GOOD. BEFORE WE BEGIN. I'D LIKE
TO MAKE A STATEMENT ON PROVIDING
TESTIMONY AT TODAY'S HEARING. WE
SEEK TO PROTECT THE RIGHTS OF
ALL WHO PARTICIPATE IN THE
LEGISLATIVE PROCESS. WE CAN HAVE
AN EFFECTIVE DECLARATION THINGS
EFFECTIVE DELIBERATION ON THE
CRITICAL ISSUES FACING
CALIFORNIA ARE WITNESSES WILL BE
TESTIFYING IN PERSON WE ALLOWED
TO MAIN WITNESSES FOR A MAXIMUM
OF THREE MINUTES EACH.
ADDITIONAL TESTIMONY WILL ALSO
BE IN PERSON AND LIMITED TO NAME
PERSON AND ORGANIZATION IF YOU
REP REPRESENT ONE ALL TESTIMONY
. COMMENTS ARE LIMITED TO THE
BILL AT HAND, AND WE DO NOT
ALLOW ANY SIGNS OR PROPS OF ANY
KIND THROUGHOUT THE TESTIMONY.
WE DO HAVE BILLS PROPOSED FOR
CONSENT FOR TODAY'S HEARING. ANY
MEMBER OF THE COMMITTEE MAY
REMOVE A BILL FROM CONSENT. THE
ITEMS PROPOSED FOR CONSENT OR
ITEM NUMBER EIGHT ASSEMBLY BILL
8 45 BY ASSEMBLY MEMBER ALVAREZ
, ITEM NUMBER 13 12 82 BY
ASSEMBLYMEMBER'S LOWENTHAL. ITEM
NUMBER 14 A B 12 39 BY
ASSEMBLYMEMBER'S CALLED IRAN. I
DIDN'T NUMBER 16 A B 16 12 BY
ASSEMBLYMEMBER'S PACHECO. THE
FOLLOWING BILLS HAVE BEEN
REMOVED FROM TODAY'S CALENDAR.
SEND ME BILLS. 6 60 BY
ASSEMBLYMEMBER'S IRWIN SUDDENLY
BILLS 7 10 BY ASSEMBLYMEMBER'S
SZABO ASSUME ITEM NUMBER 19
ASSEMBLY ABOUT 55 BY ASSEMBLY
WROTE. REMEMBER RODRIGUEZ. AN
ASSEMBLY BILL 17 51 BY
ASSEMBLYMEMBER'S GIBSON. WE DO
NOT HAVE A QUORUM. WE DO NOT
HAVE ANY OTHER MEMBERS. SO IT IS
OUR CUSTOM TO NOT START UNTIL WE
HAVE A REPRESENTATIVE FROM BOTH
BOTH HOUSES OR BOTH SIDES OF THE
HOUSE. SO, UM CARDS, YOU KNOW,
CASUAL CONVERSATION, SOCIAL
MEDIA POSTS. WHATEVER YOU'RE
GONNA DO, JUST HANG OUT. THANK
YOU.
THANK YOU. UM MR PATTERSON HAS
ARRIVED AND WE CAN NOW BEGIN OUR
HEARING. APPRECIATE THAT. THANK
YOU. UH FIRST BILL, I SEE MISS
SARRIA HERE. SORRY IT HAS ITEM
NUMBER ONE A B 4 12.
GOOD AFTERNOON CHAIR AND MEMBERS
. UM FIRST I WANT TO BEGIN BY
THANKING OUR CHAIRMAN AND ALSO
THE COMMITTEE STAFF FOR WORKING
WITH US OVER THE LAST SEVERAL
WEEKS WITH HER OFFICE TO REFINE
THE BILL. THAT IS BEFORE YOU
TODAY YOUR PATIENCE AND
COOPERATION THROUGH THE PROCESS
IS GREATLY RECOGNIZED AND
APPRECIATED. SO UM, VERY
GRATEFUL FOR ALL OF THE HELP. UM
FOR THOSE OF YOU THAT DON'T
KNOW. ON DECEMBER 22ND 2020 22,
WHICH WAS LESS THAN THREE WEEKS
FROM THE DAY I WAS SWORN IN TO
REPRESENT THE CONSTITUENCIES OF
ASSEMBLY DISTRICT 27 I LEARNED
TO I LEARNED OF MADEIRA
COMMUNITY HOSPITALS INTENTION TO
CLOSE SINCE THAT DAY, I'VE HAD
COUNTLESS MEETINGS, BRIEFINGS
AND DISCUSSIONS WITH LOCAL,
STATE AND FEDERAL LEADERS TO TRY
AND FIND A SOLUTION BOTH SHORT
TERM AND LONG TERM TO ENSURE
CONTINUED ACCESS TO CARE IN THE
CENTRAL VALLEY. THE REASON
CLOSURE OF MADEIRA COMMUNITY
HOSPITAL IS A DEVASTATING HEALTH
CARE CRISIS FOR THE PEOPLE, NOT
JUST OF MADEIRA, BUT THE
SURROUNDING NEIGHBORING RURAL
COMMUNITIES. SINCE THE HOSPITALS
CLOSURE, MADERA COUNTY HAS
DECLARED A LOCAL EMERGENCY DUE
TO THE UNPRECEDENTED IMPACTS
BROUGHT ON BY A COMMUNITY
WITHOUT A HOSPITAL. FRESNO
COUNTY FOLLOWED SUIT WITH ITS
OWN DECLARATION OF EMERGENCY
BECAUSE FRESNO AREA HOSPITALS
ARE FAILING THE IMPACTS OF THE
CLOSURE AS MADEIRA COMMUNITY
MEMBERS SEEK HEALTHCARE ACROSS
COUNTY LINES. THE REALITY TODAY
IS THAT WE FIND OURSELVES IN A
SITUATION WHERE OVER 100 AND
60,000 PEOPLE IN THE HEART OF
CALIFORNIA ARE WITHOUT ACCESS TO
EMERGENCY HEALTHCARE SERVICES,
LABOR AND DELIVERY SERVICES,
SURGERY AND SPECIALTY CARE IN
THEIR OWN HOME COUNTY. OVER 80%
OF PEOPLE WHO SOUGHT CARE,
AMADORA COMMUNITY HOSPITAL OR
MEDICAL AND MEDICARE PATIENTS,
INCLUDING PATIENTS WHO VISITED
HOSPITALS. THE HOSPITALS, RURAL
HEALTH CLINICS IN CHOWCHILLA IN
MENDOTA, WHO ARE ALSO NOW
CLOSED. THESE PATIENTS ARE
MOSTLY FARM WORKERS, LOW INCOME
WORKING PEOPLE AND ESSENTIAL
WORKERS. PATIENTS EVEN RODE
THEIR BICYCLES AND WALKED ON
FOOT TO THE HOSPITAL TO SEEK
CARE. WHERE DO THEY GO NOW? FOR
THOSE WITHOUT RELIABLE
TRANSPORTATION? THIS IS A MATTER
OF LIFE AND DEATH. AND WE ALL
KNOW MINUTES CAN MAKE A
DIFFERENCE. IN A WEALTHY STATES
SUCH AS CALIFORNIA, WHERE WE
CHAMPION HEALTHCARE EQUITY AND
DECLARE HEALTHCARE HUMAN RIGHTS
. WE MUST ASK OURSELVES HOW DID
WE GET TO THIS POINT AND MOST
IMPORTANTLY, WHAT WILL HAPPEN TO
COMMUNITIES IN THE CENTRAL
VALLEY? IF WE HAVE ANOTHER
PANDEMIC? WHERE WERE PEOPLE GO?
THIS PAST WEEKEND, MYSELF AND A
FEW LEGISLATIVE COLLEAGUES,
INCLUDING THE CHAIRMAN, HAD THE
OPPORTUNITY TO VISIT MADEIRA
COMMUNITY HOSPITAL. WHAT WE SAW
WAS TRAGIC. WE TOURED A HOSPITAL
WITH 106 EMPTY BED, 16 EMPTY ER
BEDS AND 10 EMPTY ICU BEDS. WE
STOOD IN AN EMPTY LABOR AND
DELIVERY ROOM. WE WALKED BY AN
IDLE STATE OF THE ART CT SCANNER
ROOM AND WE SAW A HOSPITAL
EQUIPMENT DRAPED IN PLASTIC
SHEETING AND UNPLUGGED UNUSED
AND COLLECTING DUST. EMPTY NO
EMPLOYEES, NO NURSES, NO DOCTORS
, AND, MORE IMPORTANTLY, NO
PATIENCE. THE CLOSURE HAS
EXACERBATED THE HEALTH CARE
CRISIS THAT WE FACE IN OUR
CENTRAL VALLEY OUT OF THE CRISIS
. WE MUST SEIZE THE OPPORTUNITY
FOR LOCAL, STATE AND FEDERAL
LEADERS TO STAND ALONGSIDE THE
COMMUNITY AND FIND A WAY FOR THE
PEOPLE OF MADEIRA TO REGAIN
ACCESS TO LIFE SAVING AND
PREVENTATIVE HEALTHCARE. THE
CLOSURE OF MADEIRA COMMUNITY
HOSPITAL REPRESENTS AN
OPPORTUNITY FOR US TO THINK
OUTSIDE THE BOX. AND DEMAND THAT
WE NOT DO BUSINESS AS USUAL FROM
HERE IN SACRAMENTO, THERE MUST
BE A RECOGNITION THAT THERE ARE
SIGNIFICANT DISTINCTIONS BETWEEN
URBAN AND RURAL CALIFORNIA AND
THAT THE SOLUTION WILL NOT BE A
ONE SIZE FITS ALL APPROACH.
BEFORE 12, WHICH IS IN FRONT OF
YOU IS AN EFFORT TO PROVIDE
IMMEDIATE FINANCIAL ASSISTANCE
TO HOSPITALS LIKE MADEIRA
COMMUNITY HOSPITAL THAT HAVE
ALREADY CLOSED BUT ARE TRYING TO
REOPEN AND ALSO TO PROVIDE A
LIFELINE TO HOSPITALS TEETERING
ON THE EDGE OF CLOSING. WELL
MADEIRA COMMUNITY HOSPITAL IS
THE FIRST HOSPITAL TO SHUT DOWN
POST THE COVID PANDEMIC, AND
FORTUNATELY IT MAY NOT BE THE
LAST. BUT WE HAVE THE
OPPORTUNITY TODAY TO MAKE A
DIFFERENCE. OTHER HOSPITALS
AROUND THE STATE HAS SIGNALED
THEIR THREAT OF CLOSURE,
INCLUDING ANOTHER COUPLE,
ANOTHER HOSPITAL IN THE CENTRAL
VALLEY, KOREA HEALTH MEDICAL
CENTER AND VISALIA. CENTRAL
REGIONAL MEDICAL CENTER IN
IMPERIAL COUNTY. THESE ARE SOME
OF THE MOST DISADVANTAGED AND
ALREADY IMPACTED COMMUNITIES
THAT LACK ADEQUATE HEALTHCARE
SERVICES AND DOCTORS. UM A B 4
12 IS SIMPLY A SHORT TERM
SOLUTION THAT WILL HELP MADEIRA
REOPEN AND BE A LIFELINE FOR
HOSPITALS THAT ARE TEETERING. I
LOOK FORWARD TO WORKING WITH ALL
OF YOU SO THAT THERE ARE NO MORE
CLOSURE, AND THAT HAPPENED ON
OUR WATCH. TODAY I RESPECTFULLY
ASK FOR YOUR I VOTE. THANK YOU
WITNESSES AND SUPPORT YOU HAVE
TWO WITNESSES THAT CAN SPEAK FOR
THREE MINUTES. GOOD AFTERNOON,
MR CHAIR AND THE MEMBERS OF THE
COMMITTEE. THANK YOU VERY MUCH
FOR ALLOWING ME TO SPEAK TODAY
AND THANK YOU, ASSEMBLYWOMAN
SORIA FOR YOUR LEADERSHIP ON
THIS ISSUE. MY NAME IS MOHAMMED
I SHIP BOARD CERTIFIED
CARDIOLOGIST WHO HAS BEEN
PRACTICING MADERA COUNTY FOR 42
YEARS. SINCE I WAS RECRUITED BY
THE HOSPITAL WHEN I WAS
FINISHING MY FELLOWSHIP, TEXAS
HEART INSTITUTE, ONLY THE RURAL
, MEDICALLY UNDERSERVED COUNTY.
MOST OF OUR 160,000 PEOPLE
BELONG TO MINORITY GROUPS, AND
MANY ARE LOW INCOME IN DECEMBER,
2022 AS THE ASSEMBLY WOMAN
MENTIONED BECAUSE IT HAD RUN OUT
OF FUNDING AND BECAUSE THE BUYER
WOULD DO IS OFFER AT THE 11TH
HOUR COMMUNITY HOSPITAL ABRUPTLY
CLOSED ITS DOORS, LEAVING THE
COUNTY WITHOUT ANY ADULT
HOSPITAL. THE ISSUE THAT PLAGUED
OUR HOSPITAL, INCLUDING COVID,
LOW MEDICAL, MEDICARE,
INVESTMENT AND MANAGEMENT ARE
VERY OBVIOUS. I ALSO THINK YOU
UNDERSTAND THE NEGATIVE IMPACTS
AND THE LACK OF HEALTHCARE HAS
ONLY COMMUNITY AND ON EFFORTS TO
ACHIEVE IT, JUST AN EQUITABLE
SOCIETY. HEALTH IS VERY
IMPORTANT TO MAINTAIN THIS
SOCIETY. TODAY I WANTED TO SHARE
WHAT I'M SEEING ON THE GROUND.
MY PATIENTS ARE TERRIFIED AND
THEY'RE GOING TO DIE BECAUSE
THEY DO NOT HAVE THE RESOURCES
WHETHER THAT WILL BE ALLIED TIME
OFF OUR MONEY TO SEEK MEDICAL
TREATMENT AT THE NEXT CLOSEST
HOSPITAL, WHICH IS OVER 35
MINUTES AWAY IN FRESNO. I'VE
LOST MULTIPLE PATIENTS MYSELF,
AND I BELIEVE THEY COULD HAVE
BEEN. THEY'VE BEEN LIVING TODAY
COMMUNITY HOSPITAL BEING OPEN
AND PROVIDED TIMELY, LIFESAVING
EMERGENCY TREATMENT A FEW WEEKS
AGO, EFFICIENT HAVING JUST BEEN
DID NOT UNDERSTAND WHAT TO DO.
AND WHERE DOES THE HEALTH CARE
AVAILABLE? GROW HERSELF TO MY
OFFICE FOR HELP? I CALLED THE
AMBULANCE. SHE HAS SURVIVED THE
TRIP TO FRESNO HOSPITAL, BUT
DIED SOON AFTER AT HOME. TO ADD
INSULT TO INJURY. THE FRESNO
HOSPITAL WAS SO OVERWHELMED THAT
IT TOOK DAYS TO GET ME WHAT I
NEEDED TO BE ABLE TO SIGN THE
DEATH CERTIFICATE DOES DEALING
OR BURIAL. WE NEED A ROBUST,
COMPREHENSIVE SOLUTION TO THE
HEALTH CARE CRISIS, BUT IN THE
MEANTIME, WE ALSO NEED EMERGENCY
PROGRAMS LIKE WORSE, AND WE IN
IN 84 12. IF SERGEANT EMERGENCY
FUNDS HAD BEEN AVAILABLE TO OUR
HOSPITAL IN DECEMBER, WE COULD
HAVE KEPT THE DOORS OPEN AND
SAVE LIVES. I URGE YOU TO VOTE
IN FAVOR OF A BEFORE 12. I'VE
BEEN IN THIS IN THIS TOWN FOR 42
YEARS. THIS IS MY ONLY PRACTICE.
AND I SIT NEXT TO THE HOSPITAL.
I SEE MY HOSPITAL EMPTY PARKING
LOT EVERY SINGLE DAY. IT'S NOT
EASY FOR ME FOR MY PATIENTS. AND
THANK YOU FOR THE OPPORTUNITY TO
SPEAK TODAY. TALENT OVER TO MY
COLLEAGUE, DR LEADERSHIP INDIAN
WHO WILL ALSO SPEAK FOR THE
REMAINDER OF MY TIME. THANK YOU.
THREE MINUTES, PLEASE. THANK YOU
SO MUCH FOR HAVING NOUS AND
MUCH. APPRECIATE YOUR TIME, UM,
COMMITTEE MEMBER? I AM DR
RASHIDI ON TRIPLE BORDERS
POSITION SPECIALIZING AND
PULMONARY, ESPECIALLY LUNG
DISEASES AND CRITICAL CARE. WHAT
I PRACTICE. ESSENTIALLY TIME IS
ESSENCE. I TAKE CARE OF THE
SECOND OF THE SICK. UM WE HAD 10
ICU BED AND THAT THERE ARE
HOSPITALS. THEY'RE ALL CLOSED
NOW. UM I ALSO PRACTICING FRESNO
AND I SEE. UNFORTUNATELY SOME OF
THE PATIENTS BROUGHT PERSONAL
WITH AMBULANCE. THAT QUITE
FRANKLY, THEY DON'T EVEN MAKE IT
TO THE I C U UPSTAIRS IN
HOSPITALS IN FARES NOW, JUST
BECAUSE IN YOUR THEY PASS AWAY
UM, IT IS EXTREMELY SAD TO SEE A
HUGE COMMUNITY UNDERSERVED.
WITHOUT BASIC NEEDS OF
HEALTHCARE. THEY CAN'T EVEN GET
A CHEST X RAY, WHICH IS THE
SIMPLEST THING AFTER THREE PM
AND WHOLE COUNTY. UM. I PRICED
OR MY CAREER? UM, AFTER I
GRADUATED FELLOWSHIP AT MADEIRA
AND IN FRESNO, I DEVELOPED THAT
I SEE YOU, UH, PROGRAM AND AFTER
A FEW YEARS SEEING IT GO AWAY.
WITHOUT ANY REPLACEMENT, QUITE
FRANKLY, IS HARD BURNING. AND,
UH, UNFORTUNATELY, AS I
MENTIONED THESE PATIENTS THEY
CAN'T EVEN BE SEEN IN FRESNO AS
AN OUTPATIENT BECAUSE OF LACK OF
ADEQUATE INSURANCE. THE ONLY
LIFELINE. FOR MEDEIROS COUNTY
AND SOME OF THE SURROUNDING
COUNTY IS MADE HAROLD HOSPITAL
WE USED TO SEE MEDICAL PATIENTS
THAT THEY WOULD TRAVEL FROM
STOCKTON. TO SEE A SPECIALTIES
IN THE CLINICS AND MADERO. THOSE
PATIENTS ARE WITHOUT HEALTHCARE
. THEY CAN'T EVEN GET THE
MEDICATION REFILL. CURRENTLY AND
THEY CAN'T EVEN END UP IN ANY
OTHER YOUR SIMPLY BECAUSE THE
OTHER YOURS ARE AWFUL. AND
FRESNO. EVERY YEAR IS
ESSENTIALLY FULL OF PATIENTS AND
MAJORITY OF THEM ARE THE HIGHER
IMPACT COMES FROM THE MADERA
COUNTY. I RESPECTFULLY AND
HUMBLY ASK YOU GUYS TO CONSIDER
THIS BELL AND VOTE FOR IT. SO
NOT JUST WE OPENED MADEIRA
HOSPITAL. WE CAN PREVENT ANOTHER
DISASTERS SUCH AS MADEIRA
HOSPITAL CLOSING. DELTA HOSPITAL
, WHICH IS WHERE 400 BEDS. I
DON'T EVEN KNOW HOW WAS GOING TO
HAPPEN. QUITE FRANKLY OF THE
HOSPITAL CLOSES. UM HOLLISTER
HOSPITAL, SO WE REALLY NEED YOUR
HELP TO, UM, GET THIS BELL PASS
, AND HOPEFULLY WE GET SOME
FUNDING TO GET HEALTHIER BASIC
HEALTHCARE TO THE COMMUNITY THAT
WE ALL LIVE IN. THANK YOU SO
MUCH FOR YOUR TIME AND
APPRECIATE YOU GIVING ME A
CHANCE TO SPEAK. THANK YOU.
PLEASE LINE UP OVER HERE. ANY
ADDITIONAL WITNESSES IN SUPPORT
, PLEASE. JUST STATE, YOUR NAME
ORGANIZATION IN POSITION ONLY.
MEMBERS OF THE COMMITTEE. PLEASE
GO FIRST AT THE TABLE. SORRY,
CATHERINE AUSTIN SCOTT WITH
CALIFORNIA HOSPITAL ASSOCIATION.
COMPLETELY APPRECIATE THE
MEMBER'S WORK ON THIS BILL. UM
AND LOOK FORWARD TO WORKING WITH
YOU ALL ON THIS BILL, AND THEY
CONTINUED SYSTEMATIC
UNDERFUNDING OF MEDIC. AL THAT
REALLY IS THE ROOT OF MANY OF
THESE PROBLEMS. THANK YOU. MR
CHAIR MEMBERS OF THE COMMITTEE
BRANDON MARCHI WITH THE
CALIFORNIA MEDICAL ASSOCIATION
AND SUPPORT. GOOD AFTERNOON, MR
CHAIR MEMBERS, CONNIE DELGADO ON
BEHALF OF THE DISTRICT HOSPITAL
LEADERSHIP FORUM AND SUPPORT
GOOD AFTERNOON. TAYLOR, RUSSIAN
ON BEHALF OF THE CALIFORNIA
FRESH FRUIT ASSOCIATION AND
SUPPORT PRESTON YOUNG FROM THE
CALIFORNIA CHAMBER OF COMMERCE
HERE TODAY IN SUPPORT THANK YOU.
CHAIR REMEMBER THIRD BRIDGE ON
BEHALF OF THE ASSOCIATION OF
CALIFORNIA HEALTHCARE DISTRICTS
AND SUPPORT GOOD AFTERNOON.
SARAH DECAY WITH THE RURAL
COUNTY REPRESENTATIVES OF
CALIFORNIA AND SUPPORT IS HE
SWIMMING ON BEHALF OF FRESNO
BORDER SUPERVISORS AND SUPPORT
AND MADERA COUNTY BOARD OF
SUPERVISORS SUPPORT. THANK YOU.
MISS THAT SHORT ON BEHALF OF
BEVERLY HOSPITAL. IMPEACH
CALIFORNIA'S COMMUNITY, UM
SAFETY NET HOSPITALS AND SUPPORT
THANK YOU ANY WITNESSES AND
OPPOSITION? WE HAVE THIS ALL
OPPOSITION. SO PLEASE COME UP TO
THE TABLE. YOU HAVE THREE
MINUTES. OR TWO WITNESSES. MR
CHAIRMAN MEMBERS, DENNIS SLOPER
FOR THE UNITED HOSPITAL
ASSOCIATION. WE ARE SUPPORTIVE,
AMENDED. WE BELIEVE THAT ALL
HOSPITALS SHOULD BE INCLUDED IN
THIS BILL AND NOT LIMITED. TO
KEEPING AN INVESTOR ON HOSPITALS
WITH KURT WITH APPROPRIATE
GUARDRAILS. YOU CAN BE ASSURED
THAT THE MONEY IS GOING TO THE
TO THE USED TO KEEP THE HOSPITAL
OPEN AND IF THEY MEET THE SAME
STRESS LEVELS THAT SHOULD BE
INCLUDED. THANK YOU. THANK YOU
HAVE A MIDDLE GROUND WITNESS.
PLEASE COME UP. GOOD AFTERNOON.
MATTLAGE IMBABA, STU, CALIFORNIA
WANT TO THANK THE AUTHOR AND, UM
, THE COMMITTEE FOR TAKING THIS
ISSUE UP. THINK IT'S A REALLY
IMPORTANT ISSUE DO JUST WANT TO
SEE AS THE BILL MOVES FORWARD,
CONTINUED GUARDRAILS AROUND
TRANSPARENCY, ACCOUNTABILITY AND
OVERSIGHT AS THE MONEY WAS
FORWARD AND LOOK FORWARD TO
WORKING WITH AUTHOR AND, UM,
COMMITTEE ON THOSE
CONVERSATIONS. THANK YOU.
QUESTIONS FROM COMMITTEE
MEMBERS. UH, YES, MR FONG. I
CERTAINLY WANT TO THANK THE
AUTHOR FOR THIS BILL. SUPPORTIVE
UH, CERTAINLY APPRECIATE YOU
ACKNOWLEDGING, UM, UM KOREA AND
VISALIA. AND OF COURSE, THE
CHALLENGES THAT WE HAVE. WE DO
HAVE TO PROBABLY DO MORE BROADER
. BUT I DO WANT TO ASK IN TERMS
OF FROM WHERE YOU'RE SITTING. I
KNOW THERE'S SPECIFIC CRITERIA
TO DETERMINE WHAT A FINANCIALLY
DISTRESSED HOSPITAL IS. WHAT
WOULD YOU ELABORATE IN TERMS OF
THE CRITERIA OF ELIGIBILITY OF
THE LOAN? THANK YOU FOR THAT
QUESTION. ASSEMBLYMEMBER'S SO WE
HAVE BEEN WORKING WITH THE
COMMITTEE AND ALSO OTHER
STAKEHOLDERS TO ENSURE THAT, UM
, THE DEPARTMENT WHICH I GUESS
WILL BE H CHI WILL BE DELETED.
K¾T DELINEATING THE CRITERIA TO
ENSURE THAT THOSE THAT ARE
STRUGGLING ARE THE ONES THAT
BENEFIT FROM THE BILL. IS THERE
ANY SPECIFIC CRITERIA YOU WANTED
TO SEE OR THE ONES THAT WE
SHOULD BE? AS LONG AS AS A
COMMITTEE SHOULD BE. SO, FOR
EXAMPLE, MADEIRA OBVIOUSLY, UM,
IS REALLY THE DRIVING FORCE
BEHIND THIS. IT'S A YOU KNOW,
RECENTLY CLOSED HOSPITAL AND SO
ENSURING THAT MADEIRA, UM, WHO
IS NOW CLOSED IS ELIGIBLE ALONG
WITH. I THINK THAT WHAT WE'VE
TALKED ABOUT IS LOOKING AT
HOSPITALS LIKE YOURSELVES. I
THINK THEY'VE MENTIONED THEY
HAVE, LIKE 60 DAYS CASH. THE
LOOKING AT MAKING SURE THAT, UH
, HOSPITAL LIKE WE ALSO WHICH IS
SHORT ON CASH HAS THE ABILITY TO
QUALIFY FOR THE SUPPORT OR FOR
THE ASSISTANCE CLARIFIED. UH,
THE BILL WOULD HAVE A JOKE. I
DEVELOPED THE CRITERIA FOR THAT.
I DON'T KNOW IF THE HOSPITAL
ASSOCIATION WANTED TO CHIME IN
HERE IN TERMS OF WHAT THE
CRITERIA. I THINK THE AUTHOR HAD
IT RIGHT. I MEAN, WE'VE BEEN
WORKING WITH THE COMMITTEE AND
THE AUTHORS OFFICE WE DO. I
THINK THE AMENDMENTS REFLECT
THAT. WE DO WANT TO MAKE SURE
THAT THERE'S A, UM, A CLEAR
MESSAGE TO THE COMMUNITY OF
HOSPITALS THAT THIS BILL IS
GOING TO HELP A VERY SMALL SET
SO THAT WE CAN PRIORITIZE THOSE
THAT ARE SITTING ON THE CLIFF.
AS WE SAY, UM AND H CHI WILL
HELP WORK ON THAT AS WE MOVE
FORWARD, BUT THERE ARE SOME.
THERE ARE SOME CONSIDERATION FOR
MAKING SURE IT'S CLEAR. IT'S A
SMALL SET. BECAUSE AS WE'RE
WORRIED THERE ON THE EDGE
BECAUSE WE'VE HAD YEARS OF
UNDERFUNDING AND WE WANT TO MAKE
SURE WE MAINTAIN THE
CONVERSATION AROUND ADDRESSING
THE LARGER UNDERFUNDING ISSUES,
WHICH THE AUTHORS ALSO OFFERING
LOOK FORWARD TO WORKING WITH YOU
AS WE DEVELOPED THE CRITERIA.
WANT TO MAKE SURE THAT THESE
THESE CRITICAL HOSPITALS
MAINTAINED AND REMAIN OPEN.
THANK YOU. OKAY THANK YOU. NO
FURTHER QUESTIONS. WE DON'T HAVE
A QUORUM YET. SO WE WILL TAKE
THIS ISSUE UP LATER. THANK YOU.
NEXT AUTHOR, MR CORA. SHE ASKED.
YEAH. MS SORIA ASSEMBLYMEMBER'S
. ONE TECHNICAL THING. WE YOU
DIDN'T AGREE TO DO THE COMMITTEE
AMENDMENTS. SO YOU AGREE TO
ACCEPT THE COMMITTEE AMENDMENTS.
OKAY? YES FOR THE RECORD, WE GOT
THAT. THANK YOU. SORRY ABOUT
THAT. NEXT AUTHOR, MR KARA.
THANK YOU, MR CHAIR AND MEMBERS
A B 4 86 MOVES THE REGULATORY
APPEAL PROCESS FOR CLASS DOUBLE
A AND A APPEALS. OUT OF COURT
AND INTO AN A AN INDEPENDENT
ADMINISTRATIVE HEARING OVERSEEN
BY ADMINISTRATIVE LAW JUDGE
APPARENTLY NURSING HOMES AND
LONG TERM CARE FACILITIES
LICENSED BY THE DEPARTMENT OF
PUBLIC HEALTH HAD THE UNUSUAL
AND SINGULAR PRIVILEGE TO PILOT
CITY CITATION APPEALED FOR THE
MOST SERIOUS VIOLATIONS THAT
INVOLVE HARM OR DEATH OF A
RESIDENT UNDER THEIR CARE IN
THEIR LOCAL SUPERIOR COURT,
HOWEVER, SUPERIOR COURT SYSTEM
IS OVERBURDENED AND NOT DESIGNED
TO HANDLE REGULATORY APPEALS.
FACILITIES CAN ALSO DRAW THIS
PROCESS OUT FOR SEVERAL YEARS TO
REDUCE OR OVERTURN CITATIONS AND
AVOID ACCOUNTABILITY. DESPITE
BEING RARELY USED. SORRY, SORRY
, DESPITE BEING RARELY ISSUED
WHEN FACILITIES ARE APPEAL
CLASS, DOUBLE A AND A CITATIONS
AND STATE MUST EXPAND ITS
CONSIDERABLE RESOURCES TO DEFEND
THE CITATION HAS THE BURDEN OF
PROOF TO SUBSTANTIATE THE
VIOLATION. UNFORTUNATELY THERE
IS A WELL ESTABLISHED
ADMINISTRATIVE LAW PROCESS THAT
CAN ABSORB AND ADJUDICATE THESE
APPEALS. THIS OUT OF COURT
PROCESSES LESS EXPENSIVE, MORE
TIME, EFFICIENT AND CONSISTENT
WITH OTHER LICENSING APPEALS
THAT ARE ALSO USUALLY HANDLED BY
ADMINISTRATIVE LAW JUDGE OR
REGULATORY APPEALS BOARD. BY
MAKING THIS LONG OVERDUE CHANGE.
MAYBE 46 ALLOWS OUR STATE
REGULATORS TO MORE EFFECTIVELY
HOLD NEGLIGENT FACILITIES
ACCOUNTABLE, SO QUALITY CARE FOR
FUTURE RESIDENTS CAN BE
IMPROVED. UNDER THIS BILL
FACILITIES RETAIN THEIR DUE
PROCESS RIGHTS AND BENEFIT FROM
ALREADY BEING FAMILIAR WITH THE
ADMINISTRATIVE LAW PROCESS
BECAUSE CLASS B APPEALS ARE
OFTEN SENT THEIR THEY'RE SAYING
FACILITIES THAT PEEL THE STATE
WAS OVERREACHING AND ITS
CITATION OR DID NOT SUBSTANTIATE
THE CAUSE OF HARM OR DEATH
SHOULD NOT SEE THIS AS AN
INFERIOR PROCESS. RECENT
AMENDMENTS CLARIFIED THAT
FACILITIES STILL DISSATISFIED
WITH THE ADMINISTRATIVE LAW
PROCESS. MEANWHILE, AT 1094.5.
10 94.5 WRIT IN THE SUPERIOR
COURT TO REVIEW THE FACTUAL AND
EVIDENTIARY RECORD FROM THE
HEARING TO DETERMINE THE PROCESS
WAS FAIR. THE OPPOSITION SAID
THE OPPOSITION HAS PROPOSED
KEEPING THE STATUS QUO AND
ADDING THE OPTION FOR FACILITIES
TO APPEAL USING IT OUT OF COURT
ARBITRATION PROCESS FOR ONE.
THIS IS NOT ADDRESSED THE
PROBLEM. AND TO THE AMERICAN
ARBITRATION ASSOCIATION PROCESS
IS NOT THE APPROPRIATE VENUE FOR
THE SEVERITY AND COMPLEXITY OF
CLASS DOUBLE A AND APPEALS
BECAUSE THE DEPARTMENT IS NOT
REVIEW THE ARBITRATOR'S DECISION
AND CANNOT REMEDY THE
ARBITRATORS. LEGAL ERRORS, IF
ANY. NURSING HOMES RECEIVE
SUBSTANTIAL STATE FUNDING TO
CARE FOR SOME OF OUR MOST
VULNERABLE RESIDENTS, AND IN
EXCHANGE, WE SHOULD EXPECT
QUALITY CARE. UNFORTUNATELY OUR
CURRENT SYSTEM MAKES IT VERY
DIFFICULT TO HOLD NEGLIGENT
ACTORS ACCOUNTABLE AND 84 86 IS
A BALANCE FIX IN THAT SYSTEM.
ACCOUNTABILITY IS THE STATE
DOING HIS JOB AT SUBSTANTIATED
VIOLATIONS OR COMPLAINTS PLAN
CAN BE MADE TO PREVENT FURTHER
HARM AND IMPROVE THE QUALITY OF
CARE FOR FUTURE RESIDENTS WITH
ME TO OFFER TESTIMONY AND
SUPPORT IS THE WHITE SEA, UM,
DISABILITY RIGHTS, CALIFORNIA
AND CHARLES ANTONIN, SUPERVISING
DEPUTY ATTORNEY GENERAL IN THE
HEALTH, EDUCATION AND WELFARE
SECTION AT THE CALIFORNIA
DEPARTMENT OF JUSTICE. THANK
YOU. WITNESS. PLEASE. YOU HAVE
THREE MINUTES. GOOD AFTERNOON,
MR CHAIR AND MEMBERS. UM SO
WHITE SEE HIM HERE ON BEHALF OF
DISABILITY RIGHTS, CALIFORNIA
AND WE ARE THE PROUD SPONSORS OF
ASSEMBLY BILL 486 AS
CALIFORNIA'S DESIGNATED
PROTECTION AND ADVOCACY AGENCY,
THE CARE AND TREATMENT OF
SKILLED NURSING FACILITY
RESIDENTS IS A TOP PRIORITY FOR
US. OUR STAFF REGULARLY GO
INSIDE THESE FACILITIES TO
INVESTIGATE ABUSE AND NEGLECT
AND MONITOR THE WELL BEING OF
RESIDENTS. FROM OUR DECADES OF
EXPERIENCE, WE HAVE CONCLUDED
THAT ROBUST OVERSIGHT AND
REGULATION IS ESSENTIAL TO
PROTECT THESE MOST VULNERABLE
RESIDENTS. THE CURRENT SYSTEM,
WHICH ALLOWS NURSING FACILITIES
REALLY TO DRAG OUT THE APPEALS
PROCESS FOR SERIOUS VIOLATIONS,
LEADING TO DEATH OR THE
PROBABILITY OF DEATH. GRAVELY
COMPROMISES THAT OVERSIGHT. DRC
INVESTIGATED AND ANALYZED
HUNDREDS OF CLASS A AND DOUBLE A
CITATIONS. ISSUED WHEN A
FACILITIES VIOLATION CAUSES
DEATH OR SUBSTANTIAL PROBABILITY
OF DEATH OF A RESIDENT. WE DID
FIND MANY INSTANCES WHERE A
FACILITY RECEIVED A LOWER
CITATION DESPITE SERIOUS
NEGLIGENCE. RECEIVING UH, TO
NAME JUST A FEW EXAMPLES. A
RESIDENT RECEIVING 50 MG OF
MORPHINE INSTEAD OF FIVE MG. A
RESIDENT WHO USED PORTABLE
OXYGEN BURNING TO DEATH AFTER
SMOKING UNSUPERVISED, A RESIDENT
BLEEDING TO DEATH FROM MULTIPLE
UNTREATED PRESSURE SORES. THIS
HAPPENS FAR TOO OFTEN AND ERODES
PUBLIC TRUST IN OUR REGULATORY
SYSTEM DESIGNED TO HOLD BACK AT
BAD ACTORS ACCOUNTABLE. SO CARE
CAN BE IMPROVED. THE CALIFORNIA
ADVOCATES FOR NURSING HOME
REFORM REVIEWED THE OUTCOMES OF
98, DOUBLE A AND A CITATION
APPEALS AND FOUND THAT OVER 90%
OF THEM WERE SETTLED OUT OF
COURT AND THAT NEARLY EVERY
SETTLEMENT INCLUDED A REDUCTION
IN FINE OR A REDUCTION IN
CITATION CLASS OR BOTH. ASSEMBLY
BILL FOR 86 WOULD MOVE THE
APPEALS PROCESS WHERE IT BELONGS
, AND INDEPENDENT ADMINISTRATIVE
BODY THAT OVERSEES THE REGULAR
REGULATOR. 84 86 TO CLOSE
PROVIDES A SOLUTION THAT ENSURES
EVERYONE'S DUE PROCESS RIGHTS
BUT BRINGS THINGS INTO ALIGNMENT
WITH HOW THINGS ARE DONE FOR
OTHER FACILITIES AND PROVIDERS.
IT KEEPS THE APPEALS PROCESS BUT
FOR THE ADMINISTRATIVE LAW JUDGE
WHO HAVE THE EXPERTISE TO HANDLE
THESE APPEALS THIS BILL IS
LONGER WE DO AND IT'LL IMPROVE
REGULATORY OVERSIGHT TO KEEP
RESIDENTS SAFE. WE URGE YOUR I
VOTE. THANK YOU. THANK YOU. NEXT
WITNESS, PLEASE. GOOD AFTERNOON
CHAIR AND MEMBERS. MY NAME IS
CHARLES ANTONIN, AND I'M A
SUPERVISING DEPUTY ATTORNEY
GENERAL IN THE HEALTH, EDUCATION
AND WELFARE SECTION AT THE
CALIFORNIA DEPARTMENT OF
JUSTICE. I AM HERE ON BEHALF OF
ATTORNEY GENERAL ROB BONTA, WHO
IS PROUD TO SUPPORT A B 4 86 AND
THANKS ASSEMBLYMEMBER'S CHOLERA
FOR CARRYING THIS IMPORTANT
PIECE OF LEGISLATION. THE
ADMINISTRATIVE PROCESS
ENVISIONED BY 84 86 WOULD ALLOW
FOR THE FASTER RESOLUTION OF
PATIENT CARE REGULATORY
VIOLATIONS BECAUSE THE DISCOVERY
OBLIGATIONS AND TIMELINES OR
HOLDING PROCEEDINGS IS
STREAMLINED COMPARED TO THE
CURRENT PROCESS. DURING MY
CAREER AT THE CALIFORNIA
DEPARTMENT OF JUSTICE, I HAVE
PERSONALLY LITIGATED
APPROXIMATELY 50 CASES INVOLVING
PATIENT CARE VIOLATIONS AT
SKILLED NURSING FACILITIES. I
HAVE TRIED FIVE OF THESE MATTERS
TO VERDICT. THE CURRENT PROCESS
USED TO CHALLENGE CITATIONS IS
AN OUTLIER. IT IS AN OUTLIER
NATIONALLY BECAUSE ONLY THREE
OTHER STATES USE A SIMILAR
PROCESS, WHEREAS THE FEDERAL
GOVERNMENT AND EVERY OTHER STATE
THAT REGULATES SKILLED NURSING
FACILITIES USES AN
ADMINISTRATIVE PROCESS SIMILAR
TO WHAT IS OUTLINED IN A B FOR
86. IT IS ALSO AN OUTLIER WITHIN
CALIFORNIA JURISPRUDENCE BECAUSE
DISPUTES BETWEEN THE LICENSEE
AND ITS REGULATOR TYPICALLY
INVOLVED IN ADMINISTRATIVE
PROCESS SIMILAR TO WHAT IS
OUTLINED IN A B 4 86. A B FOR 86
IS A COMMON SENSE REFORM THAT
WILL BRING THE REGULATION OF
SKILLED NURSING FACILITIES IN
LINE WITH THESE STANDARDS, THE
CURRENT PROCESS POSES
SIGNIFICANT ORGANIZATIONAL AND
PRACTICAL CHALLENGES. AS MANY
LAWYERS IN THIS ROOM CAN ATTEST.
CIVIL LITIGATION IS A CUMBERSOME
ENDEAVOR ON A GOOD DAY. IN MY
EXPERIENCE, THE FASTEST A
CONTESTED CITATION CAN BE
RESOLVED VIA THE CURRENT PROCESS
TAKES AT LEAST TWO YEARS. ONE
EXAMPLE I WOULD LIKE TO SHARE IS
THAT WE ARE STILL ACTIVELY
LITIGATING A CLASS DOUBLE
EXCITATION THE MOST SERIOUS
VIOLATIONS THAT WAS ISSUED IN
SEPTEMBER OF 2019. AFTER A MULTI
WEEK TRIAL THAT CONCLUDED IN
JANUARY OF 2022. WE ARE STILL
WAITING TO RECEIVE THE
TRANSCRIPTS TO FINISH THE
CLOSING BRIEFING ORDERED BY THE
COURT. THIS IS NOT UNUSUAL.
UNFORTUNATELY. THE ACCELERATED
TIMELINE OF ADMINISTRATIVE
PROCEEDINGS ALLOW FOR AN
EXPEDITED FACTUAL FINDINGS WITH
ONLY THE MOST CONTESTED
CITATIONS PROCEEDING TO A WRIT
OF MANDATE REVIEW IN SUPERIOR
COURT. THE ACCELERATED TIMELINE
AND STREAMLINE DISCOVERY WILL
SHIFT COST DOWNWARDS. THIS
SHIFTING COSTS WILL NOT CHANGE
THE LIKELIHOOD OF SETTLEMENT OR
FACILITATE FRIVOLOUS LITIGATION.
INSTEAD A B 4 86 WILL LEAD TO
THE EXPEDITED RESOLUTION OF THE
MAJORITY OF CONTESTED CITATIONS
WHILE MAINTAINING IMPORTANT DUE
PROCESS PROTECTIONS THROUGH THE
10 94.5 RIGHT PROCESS. FOR THESE
REASONS, THE ATTORNEY GENERAL IS
IN SUPPORT OF 84 86 RESPECTFULLY
ASKS FOR YOUR VOTE TODAY. THANK
YOU ANY OTHER WITNESSES IN
SUPPORT? PLEASE LINE UP AND
STATE YOUR NAME ORGANIZATION AND
POSITION ONLY. GOOD AFTERNOON,
YASMIN PELLET ON BEHALF OF
JUSTICE AND AGING AND THE
CALIFORNIA FOUNDATION FOR
INDEPENDENT LIVING CENTERS IN
SUPPORT. THANK YOU. THANK YOU.
ANYBODY IN OPPOSITION. IT'S COME
TO THE TABLE.
THANK YOU. PLEASE BEGIN THREE
MINUTES. GOOD AFTERNOON, MR
CHAIR MEMBERS. SHANE LEVIN ON
BEHALF OF THE CALIFORNIA
ASSOCIATION OF HEALTH
FACILITIES. MAYBE 486 SIMPLY
FURTHERS THE SYSTEMATIC
DECONSTRUCTION AND EROSION OF
OUR FACILITIES DUE PROCESS
RIGHTS TO DEFEND THEMSELVES
AGAINST THE MOST EGREGIOUS OF
ALLEGATIONS. BEFORE 86 BUILDS ON
LAST YEAR'S A B 3 23 FOR MR
CHOLERA. MAYBE 3 23 EFFECTIVELY
LOWERED THE BURDEN OF PROOF IN A
AND DOUBLE A CASES, CITATION
CASES AND HEIGHTEN THE FINES FOR
THE CITATIONS. A B 4 86,
UNFORTUNATELY GOES ANOTHER STEP
AND REMOVES OUR APPEAL OF THESE
CITATIONS FROM SUPERIOR COURT
AND PUTS THEM INTO AN
ADMINISTRATIVE LAW SETTING AND
FAST TRACKS. THESE CASES IN A
WAY THAT DOESN'T ALLOW OUR
FACILITIES TO ADEQUATELY LOOK AT
AND SEEK EVIDENCE OR DEPOSE
WITNESSES. THESE CASES WE ARE
TALKING ABOUT HERE ARE AKIN TO
MEDICAL MALPRACTICE CASES,
TYPICALLY IN THEIR LEVEL OF
COMPLEXITY. OVER THE COURSE OF
MANY DECADES. THE USE OF
DEPOSITIONS AND WRITTEN
DISCOVERY HAS BROUGHT TO LIGHT
SIGNIFICANT INCONSISTENCIES AND
CONTRADICTIONS WITHIN THE
VARIOUS INTERVIEWS IN FACTUAL
INVESTIGATIONS, CONDUCTED BY
SEED PH. SURVEYORS AND
INDIVIDUAL CITATION APPEALS AND
THE OUTRIGHT REJECTION OF
EXCULPATORY FACTS BY SURVEYORS.
