GOOD MORNING. THIS IS THE
ASSEMBLY BUDGET SUBCOMMITTEE
NUMBER ONE ON THE HEALTH AND
HUMAN SERVICES. TODAY'S HEARING
WILL COVER HEALTH AND HUMAN
SERVICES PROPOSALS IN THE
GOVERNOR'S MAY REVISION. AS
ALWAYS, GIVEN THE LENGTH OF
TODAY'S AGENDA. I WOULD LIKE TO
REQUEST THAT ALL OF OUR SPEAKERS
BE AS BRIEF AS POSSIBLE. I ALSO
WANT TO REMIND EVERYONE THAT ALL
PUBLIC COMMENT ON ALL ISSUES IN
THE AGENDA WILL BE TAKEN AT THE
END OF THE HEARING AFTER THE
LAST ISSUE IS PRESENTED. WE WILL
FIRST TAKE PUBLIC COMMENT FROM
INDIVIDUALS WHO ARE HERE IN THE
HEARING ROOM, FOLLOWED BY PUBLIC
COMMENTS FROM INDIVIDUALS OVER
THE PHONE. THE PUBLIC COMMENT.
COLON NUMBER IS ON THE
SUBCOMMITTEE WEBSITE, AND IT
ALSO WILL BE ON THE LIVESTREAM
SCREEN ONCE PUBLIC COMMENT HAS
STARTED. AND I'LL SHARE IT RIGHT
NOW. THAT NUMBER IS 87769. AND
THE PUBLIC ACCESS CODE IS 13151
. OF NOTE. WE WILL TAKE A BREAK
FOR LUNCH TODAY FROM NOON TO ONE
P.M. WITH THAT. LET US BEGIN.
I'M GOING TO CALL THE FIRST
PANEL UP ON HEALTH AND HUMAN
SERVICE AGENCIES PROPOSALS SO
AGENCY DEPARTMENT OF FINANCE AND
LEGISLATIVE ANALYST'S OFFICE
SHOULD COME UP TO THE WITNESS
TABLE. WE ASKED FOR THE
ADMINISTRATION FOR ALL ISSUES TO
PRESENT IN THE ORDER IN THE
AGENDA AND TO INTRODUCE
YOURSELVES BEFORE YOU BEGIN.
AGAIN PLEASE BE SUCCINCT IN YOUR
TESTIMONY AS WE HAVE A LOT TO GO
OVER TODAY. THANK YOU. AND WITH
THAT, CAL HHS PLEASE BEGIN WHEN
YOU ARE READY.
MR CHAIR. THANK YOU. ADAM
DONDERO, DIRECTOR OF OFFICE OF
SYSTEMS INTEGRATION UNDER CAL
HHS AND, UM, BECAUSE I FEEL
OBLIGATED BECAUSE THE AGENDA
MENTIONED THAT HAPPY EARLY
BIRTHDAY. I BELIEVE. SO UM, IN
THE CARROTS PROJECT. YOU'VE SEEN
MANY TIMES. WE'VE BEEN HERE IN A
LOT OF DIFFERENT VENUES. TODAY
IS PARTICULARLY EXCITING. WE'VE
BEEN WAITING A LONG TIME FOR SPR
SIX SPECIAL PROJECT REPORT WHERE
WE WERE FINALLY GOING TO HAVE
VENDORS ONBOARD CONTRACTS IN
PLACE TO GIVE US NUMBERS AND
TIMELINES THAT WE COULD COUNT
ON. I'LL BE RELATIVELY BRIEF,
THOUGH IT'S A LARGE PROPOSAL
WITH A LOT OF HISTORY, HAPPY TO
DIG INTO DETAILS. MR MASSACRE
FROM ELLIOT DID A FANTASTIC JOB
OF PROVIDING A SUMMARY OF THE
KEY POINTS IN HISTORY. OBVIOUSLY
THIS SYSTEM IS REPLACING THE CWS
CMS SYSTEM, WHICH IS THE LARGEST
CHILD WELFARE SYSTEM IN THE
NATION, WITH APPROXIMATELY
30,000 USERS ACROSS THE STATE.
