GOOD AFTERNOON. WANT TO
WELCOME EVERYBODY TO EMERGENCY
MANAGEMENT COMMITTEE,
ASSEMBLYMEMBER'S FREDDY
RODRIGUEZ, CHAIR OF EMERGENCY
MANAGER, EMERGENCY MANAGEMENT.
WELCOME TODAY'S HEARING. LET'S
TURN TODAY'S AGENDA AND REMIND
NUMBER ONE OF THE GROUND RULES
FOR TODAY'S HEARING. AS ALWAYS,
WE SEEK TO PROTECT THE RIGHTS OF
ALL WHO PARTICIPATE IN THE
LEGISLATIVE PROCESS SO THAT WE
CAN HAVE EFFECTIVE DELIBERATIONS
AND DECISIONS ON THE CRITICAL
ISSUES FACING CALIFORNIA. IN
ORDER TO FACILITATE THESE GOALS,
WE WILL NOT PERMIT CONDUCT THAT
DISRUPTS, DISTURBS OR OTHERWISE
IMPEDE THE ORDERLY CONDUCT OF
THE LEGISLATIVE PROCEEDINGS. AT
TODAY'S HEARING WILL TAKE PUBLIC
COMMENTS FROM THOSE IN THE ROOM
. MEMBERS OF THE PUBLIC MAY ALSO
SUBMIT TESTIMONY. THE COMMITTEE
AT A M DOT ASSEMBLY DOT C A DOT
GOV FIRST LET'S ESTABLISH A
QUORUM COMMITTEE SECRETARY, CAN
YOU PLEASE TAKE THE ROLL? OOH!
FRODRIGUEZ. RODRIGUEZ HERE,
WALDRON. WALDRON HERE. CURRY
CURRY HERE. ALVAREZ. ALVAREZ
HERE. CALDERON. DALLI DALLI
HERE. BROUGH. HAVING ESTABLISHED
A QUORUM. OUR NEXT ORDER OF
BUSINESS IS THE CONSENT
CALENDAR. THE FOLLOWING BILLS ON
OUR ON CONSENT. A B 296
RODRIGUEZ. THE MOTION IS DO PASS
THE COMMITTEE OF COMMUNICATIONS
AND CONVEYANCE. A B 781
MAIENSCHEIN. THE MOTION IS DUE
PASSED TO THE COMMITTEE ON
APPROPRIATIONS A B 8 13
RODRIGUEZ. THE MOTION IS DUE
PASS TO THE COMMITTEE ON
APPROPRIATIONS. DO I HAVE
EMOTION, A SECOND TO PROVE ITEMS
ON THE CONSENT. THE MOTION IS
SICK IS MOTION BY ALVAREZ,
SECOND BY DALI. SECRETARY PLEASE
CALL THERE ON THE MOTION TO
APPROVE THE CONSENT CALENDAR. ON
THE CONSENT CALENDAR. A B 2 96
RODRIGUEZ MOTION IS DUE PASS TO
COMMITTEE AND COMMUNICATIONS AND
CONVEYANCE. A B 7 81 MAIENSCHEIN
. THE MOTION IS DUE PASS TO
COMMITTEE ON APPROPRIATIONS ON
CONSENT. A B A. 13 RODRIGUEZ
MOTION IS DUE PATH TO COMMITTEE
ON APPROPRIATIONS AND CONCEPT.
RODRIGUEZ. AYE. RIGHT VERY GOOD.
ZAI WALDRON. WALDRON I AGUIRRE
CURRY CURRY. I ALVAREZ ALVAREZ.
I CALLED AROUND. CALLED AROUND I
DALLI DALLI. AYE, SHIAVO. VÚI.
CONSENT CALENDARS UP, BELIEVE
THEY'RE ALL OPEN FOR ANY
MEMBERS. SO WITH THAT I'LL WAIT
ONE MORE MINUTE. IF SOMEBODY
MEMBER FONG SHOWS UP, IF NOT,
I'LL GO AHEAD AND PRESENT ON MY
BILL COMING UP. BUT WITH THAT BY
CHAIR CAN YOU TAKE OVER? BEFORE
WE GO TO THAT. LET'S GO AHEAD
AND OPEN UP THE COURT THE ROLE
ON THE CONSENT CALENDAR
SECRETARY CALLED THE MISSING
MEMBERS. BUT WE ONLY WE DON'T WE
GOT NO DOUBT. GOOD. MARIE. YEAH,
THE PRISON.
THANK YOU. KEEP MISSING, CHEECH.
HMM?
OKAY? SO WHICH ONE OF YOU WERE
DOING 40. MR RODRIGUEZ. YOU CAN
BEGIN WHEN YOU'RE READY. THANK
YOU. CHAIR MEMBERS. I'M PLEASED
TO PRESENT A B 40 THIS AFTERNOON
, WHICH WILL REQUIRE THE
EMERGENCY MEDICAL SERVICE
AUTHORITY TO ADOPT EMERGENCY
REGULATIONS TO PREVENT THE LONG
OFFLOAD DELAYS TO ENSURE
AMBULANCES ARE BILL WOULD
RESPOND. 2911 CALLS FOR
EMERGENCY MEDICAL SERVICES. AS
SOMEONE WHO SPENT OVER 32 YEARS
WORKING AS A FIRST RESPONDER
EMERGENCY MEDICAL SERVICES
SYSTEM, ALL TOO FAMILIAR WITH
WALL TIMES. IN FACT, I'VE
PERSONALLY WAITED FOR OVER 12
HOURS OUT OF HOSPITAL. TO
TRANSFER A PATIENT. WHAT TIMES
ARE BAD FOR PATIENT CARE? WHILE
TIMES ARE BAD FOR THE M, T S AND
PARAMEDICS AND ALL FIRST
RESPONDERS? AND FOR NURSES AND
PHYSICIANS EXCESSIVE ALL TIMES
HAVE BEEN A PROBLEM FOR DECADES.
WHAT TIME'S OCCUR WHEN AN
AMBULANCE ARRIVES AT A HOSPITAL
AND IS FORCED TO WAIT FOR THE
HOSPITAL TO ASSUME
RESPONSIBILITY OF CARE FOR THE
PATIENT. NOT ONLY DO WHAT TIMES
RESENT AN ULTIMATE ULTIMATELY
CARE AND TIMELY CARE FOR
PATIENTS EXPERIENCE IN EMERGENCY
, BUT IT PREVENTS FIRST
RESPONDERS AND PARAMEDICS FROM
RESPOND TO OTHER EMERGENCIES.
LAST YEAR, THIS COMMITTEE HELD
AN OVERSIGHT HEARING ALWA TIMES.
A REPRESENTATIVE FROM SACRAMENTO
FIRE DEPARTMENT TESTIFIED ABOUT
AN INCIDENT WHERE A FIRE
DEPARTMENT PARAMEDIC WAS
PERFORMING CPR ON A PATIENT WITH
TWO AMBULANCES AT A HOSPITAL
AROUND THE CORNER, WAITING TO
TRANSFER PATIENT CARE FOR MORE
THAN AN HOUR. THE FIRE
DEPARTMENT ULTIMATELY NEEDED
NUMBERS FROM A NEIGHBORING
JURISDICTION TO RESPOND FROM
EIGHT MILES AWAY. AND THREE
CITIES OVER BECAUSE OTHER
RESEARCH WEREN'T AVAILABLE. THE
AMBULANCE SENT TO THE SCENE WAS
THE 20TH PICK IN TERMS OF
DISTANCE, BUT WAS THE CLOSEST
AVAILABLE RESOURCE. THIS IS
UNACCEPTABLE. CONVENED A WARTIME
TASK FORCE IN NOVEMBER. 2021. IN
JUNE OF 2020. THE IMSA WARTIME
TASK FORCE VOTED ON 19
RECOMMENDATIONS TO MITIGATE
AMBULANCE PATIENT OFFLOAD
DELAYS. THIS BILL WILL CODIFY
SOME OF THE MOST IMPORTANT
IMPACTS SUCH AS A PUBLIC
EDUCATION CAMPAIGN FOR PROPER
USE OF 911 AND DEVELOPING A
STATEWIDE STANDARD OF 20 MINUTES
. 90% OF THE TIME FOR AMBULANCE
PATIENT OFFLOAD TIMES WITH THAT
, LET ME TURN IT OVER TO MY
WITNESSES AND SUPPORT CAPTAIN
SEAN BURROUGHS, ALAMEDA COUNTY
FIRE DEPARTMENT AND PRESIDENT OF
THE ALAMEDA FIREFIGHTERS AND
BATTALION CHIEF MATT COLE.
SACRAMENTAL FIRE OR METROPOLITAN
FIRE DEPARTMENT AND VICE
PRESIDENT OF THE SACRAMENTO
FIREFIGHTERS. GOOD AFTERNOON.
MEMBERS OF THE COMMITTEE. MY
NAME IS SEAN BURROUGHS. I'M A 27
YEAR VETERAN OF THE FIRE SERVICE
AND SERVE AS A FIRE CAPTAIN AND
PARAMEDIC FOR THE ALAMEDA COUNTY
FIRE DEPARTMENT AND ALSO SERVED
AS PRESIDENT OF ALAMEDA COUNTY
FIREFIGHTERS. LOCAL 55.
