AFTERNOON. UM. BEFORE WE BEGIN
TODAY. I WOULD LIKE TO MAKE A
STATEMENT ON PROVIDING TESTIMONY
AT THIS HEARING. UM WE SEEK TO
PROTECT THE RIGHTS OF ALL WHO
PARTICIPATE IN THE LEGISLATIVE
PROCESS SO WE CAN HAVE EFFECTIVE
DELIBERATION ON THE CRITICAL
ISSUES THAT FACE CALIFORNIA. OR
WITNESSES WILL BE TESTIFYING IN
PERSON. WE ALLOW TWO MAIN
WITNESSES FOR A MAXIMUM OF THREE
MINUTES EACH. ADDITIONAL
TESTIMONY WILL ALSO BE IN
PERSONAL LIMITED TO NAME
POSITION. AN ORGANIZATION IF YOU
REPRESENT ONE I'LL TESTIMONY,
COMMENTS ARE LIMITED TO THE BILL
AT HAND. WE HAVE A LONG AGENDA
TODAY, BUT WE DO HAVE SOME ITEMS
PROPOSED FOR CONSENT OF THE
FOLLOWING BILLS ARE PROPOSED FOR
TODAY'S CONSENT CALENDAR. ANY
MEMBER OF THE COMMITTEE CAN
REMOVE A BILL FROM CONSENT
NUMBER SEVEN, MAYBE 4 24 BY
ASSEMBLYMEMBER'S BRIAN REMEMBER
16 ASSEMBLY BILL 8 27 BY
ASSEMBLYMEMBER'S GARCIA. I DON'T
NUMBER 23 A B 12 76 BY
ASSEMBLYMEMBER'S MAKIN ER I
DON'T REMEMBER 26 85 64 BY VIA
MR V VALLAPUDUA ITEM NUMBER 32 A
B 17 OH, ONE BY DR WEBBER. THE
FOLLOWING BILLS HAVE BEEN
REMOVED FROM TODAY'S CALENDAR
ITEM NUMBER. 5 84 12 I, MISS
SORIA. UH ITEM NUMBER 8 84 86 BY
MR CHOLERA ITEM NUMBER 13 86 57
BY DR JACKSON NUMBER 15 A B 17
51 BY MR GIBSON ITEM NUMBER 1980
13 16 BY MR IRWIN AND ITEM
NUMBER 24 8 B 13 38 I DON'T
REALLY KNOW HOW MANY THAT BILLS
THAT LEAVES US. BUT THERE'S
STILL A BUNCH. UM WE WILL NOT,
UH, IT'S OUR CUSTOM TO NOT START
UNTIL WE HAVE A MEMBER
REPRESENTATIVE FROM, UH, THE
OTHER PARTY HERE. SO, UM JUST
HANG OUT PLAY CARDS. WHATEVER SO
.
JUST FOR REFERENCE. SO MR HANEY
HAS TWO BILLS BEFORE US AND HE
WILL BE PRESENTING THOSE BILLS.
WE OVER THREE BILLS BILLS.
WHATEVER YOU GOT. HE MR. HANEY
HAS SOME BILLS BEFORE US. UM AND
THEN WE'RE GOING TO ASK THAT MR
BENNETT COME AND PRESENT A B 11
68. IT WILL BE OUT OF ORDER. BUT
I THINK BASED ON THE AUDIENCE,
THAT MIGHT BE A LOT OF PEOPLE
HERE, INTERESTED IN THAT
PARTICULAR BILL, SO WE'LL ASK MR
BENNETT TO COME AND PRESENT
AFTER MR HANEY PRESENTS HIS
BILLS. THANK YOU.
OKAY UM, UH, THANK YOU ARE VICE
CHAIR IS HERE YOU'LL SEE THAT WE
ARE WOEFULLY SHORT OF A QUORUM.
UM THE THERE'S A LOT GOING ON
TODAY. THERE ARE MULTIPLE
COMMITTEES MEETING. A LOT OF
COMMITTEE MEMBERS ARE SERVING ON
MULTIPLE COMMITTEES OR
PRESENTING BILLS AND OTHER
COMMITTEES, SO YOU'LL SEE A LOT
OF PEOPLE COMING AND GOING TODAY
, SO, UM, WITH THAT, WE'RE GOING
TO GO AHEAD AND MOVE ON TO MR
HANEY. YOU HAVE BEFORE US. WE'RE
TAKING EVERYTHING IN FIRE ORDER
TODAY EXCEPT WE'RE NOT IN WHEN
WE'RE NOT SO, UM, BUT RIGHT NOW
WE'RE GONNA DO IT IN FIRE ORDER.
UM MR HANEY, YOU HAVE A B 24.
THANK YOU, MR CHAIR AND MEMBER.
IT'S GREAT TO BE IN FRONT OF YOU
ALL. FIRST OF ALL, I WILL BE
ACCEPTING THE COMMITTEE
AMENDMENTS TODAY AND I THINK YOU
AND YOUR STAFF ARE WORKING WITH
US ON THIS BILL AND FOR YOUR
LEADERSHIP ON THIS ISSUE AS
WELL. A B 24 WILL REQUIRE GAS
STATIONS, LIBRARIES, BARS AND
RESIDENTIAL HOTELS TO HAVE
OPIOID BLOCKER NASAL SPRAYS OR
WHAT IS COMMONLY REFERRED TO AS
NARCAN. ON SITE TO PREVENT
DEATHS FROM OPIOID OVERDOSES
WOULD APPLY ONLY TO COUNTIES
THAT HAVE THAT THE DEPARTMENT OF
PUBLIC HEALTH IS IT DETERMINED
TO BE AN OPIOID OVERDOSE CRISIS
AND WOULD BE PROVIDED BY THE
DEPARTMENT IN OPIOID BLOCKER
WORKS BY BINDING TO THE SAME
RECEPTORS IN THE BRAIN THAT ARE
ACTIVATED WHEN CONSUMING OPIOIDS
AFTER THE SPRAYS ADMINISTER THE
OVERDOSE CAN BE COMPLETELY
REVERSED IN 30 SECONDS AND A
LIFE IS SAVED. IT'S ALSO EASY TO
USE. I SAY THIS IS BECAUSE I
HAVE PERSONALLY ADMINISTERED
NARCAN AFTER SOMEONE HAD
OVERDOSED ON THE SIDEWALK IN
FRONT OF MY APARTMENT IN THE
TENDERLOIN IN SAN FRANCISCO. THE
DIFFERENCE BETWEEN LIFE OR DEATH
WHEN SOMEONE OVERDOSES IS HOW
QUICKLY NARCAN CAN BE ACCESSED.
AND WHILE I BELIEVE OPIOID
BLOCKERS SHOULD ULTIMATELY BE
EVERYWHERE THROUGHOUT THE STATE
, REACHER RESEARCH SHOWS THAT
THESE ARE LOCATIONS WHERE PEOPLE
CAN COMMONLY OVERDOSE RIGHT NOW
, THE STATE DOES PROVIDE OPIOID
BLOCKERS TO ORGANIZATIONS THAT
GIVE THEM DIRECTLY TO OPIOID
USERS. HOWEVER YOUR OPIOID USERS
WHO ARE IN THE MIDST OF AN
OVERDOSE CANNOT SELF ADMINISTER.
FOR AN OPIOID BLOCKER TO BE
EFFECTIVE. IT REQUIRES SOMEONE
NEAR THE PERSON OVERDOSING TO
HAVE ACCESS TO THE MEDICATION.
ALSO THERE ARE NO DANGEROUS SIDE
EFFECTS FROM THE MEDICATION. IT
IS COMPLETELY SAFE TO USE. EVEN
IF THE PERSON WHO RECEIVED THE
MEDICATION IS NOT HAVING AN
OPIOID OVERDOSE. THIS IS TIMELY
AND NECESSARY LEGISLATION
BECAUSE CALIFORNIA IS REACHING
NEW LEVELS OF THE OPIOID CRISIS
IN 2021, THERE WERE 7000 OVER
7000 OVERDOSE, OPIOID RELATED
DEATHS IN OUR STATE. THESE ARE
SONS, DAUGHTERS, MOTHERS AND
FATHERS IN EVERY COUNTY AND
ASSEMBLY DISTRICT IN OUR STATE,
MAKING SURE THAT THE MOST
EFFECTIVE TOOL TO PREVENT
OVERDOSES IS EASILY ACCESSIBLE,
IS CRITICAL TO STOPPING DEATHS.
A B 24 IS ONE OF THE MANY BILLS
THIS YEAR THAT WILL CONFRONT THE
OPIOID CRISIS. IT IS NOT THE
ONLY THING WE MUST DO. WE MUST
GIVE FENTANYL OFF OUR STREETS
AND OUT OF OUR COMMUNITIES AND
DRAMATICALLY EXPAND ACCESS TO
TREATMENT AND RECOVERY. BUT
THERE'S NO ABSOLUTELY NO EXCUSE
TO NOT MAKE SURE THIS LIFESAVING
INTERVENTION IS AVAILABLE IN THE
PLACES WHERE IT CAN SAVE A LIFE.
WE HAVE A RESPONSIBILITY TO THE
FAMILIES WITH LOVED ONES. WHO
ARE STRUGGLING WITH ADDICTION,
AS WELL AS THOSE WHO MIGHT
ACCIDENTALLY INGESTED DEADLY
LEVEL OF FENTANYL. THIS WOULD BE
A SIGNIFICANT STEP IN THE RIGHT
DIRECTION FOR OUR STATE AND
WOULD ABSOLUTELY SAVE LIVES.
WITH ME TODAY. I HAVE OUR EXPERT
WITNESS, DR PAULA WIGHTMAN, AN
EMERGENCY ROOM PHYSICIAN IN LOS
ANGELES. AND I BELIEVE JOINING
US IS RACHEL RYAN, OWNER OF THE
OLDEST LGBT Q BAR IN SAN
FRANCISCO, THE STUD, PLEASE,
WHENEVER YOU'RE READY. MY NAME
IS PAULA WHITE MAN. I'M AN
EMERGENCY PHYSICIAN PRACTICING
IN LOS ANGELES COUNTY. THANK YOU
ALL FOR ALLOWING ME TO SPEAK
HERE TODAY. AS YOU KNOW, WE ARE
IN THE MIDST OF A PUBLIC HEALTH
CRISIS WITHIN THE STATE OF
CALIFORNIA AND ACROSS THE
COUNTRY WITH THE RECORD NUMBER
OF OPIOID DEATHS. NALOXONE IS A
SIMPLE, EASY TO USE AND
EFFECTIVE MEDICATION. IT COMES
IN THE FORM OF A NASAL SPRAY
THAT ANYONE CAN ADMINISTER. THE
MEDICATION BINDS TO THE SAME
RECEPTORS IN THE BRAIN USED BY
OPIATES, CAUSING A TEMPORARY
REVERSAL OR BLOCKING OF THE
DRUG. ALLISON BEING DISTRIBUTED
IN PUBLIC PLACES WOULD PLAY A
PIVOTAL ROLE IN REDUCING THESE
OPIOID OVERDOSE DEATHS AS AN
EMERGENCY PHYSICIAN. I HAVE
ADMINISTERED NALOXONE TO
PATIENTS EXPERIENCING AND
OVERJOYED OPIOID OVERDOSE AND
HAVE WATCHED FIRST HAND AS A
LIFELESS PATIENT WHO HAS STOPPED
BREATHING. COMES BACK TO LIFE
WITHIN SECONDS OF RECEIVING THE
LUXAN IN ADDITION TO THOSE
EXPERIENCES, I HAVE CO AUTHORED
A PAPER PUBLISHED IN A WELL
RESPECTED, PEER REVIEWED
JOURNAL, TITLED BETWEEN
EMERGENCY DEPARTMENT VISITS THE
ROLE OF HARM REDUCTION PROGRAMS
IN MITIGATING THE HARM
ASSOCIATED WITH INJECTION DRUG
USE, ALSO RECENTLY SPOKEN
INTERNATIONAL EMERGENCY MEDICINE
CONFERENCE ON EDUCATING OTHER
EMERGENCY MEDICINE PROFESSIONALS
ABOUT HARM REDUCTION. STRATEGIES
AND THE USE OF NALOXONE IN THE
PUBLIC SPACE THE ROLE OF
NALOXONE BEING DISTRIBUTED IN
PUBLIC PLACES WOULD MITIGATE THE
HARMS ASSOCIATED WITH INJECTION
DRUG USE. IS THIS A PUBLIC
HEALTH APPROACH THAT AIMS TO
REDUCE HARMS ASSOCIATED WITH
HEALTH RISK BEHAVIORS AND
MINIMIZE THE NEGATIVE EFFECTS OF
DRUG USE AND PROMOTE HEALTH AND
SOCIAL INCLUSION.
ASSEMBLYMEMBER'S HEINOUS A B 24
WOULD IMPLEMENT A NEW APPROACH
TO PREVENTING OVERDOSE DEATHS.
BY REQUIRING OPIOID REVERSAL,
NASAL SPRAYS AND CLEAR
DIRECTIONS ON HOW TO USE THEM IN
PUBLIC SPACES. THANK YOU FOR
YOUR TIME, I URGE AND I VOTE.
THANK YOU VERY MUCH. YOU HAD A
SECOND WITNESS. IT APPEARS SHE
IS IN LINE SO WE MAY HAVE TO
MOVE ON WITHOUT HER UNLESS SHE'S
WALKING IN AT THIS VERY MOMENT.
UM WELL, WE'LL GO THROUGH OTHERS
INITIALLY OTHER TESTIMONY AND IF
SHE IS ABLE TO MAKE IT IN TIME,
WE'LL GIVE THAT OPPORTUNITY.
THANK YOU SUPPORT JUST YOUR NAME
ORGANIZATION. PLEASE GOOD
AFTERNOON, MR CHAIR AND MEMBER
CONNIE DELGADO ON BEHALF OF THE
CALIFORNIA EMERGENCY NURSES
ASSOCIATION IN SUPPORT. THANK
YOU. MR CHAIR MEMBERS, ROBERT
HARRIS ON BEHALF OF CALIFORNIA
SOCIETY OF ADDICTION, MEDICINE
AND SUPPORT. GOOD AFTERNOON,
PRISCILLA KUDOS ON BEHALF OF THE
CITY OF SANTA MONICA AND SUPPORT
THANK YOU. TARA GAMBO EASTMAN
WITH THE STEINBERG INSTITUTE AND
SUPPORT THANK YOU. JIM LINDBERG
FRIENDS COMMITTEE ON LEGISLATION
IN CALIFORNIA IN SUPPORT IT
LOOKS LIKE YOUR WITNESSES
ARRIVED. HERE WE GO RIGHT ON
TIME. THAT'S RIGHT. GET YOUR
BREATH. IT'S OKAY. NO, NO
PROBLEM. UM GOOD AFTERNOON. MY
NAME IS RACHEL RYAN AND I'M A CO
OWNER AND THE GENERAL MANAGER OF
THE STUD BAR IN SAN FRANCISCO'S
SOMA NEIGHBORHOOD. WE OPENED OUR
BAR IN 1966, AND WE'RE THE
OLDEST QUEER BAR IN SAN
FRANCISCO. OVER THE LAST FIVE
YEARS. WE'VE SEEN THE IMPACT OF
THE OPIOID CRISIS AFFECTING BOTH
PEOPLE IN OUR NIGHTLIFE
COMMUNITY AND OUR OWN HOUSED
NEIGHBORS. IT'S A VERY COMMON
OCCURRENCE FOR US TO SEE PEOPLE
WITH OPIOID ADDICTION USING
FENTANYL IN THE STREETS AROUND
OUR BAR. IN 2018. THE STUD WAS
APPROACHED BY THE DRUG OVERDOSE
PREDICT PREVENTION EDUCATION
PROJECT TO BECOME THE FIRST
NIGHTCLUB TO PUBLICLY ANNOUNCED
THAT WE HAD NARCAN ON SITE. WE
PUT UP POSTERS AROUND THE BAR,
LETTING PEOPLE KNOW THAT THIS
WAS AVAILABLE AND TAUGHT OUR
STAFF HOW TO IDENTIFY AND
OVERDOSE. I'VE HAD PERSONAL
EXPERIENCE WITH ADMINISTERING
NARCAN. I WAS AT AN EVENT IN
2021, WHERE A MAN EXPERIENCED AN
OVERDOSE FROM DOING COCAINE THAT
HE DIDN'T KNOW CONTAINED
FENTANYL. WHEN HE COLLAPSED. THE
PEOPLE AROUND HIM IMMEDIATELY
RECOGNIZED IT AS AN OVERDOSE AND
STARTED SHOUTING FOR NARCAN. I
WAS ONE OF SEVERAL PEOPLE THERE
WHO ARE CARRYING NARCAN IN MY
PURSE. AS SOMEONE DIALED 911. WE
ADMINISTERED NARCAN AND I HELD
THIS MAN'S HEAD IN MY HANDS AS
ANOTHER FRIEND STARTED CPR.
WITHIN A FEW MINUTES, HE WENT
FROM BEING NON RESPONSIVE AND
TURNING BLUE FROM LACK OF LACK
OF OXYGEN TO BREATHING ON HIS
OWN AS THE NALOXONE STARTED TO
WORK. BY THE TIME THE PARAMEDICS
ARRIVED, HE WAS AWAKE AND WAS
ABLE TO WALK HIMSELF TO THE
AMBULANCE. THAT MAN WAS
INCREDIBLY LUCKY THAT HE
HAPPENED TO BE IN A SPACE THAT
HAD NARCAN, BUT WE SHOULDN'T BE
LEAVING PEOPLE SURVIVAL UP TO
LOOK AS A VINTAGE THIS OWNER, I
CAN TELL YOU THAT THIS BILL WILL
SAVE LIVES. AND OPIOID OVERDOSE
IS VERY DISTINCTIVE AND EASY TO
RECOGNIZE AND USING NALOXONE
NASAL SPRAY IS INCREDIBLY EASY.
YOU JUST PUT IT IN THE PERSON'S
NOSE, PUSH ONE PLUNGER, AND
THAT'S IT. I PROMISE YOU THAT IF
WE PROVIDE THIS IMPORTANT FIRST
AID TOOL TO WORKERS, THEY WILL
MAKE THE CHOICE TO SAVE PEOPLE'S
LIVES. I RESPECTFULLY URGE YOU
TO VOTE FOR A B 24 THANK YOU SO
MUCH. THANK YOU VERY MUCH. IS
THERE OPPOSITION TO THE BILL?
THANK YOU, MR CHAIR AND MEMBERS.
CRISTINA DICARO, REPRESENTING
THE CALIFORNIA LIBRARY
ASSOCIATION, REMOVING OPPOSITION
TODAY, SIR, AND WE WANT TO THANK
JUDY BABCOCK OF YOUR STAFF AND
THE ASSEMBLYMEMBER'S FOR WORKING
WITH US SO MUCH ON THE
AMENDMENTS REMOVING THE
PENALTIES FOR LIBRARIES. THANK
YOU VERY MUCH. THANK YOU. HERE
TAKE IT ON BEHALF OF THE RURAL
COUNTY REPRESENTATIVES OF
CALIFORNIA WERE OPPOSING LESS
AMENDED. WE APPRECIATE THE
COMMITTEE AMENDMENTS AND WE'RE
HOPEFUL WE CAN GO NEUTRAL. THANK
YOU. THANKS MR CHAIR JEAN HURST
FROM THE URBAN COUNTIES OF
CALIFORNIA. SIMILAR SITUATIONS,
THE LIBRARY ASSOCIATION RC RC
APPRECIATE EVERYBODY'S WORK ON
THIS BILL. THANK YOU. ANYONE
ELSE? OKAY SEE NO ONE. BRING IT
BACK TO THE COMMITTEE QUESTIONS
OR COMMENTS. WHY WOULD JUST LIKE
TO SAY THANK YOU VERY MUCH FOR
BRINGING THIS BILL FORWARD AND
KNOW FROM VERY EARLY ON YOUR
COMMITMENT TO WORKING ON THIS
ISSUE AND LOOK FORWARD TO
WORKING WITH YOU ON YOUR SELECT
COMMITTEE. AS AS WE MOVE FORWARD
WITH THAT, AS YOU MOVE FORWARD
TO THAT IN THE FALL I'M SORRY.
HANG ON A SECOND. I WON'T. I'LL
FINISH MY COMMENTS AND THEN
WE'LL TURN IT OVER TO HER SO,
BUT THANK YOU FOR BRINGING
BRINGING THIS IMPORTANT BILL
FORWARD. AND UH, WHEN WE DO HAVE
A QUORUM, I LOOK FORWARD TO
SUPPORTING THE BILL. SO THIS
AGUIAR-CURRY THANK YOU VERY MUCH
. SORRY FOR MY LATENESS. UM I
APPRECIATE THE BILL
ASSEMBLYMEMBER'S I'M SUPPORTIVE
OF YOUR INTENTIONS OF THE BILL.
I WAS SUPPORTING IT TODAY, BUT I
DO ASK THAT YOU CONSIDER AN
OPPORTUNITY TO CURE FOR SMALL
BUSINESSES WHO MAY BE UNAWARE OF
THIS NEW REQUIREMENT. PERHAPS A
PERIOD OF TWO WEEKS TO COMPLY
BEFORE BEING SUBJECT TO THE
PENALTIES UNDER THE BILL WOULD
PROTECT THOSE WILLING TO COMPLY
ONCE THEY'VE BEEN MADE AWARE.
GREAT YEAH, SURE IN ANY. I THINK
THAT WAS THAT WAS SINCE THERE'S
NOT VERY MANY OF US HAS PROBABLY
END OF THE COMMENTS. SO UH,
WOULD YOU LIKE TO CLOSE AND
THANK YOU, MR CHAIR FOR YOUR
SUPPORT AND YOUR LEADERSHIP AS
WELL. AND YOUR AND YOUR STAFF
AND, UH, MISS AGUILAR CURRY WERE
I BELIEVE THAT THE BILL IS NOW
BEEN REFERRED ALSO TO JUDICIARY
COMMITTEE, AND SO WE, THERE ARE
GOING TO DEAL WITH SOME OF THE
ISSUES AROUND LIABILITY AND I
DEFINITELY TAKE UH, YOUR YOUR
COMMENTS AROUND HOW TO MAKE SURE
THAT SMALL BUSINESSES ARE ABLE
TO DEAL WITH ACTUALLY COMPLYING
WITH THE BILL, AND THE INTENTION
IS NOT TO BE PUNITIVE IN THAT
WAY, SO I APPRECIATE THAT, AND
WE'LL DEFINITELY WORK ON THAT.
AND I AGAIN I JUST WANT TO THANK
YOU ALL FOR YOUR THIS COMMITTEE
FOR YOUR LEADERSHIP ON THIS
ISSUE, AND THIS IS ONE OF THE
MANY THINGS THAT WE HAVE TO DO.
AND I ALSO WANT TO RECOGNIZE IT.
I KNOW THERE ARE MANY FIRST
RESPONDERS IN THE ROOM AND I
WANT TO AND HEALTHCARE
PROFESSIONALS AND I WANT TO
THANK THEM FOR THEIR LEADERSHIP
AND THEIR LIFE SAVING
INTERVENTIONS WITH THE USE OF
NARCAN AND OTHERS WHO ARE
EXPERIENCING OVERDOSES. AND WITH
THAT, I RESPECTFULLY ASK FOR
YOUR VOTE. THANK YOU. AND WHEN
WE HAVE A QUORUM, WE'LL SEE
COMMOTION AND PUT IT UP FOR A
VOTE. SO THANK YOU VERY MUCH,
MR. FEENEY. THANK YOU TO YOUR
WITNESSES WHO CAN NOW CATCH A
BREATH. AT LEAST ONE OF THEM CAN
SO. ANYWAY UM YOU HAVE NOW
BEFORE US A B 4 59. GREAT THANK
YOU AGAIN, MR CHAIR MEMBERS, AND
BEFORE I START, I WANT TO ACCEPT
THE COMMITTEE'S AMENDMENTS TODAY
. A BEFORE 59 TAKES A CRITICAL
STEP FORWARD TO HOLD OUR
HEALTHCARE SYSTEMS ACCOUNTABLE
FOR SERVING AND IMPROVING THE
LIFE OUTCOMES OF CALIFORNIANS
LIVING WITH MENTAL ILLNESSES AND
ADDICTION ISSUES. UNFORTUNATELY
DESPITE ALL THE INVESTMENT IN
BEHAVIORAL HEALTH INITIATIVES,
THIS STATISTICS ON MENTAL
ILLNESS AND ADDICTION IN OUR
STATE ARE TROUBLING.
APPROXIMATELY ONE IN SIX
CALIFORNIA ADULTS EXPERIENCE,
MENTAL ILLNESS AND ABOUT ONE IN
25 EXPERIENCES, SERIOUS MENTAL
ILLNESS. PEOPLE LIVING WITH
SERIOUS MENTAL ILLNESS DIED 25
YEARS YOUNGER AND PIERS WITHOUT
MENTAL ILLNESS AND DRUG OVERDOSE
DEATHS NEARLY DOUBLED IN
CALIFORNIA OVER THE LAST FIVE
YEARS AS WE LOOK TO TRANSFORM
OUR SYSTEMS OF CARE TO BETTER
SERVE CALIFORNIA CALIFORNIANS
LIVING WITH MENTAL ILLNESS AND
ADDICTION, WE HAVE TO HAVE
ACCOUNTABILITY AND TRANSPARENCY.
84 59 BRINGS BOTH BY REQUIRING
COUNTIES AND HEALTH PLANS TO SET
AMBITIOUS TREATMENT GOALS AND
THE STATE TO MONITOR AND
PUBLICLY REPORT THEIR PROGRESS
TOWARDS THESE GOALS IN REAL TIME
, THE BILL WILL, UH BE DIVIDED
INTO TWO PHASES. PHASE ONE OF
THIS LEGISLATION TAKES STOCK OF
WHERE WE ARE AND WHAT DATA WE
NEED TO TRACK AND UNDERSTAND IN
ORDER TO IMPROVE SYSTEMS. IT
DOES SO BY ASKING THE U. C
SYSTEM TO EVALUATE ALL EXISTING
DATA. AND MAKE RECOMMENDATIONS
TO AN ADVISORY GROUP AS TO
POTENTIAL OUTCOME MEASURES FOR A
STATEWIDE PROGRESS DASHBOARD.
THIS ADVISORY GROUP WOULD
INCLUDE PERSONS WITH LIVED
EXPERIENCE AND OTHER KEY
BEHAVIORAL HEALTH STAKEHOLDERS.
PHASE TWO REQUIRES THE COUNTIES
AND HEALTH PLANS TO DEVELOP DATA
DRIVEN AND COMMUNITY INFORMED
SELF ASSESSMENTS BASED ON THE
DATA AND COMMUNITY INPUT
COUNTIES IN HEALTH PLANS WOULD
THEN DEVELOP SYSTEM IMPROVEMENT
PLANS. INDICATING WHICH OUTCOME
MEASURES THAT WILL TARGET AND
INTEND ANTICIPATED IMPROVEMENT
PHASE TO ALSO IMPLEMENT THE
CREATION OF THE STATEWIDE
DASHBOARD, WHICH WILL BE HOSTED
AND MAINTAINED BY THE U. C
SYSTEM. STANDARD OUTCOME.
MEASURES WILL BE TRACKED FOR
EVERY COUNTY AND HEALTH PLAN THE
THREE PILLARS OF 84 59, OR DATA
, TRANSPARENCY AND COMMUNITY
WITHOUT THESE TRUE
TRANSFORMATION OF OUR BEHAVIORAL
HEALTH SYSTEM. CANNOT HAPPEN.
TOO MANY PEOPLE ARE NEEDLESSLY
SUFFERING ON OUR STREETS AND OUR
JAILS AND HOSPITALS NOT GETTING
THE CARE THEY DESPERATELY NEED.
IT'S TIME FOR INVESTMENT. IT'S
TIME FOR ACCOUNTABILITY, AND
IT'S TIME FOR RESULTS HERE TO
TESTIFY WITH ME TODAY IS DR TOM
INSEL, A PSYCHIATRIST AND
NEUROSCIENTIST IN AN EXPERT ON
BEHAVIORAL HEALTH. AND ALSO WE
HAVE TERRA GAMBOA EASTMAN FROM
THE STEINBERG INSTITUTE, WHO IS
AVAILABLE TO ANSWER ANY
TECHNICAL QUESTIONS. THE
COMMITTEE MAY HAVE GO AHEAD WHEN
YOU'RE READY. THANK YOU VERY
MUCH. THANK YOU, MR CHAIR AND
MEMBERS OF THE COMMITTEE FOR
HAVING ME JOIN IN THIS TESTIMONY
WILL KEEP MY REMARKS BRIEF. MY
NAME IS DR THOMAS INSEL. I'M A
FORMER DIRECTOR OF THE NATIONAL
INSTITUTE OF MENTAL HEALTH
DURING THE BOTH BUSH AND OBAMA
YEARS CAME TO CALIFORNIA SPENT
ABOUT A YEAR AS AN ADVISOR TO
GOVERNOR. NEWSOM MIGHT
BEHAVIORAL HEALTH ISSUES WHEN WE
HAD A CHANCE TO MEET MR CHAIRMAN
AND HAVE SERVED AS THEY CHAIR OF
THE BOARD OF THIS STEINBERG
INSTITUTE, WHICH IS A PROUD
SPONSOR OF HB 4 59. UM I DON'T
NEED TO TELL ALL OF THE MEMBERS
OF THIS COMMITTEE THAT IN SO
MANY WAYS ARE BEHAVIORAL HEALTH
SYSTEM IS IN DIRE STRAITS THAT
DESPITE OF EVERYTHING THAT WE
HAVE DONE IN THE STATE OF
CALIFORNIA, THE INVESTMENTS WE
HAVE MADE THE PROGRAMS WE'VE SET
UP INCREDIBLY HARD WORK OF OUR
COUNTY BEHAVIORAL HEALTH
AGENCIES. UM, WE STILL SEE
UNFORTUNATELY, REALLY DIRE
RESULTS. SOME OF THIS IS DUE TO
THE FRAGMENTED AND UNDERFUNDED
NATURE OF THE HEALTH SYSTEMS
THEMSELVES. UM BUT I'M GOING TO
SUGGEST TO YOU THAT PART OF OUR
CHALLENGE HERE IS THAT WE HAVE
NOT BEEN FOCUSED ENOUGH ON
OUTCOMES AND THE LACK OF FOCUS
ON OUTCOMES RESULTS IN NEEDLESS
HUMAN SUFFERING
INSTITUTIONALIZATION,
HOMELESSNESS, INCARCERATION,
AND, UNFORTUNATELY DEATH AND AS
YOU JUST HEARD ABOUT A B 24
DEATH IS REALLY A MAJOR ISSUE IN
THE BEHAVIORAL HEALTH SPACE.
REPORT OUT TODAY. BY THE
CALIFORNIA HEALTH POLICIES
INSTITUTE. SHOW'S OVER 1000%
INCREASE IN FENTANYL DEATHS
SINCE 2017 THIS HAS BECOME THE
LEADING SOURCE. OF MORTALITY IN
THE STATE OF CALIFORNIA FOR
PEOPLE BETWEEN THE AGES OF 15
AND 44, WHICH IS JUST SIMPLY
EXTRAORDINARY. RIGHT NOW LISTEN
TO THIRD OF CALIFORNIANS LIVING
WITH A MENTAL HEALTH CONDITION
IN APPROXIMATELY 10% OF THOSE
LIVING WITH THE SUBSTANCE USE
DISORDER. RECEIVE THE CARE THEY
NEED. SO THE PROBLEM I'LL
SUGGEST TO YOU IS THAT WE SIMPLY
LACK OUR ABILITY TO MEASURE AND
TO BE ACCOUNTABLE FOR THE KINDS
OF OUTCOMES WE CARE ABOUT. A B 4
59 TAKES A CRITICAL STEP.
FORWARD TO HOLD OUR HEALTHCARE
SYSTEMS ACCOUNTABLE FOR SERVING
AND IMPROVING THE LIFE OUTCOMES
OF CALIFORNIA'S CALIFORNIA'S
LIVING WITH MENTAL ILLNESSES AND
ADDICTION ISSUES. IT'S REALLY
HIGH TIME IT'S BEEN ALMOST OVER
60 YEARS SINCE PRESIDENT KENNEDY
CALLED ALL OF US TO THIS
MISSION. AND WE HAVE FAILED AND
PART OF THAT FAILURE IS OUR LACK
OF ACCOUNTABILITY. WE DON'T
MANAGE WHAT WE DON'T MEASURE AND
THE TIME HAS COME TO BEGIN TO DO
THAT. A B OR 59 PROVIDES THE
PROCESS FOR THAT. I RESPECTFULLY
ASK FOR YOUR I VOTE AND HAPPY TO
REMAIN TO ANSWER ANY QUESTIONS
YOU MAY HAVE. THANK YOU VERY
MUCH. TARGET BO EASTMAN WITH THE
STEINBERG INSTITUTE, PROUD
SPONSORS AND JUST HERE TO ANSWER
ANY QUESTIONS. IF THE COMMITTEE
HAS ANY THANK YOU OTHERS IN
SUPPORT. HE'S JUST YOUR NAME AND
ORGANIZATION. IF YOU REPRESENT
ONE K¾T VAN DINES ON WITH HEALTH
ACCESS CALIFORNIA AND SUPPORT
THANK YOU. ANDREA BINGER WITH
THE CALIFORNIA COUNCIL OF
COMMUNITY, BEHAVIORAL HEALTH
AGENCIES AND STRONG SUPPORT.
THANK YOU. THERESA COMSTOCK WITH
CALIFORNIA ASSOCIATION OF LOCAL
BEHAVIORAL HEALTH BOARDS AND
COMMISSIONS AND SUPPORT ALL
RIGHT. THANK YOU WITH THE COUNTY
FORM AND SUPPORT. THANK YOU.
ANYONE ELSE? THEIR OPPOSITION TO
THE BILL. OKAY SO YOU KNOW ONE
BRING BACK TO THE COMMITTEE FOR
QUESTIONS OR COMMENTS FROM THE
COMMITTEE. THIS, WALDRON. THANK
YOU, MR CHAIR. UM I WANT TO
THANK THE AUTHOR FOR BRINGING
THIS BILL FORWARD. I'VE WORKED
IN THE MENTAL HEALTH AND
SUBSTANCE USE SPACE. LONGER THAN
I WANT TO ADMIT, EVEN BEFORE I
WAS IN THE LEGISLATURE. WITH THE
OPIOID TASK FORCE IN SAN DIEGO.
UM IT'S REALLY NEEDED THAT WE
UNPACK THIS AND FIGURE OUT. YOU
KNOW WHERE THE SHORTFALLS ARE,
BECAUSE WE ALL SEE THE OUTCOMES.
AH AND WHAT? WHAT THE RESULTS
HAVE BEEN SO IT'S REALLY
IMPORTANT THAT WE DO THIS SO
THAT WE CAN BE EFFICIENT AND
EFFECTIVE. AND AS YOU MENTIONED
, YOU KNOW, PATIENT OUTCOMES, AS
ALWAYS, ONE OF THE THINGS THAT
WE SEEM TO OVERLOOK AND IT'S YOU
KNOW WHERE THE MOST SUFFERING
IS. SO, UM, I'M. HAPPY TO
SUPPORT THIS BILL WHEN WE HAVE A
CHANCE, AND THANK YOU FOR
BRINGING FORWARD I'D LIKE TO SAY
THANK YOU AS WELL. UM I REALLY
DO LIKE YOUR APPROACH. I LIKE I
LIKE THE SYSTEMATIC APPROACH
DATA TRANSPARENCY COMMUNITY. I
THINK IT'S UM IT MAKES A LOT OF
SENSE AND THE FACT THAT YOU'RE
INCLUDING SO MANY PEOPLE, SO
MANY ENTITIES IN THIS IS REALLY,
REALLY CRITICAL. SO I'M A AS
PEOPLE MAY KNOW. I'M A BIG
BELIEVER IN DATA. WE THINK WITH
GOOD DATA WE GET WE GET AN
OPPORTUNITY TO MAKE BIG CHANGES.
SO UM, WHEN THE BILL, UH WE DO
HAVE A QUORUM. I'M HAPPY TO
SUPPORT THE BILL. AND SHOULD THE
BILL PASS OUT OF COMMITTEE? I'D
LIKE TO BE ADDED AS A CO AUTHOR,
IF YOU'D HAVE ME COURSE. WELL WE
DON'T HAVE TO. YES, OF COURSE.
BUT YOU'RE WELCOME. AGUIAR-CURRY
SAY ME TOO. ME TOO, SO AND
YOU'RE WELCOME AND THANK, THANK
YOU SO MUCH AND THANK YOU TO OUR
WITNESSES AND SPONSORED. UH YOU
KNOW THIS IS AN ISSUE. WE'RE
GOING TO HAVE TO WORK ON FOR A
LONG TIME TO GET THIS RIGHT. AND
SO, UM, LOOK FORWARD TO
PARTNERING WITH THIS COMMITTEE
AND ALL OF YOU TO GET IT DONE
AND TO ENSURE THAT WE GET THE
RESULTS AND HAVE THE
TRANSPARENCY AND DATA AND
ACCOUNTABILITY THAT WE NEED ALSO
WANNA ACKNOWLEDGE THERE WERE
SOME RECENT CONCERNS EXPRESSED
AROUND THE MEMBERSHIP OF THE OF
THE ADVISORY GROUP AND SOME
DIFFERENT SUGGESTIONS FROM
MEMBERSHIP AND WE WILL WORK WITH
THOSE FOLKS TO THE ADDRESS THOSE
THOSE THOSE THAT INPUT AND TRY
TO GET THAT RIGHT SO WITH THAT,
AT THE RIGHT MOMENT WOULD LOVE
TO HAVE YOUR SUPPORT ON THIS,
BILL. THANK YOU. THANK YOU VERY
MUCH. THANK YOU TO YOUR
WITNESSES. AND, UM, YOU HAVE
ALSO A B. 1001. ALRIGHT. LAST
ONE HERE. THANK YOU AGAIN, MR
CHAIR AND MEMBERS AND THANK YOU
AGAIN TO YOUR STAFF FOR YOUR
THOUGHTFUL WORK ON THIS BILL. UH
AND WE ACCEPT THAT THE COMMITTEE
AMENDMENTS A B 1001 ESTABLISHES
A MINIMUM STAFFING REQUIREMENT
FOR MENTAL HEALTH AND ADDICTION
PERSONNEL AT HOSPITALS IN ORDER
TO ENSURE PATIENTS IN NEED OF
SERVICES RECEIVED TIMELY AND
APPROPRIATE CARE. CALIFORNIA'S
HEALTH CARE SYSTEM IS BECOMING
INCREASINGLY OVERWHELMED BY THE
NUMBER OF PATIENTS SUFFERING
FROM MENTAL HEALTH AND ADDICTION
SERVICES. IN 2020 PATIENTS WITH
MENTAL HEALTH AND ADDICTION
DIAGNOSES REPRESENTED ONE THIRD
OF ALL INPATIENT
HOSPITALIZATIONS AND 1/5 OF ALL
EMERGENCY ROOM DEPARTMENT
VISITS. HOWEVER HOSPITALS ARE
UNDERPREPARED UNDERSTAFFED AND
LACKED APPROPRIATELY TRAINED AND
LICENSED STAFF TO RESPOND TO
PATIENTS EXPERIENCING EMERGENCY
PSYCHIATRIC. OR MENTAL HEALTH
AND ADDICTION CRISES. THAT THIS
PLACE IS NURSES AND OTHER HEALTH
CARE WORKERS AND THEIR PATIENTS
IN DANGEROUS CONDITIONS. IN
CALIFORNIA. THERE ARE MORE THAN
500,000 ACTIVE LICENSED NURSES,
YET ONLY 348,000 ARE WORKING IN
THE STATE OUR HOSPITAL'S
INABILITY TO EFFICIENTLY PROVIDE
FOR CARE FOR PATIENTS IN
EMERGENCY DEPARTMENTS IS CAUSING
NURSES TO LEAVE THE PROFESSION,
FURTHER STRAINING THE HEALTHCARE
WORKFORCE. THIS LACK OF ADEQUATE
STAFFING ALSO CAUSES PATIENTS
WITH MENTAL HEALTH AND ADDICTION
NEEDS TO BE INAPPROPRIATELY
BOARDED IN EMERGENCY DEPARTMENTS
OR REMAIN UNDER OBSERVATION
STATUS, LEADING TO DELAYS IN
RECEIVING MENTAL HEALTH CARE OR
ADDICTION TREATMENT. WORSE
OUTCOMES AND PREVENTABLE AIRS.
THIS BILL ENSURES THAT HOSPITALS
ACROSS THE STATE ARE STAFFED
WITH A FOUR MEMBER BEHAVIORAL
HEALTH RESPONSE PERSONNEL TEAM.
TO ASSIST HOSPITAL PATIENTS
EXPERIENCING A BEHAVIORAL HEALTH
CRISIS. THIS BILL WILL ALSO
CREATE THE BEHAVIORAL HEALTH,
EMERGENCY RESPONSE AND TRAINING
FUND, WHICH WOULD BE FINANCED
THROUGH ALREADY EXISTING
BEHAVIORAL HEALTH DOLLARS. THIS
FUND WILL PROVIDE GRANTS TO NEW
OR EXISTING PROGRAMS THAT FOCUS
ON TRAINING, MENTAL HEALTH AND
ADDICTION PERSONNEL TO WORK IN
HOSPITALS WITH ME TODAY TO
TESTIFY IS RAMONA MALL. èC UM,
ALL FROM U. C. DAVIS E R
REGISTERED NURSE AND MARIE LOPEZ
FROM THE CALIFORNIA NURSES
ASSOCIATION. GO AHEAD.
REGISTERED NURSE IN THE
EMERGENCY DEPARTMENT AT UC DAVIS
MEDICAL CENTER. I HAVE WORKED IN
HEALTHCARE FOR 32 YEARS FOR THE
1ST 17 YEARS. I WAS A LICENSED
VOCATIONAL NURSE IN BEHAVIORAL
HEALTH. AND FOR THE LAST 16
YEARS, I HAVE BEEN A REGISTERED
NURSE IN THE E. D. DURING MY
WORK AT UC DAVIS, I HAVE
WITNESSED FIRSTHAND HOW QUICKLY
SEEMINGLY MINOR PSYCHIATRIC
EVENTS CAN ESCALATE INTO A FULL
BLOWN CRISIS. IN AN OVERCROWDED
AND UNDERSTAFFED ENVIRONMENT
WHERE OUR ENDS AND OTHER WORKERS
DO NOT HAVE PROPER TRAINING AND
RESOURCES. WE LACK THE CAPACITY
TO PROVIDE THE LEVEL OF CARE
THAT OUR PATIENTS DESERVE. AT U.
C. DAVIS THE LARGEST PUBLIC
HOSPITAL IN THE REGION,
APPROXIMATELY ONE THIRD OF OUR
PATIENTS ON ANY GIVEN DAY ARE
EXPERIENCING ISSUES WITH THEIR
MENTAL HEALTH. OUR STAFF OF 200
PLUS REGISTERED NURSES ARE
REQUIRED TO COMPLETE ONLY ONE
TRAINING MODULE IN CRISIS,
INTERVENTION AND PREVENTION IN
THEIR ENTIRE CAREER AT UC DAVIS.
BY CONTRAST, BEHAVIORAL HEALTH
NURSES RECEIVE YEARS OF
CONTINUED SPECIALIZED TRAINING
TO PROVIDE A THERAPEUTIC
HOSPITAL EXPERIENCE FOR THEIR
PATIENTS RATHER THAN A TRAUMATIC
ONE. PATIENTS WHO COME TO US IN
NEED OF MENTAL HEALTH TREATMENT
DESERVE A CARE TEAM WHO ARE
TRAINED TO SAFELY AND
EFFECTIVELY ADDRESS ALL OF THE
ASPECTS OF THE CARE THEY NEED.
I'D LIKE TO SHARE A STORY AT
THIS TIME. I WAS CARRYING FOR A
MAN WHO WAS TWICE MY SIZE WHO
WAS ON A PSYCHIATRIC HOLD A 51
50. AS A RESULT, HE WAS HELD IN
ISOLATION IN THE EMERGENCY ROOM
FOR THREE DAYS. ASIDE FROM THE
OCCASIONAL VISIT FROM THE
PSYCHIATRY TEAM, IT WAS UP TO
THE NURSES TO KEEP HIM CALM AND
SAFE. ARMED ONLY WITH OUR
SINGULAR TRAINING IN CRISIS
INTERVENTION. EVENTUALLY THE
PATIENT BECAME OVERWHELMED. HE
TOLD ME I'M GOING TO GET OUT ONE
WAY OR THE OTHER. I LOOKED TO
THE E D PROVIDER FOR GUIDANCE,
BUT SHE TO LACK THE UNIQUE
TRAINING REQUIREMENT TO A TRUST
THE PATIENT'S NEEDS. HE ENDED UP
ELOPING, FURTHER ENDANGERING
HIMSELF AND OTHERS. NURSES
SUPPORT A B 1001 BECAUSE IT
GUARANTEES THAT WHAT SHOULD BE
COMMON SENSE BECOMES LAW. WHEN
IT PASSES. WE WILL HAVE THE
TOOLS AND RESOURCES WE NEED TO
PROVIDE THE CARE THAT THE MOST
VULNERABLE IN OUR COMMUNITY SO
DESPERATELY NEED. THANK YOU FOR
THIS OPPORTUNITY. GREAT. THANK
YOU. GOOD AFTERNOON. THANK YOU.
CHAIRMAN WOULD AND COMMITTEE
MEMBERS. MY NAME IS MARIA LOPEZ
, LEGISLATIVE ADVOCATE FOR THE
CALIFORNIA NURSES ASSOCIATION
AND ON BEHALF OF THE MORE THAN
100,000 REGISTERED NURSES IN OUR
STATE. WE ARE PROUD SPONSOR OF
MAYBE 1001 AND THANK
ASSEMBLYMEMBER'S HANEY FOR
OFFERING. THIS IMPORTANT BILL
HELPLINE HAS MADE GREAT GAINS IN
ADDRESSING BEHAVIORAL HEALTH AND
CONTINUES TO ADDRESS THE STATE'S
GROWING MENTAL AND BEHAVIORAL
HEALTH NEEDS. IMPORTANTLY THE
HOSPITAL ENVIRONMENT REMAINS A
MAJOR POINT OF CONTINUUM OF
BEHAVIORAL HEALTHCARE. HC AI
REPORTS THAT ONE OUT OF FIVE
EMERGENCY DEPARTMENT VISITS AND
ONE OUT OF THREE INPATIENT
HOSPITALIZATIONS ARE PATIENTS
WITH BEHAVIORAL HEALTH ISSUES.
SOME PATIENTS WITH MENTAL HEALTH
OR SUBSTANCE. SUBSTANCE USE
ISSUES SEEK CARE THROUGH OUR
HOSPITALS AND OTHER PATIENTS IN
THE ACUTE CARE SETTINGS
SOMETIMES HAVE EPISODIC,
INVOLUNTARY AND UNINTENDED
BEHAVIORAL HEALTH RESPONSES TO A
HOSPITAL ENVIRONMENT. WHERE
THERE THEY RESPOND IN A WAY THAT
PUTS THEMSELVES NURSES AND OTHER
HEALTH CARE WORKERS AT RISK FOR
VIOLENCE IN IN SAFE CONDITIONS.
THIS BILL WOULD IMPROVE BOTH
PATIENT AND HEALTHCARE WORKERS
SAFETY IN CALIFORNIA'S HOSPITALS
AND UNDER A B 1001 HOSPITAL
WOULD BE REQUIRED TO HAVE A
BEHAVIORAL HEALTH TEAM THAT
SPECIFICALLY TRAINED AND JUST
DEDICATED TO RESPONDING TO
PATIENTS EXPERIENCING A
BEHAVIORAL HEALTH CRISIS, WHICH
WOULD BE DISPATCHED THROUGHOUT
THE HOSPITAL. ACROSS THE
HOSPITAL AS NEEDED, AND WITH THE
ATTENTION OF A BEHAVIORAL HEALTH
TEAM HOSPITALS COULD BETTER
ENSURE THAT PATIENTS RECEIVE THE
CARE THAT THEY NEED. WHEN DID
THE CARE THAT WOULD NEEDED? IN A
TIMELY FASHION, WHICH WOULD HELP
FREE UP HOSPITAL BEDS AND
IMPROVE PATIENT OUTCOMES. A
DEDICATED TEAM OF KNOWLEDGE WITH
KNOWLEDGE OF PROGRAMS, RESOURCES
AND INFORMATION ON BEHAVIORAL
HEALTH WOULD PLAY A KEY ROLE IN
THE STATES CONTINUUM OF
BEHAVIORAL HEALTH GOALS. MAYBE
WINDSOR HILLS ARE ONE BUT ALSO
WOULD ALSO BE INSTRUMENTAL IN
CREATING MEETING CALIFORNIA'S
GOALS, PROVIDING APPROPRIATE
CARE TO PATIENTS. WITH MENTAL
HEALTH AND SUBSTANCE USE NEEDS.
AND IT WOULD SUPPORT NURSES AND
OTHER HOSPITAL STAFF AS THEY
PROVIDE CHARACTER TO YOUR
CONSTITUENTS. THANK YOU SO VERY
MUCH FOR THE TIME OF THE
OPPORTUNITY TO SPEAK TO YOU ALL
. THANK YOU VERY MUCH, UM OTHERS
IN SUPPORT. HI THERESA COMSTOCK
WITH CALIFORNIA ASSOCIATION OF
LOCAL BEHAVIORAL HEALTH BOARDS
AND COMMISSIONS AND SUPPORT
THANK YOU. MR CHAIR MEMBER.
SARAH FLOCKS. CALIFORNIA LABOR
FEDERATION IN SUPPORT. MR CHAIR
MEMBERS. TWO MEN REPRESENT THE
CALIFORNIA CHAPTER OF THE
AMERICAN COLLEGE OF EMERGENCY
FISHING'S. WE HAD BEEN
SUPPORTIVE, AMENDED. WE WANT TO
THANK THE AUTHOR, HIS STAFF
SPONSORS AND THE COMMITTEE STAFF
WITH THEIR HELP, AND WE'RE
MOVING TO STRAIGHT SUPPORT.
THANK YOU. THANK YOU. NO CHAIR
MEMBERS, JANICE O'MALLEY WITH
THE AMERICAN FEDERATION OF STATE
COUNTY MUNICIPAL EMPLOYEES AND
SUPPORT THANK YOU. FRIEND
MOXLEY. I HAVE CRITICAL CARE AND
RECOVERY ROOM NURSE IN SUPPORT.
THANK YOU. CHANGE CHURCH ON
CALIFORNIA NURSES ASSOCIATION
NEONATAL ICU NURSE IN SUPPORT.
THANK YOU. LET'S SEE ANYONE
ELSE. NO ONE ELSE IS THEIR
OPPOSITION TO THE BILL. HE'S
COME FORWARD. AND SHARING
MEMBERS. PUSH THE BUTTON. IF YOU
DON'T MIND THAT, THANKS. ARE WE
ON PRIME TIME? THERE WE GO. GOOD
AFTERNOON. SHARON MEMBERS. MY
NAME IS KIRSTEN BARLOW. I'M A
VICE PRESIDENT OF POLICY AT THE
CALIFORNIA HOSPITAL ASSOCIATION
, WHERE I BRING NEARLY 20 YEARS
OF EXPERTISE IN BEHAVIORAL
HEALTH POLICY. WE REALLY THANK
THE AUTHORS OFFICE AND ALL OF
THE COMMITTEE STAFF WHO REALLY
ENGAGED WITH US ABOUT CONCERNS
WE HAVE WITH THE BILL AND ARE
SUPPORTIVE OF THE AMENDMENTS
THAT ARE SUGGESTED IN THE
ANALYSIS. UM WHILE THOSE
AMENDMENTS ARE HELPFUL, THOUGH,
THE BILL STILL PUTS AN OVERLY
PRESCRIPTIVE STAFFING
REQUIREMENT ON HOSPITALS AND WE
MUST REGRETFULLY OPPOSED THE
BILL UNLESS IT IS AMENDED TO
ADDRESS THAT ASPECT. CURRENTLY
CALIFORNIA IS FACING A WORKFORCE
SHORTAGE OF NEARLY 500,000
ALLIED HEALTH PROFESSIONALS AND
40,000 RNS. UM THE BILL REQUIRES
REALLY A ONE SIZE FITS ALL
APPROACH FOR ALL AREAS OF THE
HOSPITAL, NOT JUST THE EMERGENCY
ROOM. AND IT REALLY GIVES US A
LITTLE FLEXIBILITY TO EMPLOY
OTHER INNOVATIVE SOLUTIONS THAT
INCLUDE, FOR EXAMPLE, USING PEER
SUPPORT SPECIALISTS OR SUBSTANCE
USE NAVIGATORS WHO REALLY CAN
PROVIDE, UM, YOU KNOW, LIVED
EXPERIENCE PERSPECTIVE ON HOW TO
DEESCALATE THE CRISIS. WHILE THE
BILL DOES INCLUDE A TRAINING
FUND, IT DOESN'T SPECIFY EXACTLY
WHERE THOSE FUNDS WOULD COME
FROM. IT ALSO DOESN'T MAKE THOSE
GRANTS AVAILABLE TO ALL TYPES OF
HOSPITALS, DESPITE THE FACT THAT
ALL TYPES OF HOSPITALS RIGHT NOW
ABOUT 50% ARE OPERATING IN THE
RED. GIVEN THE COVID CRISIS THAT
WE'RE ALL STILL SORT OF EMERGING
FROM LASTLY, WE BELIEVE THAT
EFFORTS TO REDUCE WORKPLACE
VIOLENCE IN THE HOSPITAL SHOULD
ACKNOWLEDGE THE WHOLE PATIENT
POPULATION THAT WE TREAT NOT
FUEL THE MYTH THAT PEOPLE WITH
MENTAL ILLNESS ARE MORE VIOLENT
, UM AND MORE DANGEROUS THAN
OTHER PATIENTS AS WE KNOW,
VIOLENCE CAN HAPPEN IN ANY
WORKPLACE IN ANY SETTING, THE
ENVIRONMENT ITSELF CAN BE A
STRESSFUL EXPERIENCE FOR ANY
TYPE OF PATIENT AND WE KNOW THAT
WORKPLACE VIOLENCE IN A HOSPITAL
CAN HAPPEN OUTSIDE OF PEOPLE
WITH A MENTAL ILLNESS OR PEOPLE
WHO HAVE A 51 50 INVOLUNTARY
HOLD. FOR THESE REASONS. WE
STRONGLY URGE YOU TO CONSIDER
OUR CONCERNS AND WE MUST
RESPECTFULLY OPPOSE A B 1001
UNLESS IT IS AMENDED. THANK YOU.
THANK YOU VERY MUCH OTHERS IN
OPPOSITION. NO ONE WILL BRING IT
BACK TO THE COMMITTEE. ANY
QUESTIONS OR COMMENTS FROM THE
COMMITTEE, DR WEBBER. GOOD
AFTERNOON, AND SOME OF THE
MEMBER HANEY, UM I WANT TO THANK
YOU SO MUCH FOR BRINGING THIS
BILL FORWARD, BUT ALSO FOR
ACCEPTING THE AMENDMENTS BECAUSE
I DID HAVE, UM, A LOT OF
CONCERNS THAT, UM, HAVE BEEN
ADDRESSED WITH THE AMENDMENT. SO
THANK YOU TO THE COMMITTEE
STAFF. UM I WILL BE SUPPORTING
IT HERE, HOWEVER, UM, I DO ECHO
WHAT WAS JUST STATED BY THE
OPPOSITION AS FAR AS THE ISSUE
OF WORKFORCE. UM, YOU KNOW, I
WAS CALLED AT FOUR A.M. THIS
MORNING FOR A PATIENT DOWN IN
SAN DIEGO, AND I WAS SPEAKING
WITH THE DOCTOR THAT CALLED ME
AND, UM, YOU KNOW, WE WERE
TALKING ABOUT THE LACK OF
NURSING FOR THAT PARTICULAR
CLINIC ONE HALF DAY NURSE OR
PART TIME NURSE FOR FOUR
PHYSICIANS. IT'S REAL. UM AND SO
, THINKING OUTSIDE OF THE BOX,
HAVING FLEXIBILITY IN ORDER TO
BE ABLE TO ACHIEVE WHAT YOU'RE
TRYING TO ACHIEVE, I THINK IT'S
GOING TO BE IMPORTANT SO I WILL
SUPPORT IT TODAY. UM TOO, SO
THAT YOU CAN CONTINUE THE
CONVERSATIONS AND KEEP THIS BILL
MOVING FORWARD BECAUSE I DO
THINK THAT IT IS IMPORTANT, BUT
I DO THINK THAT, UM THERE NEEDS
TO BE SOME KIND OF DISCUSSION
AND RESOLUTION. THAT IS THAT IS
PRESENTED, UM TO DEAL WITH THE
ISSUE OF WORKFORCE SHORTED WITH
OUR NURSES WITH OUR OTHER
PROVIDERS. SO THANK YOU. THANK
YOU. UM, JUST A COUPLE OF
COMMENTS. FIRST OF ALL. SO AS A
DENTIST. I'M PRETTY FAMILIAR
WITH THE CARVE OUT OF CERTAIN
PARTS OF THE BODY FROM THE BODY
AS A WHOLE. PATIENTS OFTEN GO TO
EMERGENCY APARTMENTS WITH DENTAL
PAIN, AND, UH AND LITTLE OR
NOTHING CAN BE DONE. EXCEPT YOU
KNOW, TAKE CALL YOUR YOU GET
SOME PAIN RELIEF AND CALL YOUR
DENTIST IN THE MORNING. I DO
UNDERSTAND THE DENTAL CARE IS
PROVIDED DIFFERENTLY, AND
EMERGENCY ROOMS ARE LITERALLY
NOT EQUIPPED TO PROVIDE SUCH
CARE. THAT BEING SAID, WE CANNOT
DO THE SAME THING TO INDIVIDUALS
SUFFERING FROM A MENTAL HEALTH
CRISIS. YES WE NEED MORE BEDS.
WE ALSO NEED APPROPRIATELY
TRAINED INDIVIDUALS WORKING IN
THE HOSPITAL. AND AS YOU SAID, I
BELIEVE ONE THAT A THIRD OF
PATIENTS PRESENTING AN EMERGENCY
ROOMS AND SOME SORT OF
BEHAVIORAL HEALTH CRISIS. UM
ROOMS, UM, WHETHER WHETHER THEY
COME IN OF THEIR OWN VOLITION OR
SUBJECT TO AN INVOLUNTARY HOLD
UNDER THE LPS SYSTEM. I DO THINK
THAT UNTIL WE ADDRESS THE ISSUE
ON PATIENTS ON 51 50 HOLDS
LANGUISHING IN THE E D, WAITING
FOR AN ASSESSMENT, WHICH IS A
REAL PROBLEM, UM, OFTEN
LANGUISHING FOR HOURS BECAUSE
THERE ISN'T APPROPRIATE STAFF
THERE TO DO THE EVALUATIONS AND
, UM AND THAT IS THAT IS HUGELY
CHALLENGING. UM WE'RE STILL JUST
KIND OF WORKING AROUND THE
EDGES. QUITE FRANKLY, WE NEED
EVERYONE TO STEP UP AND DO THEIR
PART. UM THE BILL DOESN'T AND TO
ENJOY DO PAST RECOMMENDATION. I
THANK YOU FOR WORKING WITH US
AND THE COMMITTEE STAFF. WOULD
YOU LIKE TO CLOSE? YES UH, WELL,
FIRST OF ALL, I WANT TO THANK
YOU AGAIN AND YOUR AND YOUR
STAFF FOR WORKING WITH US AND
FOR THE AMENDMENTS AND FOR THE
COMMITTEE'S COMMENTS AND FOR OUR
WITNESSES WHO ARE HERE. I UH,
ABSOLUTELY, AND WE'RE COMMITTED
TO WORKING WITH THE HOSPITAL
ASSOCIATION AND PROVIDERS ON
SOME OF THE QUESTIONS AND ISSUES
THAT WERE BROUGHT FORWARD. I DO
WANNA ALSO THEIR HEALTHCARE
WORKERS HERE AND NURSES AND I
WANT TO AGAIN ACKNOWLEDGE AND
THANK THEM FOR THEIR WORK. UH I
DO WANT TO SAY AND TO DR WEBBER.
I COULD NOT AGREE MORE. I THINK
AT THE HEART OF THIS IS THE WORK
FORCE ISSUE, AND SO WE WANTED TO
BOTH INCLUDE THE STAFFING
STANDARDS AND THIS WORKFORCE
INVESTMENT FUNDS AND REALLY SAY
WE NEED TO DO BOTH OF THESE
THINGS. AND SO I'M COMMITTED AND
I'M SURE I'LL HAVE YOUR
PARTNERSHIP AND REALLY AS WE GO
INTO THE BUDGET PROCESS, REALLY
MAKING SURE THAT THIS IS
PRIORITIZED AND THAT WE FIND
EVERY WAY POSSIBLE TO ENHANCE
THAT WORKFORCE BECAUSE THIS
CANNOT GET DONE UNLESS WE
ADDRESS THE WORKFORCE ISSUES
ALSO, UH, WOULD SAY THAT WHAT WE
HAVE HERE AS UM, AS AS WAS
STATED REALLY IS WHAT WE KNOW TO
BE COMMON SENSE. AS YOU SAID,
CHAIR IF WE BRING SOMEONE WHO
HAS BEHAVIORAL HEALTH NEEDS INTO
THE HOSPITAL, THERE HAVE TO BE
PROFESSIONALLY TRAINED
BEHAVIORAL HEALTH STAFF THERE TO
PROVIDE FOR THEM. THAT IS A
BASIC MINIMUM. AND THE QUESTION
IS HOW WE GET THERE. WE THINK
THAT THIS BILL IS A WAY FORWARD,
AND SO WITH THAT, ALLOWING US TO
CONTINUE TO MOVE IT FORWARD. AND
TO FIND A PATHWAY FORWARD TO GET
IT DONE IS GREATLY APPRECIATED.
AND THANK YOU AGAIN, MR CHAIR
AND AT THE RIGHT TIME WOULD
RESPECTFULLY REQUEST AND I VOTE
. GREAT. THANK YOU VERY MUCH, MR
HANEY AND THANK YOU TO YOUR
WITNESSES. OKAY AS I PREVIOUSLY
SAID, WE'RE GOING TO GO OUT OF
ORDER HERE. WE'RE GOING TO HAVE
MR BENNETT COME FORWARD. IT'S
GOING TO PRESENT A B 11 68.
AND BEFORE, UM, BEFORE YOU BEGIN
, MR BENNETT. I'D LIKE TO MAKE A
FEW COMMENTS, AND THAT'S A
LITTLE UNUSUAL, BUT THE
COMMITTEE LEARNED THIS MORNING
FROM STAKEHOLDERS AND THAT THE
COMMITTEE AMENDMENTS PROPOSED TO
HAVE RAISED CONCERNS ABOUT
INADVERTENTLY BROADENING THE
BILL. I WANT TO CLARIFY THAT THE
INTENT OF THE AMENDMENTS WAS TO
NARROW THE BILL, PROTECT
PATIENTS AND NOT CREATE UNDUE
DISRUPTION WITHIN THE SYSTEM.
THIS IS KIND OF ILLUSTRATIVE OF
THE CHALLENGE WITH THIS
PARTICULAR BILL. UM THIS ISSUE
HAS BEEN COME BEFORE US MANY
TIMES, SEVERAL TIMES, UM AS
RECENTLY AS LAST YEAR. AND ONE
OF THE THINGS THAT WE STRUGGLE
WITH IS IT TAKES A LOT OF
EXPLANATION TO EXPLAIN THE
INTENT OF THIS BILL. BUT THERE
TAKES VERY LITTLE EXPLANATION
FROM THE OPPOSITION AS TO WHY
THEY DON'T LIKE IT. AND SO. IT
APPEARS THAT SUPPORTERS AND THE
OPPOSITE OPPONENTS SEEM
ENTRENCHED IN THEIR PERSPECTIVES
, WHICH MAKES ANY PROGRESS
EXCEPTIONALLY DIFFICULT. MY
PREFERENCE WOULD BE THAT BOTH
SIDES TAKE A STEP BACK. SPEND
SOME TIME TRYING TO SOLVE THE
ISSUE IN A MORE COOPERATIVE
MANNER AND TO DO THIS WITHOUT
THE PRESSURE OF COMMITTEE
DEADLINES. I REALIZED THAT'S NOT
THE PREFERENCE OF STAKEHOLDERS
SO WE'LL BE HEARING THE BILL
TODAY. I COMMEND THE AUTHOR FOR
TRYING TO RESOLVE THIS VERY
COMPLEX AND CONTENTIOUS ISSUE.
UM SHOULD THE BILL PASS OUT OF
HEALTH COMMITTEE TODAY MY STAFF
IS COMMITTED TO CONTINUING TO
WORK WITH THE STAKEHOLDERS AND
THE NEXT POLICY COMMITTEE TO
ASSURE OUR AMENDMENTS ACCOMPLISH
WHAT WAS INTENDED WITHOUT THE
UNINTENDED CONSEQUENCES. SO WITH
THAT, UM PLEASE GO AHEAD, MR
BENNETT. BUT THANK YOU VERY MUCH
, MR CHAIR. UM AND I WANT TO
COMPLIMENT YOU AND YOUR STAFF.