UM OVER THE DECADES. OBVIOUSLY
IT'S WORN DOWN. A LOT OF
FUNCTIONALITY HAS BEEN ADDED
OUTSIDE THE SYSTEM, WHICH
CREATES VARIANCES AND HOW IT'S
USED ACROSS THE STATE. UM AND SO
A LOT OF THAT REQUIRES US TO
MAKE THESE CHANGES THE NEW
SYSTEM, OBVIOUSLY FIRST AND
FOREMOST NEEDS TO MEET THE NEEDS
OF THE COUNTY WELFARE WORKERS
AROUND THE STATE COUNTIES.
TRIBAL ALL OF THOSE BUT
ADDITIONALLY MADE IN STATE AND
FEDERAL COMPLIANCE IS A KEY
COMPONENT IS THE CURRENT SYSTEM
DOESN'T DO THAT. THIS BCP ALIGNS
WITH THE NOW APPROVED SPR SIX. I
WILL TALK A LITTLE BIT ABOUT
WHAT THE CHANGES IN THAT SPR ARE
JUST TO HIGHLIGHT WHAT WE'VE
DONE SINCE WE LAST TALKED ABOUT
THIS PROJECT. FOR ONE. THIS
SYSTEM STRUCTURED INTO A
DELIVERY OF VERSION ONE AND
VERSION TWO. VERSION ONE WILL
ALLOW US TO, UM, TO STOP USING
THE CWS CMS SYSTEM AND RETIRE
THAT MOVING EVERYONE OVER TO THE
NEW SYSTEM AND THEN VERSION TWO
WILL ALLOW US TO ENHANCE UPON
THAT AND BUILD OUT THE REMAINING
COMPONENTS OF CDOS REQUIREMENTS
FOR THE FEDERAL REQUIREMENTS.
THE TIMELINE FOR THOSE OR THAT
THE ONE WHICH STARTED JUST LAST
JUNE ON THE BUILD WILL BE
DELIVERED IN OCTOBER OF 2026,
ALLOWING THAT RETIREMENT OF THE
EXISTING SYSTEM AND BE TOO WILL
BE DELIVERED IN APRIL OF 2028
JUST 18 MONTHS LATER. THE NEW
REVISED TOTAL COSTS ARE 1.7
BILLION, EXCLUDING THE CARES
LIVE COSTS, AND THERE'S LARGE
BUCKETS THAT I THINK ARE
IMPORTANT TO UNDERSTAND THAT
NUMBER. WE'VE GOT APPROXIMATELY
250 MILLION IN COUNTY AND TRIBAL
PARTICIPATION COSTS RELATIVELY
UNIQUE TO THIS PROJECT, BUT
ABSOLUTELY ESSENTIAL TO THE
SUCCESS OF BUILDING SOMETHING
THAT MEETS THE NEEDS OF THE
WORKERS. ADDITIONALLY THERE'S
225 MILLION AND IMPLEMENTATION
AND STABILIZATION COSTS. PART OF
THAT I'LL TALK LATER ABOUT THE
NEW IMPLEMENTATION MODEL WE'RE
USING THAT WAS CHANGED,
PARTICULARLY TO FOCUS ON CHILD
SAFETY. ADDITIONALLY THERE'S 150
MILLION FOR DATA INFRASTRUCTURE
, WHICH IS A UNIQUE COMPONENT.