AMBULANCE PATIENT, OFFLOAD TIME
OR WALL TIME CONTINUE CONTINUES
TO GROW, AND FIREFIGHTERS
THROUGHOUT THE STATE ARE BEING
PUSHED TO THE BRINK. FROM A
FIREFIGHTER PERSPECTIVE, THERE
ARE TWO MEASURABLE AND CRITICAL
IMPACTS TO PATIENT CARE AND
PUBLIC SAFETY THAT I AM
EXPERIENCING, AND I KNOW IT'S
BEING EXPERIENCED ACROSS THE
STATE. FIRST PARAMEDICS ARE
STUCK ON THE WALL AT HOSPITAL
EMERGENCY DEPARTMENTS. NOT ONLY
IS THIS DELAYING A PATIENT FROM
GETTING CARE AT THE HOSPITAL BUT
TAKES CRITICAL 911 RESOURCES OUT
OF THE FIELD. SECOND THERE'S A
DOWNSTREAM IMPACT FOR OUR
FIREFIGHTER. PARAMEDICS. BURN
ENGINES ARE CONSISTENTLY WAITING
ON SCENE FOR AN AMBULANCE. TO
RIDE BECAUSE ZERO AMBULANCES ARE
AVAILABLE IN OUR SYSTEM.
RECENTLY IN ALAMEDA COUNTY FIRE
ENGINE WAITED ON SCENE WITH A
PATIENT. FOR NEARLY 90 MINUTES
BECAUSE THERE WERE NO AVAILABLE
AMBULANCES NOT ONLY IS THE
PATIENT IMPACTED BY NOT
RECEIVING TIMELY EMERGENCY
SERVICES. THE FIRE ENGINE IS
UNABLE TO RESPOND TO ANY
ADDITIONAL INCIDENTS IN OUR
RESPONSE AREA. THESE DELAYS ARE
NOT ONE OFFS OR ANOMALIES. THEY
OCCUR DAILY AND THROUGHOUT THE
STATE. MAYBE 40 WILL DIRECT THE
M S AUTHORITY TO ENHANCE DATA
COLLECTION ESTABLISHED A
STATEWIDE STANDARD AND MOBILE
CAR HOSPITALS TO DEVELOP
PROTOCOLS TO PRODUCE WALL TIMES.
IF THEY EXCEED A STATEWIDE
STANDARD. REDUCING WALL TIMES
DIRECTLY BENEFITS THE PATIENT
AND OUR RESIDENTS. WOULD YOU
WANT YOUR LOVED ONE TO BE
WAITING FOR HOURS AT THE
EMERGENCY DEPARTMENT AFTER BEING
TRANSPORTED BY AN AMBULANCE? OR
COULD YOU IMAGINE EXPERIENCING A
MEDICAL EMERGENCY AND HAVING TO
WAIT? FOR AN AMBULANCE TO ARRIVE
BECAUSE ALL RESOURCES ARE TIED
UP ON THE WALL. NÓ CALIFORNIAN
SHOULD HAVE TO EXPERIENCE A
DELAY IN EMERGENCY MEDICAL CARE
. AND FOR THESE REASONS, WE
RESPECTFULLY ASK FOR YOUR
SUPPORT FOR A B 40. THANK YOU.
MM. GOOD AFTERNOON MEMBERS OF
THE COMMITTEE. MY NAME IS MATT
COLE, AND I ALSO AM A 27 YEAR
VETERAN OF THE FIRE SERVICE AND
CURRENTLY SERVES AS A BATTALION
CHIEF. FOR THE SACRAMENTO
METROPOLITAN FIRE DISTRICT AND
VICE PRESIDENT OF THE SACRAMENTO
AREA FIREFIGHTERS LOCAL 5 22.
THE FIRE SERVICE HAS WORKED FOR
YEARS TO TRY TO DRIVE SOLUTIONS
TO HELP ALLEVIATE AMBULANCE,
AMBULANCE PATIENT OFFLOAD TIME,
INCLUDING MEASURES TO ENHANCE
DATA COLLECTION AND COMMUNITY
PARA MEDICINE. AS A BATTALION
CHIEF IN THE SACRAMENTO AREA. I
HAVE SEVEN TRANSPORTING UNITS
THAT ARE ASSIGNED TO MY
BATTALION. AND UNFORTUNATELY
MORE TIMES THAN I CAN COUNT. I
HAVE HAD ZERO AVAILABLE. HMM NOT
ONLY DOES THIS CAUSE OUR FIRST
RESPONDERS TO REMAIN ON AN
EMERGENCY SCENE WITH NO WAY TO
HELP A PERSON GET TO THE
HOSPITAL, BUT IT ALSO MEANS THAT
THOSE SAME FIRST RESPONDERS ARE
NOT AVAILABLE TO ANSWER THE NEXT
CALL FOR HELP. NUMEROUS TIMES I
HAVE SHOWN UP AT HOSPITALS TO
FEED CREWS THAT HAVE BEEN ON THE
WALL FOR HOURS OR TO TRY TO
ENCOURAGE SOME SORT OF MOVEMENT
TO GET WRECKED RIGS BACK INTO
THE SYSTEM, ONLY TO FIND THAT
THERE ARE EMPTY BEDS THAT ARE
PATIENTS COULD BE MOVED TO YOU
CAN IMAGINE HOW FRUSTRATING THIS
MUST BE FOR ME WHEN MY SOUL
CHARTER IS TO ENSURE MY CREWS
ARE OUT THERE, ANSWERING THE
CALLS FOR HELP. MY FRUSTRATION,
HOWEVER, IS NOT WITH THE NURSES
OR DOCTORS. THEY ARE OUR
PARTNERS IN CARING FOR THE
COMMUNITY. THEIR JOB IS CLINICAL
CARE, AND OURS IS PRE HOSPITAL
CARE. BUT WHEN THE MANAGEMENT
TEAMS OF THESE HOSPITALS REFUSED
TO PROVIDE ENOUGH EQUIPMENT OR
STAFF, ARE TAXPAYERS END UP
SUPPLEMENTING THESE PRIVATE
HOSPITALS WITH PUBLIC SAFETY
PERSONNEL THAT SHOULD BE
PROVIDING PRE HOSPITAL CARE?
THIS BILL IS AN IMPORTANT STEP
TO ENSURE THAT THERE IS HOSPITAL
ACCOUNTABILITY. WE DO. OUR JOB
OF EQUIPPING AND STAFFING OUR
FIREFIGHTERS TO TRIAGE TREAT AND
THEN TRANSPORT OUR PATIENTS TO
THE HOSPITAL. IT'S THE HOSPITALS
TURN TO ENSURE THAT THEY ARE
EQUIPPED TO DO THEIRS. YOUR
CONSTITUENTS FUND OUR SERVICES,
AND THEY EXPECT THEIR EMERGENCY
RESPONSE SYSTEM THE ENTIRE
SYSTEM. TO BE EFFICIENT AND
EFFECTIVE. FIREFIGHTERS SERVING
AS DE FACTO STAFF OF AN
EMERGENCY DEPARTMENT. WHILE
PATIENT IS WAITING FOR CARE IS
NOT AN EFFECTIVE OR EFFICIENT
SYSTEM, AND WE NEED TO WORK TO
ADDRESS THIS ISSUE. FOR ALL
THESE REASONS, WE RESPECTFULLY
REQUEST YOUR SUPPORT OF A B 40.
THANK YOU. THANK YOU ARE THERE
OTHER WITNESSES AND SUPPORT NAME
ORGANIZATION POSITION ONLY
PLEASE. THANK YOU, MADAM VICE
CHAIRMAN MEMBERS, DOUG SUPERS ON
BEHALF OF THE CALIFORNIA
PROFESSIONAL FIREFIGHTERS AND
STRONG SUPPORT. GOOD AFTERNOON
CHAIR MEMBERS JANICE SOMALI
AMERICAN FEDERATION OF STATE
COUNTY MUNICIPAL EMPLOYEES HERE
REPRESENTING LOCAL FOR 911 HOUR
. PARAMEDICS NURSES AND
DISPATCHERS AND SUPPORTIVE BABY
40. THANK YOU. REMEMBER NICK
ROMAN BEHALF OF THE LEAGUE OF
CALIFORNIA CITIES AND SUPPORT.
THANK YOU. WE'LL CALL FOR
WITNESSES IN OPPOSITION. COME
FORWARD, PLEASE. LATIFA
ALEXANDER WITH THE ASSOCIATION
OF CALIFORNIA HEALTHCARE
DISTRICTS WERE NOT OPPOSED. BUT
WE DO HAVE CONCERNS WITH THE
BILL, AND WE LOOK FORWARD TO
WORKING WITH THE AUTHOR'S
OFFICE. THANK YOU.
GOOD AFTERNOON SHARE. RODRIGUEZ
VICE CHAIR WALDRON AND COMMITTEE
MEMBERS. MY NAME IS ROSE
COLANGELO I'M DIRECTOR OF
EMERGENCY SERVICES FOR SUTTER
HEALTH, AS WELL AS THE CHAIR FOR
SETTER SYSTEM WIDE APART.
