, SUCH AS NOVEL
INFECTIOUS DISEASES. WILDFIRES
FLOODS EXTREME HEAT EXTREME COLD
TORNADO WINDS, MUDSLIDES
DROUGHT. AND EARTHQUAKES. AND
IT'S WORTH NOTING THAT
CALIFORNIA HAS EXPERIENCED ALL
OF THESE WITHIN THE PAST 12
MONTHS. WHICH BRINGS ME TO KEY
LESSON NUMBER THREE. BUILD THE
ADMINISTRATIVE INFRASTRUCTURE
NOW. OFTEN THE DECLARATION OF A
STATE OF EMERGENCY PRECIPITATES
THE AVAILABILITY OF NEW
RESOURCES FOR EMERGENCY
RESPONSE. THE STATE SHOULD
ESTABLISH A WAY TO PRE IDENTIFY
STAFF ROLES. CONDUCT ONGOING
TRAINING AND PLANNING AND PRE
QUALIFIED COMMUNITY SERVICE
PROVIDERS TO ENSURE THAT WHEN
FUNDING IS ALLOCATED IT CAN BE
DISTRIBUTED IMMEDIATELY. WE WILL
KNOW WE ARE BETTER PREPARED FOR
FUTURE CRISES IF WE HAVE A PLAN
AND FUNDING AVAILABLE TO ENSURE
THE FOLLOWING ONE. MESSAGES AND
MATERIALS THAT ARE IMMEDIATELY
AVAILABLE IN THE 17 THRESHOLD.
LANGUAGES SPOKEN IN CALIFORNIA.
CULTURAL BROKERS BEING
IDENTIFIED AND FUNDED TO PROVIDE
OUTREACH AND SERVICES IN
CULTURALLY AND LINGUISTICALLY
APPROPRIATE WAYS. PARTNERS WHO
ARE EQUIPPED TO SERVE RURAL
POPULATIONS. A PLAN TO REACH
PEOPLE WHO DON'T HAVE REGULAR
ACCESS TO TECHNOLOGY, AND THAT'S
A VERY REAL CONCERN, EVEN IN A
STATE LIKE CALIFORNIA.
PROTECTIONS FOR PUBLIC HEALTH
WORKERS. SUPPORTING BASIC NEEDS,
SUCH AS FOOD, ACCESS, EMERGENCY
HOUSING SUPPORT AND EDUCATION,
INCLUDING SCHOOLS AND DAYCARE
CENTERS. AND, MOST IMPORTANTLY,
THAT PUBLIC HEALTH DEPARTMENTS
ARE EQUIPPED AND STAFFED TO LEAD
THE RESPONSE EFFORTS. ON THE
TOPIC OF PUBLIC HEALTH
PROFESSIONALS. I'D LIKE TO TAKE
A PERSONAL LIBERTIES ON BEHALF
OF PUBLIC HEALTH ADVOCATES TO
NOTE THAT MY SUPERVISOR DR FLOW,
GENE GRIFFIN, COFER IS AN ALUMNA
OF THE CAL EPIDEMIOLOGICAL
INVESTIGATION FELLOWSHIP. PRIOR
TO JOINING OUR ORGANIZATION, SHE
WORKED AT THE DEPARTMENT OF
PUBLIC HEALTH FOR SEVEN YEARS
AND SUPPORTED THE ZIKA RESPONSE
EFFORTS. PUBLIC HEALTH ADVOCATES
IN THE STATE OF CALIFORNIA
BENEFIT REGULARLY FROM THE
$40,000 INVESTMENT. THAT MADE
THAT IT MADE IN HER TRAINING 17
YEARS AGO. AND WE CAN MEASURE
OUR PROGRESS BY RECOGNIZING IN
THE AFTERMATH OF A GLOBAL
PANDEMIC THAT PUBLIC HEALTH
TRAINING PROGRAMS ARE AMONG THE
MANY INVESTMENTS THAT NEED MORE
MONEY AND SUPPORT, NOT LESS. AS
WE CAN SEE HERE, THE PATH
PREVENTION AND INVESTMENT IN
EMERGENCY RESPONSE AND OUR
PUBLIC HEALTH INFRASTRUCTURE
ISN'T A SPECULATIVE ONE. IT'S
ONE THAT'S THAT'S SUPPORTED BY
DOCUMENTED TRIED AND EVIDENCE
BASED DATA. IT'S NOW OUR JOB TO
KEEP UP THE INVESTMENT THAT WE
ORIGINALLY PROTECTED. PROJECTED
FOR US TO ACHIEVE OUR GOALS.
THANK YOU FOR ALLOWING ME TO
SPEAK TODAY AND PROVIDE THIS
PERSPECTIVE. OUR NEXT SPEAKER IS
MICHELLE GIBBONS, WHO'S THE
EXECUTIVE DIRECTOR FOR CHEOK.
GOOD AFTERNOON CHAIR MEMBERS.
MICHELE GIBBONS WITH JACK, FIRST
AND FOREMOST, I JUST WANT TO
THANK THIS LEGISLATURE FOR YOUR
LEADERSHIP IN PRIORITIZING
PUBLIC HEALTH AND PUBLIC HEALTH
WORKFORCE. I REMEMBER COMING
BEFORE THIS SUBCOMMITTEE A
COUPLE OF YEARS AGO TO SAY, HEY,
WE HAVE SOME NEEDS. WE NEED TO
INVEST IN THE INFRASTRUCTURE.
AND YOU ALL RESPONDED AND SHOWED
TREMENDOUS LEADERSHIP. SO THANK
YOU FOR THAT, AND WE ARE DOING
OUR PART AT THE LOCAL LEVEL MY
MEMBERS TO REALLY START TO
REBUILD THAT WORKFORCE CAPACITY.
THE 200 MILLION THAT LOCAL
HEALTH DEPARTMENTS RECEIVED. I
JUST WANT TO BE VERY CLEAR. WE
DIDN'T COME AND PROMISE NEW
SHINY THINGS. WE SAID THIS IS
GOING TO ALLOW US TO HIRE PEOPLE
TO DO THE THINGS THAT WERE
REQUIRED TO DO TODAY. AND AS YOU
HEAR, THERE'S A MYRIAD OF PUBLIC
HEALTH CHALLENGES THAT ARE NEW
AND EXACERBATED AND GROWING. BUT
THESE DOLLARS WERE JUST TO DO
THE BASICS. THE FOUNDATIONAL
THINGS THAT WE SAID WE DIDN'T
HAVE ENOUGH INFRASTRUCTURE TO DO
. UM I DO ALSO WANT TO NOTE THAT
AS DR ARGON STATED CD PH
ADMINISTERS OVER 200 PROGRAMS.
MANY OF THOSE PROGRAMS ARE LOCAL
HEALTH DEPARTMENTS ARE KEY
PARTNERS WITH THE DEPARTMENT OF
PUBLIC HEALTH. TO REALLY MAKE
SURE THAT THEY'RE ADMINISTERED
LOCALLY AS WELL. SO WITH THE
FUNDS OF THE FUTURE OF PUBLIC
HEALTH FUNDS YOU'VE HEARD LOCAL
HEALTH DEPARTMENTS HAVE HIRED
HAVE PLANS TO HIRE NEARLY 1200
POSITIONS, AND THAT IS A GREAT
TO HEAR. SO FAR, WE'VE FILLED
NEARLY 50% OF THOSE, JUST WITHIN
THE FIRST FEW MONTHS. THE VAST
MAJORITY OF THOSE POSITIONS,
THOUGH THERE ARE GEOGRAPHICAL
DIFFERENCES IS TO SUPPORT
CHRONIC DISEASE PREVENTION AND
COMMUNITY COMMUNICABLE DISEASE
PREVENTION AND CONTROL. THE
FUNDS ENABLED SEVERAL
JURISDICTIONS, MANY OF THEM
ACTUALLY TO HIRE SOME OF THE
TEMPORARY WORKERS THAT HELPED TO
SUPPORT THEM DURING COVID 19,
AND I JUST WANT TO MAKE NOTE OF
THAT BECAUSE I THINK AS WE MOVE
FORWARD, THE HIRING CHALLENGES
ARE GOING TO BE EXACERBATED.
WE'RE NOT GOING TO BE ABLE TO
JUST PULL EVERYBODY THAT WAS
WORKING WITH US BEFORE SOME
JURISDICTIONS NEED TO FIND NEW
PEOPLE, AND THAT IS A CHALLENGE
FOR US. WHILE WE'RE EXCITED TO
HEAR ABOUT THE HIRING THAT'S
HAPPENED ALREADY, AS MENTIONED
BEFORE OUR LOCAL HEALTH
DEPARTMENTS HAVE BEEN FACED WITH
HARASSMENT, BURNOUT AND STAFF
TURNOVER. I'LL JUST TELL YOU IN
THE LAST THREE YEARS SINCE THE
PANDEMIC BEGUN. MY NEW COUNT IS
THAT CALIFORNIA HAS LOST OVER 75
LOCAL HEALTH DEPARTMENT LEADERS
SO THAT INCLUDES HEALTH OFFICERS
, PUBLIC HEALTH DIRECTORS AND
AGENCY DIRECTORS AS WELL. AND
THAT NUMBER JUST GREW EVEN THIS
WEEK, SO IT IS A INCREASING
NUMBER. UNFORTUNATELY, AND WE
ARE SURE THAT THE STAFF CAPACITY
IS BEING REFLECTED IN THE SAME
WAY THAT THERE ARE A NUMBER OF
DEPARTURES THAT ARE HAPPENING
LAST YEAR, THE LEGISLATURE
PRIORITIZE THESE WORKFORCE AND
DEVELOPMENT DOLLARS AND I'M NOT
GOING TO REPEAT MUCH OF WHAT I
SAID DOCTOR WOULD. I'M NOT GOING
TO REPEAT WHAT YOU SAID ABOUT
WHAT PATHWAYS IS, BUT I DO WANT
TO TELL A QUICK NOTE. UH THE
INAUGURAL COHORT WAS 45 SLOTS
ROUGHLY, THEY HAD OVER 900
APPLICANTS. THERE IS TREMENDOUS
INTEREST IN THIS PROGRAM. I
ACTUALLY HAD AN OPPORTUNITY TO
TALK TO THE COHORT, AND THERE
WAS AN OLDER GENTLEMAN AND HE
SAID, I KNOW I'M AN OLDER FACE.
BUT I AM NEW TO PUBLIC HEALTH.
AND I AM LOVING WHAT I'M DOING.
SO THERE IS AN OPPORTUNITY TO
GRASP THESE EAGER INDIVIDUALS
AND BRING THEM INTO THE HEALTH
DEPARTMENT. THE COUNTY I S
PROGRAM IS THE TRAINING PROGRAM
FOR EPIDEMIOLOGISTS. SINCE 1989
JUST LOOK AT THESE NUMBERS SINCE
1989 THERE HAVE BEEN 228
GRADUATES. 81% OF THOSE
GRADUATES WORKING GOVERNMENTAL
PUBLIC HEALTH. AND 80% OF THOSE
131 PEOPLE ARE WORKING IN
CALIFORNIA PUBLIC HEALTH
DEPARTMENTS. THAT'S GREAT
RESULTS, SMALL NUMBERS AND WE
NEED TO GROW THAT THE
MICROBIOLOGIST CERTIFICATION
TRAINING ALLOWS INDIVIDUALS TO
GAIN THE EXPERIENCE THAT THEY
NEED TO SIT FOR THE EXAM SO THAT
THEY CAN GET CERTIFIED. IF WE
DON'T INCREASE THE SLATS TO THE
TRAINING. WE DON'T GET CERTIFIED
MICROBIOLOGISTS. THESE ARE THE
PEOPLE THAT ACTUALLY SIT IN THE
LABORATORIES AND THEY RUN THE
SPECIMENS THERE. THEIR VITAL WE
CAN'T REPLACE THAT, BUT WE NEED
TO CONTINUE TO GROW THAT
PIPELINE. THE LAB ASPIRE PROGRAM
IS INTENDED TO GROW UP, GROW THE
POOL OF ELIGIBLE PEOPLE THAT CAN
SERVE AS A LAB DIRECTOR. I JUST
LOOKED AT THE MOST RECENT DATA
ON THE DEPARTMENT OF PUBLIC
HEALTH SITE THEY HAVE IN 2019,
THE GRADUATE GRADUATING COHORT.
EXCUSE ME WAS FOUR PEOPLE. TWO
OF THOSE ARE WORKING AS PUBLIC
HEALTH LAB DIRECTORS TODAY.
AGAIN. GOOD OUTCOMES. SMALL
NUMBERS. THE PUBLIC HEALTH
WORKFORCE, CAREER LADDER
EDUCATION AND DEVELOPMENT
PROGRAM. THIS WAS THE NEWER
PIECE OF THE WORKFORCE
DEVELOPMENT PROGRAMS, AND THE
DEPARTMENT DID A GREAT JOB AT
SOLICITING APPLICATIONS FROM
ACROSS THE STATE. MANY LOCAL
HEALTH JURISDICTIONS, RESPONDED
. I WILL TELL YOU THAT MY
UNDERSTANDING IS THAT THE AMOUNT
OF FUNDS REQUESTED IN THE
RESPONSE ALREADY EXCEEDED THE
FULL AMOUNT OF FUNDING THAT WAS
PROVIDED AND SO TO SLASH THIS
MEANS THAT WE'RE GOING TO HAVE
TO MAKE TOUGH CHOICES ABOUT WHAT
TO FUND AND HOW MANY YEARS IT
CAN BE SUPPORTED WHEN THESE ARE
OUR REAL, UH PROGRAMS ARE IDEAS
TO DO THINGS LIKE HELP FURTHER
SOMEBODY'S EDUCATION SO THAT
THEY CAN PROMOTE WITHIN AND NOT
LEAVE. WE'VE BEEN ASKED, YOU
KNOW, IS CALIFORNIA PREPARED FOR
WHATEVER IS NEXT? MY ANSWER TO
YOU. IS THIS IN ORDER FOR
CALIFORNIA TO BE PREPARED? WE
NEED TO HAVE THE SKILLED AND
TRAINED WORKFORCE. THERE IS NO
DISCUSSION ABOUT PREP
PREPAREDNESS IN CALIFORNIA
WITHOUT LOCAL HEALTH DEPARTMENT
STAFF AND WORKFORCE AND BEING
TRAINED AND GROWING THAT
PIPELINE. UM, WE KNOW THAT
CALIFORNIA'S NAVIGATING A TOUGH
FISCAL CRISIS. WE UNDERSTAND
THAT I WOULD JUST MENTION THAT
THE PROPOSAL FOR THE WORKFORCE
AND DEVELOPMENT CUTS FOR PUBLIC
HEALTH WAS THE ONLY ONE WHO WAS
A FULL ON CUT. IT WASN'T A
TRIGGER. IT WASN'T A DELAY,
ALTHOUGH WE WOULDN'T LIKE EITHER
OF THOSE EITHER, BUT IT REALLY
SHOWS THAT YOU KNOW THERE'S NOT
A VALUE THAT'S REALLY BEING
PLACED ON THE PUBLIC HEALTH
WORKFORCE. I UNDERSTAND WHAT THE
DEPARTMENT OF FINANCE IS SAYING,
BY, YOU KNOW, SUSTAINING THE 200
MILLION THE DIFFERENCE IS, IS
THAT THE 200 MILLION BUILDS THE
WORKFORCE CAPACITY, WHICH MEANS
ADDS POSITIONS AT THE LOCAL
LEVEL. THESE CUTS THAT THE FUNDS
THAT WE NEED FOR THOSE PROGRAMS
THAT HELPS TO GET PEOPLE IN
THOSE POSITIONS AND THAT'S A
REAL VITAL NECESSITY FOR
CALIFORNIA. OUR PUBLIC HEALTH
INFRASTRUCTURE AND WORKFORCE HAS
BEEN DECIMATED OVER DECADES.
IT'S GOING TO TAKE AWHILE TO
REBUILD IT, AND WE KNEW THAT
WHEN WE ASKED FOR THESE FUNDS
AND THESE INVESTMENTS THAT IT
WAS A STARTING POINT, NOT THE
END GAME. AND SO CALIFORNIA.
REALLY? WE CAN'T WAIT TO PULL
BACK ON. WE CAN'T WAIT TO
CONTINUE TO FUND AND GROW OUR
WORKFORCE AND WE CAN'T PULL BACK
ON THESE INVESTMENTS AT AT A
TIME WHERE WE KNOW IT'S NEEDED.
THANK YOU. THANK YOU. I WILL
BRING IT UP TO THE DIOCESE FOR
ANY MEMBERS, QUESTIONS. OUR NEXT
SPEAKER WILL BE KIM SORROW. WHAT
TIME THE RIVERSIDE COUNTY PUBLIC
HEALTH DIRECTOR AND PRESIDENT OF
GRZ THANK YOU FOR TRAVELING ALL
THIS WAY FROM RIVERSIDE TO SPEAK
WITH US TODAY. PLEASE BEGIN.
THANK YOU. GOOD AFTERNOON.
SHARON MEMBERS. I'M KIM STAR
WATERY AND I AM THE PUBLIC
HEALTH DIRECTOR FOR RIVERSIDE
COUNTY AND ALSO THE PRESIDENT
FOR THE COUNTY HEALTH EXECUTIVES
ASSOCIATION OF CALIFORNIA OR
KAYAK. THANK YOU FOR HAVING ME
HERE TODAY TO SHARE THE IMPACTS
OF THE FUTURE OF PUBLIC HEALTH
FUNDING ON RIVERSIDE COUNTY'S
PUBLIC HEALTH INFRASTRUCTURE AND
THANK YOU ALSO FOR YOUR
LEADERSHIP AND ENSURING
CONTINUED INVESTMENT IN PUBLIC
HEALTH INFRASTRUCTURE. SO COVID
CLEARLY HIGHLIGHTED THE IMPACTS
OF DECADES OF DISINVESTMENT IN
PUBLIC HEALTH INFRASTRUCTURE. WE
MET A WORLDWIDE PANDEMIC WITH AN
UNDERSTAFFED AND UNDER TRAINED
WORKFORCE. WE WORKED WITH
ANTIQUATED DATA COLLECTION
REPORTING AND ANALYSIS SYSTEMS.
WE FACED INSUFFICIENT LABORATORY
CAPABILITIES AND CAPACITY AND WE
STRUGGLED WITH INADEQUATE
STRATEGIES FOR REACHING OUR MOST
VULNERABLE COMMUNITIES AS AN
EXAMPLE OF OUR UNDERSTAFFING AND
RIVERSIDE COUNTY. WE HAD TO
EXPAND OUR WORKFORCE FROM 700
FTE S TO 1500 FTE S IN A MATTER
OF WEEKS TO BE ABLE TO RESPOND
TO THE PANDEMIC. TODAY I'M HAPPY
TO REPORT WE ARE MAKING GREAT
STRIDES IN IMPROVING OUR PUBLIC
HEALTH INFRASTRUCTURE AND OUR
ABILITY TO RESPOND TO
EMERGENCIES WHILE CARING FOR OUR
MOST VULNERABLE POPULATIONS.