IN ADDITION, THE DEPOSITION OF
THE PHYSICIAN EXPERTS UTILIZED
BY CDP H HAVE UNDER HAVE
UNCOVERED SERIOUS ISSUES WITH
THE PROFESSIONAL EXPERIENCE
REQUIRED TO QUALIFY AS AN
EXPERT. UNDER ESTABLISHED
EVIDENTIARY STANDARDS. THE USE
OF DEPOSITIONS AND STANDARD
WRITTEN DISCOVERY IS ESSENTIAL
IN THESE CASES. IF THERE ARE
FACTUAL DISCREPANCIES OR OTHER
SERIOUS QUESTIONS ABOUT THE
CITATION CITED. THIS IS A
CRITICAL ELEMENT FOR ALL PARTIES
TO CONSIDER BEFORE PROCEEDING TO
TRIAL. IN THESE CIRCUMSTANCES,
SETTLEMENT IS OFTEN THE RIGHT
CONCLUSION FOR THE PARTIES IN
CASES THAT WOULD OTHERWISE
SETTLE. IRONICALLY DESPITE WHAT
THE SPONSORS SAY A B 486 WILL
ONLY OPERATE BECAUSE EVERY
CITATION APPEAL TO GO TO A FULL
BLOWN ADMINISTRATIVE HEARING.
THAT WOULD REFLECT AN ENORMOUS
WASTE OF RESOURCES. IF WE ARE
TRULY TRULY INTERESTED IN A
SHORTENED TIMEFRAME TO MOVE
THESE CASES, THEN LET'S LOOK AT
REFORMING THE TIMING AND THE
SUPERIOR COURT PROCESS. LIKE WE
DID SUCCESSFULLY A FEW YEARS AGO
ON SP 10 95 BY THEN SENATOR
MONNING, BUT NOT BY REMOVING
THESE CASES ENTIRELY FROM THE
SUPERIOR COURT PROCESS. THE
DESIRE HERE SHOULD BE TO
MAINTAIN THE SANCTITY OF THE
JUDICIAL PROCESS AND FUNDAMENTAL
FAIRNESS TO BOTH SIDES.
UNFORTUNATELY THIS BILL
CONTINUES THE MULTI YEAR EFFORT
TO UNDERMINE THIS DESIRE. FOR
THESE REASONS, WE MUST ASK FOR A
NO VOTE. AND WITH ME TODAY IS
SCOTT KEEPING AN ATTORNEY AT
HOOPER, LUNDY AND BOOKMAN. THANK
YOU. THANK YOU. GOOD AFTERNOON
CHAIR AND MEMBERS. UH THANK YOU,
MR LEVINE. AS MR LEVINE JUST
INDICATED. MY NAME IS SCOTT,
KEEPING AN ATTORNEY AT HOOPER
LONDON BOOK. BUT IN SAN
FRANCISCO, UH, I HAVE HAD THE
HONOR OF REPRESENTING SKILLED
DIRECTION PROVIDERS FOR
APPROXIMATELY 28 YEARS. IN THAT
CONTEXT I HAVE REPRESENTED AND
MANAGED A NUMBER OF CLASS DOUBLE
A CLASS A AND CLASS B CITATIONS
THROUGH BOTH THE SUPERIOR COURT.
AS WELL AS THE ADMINISTRATIVE
FORM THAT'S PROPOSED BY 84 86 TO
EXPAND UPON MR LEVIN'S COMMENTS
. I HAVE MATERIAL CONCERNS THAT
THE PROPOSED BILL WOULD
MATERIALLY REDUCED THE DUE
PROCESS RIGHTS OF SKILLED
NURSING PROVIDERS BY REMOVING
THE FORUM FROM THE SUPERIOR
COURT WHERE THE CALIFORNIA CODE
OF CIVIL PROCEDURE GOVERNS
DISCOVERY. OVER TO THE
ADMINISTRATIVE LAW CONTEXT IN
THAT REGARD. I WOULD LIKE TO
STRESS AGAIN THAT CLASS
CITATIONS CLASS A CITATIONS ARE
THE MOST SERIOUS. WE DO CONCEDE
THAT BUT IN THAT REGARD THERE
ARE VERY SERIOUS ALLEGATIONS
ALLEGATIONS AGAINST THE STAFF.
ALLEGATIONS AGAINST THE
FACILITIES HAVE MATERIAL
CONSEQUENCES. THE ALLEGATIONS
AGAIN ARE SUCH IN THE CONTEXT OF
A DOUBLE A CITATION THAT IT'S A
DETERMINATION OR AN ALLEGATION
THAT THE STAFF SCARE WAS A
SUBSTANTIAL FACTOR IN THE DEATH
OF A RESIDENT LIKEWISE WITH A
CLASS A DOUBLE CITATION, IT'S A
DETERMINATION OR ALLEGATION THAT
THE STAFF SCARE WAS ARE CREATED
AN IMMINENT DANGER OF DEATH OR
SERIOUS HARM, OR A SUBSTANTIAL
PROBABILITY OF DEATH OR SERIOUS
HARM IN THAT REGARD. THESE ARE
VERY SERIOUS ALLEGATIONS, AND
WITH THAT COMES TREMENDOUS
COMPLEXITY. WHERE YOU HAVE A
NUMBER OF DIFFERENT FACTS, A
NUMBER OF DIFFERENT WITNESSES
THAT NEED TO BE EVALUATED FOR
THE PARTY'S NOT JUST THE
PROVIDERS, BUT FULL BUT ALL THE
PARTIES TO HAVE A FULL DISCOVERY
OF ALL THE ISSUES SO THAT YOU
CAN ACTUALLY LEND ITSELF TO A
FAIR ADJUDICATION. YOU DO NOT
HAVE THAT OPPORTUNITY IN THE
ADMINISTRATIVE LAW FORM WHERE
THE DISCOVERY IS FAR MORE
LIMITED. IN THE SUPERIOR COURT.
IT'S GOVERNED BY THE CALIFORNIA
CODE OF CIVIL PROCEDURE WHERE
YOU HAVE OPPORTUNITIES OF
DEPOSITIONS WHERE YOU CAN
ACTUALLY EXPLORE ANY EVALUATE
ALL THE FACTS. ALL THE ISSUES
CONFRONT THE WITNESSES WHO WHO
MADE THE DECISIONS TO ISSUE THE
CITATIONS AND THE UNDERLYING
WITNESSES THAT THEY OTHERWISE
GATHERED. THEIR INFORMATION FROM
THAT PROCESS IS LOST IN THE
ADMINISTRATIVE LAW FORM, WHERE
IT I WOULD CHARACTERIZE IT MORE
AS AN EXCHANGE OF INFORMATION,
AS OPPOSED TO AN OPPORTUNITY TO
FULLY EXPLORE IT THROUGH
DEPOSITIONS. WRITTEN DISCOVERY
AND THE LIKE. IT'S THAT LACK OF
PROCESS IN THE ADMINISTRATIVE
LAW FORUM THAT MATERIALLY
REDUCES THE DUE PROCESS RIGHTS
AND I DO RESPECT. WE DISAGREE
WITH MY COLLEAGUE FROM THE
CALIFORNIA ATTORNEY GENERAL'S
OFFICE. I, TOO, HAVE TRIED FACT
TRIED FAR MORE CASES THAN THAN
FIVE THE VERDICT. IN THESE
CIRCUMSTANCES. I WOULD SAY THAT
ACTUALLY THESE TYPES OF CASES
WITH THE FULL VALUE OF DISCOVERY
LENDS ITSELF TO RESOLUTION IN
ADVANCE OF TRIAL. I THINK THAT'S
VALUABLE BECAUSE UNDER THE
CIRCUMSTANCES, IT WILL PROVIDE A
FULL EXCHANGE OF INFORMATION.
THANK YOU. THANK YOU ANY OTHER
WITNESSES AND OPPOSITION? THE
STATE. YOUR NAME, ORGANIZATION
AND POSITION. SURE DARBY KERNAN,
REPRESENTING LEADING AGE
CALIFORNIA OPPOSED UNLESS
AMENDED. THANK YOU, THE OTHERS.
QUESTIONS OR COMMENTS FROM
COMMITTEE MEMBERS. UH, SEEING
NONE. CLOSE. THANK THANK YOU, MR
CHAIR. UM AS WAS INDICATED BY
OUR WITNESSES. I BELIEVE THIS IS
A, UM, COMMON SENSE CHANGE THAT
PUTS US IN LINE WITH THE
MAJORITY OF STATES AND WITH THE
FEDERAL GOVERNMENT THAT STILL
ALLOWS FOR A PROCESS THAT ALLOWS
FOR THESE PARTICULAR CASES TO BE
APPROPRIATELY ADJUDICATED. I
WOULD RESPECTFULLY ASK FOR AN
EYEBALL AT THE APPROPRIATE TIME.
THANK YOU DON'T HAVE A QUORUM
HERE, BUT WE'LL HOLD THIS ISSUE
OPEN TILL WE ESTABLISH A QUORUM.
NEXT BILL, MR KARA. THANK YOU,
MR. CHAIR A B 12 10 HAS NO
OPPOSITION IS SIMPLY REQUIRES
LABELING ON SODIUM NITRITE ABOVE
10% PURITY STADIUM CAN BE FATAL
IF INGESTED, AND THAT IS
RECOMMENDED. TREATMENT IS
INTRAVENOUS, METHYLENE BLUE.
SODIUM NITRATE IS A CHEMICAL
COMPOUND WITH NO HOUSEHOLD USED
IN HIGH PURITY AMOUNTS, BUT HAS
GROWN IN POPULATED POPULARITY
RECENTLY AS A SUICIDE METHOD.
I'VE LEARNED A LOT ABOUT THIS
RECENTLY IS PRETTY HORRIFYING.
WHEN INGESTED THIS CHEMICAL
PREVENTS THE BLOOD FROM CARRYING
OXYGEN CAN CAUSE AN AGONIZING
DEATH AND AS LITTLE AS 20
MINUTES. COMPARED TO 2018 2021
SAW A 253% INCREASE IN SELF
POISONING WITH NITRATES AND
NITRATES AND A 166% INCREASE IN
FATALITIES. HE'S OF ORDERING
SODIUM NITRITE HAS MADE IT
POPULAR MADE IT A POPULAR OPTION
AMONGST TEENAGERS AND OTHER
YOUNG PEOPLE LEADING TO MULTIPLE
LAWSUITS AGAINST AMAZON. ONE
CASE FILED IN CALIFORNIA, WHICH
HAS SINCE MOVED TO FEDERAL COURT
IN WASHINGTON, ACCUSING THE
COMPANY OF FACILITATING THE
SUICIDE OF A 17, YEAR OLD AND 27
YEAR OLD. ANOTHER CALIFORNIA
SUIT ACCUSES THE COMPANY OF
ENABLING THE SUICIDES OF A 16
YEAR OLD. AND A 17 YEAR OLD.
SOME PLATFORMS LIKE AT SEA AND
EBAY HAVE SINCE MADE COMMITMENTS
AND NOT TO SELL THIS PRODUCT.
WHILE METHYLENE BLUE IS A HIGHLY
EFFECTIVE TREATMENT FOR SODIUM
NITRITE POISONING, IT IS
RELATIVELY UNKNOWN BY CREATING
MORE AWARENESS OF METHYLENE BLUE
A B 12 10 GIVES CONSUMERS AND
MEDICAL PROFESSIONALS THE
INFORMATION THEY NEED TO QUICKLY
TREAT SODIUM NITRITE POISONINGS
AND INCREASE THE LIKELIHOOD OF
SAVING LIVES. WARNING LABELS ON
SHIPPING PACKAGES CAN ALSO ALERT
PARENTS AND OTHER HOUSEHOLD
MEMBERS WILL POTENTIAL SUICIDE
ATTEMPT. ALLOW THEM TO INTERVENE
THEIR FAMILY MEMBER OR FRANK,
AND SEEK APPROPRIATE MENTAL
HEALTH ASSISTANCE. I THINK WE'RE
ALL FAMILIAR WITH PACKAGES THAT
COME TO OUR HOME THAT YOU REALLY
DON'T KNOW WHAT IT IS AND YOUNG
PEOPLE. PEOPLE OF ALL AGES ARE
ORDERING THINGS TO THEIR HOME
THESE DAYS. AND I THINK THIS
LABELING GIVES PARENTS A CHANCE
TO HAVE THE OPPORTUNITY TO UNDER
TWO TO KNOW WHAT THEIR CHILD IS
ORDERING WHEN ESPECIALLY WHEN IT
DEALS WITH THE PRODUCT OF THIS
NATURE THAT'S BEING USED REALLY,
IN A NON COMMERCIAL SENSE. AT
THIS CONCENTRATION. IT APPEARS
JUST FOR SUICIDE AND SUICIDE
ATTEMPTS. AND SO THAT'S WHY THIS
BILL IS IMPORTANT TO REALLY HELP
INFORM CONSUMERS. UM AND
CERTAINLY PARENTS AND OTHER
LOVED ONES OF THE DANGERS OF
THIS PRODUCT. THANK YOU KNOW
EXACTLY, ASTRA. I BOAT THANK
YOU. YOU HAVE ANY WITNESSES? NO
WITNESSES. THE WITNESS. AUTHOR
SPONSORED ANYBODY IN OPPOSITION.
NOBODY IN OPPOSITION QUESTIONS
OR COMMENTS FROM COMMITTEE
MEMBERS. JUST CLOSE THE ASPIRIN.
I VOTED FOR YOU. I WILL TAKE
THIS UP WHEN WE GET A QUORUM.
THANK YOU FOR YOUR PRESENTATION.
NEXT, ASSEMBLYMEMBER'S PELLERIN.
UM FOR ME. GOOD AFTERNOON. NINE
TO FIRST, PLEASE. THANK YOU,
CHAIR AND MEMBERS. FOR MANY
CALIFORNIANS LIKE ACCESS TO
BEHAVIORAL HEALTH SERVICES IN
OUR HEALTH CARE SYSTEM LARGELY
RELIES ON AN ARRAY OF INSURANCE
OPTIONS. IN ADDITION TO
NAVIGATING THE COMPLEXITY OF
INSURANCE OPTIONS BARRIERS SUCH
AS REFERRAL REQUIREMENTS AND
BENEFIT LIMITS, OFTEN DELAY AND
RESTRICT ACCESS TO TIMELY AND
QUALITY BEHAVIORAL HEALTH
SERVICES. MANY FAMILY PLANNING
PROVIDERS, LIKE PLANNED
PARENTHOOD THAT ARE WIDELY
ACCESSIBLE TO YOUNGER AND LOW
INCOME CALIFORNIANS ALREADY
SCREENED FOR DRUG AND ALCOHOL,
USE SEXUALLY TRANSMITTED
INFECTIONS AND INTIMATE PARTNER
VIOLENCE WHEN A PATIENT COMES TO
THEM FOR REPRODUCTIVE HEALTH
CARE. FAMILY PLANNING SERVICE
PROVIDERS ARE UNIQUELY SITUATED
TO PROVIDE EARLY, AFFORDABLE AND
ACCESSIBLE MENTAL HEALTH AND
SUBSTANCE USE SCREENINGS TO
PATIENTS, ESPECIALLY THOSE WHO
ARE YOUNGER WOMEN AND LOWER
INCOME PATIENTS TO TAKE THE
NEATEST STEPS TO IMPROVE LONG
TERM HEALTH OUTCOMES. A B 492
ESTABLISHES TO PILOT PROGRAMS
WITHIN THE DEPARTMENT OF HEALTH
CARE SERVICES TO INTEGRATE THE
NEED FOR BEHAVIORAL HEALTH WITH
FAMILY PLANNING AND REPRODUCTIVE
CLINICS. ONE PROGRAM WILL
SUPPORT MEDICAL PROVIDERS THAT
ARE ENROLLED IN THE FAMILY
PLANNING, ACCESS CARE AND
TREATMENT OR FAMILY PACKED
PROGRAM THAT PROVIDES
REPRODUCTIVE AND BEHAVIORAL
HEALTH INTEGRATION PROGRAMS. THE
OTHER PROGRAM UNDER THIS BILL
WILL PROVIDE GRANTS TO
INCENTIVIZE MEDICAL MANAGED CARE
PLANS TO DEVELOP AND IMPLEMENT
REPRODUCTIVE AND BEHAVIORAL
HEALTH INTEGRATION PROGRAMS FOR
PATIENTS. INNOVATIVE PATHWAYS
CAN HELP TO PROVIDE THESE WIDELY
NEEDED SERVICES AND THE PILOT
PROGRAMS INITIATED BY THIS BILL
WILL FACILITATE ACCESS TO
CALIFORNIANS OF ALL INCOMES AND
AGES. WITH ME TO TESTIFY IN
SUPPORT OF A B 492 ARE CHRISTIAN
GARCIA, REPRESENTING PLANNED
PARENTHOOD, NORTHERN CALIFORNIA
AND ANDREAS SAN MIGUEL, WITH
PLANNED PARENTHOOD AFFILIATES OF
CALIFORNIA. THANK YOU. PLEASE
BEGIN. WITNESS YOU HAVE THREE
MINUTES PER WITNESS. THANK YOU.
GOOD AFTERNOON CHAIR MEMBERS.
ANDREAS SAN MIGUEL, POLICY
DIRECTOR FOR PLANNED PARENTHOOD
AFFILIATES OF CALIFORNIA. I'M
HERE ON THIS BEHALF OF THE SEVEN
AFFILIATES THROUGHOUT THE STATE
WHO PROVIDE HIGH QUALITY,
AFFORDABLE HEALTH CARE. AT OVER
100 HEALTH CENTERS, WHICH LEADS
TO MORE THAN 1.3 MILLION HEALTH
CENTER VISITS PER YEAR AS THE
SPONSORS OF A B 4 92. WE BELIEVE
THE BILL WILL SUPPORT
REPRODUCTIVE HEALTH PATIENTS
ACCESS TO INTEGRATED MILD TO
MODERATE BEHAVIORAL HEALTH
SERVICES WHERE THEY ALREADY SEEK
CARE, REGARDLESS OF THEIR
INSURANCE COVERAGE OR AGE. HE
PACKS POLICY INTEREST IN
SUPPORTING BEHAVIORAL HEALTH
SCREENINGS. REFERRALS INTEGRATED
, MILD, MODERATE INTERVENTIONS,
ETCETERA, UM, IN A REPRODUCTIVE
HEALTH SETTING DOES PREDATE THE
COVID 19 PANDEMIC, HOWEVER, 2020
AND 2021 CERTAINLY EXEMPLIFIED
THE ROLE THAT AFFILIATES COULD
HAVE IN SUPPORTING BEHAVIORAL
HEALTH ACCESS. AS YOU WILL HEAR
FROM AN AFFILIATE TODAY, PATIENT
NEED CONTINUES TO BE SEEN IN
COMMUNITIES. THE PILOT. EFFORTS
IN THIS BILL WILL DEMONSTRATE
HOW COMMUNITY HEALTH CENTERS
THAT PRIMARILY PROVIDE SEXUAL
AND REPRODUCTIVE HEALTH SERVICES
CAN BE RELIED UPON AS PART OF
THE BROADER STATEWIDE EFFORT TO
IMPROVE BEHAVIORAL HEALTH
ACCESS. PLANNED PARENTHOOD
HEALTH CENTERS ARE WELL SUITED
TO IMPLEMENT SCREENINGS AND
INTERVENTIONS FOR EXISTING
PATIENTS, 91% OF WHOM ARE
COVERED BY MEDICAL, FAMILY
PACKED OR UNINSURED AFFILIATES
ARE DOING WHAT THEY CAN TO MAKE
USE OF THE NO WRONG DOOR POLICY
AND CONTRACTING WITH MANAGED
CARE PLANS WHEN POSSIBLE.
HOWEVER BUILDING PROGRAMS UP TO
SCALE IS WHAT ENABLES THE PATH
TO SUSTAINABLE FUNDING FOR THESE
SERVICES THAN ALLOWING TO
INCREASE ACCESS FOR
CALIFORNIANS. IN THE PAST OUR,
UM OUR STATE HAS SEEN THE
BENEFITS OF INTEGRATING DENTAL
AND BEHAVIORAL HEALTH RESOURCES
INTO OTHER, PRIMARILY PRIMARY
CARE SETTINGS, AND IT IS OUR
BELIEF THAT IN THE COMING YEARS,
IT WILL BE SIMILARLY EVIDENT
THAT INTEGRATING BEHAVIORAL
HEALTHCARE INTO MOSTLY UM,
SEXUAL REPRODUCTIVE HEALTH CARE
SETTINGS WILL PROVE TO BE VERY
HELPFUL FOR TIMELY ACCESS FOR
PATIENTS WITH THAT. I'M HERE TO
ANSWER ANY QUESTIONS YOU MAY
HAVE ABOUT THE BILL. THANK YOU.
NEXT WITNESS, PLEASE. GOOD
AFTERNOON. SHARON MEMBERS. MY
NAME IS CHRISTIAN GARCIA, VICE
PRESIDENT OF GOVERNMENT
RELATIONS AND COMMUNICATIONS AT
PLANNED PARENTHOOD, NORTHERN
CALIFORNIA. I'M HERE TODAY IN
SUPPORT OF ASSEMBLY BILL FORD 92
, WHICH WILL CREATE
OPPORTUNITIES FOR BEHAVIORAL
HEALTH INTEGRATION WITHIN
REPRODUCTIVE HEALTH CARE CENTERS
ACROSS THE STATE. PP. NORTH CAL,
WE SERVE 20 NORTHERN CALIFORNIA
COUNTIES, UM, AND WITH 17 HOUSE
CENTERS AND THE TELE HEALTH
DEPARTMENT. MANY OF OUR PATIENTS
RECITING SOME OF THE MOST RURAL
PARTS OF THE STATE 84% OF THEM
ARE WITH FROM LOW INCOME. UM AND
56 ARE FROM COMMUNITIES OF
COLOR. VAST MAJORITY 46% BEING
LATINO. RECOGNIZING THE
INTERPLAY OF PHYSICAL AND MENTAL
HEALTH. PP NORCAL HIRED LICENSE
BEHAVIORAL HEALTH SPECIALISTS
THAT SCREEN AND MULTITUDE OF
BEHAVIORAL HEALTH THEMES DURING
VISITS. SERVICES INCLUDE
COUNSELING FOR PATIENTS DEALING
WITH TRAUMA RELATED TO PARTNER.
VIOLENCE DEPRESSION AND ANXIETY
SYMPTOMS. CONCERNS RELATED TO
ACCESSING SEXUAL AND
REPRODUCTIVE HEALTH CARE AND
PARENTAL CARE. UM AND POSTPARTUM
DEPRESSION SERVICES ARE PROVIDED
BOTH IN PERSON AND VIA
TELEHEALTH LAST YEAR, THE ROAD
HEALTH ORGANIZATION REPORTED
THAT THE COVID 19 PANDEMIC
TRIGGERED ABOUT A 25% INCREASE
IN ANXIETY AND DEPRESSION
WORLDWIDE. THIS INCREASED
DISPROPORTIONATELY IMPACTED
WOMEN. YOUNG PEOPLE AND
INDIVIDUALS WITH PRE EXISTING
CHRONIC ILLNESSES AT PP NORCAL
THE DEMAND FOR BEHAVIORAL HEALTH
SERVICES AND COUNSELING HAS
GREATLY OUTWEIGHED OUR CAPACITY.
BECAUSE OF LOW REIMBURSEMENT
RATES FOR PATIENTS WHO ARE
SEEKING HIS MENTAL HEALTH
SERVICES. WE SIMPLY LACK THE
RESOURCES NECESSARY TO MEET THIS
PATIENT DEMAND. MAYBE 92 IS
CRITICAL IN HELPING US EXPAND
THE AFFORDABILITY OF OUR MENTAL
HEALTH SERVICES TO MORE
PATIENTS. CURRENTLY WE HAVE
CONTRACTS WITH TWO REIMBURSEMENT
MANAGED MEDICAL PROVIDERS IN
CONTRA COSTA COUNTY AND IN
SOLANO COUNTY. THAT'S TWO
COUNTIES OUT OF 20 THAT WE
SERVE. ALL OTHER PATIENTS MUST
USE OUR LIMITED SLIDE, SCALING
MODEL FOR A FEE ADJUSTMENTS TO
PAY OUT OF POCKET FOR THESE
ESSENTIAL AND SUPPORTIVE
COUNSELING SERVICES. MAYBE 4 92
, I BELIEVE WILL SET THE PATH OF
IMPROVING THESE CRITICAL
HEALTHCARE SERVICES. AND THIS IS
WHY I RESPECTFULLY ASK FOR YOUR
SUPPORT. THANK YOU. ANY OTHER
WITNESSES IN SUPPORT, PLEASE.
STATE YOUR NAME ORGANIZATION IN
POSITION ONLY. GOOD AFTERNOON,
ANDREA RIVERA ON BEHALF OF THE
CALIFORNIA PEN, ETHNIC HEALTH
NETWORK AND SUPPORT YOU TAYLOR
JACKSON WITH CALIFORNIA HEALTH
PLUS ADVOCATES REPRESENTING
CALIFORNIA'S COMMUNITY HEALTH
CENTERS AND STRONG SUPPORT.
ALEXIS RODRIGUEZ WITH THE
CALIFORNIA MEDICAL ASSOCIATION
IN SUPPORT. THANK YOU. ON BEHALF
OF CALIFORNIA CITY ASSOCIATIONS
, PSYCHIATRIST AND SUPPORT.
THANK YOU. THANK YOU ANY
WITNESSES AND OPPOSITION. THING
NONE QUESTIONS OR COMMENTS FROM
MANY MEMBERS. OH, COMING UP.
YES, PLEASE. NICOLE YOUNG AND
OPPOSITION. THANK YOU, OKAY. NO
OTHER WITNESSES AND OPPOSITION
QUESTIONS OR COMMENTS FROM
COMMITTEE. REMEMBER? THAT'S YOU
KNOW, MEMBERS 02. YES UM, SEEING
NINE OR THREE, UM SAYING NONE.
MAKE CLOTHES. YEAH UM, I WANT TO
THANK PLANNED PARENTHOOD FOR
THEIR SPONSORSHIP OF THIS BILL
AND THE WORK THEY'VE BEEN DOING.
WE ARE IN A PUBLIC HEALTH CRISIS
ON MENTAL HEALTH, AND THIS BILL
TAKES AN IMPORTANT STEP FORWARD
TO MAKE SURE PEOPLE HAVE ACCESS
TO SERVICES. I RESPECTFULLY ASK
FOR YOUR VOTE. OKAY THANK YOU.
WE WILL WAIT UNTIL THERE'S A
QUORUM BEFORE WE TAKE ACTION ON
THIS NEXT BILL 14 71. OKAY? SO
AGAIN. THANK YOU. CHAIR AND
MEMBERS. THANK YOU FOR THE
OPPORTUNITY PRESENTS A B 14 71.
THIS BILL SEEKS TO EXTEND THE
DEADLINES FOR THE THREE PUBLIC
HOSPITAL SEISMIC COMPLIANCE
PROJECTS THAT ARE UNDERWAY ON
THE SANTA CLARA VALLEY MEDICAL
CENTER CAMPUS. SANTA CLARA
VALLEY MEDICAL CENTER IS A
GENERAL ACUTE HOSPITAL WITH 649
BEDS IN SAN JOSE. SANTA CLARA
VALLEY MEDICAL CENTER, ALONG
WITH O'CONNOR HOSPITAL, ST
LOUIS'S REGIONAL HOSPITAL, AND
15 COMMUNITY HEALTH CENTERS
COMPRISED SANTA CLARA VALLEY
HEALTH CARE, THE SECOND LARGEST
PUBLIC HOSPITAL AND CLINIC
HEALTH CARE SYSTEM IN THE STATE
OF CALIFORNIA. SANTA CLARA
COUNTY'S HOSPITALS AND CLINICS
SERVE A DIVERSE POPULATION OF
MORE THAN TWO MILLION SANTA
CLARA COUNTY RESIDENTS AS WELL
AS OTHERS THAT LIVE IN THE BAY
AREA REGION AND BEYOND.
SPECIFICALLY THIS BILL EXTENDS
THE DEADLINE FROM JULY 1 2023 TO
JULY 1 2025 FOR THE SANTA CLARA
VALLEY MEDICAL BUILDING F
PROJECT. FROM DECEMBER 31ST 2024
TO DECEMBER 31ST 2025 FOR THE
SANTA CLARA VALLEY MEDICAL
CENTER BUILDING AND PROJECT AND
FROM JANUARY 1 2025 TO JULY 1
2026 FOR THE SANTA CLARA VALLEY
MEDICAL CENTER, OLD MAIN
DEMOLITION AND REBUILD PROJECT.
THESE DEADLINE EXTENSIONS ARE
UNRELATED TO THE 2030 SEISMIC
STANDARDS. THE DURING THE
PANDEMIC. THE SEISMIC WORK OF AT
SANTA CLARA VALLEY MEDICAL
CENTER WAS IMPACTED BY THE SURGE
IN DEMAND FOR ADDITIONAL BED
SPACE. THE COUNTY HAD PLANNED TO
VACATE AREAS OF THE HOSPITAL
THAT WERE SLATED FOR SEISMIC
UPGRADES. HOWEVER, IN ORDER TO
ADDRESS THE NEEDS OF PATIENTS
DURING THE COVID EMERGENCY SANTA
CLARA VALLEY MEDICAL CENTER WAS
UNABLE TO VACATE THE AREAS
REQUIRING WORK. ADDITIONALLY
COVID IMPACTED THE CONSTRUCTION
WORKERS ON SITE AND ISOLATION
AND QUARANTINE PERIODS RELATED
TO COVID EXPOSURES. IN CASES,
DELAYS DELAYED THE WORK.
CONTINUED AND NEW ISSUES ARE
CAUSING FURTHER DELAYS AND THE
PROJECTS WILL NOT MEET THE
DEADLINES ESTABLISHED AND
STATUTE. THE COUNTY HAS ALSO HAD
ISSUES AND SOLICITING
CONSTRUCTION BIDS AND HAS NEEDED
TO REBID VARIOUS PROJECT
COMPONENTS. THERE ARE THE ADDED
COMPLICATIONS OF A SHORTAGE OF
QUALIFIED CONSTRUCTION WORKERS
AND SUPPLY CHAIN DELAYS FOR
EQUIPMENT AND SUPPLIES AS WELL.
LASTLY THE PROJECT BUILDINGS
WERE ORIGINALLY CONSTRUCTED IN
THE 19 THIRTIES AND FIFTIES AS
CONSTRUCTION OCCURS, ALL
EXISTING NONCOMPLIANT CONDITIONS
MUST BE BROUGHT UP TO CODE PER
DEPARTMENT OF HEALTH CARE,
ACCESS AND INFORMATION
REQUIREMENTS. THIS WORK ADDS
TIME AND COST OF THE WORK UNDER
WAY. I HAVE TWO WITNESSES WITH
ME TODAY, DR JENNIFER TONG, THE
ASSOCIATE CHIEF MEDICAL OFFICER
FOR SANTA CLARA VALLEY MEDICAL
CENTER. AND DAVID KOENIG, DEPUTY
DIRECTOR CAPITAL PROGRAMS WITH
THE SANTA CLARA COUNTY FLEET AND
FACILITIES DEPARTMENT. THANK
YOU. PLEASE BEGIN THREE MINUTES
PER WITNESS. AND CHAIRMAN WOULD
AND COMMITTEE MEMBERS. MY NAME
IS DR JENNIFER TONG, ASSOCIATE
CHIEF MEDICAL OFFICER FOR SANTA
CLARA VALLEY MEDICAL CENTER,
WHICH I'LL REFER TO HERE TODAY
AS SCV EMC. SANTA CLARA VALLEY
MEDICAL CENTER IS OUR FLAGSHIP
PUBLIC HOSPITAL, OFFERING AN
ARRAY OF CRITICAL SERVICES FOR
ALL MEMBERS OF OUR COMMUNITY,
INCLUDING A LEVEL ONE TRAUMA
CENTER, A REGIONAL BURN CENTER
AND A NATIONALLY RECOGNIZED
REHABILITATION CENTER FOR SPINAL
CORD AND BRAIN INJURY CARE. THE
COUNTY'S HOSPITALS PLAYED A
CRITICAL ROLE IN RESPONDING TO
THE COVID 19 PANDEMIC, BUT
UNFORTUNATELY THE PANDEMIC
ADVERSELY IMPACTED THE SCHEDULES
OF THE THREE SEISMIC PROJECTS
CURRENTLY UNDERWAY. DURING THE
MULTIPLE WAVES OF COVID 19,
SPANNING FROM 2020 THROUGH 2022
SC VMC MOBILIZED SURGE CAPACITY
, INCLUDING STAFFING, ADDITIONAL
ICU BEDS. AT TIMES WE UTILIZED
EVERY INPATIENT BED AVAILABLE,
INCLUDING OUR ENTIRE SURGE
CAPACITY. TO CARE FOR OUR
PATIENTS WE NEEDED TO USE THE
CONSTRUCTION PROJECTS HOSPITAL
SPACE IN OUR WOMEN'S AND
CHILDREN'S BUILDING, WHICH
OFFERED AN INCREASED NUMBER OF
PRIVATE ROOMS, AS WELL AS
NEGATIVE AIR PRESSURE ROOMS THAT
WERE NEEDED FOR INFECTION
CONTROL PURPOSES. PATIENT CARE
WAS PARAMOUNT. DURING THIS
UNPRECEDENTED TIME, WE COULD NOT
CHOOSE CONSTRUCTION OVER PATIENT
CARE IN LIGHT OF THE PANDEMIC.
MAYBE 14 71 WOULD PROVIDE A
NEEDED EXTENSION OF TIME FOR THE
THREE SC VMC PROJECTS TO COMPLY
WITH SEISMIC REQUIREMENTS. IF
THE PROJECT DEADLINES ARE NOT
EXTENDED. SCV N C WILL NOT BE
ABLE TO USE 150 OF OUR HOSPITAL
INPATIENT BEDS. THE LAST OF 150
ACUTE HOSPITAL BEDS WOULD BE
CATASTROPHIC FOR THE CARE OF OUR
COMMUNITY, GIVEN THAT ON AN
AVERAGE DAY, NEARLY ALL OF OUR
ACUTE CARE BEDS ARE IN USE.
THANK YOU FOR YOUR
CONSIDERATION. THANK YOU. NEXT.
GOOD AFTERNOON, MR CHAIR MEMBERS
FROM DOUG PRESS THE BUTTON
THERE. I'M SORRY. CAN YOU HEAR
ME NOW? OKAY GOOD AFTERNOON, MR
CHAIR MEMBERS. I'M DOUG KOENIG
I'M DEPUTY DIRECTOR FOR CAPITAL
PROGRAMS WITH THE COUNTY OF
SANTA CLARA. THANK YOU FOR THE
OPPORTUNITY TO PROVIDE TESTIMONY
IN SUPPORT OF A B 14 71. AS IT
IS DESCRIBED BY ASSEMBLYMEMBER'S
PELLERIN COVID 19 PANDEMIC
ADVERSELY IMPACTED THE SCHEDULES
OF THE PROJECTS AND A NUMBER OF
WAYS. UH UNFORTUNATELY, SINCE
THE PANDEMIC, WE'VE EXPERIENCED
ADDITIONAL DELAYS BEYOND OUR
CONTROL AND SOME UNEXPECTED YET
NECESSARY DESIGN CHANGES, WHICH
ALSO ADDED WORK AND TIME TO THE
PROJECTS. THE COUNTY HAS
ENDEAVORED TO MEET. UH THE
HOSPITAL SEISMIC DEADLINES
ESTABLISHED IN THE STATUTE. BUT
DUE TO THE VARIETY OF
CIRCUMSTANCES AND THEIR IMPACT
ON THE PROJECTS, WE WILL NOT
ACHIEVE COMPLIANCE AND TIME TO
AVOID SIGNIFICANT FINANCIAL
PENALTIES IMPOSED BY H GUY. IF
FINES ARE IMPOSED FUNDS THAT
WOULD BE USED FOR CONSTRUCTION.
FOR OPERA OR FOR OPERATIONAL
EXPENSES OF THE COUNTY'S
HOSPITAL SYSTEM AND SAFETY NET.
AH THEY WOULD BE DIVERTED TO PAY
FOR PENALTIES. THANK YOU FOR
YOUR CONSIDERATION OF OUR
SITUATION. AND YOUR SUPPORT FOR
A B 14 71. THANK YOU ANY OTHER
WITNESSES IN SUPPORT? PLEASE
LINE UP YOUR NAME ORGANIZATION
AND POSITION ONLY. KELLY BROOKS
ON BEHALF OF THE BOARD OF
SUPERVISORS FOR SANTA CLARA
COUNTY AND SUPPORT AND HE
WITNESSES AND OPPOSITION. GOOD
AFTERNOON METALLURGY ON BEHALF
OF STU, NOT IN OPPOSITION. JUST
WANT TO ENSURE THAT THE
CONVERSATIONS WHICH STARTED, UH
LATE LAST WEEK AROUND THE
CONSTRUCTION, AND HOW DO WE
PRESERVE ACCESS TO CARE?
CONTINUE WE REPRESENT THE
WORKERS AT THESE FACILITIES AND
JUST WANT TO MAKE SURE OUR
PATIENTS CAN RECEIVE CONTINUE TO
RECEIVE CARE AND APPRECIATE THE
AUTHOR BEING THE BILL FORWARD.
THANK YOU VERY MUCH. THANK YOU
QUESTIONS OR COMMENTS FROM
COMMITTEE MEMBERS. THING NONE
YOU WISH TO CLOSE. I
RESPECTFULLY ASK FOR YOUR VOTE.
THANK YOU DO NEED TO KNOW IF
YOU'RE GONNA ACCEPT THE
COMMITTEE AMENDMENTS. ABSOLUTELY
OKAY. GREAT. THANK YOU. AND WE
WILL HOLD THIS UNTIL LATER. WE
DO NOT HAVE A QUORUM IN THANK
YOU. AND WE DO NOT HAVE AUTHORS
. WE HAVE ANY OF YOU.
OKAY THANK YOU. ASSEMBLYMEMBER'S
REVIS, PLEASE COME UP AND
PRESENT YOUR BILL.
GOOD AFTERNOON, MR CHAIR AND
MEMBERS. I WANT TO START BY
THANKING LISA FOR HER WORK AND
THOUGHTFUL ANALYSIS ON THIS
BILL. I WOULD ALSO LIKE TO
ACCEPT THE AMENDMENTS PROPOSED
BY THE COMMITTEE. OKAY BABY, 8
47 WILL ENSURE THAT CHILDREN
FACE ILLNESSES AT HOME. THROUGH
UH, PALLIATIVE CARE. THIS BILL
WOULD ALLOW YOUNG ADULTS WHO
HAVE MEDICAL AND WITH PEDIATRIC
ONSET CONDITIONS TO BE ELIGIBLE
FOR HOSPICE CARE AFTER AGE 21.
SO THAT THEIR CARE WON'T GO
INTERRUPTED. CHILDREN WITH
SERIOUS LONG TERM DISEASES SUCH
AS CANCER. AND HEART DISEASE ARE
A GROWING POPULATION AS MEDICAL
ADVANCES ALLOW THEM TO LIVE
LONGER LIVES. UM WITH PPC S
ATTENTION TO QUALITY OF LIFE.
THIS TYPE OF CARE CAN HELP THIS
POPULATION LIVE A LITTLE BIT
MORE COMFORTABLY IN 2014,
CALIFORNIA SIGNED SB 1004, WHICH
CHANGED THE STRUCTURE AND
FUNDING. OF PPC, SO THAT HOME
BASED CARE FOR CHILDREN IS
PROVIDED THE SAME WAY AS IT'S
PROVIDED TO ADULT PATIENTS. THIS
BILL, UM, INADVERTENTLY PUT
YOUTH RECEIVING PALLIATIVE CARE
SERVICES AT RISK OF LOSING THIS
CARE IF THEY DID NOT MEET THE
NARROW CRITERIA SET FOR ADULTS.
WITHOUT ADEQUATE ACCESS TO
PEDIATRIC HOSPICE. MANY
SERIOUSLY ILL CHILDREN WILL BE
UNABLE TO MAXIMIZE THEIR TIME AT
HOME WITH THEIR FAMILIES. TODAY
I HAVE WITH ME TO PROVIDE
TESTIMONY. AH! BOTH YEAH? DR.
DEBORAH LOTS TÍNH, CHIEF
DIRECTOR OF THE DIVISION OF
COMFORT AND PALLIATIVE CARE AT
CHILDREN'S HOSPITAL, LOS
ANGELES. AND PATRICIA EVERETTE,
MOTHER TO RYAN EVERETTE, A
PATIENT RECEIVING CONCURRENT
HOSPICE CARE. THANK YOU. THANK
YOU. WITNESS YOU HAVE THREE
MINUTES PER WITNESS TWO
WITNESSES. THANK YOU. OKAY? GOOD
AFTERNOON. I'M DR DEBORAH LOT.
STEIN A PEDIATRIC PALLIATIVE
CARE PHYSICIAN AT CHILDREN'S
HOSPITAL, LOS ANGELES. I'M HERE
TODAY IN MY ROLE AS, UH, COACH
CHAIR OF THE STEERING COMMITTEE
FOR THE CHILDREN'S HOSPICE AND
PALLIATIVE CARE COALITION OF
CALIFORNIA. THE TRANSITION TO
ADULT MEDICAL CARE CAN BE
CHALLENGING FOR VULNERABLE
CHILDREN WITH CHRONIC MEDICAL
CONDITIONS AND MEDICAL 21. THEY
LOSE THE SUPPORT OF SERVICES
THEY'VE RECEIVED FROM OUR
CHILDREN'S HOSPITALS AND ALSO
THE CALIFORNIA CHILDREN'S
SERVICES PROGRAM. CHILDREN WITH
SERIOUS ILLNESS WHO GET
PALLIATIVE OR HOSPICE CARE ARE
AMONG THE MOST VULNERABLE OF
ALL. THEY HAVE DIFFICULT TO
MANAGE SYMPTOMS REQUIRE
COORDINATED CARE. AND FOR THOSE
RECEIVING HOSPICE MAY BE NEARING
THE END OF THEIR LIVES. UNDER
CURRENT LAW AFTER AGE 21
ELIGIBILITY FOR HOME BASED
PALLIATIVE CARE IS LIMITED AND
YOU CAN NO LONGER RECEIVE
CONCURRENT HOSPICE CARE.
FAMILIES RELY ON THESE SERVICES
TO KEEP THEIR CHILDREN
COMFORTABLE AT HOME. AND WITHOUT
THEM YOUTH MAY END UP IN THE ER
OR IN THE HOSPITAL. MY PATIENT
MILES HIGHLIGHTS THE GAP IN THE
CURRENT SYSTEM. AT 19. HE HAD A
PAINFUL AND JUST FIGURING SKIN
CONDITION. HE OFTEN MISSED
APPOINTMENTS AND HIS MEDICATIONS
LEADING TO EXTRA HOSPITAL STAYS.
BUT AFTER ENROLLING HIM WITH
HOME BASED PALLIATIVE CARE, HE
AT HOME VISITS WITH A NURSE AND
A SOCIAL WORKER AND WITH AN
EXTRA LAYER OF SUPPORT. HE COULD
FOLLOW OUR TREATMENT PLAN. HE
DID SO WELL, HE WAS EVEN ABLE TO
ATTEND COMMUNITY COLLEGE. YET
ONCE YOU TURN 21, HE LOST
ELIGIBILITY FOR THE PROGRAM. AND
AT THE SAME TIME HE WAS
STRUGGLING TO FIND NEW ADULT
PROVIDERS. HE ENDED UP WITH
FREQUENT ER VISIT. SO SORRY. HE
ENDED UP WITH FREQUENT ER
VISITS. AND STRUGGLED TO GET THE
CONSISTENT MEDICAL CARE HE
NEEDED. AND STILL NEEDS TO
FULFILL HIS CAREER DREAMS OF
WORKING IN HEALTHCARE. MAYBE 847
WOULD ALLOW PEDIATRIC HOME BASED
PALLIATIVE CARE ELIGIBILITY TO
CONTINUE TO AGE 26. AND PROVIDE
A SAFETY NET FOR VULNERABLE
YOUTH LIKE MILES DURING THE
TRANSITION TO ADULT CARE. MISS
EVERETT, THE MOTHER OF ONE OF
OUR PATIENTS WILL SHARE HER
EXPERIENCE WITH THE OTHER
PROGRAM DISCUSSED IN THIS BILL.