UM I COMPLETELY CONCUR WITH YOUR
ASSESSMENT. THIS IS A EASY
ISSUE. 22. HAVE SOMETHING
INADVERTENTLY GO WRONG OR BE
PERCEIVED AS WRONG AND YOUR
WILLINGNESS TO WORK WITH US. AND
UH, HOPEFULLY ONE OF THE
DIFFERENCES BETWEEN THIS AND IT
CERTAINLY AT LEAST THE LAST BILL
THAT CAME IN FRONT OF THIS
COMMITTEE IS WE HAVE ENDEAVORED
TO WORK WITH YOU FROM THE VERY
BEGINNING. AND TO TRY TO LET YOU
KNOW WHAT THIS WHAT THE INTENT
WAS AND TRY TO WORK WITH YOU AND
YOUR STAFF IN TERMS OF WHAT ARE
POSSIBLE SOLUTIONS TO ADDRESS
ALL THE MANY CONCERNS THAT
PEOPLE HAVE OUT THERE. SO WITH
THAT I WANT TO START BY
ACCEPTING THE COMMITTEE'S
AMENDMENTS AND THE INTENDED THE
INTENDED AMENDMENTS THAT THEY'RE
THE MODIFICATIONS THAT YOU HAVE
COMING THAT DEAL WITH THE
NARROWING DOWN OF THIS AND ALSO
STATE MY COMMITMENT TO CONTINUE
TO ENGAGE THE CHAIR AS THIS GOES
FORWARD AS THIS WON'T BE A HIDE
THE BALL KIND OF THING AT ALL.
WE WANT TO MAKE SURE THAT THAT
CHAIR IN THIS COMMITTEE STAYS
ENGAGED AND FULLY INFORMED AS
THIS STARTS TO MOVE FORWARD, SO
MOVING FORWARD, I'LL BE SPEAKING
TO THE BILL AS PROPOSED TO BE
AMENDED. A B 11 68 SO VERY
IMPORTANT BILL AND DOES THREE
MAIN THINGS. IT ALLOWS A NARROW
SET OF CITIES. OR FIRE DISTRICTS
TO RETAIN THEIR AUTHORITY OVER
PRE HOSPITAL EMERGENCY SERVICES
OR TWO OH ONE RIGHTS IF THEY
WERE PROVIDING SERVICE AS PART
OF A J P A AS OF THE END OF 2022
. IT ALLOWS THE CITY OF OXNARD
IN MY DISTRICT TO RETAIN THEIR
TWO OH ONE RIGHTS AND IT
CLARIFIES THAT GOING FORWARD
ENTERING A J P A DOES NOT
AUTOMATICALLY TAKE AWAY
SOMEONE'S TWO. OH ONE, WRITES.
I'D LIKE TO TELL YOU THAT THIS
IS AN EASY BILL. BUT AS YOU'VE
IDENTIFIED, IT CERTAINLY ISN'T
AND WE RECOGNIZE THAT WE'RE THIS
IS STILL A WORK IN PROGRESS, AND
WE CONTINUE TO TRY TO WORK WITH
YOU ON THAT. I'VE WORKED HARD
WITH THE SPONSORS AND SUPPORTERS
. OXNARD FIRE CHIEF HAMBLETON
AND WE HAVE TRIED TO LISTEN TO
THE CONCERNS OF THE OPPONENTS AS
CAREFULLY AS WE CAN, AND WE WILL
CONTINUE TO DO THIS AT AS THIS
MOVES FORWARD. WE WANT TO TRY TO
ENSURE THAT JUST BUILD CONTAINS
A REAL FAIL SAFE TO AVOID
DISRUPTING THE EXISTING SYSTEM
THAT FAIL SAFE THAT, UM, I
CERTAINLY INSISTED UPON BEFORE I
WAS WILLING TO MOVE FORWARD WITH
THIS BILL REQUIRES THAT THE CITY
OR FIRE DISTRICT THAT IS
CHOOSING TO RETAIN THEIR TWO OH
ONE RIGHTS AND NEEDS TO COVER
THE SURROUNDING EMS AREAS SO YOU
DON'T HAVE HIGHLY CONCENTRATED
CITY AREAS WHERE THERE ARE LOTS
OF FEE FOR SERVICE, UM, GETTING
GOOD SERVICE AND THEN RURAL
AREAS, POTENTIALLY WHERE THERE
IS NOT AS MUCH OPPORTUNITY BEING
LEFT WITH INFERIOR SERVICE, SO
THOSE CITIES ARE FIRE DISTRICTS
THAT CHOOSE TO RETAIN THEIR
RIGHTS CANNOT. IF THEY CAN'T
REACH AN AGREEMENT WITH THE
COUNTY THEY HAVE TO COVER ALL OF
THE AREA THAT THEY ARE
DISRUPTING WITH THEIR DECISION.
WE SHOULD NOT PROHIBIT OUR
CITIES AND FIRE DISTRICTS FROM
RETAINING THEIR TWO OH ONE
RIGHTS JUST BECAUSE THEY JOINED
JP A, PARTICULARLY IF THEY
DIDN'T EVEN HAVE A CONVERSATION
IN ADVANCE ABOUT THAT BEING THE
THICK THE FACT I WANT TO MAKE
CLEAR THAT ALTHOUGH THIS BILL
DEALS WITH TO RUN WRITES, IT'S
NOT AS WE SAID THE SAME AS SB
443 THAT CAME IN FRONT OF YOU
LAST YEAR. UNLIKE SB 443. THIS
BILL DOES NOT DEAL WITH MEDICAL
CONTROL OF LOCAL EMS AUTHORITIES
OVER PUBLIC AGENCIES. AND IT
DOES CONTAIN THE FAIL SAFE THAT
I JUST MENTIONED TO AVOID
DISRUPTION OF SERVICE. FINALLY
IF A LOCALITY WITH TWO OH ONE
RIGHTS HAD THE SERVICES
SURROUNDING AREA, THE LOCAL EMS
AUTHORITIES AND THE STATE EMS
AGENCIES WHICH STILL HAVE
OVERSIGHT OVER THOSE SERVICES
AND WOULD HAVE AND THE SERVICES
WOULD HAVE TO CONTINUE TO ENSURE
THAT SERVICES EQUAL OR BETTER
LEVEL THAN WHAT THEY PULLED OUT
OF. I UNDERSTAND THAT THERE
THERE ARE MANY FUNDAMENTAL
DISAGREEMENTS AROUND THIS ISSUE
, AND AS YOU MENTIONED MR CHAIR
, FAIRLY ENTRENCHED VIEWS, I
HOPE WE CAN HAVE AN HONEST AND
CALM DIALOGUE. AS WE CONTINUE TO
WORK TO TRY TO FIND WAYS TO DEAL
WITH THE CONCERNS OF THE
OPPOSITION AND MITIGATE THOSE
CONCERNS WITH ME TO TESTIFY
TODAY. I APPRECIATE OXNARD FIRE
CHIEF ALEXANDER HAMBLETON AND
DOUG SUPERS ON BEHALF OF THE
CALIFORNIA PROFESSIONAL
FIREFIGHTERS ASSOCIATION. THANK
YOU. CHIEF. GOOD AFTERNOON CHAIR
AND HEALTH COMMITTEE MEMBERS. MY
NAME IS ALEX HAMILTON'S AND I'M
THE FIRE CHIEF OF THE CITY OF
OXNARD, AS WELL AS THE PRESIDENT
OF THE FIRE CHIEF'S DEPARTMENT
FOR THE LEAGUE OF CITIES, WHICH
IS SPONSORING THIS MEASURE, SO
THIS MEASURE SEEKS TO CLARIFY
THE SECTION TO ONE OF THE ACT,
WHICH GRANDFATHER AND ROTS FOR
ENTITIES THAT WERE DELIVERING
PRE HOSPITAL MÁS SERVICES PRIOR
TO THE ACT, BECOMING LAW. AND I
DO APPRECIATE THAT. THIS IS A
POINTY HEADED ISSUES, SO I
WANTED TO TALK A LITTLE BIT
ABOUT OUR EXPERIENCE ON THE
GROUND. UM SO A COUPLE OF, UM,
ISSUES I WANTED TO ADDRESS, UM,
WITH THIS LEGISLATION IS THE
FACT THAT IF YOU LIVE IN, UM IN
AN AREA THAT HAS BEEN DESIGNATED
BY HARD AS 50% LOW TO MODERATE
INCOME AREA, YOU WERE TWICE AS
LIKELY TO WAIT FOR AN AMBULANCE.
THIS RISES TO ALMOST 3 TO 1
RATIO FOR NEIGHBORHOODS THAT ARE
IN A 75% LOW TO MODERATE INCOME
AREA. AFTER TRYING TO WORK
COLLABORATIVELY WITH VENTURA
COUNTY MÁS AGENCY ON THIS ISSUE
OF A NUMBER OF YEARS, NOT CITY
COUNCIL CHOSE TO LEAVE THE JOINT
POWERS AGREEMENT THAT HAD
GOVERNED AMBULANCE SERVICE IN
VENTURA COUNTY SINCE THE
SEVENTIES. THE CITY WENT OUT TO
AN RFP AND WENT OUT TO BED.
ULTIMATELY FALK AMBULANCE WAS
THE WINNER OF THAT BID. UM UH,
THE ALLIANCE MODEL THAT WE HAD
BUILT WAS GOING TO IMPROVE
SERVICE DELIVERY ACROSS OUR CITY
, REGARDLESS OF SOCIOECONOMIC
STATUS AND WAS ALSO GOING TO
IMPROVE THE WORKING CONDITIONS
OF THE EMPLOYEES WORKING FOR
THAT AMBULANCE COMPANY. UM ONE
OF THE THINGS THAT I WANTED TO
TOUCH ON WHEN IT COMES TO, UM
UH, SYSTEM IN EQUITY IS THAT THE
APPELLATE COURT IN THE RULING ON
THE OXEN VERSUS COUNTY
ADVENTURER CASE ACCEPTED
OXNARD'S EVIDENCE OF SYSTEMIC
INEQUITIES OR TO PUT IT ANOTHER
WAY. THEY RULED THAT SYSTEMIC
INEQUITIES IN THE AMBULANCE
SERVICE DELIVERY IN VENTURA
COUNTY IS A FACT. THE SECOND
POINT I'D LIKE TO MAKE IS
REGARDING AND AN INTEGRATED
SYSTEM IN A TRULY INTEGRATED
SYSTEM THAT OXYGEN IS STRIVING
TO REALIZE THERE WOULD BE A MIX
OF AMBULANCES AND FIRE
DEPARTMENT UNITS, PROVIDING
ADEQUATE PARAMEDIC COVERAGE
ACROSS THE JURISDICTION, ALWAYS
ENSURING A TIMELY RESPONSE.
HOWEVER, THERE IS CURRENTLY NO
INTEGRATION OR COORDINATION
BETWEEN AMBULANCE AND FIRE UNITS
. THE AMBULANCE COMPANY SIMPLY
SPREADS THEIR UNITS AS SIMPLY AS
POSSIBLE TO MAXIMIZE PROFITS
WHILE TRYING TO MAINTAIN THEIR
CONTRACTUAL COMPLIANCE. IN 2019
. THERE WAS 1200 OCCASIONS WHERE
THERE WAS NO AMBULANCES
AVAILABLE IN THE CITY OF OXEN
HAD A CITY OF OVER 200,000
PEOPLE. AND SO IN CLOSING, I
WOULD LIKE TO EMPHASIZE THAT THE
COURT DID NOT RULE ON THE TOUR
ONE WRITES ON OXNARD'S TOUR, ONE
WRITES. INSTEAD, THEY HELD THAT
EVEN IF OXEN HAD HAD THEM THEY
WERE SURRENDERED WHEN WE SAW IN
THE JOINT POWERS AGREEMENT, AND
SO THIS BILL IS THE GOAL OF THIS
BILL IS TO BE NARROWLY TAILORED
TO FURTHER THE INTENT OF THE EMS
ACT. AND I THANK YOU FOR YOUR
TIME TODAY. THANK YOU. THANK
YOU, MR CHAIR AND MEMBERS DOUG
SUPERS ON BEHALF OF THE
CALIFORNIA PROFESSIONAL
FIREFIGHTERS AND STRONG SUPPORT
OF A B 1168 CPF REPRESENTS MORE
THAN 34,000, PROFESSIONAL
FIREFIGHTERS AND EMERGENCY
MEDICAL SERVICES PERSONNEL
STATEWIDE. WE WOULD LIKE TO
THANK ASSEMBLYMEMBER'S BENNETT
FOR BRINGING THIS BILL FORWARD
TO THE COMMITTEE FOR THEIR
ENGAGEMENT AND WORK ON THIS
ISSUE. THIS MEASURE WILL CREATE
CLARITY AROUND THE PROVISION OF
PRE HOSPITAL EMS SERVICES AND
RIGHTS TO DELIVER THOSE
SERVICES. THE OXEN ARE DECISION
HAS RAISED AMBIGUITY AND
POTENTIAL NEGATIVE CONSEQUENCES
, AND WE FIRMLY BELIEVE IT'S
APPROPRIATE FOR THE LEGISLATURE
TO ADDRESS THIS ISSUE THROUGH A
B 11 68. IN ADDITION TO
ADDRESSING THE CITY OF OXNARD
DIRECTLY, THIS BILL WILL SEEK TO
ENSURE THAT JURISDICTIONS THAT
ARE PROVIDING PRE HOSPITAL E. M
S IS A RESULT OF A JOINT
EXERCISE OF POWERS AGREEMENT ARE
NOT NEGATIVELY IMPACTED BY THE
AUCTION. OUR DECISION SHOULD
THEY HAVE RIGHTS AND SEEK TO
DELIVER SERVICES IN THE FUTURE.
FURTHER THIS MEASURE WILL ENSURE
STATUTORY CLARITY FOR A FIRE
DEPARTMENT TO ENTER INTO A
FUTURE AGREEMENT. WITH THE
COUNTY TO DELIVER PRE HOSPITAL
MÁS WITHOUT LOSING THEIR RIGHTS
, ASSEMBLYMEMBER'S BENNETT NOTED
IN HIS COMMENTS AT THE MEASURE
CONTAINS A FAILSAFE SECTION TWO
SUBDIVISION D OUTLINES THE
PROCESS THAT ENSURES THAT
COMMUNITIES HAVE CONTINUED
ACCESS TO EMS SERVICES. SHOULD A
CITY OR FIRE DISTRICT EXERCISE
RIGHTS UNDER THIS BILL? CPF
MEMBERS CARE DEEPLY ABOUT THEIR
COMMUNITY AND SEE AM SERVICES IS
A VITAL PORTION OF THEIR WORK IN
MANY JURISDICTIONS. CPF MEMBERS
PROVIDE FIRST RESPONSE SERVICES
WHERE THEY ARE FIRST ON SCENE IN
A MEDICAL EMERGENCY AND BRUTE
BEGIN RENDERING AID ON A PATIENT
WHILE WAITING FOR AN AMBULANCE
TO TRANSPORT THE PATIENT TO A
HOSPITAL. IT IS IMPERATIVE THAT
THE SYSTEM BE EFFICIENT DELAYS
OR INEFFICIENCIES, IMPACT THE
ENTIRE PRE HOSPITAL AMS SYSTEM
AND THE WORKING CONDITIONS OF
CPF MEMBERS. FINALLY I WOULD
JUST LIKE TO ADDRESS A FEW OF
THE OPPOSITION POINTS THAT ARE
IN THE ANALYSIS NOTED ON PAGE
SEVEN OR EIGHT. FIRST WE REJECT
ANY NOTION THAT EMS SERVICES ARE
PURSUED BY FIREFIGHTERS TO
SOMEHOW ADDRESS OR SUPPORT
PENSION COSTS. ARE MEMBERS
COMMIT THEIR LIFE TO SERVICE TO
THEIR COMMUNITY. THEY BARGAIN
AND PAY FOR A SECURE RETIREMENT
. WE SEEK TO DELIVER THEM ARE
MEMBERS SEEK TO DELIVER THE BEST
CARE TO THEIR COMMUNITIES AND
YOUR CONSTITUENTS. SO WE
DISAGREE WITH ANY NOTION THAT A
SECURE RETIREMENT IS NEGATIVE.
UH, SECOND, THERE IS SOME
DISCUSSION ABOUT FIRE
DEPARTMENT'S EFFORTS TO CARVE
OUT AREAS OF GEOGRAPHY AND SERVE
ONLY CERTAIN CONSTITUENTS. WE
THINK THAT THE FAILSAFE HAS
DESCRIBED BY ASSEMBLYMEMBER'S
BENNETT WILL ADDRESS THAT ISSUE
THAT THIS WOULD NOT BE AN EFFORT
TO PICK AND CHOOSE CERTAIN
COMMUNITIES. IT WAS ENSURED THAT
THE ENTIRE COMMUNITY GETS
SERVICE. AND FINALLY, THERE IS
SOME SUGGESTION THAT A MEDICAL
REIMBURSEMENT RATE FOR PUBLIC
PROVIDERS IS EXORBITANT. AH WE
DISAGREE WITH THAT. IT IS
EXORBITANT. WE DON'T THINK IT'S
A RACE TO THE BOTTOM. AND WE
WOULD JUST RESPECTFULLY SAY THAT
THE RECOVERY IS BORN BY THE
LOCAL JURISDICTION IN THE
FEDERAL GOVERNMENT, NOT THE
STATE. FOR THESE REASONS. WE
RESPECTFULLY REQUEST YOUR I
VOTE. THANK YOU. THANK YOU VERY
MUCH OTHERS IN SUPPORT. RICHARD
PEARSE, FIRE CHIEF OF THE TEHRAN
FIRE DISTRICT, REPRESENTING FIRE
DISTRICTS OF CALIFORNIA. SUPPORT
YOU. CHAIR COMMITTEE MEMBERS.
CHRIS TUBS, PRESIDENT OF
CALIFORNIA FIRE CHIEFS
ASSOCIATION AND SUPPORT THANK
YOU. THANK YOU. ANYONE ELSE?
OPPOSITION TO THE BILL. I'M
SORRY IN BEHALF OF THE CITY OF
OXNARD AND STRONG SUPPORT. THANK
YOU.
WE STILL HAVE AS IT WAS
OURSELVES. SORRY. YOU'RE PART OF
THE OPPOSITION. OKAY, THANK YOU.
ARE THERE OTHERS AND STILL
OTHERS IN SUPPORT. I'M SORRY. I
DIDN'T MEAN TO OKAY? OKAY? OKAY,
WHENEVER YOU'RE READY. GOOD
AFTERNOON, MR CHAIR AND
COMMITTEE MEMBERS. MY NAME IS
DANIEL SHEPARD. I'M A PRACTICING
EMERGENCY DEPARTMENT PHYSICIAN
MÁS SPECIALIST IN CURRENT
EMERGENCY MEDICAL SERVICES,
MEDICAL DIRECTOR, VENTURA COUNTY
MÁS AGENCY, SPEAKING TODAY IN
RESPECT OPPOSITION TO A B 11 68
ON BEHALF OF A BROAD COALITION
OF COUNTIES. FIRST WE BELIEVE A
B 11 68 WILL UNDERMINE AND
REVERSE OVER 40 YEARS OF VMS
SYSTEM PLANNING. AND WE'LL
COMPROMISE EQUITABLE DELIVERY OF
PRE HOSPITAL MEDICAL CHARACTER
COMMUNITY STATEWIDE. PART OF THE
M S ACT. REGULATION OF VMS IN
CALIFORNIA WAS FRAGMENTED AND
HAPHAZARD. NOTHING REQUIRED MÁS
PROVIDERS TO COORDINATE OR
INTEGRATE THEIR SERVICES QUALITY
CARE VARIED AND WAS NOT
EQUITABLE ACROSS JURISDICTIONS.
THE EMBASSY ACT PROMISED, AND
FOR 40 YEARS HAS DELIVERED A
COORDINATED, INTEGRATED AND
READILY AVAILABLE SYSTEM OF PRE
HOSPITAL EMERGENCY MEDICAL CARE
AND SUPPOSED TO HOSPITAL
RESOURCES FOR EVERYONE IN
CALIFORNIA. REGARDLESS OF WHERE
ONE LIVES OR THEIR SOCIOECONOMIC
STATUS. THE CURRENT CALIFORNIA
AMS SYSTEM IS BUILT ON A
COMPREHENSIVE TWO TIERED SYSTEM
OF GOVERNANCE ACROSS THE ENTIRE
SPECTRUM OF MERGING MEDICAL
SERVICES THROUGH BOTH THE STATE
AND THIS AUTHORITY AND LOCAL
EMERGENCY MEDICAL SERVICES
AGENCY COLLAPSES HIMSELF.
PHYSICIAN MEDICAL DIRECTORS LIKE
MYSELF PROVIDE OBJECTIVE
OVERSIGHT IN THE PLANNING,
IMPLEMENTATION AND MONITORING OF
VMS SYSTEM. AN ADVOCATE FOR THE
SAFETY OF OUR COMMUNITIES BY
FOCUSING ON PATIENT NEEDS
THROUGH IMPARTIAL ASSESSMENT,
IMPARTIAL ASSESSMENT OF SYSTEM
PERFORMANCE IN 1997, THE
CALIFORNIA SUPREME COURT CASE
INVOLVING THE CITY AND COUNTY OF
SAN BERNARDINO FROM THE NEED FOR
COUNTIES. THEY MANAGE THEIR
LOCAL MÁS SYSTEMS. ADDITIONALLY
MORE RECENT CASES IN MY COUNTY
OF VENTURA AND IN THE COUNTY OF
SAN JOAQUIN, WE AFFIRM THE NEED
FOR THE COORDINATION,
INTEGRATION AND AVAILABILITY OF
AMS SERVICES. KENNY WHITE
PROPONENTS HAVE ARGUED THAT THIS
MEASURE ENSURES CITIES ARE FIRE
DISTRICT WILL RETAIN THEIR 21
RIGHTS IF THEY ENTER OR HAVE
ENTERED INTO A JOINT POWERS
AGREEMENT FOR THE PROVISION OF
AMBULANCE SERVICE. NOTHING
CURRENTLY INCLUDES JP AGREEMENT
FROM ENSURING THERE'S
ADMINISTRATIVE RESPONSIBILITIES
COULD BE MAINTAINED IN THE
CONTEXT OF A G P A. THE COUNTY
OF ENTER, HAS ADMINISTERED MÁS
SERVICES IN THE CITY OF OXFORD
FOR OVER FIVE DECADES AND LONG
BEFORE THE ENACTMENT OF THE M S
ACT WITH VIRTUALLY NO
INVOLVEMENT BY THE CITY OR THE
PROPOSED AMENDMENTS SCENARIO,
THE INTENT OF THE BILL, WE STILL
BELIEVE THE RESULT OF THE B 11
68 WILL LIKELY BE WIDESPREAD
FRAGMENTATION OF THE ORGANIZED,
EFFICIENT AND EFFECTIVE VMS
SYSTEM OF TODAY AND REVERSION TO
THE DISJOINTED STATE THAT
EXISTED PRIOR TO THE
IMPLEMENTATION OF THE M S ACT.
WE STILL BELIEVE CITIES AND FIRE
DISTRICTS WILL BE ABLE TO GIVE
THEMSELVES TO ONE ENTITIES
MOVING FORWARD, ALIGN THEM TO
LEAVE EXISTING AGREEMENTS WITH
COUNTIES OUT WELL, COUNTIES WILL
THEN BE FORCED TO OPEN UP
ALREADY COMPLEX AMBULANCE
CONTRACTING PROCESSES, WHILE
SCRAMBLING, PROVIDE CONTINUOUS
SERVICE TO IMPACTED RESIDENTS.
WE FIRST SEE A REDUCTION IN
QUALITY OF CARE AND DEEPENING OF
HEALTH DISPARITIES FOR RURAL
COMMUNITIES AND LOW INCOME OR
HISTORICALLY UNDERSERVED
POPULATIONS. MR CHAIR WHILE WE
APPRECIATE THE PROPOSED
AMENDMENTS, IT'S STILL
AGGREGATES OF OXFORD VERSUS
VENTURA RULING AND IT'S NOT
ALLEVIATE BROADER COUNTY
CONCERNS FOR THE REASONS I
OUTLINED CALIFORNIA COUNTY
STRONGLY ENERGY TO STAND FOR OUR
COMMUNITIES AND VOTE NOTE A B 11
68. SER. HELLO. AS I INTRODUCED
MYSELF TO MY PATIENTS. HELLO I'M
NATHAN, THE PARAMEDIC ON THE
AMBULANCE. I HAVE 17 YEARS OF
SONOMA COUNTY EMS EXPERIENCE IN
THE FIELD TRAINING OFFICER AND
THEN ASKED ME A LOCAL FOR 911
MEMBER AND MOST IMPORTANTLY TO
TODAY I AM YOUR E. M S. I MEAN,
THE GUY IN THE BACK WITH YOU.
BECAUSE OF ALL OF THIS, I MUST
OPPOSE ASSEMBLY BILL 11 68.
FIRST I MUST ECHO CONCERNS ABOUT
REGIONAL ARE FPS, CREATING
EQUITY AND MEASURABLE
ACCOUNTABILITY ACROSS THE
REGION. I AM THE PERSON THAT IS
FACE TO FACE WITH MY PATIENTS,
SO THE COST AND QUALITY OF THAT
CARE AND SERVICE IS DEEPLY
IMPORTANT TO ME BECAUSE OF MY
PATIENTS. I AM THAT I KNOW ONE
SYSTEM. IT HAS BEEN ARGUED THAT
THIS IS IMPROVING ON THE MODEL,
BUT UNDERSTAND THAT IS NOT WHAT
HAS BEEN ATTEMPTED. THERE IS
NUMEROUS AVENUES FOR THAT
IMPROVEMENT IS MULTIPLE
DISCIPLINES WORKING TOGETHER,
LED BY A PHYSICIAN. THIS IS
BECAUSE SOME PEOPLE ON THIS.
EXCUSE ME ON THIS POINT. THIS IS
BECAUSE SOME PEOPLE HAVE NOT
GOTTEN THEIR WAY. I MUST ALSO
POINT OUT A CLEAR CONTRADICTION
IN THIS BILL. SECTION TWO E
STATES THAT THIS BILL WILL NOT
MODIFY, AFFECT OR LIMIT THE ROLE
OF THE MEDICAL DIRECTOR. THAT IS
NOT ACHIEVABLE WHEN SECTION TWO
D. AUTHORIZES DEPARTMENTS TO
REMOVE THEMSELVES FROM OUR FPS.
THOSE ARE THOSE ARE TWO MUTUALLY
EXCLUSIVE. THOSE ARE MUTUALLY
EXCLUSIVE, EXCLUSIVE AND CANNOT
COEXIST. I HAVE TO ALSO
HIGHLIGHT THE LOSS OF REGIONAL
BUILDING WAS SEVERELY RESTRICT E
. M S UNIONS ABILITIES TO
NEGOTIATE LIVABLE CONTRACTS
AFFECTING OVER 70% OF
CALIFORNIA'S EMT ISN'T
PARAMEDICS. THAT IS AN ATTACK ON
BARGAINING ON A SCALE WE HAVE
NEVER SEEN. I ASK YOU TO DEEPLY
CONSIDER. HOW WOULD YOU WANT
YOUR E M S RAN BY THE DESIRES
AND OPINIONS? OF ONE PERSON
WITHOUT ENFORCEMENT LARGELY
ACCOUNTABLE. WE MUST HAVE REGION
WIDE LIMBS, A PHYSICIAN LED
SCIENCE DRIVEN EMS ACCOUNTABLE
AND ENFORCEABLE HERE IN SERVICE
AND THAT THE PEOPLE PROVIDING
THAT CARE ARE REPRESENTED IN AND
COMPENSATED FAIRLY. AND WE ARE
AND WE DO NOT SEE THE AMENDMENTS
AS PRESENTED AS HAVING A
POSITIVE EFFECT ON THAT. THANK
YOU VERY MUCH. THANK YOU, UM
OTHERS IN OPPOSITION, JUST YOUR
NAME AND ORGANIZATION IF YOU
REPRESENT ONE. SHELLY HUDDLESTON
. I AM THE LABOR NATIONAL
REPRESENTATIVE FOR THE
INTERNATIONAL ASSOCIATION OF
EMTS AND PARAMEDICS AND WE
OPPOSE. JOCELYN PAULSON. I'M
PRESIDENT OF AFSCME. LOCAL 49 11
49 11, REPRESENTING EMTS AND
PARAMEDICS THROUGHOUT THE STATE
OF CALIFORNIA, AND WE OPPOSE
REMEMBERS JANICE FAMILY WITH
AFSCME, CALIFORNIA WE APPRECIATE
THE COMMUNITIES WORK ON THE
BILL. YET EVEN WITH THE CHAIR
SUGGESTED AMENDMENTS, WE STILL
BELIEVE THAT 11 68 WILL LEAD TO
A FRACTURED EMERGENCY SERVICES
SYSTEM AND ULTIMATELY NEGLECTS
THE IMPACTS TO THE M S WORKFORCE
. THEREFORE WE REMAIN OPPOSED.
THANK YOU, JUST YOUR NAME AND
ORGANIZATION. I MEAN, PLEASE.
ADRIAN SOTO E M T MEMBER OF
TEMPS TO OPPOSE. THANK YOU. MY
NAME IS STEVEN STONE. I'M A
MEMBER OF TEMPS A AND I OPPOSE
11 68. THANK YOU. LATIFA
ALEXANDER WITH THE ASSOCIATION
OF CALIFORNIA HEALTHCARE
DISTRICTS IN OPPOSITION. GOOD
AFTERNOON. LINDSEY GOLDKORN ON
BEHALF OF SAN BERNARDINO COUNTY.
RESPECTFULLY OPPOSED. THANKS.
THANK YOU. CHAIR MEMBERS,
JONATHAN FELDMAN ON BEHALF OF
THE 911 AMBULANCE ALLIANCE IN
OPPOSITION. THANK YOU. GOOD
AFTERNOON, BRIAN HENDRICKS IN
WITH GLOBAL MEDICAL RESPONSE
HERE IN OPPOSITION, THANK YOU.
GOOD AFTERNOON, DAVID MAGNE, NO
REPRESENTING SACRAMENTO COUNTY
AND POSE AND ALSO REPRESENTING
THE EMERGENCY MEDICAL SERVICE
ADMINISTRATORS ASSOCIATION OF
CALIFORNIA OPPOSED. THANK YOU.
GOOD AFTERNOON. JEREMY SHOEMAKER
AMERICAN MEDICAL RESPONSE,
RIVERSIDE COUNTY, A POST THANK
YOU. GOOD AFTERNOON,
CRISSCROSSING WITH THE PRAYING
MAKELELE ON BEHALF OF COVALIN,
HEALTH AND OPPOSITION. GOOD
AFTERNOON JEAN HURST HERE TODAY
ON BEHALF OF THE URBAN COUNTIES
OF CALIFORNIA AND THE VENTURA
COUNTY BOARD OF SUPERVISORS IN
OPPOSITION. THANK YOU ON BEHALF
OF THE RURAL COUNTY
REPRESENTATIVES OF CALIFORNIA
AND ON AN OPPOSITION GOOD
AFTERNOON. MICHAEL COHEN, MEDIC,
AMBULANCE AND OPPOSITION. MR
CHAIRMAN MEMBERS, BETSY
ARMSTRONG, ON BEHALF OF THE
COUNTY HEALTH EXECUTIVES
ASSOCIATION REPRESENTING LOCAL
HEALTH DEPARTMENTS IN RESPECTFUL
OPPOSITION. AARON VAUGHN. MEDIC,
AMBULANCE WE OPPOSED. THANK YOU.
LISA CURLY MEDIC, AMBULANCE AND
I OPPOSE. THANK YOU. HELLO
STEPHEN BUCKNER WITH MEDICAL
AMBULANCE. I POSTED THANK YOU.
CATHERINE HOUSTON, UNITED
STEELWORKERS DISTRICT 12 AND
OPPOSITION. THANK YOU. THANK
YOU. GOOD AFTERNOON, AND MIKE
ESLINGER, REGIONAL DIRECTOR FOR
AMAAR IN MONTEREY, SANTA CRUZ
AND SAN BENITO COUNTIES. AND I
ASK THAT YOU STRONGLY OPPOSE.
THANK YOU. THANK YOU. HI THERE
TODAY. RURAL METRO ST CLAIR
COUNTY. A POST THANK YOU. AND ON
BEHALF OF CEMETERY COUNTY BOARD
OF SUPERVISORS AND OPPOSITION.
HI KATRINA. GARCIA PARAMEDIC
AMERICAN MEDICAL RESPONSE FROM
SAN JOAQUIN COUNTY AND I OPPOSE
. I AM MARRIED WITH A M R PEOPLE
LOCAL TO AND I'M PRESIDENT. I
OPPOSE. THANK YOU. AFTERNOON
NICOLE HENDRICKSON GLOBAL MEGA
RESPONSE I POSE YOU. CARL SPORE
, REPRESENTING THE M S MEDICAL
DIRECTORS ASSOCIATION OF
CALIFORNIA. WE OPPOSE THANK YOU.
KIM FREEMAN BY COUNTY AMBULANCE
AND 20 COUNTY EMS AGENCY OPPOSED
GOOD AFTERNOON. BRIAN HEIDRICH
AMERICAN MEDICAL RESPONSE SAM
KING COUNTY STAND OPPOSED. KATIE
ANDREWS, TOMMY COUNTY MÁS AGENCY
OPPOSED. ELIZABETH BROOKLYN
PARAMEDIC WAS WORKING COUNTY IN
OPPOSITION. STEPHANIE RIDDLE,
PARAMEDIC FOR SAMUEL, KING,
COUNTY AND OPPOSITION ALSO, WE'D
LIKE YOU TO REMEMBER THAT WE TO
DEDICATE OUR LIVES. THANK YOU.
ELIAS ASTRADA IN SAMPSON COUNTY.
AMERICAN MEDAL RESPONSE POST.
THANK YOU. HI RACHEL BLUE TO ON
BEHALF OF THE COUNTIES OF CONTRA
COSTA AND YOLO AND OPPOSITION.
GOOD AFTERNOON. JAMES TRINCHERO
. AM OUR SANDWICH, KING COUNTY
AND I OPPOSE. THANK YOU. ERIC
RIES. PARAMEDICS PROFESSOR
SAMUEL KING COUNTY. UM, ARE WE
OPPOSED? GOOD AFTERNOON BRANCH,
PEANUT CHIEF SHOP STEWARD RANKIN
COUNTY WE OPPOSE I HOPE YOU ALL
LEFT SOMEBODY IN SAN JOAQUIN
COUNTY. ANYBODY WITH AMERICAN
MEDICAL RESPONSE IN A POSITION.
THANK YOU. GOOD AFTERNOON. JILL
VINCENT WITH AMERICAN MEDICAL
RESPONSE OPPOSED. THANK YOU.
RYAN SACK AM, ARE YOU. AMERICAN
MEDICAL RESPONSE, A POST
DANIELLE LANDS, GMR POST. THANK
YOU. GOOD AFTERNOON. DOUGLAS
SPERM, YELL COUNTY EMS AGENCY
ADMINISTRATOR REPRESENTING YOLO
COUNTY, MÁS AGENCY AND THE POST.
THANK YOU. GOOD AFTERNOON, MICRO
MOST SAMMARTINO COUNTY AIMAR. I
OPPOSE. HEATHER WHAT'S SAN
BERNARDINO COUNTY AYMARA POST.
DIANA MCCAFFERTY AM OUR SATURDAY
. OH COUNTY AND I OPPOSE YOU.
MARK BELDEN AMERICAN MEDICAL
RESPONSE, SHASTA COUNTY, A POST
. TYLER HEROD, REPRESENTING, UH
, FOR 911. I POSE MADISON Y IN
PARAMEDIC, LOCAL 4911 I OPPOSE
RICHARD LEMON AM OR SHASTA
COUNTY, RESPECTFULLY OPPOSED.
THANK YOU. MICHAEL EISEN,
PARAMEDIC AM OUR SHASTA COUNTY,
A POST MCCOY, JUST COUNTY I
OPPOSE. THANK YOU. JEFF MEISNER,
LABOR REPRESENTATIVE UNITED MÁS
WORKERS IN OPPOSITION. THANK
YOU. BERNIE BRADLEY, M R SAN
FRANCISCO. I OPPOSE LEE ALAMEDA
THAMES, A UNITED STEEL WORKERS
INTERNATIONAL UNION LOCAL 12 90
11, REPRESENTING MEMBERS FROM
LOS ANGELES TO SAN FRANCISCO. WE
OPPOSE YOU, SAM MADELINE, A
PARAMEDIC, RIVERSIDE COUNTY M, R
. AND UNITED E. M S WORKERS. I
OPPOSE GOOD AFTERNOON. MY NAME
IS JENNIFER COLORLESS. I AM A
PARAMEDIC FOR SOUTHWEST COUNTY
ALSO CHIEF STEWARD. WE OPPOSE
THANK YOU. ROD BRO. HEART
AMERICAN MEDICAL RESPONSE. I
POSE. GOOD AFTERNOON. CASSIE
MADURO'S AM ARE FOR CITY AND
COUNTY OF SAN FRANCISCO, AND WE
OPPOSED. GOOD AFTERNOON.
MICHELLE FRANKLIN CLINICAL
MANAGER, RURAL METRO CALIFORNIA
WE OPPOSE QUÊ. I'M CAROL
MCCLANAHAN WITH RURAL METRO
AMBULANCE IN SANTA CLARA COUNTY
I POST JASON CHAN WITH CITY
AMBULANCE OF EUREKA AND VICE
PRESIDENT OF THE CALIFORNIA
AMBULANCE ASSOCIATION. WE ARE
OPPOSED. JACOB FROM ER WITH
SONOMA LIFE SUPPORT POST. GREG
GYPSIES. MY SUPPORT HOUSE. THANK
YOU. SUZANNE CESSNA, SANTA CLARA
COUNTY. I AM A REGISTERED NURSE
AND I OPPOSE MALCOLM GRAHAM AM
ARE HEMET, RIVERSIDE COUNTY
OPPOSED YOU? SUSAN NELSON, AM
OUR PARAMEDIC AND HIM IT IN
RIVERSIDE COUNTY, A POST THANK
YOU. DARLING CARPENTER,
PARAMEDIC FIELD TRAINING OFFICER
COUNTY OPPOSE THANK YOU. NICK
GRAHAM, M. R HEMET, RIVERSIDE
COUNTY I OPPOSE. THANK YOU.
AMBROSE STEVENS AM OUR CINEMA
LIFE SUPPORT AND I OPPOSE.
JOHNNY KRISTALINA AS UM, WITHOUT
FOR AN AMBULANCE, PARAMEDIC AND
EMERGENCY E. M S, UM, INTER
FACILITY TRANSPORT MANAGER. UH
AND WE'RE IN MY OPPOSITION.
THANK YOU. GOOD AFTERNOON. KEN
LIEBMAN. AMERICAN MEDICAL
RESPONSE, LOS ANGELES COUNTY
OPPOSED. DANIEL AND AGAIN IS
WITH GLOBAL MEDICAL RESPONSE IN
STANISLAUS COUNTY POST. THANK
YOU. GOOD AFTERNOON. DAVID. OKAY
NAIMARK, RIVERSIDE, SOUTHERN
CALIFORNIA WE OPPOSE. GOOD
AFTERNOON. PETER JOHANN. IT'S
NORMAL LIFE SUPPORT URGED
YOUTUBE REJECT THIS ASSEMBLY
BILL. GOOD AFTERNOON, ALEX. LAST
ROMANTIC CENTER, CLARA AND I
OPPOSE YOU. AFTERNOON, MELISSA,
YOU KNOW LISA, NORMAL LIFE
SUPPORT AND OPPOSITION. KATARINA
MCNULTY NORMALIZED SUPPORT
OPPOSED. RACHEL FANNING, SAN
DIEGO AM RCC TRN, UNION
PRESIDENT AND OPPOSITION. YEAH.
JULIE BELL, AIMAR, SAN DIEGO IN
OPPOSITION. AND MILLER, M. R SAN
DIEGO AND OPPOSITION. THAT IS A
RIOS, MONTEREY COUNTY MÁS AGENCY
DIRECTOR. WE OPPOSE QUÊ. GOOD
AFTERNOON. JOE CHIBLI AMERICAN
MEDICAL RESPONSE. I OPPOSE. GOOD
AFTERNOON. ESTÁ KILLORN ELS
AMERICAN MEDICAL RESPONSE
CEMETERY COUNTY STRONGLY OPPOSED
. TERRENCE FLORES, MATEO COUNTY
OPPOSED. GOOD AFTERNOON. DIANNA
SANCHEZ, AMAAR, SAN MATEO
COUNTY. WE OPPOSE. GENRE OGA
HAIMAR NAPA COUNTY IN
OPPOSITION. THANK YOU. GUERRERO
ALAMEDA COUNTY THEY OPPOSE GOOD
AFTERNOON, JOLIE ONODERA WITH
THE CALIFORNIA STATE ASSOCIATION
OF COUNTIES IN OPPOSITION. GOOD
AFTERNOON WAS CHAIRMAN MICHAEL
OLIVARI AM ARE ALAMEDA COUNTY
OPPOSED? JASON BOND, NAPA COUNTY
M. R. I OPPOSE THANK YOU. NICOLE
HICKS. AM OUR NAPA OPPOSED.
THANK YOU. RICHARD LONG, AMAAR
NAPA OPPOSE YOU. KEVIN MERCER,
AIMAR, SAN DIEGO IN IMPERIAL
COUNTY AND OPPOSITION. OOH
BURNIN WALLS. IMPERIAL COUNTY M
ARE OPPOSED QUÊ. HORNY M R SAN
DIEGO COUNTY OPPOSED. TOM
MARGALLO AWFUL. AN AMBULANCE
CHIEF EXECUTIVE OFFICER OPPOSED
THANK YOU. MARK MENDENHALL AM
OUR SACRAMENTO POST. PAUL
MAXWELL, IMPERIAL COUNTY AND
SANYO COUNTY AM ARE OPPOSED.
MICHAEL JONES, AL FOR AN
AMBULANCE CHIEF ADMINISTRATIVE
OFFICER OPPOSED THANK YOU. NICK
HOIBY AND ALPHA ONE AMBULANCE
OPPOSED. MATT BURRELL, CHIEF
OPERATIONS OFFICER, ALPHA ONE
AMBULANCE POST. THANK YOU. MIKE
WRITER E M T OPPOSED YOU. NO, I
MEAN NAVA H I ÁP UM, ARE
OPPOSED. THANK YOU. MICHAEL
RICE, VICE PRESIDENT GM ARE
OPPOSED. ARLENE SACRAMONE, IAN'S
AIMAR, PLASTER, SACRAMENTO AND
YELLOW POST. THANK YOU. SHAWN
WALTERS, PARAMEDIC VIDEOCON EMR
. UH, I OPPOSE THANK YOU. POWER
KEY SAN DIEGO EMERGENCY MEDICAL
SERVICES ASSOCIATION, ALSO POST
. NICK COOKER, AIMAR, PLASTER
SACK AND YELLOW COUNTIES
OPPOSED. MICHAEL SAKIA PLASTER
OPPOSED. MIKE SANDERS AM OUR
GOLD COAST IN VENTURA COUNTY,
AND I OPPOSE THANK YOU.
AFTERNOON CHARLES MARVEL ON
BEHALF OF MMR, VENTURA COUNTY
AND LOCAL MSP. ONE OPPOSE. THANK
YOU. IVAN MENDEZ, IMPERIAL
COUNTY AM R AND UNION PRESIDENT.
I OPPOSE THANK YOU. JEFFREY
WINTER OPERATIONS MANAGER FOR
GOLD COAST AMBULANCE CURRENTLY
SERVING THE CITY OF OXNARD
OPPOSED GOOD AFTERNOON. JEFFREY
SCHULTZ, OPERATIONS MANAGER. EMR
VENTURA COUNTY STRONGLY OPPOSED.
THANK YOU. SUSANNA SILVA AND
MARSAN DIEGO. I OPPOSE THANK YOU
, CLAUDIA REMPEL AND MARSAN
DIEGO IN OPPOSITION. THANK YOU.
GOOD AFTERNOON, MR. CHAIR. SEAN
SULLIVAN. LIFE WEST OPPOSED GOOD
AFTERNOON, MR CHAIRMAN MEMBERS,
KARIN LANG ON BEHALF OF THE
COUNTY BOARDS OF SUPERVISORS IN
THE COUNTIES OF KERN MERCED,
NAPA, NEVADA PLAZA, SHASTA,
STANISLAS AND HILLARY ALL IN
OPPOSITION. THANK YOU. THANK
YOU. MIKE NOON, THE MÁS
ADMINISTRATORS, CALIFORNIA
OPPOSED. GREAT WALL EMERGENCY
MEDICAL DIRECTORS ASSOCIATION OF
CALIFORNIA OPPOSED. ROBERTO
HERNANDEZ, PARAMEDIC CHAPTER
PRESIDENT UNITED LOCAL, UM SW
4911 OPPOSED MR. CHAIR MEMBER
SHAWN HENSHALL, REGRETTABLY
STILL OPPOSED ON BEHALF OF
AMERICAN MEDICAL RESPONSE. THANK
YOU. THANK YOU. JOHN POLAND,
REPRESENTING THIS YEAR'S
SACRAMENTO VALLEY M S AGENCY AND
OPPOSITION. GOOD AFTERNOON, SEAN
VINCENT, REPRESENTING THE NAPA
COUNTY M S AGENCY AND OPPOSITION
. THANK YOU. GOOD AFTERNOON,
MARSHAL BENNETT, REPRESENTING
CONTRA COSTA COUNTY IN
OPPOSITION. THANK YOU. ANYONE
ELSE? SEE NO ONE BRINGS BACK TO
THE COMMITTEE. QUESTIONS OR
COMMENTS. MR RODRIGUEZ. I ASSUME
YOU HAVE A QUESTION OR COMMENT.
YES I HAVE SEVERAL QUESTIONS.
COMMENTS, UM WHERE TO BEGIN YET.
FIRST OF ALL BEFORE I BEGIN. I
REALLY WANT TO THANK ALL THE M S
WORKERS WHETHER YOU WORK FOR A
PRIVATE OR PUBLIC AGENCY. MY
HAT'S OFF TO YOU GUYS FOR WHAT
YOU DO, DAY IN AND DAY OUT
PROTECTING CALIFORNIANS AS SOME
OF YOU MAY OR MAY NOT KNOW I'VE
BEEN AN E M T FOR OVER 34 YEARS
NOW. SO I WORKED A LOT IN IN THE
SOUTHERN CALIFORNIA,
PARTICULARLY THE L. A COUNTY
AREA. SO THIS BILL IS, UH REALLY
DIFFICULT FOR ME IN SOME POINTS,
BECAUSE I GET WHERE YOU'RE
COMING FROM ON BOTH SIDES HAVE
GOOD FRIENDS ON BOTH SIDES OF
THE FIREFIGHTERS OR IN THE
PUBLIC KI¾M S AGENCIES, BUT I
JUST WANTED TO TOUCH BASE ON
SOME OF THE COMMENTS THAT WERE
MEN ON BOTH SIDES ON THE ON THE
SUPPORT AND OPPOSITION. UM I'LL
JUST START WITH THE OPPOSITION
REALLY QUICK. I KNOW. I'M SORRY,
DOCTOR. I DIDN'T CATCH YOUR
NAME. BUT YOU TALKED ABOUT THIS
40 YEARS OF VMS IN THE INDUSTRY
RIGHT THAT WE'VE HAD ALL THESE
LAWS AND THINGS DONE. AND REALLY
DOESN'T SEEM LIKE THERE'S A BIG
DONE CHANGING THINGS BECAUSE
THINGS ARE SEEN. IT SEEMED TO
WORK WELL, AND I FORGOT WHAT
COUNTS. SANTA BARBARA COUNT
FORGOT WHERE IT WAS RIGHT COUNTY
BOTH AND I THINK, YEAH, I GUESS
YOU'RE TRUE TO A DEGREE THAT
MAYBE SOME COUNTIES DO A BETTER
JOB THAN OTHERS AND PROVIDING
SERVICE REALLY AT THE END OF THE
DAY BECAUSE THEY'RE VERY DYNAMIC
THE RULE SETTINGS OF THE URBAN
URBAN SETTINGS. UM SO I THINK
BECAUSE IT'S BEEN SUCH A LONG
TIME OVER 40 YEARS. I THINK
THERE HAS TO BE SOME CHANGES AND
THE WAY WE PROVIDE SERVICE TO ME
AT THE END OF THE DAY, WHETHER
IT'S A PRIVATE OR PUBLIC
AMBULANCE RESPONDING TO ANY
EMERGENCY IN CALIFORNIA THAT
THEY'D BE THERE IN THEIR
CONTRACTED RESPONSE TIMES,
WHETHER IT'S THE EIGHT MINUTES
10 MINUTES, WHATEVER IT IS UM,
BUT I THINK NOW WE'RE LIVING IN
DIFFERENT AGE, RIGHT? I THINK
THE PANDEMIC IS REALLY MOVED US
IN A DIFFERENT DIRECTION,
PROVIDING IN THIS CASE EMERGENCY
CARROT OR COMMUNITIES THROUGHOUT
CALIFORNIA. SO 40 YEARS. IT'S
BEEN A LONG TIME. I THINK WE'RE
REEVALUATE POLICIES AND
PROCEDURES MOVING FORWARD AND
ONCE AGAIN, LIKE I SAID, SOME
COUNTIES DO A BETTER JOB THAN
OTHERS. UM AND THAT LEADS ME TO
BELIEVE THAT NEXT QUESTION IS
FOR AH, FOCUS ON THE SUPPORT
SIDE CHIEF FROM OXNARD. AH YOU
SAID IN YOUR COMMENTS, UM THE
REASONS YOU GUYS HAD THIS ISSUE
BECAUSE THERE WAS OVER, I THINK
1900 TIMES AN AMBULANCE WASN'T
AVAILABLE. DO WE KNOW WHY IN THE
AMBULANCE WASN'T AVAILABLE TO
RESPOND TO THOSE CALLS?
APOLOGIES UM, COMMUNITY MEMBER
RODRIGUEZ. GENERALLY IT WAS
THOSE AMBULANCES WERE MOVED OUT
OF THE ESSAY SIX AREA WHICH IS
IN THE CITY OF OXEN AT, UM TO
COVER OTHER AREAS OF THE COUNTY.
AND IT WAS 1200 TIMES IN 2019,
AND THAT WAS IN 14 YEAR.
CORRECT. SO THAT WAS OBVIOUSLY
IN VIOLATION OF THE CONTRACT
AGREEMENTS. RIGHT CONTRACT
DOESN'T COVER ABSENCES WITHIN A
ANYWAY BUT IT DOES CONTRIBUTE TO
THOSE LIKE RESPONSES THAT THAT
WE WERE HAVING, BECAUSE WE'RE
OFTEN HAVING AMBULANCES COMING
FROM OUTSIDE THE AREA, AND SO
OBVIOUSLY THEY'RE NOT MAKING
THEIR EIGHT MINUTE COMPLIANCE.
AND WE SAY THAT, UM, MOST
DEFINITIVELY IN LIKE I SAID THAT
THE POOREST AREAS OF OUR CITY
AND WOULD THERE BE A REASON? WHY
FROM IF ANYBODY CAN ANSWER WHY
IN THESE DISADVANTAGED
COMMUNITIES WERE HAVING LONG
RESPONSE TIMES? COULD ANYBODY
ANSWER THAT QUESTION? I DON'T. I
DON'T HAVE A GOOD ANSWER FOR
THAT QUESTION. OTHER THAN THOSE
AMBULANCES ARE GETTING MOVED TO,
UM, THEY MOVED TO OTHER AREAS OF
THE COUNTY. WHERE ARGUABLY
THERE'S BETTER REIMBURSEMENTS.
BUT I DON'T HAVE A I DON'T HAVE
A GOOD ANSWER WOULD JUST BE
SPECULATING. AND THAT JUST COMES
TO MY QUESTION. WHY? YOU KNOW,
WE'RE LIVING IN DAY AND AGE, AND
IT DOESN'T MATTER WHERE YOU
LIVE. THAT THAT AMBULANCE SHOULD
BE THERE FOR THAT CONTRACT AND
AGREEMENT. UM SO MAYBE BEFORE,
UM, THE FIREFIGHTERS HERE. UM I
KNOW WE'RE TALKING A BIT ABOUT
THE ORIGINS OF THE BILL REALLY
WAS THIS WHAT WAS THE INTENT OF
THE BILL IS IT TO IMPROVE
EMERGENCY RESPONSE OR OUTCOMES
OF PATIENTS AT THE END OF THE
DAY, MOVING THIS BILL FORWARD? I
GUESS I'LL TAKE. YEAH THANK YOU
. ASSEMBLYMEMBER'S, UM I THINK
FROM THE CPS PERSPECTIVE, THIS
MEASURE HAS CREATED AMBIGUITY IN
WHETHER OR NOT THESE
JURISDICTIONS THAT ENTERED A JP
AH, HAVE THE RIGHTS OR IF
THEY'RE GOING TO GO INTO A J. P
A IN THE FUTURE? WELL THEY HAVE
THEIR RIGHTS FROM THE CPS
PERSPECTIVE. THIS IS ALL ABOUT
PATIENT CARE WHETHER THE SERVICE
WOULD BE BEING PROVIDED BY A
PUBLIC PROVIDER OR PRIVATE
PROVIDER LIKE EVERY ONE OF YOUR
CONSTITUENTS DESERVES HIGH
QUALITY EMS SERVICES SHOULD THEY
CALL 911 AND NEED THEM. AND I
THINK OUR PER OUR FOCUS HERE IS
TO CREATE THAT CLARITY AND IN
PLACES WHERE THERE COULD BE A
PARTNERSHIP BETWEEN A
JURISDICTION THAT CURRENTLY HAS
THEIR TWO OH ONE RIGHTS AND A
BROADER AREA OF THE COUNTY TO
WORK TOGETHER TO IMPROVE
SERVICE. WE THINK THAT SHOULD BE
DONE. WE DO THINK THIS BILL
PROVIDES THAT CLARITY FOR THOSE
PEOPLE MOVING FORWARD, AND I
WOULD JUST NOTE THAT WE ARE NOT
AWARE OF ANY CASE LAW THAT
SUGGESTS YOU CAN WRITE INTO A
CONTRACT THAT THIS DOESN'T
AFFECT YOUR 21 WRITES. AS THIS
COMMITTEE KNOWS, THERE ARE
MULTIPLE BILLS THAT WORK ON
VARIOUS POLICY ISSUES AROUND, UM
, SERVICES. AND OFTEN TIMES YOU
WILL SEE A PROVISION THAT
REFERENCES RIGHTS UNDER 17
97.201 AND 17 97.2 TO 4, AND
THAT IS JUST TO MAKE IT CLEAR
THAT THE LEGISLATURE IS SAYING
THAT WE ARE NOT TRYING TO DOING
AN ACTIVITY IS NOT INTENDED TO
INTERRUPT THOSE RIGHTS. OKAY? UM
I ALSO HAVE A COUPLE MORE
QUESTIONS FOR YOU, DOUG ON THAT
NOTE IN THIS AREA WERE LIKE
WHAT'S HAPPENING IN OXNARD AND
MAYBE OTHERS THAT THIS WOULD
IMPACT WELL, THIS WHAT TYPE OF
IMPACT WILL THIS HAVE ON THE
PRIVATE MÁS WORKFORCE OUT THERE?
THAT'S CURRENTLY THERE IF WE DO
THAT CHANGE SO THE ONLY EXAMPLE
THAT I COULD SPEAK TO HIM. MAYBE
I WILL DEFER THIS TO CHIEF
HAMILTON'S. THAT WAS WHEN THE
CITY OF OXEN ARE DID ATTEMPT TO
EXERCISE THE RIGHTS PRIOR TO THE
LITIGATION. THEY WERE GOING TO
WORK WITH AN EXISTING PRIVATE
PROVIDER TO DELIVER THE SERVICE.
UM SHOULD SOMEONE THIS BILL
BECOME LAW AND SOMEONE IN THE
FUTURE EXERCISE THEIR RIGHTS
THAT ARE IN A CURRENT J. P A. I
WOULD BE SPECULATING ABOUT WHO'S
GOING TO DELIVER THAT SERVICE.
COULD IT BE A PUBLIC PRIVATE?
PARTNERSHIP OR COULD IT BE JUST
A PUBLIC AGENCY? UM I WOULD ONLY
BE SPECULATING THERE AND THEN
GOING FORWARD, UM, IT WOULD BE
LARGELY DEPENDENT UPON AN
AGREEMENT BETWEEN A CITY AND THE
COUNTY FOR THE DELIVERY OF
SERVICES. WOULD IT BE TO
SUPPLEMENT EXISTING PROVIDERS OR
IN LIEU OF I MEAN, IT WOULD JUST
BE DEPENDENT ON THE
CIRCUMSTANCES. UM, THE ONE THAT
WE'RE AWARE OF RELATIVE TO THIS
BILL IS CERTAINLY THE CITY OF
OXNARD, UM, IN THE COUNTY OF
VENTURA. BECAUSE I'M HERE FROM
FROM THE LOT OF THE FOCUS ON THE
OPPOSITION THAT THIS BUILDER GO
THROUGH THAT PRETTY MUCH IS
GONNA SHUT THE DOOR TO THE
PRIVATE SECTOR EMS BECAUSE THEY
ARE NOT NO LONGER BE A NEED FOR
THEM BECAUSE THE DEPARTMENTS ARE
DOING THEIR OWN. SO JUST KIND OF
MAKES SURE IF THERE'S ANY
CLARIFICATION THAN THAT, BECAUSE
ONCE AGAIN, THIS BILL IS ONLY
NARROWED DOWN TO 10 JPS. REALLY,
THIS ISN'T A STATEWIDE MANDATE,
CORRECT. SO CERTAINLY THE
INTENTION OF THE BILL
ASSEMBLYMEMBER'S TO ADDRESS
THOSE JPS THAT WE HAVE FOUND TO
BE, UH, WHERE FIRE IS PROVIDING
M S. THERE ARE, UH, 62 TOTAL
THAT ARE REFERENCED IN THE
ANALYSIS AND ABOUT 10 OF THOSE
ARE ASSESSMENT ARE THE ONES THAT
DO AMBULANCE SERVICES. WE HAVE
THEN TRIED TO GO THROUGH EACH OF
THOSE AND DETERMINE WHO WOULD
HAVE TWO OH, ONE RIGHTS BECAUSE
THAT IS ANOTHER KEY PORTION OF
THE BILL, BUT THE INTENT HERE IS
NOT GENERATE A MASSIVELY BROAD
APPLICATION. I THINK OF THE
PROVISIONS HERE, AND I THINK THE
CHAIR AND COMMITTEE STAFF WERE
WORKING ON AMENDMENTS TO ATTEMPT
TO MAKE THAT CLEAR. AND I THINK
THAT IS THE INTENTION THERE TO,
UM TO NARROW IT DOWN TO THE
UNIVERSE THAT WE KNOW. MHM
QUESTION FOLLOWING. YEAH JUST
JUST A QUICK FOLLOW UP. I WILL
SAY THAT I'M A STRONG PROPONENT
OF THE PUBLIC PRIVATE ALLIANCE.
I THINK THERE IS ABSOLUTELY A
ROLE FOR PRIVATE PROVIDERS TO
PLAY IN THE EMERGENCY MEDICAL
RESPONSE ARENA. BUT TO YOUR TO
YOUR QUESTION ABOUT THE PAY AND
WORKING CONDITIONS WHAT WE HAD
DICTATED IN OUR CONTRACT WITH
FALK AMBULANCE UNDER THAT
ALLIANCE MODEL. WAS THAT E M. T
S WOULD RECEIVE A, UM, AN
INCREASE IN THEIR PAY OF 21% AND
PARAMEDICS WOULD, UM, HAVE AN
INCREASE OF 32% IN THE PAY OF
WHAT THE PAY WAS AT THAT TIME.
ADDITIONALLY THEIR WORKING
CONDITIONS WOULD BE IMPROVED
BECAUSE THERE'D BE NO OF THAT
NONE OF THE NON EMERGENCY
FACILITY TRANSPORTS, UM THAT
THAT THE CURRENT 911 UNITS HAVE
TO DO. AND THEY OFTEN HAVE TO DO
THESE IN THE MIDDLE OF THE NIGHT
WHEN THE 911 RESPONSES SLOW DOWN
SEPARATELY, WE WERE WE WERE
DICTATING BETTER EQUIPMENT ON
THOSE AMBULANCES. UM THINGS LIKE
POWER LIFT COTS SO THEY CAN SAVE
THE EMTS AND PARAMEDICS BACKS
AND SO WE WERE VERY CONSCIOUS OF
MAKING SURE THAT THE WORKING
CONDITIONS WERE GOING TO BE
IMPROVED FOR THOSE E M. T S AND
PARAMEDICS THROUGH OUR ALLIANCE
WITH FALK AMBULANCE, OKAY? UM
ONE LAST QUESTION, UH, PROBABLY
FOR THE FIREFIGHTERS. WELL FIRE
DISTRICTS OR CITIES THAT ASSERT
, ASSERT THEIR 21 WRITES. SELF
REGULATORY GOALS OR LIMPS IS
CONTINUE TO ENSURE THE RESPONSE
RIGHTS AND CURRENT STANDARDS.
THANK YOU. ASSEMBLYMEMBER'S
CERTAINLY MY UNDERSTANDING THAT
ANY FIRE AGENCY THAT WOULD BE
DEAL DELIVERING EMS SERVICES AND
ALEXA WOULD BE SUBJECT TO. AH.
THE RULES AND REGULATIONS THAT
OLYMPIA HAS REGARDING MEDICAL
PROTOCOLS AND ETCETERA
DEPARTMENT COULD CERTAINLY, UM,
ACT WITHIN ITS SERVICE SYSTEM TO
DETERMINE YOU KNOW, I GUESS
WHERE UNITS ARE, UM, ALLOCATED
YOU HAVE STRATEGICALLY LOCATED
FIREHOUSES ALREADY IN
COMMUNITIES, SO I THINK THERE
WOULD CERTAINLY BE THE OVERSIGHT
FROM THE LAMPS A AND WE DON'T
SEE THIS BILL UNDERMINING THAT,
UM, AND THEN IT WOULD BE
DEPENDENT ON THE SITUATION. OKAY
UM, THAT'D BE MY LAST QUESTION.
FOR NOW. SOMEBODY HAS SOME
QUESTIONS. I'M SORRY TO BE ABLE
TO TURN ME I HAD SOME ANSWERS TO
YOUR TO THE CHAIR. GO AHEAD IF
YOU OKAY? YES THANK YOU. SO UM I
WANT TO BE CLEAR. I CAN'T SPEAK
TO THE SPECIFIC EXPERIENCE IN
OXNARD COUNTY. I DON'T SERVE
THAT AREA. BUT YOU HAD ASKED THE
QUESTION INITIALLY ABOUT
RESPONSE TIMES. UM AND LEVEL
ZERO, OR THERE'LL BE NO
AMBULANCES AVAILABLE AND WHAT
MIGHT CONTRIBUTE TO THAT. SO I
THINK IF YOU HAVE THE EXPERIENCE
IN M S, YOU KNOW THAT PRETTY
MUCH EVERY SYSTEM HAS THINGS
THAT INFLUENCE THE AMOUNT OF
AVAILABLE AMBULANCES AND AT ANY
GIVEN MOMENT, UM, AND THERE WAS
A CONCERN ABOUT DELAYED RESPONSE
TIMES IN PARTICULAR AREAS. I
THINK THAT IN THE ENVIRONMENT
AROUND AN RFP THAT HAS
CONTRACTUAL LANGUAGE FOR
RESPONSE TIMES THAT ARE MANDATED
AND ENFORCEABLE. UM IF THAT'S
NOT OCCURRING, OR IF THAT'S NOT
ADEQUATELY SERVING THE COMMUNITY
TO MAKE AN EFFORT TO ENFORCE
THAT LANGUAGE OR STRENGTHEN THAT
LANGUAGE. I THINK IT'S
DEFINITELY, UH, POTENTIALLY
SOMETHING THAT'S IMPORTANT AGAIN
. I CAN'T SPEAK TO THE SPECIFICS
OF FAULKNER, OXNARD, BUT TO TAKE
THE STEP OF REMOVING AN AGENCY
FROM THE RFP, BUT THEN SUDDENLY
DOES NOT HAVE RESPONSE TIME
REQUIREMENTS. THAT ARE ONLY
EXISTENT INSIDE OF AN RFP, I
THINK IS THE OPPOSITE MOVE
TOWARDS ADDRESSING CONCERNS
AROUND RESPONSE TIMES, RIGHT? SO
I THINK THAT'S THAT'S ONE
ELEMENT TO RESPONSE TIMES. AND
YOU HAD ALSO ASKED THE QUESTION
ABOUT MEDICAL DIRECTION, AND I
THINK THE CONVERSATION OF
RESPONSE TIMES ANOTHER DIRECTION
. HAVE AN INTERESTING HAND IN
HAND IN THIS BILL, BECAUSE THE
STATEMENT IS MADE THAT THIS BILL
DOES NOT LIMIT THE ROLE OF THE
MEDICAL DIRECTOR. THE BILL TALKS
A LOT ABOUT RESPONSE TIME THIS
NEGATIVELY IMPACTING PATIENT
CARE. AND IN AN ENVIRONMENT
WHERE THE DEPARTMENT REMOVED
THEMSELVES FROM AN RFP, AND
THERE IS NO ENFORCEABLE.
RESPONSE TIME REQUIREMENTS. I DO
SEE THAT AS LIMITING THE ROLE OF
A MEDICAL DIRECTOR TO ENFORCE
LANGUAGE THAT WAS PREVIOUSLY
EXISTING THAT NOW HAS BEEN
REMOVED BECAUSE THERE IS NO MORE
RFP. SO UM, I HOPE HOPEFULLY
THAT ANSWER AND THEN I ALSO
WANTED TO SPEAK TO THE IMPACT ON
THE WORKFORCE YOU HAD ASKED
ABOUT SO UM I THINK WE CAN ALL
UNDERSTAND THAT THE POOLING OF
RESOURCES IN THE REGION CREATES
MORE SERVICES AND MORE AVAILABLE
RESOURCES FOR BOTH THE COMMUNITY
MEMBERS AS WELL AS UNIONS, RIGHT
AND I THINK THAT AS THEY'VE
TALKED ABOUT TO REMOVE
THEMSELVES FROM A BILL THEY ARE
REMOVED THEMSELVES FROM AN RFP.