WE'RE NOT WHERE WE NEED TO BE,
OF COURSE, BUT WE'RE HEADED IN
THE RIGHT DIRECTION. AND MUCH OF
THAT IS DUE TO THE $200 MILLION
FUTURE OF PUBLIC HEALTH
INVESTMENT PROVIDED TO LOCAL
HEALTH DEPARTMENTS IN RIVERSIDE
COUNTY. WE RECEIVED ABOUT $11.8
MILLION OF THIS FUNDING, WHICH
ALLOWED US TO BOTH HIRE NEW
POSITIONS AS WELL AS TRANSITION
TEMPORARY COVID BY UNDID
POSITIONS TO PERMANENT IN TOTAL
WERE FUNDING 131 POSITIONS OR
96.7. FTE S WITH FUTURE OF
PUBLIC HEALTH FUNDING TO IMPROVE
OUR CAPACITY IN COMMUNICABLE
DISEASE RESPONSE, CHRONIC
DISEASE AND COMMUNITY HEALTH,
INCLUDING CLIMATE CHANGE, DATA,
MODERNIZATION REPORTING AND
ANALYSIS, EMERGENCY RESPONSE,
LABORATORY CAPACITY AND OUTREACH
AND EDUCATION, PARTICULARLY TO
OUR MOST UNDER RESOURCED
COMMUNITIES. WE HAVE HIRED HER
IN THE PROCESS OF HIRING NURSES,
MICROBIOLOGISTS, EPIDEMIOLOGISTS
, COMMUNICABLE DISEASE
SPECIALIST COMMUNITY HEALTH
WORKERS, HEALTH EDUCATORS,
ACCOUNTANTS, CAREERS AND OTHERS
, ALL WITH THE GOAL OF SERVING
OUR COMMUNITY, IMPROVING THE
OVERALL HEALTH OF OUR RESIDENTS
AND ENHANCING OUR RESPONSE
CAPABILITIES. AS OF TODAY, WE
FILLED 68% OF THOSE 131
POSITIONS THAT ARE SUPPORTED BY
THE FUTURE OF PUBLIC HEALTH
FUNDING AND THE RESTAURANT,
ACTIVE RECRUITMENT. AND WHILE
WE'RE PROUD OF THE PROGRESS
WE'VE MADE FILLING POSITIONS, WE
ARE STRUGGLING TO FIND QUALIFIED
CANDIDATES, AND THAT STRUGGLE IS
ONLY INCREASING BECAUSE EVERY
HEALTH DEPARTMENT ACROSS THE
STATE IS STRUGGLING TO FIND THE
SAME CANDIDATES THAT WE ARE
RIGHT NOW. IN RIVERSIDE COUNTY.
OUR CURRENT VACANCY RATE IS 22%
AND THE AVERAGE LENGTH OF TIME
IT TAKES TO FILL POSITIONS IS
APPROXIMATELY SIX MONTHS TO GIVE
YOU AN IDEA OF HOW LONG IT'S IT
TAKES TO RECRUIT. QUALIFIED
INDIVIDUALS AND KEY POSITIONS
ARE PUBLIC HEALTH LABORATORY
DIRECTOR POSITION HAS BEEN OPEN
FOR THREE YEARS. IT'S TAKEN 12
MONTHS TO FILL PHYSICIAN
POSITIONS. UM BY SCIENTIFIC
ATION, ALL NURSES, EIGHT MONTHS
REGISTERED NURSES SEVEN MONTHS,
EPIDEMIOLOGISTS, SIX MONTHS. IF
WE TRULY WANT TO BUILD OUR
PUBLIC HEALTH INFRASTRUCTURE AND
BE ABLE TO RECRUIT THE TALENT
THAT THE PUBLIC DESERVES, WE
NEED TO BUILD OUR PIPELINE OF
QUALIFIED SKILLED AND PASSIONATE
INDIVIDUALS, AND THAT'S WHY
COURSE WE'RE VERY CONCERNED
ABOUT THE $49.8 MILLION CUT IN
WORKFORCE DEVELOPMENT FUNDING
FOR PUBLIC HEALTH. WITHOUT THESE
FUNDS TO DEVELOP A PIPELINE OF
QUALIFIED INDIVIDUALS, HEALTH
DEPARTMENTS WILL CONTINUE TO
STRUGGLE TO FILL POSITIONS. MY
HEALTH DEPARTMENT HAS EXPERIENCE
THE VALUE OF THESE WORKFORCE
DEVELOPMENT AND TRAINING
PROGRAMS. WE'VE HAD THE
OPPORTUNITY TO HOST ONE PATHWAY
FELLOW AND REQUESTED ANOTHER. WE
CURRENTLY HAVE THREE
MICROBIOLOGIST CERTIFICATION
TRAINEES, AND WE HAVE HAD TO
KELLY. I S FELLOWS ONE THAT WE
HIRED PERMANENTLY AND WE'VE ALSO
REQUESTED ANOTHER AGAINST SMALL
NUMBERS. HUGE IMPACT FOR US. AS
PART OF REBUILDING PUBLIC HEALTH
INFRASTRUCTURE. WE MUST INVEST
IN OUR MOST VALUABLE RESOURCE
THE PEOPLE THESE PEOPLE WORKED
TIRELESSLY DAY IN AND DAY OUT TO
PROTECT THE COMMUNITIES. WE
SERVE THE INVESTMENT WE MAKE NOW
TO DEVELOP A PIPELINE OF
QUALIFYING TRAINED PEOPLE WILL
COME BACK MANY TIMES OVER
BECAUSE WE'LL BE ABLE TO RESPOND
QUICKER, MORE EFFICIENTLY AND AT
LESS COST. IF WE INVEST IN OUR
PEOPLE, WE'RE INVESTING IN OUR
FUTURE AND WE WILL BE IN A
BETTER POSITION TO RESPOND TO
THE NEXT PUBLIC HEALTH CRISIS.
THANK YOU SO MUCH FOR YOUR TIME
TODAY. OUR NEXT WEEK ER IS BETH
MALINOWSKI, WHO IS THE
GOVERNMENT AFFAIRS ADVOCATE FOR
CTU, CALIFORNIA STATE COUNCIL.
CHAIR AND MEMBERS HAPPY TO BE
HERE TODAY ON BEHALF OF STU,
CALIFORNIA, OR 700,000 MEMBERS,
INCLUDING STATE AND LOCAL PUBLIC
HEALTH WORKERS THROUGHOUT
CALIFORNIA. HIÂU MEMBERS KNOW
WELL THAT WE CANNOT MAKE THE
PROMISE OF HEALTH, EQUITY AND
JUSTICE REALITY WITHOUT CRITICAL
PUBLIC HEALTH INVESTMENTS. WE'RE
GRATEFUL FOR THE FORESIGHT OF
THIS COMMITTEE TO BE HOSTING
THIS PANEL TODAY, THE PAST FEW
YEARS HAVE SERVED AS A BRUTAL
REMINDER TO ALL OF US THAT HOW
WE FUND PUBLIC HEALTH. FUEL OR
DISMANTLE PUBLIC HEALTH PROGRESS
ON THAT NOTE. I'D LIKE TO
BRIEFLY SHARE WITH US AS
PERSPECTIVE AND RECENT PUBLIC
HEALTH INVESTMENT, THE AVOIDABLE
FUNDING CLIFF THAT WE'RE NOW
PRESENTED WITHIN OUR VISION
FORWARD, WHICH PARALLELS NICELY
. THOSE COMMENTS MADE BY MY
PEERS THROUGHOUT THIS PANDEMIC,
CSU'S PROUD TO PARTNER WITH
STAKEHOLDERS AND THIS
LEGISLATURE TO GUARANTEE THE
CALIFORNIA STATE AND LOCAL
PUBLIC HEALTH DEPARTMENT. COULD
PIVOT TO A PANDEMIC RESPONSE AND
SUCCESSFULLY MANEUVER OUR STATE
THROUGH THE PANDEMIC. PUBLIC
HEALTH WORK FIRST JUMPED INTO
NEW ROLES TOOK ON NEW TRAINING,
NEW DUTIES, NEW RISKS ALL THE
SERVICE OF MAKING SURE
CALIFORNIA CAN NOT JUST SURVIVE
BUT THRIVE AND OUR PUBLIC HEALTH
WORKFORCE IN OUR COMMUNITIES OUR
STAFF AT CD PH. THE
LEGISLATURE'S TAKEOVER SHOULD BE
PROUD OF THIS. THE PANDEMIC
FIRST IS ALL FORCES ALL TO
REVISIT A BIG QUESTION. A
QUESTION THAT DOESN'T OFTEN GET
THE ATTENTION IT NEEDS. ARE WE
SUFFICIENTLY FUNDING PUBLIC
HEALTH? AS WE GRAPPLED WITH
THIS, ESPECIALLY IN RECENT
BUDGETS. WE GOT SOME, REALLY, WE
SET SOME REALLY IMPORTANT
INTENTIONS. WE PUT AN ADDITIONAL
300 MILLION ANNUALLY TOWARDS
PUBLIC HEALTH, MAKING A LONG
TERM COMMITMENT TO STATE AND
LOCAL INFRASTRUCTURE. LAST YEAR
, THE CALIFORNIA CAN'T WAIT
COALITION ALSO PUT FORWARD AN
ADDITIONAL REQUEST OF 180
MILLION IN NEW WORKFORCE
INVESTMENT NEEDED TO RETAIN AND
EXPAND. PUBLIC HEALTH WORKFORCE.
WHY WHY DID WE DO THIS LAST
YEAR? BECAUSE THE INFRASTRUCTURE
INVESTMENTS ALONE ARE ONLY AS
STRONG AS A WORKFORCE THAT
STANDS BEHIND IT. SO AS THIS
BODY KNOWS THE FINAL FY 22 23
BUDGET INCLUDED SOME BUT NOT ALL
OF THOSE WORKFORCE INVESTMENTS
THAT BRINGS US TO TODAY.
CONFIDENCE IN OUR PUBLIC HEALTH
INFRASTRUCTURE CAN BE SEEN IN
THE GOVERNOR'S RECENT ACTION TO
END CALIFORNIA'S PUBLIC HEALTH
EMERGENCY. THE PUBLIC HEALTH
ENVIRONMENT, THOUGH AS A WHOLE
HASN'T CHANGED. WE'RE STILL
LIVING WITH COVID 19 INFECTIOUS
DISEASES CAN BECOME A NEW
PANDEMIC. OUR REALITY AND
CLIMATE CHANGE POSES NEW PUBLIC
HEALTH RISKS WE SHOULD NOT AND
CANNOT MISTAKE THE REMOVAL OF
THAT DECLARATION AS A
CERTIFICATE OF THE WORK IS OVER,
BECAUSE IT IS NOT WELL, I'D LIKE
TO BE SITTING HERE TALKING ABOUT
HOW WE ARE POISED TO BUILD ON
OUR PUBLIC HEALTH INVESTMENTS.
INSTEAD, WE ARE FACED WITH A
PROPOSED FY 23 24 BUDGET THAT
DOES THE OPPOSITE, ELIMINATING
ROUGHLY 15 MILLION IN PUBLIC
HEALTH WORKFORCE INVESTMENTS, AS
OTHERS HAVE SPOKEN TO NOW IS NOT
THE TIME TO BACKTRACK ON OUR
COMMITMENT EVEN BEFORE THEY'VE
BEGUN. STATE AND COUNTY PUBLIC
HEALTH CANNOT BE SUCCESSFUL WHEN
WE PLAY A GAME OF CAT AND MOUSE
WITH WORKFORCE FUNDING. TO USE
THE INCUMBENT WORKER UPSCALE
TRAINING PROGRAM AS AN EXAMPLE,
SOON AFTER THE FY 22 23 BUDGET
WRAPPED UP STAKEHOLDERS BEGAN
MEETING WITH CD PH STAFF. WE GOT
APPLICATIONS OUT TO COUNTIES AND
WE RECEIVED GREAT PROPOSALS
BACK. SOME OF THESE PROPOSALS,
INCLUDING MULTI YEAR COMMITMENT
TO THEIR STAFF ON EDUCATION THAT
CANNOT BE ACCOMPLISHED IN ONE OR
TWO YEARS. BUT NOW WE'RE FACED
WITH A DIFFICULT POSITION. HOW
DO WE MAKE DECISIONS IN THIS
UNCERTAIN ENVIRONMENT? HOW DO WE
ALLOW OUR COUNTIES TO MAKE A
COMMITMENT OF MULTI YEARS THEIR
WORKFORCE? WE DON'T KNOW THE
STATE DOLLARS WILL BE THERE FOR
THEM. PUBLIC HEALTH WORKFORCE
CHALLENGES ARE A REFLECTION OF
BROADER PUBLIC SECTOR CHALLENGES
. UNDERSTAFFING AFFILIATE HIGHER
FILL VACANCIES AND OVER RELIANCE
AND REGISTRY FOR STAFFING NEEDS
THESE CHALLENGES THEY'RE FED
WHEN WE PULL BACK ON THESE
WORKFORCE INVESTMENT, WE ARE
HARMING OURSELVES OUR ABILITY TO
DO THE DAILY WORK OF PUBLIC
HEALTH AND BE PREPARED FOR THE
UNKNOWN OF THE FUTURE. IN
CLOSING THE GOVERNOR'S PROPOSAL
THIS JANUARY HIGHLIGHTS THE
ONGOING CHALLENGE PUBLIC HEALTH
HAS IN CALIFORNIA A WILLINGNESS
FOR PUBLIC HEALTH TO BE THE
FIRST TO BE CUT. AS I SIT HERE
TODAY, I'M NOT CONFIDENT IF WE
WILL BE MORE PREPARED FOR THE
NEXT PUBLIC HEALTH CRISIS. MY
HOPE IS THAT WE WILL BE BUT THAT
WILL REQUIRE COMMITMENT TO
ONGOING STATE FUNDING AND COMMIT
TO PUBLIC HEALTH WORKFORCE THAT
CAN WEATHER A BAD BUDGET YEAR
BECAUSE PANDEMICS THEY DON'T
KNOW A BAD BUDGET YEAR FROM A
GOOD BUDGET YEAR, THEY'LL BE
HERE. REGARDLESS THIS
LEGISLATURE THEIR ACTIONS
THROUGH THIS SUBCOMMITTEE AND
THROUGHOUT THE SESSION CAN
REALLY SET US BACK ON TRACK, AND
WE THANK YOU FOR TODAY'S PANEL
AND WELCOME ONGOING DIALOGUE ON
THIS MATTER. THANK YOU.
DEPARTMENT OF FINANCE. HELLO.
BRING IT UP TO THE DIETS FOR ANY
MEMBERS. QUESTIONS DOCTOR WOULD
THANK YOU. AND THANK YOU. THE
PANEL FOR YOUR COMMENTS. UM I
LOOK AT INVESTMENTS LIKE THIS AS
INVESTMENTS AGAIN IN PREVENTION
AND, UM, LIKE IT'S NOT MY NUMBER
, BUT IT'S A NUMBER RIGHT HERE
ALL THE TIME THAT FOR EVERY
DOLLAR YOU INVEST IN PREVENTION,
YOU SAVE $6 ON THE OTHER END. UM
AND THIS IS CONSISTENT
THROUGHOUT. IT FEELS LIKE
THROUGHOUT STATE GOVERNMENT. WE
DON'T INVEST IN PREVENTION ON A
MYRIAD OF THINGS. WE THOUGHT IT
WAS AN ISSUE WE TALKED ABOUT
LAST WEEK AS WELL. UM, YOU KNOW,
I LOOK AT YOU KNOW, DROUGHT
PREVENTION, YOU KNOW, OKAY, IT'S
RAINING NOW. BUT WE KNOW THAT
WE'RE GOING TO HAVE ANOTHER
DROUGHT. BUT WE DON'T INVEST IN
IN IN THE PROCESSES THAT WOULD
HELP US BE BETTER PREPARED FOR
THE NEXT DROUGHT. WE
CONSISTENTLY DO THIS OVER AND
OVER AND OVER AGAIN. THIS IS A
BIG ONE. THIS IS A REALLY
IMPORTANT ONE. AND SO, UM, I
HOPE THAT YOU KNOW WE WERE GOING
TO DO EVERYTHING WE CAN AS AS
FAR AS THIS COMMITTEE, I THINK
TO TRY TO RETAIN AS MUCH OF THE
RESOURCES AS POSSIBLE, BUT IT'S
IT JUST IS MIND BOGGLING THAT WE
COULD POTENTIALLY SET OURSELVES
UP. TO DO WHAT WE ALWAYS DO, AND
NOT PREVENT THINGS THAT ARE
PREVENTABLE AND IT JUST IT JUST
IT IS, IT IS PRETTY MIND
BOGGLING. THANK YOU, MR CHAIR.
UPBRINGING MISS. I ADORE UP IF I
MAY. YOU KNOW, I WAS STRUCK
DURING YOUR COMMENTS. YOU SAID
ABOUT THE IMPORTANCE OF
RETAINING STAFF. AND YET YOU
DIDN'T COMMENT ON RECRUITING
STAFF. AND SO I'LL HIGHLIGHT THE
RIVERSIDE DIRECTOR'S COMMENTS
ABOUT HAVING 22% VACANCIES AND
STRUGGLING TO FIND QUALITY
CANDIDATES. ISN'T IT IMPORTANT
FOR US TO SIMILARLY BE
RECRUITING STAFF AND HAVING
THESE PATHWAY PIPELINE PROGRAMS
, WHICH IS WHY WE MADE THE
INVESTMENT IN LAST YEAR'S BUDGET
? YES LET ME LET ME ADDRESS THAT
. YES WE ARE EFFORT IS TO RETAIN
AND RECRUIT AND RETAIN OUR
STAFF. RECRUITMENT IS CRITICAL,
RIGHT? WE ARE TRYING TO FILL
VACANT POSITIONS THAT WE'VE HAD.
