IF YOU REPRESENT ONE ALL
TESTIMONY, COMMENTS ARE LIMITED
TO THE BILL AT HAND. WE ALSO
WELCOME ANY COMMENTS OR LETTERS
OF SUPPORT OR OPPOSITION TO OUR
OUR HEALTH COMMITTEE PORTAL AS
WELL. TODAY WE HAVE, UM, SEVERAL
BILLS PROPOSED FOR CONSENT FOR
THE HEARING. ANY MEMBER OF THE
COMMITTEE MAY REMOVE A BILL FROM
CONSENT. UM PROPOSED FOR
CONSENT. TODAY IS ITEM NUMBER
ONE, MAYBE 5 17 BY
ASSEMBLYMEMBER'S SORIA. ITEM
NUMBER TWO A. B 5 51 BY
ASSEMBLYMEMBER'S BENNETT WITH
AMENDMENTS. I DON'T NUMBER 16.
MAYBE 11 31 BY ASSEMBLYMEMBER'S
GARCIA. ITEM NUMBER 20 A B 14 78
BY ASSEMBLYMEMBER'S CERVANTES
ITEM NUMBER 28 87 98 BY DR
WEBBER ITEM NUMBER 29 89 15 BY
DR ARAMBULA AND ITEM NUMBER 38 B
13 25 BY OUR VICE CHAIR WALDRON
AND ITEM 32 A B 6 14 BY ME. I
WOULD SO, UM, OUR CUSTOMERS. WE
DO NOT START UNTIL WE HAVE
REPRESENTATION FROM BOTH BOTH
PARTIES. SO WE ARE MISSING OUR
REPUBLICAN VICE CHAIR. SO AS
SOON AS WE HAVE, UH, A MEMBER OF
THE OTHER PARTY WILL BE ABLE TO
START ACTUALLY, WE CAN START NOW
, UM, APPRECIATE THE LIKE A BIT
LIKE THEY'RE ON CUE AS IT WAS
AMAZING. SO UM WITH THAT? I
THOUGHT I THOUGHT I SAW MR
IRWIN, ARE YOU WOULD YOU BE
READY TO YOU'RE NOT QUITE READY.
OKAY? AH, UM. YOU KNOW WHAT? UM
IN BLACK AND IN VIEW OF THAT,
I'M JUST GOING TO HAVE A BILL.
I'LL GO AHEAD AND PRESENT. MY
BILL. WOULD YOU LIKE TO TAKE
OVER FOR ME, MR MCCARTY?
OKAY? OKAY FALSE ALARM. MR LOWE
IS HERE TO PRESENT I DON'T
NUMBER 21 A B 15 77 WHENEVER
YOU'RE READY, SIR.
A CLASSIC EXAMPLE OF THE EARLY
BIRD GETS THE WORM. HMM. WELL
DONE. WELL MR CHAIR, THANK YOU
VERY MUCH FOR ACCOMMODATIONS AND
ALLOWING ME TO PRESENT IN
KINDNESS AND RESPECTFULLY ASKED
FOR I VOTE WHEN YOU'VE
ESTABLISHED A QUORUM WITH
RESPECT ASSEMBLY BILL 15 77,
WHICH HELPS TO ENSURE THAT WE
INCREASE ACCESS WAS SUPPOSED TO
HEALTHCARE NOW HAVE TWO
WITNESSES HERE IN SUPPORT TO
ALSO TESTIFY AS WELL. I
RESPECTFULLY ASK FOR OUR VOTE
WHEN YOU HAVE A STATUE LUKEWARM.
THANK YOU. GOOD AFTERNOON. THANK
YOU. CHAIR WOOD AND MEMBERS OF
THE COMMITTEE FOR CONSIDERING A
B 50 15 77 AND THANK YOU,
ASSEMBLYMAN LOW FOR YOUR
UNWAVERING SUPPORT OF NURSES. MY
NAME IS CHARMAINE MORALES,
PRESIDENT OF UNITED NURSES
ASSOCIATIONS OF CALIFORNIA UNION
OF HEALTHCARE PROFESSIONALS.
CALIFORNIA IS FACING A NURSE
STAFFING CRISIS NEVER SEEN
BEFORE, AND THE RECENT PANDEMIC
SHED LIGHT ON THE NURSING
SHORTAGE, WHICH WAS EXASPERATED
BY THE POOR, WORKING CONDITIONS
, BURNOUT AND A LUCRATIVE NURSE
TRAVEL REGISTRY INDUSTRY WHILE
THE NURSING SHORTAGE DISCUSSION
HAS BEEN ONGOING AND WELL
DOCUMENTED, IT IS IMPORTANT FOR
THE STATE OF CALIFORNIA TO
INTERVENE AND IMPLEMENT A PLAN
TO SAVE NURSING IMMEDIATELY. QUÊ
HCP RECOGNIZES THE NURSING
CHALLENGES THAT HAVE BEEN
OUTLINED BY THE STATE FOR THE
PAST FIVE YEARS, AND WE FEEL IT
IS IMPORTANT FOR CALIFORNIA TO
ACT SWIFTLY AND SOLVE THE
CRISIS. A B 15 77 IS AN
IMPORTANT COMPONENT OF SOLVING
THE CRISIS BY REQUIRING
HOSPITALS TO PROVIDE MORE
CLINICAL PLACEMENTS TO COMMUNITY
COLLEGES AS THEY GROW THEIR
NURSING PROGRAMS. COMMUNITY
COLLEGES ARE BEST POSITION TO
HELP RESOLVE THE STAFFING CRISIS
, AND WE NEED TO ENSURE THAT A
STUDENT'S MOVED THROUGH NURSING
PROGRAMS. BOTTLENECKS ARE NOT
CREATED, THUS IMPEDING NURSING
SCHOOL COMPLETION. I AM A
GRADUATE OF LOS ANGELES HARBOR
COLLEGE AND COMPLETED MY
CLINICAL THAT KAISER AND HARBOR
CITY. AND ONCE I PASSED MY
BOARDS, I WENT TO WORK FOR THE
SAME HOSPITAL WHERE I COMPLETED
MY CLINICAL. THIS IS THE PERFECT
MATCH FOR HOSPITALS, TRAIN THE
NURSE AND HOPEFULLY HIRE THEM.
MAYBE 15 77 WILL BE A GAME
CHANGER FOR CALIFORNIA AND I
WANT TO THANK ALL OF THE
STAKEHOLDERS FOR WORKING
TOGETHER TO FIND SOLUTIONS. QUÊ
HCP APPRECIATES ALL THE
RECOMMENDED AMENDMENTS AND WE
LOOK FORWARD TO CONTINUING TO
WORK COLLABORATIVELY WITH CH CH
A THANK YOU AND I RESPECTFULLY
ASK FOR YOUR I VOTE. ELIZABETH
HAWKINS FROM UNITED NURSES
ASSOCIATION OF CALIFORNIA UNION
HEALTHCARE PROFESSIONALS HAVE
BEEN IN THE NURSING PROFESSION
FOR 38 YEARS AND PRECEPT RING IS
IMPORTANT, AND IT ALSO KEEPS
NURSES IN THE COMMUNITY IN WHICH
THEY WENT TO SCHOOL BECAUSE THEY
TEND TO STAY WHERE THEY HAVE
DONE THEIR CLINICAL ROTATIONS.
THANK YOU. I ASK THAT YOU
SUPPORT THIS BILL. THANK YOU
VERY MUCH OTHERS IN SUPPORT OF
THE BILL.
GOOD AFTERNOON CHAIR COMMITTEE
STAFF AND MEMBERS, CHRISTOPH
MAYER WITH THE AMERICAN
FEDERATION OF STATE, COUNTY AND
MUNICIPAL EMPLOYEES AND STRONG
SUPPORT. THANK YOU VERY MUCH.
ANYONE ELSE? OKAY SO NO ONE WILL
BRING ACTUALLY IS THEIR
OPPOSITION TO THE BILL. MY
APOLOGIES. I WAS SO EXCITED I
WAS. WE'RE ON A ROLL THERE AND
BEFORE WE HAVE OPPOSITION. I'M
GONNA HAVE MADAM SECRETARY
CALLED THE ROLE WE HAVE A
QUORUM. WOULD HERE. WALDRON.
AGUIAR-CURRY ARAMBULA. BURNER.
WHEN HE CARILLO LARA. VINCE FONG
MAIENSCHEIN. MCCARTHY. JOE
PATTERSON. RODRIGUEZ. SANTIAGO.
VALLAPUDUA WEBER. THANK YOU.
THANK YOU VERY MUCH. MEMBERS.
YOU HAVE NO IDEA HOW HAPPY
YOU'VE MADE ME TODAY. UM. AND
THOSE OF YOU IN THE AUDIENCE MAY
NOT UNDERSTAND. BUT TRUST ME.
THIS IS A GOOD THING TO HAVE A
QUORUM. SO THANK YOU SO MUCH,
AND I JUST RECOGNIZE I HOPE TO
MEMBERS OF THE AUDIENCE. THIS IS
AN EXTREMELY BUSY WEEK FOR US.
AND TODAY IS AN EXTREMELY BUSY
DAY. SO YOU'RE GOING TO SEE
MEMBERS COMING AND GOING. UH
IT'S JUST THE NATURE OF WHAT'S
GOING ON TODAY. AND SO I'M
REALLY GRATEFUL THE COMMITTEE
MEMBERS TO COME AND HELP ME
ESTABLISH QUORUM SO WE CAN
CONTINUE. CONTINUE ON SO PLEASE.
OUR OPPOSITION WITNESS. THANK
YOU. SORRY ABOUT THAT. THANK YOU
, MR CHAIR AND MEMBERS SARAH
BRIDGE ON BEHALF OF THE
ASSOCIATION OF CALIFORNIA
HEALTHCARE DISTRICTS HERE,
RESPECTFULLY OPPOSED TO A B 15
77. I WILL NOTE THAT OUR
OPPOSITION ORIGINALLY HINGES ON
THE ORIGINAL ITERATION OF THE
BILL, AND WE ARE EXCITED ABOUT
WORKING WITH THE AUTHOR AND THE
SPONSORS ON POTENTIAL AMENDMENTS
. I WANT TO START BY RECOGNIZING
AS WELL THAT WE SHARE THE GOAL
OF INCREASING OUR HEALTHCARE
WORKFORCE. HOWEVER WE DISAGREE
WITH AN APPROACH THAT HINGES
HOSPITALS, ABILITY TO PROVIDE
CARE ON CLINICAL PLACEMENTS.
LOTS. OUR PRIMARY CONCERN
REVOLVES AROUND THE PENALTIES
AND THE THREAT TO HOSPITAL
LICENSURE. DISTRICT HOSPITALS
ARE SOME OF THE SMALLEST RURAL
AND REMOTE FACILITIES IN THE
STATE, WHERE CLINICAL PLACEMENTS
LOTS MAY NOT BE APPROPRIATE OR
AS ROBUST DISTRICTS ARE PUBLIC
HOSPITALS, MEANING THEY OPERATE
LARGELY ON PUBLIC DOLLARS AND
ARE OWNED BY THE CONSTITUENTS
THEY SERVE PENALTY HAS COME AT A
DIRECT COST TO THE PUBLIC AND
PUBLIC FUNDS. HD SUPPORTS A
COLLABORATIVE APPROACH WITH
COMMUNITY COLLEGES TO IDENTIFY
GAPS THAT COULD BE APPROPRIATELY
FILLED. HOWEVER THE REQUIREMENT
THAT HOSPITALS THEN MEET A
DEMAND IDENTIFIED BY THE
COMMUNITY COLLEGE GOES TOO FAR.
TRAINING STUDENTS IS INCREDIBLY
COSTLY, AND HOSPITALS MAY
ALLOCATE THEIR CLINICAL
PLACEMENT SLOTS TO FILL
PARTICULAR SPECIALTIES, THEIR
HOSPITALS OR REGIONS NEED
SPECIFICALLY. WHEN THE COST IS
FINANCIALLY INSURMOUNTABLE DUE
TO OTHER FIGHTS, FINANCIAL
CONSIDERATIONS, HOSPITALS MUST
HAVE THE FLEXIBILITY TO CHANGE,
ADAPT OR ELIMINATE THESE LOTS
WHILE WE APPRECIATE THE INTENT
OF MAYBE 15 77, IT'S SIMPLY GOES
TOO FAR AT THE SAKE OF HOSPITALS
AT A TIME WHERE MANY DISTRICT
HOSPITALS ARE STRUGGLING
FINANCIALLY, WE LOOK FORWARD TO
WORKING WITH THE AUTHOR IN THE
SPONSORS MOVING FORWARD ON AN
APPROPRIATE SOLUTION TO ADDRESS
THE WORKFORCE CRISIS. HOWEVER AT
THIS TIME, WE WOULD RESPECTFULLY
REQUEST YOUR NO VOTE. THANK YOU.
HEY, THANK YOU VERY MUCH. IS
THERE ARE THERE OTHERS IN
OPPOSITION? SEE NO ONE WILL
BRING IT BACK TO THE COMMITTEE.
WELL, I'M SORRY. OH, I'M SORRY.
SORRY. APOLOGIES OKAY, CHRISTY.
WE'S ON BEHALF OF THE CALIFORNIA
HOSPITAL ASSOCIATION. WE ARE IN
A POSITION OF CONCERNS. UM, LOOK
FORWARD TO WORKING WITH THE
AUTHOR AND THE SPONSORS AS
AMENDMENTS. MOVE FORWARD. THANK
YOU. WE'RE ALL ABOUT HEALTH AND
FITNESS. I JUST DIDN'T MEAN FOR
YOU TO HAVE TO RUN. BUT THANK
YOU. THANK YOU. QUESTIONS, MR
FLORA. THANK YOU, MR CHAIR, MR
LO. ALWAYS GOOD TO SEE YOU. AND
I HAVE REALLY, REALLY WANTED TO
SUPPORT THIS BILL TODAY, BUT I
ABSOLUTELY UNDERSTAND FROM A
DISTRICT HOSPITAL PERSPECTIVE,
THE CONCERNS THAT HOW YOU KNOW
THESE FINES AND POTENTIAL LOSS
OF LICENSE YOUR BASED ON A
COMMUNITY COLLEGES, YOU KNOW,
OPINION OR NOT ABILITY TO GET
SLOTS. CAN YOU ADDRESS THAT
CONCERN AND BECAUSE I DO I
REALLY WANT BECAUSE I THINK THIS
BILL IS RIGHTEOUS, AND WE NEED
TO GET MORE STUDENTS IN THE
CLINICAL TIME. WE ABSOLUTELY
AGREE WITH THAT. BUT I DO THINK
THAT POTENTIAL FINES AND LOSS
SUPPLIES AND TOURISM PROBLEM.
CAN YOU ADDRESS THAT FOR ME?
THANK YOU VERY MUCH THROUGH THE
CHAIR. THANK YOU VERY MUCH ON
THE FLOOR, UM, SPECIFICALLY
PRESENTED BEFORE TWO IN THE
ANALYSIS, AND I FORGOT TO
MENTION THAT, UH, LIKE TO ACCEPT
THE COMMITTEE SUGGESTED
AMENDMENTS AS WELL, WHICH ARE
JUST SIMPLY ADDRESS IS THAT OF
THE FINES AND WE TOOK OUT THE
REMOVAL OF LICENSURE SO THAT OF
THE FINES, BUT ULTIMATELY, IT'S
HELP INCREASE THE TYPE OF ACCESS
AND MAKING SURE THAT THE
IMPLEMENTATION ALSO WORKS, TOO.
SO. I SHARE THAT CONCERN, TOO,
AND DEEPLY COMMITTED TO HELPING
, UH, MAKING THE IMPACT
IMPLEMENTED AS WELL TOO, WHILE
ALSO RECOGNIZING THE POTENTIAL
CONCERNS THAT YOU'VE HAD AS
WELL. NO AND I APPRECIATE THAT,
AND I AM GOING TO SUPPORT THE
BILL TODAY, BUT I WILL BE
CHECKING WITH MY DISTRICT FOLKS,
BECAUSE I DON'T WANT TO DO
ANYTHING THAT'S GOING TO HURT MY
DISTRICT PEOPLE AS WELL. AND
WE'LL HOPEFULLY GET THAT SORTED
OUT BEFORE THE FLOOR. THANKS.
THANK YOU, MR FOR MR FONG. NOT
TO BELABOR THE POINT, BUT IS IT
MY UNDERSTANDING THAT AND BEING
THE ANALYSIS THAT IT AUTHORIZES
BUT DOES NOT REQUIRE UH, FINES
OR OR OR A LICENSE TO BE REVOKED
. IF THEY FAILED TO MEET IS THAT
CORRECT? SO IT DOES AUTHORIZE
ONE, BUT IT DOESN'T REQUIRE
CORRECT MANDATORY BUT
AUTHORIZES. OKAY, BUT NOT
MANDATORY. RIGHT? THANK YOU.
THANK YOU ANY OTHER QUESTIONS OR
COMMENTS? MISS WALDRON'S SO JUST
TO CLARIFY THAT THE AMENDMENTS
ALSO INCLUDED THAT IT ONLY
APPLIES TO HOSPITALS NEAR
COMMUNITY COLLEGE THAT HAS AN
APPROVED NURSING SCHOOL. YES
THAT'S NOT ALL HOSPITALS HAVE
THAT. THANK YOU. THANK YOU.
ANYONE ELSE? NO ONE THAT BILL
DOES ENJOY DO PASS
RECOMMENDATION. WOULD YOU LIKE
TO CLOSE MR LOWE JUST SIMPLY
THAT IT COMMITTED TO ALSO
WORKING WITH MEMBERS OF THIS
COMMITTEE THAT EXPRESSED SOME OF
THE CONCERNS MOVING FORWARD.
SHOULD THIS PAST THIS COMMITTEE
RESPECTFULLY ASK FOR MY VOTE.
VERY WELL. THANK YOU. THEIR
EMOTION ON THE BILL. THE MOTION
BY MR RODRIGUEZ, A SECOND BY MR
SANTIAGO. THE MOTION IS DUE PASS
AS AMENDED TO APPROPRIATIONS
SECRETARY PLEASE CALL THE ROLL.
WHAT WOULD I WALDRON WALDRON
IAGAR CURRY CURRY. I ARAMBULA
EARNER, WENDY CARILLO. FLORA. OR
IVAN'S FONG. THAT'S FUN, NOT
VOTING MAIENSCHEIN. MCCARTHY.
MCCARTHY I, JOE PATTERSON.
RODRIGUEZ RODRIGUEZ, I SANTIAGO
SANTIAGO IVY VALLAPUDUA. WEBER.
YOU HAVE SEVEN VOTES YOU'RE
TRENDING IN A POSITIVE
DIRECTIONS WILL LEAVE THE BILL
ON CALL FOR YOU. THANK YOU VERY
MUCH. MR CONNOLLY IS UP NEXT
BEFORE WE YOU CAN KEEP CAN KIND
OF WANDER UP HERE. BUT WE DO
HAVE A WE HAVE TO HAVE A CONSENT
CALENDAR. SOMEONE WANTS TO MAKE
A MOTION ON THE CONSENT MOTION
BY MR MISS SAGER CURRY SECOND BY
MR MCCARTHY ON THE CONSENT
CALENDAR, WHICH IS ITEM NUMBERS,
12. 16 2028, 29, 30 AND 32.
DIAGONAL BINGO THERE, BUT. MADAM
SECRETARY. PLEASE CALL THE ROLL
ON THE CONSENT CALENDAR. WOULD I
WOULD I. WALDRON WALDER. NIAGARA
CURRY CURRY. I ARAMBULA BURNER.
WENDY CARILLO. LARA. LARA, IVINS
FONG. SHANGHAI MAIENSCHEIN
MCCARTHY. MCCARTHY I PATERSON
RODRIGUEZ. RODRIGUEZ I SANTIAGO.
VALLAPUDUA WEBER. SEVEN ON THE
CONSENT CALENDAR WILL LEAVE THAT
ON CALL. MR CONNELLY. YOU HAVE
TWO BILLS. LET'S START WITH A B
6 20. THANK YOU, CHAIR. LET'S DO
THAT. AND THANK YOU AGAIN AND TO
MEMBERS. I'D LIKE TO BEGIN BY
THANKING THE COMMITTEE AND STAFF
FOR THEIR WORK AND INPUT ON THIS
BILL AND I WILL BE ACCEPTING THE
COMMITTEE'S AMENDMENT. A B 6 20
WOULD REQUIRE HEALTH PLANS TO
COVER MEDICAL NUTRITION THERAPY.
MEDICAL NUTRITION THERAPY IN THE
FORM OF NUTRITIONAL FORMULAS CAN
BE A SUCCESSFUL ALTERNATIVE TO
MEDICATION. TREATMENT FOR
SEVERAL DISEASES, INCLUDING
CROWNS DISEASE. THIS THERAPY HAS
A PARTICULAR BENEFIT FOR
PEDIATRIC PATIENTS BECAUSE THEY
MAY NOT HAVE HAVE ACCESS TO OR
MAY NOT BE ABLE TO USE CERTAIN
MEDICATIONS. ADDITIONALLY
PATIENTS WITH INTESTINAL BOWEL
DISEASE OR IBD, SPECIFICALLY,
CRONE'S DISEASE CAN UTILIZE
MEDICALLY NECESSARY FORMULAS FOR
NUTRITIONAL SUPPORT. HELP THEM
ACHIEVE REMISSION. EARLY
TREATMENT OPTIONS FROM METABOLIC
AND DIGESTIVE DISEASES LIKE
CROWNS HAVE PROVEN TO REDUCE
HARM AND INCREASED QUALITY OF
LIFE. THERE IS NO REASON WHY
CALIFORNIANS SUFFERING FROM
CHRONIC ILLNESSES CANNOT LEAD
FULL AND PRODUCTIVE LIVES. 86 20
PROVIDES PATIENTS WITH A PROVEN
SUCCESSFUL ALTERNATIVE TO
CERTAIN MEDICATIONS. WHICH
HEALTHCARE PROVIDERS MAY
RECOMMEND WHEN COMPLICATIONS
SUCH AS WEIGHT LOSS, SURGERY,
OBSTRUCTION OR SEVERE
INFLAMMATION, PREVENT PATIENTS
FROM GETTING THE RIGHT NEW
TRENDS. EXCLUSIVE INTERNAL
NUTRITION OR E N, AS IT'S KNOWN
AS A MEANS TO INDUCE REMISSION
IS SAFER, IMPROVES GROWTH AND
ENCOURAGES HEALING AND CHILDREN
OVER STEROID THERAPY. AND TURN
ON NUTRITION OR IAN IS A WAY TO
GIVE THE PATIENT'S BODY WET. IT
NEEDS TO STAY HEALTHY, HEALTHY.
ENTRO MEANS PASSING THROUGH THE
INTESTINES WHEN NUTRITION IS
TAKEN EITHER ORALLY OR THROUGH A
FEEDING TUBE. AND CHILDREN.
NUTRITION IS USUALLY TAKEN IN
THE FORM OF A NUTRIENT RICH
FORMULA, AND SOME COMMON
FORMULAS INCLUDE BOOST, ENSURE
AND OR GAME INHERITED METABOLISM
, METABOLISM DISORDERS AND
DIGESTIVE DISEASE, INCLUDING IBD
AFFECTS MILLIONS OF AMERICANS
WITH AS MANY AS 70,000 NEW CASES
OF IBD. THEY'RE DIAGNOSED EACH
YEAR. 86 20 WILL ALLOW
CALIFORNIANS SUFFERING FROM
THESE DISORDERS TO HAVE GREATER
ACCESS TO NUTRITIONAL SUPPORT.
IN ADDITION TO MEDICATION BY
EXPANDING HEALTH INSURANCE
COVERAGE TO QUOTE MEDICALLY
NECESSARY FOODS, WHICH HAVE
PROVEN TO REDUCE SYMPTOMS AND
IMPROVE QUALITY OF LIFE. I WILL
NOW PASS IT OFF TO DR SINDOOR A
BOUGHT YOU PEDIATRIC
GASTROENTEROLOGIST, SAID THAT
RIGHT AT U C. DAVIS AND I
RESPECT WE ASKED FOR AN I VOTE.
WELCOME, DOCTOR. THANK YOU.
CHAIR AND MEMBERS OF THE
COMMITTEE. THANK YOU FOR GIVING
ME THE OPPORTUNITY TO SPEAK
TODAY ON BEHALF OF OUR PEDIATRIC
PATIENTS WITH INFLAMMATORY BOWEL
DISEASE. MY NAME IS CINDY OR
ABOUT YOU AND I AM THE PEDIATRIC
GASTROENTEROLOGIST UC DAVIS. I
COME HERE TO VOICE MY SUPPORT
FOR A B 6 20. THE PREVALENCE OF
IBD S ABOUT 77 OUT OF 100,000
CHILDREN. AND MORE RECENTLY, THE
NUMBER OF CHILDREN WITH IBD S
INCREASING IBD, WHICH INCLUDES
CROHN'S DISEASE, AN ULCER
COLITIS, PROGRESSIVE, CHRONIC
INTESTINAL CONDITIONS
CHARACTERIZED BY INFLAMMATION,
VARIOUS PARTS OF THE
GASTROINTESTINAL TRACT. THE
PROGRESSIVE NATURE OF THIS
DISEASE CAN LEAD TO IRREVERSIBLE
DAMAGE AND, IF NOT TREATED IN A
TIMELY FASHION, SURGICAL REMOVAL
OF THE DISEASED BOWEL. CURRENT
TREATMENTS CAN VARY FROM FIVE BS
AS STEROIDS, IMMUNO MODULATORS
AND BIOLOGICS, WHICH WORKS
TOWARDS REROUTING OUR IMMUNE
SYSTEM AND DECREASING
INFLAMMATION. HOWEVER THESE
TREATMENTS ARE NOT PERFECT. A
SUBSET OF RA PATIENTS FAIL, NEED
DOSE ESCALATION AND, MORE
IMPORTANTLY, TO GET THIS
MEDICATION. THESE MEDICINES COME
WITH ADVERSE SIDE EFFECTS,
INCLUDING INFECTION. MALIGNANCY
AUTOIMMUNE SICK. WELL, THEY NEED
TO BE CLOSELY MONITORED. ANOTHER
CONCERN FOR PATIENTS. IBD IS
MALNUTRITION. MANY PATIENTS MAY
EXPERIENCE WEIGHT LOSS DUE TO
THEIR SYMPTOMS, AND PEDIATRIC
PATIENTS ARE AT RISK FOR DELAYED
GROWTH IN PUBERTY DEVELOPMENT.
THIS CENTRAL ISSUE IN IBD
IMPACTS PATIENT OUTCOMES AS WELL
AS QUALITY OF LIFE, EMPHASIZING
THE NEED FOR A DEDICATED
DIETETIC CARE FOR PATIENTS, IBD
MEDICAL NUTRITIONAL THERAPY HAS
BEEN USED IN VARIOUS FORMS OF
IBD. SIMPSON'S 19 SEVENTIES
EXCLUSIVE INTERNAL NUTRITION OR
E N IS DEFINED AS ADMINISTRATION
OF 100% OF THE BODY'S ESTIMATED
CALORIC NEEDS BY LIQUID
NUTRITIONAL FORMULAS.
NUTRITIONAL THERAPY TARGETS ARE
GUT MICROBIOME INSTEAD OF HER
INNATE IMMUNE SYSTEM TO LOWER
INFLAMMATION. IN OUR AMERICAN
SOCIETY FOR PEDIATRIC
GASTROENTEROLOGY, HEPATOLOGY
NUTRITION GUIDELINES. IT IS AN
ACTUAL RECOMMENDATION. TREATMENT
FOR INDUCTION OF REMISSION OF
INFLAMMATORY BOWEL DISEASE AND
GIVE HER THAT THERE ARE NO SIDE
EFFECTS. IT IS TRULY AN
APPEALING OPTION AND SELECT
COHORT OF PATIENTS. SUPPLEMENTAL
NUTRITION CAN ALSO INCREASE
ENERGY AND PROMOTE GROWTH FOR
THOSE CHILDREN THAT PRESENT WITH
GROWTH FAILURE. UNFORTUNATELY
MANY OF HER FAMILY'S AND TRAIL
NUTRITIONAL THERAPY IS NOT AN
OPTION AS IT IS NOT COVERED BY
INSURANCE. WHEN I MEET A FAMILY
FOR WHAT FOR THE FIRST TIME
DIAGNOSIS, THE IBD I SEE A SICK
CHILD IN A DISTRESSED FAMILY. MY
JOB AS A PHYSICIAN IS A SET THEM
ON THE BEST TRAJECTORY OF GUT
HEALING, WELLNESS AND A WIDE
NEED FOR SURGERY, PROVIDING THEM
WITH ANY LESS DESIRABLE OPTIONS.
I FEEL AS MEDICALLY INCORRECT.
IBD TREATMENTS ARE ALREADY SO
LIMITING TO BEGIN WITH, AND
ADDED BARRIER OF INSURANCE
APPROVAL, REALLY LIMITS OF
FAMILIES OPTIONS. A TEENAGER WHO
RECENTLY CAME TO A PRACTICE THE
NEW DIAGNOSIS INFLAMMATORY BOWEL
DISEASE HE PRESENTED WITH THE
STRICTURE. UM GIVEN THE EXTENT
OF THE DISEASE AND STRICTURE, HE
WOULD START ON DUAL INDUCTION
THERAPY WITH INTRO NUTRITION
BIOLOGIC. THE FAMILY WAS
DEDICATED AND DO NUTRITIONAL
THERAPY. THIS WOULD MEAN PATIENT
X WOULD NEED TO TAKE 7 TO 8
CANCER PD ASSURE A DAY IMAGINE
HAVING TO DO SO AND NOT FEEL
GREAT AND WORRY ABOUT INSURANCE
COVERAGE. I CAN TELL YOU I'VE
HAD MANY FAMILIES WHERE THIS IS
NOT EVEN A VIABLE TREATMENT
OPTION AND THERE WAS A LAPSE OF
INSURANCE COVERAGE. ON BEHALF OF
OUR PATIENTS. I STAND IN FRONT
OF YOU TO URGE TO SUPPORT A B 6
20 TO ALLOW ALL TREATMENT
OPTIONS TO BE AVAILABLE TO A
PEDIATRIC PATIENTS, BUT THIS
CHRONIC AND VERY SERIOUS
ILLNESS. THANK YOU. THANK YOU
VERY MUCH. BRIAN SPENCER ON
BEHALF OF THE CROHN'S AND
COLITIS FOUNDATION. THERE THE
SPONSORS OF THIS MEASURE. I WAS
STAYING THE ANALYSIS AND ALSO
REITERATED IN THE TO BURP
REPORT. BUT I THINK IT'S WORTH
RESTATING THAT THIS IS CURRENTLY
COVERED BY MEDICAL THROUGH
MEDICAL RX. AND SO WITH THIS
BILL, SIMPLY DOES IT APPLIES IT
TO COMMERCIAL PLANS AS WELL. AND
SO I'M ALSO HERE TO ANSWERING
TECHNICAL QUESTIONS YOU MAY HAVE
AND ASK FOR YOUR SUPPORT. THANK
YOU. THANK YOU VERY MUCH, UH,
OTHERS IN SUPPORT. OKAY IS THERE
OPPOSITION TO THE BILL? GET
AFTERNOON CHAIR AND MEMBERS OF
THE COMMITTEE ROBERT BOYKIN WITH
CALIFORNIA ASSOCIATED HEALTH
PLANS REGRETTABLY IN OPPOSITION
AT A B 6 20. WE RESPECT TO
UNDERSTAND THE INTENT OF THE
BILL. HOWEVER, WE ARE OPPOSED
BECAUSE ACCORDING TO THE SUBURB
ANALYSIS, THEY KNOW HEALTH BAND
PREMIUM INCREASE WILL BE 24
MILLION. BUT WE DO UNDERSTAND
THAT THE AMENDMENTS WILL HELP
MAYBE LOWER THAT COST BUT ALSO
KEEP IN MIND THAT THIS IS ONE OF
23 MANDATE BILLS THIS YEAR. THAT
WHEN COMBINED ARE SET TO
INCREASE ANNUAL COSTS BY MORE
THAN ONE BILLION. SO WE'VE
SPOKEN WITH THE SPONSORS AND THE
AUTHORS OFFICE OF THE BILL AND
LOOK FORWARD TO WORK WITH THEM
AS THE MOON MOVES FORWARD IN THE
PROCESS. THANK YOU. THANK YOU
VERY MUCH. MR CHAIR MEMBER,
STEPHANIE WATKINS, ON BEHALF OF
THE ASSOCIATION OF CALIFORNIA
LIFE AND HEALTH INSURANCE
COMPANIES. WE DO HAVE AN OPPOSED
THIS IS ON THE MANDATE LIST, BUT
WE DO APPRECIATE THE CONSTANT
DIALOGUE WITH THE SPONSORS AND
THE AUTHOR APPRECIATE THE
AMENDMENTS THAT WERE TAKEN AND
WORKED OUT WITH COMMITTEE AND SO
WE'LL CONTINUE THAT CONVERSATION
HAS BEEN MOVES FORWARD TODAY.
THANK YOU. THANK YOU. JOHN
WINGER ON BEHALF OF AMERICA'S
HEALTH INSURANCE PLANS WOULD
JUST ECHO THE COMMENTS OF
CAMPAÑA CLICK. OKAY. THANK YOU.
ANYONE ELSE? BRINGING BACK TO
THE COMMITTEE FOR QUESTIONS OR
COMMENTS ANY QUESTIONS OR
COMMENTS NO QUESTION. MR
RODRIGUEZ IS HERE, SO THERE'S
THREE OF US SO UM, THE BILL DOES
ENJOY DO PASS RECOMMENDATION.
WOULD YOU LIKE TO CLOSE, MR
CONNELLY? YEAH I APPRECIATE THE
CONSIDERATION THE ONGOING
DIALOGUE AND RESPECTFULLY ASK
FOR AN IBO. THANK YOU VERY MUCH.
EMOTION BY MS AGUIAR-CURRY.
SECOND BY MR RODRIGUEZ. THANK
YOU VERY MUCH. THE MOTION IS DUE
PASS AS AMENDED TO
APPROPRIATIONS. MADAM SECRETARY
, PLEASE CALL THE ROLL. WOULD
WOULD I WALDRON WALDRON II CURRY
CURRY. I ARAMBULA BURNER. WENDY
CARILLO FLORA VINCE FONG.
MAIENSCHEIN MCCARTHY, JOE
PATTERSON. RODRIGUEZ RODRIGUEZ
I, SANTIAGO BOUDOIR WEBER. WE
HAVE FOUR VOTES WILL LEAVE THE
BILL ON CALL FOR YOU. THANK YOU
VERY MUCH TO YOUR WITNESSES. AND
YOU HAVE ANOTHER BILL. THANK YOU
CHAIR ANOTHER BILL. WE'RE
EXCITED ABOUT A B 11. OH, NINE.
WANT TO START AGAIN BY THANKING
YOU, THE COMMITTEE STAFF. FOR
THE WORK ON THIS BILL AND WILL
BE HAPPILY ACCEPTING THE
COMMITTEE'S AMENDMENTS IN THIS
CASE AS WELL. I'M PLEASED TO
PRESENT A B 11 OH, NINE TODAY,
WHICH RESTRICTS THE ONLINE SALE
OF SODIUM NITRIDE TO MINORS AND
CAPS, A PURITY OF WHICH IT IS
ALLOWED TO BE SOLD AT 10. SODIUM
NITRITE IS AN INORGANIC COMPOUND
. UH AND HARD TO BELIEVE THIS
BUT HAS BECOME A FREQUENT ITEM
USED BY TEENAGERS TO TAKE THEIR
OWN LIVES. LOW LEVELS OF PURITY
, 10% AND BELOW SODIUM NITRITE
IS COMMONLY USED AS A FOOD
PRESERVATIVE. HOWEVER CONSUMING
THE COMPOUND IN HIGH LEVELS OF
PURITY CAN CAUSE FATAL
POISONING. WHILE THERE IS NO
REAL WARD APPLICATION FOR SODIUM
NITRATE CONCENTRATIONS OF PURITY
ABOVE 10. MAJOR ONLINE RETAILERS
HAVE BEEN SELLING IT AT LEVELS
OF PURITY UP TO 99. BECAUSE OF
CHEMICAL CAN EASILY BE PURCHASED
IN HIGHLY PEER FORMS AND
DELIVERED DIRECTLY TO AN
INDIVIDUAL'S RESIDENTS. IT HAS
BECOME A TRAGICALLY FREQUENT
METHOD OF COMMITTING SUICIDE.
SHOCKINGLY POISON CONTROL
CENTERS THROUGHOUT THE COUNTRY
HAVE REPORTED A 253% INCREASE IN
SELF POISONING WITH NITRIDE AND
166% INCREASE IN FATALITIES IN
2021 IN COMPARISON TO 2018.
ASSEMBLY BILL 11 09 WOULD
ADDRESS THE EASE OF ACCESS TO
THIS DANGEROUS CHEMICAL BY
PROHIBITING ONLINE RETAILERS
FROM SELLING SODIUM NITRITE TO
MINORS AND PROHIBIT THE SALE OF
SODIUM NITRATE AND CONCENTRATE
CONCENTRATIONS GREATER THAN 10.
TO A PERSON OVER 18 YEARS OF
AGE. THE BILL ALSO SPECIFIES THE
RETAILERS AND ONLINE
MARKETPLACES MUST IMPLEMENT AN
EFFECTIVE AGE VERIFICATION
SYSTEM AND INCLUDES AN EXEMPTION
FOR LEGITIMATE BUSINESS AND IT
IS THIS BILL HAS NO OPPOSITION,
AND I RESPECTFULLY ASK FOR AN
EYE BOAT. THANK YOU VERY MUCH.
MR CONNELLY, OTHERS IN SUPPORT
OF THE BILL.
YES MR CHAIR MEMBERS, BRYCE
DOUGHERTY ON BEHALF OF THE
AMERICAN ACADEMY OF PEDIATRICS,
CALIFORNIA AND STRONG SUPPORT.
THANK YOU. THANK YOU. ANYONE
ELSE? IS THERE OPPOSITION TO THE
BILL? DO YOU KNOW ONE BRING IT
BACK TO THE COMMITTEE FOR
QUESTIONS OR COMMENTS ANY
QUESTIONS OR COMMENTS DID YOU
HAVE A MOTION BY MS AGUIAR-CURRY
, A SECOND BY MS WALDRON. BILL
DOES ENJOY DO PASS
RECOMMENDATION. WOULD YOU LIKE
TO CLOSE? THANK YOU AGAIN. I
RESPECTFULLY ASK FOR AN EYE BOAT
. THANK YOU VERY MUCH. MR
CONNELLY. MADAM SICK. THE MOTION
IS DUE PASS AS AMENDED. MADAM
SECRETARY, PLEASE CALL THE ROLL
. I WOULD I, WALDRON WALDRON, I
CURRY THANK GOD CARILLO II
ARAMBULA BURNER. WENDY CARILLO
LARA, VINCE FONG MAIENSCHEIN
MCCARTHY. MCCARTHY I, JOE
PATTERSON RODRIGUEZ. SANTIAGO DE
VALLAPUDUA WEBER. THAT BILL HAS
FOUR VOTES. WE'LL LEAVE IT ON
CALL. THANK YOU, MR CONNELLY.
THAT'S HER NGUYEN.
YOU BRING GIFTS OR PROPS? I
COULD BRING GIFTS, BUT THAT'S
PROBABLY NOT LEGAL. WE COULDN'T
GET SKITTLES OUT OF MR GABRIEL.
BUT, YOU KNOW, WE TRIED.
AFTERNOON MR CHAIRMAN MEMBERS I
WOULD LIKE TO BEGIN BY ACCEPTING
THE COMMITTEE AMENDMENTS AND
THANKING THE COMMITTEE STAFF FOR
THEIR HARD WORK. I'M PLEASED TO
PRESENT A B 6 60 TODAY. FOR TOO
LONG. CALIFORNIA'S HAVE BEEN
MISLED BY UNCLEAR LABELS ON FOOD
STORES OFFER PRODUCTS WITH ALL
SORTS OF DIFFERENT LABELS LIKE
EXPIRES ON BEST BUY. UH ENJOYED
SELL. BUY TO NAME A FEW IS
LABELS CONSISTENTLY MISLEAD AND
CONFUSE CONSUMERS SELL BY DATES
, FOR EXAMPLE, ARE MEANT TO
SHALLOW GROSS RUMORS WENT TO
ROTATE STOCK AND THEY ARE
MEANINGLESS TO THE CONSUMER. THE
RESULT OF THIS CONSUMER
CONFUSION IS STAGGERING AMOUNT
OF FOOD WASTE, WITH ONE STUDY,
ATTRIBUTING AS MUCH AS AS 20% OF
FOOD WASTE. UM TO THESE LABELS,
THIS ULTIMATELY COST CONSUMERS
MONEY AT THE GROCERY STORES AND
ADDS TO CLIMATE CHANGE AS WASTED
FOOD. ROTS IN LANDFILLS. 86 60
WOULD END THIS CONFUSION. IT
TAKES THE INDUSTRY'S OWN ADOPTED
STANDARD AND REQUIRES FOOD ITEMS
THAT USE DATE LABELS TO USE THE
STANDARD ITEMS LIKE WE HAVE ON
THIS MILK BOTTLE BEST IF USED BY
TO INDICATE THE QUALITY OF FOOD
OR USED BY TO INDICATE THE
SAFETY OF FOOD. I WOULD LIKE TO
EXPRESS MY CONTINUED
APPRECIATION TO THE INDUSTRY FOR
ENGAGING IN PRODUCTIVE
CONVERSATIONS WITH OUR OFFICE.
WE WILL FIND A PATH FORWARD WITH
THIS BILL. RECENT AUTHOR
AMENDMENTS TO THE BILL WERE MADE
TO ADDRESS CERTAIN INDUSTRY
CONCERNS AND THEY ARE REFLECTIVE
OF MY COMMITMENT TO CONTINUE TO
WORK WITH ALL STAKEHOLDERS ON
THIS BILL. WITH ME TO TESTIFY
TODAY IN SUPPORT OF THIS BILL
ARE NICOLE KOREAN, REPRESENTING
CALIFORNIANS AGAINST WASTE AND
ANDREA COLLINS, REPRESENTING THE
NATURAL RESOURCES DEFENSE
COUNCIL. GOOD AFTERNOON CHAIR
AND MEMBERS NICOLE KOREAN WITH
CALIFORNIANS AGAINST WASTE. WE
ARE PROUD TO COSPONSOR 86 60,
WHICH WILL STREAMLINE EXPIRATION
DATE LABELS BY REQUIRING THE USE
OF CONSISTENT TERMINOLOGY NEXT
TO AN EXPIRY DATE TO INDICATE
THE QUALITY AND SAFETY OF A FOOD
PRODUCT. A STUDY BY RE FEED
FOUND THAT STANDARDIZING THESE
LABELS IS THE SINGLE MOST COST
EFFECTIVE WAY TO REDUCE FOOD
WASTE. DATA ALSO SHOWS THAT
HOUSEHOLDS MAKE UP A WHOPPING
43% OF FOOD WASTE BY FAR THE
LARGEST CATEGORY. FOOD WASTE
WHEN BROKEN DOWN BY SUPPLY CHAIN
STAGE. THIS IS MORE THAN GROCERY
STORES AND RESTAURANTS COMBINED
AT 31. AS I'M SURE YOU'RE AWARE
CONSUMERS ARE BOMBARDED WITH ALL
TYPES TYPES OF EXPIRATION DATE
LABEL FORMATS. EACH TERM CAN BE
USED TO MEAN DIFFERENT THINGS
WHEN USED BY DIFFERENT BRANDS,
AND SOME EXPERT DATES HAVE NO
PHRASE NEXT TO THEM AT ALL. IN
2017, THE INDUSTRY'S TWO LARGEST
TRADE ASSOCIATIONS, RELEASED A
JOINT STATEMENT ANNOUNCING THAT
THEY WOULD IMPLEMENT UNIFORM
DATE LABELING USING THE
RECOMMENDED QUALITY AND SAFETY
DATE PHRASES. THEY PROMISED
LARGE SCALE ADOPTION BY THE
FOLLOWING SUMMER AND COMMITTED
TO 100% IMPLEMENTATION BY 2020.
THE LEGISLATURE, THEN CODIFIED
THE INDUSTRY'S PROPOSED
TERMINOLOGY IN 2017, WITH 89 54
AS A VOLUNTARY STANDARD AND
DIRECTED CDF H PROMOTE THE USE
OF THESE TERMS AND DISCOURAGE
THE USE OF CONSUMER FACING SELL
BY DATES. 89 54 ALSO ESTABLISHED
SEPARATE DEFINITIONS FOR
EQUALITY, DATE SAFETY DATE AND
SELL BY DATE AND STATUTE. AND
THIS BILL PASSED WITH NO
OPPOSITION. HOWEVER IF YOU'VE
RECENTLY STOOD IN FRONT OF YOUR
FRIDGE OR PANTRY AND SQUINTED A
LABEL, YOU KNOW THAT VOLUNTARY
IMPLEMENTATION IS CLEARLY
INSUFFICIENT. FURTHER CONSUMER
EDUCATION AS TO WHAT PHRASES ON
WHICH FOODS MEAN WHAT ISN'T
POSSIBLE UNTIL WE STREAMLINE
THESE LABELS. WASTED FOOD IS A
SOCIETAL, ECONOMIC AND
ENVIRONMENTAL PROBLEM. AS A
STATE. WE THROW AWAY SIX MILLION
TONS OF FOOD EVERY YEAR.
RELEASING METHANE EMISSIONS THAT
HAVE A CLIMATE IMPACT 86 TIMES
GREATER THAN C 02. NOT TO
MENTION THE AMOUNT OF MONEY
SPENT ON FOOD THAT NEVER GETS
EATEN, AND THE COSTS OF DEALING
WITH THIS EXCESS WASTE PASSED ON
TO RATEPAYERS. 86 60 SIMPLY
REQUIRES ALL BRANDS TO USE THE
SAME TERMS THAT THEY THEMSELVES
HAVE IDENTIFIED TO REDUCE
CONSUMER CONFUSION AND THAT THE
STATE HAS ADOPTED AS A VOLUNTARY
STANDARD. THIS SMALL CHANGE WILL
HAVE HUGE RAMIFICATIONS AND FOR
THIS REGION WE ARE DRIVING ON
THE SPILL. THANK YOU. PLEASE GO
AHEAD. THANK YOU. CHAIR WOOD AND
COMMITTEE MEMBERS. MY NAME IS
ANDREA COLLINS WITH THE NATURAL
RESOURCES DEFENSE COUNCIL AND WE
SUPPORT A B 6 60 BECAUSE IT
ADDRESSES A SYSTEMIC CAUSE OF
FOOD WASTE WITH IMPLICATIONS FOR
OUR HEALTH, OUR ENVIRONMENT AND
OUR ECONOMY. TOO MANY OF US LOOK
AT A CONTAINER OF MILK, SEE THAT
THE DATE HAS PASSED AND DECIDED
TO DUMP IT RATHER THAN RISK
GETTING SICK. HOWEVER THE DATE
ON MILK WHETHER IT USES THOSE
WORDS ARE NOT AS LIKELY A SELL
BY DATE MEANT TO HELP GROCERY
STORES WITH STOCK ROTATION. AND
MANY OF THE OTHER DATES ON FOOD
ARE INTENDED TO BE AN INDICATOR
OF PEAK QUALITY. IN FACT,
THERE'S NO WAY OF KNOWING WHICH
DATES ARE ACTUALLY SAFETY DATES
AND SHOULD TELL A CONSUMER NOT
TO EAT THE PRODUCT. INSTEAD,
CONSUMERS ARE LEFT TO GUESS AT
WHAT INFORMATION IS INTENDED BY
THE DATE ON THE PACKAGE AND MORE
THAN 80% OF AMERICANS REPORT
TOSSING FOOD SIMPLY BECAUSE IT'S
PAST STATE. WE NEED CONSISTENT
DATE LABELS SO THAT PEOPLE STOP
TOSSING GOOD FOOD PREMATURELY
AND ALSO SO THAT WE HAVE MORE
CLARITY ON WHICH FOODS ARE
REALLY A HEALTH CONCERN.
CONFUSION OVER SO CALLED
EXPIRATION DATES IS RESPONSIBLE
FOR 20% OF THE WASTED FOOD IN
OUR HOMES AND AMERICANS SPEND
$1300 ON DISCARDED FOOD EVERY
YEAR. ELIMINATING CONFUSION OVER
WHETHER FOOD IS STILL GOOD WILL
HELP KEEP SOME OF THAT MONEY IN
THE POCKETS OF CALIFORNIANS. WE
HAVE ENOUGH FOOD YET EIGHT
MILLION CALIFORNIANS FACE FOOD
INSECURITY AND FOOD PACKAGING
DATES ARE A CHALLENGE FOR FOOD
BANKS AND PANTRIES THAT HELP
ENSURE THAT OUR SENIORS,
FAMILIES AND FOLKS IN NEED OF
EMERGENCY FOOD ASSISTANCE HAVE
ENOUGH TO EAT. PEOPLE WHO
RECEIVE FOOD FROM PANTRIES MAY
BE RELUCTANT TO TAKE THOSE ITEMS
THAT ARE NEAR OR PAST EIGHT
BECAUSE THEY BELIEVE THAT THE
ITEM IS UNSAFE AFTER THE DATE,
WHETHER OR NOT THAT'S THE CASE.
THE NEED FOR FOOD ASSISTANCE IN
OUR STATE IS IMMENSE, AND FOOD
INSECURITY IS DETRIMENTAL TO THE
PHYSICAL AND MENTAL HEALTH WITH
OUTCOMES THAT INCLUDE DIABETES,
HYPERTENSION, BEHAVIORAL
CHALLENGES AND CHILDREN. AND
THESE NEGATIVE RAMIFICATIONS
SHOULD MAKE ANY ATTEMPT TO
IMPROVE FOOD SECURITY A PRIORITY
FOR PUBLIC HEALTH. ADDITIONALLY
PEOPLE IN FOOD DESERTS OR FOOD
APARTHEID REGIONS, WHICH ARE
LARGELY INDIGENOUS, BLACK LATINA
AND RURAL COMMUNITIES, AND THOSE
WHO ARE DEPENDENT ON THE
EMERGENCY FOOD SYSTEM ARE
PURCHASING OR RECEIVING FOOD
THAT'S CLOSER TO THE DATE ON THE
LABEL, MEANING THAT THEY ARE
MORE OFTEN PLAGUED WITH THE
QUESTION AS TO WHETHER OR NOT
THE TASK FOOD PAST STATE MAKING
THIS A STUDENT DIFFICULT EQUITY
CONCERN. AND A LARGER PERCENTAGE
OF THEIR BUDGET IS SPENT ON
FOOD, SO THE CONSEQUENCES OF
TOSSING THAT FOOD MAKE A BIGGER
DENT ON THEIR HOUSEHOLD INCOMES
AND FINANCES. ENSURING THAT ALL
OF US UNDERSTAND WHEN FOOD IS
STILL GOOD TO EAT, WILL HELP
ALLEVIATE PRESSURE TO TOSS FOOD
THAT COULD HAVE NOURISHED US AND
DEFINING A STANDARD FOR CONSUMER
TARGETED LABELS. CLARIFIES WHEN
FOOD ACTUALLY POSES A SAFETY
RISK AND REDUCES THE LIKELIHOOD
OF DISCARDING GOOD FOOD. BEFORE
THESE REASONS, WE'RE PROUD TO
SUPPORT AND SPONSOR THIS KEY
LEGISLATION. THANK YOU. THANK
YOU VERY MUCH OTHERS IN SUPPORT.
REBECCA MARCUS, REPRESENTING
CALIPER AGAINST SUPPORT. THANK
YOU. IS HE? TWITTER IS THE
SWINDLER FROM SHELL YODER, AND
HE SMELLS ARE LYING,
REPRESENTING A FEW DIFFERENT
GROUPS. CALIFORNIA PRODUCT
STEWARDSHIP COUNCIL NATIONAL
STEWARDSHIP ACTION COUNCIL. STOP
WASTE AND SUPPORT. THANK YOU.
THANK YOU. AYMARA ANGER ON
BEHALF OF RECENT KHWEIS,
CALIFORNIA COMPOST COALITION
FIVE, GYRES INSTITUTE AND
PLASTIC FREE FUTURE AND SUPPORT.
THANK YOU. ANYONE ELSE? SEE NO
ONE WILL GO TO OPPOSITION. GOOD
AFTERNOON. DENNIS ALBION HAVE A
UM UH, TOUCH FINE ON A DIFFERENT
ON A COUPLE OF DIFFERENT
ENTITIES THAT HAVE VERY
DIFFERENT RANGES OF POSITIONS.
ALL EXPLAIN THAT AS WE GO, SO I
REPRESENT CONSUMER BRANDS
ASSOCIATION AND WE, ALONG WITH
THE FOOD MARKET INSTITUTE
ACTUALLY DEVELOPED, DID
SIGNIFICANT RESEARCH AND DEVELOP
THE TERMS THAT ARE OUTLINED IN
THIS IN THIS BILL ALSO WORKED
WITH, UM UH, MR CHU WHEN THE
BILL WENT THROUGH 954 AND SPENT
A LOT OF TIME IN THIS AREA, IT'S
ACTUALLY SOME OF OUR OWN REPORTS
THAT HAVE BEEN USED BY THE
PROPONENTS TO JUSTIFY THE BILL
AND WE'RE SUPPORTING FEDERAL
LEGISLATION, AND WE FEEL LIKE
THAT IS BY FAR THE BEST WAY TO
DO THIS. UH SINGLE STATE
LEGISLATION IS VERY CHALLENGING.
IT'S A CONCERN TO US THAT THAT,
UM YOU KNOW WHEN YOU MANDATE
SOMETHING IT BRINGS ALONG
LIABILITY, WHETHER IT'S 7200
LIABILITY, UNFAIR BUSINESS
PRACTICE OF THOSE, SO THAT'S A
CONCERN TO THE CONSUMER BRANDS
ASSOCIATION THAT HAS BEEN VERY
INVOLVED IN THIS AND HAS BEEN
MOVING THIS FORWARD AND MAKING
GREAT PROGRESS, ALTHOUGH
ADMITTEDLY NOT UH, 100%
COMPLIANCE AS DISCUSSED. THERE
ARE SOME OTHER ISSUES WITH SOME
OF THE SMALLER FOOD
MANUFACTURERS AND OUT OF COUNTRY
OUT OF STATE MANUFACTURERS AND
HOW THEY WOULD COMPLY. I THINK
THAT'S A CONCERN THAT NEEDS TO
BE FURTHER DISCUSSED. UM AND THE
REAL ISSUE IS CONSUMER EDUCATION
. WHAT REGARDLESS WHAT THE TERMS
ARE, WE NEED TO BE ABLE TO
EDUCATE THEM SO THAT SOME OF THE
CONCERNS OF THE PROPONENTS WHICH
ARE VERY VALID ARE ARE ABLE TO
BE RECOGNIZED NOW ON BEHALF OF
THE PACIFIC EGG AND POULTRY
ASSOCIATION IN THE ASSOCIATED
CALIFORNIA FARMERS, WE ARE
CONCERNED AND NEED TO BELIEVE
THAT EGGS SHOULD BE REMOVED FROM
THIS BILL, AND WE TESTIFIED
SEVERAL TIMES HAD SEVERAL
CONVERSATIONS WITH THE WITH THE
AUTHOR. UH THE EGGS ARE GOVERNED
BY A WHOLE USDA STRUCTURE OF
REGULATIONS. SIGNIFICANT STATE
LAW. IT'S ACTUALLY CODIFIED
STATE LAW. IT HAS BEEN FOR YEARS
AND HOW WE DO THAT, AND SO WE'RE
A LITTLE BIT CONCERNED. AND I
JUST SAY THIS THAT I THINK
CONSUMERS AND I THINK MOST
PEOPLE I WAS JUST AT THE
FARMER'S MARKETS THIS SATURDAY.