CONCURRENT HOSPICE CARE.
SPECULATE RESPECTFULLY ASK FOR
YOUR I VOTE ON A B 847 THANK YOU
FOR YOUR TIME AND ATTENTION TO
THIS CRITICAL ISSUE. THANK YOU.
GOOD AFTERNOON. MY NAME IS
PATRICIA EVERETTE AND I AM THE
SINGLE MOTHER OF A 22 YEAR OLD,
SEVERELY DISABLED YOUNG MAN
NAMED RYAN. AT BIRTH, RYAN DID
NOT GET ENOUGH OXYGEN TO HIS
BRAIN. HE HAS SEVERE CEREBRAL
PALSY. HE DOES NOT WALK OR TALK,
IS FED THROUGH A TUBE IN HIS
STOMACH AND SUFFERS FROM
SEIZURES DUE TO HIS BRAIN
INJURY. MY GOAL IS TO MAKE HIM
AS HAPPY AND HEALTHY AS
POSSIBLE, GIVEN HIS ISSUES. WHEN
HE WAS 19 ON CHRISTMAS DAY 2020
BEFORE COVID VACCINES. I FOUND
MYSELF IN THE BATHTUB COMFORTING
MY SON, WHERE HE WAS HAVING
CLUSTERS OF SEVERE SEIZURES. MY
DILEMMA. DO I TAKE MY SON TO THE
EMERGENCY ROOM AND POTENTIALLY
EXPOSED BOTH OF US TO COVID OR
DO I LET HIM POSSIBLY DIE IN MY
ARMS? IN THE TUB. I MADE THE
AGONIZING DECISION THAT PASSING
AWAY IN HIS MOTHER'S ARMS IN A
WARM BATH WOULD BE AN OKAY WAY
TO DIE. THANKFULLY, HE DID NOT.
OUR NEXT APPOINTMENT WITH DR
LOTS TI¾N AFTER TELLING HER
ABOUT THAT AWFUL CHRISTMAS DAY,
SHE'S STRONGLY SUGGESTED THAT WE
SIGNED UP FOR CONCURRENT HOSPICE
CARE, AND IT WAS A BLESSING. I
HAD 24 HOUR ACCESS TO NURSING
ADVICE, A DOCTOR MEDICATIONS.
AFTERWARD I NEVER HAD TO TAKE MY
SON TO THE ER. NOR DID I HAVE TO
HAVE HIM HOSPITALIZED FOR
SEIZURES. WE TAKE. WE TOOK CARE
OF HIM IN OUR HOME AND DID NOT
HAVE TO GIVE UP ACCESS TO HIS
OTHER SPECIALISTS. WHEN RYAN
TURNED 21 HE WAS DYING,
DISCHARGED FROM HIS PEDIATRIC
CONCURRENT HOSPICE. I WOULD HAVE
CONTINUED IF I COULD HAVE, SO
I'M HERE TO ENCOURAGE YOU TO
ALLOW OTHER YOUNG MEN AND WOMEN
AND THEIR FAMILIES TO CONTINUE
TO HAVE MEDICAL SUPPORT IN THE
HOME WHERE THEY ARE THE MOST
COMFORTABLE AND AVOIDING
HOSPITAL WHERE IT IS OFTEN
DIFFICULT, FRIGHTENING,
STRESSFUL AND VERY EXPENSIVE. I
STRONGLY URGE YOU TO VOTE TO
SUPPORT BILL 88 47 THANK YOU FOR
YOUR TIME. THANK YOU ANY OTHER
WITNESSES IN SUPPORT? MR CHAIR
MEMBERS OF THE COMMITTEE,
BRANDON MARCHI WITH THE
CALIFORNIA MEDICAL ASSOCIATION
AND SUPPORT THANK YOU. GOOD
AFTERNOON, ERIN TAYLOR ON BEHALF
OF THE CHILDREN'S SPECIALTY CARE
COALITION OF CALIFORNIA AND
STRONG SUPPORT. THANK YOU. ANY
WITNESSES AND OPPOSITION. ONE
MORE IN SUPPORT. SUPPORT YES. MY
NAME IS DAVID BULLOCK. I'M A
MEMBER OF THE INTERNATIONAL
BROTHERHOOD OF ELECTRICAL
WORKERS LOCAL 18 IN SUPPORT OF
THIS BILL. THANK YOU. THEY'RE
WITNESSES IN SUPPORT. SEEING
NONE ANY COMMENTS OR QUESTIONS
FROM COMMITTEE MEMBERS? SAYING
NONE. YOU MAY CLOSE. OH, SORRY.
AND I RESPECTFULLY ASK FOR AN I
VOTE. THANK YOU, AND SHE DID
ACCEPT THE COMMITTEE AMENDMENTS
SO THOSE WILL BE TAKING TO
CONSIDERATION ONCE WE GET A
QUORUM WILL TAKE THIS ITEM UP.
THANK YOU. OKAY, NEXT MEMBER. I
THINK MISS BAINES WAS HERE
FIRST. ALL RIGHT. YEAH. OKAY, MR
BAINES.
I SAY THANK YOU VERY MUCH, MR
MCCARTHY FOR HELPING US OUT.
APPRECIATE THAT ASSEMBLYMEMBER'S
BAINES. HERE YOU HAVE. MAYBE 11
22 WHENEVER YOU'RE READY. FUTURE
REMEMBERS. I WOULD LIKE TO START
BY ACCEPTING THE COMMITTEE
AMENDMENTS AND THINKING THE
COMMITTEE STAFF ARE WORKING
EXTENSIVELY WITH MY OFFICE.
MAYBE 11 22 ADDRESSES A CRITICAL
PIECE OF THE MEDICAL PROVIDER
SHORTAGE BY TARGETING THE
ADMINISTRATIVE BURDEN OF THE
MEDICAL ENROLLMENT PROCESS
SPECIFICALLY BE 11 22 WILL
REQUIRE THE DEPARTMENT OF HEALTH
CARE SERVICES TO DEVELOP A
PROCESS FOR APPLICANTS TO SUBMIT
ALTERNATIVE TYPES OF PRIMARY
AUTHORITATIVE SOURCE
DOCUMENTATION. ADDITIONALLY THIS
BILL WILL PROVIDE COMMON SENSE
FLEXIBILITY BY ALLOWING AN
APPLICANT TO SUBMIT THEIR
APPLICATION UP TO 30 DAYS.
BEFORE HAVING AN ESTABLISHED
PLACE OF BUSINESS. STATE LAW
ESTABLISHES THE FIFA SERVICE
MEDICAL PROGRAM ADMINISTERED BY
DHC S, UNDER WHICH QUALIFIED LOW
INCOME INDIVIDUALS RECEIVE
HEALTHCARE SERVICES, ACCORDING
TO THE STATE'S OWN DATA, THE
NUMBER OF MEDICAL PROVIDERS IS
DRASTICALLY LOWER RELATIVE TO
THE NEED. THIS SHORTAGE IS A
SIGNIFICANT CHALLENGE THAT
THREATENS THE HEALTH AND WELL
BEING OF CALIFORNIANS WHO RELY
ON THIS PROGRAM FOR THEIR
MEDICAL CARE. AS A PHYSICIAN IN
KERN COUNTY. I HAVE SEEN THE
IMPACT OF THIS SHORTAGE ON OUR
COMMUNITIES, SPECIFICALLY OUR
RURAL COMMUNITIES WITH LIMITED
ACCESS TO PROVIDERS, PATIENTS
FACE LONG WAIT TIMES OR FORCED
TO TRAVEL LONG DISTANCES TO
RECEIVE CARE. A 2017 STUDY
PUBLISHED BY THE CALIFORNIA
HEALTHCARE FOUNDATION FOUND THAT
ONE OF THE MAIN REASONS FOR LACK
OF PARTICIPATION IN THE MEDICAL
PROGRAM IS THE ADMINISTRATIVE
BURDEN THAT THE MEDICAL
ENROLLMENT PROGRAM HAS ON THE
PHYSICIAN OFFICE. WHILE A B 11
22 WILL NOT COMPLETELY SOLVE THE
PROVIDER SHORTAGE, WE HOPE TO
ADDRESS THE CRITICAL PIECE OF
THE PUZZLE. BY WORKING TOGETHER
TO STREAMLINE THE ENROLLMENT
PROCESS. WE CAN ENSURE THAT MORE
HEALTHCARE PROVIDERS ARE ABLE TO
PARTICIPATE IN THE PROGRAM,
EXPAND ACCESS TO HEALTH CARE
SERVICES AND IMPROVE THE HEALTH
OUTCOMES OF ALL CALIFORNIANS.
MAYBE 11 22 IS SUPPORTED BY THE
WESTERN CENTER ON LAW AND
POVERTY AND THE NATIONAL HEALTH
LAW PROGRAM. JOINING ME TODAY IN
SUPPORT IS JEANNIE VANCE. THANK
YOU. YEAH. COMMITTEE FOR HAVING
ME HERE TODAY. I'M AN ATTORNEY
LICENSED IN CALIFORNIA AND
HAWAII AND I'VE BEEN PRACTICING
FOR 29 YEARS. I'M A PARTNER WITH
THE CALIFORNIA LAW FIRM OF
WEINTRAUB. TOBIN PRACTICE
EXCLUSIVELY IN THE AREA OF
HEALTH LAW, AND, IN PARTICULAR
HAVE A SPECIALTY IN MEDICARE AND
MEDICAID PROVIDER ENROLLMENT. I
SPEAK AND WRITE BOTH WITHIN THE
STATE AND NATIONALLY FOR
ORGANIZATIONS ON THIS TOPIC,
SUCH AS THE AMERICAN HEALTH LAW
ASSOCIATION, THE AMERICAN BAR
ASSOCIATION AND THE CALIFORNIA
SOCIETY OF HEALTHCARE ATTORNEYS.
THE REASON I HAVE A SPECIALTY IN
THIS AREA OF MEDICAL PROVIDER
ENROLLMENT IS BECAUSE THERE ARE
MANY ADMINISTRATIVE PITFALLS
THAT ARE THERE LIKE TRAPS FOR
PROVIDERS THAT ARE DIFFICULT TO
DETERMINE WHAT THEY ARE, EXCEPT
THROUGH TRIAL AND ERROR WHEN A
PROVIDER SEEKS TO BECOME MEDICAL
PROVIDER. THINGS LIKE IF YOU
HAVE A BUSINESS LICENSE, AND THE
CITY THAT YOU APPLY TO DOES NOT
PUT YOUR SUITE NUMBER ON THE
BUSINESS LICENSE, YOU WILL NOT
BE ENROLLED IN THE MEDICAL
PROGRAM. YOU MAY ONLY SUBMIT
YOUR APPLICATION FOR ENROLLMENT
. ON THE FIRST DAY. YOU'RE OPEN
FOR BUSINESS IF YOU SUBMIT IT
EARLY. UM AND YOUR APPLICATION
TAKES THREE OR SIX MONTHS TO
REVIEW THEY'LL TELL YOU AT THE
END OF THAT PROCESS THAT YOU
SUBMITTED IT 10 DAYS TOO EARLY.
AND THE APPLICATION REQUIRES THE
DISCLOSURE OF QUOTE UNQUOTE
MANAGING EMPLOYEES, BUT DOES IN
FACT EXPECT YOU TO DISCLOSE
FOLKS THAT ARE NOT? IN FACT, W
TWO EMPLOYEES OF YOUR
ORGANIZATION AND SO THESE
DEFICIENCIES CAN CAUSE
SIGNIFICANT PROCESSING DELAYS
AND DENIALS FOR MEDICAL
ENROLLMENT APPLICATIONS. THE
REASON THAT THIS IS IMPORTANT IS
BECAUSE MEDICAL BENEFICIARIES
HAVE A VERY DIFFICULT TIME
FINDING PHYSICIANS THAT ARE
WILLING TO TREAT THEM. AND THERE
ARE LONG WAITS FOR ACCESS TO
SERVICES. THESE ISSUES ARE WELL
RECOGNIZED, AND LONGSTANDING,
SOME OF THESE BURDENS CAN BE
ELIMINATED. THIS BILL WOULD
ELIMINATE ONE OF THOSE REASONS
BY ALLOWING PROVIDER TO SUBMIT
THEIR APPLICATION. PRIOR TO THE
TIME THAT THEY'RE OPEN FOR
BUSINESS THAT WOULD ALLOW THEM,
UH, TO SUBMIT IT 30 DAYS AHEAD
OF THE TIME THAT THEY ARE OPEN.
UM I DID HAVE, UH, CLIENT THAT
SUBMITTED THEIR APPLICATIONS FOR
ENROLLMENT 10 DAYS BEFORE THE
DAY THAT THEY TOOK OVER AND
THEIR APPLICATIONS WERE IN THE
REVIEW PROCESS FOR, YOU KNOW,
EIGHT MONTHS OR SO AND AT THE
END OF THAT EIGHT MONTH PROCESS,
THEY SAID, OH, NO. YOU SUBMITTED
IT 10 DAYS TOO EARLY. AND IN THE
MEANTIME, THEY WERE NOT A
MEDICAL PROVIDER. DURING THAT
TIME, THIS BILL WOULD WOULD HELP
THAT AND COULD DO MUCH MORE.
THANK YOU. THANK YOU OTHERS IN
SUPPORT OF THE BILL. JUST YOUR
NAME AND ORGANIZATION. IF YOU
REPRESENT ONE LINDA WAY WITH
WESTERN CENTER ON LAW AND
POVERTY IN SUPPORT. BRANDON
MARCHI WITH THE CALIFORNIA
MEDICAL ASSOCIATION IN SUPPORT.
THANK YOU. GREG HAYES ON BEHALF
OF PEDIATRIC ASSOCIATES AND
SUPPORT THANK YOU. ANYONE ELSE?
IS THERE OPPOSITION TO THE BILL?
SEE NO ONE. BRING IT BACK TO THE
COMMITTEE FOR QUESTION OR WAS I
TOO QUICK? OKAY NOT A QUESTION.
BUT I THINK THIS IS A GREAT BILL
AND WHAT YOU JUST SAID. WE ALL
DEAL WITH THE FACT THAT WE DON'T
HAVE ENOUGH MEDICAL PROVIDERS IN
OUR DISTRICTS AND SO AT THE
APPROPRIATE TIME, I'D LOVE TO BE
ADDED AS A CO AUTHOR AS WELL.
THANK YOU ANY ANY ANYONE ELSE OR
JUST THREE OF US HERE NOW, SO I
GUESS NOT. SO THANK YOU VERY
MUCH FOR BRINGING THIS BILL. I
KNOW CERTAINLY AS HAVING BEEN A
IDENTICAL PROVIDER. AND ACTUALLY
KNOWING PEOPLE THAT ARE TRYING
TO DO THAT. NOW I THINK THE
APPLICATION IS 40 PAGES LONG.
AND, UM I THINK THINGS COULD BE
A LITTLE EASIER. QUITE FRANKLY.
UH SO APPRECIATE YOU BRINGING
THIS FORWARD WHEN THE WHEN WE DO
HAVE A QUORUM WILL ASK FOR A
MOTION AND MOVING. BILL DOES
ENJOY DO PASS RECOMMENDATION.
WOULD YOU LIKE TO CLOSE? UM YOU
KNOW, I JUST WANTED TO CLOSE
WITH A PERSONAL STORY. I WAS
PROVIDING HEALTHCARE AT THE FIRE
BASIN CINEMA WHEN WE HAD THOSE
BIG FIRES A COUPLE OF YEARS
BACK. UM AND MY EXECUTIVE
DIRECTOR OF VEGAS OR RECOVERY
SERVICES, FOR WHICH I'M THE
MEDICAL DIRECTOR FOR WAS JUST A
RESIDENTIAL BASED TREATMENT
FACILITY FOR PEOPLE RECOVERY
FROM ADDICTION REACHED OUT TO ME
AND SAID DR BAINES. IF I DON'T
GET YOU TO SIGN THIS, THEY'RE
GOING TO PULL OUR CREDENTIALS
WITHIN 24 HOURS. I WAS LITERALLY
CAUGHT TREATING FIREFIGHTERS AND
BEING THREATENED TO TAKE AWAY
OUR CREDENTIALS FOR RESIDENTIAL
BASED TREATMENT FACILITY. SO THE
ADMINISTRATIVE BURDEN IS REALLY
REAL. I PERSONALLY EXPERIENCED
IT AND I, THANKFULLY AND
RESPECTFULLY REQUEST AND I VOTE.
THANK YOU VERY MUCH, AND WE'LL
HOPEFULLY GET A QUORUM AT SOME
POINT LATER TODAY. THANK YOU SO
MUCH. MR LOWENTHAL.
SO YOU HAVE TWO BILLS A B 11 64
, WHICH WILL ASK YOU TO PRESENT
AND THEN MAYBE 12 82 IS ON
CONSENT, SO IF I WERE YOU, I'D
LEAVE THAT THERE. YOU DON'T MIND
IF I HAD A FEW MORE, DO YOU, MR
CHAIR? WELL, YOU KNOW. THANK
YOU, MR CHAIR AND MEMBERS. UM
PLEASED TO PRESENT A B 11 64,
WHICH REQUIRES HOSPITALS TO
DEVELOP AND IMPLEMENT A RESPONSE
PLAN. TO ALLEVIATE CROWDING
BASED ON A REAL TIME CALCULATOR
THAT MEASURES EMERGENCY
DEPARTMENT CROWDING EVERY FOUR
HOURS. THIS PLAN ALLOWS FOR
RAPID RESPONSE WITH PRACTICAL
SOLUTIONS BASED ON THE EVER
CHANGING CONDITIONS IN ANY GIVEN
E. D. CALIFORNIA'S EMERGENCY
DEPARTMENTS, OR E. D. S HAVE
BECOME THE HEALTHCARE SAFETY NET
AND ARE THE FRONT LINES OF
PUBLIC HEALTH EMERGENCIES.
EATING CROWDING IS NO LONGER
SIMPLE, SIMPLY AN UNCOMFORTABLE
TIME CONSUMING BURDEN FOR ITS
PATIENTS. IT IS JEOPARDIZING THE
SAFETY OF THE VERY PATIENTS FOR
WHOM TIMELY ACCESS TO CARE IS A
MATTER OF LIFE AND DEATH.
CROWDING IS OFTEN INACCURATELY
CONSIDERED A PROBLEM OF EDDIE
OPERATIONS AND INEFFICIENCY. IN
TRUTH. CROWDING IS BOTH
REFLECTIVE OF HOSPITAL
THROUGHPUT CALLED BOARDING AND
OF HEALTH SYSTEM DYSFUNCTION.
EMERGENCY DEPARTMENT BOARDING
OCCURS WHEN A PATIENT REMAINS IN
THE ED FOR MORE THAN TWO HOURS
AFTER THE DECISION TO ADMIT THEM
HAS BEEN MADE. AS THE E D
BECOMES SATURATED, WITH PATIENTS
NO LONGER REQUIRING EMERGENCY
CARE. IT CREATES A BACKLOG AND
IMPACTS THE AEDES ABILITY TO
CARE FOR ALL PATIENTS, WHETHER
THEY ARRIVE IN THE WAITING ROOM
OR BY AMBULANCE. BOARDING HAS
BEEN IDENTIFIED AS A LEADING
CAUSE OF ET CROWDING AND A
CONTRIBUTOR TO OTHER PROBLEMS,
INCLUDING AMBULANCE. REFUSALS
AMBULANCE WALL TIME FOR LONG
PATIENT WAITING TIMES AND
INCREASED PATIENTS SUFFERING.
REGARDLESS OF INSURANCE,
REGARDLESS OF GEOGRAPHY, ET
OVERCROWDING THREATENS THE
HEALTH AND SAFETY OF EVERYONE
WHO GOES TO THE AEDES SEEKING
CARE. BY REQUIRING HOSPITALS TO
DEVELOP AND IMPLEMENT A RESPONSE
PLAN. A B 11 64 WILL HELP
ALLEVIATE CROWDING BASED ON REAL
TIME CALCULATOR THAT MEASURES
CROWDING EVERY FOUR HOURS. HIS
PLAN ALLOWS FOR RAPID RESPONSE
WITH PRACTICAL SOLUTIONS BASED
ON THE EVER CHANGING CONDITIONS
IN ANY GIVEN E D. AS OUTLINED IN
THE BILL, HOSPITALS WILL DEVELOP
INDIVIDUALIZED PLANS. TAILORED
TO THEIR OWN NEEDS AND
CAPACITIES. THEREBY PROVIDING
FLEXIBILITY, WHICH WILL GO FAR
IN ENSURING THAT PLANTS WILL BE
ADHERED TO THE BENEFIT OF ALL
EDDIE PATIENTS. A B 11 64 IS THE
ADDED BENEFIT OF HELPING
HOSPITALS AND THE STATE TO
COORDINATE REGIONAL AND
STATEWIDE DISASTER RESPONSE BY
UTILIZING THE SAME CROWDING
MEASURE. HOSPITALS WILL BE ABLE
TO COMMUNICATE USING A COMMON
LANGUAGE ABOUT THE CONDITIONS
THERE FACING THIS ALLOWS FOR
DISASTER RESPONSE BASED ON A
REAL TIME MEASURE OF EDIE
CAPACITY. I'M EXTREMELY PLEASED
TO BE JOINED BY TIM MADDEN HERE
ON BEHALF OF THE CALIFORNIA
CHAPTER OF THE AMERICAN COLLEGE
OF EMERGENCY PHYSICIANS, AS WELL
AS DR VALERIE NORTON, THE
CURRENT PRESIDENT OF THE
CALIFORNIA CHAPTER OF THE
AMERICAN COLLEGE OF EMERGENCY
PHYSICIANS. WE'RE HERE TO
TESTIFY AND SUPPORTED THIS BILL.
THANK YOU, MR. CHAIR. MADAM VICE
CHAIR. TIM MADDEN REPRESENT THE
CALIFORNIA CHAPTER OF THE
AMERICAN COLLEGE OF EMERGENCY
PHYSICIANS AND I'LL MAKE MYSELF
AVAILABLE FOR QUESTIONS AND
DEFER MY TESTIMONY. DR NORTON
THANK YOU, CHAIRMAN WOULD AND
MEMBERS. WE NEED THIS BILL.
ABOUT EMERGENCY DEPARTMENT
CROWDING BECAUSE WE ARE AT A
CRISIS POINT IN HOSPITAL
CAPACITY. IT'S IMPORTANT TO
UNDERSTAND THAT EDIE CROWDING IS
DUE TO CROWDING IN THE ENTIRE
HOSPITAL. I WANT TO GIVE YOU
SOME EXAMPLES. RECENTLY WE HAD A
PATIENT WHO MISSED A COUPLE OF
DIALYSIS APPOINTMENTS AND CAME
IN WITH A DANGEROUSLY HIGH
POTASSIUM LEVEL, WHICH WAS
CAUSING HEART ARRHYTHMIAS.
BECAUSE OUR HOSPITAL WAS TOTALLY
FULL. WE DIDN'T HAVE AN
INPATIENT BED TO SEND HER TO
WHERE SHE COULD GET DIALYSIS,
AND IT'S NOT PHYSICALLY POSSIBLE
TO DO DIALYSIS IN OUR EMERGENCY
DEPARTMENT. WE GAVE HER
MEDICATIONS TO TEMPORARILY LOWER
HER POTASSIUM LEVEL, BUT SHE
SPENT TWO MORE HOURS IN THE
EMERGENCY DEPARTMENT WHILE WE
SCRAMBLED TO FREE UP THE BED
UPSTAIRS AND ALMOST DIED SEVERAL
TIMES OF HEART ARRHYTHMIAS
BEFORE WE COULD FINALLY GET HER
UP AND GET HER ON DIALYSIS.
SUPER SCARY. NOT UNCOMMON. ALL
MY COLLEAGUES HAVE MANY STORIES
LIKE THIS OF BOARDING AND I WANT
TO POINT OUT THAT THIS BILL IS
NOT JUST ABOUT TAKING A SCORE.
AND BY THE WAY, IT'S REALLY EASY
TO GET THE SCORE. I CAN DO IT IN
UNDER 15 SECONDS WITH AN APP ON
MY PHONE, ANY MEDICAL RECORD ANY
ELECTRONIC MEDICAL RECORD COULD
BE EASILY CONFIGURED TO REPORT
THE SCORE AUTOMATICALLY. IT WILL
NOT TAKE EXTRA HOSPITAL TIME AND
STAFF. BUT THE POINT IS, IT'S
NOT JUST ABOUT THE SCORE. IT'S
ABOUT HAVING A PLAN FOR SPECIFIC
INTERVENTIONS AT EACH LEVEL OF
CROWDING. WE URGENTLY NEED MORE
HOSPITAL CAPACITY. BUT IN THE
MEANTIME, WE NEED TO USE OUR
EXISTING CAPACITY MORE
EFFICIENTLY. THERE ARE LOTS OF
THINGS HOSPITALS CAN DO TO
ALLEVIATE BOARDING, INCLUDING
DISCHARGING IN PATIENTS EARLIER
IN THE DAY. ASSIGNING CASE
MANAGERS TO WORK ON LONG STAY
PATIENTS THAT ARE HAVING
DIFFICULTY GETTING PLACED AFTER
THEY'VE HAD THEIR HOSPITAL STAY
SMOOTHING THE SCHEDULE AND THE
OPERATING ROOM EVENING THE
CASELOAD AMONGST DIFFERENT
HOSPITALS IN THE SAME SYSTEM.
WITH THIS BILL, HOSPITALS CAN
CHOOSE THE STRATEGIES THAT WORK
BEST FOR THEIR UNIQUE
CIRCUMSTANCES. WE ALL NEED TO BE
ON THE SAME PAGE WITH THESE
EFFORTS BECAUSE HOSPITALS DEPEND
UPON EACH OTHER TO GET PATIENTS
TO THE RIGHT PLACE FOR THEIR
CARE. TERTIARY CARE HOSPITALS
ARE AT CAPACITY, THEY CAN'T TAKE
TRANSFERS FROM OTHER HOSPITALS.
WE RECENTLY HAD A PATIENT WITH
AN ULCER ON THE CORNEA OF HIS
EYE THAT NEEDED A SPECIAL
PROCEDURE AND WE DIDN'T HAVE THE
RIGHT SPECIALIST. WE FOUND AN
OPHTHALMOLOGIST AT A NEARBY
HOSPITAL WHO WAS WILLING TO
TREAT HIM BUT THE HOSPITAL
REFUSED TO TAKE THE PATIENT AND
TRANSFER BECAUSE THEY WERE
COMPLETELY FULL. SO WE ADMITTED
HIM AND KEPT ASKING DAY AFTER
DAY TO NO AVAIL. AND FINALLY,
AFTER TWO WEEKS, THIS POOR
PATIENTS CORNEA RUPTURED AND HE
WENT BLIND IN THAT EYE. SO THIS
BOTTLENECK HAS LOTS OF SPILLOVER
EFFECTS ON ANY GIVEN MONDAY. ONE
THIRD OF MY E D BEDS ARE FILLED
WITH BOARDING PATIENTS.
PRACTICALLY SPEAKING, THAT MEANS
INSTEAD OF HAVING A 50 BETTY D.
I ONLY HAVE A 35. BETTY D. MY
COLLEAGUE FROM FRESNO, WHO'S
HERE WITH ME TODAY SHARED WITH
ME THAT OUT OF THE 195 PATIENTS
IN HER EDDIE. TODAY 97 ARE
BOARDING, WAITING TO BE ADMITTED
THE LONGEST FOR 53 HOURS. IF YOU
CAN IMAGINE THAT. WE CAN'T
CONTINUE TO FUNCTION LIKE THIS.
I URGE YOUR I VOTE. THANK YOU
VERY MUCH. OTHERS IN SUPPORT. OR
A FERNANDEZ, EMERGENCY PHYSICIAN
REPRESENTING CALIFORNIA ASAP AND
SUPPORT. THANK YOU. HANDWRITTEN
NUMBER TWO POSITION HERE IN
MIDTOWN SACRAMENTO IN SUPPORT
YOU MARY GRAHAM. I'M AN
EMERGENCY PHYSICIAN HERE IN
SACRAMENTO AND I SUPPORT THANK
YOU, MR CHAIR MEMBERS, DOUG
SUPERS ON BEHALF OF THE
CALIFORNIA PROFESSIONAL
FIREFIGHTERS IN SUPPORT. THANK
YOU. RAY WHITING, EMERGENCY
MEDICINE PHYSICIAN, SAN DIEGO
HERE FOR SUPPORT. THANK YOU.
WHAT DO YOU GIVE TO EMERGENCY
PHYSICIAN IN L. A COUNTY
SUPPORT? THANK YOU. HUBERT WONG,
EMERGENCY PHYSICIAN IN ORANGE
COUNTY IN SUPPORT. THANK YOU.
RUNWAY GIVE EMERGENCY PHYSICIAN
IN SAN DIEGO IN SUPPORT. THANK
YOU. MARK ATTORNEY COMING
EMERGENCY PHYSICIAN IN DOWNTOWN
LOS ANGELES AND I SUPPORTED ALSO
REPRESENT A LARGER NATIONAL
COMPANY CALLED US ACUTE CARE
SOLUTION WE HAVE ABOUT 300
YARDS. THIS IS A MAJOR NATIONAL
PROBLEM. IT'S BEEN GOING ON FOR
DECADES. IT'S TIME TO FIX IT
BECAUSE IT'S GETTING WORSE.
ANYONE ELSE? IS THERE OPPOSITION
TO THE BILL?
GOOD AFTERNOON CHAIR WOOD AND
COMMITTEE MEMBERS VANESSA
GONZALEZ WITH A CALIFORNIA
HOSPITAL ASSOCIATION IN
RESPECTFUL OPPOSITION TO A B 11
64 HOSPITAL. EMERGENCY
DEPARTMENTS PLAY A CRITICAL ROLE
IN CALIFORNIA'S HEALTH CARE
DELIVERY SYSTEM AND STAND READY
TO CARE FOR PATIENTS. 24 7 AS
THE AUTHOR AND DR NORTON STATED
DUE TO SEVERAL CHALLENGES AND
THE ENTIRE HEALTH CARE DELIVERY
SYSTEM, SUCH AS LACK IN PRIMARY
CARE AND AN INCREASE IN PATIENTS
AND BEHAVIORAL HEALTH CRISIS.
EMERGENCY DEPARTMENTS HAVE SEEN
A 42% INCREASE IN PATIENTS AND
WE EXPECT THIS NUMBER TO
CONTINUE TO RISE DURING THE
PANDEMIC, AND CONTINUING TODAY,
EMERGENCY DEPARTMENTS HAVE
PROVEN THEIR ABILITY TO BE
PREPARED TO FLEXIBLE AND
RESPONSIVE DURING VOLUME
FLUCTUATIONS. A B 11 64 WOULD
REQUIRE HOSPITAL EMERGENCY
DEPARTMENTS TO CALCULATE AND
RECORD A CROWDING SCORE AT LEAST
EVERY FOUR HOURS. TO ASSESS ITS
VOLUME AND CAPACITY.
ADDITIONALLY HOSPITALS WOULD BE
REQUIRED TO DEVELOP AND
IMPLEMENT SIX INDIVIDUAL FULL
CAPACITY PROTOCOLS AND FILE
THESE PROTOCOLS WITH THE
DEPARTMENT OF HEALTH CARE.
ACCESS AND INFORMATION.
HOSPITALS THROUGHOUT CALIFORNIA
CURRENTLY USE VARIOUS TOOLS AND
SYSTEMS TO ASSESS PATIENT VOLUME
. HOSPITALS NEED THE FLEXIBILITY
TO USE THE METHODS THAT WORK
BEST FOR EACH FACILITY RATHER
THAN BE RESTRICTED TO THE SOLE
METHOD AND FORMULA SPECIFIED IN
A B 11 64. IN FACT, DESPITE
SUBSTANTIAL PUBLISHED RESEARCH,
THERE IS STILL NO CONSENSUS
CONSENSUS AROUND THE BEST METRIC
TO MEASURE AND DEFINE EMERGENCY
DEPARTMENT CROWDING. DIFFERENT
STUDIES AND DIFFERENT EMERGENCY
DEPARTMENTS SHOWED MIXED RESULTS
FOR THE USABILITY OF THE E D
CROWDING SCORE. ADDITIONALLY
BECAUSE THE SCORING SYSTEM IN 11
64 ONLY CONSIDERS A FEW SPECIFIC
FACTORS AND DOES NOT REFLECT THE
UNIQUE CHARACTERISTICS OF
INDIVIDUAL EMERGENCY DEPARTMENTS
, SUCH AS VARYING PATIENT
POPULATION, STAFFING LEVELS AND
PHYSICAL LAYOUTS. THIS SCORE
WOULD NOT FULLY CAPTURE THE
COMPLEXITY OF EACH EMERGENCY
DEPARTMENT IN ORDER TO MEET THE
INCREASING DEMAND OF HOSPITAL
EMERGENCY DEPARTMENTS, HOSPITALS
HAVE IMPLEMENTED SEVERAL
SOLUTIONS. SUCH AS ADDING
ADDITIONAL BEDS, CONVERTING
OFFICE AND THEN EMITTER AND
ADMINISTRATIVE SPACE FOR
TREATMENT AREAS, HIRING
ADDITIONAL NURSES AND STAFF AND
HIRED PATIENT FLOW CONSULTANTS
TO IMPROVE PROCESSES HOSPITALS
ON THEIR OWN, KEEP TRACK OF
CROWDING LEVELS IN THE EMERGENCY
DEPARTMENT AND ALREADY HAVE
PLANS IN PLACE TO ADDRESS
OVERCROWDING. THE PRESCRIPTIVE
APPROACH AND MAYBE 11 64 WILL
NOT LEAD TO SIGNIFICANT
IMPROVEMENTS. I WANT STEAD
DIVERT STAFF TIME AWAY FROM
DIRECT PATIENT CARE.
ADDITIONALLY AS STATED IN THE
COMMITTEE ANALYSIS, THE FULL
CAPACITY PROTOCOL THAT THE HOUSE
THAT HOSPITALS WOULD BE REQUIRED
TO PLAN AND IMPLEMENT IN THIS
BILL IS SUBSTANTIALLY SIMILAR TO
THE A POT REDUCTION PROTOCOL
REQUIRED IN ANOTHER BILL THAT
THE BILL WON'T BE CONSIDERING
LATER TODAY, WHICH WE HAVE BEEN
WORKING CLOSELY WITH THE AUTHOR
AND WILL ADDRESS MANY OF THE
SAME CONCERNS BECAUSE HOSPITALS
MUST BE ABLE TO UTILIZE THE
METHODS THAT WORK BEST FOR THEIR
FACILITIES. WE RESPECTFULLY
REQUEST OR NO VOTE ON A B 11 64.
THANK YOU. THANK YOU. TWO
WITNESSES, SO I SEE THREE OF YOU
THERE. SO, UM WHOEVER THANK YOU
. THANK YOU GOOD AFTERNOON CHAIR
AND COMMITTEE MEMBERS. MY NAME
IS MONICA DEVILLE. UM, THE CHIEF
NURSING OFFICER AT STANFORD
HEALTHCARE, TRI VALLEY. UM WELL,
WE UNDERSTAND THE IMPORTANCE OF
ADDRESSING OVERCROWDING AND
EMERGENCY ROOMS. WE ARE
CONCERNED ABOUT THE
IMPLEMENTATION OF STATEWIDE
STANDARDIZED OVER CARDING SCORE
PROTOCOLS. UH SUCH A PROTOCOL AS
A B 11 64 THAT'S NOT TAKE INTO
ACCOUNT THE UNIQUE CHALLENGES
AND CIRCUMSTANCES THAT
INDIVIDUAL HOSPITALS AND
EMERGENCY ROOMS FACE AND IT MAY
BE DIFFICULT TO ENSURE
CONSISTENCY AND ACCURACY AND
IMPLEMENTING SUCH PROTOCOL IN
DIFFERENT FACILITIES. WOULD YOU
MIND PULLING THE MICROPHONE JUST
A LITTLE CLOSER? SURE, THANK
YOU. FURTHERMORE THE
IMPLEMENTATION OF SUCH A
PROTOCOL WOULD CREATE
ADMINISTRATIVE BURDEN FOR
HOSPITALS TAKEN AWAY. THE VERY
MUCH DEDICATED RESOURCES THAT WE
NEED AT BEDSIDE TO CARE FOR OUR
PATIENTS, UM, AT STANFORD
HEALTHCARE TRI VALLEY, WE
IMPLEMENT A NUMBER OF DIFFERENT
SYSTEMS AND PROTOCOLS PROCESSES
STARTING WITH OUR EMR ARE EPIC.
UH DOCUMENTATION TOOL ALLOWS US
TO TRACK SENSES SECURITIES. UH,
LITERALLY REAL TIME. DATA DAY
SHIFT TO SHIFT ALLOWS US TO PULL
PROCESS. UH REPORTS, UM, IN
ADDITION TO OUR EPIC POOL TOOL,
WE ALSO HAVE ORGANIZATIONAL
STRUCTURES. WE HAVE DAILY
CAPACITY HUDDLES. WE HAVE
PATIENT FLOW COMMITTEES, WHICH
ARE COLLEAGUES ARE PHYSICIANS.
UM ARE CLINICIANS ATTEND TO
ADDRESS BARRIERS TO ADDRESS
PROCESSES THAT WE NEED TO CREATE
AS AN ORGANIZATION INSTITUTION
SO THAT WE CAN ENSURE WE HAVE
CAPACITY AND THE ADEQUATE
RESOURCES UM SO I DO
RESPECTFULLY REQUESTS A NO VOTE
FOR A B 11 64 AS THIS WILL
CONTINUE TO ADD ADMINISTRATIVE
BURDEN AND PULL THOSE VERY MUCH
DEDICATED RESOURCES THAT WE NEED
A PATIENT CARE AWAY FROM PATIENT
CARE. THANK YOU FOR YOUR
CONSIDERATION. THANK YOU ARE
THERE OTHERS IN OPPOSITION IN
THE AUDIENCE? MR CHAIR AND
MEMBERS AMY BLOOMBERG WITH THE
CALIFORNIA CHILDREN'S HOSPITAL
ASSOCIATION, ALSO IN OPPOSITION.
THANK YOU. ANYONE ELSE? SEE NO
ONE. BRING IT BACK TO THE
COMMITTEE FOR QUESTIONS OR
COMMENTS ANYTHING, DR WEBBER.
GOOD AFTERNOON, EVERYONE. THANK
YOU SO MUCH FOR BRINGING THIS
BILL AND, UH, STARTING THIS
CONVERSATION, UM I GUESS WHEN MY
FIRST QUESTION WHEN I READ THIS
BILL UM WAS WHAT EXACTLY IS THE
PURPOSE OR WHAT IS THE OUTCOME
THAT IT IS THAT YOU'RE LOOKING
FOR? SO I THINK YOU KNOW, WE ALL
KNOW THAT THERE'S A PROBLEM IN
THE EMERGENCY ROOMS. WE HAVE, UM
YOU KNOW OVERCROWDING. PEOPLE GO
THERE, NOT FOR EMERGENT CARE,
BUT THEY GO THERE FOR URGENT AND
SOMETIMES JUST REGULAR PRIMARY
CARE THAT THEY SHOULD BE GOING
TO A CLINIC FOR. UM, WE'VE HAD
THAT AS AN ISSUE FOR A VERY,
VERY, VERY LONG TIME. UM SO
ANYONE WHO GOES TO THE EMERGENCY
ROOM OR WORKS IN AN EMERGENCY
ROOM. WE KNOW THAT THAT THEIR
LONG WAYS THAT THERE ARE A LOT
OF PEOPLE THERE ANYONE THAT
WORKS THERE KNOWS THAT THERE IS
AN ISSUE WITH PEOPLE BEING IN
THE ER FOR A VERY LONG TIME,
BECAUSE THERE'S NO BEDS UPSTAIRS
, THEIR STAFFING SHORTAGES. FOR
THOSE OF US THAT ARE PHYSICIANS.
WE NOT FUN TO HAVE TO GO DOWN TO
THE E D TWO ROUND ON YOUR
PATIENT THAT YOU ADMITTED 12
HOURS BEFORE, BUT THESE ARE
THINGS THAT WE ALREADY KNOW. AND
THESE ARE METRICS THAT HOSPITALS
HAVE ALREADY LOOKED INTO, UM SO
WHAT, EXACTLY? IS THE PURPOSE OF
THIS OF THIS PARTICULAR BILL
BECAUSE IT WOULD JUST REVEAL
INFORMATION THAT WE ALREADY KNOW
. UM BUT NOT ACTUALLY GET AT THE
CRUX OF WHAT THE PROBLEM IS,
WHICH IS STAFFING, OR, UM, YOU
KNOW, DELAYS AND DISCHARGED AND
THINGS LIKE THAT. AND SO, TO ME,
IT DOES SEEM LIKE IT'S TAKING.
EXTRA TIME OR PUTTING EXTRA
ADMINISTRATIVE BURDEN ON ON
PEOPLE THAT WORK IN THE E D TWO
TO PRODUCE INFORMATION THAT WE
ALREADY HAVE. AND WE ALREADY
KNOW. THAT'S AN EXCELLENT
QUESTION, DR WEBBER. THANK YOU
FOR ASKING IT. FIRST OF ALL THE
SCORING CAN BE AUTOMATED. IT
DOESN'T TAKE ANYONE'S TIME. YOUR
EMR CAN SPIT OUT A SCORE FOR YOU
EVERY FOUR HOURS AND THEN IT'S
INCUMBENT UPON THE ENTIRE
HOSPITAL LEADERSHIP STRUCTURE TO
FIGURE OUT WHAT TO DO AT EACH
SCORING LEVEL. MOST HOSPITALS DO
HAVE SOME KIND OF FULL CAPACITY
PROTOCOL RIGHT NOW, BUT THEY'RE
NOT ADEQUATE. SOME OF US ARE
BLESSED TO WORK IN SYSTEMS LIKE
OUR COLLEAGUES AT STANFORD,
WHERE THEY'VE REALLY DONE A LOT
OF WORK ON THIS, AND I BET IT'S
PRETTY GOOD AT STANFORD. IT'S
ACTUALLY PRETTY GOOD IN MY OWN
HEALTHCARE SYSTEM. AT SCRIPTS.
USUALLY PATIENTS WAIT NO MORE
THAN THREE OR FOUR HOURS TO GET
UPSTAIRS. BUT AT COMMUNITY
REGIONAL MEDICAL CENTER IN
FRESNO WE HAVE A DIFFERENT
STORY, AND THERE ARE A LOT OF
HOSPITALS IN THE STATE THAT
WHERE IT'S A VERY DIFFERENT
STORY, AND WE WERE HEARING
REALLY, REALLY SCARY, SCARY
INDIVIDUAL TALES OF HORRIBLE
OUTCOMES AND HORRIBLE SUFFERING
. SO WE NEED HOSPITALS TO ALL
GET ON THE SAME PAGE. WE NEED
OUR TREASURY CARE CENTERS TO DO
WHAT IT TAKES TO BE ABLE TO
ACCEPT TRANSFERS FOR HIGHER
LEVELS OF CARE. HOSPITALS ARE
THEY COULD BE DOING ALL THIS
STUFF RIGHT NOW, BUT THEY'RE
NOT. SO WE NEED TO GET THEM TO
DO IT. WE NEED TO DO SOMETHING
TO GET EVERYONE ON THE SAME
PAGE. AND THERE IS RESEARCH THAT
SHOWS THAT THIS WORKS WHEN L. A
COUNTY USC STARTED THIS SYSTEM
BACK IN 2008. THEY WERE AT A
DANGEROUSLY OVERCROWDED
SITUATION BY THE SCORING SYSTEM
ABOUT 40% OF THE TIME. AFTER
THEY PUT THEIR FULL CAPACITY
PROTOCOL INTO PLACE AND HAD
LEVELS THAT THEY RESPONDED TO AT
EACH STAGE OF CROWDING. THEY
WENT DOWN TO WHERE THEY WERE
ONLY DANGEROUSLY OVERCROWDED 1%
OF THE TIME AND THEY WERE ONLY
JUST OVERCROWDED ABOUT TWO
THIRDS OF THE TIME, WHICH IS
PRETTY GOOD. IF YOU KNOW L, A
COUNTY USC, SO IT MADE A
DRAMATIC DIFFERENCE FOR THEM,
AND IT'S BEEN DONE IN DOZENS OF
OTHER HOSPITALS AROUND THE
COUNTRY AS WELL. SO WE DO HAVE
GOOD EVIDENCE THAT IT CAN WORK.