WE BUILT INTO THE SYSTEM TO
MAINTAIN THE AUTHORITY AND
AUTONOMY OF THE STATE TO UTILIZE
THAT DATA EFFECTIVELY NOT JUST
FOR CASE MANAGEMENT, BUT FOR IN
DEPTH ANALYTICS SO THAT WE CAN
SERVE THE FAMILIES THAT ARE
USING OUR SYSTEMS. AND LASTLY,
THERE'S $200 MILLION FOR
SALESFORCE LICENSES JUST TWO
COMPONENT OF THE MODEL THAT
WE'RE USING. SO THE REASON THAT
WE MADE THE CHANGES WE NOW HAVE
VENDORS ON BOARD. WE HAVE
CONTRACTS NEGOTIATED. WE HAVE
ACTUAL NUMBERS IN PLACE. FOR
WHAT THAT'S GOING TO BE. AN
IMPORTANT NOTE HERE IS THAT WE
HAVE AN INDEPENDENT THIRD PARTY
ADVISOR, SO WE DIDN'T JUST ASK
THE VENDORS. HOW MUCH DO YOU
WANT US TO PAY YOU TO BUILD
THIS? WE TALKED TO THEM ABOUT
WHAT THEY THINK IT WOULD TAKE
FROM THEIR EXPERIENCE IN OTHER
STATES WITH OTHER SYSTEMS, AND
THEN WE HAD AN INDEPENDENT
ADVISOR WHO LOOKED AT COMPARABLE
COMPLEXITY LOOKED AT THE SCOPE
OF A C WEST REQUIRED SYSTEM. AND
HELPED US USE METRICS TO
DETERMINE WHAT'S INAPPROPRIATE
TIMELINE AND COST FOR A SYSTEM
OF THIS AND THE PROPOSAL IN SPR
SIX AND IN FRONT OF YOU IN THIS
PCP WAS VALIDATED BY THEM FOR
THOSE PURPOSES. ADDITIONALLY WE
DID A DEMONSTRATION PILOT, A
SMALL PIECE OF FUNCTIONALITY,
TESTED AND USED BY THE COUNTIES
, AND WE HAD A LOT OF LESSONS
LEARNED OUT OF THAT. AND SO
WE'VE MADE ADJUSTMENTS TO OUR
PROCESSES FOR DEVELOPMENT FOR
IMPLEMENTATION ALONG THE WHOLE
SPECTRUM TO ALIGN WITH THOSE
LESSONS THAT WE'VE LEARNED,
WHICH INDEED WAS THE POINT OF
DOING A DEMONSTRATION PILOT SO
THAT WE DIDN'T SPEND YEARS
LEARNING THEM. WE DO A QUICK UP
FRONT AND MAKE THE ADJUSTMENTS.
IN SPR SIX. AND IN THIS
PROPOSAL, YOU SEE SCOPE,
CLARIFICATION AND ELABORATION.
INFORMED BY THAT WORK. WE'VE
ADJUSTED THE ROLES AND
RESPONSIBILITIES AS YOU'LL
RECALL. THIS IS A MULTI VENDOR
ENVIRONMENT. WE LOOKED AT THAT
AND WE'RE SEEING GAPS
INEFFICIENCIES IN THE WAY THAT
PROCESS WAS WORKING. SO WE'VE
RENEGOTIATED THE CONTRACTS AND
INCLUDED WHAT'S CALLED A RACY
THAT DEFINES WHO IS RESPONSIBLE
FOR WHAT BOTH THE VENDORS STATE
OR COUNTY PARTNERS, TRIBAL
PARTNERS TO MAKE SURE THERE'S
CLARITY ON WHO'S RESPONSIBLE FOR
WHAT COMPONENTS TO DELIVER THEM.