CONSUMERS HAVE A VERY DIFFERENT
RELATIONSHIP WITH THEIR EGGS,
THEN THEY DO WITH THEIR PANCAKE
MIX. AND I THINK THAT'S JOE. I
KNEW THERE TO GET AT LEAST A
GOOD SMILE. I THINK THAT'S VERY
REAL, AND THEY DEMAND CERTAIN
THINGS AND THEY WANT THE DATES
ON THERE. AND THEY WANT TO KNOW
WHAT'S GOING ON WITH THEIR EGGS.
UH YOU KNOW, AGAIN, CRACKERS,
PACKERS, DIFFERENT THINGS AND
DIFFERENT STANDARDS. SO WE
BELIEVE THAT THAT EGGS SHOULD BE
REMOVED FROM THIS AND WE'LL
CONTINUE TO HAVE THAT POSITION.
SO WITH THAT WE ARE WORKING WITH
THE AUTHOR WORK THE STAFF. KEEP
WORKING ON THE OPT IN APPRECIATE
SOME OF THE AMENDMENTS THAT
THEY'RE BRINGING FORWARD AND
LOOK FORWARD TO WORKING ON THE
ISSUE AS IT MOVES AS IT
PROGRESSES. THANK YOU. THANK
YOU, OTHERS IN OPPOSITION. SO
RYAN ELAINE ON BEHALF OF THE
CALIFORNIA RETAIL ASSOCIATION.
WE HAVE NO FORMAL POSITION WE'RE
WORKING AND COMMITTED TO WORKING
WITH THE AUTHOR. THERE'S INITIAL
CONCERNS, BUT I JUST WANT TO LET
EVERYONE KNOW THAT WE'RE GOING
TO WORK THOSE THANK YOU. HI
MARGIE LEE ON BEHALF OF THE
CALIFORNIA LEAGUE OF FOOD
PRODUCERS WITH SOME CONCERNS BUT
APPRECIATE THE AUTHOR. THANK YOU
ANYONE ELSE? QUESTIONS. NOT
EXCUSE ME. I'LL MAKE A COMMENT.
AS A CONSUMER. I GET SO CONFUSED
BY THESE CELL BY DUBAI WHATEVER
ON THE ON THE PACKAGING AND SO I
APPLAUD YOU FOR WORKING ON THIS.
I KNOW YOU'LL CONTINUE TO WORK
ON IT BECAUSE THERE ARE SOME
ISSUES. THOSE OF US THAT ARE NAG
HAVE SOME CONCERNS ABOUT IT. BUT
I DO THINK WE NEED TO HONE IN ON
IT. I KNOW THE FEDS FEDERAL
GOVERNMENT'S WORKING ON THIS AS
WELL. BUT HOW LONG DO WE WAIT?
AND THE WASTE IS JUST INCREDIBLE
. SO UM, I'LL BE SUPPORTING THE
BILL. TODAY I WOULD HOPE THAT
YOU CONTINUE TO WORK WITH THE
OPPOSITION. THANK YOU ANY WELLS.
AYE. THANK YOU. I WANT TO THANK
THE AUTHOR, UM, SUPPORTED THIS
IN THE AG COMMITTEE AND I SAID,
REMEMBER SUPPORTING 9 54. BACK
IN 2017. AND IT IS CONFUSING. I
MEAN, MR MR AVIANO. WHAT IS WHAT
IS THE DESIGNATION ON EGGS? WHAT
IS IT? WHAT IS A CARTON OF EGGS
SAY BY DATES IS THE WALTERS SELL
BY ON 30 DAYS AND IT'S CODIFIED
IN LAW. THAT'S WHAT'S CORRECT.
AND SO WHAT IS SELL BY MEAN? UM
IT MEANS THAT THE FOLKS NEED TO
SELL IT WITHIN 30 DAYS. AND THEN
AFTER THAT YOU HAVE TIME, BUT
EGGS DO START TO THEIR QUALITY
GREATLY DIMINISHED HIS AFTER
ABOUT 40 TO 45 DAYS. UM AND
YOU'LL START SEEING WHERE THE
YELLOW STARTS BLENDING INTO THE
WHITE AND IT REALLY DEGRADES
OVER TIME. PRETTY QUICKLY AFTER
THE 30 DAYS. SO THE SELL BY IS
30 DAYS, BUT IT YOU CAN GO FOR
45. YOU JUST ILLUSTRATED THE
CHALLENGE THAT CONSUMERS HAVE
WHEN YOU SAY SO BY WE DON'T I
DON'T KNOW WHAT THAT MEANS. AND
SO I THINK IT'S AN EXPIRATION
DATE. SO I PROBABLY THROWN A
WHOLE LOT OF EGGS AWAY THAT I
COULD HAVE USED WITH MY PANCAKE
BATTER, AND YOU KNOW, AND, UM,
YOU KNOW, OR WHATEVER ELSE SO I
GUESS AND YOU KNOW, AND I AND I
AND I APPRECIATE THE CONUNDRUM.
YOU KNOW, I REALLY DO. UM AND
BUT I THINK I THINK YOU ALL KNOW
THAT CALIFORNIA DOESN'T ALWAYS
WAIT FOR THE FEDERAL GOVERNMENT
IF WE DID MY GOODNESS, THE
NUMBER OF THINGS IN THE
HEALTHCARE SPACE WE'D BE WE'D BE
STUCK IN THE MUD. YOU KNOW, UM,
OUR BILL THAT WE DID TO PROTECT
CONSUMERS FROM, UH, SURPRISE
MEDICAL BILLING WAS PASSED IN
2017 OR 2016. I BELIEVE UM, AND
IT TOOK THE FEDERAL GOVERNMENT
SIX PLUS YEARS TO CATCH UP WITH
CALIFORNIA. SO WE'RE NOT GONNA
WAIT AND ACTUALLY, I WOULD. I
WOULD JUST SAY THAT, YOU KNOW.
PEOPLE SELLING FOOD PRODUCTS.
WHY NOT FOLLOW A STANDARD THAT
WE SAID IN CALIFORNIA? WHY WAIT
FOR THE FEDERAL GOVERNMENT
MOVING FORWARD? SO UM, I DON'T
THINK WE NEED TO. WE HAD THIS
SIMILAR DISCUSSION AROUND THE
DANCING ARROWS ON RECYCLING
RECYCLING OF PLASTICS AND THINGS
LIKE THAT, UM, NOBODY WANTS THIS
. NOBODY WANTS TO HAVE, YOU
KNOW, HAVE DIFFERENT LABELS FOR
DIFFERENT STATES. SO WHY NOT
JUST DO THE RIGHT THING AND DO
IT QUICKLY AND LET THE FEDERAL
GOVERNMENT CATCH UP FIVE OR SIX
YEARS FROM NOW AND LET US LET US
AS CONSUMERS? KNOW WHAT WE'RE
EATING WHAT WE CAN USE IN OUR
PANCAKE BATTERS AND WHAT WE
CAN'T AND A MORE ACCURATE WAY.
CAN I AND I WOULD JUST SAY, I
WOULD JUST SAY, YOU KNOW, THE
BILL WAS PASSED IN 2017. SO AND
WE WERE HERE WE ARE SIX YEARS
LATER, UM, WE BECAUSE, AND WE
TOOK IT ON FAITH THAT THE
INDUSTRY WAS ACTUALLY GOING TO
DO MORE THAN THAN HAS BEEN DONE,
SO I THINK THEY'RE IN RESPONSE.
YOU KNOW, WE'RE KIND OF TIRED OF
WAITING, QUITE FRANKLY SURE, AND
25 TOP PRODUCERS WHO SIGNED ONTO
THE MOU HAVE EVOLVED. THERE ARE
AS WE MENTIONED SOME OF THE
SMALLER ONES FROM THE OTHER
ENTITIES. DON'T I DID WANT TO
ADDRESS THAT? JUST ONE ISSUE. I
GENERALLY AGREE. BUT I DO WANT
TO SAY, DO YOU PREFER TO HAVE A
DATE OR NO DATE? I'M USING ON
EGGS. AND I THINK CONSUMERS DO
PREFER A DATE AND WOULD PREFER
THAT AND I THINK IF WE DIDN'T DO
THAT, WE WOULD GET AN PRETTY
POSITIVE. THIS IS HOW IT WORKS.
I KNOW THE EGG INDUSTRY WE WOULD
BECOME THE DUMPING GROUND OF
EGGS FROM REPACKAGING OUT OF
OTHER STATES THAT HAVE TIGHTER
DATES. SO WE SO THIS IS A WALK,
AND I APPRECIATE YOUR POINT THAT
WE TALKED ABOUT IT. WE DO NEED
TO BE VERY CAREFUL ABOUT HOW WE
HANDLE THIS. AND THEN I THINK WE
DO. WE ARE MAKING PROGRESS.
APPRECIATE THAT. WE'RE WORKING
WITH THE FOLKS WHO WILL CONTINUE
TO, BUT I DO THINK THERE IS A
DIFFERENCE WHEN YOU LOOK AT EGGS
AND EVEN DAIRY. I THINK WE WANT
A DATE AND WE WANT TO KNOW WHAT
THAT DATE MEANS. SURE THAT'S THE
BOTTOM LINE. 100% ON THAT. SO
HOW DO YOU ENVISION THE LABEL ON
EGGS? I WOULD KEEP IT WITH WHAT
THE CONSUMERS ARE CURRENTLY
FAMILIAR WITH WHICH IS SELL BY
AND THAT'S BEEN CODIFIED AND
KIND OF STANDARDIZED THROUGHOUT
THE COUNTRY. UM, BUT YOU KNOW,
AGAIN, WE CAN HAVE THAT
CONVERSATION. BUT IF WE DON'T
STANDARDIZED ACROSS THE COUNTRY
, I THINK IT'S BEEN VERY, VERY
DIFFICULT FOR PEOPLE TO UM, TO
DO THAT TYPE OF EDUCATION THAT'S
REQUIRED. I WOULD REMIND. WELL,
I DON'T REMIND, BUT JUST WANT TO
STAY. THERE IS LIKELY TO BE VERY
MAJOR FEDERAL, UH FOOD AND
AGRICULTURAL UH, UH, LEGISLATION
PASSED THIS YEAR. IT'S CALLED
THE FARM BILL. THEY DO IT EVERY
FIVE YEARS, AND THERE'S A THERE.
YOU KNOW, IT'S KIND OF LIKE OUR
BUDGET PUT IN A BILL AND IT GETS
INTO THE BUDGET YOU PUT IN A
FEDERAL BILL WHICH WHICH
RESPOND, WHICH WERE SUPPORTING
AND YOU KNOW YOU, YOU YOU PLAY
THAT OUT, SO WE'RE WORKING. AND
THEN MY FINAL QUESTION. I LIKE
THIS BILL IS WHAT I'M TALKING
ABOUT IT SO MUCH, BUT, UM, AND
THAT'S SO WHAT IS THE EGG
INDUSTRY DUE TO EDUCATE
CONSUMERS ABOUT WHAT THE SELL BY
DATE MEANS BECAUSE I DIDN'T KNOW
. I JUST ASSUME WHEN IT SAYS SO
BY THAT MEANS THAT IT'S AN
EXPIRATION DATE. SO WHAT IS WHAT
WHAT WILL THE EGG INDUSTRY DO?
SELL BUY AND GOODBYE OR OR SO I
MEAN, WHAT? HOW DO WE? HOW DO I
KNOW? BECAUSE I DIDN'T. I DIDN'T
KNOW UNTIL YOU JUST TOLD ME
TODAY. UM I THINK SO. THE
PROPOSAL WOULD PUT BEST IF USED
BY AND I THINK THAT'S ON AN EGG
CARTON. AND I THINK THAT, UH,
HAS THE SIMILAR UNDEFINED AT
THIS POINT. I GUESS THAT THE
IDEA WOULD BE POST THE BILL
BEING PASSED THAT THEN THERE
WOULD BE SOME CONSUMER EDUCATION
ELEMENT TO IT. BUT UM, I THINK
THERE IS AN EQUIVALENT AMOUNT OF
IF THERE IS CONFUSION EQUIVALENT
OF CONFUSION. AH ON MANY OF THE
TERMS, I THINK THAT'S WHY THEY
YOU KNOW THE ENTITIES GOT
TOGETHER. AND DID A WHOLE LOT OF
CONSUMER REVIEW AND TRYING TO
FIGURE OUT WHAT THEY COULD
PROMOTE AS THIS MOVES FORWARD. I
LOOK FORWARD TO LEARNING HOW TO
TAKE CARE OF MY EGGS BECAUSE MY
DOG GETS A LOT OF THEM RATHER
THAN THROWING THEM AWAY. SO UM,
ANYWAY, THANK YOU. UM AND HE
SURVIVED. SO I GUESS THAT'S I
GUESS THEY'RE OKAY. Ó. OKAY,
YOU YOU MAY MOVE THE BILL. I'D
BE HAPPY TO SECOND. THE BILL. UM
UH, MR IRWIN. THE BILL ENJOYS
THAT DO PASS RECOMMENDATION
THERE IS, BUT THERE IS A SELL BY
DATE. SO UM, WOULD YOU LIKE TO
CLOSE? OKAY I WON'T MAKE IT TO
HAVE ALREADY MADE MOST OF MY
ARGUMENTS FOR ME AND WE DO WANT
TO REDUCE CONSUMER UM, CONFUSION
AND I WILL STATE AGAIN. WE WILL
CONTINUE TO WORK WITH MR ALBION
E AND THE INDUSTRY. BUT WHEN WE
TALK ABOUT OH, CALIFORNIA SHOULD
SLOW DOWN. WE'RE SLOWING DOWN ON
WHAT ALREADY IS A NATIONAL
VOLUNTARY PROGRAM. AND IF THE
FARM BILL PASSES, I WOULD BE
PRETTY CERTAIN THAT THEY WOULD
USE THE SAME STANDARD THAT THE
INDUSTRY HAS COME UP WITH, WHICH
IS AGAIN. BEST OF USED BY IF IT
IS, UM, TO INDICATE THE QUALITY
DATA FOOD OR USED BY TO INDICATE
THE SAFETY OF THE FOOD AND ¦
HAVE DAIRY THAT'S ALREADY DOING
IT. WE HAVE ENJOYED BY WHICH
DOESN'T WE DON'T KNOW WHAT THAT
MEANS. WE'RE NOT SURE WHAT THIS
STATE MEANS. BUT WE DO HAVE THE
JULIAN DATE ON HERE, WHICH I
THINK WE WERE TALKING ABOUT, UM
AND BAGS, SO LET'S LET'S REDUCE
CONSUMER CONFUSION AND WORK TO
REDUCE CLIMATE OR THEY ARE
EFFECTS ON CLIMATE CHANGE BY
PUTTING LESS FOOD INTO THE
LANDFILLS. AND WITH THAT, I
RESPECTFULLY ASK FOR YOUR VOTE.
WELL, THANK YOU VERY MUCH FAMILY
MIRROR WHEN I KNOW YOU'LL
CONTINUE TO WORK THROUGH WITH
THE OPPOSITION ON THIS. UM AND
YEAH, IT WOULD BE REALLY GREAT
TO SEE THAT WE AREN'T WASTING AS
MUCH FOOD AS WEAK AS WE
CURRENTLY DO. AND THEN THERE ARE
ISSUES THAT WILL IMPACT THE
DEPARTMENT OF PUBLIC HEALTH,
WHICH WE, UM AND WE I HOPE THAT
YOU'LL CONTINUE WORKING WITH THE
COMMITTEE HERE AS WE FOUND A LOT
FINALIZED THIS PIECE OF IT, SO
AH, WE HAVE EMOTION IN A SECOND.
THE MOTION IS DUE PASS AS
AMENDED TO APPROPRIATIONS AND I
WANT TO THANK THE OPPOSITION TO
THIS IS DIFFICULT. I RECOGNIZE,
YOU KNOW, UM WE CAN. MAYBE WE
CAN HAVE BREAKFAST SOMEDAY.
EXACTLY STEAK AND EGGS WILL GO
FOR IT. MADAM SECRETARY, PLEASE
CALL THE ROLL. Dð PASS AS
AMENDED TO APPROPRIATIONS WOULD
I WOULD I. WALDRON. WALDRON THAT
VOTING EDGAR KRI KRI I ARAMBULA
EARNER, WENDY CARILLO FLORA.
VINCE WONG MAIENSCHEIN. MCCARTHY
JOE PATTERSON RODRIGUEZ.
SANTIAGO. VALLAPUDUA WEBER.
HOWEVER, I. THAT'S 30. WE'LL
LEAVE THE BILL ON CALL. THANK
YOU VERY MUCH. LOOKING AROUND
THIS. SH THE SZABO.
WHENEVER YOU'RE READY. YOU HAVE
A B 7 10. WE'LL START WITH THAT
ONE IF THAT'S OKAY. YES THANK
YOU SO MUCH. THANK YOU, MR CHAIR
AND MEMBERS AND I'D LIKE TO
BEGIN JUST BY SAYING I ACCEPT
THE COMMITTEE'S AMENDMENTS AND
APPRECIATIVE OF THE STAFF ARE
WORKING WITH US TO MAKE
IMPROVEMENTS ON THE BILL. UM
WE'RE ALL AWARE OF THE CRISIS
FACING ABORTION RIGHTS IN
AMERICA AT THIS TIME. I'M A I AM
PASSIONATE ABOUT BRINGING TO
LIGHT THE ISSUE OF DECEPTION
THAT CONSTITUENTS IN ALL OF OUR
DISTRICTS ENCOUNTER AT A
CRITICAL TIME WHEN THEY'RE FACED
WITH A VERY DIFFICULT DECISION,
SOMETHING PERSONAL TO THEM TO
THEIR BODIES AND TO THEIR
HEALTH. ACROSS CALIFORNIA CRISIS
. PREGNANCY CENTERS OUTNUMBER
ABORTION CLINICS BY 20. THESE
CLINICS USED DECEPTIVE PRACTICES
TARGETED AT VULNERABLE
POPULATIONS TO DRAW THEM IN BY
CLAIMING THEY PROVIDE ABORTION
SERVICES WHEN THEY HAVE NO
EQUIPMENT OR CAPACITY TO PROVIDE
ABORTIONS. THESE CRISIS,
PREGNANCY CENTERS, SHAME,
INTENTIONALLY MISLEAD AND LIE TO
WOMEN ABOUT THEIR REPRODUCTIVE
HEALTH CARE OPTIONS TO BLOCK
THEM FROM ACCESSING ABORTION
CARE. AND ARE CONFUSING A LOT OF
PEOPLE IN OUR COMMUNITY. AS A
NURSE ADVOCATE WHO WORKED WITH
NURSES ON ENSURING SAFE ACCESS
TO HEALTHCARE. I SEE IT AS
EXTREMELY DANGEROUS THAT THESE
FAKE PREGNANCY CENTERS PRESENT
THEMSELVES AS MEDICAL CLINICS.
TO BE CLEAR. THEY'RE NOT
LICENSED MEDICAL CLINICS. WELL
WOMEN ARE IN THEIR MOST
VULNERABLE STATE WORKING TO GET
RELIABLE MEDICAL INFORMATION AND
POSSIBLY REFERRALS FOR OR
ABORTION CARE. THEY INSTEAD ARE
MET WITH SHAMING AND FEAR
TACTICS AND FED MISINFORMATION
ABOUT ABORTIONS LEADING TO
INFERTILITY, DEPRESSION AND
HIGHER SUIT. SUICIDE RATES. ALL
MISINFORMATION. A B 7 10 WILL
DELIVER ACCURATE INFORMATION
ABOUT HOW THESE FAKE WOMEN'S
HEALTH CARE CENTERS OPERATE. AND
WHAT OPTIONS ARE AVAILABLE FOR
PEOPLE. THIS LEGISLATION WOULD
PROMPT THE LAUNCH OF A PUBLIC
AWARENESS CAMPAIGN TO
COMMUNICATE THE FACTS ABOUT
ACTUAL PREGNANCY CARE AND
ABORTION SERVICES BEING PROVIDED
AT PRIMARY. WHEN WOMEN NEED. TO
ACCESS HEALTHCARE. IT'S CRITICAL
TO INFORMATION THEY GET IS
FACTUAL. AND THAT THE PROVIDERS
HAVE YOUR BEST INTEREST IN MIND
IN MIND. NOT AN AGENDA TO
DISCOURAGE YOU FROM SEEKING
ABORTION CARE. WITH A B 7 10
FACTUAL INFORMATION WILL BE
DELIVERED TO THE GENERAL PUBLIC
AS WELL AS THOSE IN THE
HEALTHCARE SPACE TO ENSURE
ANYONE SEEKING ABORTION CARE.
WOULD KNOW WHERE THEY CAN GET
MEDICALLY ACCURATE,
COMPREHENSIVE AND UNBIASED
INFORMATION. TIMELY REPRODUCTIVE
HEALTHCARE IS ESSENTIAL AND MUST
BE MET WITHOUT DELAY. THE DELAY
THAT THESE BIG HEALTH CARE
CENTERS CAN PROVIDE CAN, UM,
IMPEDE A PREGNANT PERSON FROM
MAKING THE CHOICES THAT'S BEST
IN THEIR FAMILIES AND THEIR
HEALTH CARE NEEDS. REST ASSURED
CALIFORNIA WILL CONTINUE TO LEAD
BY A PROTECTING WOMEN'S HEALTH
CARE, INCLUDING ABORTION CARE. I
HAVE WITH ME TODAY AS WITNESSES
SHANNON HOVIS, DIRECTOR OF NARAL
PRO CHOICE CALIFORNIA AND DR
KELLY PFEIFFER, EXECUTIVE
DIRECTOR OF ARIA MEDICAL THANK
YOU. GOOD AFTERNOON CHAIR AND
MEMBERS. MY NAME IS SHANNON
OLIVIERI HARVEST AND I'M THE
DIRECTOR OF NARAL PRO CHOICE,
CALIFORNIA, REPRESENTING THE
FOUR MILLION MEMBERS NATIONALLY
WHO ARE FIGHTING FOR
REPRODUCTIVE FREEDOM.
REPRODUCTIVE FREEDOM MEANS THE
THAT EVERY INDIVIDUAL HAS THE
ABILITY TO MAKE PERSONAL
DECISIONS ABOUT THEIR
REPRODUCTIVE LIVES FREE FROM
GOVERNMENT INTERFERENCE AND FREE
FROM ANY FORM OF OPPRESSION OR
COERCION. CALIFORNIA LAW
STRONGLY PROTECTS REPRODUCTIVE
FREEDOM, INCLUDING THE RIGHT TO
ACCESS, BIRTH CONTROL, ABORTION
CARE, PRENATAL CARE AND MORE.
AND SINCE THE SUPREME COURT
OVERTURNED ROE V. WADE NEARLY
ONE YEAR AGO, CALIFORNIA HAS
TAKEN ADDITIONAL STEPS TO ENSURE
THAT CALIFORNIANS AND THOSE
FORCED TO TRAVEL HERE UNDERSTAND
THEIR LEGAL RIGHTS TO ACCESS
ABORTION CARE, INCLUDING BY
CREATING ABORTION THAT CA.GOV
BUT THE REALITY IS THAT
CALIFORNIA MUST DO MORE TO
ENSURE THAT ALL COMMUNITIES
INCLUDING IMMIGRANTS, LGBTQ PLUS
FOSTER YOUTH PEOPLE EXPERIENCING
HOMELESSNESS, HOMELESSNESS AND
MORE HAVE ACCESS TO MEDICALLY
ACCURATE AND COMPREHENSIVE
INFORMATION ABOUT SERVICES
AVAILABLE ABORTION SERVICES IN
PARTICULAR AVAILABLE IN OUR
STATE. FAKE HEALTH CENTER, SOME
KIND OF SOMETIMES CALLED CRISIS.
PREGNANCY CENTERS, THREATENED
REPRODUCTIVE FREEDOM AND PREY
UPON OUR MOST VULNERABLE
COMMUNITIES, FREQUENTLY
TARGETING PEOPLE OF COLOR AND
PREGNANT PEOPLE WITH LOW
INCOMES. HEALTH CENTERS ARE RUN
BY ANTI CHOICE ORGANIZATIONS
THAT INTENTIONALLY LIE TO SHAME
AND MISLEAD PREGNANT PEOPLE
SEEKING AN ABORTION IN ORDER TO
BLOCK THEM FROM ACCESSING CARE.
THESE GROUPS PROVIDE FEW OR NO
MEDICAL REAL MEDICAL SERVICES,
MISLEAD PEOPLE ABOUT THE
SERVICES THEY DO PROVIDE
EXAGGERATE THE LIKELIHOOD OF
MISCARRIAGE IN EARLY PREGNANCY
TO DOWNPLAY THE URGENCY IN
SEEKING ABORTION CARE. PUSH
HEALTH DISINFORMATION LIKE
EMPHASIZING NON FACTUAL
RELATIONSHIPS BETWEEN ABORTION
AND INFERTILITY, AS WELL AS
BREAST CANCER TO DISSUADE PEOPLE
PREGNANT PEOPLE FROM ACCESSING
ABORTION AND HAVE BEEN SHOWN TO
DELAY ACCESS TO MEDICALLY
LEGITIMATE PRENATAL AND ABORTION
CARE. ALARMINGLY AS
ASSEMBLYMEMBER'S SHAVE. OH SAID
THE NUMBER OF FAKE HOUSE CENTERS
IN CALIFORNIA IS 20% HIGHER THAN
THE NUMBER OF HEALTH CENTERS
THAT PROVIDE ABORTION. EVERYBODY
DESERVES TO HAVE ACCESS TO THE
MEDICALLY ACCURATE,
COMPREHENSIVE AND UNBIASED
INFORMATION THEY NEED TO MAKE
PERSONAL DECISIONS ABOUT THEIR
LIVES. MAYBE 7 10 WILL
COMPLEMENT ABORTION DOT CA.GOV
BY ESTABLISHING A PUBLIC
AWARENESS CAMPAIGN TO
COMMUNICATE THE FACTS ABOUT
PREGNANCY CARE AND ABORTION
SERVICES BEING PROVIDED A
PRIMARY AND SPECIALTY CLINICS IN
CALIFORNIA. THIS BILL REFLECTS
ONE OF THE RECOMMENDATIONS OF
THE CALIFORNIA FUTURE OF
ABORTION COUNCIL AND I URGE YOUR
I VOTE. THANK YOU. THANK YOU.
I'M DR KELLY PAPER. I'VE BEEN AN
ABORTION PROVIDER FOR OVER 25
YEARS AND A CURRENTLY PRACTICE
IN RURAL CALIFORNIA, ARIZONA AND
KANSAS. AND I RECENTLY STARTED A
MEDICATION ABORTION CLINIC IN
KANSAS. EVERY DAY. I SEE PEOPLE
WHO HAVE BEEN HARMED BY THESE
FAKE CLINICS. MANY PATIENTS ARE
MADE TO GO THROUGH LATER, MORE
COMPLEX PROCEDURES BECAUSE THEY
WENT TO A FAKE CLINIC THINKING
THEY'D GET THE ABORTION PILL.
THEY'RE TOLD THEY'RE TOO EARLY
TO COME BACK REPEATEDLY AND THEN
THEY ARE TOO LATE AND ANY OTHER
PART OF MEDICINE WHEN I GET A
TEST RESULT FROM ANOTHER DOCTOR
CLINIC. I TRUST IT WHEN I GET IT
. ULTRASOUND FROM ONE OF THESE
CLINICS. I HAVE TO REPEAT IT
BECAUSE WE'VE HAD CASES WHERE
PEOPLE HAVE BEEN GIVEN THE WRONG
IMAGE TO BE CONVINCED THAT
THEY'RE TOO FAR ALONG WHEN
THEY'RE REALLY TOO EARLY OR LET
WORT WHEN THEY'RE CONVINCED
THEY'RE MUCH EARLIER JUST TO RUN
OUT OF TIME. ALWAYS TO MAKE SURE
THAT THEY YOU CAN WASTE TIME
UNTIL SOMEONE NO LONGER HAS THAT
OPTION. MY PATIENTS HAVE NO
IDEA. THAT THEIR INFORMATION IS
NOT PRIVATE, THAT THESE ARE NOT
REAL MEDICAL CLINICS AND THAT
PEOPLE CAN SHARE THEIR PRIVATE
DATA WITH WHOMEVER THEY WANT. I
SAY TEENAGERS WHO WOULD BE
PROFOUNDLY HARMED IF THEIR
FAMILIES FOUND OUT THESE
PREGNANT THEY'RE PREGNANT, AND
THESE CENTERS HAVE NO OBLIGATION
OF CONFIDENTIALITY. I SEE
PATIENTS WEEPING BECAUSE THEY
FEAR THEY WILL NEVER BE ABLE TO
HAVE A BABY AGAIN THAT THEY'RE
GETTING GONNA GET CANCER THAT
THEY'RE GOING TO GET SOME
TERRIBLE THINGS THAT THEY'VE
BEEN TOLD. AND THEY'RE DESPERATE
TO HAVE THEIR ABORTION. THEY
COME ANYWAY, BUT THEY'RE
TERRIFIED OF WHAT THEY'RE DOING
TO THEMSELVES ALL OF THESE
THINGS THAT THEY WALKED OUT OF
THIS CLINIC BELIEVING WHAT THEY
WERE TRUE, BUT THEY ARE NOT TRUE
IN ANY OTHER PART OF THE HEALTH
CARE SYSTEM. THIS WOULD BE
INCONCEIVABLE. CAN YOU IMAGINE
GOING INTO A CARDIOLOGIST AND BE
GIVEN A FAKE RESULT TO BE
CONVINCED YOU THAT YOU'RE ABOUT
TO HAVE A HEART ATTACK TO TRICK
YOU INTO SURGERY? THIS HAPPENED
IN REDDING, CALIFORNIA IT WAS
CRIMINAL AND IT WAS SHUT DOWN.
BUT IN FAKE CLINICS, PEOPLE GET
THIS INFORMATION THAT AFFECTS
THEM PROFOUNDLY FALSE
INFORMATION. AND THERE ARE NO
CONSEQUENCES. CALIFORNIANS
DESERVE TO BE INFORMED. THEY
HAVE THE RIGHT TO MEDICAL CARE
WITHOUT BEING TRIPPED. I URGE
YOU TO SUPPORT A B 7 10 AND
THANK YOU FOR INVITING ME TODAY.
THANK YOU OTHERS IN SUPPORT.
GOOD AFTERNOON MEMBERS AND
COMMITTEE MEMBERS MARIE LOPEZ
WITH CALIFORNIA NURSES
ASSOCIATION IN SUPPORT. AND
MEMBERS, AARON EVANS ON BEHALF
OF THE CALIFORNIA NURSE MIDWIVES
ASSOCIATION AND SUPPORT GOOD
AFTERNOON, MOLLY ROBSON WITH
PLANNED PARENTHOOD, AFFILIATES
OF CALIFORNIA AND SUPPORT. GOOD
AFTERNOON, RYAN SUSAN ON BEHALF
OF ESSENTIAL ACCESS, HEALTH AND
SUPPORT. THANK YOU. VERONICA DE
LOBOS WITH THE CALIFORNIA
LATINAS FOR REPRODUCTIVE JUSTICE
AND SUPPORT. THANK YOU. THANK
YOU. DR TAIWO MIDWIFE WITH BLACK
WOMEN FOR WELLNESS AND BLACK
WOMEN FOR WELLNESS ACTION
PROJECT STRONGLY SUPPORT OF THIS
BILL. THANK YOU. THEIR
OPPOSITION TO THE BILL.
MR CHAIR AND MEMBERS OF THE
COMMITTEE. IT IS AN HONOR TO BE
BEFORE YOU TODAY. HELLO MY NAME
IS HEIDI MATZKE. AND I'M THE
EXECUTIVE DIRECTOR OF
ALTERNATIVES PREGNANCY CENTER IN
SACRAMENTO. I OPPOSE A B 7 10, A
BILL THAT DEFAMES AND FALSELY
ACCUSES LICENSED MEDICAL CLINICS
LIKE OURS. THIS BILL HAS DEFINED
IN THE FACT SHEET ALSO SEEKS TO
DERAIL WOMEN'S ACCESS TO
COMPREHENSIVE HEALTH CARE.
PROVIDED THROUGH PREGNANCY
CENTERS LIKE OURS AT
ALTERNATIVES. PREGNANCY CENTER,
UNDERPRIVILEGED WOMEN RECEIVE
PREGNANCY TESTS ULTRASOUNDS,
PRENATAL CARE, FULL SERVICE,
GYNECOLOGICAL CARE AND TREATMENT
, ABORTION, PILL REVERSAL,
SERVICES AND POST ABORTIVE CARE.
AT NO CHARGE. NEARLY $1.5
MILLION WORTH LAST YEAR. OUR
WEBSITE SIGNAGE AND PHONE
PERSONNEL CLEARLY STATE THAT WE
DO NOT PERFORM A REFER FOR
ABORTION, AND INSTEAD WE PROVIDE
UNBIASED, PURE REVIEWED
EDUCATION ON ABORTION PROCEDURES
SO WOMEN CAN MAKE INFORMED
CHOICES REGARDING THEIR
PREGNANCIES AND THEIR
REPRODUCTIVE HEALTH. THE DOCTORS
, NURSES, NURSE PRACTITIONERS,
MEDICAL ASSISTANCE AND FLOW.
BOTTOM ISTS AT ALTERNATIVES ARE
ALL LICENSED MEDICAL
PROFESSIONALS MANY HAVE
EXPERIENCED OR PERFORMED
ABORTION IN THEIR PAST AND ARE
COMPELLED TO HELP OTHERS. KOREA
IS A PATIENT OF ALTERNATIVES WHO
WAS FACED WITH DOMESTIC ABUSE,
HOMELESSNESS AND AN UNPLANNED
PREGNANCY, ONLY TO BE HANDED THE
ABORTION PILL AS PLANNED
PARENTHOOD'S ONLY OPTION INSTEAD
AT ALTERNATIVES PREGNANCY CENTER
TORIA WAS PROVIDED ABORTION PILL
REVERSAL SERVICES, PRENATAL CARE
FOR HER HEALTHY BABY FINANCIAL
SUPPORT, HOUSING SUPPORT AND
EMOTIONAL SUPPORT. SHANNON IS
ONE OF 100 AND 77 WOMEN IN THE
LAST TWO YEARS WHO HAS DENIED
CARE AT PLANNED PARENTHOOD
BECAUSE THEY WOULD NOT CHOOSE AN
ABORTION AND THEN CAME TO
ALTERNATIVES FOR COMPREHENSIVE
MEDICAL CHARACTER CARE. KELLY
WAS TOLD BY PLANNED PARENTHOOD
THAT THE ABORTION THAT THAT
ABORTION WAS HER ONLY OPTION BUT
WAS NEVER EDUCATED ON THE
DIFFERENT PROCEDURES OR HOW THEY
WOULD IMPACT HER LONG TERM. THEY
PROVIDED HER WITH FIVE
ABORTIONS, AND IT WAS YEARS
BEFORE SHE FOUND HEALING.
REPORTS TO BOARD OF CLASSES
OFFERED FOR FREE AT ALTERNATIVES
PREGNANCY CENTER, ARIANE WAS
PREGNANT, STRUGGLING WITH
ADDICTION AND HOMELESSNESS
ALTERNATIVES, PROVIDING
COMPREHENSIVE CARE AND HOUSING
FOR HER. NOW SHE HAS A HEALTHY
DAUGHTER HAS RECOVERED FROM HER
ADDICTIONS AND HIS MENTORING
OTHER WOMEN AFTER LIVING AS A
MAN CHOOSING TO DE TRANSITION
JUST SOUGHT US OUT A PLACE THAT
WOULDN'T SHAME HER BUT INSTEAD
PROVIDED THE GYNECOLOGICAL CARE
SHE NEEDED AS A WOMAN WITH THE
MEDICAL TEAM AND STAFF OF
ALTERNATIVES. PREGNANCY CENTER,
PLEASE STAND RIGHT NOW. WHO WAS
THERE FOR THESE WOMEN WHO NEEDED
COMPREHENSIVE MEDICAL CARE WHO
WAS THERE? WHEN THEY NEED IT?
THEY WANTED TO PRACTICE THEIR
FULL RIGHT TO CHOOSE
ALTERNATIVES. PREGNANCY CENTER
WAS THE LICENSED MEDICAL
FACILITY THAT WAS THERE FOR
EVERY ONE OF THEM AS MANY
PREGNANCY CENTERS THROUGHOUT
CALIFORNIA ARE I AM GRATEFUL FOR
OUR GOD WHO HAS MADE THE WORK OF
ALTERNATIVES POSSIBLE FOR WE
LOVE. BECAUSE HE FIRST LOVED US
NOW THE FACTS AND THE TRUTH HAVE
BEEN PRESENTED. YOU MUST
RECOGNIZE THAT THIS BILL SEEKS
TO DISCREDIT THE VERY FACILITIES
THAT WOMEN DESERVE TO HAVE
ACCESS TO. SO I'M ASKING YOU TO
RESPECTFULLY OPPOSE A B 7 10.
THANK YOU. PLEASE. NO APPLAUSE
AND WE DON'T KNOW NO EXPRESSIONS
ONE WAY OR THE OTHER. NO
APPLAUSE. NO BOOZE. NO ANYTHING
SO THANK YOU. NEXT WITNESS,
PLEASE. MY NAME IS THE TORIA
FOLEY, MOTHER OF A DAUGHTER BORN
AFTER TWO SUCCESSFUL ABORTION
PILL REVERSALS, I STAND HERE
TODAY IN FULL OPPOSITION OF BILL
A B 7 10. A B 7 10 MANIPULATIVE
BURBAGE BEGINS WITH DESCRIBING
PRESIDENT PREGNANCY CARE CLINICS
AS FAKE, INTENTIONALLY
MISLEADING, EVEN GOING FAR
ENOUGH TO STATE THAT PREGNANCY
CARE CENTERS. SHAME PREGNANT
WOMAN. IN ALL ACTUALITY, I WOULD
DESCRIBE MY EXPERIENCES WITH
PLANNED PARENTHOOD AS FAKE,
SHAMEFUL AND INTENTIONALLY
MISLEADING. A B 7. 10 ALSO
CLAIMS THAT THOSE SEEKING
ABORTION SERVICES ARE DERAILED
BY THE NUMBER OF PREGNANCY
CENTERS IN CALIFORNIA. YET HERE
IN DOWNTOWN SACRAMENTO TO
PLANNED PARENTHOOD LOCATION SITS
A MERE EIGHT MINUTES APART.
THERE IS NO SHORTAGE OF ABORTION
ACCESSIBILITY IN CALIFORNIA. AS
A RESULT OF THE OPENLY BIASED
AND DISAPPROVAL STATEMENTS USED
IN CHICAGO SUMMARY OF A B 7 10,
THE DECEPTIVE NATURE BEHIND THIS
BILL IS REVEALED. IMMEDIATELY
REFUTING THE CLAIM THAT QUOTE,
ACCURATE AND UNBIASED
INFORMATION WOULD BE DISTRIBUTED
THROUGH THIS CAMPAIGN. INSTEAD
WHAT A B 7 10 WILL ACCOMPLISH IS
THE INTENTIONAL SWAYING OF A
VULNERABLE POPULATION OF WOMEN
AND MEN TOWARDS SEEKING ABORTION
SERVICES THROUGH LIMITED AND
BIASED INFORMATION.
MISINFORMATION MISINFORMATION
THAT HOLDS THE POWER TO END THE
LIFE OF AN UNBORN BABY. A CHILD
WHOSE LIFE MAY BE PRESERVED IF
THEIR MOTHER HAS FULL ACCESS TO
COMPREHENSIVE MEDICAL CARE AS I
RECEIVED ALTERNATIVES, PREGNANCY
CENTER AND TRUTH REGARDING
ABORTION TRUTH, SUCH AS THE
VALIDITY BEHIND ABORTION PILL
REVERSALS, TRUTH THAT A REVERSAL
DOES NOT HARM A DEVELOPING BABY
TRUTH THAT MY DAUGHTER IS A
LIVING TESTAMENT TO AFTER TWO
ATTEMPTED ABORTIONS AND TWO
SUCCESSFUL REVERSALS WITHIN ONE
PREGNANCY. A TRUTH THAT A B 7 10
SEEKS TO SILENCE. IT IS
ABSOLUTELY CRUCIAL THAT PEOPLE
RECEIVE UNBIASED CARE AND
INFORMATION WHEN CONSIDERING
ABORTION, INCLUDING INFORMATION
ABOUT REVERSALS AT PLANNED
PARENTHOOD, I DID NOT RECEIVE
THAT, AS I SAT IN FEAR AND
REGRET ASKING HOW TO REVERSE MY
ABORTION. I WAS TOLD THAT I
SAFELY COULD NOT. THAT WAS A
LIE. I FOUND MYSELF REPEATEDLY
APOLOGIZING TO THE NURSE AS SHE
INCREASINGLY GREW IN HER
ANNOYANCE. ANNOYANCE AT MY
HESITANCY, ANNOYANCE THAT MY
TEARS ANNOYANCE ABOUT MY
QUESTIONS ABOUT ABORTION PILL
REVERSAL. I LOOK BACK ON MYSELF
THAT DAY, AND I'M SADDENED AT
WHO I WAS. I WAS SCARED, SAD,
LOST AND AFRAID TO SPEAK UP FOR
MYSELF, BUT I AM NO LONGER THAT
VERSION OF MYSELF TODAY AND
TODAY I WILL NOT BE AFRAID TO
SPEAK UP. I WILL SPEAK UP FOR
WOMAN IN MY PAST SHOES. I WILL
SPEAK UP FOR GOD, THE AUTHOR OF
LIFE TO SPEAK UP FOR THOSE WHO
CANNOT YET SPEAK FOR THEMSELVES.
LAST WEEK, I WILL SPEAK UP FOR
WHAT IS WRONG. AND MAYBE 7 10 IS
DECEITFULLY INTENTIONALLY WRONG.
IT IS MY HOPE THAT YOU WILL
SPEAK UP AND STAND WITH ME IN
OPPOSITION. THANK YOU. THANK YOU
ARE THERE OTHERS IN OPPOSITION?
OR JUST YOUR NAME AND
ORGANIZATION. IF YOU REPRESENT
ONE. SOFIA LORI WITH YOUNG WOMEN
FOR AMERICA, CALIFORNIA FAMILY
COUNCIL AND RELATIVE TO A WOMAN
WHO HAS LIED TO BY PLANNED
PARENTHOOD IN OPPOSITION
OPPOSITION, PLEASE. ESTHER
BRANDON CAMPBELL WITH THE NORTH
CALIFORNIA CAPITAL CONNECTION
FOR INDEPENDENT BAPTIST CHURCHES
IN OPPOSITION. THANK YOU.
SHANNON GAIL. I'M A MOTHER AND
I'M IN STRONG OPPOSITION. HUSING
GOSSELIN. I'M UNDER PRACTITIONER
AT ALTERNATIVE PREGNANCY CENTER
, AND I STRONGLY OPPOSE HI. I'M
JESS ROSE. I WAS BORN A WOMAN
TRANSITION TO MALE AND IDENTIFY
NOW AS A WOMAN, AND I OPPOSED
THIS BILL. YOU MARY ANN CLARK,
RESIDENT OF CALIFORNIA AND A
MOTHER, I OPPOSE THIS BILL. LISA
EICHINGER ALTERNATIVES PREGNANCY
CENTER. I STRONGLY OPPOSE THIS
BILL. BELIEVE ELENA VAN COVA
SACKS STATE STUDENT AND I OPPOSE
THIS BILL. DIANA WITH
ALTERNATIVES PREGNANCY CENTER. I
WAS A LICENSED PHLEBOTOMIST AND
I STRONGLY OPPOSE THIS BILL.
TOBACCO LATHROP WITH
ALTERNATIVES PREGNANCY CENTER
AND I OPPOSE THIS BILL. NELLIE
VASSAL COBB WITH CITY BIBLE AND
I OPPOSE THIS BILL. THANK YOU.
NIKKI DATTNER AND I OPPOSE THIS
BILL. OKSANA PEACE RIVER
REGISTERED NURSE STRONGLY OPPOSE
THIS BILL. ALAMEDA FLAT. BOTTOM
IS A MOTHER OF FIVE. I OPPOSED
THIS BILL. THANK YOU. AFTER AN
AL MONTE OR BE GIVEN AND
STRONGLY OPPOSES BILL IN THE
MEDICAL DIRECTOR OF ALTERNATIVE
PREGNANCY CENTER. THANK YOU.
RAINY DAY. GARCIA ALTERNATIVES
PREGNANCY CENTER AND I OPPOSE
THIS BILL. HELLO COMEDIAN. MY
NAME IS ROBERT BYRD. I'M A BAY
AREA RESIDENT POLITICAL
INDEPENDENCE, AND I URGE YOU TO
VOTE NO ON THIS, BILL. THANK
YOU. THANK YOU. CHAIR AND
MEMBERS. MY NAME IS JONATHAN
KELLER, PRESIDENT OF CALIFORNIA
FAMILY ALLIANCE, ALSO SPEAKING
ON BEHALF OF THE CALIFORNIA
SOUTHERN BAPTIST CONVENTION, AND
THEIR 2000 CHURCHES,
RESPECTFULLY OPPOSING THE BILL.
THANK YOU. AND BREEZY BRAY DEAN
REPRESENTING 45 DAYS, 40 DAYS
FOR LIFE, AND I STRONGLY OPPOSE
THIS BILL. ELLIE BRADFORD.
MULTIPLE POST ABORTIVE WOMAN AND
I OPPOSE THIS BILL. OLGA HERMAN
. REVEREND OLGA HERMAN. I'M WITH
J. C RESOURCE CENTER AND I
REPRESENT LIFE TEAMS AND THE
COUNCIL OF THE UNITED STATES AND
I OPPOSE OF THIS BILL, PLEASE.
BUT WITH THE CALIFORNIA FAMILY
COUNCIL AND STRONG OPPOSITION
THANK YOU. THANK YOU. AMY SHIRTS
LIKE VOLUNTEERS HERE, A
PREGNANCY PLUS HEALTH IN
ROSEVILLE, AND I STRONGLY OPPOSE
THIS BILL. èC CARPENTER, AND I
AM A FOUNDER OF LIFE LOVE LEADER
WITH 40 DAYS FOR LIFE AND THREE
TIME POSTER BOARD OF WOMAN. I
STAUNCHLY OPPOSED THIS BILL. BOB
SIMMONS WITH ALTERNATIVES AND
ADOPTIVE FATHER. I STRONGLY
OPPOSE YOUR BILL. DR VANSEN WANG
O B. G Y N IN OPPOSITION TO THIS
BILL. JACKIE THE STREET PREACHER
OF KINGDOM ROAR, AND I STRONGLY
OPPOSED THIS BILL AS AN ADOPTED
DAUGHTER. ANYONE ELSE?
LIFTING BUILDINGS. 74 YEAR OLD.
VIETNAM VETERAN OR FDA
MICROBIOLOGIST. A STRONGLY
OPPOSE THIS BILL. THANK YOU.
SEEING NO ONE ELSE WILL BRING IT
BACK TO THE COMMITTEE QUESTIONS
OR COMMENTS. DR WEBBER. THANK
YOU TO THE AUTHOR AND TO THE
OPPOSITION AND TO THE
SUPPORTERS. I ACTUALLY HAD NOT
PLANNED ON SPEAKING ON THIS
BILL, BUT UM. THE STATEMENT FROM
THE OPPOSITION HAS COMPELLED ME
TO SPEAK AND TO ASK A FEW
QUESTIONS. UM. ARE YOUR
PHYSICIANS? BOARD CERTIFIED AND
MEMBERS OF A. YES, THEY ARE. SO
DO THEY. DO YOU ALIGN YOUR
PRINCIPLES AND POLICIES WITH THE
AMERICAN COLLEGE OF
OBSTETRICIANS GYNECOLOGISTS? UM
OUR POLICIES AND PROCEDURES. I
WOULD HAVE TO ASK THEM. FOR
THAT. OKAY? I'M LOOKING AT THEM
IN THE AUDIENCE, AND THEY'RE NOT
SAYING ANYTHING. SO, UM WHAT
RANDOMIZED CONTROLLED TRIALS
HAVE VALIDATED THE ABORTION PILL
REVERSAL SERVICES. I DON'T KNOW
THAT THERE HAS BEEN. I KNOW THAT
THE FDA THERE WAS A, UM, A TRIAL
THAT WAS BEING DONE IN SOUTHERN
CALIFORNIA. BUT I DON'T KNOW HOW
THAT TRIAL ENDED. WHAT I DO KNOW
IS FOR THE LAST FOUR YEARS
ALTERNATIVES PREGNANCY CENTER
HAS BEEN DOING ABORTION PILL
REVERSAL SERVICES, AND THERE
HAVE BEEN, UM AT LEAST 100 WOMEN
WHO HAVE HAD BABIES AS A RESULT
OF IT. HAVE YOU, UH, PUT THOSE
INTO ACTUAL PAPER, AN ARTICLE OR
PEER REVIEW SO THAT IT COULD BE
EVALUATED? NO, I HAVE NOT. UM
AND THE REASON WHY I ASK IS,
I'VE SAID A LOT ABOUT ABORTION
PILL REVERSAL SERVICES. THERE
WAS TESTIMONY. UM, THAT UM. IT
WAS VERY MOVING ABOUT THE FACT
THAT YOU HAD NOT BEEN COUNSELED
ON THAT AS A POSSIBILITY. AND UM
I AM AN O B G Y N AND A MEMBER
OF A COG AND I'M BOARD
CERTIFIED. AND ACOG STATES.
FACTS ARE IMPORTANT, WHICH IS
TRUE MEDICATION. ABORT ABORTION
REVERSAL IS NOT SUPPORTED BY
SCIENCE. HMM. UM, FACTS ARE
IMPORTANT, ESPECIALLY WHEN IT
COMES TO POLICIES AND
DISCUSSIONS THAT IMPACT PATIENTS
CLAIMS REGARDING ABORTION
REVERSAL. TREATMENTS ARE NOT
BASED ON SCIENCE AND DO NOT MAKE
CLINICAL STANDARDS. THE AMERICAN
COLLEGE OF OBSTETRICIANS AND
GYNECOLOGISTS RANKS HIS
RECOMMENDATION ON THE STRENGTH
OF EVIDENCE AND DOES NOT SUPPORT
PRESCRIBING PROGESTERONE TO STOP
MEDICATION ABORTION. A 2012 CASE
SERIES REPORTED ON SIX WOMEN WHO
TOOK MEDFORD, KRISTEN AND WERE
THEN ADMINISTERED VARYING DOSES
OF PROGESTERONE. FOR CONTINUED
THEIR PREGNANCIES. THIS IS NOT
SCIENTIFIC EVIDENCE THAT
PROGESTERONE RESULTED IN THE
CONTINUATION OF THOSE
PREGNANCIES. THIS CASE CONTROL
SERIES WITH NO CONTROL GROUPS
ARE AMONG THE WEAKEST FORM OF
MEDICAL EVIDENCE. SO UM, CAN I
ASK A QUESTION? 2020 STUDY
INTENDING TO EVALUATE
MEDICATION, ABORTION REVERSAL
AND IT CONTROLLED. I R B BECAUSE
THE INITIAL ONE WAS NOT I. R B
APPROVED INITIAL ONE THAT HAD
SIX PEOPLE. THE STUDY WAS NOT
SUPERVISED BY AN INSTITUTIONAL
REVIEW BOARD RB OR AN ETHICAL
REVIEW COMMITTEE REQUIRED TO
PROTECT HUMAN RESEARCH SUBJECTS
, RAISING SERIOUS QUESTIONS
REGARDING THE ETHICS AND
SCIENTIFIC VALIDITY OF THOSE
RESULTS IN 2012. 2020 STUDY
INTENDING TO EVALUATE MEDICATION
ABORTION REVERSAL IN A
CONTROLLED I R B APPROVED
SETTING? THAT'S PROBABLY WHAT
YOU'RE REFERRING TO A COUPLE OF
YEARS AGO WAS ENDED EARLY DUE TO
SAFETY CONCERNS AMONG THE
PARTICIPANTS. SO UM, I ASK IF
YOU'RE PRACTITIONERS ARE MEMBERS
OF A ARE BOARD CERTIFIED AND
ALIGN THEIR POLICIES WITH A COG
BECAUSE THIS IS IMPORTANT. IF
YOU IF PATIENTS ARE COMING TO
YOU OR YOUR FACILITIES. WHEREVER
THEY MAY BE. UM IN A VERY
VULNERABLE STATE, RIGHT
PREGNANCY. SOMETIMES THERE'S A
SURPRISE FOR PEOPLE. THERE'S A
LOT OF DIFFERENT EMOTIONS GOING
ON. IT'S EXTREMELY IMPORTANT
THAT THEY ARE COUNSELED PROPER
PROPERLY ON MEDICALLY FOUND
INFORMATION. AS AN O B G Y N
DOCTOR. WHAT WOULD MAKE YOU NOT
WANT TO ALLOW A WOMAN TO HAVE A
SECOND CHANCE AT LIFE TO SAVE
HER BABY? AS THAT HAS HAPPENED,
TIME AND TIME AND TIME AGAIN AT
ALTERNATIVES. AS A PHYSICIAN.
ALL PHYSICIANS WENT TO SAVE
LIVES. THAT IS WHAT THAT IS WHAT
WE GO TO MEDICAL SCHOOL FOR WHY
WOULD YOU BE IN OPPOSITION TO
WHAT WE ARE DOING? THIS IS NOT A
BACK AND FORTH. THAT IS WHAT WE
GO TO MEDICAL SCHOOL FOR. THAT
IS WHAT WE DO OUR RESIDENCIES
FOR US, AND FOR THOSE OF US WHO
GO ON LIKE MYSELF TO DO A
FELLOWSHIP TO DO EXTRA TRAINING,
THAT'S WHAT WE DO IT FOR ALL
WANT TO SAVE LIFE. BUT WE ALSO
KNOW THAT WE HAVE TO PROVIDE AND
CORRECT INFORMATION AND NOT
FACTUAL INFORMATION. SO, YOU
KNOW. I WHOLEHEARTEDLY SUPPORT
YOUR BILL. UM, I. WAS NOT GOING
TO SPEAK TODAY BUT LEARNING WHAT
IS BEING PUT OFF AS FACTUAL
INFORMATION IS VERY CONCERNING
AND VERY DISAPPOINTING NOT ONLY
AS AN O B G Y N BUT AS A WOMAN
AND A MOTHER OF TWO CHILDREN IF
I WENT TO ONE OF YOUR CENTERS
AND WAS GIVEN THIS FACTUALLY
MEDICALLY INCORRECT INFORMATION,
I WOULD BE VERY UPSET. THANK
YOU. ANYONE ELSE? MR PATTERSON.
THANK YOU. FIRST I WANT TO SAY I
HAVE A GREAT DEAL OF PERSONAL
RESPECT FOR THE AUTHOR OF THIS
BILL, AND I DID WARN HER LAST
NIGHT THAT I HAVE A DIFFERENT
PERSPECTIVE ON THIS PARTICULAR
TOPIC. UM I WANT TO THANK THE
MOMS AND THE BENEFICIARIES OF
THESE SERVICES AND MEDICAL
PROFESSIONALS THAT ARE HERE. UM
BECAUSE OF CONVERSATIONS LIKE
THIS, I THINK YOU KNOW, CRISIS
PREGNANCY CENTERS HAVE WRONGLY
BEEN TARGETED FOR VIOLENCE. UM
THESE CENTERS HAVE HAD TO SHUT
DOWN BECAUSE OF SECURITY
CONCERNS. UM I'M THANKFUL FOR
THESE CENTERS. I'M NOT A
SCIENTIST LIKE YOU KNOW, I CAN'T
REALLY, UH, DEBATE THE REVERSAL
MEDICATION SITUATION. UM I
REALLY DON'T KNOW. ALL I KNOW IS
I'VE MET A LOT OF THESE WOMEN
AND THESE FAMILIES THAT HAVE
BENEFITED FROM THEIR SERVICES.