COMMITTEE FOR ALL 21 EMERGENCY
DEPARTMENT. I'VE BEEN EMERGENCY
DEPARTMENT RN FOR 19 YEARS HAVE
BEEN IN THE LEADERSHIP FOR 12
YEARS. THERE IS NO GREATER
PRIORITY FOR ME AND MY EMERGENCY
DEPARTMENT AND THE SAFETY OF OUR
PATIENTS. AND WHILE WE AGREE
THAT A PRODUCT DELAYS OR A
PROBLEM AND SUPPORT MANY OF THE
PROVISIONS IN A B 40 CENTER,
HEALTH AND MORE THAN 20 OF OUR
EMERGENCY DEPARTMENTS ARE
OPPOSED TO MAYBE 40 UNLESS IT IS
AMENDED TO REMOVE THE STATEWIDE
20 MINUTE AMBULANCE PATIENT,
OFFLOAD TIME AND MAKE IT MORE OF
A COLLABORATIVE APPROACH TO
REDUCING OFFLOAD DELAYS. THERE'S
A LACK OF ACCESS TO PRIMARY AND
SPECIALTY CARE, RESULTING IN AN
INCREASE OF 13% PATIENT VOLUME
FOR ETCETERA ROOSEVELT 2022, FOR
EXAMPLE, 45 OF OUR 68 BEDS HAVE
PATIENTS AWAITING TRANSFER TO
THEIR NEXT LEVEL OF CARE,
LEAVING US 23 BEDS. TWO C 300
NEW PATIENTS EXPECTED TO ARRIVE
AT THE DOOR. IF WE CANNOT GET
PATIENTS OUT THE BACK DOOR MAKES
IT DIFFICULT TO GET PATIENTS IN
THE FRONT DOOR. LAST YEAR ALONE
, WE HIRED 143 ADDITIONAL STAFF
IN THE E D. WE EXPANDED OUR
DEPARTMENT FROM 38 68 BEDS IN
2020. STILL, WE CAN'T CANNOT
KEEP UP WITH THE UNPRECEDENTED
VOLUME GROWTH. IF WE TRULY WANT
TO REDUCE THE WAYS IT WILL TAKE
A COLLABORATIVE APPROACH BETWEEN
HOSPITALS, FIRE AMBULANCE, LIM
SAYS, AND OTHERS TO GET TO THE
ROOT CAUSE OF THESE DELAYS,
SIMPLY SAYING A 20 MINUTE
STANDARD WITHOUT ADDRESSING THE
SYSTEMIC CHANGES THAT ARE
CAUSING DELAYS WILL NOT SOLVE
THE PROBLEM. AS AN EXAMPLE OF
WORKING COLLABORATIVELY TO
ROOSEVELT WORKED WITH OUR LAMPS,
A SACK SIERRA VALLEY FIRE AND
AMBULANCE FOR MANY MONTHS AFTER
DELAYS BY CREATING A PARK
COMMITTEE DISTRICT, INTENSE WORK
TO REVIEW THE DATA AND HOLD BOTH
HOSPITAL AND THE EMS PROVIDERS
ACCOUNTABLE BY REPORTING
DISCREPANCIES IN REAL TIME FOR
FOLLOW UP WITH THE AGENCIES.
EVEN WITH ALL THIS WORK, WE'RE
STILL AT 32 MINUTES IN THE 90TH
PERCENTILE. COMMITTEE MEMBERS.
IT IS ALSO IMPORTANT TO
UNDERSTAND THAT THERE HAS BEEN
NO STUDY ON IT OR ANALYSIS ON MY
20 MINUTES WOULD BE THE
STATEWIDE STANDARD. EVERY PART
OF THE STATE IS SO DIFFERENT.
WHAT WORKS FOR RURAL COUNTY WILL
NOT WORK FOR URBAN AREAS OF THE
STATE LIKE LOS ANGELES OR EVEN
SACRAMENTO. ONE SIZE FITS ALL
APPROACH FROM THE ENTIRE STATE
IS JUST NOT APPROPRIATE. IT'S
ALSO IMPORTANT TO NOTE THE DATA
BEING REPORTED TO AMSA TO TRACK
A PART TIMES IS UNRELIABLE. WHEN
HOSPITALS CONDUCT OUR OWN AUDITS
. WE FIND DISCREPANCIES, SUCH AS
DIFFERING TRANSFER OF CARE TIMES
UP TO 90 MINUTES AND EVEN A POT
RECORDED TIMES FOR PATIENTS THAT
WERE NEVER TRANSPORTED TO OUR
HOSPITAL. IT IS CRITICAL
IMPORTANCE THAT HOSPITALS HAVE
THE OPPORTUNITY TO VALIDATE THE
DATA BECAUSE DATA DRIVES CHANGE.
BEFORE WE CAN EVEN LOOK AT
SAYING A STATEWIDE STANDARD. WE
MUST HAVE ACCURATE DATA TO TRACK
OFFLOAD TIMES. THANK YOU. GOOD
AFTERNOON, MADAM CHAIR AND
MEMBERS OF BETSY ARMSTRONG WITH
THE COUNTY HEALTH EXECUTIVES
ASSOCIATION. BUT HERE TODAY ON
BEHALF OF THE E M S
ADMINISTRATORS ASSOCIATION OF
CALIFORNIA BACK IS NOT OPPOSED
TO THE BILL. HOWEVER THEY DO
HAVE SOME CONCERNS WITH SEVERAL
PROVISIONS OF THE BILL. A POD IS
A COMPLEX ISSUE AND INVOLVES
MANY STAKEHOLDERS, INCLUDING
HOSPITALS, EMS PROVIDERS,
REGULATORY AGENCIES, SUCH AS
LIMBS IS THE AMS AUTHORITY AND
CITY PH, AMONG OTHERS, AND
APPRECIATES THE AUTHORS EFFORTS
TO ADDRESS THIS PROBLEM, BUT ANY
SOLUTION MUST INCLUDE ALL
STAKEHOLDERS TO ADDRESS THE
MULTIPLE FACTORS WE OUTLINED IN
OUR LETTER, CAUSING EXTENDED
WAITS FOR EMS PERSONNEL IN
EMERGENCY DEPARTMENTS.
FURTHERMORE WE WOULD LIKE TO
NOTE THAT COUNTIES ARE ALREADY
REQUIRED TO CREATE MEDICAL SURGE
PLANS THROUGH THEIR HOSPITAL
PREPAREDNESS PROGRAMS. SO WE ARE
UNCLEAR ON HOW THE REQUIREMENT
IN A B 40 DIFFERS FROM EXISTING
PLANNING PRACTICES. WE COMMIT TO
CONTINUING TO WORK WITH THE
CHAIR AND HIS STAFF, AND WE
APPRECIATE YOU LISTENING TO OUR
CONCERNS. THANK YOU. THANK YOU,
UH OTHER PERSONS IN OPPOSITION
NAME ORGANIZATION POSITION AND
OTHER MEMBERS POLIO ON BEHALF OF
THE SOLANO COUNTY BOARD OF
SUPERVISORS. THEY ARE OPPOSED TO
THE BILL. AND THEY URGE YOUR OR
YOUR NOTEBOOK. EXCUSE ME. GOOD
AFTERNOON, VANESSA GONZALEZ WITH
THE CALIFORNIA HOSPITAL
ASSOCIATION, AND WE WOULD ALIGN
OUR COMMENTS WITH THOSE OF MS
COLANGELO'S FROM SET HER HEALTH
. WE ARE OPPOSED TO THE 40
UNLESS IT IS AMENDED TO REMOVE
THE STATEWIDE 20 MINUTES
STANDARD AND TAKE SOME MORE
COLLABORATIVE APPROACH TO
ADDRESSING THE SYSTEMIC
CHALLENGES THAT OUR EMERGENCY OR
E. M S SYSTEM BASED. THANK YOU.
SO MY IN THE HAIR ON BEHALF OF
THE MEMORIAL CARE HEALTH SYSTEMS
. WE ALSO HAVE AN OPPOSED UNLESS
AMENDED POSITION ON THE BILL.
THANK YOU. GOOD AFTERNOON, MADAM
CHAIR AND COMMITTEE MEMBERS.
JONATHAN CLAIM BAFTA SCRIPTS.
HEALTH ALSO OPPOSED UNLESS
AMENDED. GOOD AFTERNOON, MADAM
CHAIR AND MEMBERS CONNIE DELGADO
ON BEHALF OF THE 5000 EMERGENCY
NURSES IN THE CALIFORNIA
EMERGENCY NURSES ASSOCIATION
WITH AN OPPOSING LESS AMENDED
POSITION. GOOD AFTERNOON, MEGAN
LOOPER ON BEHALF OF THE UNITED
HOSPITAL ASSOCIATION, ALSO WITH
AN OPPOSING LESS AMENDED
POSITION. LISTEN, REMY ON BEHALF
OF KAISER PERMANENTE, ALSO WITH
AN OPPOSED UNLESS AMENDED
POSITION. THANK YOU SEEING NO
OTHER, UH, PERSONS IN OPPOSITION
. I'LL BRING HIM BACK TO THE
COMMITTEE FOR QUESTIONS,
COMMENTS. YES. THANK YOU. THANK
YOU, MADAM CHAIR. I HAVE A
QUESTION, I GUESS FOR
OPPOSITION. UM ARE THERE
DIFFERENT THRESHOLDS YOU BELIEVE
OR MORE ACHIEVABLE THAN THE 20
MINUTE 90% OF THE TIME THRESHOLD
IN THE BILL. THANK YOU FOR THAT
QUESTION AND SO WE DO FEEL THAT
LEAVING IT TO THE LAMB SAYS TO
WORK COLLABORATIVELY WITH THEIR
LOCAL HOSPITALS IS BETTER
OPPORTUNITY FOR THEM TO WORK ON
A NUMBER THAT WOULD BE WOULD
THEY COULD BE MORE SUCCESSFUL
ACT. SO FOR EXAMPLE, IN OUR
WHERE WE ARE AT CETA ROOSEVELT
AND PLASTER COUNTY WE THEY HAVE
A 20 MINUTE RIGHT NOW, BECAUSE
THAT WAS WHAT WHEN THE, UM SORRY
WHEN THE BOOK CAME OUT IN 2014 C
H AND M S WORK TOGETHER ON
TOOLKIT, AND THEY HAD A 15 TO 30
MINUTES, BUT THAT BOOK WAS FROM
2014. AND WHAT WE RECOMMEND IS
THAT WE LOOK AT THAT TOOL, CUT
AND SEE HOW WE CAN REVISIT IT
FROM 10 YEARS AGO. TO SEE HOW IT
HOW IT WOULD BE MORE APPLICABLE
TODAY TO TODAY, BUT LOOKING AT
THOSE TIMES, TOO, WE WORK SUPER
HARD AND DONE A LOT OF
COLLABORATIVE WORK WITH CETA
ROOSEVELT WITH PLASTER COUNTY
WITH SSV TO LOOK AT THOSE TIMES,
AND WE ARE CHALLENGED AT HITTING
THAT 20 MINUTES, EVEN DOING THAT
PIECE OF IT, BUT EACH HAMSA IN
COLLABORATION AND WORKING
TOGETHER I FEEL CAN ACHIEVE THAT
NUMBER THAT THEY THAT WOULD BE A
SUCCESSFUL NUMBER FOR THEM TO
ACHIEVE. OKAY. THANK YOU.