IT ONLY HAS TO BE CERTAIN
COUNTIES OR CERTAIN CITIES THAT
HAVE THE FINANCIAL MEANS TO DO
SO. SO IN IN THE CONTEXT OF THE
WORKERS' RIGHTS AND THE
LIMITATION ON THE WORKFORCE, UM
IF THE MOST LUCRATIVE CITIES IN
THE REGION HAVE THE FINANCIAL
RESOURCES TO REMOVE THEMSELVES
AND THEN THEY DO THAT. THE
ABANDONED ONES ARE PRESUMABLY
THE ONES THAT DON'T HAVE THOSE
RESOURCES AND SO TO, UH, TO HAVE
THE UNION BE ABLE TO NEGOTIATE
EQUIVALENTS, UM, CONTRACTS
BECOMES MUCH MORE DIFFICULT
BECAUSE THE WORLD DONE TO THIS
ANALOGY, BUT I MEAN ON THE BONE
HAS ALREADY BEEN REMOVED. AND IS
SERVING A PARTICULAR CITY AS
OPPOSED TO THE COMPANY. SO I
HOPE THAT THAT PROVIDES SOME
CONTEXT FOR YOUR QUESTION FROM
MY PERSPECTIVE. OKAY DOCTOR, DO
YOU HAVE A QUESTION? YES THANK
YOU. SENATOR RODRIGUEZ WITH THE
CHAIR. I MEAN, OBVIOUSLY, WE
DON'T WANT TO RELITIGATE THE
CASE IN OXNARD, BUT, UM IT'S
SAFE TO SAY THAT VENTURA COUNTY
HAS A MUCH DIFFERENT PERSPECTIVE
OF THE DATA. UM YOU KNOW, I'M
ETHICALLY OBLIGATED TO MAKE SURE
THE SYSTEM IS FUNCTIONAL AS
POSSIBLE, AND I WOULD NEVER
CREATE A SYSTEM OR ALLOW A
SYSTEM TO CONTINUE THAT THAT WAS
, UM, NEGLECTING CERTAIN AREAS
OF THE COUNTY. WHEN WE READ THE
DATA WE FOUND AREAS THE COUNTY
WITH, YOU KNOW VERY, YOU KNOW,
HIGH INCOME AREAS OR WEALTHY
AREAS THAT HAD LONGER RESPONSE
TIMES IN OXNARD. AND I THINK SO,
THAT KIND OF UM GOES AGAINST THE
NARRATIVE THAT THEY WERE
TARGETING CERTAIN AREAS AND WE
HAVE AN EXCLUSIVE SYSTEM SO THE
AMBULANCE PROVIDER IS GIVING THE
TRANSPORT EITHER WAY. SO THERE.
UM IT DOESN'T REALLY, UM,
BENEFIT THEM TO, YOU KNOW, JUST
FOCUS ON ONE AREA AND NEGLECT.
ANOTHER UM AND VMS ACT IS 40
YEARS OLD, BUT THE SYSTEMS ARE
NOT. WE ARE CONSTANTLY
INNOVATING AND AS NEW
TECHNIQUES, DEVELOPERS, NEW, UM
METHODS OF DEPLOYMENT AND SORT
OF RESPONSE. WE'RE ALWAYS
THINKING ABOUT DOING MÁS
ASSESSMENTS AND TRYING TO
IMPROVE THE SYSTEM. WE PROVIDE
OUR COMMUNITIES AND, UM THAT'S
WHERE THE COMPETITIVE
PROCUREMENT PROCESS IS IMPORTANT
BECAUSE THE BIDDERS CAN GIVE
THEIR VISION FOR THE CITY AND
FOR THE COUNTY AND THE COUNTY
SKIN, ANALYZE THAT AND FIND THE
BEST, YOU KNOW, UM, OPTION FOR
THE COUNTY AND WE CAN MOVE
FORWARD. OKAY THANK YOU. AND
ONCE AGAIN, I'M I'M JUST TALKING
ABOUT OTHERS NEED IN SOME AREAS
TO MAKE SOME CHANGES RIGHT. IF
THE SYSTEM IS WORKING GREAT THE
WAY IT IS LEAVE IT ALONE. BUT IF
THERE'S OTHER AREAS WHERE WE'RE
HAVING SOME ISSUES THAT RESPONSE
TIMES OR THE DELIVERY SERVICE BY
WHETHER IT'S THE PRIVATE OF THE
PUBLIC AGENCY, THERE HAS TO BE
CHANGES. WE CAN'T CONTINUE
KICKING THE COUNT DOWN THE ROAD
LIKE THEY SAY THIS BILL CAME TO
US LAST YEAR. UNFORTUNATELY IT
CAME TOWARDS THE END. WE REALLY
CONNECTING DISCUSSIONS. IN THE
BUILDING. MOVE IT CAME. IT'S
BACK HERE TODAY. WE'RE NOW WE
CAN HAVE SOME DISCUSSIONS ABOUT
IT MOVING THE BILL ALONG BECAUSE
DEFINITELY THERE IS A NEED FOR
SOME TYPE OF CHANGES RIGHT AND
EVERYBODY'S GOING TO LEARN TO.
WE'RE NOT GOING TO BE ABLE TO
GET EVERYTHING BUT WE'RE GOING
TO LEARN TO AGREE AND DISAGREE
AND HOPEFULLY COME TO A BETTER
UNDERSTANDING. HOW DO WE PROVIDE
AMS SERVICES ACROSS THE STATE?
AND ONCE AGAIN YOU SHOULD NOT BE
WAITING FOR AMBULANCES. AND IN
THESE DISADVANTAGED COMMUNITIES
IS ONE OF THE REFERENCES WE
TALKED ABOUT WHY THIS BILL CAME
FORWARD, MAYBE JUST A STAFFING
ISSUE, WHETHER IT'S THE PRIVATE
AGENCIES OR THE PUBLIC AGENCIES,
BUT WE SHOULD NOT ONCE AGAIN, UM
DELAY THE RESPONSES TO OUR
COMMUNITIES IN THE STATE. UM,
ONCE AGAIN, THIS BILL HAS ME
VERY TORN ABOUT BOTH SIDES, BUT
I THINK THIS IS A VERY IMPORTANT
THAT WE NEED TO CONTINUE HAVING
THIS DISCUSSION AND HOPEFULLY
GETTING IN BETTER PLACE WITH
EVERYBODY AND REALLY, ULTIMATELY
, MAKING SURE THAT THOSE
AMBULANCE ARE, UM RESPONDING TO
PROPERLY AS THEY SHOULD SO. OH,
I KNOW WE DON'T HAVE A QUORUM
YET, BUT I'LL PROBABLY BE
LOOKING TO SUPPORT THIS BILL TO
CONTINUE THAT DISCUSSION BECAUSE
I THINK IT GOES TO ANOTHER
COMMITTEE AFTER THIS ONE. AND
WITH THAT, IN MY COMMENTS, I'M
SURE CHAIR YOU MIGHT HAVE
SOMETHING TO SAY AS WELL. THANK
YOU. THANK YOU, MR RODRIGUEZ. SO
UM, QUESTION TO THE CHIEF, UM,
FROM VENTURA FROM OCHSNER.
EXCUSE ME. YOU MENTIONED
SOMETHING ABOUT INTER FACILITY
TRANSPORTS. COULD YOU REPEAT
WHAT YOU SAID? SAID SOMETHING
ABOUT NEGOTIATIONS REGARDING
SAID ONE OF THE THINGS THAT UM
UH IT WAS IN REFERENCE TO
IMPROVING THE WORKING CONDITIONS
OF THE PARAMEDICS AND EMTS
THROUGH THE ALLIANCE THAT WE HAD
WITH TALC AMBULANCE, UM, IN THE
CURRENT SYSTEM ON 911.
AMBULANCES OCCASIONALLY PULLED
AWAY FROM 911 RESPONSE TO DO
THESE NON EMERGENCY INTER
FACILITY TRANSFERS. AND SO AND
OFTEN THOSE TRANSFERS WILL HAVE
WILL OCCUR IN THE MIDDLE OF THE
NIGHT, SO E M T OR PARAMEDIC
THAT'S BEEN WORKING ON AN
AMBULANCE ALL DAY RUNNING 911
RESPONSES IS THEN ASKED TO DO A
NON EMERGENCY, UM, TRANSFER
DURING THE NIGHT. THE DAY AFTER
THAT, UH, THE CITY OF OXNARD
COUNCIL VOTED TO LEAVE THE JP
AH. WE HAD A FULL ARREST CALL IN
A LARA SOCIOECONOMIC AREA IN THE
AMBULANCE ASSIGNED TO THAT AREA
WAS DOWN IN LOS ANGELES RUNNING
IN. I HAVE TO CALL AT THE TIME,
RESULTING IN A LATE RESPONSE
FROM THE NEXT NEAREST AMBULANCE
. THIS IS AN EXAMPLE OF WHAT
WHAT HAPPENS ON THE GROUND FOR
US WHEN THEY DO THESE, NONE OF
IT. NON EMERGENCY I FT
TRANSFERS. SO DON'T SOME OF
THOSE 50 TRANSFERS COME FROM
HOSPITALS TO GO TO, LIKE SKILLED
NURSING FACILITIES OR OTHER
AREAS, WHICH THEN FREE UP
HOSPITAL, EMERGENCY ROOMS AND
BEDS. ABSOLUTELY AND THERE'S
ABSOLUTELY ROLE FOR, UM I F T,
UH AMBULANCES TO PLAY, BUT I
DON'T LIKE THE IDEA OF MOVING
AMBULANCES THAT ARE DEDICATED
FOR 911 RESPONSE AWAY FROM 911
RESPONSE I WOULD PREFER HAVE
THOSE UNITS AVAILABLE TO RESPOND
TO EMERGENCIES. UM, AND HAVE
OTHER AMBULANCES AVAILABLE TO DO
50. RESPONSES BECAUSE THEY
YOU'RE ABSOLUTELY RIGHT. THEY
PLAY A CRITICAL ROLE IN THE
SYSTEM. THEY DO NEED TO MOVE
PATIENTS OUT OF THE HOSPITAL SO
THAT THE PATIENT, THE HOSPITALS
CAN ACCEPT MORE PATIENTS. OKAY?
AND IT'S JUST THESE. THESE
THINGS JUST ADD TO THE
COMPLEXITY OF THIS ENTIRE
SUBJECT, AND WHICH IS REALLY,
REALLY CHALLENGING. SO I DO NOT
ENVY YOU, MR BENNETT. YOU'RE
SITTING BETWEEN A COUNTY ON ONE
SIDE. THAT'S AN OPPOSITION A
CITY IN THE OTHER SIDE. THAT'S
IN SUPPORT OF THIS OF THIS BILL.
YOU'RE IN A NO WIN SITUATION. SO
GOD BLESS YOU FOR THAT. UM BUT,
UM, YOU KNOW, AT THE END OF THE
DAY, UM YOU ALSO HAVE WE HAVE
HEALTH CARE DISTRICTS AND
OPPOSITION COUNTIES AND
OPPOSITION LABOR AND OPPOSITION.
I DIDN'T KNOW STEELWORKERS
ACTUALLY REPRESENTED E M S, UH,
FOLKS AS WELL, UM UM, WE HAVE A
MEDICAL DIRECTOR IN OPPOSITION.
UM, WE HAVE A CITY. AND SUPPORT.
WE HAVE CPF IN SUPPORT. UM JUST
A COUPLE OF OTHER COMMENTS JUST
THAT THOSE ARE JUST
OBSERVATIONS. SO, UM I WOULD
SAY, UM AND. AND MY FRIEND, MR
RODRIGUEZ AND HONOR HIS HIS HIS
WORK AND ALL THE YEARS AND
EVERYBODY WHO PROVIDES LIFE
SAVING SERVICES HERE. NO IN IN
MY DISTRICT, THE NORTH COAST.
IT'S 300, PLUS MILES FROM NORTH
TO SOUTH. I HAVE ONE OF THE
LARGEST DISTRICTS IN THE STATE.
UM IF WE HAD EIGHT MINUTES
RESPONSE TIME AND EVERY PART OF
MY DISTRICT UM I DON'T KNOW HOW
MANY AMBULANCES WE'D HAVE. WE'D
HAVE A WHOLE LOT OF THEM AND SO
WE WILL NEVER BE ABLE TO ACHIEVE
THAT KIND OF RESPONSE IN IN MY
DISTRICT BECAUSE OF THE NATURE
OF THE GEOGRAPHIC CENTERS AND
THE AND THE RUGGED NATURE OF THE
DISTRICT IN GENERAL. UM MY
CONCERN WITH THE WITH THE BILL
FROM THE BEGINNING HAS BEEN WHAT
I CONTINUE TO WORRY ABOUT IS
FURTHER FRAGMENTATION OF I MEAN,
ALREADY CHALLENGED CHALLENGE
SYSTEM HERE. AND AS I SAID, MY
PREFERENCE WOULD BE FOR
SUPPORTERS AND OPPOSITION TO GET
INTO A ROOM AND WORK THIS OUT IN
A WAY. THAT WE COULD COME TO
SOME AGREEMENT THAT MAYBE MERITS
A LEGISLATIVE PROPOSAL. OR MAYBE
NOT, UM UM, BUT WHAT I WOULD SAY
IS THAT THIS IS THE FIRST
COMMITTEE AND I WANT THIS
CONVERSATION TO CONTINUE. AND UM
, AND THAT I BELIEVE THAT IS IN
IN IN LIGHT OF THE FACT THAT IT
DOESN'T APPEAR WE'RE GOING TO
GET EVERYBODY IN A ROOM TO
REALLY WORK THIS OUT. WHICH UM,
AND MAYBE YOU CAN, MR BENNETT. I
HOPE YOU CAN AND UM, BUT WE NEED
THIS DISCUSSION TO CONTINUE
GOING FORWARD. UM AND SO IN WHEN
THERE IS A CORE QUORUM, I WILL
RECOMMEND AND I VOTE TO KEEP THE
CONVERSATION GOING. BUT I WILL
REMIND YOU THAT IF THE BILL DOES
MAKE IT THROUGH BOTH HOUSES, AND
IT DOESN'T COME BACK IN A FORMAT
THAT SUITS THE CONCERNS OF THE
COMMITTEE, UM THIS COMMITTEE
DOES HAVE THE LAST SAY SO, UM,
SO WITH THAT, WOULD YOU LIKE TO
CLOSE? I WOULD NORMALLY LIKE TO
CLOSE WITH JUST RESPECTFUL
REQUEST FOR AN I VOTE, BUT I
DON'T THINK THAT'S APPROPRIATE
IN THIS SITUATION. SO IF YOU
WILL INDULGE ME TO MAKE SOME
COMMENTS, I WOULD APPRECIATE IT.
UM, NUMBER ONE AGAIN RECOGNIZED
AND I APPRECIATE THE SINCERITY
OF YOUR COMMENTS AS YOU GO
FORWARD IN TERMS OF WHAT YOUR
GOAL IS, WHICH IS WE DON'T WANT
TO FRAGMENT THE SYSTEM. UM AND I
APPRECIATE, UM ASSEMBLYMEMBER'S
RODRIGUEZ BEING HERE, UH, AND
ASKING THOSE THOUGHTFUL
QUESTIONS AND ASSEMBLY MEMBER
REGULAR. THIS IS A BIG COMMITTEE
AND THERE'S THREE OF YOU HERE,
AND THERE ARE MANY OTHER
COMMITTEE MEMBERS THAT I WISH I
COULD HEAR THIS. THE FIRST THING
I'D JUST LIKE TO SAY IS IT WAS
GOOD FOR ME TO BE HERE TODAY
BECAUSE IT WAS GOOD FOR ME TO
HEAR THE FEAR. THAT I'M HEARING
FROM, UM PEOPLE OUT THERE IF, IN
FACT I THOUGHT THIS WAS GOING TO
DESTROY. UH MY UNION. IT WAS
GOING TO DESTROY MY WORKING
CONDITIONS. UM I WOULD BE
FEARFUL ABOUT THIS. AND WHENEVER
CHANGES MADE, WE CAN DO IT. WHEN
YOU DO PUBLIC POLICY, IT IS EASY
TO HAVE THE PORTRAYAL OF SOME
PART OF A BILL AND PORTRAY IT IN
A WAY THAT ESCALATES THE FEAR.
UM OR FOUR DOZEN, AND I'M NOT
SAYING IT'S WRONG TO ESCALATE
THE FEAR. THAT'S JUST A FACT.
PEOPLE LINKED THIS AND THIS
MEANS THIS AND THEN THIS. THIS
MEANS REGIONALLY YOU CAN'T BILL
AND THEN THEREFORE YOU LOSE THE
ABILITY AND THOSE ARE ALL
LOGICAL QUESTIONS TO BE ASKED.
AND THAT'S WHY, UH, I AS THIS AS
I WAS APPROACHED ABOUT THIS
BILL, I ACTUALLY FELT I
APPRECIATED THE CHALLENGE OF
SAYING, I THINK THAT I'M IN A
UNIQUE POSITION TO BE ABLE TO
TRY TO BRING THAT SAME
CONVERSATION THAT YOU'RE TALKING
ABOUT TOGETHER. AND SO LET ME
SHARE SOMETHING THAT, UM IS
IMPORTANT. I THINK FOR EVERYBODY
TO KNOW I SERVED ON OF THE
VENTURA CITY COUNCIL AND CITIES
GENERALLY AND HASN'T BEEN
POINTED OUT THAT THE LEAGUE OF
CITIES IS THE SPONSOR OF THIS
BILL. WHILE WE HAVE YOU HAVE
IDENTIFIED MANY PEOPLE WHO ARE
IN OPPOSITION, YOU HAVE CITIES
ACROSS THE STATE THAT MANY OF
THEM ARE OVERWHELMINGLY IN FAVOR
OF THIS CHANGE, AND THAT'S BEEN
THE CASE FOR DECADES THAT
THERE'S BEEN THIS TENSION
BETWEEN CITIES AND COUNTIES
WHILE I WAS ON A CITY COUNCIL,
NEW TO THE CITY COUNCIL DIDN'T
KNOW VERY MUCH. BUT I HAVE
ADVOCATED AND I BELIEVE THAT
HAVING OUR FIREFIGHTERS WHO HAVE
BEEN TRANSITIONING MORE AND MORE
FROM JUST FIRE SUPPRESSION TO
MORE AND MORE MEDICAL CALLS AND
STUFF THAT HAVE JUST MADE SENSE
FOR THEM TO BE MORE INVOLVED IN
THIS, AND I ACTUALLY MOVE THIS
FORWARD. UNBEKNOWNST ABOUT ALL
OF THE THINGS AS A NEW CITY
COUNCIL MEMBER THAT WAS GOING ON
WITH THE COUNTY AND THE M S ACT,
ETCETERA. NOT LONG AFTER THAT
THE COUNTY OF VENTURA OVERRODE
THE DECISION OF THE CITY OF
VENTURA THAT I ACTUALLY CAME FOR
CAKE YOU PRESENTED AND I BECAME
A COUNTY SUPERVISOR FOR 20 YEARS
, AND FOR 20 YEARS I WAS A BIG
ADVOCATE OF VMS AND A
COORDINATED SYSTEM AND I HAD
LEARNED FROM THAT EXPERIENCE
THAT WHAT I HAD CREATED IN THE
CITY OF VENTURA UNINTENTIONALLY
WAS TRULY FRAGMENTED SYSTEM. THE
CITY OF VENTURA WAS JUST GOING
TO PULL OUT AND NOT PAY
ATTENTION TO THE UNINCORPORATED
AREAS. SO I BECAME A STRONG
ADVOCATE FOR THE E M S SYSTEM
AND I COMPLETELY BELIEVE AND
SUPPORT THE DOCTOR WHEN HE SAYS
I'M NOT TRYING TO DISCRIMINATE
WITH ANYBODY WHEN I'M MANAGING
THE SYSTEM. I'M TRYING TO JUST
DO IT. IT'S JUST DIFFICULT IN A
AND IN VENTURA COUNTY IS A
CLASSIC EXAMPLE. IT IS A SEMI
RURAL COUNTY. WE HAVE VERY HARD
TO REACH AREAS LIKE YOU HAVEN'T
IN YOUR IN YOUR AREA. SOME OF
THOSE ARE ENCLAVES OF VERY HIGH
INCOME PEOPLE, BUT HARD TO GET
AMBULANCE SERVICE TO AND SOME OF
THEM ARE ON PLAYS. A VERY LOW
INCOME DISADVANTAGED PEOPLE ALSO
GEOGRAPHICALLY JUST VERY
DIFFICULT TO PROVIDE AMBULANCE
SERVICE TO, AND SO, UH, AS THIS
CAME FORWARD, I THOUGHT I KNOW
THIS ISSUE. AND I DON'T WANT TO
BREAK THE SYSTEM UP. I DON'T
WANT TO HAVE THIS IN GENDER
UNDUE FEAR IN EVERYBODY THAT
WE'RE UNRAVELING THE WHOLE THING
. SO AS THE DOCTOR SPOKE WHAT I
HEARD WAS A COMPARISON BETWEEN
WHAT COULD HAPPEN IF WE UNRAVEL
THE SYSTEM. COMPARISON BETWEEN
WHAT WAS HAPPENING BEFORE WE HAD
A SYSTEM AND NOW AND I'M SURE
YOU DON'T WANT TO GO BACK THERE
AND I'M SURE I DON'T WANT TO GO
BACK THERE AND I FIRMLY BELIEVE
THAT'S WHAT WILL COME UP WITH IS
SOMETHING THAT DOES NOT TAKE US
BACK THERE. BUT AS
ASSEMBLYMEMBER'S RODRIGUEZ SAID
AFTER 40 YEARS AND AFTER THE
EXPERIENCES I'VE HAD ON BOTH
SIDES OF THIS, I DO THINK THAT
PARTICULARLY WITH THE RECENT
RULING BY THE JUDGE, IT CALLS
INTO QUESTION. IS THERE A NEED
FOR CLARIFICATION? AFTER 40
YEARS AND A JUDGE'S RULING THAT
SAYS CITIES THAT DIDN'T EVEN
KNOW THEY WERE GIVING UP THEIR
TWO OH ONE WRITES, GAVE THEM UP.
WELL, THAT SEEMS LIKE AN
APPROPRIATE TIME FOR US TO HAVE
THIS CONVERSATION, AND I HOPE WE
CAN HAVE IT IN A WAY. THAT DOES
NOT CAUSE THE FEAR TO GO UP BUT
IS RECOGNIZED BY BOTH THE
OPPONENTS AND SUPPORTERS THAT
WE'RE TRYING TO GET TO A PLACE
THAT CLARIFIES THOSE TWO. OH ONE
RIGHT THAT CLARIFIES THAT
JUDGE'S DECISION THAT ALLOWS FOR
APPROPRIATE MODIFICATIONS THAT
ALLOWS. FOR PLACES WHERE FIRE
DISTRICTS ARE REALLY PRIMED TO
POTENTIALLY ENHANCE THE SERVICE
OF PRE HOSPITAL DELIVERY AND ALL
OF THAT, TO HAVE THOSE FIRE
DISTRICT WHERE THEY'RE ABLE TO
DO THAT BE ABLE TO WORK WITH
PRIVATE AMBULANCE. WHATEVER
SYSTEM SEEMS TO WORK, BUT TAKE
ADVANTAGE OF THAT AND HAVE THAT
CONVERSATION AND HAVE THIS BILL
AS YOU SAID. BE NARROWLY LIMITED
. SO THERE'S TWO THINGS I REALLY
APPRECIATE ONE. THE FAIL SAFE,
WE WILL NOT LEAVE THE
UNINCORPORATED AREAS RIGHT NEXT
TO A CITY BEHIND. AND THE
REFERENCE THAT. WHEN THEY GET
OUT, THEY WON'T HAVE ANY
RESPONSE TIMES. IS NOT THE BILL
THAT I'M HOPING IT'S GOING TO
COME OUT OF THIS. I THE
INTENTION HERE IS THAT THEY WILL
STILL HAVE TO MEET ALL THE
REQUIREMENTS THAT THE E M S
SYSTEM PUTS ON THEM. THAT THE L
E. WHATEVER YOU CALL THAT LEAF
LES MIS SYSTEM, YOU KNOW WHAT'S
THAT? LET THE SYSTEM YOU KNOW,
PUTS ON RIGHT THAT THEY WILL
HAVE TO HAVE RESPONSE TIMES THEY
WILL HAVE TO HAVE ALL THIS. THEY
WILL BE MONITORED. SO BY
NARROWING THIS BY HAVING IT
LIMITED WITH THE ATTEMPT AT THE
COMMITTEE IS TRYING TO DO BY
HAVING THEM RECOGNIZE THAT THEY
ARE PUSHING FOR LIMITED BILL,
NOT THE BILL THEY DID LAST YEAR
WHERE THEY JUST WANTED TO WIPE
OUT THE SYSTEM HAVING APPLY
COUNTYWIDE. I THINK THIS IS AN
APPROPRIATE TIME FOR US TO
CONTINUE TO HAVE THAT THAT THAT
CONVERSATION, UM AND, UM, UH,
FINALLY, THE WAY I ENVISION IT
JUST IN IN IN CLARITY WITH THE
CHAIR BECAUSE WE WILL HAVE MORE
CONVERSATIONS ON THIS. I AM SURE
IF THIS PASSES OUT OF THIS
COMMITTEE IS THAT THE INTENTION
IS CITY AND THEIR FIRE DISTRICT
, ASSUMING IN THIS SITUATION
WOULD HAVE TO NEGOTIATE WITH THE
COUNTY OF VENTURA. WE WANT OUT
WHAT'S THE RIGHT WAY FOR US TO
GET OUT? MAYBE THE COUNTY OF
VENTURA WILL SAY, WELL, YOU JUST
GO AHEAD. GO ON, BECAUSE WE CAN
ACTUALLY DO THE REST AROUND YOU
BETTER WITHOUT YOU ALL RIGHT?
THAT COULD HAPPEN. OR THEY'D SAY
NO. YOU'VE GOT TO TAKE ALL OF
THIS STUFF BECAUSE WE CAN'T DO
THAT PROPERLY. BUT THERE'S GOING
TO BE A NEGOTIATIONS THERE'S
GOING TO BE, UH, YOU KNOW THIS
THIS HEALTHY COLLABORATION ABOUT
WHAT THE BEST SYSTEM IS. AND
MAYBE AFTER 40 YEARS, WE MAY
FIND THAT THAT ENHANCED
CONVERSATION BETWEEN CITIES AND
COUNTIES WILL LEAD TO A BETTER
SYSTEM IN A FEW AREAS. AND WE
CAN ALL LEARN SOMETHING FROM
THAT TO DECIDE WHETHER THERE
SHOULD BE MORE OR LESS OR OR
WHATEVER. AND IF YOU'RE
TERRIFIED THAT THIS MIGHT
ULTIMATELY CHANGES SYSTEM. YES
YOU YOU WILL THEN NOT WANT TO
HAVE ANY CHANGE. BUT IF YOU HAVE
CONFIDENCE THAT YOU'RE PROVIDING
GOOD SERVICE ALREADY THAT IF THE
ELECTED REPRESENTATIVES OF THE
PEOPLE THAT YOU'RE SERVING ARE
COMFORTABLE WITH WHAT YOU'RE
DOING, YOU OUGHT TO HAVE
CONFIDENCE THAT WE SHOULD BE
ABLE TO FIND AN APPROPRIATE
COMBINATION HERE THAT WORKS FOR
EVERYBODY. THANK YOU FOR
INDULGING ME WITH THAT. AND WITH
THAT, I WOULD RESPECTFULLY ASK
FOR AND I VOTE WHENEVER YOU HAVE
A QUARTER MAYOR. OKAY AND I LOOK
FORWARD TO GENUINELY LOOK
FORWARD TO TALKING TO ANYBODY IN
THE OPPOSITION THAT WANTS TO
TALK ABOUT WHERE WE GO. THANK
YOU. THANK YOU, MR BENNETT. I
WANT TO THANK THE WITNESSES. I
WANT TO THANK EVERYBODY WHO
TRAVELED HERE TO BE HERE TODAY
FOR THIS DISCUSSION. THIS ISN'T
THIS THIS IS THE FIRST COMMITTEE
THERE WILL BE ADDITIONAL
DISCUSSION GOING FORWARD AND I
LOOK FORWARD TO THOSE
DISCUSSIONS. SO, UM, WHEN THE
BILL LIKE I SAID, WHEN WE HAVE A
QUORUM, THE BILL WILL ENJOY A DO
PASS RECOMMENDATION. THANK YOU,
MR BENNETT. THANK YOU TO THE
WITNESSES.
BUT WAIT JUST A MINUTE. LET
PEOPLE MOVE OUT IF YOU'D LIKE
TO.
THAT'S TRUE. YEAH.
OKAY, MISS BARRACK AYHAN. ARE
YOU READY?
WHENEVER YOU'RE READY. THANK
YOU, MR CHAIR. WE PROMISED TO BE
SLIGHTLY SHORTER THAN THE LAST
ONE. UM YEAH, WE'RE HERE TO
PRESENT A B 3 52 A BILL TO
FURTHER PRODUCTIVE REPRODUCTIVE
RIGHTS BY PREVENTING INFORMATION
ON ABORTION FROM CROSSING STATE
LINES. THIS BILL CAME TO ME A
YEAR AGO IN THE MIDST OF THE
POST ROAD WORK. WE WERE DOING A
DOCTOR IN MY DISTRICT WHO
PROVIDES ABORTIONS IN THE
HARDEST TO REACH PARTS OF
CALIFORNIA AND BEYOND. IN BORDER
STATES, WHERE PEOPLE HAVE TO
LEAVE THEIR OWN STATES TO GO
ACCESS. ABORTION CAME AND SHE
HAD BEEN IN ONE OF THOSE BORDER
STATES AND NOTICED THAT THE
ELECTRONIC MEDICAL RECORDS WERE
CROSSING STATE LINES, AND SHE
WAS ABLE TO SEE EVERY SINGLE
THING THAT WAS HAPPENING IN
ANOTHER STATE, AND SHE REALIZED
THAT FOR THOSE PATIENTS CROSSING
STATE LINES TAKING THE TIME AND
EFFORT AND AT TIMES RISK TO GO
RECEIVE THAT HEALTHCARE. THE
INFORMATION WAS SEAMLESSLY
SHARED BACK TO THEIR HOME STATE
, RISKING BOTH CRIMINAL AND
CIVIL PENALTIES DEPENDING ON
WHAT THE STATE HAS DONE AT THIS
POINT. SO AS OUR FURTHER EFFORTS
CONTINUE TO PROTECT THOSE
ACCESSING SAFE AND LEGAL
ABORTIONS HERE IN CALIFORNIA,
WE'RE BRINGING THIS BELL FOR
ORDER FORWARD TO PROTECT THE
PRIVACY OF OUR PATIENTS TO
ENSURE THAT THEY HAVE ACCESS TO
THAT SAFE AND EQUITABLE
HEALTHCARE, INCLUDING ABORTION,
AND IN SO DOING ARE PROTECTED
FROM THOSE RECORDS GOING OUT OF
STATE AND THEN FACING THAT
LIABILITY WITH ME TODAY IS LISA
MATSUBARA, VICE PRESIDENT OF
POLICY WITH PLANNED PARENTHOOD
AND DR MICHELLE GOMEZ, THE
FAMILY MEDICINE PHYSICIAN AND
ABORTION PROVIDER. PEACE. GOOD
AFTERNOON CHAIR, WOOD AND
MEMBERS. I'M GRATEFUL TO BE HERE
IN SUPPORT OF A B 352. MY NAME
IS DR MICHELLE GOMEZ AND I'M, A
FAMILY MEDICINE PHYSICIAN AND
VOLUNTEER CLINICAL FACULTY WITH
UCSF SCHOOL OF MEDICINE IN
CALIFORNIA. I'VE BEEN PROVIDING
AND TEACHING BOTH PRIMARY CARE
AND ABORTION FOR 20 YEARS AND
I'M HERE TODAY BECAUSE I AM
DEEPLY CONCERNED FOR MY PATIENTS
AND MY COLLEAGUES. FIRST AND
FOREMOST ABORTION IS SAFE,
EFFECTIVE AND A COMMON PROCEDURE
WITH LOW COMPLICATION RATES.
DECADES OF STUDIES SUPPORT THE
SAFETY AND EFFICACY OF ABORTION
PROCEDURES, INCLUDING MEDICATION
ABORTION. WHEN PATIENTS SEEK
THIS CARE IN CALIFORNIA, WE MUST
DO ALL WE CAN TO PROTECT THEIR
CONFIDENTIALITY, PARTICULARLY IF
THAT PATIENT IS TRAVELING TO
CALIFORNIA FOR CARE AND MUST
RETURN BACK TO THEIR HOME STATE.
WHERE ABORTION MAY BE BANNED OR
CRIMINALIZED. WHILE THE EXCHANGE
OF ELECTRONIC MEDICAL
INFORMATION IS VALUABLE IN
MAKING SURE PROVIDERS HAVE
ESSENTIAL INFORMATION TO PROVIDE
APPROPRIATE CARE IN STATES WHERE
ABORTION IS CRIMINALIZED, THE
EXCHANGE OF INFORMATION MAY
EXPOSE PATIENTS TO PROSECUTIONS
AND OTHER STATE ACTIONS THAT ARE
HARMFUL TO THEM. LET ME GIVE YOU
TWO EXAMPLES FROM MY OWN
EXPERIENCE. I HAVE PATIENTS WHO
LIVE IN TEXAS WHO COME TO ME FOR
ABORTION CARE IN CALIFORNIA. IN
ONE CASE, A TEXAS PATIENT
RETURNED HOME TO TEXAS CONTINUE
TO EXPERIENCE BLEEDING AND
SOUGHT FOLLOW UP CARE IN THE
EMERGENCY ROOM. THAT DAY. I GOT
A NOTIFICATION THROUGH MY
ELECTRONIC MEDICAL RECORD THAT
THE PATIENT WAS SEEN IN A TEXAS
CG. I COULD SEE THE WHOLE VISIT
AND IT OCCURRED TO ME THAT THE
PROVIDER THAT SAW THE PATIENT IN
THE TEXAS CD COULD ALSO SEE HER
ENTIRE VISIT WITH ME THAT THE
TEXAS DOCTOR COULD SEE THAT THIS
PATIENT HAD HAD AN ABORTION IN
CALIFORNIA. THE CHART ALSO
SHOWED THAT THE PATIENT WAS
REFERRED TO AN OBEDIENT IN TEXAS
WHO COULD ALSO SEE THAT SHE'D
HAD AN ABORTION IN CALIFORNIA.
AT A TIME WHEN TEXAS LAW IS
TRYING TO PUNISH PROVIDERS,
PATIENTS AND THOSE WHO HELP
PATIENTS UNDER THE STATE'S
ABORTION BAN. I WONDERED HOW
MANY OTHER PEOPLE NURSES, SOCIAL
WORKERS BUILDING PEOPLE,
ETCETERA HAD ACCESS TO THAT
INFORMATION THROUGH THE
PATIENT'S MEDICAL RECORD. UNDER
TEXAS LAW, I COULD BE PUNISHED
WITH LIFE IN PRISON AND OR A
$100,000 FINE JUST FOR HELPING A
PATIENT DO WHAT SHE FELT WAS
BEST FOR HER OWN BODY AND HER
FAMILY'S FUTURE. ALSO UNDER
TEXAS LAW. ANYONE CLOSE TO MY
PATIENT WHO MAY HAVE KNOWN WHAT
SHE WAS DOING COULD BE SUED FOR
$10,000 AND SERVE UP TO FIVE
YEARS IN PRISON FOR AIDING AND
ABETTING HER. I ALSO HAVE A
COLLEAGUE WHO REPORTED THAT A
PATIENT WHO TRAVELED TO HER FOR
CARE FROM A STATE WITH AN
ABORTION BAN WENT BACK TO THEIR
HOME STATE, WHERE INFORMATION IN
THEIR MEDICAL RECORD RELATED TO
THE ABORTION CARE THEY RECEIVED
RESULTED IN A REPORT TO CHILD
PROTECTIVE SERVICES. THIS
PATIENT IS NOW DEALING WITH THE
RAMIFICATIONS OF BEING ACCUSED
OF BEING AN UNFIT MOTHER AS A
MOTHER MYSELF. I CANNOT EVEN
IMAGINE THAT HEARTBREAK AND FEAR
OTHER PROVIDERS HAVE ALSO SHARED
THAT THEY'VE RESORTED TO USING
PAPER RECORDS RATHER THAN THE
ELECTRONIC HEALTH RECORDS FOR
OUT OF STATE PATIENTS TO BETTER
PROTECT THEIR CONFIDENTIALITY. A
MOVE THAT MAKES IT HARDER TO
RECONCILE THE PATIENT'S MEDICAL
CHARTS AND MAY EXPOSE PROVIDERS
TO OTHER FORMS OF LEGAL
LIABILITY. THIS IS URGENT. WE DO
NOT WANT TO WAIT UNTIL SOMEONE
IS HARMED BEFORE WE DO SOMETHING
IN CALIFORNIA TO PROTECT
ABORTION PATIENTS AND PROVIDERS
. THESE ARE REAL LIVES WITH REAL
CONSEQUENCES IN CALIFORNIA HAS
THE OPPORTUNITY TO CONTINUE TO
BE A LEADER IN THE FIGHT FOR
REPRODUCTIVE FREEDOM AND PROTECT
PATIENT PRIVACY. THANK YOU. GOOD
AFTERNOON CHAIR, WOOD AND
MEMBERS. MY NAME IS LISA
MATSUBARA. I'M THE GENERAL
COUNSEL AND VP OF POLICY AT
PLANNED PARENTHOOD AFFILIATES OF
CALIFORNIA, REPRESENTING THE
SEVEN PLANNED PARENTHOOD
AFFILIATES THROUGHOUT THE STATE
WHO OPERATE OVER 100 HEALTH
CENTERS IN CALIFORNIA AND
PROVIDE OVER 1.3 MILLION PATIENT
VISITS ANNUALLY. I'M HERE TODAY
IN SUPPORT OF 83 52. PLANNED
PARENTHOOD HEALTH CENTERS.
CONFIDENTIALITY IS AT THE CORE
OF ITS ROLE AS A TRUSTED
HEALTHCARE PROVIDER, AND
PATIENTS SHOULD BE ABLE TO
ACCESS SENSITIVE SERVICES,
INCLUDING ABORTION CARE WITH
DIGNITY, COMPASSION AND WITHOUT
FEAR OF HAVING THEIR PRIVATE
INFORMATION WIDELY SHARED. THE
IMPORTANCE OF CONFIDENTIALITY IS
EVEN MORE IMPORTANT IN TODAY'S
LEGAL LANDSCAPE FOLLOWING THE
SUPREME COURT'S DECISION AND
JOBS THAT OVERTURNED THE
PROTECTIONS IN ROW AND NOW ALLOW
STATES TO CRIMINALIZE ABORTION.
AS OF TODAY. 13 STATES BAN
ABORTION AT ALL STAGES OF
PREGNANCY IN FIVE STATES OF
IMPLEMENTED PRE VIABILITY BANDS
, WITH SEVERAL STATES ALSO
CONSIDERING LEGISLATION THAT
FURTHER RESTRICTS ACCESS. WHILE
I RECOGNIZE THE IMPORTANCE OF
THE EXCHANGE OF HEALTH
INFORMATION IN CARING FOR
PATIENTS, WE ARE NOW FACING AN
UNPRECEDENTED SCENARIO WHERE
INFORMATION THAT IS A PART OF A
PATIENT'S CARE IN ONE STATE WHEN
SHARED THROUGH AN ELECTRONIC
HEALTH RECORD SYSTEM IN ANOTHER
STATE MAY PUT THE PATIENTS AND
THEIR PROVIDERS THAT PROVIDED
THAT CARE AT RISK. A RECENT
REPORT BY IF ONE HOUSE SHOWED
THAT AMONG PEOPLE WHO ARE
INVESTIGATED OR ARRESTED FOR
ALLEGEDLY ENDING THEIR OWN
PREGNANCY, OR HELPING SOMEONE
ELSE DO SO ALMOST 40% OF THEM
CAME TO THE ATTENTION OF LAW
ENFORCEMENT WHEN THEY WERE
REPORTED BY THEIR HEALTHCARE
PROVIDERS. NO PATIENT SHOULD
FEAR THAT THEIR MEDICAL RECORDS
WOULD BE USED AS EVIDENCE
AGAINST THEM, AND WE MUST ENSURE
THAT PEOPLE WHO GET KAREN
CALIFORNIA ARE NOT RISKING THEIR
LIVES AND FREEDOM WHEN THEY
RETURN HOME. MAYBE 3 52 WILL
PROVIDE FURTHER PROTECTIONS FOR
MEDICAL RECORDS. AND MAKE SURE
THAT CALIFORNIA IS A HAVEN FOR
REPRODUCTIVE HEALTH CARE. THANK
YOU. THANK YOU OTHERS IN
SUPPORT. IT'S JUST YOUR NAME AND
ORGANIZATION IF YOU REPRESENT
ONE. GOOD AFTERNOON, MARTIN
RADOSEVIC ON BEHALF OF CNN, A
AND NEIGHBOR OUT PRO CHOICE
CALIFORNIA AND SUPPORT. THANK
YOU. AFTERNOON SERGEANT LOU WITH
THE ELECTRONIC FRONTIER
FOUNDATION AND STRONG SUPPORT.
THANK YOU. ALEXIS RODRIGUEZ WITH
THE CALIFORNIA MEDICAL
ASSOCIATION IN SUPPORT. THANK
YOU. BRIAN SPENCER ON BEHALF OF
THE AMERICAN COLLEGE OF OBGYN
WOMEN'S DISTRICT NINE. WE ARE CO
SPONSORS ON THE MEASURE IN
SPORT. THANK YOU. TAYLOR JACKSON
WITH CALIFORNIA HEALTH PLUS
ADVOCATES REPRESENTING
CALIFORNIA'S COMMUNITY HEALTH
CENTERS AND STRONG SUPPORT.
VERONICA AVAILABLE SCREWS WITH
THE CALIFORNIA LATINAS FOR
REPRODUCTIVE JUSTICE AND
SUPPORT. THANK YOU. GOOD
AFTERNOON ONION, MOBY KIA WITH
BLACK WOMEN FOR WELLNESS ACTION
PROJECT AND STRONG SUPPORT.
THANK YOU. THANK YOU. LUCY
KWACHA NELLA ON BEHALF OF
MATERNAL AND CHILD HEALTH ACCESS
AND STRONG SUPPORT. THANK YOU.
MR CHAIRMAN, MEMBERS BRACE
DOUGHERTY ON BEHALF OF THE
CALIFORNIA ACADEMY OF FAMILY,
PHYSICIANS AND SUPPORT THANK
YOU. ANYONE ELSE? OKAY, SO YOU
KNOW, ONE IS THEIR OPPOSITION TO
THE BILL. SEE NO OPPOSITION WILL
BRING IT BACK TO THE COMMITTEE
FOR QUESTIONS OR COMMENTS,
QUESTIONS. MS AGUIAR-CURRY. I
DON'T KNOW HOW TO SAY RIGHT NOW.
IT'S BEEN SO, UM UPSETTING THE
PAST COUPLE OF WEEKS. YOU KNOW,
IT GOES FROM BAD TO WORSE. AND I
REALLY WANT TO THANK YOU,
SOMEBODY WOMAN FOR TAKING THIS
ON, YOU KNOW IT'S RISKY. PEOPLE
GIVE US A BAD TIME ABOUT THINGS
IN THIS REALM OF TALKING ABOUT
WOMEN'S FREEDOMS AND
REPRODUCTIVE WORK. AND I'M
REALLY PROUD THAT YOU'RE YOU'VE
TAKEN THIS ON AND THAT YOUR
SUPPORTERS HERE IN SPONSORS
REALIZE AND HAVE BROUGHT IT TO
OUR ATTENTION OF WHAT'S
HAPPENING IN THE INEQUITIES. AND
SO I WANT TO THANK YOU FOR
BRINGING FORWARD AND I'D LIKE TO
BE A CO AUTHOR OF THE BILL.
THANK YOU, DR WEBBER. THANK YOU
. THANK YOU TO THE SPONSORS FOR
THIS BILL. IT IS DEFINITELY
NEEDED. UM AND I'M SORRY I WAS
AT ANOTHER COMMITTEE. SO I JUST
WANNA MAKE SURE THAT I AM CLEAR
THAT THIS IS JUST FOR PEOPLE WHO
ARE REQUESTING INFORMATION OUT
OF STATE CORRECT. HAVE AN
ADDRESS THAT WORKS. YES THE
PRIVACY, UH, THE RESTRICTIONS IN
SHARING INFORMATION IS IN
RESPONSE TO REQUESTS FROM OUT OF
STATE. OKAY PERFECT. AND UM, THE
ONLY OTHER THING THAT I WOULD
SAY AND MAYBE THIS WAS MENTIONED
AS, UH, REALLY FIGURING OUT WHEN
THE PARTICULAR PATIENT WOULD BE
CONSENTING FOR THIS. UM, IS IT.
EXCUSE ME A ONE TIME CONSENT, OR
IS IT? UM I'M CONSENTING TO
RELEASE THIS TEST VERSUS I'VE
GOT TO CONSENT TO RELEASE THE
FIVE TESTS THAT I HAVE AT
DIFFERENT TIMES. SO YOU KNOW IS
THIS INFORMATION PUT IN LIKE A
POOL OF SENSITIVE MATERIAL
BECAUSE WE HAVE THAT LIKE RIGHT
NOW, WITH SOME OF OUR ELECTRONIC
MEDICAL RECORDS LIKE THERE'S A
POOL OF SENSITIVE MATERIAL INTO
A FARM. CONSENTING IT'S REALLY
FOR ALL OF THAT, OR IS IT JUST
ONE PIECE OF THAT? SO I KNOW THE
DISCUSSIONS WILL CONTINUE, BUT
THAT'S GOING TO BE AN IMPORTANT
THING TO KIND OF FIGURE OUT TO
MAKE SURE THAT THIS IS, UM AS
SUCCESSFUL AS WE'D ALL LIKE IT
TO BE, BUT THANK YOU. ANYONE
ELSE? UM. JUST A QUESTION. AND
FIRST OF ALL, LOOK, I'M IN
SUPPORT OF THE BILL, AND WHEN WE
DO HAVE A QUORUM I'M GOING TO
RECOMMEND AND I VOTE. DO YOU
HAVE A QUESTION AND THINKING
JUST AS A AS A MEDICAL PROVIDER.
UM. IF A WOMAN HAS A HAS A
COMPLICATION OUT OF STATE LIKE
YOUR PATIENT YOU TALKED ABOUT IN
TEXAS. UM AND OBVIOUSLY. THE
SENSITIVITY ABOUT WHY THERE'S A
MEDICAL COMPLICATION. HOW DO WE
ENSURE THAT THE PATIENT IS
GETTING THE APPROPRIATE CARE AND
THAT THERE'S THE ACT THAT THAT
THERE IS A DIAGNOSIS TO SUPPORT
THAT? BECAUSE IF WE DON'T HAVE
THE INFORMATION, THEN HOW DO WE
KNOW YOU'RE TREATING THE RIGHT
CONDITION BECAUSE THE PATIENT IS
NOT GOING TO WANT TO SAY
ANYTHING. UM AND WHAT ARE THE
PATIENT'S UNCONSCIOUS OR YOU
KNOW, AND I DON'T THAT MAYBE
THAT'S RARE. THAT'S PROBABLY
EXTREMELY RARE. BUT IT IS A
POSSIBILITY. YOU'VE LOST ENOUGH
BLOOD. YOU MIGHT YOU COULD BE
UNCONSCIOUS SO HELP ME
UNDERSTAND THAT WE'RE NOT
INADVERTENTLY CREATING A
SITUATION WHERE SOMEONE DOESN'T
GET THE APPROPRIATE CARE AND
THEY HAVE A COMPLICATION THAT
COULD BE AVOIDED. ABSOLUTELY
THAT'S A GREAT QUESTION. AND OF
COURSE, OUR PRIMARY CONCERN IS
ALWAYS FOR OUR PATIENT SAFETY.
FORTUNATELY, ABORTIONS ARE
EXTREMELY SAFE. THEY'RE ACTUALLY
SAFER THAN CARRYING A PREGNANCY
TO TERM. SO JUST FOR THAT
PERSPECTIVE, IT'S PROBABLY 14
TIMES MORE DANGEROUS TO CARRY A
PREGNANCY TO TERM IN THE UNITED
STATES THAN IT IS TO HAVE AN
ABORTION. BUT RIGHT SOMETIMES
THERE WILL BE COMPLICATIONS AND
BLEEDING IS ONE OF THE MOST
COMMON COMPLICATIONS.
FORTUNATELY IT DOESN'T TEND TO
BE ENOUGH BLEEDING WHERE PEOPLE
ARE UNCONSCIOUS. I THINK IN I
DON'T HAVE EXACT NUMBERS FOR
YOU, BUT I CAN TELL YOU IT'S
EXTREMELY RARE THAT PATIENTS
NEED A TRANSFUSION AFTER A
MEDICATION ABORTION, FOR
EXAMPLE, WHICH IS WHAT YOU KNOW
MORE THAN HALF OF ABORTION. ARE
NOW. IT'S ABOUT ONE IN 500 CASES
WHERE PATIENTS NEED A
TRANSFUSION, SO IT'S EXTREMELY
RARE LESS THAN 1% OF THE TIME.
ARE THERE SIGNIFICANT
COMPLICATIONS? HOWEVER IF THERE
IS A COMPLICATION THAT TAKES A
PATIENT TO THE EMERGENCY
DEPARTMENT, THERE IS NO
DIFFERENCE BETWEEN BLEEDING FROM
AN ABORTION OR BLEEDING FROM A
MISCARRIAGE SO THAT PATIENT
COULD STILL USE THAT, YOU KNOW.
IT IS A FORM OF A MISCARRIAGE.
PREGNANCY IS NOT CONTINUING, SO
THEY COULD SAY THAT THEY WERE
PREGNANT. THEIR HAVING BLEEDING
. THEY DON'T KNOW WHY IT'S UP TO
THEM TO SHARE WHAT THEY WANT TO
SHARE. BUT THERE IS NOTHING
ABOUT, UM, YOU KNOW, BLEEDING
FROM AN ABORTION THAT WOULD NEED
THEM TO TALK ABOUT THAT THE
TREATMENT WOULD BE EXACTLY THE
SAME. I WOULD ALSO SAY THAT IN
MOST CASES BECAUSE IT'S
UNCOMPLICATED, A FIRST TRIMESTER
, UNCOMPLICATED ABORTION IS NOT
RELEVANT PAST MEDICAL HISTORY.
IT'S LIKE HAVING AN I U D PLACED
SO THEY CERTAINLY DON'T NEED
THAT INFORMATION. UNLESS THERE'S
A COMPLICATION. I HOPE THAT
ANSWERS YOUR QUESTION. YES,
THANK YOU. AND I APPRECIATE THAT
, SO AND I JUST KIND OF A FOLLOW
UP QUESTION. UM IS THE IS THE,
UM IS THE INFORMATION REDACTED
OR IS IT JUST NOT INCLUDED?
BECAUSE IF YOU IF YOU'RE
SUBMITTING A REPORT THIS
REDACTED IT'S KIND OF A KIND OF
A CLUE AS TO WHAT THE HECK IS
GOING ON, OR WHAT HAS HAPPENED
FOR THIS PATIENT. SO EXPLAIN
THAT TO ME IF YOU DON'T MIND,
PLEASE SO, UM, I THINK IN
RESPONSE TO REMEMBER WEBER'S.
THERE ARE SOME SORT OF DETAILS
ON THE IMPLEMENTATION SIDE THAT
I THINK WERE POINTED OUT IN THE
COMMUNITY ANALYSIS THAT WE ARE
GOING TO BE ADDRESSING. UM BUT
THIS ALSO THIS BILL ALSO, UM,
HAS A PROVISION IN IT THAT WOULD
REQUIRE ELECTRONIC HEALTH RECORD
SYSTEMS IN CALIFORNIA. TO CREATE
CERTAIN TECHNOLOGICAL
CAPABILITIES TO PROPERLY
SEGREGATE THE INFORMATION. AND
IF I MAY THIS AS DR WEBBER
MENTIONED, THIS IS NOT THE FIRST
TIME THAT THIS TYPE OF PRACTICE
IS HAPPENING. RIGHT SUBSTANCE
ABUSE, FOR EXAMPLE, PATIENTS CAN
WITHHOLD THAT, AND IT ISN'T
SHARED THROUGH ELECTRONIC
MEDICAL RECORDS. SO THE CONCEPT
HERE IS NOT A NEW ONE. WE'RE
JUST APPLYING IT TO NEW AREAS.
GREAT OKAY. THANK YOU. ANY OTHER
ANY OTHER QUESTIONS? OKAY WELL,
I JUST WANT TO THANK YOU. THE
BILL DOES ENJOY ENJOY DO PASS
RECOMMENDATION AND I WHEN WE GET
A QUORUM, WE'RE GETTING CLOSER.
SLOWLY BUT ANYWAY, SO, UM, WOULD
YOU LIKE TO CLOSE? THANK YOU, MR
CHAIR AND MEMBERS FOR YOUR
SUPPORT AND ALSO, UM, FOR ALL
THAT WE'VE DONE AS A
LEGISLATURE, I THINK YOU KNOW IN
THE PAST WEEK OR TWO WEEKS. WE
SAW, UM, A FOREIGN STATE
CRIMINALIZE ASSISTING A YOUTH IN
ACCESSING ABORTION OUT OF STATE
, RIGHT? SO IMAGINE THE SCENARIO
WHERE A YOUNG CHILD. SEXUALLY
ASSAULTED, GETS PREGNANT. MOM
DECIDES TO TAKE THAT CHILD OUT
OF STATE TO ACCESS ABORTION
SERVICES SAFELY AND LEGALLY AND
THE MEDICAL RECORDS THEN ARE
SHOWN IN STATE AND THAT PARENT
IS CRIMINALIZED UNDER HUMAN
TRAFFICKING LAWS. THAT'S WHAT
WE'RE TALKING ABOUT HERE, AND
PEOPLE HAVE A RIGHT TO ACCESS
SAFE AND LEGAL HEALTH CARE, AND
WE WANT THEM TO DO IT HERE IN
CALIFORNIA, AND WE WANT THEM NOT
TO HAVE THE NEGATIVE
CONSEQUENCES THAT OTHER STATES
ARE TRYING TO PUT ON. WHAT IS
HEALTH CARE? SO THANK YOU. AND I
RESPECTFULLY ASK FOR YOUR VOTE.
OKAY THANK YOU. WHEN WE HAVE A
QUORUM, WE'LL WE'LL SEE
COMMOTION AND HOPEFULLY MOVE
YOUR BILL ON. THANK YOU SO MUCH.
MR CARILLO.
AND YOU HAVE ASSEMBLY BILL 503
WHENEVER YOU'RE READY, SIR.
THANK YOU, MR CHAIR. THANK YOU
FOR ALLOWING ME TO PRESENT A
SIMILAR BILL FIVE OR THREE. AND
BEFORE I BEGIN, I WOULD LIKE TO
RESPECTFULLY ACCEPT THE
COMMITTEE'S AMENDMENTS AND THANK
THE CHAIR AND CONSULTANT FOR
OTHER HARD WORK ON THIS BILL.
MAYBE FIVE, OR 36 TO DEVELOP
ADDITIONAL OPPORTUNITIES TO
REGISTER INDIVIDUALS,
ORGANIZATIONS, DONORS WITH THE
GOAL OF IN CHRISTIAN
REGISTRATION RATES TO SAVE MORE
LIVES. COMMITTEE AMENDMENTS
SPECIFY THAT ADDITIONAL
QUESTIONS ASKING APPLICANTS IF
THEY WOULD LIKE TO ENROLL WILL
BE LIMITED TO THE ONLINE
APPLICATION KNOWN AS THE SINGLE
STREAMLINE APPLICATION. THE
AMENDMENTS ALSO SPECIFIED THAT
THE QUESTION BE OPTIONAL. AND
NOT A REQUIRED PART OF THE
APPLICATION CURRENTLY MORE THAN
104,000. INDIVIDUALS ACROSS THE
COUNTRY ARE WAITING FOR LIFE
SAVING ORGAN OR TISSUE
TRANSPLANTS. NEARLY 1/5 OF THESE
INDIVIDUALS ARE IN CALIFORNIA.
ALL OF THESE PEOPLE IN NEED OF
TRANSPLANT NATIONWIDE. 17 OF
THEM DIE EACH DAY WITHOUT ONE.
BECAUSE OF THIS ORGANIZATION.
DONATION IS A VITAL PROCESS FOR
IMPROVING AND EVEN SAVING THE
LIVES OF CALIFORNIANS. DONATE
LIFE CALIFORNIA IS RESPONSIBLE
FOR MANAGING THE STATE'S ORGAN
AND TISSUE DONOR REGISTRY AND
PRIORITY 2004 NOR REGISTRY THAT
EXISTED FOR THOSE WHO WISH TO
GIVE CONSENT TO BE AN ORGAN AND
OUR TISSUE DONOR. MANY OF YOU
PROBABLY RECALL BEING ASKED IF
YOU WANTED TO BECOME AN ORGAN
DONOR AT THE D. M. B THIS HAS
BEEN MADE POSSIBLE THROUGH
DONATE LIFE CALIFORNIA
PARTNERSHIP WITH THE DEPARTMENT
OF MOTOR VEHICLES. WHICH BEGAN
IN 2006. TODAY OVER 18.5 MILLION
INDIVIDUALS HAVE EXPRESSED THEIR
INTENT TO DONATE WITH REGISTRY
WITH OVER 98% OF THOSE COMING
THROUGH THE DONORS OF THE D M B.
STILL, WE NEED TO DO BETTER.
ROUGHLY 90% SUPPORT ORGAN
DONATION. BUT ONLY 60% ARE
ACTUALLY SIGNED UP AS DONORS.
SINCE 2006 MORE THAN 600,000
LIVES HAVE BEEN SAVED OR HEALED
THEIR ORGANIZATION THE NATION
BECAUSE OF THE REGISTRY. THIS
BILL RESERVED RESERVES. I'M
SORRY. THIS BILL SERVES AS A
NATURAL NEXT STEP TOWARD THAT
GOAL. CHEN JOINING ME TO TESTIFY
IN SUPPORT AND ANSWER QUESTIONS
IS MR JEAN MARC IN CEO OF DONATE
LIFE CALIFORNIA AND LACEY FILTER
AND ORGAN RECIPIENT. PUSH THE
BUTTON THERE, PLEASE. AFTERNOON
CHAIR AND COMMITTEE MEMBERS. JIM
MARTIN DONATE DONATE LIFE
CALIFORNIA CEO THANKS FOR THE
OPPORTUNITY TO TESTIFY ON A B
503 AS SOMEONE MEMBER UM CARILLO
STATED WHERE THE NONPROFIT STATE
AUTHORIZED ORGANIZED TISSUE
REGISTRY FOR THE STATE OF
CALIFORNIA AND WE WERE
ESTABLISHED IN 2006 IN
PARTNERSHIP WITH THE CALIFORNIA
DMV. UM TO REGISTER AS MANY.
DONORS AS WE POSSIBLY COULD. THE
17 YEARS SINCE INCEPTION, WE'VE
HAD A GREAT RELATIONSHIP WITH
THE DMV, RESULTING IN THE 18.6
MILLION REGISTERED CALIFORNIANS.
UM. OF THE 23RD 20,000
CALIFORNIANS THAT ARE CURRENTLY
ON THE NATIONAL WAITING LIST OF
THOSE 46% ARE FROM HISPANIC
LATINO COMMUNITY 21% OR FROM THE
WHITE, NON HISPANIC COMMUNITY
20% ARE FROM THE ASIAN COMMUNITY
IN 10% ARE FROM THE BLACK, NON
HISPANIC COMMUNITY. ONE PERSON'S
DONATION GIFTS CAN SAVE UP TO
EIGHT LIVES AND IMPROVE THE
LIVES OF OVER 75 OTHERS. WHILE
OUR PARTNERSHIP WITH THE DMV'S
BEEN AMAZING, UM FIELDS
IMPERATIVE REALLY, TO SHIFT THE
CONVERSATION INTO THE PUBLIC
HEALTHCARE DOMAIN, SIMILAR TO
ANY OTHER END OF LIFE DECISION
AND OR ADVANCED DIRECTIVE. THAT
THE INCREASED FREQUENCY AND
REPETITION OF THE ORGAN DONATION
REGISTRATION QUESTION ON THE
HEALTHCARE REGISTRATION FORMS AS
A HUGE FIRST STEP IN REFRAMING
ORGAN DONATION AND TRANSPLANT AS
A PUBLIC HEALTH ISSUE, AND WE
BELIEVE 503 IS THE MECHANISM TO
MAKE THIS IMPORTANT AND
SUBSTANTIVE CHANGE. 85 03
PROVIDES A CRITICAL OPPORTUNITY
TO INCREASE THE NUMBER OF
REGISTERED DONORS IN CALIFORNIA.
IN THE BILL REQUIRES THE
APPLICATION FOR INSURANCE
AFFORDABILITY PROGRAMS TO
INCLUDE A CHECKBOX, ALL
INDIVIDUALS. IN THEREFORE GIVE
THEIR CONSENT TO ENROLL IN THE
DONATE LIFE ORGAN AND TISSUE
DONOR REGISTRY. WE BELIEVE THIS
BILL WILL SIGNIFICANTLY IMPACT
THE NUMBER OF THOSE REGISTERED
IN CALIFORNIA, AND WE APPRECIATE
THE EFFORTS OF ASSEMBLYMEMBER'S
CORIO IN INTRODUCING THIS
IMPORTANT LEGISLATION. URGE YOUR
SUPPORT. THANK YOU. THANK YOU.
LET'S GO AHEAD. GOOD AFTERNOON,
MR CHAIR AND MEMBERS. MY NAME IS
LACEY FELDER. AND I AM HONORED
TO SAY THAT I AM THE PROGRAM
MANAGER AT DONATE LIFE,
CALIFORNIA WHEN I WAS 10 MONTHS
OLD. MY PARENTS WERE TOLD THAT I
WAS IN HEART FAILURE. HAD CAUGHT
A VIRUS THAT ATTACKED MY HEART.
AND A HEART TRANSPLANT WAS THE
ONLY OPTION FOR ME TO LIVE. I'M
HUMBLED AND PROUD TO BE ABLE TO
STAND BEFORE YOU TODAY BECAUSE
THE FAMILY SAID YES TO ORGAN
DONATION. MY DONOR'S NAME WAS
JAMES. HE WAS 22 MONTHS OLD. AND
HE WAS IN A TRAGIC ACCIDENT
RIGHT HERE IN SACRAMENTO. LAST
OCTOBER. I CELEBRATED 32 YEARS
WITH BABY JAMES HIS HEART. AND I
LIVE EACH AND EVERY DAY FOR
JAMES AND HIS FAMILY. THE MOST
CHALLENGING ASPECT OF ADVOCATING
ORGAN DONATION AS A RECIPIENT IS
THE FACT THAT WE LOOK LIKE
NORMAL PEOPLE. YOU CAN'T SEE THE
HUNDREDS OF INCHES OF SCARS OR
THE STRAIGHT GRATITUDE THAT WE
FEEL FOR SIMPLY LIVING. MY
JOURNEY HASN'T BEEN AN EASY ONE.
AND BECAME EVEN HARDER WHEN I
WAS DIAGNOSED WITH KIDNEY
FAILURE IN HIGH SCHOOL. I'M SO
LUCKY THAT MY BROTHER TYSON, MY
HERO, STEPPED UP AND DONATED HIS
KIDNEY TO ME IN 2006. BECAUSE OF
TYSON AND BABY JAMES. I HAVE
BEEN THE FIRST PERSON IN MY
FAMILY TO GRADUATE COLLEGE. AND
MOST RECENTLY, I GOT TO MARRY
THE LOVE OF MY LIFE, AND WE ARE
NOW ON THE JOURNEY OF STARTING A
FAMILY THROUGH SURROGACY. ORGAN
DONATION DOESN'T JUST SAVE
LIVES, IT TRANSFORMS THEM. IT
CREATES MEMORIES, EXPERIENCES
AND MILESTONES THAT WE NEVER
EVEN KNEW WHERE POSSIBLE. I'M
GOING TO BE HONEST WHEN WRITING
THIS TESTIMONY. I REALLY
STRUGGLED IN FINDING THE WORDS
TO CAPTURE WHAT THIS MOMENT
MEANS TO ME. WALKING PAST THE
CAPITAL FILLS MY HEART WITH PAIN
AND GRATITUDE. NOT JUST BECAUSE
BABY JAMES PASSED AWAY RIGHT
NEAR HERE. BUT BECAUSE THE LAST
TIME I WAS HERE, TESTIFYING I
WAS EIGHT YEARS OLD SHARING THE
INCREDIBLE IMPACT WE COULD HAVE
IF WE STARTED THE DONATE LIFE,
CALIFORNIA DONOR REGISTRY. WE
NOW HAVE OVER 18.6 MILLION
CALIFORNIANS REGISTERED BUT
UNFORTUNATELY, THAT'S ONLY ABOUT
HALF OF OUR POPULATION IN THE
STATE OF CALIFORNIA. I'VE MADE
IT MY LIFE'S MISSION TO HONOR
BABY JAMES EVERY SINGLE DAY AND
HELP GIVE THE 20,000 PEOPLE
WAITING FOR AN ORGAN IN
CALIFORNIA. THE SAME CHANCES ME
BY SUPPORTING A B 503. I KNOW
THE LIVES SAVED WILL BE WORTH
IT. AND IT WILL GIVE EVEN MORE
CALIFORNIANS THE OPPORTUNITY TO
SAY YES TO TRANSFORMING LIVES
LIKE MINE. THANK YOU SO MUCH FOR
THIS OPPORTUNITY TO SHARE MY
STORY AND REMEMBER LIVE LIFE TO
THE FULLEST. WE DON'T ALL GET A
SECOND CHANCE AT IT. THANK YOU.