THANK YOU. SO YOUR ASSERTION IS
THAT HOSPITALS CAN DO THIS. THEY
JUST AT THIS POINT DON'T WANT
TO, EVEN THOUGH IT'S BEEN A
PROBLEM FOR A VERY LONG TIME. I
THINK IT'S NOT SO MUCH THAT THEY
DON'T WANT TO AS THAT THERE ARE
MANY COMPETING FACTORS VYING FOR
HOSPITAL ADMINISTRATORS, TIME
AND ATTENTION. THEY ALSO WANT TO
GET THEIR PATIENTS THROUGH THE
ARE SMOOTHLY THEY WANT TO GET
ELECTIVE SURGERIES DONE. THERE
ARE ALL KINDS OF THINGS THAT ARE
IMPACTING THE ABILITY TO UNLOAD
THE E D. AND SOMETIMES IT'S NOT
EVEN ABOUT SPENDING MORE MONEY.
IT'S ABOUT DEPLOYING YOUR
RESOURCES DIFFERENTLY, LIKE
HAVING A LONG STAY PATIENT
PROGRAM OR HAVING A CAMPAIGN
WITH YOUR DOCTORS TO MAKE SURE
THEY DISCHARGE THEIR PATIENTS BY
10 A.M. THAT KIND OF THING CAN
MAKE BIG DIFFERENCES, BUT A LOT
OF HOSPITALS AREN'T DOING THESE
VERY SIMPLE MEASURES. THANK YOU.
MR V VALLAPUDUA. SURE I AM. I'M
GLAD YOU BROUGHT THAT UP.
SOMEBODY MEMBER, HOWEVER. I'M AS
A FORMER COUNTY SUPERVISOR SAID
ON ALL OF OUR HOSPITAL
COMMITTEES. AND THESE ISSUES AND
CONCERNS ALWAYS CAME UP, AND
I'VE HAD LONG TALKS WITH OUR
CEO. WHICH USUALLY ONLY LASTS
ABOUT THREE YEARS. YOU KNOW AT
HOSPITALS THEY ROTATE. UM, WHICH
. WHICH MAKES ME ASK THE
QUESTION, YOU KNOW, BECAUSE AS
AS AS YOU HEAR WELL, WELL, SHE
WAS SHUT DOWN CLINICS.
COMMUNITIES WHICH DRIVES FOLKS
TO GO TO, ER. UM AND YOU'RE
HEARING MORE THAT MORE HOSPITALS
ARE CLOSING DOWN. AND SO THAT'S
A SCARE BECAUSE OTHER HOSPITALS
DON'T WANT TO HEAR THAT, BECAUSE
NOW THEY'RE GOING TO DRIVE THOSE
HOURS IN THE ER EVEN LONGER,
RIGHT? UM SO, BUT THE QUESTION I
HAVE, IS IT IS IT? IS IT REALLY
THE ADMINISTRATION? IS IT OR IS
IT LABOR OR IS IT YOU KNOW, IT'S
HARD TO GET FOLKS TO GO ON THIS
PROFESSIONS. DO WE HAVE ENOUGH?
YOU KNOW? IS IT A RATIO? A
NUMBER? I DON'T KNOW. YOU KNOW,
I BUT I. I LIKE WHAT THE AUTHOR
IS DOING? UM BUT I'M JUST TRYING
TO FIGURE OUT YOU KNOW, ARE WE
ARE WE ADDING TOO MUCH TO THIS?
Tð A PROBLEM THAT WE'RE REALLY
YOU KNOW, IT'S NOT NOT SO MUCH
OF THE ADMINISTRATION'S ISSUE.
IT'S REALLY KIND OF THE ISSUE OF
HAVING EITHER MORE DOCTORS OR
MORE NURSES IN CENTRAL VALLEY.
IT'S HARD TO GET DOCTORS AND
NURSES THERE, RIGHT. THEY DON'T
THEY DON'T WANT TO WORK THERE.
THEY'LL GO TO BARRIER L A SO
IT'S ALWAYS A RACIAL ISSUE
THERE. AND I I'M I'M TRYING TO
FIGURE OUT YOU KNOW, I DON'T I
DIDN'T THINKING ABOUT THIS ALL
YESTERDAY AND TODAY. HOW DO WE
FIX THIS? WITHOUT FORCING THE
ADMINISTRATION AND TELLING THEM
THAT THEY'RE NOT DOING THEIR JOB
WHEN THEY ARE SO IS IT. IS IT A
LABOR ISSUE? OF COURSE, WE NEED
MORE DOCTORS AND NURSES. THERE'S
NO QUESTION I TOTALLY AGREE WITH
YOU. WE HAVE A HUGE CRISIS IN
HOSPITAL CAPACITY AND THIS
ENTIRE COUNTRY AND IT'S
DEFINITELY FELT VERY KEENLY IN
CALIFORNIA BECAUSE WE HAVE THE
HIGHEST NURSING WAGES IN THE
NATION AND THE LOWEST MEDICAID
REIMBURSEMENT IN THE NATION. SO
HOSPITALS ARE ALL RUNNING ON
RAZOR THIN MARGINS. THERE'S NO
QUESTION THAT HOSPITALS ARE IN
DISTRESS AND THAT WE NEED MORE
STAFFING. BUT WE STILL HAVE TO
DO SOMETHING WITH THE RESOURCES
THAT WE DO HAVE, AND THERE'S
LOTS OF EVIDENCE OUT THERE THAT
YOU CAN MAKE DIFFERENCES JUST BY
CHANGING HOW YOUR OUR SCHEDULING
IS DONE, FOR INSTANCE, AND
ALLOWING SOME CASES TO BE DONE
ON WEEKENDS OR IN THE EVENINGS
JUST BY SMOOTHING THE FLOW OF
PATIENTS OUT OF THE O R. YOU CAN
MAKE A BIG IMPACT ON E D
BOARDING. A LOT OF PEOPLE DON'T
KNOW THAT. BUT THERE'S VERY GOOD
EVIDENCE FOR THAT. AND MANY OF
THE OTHER INTERVENTIONS THAT I
DISCUSSED ALSO HAVE A BIG
IMPACT. SO WE HAVE TO BE
CREATIVE, AND WE'RE NOT ASKING
HOSPITALS TO COME UP WITH NURSES
OUT OF THIN AIR. WE'RE ASKING
THEM TO HAVE A CAPACITY PROTOCOL
AT EACH LEVEL THAT THEY THINK
THEY CAN DO. WE'RE NOT
PRESCRIBING WHAT THEY HAVE TO
DO. WE'RE SAYING FOR YOUR UNIQUE
CIRCUMSTANCES WHERE YOU ARE.
WHAT CAN YOU DO AT EACH LEVEL OF
CROWDING? IT'S A LITTLE BIT MORE
THAN WHAT YOU'RE DOING RIGHT
NOW. TO JUST COME ON CROSSING SO
IS IT A ONE FIXED HALL? BECAUSE
NOT EVERY HOSPITAL IS DIFFERENT
, AND THAT'S WHY THE
INTERVENTIONS ARE NOT SPECIFIED
SO EVERY HOSPITAL CAN DECIDE ON
THEIR OWN INTERVENTIONS FOR EACH
LEVEL. BUT AT LEAST WE WANT TO
BE ABLE TO COMPARE APPLES TO
APPLES IN TERMS OF WHAT THE
SCORE IS FOR DIFFERENT HOSPITALS
AND DURING A COVID SURGE,
WOULDN'T IT BE HELPFUL, FOR
INSTANCE, TO KNOW THAT EL CENTRO
REGIONAL IS THAT A 1 97 OUT OF
200, WHEREAS SCRIPTS LA HOYA IS
ONLY AT AN 83. THEREFORE WE CAN
TAKE 10 OF THEIR PATIENTS IN
TRANSFER. THAT'S REALLY HELPFUL
INFORMATION IF YOU'RE THE
DISASTER MANAGEMENT TEAM TRYING
TO ALLOCATE RESOURCES IN AN AREA
THANK YOU. MAY I RESPOND? THANK
YOU. THAT'S ACTUALLY A VERY
COMPLEX QUESTION THAT I ASK
MYSELF EVERY DAY. HOW DO WE
SOLVE FOR A LOT OF OUR CAPACITY
AND OVERCROWDED NOUS? UM IN OUR
ORGANIZATION AND YES, IT'S
STANFORD. WE DO HAVE, UM, WE'RE
FORTUNATE TO HAVE SOME OF THE
RESOURCES THAT ALLOWS US TO
REALLY MOVE CAPACITY AND
PATIENTS THROUGH OUR
ORGANIZATION. BUT WE ALSO
RECOGNIZE THAT THERE ARE
ORGANIZATIONS ACROSS THE STATE.
THAT ARE NOT AS FORTUNATE.
THEREFORE I THINK TO THE
COLLECTIVE IMPLEMENTING
SOMETHING LIKE THIS IS REALLY UM
, PUTTING A HUGE BURDEN ON THE
ADMINISTRATION AND THE
ORGANIZATION, UH, TO PULL AWAY
THOSE BEDSIDE NURSES DOES
CLINICIANS THAT WE SO MUCH VALUE
AND ARE PROTECTIVE OF SO THAT
THEY'RE NOT PULLED AWAY? TO
FIGURE OUT THIS ADMINISTRATIVE
BURDEN. WE DO HAVE PROCESSES AND
PROTOCOLS CURRENTLY, UH, TO
ADDRESS CAPACITY, OVERCROWDED,
NOUS SECURITIES. UM EPIC AS AN
EMR IS AN EMR THAT'S HAS
VISIBILITY AND CROSSES MANY
ORGANIZATIONS ACROSS THE STATE,
NOT JUST STANFORD, SUTTER. MANY
ORGANIZATIONS, SO THERE IS
TRANSLATABLE KNOWLEDGE AND
INFORMATION ACROSS OTHER
ORGANIZATIONS, UM. SO I THINK
THERE'S NOT A COOKIE CUTTER
ANSWER TO A LOT OF THE
COMPLEXITIES. IT IS STAFFING. IT
IS OUR PROVIDERS. IT IS SPACE
ITS CAPACITY. IT'S BURDEN. UM UH
, CURRENTLY THAT WE'RE SEEING
WITH OUR WORKFORCE. UH, SO THERE
IS. NO ONE ANSWER ON HOW TO
SOLVE, BUT I THINK IT DOES TAKE
ALL OF US TO SIT DOWN AT THE
TABLE AND HAVE DIALOGUES AND
DISCUSSION ABOUT HOW TO MOVE
FORWARD AS A HEALTHCARE, UM,
ORGANIZATION. ANYONE ELSE? UM,
FIRST OF ALL, UM THE BILL DOES
DO ENJOY A DO PASS
RECOMMENDATION, BUT A COUPLE OF
COMMENTS I WANT TO THANK YOU.
ASSEMBLYMEMBER'S APPRECIATE YOUR
WORK ON THIS BILL. WE'VE SEEN
SEVERAL BILLS THIS YEAR THAT ARE
WORKING TO ADDRESS THE ISSUE OF
CROWDING. PATIENT BOARDING
THROUGHPUT AN AMBULANCE PATIENT
OFFLOAD TIME. ASSEMBLYMEMBER'S
RODRIGUEZ, IN PARTICULAR, HAS
BEEN WORKING FOR SEVERAL YEARS
TO ADDRESS THE A POD ISSUE.
SHOULD THIS BILL MOVE FORWARD
TODAY? I ENCOURAGE YOU TO WORK
WITH MR RODRIGUEZ SO THAT THE
APPROACH THE PROTOCOLS
ESTABLISHED IN THIS BILL OR NOT
DUPLICATIVE OF WHAT HE'S
ATTEMPTING TO DO IN A B 40. SO
UM, WE'LL BE WATCHING THAT GOING
FORWARD. SO WITH THAT, WOULD YOU
LIKE TO CLOSE SIMPLY WANT TO
THANK THE MEMBERS FOR THEIR VERY
THOUGHTFUL COMMENTS WERE KEENLY
FOCUSED ON THEM ALL WE ARE
WILLING TO WORK WITH ANYBODY AND
EVERYBODY TO STRENGTHEN THIS AND
ARE CERTAINLY CONCERNED ABOUT
HOW ARE HOSPITALS FEEL? I WANT
TO, UM REITERATE WHAT DR NORTON
SAID. WE NEED TO BE ABLE TO TALK
ABOUT THESE THINGS. APPLES TO
APPLES. THAT IS WHAT THIS BILL
SEEKS. SO WHEN ASSEMBLYMEMBER'S
V VALLAPUDUA WANTS TO TALK ABOUT
WHAT'S HAPPENING IN HOSPITALS IN
HIS DISTRICT VERSUS OTHER
DISTRICTS, YOU HAVE A
COMMONALITY TO BE ABLE TO
COMPARE THESE THINGS AGAINST
THAT IS THE FUNDAMENTAL PART OF
WHAT THIS BILL SEEKS. ONCE AGAIN
. WE CERTAINLY APPRECIATE ALL OF
THE INPUT WILL BE. WE'RE WILLING
TO WORK WITH EVERYONE AND ANYONE
TO STRENGTHEN THIS LEGISLATION
ON BEHALF OF ALL CALIFORNIANS. I
RESPECTFULLY ASK FOR YOUR EYE,
BUT GREAT. THANK YOU. DON'T YOU
SEE? WE'RE WE'RE GETTING CLOSER
TO A QUORUM. BUT YOU KNOW, WE'RE
STILL NOT THERE YET. SO ANYWAY,
THANK YOU VERY MUCH. APPRECIATE
IT. MR LOWE.
MR LOW. YOU HAVE A BABY 11 24
WHENEVER YOU'RE READY. AND THANK
YOU VERY MUCH, MR CHAIR. AND
COLLEAGUES FOR ALLOW ME TO
PRESENT ASSEMBLY BILL 11 24,
WHICH IS A SIMPLE STUDY BILL AND
RESPECTFULLY ASK FOR OUR VOTE
WHEN YOU HAVE REACHED A QUORUM.
DO YOU HAVE ANY WITNESSES AND
SUPPORT? YES BRIEF FOR ANY
TECHNICAL ANSWERS, AS, UH, THEY
WILL PROVIDE THEM TO THANK YOU.
MISSED. THANK YOU. THANK YOU, MR
CHAIR AND MEMBERS FOR ALLOWING
ME TO ADDRESS YOU TODAY. MY NAME
IS DR JULIA CORCORAN. I'M A
LICENSED CLINICAL PSYCHOLOGIST
IN CALIFORNIA, AND I'M ALSO THE
DIRECTOR OF CLINICAL EXCUSE ME A
CLINICAL STRATEGY AT MODERN
HEALTH. UM I'M ALSO JUST A HUMAN
BEING WITH MY OWN AND MY LOVED
ONES. MENTAL HEALTH NEEDS THAT
ARE ON MY MIND. AS I THINK ABOUT
OUR MENTAL HEALTH CARE SYSTEMS
IN CALIFORNIA. SO WHILE I'M HERE
ON BEHALF OF MODERN HEALTH, I'M
ALSO HERE JUST THINKING ABOUT
THE BIGGER PICTURE. MODERN
HEALTH IS AN INNOVATIVE PLATFORM
THAT IS LOOKING TO KIND OF
BROADENED WHAT MENTAL HEALTH
CARE LOOKS LIKE. WE FOCUS ON
MENTAL HEALTH AND WELL BEING
BENEFITS FOR EMPLOYERS. OUR
MISSION IS TO IMPROVE THE LIVES
OF PEOPLE AND THEIR COMMUNITIES
BY OFFERING INCLUSIVE MENTAL
HEALTH SOLUTIONS THAT DRIVE
EXCELLENT OUTCOMES AND THAT IS
ENGAGING. WE'RE VERY PROUD TO
OFFER PROGRAMS TO EMPLOYERS THAT
ASSIST THEIR EMPLOYEES AS WELL
AS THE EMPLOYEE'S FAMILIES. IN
IDENTIFYING AND ADDRESSING A
WIDE RANGE OF MENTAL HEALTH AND
WELL BEING GOALS, INCLUDING
RELATED TO THEIR EMOTIONAL,
PROFESSIONAL AND INTERPERSONAL
WELL BEING. OUR PLATFORM
IMPROVES ACCESS TO MENTAL
HEALTHCARE BY OFFERING SERVICES
AND RESOURCES THAT ENCOURAGE
INDIVIDUALS TO ENGAGE IN WAYS
THAT ARE MOST SUITABLE FOR THEM.
WE DO THAT THROUGH DIGITAL
PROGRAMS, COACHING SHORT TERM
THERAPY AND AS NEEDED REFERRALS
TO MORE SIGNIFICANT CARE. THANK
YOU VERY MUCH, MR CHAIR. THANK
YOU. I JUST CONFIRM ARE YOU
ACCEPT YOU ACCEPTING OUR
AMENDMENTS? YES. OKAY THERE, AS
SUBMITTED AS AUTHOR EVENTS IS
THAT CORRECT? YES YEAH. THANK
YOU. THANK YOU VERY MUCH OTHERS
IN SUPPORT OF THE BILL. HE'S
JUST YOUR NAME AND ORGANIZATION
IF YOU REPRESENT ONE. AND THE
OPPOSITION TO THE BILL. SO YOU
KNOW, I'M BRINGING BACK THE
QUESTIONS OR COMMENTS FROM THE
COMMITTEE. SEEN NONE. UM THE
BILL DOES ENJOY DO PASS
RECOMMENDATION. WELL, THANK YOU
FOR BRINGING IT FORWARD, MR LOW
. WHEN WE HAVE A QUORUM, WE WILL
MOVE FOR EMOTION AND HOPEFULLY
MOVE YOUR BILL OUT OF COMMITTEE.
THANK YOU. THANK YOU VERY MUCH.
THE, UM WE'RE GONNA.
YEAH WE'RE GONNA GO AHEAD AND
MOVE TO ASSEMBLY BILL 6 59 BY
MISS AGUILAR CURRY. HER
WITNESSES ARE UPSTAIRS. THEY'RE
GOING TO BE COMING DOWN, BUT
ALSO WILL GIVE THEM A MINUTE TO
DO THAT. SO.
WE'LL WAIT JUST A MINUTE TO YOUR
WITNESSES ARRIVED. YEAH. THANK
YOU.
THE FOLLOWING THIS BILL WILL
TAKE UP MR RODRIGUEZ'S BILL A B
40.
THANK YOU FOR YOUR PATIENCE
COMMITTEE AND CHAIRMAN. GOOD
AFTERNOON, MR CHAIRMAN AND
MEMBERS. MR CHAIRMAN, I WANT TO
THANK YOU AND YOUR INCREDIBLE
COMMITTEE STAFF FOR THE MANY
HOURS WE'VE SPENT WORKING ON
THIS ISSUE FOR THE PAST FIVE
YEARS. COLLEAGUES IN THE UNITED
STATES. 37,000 CASES OF CANCER
CAUSED BY HPV EVERY YEAR AND
OVER 7000 PEOPLE DIE PER YEAR
FROM CANCERS CAUSED BY HPV,
ACCORDING TO THE CDC. SO SO
WHILE I'VE BEEN WAITING TO BRING
THIS PROPOSAL TO YOU OVER
203,000 AMERICANS HAVE DEVELOPED
CANCER OR AND MORE THAN 35
PEOPLE HAVE DIED. CERVICAL.
THROAT PENAL, VAGINAL AND VULVAR
CANCERS. CAUSED BY THIS VIRUS,
AND THERE IS NO WAY TO KNOW WHO
WILL DEVELOP THE CANCER OR OTHER
HEALTH PROBLEMS FROM HPV, WHILE
SOME TESTING EXAMINATIONS CAN
REVEAL COMING HEALTH THREATS
OTHERS REMAIN UNDETECTED UNTIL
THEY BECOME A THREAT TO A
PERSON'S LIFE. DESPITE ALL OF
THE DIFFERENT TYPES OF CANCER
THAT HPV CAN CAUSE, CURRENTLY
THE ONLY TWO WAYS FOR TESTING
FOR AND MONITORING HPV ARE
THROUGH PERHAPS SMEARS AND
CYTOLOGY. THEY ARE NOT FAIL
SAFE, AND THEY DETECT THE
DISEASE AFTER IT'S ALREADY
STARTED. THERE IS CURRENTLY NO
STANDARD WAY OF PENAL TESTING OF
HPV IN MEN AND NO APPROVED OR
USED WAY OF HPV TESTING THAT CAN
BE DONE FOR THE THROAT. THESE
LIMITATIONS LEAVE TO LARGER GAP
IN TESTING FOR AND MONITORING
HPV, WHICH IS WHY HPV
VACCINATION IS A GREAT
PREVENTATIVE MEASURES THAT CAN
BE TAKEN TO TRY TO AVOID
NUMEROUS TYPES OF HPV CAUSED
CANCERS, ESPECIALLY THE TYPES
THAT ARE NOT TESTED FOR. MORE
THAN 135 MILLION DOSES OF THE
HPV VACCINE HAVE BEEN
ADMINISTERED THE UNITED STATES
SINCE THE VACCINE WAS INTRODUCED
IN 2006, THE AMERICAN ACADEMY OF
PEDIATRICS RECOMMENDS THAT YOUNG
PEOPLE GET THE HPV VACCINE
VACCINE BETWEEN THE AGES OF NINE
AND 12. 12 YEARS BECAUSE THE HPV
VACCINE IS MORE EFFECTIVE IF
GIVEN AT AN EARLIER AGE AND
HOPEFULLY BEFORE BEING EXPOSED
TO IN CONTRACTING THE VIRUS.
DESPITE THIS, THE OVERALL HPV
VACCINATION RATES IN YOUNG
PEOPLE IS AS LOW AS 51% IN
CALIFORNIA. WELL BELOW THE
NATIONAL GOAL OF ANY PERCENT. IT
IS SIGNIFICANTLY WORSE IN SMALL
AND RURAL COMMUNITIES LIKE MINE
AND THE COMMUNITIES OF COLOR AND
LOWER INCOME COMMUNITIES
THROUGHOUT THE STATE. A B 6 59
WILL REQUIRE NOTIFICATION OF
PARENTS IN THE SIXTH GRADE THAT
THE VACCINATION REQUIREMENT FOR
THE FOR EIGHTH GRADE IS COMING.
GIVING PARENTS AMPLE TIME TO
CONSULT MEDICAL PROFESSIONALS.
THE BILL WILL ALSO REQUIRE HPV
VACCINATION OF STUDENTS 26 YEARS
OF AGE OR YOUNGER FOR ATTENDANCE
AT THE CALIFORNIA STATE
UNIVERSITY, UNIVERSITY OF
CALIFORNIA AND CALIFORNIA
COMMUNITY COLLEGES WHEN STUDENTS
ARE STILL AT THE AGE WHERE THEY
CAN SAFELY RECEIVED VACCINE. A B
659 WILL GUARANTEE THAT THE HPV
VACCINE IS COMPLETELY COVERED.
REGARDLESS OF HEALTH INSURANCE
STATUS BY EXTENDING EXPANDING
COVERAGE REQUIREMENTS FOR THE
HPV VACCINE AND EXPANDING
COMPREHENSIVE CLINICAL FOR
FAMILY PLANNING SERVICES UNDER
THE FAMILY PACKED WAIVER PROGRAM
TO INCLUDE THE HPV VACCINE FOR
FDA APPROVED PATIENTS. REQUIRING
BANKS BY REQUIRING VACCINATION.
THIS BILL WILL HELP NOTIFY AND
EDUCATE CALIFORNIA AT THESE
VITAL AGES, WHEN RECEIVING THE
VACCINE IS MOST EFFECTIVE. IT
WILL FOSTER A PRIVATE
CONVERSATION BETWEEN DOCTORS.
THEIR PATIENTS AND PARENTS
EXACTLY WHAT THE OPPONENTS HAVE
SAID THEIR SUPPORT. DOING SO
WILL PREVENT THE SPREAD OF HPV
AND GIVE MORE CALIFORNIA'S
PROTECTION FOR CANCERS AND OTHER
HPV INDUCED DISEASES AND FOR
THOSE WHO CANNOT OR REFUSE TO
GET THE VACCINE. IT WILL OFFER
THEM PROTECTION BY DECREASING
THE POPULATION WHO CAN PASS IT
ON TO THEM. WE HAVE AMENDED THE
BILL SO THAT SCHOOL DISTRICTS
AND HIGHER EDUCATION
INSTITUTIONS ARE NOT REQUIRED TO
CONFIRM VACCINATION STATUS FOR
ENTRY, MEANING THAT IS NOT A
MANDATE AGAIN, NOT A MANDATE FOR
SCHOOL ATTENDANCE. MEMBERS. WE
HAVE LISTENED TO SCHOOL
OFFICIALS, PARENTS AND MENTAL
HEALTH PROFESSIONALS ABOUT THE
IMPACT OF THE PANDEMIC ON OUR
YOUTH. SO WE HAVE DECIDED NOT TO
BAR ENTRY TO SCHOOL FOR THESE
NEW VACCINE REQUIREMENT. I HAVE
BEEN QUESTIONED ON WHY I WOULD
MOVE FORWARD WITH A BILL THAT
DOESN'T INCLUDE ENFORCEMENT
REQUIREMENTS. AREN'T YOU
SACRIFICING THE ELEMENT THAT
WILL HAVE THE GREATEST EFFECT
I'VE BEEN ASKED I AM WILLING
COLLEAGUES TO TAKE THIS
INCREMENTAL STEP BECAUSE IT WILL
STILL SAVE LIVES. LIVES LIKE THE
COUSIN. I LOST TWO FROM THIS
PREVENTABLE DISEASE. IF WE CAN
SAY ONE MORE FAMILY FROM THAT
PAIN. ONE YOUNG WOMAN'S ABILITY
TO HAVE A FAMILY LIKE THE
BEAUTIFUL ONE. I HAVE ONE YOUNG
MAN FROM THE TARIFF, FINDING OUT
THAT HE MAY DIE OR LOSE THE
ABILITY TO SPEAK FROM CANCER OF
THE THROAT. THEN ALL OF THE WORK
WE'VE DONE ON THIS BILL FOR THE
PAST FIVE YEARS HAS BEEN WORTH
IT. OVER 203,000 AMERICANS HAVE
DEVELOPED CANCER AND MORE THAN
35,000. PEOPLE HAVE DIED SINCE I
BEGAN WORKING ON THIS IMPORTANT
ISSUE. WE CAN'T WAIT. HERE WITH
ME TODAY TO SPEAK AND SUPPORT IS
DR JEFFREY KLAUSNER, CLINICAL
PROFESSOR OF MEDICINE,
INFECTIOUS DISEASES, POPULATION
. PUBLIC HEALTH SCIENCE FROM USC
, KECK SCHOOL OF MEDICINE, AND
AARON PARIS, FOUNDER OF THE
YOUTH ORGANIZATION. TEENS FOR
VACCINATIONS VACCINES. PLEASE.
HAVE TO PUSH THAT BUTTON.
THERE'S A BUTTON UP THEIR PUSH
THE BUTTON THERE. THANKS THANK
YOU FOR THE OPPORTUNITY TO SPEAK
TO YOU TODAY. MY NAME IS DR
JEFFREY KLAUSNER, PROFESSOR OF
MEDICINE, INFECTIOUS DISEASES,
POPULATION AND PUBLIC HEALTH
SCIENCES AT THE KECK SCHOOL OF
MEDICINE IN THE UNIVERSITY OF
SOUTHERN CALIFORNIA. I'M ALSO A
FORMER CDC MEDICAL OFFICER AND
FORMER DEPUTY HEALTH OFFICER FOR
THE CITY AND COUNTY OF SAN
FRANCISCO. I HAVE A MEDICAL
DEGREE FROM CORNELL UNIVERSITY
AND A MASTER'S DEGREE IN PUBLIC
HEALTH FROM HARVARD UNIVERSITY.
I'M BOARD CERTIFIED IN INTERNAL
MEDICINE AND INFECTIOUS GHOZI'S
IS I'M CURRENTLY LICENSED IN
CALIFORNIA AND AN ACTIVE MEDICAL
PRACTICE. I AM HERE TODAY TO
TELL YOU WHY YOU MUST VOTE YES.
ON ASSEMBLY BILL 659, AND WHY
THE VOTE MUST BE UNANIMOUS.
TODAY IN CALIFORNIA. ONLY ABOUT
50% OF ADOLESCENTS HAVE
COMPLETED THE HPV. CANCER
VACCINE SERIES THAT LEAVES ABOUT
HALF OF ADOLESCENTS IN
COMPLETELY OR FULLY UNPROTECTED
AGAINST THOSE CANCER CAUSING
VIRUSES. THE STATE OF CALIFORNIA
CONSIDERS HPV A KNOWN
CARCINOGEN. OR CANCER CAUSING
AGENT BELOW POPULATION
VACCINATION COVERAGE. RESULTS IN
AN EXCESS NUMBER OF PREVENTABLE
CANCERS AND HPV RELATED CANCER
DEATHS. IT IS ESTIMATED THAT
EVERY SINGLE DAY TO CALIFORNIANS
DIE TO CALIFORNIANS DIE EVERY
SINGLE DAY FROM HPV RELATED
CANCER. THE HPV CANCER VACCINE
WAS APPROVED BY THE FDA IN 2006.
IN THE 17 YEARS SINCE ITS
APPROVAL, IT IS PROVEN TO BE
VERY SAFE AND HIGHLY EFFECTIVE.
SAFETY CONCERNS HAVE NEVER BEEN
VALIDATED IN WELL DONE
SCIENTIFIC STUDIES. SYSTEMATIC
REVIEWS AND META ANALYSIS HAVE
FOUND NO ASSOCIATION BETWEEN HPV
CANCER VACCINATION AND AUTO
IMMUNE DISEASE, JAMBOREE
SYNDROME OR OTHER SUPPOSED
INJURIES. THE FIRST STUDY IS
LEADING TO THE APPROVAL OF THE
VACCINE SHOWED IN RANDOMIZED
CONTROLLED TRIALS. THE HIGHEST
LEVEL OF SCIENTIFIC EVIDENCE
THAT THE VACCINE PRESENTED
PERSISTENT INFECTION. FURTHER
STUDIES HAVE SHOWN THAT HPV
CANCER VACCINATION CLEARLY
PREVENTED CANCER AND 88%
REDUCTION AT THE POPULATION
LEVEL IN SWEDEN IN COUNTRIES
LIKE AUSTRALIA, WHERE HPV CANCER
VACCINATION IS ROUTINE. CERVICAL
CANCERS MAY BE ELIMINATED BY
2035. HPV CANCER VACCINE
PREVENTS MULTIPLE VACCINES,
CANCERS, PARTICULARLY ORAL
CAVITY AND THROAT CANCERS, WHICH
ARE RAPIDLY REVISED, UH, RISING
IN IN MALES. CRITICS HAVE
EXPRESSED CONCERN THAT VACCINE
REQUIREMENTS ARE NOT APPLICABLE
TO INFECTIONS NOT SPREAD IN THE
SCHOOL SETTING. IN FACT, MANY OF
THE CURRENT RECOMMENDED AND
REQUIRED VACCINES ARE ACQUIRED
OUTSIDE OF SCHOOL OR THE
COMMUNITY. TETANUS POLIO,
HEPATITIS B. ANOTHER CAUSE OF
CANCER ARE NOT TYPICALLY SPREAD
IN SCHOOL, BUT SCHOOL ANSWER
REQUIREMENTS HAVE RESULTED IN
THE NEAR ELIMINATION OF THOSE
DISEASES AMONG PEOPLE BORN IN
CALIFORNIA. LASTLY I HAVE
PERSONAL EXPERIENCE TAKING CARE
OF PATIENTS WITH HPV RELATED
CANCERS, SOME OF WHOM HAVE DIED.
ONE PATIENT WAS DOING VERY WELL
LIVING WITH HIV, ONLY TO SUCCUMB
TO HPV RELATED CANCER. ANOTHER
SUFFERED THROUGH STAGE FOUR
THROAT CANCER HIGHLY PREVENTABLE
WITH VACCINATION. I URGE ALL OF
YOU TO MAKE THE RATIONAL
DECISION HELP PROTECT
CALIFORNIANS FROM CANCER, REDUCE
HEALTH DISPARITIES AND HAVE THE
COURAGE TO DO THE RIGHT THING.
OH YES, ON A B 659 THANK YOU
VERY MUCH. AND MY APOLOGIES. WE
BOTH ALLOWING A LITTLE EXTRA
TIME FOR EVERYONE ON THIS ON
THIS ISSUE, SO IF I DIDN'T MEAN
TO CUT YOU OFF, DOCTOR SO MY
APOLOGIES. ERROR ERROR UP HERE
SO UM AND PLEASED TO YOUR NEXT
WITNESS. SO RIGHT? SO GOOD
MORNING, HONORABLE MEMBERS OF
THE ASSEMBLY HEALTH COMMITTEE.
MY NAME IS OR IN PARSA. I AM
1/10 GRADER FROM SAN JOSE. AND
I'M THE FOUNDER OF TEAMSTER
VACCINES, A YOUTH ORGANIZATION
WITH AMBASSADORS ACROSS MANY
SEATS IN THE U. S PROMOTING THE
LIFE SAVING POWER OF VACCINE SO
ALL TEAMS CAN LEAD HEALTHY LIVES
WITHOUT WORRYING ABOUT PRINCIPLE
DISEASES. I'M HERE TODAY TO
VOICE MY STRONG SUPPORT FOR
ASSEMBLY BILL 6 59, SO STUDENTS
LIKE ME CAN LIVE WITHOUT THE
FEAR OF HPV CANCER CAUSING
VIRUS. HPV IS A PREVENTABLE
CANCER. BUT ALL RIGHT HERE IN
CALIFORNIA AMONG TEENS,
ESPECIALLY IN RURAL AND LOW
INCOME COMMUNITIES ARE REALLY
LOW. LESS THAN 30% WHICH IS
NOWHERE NEAR THE 80% OF GOLD
THAT WE ASPIRE FOR. I GOT MY TWO
DOSES OF THE HPV VACCINE WHEN I
WAS IN MIDDLE SCHOOL BECAUSE I
WAS FORTUNATE ENOUGH TO HAVE
ROUTINE WELLCARE DOCTOR VISITS
TO KEEP ALL OF MY IMMUNIZATIONS
UP TO DATE. BUT NOT ALL TEAMS
ARE AS FORTUNATE AS I WAS. SOME
FAMILIES ARE UNAWARE THAT THE
HPV VACCINE IS MOST EFFECTIVE
WHEN ADMINISTERED TO YOUNG
PEOPLE. 9 TO 12 YEARS OF AGE,
OTHER FAMILIES SIMPLY CAN'T
AFFORD TO GET THE VACCINE WITH
ASSEMBLY BILL 6 59 REQUIRING ALL
PUBLIC AND PRIVATE HEALTH
INSURANCE PROGRAMS TO COVER THE
COST OF VACCINATING FOR HPV. WE
HAVE A REAL OPPORTUNITY HERE TO
CLOSE STANDING LONGSTANDING
INEQUITIES THAT AFFECTS SO MANY
TEENS. I FOUND A TEAMSTER
VACCINES WHEN I WAS IN SEVENTH
GRADE DURING THE 2019 MEASLES
OUTBREAKS. TO ME, IT WAS
SHOCKING AND ALSO GUT WRENCHING
THAT CHILDREN AND TEENS IN
MODERN TIMES STILL FACE THREATS
FROM FROM THE SAME DISEASE IS
LEADING US, 50 AND 100 YEARS
AGO. SINCE THEN, I HAVE BEEN
TIRELESSLY ADVOCATING FOR EVERY
CHILD'S RIGHT TO LIFE SAVING
VACCINES AND HEALTH CARE. BUT
THE COVID 19 PANDEMIC HAVING
RAVAGED OUR COMMUNITIES FOR TWO
YEARS, ROUTINE VACCINATION RATES
HAVE FALLEN TO DANGEROUS LEVELS
. WE KNOW THAT HPV IS A IS THE
MOST COMMON SEXUALLY TRANSMITTED
INFECTION, INFECTING ABOUT THE
ROUTINE MILLION PEOPLE,
INCLUDING TEAMS EACH YEAR. THERE
IS UNDENIABLE EVIDENCE I LOVED
UNTREATED. THE HPV INFECTION
LEADS TO CANCER. KNOWING THAT
THERE WAS A SAFE AND EFFECTIVE
LIFESAVING HPV VACCINE
AVAILABLE. ONE THAT HAS SAVED
MILLIONS OF LIVES SINCE 2006. WE
MUST PROTECT EVERY TEAM HERE IN
CALIFORNIA. IT IS TIME WE TAKE
ACTION AND IT IS TIME WE MAKE
REPRODUCTIVE HEALTH EQUITY AND A
B 6 59 A PRIORITY. WE HAVE
TREMENDOUS LEADERSHIP HERE IN
CALIFORNIA, AND WE HAVE SHOWN IN
THE PAST WE CAN FORGE A PATH AND
SET AN EXAMPLE. IT'S TIME TO
PASS A B 6 59, THE CANCER
PREVENTION ACT, SO WE TEAMS CAN
LIVE HAPPY AND HEALTHY LIVES
WITHOUT WORRYING ABOUT HPV.
THANK YOU SO MUCH. THANK YOU
VERY MUCH OTHERS IN SUPPORT,
PLEASE. AS I AS I SAID EARLIER
TODAY, JUST YOUR NAME
ORGANIZATION. NO POSTERS, NO
EXHIBITS. JUST JUST NAME AND
ORGANIZATION, PLEASE. I SHANNON
OLIVIERI, HOVIS WITH NARAL PRO
CHOICE CALIFORNIA AND SUPPORT.
THANK YOU. MR CHAIRMAN MEMBERS
RAND MARTIN HERE ON BEHALF OF
THE AIDS HEALTHCARE FOUNDATION,
WHICH IS ALSO A MAJOR PROVIDER
OF STD PREVENTION AND CARE
SERVICES, IN VERY STRONG SUPPORT
OF THIS BILL. BUT YOU KNOW
PEZZELLA ON BEHALF OF ACCESS TO
REPRODUCTIVE JUSTICE AND STRONG
SUPPORT. THANK YOU. GOOD
AFTERNOON, MOLLY ROBSON WITH
PLANNED PARENTHOOD, AFFILIATES
OF CALIFORNIA AND STRONG
SUPPORT. THANK YOU. ALEXIS
RODRIGUEZ WITH THE CALIFORNIA
MEDICAL ASSOCIATION IN SUPPORT.
TAYLOR JACKSON WITH CALIFORNIA
HEALTH PLUS ADVERSITY KITS
REPRESENTING CALIFORNIA'S
COMMUNITY HEALTH CENTERS IN
STRONG SUPPORT. BRIAN SPENCER,
AND PERHAPS THE AMERICAN COLLEGE
OF O. B. G Y N IS DISTRICT NINE
AND SUPPORT. THANK YOU. ANYONE
ELSE? NO ONE IS THEIR OPPOSITION
TO THE BILL. WE HAVE TWO MAIN
WITNESSES.
SORRY. WE HAVE THREE WITNESSES
HERE, MAN.
MY APOLOGIES. I DIDN'T DIDN'T
READ ALL OF MY NOTES WHEN WE
STARTED HERE EARLIER, SO WE DO
HAVE WE ARE ALLOWING, UM, A
THIRD WITNESS AND OPPOSITION
HERE TO SPEAK, SO THERE'S A
TOTAL OF NINE MINUTES
ALTOGETHER. PLEASE. WHENEVER
YOU'RE READY. MY NAME IS JOSHUA
COLEMAN AND I AM CO FOUNDER OF
VISAS FOR VACCINE, THE WORLD'S
LARGEST VACCINE RISK PUBLIC
EDUCATION ORGANIZATION. ALL
VACCINES ARE DIFFERENT. SO WHEN
DISCUSSING A PARTICULAR VACCINE
, IT'S IMPORTANT TO DO A COST
VERSUS BENEFIT ANALYSIS. THIS
BILL, A B 659 WOULD BE PROMOTING
UPTAKE OF THE HPV VACCINE.
THERE'S ONLY ONE HPV VACCINE
AVAILABLE. AND THAT IS GARDASIL
. NINE SO I'M GOING TO TALK
SPECIFICALLY ABOUT THIS VACCINE.
I HAVE HERE THE VACCINE INSERT
REGARDLESS TILL NINE. THE SAFETY
STUDIES BY MERCK PHARMACEUTICALS
COMPANY THAT MAKES THE VACCINE
SHOWED THAT 2.3% OF PEOPLE WHO
RECEIVED THIS VACCINE
EXPERIENCED SERIOUS ADVERSE
EVENTS. THE FDA THAT HAS ALL THE
VACCINE INSERTS AVAILABLE ON
THEIR SITE. DEFINES A SERIOUS
ADVERSE EVENT AS HOSPITAL
HOSPITALIZATION, INITIAL OR
PROLONGED. DISABILITY OR
PERMANENT DAMAGE, LIFE
THREATENING CONDITION AND DEATH.
SO THAT'S THE COST. NOW. WHAT'S
THE BENEFIT? IN THE UNITED
STATES FOR THE PAST 20 YEARS,
CASES OF CERVICAL CANCER HAVE
NOT EXCEEDED MORE THAN EIGHT PER
100,000 PEOPLE. SO DOING THE
ANALYSIS. IF 100,000 PEOPLE ARE
VACCINATED WITH THE HPV VACCINE
AT BEST, EIGHT CASES OF CERVICAL
CANCER MIGHT BE PREVENTED. BUT
AT THE SAME TIME 2300 PEOPLE
2.3% WILL EXPERIENCE SERIOUS
ADVERSE EVENTS. DO YOU THINK THE
BENEFIT OUTWEIGHS THE COST? ALSO
KEEP IN MIND. CERVICAL CANCER IS
NOT A DEATH SENTENCE OUT OF THAT
SAME 100,000. THE RATE OF DEATH
BY CERVICAL CANCER IS TOO IF YOU
STILL WANT TO PROCEED WITH THIS
. OUR BIG CONCERN IS THAT THE
NOTIFICATION THAT WILL BE SENT
TO STUDENTS AND PARENTS STATING
THAT ITS PUBLIC POLICY AND IT'S
EXPECTED WILL LEAD MANY TO THINK
IT'S LEGALLY REQUIRED TO GET
THIS VACCINE IN ORDER TO ATTEND
SCHOOL, ESPECIALLY FOR NON
ENGLISH SPEAKING STUDENTS. IF
THE AUTHORS OF THE BILL ARE NOT
SEEKING TO DECEIVE PEOPLE INTO
THINKING THIS, WE WOULD ASK FOR
AN AMENDMENT THAT THE
NOTIFICATION INCLUDE THE
FOLLOWING STATEMENT QUOTE WHILE
THE HPV VACCINE IS EXPECTED, IT
IS NOT LEGALLY REQUIRED SCHOOL
ENTRY AND ATTENDANCE WILL NOT BE
DENIED BASED UPON HPV
VACCINATION STATUS, END QUOTE.
ADDITIONALLY GARDASIL NINE IS
DIFFERENT FROM MANY VACCINES
WHERE BOTH THE MANUFACTURER AND
FDA ADVISE AGAINST ANYONE
PREGNANT OR ACTIVELY TRYING TO
GET PREGNANT TO TAKE THIS
VACCINE, SO WE ALSO REQUEST AN
AMENDMENT THAT IT IS STATED IN
THE NOTIFICATION QUOTE. IT IS
ADVISED BY THE FDA AND MERCK
PHARMACEUTICALS THAT THOSE WHO
ARE PREGNANT OR TRYING TO GET
PREGNANT. DO NOT TAKE THE HPV
VACCINE AND QUOTE AN INDIVIDUAL
MAKING THEIR OWN CHOICES ON WHAT
TO DO WITH THEIR OWN BODIES IS
EXTREMELY IMPORTANT AND COERCION
BY DECEPTION IS OUTRIGHT
UNETHICAL. PLEASE MAKE IT
CRYSTAL CLEAR TO CALIFORNIANS
THAT THIS IS NOT A REQUIRED
MANDATE FOR SCHOOL ATTENDANCE.
THANK YOU. THANK YOU NEXT
WITNESS. GOOD AFTERNOON MEMBERS
OF THE HEALTH COMMITTEE. MY NAME
IS KARINA POWERS FOUNDER LATINOS
FROM MEDICAL FREEDOM AND MEMBER
ORGANIZATION WITH CONVENTION ON
HEALTH RIGHTS WITH THE
CONSORTIUM OF ORGANIZATIONS
ADVOCATING FOR HEALTH RIGHTS.