AGUIAR-CURRY. UM THANK YOU SO
MUCH. REMEMBER FOR BRINGING UP
THIS BILL FORWARD. AND YOU KNOW
THAT I ALWAYS SCARED AND WORRIED
ABOUT MY RURAL COMMUNITIES,
RIGHT? AND SO THE ONE SIZE FITS
SALT DOESN'T ALWAYS WORK.
HOWEVER UM IT'S ONLY FAIR THAT,
UM, WE SIT DOWN AND HAVE MORE
MITIGATION ON THIS BILL. I THINK
IT'S IMPORTANT PUBLIC SAFETY
ISSUES ADDRESSED HAS MULTIPLE
CONTRIBUTING PLAYERS. I'M GOING
TO SUPPORT YOUR BILL TODAY
BECAUSE I KNOW THAT YOU WILL
WORK HARD AND TRYING TO FIGURE
THIS OUT. I JUST DON'T WANT TO
BE LEFT BEHIND AND YOU'VE HEARD
THAT A MILLION TIMES FOR ME. SO
I'LL VOTE FOR YOUR BILL TODAY,
BUT EXPECT TO SEE SOME CHANGES
BEFORE IT HITS THE FLOOR. THANK
YOU VERY MUCH. MR ALVAREZ. THANK
YOU, MISS HOLLAND. FIRST OF ALL,
THANK YOU TO THE CHAIR FOR THE
BILL, AND I WANT TO THANK THE,
UM ADVOCATES ON BOTH SIDES FOR
FIRST I SHOULD ACKNOWLEDGE THAT
COMING FROM NEITHER THE HOSPITAL
SETTING OR FROM THE EMERGENCY
EMERGENCY MANAGEMENT, UH
SYSTEMS. I AM BEING EDUCATED ON
WHAT THIS BILL IS ATTEMPTING TO
DO. AND I THINK WHAT REALLY KIND
OF STANDS OUT TO ME IS THAT AH!
EVEN THOUGH THERE'S TWO SIDES TO
THIS DISCUSSION, LIKE EVERYBODY
WANTS TO GET TO THE SAME THING,
SO IT'S LIKE IT MAKES IT EVEN
MORE COMPLICATED, AND THAT'S
CERTAINLY THE INTENT OF OUR
CHAIR, WHICH IS TO PROVIDE
BETTER QUALITY CARE FOR PEOPLE,
AND THAT'S REALLY WHAT IT SHOULD
ALWAYS BE ABOUT. AND I WANT TO
ACKNOWLEDGE THAT UM I HAVE TWO
QUESTIONS THAT ARE KIND OF BASIC
AND REALLY, FOR ANYBODY TO
ANSWER FEELS COMFORTABLE
ANSWERING. ONE IS ON THE 20
MINUTES STANDARD. JUST JUST
CURIOUS. AND MAYBE THERE'S TWO
DIFFERENT POSITIONS UPON OUR
VIEWS ON THIS. IS THAT A IS
THERE A DIFFERENT STANDARD AND
OTHER STATES? IS THERE A
STANDARD IN THE INDUSTRY? UM,
I'M JUST CURIOUS. HOW DOES THIS
COMPARE TO OTHER STANDARDS AND
AGAIN? BOTH SIDES. YEAH. THANK
YOU ASSEMBLYMEMBER'S DUCK SUPERS
ON BEHALF OF THE CALIFORNIA
PROFESSIONAL FIREFIGHTERS, UM,
THERE ARE DIFFERENT STANDARDS
WITHIN THE STATE AND DIFFERENT
LOCALLY. M S AGENCIES. THERE ARE
SEVERAL LOCAL EMS AGENCIES THAT
HAVE INDICATED THAT 20 MINUTES
STANDARD AS LONG AS AS WELL AS
THE STATE EMERGENCY MEDICAL
SERVICES AUTHORITY THAT THE
ASSEMBLYMEMBER'S REFERENCED IN
HIS OPENING, BUT DO RECOGNIZE
THAT THERE ARE OTHER LENSES THAT
HAVE 25 MINUTES AND 30 MINUTES
STANDARDS. I THINK FROM THE CPS
PERSPECTIVE, UM ARE MEMBERS
OFTEN HAVE TO BE ON SCENE IN
LESS THAN EIGHT. MINUTES AND TO
ARRIVE TO PROVIDE PRE HOSPITAL
CARE FOR SOMEONE WHO CALLS 911.
AND SO FROM THAT PERSPECTIVE,
YOU KNOW, WE THINK 20 MINUTES IS
AN APPROPRIATE BALANCE. UM AND
IT DOES HAVE 20 MINUTES 90% OF
THE TIME TO ALLOW SOME
FLEXIBILITY FOR SITUATIONS IN
WHICH IT DOES GO OVER. THANK
YOU. AND I THINK YOUR QUESTION
TO LOOKING AT OTHER STATES AND
DOING SOME RESEARCH ON IT. THERE
ISN'T REALLY A STANDARD ACROSS
LIKE DIFFERENT STATES ACROSS OUR
STATE. WE DO HAVE THAT
VARIATION, BUT WE CAN LOOK AT MY
OUR EMERGENCY DEPARTMENT FOR THE
AMBULANCE BAY FOR TIRE ARRIVAL
UNTIL THEY GET TO THE TRIAGE
NURSES SEVEN MINUTES, SO THAT
GIVES OUR STAFF 13 MINUTES TO
TRY TO GET THE PATIENT CHECKED
IN. MAKE SURE THAT THEY CAN
VERIFY WHAT KIND OF BED THAT
PATIENTS GOING TO NEED ON
ARRIVAL AND THEN GET THEM TO
THAT BED AND TURNOVER OF CARE TO
OUR NURSE IN THAT FRAMEWORK. AND
SO THAT'S WHY LOOKING AT THE
DIFFERENT WORKING WITH THE
DIFFERENT LENSES INDEPENDENTLY
AT THE DIFFERENT SYSTEM SITES
WOULD WORK TO MAKE THAT
ACCOMMODATION. I MEAN, JUST MAKE
SURE I UNDERSTAND THAT
CORRECTLY. SO YOU'RE SHARING
WITH US THAT, UM THERE'S A
STANDARD OF 13 MINUTES ONCE
THERE'S AN ARRIVAL AT A HOSPITAL
TO VALUE EIGHT AND MAKE A
DECISION. I'M SORRY SO FROM SO
ONCE THEY ARRIVE INTO THE
PARKING LOT IN OUR AMBULANCE
BAIT USING OUR FACILITIES, AN
EXAMPLE SO ONCE THEY ARRIVE,
THAT'S THE ARRIVAL TIME, SO ONCE
THEY OFFLOAD THE PATIENT AND
BRING THE PATIENT IN TO GET TO
THE REGISTRATION AREA, IT COULD
TAKE THEM SEVEN MINUTES. SO THAT
WHEN YOU HAVE AN OFFLOAD TIME OF
20 MINUTES TOTAL THAT GIVES THE
HOSPITAL 13 MINUTES TO TRY TO
REGISTER THAT PATIENT AND THEN
FINDING APPROPRIATE BED TO PLACE
THEM IN. ARE THERE STANDARDS? UM
BASED ON TRIAGE IN TERMS OF
ACUITY OF CARE THAT ARE EITHER
NATIONAL STANDARDS OR NOT, OR
EXISTING STANDARDS. YES AND
THANK YOU FOR BRINGING THAT
FORWARD ALSO. SO WE HAVE IN THE
EMERGENCY DEPARTMENTS. WE USE
THE TRIAGE TOOL TO IDENTIFY
PATIENTS WHEN THEY'RE COMING IN,
AND IT'S CALLED THE ES. I'D
EMERGENCY SEVERITY INDEX AND SO
THAT WAY WE CAN TRIAGE PATIENTS
EITHER VERSUS WALKING IN OR
COMING IN BY AMBULANCE AND
DECIDE WHAT LEVEL THAT PATIENTS
AT TO DETERMINE WHO NEEDS THAT
APPROPRIATE CARE FIRST. AND SO
WE FOLLOW THAT SAME TRIAGE.
REGARDLESS WHETHER IT COMES,
SOMEBODY COMES IN BY AMBULANCE
OR BY OR WALKS IN THE DEPARTMENT
SO WE CAN TRIAGE THEM TO THE
MOST APPROPRIATE AREA AND TRIAGE
IN SAFELY TO MAKE SURE THAT
THEY'RE SEEN IN A TIMELY
FASHION. TO THE ISSUE OF THE 20
MINUTES. UM, WHAT IS THE PENALTY
IF YOU WILL. I DON'T THINK I
IDENTIFIED ANY AND MAYBE TO THE
PROPONENTS, UM PART OF THIS BILL
. WHAT IS THE PENALTY OF SOMEONE
DOESN'T MEET THAT STANDARD ON A
REGULAR BASIS, OR WHATEVER THE
90% OF THE TIME IS THE STANDARD.
IS THERE ANY PENALTY ASSOCIATED
WITH THAT? WELL I THINK THE WAY
THE MEASURE IS CONSTRUCTED IF
THE IF THE HOSPITAL ACUTE CARE
HOSPITAL THE EMERGENCY
DEPARTMENT EXCEEDS THE STANDARD
, THEY WOULD HAVE TO IMPLEMENT
THE PROTOCOL. UM THAT IS
REQUIRED IN SUBDIVISION OR
SECTION THREE OF THE BILL.