THANK YOU OTHERS IN SUPPORT. HI
CRISTI FOY ON BEHALF OF THE
CALIFORNIA DIALYSIS COUNCIL IN
STRONG SUPPORT YOU GOOD
AFTERNOON, SANDRA POOL WITH
WESTERN CENTER ON LAW AND
POVERTY AND SUPPORT. KELLY BEAN
FOR HEALTH NET OF CALIFORNIA AND
SUPPORT ANYONE ELSE? NO ONE. IS
THERE ANY OPPOSITION TO THE
BILL? NO ONE WILL BRING IT BACK
TO THE COMMITTEE FOR QUESTIONS
OR COMMENTS. ANY QUESTIONS ARE
COMING. UM, I JUST LIKE TO SAY
THANK YOU, MR CARILLO FOR
BRINGING THIS BILL FORWARD. IT
DOES ENJOY A DO PASS
RECOMMENDATION. I WANT TO THANK
YOUR WITNESSES. AND LACEY LACEY.
THANK YOU. SO MUCH FOR SHARING
YOUR STORY WITH US TODAY. UM
WHEN WE DO GET A QUORUM WHO WILL
ASK FOR A MOTION? MR CAREER.
WOULD YOU LIKE TO CLOSE? YOU
KNOW, I REALLY WAS NOT PREPARED
FOR THAT TESTAMENT TAPE. REALLY
GOT TO ME. UM THE DISABILITY
COMMON SENSE MEASURE THAT WOULD
HELP SAVE MORE LIVES. Dð
ORGANIZATION DONATION BY
EXPANDING OPPORTUNITIES TO SIGN
UP. WITHOUT I RESPECTFULLY URGE
ARRIVE. VOTE AND I THANK YOU.
THANK YOU.
ASSEMBLYMEMBER'S CALDERON.
WHENEVER YOU'RE READY. GOOD
AFTERNOON CHAIR AND MEMBERS.
ASSEMBLY BILL 5 86 WOULD ADD
CLIMATE CHANGE OR ENVIRONMENTAL
MEDIATION DEVICES TO THE LIST OF
COMMUNITY SUPPORTS UNDER THE CAL
AIM INITIATIVE. I AM CURRENTLY
LIST 14 COMMUNITY SUPPORTS THAT
PROVIDE NON CLINICAL
INTERVENTIONS, TARGET THE SOCIAL
DETERMINANTS OF HEALTH AND
REDUCE HEALTH DISPARITIES. KELLY
I'M CURRENTLY LACKS COMMUNITY
SUPPORT SERVICES THAT DIRECTLY
ADDRESS CLIMATE CHANGE AND
ENVIRONMENTAL HEALTH, IMPACTS,
EXTREME HEAT AND POOR AIR
QUALITY OR LINKED TO NEGATIVE
HEALTH OUTCOMES, ESPECIALLY
AMONG VULNERABLE POPULATIONS WHO
BEAR THE DISPROPORTIONATE BURDEN
OF CLIMATE CHANGE IMPACTS. THESE
ARE THE SAME POPULATIONS WHO ARE
LIKELY ENROLLED IN MEDICAL AND
WHO WOULD BENEFIT FROM FROM CAL
AIMS COMMUNITY SUPPORTS. 85 86
ADDRESSES THESE GAPS BY COVERING
DEVICES SUCH AS AIR CONDITIONERS
, ELECTRIC HEAT PUMPS AND BACKUP
POWER SOURCES TO MITIGATE THE
IMPACTS OF EXTREME WEATHER
CONDITIONS CAUSED BY CLIMATE
CHANGE. A B 5 86 ALSO PROMOTES
ENVIRONMENTAL JUSTICE BY
PROTECTING THE HEALTH OF
MARGINALIZED COMMUNITIES IN OUR
STATE AND REDUCING STRAINS ON
OUR HEALTH CARE SYSTEM. WITH ME
IN SUPPORT OF 85 86 IS A MAYOR
RASHID WITH THE COUNTY BEHAVIOR
, BEHAVIORAL HEALTH DIRECTORS
ASSOCIATION, AND DENNIS CUEVAS
ROMERO WITH CALIFORNIA HEALTH
ADVOCATES. GOOD AFTERNOON CHAIR
AND MEMBERS AND THANK YOU FOR
YOUR TIME TODAY. MY NAME IS EMMA
RASHID AND I'M HERE ON BEHALF OF
THE COUNTY BEHAVIOR HEALTH
DIRECTORS ASSOCIATION OF
CALIFORNIA. TBH D A IS COMPRISED
OF THE LEADERS OF THE PUBLIC
HEALTH. EXCUSE ME, PUBLIC
BEHAVIOR, HEALTH AGENCIES THAT
SERVE THE MENTAL HEALTH AND
SUBSTANCE USE DISORDER NEEDS OF
UNINSURED AND UNDER INSURED
CALIFORNIANS, AND IT IS BECAUSE
OF THAT WORK AND THE POPULATIONS
THAT WE SERVE THAT WE STRONGLY
SUPPORT A B 586. COMMUNITY
SUPPORTS OUR SERVICES THROUGH
CALAIS AND THAT ARE DESIGNED TO
ADDRESS THE SOCIAL DRIVERS OF
HEALTH GOING WELL BEYOND
SERVICES OFFERED IN TRADITIONAL
MEDICAL SETTINGS. THESE SERVICES
AIM TO RECOGNIZE COMPLEX AND
UNMET WHOLE PERSON NEEDS, WHICH
IMPACT PHYSICAL HEALTH. 85 86
WILL ADD CLIMATE CHANGE
REMEDIATION TO THE LIST OF
COMMUNITY SUPPORTS COVER THROUGH
CALAIS, AND THIS EXPANSION OF
COMMUNITY SUPPORTS IS BECOMING
MORE IMPERATIVE AS ALREADY
VULNERABLE POPULATIONS OF
CALIFORNIANS ARE IMPACTED BY
INCREASING HEATWAVES, AIR
POLLUTION AND OTHER EXTREME
WEATHER EVENTS, WHICH HAVE BEEN
HAPPENING AT A GROWING FREQUENCY
ACROSS THE STATE. IN THE PAST
DECADE, CALIFORNIA HAS
EXPERIENCED MORE FREQUENT AND
INTENSE HEAT EVENTS. WILDFIRES
DROUGHTS, REDUCED AIR QUALITY
AND ATMOSPHERIC STORMS, WHICH
HAVE ALL OUTPACED HISTORICAL
RECORDS CENTER FOR DISEASE
CONTROL AND PREVENTION HAS NOTED
THAT THESE EXTREME WEATHER
EVENTS IMPACT SOME OF
CALIFORNIA'S MOST VULNERABLE
POPULATIONS SUCH AS CHILDREN,
PREGNANT PEOPLE, OLDER ADULTS,
PERSONS WITH DISABILITIES AND
COMMUNITIES OF COLOR. THESE
IMPACTS CAN LOOK LIKE
TEMPERATURE RELATED DEATH AND
ILLNESS, AIR QUALITY HEALTH
IMPACT VECTOR BORNE DISEASE AND
WATER RELATED ILLNESSES AND A
NUMBER OF MENTAL HEALTH IMPACTS
WITH THE PASSAGE OF A B 586 WE
CAN ADEQUATELY RECOGNIZE AND
ADDRESS THE HEALTH IMPLICATIONS
OF CLIMATE CHANGE, THE BEST
SUPPORT THE HEALTH AND WELL
BEING OF CALIFORNIANS, WHICH
ULTIMATELY IS THE INTENT AND
GOAL OF CALCIUM COMMUNITY
SUPPORT SERVICES. PASSING 85 86
AND ENSURING CLIMATE CHANGE AND
ENVIRONMENTAL REMEDIATION
DEVICES ARE INCLUDED IN COMMON.
IT COUNTS IN COMMUNITY SUPPORT
SERVICES WERE NOT ONLY MAKE CAL
AIM EVEN MORE EFFICACIOUS BY
EXTENSION. ALSO MAKE
CALIFORNIANS HEALTHIER IS FOR
THESE REASONS. WE RESPECTFULLY
REQUEST HER, IVO AND THANK YOU
FOR YOUR TIME TODAY. PLEASE.
GOOD AFTERNOON, MR CHAIR
MEMBERS, DENNIS CUEVAS ROMERO
WITH THE CALIFORNIA HEALTH PLUS
ADVOCATES ADVOCACY AFFILIATE OF
THE CALIFORNIA PRIMARY CARE
ASSOCIATION. WE REPRESENT 1300
HEALTH CENTERS UP AND DOWN THE
STATE. UH HERE TO SUPPORT UH, A
B 5 86 ARE YOU KNOW WE REPRESENT
WE PROVIDE CARE TO 7.7 MILLION
PATIENTS IN THE STATE OF
CALIFORNIA AND AS SPEAKER
PREVIOUSLY MENTIONED, YOU KNOW,
CLIMATE CHANGE IS A BIG DRIVER
OF HEALTH ISSUES, PARTICULARLY
WITH WILDFIRES AND THE RURAL
WELL NORTH AT RECENTLY AS LAST
YEAR, YOU KNOW, SOME OF OUR
PATIENTS AT OUR HEALTH CENTERS
WERE STRUGGLING WITH THE LACK OF
AIR FILTRATION IN THEIR HOMES,
AND IT'S REALLY DRIVING THE
CHRONIC CARE CONDITIONS IN OUR
HEALTH CENTERS. SO FOR THOSE
REASONS ARE CALIFORNIA HEALTH
PLUS ADVOCATES ARE STRONG
SUPPORTING IN STRONG SUPPORT OF
THE BILL. THANK YOU VERY MUCH
OTHERS AND SUPPORT. SANDRA POOL
WESTERN CENTER ON LAW AND
POVERTY AND SUPPORT. THANK YOU.
THE ROPES AND WITH PLANNED
PARENTHOOD AFFILIATES OF
CALIFORNIA WERE IN SUPPORT OF
ANYONE ELSE. LET'S SEE. NO ONE
IS THEIR OPPOSITION TO THE BILL.
SEE NO ONE WILL BRING BACK TO
THE COMMITTEE FOR QUESTIONS OR
COMMENTS ANY QUESTIONS OR
COMMENTS FROM THE COMMITTEE.
SEEN NONE. THE BILL DOES ENJOY
DO PASS RECOMMENDATION WHERE ONE
SHY OF A QUORUM OR GETTING
CLOSER. UM WOULD YOU LIKE TO
CLOSE MISS CALDERON? THANK YOU,
MR CHAIR. I RESPECTFULLY ASK FOR
AN I VOTE AT THE APPROPRIATE
TIME. PERFECT THANK YOU. THANK
YOU WILL DO THAT. YOU HAVE
ANOTHER BILL. YES SIR. NUMBER 17
89 04. ONE WITNESS. PERFECT.
ASSEMBLY BILL 904 REQUIRES
PRIVATE HEALTH CARE PLANS TO
DEVELOP MATERNAL AND INFANT
HEALTH EQUITY PROGRAM BY
JANUARY. 1ST 2025 THIS PROGRAM
AIMS TO REDUCE RACIAL INEQUITIES
AND BIRTHING OUTCOMES THROUGH
THE USE OF DOULAS. THE BILL ALSO
REQUIRES PRIVATE HEALTH PLANS TO
CONVENE A DOUBLE DUELIST
STAKEHOLDER GROUP. TO EXAMINE
THE IMPLEMENTATION OF THESE
PROGRAMS. CALIFORNIA FACES STARK
RACIAL DISPARITIES IN BIRTHING
OUTCOMES. BLACK INDIGENOUS AND
PEOPLE OF COLOR ARE MORE LIKELY
TO DIE OF PREGNANCY OR BIRTH
RELATED COMPLICATIONS. RESEARCH
SHOWS THAT DOULA SERVICES CAN
PREVENT NEGATIVE BIRTHING
OUTCOMES LIKE PRETERM BIRTH. AND
CESAREAN SECTIONS BY PROVIDING
SUPPORT THROUGHOUT PREGNANCY AND
CHILDBIRTH. THE MEDICAL PROGRAM
STARTED COVERING DOULA BENEFITS
ON JANUARY 1ST 2023. HOWEVER
THEY ARE NOT YET COVERED BY
PRIVATE HEALTH PLANS. SOME
COMMERCIAL HEALTH PLANS LIKE
BLUE SHIELD OF CALIFORNIA AND
HEALTH NET HAVE SPONSORED DOULA
PILOT PROGRAMS THROUGHOUT THE
STATE, WITH PARTICIPANTS
REPORTING POSITIVE HEALTH
OUTCOMES. MAYBE 904 WOULD MAKE
CALIFORNIA ONE OF THE FIRST
STATES TO EXPAND ACCESS TO
DUELIST SERVICES FOR PEOPLE
INSURED THROUGH PRIVATE HEALTH
PLANS. WITH ME IN SUPPORT OF A B
904 IS KYRA'S GEOLOGY. ON BEHALF
OF BIRTHING PROJECT USA. GOOD
AFTERNOON, SHER WOOD AND MEMBERS
AS A VETERAN COMMUNITY AND
PROFESSIONAL DOULA WHO SPENT THE
LAST 2.5 DECADES, PROVIDING
FAMILY ADVOCACY AND PEER SUPPORT
AS WELL AS DIRECT SUPPORT AND
EDUCATION. DURING PREGNANCY,
LABOR, BIRTH AND 12 MONTHS
POSTPARTUM. I AM EXCITED FOR A
FUTURE WITH LESS INFANT AND
MATERNAL LOSS. MORE TRAUMA
PREVENTION AND DECONSTRUCTING
DISTRUST OF MATERNITY CARE AND
BIRTH SETTINGS IN OUR STATE.
COMBATING DISPARITIES AND BIRTH
OUTCOMES BY ACTING AS A BRIDGE
BETWEEN COMMUNITY AND HEALTH
CARE IS ANCIENT WISDOM. AND
INTEGRATING THIS WISDOM INTO THE
HEALTHCARE SYSTEM AS
STANDARDIZED CARE, EMPOWERS,
PROTECTS AND SAVES THE LIVES OF
BIRTHING PEOPLE. BIRTHING
PROJECT USA WAS FOUNDED IN
SACRAMENTO AT 35 YEARS AGO.
CURRENTLY THE CENTER FOR
COMMUNITY HEALTH AND WELL BEING
IS THE HOME OF HER HEALTH FIRST.
THROUGH THAT I'VE HAD THE
PRIVILEGE OF TRAINING COMMUNITY
DUELISTS FOR OVER 20 YEARS.
USING A SISTER FRIEND. SOCIAL
SUPPORT MODEL BIRTHING PROJECT
USA HAS SUPPORTED AND GUIDED
THOUSANDS OF PREGNANT PEOPLE
THROUGH THE LAND MINES OF OUR
CURRENT MATERNAL HEALTH CRISIS
AND HAS TOUCHED THE LIVES OF
OVER 13,000 BABIES. I PERSONALLY
HAVE ATTENDED 56 BIRTHS AND
ASSISTED OVER 77 FAMILIES IN THE
LAST TWO YEARS, WHICH HAS
RESULTED IN SIGNIFICANTLY
REDUCED HOSPITAL STAYS DURING
THE PANDEMIC LESSENED FEAR,
STRESS AND ANXIETY ASSOCIATED
WITH CHILDBIRTH, IDENTIFYING AND
ADDRESSING POTENTIAL PROBLEMS
EARLY AND CONNECTING FAMILIES TO
RESOURCES. THAT ADDRESS THEIR
NEEDS OUTSIDE OF A DOULA SCOPE
OF WORK. IN THE PAST YEAR, 96%
OF MY 28 BIRTHS WERE FULL TERM
100% BORN AT HEALTHY WEIGHTS, A
REFLECTION OF SOCIAL SUPPORTS
ABILITY TO REDUCE PRETERM
DELIVERY. WHILE THESE WINDS
HIGHLIGHT THE JOYS OF BIRTH WORK
, THERE ARE TIMES WHEN BIRTH
WORK CAN BE CHALLENGING. A
COUPLE I WORKED WITH LOST THEIR
FIRST BABY IN UTERO AND HAD TO
DELIVER THEIR FULL TERM DAUGHTER
TWO DAYS AFTER SHE PASSED AWAY.
COACHING GRIEVING PARENTS
THROUGH A SILENT LABOR BUILDING
, A SUPPORT TEAM THAT FELT AND
FUNCTIONED LIKE FAMILY HOLDING
SPACE FOR FAITH AND MEDICINE TO
COEXIST GOES BEYOND
PRESCRIPTIONS AND CO PAYS. THE
TRAINING THE EXPERIENCE AND THE
SKILLS THAT IT TAKES TO CONNECT
A GRIEVING FAMILY TO PERINATAL
LOSS RESOURCES WHILE CONTINUING
TO HOLD AND BUILD HOPE FOR THEIR
FUTURE CHILDREN PUTS THE HEART
OF DOULAS ON FULL DISPLAY. THAT
KIND OF CARE DOESN'T END WITH
SHIFT CHANGES. NOW THAT DOULA
SERVICES ARE COVERED BY MEDICAL
89 04 WILL ENABLE BIRTH WORKERS
TO CONTINUE NURTURING PARENTS
WHO USE PRIVATE HEALTH PLANS
THROUGH CHILDBIRTH IN WAYS THAT
PRESERVE AND PROMOTE BODILY
AUTONOMY. BIRTHING EQUITY,
JUSTICE AND JOY. THIS BILL WILL
ALSO HELP LAY THE FOUNDATION FOR
PRIVATE HEALTH PLANS TO
INTEGRATE DOULAS INTO THEIR
COVERAGE SERVICES. AND IT IS FOR
THIS REASON THAT I RESPECTFULLY
REQUEST YOU'RE I VOTE. THANK
YOU. THANK YOU. THANK YOU VERY
MUCH OTHERS IN SUPPORT. SANDRA
PULL WESTERN CENTER ON LAW AND
POVERTY AND SUPPORT. THANK YOU.
MOLLY ROBSON. PLANNED PARENTHOOD
AFFILIATES OF CALIFORNIANS PART
THANK YOU. AARON EVANS ON BEHALF
OF THE CALIFORNIA NURSE MIDWIVES
ASSOCIATION AND NARAL PRO CHOICE
CALIFORNIA AND SUPPORT. THANK
YOU. ON YOUR MOBILE OKAY WITH
BLACK WOMEN FOR WELLNESS ACTION
PROJECT AND SUPPORT YOU. IS
THERE OPPOSITION TO THE BILL?
SAYING NO ONE WILL BRING BACK TO
THE COMMITTEE QUESTIONS OR
COMMENTS FROM THE COMMITTEE. DR
WEBBER. THANK YOU
ASSEMBLYMEMBER'S FOR BRINGING
THIS BILL FORWARD A COUPLE OF
QUESTIONS. UM SO THIS BILL
ESTABLISHES A WORKING GROUP
CORRECT. OKAY UM, ONE OF THE
THINGS THAT I WOULD RECOMMEND,
UM, IS TO CONSIDER BECAUSE WHEN
YOU'RE TALKING ABOUT A LOT OF
THE INEQUITIES, AND I SEE THE
REQUIREMENT THAT FOR THE WORKING
GROUP 80% PRACTICING DOULAS AND
AT LEAST 75% BE DOULAS THAT
PROVIDE SERVICES TO MEDICAL
ENROLLEES. YOU MAY ALSO WANT US
TO THINK ABOUT, UM, TALKING
ABOUT THE BACKGROUND OR THE
ETHNIC BACKGROUND TO THE
CULTURAL BACKGROUND OF THE
PEOPLE WHO WILL BE ON THIS
WORKING GROUP TO MAKE SURE THAT
WHATEVER RECOMMENDATIONS THAT
COME FORWARD, UM ARE ACTUALLY
INCLUSIVE OF EVERYONE THAT WOULD
BE UTILIZING DOULA SERVICES SO I
WOULD JUST SOMETHING I THOUGHT
ABOUT. IN THE OTHER THING I JUST
LOOKED AT AND I'LL BE BRINGING
THIS, UM AH! UP WITH ANOTHER
BILL IS POSTPARTUM. UM
POSTPARTUM DOES NOT MEAN ONE
YEAR FOLLOWING THE END OF A
PREGNANCY. UM YOU CAN TALK ABOUT
THE PERINATAL PERIOD. UM WHICH
DOES INCLUDE YOU KNOW,
PREGNANCY. AND THEN DELIVERY AND
THEN ONE YEAR AFTER, BUT WHEN WE
TALK ABOUT POSTPARTUM, IT'S
GENERALLY SIX WEEKS AFTER
DELIVERY. SOME PEOPLE MAY KIND
OF SPARSE IT OUT, AND TWO
DIFFERENT DEFINITIONS. THE MOST.
IT WOULD GO UP IS EIGHT MONTHS,
BUT GENERALLY WE SAY, POSTPARTUM
A SIX WEEKS SO LIKE YOU GO FOR
YOUR POSTPARTUM CHECK. THAT'S
ONLY ABOUT SIX WEEKS AFTER YOU
DELIVER. UM AND I JUST WANT TO
MAKE SURE THAT WE ARE MAKING
THOSE TERMS CLEAR AND ACCURATE
AND THEY ALIGN WITH LIKE WHAT WE
TALKED ABOUT IN THE MEDICAL
FIELD, AND IT'S NOT JUST YOUR
BILL. THERE'S ANOTHER BILL LATER
ON, AND I JUST HAPPENED TO SEE
THAT SO YOU MIGHT WANT TO KIND
OF LOOK AT THAT. AND EITHER USE,
UM, THE PERINATAL PERIOD OR, YOU
KNOW, ONE YEAR POST PREGNANCY,
BUT POSTPARTUM IS NOT GENERALLY
A YEAR AFTER YOU DELIVER, BUT
THANK YOU. THANK YOU. SOME OTHER
WOMAN. I REALLY APPRECIATE THAT.
AND WE WILL. WORK ON THAT. THIS
IS A GOOD SUGGESTIONS. THANK
YOU. THANK YOU. ANY OTHER
QUESTIONS OR COMMENTS. AND THEN
THE BILL DOES ENJOY DO PASS
RECOMMENDATION. WHEN WE GET A
QUORUM, THERE'LL BE EMOTION I
SUSPECT WOULD YOU LIKE TO CLOSE
? THANK YOU, MR CHAIR. YES I
RESPECTFULLY ASK FOR AN I VOTE
AT THE APPROPRIATE TIME. THANK
YOU. THANKS VERY MUCH.
SZABO.
OH, GOOD AFTERNOON. UM THANK
YOU, MR CHAIR AND MEMBERS I
WANTED TO FIRST JUST SAY THANK
YOU TO THE STAFF FOR THEIR
FEEDBACK AND WE'LL BE TAKING THE
RECOMMENDATIONS. UM AND WANT TO
THANK YOU FOR THE OPPORTUNITY TO
PRESENT ON A B 608, WHICH IS
TRULY A HEALTH EQUITY BILL
DESIGNED TO SUPPORT MEDIC,
HEALTH FAMILIES THAT TOO OFTEN
FALL THROUGH THE CRACKS AND OUR
HEALTHCARE SYSTEM BY EXTENDING
PERINATAL SERVICES FROM 60 DAYS.
TO THE FULL YEAR OF BIRTH. THIS
PROVIDES NURTURING, SUPPORTIVE
AND CULTURALLY COMPETENT,
POSTPARTUM CARE TO NEW MOMS,
PARENTS AND BABIES WHEN THEY
NEED IT MOST IN THAT FIRST YEAR
OF LIFE AND PARENTHOOD AS A MOM
MYSELF, I KNOW THAT THE FIRST
YEAR AFTER PREGNANCY IS
CHALLENGING FOR MOMS AND BABIES
FOR ME WHEN MY DAUGHTER GOT TO
BE A YEAR OLD, I FELT LIKE WE
NEEDED A WHOLE EXTRA CELEBRATION
JUST FOR KEEPING HER ALIVE THAT
FIRST YEAR BECAUSE THEY SCARE
YOU SO MUCH ABOUT WHAT CAN
HAPPEN TO YOUR BABY IN THE FIRST
YEAR. UM AND IT CAN BE REALLY
OVERWHELMING FOR PARENTS AND SO
HAVING SUPPORT IS CRITICAL. THE
FIRST YEAR CAN BE DIFFICULT TO
MAINTAIN MENTAL OR PHYSICAL
HEALTH FOR SOME FAMILIES AND
MANY ON MEDICAL ALSO EXPERIENCE
, FOOD OR HOUSING INSECURITY. A
B 608 EXTENDS THE ABILITY OF
COMPREHENSIVE PARA NATAL HEALTH
WORKERS TO HELP ADDRESS THESE
CRITICAL NEEDS THROUGH A
COMPREHENSIVE APPROACH TO CARE
THAT SUPPORTS FAMILIES IN THEIR
HOMES AND IN THEIR COMMUNITIES.
PERINATAL HEALTH WORKERS GREEN
FOR BEHAVIORAL, MENTAL AND
PHYSICAL HEALTH ISSUES CONNECT
PATIENTS WITH SOCIAL SERVICES
PROMOTE PREVENTATIVE CARE AND
FOSTER STRONGER PARENT CHILD
BONDS. UNFORTUNATELY ASSESSMENTS
AND VISITS FROM PERINATAL HEALTH
WORKERS ARE CURRENTLY ONLY
COVERED FOR 60 DAYS. POSTPARTUM
FOR MEDICAL ENROLLEES. TODAY
ONLY ONE IN FOUR MEDICAL
CHILDREN RECEIVE CHILD WELL
VISITS IN THE 1ST 15 MONTHS, AND
WHAT'S INCREDIBLY HEARTBREAKING
IS THAT RESEARCH SHOWS THAT
DEATH BY SUICIDE IS MORE LIKELY
TO OCCUR IN LATE TERM,
POSTPARTUM PERIOD OF TIME FOR
MOMS AND PARENTS. A B 608 WOULD
EXPAND COVERAGE FOR VISITS OF
PERINATAL WORKERS FOR THE FULL
YEAR OF POSTPARTUM. AND ALLOWS
WORKERS TO MEET PATIENTS WHERE
THEY'RE AT IN THEIR COMMUNITIES
AND IN THEIR HOMES BY EXTENDING
THESE CULTURALLY COMPETENT
PERINATAL SERVICES OUTSIDE OF
THE HOSPITAL, CALIFORNIA CAN
BETTER SUPPORT PARENTS AND
CHILDREN RECOGNIZING THE HURDLES
OF LOW INCOME FAMILIES THAT
THEY'RE SEEKING WHEN THEY'RE
SEEKING OUT CARE. EVERY CHILD
DESERVES A HEALTHY START IN LIFE
AND A B 608 ENSURES THEY GET
JUST THAT. AND FINALLY I WANT TO
UM, INTRODUCE OUR SPONSOR, LUCY
QUESTION, ELLA. WHO IS A
CONSULTANT FOR MATERNAL AND
CHILD HEALTH ACCESS, AND ALSO
SHANNON SHAW PACE, WHO'S
EXECUTIVE DIRECTOR OF HER HEALTH
FIRST WE'RE HERE TO SHARE
TESTIMONY ABOUT, UM, AND
SUPPORTIVE 86 08 AS WELL. THANK
YOU. LUCY QUESTION L A ON BEHALF
OF MATERNAL AND CHILD HEALTH
ACCESS CO SPONSOR OF THIS
MEASURE, ALONG WITH THE MARCH OF
DIMES AND THE CHILDREN'S
PARTNERSHIP, EMC HJ'S HOME
VISITORS WHO MEET WITH LOW
INCOME FAMILIES IN LOS ANGELES
COUNTIES WHO HAVE NEWBORNS OR
INFANTS AND EMC AGES. HEALTH
NAVIGATORS ASSIST OVER 1000
INDIVIDUALS A MONTH. WE ALSO
COLLABORATE EXTENSIVELY
THROUGHOUT THE STATE WITH
SIMILAR PROGRAMS IN THE CENTRAL
VALLEY. RIGHT NOW WE'RE DOING A
LOT OF WORK IN REMOTE RURAL
AREAS IN THE NORTH, INCLUDING IN
SONOMA AND NAPA COUNTIES. WE
FIND A GREAT UNMET NEED AFTER A
BIRTH, STILLBIRTH OR MISCARRIAGE
FOR HEALTH EDUCATION, WHICH CPS
P PROVIDES FOR ASSISTANCE WITH
BREASTFEEDING SUPPORT, WHICH
PROVIDERS INDICATE IS BEST
PROVIDED THROUGH THE CPS P
BENEFIT. IT'S THE EASIEST WAY TO
GET REIMBURSEMENT FOR THAT KIND
OF SUPPORT AND WITH NEWBORN
CARE, AS THE ASSEMBLY MEMBER
MENTIONED. WE ALSO FIND AN
INCREDIBLY GREAT NEED FOR
ASSISTANCE WITH SOCIAL NEEDS
THINGS LIKE FOOD INSECURITY,
HOUSING INSECURITY, NOT HAVING A
REGULAR PLACE TO SLEEP, BEING
HOMELESS, HAVING TO MOVE LOSING
A JOB OR NOT HAVING PRACTICAL OR
EMOTIONAL SUPPORT. THESE FACTORS
, INCLUDING THE LAST ONE, NOT
HAVING PRACTICAL OR EMOTIONAL
SUPPORT ARE DOCUMENTED FACTORS
IN NEGATIVE HEALTH IMPACTS IN
THE PERINATAL PERIOD. THE
CALIFORNIA DEPARTMENT OF PUBLIC
HEALTH HAS DATA SUPPORTING WHAT
WE SEE IN THE FIELD. MEDICAL
CONSUMERS BEAR A
DISPROPORTIONATE BURDEN OF THESE
KINDS OF IMPACTS IN THE
PERINATAL PERIOD. AND THE COVID
PANDEMIC HAS ONLY MADE THESE
KINDS OF HARMS EVEN WORSE IN OUR
EXPERIENCE. THE NEED FOR
SERVICES DOESN'T APPEAR AT THE
END OF THE 60 DAY PERINATAL
PERIOD. IT EXTENDS THROUGHOUT
THAT YEAR. AND IT IMPACTS NOT
JUST INDIVIDUALS WHO HAVE A LIVE
BIRTH BUT ALSO THOSE WHO
MISCARRY OR HAVE A STEEL BIRTH
STILLBIRTH. SO WE BELIEVE VERY
STRONGLY THAT IT'S TIME TO ALIGN
MEDICAL C P S PS BENEFIT WITH
THE NEW 12 MONTH POST PREGNANCY
ELIGIBILITY ELIGIBILITY PERIOD.
AS THE ASSEMBLY MEMBER MENTIONED
MENTAL HEALTH IS A MAJOR ISSUE
IN OUR STATE, UNFORTUNATELY, AND
THE CD PH DATA INDICATE THAT OF
MATERNAL SUICIDES IN CALIFORNIA.
85% HAD ONE OR MORE CYCLE SOCIAL
STRESSORS DOCUMENTED NEAR THE
TIME OF BIRTH. THESE ARE THE
KINDS OF STRESSORS THAT CPS P IS
DESIGNED TO IDENTIFY EARLY. MY
COLLEAGUE SHANNON SHAW, PASTE
HERE, UH, WILL EXPLAIN HOW HER
PROGRAM WORKS WITH THESE
PROTOCOLS TO IMPROVE MATERNAL
AND CHILD HEALTH. THANK YOU.
GOOD AFTERNOON. MY NAME IS
SHANNON SHAW. PACE REMEMBER
ETERNAL HEALTH CONSULTANT
CURRENTLY WORKING WITH FEDERALLY
QUALIFIED HEALTH CENTERS
THROUGHOUT MERCED, MODESTO IN
THE LARGER CENTRAL VALLEY TO
SUPPORT THE EXPANSION OF THEIR C
PSP SERVICES. AND HERE IN
SACRAMENTO, I'M THE EXECUTIVE
DIRECTOR OF HER HEALTH, FIRST
LOCAL BASED AGENCY COMMITTED TO
DECREASING THE DISPROPORTIONATE
AFRICAN AMERICAN MATERNAL AND
INFANT MORTALITY RATES. OUR
PILLAR PROGRAM. BLACK MOTHERS
UNITED FUNDED BY FIRST FIVE
SACRAMENTO FOR OVER NINE YEARS,
IS MODELED ON C PSP AND THE
LIVED EXPERIENCES OF BLACK
BIRTHING PEOPLE IN OUR COUNTY,
LED BY KEY STAFF KENYA BE ME AND
LEONA'S SPIVEY, WHO ARE SEASONED
DOULAS AND COMPREHENSIVE
PERINATAL HEALTH WORKERS WITH A
COMBINED 45 PLUS YEARS OF
EXPERIENCE, OUR TEAM OF
PREGNANCY COACHES PROVIDE
COMPREHENSIVE PERINATAL
EDUCATION AND SOCIAL SUPPORTS
THROUGHOUT THEIR PREGNANCIES AND
POSTPARTUM PERIODS. OUR ABILITY
TO MEET CLIENTS WHERE THEY'RE AT
OUTSIDE OF THE CLINIC ALLOWS OUR
TEAM TO BUILD RELATIONSHIPS
BASED ON TRUST, CENTERING THE
UNIQUE NEEDS OF THE PREGNANT
CLIENT EVERY STEP OF THE WAY
LEVERAGING CP SP TOOLS LIKE THE
INITIAL ASSESSMENT STEPS TO TAKE
IN THE INDIVIDUALIZED CARE PLAN
. WE HAVE DEVELOPED A ROBUST
DATABASE AND THROUGH INDEPENDENT
EVALUATION, WE HAVE SEEN THE
FOLLOWING STATISTICALLY
SIGNIFICANT OUTCOMES. REPORTED
NUTRITIONAL DEFICIENCIES
DECREASED FROM 20% A PROGRAM
INTAKE TO 6% AT FOLLOW UP
MATERNAL ANXIETY AND DEPRESSION
, AS INDICATED BY THE P H Q NINE
ASSESSMENT WAS RATED MODERATE OR
HIGH IN 30% OF OUR CLIENTS PRIOR
TO ENTERING OUR PROGRAM AND
DECREASED TO 11% AFTER PROGRAM
COMPLETION, HIGHER DOSAGE OF
SERVICE WAS STATISTICALLY SHOWN
TO PREDICT HEALTHY BIRTH WEIGHTS
AND BABIES BORN AT FULL TERM,
AND BOTH WERE MOST WORTHY OF
CELEBRATION. OUR PROGRAM HAS HAD
ZERO INFANT DEATHS FOR THE LAST
THREE CONSECUTIVE YEARS. AS YOU
CONSIDER A B 608. IT IS KEY TO
NOTE THAT THE EARLY LOW
INTERVENTIONS THAT PMU BLACK
MOTHERS UNITED PROVIDES BASED ON
THE CPI SP MODEL ARE KEY
PREVENTIONS FOR HIGHER LEVELS OF
CARE. ARE BLACK MOTHERS. UNITED
PREGNANCY COACHES AGAIN
LEVERAGING THE CPS P MODEL DO
COORDINATE WITH OUR CLIENTS, OBI
CARE TEAM DESPITE NOT BEING
DIRECTLY UNDER THE SUPERVISION
OF LICENSED MEDICAL PROVIDERS,
MAYBE SIX SO IT WOULD NOT ONLY
ALLOW REIMBURSEMENTS FOR CPH W
SERVICES PROVIDE. I'M SORRY FOR
CPS P SERVICES PROVIDED AWAY
FROM A MEDICAL SITE BUT ALSO
ALLOWS CBOS SUCH AS OUR PROGRAM
NOT TO HAVE TO BE UNDER
SUPERVISION OF A LICENSED
PROVIDER. AND PLEASE NOTE THAT
THIS MORE FLEXIBLE APPROACH HAS
ALREADY BEEN ADOPTED BY THE
STATE. FOR COMMUNITY HEALTH
WORKERS. AND BLACK MOTHERS
UNITED. DO YOU MAKE REFERRALS TO
BEHAVIORAL HEALTH SERVICES AND
PROVIDERS WHEN THE TRIMESTER IN
POSTPARTUM ASSESSMENTS INDICATE
THAT LEVEL OF CARE IS NEEDED,
AND IN FACT, WE FIND THAT OUR
CLIENTS FEEL MORE COMFORTABLE
HAVING THEIR PREGNANCY COACHES
PROVIDING A WARM HANDOFF TO
BEHAVIORAL HEALTH SERVICES. IT'S
BEEN INCREDIBLE TO SEE THE
STRIDES THAT WE CONTINUE TO MAKE
WITH THE EXPANSIONS OF SO MANY
NEW MEDICAL BENEFITS. HOWEVER
THE IMPORTANT SERVICES SHOULD BE
SEEN AS ENHANCEMENTS TO AN
EXISTING PROGRAM THAT HAS BEEN
SHOWN TO HAVE A PROFOUND IMPACT
ON MATERNAL AND INFANT HEALTH
OUTCOMES AND WHEN CONSIDERING
WAYS TO ADDRESS THE HARROWING
MATERNAL AND INFANT DEATH
CRISIS. PERHAPS A KEY PART OF
THAT SOLUTION IS RIGHT HERE IN
FRONT OF US. SEE PSP. THANK YOU.
THANK YOU VERY MUCH OTHERS IN
SUPPORT. JIM LINDBERG FRIENDS
COMMITTEE ON LEGISLATION IN
CALIFORNIA IN SUPPORT. THANK
YOU. ANDHRA POOL, WESTERN CENTER
ON LAW AND POVERTY AND SUPPORT.
THANK YOU. NICOLE WARD ULLMAN ON
BEHALF OF THE CHILDREN'S
PARTNERSHIP, PROUD CO SPONSOR
AND SUPPORT YOU. AND THAT YOU
ARE WITH HEALTH ACCESS
CALIFORNIA AND SUPPORT. THANK
YOU. TAYLOR JACKSON WITH
CALIFORNIA HEALTH PLUS ADVOCATES
IN STRONG SUPPORT. MOLLY SHANNON
WITH THE CALIFORNIA CATHOLIC
CONFERENCE AND SUPPORT JOHAN
CARDONA'S WITH CALIFORNIA PAN
ETHNIC HEALTH NETWORK AND
SUPPORT THANK YOU. MOLLY ROBSON
WITH PLANNED PARENTHOOD,
AFFILIATES OF CALIFORNIA AND
SUPPORT THANK YOU. AARON EVANS
ON BEHALF OF THE CALIFORNIA
NURSE MIDWIVES ASSOCIATION AND
NARAL PRO CHOICE CALIFORNIA BOTH
IN SUPPORT. THANK YOU. MOVIE
OKAY WITH BLACK WOMEN FOR
WELLNESS ACTION PROJECT AND
SUPPORT. THANK YOU. THANK YOU.
BRIAN SPENCER ON BEHALF OF THE
AMERICAN COLLEGE OF O B. G Y N S
DISTRICT NINE AND SUPPORT. THANK
YOU. THAT'S NOT ASK YOU. THAT'S
THE CALIFORNIA AND SUPPORT THANK
YOU. KATHY MOSSBERG WAS FIRST
FIVE ASSOCIATION OF CALIFORNIA
AND SUPPORT YOU. SORRY ABOUT
THAT PRICE. DOUGHERTY WITH THE
CALIFORNIA ACADEMY OF FAMILY
PHYSICIANS AND SUPPORT THANK
YOU. THANK YOU. ANYONE ELSE? CÁC
. DO YOU KNOW WHAT IS THEIR
OPPOSITION TO THE BILL AND THE
OPPOSITION? NO ONE WILL BRING IT
BACK TO THE COMMITTEE QUESTIONS
OR COMMENTS FROM THE COMMITTEE.
SEE NONE THE BILL DOES ENJOY DO
PASS RECOMMENDATION. UM WE DON'T
HAVE A QUORUM YET, UM, THREE
HOURS INTO THE HEARING, BUT
PEOPLE ARE BUSY. SOMEDAY SOMEDAY
, SOMEDAY, HOPEFULLY TODAY.
HOPEFULLY TODAY, SO, UH AND SO
AT THIS POINT WOULD YOU LIKE TO
CLOSE? I JUST WANT TO SAY THANK
YOU ALSO. THANK YOU TO DR
ARAMBULA, WHO I KNOW HAS MOVED
THIS ISSUE FORWARD IN THE PAST.
UM AND I JUST THINK IT'S A
REALLY IMPORTANT HEALTH EQUITY
ISSUE. UM, AND ALSO TO REALLY
BRING ALIGNMENT TO THE EXPANSION
OF PERINATAL SERVICES. UM THAT
MEDICAL RECIPIENTS ARE Dð. RIGHT
NOW. SO UM, SO THANK YOU
RESPECTFULLY HOPE THERE IS AN I
VOTE WHEN YOU DO HAVE A QUORUM.
VERY WELL, THANKS SO MUCH
APPRECIATE YOU. MISS WAIT. I'M
SORRY. OH, HANG ON. WE HAVE A
QUORUM, BUT IT'S UP TO YOU
WHETHER YOU STICK AROUND OR NOT,
BUT, YOU KNOW WOW, WE GOT MORE
THAN A QUORUM. NOW, MAN. IT'S
LIKE COMING IN SAVING THE DAY
SECRETARY. PLEASE CALL THE ROLL.
WOULD WALDRON. AGUIAR-CURRY
ARAMBULA. BOERNER HORVATH
CARILLO. FLORA. PHªN
MAIENSCHEIN. MCCARTHY. JOE
PATTERSON. RODRIGUEZ. SANTIAGO.
VÆ VALLAPUDUA. WEBER. WE HAVE A
QUORUM. HAPPY TO ENTERTAIN A
MOTION. UM WE HAVE A MOTION AND
I DIDN'T HEAR I DID NOT HEAR THE
SECOND MOTION BY DOCTOR
AMBULANCE DID NOT HEAR THE
SECOND. OKAY SECOND BY MS
AGUILERA CURRY MOTION IS DUE
PASS AS AMENDED TO
APPROPRIATIONS. MADAM SECRETARY,
PLEASE CALL THE ROLL. I WOULD. I
WOULD I. WALDRON, WALDRON, IAGAR
CURRY. AGUIAR-CURRY AYE,
ARAMBULA ARAMBULA. AYE,
BOERNER HORVATH. BOERNER HORVATH
CARILLO. FLORA. VINCE FONG.
VINCE WANG. I MAIENSCHEIN
MCCARTY, JOE PATTERSON.
RODRIGUEZ RODRIGUEZ, I SANTIAGO
VALLAPUDUA PUT WHY WEBER
HOWEVER, I. YOUR BILL HAS NINE
VOTES. IT'S OUT WILL LEAVE THE
ROLE OPEN FOR OTHERS TO ADD ON.
THANK YOU. MS. THIS WEEK'S, HUH?
WELL, HE TOOK THREE HOURS TO GET
THERE. BUT, YOU KNOW PROGRESS
ALMOST THREE HOURS. THIS MAKES
YOU HAVE A B 5 83. I DO. THANK
YOU, MR CHAIR. MEMBERS AND
COMMITTEE STAFF, CALIFORNIA'S
OVERALL MATERNAL MATERNAL
MORTALITY RATE HAS DECLINED BY
65% SINCE 2006. HOWEVER
MORTALITY AND MORBIDITY FOR
BLACK AND INDIGENOUS PREGNANT
PEOPLE AND BABIES REMAIN 40%
HIGHER THAN FOR THEIR WHITE
COUNTERPARTS. 85 83 ESTABLISHES
THE BIRTHING JUSTICE FOR
CALIFORNIA FAMILIES PILOT
PROJECT TO EXPAND CALIF. TO
EXPAND ACCESS TO DOULA CARE AND
ADDRESS ADVERSE MATERNAL AND
INFANT HEALTH OUTCOMES BY
EXPANDING DOULA CARE TO
BREATHING PEOPLE WHO EXPERIENCE
DISPROPORTIONATELY HIGH NEGATIVE
BIRTH OUTCOMES. THROUGH THEIR,
UH THROUGH THE PROVISION OF
CULTURALLY CONGRUENT AND CLIENT
CENTERED CARE AS WELL AS
ADVOCACY. DUELIST CAN HELP
REDUCE THE IMPACTS OF RACISM AND
RACIAL BIAS ON BIRTHING PEOPLE
OF COLOR. WE HAVE A LARGE
SUPPORT COALITION, INCLUDING
PLANNED PARENTHOOD, COMMUNITY
HEALTH EXECUTIVES AND
ASSOCIATION OF CALIFORNIA
HEALTHCARE DISTRICTS. I
RESPECTFULLY ASK FOR YOUR I VOTE
AND WITH ME HERE TO TESTIFY IN
SUPPORT, ISO NUMA Ó, POLICY
DIRECTOR FOR BLACK WOMAN FOR
WELLNESS. ACTION PROJECT AND
NIKKI WOODS, A DOULA AND BIRTH
WORKER. YEP. OKAY? GOOD
AFTERNOON CHAIR, WOOD AND
MEMBERS. MY NAME IS NICAEA WOODS
. I'M A STUDENT MIDWIFE FOR
SPECTRUM BIRTH WORKER AND A
MEMBER OF THE ROOTS OF LABOR,
BIRTH COLLECTIVE. I'M HERE TODAY
IN SUPPORT OF ASSEMBLY BILL 5 83
, WHICH WOULD ESTABLISH THE
BIRTHING JUSTICE FOR CALIFORNIA
FAMILIES PILOT PROJECT. TO
EXPERIENCE ACCESS TO DUAL CARE
FOR PEOPLE IN CALIFORNIA. I'M A
REPRODUCTIVE JUSTICE ADVOCATE,
BIRTH WORK AND SEX EDUCATOR WHO
IS COMMITTED TO THE BETTERMENT
OF BARGING PEOPLE, YOUNG FOLKS
AND OTHER MARGINALIZED
COMMUNITIES. THROUGHOUT THE PAST
DECADE, I HAVE BECOME WELL
ACQUAINTED WITH REPRODUCTIVE
JUSTICE, EMPHASIZING STRATEGIES
NECESSARY TO CHIP AWAY AT THE
BARRIERS TO ADEQUATE
REPRODUCTIVE AND SEXUAL HEALTH
CARE. AS A BIRTH WORKER. MY
FIRST PRIORITY IS ENSURING THAT
THOSE I SERVE HAVE BREATHING
EXPERIENCES THAT ARE NOT ONLY
SAFE BUT ALIGNED WITH THEIR
BIRTH VISIONS. THE CLIENTS THAT
I WORK WITH SO CONFIDENT THAT I
WILL PROVIDE QUALITY CARE AND
ARM THEM WITH THE TOOLS
NECESSARY TO ADVOCATE FOR
THEMSELVES IN A MEDICAL SETTING.
I AM TO DISRUPT THE TRADITIONAL
MEDICAL THE AIM TO DISRUPT THIS
TRADITIONAL HIERARCHIES INHERENT
TO YOUR TOO EUROCENTRIC MEDICAL
PRACTICES AND MEET MY CLIENTS
WHERE THEY ARE AS AN EQUAL
PARTNER AS A BLACK PERSON WHO
SUPPORTS BIPOD CLIENTS. I
UNDERSTAND THE COMPLEX HISTORIES
, TRAUMAS AND RIGHTFUL DISTRUST
OF MEDICAL PROFESSIONALS. AS A
BIRTH WORKER. I'M ABLE TO
APPROACH MY CLIENTS WITH
HUMILITY AND SPEAK TO SPEAK IN
WAYS THAT ARE ACCESSIBLE AND NON
CONDESCENDING. I LISTENED TO
THEIR SPECIFIC CULTURAL NEEDS
AND UNDERSTAND THAT I CANNOT
ASSUME OTHERS LIFE EXPERIENCES.
MANY DUELS LIKE MYSELF USED
COMMUNITY BASED CARE MODELS TO
SHIFT THE BURNING OUTCOMES FOR
BIPAC FOR BIPAC BURNING FOLKS.
MANY OF THE PEOPLE I SERVE DO
NOT QUALIFY FOR MEDICAL BUT ALSO
CANNOT AFFORD DOULA CARE. I
WOULD LIKE TO SHARE A QUICK
STORY ABOUT CYNTHIA NAMES
CHANGED CLIENT I SUPPORTED PRO
BONO THAT GAVE BIRTH TO 34 WEEKS
DUE TO PREECLAMPSIA. CYNTHIA
LABOR FOR 12 HOURS AND WAS
CONSTANTLY TALKED DOWN TO EVEN
THOUGH HER BABY WAS IN AN
OPTIMAL BIRTHING POSITION IN HER
VITALS WERE UNDER CONTROL. SHE
WAS RUSHED TO MAKE DECISIONS TO
SPEED UP HER BIRTH. THE METHODS
, THE METHODS SUGGESTED, WOULD
PROVIDE FURTHER COMPLICATIONS TO
CYNTHIA'S, SUCH AS INCREASED
RISK OF POSTPARTUM HEMORRHAGE BY
A TEAM THAT WAS SUPPOSED TO HELP
HER BRING HER NEW BABY INTO THE
WORLD. SHE WAS TOLD THAT SHE WAS
GONNA HAVE A C SECTION BE FORCED
TO LABOR IN WAYS THAT SHE DID
NOT FEEL WE'RE SAFE TOGETHER. WE
ADVOCATED AND FOUGHT HER CARE
TEAM UNTIL SHE WAS ABLE TO BURST
A HEALTHY BABY VAGINALLY. THIS
IS THE POWER OF DOULA CARE,
INADEQUATE SUPPORT. THROUGH A B
5 83 DOULA CARE WILL BE MADE
AVAILABLE TO PEOPLE LIKE CYNTHIA
, WHO CAN'T AFFORD THE CARE AND
ARE NOT ELIGIBLE FOR MEDICAL I'M
PROUD TO BE HERE IN SUPPORT OF
85 83 RESPECTFULLY ARGUED AND
ARE RESPECTFULLY URGE YOUR
SUPPORT ON THIS BILL TODAY.
THANK YOU. THANK YOU. GOOD
AFTERNOON AND THANK YOU, MR
CHAIR AND COMMITTEE MEMBERS. MY
NAME IS SONYA MOBY AGAIN IN THE
POLICY DIRECTOR WITH BLACKMAN
FOR WELLNESS AND BLACK WOMEN
PERONNAS ACTION PROJECT. WE ARE
REPRODUCTIVE JUSTICE, COMMUNITY
BASED ORGANIZATION COMMITTED TO
THE IMPROVING THE OVERALL HEALTH
STATUS AND WELL BEING OF BLACK
WOMEN AND GIRLS. WE HAVE OFFICES
IN LOS ANGELES AND STOCKTON AND
I'M HERE TO EXPRESS OUR STRONG
SUPPORT FOR MAYBE 5 83, THE
BIRTHING JUSTICE FOR CALIFORNIA
FAMILIES PILOT PROGRAM. PROJECT
BEFORE I BEGIN. I'D LIKE TO NOTE
THAT TODAY DOES MARK THE FIRST
DAY OF BLACK MATERNAL HEALTH
WEEK, WHICH IS HELD ANNUALLY ON
APRIL 11TH THROUGH 17TH. IT'S A
WEEK LONG CAMPAIGN FOUNDED AND
LED BY BLACK MAMAS MATTER
ALLIANCE AND IT'S THE WEEK IS
INTENTIONALLY HELD DURING
NATIONAL MINORITY HEALTH MONTH
AND BEGINS ON APRIL 11TH
ANNUALLY TO JOIN DOZENS OF
GLOBAL ORGANIZATIONS. IN MAKING
THIS DAY AS INTERNATIONAL DAY
AND INTERNATIONAL DAY FOR
MATERNAL HEALTH AND RIGHTS AND
OPPORTUNITY TO ADVOCATE FOR THE
ELIMINATION OF MATERNAL
MORTALITY GLOBALLY. SO THIS BILL
WOULD BUILD UPON OUR STATE'S
EFFORTS TO IMPROVE BIRTH
OUTCOMES FOR ALL CALIFORNIANS IN
ADVANCED BIRTH EQUITY BY
EXPANDING ACCESS TO DOULA CARE,
WE'VE HEARD ABOUT THE
COMMENDABLE STRIDES TO IMPROVE
MATERNAL AND INFANT HEALTH
OUTCOMES IN CALIFORNIA YET AND
STILL WE KNOW THAT DEEP
INEQUITIES EXIST FOR BLACK WOMEN
AND BIRTHING PEOPLE. THESE ARE
PERSISTENT IN CALIFORNIA BLACK
WOMEN ARE 4 TO 6 TIMES MORE
LIKELY TO DIE FROM PREGNANCY
RELATED CAUSES IN OUR
COUNTERPARTS, EVEN AFTER
CONTROLLING FOR THE GENERALLY
MITIGATING FACTORS OF EDUCATION
AND SOCIO ECONOMIC STATUS. BLACK
WOMAN IN BIRTHING PEOPLE REMAIN
AT HIGHER RISK FOR MATERNAL
MORTALITY AND MORBIDITY,
MOUNTING RESEARCH POINTS TO
RACISM AND IMPLICIT BIAS, IN
ADDITION TO OTHER SOCIAL
DETERMINANTS OF HEALTH IS
FACTORS THAT CONTRIBUTE TO THESE
INEQUITIES. DO LOOK HAIR HAS
BEEN ESTABLISHED AS AN IMPORTANT
TOOL AND RESOURCE, IMPROVING
BIRTH OUTCOMES, COMBATING
INTERPERSONAL AND SYSTEMIC
RACISM AND OFFERING CULTURALLY
CONGRUENT CARE. YET IT REMAINS A
PARTICULARLY UNDER USED RESOURCE
WOMEN OF COLOR FOLKS WITH THE
HIGHEST RISK OF POOR BIRTH
OUTCOMES ARE MOST LIKELY TO
REPORT WANTING BUT NOT HAVING
ACCESS TO DO A SERVICES. THIS IS
IN LARGE PART DUE TO THE COST IN
CALIFORNIA, WHERE THE ECONOMIC
STATUS OF BLACK WOMEN IS SUCH
THAT WE MAKE 63 CENTS FOR EVERY
$1 THAT, UM, A WHITE MAN MAKES
OUT OF POCKET COSTS FOR DOULA
CARE THAT CAN AMOUNT TO $2000
PLACES THIS ESSENTIAL SERVICE
OUT OF REACH FOR THE MAJORITY OF
US. A GROUP THAT'S OFTEN
OVERLOOKED ARE INCARCERATED,
BIRTHING PEOPLE. ALMOST THREE
QUARTERS OF INCARCERATED WOMEN
ARE BETWEEN 18 AND 44. THE AGE
RANGE WHEN MOST BIRTHING PEOPLE
BECOME PREGNANT AND BEAR
CHILDREN, SO IT IS LIKELY THAT A
NUMBER OF PEOPLE CAPABLE OF
GIVING BIRTH WILL ENTER PRISON
OR JAIL WHILE PREGNANT OR DURING
THE POSTPARTUM PERIOD, WITH
HIGHER RISK OF ADVERSE BIRTH
OUTCOMES AND OTHER COEXISTING
CONDITIONS THAT CAN LEAD THE
COMPLICATIONS IN PREGNANCY AS
COMPARED TO NON INCARCERATED
WOMEN, INCARCERATED WOMEN AND
BIRTHING PEOPLE STAND TO BENEFIT
TREMENDOUSLY FROM DOULA CARE
THANKS TO A B 7 32 INCARCERATED
PEOPLE CAN NOW HAVE A DOULA OR
SUPPORT PERSON, BUT THERE'S NO
FUNDING AVAILABLE TO SUPPORT
THIS. MAYBE 5 83 WILL ADVANCE
EQUITY BY ENSURING THAT MORE
BIRTHING PEOPLE, PARTICULARLY
THOSE IN THE GAP. WHO DO NOT
QUALIFY FOR MEDICAID AL, BUT
COST REMAINS A BARRIER HAVE
ACCESS TO A CRITICAL COMPONENT,
UH, OF THE PERINATAL CARE
NECESSARY TO ENJOY A SAFER
BIRTHING EXPERIENCE. IT SEEKS TO
REMOVE THE COST BARRIER OF CARE
WHILE ENSURING THAT INVALUABLE
CARE THAT DUELS PROVIDE IS
RECOGNIZED AND COMPENSATED IN A
SUSTAINABLE AND EQUITABLE
MANNER. IT ALSO ENCOURAGES THE
DEVELOPMENT OF A PIPELINE OF
DOULAS CAPABLE OF OFFERING
CULTURALLY CONGRUENT CARE.
EVERYONE IS DESERVING OF DIGNITY
AND THE SUPPORTS NECESSARY TO
ENSURE A SAFE, HEALTHY AND
JOYOUS BIRTHING EXPERIENCE. THIS
BILL RECOGNIZES THAT AND
PRESENTS AN OPPORTUNITY TO
REALIZE THIS VISION IS PROUD CO
SPONSORS OF A B 5 83. I INVITE
YOU TO CONTRIBUTE TO THE
REALIZATION OF THE VISION OF FOR
JOYOUS ECUADOR LITTLE BIRTH
OUTCOMES FOR ALL WOMEN IN
BIRTHING PEOPLE. BY CASTING A
YES VOTE FOR THIS BILL. THANK
YOU. THANK YOU. THANK YOU VERY
MUCH. WE HAVE A MOTION BY DR
ARAMBULA SECOND BY MS
BOERNER HORVATH. OTHERS IN
SUPPORT, PLEASE. HI. MOLLY
ROBSON. PLANNED PARENTHOOD
AFFILIATES CALIFORNIA WHERE CO
SPONSOR AND STRONG SUPPORT.
THANK THANK YOU. AND ALSO ON
BEHALF OF THE CALIFORNIA FACULTY
ASSOCIATION IN SUPPORT. THANK
YOU. AARON EVANS ON BEHALF OF
THE CALIFORNIA NURSE MIDWIVES
ASSOCIATION AND NARAL PRO CHOICE
CALIFORNIANS SUPPORT THANK YOU.
THANK YOU. THANK YOU TO REMEMBER
SARAH BRIDGE ON BEHALF OF THE
ASSOCIATION OF CALIFORNIA
HEALTHCARE DISTRICTS IN SUPPORT.
TAYLOR JACKSON WITH CALIFORNIA
HEALTH PLUS ADVOCATES
REPRESENTING CALIFORNIA'S
COMMUNITY HEALTH CENTERS IN
SUPPORT. VERONICA VILLALOBOS
CRUISE ON BEHALF OF THE
CALIFORNIA LATINAS FOR
REPRODUCTIVE JUSTICE AND SUPPORT
BETSEY ARMSTRONG, WITH THE
COUNTY HEALTH EXECUTIVES
ASSOCIATION REPRESENTING
CALIFORNIA'S LOCAL HEALTH
DEPARTMENTS AND STRONG SUPPORT.
THANK YOU. IS THERE ANY
OPPOSITION TO THE BILL? AND NO
ONE WILL BRING BACK TO THE
COMMITTEE BEFORE WE DO, WOULD
YOU? HAVE YOU ACCEPTED OUR
AMENDMENTS? YES THANK YOU ANY
QUESTIONS, MISS DR WEBBER? THANK
YOU SO MUCH FOR THIS, UM MUCH
NEEDED VALUE, AND I HAVE
DISCUSSED THIS ALREADY, BUT I
JUST WANTED TO HIGHLIGHT IT
AGAIN. THE DEFINITION OF
POSTPARTUM VERSUS PERRY NATAL
BECAUSE WE HAVE BEEN IN
COMMUNICATION WITH YOUR OFFICE.
AND WHAT THEY SENT US. UM AH,
THE HEALTH AND SAFETY CODE
ARTICLE THREE COMMUNITY BASED
PERINATAL. SYSTEM. UM SECTION C
DOES NOT MENTIONED POSTPARTUM.
IT DOES MENTION PERINATAL CARE,
WHICH IS THE CARE RECIEVED FROM
THE TIME OF CONCEPTION THROUGH
THE FIRST YEAR AFTER BIRTH, SO
IN THIS PARTICULAR BILL. WITH
YOUR DEFINITION OF POSTPARTUM
EXTENDING OUT FOR A YEAR. UM IT
DOES REDEFINE WHAT POSTPARTUM
ACTUALLY IS. SO UM, I JUST
RECOMMEND THAT WE KIND OF LOOK
AT THAT. AND MAYBE CONSIDER THAT
YEAH. SORRY NOT ATTEMPTING TO
REDEFINE ANYTHING, BUT WE CAN
WORK THROUGH THE LANGUAGE WITH
YOU AND YOUR OFFICE AND THE
COMMITTEE AS WELL IN THE CHAIR.
TO MAKE SURE THAT WERE
CONSISTENT WITH WHAT THE I THINK
CURRENT DEFINITIONS ARE UM,
WITHOUT MY UNDERSTANDING IS THAT
UNDER MEDICAL, THE POSTPARTUM
PERIOD IS A ONE YEAR PERIOD SO
IT MAY NOT ALIGN WITH CLINICAL
GUIDELINES. BUT ACCORDING TO THE
MEDICAL PROGRAM, THAT IS THE WAY
IT IS DEFINED. WELL I'M GOING
BASED OFF OF WHAT WAS SENT BY,
UM ASSEMBLYMEMBER'S QUICK STAFF
, WHICH I THINK SHE GOT FROM
COMMITTEE STAFF. AND THERE IS NO
DEFINITION OF POSTPARTUM,
SPECIFICALLY STATES PERRY NATAL.
UM WELL, I'M READING ITEM ONE E
POSTPARTUM MEANS THE ONE YEAR
PERIOD FOLLOWING THE END OF
PREGNANCY, SO I'M NOT SURE THIS
IS IN OUR HEALTH AND SAFETY CODE
. ARTICLE THREE, SO IT'S IN
STATUTE. YEAH I THINK WE CAN.
WE'LL MAKE SURE THIS IS SQUARED
AWAY. THE POINT IS WELL TAKEN,
AND I THINK WE CAN MAKE SURE THE
DEFINITIONS CLEANED UP FOR THE
NEXT YEAH, OKAY. OKAY BUT I'M
DEFINITELY NOT TRYING TO
REDEFINE ANYTHING. I THINK WE'LL
JUST WHATEVER THE KIND OF
CURRENT STANDARD IS, WE'LL MAKE
SURE THE LINES WITH YOUR
INTERPRETATION AS WELL. I
WOULDN'T SAY MY INTERPRETATION,
MEDICAL AND MEDICAL
INTERPRETATION AND WHAT WE HAVE
IN CURRENT STATUTES. YEAH I WANT
TO BE CONSISTENT WITH CURRENT
STATUTE. EXACTLY YES, THANKS.
YES OKAY. ALRIGHT. OTHER
QUESTIONS OR COMMENTS ANYTHING.
SEEING NONE. BILL DOES ENJOY DO
PASS RECOMMENDATION. I BELIEVE
THERE WAS EMOTION BY DR ARAMBULA
SECOND BY MS BOERNER HORVATH
MOTION IS DUE PASS AS AMENDED TO
APPROPRIATIONS. WOULD YOU LIKE
TO CLOSE RESPECT? THEY ASK FOR
MY VOTE. MADAM SECRETARY. PLEASE
CALL THE ROLL MOTION IS DUE PASS
AS AMENDED TO APPROPRIATIONS.
WOULD WOULD I, WALDRON.
AGUIAR-CURRY. ARAMBULA ARAMBULA.
AYE, BOERNER HORVATH.
BOERNER HORVATH. AYE, CARILLO.
FLORA. THAT'S FONG. THAT'S FINE.
NO MAIENSCHEIN. MCCARTHY
MCCARTHY I PATERSON RODRIGUEZ
RODRIGUEZ, I SANTIAGO VALLAPUDUA
THEY PUT WHY WEBER WEBER. AYE.
SO THE YEAR BILL HAS SEVEN
VOTES. IT'S ON CALL. GREAT.
THANK YOU. THANK YOU VERY MUCH.
LET'S SEE, MR CONNELLY.
OKAY MR CONNELLY. YOU HAVE A B 9
35. BUT PUSH THE BUTTON IF YOU
DON'T MIND THINGS. UH AGAINST
STARTING. THANK YOU TO YOU CHAIR
AND MEMBERS ON HONOR TO PRESENT
ON 89 35. I'D LIKE TO BEGIN BY
THANKING THE COMMITTEE AND STAFF
FOR THEIR WORK. ALRIGHT AND
INPUT ON THIS BILL, I WILL BE
ACCEPTING THE COMMITTEE
AMENDMENT. IN 2022 63% OF
CALIFORNIA VOTERS VIA
PROPOSITION 31 UPHELD THE STATE
LAW. SB 97 93 PROHIBITING
TOBACCO RETAILERS FROM SELLING
MOST FLAVORED TOBACCO PRODUCTS.
SB 7 93 WAS GROUNDBREAKING AND
COVERS FLAVORED E CIGARETTES,
MENTHOL CIGARETTES AND TOBACCO
PRODUCTS. FLAVOR ENHANCERS IN
RETAIL LOCATIONS, INCLUDING
STORES AND VENDING MACHINES
THROUGHOUT CALIFORNIA. AS A LAST
STAND RETAILERS, THEIR AGENTS OR
THEIR EMPLOYEES WILL BE FOUND
GUILTY OF AN INFRACTION AND
FINED $250 FOR VIOLATIONS.
CURRENT LAW DOES NOT PUNISH OR
CRIMINALIZE ANYONE FOR
PURCHASING USING OR POSSESSING
WITH THE INTENT TO USE A
FLAVORED TOBACCO PRODUCT OR
TOBACCO PRODUCT FLAVORED
ENHANCER. DESPITE THE
OVERWHELMING SUPPORT FROM VOTERS
TO RATIFY SP 7 93 FLAVORED
TOBACCO PRODUCTS CONTINUE TO BE
SOLD IN MANY STORES ACROSS THE
STATE. WHICH ALLOWS MANY
TEENAGERS TO CONTINUE ACCESSING
THESE DANGEROUS PRODUCTS. 89 35
WILL EXPLICITLY AUTHORIZED THE
CALIFORNIA DEPARTMENT OF HEALTH
AND THE ATTORNEY GENERAL TO
ENFORCE THE FLAVOR. TOBACCO BAN
PURSUANT THE BUSINESS AND
PROFESSIONS CODE SECTION 2 TO
950.5 KNOWN AS A STOP TOBACCO
ACCESS TO KIDS OR STEAK ACT. UH
CONSISTENT WITH OTHER TOBACCO
ENFORCEMENT EFFORTS. 89 35 WILL
ALSO REPLACE THE SUBDIVISION
FROM THE HEALTH AND SAFETY CODE
, WHICH MAKES VIOLATION OF SP 93
, A MISDEMEANOR AND CRIMINAL
PENALTY. INSTEAD PURSUANT TO THE
STAKE ACT. IT WILL BECOME A
CIVIL PENALTY TO RETAILERS,
THEIR AGENTS OR THEIR EMPLOYEES
WHO ARE IN VIOLATION. PREVENTING
THE NEXT GENERATION OF
CALIFORNIANS FROM BECOMING
ADDICTED TO SMOKING SHOULD BE A
PRIORITY FOR ALL OF US WHO CARE
ABOUT THE PUBLIC HEALTH OF OUR
STATE AND THE WELL BEING OF OUR
CHILDREN. SB 7 93 CAN HELP TO
ACHIEVE THIS GOAL, BUT ONLY IF
THE LAW IS PROPERLY ENFORCED. 89
35 WILL MAKE EXPLICIT
ENFORCEMENT BY CALIFORNIA
DEPARTMENT OF PUBLIC HEALTH. AND
THE A G IN ADDITION TO LOCAL
AGENCIES TO ENSURE COMPLIANCE
AND PROTECTION OF PUBLIC HEALTH.