AND I TAKE COMPLETE OFFENSE TO
CALLING THEM FAKE HEALTH
CENTERS. I TAKE OFFENSE TO YOU,
CALLING THAT LICENSED DOCTORS,
THE NURSES AND OTHER MEDICAL
PROFESSIONALS AS FAKE. THE WOMEN
WHO HAD ABORTIONS AND HAVE GONE
THROUGH THESE CENTERS AND HAVE
YOU SERVICES, PLANNED PARENTHOOD
AND THE CRISIS. PREGNANCY
CENTERS IN ATTACKING THEM IS NOT
APPROPRIATE. IT'S FALSE. THEY
CANNOT PROVIDE DATA WITH
WHOMEVER THEY WANT. JUST HEARD A
BILL IN PRIVACY JUST NOW, WHERE
I SERVE AS THE VICE CHAIRMAN,
AND THERE'S ACTUALLY LEGISLATION
UP RIGHT NOW TO MAKE
CALIFORNIA'S ALREADY STRONG
PRIVACY LAWS THAT ARE LANDMARK
LEGISLATION EVEN STRONGER TO
PROTECT WOMEN WHO ARE COMING IN
FROM OUT OF STATE AND DECIDING
HAVE AN ABORTION HERE. AND SO
IT'S NOT ACCURATE TO SAY THAT
THEY CAN SHARE PERSONAL
INFORMATION AND IF THEY'RE DOING
THAT THAT'S A VIOLATION OF
ALREADY EXISTING LAW. YOU JUST
DESCRIBED AN EXAMPLE OF A
SITUATION OF READING. I DON'T I
DON'T KNOW ANYTHING ABOUT IT. I
TRIED TO GOOGLE. IT COULDN'T
FIND ANYTHING ABOUT IT. BUT
LET'S ASSUME IT'S TRUE. AND IT
SOUNDS LIKE TO ME IF IT WAS SHUT
DOWN THAT THE LAW TOOK CARE OF
IT. UM, THERE ARE BAD ACTORS IN
A LOT OF FIELDS OF STUDY A LOT
OF DIFFERENT KIND OF SITUATIONS
, AND I'M NOT GOING TO PAINT A
BROAD BRUSH BUT VERY SOON I'M
GOING TO AN EVENT IN MY DISTRICT
WITH LITERALLY HUNDREDS OF
FAMILIES THAT ARE GOING TO BE
SUPPORTERS OF ONE OF THESE
CENTERS IN MY DISTRICT, AND IT
ISN'T BECAUSE THEY'RE FAKE. AH
IT'S BECAUSE THEY'RE ACTUALLY
BENEFITING MY COMMUNITY AND
WOMEN WHO BENEFITED FROM THIS
SERVICE. AND SO I WROTE MY
COMMENTS AS I WAS SITTING HERE
LISTENING TO THIS BECAUSE I
THINK THE MISCHARACTERIZATION OF
THESE CENTERS THROUGHOUT THE
COUNTRY HAS BEEN REALLY
PROBLEMATIC TO ME. I'VE SEEN
WHAT THEY'VE DONE. I'VE SEEN THE
WOMEN WHO HAVE BENEFITED FROM
THEM. AND IF WE WANT TO HAVE A
DISCUSSION ABOUT THE TYPES OF
THINGS THAT THEY CAN DO, I THINK
THAT THAT'S FINE. BUT GIVING
THIS LEGISLATION IN MY OPINION,
PAINTS THEM WITH A BROAD BRUSH,
AND I JUST I DEFINITELY CANNOT
SUPPORT THIS LEGISLATION AS A
RESULT. THANK YOU. ANYONE ELSE?
YOU KNOW. ONE THE MOTION BY
ASSEMBLYMEMBER'S AGUIAR-CURRY, A
SECOND BY DR WEBBER MOTION IS
DUE PASS AS AMENDED TO
APPROPRIATIONS WOULD LIKE TO
CLOSE.
YOU'RE YOU'RE STILL OFF. IT'S
LIKE BLINKING AT ME. OKAY? OKAY
I'M NOT TOUCHING IT. AND IT'S
WORKING. YES, OKAY. UM SO THANK
YOU SO MUCH CHAIR AND MEMBERS
AND APPRECIATE EVERYONE'S
COMMENTS TODAY, UM, AND INSIGHTS
, I THINK, UM YOU KNOW, THE
ALTERNATIVES PREGNANCY CENTER IS
NOT THE NORM. IT IS THE
EXCEPTION. THEY ARE ACTUALLY
MEDICALLY LICENSED, BUT IT IS
RARE IN THE MAJORITY OF THEM ARE
NOT. AND AS WE'VE HEARD TODAY,
EVEN IN THE CASE OF A LICENSED
CENTER, THEY'RE NOT PROVIDING
MEDICALLY ACCURATE OR FACTUAL
INFORMATION. TWO PEOPLE EVEN
WHEN THEY ARE HERE IN FRONT OF A
LEGISLATIVE BODY. UM AND, UM,
I'M GLAD I DIDN'T WEAR PINK
TODAY BECAUSE WE ALL KNOW THAT'S
WHAT ABORTION RIGHTS ACTIVISTS
HAD BEEN WEARING. AND YOU KNOW,
EVEN VISUALLY CONFUSING PEOPLE,
AND I THINK IT'S EMBLEMATIC OF
WHAT'S HAPPENING WITHIN THESE
CENTERS. THIS IS SIMPLY A PUBLIC
INFORMATION CAMPAIGN. THIS IS
NOT RESTRICTING THEM IN ANY WAY
IT IS MAKING SURE THAT ANYONE
WHO IS PREGNANT KNOWS WHERE THEY
CAN GET CERTAIN KINDS OF
INFORMATION IF THEY WANT FACTUAL
INFORMATION, MEDICALLY BASED
INFORMATION ABOUT ABORTION, THEY
SHOULD KNOW WHERE THEY CAN GET
IT RIGHT NOW. I JUST I HAPPEN TO
HAVE, UM THE WEBSITE FROM THE
ALTERNATIVES. PREGNANCY CENTER
AND THIS IS WHAT YOU FIND ON
THEIR WEBSITE, WHICH, UM, TALKS
ABOUT ABORTION. THESE ARE
QUESTIONS TO ASK YOURSELF. IS
ABORTION. THE RIGHT DECISION FOR
ME. WOULD I CONSIDER PARENTING
OR ADOPTION? WILL I REGRET
HAVING AN ABORTION? DO I HAVE A
STRONG PERSONAL OR RELIGIOUS
BELIEF ABOUT ABORTION WITH MY
FAMILY? FRIENDS AND PARTNERS
SUPPORT ME IN THIS DECISION. AM
I FEELING PRESSURED TO HAVE AN
ABORTION WOULD HAVING AN
ABORTION CHANGED MY LIFE IN A
NEGATIVE WAY? WOULD I RECEIVE
THE SUPPORT I NEED IF I DECIDED
TO PARENT A CHILD. NOW, I WOULD
NOT SAY THAT THIS IS
COMPREHENSIVE OF ABORTION
INFORMATION WHEN PEOPLE ARE
SEEKING INFORMATION ABOUT
ABORTIONS, AND THIS IS ON THEIR
WEBSITE, THEY'RE NOT EVEN HIDING
THIS. UM SO WE ARE JUST
SUGGESTING AND MOVING FORWARD
THE IDEA THAT WE NEED TO MAKE
SURE THAT PEOPLE KNOW SOLID
INFORMATION WHEN IT COMES TO
WHAT THEIR OPTIONS ARE AROUND.
ABORTION OF PEOPLE WANT TO KEEP
THEIR CHILDREN AND THEY PROVIDE
THE KINDS OF SERVICES THEY'RE
TALKING ABOUT THAT THEY WANT TO
KEEP THAT BABY. FINE. THAT'S
GREAT. THAT'S WONDERFUL. AND
THAT SHOULD BE CLEAR. BUT IT IS
NOT A PLACE WHERE YOU GET A
REFERRAL FOR ABORTION. OR REAL
MEDICAL ADVICE AROUND ABORTION
OPTIONS, AND THAT SHOULD ALSO BE
CLEAR. WE SHOULD MAKE IT CLEAR
WHERE YOU CAN GET THAT
INFORMATION. SO WHEN PEOPLE ARE
AT THIS MOMENT WHEN IT IS SO
HARD WHEN IT IS SUCH A DIFFICULT
MOMENT FOR PEOPLE TO GO AND BE
SHAMED AND CONFUSED AND MISLED.
AT THAT VULNERABLE MOMENT. TO ME
IS UNCONSCIONABLE AS A MOM. HèA
. I'M TWO DAUGHTERS, AND I AM
VERY HAPPY THAT I WAS ABLE TO
CHOOSE WHEN I HAD A BABY. AT A
TIME WHERE I COULD SUPPORT MY
DAUGHTER. UM AND I THINK THAT
EVERYONE NEEDS TO BE ABLE TO
MAKE THAT DECISION ON THEIR OWN.
WITHOUT PRESSURE AND SHAME AND
EMBARRASSMENT. UM THIS IS SIMPLY
PUBLIC INFORMATION. AND IF WHAT
YOU'RE DOING, YOU'RE PROUD OF
THEY SHOULD NOT SCARE ANYONE AND
THERE SHOULD NOT BE OPPOSITION
TO IT. I RESPECTFULLY ASK YOUR I
VOTE. THANK YOU. THANK YOU, MISS
SZABO. UM THE MOTION IS DUE PASS
AS AMENDED TO APPROPRIATIONS
SECRETARY. PLEASE CALL THE ROLL.
I WALDRON BROTHER. NO ANGER, KRI
KRI I ARAMBULA BOERNER HORVATH
VÚI FLORA. VINCE FONG
MAIENSCHEIN. MCCARTHY. PATERSON
PATERSON, NO RODRIGUEZ SANTIAGO
VALLAPUDUA. WEBBER. HOWEVER, I.
IT'S 3 TO 2 WILL LEAVE THE BILL
ON COP. THANK YOU VERY MUCH. YOU
HAVE A SECOND YOU HAVE AN A. J.
R.
FROM THE HISTORY AHEAD. WHENEVER
YOU'RE READY. OKAY, NUMBER TWO.
SO UM, CHAIR REMEMBERS. THANK
YOU SO MUCH HAPPY TO PRESENT A.
J R FOUR, WHICH IS A JOINT
RESOLUTION REQUESTING THE BIDEN
ADMINISTRATION DISSOLVED THE
ACCOUNTABLE CARE ORGANIZATIONS
OR A CEO REACH PROGRAM THEY
STILL REACH IS THE BIDEN
ADMINISTRATION'S ATTEMPT TO
REBRAND A TRUMP ADMINISTRATION.
UM GLOBAL PROFESSIONAL DIRECT
CONTRACTING MODEL. THIS MODEL
WAS INTENDED TO FURTHER PRIVATE
, PRIVATIZE TRADITIONAL MEDICARE
BY ENROLLING MILLIONS OF
MEDICARE RECIPIENTS AND PRIVATE
DIRECT CONTRACT ENTITIES OR D. C
E S WITHOUT CONSENT. OUR
NATION'S MEDICARE PROGRAM HAS
KEPT ELIGIBLE SENIORS AND PEOPLE
WITH DISABILITIES FROM DYING AND
OUT OF POVERTY FOR CLOSE TO 60
YEARS. BY PROVIDING GUARANTEED
HEALTHCARE. WHEN FIRST
ESTABLISHED MEDICARE ALLOWED
PATIENTS TO SEE A PHYSICIAN AND
ACCEPT MEDICARE AND KEPT IN
ADMINISTRATIVE COSTS. AT A
MINIMUM. MEDICARE, FOR EXAMPLE,
HAS AN ADMINISTRATIVE UM
PERCENTAGE OF 4% 2 TO 4% VERSUS
INSURANCE COMPANIES WHICH HAVE
ADMINISTRATIVE LEVELS OF AROUND
16. SINCE THE MID 19 SIXTIES,
THE FEDERAL GOVERNMENT HAS
INCREASINGLY USED MEDICARE TO
PRAY PRIVATE INSURERS IN THE
NINETIES. IT WAS CALLED MEDICARE
PART C AND NOW OFTEN REFERRED TO
AS MEDICARE ADVANTAGE. TO
ADMINISTER OUR COUNTY'S MEDICARE
PROGRAM. MANY OF THE PROVIDERS
OF THE CEO REACH OR SOMETIMES
PRIVATE EQUITY FIRMS AND ARE
RUSHING TO EXPLOIT AND UNDERMINE
MEDICARE SOLVENCY BY OVER
DIAGNOSING AND INFLATING BILLION
PRACTICES. PRIVATIZING MEDICARE
FUNDING HAS CREATED A $350
BILLION MARKET. UNDERMINING
MEDICARE SOLVENCY AND PUTTING
CRITICAL CARE DECISIONS FOR
PATIENTS AT THE IN THE HANDS OF
INSURANCE COMPANIES RATHER THAN
MEDICAL PROVIDERS. CALIFORNIA IS
MOST VULNERABLE BECAUSE WE
HOUSED 27 OF THE 132 NATIONALLY
APPROVED A C E. O S. WE ARE ONE
OF THE STATES THAT HAS CLOSE TO
20% OF THE NATION'S A CEO REACH
PROVIDERS. JOINING ME TODAY I
HAVE DWAYNE CAMP STATE POLICY
DIRECTOR FOR CALIFORNIA ALLIANCE
FOR RETIRED AMERICANS TO TESTIFY
AND SUPPORT AND ALSO HAVE TWO
POSITIONS HERE TO ANSWER
TECHNICAL QUESTIONS IF NEEDED,
AS WELL. THANK YOU. CAN YOU HEAR
ME? OK OKAY. WE'RE GOOD. SORRY.
SEE, YOU'RE ACTING ME. WELL,
GOOD AFTERNOON CHAIR, WOOD AND
ESTEEMED MEMBERS OF THE
COMMITTEE. MY NAME IS DWAYNE
CAMP AND I'M HUMBLED TO SPEAK ON
OUR RESOLUTION TODAY. I HAVE THE
PRIVILEGE OF WORKING FOR THE
CALIFORNIA ALLIANCE FOR RETIRED
RETIRED AMERICANS. WE ARE A
STATEWIDE NONPROFIT, SENIOR AND
DISABILITY ADVOCACY ORGANIZATION
REPRESENTING OVER ONE MILLION
MEMBERS THROUGH OUR OVER 300
AFFILIATED ORGANIZATIONS. MANY
OF OUR MEMBERS ARE MEDICARE
BENEFICIARIES, AND UPON THEIR
ENROLLMENT, THEY MADE A
CONSCIOUS CHOICE. ABOUT THEIR
PREFERRED MODEL OF CARE,
TRADITIONAL OR FEE FOR SERVICE,
MEDICARE OR MEDICARE ADVANTAGE.
PART C. IN ADDITION TO DECIDING
ON WHICH SUPPLEMENTAL PLANS BEST
FIT THEIR NEEDS. OVER SIX
MILLION CALIFORNIANS HAVE BEEN
FACED WITH THAT SAME CHOICE AND
AS THIS COMMITTEE IS WELL AWARE
OUR STATE IS ON THE PRECIPICE OF
THE LARGEST DEMOGRAPHIC SHIFT IN
HISTORY, AS OLDER ADULTS AND
SENIORS ARE PROJECTED TO
COMPRISE AT LEAST 25% OF
CALIFORNIA'S POPULATION BY 2030.
FOR NEARLY 60 YEARS, MEDICARE
HAS PROVIDED HEALTHCARE COVERAGE
TO TENS OF MILLIONS OF AMERICANS
. HOWEVER IN THE LAST DECADE,
MEDICARE INCURRED A BILLIONS OF
DOLLARS IN OVERPAYMENTS TO
MEDICARE ADVANTAGE INSURERS AS A
RESULT, IN PART OF THE
PROLIFERATION OF PRIVATIZATION
IN MEDICARE AND THROUGH THE
SYSTEMATIC EXPLOITATION OF
MEDICARE ADVANTAGE OF LOOPHOLES
SUCH AS RISK OR GAMING AND UP
CODING. THESE OVERPAYMENTS ARE
CONSEQUENTIAL. AS MODELS PROJECT
THE MEDICARE HOSPITAL INSURANCE
TRUST FUND IS PROJECTED TO HIT
INSOLVENCY AS EARLY AS 2028.
DIRECT CONTRACTING, NOW
REBRANDED AS A CEO REACHED UNDER
THE BIDEN ADMINISTRATION
AUTOMATICALLY ALIGNS OR ENROLLS
TRADITIONAL MEDICARE
BENEFICIARIES INTO AN A C O AN
ACCOUNTABLE CARE ORGANIZATION.
BASED ON THEIR PHYSICIANS
AFFILIATION WITH AN EXISTING
NETWORK. THESE A CEO'S
ESSENTIALLY OPERATE AS A MANAGED
CARE PLAN, UH, MOST BACKED BY BY
BY PRIVATE INSURERS, MANY OF
WHICH ARE INVESTOR CONTROLLED.
ADDITIONALLY UNDER THE REACH
PROGRAM, A CEO'S ARE ONLY
REQUIRED TO SPEND AS LITTLE AS
60% OF THEIR MEDICARE PAYMENTS
ON PATIENT CARE, LEAVING THE
REMAINING 40% TO KEEP AS PROFIT
AND OR COVER ADMINISTRATION AND
OVERHEAD. BY COMPARISON,
TRADITIONAL MEDICARE SPENDS 98%
OF ITS FUNDS AND PATIENT CARE
AND MEDICARE ADVANTAGE IS
REQUIRED THROUGH THE A TO SPEND
85% ON PATIENT CARE. 2.1 MILLION
AMERICANS HAVE BEEN ALIGNED INTO
A CEO REACHED THUS FAR. AND
WHILE CMS HAS INDICATED PROGRAM
EXPANSION IS MOMENTARILY CAPPED
WE HAVE MEMBERS WHO ARE
RECEIVING 30 DAY NOTICES ABOUT
THEIR REACH ALIGNMENT AS
RECENTLY AS MARCH OF THIS YEAR.
ONCE ENROLLED THE ONLY WAY FOR
BENEFICIARY TO REMOVE THEMSELVES
FROM A FROM A RICH PROGRAM IS TO
CHANGE PRIMARY CARE PROVIDERS.
AND IN CLOSING. A CEO REACH IS
THE PATHWAY TO PRIVATIZE THE
ENTIRE TRADITIONAL MEDICARE
POPULATION. PRIVATE EQUITY
GROUPS ARE RACING TO INVEST IN
PRIMARY CARE PRACTICES AND
HEALTH PLANS. IN FACT, OVER
ABOUT OVER THE LAST 15 YEARS,
MEDICARE ADVANTAGE PLANS HAVE
BEEN THE MOST POPULAR FORM OF
HEALTH INSURANCE STARTUPS. BUT
CORA IS NOT ALONE IN OUR
CONDEMNATION OF THIS PROGRAM.
MEMBERS OF CONGRESS, INCLUDING
PROMINENT LEADERS FROM
CALIFORNIA'S CONGRESSIONAL
DELEGATION, ADVOCACY
ORGANIZATIONS AND OTHERS HAVE
EXPRESSED THEIR OPPOSITION TO
REACH AND WE'LL CMS HAS TAKEN
STEPS TO ADDRESS SOME OF THE
CONCERNS, REMOVING A FEW BAD
ACTORS OR INSURERS WITH A
DOCUMENTED HISTORY OF MEDICARE
ABUSE DOESN'T SOLVE THE
PROGRAMMATIC FLAWS AND REACHES
DESIGN, NOR DOES IT ADDRESS THE
SUBJECT TO THE SUBSTANTIVE
CONCERNS ABOUT CONSUMER CHOICE.
COR EACH THREATENS TO UNDERMINE
THE GREAT WORK OF THIS
LEGISLATURE TO IMPROVE ACCESS,
AFFORDABILITY AND QUALITY OF
HEALTH CARE. UH TRADITIONAL
MEDICARE, WHICH REMAINS THE MOST
POPULAR COST EFFECTIVE HEALTH
CARE PROGRAM FOR SENIORS
DESERVES AND REQUIRES US TO
PROTECT IT, AND WE SHOULD BE
TAKING STEPS TO UH, ENSURE WE
ARE HITTING OUR SOLVENCY NUMBERS
AND THAT EVERY SENIOR OR SORRY
AS EVERY CALIFORNIAN AGES IN
THIS STATE THAT THEY HAVE
EQUITABLE ACCESS TO MEDICARE,
TRADITIONAL MEDICARE OR AT LEAST
BE ABLE TO DIRECT THEIR CHOICES
FOR MEDICARE COVERAGE. THANK YOU
, OWEN WITH ME. SORRY TO CLARIFY
. WE HAVE DEBRA AND MARC DOLMAN,
WHO ARE FROM NAPA. AND THEY HAVE
BEEN ALIGNED INTO AN A C O.
OKAY, OTHERS IN SUPPORT.
AYE. I'M SORRY. I WAS CONFUSED.
I THOUGHT WE JUST HAD ONE
WITNESS SPEAKING. SO HE WENT
WELL OVER TIME, SO OH, YEAH,
ABSOLUTELY. YEAH. YEAH, I'M
DEBORAH DAHLMAN AND I REPRESENT
PHYSICIANS FOR NATIONAL HEALTH
PROGRAM. HEALTH CARE FOR ALL
CALIFORNIA AND HEALTHY
CALIFORNIA NOW COALITION. WE ARE
ALL IN SOLIDARITY WITH KARA, AND
WE STRONGLY SUPPORT A J. R FOUR.
AS I'M DIRECTLY AFFECTED BY A
CEO REACH. I'M ALSO AVAILABLE
FOR QUESTIONS JUST AND JUST NAME
AND POSITION ALMOND. I'M WITH
HEALTH CARE FOR ALL CALIFORNIA
AND STRONG SUPPORT. THANK YOU.
THANK YOU ANYONE ELSE? THERE ANY
OPPOSITION TO THE BILL OR THE
IT'S AN A. J. R IT'S NOT A IT'S
NOT A BILL RESOLUTION. NO. ONE.
BRING IT BACK TO THE COMMITTEE
FOR QUESTIONS OR COMMENTS. I
THINK THERE WAS A THERE WAS A
MOTION BY ADMITS AGUIAR-CURRY.
NO QUESTIONS OR COMMENT. I WILL
. SECOND TO SECOND THE MOTION.
UM WOULD YOU DOESN'T JOY A BE
ADOPTED RECOMMENDATION? WOULD
YOU LIKE TO CLOSE, MISS SZABO?
JUST THANK YOU SO MUCH. AND UH,
ENCOURAGE AND I VOTE. THANK YOU.
THANK YOU, MADAM SECRETARY.
PLEASE CALL THE ROLL. WOULD
WALDRON WALDRON I EDGAR CURRY
AGUIAR-CURRY? AYE, ARAMBULA.
BOERNER HORVATH VÚI FLORA VINCE
WONG MAIENSCHEIN. MCCARTY. JOE
PATTERSON, RODRIGUEZ SANTIAGO VÆ
VALLAPUDUA. HOWEVER. HOWEVER, I
. THANK YOU. THAT'S 40. WE'LL
LEAVE THE BILL OR THE A. J ARE
ON CALL. SO THANK YOU. THANK YOU
VERY MUCH. MR. LOWENTHAL, YOU'RE
UP NEXT. MR LOWENTHAL HAS A B
907.
THANK YOU, MR CHAIR AND MEMBERS.
I AM. PLEASED TO PRESENT A B
907, WHICH REQUIRES A HEALTH
CARE SERVICE PLAN CONTRACT. OR
HEALTH INSURANCE POLICY ISSUED
AMENDED RENEWED ON OR AFTER
JANUARY. 1ST 2024 TO PROVIDE
COVERAGE FOR TREATMENT OF
PEDIATRIC AUTOIMMUNE.
NEUROPSYCHIATRIC DISORDER
ASSOCIATED WITH STREPTOCOCCAL
INFECTIONS. OR PANDAS, PEDIATRIC
, ACUTE ONSET NEUROPSYCHIATRIC
SYNDROMES SYNDROME. OR PANS
PRESCRIBED OR ORDERED BY A
PROVIDER. PANDAS AND PANS ARE
INFLAMMATORY DISEASES OF THE
BRAIN THAT RESULTS IN SUDDEN
ONSET, DEVASTATING BEHAVIORAL
AND NEUROLOGICAL DYSFUNCTION
THAT USUALLY OCCUR AFTER A
TRIGGERING INFECTION. THESE
DISORDERS ARE THOUGHT TO BE
CAUSED BY AUTO ANTIBODIES
GENERATED AFTER THE INFECTION
THAT MISTAKENLY ATTACKED THE
BRAIN. ANYBODY AND ORAL ANTI
INFLAMMATORY MEDICATION HELPED
MOST CHILDREN, BUT A MINORITY
NEEDS STRONGER IMMUNE MODULATING
TREATMENTS SUCH AS INTRAVENOUS.
IN ME, IMMUNOGLOBULIN OR I V I G
ALWAYS SCREWED THAT UP. SORRY.
DESPITE PUBLISHED PANDAS AND
PANS TREATMENT GUIDELINES THAT
ESTABLISHED THE STANDARD OF CARE
IN 2017 6 YEARS AGO, INSURERS
HAVE CONTINUED TO ADHERE TO
THEIR OWN POLICY STATEMENTS
FORBIDDING AUTHORIZATION OF
IMMUNE FOCUS TREATMENTS LIKE I V
I, G. AND AS A RESULT,
TREATMENTS ARE ROUTINELY DENIED
WITHOUT ROUTINE CONSIDERATION.
PRESCRIBER OR FAMILY APPEALS
INSURERS TYPICALLY UPHOLD THEIR
DENIAL, CLAIMING QUOTE A LACK OF
MEDICAL NECESSITY. OR THAT QUOTE
THE TREATMENT IS EXPERIMENTAL.
UNFORTUNATELY MOST REVIEWERS
WORKING FOR INSURERS LACK
EXPERIENCE IN THIS COMPLEX,
UNCOMMON AND DEVASTATING
DISORDER. THE TYPICAL DELAY IN
RECEIVING I V I G. DOO DOO
INSURANCE DENIALS IS USUALLY
MEASURED IN MONTHS, IF NOT YEARS
. MEANWHILE MOST PANS AND PANDAS
SUFFERERS CANNOT ATTEND SCHOOL.
REQUIRE INTENSIVE ACADEMIC
ACCOMMODATIONS SUCH AS HOME
HOSPITAL SCHOOL. THEY MAY BE
HOSPITALIZED MEDICALLY OR
PSYCHIATRICALLY, RESULTING IN
MORE COST AND UNNECESSARY
SUFFERING. AS A RESULT OF DELAYS
IN TREATMENT. INDIVIDUALS
SUFFERING FROM PANS AND PANDAS
MAY CUMULATE PERMANENT
NEUROLOGICAL DAMAGE. THEIR
PARENTS ARE OFTEN UNABLE TO WORK
AND MAY REQUIRE STATE
UNEMPLOYMENT OR FAMILY MEDICAL
LEAVE BENEFITS. CHILDREN LUCKY
ENOUGH TO HAVE PARENTS WITH THE
FINANCIAL WHEREWITHAL TO PAY OUT
OF POCKET OR THE SAVVY AND
PERSISTENCE NECESSARY TO BATTLE
. THE PROTRACTED APPEALS PROCESS
TYPICALLY RECOVER WELL WITH THE
APPROPRIATE TREATMENT. YOU HAVE
FAMILIES WHO LACK THESE
RESOURCES OFTEN END OR FINANCIAL
RUIN. POSSIBLE CHILD ABUSE
ALLEGATIONS. POLICE QUOTE
UNQUOTE WELLNESS CHECKS THAT GO
AWRY AND EVEN SUICIDES. THIS
LAST TRAGIC FACT HAS LED TO THE
ESTABLISHMENT OF THE POND BRAIN
BANK AT GEORGETOWN UNIVERSITY,
WHERE THE BRAINS HAVE THREE
DECEASED YOUNG PANDAS AND PANS.
PATIENTS ARE NOW CONTRIBUTING TO
SCIENTIFIC KNOWLEDGE. COMMUNITY.
PHYSICIANS ARE OFTEN RELUCTANT
TO TREAT THIS DISORDER DUE TO
ITS INTENSITY, ITS COMPLEXITY.
IT'S RELATIVE RARITY WITH THE
ADDED BURDEN OF LENGTHY
INSURANCE APPEALS, THE POOL OF
WILLING TREATING PHYSICIANS
SHRINKS EVEN FURTHER. IN
ADDITION, INSURERS OFTEN
RESTRICTED DELAY ACCESS TO OUT
OF NETWORK SPECIALIST WITH
EXPERIENCE AND EXPERTISE IN THIS
ILLNESS. THIS BILL SEEKS TO
ALLEVIATE THESE BARRIERS BY
DIRECTING INSURANCE TO INSURERS
TO FOLLOW TREATMENT. GUIDANCE
PUT FORTH BY UNIVERSITY LEVEL
MULTI SPECIALTY EXPERTS IN THE
FIELD. AS INDICATED IN THE
SUBURB ANALYSIS AND REFLECTED IN
THE COMMITTEE ANALYSIS. THE
INCREASE TO TOTAL NET ANNUAL
EXPENDITURES, IF THEY BE 907
WERE ENACTED, IS RELATIVELY LOW
, CONSTITUTING A 9070.0 TO
INCREASE FOR ENROLLEES WITH CMHC
REGULATED PLANS. WITH REGARD TO
THE CONCLUSION IN THE SUBURBAN
ANALYSIS THAT THE EVIDENCE OF
THE EFFICACY OF TREATMENTS IS
INSUFFICIENT OR INCONCLUSIVE. I
WILL SAY THE FOLLOWING WE ARE
FORTUNATE PANDAS AND PANS ARE
RELATIVELY RARE. HOWEVER THAT
MEANS THAT THERE ARE NOT MANY
INDIVIDUALS WHO WILL REQUIRE THE
TREATMENTS THAT ARE COMMONLY
PRESCRIBED FOR THESE DISORDERS.
AND UNFORTUNATELY, THAT MEANS
THAT THE SAMPLE SIZES ARE VERY
SMALL, AND AS A RESULT, THERE'S
NOT MUCH DATA AVAILABLE ON THE
EFFICACY OF THE COMMONLY
PRESCRIBED TREATMENTS. BUT THAT
DOES NOT MEAN THE TREATMENTS ARE
INEFFECTIVE. ADDITIONALLY AND
PERHAPS, MOST IMPORTANTLY,
BECAUSE THIS IS USUALLY A
PEDIATRIC DIAGNOSIS. THIS IS
THERE IS NOT THE SAME DRUG OR
TREATMENT TRIAL DATA AVAILABLE
AS THEY'RE TYPICALLY WOULD BE
FOR ADULTS. THIS COMBINED WITH A
LIMITED OCCURRENCE OR RARITY OF
THESE DISORDERS MAKE IT
DIFFICULT TO PROVIDE CONCLUSIVE
EVIDENCE. HOWEVER FROM THE
PERSPECTIVE OF THE PEDIATRICIANS
AND PHYSICIANS WERE TREATING
KIDS WITH PANDAS AND PANTS. THE
TREATMENTS ARE EXTREMELY
EFFECTIVE, AND THE EARLIER THEY
RECEIVED TREATMENT, THE BETTER
THE OUTCOME FOR THESE PATIENTS.
EARLY IN EX EXPEDIENT ACCESS TO
THE TREATMENT IS CRUCIAL TO THE
EFFECTIVE TREATMENT OF PANDAS
AND PANTS IN ORDER TO AVOID THE
DEBILITATING SYMPTOMS,
POTENTIALLY PERMANENT
NEUROLOGICAL DAMAGE. AND
SOMETIMES FATAL OUTCOMES
ASSOCIATED WITH THESE DISORDERS.
MAYBE 907 WILL ENSURE THAT
INDIVIDUALS AND FAMILIES WHO ARE
CONFRONTED WITH THESE DISORDERS
DO NOT EXPERIENCE UNNECESSARY
DELAYS IN TREATMENT THAT CAN
LEAD TO DISASTROUS AND TRAGIC
OUTCOMES. I AM VERY PLEASED TO
BE JOINED BY CONSTITUENTS.
STAKEHOLDERS OF THE 69TH. APRIL
RENEE AND DR TEMP EIGHT. CHEN
WHO ARE HERE TO TESTIFY IN
SUPPORT OF A B 907. HI I'M
APRIL. RONAY. THANK YOU FOR
ALLOWING ME TO SPEAK. MY
BEAUTIFUL SON. AIDEN WAS A
HEALTHY, VIBRANT EIGHT YEAR OLD
WHEN HE GOT PNEUMONIA. NINE
YEARS AGO, HE WOKE UP A
COMPLETELY DIFFERENT CHILD
AFTERWARDS SUDDENLY CONSUMED BY
OECD HALLUCINATIONS AND EXTREME
SEPARATION ANXIETY. HE COULDN'T
LEAVE THE HOUSE OR PLAY HE RAGED
AND THROUGH THINGS THAT HIS BABY
BROTHER HE STOPPED SLEEPING,
REFUSED TO EAT AND COULDN'T DO
ANY SCHOOLWORK. WHAT HAPPENED TO
MY SON? FOUR MONTHS LATER, AIDAN
WAS DIAGNOSED WITH PANTS. HE
STARTED ANTIBIOTICS AND IN DAYS
WE HAD OUR SON BACK. FOR YEARS.
HIS OCCASIONAL FLARES WERE
MANAGED WITH ANTIBIOTICS,
STEROIDS AND INSIDES.
UNFORTUNATELY AT THE AGE OF 14,
A SIMPLE FLU PLUNGED EIGHT AND
BACK INTO SEVERE PANTS. THIS
TIME ANTIBIOTICS DIDN'T WORK. HE
LOST ALL QUALITY OF LIFE, AND I
STOPPED TEACHING TO BECOME HIS
CARETAKER. DESPERATE WE FOUND
SPECIALISTS FROM OUR LOCAL
CHILDREN'S HOSPITAL AND U C. L.
A MY SON'S NEW DOCTORS. GRAVELY
CONCERNED PRESCRIBED, I V I G,
WHICH IS A STANDARD OF CARE FOR
MORE SEVERE PANS, ACCORDING TO
PUBLISHED GUIDELINES. THAT IS
WHY WE WERE SHOCKED WHEN OUR
INSURANCE DENIED. I V I G,
SAYING IT WAS NOT MEDICALLY
NECESSARY. TWO YEARS INTO THIS
HORRIBLE FLARE. AIDEN WAS
HOSPITALIZED FOR SEVERE STOMACH
PAIN BY NOW. HE WAS 16 AND STILL
WAITING FOR TREATMENT. IN THE
HOSPITAL, 80 AND FINALLY
RECEIVED I V I G WITH IMMEDIATE
RELIEF. HIS DOCTOR CALLED HIS
RECOVERY MIRACULOUS AND
RECOMMENDED ANOTHER INFUSION TO
SOLIDIFY GAINS. WE WERE ASKED TO
KEEP A JOURNAL OF ADEN'S
IMPROVEMENT FOR PROOF OF
POSITIVE OUTCOMES. I JOURNAL AS
HE BEGAN TO EAT AGAIN, GAINING
WEIGHT IS JOINT STOP TAKING. HE
SLEPT THROUGH THE NIGHT ANXIETY
O, C D AND SHORT TERM MEMORY
LOSS MELTED. MY ENTIRE FAMILY
STARTED TO HEAL. UNTIL WE OPENED
ANOTHER DENIAL LETTER THIS TIME
CLAIMING I B I G S EXPERIMENTAL.
SADLY, MY SON'S HEALTH BEGAN TO
DETERIORATE FROM THE INABILITY
TO GET MEDICINE. OUR TASK OF
DOCUMENTING AIDEN'S MIRACULOUS
RECOVERY TURNED INTO THE
HEARTBREAK OF DOCUMENTING HIS
DECLINE. MONTHS LATER, I GOT A
LETTER SAYING, I VE HAD FINALLY
BEEN APPROVED. NO EXPLANATION
WAS GIVEN BY NOW. OUR SON HAD
UNCHECKED BRAIN INFLAMMATION FOR
TWO YEARS, THREE MONTHS AND 24
DAYS. THE DAY. AIDEN IS 17. HE
IS 80% HEALED WITH I V I G AND I
CAN FINALLY RETURN TO WORK BUT
THE 20% HE LOST TO INSURANCE
DELAYS LEFT A MARK. HE HAS
FATIGUE LIKE NEVER BEFORE HE NOW
NEEDS THERAPY FOR RESIDUAL OCD
AND TUTORING PAID OUT OF POCKET.
THE CONSEQUENCES OF DENIALS ARE
TREMENDOUS FAMILIES TOOTH
BETWEEN PAYING THEIR BILLS AND
THEIR CHILDREN'S HEALTH.
DESPERATE SOME FAMILIES SO HOMES
TO BUY MEDICINE, SO I'M JUST
LOSE THEIR CHILDREN FOREVER.
ENOUGH PANTS. CHILDREN HAVE
COMMITTED SUICIDE THAT THERE'S A
BRAIN BANK AT GEORGETOWN TO
STUDY KIDS LIKE MAX WALLIS. MAX
KILLED HIMSELF THE DAY BEFORE
CHRISTMAS 2016 WHILE WAITING FOR
TREATMENT. HE WAS JUST 13. RIGHT
NOW. 10 STATE TOP LAWS LIKE 89
07. A DOZEN MORE STATES
INTRODUCED BILLS THIS YEAR
ALONE. MEANWHILE CALIFORNIA
FAMILIES STILL CAN'T ACCESS LIFE
SAVING MEDICINE. DESPITE HAVING
TWO LEADING PANTS, CLINICS YOU,
C L A AND STANFORD IT'S TIME FOR
CALIFORNIA TO PROTECT ITS
CHILDREN ON BEHALF OF ALL
CALIFORNIA FAMILIES IMPACTED. I
RESPECTFULLY URGE I ON A B 907.
GOOD AFTERNOON. MY NAME IS DR
TEMPE. CHEN AND I'M, A
PRACTICING PEDIATRIC INFECTIOUS
DISEASE PHYSICIAN AT MILLER,
CHILDREN'S AND WOMEN'S HOSPITAL
IN LONG BEACH TRADING CALIFORNIA
KIDS WITH PANDAS AND PANS, WHICH
ARE FORMS OF AUTOIMMUNE
ENCEPHALITIS. WHEN PANS STRIKES
A CHILD'S BRAIN IS ATTACKED BY
MISGUIDED ANTIBODIES OVERNIGHT,
A CHILD CAN BE DEVASTATED BY
WHAT LOOKS LIKE PSYCHIATRIC
DISEASE WITH THE ILLNESS,
DESTROYING AN ENTIRE FAMILY'S
ABILITY TO FUNCTION. I'M THE
ONLY DOCTOR TREATING PANS AT MY
HOSPITAL. OTHERS ARE
UNCOMFORTABLE MANAGING THE
COMPLEX DISEASE. WHILE MANY WILL
TURN AWAY THESE PATIENTS FOR
ANOTHER REASON THEY'VE
ENCOUNTERED TOO MANY INSURANCE
DENIALS, AND IT'S AWFUL FACING
DESPERATE FAMILIES WITH THEIR
HANDS TIED. LARGE RANDOMIZED
TRIALS ARE NOT POSSIBLE. WHEN A
DISEASE IS RARE. WE HAVE EIGHT
SMALL TRIALS SHOWING GREAT
BENEFIT AND ONE SMALL, FLAWED
TRIAL SHOWING NONE IN TREATING
PANS. I FOLLOW THE PUBLISHED
EXPERT CONSENSUS GUIDELINES
ESTABLISHING STANDARD OF CARE
THAT WERE DEVELOPED BY EXPERTS
FROM THE NIH, STANFORD, HARVARD
, GEORGETOWN AND OTHER ACADEMIC
CENTERS OF EXCELLENCE. ALMOST
EVERY REQUEST FOR I V I G GETS
DENIED. INSURER SHAMELESSLY POST
I V I G POLICIES, CLAIMING IT'S
NOT NECESSARY FOR PANS. I SPENT
HOURS ON THE PHONE, CITING THE
TREATMENT GUIDELINES TO
INSURANCE REPRESENTATIVES WITH
NO EXPERIENCE IN THIS FIELD, I
SENT IN REAMS OF APPEALS
PAPERWORK TO NO AVAIL. THE ONLY
WAY TO GET AN APPROVAL IS TO
ENDURE, MULTILEVEL WROTE DENIALS
, THEN FILE A GRIEVANCE WITH
REGULATORS LIKE GMHC. MOST
RECENT GMHC DECISIONS OVERTURNED
THE I V BAG DENIALS. SO WHY DO
YOU INSURERS DENY THIS IMPORTANT
TREATMENT, ACCORDING TO A RECENT
PROPUBLICA REPORT LAST MONTH
SIGNAL KNOWS THAT ONLY 5% OF
DENIALS ARE APPEALED, AND
INSURERS ARE BANKING ON FAMILIES
TO SIMPLY GIVE UP. I'VE SEEN THE
DRAMATIC RECOVERIES FROM I V. I
G. I FEAR THAT THE LACK OF
COVERAGE MAY RESULT IN PERMANENT
HARM TO YOUNG DEVELOPING BRAINS
, KEEPING A KID IN SPECIAL ED OR
LOCKED IN A PSYCH WARD. WHILE
THEIR CAREGIVER PARENTS CAN'T
WORK IS MUCH MORE EXPENSIVE THAN
JUST TREATING PROMPTLY AND
CORRECTLY RIGHT NOW ONLY THE
MOST EDUCATED, PERSISTENT AND
WEALTHY FAMILIES GET THE
MEDICINE THEY NEED. WE DON'T
NEED A RESEARCH STUDY TO PROVE
THAT HEALTHCARE AND EQUITY AND
SOCIETAL DAMAGE IS HAPPENING
HERE. THIS BILL WOULD SAVE
CALIFORNIA MONEY, EVEN SUBURBS
ESTIMATES WHICH IGNORE SOCIETAL
COST FIGURE THAT A B 907 WOULD
INCREASE INSURANCE PREMIUMS BY
0.16% LESS THAN ONE CENT, GIVING
A PANS FAMILY THE CHANCE TO
REJOIN PRODUCTIVE CALIFORNIA
SOCIETY IS TRULY PRICELESS. AND
THE CHOICE IS CRYSTAL CLEAR TO
ME. IN DESPERATION. I REFERRED
PATIENTS TO U C L A THINKING
THEY'D HAVE BETTER SUCCESS WITH
INSURANCE, BUT THEY DON'T EITHER
LIKE TO READ A STATEMENT FROM MY
COLLEAGUE AT U. C L. A
RHEUMATOLOGIST DR PATRICK
WHELAN. I CARE FOR ALMOST 400
FAMILIES WITH PANS FROM ALL OVER
CALIFORNIA TIME IS OF THE
ESSENCE AND TREATMENT AND THE
SITUATION IS DIRE, ANGUISHED
PARENTS WITH SCREAMING CHILDREN
SIT IN MY OFFICE DAY AFTER DAY,
AND IT'S AGONIZING FOR FAMILIES
AND PROVIDERS LOCKED IN A
RELENTLESS BATTLE WITH INSURERS
FOR MONTHS OVER TREATMENTS THAT
OFTEN BRINGS RAPID RELIEF.
CALIFORNIA KIDS DESERVE THE
LEGAL PROTECTIONS THAT ALREADY
EXIST IN 10. OTHER STATES NOT
UNCONSCIONABLE DELAYS. A DOZEN
MORE STATES HAVE INTRODUCED PANS
BILLS THIS YEAR, AND IT'S CLEAR
THAT THE SITUATION WILL NOT
IMPROVE WITHOUT A B 907. PLEASE
HELP ME HEAL THESE STRUGGLING
CHILDREN. THANK YOU. THANK YOU
OTHERS AND SUPPORT. MY NAME IS
SHERRY STILLSON. I'M A MOM OF A
CHANCE TO TRY OUT AND I STRONGLY
SUPPORTED THE 907. THANK YOU. MY
NAME IS DR ANGELA TANG. I'M AN
ADJUNCT PROFESSOR WITH STANFORD
PANS CLINIC. I URGE YOU TO
SUPPORT A B 907. THANK YOU. MY
NAME IS RILEY SPRAY. I HAVE
PANTS AND I STRONGLY SUPPORT
THIS BILL. THANK YOU. MY NAME IS
RACHEL SPRAY. I'M A REGISTERED
NURSE AND A MOM DAUGHTER WAS
RECENTLY DENIED. I V I G. I
STRONGLY SUPPORT THIS BILL.
THANK YOU. KEVIN REILLY, FATHER
OF A PANDA'S CHILD. SUPPORT THIS
BILL. THANK YOU. CHEN JOB ART
MOTHER OF TWO CHILDREN WITH
PANS. I STRONGLY SUPPORT A B
907. HI, DANIEL ON A MY FATHER.
FOR MY SON, AIDEN. I STRONGLY
SUPPORT A B 907. THANK YOU. PAUL
MURPHY ON BEHALF OF THE ALEX MAN
FULL FUND. WE SUPPORT THIS
LEGISLATION. THANK YOU. THANK
YOU. THEIR OPPOSITION TO THE
BILL.
GOOD AFTERNOON, MR CHAIR AND
MEMBERS OF THE COMMITTEE JED
HAMPTON WITH THE CALIFORNIA
ASSOCIATION OF HEALTH PLANS HERE
REPRESENTING 43 HEALTH PLANS, UM
, COVERING NEARLY 28 MILLION
LIVES. REGRETTABLY HERE IN
OPPOSITION TO 89 07 TODAY, I
FIRST WANT TO TAKE SOME TIME TO
THANK THE WITNESSES AND SUPPORT
AND THE OTHER WITNESSES HERE
TODAY. OBVIOUSLY, IT'S A VERY
CHALLENGING UM, DISEASE. WE WANT
TO ACKNOWLEDGE THAT FIRST AND
FOREMOST, UM YOU KNOW, AS AS I
MENTIONED PANDAS AND PANS IS
VERY CHALLENGING TO DEFINITIVELY
DIAGNOSED VERY CONTROVERSIAL
DIAGNOSIS. UM AND THERE ARE NOT
SPECIFIC DIAGNOSTIC TESTS
CONFIRM A DIAGNOSIS FOR PAN
PANDAS OR PANS AND GENERALLY
CLINICIAN TO USE DIFFERENT
DIAGNOSTIC PROCESSES NOW CONFIRM
A DIAGNOSIS BUT ALSO TO RULE OUT
OTHER CONDITIONS WITH SIMILAR
SYMPTOMS. DÍAS AND THE LIKE. AS
THE COMMITTEE ANALYSIS POINTS
OUT, AND I SEE 10 CODE DOES
EXIST FOR PANDAS WHO WANT TO
ACKNOWLEDGE THAT UNDER THE
DEFINITIONS OF DISORDERS
INVOLVING IMMUNE MECHANISMS, BUT
GENERALLY SPEAKING, UH NATIONAL
BUILDING CODES DO NOT EXIST TO
REIMBURSE FOR THESE SPECIFIC
SERVICE SERVICES CURRENTLY IN
FACT, THIS BILL REQUIRES THE
HEALTH PLANS TO ACTUALLY ACCEPT
THE DIFFERENT BUILDING CODE FOR
A DIFFERENT, ALBEIT SIMILAR
CONDITION, UM, IN THE ABSENCE OF
NATIONALLY RECOGNIZED BUILDING
CODES FOR PANDAS AND PANS.
ULTIMATELY UH, YOU KNOW OUR
CONCERNS LIE IN THE FACT THAT
THE BILL WOULD PROBABLY REQUIRE
THE PLANS TO COVER ALL
TREATMENTS FOR THESE CONDITIONS
WITHOUT MEETING THE CRITICAL
CLINICAL AND MEDICALLY NECESSARY
GUIDELINES SET FORTH AND CURRENT
LAW, WHICH IS PROBABLY MOST
CONCERNING FROM OUR MEMBERS
PERSPECTIVE. IT WOULD ALSO
PROHIBIT HEALTH AND FROM
IMPOSING ANY LIMITATIONS ON THE
VOLUME OF TREATMENTS. UH AND
ALTERS BENEFIT DESIGNED BY
LIMITING COST SHARING AND CO
PAYMENTS FOR THESE TREATMENTS.
UM AS YOU'VE HEARD PREVIOUSLY,
AND WE'LL PROBABLY HEAR LATER ON
. THIS IS JUST ONE OF 23
INDIVIDUAL MANDATES THAT HAVE
INTRODUCED THIS YEAR. AND WHILE
WE WILL CERTAINLY ACKNOWLEDGE
THAT THIS PARTICULAR BILL IS NOT
THE MOST EXPENSIVE OF MANDATES,
UM WE DO HAVE TO LOOK AT THESE
MANDATES CUMULATIVELY IN TERMS
OF THEIR TOTAL IMPACT ACROSS THE
BOARD, AND JUST JUST FOR CONTEXT
, MEMBERS, UH, LAST YEAR THERE
WERE 13 MANDATES THAT WERE
INTRODUCED IN THE LEGISLATURE
LAST YEAR THAT HAD A TOTAL
CUMULATIVE IMPACT OF $1.5
BILLION AND PREMIUM INCREASES.
SO WITH 23 MANDATES AGAIN, WE DO
HAVE TO LOOK AT ALL OF THESE IN
CONTEXT, BUT I DO WANT TO THANK
THE AUTHOR AND THE WITNESSES FOR
BEING HERE TODAY, BUT WE ARE
REGRETTABLY OPPOSED TO THEM. MR
CHAIR. REMEMBER STEPHANIE
WATKINS ON THE BEHALF OF THE
ASSOCIATION OF CALIFORNIA LIFE
AND HEALTH INSURANCE COMPANIES.
WE TOO, ARE REGRETTABLY HERE IN
OPPOSITION. I THINK OUR HEARTS
GO OUT TO THOSE WHO ARE HERE
TODAY THAT HAVE BEEN IMPACTED BY
THIS. UNFORTUNATELY I THINK ONE
OF THE THINGS I'D LIKE TO
HIGHLIGHT IS THE REMOVAL OF THE
MEDICAL NECESSITY STANDARD.
THAT'S A UBIQUITOUS STANDARDS
THAT WE SEE ALL THROUGH THE
CODES THAT HELPS GUIDE AND
DIRECT THOSE SERVICES THAT ARE
PROVIDED TO ENROLLEES AND
INSURANCE, AND THERE IS
CERTAINLY A CONCERN BY OUR
MEMBERS TO SET A PRECEDENT TO
REMOVE THAT STANDARD FROM THIS.
SO FOR THOSE REASONS,
UNFORTUNATELY, WE ARE OPPOSED.
TODAY WE LOOK FORWARD TO
CONTINUING CONVERSATIONS OF THIS
BILL MOST FOR TODAY. JOHN WINGER
, I'LL BE AT THE AMERICAN SOUTH
INSURANCE PLANS TO JUST ECHO THE
COMMENTS OF CAP IN A CLICK.
ANYONE ELSE IN OPPOSITION. NO
ONE BRING IT BACK TO THE
COMMITTEE AND HE QUESTIONS OR
COMMENTS. DR WEBBER. THANK YOU.
SO MUCH FOR THE AUTHOR AND TO
THE FAMILIES AND TO THE
PHYSICIANS WHO HAVE COME TO
SPEAK ON THIS BILL. UM AND ALSO
TO THE OPPOSITION. UM YOU TALKED
ABOUT THE REMOVAL OF THE MEDICAL
NECESSITY. IS THERE ANY
PARTICULAR REASON WHY THAT WAS
NOT A PART OF THIS BILL. UM
UNFORTUNATELY, AS AS THE DISEASE
IS RARE, AND EVERY PATIENT IS
DIFFERENT. THERE IS NOT ONE
COOKIE CUTTER DESCRIPTION OR
TREATMENT PLAN FOR EVERY PATIENT
. SO YOU KNOW ONE THING, MAYBE
MEDICALLY NECESSARY FOR ONE
PATIENT AND NOT AS MEDICALLY
NECESSARY FOR THE OTHER, SO WE
TRIED TO LEAVE IT BROAD BECAUSE
THERE IS ACTIVE, ONGOING
RESEARCH. INTO THE CONDITION AND
ITS TREATMENTS. THIS IS A TOUGH
ONE. UM BECAUSE I'M SURE. UM,
YOU CAN UNDERSTAND IT'S HARD. IF
THERE IS NO STANDARD FOR MEDICAL
NECESSITY. UM IT'S HARD TO SAY
THAT A PROVIDER IS DOING WHAT HE
OR SHE SHOULD BE DOING. BEFORE
GOING TO ANOTHER TREATMENT.
THAT'S I MEAN, WE HAVE, UM YOU
KNOW, TREATMENT GUIDELINES AND
IF THERE'S AMBIGUITY THERE UM.
IT'S ALSO A LITTLE CONCERNING
BECAUSE ONE. ONE CHILD CAN GET
ONE TREATMENT WITH SOMEONE IN A
COMPLETELY DIFFERENT ONE WITH
ANOTHER PROVIDER. THAT'S A
LITTLE CONCERNING FOR ME, BUT UM
YOU KNOW, THIS IS A VERY RARE UM
AND VERY DEBILITATING CONDITION.
AND, UM. YOU KNOW, I UNDERSTAND
WHAT THE HEALTH PLANS ARE
SAYING. AND I KNOW THAT YOU'VE
GOT A LOT OF BILLS. I'VE GOT ONE
TOO. UM BUT I THINK THAT IF WE
DON'T DO SOMETHING UM YOU CAN
HAVE A LONG TERM DEVASTATING
IMPACTS NOT ONLY ON THE FAMILY,
BUT THE INDIVIDUAL CHILD. I
USUALLY LIKE TO GO WHERE THE
DATA GOES. BUT IN THIS
SITUATION, IT IS SO RARE AND SO
DEVASTATING. THAT, UM I WILL BE
SUPPORTING YOUR BELT. THANK YOU
VERY MUCH. DOCTOR WEBER. I WOULD
LIKE TO COMMENT, ACTUALLY,
UNLESS SHE'S ASKED A QUESTION.
I'M SORRY. THANK YOU. UM. THANK
YOU AS CO CHAIR OF THE RARE
DISEASE CAUCUS, UM,
UNDERSTANDING THE ISSUE OF
RARITY, SOMETHING THAT WE
GRAPPLE WITH ALL THE DAY ALL THE
TIME. THE NUMBER OF STUDIES
SAMPLE SIZES. YOU KNOW? CAN PUT
UP A BARRIER TO TRYING TO FIGURE
OUT HOW MANY PEOPLE ARE AFFECTED
BE. WHAT'S YOU KNOW THE. CHANCE
THAT THIS COULD BE HANDS OR
PANDA, YOU KNOW, AND WE HAVE TO
LOOK TO THE PROVIDERS THAT ARE
FAMILIAR WITH IT BECAUSE AS IN
RARE DISEASES IN GENERAL. THERE
ARE A LOT OF PROVIDERS WHO ARE
NOT FAMILIAR WITH THE SIGNS. AND
SOMETIMES IT COULD TAKE YEARS
AND YEARS TO GET A DIAGNOSIS.