CERTAINLY AND THEN, IF THAT, UM
, PROTOCOL IF THE IF THERE WAS A
20 ACCIDENTS OF THE 20 MINUTE
STANDARD 90% OF THE TIME FOR A
MONTH. THEN UH, THE AMSA WOULD
NOTIFY THAT HOSPITAL AND THERE
WILL BE STEPS AND JUST TO SPEAK
TO COLLABORATION. IT WOULD
DIRECT. THE AMSTERDAM HOST
WEEKLY CALLS WITH THE RELEVANT
HOSPITAL ADMINISTRATION, EMS
PROVIDERS, LOCAL EMS AGENCY
HOSPITAL EMPLOYEES TO DISCUSS
IMPLEMENTATION OF THE PROTOCOL.
I THINK THE GOAL FROM OUR
PERSPECTIVE IS TO DRIVE
REDUCTIONS AND THESE AMBULANCE
PATIENT OFFLOAD TIMES TO MAKE
SURE OUR MEMBERS ARE BACK INTO
THE FIELD AND PROVIDING THAT PRE
HOSPITAL CARE. SO THAT'S AH, THE
MECHANISM THAT'S IN THE BILL.
CURRENTLY, THAT WOULD HAPPEN IF
A HOSPITAL WERE TO EXCEED THEIR
20 MINUTES. UM STANDARDS. ARE
YOU SAYING THAT IT'S NOT YOUR
EXPECTATION THAT THIS BILL WOULD
REQUIRE THE 20 MINUTES IT WOULD
JUST GET MONITORED. AND IF IT'S
IN EXCESS OF 20 MINUTES, THEN
YOU GO INTO A PROCESS OF
IMPROVEMENT BASICALLY. YES I
MEAN, IT ESTABLISHES A STATEWIDE
STANDARD. THAT IS THE STANDARD
THAT THE EXPECTATION IS THAT THE
HOSPITALS WOULD MEET THAT
TRANSFER OF CARE. BUT IF THEY DO
NOT MEET THAT STANDARD, THE WAY
THE BILL IS CONSTRUCTION
CONSTRUCTED, IT WOULD REQUIRE
THE HOSPITAL TO INITIATE THAT
PROTOCOL, WHICH THEY HAVE TO
COMPLETE UPFRONT, SO THE BILL
WOULD REQUIRE THEM TO COMPLETE
THEIR PROTOCOL, BUT IT WOULD BE
REQUIRED TO BE IMPLEMENTED IF
THEY EXCEEDED THAT TIMELINE FOR
A MONTH OR MORE. WHAT WOULD YOU
EXPECT THAT TO LOOK LIKE THEN?
REALLY IF BECAUSE I MEAN WE'RE
OVERHEARING FROM HOSPITALS IS
LIKE A LOT OF THEM AREN'T
MEETING THE 20 MINUTES JUST TO
BE VERY REALISTIC. UM SO WHAT
WOULD YOU EXPECT THEIR PLAN TO
DO THAT WOULD CHANGE THAT AND
GET US TO UH, UNDER 20 MINUTES
90% OF THE TIME. YEAH I THINK
FROM OUR PERSPECTIVE, THERE ARE
PLACES WHERE HOSPITALS CAN MAKE
INVESTMENTS TO, UM EFFICIENTLY
EXPEDITE THE TRANSFER OF CARE.
THEY COULD HAVE TRIAGE TEAMS ON
SITE AT THE HOSPITAL TO MEET
AMBULANCE CREWS WHEN THEY COME
IN THE DOOR TO TRIAGE THAT
PATIENT AND ACCEPT PATIENT CARE
IN THE ABSENCE OF SOME ACTION BY
THE HOSPITAL. OUR MEMBERS ARE
AND FIREFIGHTERS ARE OFTEN
WAITING TO TRANSFER THAT PATIENT
CARE AND OFTEN PROVIDING CARE
AND COMFORT SERVICES. AS YOU
HEARD, THE WITNESSES TESTIFIED
FOR SOMETIMES SEVERAL HOURS, AND
THAT PATIENT IS NOT GETTING
FOLLOW UP ON THAT. BUT WHAT IS
YOUR PERSPECTIVE? THE BILL
EITHER ONE OF YOU, UM ABOUT WHAT
THE LANGUAGE SAYS ABOUT IF THE
20 MINUTES STANDARD ISN'T MET
AND WHAT WOULD BE REQUIRED TO
DO? AND SO I THINK THAT THAT'S
BEEN VERY REACTIVE TO A PROBLEM
THAT WE NEED TO BE PROACTIVE
ABOUT. AND SO HAVING THE
COLLABORATION HAVING THE A PARK
COMMITTEES WITH OUR LAMB SAYS,
HAVING THINGS IN PLACE TO
ADDRESS SOME OF THOSE WE REDUCED
OUR TIMES FROM AN HOUR AND 40
MINUTES TO 32 MINUTES. AND THAT
WAS WITH COLLABORATION THAT
WASN'T HAPPENING. SO WE BROUGHT
THAT COLLABORATION TO THE TABLE
, AND WE'RE DOING THE SAME THING
WITH SACRAMENTO COUNTY RIGHT NOW
WITH ACROSS OUR SITE, SO IN OUR
20 SITES ACROSS CENTER ACROSS
THE BAY IN THE VALLEY. WE'RE
WORKING TOGETHER. WE CREATED A
SYSTEM WIDE A POT COMMITTEE AND
SO WE'RE WORKING IN TOGETHER TO
SHARE BEST PRACTICES ON WHAT'S
WORKING AT SOME SITES AND WHAT'S
NOT WORKING AT OTHER SITES. AND
HOW CAN WE HELP EACH OTHER SHARE
THOSE BEST PRACTICE TO IMPROVE
WHICH IS VERY PROACTIVE AND THEN
COLLABORATING AND BRINGING OUR
LUM SAYS, TOGETHER WITH OUR FIRE
AND E M S AGENCIES. TO MAKE SURE
WE'RE DOING REAL TIME DATA
EXCHANGE. WE STRUGGLE AT THE
HOSPITAL LEVEL TO TRY TO GET
THAT DATA AND DATA REALLY DRIVES
CHANGE IF WE COULD GET THE DATA
AND COLLABORATE WITH THE LAMB
SAYS I'M LOOKING AT THOSE TIMES
INSTEAD OF BEING REACTIVE. WE
COULD BE PROACTIVE. AND THEN
WHEN WE HAVE A SURGE, WE ALL
HAVE SURGE PLANS. YOU HEARD OUR
COUNTIES HAVE SURGED PLANS, BUT
WHEN WE HAVE A SURGE, THEN IT'S
REACTING TO I KNOW A NUMBER OF
PATIENTS COMING IN AT ONCE, BUT
WE SHOULD BE FOCUSING ON BEING
VERY PROACTIVE AND LOOKING AT
SOME OF THESE OTHER
OPPORTUNITIES THAT WE CAN WORK
ON TOGETHER. COLLABORATIVELY TO
TRY YOU STATING THAT YOU BELIEVE
THERE'S A WAY TO REDUCE EVEN
FURTHER YOUR WAIT TIMES, WHICH
YOU'VE ALREADY SAID WENT FROM
WELL OVER AN HOUR TO 30
SOMETHING MINUTES TO CLOSER TO
20 MINUTES. I THINK THAT'S IN
THE DATA COLLECTION. I THINK
THAT WE DON'T HAVE A GOOD TOOL
TO MEASURE THE ARRIVAL AND THE
TRANSFER OF CARE TIME WHICH
WE'RE WORKING ON ACROSS OUR
SITES FOR OUR 20, AND THEN NOT
ONLY JUST WORKING INTERNALLY
WITH SUTTER BUT WORKING ACROSS
DIFFERENT HEALTH CARE SYSTEMS
ACROSS THE STATES TO LOOK AT
WHAT THEY'RE USING, AND WHAT'S
WORKING AND NOT WORKING AND HAVE
THEN THEY CAN LOOK AT THEIR
LIMBS SAYS TO GET THAT DATA TO
MAKE SURE THAT WE'RE LOOKING AND
COMPARING APPLES, APPLES,
ORANGES TO ORANGES, SO THAT WAY
IT'S NOT. IT'S VERY LIKE I SAID
, DATA DRIVES CHANGE AND HAVING
THAT DATA UPFRONT. I CAN LOOK AT
YESTERDAY'S DATA AND SAY, OKAY,
THESE WERE THE BARRIERS. WE HAVE
A SYSTEM IN PLACE AT OUR SITE,
AND WE'VE SHARED IT ACROSS OUR
SYSTEM THAT WE'RE TRYING TO
IMPLEMENT IS WHEN WE GET AN
AMBULANCE CALL IF I AM I SEE AND
OUR MOBILE INTENSIVE CHRIST
NURSE THAT CAN'T HAVE A BED PLAN
FOR THAT PATIENT EITHER TRIAGE
OR A ROOM IF NEEDED. 20 MINUTES
THEY ESCALATE TO OUR CHARGE.