I WILL NOW PASS IT OFF TO GEORGE
OSBORNE, WHO REPRESENTS UNION OF
AMERICAN PHYSICIANS AND DENNIS,
UH, AFTER ME, LOCAL TWO. OH SIX,
THE BILL'S SPONSOR, AND THEN
WE'LL HEAR FROM DR JOHN MÀ.
GEORGE THANK YOU, ASSEMBLYMAN
CALI. THANK YOU, MR CHAIR AND
MEMBERS GEORGE OSBORNE. FOR THE
UNION OF AMERICAN PHYSICIANS AND
DENTISTS ASKED ME LOCAL TWO OH
SIX, WHERE THE SPONSOR OF HB 29
35. I'D LIKE TO THANK
ASSEMBLYMEMBER'S CONNELLY FOR
BRINGING THIS BILL FORWARD. AS
THIS IS SUCH AN IMPORTANT ISSUE.
BOTH THE LEGISLATURE AND
CALIFORNIA VOTERS SUPPORTED THE
PASSAGE OF THE FLAVOR TOBACCO
BAN, SO WE NEED TO BE AND WE
NEED TO ENSURE THAT IS BEING
ENFORCED PROPERLY BECAUSE IT'S
AS IT STANDS, THESE LETHAL
PRODUCTS ARE STILL FALLING INTO
THE HANDS OF TEENAGERS. WHICH IS
INEXCUSABLE AND UNACCEPTABLE. ON
BEHALF OF YOU A P D. I
RESPECTFULLY REQUEST THAT YOU
SUPPORT A B 9 35 THANK YOU. AND
NOW I'D LIKE TO INTRODUCE DR
JOHN MÀ, GENERAL SURGEON FROM
SAN FRANCISCO. THANK YOU, GEORGE
CHAIR WOOD AND MEMBERS OF THE
ASSEMBLY HEALTH COMMITTEE. MY
NAME IS JOHN MY SERVICES OF
2018, PRESIDENT OF THE SAN
FRANCISCO MARIN MEDICAL SOCIETY,
WHICH LAST NIGHT ENDORSED THIS
AMENDED LEGISLATION. IT'S AN
HONOR TO SHARE OUR PERSPECTIVE.
TODAY SMOKING IS LINKED TO OVER
13 HUMAN CANCERS, HEART DISEASE
AND COPD. AMONG MANY OTHER
ILLNESSES. SMOKING IS THE
LEADING CAUSE OF DEATH FOR
AMERICANS. THE COVID PANDEMIC IS
ONLY HIGHLIGHTED FURTHER THE
URGENCY TO ENCOURAGE SMOKING
CESSATION AS EXTENSIVE RESEARCH
SHOWS THAT SMOKING IS LINKED TO
WORSE OUTCOMES FROM COVID A
LIFETIME OF HEALTH PROBLEMS FROM
NICOTINE ADDICTION LIKELY
PREDISPOSED MANY PATIENTS THAT
HAVE A LOT MORE SEVERE COVID
DISEASE AND DIE SOONER THAN
EXPECTED, AND THE NUMBER OF
DEATHS FROM SMOKING FAR EXCEEDED
THE NUMBER OF COVID DEATHS OVER
THE PAST THREE YEARS. OVER MY
SURGICAL CAREER. I'VE WITNESSED
THE HIDDEN COSTS OF SOCIETY FROM
SMOKING THAT WE OFTEN DON'T
DISCUSS FROM RESPIRATORY FAILURE
. RE INTUBATION FAILED
OPERATIONS, PROLONGED HOSPITAL
STAYS, READMISSIONS AND DEATHS.
TOBACCO USE COSTS CALIFORNIA
OVER $24 BILLION EACH YEAR $13.5
BILLION IN HEALTH CARE COSTS AND
$10.3 BILLION IN LOST
PRODUCTIVITY. IT WAS AN HONOR TO
WORK WITH MAYOR ED LEE ON HIS
FLAVORED TOBACCO ORDINANCE THAT
PROVED TO BE HIS FINAL PUBLIC
HEALTH LEGACY AND LATER INSPIRED
SENATE BILL 7 93 BY SENATOR
JERRY HILL AFTER MAYOR LEE'S
UNTIMELY PASSING, WE DEFENDED
HIS LEGISLATION AGAINST TWO
REFERENDUMS LED BY THE TOBACCO
INDUSTRY AND JEWEL IN 2018 AND
2019 ASSEMBLYMEMBER'S CONNOLLY
HAD THE VISION TO IMMEDIATELY
EXTEND MERRILEES LEGISLATION
INTO MARIN COUNTY JUST DAYS
AFTER THE TOBACCO INDUSTRY WAS
DEFEATED IN 2018. AND IT'S AN
HONOR TO JOIN HIM NOW IN SUPPORT
OF THIS LEGISLATION TO
STRENGTHEN THE ENFORCEMENT OF
SENATE BILL 7 93. I WOULD LIKE
TO THANK CHAIR WOOD OR BEING AN
AUTHOR OF SENATE BILL 7 93 AND
MEMBERS ARAMBULA, SANTIAGO,
HORVATH AND KOREA ALONG WITH ROB
BONTA AND SHIRLEY WEBER FOR
SERVING AS CO AUTHORS,
CALIFORNIA VOTERS OVERWHELMINGLY
REJECTED PROP 31, WHICH WAS THE
THIRD ATTEMPT TO OVERTURN MAYOR
LEE'S INTENT THROUGH A
REFERENDUM. LAST NOVEMBER BY A 2
TO 1 MARGIN. THIS LEGISLATION
BECAME NECESSARY AFTER PROP 31
DELAYED THE IMPLEMENTATION OF
SENATE BILL 7 93 FOR OVER TWO
YEARS. THE CONFUSION WAS FURTHER
EXACERBATED BY THE INTRODUCTION
OF NEW NON MENTAL PRODUCTS BY
THE TIP BRACCO INDUSTRY THAT ARE
DESIGNED TO APPEAL TO MENTAL
SMOKERS. THIS BILL WILL PROVIDE
THE ATTORNEY GENERAL AND THE
DEPARTMENT OF HEALTH WITH THE
NECESSARY TOOLS TO EDUCATE
RETAILERS AND BRING AN END TO
ILLICIT FLAVORED TOBACCO
PRODUCTS SALES IN OUR STATE. I
APPLAUD ASSEMBLYMEMBER'S
CONNOLLY'S CONTINUED EFFORTS TO
STRENGTHEN THE LEGISLATION AND
TO PROTECT ANOTHER GENERATION OF
YOUTH FROM A LIFETIME OF
NICOTINE ADDICTION, URGED THE
COMMITTEE MEMBERS TO VOTE I FOR
A B 9 35 TODAY AND BE HAPPY TO
ANSWER ANY QUESTIONS THAT YOU
MAY HAVE. THANK YOU. THANK YOU
VERY MUCH. MOTION BY DR ARAMBULA
SECOND BY DR WEBBER. OTHERS IN
SUPPORT, PLEASE. HELLO JANICE
O'MALLEY WITH ME, CALIFORNIA IN
SUPPORT. THANK YOU. CRYSTAL
COULD ALSO ON BEHALF OF THE
NATIONAL STEWARDSHIP ACTION
COUNCIL IN SUPPORT. IS THERE
OPPOSITION TO THE BILL? SAME
THEN WE'LL BRING IT BACK TO THE
COMMITTEE FOR QUESTIONS OR
COMMENTS. QUESTIONS ARE COMING
FROM THE GAME, MR MCCARTY. THANK
YOU, MR CHAIR. I'LL MOVE THE
BILL. UM YOU'RE TOO LATE, BUT
THAT'S OKAY. YOU CAN BE THE
THIRD HOUSE THAT ALSO WANT TO
NOTE THE DOCTOR DOCTOR WOULD AND
I WERE THE JOINT AUTHORS OF THIS
BILL AND WE HAD TWO BILLS. IN
THE VERY END. WE JUST WENT WITH
THE SENATE BILL. BUT YOU KNOW,
SUCCESS HAS MANY, MANY FATHERS
AND MOTHERS AND FAILURES. AN
ORPHAN. BUT THE SUCCESS WAS THE
PEOPLE OF CALIFORNIA BECAUSE
THEY SAW RIGHT THROUGH THIS AND
UPHELD OUR LAW. UM BUT I THINK
THIS IS IMPORTANT TO MAKE SURE
WE HAVE FOLLOWED THROUGH TO MAKE
SURE THAT WE HAVE TEETH IN THE
LAW TO FOCUS ON A RETAILER'S AND
BAD ACTORS WHO ARE WORKING
AROUND THE INTENT OF THIS
POLICY. SO THANK YOU FOR
FOLLOWING UP. THANK YOU VERY
MUCH ANYONE ELSE? OKAY I'M ALL
ABOUT TEETH. I CAN'T HELP IT.
I'M SORRY. NEVER MIND SLATE
ANYWAY. UM THE BILL DOES ENJOY A
Dð PAST RECOMMENDATION. MR
CONNOLLY, WOULD YOU LIKE TO
CLOSE? THANK YOU. I RESPECTFULLY
ASK FOR AN IBO. THANK YOU. THE
MOTION IS DUE PASS AS AMENDED TO
GOVERNMENT GOVERNMENTAL
ORGANIZATION. UM MADAM SECRETARY
THEY THE MOTION BY DR ARAMBULA
SECOND BY DR WEBBER. MADAM
SECRETARY, PLEASE CALL THE ROLL
BY WALDRON. CURRY. ARAMBULA.
ARAMBULA. AYE, BOERNER HORVATH.
CARILLO. FLORA. THAT'S FONG.
MAIENSCHEIN MCCARTY. MCCARTHY I
PATERSON RODRIGUEZ RODRIGUEZ, I
SANTIAGO VALLAPUDUA. YOU PUT ONE
A VOTING, HOWEVER. WHOEVER I.
YOU HAVE SIX VOTES WILL LEAVE
THE BILL ON CAR. I'M SORRY. FIVE
VOTES WILL LEAVE THE BILL ON
CALL. WE'VE GOT A BUNCH OF
MEMBERS THAT AREN'T HERE. THANK
YOU VERY MUCH. THANK YOU.
THANKS, EVERYONE. MR GABRIEL.
WELL, MR GABRIEL, YOU HAVE A
BABY FOR 18. PLEASE. THANK YOU,
MR CHAIR AND MEMBERS. I AM
PLEASED TODAY TO BE HERE TO
PRESENT ASSEMBLY BILL 4 18,
WHICH WOULD BAN THE USE OF FIVE
TOXIC CHEMICALS IN FOOD HERE IN
THE STATE OF CALIFORNIA. THE
GOAL OF THIS LEGISLATION IS TO
PROTECT KIDS AND FAMILIES AND
CONSUMERS HERE IN THE STATE OF
CALIFORNIA AND BY BY BANNING
THESE FIVE CHEMICALS, WHICH ALL
HAVE WELL DOCUMENTED RISK OF
HARM, WITH STRONG SCIENTIFIC
EVIDENCE LINKING THEM TO CANCER.
TO REPRODUCTIVE ISSUES TO
DEVELOPMENT ON BEHAVIORAL ISSUES
AND CHILDREN. ALL FIVE OF THESE
CHEMICALS ARE BANNED IN THE
EUROPEAN UNION. THEY ARE BEING
MANY OF THEM ARE BANNED IN OTHER
JURISDICTIONS, INCLUDING THE UK
, CANADA, INDIA, CHINA, OTHER
PLACES AROUND THE GLOBE. AND
MANY MAJOR BRANDS HAVE MOVED
AWAY FROM USING THESE CHEMICALS
AND GROCERY STORES. SO COKE,
PEPSI GATORADE PAPA JOHN'S
PANERA DUNCAN DONUTS, WHOLE
FOODS, KROGER MANY OF THE BRANDS
THAT WE ALL ENJOY, HAVE STOPPED
USING THESE KIND. NICHOLS
BECAUSE THEY UNDERSTAND THAT
THERE ARE STRONG SCIENCE LINKING
THEM TO HARMS. ONE THING I DO
WANT TO MAKE CLEAR IS THAT, UM,
THIS IS NOT INTENDED TO PULL ANY
PRODUCTS OFF THE SHELF. NOR DO
WE THINK THAT THERE IS ANY
REALISTIC CHANCE OF PRODUCTS
COMING OFF THE SHELF. I'M SURE
SOME OF YOU MAY HAVE SEEN THANKS
TO SOME CRACK REPORTING BY
BRITISH TABLOID THE NOTION THAT
CALIFORNIA IS GOING TO BAN
SKITTLES AND I WANT TO ASSURE
YOU SOMEBODY WHO LOVES SKITTLES
THAT NOTHING COULD BE FURTHER
FROM THE TRUTH. AND ACTUALLY,
SEVERAL OF OUR COLLEAGUES WHO
WERE TRAVELING IN EUROPE OVER
THE SUMMER OVER THE SPRING
RECESS MADE A POINT TO BRING ME
BACK SOME SKITTLES TO PROVE THE
POINT. SO WE HAVE FROM BOTH
FRANCE AND FROM DENMARK,
SKITTLES THAT ARE MADE WITHOUT
ANY OF THESE INGREDIENTS. I
ACTUALLY JUST OPENED THEM AND
TASTED THEM HERE IN THE HEARING
ROOM. I CAN ASSURE YOU THAT THEY
ARE DELICIOUS AND TASTE EXACTLY
THE SAME AS THE SKITTLES THAT WE
KNOW AND LOVE HERE. IN THE STATE
OF CALIFORNIA. BUT REALLY NOT TO
MAKE LIGHT OF THIS ISSUE. WE
KNOW THAT THIS IS PARTICULARLY
IMPORTANT FOR PROTECTING YOUNG
PEOPLE WHEN THEY'RE, UM UM, WHEN
THERE IS A HEIGHTENED RISK FOR
KIDS, THEIR BRAINS ARE AT A
CRITICAL STAGE OF DEVELOPMENT.
UM AND I THINK JUST TO
UNDERSTAND HERE THE IMPORTANT
BACKDROP WE UNDERSTAND WELL, WHY
ARE THESE CHEMICALS ALL BANNED
IN EUROPE? WHY HAVE SO MANY
COMPANIES OUT THERE? SOME OF THE
BIGGEST CORPORATIONS IN THE
UNITED STATES MOVED AWAY FROM
USING THESE CHEMICALS AND YET
THEY'RE NOT BANNED HERE IN THE
UNITED STATES OF AMERICA, AND
THAT TO ME WAS SOMETHING THAT
REALLY CAME TO MY ATTENTION.
WHEN I STARTED WORKING ON THIS
BILL, THE FDA HAS REALLY FALLEN
DOWN ON THE JOB. AND THAT IS
BECAUSE OF A LOOPHOLE KNOWN AS
THE GRASS LOOPHOLE THE GENERALLY
RECOGNIZED AS SAFE, WHICH WAS
ORIGINALLY PUT INTO LEGISLATION
TO ALLOW FOR CHEMICALS LIKE
VINEGAR AND SUGAR AND OTHER
HOUSEHOLD ITEMS TO ESCAPE
REVIEW. THAT LOOPHOLE HAS BEEN
EXPLOITED TO THE POINT WHERE
APPROXIMATELY 99% OF CHEMICALS
THAT HAVE BEEN INTRODUCED INTO
OUR FOOD SUPPLY RECENTLY HAVE
BEEN DONE SO WITHOUT INDEPENDENT
, MEANINGFUL REVIEW BY THE FDA.
AND SO THAT IS WHY,
UNFORTUNATELY WHY THE UNITED
STATES IS SO FAR BEHIND THE REST
OF THE WORLD, AND IT HAS REALLY
LED TO SOME ABSURD OUTCOMES. ONE
OF THE CHEMICALS THAT WERE IS
SUBJECT TO THIS BILL. RED DYE
NUMBER THREE, RED DYE, NUMBER
THREE, HAS BEEN BANNED IN
COSMETICS IN THE UNITED STATES
SINCE 1990 AND YET, MORE THAN
THREE DECADES LATER, STILL
ALLOWED INTO OUR FOOD SUPPLY.
THERE WAS JUST REALLY IMPORTANT
RESEARCH DONE ABOUT THE LINKS
BETWEEN THIS DIE AND HARMS TO
CHILDREN, SO WE BELIEVE THAT
THIS IS A REALLY IMPORTANT STEP
FORWARD TO BRING THE UNITED
STATES INTER PARITY WITH THE
REST OF THE WORLD IN TERMS OF
PROTECTING OUR KIDS AND
PROTECTING CONSUMERS. SO WITH
THAT, I'M VERY PLEASED TO HAVE
WITH ME. LILLIAN ZOO FROM THE
ATTORNEY WITH THE ENVIRONMENTAL
WORKING GROUP. AND LORRAINE TO
BROKER A RETIRED NURSE TO
TESTIFY AND SUPPORT. THANK YOU
AND I WOULD RESPECTFULLY REQUEST
YOUR I VOTE. THANK YOU. THANK
YOU CHAIR, WOOD AND MEMBERS FOR
THE TIME TO SPEAK HERE TODAY. MY
NAME IS LILLIAN'S. OH, AND I'M
WITH THE ENVIRONMENTAL WORKING
GROUP, WHICH IS A CO SPONSOR OF
THIS BILL, ALONG WITH CONSUMER
REPORTS. I'M AN ATTORNEY AND I
SERVE AS INTERNAL EXPERT ON FOOD
CHEMICAL REGULATION IN THE U. S.
AND IN THE EUROPEAN UNION. FOOD
REGULATION IN THE U. S HAS LONG
LAGGED BEHIND EUROPEAN STANDARDS
. THE EU HAS BANNED ALL FIVE OF
THESE CHEMICALS FROM FOOD, BUT
THE U. S. FDA CONTINUES TO ALLOW
FOR THEIR USE. BUT HERE'S WHY
THE EU IS SO FAR AHEAD OF THE
FDA FOOD SAFETY. UNLIKE THE FDA
, THE EU PROACTIVELY REGULATES
FOOD CHEMICALS AND IS CURRENTLY
UPDATING THE SAFETY ASSESSMENT
OF EVERY CHEMICAL THEY'VE
APPROVED FOR USE IN FOOD. THREE
OF THE CHEMICALS IN THIS BILL
WERE BANNED AFTER RECENT
REASSESSMENTS AND THE OTHER TWO
HAVE NOT BEEN ALLOWED IN EUROPE
FOR DECADES. ON THE OTHER HAND,
THE FDA ALMOST NEVER REASSESSES
CHEMICALS, EVEN WHEN THERE'S NEW
EVIDENCE OF HARM. THE FDA HAS
NOT THOROUGHLY LOOKED AT MOST OF
THESE CHEMICALS SINCE THE 19
SEVENTIES, EVEN THOUGH AMPLE NEW
EVIDENCE HAS SHOWN THAT THE POST
SERIOUS HEALTH RISKS TO THE
PUBLIC. FOR INSTANCE, AS THE
ASSEMBLYMEMBER'S STATED RED
THREE IS A KNOWN CARCINOGEN,
WHICH THE FDA BANNED FROM
COSMETICS IN 1990, BUT STILL
ALLOWS IN FOOD. TITANIUM DIOXIDE
AS THE COMMITTEE ANALYSIS STATES
CAN DAMAGE DNA, POTASSIUM
BROMATE CAUSES CANCER AND AS A
PROP 65 CHEMICAL. PROPER PARABEN
CAUSES REPRODUCTIVE HARMS. AND
BROMINATED VEGETABLE OIL AS A
NEUROTOXIN. THERE'S NO
JUSTIFICATION FOR THESE TOXICS
TO BE PUT IN FOOD AND ESPECIALLY
NOT IN FOOD MARKETED TO
CHILDREN. AND THE LAST POINT
I'LL EMPHASIZE IS THAT THERE ARE
EFFECTIVE AND COST EFFICIENT
ALTERNATIVES FOR ALL OF THESE
CHEMICALS. COMPANIES THAT SELL
THE SAME BRANDS TO BOTH EUROPEAN
AND US MARKETS HAVE MADE SAFER
VERSIONS TO COMPLY WITH EU
STANDARDS, EVEN AS THEY CONTINUE
TO SELL HARMFUL FOOD TO US
CONSUMERS. THIS BILL WILL MAKE
CALIFORNIANS SAFER BY
RESTRICTING THE WORST OF THE
WORST CHEMICALS SO THE EU HAS
BANNED BUT THAT THE FDA HAS LONG
FAILED TO ACT ON SO WE
RESPECTFULLY ASK YOU TO VOTE AYE
ON A B 418. THANK YOU. GOOD
AFTERNOON AND THANK YOU FOR
ALLOWING ME TO SPEAK ON THIS
IMPORTANT TOPIC TODAY. MY NAME
IS LORRAINE THABO. I AM A
RETIRED REGISTERED NURSE FOR
ALMOST 40 YEARS ON 12 HOUR NIGHT
SHIFT. I WORKED IN THE SAN
FRANCISCO GENERAL HOSPITAL
TRAUMA CENTER AND INTENSIVE CARE
UNIT AND THE POST ANESTHESIA
RECOVERY. I ALSO WORKED ABOUT
SIX YEARS VOLUNTEERING IN LATIN
AMERICA. THROUGHOUT MY CAREER. I
HELP PATIENTS AND FAMILIES
RESPOND TO CAR CRASHES, GUNSHOT
WOUNDS, STAB WOUNDS, BICYCLE AND
SKATEBOARD ACCIDENTS, SERIOUS
HEALTH CONDITIONS AND ILLNESSES.
BUT MY SPECIALTY WAS ALWAYS
WORKING WITH CHILDREN. I HAVE
RAISED FOUR OF MY OWN. AS HEALTH
PROFESSIONALS. WE ALWAYS DO ALL
THAT WE CAN TO HELP CHILDREN AND
THEIR FAMILIES RESPOND TO A
CRISIS AFTER A DEVASTATING
INCIDENT TO OVERCOME THEIR
DISABILITIES AND TO RETURN TO A
NORMAL LIFE. TREMENDOUS
RESOURCES ARE ALWAYS EXPENDED
AFTER A CATASTROPHIC EVENT OVER
THE COURSE OF TREATMENT.
FAMILIES PAY A HUGE COST WHEN A
LOVED ONE IS SERIOUSLY ILL. AND
DO EVERYTHING THEY CAN TO TREAT
THEIR CHILD. THEY FACE
TREMENDOUS EMOTIONAL AND
FINANCIAL HARDSHIPS AS A RESULT.
NOT ONLY DO ILLNESSES AND
DISEASE CAUSED LOSS AND
SUFFERING, THEY OFTEN
PERMANENTLY ALTER AND A FAMILY
AND A CHILD'S WAY OF LIFE AND I
HAVE WITNESSED TOO MUCH
SUFFERING. MY RETIREMENT HAS
BEEN DEDICATED TO THE PREVENTION
OF THE ROOT CAUSES OF THAT
SUFFERING. AND FOR THAT REASON
I'M HERE TODAY AS AN INDIVIDUAL
AND AS A LEADER OF THE
CALIFORNIA NURSES FOR
ENVIRONMENTAL, HEALTH AND
JUSTICE TO PLEAD WITH YOU TO NOT
ALLOW FOOD MANUFACTURERS TO
INTENTIONALLY PUT HARMFUL
SUBSTANCES IN OUR FOOD. THESE
SUBSTANCES CAN CAUSE CANCERS,
DEVELOPMENTAL DELAYS, IMMUNE
DISORDERS AND DAMAGED DNA, AS
OTHERS HAVE ALREADY SAID
CHILDREN'S OUR CHILDREN ARE
ESPECIALLY SENSITIVE TO THE
EFFECTS OF CHEMICALS AND FOOD
AND SUFFER THE MOST FROM
ILLNESSES AND CHRONIC
CONDITIONS. THESE CHEMICALS THAT
BIO ACCUMULATE IN THEIR LITTLE
BODIES AND ARE CANCER CAUSING
SHOULD NOT BE ADDED TO THE FOODS
THAT CHILDREN EAT EVERY DAY.
PLEASE JOIN ME TODAY AND
SUPPORTING 84 18 AND HELP US
ENSURE THAT THE FOOD THAT WE
PROVIDE FOR OUR FAMILIES TRULY
FEEDS THEIR BODIES, AND IT'S
HELPFUL, NOT HARMFUL. YOUR
DECISION TODAY IS IMPORTANT.
THANK YOU FOR YOUR ATTENTION.
THANK YOU VERY MUCH OTHERS IN
SUPPORT, PLEASE. NEW ORLEANS
WITH CHILDREN NOW IN SUPPORT.
THANK YOU. QUENTIN LEVEQUE ON
BEHALF OF CALIFORNIA HEALTH,
COALITION. ADVOCACY AND SUPPORT.
THANK YOU. THANK YOU. CHAIR
MEMBERS. MY NAME IS NO ITALY AND
ON BEHALF OF BREAST CANCER
PREVENTION PARTNERS PESTICIDE
ACTION NETWORK, LONG BEACH GRAY
PANTHERS RECALL ENERGY AND THE
FRIENDS CAN BE ON LEGISLATION
WHEREIN SUPPORT. THANK YOU. IT'S
LIKE YOU ALSO ON BEHALF OF THE
NATIONAL STEWARDSHIP, ACTION,
COUNSEL AND SUPPORT THANK YOU.
THAT'S NOT TO ASK YOU THAT CEO
CALIFORNIA AND SUPPORT THANK
YOU. BRIAN SPENCER, AMERICAN
COLLEGE OF O B. G. Y. N S
DISTRICT NINE AND SUPPORT. THANK
YOU. ANYONE ELSE? SEE NO ONE. IS
THERE ANY OPPOSITION TO THIS
BILL?
GOOD AFTERNOON CHAIR AND MEMBERS
OF THE COMMITTEE. I'M BRENDAN
FLANAGAN ON BEHALF OF THE
CONSUMER BRANDS ASSOCIATION,
SPEAKING IN OPPOSITION TO A B
FOR 18. FOOD SAFETY IS OF
PARAMOUNT CONCERN TO OUR
MEMBERS, AND WE BELIEVE THE
EXISTING COMPREHENSIVE SCIENCE
BASED APPROVAL SYSTEM. SHOULD BE
RELIED UPON TO MAKE
DETERMINATIONS REGARDING THE
SAFETY AND USE OF FOOD
INGREDIENTS AND ADDITIVES. WE
BELIEVE THE CURRENT REGULATORY
ENVIRONMENT PROVIDES SIGNIFICANT
SCIENTIFIC OVERSIGHT WERE
QUALIFIED, SCIENTISTS ARE ABLE
TO REVIEW HAZARDS AND RISKS.
THESE REGULATORY BODIES ARE
COMPRISED OF CREDENTIAL
PROFESSIONAL SCIENTISTS WHO HAVE
RESPONSIBILITY OVER ALL FOOD
ADDITIVES. AND THESE SCIENCE
BASED PROCESSES SHOULD BE
ALLOWED TO CONTINUE WITHOUT
SUPPLANTING OR SECOND GUESSING
THEIR OUTCOMES. OUR CURRENT
REVIEW AND APPROVAL SYSTEM
INCLUDES, OF COURSE, THE UNITED
STATES FEDERAL GOVERNMENT THAT
UNDERTAKES A THOROUGH SCIENCE
BASED PROCESS. IN ADDITION,
CALIFORNIA HAS SEVERAL LAWS THAT
REQUIRE REMOVING CHEMICALS FROM
FOODS. ATTACHING WARNING LABELS
AND CHECKING ALTERNATIVES IF
THOSE FOOD ADDITIVES ARE ON
SAFER, EXPOSED CONSUMERS TO
ALLERGIES. ALL FIVE OF THESE
ADDITIVES HAVE BEEN THOROUGHLY
REVIEWED BY THE FEDERAL AND
STATE SYSTEMS AND NUMEROUS
INTERNATIONAL SCIENTIFIC BODIES
AND CONTINUED TO BE DEEMED SAFE.
UNDER THE EXISTING FOOD SAFETY
PROCESS. SCIENTIFIC REGULATORS
LEVERAGE THEIR EXPERTISE AND
MAKE DETERMINATIONS TO ESTABLISH
RECOGNIZED SAFETY THRESHOLDS.
THEN WHEN APPROPRIATE AND
SUPPORTED BY PEER REVIEWED
SCIENTIFIC EVALUATIONS. THEY ACT
TO REQUIRE ADDITIONAL LABELS OR
TO REMOVE THE ADDITIVES FROM THE
MARKET. ADDITIONALLY OUR
COMPREHENSIVE SYSTEM REQUIRES
INGREDIENT LABELING ALLOWING
CONSUMERS TO MAKE INFORMED
DECISIONS. SPECIFICALLY THERE
ARE CURRENTLY TWO ONGOING
REGULATORY ACTIVITIES TO
DETERMINE THE SAFETY OF
ADDITIVES WITHIN THIS BILL.
FIRST UNDER THE FEDERAL FOOD
DRUG AND COSMETIC ACT. ADVOCATES
INITIATED PETITION BEFORE FDA
JUST LAST FALL FOR THE REMOVAL
OF RED DYE NUMBER THREE THE
COMMENT PERIOD FOR THIS PETITION
IS CURRENTLY ACTIVE AND
CONCLUDES ON MAY 18TH IN
ADDITION, CALIFORNIA DEPARTMENT
OF PUBLIC HEALTH EARLIER THIS
MORNING CONDUCTED A HEARING ON A
SEPARATE PETITION THAT ADVOCACY
GROUPS INITIATED WITH THE
DEPARTMENT TO REQUIRE A WARNING
LABEL ON FOODS CONTAINING
NUMEROUS SYNTHETIC DYES. THE
COMMENT PERIOD FOR THIS PETITION
CLOSES NEXT MONTH. THE FEDERAL
GOVERNMENT AND THE STATE OF
CALIFORNIA HAVE DEVELOPED AROUND
THE WORLD'S MOST ROBUST AND
PROTECTIVE SYSTEMS FOR FOOD
SAFETY. WE THEREFORE ENCOURAGE
THE LEGISLATURE TO ALLOW THAT
SYSTEM TO CONDUCT THIS CRITICAL
WORK AND RESPECTFULLY OPPOSED.
MAYBE 4 18. THANK YOU. THANK
YOU. GO AHEAD. GOOD AFTERNOON.
MY NAME IS SARAH KADRE AND I
SERVE AS THE EXECUTIVE DIRECTOR
FOR THE INTERNATIONAL
ASSOCIATION OF COLOR
MANUFACTURERS. THANK YOU FOR THE
OPPORTUNITY TO SPEAK TO YOU
TODAY ABOUT THE SCIENCE
SUPPORTING THE CONTINUED SAFE
USE OF FDN C RED NUMBER THREE IN
TITANIUM DIOXIDE AND FOOD. ALSO
ON A PERSONAL NOTE AS A MOTHER
OF TWO YOUNG BOYS. I APPRECIATE
THE DESIRE TO ENSURE THAT THE
FOOD THAT THEY EAT A SAFE AND
I'VE SEEN THE SCIENCE SUPPORTING
THESE COLORS AND I HAVE NO
CONCERNS WITH FEEDING MY
CHILDREN FOODS THAT CONTAIN
THESE COLORS IN THE UNITED
STATES. THE FDA REGULATES THE
SAFETY OF ALL COLOR ADDITIVES,
INCLUDING FD AND C RED THREE AND
TITANIUM DIOXIDE, AND IT DOES SO
BASED ON SCIENTIFIC EVIDENCE.
READ THREE. NO AUTHORITATIVE
BODY, INCLUDING THE FDA, OR
EUROPEAN FOOD SAFETY AUTHORITIES
HAVE IDENTIFIED ANY SAFE ANY
SAFETY CONCERNS WITH ITS
CONTINUED USE IN FOOD. AND IT'S
1990 FINAL RULE. FDA ACTUALLY
CONCLUDED THAT RED THREE POSES
NO THREAT TO HUMAN HEALTH.
GLOBAL EXPERTS HAVE PUBLISHED
OPINIONS ON THE SAFETY OF RED
THREE MORE RECENTLY WITH THE U.
N. WORLD HEALTH ORGANIZATION,
AND FOOD AND AGRICULTURAL
ASSOCIATIONS, JOINT EXPERT
COMMITTEE ON FOOD ADDITIVES OR
JACK TO, AS IT'S KNOWN. BUT WHEN
I ALSO KNOW THIS IS A COMMITTEE
THAT INCLUDES REPRESENTATIVES.
EVERY CONFIRMED ITS SAFE USE
JUST IN 2018 EUROPEAN FOOD
SAFETY AUTHORITIES, WHICH AS THE
OPPONENTS OF THE, UH SUPPORTERS
OF THE BILL NOTED, ARE ACTIVELY
REEVALUATING COLORS. THEY RE
EVALUATE THIS COLOR AND ON AND
CONFIRMED ITS SAFETY JUST IN
2011. IT WAS INCORRECT TO SAY
THAT EUROPE HAS BANNED RED THREE
EUROPE ALLOWS, READ THREE. IT'S
KNOWN THERE AS A RICH ROGGIN.
IT'S ALLOWED IN CANDIED CHERRIES
, PHARMACEUTICALS, COSMETICS AND
TOOTHPASTE PRODUCTS. EUROPE'S
LIMITS TO OUR THORAZINE AND FOOD
IS NOT DUE TO ANY SAFETY
CONCERNS, BUT BECAUSE THE EU
LIMITS APPROVALS OF ADDITIVES,
INCLUDING COLORS TO SPECIFIC
FOOD PRODUCT CATEGORIES, WHERE
THEY PROVIDE A SPECIFIC
TECHNICAL ADVANTAGE. IN FACT,
EUROPEAN MANUFACTURERS HAVE FIVE
RED SYNTHETIC COLOR OPTIONS,
WHILE THOSE IN THE U. S ONLY
HAVE TWO, INCLUDING RED THREE
CURRENTLY PROTECT HIM DIOXIDE.
THERE'S NO ACTUAL SAFETY
CONCERNS TO JUSTIFY A BAN.
EUROPE'S 2021 DECISION WAS BASED
ON SAFETY DATA, NOT
REPRESENTATIVE OF THE MATERIAL
APPROVED FOR USE AS A FOOD
COLOR. SINCE THEN, HIGHLY
REGARDED FOOD AGENCIES FROM THE
UNITED KINGDOM, CANADA,
AUSTRALIA AND NEW ZEALAND HAVE
REVIEWED THE SAME DATA AND
CONFIRMED ITS CONTINUED SEA
VIEWS. ADDITIONALLY THE FDA
CONDUCTED ITS OWN INTERNAL
REVIEW RECENTLY ISSUED A
STATEMENT CONFIRMING THAT THE
AGENCY CONTINUES TO CONSIDER IT
SAFE FOR USE. IN THE U. S. ALSO
COLORS ARE SUBJECT TO PRE MARKET
APPROVAL. THERE IS NO GENERALLY
RECOGNIZED AS SAFE OR GRASS
EXEMPTION FOR COLORS. THIS MEANS
THAT THE FOUR MARKETING A
MANUFACTURER MUST PETITION THE
AGENCY SUBMIT AN EXTENSIVE
BATTERY IS STUDIES DEMONSTRATING
ITS SAFETY, THE PROCESS THAT
TAKES MANY YEARS AND MILLIONS OF
DOLLARS, ENSURING THAT NO COLOR
IS PUT ON THE MARKET. BEFORE AN
EXTENSIVE TO SAFETY EVALUATION
AND CONTRARY TO SOME MEDIA
REPORTS, THERE ARE NO IMMEDIATE
REPLACEMENTS AVAILABLE FOR
EITHER OF THESE COLORS AND ALL
THE APPLICATIONS. THEY'RE USED.
THANK YOU. THANK YOU. OTHERS IN
OPPOSITION. DENNIS ALBION ON
BEHALF OF THE AMERICAN BEVERAGE
ASSOCIATION. WE OPPOSED THANK
YOU. GLORIA YELL IT AND
REPRESENTING NATIONAL
CONFECTIONERS ASSOCIATION AND
OPPOSITION. CARLOS GUTIERREZ
WITH THE CONSUMER HEALTHCARE
PRODUCTS ASSOCIATION AND
OPPOSITION MARGIE LEE ON BEHALF
OF THE CALIFORNIA LEAGUE OF FOOD
PRODUCERS AND THE COUNCIL FOR
RESPONSIBLE NUTRITION AND
OPPOSITION. THANK YOU. GOOD
AFTERNOON CHAIR MEMBERS DEAN
TALLY ON BEHALF OF THE
CALIFORNIA MANUFACTURERS AND
TECHNOLOGY ASSOCIATION, AS WELL
AS THE CALIFORNIA GROCERS
RESPECTFULLY POSED. POWER CAN BE
HALF OF THE AMERICAN CHEMISTRY
COUNCIL A POST THANK YOU. RYAN
ELAINE, ON BEHALF OF THE
CALIFORNIA RETAILERS,
ASSOCIATION AND OPPOSITION.
THANK YOU. ANYONE ELSE? BRING IT
BACK TO THE COMMITTEE FOR
QUESTIONS OR COMMENTS, MR
MCCARTHY? YES, THANK YOU. UM I
KNOW THAT YOU'RE THE AUTHOR IS
ATTEMPTING TO ADDRESS THIS
BECAUSE OF THE CHEMICALS. I KNOW
. SOME LIKE OUR CHAIR WOULD WANT
TO GET RID OF THESE PRODUCTS
BECAUSE OF THE SUGAR IMPACTS
IMPACTS ON OUR TEETH. BUT THAT'S
ANOTHER. ANOTHER THING. UM THAT
THAT BEING SAID, I'M JUST KIND
OF CONFUSED FROM THE OPPOSITION
. SO YOUR ESSENTIAL ARGUMENT IS
THAT THE AMERICAN EVALUATION OF
THE SAFETY AND THE SCIENCE OF
THIS SAYS ALL CLEAR. IT'S UH,
ADEQUATELY SUFFICIENT. SO ARE
YOU SAYING THAT THE EUROPEAN
EVALUATION IS. IS, UM INADEQUATE
AND IS IT IS IT IS INCORRECT.
THANKS FOR THE QUESTION. I CAN'T
SPEAK TO THE EUROPEAN EVALUATION
SYSTEM. WHAT I CAN SPEAK TO IS
THE SCIENCE BASED EVIDENTIARY
APPROACHED EVIDENTIARY APPROACH
THAT OUR FEDERAL AND STATE
SYSTEM TO TAKE TO REVIEW THE
SCIENCE AND TO DIFFERENTIATE
BETWEEN CORRELATION AND
CAUSATION. AND BASED ON THAT ALL
FIVE OF THESE HAVE BEEN
DETERMINED TO BE SAFE IN THE
UNITED STATES. SO BUT THOSE ARE
BASED ON OUR STAR. YOU'RE SAYING
THEIR SCIENCE YOU DON'T KNOW
ABOUT THEIR SCIENCE, OR DO YOU
BELIEVE THAT THERE ARE SCIENCE
IS A HIGHER STANDARD OR EQUAL? I
JUST DON'T KNOW ENOUGH ABOUT THE
EUROPEAN SYSTEM TO BE ABLE TO
COMPARE. THERE'S TWO HOURS I'M
HERE TO SPEAK TO THE BENEFITS OF
OUR SYSTEM. AND THEN I GUESS
THEY AT THE END OF THE DAY GOES
DOWN TO DOLLARS AND CENTS. WOULD
IT COST MORE? FOR YOU TO PRODUCE
THE SKITTLES THAT ALLEGEDLY
TASTE THE SAME. I LIKE TO ASK MR
GABRIEL TO IF YOU WOULD TO HAND
THEM OUT TO THE TO THE WITNESS
TO THE TO THE TO THE MEMBERS SO
WE CAN HAVE OUR OWN TASTE TEST.
UM WOULD IT COST MORE FOR CUT
FOR WHOEVER MANUFACTURER
SKITTLES? TO PRODUCE THESE
PRODUCTS BASED UPON THE EUROPEAN
STANDARD VERSUS THE CURRENT
AMERICAN STANDARD. UM CAN I
ACTUALLY ANSWER YOUR FIRST
QUESTION AS WELL? UM OR SPEAK TO
YOUR FIRST QUESTION AS WELL IN
THE EUROPEAN SYSTEM. I'M NOT
SAYING IT'S BETTER OR WORSE.
IT'S JUST DIFFERENT. THEY HAVE A
DIFFERENT PROCESS. AND AS I
NOTED, THEY JUST RECENTLY
REEVALUATED RED THREE IN 2011
AND CLEARED IT SO UM, F D IS
LOOKING AT IT RIGHT NOW, AND
THEY'LL MAKE IT THEIR OWN
DETERMINATION. UM TITANIUM
DIOXIDE, LIKE I SAID THAT THEIR
DECISION WAS BASED ON ON
MATERIAL THAT'S NOT USED AS A
FOOD COLOR, BUT USED FOR
INDUSTRIAL. THE STUDIES THEY
LOOKED AT. WE'RE NOT BASED ON
ITS USES THE FOOD COLOR TO YOUR
QUESTION. I CAN'T SPEAK. TO MARS
WHO MANUFACTURE SKITTLES. UM,
BUT THERE ARE DIFFERENT
INGREDIENTS ALLOWED FOR COLORS
AND THE U. S AND THE IN EUROPE.
IT'S NOT QUITE SO SIMPLE AS THAT
THEY THESE COLORS ARE AVAILABLE.
UM AND I CAN TELL YOU THAT
SKITTLES DON'T USE RED THREE IN
THE U. S. SO IT'S I'M NOT SURE
EXACTLY. UM WHAT? WHAT THE
CONCERN IS WITH SKITTLES IN
PARTICULAR. BUT MAYBE IT'S NOT
TITANIUM DIOXIDE. I USED THE
WRONG ONE. SO THE POINT IS,
WHAT'S THE PROBLEM? IF MARKET IF
MARS. MARS USED THE TITANIUM
DIOXIDE AS OPPOSED TO GET RID OF
THAT AND WENT TO THE EUROPEAN
MODEL. WOULD THAT COST THEM MORE
MONEY? IS THAT WHY YOU'RE THERE?
YES, I MEAN, THERE IS NOT
CURRENTLY THERE IS VERY LIMITED
ALTERNATIVES. THE TITANIUM
DIOXIDE IN THE UNITED STATES FOR
USES OF COLOR. UM AND THOSE THAT
ARE AVAILABLE, YOU HAVE TO USE
MORE OF THEM, AND THEY COST MORE
MONEY. SO, YES. THAT'S A
FINANCIAL DECISION. I'M NOT
SAYING THAT THAT'S I CAN'T SPEAK
FROM OURS, BUT I CAN TELL YOU
THAT AS FAR AS THE COLORS THAT
ARE AVAILABLE. CURRENTLY IN THE
U. S. OKAY? YEAH I THINK THIS
MAKES SENSE. I SUPPORTED. THOSE
ARE EMOTION MADE SO FAR, MR
CHAIR. AH I HEAR ONE NOW. OKAY
SURE. AND THEN ASSUMING IT
PASSES APPLY THE AUTHOR AND I
CAN ADD MY NAME AS A CO OP. UH
DR WEBBER, I THINK WAS NIXON. MR
FONG THEN, OKAY? I'LL JUST BE
REAL QUICK. THANK YOU, MR CHAIR.
JUST A QUESTION ABOUT TIMING. UM
I MISSED THE OPENING, BUT I'D
HAVE DONE SOME RESEARCH AND
UNDERSTANDING AS AS MENTIONED
BEFORE IS THAT THE FDA IS IN IN
A PUBLIC COMMENT PERIOD
REVIEWING, UM, THE DATA AND IN
THE SCIENCE. I UNDERSTAND THAT
THAT THE CALIFORNIA DEPARTMENT
PUBLIC HEALTH IS ALSO GOING
THROUGH KIND OF A PUBLIC COMMENT
PERIOD NOW. SO I GUESS THE
QUESTION IS, SINCE THERE IS A
REVIEW, AND THERE'S IT'S IN A
SCIENCE BASED APPROACH AND
THEY'RE THEY'RE LOOKING AT ALL
THE DATA AND THIS AND THE
SPECIFICS. WHY NOT WAIT UNTIL
THEY COME BACK WITH SOME
CONCLUSION BEFORE THAT ARE
COMING OUT WITH THIS BAND
PROPOSAL. IT SEEMS LIKE THE CARD
IS BEFORE THE HORSE HERE AND
MAYBE YOU CAN EXPOUND ON YES,
THANK YOU. I THINK THAT'S A
GREAT QUESTION, ACTUALLY, UM, SO
I GUESS THE BEST EXAMPLE AND
GIVE ABOUT THIS IS RED DYE,
THREE, WHICH WAS WHICH WAS
BROUGHT UP HAS BEEN BANNED IN
COSMETICS BY THE FDA IN UNITED
STATES OF AMERICA SINCE 1990 AND
33 YEARS, AND THEY'VE BEEN
MAKING NOISE ABOUT POTENTIALLY
BANNING IT IN FOOD SINCE THEN,
BUT 33 YEARS LATER, IT'S STILL
OUT IN OUR FOOD SUPPLY, AND IT'S
BANNED IN ALL OF THESE OTHER
COUNTRIES AROUND THE WORLD. SO I
THINK THE NOTION HERE IS THAT WE
ARE VERY, VERY FAR BEHIND THE
REST OF THE WORLD IN PROTECTING
OUR YOUNG PEOPLE. THE IDEA TO ME
THAT YOUNG PEOPLE IN BULGARIA
AND ROMANIA AND ALL OF THESE
OTHER COUNTRIES AROUND THE WORLD
ARE ENTITLED TO BETTER
PROTECTIONS AND WE ARE UM, JUST
DOESN'T SIT WELL, AND THERE'S NO
REQUIREMENT THAT THE FDA ACT ON
THESE PETITIONS. THERE'S NO
REQUIREMENT THAT THEY DO
ANYTHING. THERE'S NO REQUIREMENT
THAT THEY'RE GOING TO ACTUALLY
MOVE FORWARD WITH ANY KIND OF
REGULATION. AND I THINK WHAT
WE'VE SEEN ACTUALLY IS THAT THEY
HAVE NOT DONE THAT THAT THEY
HAVE NOT BEEN PROACTIVE THAT
THEY HAVE NOT BEEN UP TO THE
TASK OF PROTECTING US AND SO
BECAUSE WE HAVE WAITED FOR SO
LONG FOR MEANINGFUL ACTION AND
NOT SEEN ANY ME FEELS TO ME THAT
IT'S WAY PAST TIME HERE. UM FOR
US TO TAKE ACTION. I DO WANT TO
MAKE WITH YOUR PERMISSION, MR
FONG, JUST JUST TO HELP FOLKS
UNDERSTAND. IT IS NOT JUST THE
EU HERE, RIGHT? WE'RE USING THE
EU AS AN EXAMPLE. BUT YOU LOOK
AT THE EXAMPLE SO POTASSIUM
BROMATE THAT IS ALSO BANNED IN
ARGENTINA, BRAZIL, NIGERIA,
SOUTH KOREA, PERU, SRI LANKA,
CHINA AND INDIA. SO THIS IS THE
REST OF THE WORLD THAT IS A VERY
VERY FAR AHEAD OF THE UNITED
STATES AND PROTECTING THEIR
CHILDREN, AND IT'S A LITTLE BIT
MYSTIFYING TO ME ABOUT, UM, THE
COMMENTS THAT WERE MADE ABOUT
THE DIES BECAUSE ACTUALLY OUR
STATE OF CALIFORNIA THANKS ON
BUDGET FUNDING, WE ASKED THE
STATE DEPARTMENT TO DO AN
INDEPENDENT REVIEW OF ALL THIS.
AND IF YOU LOOK AT PAGE NINE IN
YOUR ANALYSIS, YOU CAN SEE THE
RESULTS OF THAT. THAT THE
DEPARTMENT EXTENSIVELY REVIEWED
EXISTING STUDIES OF THE EFFECTS
OF THESE DYES ON HUMANS AND
LABORATORY ANIMALS. IT FOUND
THAT CONSUMPTION CAN RESULT IN
HIGHER ACTIVITY, HYPERACTIVITY
AND NEURAL NEUROBIOLOGICAL
PROBLEMS IN CHILDREN AND THAT
THE CURRENT FEDERAL LEVELS OF
INTAKE MAY NOT BE SUFFICIENT TO
PROTECT CHILDREN'S BEHAVIORAL
HEALTH AND THE LEVELS WERE
ESTABLISHED BY THE FDA DECADES
AGO AND DO NOT REFLECT NEWER
SCIENCE. SO I THINK PART OF THE
ISSUE HERE IS THAT WE HAVE SEEN
YES, THERE ARE PETITIONS
PENDING, BUT THERE'S NO
GUARANTEE THAT THE FDA IS GOING
TO TAKE ANY ANY ACTION AND THE
LAST 33 YEARS OF EVIDENCE
SUGGESTS TO US THAT WE SHOULDN'T
HOLD OUR BREATH THERE, SO I
THINK IT'S IMPORTANT WHEN WE'VE
SEEN AN ABSENCE OF FEDERAL
ACTION THAT WE HERE IN
CALIFORNIA HAVE TO STEP UP AND
TAKE IT AND I GUESS I GOT I
GUESS THAT'S THE CRUX OF THE
QUESTION. AND OUR DIALOGUE IS
AH. IS THAT YOU COME TO A
CONCLUSION ON THE FEDERAL REVIEW
? I MEAN, AND THAT'S AND I'M I
MEAN, I DON'T KNOW WHAT THE FDA
IS GOING TO DO WITH THIS CURRENT
REVIEW. I MEAN, THEY COULD COME
BACK AND AGREE WITH YOU. AND AT
THAT POINT, YOU KNOW, I WOULD
SAY THAT WE PROBABLY WOULD HAVE
TO ACT. I JUST DON'T KNOW AND SO
AND IN THE SAME WITH THE
CALIFORNIA APARTMENT OF PUBLIC
HEALTH SO I GUESS THAT'S THE
STRUGGLE THAT I HAVE RIGHT NOW
IS THAT WE'RE PUTTING THE BAND
BEFORE THE DATA AND IT MEANS AND
I GUESS MAYBE THAT GOES TO MY
COLLEAGUE. THAT'S THAT'S TEXT ME
FROM SACRAMENTO IS THAT IF THE
FDA YOU IF THE CONCLUSION IS THE
FDA ITSELF AS A IT'S JUST
STRUCTURALLY FLAWED AND WE JUST
AREN'T GOING TO ACCEPT WHAT THEY
WHAT THEY CONCLUDE WITH THEN
THAT BECOMES A BIGGER LIKE
INDICTMENT, RIGHT? A BIGGER
CONCERN IS LIKE THEN ARE WE
QUESTIONING EVERY DECISION THE
FDA MAKES IS IT ONLY WITH THESE
FIVE ITEMS OR IS THAT WE DON'T
START AGREEING WITH THE FDA ON
THIS, BUT WE AGREE WITH THE FDA
ON EVERYTHING ELSE. I THINK THAT
THAT I ACTUALLY THINK THE LARGER
STORY HERE IS A FLAWED PROCESS
AT THE FDA, AND I THINK THE
PROBLEM THAT WE HAVE WITH THE
GRASS LOOPHOLE IS THAT THE
INDUSTRY IS ESSENTIALLY BEEN
ALLOWED TO POLICE ITSELF. THAT
IT'S GRADING ITS OWN HOMEWORK,
RIGHT? AND THERE'S AN INHERENT
CONFLICT HERE. AND THAT FOR ME
IS THE EXPLANATION BECAUSE WHEN
I FIRST LOOKED AT THIS, IT
DIDN'T MAKE SENSE TO ME. I MEAN,
I ALWAYS ASSUMED THAT THERE WAS
SOMEONE OUT THERE WATCHING OUR
BACK. I MEAN, I CAN'T PICK UP A
BAG OF SKITTLES AND READ THE
LABEL AND UNDERSTAND ANYTHING
ABOUT THESE CHEMICALS AND KNOW
IF THEY'RE HARMFUL TO ME OR
HARMFUL TO MY KIDS, RIGHT. ALL I
KNOW IS THAT, FOR EXAMPLE,
DUNKIN DONUTS STOP USING
TITANIUM DIOXIDE IN 2015. IT
STILL SELLS A LOT OF DONUTS.
PEOPLE STILL ENJOY DUNKIN
DONUTS. THEY CAME TO THE
CONCLUSION THAT THIS WAS NOT
SAFE AND THEY DIDN'T WANT TO PUT
IT BECAUSE THEY CARE ABOUT THEIR
CUSTOMERS. THEY DIDN'T WANT TO
PUT IT IN THEIR MATERIALS. PAPA
JOHN'S CAME TO THE SAME
CONCLUSION. COKE CAME TO THE
SAME CONCLUSION. PERHAPS HE CAME
TO THE SAME CONCLUSION. GATORADE
CAME TO THE SAME CONCLUSION.
PANERA WHEN YOU GO THROUGH THE
ANALYSIS AND SEE THE LIST OF
GROCERY STORES THAT WON'T SELL
PRODUCTS CONTAINING THESE
INGREDIENTS, SO WE ARE REALLY
FAR BEHIND THE REST OF THE
WORLD, NOT JUST THE 27 COUNTRIES
IN THE EU. BUT MANY OTHER
JURISDICTIONS AROUND THE WORLD
WERE REALLY FAR BEHIND GOOD
ACTORS IN THE PRIVATE SECTOR,
SOME OF THE BIGGEST, MOST ICONIC
GLOBAL CORPORATIONS LIKE COKE
AND PEPSI, HAVE SAID. THIS STUFF
IS REALLY DANGEROUS, AND WE'RE
NOT GOING TO PUT IT IN OUR
PRODUCTS BECAUSE WE WANT
CONSUMERS TO HAVE CONFIDENCE
THAT WHAT THEY ARE WHAT THEY ARE
EATING AND DRINKING IS SAFE. SO
UM, I THINK THAT THE SCIENCE IS
AGAIN IN THE STATE OF CALIFORNIA
HAS LOOKED AT THIS REACHED THE
SAME CONCLUSION. WE DID OUR OWN
INDEPENDENT ANALYSIS AGAIN. LOOK
AT PAGE NINE OF THE OF THE
COMMITTEE ANALYSIS, YOU'LL SEE
THAT THE STATE OF CALIFORNIA
EXTENSIVELY REVIEWED ALL OF THE
SCIENCE OUT THERE, AND I THINK
THAT'S THE YOU KNOW THAT THAT TO
ME GIVES ME A LOT OF CONFIDENCE
THAT WE'RE FAR BEHIND. THE OTHER
POINT I MAKE TO YOU IS WHICH
SIDE DO WE WANT TO AIR ON? RIGHT
DO WE WANT TO AIR ON, YOU KNOW,
MOVING TIMIDLY TO PROTECT KIDS
AND TO PROTECT CONSUMERS IN THE
STATE OF CALIFORNIA, OR DO WE
WANT TO TRY TO BRING OURSELVES
UP TO WHERE THE REST OF THE
WORLD IS THAT ON ALL OF THIS,
AND I THINK MY I'VE ALWAYS
MAINTAINED. WE DON'T LOVE OUR
KIDS IN THE STATE OF CALIFORNIA
ANY LESS THAN THEY DO AND ALL
THESE OTHER COUNTRIES AND RIGHT
NOW WE'RE FAILING THEM. AND SO I
WOULD RATHER SPEED UP COME UP TO
WHERE THE REST OF THE WORLD IS
COME UP TO OUR SO MANY
RESPONSIBLE ACTORS IN THE
PRIVATE SECTOR R AND MAKE SURE
THAT WE'RE DOING EVERYTHING WE
NEED TO PROTECT OUR KIDS. I
THINK WE CERTAINLY HAVE TO DO
EVERYTHING WE CAN TO PROTECT OUR
KIDS. I I'M JUST TRYING TO
FOLLOW THE SCIENCE AND I THINK
THIS IS SOMETHING THAT HAS SAID
A LOT UP HERE AND IN THE
LEGISLATURE. AND SO THIS IS IF
THE QUESTION IF THE IF THE
REASON FOR THIS LEGISLATION IS
TO PREEMPT AN OUTCOME THEN THEN
WE'LL SAY IT AND BE TRANSPARENT
ABOUT IT. IF IT IS TO WAIT IF WE
WANT TO, I GUESS MAKE A DECISION
WITH WE ALL MAKE DECISIONS AND
IMPERFECT INFORMATION, RIGHT?
AND SO IF THERE IS GOING TO BE
ADDITIONAL DATA IN ADDITIONAL
SCIENCE, I GUESS PROVIDED BY THE
FDA. UM YOU KNOW, AND WE AND
EVERYONE CAN COME TO A
CONCLUSION WHETHER THEY TRUST
THE FDA OR NOT IN THIS SPACE AND
ACCEPT A REPORT AND INPUT FROM
THE CAVERN PUBLIC DEPARTMENT OF
PUBLIC HEALTH, WHICH IS IN THE
MIDST OF DOING THIS REVIEW IF
THERE IS A TWO REVIEWS ONGOING
FOR ME. IT SEEMS TO ME THAT WELL
AS LEGISLATORS. WE MAY WANT TO
LOOK AT THAT NEW DATA THAT'S THE
MOST UP TO DATE IN ADDITION TO
ON TOP OF EVERYTHING THAT'S BEEN
DONE AND LOOK AT THAT AND SAY IF
THEY COME TO A CONCLUSION, YEAH
OR NAY, THEN WE ACT ACCORDINGLY
ON THAT. I'LL JUST I'LL JUST ADD
. I UNDERSTAND WHAT YOU'RE
SAYING. I MEAN, I'LL JUST ADD
THE CALIFORNIA'S ONLY ALREADY
DONE ITS REVIEW. RIGHT AND
THAT'S IF YOU LOOK AT PAGE NINE
OF THE ANALYSIS, YOU'LL SEE THAT
RIGHT, SO THERE'S NOT. THERE IS
AN ADDITIONAL PETITION IN
PROCESS ON SOMETHING ELSE, BUT
CALIFORNIA NO, THIS IS ALREADY
THIS HAS ALREADY BEEN REVIEWED
IN THE STATE OF CALIFORNIA STATE
HAS MADE A VERY FIRM CONCLUSION
. THEY DIDN'T JUST LOOK AT THEY
DIDN'T DO. IN ONE STUDY. THEY
LOOKED AT A VARIETY OF STUDIES
OUT THERE. BASED ON ALL OF THAT
SCIENTIFIC RESEARCH CAME TO A
FIRM CONCLUSION. THERE'S A
PETITION ON ONE OF THESE
CHEMICALS AT THE FDA THAT MAY OR
MAY NOT PROMPT ANY TYPE OF
ACTION, SO I THINK I MEAN, I
THINK SOME OF THIS IS JUST AN
ATTEMPT TO DISTRACT AND SLOW
THIS DOWN, BUT THIS IS NOT. IT'S
NOT LIKE THE FDA SITTING DOWN
LOOKING AT THESE FIVE CHEMICALS
RIGHT NOW, AND IN THE NEXT
COUPLE OF WEEKS, WE'RE GOING TO
GET SOME DETERMINATION. THAT IS
ABSOLUTELY NO. I'M NOT SAYING
THAT I AND I AND I I'VE ALMOST
RESPECT FOR YOU AND YOU AND YOU
AND I, YOU KNOW OUR HAVE A GREAT
WORKING RELATIONSHIP. THAT'S WHY
I'M JUST TRYING TO GET
UNDERSTANDING IS IF THERE IS
GOING TO BE ADDITIONAL
FORMATION, PROVIDED AND I THINK
THAT'S THE POINT EVERY EVERY
THERE'S FIVE OF THEM THESE FIVE
SPECIFIC SUBSTANCES, AND SO EACH
ONE HAS ITS OWN, YOU KNOW,
SCIENTIFIC. UM UM, COMPONENT AND
SO YOU KNOW, SO IF, AS THE ONE
OF THE SPEAKERS HAVE SAID, SO,
THE EU ALLOWS ONE AND DOESN'T
ALLOW THE OTHER AND SO WE ARE.
I'M NOT TRYING TO PICK AND
CHOOSE. I'M JUST TRYING TO
UNDERSTAND. LIKE WHERE YOU KNOW
WHERE THE CONSENSUS IS. 100% AND
I AND I VERY MUCH APPRECIATE
YOUR THOUGHTFUL APPROACH TO THIS
AND TO SO MANY OTHER ISSUES. TO
BE CLEAR. I THINK JUST TO
CLARIFY WHAT THE SPEAKER SAID.
RED DYE THREE IS ALLOWED IN ONE
FOOD PRODUCT IN EUROPE, WHICH IS
COCKTAIL CHERRIES, RIGHT? UM SO
IT IS. IT IS. IT IS NOT ACCURATE
TO SAY THAT IT IS NOT BANNED IN
EUROPE AND AGAIN. IT'S BEEN
BANNED IN COSMETICS IN THE U. S.
SINCE 1990 RIGHT, THE FDA HAS
LOOKED AT THE SCIENCE SAID.
THERE'S SO MUCH CONCERN ABOUT
CANCER. YOU CAN'T EVEN PUT THIS
STUFF ON YOUR FACE. AND YET, FOR
SOME REASON, IT'S STILL IN ALL
THESE FOODS THAT WE AND OUR KIDS
ARE EATING. SO I THINK THE
SCIENTIFIC QUESTIONS BECAUSE AND
YOU LOOK AT SORT OF THE
CONSENSUS OF THE REST OF THE
WORLD WHICH I SHOWED YOU IT'S
NOT JUST THE 27 COUNTRIES IN THE
EU. IT'S A LOT OF OTHER
JURISDICTIONS ON A LOT OF THESE
OTHER CHEMICALS. WE CHOSE THESE
FIVE ORIGINALLY WE LOOKED, YOU
KNOW WE WERE CONVERSATIONS WITH
OTHER CHEMICALS. I SAT ON ON
THESE FIVE BECAUSE THEY WERE THE
WORST OF THE WORST. THERE'S
REALLY STRONG SCIENCE LINKING
THEM TO HARMS AND REALLY
SIGNIFICANT HARMS, INCLUDING
CANCER AND BEHAVIOR AND
DEVELOPMENTAL ISSUES AND YOUNG
PEOPLE, AND BECAUSE FOR EACH OF
THEM THERE IN HIS EASY AND IN
MANY CASES CHEAPER ALTERNATIVE
TO MAKE THE SAME PRODUCT. I
THINK THE ANALYSIS DOESN'T A
BEAUTIFUL JOB OF POINTING OUT
THAT FOR EACH OF THESE CHEMICALS
, YOU CAN REPLACE THIS FOOD DYE
WITH SOMETHING NATURAL OR
SOMETHING SAFE. FOR CHEAPER AND
AGAIN THE REASON I THINK WHAT
JUST BLOWS APART THE OPPOSITION
ARGUMENTS HERE. YOU SEE, THEY
HAVE ALL OF THESE PRODUCTS IN
EUROPE. THEY HAVE THESE PRODUCTS
IN OTHER PLACES. THEY ENJOY THEM
SOME OF THE BIGGEST CORPORATIONS
AGAIN. DUNKIN DONUTS, PANERA
PAPA JOHN'S. ALL OF THESE
COMPANIES HAVE BEEN ABLE TO
SUCCESSFULLY STAY IN BUSINESS
PROVIDE CONSUMERS WITH FOOD THAT
THEY LOVE. THEY JUST TOOK THE
TOXIC POISONOUS INGREDIENTS OUT
. AND I THINK THAT SEEING THIS
THIS BODY OF EVIDENCE THERE I
THINK SHOULD GIVE US A LOT OF
COMFORT. NOT THAT WE'RE AHEAD OF
THE GAME HERE AND AHEAD OF THE
SCIENCE. WE'RE ACTUALLY WAY
BEHIND. AND THIS IS JUST TRYING
TO BRING US UP TO PARITY WITH
THE REST OF THE WORLD AND,
FRANKLY WITH THE RESPONSIBLE
ACTORS IN THE PRIVATE SECTOR, I
DON'T HAVE TO ANSWER THIS
QUESTION. THAT WAS MY LAST
QUESTION. BUT WHY ALLOW IT AND
CHERRIES ARE NOT ANYTHING ELSE?
CURIOSITY WELL, AS I NOTED, IT'S
ALSO A LOT IN COSMETICS,
PHARMACEUTICALS AND TOOTHPASTE
IN THE EU, SO IT'S NOT JUST
CHERRIES. SO YOU KNOW, WE MAY
NOT ALLOW IT IN COSMETICS IN THE
U. S. BUT THE EU DOES SO AGAIN.
THEIR SYSTEMS ARE DIFFERENT. WE
LOOK AT DIFFERENT THINGS FOR THE
EU FOR THEM TO APPROVE A COLOR
THEY CONSIDER ITS USE. THEY
CONSIDER WHERE IT PROVIDES A
SPECIFIC TECHNICAL ADVANTAGE TO
AN ALTERNATIVE. SO IN THE CASE
OF THE EU, THEY HAVE OTHER RED
OPTIONS THAT THE U. S. DOES NOT
HAVE BOTH NATURAL AND SYNTHETIC,
NOT JUST NATURAL. THAT MAY
PROVIDE A TECHNICAL ADVANTAGE.
AND THOSE ARE THE COLORS THAT
THEY USE THAT YOU HAS DECIDED
FOR WHATEVER REASON THAT THE U.