BUT LOOKING AT THIS. YOU KNOW,
WE'RE DEALING WITH CHILDREN. AND
ANY DELAYS INCREASE THE RISK OF
A LONG TERM PROBLEM. WE CAN'T
CONSCIONABLE E. SAY THAT YOU
KNOW, WE CAN DELAY TREATMENT OR
IN THIS CASE, PROLONGED
SUFFERING. UM WE NEED TO BE SURE
THAT FAMILIES ONE OF THE THINGS
I'VE ALWAYS FELT AS SITTING ON
THIS HEALTH COMMITTEE NOW FOR
SIX YEARS THAT I WANT TO BE SURE
THAT EVERY PERSON MOM ON
MEDICARE OR MEDIC. AL WHO CAN'T
SPEAK ENGLISH CAN GET THE BEST
TREATMENTS AVAILABLE FOR THEIR
CHILD. UM AND YOU KNOW IF
THERE'S A TREATMENT THAT THE
PROVIDER IN THEIR KNOWLEDGE
THANKS COULD GIVE RELIEF. MAYBE
NOT. MAYBE SO. BUT IN THEIR
EXPERIENCE COULD I THINK WE
OUGHT TO BE ABLE TO GIVE THEM A
TRY. SO SPEAKING AS A MOM. AND,
UH, I THINK IT'S IMPORTANT THAT
WE DO SO PROBABLY SUPPORTING THE
BILL TODAY. I WANT TO THANK YOU
, MR LOWENTHAL FOR BRINGING THE
BILL FORWARD AND THANK YOUR
WITNESSES, UH AS WELL. OBVIOUSLY
RARE DISEASES POSE REAL
CHALLENGES AND THE DELIVERY OF
HEALTH CARE, UH AND OFTENTIMES
COVERAGE, UH, LAGS SIGNIFICANTLY
AND CATCHING UP WITH THAT. UM I
WOULD NOTE THAT OBVIOUSLY IN OUR
ANALYSIS, THERE ARE 10 STATES
NOW, INCLUDING THAT MANDATING AT
LEAST TEMPORARY COVERAGE HERE.
AND, UM, AND NONE OF THOSE
APPEAR TO BE CALIFORNIA. UM
WHICH IS KIND OF SHOCKING AND IN
MANY WAYS, CONSIDERING THE
RESEARCH AND MEDICAL RESEARCH
AND THE FACILITIES CARE WE CAN
ACTUALLY PROVIDE IN THE STATE.
UM SO THE BILL DOES ENJOY A DO
PASS RECOMMENDATION. UM AND I
WOULD JUST NOTE TO THE
OPPOSITION. YES THERE WERE 23
MANDATE BILLS, BUT NOT ALL OF
THOSE BILLS. MOVED. SO WE WILL
BE FAR SHORT OF THE $1.5 BILLION
THAT SCARES THE INDUSTRY. AS
BILLS MOVE FORWARD, UM AND, UM
AS SUCH. I WANT TO GIVE YOU AN
OPPORTUNITY NOW, MR. LOWENTHAL,
UH, WOULD YOU LIKE TO CLOSE? I
SIMPLY WANT TO SAY THANK YOU FOR
THE VERY THOUGHTFUL COMMENTS. DR
WEBBER. UH MISS WALDRON AND MR
CHAIR REALLY APPRECIATE THEM AND
RESPECTFULLY ASKED FOR YOUR I
VOTE. THANK YOU VERY MUCH, UM WE
HAVE A. A MOTION BY MISS AGUILAR
CURRY, A SECOND BY DR WEBBER
MOTION IS DUE PASS TO
APPROPRIATIONS SECRETARY PLEASE
CALL THE ROLL. WOULD WOULD I,
WALDRON, WALTER, AND I
AGUIAR-CURRY CREE. I ARAMBULA
BURNER. CARILLO FLORA, VINCE
WANG MAIENSCHEIN MCCARTHY, JOE
PATTERSON. RODRIGUEZ. RODRIGUEZ?
AYE. SANTIAGO. VALLAPUDUA WEBER.
HOWEVER, I. THAT'S 50. WE WILL
LEAVE THE BILL ON CALL. THANK
YOU VERY MUCH. MR RODRIGUEZ, ARE
YOU? I DON'T SEE ANOTHER AUTHOR.
ARE YOU READY WITH YOUR BILL?
OKAY PLEASE GO AHEAD.
OKAY. YOU HAVE A B 55 WHENEVER
YOU'RE READY, SIR. THANK YOU, MR
CHAIRMAN MEMBERS. THANK YOU FOR
THE OPPORTUNITY TO PRESENT A B
55. WHICH ARE CREATE A WORKFORCE
ADJUSTMENT PROGRAM, WHICH SERVES
AS A SUPPLEMENTAL PAYMENT FOR
GROUND AMBULANCE TRANSPORTATION
PROVIDERS THAT PROVIDE THEIR
EMPLOYEES A WAGE INCREASE. I
WOULD LIKE TO START BY ACCEPTING
THE COMMITTEE'S AMENDMENTS TO
LIMIT THE STATE SHARE OF PAYMENT
NOT TO EXCEED 80% OF THE
MEDICARE PAYMENT LEVEL.
BENCHMARK. CALIFORNIA PROVIDES
APPROXIMATELY $110 PER GROUND
AMBULANCE TRANSPORT, WHICH RANKS
46 IN THE UNITED STATES FOR
MEDICAID REIMBURSEMENT.
CALIFORNIA HAS FAILED TO PROVIDE
MEDICAL BASE RATE INCREASES FOR
AMBULANCE SERVICES SINCE THE
LAST INCREASE IN 1999. WHEN
ADJUSTING THE CURRENT RATE FOR
INFLATION AND COST INCREASES.
THE REIMBURSEMENT RATE SHOULD BE
ABOUT $60 IS ABOUT $60 AND
COMPARISON THE NATIONAL AVERAGE
IS 260. FLORIDA'S RATE IS 200,
TEXAS, RIGHT? 300 ARIZONA IS
375. AS YOU CAN SEE, CALIFORNIA
HAS FALLEN BEHIND. NOW IT'S TIME
TO SOUND THE ALARM BECAUSE THE
LONG REIMBURSEMENT RATE IS
THREATENING THE STABILITY OF OUR
EMERGENCY MEDICAL RESPONSE
SYSTEMS PROVIDERS ARE ENDING
EMERGENCY AND NON EMERGENCY
CONTRACTS BECAUSE OF THE
INABILITY TO RECRUIT EMPLOYEES,
INCREASING EXPENSES AND LOW
REIMBURSEMENT RATES. AS SOMEONE
WHO SPENT OVER 30 YEARS WORKING
AS A FIRST RESPONDER AND
EMERGENCY MEDICAL SERVICES. THIS
ISSUE IS VERY PERSONAL TO ME,
ACCORDING TO THE BREW OF LABOR
STATISTICS, THE MEDIAN PAY FOR
AN E M T IS ABOUT $17 AN HOUR OR
36,000 PER YEAR. THAT'S LESS
THAN SOME FAST FOOD WORKERS
BECAUSE OF LOW WAGE MY
COLLEAGUES AND I WOULD REGULARLY
WORK MULTIPLE 24 12 HOUR SHIFTS
JUST TO MAKE ENDS MEET. IN FACT
, IT TOOK ME ABOUT 25 YEARS TO
START MAKING ABOUT $20 AN HOUR.
AS YOU CAN IMAGINE. I'M HIS
BIRTHDAYS, ANNIVERSARIES,
ANOTHER FAMILY EVENTS TO SUPPORT
MY FAMILY. FOR THAT REASON I'M
PROUD TO AUTHOR A B 55, WHICH
HAS THE SUPPORT OF THE PROVIDERS
AND THE LABOR UNIONS WHO
REPRESENT FRONTLINE, THE SEXUAL
WORKERS. WITH THAT. LET ME TURN
OVER TO MY WITNESSES AND SUPPORT
JIMMY PEARSON, PRESIDENT AND CEO
OF MEDICAL AMBULANCE SERVICE AND
PRESIDENT OF THE CALIFORNIA
ASSOCIATION, AND JIMMY WEBB,
REPRESENTATIVE INTERNATIONAL
ASSOCIATE OF EMTS, AND
PARAMEDICS. S C I U LOCAL 5000.
JIMMY. CHAIRMAN WOULD AND
MEMBERS OF THE COMMITTEE. GOOD
AFTERNOON AND THANK YOU FOR THE
CHANCE TO SPEAK TODAY AND
SUPPORT OF ASSEMBLY BILL 55. MY
NAME IS JIMMY WEBB AND REPRESENT
MÁS PROFESSIONALS ACROSS THE
STATE OF CALIFORNIA ON BEHALF OF
THE INTERNATIONAL ASSOCIATION OF
EMTS, AND PARAMEDICS S E I U
LOCAL 5000. I'M NOT ONLY AN M S
ADVOCATE, BUT I'M ALSO A
LIFELONG MÁS PROFESSIONAL. THE
BILL BEFORE YOU FOR
CONSIDERATION TODAY, A B 55
PRESENTS THE LEGISLATIVE BODY
WITH THE OPPORTUNITY TO IMPACT E
. M S PROFESSION ACROSS
CALIFORNIA AND IN MONUMENTALLY
POSITIVE FASHION. THE CURRENT
VERSION OF A B 55 ALLOWS FOR A
CRITICAL INCREASE IN REVENUE FOR
PRIVATE SECTOR EMS PROVIDERS.
WHILE ALSO TAKING THE HISTORIC
STEP OF GUARANTEEING THESE
INCREASED REVENUES WOULD
DIRECTLY AND POSITIVELY IMPACT
THE WAGES OF ALL PRIVATE SECTOR
MÁS PROFESSIONALS. TODAY MÁS
PROFESSIONALS EMPLOYED IN THE
PRIVATE SECTOR PROVIDE THE VAST
MAJORITY OF ALL M S SERVICES IN
THE STATE OF CALIFORNIA.
UNFORTUNATELY, IT HAS BEEN WELL
OVER. HMM A DECADE SINCE THIS
INDUSTRY HAS BEEN HAS SEEN
SUPPORT IN THE FORM OF A
REIMBURSEMENT RATE INCREASE,
RESULTING IN THE STATE
REIMBURSING ITS PRIVATE SECTOR
RESPONDERS AT SOME OF THE LOWEST
RATES IN THE US WHEN COMBINED
WITH THE HISTORIC RISING COSTS
OF DOING BUSINESS IN 2023.
CALIFORNIA MÁS PROVIDERS ARE
FACED WITH A PERFECT STORM OF
PROBLEMS. I AM PROUD TO STAND
HERE IN PARTNERSHIP WITH THE
CALIFORNIA AMBULANCE ASSOCIATION
AND OUR PRIVATE SECTOR PARTNERS
AS WE URGE YOUR SUPPORT FOR AB
55. WHILE IT IS TRUE THAT OUR
MEMBERS HISTORICALLY FIGHT WITH
MANAGEMENT. I CAN ATTEST TO
THAT, TOO, IN THE PUBLIC EYE TO
GAIN FAIR WAGES AND BENEFITS AND
THE WORKPLACE TODAY WE ARE
STANDING WITH THEM. AND ASKING
FOR YOUR HELP. THE INDUSTRY IS
AT A TIPPING POINT IN THE TIME
FOR ACTING TOGETHER IS UPON US
BY PASSING A B 55. WE ARE
GUARANTEEING THAT E. M S
PROVIDERS CAN'T AFFORD THE
RESOURCES THEY NEED TO KEEP
CREWS RESPONDING TO PATIENTS. IN
A SAFE AND TIMELY MANNER. THIS
GOES BEYOND WAGES AND INCLUDES
SAFETY EQUIPMENT, IMPROVED
TRAINING AND SO MUCH MORE WHEN
OUR PROVIDERS ARE PROPERLY
REIMBURSED AND FUNDED THAN RMS
PROFESSIONALS CAN REACH FAIR
CONTRACTS THAT HELP ENSURE THAT
TMS SYSTEM CONTINUES TO THRIVE
THROUGHOUT THE FUTURE. THERE'S
NO DOWNSIDE TO INCREASING THE
REIMBURSEMENT RATE FOR PRIVATE
SECTOR PROVIDERS. IN THE SAME
MANNER BY WHICH PUBLIC SECTOR
PROVIDERS HAVE SEEN THEIR
REIMBURSEMENT RATES INCREASED
DURING RECENT YEARS. SIMPLY PUT
, THIS IS A PROMISE TO PRIVATE
SECTOR FIRST RESPONDERS THAT
THEIR INDUSTRY WILL BE FUNDED
FAIRLY AND THAT THEIR WAGES WILL
BE IMPACTED POSITIVELY AS A
DIRECT RESULT OF SWIFT
LEGISLATIVE ACTION. OUR ACTIONS
TOGETHER TODAY CAN HELP BUILD
THE M S INDUSTRY. WE ALL DESERVE
TOMORROW. THANK YOU FOR THE
OPPORTUNITY TO SPEAK TODAY.
THANK YOU. I'LL GET AFTERNOON
CHAIRMAN WOULD AND MEMBERS OF
THE COMMITTEE. MY NAME IS JIMMY
PEARSON ON THE PRESIDENT, CEO OF
MEDICAL AMBULANCE SERVICE. MEDIC
WAS FOUNDED BY MY GRANDPARENTS
AND UNCLE WHO IMMIGRATED TO
CALIFORNIA FROM ITALY IN PURSUIT
OF THEIR AMERICAN DREAM. MEDICS
STARTED IN THE HOUSE ON NEBRASKA
STREET IN VALLEJO, CALIFORNIA
WITH FOUR EMPLOYEES AND TWO
AMBULANCES. TODAY. AMERICA
EMPLOYS OVER 450 DEDICATED
EMPLOYEES AND OPERATES OVER 100
AMBULANCES. THAT SORT OF SOLANO
SACRAMENTO, YOLO PLASTER NAPA
PHENOMENON. ELDORADO COUNTY'S
I'M HERE TODAY ON BEHALF OF THE
CALIFORNIA AMBULANCE ASSOCIATION
, WHERE I SERVED AS THE
PRESIDENT TO RESPECTFULLY
REQUEST. YOU'RE A VOTE. TO
SUPPORT A B 55 THE THOUSANDS OF
PRIVATE SECTOR M S WORKERS WHO
STAND TO BENEFIT FROM THIS BILL,
ALL OF WHOM ARE CHASING THEIR
AMERICAN DREAM. A B 55 REQUIRES
. INCREASED MEDICAL PAYMENTS TO
IMPROVE VMS WORKER WAGES. THIS
BILL DIRECTLY IMPACTS THE LIVES
OF THOSE WHO TAKE CARE OF OUR
LOVED ONES AND IN THEIR TIME OF
NEED PRIVATE SECTOR AMS WORKERS
PROVIDE ABOUT 3/4 OF ALL
AMBULANCE SERVICES IN CALIFORNIA
AND ARE CALLED ON TO PROVIDE
CARE AND TRANSPORTATION TO MORE
THAN 10,000 MORE THAN 10,000
TIMES EVERY DAY. OFTEN FOR
UNIMAGINABLE SITUATIONS AND IN
THE WORST CONDITIONS, POSSIBLY
THE WORST TIMES OF THE DAY. MÁS
WORKERS ARE TRULY THE ANSWER TO
A PRAYER. IMAGINE A JOB WHERE
EVERY DAY IN MOST CASES, SOMEONE
IS LITERALLY PRAYING THAT YOU
WALK IN THE DOOR. AND HANDLE
THEIR DIFFICULT SITUATION. YES.
WITHOUT A DOUBT, RMS WORKERS AND
OUR EMPLOYEES ARE HEROES. WHEN
THEY GET THEIR PAYCHECK AND THEN
THE WEEK MANY EMS WORKERS DON'T
FEEL LIKE HEROES. THEY STRUGGLE
TO MAKE ENDS MEET ON A MEET ON
WAGES AND ARE BARELY SOME ARE
BARELY ABOVE MINIMUM WAGE. THIS
ISN'T HOW WE SHOULD REWARD
HEROES. I LOVE UM S I LOVE BEING
A PARAMEDIC. I'VE BEEN A
PARAMEDIC FOR NEARLY 20 YEARS
AND LOVED BEING AN E. M S
COMMISSION. CLINICIAN LIKE
ASSEMBLYMEMBER'S RODRIGUEZ HAVE
A DEEP, PROFOUND APPRECIATION
FOR WHAT EMS WORKERS DO AND
DESPERATELY WANT TO SEE OUR
INDUSTRY ACROSS THE BOARD, PAY
THEM WHAT THEY DESERVE. THE
SINGLE GREATEST CHALLENGE WE
FACE IS SHAMEFULLY LITTLE
MEDICAL REIMBURSEMENT. HELLO.
MEDICAL REIMBURSEMENT MAKES IT
DIFFICULT TO RECRUIT AND RETAIN
E. M S WORKERS AND ALSO PUTS AT
RISK SUSTAINABILITY OF THE
AMBULANCE INDUSTRY, ESPECIALLY
THE EQUITABLE DELIVERY OF
SERVICES TO RURAL AND
DISADVANTAGED COMMUNITIES. WE
HAVE ALREADY SEEN SEVERAL
AMBULANCE COMPANIES. GO OUT OF
BUSINESS IN RECENT YEARS DUE IN
LARGE PART TO LOW MEDICAL
REIMBURSEMENT. PRIVATE SECTOR.
HAMILTON'S RIDERS HAVE WAITED
NEARLY A QUARTER CENTURY OR AN
INCREASE IN MEDICAL
REIMBURSEMENT. WE ARE PROBABLY
THE HEALTHCARE PROVIDER TYPE
THAT HAS WAITED THE LONGEST FOR
AN INCREASE. YOU MAY WONDER HOW
WE'VE BEEN ABLE TO SURVIVE IN
THE INDUSTRY AS BECAUSE AMAZING
WORKERS LIKE JIMMY RIGHT NEXT TO
ME AND THE ONES THAT WE HAVE
ACROSS OUR PROFESSION. THEY HAVE
WORK SMARTER AND HARDER TO GET
THE JOB DONE. EVEN WHEN STRAINED
BY COVID AND RESPONDING TO
NATURAL DISASTERS BROUGHT ON BY
CLIMATE CHANGE. I DO. I DON'T
THINK WE CAN REASONABLY ASK THEM
TO WORK HARDER THAN THEY ALREADY
HAVE. I RESPECTIVELY ASK YOU FOR
YOUR COMMITTEE TO VOTE A MAYBE
55 SO WE CAN IMPROVE THE WAGES
AND BENEFITS FOR AMS WORKERS.
THANK YOU, SIR. THANK YOU VERY
MUCH OTHERS IN SUPPORT OF THE
BILL. SO JUST YOUR NAME AND
ORGANIZATION, PLEASE. KRYSTLE
CURIOUS ON BEHALF OF THE CITY OF
SANTA MONICA, AND SUPPORT THANK
YOU. CHRISTOPH MAYER WITH THE
AMERICAN FEDERATION OF STATE,
COUNTY AND MUNICIPAL EMPLOYEES
AND SUPPORT THANK YOU. REMEMBERS
JONATHAN FELDMAN WITH THE 911
AMBULANCE ALLIANCE AND SUPPORT
THANK YOU. MR CHAIRMAN, MICHAEL
COHEN, ON BEHALF OF MEDIC
EMULATES AND SUPPORT. THANK YOU.
BRIAN METER STRONGLY SUPPORT
MEDICARE MONTH SERVICE. ERIN
WALTON, MEDIC, AMBULANCE AND
SUPPORT. THANK YOU. SHALL BE
HANDLE MEDICAID BILLINGS AND I
SUPPORT. KEVIN SIMON MEDICAL
AMBULANCE. I SUPPORT THANK YOU.
BASIC EARLY MEDICAL AMBULANCE
AND I STRONGLY SUPPORT. TOM
MARSHALL, ALFA ONE AMBULANCE
MEDICAL SERVICES IN SUPPORT.
MICHAEL JONES. AL FOR AN
AMBULANCE SUPPORT QUÊ. MICHAEL
COURTNEY WITH THAT COMMUNITY
HEALTHCARE DISTRICT IN SUPPORT.
THANK YOU. MELISSA HARRIS,
PRESIDENT, CEO OF AMBROSE, SERVE
AMBULANCE AND I SUPPORT THANK
YOU. IS THERE OPPOSITION TO THE
BILL? SEE NONE OF BRINGING BACK
TO THE COMMITTEE QUESTIONS OR
COMMENTS AND QUESTIONS OR
COMMENTS FROM THE COMMITTEE. IS
THERE A MOTION FROM THE
COMMITTEE? OPEN MOTION BY DR
WEBBER A SECOND BY MR V.
VALLAPUDUA MOTION IS DUE PASS AS
AMENDED TO APPROPRIATIONS. WOULD
YOU LIKE TO CLOSE MR RODRIGUEZ
FOR OUR VOTE? THANK YOU. THANK
YOU VERY MUCH. IT DOES ENJOY DO
PASS RECOMMENDATION. I THINK YOU
SO MUCH FOR WORKING WITH THE
COMMITTEE. UM, MADAM SECRETARY,
PLEASE CALL THE ROLL. WHAT WOULD
I, WALDRON WALDRON? I
AGUIAR-CURRY ARAMBULA.
BOERNER HORVATH CARILLO LARA
SPONG MAIENSCHEIN MCCARTY. JOE
PATTERSON. RODRIGUEZ RODRIGUEZ
I, SANTIAGO VALLAPUDUA BUT WHAT
I WEBER WEBER. AYE. YOU HAVE
FIVE VOTES WILL LEAVE THE BILL
ON CALL. AND I'M NEED TO TURN
THIS OVER TO OUR VICE CHAIR.
I'VE GOT A PRESENT A BILL AND
ANOTHER COMMITTEE SO I WILL BE
BACK QUICKLY. THANK YOU.
HAVE ITEM NUMBER 11 A B 10 48
ASSEMBLYMEMBER'S WICKS MAY START
WHEN YOU'RE READY. GOOD
AFTERNOON CHAIR MEMBERS. FIRST.
I WANT TO ACCEPT THE COMMITTEE'S
PROPOSED AMENDMENTS AND THINK
THEIR STAFF FOR THEIR WORK ON
THIS BILL. EVEN IN A STATE THAT
HAS EMBRACED THE AFFORDABLE CARE
ACT. DENTAL INSURANCE PLANS HAVE
OPERATED WITH MUCH LESS
OVERSIGHT AND REGULATION AND
FULL SERVICE HEALTH PLANS.
REGULATORY EXEMPTIONS HAVE
ALLOWED DENTAL PLANS TO RESTRICT
PATIENT BENEFITS WITH ARBITRARY
WAITING PERIODS, DENY COVERAGE
OF PREEXISTING CONDITIONS AND
INCREASED PATIENT PREMIUMS
WITHOUT INCREASING BENEFITS.
THESE EXEMPTIONS CRITICALLY HURT
PATIENTS DENIED COVERAGE DUE TO
OR PREVENTED FROM RECEIVING
MEANINGFUL, MEANINGFUL VALUE FOR
THEIR DENTAL PREMIUMS. THIS IS
ESPECIALLY IMPORTANT AS OUT OF
POCKET EXPENSES FOR DENTAL
SERVICES ARE CONTINUALLY ON THE
RISE. 16% IN 2021 ALONE, AND A
NEW CALIFORNIA HEALTHCARE
FOUNDATION SURVEY FOUND THAT 38%
OF CALIFORNIANS HAVE A FAMILY
MEMBER WHO SKIPPED DENTAL CARE
LAST YEAR DUE TO HIGH COSTS. AS
AMENDED. MAYBE 10 48 WILL
ESTABLISH ESSENTIAL PATIENT
PROTECTIONS AND CREATE
ACCOUNTABILITY THROUGH
PROHIBITING LARGE GROUP DENTAL
PLANS FROM IMPLEMENTING
ARBITRARY WAITING PERIODS ON
PATIENTS. PROHIBITING DENTAL
PLANS FROM DENYING CLAIMS
RELATED TO PRE EXISTING
CONDITIONS. AND REQUIRING AN
ANNUAL REVIEW. DENTAL HEALTH
PLAN PREMIUM RATES. AS YOU WILL
HEAR SHORTLY. THE DENTAL PLANS
ARE OPPOSED TO MY BILL, SAYING
THAT IT WOULD RAISE PREMIUMS BY
45 TO 80% WHILE INDEPENDENT
ANALYSIS OF TO BURP ESTIMATED
THAT THE INCREASES WOULD BE
BETWEEN ONE AND 4% I HAVE
ACCEPTED THE CHAIRS, AMENDMENTS
TO EXCLUDE THE INDIVIDUAL AND
SMALL GROUP MARKETS FROM THE BAN
ON WAITING PERIODS. ADDRESSING
THE PRIMARY DRIVER OF THE
ESTIMATED COST INCREASE, ALSO
ADDING RATE REVIEW. ALIGNS
DENTAL INSURANCE WITH OTHER
TYPES OF INSURANCE, INCLUDING
MEDICAL HOME OWNERS AND PET
INSURANCE. IT IS TIME FOR DENTAL
PLANS TO BE HELD ACCOUNTABLE AND
TO ENSURE CONSUMERS RECEIVE
VALUE FOR THEIR PREMIUMS. IF WE
CAN'T REGULATE DENTAL INSURANCE
, THE WAY WE REGULATE OTHER
TYPES OF INSURANCE, WE NEED TO
STOP, UH, CALLING AND THINKING
OF IT AS INSURANCE FESTIVAL IN
SUPPORT WITH ME TODAY ARE DR
JOHN BLANK PRESIDENT THE
CALIFORNIA THEN ALL ASSOCIATION.
AND JESSICA MORON, LEGISLATIVE
ADVOCATE CALIFORNIA ASSOCIATION
RESPECTFULLY ASK FOR MY VOTE.
GOOD AFTERNOON CHAIR AND MEMBERS
. MY NAME IS DR JOHN BLAKE. I'M
A PRACTICING DENTIST IN LONG
BEACH WITH 35 YEARS OF
EXPERIENCE AND CURRENTLY SERVING
AS THE PRESIDENT OF THE
CALIFORNIA DENTAL ASSOCIATION.
I'M HERE TODAY, SPEAKING ON
BEHALF OF A AND R 27,000 MEMBERS
THROUGHOUT THE STATE AND SUPPORT
OF ASSEMBLY, BILL 10 48 SINCE
THE IMPLEMENTATION OF THE
AFFORDABLE CARE ACT. WE'VE SEEN
SIGNIFICANT REFORM IN HEALTH
INSURANCE PLANS WITH THE
ELIMINATION OF WAITING PERIODS,
PREEXISTING CONDITION CLAUSES
AND ESTABLISHING A PREMIUM
PREMIUM RATE REVIEW PROCESS.
HOWEVER DENTAL INSURANCE PLANS
WERE LARGELY LEFT OUT OF THESE
PROVISIONS, WHICH ALLOWS THESE
PLANS TO CONTINUE TO OPERATE
WITH MUCH LESS REGULATION THAN
FULL SERVICE HEALTH PLANS. EVERY
DAY. MY COLLEAGUES AND I SEE
COUNTLESS PATIENTS FORGO CARE OR
HAVE THEIR CLAIMS DENIED DUE TO
LACK OF PATIENT PROTECTIONS AND
TRANSPARENCY IN DENTAL
INSURANCE. DENTAL INSURANCE
PLANS STILL IMPOSE WAITING
PERIODS ON PATIENTS DENYING
COVERAGE FOR SERVICES SUCH AS
FILLINGS, ROOT CANALS, CROWNS
FOR 6 TO 12 MONTHS, ALL WHILE
THE PATIENT IS PAYING THEIR
MONTHLY PREMIUMS. THESE WAITING
PERIODS LEAVE PATIENTS WITH TWO
OPTIONS. DELAY CARE. UNTIL THE
WAITING PERIOD IS OVER AND RISK
THE CONDITION GETTING WORSE OR
PAY FOR THE SERVICES OUT OF
POCKET. DENTAL INSURANCE PLANS
ALSO REGULARLY DENY CLAIMS FOR
ENROLLEES WITH PRE EXISTING
DENTAL CONDITIONS. THIS USUALLY
SHOWS UP WITH A WHEN A DENTAL
PLAN WILL NOT COVER BRIDGES,
DENTURES OR IMPLANTS FOR A TOOTH
THAT WAS LOST EITHER DUE TO
TRAUMA OR GENETIC REASONS.
BEFORE AN ENROLLEE ENROLLED IN
THAT PLAN, THE MOST EGREGIOUS
EXAMPLE OF THIS IS A PATIENT WHO
NEEDED TO REPLACE THEIR DENTURES
THAT HAD SWITCHED PLANS SINCE
THEY RECEIVED THEIR LAST PAIR OF
YEARS AGO. THE NEW DENTAL PLAN
REFUSED TO COVER THE PAIR OF
DENTURES SINCE THE PATIENT WAS
CONSIDERED TO HAVE A PRE
EXISTING CONDITION, WHICH
HAPPENED TO BE HAVING NO TEETH.
THESE PROHIBITIONS AND COVERAGE
BEGGED THE QUESTION AS TO THE
VALUE OF DENTAL INSURANCE PLANS.
WHAT ARE THEY ACTUALLY PROVIDING
TO ENROLLEES IF THEY WILL NOT
COVER DENTAL PROCEDURES WHEN
THEY ARE NEEDED THE MOST. MAYBE
10 48, BUT ALSO REQUIRE DENTAL
INSURANCE PLANS TO GO THROUGH A
PREMIUM RATE REVIEW PROCESS. MY
COLLEAGUES AND I HAVE SEEN THE
VALUE OF DENTAL PLANS TO OFFER
OUR PATIENTS CONTINUE TO ERODE
AS DENTAL PREMIUMS GO UP, WHILE
THE ANNUAL MAXIMUM OF THE PLAN
THAT WE THAT WE PAY HASN'T RISEN
IN DECADES AND PLANS HOLD STEADY
OR EVEN CUT PROVIDER RATES. AS
DENNIS OUR ULTIMATE GOAL IS TO
PROVIDE QUALITY CARE TO ALL
PATIENTS IF DENTAL PLANS CAN
DENY COVERAGE FOR ARBITRARY
REASONS. HOW CAN WE PROVIDE THE
NECESSARY CARE FOR OUR PATIENTS?
WE ALL KNOW THAT THE MOUTH IS
CONNECTED TO AN INTEGRAL TO THE
BODY THAT'S ORAL HEALTH CARE IS
IN RELATED TO PHYSICAL HEALTH.
DENTAL INSURANCE PLANS SHOULD
RECOGNIZE AND SUPPORT THE
PREVENTION AND MAINTENANCE OF
ORAL HEALTH AND NOT DODGE
COVERAGE THROUGH FIXABLE
TECHNICALITIES. I RESPECTFULLY
ASK FOR YOUR EYE BOAT. THANK
YOU. GOOD AFTERNOON CHAIR AND
MEMBERS. JESSICA MORAN HERE AT
THE CALIFORNIA DENTAL
ASSOCIATION HERE IS THE SPONSORS
OF ÁP 10 48. I JUST LIKE TO
QUICKLY WRAP UP OUR COMMENTS BY
SAYING THAT OUR OPPOSITION IS
GOING TO COME UP HERE AND LIKELY
SAY THAT DENTAL PLANS CANNOT BE
HELD TO THE SAME STANDARDS AS
MEDICAL PLANS BECAUSE DENTAL IS
DIFFERENT. MEMBERS I'D LIKE TO
ASK INSTEAD AS TO WHY WE
CONTINUE TO BE OKAY WITH
TREATING MEDICAL INSURANCE
DIFFERENTLY THAN WE TREAT DENTAL
INSURANCE WHEN WE KNOW HOW
INTEGRAL YOUR DENTAL HEALTH IS
YOUR OVERALL PHYSICAL HEALTH
WE'VE SEEN HOW SUCCESSFUL THESE
PATIENT PROTECTIONS HAVE BEEN ON
THE MEDICAL SIDE. AND, UH,
CALIFORNIA HAS THE OPPORTUNITY
WITH THIS BILL TO BE THE FIRST
STATE TO IMPLEMENT TO START
RAISING THE BAR ON DENTAL
INSURANCE AND GIVE MAKE SURE
THAT CONSUMERS ARE RECEIVING
REAL VALUE FOR THE PREMIUMS THAT
THEY'RE PLAYING PAYING MY VOTE
TODAY. THANK YOU. THANK YOU. ARE
THERE OTHER WITNESSES AND
SUPPORT? PLEASE COME FORWARD
NAME ORGANIZATION POSITION. GOOD
AFTERNOON CHAIR AND MEMBERS
JENNIFER TANNEHILL WITH AARON
REID AND ASSOCIATES ON BEHALF OF
THE CALIFORNIA DENTAL HYGIENISTS
ASSOCIATION. AND SUPPORT THANK
YOU. GOOD AFTERNOON, CARLY MYERS
ON BEHALF OF THE NATIONAL HEALTH
LAW PROGRAM AND SUPPORT. GOOD
AFTERNOON, MEL ASKED THE GUY FOR
THE CALIFORNIA ASSOCIATION OF
ORTHODONTISTS DIDN'T GET OUR
LETTER IN WIN STRONG SUPPORT.
THANK YOU. GOOD AFTERNOON, MARIE
LOPEZ, CALIFORNIA NURSES
ASSOCIATION AND SUPPORT. GOOD
AFTERNOON. BETH BONKOWSKI.
THAT'S YOUR CALIFORNIA AND
SUPPORT. CHRISTOPH MAYER WITH
THE AMERICAN FEDERATION OF
STATE, COUNTY AND MUNICIPAL
EMPLOYEES AND SUPPORT. DIAMOND
KIM ON BEHALF OF CHILDREN'S
CHOICE AND SUPPORT. GOOD
AFTERNOON CHAIR MEMBERS JOSE
TORRES WITH HEALTH ACCESS
CALIFORNIA AND STRONG SUPPORT.
NEW ORLEANS WITH CHILDREN NOW IN
SUPPORT. THANK YOU. UM AND HE
WITNESSES IN OPPOSITION. PLEASE
COME FORWARD.
THE CALIFORNIA ASSOCIATION OF
DENTAL PLANS. WE ARE IN
OPPOSITION TODAY. IN SPITE OF
THE COMMENTS MADE BY THE
SPONSORS ABOUT THE VALIDITY OF
DENTAL INSURANCE, WE BELIEVE
THAT WE SHARE THE INTENTION OF
BOTH THE SPONSORS AND THE
AUTHOR, WHICH IS TO MAKE SURE
THAT INDIVIDUALS HAVE ACCESS TO
COVERAGE ACCESS TO DENTAL
INSURANCE. DENTAL INSURANCE IS
DIFFERENT. WE TALKED ABOUT IT
ALL THE TIME IN THIS COMMITTEE
AND YOU KNOW THE MEASURES IN
THIS BILL ARE LEVERS THAT ARE
USED PRIMARILY IN THE INDIVIDUAL
MARKET. EXCUSE ME TO KEEP THE
PREMIUM COSTS DOWN AND MAKE SURE
THAT CONSUMERS WHO DO NOT HAVE
EMPLOYER SPONSORED COVERAGE AND
STILL ACCESS DENTAL SERVICES SO
WE VERY MUCH APPRECIATE THAT THE
AUTHOR HAS TAKEN THE COMMITTEE
AMENDMENTS. WE REMAIN OPPOSED TO
THE BILL RIGHT NOW, BUT LOOK
FORWARD TO CONTINUING
CONVERSATIONS AS THE BILL MOVES
FORWARD. THANK YOU. OTHER
ADDITIONAL WITNESSES AND
OPPOSITION. PLEASE COME FORWARD.
JOHN WINGER ON BEHALF OF
AMERICA'S HEALTH INSURANCE PLANS
WOULD JUST ECHO THE COMMENTS
THAT KATHY LOOK FORWARD TO
FUTURE CONVERSATIONS. GORGEOUS
ON BEHALF OF THE CALIFORNIA
AGENTS AND HEALTH INSURANCE
PROFESSIONALS, VERY APPRECIATIVE
OF YOUR AGREEMENT TO TAKE THOSE
AMENDMENTS AND LOOK FORWARD TO
REVIEWING THE BILL IN PRINT. YOU
PRESTON YOUNG FROM THE
CALIFORNIA CHAMBER OF COMMERCE
HERE TODAY IN OPPOSITION TO THE
BILL AS IT APPEARS IN PRINT TO
THE COST BASED CONCERNS. THANK
YOU. THANK YOU. DO WE HAVE ANY
COMMENTS? QUESTIONS FROM THE
COMMITTEE. BEING NONE. UM. MS.
WHISK IF YOU WOULD LIKE TO CLOSE
DISRESPECTFULLY, ASTOR AND I
VOTE. THANK YOU. UM DO WE HAVE A
MOTION? WE HAVE A MOTION AND A
SECOND. MADAM SECRETARY. PLEASE
CALL THE ROLL THIS THE MOTION IS
DUE PASS AS AMENDED TO
APPROPRIATION. WOULD WALDRON,
WALTER AND I AGUIAR-CURRY
ARAMBULA BURNER. WENDY CARILLO
LARA, VINCE FONG, MAIENSCHEIN
MCCARTHY, PATTERSON. RODRIGUEZ.
RHETORIC ASIDE, I SANTIAGO
VALLAPUDUA BUT WHY WEBER? RIGHT
NOW. IT'S 30. BILL IS ON CALL.
THANK YOU.
SO GOING IN ORDER HERE ON NEXT
BILL A B 14 70 ITEM 19 BY
ASSEMBLYMEMBER'S QUIRK-SILVA.
YOU MAY PROCEED WHEN YOU'RE
READY. GOOD AFTERNOON, MADAM
CHAIR AND MEMBERS FIRST. I WANT
TO THANK THE COMMITTEE
CONSULTANT FOR ALL OF HER WORK
ON THIS BILL WITH MY OFFICE AND
I ACCEPT THE PROPOSED COMMITTEE
AMENDMENTS MEMBERS. A B 14 70 IS
A RESULT OR LACK THEREOF OF AN
ISSUE THAT HAS BEEN RAISED FOR
ALMOST A DECADE, REDUCING THE
UNNECESSARY PAPERWORK BURDEN TO
ALLOW MENTAL AND BEHAVIOR.
HEALTH PROVIDERS. TO CONCENTRATE
ON THEIR PRIMARY MISSION.
IMPROVING PATIENT OUTCOMES AND
2014 IN LIEU OF A BILL, THE
DEPARTMENT OF HEALTH CARE
SERVICES AND STATE COURT HOLDERS
AGREED TO A THIRD PARTY REVIEW
OF THE DEPARTMENT'S
DOCUMENTATION REQUIREMENT IN
2016. THE REPORT BASED ON A
SAMPLE OF SIX CALIFORNIAN
CALIFORNIA COUNTIES COMPARED
DATA TO NEW YORK. AND
MASSACHUSETTS STATEWIDE
STANDARDIZED DOCUMENTATION
REQUIREMENTS IN AN EFFORT TO
IDENTIFY REDUNDANCIES AND
METHODS THAT COULD BE MORE
EFFICIENT WAS COMPLETED IN ITS
FINDINGS AND RECOMMENDATIONS
RELEASE THERE WERE A NUMBER OF
RECOMMENDATIONS, HOWEVER, NOT
MUCH HAS BEEN DONE TO REDUCE
REDUNDANT AND UNNECESSARY
PAPERWORK SO THAT PROVIDERS CAN
FOCUS ON MINIMUM STANDARDS, MEET
AUDIT REQUIREMENTS AND SPEND
MORE TIME TREATING PATIENTS AND
FAMILIES. OUR VULNERABLE
WORKFORCE DEPENDS ON IT BECAUSE
ONE OF THE PRIMARY REASONS
CLINICIANS ARE LEAVING THE
PUBLIC AND MENTAL BEHAVIORAL
HEALTH SECTOR SECTOR IS
EXCESSIVE PAPERWORK. A B 14 70
REQUIRES D HCS TO DEVELOP
STANDARD FORMS BY JANUARY 1ST
2024 RELATING TO MEDICAL
NECESSITY CRITERIA. MANDATORY
SCREENING TRANSITION OF CARE
TOOLS AND DOCUMENTATION
REQUIREMENTS FOR MENTAL AND
BEHAVIORAL HEALTH SERVICES
PROVIDED UNDER THE MEDICAL
PROGRAM. THIS INCLUDES SPECIALTY
MENTAL HEALTH SERVICES, NON
SPECIALTY MENTAL HEALTH SERVICES
AND STEP SUBSTANCE USE DISORDER
SERVICES. IT IS TIME TO STOP
KICKING THE CAN DOWN THE STREET
WITH ME TODAY TO TESTIFY AND
SUPPORT AND ANSWER ANY QUESTIONS
. COMMITTEE MEMBERS MAY HAVE L
ROLL IT, PRESIDENT OF THE
CALIFORNIA COUNCIL OF COMMUNITY
BEHAVIORAL HEALTH AGENCIES AS
WELL AS C E O OF TURNING POINT
COMMUNITY PROGRAMS, AND VICTORIA
KELLY, CHIEF EXECUTIVE OFFICER
OF REDWOOD COMMUNITY SERVICES.
THANK YOU, CHAIR AND MEMBERS OF
THE COMMITTEE AGAIN. MY NAME IS
AL ROULETTE. AND I'M THE
PRESIDENT OF THE CALIFORNIA
COUNCIL OF COMMUNITY BEHAVIORAL
HEALTH AGENCIES, PRESIDENT AND
CEO OF TURNING POINT COMMUNITY
PROGRAMS AND ORGANIZATION THAT
IS PRIVILEGED TO PROVIDE
SERVICES IN 10, NORTHERN
CALIFORNIA COUNTIES. I'M ALSO A
LICENSED CLINICAL SOCIAL WORKER.
SERVING IN THIS FIELD FOR OVER
40 YEARS. SO THE TOPIC OF
REDUCING REDUNDANT AND
UNNECESSARY PAPERWORK IS NOT THE
MOST EXCITING ISSUE. IT IS
NECESSARY AND IMPORTANT, AND I
ENTHUSIASTICALLY ASK FOR YOUR
SUPPORT OF A B 14 70. C B H A
HAS LONG ADVOCATED AS EARLIER
FOR THE REDUCTION OF PAPERWORK
EVENING SUPPORTING THE
COMMISSION OF A STUDY IN 2015
THAT FOUND THAT IT TAKES
CALIFORNIA CLINICIANS FIVE TIMES
LONGER TO COMPLETE PAPERWORK
THAN CLINICIANS AND OTHER
STATES. I ESTIMATE THAT
CLINICIANS AT TURNING POINT AT
OUR CRISIS RESIDENTIAL AND
URGENT CARE PROGRAMS SPEND 40%
OF THEIR TIME ON AVERAGE,
COMPLETING PAPERWORK. MANY TIMES
CLIENTS WILL RIP REFERRED TO US
TO THE OTHER PAPERWORK THAT
THEY'VE ALREADY FILLED OUT AND
STATE HAVE ALREADY ANSWERED
THESE QUESTIONS. IT'S IN MY
RECORD. I APPRECIATE THE
DEPARTMENT'S EFFORT TO IMPROVE
THE BEHAVIORAL HEALTH DELIVERY
SYSTEM. THROUGH CAL AIM.
CALIFORNIA CONTINUES TO GRAPPLE
WITH SEVERE SHORTAGES IN THE
MENTAL HEALTH AND SUBSTANCE USE
PROFESSIONALS AT STATED EARLIER.
IT IS TIME FOR TRANSFORMATION.
BURDENSOME AND UNNECESSARY
PAPERWORK PREVENTS US FROM
IMMEDIATELY AMELIORATING THE
CRISIS THAT MANY OF THE
INDIVIDUALS THAT WERE PRIVILEGED
TO SERVE PRESENT US WITH WHEN WE
SEE THEM. I ASK FOR YOUR
SUPPORT. A B 14 70. GOOD
AFTERNOON CHAIR AND MEMBERS OF
THE ASSEMBLY HEALTH COMMITTEE.
VICTORIA KELLY, CHIEF EXECUTIVE
OFFICER AT REDWOOD COMMUNITY
SERVICES AND MULTISERVICE
ORGANIZATION SERVING INDIVIDUALS
ACROSS THE LIFESPAN IN RURAL
NORTHERN CALIFORNIA, INCLUDING
MENDOCINO LAKE AND HUMBLE
COUNTIES. WE PROVIDE MENTAL
HEALTH AND SUBSTANCE USE
DISORDER SERVICES, FOSTER CARE,
HOUSING AND HOMELESS SERVICES IN
SCHOOL BASED SUPPORT. I'M HERE
TODAY TO URGE YOUR SUPPORT FOR A
B 14 70 TO STREAMLINE THE
DOCUMENTATION EXPECTATIONS
THROUGHOUT CALIFORNIA'S MEDICAL
BEHAVIORAL HEALTH SYSTEM. OUR
CURRENT SYSTEM IS AT A CRITICAL
BREAKING POINT. THIS BILL WILL
HAVE BENEFICIAL EFFECTS ON
WORKFORCE RETENTION AND
RECRUITMENT. OF QUALIFIED
PROVIDERS DURING AN INCREDIBLY
CHALLENGING TIME BY REDUCING
BURDENSOME DOCUMENTATION
STANDARDS ON PROVIDERS AND
INCREASING THE FOCUS ON LIFE
CHANGING SERVICES TO OUR MOST
VULNERABLE POPULATIONS. IN MY
ORGANIZATION ALONE. WE WITNESSED
TOO MANY OF OUR PROVIDERS
LEAVING DUE TO THE OVERWHELMING
PAPERWORK DEMANDS AS OPPOSED TO
THE QUALITY SERVICES AND IMPACT
ON THEIR CLIENTS AND
COMMUNITIES. WE TO ESTIMATE THAT
THE PAPERWORK CONSUMES 40 TO 50%
OF OUR PROVIDERS TIME AND IS
EVEN HIGHER FOR MULTI COUNTY
PROVIDERS SUCH AS OURS. EACH
COUNTY BEHAVIORAL HEALTH
DEPARTMENT HAVE DIFFERING
STANDARDS AND INTERPRETATIONS.
FOR EXAMPLE, OUR CURRENT
ASSESSMENT RECENTLY WENT FROM 14
SECTIONS. TO COMPLETE 2 21
SECTIONS FOR PROVIDER TO
COMPLETE. IN SUBSTANCE USE
DISORDER. RESIDENTIAL SERVICES.
WE'RE GOING BACK TO A DAILY NOTE
AND A WEEKLY NOTE, WHICH MEANS
IT PROVIDER WILL HAVE TO
COMPLETE EIGHT NOTES PER CLIENT
PER WEEK INSTEAD OF ONE NOTE PER
CLIENT PER WEEK. ALL OUR
PROVIDERS SAY THE SAME THING. WE
WANT TO CHANGE LIVES. PROVIDERS
WANT TO ENGAGE IN DOCUMENTATION
THAT SHOWS THE IMPACT OF THE
WORK ON THE LIVES OF THEIR
CLIENTS AND FAMILIES. THEY WANT
TO KNOW THAT THE TIME THEY ARE
SPENDING IN THEIR PROFESSION IS
FIRST AND FOREMOST ABOUT DIRECT
CLIENT CARE THAT POSITIVELY
IMPACTS AND CHANGES LIVES AND IS
NOT RULED BY DOCUMENTATION. WE
ASK THAT YOU SUPPORT A B 14 70
TO ADDRESS THE BEHAVIORAL HEALTH
WORKFORCE CRISIS AND FREE UP
PRECIOUS TIME AND RESOURCES FOR
PROVIDERS TO DO WHAT THEY DO
BEST SERVE CLIENT NEEDS AND
EMPOWER COMMUNITIES FOR LONG
TERM SUCCESS. THANK YOU. ARE
THERE ADDITIONAL WITNESSES IN
SUPPORT? PLEASE COME FORWARD.
TOM RENT FREE ON BEHALF OF THE
CALIFORNIA ASSOCIATION OF
ALCOHOL AND DRUG PROGRAM
EXECUTIVES AND SUPPORT THANK
YOU. REBECA GONZALEZ
NATIONALISTS ASSOCIATION OF
SOCIAL WORKERS CALIFORNIA
CHAPTER AND SUPPORT. GOOD
AFTERNOON, ADRIAN SHELTON WITH
THE CALIFORNIA ALLIANCE OF CHILD
AND FAMILY SERVICES, PROUD CO
SPONSOR AND SUPPORT. TAYLOR
JACKSON WITH THE CALIFORNIA
PRIMARY CARE ASSOCIATION AND
SUPPORT. AMY BLUMBERG ON BEHALF
OF THE CALIFORNIA CHILDREN'S
HOSPITAL ASSOCIATION AND SUPPORT
. COREY ASHIDA ON BEHALF OF THE
STEINBERG INSTITUTE AND SUPPORT
. JOHN BRABENDER, CALIFORNIA
COUNCIL OF COMMUNITY BEHAVIORAL
HEALTH AGENCIES, C B H, A CO
SPONSOR AND IN SUPPORT FEW
MODELS ON BEHALF OF BEHAVIORAL
HEALTH COLLABORATIVE OF ALAMEDA
COUNTY IN SPORT. THANK YOU. ARE
THERE ANY WITNESSES IN
OPPOSITION? PLEASE COME FORWARD.
LISA GARDNER WITH THE COUNTY
BEHAVIORAL HEALTH DIRECTORS
ASSOCIATION. WE REPRESENT THE
LEADERS OF THE PUBLIC BEHAVIORAL
HEALTH SAFETY NET AND 58
COUNTIES AND CITIES, AND WE HAVE
A POSITION OF CONCERNS ON THIS
LEGISLATION. UM, WE RECOGNIZE
LIKE EVERYONE DOES THAT OVERTIME
. COUNTY BEHAVIORAL HEALTH
AGENCIES HAVE BEEN OVERBURDENED
BY PAPERWORK. UM AND THAT HAS
LED PEOPLE TO TREAT THE CHART
RATHER THAN THE PATIENT. AND WE
ALSO AGREE THAT MORE SHOULD BE
DONE TO PUT PATIENTS FIRST.
HOWEVER WE FELT THAT THIS
LEGISLATION DID NOT REFLECT THE
SIGNIFICANT WORK THAT'S BEING
DONE THROUGH THE CALEN PROGRAM
TO REDUCE DOCUMENTATION. THAT
WORK IS UNDERWAY. WE APPRECIATE
THE AMENDMENTS OFFERED BY THE
COMMITTEE AND LOOK FORWARD TO
REVIEWING THEM. UM AND WORKING
FURTHER WITH THE AUTHOR. THANK
YOU VERY MUCH. THANK YOU ANY
OTHER ADDITIONAL OPPOSITION?
THING NONE WILL BRING IT BACK TO
THE COMMITTEE. COMMENTS. MOTION
AND A SECOND. WITH THE AUTHOR
LIKE TO CLOSE. MM. UH JUST AS WE
KNOW TIME IS PRECIOUS AND THE
BELIEF THAT MOST OF THE TIME
THAT A CLINICIAN IS WORKING WITH
A PATIENT SHOULD BE WORKING WITH
THE PATIENT. UH VERSUS FILLING
OUT PAPERWORK. ALL OF US HAVE
SEEN A DOCTOR AT SOME POINT, AND
I KNOW FOR SURE, I NOTICED THERE
OFTEN TYPING AWAY PUTTING IN
INFORMATION AS THEY'RE TRYING TO
TREAT UH, THE PATIENT AND I KNOW
THAT IS BECAUSE OF THEIR
RESPONSIBILITY TO MAKE SURE
PAPERWORK IS DONE, BUT I THINK
THE EFFORT TO REALLY FOCUS ON
THE PATIENT IS VERY IMPORTANT
WITH THAT. I RESPECTFULLY ASK
FOR AN I VOTE. THANK YOU. WE
HAVE A MOTION DO PASS AS AMENDED
TO APPROPRIATIONS. MADAM
SECRETARY, PLEASE CALL THE ROLL.
WOULD WALDRON, I, WALTER AND I
GOT CURRY. ARAMBULA.
BOERNER HORVATH REAL. LARA AND
STRONG. MAIENSCHEIN MCCARTHY,
JOE PATTERSON. RODRIGUEZ
RODRIGUEZ I, SANTIAGO VALLAPUDUA
PUT WHAT I WEBER. 30. YOUR BILL
IS ON CALL. THANK YOU. THANK YOU
MEMBERS.
OKAY, NEXT IN ORDER. ITEM 22 A B
16 45 ASSEMBLYMEMBER'S OF BIRTH.
PLEASE. UH PROCEED WHEN YOU'RE
READY. THANK YOU.
THANK YOU, MADAM CHAIR AND
MEMBERS OF THE COMMITTEE. UM
I'LL START BY EXTENDING MY
THANKS TO YOU AND THE COMMITTEE
STAFF WHERE YOUR ENGAGEMENT ON
THIS BILL AND I'D BE HAPPY TO
ACCEPT THE COMMITTEE'S PROPOSED
AMENDMENTS. TODAY I'M PROUD TO
PRESENT A B 16 45, WHICH IS
SPONSORED BY INSURANCE
COMMISSIONER RICARDO LADA.
EQUALITY CALIFORNIA ÁP L, A
HEALTH IT'S ANGELES LGBT CENTER
AND THE SAN FRANCISCO AIDS
FOUNDATION. ABOUT A MONTH AGO.
YOU MAY HAVE SEEN HEADLINES
ABOUT A FEDERAL JUDGE IN TEXAS
WHO STRUCK DOWN NATIONAL
PROTECTIONS FOR PREVENTIVE CARE
BENEFITS UNDER THE AFFORDABLE
CARE ACT. WELL, WE DO HAVE
PROTECTIONS IN CALIFORNIA. SOME
OF THEM ARE BASED ON THESE
FEDERAL PROTECTIONS. SO THERE'S
CONCERN NOW THAT THIS TEXAS CASE
THEY FOOT MAY PUT THE FEDERAL
PREVENTIVE SERVICES REQUIREMENTS
ON WHICH OUR STATE RELIES INTO
PERIL. AMONG OTHER THINGS, A B
16 45 WILL CODIFY IN CALIFORNIA
LAW EXISTING FEDERAL GUIDANCE TO
ENSURE THAT CONSUMERS CAN STILL
ACCESS, PREVENTIVE CARE AND ALL
THE NECESSARY SERVICES FOR
DELIVERING THAT CARE. WITHOUT
COST SHARING. SHOULD THIS
FEDERAL LAW ULTIMATELY BE STRUCK
DOWN ON APPEAL? SO THIS BILL IS
ABOUT PROTECTING CALIFORNIANS
FROM THE SWEEPING HEALTHCARE
ROLLBACKS. WE'RE SEEING COMING
OUT OF COURTS IN TEXAS AND
ELSEWHERE. EVERY CALIFORNIAN
DESERVES ACCESS TO PREVENTIVE
HEALTH CARE THAT IS
COMPREHENSIVE, INCLUSIVE AND
AFFORDABLE. CALIFORNIANS MOST
AFFECTED BY STDS INCLUDE PEOPLE
OF COLOR YOUNG PEOPLE, AGED 8 15
THROUGH 29 L G B T Q. PLUS
PEOPLE AND PEOPLE WHO USE
SUBSTANCES. UNDERLYING THESE
DISPARITIES IS A LACK OF PRIMARY
AND PREVENTIVE HEALTH CARE DUE
TO A RANGE OF FACTORS, INCLUDING
FAMILY REJECTION, UNEMPLOYMENT,
HOMELESSNESS OR LACK OF ACCESS
TO CULTURALLY COMPETENT LOCAL
SERVICES AND PROVIDERS.
COMPREHENSIVE INCLUSIVE AND
AFFORDABLE PREVENTIVE CARE IS
CRITICAL TO IDENTIFYING AND
ADDRESSING HEALTH CHALLENGES
BEFORE THEY BECOME SERIOUS,
PARTICULARLY FOR MARGINALIZED
POPULATIONS. OUR SPONSORS WHO
ARE WITH ME TODAY HAVE DEDICATED
THEMSELVES FOR YEARS TO
STRENGTHENING ACCESS TO PREP A
LIFESAVING HIV PREVENTION
MEDICATION BECAUSE THEY
UNDERSTAND THAT COMPREHENSIVE
COVERAGE FOR PREVENTIVE HEALTH
CARE IS CRITICAL TO MAXIMIZING
UTILIZATION AND PREVENTING HIV.