NURSE WHO, IF THEY CAN'T PLACE
THAT PATIENT, IT ESCALATES ALL
THE WAY TO ME. WE BARELY HIT AN
HOUR NOW. LAST MONTH, WE HAD 11
AMBULANCES THAT WERE THERE
GREATER THAN AN HOUR AND THE
ONLY IN THE WHEN WE PULLED THOSE
11 8 OF THEM. TWO OF THEM DIDN'T
EVEN COME TO OUR FACILITY. BUT
THAT A PART TIME WAS ON OUR
REPORT AND THE OTHER. THE OTHER
SIX OF THEM. THAT CAME WERE
PATIENTS THAT WOULD NEVER HAVE
WAITED BECAUSE THEY WERE EITHER
TRAUMAS OR C. P R. S. AND THEY
WERE IPOD TIMES IN 90 MINUTES,
WHICH DIDN'T HAPPEN. AND SO IT'S
HARD TO DRIVE CHANGE. WE DON'T
HAVE THAT DATA IN REAL TIME AND
WE CAN'T GET IT TILL WE
REQUESTED. OKAY I UNDERSTAND
DATA AS AN ISSUE OF LAST TWO
QUESTIONS ARE RELATED TO
POTENTIALLY, UM AH ITEMS. BUT
THAT CAN PROCESS CHANGES. I
COULD MAYBE CREATE EFFICIENCIES
, SCRIPTS HEALTH, WHICH IS ONE
OF THE PROVIDERS IN SAN DIEGO,
WROTE THAT AS AN EXAMPLE WHEN AN
AMBULANCE BRINGS A PATIENT TO
ONE OF THE EMERGENCY ROOMS THAT
IS LOW ACUITY, SO THE PERSON THE
AMBULANCES, LOW ACUITY AND DOES
NOT REQUIRE SUPERVISION, WHICH
HAPPENS OFTEN. WE QUICKLY CHECK
THAT PATIENT INTO OUR WAITING
ROOM. SHARP ALSO IN SAN DIEGO,
WROTE THAT 20% OF ARRIVALS INTO
SHARPS EMERGENCY DEPARTMENT UM
55% ARE LOWER ACUITY. I DON'T
KNOW WHETHER SHARP DOES THE
WAITING ROOM OR NOT, BUT IS THIS
A, UH A TACTIC OR SOMETHING THAT
IS MORE COMMON OR LESS COMMON?
THE IDEA OF REVIEWING ACUITY AND
PLACING THEM POTENTIALLY IN A
WAITING ROOM AS OPPOSED TO IN
THE EMERGENCY ROOM ON A BED. SO
FORTUNATELY, I ACTUALLY CAME
FROM SCRIPTS, SO I WAS DOWN
THERE. I WAS IN SOUTHERN
CALIFORNIA. ALSO AS I HAVE THE
STATEWIDE PERSPECTIVE, SO MANY
OF OUR FACILITIES THAT IS ONE OF
THE BEST PRACTICES THAT WE'RE
LOOKING AT ACROSS THE STATE TO
MAKE SURE THAT WE'RE ALL DOING
IT. WE SHOULD ALL BE DOING IT
THE SAME BUT AGAIN, MAKING SURE
THAT WE'RE STANDING NICE. THOSE
BEST PRACTICES ACROSS THE STATE
TO MAKE SURE THAT EVERY FACILITY
IS DOING IT IS ABSOLUTELY
SOMETHING THAT WE WANT AS A
STATE TO LOOK AT. HOW CAN WE
CREATE A PARK COMMITTEE? NOT
JUST AT OUR LOCAL LEVELS, BUT
THE STATE TO DO THAT EXACT
THING. SACRAMENTO ACTUALLY
INTRODUCED POLICY TO ENSURE THAT
THAT WAS HAPPENING ACROSS
SACRAMENTO, AND WE DID SOMETHING
WE'RE WORKING ON THAT. STILL AND
STILL DEVELOPING THAT PIECE OF X
OR SOME CHANGES WE NEED, BUT
ABSOLUTELY THAT SHOULD BE
HAPPENING. ALRIGHT I'LL END WITH
THAT. I'LL JUST RECOGNIZE THAT
THE WORK THAT THE CHAIR IS
TRYING TO DO IS TRYING TO DO
EXACTLY THAT WHICH IS TO REDUCE
WAIT TIMES AND GIVEN THAT
THERE'S STILL APPARENTLY, UM
SOME PRACTICES THAT ARE NOT
STANDARDIZED IN HOSPITALS. IT'S
WORTHWHILE FOR THAT DISCUSSION
ALONE IF THERE ARE GOOD
PRACTICES, BEST PRACTICES. UM I
WOULD HOPE THAT AS THIS BILL
MOVES FORWARD, WE CAN MAYBE
ADOPT SOME OF THOSE AS PART OF
THIS CONVERSATION. AND CERTAINLY
DATA COLLECTION TO BE ABLE TO BE
MORE PROACTIVE AS OPPOSED TO
REACTIVE. UM AS I STILL AM
GETTING MORE INFORMED WITH THE
WITH THIS TOPIC AND WANTING TO
SEE SOME OF THOSE PRACTICES
POTENTIALLY BE DISCUSSED. AS
PART OF THIS MOVING FORWARD. I'M
GOING TO ABSTAIN FROM VOTING
TODAY, BUT I WANT TO RECOGNIZE
THE WORK, PARTICULARLY THE CHAIR
IS DOING IN THIS REGARD AND HOPE
THAT WE CAN CONTINUE
CONVERSATIONS SO THAT I CAN
SUPPORT THIS AT THE NEXT. NEXT
STOP. THANK YOU. THERE ANY OTHER
COMMENTS QUESTIONS, MISS
DARLING. NO. I JUST WANTED. IS
IT ON? I JUST WANT TO KIND OF
ELABORATE FROM MY OWN PERSONAL
EXPERIENCES AS WE TALK ABOUT
MORE DATA IN THIS ISSUE
REGARDING A POD TIMES AND THE
FACT THAT I'VE BEEN TRYING TO
WORK WITH ALL THE STAKEHOLDERS,
PROBABLY PROBABLY THE LAST THREE
YEARS. AND THE FACT THAT THIS
ISN'T A NEW ISSUE THAT MAYBE
JUST CAME ABOUT BECAUSE OF THE
PANDEMIC THAT'S BEEN GOING FOR
DECADES. I CAN TELL YOU OVER 20
YEARS AGO, I PERSONALLY WAITED
12 HOURS IN THE EMERGENCY ROOM.
I DON'T THINK ANYBODY HERE OTHER
THAN THE FIREFIGHTERS BACK THERE
CAN TELL US WHAT THAT MEANS
STANDING AGAINST THE WALL FOR 12
HOURS, WAITING FOR A BED.
BECAUSE THE FACILITY I WENT TO
DIDN'T MAYBE HAVE APPROPRIATE
STAFFING OR THE BIDS. NGUYEN
VILLA NUMBER OF THINGS, SO THIS
ISN'T NEW TO ANYBODY. NOTHING
ANYBODY. WE'RE LIVING IN 2023
NOW, AND WE STILL HAVE NOT
SOLVED THIS ISSUE OTHER THAN
WANT MORE TIME, MORE DATA, OR WE
DON'T EVEN WANT TO TIME AT ALL
PERIOD BECAUSE LET US FIGURE IT
OUT. THAT MEANS IT'S NOT GOING
TO GET DONE IF THEY HAVEN'T DONE
IT 20 YEARS AGO WHAT INSURANCES
ARE GOING TO BE IN PLACE THAT'S
GOING TO GET DONE IN 30 DAYS,
SIX MONTHS A YEAR, THERE REALLY
ISN'T ANY INCENTIVE. IN THE
MEANTIME. WE'RE GETTING OUR
FIRST RESPONDERS STUCK IN A
WALL. WE HAVING DELAYED 911
RESPONSE TIMES AND NOT TO
MENTION I DON'T THINK THE
FIREFIGHTERS TALKED ABOUT IT,
BUT I THINK MAYBE THEY HAVE WHAT
DO WE DO WHEN OUR FIRST
RESPONDERS SHOWED UP ON SCENE OF
A MEDICAL EMERGENCY, AND THERE'S
NO AMBULANCE AVAILABLE BECAUSE
PART OF THE REASON IS THEY'RE
STUCK AT THE HOSPITAL. AND
WHAT'S THE WORST RESULT? THEY'RE
GOING TO PUT THAT PATIENT BACK
FRONT AND IN BACK OF A FIRE
ENGINE IN TRANSPORT TO A
HOSPITAL OR WORST CASE, A POLICE
CAR AND I'M SAYING POLICE CAR
BECAUSE NOT TOO NOT TOO LONG
AGO. MY SON IS A POLICE OFFICER
DOWN SOUTHERN CALIFORNIA AND HE
TOLD ME DAD ON A CALL. THEY WENT
TO NO AMBULANCE WERE AVAILABLE.
THEY HAD TO THROW A PATIENT IN
THE BACK SEAT OF A POLICE CAR.
TO DRIVE CO. THREE TO HOSPITAL
BECAUSE NO AMBULANCE WERE
AVAILABLE. AND ONCE AGAIN THIS
HAS BEEN GOING ON FOR DECADES.
IS THIS STILL THE THINGS WE'RE
GOING TO HAVE TO BE, UH,
RESPONSIBLE OUT THERE WHEN
PEOPLE ARE SUFFERING AND DYING,
AND FOLKS IN THE HOSPITALS ARE
GOING TO SAY WE NEED MORE TIME.
I'LL DO RESPECT TO OUR HOSPITAL.
FOLKS ARE DOCTORS OR NURSES OR
TECHNICIANS. THEY DO A GREAT
JOB, BUT I THINK NOW WE NEED TO
DO SOMETHING MORE CONCRETE. TO
MAKE SURE ALL OUR PATIENTS ARE
GETTING THEIR FAIR TREATMENT AND
CARE WHETHER IT'S A MOUNTAIN
EMERGENCY, ANONYMOUS URGENCY AND
REALLY GET OUR FIRST RESPONDERS
BACK OUT THERE TO PROVIDE
SERVICE TO THOSE CRITICAL
PATIENTS, AND IT'S GOING TO TAKE
SOME TIME. BUT I SAID, I'VE BEEN
ASKING FOR A TIME ASKING FOR
SOME ADDITIONAL LANGUAGE TO
ADDRESS THE ISSUE FOR OVER THREE
YEARS NOW AND GOING BACK TO ONCE
AGAIN. I HATE TO SAY IT. OVER
TWO DECADES, WAITING 12 HOURS IN
A HOSPITAL. WAITING ROOM IS
TOTALLY UNACCEPTABLE. THAT WAS
HALF OF MY SHIFT WORK 25 SHIFTS,
SO I JUST WANTED TO LEAVE THAT
ON OUT THERE, AND I KNOW
SOMEBODY HAD SOME OTHER
QUESTIONS. I THINK MORE OF JUST
A COMMENT. I THINK, UM, LIKE
COREY AND I BOTH HAVE THE SAME
LENS, WHICH IS OUR RURAL
HOSPITALS, AND, UM THEY'RE
CURRENTLY IN OPPOSITION. AND I
THINK WHAT I'M HEARING FROM THEM
IS STAFFING SHORTAGES WE DON'T
HAVE, UM, YOU ARE EVEN, YOU
KNOW, ER, DOCTORS THAT ARE
TRAVELING AND THAT'S A THAT'S A
REAL ISSUE FOR US. AND SO I ALSO
WANTED TO HAVE A LITTLE MORE
CLARITY ABOUT THE TRIAGING.