S HASN'T THAT THOSE ARE OKAY AND
THAT'S WHAT THEY USE IN CANDY OR
WHATNOT. SO IT'S NOT QUITE SO
SIMPLE. THANK YOU. THIS IS NOT
VERY SIMPLE, SO I'LL RESERVE
I'LL RESERVE IT FOR THE REST OF
MY QUESTIONS JUST ON THE ON A
PRIVATE LEVEL WITH THE MEMBER,
BUT I'LL DEFER THE REST OF MY
TIME TO MY COLLEAGUES. THANK
YOU. UM MAY I ACTUALLY EXPLAINED
THAT? WHY? THAT YOU DIDN'T BAN
RED THREE FROM CHERRIES? SO UM,
BASICALLY IN THE EU SCIENTIFIC
PANELS ESTABLISHED A SAFE DAILY
INTAKE AMOUNT AT 0.1 MG PER
KILOGRAM OF BODY WEIGHT PER DAY
. THAT'S WHAT THE 2011 OPINION
REFERS TO. IT DOESN'T SAY THAT
RED THREE IS ABSOLUTELY SAFE. IT
SAYS THAT THIS VERY SMALL LIMIT
THAT WE'VE HAD SINCE 1994 CAN
CONTINUE. UM AND SO, LIMITING
THE USE OF RED THREE TO ONLY
COCKTAIL CHERRIES WOULD
BASICALLY ALLOW THESE SPECIFIC
THIS ONE SPECIFIC FOOD TO
CONTINUE USING THE DIE WHILE
KEEPING EXPOSURE LOW AND I WAS
SAFE LEVEL. UM BUT WHAT I WANT
TO EMPHASIZE IS THAT, UM THE
STUDY RELEASED BY THE CALIFORNIA
OFFICE OF ENVIRONMENTAL HEALTH
HAZARD ASSESSMENT IN 2021 THAT
ASSESSED THE CONSUMPTION AND
DANGERS OF SYNTHETIC DYES
ESTIMATED THAT THE HIGHEST
CONSUMERS OF RED THREE DIE
SPECIFICALLY EASILY EXCEED THIS
LIMIT. UM THAT'S ONE THING WHERE
WE KNOW THAT THE ASSUMED
CONSUMPTION LEVELS FOR THE
PEOPLE IN THE US WHO CONSUMED
THE MOST READ THREE ACTUALLY
EXCEED THE SAFE LIMITS THAT ARE
ALLOWED IN THE EU. AND THE
SECOND THING IS THAT THE EU
LIMIT IS BASED SOLELY ON THE
POTENTIAL OF RED THREE TO CAUSE
CARCINOGENIC EFFECTS. WHAT THE
STUDY FROM COW LOHIA TWO YEARS
AGO STUDIED WAS ITS POTENTIAL TO
CAUSE NEURO BEHAVIORAL EFFECTS
IN CHILDREN. AND SO THAT
INFORMATION IS NOT INCLUDED IN
THE ASSESSMENT. UM, FROM THE YOU
THAT RE FROM THIS VERY SMALL
LIMIT OF RED THREE IN THIS ONE
FOOD JUST QUICK. DO YOU SAY
CAUSATION? SO THERE IS THERE'S
STUDIES THAT SAY IT'S CAUSATION
OR CORRELATION FOR THE HERO.
BEHAVIORAL EFFECTS? YES SO IF
YOU LOOK AT THE CALENDAR, HIS
STUDY THEY LOOKED AT BASICALLY
ALL SYNTHETIC DYES THAT ARE
APPROVED BY THE F D A FOR USING
FOOD IN THE US UM, AND THEY'VE
DONE ANIMAL STUDIES. OBVIOUSLY,
IT'S UNETHICAL TO TEST ON HUMAN
SUBJECTS. BUT THEY'VE DONE
ANIMAL STUDIES ESSENTIALLY A
SHOWING THAT THERE IS CAUSING
NATIONAL EFFECT ON YOUR
BEHAVIORAL OUTCOMES. OKAY THANK
YOU. THANK YOU TO DRINK A LOT OF
OLD FASHIONED WITH THOSE
COCKTAIL CHERRIES TO GET UP TO
THE UNSAFE AMOUNT. NO COMMENT ON
THAT. THERE WAS A ROGERS SO, DR
WEBBER. THANK YOU, UM
ASSEMBLYMEMBER'S FOR BRINGING
THIS BILL AND ENCOURAGING THIS
CONVERSATION. I WANTED TO, UM,
GO BACK TO WHAT OPPOSITION SAID,
BECAUSE I WAS VERY CONFUSED. SO
YOU'RE SAYING THAT RED DICE
THREE IS SAFE? IS THAT WHAT
YOU'RE SAYING? I'M SAYING
THERE'S NO EVIDENCE THAT IT'S
UNSAFE FOR USE IN FOODS AT THE
LEVELS THAT IT'S ALLOWED TO BE
USED. OKAY UM, BUT WE HAVE
DETERMINED THAT IT'S UNSAFE TO
PUT ON OUR SKIN. THE FDA MADE A
RULING IN 1990 IN WHICH IT SAID
THAT THEY HAD NO CONCERNS WITH
THE USE OF RED THREE IN HUMAN
HEALTH. IT WAS THE REASON THEY
DENIED THE PETITION. THAT'S WHAT
IT WAS. IT WAS A PETITION TO
ALLOW FOR ITS USE IN COSMETICS.
UM WAS BECAUSE OF A LEGAL
STANDARD, NOT A SCIENTIFIC
STANDARD. I COULD SPEND A LOT OF
TIME TALKING ABOUT IT, BUT I
DON'T KNOW THAT WE ALL WANT THE
HISTORY OF THE STANDARD FROM THE
19 SIXTIES. I'M HAPPY TO EXPLAIN
IT IF IT'S HELPFUL FOR EVERYONE
, BUT IT'S SOMETHING CALLED THE
DELANEY CLAUSE, AND IT JUST IT
WAS IMPLEMENTED IN THE COLOR OUT
OF AMENDMENTS IN 1960. IT
INDICATES THAT IF EVEN ONE
MOLECULE OF A SUBSTANCE WAS
FOUND TO CAUSE CANCER AND ANY
RODENT OR STUDYING HUMAN STUDY
THAT IT CANNOT BE APPROVED FOR
USE. AND FOOD AND THAT'S A
ALMOST IMPOSSIBLE SAFETY
STANDARD TO ADHERE TO FOR ANY
FOOD OR COLOR ADDITIVE. UM AND
SO THERE WAS A STUDY THAT HAD
COME HAD JUST BEEN COMPLETED IN
RODENTS WHERE DIETARY
CONCENTRATIONS THAT WERE HIGHER
THAN HUMAN WHATEVER CONSUME
PRODUCED INCIDENCES OF TUMORS,
AND THAT'S WHY THEY DENIED THE
PETITION. BUT THEY SAID IN THE
SAME DENIAL THAT THEY HAD NO
CONCERNS FOR ITS USE IN HUMAN
HEALTH, AND THAT SEEMS STUDY HAS
BEEN LOOKED AT BY EUROPE BY JACK
FA AND THEY'VE DECIDED THAT IT'S
NOT RELEVANT FOR MAKING A SAFETY
DETERMINATION ON RED THREE. I'M
SORRY. SO YOU JUST TOLD ME THAT
THE RODENTS DEVELOPED TUMORS E
CANCER. YES. OH, OKAY. UM SO I
THINK THAT THANK YOU VERY MUCH
FOR ANSWERING THAT QUESTION. UM
I THINK ONE OF THE OTHER THINGS
THAT I'VE NOTICED JUST FROM
LISTENING AND READING THROUGH
THE ANALYSIS AND UM YOU KNOW HOW
YOU POINTED OUT THAT THERE ARE
CERTAIN ENTITIES THAT NO LONGER
USE. THESE SUPPLIES ARE LIMITED
, SUCH AS WHOLE FOODS, AND, UM,
TRADER JOE'S AND PANERA, UM WHAT
STRUCK ME WAS I DON'T KNOW HOW
MANY INNER CITIES HAVE. WHOLE
FOODS TRADER JOE'S. PANERA. OR
CHIPOTLE. SO TO ME, THIS IS NOT
ONLY A HEALTH ISSUE, BUT IT'S A
SOCIAL JUSTICE AND EQUITY THING.
WHERE ONCE AGAIN THOSE WHO HAVE
MORE. ARE ABLE TO PUT THEMSELVES
IN PLACES WHERE THEIR CHILDREN
AND THEMSELVES WILL NOT BE
EXPOSED TO THINGS THAT ARE
HARMFUL. AND THIS IS VERY
CONCERNING FOR ME. NOW WE HAVE,
AS WAS STATED BY, UH, SOMETHING
MY MOM MCCARTHY. WE HAVE, UM,
PRODUCTS THAT DON'T HAVE THESE,
UM HARMFUL. SUBSTANCES IN THEM
OR IF YOU WANT TO SAY
POTENTIALLY HARMFUL SUBSTANCES
IN THEM. AND THAT POTENTIAL IS
WHAT'S CONCERNING FOR ME AND THE
FACT THAT THERE IS AN INEQUITY
IN TERMS OF WHO HAS ACCESS TO
THOSE PRODUCTS THAT DON'T HAVE
IT VERSUS THOSE THAT DO BECAUSE
I CAN TELL YOU THERE'S A LOT OF
UM HMM. LOWER LEVEL SUPERMARKETS
AND MY DISTRICT. UM WHERE YOU
DON'T FIND A LOT OF TRADER JOE'S
AND WHOLE FOODS. AND SO. FOR ME,
I WOULD RATHER NOT AS A MOTHER
AS A PHYSICIAN. UM. AS SOMEONE
WHO COMES FROM A COMMUNITY THAT
HAS DEALT WITH LOTS OF
INEQUITIES HISTORICALLY. UH
WOULD RATHER MAKE SURE THAT WE
ALLOW THIS SAME PLAYING FIELD
FOR EVERYONE, REGARDLESS OF
WHERE THEY LIVE THEIR ZIP CODE
WHERE THEY LIVE IN A FOOD DESERT
. AH OR HAVE ACCESS TO THE MOST
, UM, EXPENSIVE, EXCLUSIVE.
BRANDS SO I THANK YOU FOR
BRINGING THIS UP. NOT ONLY, UH,
TO HELP UM. YOU KNOW SOME, BUT
TO REALLY MAKE SURE THAT
EVERYONE HAS ACCESS TO THESE
THESE HEALTHY INGREDIENTS. SO
THANK YOU. MR PATTERSON. THANK
YOU VERY MUCH. I JUST LIKE TO
NOTE THAT SKITTLES ARE ACTUALLY
MY FAVORITE CANDY AND I HAVE YET
TO TRY THE EUROPEAN VERSION AND
HOPEFULLY AT SOME POINT LOOK AT
THAT OPPORTUNITY. UM YOU KNOW, I
THINK REALLY WHAT? UH YOU KNOW,
I'M KIND OF CONFLICTED WITH HERE
IS YOU KNOW, I REMEMBER THOSE
COMMERCIALS. I DON'T KNOW IF IT
WAS WHEN I WAS A KID OR
SOMETHING. I DON'T KNOW. I
HAVEN'T WATCHED TV REALLY? FOR A
LONG TIME, BUT, YOU KNOW, KID
READING LIKE AN ICE CREAM BOX OR
SOMETHING, AND HE WAS ABLE TO
READ THE INGREDIENTS OF ONE
COMPANY AND THEN ANOTHER COMPANY
COULDN'T READ IT, AND IT WAS
KIND OF THAT WAS THEIR MARKETING
THING TO PARENTS, YOU KNOW,
LIKE, HEY, WE, YOU KNOW, ONLY
HALF CREAM AND, UM, CHOCOLATE IN
OUR, UM YOU KNOW, SO IT'S
DEFINITELY SOMETHING I THINK
PARENTS CARE ABOUT. YOU KNOW, I
KNOW I DO. UM BUT I ALSO KNOW
THAT I'M NOT A SCIENTISTS AND
YOU KNOW, I'M HEARING KIND OF
THE DEBATE HERE AND THE
DISCUSSION. UM YOU'VE RAISED A
LOT OF CONCERNS THAT I HAVE UM,
AND THEN ALSO, I KIND OF HEAR
THE YOU KNOW THE REASONS AND THE
BACK AND FORTH. AH AND I DON'T.
I MEAN, FRANKLY, I DON'T. I
DON'T THINK YOU KNOW PRODUCT
BANS WHEN THERE ARE PROCESSES TO
DO THIS. I MEAN, WE EITHER TRUST
THE PROCESS OR WE DON'T. MAYBE
WE DON'T. MAYBE WE DON'T TRUST
THE FDA. MAYBE WE DON'T. BUT YOU
KNOW, THAT'S THE SYSTEM WE HAVE.
MAYBE WE NEED REFORM THERE. BUT
I THINK YOU KNOW BANDS LIKE THIS
ON AN INDIVIDUAL, UM YOU KNOW
PRODUCTS AND I THINK THERE'LL BE
MORE COMING THROUGH. YOU KNOW,
IT'S VERY DIFFICULT BECAUSE I'M
NOT PERSONALLY EQUIPPED. I MEAN
, FRANKLY, TO, YOU KNOW, I CAN
READ THE ANALYSIS AND I, YOU
KNOW, OBVIOUSLY WE'VE CHATTED
ABOUT THIS BILL, AND YOU KNOW, I
REALLY APPRECIATE THAT. BUT YOU
KNOW, I'M JUST NOT EQUIPPED TO
MAKE THE DETERMINATION. YOU
KNOW, IT SOUNDS LIKE A 22
DIFFERENT ARGUMENTS THAT YOU
KNOW ARE BOTH VERY INTERESTING,
BUT THAT'S WHY WE HAVE THESE
PROCESSES THAT GO THROUGH AND
I'D BE HAPPY TO IF WE NEED TO
STRENGTHEN THAT PROCESS IN
CALIFORNIA. I THINK YOU KNOW
THAT'S A CONVERSATION THAT I'M
WILLING TO HAVE. BUT I'M NOT
PERSONALLY EQUIPPED TO SAY HEY,
WE SHOULD WE SHOULD BAN THESE
PRODUCTS. I'M OBVIOUSLY
INTERESTED IN THE REST OF THE
CONVERSATION. AND HOW THIS GOES
, YOU KNOW, BEFORE MAKING MY
VOTE, BUT THAT'S KIND OF THE
CONCERN. I HAVE SAID THANK YOU.
OTHER ANYONE ELSE HERE, MISS
WALDRON. JUST MAKE A QUICK
COMMENT, HAVING HEARD OF SOME OF
THE DISCUSSION, UM YEAH. I HAD
ALSO THOUGHT OF AS
ASSEMBLYMEMBER'S. WHEREVER HAD
MENTIONED THE DISPARITY ISSUE
WHEN IT CAME TO ESPECIALLY
HEALTH CARE IS A MOM AND JUST AS
A PERSON, I ALWAYS LOOK AT THE
INGREDIENTS AND THINGS AND YOU
KNOW IF I'M COMPARING THINGS,
AND THERE'S SYNTHETIC DYES OR
THINGS I WOULD NEVER GIVE THOSE
TO MY CHILD. IN FACT, HE HAD
ORGANIC HOMEMADE FOOD WHEN HE
WAS A BABY, SO UM, BUT I THINK
IT'S IMPORTANT THAT WE HAVE THIS
DISCUSSION AND MAYBE ISSUES WITH
THE IMPLEMENTATION TIMELINES AND
THINGS LIKE THAT. BUT I THINK
YOU KNOW, AS YOU SAID, THE REST
OF THE WORLD IS AHEAD OF US AND
A LOT OF WAYS AND WE SAW THAT
THE DOCTOR WOULD WHEN WE DEALT
WITH THE UNIVERSAL CARE
COMMITTEE. WE SAW HOW HOW HEALTH
CARE IN GENERAL AROUND THE WORLD
AS FAR EXCEEDING US AND A LOT OF
WAYS. SO ANYWAY, THANK YOU. I
JUST WANTED TO MAKE THAT
COMMENT. ANYONE ELSE? I JUST I
GUESS THAT JUST LEAVES ME. SO UM
, I WANT TO SAY THANK YOU, MR
GABRIEL FOR YOUR VERY THOROUGH
STUDY OF THIS ISSUE AND YOUR
COMMAND OF THE OF THE CONTENT AS
IMPRESSIVE AS WE WERE SITTING
HERE TALKING, UH, WITH MY CHIEF
CONSULTANT HERE. AH UM, ABOUT
THE FACT THAT IT WAS A COMMENT
BROUGHT UP ABOUT SHOULDN'T WE
WAIT FOR THE FDA AND NOTING THAT
THE FDA IS CURRENTLY ONLY
REVIEWING RED DYE NUMBER THREE.
THE OTHER FOUR CHEMICALS THAT
WE'RE TALKING ABOUT WHICH, AS I
HEARD ARE CONSIDERED TO BE TOXIC
CHEMICALS, UM, ARE NOT UNDER
REVIEW BY THE FDA CURRENTLY, UM
AND SO YOU KNOW, WE COULD WAIT
FOR WHO KNOWS HOW LONG FOR THE
FDA TO GET AROUND TO DECIDING
WHETHER OR NOT IT'S APPROPRIATE
TO HAVE TOXIC CHEMICALS IN FOOD
, BUT I WOULD ALSO NOTE THAT YOU
KNOW WE ARE WE IN CALIFORNIA DO
NOT TEND TO ALWAYS WAIT FOR THE
FDA. I'LL GO BACK TO AN ISSUE
THAT WAS RIGHT BEFORE YOU AROUND
FLAVORED TOBACCO. UH HUH. AND
MENTOR IN CIGARETTES, WHICH ARE
THERE TO ATTRACT YOUNG PEOPLE
WHO ARE CARCINOGENIC MATERIAL
THAT THAT WILL HAVE LIFETIME
TIME HEALTH EFFECTS ON THEM. SO
SO I APPLAUD YOU FOR BRINGING
THIS FORWARD. UM AND IT DOES
ENJOY DO PASS RECOMMENDATION. UM
I'M WITH THAT I'D LIKE TO GIVE
THE OPPORTUNITY CLOSE. YEAH
THANK YOU VERY MUCH, MR CHAIR
AND THANK YOU COLLEAGUES FOR THE
THOUGHTFUL QUESTIONS AND
DISCUSSIONS. I'LL JUST OFFER A
COUPLE OF OBSERVATIONS. I THINK
WE'VE SORT OF GOTTEN BOGGED DOWN
IN SOME OF THE DETAILS HERE, AND
I JUST WANT TO TAKE US BACK UP
TO A HIGHER LEVEL. UM AND
THINKING ABOUT SOME OF THE
COMMENTS THAT YOU MADE
ASSEMBLYMEMBER'S PATTERSON THERE
ARE OVER 3000 CHEMICALS THAT WE
PUT INTO OUR FOOD. WE ARE
FOCUSED ON FIVE OF THEM BECAUSE
THEY ARE THE WORST OF THE WORST.
I WOULD HOPE THAT THE REAL I
THINK THE REAL SOLUTION OF THIS
PROBLEM IS REFORM OF THE FDA
PROCESS. UNFORTUNATELY WE CAN'T
DO ANYTHING ABOUT THAT IN THE
STATE OF CALIFORNIA. THAT IS NOT
SOMETHING THAT'S WITHIN OUR
POWER. SO SEEING WHAT WE'VE
SEEN, IT WAS INTERESTING TO
HEARD FROM AN ATTORNEY WHO WHO
SPECIALIZES IN THIS AREA THAT
THEY SHOULD CHANGE THE NAME OF
THE FDA REALLY TO THE D A TO THE
DRUG ADMINISTRATION BECAUSE IT
IS REALLY ABDICATED
RESPONSIBILITY ON FOOD. BUT
AGAIN, THERE'S NOTHING THAT WE
CAN DO ABOUT THAT. SO THE ONLY
THING THAT WE CAN DO IN THE
ABSENCE OF MEANINGFUL FEDERAL
ACTION IS MAKE A DECISION ABOUT
WHAT'S UNDER OUR CONTROL HERE IN
THE STATE OF CALIFORNIA, AND I
THINK WHEN WE YOU KNOW, I HAVE
NOT HEARD THE INDUSTRY EVEN
DEFEND THREE OF THESE CHEMICALS.
MAYBE FOUR. I KNOW THEY'VE MADE
A FEW NITPICKS HERE ON ON SOME
STUDIES AROUND SOME OF THE DIES,
BUT FOR SOME OF THESE CHEMICALS,
THEY HAVEN'T EVEN MADE AN
ARGUMENT THAT THEY'RE SAFE. AND
YOU HEARD WHEN ASKED DIRECTLY IS
THE SAFE. THEY WON'T EVEN SAY
YES, BECAUSE THEY CAN'T SAY YES.
SO I THINK IF YOU JUST LOOK AT
THE BODY OF EVIDENCE, WHICH IS
NOT JUST THE 27 NATIONS IN THE
EUROPEAN UNION, BUT SO MANY
OTHER NATIONS, INDIA AND CHINA
AND THE U. K AND CANADA AND
JAPAN AND SO MANY OTHERS THAT
ARE AHEAD OF US ON BANNING THESE
CHEMICALS WHEN YOU LOOK AT ALL
OF THE RESPONSIBLE ACTORS IN THE
PRIVATE SECTOR SECTOR BRAND NAME
ICONIC GLOBAL CORPORATIONS, COKE
AND PEPSI MOVED AWAY FROM B VÚI
INTO 1014. WE ARE. THIS IS NOT
SOMETHING THAT IS AHEAD OF THE
SCIENCE. THIS IS NOT SOMETHING
WHERE WE'RE GOING TO BE AHEAD OF
THE GAME. I ACTUALLY THINK WE'RE
JUST RUSHING TO PLAY CATCH UP SO
THAT OUR KIDS HERE IN AMERICA
AND IN THIS, PARTICULARLY IN THE
STATE OF CALIFORNIA WILL BE AS
SAFE AS KIDS AND THE REST OF THE
GLOBE. SO I THINK IF WE'RE GOING
TO AIR ONE WAY OR THE OTHER AS A
PARENT, AND AS A LAWMAKER, I
WOULD ALWAYS AIR ON THE SIDE OF
TRYING TO PROTECT OUR KIDS,
ESPECIALLY ESPECIALLY WHEN THERE
ARE READILY AVAILABLE
ALTERNATIVES FOR ALL OF THESE.
WE KNOW THAT NO PRODUCTS ARE
GOING TO COME OFF THE SHELF. WE
KNOW THAT THERE'S REALLY NO HARM
TO THE INDUSTRY. IN THAT CASE,
AND ON BEHALF OF OUR CHILDREN
WOULD RESPECTFULLY REQUEST YOUR
I VOTE. THANK YOU VERY MUCH. UM
I'M I THINK THERE WAS A MOTION
BY MR MCCARTY. BUT I DIDN'T HEAR
US. A SECOND BY MS AGUIAR-CURRY.
THE MOTION IS DUE PASS TO
ENVIRONMENTAL SAFETY AND TOXIC
MATERIALS. MADAM SECRETARY
PLEASE CALL THE ROLL. WOULD
WOULD I, WALDRON, WALDRON, IAGAR
CURRY CURRY. I ARAMBULA.
ARAMBULA. I'M BOERNER HORVATH.
CARILLO. FLORA. VINCE FONG.
MAIENSCHEIN. MAIENSCHEIN I
MCCARTY MCCARTHY I JOE
PATTERSON. PATERSON, NOT VOTING
RODRIGUEZ. RODRIGUEZ? AYE.
SANTIAGO. VALLAPUDUA VALLAPUDUA.
AYE, WEBER. WEBER. AYE. YOU HAVE
NINE VOTES. YOUR BILL IS OUT. WE
WILL LEAVE THE ROYAL OPEN FOR
OTHERS TO ADD ON. THANK YOU VERY
MUCH. HE SAID THAT THE REQUEST
WAS TO LEAVE THE SKITTLES.
ALRIGHT? NO, APPARENTLY
APPARENTLY. APPARENTLY THAT HAS
FALLEN ON DEAF EARS. SO WELL, IT
WAS A NICE TRY, THOUGH. FOR
THAT. MR GIBSON. AT THIS HOUR.
DO YOU BRING ANY TASTY TREATS
WITH YOU OR OKAY. ALL RIGHT.
THANK YOU. MOTION IN A SECOND.
THANK YOU. MR CHAIRMAN AND
MEMBERS VICE CHAIR. THANK YOU
VERY MUCH FOR ALLOWING ME TO
PRESENT ASSEMBLY BILL 767, WHICH
AIMS TO CONTINUE AUTHORIZING
LOCAL EMERGENCY MEDICAL SERVICE
AGENCIES TO DEVELOP PROGRAMS
THAT PROVIDES COMMUNITY PARA
MEDICINE SERVICES. COMMUNITY
PARA MEDICINE SERVICES ALLOW
SPECIFICALLY TRAINED PARAMEDICS
TO PERFORM DUTIES OUTSIDE OF
THEIR TRADITIONAL ROLE TO
ENHANCE, UM AND ACCESS. CARE UM
, LET ME JUST TURN IT OVER TO
APPRECIATE THE THIS BILL BEING
MOVED BY MY COLLEAGUES. I WANT
TO INTRODUCE A REPRESENTATIVE
WHO WAS SELF INTRODUCED
REPRESENTATIVE CALIFORNIA
PROFESSIONAL FIREFIGHTERS AND
ALSO THE CALIFORNIA EMERGENCY
PHYSICIANS TO NOT ONLY SELF
INTRODUCED WITH SPEAKING SUPPORT
OF THIS BILL. THANK YOU, MR
CHAIR MEMBERS, TIM MADDEN,
REPRESENTING THE CALIFORNIA
CHAPTER. THE AMERICAN CALLS AN
EMERGENCY OFFICIALS WERE ONE OF
THE CO SPONSORS, AND WE JUST
WANT TO THANK MR GIBSON FOR HIS
CONTINUED SUPPORT AROUND THE
IDEA OF COMMUNITY PARAMEDICS AND
AS WE SEE EMERGENCY DEPARTMENTS
WITH OVERCROWDING LEVELS NEVER
SEEN BEFORE. THE TIME IS NOW TO
LOOK AT DIFFERENT WAYS TO LOOK
AT THE HEALTH CARE SYSTEM,
PARTICULARLY THE EMERGENCY
MEDICAL SERVICES SYSTEM. TO TRY
AND GET SOME RELIEF THERE. WE
ARE ENCOURAGED BY SOME OF THINGS
WE'RE SEEING IN THESE PROGRAMS.
I'M SO EXCITED TO SEE THIS BILL
EXTEND THAT AND ALSO INCLUDE THE
POST DISCHARGE FOLLOW UP CARE
PROGRAM, WHICH SHOWED SOME SIGNS
OF GOOD RESULTS WITH THAT
ALTERNATE OVER TO MY COLLEAGUE.
DOUG AND HAVE HIM TALK ABOUT,
THOUGH. THANK YOU, MR CHAIR AND
MEMBERS. DOUG SUPERS ON BEHALF
OF THE CALIFORNIA PROFESSIONAL
FIREFIGHTERS REPRESENTING MORE
THAN 34,000, PROFESSIONAL
FIREFIGHTERS AND EMERGENCY
MEDICAL SERVICES PERSONNEL
STATEWIDE. WE I WOULD ECHO THE
COMMENTS OF MR GIBSON AND MR
MADDEN. WE WOULD APPLAUD
ASSEMBLYMEMBER'S GIBSON'S
ONGOING LEADERSHIP ON THIS ISSUE
. UM THE BILL DOES EXTEND THE
SUNSET, SO WE CONTINUE TO SEE
THE BENEFITS OF THESE PROGRAMS
THAT WILL BE STUDIED AS THEY GO
ALONG. AND WE'RE GOING WITH
REGARD TO AUTHORIZATION OF POST
DISCHARGE. FOLLOW UP. THIS IS,
UH, COMMUNITY PARAMEDIC,
FOLLOWING UP WITHIN A SHORT
PERIOD OF TIME AFTER SOMEONE IS
DISCHARGED FROM THE HOSPITAL
WITH A CHRONIC CONDITION,
ENSURING THEY UNDERSTAND THEIR
DISCHARGE ORDERS AND
UNDERSTANDING THEIR MEDICATION.
IT IS NOT IN LIEU OF HOME HEALTH
OR ANY OTHER SERVICES. IT IS
REALLY TO TRY TO PROVIDE A GAP
IN COMMUNITY. CARE WHICH ALL OF
THESE SPECIALTIES DO FOR THOSE
REASONS. WE RESPECTFULLY REQUEST
YOUR VOTE. THANK YOU. THANK YOU
VERY MUCH OTHERS IN SUPPORT. HI
DERBY. KERNAN ON BEHALF OF
LEADING AGE, CALIFORNIA IN
SUPPORT. GOOD EVENING, CONNY
DELGADO ON BEHALF OF THE
CALIFORNIA EMERGENCY NURSES
ASSOCIATION AND SUPPORT. ALEXIS
RODRIGUEZ WITH THE CALIFORNIA
MEDICAL ASSOCIATION AND SUPPORT
ANYONE ELSE? SO YOU KNOW, ONE IS
THEIR OPPOSITION TO THE BILL.
SEE NO ONE WILL BRING IT BACK TO
THE COMMITTEE OF QUESTIONS OR
COMMENTS FROM THE COMMITTEE. MR
RODRIGUEZ JUST WANT TO THANK
SOME REMEMBER GIBSON FOR A
REALLY WORKING ON THIS ISSUE FOR
THE LAST COUPLE OF YEARS. IT
REALLY IS A BIG BENEFIT. AS WE
LOOK TO DO SOME CHANGES IN THE
WAY WE PROVIDE EMERGENCY CARE
AND SERVICES OUT THERE IN THE
STREETS. ONE THING COMES TO MIND
THINKING YOUR BILL. WHAT YOU'RE
DOING IS THERE'S BEEN SEVERAL
TIMES AND I WAS WORKING IN THE
FIELD THAT WE WOULD GET
RESPONDED TO PATIENTS HOME
ADDRESSES THAT WERE DISCHARGED
THEIR TWO EARLIER AND GUESS WHAT
? THEY HAD SOME ISSUES CALLING
911 AND HERE WE GO ACTIVATING
THE SYSTEM. WHEN IF THEY HAD
SOMETHING LIKE THIS IN PLACE
COULD DO THE FOLLOW UP CARATS SO
THEY DON'T HAVE TO PUT A BURDEN
ON THE 911 SYSTEM. I KNOW WE HAD
A BILL A BIT EARLIER REGARDING
RESPONSE TIMES OF AMBULANCES AND
THIS IS JUST I THINK ONE
COMPONENT OF HOW WE CAN
ALLEVIATE THOSE ISSUES BY
PROVIDING THE SERVICES. I WANT
TO THANK YOU, AND ALSO THE
SPONSOR OF BRINGING THIS BILL
FORWARD AND EXTENDING IN IT. AND
LOOKING AT IT MORE IN DEPTH AS
WELL. THANK YOU. THANK YOU
ANYONE ELSE? YOU KNOW, ONE THAT
YOUR BILL DOES ENJOY A DO PASS
RECOMMENDATION. WE HAVE EMOTION
BY DR ARAMBULA. SECOND BY MR
RODRIGUEZ. WOULD YOU LIKE TO
CLOSE, MR GIBSON? I RESPECTFULLY
ASK WHEN I VOTE AND THANK THE
COMMITTEE. THANK YOU VERY MUCH.
THE MOTION IS DUE PASS TO
APPROPRIATIONS. MADAM SECRETARY.
PLEASE CALL THE ROLL. WOULD
WOULD I? WALDRON WALDRON,
NIAGARA QUERY. THANK YOUR
CAREER. I ARAMBULA ARAMBULA. I'M
BOERNER HORVATH. CARILLO. FLORA.
WANG. MAIENSCHEIN MCCARTHY.
MCCARTHY I, JOE PATTERSON.
RODRIGUEZ RODRIGUEZ, I SANTIAGO
VALLAPUDUA HOWEVER. HOWEVER, I.
SO YOU BILL HAS SEVEN VOTES.
WE'LL LEAVE IT ON CALL. WE'VE
GOT SOME PEOPLE MISSING. THANK
YOU. FAMILY MEMBER IRWIN.
SO YOU HAVE TWO BILLS BEFORE US.
LET'S START WITH A B 9 31.
MICROPHONE, PLEASE. GOOD EVENING
, MR CHAIR AND MEMBERS. I'M
PLEASED TO PRESENT A B 931 TODAY
AS A PATIENT LOOKS TO GET
PHYSICAL THERAPY TREATMENT
THERE. DOCTOR HAS PRESCRIBED A
FREQUENT BARRIER THEY RUN INTO
FROM THE INSURERS A DELAY IN
PRIOR AUTHORIZATION SURVEY
PERFORMED BY THE AMERICAN
PHYSICAL THERAPY ASSOCIATION SAW
THAT NEARLY 75% OF PHYSICAL
THERAPISTS THEY SURVEYED WAITED
AT LEAST THREE DAYS PER PRIOR.
AUTHORIZATION A PRIOR
AUTHORIZATION DECISION FROM THE
INSURER. OVER 25% OF THE PTS
REGULARLY WEIGHT OVER A WEEK FOR
PRIOR AUTHORIZATION DECISIONS.
THESE DELAYS CAN LEAVE PATIENTS
SUFFERING FROM PAIN AND REDUCED
MOBILITY WHILE THEY WAIT FOR
THEIR INSURER TO GRANT THEM THE
CARE THAT THEY NEED TO FIND.
RELIEF PATIENTS IN CHRONIC PAIN
OFTEN ARE FORCED TO CONTINUE THE
USE OF PAINKILLERS AS THEY WAIT
FOR PRIOR AUTHORIZATION. OTHER
PATIENTS MAY GIVE UP ON THEIR
COURSE OF CARE ENTIRELY. 89 31
WOULD AVOID THESE NEGATIVE
OUTCOMES BY OR PATIENTS BY
MANDATING THAT INSURERS MAY NOT
REQUIRE PRIOR AUTHORIZATION FOR
THE 1ST 12 PHYSICAL THERAPY
VISITS RELATED TO A NEW EPISODE
OF CARE IN DOING SO, THIS BILL
PREVENTS THE RESTRICTIONS
CREATED BY THE DENIAL OF CARE
AND UNNECESSARY REVIEWS FOR
MEDICALLY NECESSARY PHYSICAL
THERAPY TREATMENT. I WOULD LIKE
TO EXPRESS MY APPRECIATION TO
THE OPPOSITION FOR ENGAGING IN
PRODUCTIVE CONVERSATIONS WITH MY
STAFF. UM WHILE WE WORK ON THIS
BILL, AND WITH ME TODAY TO SPEAK
IN SUPPORT IS DR RICK KATZ,
PRESIDENT OF THE CALIFORNIA
PHYSICAL THERAPY ASSOCIATION.
THANK YOU VERY MUCH. MY NAME IS
RICK KATZ. I'M A DOCTOR.
PHYSICAL THERAPY, AND I'M THE
PRESIDENT OF THE CALIFORNIA
PHYSICAL THERAPY ASSOCIATION. WE
REPRESENT OVER 10,000 PHYSICAL
THERAPIST, PHYSICAL THERAPIST,
ASSISTANTS AND STUDENTS IN THE
STATE OF CALIFORNIA. AND AS
ASSEMBLYMEMBER'S IRWIN STATED,
89 31 WILL IMPROVE ACCESS AND
REDUCE DELAYS IN CARE TO
PATIENTS RECEIVING PHYSICAL
THERAPY. IN RECENT YEARS, WE'VE
SEEN INCREASES IN HEALTH CARE
REVIEW DECISIONS DONE A LOT BY
COMPUTER ALGORITHMS THAT DO NOT
PROPERLY RECOGNIZED THE TRAINING
AND OPINION OF THE PHYSICIANS.
AND PHYSICAL THERAPIST TO ASSESS
THE NEEDS OR THE FREQUENCY AND
DURATION OF CARE BASED UPON
THEIR INITIAL EVALUATIONS. IN
FACT, THE DATA REVIEW FROM ABOUT
1.2 MILLION CASES FROM THE
NATION'S LARGEST ELECTRONIC
MEDICAL RECORDS PROVIDER FOR
PHYSICAL THERAPY SHOWS THAT A
STANDARD APPROVAL OF VISITS WAS
ABOUT 3.8 VISITS WHEN DONE BY A
COMPUTER ALGORITHM AND EXCEEDED
OVER 10 WHEN REVIEW IS DONE BY
AN ACTUAL INDIVIDUAL, THE
OPPOSITION TO THIS BILL STATES
THAT IS NECESSARY FOR THE
INSURERS TO BE INVOLVED VERY
EARLY IN THE AUTHORIZATION
PROCESS. THEY'RE ESSENTIALLY
STATING THAT THE INSURER NEEDS
TO ESTABLISH MEDICAL NECESSITY
BECAUSE A PHYSICIAN AND PHYSICAL
THERAPISTS ARE UNABLE TO MAKE
THAT DECISION ON THEIR OWN.
PATIENT WHO HAS DEFINED PHYSICAL
THERAPY BENEFIT, AND THE OPINION
OF MULTIPLE HEALTHCARE
PROFESSIONALS SHOULD NOT BE
DENIED CARE OR HAVE CARE DELAYED
AT INTERVALS BASED UPON COMPUTER
ALGORITHMS. THIS BILL WILL NOT
LIMIT AND ENSURES ABILITY TO
PERFORM RETROSPECTIVE REVIEWS OR
TO REMOVE A PROVIDER THAT HAS A
PATTERN OF OVER UTILIZATION.
THIS BILL ALSO ALLOWS CARE TO BE
LIVERED WITHOUT UNNECESSARY
DELAYS. PUBLISHED STUDIES IN
MUSCULOSKELETAL MEDICINE SHOW
THAT COSTS CAN BE AS MUCH AS 75%
HIGHER ACCESS TO PHYSICAL
THERAPY IS DELAYED, AND THESE
ADDED COSTS ARE ATTRIBUTED TO
INCREASED OPIOID USE AS AN
ALTERNATIVE DIED, DIAGNOSTIC
TESTS AND SURGERY OR THE PATIENT
JUST STOPS COMING BECAUSE
THEY'RE FRUSTRATED WITH THE
WEIGHT AND DELAYS. ATTEMPTED
ROLL OUT OF ONE OF THESE
RESTRICTIVE UTILIZATION
MANAGEMENT PROGRAMS A COUPLE
YEARS AGO FROM PT IN CALIFORNIA
RESULTED IN 51 COMPLAINTS TO THE
DEPARTMENT OF MANAGED HEALTH
CARE BEFORE THE INSURER HAD
ACTUALLY PULLED BACK ON THE
PROGRAM AND REVISE IT. THIS
OCCURRED WITHIN A SHORT PERIOD
OF TWO WEEKS, AND DESPITE THAT
THEY STILL PLAN TO RE IMPLEMENT
THE PROGRAM AGAIN LATER THIS
YEAR, AND THAT PROGRAM IS
FRAUGHT WITH ISSUES AND OTHER
STATES RIGHT NOW. THE CALIFORNIA
PIZZA ASSOCIATION HAS ENGAGED
THE DEPARTMENT OF MANAGED HEALTH
CARE TO HELP ADDRESS THE ISSUE
THAT EXISTS WITH DELAYED ACCESS
AND DELAYED REAUTHORIZATION. BUT
THEIR ABILITIES ARE REALLY
LIMITED BASED UPON CURRENT LAW.
THE BILL DIMINISHES THE NEED FOR
A PATIENT TO ACTUALLY FILE A
COMPLAINT IN ORDER TO ACCESS
CARE THAT THEY'RE MEDICALLY
ENTITLED TO THEIR BENEFIT PLAN.
SO I URGE YOU TO SUPPORT 9 31.
AND WE THANK YOU SO MUCH.
REMEMBER IRWIN OR THANK YOU.
JUST ONE? YEAH, THAT'S THE ONE
WITNESS. OKAY GREAT OTHERS IN
SUPPORT OF THE BILL. I'M STEVE
CATHOLIC. I REPRESENT THE
INDEPENDENT PHYSICAL THERAPISTS
OF CALIFORNIA. STRONG SUPPORT.
THANK YOU. ANYONE ELSE? NO ONE
IS THEIR OPPOSITION TO THE BILL.
GOOD AFTERNOON, MR CHAIR MEMBERS
OF THE COMMITTEE JED HAMPTON
WITH CALIFORNIA ASSOCIATION OF
HEALTH PLANS REPRESENTING 43
KNOCKS SKIN LICENSE HEALTH PLAN
REPRESENTING OVER 27 MILLION
CALIFORNIANS HERE, REGRETTABLY,
IN OPPOSITION TO 89 31 WOULD
LIKE TO THANK THE AUTHORS, THE
AUTHOR AND HER OFFICE AND THE
COMMITTEE STAFF AND THE SPONSORS
AS WELL. WE HAVE HAD SOME
PRODUCTIVE CONVERSATIONS ON THIS
BILL AS FAR SO WE REALLY
APPRECIATE OTHER OPENNESS AND
WILLINGNESS TO ENGAGE WITH US ON
THIS ISSUE. REGRETTABLY THAT WE
ARE WE ARE OPPOSED TO THE BILL,
PRINCIPALLY BECAUSE THIS BILL
WILL EXEMPT CERTAIN PROVIDERS
FROM SEEKING PRIOR AUTHORIZATION
FOR PHYSICAL THERAPY SERVICES.
PRIOR AUTHORIZATION SERVES AS A
CRITICAL FUNCTION WITHIN THE
HEALTH CARE SYSTEM, AS IT ALLOWS
HEALTH PLANS INSURERS THE
OPPORTUNITY TO EVALUATE SPECIFIC
SERVICES AND ENSURE THAT THEY
ARE NOT ONLY MEDICALLY NECESSARY
, BUT ALSO CONSISTENT WITH
APPROPRIATE CLINICAL CARE
GUIDELINES. PRIOR AUTHORIZATION
PROTOCOLS PROMOTES SAFE,
EFFECTIVE AND AFFORDABLE CARE
FOR PLAN ENROLLEES WHILE
ENSURING THAT THE PATIENTS
RECEIVE THE RIGHT CARE. AT THE
RIGHT TIME FROM THE RIGHT
PROVIDER. REGRETTABLY 89 31
WOULD UNDERMINE THIS PROCESS BY
SPECIFICALLY EXEMPTING PHYSICAL
THERAPY PROVIDERS FROM PRIOR
AUTHORIZATION FOR UP TO 12
PATIENT VISITS WITHOUT ANY
OVERSIGHT OR REVIEW BY THE
PATIENT'S HEALTH PLAN OF THE
PRIMARY CARE PHYSICIAN. IN
ESSENCE, THAT WE BELIEVE THAT
THIS BILL WOULD GRANT UNFETTERED
ACCESS TO THIS PARTICULAR
SERVICE AGAIN RESTRICTING OUR
HEALTH PLAN OR INSURERS ABILITY
TO TURN INTO THE TREATMENT.
TREATMENT VISITS ARE MEDICALLY
NECESSARY OR FOLLOW THOSE THOSE
STANDARD CLINICAL CARE
GUIDELINES. WE ARE CONCERNED
THAT THIS MAY RESULT IN PATIENTS
RECEIVING UNNECESSARY AND OR
INAPPROPRIATE CARE. UM WHICH
WOULD WILL UNNECESSARILY DRIVE
UP COSTS WITHIN THE HEALTH CARE
SYSTEM. WE WOULD ALSO LIKE TO
POINT OUT, UM THAT THERE HAVE
BEEN SEVERAL BILLS INTRODUCED IN
THE LEGISLATURE THIS YEAR. UM
THAT THAT YOU KNOW, WE THINK WE
NEED TO MENTION THAT IN ONE WAY
OR ANOTHER, ARE SEEKING TO
UNRAVEL SOME OF THE COMMENTS
SINCE CHECKS AND BALANCES WITHIN
CALIFORNIA'S HEALTH CARE
DELIVERY SYSTEM. UM YOU KNOW,
AND WE, UM THIS IS BY EITHER
RESTRICTING REMODELING OR
OUTRIGHT REMOVING UTILIZATION
MANAGEMENT TOOLS FROM THE HEALTH
PLANS. SO AGAIN. WE JUST WANTED
TO MENTION THAT AND KEEP THAT
YOU KNOW, IN CONTEXT, NOT JUST
SPECIFICALLY THIS BILL, BUT BUT
AS A WHOLE SO AGAIN FOR THESE
REASONS, WE ARE OPPOSED A B 9 31
BUT LOOK FORWARD TO CONTINUING
TO WORK WITH THE AUTHOR'S OFFICE
AND THE SPONSORS TO ADDRESS OUR
CONCERNS. THANK YOU. MR CHAIR
MEMBER, STEPHANIE WATKINS ON
BEHALF OF THE ASSOCIATION OF
CALIFORNIA LIFE AND HEALTH
INSURANCE COMPANIES IN THE
INTEREST OF TIME I KNOW WE'RE
GOING LATE. I WILL ECHO MY
COLLEAGUE'S COMMENTS AND REALLY
JUST POINT OUT. UM THIS IS ONE
OF MANY BILLS THAT WE WILL SEE
THIS YEAR ON PRIOR AUTHORIZATION
. AND WHILE CERTAINLY THIS IS A
FAR MORE TARGETED APPROACH,
WHICH WE APPRECIATE WE ARE
CONCERNED ABOUT THAT.
CUMULATIVE, UM IMPACT AND
RESTRICTING OF PLANS ABILITY TO
LOOK AT PROVIDING THE RIGHT CARE
AT THE RIGHT TIME. SO FOR THAT
REASON WE ARE OPPOSED. THAT
BEING SAID, WE HOPE TO WORK WITH
THE AUTHORS AND SPONSORS TO SEE
IF THERE'S MAYBE A PATHWAY
FORWARD, UM TO COME TO SOME SORT
OF RESOLUTION, SO THANK YOU.
THANK YOU. OTHERS IN OPPOSITION.
NO. ONE. BRING IT BACK TO THE
COMMITTEE FOR QUESTIONS OR
COMMENTS. DR WEBBER. THANK YOU.
AND GOOD EVENING. IT IS GETTING
LATE. UM I HAVE A QUESTION FOR
THE OPPOSITION. DO YOU ALL KNOW
WHAT IS THE TIMEFRAME OR THE
AVERAGE TIME FRAME BETWEEN THE
REFERRAL BEING PLACED? UM TO SEE
A PHYSICAL THERAPIST AND THAT
REFERRAL BEING APPROVED SO THAT
THAT PATIENT CAN ACTUALLY GET IN
TO SEE THE PHYSICAL THERAPIST.
MIGHT BE. I DON'T KNOW WHAT THE
AVERAGE TIME SPECIFICALLY TO
PHYSICAL THERAPY. I CAN TELL YOU
THEIR STATUTORY REQUIREMENTS. I
THINK IT'S 3 TO 5 DAYS,
DEPENDING ON IF IT'S URGENT, OR
NON URGENT THAT ARE STATUTORILY
REQUIRED TO PROCESS THOSE THERE
ARE TIMES WHERE A CLAIM CAN BE
APPENDED WAITING ADDITIONAL
INFORMATION. IF IT'S NOT A
COMPLETED CLAIMS, SO THERE ARE
TIMES THAT ARE SLIGHTLY MORE
DELAYED, BUT THERE ARE STATUTORY
PROVISIONS OF THE PLANS WORK
WITHIN. AND DO YOU HAPPEN TO
KNOW? UM AS FAR AS
AUTHORIZATIONS ARE CONCERNED,
WOULD IT BE REQUIRED THAT A
PHYSICIAN, YOU KNOW, SUBMIT A
NEW REQUEST AFTER EVERY VISIT
AFTER EVERY TWO VISITS AFTER
EVERY FOUR VISITS? DO YOU DO YOU
KNOW HOW OFTEN THEY WOULD HAVE
TO DO THAT? THANK YOU FOR THE
QUESTION. DR WEBBER, I THINK
GENERALLY DEPENDS ON THE INITIAL
DIAGNOSIS OR THE NEED FOR THE
SERVICE WAS MY UNDERSTANDING. SO
YOU KNOW, WHILE THAT MAY BE TWO
VISITS FOR EXCUSE ME FOR A
PARTICULAR, UM, DIAGNOSIS OR
SITUATION THAT COULD BE
STRETCHED OUT, DEPENDING ON
AGAIN. THE SEVERITY OF THE
INJURY AND THE SECURITY OF THE
ARE THE NEED FOR TREATMENT ON
THAT, SO IT REALLY DOES FROM MY
UNDERSTANDING. KIND OF DEPENDS
ON WHAT? WHAT? UM SITUATION THAT
THAT IS BEING TREATED IN A GIVEN
MOMENT SO IT CAN VARY FROM, YOU
KNOW. ONE UP INTO YOU KNOW, I
KNOW WE DO HAVE PLANS THAT DO
INITIALLY AUTHORIZED AT THE 12
VISITS, YOU KNOW, FOR A
PARTICULAR SERVICE. IF THAT IF
THE DIAGNOSIS, YOU KNOW WARRANTS
THAT THAT WE WERE OVER THE PRIOR
AUTHORIZATION YOU KNOW, I WILL
JUST SAY, UM I THINK ONE OF THE
REASONS WHY YOU'RE SAYING, UM,
AS YOU STATED SO MANY BILLS OR
LEGISLATION, POTENTIAL BILLS
DEALING WITH PRIOR
AUTHORIZATIONS. UM IS THAT IT IS
IT HAS BECOME I'M NOT ONLY
CHALLENGING FOR PHYSICIANS BUT
ALSO CHALLENGING FOR PATIENTS.
SO WHEN YOU TALK ABOUT, UM, WELL
, YOU KNOW, THERE'S NO, IT'S 3
TO 5 DAY. BUT THEN IF
SOMETHING'S MISSING LIKE SOMEONE
DIDN'T CHECK A BOX OR SOMETHING
, THEN THEY'VE GOT TO GO BACK
AND START ALL OVER. THEN ALL
YOU'RE DOING IS JUST REALLY KIND
OF DELAYING THE CARE FOR THE
PATIENT, AND IT'S ALSO EXTREMELY
FRUSTRATING AND BURDENSOME ON
THE PROVIDER AND THE HEALTH CARE
SYSTEM. UM THAT BEING SAID, UM I
DO UNDERSTAND THE NEED TO HAVE,
UM, YOU KNOW, SOMEONE ELSE'S EYE
ON SOME OF THESE PROCESSES AND
NOT JUST KIND OF OPEN UP THE
FLOODGATES TO JUST LET ANYBODY
GET ANY KIND OF THING, BECAUSE
YOU KNOW THEY MAY NOT NEED IT.
IT MAY NOT BE BASED ON, UM BEST
PRACTICES OR EVIDENCE BASED, AND
I CAN, YOU KNOW, BE VERY HONEST
ABOUT THAT. SO I HOPE THAT YOU
CONTINUE TO WORK WITH YOU KNOW
THIS PARTICULAR AUTHOR? UM I DID
THINK 12 TREATMENTS WITH A
LITTLE EXCESSIVE AND I SPOKE
WITH, UM, A PHYSICAL THERAPIST
ABOUT THAT. BUT I DO THINK THAT
WAITING FOR AN AUTHORIZATION FOR
SOMEONE THAT MAY NEED PHYSICAL
THERAPY WAITING FOR THREE DAYS.
FIVE DAYS, TWO WEEKS A MONTH IS
A BIT MUCH, UM SO FIGURING OUT A
HAPPY MEDIUM WHERE THEY CAN AT
LEAST STARTED. UM AND WHEN YOU
FIGURE OUT HOW MUCH TIME IT
TAKES TO ACTUALLY GET THAT
REFERRAL DONE, WHETHER IT'S TWO
WEEKS, YOU KNOW THEN THEY CAN,
YOU KNOW, GET THAT INFORMATION.
UM IN THE PROPER TIME FRAME
BECAUSE I ALSO DON'T WANT TO
START TALKING ABOUT. WELL THEY
CAN START IT AND THEN
RETROACTIVELY BE BUILT. THAT
WOULD BE ABSOLUTELY HORRIBLE. UM
TO HAVE SOMEONE GOING FOR
SOMETHING THINKING THAT IT'S
GOING TO BE COVERED. UM AND THEN
THEY END UP WITH A LARGE BILL AT
THE END OF THEIR TREATMENT
BECAUSE THEIR PLAN HAS DENIED
THAT PARTICULAR CLAIM. UM SO I
WILL BE SUPPORTING IT TODAY
BECAUSE I CAN SEE THINGS FROM
BOTH SIDES, BUT I THINK THAT
CONVERSATIONS NEED TO CONTINUE.
UM AND HOPEFULLY YOU ALL WILL BE
ABLE TO COME TO A HAPPY MEDIUM.
THANK YOU. ANYONE ELSE? QUESTION
FOR THE OPPOSITION YOU TALKED
ABOUT, UM AND MAYBE UNNECESSARY
. I CAN'T REMEMBER THE WAY YOU
PHRASES YOU USE ABOUT OR
INAPPROPRIATE USE OF PHYSICAL
THERAPY. UM, UNFETTERED ACCESS.
UH, UNFETTERED ACCESS AND ACCESS
. SO UM, AS SOMEONE WHO'S
EXPERIENCED PHYSICAL THERAPY
MULTIPLE TIMES FOR ORTHOPEDIC
INJURIES. TRUST ME. I WOULDN'T
WANT TO GO UNLESS I ABSOLUTELY
HAD TO. SO UM, CAN YOU EXPLAIN
WHAT YOU MEAN BY THAT AND WHAT
PROCEDURES MIGHT NOT BE
APPROPRIATE OR PHYSICAL THERAPY?
THANK YOU, MR CHAIR. I THINK
JUST IN GENERAL WHEN YOU'RE
LOOKING AT AT THE 12 VISITS. I
MEAN, THAT DOESN'T NECESSARILY
MEAN AS YOU CAN IMAGINE THAT
THAT PATIENT WOULD NEED 12
VISITS SOMEONE WE'RE LOOKING AT
AT AT, UM, YOU KNOW, RESTRICTING
OR ELIMINATING THE PRIOR
AUTHORIZATION FOR, YOU KNOW, UP
TO 12 VISITS. UM, YOU KNOW, WE
WANT TO MAKE SURE THAT THAT
THOSE TREATMENTS ARE OBVIOUSLY
MEDICALLY NECESSARY AND THAT WE
HAVE OTHER FOLKS YOU KNOW,
OTHERWISE. ON ON ON THAT ON THAT
TREATMENT, SO IT'S NOT, YOU KNOW
, IT'S NOT THAT THEY WILL USE
ALL 12 OF THOSE TREATMENTS. WE
UNDERSTAND THAT BUT YOU KNOW
WHEN WE'RE LOOKING AT THE
MEDICAL NECESSITY OF, YOU KNOW,
PARTICULAR INJURY OR PARTICULAR
DIAGNOSIS. UM YOU KNOW, IF THAT
COULD BE, YOU KNOW
HYPOTHETICALLY 2 TO 4, BUT THEY
WOULD HAVE ACCESS TO 12. YOU
KNOW, WE THINK THAT DEPENDING ON
YOU KNOW, THE POSSIBILITY IS
THERE THAT THAT SOMEBODY COULD
UTILIZE ALL 12 INSTEAD OF YOU
KNOW WHAT WE WOULD DEEM AS
MEDICALLY NECESSARY, SO THAT'S
GENERALLY YOU KNOW, WHEN WE WERE
SAYING THAT THAT TYPE OF ACCESS
IS THAT'S KIND OF WHERE WE'RE
CONCERNED WITH, YOU KNOW, AT
LARGE WHEN IT COMES TO OPENING
IT UP TO 12 PARTICULAR VISITS.
BUT THE DOCTOR WOULD NOT HAVE TO
PRESCRIBE 12. IT WOULD JUST
POTENTIALLY HAVE ACCESS FOR UP
TO 12. IT WITH A WITH SO I DON'T
I WOULD GET HONESTLY HAVING GONE
THROUGH LIKE A COUPLE OF
ORTHOPEDIC REHABS, UM AND HAVING
HAD TO WAIT AS THE CONSUMER FOR
A PRE OFF FOR THE NEXT 66. I
FOUND THAT I FOUND THAT
FRUSTRATING AND INDEED ONE TIME
I JUST SAID THE HECK WITH IT.
I'M GOING TO DO IT ANYWAY,
BECAUSE I DON'T WANT TO LOSE
PROGRESS. DON'T WANT TO WAIT 3
TO 5 DAYS. UM SO, UM, I CAN SEE
YOU KNOW FROM THE FROM THE
COMPANY FROM THE PATIENT'S
PERSPECTIVE THERE AND TRUST ME
LIKE I SAID, I'M NOT GOING TO
SEE THE PHYSICAL THERAPIST
THAT'S ABSOLUTELY NEED TO UM I
LOVE YOU GUYS, BUT I DON'T
ALWAYS CARE FOR WHAT YOU HELPED
ME. DO. SO UM SO I THIS AND I
UNDERSTAND THE CONCERN ABOUT A
LOT OF OTHER THINGS. MAYBE WE'RE
LOOKING AT AND, YOU KNOW,
CHANGING UTILIZATION REVIEW. BUT
ON THIS ONE I HAVE TO, YOU KNOW,
HAVE TO SIDE WITH THE AUTHOR ON
THIS, I THINK BECAUSE OF TWO.
IT'S AN UP TO THAT, YOU KNOW, I
MEAN, NOT EVERY NOT EVERYONE'S
GONNA NEED 12. SO IT'S NICE TO
KNOW THAT THEY'RE THERE. AND I
HOPE THAT BETWEEN THE DOCTOR AND
THE PATIENT AND THE PHYSICAL
THERAPIST THAT THEY TREAT THE
PATIENT APPROPRIATELY. UM.
THAT'S HER WINDOW THAT YOU ENJOY
A DO PASS RECOMMENDATION. I
HAVEN'T HEARD OF MOTION OR WE
HAVE A MOTION. WE HAVE A MOTION
BY MISS A GEAR. KOREA'S SECOND
BY DR ARAMBULA, WOULD YOU LIKE
TO JUST RESPECTFULLY ASK FOR
YOUR VOTE AND WE WILL CONTINUE
TO WORK WITH THE OPPOSITION. IF
THERE'S UM SOME COMPROMISE THERE
THAT WE CAN BOTH BE HAPPY WITH.
THANK YOU VERY MUCH, SO THE
MOTION IS DUE PASS TO
APPROPRIATIONS. MADAM SECRETARY,
PLEASE CALL THE ROLL. WOULD,
WOULD I, WALDRON. I GET CURRY
CURRY, I ARAMBULA ARAMBULA. I'M
BOERNER HORVATH. KOREA. LARA.
KHÔNG. MAIENSCHEIN MCCARTY. JOE
PATTERSON RODRIGUEZ. SANTIAGO.
VALLAPUDUA WHOEVER. WHOEVER I
YES, YOU ARE. THANK YOU FOR
THAT. YEAH, YEAH. NO THANK YOU.
I THINK WE ALL DESERVE SCHEDULES
JUST FOR BEING HERE. QUITE
FRANKLY SO UM, BUT MR GABRIEL
TOOK THEM ALL SO ANYWAY, SO
WE'LL LEAVE THE BILL ON CALL
THIS MR NGUYEN. AND MOVE ON TO
YOUR NEXT BILL. ALL RIGHT, UM.
LET'S HOPE THIS IS A QUICK 12.
I'M SURE YOU'RE ALL READY TO GO
HOME. UM I WANT TO BEGIN BY
THANKING, UH, MR WOOD, AS WELL
AS THE COMMITTEE STAFF ARE
WORKING CLOSELY WITH MY OFFICE
ON THE AMENDMENTS THAT I WILL BE
ACCEPTING. UH CURRENTLY 1.3
MILLION CALIFORNIANS HAVE
SERIOUS MENTAL ILLNESS SUCH AS
SCHIZOPHRENIA, BIPOLAR DISORDER
AND PTSD, WHICH IMPACTS THEIR
DAY TO DAY LIVES. FOR
INDIVIDUALS WITH SME. IT IS
CRUCIAL THAT THEY AVOID
DISRUPTIONS IN THEIR MEDICAL
REGIMENTS IN ORDER TO PREVENT
NEGATIVE OUTCOMES LIKE EMERGENCY
ROOM VISITS, INCARCERATION OR
HOMELESSNESS. HOWEVER STUDIES
HAVE UNVEILED THAT 57.9% OF
PATIENTS WITH PSYCHIATRIC
DIAGNOSIS HAVE EXPERIENCED
ACCESS PROBLEMS WHILE TRYING TO
REFILL THEIR PRESCRIPTIONS. AN
EFFORT TO REDUCE NEGATIVE
OUTCOMES. A B 14 37 WILL REMOVE
UNNECESSARY PRESCRIPTION REFILL
AUTHORIZATION BARRIERS FOR
MEDICAL PATIENTS OBTAINING
THERE. S M MY MEDICATIONS. BY
TAKING THIS CRITICAL STEP WE CAN
ENSURE THAT ARE MOST VULNERABLE,
ARE ABLE TO ADHERE TO THEIR
RECOMMENDED MEDICATION REGIMENTS
WITHOUT NEEDING TO JUMP THROUGH
ANY ADDITIONAL HURDLES THAT CAN
NEGATIVELY IMPACT THEIR
CONTINUATION OF CARE WITH ME IN
SUPPORT TODAY IS DR LEANDRA
CLARK HARVEY, CEO OF THE
CALIFORNIA COUNCIL OF COMMUNITY
BEHAVIORAL HEALTH AGENCIES. AND
REVEREND TAMMY DENSITY CEO AND
FOUNDER OF KERRY'S TYPE. THANK
YOU. GOOD EVENING. I USED TO SAY
AFTERNOON ON MY PAPER, BUT GOOD
EVENING ESTEEM CHAIR AND MEMBERS
. I'M DR LEANDRO CLARK HARVEY,
CEO OF THE CALIFORNIA ACCESS
COALITION, AND BBH. A UH, THE
ACTS OF COALITION IS A GROUP OF
PATIENT ADVOCACY ORGANIZATIONS
HELP INDUSTRY COMPANIES AND
GOVERNMENTAL GROUPS ALIGNING TO
CREATE AND CHANGE POLICIES THAT
SUPPORT PATIENT ACCESS TO
MEDICATIONS. AH ARE CO SPONSORS
THE ALLIANCE FOR PATIENT ACCESS
AND THE PSYCHIATRIC PHYSICIANS
ALLIANCE OF CALIFORNIA. THANK
ASSEMBLY NGUYEN AND CRICK.
SYLVIA EXCUSE ME, QUIRK-SILVA
FOR CHAMPION 18 A B 14 37 THIS
PSYCHOLOGIST. I'VE HELPED
PATIENTS WITH CHRONIC CONDITIONS
WHO NEED CONSISTENT AND
UNINTERRUPTED TREATMENT. I'VE
SEEN WHAT IT LOOKS LIKE WHEN A
PATIENT SKIPS DOSES BECAUSE OF
DIFFICULTY ACCESSING A
PRESCRIPTION AND RELAPSES OR HAS
A PSYCHOTIC EPISODE, RENDERING
THEM UNSAFE AT TIMES AND IN NEED
OF EMERGENCY CARE. IT WORKED
ALONGSIDE TALENTED PSYCHIATRISTS
WHO DUE TO IMPACTED SCHEDULES
AND WORKFORCE SHORTAGES ARE NOT
ABLE TO RESPOND TO THE MANY
CALLS EMAILS ETCETERA FOR PRIOR
AUTHORIZATIONS BEFORE THE
PATIENT IS SENT AWAY FROM
PHARMACY COUNTERS FOR HOURS,
SOMETIMES DAYS UNTIL
ADMINISTRATIVE HURDLES ARE
RESOLVED. IN THIS ONGOING
PANDEMIC OR BEHAVIORAL HEALTH
NEEDS ARE ESCALATING. WE JUST
CAN'T AFFORD FOR PEOPLE TO STAND
IN LINE AND LEAVE EMPTY HANDED
OR WAIT LONGER THAN THEY NEED TO
GET CONSISTENT CARE. WHEN
SOMEONE IS DIAGNOSED WITH A
SERIOUS MENTAL ILLNESS.
ADHERENCE TO THEIR MEDICATION IS
CRITICAL TO ALLOW THEM TO CARRY
OUT THEIR NORMAL DAILY FUNCTIONS
. IT'S ALSO IMPORTANT FOR THEIR
CAREGIVERS AND THEIR FAMILIES
WHO ALSO ENDURE THESE
ADMINISTRATIVE HURDLES. A B 14
37 PROVIDES A PHYSICIAN WITH THE
ABILITY TO IDENTIFY PATIENTS WHO
ARE STABILIZED ON MEDICATION AND
WAVE PRIOR AUTHORIZATIONS AND
HONORS, CLINICAL JUDGMENT OF
DOCTORS AND IMPORTANTLY, IT
PROVIDES PATIENTS WITH WHAT CAN
BE FOR MANY A LIFESAVING
INTERVENTION. THANK YOU FOR
CONSIDERATION OF THIS PROPOSAL.
GOOD EVENING, MR CHAIR AND
COMMITTEE MEMBERS. THANK YOU FOR
THIS HERCULEAN ACT OF A DAY, AND
REVEREND DOCTOR TAMMY DENISE,
THE CEO AND CO FOUNDER OF
KERRY'S TOUCH, A NONPROFIT
ORGANIZATION AIMED AT CLOSING
THE 41% MORTALITY GAP BETWEEN
BLACK WOMEN AND WHITE WOMEN FOR
BREAST CANCER, BREAST CANCER
DIAGNOSIS. WE ALSO PROVIDE
SUPPORT TO THOSE SURVIVORS AND
THEIR COMMUNITIES. FOR NECESSARY
THAT ARE NECESSARY TO ENHANCE
THEIR OVERALL WELL BEING AFTER A
DIAGNOSIS AND TREATMENT. AS AN
18 YEAR BREAST CANCER SURVIVOR.
I'VE EXPERIENCED FIRSTHAND THE
IMPACT OF ADMINISTRATIVE HURDLES
AND DELAYS WHEN SEVERAL EVENTS
LEFT ME WITHOUT CRITICAL
MEDICATION TO MANAGE MY SYMPTOMS
OF DEPRESSION. I WAITED DAYS
BEFORE THE PHARMACY AND DOCTOR
COULD CONNECT AND PROVIDE A NEW
AUTHORIZATION FOR MY MEDICATION.