THE SAME CAN BE SAID FOR THE
OTHER PREVENTIVE CARE THAT FALLS
UNDER THIS BILL. BARRIERS TO
PREVENTIVE CARE CAN FORCE PEOPLE
TO CHOOSE BETWEEN PREVENTING
EXPENSIVE AND DEVASTATING HEALTH
CARE PROBLEMS BEFORE THEY OCCUR
BECAUSE THEY HAVE TO PAY MONEY
FOR SOMETHING IN WHICH THEY'RE
NOT ILL YET AND CHOOSE BETWEEN
DOING THAT OR PUTTING FOOD ON
THE TABLE FOR THEIR FAMILIES. IN
ESSENCE, THIS BILL IS ABOUT
ENSURING THAT LOW INCOME PEOPLE
HAVE ACCESS TO THE SAME
COMPREHENSIVE AND AFFORDABLE
PREVENTIVE HEALTHCARE AS
EVERYONE ELSE. I ASK FOR YOUR I
VOTE AT THE APPROPRIATE TIME
TODAY WITH ME ABOUT JOSEPHINE
FIGUEROA, WHO IS THE CHIEF
DEPUTY LEGISLATIVE DIRECTOR FOR
THE DEPARTMENT OF INSURANCE. AND
RAINA HERNANDEZ, ASSOCIATE
DIRECTOR OF PREP AND HIV
NAVIGATION SERVICES AT THE SAN
FRANCISCO AIDS FOUNDATION, AND
TO ANSWER ANY TECHNICAL
QUESTIONS YOU HAVE HERE IS
JESSICA RYAN, ATTORNEY WITH THE
HEALTH EQUITY AND ACCESS OFFICE
, WHERE THE CALIFORNIA
DEPARTMENT OF INSURANCE JUST
SITTING UM. GOOD AFTERNOON,
MADAM CHAIR AND MEMBERS OF THE
COMMITTEE. JOSEPHINE FIGARO,
CHIEF DEPUTY LEGISLATIVE
DIRECTOR. FOR THE DEPARTMENT OF
INSURANCE HERE ON BEHALF OF
INSURANCE COMMISSIONER GOT A LOT
OF UH, COMMISSIONER LOTTA IS A
PROUD CO SPONSOR OF A B 16 45
1ST. I WANT TO THANK
ASSEMBLYMEMBER'S BERG FOR
AUTHORING THIS IMPORTANT
MEASURE. MAYBE 16 45 WOULD
REMOVE BARRIERS TO ACCESSING $0
PREVENTATIVE CARE UNDER THE
AFFORDABLE CARE ACT AND ADD CDC
RECOMMENDED SCREENING FOR
SEXUALLY TRANSMITTED INFECTIONS
TO THE LIST OF PREVENTATIVE CARE
BENEFITS. THE INCIDENTS OF S T.
I S HAVE BEEN GROWING OVER THE
LAST 20 YEARS AND IMPACTS
HISTORICALLY DISADVANTAGED
COMMUNITIES. INCLUDING PEOPLE OF
COLOR, YOUTH AND LGBTQ, PLUS
COMMUNITY. BY STRENGTHENING
EXISTING LAW AND REQUIRING
SCREENING TO BE COVERED WITHOUT
COST SHARING. A B 16 45 WILL
IMPROVE HEALTH BY IDENTIFYING S
D I S AND OTHER ILLNESSES
EARLIER, ALLOWING ST'S TO BE
MANAGED MORE EFFECTIVELY AND TO
BE TREATED BEFORE THEY DEVELOP
INTO SOMETHING MORE COMPLICATED
IN DEVELOPING CONDITION. WE ALSO
KNOW THAT EVEN SMALL AMOUNTS OF
COST SHARING LEAD TO REDUCE
CARE. STUDIES DEMONSTRATE THAT
RISING COST SHARING MAY WORSEN
DISPARITIES AND ADVERSELY AFFECT
HEALTH, PARTICULARLY AMONG
PATIENTS LIVING IN LOW INCOME
AREAS. FURTHER ELIMINATION OF
COST SHARING IS PREVENTED IN
PREVENTATIVE SERVICES WAS FOUND
TO REDUCE DISPARITIES IN
ACCESSING TO IT. A B 16 45
ELIMINATES LOOPHOLES THAT ALLOW
COST SHARING FOR USING
RECOMMENDED $0 PREVENTATIVE CARE
BENEFITS. FINALLY. IT CODIFIES
CERTAIN FEDERAL GUIDELINES FOR
COVERAGE OF PREVENTIVE SERVICES
WITHOUT COST SHARING, WHICH IS
PARTICULARLY IMPORTANT GIVEN
CONTINUED TAX ON THE E A
PREVENTIVE SERVICES IN FEDERAL
COURTS. INSURANCE COMMISSIONER,
LOTTE HAS BEEN COMMITTED TO
FIGHTING FOR AFFORDABLE
HEALTHCARE AND MORE EQUITABLE
ACCESS TO HEALTH SERVICES DURING
HIS TIME IN THE CALIFORNIA STATE
LEGISLATURE AND NOW, AS
INSURANCE COMMISSIONER CONTINUES
THAT THIS EFFORT WE MUST ENSURE
THAT CALIFORNIA CAN CONTINUE TO
PROVIDE FAIR AND EQUITABLE
ACCESS TO BERNARD CARE FOR ALL.
AS POTENTIAL CONTINUED CHANGES
BY SOME FEDERAL COURTS MAY
ATTEMPT TO CURTAIL ACCESS. TO
THESE ESSENTIAL SERVICES ON
BEHALF OF INSURANCE COMMISSIONER
RICARDO LARA. I ASKED FOR YOUR I
VOTE. GOOD AFTERNOON. I WOULD
LIKE TO THANK THE ASSEMBLY
HEALTH COMMITTEE FOR ALLOWING ME
TO TESTIFY TODAY IN SUPPORT OF A
V 16 45. MY NAME IS BRENDA
HERNANDEZ AND I'M CURRENTLY THE
ASSOCIATE DIRECTOR OF PREP AND
HIV SERVICES AT THE SAN
FRANCISCO AIDS FOUNDATION. UM,
WHERE OUR MISSION IS TO PROMOTE
THE HEALTH AND WELLNESS OF THE
COMMUNITIES MOST IMPACTED BY HIV
AND AIDS. WE PROVIDE
COMPREHENSIVE, FREE AND HIV, HIV
AND STD TESTING, HIV TREATMENT
PEP AND PREP AND I AM HERE TO
EXPRESS SUPPORT FOR A B 16 45
BECAUSE I FIRMLY BELIEVE
EVERYBODY DESERVES EQUITABLE
ACCESS TO NO COST SHARING
COMPREHENSIVE PREVENTATIVE
SERVICES, REGARDLESS OF THEIR
RACE, CLASS, GENDER OR FINANCIAL
STATUS AND ABILITY TO DO SO. A B
16 45 WOULD STRENGTHEN CURRENT
STATE LAW AND CLOSE LOOPHOLES TO
ENSURE THAT THE PEOPLE WE SERVE
LGBTQ COMMUNITY, YOUTH AND
COMMUNITIES OF COLORS OF COLOR
HAVE ACCESS TO CRITICAL
PREVENTATIVE CARE AND SC I
SCREENING, INCLUDING ALL OF THE
SERVICES AND OFFICE VISITS THAT
ARE NECESSARY TO DELIVER THAT
CARE WITHOUT COST SHARING. BY
WAY, OF EXAMPLE, IN OUR
EXPERIENCE, OUR IN OUR
EXPERIENCE OFFICE VISITS
CONTINUED TO REMAIN AS A
ROADBLOCK FOR MANY OF OUR
PRIVATELY INSURED CLIENTS WERE
USING PREP AND ACCESSING
SERVICES. WE SERVE OVER 20,000
INDIVIDUALS IN ANY GIVEN YEAR
AND ONE THIRD OF THOSE
INDIVIDUALS ARE PRIVATELY
INSURED. I WOULD HONESTLY LIKE
TO THINK THAT THE MAIN REASON
WHY PEOPLE COME TO OUR CLINIC IS
BECAUSE WE'RE LGBTQ FRIENDLY. UM
IT'S A JUDGMENT FREE SPACE AND
PROVIDER SERVICE DELIVERY MODEL
AND OUR HARM REDUCTION APPROACH
. BUT WHEN WE ASK CLIENTS ABOUT
THEIR CHOICE AND PROVIDERS,
THEIR RESPONSE IS ALMOST THE
SAME AS TO WHY THEY COME TO US
BECAUSE I DON'T HAVE TO PAY A
COPAY FOR MY VISIT. AND UPON
FURTHER DISCUSSION CONCERNS
ABOUT THE COST OF LIVING COME
UP, AND IT BECOMES CLEAR THAT IF
THEY WOULD RECEIVE CARE FROM
THEIR PRIMARY CARE PROVIDER THAT
THEY WOULD RECEIVE PRIMARY CARE
FROM THEIR PRIMARY FROM THEIR
PROVIDERS, IF IT WAS NOT FOR THE
FINANCIAL COST OF DOING SO, AND
A B 16 45 WOULD ENSURE THAT
PEOPLE WOULD NOT BE CHARGED A
COPAY FOR OFFICE VISITS
ASSOCIATED WITH WITH
PREVENTATIVE CARE REGARDLESS OF
HOW THEY'RE BUILT. ANOTHER
IMPORTANT PROVISIONS OF THIS
BILL THAT HAS DIRECT IMPACT FOR
OUR CLIENTS IS THE REQUIREMENT
FOR STATE REGULATED PLANS TO
COVER STD SCREENING THAT IS
RECOMMENDED BY THE CDC AT NO
COST. CURRENT LAW PROHIBITS COST
SHARING FOR SCREENING
RECOMMENDED BY THE USPS TF, BUT
THE TASK FORCE RECOMMENDATIONS
DON'T ALWAYS ALIGN WITH THE BEST
CLINICAL PRACTICE. CURRENTLY
CLIENTS USING THEIR INSURANCE
WHEN THE RISK OF BEING CHARGED A
COPAY FOR A SCREENING THAT IS
RECOMMENDED FOR THEM AND
IMPORTANT FOR THEIR HEALTH AND A
B 16 45 WOULD CLOSE THIS
LOOPHOLE AND ENSURE EQUITABLE
ACCESS TO S T I SCREENING. THIS
IMPORTANT BILLS ASSURED ENSURES
THAT PEOPLE WILL BE ABLE TO HAVE
ACCESS TO COMPREHENSIVE S T I
CARE REGARDLESS OF THE POLITICAL
AND JUDICIAL ATTACKS ON THE
AFFORDABLE CARE ACT. UM AND I
WOULD JUST LIKE TO SAY THAT WE
HAVE ALL OF THE TOOLS NECESSARY
TO PREVENT HIV AND STD
INFECTIONS AND GET TO ZERO. WE
JUST NEED PEOPLE TO HAVE ACCESS
TO THEM. THANK YOU. ARE THERE
OTHER WITNESSES IN SUPPORT?
PLEASE COME FORWARD NAME
ORGANIZATION IN POSITION ONLY.
GOOD AFTERNOON KTV INDIANS WITH
HEALTH ACCESS CALIFORNIA AND
SUPPORT. THANK YOU. GOOD
AFTERNOON, MOLLY ROBSON WITH
PLANNED PARENTHOOD, AFFILIATES
OF CALIFORNIA AND SUPPORT. GOOD
AFTERNOON, AND DONNELLY WITH, UM
AND EPIDEMICS COALITION,
CALIFORNIA AND ALSO ON BEHALF OF
CAL HEP OR CALIFORNIA HEPATITIS
ALLIANCE IN SUPPORT. THANK YOU.
GOOD AFTERNOON RYAN SUZANNE
BEHALF OF ESSENTIAL ACCESS
HEALTH AND ÁP, TELEHEALTH AND
SUPPORT. AFTERNOON CRAIG POSTER
ON BEHALF OF CO SPONSORS,
EQUALITY CALIFORNIA AND THE LOS
ANGELES LGBT CENTER. ALSO HERE
ON BEHALF OF VIENNA STAR, THE
CALIFORNIA LGBTQ HEALTH AND
HUMAN SERVICES NETWORK. SF HAPPY
FREE BAY AREA AND JUSTICE AND
AGING. GOOD AFTERNOON, CARLY
MYERS ON BEHALF OF THE NATIONAL
HEALTH LAW PROGRAM AND SUPPORT.
GOOD AFTERNOON. SANDRA PULL
WESTERN CENTER ON LAW, POVERTY
AND SUPPORT. AND MARTIN ON
BEHALF OF THE AIDS HEALTHCARE
FOUNDATION AND STRONG SUPPORT.
THANK YOU. THANK YOU WILL RETURN
TO THE COMMITTEE FOR ANY
QUESTIONS, COMMENTS OH,
OPPOSITION OF FORGETTING ABOUT
OUR POSITION. IS THERE ANY
OPPOSITION TO THIS BILL? GOOD
AFTERNOON CHAIR AND MEMBERS OF
THE COMMITTEE ROBERT BOYKIN WITH
CALIFORNIA ASSOCIATION OF HEALTH
PLANS OR YOU RESPECT IN SYRIAN
OPPOSITION, REGARDLESS IN
OPPOSITION TO ABC, 45. WE
RESPECT AND UNDERSTAND THE
INTENT OF THE BILL. HOWEVER WE
ARE OPPOSED BECAUSE THIS REMOVES
COST SHARING ON SERVICES THAT
ARE COVERED BY HEALTH PLANS,
ACCORDING TO THE CALIFORNIA
HEALTH BENEFIT BENEFITS REVIEW
PROGRAM. THIS WILL INCREASE
ANNUAL COSTS BY 20 MILLION FOR
ALL CALIFORNIANS ONCE AGAIN
KEEPING IN MIND THAT THIS IS ONE
OR 23 MANDATE BILLS THIS YEAR
THAT WE'VE TAKEN ALL TOGETHER
ARE SET TO INCREASE ANNUAL COSTS
BY MORE THAN ONE BILLION ON ALL
CALIFORNIANS. THANK YOU FOR YOUR
TIME TODAY. MR CHAIR MEMBER,
STEPHANIE WATKINS ON BEHALF OF
THE ASSOCIATION OF CALIFORNIA
LIFE AND HEALTH INSURANCE
COMPANIES, ALSO, REGRETTABLY
OPPOSED. WE DID HAVE SOME
CONVERSATIONS TO KIND OF WORK
THROUGH SOME OF THE PROPONENTS
OF THE BILL. WE DO BETTER
UNDERSTAND, BASED ON SOME OF THE
JUDICIARY ACTION, SOME OF THE
CONCERNS ABOUT PREVENTATIVE
SERVICES NOT NO LONGER BEING
INCLUDED, OR AT LEAST THE RISK.
WE'D LIKE TO CONTINUE THOSE
CONVERSATIONS WITH RESPECT TO
THE CDC GUIDELINES AND
POTENTIALLY IMPLEMENTING THOSE
EARLIER THAN WE NORMALLY DO. THE
TASK FORCE. SO WITH THOSE WE
HOPE TO LOOK FORWARD TO
CONTINUING THOSE CONVERSATIONS
WITH BOTH C D I AND THE AUTHOR
OF THE BILL, THANK YOU. OTHER
WITNESSES IN THE OPPOSITION.
PLEASE COME FORWARD. THANK YOU
FOR ASKING YOUNG FROM THE
CALIFORNIA CHAMBER OF COMMERCE
HERE IN OPPOSITION BECAUSE OF
THE PREMIUM IMPACT. THANK YOU.
SEEING NO OTHER OPPOSITION. NOW
WE'LL BRING IT BACK TO THE
COMMITTEE FOR QUESTIONS,
COMMENTS. MOTION. AND WITH THE
AUTHOR LIKE TO CLOSE SURE. SO
FIRST OF ALL, LET ME THANK THE
COMMITTEE AGAIN AND THE STAFF
FOR THE HARD WORK ON THIS BILL.
I JUST WANT TO REITERATE THAT 16
45 IS NOT A MANDATE. BILLET
WAVES COUGH SHARING FOR INTEGRAL
SERVICES PROVIDED BY FEDERAL
LAW. THEY'RE AT RISK OF GOING
AWAY AND FOR CDC RECOMMENDED STI
SCREENINGS, WHICH ARE ALREADY
BASIC HEALTHCARE COVERAGE. THE
BRICKS OF THE BILL AT THE COST
OF THE BILL AS ESTIMATED BY
SUBURB OR MINIMAL, IT'S
LITERALLY A LITTLE MORE THAN
1/100 OF 1. IN TERMS OF THE
COSTS INCREASE FOR THE FEDERAL
FOR THE PREVENTIVE CARE SO I
PROUDLY WANT TO THANK MY
SPONSORS AND THE FOLKS THAT ARE
HERE TODAY AND ASPIRIN, IVO.
THANK YOU. THE MOTION IS DUE
PASS AS AMENDED TO
APPROPRIATIONS. MADAM SECRETARY
PLEASE. COLORADO WOULD WOULD I?
WALDRON GOLDENEYE CURRY CURRY, I
ARAMBULA EARNER, WENDY CARILLO
LARA. VINCE FONG, MAIENSCHEIN
MCCARTHY, JOE PATTERSON
RODRIQUEZ. RODRIGUEZ I SANTIAGO
VALLAPUDUA. VALLAPUDUA. AYE.
WEBER. YOUR BILL HAS FIVE VOTES
WILL LEAVE THE BILL ON CALL.
THANK YOU VERY MUCH. BELIEVE,
UM, MISS REYES IS NEXT. I TOLD
YOU.
WHENEVER YOU'RE READY. THANK YOU
FOR THE OPPORTUNITY TO PRESENT A
B 12 88. THE BILL PROHIBITS
COMMERCIAL HEALTH INSURERS FROM
IMPOSING PRIOR AUTHORIZATION
RULES THAT CREATE BARRIERS FOR
MEDICATION ASSISTED TREATMENT.
MEDICATIONS SUCH AS BOOP BOOP.
NORTH MEAN YOU CAN CALL SUBOXONE
Tð. METHADONE OR LONG ACTING
NALTREXONE CAN SIGNIFICANTLY
IMPROVED TREATMENT FOR MANY
SUBSTANCE USE DISORDERS BY
TREATING CRAVING AND WITHDRAWAL
SYMPTOMS. HOWEVER MEDICATION
ASSISTED TREATMENT IS UNDER USED
ALMOST TWO THIRDS OF
COMMERCIALLY INSURED PERSONS IN
CALIFORNIA WITH DRUG OR ALCOHOL
DEPENDENCE DO NOT INITIATE
TREATMENT. PRIOR AUTHORIZATION
REQUIREMENTS CREATE UNNECESSARY
BARRIERS THAT DELAY
AUTHORIZATION REQUIREMENTS. THAT
. THAT DELAY OR INTERRUPT ACCESS
TO EFFECTIVE TREATMENT.
SKYROCKETING OVERDOSES.
REPRESENTS A PUBLIC HEALTH
EMERGENCY, DEMANDING NEW
STRATEGIES OF RESPONSE,
INCLUDING THE REMOVAL OF
UNNECESSARY BARRIERS TO
EFFECTIVE TREATMENT. A B 12 88
IS AN IMPORTANT FIRST STEP THAT
WILL REDUCE OVERDOSE RATES AND
SAVE LIVES HERE TO SPEAK IN
SUPPORT OF THE BILL IS DR AMY
MULAN. PROFESSOR OF EMERGENCY
MEDICINE AND DIVISION CHIEF OF
ADDICTION MEDICINE AT U. C.
DAVIS AND DIRECTOR OF THE
CALIFORNIA BRIDGE PROGRAM. THANK
YOU. I'M AN EMERGENCY PHYSICIAN
. I ALSO WORK WITH A NETWORK OF
OVER 279 EMERGENCY DEPARTMENTS,
WHICH ARE PROVIDING ADDICTION
TREATMENT IN THE EMERGENCY
DEPARTMENT. AND WHAT WE CAN TELL
YOU IS THAT MEDICATIONS FOR
ADDICTION TREATMENT,
PARTICULARLY OPIOIDS, LIKE
FENTANYL ARE VERY EFFECTIVE IN
OUR CHALLENGE IS GETTING
MEDICATIONS TO PEOPLE IN A
TIMELY FASHION, AND WHEN WE
ENCOUNTER DELAYS OR PATIENTS
HAVE DIFFICULTY ACCESSING
MEDICATIONS. WE LOSE THEM, AND
WE LOSE AN OPPORTUNITY TO SAVE
LIVES AND GET PEOPLE INTO
TREATMENT. I REALLY WANT TO
THANK ASSEMBLYMEMBER'S RAISE FOR
BRINGING THIS BILL FORWARD
BECAUSE I BELIEVE IT WILL SAVE
LIVES. THANK YOU. THANK YOU VERY
MUCH OTHERS IN SUPPORT. THANK
YOU, MR. CHAIR, TIM MADDEN,
REPRESENTING THE CALIFORNIA
CHAPTER OF THE AMERICAN COLLEGE
OF EMERGENCY PHYSICIANS IN
SUPPORT. THANK YOU. HARLEY MYERS
ON BEHALF OF THE NATIONAL HEALTH
LAW PROGRAM AND SUPPORT THANK
YOU. BRANDON MARCHI WITH THE
CALIFORNIA MEDICAL ASSOCIATION
AND SUPPORT THANK YOU. DR NEIL
MERRY WITH CALIFORNIA SOCIETY OF
ADDICTION, MEDICINE IN STRONG
SUPPORT. THANK YOU. TAYLOR
JACKSON WITH THE CALIFORNIA
PRIMARY CARE ASSOCIATION AND
SUPPORT THANK YOU. SO WHAT'S
WITH THE CALIFORNIA ACADEMY OF
FAMILY? PHYSICIANS AND SUPPORT?
THANK YOU. ANYONE ELSE? IS THERE
OPPOSITION TO THE BILL? OKAY SEE
? NO NO OPPOSITION. I THINK
QUESTIONS OR COMMENTS FROM THE
COMMITTEE. THE MOTION BY MISS
HAGAR CURRIE IS SECOND BY MR V.
VALLAPUDUA MOTION IS DO PASS
THROUGH APPROPRIATIONS. BENHAM
SECRETARY, PLEASE CALL THE ROLL.
WOULD WOULD I, WALDRON WALDRON,
I AGUIAR-CURRY AGUIAR-CURRY.
AYE, ARAMBULA. BOERNER HORVATH
VÚI. LARA BENSON, FONG,
MAIENSCHEIN MCCARTHY, JOE
PATTERSON, RODRIGUEZ RODRIGUEZ
I, SANTIAGO. VALLAPUDUA
VALLAPUDUA I EVER. WEBER. FIVE
VOTES WILL LEAVE THE BILL ON
CALL. THANK YOU. THANK YOU VERY
MUCH. NEXT UP, DR. JACKSON. I
BELIEVE.
DO YOU HAVE A B 14 51 WHENEVER
YOU'RE READY. THANK YOU VERY
MUCH, MR CHAIR AND COMMITTEE
MEMBERS. UM, I WOULD LIKE TO
START BY ACCEPTING THE
COMMITTEE'S AMENDMENTS TO UM UM
UH A B 14 51. TO UM THAT'S
REMOVING THE REQUIREMENT FOR
PREAUTHORIZATION FOR TREATMENTS
OF URGENT OR EMERGENT MENTAL
HEALTH OR SUBSTANCE USE
DISORDERS. AS WE KNOW WE ARE IN
THE MIDST OF A MENTAL HEALTH
CRISIS. UM, AND THERE'S NOT VERY
MANY TOOLS THAT WE HAVE TO
REALLY DEAL WITH THE CRISIS AT
THIS TIME. UM AND SO THIS
BUILDING IS DESIGNED TO ENSURE
THAT WE CREATE AS MANY
OPPORTUNITIES. WHILE SOMEONE IS
WILLING TO RECEIVE UH, THEY HELP
NECESSARY THAT THERE ARE LESS
BARRIERS AND MAKING SURE WE CAN
SERVE THEM IN A QUICKER UM AND
MORE EFFICIENT WAY. AH,
OBVIOUSLY, UM. WE HAVE SEEN TOO
MANY CIRCUMSTANCES AND FOR THOSE
WHO DON'T KNOW HOW MENTAL
INNOCENCE SOMETIMES WORK IS THAT
SOMETIMES YOU ONLY HAVE A BRIEF
PERIOD OF TIME. UM, IN WHICH YOU
SOMEONE IS WILLING TO ACCEPT.
UM, TREATMENT OR ACCEPT ANY TYPE
OF HELP. UM, SO THE LONGER WE
WAIT THE LESS LIKELY SOMEONE
WILL BE SERVED. AND THIS BILL
DOES THAT. UNFORTUNATELY THE
HEALTH CARE INDUSTRY IS, UM,
WORKFORCE IS, UM IS IMPACTED
THERE. WE HAVE A WORKFORCE
SHORTAGE. AND SO FACILITIES THAT
ACTUALLY HAVE THE PROFESSIONALS
THERE. FACILITIES WHO ACTUALLY
HAVE EVERYTHING THAT THEY NEED
TO BE ABLE TO SERVE SOMEONE. WE
MUST CONTINUE TO BREAK DOWN AS
MANY BARRIERS. UM, AS POSSIBLE.
AND CERTAINLY JUST WAITING FOR A
AUTHORIZATION TO RECEIVE
SERVICES. UM, IT'S SOMETHING
THAT WE CANNOT AFFORD TO
CONTINUE TO ACCEPT THAT THIS
TIME DURING SUCH A CRISIS. UM
AND SO WITH THAT, I WANT TO
THANK THE COMMITTEE FOR WORKING
WITH US ON THIS BILL. UM AND
RESPECTFULLY ASKED FOR AN I
VOTE. THANK YOU SUPPORT. GOOD
AFTERNOON. MARIE LOPEZ,
CALIFORNIA NURSES ASSOCIATION IN
SUPPORT. CARLY MYERS ON BEHALF
OF THE NATIONAL HEALTH LAW
PROGRAM AND SUPPORT. HI TASHA.
WHAT'S WITH THE CALIFORNIA
ACADEMY OF FAMILY PHYSICIANS AND
SUPPORT? THANK YOU. TAYLOR
JACKSON WITH THE CALIFORNIA
PRIMARY CARE ASSOCIATION AND
STRONG SUPPORT. HE'S FROM LA
ROCHELLE YODER. ANDREW SMELLS
ARE IN LINE WITH A FEW CLIENTS
AND SUPPORT CALIFORNIA STATE
ASSOCIATIONS, PSYCHIATRIST AND
CALIFORNIA ACADEMY OF CHILD
ADOLESCENT PSYCHIATRY AS WELL,
BOTH IN SUPPORT. THANK YOU.
THANK YOU. MR CHAIR MEMBERS,
BRANDON MARSHALL WITH THE
CALIFORNIA MEDICAL ASSOCIATION
AND SUPPORT THANK YOU. REBECA
GONZALEZ NATIONAL ASSOCIATION OF
SOCIAL WORKERS. CALIFORNIA
CHAPTER AND SUPPORT. THANK YOU.
MR CHAIR MEMBERS, TIM MADDEN
REPRESENT THE CALIFORNIA CHAPTER
OF THE AMERICAN COLLEGE OF
EMERGENCY PHYSICIANS AND SPORT.
THANK YOU. HELLO MOLLY ROBSON
WITH PLANNED PARENTHOOD,
AFFILIATES OF CALIFORNIA AND
SPORT. THANK YOU. IS THERE
OPPOSITION TO THE BILL? AH, GOOD
AFTERNOON CHERRY MEMBERS OF THE
COMMITTEE, ROBERT BOYKIN WITH
THE CALIFORNIA ASSOCIATION OF
HEALTH HANDS HARDLY IN
OPPOSITION TO A B 14 51 ARE WE
RESPECT AND UNDERSTAND THE
INTENT OF THE BILL. HEALTH PLANS
CURRENTLY COVERED THE TREATMENT
AND CARE FOR MENTAL HEALTH AND
SUBSTANCE USE DISORDERS. HOWEVER
THIS BILL SEEKED TO REMOVE PRIOR
AUTHORIZATION. WE UNDERSTAND
THERE'S AMENDMENTS BEFORE US,
AND SO WE'LL MAKE SURE TO TAKE A
LOOK AT HIM. BUT THAT WAS ONE OF
THE REASONS REMOVING PRIOR
AUTHORIZATION. UM GET RID OF THE
GUARDRAILS TO HELP KEEPS
HEALTHCARE PREMIUMS STABLE. UM
THAT PLUS THE LACK OF COHESIVE
DEFINITION BUT FOR BEHAVIORAL
HEALTH CRISIS IS WHY WE ARE
OPPOSED. BUT ONCE AGAIN, WE HAVE
REACHED OUT AND SPOKEN TO THE
AUTHOR'S OFFICE AND WE LOOK
FORWARD TO WORK WITH THEM AS
THIS BILL MOVES FORWARD IN THE
PROCESS. THANK YOU FOR YOUR
TIME. THANK YOU. MR. CHAIR
MEMBER STEPHANIE WATKINS ZOMBIE
HAVE THE ASSOCIATION OF
CALIFORNIA LIFE AND HEALTH
INSURANCE COMPANIES. WE, TOO,
HAVE A OPPOSITION ON THE BILL.
WE LOOK FORWARD TO CONTINUING
THOSE CONVERSATIONS AND SEEING
THE AMENDMENTS AS THE BILL WAS
OUT TODAY. THANK YOU ANYONE
ELSE? NO ONE WILL BRING IT BACK
TO THE COMMITTEE FOR QUESTIONS
OR COMMENTS. UM, OUR VICE CHAIR,
WALDRON. THANK YOU, UM, HAVING
DONE QUITE A BIT OF WORK IN THE
MENTAL HEALTH SPACE, I WANNA
THANK YOU FOR BRINGING THIS
FORWARD. UM YOU KNOW, WE TALK
ABOUT MENTAL HEALTH PARODY WITH
PHYSICAL HEALTH, WHICH WE
ACHIEVED WITH SENATOR WIENERS
BILL 855 COUPLE OF YEARS AGO. SO
WHEN WE LOOK AT THIS IF A
PATIENT IS IN FOR TREATMENT, I
MEAN, WOULD WE CONSIDER, YOU
KNOW NOT. BEGINNING TREATMENT,
OR, UH, STARTING A REFERRAL
PROCESS IF A HEART CONDITION WAS
DISCOVERED, OR ANY OTHER
PHYSICAL CONDITION, UH, IF THEY
WERE IDENTIFIED AT THE TIME OF
THE APPOINTMENT UH, UM, FOR A
SEPARATE CONDITIONS, SO YOU KNOW
WHEN WE LOOK AT PARODY, MENTAL
HEALTH ALSO, YOU KNOW, TO SEND
THEM HOME AT A TIME WHEN MAYBE
THE MOST READY TO RECEIVE
TREATMENT WOULD NOT ONLY BE
INEFFICIENT, BUT IT WILL ALSO IN
THE LONG RUN, BEING MORE COSTLY
, OR, UM, YOU KNOW, FAR MORE
DETRIMENTAL SO OBVIOUS
SUPPORTING YOUR BILL. THANK YOU
ANYONE ELSE? MOTION ON THE BILL.
EMOTION BY MR V. VALLAPUDUA
SECOND BY MR MCCARTY DOES ENJOY
DO PASS RECOMMENDATION. IT'S DO
PASS AS AMENDED TO
APPROPRIATIONS WHICH ACTED
CLOSE, DR JACKSON. ONCE AGAIN,
MR CHAIR. THANK YOU. AND THE
COMMITTEE FOR, UM, YOUR HELP
WITH THIS BILL. UM OBVIOUSLY,
THIS IS JUST ONE BILL AMONGST
MANY THAT WILL HELP TO PUT
TOGETHER THE PIECES. OF HOW WE
CAN TRULY TREAT MENTAL HEALTH AS
THE CRISIS. IT IS. AND I KNOW
THIS COMMITTEE DOESN'T NEED TO
UNDERSTAND THAT THIS IS A CRISIS
, BUT CERTAINLY FOR THOSE
LISTENING. OH IT IS SO IMPORTANT
TO UNDERSTAND JUST HOW MUCH OF A
MENTAL HEALTH CRISIS CALIFORNIA
HAS, AND PARTICULARLY WITH OUR
YOUNG PEOPLE AS WELL, UM, AND SO
I RESPECTFULLY ASK FOR AN I VOTE
. THANK YOU VERY MUCH. MADAM.
SECRETARY CALL, PLEASE CALL THE
ROLL. WOULD, WOULD I, WALDRON
WALDRON, IAGAR CURRY CURRY. I
ARAMBULA BURNER. WENDY CARILLO
FLORA, VINCE FONG MAIENSCHEIN
MCCARTHY MCCARTHY I, JOE
PATTERSON RODRIGUEZ. RODRIGUEZ I
SANTIAGO VÆ VALLAPUDUA.
VALLAPUDUA HIGH, WEBER. YOU HAVE
SIX VOTES WILL LEAVE THE BILL ON
CALL. THANK YOU. SEEING NO OTHER
AUTHORS PRESENT. I'M GONNA GO
AHEAD AND PRESENT MY BILL, SO
I'LL TURN THIS OVER TO VICE
CHAIR.
OKAY WE ARE MOVING TO ITEM 33 A
B 13 31 DOCTOR WOULD PROCEED
WHEN YOU ARE READY. THANK YOU
VERY MUCH. MADAM VICE CHAIR.
CALIFORNIA HAS A FRAGMENTED AND
DECENTRALIZED HEALTH INFORMATION
EXCHANGE NETWORK WITH AREAS OF
THE STATE WITH NO HEALTHY HIV
CALLED EIGHTH, UM, ENTITY AND
LIMITED PARTICIPATION BY MAJOR
TYPES OF PROVIDERS. THIS LIMB
ASI ABILITY OF PATIENTS,
HEALTHCARE PROVIDERS AND PUBLIC
HEALTH DEPARTMENTS TO USE DATA
TO IMPROVE HEALTHCARE QUALITY
AND CARE COORDINATION. IN 2021,
THE CALIFORNIA HEALTH AND HUMAN
SERVICES AGENCY CREATED A DATA
SHARING AGREEMENT DEFINING THE
PARTIES THAT WILL SUB WILL BE
SUBJECT TO NEW DATA EXCHANGE
RULES AND SETTING FORTH A COMMON
SET OF TERMS, CONDITIONS AND
OBLIGATIONS TO SUPPORT SECURE
REAL TIME ACCESS TO AN EXCHANGE
OF HEALTH AND SOCIAL SERVICES
INFORMATION. IN COMPLIANCE WITH
APPLICABLE FEDERAL, STATE AND
LOCAL LAWS, REGULATIONS AND
POLICIES. THIS BILL ESTABLISHES
THE NEXT STEP BY CREATING A
BOARD TO ENSURE THAT THE DATA
EXCHANGE FRAMEWORK IS SUCCESSFUL
IN ACHIEVING THE EXCHANGE OF
INFORMATION TO ENSURE THAT
CALIFORNIA ACHIEVES ITS
HEALTHCARE ACCESS EQUITY
AFFORDABILITY, PUBLIC HEALTH AND
QUALITY OF CARE GOALS. I
RESPECTIVELY ASK FOR YOUR I
VOTE. THANK YOU. ARE THERE
WITNESSES IN SUPPORT? GOOD
AFTERNOON, MADAM CHAIR, K¾T
ABANDONS HIS HEALTH ACCESS
CALIFORNIA AND WE HAVE SUPPORTED
AMENDED POSITION AND LOOK
FORWARD TO WORKING WITH THE
AUTHOR AS THE BILL MOVES
FORWARD. THANK YOU. GOOD
AFTERNOON. SANDRA PULL WESTERN
CENTER OF LAW POVERTY. WE ALSO
HAVE A SUPPORTIVE AMENDED. GOOD
AFTERNOON, JOHAN CARDINALS WITH
THE CALIFORNIA AND DIGNITY
HEALTH NETWORK AND SUPPORT THANK
YOU, BILL. ARE THERE ANY
WITNESSES IN OPPOSITION? THING
NONE. UH WE'LL BRING IT TO THE
COMMITTEE FOR COMMENTS
QUESTIONS. THE AUTHOR LIKE TO
CLOSE. RESPECTFULLY ASK YOUR I
VOTE. THANK YOU. THE MOTION IS
DUE PASS TO APPROPRIATIONS.
MADAM SECRETARY, PLEASE CALL THE
ROLL. WOULD WOULD I, WALDRON
WALDRON, I AGUIAR-CURRY
AGUIAR-CURRY AYE ARAMBULA BURNER
WENDY CARILLO. FLORA VINCE FONG.
MAIENSCHEIN MCCARTHY. MCCARTHY
I, JOE PATTERSON. RODRIGUEZ.
RODRIGUEZ RODRIGUEZ. AYE.
SANTIAGO. VALLAPUDUA PUT WHAT I
WEBER. YOUR BILL HAS 6 TO 0 WILL
REMAIN ON CALL. THANK YOU, MADAM
VICE CHAIR AND WE ARE WAITING
FOR AUTHORS. OH, WE'LL WAIT FOR
AUTHORS. AND. GO THROUGH, WE CAN
GO THROUGH. WE MIGHT WE CAN GO
THROUGH THE ROLE AND WE'RE JUST
SITTING HERE SO MADAM SECRETARY.
PLEASE. UH. LIFT THE CALL ON THE
CONSENT CALENDAR. ARAMBULA
BURNER. WENDY CARILLO,
MAIENSCHEIN PATERSON SANTIAGO V
VALLAPUDUA. VALLAPUDUA. AYE,
WEBER. YOU CAN SEND CALENDAR
PASSES 80 ITEM NUMBER UH, THREE
A B 6 20, PLEASE LIFT THE CALL
AND CALL THE ABSENT MEMBERS.
ARAMBULA BURNER. WENDY CARILLO
FLORA, VINCE FONG MAIENSCHEIN
MCCARTY. MCCARTHY. AYE. PATERSON
SANTIAGO VALLAPUDUA. BUT WHAT I
WEBER. ITEM NUMBER FOUR THAT
THAT VOTE WAS 60 WAS STILL ON
CALL ITEM NUMBER FOUR A. B 11
OH, NINE BY MR CONNOLLY, PLEASE
LIFT THE ROLL CALL THE ABSENT
MEMBERS. ARAMBULA. OPEN THE
ROLE. EXCUSE ME LIFT THE CALL.
WHATEVER LIFT THE CAR COFFEE
ABSENT MEMBERS. YOU CAN'T DO
WHAT A MESS. ARAMBULA BURNER.
WENDY CARILLO FLORA VINCE WANG
MAIENSCHEIN PATERSON RODRIGUEZ.
ON TIAGO, THE VALLAPUDUA. IF IT
WAS I, WEBER. THAT'S 50. WE'RE
CHIPPING AWAY AT THINGS HERE. UM
WE'LL MOVE ON TO ITEM NUMBER
FIVE. A B 6 60 BY MR IRWIN,
PLEASE LIFT THE CALL AND CALL
THE ABSENT MEMBERS. ARAMBULA.
BOERNER HORVATH VÚI FLORA, VINCE
FONG MAIENSCHEIN MCCARTY.
MCCARTHY I JOE PATTERSON,
RODRIGUEZ SANTIAGO VALLAPUDUA.
IF IT WA I. 50 WILL LEAVE THAT
BILL ON CALL. ITEM NUMBER SIX.
MAYBE. 7 10 BY MS SZABO, PLEASE
LIFT THE CALL. CALL THE ABSENT
MEMBERS. ARAMBULA BURNER. WENDY
CARILLO FLORA VINCE FANG
MAIENSCHEIN MCCARTHY MCCARTHY.
AYE. RODRIGUEZ. SANTIAGO DE
VALLAPUDUA. IF BOUDOIR, AYE.
THAT ONE IS FIVE TO BELIEVE THAT
BELONG. CALL ITEM NUMBER SEVEN H
A. R FOUR BY MS SZABO. THESE
THAT LIFT THE CALL CALL THE
ABSENT MEMBERS. ARAMBULA BURNER
. WENDY CARILLO FLORA, VINCE
FONG MAIENSCHEIN MCCARTHY
MCCARTHY I, JOE PATTERSON,
RODRIGUEZ SANTIAGO VALLAPUDUA.
YOU PUT WHAT I. THAT'S 60.
THAT'S STILL ON CALL. REMEMBER
EIGHT? MAYBE. 907 BY MR
LOWENTHAL, PLEASE LIFT THE CALL.
CALL THE ABSENT MEMBERS.
ARAMBULA BURNER. WENDY CARILLO
FLORA FENCE. WONG MAIENSCHEIN
MCCARTHY. MCCARTHY I, JOE
PATTERSON. SANTIAGO DE
VALLAPUDUA. VALLAPUDUA. AYE. AT
70 ITEM NUMBER 11, MAYBE 10 48,
PLEASE LIFT THE CALL. CALL THE
ABSENT MEMBERS. WOULD WOULD I
AGUIAR-CURRY AGUIAR-CURRY AYE
ARAMBULA EARNER WENDY CARILLO
FLORA. THAT'S WANG MAIENSCHEIN
MCCARTHY MCCARTHY I, JOE
PATTERSON ON TIAGO WEBER. 60.
ITEM NUMBER 17. WE JUST DID. I
THINK EVERYBODY WAS HERE FOR
THAT. AS WAS NUMBER 18 ITEM
NUMBER 19. SORRY. UM WELL,
YOU'RE NOT HERE FOR 17. OKAY I'M
EXCUSE ME. THEN WE'LL LIFT THE
CALL. CALL THE ABSENT MEMBERS
FOR A B 12 88 BY MS REYES
ARAMBULA BURNER. WENDY CARRILLO
FLORA, VINCE WONG MAIENSCHEIN
MCCARTHY MCCARTHY I, JOE
PATTERSON. SANTIAGO WEBER 60
WILL STILL ON CALL. I REMEMBER
18. MAYBE 14 51. I THINK WE WERE
ALL HERE FOR THAT. ITEM NUMBER
1980 14 70 BY MS QUIRK-SILVA,
PLEASE LIFT THE CALL AND CALL
THE ABSENT MEMBERS. WOULD WOULD
I CURRY CURRY, I ARAMBULA BURNER
. WENDY CARILLO, LAURA BENSON,
FONG MAIENSCHEIN MCCARTHY
MCCARTHY I, JOE PATTERSON.
SANTIAGO WEBER. THAT'S 60. ITEM
NUMBER, 21 A B 15 77 BY MR LOWE
, PLEASE LIFT THE CALL CALLED
THE ABSENT MEMBERS.
ARAMBULA BURNER. WENDY CARILLO
MAIENSCHEIN PATERSON VALLAPUDUA.
AYE, WEBER. THAT IS THAT IS 80.
THAT BILL IS OUT. ITEM NUMBER 22
A B 16 45 BY MR ZUBER, PLEASE
LIFT THE CALL AND CALL THE
ABSENT MEMBERS. ARAMBULA BURNER
. WENDY CARILLO LARA, VINCE FONG
MAIENSCHEIN MCCARTHY MCCARTHY I,
JOE PATTERSON. SANTIAGO WEBER.
FIX ZERO. I DON'T NUMBER 24 A B.
55 BY MR RODRIGUEZ, PLEASE LIFT
THE CALL. CALL THE ABSENT
MEMBERS. HAGAR CURRIE. THANK
YOU. VERY I ARAMBULA BURNER.
WENDY CARILLO FLORA, VINCE FONG
MAIENSCHEIN MCCARTY MCCARTY I.
PATERSON SANTIAGO. THAT'S 70.
AND THEN WE WERE ALL HERE FOR A
B 30 13 31 BY ME. UM SO WE'RE
ABOUT AS CAUGHT UP AS WE COULD
POSSIBLY BE. SO WE'RE JUST GONNA
WAIT. THERE ARE AUTHORS, PLEASE
AUTHORS. YOU HAVE BILLS BEFORE
THE HEALTH COMMITTEE, PLEASE
COME ON DOWN.
THAT'S ORTEGA. YOU HAVE TWO
BILLS BEFORE US. THANK YOU.
WHENEVER YOU'RE READY, ALL RIGHT
. THANK YOU, UM, MR CHAIR FOR
THE OPPORTUNITY TO PRESENT TO
YOU TODAY. A B 10 60. AS AS A
MAMA FOR AND A LEGISLATOR.
FENTANYL CRISIS KEEPS ME UP AT
NIGHT. THE NUMBERS ARE SHOCKING
OVER 150 PEOPLE PER DAY. ARE
DYING IN THE UNITED STATES FROM
OPIOID OVERDOSES, WITH FENTANYL
BEING THE DEADLIEST OVER 6000
PEOPLE IN CALIFORNIA DIED FROM
OVERDOSES IN 2021. EVEN MORE
TROUBLING THAN THAT. IT'S WHAT
IT'S DOING TO OUR KIDS. THAT NO
IS NOW THE LEADING CAUSE OF
FEDERAL FATAL POISONING AMONG
CHILDREN UNDER FIVE. THIS BILL
WILL MAKE NARCAN AVAILABLE TO
ALL CALIFORNIANS BY REQUIRING
PRIVATE INSURERS AND MEDICAL TO
COVER THE TOTAL COST. OVER THE
COUNTER NARCAN. NARCAN IS A
LIFESAVING DRUGS THAT QUICKLY
REVERSES FENTANYL OVERDOSES AND
AS AN EFFECTIVE TOOL IN
PREVENTING DEATHS. NARCAN IS
EXTREMELY EFFECTIVE. IT IS ALSO
EXPENSIVE. POCKET COSTS FOR
NARCAN CAN BE OVER $100,
DEPENDING ON THE DOSAGE. WHICH
IS UNAFFORDABLE TO MOST FAMILIES
WHO CAN BARELY MAKE IT MEAN MAKE
ENDS MEET TODAY. A B 10 60 WILL
ENSURE THAT CALIFORNIANS HAVE
ACCESS TO THIS LIFE SAVING DRUG.
TODAY TESTIFYING AND SUPPORT IS
DR NEIL MERA. WITH THE
CALIFORNIA SOCIETY OF ADDICTION
MEDICINE. AND TESTIFYING AND
SUPPORT IS MARIKA COAL, A MOM
WHO LOST HER SON DUE TO FEDERAL
POISONING. GOOD AFTERNOON
MEMBERS OF THE COMMUNITY. HELLO
I'M DR NEIL, MARYLAND, AND IT'S
HONOR TO SPEAK ON BEHALF OF
CALIFORNIA SOCIETY OF ADDICTION
MEDICINE. I SPECIALIZE IN
ADDICTION MEDICINE. I'M MEDICAL
DIRECTOR OF TWO PROMINENT
NONPROFIT ORGANIZATIONS IN
SACRAMENTO. WE TREAT BOTH
PATIENTS THAT HAVE OPIOID
ADDICTION AS WELL AS PATIENTS
THAT DO NOT HAVE ADDICTION BUT
NEED HELP IN TAKING PRESCRIBED
OPIOIDS MORE SAFELY. WHEN WE
THINK OF OVERDOSE. WE OFTEN
EQUATE THIS WITH PEOPLE WITH
ADDICTION. HOWEVER, IT IS ALSO
EXCEEDINGLY MORE COMMON THAT
PEOPLE WITHOUT ADDICTION ARE
UNKNOWINGLY EXPOSED. HIGH
POTENCY SYNTHETIC OPIOIDS SUCH
AS FENTANYL. AS NOTED IN YOUR
REPORTS BY STANDARDS WERE
PRESENT BUT UNABLE TO PROVIDE
LIFE PROVIDE LIFE SAVING
MEASURES IN APPROXIMATELY 3300
UNNECESSARY DEATHS IN CALIFORNIA
, JUST IN 2021 THAT COULD THAT
COULD HAVE BEEN PREVENTED SIMPLY
BY THE BYSTANDER HAVING ACCESS
TO NARCAN. THIS IS A CRITICAL
REASON WHY EVERYONE NEEDS NARCAN
. WHILE OPIATE ADDICTION IS VERY
PREVALENT NOW IS AN ESPECIALLY
UNPRECEDENTED TIME WHEN PEOPLE
WITHOUT ADDICTION ARE
UNKNOWINGLY AND UNWILLINGLY
EXPOSED THE HIGH POTENCY AND
LETHAL SYNTHETIC OPIOIDS SUCH AS
FENTANYL AND ANALOGS, INCLUDING
CAR FENTANYL. THE FIRST
ILLUSTRATION I'D LIKE TO SHARE
IS WITH CHILDREN AND YOUNG
ADULTS THAT ARE NOT ADDICTED,
BUT MAYBE EXPERIMENTING WITH
DRUGS. YEAH, AND ALCOHOL FOR THE
FIRST TIME. IT IS EXTREMELY EASY
FOR KIDS TO ORDER DRUGS OVER THE
INTERNET AND HAVE THEM DELIVERED
DIRECTLY TO THEM. IN MANY CASES
, THE ILLICIT PILLS AWRY WITH
VARIABLE AMOUNTS OF FENTANYL
THAT IS 100 TIMES MORE POTENT
THAN MORPHINE OR CAR FENTANYL.
THAT IS 10,000 MORE TIMES MORE
POTENT THAN MORPHINE. THIS HAS
LED TO THE PHENOMENA WHERE ONE
PILL CAN KILL. PERHAPS THE VERY
FIRST PILL THEY TRY. THIS IS,
UH, HAVING ANY COST BARRIER TO
NARCAN WOULD DETER AND MAKE IT
EVEN MORE LIKELY THAT PARENTS,
FRIENDS AND OTHERS WOULD NOT
PRIORITIZE OBTAINING IT AND THUS
NOT BE PREPARED IN CASE OF A
FATAL OVERDOSE. A SECOND
INCREASINGLY COMMON EXAMPLE AS A
CONSEQUENCE OF MOST PROVIDERS
BEING FEARFUL OF PRESCRIBING
OPIOIDS, EVEN FOR APPROPRIATE
REASONS. AS A RESULT, MANY
CHRONIC PAIN PATIENTS, INCLUDING
THE ELDERLY AND VETERANS ARE
GETTING ABRUPTLY CUT OFF FROM
THEIR MEDICATIONS AND ARE GOING
THROUGH WITHDRAWAL AND HIGH
LEVELS OF PAIN. MANY OF THESE
PATIENTS DEPEND ON OPIOIDS BUT
ARE NOT NECESSARILY ADDICTED AND
ARE RELUCTANTLY RESORTING TO
BUYING PILLS OFF THE STREETS.
AGAIN MANY OF THESE PEOPLE ARE
KNOWINGLY BUYING FAKE PILLS THAT
CONTAIN LETHAL DOSES OF FENTANYL
. THESE PEOPLE NEED AND DESERVE
PEOPLE AROUND THEM TO HAVE EASY
ACCESS TO NARCAN TO SAVE THEM IN
CASE OF AN OVERDOSE, GREATER
ACCESS TO NARCAN WILL NOT ONLY
SAVE LIVES, BUT IT COULD ALSO
POTENTIALLY REDUCE SOME COSTS OF
EMS RESPONSE AND ER VISITS AS
SOME PEOPLE THAT RECEIVED
NARCAN. DO NOT NEED FURTHER
INTERVENTION. EVERYONE NEEDS AND
EVERYONE NEEDS A LOW BARRIER
ACCESS TO NARCAN AS ANY OF US AT
ANY TIME ENCOUNTER PERSON OF ANY
POSITION IN SOCIETY THAT MAY BE
EXPERIENCING A LETHAL OVERDOSE.
I COULD CONTINUE WITH MY
EXPERIENCE, BUT I WANT TO
ENCOURAGE YOU TO ASK ME
QUESTIONS TO CLARIFY IF THERE'S
ANYTHING I COULD DO TO EXPLAIN
THIS TO TREMENDOUS IMPORTANCE
FOR ENSURING DARKENS AVAILABLE
TO EVERYONE. THANK YOU. THANK
YOU, PLEASE. HELLO MY NAME IS
MERICA COAL, AND I'M HERE TODAY
THEY ASK YOU TO SUPPORT A B 10
60. AND TO SHARE MY STORY TO
ILLUSTRATE WHY IT'S SO IMPORTANT
. MY SON MERRICK WAS 25 YEARS
OLD WHEN WE LOST HIM. HMM HE
LOVES SKATEBOARDING. HE DIDN'T
DRIVE. HE HAD AUTISM, AND HE
DIDN'T REALLY TALK. BUT HE WAS
INCREDIBLY BRIGHT. HE WAS A
POLYGLOT. THAT MEANS HE KNEW
VARIOUS LANGUAGES AND HE COULD
READ AND WRITE RUSSIAN FLUENTLY
. HE COULD SPEAK SPANISH, AND HE
KNEW AMERICAN SIGN LANGUAGE. HE
LOVED PLAYING VIDEO GAMES, LIKE
MOST PEOPLE THAT ARE ON THE
SPECTRUM. WHEN HE WAS PLAYING, I
WOULD HEAR HIM SPEAKING OTHER
LANGUAGES. AND UH, BUT HE
COULDN'T SOCIALIZE VERY WELL AND
HE WAS WAY TOO TRUSTING. SO HE
NEEDED CONSERVATORSHIP, WHICH I
OBTAINED AND I WAS HIS
CONSERVATOR. WHEN A PERSON HAS
AUTISM, THEY JUST WANT TO MEET
FRIENDS. ONE DAY AMERICA ASKED
ME IF HE COULD GO TO HIS
FRIEND'S HOUSE, AND HE ONLY HAD
THREE SO I SAID YES. YOU
PROMISED TO BE BACK WITHIN AN
HOUR BECAUSE HE WAS LOOKING
FORWARD TO ME COMING HIS HAIR,
WHICH WAS RARE. HE HAD
DIFFICULTY WITH HAVING HIS HAIR
COMB BECAUSE HE HAD SENSORY
ISSUES. AND I PROMISE HIM A NEW
PAIR OF NIKE SLIDES, WHICH WERE
SLIPPERS, WHICH HE WAS REALLY
EXCITED ABOUT. WHEN HE CAME HOME
FROM HIS FRIEND'S HOUSE AND I
LEFT TO GO SHOPPING. I WAS GONE
FOR ABOUT 45 MINUTES. WHEN I
CAME BACK AND WENT TO HIS ROOM
TO SHOW HIM HIS SLIPPERS, I
FOUND HIM UNRESPONSIVE. I HAD
BOUGHT TWO DOSES OF NARCAN.
PREVIOUSLY BECAUSE WE HAVE
HOMELESS IN THE AREA. AND I
THOUGHT MAYBE I COULD SAVE A
LIFE JUST IN CASE. SO I HAD
THOSE TWO DOSES OF NARCAN TO
GIVE HIM BUT I ONLY HAD TWO IT
WAS TOO EXPENSIVE. FOR ME TO BUY
AND I WISH I WOULD HAVE BOUGHT
MORE. I TRIED GIVING HIM BOTH
DOSES THAT I HAD, BUT IT WASN'T
ENOUGH. ADMINISTER CPR AND
CALLED 911. THE PARAMEDICS CAME
PRETTY FAST, AND THEY GAVE HIM I
V, WHICH HAD NARCAN IN IT. BUT
IT WASN'T ENOUGH. AN AUTOPSY
LATER FOUND THAT HE HAD BEEN AND
CAR PANEL IN HIS SYSTEM. AND
THAT'S WHY THE DOSES IT DOSAGES
WERE EURO HE WAS AMONG THE FIRST
OVERDOSE IN THIS AREA IN THIS
REGION INVOLVING CAR PHENOMENAL.
SO THE PARAMEDICS HAD NO IDEA
WHY HE WASN'T RESPONDING. SINCE
THEN, I'VE DONE A LOT OF
RESEARCH AND LEARN THAT NARCAN
CAN SAVE LIVES. AND AT THE RIGHT
DOSAGE AND AT THE RIGHT TIME. IF
IT HAD BEEN MORE AFFORDABLE, I
WOULD HAVE HAD MORE BECAUSE I'M
ABOUT TRYING TO SAVE SOMEONE'S
LIFE. WHEN I STARTED STUDYING
ABOUT THIS AND, UM. IF IT HAD
BEEN MORE AFFORDABLE. I
DEFINITELY WOULD HAVE BOUGHT
MORE. DEFINITELY WE NEED NARCAN
TO BE MADE AFFORDABLE AND
AVAILABLE TO EVERYONE. NOT JUST
IN SCHOOLS AND OTHER PUBLIC
PLACES, BUT TO EVERYONE SO
PEOPLE CAN CARRY IT AROUND AND
BE READY. WE NEED NARCAN TO BE,
UM WELL, WE KNOW THAT PANEL IS A
POISON, AND IT WILL KILL WE NEED
TO PROVIDE PARENTS, CAREGIVERS
AND NEIGHBORS. THIS TOOL SO THAT
WE CAN SAVE LIVES. I ASKED THE
COMMITTEE TO PLEASE VOTE YES, ON
A B 10 60. AND HELP SAVE MORE
LIVES. IT WOULD DEFINITELY HAVE
SAVED MY SON'S LIFE. THANK YOU.