ADDITIONAL IMPORTANT POINT ON
THAT IS THAT WE HAVE ENHANCED
THE AUTHORITY AND REQUIREMENTS
ON OUR PRIMARY VENDOR. BUILDING
THE SYSTEM AS A SYSTEM
INTEGRATOR. HISTORICALLY THAT'S
BEEN WITH THE VENDOR. PREVIOUSLY
WE HAD A LOT OF THOSE
RESPONSIBILITIES WITH THE STATE
. IT'S A DIFFICULT SKILL SET TO
GET IN THE STATE FOR SOMETHING
THAT WE DON'T DO ON A REGULAR
BASIS. SO IN THE CONTRACT, WE
HAVE ENHANCED THAT REQUIREMENT
UPON THEM TO MAKE SURE THAT ONE
PERSON IS RESPONSIBLE FOR
MONITORING ACROSS THOSE VENDORS
AND THINGS DON'T FALL THROUGH
THE GAPS. WE HAVE, ADDITIONALLY
ENHANCED THE USER FEEDBACK
PROCESS CODE DESIGN WITH OUR
COUNTY AND TRIBAL PARTNERS. REAL
TIME CHECKS WHERE THEY GET TO
SEE THE SYSTEM IN USE, NOT
DELIVERED TO IDENTIFY GAPS AND
ISSUES THAT WE CAN CHANGE BEFORE
DELIVERY. AND THEN OBVIOUSLY, AS
I MENTIONED THE IMPLEMENTATION
PIECE WE WERE GOING TO DO A NINE
MONTH WAVED ROLLOUT WITH GROUPS
OF COUNTIES. THAT'S WHAT WE'RE
DOING WITH THE SAUCE SYSTEM,
OFTEN WITH OUR COUNTY RUN
PROGRAMS. THAT'S WHAT WE DO FROM
A TECHNOLOGY PERSPECTIVE. THAT'S
WHY WE DO THAT. BUT WHEN WE TALK
TO OUR COUNTY PARTNERS AND THE
VENDORS WHEN WE LOOKED AT THIS A
WAVED ROLLOUT WITH THIS SYSTEM
WOULD REQUIRE THE COUNTY WORKERS
TO WORK IN TWO SYSTEMS AT THE
SAME TIME. DATA WOULD BE IN ONE
SYSTEM AND ONE COUNTY IN A
DIFFERENT SYSTEM IN A DIFFERENT
COUNTY COUNTY LINES MEAN NOTHING
TO FAMILIES RIGHT WHEN PEOPLE
CROSS OVER, THINGS WOULD GET
MISSED RIGHT? THERE WOULD BE
THINGS THAT HAVE BEEN ENTERED IN
ONE COUNTY OR EVEN IN THE SAME
COUNTY THAT THE WORKER DIDN'T
KNOW TO CHECK THAT OTHER SYSTEM
AND WE DECIDED IN PARTNERSHIP
WITH THE COUNTIES THAT JUST
WASN'T ACCEPTABLE, AND SO WE'VE
SWITCHED TO AN ALL AT ONCE
ROLLED OUT. OBVIOUSLY
TECHNOLOGICALLY, THERE'S A LOT
OF RISK TO THAT. THAT'S A BIG
CHANGE ALL AT ONCE WITH OVER
30,000 WORKERS RIGHT AND SO
YOU'LL SEE IN THE TIMELINE WE'VE
BUILT IN SIGNIFICANT TIME TO
REDUCE THAT RISK. TRAINING.
MODELING TESTING AND PRODUCTION
PILOT WHERE A HANDFUL OF
COUNTIES WILL GO AND WORK INTO
SYSTEMS FOR A LIMITED TIME
PERIOD AND TEST THOSE THINGS OUT
SO THAT BEFORE WE WORK INTO THAT
PROCESS WILL ADJUST THOSE
THINGS. THOSE ARE SOME OF THE
MAJOR CHANGES. WE'VE ALSO WORKED
HARD TO ENHANCE ACCOUNTABILITY.