BUT BY THEN I WAS SICK FROM LACK
OF CONSISTENT MEDICATION IN MY
SYSTEM. THIS GREATLY IMPACTED MY
ABILITY TO ADEQUATELY CARE FOR
MY ADOLESCENT CHILDREN,
THEREFORE, GROSSLY DISRUPTING
THE HARMONY AND FLOW IN OUR HOME
. I DON'T SPEAK JUST FOR MYSELF
. I SPEAK FOR THE MANY PATIENTS
WHO CARRIES TOUCH SUPPORT AND
COULD SHARE AND I COULD SHARE
COUNTLESS STORIES. UM WHEN I
TALK ABOUT HAVING A CHRONIC
ILLNESS THAT IMPACTS YOUR
OVERALL PHYSICAL BODY AND YOUR
MENTAL HEALTH AS WELL, THE LAST
THING THAT A PATIENT NEEDS WHEN
NAVIGATING A FILM PHYSICAL
ILLNESS IS A MENTAL HEALTH
CRISIS DUE TO DELAYS AND GETTING
MUCH NEEDED MEDICATION. I'M ONE
OF THE LUCKY ONES. I HAD HOUSING
AND I HAVE THE SUPPORT. I NEEDED
TO FIGHT TO GET MY MEDICATION
EACH TIME I FOUND MYSELF IN THIS
PREAUTHORIZATION DEBACLE, MY
DEPRESSION. THOSE SEVERE AT THE
TIME WAS MEDICALLY INDUCED AND
TEMPORARY. BUT WHAT ABOUT ALL OF
THOSE WHOSE EXPERIENCES ARE
DIFFERENT AND LIVED DAILY WITH
THE DEBILITATING EFFECTS OF
SOCIAL MEDIA, SOCIAL MEDIA? AH,
SEVERE MENTAL ILLNESS AND OR
DON'T HAVE THE RESOURCES TO
SUPPORT OR REPRESENT THEM.
THAT'S WHY I'M HERE TODAY TO
ADVOCATE FOR THOSE WHO CAN'T WHO
WON'T AND DON'T KNOW HOW TO
ADVOCATE FOR THEMSELVES. I'M
HERE IN SUPPORT OF A B 14 37
BECAUSE IT PROVIDES A SIMPLE FIX
TO UNNECESSARY DELAYS IN CARE.
URGE YOUR SUPPORT. THANK YOU
VERY MUCH OTHERS AND SUPPORT.
GOOD EVENING, MR CHAIRMAN.
MEMBERS OF THE COMMITTEE,
RANDALL HAGAR REPRESENTED THE
PSYCHIATRIC PHYSICIANS ALLIANCE
OF CALIFORNIA WERE CO SPONSORS
HAPPY TO ANSWER ANY QUESTIONS.
JOHN BRABENDER WITH THE
CALIFORNIA COUNCIL OF COMMUNITY
BEHAVIORAL HEALTH AGENCIES. C B
H A. WE'RE IN SUPPORT AND WAS
ALSO ASKED TO RELEASE SUPPORT
FROM THE STEINBERG INSTITUTE.
ALEX CON AND BE HAPPY THAT
CALIFORNIA CHRONIC CARE
COALITION AND SUPPORT. MR CHAIR
MEMBERS OF THE COMMITTEE,
BRANDON MARCHI WITH THE
CALIFORNIA MEDICAL ASSOCIATION
AND SUPPORT. THERESA COME STOCK
WITH CALIFORNIA ASSOCIATION OF
LOCAL BEHAVIORAL HEALTH BOARDS
AND COMMISSIONS IN SUPPORT, AS
WELL AS THE CALIFORNIA COALITION
FOR MENTAL HEALTH IN SUPPORT.
NEIL MILLER, CALIFORNIA
ACUPUNCTURE TRADITIONAL MEDICAL
ASSOCIATION IN SUPPORT OF
ANYTHING THAT HELPS PATIENTS.
THANK YOU. YOU KNOW? AND NO ONE
IS THERE. IS THERE OPPOSITION TO
THE BILL. NO ONE TO BRING IT
BACK TO COMMITTEE QUESTIONS OR
COMMENTS FROM THE COMMITTEE.
BILL DOES ENJOY DO PASS
RECOMMENDATION. WE HAVE A MOTION
FROM, UH DR ARAMBULA, SECOND BY
DR WEBBER. UM. MR IRWIN, WOULD
YOU LIKE TO CLOSE WOULD LIKE TO
HAVE THE COMMITTEE SUPPORT,
PLEASE? MADAM SECRETARY, PLEASE
CALL THE ROLL OF THE HAVE YOU
ACCEPTED THE AMENDMENTS, OKAY.
OKAY. SORRY. BEEN A LONG DAY.
UM, AND WE DIDN'T GET SKITTLES.
SO THERE'S A LOW BLOOD SUGAR UP
HERE JUST SAYING, UM SO, MADAM
SECRETARY. PLEASE CALL THE ROLL
. THE MOTION IS DUE PASS AS
AMENDED TO APPROPRIATIONS, WOULD
I, WALDRON ALDRIN. I
AGUIAR-CURRY EAGER CURRY. I
ARAMBULA ARAMBULA IEPER,
HORVATH. CARILLO FLORA AND
SPONG. MAIENSCHEIN MCCARTHY.
PATERSON RODRIGUEZ. RODRIGUEZ I
SANTIAGO. VALLAPUDUA WEBER.
WHOEVER I. YOU HAVE SIX. WE'LL
LEAVE THE BILL ON CALL. THANK
YOU. WE WILL NOW GO TO DR
ARAMBULA, WHO HAS ASSEMBLY BILL
FOUR.
THANK YOU TO THE CHAIRMAN
COMMITTEE FOR ALLOWING ME TO
PRESENT A B FOUR. A B FOUR WILL
EXPAND COVERED CALIFORNIA ACCESS
. TO ALL CALIFORNIANS BY
REMOVING IMMIGRATION STATUS AS A
BARRIER TO ELIGIBILITY. THE
HISTORICAL EXCLUSION OF
UNDOCUMENTED IMMIGRANTS FROM THE
HEALTH CARE SYSTEM THREATENS THE
WELL BEING OF INDIVIDUALS AND
FAMILIES IN OUR COMMUNITIES. WE
HAVE BEEN WORKING TO END THAT
EXCLUSION THROUGH THE RECENT
EFFORTS TO EXPAND FULL SCOPE,
MEDICAL COVERAGE TO ALL INCOME
ELIGIBLE ADULTS. HOWEVER. HIGHER
EARNING UNDOCUMENTED INDIVIDUALS
ARE STILL RESTRICTED FROM
PURCHASING COVERAGE ON THE
COVERED CALIFORNIA MARKETPLACE.
EXPANDING ACCESS TO HEALTHCARE
COVERAGE WILL BOTH SAVE LIVES
AND DOLLARS. BY REMOVING
IMMIGRATION STATUS AS AN
ELIGIBILITY BARRIER TO COVERED
CALIFORNIA. WE CAN CONTINUE TO
BUILD A MORE UNIVERSAL EQUITABLE
HEALTHCARE SYSTEM FOR ALL WHO
LIVE IN CALIFORNIA. IT IS TIME
THAT WE RECOGNIZE THAT
HEALTHCARE ACCESS IS A HUMAN
RIGHT AND TO REMOVE EXCLUSIONS
FROM VITAL HEALTHCARE SERVICES.
TESTIFYING IN SUPPORT OF A B
FOUR IS JOSE TORRES CASILLAS
WITH HEALTH ACCESS AND LILIA
BEST. CYRIL, WHO IT'S AN
INDIVIDUAL HAS PERSONALLY
IMPACTED BY 84. GOOD AFTERNOON
CHAIR AND MEMBERS. MY NAME IS
JOSE TORRES CASILLAS WITH HEALTH
ACCESS CALIFORNIA, THE STATEWIDE
HEALTHCARE CONSUMER ADVOCACY
COALITION. I WILL BE TRANSLATING
FOR LILIA HERE, AND SHE WILL BE
SPEAKING FIRST. WHEN I STARTED
THE OTHER IS THAT THIS? SURREAL,
SO IMMIGRANT MEXICO, CALIFORNIA
FOR MÁS POSA MADRE ADOPTIVE Ó.
A LA VIDA IMMIGRANTS.
INDOCUMENTADOS CALIFORNIA MORE
THAN IN FORMER S¼ HONESTLY,
MEDICAL AMERICA COMPARED TO
CANCER. COUNTRY WIDOW ECONOMY
MAMA'S CALIFORNIA. PROPUBLICA
LITERALLY, THAT IS BASIS. NO
RECIPE MOST GOBIERNO SYSTEM OF
THE NO, NO, NO, DON'T OPTIONS.
CONSULTANTS MEDICAL DISPOSITIVE
PHÐ NECESITO. YES, CAN SAID ALSO
NÓ ACEROS, BUT IN THE LORD
CONSULT AS AMERICA'S. MEDICAL
BUT IT STARTS COMPLICATIONS
DISSOLUTE. KAISER MEDIOS PLAN
THE PREMIER, BUT I'M ESPRESSO
ALTO SALMASI TOÀN. YES, MASK
ECONOMIC ALTURAS FUNERAL
AMERICA. NO SO MALESANI ESTO.
GUSTEAU INCLUDE EXCLUDE THOSE
AMERICAN OAN ECONOMICAL.
MEDICAL MAS SALAS RODRIGO. YEAH,
YES, BUT. SUPPORT THAT BIG NHÀ.
ALTO. GOOD AFTERNOON, EVERYONE.
MY NAME IS LILIA BECERRIL AND I
AM AN IMMIGRANT FROM MICHOACAN,
MEXICO. I HAVE LIVED IN
CALIFORNIA FOR MORE THAN 33
YEARS. I AM A WIFE, MOTHER TO
THREE BIOLOGICAL CHILDREN AND
ONE ADOPTED ADOPTED SON. I
CONSIDER MYSELF A LEADER IN MY
COMMUNITY, AND I'M HERE TO TELL
YOU THE REALITY OF MY LIFE AND
THAT THOUSANDS OF UNDOCUMENTED
IMMIGRANTS THAT RESIDE IN
CALIFORNIA AND LIVE WITH THE
FEAR OF GETTING SICK OR NEEDING
MEDICAL ATTENTION BECAUSE WE
DON'T QUALIFY FOR MEDICAL AND WE
CAN BUY AFFORDABLE COVERAGE. MY
HUSBAND AND I HAVE WORKED IN
THIS COUNTRY AND CONTRIBUTED TO
THE ECONOMY SINCE OUR ARRIVAL
SORT OF CALIFORNIA. A LOT OF
PEOPLE LOOK AT UNDOCUMENTED
IMMIGRANTS AS A PUBLIC CHARGE,
BUT THE REALITY IS THAT A LOT OF
US DON'T GET GOVERNMENT
ASSISTANCE. SOME OF US DON'T
WANT TO BE PART OF THE SYSTEM,
AND SOME OF US DON'T HAVE OTHER
OPTIONS. MY HUSBAND HAS HAD
HERNIAS FOR MORE THAN 20 YEARS
AND HAS NEEDED SURGERY HE CAN'T
GET BECAUSE WE CAN'T HAVE
COVERAGE AND CAN'T AFFORD THE
FULL TICKET PRICE OF THE SURGERY
. I HAVE BEEN NEEDING TO GET
CARE SINCE I FOUND OUT I HAD
THREE CYSTS IN MY BREAST. AND I
HAVEN'T BEEN ABLE TO GET IMAGING
NECESSARY TO SEE IF THEY ARE
CANCEROUS. WE HAVE TO TAKE
OURSELVES. WE HAD TO TAKE CARE
OF OURSELVES AND USE HOME
REMEDIES FOR PAIN BECAUSE WE
CANNOT AFFORD TO GO TO THE
DOCTOR FOR THESE HEALTH
COMPLICATIONS. I HAVE TRIED TO
PURCHASE A PLAN AT KAISER AND
OTHER INSURANCES AND THEY PLAN
FOR ME AND MY HUSBAND WOULD COST
OVER $1200 A MONTH AND THAT IS
JUST TOO HIGH. IT IS CHEAPER FOR
US TO PURCHASE FUNERAL INSURANCE
THAN TO PURCHASE HEALTH
INSURANCE. WE AREN'T THE ONLY
ONES THAT ARE GOING THROUGH THIS
UNDOCUMENTED IMMIGRANTS ARE
HUMAN, TOO, AND IT'S NOT FAIR
THAT WE ARE LEFT OUT OF BEING
ABLE TO PURCHASE AFFORDABLE
HEALTHCARE. AND GET THE CARE. WE
NEED. WE DON'T ASK FOR MORE. WE
ASK EQUALITY FOR ALL I ASK YOU
TO SUPPORT A BEFORE TODAY AND TO
SUPPORT US UNTIL UNDOCUMENTED
IMMIGRANTS GET THE SAME
OPPORTUNITIES TO LIVE A LIFE
WITH DIGNITY AND THAT WE ARE
ABLE TO PURCHASE AFFORDABLE
HEALTHCARE COVERAGE. JUST LIKE
EVERYONE ELSE. GOD BLESS YOU
ALL. AND THANK YOU FOR HEARING
MY STORY. THANK YOU. OTHERS IN
SUPPORT CHAIR WOULD SORRY. I'M
SORRY. I'M SORRY. YOU YOU WE
HAVE A STATEMENT AS WELL. YES I
HAVE THE SAME A LOT. UM CHAIR
WOOD AND MEMBERS. I WANT TO
START OFF BY SAYING THANK YOU
FOR THE LEADERSHIP AND THE WORK
THAT THIS COMMITTEE HAS DONE THE
PAST FEW YEARS TO EXPAND MEDICAL
TO UNDOCUMENTED CALIFORNIANS. SO
MANY PEOPLE NOW HAVE ACCESS TO
HEALTHCARE COVERAGE OR ARE ABOUT
TO HAVE ACCESS BECAUSE OF THE
WORK THAT WAS DONE HERE. WHILE
WE HAVE MADE GREAT PROGRESS, THE
WORK STILL CONTINUES. MEDICAL
HAS AN INCOME THRESHOLD AND NF N
END IF AN INDIVIDUAL HAS INCOME
OVER THE THRESHOLD, THEY ARE
INELIGIBLE FOR COVERAGE.
NORMALLY FOREIGN AN NORMALLY FOR
A DOCUMENTED PERSON, THEY WOULD
BE ABLE TO PURCHASE COVERAGE ON
COVERED CALIFORNIA. HOWEVER
UNDOCUMENTED CALIFORNIANS ARE
EXPLICITLY PROHIBITED FROM DOING
SO BECAUSE OF LANGUAGE IN THE
AFFORDABLE CARE ACT. AS LILIA
JUST SHARED. SHE AND HER HUSBAND
FACE A VARIETY OF HEALTH ISSUES
, BUT THEY ARE UNABLE TO ADDRESS
THEM DUE TO BEING UNABLE TO SIGN
UP FOR PRIMARY AND PREVENTATIVE
CARE. THEY RELY ON HOME REMEDIES
. BUT THIS IS NOT ADDRESS THEIR
HEALTH ISSUES, AND IT'S NOT A
SUBSTITUTE FOR MEDICAL COVERAGE.
THIS STORY IS SO SIMILAR TO SO
MANY OTHER AND DOCUMENTED
CALIFORNIANS. JUST RECENTLY, THE
U. C. BERKELEY LABOR CENTER
RELEASED A REPORT ESTIMATING
THAT 520,000 CALIFORNIANS WOULD
BE ELIGIBLE FOR COVERAGE THROUGH
COVERED CALIFORNIA. BUT DUE TO
THE IMMIGRATION STATUS, THEY ARE
INELIGIBLE. THAT'S 500,000
PEOPLE WHO ARE OUR FRIENDS, OUR
NEIGHBORS, OUR FAMILY. THEY ARE
DIAZ ARE THEO'S AND RAMOS WHO
LACK ACCESS TO HEALTHCARE
COVERAGE. 84 TAKES THE FIRST
STEP IN SEEKING A WAY TO GET
COVERAGE FOR THESE CALIFORNIANS.
84 CONTINUES OUR STATE
LEADERSHIP TO CREATE A MORE
INCLUSIVE HEALTH HEALTHCARE
SYSTEM THAN WHAT WE CURRENTLY
HAVE. AS WE HAVE LEARNED OVER
THE YEARS, OUR HEALTH IS TRULY
INTERCONNECTED WITH THOSE AROUND
US. I WANT TO REITERATE LILY'S
LAST I WANT TO REITERATE LILIES.
WORDS AS THESE EXCLUSIONS ARE
IMPACTING THE UNDOCUMENTED
COMMUNITY. IT IS CHEAPER FOR US
TO PURCHASE YOUR INSURANCE THAN
TO PURCHASE HEALTH INSURANCE. AS
SUCH, I RESPECTFULLY ASK FOR
YOUR SUPPORT HERE TODAY ON A
BEFORE. THANK YOU VERY MUCH
OTHERS IN SUPPORT. UNDER POOL,
WESTERN CENTER ON LAW AND
POVERTY AND SUPPORT. ANDRE
RIVERA ON BEHALF OF THE
CALIFORNIA PEN, ETHNIC HEALTH
NETWORK AND SUPPORT CHRIS MEYERS
WITH THE CALIFORNIA SCHOOL
EMPLOYEES ASSOCIATION AND
SUPPORT THANK YOU. SOMALI ASKED
ME CALIFORNIANS SUPPORT. THANK
YOU. NICOLE WARD WOMAN ON BEHALF
OF THE CHILDREN'S PARTNERSHIP
AND SUPPORT KATHY MOSSBERG ON
BEHALF OF ONE OF THE CO
SPONSORS, CALIFORNIA IMMIGRANT
POLICY CENTER AND PROUD SUPPORT
AND ALSO WANT TO ADD THE SUPPORT
OF A PLOT HEALTH. THANK YOU.
DIANA HOENIG WITH THE MULTIFAITH
ACTION COALITION IN SUPPORT.
GREAT POST FOR EQUALITY,
CALIFORNIA IN SUPPORT. THANK
YOU. BOLANOS SERVICES, IMMIGRANT
RIGHTS, EDUCATION NETWORK AND
SUPPORT. THANK YOU. DENNIS
SQUARES ROMERO WITH THE
CALIFORNIA HEALTH PLUS ADVOCATES
IN SUPPORT. THAT'S NOT NOW
BECAUSE THAT'S YOUR CALIFORNIA
IN SUPPORT. IF I JUST ON BEHALF
OF UNITED WAS A CALIFORNIAN
SUPPORT. THANK YOU. WHILE THE
ROPES AND PLANNED PARENTHOOD
AFFILIATES OF CALIFORNIAN
SUPPORT. THANK YOU. NEIL MILLER
, REPRESENTING MYSELF. AND MY
WIFE, WHO IS AFFECTED BY THIS IN
SUPPORT. THANK YOU ANYONE ELSE?
IS THERE ANY OPPOSITION TO THE
BILL? AND I DON'T BRING IT BACK
TO THE COMMITTEE QUESTION FOR
QUESTIONS OR COMMENTS. EMOTION
BY MISS AGGIE ARE CURIOUS SECOND
BY MR RODRIGUEZ. ENJOY DO PASS
RECOMMENDATION. WOULD YOU LIKE
TO CLOSE DOCTOR? ARAMBULA THANK
YOU. AND I RESPECTFULLY ASK FOR
MY VOTE. THANK YOU. THE MOTION
IS DUE PASS TO APPROPRIATIONS
AND MADAM SECRETARY, PLEASE CALL
THE ROLL. WOULD WOULD I? WALDRON
WALDRON, IAGAR CURRY
AGUIAR-CURRY? AYE, ARAMBULA.
ARAMBULA. AYE, BOERNER HORVATH.
CARILLO LARA, VINCE FONG
MAIENSCHEIN. MAIENSCHEIN. AYE
MCCARTY. PATERSON. RODRIGUEZ
RODRIGUEZ, I SANTIAGO VALLAPUDUA
RUBBER HOWEVER, I. SEVEN WILL
LEAVE THE ROLE ACTUALLY BELIEVE
THE BILL ON CALL. EXCUSE ME.
THANK YOU, DR WEBBER.
GOOD EVENING. I AM HERE TO
PRESENT A B 5 76, WHICH UPDATES
THE MEDICAL GUIDELINES FOR
ABORTION MEDICATION. MEDICATION
ABORTION IS SAFE AND EFFECTIVE
METHOD OF TERMINATING A
PREGNANCY AND IS PREFERRED BY
MANY PEOPLE WHO OBTAIN ABORTIONS
SENT TO US FOOD AND DRUG
ADMINISTRATION FIRST APPROVED
THE DRUG FOR MEDICATION OR
ABORTION. IN 2000, ITS USE HAS
GROWN SUBSTANTIALLY AND IN 2021
HALF OF ABORTIONS IN THE UNITED
STATES, WHERE MEDICATION
ABORTION CURRENTLY MEDICAL ONLY
COVERS MEDICATION ABORTION FOR
UP TO 70 DAYS. JUST STATION 2019
STUDY DEMONSTRATED THE
MEDICATION ABORTION FOR
PREGNANCIES BETWEEN 71 77 DAYS
WAS SAFE AND EFFECTIVE AS THE
REGIMEN FOR 64 TO 70 DAYS. A B 5
76 WOULD REQUIRE THE DEPARTMENT
OF HEALTH CARE SERVICES BY MARCH
1ST 2024 TO REVIEW AND UPDATE
MEDICAL COVERAGE POLICIES FOR
MEDICATION ABORTION TO ALIGN
WITH CURRENT EVIDENCE BASED
CLINICAL GUIDELINES. AFTER THE
INITIAL REVIEW. THE BILL WOULD
REQUIRE THE DEPARTMENT TO UPDATE
ITS MEDICAL COVERAGE POLICIES
FOR MEDICATION ABORTION AS
NEEDED TO ALIGN WITH CLINICAL
GUIDELINES. THIS BILL WOULD ALSO
REQUIRE THE DEPARTMENT TO ALLOW
FLEXIBILITY FOR PROVIDERS TO
EXERCISE THEIR CLINICAL JUDGMENT
WHEN SERVICES ARE PROVIDED. BY
EXTENDING THE TIME THAT A
PREGNANT PATIENT CAN RECEIVE
ABORTION MEDICATION UNDER
MEDICAL. WE ARE ALLOWING
FAMILIES TO MAKE THE FAMILY
PLANNING DECISION THAT IS MOST
APPROPRIATE FOR THEIR LIFE. THIS
BILL IS SPONSORED BY ESSENTIAL
ACCESS HEALTH, THE NATIONAL
HEALTH LAW PROGRAM. THEY WERE
ALL PRO CHOICE CALIFORNIA AND
PLANNED PARENTHOOD AFFILIATES OF
CALIFORNIA. HERE TO TESTIFY WITH
ME TODAY IS DR JOSIE URBINA. O B
G Y N FROM UCSF AND KELLY LIN VP
OF REGULATORY AFFAIRS AT PLANNED
PARENTHOOD AFFILIATES OF
CALIFORNIA. THANK YOU. THANK
YOU. GOOD AFTERNOON. SHERWOOD
AND MEMBERS. MY NAME IS DR JOSIE
OR BINA. I'M A PRACTICING O B G
Y N AND I'M ALSO FELLOWSHIP
TRAINED IN ADVANCED ABORTION
CARE AND COMPLEX FAMILY
PLANNING. HMM. I WORK PRIMARILY
OUT OF SAN FRANCISCO GENERAL
HOSPITAL, WHICH SERVES MOSTLY
MEDICAL AND UNINSURED
POPULATION. I'M HERE TODAY IN
SUPPORT OF BILL 5 76, WHICH WILL
REQUIRE THE DEPARTMENT OF HEALTH
CARE SERVICES TO UPDATE THEIR
BILLION POLICY FOR MEDICATION
ABORTION TO REFLECT CURRENT
UPDATED EVIDENCE BASED RESEARCH
, CLINICAL GUIDELINES AND ALSO
THE DISCRETION OF THE
PRESCRIBING PHYSICIAN. EVERY
PERSON SHOULD BE ABLE TO HAVE
THE ABORTION EXPERIENCE THAT'S
RIGHT FOR THEM. NO MATTER WHO
THEY ARE. WHERE THEY LIVE, OR
HOW MUCH MONEY THEY HAVE. FOR
MANY PATIENTS, ENDING THEIR
PREGNANCIES WITH MEDICATION.
ABORTION IS THE RIGHT OPTION FOR
THEM. MEDICATION ABORTIONS NOW
MAKE UP MORE THAN HALF OF ALL
ABORTIONS ACROSS THE UNITED
STATES. SOME PEOPLE PREFER
TAKING THE PILLS AT HOME. HAVING
THEIR ABORTION PASSED IN A
PRIVATE SPACE AND AT A TIME
THAT'S CONVENIENT FOR THEM THAT
WON'T INTERFERE WITH THEIR
PRIVATE LIVES ARE WORTH WORK.
MEDICATION ABORTION. TELEHEALTH
ALSO SAVES PEOPLE THE BURDENS OF
TRAVELING, GETTING TIME OFF OF
WORK OR HAVING TO FIND CHILDCARE
. WHATEVER THE REASON, WE SHOULD
MAKE SURE MEDICATION. ABORTION
IS A WIDELY AVAILABLE OPTION,
ESPECIALLY AS ABORTION ACCESS IS
UNDER ATTACK ACROSS THE COUNTRY.
THAT INCLUDES LINING OUR
POLICIES HERE IN CALIFORNIA.
WITH RESEARCH AND CLINICAL
GUIDELINES TO REIMBURSE FOR
MEDICATION ABORTION THROUGH 7 77
DAYS. OR 11. WEEKS OF PREGNANCY
RESEARCH HAS SHOWN THAT
MEDICATION ABORTION IS SAFE AND
EFFECTIVE BEYOND THE CURRENT 70
DAY LIMIT, THE WORLD HEALTH
ORGANIZATION, WORLD HEALTH
ORGANIZATION AND NATIONAL
ABORTION FEDERATION. HMM HAVE
PROTOCOLS THAT REFLECT THIS
EVIDENCE. THIS CARE IS TYPICALLY
OFFERED TO PEOPLE WITH PRIVATE
INSURANCE THAT OUR MEDICAL
PATIENTS ARE LEFT WITH FEWER
OPTIONS SIMPLY BECAUSE OF THEIR
INCOME. PEOPLE WITH LOW INCOMES
SHOULDN'T BE REQUIRED TO COME
INTO A CLINIC FOR PROCEDURAL
ABORTION SIMPLY BECAUSE MEDICAL
DOESN'T REIMBURSE FOR A SAFE
AVAILABLE MEDICATION OPTION AT 7
77 DAYS. AS A SPANISH SPEAKING
DAUGHTER OF MEXICAN IMMIGRANTS.
I CHOSE TO GIVE BACK AND SERVE
IN THE SAME TYPE OF HOSPITAL WAS
BORN IN A COUNTY HOSPITAL AT THE
SAFETY NET HOSPITAL THAT I TAKE
CARE OF PATIENTS WHO ARE
STRUGGLING TO MAKE ENDS MEET.
SOME ARE UNDOCUMENTED, LEAVING
MEDICAL AS OUR ONLY HEALTH
INSURANCE OPTION. A PATIENT LIKE
THIS WHO CAN'T FIND TIME OFF OF
WORK EARLIER FOR DOCTORS VISIT
TO CONFIRM THEIR PREGNANCY MAY
HAVE TO PAY OUT OF POCKET FOR A
MEDICATION ABORTION, EVEN THOUGH
MEDICATION ABORTION UP TO 77
DAYS IS SAFE AND EFFECTIVE. AS
YOU ALL KNOW EVERYDAY MATTERS
WHEN MAKING A DECISION ABOUT
ENDING A PREGNANCY, PARTICULARLY
IN OUR CURRENT POLITICAL
ENVIRONMENT. WE MUST DO AWAY
WITH BARRIERS THAT PERPETUATE
INEQUITIES IN HEALTH CARE ACCESS
AND ARE OUT OF STEP WITH
EVIDENCE AND BEST CLINICAL
PRACTICE. THANK YOU. THANK YOU
NEXT. GOOD EVENING CHAIR WOOD
AND MEMBERS OF THE COMMITTEE. MY
NAME IS KALBE LIND WITH PLANNED
PARENTHOOD AFFILIATES OF
CALIFORNIA, REPRESENTING SEVEN
PLANNED PARENTHOOD AFFILIATE TO
OPERATE OVER 100 HEALTH CENTERS
ACROSS CALIFORNIA AND PROVIDE
OVER 1.3 MILLION PATIENT VISITS
EACH YEAR. MEDICAL SHOULD BE
LEADING IN A TIME OF NATIONAL
ABORTION CRISIS. IT'S BEEN LESS
THAN ONE YEAR SINCE GOD HAS
OVERTURNED NEARLY HALF A CENTURY
OF FUNDAMENTAL RIGHTS TO
ABORTION AND BODILY AUTONOMY. AS
ANTI ABORTION EXTREMISTS
CONTINUE TO INTERFERE WITH
MEDICAL PRACTICE AND TO SEEK TO
OVERTURN TWO DECADES OF SAFE AND
EFFECTIVE ACCESS TO MEDICATION
ABORTION, INCLUDING LAST WEEK'S
DECISION IN TEXAS. CALIFORNIA
SHOULD BE LEADING THE COUNTRY BY
ENSURING ACCESS TO EVIDENCE
BASED MEDICAL CARE, INCLUDING
MEDICATION ABORTION, REGARDLESS
OF A PERSON'S BACKGROUND OR
INCOME. FOR MORE THAN TWO
DECADES. MEDICATION ABORTION HAS
BEEN A METHOD PREFERRED BY
PATIENTS TO END A PREGNANCY MORE
THAN 70% OF PLANNED PARENTHOOD
PATIENTS WHO SEEK AN ABORTION
ULTIMATELY RECEIVE A MEDICATION
ABORTION. WHILE MEDICAL IS
REQUIRED TO COVER MEDICATION.
ABORTION GRANT POLICIES LIMIT
THAT COVERAGE AS NOTED TO 10.
WEEKS OF PREGNANCY OR 70 DAYS,
GESTATIONAL AGE. PARENTHOOD
BELIEVES MEDICAL SHOULD FOLLOW
EVIDENCE BASED PRACTICE. STUDIES
HAVE DEMONSTRATED THAT
MEDICATION ABORTION IS SAFE AND
EFFECTIVE BEYOND THE CURRENT 70
DAY LIMIT. AND AS NOTED THE
NATIONAL ABORTION FEDERATION,
WORLD HEALTH ORGANIZATION AND
PLANNED PARENTHOOD OF ALL
UPDATED THEIR GUIDELINES TO
REFLECT THIS AND TO INCREASE
ACCESS TO MEDICATION ABORTION
FOR PATIENTS. BY RESTRICTING
MEDICAID BENEFICIARIES. COVERAGE
OF MEDICATION ABORTION BASED ON
OUTDATED GUIDELINES. MEDICAL
PREVENTS THE PATIENT'S ABILITY
TO CHOOSE A SAFE, EFFECTIVE
NONINVASIVE MEDICATION ABORTION
AND INSTEAD LEAVES PATIENTS AND
PROVIDERS. WITH AN IN CLINIC
PROCEDURAL ABORTION AS THEIR
ONLY OPTION FOR CARE. INSTEAD,
MEDICAL POLICY SHOULD
INCENTIVIZE THE MOST APPROPRIATE
CARE FOR THE PATIENT, WHICH MAY
CHANGE OVER TIME AS NEW EVIDENCE
EMERGES. FURTHERMORE MEDICAL
SHOULD ENSURE ABORTION ACCESS
AND PROTECTIONS ARE EQUITABLE TO
COMMERCIAL COVERAGE. GRANT
POLICIES ACTIVELY PREVENT
MEDICAL PATIENTS FROM ACCESSING
THE SAME LEVEL OF CARE AND
INCREASED PROTECTIONS. AFFORDED
TO PATIENTS COVERED BY
COMMERCIAL PLANS. MEDICAL
BENEFICIARIES DESERVE HIGH
QUALITY CARE AND SERVICES BASED
ON THE MOST UP TO DATE CLINICAL
GUIDELINES EQUAL TO WHAT IS
AVAILABLE THROUGH COMMERCIAL
COVERAGE. BY ENSURING MEDICAL
POLICIES REFLECT THE MOST UP TO
DATE CLINICAL GUIDELINES. MAYBE
576 WOULD GIVE AN ADDITIONAL 10%
OF MEDICAL PATIENTS THE ABILITY
TO CHOOSE A MEDICATION ABORTION
RATHER THAN BEING RESTRICTED TO
AN IN CLINIC PROCEDURE. 85 76
WILL ALSO ENSURE FLEXIBILITY FOR
PROVIDERS TO EXERCISE THEIR
CLINICAL JUDGMENT WHEN
DETERMINING THE BEST CARE FOR A
PATIENT. FOR THESE REASONS. I
RESPECTFULLY REQUEST YOUR
SUPPORT. THANK YOU. THANK YOU
VERY MUCH OTHERS IN SUPPORT.
ALEXIS RODRIGUEZ WITH THE
CALIFORNIA MEDICAL ASSOCIATION
IN SUPPORT YOU. AARON EVANS ON
BEHALF OF NARAL PRO CHOICE,
CALIFORNIA, PROUD CO SPONSOR OF
THIS MEASURE, AS WELL AS THE
CALIFORNIA NURSE, MIDWIVES
ASSOCIATION AND STRONG SUPPORT,
THANK YOU. GROUPS AND ISSUING
SUPPORT ON BEHALF OF BLACK WOMEN
FOR HONEST ACTION PROJECT. THEN
THE SQUAREST ROMERO WITH THE
CALIFORNIA HEALTH PLUS ADVOCATES
AND STRONG SUPPORT. THANK YOU.
RYAN SPENCER WITH THE AMERICAN
COLLEGE OF O B. G. Y N DISTRICT
NINE IN SUPPORT. THANK YOU.
CATHY MOSSBERG WITH ESSENTIAL
ACCESS HEALTH. ANOTHER ONE OF
THE CO SPONSORS. THANK YOU
SUPPORT THAT'S NOT ASKING THAT
CEO CALIFORNIAN SUPPORT THANK
YOU. IS THERE OPPOSITION TO THE
BILL?
COMMITTEE MEMBERS. I AM SOFIA.
LAURIE AND I'M WITH CALIFORNIA
FAMILY COUNCIL. 85 76 WOULD
REQUIRE TAXPAYERS MEDICAL
FUNDING TO FULLY REIMBURSE
PROVIDERS FOR MEDICATION
ABORTIONS UP TO 77 DAYS
GESTATION CHEN. FIRST LET'S WALK
THROUGH WHAT ABORTION MEDICATION
DOES. A MEDICAL ABORTION IS DONE
BY TAKING TWO PILLS KRISTEN AND
MISSILE CRYSTAL KRISTEN
CHEMICALLY STARVES, A PRE BORN
CHILD OF PROGESTERONE, WHICH
CAUSES THE PLACENTA TO
DEGENERATE SO THAT IT CAN NO
LONGER PROVIDE OXYGEN AND
NUTRIENTS TO THE CHILD. THE
WOMAN THEN TAKES MR CRYSTAL
WITHIN 24 TO 48 HOURS, CAUSING
SEVERE CRAMPING, CONTRACTIONS
AND OFTEN HEAVY BLEEDING TO
EXPEL THE DEAD BABY OUT OF A
WOMAN'S UTERUS, USUALLY ON HER
OWN SITTING OVER A TOILET.
THROUGH THIS BILL MEDICAL WILL
BE FORCED TO PAY FOR ABORTION
MEDICATION UP TO 11 WEEKS OF
PREGNANCY. SO LET'S WALK THROUGH
WITH THE 1ST 11 WEEKS OF A
PREGNANCY LOOKS LIKE BY THREE
WEEKS, AND ONE DAY A BABY'S
HEARTBEAT CAN BE DETECTED
BETWEEN 5 TO 6 WEEKS, THE BABY'S
LUNGS AND DIGESTIVE SYSTEMS
START FORMING IN BRAIN ACTIVITY
CAN BE RECORDED. AT NINE WEEKS.
THE BABY CAN SUCK THEIR THUMB
SIDE AND STRETCH AT 10 WEEKS. A
BABY IS ABOUT AN INCH AND A
QUARTER LONG, ALL VITAL ORGANS
ARE IN PLACE AND THEIR TEETH ARE
STARTING TO HARDEN AND CONNECT
TO THEIR JAWBONE. EVERY
SUCCESSFUL MEDICAL ABORTION ENDS
IN AT LEAST ONE PERSON DEAD
SINCE 2005.6 MILLION UNBORN
CHILDREN HAVE DIED FROM ABORTION
MEDICATION. SINCE 2028 WOMEN
HAVE DIED FROM ABORTION
MEDICATION AND THIS IS NOT
MISINFORMATION. THIS COMES
DIRECTLY FROM THE U. S FOOD AND
DRUG MINISTRATIONS. THE FDA HAS
ALSO REPORTED THAT SINCE 3048
WOMEN HAVE BEEN HOSPITALIZED,
604 WOMEN HAVE EXPERIENCED BLOOD
LOSS REQUIRING TRANSFUSIONS AND
414 WOMEN HAVE EXPERIENCED
INFECTIONS ALL DUE TO ABORTION
MEDICATION. DUE TO THE PHYSICAL
HARM THAT ABORTION MEDICATION
CAUSES TWO WOMEN TAXPAYERS
MEDICAL FUNDING TO FULLY
REIMBURSE PROVIDERS FOR
MEDICATION ABORTIONS SHOULD NOT
EXIST AT ALL, LET ALONE BE
INCREASED UP TO 77 DAYS.
GESTATION URGE A NO VOTE ON A B
5 76. THANK YOU. GOOD AFTERNOON
CHAIR AND MEMBERS MOLLY SHE IN
WITH THE CALIFORNIA CATHOLIC
CONFERENCE. UM I'LL BE BRIEF.
ESSENTIALLY THEY'RE THEY'RE A
COUPLE OF DIFFERENT THINGS THAT
WE'RE LOOKING AT. WHEN WE'RE
OPPOSED TO THIS BILL, OBVIOUSLY
THE CATHOLIC CONFERENCE AS
OPPOSED TO EXPANDING ABORTION,
BUT I WANT TO LOOK AT WHAT THIS
DOES WHEN IT COMES TO THE EFFECT
THAT IT WILL HAVE ON CALIFORNIA
WOMEN, SO JUST FOR AS WELL AS
THE LITIGATION THAT IS ONGOING
RIGHT NOW, UH, YOU PROBABLY ARE
AWARE THERE IS A FEDERAL COURT
CASE THAT'S BATTLING ITS WAY
THROUGH THE COURTS. A FEDERAL
JUDGE HAS YOU TO STAY ON. THE
ADMINISTRATION OF THIS MYTHIC
KRISTEN. UM, ACCORDING TO THE
FDA AND A DIFFERENT JUDGE IN
WASHINGTON STATE HAS SAID THAT
FEDERAL JUDGE HAS SAID THAT THAT
CAN PROCEED, SO THAT'S BEING
BATTLED IN THE COURTS AND THE
HHS FEDERALLY IS WORKING ON
THAT. SO IT WOULD BE PREMATURE
TO PASS THIS BILL WHEN
LITIGATION IS ONGOING. THAT'S
THE FIRST ISSUE. THE SECOND
ISSUE THAT I WOULD LIKE TO RAISE
IS THE RISKS THAT EXPANDING UH,
MEDICATION ABORTION WOULD POSE
TO WOMEN. THE ABORTION PILL
REGIMEN CARRIES A FOUR TIMES
GREATER RISK OF SEVERE
COMPLICATIONS COMPARED TO
SURGICAL ABORTION, INCLUDING
HEMORRHAGE, ER, VISITS,
INFECTIONS, EATING BLOOD
TRANSFUSIONS. FALLOPIAN TUBE
RUPTURE DUE TO MYSTIC TOPIC.
PREGNANCY UP TO 7% OF CASES
REQUIRE SURGERY LATER TO
COMPLETE THE ABORTION AND THE
RATE OF ER VISITS INCREASED 500.
WITH MEDICATION ABORTION SINCE
2002 AND THE COMPLICATION RATE
HAS INCREASED AS THE FDA
LOOSENED RESTRICTIONS, SO THAT'S
THE CONCERN WITH THIS BILL IS
THAT WHEN YOU LOSE IN THE
REGULATIONS, IT WOULD INCREASE
THE COMPLICATION RATE.
ORIGINALLY ABORTION PILLS COULD
BE PRESCRIBED THROUGH SEVEN
WEEKS OF PREGNANCY IN 2016. THE
FDA LOOSENED THAT TO 10 WEEKS OF
PREGNANCY WHILE ACKNOWLEDGING ON
THE LABEL THAT THE GREATER THAN
GESTATIONAL AGE, THE GREATER THE
RISK TO WOMEN. SO BY EXPANDING
THIS YET ANOTHER WEEK YOU'RE
POTENTIALLY EXPANDING THE RISK
TO WOMEN. AT THE SAME TIME, THE
FDA HAS STOPPED REQUIRING
REPORTING OF NON FATAL ADVERSE
EVENTS, SO THOSE STATISTICS ARE
NOT CONTINUING TO BE COLLECTED
UNLESS THE WOMAN IN QUESTION HAS
HAS DIED. AS A RESULT, UM SO
YOU'RE YOU'RE NOT ABLE TO
COLLECT THE DATA THAT YOU MIGHT
NEED TO BE ABLE TO ADDRESS THIS
BILL? UM FINALLY IN 2021. THE
FDA FURTHER ELIMINATED THE
REQUIREMENT FOR IN PERSON VISITS
FOR ADMINISTRATION AND PRESTON.
AND NOT SEEING THE DOCTOR IN
PERSON CAN HINDER SCREENING FOR
CONTRA INDICATIONS LIKE
GESTATIONAL AGE, ECTOPIC
PREGNANCY, ADRENALINE, BLOOD
DISORDERS, ALL INCREASING
COMPLICATION RISKS. SO THE FDA
AGAIN ACKNOWLEDGES THE INCREASE
IN RISK BY THE INCREASE IN
GESTATIONAL AGE, SO LOOSENING
THESE REGULATIONS COULD PUT
WOMEN AT ADDITIONAL RISK AND
COULD BE DETRIMENTAL TO WOMEN'S
HEALTH AND SAFETY, SO GIVEN THE
ONGOING LITIGATION AND THE
POTENTIAL FOR INCREASED RISK, WE
WOULD URGE A NO VOTE. THANK YOU.
THANK YOU. OTHERS IN OPPOSITION.
SAYING NO ONE WILL BRING IT BACK
TO THE COMMITTEE FOR QUESTIONS
OR COMMENTS. THERE'S YOUR
COMMENTS. UM WE DO HAVE A MOTION
BY DR ARAMBULA SECOND BY MR
RODRIGUEZ. I WANT TO THANK YOU
VERY MUCH. DR RIVERS FOR
BRINGING THIS BILL FORWARD. IT'S
VERY IMPORTANT BILL FORWARD.
WOULD YOU LIKE TO CLOSE? I WOULD
JUST LIKE TO THANK THE COMMITTEE
FOR THE ANALYSIS AND WORKING
WITH MY STAFF AND RESPECTFULLY
AS WHEN I VOTE. THANK YOU, DR
WEBBER. THE MOTION IS DO PASS
THROUGH APPROPRIATIONS. MADAM
SECRETARY, PLEASE CALL THE ROLL.
I WOULD I, WALDRON WALDRON, NO
AGUIAR-CURRY. ARAMBULA.
ARAMBULA. I'M BOERNER HORVATH.
CARILLO. LARA AND SWUNG
MAIENSCHEIN. MAIENSCHEIN I
MCCARTY MCCARTHY I JOE
PATTERSON. RODRIGUEZ RODRIGUEZ
SANTIAGO SANTIAGO. I BE
VALLAPUDUA. WEBBER. HOWEVER, I.
SEVEN VOTES WILL LEAVE THE BILL
ON CALL. THANK YOU, DR WEBBER.
THANK YOU, EVERYONE. UM. WILL
OPEN THAT WILL LIFT THE CALL
AND, UH, CALL THE ABSENT
MEMBERS. AGUIAR-CURRY
AGUIAR-CURRY. AYE.
BOERNER HORVATH CARILLO FLORA
FENCE. FONG JOE PATERSON V
VALLAPUDUA. THAT BILL NOW HAS
EIGHT VOTES. THE BILL IS OUT,
WE'LL LEAVE THE LEAD THE ROLE
OPEN FOR OTHERS TO ADD ON. UM SO
MR RODRIGUEZ, A COUPLE OF BILLS.
WHENEVER YOU'RE READY, SIR, I'M
SORRY. THAT SOUNDS GREAT. THANK
YOU. YEAH, BUT WAIT A SECOND.
WAIT. WHAT COMMITTEE ARE YOU IN
ABOUT? 616 I DON'T EVEN HAVE
THAT BILL. ALL RIGHT. THANK YOU.
UM UH, MICROPHONE. OKAY IT'S A
LONG DAY AND LOW BLOOD SUGAR
ONCE AGAIN BECAUSE MR GABRIEL
AND NO SKITTLES. YEAH. FIRST OF
ALL, LIKE TO THANK CHAIR WOOD
AND THE STAFF ROZ AND CHRISTINE
FOR TAKING TIME. TO WORK WITH MY
STAFF AND THE SPONSORS ON
AMENDMENTS TO ADDRESS YOUR
CONCERNS. THANK YOU, MR CHAIRMAN
MEMBERS. THANK YOU FOR ALLOWING
ME TO PRESENT A B 616, WHICH
WERE REMOVED THE EXCEPTION FOR
PUBLIC DISCLOSURE, FINANCIAL
DATA REPORTS FOR THE LARGE
MEDICAL GROUPS AND MEDICAL
GROUPS THAT TAKE ON DELEGATED
RISK FROM HEALTH PLANS,
ACCORDING TO THE CENTERS FOR
MEDICARE AND MEDICAID SERVICES
MORE THAN 25% OF THE MONEY SPENT
ON HEALTH CARE SERVICES IN
CALIFORNIA IS INCLUDED IN THE
CATEGORY OF PHYSICIAN AND
CLINICAL SERVICES TOTALLY MORE
THAN 100 BILLION IN 2020.
HOWEVER THERE'S VERY LITTLE
INFORMATION TO SHOW HOW MUCH OF
THE MONEY AND THAT CATEGORY
ATTRIBUTABLE TO MEDICAL GROUPS
IS GOING TO HEALTH CARE SERVICES
AND HOW MUCH IS USED FOR NON
CLINICAL PURPOSES. TO ADVANCE
THE STATE'S EFFORTS TO LIMIT
HEALTH CARE COST GROWTH. THIS
BILL WILL ALLOW POLICYMAKERS,
ADVOCATES AND ACADEMICS TO
ACCESS THIS INFORMATION ORDER
BETTER UNDERSTAND THE FACTORS
DRIVING RISING COSTS AND
IDENTIFY POTENTIAL COST SAVINGS
FOR CONSUMERS AND PURCHASERS FOR
20 YEARS, THE MEDICAL GROUPS
THAT TAKE ON DELEGATED RISK FROM
HEALTH PLANS HAVE REPORTED
FINANCIAL DATA. TO THE
DEPARTMENT OF MANAGED HEALTH
CARE. CURRENTLY THERE ARE
ROUGHLY 200 OF THESE ARE BEOS
REPORTING FINANCIAL AREA TWO D
MHC, INCLUDING MANY OF THE
LARGEST MEDICAL GROUPS IN
CALIFORNIA. THE DEPARTMENT OF
HEALTH CARE, ACCESS AND
INFORMATIONAL. OFFICE OF HEALTH
CARE AFFORDABILITY WILL SOON
COLLECT SIMILAR FINANCIAL DATA
ON ALL MEDICAL GROUPS THAT HAVE
MORE THAN 25 PHYSICIANS AT DEBT.
AND DO NOT ALREADY REPORT TO D.
M. H C. SIMILAR FINANCIAL
INFORMATION. INFORMATION IS ALSO
REPORTED BY PROVIDERS AND HEALTH
PLANS ACROSS THE HEALTHCARE
SYSTEM. BUT THERE IS ONE MAJOR
DIFFERENCE. FINANCIAL DATA
COLLECTED BY THE STATE FOR
HOSPITALS, HEALTH PLANS, CLINICS
AND SKILLED NURSING FACILITIES
IS PUBLICLY AVAILABLE TODAY.
MAYBE 616 WOULD CREATE GREATER
ACCOUNTABILITY AND THE HEALTH
CARE DELIVERY SYSTEM. AND CLOSE
THE GAP IN PUBLICLY ACCESSIBLE
FINANCIAL DATA BY MAKING PUBLIC
THE FINANCIAL DATA ALREADY
REPORTED TO D. M. H C AND MAKING
PUBLIC THE FINANCIAL DATA AS
SOON AS WE COLLECTED BY HC AI
FOR OTHER LARGE MEDICAL GROUPS.
WITH ME TO PROVIDE TESTIMONY IS
BETH MALINOWSKI, WHO IS THE
GOVERNMENT AFFAIRS ADVOCATE WITH
ESSAY YOU, CALIFORNIA. K¾T VAN
DYNES, WHO IS ALSO THE
LEGISLATIVE ADVOCATE WITH ACCESS
CALIFORNIA AND JOAN ALLEN. WITH
S E I U U H W WHO IS ALSO
AVAILABLE FOR TECHNICAL
QUESTIONS. THANK YOU. THANK YOU,
MR CHAIR AND MEMBERS BETH NOT
ASK E HERE TODAY ON BEHALF OF
STU, CALIFORNIA AT 700,000
MEMBERS, STU FOR NYA IS A PROUD
SPONSOR OF A B 616. WE'RE
GRATEFUL FOR SUMMER, RODRIGUEZ
FOR HIS LEADERSHIP AND US.
REMEMBER NOTED, WE, TOO, ARE
DEEPLY APPRECIATIVE OF THE
MEANINGFUL ENGAGEMENT WE'VE HAD
WITH COMMITTEE STAFF ON THAT
NOTE. I'D LIKE TO OFFER BRIEF
REMARKS AND ISSUES PERSPECTIVE.
WE MIGHT NOT SAY THIS ENOUGH,
BUT EVERY WORKER REGARDLESS OF
WHAT THEY DO IS A HEALTH CARE,
CONSUMER AND HEALTHCARE COSTS
ARE RISING OUT OF CONTROL. THE
COST OF HEALTH CARE HAS BEEN
RISING ABOVE INFLATION FOR YEARS
, TAKING LARGER AND LARGER
CHUNKS OUT OF WORKERS' WAGES AND
DESTABILIZING FAMILY BUDGETS.
EVERY DOLLARS. WORKERS PUT INTO
A COPAY AS ONE LESS DOLLAR THAT
THEY CAN REINVEST INTO THEIR
COMMUNITIES. SUS MEMBERS AT THE
BARGAINING TABLE HEALTHCARE
COVERAGE AND COSTS ARE THE
NUMBER ONE ISSUE. EMPLOYERS
FACED WITH THESE RISING COSTS,
EITHER SEEK TO REDUCE HEALTH
BENEFITS OR PUSH MORE OF THOSE
COSTS ONTO THE WORKFORCE,
LEAVING LESS OF THEIR PAYCHECK
FOR RENT OR PUTTING FOOD ON THE
TABLE TO LOSING PROPOSITION FOR
CALIFORNIA'S WORKFORCE. STU HAS
FOR YEARS ADVANCED EFFORTS TO
REIN IN HEALTHCARE SPENDING IN
COALITION WITH CONSUMERS,
LABORERS AND PURCHASERS. THE JOB
OF ADDRESSING THE UNDERLYING
COSTS IN OUR HEALTHCARE SYSTEM
IS FAR FROM OVER. TO TACKLE THIS
ISSUE. WE MUST CREATE A MORE
TRANSPARENT AND ACCOUNTABLE
HEALTHCARE SYSTEM WITH PUBLIC
ACCESS TO MORE DATA. A B 616
DOES JUST THAT AS THE SAME,
IRODRIGUEZ NOTED. THIS BILL
CLOSES SIGNIFICANT REMAINING GAP
AND FINANCIAL DATA THAT IS
PUBLICLY AVAILABLE CREATING
PARITY ACROSS HEALTH CARE
DELIVERY SYSTEM THAT MEDICAL
GROUP DATA IS TREATED IN THE
SAME WAY AS HOSPITAL HEALTH PLAN
DATA. THE RESULTS WOULD BE THAT
MEDICAL GROUPS WOULD BE SUBJECT
TO SIMILAR PUBLIC TRANSPARENCY
THAT CURRENTLY EXISTS FOR
FINANCIAL DATA REPORTED BY
HOSPITALS, SKILLED NURSING
FACILITIES, CLINICS AND HEALTH
PLANS AS HEALTHCARE INCREASINGLY
MOVES TO OUTPATIENT SETTINGS
OPERATED BY PHYSICIAN
ORGANIZATIONS AND AS ONGOING
PROVIDER CONSOLIDATION INCREASES
THE MARKET POWER OF LARGE
POSITION ORGANIZATIONS.
APPROPRIATE TO BRING THE SAME
LEVEL OF PUBLIC SCRUTINY TO
PHYSICIAN ORGANIZATIONS THAT
ALREADY EXIST FOR OTHER TYPES OF
PROVIDERS AND HEALTH PLANS.
THAT'S WHY I SEE I USE PROUD
THIS YEAR TO SPONSOR A B 616
WITH DECEMBER RODRIGUEZ. THANK
YOU IN ADVANCE FOR YOUR IVO AND
I'LL HAND IT OVER TO MY
COLLEAGUE KATIE VAN DINED TO
OFFER CONSUMER VOICE. GOOD
EVENING, MR CHAIR AND MEMBERS.
I'M KTV INDIANS WITH HEALTH
ACCESS CALIFORNIA, THE STATEWIDE
HEALTHCARE CONSUMER ADVOCACY
COALITION, AND WE ARE HERE IN
STRONG SUPPORT OF A B 616. 616
IS A CRITICAL PRO CONSUMER
MEASURE TO HELP US BETTER
UNDERSTAND THE DRIVERS OF HEALTH
CARE COSTS. PRACTICE HAS BEEN
ADVOCATING FOR INCREASED MEDICAL
, UH, MEDICAL FINANCIAL
TRANSPARENCY SINCE THE NINETIES
, AND THIS TRANSPARENCY IS MORE
IMPORTANT NOW. MORE IMPORTANT
NOW, MORE THAN EVER, WITH
INCREASED CONSOLIDATION, DRIVING
HIGHER HEALTH CARE COSTS. JUST
LIKE IN THE ADMINISTRATION TOOK
A HISTORIC STEP LAST YEAR
CREATED ESTABLISHING THE OFFICE
OF HEALTH CARE AFFORDABILITY,
WHICH WILL DEVELOP COST GROWTH
TARGETS FOR THE ENTIRE
HEALTHCARE INDUSTRY. THE OFFICE
REQUIRES ADDITIONAL CATEGORIES
FOR POSITION. ORGANIZATIONS, UM
. THE REPORT. FINANCIAL DATA
INFORMED SETTING THE COST GROWTH
TARGETS. AND BUT THIS DATA IS
EXEMPT FROM PUBLIC DISCLOSURE.
BASED ON RECENT REVIEW FILINGS.
WE'VE SEEN THAT AT LEAST 20% OF
HEALTH PLAN PREMIUMS FOR SOME
HEALTH PLANS GO TO PHYSICIAN
PHYSICIAN SERVICES. BUT WE DON'T
HAVE THE MOST BASIC INFORMATION
ABOUT MEDICAL GROUPS. HOW
FINANCIALLY SOLVENT ARE THESE
GROUPS DO THEY HAVE? DOLLARS IN
RESERVES. ARE THESE RESERVES
AMPLE, OR DO THESE MEDICAL
GROUPS RELY ON AFFILIATED HEALTH
SYSTEMS LIKE KAISER MATTER AND
SHARP FOR RESERVES? BUT WE DO
KNOW IS THAT DURING THE FIRST
FEW WEEKS AND MONTHS OF THE
PANDEMICS. SOME OF LARGE MEDICAL
GROUPS CANNOT MAKE PAYROLL AFTER
THE FIRST TWO WEEKS AND CALLED
ON OTHERS, INCLUDING THE
LEGISLATURE AND HEALTH PLANS FOR
HELP THIS SUGGEST THAT THESE
GROUPS LACK EVEN THE BASIC
FINANCIAL RESERVES. WE ALSO KNOW
THAT NEARLY HALF OF PHYSICIANS
ARE NOW PART OF THE 10 LARGEST
HEALTH SYSTEMS IN CALIFORNIA. AS
PROVIDERS CONTINUE TO
CONSOLIDATE AND INCREASE THEIR
MARKET POWER. THESE ARE ALL
REASONS THAT PHYSICIAN GROUPS
SHOULD HAVE THE SAME PUBLIC
OVERSIGHT, THE HEALTH PLANS AND
HOSPITALS DO UNDER EXISTING LAW.
RISING HEALTH CARE COSTS ARE
DRIVING MORE THAN HALF OF
CALIFORNIANS TO SKIP THE CARE
THAT THEY NEED AND NEARLY A
THIRD INTO MEDICAL DEBT. E B
6161 SURE THAT WE CAN ENGAGE IN
THE OFFICE OF HEALTH CARE
AFFORDABILITY WORK WITH THE
TRANSPARENCY NEEDED TO
UNDERSTAND AND ADDRESS RISING
HEALTH CARE COSTS. I
RESPECTFULLY ASK FOR YOUR I VOTE
ON 86 16. THANK YOU. THANK YOU
OTHERS AND SUPPORT. GOOD
AFTERNOON, ANDREA RIVERA ON
BEHALF OF THE CALIFORNIA PAN
ETHNIC HEALTH NETWORK AND
SUPPORT HI SHEILA SILVER ON
BEHALF OF THE CALIFORNIA STATE
RETIREES AND SUPPORT THANK YOU.
CHRIS MEYERS WITH THE CALIFORNIA
SCHOOL EMPLOYEES ASSOCIATION AND
STRONG SUPPORT. SANDRA POOL WITH
WESTERN CENTER ON LONG POVERTY
AND SUPPORT. THANK YOU. THEIR
OPPOSITION TO THE BILL.
THANK YOU, MR CHAIRMAN MEMBERS
TERESA STARK WITH KAISER
PERMANENTE. UNFORTUNATELY HERE
IN OPPOSITION TODAY, UH, WE HAVE
BOTH PROCESS AND POLICY CONCERNS
WITH THE MEASURE BEFORE YOU
TODAY FROM A PROCESS PERSPECTIVE
AS YOU HEARD THAT THE LANGUAGE
THAT THIS BILL IS AMENDING, WAS
ACTUALLY PART OF THE OFFICE OF
HEALTH CARE AFFORDABILITY
STATUTE THAT WAS PASSED AND
SIGNED BY THE GOVERNOR JUST LAST
YEAR. UM, SO THE STATUTE IS, I
THINK, BARELY SIX MONTHS OLD,
AND WE WERE VERY PLEASED
ACTUALLY TO WORK WITH WITH YOU,
MR CHAIRMAN AND SENATOR PAN AND
THE GOVERNOR'S OFFICE AND YOU'RE
TERRIFIC STAFF. ON THE OFFICE OF
HEALTH CARE AFFORDABILITY FOR
THREE YEARS. IT WAS A IT WAS A
LONG PROCESS. IT WAS GRUELING
PROCESS MANY, MANY HOURS OF
MEETINGS AND NEGOTIATIONS IN
THAT STAKEHOLDER PROCESS, BUT WE
VERY MUCH APPRECIATE IT. AND WE
APPRECIATE YOUR YOUR PROCESS.
ALWAYS DOCTOR WOULD ON ON COMING
TO AN AGREEMENT BECAUSE WE DID,
UM WE APPRECIATED A NUMBER OF
AMENDMENTS THAT WERE TAKEN TO
THAT STATUE BECAUSE WE SUPPORTED
THE UNDERLYING GOALS OF GETTING
TO HEALTH CARE, AFFORDABILITY
AND REALLY BEGINNING TO
UNDERSTAND THOSE UNDERLYING
HEALTH CARE COSTS. UM AND THERE
WERE A NUMBER OF AMENDMENTS
TAKEN TO THE OCA STATUTE FOR
KAISER PERMANENTE, WHICH WE DID
APPRECIATE. UH THE LANGUAGE THAT
THIS BILL IS AMENDING WAS ONE OF
THEM. AND SO I DO HAVE TO SAY
WE'RE A LITTLE BIT TAKEN ABACK
THAT WE ARE HERE TODAY WITH THIS
BILL. WE LOVE AND APPRECIATE
ASSEMBLYMEMBER'S RODRIGUEZ. BUT
WE'RE IT'S QUITE UNFORTUNATE
THAT WE'RE HERE TODAY, AND WE
THINK IT SENDS KIND OF AN
UNFORTUNATE MESSAGE AROUND
WHETHER IT IS WORTHWHILE TO
NEGOTIATE AND COMPROMISE ON A
BILL. WE YOU KNOW, WE WERE NOT
TOTALLY THRILLED WITH WITH THE
END PRODUCT. IT WAS NOT A
PERFECT BILL. BUT IT WAS GOOD
POLICY. AND I THINK YOU DOCTOR
WOULD AND SENATOR PAN AND
EVERYONE WHO WORKED ON IT. WE
CAME TO A GOOD PLACE. WE CAME TO
A BALANCED, UM, A BALANCED
PRODUCT THAT BALANCED A LOT OF
ISSUES. SO FROM A PROCESS
PERSPECTIVE WHERE IT'S
UNFORTUNATE THAT THIS BILL IS
HERE TODAY IN REVERSE IS A VERY
IMPORTANT UH UH, AMENDMENT THAT
WE GOT SO FROM A POLICY
PERSPECTIVE. LET ME TELL YOU WHY
THAT AMENDMENT WAS SO IMPORTANT
. UM THE CONFIDENTIALITY
LANGUAGE THAT THIS BILL CHANGES
IS IMPORTANT FOR THOSE FINANCIAL
STATEMENTS BECAUSE THE FINANCIAL
STATEMENTS OF THE MEDICAL GROUPS
AND IN PARTICULAR THE PERMANENTE
MEDICAL GROUPS CONTAINS
SENSITIVE AND PROPRIETARY
INFORMATION. AND IF YOU OPEN IT
UP FOR PUBLIC INSPECTION, I
THINK IT WILL CREATE A LOT OF
UNINTENDED CONSEQUENCES. WE
AGREED TO LANGUAGE THAT SAYS THE
FINANCIAL STATEMENTS HAVE TO BE
SUBMITTED TO THE OFFICE AND USED
ONLY FOR THE PURPOSE OF THE
OFFICE. UH AND HELP CONFIDENTIAL
BY THE BOARD AND THE STAFF OF
THE OFFICE AND NOT TO BE MADE
AVAILABLE WITH THE PUBLIC
RECORDS ACT REQUEST. THIS BILL
CREATES A YOU KNOW, HUGE
EXCEPTION TO THAT AND REALLY IS
A PERFECT EXAMPLE OF THE
EXCEPTION. SWALLOWING THE RULE.
WE THINK THIS COULD HAVE
ANTICOMPETITIVE CONSEQUENCES. WE
THINK IT COULD DRIVE UP
HEALTHCARE COST ACTUALLY
INCREASE CONSOLIDATION, UM AND
JUST BE MISINTERPRETED AND
MISUSED. SO UM, WE WANT TO MOVE
FORWARD. WE WANT TO MAKE THE
OFFICE OF HEALTH CARE
AFFORDABILITY WORK. WE ARE
PLEASED TO CONTINUE TO WORK ON
THAT. THAT'S WE WANT TO MOVE
FORWARD. WE AND UNFORTUNATELY I
THINK THIS GOES BACKWARDS. AND
WOULD ASK THAT THE BILL NOT MOVE
FORWARD TODAY. THANK YOU. THANK
YOU. THANK YOU, MR CHAIRMAN,
MEMBERS OF THE COMMITTEE BRANDON
MARCHI WITH THE CALIFORNIA
MEDICAL ASSOCIATION HERE
RESPECTFULLY IN OPPOSITION TO
THE BILL, BUT WITH TREMENDOUS
RESPECT FOR THE AUTHOR
ASSEMBLYMEMBER'S RODRIGUEZ. I
WANT TO START BY ECHOING THE
CONCERNS MADE BY MY COLLEAGUE
ABOUT THE BILL, UNRAVELING THE
AGREEMENT THAT THE STAKEHOLDERS
CAME TO, UH, ON QUITE FRANKLY,
SYSTEM ALTERING LEGISLATION
AGAIN. GREAT POLICY. WE WORKED
EXTREMELY HARD IN ORDER TO GET
TO A PLACE WHERE ALL
STAKEHOLDERS WERE ON BOARD. THIS
PROVISION IN THAT LEGISLATION
BEING A CENTRAL ONE OF THE
CENTRAL TENANTS TO THAT, HOWEVER
, ON A POLICY LEVEL THE BILL
REALLY DOES. A COUPLE OF THINGS
THAT DESCEND TO DIS INCENTIVIZES
MEDICAL GROUPS AND DELEGATED
ENTITIES FROM BECOMING DELEGATED
ENTITIES AND MOVING TOWARDS
THOSE VALUE BASED ARRANGEMENTS
THAT THE STATE HAS QUITE FRANKLY
INVESTED A LOT OF RESOURCES IN
AND HAS RE EMPHASIZED THAT GOAL
OF GETTING PATIENTS INTO THOSE
ARRANGEMENTS. AND DELIVERING ON
THAT WHOLE PERSON CARE. UM SO WE
REALLY SEE THIS AS SORT OF
OPENING UP THE FINANCIAL AUDITS
OR THE AUDITED FINANCIALS OF
THESE GROUPS. UH THAT REALLY
DON'T HAVE ANY TYPE OF BEARING
ON HOW CARE IS DELIVERED. IT IS
AN OPERATING BUDGET OF A MEDICAL
GROUP. UM SO REALLY DOESN'T
PROVIDE HOW THE CARE DELIVERY
COST. UH FURTHERMORE, THAN
TRANSPARENCY THAT IS, UH, QUOTE
UNQUOTE PROVIDED IN THIS BILL IS
LARGELY DUPLICATIVE, AND THERE
ARE ALSO SEVERAL OTHER
MECHANISMS IN PLACE IN CURRENT
LAW THAT ALLOW PATIENTS TO REST
ASSURED THAT MEDICAL GROUPS ARE
FINANCIALLY SOLVENT. THEIR
FINANCIAL SOLVENCY BOARD
LITERALLY TAKES THESE ENTITIES
AND EVALUATES WHETHER OR NOT
THEY ARE SOLVENT AND WHETHER OR
NOT THEY WILL GO INSOLVENT.