LATINOS FROM MEDICAL FREEDOM
REPRESENTS THOUSANDS OF
INDIVIDUALS, MANY NON ENGLISH
SPEAKERS AND THOSE WITH LIMITED
ENGLISH PROFICIENCY THROUGHOUT
THE STATE OF CALIFORNIA. WHILE A
B 659 THE CANCER PREVENT CANCER
PREVENTION ACT AS WELL INTENDED
BY PROVIDING EXPANDED COVERAGE
FOR HPV VACCINES AND CERVICAL
CANCER SCREENING. IT IS
UNFORTUNATELY MISLEADING COURSE
OF LACKS CLARITY, AND IT'S
CONFUSING AND AUTHORITATIVE TO
COUNTLESS CHILDREN AND THEIR
FAMILIES, NOTABLY FOR NON
ENGLISH SPEAKERS AND THOSE WITH
LIMITED ENGLISH PROFICIENCY IN
CALIFORNIA. DESPITE THE
AMENDMENTS, WITH THE WORDS STATE
PUBLIC POLICY AND EXPECTED AS
STATED IN THE BILL LANGUAGE ARE
PROBLEMATIC. AND EXPECTATION IS
AN ORDER. MANY OF OUR FAMILIES
AS WELL AS STUDENTS WILL
INTERPRET THIS AS A MANDATE. A B
659 COURSES ARE MOST UNDERSERVED
AND VULNERABLE FAMILIES TO GO
AGAINST THEIR PERSONAL MEDICAL
DECISIONS IN ORDER TO COMPLY
WITH PERCEIVED REQUIREMENTS.
ADDITIONALLY THERE IS NO
REQUIREMENT OUTLINED IN THIS
BILL TO PROVIDE A WRITTEN
NOTIFICATION IN LANGUAGES OTHER
THAN ENGLISH, WHICH THE NICEST
FAMILIES PROPER INFORMED
CONSENT. AS TRUST AND MEDICAL
PUBLIC HEALTH IS DECLINING.
THESE COMMUNITIES THERE'S WILL
FURTHER DIMINISH THE TRUST IN
THE PUBLIC HEALTH. AS WE HAVE
WITNESSED IN THE PAST SEVERAL
YEARS, MANY OF OUR CHILDREN HAVE
FACED MUCH DISCRIMINATION,
SOCIAL, EMOTIONAL AND MENTAL
HEALTH STRUGGLES DUE TO AN IN
PERSON SCHOOL CLOSURES AS WELL.
EXAMPLES OF COERCION AND VARIOUS
SCHOOL DISTRICTS TO COMPLY WITH
PUBLIC POLICIES IN RELATION TO
THE COVID VACCINE. WE HAVE SEEN
EXAMPLES OF COERCION AND
INCENTIVIZE AND THE WAY OF FOOD
SUCH AS PIZZA PARTIES AND
ELECTRONIC DEVICES IN EXCHANGE
FOR RECEIVING THE COVID VACCINE
. IT IS POSSIBLE THAT THE STATE
POLICY COULD BE UTILIZED IN THE
SAME WAY. THE EXPECTATION IN THE
STATE POLICY LANGUAGE CURRENTLY
IN THE BILL OFFERS NO GUARDRAILS
FOR STUDENTS ON EP NOR FAMILIES
WITH NON ENGLISH SPEAKERS AND
THOSE WITH LIMITED ENGLISH
PROFICIENCY. I ASKED YOU TO
CONSIDER THESE FAMILIES AND
ENCOURAGE YOU TO OPPOSE THESE
BILLS. THIS BILL UNLESS AMENDED
TO ADD LANGUAGE TO CLARIFY THAT
THE HPV VACCINE AS RECOMMENDED,
BUT NOT REQUIRED, THANK YOU.
THANK YOU. MY NAME IS KATHERINE
SUAZO. ROBY I'M A LIFELONG
CALIFORNIAN AND I LIVE IN
PASADENA, CALIFORNIA. I'M HERE
REPRESENTING MY FAMILY. I OPPOSE
A B 6 59. MY DAUGHTER, JENNIFER
SUFFERED A SEVERE ADVERSE
REACTION TO THE CERVICAL CANCER
VACCINE GARDASIL AS A TEENAGER.
THE HPV VACCINE CAUSED
DEBILITATING AND DEVASTATING
INJURIES. MY DAUGHTER WAS A HIGH
SCHOOL ATHLETE AND HONOR STUDENT
AND HAD TO DROP OUT OF SCHOOL.
AND HAS BEEN DISABLED. FOR OVER
A DECADE. JENNIFER HAS BEEN BED
BOUND AND WHEELCHAIR BOUND FOR
EXTENDED PERIODS OF TIME. THE
GARDASIL VACCINE HAS DESTROYED
MY DAUGHTER'S LIFE AND
DEVASTATED OUR FAMILY. THE
CERVICAL CANCER VACCINE,
GARDASIL HAS BEEN GROSSLY MIS
MARKETED BY ITS PHARMACEUTICAL
MANUFACTURER MERCK. MERCK HAS
OVERSOLD THE ADVOCACY OF THE
VACCINE AND CONCEALED SAFETY
RISKS. THE GARDASIL VACCINE, IN
ADDITION TO BEING DANGEROUS, IS
ALSO MISLEADING. THE BEST WAY TO
PREVENT CERVICAL CANCER IS THE
PAP SMEAR CERVICAL CANCER
MORTALITY RATES IN THE UNITED
STATES HAS BEEN AT A STEADY
DECLINE FOR DECADES DUE TO THE
WIDESPREAD USE OF PAP SCREENINGS
, MERCK'S OWN LITERATURE STATES
THAT THE CERVICAL CANCER VACCINE
DOES NOT REMOVE THE NEED FOR
CERVICAL CANCER SCREENING. DOES
NOT TREAT HPV INFECTION DOES NOT
PROTECT AGAINST PREEXISTING
PREEXISTING HPV INFECTIONS DOES
NOT PROTECT AGAINST HPV STRAINS
NOT COVERED BY THE VACCINE AND
MAY NOT FULLY PROTECT EACH
PERSON WHO GETS THE VACCINE. IT
IS AN EXPENSIVE AND OPTIONAL ADD
ON TREATMENT. IT IS IMPORTANT
THAT THE PUBLIC IS AWARE THAT
THE BEST WAY TO PREVENT CERVICAL
CANCER IS THE PAP SMEAR. A B 6
59 AS IT CURRENTLY STANDS, USES
LANGUAGE THAT IS DECEPTIVE AND
INTENTIONALLY MISLEADING AND
WOULD LEAD THE AVERAGE
CALIFORNIAN TO BELIEVE THAT THE
STATE IS MANDATING CERVICAL
CANCER VACCINATION FOR EIGHT
GRADE THROUGH COLLEGE STUDENTS,
THE WORDS EXPECTED AND PUBLIC
POLICY OF THE STATE ARE COERCIVE
, AND THE BILL NEEDS TO MAKE
CLEAR THAT THE VACCINE IS ONLY A
RECOMMENDATION AND NOT A MANDATE
. IT NEEDS TO BE EXPRESSLY
STATED THAT STUDENTS WILL NOT BE
DENIED ACCESS TO EDUCATION IF
THEY CHOOSE NOT TO GET THE
CERVICAL CANCER VACCINE. I WOULD
HATE FOR ANOTHER FAMILY TO HAVE
TO LIVE THROUGH THE NIGHTMARE MY
FAMILY HAS HAD TO ENDURE OR HAVE
THEIR CHILDREN DENIED THE RIGHT
TO AN EDUCATION BECAUSE THEY
LACK MEDICAL LITERACY. I BELIEVE
IT IS INAPPROPRIATE FOR THE
STATE TO BE RECOMMENDING THE
VACCINE WITH SERIOUS SIDE
EFFECTS FOR SCHOOL AGE STUDENTS
BECAUSE THE HPV VACCINE IS
DESIGNED TO TREAT A SEXUALLY
TRANSMITTED VIRUS, STUDENTS ARE
NOT AT RISK OF DEVELOPING HPV IN
THE CLASSROOM. SETTING HPV ONCE
TRANSMITTED DOES NOT TURN INTO
CERVICAL CANCER OVERNIGHT. IF
THE DISEASE IF THE DISEASE
PROGRESSES. PROGRESSES IT TAKES
YEARS TO DEVELOP. AND THE AGE
GROUP IN TARGETED BY THIS BILL
IS NOT AT RISK FOR CERVICAL
CANCER. I WOULD LIKE TO KNOW
THAT THERE ARE CURRENTLY
HUNDREDS OF LAWSUITS IN THE
UNITED STATES, INCLUDING IN
CALIFORNIA, AGAINST MARK FOR
SERIOUS INJURIES CAUSED BY
GARDASIL. I STRONGLY URGE YOU TO
VOTE NO ON A B 6 59. THE VACCINE
IS DANGEROUS. IT HAS BEEN
INTENTIONALLY MIS MARKETED AND
IT IS GUARANTEED TO INJURE.
INNOCENT CALIFORNIANS. THANK
YOU. THANK YOU. OTHERS IN
OPPOSITION, JUST YOUR NAME
ORGANIZATION IF YOU REPRESENT
ONE AND POSITION ON THE BILL.
NATHAN PEARCE, PRIVATE HOME
EDUCATORS OF CALIFORNIA. OUR
POSITION IS CURRENTLY OPPOSED
UNLESS AMENDED. YOU OLIVIA
MICHAEL'S CO FOUNDER OF VENUS
FOR VACCINE IMPOSED UNLESS
FURTHER AMENDED. DAVID BALL
RESIDENT OF COUNTER SACRAMENTO
COUNTY, AND I OPPOSE YOU. ROBI
FROM PASADENA, CALIFORNIA. I
STRONGLY OPPOSE. WENDY BEALE ON
BEHALF OF MOMS FOR LIBERTY,
PLASTER COUNTY AND OVER 2000
MEMBERS. WE STRONGLY OPPOSED
THIS BILL. NICOLE YOUNG, PLASTER
COUNTY STRONG OPPOSITION. DALAI
LAMA EPPERSON, FOUNDER OF ACT,
MONTEREY PAY ACT, MONTEREY BAY,
AND WE STRONGLY OPPOSE THIS
BILL. AMANDA QUINTERO OF SAN
JOAQUIN COUNTY STRONGLY OPPOSE
UNLESS FURTHER AMENDED. ABOUT
TODAY'S PROGRAM. MONTEREY COUNTY
STRONGLY ABOUT. WILLIAMS ON
BEHALF OF CALIFORNIA PARENTS
UNION REPRESENTED REPRESENTING
THOUSANDS OF MEMBERS ACROSS
CALIFORNIA, ASKING FOR A NO OR
ABSTAIN ON A B 659. THANK YOU.
DAVID VICTOR, BULLDOG, LOS
ANGELES AND OPPOSITION UNLESS
AMENDED IT THANK YOU. THAT'S
FELT SACRAMENTO COUNTY OPPOSED.
I'VE LEARNED FROM ALAMEDA COUNTY
AND I OPPOSE THANK YOU. ROSALYNN
FROM ALAMEDA COUNTY, AND I
OPPOSE THIS BILL YOU MINUTES
FROM HAYWARD AND I OPPOSE ENLIST
. THE LANGUAGE IS AMENDED TO BE
, UM, NOT REQUIRED. THANK YOU.
STEPHANIE GONZALEZ. SACRAMENTO
COUNTY OPPOSED. THANK YOU.
STEPHANIE DEGREE REPRESENTING
CALIFORNIA NURSES UNITED AND WE
OPPOSED THE BILL UNLESS FURTHER
AMENDED. ELIZABETH SCALPEL
SAMMARTINO COUNTY PATRIOTS FROM
BARSTOW AND OPPOSE THIS BILL.
THANK YOU. SARAH MARTINEZ FROM
CONCORD, AND I OPPOSE THIS BILL
UNLESS AMENDED WITH LANGUAGE YOU
KAREEN WHITLOW, CO FOUNDER OF
TAKE A STAND STANISLAS AND WE
OPPOSED UNLESS AMENDED. YOU
RACHEL CATAN WITH STAND UP
SACRAMENTO COUNTY AND THOMAS USD
FOR FREEDOM OPPOSED UNLESS
AMENDED. ANYONE ELSE? YOU KNOW,
BRING IT BACK TO THE COMMITTEE
QUESTIONS OR COMMENTS FROM THE
COMMITTEE. MR PATTERSON. THANK
YOU. ASSEMBLYMEMBER'S FOR TAKING
THE FOR CHANGING YOUR BILL AND
AMENDING IT A FEW TIMES. I THINK
BASED ON UM YOU KNOW, OBVIOUSLY
FEEDBACK. I THINK YOU KNOW, I
DIDN'T HAVE THE PRIVILEGE OF
BEING A LEGISLATOR THE LAST
SEVERAL YEARS. UM BUT I KNOW
THERE WAS A LOT OF ACTIVITY
HERE. UM YOU KNOW, LARGELY OR
NOT LARGELY, BUT YOU KNOW, AT
LEAST IN PART BECAUSE OF VARIOUS
VACCINE MANDATES, AND I THINK
YOU KNOW, COMING INTO THIS YEAR
WITH THAT, UM YOU KNOW, SORT OF
ON PEOPLE'S MINDS WAS CONCERNING
TO ME WHEN I SAW THIS, AND, UM
YOU KNOW, I THINK, UH, YOU KNOW,
YOU PUT A LOT OF TIME AND
THOUGHT INTO IT. UM ONE THING
THAT I DO. AH YOU KNOW, I'M
STILL DEBATING. LOOK HONESTLY, I
DON'T KNOW A LOT ABOUT THE
VACCINE. I'M NOT A DOCTOR. I'M
NOT A SCIENTIST. I GUESS NOW I'M
A POLITICIAN. RIGHT? SO UM SO I
CAN JUST READ WHAT PEOPLE TELL
ME AND SOME CONCERNS OR ISSUES
THAT ARE RAISED. AND UM, YOU
KNOW, SO I ALL MY KIDS ARE
VACCINATED FOR EVERYTHING. AND I
HAVEN'T REALLY CONSIDERED THE
HPV VACCINE. I HAVE TWO
DAUGHTERS AND TWO SONS AND, UH,
UM, YOU KNOW, IT HASN'T BEEN
SOMETHING THAT I'VE THOUGHT
ABOUT, BUT WHEN I WAS ACTUALLY
USED TO BE A LEGISLATIVE STAFFER
FORGOT MY FIRST INTERNSHIP OVER
A DECADE 20 YEARS AGO NOW
BELIEVE OR NOT, I KNOW I'M YOUNG
AND HANDSOME, BUT IT WAS 20
YEARS AGO, AND I REMEMBER
SOMETIME AROUND 2010 OR SO, UM,
WE STARTED DISCUSSING AT THAT
TIME. SOME LEGISLATION AROUND
THE HPV VACCINE, AND I DON'T
REALLY REMEMBER WHAT IT WAS
EXACTLY AT THAT POINT. I THINK
IT WAS A MANDATE, ACTUALLY, BUT
I DON'T I DON'T ACTUALLY KNOW
THAT. UM AND SO FOR SOME REASON
, YOU KNOW THAT WAS PULLED BACK,
AND I DON'T REALLY REMEMBER ALL
THE DETAILS. BUT ONE THING THAT
DOES KIND OF CONCERN ME. I THINK
MAKING THE YOU KNOW,
RECOMMENDATION TO PARENTS AND I
THINK NOTIFYING PARENTS ACTUALLY
HAVE LEGISLATION ON UM THE
DANGERS OF FENTANYL THAT PARENTS
WOULD BE NOTIFIED OF THAT. AND I
LOOK AT HIS HEY. SIX MILLION
PARENTS WILL RECEIVE
NOTIFICATION OF THE DANGERS THAT
ARE OUT THERE AND I THINK YOU
KNOW, INFORMING PARENTS ABOUT
THE DANGERS OF CANCER. UM YOU
KNOW, COULD BE A GOOD GOOD GOAL.
AND I MEAN, ACTUALLY, SOMETHING
THAT I WOULD CONSIDER AND HIS
PEOPLE HAVE DIED FROM FENTANYL
POISONING AND PEOPLE DIE FROM
CANCER AND WE NEED TO DO
EVERYTHING WE CAN TO PREVENT
THAT. BUT ONE THING I DO GET
CONCERNED ABOUT IS A JUDGE
MAKING THE DETERMINATION THAT
THIS IS THE PUBLIC POLICY A
CALIFORNIA TO EXPECT THAT
CHILDREN ARE, UM, ARE VACCINATED
WITH THIS, AND I DON'T THINK I'M
QUITE THERE YET. YOU KNOW, THERE
ARE A LOT OF JUDGES IN
CALIFORNIA, UM, THAT BECAUSE YOU
KNOW, MAY MAKE SOME GOOD
DECISIONS, SOME BAD DECISIONS
SOME LIKE WE COULD ALL AGREE OR
DISAGREE ON. BUT I DO GET
CONCERNED ABOUT ONE. AND IF YOU
PUT SOME THOUGHT INTO THAT
PARTICULAR STATEMENT ABOUT A
JUDGE MAKING THAT RULING ONE DAY
. UM YOU KNOW, I'D APPRECIATE
OBVIOUSLY YOUR COMMENTS ON THAT
. BUT AGAIN, I JUST WANT TO SAY
I APPRECIATE YOU WORKING ON THIS
BILL AND PAIRING IT BACK A
LITTLE BIT. AND I KNOW IT'S
REALLY IMPORTANT TO YOU. SO
THANK YOU. THANK YOU VERY MUCH
FOR YOUR COMMENTS.
ASSEMBLYMEMBER'S PATTERSON I
APPRECIATE THE FACT THAT YOU
REALIZED THAT WE'VE WORKED
REALLY HARD ON THIS. I THINK
I'VE SPENT A LOT OF TIME AND I
KNOW I'VE SPENT A LOT OF TIME
WITH SOME OF THE PEOPLE THAT ARE
HERE IN THE AUDIENCE THAT
OPPOSED THE BILL TO MAKE SURE WE
GOT IT RIGHT THERE. WE'RE NOT
GONNA ALWAYS MAKE EVERYBODY
HAPPY. BUT I WORKED REALLY HARD
ON. THE QUESTION IS, DOES THE
BILL NOT MANDATE THE HPV
VACCINE? WHILE THE BILL BILL
SETS REQUIREMENTS FOR STUDENTS
AT THE HIGH SCHOOL AND COLLEGE
UNIVERSITY LEVEL INSTITUTIONS,
INCLUDING THIS IN THIS BILL ARE
NOT REQUIRED TO CONFIRM
VACCINATION FOR INTERIOR
ENROLLMENT, YOU KNOW, GIVE SOME
TIME FOR PEOPLE AS THEY HAVE
THEIR CHILDREN GO TO THE DOCTOR.
HAVE A CONVERSATION WITH THE
DOCTOR. THEY CAN BE NOTIFIED
THAT THIS HPV VACCINATION IS DUE
IF THEY WOULD LIKE TO TAKE IT,
AND THE FAMILY CAN HAVE SPENT
SOME TIME IN REALIZING IS THIS
RIGHT FOR MY CHILD. DO THEY HAVE
, UH, COMPROMISED IMMUNE SYSTEM
OR WHATEVER THE CASE MIGHT BE. I
THINK THE EDUCATION PIECE IS
REALLY IMPORTANT. LIKE I SAID, I
WISH I COULD GET EVERYBODY TO
GET THIS VACCINATION. I'VE SEEN
TOO MANY PEOPLE DIE FROM THIS.
AND IT'S HARD. IT'S REALLY,
REALLY HARD. IT'S SOMETHING WE
CAN PREVENT. AND WHY WOULD WE
WANT TO TRY TO PREVENT
SOMETHING? SO WITH THAT, I JUST
THINK THAT I APPRECIATE THE
OPPOSITION. I WILL CONTINUE TO
WORK WITH THEM. THEY KNOW THAT I
HAVE HAD REALLY GOOD
CONVERSATIONS WITH THEM. WE MAY
NOT COME TO A PLACE THAT WE ALL
AGREE ON. BUT I'VE BEEN A
LISTENER AND I HAVE NOT SAID
THEY COULDN'T SEE ME. I HAVE
TAKEN THEIR INFORMATION IS
IMPORTANT. WE'RE CONCERNED ABOUT
KIDS GETTING BACK TO SCHOOL. I
THOUGHT THAT WAS REALLY
IMPORTANT. AND BECAUSE OF COVID
YOU KNOW SOME KIDS WE DON'T NEED
TO ADD ANOTHER BARRIER FOR KIDS
NOT GETTING TO SCHOOL, RIGHT?
AND I THINK I REALLY PAID
ATTENTION AND THAT MADE A LOT OF
SENSE TO ME. SO WITH THAT. I'M
HOPING THAT ANSWERED YOUR
QUESTION. REMEMBER WOULD YOU
MIND IF I JUST DON'T WANT TO
TAKE YOUR LAP YOU'LL GET THE
LAST WORD, OF COURSE, IS THE
AUTHOR OF THE BILL, BUT JUST
SOMETHING TO CONSIDER. MOVING
DOWN THE LINE IS MAYBE SOME
INTENT LANGUAGE OR CLARIFICATION
JUST TO A FUTURE COURT THAT THIS
SHOULDN'T BE INTERPRETED TO BE A
MANDATE. OBVIOUSLY, WE'RE HAVING
THAT DISCUSSION NOW, RIGHT? BUT
YOU KNOW, NO JUDGE IS GOING TO
GO BACK AND WATCH THIS VIDEO. I
WON'T EVEN GO BACK AND WATCH THE
VIDEO, RIGHT? SO UM, JUST
SOMETHING TO CONSIDER DOWN THE
LINE. UM, YOU KNOW, I DO GET
CONCERNED. LIKE I SAID ABOUT A
JUDGE. UM BUT I DO APPRECIATE
YOU LISTENING TO THE OPPOSITION
ON THIS. AND ALTHOUGH I HAVE
CONCERNS NOW, I REALLY
APPRECIATE YOUR SINCERITY AND
WORKING ON THIS ISSUE. THANK
YOU. I APPRECIATE YOU BRINGING
UP THE JUDGE. I WON'T SAY
ANYTHING ELSE. MR GAY PROGRAMS.
YOU HAVE QUESTIONS, COMMENTS?
JUST MORE OF A COMET. UM, AND A
QUESTION. FIRST I DO WANT TO
THANK EVERYONE THAT SHOWED UP
TODAY AND THE AUTHOR. I MEAN,
UH, THIS IS ONE OF THOSE BILLS
THAT I CAN HONESTLY SAY THAT
IT'S AGED ME RIGHT BECAUSE
YOU'RE GOING BACK AND FORTH. YOU
KNOW, WORKING WITH FOLKS.
EVERYONE'S CALLING YOU? UM I
DON'T KNOW. I MEAN, LONG TALKS I
HAD WITH THE AUTHOR OVER THIS.
UM, AND SHE WAS A GREAT LISTENER
AND TRYING TO FIGURE OUT YOU
KNOW. HOW DO WE? HOW DO WE GET
THIS? YOU KNOW I WANT TO SAY
ACROSS BUT UM SHE WAS REALLY
WORKING HARD, YOU KNOW, TO
COMPASS WHERE SHE'S AT NOW. THE
ONLY COMMENT THAT I HAVE TO IS
THAT I THINK OF MY MOM, RIGHT?
WHO WOULD TURN TO US TOO. YOU
KNOW WHEN SHE COULDN'T
UNDERSTAND SOMETHING, YOU KNOW
IF IT'S IF IT'S A LETTER GOING
THROUGH SCHOOL UM. SHE WAS VERY
SMART, BUT SHE COULDN'T READ ALL
THE TIME. SO I HAD TO KIND OF
READ FOR HER, AND I JUST WANT TO
MAKE SURE THAT THE CONFUSION IF
THERE'S ANY CONFUSION,
ESPECIALLY WHEN IT COMES TO LIKE
THE SPANISH LANGUAGE THAT THEY
UNDERSTAND THAT THEY YOU'RE NOT
DOING SOMETHING THAT THEY DON'T
WANT TO. DO YOU KNOW HERE. WE
FIGHT FOR, UM AH! FOR MAKING
SURE THAT WE DECIDE THAT THAT
ALL OF US CAN DECIDE ON WHAT WE
WANNA DO. YOU KNOW, IT'S NOT
GOVERNMENT TRYING TO PUSH US TO
DECIDE. THAT A PERSON OF AND I
PICTURE AGAIN. MY MOM. SHE MAKES
THAT DECISION. UM AND SHE
EXPLAINS IT TO US AS AS AS AS A
PARENT RIGHT AT THE END. WE HAVE
TO MAKE THAT DECISION TO WITH
HER. I JUST WANT TO MAKE SURE
THAT WHEN IT COMES TO THE
LANGUAGE, ANYTHING THAT'S IN
BEING MAILED OUT THAT THAT
PERSON LIKE MY MOM WOULD
UNDERSTAND IT WOULDN'T BE ANY
CONFUSION. SO IT'S MORE OF A
COMMENT. THANK YOU, MR AND I
APPRECIATE YOUR COMMENT.
ASSEMBLY MEMBER. I THINK OF MY
OWN COMMUNITY, AND IT'S
PRIMARILY LATINOS. AND OUR
DOCTORS ARE WELL VERSED WITH THE
LATINO COMMUNITY, AND I FEEL
LIKE THAT THEY AS LONG AS MANY
OTHERS THEY WANT TO MAKE SURE
THAT THEY TAKE GOOD CARE OF
THEIR PATIENTS. AND SO THEY
DON'T HAVE A TRANSLATOR OR THEY
ACTUALLY SPEAK SPANISH. AND I'M
SURE THIS HAPPENS THROUGHOUT THE
STATE OF CALIFORNIA AS WELL. I
AGREE WITH YOU THAT WE WANT TO
MAKE SURE THAT PEOPLE
UNDERSTAND. WHAT THE VACCINATION
IS AND THE PROS AND CONS OF IT
AND I'LL TELL YOU THERE'S MORE
PRAWNS. YOU CAN'T CONVINCE ME.
THERE'S MORE CONS ON THIS, UM
I'D LOVE TO SHARE OTHER STORIES.
FAMILY STORIES ABOUT THIS. I
CAN'T BECAUSE I'LL CRY. UM I'M
VERY FORTUNATE THAT I SIT IN THE
SEAT AND THEN I CAN HELP CHANGE
SOMEONE'S LIVES. THAT'S ALL I
CAN SAY. YEAH ANY OTHER
COMMENTS? HMM? I'D LIKE TO THANK
YOU, UH, NUMBER ONE FOR YOUR
PERSISTENCE AND NUMBER ONE
NUMBER TWO FOR YOUR MISSION. UM,
TO DO THIS, UM YOU KNOW, I'VE
BEEN A BELIEVER IN WHAT YOU'RE
DOING FROM THE BEGINNING. UM AND
SUPPORTIVE FROM THE BEGINNING
AND UM, YOU KNOW, THIS IS A THIS
IS A HORRIBLE VIRUS. MANY IN THE
AUDIENCE PROBABLY DON'T REALIZE
THAT MORE THAN 50% OF THE CANCER
FROM HUMAN PAPILLOMA VIRUS IS
THROAT CANCER. ARE THE WORST
THROAT SORE THROAT YOU COULD
EVER IMAGINE. AND ONE THAT WILL
KILL YOU. UM. I RECOGNIZE YOU'VE
COME A LONG WAY. THIS ISN'T
EXACTLY WHAT YOU'RE LOOKING FOR.
UM NONE OF US WANT TO KEEP KIDS
OUT OF SCHOOL. UM RECOGNIZE THE
CHALLENGES WE FACE IN, CERTAINLY
WITH WHAT WE SAW DURING COVID.
UM I SUPPORT YOUR BILL. UM AND I
APPRECIATE THAT YOU YOUR
STATEMENT OF CONTINUING TO WORK
WITH OPPOSITION AND THROUGHOUT
THE PROCESS. THIS IS THE FIRST
COMMITTEE UM AND, UM, YOU'VE
SPENT A LONG TIME WE'VE BEEN
TALKING ABOUT THIS FOR A VERY
LONG TIME. MY STAFF HAS WORKED
WITH YOU FOR A LONG TIME, AND
WE'RE HAPPY. WE'RE HAPPY TO DO
IT. SO, UM THANK YOU ONCE AGAIN
FOR BRINGING IT FORWARD. THE
BILL DOES ENJOY DO PASS
RECOMMENDATION WHEN WE HAVE A
QUORUM. AND LIKE TO GIVE YOU AN
OPPORTUNITY TO CLOSE IF YOU'D
LIKE. ICE I THINK TO MAKE IT
EASY ON MYSELF WITHOUT TEARS.
SIMPLY ASK FOR YOUR VOTE. THANK
YOU VERY MUCH. AND THANK
EVERYBODY. WITNESSES ON BOTH
SIDES WHO CAME TODAY. APPRECIATE
IT. THANK YOU.
MR RODRIGUEZ.
OKAY, MR RODRIGUEZ. THANK YOU,
MR CHAIRMAN MEMBERS. THANK YOU
FOR GIVING ME THE OPPORTUNITY TO
PRESENT A B 40, WHICH TAKES
SEVERAL STEPS. TO PREVENT
AMBULANCE PATIENT OFFLOAD DELAYS
TO ENSURE AMBULANCES ARE
AVAILABLE TO RESPOND, AND 911
CALLS FOR EMERGENCY MEDICAL
SERVICES. I WOULD LIKE TO START
BY ACCEPTING THE COMMITTEE
AMENDMENTS TO REQUIRE ALL
THEMSELVES TO ESTABLISH AN A POT
STANDARD OF NO MORE THAN 30
MINUTES. MAYBE 40 WOULD ALSO
REQUIRE HOSPITALS TO DEVELOP AN
A POD REDUCTION PROTOCOL AND
FILED THE PROTOCOLS WITH MSA. AS
SOMEONE WHO SPENT OVER 30 YEARS
WORKING AS A FIRST RESPONDER IN
THE EMERGENCY MEDICAL SERVICES
SYSTEM. I'M ALL TOO FAMILIAR
WITH WALL TIMES. EXCESSIVE WAR
TIMES HAS BEEN A PROBLEM FOR
DECADES. IN FACT, I'VE PERCY
WAITED OVER 12 HOURS AT
EMERGENCY DEPARTMENT TO TRANSFER
PATIENT TO HOSPITAL STAFF.
ACCORDING TO A 2020 M SER REPORT
EACH YEAR, ROUGHLY 70,000
CALIFORNIANS WAIT OVER AN HOUR
ON AN AMBULANCE GURNEY ONCE THEY
ARRIVE AT A HOSPITAL. NOT ONLY
DO WARTIME RESULT IN UNTIMELY
CARE FOR PATIENTS EXPERIENCING
EMERGENCY, BUT IT PREVENTS M. T
S AND PARAMEDICS RESPONDING TO
OTHER EMERGENCIES. IN NOVEMBER.
2021 EMC CONVENED A WARTIME TASK
FORCE IN JUNE 2022 THE M SO
WARTIME TASK FORCE VOTED ON 19
RECOMMENDATIONS TO MITIGATE
AMBULANCE PATIENT ALTHOUGH
UPLOAD DELAYS THIS BILL CODIFIES
SOME OF THE MOST IMPORTANT
RECOMMENDATIONS. WITH THAT. LET
ME TURN IT OVER TO MY WITNESSES
AND SUPPORT BRIAN RICE,
PRESIDENT OF THE CALIFORNIA
PROFESSIONAL FIREFIGHTERS, AND
SEAN BURROUGHS, PRESIDENT OF THE
ALAMEDA COUNTY FIREFIGHTERS,
LOCAL 55. THANK YOU. GOOD
AFTERNOON. MEMBERS OF THE
COMMITTEE. MY NAME IS BRIAN RICE
, THE PRESIDENT OF THE
CALIFORNIA PROFESSIONAL
FIREFIGHTERS AND I HAVE THE
HONOR OF REPRESENTING NEARLY
35,000 PROFESSIONAL FIREFIGHTERS
, E. M. T S AND PARAMEDICS
STATEWIDE ALSO SERVED NEARLY 30
YEARS AS A FIREFIGHTER WITH THE
SACRAMENTO METROPOLITAN FIRE
DEPARTMENT. CPF IS A PROUD
SPONSOR OF HB 40. AND I WOULD
LIKE TO THANK ASSEMBLYMEMBER'S
RODRIGUEZ FOR HIS LEADERSHIP ON
THIS ISSUE, AND I WOULD ALSO
LIKE TO THANK YOU, DOCTOR WOULD
AND YOUR COMMITTEE AND STAFF FOR
WORKING WITH US ON THIS MEASURE.
THANK YOU. DANGEROUSLY LONG WALL
TIMES HAVE BEEN GATHERING CRISIS
IN THE STATE'S EMERGENCY
RESPONSE FOR MORE THAN A DECADE
. IN JANUARY, 2023 E. M S CREWS
WERE HELD ON THE WALL IN
SACRAMENTO COUNTY FOR 3267 HOURS
, RESULTING IN A COST OF OVER
$688,000 IN WALL TIME COSTS FOR
JUST ONE MONTH. THAT EQUATES TO
100 HOURS PER DAY THAT UNITS ARE
NOT ABLE TO RESPOND TO
EMERGENCIES JUST HERE IN THE
COUNTY OF SACRAMENTO. WHEN
AMBULANCES ARE STUCK ON THE
WALL. THEY CAN'T DO THEIR JOBS
PROTECTING THE PUBLIC. THAT
MEANS LONGER AND LONGER RESPONSE
TIMES FOR OTHER PATIENTS. WHEN
SECONDS COUNT, IT CAN LITERALLY
BE A MATTER OF LIFE AND DEATH.
THIS ALSO CREATES A COST TO THE
TAXPAYER BY FORCING FIREFIGHTER
MTS AND FIREFIGHTER PARAMEDICS
TO EFFECTIVELY SUBSIDIZE THE
STAFFING LEVELS IN HOSPITALS
WHILE THEY WAIT TO TRANSFER
PATIENT CARE. IN 2022, ANAHEIM,
FIRE DEPARTMENT MEDIC UNITS HOLD
ON THE WALL FOR OVER 5800 HOURS
. THIS EQUATES TO TWO FULL TIME
STAFF UNITS IN THE ER IN THE IN
ANAHEIM EVERY YEAR. CPF HAS
WORKED FOR YEARS TO TRY TO DRIVE
SOLUTIONS THAT HELP ALLEVIATE
AMBULANCE PATIENT OFFLOAD TIMES
IN A B 40 IS A NECESSARY STEP TO
CREATE ACCOUNTABILITY AND DRIVE
REDUCTIONS IN WALL TIMES. AS AS
PROPOSED TO BE AMENDED. A B 40
WILL SET A STATEWIDE CAP OF 30
MINUTES FOR AMBULANCE PATIENT,
OFFLOAD TIME AND DIRECT EACH
LAMSON TO ADOPT A STANDARD AS
NOTED IN THE ANALYSIS, A
SIGNIFICANT NUMBER OF LOCAL
JURISDICTIONS HAVE ADOPTED A
STANDARD OF 20 MINUTES OR LESS.
CPF WILL STAND READY TO WORK
WITH ALL OUR LOCAL PARTNERS TO
ENSURE THAT ADOPTED STANDARDS
MEET. LOCAL NEEDS AND ARE IN THE
BEST INTERESTS OF PATIENT CARE.
MAYBE 40 WILL ALSO REQUIRE
HOSPITALS TO DEVELOP AND
IMPLEMENT PROTOCOL TO REDUCE
OFFLOAD TIMES IF THEY EXCEED THE
STANDARD. HOSPITALS STRUGGLED
WITH COVID 19 AND THE INCREASING
DEMANDS ON HEALTH CARE SYSTEM.
THERE'S NO DOUBT ABOUT IT, BUT
THIS CAN'T BE AN EXCUSE TO PUT
AN ENDLESS TAP ON TAXPAYER
FUNDED EMERGENCY RESPONSE SYSTEM
. THE HEALTH AND SAFETY OF OUR
COMMUNITY DEPENDS ON FAST,
EFFECTIVE, FULLY STAFFED AND
AVAILABLE AVAILABLE EMERGENCY
RESPONSE. THIS CAN'T HAPPEN WHEN
AMBULANCES ARE STACKED IN THE
LINE IN THE ER, WAITING TO
OFFLOAD PATIENTS. FOR ALL THESE
REASONS, I RESPECTFULLY REQUEST
YOUR SUPPORT ON A B 40. THANK
YOU. THANK YOU. GOOD AFTERNOON,
CHAIRMAN WOULD AND MEMBERS OF
THE COMMITTEE. MY NAME IS SEAN
BURROUGHS. I'M A 27 YEAR VETERAN
OF THE FIRE SERVICE AND
CURRENTLY SERVES AS A FIRE
CAPTAIN, PARAMEDIC FOR THE
ALAMEDA COUNTY FIRE DEPARTMENT,
AS WELL AS PRESIDENT THE ALAMEDA
COUNTY FIREFIGHTERS, LOCAL 55.
AS YOU HAVE HEARD FROM
ASSEMBLYMEMBER'S RODRIGUEZ AND
PRESIDENT RICE, AMBULANCE
PATIENT OFFLOAD TIME OR WALL
TIME CONTINUE TO GROW AND
FIREFIGHTERS THROUGHOUT THE
STATE ARE BEING PUSHED TO THE
BRINK. I'D LIKE TO HIGHLIGHT HOW
AMBULANCE PATIENT OFFLOAD TIMES
IMPACT MY COMMUNITY AND THE
ALAMEDA COUNTY FIRE DEPARTMENT'S
ABILITY FOR SERVICE DELIVERY. TO
PROVIDE TO OUR RESIDENTS.
EXCESSIVE WALL TIME IMPACTS CARE
FOR THE PATIENT WAITING AT THE
HOSPITAL AND IMPACTS THE SAFETY
FOR THE NEXT PATIENT,
EXPERIENCING AN EMERGENCY AND
WAITING ON AN AMBULANCE. IN MANY
EMERGENCIES. ONE OF OUR FIRE
ENGINES ARE FIRST ON SCENE TO
BEGIN RENDERING PATIENT CARE
WHILE WAITING FOR AN AMBULANCE
TO ARRIVE. IN MY COMMUNITY FIRE
ENGINES ARE CONSISTENTLY WAITING
ON SCENE FOR AN AMBULANCE TO
ARRIVE BECAUSE ZERO AMBULANCES
ARE AVAILABLE IN THE SYSTEM.
RECENTLY AND ALAMEDA COUNTY FIRE
ENGINE WAITED ON SCENE WITH A
PATIENT FOR NEARLY 90 MINUTES
BECAUSE THERE WERE NO AVAILABLE
AMBULANCES IN MANY CASES LIKE
THESE. NOT ONLY IS THE PATIENT
IMPACTED BY NOT RECEIVING TIMELY
EMERGENCY SERVICES, BUT THE FIRE
ENGINE IS ALSO UNABLE TO RESPOND
TO ANY ADDITIONAL INCIDENTS IN
OUR RESPONSE AREA. THESE DELAYS
DELAYS ARE NOT ONE OFFS OR
ANOMALIES. THEY OCCUR DAILY AND
HAPPENED THROUGHOUT THE STATE.
80 40 WILL DIRECT THE M S
AUTHORITY TO ENHANCE DATA
COLLECTION ENSURE THAT EACH
LOCAL EMS AGENCY HAS A POT
STANDARDS NOT TO EXCEED 30
MINUTES AND WILL REQUIRE
HOSPITALS TO DEVELOP PROTOCOLS
TO PRODUCE WALL TIMES IF THEY
EXCEED THE LIMITS ADOPTED
STANDARD. REDUCING WALL TIMES
DIRECTLY BENEFITS THE PATIENT
AND OUR RESIDENTS. WOULD YOU
WANT YOUR LOVED ONE TO BE
WAITING FOR HOURS AT AN
EMERGENCY DEPARTMENT AFTER BEING
TRANSPORTED BY AN AMBULANCE? OR
COULD YOU IMAGINE EXPERIENCE A
MEDICAL EMERGENCY? AND HAVING TO
WAIT AN HOUR AND A HALF FOR AN
AMBULANCE TO ARRIVE BECAUSE ALL
RESOURCES ARE TIED UP ON THE
WALL. IT SHOULD BE UNIMAGINABLE
BECAUSE NO CALIFORNIANS SHOULD
HAVE TO EXPERIENCE A DELAY IN
EMERGENCY MEDICAL CARE. AND FOR
THESE REASONS, WE RESPECTFULLY
ASK FOR YOUR SUPPORT ON A B 40.
THANK YOU VERY MUCH OTHERS AND
SUPPORT.
DR DAN HAVERTY. I'M A FIRE CHIEF
FOR THE SACRAMENTO METROPOLITAN
FIRE DISTRICT SUPPORT. THANK
YOU. GENRE NIKKI, ASSISTANT
CHIEF WITH THE SACRAMENTO
METROPOLITAN FIRE DISTRICT
SUPPORT THANK YOU. MR CHAIR
MEMBER. SARAH FLOCKS. CALIFORNIA
LABOR FEDERATION IN SUPPORT.
THANK YOU. AFTERNOON JOHN BAGLEY
, PRESIDENT OF PROFESSIONAL
FIREFIGHTERS, 17 75, WE ASK FOR
YOUR SUPPORT. THANK YOU. GOOD
AFTERNOON. DAVID RILES DIRECTOR
UNITED FIREFIGHTERS HAVE LOS
ANGELES I'M IN SUPPORT. THANK
YOU. FIREFIGHTER PARAMEDIC RYAN
QUIGLEY, WITH LOS ANGELES FIRE
DEPARTMENT SUPPORTING FIVE
FRIENDS AND PARAMEDICS. WE
SUPPORT THANK YOU. STEVE ADELMAN
, REPRESENTING THE 3400 MEMBERS
OF THE LOS ANGELES CITY FIRE
DEPARTMENT IN SUPPORT OF A B 40.
THANK YOU. JAMES MICHAEL POWER
WITH THE AMERICAN FEDERATION OF
STATE COUNTY MUNICIPAL EMPLOYEES
ASKED ME IN SUPPORT. SEAN
EHRENBERG, CAPTAIN WITH
STANISLAS CONSOLIDATED FIRE AS
WELL AS YOU KNOW, PRESIDENT FOR
STEM CELLS. FIREFIGHTERS OVER 33
99 ALSO IN SUPPORT. JAMES CORN
WAIBEL, VICE PRESIDENT OF
ROOSEVELT FIREFIGHTERS, LOCAL 15
92. ALSO IN STRONG SUPPORT.
THANK YOU. SCOTT LEMIRE WITH
LOCAL 5 TO 2 AND SUPPORT. THANK
YOU. DAVID SPRAGUE, BERKELEY
FIRE CHIEF. IN SUPPORT. THANK
YOU. KEITH MAY INTERIM DEPUTY
CHIEF IN SUPPORT DEPARTMENT.
STEVE PENDERGRASS. HANFORD FIRE
CHIEF. ITS SUPPORT. THANK YOU.
AUSTIN THOMAS WITH 70 FIRE
ASSOCIATION, AND WE'RE IN
SUPPORT. THANK YOU. CODY REDDICK
, ALSO WITH SANTEE, FIRE
DEPARTMENT AND LOCAL 43 73. WE
SUPPORT YOU. GOOD AFTERNOON,
KYRA ROSS ON BEHALF OF THE CITY
OF CORONADO, AND SUPPORT THANK
YOU. GOOD AFTERNOON. FELIPE
RODRIGUEZ FIRE CHIEF BECAUSE
SOME OF THIS COMMUNITY SERVICES
DISTRICT FIRE DEPARTMENT AND ELK
GROVE AND GULF IN SOUTH
SACRAMENTO COUNTY FULL SUPPORT
GOOD AFTERNOON, JOHN JORDAN,
BATTALION CHIEF REPRESENTING THE
SANTEE LAKESIDE EMERGENCY
MEDICAL SERVICES, AUTHORITY AND
SUPPORT YOU. GOOD AFTERNOON.
DAVID PARSONS, FIRE CHIEF CITY
OF OCEANSIDE, STANDING ALL
COUNTY STRONG SUPPORT. QUÊ. DON
BUTTS, FIRE CHIEF LAKESIDE FIRE
PROTECTION DISTRICT, SANDY OH,
KENNY IN SUPPORT. GOOD
AFTERNOON. CHRIS TUBS,
PRESIDENT, CALIFORNIA FIRE
CHIEFS ASSOCIATION IN STRONG
SUPPORT. THANK YOU. RICHARD
PEARSE TEHRAN FIRE DISTRICT
REPRESENTING FIRE DISTRICT
ASSOCIATION OF CALIFORNIA STRONG
SUPPORT. PEARSON DIVISION CHIEF
. CARLSBAD FIRE DEPARTMENT.