RIGHT? IF, UM PEOPLE ARE WALKING
INTO AN ER AND THEN I'M
CONCERNED THAT IF I AMBULANCE
SHOWS UP, YOU'RE GOING TO
PRIORITIZE THE AMBULANCE FOR THE
FEAR OF PENALTY. I UNDERSTAND
THAT THANK YOU FOR THE QUESTIONS
THAT THERE IS NOT CURRENTLY A
PENALTY. UM IN THIS BILL, BUT
OUR RURAL HOSPITALS ARE ON AND
I'M JUST SPEAKING ABOUT OUR
SMALL RURAL HOSPITALS THERE ON A
FINANCIAL COST. THEY REALLY ARE,
AND SO I THINK JUST THE FEAR OF
PENALTY IS ALSO WHERE IS DRIVING
PART OF A BIG PART OF THEIR
OPPOSITION. SO IF YOU COULD, AND
FOR ME PERSONALLY, I WANT TO
MAKE SURE THAT OUR PATIENTS
AREN'T AND I AM NOT IN THE
MEDICAL FIELD. I'VE LEARNED A
LOT THROUGH THIS WHOLE PROCESS.
UM BUT IF YOU WALK IN AND YOU'RE
HAVING A HEART ATTACK, BUT
SOMEONE TO DRIVE, YOU KNOW,
SHOWS UP WITH A SPRAINED ANKLE.
I JUST DON'T WANT I WANT TO MAKE
SURE THAT IN IN THAT WE'RE NOT,
UM THE PATIENT IN THE AMBULANCE.
GETS PRIORITY BECAUSE. OF FEAR
OF PENALTY. SO CAN MAYBE YOU
JUST TALK A LITTLE BIT MORE
ABOUT THE TRIAGE BECAUSE I DON'T
UNDERSTAND THAT PEACE. THANK
YOU. THANK YOU FOR BRINGING THAT
FORWARD. SO ON A DAILY BASIS, ON
AVERAGE, WE HAVE 300 PATIENTS
THAT WALK IN OR WE HAVE 300
PATIENTS THAT WILL SEE 70 OF
THOSE ARE BY AMBULANCE. WE
PRIORITIZE ALL PATIENTS,
REGARDLESS, WHETHER WE'RE BEING
FINED OR NOT. I'M A MEMBER OF
THE COMMUNITY, TOO, AND I WANT
911 TO BE AVAILABLE. FOR MY
FAMILY MEMBERS ALSO, BUT BEING
IN THE EMERGENCY DEPARTMENT, WE
MAKE SURE THAT WE'RE DOING THE
RIGHT THING FOR THE PATIENT, AND
THAT'S WHY IT'S SO IMPORTANT FOR
US TO WORK TOGETHER
COLLABORATIVELY BECAUSE WE ALL
HAVE THE SAME GOAL. WE'RE ALL
HERE TO ADVOCATE FOR PATIENTS
AND TO BE A RESOURCE FOR OUR
COMMUNITY. I DON'T WANT
AMBULANCES SITTING IN A HOSPITAL
FOR 12 HOURS. I DON'T WANT THEM
SITTING IN THERE FOR MORE THAN
30 MINUTES LIKE I WANT TO GET
THEM OUT. I WANT TO GET THEM OUT
SAFELY FOR THE PATIENTS AND MAKE
SURE THAT THOSE PATIENTS THAT
CHOSE NOT TO CALL 911 BECAUSE
SOMETIMES IT IS THOSE PATIENTS
THAT ARE MORE STUBBORN AND MIGHT
DRIVE THEMSELVES IN BECAUSE THEY
WAITED AND DIDN'T WANT TO CALL
911 ARE GETTING THAT PRIORITY,
TOO. SO ABSOLUTELY, REGARDLESS
OF WHAT HAPPENS, WE WILL ALWAYS
DO WHAT'S RIGHT FOR THE PATIENT
, WHICH I THINK IS WHAT WE'RE
ALL SAYING. AND WHY WE'RE THIS
IS ALSO IMPORTANT TO US AND WHY
WE'RE SO PASSIONATE ABOUT IT.
THANK YOU AND I'LL JUST SAY A
COMMENT MYSELF. UM WE ALL AGREE
IT'S UNACCEPTABLE THE WAY IT IS
RIGHT NOW, WITH PATIENTS
WAITING, SOMETIMES HOURS. UM
CERTAINLY OVER 40 MINUTES OF TO
90 AS WELL AS PARAMEDICS
STANDING ON THE WALL. UM
AFFECTING PUBLIC SAFETY, AND
THEY'RE NOT ABLE TO GET OUT
THERE AND HELP OTHER OTHER
PEOPLE AND RESPOND TO CALLS, SO
THIS IS A CRITICAL ISSUE. IT'S
BEEN MENTIONED. SAN DIEGO COUNTY
HAS 30 MINUTES. AMBULANCE
PATIENT OFFLOAD TÌM. THAT
THEY'RE WORKING WITH. UM BUT ONE
SIZE DOESN'T FIT ALL, UM
HOSPITALS ARE DIFFERENT.
SITUATIONS ARE DIFFERENT. UM.
HAVING THE LAMPS IS HAVE MORE
LOCAL CONTROL IS ALSO IMPORTANT
BECAUSE THEY KNOW WHAT'S GOING
ON IN THE LOCAL AREA. UM I'LL
I'M SUPPORTIVE OF THIS BILL
TODAY AND I WANT TO BE ABLE TO
SEE MORE INTERACTION AND MORE
WORK ON SOME OF THESE ISSUES. SO
THAT, UM AND WE'LL SEE IT A
COUPLE OF TIMES IN THE ASSEMBLY
FOR SURE. SO MY HOPE IS THAT
SOME OF THESE CRITICAL ISSUES
CAN BE WORKED OUT BECAUSE IT IS
AN IMPORTANT ISSUE. WE NEED TO
DEAL WITH IT. UM MR CHAIR. WOULD
YOU LIKE TO CLOSE WITH THAT SAID
I RESPECT TO ASK FOR I WILL.
THANK YOU. IS THERE A MOTION?
WHO HAVE EMOTION IN A SECOND.
WE DO HAVE TO PASS TO HEALTH
COMMITTEE IS THE MOTION. MADAM
SECRETARY, POLICE CALL A ROLE.
AND A B 40. THE MOTION IS DUE
PASS TO COMMITTEE ON HEALTH.
RODRIGUEZ RODRIGUEZ. AYE.
WALDRON WALDRON, I AGUIRRE
CURRY. AGUIAR-CURRY AYE ALVAREZ.
PALABRAS, NOT VOTING. CALDERON.
CALLED AROUND. I DALLI. TALLY,
NOT VOTING. BROUGH. VÚI. MM HMM
. BILLS 40.
GOOD GUY. WE HAVE THE MAN. YEAH,
WE'RE IT.
ALL RIGHT BEFORE YOU GO TO THE
NEXT BUILDING. SIMPLY MEMBER
PHªN JUST WANT TO MAKE THE
MOTION. THAT BILL IS OUT WITH
FIVE VOTES, OKAY? BILL IS OUT.
OKAY. NEXT. WE HAVE. WHERE WE
ARE. OKAY SEE, MR FUNK, PLEASE
PRESENT A B 6 19 WHEN YOU'RE
READY, SIR. GO AHEAD. THANK YOU,
MR CHAIR MEMBERS. CALIFORNIA
NONPROFITS ARE DEEPLY ENGAGED IN
OUR COMMUNITIES AND AS YOU ALL
KNOW THAT AND PROVIDE ESSENTIAL
SERVICES BOTH INDEPENDENTLY AND
THROUGH GOVERNMENT CONTRACTED
PROJECTS WHEN A STATE OF
EMERGENCY IS DECLARED NONPROFIT
TO CONTRACT WITH THE STATE DO
NOT HAVE THE FLEXIBILITY NEEDED
TO PIVOT TO HANDLE THE CRISIS
AND CONTINUE TO DELIVER CRITICAL
COMMUNITY BASED SERVICES. THIS
BILL WILL AFFORDING NONPROFITS
WHO HAVE STATE CONTRACTS, THE
ABILITY TO MODIFY PROGRAMS AND
PROGRAM BUDGETS TO FLEXIBLY
RESPOND TO IMMEDIATE NEEDS. AS
SEEN BY THE PROLIFIC RESPONSE
FROM NON PROFITS OVER THE LAST
COUPLE OF YEARS. THEY ASSIST THE
STATE'S BOOTS ON THE GROUND
RESPONSE TO EMERGENCY SITUATIONS
. UNFORTUNATELY THEIR COUNTRY
CONTRACTUAL BUDGET RESTRICTIONS
WITH THE STATE OFTEN LIMIT THEIR
ABILITY TO ADEQUATE ADEQUATELY
ADAPT TO FIT THE NEEDS OF AN
UNPREDICTABLE SITUATION.