OTHERS IN SUPPORT. GOOD
AFTERNOON. JUSTIN ROUSER OFFICE
OF ATTORNEY GENERAL BANTA IN
SUPPORT. THANK YOU. THANK YOU.
GOOD AFTERNOON. MARIE LOPEZ,
CALIFORNIA NURSES ASSOCIATION IN
SUPPORT. KELLY BROOKS ON BEHALF
OF THE COUNTY HEALTH EXECUTIVES
ASSOCIATION OF CALIFORNIA HERE
IN SUPPORT. VANDERPOOL WESTERN
CENTER ON LAW AND POVERTY AND
SUPPORT. THANK YOU. CARLY MYERS
ON BEHALF OF THE NATIONAL HEALTH
PROGRAM AND SUPPORT THANK YOU.
LISA GARDNER WITH THE COUNTY
BEHAVIORAL HEALTH DIRECTORS
ASSOCIATION AND SUPPORT THANK
YOU. TASHA HEDEMAN PRC, A
BEHAVIORAL HEALTH ORGANIZATION
IN SAN FRANCISCO AND SUPPORT
THANK YOU. IS THERE OPPOSITION
TO THE BILL? SEE, NONE WILL
BRING IT BACK TO THE COMMITTEE
FOR QUESTIONS OR COMMENTS ANY
QUESTIONS OR COMMENTS A DOCTOR
ARAMBULA. I WANT TO THANK THE
ASSEMBLY MEMBER FOR BRINGING
THIS BILL FORWARD AND FROM
ERIC'S MOM FOR TESTIFYING HERE
TODAY BY INCREASING ACCESS TO
NARCAN, WE HAVE A GREATER CHANCE
OF SAVING LIVES AND APPRECIATE
THE BILL AND LOOK FORWARD TO
SUPPORTING. THANK YOU, DOCTOR,
ARAMBULA AND ANYONE ELSE? DR
WECHT. DR WEBBER. THANK YOU SO
MUCH. UM HOW? HOW DO YOU
ENVISION THIS BILL ACTUALLY
BEING IMPLEMENTED? SO IF IT'S
OVER THE COUNTER UM. HOW HOW
WOULD PATIENTS NOT HAVE TO
INITIALLY COME OUT OF THEIR
POCKET TO GET IT ACTUALLY
COVERED BY THEIR INSURANCE. YEAH
WE JUST HAVE RECEIVED THE REPORT
FROM THE CALIFORNIA BENEFITS
HEALTH REVIEW PROGRAM, AND THAT
WAS ONE OF THE THINGS THEY
BROUGHT UP. YOU KNOW, THERE'S
SUGGESTED THAT PEOPLE WOULD
INITIALLY MIGHT BE ABLE TO.
WE'LL HAVE TO PAY OUT OF POCKET
AND THEN SEND IN THE
REIMBURSEMENTS RECEIPTS. SO IT'S
SOMETHING THAT I'M GONNA WORK
ON. AS WE MOVE THIS BILL FORWARD
TO MAKE SURE THAT YOU KNOW,
THERE'S A WAY TO MAKE SURE THAT
EVERYONE GETS IT AND IT'S FREE
AND THERE'S NO OTHER BARRIERS
THAT GET IN THE WAY OF MAKING
SURE THAT THEY CAN GET IT. THANK
YOU. THANK YOU. ANYONE ELSE? UM
YOUR BILL HAS EMOTION BY MS
WALDRON, SECOND BY DR ARAMBULA
ENJOYS A Dð PAST RECOMMENDATION
IS, UH, DO PASS TO
APPROPRIATIONS. MR. TAKE IT.
WOULD YOU LIKE TO CLOSE? YES
THANK YOU. COMMITTEE MEMBERS AND
CHAIR FOR ALLOWING ME TO PRESENT
A B 10 60 WHILE I RECOGNIZE THAT
THIS COMMITTEE IS ABOUT POLICY,
I DO WANT TO MENTION THAT THE
BILL. THE COST OF THIS BILL IS
ABOUT $9 MILLION. I JUST
RECEIVED THE REPORT. AND I
STARTED TO DO THE MATH. AND
ACCORDING TO THE CALIFORNIA
BENEFITS HEALTH REVIEW PROGRAM,
AN ESTIMATED 78,000 PEOPLE WILL
OBTAIN ARKAN UNDER THIS BILL. IF
WE ASSUME THE SAME RATE OF USAGE
AS A STATE NON PROFIT
DISTRIBUTION PROGRAM THIS BILL
WILL REVERSE ABOUT 5000
OVERDOSES. THAT'S FIVE THOUSANDS
LIVE STATES IF I DO MORE MATH
THAT'S $1800 PER LIFE SAVED. DO
WE GET TO SAVE 5000 LIVES A DAY
FOR $1800. NOT REALLY RIGHT NOW.
THE AVERAGE COST OF A VISIT TO
THE CALIFORNIA ER IS $2900. SO
THIS BILL. WHAT COSTS FAR LESS
SAVED THOUSANDS OF CALIFORNIA'S
FROM POISONING FENTANYL
POISONING. AND MORE IMPORTANTLY
, SAVE MANY MORE LIVES. THANK
YOU. I RESPECTFULLY ASK FOR YOUR
EYEBALL. THANK YOU VERY MUCH.
ASSEMBLYMEMBER'S THE MOTION IS
DUE PAST YOU, APPROPRIATIONS.
MADAM SECRETARY. PLEASE CALL THE
ROLL. WOULD I WOULD I? WALDRON
WALDRON. NIAGARA CURRY.
AGUIAR-CURRY. AYE, ARAMBULA.
ARAMBULA. AYE BURNER. WENDY
CARILLO. WHEN THEY CREOLE I
FLORA. PHªN MAIENSCHEIN MCCARTY.
MCCARTHY I, JOE PATTERSON.
RODRIGUEZ. SANTIAGO. VALLAPUDUA
YOU PUT WHAT I WEBER. WEBER.
AYE. YOUR BILL HAS EIGHT VOTES.
IT'S OUT OF COMMITTEE. THANK YOU
. THANK YOU. AND YOU HAVE ONE
MORE, BILL. YES, I DO. A B 11
57. THANK YOU, MA'AM CHAIR
MEMBERS FOR THE OPPORTUNITY TO
PRESENT A B 11 57 BEFORE YOU ALL
TODAY. THIS BILL WOULD CLARIFY
THAT DURABLE MEDICAL EQUIPMENT
OR D M E S, D. M E S ARE COVERED
ESSENTIAL HEALTH BENEFITS AND
INDIVIDUAL AND SMALL GROUP
HEALTH PLANS WHEN MEDICALLY
NECESSARY AND PRESCRIBED BY
HEALTH CARE PROVIDER. DURABLE
MEDICAL EQUIPMENT, SUCH AS
WHEELCHAIRS AND VENTILATORS
ENABLES INDIVIDUALS BASIC
FUNCTIONING, SUCH AS MOBILITY,
BREATHING AND COMMUNICATION AS
IT'S PRIMARILY USED BY PEOPLE
WITH DISABILITIES AND CHRONIC
CONDITIONS. YET PRIVATE HEALTH
PLANS IN CALIFORNIA GENERALLY DO
NOT PROVIDE ADEQUATE COVERAGE OF
DME. MANY HEALTH PLANS
COMPLETELY EXCLUDE MOST DME
ITEMS LIKE WE ALL CHAIRS,
HEARING NIGHTS AND VENTILATORS.
OTHER PLANTS IMPOSED $2000
ANNUAL DOT ANNUAL LIMITS ON DME
ITEMS, WHICH ONLY COVERS A
FRACTION OF COSTS OF MOST YEMI.
A B 11 57 PROVIDES A SOLUTION
THAT WILL HELP ENSURE THAT ALL
CALIFORNIANS HAVE ACCESS TO
DURABLE MEDICAL EQUIPMENT THEY
NEED TO FULFILL TO LIVE,
FULFILLING LIVES. TODAY. I HAVE
WITH ME. CARL CARLY MYERS, STAFF
ATTORNEY AT THE NATIONAL HEALTH
LAW PROGRAM, AND JIM LEVERAGE A
LONGTIME BOARD MEMBER OF THE
DISABILITY RIGHTS, EDUCATION AND
DEFENSE FUND AND FOUNDER OF TWO
ORGANIZATIONS ADVOCATING FOR
GREATER INCLUSION OF PEOPLE WITH
DISABILITIES. THANK YOU. UM,
GOOD AFTERNOON. MY NAME IS CARLY
MYERS AND WITH THE NATIONAL
HEALTH LAW PROGRAM, A NONPROFIT
PUBLIC INTEREST LAW FIRM THAT
PROTECTS AND ADVANCES THE
HEALTHCARE RIGHTS OF LOW INCOME
INDIVIDUALS AND FAMILIES. WE
STRONGLY SUPPORT A B 11 57 AND
BELIEVE IT WILL PLAY A VITAL
ROLE IN IMPROVING ACCESS TO THE
HEALTHCARE DEVICES THAT PEOPLE
WITH DISABILITIES NEED TO LEAVE
THEIR HOMES. MAINTAIN THEIR
HEALTH AND PARTICIPATE FULLY IN
COMMUNITY LIFE. CURRENTLY MANY
CALIFORNIANS DO NOT HAVE ACCESS
TO THE WHEELCHAIRS, HEARING AIDS
VENTILATORS AND OTHER DURABLE
MEDICAL EQUIPMENT OR DME THAT
THEY NEED. PRIVATE HEALTH PLANS
OFFERED IN CALIFORNIA'S
INDIVIDUAL AND SMALL GROUP
MARKETS REGULARLY EXCLUDE OR
SEVERELY LIMIT COVERAGE OF THIS
EQUIPMENT. WITHOUT ADEQUATE
COVERAGE. MANY PEOPLE GO WITHOUT
MEDICALLY NECESSARY DEVICES THEY
OBTAIN INFERIOR ONES THAT CAN
PUT THEIR HEALTH AND SAFETY AT
RISK, OR THEY TURN TO PUBLICLY
FUNDED PROGRAMS SUCH AS MEDICARE
AND MEDICAID, CAL, WHICH DO
COVER DME FOR HELP. THIS GAP IN
PRIVATE HEALTH INSURANCE OCCURS
DESPITE THE AFFORDABLE CARE
ACT'S CLEAR MANDATE. OTHERWISE
THEY SEE A REQUIRES PLANS TO
COVER CERTAIN ESSENTIAL HEALTH
BENEFITS, OR E H B, INCLUDING
REHABILITATIVE AND DEBILITATED
DEVICES. STATES HAVE SOME
FLEXIBILITY IN DEFINING THE
CONTENT OF THE HBS, HOWEVER,
PURSUANT TO FEDERAL LAW, THE
DESIGN OF THE BENEFIT PACKAGE
MUST NOT DISCRIMINATE ON THE
BASIS OF DISABILITY OR HEALTH
STATUS. DEVICES WHICH ARE
ESSENTIAL FOR THE BASIC
FUNCTIONS SUCH AS MOBILITY,
BREATHING AND COMMUNICATION ARE
PRIMARILY USED BY PEOPLE WITH
DISABILITIES. WHEN DME IS
EXCLUDED OR SEVERELY LIMITED
FROM HEALTH PLAN COVERAGE. IT
CREATES AN ACCESS BARRIER FOR
THE ADULTS AND CHILDREN WHO RELY
ON THIS EQUIPMENT BUT WHO CANNOT
AFFORD IT OUT OF POCKET. FURTHER
HOME USE RULES, WHICH LIMIT
COVERAGE TO ONLY THE DEVICES
THAT AN INDIVIDUAL NEEDS INSIDE
THEIR HOME TO THE EXCLUSION OF
DEVICES. THEY MAY NEED TO TRAVEL
. EVEN 10 FT. OUTSIDE SERVED A
FURTHER SEGREGATE AND ISOLATE
PEOPLE FROM THEIR COMMUNITIES.
THIS BILL WILL HELP ADDRESS THIS
INEQUITY. A B 11 57 CLARIFIES
THAT MEDICALLY NECESSARY DMI IS
COVERED ESSENTIAL HEALTH
BENEFITS IN THE STATE OF
CALIFORNIA, AND IT WILL STOP THE
DISCRIMINATORY EXCLUSIONS AND
LIMITATIONS THAT PEOPLE WITH
DISABILITIES HAVE ENDURED FOR
DECADES. WITH GREATER ACCESS TO
DEMI MOORE. CALIFORNIANS WILL
HAVE THE TOOLS THAT THEY NEED TO
PURSUE EDUCATION AND EMPLOYMENT
TO TAKE CARE OF THEIR FAMILIES
AND TO DO WHATEVER ELSE A PERSON
MAY NEED OR WANT TO DO. 13 YEARS
AFTER THE PASSAGE OF THE
AFFORDABLE CARE ACT, IT IS NO
LONGER ACCEPTABLE. THE HEALTH
PLANS CONTINUE TO EXCLUDE
DEVICES AS FOUNDATIONAL AS A
WHEELCHAIR. CALIFORNIA NOW HAS
THE OPPORTUNITY TO CORRECT THIS
INJUSTICE. AND WE URGE YOU TO
TAKE IT. THANK YOU. THANK YOU.
HI. MY NAME IS JIM LEBRECHT. I'M
GRATEFUL FOR THIS OPPORTUNITY TO
SPEAK TO YOU TODAY AND
SUPPORTIVE A B 11 57. I'D LIKE
TO SHARE MY LIVED EXPERIENCE
WHAT IT'S LIKE AND WHAT IT MEANS
TO ME TO LIVE WITH THE CURRENT
DOLLAR CAPS AND HOME USE LIMITS
OF DMI COVERAGE UNDER PRIVATE
INSURANCE COVERAGE. I'VE BEEN
USING A WHEELCHAIR USING A
WHEELCHAIR HAS BEEN PART OF MY
LIFE SINCE I WAS TWO YEARS OLD.
I WAS BORN UNABLE TO WALK
BECAUSE IT'S BEEN A DIFFICULT
WHEN I FIRST UNDERSTOOD THAT MY
INSURANCE WOULD ONLY PAY FOR DME
COVERAGE FOR ITEMS USED IN THE
HOME. I WAS OUTRAGED. THAT THIS
WAS THE LAW TOLD ME ALL I NEEDED
TO KNOW ABOUT HOW MOST OF
SOCIETY AND MANY ELECTED
OFFICIALS THOUGHT OF ME AND THE
DISABLED COMMUNITY. WHY WOULDN'T
THEY PAY FOR A WHEELCHAIR THAT
WOULD ALLOW ME TO TRAVEL AWAY
FROM MY HOME? WHY WASN'T IT
CONSIDERED NECESSARY FOR PEOPLE
LIKE ME HAVE ACCESS TO THE WORLD
AROUND US. FRESH AIR. SUNNY
DAYS. VISITING FAMILY AND GOING
TO WORK. IT WAS ABOUT PAINFULLY
LOW EXPECTATIONS FOR US. THE
MESSAGE I TOOK FROM THIS WAS
THAT SOCIETY AND THE LAW ONLY
THOUGHT OF THE DISABLED AS SICK
PEOPLE WHO ARE ONLY ABLE TO LIVE
AT HOME AND NOT HOLD JOBS. WE
WERE INSIGNIFICANT. DISPOSABLE.
AND NOT VALUED AS HUMAN BEINGS,
LIKE OTHERS. I WISH I WAS BEING
MELODRAMATIC HERE, BUT I'M NOT.
I MEAN, WHAT WOULD YOU ASSUME IT
WAS UNTHINKABLE. WAS IT
UNTHINKABLE THAT THEY MIGHT BE
ABLE TO CONTRIBUTE TO SOCIETY IN
A MEANINGFUL WAY THAT I COULD
START A SMALL BUSINESS AND
EMPLOY PEOPLE IN MEANINGFUL
CREATIVE JOBS? THE REALITY IS
THAT I DID START AN AUDIO
COMPANY AND HIRED SEVERAL
EMPLOYEES IN MY COMPANY PAID
TAXES AND PROVIDED AN AFFORDABLE
AND NEEDED SERVICE TO THE LOCAL
FILM INDUSTRY. AND WHEN THE
OPPORTUNITY AROSE, I'M DOZENS OF
PEOPLE WERE EMPLOYED OVER. FIVE
AND WE PAID FOR SERVICES FROM AT
LEAST A DOZEN COMPANIES. I DON'T
LIKE ACQUITTING SOMEONE'S VALUE
TO ECONOMICS. BUT I AM TELLING
YOU THAT THE BENEFITS OF THIS
BILL FAR OUTWEIGH THE CAUSE. AND
I DON'T FEEL AS THOUGH I NEED A
SPREADSHEET. BACK UP THIS
RESEARCH IN ON A MORE BASIC
LEVEL WHEN WE ALLOW SENIORS OR
THE DISABLED TO FULLY
PARTICIPATE IN DAILY LIVING,
EVERYONE BENEFITS IT'S NOT A ONE
WAY STREET. GRANDPARENTS CAN BE
ABBAS IT CHILDREN AFTER SCHOOL,
SO A SINGLE PARENT CAN HOLD DOWN
A FULL TIME JOB. THIS IS JUST
ONE EXAMPLE. I COULD TELL YOU
ABOUT. THIS BILL ISN'T CHARITY
OR SOMETHING NICE TO DO FOR THE
LESS FORTUNATE. IT'S ABOUT
CORRECTING A POLICY THAT
DEVALUES US. IT'S ABOUT ALLOWING
US THE SAME FREEDOMS THAT
EVERYONE ELSE TAKES FOR GRANTED.
THIS IS ABOUT HUMAN RIGHTS. THIS
BILL. ANYONE WILLING TO SAY THAT
IT'S TOO EXPENSIVE. I DON'T
BELIEVE REALLY BELIEVES IN
FREEDOM FOR ALL ALL OF US WANT
TO HAVE A FULL LIFE A LIFE AT
ONCE CHOOSING BUT WHEN YOU CAN'T
AFFORD THE CENTRAL ITEMS THAT
THE CURRENT REGULATIONS STATE OR
NOT ESSENTIAL HEALTH BENEFITS,
YOU'RE KEEPING US SHUT AWAY IN
OUR HOMES. OUT OF SIGHT. IT
MAKES ME WONDER IF THAT MIGHT
HAVE BEEN THE INTENT ALL ALONG.
THANK YOU. THANK YOU. OTHERS IN
SUPPORT.
GOOD AFTERNOON. MY NAME IS DAN O
CANVAS, REPRESENTING THE
CALIFORNIA FOUNDATION OF
INDEPENDENT LIVING CENTERS HERE
IN SUPPORT. THANK YOU. THANK
YOU. K¾T ABANDONS WITH HEALTH
ACCESS CALIFORNIA AND SUPPORT.
THANK YOU. THANK YOU. MATT LEWIS
AND PAT ON BEHALF OF STU,
CALIFORNIA AND SUPPORT THANK
YOU. JOHAN CARDONA'S WITH THE
CALIFORNIA PAN ETHNIC HEALTH
NETWORK AND SUPPORT THANK YOU.
GOOD EVENING, ALEX CON ON BEHALF
OF THE ALS ASSOCIATION AND
SUPPORT THANK YOU. SANDRA PULL
WESTERN CENTER ON LAW AND
POVERTY WHERE CO SPONSOR OF THIS
BILL, AND IN STRONG SUPPORT.
THANK YOU. STUART FERRY WITH THE
NATIONAL MULTIPLE SCLEROSIS
SOCIETY IN SUPPORT. A BUTLER ON
BEHALF OF THE CALIFORNIA
ASSOCIATION, MEDICAL PRODUCTS,
SUPPLIERS AND SUPPORT THANK YOU.
NEW ORLEANS WITH CHILDREN NOW IN
SUPPORT. THANK YOU. IS THERE ANY
OPPOSITION TO THE BILL? SEE NONE
WILL BRING IT BACK TO THE
COMMITTEE FOR QUESTIONS OR
COMMENTS ANY QUESTIONS OR
COMMENTS. MOTION BY MISS AGUILAR
CURRY. SECOND BY MR V.
VALLAPUDUA. UM WOULD YOU LIKE TO
CLOSE? THANK YOU FOR ALLOWING ME
TO PRESENT TODAY'S BILL AND
RESPECTFULLY ASK FOR YOUR VOTE.
THAT'S WHY I SAY THANK YOU FOR
BRINGING THE BILL FORWARD. IT
DOES ENJOY DO PASS
RECOMMENDATION. THANK YOU TO
YOUR WITNESSES VERY MUCH
APPRECIATE TESTIMONY. THE MOTION
IS DO PASS THROUGH
APPROPRIATIONS. MADAM SECRETARY
. PLEASE CALL THE ROLL. WOULD
WOULD I? WALDRON WALDRON II
AGUIAR-CURRY AGUIAR-CURRY? AYE,
ARAMBULA. EARNER. WENDY CARILLO.
WENDY CARILLO I FLORA. IT'S
FONG. MAIENSCHEIN MCCARTHY.
MCCARTHY I PATERSON RODRIGUEZ.
SANTIAGO. VALLAPUDUA BUT WHAT I
WEBER HOWEVER, I. YOU HAVE SEVEN
VOTES WILL LEAVE THAT BILL ON
CALL. THANK YOU. THANK YOU.
THANK YOU. THANK YOU. AND THIS,
PONTA.
OKAY WHAT IT WOULD BE 9 21.
THANK YOU. CHAIR AND MEMBERS
GOOD EARLY EVENING. A B 9 21
REQUIRES THE DEPARTMENT OF
HEALTH CARE ACCESS AND
INFORMATION OR H CHI TO
ESTABLISH THE BEHAVIORAL HEALTH
COMMUNITY BASED ORGANIZATION
MENTORSHIP PROGRAM CONNECTING
STUDENTS WITH CBOS AND PROVIDING
THEM WITH RESOURCES OR
EXPERIENCE IN A PATHWAY TO
SUSTAINED EMPLOYMENT AS A
BEHAVIORAL HEALTH PROFESSIONAL.
OUR BEHAVIORAL HEALTH CRISIS IS
REAL AND FELT IN HOMES,
CLASSROOMS ON THE STREETS AND IN
OUR COMMUNITY THROUGHOUT THE
STATE. ACCORDING TO THE WORKING
PAPER, CALIFORNIA'S CHILDREN AND
YOUTH BEHAVIORAL HEALTH
ECOSYSTEM COMMISSIONED BY CAL
HHS MENTAL HEALTH IS THE NUMBER
ONE REASON CHILDREN 0 TO 14 17
ARE HOSPITALIZED. 58% OF
ADOLESCENTS WITH FAMILY INCOMES
BELOW THE POVERTY LINE REPORTED
MODERATE TO SEVERE PSYCHOLOGICAL
DISTRESS DISPARITIES EXISTING
ACROSS COMMUNITIES AND COVID 19
HAS WORSENED WHAT WAS ALREADY A
CRISIS. SUBSTANCE USE AND ABUSE
BY YOUTH AND THEIR FAMILY
MEMBERS ROSE SIGNIFICANTLY
THROUGH 2020 AND INCIDENTS OF
DOMESTIC VIOLENCE HAVE INCREASED
DRAMATICALLY. THE WORKING PEOPLE
ALSO FOUND THE NEED FOR A
LARGER, CULTURALLY COMPETENT AND
HUNGRY AND BEHAVIORAL HEALTH
WORKFORCE SO THAT CHILD CHILD
SERVING ORGANIZATIONS HAVE THE
CAPACITY TO DELIVER ON
CULTURALLY RESPONSIVE COMMUNITY
INFORMED AND DESIGNED,
SUPPORTIVE SERVICES. ADDRESSING
THE BEHAVIORAL HEALTH CRISIS
REQUIRES US TO BUILD A ROBUST
PIPELINE OF BEHAVIORAL HEALTH
PROVIDERS THAT ARE CULTURALLY
CONNECTED AND REPRESENTATIVE OF
HIGH NEED COMMUNITIES. 80 21
MEETS THIS MOMENT WITH THE
BEHAVIORAL HEALTH CBO MENTORSHIP
PROGRAM, FURTHER BUILDING THE
WORKFORCE PIPELINE WITH
MENTORSHIP THROUGH CBOS AND
EMPOWERING OUR PEOPLE TO HEAL
OUR COMMUNITIES. THIS BILL
REALLY CAME OUT OF A WORK GROUP
THAT WORKED TOGETHER OVER THE
COURSE OF A YEAR. OF FRONTLINE
FOLKS WHO ARE HEALTHCARE
PROVIDERS, BEHAVIORAL
SPECIALISTS WHO ARE SEEING, UM
THE LACK OF BEING ABLE TO
PROVIDE THE KIND OF PIPELINE
THAT WE NEED AND CAME UP WITH A
VERY CREATIVE SOLUTION THAT
WOULD ENGAGE THE CBOS THAT WE
ARE ENTIRELY RELIANT ON. UH TO
BE ABLE TO PROVIDE THE LEVEL OF
SERVICE THAT WE NEED AND CARE
THAT WE NEED DURING THIS MENTAL
HEALTH CRISIS WITH ME TODAY AND
SUPPORT I HAVE MATTHEW MEDIAS L.
C S W, EXECUTIVE DIRECTOR OF
BEHAVIORAL HEALTH COLLABORATIVE
OF ALAMEDA COUNTY. AND ADRIAN
SHELTON, DIRECTOR OF PUBLIC
POLICY AND STRATEGY AT THE
CALIFORNIA ALLIANCE OF CHILDREN
AND FAMILY SERVICES. PLEASE GO
AHEAD. THANK YOU. THANK YOU FOR
THE OPPORTUNITY TO SPEAK ON
BEHALF OF THIS BILL. I'M THE
EXECUTIVE DIRECTOR OF THE
BEHAVIORAL HEALTH COLLABORATIVE
OF ALAMEDA COUNTY OR ASSOCIATION
INCLUDES OVER 40 NONPROFIT
MENTAL HEALTH AND SUBSTANCE USE
TREATMENT PROVIDERS SERVING TENS
OF THOUSANDS OF THE MOST
VULNERABLE CHILDREN, ADULTS AND
SENIORS EVERY YEAR. WE SPONSORED
THIS BILL BECAUSE WE FEEL WE
NEED ONE COMPREHENSIVE AND
SUSTAINABLE SYSTEM THAT CONNECT
UNDERGRADUATE STUDENTS PURSUING
BEHAVIORAL HEALTH EDUCATION WITH
PERMANENT EMPLOYMENT. WE ARE
FACING AN EXTRAORDINARY INCREASE
IN DEMAND FOR BEHAVIORAL HEALTH
SERVICES. AT THE SAME TIME THAT
WE FACE A WORKFORCE CRISIS. WE
HAVE AN EXTREME SHORTAGE OF
BILINGUAL AND BICULTURAL STAFF.
AND WE NEED A SYSTEM TO BRING
PEOPLE OF COLOR TO COMMUNITY
MENTAL HEALTH. THIS BILL WILL
CONNECT STUDENTS WITH COMMUNITY
BASED ORGANIZATIONS PROVIDE THEM
WITH MENTORING AND SUPPORT
THROUGHOUT THEIR SCHOOL PROGRAM
AND OFFER ENHANCED STIPENDS FOR
BILINGUAL STUDENTS. CBOS WILL
GUARANTEE THE STUDENT MENTEE
EMPLOYMENT AND THE STUDENT WILL
COMMIT TO TWO YEARS OF CBO
EMPLOYMENT FOLLOWING GRADUATION.
THIS BILL IS AN ESSENTIAL
INVESTMENT THAT WILL RAPIDLY
EXPAND THE TOTAL CBO WORKFORCE.
INCREASE THE NUMBER OF BILINGUAL
AND BICULTURAL STAFF. AND
INCREASE THE EARNING POWER AND
SKILLS OF THE MENTEES. THEREBY
INCREASING CBOS CAPACITY TO
SERVE MORE PEOPLE AND IMPROVE
THE WELL BEING OF THE CALIFORNIA
RESIDENTS. THANK YOU FOR YOUR
CONSIDERATION OF THIS BILL. I
HOPE YOU WILL SUPPORT IT. PLEASE
GO AHEAD AFTERNOON CHAIR AND
MEMBERS ADRIAN SHELTON WITH THE
CALIFORNIA ALLIANCE OF CHILD AND
FAMILY SERVICES, AND WE, TOO,
ARE PROUD TO SUPPORT A B 9 21
TODAY. WE REPRESENT 160
NONPROFIT, COMMUNITY BASED
ORGANIZATIONS THROUGHOUT
CALIFORNIA SERVING VULNERABLE
YOUTH AND FAMILIES. SOME OF
THESE SERVICES INCLUDE FOSTER
YOUTH BEHAVIORAL HEALTH, HOUSING
, ANOTHER SCHOOL BASED SERVICES
AND SUPPORTS AND OUR PROVIDERS
ARE CURRENTLY DEALING WITH
STAFFING SHORTAGES ACROSS ALL
LEVELS OF PROVIDERS. AT THE SAME
TIME, THERE'S A HIGH DEMAND IN
COMMUNITY. UM, FOR THOSE WHO
NEED MENTAL HEALTH SUPPORT MORE
THAN EVER, ESPECIALLY AMONG OUR
YOUNG PEOPLE. AND NONPROFIT,
COMMUNITY BASED ORGANIZATIONS
ARE OFTEN THE BACKBONE OF
SERVICE DELIVERY IN CALIFORNIA.
UM AND THIS WORKFORCE CRISIS IS
REAL. SO THIS PROGRAM REALLY HAS
THE POTENTIAL TO HELP WITH THE
RECRUITMENT AND RETENTION OF
PEOPLE OF COLOR AND ALSO
BILINGUAL STAFF IN PARTICULAR,
SO WE FEEL THAT A B 9 21 REALLY
FILLS A CRITICAL GAP. SO WE ASK
FOR YOUR SUPPORT TODAY. THANK
YOU. THANK YOU. OTHERS IN
SUPPORT. REBECA GONZALEZ
NATIONAL ASSOCIATION OF SOCIAL
WORKERS CALIFORNIA CHAPTER AND
SUPPORT. NICOLE WARD ULLMAN ON
BEHALF OF THE CHILDREN'S
PARTNERSHIP AND SUPPORT. THANK
YOU. TAYLOR JACKSON WITH THE
CALIFORNIA PRIMARY CARE
ASSOCIATION AND SUPPORT. TASHA
HANNEMANN ON BEHALF OF PRC AND
SUPPORT. THANK YOU. IS THERE ANY
OPPOSITION TO THE BILL? SEE NONE
WILL BRING IT BACK TO THE
COMMITTEE FOR QUESTIONS OR
COMMENTS MOTION BY MS
AGUIAR-CURRY SECOND BY MR V.
VALLAPUDUA OCEANS DO PASS
THROUGH APPROPRIATIONS AND
QUESTIONS OR COMMENTS. JUST MAKE
IT QUICK COMMENT. THANK YOU SO
MUCH FOR BRINGING THIS FORWARD
EVERY SINGLE TIME WE TALK ABOUT
BEHAVIORAL HEALTH WE'RE TALKING
ABOUT WHERE'S OUR WORKFORCE? AND
THIS IS A GREAT BILL TO KIND OF
GET US JUMP START, BUT WE NEED
TO DO MORE. THIS IS JUST THE I'M
SURE ONE OF MANY STEPS THAT
YOU'RE GOING TO PLAN ON. SOME
REMEMBER BONDED, BUT IT'S A
GREAT BILL. I'M HAPPY TO SUPPORT
IT TODAY. ANYONE ELSE? MR. V
VALLAPUDUA WITH MY COLLEAGUE TO
IF YOU CAN ALSO ADD ME AS A CO
AUTHOR. YEAH YOU'RE GATHERING
FRIENDS HERE. OKAY ALL RIGHT.
THANK YOU VERY MUCH. WOULD YOU
LIKE TO CLOSE MISS PRONTO? THANK
YOU. I KNOW IT'S BEEN A LONG DAY
FOR YOU. AND YOU HAVE MANY MORE
BILLS TO HEAR. SO I RESPECTFULLY
REQUEST YOUR I VOTE. THANK YOU
VERY MUCH. THE MOTION IS DO PASS
THROUGH APPROPRIATIONS. MADAM
SECRETARY, PLEASE CALL THE ROLL.
I WOULD I, WALDRON WALDRON, I
AGUIAR-CURRY AGUIAR-CURRY AYE
ARAMBULA EARNER. WENDY CARILLO,
WENDY CARILLO I FLORA. SPHANG
MAIENSCHEIN MCCARTHY MCCARTHY I.
PATERSON RODRIGUEZ. SANTIAGO DE
VALLAPUDUA PUT WHAT I WEBER
HOWEVER, I. YOU HAVE SEVEN VOTES
WILL BE LEAVE THAT BILL ON CALL.
THANK YOU.
PLEASE GO AHEAD WHENEVER YOU'RE
READY. THANK YOU. I'M PRESENTING
A B 16 44 MEDICALLY SUPPORTIVE
FOOD AND NUTRITION. I WANT TO
START BY THINKING THE CHAIR AND
COMMITTEE WERE WORKING SO
DILIGENTLY WITH SUCH CARE ON
THIS ON THIS BILL, AND I WANT TO
ACCEPT THE COMMITTEE AMENDMENTS
A B 16 44 WOULD MAKE MEDICALLY
SUPPORTIVE FOOD AND NUTRITION
INTERVENTIONS, A COVERED BENEFIT
TO ALL MEDICAL RECIPIENTS WHEN
DEEMED MEDICALLY NECESSARY. BY
THEIR HEALTH PROVIDER. WITH THE
AMENDMENTS, THE DEPARTMENT OF
HEALTH CARE SERVICES WOULD FORM
A COMMITTEE ON OR BEFORE JULY.
1ST 2025 ISSUE FINAL GUIDANCE BY
JULY 1ST 2026 FOR THE
IMPLEMENTATION OF THESE
INTERVENTION SERVICES, OUR
WITNESSES TODAY, GIVING
TESTIMONY INCLUDE INCLUDE GINA
MORON, JOHN MD. MPH AND FORMER
PRODUCE. PRESCRIPTION PROJECT
PATIENT, ROSALINA MICHAEL. THE
LIBERATION, BUT THANK YOU. IN
ADDITION, WE HAVE K¾T EDMUND,
THE FOOD AND AGRICULTURAL POLICY
MANAGER WITH SPUR TO ANSWER ANY
QUESTIONS. HELLO CHAIR AND
MEMBERS OF THE COMMITTEE. GOOD
AFTERNOON. MY NAME IS GINA
MARENO. JOHN I'M A PRIMARY CARE
DOCTOR AND PROFESSOR OF MEDICINE
AT UCSF. I'VE BEEN A PHYSICIAN
FOR 24 YEARS, SEEING PATIENTS
TEACHING RESIDENTS DOING
RESEARCH, AND NOW I'M THE
MEDICAL DIRECTOR OF OUR FOOD
PHARMACY. SO I'M HERE TODAY ON
BEHALF OF PATIENTS WHO DO NOT
ALWAYS HAVE FOOD TO EAT. OR
ENOUGH NUTRITIOUS FOOD TO STAY
HEALTHY. SO IN MY CLINIC, WE
FOUND OUT THAT ONE OUT OF FOUR
PATIENTS DOESN'T ALWAYS HAVE
FOOD TO EAT. OF COURSE, FOOD IS
PRIMAL. YOU CAN'T LIVE WITHOUT
IT. YOU CAN'T BE HEALTHY WITHOUT
IT. A GROUP OF DOCTORS WITH
SUPPORT FROM THE SAN FRANCISCO
MARIN FOOD BANK, AND THE FOOD IS
MEDICINE COLLABORATIVE. WE
DECIDED TO START A FOOD
PHARMACY. THE FOOD FIRST
PHARMACY IN OUR CLINIC, UM, IS A
MEDICALLY BASED INTERVENTION. WE
SERVE DELICIOUS, HIGH QUALITY,
CULTURALLY RELEVANT FOOD TO OUR
PATIENTS WITH NUTRITION
EDUCATION. UM THE DOCTORS REFER
THEIR PATIENTS TO US THE SAME
WAY THEY WOULD REFER THEM TO A
PHARMACY. WE'VE SERVED OVER 600
PATIENTS. WE REDUCED FOOD
INSECURITY BY 67% AND OUR
PATIENTS ARE MUCH HEALTHIER. NOT
SURPRISINGLY, 100% OF THE
PATIENTS WANT THE PROGRAM TO
CONTINUE. I'VE SEEN FIRSTHAND
WHY MEDICALLY SUPPORTED FOOD AND
NUTRITION INTERVENTIONS IS
PROBABLY THE MOST IMPORTANT
THING WE CAN DO TO ACT RIGHT NOW
TO SAFEGUARD AND IMPROVE THE
HEALTH OF CALIFORNIANS. UM FOR
THE FIRST CASE, RESEARCH SHOWS
THAT HEALTHY FOOD PREVENTS
DISEASES LIKE CANCER AND
DIABETES. SECOND RESEARCH SHOWS
THAT HEALTHY FOOD TREATS MEDICAL
CONDITIONS LIKE HYPERTENSION AND
HYPER LIPID DENIA. THIRD
RESEARCH SHOWS THAT EATING A LOT
OF HEALTHY FOODS CAN ACTUALLY
REDUCE YOUR RISK FOR EARLY
DEATH. NOW FINANCES ARE
IMPORTANT. BUT THE GOOD NEWS IS
THAT THESE MEDICAL FOOD PROGRAMS
ACTUALLY SAVE MONEY. SO THERE IS
A REDUCTION IN HEALTH CARE COSTS
BECAUSE PATIENTS WHO RECEIVE
FOOD ARE LESS LIKELY TO GO TO
THE EMERGENCY ROOM LESS LIKELY
TO BE HOSPITALIZED LESS LIKELY
TO HAVE A NURSING HOME
ADMISSION. SO THINK ABOUT HOW
MUCH MONEY YOU SPEND ON YOUR
GROCERIES PER WEEK AND THEN
THINK ABOUT HOW MUCH IT COSTS TO
HOSPITALIZE A PATIENT FOR A WEEK
AND YOU GET THE IDEA ABOUT COST
SAVINGS. WITH REGARD TO RACIAL
JUSTICE. YOU PROBABLY KNOW THAT
BLACK AFRICAN AMERICAN
INDIGENOUS LATINA X AND OTHER
PEOPLE OF COLOR HAVE MUCH HIGHER
RATES OF MEDICAL DISEASE AND
MUCH POORER OUTCOMES AND ONE
RESEARCHED WAY TO REDUCE THOSE
HEALTH DISPARITIES. IS TO OFFER
FOOD TO PEOPLE. SO IN SUMMARY,
MEDICALLY SUPPORTED FOOD AND
NUTRITION INTERVENTIONS. ARE
HIGHLY REGARDED BY PATIENTS.
SAVE MONEY SAVE LIVES. PREVENT
DISEASES, TREAT DISEASES AND
REDUCE HEALTH DISPARITIES. SO MY
JOB IS TO PROTECT THE WELL BEING
OF MY PATIENTS, BUT I NEED TOOLS
TO DO THAT. THEREFORE I
RESPECTFULLY ASK FOR YOUR VOTE.
THANK YOU. THANK YOU. GOOD
AFTERNOON, CHAIRMAN. MY NAME IS
ROSA. LINA. MICHELLE. I GREW UP
IN LOS ANGELES AND NOW I LIVE.
THE CITY OF SAN FERNANDO. I USED
MEDICAL AND HAVE BEEN A PATIENT
IN NORTHEAST VALLEY HEALTH
CORPORATION SINCE 1987 WHEN I
WAS PREGNANT, I HAVE EXPERIENCED
PERSONALLY HOW IMPORTANT
NUTRITION IS IN COMMUNITIES LIKE
MINE WITH THE LOWEST INCOME AND
HIGHER RATES OF DIABETES AND
OTHER CONDITIONS. TWO YEARS AGO
, I WENT IN FOR A LAB AND MY
DOCTOR TOLD ME I WAS IN DANGER
OF DEVELOPING DIABETES. AT THAT
TIME IN MY LIFE, I WAS ILL, SOME
OTHER CONDITIONS AND HAVING
PREDIABETES MADE IT WORSE. I
ASKED A LOT OF QUESTIONS. I WAS
THE FIRST ONE IN MY FAMILY TO
GET RETIRED BILLIONS. AND I WAS
LOOKING FOR RESOURCES. I DIDN'T
WANT TO BE A DIABETIC, AND I
DIDN'T WANT TO BE AN INSULIN ON
MY LIFE. I WANT TO SEE MY
GRANDKIDS GROW. MY DOCTOR
REFERRED ME TO A PROGRAM CALLED
CALLED FRESH AND HEALTHY. WHICH
WAS A SIX MONTH PRODUCE
PRESCRIPTION PROGRAM. I WAS ONE
OF THE FIRST PATIENTS TO TRY IT
OUT. EVERY MONTH. I GOT $40 TO
BUY FRESH FRUITS AND VEGETABLES
BEFORE I COULD NOT AFFORD IT. I
ALSO PARTICIPATED NUTRITION
CLASSES AND LEARNED ABOUT
HELPING COOK COOKING. I STAYED
INVOLVED IN MY CLINIC BY BEING
PART OF OUR PATIENT AND FAMILY
ADVERSARY COUNCIL. BEING PART OF
FRESH AND HEALTHY PROGRAM. NOT
ONLY CHANGED MY DIET, IT CHANGED
MY WHOLE LIFE. I GOT TO TRY NEW
FRUITS AND BRANCHES. NEXT
STARFRUIT ASPARAGUS THAT I NEVER
BOUGHT BEFORE BECAUSE THERE WERE
TOO EXPENSIVE. EVEN THOUGH THE
PROGRAM ENDED, I'M STILL EATING
HEALTHIER. I'VE HAD THE CHANCE
TO TRY NEW FOODS. NOW WHEN I GO
TO THE FOOD BANKS, I'M ALREADY
INTRODUCED TWO DIFFERENT THINGS.
TODAY MY A ONE C HAS GONE DOWN
ONE POINT AND HAS STABILIZED.
I'VE BEEN ABLE GET ON MY FEET
AGAIN. WALKING AROUND THE BLOCK
MY NUMBER I CRIED. THESE THINGS
THAT I HADN'T TIED IN MANY
YEARS. MY BODY FEELS DIFFERENT.
I FEEL BETTER. I'M ALSO SHOWING
OTHER PEOPLE IN MY LIFE THAT
THEY CAN MAKE CHANGES TO. IT
DOESN'T HAVE TO BE BIG AND ALL
AT ONCE. A LITTLE HERE AND
LITTLE THERE. MY GRANDSON IS
SEVEN AND SIGN IMAGE OF A
HEALTHY PLATE AND ASKED ABOUT IT
. I TOLD HIM IT SHOWS US HOW TO
EAT WITH DIFFERENT HEALTHY
PORTIONS AND FOOD. NOW HE'S
ASKING MOM. TO EAT HEALTHY EVERY
SINGLE TIME HE EAT. I WAS ABLE
TO START STUDYING. AND TAKE
COURSES TO FULFILL MY DREAM. A
PROFESSIONAL GOAL FOR MY LIFE.
AND HELP OTHERS. LAST YEAR, I
WAS COMMISSIONED AS A NOTARY
PUBLIC. AND TWO WEEKS AGO, I WAS
CERTIFIED AS A LEGAL SECRETARY
AND NOW I'M STUDYING TO BECOME A
LIFE INSURANCE AGENT. IT ALL
STARTED WITH THE PRODUCE
PRESCRIPTION PROGRAM IN THE
NUTRITION CLASSES. I BELIEVE
THAT IF I DIDN'T MAKE THIS
CHANGES AND WHAT I WAS EATING
THAT I WOULD BE DIABETIC NOW. WE
MUST BE HEALTHY TO CONQUER ALL
OF OUR DREAMS. OH PATIENTS LIKE
ME SHOULD HAVE THE OPPORTUNITY.
TO BENEFIT FROM PROGRAMS LIKE
THE PRODUCE PRESCRIPTION. THESE
INTERVENTIONS CAN HAVE LONG
LASTING IMPACT, NOT ONLY FOR US
BUT FOR OUR FAMILIES AND OUR
COMMUNITIES AND I URGE YOU URGE
YOUR SUPPORT FOR A B 16 44.
THANK YOU. THANK YOU. OTHERS IN
SUPPORT. MR CHAIRMAN MEMBERS.
I'M AARON EVANS ON BEHALF OF
SUPERB AREA BASED THINK TANK AND
PROUD CO SPONSOR OF THIS MEASURE
, HAVE ALSO BEEN ASKED TO CONVEY
SUPPORT ON BEHALF OF CALIFORNIA
FOOD AND FARMING NETWORK AS WELL
AS THE NEVADA COUNTY FOOD POLICY
COUNCIL. THANK YOU. HI ERIN.
FRANNY WITH THE FOOD IS MEDICINE
COLLABORATIVE, PROUD, CO SPONSOR
OF THE BILL AND VERY SUPPORTIVE.
THANK YOU. GOOD EVENING, TAYLOR
ROSHAN ON BEHALF OF THE
CALIFORNIA FRESH FRUIT
ASSOCIATION AND SUPPORT THANK
YOU. THANK YOU. LARA SHOW YOU
DURING TWO SMELLS ARE RELYING ON
BEHALF OF THE AMERICAN HEART
ASSOCIATION AND PROUD SUPPORT.
THANK YOU. GOOD AFTERNOON, LINDA
WAY WITH WESTERN CENTER ON LAW
AND POVERTY IN SUPPORT.
REMEMBERS KATHY MOSSBERG ON
BEHALF OF A FEW CLIENTS. PUBLIC
HEALTH INSTITUTE, ROOTS OF
CHANGE PROJECT OPEN HAND AND THE
CALIFORNIA FOOD AS MEDICINE.
COALITION SUPPORT. THANK YOU.
TAYLOR JACKSON WITH THE
CALIFORNIA PRIMARY CARE
ASSOCIATION IN SUPPORT. HELLO
TASIA. WHAT'S WITH THE
CALIFORNIA ACADEMY OF FAMILY
PHYSICIANS AND SUPPORT THANK
YOU. IS THERE ANYONE IN
OPPOSITION TO THE BILL? C AND C
NO ONE WILL BRING IT BACK TO THE
COMMITTEE FOR QUESTIONS OR
COMMENTS ANY QUESTIONS OR
COMMENTS. MR V VALLAPUDUA. FIRST
I WANT TO THANK THE OP THERE AND
ESPECIALLY UM, THE WITNESSES
TODAY. WE SHOULD BE DOING MORE
IT'S SITTING AND THANK YOU FOR
BEING A VOICE IN YOUR COMMUNITY
AND WE NEED THIS MORE NOT JUST
IN YOUR COMMUNITY, BUT
THROUGHOUT THE WHOLE STATE. I
MEAN, I COME FROM? MY BACKGROUND
IS A SOCIAL WORKER BACKGROUNDS
WORKING AT COMMUNITY CENTERS.
AND WOULD I HAVE ENJOYED IS A
LOT OF FOLKS CANNOT AFFORD IT.
YOU KNOW WHEN YOU'RE PUTTING 304
100 BUCKS MORE ON THE TABLE. UM,
THAT GOES A LONG, LONG WAY. BUT
I LIKE THE FACT THAT WE NEED TO
NOT JUST PUT FOOD, BUT WE NEED
TO PUT HEALTHY FOOD. AND I KNOW
A LOT OF FOLKS THAT HAVE GONE
THROUGH THE SAME PATHWAY OF
BEING BORDERLINE DIABETIC AND
FOLKS THAT ARE DIABETIC. UM
THERE'S TIMES THAT FOLKS DON'T
KNOW THEY DON'T KNOW HOW TO EAT.
UM PROPERLY RIGHT, AND I KNOW
THAT THERE'S THERE IS A LOT OF
PROGRAMS OUT THERE, BUT WE NEED
TO DO MORE. SO, UM, THANK YOU
FOR BRINGING THIS FORWARD. THANK
YOU, MR WALDRON. THANK YOU. I'D
LIKE TO ECHO THOSE COMMENTS AS
WELL. UM AS MANY OF YOU KNOW, MY
BROTHER IS A PHYSICIAN IN NEW
YORK. UM, IT HE DOES A LOT OF
QUITE A FEW SPECIALTIES, BUT I
LIVED AT HOME WHEN HE WAS GOING
THROUGH MEDICAL SCHOOL, AND HE
DID NOT HAVE ONE CLASS IN
NUTRITION AND MEDICAL SCHOOL. UM
WHICH IS SHOCKING, ACTUALLY,
WHEN YOU THINK THAT IT'S SUCH A
AN AMAZING AND REALLY, UM.
PROFOUND TYPE OF PREVENTATIVE.
YOU KNOW, TO ANY TYPE OF
DISEASE? UM AND THEN WHAT YOU
ARE SAYING ABOUT, YOU KNOW? THE
YOUNG PEOPLE SEE YOU KNOW YOU'RE
EATING RIGHT AND HOW IT AFFECTS
YOUR LIFE. AND THEN THEY LEARN,
YOU KNOW FROM THAT SO YOU KNOW,
I THINK IT'S A GOOD THING AND
LESS IS MORE ORGANIC IS GREAT.
SO. YOU KNOW, WE NEED TO DO MORE
OF IT. THANK YOU. THANK YOU
ANYONE ELSE? SO WE HAVE A MOTION
BY MR B. VALLAPUDUA SECOND BY MS
BURNER WOULD YOU LIKE TO CLOSE?
THANK YOU. MEMBERS OF THE
COMMITTEE AND A SPECIAL THANK
YOU TO THE FOLKS WHO HAVE
TESTIFIED WITH ME TODAY. TO TALK
ABOUT THE IMPORTANCE OF REALLY
GENERATIONAL SHIFT THAT CAN
HAPPEN WHEN WE GIVE APPLES
INSTEAD OF ANGIOPLASTIES HIS
LIFE BUT HIS SUSTENANCE FOOD AS
MEDICINE. I RESPECTFULLY REQUEST
YOUR I VOTE. THANK YOU VERY MUCH
. MR BAN TO THE MOTION IS DUE
PAST AS AMENDED TO
APPROPRIATIONS HAPPY TO SUPPORT
THE BILL TODAY, MADAM SECRETARY
, PLEASE CALL THE ROLL. WOULD
WOULD I? WALDRON WALDRON, I
AGUIAR-CURRY CREE. I ARAMBULA
BURNER. BURNER I WENDY CARILLO.
WENDY CARILLO I FLORA VINCE FONG
MAIENSCHEIN MCCARTHY. MCCARTHY
I, JOE PATTERSON RODRIGUEZ.
SANTIAGO VALLAPUDUA PUT WHAT I
WEBER WHOEVER I. YOU HAVE EIGHT
VOTES THAT BILL IS OUT, BUT
WE'LL LEAVE THE ROLE OPEN FOR
OTHERS TO ADD ON. THANK YOU.
THANK YOU. OKAY, MR GIBSON.
MAYBE 16 70. THANK YOU VERY MUCH
. MR CHAIRMAN. NO THE OURS IS
FAR SPENT. THIS IS A SPOT BILL.
BUT THANK YOU VERY MUCH FOR
ALLOWING ME TO PRESENT 16 17,
WHICH WILL MAKE VERY MINIMUM
CHANGES TO EXISTING LAW,
REFERRING TO THE PERSONAL OR
BUSINESS, REFERRING OR
RECOMMENDING TREATMENT FOR
PROFIT. AH MR CHAIRMAN AND
COMMITTEE. THIS BILL IS ACTUALLY
INTENDED AS A MOVABLE SPOT AND
MAKES VERY MINIMUM CHANGES IN
THE LAW. GIVEN THIS, HOWEVER, I
DO ACCEPT THE COMMITTEE
AMENDMENTS TO INCREASE THE FINE
AMOUNT, INCLUDING INTO THE BILL
FROM 5000 TO 10,000 FOR
VIOLATION. I RESPECTFULLY ASK,
BUT I VOTE. THANK YOU. I'M
SORRY. I WAS THE LUCK GOING ON
UP HERE SOMETIMES. OKAY THANK
YOU. MEMBERS IS THEIR SUPPORT
FOR THE BILL. THE OPPOSITION TO
THE BILL. WHERE WE START HEARD
EMOTION IN A SECOND. FROM FROM
MR DID YOU SUPPORTED IT AND MADE
A MOTION. OKAY MR MCCARTHY MADE
EMOTION BURNER MADE A SECOND, UM
. WOULD YOU LIKE TO CLOSE?
RESPECTFULLY ASKED WHEN I VOTE.
THANK YOU. THANK YOU, UH, MOTION
IS DO PASS THROUGH
APPROPRIATIONS. MADAM SECRETARY,
PLEASE CALL THE ROLL. WOULD,
WOULD I, WALDRON. AGUIAR-CURRY
AGUIAR-CURRY. AYE, ARAMBULA.
BURNER. BURNER I WENDY CARILLO,
WENDY CARILLO I FLORA. VINCE
FANG. MAIENSCHEIN MCCARTHY.
MCCARTHY I, JOE PATTERSON.
RODRIGUEZ. SANTIAGO VALLAPUDUA
AIRPORT. WA I. WEBER. WHETHER I
. OH I'M SORRY. YOU HAVE SEVEN
VOTES THAT BUILDS ON CALL. WE
LOST A MEMBER. I MEAN, NOT. I
MEAN, THEY'RE THEY'RE AROUND,
BUT, YOU KNOW, OKAY. THANK YOU.
MISS KOREA. WELL, I WENT OUT OF
ORDER. I'M SORRY. NO, GO AHEAD.
I'M MY BAD. DO YOU? OKAY? WE'RE
WAITING FOR SKITTLES OR
SOMETHING BECAUSE YOU KNOW, BUT
SO WE'RE KINDA ON LOW BLOOD
SUGAR RIGHT NOW BROUGHT DONUTS,
HUH? I DON'T I DON'T KNOW. I
DON'T KNOW HOW LONG THOSE DONUTS
HAVE BEEN THERE, SO I DON'T KNOW
WHAT THE SELL BY DATE IS OR THE
OR ANY OF THAT STUFF. I'M NOT
TOUCHING THE DONUTS TOOK A BITE
. OH, NO, THAT'S NOT GOOD. OKAY,
WELL, THANK YOU, MR CHAIR AND
MEMBERS AND THANK YOU TO, UM
ASSEMBLYMEMBER'S SORRY. DIDN'T
MEAN TO SKIP OVER. I'M PROUD TO
PRESENT A B 15 49, WHICH WOULD
UPDATE TO THE PROSPECTIVE
PAYMENT SYSTEM FOR CALIFORNIA'S
COMMUNITY HEALTH CENTERS. I ALSO
WANT TO THANK THE COMMITTEE
STAFF AND ACCEPT THE COMMITTEE
AMENDMENTS. UH AND THANK YOU SO
MUCH FOR WORKING WITH MY TEAM
AND OUR SPONSORS FOR THIS BILL.
COMMUNITY HEALTH CENTERS ARE
CRITICAL PART OF OUR HEALTH CARE
SYSTEM, PROVIDING HIGH QUALITY
CARE TO MORE THAN 7.8 MILLION
CALIFORNIANS ANNUALLY,
REGARDLESS OF THEIR ABILITY TO
PAY OR IMMIGRATION STATUS.