SANTIAGO COUNTY IN SUPPORT.
THANK YOU. HOLMES, PRESIDENT OF
CARLSBAD FIREFIGHTERS, LOCAL 37
30 STANDING STRONG SUPPORT.
THANK YOU. GOOD AFTERNOON. GOOD
AFTERNOON, CHRISTOPHER KICKING
IN FIRE AND RESCUE SPORT. THANK
YOU. THEY'RE VERY CAPTAIN
PARAMEDIC WITH ANAHEIM FIRE AND
RESCUE STRONG SUPPORT. GOOD
AFTERNOON. GRAHAM OWEN, ENGINEER
PARAMEDIC FOR CONSUMERS FIRE
ALSO LOCAL 5 TO 2 MEMBER STRONG
SUPPORT. AFTERNOON ERIC JACKSON
, HERMETIC AND MÁS, SPECIALIST
FOR SIMMONS, FIRE DEPARTMENT AND
SUPPORT. THANK YOU. AFTERNOON
CHRISTIAN THOMPSON, YOU MISS
DIVISION CHIEF WITH NEWPORTS
FIRE AND FULL SUPPORT. GOOD
AFTERNOON. ROBERT BROWN WITH
CONSUMPTIONS FIRE DEPARTMENT.
STRONG SUPPORT. THANK YOU.
AFTERNOON PRISCILLA KIDDOS ON
BEHALF OF THE CITY OF SANTA
MONICA, AND SUPPORT YOU. ROBERT
WEBBER, BOARD OF DIRECTOR FOR
SACRAMENTO METROPOLITAN FIRE
DISTRICT. STRONGLY SUPPORT THANK
YOU. ANDREW GALLEY CAPTAIN WITH
THE HAYWARD FIRE DEPARTMENT AND
UNION PRESIDENT FOR HIBBERT.
FIREFIGHTERS LOCAL 19. OH, NINE.
STRONGLY SUPPORT THANK YOU. LIKE
TAYLOR, DEPUTY CHIEF SACRAMENTO
CITY FIRE DEPARTMENT AND SUPPORT
THANK YOU. JEFF NEALE,
REPRESENTING THE CITY OF CHULA
VISTA AND SUPPORT THANK YOU.
FREDDY ESCOBAR, CAPTAIN TO YOU,
FLACK PRESIDENT REPRESENTING
3400, BROTHERS AND SISTERS OF
YOU, FLACK OR IN STRONG SUPPORT.
THANK YOU, CHAIRMAN AND ANYBODY
IN THIS COMMITTEE, PLEASE REACH
OUT TO YOUR FIRE DEPARTMENT. DO
IT RIGHT OUT AND SEE WHAT THE
MEN AND WOMEN ARE GOING THROUGH
EVERY SINGLE DAY. THANK YOU.
THANK YOU. ANYONE ELSE? IS THERE
OPPOSITION TO THE BILL? SEE NO
ONE. ARE YOU TWEENERS OR. THANK
YOU. GOOD AFTERNOON, VANESSA
GONZALEZ WITH A CALIFORNIA
HOSPITAL ASSOCIATION. WE'D LIKE
TO THINK OF SOME REMEMBER
RODRIGUEZ, CHAIR, WOOD AND
COMMITTEE STAFF FOR YOUR WORK ON
A B 40. WE APPRECIATE
ASSEMBLYMEMBER'S RODRIGUEZ
AGREEING TO THE COMMITTEE
AMENDMENTS TO ALLOW LUMPS IS TO
SET THEIR STANDARDS LOCALLY
PENDING REVIEW OF THE LANGUAGE.
WE BELIEVE THIS WILL REMOVE OUR
OPPOSE UNLESS AMENDED POSITION
ON THE BILL. HOSPITALS AGREE
THAT AMBULANCE PATIENT OFFLOAD
DELAYS ARE PROBLEMS THAT NEED TO
BE ADDRESSED, AND WE LOOK
FORWARD TO WORKING, WORKING
CLOSELY WITH OUR FIRE AND
AMBULANCE PROVIDERS ON REDUCING
DELAYS. THANK YOU. THANK YOU. HI
GOOD AFTERNOON CHAIR WOOD AND
THE MEMBERS OF THE COMMITTEE AND
BARBARA BOND. I'M AN EMERGENCY
PHYSICIAN. ALSO PHYSICIAN LEADER
, CO CHAIR OF THE PHYSICIAN
LEADERSHIP GROUP FOR CENTER
HEALTH. UM AND I WE SUPPORT THE
CALIFORNIA HOSPITAL ASSOCIATION
STATEMENTS AND, UM APPRECIATE
ALL THE WORK THAT SOMEBODY
MEMBER RODRIGUEZ AND THE REST OF
THE COMMITTEE HAVE DONE ON A B
40. I JUST REALLY WANT TO MAKE
KIND OF A HEARTFELT STATEMENT
THAT THIS IS AN IMPORTANT ISSUE
FOR US TO AS EMERGENCY POSITIONS
AND ANYONE WHO WORKS IN AN ER.
WE DON'T WANT OUR PATIENTS
SITTING ON THE WALL. WE DON'T
WANT ANY OF THIS EITHER. WE ALL
UNDERSTAND THAT THIS IS AS WE'VE
HEARD TODAY AND EXTREMELY
COMPLEX ISSUE IN TERMS OF
CAPACITY ISSUES IN OUR HOSPITALS
, AND WE MORE THAN ANYTHING WANT
TO BE PARTNERING WITH OUR LENSES
, FIRE AGENCIES, AMBULANCE
COMPANIES TO REDUCE A PART AND I
THINK OUR APPROACH IN DOING THAT
HAS BEEN VERY SUCCESSFUL. UM
SORT OF ROSEVILLE HAS BY
IMPLEMENTING, UM, AND A PACK
COMMITTEE SYSTEM WIDE FOR
SUTTER. WE REDUCED THE WALL
TIMES ARE FROM AN HOUR AND 42
MINUTES TO 30 MINUTES. OTHER
SACRAMENTO HAS HAD SIMILAR
IMPROVEMENTS JUST BY
COLLABORATING LOCALLY, SO AH, I
THINK THAT'S THE MAJORITY OF MY
COMMENTS AGAIN. THANKS TO YOU,
AND THANKS TO THE COMMITTEE.
OKAY, WE'LL TAKE THOSE TWO AS
TESTIMONY. SO ANYBODY ELSE JUST
I'M IN BETWEEN OR WHATEVER YOU
ARE, ROSE, COLANGELO SAID. HER
HEALTH AND I ALSO WANT TO
SUPPORT THE COMMENTS MADE BY C H
A AND DR BOND AND THANK YOU FOR
COLLABORATION. GOOD AFTERNOON.
I'M HEIDI VULGAR. I AM THE NURSE
MANAGER AT SUMMIT EMERGENCY IN
OAKLAND ABS AND SEE PART OF
CENTER HEALTH AND I DO ALSO WANT
TO SUPPORT DR. BONDS, COMMENTS.
THANK YOU AND THANK THE TEAM FOR
THEIR SUPPORT AND COLLABORATION.
THANK YOU. I AM LARRY JOHNSON.
I'M THE NURSING DIRECTOR FOR
CENTER ALTA BATES IN BERKELEY
AND OAKLAND, AND I SUPPORT THE
COMMENTS MADE BY DR BOND. THIS
AFTERNOON CHAIR AND MEMBERS
CONNIE DELGADO ON BEHALF OF THE
CALIFORNIA EMERGENCY NURSES
ASSOCIATION. WE HAD AN OPPOSING
LESS AMENDED POSITION. LOOK
FORWARD TO REVIEWING AMENDMENTS.
THANK YOU. THANK YOU. SOLANO
COUNTY BOARD OF SURPRISES AND
OPPOSITION. THANK YOU. THANK
YOU. SLOPER WITH UNITED HOSPITAL
ASSOCIATION WOULD LIKE TO THANK
THE CHAIR AND THE AUTHOR FOR
THEIR HARD WORK. WE ASSUME THE
AMENDMENTS ARE FINE, THANK YOU.
KELLY ASH WITH DIGNITY. HEALTH
UM WE WERE OPPOSED TO LESS THAN
MENDED, BUT WE LOOK FORWARD TO
REVIEWING AND THANK YOU. THANK
YOU. GOOD AFTERNOON, JONATHAN
CLAIRE ON BEHALF OF SCRIPTS.
HELP BIGGER KNEELING IS BETTER
HERE. WE ALSO HAVE AN IMPOSING
LESS CEMENT POSITION. BUT WE
LOOK FORWARD TO SEEING THE
AMENDMENTS. WE APPRECIATE THE
HARD WORK OF THE COMMITTEE.
THANK YOU. GOOD AFTERNOON. ERIN
TAYLOR ON BEHALF OF MEMORIAL
CARE HEALTH SYSTEM ALSO HAD AN
OPPOSING LESSON IN POSITION AND
LOOK FORWARD TO SEEING THE
LANGUAGE IN PRINT. THANK YOU.
ALISON REMY ON BEHALF OF KAISER
PERMANENTE. WE ALSO HAD AN
OPPOSED UNLESS AMENDED POSITION
. LOOK FORWARD TO REVIEWING THE
AMENDMENTS AND THANK YOU TO THE
AUTHOR AND THE COMMITTEE. THANK
YOU. IS THAT SHORT ON BEHALF OF
THE ALLIANCE OF CATHOLIC
HEALTHCARE, ADVENTIST HEALTH AND
RADIANCE, CHILDREN'S HOSPITAL
AND LIKE SOME OF MY OTHER FOLKS
APPRECIATE THE WORK OF THE
AUTHOR AND THE COMMITTEE. UM AND
HOPE TO REMOVE OUR OPPOSITION
WHEN WE SEE THE AMENDMENTS IN
PRINT, SO THANK YOU. THANK YOU.
AMY BLOOMBERG WITH THE
CALIFORNIA CHILDREN'S HOSPITAL
ASSOCIATION. WE WERE PREVIOUSLY
OPPOSED UNLESS AMENDED. THANK
THE AUTHOR AND THE COMMITTEE FOR
THE WORK AND LOOK FORWARD TO
LOOKING AT THE AMENDMENTS. THANK
YOU. ANYONE ELSE? AND BRING IT
BACK TO THE COMMITTEE QUESTIONS
OR COMMENTS. MR MR FONG. I'LL BE
VERY QUICK. I JUST WANT TO THANK
THE AUTHOR. HE AND I HAVE HAD
EXTENSIVE CONVERSATIONS ABOUT
THIS. APPRECIATE THE AMENDMENTS
AND HAPPY TO SUPPORT. SO UH,
ONCE AGAIN, I THINK THANK YOU,
MR RODRIGUEZ. AND YOUR EFFORTS
ON THIS. I KNOW YOU'VE BEEN
WORKING ON THIS IN THIS ISSUE
AREA FOR THE WHOLE TIME. I'VE
BEEN IN THE LEGISLATURE, SO I
APPRECIATE YOUR PERSEVERANCE ON
THIS. THANK YOU FOR ACCEPTING
THE AMENDMENTS AND APPRECIATE
WILL CONTINUE WORKING AS AS
THINGS GO FORWARD AND THANK YOU
TO YOUR WITNESSES AS WELL, UH,
DOES ENJOY DO PASS
RECOMMENDATION WHEN WE HAVE A
QUORUM. WE'RE NOW AT THREE HOURS
IN SEARCH OF A QUORUM. WE
MANAGED TO GET PAST LAST WEEK'S
RECORD OF TWO HOURS AND 45
MINUTES. AND COUNTING. SO ANYWAY
, WOULD YOU LIKE TO CLOSE MR
RODRIGUEZ? YES FIRST OF ALL I
WANT TO THANK COMMITTEE STAFF
AND YOU, CHAIRMAN WOULD FOR
WORKING WITH ME AND THE SPONSORS
AS WELL ON THIS VERY IMPORTANT,
BILL. YOU KNOW, OBVIOUSLY MY
BACKGROUND IS E M S. THIS IS A
DECADES OLD ISSUE WITH WALL
TIMES. AS I STATED IN MY OPENING
. I WAITED 12 HOURS IN THE
HOSPITAL ER DECADES AGO AND
STILL TO SEE THIS ISSUE IN THE
PANDEMIC. I THINK JUST
HIGHLIGHTED THE POINTS OF THIS
TYPE OF LEGISLATION TO FREE UP
OUR FIRST RESPONDERS HAVE PUT
THEM BACK IN SERVICE TO RESPOND
TO EMERGENCIES TO PROTECT US
THAT THE STATE OF CALIFORNIA SO
WITH THAT RESPECT TO ASK FOR I
VOTE THANK YOU. THANK YOU VERY
MUCH. APPRECIATE IT. THANK YOU.
WHILE YOU'RE THERE. YOU GOT
ANOTHER BILL? YEAH. OKAY. GOOD.
HMM.
ONCE AGAIN. THANK YOU, MR
CHAIRMAN MEMBERS. FIRST I'M
GONNA TANK CHAIR WOOD AND THE
STAFFORD LARA. FOR TAKING THE
TIME TO WORK WITH MY STAFF ON
THE AMENDMENTS. THANK YOU ACCEPT
THESE AMENDMENTS. THANK YOU FOR
ALLOWING ME TO PRESENT A B 11
80. WHICH WOULD REMOVE THE
REQUIREMENT FOR THE AMSA
DIRECTOR TO BE A PHYSICIAN AND
CREATE A NEW CHIEF MEDICAL
OFFICER POSITION IN IMSA. THE M
S COMMUNITY IS MUCH MORE
EXPENSIVE THAN JUST YOUR
PHYSICIANS AND OTHER E. M S
PROFESSIONALS, INCLUDING
PARAMEDICS. E. M. T S
FIREFIGHTERS, DISPATCHERS,
NURSES, EMERGENCY ADMINISTRATORS
AND MORE. THE DUTIES OF THE EMC
DIRECTOR SPEND MANY AREAS OF
EXPERTISE OR THE CURRENT
PHYSICIAN REQUIREMENTS, MANY
PROFESSIONALS WITH APPLICABLE
EXPERIENCE ARE AUTOMATICALLY
INELIGIBLE. WE ALREADY KNOW THAT
A NON PHYSICIAN CAN SUCCESSFULLY
RUN IMSA THANKS TO OUR ACTING
DIRECTOR, LIZ BASSINET ACTING
DIRECTOR. BASSINET IS NOT A
PHYSICIAN, OR RATHER IN
EMERGENCY MANAGEMENT
PROFESSIONAL WHO IN ADDITION TO
SERVING AS EMC'S ACTING DIRECTOR
, ALSO SERVES AS THE ASSISTANT
SECRETARY WITH THE HEALTH AND
HUMAN SERVICES AGENCY, WHERE SHE
LEADS THE COORDINATION OF
EMERGENCY PREPAREDNESS, RESPONSE
AND RECOVERY ACROSS ALL OF A H
S. SHE HAS LED TO SINCE 2021,
INCLUDING THROUGH THE HEIGHT OF
THE COVID 19 PANDEMIC AND HIS
WIDELY RESPECTED BY
PROFESSIONALS ACROSS
CALIFORNIA'S BMS SYSTEM. SHE
CLEARLY DEMONSTRATES THAT WITH
THE RELEVANT QUALIFICATIONS THAT
DIRECTORS DID NOT NEED TO BE A
DOCTOR. HOWEVER EMERGENCY
MEDICAL REPRESENTATION OF AMSA
IS IMPORTANT, WHICH IS WHY THIS
BILL ALSO CREATES A CMO
POSITION. CREATING A CMO ENSURE
A LICENSE EMERGENCY PHYSICIAN
PERFORMS THE DUTIES THAT TRULY
REQUIRE MEDICAL BACKGROUND AND
CAN PROVIDE INSIGHT AND ADVICE
TO THE DIRECTOR. FURTHERMORE HAS
ALREADY SUBMITTED A BUDGET
CHANGE PROPOSAL TO CREATE THIS
POSITION. BROADENING THE
QUALIFICATION TO BECOME A
DIRECTOR AND CREATING A CMO OR
CREATE A MORE DYNAMIC, MORE
PREPARED AND MORE REPRESENTATIVE
OF IMSA. WITH ME TO PROVIDE
TESTIMONY IS THE SUPER'S
REPRESENTING THE CALIFORNIA
PROFESSIONAL FIREFIGHTERS. THANK
YOU, MR CHAIR MEMBERS, DOUG
SUPERS ON BEHALF OF THE
CALIFORNIA PROFESSIONAL
FIREFIGHTERS. THE AUTHOR DID A
GREAT JOB OF GOING OVER THE
ISSUE. CPF IS IN SUPPORT OF A B
11 80. WE DO THINK REMOVING THE
MEDICAL DOCTOR REQUIREMENT FROM
THE AMSA DIRECTOR WILL HELP
BROADEN THE POOL OF AVAILABLE
CANDIDATES TO PURSUE THAT
POSITION. WE ALSO THINK IT IS
IMPORTANT TO HAVE A CMO TO
ENSURE THAT PATIENT CARE
CONSIDERATIONS CONTINUE TO BE
MADE. AT M C. A. IN ADDITION TO
SUPPORTING A B 11 80 CPF IS ALSO
SUPPORTING THE DISCUSSION WITHIN
THE BUDGET PROCESS, THE TRAILER
BILL LANGUAGE AND THE BUDGET
CHANGE PROPOSAL TO FUND A CMO.
UM UH, AT THE AT IMSA. AND FOR
THOSE REASONS, WE RESPECTFULLY
REQUEST YOUR SUPPORT. THANK YOU.
THANK YOU VERY MUCH OTHERS IN
SUPPORT.
AFTERNOON DR DAN HAVERTY FIRE
CHIEF SACRAMENTO METROPOLITAN
FIRE DISTRICT SUPPORT THANK YOU.
STEEP IN THE GRASS FIRE CHIEF
CITY BRANFORD THANK YOU. DON BUT
SPAR CHIEF LIKES THAT FIRE
PROTECTION DISTRICT AND SUPPORT.
THANK YOU. JOHN JORDAN BATTALION
CHIEF ANTI LIKE SIDE EMERGENCY
MEDICAL SERVICES, AUTHORITY AND
SUPPORT. THANK YOU. FIRST TIMES
PRESIDENT CALIFORNIA FIRE CHIEFS
ASSOCIATION AND FULL SUPPORT
THANK YOU. CHRISTIAN THOMPSON,
UM S DIVISION CHIEF WITH NEWPORT
BEACH FIRE AND FULL SUPPORT.
THANK YOU. RICHARD PEARSE FIRE
CHIEF REPRESENTING FIRE DISTRICT
ASSOCIATION OF CALIFORNIA,
STRONG SUPPORT. DAVID SPRAGUE,
REPRESENTING BERKELEY, FIRE
DEPARTMENT AND SUPPORT THANK
YOU. ANYONE ELSE? THEIR
OPPOSITION TO THIS BILL. THANK
YOU. CHAIR MEMBERS. TWO MEN
REPRESENTING THE CALIFORNIA
CHAPTER OF AMERICAN COLLEGE OF
EMERGENCY FISHING'S. WE HAVE AN
OPPOSING LESS AMENDMENT POSITION
WITH THE AMENDMENTS THAT THE
AUTHORS ACCEPTED. WE WANT TO
THANK THE AUTHOR AND HIS STAFF
AND THE COMMITTEE STAFF ARE
LOOKING AT OUR AMENDMENTS, AND I
BELIEVE THIS REMOVES HER
OPPOSITION, AND WE'LL DO THAT
ONCE THAT'S IN PRINT. THANK YOU.
THANK YOU. THANK YOU. CADBURY
WITH THE HEALTH OFFICERS
ASSOCIATION OF CALIFORNIA, ALSO
WITH AN OPPOSING LESS AMENDED.
WE WANT TO MAKE SURE THAT THE
CMO POSITION IS PROTECTED AND
HAS THE AUTHORITY THAT THEY NEED
TO PROTECT THE HEALTH OF ALL
CALIFORNIANS, AND WE LOOK
FORWARD TO CONTINUING TO WORK
WITH THE AUTHOR SHOULD BILL
PASSED TODAY TO MAKE SURE THAT
THAT LANGUAGE IS INCORPORATED.
THANK YOU. ANYONE ELSE? OKAY SO
YOU KNOW ONE. BRING BACK THE
COMMITTEE FOR QUESTIONS OR
COMMENTS. ANY QUESTIONS? IN
NONE. UM MR RODRIGUEZ. YOUR BILL
DOES ENJOY DO PASS
RECOMMENDATION AND YOU KNOW, WE
DON'T HAVE A QUORUM. SO SO WITH
THAT. WOULD YOU LIKE TO CLOSE
RESPECT TO ASK FOR I VOTE. THANK
YOU, MR MR MR RODRIGUEZ. SO UH,
SEEING NO OTHER AUTHORS PRESENT
. I'M GOING TO TAKE THIS
OPPORTUNITY TO PRESENT TWO BILLS
ASKED THE VICE CHAIR TO TAKE
OVER FOR ME. THANK YOU.
CHAIRMAN WOULD WILL BE
PRESENTING A B 815. THANK YOU
VERY MUCH, MADAM VICE CHAIR. UM
PROVIDER CREDENTIAL IMPOSES
ADMINISTRATIVE CHALLENGES
SIMILAR TO PRIORITIZATION AND
PROVIDER DIRECTORIES. AS HEALTH
CARE PROVIDERS CAN BE SUBJECT TO
DIFFERENT CRITERIA, DEPENDING
UPON HOW MANY PLANS THEY
CONTRACT WITH. THIS PROPOSAL
WOULD STREAMLINE THE
CREDENTIALING PROCESS FOR
DOCTORS AND HEALTH PLANS BY
CREATING A BOARD TO CERTIFY
CREDENTIALING ENTITIES. RATHER
THAN WASTE TIME ON OVERLY
BURDENSOME ADMINISTRATIVE
PROCESSES. HEALTH PLANS CAN
FOCUS ON ENSURING ITS ENROLLEES
HAVE ACCESS TO AN ADEQUATE
NETWORK AND PROVIDERS CAN FOCUS
ON PROVIDING MEDICAL CARE. THE
AMENDMENTS, IDENTIFY MINIMUM
STANDARDS AND CLARIFY THAT THIS
BILL ONLY APPLIES TO DOCTOR'S
INSURGENTS WITH ME IS IN SUPPORT
IS THE CALIFORNIA MEDICAL
ASSOCIATION. I THINK THEY'RE
COMING. WE HOPE THEY DON'T TRIP
AND FALL AND REQUIRE MEDICAL
ATTENTION HERE, BUT, YOU KNOW.
EXCUSE ME. UH THANK YOU, MR
CHAIR. MADAM CHAIRMAN
MANUFACTURE, REMEMBERS THE
COMMITTEE BRANDON MARGIE WITH
THE CALIFORNIA MEDICAL
ASSOCIATION. EXCUSE ME, UH, WE
WANT TO THANK THE CHAIR FOR
TAKING ON THIS ISSUE OF
MODERNIZING, UH AND UPDATING THE
DELIVERY OF CARE AND MAKING SURE
THAT WE CAN CUT ADMINISTRATIVE
AND REDUNDANT RED TAPE WHERE WE
CAN WORD. UM SO, UH, WE LOOK
FORWARD TO CONTINUE
CONVERSATIONS WITH STAKEHOLDERS
AND WOULD RESPECTFULLY REQUEST
YOUR I VOTE. THANK YOU OTHER
OTHER WITNESSES IN SUPPORT.
PLEASE COME FORWARD. BRENT
SPENCE ON BEHALF OF THE AMERICAN
COLLEGE OF O B. G. Y N NINE AND
THE CALIFORNIA PODIATRIC MEDICAL
ASSOCIATION, BOTH IN SUPPORT.
GOOD AFTERNOON, PRISCILLA
KYOTO'S ON BEHALF OF THE
CALIFORNIA ACADEMY OF CHAD, AND
ANALYSTS, PSYCHIATRY AND SUPPORT
. IS HE SWIMMING ON BEHALF OF
CALIFORNIA STUDIO ASSOCIATIONS,
PSYCHIATRISTS AND SUPPORT. THANK
YOU. THANK YOU. ARE THERE ANY
WITNESSES IN OPPOSITION? UM GOOD
AFTERNOON CHAIR AND MEMBERS OF
THE COMMITTEE KIND OF IN BETWEEN
HER POSITION. WE SUBMITTED A
LETTER OF CONCERNS. UM, SO MY
NAME IS ROBERT BOYKIN WITH THE
CALIFORNIA ASSOCIATION OF HEALTH
PLANS. WE APPLAUD THE AUTHORS,
SPONSORS AND COMMITTEE STAFF FOR
THEIR WORK INTENTION BEHIND THIS
BILL. NEVERTHELESS UM OUR
MEMBERS HAVE REVIEWED THE BILL
AND WE'RE NOT OPPOSED. BUT WE DO
HAVE SOME SOMEBODY CONCERNS. AND
WHILE WE APPRECIATE THE INTENT
OF A B E 15, WE MUST POINT OUT
THAT SARAH POLICIES HAVE BEEN
ATTEMPTED IN OTHER STATES
WITHOUT THE DESIRED RESULTS. FOR
EXAMPLE, THE ORGAN COMMENT
CREDENTIALING PROGRAM WAS
ENACTED IN 2013. THE PROGRAM WAS
INTENDED TO SIMPLY TO SIMPLIFY
THE AGING PROCESS, REDUCE BURDEN
OUR PRACTITIONERS AND ELIMINATE
DUPLICATION. WHILE THERE WAS
BROCK INSTANCES THAT THE CONCEPT
OF CENTRALIZING CREDENTIAL
INFORMATION HAS MERIT
COUNSELORS, SIGNIFICANT
CHALLENGES, THEY MADE IT
DIFFICULT TO IMPLEMENT A COST
EFFECTIVE PROGRAM THAT WOULD
BENEFIT ALL ORGAN PRACTITIONERS
. AFTER YEARS OF TRYING AND
MILLIONS OF DOLLARS SPENT, THEY
EFFECTIVELY ENDED THEIR EFFORT
TO CREATE THE PROGRAM IN 2020.
OTHER TECHNICAL CONCERNS ABOUT
THE BILL ABOUT THIS BILL ARE
WELL STATED ANALYSIS, AND WE
WILL WORK WITH THE OTHER PARTIES
INVOLVED TO REACH CONSENSUS ON
OUR QUESTIONS. AND IF SHE'S
GOING FORWARD, THANK YOU FOR
YOUR TIME TODAY. THANK YOU.
MADAM CHAIR AND MEMBERS
STEPHANIE WATKINS ON BEHALF OF
THE ASSOCIATION OF CALIFORNIA
LIFE AND HEALTH INSURANCE
COMPANIES WOULD LIKE TO ECHO MY
COLLEAGUE'S CONCERNS, AND WE
APPRECIATE THE AUTHOR IN THE
SPONSOR REACHING OUT EARLY AND
WE'VE HAD SOME REALLY PRODUCTIVE
CONVERSATIONS ARE INTENT IS JUST
TO ENSURE THAT OUR MEMBER PLANS
CONTINUE TO HAVE THE ABILITY TO
CREDENTIAL THOSE PHYSICIANS TO
ENSURE THAT WE PROVIDE THE
HIGHEST QUALITY OF CARE FOR OUR
MEMBER COMPANIES. SO FOR THOSE
REASONS WE LOOK FORWARD TO
CONTINUING THESE CONVERSATIONS
AND COMING TO POSITIVE
RESOLUTION. THANK YOU. THANK
YOU. THANK YOU, MADAM CHAIR
MEMBERS OF THE COMMITTEE DAVID
GONZALEZ ON BEHALF OF AMERICANS,
PHYSICIAN GROUPS. I APOLOGIZE. I
DIDN'T GET HERE ON TIME OR
ACTUALLY IN SUPPORT AND LOOK
FORWARD TO WORKING WITH THE
AUTHOR AND SOME ADDITIONAL
ISSUES BUT HAPPY TO BE IN
SUPPORT. THANK YOU. OKAY SEEING
NO OTHER WITNESSES AND
OPPOSITION OR TWEENERS, BRING IT
TO THE COMMITTEE. THE TWO OF US
COMING LUZ RIVAS ANY COMMENTS?
YEAH. AH! SO I'LL ASK THE AUTHOR
TO CLOSE THANK YOU VERY MUCH,
MADAM. VICE CHAIR. UH YOU KNOW
THIS? WE OBVIOUSLY WILL CONTINUE
TO WORK WITH THE OPPOSITION. WE
HAVE AMENDMENTS THAT WE ARE
ACCEPTING. UH I DIDN'T MENTION
THAT EARLIER. UM MY BAD. UM AND
CONSIDER THIS A LITTLE BIT OF A
WORK IN PROGRESS, BUT BUT
UNDERSTAND THE INTENT. UM IT
SHOULD BE MUCH SIMPLER TO
CREDENTIAL PROVIDERS RATHER THAN
HAVING TO CREDENTIAL WITH EVERY
SINGLE ENTITY OUT THERE, WHICH
DUPLICATIVE? IT'S WASTEFUL. UH
AND IT TAKES PEOPLE AWAY FROM
DOING WHAT THEY REALLY NEED TO
DO, WHICH IS PROVIDE CARE TO
PATIENTS. SO WITH THAT, UM, WHEN
WE HAVE A QUORUM, WHATEVER DAY
THAT IS, UM, I WOULD
RESPECTFULLY ASK FOR AN I VOTE.
THANK YOU. AND YOU DO HAVE
ANOTHER BILL. I'M GONNA I'M
GONNA STEP ASIDE AND LET MISS
PETRIE-NORRIS, UH, PRESENT HER
BILL THAT SHE'S HERE. UM AND
I'LL PICK THIS UP LATER. OKAY.
THANK YOU. MHM MISS
PETRIE-NORRIS WILL BE PRESENTING
A B 1338.
JUST A LITTLE BUTTON THERE IF
YOU DON'T MIND, ALRIGHT. OKAY?
THANK YOU, MR CHAIR AND MEMBERS
. UH PLEASED TO JOIN YOU THIS
AFTERNOON TO PRESENT A B 13 38.
A B 13 38 WILL HELP EXPAND
HEALTH EQUITY, IMPROVED QUALITY
OF LIFE AND PROVIDE LONG TERM
HEALTH CARE SAVINGS TO CAL
RECIPIENTS BY ADDING FITNESS AND
WELLNESS SERVICES TO THE LIST OF
PRE APPROVED COMMUNITY SUPPORTS
UNDER CAL AIM, I WANT TO THANK
THE CHAIR AND COMMITTEE STAFF
ARE WORKING WITH MY OFFICE AND
HAPPY TO ACCEPT THE COMMITTEE'S
RECOMMENDED AMENDMENTS IN 2022,
THE DEPARTMENT OF HEALTH CARE
SERVICES COUNT AIM PROGRAM WAS
IMPLEMENTED TO IMPROVE THE
QUALITY OF LIFE AND HEALTH
OUTCOMES OF MEDICAL BENEFITS.
FISHY AIRES BY ENACTING BROAD
DELIVERY SYSTEM, PROGRAMMATIC
AND PAYMENT SYSTEM REFORMS. A
KEY FEATURE OF CAL AIM WAS THE
INTRODUCTION OF A NEW MENU OF
COMMUNITY SUPPORTS. WHICH OFFER
A COST EFFECTIVE ALTERNATIVE TO
TRADITIONAL MEDICAL SERVICES AND
CAN BE USED IN LIEU OF EXISTING
MEDICAL BENEFITS. THESE BENEFITS
INCLUDE SERVICES LIKE MEDICALLY
SUPPORTIVE FOODS OR HOUSING
SUPPORTS AND ARE DESIGNED TO
ADDRESS THE SOCIAL DETERMINANTS
OF HEALTH. NEARLY TWO THIRDS OF
ALL MEDICAL RECIPIENTS COME FROM
DISADVANTAGED COMMUNITIES THAT
ARE DISPROPORTIONATELY IMPACTED
BY HEALTH DISPARITIES.
COMMUNITIES LIKE THESE OFTEN
FACE SIGNIFICANT BARRIERS TO
ACCESSING PLACES AND MEANS TO
EXERCISE DUE TO COST SAFETY AND
LACK OF INFORMATION ABOUT THE
BENEFITS OF EXERCISE. A B 13 38
WOULD BRING EQUITY TO MEDICAL
RECIPIENTS BY ALLOWING THEM
ACCESS. Tð FITNESS, PHYSICAL
ACTIVITY OR RECREATIONAL SPORTS
PROGRAMS SO THEY CAN IMPROVE
THEIR PHYSICAL AND MENTAL MENTAL
HEALTH. UM AND IMPORTANTLY ON
THE PROVISION OF THESE HEALTH
AND FITNESS BENEFITS TO MEDICAL
BENEFICIARIES ISN'T JUST A NICE
THING TO DO INCREASINGLY IN
PRIVATE INSURANCE PLANS ALL
ACROSS THE STATE AND COUNTRY.
THESE BENEFITS ARE BEING OFFERED
TO MEMBERS. AND THERE'S ONE BIG
REASON FOR THAT, BECAUSE THESE
BENEFITS NOT ONLY IMPROVE
QUALITY OF LIFE FOR MEMBERS AND
LONG TERM HEALTH CARE OUTCOMES
FOR MEMBERS. THEY ALSO LOWER
LONG TERM TERM LONG TERM COSTS
AS WELL. SO WITH THAT REALLY
PLEASED TO BE JOINED BY OUR
WITNESSES, WE HAVE FRANCESCA
SCHULER, WHO IS THE PRESIDENT OF
THE CALIFORNIA FITNESS ALLIANCE
, AND SHARE GONZALEZ, WHO IS
JOINING US FROM THE AMERICAN
DIABETES ASSOCIATION. GOOD
AFTERNOON, MR CHAIR AND
COMMITTEE MEMBERS. THANK YOU FOR
EXTENDING US THE OPPORTUNITY TO
TESTIFY FOR ABBY 13 38, AND I
WANT TO THANK ASSEMBLYMEMBER'S
PETRIE-NORRIS FOR HER COMMITMENT
ON IMPROVING THE HEALTH OF
CALIFORNIANS BY AUTHORING THIS
BILL. UH I'M FRANCESCA SCHULER
ON THE PRESIDENT OF THE
CALIFORNIA FITNESS ALLIANCE. WE
REPRESENT A UNITED VOICE OF ALL
FITNESS PROFESSIONALS IN THE
STATE 345 PARTNER ORGANIZATIONS
, 3000 FITNESS CENTERS THAT
PROVIDE SAFE PLACES FOR PHYSICAL
AND MENTAL ACTIVITIES FOR
MILLIONS OF CALIFORNIANS EVERY
YEAR, AND OUR MISSION IS REALLY
TO PROMOTE A HEALTHY CALIFORNIAN
BY PROVIDING SAFE AND EQUITABLE
ACCESS TO EXERCISE FOR ALL
THAT'S WHY WE'RE PROUD SPONSOR
OF HB 13 38, WHICH WOULD ADD A
NEW MEDICAL COMMUNITY SUPPORT TO
THE LIST OF APPROVED SERVICES TO
EXPAND ACCESS TO PHYSICAL
ACTIVITY PROGRAMS, MEMBERSHIPS
AND ACTIVITIES FROM MEDICAL
RECIPIENTS. WHY DOES THIS MATTER
? FIRST AND FOREMOST, THIS BILL
WILL IMPROVE THE HEALTH OF
TRADITIONALLY UNDERSERVED
COMMUNITIES BY FOCUSING ON
PREVENTATIVE BENEFITS OF
PHYSICAL ACTIVITY. THE CDC NOTES
THAT REGULAR PHYSICAL ACTIVITY
IS ONE OF THE MOST IMPORTANT
THINGS YOU CAN DO TO REDUCE THE
RISK OF DISEASE AND IMPROVE YOUR
BOTH YOUR PHYSICAL AND MENTAL
HEALTH. UNFORTUNATELY
UNDERSERVED COMMUNITIES THAT
MAKE UP THE MAJORITY OF MEDICAL
RECIPIENTS OFTEN FACE
SIGNIFICANT BARRIERS TO EXERCISE
DUE TO COST OR LACK OF
INFORMATION. NEARLY TWO THIRDS
OF ALL MEDICAL RECIPIENTS COME
FROM MARGINALIZED COMMUNITIES
THAT WOULD BENEFIT THE MOST AS
THEY ARE MOST AFFECTED BY HEALTH
DISPARITIES AND CHRONIC
ILLNESSES SUCH AS HEART DISEASE,
DIABETES OR HIGH BLOOD PRESSURE.
A B 13 38 WOULD ENCOURAGE
HEALTHCARE PROFESSIONALS TO
EDUCATE PATIENTS ABOUT THE
BENEFITS OF EXERCISE AND BRING
EQUITY TO MEDICAL RECIPIENTS
THROUGH THIS NEW PROPOSED
COMMUNITY SUPPORT PROGRAMS LIKE
THIS DO WORK. MEDICARE PROVIDES
ACCESS TO EXERCISE MEMBERSHIPS
TO SENIORS THROUGH THEIR SILVER
SNEAKERS PROGRAM, AND A STUDY
COMPLETED IN 2021, EVALUATING
ITS IMPACT FOUND THAT TOTAL
HEALTH CARE COSTS WERE REDUCED
BY 16% FOR PARTICIPANTS VERSUS
NON PARTICIPANTS AND MEDICAL
COSTS WERE REDUCED BY 18%
THROUGH REDUCTIONS AND INPATIENT
COSTS. HOSPITAL STAYS WERE ALSO
REDUCED. TODAY 42% OF THE STATE
HEALTH CARE COSTS GO TO TOWARDS
TREATING THE TOP FIVE CHRONIC
DISEASES WHEN AN ESTIMATED $141
BILLION IN DIRECT COSTS SPENT ON
HEART DISEASE, ARTHRITIS,
CANCER, DIABETES, DEPRESSION AND
ASTHMA. IF INCREASED ACCESS TO
EXERCISE RESULTS IN EVEN A 1%
REDUCTION IN HEALTH RISK FACTORS
, IT WOULD CUT PER PERSON ANNUAL
MEDICAL COSTS FROM $183 TO 103
AND COULD SAVE THE STATE UP TO
$135 MILLION A YEAR. CALIFORNIA
NEEDS TO BE PROACTIVE AND
INNOVATIVE AND ITS APPROACH TO
PREVENTATIVE HEALTH AND THIS
BILL IS A STRONG STEP FORWARD IN
IMPROVING THE HEALTH OF ITS
RESIDENTS, PARTICULARLY IN
UNDERSERVED COMMUNITIES. FOR
THESE REASONS, THE FAA IS
PLEASED TO SPONSOR A B 13 38 AND
ASK FOR YOUR VOTE ON THIS
MEASURE. THANK YOU. THANK YOU.
PLEASE GO AHEAD. GOOD AFTERNOON,
MR CHAIR AND MADAM VICE CHAIR
AND MEMBERS OF THE COMMITTEE.
I'M SHERIFF GONZALEZ. I'M HERE
ON BEHALF OF MY CLIENT, THE
AMERICAN DIABETES ASSOCIATION.
WHICH IS A SUPPORTER OF THIS
IMPORTANT BILL. WE WANT TO FIRST
BE ABLE TO THANK THE ASSEMBLY
MEMBER FOR HER LEADERSHIP IN
BRINGING THIS BILL FORWARD. THE
AMERICAN DIABETES ASSOCIATION
LEADS THE FIGHT TO PREVENT AND
FIND A CURE FOR DIABETES. WE
ALSO WORK TO IMPROVE THE LIVES
OF ALL PEOPLE AFFECTED BY
DIABETES, INCLUDING THE OVER
THREE MILLION CALIFORNIANS
LIVING WITH DIABETES. I'M HERE
TODAY IN STRONG SUPPORT OF
ASSEMBLY BILL 13 38, THE MEDICAL
EXERCISE AND MENTAL WELL BEING
ACT, WHICH WOULD ADD A NEW
MEDICAL COMMUNITY SUPPORT AND
EXPAND ACCESS TO EXERCISE FOR
MEDICAL RECIPIENTS. COMMUNITY
SUPPORTS WERE DESIGNED TO
ADDRESS THE SOCIAL DETERMINANTS
OF HEALTH THAT HAVE A MAJOR
IMPACT ON PEOPLE'S HEALTH, WELL
BEING AND QUALITY OF LIFE. SOME
EXAMPLES OF SOCIAL DETERMINANTS
OF HEALTH INCLUDES SAFE HOUSING
, RACISM, EDUCATION, INCOME
POLLUTION AND ACCESS TO PHYSICAL
ACTIVITY OPPORTUNITIES. A RECENT
NEW YORK TIMES ARTICLE TITLED
THE INCOME GAP IS BECOMING A
PHYSICAL ACTIVITY. DIVIDE
DETAILS HOW LOW INCOME FAMILIES
AND CHILDREN ARE BEING PRICED
OUT OF PHYSICAL ACTIVITY
OPPORTUNITIES SUCH AS SPORTS
ACTIVITIES. ACCESS TO A SAFE AND
CONSISTENT PLACE TO EXERCISE CAN
HELP IMPROVE THE HEALTH AND WELL
BEING OF COUNTLESS CALIFORNIANS.
THE DEPARTMENT OF HEALTH CARE
SERVICES NOTES THAT THERE IS
STRONG EVIDENCE THAT PHYSICAL
ACTIVITY REDUCES THE RISK OF
TYPE TWO TYPE DIABETES, WHICH
DISPROPORTIONATELY AFFECT
COMMUNITIES OF COLOR BECAUSE OF
A VARIETY OF SOCIAL DETERMINANTS
OF HEALTH. CURRENTLY NEARLY 40%
OF CALIFORNIAN ADULTS REPORT
HAVING AT LEAST ONE OF FIVE
CHRONIC HEALTH CONDITIONS,
INCLUDING HIGH BLOOD PRESSURE,
HEART DISEASE, DIABETES AND
ASTHMA. RESEARCH SHOWS THAT UP
TO 80% OF TYPE TWO DIABETES,
HEART DISEASE, STROKE AND MORE
THAN 30% OF CANCERS COULD BE
PREVENTED THROUGH THE INCREASED
EXERCISE, ELIMINATING TOP BACKO
IMPROVING DIET AND DECREASING
ALCOHOL USE. WITH THE MEDIC, AL
EXERCISE AND MENTAL WELL BEING
ACT. WE CAN PROVIDE A NEW
OPPORTUNITY TO MARGINALIZED
COMMUNITIES MOST AFFECTED BY
DIABETES, HEART DISEASE AND
OTHER CHRONIC ILLNESSES,
EXPANDING ACCESS TO PHYSICAL
ACTIVITY OPPORTUNITIES WILL HELP
COUNTLESS CALIFORNIANS CREATE
LIFELONG HABITS THAT WILL PROVE
THEIR AND THEIR CHILDREN'S
LIVES. FOR THESE REASONS. WE ARE
A STRONG SUPPORTER OF THE BILL,
AND WE ASK FOR YOUR VOTE. THANK
YOU VERY MUCH OTHERS IN SUPPORT.
GOOD AFTERNOON, JAMIE MORGEN ON
BEHALF OF THE AMERICAN HEART
ASSOCIATION AND SUPPORT THANK
YOU. MR CHAIR MEMBERS TO MADDEN,
REPRESENTING THE CALIFORNIA
CHAPTER OF THE AMERICAN COLLEGE
OF CARDIOLOGY AND SUPPORT. THANK
YOU. TAYLOR JACKSON,
REPRESENTING CALIFORNIA HEALTH
PLUS ADVOCATES CALIFORNIA'S
COMMUNITY HEALTH CENTERS IN
STRONG SUPPORT. HI THERESA ORGAN
WITH CALIFORNIA HEALTH,
COLLABORATIVE AND SUPPORT AND
ALSO AS AN INDIVIDUAL LIVING
WITH TYPE ONE DIABETES FOR 44
YEARS. AND AN A ONE C OF NEARLY
NORMAL SUPPORT. THANK YOU. ALEX
CON ON BEHALF OF THE CALIFORNIA
CHRONIC CARE COALITION AND
SUPPORT THANK YOU. IS THERE
OPPOSITION TO THE BILL? SEE NO
ONE BRING BACK TO THE COMMITTEE.
QUESTIONS ARE COMING TO THE
COMMITTEE, MS WALDRON. THANK
YOU, UM ADDING FITNESS AND
PHYSICAL ACTIVITY AND
RECREATIONAL SPORTS. AH! TO
MEDICAL IS I FEEL REALLY
MEDICALLY APPROPRIATE WHEN I
LOOK BACK, YOU KNOW YOU CONSIDER
LOOKING AT A HOLISTIC APPROACH
TO HEALTH, ESPECIALLY
PREVENTION. NOT LOOKING AT
PHYSICAL FITNESS AND THE TYPES
OF THINGS THAT ACTUALLY PROMOTE.