THROUGH SOME OF THESE MEASURES
WE'VE TALKED OUT, INCLUDING WHAT
WE CALL EARNED VALUE MAD
MANAGEMENT. THE KEY HERE IS WE
USED TO HAVE WHAT WE CALL
TESTIMONY INCREMENTS VERY
TECHNOLOGICAL TERM TO FIND THE
TIME BASE BY WHICH THE VENDORS
WOULD DELIVER AN AMOUNT OF CODE
. IT DIDN'T ALIGN THE VALUE. IT
DIDN'T LAST ALLY INTO WHAT
WORKERS WOULD BE ABLE TO USE,
MAKING TRACKING DIFFICULT
TESTING DIFFICULT. WE SHIFTED
OVER TO THIS EARNED VALUE
MANAGEMENT. THAT I THINK WHEN WE
TALK ABOUT SOME OF THE THINGS
THAT THE L A IS HIGHLIGHTED,
WILL ENABLE US TO GIVE YOU A
MUCH BETTER PERSPECTIVE OF
WHAT'S BEING DELIVERED NOT JUST
IN ZEROS AND ONES BUT IN ACTUAL
VALUE TO THE COUNTY WORKERS THAT
WERE PREPARED TO DELIVER. THOSE
ARE SOME KEY THINGS, OBVIOUSLY,
A LOT MORE LIKE TO HAND IT OVER
TO MY PARTNER FROM DEPARTMENT OF
SOCIAL SERVICES TO TALK ABOUT A
LITTLE OF OUR WORK WITH THE
COUNTY'S GOOD MORNING CHAIR AND
MEMBERS OF THE SUBCOMMITTEE. I'M
SELINA CHOW, AND I AM THE CHIEF
OPERATING OFFICER AT DEPARTMENT
OF SOCIAL SERVICES. AND I AM
REPRESENTING THE PROJECT SPONSOR
. UM, WITH THIS CARES PROJECT.
THE PROJECT SCOPE INCLUDES SOME
REALLY CRITICAL UPDATES AS
DIRECTOR DEANDRA WAS MENTIONING
REGARDING ENGAGEMENT WITH THE
COUNTIES AND TRIBES. AND A LOT
OF THAT IS TO DEVELOP AN
ENGAGEMENT AND COMMUNICATION AND
SYSTEM USER ADOPTION MODEL. WE
COMMONLY REFER TO IT IN THE
PROJECT AS THE CORE CONSTITUENTS
PARTICIPATION MODEL, AND IT
INCLUDES 37 COUNTIES AND THE TWO
TITLE FOR YOU TRIBES THAT ARE
SERVING CHILD WELFARE SOURCES.
AND THEY WILL BE DIRECTLY
INVOLVED IN CO DESIGN AND
PROVIDING IMMEDIATE FEEDBACK.
THEY'LL HAVE OPPORTUNITIES TO
REALLY TEST OUT THE SYSTEM HAVE
HANDS ON EXPERIENCE TO REALLY
PROVIDE THAT FEEDBACK AS TO
WHETHER OR NOT IT'S WORKING FOR
THEM, AND WHAT FUNCTIONALITY IS
REALLY USABLE FROM DESIGN TO
IMPLEMENTATION. SO IT'S GOING TO
HAPPEN THROUGHOUT THE PROJECT AT
VARIOUS MILESTONES AND WILL HAVE
AN OPPORTUNITY TO ITERATE AND
MAKE CHANGES ALONG THE WAY. AND
THIS IS EXTREMELY CRITICAL TO
MAKE SURE THAT THE SYSTEM THAT
WE'RE BUILDING IS GOING TO WORK
FOR ALL 50 COUNTIES ACROSS THE
ENTIRE SYSTEM OF CHILD WELFARE
SERVICES AND ALL THE DIFFERENT
VARIOUS SUPPORT AREAS THAT WE
HAVE. AND ONE OTHER CAN
IMPORTANT CONSIDERATION, TOO, IS
INCREASED COMMUNICATION WITH THE
COUNTIES IN TERMS OF THIS
FEEDBACK PROCESS, SO REALLY
TRACKING AND HAVING TRANSPARENCY
WITH REGARDS TO THE FEEDBACK
THAT THEY'RE PROVIDING, HOW ARE
TRIAGING IT AND WHAT THE STATUS
IS IN TERMS OF WHETHER IT GETS
INCORPORATED INTO THE FINAL
PRODUCT THAT WE'RE DEVELOPING?