FOR YEARS AND WITH THE DEPARTURE
OF PUBLIC HEALTH WORKFORCE,
WE'RE TRYING TO FILL THOSE
POSITIONS AS WELL. AND TO BE
HONEST, WE'RE COMPETING WITH THE
SAME FOR THE SAME INDIVIDUALS
ACROSS THE STATE. THAT IS A
CHALLENGE AND WE NEED AND THAT'S
WHY WE YOU KNOW, IT IS IMPORTANT
THAT WE HAVE, YOU KNOW, A
RECRUITMENT EFFORTS AND UP
SKILLING AND TO RETAIN OUR
STUFF, BUT ALSO TO HAVE STAFF TO
RECRUIT FROM AS WELL SO I'LL
BRING IN MISS GIBBONS, BUT IT
WOULD SEEM IF WE HAVE 900
APPLICANTS FOR 45 SLOTS IN A
COHORT THAT THERE IS MUCH MORE
WE COULD BE DOING IN TERMS OF
RECRUITING. FUTURE PUBLIC HEALTH
WORKFORCE AND SO AGAIN WELL
EMPHASIZED THE IMPORTANCE OF US
MAKING THAT INVESTMENT, MISS
GIBBONS. I JUST WANTED TO
EMPHASIZE AS WELL THAT A NUMBER
OF THOSE PUBLIC HEALTH WORKFORCE
DEVELOPMENT TRAINING PROGRAMS
THOSE AREN'T JUST FOR LOCALS,
RIGHT AND IT WASN'T EVEN JUST
MONEY THAT WE SAID GIVE IT TO
US, AND WE'LL FIGURE IT OUT. THE
REASON WHY WE ASKED FOR THESE
PROGRAMS IS THAT THERE IS
ALREADY A STATEWIDE SYSTEM IN
PLACE FOR MANY, MOST OF THESE
ALL BUT ONE AND EVEN THE
INCUMBENT WORKER UPSCALE
TRAINING IT WAS TO SUPPORT BOTH
STATE AND LOCAL HEALTH
DEPARTMENT WORKFORCE. SO WE
RECOGNIZE THAT THERE IS A NEED
BOTH AT THE STATE LEVEL AND AT
THE LOCAL LEVEL. I WON'T SPEAK
FOR THE STATE, BUT I WILL TELL
YOU I USED TO WORK FOR THE STATE
AND RECRUITMENT AND IN RETENTION
IS HARD AND SO WE WANTED TO BE
DELIVERED IT DELIBERATE ABOUT
MAKING SURE THAT THESE PROGRAMS
COULD YIELD SUCCESS BOTH AT THE
STATE AND LOCAL LEVEL BECAUSE WE
ARE ALL COMPETING FOR THE SAME
POT. UM WITH THAT. I DO WANT TO
THANK VERY MUCH THIS ENTIRE
PANEL. WE WILL NOW MOVE ON TO
ISSUE 14. THANK YOU. ISSUE. 14
IS AN OVERVIEW OF THE AIDS DRUG
ASSISTANCE PROGRAM ESTIMATES TO
BE PRESENTED BY CHERIE'S KEMP,
THE TOP BRANCH CHIEF AT CD PH,
MISS KEMP. AFTERNOON. CAN YOU
ALL HEAR ME, OKAY. WE CAN PLEASE
BEGIN. OKAY GOOD AFTERNOON CHAIR
IN ASSEMBLYMEMBER'S. I'M HAPPY
TO BE BEFORE YOU TO PROVIDE AN
OVERVIEW OF THE AGE DRUG
ASSISTANCE PROGRAM. NOVEMBER
ESTIMATE PACKAGE WILL PROVIDE A
BEEF OVERVIEW OF THE ESTIMATE
PACKAGE AND THEN PROVIDE
RESPONSES TO THE SUBMITTED
QUESTIONS. FOR CURRENT YEAR THE
BUDGET ACT OF 2022 INCLUDED
EIGHT UP LOCAL ASSISTANCE
FUNDING OF 445.1 MILLION. THE
REVISED CURRENT YEAR BUDGET IS
440.5 MILLION, WHICH IS A
DECREASE OF 14.5 MILLION WHEN
COMPARED TO THE BUDGET ACT. THE
DECREASE IS PRIMARILY DRIVEN BY
LOWER MEDICATION EXPENDITURES
AND PREMIUMS FOR THE IN SHORT
CLIENT GROUPS THAN PREVIOUSLY
ESTIMATED CHANGES TO THE 28 APPS
BUDGET AUTHORITY WHEN COMPARED
TO THE BUDGET ACT INCLUDE AN
INCREASE OF 8.1 MILLION IN
FEDERAL FUNDS AND A DECREASE OF
22.7 MILLION AND EIGHT UP REBATE
FUNDS. FOR BUDGET YEAR PROPOSED
EIGHT OUTLOOK ASSISTANCE FUNDING
FOR THE BUDGET YEAR IS 440.1
MILLION, WHICH IS A DECREASE OF
14.9 MILLION WHEN COMPARED TO
THE BUDGET ACT. THE DECREASE IS
PRIMARILY DRIVEN BY MEDICAL
EXPANSIONS AND LOWER MEDICATION
EXPENDITURES AND PREMIUMS FOR
THE INSURED CLIENT GROUPS THAN
PREVIOUSLY ESTIMATED CHANGES TO
THE 28 APPS BUDGET AUTHORITY.
FOR BUDGET YEAR, UM TO THE
BUDGET ACT INCLUDE AN INCREASE
OF 2.6 MILLION IN FEDERAL FUNDS
AND A DECREASE IN 17.5 MILLION
AND, UM, EIGHT OF REBATE FUNDS.
NEXT I WILL MOVE ON TO THE
QUESTIONS AS I KNOW. SOME OF THE
QUESTIONS ACTUALLY INCLUDE
REFERENCES TO OUR ASSUMPTIONS.
SO IT FOR QUESTION. ONE. UM IN
REGARDS TO THE PRIMARY CHANGES
AND DYNAMICS AND FUNDING
REFLECTED IN THE ESTIMATE. THE
3.2% DECREASE IN CURRENT YEAR IS
DRIVEN PRIMARILY BY LOWER
MEDICATION EXPENDITURES,
PREMIUMS AND CASELOAD FOR THE
INSURANCE CLAIM GROUPS THAN
PREVIOUSLY ESTIMATED. WHILE THE
INSURED MEDICATION ONLY CASELOAD
IS PROJECTED TO INCREASE THE
INSHORE CLIENT GROUP CASELOAD
DECREASE MORE MORE MORE THAN
OFFSETS THIS IMPACT 3.3%
DECREASE IN BUDGET YEAR IS
DRIVEN PRIMARILY BY MEDICAL
EXPANSIONS AND LOWER MEDICATION
EXPENDITURES AND PREMIUMS FOR
THE INCH TOWARD CLIENT GROUPS
THAN PREVIOUSLY ESTIMATED.
MOVING ON TO QUESTION TWO. UM IN
REGARDS TO AN EXPLANATION AROUND
THE INCREASE IN FEDERAL FUNDS ON
JUNE 2ND 2022 THE EIGHT UP THE
EMERGENCY RELIEF FRONT GRANT
NOTICE OF AWARD WAS RECEIVED BY
EIGHT UP AND THAT WAS IN THE
AMOUNT OF 3.8 MILLION FOR THE 22
GRANT BUDGET PERIOD CONTAINING
AN UNANTICIPATED AMOUNT OF 2.7
MILLION FROM THE 2020 GRANT
BUDGET PERIOD. ON OCTOBER 2025
OCTOBER. 25TH 2022 MY APOLOGIES
. THE 21 RYAN WHITE PART B.
GRANT CARY OVER NOTICE OF AWARD
WAS RECEIVED IN THE AMOUNT OF
5.6 MILLION, WHICH WILL BE SPENT
IN 22 23. MHM QUESTION. THREE UM
, THERE WAS AN ASKED TO EXPLAIN
THE ONGOING OVER ESTIMATES OF
DRUG COSTS. AWAY USES
METHODOLOGIES IN LINE WITH
INDUSTRY STANDARDS FOR CURRENT
YEAR CD PH OF ESTIMATING,
APPROXIMATELY, UM 0.11% CHANGE
AND MEDICATION COSTS FOR THE
EIGHT FM PREP APP PROGRAMS FROM
THE 2022 BUDGET ACT, WHICH IS A
VERY SMALL DECREASED UM, ARE
VERY SMALL DIFFERENCE MONTHLY
CASELOAD AND COST PER CLIENT PER
MONTH MAY VARY PER CLIENT GROUP
AS MORE UPDATED DATA IS LOADED
INTO THE BUDGET PROJECTION MODEL
. IN ADDITION DUE TO COVID 19
AND THE UNCERTAINTY OF WHEN THE
PUBLIC HEALTH EMERGENCY WOULD
END OVER ESTIMATIONS OCCUR TO
ACCOUNT FOR THE POTENTIAL
INCREASE IN CLIENT COUNT AND
MEDICATION EXPENDITURES, WHICH
WERE DUE TO INDIVIDUALS
POTENTIALLY BEING DECEMBER OLD
FROM MEDICAL QUESTION FOR, UM
EXPLAIN. ASKED FOR AN
EXPLANATION OF THE ASSUMPTIONS
AND CONDITIONS THAT ARE
AFFLICTED THAT ARE AFFECTING THE
CASELOAD PROJECTIONS. AND SO FOR
OUR NEW ASSUMPTIONS, UM IN
REGARDS TO THE EXPANSION OF
MEDICAL TO ALL INCOME ELIGIBLE
CALIFORNIANS, WHICH WILL BEGIN
NO SOONER THAN JANUARY. 1ST 2024
MEDICAL WILL BE AVAILABLE TO ALL
INCOME ELIGIBLE CALIFORNIANS.
THIS WILL REDUCE MONTHLY
CASELOADS AND BUDGET YEAR AS
MORE ATE UP CLIENTS WILL BECOME
ELIGIBLE FOR MEDICAL VERY
SIMILARLY FOR THE MEDICAL
EXPANSION WITH THE ASSET LIMIT
CHANGES SO DUE TO THE PASSAGE OF
81 33, THE MEDICAL ASSET TESTS
WILL BE ELIMINATED FOR NON
MODIFIED ADJUSTED GROSS INCOME
MEDICAL PROGRAMS AND A TWO
PHASED APPROACH. THIS CHANGE
WILL REDUCE MONTHLY CASE SALUD.
MUSLIM MONTHLY CASELOAD IN
CURRENT YEAR END BUDGET YEAR AS
MORE AID UP CLIENTS WILL BECOME
ELIGIBLE FOR MEDICAL WHERE
EXISTING ASSUMPTIONS IN REGARDS
TO THE MEDICAL EXPANSION FOR
INDIVIDUALS AGED 50 AND OLDER,
REGARDLESS OF IMMIGRATION STATUS
. THIS IS WHERE THE GOVERNOR'S
BUDGET EXPANDED ELIGIBILITY FOR
FULL SCOPE MEDICAL BENEFITS TO
THIS POPULATION, WHICH WILL ALSO
REDUCE MONTHLY CASELOADS IN
CURRENT YEAR AND BUDGET YEAR.
FOR EIGHT UP. WE EXPECT THAT AT
LEAST HALF OF THE 2076 CURRENTLY
ENROLLED AND ENSURED CLIENTS
BETWEEN THE AGES OF 15 AND 60 64
YEARS OLD WILL BEGIN TO
TRANSITION TO MEDICAL. AND NEXT
IN REGARDS TO THE EIGHT UP PILOT
PILOT JAIL PROGRAM. UM THE 22 23
NEIGHBOR VISION ESTIMATE
APPROVED SEVEN COUNTIES AWAY HAS
A CONTRACT IN PLACE WITH ONE OF
THOSE COUNTIES AND CONTINUES TO
CONDUCT OUTREACH TO THE
REMAINING SIX COUNTIES FOR 22 23
24 REQUEST APPROVAL FOR THREE
ADDITIONAL INTERESTED COUNTIES
AND THIS GEL PILOT PROGRAM WILL
INCREASE OUR CASELOAD IN CURRENT
YEAR AND BUDGET YEAR. AND THEN
LASTLY, THE, UM CRAP AND PEP
INITIATION AND RETENTION
INITIATIVE. UM THIS IS WHERE A B
1 33 ALLOWED FOR EIGHT. APT TO
FUND LOCAL HEALTH DEPARTMENTS
AND COMMUNITY BASED
ORGANIZATIONS TO THE EXTENT THAT
FUNDS WERE AVAILABLE FOR PREP
AND PEP NAVIGATION AND RETENTION
, COORDINATION AND RELATED
SERVICES, AND THIS WILL ALSO
INCREASE OUR MONTHLY CASELOAD IN
CURRENT YEAR IN BUDGET YEAR. AND
THAT IS THE LAST QUESTION. THANK
YOU. DEPARTMENT OF FINANCE.
SELENA NARROWLY DEPARTMENT OF
FINANCE NOTHING FURTHER TO ADD
WILLOW AND YELLOW. NOTHING BAD
WILL BRING IT UP TO THE DIASPORA
MEMBERS QUESTIONS SEEING NONE. I
WILL THANK VERY MUCH. THIS
PANEL. WE WILL NOW MOVE ON TO
ISSUE 15. THANK YOU. ISSUE 15
COVERS THE BABY, BIG INFANT
BOTULISM TREATMENT AND
PREVENTION PROGRAM BCP, WHICH
WILL BE PRESENTED BY KATIA,
LEADEN, INFECTIOUS TO THESE
LABORATORIES, DIVISION CHIEF AT
C D PH. PLEASE BEGIN WHEN YOU'RE
READY. THANK YOU. GOOD AFTERNOON
, MR CHARRON. HONORABLE
COMMITTEE MEMBERS. UM OTHER RARE
INFANT BOTULISM. IT'S THE MOST
COMMON FORM OF HUMAN BOXES. I
MEAN, IN THE UNITED STATES AND
THE POTENTIALLY LIFE THREATENING
DISEASE SINCE INFANT BOTULISM
WAS FIRST RECOGNIZED AS A NOVEL
FORM OF HUMAN BOTULISM IN
CALIFORNIA IN 1976 CD PAGE HAS
LED EFFORTS. TO INVESTIGATE AND
ADDRESS THIS DISEASE
HISTORICALLY, APPROXIMATELY 40%
OF ALL INFANT BOXES, UM, CASES
IN THE UNITED STATES HAVE
OCCURRED IN CALIFORNIA. THE
ENGINE BOXES AND PROGRAM AND ITS
SPECIAL FUND CONSTITUTED SELF
CONTAINED PROGRAM STATUTORILY
IMPLEMENTED IN 1996 BY THE
CALIFORNIA HEALTH AND SAFETY
COULD SECTIONS 123 700 TO 709.
AFTER MANY YEARS OF WORK IN
OCTOBER, 2003 ALMOST EXACTLY 20
YEARS AGO, THE INFANT BOTULISM
TREATMENT AND PREVENTION PROGRAM
RECEIVED U. S. FOOD AND DRUG
ADMINISTRATION LICENSURE TO
PRODUCE AND DISTRIBUTE THE
PUBLIC SERVICE. ORPHAN DRUG
HUMAN BOTULISM IMMUNE GLOBULIN,
ALSO KNOWN AS BABY BIG FOR THE
TREATMENT OF INFANT BOTULISM. CD
PH IS THE ONLY SOURCE OF BABY
BIG IN THE WORLD. AS A
RECOGNITION OF INFANT BOTULISM
DISEASE HAS INCREASED
UTILIZATION OF BABY BIG HIS
INCREASE CALENDAR YEAR. 2022
UTILIZATION RECENT ALL TIME HIGH
OF 218 TREATMENTS START PASSING
THE PREVIOUS YEAR'S RECORD OF
206. THIS PROPOSAL REQUESTS
AUTHORITY TO ENCUMBER A TOTAL OF
67.8 MILLION OF THE INFANT
BOTULISM TREATMENT AND
PREVENTION PROGRAMS SPECIAL FUND
OVER THE NEXT FIVE YEARS FROM
2023 TO 2028 FOR THE MANUFACTURE
AND DISTRIBUTION OF BABY BIG
THIS PROPOSAL SPECIFIC TO THE
INFANT BOXES AND TREATMENT
PREVENTION PROGRAMS SPECIAL FUND
, WHICH HAS A HEALTHY BALANCE
AND ONGOING REVENUE DOES NOT
AFFECT THE GENERAL FUND. THERE'S
NO ENCUMBRANCES REQUESTED ARE
NEEDED FOR THE UPCOMING FIVE
YEAR MANUFACTURING CYCLE, BABY
BIG TO OFFSET INFLATION RELATED
INCREASES IN PERSONAL OPERATING
AND REGULATORY COSTS REQUESTED.
INCUMBENTS DOES INCLUDE SOME
OVERESTIMATE DO THE ONGOING THIS
ISSUE OF MISALIGNMENT OF
MANUFACTURING VENDOR CALENDAR
YEARS WITH AGENCY FISCAL YEARS
TO PROVIDE SUFFICIENT AUTHORITY.
FOR EXPENSES, TOO, IS THAT NEED
TO BE SHIFTED FROM JUNE TO JULY
AUGUST TIME FRAMES? THE COST OF
BABY BIG MANUFACTURER FULLY
RECOUPED YOUR FEES CHARGED PER
TREATMENT, WHICH ARE PAID BY
HOSPITALS AND INSURANCE
DISTRIBUTIONS THAT BABY BIG HAVE
CONTINUOUSLY INCREASES MORE
CASES OF INFANT BOXES AND ARE
BEING RECOGNIZED. THERE'S NO FEE
INCREASES NEEDED AT THIS TIME,
HOWEVER, PROGRAM IS CLOSELY
MONITORING THE COST OF
MANUFACTURING DISTRIBUTION IS
PREPARED. INCREASE FEES IN
FUTURE YEARS IS NEEDED TO OFFSET
ANY INCREASES IN COSTS DUE TO
INFLATION. SHALL I ANSWER THE
QUESTION? AS WELL. PLEASE DO.
YES. UM SO, UM. IN ANSWER TO THE
QUESTION ABOUT RESEARCH IN FOR
ALTERNATIVES TO BABY BAKE. THAT
DOES NOT RELY ON HUMAN SUBJECTS
OR PLASMA. UM RESEARCH INTO
BATTLE. AND, YES, UM, THAT
RESEARCH INTO BOTULISM, ONE OF
THE MOST TOXIC SUBSTANCES KNOWN
TO HUMANS IS VERY HIGHLY
REGULATED BY THE US GOVERNMENT
AND THE MILITARY. THE US
GOVERNMENT HAS BEEN FUNDING
PROGRAMS TO DEVELOP MONOCLONAL
ANTIBODIES AGAINST BOTULINUM
NEUROTOXINS AS MILITARY AND
MEDICAL COUNTERMEASURES FOR
ADULTS. AND SO COMBINATIONS OF
INVESTIGATIONAL MONOCLONAL
ANTIBODIES HAVE UNDERGONE ANIMAL
STUDIES AND VERY EARLY PHASE
STUDIES IN ADULTS. ADDITIONAL
CLINICAL DATA WOULD BE NEEDED
AND MULTIPLE REGULATORY STEPS.
IN ORDER TO DETERMINE THE SAFETY
AND EFFECTIVENESS OF ANTI
BOTULINUM MONOCLONAL ANTIBODIES
TO TREAT INFANTS. THAT MEANS
THAT THE DEVELOPMENT OF A SAFE
TESTED AND FDA APPROVED
ALTERNATIVE TO BABY BIG FOR THE
TREATMENT OF INFANTS IS, UH
POTENTIAL, BUT IT'S STILL MANY
YEARS AWAY, POTENTIALLY A DECADE
OR MORE. AS WE KNOW THE INFANTS
ARE THE VERY LAST GROUP THAT IS
HAS A SAFETY CHILD'S DONE AFTER
SOMETHING AFTER SUBSTANCES
PROVEN SAFE AND ADULTS AND OTHER
AGE GROUPS. THAT CONCLUDES MY
INFORMATION. PLEASE LET ME KNOW
IF THERE'S ANY QUESTIONS.