OR EVEN MAYBE DELAY. UM THE
ONSET OF SOME TYPES OF THIS
DISEASE IS REALLY IMPORTANT. UM,
PART OF LOOKING HOLISTICALLY AT
HEALTH. MY BROTHER IS A
PHYSICIAN WHEN HE WENT TO
MEDICAL SCHOOL. THEY DIDN'T EVEN
LOOK AT NUTRITION. AND I DON'T
KNOW IF THEY DO NOW IN MEDICAL
SCHOOL, BUT IT JUST SEEMS LIKE
YOU'RE MISSING A WHOLE SEGMENT
OF YOU KNOW WHAT HEALTH IS
ABOUT? WITHOUT LOOKING AT ALL OF
THOSE THINGS HOLISTICALLY, SO WE
KNOW THE BENEFITS OF PHYSICAL
FITNESS. UM AND THAT INCLUDES
MENTAL HEALTH. SUPPORT AS WELL.
SO I'LL BE SUPPORTING YOUR BILL.
THANK YOU. THANK YOU. THANK YOU,
MADAM. VICE CHAIR. ANYONE ELSE?
I WAS BERNARD, YOU HAVE A
COMMENT? YES THANK YOU. UM I
REALLY APPRECIATE YOU BRINGING
THIS FORWARD TO SOMEBODY WHO'S
GONE, UNDERGONE A HEALTH JOURNEY
IN THE LAST YEAR AND A HALF. UM
I CAN SAY IT MIGHT BE A MAYA'S
TEMPLE. 10 POINTS LOWER NOW, AND
I FEEL MUCH HEALTHIER AND I KNOW
I'M GOING TO LIVE LONGER BEFORE
BECAUSE OF IT, BUT I KNOW IT'S
ALSO BECAUSE I COULD AFFORD
ACCESS. TO THE HEALTH AND
WELLNESS SERVICES TO BE ABLE TO
GO ON THAT JOURNEY, SO I REALLY
APPRECIATE THE AUTHOR FOR
BRINGING THIS FORWARD AND THE
SPONSORS AND WOULD LIKE TO BE
ADDED AS A CO AUTHOR AT THE
APPROPRIATE TIME, THANK YOU FOR
THOSE COMMENTS AND WOULD BE
HONORED TO HAVE YOU THANK YOU.
THANK YOU ANYONE ELSE? THE BILL
DOES ENJOY DO PASS
RECOMMENDATION. AND, UM AS YOU
MAY HAVE HEARD, I BEEN WAITING
FOR A LONG TIME FOR A QUORUM,
WHICH WE DON'T HAVE. YEAH
APPROACHING, UH, 4.5 HOURS NOW.
UH WE'RE 3.5. I DON'T KNOW WHERE
IT'S A LONG TIME ANYWAY. UM,
WOULD YOU LIKE TO CLOSE MS
PETRIE? THANK YOU, MR CHAIR. AND
THANK YOU MEMBERS FOR YOUR
COMMENTS. UM THIS SPELL IS
REALLY A WIN WIN. IT'S A WIN FOR
OUR CONSTITUENTS. IT'S A WIN FOR
CALIFORNIA SO AT THE APPROPRIATE
TIME, I WOULD RESPECTFULLY ASK
FOR YOUR VOTE. THANK YOU. THANK
YOU VERY MUCH. I SEE NO OTHER
AUTHORS. I'LL GO BACK AND DO MY
OTHER BILL AND TURN THIS BACK
OVER TO MADAM VICE CHAIR.
OKAY WE WILL MOVE TO A B. 15 37
CHAIRMAN WOULD PRESENT. THANK
YOU, MADAM VICE CHAIR AND
MEMBERS. UM THIS BILL MAKES SOME
IMPORTANT CHANGES IN HOW SKILLED
NURSING FACILITIES WILL MANAGE
THEIR MONEY. AND IT WILL IMPROVE
THE QUALITY OF CARE THAT
RESIDENTS RECEIVE. THE BILL
REQUIRES A FACILITY TO SPEND 85%
OF ITS TOTAL REVENUES ON DIRECT
PATIENT CARE. MUCH THE SAME WAY
THAT INSURANCE COMPANIES ARE
ALREADY REQUIRED TO PUT 85% OF
REVENUES INTO PATIENT CARE
THROUGH THE USE OF MEDICAL LOSS
RATIOS, OR MLRS. DIRECT PATIENT
CARE INCLUDES AN APPROPRIATELY
SO STAFFING WAGES, BENEFITS
THERAPY SUPPLIES, PHARMACY PLANT
OPERATION AND MAINTENANCE,
LAUNDRY, DIETARY AND ALL OF THE
THINGS THAT DIRECTLY BENEFIT A
RESIDENT OF A NURSING HOME. NON
DIRECT CARE WON'T COUNT TOWARDS
THAT 85% SPENDING REQUIREMENT
AND INCLUDES ADMINISTRATIVE
COSTS. EXECUTIVE WAGES PAYMENTS
TO MANAGEMENT COMPANIES, HOME
OFFICE EXPENSES FOR PARENT
COMPANIES AND PROFITS PAID TO
CONTRACTORS OR RELATED PARTY
ENTITIES, AMONG OTHER THINGS.
RELATED PARTY COMPANIES ARE
AFFILIATED WITH THE SKILLED
NURSING FACILITY, OWNERSHIP OR
SNIFF THEY THEY USED TO SIPHON
PROFITS, OFTEN PAYING THEMSELVES
MUCH MORE THAN THE COSTS ALLOWED
BY MEDICAL AND MEDICARE. FOR
EXAMPLE, I DON'T WANT FACILITY
OWNERS TAKING ADVANTAGE OF
LOOPHOLES THAT ALLOW COMPANIES
THAT OWN S¼ BY FACILITIES USE A
RELATED ENTITY. THEY ALSO OWN TO
BUILD THOUSANDS EVERY MONTH IN
ADMINISTRATIVE FEES OR USING A
LAUNDRY COMPANY THAT THEY ALSO
OWN TO BUILD EACH OF THEIR
FACILITIES. WHAT MAY BE OVER
MARKET FEES FOR SERVICE FOR THE
SERVICE. I'M IN CONVERSATIONS
WITH THE ADMINISTRATION ON HOW
BEST TO IMPLEMENT THE PAYMENT
CLAWBACKS, WHICH WERE CONCERNED
WITH THE BILL I AUTHORED LAST
YEAR ON THIS SUBJECT AND
CONFIDENT WE WILL COME UP WITH A
SOLUTION. I'M GONNA STOP HERE.
I'M GONNA GIVE MY WITNESS A
CHANCE TO COVER ANYTHING. I'VE
MISSED. DR WHITE. MICHAEL
WASSERMAN IS THE IMMEDIATE PAST
PRESIDENT OF THE CALIFORNIA
ASSOCIATION OF LONG TERM CARE
MEDICINE. THANK YOU. DR
WESTERMAN. THANK YOU. CHAIRMAN
WOULD COMMITTEE MEMBERS, UM, ON
BEHALF OF CAL TCM? I'M
TESTIFYING IN SUPPORT OF A B 15
37. WE ARE CALIFORNIA'S MEDICAL
VOICE FOR LONG TERM CARE. OUR
MEMBERS CARE DEEPLY ABOUT
QUALITY. DEDICATED
ADMINISTRATORS AND DIRECTORS OF
NURSING STRUGGLE DAILY WITH
FINANCIAL PRESSURES THAT
CONTRIBUTE TO INADEQUATE
STAFFING LEVELS AND POOR
CLINICAL QUALITY UNDER RESOURCED
HOMES ARE LESS PREPARED TO DEAL
WITH INFECTIONS. WE HAVE
WITNESSED THE TRAGIC
CONSEQUENCES OF A BADLY BROKEN
SYSTEM DURING THE PANDEMIC. MANY
VULNERABLE ELDERS SUFFERED AND
DIED UNNECESSARILY. IS IT TOO
MUCH TO ASK THAT WE RESPECT THE
DIGNITY AND LIVES OF THOSE WHO
REQUIRE CARE IN NURSING HOMES?
ENSURING THAT REVENUE IS
APPROPRIATELY BUDGETED TOWARDS
CARE COULD HAVE PREVENTED SUCH
LOSS. THE NURSING HOME INDUSTRY
IS GOING TO TELL YOU THAT THIS
BILL IS ONEROUS AND UNNECESSARY
. THEY ARE GOING TO TELL YOU
THAT ALL THEY NEED IS MORE
MONEY. TO THAT I SAY, FOOL ME
ONCE. SHAME ON YOU FOR ME TWICE.
SHAME ON ME. A SIGNIFICANT
PORTION OF TAXPAYER DOLLARS
MEANT FOR THE HEALTH AND WELL
BEING OF VULNERABLE NURSING HOME
RESIDENTS ARE NOT BEING USED FOR
THAT PURPOSE. TRANSPARENCY IS
ONLY THE FIRST STEP, TAXPAYER
DOLLARS MUST BE APPROPRIATELY
SPENT ON THE DIRECT CARE OF
RESIDENTS PRIORITIZING EXCESSIVE
REAL ESTATE AND RELATED PARTY
PROFITS. OVER THE HEALTH AND
WELL BEING OF VULNERABLE ELDERS
IS UNACCEPTABLE. CALIFORNIA
NURSING HOME PROFITS INCREASED
BETWEEN 2019 AND 2020, WHILE
THOUSANDS OF RESIDENTS LOST
THEIR LIVES. NURSING HOME OWNERS
SHOULD BE HELD ACCOUNTABLE. FOR
HOW TAXPAYER DOLLARS ARE SPENT.
BY LIMITING EXCESSIVE
ADMINISTRATIVE, REAL ESTATE AND
RELATED PARTY PROFIT NURSING
HOMES CAN REALLOCATE THEIR
REVENUES TO FOCUS ON THE HEALTH
CARE NEEDS OF MEDICALLY COMPLEX
INDIVIDUALS. IT'S TIME TO
COMBINE FULL TRANSPARENCY WITH
ACCOUNTABILITY. A B 15 37
INSURERS THAT TAXPAYER DOLLARS
ARE FOCUSED. ON THE CARE OF
VULNERABLE ELDERS IN THE WAKE OF
THE COVID 19 PANDEMIC, AND IT'S
TRAGIC OUTCOMES IN NURSING
HOMES. WE CAN NO LONGER AFFORD
TO TRUST THE INDUSTRY WITH OUR
PRECIOUS TAX DOLLARS. I
RESPECTFULLY ASKED FOR YOUR I
VOTE ON A B 15 37. ARE THERE ANY
OTHER WITNESSES IN SUPPORT?
THING NONE. WITNESSES AND
OPPOSITION. THING NONE COMMENTS
QUESTIONS COMMITTEE MEMBERS.
WAITING FOR A MOTION DOCTOR.
WOULD WOULD YOU LIKE TO CLOSE?
WELL, YOU DON'T HAVE A QUORUM.
CHRISTIAN APPRECIATE THE
THOUGHT, THOUGH MAYBE MAYBE SOME
MEMBERS WILL COME DOWN. WE'LL BE
ABLE TO GET A QUORUM. UM THANK
YOU. I THINK I'M GONNA THANK MY
WITNESS. AND, UH, I DO. LOOK
FORWARD TO AND I VOTE. I
RESPECTFULLY ASK YOUR I VOTE
WHEN WE HAVE A QUORUM. THANK YOU
VERY MUCH. THANK YOU.
OKAY DR. WEBBER YOU HAVE ITEM
NUMBER 23 A B 10 57. NO THAT
GOOD AFTERNOON. SHARON MEMBERS.
THANK YOU TO THE COMMITTEE CHAIR
AND STAFF FOR THE THOUGHTFUL
CONVERSATIONS LEADING UP TO THIS
HEARING. I AM HERE TO PRESENT A
B 10 57, WHICH WILL CODIFY THE
EXISTING CALIFORNIA HOME
VISITING PROGRAM TO SUPPORT
PREGNANT PEOPLE AND PARENTS WITH
YOUNG CHILDREN WHO LIVE IN
COMMUNITIES THAT FACE RISK AND
BARRIERS TO ACHIEVING POSITIVE
MATERNAL AND CHILD HEALTH
OUTCOMES. THE CALIFORNIA
DEPARTMENT OF PUBLIC HEALTH
ADMINISTERS PROGRAM WITH FUNDS
PROVIDED BY THE MATERNAL INFANT
AND EARLY CHILDHOOD HOME
VISITING PROGRAM, WHICH WAS
ESTABLISHED IN 2010 BY THE
PATIENT PROTECTION AND
AFFORDABLE CARE ACT TO PROVIDE
FUNDS FOR EVIDENCE BASED HOME
VISITING IN EVERY STATE.
FAMILIES CHOOSE TO PARTICIPATE
IN HOME, VISITING PROGRAMS AND
PARTNER WITH HEALTH, SOCIAL
SERVICE AND CHILD DEVELOPMENT
PROFESSIONALS TO PREVENT CHILD
ABUSE, NEGLECT, REDUCE CRIME,
DOMESTIC VIOLENCE AND PROMOTE
CHILDREN'S DEVELOPMENT AND
READINESS TO PARTICIPATE IN
SCHOOL. HOME VISITORS AND
FAMILIES DEVELOP STRONG
RELATIONSHIPS AND TRUST THROUGH
MEETING REGULARLY AND ADDRESSING
FAMILY'S NEEDS, INCLUDING BY
CONNECTING THEM TO NEEDED
COMMUNITY RESOURCES AND SUPPORT.
THERE ARE CURRENTLY 20 HOME
VISITING MODELS UNDER THE
FEDERAL HOME VISITING PROGRAM.
ALL 20 MODELS HAVE BEEN
THOROUGHLY REVIEWED UNDER THE
HOME VISITING EVIDENCE OF
EFFECTIVENESS. TO ENSURE THAT
MODELS EFFECTIVELY MEET FAMILY
NEEDS. ADDITIONALLY MODELS ARE
REQUIRED TO REPORT ON THEIR
PROGRAMS, PERFORMANCE AND
DEMONSTRATE IMPROVEMENTS IN AT
LEAST FOUR OUT OF SIX
BENCHMARKS. THE CALIFORNIA
DEPARTMENT OF PUBLIC HEALTH HAS
APPROVED THREE MODELS. THE
HEALTH FAMILIES AMERICA NURSE,
FAMILY PARTNERSHIP AND PARENTS
AS TEACHERS ACROSS 34 COUNTIES.
THE THREE MODELS HAVE EXCELLENT
GOALS OF INCREASING PARENT
KNOWLEDGE OF EARLY CHILDHOOD
DEVELOPMENT, IMPROVING PARENTAL
PRACTICES AND PREVENTING CHILD
ABUSE AND NEGLECT. MAYBE 10 57
SEEKS TO EXPAND MODELS THAT THE
CALIFORNIA DEPARTMENT OF PUBLIC
HEALTH ADMINISTERS WITHOUT
DISRUPTING THE MODELS THAT WE
USE TODAY. GIVING COUNTY HEALTH
DEPARTMENTS THE FLEXIBILITY TO
IMPLEMENT OTHER FEDERALLY
APPROVED MODELS TO RESPOND TO
THE UNIQUE NEEDS OF THEIR
COMMUNITIES. FURTHERMORE THIS
BILL ALLOWS LOCAL HEALTH
DEPARTMENTS TO SUBMIT AND
ALTERNATIVE PUBLIC HEALTH
NURSING MODEL TO TARGET A
DISTINCTIVE NEED IN THE
COMMUNITY, SUCH AS PREGNANT
PERSONS OR NEW PARENTS
EXPERIENCING HOMELESSNESS.
LASTLY MAYBE 10 57 WILL ALLOW
HEALTH DEPARTMENTS TO INTEGRATE
MENTAL HEALTH SUPPORT IN THEIR
HOME VISITING PROGRAMS A SERVICE
NEEDED MORE THAN EVER AS WE
EMERGE FROM THIS PANDEMIC. THIS
BILL IS SPONSORED BY THE COUNTY
HEALTH EXECUTIVE ASSOCIATION OF
CALIFORNIA AND SUPPORTED BY MORE
THAN 15 COUNTIES AND CITIES.
WITH ME HERE TODAY TO SPEAK IN
SUPPORT OF MAYBE 10 57 ARE
MICHELLE GIBBONS, EXECUTIVE
DIRECTOR OF COUNTY HEALTH
EXECUTIVE ASSOCIATION, AND SOFIA
PEREIRA, PUBLIC HEALTH DIRECTOR
AT HUMBOLDT COUNTY'S HEALTH AND
HUMAN SERVICE. THANK YOU. GOOD
AFTERNOON, CHAIRMAN WOULD AND
MEMBERS OF THE ASSEMBLY HEALTH
COMMITTEE. MY NAME IS SOPHIA
PEREIRA, PUBLIC HEALTH DIRECTOR
IN HUMBOLDT COUNTY. AND WE
SUPPORT MAYBE 10 57. IN 2009,
HUMBOLDT COUNTY, INITIATED NURSE
FAMILY PARTNERSHIP AND FP AND
EVIDENCE BASED PROGRAM, WHICH
PROVIDES HOME VISITS BY PUBLIC
HEALTH NURSES TO FIRST TIME LOW
INCOME MOTHERS BEGINNING DURING
PREGNANCY AND CONTINUING THROUGH
THE CHILD'S SECOND BIRTHDAY. AS
ONE OF THE 13 ORIGINAL COUNTIES
IN CALIFORNIA TO IMPLEMENT AN FP
HUMBOLDT COUNTY WAS THE SMALLEST
AND MOST RURAL COUNTY TO
INITIATE THE PROGRAM AT THE
TIME. WE CURRENTLY SERVE OVER
130 CLIENTS ABOUT 14% OF OUR
COUNTY'S FIRST TIME MOTHERS. WE
ARE PILOTING A LICENSED CLINICAL
SOCIAL WORKER ADJACENT TO N F P
THIS PILOT HAS ALLOWED US TO
PROVIDE CASE MANAGEMENT AND
MENTAL HEALTH SERVICES WHILE
WORKING ON REFERRAL TO LONG TERM
CARE AFTER THE PROGRAM ENDS. OUR
NURSE HOME. VISITORS DO AN
INCREDIBLE JOB SUPPORTING OUR
CLIENTS, CONNECTING THEM TO
RESOURCES AND INSTILLING
CONFIDENCE IN THEM AS NEW
PARENTS. WE HAD A CLIENT
RECENTLY THAT GREW UP IN A HOME
WITH ABUSE, SMOKING A PACK PER
DAY AND USING CANNABIS DAILY
PRIOR TO KNOWING OF HER
PREGNANCY. SHE HAD A HISTORY OF
OTHER DRUG USE PTSD AND
DEPRESSION. SHE EXPERIENCED
DOMESTIC VIOLENCE BY THE FATHER
OF THE BABY, A MEMBER OF A GANG
WITH A HISTORY OF FELONY
CONVICTIONS FOR DOMESTIC
VIOLENCE. WITH THE SUPPORT OF
HER NURSE HOME VISITOR. OUR
CLIENT WAS ABLE TO COMPLETE ALL
OF HER OBE CARE AND DELIVER A
HEALTHY BABY. ADDITIONALLY SHE
WAS ABLE TO DECREASE OR TOBACCO
USED TO 1 TO 2 CIGARETTES PER
DAY, STOP HER CANNABIS USE AND
HAS BEEN SUCCESSFULLY
BREASTFEEDING SINCE THE BIRTH.
SHE MAINTAINED HER VISITS WITH
HER NURSE AND TOOK HER CHILD TO
EVERY WELL, CHILD. CHECK. CHECK
ON TIME. SHE'S SUCCESSFULLY
COMPLETED, HER COURT ORDERED
COMMUNITY SERVICE HOURS,
ENROLLED IN COMMUNITY COLLEGE
AND GAINED EMPLOYMENT. OUR NF P
PROGRAM SHOWS THE IMPACT WE THAT
WE ARE IMPACTFUL AND SERVING OUR
CLIENTS AND THEIR BABIES.
HOWEVER WE KNOW THE NEED IS WELL
BEYOND THOSE WHO ARE FIRST TIME
MOTHERS AND THE NEEDS OF MOTHERS
ARE DIVERSE. WITH A B 10 57. THE
EXPANSION OF MODELS LISTED WOULD
ALLOW US TO EXPAND OUR NURSE
HOME VISITING PROGRAMS TO
ADDRESS ADVERSE CHILDHOOD
EXPERIENCES IN OUR COMMUNITY FOR
THE 0 TO 3 AGED POPULATION FOR
MORE THAN JUST FIRST TIME
MOTHERS. MODELS LIKE THE
MATERNAL INFANT HEALTH PROGRAM
AND FAMILY CONNECTS WOULD HELP
US TO ACTUALLY BE UNIVERSAL HOME
VISITING IN OUR COUNTY. THE
ABILITY FOR PUBLIC HEALTH
DEPARTMENTS TO CONSIDER VARIOUS
MODELS INCREASES ACCESS,
ESPECIALLY IN RURAL COMMUNITIES.
WE THANK DR WEBBER FOR
INTRODUCING THIS IMPORTANT
MEASURE AND URGE YOU TO VOTE IN
FAVOR OF A B 10 57 THANK YOU FOR
THE OPPORTUNITY TO SPEAK ON
BEHALF OF HUMBOLDT COUNTY PUBLIC
HEALTH. THANK YOU VERY MUCH.
GOOD AFTERNOON TO YOU REMEMBERS
MICHELLE GIBBONS WITH THE COUNTY
HEALTH EXECUTIVES ASSOCIATION OF
CALIFORNIA. WE ARE THE PROUD
SPONSORS OF AB 10 57, AND I WANT
TO SHARE OR START BY SHARING MY
OWN EXPERIENCE ON A PUBLIC, UH,
HOME VISIT RIGHT ALONG THE
PUBLIC HEALTH NURSE DROVE ME TO
A MOTEL WHERE SHE VISITED IT A
NEW MOTHER WITH HER CHILD WHO IS
ROUGHLY 18 MONTHS OLD. THE TWO
WERE RECENTLY EXPERIENCING
UNSTABLE HOUSING AND THE PUBLIC
HEALTH NURSE HELPED TO FIND
VOUCHERS SO THAT THE MOM AND THE
BABY COULD HAVE A HOTEL. STAY AT
THE TIME. WHEN WE ARRIVED ON,
NEVER FORGET I SAW THE MOM COOK
A FULL MEAL IN A COFFEE MAKER.
SHE WAS STEAMING VEGETABLES AT
THE TOP OF THE COFFEE MAKER AND
BOILING NOODLES. WITHIN THE PART
, THE PART THAT YOU POUR, UM AND
THIS WAS BECAUSE SHE WAS REALLY
TRYING TO INTEGRATE HEALTHIER
FOOD OPTIONS BASED ON THE
CONVERSATIONS AND THE ENCOUNTERS
AND EXPERIENCES WITH THE PUBLIC
HEALTH NURSE. I ALSO WATCHED THE
PUBLIC HEALTH NURSE SIT ON THE
FLOOR WITH THE BABY AND DO
DIFFERENT DEVELOPMENTAL PLAY
ACTIVITIES TO ASSESS THE
DEVELOPMENTAL GROWTH OF THE
CHILD. SOMETHING THAT THE MOM
HAD EXPRESSED CONCERNS WITH AND
SOMETHING THAT THEY HAD A CARE
PLAN TO WORK, UH ON AND TRY TO
INCORPORATE, INCLUDING READING
BOOKS AND ALSO SHOWING THE MOM
HOW TO INCORPORATE THOSE
DIFFERENT STRATEGIES AND HELPING
THE BABY TO REACH THE AGE
APPROPRIATE MILESTONES. UH THIS
IS JUST A SNAPSHOT OF THE
CRITICAL WORK THAT HAPPENS IN
THE CALIFORNIA HOME VISITING
PROGRAM. WE SURVEYED OUR LOCAL
HEALTH DEPARTMENTS ABOUT THE
FLEXIBILITIES THAT THEY NEED AND
WHY THEY ARE ASKING FOR
DIFFERENT MODELS IN WHICH MODELS
WOULD BE OF INTEREST OF THE
EVIDENCE BASED MODELS. A COUPLE
OF EXAMPLES, I'LL GIVE YOU ONE
ONE IS THAT EARLY INTERVENTION
PROGRAM FOR ADOLESCENT MOTHERS.
THIS FOCUSES ON LATINO AND
AFRICAN AMERICAN ADOLESCENT MOMS
, AND IT WORKS WITH THOSE YOUNG
MOTHERS ON VARIOUS AREAS,
INCLUDING THEIR HEALTH, FAMILY
PLANNING AND LIFE SKILLS. OTHERS
WERE INTERESTED IN A MODEL THAT
WAS MORE GEARED TOWARDS THE
NATIVE AMERICAN POPULATION.
THERE'S ONE CALLED FAMILY
SPIRITS. IT PROVIDES SUPPORT TO
FAMILIES IN A MORE CULTURALLY
COMPETENT MANNER TO ADDRESS THE
DISPARITIES THERE. EVIDENCE
BASED MODELS ALSO REQUIRE
FIDELITY TO THE MODEL, WHICH
MEANS THAT YOU NEED TO HAVE A
FAMILY WHO CAN MEET REGULARLY
THAT YOU CAN FIND REGULARLY. UH
AND ALSO THAT YOU CATCH BETWEEN
WEEK 28, FOR EXAMPLE, IN ONE OF
THE MODELS. THAT MAY NOT BE THE
CASE, YOU MAY HAVE MOTHERS WHO
ARE EXPERIENCING HOMELESSNESS
AND YOU DON'T CATCH THEM UNTIL
THEY HAVE ALREADY HAD THE BABY
AND WE NEED THE FLEXIBILITY TO
BE ABLE TO SERVE THOSE MOMS AS
WELL. UH THE ONLY THING THE
OTHER THING I WOULD JUST MENTION
IS THAT I WATCHED A CLOSE FAMILY
MEMBERS STRUGGLE WITH POSTPARTUM
DEPRESSION. SHE ACTUALLY HAD
JUST HAD TWINS AND THE REALITY
WAS IS LIKE GETTING HER TO GO
GET THE SUPPORT SOMEWHERE ELSE.
OUTSIDE OF THE HOME WAS A REAL
CHALLENGE. IMAGINE HAVING A
PUBLIC HEALTH NURSE WHO COME
INTO THE HOME AND REALLY HELP
HER IDENTIFY THE CHALLENGES AND
TO BE ABLE TO HAVE SUPPORTS TO
CONNECT HER TO SERVICES. THAT'S
WHAT WE'RE HOPING TO HAVE THEIR
BABY 10 57 WE WANT TO DO WE SEE
THESE MOMS FIRST WE'RE IN THEIR
HOMES, AND WE CAN HELP ADDRESS
SOME OF THE CHALLENGES THAT
THEY'RE EXPERIENCING AND CONNECT
THEM TO SERVICES RIGHT AWAY. AND
SO THESE ARE THE FLEXIBILITIES
IN THE NEEDS THAT LOCAL HEALTH
DEPARTMENTS HAVE IDENTIFIED AND
WHY WE ARE STRONGLY IN AND
PLEASED TO SUPPORT A B 10 57.
THANK YOU. THANK YOU VERY MUCH
OTHERS IN SUPPORT. GOOD EVENING,
LINDA WAY WITH WESTERN CENTER ON
LAW AND POVERTY AND SUPPORT.
THANK YOU. DAVID BULLOCK, LOS
ANGELES AND SUPPORT THANK YOU.
BRIAN SPENCER, AMERICAN COLLEGE
OF O B. G. Y. N S DISTRICT NINE
AND SUPPORT. GOOD AFTERNOON,
KIRA ROSS ON BEHALF OF THE CITY
OF PASADENA, AND SUPPORT THANK
YOU. THANK YOU, MR CHAIR AND
MEMBERS AARON TAYLOR ON BEHALF
OF THE COUNTY OF ALAMEDA AND THE
COUNTY OF SAN MATEO IN STRONG
SUPPORT. KELLY BROOKS ON BEHALF
OF THE URBAN COUNTIES OF
CALIFORNIA, THE RURAL COUNTY
REPRESENTATIVES OF CALIFORNIA
AND THE BOARDS OF SUPERVISORS OF
SANTA CLARA AND VENTURA COUNTIES
ALL IN SUPPORT. GOOD AFTERNOON
CHAIR AND MEMBERS AMARU SHED
WITH THE COUNTY BEHAVIOR HEALTH
DIRECTORS ASSOCIATION OF
CALIFORNIA AND SUPPORT THANK
YOU. JEFF NEAL, ON BEHALF OF THE
COUNTY OF CONTRA COSTA AND ON
BEHALF OF MY COLLEAGUES AT THE
CALIFORNIA STATE ASSOCIATION OF
COUNTIES AND SUPPORT. THANK YOU.
AS HE'S WHEN THEY'RE ON BEHALF
OF THE BORDER SUPERVISORS OF
HUMBOLDT COUNTY, MENDOCINO
COUNTY, NEVADA COUNTY IN FRESNO
COUNTY. THANK YOU. THANK YOU.
ANYONE ELSE? THEIR OPPOSITION TO
THE BILL. ACTUALLY I'M BRINGING
BACK TO THE COMMITTEE QUESTIONS
OR COMMENTS ASSEMBLYMEMBER'S
BURNER. YES I WANT TO THANK YOU
FOR BRINGING THIS FORWARD. IT'S
REALLY IMPORTANT. I HAD BOTH OF
MY CHILDREN IN GERMANY AND I HAD
AN IN HOME NURSE THAT CAME EVERY
SINGLE DAY TO MAKE SURE THAT MY
CHILDREN THRIVED WHEN THEY WERE
BABIES. I TOOK ME NINE WEEKS TO
BE ABLE TO NURSE MY SON AND FIVE
WEEKS TO BE ABLE TO NURSE MY
DAUGHTER. YOU KNOW, WE HAD
QUESTIONS ABOUT FAILURE TO
THRIVE AND ALL THESE THINGS AND
YOU KNOW, IT'S SO IMPORTANT.
IT'S SUCH A GOOD USE OF MONEY TO
MAKE SURE THAT BABIES AND
MOTHERS ARE THRIVING AT THE VERY
BEGINNING, SO AT THE APPROPRIATE
TIME, I'D LOVE TO BE ADDED AS A
CO AUTHOR AS WELL. THANK YOU
ANYONE ELSE? NO ONE OF THEM WAS
A THANK YOU VERY MUCH DOCTOR
WEBER FOR BRINGING THIS BILL
FORWARD. IT DOES ENJOY DO PAST
RECOMMENDATION WHERE A QUORUM
THAN WE'VE BEEN ALL DAY. WELL,
NOT REALLY. BUT WE'RE GETTING
THERE. UM AND, UM I WANNA SAY
IT, UH, HELLO TO US WHEN MY
CONSTITUENTS WHO CAME DROVE THE
LONG DISTANCE FROM HUMBOLDT
COUNTY. THANK YOU VERY MUCH FOR
BEING HERE, MADAM DIRECTOR UM,
WOULD YOU LIKE TO CLOSE DR
WEBBER? I'M SORRY BEFORE YOU
CLOSE ACCEPTING THE AMENDMENTS.
YES, THANK YOU. I JUST WANT TO
THANK AGAIN THE COMMITTEE FOR
ALLOWING THIS BILL TO BE HEARD.
UM THE HOME VISITING PROGRAM IS
DESIGNED TO BE PREVENTATIVE
INTERVENTION FOR VULNERABLE
COMMUNITIES. AS YOU'VE HEARD, IT
IS TRULY SETTING UP FAMILIES
FOR, UM, BEING SUCCESSFUL, IT IS
TRULY CREATING HEALTHY
INDIVIDUALS, HEALTHY FAMILIES
AND HEALTHY FUTURE. UM IT IS
FURTHERING CALIFORNIA'S GOAL OF
HEALTH AND EQUITY FOR ALL AND
OPTIMIZING HEALTH OUTCOMES FOR
EVERYONE, REGARDLESS OF THEIR
SOCIAL ECONOMIC STATUS. AND SO
FOR THAT, I RESPECTFULLY ASK FOR
YOUR I VOTE. THANK YOU VERY
MUCH, DOCTOR, WEBER AND WELL.
HOPEFULLY GET A QUARRYMEN
EMOTION AND BE ABLE TO MOVE YOUR
BILL. THANK YOU. MR MCCARTY. NO,
WE STILL HAVE ONE MORE AFTER
YOU.
ALL RIGHT. WE HAVE A B 13 60.
BEFORE US. AND WE HAVE
AMENDMENTS ARE ACCEPTING OUR
AMENDMENTS. YES THANK YOU. AND I
WILL BE ACCEPTING THE AMENDMENTS
AND THANK YOU AND YOUR TEAM FOR
WORKING WITH US. AND THIS IS A
BILL THAT THAT SOME OF YOU MAY
REMEMBER. WE'VE ADDRESSED THIS
ISSUE BEFORE THIS BILL BEFORE,
AND THIS IS KIND OF A CROSS
PUBLIC SAFETY HEALTH BILL WENT
TO THE PUBLIC SAFETY COMMITTEE
LAST WEEK'S RELATING TO A
SUBSTANCE USE DISORDER AND HOW
INTER PLAYS WITH THE CRIMINAL
JUSTICE SYSTEM. AND THAT'S KIND
OF OUR POINT. PEOPLE DON'T GET
WELL WHEN THEY GO AND SERVE A
LONG SENTENCE IN A COUNTY JAIL
OR STATE PRISON AND THEY HAVE A
DRUG ADDICTION. MANY TIMES THEY
COME OUT. YOU KNOW THE SAME
ADDICTION AND GO BACK TO WHERE
THEY WERE IN THE FIRST PLACE, SO
THIS WOULD CREATE AN INNOVATIVE
PILOT PROJECTS. PROGRAM A FIVE
YEAR PILOT, ALLOWING TWO
COUNTIES SACRAMENTO AND YOLO TO
PROVIDE VOLUNTARY TEMPORARY
CONFINED TREATMENT FOR THOSE
ELIGIBLE. UH PAST VERSIONS OF
THIS BILL HAVE BEEN BIPARTISAN
AND ASK FOR THAT CONSIDERATION
AGAIN TODAY, JUDGES CAN OFFER
INDIVIDUALS PARTICIPATION IN
THIS PROGRAM BASED UPON
RECOMMENDATIONS, UH, FROM
TREATMENT PROVIDERS AND THE
LOCAL D A. WHICH WE HAVE HERE
TODAY. THE YOLO COUNTY D. A AH,
YOU KNOW, WE KNOW THE CURRENT
SYSTEM IS NOT ALWAYS WORKING.
PRISONS AND JAILS ARE NOT THE
PLACE TO GET TREATMENT FOR
ADDICTION. UH, INDIVIDUALS COME
OUT AND MANY TIMES GET RIGHT
BACK IN THAT ON THAT VICIOUS
CYCLE. UH WE'RE AWARE OF
CONCERNS AND OPPOSITION AND TO
THIS IDEA WE'VE TAKEN OVER 50
AMENDMENTS IN THE PAST TWO
YEARS, INCLUDING ISSUES WE'RE
ADDRESSING HERE TODAY. AND I
GUESS I'LL ASK THE SAME QUESTION
TO OTHERS THROUGHOUT CALIFORNIA
IS WHAT'S THE ALTERNATIVE
BECAUSE THE CURRENT SYSTEM ISN'T
ALWAYS WORKING WITH PEOPLE
CYCLING THROUGH THE SYSTEM. WITH
THE INTERPLAY OF ADDICTION AND
COMMITTING, UH, OFFENSES THAT
HAVE MULTI YEAR AND MULTI MONTH
UH, PRISON SENTENCES, ADDICTION
CRISIS IS COMPLEX AND NOT GOING
AWAY, AND THIS WILL PROVIDE AN
INNOVATIVE OPPORTUNITY TO LOOK
AT A SOLUTION RIGHT HERE IN THE
SACRAMENTO CAPITAL REGION,
SPONSORED BY THE YOLO COUNTY
DISTRICT ATTORNEY AS WELL AS THE
COUNTY OF YOLA AND WITH ME TODAY
IS MR JONATHAN RAVEN, CHIEF
DEPUTY D A. FROM YELLOW COUNTY.
THANK YOU. GOOD AFTERNOON OR
MAYBE GOOD EVENING CHAIR AND
MEMBERS. UM AS THE ASSEMBLY
MEMBER SAID. MY NAME IS JONATHAN
RAVEN. I'M THE CHIEF DEPUTY OF
THE YELLOW COUNTY DISTRICT
ATTORNEY'S OFFICE. I'M ALSO
CHAIR OF THE LOCAL MENTAL HEALTH
BOARD AND YELLOW COUNTY. TOO
MANY PEOPLE WHO SUFFER FROM
SERIOUS SUBSTANCE ABUSE
DISORDERS ARE GOING TO PRISONS
AND JAILS. THAT ARE MOTIVATED BY
THEIR ADDICTION. PRISONS AND
JAILS ARE NOT THE PLACE WHERE
PEOPLE WHO ARE NOT WELL GO TO
GET BETTER. AND WE ALL KNOW THAT
AND WHAT WE'RE DOING IN
CALIFORNIA RIGHT NOW SIMPLY
ISN'T WORKING. WE HAVE REVOLVING
DOOR. MAYBE 13 60 PROPOSES A
LOCAL TREATMENT ALTERNATIVE TO
PRISON AND JAIL. FOR THOSE
PEOPLE WHO HAVE BEEN CONVICTED
OF FELONY LEVEL CRIMES MOTIVATED
BY THEIR SERIOUS ADDICTION TO
DRUGS. OPPOSED TO MUCH OF A RISK
FOR A JUDGE TO SIMPLY RELEASE
THEM INTO AN UNSECURED
RESIDENTIAL FACILITY IN THE
COMMUNITY WHERE THEY CAN SIMPLY
WALK OR CRAWL AWAY OUT OF A
WINDOW ON DAY ONE AND
POTENTIALLY CAUSE MORE HARM TO
THEMSELVES AND OTHERS INSTEAD OF
A B. 13 60 ENVISIONS CREATING A
SECURE HOSPITAL LIKE TREATMENT
ENVIRONMENT. WITHOUT JAIL BARS
AND GUARDS WITH GUNS THAT CAN
SERVE AS A SANCTUARY FOR
SERIOUSLY ADDICTED FELONY
OFFENDERS WHO VOLUNTARILY CHOOSE
TO TRY LOCAL COMMUNITY BASED
TREATMENT AND WRAP AROUND
SERVICES IN A SAFE AND SECURE
SETTING, INSTEAD OF MERELY BEING
WAREHOUSE BEHIND BARS. WE CALL
THIS POTENTIAL PLACE OF
CALIFORNIA. WHAT ALSO MAKES THIS
TREATMENT ALTERNATIVE UNIQUE IS
THAT IT WILL BE DESIGNED AND
STAFFED BY TREATMENT PROVIDERS,
AND THEY WILL DECIDE WHO IS AN
APPROPRIATE CANDIDATE AND WHO IS
NOT. AND WHAT THE DOSAGE OF
TREATMENT WILL LOOK LIKE. FOR
THOSE WHO SUCCESSFULLY CHOOSING
COMPLETE TREATMENT OVER PRISON.
THEY WILL HAVE THEIR CONVICTIONS
EXPUNGED AND GET A PLATE CLEAN.
START RIGHT HERE AT HOME.
ULTIMATELY A B 13 60 IS A VERY
MEASURED BILL IN JUST TWO
COUNTIES SACRAMENTO AND YOLO
THAT IS DESIGNED TO OFFER A
VOLUNTARY TREATMENT ALTERNATIVE
TO THOSE WHO ARE OTHERWISE ON
THEIR WAY TO PRISON OR JAIL. I
WOULD URGE THIS COMMITTEE TO
GIVE THIS PROGRAM A CHANCE AND
SUPPORT THE BILL. THANK YOU.
THANK YOU VERY MUCH OTHERS IN
SUPPORT. JEFF NEAL ON BEHALF OF
YOLO COUNTY. UH, AS A WHOLE,
ALSO IN SUPPORT. THANK YOU. IS
THERE OPPOSITION TO THE BILL?
COME ON.
RIGHT AND GOOD EARLY EVENING
CHAIR AND MEMBERS. I'M ALICIA
BENAVIDEZ, LOUIS REPRESENTING
DRUG POLICY ALLIANCE, A NATIONAL
ORGANIZATION THAT ADVOCATES FOR
DRUG POLICY BASED ON SCIENCE,
COMPASSION, HEALTH AND HUMAN
RIGHTS HERE AGAIN IN OPPOSITION
TO 13 60, A BILL THAT AIMS TO
ESTABLISH THE LOCK TREATMENT
FACILITIES IN SACRAMENTO AND
YELLOW COUNTIES, AND I'VE BEEN
HERE FOR SEVERAL TIMES BEFORE SO
I KNOW THAT WE HAVE RAISED
CONCERNS OVER THE YEARS AND
CONTINUE TO DO SO. HAVE BEEN
SEVERAL ATTEMPTS OF THIS MEASURE
IN SIMILAR TO THE VERSION FROM
LAST YEAR. WE THINK IT'S STILL
FAILS TO ADDRESS THE CONCERNS OF
THE GOVERNOR'S VETO MESSAGE FROM
TWO YEARS AGO THAT COURSE
TREATMENT FOR SUBSTANCE USE
DISORDER IS STILL NOT THE
ANSWER. THE PROPOSED LANGUAGE
THAT WOULD ALLOW A JUDGE TO FIND
A PERSON'S DECISION TO
PARTICIPATE IN A VALENCE IN A
PILOT PROGRAM IS VOLUNTARY, IS
STILL BASED ON THE FLAWED
ASSUMPTION THAT MANDATED
TREATMENT IS DESIRABLE AND
EFFECTIVE WHEN ALL RESEARCH
SHOWS THE CONTRARY. YOUR MAIN,
DEEPLY CONCERNED THAT 13 60 WILL
BE IMPLEMENTED IN A RACIALLY
INEQUITABLE MANNER LEADING TO
THE UNNECESSARY INCARCERATION OF
BLACK AND BROWN INDIVIDUALS.
ARREST RATES FROM 2020
DEMONSTRATE THAT BLACK AND
LATINOS ARE UNFAIRLY TARGETED
FOR DRUG ARRESTS. AND LATINOS
CONSISTENT CONSTITUTED 42.4% OF
ALL FELONY DRUG ARRESTS AND
BLACK AMERICANS MADE UP 13.3% OF
ARRESTS DESPITE MAKING UP ONLY
6.5% OF THE STATE POPULATION.
AND AS WE KNOW, FROM 50 YEARS OF
ENFORCING THE WAR ON DRUGS,
COMMUNITIES OF COLOR HAVE BORNE
THE BRUNT OF THE ENFORCEMENT OF
THE WAR ON DRUGS LEADING TO
DISPROPORTIONATE FORCE TREATMENT
, LONGER JAIL SENTENCES AND
SOMETIMES FATAL OUTCOMES. 13 60
ENFORCES THE FALSE BELIEF THAT
THE ONLY WAY PEOPLE CAN ACCESS
SUBSTANCE USE DISORDER TREATMENT
IS THROUGH ARREST AND
PROSECUTION. SENTENCING A PERSON
TO DRUG TREATMENT INSIDE OF A
LOCKED FACILITY IS STILL
CRIMINALIZATION. IT IS NOT
SUPPORTED BY SCIENTIFIC EVIDENCE
. INSTEAD IT IS INEFFECTIVE,
COSTLY AND DANGEROUS. AND WHILE
THIS IS BEING PERPETUATED AS A
PILOT PROGRAM IN TWO COUNTIES,
IT IS STILL DANGEROUS AND LOCK
TREATMENT FACILITIES IS STILL
CRIMINALIZATION. TREATMENT
PROFESSIONALS RECOMMEND MOVING
AWAY FROM MANDATED TREATMENT
TOWARDS EVIDENCE BASED
APPROACHES THAT WORK INCLUDING
LOW BARRIER COMMUNITY DRUG
TREATMENT, OVERDOSE PREVENTION
PROGRAMS AND CULTURAL,
RESPONSIVE OUTREACH AND
COMMUNITY BASED SETTINGS. WE
REMAIN OPPOSED TO THIS MEASURE
AND ASK FOR YOUR NO VOTE. THANK
YOU VERY MUCH. UH, IS THERE
ANYONE ELSE IN OPPOSITION?