CONTRACT MODIFICATIONS CAN TAKE
MANY MONTHS. NONPROFITS NEED TO
BE ABLE TO ACT FLEXIBLY TO
RESPOND APPROPRIATELY AND
QUICKLY IN AN EMERGENCY MANY
TIMES THESE THESE EMERGENCIES
CANNOT BE PREDICTED NOR PREPARED
FOR IT. AND THE RESPONSE
REQUIRES ADAPTATION FROM THE
STATE AND THEIR CONTRACTED
PARTNERS TO DEFINITELY SERVICE
THE COMMUNITIES THEY'RE
RESPONSIBLE FOR, AS SEEN AT THE
BEGINNING OF THE PANDEMIC
EMERGENCIES OFTEN REQUIRED
IMMEDIATE CHANGES TO CONTRACT
PROGRAMS. RESOURCES WERE
BOTTLENECKED AND NONPROFITS THAT
DID NOT HAVE THE ABILITY TO RE
PRIORITIZE THEIR STATE FUNDS TO
PROVIDE THE MUCH NEEDED SERVICES
TO THEIR COMMUNITIES. WITH THE
RECENT FLOODING EMERGENCIES
AFFECTING COMMUNITIES ACROSS THE
STATE, BUT ESPECIALLY IN MY
COMMUNITY IN THE CENTRAL VALLEY.
THESE PROPOSED CONTRACT
MODIFICATIONS WILL ALLOW FOR
RESOURCES TO BE BETTER UTILIZED
TO HELP THE PEOPLE WHO ARE IN
DESPERATE NEED OF ADDITIONAL
FLOOD ASSISTANCE. GREATER
CONTRACT FLEXIBILITY WILL ALLOW
THESE NONPROFITS SUCCESSFULLY
IMPLEMENT AND ENGAGE OUR
COMMUNITIES DURING CRISIS.
RESPONSES FOR FUTURE EMERGENCIES
RELATING TO HEALTH, WILDFIRES OR
OTHER NATURAL DISASTERS. I'M
JOINED TODAY BY JENNIFER FEARING
ON BEHALF OF THE CALIFORNIA
ASSOCIATION OF NONPROFITS AND
SUPPORT THANK YOU. GO AHEAD.
THANK YOU. GOOD AFTERNOON, MR
CHARRON MEMBERS. I AM JENNIFER,
FEARING THE SACRAMENTO ADVOCATE
FOR CALIFORNIA ASSOCIATION OF
NONPROFITS OR COUNT ON PROFITS,
AND WE ARE VERY PLEASED TO
SUPPORT A B 6 19 TO BRING MUCH
NEEDED CONTRACT FLEXIBILITY
DURING STATE EMERGENCIES TO
NONPROFITS PROVIDING DIRECT
SERVICES UNDER CONTRACTS WITH
CALIFORNIA STATE AGENCIES. UM
FOR THOSE OF YOU WHO DON'T KNOW
US COUNT ON PROFITS IS THE
STATEWIDE POLICY ALLIANCE OF
MORE THAN 10,000 ORGANIZATIONS
SERVING AS THE VOICE FOR
CALIFORNIA'S NONPROFIT
COMMUNITY. I AM ALSO PLEASED TO
CONVEY SUPPORT TODAY ON BEHALF
OF MY OTHER NONPROFIT CLIENTS,
THE SAN DIEGO HUMANE SOCIETY AND
MEALS ON WHEELS, CALIFORNIA
MAYBE 6 19 IS PART OF THE
CALIFORNIA NONPROFIT EQUITY
INITIATIVE THAT WE ALONG WITH
MORE THAN 550, NONPROFIT AND
COMMUNITY LEADERS CALLED FOR IN
AN OCTOBER 2022 LETTER TO
GOVERNOR NEWSOM AND LEGISLATIVE
LEADERS. THE COMBINATION OF
IMPACTS FROM THE PANDEMIC,
HIGHER ECONOMIC INSECURITY AND
INFLATION AND WHAT FEELS LIKE
NEAR CONSTANT NATURAL DISASTERS
OF ONE TYPE OR ANOTHER, ARE
INCREASING DEMAND FOR OUR
SERVICES AND HAVE PUSHED THE
PARTNERSHIP BETWEEN CALIFORNIA
STATE GOVERNMENT AND NONPROFITS
TO A CRITICAL JUNCTURE. IT'S
CHALLENGING OUR MUTUAL EFFORTS
TO DELIVER THE HIGHEST QUALITY
SERVICE TO THE PEOPLE OF
CALIFORNIA, ESPECIALLY IN OUR
MOST VULNERABLE COMMUNITIES. WE
PROVIDE VITAL SERVICES,
INCLUDING 32% OF ALL MEDICAL
SERVICES AND NONPROFIT STEPPED
UP EVEN MORE DURING THE PANDEMIC
TO RESPOND QUICKLY AND FLEXIBLY
TO THE NEEDS OF CALIFORNIANS.
DURING 2020. WE SURVEYED MORE
THAN 600 NONPROFITS FROM ACROSS
48 COUNTIES AND FOUND THAT 86%
NEEDED CHANGES IN THEIR STATE
CONTRACT DELIVERABLE
REQUIREMENTS AS A RESULT OF THE
PANDEMICS IMPACT ON THEIR WORK.
FOR EXAMPLE, A NONPROFIT FOSTER
CARE AGENCY WAS UNCLEAR HOW TO
CONTEND WITH PERFORMANCE
OBLIGATIONS WHEN SHELTER IN
PLACE REQUIREMENTS COMPLICATED
REQUIRED HOME VISITS TO CONFIRM
THE HEALTH AND SAFETY OF FOSTER
CARE CHILDREN. A NONPROFIT
MENTAL HEALTH PROVIDER FOR
MEDICAL RECIPIENTS WANTED TO
ADJUST ITS PAYMENTS TO ENSURE
PROVIDERS WOULD NOT HAVE TO BE
LAID OFF AND NEED A QUICK AGENCY
GUIDANCE IN ORDER TO MAKE THOSE
CHANGES, AND CALIFORNIA IS
NONPROFIT, SENIOR NUTRITION
PROVIDERS HAD TO QUICKLY PIVOT
TO CONGREGATE MEALS AS UM, FROM
THE CONGREGATE MEALS THEY
USUALLY PROVIDED TO HOME
DELIVERED MEALS FOR TENS OF
THOUSANDS OF VULNERABLE SENIORS
, AND WE NEEDED THE CONFIDENCE
THAT THEY WOULD BE REIMBURSED.
MAYBE 6 19 WOULD PROVIDE IN A
DECLARED EMERGENCIES THAT
NONPROFITS PARTY TO A CONTRACT
WITH THE STATE MAY ADJUST THEIR
CONTRACT TO ACCOMPLISH THE
PRIMARY PURPOSE OF THE CONTRACT
. IMPORTANTLY THE BILL WILL
REQUIRE NONPROFITS TO NOTIFY THE
CONTRACTING AGENCY OF ANY
CHANGES TO CERVANTES AND
EXPENSES AND AGAIN AND AS SOON
AS THEY'RE THEY'RE CONTRACTING
AGENCIES ARE ABLE TO THROUGH
TRIAGE, WHICH I HEARD MENTIONED
DURING THE LAST BILL. GET TO
THESE NONPROFITS TO DECLARE WHAT
THEY'D LIKE TO SEE DONE. WE ARE
ASKING THAT NONPROFITS BE
TRUSTED IN THE INTERIM TO
DELIVER SERVICES AND MAINTAIN,
UM, MAINTAIN WHAT WE KNOW OUR
COMMUNITIES NEED FROM US DURING
DURING THOSE MOMENTS, SO YOUR
COMMITTEE UNANIMOUSLY SUPPORTED
SENATOR GLASER'S VERY SIMILAR
EFFORT LAST SESSION, AND WE
THANK YOU REMEMBER FONG FOR
CONTINUING THE EFFORT AND
RESPECTFULLY REQUEST THAT I
VOTE. THANK YOU. THERE'S EMOTION
AND SECOND, I THINK EMOTION BY
CALDERON SECOND BY REGULAR
CURRY. IS THERE ANYONE ELSE IN
SUPPORT? I THINK WE HAVE
SOMEBODY COMING UP. CHAIR AND
MEMBERS AUSTIN WEBSTER WITH W
STRATEGIES ON BEHALF OF 211.
ANYONE ELSE IN SUPPORT. SAYING
NONE. ANYONE IN OPPOSITION TO A
B 6 19. SEE NONE WITH THAT, OR
BRING IT BACK TO COMMITTEE
MEMBERS ANY, UH QUESTIONS,
COMMENTS. NONE. WITH THAT
SOMEBODY MEMBER PHªN CLOSING. I
RESPECTFULLY ASK WHEN I VOTE.
THANK YOU. THE MOTION PASSED.
COMMITTEE. APPROPRIATIONS WILL
BE SUPPORTING AS WELL. THANK
YOU, SECRETARY CALDERON. A B A B
6 19. THE MOTION IS DUE PASS TO
COMMITTEE ON APPROPRIATIONS.
RODRIGUEZ RODRIGUEZ. I WALDRON
WALDRON, I AGUIAR-CURRY HI GARY
CURRY. I ALVAREZ ALVAREZ. I
CALDERON. CALLED AROUND I DALI
DALI, I SHIAVO VÚI. THAT MOTION
IS OUT. THANK YOU. THANK YOU.
THANK YOU. THAT WAS GOOD. SO
WITH THAT THIS MEETING IS
ADJOURNED. THANK YOU. HMM.
THANK YOU.
TO HELP YOU. BECAUSE BY THE WAY
. I'M SORRY ABOUT FIRST TIME
WORKING WITH THE. THAT'S RIGHT.
I JUST HERE IN THE SECOND ONE OF
THOSE TWO OVER THERE. THE OCEAN.
YEAH. THE SECOND.