DEPARTMENT OF FINANCE. GENERALLY
NOTHING FURTHER TO ADD. WILL
OWNS. WE HAVE NO CONCERNS WITH
THIS PROPOSAL. I WILL BRING IT
UP TO THE DIOCESE FOR ANY
MEMBERS QUESTIONS. I'LL KEEP IT
HERE AT THE CHAIR. UM I'LL FIRST
IF I CAN MISLEAD IN, I THINK WE
ANSWERED THE WRONG QUESTION. THE
QUESTION WE WERE TRYING TO ASK
WAS WHO PAYS THE FEES THAT
SUPPORT THIS PROGRAM. AND IS
THERE ANY REASON TO BELIEVE THAT
THE FEE INCREASE COULD BE A
HARDSHIP FOR ANYONE? UM, SO THE
INCREASE THE FEES ARE PAID BY
HOSPITALS AND INSURERS. AND, UM
AS FAR AS WE KNOW, WE HAVEN'T
HAD, UM AH! SITUATION WHERE THE
FEE WAS NOT ABLE TO BE PAID. UM
SO WE DON'T BELIEVE IT'S A
HARDSHIP. UM AND OF NOTE THAT
FEARS FOR THE COMPLETE TREATMENT
REGARDLESS OF HOW MANY DOSES ARE
NEEDED PER PATIENT, I WILL SAY I
TOOK INTEREST IN THIS AS WE ARE
THE ONLY ONE IN THE WORLD WHO
ARE CURRENTLY MAKING THIS
TREATMENT. AND YET WHAT STUCK
OUT TO ME IS THAT BASED ON A
FIVE YEAR AVERAGE, APPROXIMATELY
30% OF THE TREATMENTS ARE
DISTRIBUTED HERE IN CALIFORNIA.
WE DON'T HAVE 30% OF THE
CHILDREN IN OUR NATION YET LET
ALONE THE WORLD AND I'M
WONDERING HOW WE CAN MAKE SURE
THAT THIS MEDICATION IS
AVAILABLE FOR ALL WHO MAY NEED
THIS TREATMENT. UH THE PROGRAM
IX EVERY EFFORT, UM, TO MAKE THE
MEDICATION AVAILABLE, AND IT'S
INCREDIBLY RESPONSIVE. THEY HAVE
24 HOURS, SEVEN DAYS A WEEK.
CONTACT NUMBER AND THEY SHIP
OVERNIGHT. UM AND SO THE MAIN
OBSTACLE FOR US IS RECOGNITION
OF THIS WEIRD DISEASE, AND WE
FIND THAT AS THE PROGRAM IS ABLE
TO MAKE ITS FINDINGS NO TO YOU,
THE INTERNATIONAL MEDICAL
COMMUNITY THERE'S MORE AND MORE
RECOGNITION OF CASES. SO UH,
CALIFORNIA LEADS THE CASE
RECOGNITION. UM, BUT WE ARE SURE
THAT THE USE OF THIS TREATMENT
HAS NOT BEEN SATURATED ANYWHERE
IN THE WORLD BECAUSE EVERY YEAR
MORE AND MORE CASES THAT
RECOGNIZED HAVING SEEN THIS
FIRSTHAND AND SEEN THE TREATMENT
. I KNOW HOW IMPRESSIVE IT IS
FOR US AS A STATE TO BE
PRODUCING THIS AND AGAIN JUST
WANT TO ELEVATE AND THANK THE
DEPARTMENT OF PUBLIC HEALTH FOR
CREATING THIS WITH THAT. WE WILL
THANK VERY MUCH THIS PANEL AND
WE WILL NOW MOVE ON TO ISSUE 17.
AS WE WILL BE SKIPPING ISSUES 16
SINCE IT HAS BEEN MOVED TO NON
DISCUSSION. FOR ISSUES 17. THIS
COVERS THE RESTROOM ACCESS
MEDICAL CONDITIONS. MAYBE 16 32
B C P THIS PROPOSAL WILL BE
PRESENTED BY MARIA OCHOA,
ASSISTANT DEPUTY DIRECTOR AT THE
CENTER FOR HEALTHY COMMUNITIES
THAT CD PH. MR CHOI. GOOD
AFTERNOON CHAIR MEMBERS. CAN YOU
HEAR ME? MY NAME IS MARIO CHOU,
ASSISTANT DEPUTY DIRECTOR WITHIN
THE CENTER FOR HEALTHY
COMMUNITIES OF THE CALIFORNIA
DEPARTMENT OF PUBLIC HEALTH, AND
TODAY WILL PROVIDE A BRIEF
OVERVIEW OF SEVERAL OF THE
BUDGET ADJUSTMENTS FOR OUR
CENTER, SO THE FIRST ADJUSTMENT
IS FOR A B 16 32. THE GOVERNOR'S
BUDGET REFLECTS AN INCREASE OF
NINE POSITIONS AND 1.4 MILLION
IN GENERAL FUND STATE OPERATIONS
AND ONGOING TO IMPLEMENT AND
PROVIDE OVERSIGHT FOR THE
RESTROOM ACCESS ACT. AS MANDATED
BY ASSEMBLY BILL 16 32. THIS
FUNDING WILL CREATE A NEW
PROGRAM TO IMPLEMENT AND PROVIDE
OVERSIGHT FOR THE RESTROOM
ACCESS ACT, INCLUDING
INVESTIGATIONS AND ISSUING FINES
, AS MANDATED BY A B 16 32. THE
FUNDING PROVIDES RESOURCES
REQUIRED TO HIRE STAFF AND
ESTABLISH A NEW PROGRAM
PROMULGATE REGULATIONS WITH
SCOPE THAT WILL INCLUDE BUILDING
SANCTIONS FOR VIOLATIONS,
ESTABLISHING THE COMPLAINT
REVIEW PROCESS AND ESTABLISHING
THE DUE PROCESS FOR COMPLIANCE
UPON IMPLEMENTATION OF THE
PROGRAM. CD PH WILL PROVIDE
STATEWIDE REVIEW OF VIOLATIONS
COMPLAINTS CONDUCT
INVESTIGATIONS. PERFORM
OVERSIGHT AND MONITORING THEM
INVESTIGATIONS COLLECT FINES AND
CONDUCT DUE PROCESS COMPLIANCE.
CITY PH WILL ISSUE FINDS THAT
ARE THE RESULT FROM THE
INVESTIGATIONS FOR COMPLAINTS
RECEIVED. CITY PH WILL MONITOR
COMPLAINTS BY GEOGRAPHICAL AREA
AND THE BUSINESS TYPE TO
IDENTIFY TRENDS AND COMPLAINTS.
CITY PH WILL DEVELOP A STANDARD
ELECTRONIC FORM AND POST THE
REQUIRED FORM ON THE CD PH
WEBSITE FOR THOSE WITH ELIGIBLE
MEDICAL CONDITIONS TO HAVE
SIGNED AS A REASONABLE EVIDENCE
BY HEALTHCARE PROVIDER. CD PH
WILL ESTABLISH AND MAINTAIN A
DATABASE THAT COLLECTS VIOLATION
DATA TO TRACK FREQUENT
VIOLATORS. CD PHÐ EDUCATE THE
BUSINESS COMMUNITY ABOUT THEIR
NEW LEGAL OBLIGATIONS THROUGH
GUIDANCE BULLETINS AND OR FACT
SHEETS POSTED ON THE CD PH
WEBSITE CD PH WILL PARTNER WITH
OTHER STATE DEPARTMENTS AND
BUSINESS ASSOCIATIONS TO POST
AND INFORMATIONAL BULLETIN
BULLETIN ON THEIR WEBSITES AS
WELL. C D PH WILL BE RESPONSIBLE
FOR MONITORING AND ENFORCEMENT.
LOCAL HEALTH DEPARTMENTS WILL
NOT MONITOR MONITOR ENFORCED
THIS PROPOSAL BECAUSE THE
LANGUAGE OF A B 16 32 DID NOT
GIVE CD PH THE AUTHORITY TO
REQUIRE LOCAL HEALTH DEPARTMENTS
TO ENFORCE THE LAW. CITY PH WILL
WORK WITH SHOCK AND C C H L ZERO
CC H L O TO COMMUNICATE THE NEW
REGULATIONS AND CORRESPONDING
FACT SHEETS TO LOCAL HEALTH
DEPARTMENTS FOR INFORMATIONAL
PURPOSES. CD PH DOES NOT
ANTICIPATE THAT THE FEES
COLLECTED FROM THE FINE REVENUE
WILL ULTIMATELY PAY THE COST OF
THE PROGRAM BECAUSE THE COST OF
THE FEE IS $100 PER FINE.
HOWEVER ANY FEES COLLECTED MAY
OFFSET A PORTION OF THE COST OF
THE PROGRAM ONCE IT IS FULLY
IMPLEMENTED. DEPARTMENT OF
FINANCE. AFTERNOON NICK MILLS
DEPARTMENT OF FINANCE NOTHING
FURTHER TO ADD. HELLO. WE HAVE
NO CONCERN FOR THIS PROPOSAL.
BRING IT UP TO THE DIOCESE FOR
ANY MEMBERS, QUESTIONS. I WAS
HOPING, MR CHOE IF YOU CAN, UM,
THE FIFTH QUESTION WE HAD WITHIN
THE AGENDA ON PAGE 60 REGARDING
HOW THE COST OF THIS PROGRAM
HAVE EXCEEDED THE ESTIMATE,
WHICH WAS SHARED WITH THE
ASSEMBLY APPROPRIATIONS
COMMITTEE, WHICH ANALYZED THIS
BILL. CAN YOU SPEAK TO THAT,
PLEASE? YES SO ORIGINALLY WHEN
CD PH REVIEWED A B 16 32. WE DID
NOT BELIEVE THAT THE COST WOULD
WE DID BELIEVE THAT THE COST
WOULD BE MINOR AND ABSORBABLE
BECAUSE OUR ORIGINAL
INTERPRETATION WAS THAT WE'RE
JUST GOING TO HAVE TO DEVELOP A
FORM AND POSTED TO OUR WEBSITE.
BUT AFTER FURTHER REVIEW AND
INTERPRETATION OF THE BILL,
WE'VE DETERMINED THAT THE
RESTROOM ACCESS ACT ENFORCEMENT
FALLS UNDER CITY PH. UM AND
BECAUSE THE NEW LAW AMENDED THE
HEALTH AND SAFETY CODE, NOT THE
CIVIL CODE, SPECIFICALLY ADDING
A NEW SECTION. IT STATES THAT
THE STATE DEPARTMENT OF PUBLIC
HEALTH SHALL IMPLEMENT THIS
ARTICLE, SO THEREFORE, AFTER
FURTHER INTERPRETATION, WE ARE
RESPONSIBLE FOR THE ENFORCEMENT
MONITORING AND COLLECTING FEES
AND THE WHOLE IMPLEMENTATION OF
THE PROGRAM. WITH THAT I WILL
THANK VERY MUCH THIS PANEL AND
WE WILL NOW MOVE ON TO ISSUE 20
SKIPPING ISSUES 18 AND 19 AGAIN,
WHICH ARE NON DISCUSSION ISSUES.
ISSUED 20 AS AN UPDATE ON THE
PROPOSITION 99 ADJUSTMENTS
WITHIN CD PH, WHICH WILL BE
PRESENTED BY MARIA OCHOA. MR
COOPER, PLEASE BEGIN. YES WE
HAVE QUITE A FEW ADJUSTMENTS TO
GO OVER. SO THE FIRST ADJUSTMENT
IS OUR PROP. NIGHT PROPOSITION.
99 HEALTH EDUCATION ACCOUNT
FUND. OH, 231. AND THE
GOVERNOR'S BUDGET REFLECTS AN
INCREASE OF 505,000 AND
PROPOSITION 99 HEALTH EDUCATION
FUND. INCLUDING A DECREASE OF
870,000 AND STATE OPERATIONS AND
AN INCREASE OF 1.375 AND LOCAL
ASSISTANCE BECAUSE OF THE
UPDATED PROPOSITION, 99 REVENUE
PROJECTIONS. THE CALIFORNIA
TOBACCO CONTROL PROGRAM IS
PLANNING TO FOLLOWING
ADJUSTMENTS SO INCREASING
141,000 AND THE STATE
ADMINISTRATION APPROPRIATION
FUNDS AVAILABLE FOR PROGRAM
TRAINING, TRAVEL AND
CONFERENCES. INCREASING 1.375
MILLION FOR THE COMPETITIVE
GRANTS APPROPRIATION THAT WILL
MAKE ADDITIONAL FUNDING
AVAILABLE FOR FUTURE COMPETITIVE
GRANT PROGRAMS. INCREASING
826,000. FOR THE EVALUATION
APPROPRIATION, WHICH WILL RESULT
IN ADDITIONAL FUNDS AVAILABLE
FOR SURVEILLANCE AND
COMMUNICATING DATA FINDINGS TO
THE PUBLIC. AND DECREASING 1.493
MILLION FROM THE MEDIA CAMPAIGN
APPROPRIATION THAT MAY RESULT IN
REDUCED SPECIALIZED MEDIA
EFFORTS. AND DECREASING 344,000
IN THE COMPETITIVE GRANTS
APPROPRIATION, WHICH MAY AFFECT
FUNDS AVAILABLE FOR STATEWIDE
TECHNICAL ASSISTANCE AND
TRAINING PROVIDERS THAT SUPPORT
LOCAL PROGRAMS. AND NEXT IS THE
PROPOSITION 99 RESEARCH ACCOUNT
FUND FUND. OH 234. AND THE
GOVERNOR'S BUDGET REFLECTS AN
INCREASE OF 1.491 IN THE
PROPOSITION 99 RESEARCH ACCOUNT
, UM AS A RESULT OF UPDATED PROP
99 REVENUE PROJECTIONS, THE
REVENUES ARE USED FOR TOBACCO
RELATED DISEASE RESEARCH. THIS
INCLUDES FUNDING TO OUR
ENVIRONMENTAL HEALTH BRANCH AND
TO OUR CHRONIC DISEASE
SURVEILLANCE RESEARCH BRANCH.
AND THE ENVIRONMENTAL HEALTH
INVESTIGATIONS BRANDS USES THESE
FUNDS TO FUND PROJECTS SUCH AS
TOXIC COLLEGE TOXICOLOGICAL
OUTBREAK PROGRAM CONDUCTING
ENVIRONMENTAL EXPOSURE,
INVESTIGATIONS, ASTHMA
SURVEILLANCE AND THE ASTHMA
MANAGEMENT PROGRAM. AND THE
CHRONIC DISEASE SURVEILLANCE
RESEARCH BRANCH UTILIZES THE
PROP 99 ACCOUNT FUNDS TO CONDUCT
CENTRAL OPERATIONS OF THE
CALIFORNIA CANCER REGISTRY.
WHICH PROCESSES APPROXIMATELY
FIVE MILLION PIECES OF
INFORMATION ANNUALLY TO TRACK
CANCER INCIDENTS AND
SURVEILLANCE STATEWIDE TO CREATE
HIGH QUALITY DATA FOR CANCER
RESEARCH AND INFORMATIONAL
PROGRAM POLICY DEVELOPMENT. AND
NEXT IS THE PROP 99 ALLOCATED
ACCOUNT AND THE GOVERNOR'S
BUDGET REFLECTS A DECREASE OF
60,000 IN THE PROPOSITION 99 AN
ALLOCATED ACCOUNT AND THE
REVENUES ARE USED TO SUPPORT
SUPPORT. TOBACCO EDUCATION.
TOBACCO PREVENTION EFFORTS.
TOBACCO RELATED PROGRAMS,
TOBACCO RELATED HEALTH CARE
SERVICES AND ENVIRONMENTAL
PROTECTION AND RECREATIONAL
RESOURCES. AND. OPEN IT UP TO
ANY QUESTIONS ON THE PROP 99
ACCOUNTS. DEPARTMENT OF FINANCE.
AFTERNOON NICK MILLS DEPARTMENT
OF FINANCE NOTHING FURTHER TO
ADD. WE HAVE NOTHING THAT AT
THIS TIME, BRING IT UP TO THE
DIASPORA MEMBERS QUESTIONS
SAYING NONE. WE WILL THINK THIS
PANEL AND WE WILL NOW MOVE ON TO
ISSUE 21. WHICH IS AN UPDATE ON
THE PROPOSITION. 56 ADJUSTMENTS
WITHIN CD PH. WE WILL BEGIN WITH
MARIA KOA, FOLLOWED BY MIRREN
KLEIN, DEPUTY DIRECTOR FOR THE
CENTER FOR ENVIRONMENTAL HEALTH
. THAT CD PH. MR CHOI. YES, AND
I BELIEVE MORAN IS NOT AVAILABLE
, SO I WILL GO AHEAD AND PROVIDE
HER UPDATE TODAY. SO THE FIRST
THE FIRST ADJUSTMENT IS THE
PROPOSITION 56 STATE DENTAL
PROGRAM ACCOUNT AND THE
GOVERNOR'S BUDGET REFLECTS AN
INCREASE OF 4.842 MILLION AND
STATE DENTAL PROGRAM ACCOUNT
THAN 33 7. INCLUDING A DECREASE
OF 1.547 IN STATE OPERATIONS AND
AN INCREASE OF 6.389 MILLION AND
LOCAL ASSISTANCE AS A RESULT OF
UPDATED PROPOSITION 56 REVENUE
PROJECTIONS. THE STATE OPS
DECREASE OF 1.547 WILL BE OFFSET
USING PROP 56 BACKFILL FUNDS.
THESE FUNDS WILL BE NEEDED TO
SUPPORT STAFFING AND CONTRACTS
SUCH AS AN I A WITH C SUS TO
FACILITATE THE SMILE SURVEY OF
THIRD GRADERS THROUGHOUT
CALIFORNIA THE LOCAL ASSISTANCE
INCREASE OF 6.389 WILL BE USED
TO SUPPORT LOCAL ORAL HEALTH
PROGRAMS EFFORTS. TO IMPROVE
ORAL HEALTH OF PREGNANT WOMEN
AND CHILDREN AND WILL GO TO
LOCAL ORAL HEALTH PROGRAMS TO
SUPPORT THE SMILE SURVEY OF
THIRD GRADERS NEXT IS THE
PROPOSITION 56 PREVENTION AND
CONTROL PROGRAM ACCOUNTS. THE
GOVERNOR'S BUDGET REFLECTS A
DECREASE OF 2.250 MILLION IN
TOBACCO PREVENTION AND CONTROL
PROGRAMS FUND 33 22. INCLUDING
AN INCREASE OF 5.756 MILLION AND
STATE OPERATIONS AND A DECREASE
OF 8,000,006 AND LOCAL
ASSISTANCE AS A RESULT OF
UPDATED PROP 56 REVENUE
PROJECTIONS. THE CALIFORNIA
TOBACCO CONTROL PROGRAM PROGRAM
IS PLANNING THE FOLLOWING
ADJUSTMENTS DECREASING 406,000
AND MEDIA CAMPAIGN APPROPRIATION
FOR REDUCED SPECIALIZED MEDIA
EFFORTS. A DECREASE OF 4.744 AND
COMPETITIVE GRANTS.