FEDERALLY QUALIFIED HEALTH
CENTERS. THE MAJORITY OF CH CS
IN CALIFORNIA ARE REIMBURSED
THROUGH THE PROSPECTIVE PAYMENT
SYSTEM. HOWEVER THE CURRENT PPS
RATE ONLY ACCOUNTS FOR THE RANGE
OF SERVICES. A CHC OFFERS, WHICH
LIMITS THEIR ABILITY TO INVEST
IN PATIENT OUTCOMES AND IMPROVE
COMMUNITY HEALTH. MAYBE 15 49
WOULD UPDATE THE PPS SYSTEM TO
ACCOUNT FOR EXPANDED SERVICES
AND CARE COORDINATION COSTS,
ADDING MORE TRIGGERS THAT WOULD
ALLOW HEALTH CENTERS TO REQUEST
A REVIEW FROM THE DEPARTMENT OF
HEALTH CARE SERVICES TO ADJUST
THEIR PPS RATE UPWARD. THIS
WOULD ENABLE CH CS TO
COMPREHENSIVELY INCLUDES STEAD
STATE LED CARE TRANSFORMATION
INITIATIVES IN THEIR ALLOWABLE
COSTS AND TRANSITION TO A VALUE
BASED CARE SYSTEM. FOR EXAMPLE,
CLINICS WOULD BE ABLE TO ADD
EXPANDED CARE TEAM MEMBERS AND
ADOPT THE WHOLE PERSON CARE
APPROACH OF CAL AIM. THIS BILL
IS ABOUT EXPANDING THE ABILITY
TO INVEST IN PATIENT OUTCOMES
AND IMPROVE COMMUNITY HEALTH
HERE TO TALK MORE ABOUT THE NEED
FOR THE BILL AND ANSWER ANY
TECHNICAL QUESTIONS. ONE OF MY
FAVORITE PEOPLE, MISS LEWIS
MCCARTY, PRESIDENT OF THE CEO,
PRESIDENT AND CEO OF THE L, A
COUNTY COMMUNITY CLINIC
ASSOCIATION, AS WELL AS LARA
SHECKLER, DEPUTY DIRECTOR OF
POLICY AND REGULATORY AFFAIRS AT
THE CALIFORNIA HEALTH PLUS WITH
CALIFORNIA HEALTH PLUS ADVOCATES
. HMM THERE WE GO. GOOD
AFTERNOON CHAIR COMMITTEE
MEMBERS. LOUISE MCCARTHY,
PRESIDENT, CEO OF THE COMMUNITY
CLINIC ASSOCIATION OF L. A
COUNTY. UM, FOR SOME CONTEXT IN
LOS ANGELES, WE HAVE 110
LICENSED COMMUNITY CLINIC
ORGANIZATIONS THAT OPERATE 380
SITES AND SERVE 1.89 MILLION
PATIENTS PER YEAR. UM 64% OF THE
CLIENTS SEEN IN A HEALTH CENTER
IN LOS ANGELES ARE IN MEDICAL
YET ONLY 50% OF THE REVENUE
COMING INTO HEALTH CENTERS COMES
FROM MEDICAL UM, THEY'RE SEEING
ALL OF THESE FOLKS AND USING
GRANT FUNDS AND OTHER RESOURCES
TO TRY TO MAKE UP THE COST OF
CARE. UM AS MENTIONED BY OUR
ESTEEMED REMEMBER THE
PERSPECTIVE PAYMENT SYSTEM RATE
THIS PER VISIT RATE ATTEMPTS TO
GET AT A FAIR PAYMENT FOR HEALTH
CENTERS, BUT BECAUSE OF SOME
STRUCTURAL BARRIERS, IT REALLY
HAS DEPRESSED THE REVENUES
COMING INTO HEALTH CENTER AS
WELL. THEIR COSTS ARE INCREASING
DRAMATICALLY OVER TIME, MOST
SPECIFICALLY IN THE RATE
SETTING. WHEN WE DO THE RIGHT
SETTING, UH THE STATE IS
REFERRING TO MEDICARE COST
PRINCIPLES WHICH ARE DATED
INSTEAD, THIS BILL WOULD MOVE
TO, UM, BE COST PRISON
PRINCIPLES WHICH DO GET UPDATED
OVER TIME, SO IT ALLOWS US TO
MODERNIZE THE COST PRINCIPLES
THAT ARE TAKEN INTO THE RATE
SETTING. SECOND OF ALL IS THE
CHANGE IN SCOPE PROCESS NOW IN
TECHNICALLY A HEALTH CENTER CAN
CHANGE THEIR RATE ANYTIME THEY
CHANGE THE TYPE INTENSITY. UM
AH! UH AND DURATION OF SERVICES
THAT THEY PROVIDE. BUT REALLY,
WHEN IT COMES DOWN TO IT, IT'S
ONLY WHEN THEY CHANGE THE TYPE.
AND SO THERE'S A LOT OF HEALTH
CENTERS IN LOS ANGELES THAT ARE
SITTING ON RATES THAT THEY'VE
HAD FOR 10 OR 20 YEARS. THEY
HAVE NOT BEEN ABLE TO GET THEM
CHANGED IN SCOPE, SO THEY HAVE
NOT BEEN ABLE TO REOPEN THEIR
RATES AND THEY'RE SITTING ON OLD
RATES AND NOT ABLE TO BRING IN
NEW COSTS. WHEN WE THINK ABOUT
THIS, FOR EXAMPLE, UM, AS
MENTIONED WITH CALLUM, WHERE
EXPANDING CARE TEAMS AND THESE
CARE TEAMS ARE COSTING MORE
MONEY YET WE CANNOT ADD THOSE
COSTS TO OUR RATE. ADDITIONALLY
HEALTH CENTERS NOW ARE 10 15
YEARS INTO THEIR ELECTRONIC
HEALTH RECORD SYSTEMS, BUT
BECAUSE THEY'VE USED THAT THR AS
A TRIGGERING EVENT TO DO A
CHANGE IN SCOPE THEY CAN'T DO IT
A SECOND TIME AND SO THEY'VE
TAKEN ON THESE NEW COSTS, BUT
THEY CAN'T BE REFLECTED IN THEIR
RATE. SO FOR THIS, IT'S
IMPACTING ACCESS. IT'S IMPACTING
FINANCIAL SUSTAINABILITY OF THE
HEALTH CENTERS AND WE ENCOURAGE
YOUR SUPPORT. GOOD AFTERNOON. MY
NAME IS LAURA SHECKLER. I'M THE
DEPUTY DIRECTOR OF POLICY AND
REGULATORY AFFAIRS WITH
CALIFORNIA HEALTH PLUS ADVOCATES
, WHICH IS THE ADVOCACY
AFFILIATE OF THE CALIFORNIA
PRIMARY CARE ASSOCIATION. AND
CPC A REPRESENTS NEARLY 1300
HEALTH CENTERS ACROSS THE STATE
OF CALIFORNIA AND SERVED 7.8
MILLION PATIENTS OR ONE IN FIVE
CALIFORNIANS. AH, AND WE ARE THE
PROUD SPONSORS OF A B 15 49. SO
WHILE THIS IS A VERY TECHNICAL
BILL, THAT'S REGARDING PAYMENT
METHODOLOGY. I JUST WANTED TO
REITERATE THAT THE BIG PICTURE
OF THIS BILL IS REALLY TO MODERN
, MODERNIZE OUR HOUSE CENTER
PAYMENT SYSTEM AND BRING IT INTO
ALIGNMENT WITH THE DIFFERENT
TYPES OF CARE TRANSFORMATION
INITIATIVES THAT ARE BEING
ADVANCED RIGHT NOW BY THE
DEPARTMENT OF HEALTH CARE
SERVICES. SO THINGS LIKE HELL
CAME THE POPULATION HEALTH
MANAGEMENT STRATEGY AND ALSO THE
FQ HC ALTERNATIVE PAYMENT MODEL
OR A PM SO THIS IS REALLY
NECESSARY FOR HEALTH CENTERS TO
SUCCESSFULLY IMPLEMENT THOSE
CURRENT AND EMERGING MODELS OF
CARE. AND EFFECTIVELY INTEGRATE
THE EXPANDED CARE TEAMS THAT
LOUISE MENTIONED THAT ARE
CONTEMPLATED BY THESE
INITIATIVES. SO CURRENTLY
COMMUNITY HEALTH CENTERS WHO
SERVE ONE AND THREE OF ALL
MEDICAL BENEFICIARIES FACE A
NUMBER OF BARRIERS TO
SUCCESSFULLY IMPLEMENTING THOSE
THOSE CHARACTERS INFORMATION
INITIATIVES BECAUSE OF THESE
OUTDATED LIMITATIONS ON WHAT CAN
BE INCLUDED INTO A HEALTH
CENTERS RATE. SO LIKE LOUISE
SAID THAT THAT MEANS THAT EITHER
HEALTH CENTERS ARE UNABLE TO
INCORPORATE NEW MEDICAL BENEFITS
AND SERVICE SERVICES. OR THEY
ARE ON OR UNDER COMPENSATED FOR
THE INTEGRATION OF THOSE
SERVICES AND TO THEIR CARE
TEAMS. SO THE PPS SYSTEM OR
PERSPECTIVE PAYMENT SYSTEM. IT
WAS DEVELOPED OVER 20 YEARS AGO
, AND IN THAT TIME BOTH THE WAY
THAT CARE HAS BEEN IS DELIVERED
. AND WHO DELIVERS THAT CARE IS
CHANGED REALLY DRAMATICALLY. SO
AT THIS POINT IN ORDER FOR
HEALTH CENTERS TO REALLY BE ABLE
TO INTEGRATE ALL OF THESE
DIFFERENT CHANGES AND BEST
PRACTICES OF HOW WE HOW PHDS IS
ASKING US TO DELIVER CARE IN
CALIFORNIA. WE NEED TO BRING OUR
PAYMENT SYSTEM ALONG WITH IT AND
UPDATE IT SO THAT WE CAN ALL BE
MOVING IN THE SAME DIRECTION
WITH WHERE CARE IS GOING IN
CALIFORNIA. I'M HAPPY TO ANSWER
ANY TECHNICAL QUESTIONS ON THE
BILL. UM BUT AS FOR A SUPPORT
BOAT, THANK YOU. THANK YOU
OTHERS IN SUPPORT. HE REMEMBERS
KATHY MOSSBERG WITH APPLE, A
HEALTH AND STRONG SUPPORT.
WHAT'S WITH THE CALIFORNIA
ACADEMY OF FAMILY PHYSICIANS AND
SUPPORT THANK YOU. IS THERE ANY
OPPOSITION TO THE BILL? NO,
DON'T BRING IT BACK TO THE
COMMITTEE QUESTIONS OR COMMENTS.
THE MOTION BY MR V. VALLAPUDUA
SECOND BY MS AGUIAR-CURRY ENJOY
A DO PASS RECOMMENDATION BY THE
CHAIR AND MOTION DO PASS AS
AMENDED TO APPROPRIATIONS. WOULD
YOU LIKE TO CLOSE MR GRILL?
THANK YOU, MR CHAIR IN RECENT
YEARS, INITIATIVES FROM THE
LEGISLATURE AND THE GOVERNOR
HAVE PROMOTED AND MOVED TOWARDS
A WHOLE PERSON CARE SYSTEM AS A
WAY TO MAKE CARE MORE ACCESSIBLE
AND PROMOTE COMMUNITY HEALTH.
HOWEVER WELL, WE HAVE ADVANCED
CERTAIN GOALS WE HAVE NOT GIVEN
OUR COMMUNITY CLINICS THE
ABILITY TO ACTUALLY HAVE A
PATHWAY TO REACH THOSE GOALS.
THIS BILL IS ABOUT GIVING
COMMUNITY HEALTH CENTERS THE
TOOLS THAT THEY NEED TO
IMPLEMENT THE MODELS THAT THE
LEGISLATURE AND THE GOVERNOR'S
OFFICE HAVE PUT IN PLACE. BILL
HAS NO OPPOSITION RESPECTFULLY
REQUEST AND I VOTE. THANK YOU.
DID YOU? DO YOU THINK I'M SORRY?
YOU HAD A QUESTION ON UM I'M
JUST TRYING TO GET SOME CLEAR
ALREADY VOTED FOR IT, BUT, UH,
YOU MEANT YOU MENTIONED I'LL
CENTERS IS THAT THE SAME AS
CLINICS. SO THE LARGER UMBRELLA
IS COMMUNITY CLINICS FOR
LICENSURE, AND THEN WITHIN THE
COMMUNITY CONNECT LICENSURE AS A
SUBSET OF FEDERALLY QUALIFIED
HEALTH CENTERS. SO FOR EXAMPLE,
PLANNED PARENTHOOD'S WOULD BE
COMMUNITY CLINICS, BUT NOT
FEDERALLY QUALIFIED HEALTH
CENTERS. AND THEN THE OTHER
QUESTION. I HAVE UM. IS I KNOW
THAT WE HAVE A PROBLEM LIKE
REIMBURSEMENT, RIGHT? IT'S
ALWAYS LATE. THIS EXPEDITED, BUT
IT HELPED UM, THIS CHANGES THE
RATE ITSELF. IT DOES NOT
NECESSARILY CHANGE THE PROCESS
BY WHICH THE HEALTH CENTERS ARE
REIMBURSED THROUGH THEIR
RECONCILIATION PROCESS. WE ARE
CONTINUING TO WORK WITH THE
DEPARTMENT ON THAT. OKAY. THANK
YOU. OKAY. THANK YOU. SO. MOTION
IS DUE PASS AS AMENDED TO
APPROPRIATIONS. MADAM SECRETARY
PLEASE CALL THE ROLL. WOULD
WOULD I? WALDRON WALDRON. AYE. I
GET CURRY CURRY. I ARAMBULA
BURNER. EARNER. I WENDY CARILLO.
WHEN YOU CARILLO I FLORA
FRANCOIS MAIENSCHEIN MCCARTHY.
MCCARTHY I, JOE PATTERSON,
RODRIGUEZ SANTIAGO VALLAPUDUA.
BUT WHAT I WHIPPER. HOWEVER, I.
HÌ STATE VOTES. IT'S OUT, WE'LL
LEAVE THE ROLE OPEN FOR OTHERS.
DAD ON DR WEBBER.
GOOD EVENING CHAIR AND MEMBERS.
I WANT TO START BY THANKING THE
COMMITTEE CHAIR AND STAFF FOR
THE THOUGHTFUL CONVERSATIONS
LEADING UP TO THIS HEARING. I'M
HERE TO PRESENT A B 85, WHICH
WILL REQUIRE HEALTH PLANS AND
INSURERS TO INCLUDE COVERAGE FOR
SOCIAL DETERMINANTS OF HEALTH
SCREENING AND ACCESS TO
COMMUNITY HEALTH WORKERS. THANK
YOU. SOCIAL DETERMINANTS OF
HEALTH IS COMING TO FIND AS THE
CONDITIONS IN WHICH PEOPLE ARE
BORN, GROW WORK, LIVE PLAY AND
AGE IN WHICH WIDER SET OF FORCES
AND SYSTEMS SHAPE THE OUTCOMES
OF YOUR DAILY LIFE AND AFFECT
HEALTH FUNCTIONING AND QUALITY
OF LIFE OUTCOMES AND RISK.
DETERMINANTS ARE THINGS LIKE
SAFE HOUSING, EDUCATION, FOOD,
ACCESS, TRANSPORTATION AND
ECONOMIC STABILITY. SOCIAL
DETERMINANTS OF HEALTH,
SCREENING TOOLS AND CLINICAL
PRACTICE, HELP IDENTIFY THESE
SOCIAL AND ECONOMIC RISK OF
PATIENTS THAT MAYBE PREVIOUSLY
UNKNOWN TO HEALTH PROVIDERS.
IDEALLY THAT INFORMATION LEADS
TO HEALTH CARE TEAMS LINKING
PATIENTS TO COMMUNITY RESOURCES
OR DISCUSSIONS ABOUT CHANGING
PATIENT TREATMENT PLANS TO
MITIGATE THE SOCIAL NEEDS TO
IMPROVE HEALTH OUTCOMES. ONE
SURVEY CONDUCTED BY THE AMERICAN
ACADEMY OF FAMILY PHYSICIANS
INDICATED THAT FAMILY PHYSICIANS
WANT TO HELP ADDRESS THEIR
PATIENTS NEEDS BUT MAY FACE
BARRIERS AND OFFERING THE
SUPPORT THAT THEY NEED. 80 85
HELPS ADDRESS THESE GAPS IN
HEALTH CARE BY REQUIRING
COVERAGE AND REIMBURSEMENT OF
SOCIAL DETERMINANTS OF HEALTH
SCREENINGS AND ACCESS TO
COMMUNITY HEALTH WORKERS. IT
ALSO MAKES SCREENING A COVERED
BENEFIT UNDER MEDICARE
BENEFICIARIES. SPELL ALSO
REQUIRES THE DEPARTMENT OF
HEALTH CARE, ACCESS AND
INFORMATION TO CONVENE A WORKING
GROUP TO CREATE A STANDARDIZED
MODEL AND PROCEDURES WERE
CONNECTING PATIENT'S WITH
COMMUNITY RESOURCES TO ACCESS
THE NEED FOR CENTRALIZED LIST OF
ACCREDITED COMMUNITY PROVIDERS
AND DETERMINED GAPS IN RESEARCH
TO INFORM POLICY. SPILL, A
SPONSORED BY THE CALIFORNIA
ACADEMY OF FAMILY PHYSICIANS AND
HIS CO SPONSORED BY NUMEROUS
ORGANIZATIONS SUCH AS CALIFORNIA
PRIMARY CARE ASSOCIATION,
CALIFORNIA BLACK HEALTH NETWORK
AND THE BLACK LEADERSHIP COUNCIL
WITH ME HERE TODAY TO SPEAK IN
SUPPORT OF A B 85, OR KATRINA
RAISE, VICE PRESIDENT OF
ADVOCACY AND POLICY AT THE
CALIFORNIA ACADEMY OF FAMILY
PHYSICIANS. AND DR SCRUB, A
FAMILY PHYSICIAN FROM CENTER
FAIRFIELD. THANK YOU. CHAIR AND
COMMITTEE MEMBERS. MY NAME IS
KATRINA RAISE AND THE VICE
PRESIDENT OF ADVOCACY AND POLICY
FOR THE CALIFORNIA ACADEMY OF
FAMILY PHYSICIANS AND THE PROUD
SPONSOR OF HB 85. WE LIKE TO
THINK ASSEMBLYMEMBER'S WEBER FOR
INTRODUCING THIS CRITICAL BILL
THAT WILL MAKE REAL IMPACT ON
HEALTH OUTCOMES, HEALTH, EQUITY
AND HEALTH CARE COSTS. AS YOU
KNOW, SOCIAL DETERMINANTS OF
HEALTH ARE GROWING CAUSE OF
HEALTHCARE INEQUITY, RESULTING
IN WORSENING HEALTH OUTCOMES AND
INCREASING HEALTH CARE COSTS.
MAYBE 85 6 TO IDENTIFY SOCIAL
DETERMINANTS OF HEALTH AND
INTERVENE EARLIER BY REQUIRING
HEALTH PLANS AND INSURERS TO
PROVIDE COVERAGE FOR SOCIAL
DETERMINES OF HEALTH SCREENINGS
AND TO PROVIDE ADEQUATE ACCESS
TO COMMUNITY HEALTH WORKERS
PERMIT TORRES OR SOCIAL WORKERS.
THE IMPACT OF SOCIAL NEED ON
HEALTH AS WELL DOCUMENTED.
STUDIES HAVE FOUND THAT FOOD
INSECURE INDIVIDUALS ARE 20%
MORE LIKELY TO REPORT THAT THEY
HAVE HYPERTENSION AND 30% MORE
LIKELY TO REPORT THAT THEY HAVE
HYPER LIPID E MIA THAN THEIR
FOOD, SECURE COUNTERPARTS.
SUBSTANDARD HOUSING CONDITIONS
ARE DIRECTLY ASSOCIATED WITH
RESPIRATORY DISEASES AND IN A
STUDY IN 2000 ATTRIBUTED SOCIAL
FACTORS OF THE DIRECT CAUSE OF
DEATH. TAKING THE FIRST STEPS IN
ADDRESSING SOCIAL DETERMINANTS
OF HEALTH. SCREENINGS AND
CLOSING THE REFERRAL GAPS TO
COMMUNE RESOURCES WILL RESULT IN
BETTER HEALTH OUTCOMES AND LOWER
COSTS. IN 2015 2 OF THE MOST
COMMONLY TREATED CONDITIONS
AMONG THE TOP 5% OF HEALTH
SPENDERS, HYPERTENSION AND HYPER
LIPID E MIA WERE LINKED TO UNMET
SOCIAL NEEDS. OTHER CONDITIONS
FOR WHICH AT LEAST 25% OF
PERSONS IN THE TOP 5% OF HEALTH
SPENDERS WERE TREATED INCLUDES
MENTAL HEALTH DISORDERS, HEART
DISEASE, COPD, OR ASTHMA,
DIABETES AND TRAUMA RELATED
DISORDERS, ALL OF WHICH HAVE
BEEN LINKED OR EXACERBATED BY
SOCIAL AND ECONOMIC CONDITIONS.
BY ADDRESSING THE SOCIAL NEEDS
OF HIGH HEALTHCARE SPENDERS,
PARTICULARLY THROUGH COMMUNITY
HEALTH WORKER INTERVENTION. WE
CAN IMPROVE CHRONIC DISEASE
CONTROL, MENTAL HEALTH, QUALITY
OF CARE AND HOSPITALIZATIONS AND
THUS LOWER HEALTHCARE COSTS. A
STUDY ON THAT ON THE EXPENDITURE
REDUCTIONS ASSOCIATED WITH
SOCIAL SERVICE REFERRAL PROGRAMS
FOUND A 10% REDUCTION IN HEALTH
CARE COSTS EQUATING TO MORE THAN
2400 ANNUAL SAVINGS PER PERSON.
ANOTHER STUDY CONDUCTED BY THE
UNIVERSITY OF PENNSYLVANIA AND
THE RETURN ON INVESTMENT FOR
COMMUNITY HEALTH WORKERS. FOR
THEIR MEDICAID PROGRAM FOUND
THAT ONE TEAM OF COMMUNITY
HEALTH WORKERS SERVING JUST 330
PATIENTS WOULD PREVENT 295 BED
DAYS, YIELDING A SAVINGS OF OVER
700,000. A B A B FIVE WILL
IMPROVE HEALTH OUTCOMES AND
HEALTH EQUITY AND REDUCE HEALTH
CARE COSTS. IT IS FOR THESE
REASONS THAT WE URGE AND I VOTE
ON A B 85 HAPPY TO ANSWER ANY
TECHNICAL QUESTIONS THAT COULD
BE COMMITTEE MAY HAVE. THANK
YOU. THANK YOU. PLEASE GO AHEAD.
THANK YOU, CHAIRMAN AND
COMMITTEE MEMBERS. MY NAME IS
IDEA SCRUB AND I AM A FAMILY
MEDICINE PHYSICIAN FROM OAKLAND
, CALIFORNIA, CURRENTLY WORKING
IN FAIRFIELD. I LEARNED EARLY ON
FROM MY MENTORS AND MEDICINE
THAT COMMUNITY THAT COMMUNITY
PHYSICIAN CAN ALSO REACH BEYOND
THE CLINICAL WALLS TO MAKE AN
IMPACT. I URGE YOU TO VOTE AYE
ON A B 85 BECAUSE IT WILL ENSURE
THAT HEALTH CARE PROVIDERS HAVE
THE RESOURCES TO BETTER
UNDERSTAND FACTORS IMPACTING OUR
PATIENTS. HEALTH BOTH INSIDE AND
OUTSIDE OF THE CLINIC. SCREENING
FOR THE SOCIAL DETERMINANTS OF
HEALTH IS CRITICAL TO DEVELOPING
A TREATMENT PLAN. THAT IS BEST
FOR MY PATIENTS. IF I AM
INFORMED THAT A PATIENT DOESN'T
HAVE RELIABLE TRANSPORTATION,
THEN I TRY TO SELECT MEDICINES
THAT REQUIRE LESS FOLLOW UP AND
MONITORING. IF I AM INFORMED
THAT AN UNHAPPY AS DIABETIC
PATIENT DOESN'T HAVE ACCESS TO
REFRIGERATION TO KEEP INSULIN
THEN I HAVE TO MAXIMIZE
TREATMENT WITH ORAL MEDICATIONS
. HOWEVER THERE IS A NEED TO DO
MORE THAN JUST SCREEN BECAUSE
THERE ARE OBSTACLES OUTSIDE OF
THE CLINIC THAT INTERFERE WITH
THE PATIENT'S ABILITY TO
COMPLETE TREATMENT. THIS BILL
WILL PROVIDE THE LINKAGE BETWEEN
THE HEALTH CARE TEAM AND THE
COMMUNITY RESOURCE. THROUGH
COMMUNITY HEALTH WORKERS OR
SOCIAL WORKERS. THEY CAN ENSURE
THAT PATIENTS ARE RECEIVING THE
DIRECT ASSISTANCE THEY NEED TO
ACCESS, FOOD, TRANSPORTATION,
HOUSING AND HEALTHCARE. I RECALL
HAVING A PATIENT ON LIMITED
INCOME, WHO KEPT MISSING HER
APPOINTMENTS IN CLINIC AFTER
HAVING A STROKE. SHE LATER
SHARED WITH ME THAT SHE LIVED
ALONE WITH NO ACCESS TO
TRANSPORTATION AND USED UP WHAT
SHE HAD LEFT TO TAKE AN UBER TO
THE EMERGENCY ROOM FOR HER
STROKE SYMPTOMS. A SOCIAL WORKER
UNDOUBTEDLY WOULD HAVE BEEN ABLE
TO HELP HER WITH TRANSPORTATION
VOUCHERS OR REGISTRATION FOR
RIDE SERVICES TO HELP HER WITH
HER FOLLOW UP VISITS. MY FLAT
FAMILY MEDICINE COLLEAGUE HAD
DIFFICULTIES WITH GETTING AN IN
HOUSE PATIENT AND MUCH NEEDED
SURGERY BECAUSE HE DID NOT HAVE
AN ADDRESS WHERE HE COULD BE
DISCHARGED TO AFTER THE SURGERY.
A SOCIAL WORKER WOULD HAVE BEEN
ABLE TO ASSIST THE PATIENT WITH
NAVIGATING AND OBTAINING AT
LEAST SOME TYPE OF TEMPORARY
HOUSING TO BE ABLE TO MOVE
FORWARD WITH THE SURGERY. IT IS
FOR THESE REASONS THAT I
RESPECTFULLY ASK FOR AN EYE
VOIGTS AVON A B 85. THANK YOU.
THANK YOU OTHERS IN SUPPORT.
GOOD EVENING, MOLLY ROBSON WITH
PLANNED PARENTHOOD, AFFILIATES
OF CALIFORNIA AND SUPPORT. THANK
YOU. TENNESSEE HEARING WITH THE
CALIFORNIA HIGH END AND STRONG
SUPPORT. JENNIFER ROLLS WITH
HEALTH ACCESS CALIFORNIA AND
SUPPORT. TO MIND HER WITH THE
CHILDREN'S SPECIALTY CARE,
COALITION AND SUPPORT. THANK
YOU. IS THAT SHORT ON BEHALF OF
RADIO CHILDREN'S HOSPITAL IN THE
ALLIANCE OF CATHOLIC HEALTHCARE.
TAYLOR JACKSON WITH THE
CALIFORNIA PRIMARY CARE
ASSOCIATION. WE'RE PROUD CO
SPONSORS AND RESPECTFULLY URGE
YOUR SUPPORT TODAY. REBECA
GONZALEZ NATIONAL ASSOCIATION OF
SOCIAL WORKERS. CALIFORNIA
CHAPTER AND SUPPORT. THANK YOU.
DIAMOND KIM ON BEHALF OF
CHILDREN'S CHOICE, DENTAL CARE
AND SUPPORT. THANK YOU. IS HE
STILL IN THERE ON BEHALF OF
CALIFORNIA CITY ASSOCIATION OF
PSYCHIATRISTS AND SUPPORT? THANK
YOU. ALEX CON ON BEHALF OF THE
CALIFORNIA CHRONIC CARE
COALITION AND SUPPORT THANK YOU.
SANDRA POOL, WESTERN CENTER ON
LAW AND POVERTY AND SUPPORT.
THANK YOU. BRANDON MARCHI WITH
THE CALIFORNIA MEDICAL
ASSOCIATION AND SUPPORT THANK
YOU. NICOLE WARDIMAN ON BEHALF
OF THE CHILDREN'S PARTNERSHIP
AND SUPPORT. THANK YOU. RONALD
COLMAN BASIL HERE ON BEHALF OF
THE CALIFORNIA PAN ETHNIC HEALTH
NETWORK AND HAVING OUR SAY
COALITION HERE IN SUPPORT. THANK
YOU. THANK YOU. IN GHANA FOR
WITH CALIFORNIA BLACK HOUSE, SO
NETWORK AND SUPPORT AND CO
SPONSOR. TASHA HANNEMAN WITH THE
BLACK, UM I'M SORRY, UM WITH THE
BLACK LEADERSHIP COUNCIL AND
INITIATIVE, A PRC IN SUPPORT,
BOTH OF THE BLACK LEADERSHIP
COUNCIL, PROUD CO SPONSOR AND
ALSO ON BEHALF OF PRC IN
SUPPORT. THANK YOU. THANK YOU.
FRANK SPENCER ON BEHALF OF OCEAN
, THE CALIFORNIA HEALTH NETWORK
, THE CROHN'S AND COLITIS
FOUNDATION AND THE AMERICAN
COLLEGE OF OBGYN. RYAN'S
DISTRICT NINE ON SUPPORT. THANK
YOU. THERE ANY OPPOSITION TO THE
BILL?
GOOD EVENING, MR CHAIR MEMBERS
JUDD HAMPTON WITH THE CALIFORNIA
ASSOCIATION OF HEALTH PLANS HERE
, REGRETTABLY, IN OPPOSITION TO
BE 85. I DO WANT TO THANK THE
AUTHORS OFFICE AND HER STAFF AND
THE COMMITTEE STAFF AS WELL AS
WE HAVE HAD SEVERAL
CONVERSATIONS AROUND THIS FILM.
WE REALLY APPRECIATE THE OPEN
DIALOG. WE ALSO WANT TO SAY THAT
WE CERTAINLY APPRECIATE THE
INTENT OF THIS BILL AND AGREE
WITH THE AUTHOR THAT SOCIAL
DETERMINANTS OF HEALTH UM, ARE
SIGNIFICANT DRIVERS OF HEALTH
DISPARITIES AND ARE CRITICAL
COMPONENT OF DETERMINING HEALTH
OUTCOMES. UNFORTUNATELY, HOWEVER
, WE FEEL THAT THE BILL, AS IT'S
CURRENTLY WRITTEN, IS OVERLY
BROAD AND DOES NOT REALLY
PROVIDE HEALTH PLANS ARE CLEAR
DIRECTION ON HOW TO IMPLEMENT
THE BILL TO THE BEST OF ITS
ABILITY. UM YOU KNOW, AS STATED
IN THE COMMITTEE ANALYSIS, THE
BILL IS SILENT ON SOCIAL
DETERMINANT OF HEALTH SCREENING
CRITERIA, WHICH POPULATIONS
SHOULD BE SCREENED AND WHO
SHOULD BE PERFORMING THE
MANDATED SCREENINGS OR THAT'S
YOU KNOW, HEALTH PLANS STAFF FOR
PRIMARY CARE PHYSICIANS,
COMMUNITY HEALTH WORKERS LIKE SO
WE ARE A LITTLE UNCLEAR, UH,
CURRENTLY ON HOW THE HOW OR WHO
IS SUPPOSED TO BE PROVIDING
THOSE SCREENINGS? I'M MOVING
FORWARD. UM WE WOULD ALSO LIKE
TO POINT OUT THAT EXISTING
SCREENING TOOLS, UH, VERY WIDELY
IN THE NUMBER OF THE
CLASSIFICATION, LABELING OF
CATEGORIES AND THEIR SPECIFIC
QUESTIONS WITHIN THOSE
CATEGORIES, BUT THERE'S NO
CURRENT, UM, CONSENSUS ON THE
BEST OR THE MOST APPROPRIATE
TOOL. NOR IS IT REALLY
CONSENSUS. GENERALLY SPEAKING IN
THE SOCIAL DETERMINANTS HEALTH
HEALTH LEXICON, SO WE WOULD
CERTAINLY APPRECIATE A LITTLE
BIT MORE CLARITY ON THAT
COMPONENT MOVING FORWARD. UM AS
FOR THE COMMUNITY HEALTHCARE
WORKFORCE, UM THIS BILL
OBVIOUSLY REQUIRES HEALTH PLANS
TO PROVIDE PRIMARY CARE
PHYSICIANS WITH ADEQUATE ACCESS
TO A VARIETY OF COMMUNITY BASED
HEALTH WORKERS. UM OBVIOUSLY,
THIS IS SOMETHING THAT WE'VE
BEEN DOING WITHIN THE MEDICAL
PROGRAM, WHICH JUST SOME OF THE
LESSONS LEARNED AND CHALLENGES
THAT WE'VE SEEN IN THE MEDICAL
PROGRAM RELATED TO COMMUNITY
HEALTH WORKERS, IS THAT WE'VE
HAD CHALLENGES CONTRACTING WITH
COMMUNITY HEALTH WORKERS AND
MEDICAL AID TO A VARIETY OF
SPECIFIC FACTORS, INCLUDING
EXISTING REQUIREMENTS ON
COMMUNITY HEALTH WORKERS AND AN
OVERALL LACK OF CAPACITY OF
WORKERS TO CONTRACT WITH SO WE
UNDERSTAND THAT H. CHI IS IN THE
PROCESS OF DEVELOPING SOME
STANDARDIZATION FOR COMMUNITY
HEALTH WORKERS MOVING FORWARD,
SO THOSE ARE SOME OF THE
CONCERNS THAT WE HAVE IN AROUND
THE BILL WRIT LARGE AND LIKES
MORE CLARITY ON BUT AGAIN
APPRECIATE THE INTENT SUPPORT
THE INTENT. HOWEVER WE ARE
OPPOSED FOR THE REASONS I JUST
STATED THANK YOU. THANK YOU. MR
CHAIRMAN MEMBERS, STEPHANIE
WATKINS ON BEHALF OF THE
ASSOCIATION OF CALIFORNIA LIFE
AND HEALTH INSURANCE COMPANIES.
IN THE INTEREST OF TIME, I WILL
ALIGN MY COMMENTS WITH MY
COLLEAGUE. WE LOOK FORWARD TO
WORKING ON THIS. I THINK IT'S
KEY TO MAKE SURE THAT WE GET IT
RIGHT AND THAT WE SERVE THE
POPULATIONS THAT WERE, UM TO THE
BEST OF ABILITY FOR THE PLANS.
THANK YOU. THANK YOU. BE BACK TO
THE COMMITTEE FOR QUESTIONS OR
COMMENTS. ANY QUESTIONS ARE
COMING. THIS WILL MISS THE
ESSENCE OF TIME WILL BE QUICK.
UM SO I THINK IT'S IMPORTANT
THAT WE DO UNDERSTAND YOU KNOW
WHAT EACH INDIVIDUALS FACING,
YOU KNOW, I'VE ALWAYS BEEN A BIG
PROPONENT OF WHOLE PERSON CARE.
UM INDIVIDUALIZED CARE. AND WE
DO HAVE RIGHT NOW WE'RE ABLE TO
COVER UM, ACES SCREENINGS, AND
THIS WILL BROADEN IT TO LOOK AT
SOME OF THE OTHER ISSUES THAT
CAN AFFECT PEOPLE'S HEALTH. UM.
THOSE THINGS DO AFFECT ME. WE
DON'T EVEN REALIZE SOMETIMES
SOME OF THE THINGS THAT COULD
AFFECT SOMEBODY, UM SO I THINK
IT'S IMPORTANT THAT WE DO I DO,
UM, UNDERSTAND WHAT THE
OPPOSITION IS SAYING AS WELL AND
I THINK IT'S IMPORTANT THAT YOU
ALL KEEP WORKING TOGETHER
BECAUSE THE ISSUES NEIGHBORING
FORWARD ARE RELEVANT. AND EVEN
IF WE DO THIS, WE'RE GOING TO
GET IT TO ACTUALLY WORK BECAUSE
WE WANTED TO WORK. SO THOSE WILL
BE IMPORTANT THINGS. SO THANK
YOU FOR BRINGING THIS FORWARD.
ANY OTHER QUESTIONS OR COMMENTS.
WOULD YOU LIKE TO CLOSE DR
WEBBER? YES. WELL THANK YOU VERY
MUCH FOR ALLOWING THIS BILL TO
BE HEARD. UM DEFINITELY WILL
CONTINUE WORKING WITH THE
OPPOSITION. WE UNDERSTAND THAT
IT IS IMPORTANT LIKE THEY SAID
TO GET IT, RIGHT. UM ACES IS
IMPORTANT, BUT THOSE ARE
SPECIFICALLY FOCUSED ON ADVERSE
CHILDHOOD EVENTS. AND YOU KNOW
WHEN WE TALK ABOUT SOCIAL
DETERMINANTS OF HEALTH, IT'S NOT
JUST THE PAST BUT CURRENT, SO AS
UH, MY FELLOW PHYSICIAN WAS
TALKING ABOUT, UM, UNDERSTANDING
IF SOMEONE IS UNHAPPY, HOUSED
CURRENTLY AND THEIR DIET
DIAGNOSED WITH DIABETES, DO YOU
PRESCRIBE THEM INSULIN, WHERE
THEY WON'T BE ABLE TO ACTUALLY
GET IT REFRIGERATED. SO UM,
UNDERSTANDING WHAT'S HAPPENED IN
YOUR CHILDHOOD BUT ALSO
UNDERSTANDING WHAT'S GOING ON IN
YOUR SOCIETY RIGHT NOW IS AN
EXTREMELY IMPORTANT TOOL. UM AND
HEALTHCARE PROVIDERS TOOLKIT TO
BE ABLE TO PROVIDE THE BEST CARE
AND REALLY CREATE HEALTHY
INDIVIDUALS. AND I THINK, UM,
FOR THOSE OF US IN A HEALTHCARE
SETTING AND HOPEFULLY THOSE IN
THE INSURANCE COMPANIES
UNDERSTAND THAT PREVENTING
ILLNESS IS MUCH CHEAPER THAN
ACTUALLY TREATING IT IN THE LONG
TERM AND UNDERSTANDING THE
SOCIAL DETERMINANTS OF HEALTH
WILL ACTUALLY HELP PREVENT
TREATMENT AND CREATE HEALTHIER
INDIVIDUALS AND HEALTHIER
COMMUNITIES. AND WITH THAT, I
RESPECTFULLY ASK FOR YOUR I
VOTE. THANK YOU. THANK YOU VERY
MUCH. THE MOTION. THERE IS A
MOTION. IT IS BYE. MR MCCARTY, A
SECOND BY MS BURNER JOYS, ADO
PAST RECOMMENDATION FROM THE
CHAIR AND EMOTION IS DO PASS
THROUGH APPROPRIATIONS. SO
HAPPY, MADAM SECRETARY, PLEASE
CALL THE ROLL. WOULD WOULD I
WALDRON? WALDRON I AGUIAR-CURRY
AGUIAR-CURRY. AYE ARAMBULA
BURNER. BURNER I WENDY CARILLO.
FLORA. KHÔNG MAIENSCHEIN
MCCARTHY. MCCARTHY I, JOE
PATTERSON. RODRIGUEZ SANTIAGO
VALLAPUDUA. THEY PUT WHAT I
WEBER. HOWEVER, I. YOU HAVE
SEVEN VOTES WILL LEAVE THE BILL
ON CALL. AND NEXT UP IS MR
GABRIEL.
OKAY B 10 63 SORRY. I HAVE NO
SKITTLES. UM, THANK YOU COMMENT
ABOUT THAT, BUT NOT UNTIL WE GET
TO THE NEXT BILL. OKAY? SOUNDS
GOOD. THANK YOU. THANK YOU.
CHAIR AND COLLEAGUES AND I WANT
TO START BY ACCEPTING THE
COMMITTEE AMENDMENT. THANK YOU
FOR YOUR THOUGHTFUL FEEDBACK AND
ASSISTANCE HERE. UM AS I SHARED
WITH THE COMMITTEE WHEN WE, UM
PRESENTED A B 14 22 A FEW YEARS
AGO. A LOT OF MY INTEREST IN
THIS AREA COMES FROM MY MOM'S
EXPERIENCE AS A REGISTERED
NURSE, THE WORK THAT SHE DID AS
A BEDSIDE NURSE. THE FACT THAT
SHE SHE FELT THAT THERE WERE
TIMES THAT SHE WAS SO
UNDERSTAFFED THAT WOULD ACTUALLY
PUT PATIENTS LIVES AT RISK FOR
HER TO GO TAKE A RESTROOM BREAK.
AND THE IMPORTANCE THAT WE HAVE
AROUND NURSE TO PATIENT RATIOS
AND MAKING SURE THAT THOSE ARE
ENFORCED. AND SO THIS BILL IS
ANOTHER MOVE IN THAT DIRECTION.
IT WOULD REQUIRE THE DEPARTMENT
OF PUBLIC HEALTH TO OFFICIALLY
DOCUMENT THE EFFECTIVENESS OF
ITS EFFORTS TO ENFORCE THOSE
RATIOS AND HOSPITALS AND HEALTH
FACILITIES AND WOULD ALLOW
GREATER TRANSPARENCY AND
ACCOUNTING ABILITY REGARDING THE
IMPACTS OF LEGISLATION THAT HAVE
BEEN PASSED IN PRIOR YEARS, WILL
REQUIRE THE DEPARTMENT OF HEALTH
HEALTH TO PREPARE AND PUBLISH AN
ANNUAL REPORT. DOCUMENTING ITS
ENFORCEMENT OF EXISTING
REGULATIONS, INCLUDING ACTUAL
DATA REGARDING THE NUMBER OF
COMPLAINTS AND INVESTIGATORY
STEPS TAKEN AND REQUIRED TO TAKE
INPUT. FROM HEALTH CARE
PROFESSIONALS ABOUT THE WAYS TO
IMPROVE ITS ENFORCEMENT IN THE
IN THE FUTURE. SO ACTUALLY
GIVING OUR FRONTLINE HEALTHCARE
WORKERS THE FOLKS THAT WE CALLED
OUR FRONTLINE HEALTHCARE HEROES
DURING THE PANDEMIC, AN
OPPORTUNITY TO HAVE A VOICE IN
THE PROCESS TO MAKE SURE THAT
THEY ARE IN SAFE WORKING
CONDITIONS AND THAT THEY CAN
STAND UP FOR PATIENT SAFETY. SO
WITH ME TODAY TO TESTIFY ARE
CHARMAINE CHARMAINE MORALES ARE
EN THE PRESIDENT OF YOU KNOCK
YOU HCP AND MATTLAGE, A
GOVERNMENT RELATIONS ADVOCATE
WITH S E A U CALIFORNIA THANK
YOU VERY MUCH AND RESPECTFULLY
REQUEST YOUR I VOTE. GOOD
EVENING. THANK YOU. CHAIR WOOD
AND MEMBERS OF THE COMMITTEE FOR
CONSIDERING A B 10 63 AND THANK
YOU ASSEMBLYMEMBER'S GABRIEL FOR
YOUR UNWAVERING SUPPORT OF OUR
MEMBERS ARE NURSES. MY NAME IS
SHARMEEN MORALES, PRESIDENT OF
UNITED NURSES ASSOCIATIONS OF
CALIFORNIA UNION OF HEALTHCARE
PROFESSIONALS. MAYBE 10 63
REQUIRES THE DEPARTMENT OF
PUBLIC HEALTH TO OFFICIALLY
DOCUMENT THE EFFECTIVENESS OF
ITS EFFORTS TO ENFORCE NURSE
STAFFING RATIOS AND HOSPITALS
AND HEALTH FACILITIES, LEADING
TO GREATER TRANSPARENCY AND
ACCOUNTABILITY. NURSE TO PATIENT
RATIOS BECAME LAW IN CALIFORNIA
TO PROTECT PATIENTS. AS WELL AS
TO SUPPORT OUR ENDS.
UNFORTUNATELY FOLLOWING THE
STAFFING, RACE, STAFFING RATIOS
LAW HAS BEEN A PROBLEM FOR
HOSPITALS, WHICH HAS LED TO
NURSE BURNOUT. SINCE I BECAME
PRESIDENT IN OCTOBER. I HAVE
BEEN VISITING OUR NURSES
THROUGHOUT THE STATE. CHECKING
IN ON THEIR WELL BEING AND THEIR
MORALE. THE PRIMARY RESPONSE
FROM OUR NURSES HAS BEEN TO FIX
THE STAFFING CRISIS AT THEIR
WORKPLACE. MANY OF OUR STAFFING
CHALLENGES. SPECIFICALLY
UNDERSTAFFING EXISTED PRIOR TO
THE COVID 19 PANDEMIC. COVID
ONLY EXASPERATED THE PROBLEM
MORE THE STAFFING CRISIS HAS
TAKEN A HEAVY TOLL ON OUR NURSES
AND FILL YOUR STAFF
APPROPRIATELY RESULTS IN HIGHER
LEVELS OF NURSE BURNOUT AND
NURSE TURNOVER. UNDERSTAFFING
HAS ALSO LED TO UNNECESSARY COST
TO THE EMPLOYER HOSPITALS HAVE
SPENT MILLIONS OF DOLLARS IN
TRAVELERS INSTEAD OF HIRING
PERMANENT RANK AND FILE NURSES.
HIRING THESE TEMPORARY RN
SOMETIMES FROM OTHER STATES COST
MUCH, MUCH MORE THAN A FULL TIME
RANK AND FILE NURSE ON AN HOURLY
BASIS. MORE MORE OVER A B 10 63
WILL ALLOW DIRECT CARE NURSES TO
PROVIDE INPUT REGARDING THE
EFFICACY OF DPH S ENFORCEMENT
EFFORTS AS WELL AS SUGGESTIONS
FOR IMPROVING ENFORCEMENT. THIS
BILL DOES NOT IMPOSE ANY NEW
OBLIGATIONS ON HOSPITALS, NOR
DOES IT IMPOSE ANY FINES, BUT IT
DOES ENSURE THAT THE DPH IS
ENFORCEMENT EFFORTS REGARDING
EXISTING LAWS ARE AFFECTIVE.
THANK YOU FOR YOUR TIME, AND I
RESPECTFULLY ASK FOR YOUR I
VOTE. GOOD AFTERNOON CHAIR AND
MEMBERS MATTLAGE A ON BEHALF OF
S C I U CALIFORNIA AND PROUD
SUPPORT OF A B 10 63. WE LIKE TO
THINK THE AUTHOR FOR BRINGING
THIS ISSUE FORWARD AND
CONTINUING TO CHAMPION ISSUES
RELATED TO NURSING NURSING CARE
AND PATIENT CARE. WE KNOW THAT
NURSES ARE STRONG ADVOCATES FOR
THEIR PATIENTS, AND
UNFORTUNATELY WHEN NURSES ARE
OVERWHELMED AND UNDERSTAFFED, IT
DOES IMPACT PATIENT CARE. FOR
YEARS. I SEE YOU IN PARTNERSHIP
HAS PUSHED FOR GREATER
TRANSPARENCY AND ACCOUNTABILITY
OF NURSE TO PATIENT RATIOS,
INCLUDING A B 14 22 AND ALSO SB
2 TO 7 TO IMPORT IMPOSED FINES
ON HOSPITALS WHO ARE VIOLATING
STATE STAFFING LAWS. NURSES ON
THE FRONT LINES OF PATIENT CARE
OF REPORTED VIOLATIONS OF NURSE
RATIOS AND HAVE REPEATED THE
CALL TO HOLD HOSPITALS,
ACCOUNTABILITY ACCOUNTABLE TO
STATE STAFFING LAWS WHEN NURSES
ARE PUSHED TO CARE FOR MORE
PATIENTS THAN THEY'RE ALLOWED IN
THE NURSERY IN THE RATIOS, IT
JEOPARDIZES PATIENT SAFETY AND
LEADS TO POOR HEALTH OUTCOMES. S
C I U SUPPORTING THIS MEASURE
BECAUSE IT WILL ENSURE THAT
DURING THE DEPARTMENT OF PUBLIC
HEALTH PROCESS THAT THE NURSES
VOICE IS WOVEN INTO THE
ENFORCEMENT PROCESS. WE KNOW
THAT AFTER DEPARTMENT VACANCY
AND TURNOVER IS AN ISSUE WITH
ENFORCEMENT. HOWEVER WE URGED
THE STATE TO CONTINUE ADDRESS
THAT ISSUE WHILE ALSO ENSURING
THAT NURSE'S VOICE IS INCLUDED
IN THE ENFORCEMENT PROCESS. FOR
THESE REASONS S I U IS PROUD TO
SUPPORT A B 10 63. AND URGE YOUR
I VOTE. THANK YOU. THANK YOU.
I'M SORRY. WHICH IS SOMEBODY
SOMEBODY WAS THINKING ABOUT US.
PROMOTION BY MISS AGUILAR.
EXCUSE ME MY EMOTION BY MS
BOERNER HORVATH, A SECOND BY MS
AGUIAR-CURRY OTHERS IN SUPPORT
OF THE BILL, PLEASE. I'M SORRY.
I WAS DISTRACTED BY CHRISTOPH
MAYER, AMERICAN FEDERATION OF
STATE, COUNTY AND MUNICIPAL
EMPLOYEES AND SUPPORT THANK YOU.
ELIZABETH HAWKINS, YOU EVACUATE
CP REGISTERED NURSE AND SUPPORT
THANK YOU. ANY ANYONE ELSE? IS
THERE OPPOSITION TO THE BILL?
GOOD EVENING CHAIR AND COMMITTEE
MEMBERS. VANESSA GONZALEZ WITH
THE CALIFORNIA HOSPITAL
ASSOCIATION AND OPPOSITION TO 10
63. AS YOU ALL KNOW, THE
PANDEMIC HAS TAKEN A HEAVY TOLL
ON THE HEALTH CARE DELIVERY
SYSTEM, AND HOSPITALS THROUGHOUT
THE STATE ARE STILL RECOVERING.
HOSPITALS ARE EXPERIENCING AN
UNPRECEDENTED UNPRECEDENTED
LEVEL OF PATIENT VOLUME,
PARTICULARLY IN OUR EMERGENCY
DEPARTMENTS. WHICH ARE
EXPERIENCING IN 42% INCREASE IN
PATIENT VOLUME, AND THAT NUMBER
IS ONLY EXPECTED TO INCREASE AT
THE SAME TIME, CALIFORNIA'S IN
THE MIDST OF A HEALTHCARE WORK
FIRST CRISIS AND HOSPITALS ARE
FACING THE WORST STAFFING
SHORTAGES IN MEMORY, ACCORDING
TO A RECENT U. U C. S F, UH,
STUDY. CALIFORNIA HAS A DEFICIT
OF 40,000 REGISTERED NURSES, AND
THAT NUMBER WILL ONLY CONTINUE
TO GROW. AND IT'S NOT ONLY
NURSES. THERE IS ALSO AN
ESTIMATED SHORTAGE OF 500,000
ALLIED HEALTH EMPLOYEES BY 2020
2024. HOSPITALS ARE TRYING TO
HIRE NURSES AS QUICKLY AS
POSSIBLE. AND DOING THEIR PART
IN TRAINING NURSING STUDENTS. IN
FACT, CH IS WORKING WITH THE
SPONSORS OF THE BILL ON ANOTHER
PROPOSAL TO ENSURE THAT NURSING
SLOTS ARE AVAILABLE AT HOSPITALS
FOR STUDENTS TO COMPLETE THEIR
CLINICAL ROTATIONS. CH IS ALSO
COOKED, COSPONSORING A BILL WITH
S E I U THAT ALSO IN CAPE AIMS
TO INCREASE HEALTH CARE WORK OF
WORKFORCE TO THE COMMUNITY
COLLEGE SYSTEM. WHAT HOSPITALS
ARE DOING EVERYTHING THEY CAN TO
BRING ON MORE NURSES, INCLUDING
HIRING MORE EMPLOYED NURSES, AS
WELL AS BRINGING ON TRAVELER
NURSES TO HELP FILL THAT GAP TO
MEET STAFFING RATIOS. THERE ARE
CIRCUMSTANCES WHEN THE NUMBER OF
PATIENTS WHO NEED CARE MAY
EXCEED THE NUMBER OF NURSES.
THAT HOSPITALS HAVE AVAILABLE,
MAKING IT IMPOSSIBLE TO IN HERE
ADHERE TO THE STAFFING RATIOS.
FORTUNATELY IN THE CIRCUMSTANCES
, RATHER THAN REQUIRING THE
HOSPITAL TO TURN AWAY PATIENTS,
THE LAW PROVIDES AN EXEMPTION TO
THE RADIO RATIO REQUIREMENT.
SOMETIMES THESE CIRCUMSTANCES
MAYBE ANTICIPATED, FOR EXAMPLE,
DURING COVID SEARCHES, SURGES OR
COMPLETELY UNEXPECTED, SUCH AS
DURING NATURAL DISASTERS OR
OTHER EMERGENCIES. UH IN
ADDITION, THESE AND OTHER
COMPLIANCE RELATED INFORMATION
ON STAFFING RATIO COMPLIANCE AND
QUALITY, PARTICULARLY
ENFORCEMENT ACTIONS ARE ALREADY
PUBLICLY AVAILABLE. STATE LAW
ALREADY HAS A PROCESS. IN PLACE
FOR ANYONE TO REPORT STAFFING
COMPLAINTS, STAFFING, RACIAL
COMPLAINTS AND INVESTIGATION
PROCESS FOR CD PH. THE REPORTING
REQUIREMENTS IN MAYBE 10 63
WOULD NOT RESULT AND IMPROVE.
QUALITY OF CARE IN OUR
COMMUNITIES. FOR THESE REASONS,
CH A RESPECTFULLY REQUEST YOUR
NO VOTE ON A B 10 63. THANK YOU.
THANK YOU IS THERE ARE THERE
OTHERS IN OPPOSITION? AND NO ONE
WILL BRING IT BACK TO THE
COMMITTEE FOR QUESTIONS OR
COMMENTS ON MR V. VALLAPUDUA HAD
A COMMON QUÊ. THANK YOU THROUGH
THE CHAIR. UM I DO WANT TO THANK
THE AUTHOR FOR BRINGING THIS
FORWARD. AS A FORMER COUNTY
SUPERVISOR. I SAT ON ALL OUR
HOSPITAL COMMITTEE. UM UM,
COMMITTEES AND. THIS HAS BEEN AN
ONGOING PROBLEM, RIGHT RATIO.
I'M NOT JUST JUST WITH NURSES,
BUT LYING STAFF. IT'S ALWAYS
HARD. IT'S ALWAYS A VERY HARD
ESPECIALLY IT'S HARDER EVEN TO
WHEN WE CLOSED DOWN CLINICS IN
OUR DISTRICT. UM IT JUST MAKES
IT HARDER. AND OUR HOSPITAL.
I'VE ALWAYS LEARNED THAT OUR
NURSES ALWAYS HAD LIKE THIS
PASSIONATE HARD BECAUSE
SOMETIMES THEY HAVE TO CARE FOR
MORE THAN THEY'RE SUPPOSED TO
HAVE HEARD OF OTHER CONCERNS AND
COMPLAINTS. UM. AND IT'S
DIFFICULT BECAUSE I ALSO FEEL
THAT YOU KNOW. HOW DO WE FIX
THIS PROBLEM? HOW DO WE GET MORE
NURSES THROUGH? UM, I HEARD THE
OPPOSITION RIGHT TALK. I THINK
THAT I'VE ALWAYS LEARNED THAT
YOU KNOW, IT SEEMS LIKE THAT'S
IT'S A FIELD THAT PEOPLE REALLY
DO WANT TO GO. GO INTO. BUT HOW
DO WE? HOW DO WE WAVE THAT STEAK
? MORE RIGHT TO OUR HOSPITALS.
IT'S MUCH NEEDED, UM. I HEAR I
KNOW UNIFORMLY ENFORCED SO DOES
THAT MEAN THAT, UM WE'LL GET
NUMBERS FROM EVERY HOSPITAL IS
THAT IT WOULD BE SOMETHING
QUARTER YEARLY ON HOW THAT'S
GOING. YEAH THANK YOU VERY MUCH.