SHOULD SOMETHING HAPPEN. COVID
BEING AN EXTREME CASE IN WHICH
THESE MEDICAL GROUPS WERE FORCED
TO CLOSE THEIR DOORS, NOT
PROVIDE SERVICES OUTSIDE OF
HOSPITALS OR LARGE SYSTEMS. SO
THAT IS AN EXTREME CASE IN WHICH
YES, A LOT WANTED TO REMAIN
EMPLOYERS AND PROVIDE EMPLOYEES
WITH THEIR LIVING WAGES DURING A
PANDEMIC. SO YES, WE SAW THEM
WITHOUT AN INCOME START TO
UNRAVEL A LITTLE BIT. BUT THAT
DOES NOT MEAN THAT THIS TYPE OF
TRANSPARENCY IS HELPFUL. RATE
REVIEW FOR HEALTH PLANS MEASURES
REASONABLE IN THIS OF RATES
RIGHT. THE HEALTH PAYMENTS
DATABASES, THE ACTUAL COSTS OF
CARE DELIVERY. THAT IS HOW MUCH
A PHYSICIAN IS BILLING HEALTH
PLANS AND HOW MUCH THEY GET PAID
FROM THOSE HEALTH PLANS. SO FOR
THESE REASONS, WE RESPECTFULLY
REQUEST YOUR NO VOTE ON THIS.
AND, UM I APPRECIATE YOUR TIME.
THANK YOU. OTHERS IN OPPOSITION.
THANK YOU, MR CHAIRMAN MEMBERS,
DAVID GONZALEZ ON BEHALF OF
AMERICA'S POSITION GROUPS ALSO
RESPECTFULLY OPPOSED. MIRROR
MARTIN ON BEHALF OF THE
CALIFORNIA ORTHOPEDIC
ASSOCIATION, ALSO A POST. THE
SQUARE WAS WITH THE CALIFORNIA
HEALTH PLUS ADVOCATES. WE HAVE
AN OPPOSED UNLESS AMENDED
POSITION. LOOK FORWARD TO
WORKING WITH THE AUTHOR AND
SPONSORS. THANK YOU. THANK YOU.
ANYONE ELSE? BRING IT BACK TO
THE COMMITTEE FOR QUESTIONS OR
COMMENTS ANY QUESTIONS OR
COMMENTS DR WEBBER. I WILL KEEP
THIS BRIEF BECAUSE IT IS VERY
LATE. UM I GUESS WHEN I WAS
READING THROUGH THIS, I WAS A
LITTLE CONFUSED AS TO WHY WE
WERE DOING THIS SINCE WE'VE JUST
ESTABLISHED THE OFFICE OF HEALTH
CARE AFFORDABILITY. AND, UM. YOU
KNOW, NOW LISTENING, YOU KNOW,
TO THE FACT THAT THERE WERE
NEGOTIATIONS THAT THAT WERE DONE
. UM AND I COULD I COULD
UNDERSTAND IT IF YOU KNOW, THE
OFFICE OF FOURTH CARE OFFICER
FOR HEALTH CARE AFFORDABILITY.
UM, WAS NOT DOING ITS JOB OR YOU
KNOW, WE WEREN'T SEEING THE
OUTCOMES THAT WE NEEDED OR IF,
UM, YOU KNOW, PEOPLE WERE NOT
ADHERING TO THE REQUIREMENTS OF
THE REQUEST OF THE OFFICE, BUT I
DON'T EVEN THINK THEY REALLY
GOTTEN STARTED. SO. I GUESS I'M
FOR ME. I'M JUST A LITTLE
CONFUSED AS TO WHY WE ARE DOING
THIS AT THIS POINT. UM
DEFINITELY WELCOME TO CONTINUING
THE CONVERSATION. UM, WITH ALL
PARTIES. BUT I THINK BECAUSE OF
MY CONFUSION, I'M JUST GOING TO
KIND OF LAY OFF TODAY. I KNOW.
UM JOAN ALLEN. WITH S C I U U H
W IF I CAN SPEAK TO THAT
BRIEFLY. UM THE OFFICE OF HEALTH
CARE AFFORDABILITY IS ONLY ONE
PIECE OF THE DATA THAT WE'RE
DISCUSSING THE OTHER PIECES. THE
DEPARTMENT OF MANAGED HEALTH
CARE SO ABOUT ROUGH ROUGH
NUMBERS. 9 TO 10. MILLION
CALIFORNIANS ARE COVERED BY
MEDICAL GROUPS THAT REPORT THEIR
DATA TO THE DEPARTMENT OF
MANAGED HEALTH CARE. AND THAT
WAS NOT AT ALL PART OF THE
CONVERSATION ABOUT THE OFFICE OF
AFFORDABILITY. LAST YEAR, THE
OFFICE OF AFFORDABILITY WAS
COLLECTING DATA FROM THE REST OF
THE MEDICAL GROUPS. AND SO LAST
YEAR EVEN IF THIS HAD GONE THE
OTHER DIRECTION, AND WE HAD MADE
THIS DATA PUBLIC AS PART OF THE
OFFICE OF HEALTH CARE
AFFORDABILITY. WE WOULD STILL
NEED THIS BILL IN ORDER TO LEVEL
THE PLAYING FIELD AND ADDRESS
ALL MEDICAL GROUPS THE SAME SO,
UM THAT WAS. THAT WAS NOT THE
FULL CONVERSATION LAST YEAR SO
THAT SO THOSE RISK BEARING
ORGANIZATIONS THAT REPORTED
DEPARTMENT OF MANAGED HEALTH
CARE NO MATTER WHAT WE DID IN,
OKA STILL WOULDN'T HAVE BEEN
PUBLIC. AND, UM AND I APPRECIATE
THAT, AND I LOOK FORWARD TO
FURTHER CONVERSATIONS BECAUSE I
DID NOT GET A CHANCE TO HAVE
CONVERSATIONS WITH ACTUALLY
ANYONE FROM EITHER SIDE ON THIS
PARTICULAR BILL. UM SO YOU KNOW
, IT'S A COMPLICATED ISSUE. UM
AND I LOOK FORWARD TO LEARNING
MORE AND SEEING WHERE IT GOES,
YOU KNOW IF IT GETS OUT AND GETS
TO THE FLOOR UM, BUT BECAUSE I
STILL HAVE SOME CONFUSIONS AND.
DIDN'T GET A CHANCE TO HAVE
THESE IN DEPTH DISCUSSIONS IN
ADVANCE. TODAY, I WILL BE LAYING
OFF. THANK YOU. UM THANK YOU, DR
. UH ASSEMBLY MEMBER RODRIGUEZ.
MAYBE DR TONIGHT. DON'T YOU KNOW
AT THIS POINT UH, ANYWAY. THANK
YOU FOR OFFERING THIS BILL. I
WILL BE SUPPORTING YOUR BILL
TODAY. WHEN WE NEGOTIATED THE
CREATION OF THE OFFICE OF
HEALTHCARE 40 AFFORDABILITY I
SUPPORTED MAKING PUBLICLY
AVAILABLE THE AUDITED FINANCIALS
OF OR FINANCIAL STATEMENTS OF
PHYSICIAN GROUPS. SINCE THIS
INFORMATION IS ALREADY AVAILABLE
FOR HEALTH PLANS AND HOSPITALS,
I VIEWED THIS AS LEVELING THE
PLAYING FIELD. UM MORE
IMPORTANTLY, ALTHOUGH SOME WOULD
ARGUE THAT THESE FINANCIALS HAVE
NO BENEFIT, OR IT COULD RAISE
HEALTH CARE COSTS. I DISAGREE.
OUR HEALTHCARE SYSTEM IS
SHROUDED IN PRICING OBSCURITY OR
SECRECY, AND THIS HAS LED TO I
BELIEVE TO A LESS COMPETITIVE
AND MORE EXPENSIVE HEALTH CARE
SYSTEM. TRANSPARENCY AND COST
AND PRICES IS A METHOD TO
EVALUATE HEALTH OUTCOMES AND
QUALITY BECAUSE THIS INFORMATION
SHOWS US WHETHER HEALTH CARE
RESOURCES ARE BEING SPENT ON THE
MOST EFFECTIVE SERVICES. SO, UM
, I AM SUPPORTING THE BILL TODAY
. UM WOULD WOULD YOU LIKE WITH
THAT? WOULD YOU LIKE TO CLOSE
ASSEMBLYMEMBER'S RODRIGUEZ?
THANK YOU. I RESPECT THE
ASTRONAUT VOTE. THANK YOU. WE
HAVE THE BILL BEFORE US, UM WE
DON'T HAVE EMOTION YET. MOTION
BY MR MCCARTHY. A SECOND BY MR
SANTIAGO. I BELIEVE YEAH, THANK
YOU. MOTION IS DUE PASS TO
APPROPRIATIONS. MADAM SECRETARY
, PLEASE CALL THE ROLL. WOULD I?
WALDRON WALL THERE? NO
AGUIAR-CURRY. THANK GOD CURRY. I
ARAMBULA ARAMBULA I BORN AHORA.
BOERNER HORVATH. AYE, CARILLO.
FLORA. MONNING AND STRONG NO.
MAIENSCHEIN. MAIENSCHEIN I
MCCARTY MCCARTHY I JOE
PATTERSON. RODRIGUEZ. RODRIGUEZ
EYES SANTIAGO OKAY, GO IVY
VALLAPUDUA. THEY PUT WHAT I
WEBER. WEBER, NOT VOTING. YOUR
BILL IS OUT. YOU HAVE NINE VOTES
WILL LEAVE THE WILL LEAD THE
ROLE OPEN FOR OTHERS TO ADD ON.
YOU HAVE NOW YOU CAN DO 13 92.
MR CHAIR. I MOVED THE BILL. OKAY
YOU HAVE EMOTION BY MR MCCARTHY,
A SECOND BY MS BOERNER HORVATH.
SER. WHENEVER YOU'RE READY. ONCE
AGAIN. THANK YOU. CHAIRMAN
MEMBERS. THANK YOU FOR ALLOWING
ME TO PRESENT A B 19. 92 WHICH
WOULD STRENGTHEN THE HOSPITAL
SUPPLIER DIVERSITY REPORTING
PROGRAM. THIS BILL WOULD REQUIRE
THE PROGRAM TO SUBMIT A PLAN TO
THE DEPARTMENT OF HEALTH CARE,
ACCESS AND INFORMATION, OR HC AI
TO INCREASE PROCUREMENT FROM
MINORITY WOMEN, LGBT AND
DISABLED, VETERAN OWNED BUSINESS
ENTERPRISES. INCREASING
PROCUREMENT. DIVERSITY IS NOT
JUST A SOCIAL MISSION, BUT ALSO
A BUSINESS STRATEGY THAT WIDENS
THE SUPPLIER POOL TO MIRROR THE
PATIENT POPULATION THEY SERVE.
IN 2019 89 62 WAS APPROVED BY
THE LEGISLATURE TO REQUIRE
HOSPITAL SUBMIT AND THEN THE
REPORTER HC AI UNDER PRIOR
SUPPLIER DIVERSITY EFFORTS IN
THE MOST RECENT REPORT, DIVERSE
PROCUREMENT SPENDING ONLY
ACCOUNTED FOR 2% OF THE HOSPITAL
OF THE TOTAL SUPPLIER SPENDING
ARE DISADVANTAGED COMMUNITIES
DESERVE MORE DOLLARS. CALIFORNIA
ALREADY HAS TWO SUCCESSFUL FOR
SUPPLIER DIVERSITY PROGRAMS FROM
THE CALIFORNIA PUBLIC UTILITIES
COMMISSION AND THE INSURANCE
COMMISSIONER. THESE PROGRAMS
HAVE LED TO SUCCESSES. FOR
EXAMPLE, INSURANCE COMPANIES
HAVE INCREASED THEIR DIVERSE
PROCUREMENT DOLLARS FROM 930
MILLION TO 3.1 BILLION FROM 2012
TO 2021 LARGE UTILITIES REPORT
THAT 31% OF THE TOTAL
PROCUREMENT CAME FROM DIVERSE
SUPPLIERS, SURPASSING THE
AGENCY'S GO OF 21% A B 1932 WERE
STRENGTHENED THE HOSPITAL
SUPPLIER DIVERSITY REPORTING
PROGRAM. BY PULLING STRATEGIES
FROM THE LINING STATUTORY
LANGUAGE. THESE TWO EXISTING
PROGRAMS. WITH ME TO PROVIDE
TESTIMONY IS JULIAN CANNOT
PRESIDENT OF CEO OF THE
CALIFORNIA HISPANIC CHAMBER OF
COMMERCE AND DARRYL. SO SUDHA,
CHAIRMAN OF THE LOS ANGELES
LATINO CHAMBER OF COMMERCE. SOME
. MR CHAIRMAN MEMBERS. THANK YOU
VERY MUCH. IT'S BEEN A LONG DAY.
YOU KNOW, I'VE BEEN SITTING OUT
THERE, RIGHT? OH, MY GOD. SO
ANYWAYS, LET ME MY NAME IS
DARRYLL SOUTH SAID. I REPRESENT
THE LOS ANGELES LATINO CHAMBER
OF COMMERCE AND, UM, OUR
MEMBERSHIP IS OVER 800 STRONG
WITH SMALL BUSINESSES WITH THE
SUBSCRIPTION OF 15,000
BUSINESSES THAT ARE PART OF OUR
CHAMBER. UM, I'M AN OPERATING
OFFICER. I OWN MY OWN BUSINESS.
ARMY GENERAL CONTRACTOR BY TRADE
. UM AND, UM, WE'VE BEEN
TRACKING A B 1962 CENTS. UH JULY
OF 2020. AND YOU KNOW, WE'VE
WE'VE WE'VE HAD NUMEROUS
MEETINGS WITH A LOT OF THE
MEMBERS OF THE CALIFORNIA
HOSPITAL ASSOCIATION AND, YOU
KNOW, WE UNDERSTAND, YOU KNOW,
AND THE LAST MEETING WE HAD WITH
THEIR GROUP THAT THEY WERE
THINKING OF HAVING STAKEHOLDER
MEETINGS AND GIDDY STATISTICS
THAT WAS GOING TO PUT HIM ONTO
ANOTHER THREE YEARS AND NOW I
UNDERSTAND THAT THEY WANT TO
2027 SO UM, AND AGAIN, YOU KNOW,
WE'RE YOU KNOW, BEING A SMALL
BUSINESS MINDED PERSON, YOU
KNOW, WE TEND TO THINK THINGS
ARE MUCH EASIER THAN THEY ARE.
BUT I'M HERE TO ASK OF THE
COMMITTEE MEMBERS. DO YOU
UNDERSTAND THAT? YOU KNOW, UH,
2027 IS A LONG TIME AWAY. AND I
KNOW THAT THIS COULD HAPPEN
SOONER. I JUST RECEIVED A EMAIL
FROM ONE OF THE PARTNERS OF THE
CALIFORNIA HISPANIC, UH,
CALIFORNIA. HOSPITAL ASSOCIATION
WANTING TO MEET WITH US TO SEE
HOW WE CAN GET OUR PROCUREMENT
PROGRAM GOING AND THEY WANT TO
SEE HOW THEY CAN FINISH TO WORK
JUNE OF THIS YEAR. UM AGAIN, YOU
KNOW, I HAVE A BUNCH OF
STATISTICS HERE THAT I'M SURE
THAT YOU ALL HAVE SEEN BEFORE.
BUT, UM THAT'S IT. BUT THE
NUTSHELL. HMM. THANK YOU. WELL.
GOOD EVENING, MR CHAIRMAN AND
COMMITTEE MEMBERS. THANK YOU FOR
THE OPPORTUNITY. UM AND I WANT
TO THANK UM ASSEMBLY MEMBER
RODRIGUEZ AND OUR LOS ANGELES
LATINO CHAMBER OF COMMERCE FOR
THEIR HARD WORK ON THIS ON THIS
BILL. YOU KNOW, THIS BODY IS NO
STRANGER TO DEVELOPING, UH,
DIVERSE PROCUREMENT PROGRAMS,
STARTING, OF COURSE WITH
ASSEMBLYMEMBER'S WHEN MORE AND
WHAT BECAME GEO 1 56. TO WHAT
WE'VE DONE IN THE INSURANCE
INDUSTRY. UH AND NOW WOULD THEY
BE 2019 LAST SESSION IN THE 25%
PROCUREMENT OPPORTUNITIES? UH,
GOALS FOR STATE AGENCIES HERE IN
CALIFORNIA. SO I THINK THIS BODY
KNOWS THE IMPORTANCE THAT THIS
IS NOT ABOUT JUST GIVING OUT
CONTRACTS RIGHT? THIS IS ABOUT
ECONOMIC DEVELOPMENT. THIS IS
CREATING AN ECONOMIC ECOSYSTEM
WHERE WE ARE SUPPORTING OUR
BUSINESSES IN CALIFORNIA, WHO
ARE ALSO IN THIS EXAMPLE PAYING
HEALTH PREMIUMS. AS YOU KNOW
THAT 60% OF HOSPITAL REVENUES.
HERE IN CALIFORNIA COME FROM
ETHNIC MINORITY COMMUNITIES. BUT
YET LESS THAN 4% OF THOSE
DOLLARS OR PROCUREMENT
OPPORTUNITIES THAT THESE
HOSPITALS HAVE ARE BEING
RETURNED BACK TO THOSE
COMMUNITIES. UM. YOU KNOW,
HISTORICALLY, HISTORIC
PROCUREMENT POLICIES HAVE NEVER
. TAKEN IN CONSIDERATION OF THE
IMPORTANCE OF DIVERSE BUSINESS
AND TO YOUR TO THEIR BUSINESS
PLANS AND TO THEIR BOTTOM LINE,
WHICH IT HAS BEEN PROVEN THAT
DOING BUSINESS WITH SMALL
BUSINESS AND DIVERSE BUSINESSES
ACTUALLY SAVES MONEY. UM YOU
KNOW, A LOT OF THESE HOSPITALS
DO WHAT THEY CALL G. P O S, UM,
PURCHASING. UM UNDERGROUND, UH,
PURCHASING GROUPS. UM AND EVEN
THERE. YOU KNOW, THEY'LL SAY,
OH, WELL, WE USE A GPO, BUT YOU
KNOW, THEY CAN ALSO WORK WITH
THOSE GPS TO SAY, HEY, WE
UNDERSTAND THAT A LOT OF SMALL
BUSINESSES DIVERSE INSTANCES
WILL BE SECOND TIER, AND THEN
IT'S PUT IN PLACE THERE. YOU
KNOW SOME OF OUR STUDIES AND OUR
RESEARCH. WE'VE DONE A NUMBER OF
HOSPITALS, AND IT'S REALLY SAD
WHEN YOU SEE THAT THESE
HOSPITALS WHO ARE. YOU KNOW,
HAVE THESE OVER $50 MILLION IN
REVENUE. BUT YET THEY'RE ONLY
DOING BARELY 1.5% I'VE OF THEIR
PURCHASING WITH DIVERSE
BUSINESSES. UM WE THINK THIS PUT
SOME TEETH INTO, UM WHAT WAS, UM
ASSEMBLYMEMBER'S WORKS. A B 1962
MOVES IT FORWARD AND ENCOURAGES
THESE BUSINESS. THESE HOSPITALS
, THE PRACTICE, A GOOD BUSINESS
PRACTICE AND THE UTILIZATION OF
CALIFORNIA'S SMALL, DIVERSE
BUSINESSES IN THEIR PURCHASING,
SO WE URGE YOU TO VOTE. AYE ON
THIS. THANK YOU. THANK YOU. ARE
THERE OTHERS IN SUPPORT? MR
CHAIRMAN, MANNY DIAZ,
REPRESENTING THE CALIFORNIA
HISPANIC CHAMBERS OF COMMERCE
VERY MUCH IN SUPPORT. AND OUR
SUPPORT LETTER IS IN THE MAIL.
THANK YOU. GOOD EVENING, KIKI
LIZARRAGA WITH THE EAST LOS
ANGELES COMMUNITY UNION, TELE
CæA AND STRONG SUPPORT. IS THERE
OPPOSITION TO THE BILL?
GOOD EVENING CHAIR WOOD AND
COMMITTEE MEMBERS, VANESSA
GONZALEZ WITH A CALIFORNIA
HOSPITAL ASSOCIATION WITH AN
OPPOSED UNLESS AMENDED POSITION
ON A B 13 92. C J IS NOT OPPOSED
TO THE INTENT OR TO THE NEW PLAN
REQUIREMENTS PROPOSED IN A IN
THE LEGISLATION, HOWEVER, IN
LIGHT OF EFFORTS CURRENTLY
UNDERWAY TO INCREASE DIVERSITY
PROCUREMENT FROM PRIOR
LEGISLATION, WE ARE REQUESTING A
DELAY IN IMPLEMENTATION. IN 2019
80 1962 WAS SIGNED INTO LAW AND
CREATED THE HOSPITAL SUPPLIER
DIVERSITY DIVERSITY PROGRAM,
WHICH REQUIRES HOSPITALS TO
ANNUALLY COLLECT AND SUBMIT A
REPORT ON ITS DIVERSITY
PROCUREMENT EFFORTS.
ADDITIONALLY IT REQUIRES HK TO
CONVENE THE HOSPITAL SUPPLIER
DIVERSITY COMMISSION, WHOSE
PURPOSE IS TO PROVIDE
RECOMMENDATIONS TO H CHI AND THE
HOSPITAL INDUSTRY ON THE BEST
METHODS TO INCREASE PROCUREMENT
WITH DIVERSE SUPPLIERS. DUE TO
DELAYED IMPLEMENTATION OF 89 62
BECAUSE OF THE COVID PANDEMIC.
THE HOSPITAL SUPPLIER DIVERSITY
COMMISSION DIDN'T MEET UNTIL
MARCH 2021 STANDARDIZED
REPORTING FOR HOSPITALS ALSO
DIDN'T BEGIN UNTIL 2021 IN ORDER
TO ALLOW THE WORK THAT IS
CURRENTLY UNDERWAY FROM 89 62 CH
IS REQUESTING THAT THE
REQUIREMENT THAT HOSPITALS
DEVELOPED DETAILED AND
VERIFIABLE PLANS. INCREASING
DIVERSITY PROCUREMENT BE DELAYED
UNTIL 2027. THIS WOULD GIVE A
JOKE. I UH FIVE YEARS TO COLLECT
. THIS WILL GIVE A CHECK I FIVE
YEARS OF DATA FROM HOSPITALS
REPORTING AND GIVE THE HOSPITAL
SUPPLIER DIVERSITY COMMISSION
TIME TO EVALUATE AND DEVELOP
RECOMMENDATION FOR THE STATE'S
CONSIDERATION. ADDITIONALLY
WE'RE REQUESTING THAT THE PLANT
SUBMISSION REQUIREMENTS BE
CHANGED FROM ANNUALLY TO EVERY
THREE YEARS SIMILAR TO COMMUNITY
BENEFITS ASSESSMENTS. HOSPITALS
ARE COMMITTED TO SUPPLIER
DIVERSITY AND WE'LL CONTINUE
THEIR INDIVIDUAL EFFORTS AS
REQUIRED UNDER A B 9 62. IN
ADDITION TO RECOMMENDATIONS FROM
H CHI AND THE COMMISSION, WE
LOOK FORWARD TO CONTINUE
CONVERSATIONS WITH THE AUTHOR
AND SPONSORS ON THIS IMPORTANT
ISSUE. UM, AND HERE WITH ME
TODAY IS KAREN NETTO FROM
COMMUNITIES LIFTING COMMUNITIES
WHO WILL FURTHER DISCUSS EFFORTS
GOING ON IN L. A COUNTY TO
IMPLEMENT A B 9 62. GOOD
EVENING. MY NAME IS KAREN OCHOA
, AND I AM THE DIRECTOR OF
HEALTH, EQUITY PROGRAMS AND
OPERATIONS, UM, FOR COMMUNITY
LIFTING COMMUNITIES. WE WORK IN
PARTNERSHIP WITH LOCAL
COMMUNITIES TO FACILITATE THE
TRANSFORMATION OF HEALTHCARE
SYSTEMS TO REDUCE INEQUITIES AND
IMPROVE COMMUNITY HEALTH. AS A
FIVE OH ONE C THREE NONPROFIT
AFFILIATE OF THE HOSPITAL
ASSOCIATION OF SOUTHERN
CALIFORNIA. WE HAVE PARTNERED TO
SUPPORT THE DEVELOPMENT OF A
REGIONAL SUPPLIER DIVERSITY
STRATEGY TO ADVANCE. EQUITY AND
INCREASE ECONOMIC OPPORTUNITY
FOR DIVERSE OWNED BUSINESSES IN
LOS ANGELES COUNTY. WHEN A B 9
62 PASSED IN 2019. OUR HOSPITALS
AND HEALTH SYSTEMS WERE UNDER
THE COVID PANDEMIC AND THEREFORE
HK DELAYED THE IMPLEMENTATION.
TO JULY 1ST 2021 FOR THE
HOSPITALS TO REPORT THEIR
DIVERSE SPENDING. THE AFTERMATH
OF THE PANDEMIC LEFT SOME OF OUR
HOSPITALS AND HEALTH SYSTEMS
ANALYZING THEIR DATA FOR THE
FIRST TIME TO MEET REPORTING
REQUIREMENTS. OF WHICH WE
PROVIDED SUPPORT AND ANALYZING
THEIR SPIN. WE CONTINUE TO
SUPPORT OUR MEMBER HOSPITALS AND
AIM TO BUILD RELATIONSHIPS
BETWEEN OUR HOSPITALS, HEALTH
SYSTEMS AND IDENTIFYING THE GAPS
TO REDUCE THE BARRIERS, DIVERSE
OWNED BUSINESSES FACE AND
ACCESSING HOSPITAL PROCUREMENT
CONTRACTS BY BEING INTENTIONAL
AND CONNECTING HOSPITAL HEALTH
SYSTEMS TO DIVERSE OWNED
BUSINESSES HOSTING EDUCATION
SESSIONS ON ENHANCING THEIR
INCLUSIVE PROCUREMENT PROCESS.
PROVIDING PILOT PROJECT
OPPORTUNITIES FOR HOSPITALS TO
INCREASE THEIR VENDOR VENDOR
POOLS THROUGH PARTICIPATION IN A
REGIONAL DATABASE. WE CONTINUE
CONVERSING WITH THE BILL'S
SPONSOR. AND BRIDGING
RELATIONSHIPS. THANK YOU SO VERY
MUCH FOR YOUR ATTENTION AND
CONSIDERATION. THANK YOU. OTHERS
IN OPPOSITION. GOOD EVENING, MR
CHAIR AND MEMBERS CONNIE DELGADO
ON BEHALF OF THE DISTRICT
HOSPITAL LEADERSHIP FORUM. WE
HAVE AN OPPOSING LESS AMENDED
POSITION WOULD LIKE TO ALIGN OUR
COMMENTS WITH THE A. J. THANK
YOU. BRING IT BACK TO THE
COMMITTEE FOR QUESTIONS OR
COMMENTS. WE HAVE A MOTION BY MR
MCCARTHY IS SECOND BY MS
BOERNER HORVATH. WOULD YOU LIKE
TO CLOSE? MR RODRIGUEZ
ESPECIALLY ASKED FOR I VOTE.
THANK YOU. WE HAVE A MOTION LIKE
I SAID, UM, THE MOTIONS DO PASS
THROUGH APPROPRIATIONS. MADAM
SECRETARY, PLEASE CALL THE ROLL.
WOULD WOULD I? WALDRON?
AGUIAR-CURRY KOREA ARAMBULA
ARAMBULA. AYE, BOERNER HORVATH.
BOERNER HORVATH. AYE, CARILLO.
LARA. VINCE FONG. VINCE VAUGHN,
NOT VOTING MAIENSCHEIN.
MCCARTHY. PATERSON. RODRIGUEZ.
RODRIGUEZ I, SANTIAGO SANTIAGO,
I BE VALLAPUDUA YOU PUT WHY
WEBER. HOWEVER, I. YOUR BILL HAS
EIGHT VOTES. IT'S OUT WILL LEAVE
THE ROLE OPEN FOR OTHERS TO ADD
ON. WE'RE GETTING THERE. WE GOT
TWO MORE LEFT. MR.
BOERNER HORVATH, YOU ARE UP
NEXT.
I'LL KEEP THIS SHORT AND SWEET
MR. CHAIR MEMBERS A B. DID YOU
BRING SKITTLES? YEAH. I'M SORRY
. OH OK, WE'LL JUST KEEP IT
SHORT, THEN 87 19 REQUIRE
MEDICAL MANAGED CARE PLANS CPS
TO REIMBURSE PUBLIC TRANSIT
OPERATORS FOR NON MEDICAL
TRANSPORTATION. N M. T S AND NON
EMERGENCY MEDICAL TRANSPORTATION
AND E M T SERVICES. PUBLIC
TRANSIT OPERATORS ARE FEDERALLY
MANDATED UNDER THE AMERICANS
WITH DISABILITIES ACT TO PROVIDE
AN M T AND N E M T PARA TRANSIT
TRANSPORTATION TO MEDICAL
ENROLLEES SEEKING TO ACCESS
MEDICALLY NECESSARY, MEDICAL
COVERED SERVICES. THESE INCLUDE
TRAVEL TO DOCTORS, APPOINTMENTS
, PHYSICAL THERAPY OR OTHER
MEDICALLY NECESSARY SERVICES. A
B 23 94 ASSEMBLYMEMBER'S
CRISTINA GARCIA 2016 HAD THE
UNINTENDED CONSEQUENCE OF
PROVIDING A FINANCIAL INCENTIVE
TO THE M C. P S TO PUSH THEIR
CLIENTS ONTO PUBLIC TRANSIT AND
KEEP THE TRANSPORTATION PORTION
OF THE MEDICAL FUNDING. AS A
RESULT, CPS BEGAN RECEIVING
STATE AND FEDERAL FUNDING TO
PROVIDE MEDICAL TRANSPORTATION
SERVICES. BUT WE'RE NOT
OBLIGATED TO REIMBURSE PUBLIC
TRANSIT AGENCIES FOR THE
TRANSPORTATION THAT THEY PROVIDE
A B 7 19 WOULD ENSURE THAT THE
PUBLIC TRANSMIT TRANSIT AGENCIES
ARE REIMBURSED FOR ELIGIBLE
MEDICAL TRIPS EMANATING THE
UNINTENDED CONSEQUENCES FROM A B
23 94. I RESPECTFULLY ASK FOR AN
I VOTE, AND TODAY I HAVE HERE
WITH ME ALCHEMY GRAHAM,
LEGISLATIVE ADVOCATE WITH THE
CALIFORNIA TRANSIT ASSOCIATION,
THE SPONSORS OF THE BILL. GOOD
EVENING, MR CHAIR AND MEMBERS
ALCHEMY GRAHAM, LEGISLATIVE AND
REGULATORY ADVOCATE WITH THE
CALIFORNIA TRANSIT ASSOCIATION
ON BEHALF OF OUR MORE THAN 220
MEMBER ORGANIZATIONS. I'M HERE
TODAY TO VOICE OUR SUPPORT FOR
AND PROUD CO SPONSORSHIP OF A B
7 19 BASIL. REMEMBER BERNARD
HARDCORE BACK? A B 7 19 WOULD
REQUIRE MEDICAL MANAGED CARE
PLANS CPS TO REIMBURSE PUBLIC
TRANSIT OPERATORS FOR NON
MEDICAL AND NON EMERGENCY
MEDICAL TRANSPORTATION SERVICES
AND NM RESPECTIVELY. PUBLIC
TRANSIT OPERATORS PROVIDE 88
MANDATED N M T AND N. M T
PARATRANSIT SERVICES TO
CUSTOMERS TO ACCESS MEDICALLY
NECESSARY MEDICAL COVERED
SERVICES, SUCH AS TRAVEL TO
APPOINTMENTS BEFORE A B 23 94
PASSED IN 2016 MEDICAL DIRECTLY
REIMBURSED TRANSPORTATION
PROVIDERS WHEN THEY OFFERED
THESE SERVICES TO MEDICAL
CUSTOMERS. HOWEVER WHEN A B 23
94 WAS SIGNED INTO LAW, IT HAD
THE UNINTENDED EFFECT OF CUTTING
TRANSPORTATION PROVIDERS OUT OF
THE REIMBURSEMENT LOOP BY
PROVIDING STATE AND FEDERAL
FUNDING DIRECTLY TO CPS FOR
THOSE TRANSPORTATION SERVICES.
THIS DISINCENTIVIZE IS M C. P S
FROM CONTRACTING WITH PUBLIC
SERVICE AGENCIES AS THEY'RE NOT
REQUIRED TO REIMBURSE THEM FOR
THE SERVICES THAT THEY PROVIDE,
AND PUBLIC TRANSIT AGENCIES ARE
NOT LEGALLY ALLOWED TO TURN AWAY
CUSTOMERS. AS A RESULT, PUBLIC
TRANSIT AGENCIES HAVE SEEN
REDUCTIONS OF HUNDREDS OF
THOUSANDS TO SEVERAL MILLIONS OF
DOLLARS IN REIMBURSEMENT
FUNDING. WHILE I'M CPS CONTINUE
TO RECEIVE TRANSPORTATION,
FUNDING AND POCKET THEM. FURTHER
CPS CONTEND THAT TRANSPORTATION
COSTS ONLY NEED TO BE REIMBURSED
IF THE MEDICAL CUSTOMER REQUESTS
PRIOR APPROVAL FROM M C P FROM
THE M C P THIS PLACES AN UNDUE
BURDEN ON MEDICAL CUSTOMERS WHO
ARE ALREADY UTILIZING PERIOD
TRAINS AT SERVICES BECAUSE
REQUESTING TRANSPORTATION IN
ADVANCE REQUIRES EXTRA STEPS AND
PRE PLANNING TIME THAT MAY NOT
BE VIABLE, VIABLE FOR THE
CUSTOMER, ADDITIONALLY, ON TOP
OF REPORTED QUALITY AND SAFETY
ISSUES, CUSTOMERS HAVE ALSO
SHARED DIFFICULTIES WITH
SCHEDULING. M C P M C P PROVIDED
TRANSPORTATION. EXCUSE ME. A B 7
19 WILL ENSURE THAT PUBLIC
TRANSIT AGENCIES ARE REIMBURSED
FOR ELIGIBLE MEDICAL TRIPS
REMEDY REMEDYING THE UNINTENDED
COUNCIL CONSEQUENCES FROM A B 23
94, PROVIDING CUSTOMERS WITH
RELIABLE AND ACCESSIBLE
TRANSPORTATION SERVICES. THANK
YOU. THANK YOU OTHERS IN SUPPORT
OF THE BILL. THEIR OPPOSITION TO
THE BILL. CAN NO ONE. BRING IT
BACK TO THE COMMITTEE FOR
QUESTIONS OR COMMENTS ANY
QUESTIONS OR COMMENTS FROM THE
COMMITTEE? EMOTION BY THE MR
MCCARTHY, A SECOND BY MR
RODRIGUEZ. UM WELL ENJOYS. I DO
PASS RECOMMENDATION. WOULD YOU
LIKE TO CLOSE? RESPECTFULLY ASK
FOR YOUR I VOTE. THANK YOU.
THANK YOU VERY MUCH. THE MOTION
IS DO PASS THROUGH
APPROPRIATIONS. MADAM SECRETARY,
PLEASE CALL THE ROLL. I WOULD I,
WALDRON. WALDRON NOT VOTING
ANGER. CURRY CURRY. I ARAMBULA.
ARAMBULA. AYE, BOERNER HORVATH.
BOERNER HORVATH. AYE, CARILLO.
LARA. PHªN I'M NOT VOTING
MAIENSCHEIN. MAIENSCHEIN I
MCCARTY MCCARTHY I, JOE
PATTERSON. RODRIGUEZ RODRIGUEZ,
I SANTIAGO. SANTIAGO. I
VALLAPUDUA VALLAPUDUA. AYE,
WEBER. WHATEVER I. RIGHT SO AS
WE MR SANTIAGO HAS OUR FINAL
BILL, AS WE MOVE INTO OUR FINAL
BILL WOULD ASK THE COMMITTEE
MEMBERS COME TO VOTE. WE'D
REALLY LIKE THE OPPORTUNITY TO
GO THROUGH THE BILLS. ONE TIME.
UM SO THOSE OF YOU WHO ARE
HAVEN'T MADE YOUR WAY TO THE
1100 TODAY. PLEASE COME ON DOWN.
IF YOU'RE AROUND. ABOUT THAT
VOTE WAS 10 0 THAT AND WE'LL
LEAVE THAT BELIEVE THE ROAD OPEN
FOR OTHERS TO ADD ON. MR
SANTIAGO, PLEASE THE FINAL BILL
OF THE DAY. YOU HAVE. WHERE'S
YOUR SKITTLES? NÓ. THE BUTTON,
PLEASE, SIR. THANK YOU. THANK
YOU, MR CHAIR AND COMMITTEE
MEMBERS WHO HAVE BEEN HERE TODAY
THROUGHOUT THE DAY. SO I
APPRECIATE IT. I WILL BE BRIEF
AND ALLOWED MY WITNESSES TO, UH,
DO THE SPEAKING FOR US. IF THAT
WOULD BE OKAY WITH THE CHAIR.
AND TODAY WE'RE PRESENTING A B,
UH 14 87 THAT WOULD ESTABLISH
THE TRANSGENDER BY THE T G I
REENTRY FUND TO BE BRIEF, I WILL
HAND IT TO MY, UM MY CO
PRESENTERS. THANK YOU, MR AND MY
WITNESSES. THANK YOU, MR CHAIR.
I NEVER THOUGHT I'D PLEASE PUSH
THE BUTTON. THERE YOU GO. THANK
YOU SAID MY HEART BEATING FAST.
I NEED SOME OF THEM SKITTLES.
OKAY I'M GOOD AFTERNOON. GOOD
EVENING. MY NAME IS DIRE. ACERRA
I'M A REENTRY CASE. MANDER
GENERAL MANAGER AT TRANSGENDER
GENDER VARIANT INTERSEX JUSTICE
PROJECT. T G I J P FOR SHORT IN
1990. I WAS SENT TO PRISON AND
GRANTED PAROLE IN 2019.
UNFORTUNATELY I WAS RELEASED TO
A PROGRAM IN SAN DIEGO THAT DID
NOT WANT TRANSGENDER PEOPLE. IN
THEIR UM, COMMUNITY OR THEIR
TRANSITIONAL HOUSING, AND IT WAS
OUTWARDLY TRANSPHOBIC. MY PAROLE
OFFICER CAUGHT UP TO THE PRESENT
PRISON BEFORE I WAS PAROLED AND
STATED THAT HE DID NOT WANT
TRANSGENDER IN HIS COUNTY. THE
LACK OF SUPPORT AND THE LACK OF
SUPPORT AND RESOURCES LED TO MY
RECORD REINCARCERATION. THE NEXT
TIME I WAS GRANTED PAROLE, I WAS
FORTUNATE TO BE CONNECTED WITH G
I J P, WHICH PROVIDED ME WITH
RESOURCES AND EVERYTHING I
NEEDED TO SUCCESSFULLY, UM
COMPLETE OR RE ENTRY PROGRAM. I
WAS GRANTED EARLY RELEASE FROM
PAROLE THIS JANUARY. ACTUALLY, I
AM NOW ACTIVELY INVOLVED IN
ADVOCATING FOR THE NEED FOR
TRANSGENDER AND GENDER EXPENSIVE
INDIVIDUALS WHO WAS COMING OUT
OF PRISON IN NEED OF RE ENTRY.
PROGRAM AND RESOURCES FOR THIS
FROM THE STATE ARE NECESSARY IN
ORDER TO MEET THE NEEDS FOR ALL
T G I PERSONS COMING OUT OF
PRISON, SPEAKING IN HOPES OF
RECEIVING YOUR SUPPORT IN THE
ENDEAVOR SUIT, ENSURE ADEQUATE
REENTRY SERVICES TO ALL T G. I,
UM T G. I PEOPLE, PEOPLE, WE
HAVE THE RIGHT TO BE SAFE,
SUCCESSFUL AFTER PRISON AND SUCH
A GOAL CAN BE ACHIEVED WITH
INVESTMENT FROM THE STATE. I'M
ASKING THAT YOU PLEASE SUPPORT.
THANK YOU. UM, GREETINGS. UM. AH
UM, COMMITTEE. THANK YOU SO MUCH
FOR THE OPPORTUNITY TO BE HERE
WITH ALL OF YOU TODAY. MY NAME
IS BAMBI, SALCEDO. AND I DON'T
HAVE THE PRIVILEGE TO BE THE
PRESIDENT IN THE SEA OF THE
CONSULTING OUR COALITION. I'M
ALSO HERE ON BEHALF OF THE
CALIFORNIA TRANS GENDER
NONCONFORMING AND INTERSEX
POLICY ALLIANCE, OR T G, UM, THE
CART PATH TO BE SHORT. UM AND I
AM A TRANSFORM IN WHO IS 53
YEARS OLD. WHEN I WAS 18 YEARS
OLD, I STARTED BEING
INCARCERATED. UM FOR PETTY
TOUGHS AS AWAY, YOU KNOW, JUST
FOR THINGS THAT I NEEDED TO DO
IN ORDER TO SURVIVE. UM THAT
PRECIPITOUS SERVICE AND PROCESS
THAT HAPPEN, UH, FROM WHEN I WAS
18 TO UNTIL I WAS 32 YEARS OLD,
UM YOU KNOW, IT WAS CRAZY THAT I
HAD TO EXPERIENCE HORRIBLE
THINGS WHILE I WAS INCARCERATED.
UH, BUT IF THERE WAS SERVICES
THAT WOULD HAVE SUPPORTED ME
WHEN I WAS YOUNG, UM TO INSTEAD
OF GOING TO PRISON, AND BIÂU, UM
YOU KNOW, VIOLATED BY. PEOPLE
WHO ARE INCARCERATED AND BY
GUARDS AND MANY DIFFERENT WAYS.
UH IF I HAD HAD THE OPPORTUNITY
TO RECEIVE THAT SERVICES THAT I
NEEDED IN ORDER FOR ME TO NOT
JUST SURVIVE, BUT ALSO THRIVE,
UM I WOULDN'T SPEND MORE THAN.
15 YEARS OF MY LIFE COMING IN IN
AND OUT OF JAIL IMPRISONS, AND
SO FOR THIS REASON I AM ASKING
FOR YOU TO PLEASE SUPPORT
ASSEMBLY BILL 14 87, WHICH WILL
SUPPORT OTHER TRANSGENDER
NONCONFORMING AND INTERSEX
INDIVIDUALS WHO, UM YOU KNOW WHO
DESERVE TO HAVE DIGNIFIED LIVES
WHO DESERVED TO HAVE BETTER
QUALITIES OF LIFE IN OUR STATE.
UM RATHER THAN BEING CONTINUED
TO BE CRIMINALIZED AND
INCARCERATED SIMPLY BECAUSE OF
WHO WE ARE, AND I ASKED THAT
PLEASE VOTING PAPER OF THIS
BILL, WHICH WILL SUPPORT NOT
JUST THE LIVELIHOOD OF OTHER
TRANSGENDER NONCONFORMING INTO
SIX PEOPLE. BUT WILL ELIMINATE,
UM, THAT OUR COMMUNITY CONTINUED
TO BE INCARCERATED. UM AND
REALLY RECEIVE THE CRITICAL AND
MUCH NEEDED SERVICES THAT OUR
COMMUNITY NEEDS TO IN ORDER TO
BE ABLE TO LIVE. FRUITFUL LIVES
, SO I ASK YOU TO PLEASE
SUPPORT. UM ASSEMBLY BILL 14 87
. THANK YOU. THANK YOU VERY MUCH
, UM OTHERS IN SUPPORT. GREAT
POST FOR EQUALITY, CALIFORNIA
STRONG SUPPORT. THANK YOU. ALEX
BINS FELLED FOR BEYOND BINARY
LEGAL AND STRONG SUPPORT. THANK
YOU. IS THERE ANY OPPOSITION TO
THE BILL? AND NO ONE WILL BRING
IT BACK TO THE COMMITTEE. ANY
QUESTIONS OR COMMENTS COMMITTEE?
NO NO QUESTIONS OR COMMENTS. WE
DO HAVE A MOTION BY MS
BOERNER HORVATH. I'M SORRY. HAVE
YOU AMENDMENTS? YEAH. I WAS
GOING TO STATE THAT I FORGOT TO
SAY FROM THE ONSET THAT I WOULD
THANK YOU. THANK YOU. SO WE HAVE
A MOTION FROM THIS
BOERNER HORVATH. SECOND BY MR V.
VALLAPUDUA I BELIEVE, UH AND
THIS IS DUE PASS AS AMENDED TO
APPROPRIATIONS. WOULD YOU LIKE
TO CLOSER? RESPECTFULLY ASK FOR
MY VOTE. THANK YOU VERY MUCH.
MADAM SECRETARY, PLEASE CALL THE
ROLL. I WOULD I. WALDRON WALDRON
II. HURRY CURRY. I ARAMBULA
ARAMBULA. I'M BORN A HORVATH.
HARVEST. I CARILLO. LARA. FLORA,
NOT VOTING. VINCE FONG. I'M NOT
PHONING MAIENSCHEIN. MAIENSCHEIN
I'M MCCARTY MCCARTHY I, JOE
PATTERSON. JOE PATTERSON, NOT
VOTING. RODRIGUEZ RODRIGUEZ,
ICELAND, SANTIAGO SANTIAGO. I BE
VALLAPUDUA. YOU PUT WHAT I
WEBER. REMEMBER, I. THAT VOTE IS
11 0. YOUR BILL IS OUT. WE'LL
LEAVE THE ROLE OF THE OPEN FOR
OTHERS TO ADD ON. THANK YOU.
OKAY, FOLKS. WE'RE GOING TO
START AT THE TOP OF THE ORDER.
ITEM NUMBER ONE A. B 24. SO
EMOTION BY MISS AGUIAR-CURRY A
SECOND. I'VE MISSED
BOERNER HORVATH. MOTION IS DUE
PASS AS AMENDED TO JUDICIARY.
MADAM SECRETARY. PLEASE CALL THE
ROLL. WOULD WOULD I? WALDRON
WALDRON. I AGUIAR-CURRY
AGUIAR-CURRY. AYE ARAMBULA
ARAMBULA. AYE BOERNER HORVATH
BOERNER HORVATH. AYE, CARILLO.
FLORA. FLORA IVINS, FONG. MY
MAIENSCHEIN MAIENSCHEIN I
MCCARTY MCCARTHY I, JOE
PATTERSON. JOE PATTERSON. I
RODRIGUEZ RODRIGUEZ SAYS
SANTIAGO. SANTIAGO. I VE
VALLAPUDUA IF YOU PUT BY WEBER
WEBER. AYE. THAT BILL HAS 14
VOTES. IT'S OUT. UM ITEM NUMBER
2 84 59 IN SEARCH OF EMOTION.
SECOND BUT OR MOTION BY MS
AGUILERA CURRY IS SECOND BY MR
RODRIGUEZ. UM MOTION IS DUE PASS
AS AMENDED TO APPROPRIATIONS.
MADAM SECRETARY, PLEASE CALL THE
ROLL. WOULD WALDRON WALDRON
IAGAR CURRY CURRY? I ARAMBULA
ARAMBULA. AYE, BOERNER HORVATH
BOERNER HORVATH. AYE CARILLO.
FLORA FLORA IVINS FANG. THAT'S
WANG. I MAIENSCHEIN. MAIENSCHEIN
I MCCARTY MCCARTHY I JOE
PATERSON, PATERSON. I RODRIGUEZ
RODRIGUEZ I SANTIAGO SANTIAGO
IVY. VALLAPUDUA VALLAPUDUA. AYE,
WEBER. WHOEVER I THAT'S 14 0.
REMEMBER THREE A B 1001 BY MR
HANEY. MOTION BY MISS AGUILAR
CURRY IS SECOND BY MS
BOERNER HORVATH MOTION IS DUE
PASS AS AMENDED TO
APPROPRIATIONS. MADAM SECRETARY
PLEASE CALL THE ROLL. WOULD
WOULD I, WALDRON? WALTER NOT
VOTING. AGUIAR-CURRY
AGUIAR-CURRY. AYE, ARAMBULA.
ARAMBULA. AYE, BOERNER HORVATH.
BERNARDA I CARILLO. LARA. OR A
NO VINCE FONG. GOOD SONG SONG.
NO MAIENSCHEIN. MAIENSCHEIN I
MCCARTY MCCARTHY I JOE
PATTERSON. PATERSON, NOT VOTING
RODRIGUEZ. RODRIGUEZ I SANTIAGO.
SANTIAGO IVY VALLAPUDUA, THE
VALLAPUDUA WEBER HOWEVER, I.
THAT BOAT IS 10 TO 2. ITEM
NUMBER FOUR A B 3 52 BY MISS
BARRACK CAHAN. CONFIRM EMOTION.
MOTION BY MISS. UH MISS
BOERNER HORVATH, SECOND BY MR
MCCARTHY MOTION IS DUE PASS TO
PRIVACY AND CONSUMER PROTECTION
. MADAM SECRETARY. PLEASE CALL
THE ROLL. WOULD WOULD I WALDRON?
WALDRON NO AGUIAR-CURRY CURRY. I
ARAMBULA ARAMBULA. AYE
BOERNER HORVATH. AYE, CARILLO
LARA. FOREIGN THAT VOTING VINCE
WONG IT'S FUN. NO MAIENSCHEIN.
MAIENSCHEIN I MCCARTY MCCARTHY I
JOE PATTERSON. JOE PATTERSON.
NO, RODRIGUEZ RODRIGUEZ. I
SANTIAGO SANTIAGO IVY
VALLAPUDUA. VALLAPUDUA AYE.
WEBBER WEBBER? AYE. THAT VOTE IS
10 TO 3. THAT BILL IS OUT. I
DON'T REMEMBER FIVE WAS
WITHDRAWN. FROM THE FROM THE
HEARING ITEM NUMBER SIX A BEFORE
18 BY MR GABRIEL, PLEASE OPEN
THE ROLE CALLED THE ABSENT
MEMBERS BOERNER HORVATH.
BOERNER HORVATH AYE CARILLO
LARA. FOR IVAN SPHANG. THAT'S
FINE, YOU KNOW? SANTIAGO.
SANTIAGO. AYE. THAT VOTE IS 12
TO 1. ITEM NUMBER. 78 IS PART OF
THE CONSENT CALENDAR. SO CONSENT
CALENDAR INCLUDES ITEM NUMBER
SEVEN, MAYBE 4 24 BY MR BRIAN
ITEM NUMBER 16 A B 8 27 BY MR
GARCIA ITEM NUMBER 23 A B 12 76
BY MISS MCKENNA. ITEM NUMBER 26
A B 5 64 BY MR V VALLAPUDUA AND
ITEM NUMBER 32 A B 17 OH, ONE BY
DR WEBBER LOOKING FOR EMOTION.
BY, UM. MS AGUIAR-CURRY SECOND
BY MR V. VALLAPUDUA MADAM
SECRETARY, PLEASE CALL THE ROLL
ON THE CONSENT CALENDAR.
WALDRON. WALTER AND I ARE CURRY
CURRY. I ARAMBULA ARAMBULA. AYE,
BOERNER HORVATH.
BOERNER HORVATH. AYE, CARILLO.
LARA. FLORA IVAN'S PHªN. HØI
MAIENSCHEIN MAIENSCHEIN I
MCCARTY MCCARTHY I JOE PATTERSON
, JOE PATERSON. I RODRIGUEZ
RODRIGUEZ I SANTIAGO SANTIAGO
IVY VALLAPUDUA. VALLAPUDUA. AYE,
WEBER. HOWEVER, I. 14 14 TO 0
ITEM NUMBER 9 85 OH, ONE BY ONE
CARILLO. UH LOOKING FOR EMOTION.
OH MAN, OF COURSE, I DON'T EVEN
KNOW WHERE TO START. WE'LL GIVE
THAT TO MR MCCARTY. SECOND BY MR
FONG MOTION IS DUE PASS AS
AMENDED TO APPROPRIATIONS. MADAM
SECRETARY, PLEASE CALL THE ROLL.
WOULD WOULD I, WALDRON WALDRON.
I AGUIAR-CURRY CURRY. I ARAMBULA
ARAMBULA. AYE BOERNER HORVATH.
BOERNER HORVATH KOREA. LARA.
FLORA IVINS, FONG. THAT SONG. I
MAIENSCHEIN MAIENSCHEIN I'M
MCCARTY MCCARTHY I, JOE
PATTERSON, PATERSON. I RODRIGUEZ
RODRIGUEZ I SANTIAGO SANTIAGO
IVY VALLAPUDUA VÆ VALLAPUDUA,
AYE, WEBER WHOEVER I 14 0 14 0.
I DON'T NUMBER 10 A B 5 83 BY
ASSEMBLYMEMBER'S WICKS LOOKING
FOR EMOTION THAT ONE WHOOPS. WAS
THAT ON CALL? I'M SORRY. THAT'S
ON CALL, SO I'M SORRY. THAT IS,
UH PLEASE ON SO ITEM NUMBER 10
85 83. PLEASE LIFT THE CALL.
CALL THE ABSENT MEMBERS,
WALDRON. WALTER AND I ARE CURRY
AGUIAR-CURRY. AYE. CARILLO.
LARA. FOR A NO. MAIENSCHEIN
MAIENSCHEIN I, JOE PATTERSON.
PATERSON. NO. SANTIAGO.
SANTIAGO. AYE. 11-3 IS 11 TO 3.
ITEM NUMBER 11 85 86, PLEASE
LIFT THE CALL. CALL THE UP. I'M
SORRY THAT WE NEED EMOTION ON
THAT ONE. I'M SORRY. WE'LL NEED
EMOTION ON THAT ONE. SO MOVED BY
THAT WAS THAT, MR SANTIAGO?
THANK YOU. MR SANTIAGO. MOTION
BY MR SANTIAGO IS SECOND BY MS
BOERNER HORVATH ITEM NUMBER 85
86 DO PASS THROUGH
APPROPRIATIONS. MANA SECRETARY,
PLEASE CALL THE ROLL. WOULD
WALDRON. WALTER NOT VOTING FOR
FREE. I GOT CURRY. I ARAMBULA
ARAMBULA. AYE BOERNER HORVATH
BOERNER HORVATH. AYE, CARILLO.
CARILLO I FLORA. OR NOT VOTING
THAT'S FINE. PHªN NO
MAIENSCHEIN. MAIENSCHEIN I
MCCARTY MCCARTY AYE. SO,
PATTERSON. BILL PATTERSON NOT
VOTING RODRIGUEZ. RODRIGUEZ I
SANTIAGO. SANTIAGO IVY
VALLAPUDUA. VÆ VALLAPUDUA. AYE,
WEBER. RUBBER? AYE. 11. OH ONE
VOTE IS 11 TO 1 ITEM NUMBER 12 A
B 608 BY ASSEMBLYMEMBER'S SZABO
. UM PLEASE OPEN THE ROLL CALL
THE ABSENT MEMBERS. CARILLO.
CARILLO I FLORA. LARA? AYE.
MAIENSCHEIN MAIENSCHEIN I
MCCARTY MCCARTHY I JOE PATERSON,
PATERSON I SANTIAGO SANTIAGO. I
15 0 15 0. YEAH, OKAY. OKAY ITEM
NUMBER 14, ABC. 7 67, PLEASE
LIFT THE CALL CALL THE OPPOSITE
MEMBERS. BOERNER HORVATH
BOERNER HORVATH. AYE, CARILLO.
CARILLO I FLORA. FOR IVAN'S
FONG. SHANGHAI MAIENSCHEIN.
MAIENSCHEIN I, PATERSON
PATERSON. I SANTIAGO SANTIAGO
IVY VALLAPUDUA VALLAPUDUA, AYE.
THAT'S 15 0 ITEM NUMBER 17.
PROMOTION IN SEARCH OF EMOTION
IS A B 904. WHO WHO? WHO? MR
MCCARTY, SECOND BY MS CARILLO.
SORRY I IT'S A LONG DAY. UM ITEM
NUMBER 17 89 04 MOTION IS TO
PASS THROUGH APPROPRIATIONS.
MADAM SECRETARY, PLEASE CALL THE
ROLL. WOULD WALDRON WALDRON, I
AGUIAR-CURRY AGUIAR-CURRY. AYE,
ARAMBULA. ARAMBULA, NOT VOTING.
BOERNER HORVATH BOERNER HORVATH.
AYE, CARILLO. VÚI FLORA. FLORIDA
VOTING VINCE FONG. I'M NOT
VOTING MAIENSCHEIN. MAIENSCHEIN
I MCCARTY MCCARTHY I JOE
PATTERSON. PATERSON, NOT VOTING
RODRIGUEZ. RODRIGUEZ I SANTIAGO.
SANTIAGO IVY VALLAPUDUA
VALLAPUDUA, AYE, WEBER. WEBER.
AYE. 0 11 0 ITEM NUMBER 18 A B 9
31 BY MR IRWIN, PLEASE LIFT THE
CALL. CALL THE ABSENT MEMBERS,
WALDRON. ALTERING, NOT VOTING.
BOERNER HORVATH BOERNER HORVATH.
AYE, CARILLO. A BEING ITEM
NUMBER. 18 89 31 BY MR IRWIN
CARILLO. AYE, LARA. FOREIGN THAT
VOTING VINCE FONG WANG, I
MAIENSCHEIN MAIENSCHEIN I
MCCARTY MCCARTHY I, JOE
PATTERSON. THE PATERSON NOT
VOTING RODRIGUEZ. RODRIGUEZ I
SANTIAGO SANTIAGO IVY
VALLAPUDUA. THEY PUT WHAT I.
THAT'S 12 0. ITEM NUMBER 20,
PLEASE A B 14 37 BY MR IRWIN,
PLEASE LIFT THE CALL. CALL THE
ABSENT MEMBERS BOERNER HORVATH.
BOERNER HORVATH. AYE, CARILLO.
REAL I FLORA. FLORA I VINCE FONG
FONG. I MAIENSCHEIN IN CHINA. I
MCCARTY MCCARTHY I JOE PATERSON,
PATERSON I SANTIAGO SANTIAGO IVY
VALLAPUDUA. VALLAPUDUA I 15 0 15
0 ITEM NUMBER 21 A B 9 35 BY MR
CONNOLLY, PLEASE LIFT THE CALL
CALLED THE ABSENT MEMBERS
WALDRON. WALDRON. NO
AGUIAR-CURRY. THANK YOUR CAREER.
I BOERNER HORVATH
BOERNER HORVATH. AYE, CARILLO.
FOR REAL, I FLORA. LARA NÓ. YEAH
VINCE FONG FONG. NO MAIENSCHEIN
MAIENSCHEIN I. PATERSON
PATERSON, NO. SANTIAGO ON TIAGO.
AYE. HE WAS STOPPED WORKING.
THAT IS 10. 24, OKAY? ITEM
NUMBER 22 A B 11 68 LOOKING FOR
EMOTION. MOTION BY MR FLORA
SECOND BY MR RODRIGUEZ. I GUESS
MAYBE OKAY? MOTION IS DUE PASS
AS AMENDED TO EMERGENCY
MANAGEMENT AND SECRETARY PLEASE
CALL THE ROLL. WOULD WOULD I
WALDRON? WALDER, NIAGARA CURRY.
THANK YOU, COREY. I ARAMBULA
RAMBLING, NOT VOTING
BOERNER HORVATH.
BOERNER HORVATH. AYE, CARILLO.
VÚI FLORA. LARA. I'VE BEEN
SPHANG. THAT'S FINE. NO
MAIENSCHEIN. MAIENSCHEIN I'M
MCCARTY MCCARTHY I, JOE
PATTERSON. PATERSON IRODRIGUEZ.
RODRIGUEZ I SANTIAGO. SANTIAGO
IVY VALLAPUDUA. PUT ONE OF
VOTING WEBER WEBER. AYE. THAT'S
WHAT THE VOTE IS 12 TO 1 BILL IS
OUT. I DON'T REMEMBER. 25 MAYBE
FOUR BY DR ARAMBULA, PLEASE LIFT
THE CALL. CALL THE ABSENT
MEMBERS. BOERNER HORVATH UP.
BOERNER HORVATH. AYE, CARILLO.
CARILLO I FLORA. FLORA IVAN'S
FANG. IT'S FUN, NOT VOTING.
MCCARTHY MCCARTHY I, JOE
PATTERSON. PATERSON, NOT VOTING.
SANTIAGO. SANTIAGO. I VE
VALLAPUDUA VÆ VALLAPUDUA, AYE.
13 0 13 0. ITEM NUMBER 27 A B 5
76 BY DR WEBBER. PLEASE LIFT THE
CALL AND CALL THE ABSENT MEMBERS
. BOERNER HORVATH
BOERNER HORVATH. AYE, CARILLO.
FOR REAL, I FLORA. LARA? NO,
THAT'S FINE. PHªN NO JOE
PATTERSON. JOE PATTERSON, NOVY
VALLAPUDUA. YOU PUT ONE NOT
VOTING. AND THEREFORE I'M SORRY
FOR 10 TO 4. ITEM NUMBER 28 A B
6 16 BY MR RODRIGUEZ, PLEASE
OPEN THE ROLL CALL THE ABSENT
MEMBERS CARILLO. ITEM NUMBER 28
6616 FLORA. OR A NO. PATERSON.
PATERSON. NO. 4 10 4. ITEM
NUMBER 29 A B 13 92 BY MR
RODRIGUEZ, PLEASE LIFT. OPEN THE
ROLL. CALL THE ABSENT MEMBERS.
SORRY. WALDRON. WELL, THEY'RE
NOT VOTING. CARILLO. CARILLO I
FLORA. LARA, NOT VOTING
MAIENSCHEIN. MAIENSCHEIN I
MCCARTY. PATERSON. THE PATERSON
NO. AND THE ONE THAT'S 10 TO 1
ITEM NUMBER 30 A B 7 19. PLEASE
MISS BOERNER HORVATH, PLEASE
OPEN THE ROLE CALLED THE ABSENT
MEMBERS FOR REAL. CARILLO I
FLORA. FOREIGN THAT VOTING
PATERSON. PATERSON, NOT VOTING.
11, ISRAEL THAT'S 11 TO 0. AND
FINALLY, ITEM NUMBER 31 A B 14
87 PLEASE OPEN THE ROLE CALLED
THE ABSENT MEMBERS. CARILLO?
AYE. 12 0 12 0. SO YOU. WHICH UM
. UH IT WAS ITEM NUMBER
SURVIVORS OUT OF NUMBER 17 89 04
BY MS CALDERON. SO MR DOCTOR
ARAMBULA VOTING. I ON A B 904 MS
CALLED AROUND. AMBULANCE, NOT
VOTING TÔI. 12 0 WOULD LIKE TO
MAKE A VOTE CHANGE AS WELL. I'M
SORRY. I'M SORRY. IT'S TOO LATE.
I WOULD I WOULD ACCEPT THAT. I'M
JUST KIDDING. OF COURSE, MR
FLORA, WHICH WHICH A B, UH FOR
18 GABRIEL. ITEM SIX. YEAH, NOT
VOTING. UH SO THAT I DO NOT
KNOW. INTERNET VOTING. OKAY
THANK YOU, MR CHERRY. CAN I DO
VOTE CHANGE AS WELL? SURE.
FLORA. I DID NOT VOTING. 11 TO 1
TO ONE. SO, MR FONG ON MAYBE
FOUR. CAN I CHANGE MY VOTE FROM
NOT VOTING TO KNOW? YES, YOU
CAN. SO I REMEMBER 25 84. MR
FONG IS NOT VOTING TO KNOW. PHªN
NOT VOTING TO KNOW. THAT'S 13 1
BECOMES 13 TO 1. MISS KOREA. I
THINK THE ONLY PERSON WHO HASN'T
WE'LL GO, BUT WE'LL GO UP TO THE
BEGINNING FOR MISS CARILLO. I
THINK THAT'S I THINK THAT'S
RIGHT. OKAY SO ITEM NUMBER ONE A
B 24, PLEASE OPEN THE ROLL. CALL
THE ABSENT MEMBERS FOR REAL.
REALIZE 15 0 15 0 ITEM NUMBER 2
84 59 BY MR HANEY, PLEASE OPEN
THE ROLL CALL THE ABSENT MEMBERS
CARILLO. CARILLO I 15 0. THAT'S
15 0. I DON'T NUMBER THREE A B.
1001 BY MR HANEY, PLEASE OPEN
THE ROLE CALLED THE ABSENT
MEMBERS. FOR REAL, I 11 OR TWO.
THAT'S 11 TO 2. UM ITEM NUMBER
FOUR A B 3 52 BY MISS BARRACK
CAHAN, PLEASE OPEN THE ROLL CALL
THE ABSENT MEMBERS. CARILLO AYE
11-3 11 TO 3 ITEM NUMBER 6 84 18
BY MR GABRIEL PLEASE OPEN THE
ROLE CALLED THE ABSENT MEMBERS.
RIO. FREE. OH, I. 12-1 THAT'S 12
TO 1 ITEM NUMBER 7 16 23 26 32
ARE THE CONSENT CALENDAR. PLEASE
OPEN THE ROLL CALL THE ABSENT
MEMBERS. KOREA. REAL. I 15 0 15
0. ITEM NUMBER NINE A. B 503 BY
ONE CARILLO, PLEASE OPEN THE
ROLL CALL THE ABSENT MEMBERS.
FREE OH, I 15 0 15 0 AND FINALLY
, ITEM NUMBER 10 85 83 BY MS
WICKS, PLEASE OPEN THE ROLE
CALLED THE ABSENT MEMBERS FOR
REAL. RIO. AYE. 12 3 12 TO 3.
AND WITH THAT. WE CONCLUDE THE
BUSINESS OF THE HEALTH COMMITTEE
AND WE ARE ADJOURNED.