APPROPRIATION. UM WHICH MAY
AFFECT FUNDING FOR FUTURE
COMMUNITY BASED COMPETITIVE
GRANT PROGRAMS. DECREASING 3.261
TO OUR LOCAL LEAD AGENCIES AND
INCREASING 2.644 AND STATE
ADMINISTRATION APPROPRIATION,
WHICH WILL ALLOW FUNDING FOR
PROGRAM PURCHASES, TRAVEL
TRAININGS CONFERENCES AND
SUPPORT FOR ADMINISTRATIVE
OVERSIGHT AND AN INCREASE OF
1.174 MILLION. ANY VALUATION
APPROPRIATION. WHICH WILL RESULT
IN ADDITIONAL FUNDS AVAILABLE
FOR SURVEILLANCE. HATING DATA
FINDINGS TO THE PUBLIC AND
LASTLY, AN INCREASE OF 2.344
MILLION IN THE COMPETITIVE
GRANTS APPROPRIATION, WHICH MAY
ALLOW FOR ADDITIONAL FUNDS FOR
CESSATION RELATED TECHNICAL
ASSISTANCE. AND THE LAST ONE IS
THE PROP 56, THE TOBACCO LAW
ENFORCEMENT ACCOUNT AND 3318,
AND THIS REFLECTS A DECREASE OF
790 $97,000, WHICH MAY RESULT IN
FEWER COMPLIANCE CHECKS OF
RETAILERS. DEPARTMENT OF
PENDANT. GOOD AFTERNOON. NICK
MILLS DEPARTMENT OF FINANCE. I
JUST WANTED TO ANSWER THE FIRST
QUESTION HERE. THE INCREASE IN
THE PROP 56 STATE DENTAL PROGRAM
ACCOUNT REFLECTS REPURPOSED
SAVINGS FROM THE 2021 22 FISCAL
YEAR. ELIO. WILL OWNS A LEO. WE
HAVE NOTHING TO COMMENT AT THIS
TIME. WE'LL BRING IT UP TO THE
DIOCESE FOR ANY MEMBERS.
QUESTIONS DOCTOR WOULD I GUESS I
JUST SAY I DISAPPOINTED SEE A
REDUCTION AND TOBACCO LAW
ENFORCEMENT ACCOUNT. WE JUST HAD
A REFERENDUM ON THE BALLOT. UH
THAT, UM, PROTECTED A BILL
PASSED BY THE LEGISLATURE SIGNED
BY THE GOVERNOR AND WE KNOW IT'S
GOING TO BE CHALLENGING TO
ENFORCE THAT THAT LAW SO
DISAPPOINTING TO SEE THAT. WE
WOULD THEN DECREASE HEART
TOBACCO ENFORCEMENT ACCOUNT. IT
SEEMS COUNTERINTUITIVE. WELL
THANKS VERY MUCH THIS PANEL AND
NOW MOVE ON TO ISSUE 22. ISSUE
22 AS AN OVERSIGHT ISSUE ON THE
CALIFORNIA CANCER REGISTRY
BUDGET, WE WILL BEGIN WITH DR
ALLISON KOREAN FROM STANFORD
UNIVERSITY SCHOOL OF MEDICINE
WHO'S TESTIFYING REMOTELY.
DOCTOR CURRIE IN WILL BE
FOLLOWED BY MARIA COACHELLA. DR
KOREAN THANK YOU. CAN YOU HEAR
ME? WE CAN PLEASE PROCEED. OH,
GOOD. THANK YOU SO MUCH. CHAIR
MEMBERS OF THE COMMITTEE. MY
NAME IS ALISON KOREAN. I'M A
PROFESSOR OF MEDICINE AND
EPIDEMIOLOGY AT STANFORD
UNIVERSITY. AND I'M ALSO A
PRACTICING ONCOLOGIST
SPECIALIZING IN BREAST CANCER
TREATMENT. I'M A CANCER
SCIENTISTS STUDYING THE CAUSES
AND OUTCOMES OF CANCER IN THE
REAL WORLD, NOT JUST FOR
PATIENTS TREATED AT THE
UNIVERSITY LIKE STANFORD, BUT
FOR EVERY PATIENT DIAGNOSED WITH
CANCER. I AM PLEASED TO HAVE AN
OPPORTUNITY TODAY TO DISCUSS THE
IMPORTANCE OF THE CALIFORNIA
CANCER REGISTRY, WHICH I WILL
REFER TO AS THE CCR AND TO URGE
THAT THE LEGISLATURE TAKE ACTION
TO PROTECT THIS PROGRAM, WHICH
IS THREATENED BY FUNDING
RESTRICTIONS. IN THE INTEREST OF
TIME I SPOKEN REMARKS TODAY WILL
BE ABBREVIATED, BUT I HAD
SUBMITTED A FULL WRITTEN
STATEMENT FOR THE RECORD. FIRST
I WANT TO SHARE SOME BACKGROUND
THAT SHOWS THE IMPORTANCE OF
CALIFORNIA'S CANCER REGISTRY. MY
WORK AS A KID SER SCIENTIST. 20
YEARS. I HAVE CENTERED MY
RESEARCH ON A PARTNERSHIP WITH
CCR, WHICH IS MANDATED BY LAW TO
TRACK EVERY NEW CANCER THAT
OCCURS IN CALIFORNIA. CRS
EXCEPTIONAL IN THAT IT LEAVES NO
ONE OUT WHATEVER THEIR AGE,
RACE, ETHNICITY, GENDER INCOME,
EDUCATION OR OTHER
CHARACTERISTICS. EVERY PATIENT'S
CANCER JOURNEY IS RECORDED. CCR
IS CALLED A POPULATION BASED
CANCER REGISTRY AND WITH THE
NATIONAL SYRUP PROGRAM, WHICH
CONTRIBUTES THEY HAVE BEEN
DESCRIBED AS THE EYES WITH WHICH
WE SEE THE CANCER PROBLEM.
WITHOUT IT. WE WOULD BE BLIND TO
HOW A MAJOR CAUSE OF ILLNESS AND
DEATH HAS AFFECTED THE PEOPLE OF
CALIFORNIA AND THE NATION ACROSS
THE PAST 50 YEARS. CCR THUS
SERVES AS A VITAL BACKBONE
ANCHORS OTHER DATA SOURCES FOR
CANCER RESEARCH LEADER PROJECT
BASED ON EXTRACTING DATA FROM
ELECTRONIC MEDICAL RECORDS,
USING ADVANCED TECHNOLOGIES,
INCLUDING ARTIFICIAL
INTELLIGENCE, AND WE FOUND THAT
THE EXTRACTED RESULTS WERE NOT
INTELLIGIBLE OR USEFUL UNTIL WE
LINKED THEM TO THE CCR. WHICH
THEN ENABLED US TO LEAD A HIGH
IMPACT RESEARCH SUCH AS ARE
FINDING THAT LGBT Q PATIENTS
HAVE HIGHER MORTALITY AFTER A
BREAST CANCER DIAGNOSIS AND
HELPED US PINPOINT DISPARITIES
IN ACCESS TO CARE. THIS SHOWED
THAT THE CCR CANNOT BE REPLACED
BY AN AI GENERATED DATA SET,
WHICH DOES NOT COMPLETELY
INCLUDE METICULOUS DATA
COLLECTION AND QUALITY
CONTROLLED BY TRAIN CANCER
REGISTRARS. THE CCR IS ESSENTIAL
TO UNDERSTAND WHETHER THE
NATION'S INVESTMENT IN NEW
TREATMENTS, VACCINES AND GENETIC
TECHNOLOGIES, OFTEN CALLED
PRECISION ONCOLOGY IS WORKING
FOR EVERYONE. WE CANNOT ANSWER
THAT QUESTION USING CLINICAL
TRIALS, WHICH ENROLL ONLY A
SMALL FRACTION OF CANCER
PATIENTS, WE CAN ANSWER IT ONLY
WITH THE REAL WORLD VIEW OF
EVERY CANCER PATIENTS, DIAGNOSIS
, TREATMENT AND SURVIVAL, WHICH
THE CCR PROVIDES. MY WORK WITH
CCR HAS REVEALED RACIAL AND
ETHNIC DISPARITIES IN WHICH
PATIENTS BENEFIT FROM ADVANCES
SUCH AS GENETIC TESTING AND HAS
HELPED US TO TARGET THESE
DISPARITIES FOR IMPROVEMENT. THE
CCR IS ALSO CRUCIAL TO HELP US
UNDERSTAND HOW TO FIND CANCER
EARLY. I HAVE USED PCR DATA TO
IDENTIFY WHICH WOMEN BENEFIT
FROM NOVEL BREAST CANCER
SCREENING APPROACHES, SUCH AS
MAGNETIC RESONANCE IMAGING, AND
THIS RESEARCH LED TO A CHANGE IN
THE NATIONAL SCREENING
GUIDELINES AND HIS SAVED WOMEN'S
LIVES. THESE ARE JUST SOME
EXAMPLES OF THE WAYS THAT THE
CCR HAS CONTRIBUTED TOWARDS
VICTORIES IN OUR FIGHT AGAINST
CANCER. BUT TODAY THIS VITAL
RESOURCE IS UNDER THREAT. CCR IS
FUNDED THROUGH A BLEND OF
RESOURCES FROM THE STATE AND
FEDERAL GOVERNMENT, WITH MOST
FUNDING PROVIDED THROUGH THE NCC
, A PROGRAM TO CALIFORNIA'S
THREE DESIGNATED SYRIA REGIONAL
REGISTRIES. FEDERAL FUNDS
REQUIRE A 20% COST SHARE. STATE
FUNDING FOR THE CCR HAS BEEN ON
THE DECLINE DUE TO THE DECLINING
REVENUES FROM PROPOSITION 99,
CALIFORNIA'S TOBACCO TAX AND A
LACK OF STATE INVESTMENT. BASED
ON ESTIMATES PROVIDED BY THE
DEPARTMENT OF PUBLIC HEALTH IN
THE UPCOMING FISCAL YEAR. THE
ALLOCATION OF THE TOBACCO TAX
REVENUE THAT FUNDS THE CCR IS
FORECASTED TO HAVE A SHORTFALL
OF JUST UNDER $1 MILLION. THERE
ARE CURRENTLY NO CONFIRMED PLANS
TO OFFSET THIS FUNDING REDUCTION
FROM OTHER SOURCES. THIS CUT
COMES ON TOP OF PRIOR REDUCTIONS
, RESULTING IN FLAT FUNDING FOR
THE REGISTRIES FOR A DECADE AND
INCREASED FUNDING PRESSURES FROM
THE IMPLEMENTATION OF ELECTRONIC
PATHOLOGY REPORTING. BASED ON
CURRENT PROJECTIONS. BECAUSE OF
THESE BUDGET THREATS, CALIFORNIA
WILL BE UNABLE TO MAINTAIN ITS
20% INSTITUTIONAL COST SHARE FOR
THE FEDERAL SOUP PROGRAM. AND IF
THIS HAPPENS, CALIFORNIA'S
CANCER REGISTRY AND ITS CURRENT
FORUM WOULD COME TO AN END. THE
NEGATIVE IMPACT ON MY WORK AND
THAT OF CANCER. SCIENTISTS LIKE
ME WOULD BE INCALCULABLE. THE
CCR IS TRULY THE ENVY OF CANCER
SCIENTISTS AROUND THE COUNTRY
AND THE WORLD. IT IS ALSO
CRITICALLY IMPORTANT TO
ELIMINATING GAPS IN HEALTH
EQUITY. TRULY THE CCR DELIVERS
VASTLY MORE THAN IT COSTS FOR
THE PEOPLE OF CALIFORNIA, AND
THUS IT IS CRITICAL THAT WE
FUNDED FULLY AND EFFECTIVELY.
WITH THE APPROPRIATE ONGOING
FUNDING WE CAN SUSTAIN AND
STRENGTHEN OUR CANCER REGISTRY
IMPLEMENTING CHANGES THAT WOULD
PROVIDE REAL TIME DATA FOR
RESEARCHERS AND CLINICAL TRIALS
. AND THAT'S THAT URGED THE
ASSEMBLY BUDGET COMMITTEE TO
TAKE ACTION TO PROTECT
CALIFORNIA'S VITAL TOOLS IN OUR
FIGHT AGAINST CANCER IN THIS
YEAR'S BUDGET AND TO PROTECT
FUNDING FOR THE CCR. I THANK YOU
FOR THIS OPPORTUNITY TO TESTIFY
TODAY. THANK YOU, DOCTOR. MR
CHOI. THANK YOU FOR THE OVERVIEW
, DOCTOR, KOREAN AND CD PH FULLY
AGREES WITH THE IMPORTANCE OF
THE CCR. SO WE HAVE BEEN WORKING
CLOSELY WITH OUR REGIONAL
PARTNERS TO ADDRESS THESE ISSUES
, AND I WILL PROVIDE A BRIEF
OVERVIEW OF THE CALIFORNIA
CANCER REGISTRY AND HOW IT
OPERATES AND JUST ADDRESS SOME
OF THE ISSUES THAT WERE RAISED.
SO THE CALIFORNIA CANCER
REGISTRY IS PROJECTED TO RECEIVE
10.6 MILLION AND FISCAL YEAR
2023 24. THIS INCLUDES FUNDING
FROM STATE AND FEDERAL RESOURCES
AND FISCAL YEAR 23 24. WE ARE
PROJECTING A SHORTFALL OF
APPROXIMATELY 750,000. DOLLARS
TO MAINTAIN THE CURRENT LEVEL OF
FEDERAL FUNDING. AGAIN CD PHS
CONTINUING TO WORK ON SOLUTIONS
TO ADDRESS THE SHORTFALL, AND IT
MAY BE HELPFUL TO EXPLAIN A
LITTLE BIT OF HOW THEIR REGIONS
ARE DIRECT THEIR DIRECT FUNDING
METHODOLOGY. SO CURRENTLY,
FEDERAL FUNDS ARE PROVIDED
DIRECTLY TO THEIR REGIONS AND
THE AMOUNT OF $13 MILLION FOR
FUNDING TO MAINTAIN THE REGION'S
CURRENT LEVEL OF DIRECT FEDERAL
FUNDING. THE REGIONAL REGISTRIES
ARE REQUIRED TO IDENTIFY A
FUNDING COST SHARE AND THE
AMOUNT OF 20% OF THE TOTAL
FEDERAL ALLOCATION THIS EQUALS
APPROXIMATELY 3.3 MILLION OF NON
FEDERAL FUNDS. THE REGION'S USED
STATE GENERAL FUND ALLOCATIONS
TO MEET THIS COST SHARE
REQUIREMENT. SO AGAIN FOR FISCAL
YEAR 23 24. WE ARE PROJECTING A
750,000 SHORTFALL, WHICH WOULD
LEAD TO THE REGIONS NOT MEETING
THE 20% LEVEL OF COST SHARE. THE
REGIONS CURRENTLY HAVE A COST
SHARE SHORTFALL OF 807,000 FOR
FISCAL YEAR 22 23, ALTHOUGH THIS
YEAR HAS CONTINUED TO FUND THE
REGIONS THAT THE FULL AMOUNT OF
FEDERAL FUNDING, UM EVEN THOUGH
THEY'RE NOT MEETING THEIR
REQUIRED COST SHARE THAT COULD
CHANGE IT ANYTIME SO, IN
ADDITION TO THIS CD PH DIRECTLY
RECEIVES 2.5 MILLION FROM THE
CENTER FOR DISEASE CONTROL AND
PREVENTION. CDC CD PHS REQUIRED
TO PUT IN FIVE MILLION TO THE
CANCER REGISTRY FROM MAINTENANCE
OF EFFORT AND IS REQUIRED TO
PROVIDE 25% IN MATCHING FUNDS TO
MAINTAIN THE CURRENT LEVEL OF
FEDERAL FUNDING FROM THE CDC. TO
MEET THIS REQUIREMENT SEED PH
USERS GENERAL FUND AND PROP 99
FOR THE MAINTENANCE OF EFFORT
AND THE BREAST CANCER RESEARCH
ACCOUNT TO MEET THE MATCHING
REQUIREMENT. AND FISCAL YEAR 23
24. THE BREAST CANCER RESEARCH
ALLOCATION IS PROJECTED TO
DECREASE BY 98,000 REQUIRING
ADDITIONAL GENERAL FUND TO MEET
THIS REQUIREMENT. PROP 99 CANNOT
BE USED TO MEET THE REGION'S 20%
SHARE COST SHARE REQUIREMENT AND
THE AMOUNT OF 3.3 MILLION.
ADDITIONALLY IT CANNOT BE USED
TO MEET THE STATE'S CDC 25%
MATCHING FUNDS REQUIREMENT AND
THE AMOUNT OF 625,000 WHEN PROP
99 ALLOCATIONS DECREASED GENERAL
FUND IS USED TO COVER THAT THE
DECREASES WHICH IN TURN IMPACTS
THE AMOUNT OF GENERAL FUND
AVAILABLE TO ALLOCATE TO THE
REGIONS, AND I JUST WANT TO NOTE
THAT IN 1988. THE CANCER
REGISTRY WAS 100% FUNDED BY THE
GENERAL FUND AND WITH THE
IMPLEMENTATION OF PROP 99 1989.
THE CCR RECEIVED PROP 99 FUNDING
IN ADDITION TO ITS GENERAL FUND
ALLOCATIONS. IN 1991 JOURNAL
FUND ALLOCATIONS WERE CUT
ALTOGETHER FOR THE CANCER
REGISTRY. SO CONTINUING
DECREASES IN PROP 99 THE BREAST
CANCER RESEARCH ACCOUNT WILL
IMPACT THE REGISTRY AS THE COST
SHARE AND MAINTENANCE OF
OPERATIONS REQUIREMENT TO
CONTINUE. THE CURRENT LEVEL OF
FEDERAL FUNDING ARE INCREASINGLY
DIFFICULT TO MEET. HOWEVER CD PH
IS COMMITTED TO WORKING ON
ALTERNATIVE SOLUTIONS.
DEPARTMENT OF FINANCE. GOOD
AFTERNOON, NICK MILLS DEPARTMENT
OF FINANCE, THE ADMINISTRATION
CONTINUES TO EVALUATE ONGOING
COSTS ASSOCIATED WITH THE CANCER
REGISTRY AND HOW TO BEST ADDRESS
PROJECTED REDUCED REVENUE.