ASSEMBLYMEMBER'S AND I JUST WANT
TO, UM, ACKNOWLEDGE THE POINT
THAT YOU MADE. I MEAN, I THINK
THAT THIS IS A PROFESSION IN
CRISIS. UM AND A LOT OF THESE
CHALLENGES PREDATE COVID. WE'RE
CERTAINLY EXACERBATED BY COVID.
I KNOW WE HAVE CHALLENGES IN
RURAL AREAS IN PARTICULAR. AND
UM, THAT'S WHY I THINK THERE'S A
LOT OF BILLS IN THIS AREA THIS
YEAR AS YOU HEARD FROM
OPPOSITION AND FROM AH FROM
SUPPORTING WITNESSES. THERE ARE
WAYS THAT FOLKS ARE LOOKING TO
WORK TOGETHER TO SAVE THE
PROFESSION TO CREATE A STRONGER
PIPELINE WINNER, SO I THINK
THOSE ARE REALLY, REALLY
IMPORTANT PIECES OF THE PUZZLE.
WE THINK THAT THIS IS A LITTLE
IN. THIS IS A LITTLE BUT
IMPORTANT PIECE OF THE PUZZLE AS
WELL, WHICH IS TO BRING MORE
TRANSPARENCY AND ACCOUNTABILITY
TO THE ENFORCEMENT. SOMETIMES
THE HOSPITALS ARE OUT OF RATIO
BECAUSE OF NATURAL DISASTERS OR
OTHER THINGS THAT ARE NO FAULT
OF THEIR OWN, AND WE WORKED WITH
THEM ON 14 22 WITH THE HOSPITAL
ASSOCIATION TO HEAR THEIR
CONCERNS TO GET THEM TO A PLACE
WHERE THEY WERE NEUTRAL. BUT I
ALSO KNOW FROM MY OWN DISTRICT
AND I ACTUALLY HAVE FIVE
HOSPITALS IN MY IN MY ASSEMBLY
DISTRICT. I THINK I MAY HAVE
MORE HOSPITALS IN MY ASSEMBLY
DISTRICT, UH THAN ANY EVERYONE
SHAKING THEIR HEAD THAN ANY
MEMBER OF THE LEGISLATURE. UM
THERE ARE DISTINCT DIFFERENCES
THAT ARE GOOD ACTORS, AND
THEY'RE BAD ACTORS IN THEIR
SPACE AND THEIR FOLKS OUT THERE
WHO BECAUSE OF PROFIT MOTIVATION
BECAUSE OF FINANCIAL INCENTIVES
BECAUSE OF CORPORATE PARENTS,
WHO ARE DEMANDING THAT THEY
SQUEEZE EVERY LAST DIME OUT OF
THE CARE THAT THEY ARE PROVIDING
ARE PUTTING NURSES AND UNTENABLE
POSITIONS WHICH ARE UNFAIR TO
THE WORKFORCE AND REALLY
COMPROMISING PATIENT SAFETY. AND
SO THIS WE THINK, IS ACTUALLY A
LIGHT TOUCH APPROACH. IT GIVES
MORE TRANSPARENCY, MORE
ACCOUNTABILITY. I'M A BIG
BELIEVER IN TRANSPARENCY AND
ACCOUNTABILITY THAT ENCOURAGES
FOLKS USUALLY GIVES THEM THE
INCENTIVES TO DO THE RIGHT THING
WILL GIVE US AS A LEGISLATURE.
MORE INFORMATION SO WE CAN THINK
ABOUT WHAT WHAT ADDITIONAL
POLICY INTERVENTIONS, IF ANY,
ARE NECESSARY AND ALSO VERY
IMPORTANTLY, WE'LL GIVE THOSE
NURSES UH, VOICE IN THE PROCESS.
I THINK WHAT WE'VE HEARD SO MUCH
AS JUST FRUSTRATION FROM A
WORKFORCE THAT HAS DONE
INCREDIBLE WORK OFTEN PUT
THEMSELVES AND THEIR FAMILIES AT
RISK DURING THE COVID PANDEMIC,
PEOPLE WHO WENT INTO HOSPITALS
DAY IN AND DAY OUT PRE VACCINE
PRE PACKED SLOVIN TO PROTECT
OTHER FOLKS AND ARE REALLY
BURNED OUT AND TO GIVE THEM A
VOICE IN THIS PROCESS TO GIVE
THEM SOME AGENCY, I THINK WILL
HELP US, UM TO SAVE THE
PROFESSION AND ALSO TO, UM AND
ALSO THE CRAFT. BETTER POLICY.
SO, UM, APPRECIATE THE CONCERNS
ARE RAISED, HAD AN INITIAL
CONVERSATION WITH THE OPPOSITION
. I THINK WE'RE VERY, VERY
COMMITTED TO WORKING WITH THEM
TO UNDERSTANDING THE CHALLENGES
HERE. SOME OF THESE CHALLENGES
ARE NOT OF THEIR MAKING. BUT
THIS IS AN IMPORTANT PIECE OF
THE PUZZLE, AND THAT'S WHY WE
THINK THE TRANSPARENCY AND
ACCOUNTABILITY ARE CALLED FOR IN
THESE CIRCUMSTANCES. I WOULD
AGREE WITH YOU. I MEAN, IT'S
NOT. IT'S NOT LABOR OR THE
NURSE'S FAULT. I MEAN, SOMETIMES
IT'S THE ADMINISTRATION RIGHT
AND IT IS A TOUGH THING TO DO.
BUT I THINK THAT'S WHY SOMETIMES
YOU KNOW, YOU LOOK AT COUNTY
ADMINISTRATORS. I THINK THE
RATIOS LAST THEY LAST LIKE EVERY
THREE YEARS OF ROTATE. I THINK
WE NEED TO DO A BETTER JOB. UM
SO I WILL BE SUPPORTING TODAY.
THANK YOU. THANK YOU APPRECIATE
THAT, OKAY? ARE THERE OTHER DR
WEBBER? THANK YOU. SOME OF THE
MEMBER GABRIEL FOR BRINGING THIS
FORWARD AND THANK, UM EVERYONE
WHO'S COME UP IN SPOKE, UM, FROM
SOMEONE WHO IS, UM ON THE GROUND
. I THINK THOSE BAD ACTORS ARE
FEW AND FAR BETWEEN. UM YOU
KNOW, I DO BELIEVE THAT THE
HOSPITALS ARE DOING WHAT THEY
CAN AND THE FACT THAT THERE IS A
NURSING SHORTAGE IS REAL. UM, I
HAVE SEEN FLATS POSITIONS BE
UNFILLED, ESPECIALLY AFTER COVID
BECAUSE PEOPLE ARE BURNED OUT.
HEALTHCARE PROVIDERS ARE BURNT
OUT. UM BUT I WILL BE SUPPORTING
THIS BILL BECAUSE I DO THINK
THAT IT IS ANOTHER TOOL IN OUR
KIT. Tð UM, FIX THE PROBLEM
WHICH, ACTUALLY, I THINK STARTS
ALL THE WAY BACK INTO THE NUMBER
OF SLOTS WE HAVE FOR OUR
STUDENTS TO ACTUALLY GET INTO
NURSING SCHOOL, AND THERE ARE
SOME BILLS AROUND THAT, BUT
WE'VE GOT SOME GREAT RESIDENTS
HERE IN CALIFORNIA THAT WANT TO
BE NURSES THAT CAN'T THEY HAVE
TO WAIT FOR YEARS? UM AND SOME
OF THAT HAS TO DO WITH, UM YOU
KNOW OUR OUR NURSING BOARD AND
THE NUMBER OF SLOTS THAT THE
ALLIGATOR ALLOCATE SOME OF IT
HAS TO DO WITH THE PLACES IN
WHICH THEY CAN ACTUALLY DO
CLINICAL ROTATIONS. AND I KNOW
YOU MENTIONED THAT BILL OR
SOMEONE WENT IN THAT BILL
EARLIER TODAY. UM AND SO FOR ME,
I THINK THAT THIS BILL EVEN IF
IT'S INFORMATION THAT WE ALREADY
HAVE KIND OF AN OTHER DIFFERENT
PLACES BEING TOGETHER IN ONE
REPORT, UM WILL REALLY HELP IN
OUR PUSH TO, UM, INCREASE OUR
NUMBERS OF OUR NURSES MAKE SURE
THAT THEY'RE SUPPORTED, UM AND
REALLY DEAL WITH IT FROM A
HOLISTIC STANDPOINT. SO UM,
THANK YOU FOR BRINGING IT
FORWARD JUST SO THAT WE HAVE UH
, MORE MORE TO WORK WITH WHEN
WE'RE TACKLING THIS PROBLEM, SO
THANK YOU. ANYONE ELSE? WE DO
HAVE A MOTION BY MS BURNER
SECOND BY PARDON? AGUIAR-CURRY
THANK YOU WITH. AND THE MOTION
IS DUE PASS AS AMENDED TO
APPROPRIATION. WELL, THANK YOU
FOR WORKING WITH US ON THIS.
WOULD YOU LIKE TO CLOSE? THANK
YOU VERY MUCH. JUST WOULD
RESPECTFULLY REQUEST AND I VOTE
VERY WELL. THANK YOU. MADAM
SECRETARY. PLEASE CALL THE ROLL.
I WOULD. I WOULD I. WALDRON
WALDRON. NO AGUIAR-CURRY CURRY,
I ARAMBULA ARAMBULA. AYE BURNER.
BURNER I WENDY CARILLO. FLORA.
MONNING VINCE PHªN NO
MAIENSCHEIN. MAIENSCHEIN I'M
MCCARTY. MCCARTHY I, JOE
PATTERSON. RODRIGUEZ. SANTIAGO.
SANTIAGO IVY VALLAPUDUA YOU PUT
WHAT I WEBER. HOWEVER, I. THAT
IS 92. THAT BILL IS OUT. GO
AHEAD AND MOVE ONTO YOUR NEXT
BUILDING.
MOTION WAS MR FONG WAS THAT
CORRECT? MR SANTIAGO. MR
MCCARTHY. WHENEVER YOU'RE READY,
SIR. I'M SORRY. THANK YOU, MR
CHAIR MEMBERS. I WILL BE BRIEF.
JUST GIVEN THE TIME. I JUST WANT
TO THANK THE COMMITTEE FOR THEIR
THOUGHTFUL WORK ON THIS BILL
CONFIRM THAT WE WILL BE
ACCEPTING THE AMENDMENTS. THIS
IS JUST A CONTINUATION OF A B
61, WHICH I OFFERED IN WHICH I
AUTHORED IN 2021 WITH MANY
PEOPLE IN THIS ROOM TO PROVIDE
SOME REGULATORY FLEXIBILITY TO
OUR, UH NEIGHBORHOOD RESTAURANTS
THAT WERE JUST STRUGGLING SO
MUCH DURING THE PANDEMIC,
OUTDOOR DINING AND REGULATORY
FLEXIBILITY BECAME, UM, REALLY A
LIFELINE FOR THESE SMALL
BUSINESSES, WHICH ARE THE
BACKBONE OF SO MANY COMMUNITIES
ACROSS THE STATE. WE KNOW THAT
MANY FOLKS MADE SIGNIFICANT
INVESTMENTS IN OUTDOOR DINING
THERE DURING THE PANDEMIC. UM
FOLKS ARE STILL STRUGGLING TO
COME BACK FROM THAT. THEY'RE
OBVIOUSLY STILL STRUGGLING WITH
INFLATION AS WELL. UM AND WE
KNOW THAT THESE NEIGHBORHOOD
RESTAURANTS AGAIN ARE JUST
BELOVED. THEY CONTRIBUTE GREATLY
TO THE CULTURAL AFFAIRS IN OUR
COMMUNITY. THEY ARE AN ENGINE OF
UPWARD SOCIAL MOBILITY. THEY
EMPLOY ONE OF THE REMOTE, MOST
DIVERSE WORKFORCES IN THE STATE.
AND SO I THINK IT IS WOULD BE,
UM REALLY IMPORTANT FOR US TO
CONTINUE THAT FLEXIBILITY SO
THEY CAN GET BACK ON THEIR FEET
WITH ME TODAY TO TESTIFY ON
BEHALF OF OUR SPONSOR IS THE
CALIFORNIA RESTAURANT
ASSOCIATION IS JOHN ROSS. THANK
YOU AND WOULD RESPECTFULLY
REQUEST AND I VOTE. MY FIRST
HEARING JOHN ROSS ON BEHALF OF
THE CALIFORNIA RESTAURANT
ASSOCIATION. UH ASSEMBLYMEMBER'S
GABRIEL A V 61 WAS CRITICAL AS
HE MENTIONED FOR THE SURVIVAL
THE INDUSTRY OVER THE LAST FEW
YEARS. IT'S TURNED INTO AN
AMENITY THAT THE PUBLIC LOVES
AND WE ENCOURAGE THIS COMMITTEE
TO CONTINUE THE FACILITATION
PROVIDED BY THAT ORIGINAL BILL.
THANK YOU. WELL, THANK YOU
OTHERS IN SUPPORT. THERE ANY
OPPOSITION? I'M SORRY. EXCUSE
ME. I'M SORRY WAS I DIDN'T MEAN
TO BE SOFTWARE ON BEHALF OF THE
CALIFORNIA TRAVEL ASSOCIATION
AND SUPPORT THANK YOU. ANYONE
ELSE? THERE ANY OPPOSITION TO
THE BILL? DON'T BRING IT BACK TO
THE COMMITTEE FOR QUESTIONS OR
COMMENTS AND I HAVE A COMMENT.
MS AGUIAR-CURRY ATTENTION. I
LOVE THIS FILL OF SAVE MY
COMMUNITY AND MY COMMUNITY IS
JUST FALLING APART. I HAVE ONLY
FOUR RESTAURANTS, ONE
RESTAURANTS IN TOWN. THEY'RE OFF
FLOURISHING. IT WASN'T FOR THIS
BILL. THEY I ONLY ONE THINK
ABOUT WHAT WOULD MY DOWNTOWN
LOOK LIKE? SO I APPRECIATE IT
AND I WILL STRONG SUPPORT FOR
YOU. THANK YOU VERY MUCH. THANK
YOU ANYONE ELSE? YEAH I'VE
NOTICED THE SAME THING IN MY
TOWN. SO YOU HAVE OBVIOUSLY HAVE
FLEXIBILITY FOR THE OUTDOOR
DINING AND ALCOHOLIC BEVERAGES
AS WELL, WHICH HAS BEEN REALLY
IMPORTANT TOO. ESPECIALLY A LOT
OF SMALL TOWNS, SMALLER
RESTAURANTS. SO UM, HAPPY TO
SUPPORT YOUR BILL TODAY? SO I'VE
NOTICED YOU. WORKING ON SAFE
FOOD FOR US. EXTENDING THESE
PRIVILEGES OUT THERE. WE JUST
ASK THAT IF YOU'RE GOING TO DO
ANYTHING ON MARASCHINO CHERRIES
THAT YOU LET US KNOW IN ADVANCE
BECAUSE WE HAVE REAL CONCERN
ABOUT THAT UP HERE, SO, UM, WITH
THAT WE DO HAVE EMOTION BY THE.
MR SANTIAGO IS SECOND BY MR
MCCARTY MOTION IS DUE PASS AS
AMENDED TO APPROPRIATIONS. WOULD
YOU LIKE TO CLOSE? RESPECTFULLY
QUESTION I VOTE. THANK YOU.
THANK YOU, MADAM SECRETARY.
PLEASE CALL THE ROLL. WOULD
WOULD I? WALDRON WALDRON, I
AGUIAR-CURRY CURRY I ARAMBULA
ARAMBULA. AYE BURNER. BURNER I
WENDY CARILLO. LARA. WANG.
THAT'S WRONG. I MAIENSCHEIN
MAIENSCHEIN I MCCARTY MCCARTHY
I, JOE PATTERSON, PATTERSON
IRODRIGUEZ. SANTIAGO. SANTIAGO.
I'D BE VALLAPUDUA. VALLAPUDUA.
AYE, WEBER. WEBER. AYE. 12 0
THAT YOUR BILL IS OUT. THANK YOU
SO MUCH FOR LEAD THE ROLE OPEN
FOR OTHERS TO ADD ON. UH TWO
BILLS LEFT MISS BURNER. YOU ARE
UP. MAYBE 7 16. CAN WE DO? 14 81
1ST. YEAH WE CAN DO THAT. SO
WE'LL START. WHOEVER MADE THE
MOTIONS WILL JUST YOU CAN.
YOU'RE GONNA MOVE 14 81. MOTION
BY MR MCCARTY, A SECOND BY MR
SANTIAGO ON A B 14 81. SO. OKAY
GOOD AFTERNOON, MR CHAIRMAN
MEMBERS. MAYBE 14 81 REQUIRES
THE DEPARTMENT OF HEALTH CARE
SERVICES TO TWO THINGS ENSURE
THAT A PREGNANT PERSON IS
COVERED UNDER THE P E P FOR PE
FOR P W I HATE THIS PRESUMPTIVE
ELIGIBILITY FOR PREGNANT WOMEN
UNTIL THEY ARE ENROLLED IN FULL
SCOPE, MEDICAL BENEFITS AND
UPDATES THE PROGRAM TO BE NAMED
PRESUMPTIVE ELIGIBILITY FOR
PREGNANT PEOPLE AS A GENDER
NEUTRAL TERM. THAT IS MORE
INCLUSIVE TO NON BINARY,
TRANSGENDER AND GENDER
NONCONFORMING CALIFORNIANS UNDER
THE CURRENT LAW, THE PRESUMPTIVE
ELIGIBILITY FOR PREGNANT WOMEN
PROGRAM PROVIDES A PREGNANT
PERSON WITH A LOW INCOME
IMMEDIATE TEMPORARY COVERAGE FOR
UP TO 60 DAYS WHILE THEY'RE
APPLYING FOR FULL SCOPE. MEDICAL
OVER IT OFTEN CAN TAKE LONGER
THAN 60 DAYS FROM MEDICAL
APPLICATION TO BE APPROVED AND
AT THAT TIME P E FOUR PW
COVERAGE CAN LAPSE LEADING TO A
GAP IN COVERAGE. MANY PEOPLE ARE
LEFT WITHOUT COVERAGE AND EITHER
HAVE TO PAY OUT OF POCKET FOR
SERVICES OR, UNFORTUNATELY,
FORGO ESSENTIAL MEDICAL CARE
ENTIRELY WHILE THEY WAIT FOR THE
MEDICAL DETERMINATION. IN
ADDITION, THE PROGRAM PROVIDES
COVERAGE FOR ALL PREGNANT
PATIENTS WITH LOW INCOMES
REGARDLESS OF GENDER. THE
CURRENT NAME CAN SEEM ALIENATING
TO NON BINARY, TRANSGENDER AND
GENDER. NONCONFORMING PREGNANT
PEOPLE AND DOES NOT ACCURATELY
REFLECT THE INCLUSIVENESS OF THE
PROGRAM. MAYBE 14 81 IS BASED ON
ONE OF THE FUTURE OF ABORTION
COUNCIL'S RECOMMENDATIONS. THE
BILL IS ALSO A WOMAN'S
LEGISLATIVE CAUCUS. PRIORITY
BELL. I RESPECTFULLY ASK FOR
YOUR VOTE AND WITH ME IS THE
JOINT AUTHOR AND ACTUALLY THE
ORIGINAL AUTHOR OF THE BILL
ASSEMBLYMEMBER'S BAUER-KAHAN
WILL SPEAK IN SUPPORT. IT'S FUN
TO BE A SPECIAL GUEST HERE TODAY
, UM, COMMITTEE? I JUST WANTED
TO BE HERE BECAUSE I THINK THAT,
UM THE WOMEN'S CAUCUS REALLY
STANDS IN STRONG SOLIDARITY AT
THE RIGHT FOR WOMEN TO CHOOSE,
AND THAT MEANS TO CHOOSE
ABORTION AND TO CHOOSE PREGNANCY
AND EVERYTHING IN BETWEEN, AND
THIS BILL IS REALLY CRITICAL FOR
THOSE THAT CHOOSE PREGNANCY
BECAUSE RIGHT NOW, THE COVERAGE
THAT ONE GETS UNDER MEDIC AL IS
LIMITED. IT'S LIMITED IN TWO
WAYS. ONE IS IT CAN LAPSE AFTER
60 DAYS WHICH THIS BILL CORRECT,
BUT THE SECOND WAY IS IT ONLY
COVERS PRENATAL AMBULATORY CARE.
IT DOESN'T COVER WHOLE
HEALTHCARE AND HIS THOSE OF US
SITTING HERE TODAY KNOW WHEN
YOU'RE PREGNANT. YOU NEED YOUR
WHOLE BODY TO BE HEALTHY IN
ORDER FOR THAT, UM, GROWING
FETUS INSIDE OF YOU TO BE
HEALTHY AND CARRY YOUR BABY TO
TERM IN A HEALTHY WAY. AND SO
THAT IS MISSING FROM THE BILL
NOW, AND I HOPE WE'LL GET ADDED
BECAUSE WE REALLY HAVE A LONG
WAY TO GO AND ENSURING THAT
PREGNANT PEOPLE IN CALIFORNIA
ARE GETTING THE HEALTH CARE THEY
NEED. TO BE ABLE TO DELIVER THE
HEALTHY BABIES THEY DESERVE IF
THEY SO CHOOSE, AND WITH THAT
I'LL GO AHEAD AND ADD ON ONE OF
THE THINGS I THINK MY COLLEAGUES
REFERENCING IS AND WE'RE
CLARIFYING WHETHER THIS WAS
ACTUALLY TAKEN OUT OF THE MOMENT
AND WE WANT TO MAKE SURE I HAD A
UTI FOR THREE MONTHS WHEN I HAD
MY DAUGHTER, MAYA. IF THAT'S NOT
COVERED UNDER MEDICAL. YOU LOSE
A BABY. THEY WERE READY TO PUT
ME ON INTER VENOUS ANTIBIOTICS
TWICE A DAY SO THAT I COULD KEEP
MY BABY. AND SO THESE ARE THE
SERVICES THAT WOMEN NEED IN
CALIFORNIA AND THEY'RE NOT.
THEY'RE NOT UNCOMMON. IT'S VERY
COMMON TO GET A UTI AND IT WAS A
LOW LEVEL. I DIDN'T HAVE ANY
SYMPTOMS I WOULDN'T HAVE KNOWN
HAD I NOT GONE TO THE DOCTOR. UM
AND SO I'M VERY GRATEFUL FOR MY
DAUGHTER TODAY, AND I WANT
EVERYBODY WHO CHOOSES TO HAVE A
CHILD IN CALIFORNIA TO BE ABLE
TO HAVE THAT REALLY IMPORTANT
PRENATAL CARE. RESPECTFULLY ASK
FOR MY VOTE. THANK YOU, UM
OTHERS IN SUPPORT. CHRISTOPH
MAYER WITH THE AMERICAN
FEDERATION OF STATE, COUNTY AND
MUNICIPAL EMPLOYEES AND SUPPORT
. AARON EVANS ON BEHALF OF THE
CALIFORNIA NURSE MIDWIVES
ASSOCIATION AND NARAL PRO CHOICE
CALIFORNIA AND SUPPORT BRIAN
SPENCER BEHALF THE AMERICAN
COLLEGE OF O B. G. Y N NINE IN
SUPPORT. BRANDON MARCHI WITH THE
CALIFORNIA MEDICAL ASSOCIATION
AND SUPPORT THANK YOU VERY MUCH.
IS THERE ANY OPPOSITION TO THE
BILL? WE'LL BRING IT BACK TO THE
COMMITTEE FOR QUESTIONS OR
COMMENTS. THE BILL IS MOVED BY
MR MCCARTY AND SECONDED BY MR.
OH, MR SANTIAGO? YES. SO. YOU'RE
GOOD. EVERYONE'S GOOD, OKAY,
MOTION IS DUE PASS TO
APPROPRIATIONS. MADAM SECRETARY,
PLEASE CALL THE ROLL. I WOULD, I
WOULD I. WALDRON. WALTER, NOT
VOTING. I GOT CURRY CURRY, I
ARAMBULA ARAMBULA. AYE BURNER.
BURNER I WENDY CARILLO. FLORA.
FOR NOT VOTING. VINCE FONG. AND
I MAIENSCHEIN MAIENSCHEIN. AYE
MCCARTY. MCCARTHY I, JOE
PATTERSON. JOE PATTERSON, NOT
VOTING RODRIGUEZ. SANTIAGO.
SANTIAGO. I VE VALLAPUDUA
VALLAPUDUA. AYE, WEBER. WHOEVER
I. WOULD YOU? WOULD YOU LIKE TO
. THAT PUTTING TÔI LARA NOT
VOTING TÔI. 11 11 20 THANK YOU
VERY MUCH. UM. MOVING ON? NO IT
WILL BE NINE TO A B 7 16. YES WE
ALREADY HAD EMOTION. I THINK IT
WAS MR MCCARTHY AND MR SANTIAGO
AGAIN, SO MR CHAIR MEMBERS.
FIRST. I'D LIKE TO ACCEPT THE
COMMITTEE AMENDMENTS AND WOULD
LIKE TO THANK THE CHAIR AND YOUR
STAFF FOR THEIR WORK ON THIS
BILL 87 16 QUITE SIMPLY SIX TO
PREVENT CONSUMERS FROM BEING HIT
WITH SURPRISE BILLS FOR GROUND
AMBULANCE SERVICE. CALIFORNIA
ALREADY HAS STRONG PROTECTIONS
IN PLACE FOR SURPRISE MEDICAL
BILLS, BUT THERE REMAINS A
LOOPHOLE FOR GROUND AMBULANCE
BILLS. UNDER THIS BILL, PATIENTS
WITH INSURANCE WILL ONLY BE
RESPONSIBLE TO PAY THE IN
NETWORK COST SHARING AMOUNTS.
THOSE WITHOUT INSURANCE. WE
CHARGE NO MORE THAN THE MEDICAL
OR MEDICARE RATE FOR THAT
SERVICE, WHICHEVER IS GREATER,
AND THE BILL WOULD REQUIRE THAT
ABSENT A CONTRACT BETWEEN THE
AMBULANCE PROVIDER AND THE
INSURER OR HEALTH PLAN, THE
HEALTH PLANNER INSURER PAYS THE
AMBULANCE PROVIDER THE LOCALLY
AUTHORIZED RATE FOR THAT AREA,
INCLUDING THOSE SET THROUGH
LAMSON. MEANING THAT OUR LOCAL
FIREFIGHTERS AND PARAMEDICS ARE
COMPENSATED FOR THE HEROIC WORK
THEY DO. THIS ISSUE IS PERSONAL
TO ME. MY DAUGHTER HAD TO TAKE
AN EMERGENCY TRIP TO THE
HOSPITAL. THINK SOME OF YOU WHO
ARE HERE WITH ME IN 2019
REMEMBER WHEN WE CAME BACK FROM
CERTAIN RECESS. SUDDENLY MY
DAUGHTER IS IN THE HOSPITAL. I
HAD TO MAKE A DIFFICULT CHOICE.
DO I GO TO PRESENT MY BILLS IN
COMMITTEE OR DO I FLY BACK AND
BE WITH HER IN THE HOSPITAL
BECAUSE SHE HAD TO BE IN THE
HOSPITAL FOR THREE DAYS WITH
ORBITAL CELLULITIS. UM AND SHE
HAD TO HAVE WE HAD A GOT A
SURPRISE AMBULANCE SPELL. UM AND
DESPITE HAVING EXCELLENT HEALTH
INSURANCE, SO YOU CAN IMAGINE,
FOLKS THAT DON'T HAVE EXCELLENT
HEALTH INSURANCE. WHAT IS THIS
DOING TO THEM? SO WHEN CALLING
AN AMBULANCE. THE LAST THINGS
YOU ANYONE SHOULD BE THINKING
ABOUT IS WHETHER THAT LIFE
SINGING RIDE RESULTS AND
FINANCIAL HEART SET SHIP 87 16
IS A COMMON SENSE SOLUTION THAT
I HOPE ALL MY COLLEAGUES IN THE
LEGISLATURE WILL JOIN ME IN
SUPPORTING. I RESPECTFULLY ASK
FOR AN I VOTE AND I HAVE WITH ME
HERE TODAY. JENNIFER REESE, WHO
WILL FIRST SHARE THE STORY ABOUT
WHAT HAPPENED WHEN HER DAUGHTER
WAS INJURED. WE'LL ALSO HAVE
CAITLIN. THEY DID THIS WRONG.
LAST TIME. VAN DEAN'S, UM POLICY
AND LEGISLATIVE ADVOCATE FOR
HEALTH ACCESS CALIFORNIA IS THE
SPONSORS OF THE SPELL. THANK
YOU. PUSH THE BUTTON THERE,
PLEASE. THANK YOU. THANK YOU.
GOOD EVENING CHAIRMAN WOULD AND
COMMITTEE MEMBERS. MY NAME IS
JENNIFER REESE AND I LIVE IN
FRESNO COUNTY. I AM HERE TODAY
TO SUPPORT A B 7 16. I HOPE
AFTER YOU HEAR MY STORY, YOU
WILL UNDERSTAND WHY, AND I VOTE
IS SO IMPORTANT TO ALL
CALIFORNIANS. ALMOST EXACTLY A
YEAR AGO, MY DAUGHTER AT 21 YEAR
OLD STUDENT SUSTAINED SERIOUS
INJURIES DUE TO BEING KICKED
MULTIPLE TIMES IN THE CHEST BY A
HORSE. AFTER BEING KICKED, SHE
FELL TO THE GROUND AND ABLE TO
MOVE OR SPEAK THE APPLE WATCH.
SHE WAS WEARING IMMEDIATELY
ACTIVATED AND CALLED 911. AN
AMBULANCE ARRIVED AT OUR HOME
AND TRANSPORTED HER TO THE
NEAREST HOSPITAL FIVE MILES
AWAY. WHILE THERE SHE WAS
DIAGNOSED WITH FOUR BROKEN RIBS
AND A PARTIALLY COLLAPSED LUNG.
THE SERIOUSNESS OF HER INJURIES
PROMPTED HER TO BE TRANSPORTED
AGAIN BY AMBULANCE TO A LEVEL
ONE TRAUMA CENTER 12 MILES AWAY
. SHE SPENT THREE NIGHTS IN THE
HOSPITAL. A MONTH LATER, SHE
RECEIVED A BILL FROM THE
AMBULANCE COMPANY COMPANY
TOTALING $4600. MY DAUGHTER IS
COVERED BY MY EMPLOYER SPONSORED
HEALTH PLAN. BUT OUR INSURANCE
COMPANY PAID LESS THAN HALF THE
BILL. LEAVING MY DAUGHTER WITH
THE $2400 BILL. SHE WAS
DISTRAUGHT BECAUSE SHE DIDN'T
KNOW HOW SHE WAS GOING TO PAY
THIS BILL. I INITIALLY THOUGHT
MY INSURANCE COMPANY WAS
PROCESSING THE CLAIM INCORRECTLY
. BUT AFTER MANY HOURS ON THE
PHONE, I FOUND OUT THAT $2400
BILL WAS BECAUSE THE AMBULANCE
COMPANY WAS OUT OF MY INSURANCE
PLAN NETWORK. I ALSO DISCOVERED
THAT ALL FRESNO COUNTY 911 CALLS
ARE HANDLED BY THIS AMBULANCE
COMPANY, AND THIS COMPANY
CHOOSES NOT TO CONTRACT WITH ANY
EMPLOYER SPONSORED HEALTH
INSURANCE PLANS. THIS CHOICE
MAKES THEM OUT OF NETWORK FOR
ALL FRESNO COUNTY RESIDENTS WITH
EMPLOYER SPONSORED HEALTH
INSURANCE PLANS. WITH A MILLION
RESIDENTS IN FRESNO COUNTY.
THAT'S A LOT OF PEOPLE RECEIVING
A SURPRISE AMBULANCE BILL. TO
MAKE MATTERS WORSE FOR MONTHS
AFTER RECEIVING THE FIRST
AMBULANCE BILL, AND DESPITE
KNOWING I WAS WORKING TO RESOLVE
THE CLAIM WITH MY INSURANCE
COMPANY, THE AMBULANCE COMPANIES
SENT MY DAUGHTER TO COLLECTIONS.
TO PROVIDE PERSPECTIVE. THE
TOTAL BILL FOR THE THREE DAY
HOSPITAL STAY AT THE LEVEL ONE
TRAUMA CENTER WAS $57,000 MY
INSURANCE COVERED ALL BUT $1700
. BASICALLY MY DAUGHTER OWED 3%
OF THE HOSPITAL BILL YET OWED
MORE THAN 50% OF THE AMBULANCE
BILL. I'M ACTIVELY FIGHTING TO
PREVENT OTHER CALIFORNIANS FROM
ENDURING THE STRUGGLE I'VE
ENDURED OVER THE LAST YEAR.
GROUND TRANSPORTATION.
AMBULANCES SHOULD BE STOPPED
FROM SURPRISE BILLING FOR
CRITICAL EMERGENCY SERVICES. I
URGE YOU TO VOTE AYE ON ABC. 7
16. THANK YOU. PLEASE GO AHEAD.
GOOD EVENING, MR CHAIR AND
MEMBERS. I'M KIDDING. MAN DINES
WITH HEALTH ACCESS CALIFORNIA
THAT STATEWIDE HEALTHCARE
CONSUMER ADVOCACY COALITION, AND
WE WERE PROUD TO SUPPORT AND
SPONSOR A B 7 16. 7 16 WILL
CLOSE A GLARING GAP IN OUR
PROTECTIONS AGAINST SURPRISE
BILLING BY REQUIRED BY
PROHIBITING, UM PROVIDERS FOR
SURPRISE BILLING CONSUMERS FOR
AMBULANCE SERVICES. IT'S ONE
SURE THAT CONSUMERS WILL ONLY
PAY THEIR AND NETWORK COST
SHARING, AND THIS WILL ALSO
PLACE A CAP ON UNINSURED
CALIFORNIANS WILL PAY FOR
AMBULANCE SERVICES, ENSURING
THEY'RE NOT CHARGED THAT FULL
RATE. AS FAR AS WHAT HAPPENS
WHEN A CONSUMER DOES THE RIGHT
THING BY GOING TO AN EMERGENCY
ROOM OR TAKING AN AMBULANCE GETS
CARE FROM AN OUT OF NETWORK
PROVIDER THROUGHOUT NO FOR ALL
OF THEIR OWN. IN THE CASE OF AN
AMBULANCE, A CONSUMER DOESN'T
HAVE A CHOICE AND WHETHER THE
AMBULANCE THAT SHOWS UP IS IN
THEIR NETWORK, RESULTING IN MANY
SURPRISE BELTS. AND I AM FOR AN
AMBULANCE RISE, CONSUMERS OFTEN
RECEIVE BILLS OVER 1000 AND
SOMETIMES $2000, WHICH CAN BE
FINANCIALLY DESTABILIZING FOR
CALIFORNIANS, ESPECIALLY THOSE
WITH LOW AND MODERATE INCOMES
WITHOUT SAVINGS. WE HEAR FROM
CALIFORNIA IN 70 WILL NOT EVEN
TAKE AN AMBULANCE OUT OF
LEGITIMATE FEAR OF THE BILL,
PUTTING THEIR HEALTH AT RISK. IF
THERE'S NO CONTRACTING, NOT
HELPING, AND PROVIDER A B SEVEN
STICK, 16 WILL REQUIRE THAT THE
HEALTH PLANNER INSURER WILL PAY
THE PROVIDER THAT LOCALLY SET
LIMBS SO RATE. 7 16 WILL
ENTERPRISE BUILDING FOR GROUND
AMBULANCE SERVICES AND GIVE
CONSUMERS THE PEACE OF MIND
KNOWING THAT THEY'LL HAVE BETTER
FINANCIAL SECURITY DURING AND
AFTER AN EMERGENCY, ENSURE THAT
THEY CAN FOCUS ON GETTING THE
CARE. THEY NEED, NOT THE BILL
THAT THEY'LL RECEIVE. THANK YOU
AND I RESPECTFULLY ASK YOUR I
VOTE. THANK YOU. OTHERS IN
SUPPORT. GOOD EVENING, LINDA WAY
WITH WESTERN CENTER ON LAW AND
POVERTY AND SUPPORT. THANK YOU.
REBECCA MARCUS WITH CALPURNIA
AND SUPPORT THANK YOU. FAITH
GORGEOUS WITH CALIFORNIA AGENTS
AND HEALTH INSURANCE
PROFESSIONALS AND SUPPORT THANK
YOU. RONALD KOEMAN, BASED OFF OF
THE CALIFORNIA PAN ETHNIC HEALTH
NETWORK SEEP IN AND STRONG
SUPPORT. THANK YOU. THANK YOU.
THEIR OPPOSITION TO THE BILL.
AND THEN WE'LL BRING IT BACK TO
THE COMMITTEE FOR QUESTIONS OR
COMMENTS. MR RODRIGUEZ. WELL, I
WANT TO THANK THE AUTHOR FOR
BRINGING THIS BILL FORWARD. I
MEAN, I'VE DONE THIS JOB FOR
OVER 30 YEARS AND THE AMBULANCE
INDUSTRY AND THIS WAS ONE OF THE
BIG ISSUES WE FACE. THE ONLY
PROBLEM. I'M HAVING IT WITH THIS
BILL IS I DON'T KNOW WHY I
DIDN'T THINK ABOUT THIS YEARS
AGO BEFORE YOU DID, SO I'M
OBVIOUSLY, UM, BE SUPPORTING
THIS BILL AND THANK YOU FOR
BRINGING THIS FORWARD TO PROTECT
OUR COMMUNITIES ACROSS THE
STATE. THANK YOU. THANK YOU
ANYONE ELSE? I JUST WANT TO SAY
I APPRECIATE YOU BRINGING THIS
BILL FORWARD. UM I NEVER THOUGHT
ABOUT AMBULANCES BEING IN OR OUT
OF A NETWORK. WE WORKED ON A B
72 WAY BACK WHEN AND WE DIDN'T
NEVER REALLY THOUGHT OF THAT.
AND I'M SHOCKED TO HEAR THAT
THEY COUNTY WOULD HAVE NO
PROVIDERS IN ANY NETWORK, WHICH
IS AND FATHOMABLE SO THANK YOU
FOR VERY MUCH FOR BRINGING THIS
FORWARD. IT DOES ENJOY A DO PASS
RECOMMENDATION. UM LIKE TO HAVE
YOU ADD ME AS A CO AUTHOR, IF
YOU'D BE WILLING THE BILL IS DUE
PASS AS AMENDED TO
APPROPRIATIONS. WE DO HAVE A
MOTION IN A SECOND. WOULD YOU
LIKE TO CLOSE? YES THANK YOU.
UM, ONE. NOBODY SHOULD HAVE
MESSED WITH HER MOTHER. I THINK
THAT'S A VERY GOOD RULE. UM,
UNTIL IT WASN'T ACTUALLY ME.
THIS HAPPENED TO ME, AND I JUST
THOUGHT THAT'S HOW IT IS. AND I
HAVE DISTRICT ADVISORY COUNCILS
AND MY LOCAL FIRES. EVEN THE
OCEAN SIDE BROUGHT THIS UP. WHEN
WE WERE DEBATING WHAT BILLS I
SHOULD I SHOULD RUN. UM SO WE
CAME UP WITH IN DECEMBER 2019
AND HE WAS THE ONE THAT SPOTTED
THAN AN OCEAN SIDE. THEY HAD, UM
THEIR AMBULANCE WAS PART OF
THEIR FIREFIGHTERS AND SYDNEY'S
. WE CONTRACT WITH AMAAR AND HE
SAID, WE HAVE THIS PROBLEM THAT
WE ARE ALWAYS HAVING A WHOLE
BECAUSE PEOPLE JUST CAN'T PAY
THESE BILLS. AND SO THIS IS OUR
THIRD YEAR READING IT AND
HOPEFULLY, THIRD TIME'S THE
CHARM, AND I REALLY APPRECIATE
THAT AND APPRECIATE ATTITUDE ON
THE CO AUTHOR, AND I WOULD LIKE
TO ASK FOR RESPECTFULLY ASK FOR
YOUR VOTE. THANK YOU VERY MUCH.
THE MOTION IS DUE PASS AS
AMENDED TO APPROPRIATIONS. MADAM
SECRETARY. PLEASE CALL THE ROLL.
I WOULD I, WALDRON. WALTER AND I
GOT CURRY AGUIAR-CURRY. AYE
ARAMBULA ARAMBULA. AYE BURNER.
FOR HER. I WENDY CARILLO. LARA.
LARA, IVAN'S FONG. THAT'S FINE.
I MAIENSCHEIN MAIENSCHEIN I
MCCARTY. PATERSON PATERSON
IRODRIGUEZ. RODRIGUEZ I
SANTIAGO. SANTIAGO IVY
VALLAPUDUA. VALLAPUDUA. AYE,
WEBER. HOWEVER, I. THAT'S 13 0.
SO OKAY? THAT IS ALL OF THE
BILLS. WE NEED TO GO THROUGH THE
ORDER NOW. AND, UM. WAIT JUST A
SECOND AND MR MCCARTHY IS
MISSING. CARILLO IS MISSING. MR
PATTERSON IS HERE. OKAY. AND MR
MCCARTHY IS HERE. SO LET'S UH
LET'S GO AHEAD. ARE YOU ARE YOU
ARE YOU OKAY? ALL RIGHT. LET ME
IN THERE. MR MCCARTHY'S EXCUSE
EXCEPT YOU DID MISS THE LAST
VOTE. OKAY? YEAH, I DID. OKAY
OKAY. ALL RIGHT. WE'LL GO AHEAD
TO THE TOP OF THE ORDER, THEN
THE HAVE. MADAM SECRETARY,
PLEASE OPEN THE ROLL CALL THE
ABSENT MEMBERS ON THE CONSENT
CALENDAR. ARAMBULA. ARAMBULA.
AYE BURNER. BURNER I WENDY
CARILLO. CARILLO? AYE.
MAIENSCHEIN MAIENSCHEIN I.
PATERSON. PATERSON. I SANTIAGO.
HERE I GO. I WEBER WEBER. AYE.
15 0 ITEM NUMBER THREE A B 6 20,
PLEASE LIFT THE CALL AND CALL
THE ABSENT MEMBERS. ARAMBULA
ARAMBULA. AYE BURNER. BURNER I
WENDY CARILLO. CARILLO I FLORA.
LARA NÓ. VINCE FONG. AYE,
MAIENSCHEIN. MAIENSCHEIN. AYE.
JOE PATTERSON. PATERSON. I
SANTIAGO. SANTIAGO, I WEBER
WEBER. I WON 14 1 ITEM NUMBER
FOUR A. B 11 OH, NINE BY MR
CONNOLLY, PLEASE OPEN THE ROYAL
CALLED EXCUSE ME LIFT THE CALL
CALLED THE ABSENT MEMBERS.
ARAMBULA. ARAMBULA. AYE BURNER.
BURNER I WENDY CARILLO, WENDY
CARILLO I FLORA. LARA, IVAN'S
FONG. THAT'S FUNNY. I
MAIENSCHEIN MAIENSCHEIN I, JOE
PATTERSON. JOE PATTERSON
IRODRIGUEZ. RODRIGUEZ I
SANTIAGO. SANTIAGO, I WEBER
HOWEVER, I. 15 0 ITEM NUMBER
FIVE A B 6 60 BY MR NGUYEN,
PLEASE LIFT THE COLUMN CALLED
THE ABSENT MEMBERS. ARAMBULA
ARAMBULA. AYE BURNER. BURNER I
WENDY CARILLO, WENDY CARILLO I
FLORA. FLORA NO, FONG. VINCE
PHªN NO MAIENSCHEIN. MAIENSCHEIN
I, JOE PATERSON, PATERSON? NO,
RODRIGUEZ. RODRIGUEZ SANTIAGO.
SANTIAGO. AYE. 11 TO 3. THAT'S
11 TO 3. UM, ITEM NUMBER SIX.
MAYBE 7 10 BY MS SZABO, PLEASE
LIFT THE CALL. CALL THE ABSENT
MEMBERS. ARAMBULA ARAMBULA. AYE
BURNER. BURNER I WENDY CARILLO
20 CARILLO I FLORA. FLORA? NO,
VINCE WANG. PHªN NO MAIENSCHEIN.
MAIENSCHEIN, AYE, RODRIGUEZ.
RODRIGUEZ I SANTIAGO. SANTIAGO.
AYE. 11 TO 4. THAT'S 11. 4 ABOUT
BILL IS OUT. ITEM NUMBER SEVEN
A. JR FOUR BY MASHABA, PLEASE
LIFT THE CALL. CALL THE ABSENT
MEMBERS ARAMBULA. ARAMBULA AYE.
BURNER I WENDY CARILLO WHEN THEY
CARILLO I FLORA. FLORA NO, FONG.
THAT'S FINE. NO MAIENSCHEIN
MAIENSCHEIN I PATERSON PATERSON,
NO, RODRIGUEZ. RODRIGUEZ I
SANTIAGO. SANTIAGO. AYE. THE
THREE THAT'S 12 TO 3. REMEMBER
EIGHT, MAYBE. 907 BY MR
LOWENTHAL, PLEASE LIFT THE CALL.
CALL THE ABSENT MEMBERS.
ARAMBULA. ARAMBULA, NOT VOTING.
BURNER. BURNER I WENDY CARILLO.
WENDY CARILLO I FLORA. LARA, NOT
VOTING AND SPONG. VINCE VAUGHN.
NOT VOTING MAIENSCHEIN
MAIENSCHEIN I. PATERSON.
PATERSON, NOT VOTING. SANTIAGO
SANTIAGO. AYE. THAT'S 11 0. THAT
BILL IS OUT. ITEM NUMBER NINE A.
B 9 21, PLEASE LIFT THE CALL
CALLED THE ABSENT MEMBERS ASKED
BY MS BONTA. ARAMBULA ARAMBULA.
AYE BURNER. BURNER. I LARA. LARA
NOT VOTING. VINCE WANG. THAT'S
WHY I'M NOT VOTING MAIENSCHEIN
MAIENSCHEIN I. PATERSON
PATERSON. I RODRIGUEZ RODRIGUEZ.
I SANTIAGO SANTIAGO. AYE. 30.
THAT'S 13 0. ITEM NUMBER 10 A B
16 44 BY MS BONTA, PLEASE OPEN
THE ROLE CALLED THE ABSENT
MEMBERS ARAMBULA. ARAMBULA I
FLORA. FLOORING THAT VOTING
VINCE FONG. THAT'S FUNNY, NOT
VOTING MAIENSCHEIN. MAIENSCHEIN
I, JOE PATTERSON. JOE PATTERSON,
NOT VOTING RODRIGUEZ. RODRIGUEZ
I SANTIAGO. SANTIAGO I 0 13 0
ITEM NUMBER 11 A B 10 48 BY MR
EXCUSE ME, 12 0. EXCUSE ME.
MAYBE I REMEMBER 11 A B 10 48 BY
MS WICKS, PLEASE LIFT THE CALL
CALLED THE ABSENT MEMBERS.
ARAMBULA ARAMBULA. AYE BURNER.
BURNER I WENDY CARILLO, WENDY
CARILLO I FLORA. LAUREN THAT
VOTING VINCE FONG. THAT'S FUNNY.
I MAIENSCHEIN MAIENSCHEIN I.
PATERSON PATERSON. I SANTIAGO.
SANTIAGO, I WEBER. HOWEVER I 0
14 0. REMEMBER 12 A B 10 60 BY
MS ORTEGA, PLEASE LIFT THE CALL
CALLED THE ABSENT MEMBERS.
BURNER. BURNER I FLORA. LARA.
I'VE BEEN STRONG. THAT SONG. I
MAIENSCHEIN MAIN CHINA. I JOE
PATERSON, PATERSON. I RODRIGUEZ.
RODRIGUEZ I SANTIAGO. SANTIAGO I
15 0 ITEM NUMBER 13 11 57 BY MS
ORTEGA, PLEASE LIFT THE CALL
CALLED THE ABSENT MEMBERS.
ARAMBULA ARAMBULA. AYE BURNER.
BURNER I FLORA. FLOORING THAT
VOTING VINCE FONG. VINCE VAUGHN,
NOT VOTING MAIENSCHEIN.
MAIENSCHEIN I, JOE PATTERSON.
JOE PATTERSON, NOT VOTING
RODRIGUEZ. RODRIGUEZ I SANTIAGO.
SANTIAGO. AYE. 12 0 12 0. MOVING
ON TO ITEM NUMBER 14 A B 10 63
BY MR GABRIEL, PLEASE LIFT THE
CALL. CALL THE ABSENT MEMBERS.
WENDY KOREA. WENDY CARILLO I
FLORA. FOR A NO. PATERSON.
PATERSON IRODRIGUEZ. RODRIGUEZ?
AYE. 12 TO 3. THAT'S 12 TO 3. UM
ITEM NUMBER 15 PLEASE OPEN THE
ROLE CALLED THE ABSENT MEMBERS,
WENDY CARILLO. WENDY CARILLO I
FLORA. LARA NÓ. RODRIGUEZ. MHM
RODRIGUEZ. AYE. THIS IS FOR
SMALL BUSINESSES. JUST LARA NÓ
TÚI. THERE ARE 15 15 0. ITEM
NUMBER 16 WAS ON THE CONSENT
CALENDAR ITEM NUMBER 17, PLEASE
LIFT THE CALL CALLED THE ABSENT
MEMBERS. I A B 12 88 BY MR
REYES. ARAMBULA. ARAMBULA. AYE
BURNER. BURNER. I WENDY CARILLO,
WENDY CARILLO I FLORA. FLORA?
NO, VINCE FONG. WANG. I
MAIENSCHEIN MAIENSCHEIN I.
PATERSON. PATERSON. I SANTIAGO.
SANTIAGO, I WEBER HOWEVER, I. 14
TO 1. THAT'S 14 TO 1. THAT BILL
IS OUT. ITEM NUMBER 18 A B 14 51
BY DR JACKSON, PLEASE LIFT THE
CALL. CALL THE ABSENT MEMBERS
ARAMBULA. ARAMBULA. AYE BURNER.
BURNER I WENDY CARILLO. WHEN HE
CARILLO AYE. FLORA. LARA NOT
VOTING SINCE WANG. THAT'S WHY
I'M NOT VOTING. MAIENSCHEIN
MAIENSCHEIN I. PATERSON JOE
PATTERSON, NOT VOTING. SANTIAGO.
SANTIAGO. AYE. WEBER. HOWEVER, I
. 12 TO 0. THAT'S 12 TO 0. THAT
BILL IS OUT. I DIDN'T NUMBER
1980 14 70 BY MS QUIRK-SILVA,
PLEASE LIFT THE CALL CALLED THE
ABSENT MEMBERS ARAMBULA.
ARAMBULA. AYE BURNER. BURNER. I
WENDY CARILLO, WENDY CARILLO I
FLORA. FOR IVAN SWAN. WANG. I'M
MAIENSCHEIN. MAIENSCHEIN I, JOE
PATTERSON. JOE PATERSON. I
SANTIAGO SANTIAGO. I WEBBER.
HOWEVER, I 15 0 15 0 ITEM NUMBER
20 IS ON THE CONSENT CALENDAR
ITEM NUMBER 21, PLEASE. OPEN IS
A B 15 77 BY MR LOWE, PLEASE
OPEN THE ROLL CALL THE ABSENT
MEMBERS. ARAMBULA ARAMBULA. AYE
BURNER. BURNER I WENDY CARILLO,
WENDY CARILLO IPHONES PONG. 21.
VINCE FANG. NOT VOTING
MAIENSCHEIN MAIENSCHEIN I.
PATERSON. PATERSON. I WEBER.
WHOEVER I. 14 0. THAT'S 14 TO 0
. REMEMBER 22 A B 16 45 BY MR
DOES MR ZUBER, PLEASE LIFT THE
CALL AND CALL THE ABSENT MEMBERS
ARAMBULA. ARAMBULA. AYE BURNER.
BURNER I WENDY CARILLO, WENDY
CARILLO I FLORA. FOREIGN THAT
VOTING PHªN THAT'S NOT VOTING.
PATERSON. PATERSON, NOT VOTING.
SANTIAGO SANTIAGO, I WEBER
WEBER. AYE. THAT'S 11 0. DID WE
GET MAIENSCHEIN MAIENSCHEIN.
AYE. 12 0 12 0. HMM. ITEM NUMBER
23 A B 16 70 BY MR GIBSON,
PLEASE LIFT THE CALL. CALL THE
OPPOSITE MEMBERS, WALDRON.
ARAMBULA. ARAMBULA? AYE. FLORA.
FLORIDA NOT VOTING IN SONG
THAT'S PHªN NOT VOTING
MAIENSCHEIN. MAIENSCHEIN I, JOE
PATTERSON. PATERSON NOT VOTING.
RODRIGUEZ RODRIGUEZ I SANTIAGO.
SANTIAGO, NOT VOTING. DID YOU
SAY? YOU SAID I'M SORRY, OKAY?
SANTIAGO. AYE. ON THE 11 TO 0
ITEM NUMBER 24 80 55 BY MR
RODRIGUEZ, PLEASE LIFT THE CALL.
CALL THE ABSENT MEMBERS
ARAMBULA. ARAMBULA. AYE BURNER.
BURNER I WENDY CARILLO, WENDY
CARILLO I FLORA FLORA IVAN'S
FONG. VINCE FONG, I MAIENSCHEIN
. MAIENSCHEIN I, PATERSON
PATERSON. I SANTIAGO SANTIAGO. I
15 0 15 0 ITEM NUMBER 25 BABY 85
BY DR WEBBER, PLEASE LIFT THE
CALL AND CALL THE ABSENT MEMBERS
ARAMBULA. ARAMBULA, I WENDY
CARILLO, WENDY CARILLO I FLORA
FLORA, NOT VOTING VINCE FONG.
VINCE PHªN NOT VOTING
MAIENSCHEIN MAIENSCHEIN I, JOE
PATTERSON. PATERSON, NOT VOTING.
RODRIGUEZ. RODRIGUEZ I SANTIAGO.
ON TIAGO. AYE. 12 0 ITEM NUMBER
26 BY MS BURNER, MAYBE 7 16,
PLEASE. AH! LIFT THE CALL CALL
THE OPPOSITE MEMBERS. I'M SORRY
. PLEASE OPEN THE ROLL. CALL THE
ABSENT MEMBERS. WENDY CARILLO.
WENDY CARILLO. AYE, MCCARTY. 14
CENTS. 14 0 ITEM NUMBER 27 A B
14 81 PLEASE OPEN THE ROLE AND
CALLED THE ABSENT MEMBERS WHEN
THEY CARILLO WHEN HE CARILLO
AYE. RODRIGUEZ RODRIGUEZ. AYE.
13 0 ITEMS NUMBER 28 29 30 WERE
ON THE CONSENT CALENDAR.
REMEMBER 31 A B 15 45 BY MS
WENDY CARILLO, PLEASE LIFT THE
CALL. CALL THE ABSENT MEMBERS
ARAMBULA. ARAMBULA I FLORA.
FLORA. I'VE BEEN STRONG. THAT'S
FUNNY. I MAIENSCHEIN.
MAIENSCHEIN I. JOE PATTERSON,
PATERSON. I RODRIGUEZ RODRIGUEZ
I SANTIAGO SANTIAGO. I 15 0 15 0
ITEM 32 IS ON CONSENT ITEM 33 A
B 13 31 BY WOULD PLEASE LIFT THE
CALL CALLED THE ABSENT MEMBERS.
ARAMBULA ARAMBULA. AYE BURNER.
BURNER I WENDY CARILLO, WENDY
CARILLO. I FLORA OR I'VE BEEN
SWANG VINCE WANG. I MAIENSCHEIN
MAIENSCHEIN I, JOE PATERSON,
PATERSON. I SANTIAGO SANTIAGO. I
WEBBER. HOWEVER I 15 0 15 0. AND
THAT CONCLUSIVE BUSINESS OF THE
HEALTH COMMITTEE TODAY THANK YOU
VERY MUCH. IT'S 45. OKAY?