MEMBER SHED WITH THE COUNTY
BEHAVIOR. HEALTH DIRECTORS
ASSOCIATION RESPECTFULLY
OPPOSED. THANK YOU. THANK YOU
BEFORE WE BRING IT BACK TO THE
COMMITTEE FOR QUESTIONS OR
COMMENTS. WE HAVE THAT LONG
AWAITED FOR QUORUM. SO I WAS
SECRETARY. PLEASE QUICKLY CALL
THE ROLE WOULD WALDRON CURRY
ARAMBULA. BURNER. CARILLO. LARA.
THAT'S FONG MAIENSCHEIN
MCCARTHY. PATERSON. RODRIGUEZ.
SANTIAGO. VALLAPUDUA WEBER.
ALRIGHT WHEN IT RAINS, IT POURS
NOW WE GOT A BUNCH OF PEOPLE. UM
BUT BACK TO THE COMMITTEE OF
QUESTIONS OR COMMENTS, QUESTIONS
OR COMMENTS FOR MR MCCARTHY. SEE
NONE. UM BILL DOES ENJOY DO PASS
RECOMMENDATION, MR. MCCARTY. UM,
WE ACTUALLY HAVE A QUORUM. WOULD
YOU LIKE TO CLOSE? UH THANK YOU
FOR THE ENGAGEMENT ON THIS THIS
YEAR AND IN PRIOR YEARS CHAIR
WOULD AS AS YOU KNOW, I'M NOT A
BELIEVER IN MASS INCARCERATION
IS THE OPPOSITE. WE'RE TRYING TO
KEEP PEOPLE OUT OF PRISONS AND
JAILS AND THESE INDIVIDUALS ARE
BEING SENTENCED TO A STATE
PRESIDENT, ER JAIL TERM AND
WE'RE TRYING TO GIVE THEM AN
ALTERNATIVE TO GET WELL. AND
THIS IS A THIS IS A TWO COUNTY
PILOT ALLOWS US TO ATTEMPT TO
TRY SOMETHING DIFFERENT WITH
REPORTING TO MAKE SURE THAT WE
KNOW WHAT HAPPENED AND
POTENTIALLY COME UP WITH A
SOLUTION FOR OUT THROUGHOUT
CALIFORNIA. SO WITH THAT,
RESPECTFULLY ASK THE RIGHT BOOK.
THANK YOU. THANK YOU VERY MUCH
THE MOTION. WE DON'T HAVE A
MOTION. I'M WAITING FOR A
MOTION. I'M SORRY I HEARD YOU
WHO I DIDN'T HEAR THE FIRST MR
SANTIAGO WAS A MOTION. A SECOND
BY MR V. VALLAPUDUA MOTION IS
DUE PASS AS A MINUTE TO
APPROPRIATIONS. MADAM SECRETARY
. PLEASE CALL THE ROLL. WOULD I
WOULD I? WALDRON WALDRON. I
AGUIAR-CURRY ARAMBULA. EARNER.
BURNER. I CARILLO. FLORA. LARA.
I'VE BEEN STRONG. THAT'S WANG. I
MAIENSCHEIN. MAIENSCHEIN I
MCCARTY MCCARTHY I JOE
PATTERSON. RODRIGUEZ. RODRIGUEZ
I SANTIAGO. SANTIAGO. I BE
VALLAPUDUA. BUT WHILE I WEBER
HOWEVER, I. THAT VOTE IS 11 0.
WHAT WE'LL DO NOW WE STILL HAVE
ONE MORE. BILL. WE'RE WAITING
FOR MISS CARILLO. UM, WHO'S
CHAIRING HER OWN. SUBCOMMITTEE.
SO WHAT WE'LL DO IS WE'LL GO TO
THE TOP OF THE TOP OF THE FILE
ORDER. UM THAT WAS THE FIRST
BILL THAT WE HAD A MOTION ON. SO
EVERY BILL IS LOOKING IN SEARCH
OF EMOTION. AH, SO LET'S START
AT THE TOP. WELL, WE CAN'T DO IT
THAT WAY. I LOVE THE WAY YOU
THINK, THOUGH. UM I A B 4 12.
MS. SORIA, WE HAVE A MOTION. BYE
MR FONG, A SECOND BY MR SANTIAGO
. THE MOTION IS DUE PASS AS
AMENDED TO APPROPRIATIONS. MADAM
SECRETARY, PLEASE CALL THE ROLL.
WOULD WOULD I, WALDRON WALDRON,
I AGUIAR-CURRY ARAMBULA. BURNER.
BURNER. I CARILLO. LARA. FOR
IVAN'S FONG. VINCE WANG. I
MAIENSCHEIN MAIENSCHEIN I
MCCARTY MCCARTHY I, JOE
PATTERSON. PATERSON. I
RODRIGUEZ. RODRIGUEZ I SANTIAGO.
SANTIAGO I VE VALLAPUDUA PUT WHY
WEBER. HOWEVER, I. THAT'S 12 0.
THAT BILL IS OUT. ITEM NUMBER
TWO A B 4 86 BY MR KALRA. THE
APPROPRIATE RESPONSE IS SOMEBODY
MOVED THE BILL. OH, GOSH, I LOVE
THAT. SO MOVED THE BILL MOTION
BY MR BOERNER HORVATH. I DON'T
KNOW WHO DID THE SECOND WE'LL
GIVE IT TO MISS WEBB. DR WEBBER.
MOTION IS DO PASS THROUGH
APPROPRIATIONS. MADAM SECRETARY,
PLEASE CALL THE ROLL. WOULD
WOULD I? WALDRON WALDRON, NO
AGUIAR-CURRY. ARAMBULA. BURNER.
BURNER. I CARILLO. LARA. OR A NO
BEN FONG. VINCE VAUGHN. NO
MAIENSCHEIN MAIENSCHEIN I
MCCARTY MCCARTHY I JOE PATERSON
, PATERSON NO, RODRIGUEZ.
RODRIGUEZ I SANTIAGO. SANTIAGO
IVY VALLAPUDUA. WHAT I WEBBER
WEBBER? AYE. THAT IS 8 TO 4.
THAT BILL IS OUT. WE'LL LEAVE
THE ROLE OPEN FOR OTHERS TO ADD
ON ITEM NUMBER THREE A. B 12 10.
MOTION BY MISS YOUR FLOOR, A
SECOND BY. MR FONG. THANK YOU.
MOTION IS DUE PASS TO JUDICIARY.
MADAM SECRETARY, PLEASE CALL THE
ROLL. WOULD WOULD I? WALDRON,
NIAGARA CURRY ARAMBULA BURNER.
BURNER. I CARILLO. LARA. LAURA
IVAN SPHANG. THAT SONG. I
MAIENSCHEIN MAIENSCHEIN. AYE
MCCARTY. MCCARTHY I. JOE
PATTERSON, PATTERSON IRODRIGUEZ.
RODRIGUEZ I SANTIAGO. SANTIAGO
IVY VALLAPUDUA VALLAPUDUA, AYE,
WEBER. HOWEVER, I. THAT'S 12 0
ITEM NUMBER FOUR A B 4 92 BY MS
PELLERIN. MOTION BY, UH, MISS
BURNER AND MR SANTIAGO. THE
MOTION IS DO PASS THROUGH
APPROPRIATIONS. MADAM SECRETARY
, PLEASE CALL THE ROLL. WOULD
WALDRON WALDRON NO AGUIAR-CURRY.
ARAMBULA BURNER. BURNER. I
CARILLO. FLORA FLORA, NO VINCE
PONG. PHªN NO MAIENSCHEIN
MAIENSCHEIN I MCCARTY MCCARTHY
I, JOE PATERSON, PATERSON? NO,
RODRIGUEZ. RODRIGUEZ I SANTIAGO.
SANTIAGO. I BE VALLAPUDUA.
VALLAPUDUA HIGH, WEBER. WEBER.
AYE. THAT'S 84. THAT BILL IS OUT
. WE'LL LEAVE THE ROLE OPEN FOR
OTHERS TO ADD ON. I DIDN'T
NUMBER FIVE A B 14 71. MOTION BY
MR FONG. SECOND BY DR WEBBER,
SECRETARY PLEASE. THE MOTION IS
DUE PASS AS AMENDED TO
APPROPRIATIONS. MADAM SECRETARY,
PLEASE CALL THE ROLL, WOULD I?
WALDRON? WALTER AND I ARE CURRY.
ARAMBULA. EARNER. BURNER. I
CARILLO. LARA. FLOOR. I MONNING
. THAT SONG. I MAIENSCHEIN
MAIENSCHEIN I MCCARTY MCCARTHY I
, JOE PATTERSON, PATTERSON
IRODRIGUEZ. RODRIGUEZ, NOT
VOTING. SANTIAGO. ONTARIO, IVY
VALLAPUDUA. VALLAPUDUA. AYE,
WEBER. WHERE WERE I? THAT'S 11
TO 0 DECEMBER SIX AND SEVEN WERE
PULLED FROM THE AGENDA. I
REMEMBER 8 13 14. AND 16 ARE THE
CONSENT CALENDARS OR EMOTION FOR
THE CONSENT CALENDAR. MOTION BY
MR SANTIAGO IS SECOND BY MR FONG
FOR THE CONSENT CALENDAR. MADAM
SECRETARY. PLEASE CALL THE ROLL.
WOULD WALDRON WALDRON IAGAR
CURRY ARAMBULA EARNER. BUT ER I
CARILLO LARA. FLOOR. I VINCE
WONG. SHANGHAI MAIENSCHEIN
MAIENSCHEIN I MCCARTY MCCARTHY I
JOE PATERSON, PATERSON, I
RODRIGUEZ RODRIGUEZ I SANTIAGO.
SANTIAGO IVY VALLAPUDUA
VALLAPUDUA, AYE, WEBER. HOWEVER
I THAT'S 12 0 ITEM NUMBER NINE A
B 8 47 BY THREE OF US. MOTION BY
MR BURNER, A SECOND BY MR
SANTIAGO. THE MOTION IS DUE PASS
AS AMENDED TO APPROPRIATIONS.
MADAM SECRETARY, PLEASE CALL THE
ROLL. WOULD WOULD I? WALDRON
WALDRON, I AGUIAR-CURRY ARAMBULA
BURNER BURNER. I CARILLO LARA.
LARA I'VE BEEN STRONG, STRONG. I
MAIENSCHEIN MAIENSCHEIN I'M
MCCARTY. MCCARTHY I, JOE
PATTERSON, PATTERSON IRODRIGUEZ.
RODRIGUEZ I SANTIAGO. SO I VE
VALLAPUDUA VALLAPUDUA. AYE,
WEBER. WEBER. AYE. THAT'S 12 0.
BELIEVE THE ROLE OPEN FOR OTHERS
TO ADD ON ITEM NUMBER 10 A B 11
22 BY BY DR BAINES. A MOTION BY
MR SANTIAGO SECOND BY MS BURNER
MOTION IS DUE PASS AS AMENDED TO
APPROPRIATIONS. MADAM SECRETARY
PLEASE CALL THE ROLL. WOULD
WOULD I? WALDRON WALDER, NIAGARA
CURRY. ARAMBULA BURNER. BURNER.
I CARILLO. FLORA. LAURA IVAN
SWANG. THAT'S WANG. I
MAIENSCHEIN MAIENSCHEIN I
MCCARTY MCCARTHY I, JOE
PATTERSON. PATERSON I RODRIGUEZ
RODRIGUEZ. I SANTIAGO SANTIAGO
IVY VALLAPUDUA. VALLAPUDUA. AYE,
WEBER. HOWEVER I WILL DO 12 0
NUMBER 11 A B 11 24 BY
ASSEMBLYMEMBER'S LOW MOTION BY
MR SANTIAGO A SECOND BY MS
BURNER, THE MOTION IS THE
MOTIONS DO PASS AS AMENDED TO
APPROPRIATIONS. MADAM SECRETARY,
PLEASE CALL THE ROLL. WOULD
WOULD I, WALDRON WALDRON, I
AGUIAR-CURRY ARAMBULA. EARNER.
ER I CARILLO. CARILLO I FLORA.
FOR A IVAN SWANG. THAT'S FUNNY.
I MAIENSCHEIN MAIENSCHEIN I
MCCARTY MCCARTHY I, JOE
PATTERSON. JOE PATTERSON. I
RODRIGUEZ. RODRIGUEZ I SANTIAGO.
SANTIAGO IVY VALLAPUDUA.
VALLAPUDUA AYE, WEBBER. HOWEVER,
I 13. THAT'S 13 0. WE'RE JUST
GOING TO CYCLE THROUGH. AND
THEN, UM, MISS MISS CARILLO HAS
A BUILDER PRESENT. OKAY?
EVERYBODY OKAY WITH THAT. IT
DOESN'T REALLY MATTER. WE'RE
GOING TO DO IT ANYWAY. BUT I'M
SORRY. THAT WASN'T VERY NICE. UM
WILL MOVE ON TO ITEM NUMBER 12 A
B 11 64. IN SEARCH OF EMOTION. A
MOTION BY MR SANTIAGO. SECOND BY
MR FLORA MOTION IS DUE PASS TO
APPROPRIATIONS MANUFACTORY.
PLEASE CALL THE ROLL. WOULD
WOULD I? WALDRON WILDER, NOT
VOTING. EDGAR CURRY. ARAMBULA.
ARAMBULA? AYE. BURNER. BURNER. I
CARILLO. REAL I FLORA. LARA
IVINS FARM. IT'S FUN, NOT
VOTING. MAIENSCHEIN MAIENSCHEIN
I'M MCCARTY. MCCARTHY I, JOE
PATTERSON. PATERSON NOT VOTING.
RODRIGUEZ RODRIGUEZ I SANTIAGO
SANTIAGO IVY VALLAPUDUA.
VALLAPUDUA I PEPPER? WHETHER OR
NOT VOTING. FROM MISSOURI.
THAT'S THAT IS 10 0 ITEM NUMBER
15 A B 13 38 BY MS
PETRIE-NORRIS. MOTION BY, UM MR
SANTIAGO, SECOND BY MR RODRIGUEZ
. EMOTIONS DO PASS AS AMENDED TO
APPROPRIATIONS. MADAM SECRETARY,
PLEASE CALL THE ROLL. WALDRON,
WALDRON, IAGAR CURRY. ARAMBULA.
ARAMBULA. AYE BURNER. BURNER. I
CARILLO. CARILLO I FLORA. OR
IVAN'S FONG. I'M NOT VOTING
MAIENSCHEIN MAIENSCHEIN I
MCCARTY MCCARTHY I, JOE
PATTERSON. JOE PATTERSON, NOT
VOTING RODRIGUEZ. RODRIGUEZ I
SANTIAGO. SANTIAGO. I BE
VALLAPUDUA. VALLAPUDUA. AYE.
WEBER. WHETHER I CULTURAL THAT'S
. WELL 0 12 0. THANK YOU. OKAY
ITEM NUMBER. 16 WAS PART OF THE
CONSENT CALENDAR ITEM NUMBER. 17
WAS PULLED BY THE AUTHOR. MOVING
TO ITEM NUMBER 18 A B 40 BY MR
RODRIGUEZ. EMOTION FOR MR
RODRIGUEZ IS A MOTION BY MR
SANTIAGO, A SECOND BY MR V
VALLAPUDUA MOTION IS DUE PASSES
AMENDED TO APPROPRIATIONS. MADAM
SECRETARY, PLEASE CALL THE ROLL.
WOULD WOULD I? WALDRON WALDRON,
IAGAR CURRY. EDGAR CURRY. I
ARAMBULA ARAMBULA. AYE BURNER.
BURNER. I CARILLO. REAL I FLORA.
FOR A IVAN'S FANG. VINCE FONG.
I'M MAIENSCHEIN MAIENSCHEIN. I'M
MCCARTY MCCARTHY I, JOE
PATTERSON, PATERSON. I RODRIGUEZ
RODRIGUEZ I SANTIAGO SANTIAGO. I
VE VALLAPUDUA VALLAPUDUA. AYE,
WEBER. WHERE I 15 0 15 0 ITEM
NUMBER 19 WAS PULLED FROM THE
AGENDA ITEM NUMBER 20 A B 11 80
BY MR RODRIGUEZ. MOTION BY MS
BURNER SECOND BY MR SANTIAGO.
THE MOTION IS DUE PASS AS
AMENDED TO APPROPRIATIONS. MADAM
SECRETARY, PLEASE CALL THE ROLL.
WOULD, WOULD I, WALDRON. WALTER
AND I AGUIAR-CURRY AS YOUR
CAREER ARAMBULA OR AMBULANCE I
BURNER. BURNER. I CARILLO.
CARILLO I FLORA FOR IVAN'S FONG.
THAT SONG. I MAIENSCHEIN
MAIENSCHEIN I MCCARTY MCCARTHY
I, JOE PATTERSON. THE PATERSON
IRODRIGUEZ. RODRIGUEZ I
SANTIAGO. SANTIAGO IVY
VALLAPUDUA. VALLAPUDUA. AYE,
WEBER. HOWEVER, I 15 0 15 0.
ITEM NUMBER 21 A B 6 59 BY MS
AGUIAR-CURRY. MOTION BY MR
SANTIAGO. SECOND BY MR
RODRIGUEZ. MOTION IS DUE PASS TO
AS YOU PASSED YOUR
APPROPRIATIONS, RIGHT? I'M SORRY
, MADAM SECRETARY. PLEASE CALL
THE ROLL. WOULD WOULD I? WALDRON
WALDRON, NO CURRY CURRY. I
ARAMBULA ARAMBULA. AYE BURNER.
BURNER. I CARILLO. KOREA, I
FLORA. FLORA? NO, VINCE PHªN.
PHªN NO MAIENSCHEIN MAIENSCHEIN.
AYE MCCARTY MCCARTHY I, JOE
PATERSON, PATERSON? NO,
RODRIGUEZ. RODRIGUEZ I SANTIAGO.
SANTIAGO IVY VALLAPUDUA
VALLAPUDUA, AYE, WEBER. BUT
WE'RE NOT VOTING. THAT BOOK THAT
BILL HAS 10 VOTES. IT'S 10 4
OUT, WE WILL PASS OVER ITEM
NUMBER 22. WE'LL GO TO ITEM
NUMBER 23 A B 10 57 BY DR
WEBBER. MOTION BY MR SANTIAGO IS
SECOND BY VICE CHAIR WALDRON
MOTION IS DUE PASS AS AMENDED TO
APPROPRIATIONS. MADAM SECRETARY
PLEASE CALL THE ROLL. WOULD I?
WALDRON WALDRON, I CURRY
AGUIAR-CURRY. AYE ARAMBULA
ARAMBULA. AYE BURNER. BURNER. I
CARILLO. CARILLO I FLORA. LARA,
IVAN'S FONG. SHANGHAI
MAIENSCHEIN MAIENSCHEIN. I'M
MCCARTY MCCARTHY I, JOE
PATTERSON, PATTERSON IRODRIGUEZ.
RODRIGUEZ I SANTIAGO. SANTIAGO.
I BE VALLAPUDUA. VALLAPUDUA.
AYE, WEBER. HOWEVER, I 15 0.
THAT'S 15 0. ITEM NUMBER 24 13
60 BY MR MCCARTY WAS ACTUALLY
ACTUALLY JUST OPENED THE ROYAL
CALLED THE ABSENT MEMBERS.
AGUIAR-CURRY CARILLO. AYE
ARAMBULA ARAMBULA. AYE, CARILLO.
CARILLO I PATERSON. THE PATERSON
NOT VOTING. 14 0. 14 C.
PATERSON. I 15 15 0. I REMEMBER
25 A B 18 8 15 BY WOOD. MOTION
BY MS BURNER SECOND BY MR V.
VALLAPUDUA AS MOTION IS DUE PASS
AS AMENDED TO APPROPRIATIONS
MANUFACTORY, PLEASE CALL THE
ROLL. ALRIGHT WALDRON WALDRON, I
AGUIAR-CURRY I GOT CARILLO II
ARAMBULA. ARAMBULA. AYE BURNER.
BURNER. I CARILLO. CARILLO I
FLORA. FLOORING THAT VOTING
VINCE FONG. VINCE VAUGHN. NOT
VOTING MAIENSCHEIN MAIENSCHEIN I
MCCARTY MCCARTHY I, JOE
PATTERSON. JOE PATTERSON, NOT
VOTING RODRIGUEZ. RODRIGUEZ.
I'VE SANTIAGO. SANTIAGO. I BE
VALLAPUDUA. VALLAPUDUA. AYE,
WEBER. WHOEVER I 12 0 12 0 AND
ITEM NUMBER 26 AB 15 37 BY WOOD.
THANK YOU. MOTION BY MR MS
BURNER, SECOND BY MR SANTIAGO.
THE MOTION IS DUE PASS TO
APPROPRIATIONS. MADAM SECRETARY
, PLEASE CALL THE ROLL. ALRIGHT
WALDRON WALDRON, I CARRY
AGUIAR-CURRY. AYE ARAMBULA
ARAMBULA. AYE BURNER. BURNER. I
CARILLO. CARILLO I FLORA. LARA,
NOT VOTING. VINCE FONG. IT'S
FUN, NOT VOTING. MAIENSCHEIN
MAIENSCHEIN, AYE MCCARTHY.
MCCARTHY I, JOE PATTERSON.
PATERSON. AYE. RODRIGUEZ.
RODRIGUEZ I SANTIAGO. SANTIAGO
IVY VALLAPUDUA. VALLAPUDUA. AYE,
WEBER. WEBER. AYE. ZERO. 13 0,
AND NOW WE WILL HAVE MS CARILLO
PRESENT HER BILL. MAYBE 14 32.
THANK YOU, MR CHAIR AND MEMBERS
. I'M PROUD TO PRESENT ASSEMBLY
BILL 14 32, WHICH WOULD REQUIRE
OUT OF STATE HEALTH INSURANCE
CARRIERS WHO PROVIDE COVERAGE TO
CALIFORNIA RESIDENTS AND WHO ARE
CURRENTLY ACCEPTED FROM STRAIGHT
FROM STATE LAWS TO COMPLY WITH
CALIFORNIA STATE LAWS PERTAINING
TO COVERAGE OF ABORTION AND
GENDER AFFIRMING CARE. THIS
CHANGE IS CONSISTENT WITH
CALIFORNIA'S CONSTITUTIONAL
AMENDMENT, WHICH PROVIDES
REPRODUCTIVE FREEDOM AS A RIGHT
CURRENTLY THERE ARE THERE IS AN
EXCEPTION FOR POLICIES ISSUED
OUTSIDE OF OUTSIDE OF CALIFORNIA
TO AN EMPLOYER WHOSE PRINCIPAL
PLACE OF BUSINESS AND MAJORITY
OF EMPLOYEES OUTSIDE CALIFORNIA
. THIS EXEMPTION IS A MAJOR
CONCERN BECAUSE SINCE THE U. S
SUPREME COURT OVERTURNED THE
FIVE DECADE OLD CONSTITUTIONAL
RIGHT FOR A WOMAN TO OBTAIN AN
ABORTION. THERE HAS BEEN A WAVE
OF ANTI CHOICE LEGISLATION
ACROSS THE NATION. THERE HAS
ALSO BEEN A GROWING NUMBER OF
STATES BANDING, GENDER AFFIRMING
CARE. WE SHOULD DO AS MUCH AS WE
CAN TO ENSURE THAT CALIFORNIA
RESIDENTS AND WORKERS HAVE
ACCESS TO THESE HEALTHCARE
SERVICES, REGARDLESS OF WHERE
THEIR HEALTH INSURANCE POLICY OR
CERTIFICATE OR HEALTHCARE
SERVICES, PLANNED CONTRACT IS
ISSUED OR DELIVERED. A B 14 32
IS A PRIORITY PIECE OF
LEGISLATION TO THE LEGISLATIVE
WOMEN'S CAUCUS AND THE FUTURE OF
ABORTION COUNCIL. IN FACT, THERE
WAS A, UH, AN EVENT EARLIER
TODAY WITH OUR GOVERNOR TO
REAFFIRM CALIFORNIA'S
COMMITMENT. TO REPRODUCTIVE
FREEDOM. THIS BILL IS SPONSORED
BY THE CALIFORNIA DEPARTMENT OF
INSURANCE AND EQUALITY,
CALIFORNIA WITH US TODAY TO
TESTIFY AND SUPPORT OUR
REPRESENTATIVES FROM OUR CO
SPONSORS, AND I WILL ALLOW THEM
TO INTRODUCE THEMSELVES. THANK
YOU. GOOD EVENING, MR CHAIR AND
MEMBERS. JOSEPHINE FIGARO. I AM
THE CHIEF DEPUTY LEGISLATIVE
DIRECTOR FOR THE DEPARTMENT OF
INSURANCE HERE ON BEHALF OF
INSURANCE COMPUTER, RICARDO
LARA. INSURANCE COMMISSIONER
LOTTO IS A PROUD CO SPONSOR OF
HB 14 32. I FIRST WANT TO THANK
ASSEMBLYMEMBER'S CARILLO FOR
AUTHORING THIS VERY IMPORTANT
MEASURE. BODY AUTONOMY AND
INTEGRITY ARE UNDER ATTACK.
THROUGHOUT THE UNITED STATES. WE
HAVE ALL HEARD ABOUT THE BANDS
ON ABORTION AND GENDER
PHARMACARE. AND THESE ATTACKS
ARE GETTING WORSE. ABORTION IS
OUTRIGHT BANNED IN 13 STATES AND
ANOTHER 12 STATES LIMITING
ACCESS BETWEEN 6 22 WEEKS. AS OF
MARCH OF THIS YEAR. 30 STATES
HAVE EITHER RESTRICTED GENDER
AFFIRMING CARE OR CONSIDERING
LAWS. THAT WOULD DO SO FOR YOUTH
, NINE STATES HAVE ENACTED
LEGISLATIVE BOUNDS ON GENDER
FIRM AND CARE FOR YOUTH AND
YOUNG ADULTS. JUST LAST WEEK,
THE MISSOURI ATTORNEY GENERAL
ISSUED AN EMERGENCY ORDER
RESTRICTING GENDER AFFIRMING
HEALTH CARE FOR MINORS AND
ADULTS. WE MUST MAKE SURE THAT
THESE EGREGIOUS LAWS DO NOT FIND
THEIR WAY INTO THE HEALTH
INSURANCE COVERAGE FOR
CALIFORNIA RESIDENTS. ALTHOUGH
CALIFORNIA HAS STRONG CONSUMER
PROTECTIONS IN PLACE REGARDING
ABORTION AND GENDER AFFIRMING
CARE AND HEALTH COVERAGE, THERE
ARE CERTAIN INSTANCES WHERE
CALIFORNIA RESIDENTS AND THEIR
DEPENDENTS ARE NOT AFFORDED
PROTECTIONS FOUND IN STATE LAW.
A B 14 32 IS JUST ONE STEP WE
CAN TAKE TO RECOGNIZE A PERSON'S
ABILITY TO MAKE DECISIONS ABOUT
THEIR OWN BODY, WHICH IS
FUNDAMENTAL TO THE ABILITY OF A
PERSON TO ENJOY BULLYING THEIR
RIGHTS. AS A STATE. WE HAVE A
DUTY TO PROTECT CALIFORNIA
RESIDENTS FROM THE LAWS OF OTHER
STATES THAT POLICE THEIR BODIES
AND THE BODIES OF THEIR LEAD
WOODS ON BEHALF OF INSURANCE
COMMISSIONER RICARDO LARA, I
ASKED FOR YOUR I VOTE. THANK
YOU. GOOD AFTERNOON CHAIR AND
MEMBERS. CRAIG POLLSTER ON
BEHALF OF A QUALITY CALIFORNIA,
PROUD CO SPONSOR OF A B 14 32,
AS YOU ALL KNOW, CALIFORNIA HAS
SOME OF THE STRONGEST
PROTECTIONS IN THE NATION FOR
ABORTION AND GENDER AFFIRMING
CARE, GENDER AFFIRMING CARE IS
COVERED UNDER THE STATE'S
MEDICAL PROGRAM AND STATE LAW
PROHIBITS HEALTH PLANS FROM
DENYING HEALTH COVERAGE OR
LIMITING BENEFITS BECAUSE OF
THEIR GENDER IDENTITY OR SEXUAL
OR GENDER EXPRESSION. GENDER
AFFIRMING CARE IS ESSENTIAL AND
LIFESAVING HEALTHCARE FOR TRANS
PEOPLE OF ALL AGES, CARE THAT IS
BACKED BY DECADES OF RESEARCH
AND SUPPORTED BY EVERY MAJOR
MEDICAL ORGANIZATION. GENDER
AFFIRMING CARE IS CRITICAL TO
ALLOWING TRANS PEOPLE TO LIVE
OPENLY AND AUTHENTICALLY AS
THEIR TRUE SELVES. SADLY STATE
LEGISLATURES ACROSS THE COUNTRY
ARE NOW DEMONIZING TRANS PEOPLE.
AND TAKING STEPS TO ELIMINATE
ACCESS TO GENDER AFFIRMING CARE
FOR TRANS YOUTH AND IN SOME
CASES, EVEN ADULTS. THESE BANDS
ARE OCCURRING AT THE SAME TIME
THAT STATES ARE PASSING
DRACONIAN LAWS TO LIMIT ACCESS
TO ABORTION CARE, AND NO ONE IN
OUR STATE SHOULD BE SUBJECT TO
THESE DISCRIMINATORY OUT OF
STATE LAWS. UNDER EXISTING LAW
INSURANCE PROVIDED BY EMPLOYERS
LOCATED OUT OF STATE WITH ADAM
STATE INSURANCE CONTRACTS MAY
NOT COVER ABORTION OR GENDER
AFFIRMING CARE, AND ABBY 14 32
WILL MAKE IT CLEAR THAT THESE
SERVICES MUST BE COVERED TO THE
EXTENT REQUIRED UNDER CALIFORNIA
LAW. A B 14 32 IS ESSENTIAL TO
ENSURING THAT ALL CALIFORNIA
RESIDENTS HAVE ACCESS TO THESE
ESSENTIAL HEALTH CARE SERVICES.
AND I RESPECTFULLY URGE HER I
VOTE. THANK YOU VERY MUCH OTHERS
IN SUPPORT. AFTERNOON ANDREA
RIVERA ON BEHALF OF THE
CALIFORNIA PEN, ETHNIC HEALTH
NETWORK AND SUPPORT THANK YOU.
GOOD AFTERNOON, JENNIFER ROUBLES
WITH HEALTH ACCESS CALIFORNIA
AND SUPPORT MOLLY ROBSON,
PLANNED PARENTHOOD AFFILIATES OF
CALIFORNIA AND SUPPORT THANK
YOU. BRIAN SPENCER ON BEHALF OF
THE CALIFORNIA MEDICAL
ASSOCIATION AND THE AMERICAN
COLLEGE OF RBG. RYAN'S DISTRICT
NINE IN SUPPORT. THANK YOU. GOOD
AFTERNOON, BETH ANNOUNCED THAT
CEO CALIFORNIA AND SUPPORT THANK
YOU VERY MUCH OPPOSITION TO THE
BILL. GOOD EVENING CHAIR AND
MEMBERS. MY NAME IS SUSAN SWIFT
ARNEL. I'M A CALIFORNIA
ATTORNEY, AND I'M THE VICE
PRESIDENT OF LEGAL AFFAIRS AT
THE RIGHT TO LIFE LEAGUE,
AMERICA'S FIRST PRO LIFE
ORGANIZATION, AS CURRENTLY
DRAFTED A B 14 32 UNFAIRLY
FAVORS ABORTION SERVICES OVER
CHILDBIRTH SERVICES. A B 14 32
COMPELS INSURERS TO COVER
ABORTION. BUT IT DOES NOT
MANDATE INSURERS TO COVER
PRENATAL AND CHILD BIRTHING
SERVICES. MAYBE 13 OR 14. 32
ALSO THREATENS INSURANCE
PROVIDERS WITH CRIMINAL
PENALTIES FOR FAILING TO COVER
ABORTION AND ABORTION RELATED
SERVICES, BUT DOES NOT SPEAK TO
CHILD BIRTHING SERVICES. A B 14
32 IS USING INSURANCE COMPANIES
TO CONDITION BENEFITS BASED ON A
WOMAN'S RIGHT TO CHOOSE
CHILDBIRTH. BY MANDATING
INSURANCE COVERAGE IN THIS
MANNER, THE STATE IS CREATING AN
UNEQUAL FINANCIAL TREATMENT OF
ABORTION AND CHILDBIRTH. IN
COMMITTEE TO DEFEND REPRODUCTIVE
RIGHTS VERSUS MYERS, OUR SUPREME
COURT, THE CALIFORNIA STATE
SUPREME COURT SAID. CAN THE
STATE TELL A WOMAN THAT IT WILL
PAY FOR HER NEEDED MEDICAL CARE
, BUT ONLY IF SHE GIVES UP HER
CONSTITUTIONAL RIGHT TO CHOOSE
WHETHER OR NOT TO HAVE A CHILD?
TO TRULY HELP ALL CALIFORNIA
RESIDENTS OBTAIN INSURANCE
COVERAGE FOR THEIR CHOICES. WE
SHOULD INCLUDE COVERAGE FOR
CHILDBIRTH TO IT IS A SIMPLE
MATTER TO CURE THE BILL BY
AMENDING IT TO REQUIRE OUT OF
STATE INSURANCE PROVIDERS COVER
PRENATAL AND RBG IN SERVICES TO
INCLUDE CHILDBIRTH AND PERINATAL
SERVICES. EQUAL TREATMENT UNDER
THE LAW WILL ALLOW WOMEN TRUE
REPRODUCTIVE FREEDOM BY ENSURING
INSURANCE COVERAGE. PLEASE VOTE
NO ON A B 14 32 IN ITS CURRENT
FORM AND RECOMMEND THAT THE
AUTHOR PLEASE EXPAND INSURANCE
PROTECTIONS TO INCLUDE
CHILDBIRTH SERVICES AS WELL.
THANK YOU FOR YOUR TIME. THANK
YOU AND ANYONE ELSE IN
OPPOSITION. NO ONE WILL BRING IT
BACK TO THE COMMITTEE FOR
QUESTIONS OR COMMENTS FROM THE
COMMITTEE, DR WEBBER. THANK YOU
FOR PRESENTING THIS BILL. THIS
QUESTION IS ACTUALLY FOR THE
OPPOSITION. WHAT OUT OF STATE
INSURANCE COMPANIES DO NOT COVER
PRENATAL CARE AND CHILDBIRTH. I
DON'T HAVE THAT INFORMATION
THAT'S OUTSIDE INFORMATION, BUT
THE WAY THAT THE BILL IS
STRUCTURED IS IT IS
DISCRIMINATORY AGAINST THOSE.
THOSE PLACES THAT WOULD PROVIDE
IT AND SO WHAT YOU WANT TO DO IS
YOU WANT TO HAVE EQUAL
OPPORTUNITY FOR A WOMAN WHO
WANTS TO CHOOSE ABORTION. I KNOW
THAT THAT IS SOMETHING THAT YOU
ALL FAVOR HERE. I UNDERSTAND
THAT, BUT IF SHE WANTS TO CHOOSE
CHILDBIRTH, TOO, IT'S VERY
SIMPLE TO MAKE SURE THAT THIS
BILL AFFORDS HER THAT
OPPORTUNITY UNDER HER INSURANCE
AS WELL, WHETHER IT'S OUT OF
STATE OR OTHERWISE. I UNDERSTAND
THAT I DO UNDERSTAND THAT THERE
ARE SOME OUT OF STATE INSURANCE
COMPANIES THAT DO NOT COVER
ABORTION. BUT AS AN O B G Y N
I'VE NEVER SEEN AN INSURANCE
COMPANY NOT COVER PRENATAL CARE
AND DELIVERY SERVICES. SO I WAS
JUST WONDERING SINCE YOU BROUGHT
IT UP. IF YOU ACTUALLY HAD THAT
INFORMATION, I DON'T HAVE IT AT
HAND. AND I'D BE HAPPY TO TRY TO
PROVIDE IT TO YOU LATER. I WILL
SEND IT TO YOU. BUT MY CONCERN
IS MORE WHAT WHAT WILL HAPPEN IS
BECAUSE INSURANCE PROVIDERS
OBVIOUSLY WANT TO SAVE COST AND
THERE THEY ARE VERY COST
CONSCIOUS IT AND UNFORTUNATELY
FOR THE WAY THAT OUR WORLD
WORKS. ABORTION IS FAIRLY
INEXPENSIVE. BECAUSE IT IS NOT
AS EXPENSIVE AS A LONG TERM OF
CHILDBIRTH AND PROVIDING
PRENATAL CARE AND HELPING WOMEN
ACTUALLY HAVE THEIR CHILDREN AND
SO THEY CAN BE PRESSURED INTO
ESPECIALLY INSURANCE COMPANIES.
THEY CAN CHOOSE ALSO NOT TO
AFFORD THOSE SAME SERVICES, AND
WE REALLY SHOULD IF WE'RE REALLY
GOING TO OFFER FULL REPRODUCTIVE
FREEDOM TO WOMEN, WE SHOULD MAKE
SURE THAT THEY HAVE THE SAME
CHOICES, WHETHER IT'S IN STATE
OR OUT OF STATE INSURANCE THAT
THEY CAN ALSO HAVE THAT
INSURANCE COVERED FULLY. IF THEY
CHOOSE TO HAVE THEIR CHILD, AND
I'M CONCERNED THAT IT'S A VERY
SIMPLE FIX ON THE BILL BECAUSE
IT'S SOMETHING THAT YOU CAN
INCLUDE THAT WAY OUT OF STATE
INSURANCE COMPANIES WILL KNOW.
OH WELL, WE CAN'T PICK AND
CHOOSE. WE CAN'T JUST OFFER.
COVERAGE FOR ABORTION IN
CALIFORNIA. WE ALSO WOULD HAVE
TO ALSO OFFER THE INSURANCE FOR
CHILDBIRTH AND PRENATAL AND THAT
WOULD PROTECT WOMEN WHO CHOOSE
LIFE AS WELL. YEAH, NO, I JUST
WANTED TO ASK AND SHE BROUGHT
THAT UP SINCE YOU KNOW, I
PRACTICE AND TEXAS AND OHIO AND
ILLINOIS AND CALIFORNIA IT HAD
LICENSE IN KENTUCKY AND INDIANA.
I'VE NEVER HEARD OF INSURANCE
COMPANY NOT COVERING PRENATAL
CARE AND CHILDBIRTH SERVICES. I
THINK THAT WITH ALL OF THE
DIFFERENT CHANGES THAT ARE GOING
ON IN DIFFERENT STATES THAT WE
ARE ALL SEEING NATIONWIDE. I
THINK WE MIGHT SEE THE CASES
WHERE CERTAIN INSURANCE
COMPANIES MAKE DECISIONS.
WHETHER OR NOT THEY'RE GOING TO
OFFER CERTAIN SERVICES IN IN IN
CALIFORNIA, AND SO BECAUSE THIS
BILL IS BEFORE YOU KNOW, I JUST
URGE YOU TO AMEND IT SO THAT IT
CAN MAKE SURE THAT THAT WOMEN
CALIFORNIA DON'T FACE THAT
CHOICE WHERE THEY'RE DENIED
COVERAGE FOR CHILDBIRTH SERVICES
THAT THEY CHOOSE. IF THAT IS AN
ISSUE, PLEASE FOR THAT TO ME,
BECAUSE, LIKE I SAID, I'VE NEVER
HEARD OF THAT BEFORE, AND I JUST
WANTED TO KNOW IF YOU HAD ANY
SURE CONCRETE EVIDENCE TO BACK
UP THAT CONCERN, BUT THANK YOU
SO MUCH. THANK YOU. THANK YOU
ANY OTHER QUESTIONS OR COMMENTS?
I'LL JUST ADD THAT BELIEVE THAT
IS AN ESSENTIAL BENEFIT UNDER
THE AFFORDABLE CARE ACT, THE LAW
OF THE LAND. SO I FEEL LIKE THAT
IS A MOOT POINT. BUT THAT'S MY
OPINION. UM ANYBODY ELSE? THIS
BILL HAS A MOTION BY, UM MR
AGUILAR CURRY, A SECOND BY MS
BURNER. ENJOY THE Dð PAST
RECOMMENDATION. WOULD YOU LIKE
TO CLOSE MISS KOREA? THANK YOU,
MR CHAIR, RESPECTFULLY REQUESTS
AND I VOTE. THANK YOU VERY MUCH
MOTION IS DO PASS THROUGH
APPROPRIATIONS. MADAM SECRETARY
, PLEASE CALL THE ROLL. WOULD I?
WALDRON WALTER. NO ANGER CURRY
CURRY. I ARAMBULA ARAMBULA. AYE
BURNER. BURNER. I CARILLO.
CARILLO I FLORA LARA. NO BINS
FROM PHªN NO MAIENSCHEIN
MAIENSCHEIN I MCCARTY MCCARTHY I
JOE PATERSON, PATERSON NO,
RODRIGUEZ. RODRIGUEZ. I SANTIAGO
SANTIAGO. I VE VALLAPUDUA BE
VALLAPUDUA. AYE, WEBER. HOWEVER,
I 11. THAT'S 11 TO 4. SO WE'RE
GOING TO GO BACK TO THE TOP OF
THE FILE ORDER. THERE ARE SOME
OF THE BILLS HAVE OF HAVE BEEN
PASSED OUT OF COMMITTEE. BUT
THERE ARE PEOPLE WHO HAVE NOT
VOTED FOR ALL OF THE BILLS. SO
THIS IS OUR LAST RUN THROUGH
HERE. UM SO, MADAM SECRETARY
ITEM ONE, PLEASE OPEN THE ROYAL
CALLED THE ABSENT MEMBERS. CURRY
CURRY. I ARAMBULA ARAMBULA. AYE,
CARILLO. CARILLO? AYE. 13 0 15 0
ITEM NUMBER 2 84 86 MR. CALLER
PLEASE OPEN THE ROLE CALLED THE
ABSENT MEMBERS CURRY. I GOT
KOREA I ARAMBULA ARAMBULA. AYE,
CARILLO. ITEM NUMBER TWO A B 4
86 MR CHOLERA. CARILLO? AYE. 11
4 11 TO 4 ITEM NUMBER THREE A. B
12 10, MR CHOLERA PLEASE OPEN
THE ROLL. CALL THE ABSENT
MEMBERS CARRY GET KOREA ARAMBULA
ARAMBULA. AYE, CARILLO. CARILLO
I 15 0 15 0. I DON'T NUMBER FOUR
BEFORE 92. MS PELLERIN, PLEASE
OPEN THE ROLL. CALL THE OPPOSITE
MEMBERS ARE CHARY CHARY. AYE
ARAMBULA ARAMBULA. AYE, CARILLO.
CARILLO I 11 4 11 4 ITEM NUMBER
FIVE A B 14 71 MISS PELLERIN,
PLEASE OPEN THE ROLL CALL THE
ABSENT MEMBERS CARRY
AGUIAR-CURRY. AYE, ARAMBULA
ARAMBULA. AYE, CARILLO. CARILLO
I 14 0 14 0 REMEMBER SIX AND
SEVEN WERE ARE OVER WERE PULLED
FROM THE AGENDA. ITEM NUMBER 8,
13, 14 AND 16 WERE THE CONSENT
CALENDAR. PLEASE OPEN THE ROLL
CALL THE ABSENT MEMBERS CARRY
CARRY I ARAMBULA ARAMBULA. AYE,
CARILLO. CARILLO. I 15 0 15 0
ITEM NUMBER 988 47 BY
THREE OF US PLEASE OPEN THE ROLE
AND CALL THE OPPOSITE MEMBERS.
CREE I GOT COREY I ARAMBULA
ARAMBULA. AYE, CARILLO. CARILLO
I 15 0 15 0 ITEM NUMBER 10,
MAYBE 11 22 BY DR BAINES. PLEASE
OPEN THE ROYAL CALLED THE ABSENT
MEMBERS. CURRY KOREA. I ARAMBULA
ARAMBULA. AYE, CARILLO. REAL. I
15 0 15 0 ITEM NUMBER 11 8 11 24
VICE ASSEMBLYMEMBER'S LOW PLEASE
OPEN THE ROLE CALLED THE ABSENT
MEMBERS CURRY CURRY, I ARAMBULA
ARAMBULA. I 15 0 15 0 ITEM
NUMBER 12 B 11 64 BY MR
LOWENTHAL IS OPEN THE ROYAL
CALLED THE ABSENT MEMBERS CURRY
AGUIAR-CURRY I 11 TO 0 11 TO 0
ITEM NUMBER 15 13 38 BY MS
PETRIE NORRIS PLEASE OPEN THE
ROLL CALL THE OPPOSITE MEMBERS.
COREY I 13 0 13 0. AND THAT IS
IT. I THINK SO. I THINK SO.
OKAY? WITH THAT THAT ENDS THE
ASSEMBLY HEALTH COMMITTEE
HEARING. THANK YOU VERY MUCH.