THAT'S FORCES PROGRAM AND ANY
REQUESTS FOR ADDITIONAL
RESOURCES WILL BE CONSIDERED
THROUGH THE MAYOR. REVISION
BUDGET PROCESS. VÚI WILL OWNS
ELIO, WE HAVE NOTHING AT THIS
TIME. WE'LL BRING IT UP TO THE
DIOCESE FOR ANY MEMBERS
QUESTIONS. I'LL KEEP IT HERE AT
THE CHAIR IF I CAN UM MY MOTHER
IS A BREAST CANCER SURVIVOR. AND
FOR MANY OF US, WE LOOK TOWARDS
THESE REGISTRIES TO MAKE SURE
THAT WE ARE PROVIDING PRECISION
ONCOLOGY. SHE HAD HEARD TO
POSITIVE RECEPTOR, WHICH ALLOWED
US TO HAVE HERCEPTIN BE THE
TREATMENT, AND YET IT WILL BE
THINGS LIKE THE REGISTRY THAT
ALLOW US TO DECIDE IF THERE ARE
PATTERNS IF THERE IS A GENETIC
COMPONENT. IF THIS IS PASSED ON
TO MY DAUGHTERS, AND SO FOR MANY
OF US, WE LOOK TOWARDS THIS
REGISTRY AS BOTH THE ENVY OF THE
NATION. BUT UM, A PROGRAM THAT
WE'VE UPLIFTED AND ARE QUITE
PROUD OF HERE IN CALIFORNIA AS
WELL. THAT I'D LIKE TO REALLY
DIG IN A LITTLE BIT TO TALK
ABOUT THE SHORTFALL, BECAUSE IT
SEEMS TO BE A PERSISTENT PROBLEM
THAT HAS GONE ON SINCE WE'VE
MOVED TO PROPOSITION 99. AND AS
THIS WAS STATED SO ELOQUENTLY,
THIS HELPS TO ELIMINATE MANY OF
THE GAPS IN HEALTH EQUITY. CAN
YOU EXPLAIN THROUGH A LENS OF
EQUITY? WHAT IT MEANS WHEN WE'RE
NOT FULLY FUNDING THIS CANCER
REGISTRY AND WHAT IMPACT THAT
WOULD HAVE ON OUR COMMUNITIES
WHO ARE VULNERABLE. UM YES, I
CAN SPEAK ON THAT. SO WE DO WE
DO AGREE. AND, UM, YOU KNOW,
PART OF US WANTING TRYING TO
ASSIST IN FUNDING THIS FULLY IS
WE REALLY WANT TO RECEIVE TIMELY
AND COMPLETE INFORMATION ON
STATEWIDE CANCER CASES. UM, AND
MAKE SURE THAT THERE IS
AVAILABLE RESEARCH. FOR
AVAILABLE. I'M SORRY. UM WE
DON'T WANT TO MISS ANY
OPPORTUNITIES TO PROMOTE EQUITY
AND CANCER PREVENTION, TREATMENT
AND SURVIVAL. SO PART OF US
MAKING SURE WE'RE FUNDING THE
REGISTRY FULLY IS MAKING SURE
THAT THE ACCURACY AND VALIDITY
OF THE DATA THAT WE'RE
COLLECTING IS VALID AND IS
USABLE BY THE PUBLIC AND PRIVATE
RESEARCHERS. WE WANT TO MAKE
SURE THAT THE DATA IS GOOD DATA.
CAN I DIG IN A LITTLE BIT? IT
SEEMED THAT THERE WAS A
SHORTFALL. ARE WE REQUESTING
THESE CENTERS TO BE. UM,
COLLECTING A FUNDING COST SHARE.
AND IF SO, IS THAT THE MOST
EFFECTIVE WAY FOR US TO ENSURE
THAT WE ARE CONTINUED?
CONTINUING TO FUND THIS AS THEY
HAVE NOT SHOWN THAT ABILITY TO
COLLECT THAT COST. SURE. ARE WE
SPEAKING FOR THE STATE
REIMBURSEMENT OF THE COST? SHARE
YES. SO IN ORDER FOR US TO MEET
OUR CDC REQUIREMENT THIS STATE
IS REQUIRED TO PUT IN A 25.
MAINTENANCE OF THE EFFORT,
MAINTENANCE OF EFFORT AND A 25%
AND MATCHING FUNDS TO MAINTAIN
OUR CDC LEVEL OF FUNDING. IF THE
SHORTFALL IS NOT ADDRESSED
SUCCESSFULLY DURING THE MAY
REVISION, WHAT WOULD OCCUR TO
THE CCR? IF IT IS NOT ADDRESSED
. THERE COULD BE DECREASES. UM
AND THE ACCURACY OF THE VALIDITY
OF THE DATA. THE CALIFORNIA
REGIONAL REGISTRIES COULD LOSE
UP TO 6.2 MILLION AND NCE
FUNDING IF THEY CANNOT PROVIDE
THE 20% COST SHARE. UM TIMELY
AND COMPLETE INFORMATION ON
STATE RIGHT CANCER CASES WILL
NOT BE AVAILABLE FOR RESEARCH
PURPOSES AND MAY RESULT IN A
LOSS OF UP TO AN ADDITIONAL 9.5
MILLION AND FEDERAL FUNDING TO
THE CCR. UM AND AGAIN, IT COULD,
UH, AFFECT CDP H S ABILITY TO
INTEGRATE THE CCR. INTO
CALIFORNIA AND FEDERAL DATA
MONITORED MODERNIZATION, AND
THIS COULD BE SIGNIFICANTLY
DIMINISHED. DR JACKSON. AS SOON
AS YOU STARTED IT, SAYING,
AFFECTING THE VALIDITY OF THE
DATA AT MY, MY EARS STARTED
RINGING. BECAUSE OBVIOUSLY, IF
THAT IS NOT VALID, WE SHOULDN'T
HAVE THIS AT ALL. RIGHT? IF
PEOPLE START WONDERING WHETHER A
LOT OF GOOD BIG DECISIONS ARE
BEING. HE SAYS, THOUGH IN THE
NATION'S GREAT LARGEST REGISTRY
THAT WE SHOULD DO EVERYTHING WE
CAN TO MAKE SURE THAT THE
INTEGRITY OF THE DATA. IS GOING
TO BE MAINTAINED. UM AND SO
OBVIOUSLY WE NEED TO FIX THIS
BECAUSE THE CURRENT PROPOSAL IS
SIMPLY NOT ACCEPTABLE. WHEN YOU
START TALKING ABOUT UH, I MEAN,
IF I WAS WELL, I AM A RESEARCHER
. BUT IF I WAS A RESEARCHER IN
ANOTHER COUNTRY AND I'M LOOKING
FOR THE BIGGEST SET OF DATA AND
THE NATION AND IN THE UNITED
STATES, I WOULD TURN TO THIS
ONE. RIGHT AND SO WE HAVE TO BE
CAREFUL ABOUT HOW WE TREAT OUR
DATA. OBVIOUSLY. AND MAKING SURE
THAT POTENTIALLY GLOBAL
DECISIONS CAN BE MADE WHEN IT
COMES TO CANCER. AND SO I HOPE
WE CAN WORK WITH YOU ALL TO BE
ABLE TO FIX THIS BECAUSE THE
UNINTENDED CONSEQUENCES CAN CAN
REALLY BE UH, TRYING NOT TO BE
DRAMATIC, BUT YOU KNOW BIG, BIG
BAD THINGS CAN HAPPEN. UM IF WE
DON'T MAINTAIN THE INTEGRITY OF
THIS DATA, SO LET'S LET'S FIND A
FIX HERE. CLEARLY, THIS SHOULD
BE A PRIORITY FOR THE STATE OF
CALIFORNIA. THANK YOU. AND I
WILL END UP I CAN THAT I THOUGHT
DOCTOR KURIAN SAID IT WELL ABOUT
THE RACIAL, ETHNIC AND SOCIAL
DISPARITIES, WHICH ARE PRESENT
WITHIN OUR CANCER REGISTRY AND
ALLOW US TO DESIGN PRECISION
TREATMENTS FOR COMMUNITIES WHO
ARE SUFFERING DISPARATE IMPACTS
TO CANCER AND THUS BELIEVE IT'S
IMPERATIVE FOR US TO GET THIS
RIGHT AND LOOK FORWARD TO THOSE
ALTERNATIVE SOLUTIONS FROM THE
ADMINISTRATION COMPANY REVISION
WITH THAT I WILL THANKS VERY
MUCH THIS PANEL AND WE WILL MOVE
ON TO OUR FINAL ISSUE FOR THE
DAY. ON ISSUE 23. THIS IS AN
OVERVIEW OF THE WIC PROGRAM
ESTIMATE, WHICH WILL BE
PRESENTED BY CHRISTINE SULLIVAN
, THE WORK DIVISION CHIEF AT THE
CD PH. MISS SULLIVAN. CAN YOU
THANK YOU AND GOOD AFTERNOON,
I'LL PROVIDE A HIGH LEVEL
OVERVIEW THE WEEK ESTIMATE AND
ADDRESS THE TWO QUESTIONS FROM
THE AGENDA. ESTIMATES AN
INCREASE IN EXPENDITURES OF MORE
THAN $200 MILLION IN THE CURRENT
BUDGET YEAR, WITH ABOUT HALF OF
THE INCREASE DUE TO THE FRUITS
AND VEGETABLES INCREASE AND HALF
DUE TO INCREASES IN INFLATION
AND PARTICIPATION. THIS
INCREASED BRINGS TOTAL
EXPENDITURES FOR FOOD TO $921
MILLION IN THE CURRENT YEAR AND
$944 MILLION IN THE BUDGET YEAR.
FOOD EXPENDITURES ARE COVERED BY
FEDERAL REVENUE AND REBATE
REVENUE. THE NOVEMBER ESTIMATE
INCLUDES PROJECTIONS OF MORE
THAN 940,000 WORK. PARTICIPANTS
SERVED EACH MONTH, WHICH IS A
SMALL INCREASE OVER THE PREVIOUS
ESTIMATE. IN JANUARY OF THIS
YEAR, THE USDA RELEASED ITS
LATEST WIC PROGRAM REACHED
COVERAGE REPORT USING DATA FROM
2020. USDA ESTIMATED NATIONALLY
THAT WICKS IS 50% OF ITS
ELIGIBLE POPULATION IN 2020,
WHILE CALIFORNIA SERVED 65% OF
ITS ELIGIBLE POPULATION. NO
OTHER STATE HAS A HIGHER WHAT
COVERAGE RATE OR HIGHER NUMBER
OF WIC PARTICIPANTS THAN
CALIFORNIA. NOTE THAT IN THIS
LATEST REPORT FROM USDA, UM USDA
MADE MODIFICATIONS TO THEIR
METHODOLOGY, SO THEY CHANGE
THEIR ESTIMATES FROM PRIOR YEARS
, AND WE'LL UPDATE LANGUAGE
ACCORDINGLY. IN THE MAY
REVISION. AT THE ONSET OF THE
PANDEMIC. CALIFORNIA AND OTHER
STATES EXPERIENCED AN INCREASE
IN WIDTH PARTICIPATION,
PARTICULARLY IN CHILDREN, DUE IN
PART TO ECONOMIC HARDSHIPS, AS
WELL AS CHANGES IN WAKE UP
PROGRAM OPERATIONS. NATIONALLY
THE HIGHER LEVEL OF
PARTICIPATION HAS NOT BEEN
MAINTAINED, BUT IT HAS IN
CALIFORNIA. FROM EARLY 2022
LATER IN 2022, CALIFORNIA HAS
SEEN AN INCREASE IN ALL
PARTICIPANT CATEGORIES. WOMEN
INFANTS AND CHILDREN WHILE THE
REST OF THE COUNTRY HAS HAD
INCREASES IN CHILDREN, BUT
RECENT DECREASES IN WOMEN AND
INFANTS. THE FEDERAL PANDEMIC
FLEXIBILITIES HAVE HAD
SIGNIFICANT POSITIVE IMPACT ON
THE WIC PROGRAM BY INTRODUCING
CHANGES IN PROGRAM OPERATIONS
AND LEADING TO BROADER EFFORTS
BY USDA TO MODERNIZE THE
PROGRAM. PRIOR TO THE PANDEMIC,
THE NATIONAL ACADEMIES OF
SCIENCE AND ENGINEERING AND
MEDICINE MADE RECOMMENDATIONS TO
USDA TO CHANGE THE FOOD PACKAGES
. THE FOODS THAT WICK
AUTHORIZES. USDA IMPLEMENTED A
COMPONENT OF THESE
RECOMMENDATIONS IN SUMMER OF
2020. BY INCREASING THE MONTHLY
BENEFITS FOR FRUITS AND
VEGETABLES. SINCE THEN, THE
INCREASE HAS BEEN TIED TO THE
FEDERAL BUDGET BILL AND HAS BEEN
APPROVED WITH EACH BUDGET. IN
NOVEMBER OF 2020 USDA RELEASED
PROPOSED REGULAR REGULATIONS
THAT WOULD MAKE THE FRUITS AND
VEGETABLES BENEFIT PERMANENT.
AND FOR CONTEXT PRIOR TO THIS
CHANGE. OF. A CHILD RECEIVED $9
PER MONTH FOR FRUITS AND
VEGETABLES AND A PREGNANT OR
POSTPARTUM WOMAN WOULD HAVE
RECEIVED $11. NOW WITH THIS
CHANGE, WOMEN, POSTPARTUM OR
PREGNANT WOMEN RECEIVE EITHER 44
OR $49, SO QUITE A SIGNIFICANT
INCREASE. AND TO TAG ON TO IT,
DOCTOR, ARAGON SAID. IT'S REALLY
NICE TO BE ABLE TO MAKE THE
HEALTHY CHOICE. THE EASY CHOICE
IN THIS AREA. LASTLY USDA
RELEASED ANOTHER PROPOSED
REGULARIZATION CHANGE, UM, JUST
LAST MONTH THAT WOULD ALLOW
ONLINE SHOPPING FOR WIC. WHILE
ONLINE SHOPPING HAS NOT BEEN
POSSIBLE FOR WIC DURING THE
PANDEMIC, USDA IS AWARE OF THE
HIGH LEVEL OF INTEREST FROM
FAMILIES IN WICK PARTNERS, AND
SO WE'RE VERY PLEASED TO SEE
THIS PROPOSAL. AND FINALLY,
FLEXIBILITIES PERMIT REMOTE
APPOINTMENTS, AND USDA HAS
RECENTLY APPROVED FOR STATES TO
CONTINUE REMOTE APPOINTMENT AND
FLEXIBILITIES THROUGH AT LEAST
SEPTEMBER OF 2026 SO INDICATING
AGAIN THAT USDA'S COMMITMENT TO
ENHANCING ACCESSIBILITY AND
CONVENIENCE FOR WIC PARTICIPANTS
THANK YOU. DEPARTMENT OF FINANCE
SALES DEPARTMENT OF FINANCE
NOTHING FURTHER TO ADD ELIO
WILLOW AND CELIO. NO COMMENT AT
THIS TIME. BRING IT UP TO THE
DIOCESE. SEE IF THERE'S ANY
MEMBER QUESTIONS. I'LL BEGIN. UM
YOU STATED THAT SOME OF THE
FLEXIBILITIES HAVE BEEN QUITE
HELPFUL. CAN YOU GO THROUGH
WHICH WORKS ABILITIES WILL BE
DISCONTINUED. UM SO RIGHT NOW,
THERE'S NOTHING THAT HAS THAT IS
BEING DISCONTINUED JUST YET. THE
USDA WITH WITH THE EXCUSE ME
WITH THE END OF THE PUBLIC
HEALTH EMERGENCY, THE USDA IS
FLEXIBLE EFFECTS FLEXIBILITIES
CONTINUE THROUGH THIS SUMMER AND
THROUGH ARPAIO AUTHORITY, USDA
IS ABLE TO CONTINUE THOSE, AND
SO THEY HAVE. UM NOTIFIED STATES
THAT WE CAN OPT IN TO CONTINUE
THOSE FLEXIBILITIES AND WE'LL BE
DOING THAT. SO THERE'S NOTHING
ON THAT FRONT THAT'S ENDING
ANYTIME SOON. EXCELLENT. WITH
THAT I WILL. THANKS VERY MUCH
THIS PANEL AND SINCE WE MOVED
ISSUES 24 THROUGH 32 THE NON
DISCUSSION THAT WAS OUR LAST
ISSUE AND PANEL. FOR TODAY, AND
WITH THAT WE WILL NOW MOVE ON TO
PUBLIC COMMENT. WE WILL WELCOME
PUBLIC COMMENT ON ALL 30 ISSUES
THAT ARE ON TODAY'S AGENDA. BUT
ASK YOU TO KEEP YOUR COMMENTS TO
THESE ISSUES ONLY. WE WILL BEGIN
PUBLIC COMMENT WITH INDIVIDUALS
FOR HERE IN THE HEARING ROOM,
AND THEN WE WILL GO TO THE PHONE
LINES AS A REMINDER THE PHONE
NUMBER AND ACCESS CODE OR ON THE
FIRST PAGE OF OUR AGENDA ON THE
SUBCOMMITTEE'S WEBSITE AND
SHOULD ALSO BE APPEARING ON YOUR
SCREEN IF YOU ARE WATCHING THE
LIVESTREAM. THE PHONE NUMBER IS
877692. WITH THE ACCESS CODE
1315126. WITH THAT. LET'S BEGIN
WITH PUBLIC COMMENTS. THANK YOU
, MR CHAIR MEMBERS, DOUG SUPERS
ON BEHALF OF THE CALIFORNIA
PROFESSIONAL FIREFIGHTERS. CPF
REPRESENTS. NEARLY 35,000 DOING
IT. YES, SIR. THANK YOU. YEAH,
THAT WORKS. THANK YOU, MR CHAIR
MEMBERS, DOUG SUPERS ON BEHALF
OF THE CALIFORNIA PROFESSIONAL
FIREFIGHTERS. CPF REPRESENTS
NEARLY 35,000 PROFESSIONAL
FIREFIGHTERS AND EMERGENCY
MEDICAL SERVICES PERSONNEL
STATEWIDE. WE'RE PLEASED TO BE
HERE IN STRONG SUPPORT OF THE
TRAILER LANGUAGE AND UNDER ISSUE
NUMBER SIX. WE I THINK JUST TO
ECHO SOME OF THE COMMENTS
EARLIER. WE DO THINK WE'RE
MOVING THE PHYSICIAN REQUIREMENT
FROM THE DIRECTOR OF THE
EMERGENCY MEDICAL SERVICES
AUTHORITY WELL, EXPAND THE POOL
OF AVAILABLE CANDIDATES TO BE
CONSIDERED. UM AND ALSO
IMPORTANTLY, THE PROPOSED
CHARLIE BELL LANGUAGE INCLUDES A
NEW POSITION OF THE CHIEF
MEDICAL OFFICER TO ENSURE THAT
MEDICAL OVERSIGHT CONTINUES TO
BE AN IMPORTANT ROLE OF THE
EXECUTIVE TEAM AT THE
AUTHORITIES. SO FOR THOSE
REASONS, WE URGE YOUR SUPPORT
WHEN IT COMES BEFORE YOU. THANK
YOU. THANK YOU. MICHELLE GIVENS
WITH THE COUNTY HEALTH
EXECUTIVES ASSOCIATION OF
CALIFORNIA STAYING ON TOPIC OF
THIS ISSUE. SIX CHECK HAS TAKEN
A SUPPORT IF AMENDED POSITION.
WE ALSO AGREE THAT REMOVING THE
PHYSICIAN REQUIREMENT FOR THE
DIRECTOR WILL DIVERSIFY THE POOL
OF CANDIDATES, ESPECIALLY
THINKING ABOUT HOW MINORITY
POPULATIONS ARE UNDER
REPRESENTED IN THE MEDICAL
COMMUNITY. WE THINK THAT THIS
WOULD BRING AN OPPORTUNITY FOR
DIVERSITY, HOWEVER. WE DO WANT
TO MAKE SURE THAT THERE IS
PHYSICIAN OVERSIGHT OVER THE E M
S SYSTEM AT THE STATE LEVEL. AND
WHILE WE UNDERSTAND THAT THAT'S
THE INTENT OF CREATING THE CHIEF
MEDICAL OFFICER POSITION IN
STATUTE, THERE ARE A LOT OF
REFERENCES TO THE DIRECTOR OF S
A HAVING THAT PHYSICIAN OR
MEDICAL OVERSIGHT OVER THE
SYSTEM BECAUSE THEY'RE CURRENTLY
A PHYSICIAN, SO WE WOULD LIKE
THOSE REFERENCES IN STATUTE
MOVED FROM THE DIRECTOR OVER TO
THE CHIEF MEDICAL OFFICER. WE
ALSO HOPE THAT THE DIRECTOR HAVE
SOME EXPERIENCE IN E. M S HEALTH
, PUBLIC HEALTH BACKGROUNDS AS
WELL ON ISSUE 11 RELATED TO
INFORMATION TECHNOLOGY AND THE
MODERNIZATION WOULD JUST ASK
THAT THE STATE CONTINUES TO
REMEMBER THAT LOCAL HEALTH
DEPARTMENTS OFTEN HAVE TO
INTEGRATE AND INTERACT WITH THE
SYSTEMS THAT THE STATE IS DOING,
AND WE WOULD ASK FOR THE STATE
TO CONTINUE TO LOOK HOLISTICALLY
TO SOME OF THE QUESTIONS THAT
DOCTOR WOULD WAS ASKING. YOU
KNOW, WE HAVE A LOT OF SYSTEMS
AT THE STATE LEVEL AND AS WE ARE
UNDERTAKING THIS, THIS, UH YOU
KNOW, DEVELOPMENT, REALLY
STREAMLINED SYSTEMS AND RENEW
SYSTEMS AND ALL OF THAT WE WOULD
JUST HOPE THAT WE WOULD TAKE A
BIG LOOK AND MAP IT OUT AND THEN
MAKE SURE THAT ANY CHANGES
REALLY ARE SUPPORTED BOTH AT THE
STATE AND LOCAL LEVEL. THANK
YOU. OKAY. THANK YOU. GOOD
AFTERNOON, MR CHAIR AND MEMBERS
JULIANA DARYL WITH A CALIFORNIA
STATE ASSOCIATION OF COUNTIES
HERE ON BEHALF OF ALL 58
COUNTIES ON ISSUE 13. I WOULD
LIKE TO SAY THAT SEE SECT DOES
APPRECIATE THE ONGOING FUNDING
FOR PUBLIC HEALTH INFRASTRUCTURE
THAT WAS APPROVED IN LAST YEAR'S
BUDGET IS MAINTAINED. WE ARE
DISAPPOINTED, HOWEVER, BY THE
PROPOSAL IN ISSUE NUMBER 13
EXCUSE ME ISSUED 12 TO REDUCE
INVESTMENTS IN PUBLIC HEALTH
WORKFORCE DEVELOPMENT. UM BY
NEARLY $50 MILLION AT A TIME
WHEN HEALTHCARE WORKFORCE
CHALLENGES CONTINUE TO RISE. WE
THEREFORE WHICH STRONGLY SUPPORT
STAFF RECOMMENDATION, URGING THE
ADMINISTRATION TO WITHDRAW THAT
PROPOSAL FOR $49.8 MILLION
REDUCTION. THANK YOU. THANK YOU.
GOOD AFTERNOON CHAIR AND MEMBERS
OF THE COMMITTEE. ISABELLA OUR
QUOTA WITH THE HEALTH OFFICERS
ASSOCIATION OF CALIFORNIA, WHICH
REPRESENTS THE POSITION, HEALTH
OFFICERS AND CALIFORNIA'S CITY
IN COUNTY JURISDICTIONS. I'M
HERE TODAY TO REQUEST THAT THE
COMMITTEE REJECT THE GOVERNOR'S
PROPOSAL TO CUT ONE TIME FUNDING
ENACTED IN LAST YEAR'S BUDGET TO
HELP SUPPORT THE PUBLIC HEALTH
WORKFORCE. UM TO ADD TO WHAT MY
COLLEAGUES HAVE SAID ONE OF THE
TRAINING AND DEVELOPMENT
PROGRAMS THAT WOULD BE IMPACTED
AS THE PUBLIC HEALTH LAB ASPIRE
PROGRAM, WHICH ADDRESSES THESE
SEVERE SHORTAGE OF TRAINED AND
QUALIFIED PUBLIC HEALTH
LABORATORY DIRECTORS. LABS ARE
ESSENTIAL TO THE CORE FUNCTIONS
OF PUBLIC HEALTH AND ARE CHARGED
WITH DISEASE SURVEILLANCE AND
DIAGNOSIS. MONITORING THE SAFETY
OF DRINKING WATER AND FOOD
SUPPLIES AND ENVIRONMENTAL
INSPECTOR TESTING. THESE LABS
REQUIRE SPECIALIZED STAFF THAT
HAVE EXPERTISE IN THE NEEDS OF
EACH OF YOUR DISTRICTS AND
VARIED FROM LAB TO LAB. EVEN AS
CALIFORNIA'S POPULATION HAS
INCREASED, THE NUMBER OF LOCAL
LABS HAS DECREASED, WITH 11
LOCAL LABS CLOSING SINCE 1999,
MOSTLY DUE TO A LACK OF
QUALIFIED STAFF. CUTTING THIS
FUNDING WILL LEAVE CALIFORNIANS
UNPREPARED AND VULNERABLE TO THE
NEXT PANDEMIC. WE LOOK FORWARD
TO WORKING WITH YOU AND ENSURING
THAT CALIFORNIANS RECEIVE A
ROBUST, WELL FUNDED PUBLIC
HEALTH SYSTEM THAT SAVES LIVES.
THANK YOU. THANK YOU. MR CHAIR
AND MEMBERS BETSY ARMSTRONG WITH
THE COUNTY HEALTH EXECUTIVES
ASSOCIATION. BUT HERE TODAY ON
BEHALF OF THE M S ADMINISTRATORS
OF CALIFORNIA ON ISSUE SIX THE
I'M SO DIRECTOR POSITION. I
WOULD ECHO THE COMMENTS OF MY
BOSS, BUT THE E. M S
ADMINISTRATORS SUPPORTED IN
CONCEPT THEY'VE SUBMITTED
PROPOSED AMENDMENTS TO THE
STATUTE FOR YOUR CONSIDERATION
WOULD HOPE THAT YOU WOULD LOOK
AT THAT AS WELL. THANK YOU.
THANK YOU. SAYING NO FURTHER
PUBLIC COMMENT AND PERSON WE
WILL NOW TRANSITION TO THE PHONE
LINES. OPERATORS WERE READY TO
BEGIN PUBLIC COMMENT ON THE
PHONES WHEN YOU ARE READY. THANK
YOU, MR CHAIR. FOR THOSE OF YOU
WHO WISH TO MAKE A COMMENT.
PLEASE PRESS ONE THAN ZERO PRESS
10 ONLY ONCE PRESSING ONE AND
ZERO SECOND TIME WILL REMOVE YOU
FROM THE KILL. WE WILL NOW GO TO
LINE 18. GOOD AFTERNOON, MR
CHAIRMAN MEMBERS NICOLE WARD
ULLMAN ON BEHALF OF THE ORANGE
COUNTY BOARD OF SUPERVISORS,
REQUESTING THAT LEGISLATURE
REJECT CUT TO THE PUBLIC HEALTH
WORKFORCE TRAINING SUNDAY. LIKE
OTHER COUNTIES, ORANGE COUNTY
FACES SIGNIFICANT WORKFORCE
CHALLENGES. EVEN AS CALIFORNIA
CONTINUES TO REGAIN MOST OF
THOSE NON AGRICULTURE JOBS. LOST
DUE TO THE COVID 19 PANDEMIC.
WORKFORCE CHALLENGES ARE
PARTICULARLY ACUTE IN OUR HEALTH
AND HUMAN SERVICES AGENCIES, AND
THEREFORE WE ASK THAT YOU RETAIN
THE FUNDING AS PART OF THE 2023
24 BUDGET ACT. THANK YOU. THANK
YOU. NEXT CALLER, PLEASE. LINE
41 YOU'RE LYING IS NOW OPEN.
THANK YOU, MR CHAIR AND MEMBERS
VANESSA KAHIN OUT ON BEHALF OF
THE VECTOR CONTROL ASSOCIATION
OF CALIFORNIA. TODAY'S
DISCUSSION ON ISSUE 11. I JUST
WANTED TO SHINE AND BRIEFLY AND
SAY THAT WE GREATLY APPRECIATE
THE SERIOUSNESS THAT ASSEMBLYMAN
WOULD HAVE PROVIDED THE LOOMING
THREAT OF LOCAL TRANSMISSION OF
THE MOSQUITO BORN ILLNESS IN
THIS BUDGET PROPOSALS SUPPORT
LOCAL MOSQUITO CONTROL AGENCIES
USING EXTRAORDINARY RESOURCES.
TO COMBAT AND BASIC MOSQUITOES.
WE APPRECIATE CD PH OF
PARTNERSHIP IN ELEVATING THIS
ISSUE IN THEIR PARTNERSHIP AND
TRACKING THE SPREAD AND SPREAD
OF LOCAL MOSQUITO BORN ILLNESS
TRANSITION AND LOOK FORWARD TO
FURTHER CONVERSATIONS ON
DATABASE MANAGEMENT. THANK YOU.
THANK YOU. NEXT CALLER, PLEASE.
LINE 30. HI UM, IS THAT ISN'T
ME. YES, MA'AM. IT IS. OH,
EXCELLENT. UM. WELL, I WAS
ACTUALLY, UM, ANTICIPATING.
TALKING ABOUT A COUPLE OF
DIFFERENT ITEMS. UM BUT ONE OF
THEM SEEMED TO JUST VANISH. I AM
NUMBER 16. SO UM, I'M STILL
TRYING TO GET INTO THE, UM SORT
OF CULTURE OF THESE HEARINGS
BECAUSE I'M I'M A LITTLE BIT NEW
TO THE LEGISLATURE. UM SO I
GUESS WHAT I CAN STAY FOR NOW.
IS THAT, UM. I HEAR THIS SORT OF
AH! IMPULSE TO CUT WHAT I HEARD
WAS NEARLY $50 MILLION FROM
THESE PUBLIC HEALTH WORKFORCE
POSITIONS WHILE AT THE SAME TIME
BY YOUR OWN NUMBERS. IT SOUNDS
LIKE UM, ONE OF YOUR EXPERTS
REVEALED THAT CALIFORNIA LOST AH
75, PUBLIC HEALTH DOCTORS AND
DIRECTORS. UM SO JUST AS AN
EXAMPLE OF, YOU KNOW, ONE OF THE
SITUATIONS THAT TOOK PLACE IN
THE PANDEMIC LIKE USED THE WORD
PANDEMIC IN QUOTES. UM I'M
THINKING OF THE PUBLIC HEALTH.
DR AMY SMITHSON, WHO LEFT CLASS
OR COUNTY LARGELY BECAUSE
CLASSIC COUNTY ENDED THE
EMERGENCY AND SHE DIDN'T REALLY
LIKE THAT. SO SHE WENT TO YOLO
COUNTY BECAUSE YOLO COUNTY
STAYED, YOU KNOW, ON THE COVID
PROTOCOL AND, YOU KNOW, KEPT
THINGS LOCKED DOWN NICE AND
TIGHT. SO YOU KNOW, NOT TO, LIKE
WAX AND WANE ABOUT BYGONES, BUT
IT COMES TO MY ATTENTION THAT
MAYBE YOU LAWMAKERS COULD START
TO CONNECT THE DOTS ON SOME OF
THIS IF YOU'RE NOT ABLE TO
RETAIN AND ATTRACT PUBLIC HEALTH
DOCTORS AND DIRECTORS. IS IT
POSSIBLE THAT THERE'S MAYBE A
REASON AS TO WHY NOT? IS IT
POSSIBLE THAT THE PUBLIC
PRESSURE UM FELT BY THESE
INDIVIDUALS BECAUSE CALIFORNIANS
ARE NOT AND HAVE NOT BEEN IN
SUPPORT OF THESE LOCKDOWNS MIGHT
HAVE SOMETHING TO DO WITH AH!
THE LACK OF BEING ABLE TO RETAIN
AND EVEN FILL THESE POSITIONS,
SO I MEAN, THAT'S ONE OF THE
THINGS THAT COMES TO MY MIND
FROM THIS HEARING. IN TERMS OF
THE TOPICS THAT ARE APPARENTLY,
UM ON THE GREEN LIGHT LIST THAT
WE ARE BEING PERMITTED TO SPEAK
ABOUT. UM BUT AGAIN, MY KEEN
INTEREST AND THE INTEREST OF
MANY OTHER CALIFORNIA FOR
INDIANS WAS, UH, ITEM NUMBER 16
. SO I'M STILL TRYING TO FIGURE
OUT WHERE THAT WENT. WHY IT
WASN'T DISCUSSED. WHEN IT'S
COMING BACK. UM BUT I COULD
CONTINUE TO GO ON SINCE YOU'RE
LETTING ME SPEAK. WHAT I'VE ALSO
HEARD IN THIS HEARING IS MORE
FEARMONGERING. YOU WANT US TO BE
AFRAID OF ZIKA, YOU'RE ALREADY
TALKING ABOUT THE NEXT PANDEMIC
. YOU'VE MENTIONED EBOLA. YOU'VE
TALKED ABOUT MOSQUITOES, AND YOU
KNOW, IT'S BECOME PRETTY CLEAR
TO MANY OF US IN CALIFORNIA THAT
YOUR POSTURE IS JUST THAT IT'S
OF FEARMONGERING AND COERCION
AND REMOVING OUR RIGHTS FROM US
JUST LIKE THIS. CORRUPT
LEGISLATURE HAS DONE FOR THE
LAST TWO PLUS YEARS BEING THREE
PLUS YEARS THAT THAT WE'RE NOW
OFFICIALLY, I GUESS OUT OF THE
STATE OF EMERGENCY, BUT YOU
FOLKS PANDERED TO THIS GOVERNOR
FOR THREE YEARS. EVEN AS ONE OF
YOUR, YOU KNOW. LAWMAKERS SITS
UP THERE TALKING ABOUT WHAT
RIGHTS YOU'RE GOING TO TAKE FROM
US NEXT. WE'RE GONNA MOVE ON TO
LINE 44 LINE. 44 YEAR LINE IS
NOW OPEN. OPERATOR CAN I ASK YOU
NOT AFTERNOON, RONALD. JUST A
SECOND OPERATOR. I'D ASK YOU NOT
TO CUT OFF THOSE WHO ARE
PROVIDING PUBLIC COMMENT. I'M
HAPPY TO SAID AND RECEIVED THE
PUBLIC COMMENT. I WOULD INVITE
THOSE WHO ARE COMMENTING TO ALSO
FEEL FREE TO SUBMIT WRITTEN
TESTIMONY. IF YOU'RE UNABLE TO
PROVIDE YOUR COMMENTS TODAY, AND
FINALLY I'LL JUST REMIND THAT
YOU CAN COMMENT ON ANY OF THE
ISSUES THAT ARE IN THE AGENDA
TODAY, WHETHER THEY WERE
DISCUSSED OR ON THE NON
DISCUSSION PORTION OF THE AGENDA
, AND SO IF YOU WISH TO SPEAK TO
ANY OF THE ISSUES, PLEASE FEEL
FREE TO DO SO. NEXT CALLER,
PLEASE. THANK YOU, MR CHAIR. THE
PREVIOUS SPEAKER IS FREE TO QUÊ
BACK UP AGAIN BY PRESSING ONE
AND ZERO AGAIN IN 44 YEAR LINE
IS NOW OPEN. HMM GOOD EVENING,
RONALD. COMING BY WITH THE
CALIFORNIA PANELS AND NETWORK
DEPENDENT WHILE WE UNDERSTAND
LEGISLATORS MUST MAKE INCREDIBLY
DIFFICULT DECISIONS THIS YEAR,
GIVEN THE CONDITION OF OUR
FISCAL OUTLOOK, THE LEGISLATURE
TO ONCE AGAIN PRIORITIZED THE
CALIFORNIA EQUITY AND RACIAL
JUSTICE. FUN AS YOU KNOW, IT
WASN'T IN THE GOVERNOR'S BUDGET,
SO IT'S NOT PART OF THE
DISCUSSION TODAY, BUT IT IS A
CRITICAL MISSING PIECE TO
ENSURING A COMPREHENSIVE PUBLIC
HEALTH INFRASTRUCTURE TO ADDRESS
THE SOCIAL DETERMINANTS OF
HEALTH. TO FURTHER HELP AND
RACIAL EQUITY IN ORDER TO
IMPROVE COMMUNITY HEALTH
OUTCOMES. WE URGED THE
LEGISLATURE TO CREATE A PILOT
PROGRAM AND FUNDING THE HEALTH,
EQUITY AND RACIAL JUSTICE FUND
INITIALLY WITH $50 MILLION OVER
TWO YEARS. ADDITIONALLY WE URGED
THE LEGISLATURE TO REJECT THE
GOVERNOR'S PROPOSED $49.8
MILLION IN CUTS TO PUBLIC HERO
WORKFORCE DEVELOPMENT AND
TRAINING PROGRAMS AND TO SUSTAIN
ON THE $200 MILLION FOR PUBLIC
HEALTH INFRASTRUCTURE, BUT A
REMINDER THAT THE COMMUNITY
INVESTMENTS MATTER TO THANK QUÊ
THANK YOU. NEXT CALLER, PLEASE.
LINE 39. GOOD AFTERNOON. MY NAME
IS RACHEL BHAGWAT AND I HAVE THE
DEPUTY DIRECTOR OF THE
CALIFORNIA LIONS AND ACADEMICS
AND COMMUNITIES FOR PUBLIC
HEALTH EQUITY OR THE ALLIANCE AT
THE PUBLIC HEALTH INSTITUTE. I'M
HERE WE BRING TOGETHER AND
REPRESENT ACADEMIC EXPERTS,
UNIVERSITY PUBLIC HEALTH SCHOOLS
AND PROGRAMS ACROSS CALIFORNIA
IN PARTNERSHIP WITH COMMUNITY,
PUBLIC HEALTH LEADERS AND
PRACTITIONERS. YOU HEAR ABOUT
ISSUES 12 AND 13. THE ALLIANCE
STRONGLY OPPOSES THE PUBLIC
HEALTH WORKFORCE CUTS PROPOSED
IN THE GOVERNOR'S BUDGET THAT WE
URGED THE LEGISLATURE TO LEAD
THE STATE TOWARDS A DIFFERENT
SOLUTION THAT DOESN'T INCLUDE
THE 49.8. YOU KNOW CUTS. WE NEED
A STRONG, DIVERSE
REPRESENTATIVES, PUBLIC HEALTH
WORKFORCE AND PIPELINE PROGRAMS
, LIKE THOSE IMPACTED ARE
CRITICAL TO BUILDING A STEAMING
THAT WORKFORCE DURING THE
TESTIMONY THAT THE BUDGET CUTS
WOULD LEAD TO MANY OF THESE
PROGRAMS ENDING AT THE END OF
THE YEAR, DEEPLY DISTURBING, AND
IT'S THE OPPOSITE OF THE
DIRECTION. CALIFORNIA NEEDS TO
GO. AND ADDITION, CALIFORNIA
ALSO MUST STRENGTHEN THE
COMMUNITY BASED PUBLIC HEALTH
INFRASTRUCTURE, AND THAT MEANS
INVESTING IN COMMUNITY HEALTH
WORKERS FROM A TORY PEER
SPECIALISTS AND MORE. WE KNOW
THAT THESE FOLKS ARE THE PEOPLE
WHO ARE REACHING MANY OF OUR
HARDEST TO REACH COMMUNITIES,
BLACK BROWN WORLD AND OTHER
UNDERSERVED GROUPS, AND THEY'RE
INVESTING MEANING PIPELINE
PROGRAMS BUT ALSO VALUING THESE
WORKERS JUST AS HIGHLY AGREED
VALUE TRADITIONAL HEALTH
PROFESSIONS WITH SALARY, EQUITY
PATHWAYS TO LEADERSHIP AND
DEVELOPMENT, WORKER PROTECTIONS
AND MORE. THANK YOU. THANK YOU.
NEXT CALLER, PLEASE. LINE 38.
YOUR LINE IS NOW OPEN. HI I'M
CALLING FOR ISSUE NUMBER SEVEN.
MY NAME IS SCOTT SUK OH, AND THE
EXECUTIVE DIRECTOR OF THE LIVER
COALITION HERE IN SAN DIEGO,
CALIFORNIA. AND I'LL BE HAPPY TO
LIVER COALITION. I'M CALLING IN
SUPPORT OF THE $11 MILLION
REQUEST FOR ADULTS WITH SICKLE
CELL DISEASE, SICKLE CELL
DISEASE OR TREATMENT, INCLUDING
BLOOD TRANSFUSIONS CAN INCREASE
THE RISK OF LIVER DAMAGE FROM
IRON OVERLOAD IN HEPATITIS
DELIVER COALITION. THANKS. UM,
THE SEAVEY PH FOR THEIR PREVIOUS
SUPPORT AND DEDICATION OF THE $5
MILLION FOR THE CLINICS IN THE
LAST BUDGET CYCLE, AND WE ARE IN
SUPPORT OF THE ADDITIONAL 11
MILLION AND SUSTAINED FUNDING TO
ENSURE NOT WORKING CALIFORNIA
FOR SINGLE SELF CARE AND
CONTINUE IMPROVING HEALTH AND
OUTCOMES FOR ADULTS LIVING WITH
SICKLE CELL DISEASE BY ENSURING
LONG TERM STANDING WITHIN
CALLUM. UNDER DIETZ. YES THANK
YOU FOR ALLOWING ME TO SPACE
GEEK. THANK YOU. NEXT CALLER,
PLEASE. LINE. 43 YOUR LINUS NO
OPEN. HELLO CHAIR MEMBERS. THIS
IS AUTOMOBILE SMITH WITH THE
AMERICAN CANCER SOCIETY CANCER
ACTION NETWORK, AND I WANTED TO
SPEAK ON ISSUE NUMBER 22
REGARDING THE CALIFORNIA CANCER
DESERT REGISTRY AS YOU HEARD THE
CCR S AMBASSADOR DEPOSITORY OF
CANCER DATA THAT PROVIDES VITAL
INFORMATION THAT PUBLIC HEALTH
OFFICERS AND RESEARCHERS WITH
THIS DATA, IT IS POSSIBLE
DETERMINED CANCER, RESPECT,
EAR'S AND STUDY GROUPINGS OF
CANCERS AND COMMUNITIES. WITH
PROPER FUNDING. WE WILL BE ABLE
TO USE THIS DATA IN REAL TIME TO
CONNECT CANCER PATIENTS WITH
CLINICAL TRIALS. CCR IS THE TOP
IN THE NATION AND USED BY
RESEARCHERS WORLDWIDE, HOWEVER,
IN ORDER FOR OUR REGISTRY TO
SURVIVE AND CONTINUE, WE MUST
ENSURE THAT IS FULLY FUNDED.
THANK YOU SO MUCH. THANK YOU.
NEXT CALLER, PLEASE. LINE 48.
YOUR LINE IS NOW OPEN. THANK YOU
. CHAIR MEMBERS OF THE
COMMITTEE. MY NAME IS MATTHEW
MASUM WITH THE PUBLIC HEALTH
INSTITUTE. I'M HERE TO SPEAK
ABOUT BOTH ISSUE. 42 SORRY ISSUE
22 ISSUE 12 1ST REGARDING THE
CANCER REGISTRY. I ECHOED THE
REMARKS ALREADY BE MADE ON
BEHALF OF PUBLIC HEALTH
INSTITUTE. WE ARE IN STRONG
SUPPORT OF PROTECTING AND
MAINTAINING FUNDING FOR THE
CANCER REGISTRY. I THOUGHT THE
APPRECIATE GREATLY. THE COMMENTS
MADE BY MEMBERS OF THE COMMITTEE
EARLIER DURING THE ITEM WHEN IT
WAS HEARD, I WOULD JUST ECHO
THAT THE FLAT FUNDING THAT THEY
CAN THE REGISTRY HAS EXPERIENCED
NOW FOR A DECADE HAS CONTINUED
TO EXACERBATE THE IMPACT AND
THAT THE LOCAL REGIONS AND THE
STATE OF NOT ABLE TO MEET THEIR
COST YEAR REQUIREMENTS. AND WE
NEED TO DO EVERYTHING WE CAN TO
PROTECT THE CANCER REGISTRY, SO
WE LOOK FORWARD TO WORKING WITH
MEMBERS AND ALSO THE DEPARTMENT
AND THE ADMINISTRATION TO
PROTECT MONEY FOR CANCER
REGISTRY REGARDING ISSUE 12. I
ALSO JOIN OTHERS TODAY AND URGED
THE LEGISLATURE TO REJECT THE
CUTS. THAT WOULD ELIMINATE THE
INVESTMENTS IN PUBLIC HEALTH
WORKFORCE, THE COLLEAGUES AND
ADVOCATE SPOKE EARLIER ABOUT THE
NEED TO PROTECT FUNDING FOR
GOVERNMENTAL PUBLIC HEALTH. I
ALSO I ECHO THAT IT'S SO
IMPORTANT, BUT ALSO EMPHASIZED
THE NEED TO CONTINUE INVESTMENTS
IN COMMUNITY PUBLIC HEALTH. WE
ARE ALL PUBLIC CALCULATES. WE'VE
SEEN THROUGH THE PANDEMIC, THE
ROLE THAT COMMUNITY WORKFORCE
PLAY. IN REACHING THE HARDLY
REACHED IN THE HARDEST TO REACH
COMMUNITIES IS VITAL AND SO
ENSURING ONGOING INVESTMENTS TO
COMMUNITY BASED ORGANIZATIONS
FOR PUBLIC HEALTH WORKFORCE IS
CRITICAL, AND THAT'S WHY WE'RE
IN STRONG SUPPORT FOR THE HEALTH
EQUITY AND RECENT JUSTICE FUND.
THANK YOU VERY MUCH FOR THE
OPPORTUNITY TO SPEAK. THANK YOU.
NEXT CALLER, PLEASE. LINE 35.
YOUR LINE IS NO OPEN. GOOD
AFTERNOON CHAIR AND MEMBERS
KATHLEEN VERY AND THE UNIVERSITY
OF SOUTHERN CALIFORNIA. WE
APPRECIATE THE OPPORTUNITY TO
COMMENT ISSUE 22 ON THE
CALIFORNIA CANCER REGISTRY. I'D
LIKE TO ECHO THE COMMENTS MADE
BY MY COLLEAGUES AT THE AMERICAN
CANCER SOCIETY, CANCER ACTION
NETWORK AND THE PUBLIC HEALTH
INSTITUTE. USC IS ONE OF THE
THREE REGIONAL REGISTRIES THAT
WORKS DIRECTLY WITH THE CCR,
PROVIDING CRITICAL SUPPORT ON
LOCAL INSTANCES OF DISEASE. US
SUPPORTS ALL EFFORTS TO END
ONGOING SUPPORT FROM THE STATE
GENERAL FUND TO PROTECT THE
REGISTRY AND RESPECTFULLY
DISAGREES WITH ANY PROPOSED
CUTS. FUNDING WILL PROTECT AND
STRENGTHEN THE CANCER REGISTRY
AND HELP MAINTAIN ONGOING
FEDERAL FUNDING THAT'S VITAL TO
THE PROGRAMS ONGOING SURVIVAL.
USC LOOKS FORWARD TO CONTINUING
WORKING WITH THE LEGISLATURE,
DPH AND THE ADMINISTRATION ON
THIS IMPORTANT ISSUE. THANK YOU
. THANK YOU. NEXT CALLER,
PLEASE. LINE 13 YOUR ALIGN IS
NOW OPEN. THANK YOU. CHAIR AND
MEMBERS MADONNA FOR WITH POLICY
AND LEGISLATIVE AFFAIR MANAGER
THE CALIFORNIA BLACK HOUSE
NETWORK CALLING TO SPEAK ON TWO
ISSUES ON BEHALF OF THE BHN. I'M
CALLING IN SUPPORT OF THE $11
MILLION FUNDING REQUESTS FOR
CLINICS FOR ADULTS WITH SICKLE
CELL DISEASE. WE WOULD LIKE TO
THANK CD PH FOR PROVIDING $5
MILLION LAST YEAR TO SUSTAIN THE
INNOVATIVE NETWORK AND SUPPORT
IT $11 MILLION TO TRANSITION AND
NETWORKING CALIFORNIA FOR SICKLE
CELL CARE INTO THE UNDER CALLING
THIS NETWORKS DIRECTLY ADDRESS
HEALTH INEQUITIES BY PROVIDING
MORE ACCESS TO COMPREHENSIVE
CARE FOR ADULTS WITH SICKLE CELL
DISEASE. REGARDING THE HEALTH,
EQUITY AND ORIGINAL JUSTICE FUND
ON BEHALF OF TBH IN I'M CALLING
IN SUPPORT OF ESTABLISHING PILOT
PROJECT OF 50 MILLION OVER TWO
YEARS TO CREATE THE HEALTH AND
EQUITY RACIAL JUSTICE FUND TO
DIRECTLY FUND COMMUNITY BASED
ORGANIZATIONS, CLINICS AND
TRIBAL ORGANIZATIONS. THIS IS
PART OF THE COMPREHENSIVE
APPROACH TO ADDRESS THE SOCIAL
DETERMINANTS OF HEALTH. LOCAL
LEADERS KNOW THE NEEDS OF THE
NEIGHBORHOOD LEVEL THAT MAY NOT
SHOW UP IN THE STATE, COUNTY OR
HOSPITAL NEEDS ASSESSMENTS. BHN
URGE YOUR SUPPORT. THANK YOU FOR
YOUR TIME. THANK YOU. OPERATOR
BEFORE WE GO TO OUR NEXT CALL.
WE HAVE A FEW MORE PUBLIC
COMMENTS WHO ARE HERE IN THE
HEARING ROOM. WE'RE GOING TO
TAKE THOSE NEXT AND THEN WE WILL
RETURN TO PUBLIC COMMENT ON THE
PHONE. MR CHAIR. GOOD AFTERNOON
. I'M MARY BROWN ON THE
PRESIDENT'S CEO OF SICKLE CELL
DISEASE FOUNDATION AND COLLEAGUE
WITH DR DIANA JET FOR
NETWORKING, SICKLE CELL CARE.
THANK YOU FOR YOUR FUNDING
SUPPORT OF THE PAST FEW YEARS.
WE HOPE THAT YOU WILL CONTINUE
TO LET US MAINTAIN AND GROW
THESE CLINICS. THANK YOU SO
MUCH. THANK YOU. THANK YOU FOR
ALLOWING US TO TESTIFY ON BEHALF
OF THE 12 CLINICS THAT HAVE BEEN
DEVELOPED THANKS TO THE FUNDING
PROVIDED BY THE STATE BACK IN
2019 WERE ALREADY DEMONSTRATING
A SIGNIFICANT IMPACT ON LIFE
EXPECTANCY FOR SICKLE CELL
IMPROVED CARE, QUALITY WORKFORCE
EXPANSION AND EDUCATION OF OUR
YARDS AND HOSPITALIZATION, WITH
SIGNIFICANT COST SAVINGS THAT
HAVE BEEN DEMONSTRATED BY THE
CDC ALREADY. SO WE THANK YOU.
YOU FOR A WILLINGNESS TO
MAINTAIN. FUNDING THIS YEAR AND
HELP US TRANSITION TO CALAIS
MEAN THE PATH CITED PROGRAM,
WHICH IS WHAT WE'RE APPLYING FOR
NOW. SO THANK YOU VERY MUCH.
THANK YOU. OPERATOR WE WILL NOW
RETURN BACK TO THE FRONT LINES
FOR PUBLIC COMMENT. THANK YOU,
MR CHAIR AND AS A REMINDER, IF
YOU WISH TO SPEAK, PLEASE PRESS
ONE AND 00 2ND TIME WILL REMOVE
YOU FROM THE KILL WENT INTO YOUR
ONLY ONCE WE'RE GONNA GO TO LINE
36. THERE MY NAME IS MIKE, ONE
OF THE PEOPLE IN THE STATE OF
CALIFORNIA AND YOU GUYS ARE
SPENDING A LOT OF MONEY. UH UM.
AND THEN I FIND IT INTERESTING
THAT THE DOCTORS FOR THE
CALIFORNIA DEPARTMENT OF PUBLIC
HEALTH HAS BEEN STEPPING DOWN
AND NOT BEING REPLACED. I
COULDN'T THINK OF ANYTHING
THAT'S BETTER. BASED ON WHAT
HAPPENED IN SANTA CLARA COUNTY
WITH TERRACOTTA. HELP DIRECTOR
HERE AND OVER AND, UH SANTA CRUZ
COUNTY. WITH GAIL KNOW THESE
GUYS ARE. BYRON AND YOU GOT
FUNDING TYRANTS? UM PEOPLE DON'T
APPRECIATE IT BEING ONE OF THE
PEOPLE I CAN TELL YOU. THAT'S
THE TRUTH. AND ASKING FOR MORE
MONEY FOR MORE TYRANTS. I AGREE
THAT WE SHOULDN'T HAVE THAT
MONEY SO WAY TO GO ON THAT ONE.
AND AS FAR AS THE MOSQUITOES GO
YEAH. HOW ABOUT NOT RELEASING
GENETICALLY MODIFIED ANIMALS
INTO THE FREAKING ATMOSPHERE?
WITHOUT LETTING PEOPLE KNOW.
THAT EVERYTHING COULD CHANGE.
AND YOU MIGHT BE GETTING SOME
KIND OF DISEASES THAT YOU HAVE
NO IDEA ABOUT. NOBODY
UNDERSTANDS ANY OF THAT
TECHNOLOGY. OTHER THAN THAT,
HAVE A FABULOUS DAY, YOU KNOW,
KEEP DOING WHAT YOU'RE DOING
THAT'S CUTTING THE BUDGET. ALL
THE WAY DOWN TO ZERO TO GO.
THANK YOU. NEXT CALLER, PLEASE.
LINE 49. YOUR LINE IS NOW OPEN.
GOOD AFTERNOON COMMITTEE CHAIR
AND MEMBERS. MY NAME IS ANA
POSITIVE AND I'M CALLING ON
BEHALF OF THE PUBLIC HEALTH
INSTITUTE AND SUPPORT OF THE
CREATION OF A HEALTH, EQUITY AND
RACIAL JUSTICE FUND. ALONG WITH
OUR PARTNERS, WHICH WE HAVE
HEARD FROM TODAY. I AM JOINED BY
OVER 200 COMMUNITY ORGANIZATIONS
ACROSS THE STATE THAT SHARE OUR
DESIRE TO CREATE THIS ONE. WE
CALL UPON THE COMMITTEE TO
CREATE THE FUNDING LAW THIS
YEAR, ESPECIALLY GIVEN THE
CONVERSATIONS YOU'VE HAD TODAY
REGARDING RACISM AS A PUBLIC
HEALTH CRISIS AND THE IMPORTANCE
OF INVESTING IN PREVENTION. WITH
THE END OF PROGRAMS, WHICH IS
THE SUPPLEMENTAL NUTRITION
ASSISTANCE PROGRAM. WE EXPECT TO
SEE HEALTH DISPARITIES PERSIST
AND WORSEN FOR COMMUNITIES OF
COLOR. WE NEED TO RECOGNIZE AND
SUPPORT COMMUNITY ORGANIZATIONS
AS PART OF OUR PUBLIC HEALTH
SYSTEM. CBOS CAN BETTER ADDRESS
ISSUES THAT DRIVE ILLNESS LIKE
HEALTHY FOOD, ACCESS, VACCINE
HESITANCY OR COMMUNITY VIOLENCE.
RECOGNIZING THE FISCAL
CHALLENGES THIS YEAR, THE
REQUEST A SMALLER AMOUNT OF $50
MILLION OVER TWO YEARS FOR A
PILOT EFFORT THAT WILL SUPPORT
CBO CLINICS AND TRIBAL
ORGANIZATIONS TO ADDRESS THE
SOCIAL DETERMINANTS OF HEALTH
AND SYSTEMIC RACISM. PH I ALSO
SUPPORTS FUNDING FOR CALIFORNIA
CAN'T WAIT PRIORITIES. WE
RECOGNIZE THE DIFFICULT
BUDGETARY CONTEXT THAT YOU FIND
YOURSELF IN. BUT AS THE YEAR OF
THE ESTABLISHMENT OF THE HEALTH
, EQUITY AND RACIAL JUSTICE, ONE
OUR MOST VULNERABLE COMMUNITIES
FOR COUNTING ON YOU, THANK YOU
SO MUCH. THANK YOU. NEXT CALLER,
PLEASE. AND THIS IS THE FINAL
CALL. IF ANYONE HAS A COMMENT,
PLEASE PRESS ONE AND ZERO. MR
CHAIR. NO ONE ELSE HAS SIGNALED
THAT THEY WISH TO SPEAK. THANK
YOU, MR. OPERATOR I WILL TAKE
THAT AS THE CONCLUSION OF PUBLIC
COMMENT FOR TODAY. I WILL TAKE A
MOMENT TO THANK THE
ADMINISTRATION DOCTOR ARAGON.
DEPARTMENT OF FINANCE L. A. OH
ALL OF THE STAKEHOLDERS AND
PANELISTS. OUR COLLEAGUES WHO
WAS HERE, BUT MOST IMPORTANTLY,
I WANT TO THANK THE PUBLIC FOR
PARTICIPATING IN MAKING OUR
PROCESS BETTER. FINALLY I WOULD
LIKE TO THANK SERGEANTS AND THE
TECH AS WELL BEFORE WE CLOSE
TODAY'S HEARING OUT AND I WOULD
LIKE TO APPRECIATE ANDREA
MARGOLIS FOR CREATING ANOTHER
WONDERFUL AGENDA AND CREATING
THE DISCUSSION. TODAY WE ARE
ADJOURNED FOR THE NIGHT. HAVE A
GOOD NIGHT.