WE DO HAVE FIVE POSITIONS FOR
CDSS THAT ARE NEW THAT ARE IN
THE BCP REQUEST AND THAT THOSE
POSITIONS ARE FOCUSED ON
SUPPORTING ENGAGEMENT WITH
COUNTIES AND TRIBES. AND THE
PROCESS WILL INCLUDE
UNDERSTANDING WHAT EXTERNAL
SYSTEMS THEY CURRENTLY USE,
MAKING SURE THAT WE'RE AVOIDING
THE, UM DUPLICATE DATA ENTRY
ISSUE, AND, UM ENSURING THAT WE
ARE ABLE TO MEET FEDERAL
COMPLIANCE. AND FINALLY, WHAT
CAN BE IN THE SCOPE SO THAT WE
CAN FINALLY DECOMMISSIONED. SOME
OF THOSE OTHER, UM LEGACY
SYSTEMS AND EXTERNAL SYSTEMS
THAT ARE BEING USED. UM AND ONE
LAST POINT HERE IS THAT THE
REVISION BUDGET DOES INCLUDE $23
MILLION. THE GENERAL FUND
PORTION IS 11.5 MILLION, AND
THIS IS AN UPFRONT FUNDING
ALLOCATION TO THE COUNTIES. IN
RECENT YEARS. WE'VE SEEN IT.
IT'S BEEN A STRUGGLE. IF THERE'S
UNCERTAINTY ABOUT HOW MUCH
INVESTMENT IS GOING TO BE
AVAILABLE TO SUPPORT COUNTY
OPERATIONS, SO WE'RE PUTTING
THAT FUNDING UPFRONT. UM, WE ARE
TYING IT TO THE PROJECT
MILESTONES AND WILL BE WORKING
DIRECTLY WITH C W, D, A AND
COUNTIES ON THE FUNDING
DISTRIBUTION METHODOLOGY, BUT
THE GOAL HERE IS TO MAKE SURE
THAT THE COUNTIES ARE AWARE OF
WHAT IS THE INVESTMENT. THAT'S
GOING TO BE PROVIDED TO THEM SO
THAT THEY CAN REALLY BE A
PARTNER IN OPERATIONAL PLANNING
AND GETTING THE NECESSARY
APPROVALS IN THE COUNTIES AND
REALLY PREPARING THEM FOR THE
READINESS OF ALL THE ACTIVITIES
TO COME. DEPARTMENT OF FINANCE.
AARON CARSON DEPARTMENT OF
FINANCE. NOTHING AT THIS TIME
THAT HAPPENING. ANSWER ANY
QUESTIONS, YOU GOOD MORNING
CHAIR AND MEMBERS, BRIAN METZGER
WITH THE LEGISLATIVE ANALYST'S
OFFICE. WE FIND THAT THE
RECENTLY APPROVED PROJECT
DOCUMENTATION, SPR SIX DOES
PROVIDE A CLEAR PROJECT BASELINE
IN TERMS OF COST SCHEDULE AND
SCOPE THAT CAN BE USED TO
MONITOR THE PROJECT'S PROGRESS
TOWARDS COMPLETION. THAT
BASELINE IS THE DELIVERY OF A
NEW FEDERALLY COMPLIANCE SYSTEM
BY APRIL 2028 AT A TOTAL COST OF
$1.7 BILLION, OF WHICH HALF IS
STATE FUNDING. HOWEVER THIS
PROJECT HAS BEEN IN DEVELOPMENT
AND IMPLEMENTATION FOR OVER A
DECADE, WITH PROJECT
EXPENDITURES EXCEEDING $300
MILLION. THEREFORE WE CAUTION
AGAINST THE APPROVAL OF ANY
ADDITIONAL PROJECT FUNDING
WITHOUT MORE LEGISLATIVE
INVOLVEMENT IN AND OVERSIGHT OF
THE PROJECT. CONTINUED LACK OF
PROGRESS ON THIS PROJECT COULD
PUT FEDERAL FUNDING AT RISK AND
FURTHER DELAY THE IMPLEMENTATION
OF LEGISLATIVE AND OTHER CHANGES
TO CHILD WELFARE PROGRAMS AND
SERVICES. WE RECOMMEND THE
LEGISLATURE TAKES SEVERAL
ACTIONS TO ENSURE PROGRESS
TOWARDS PROJECT COMPLETION
CONTINUES ON TIME AND WITHIN
BUDGET. FIRST WE RECOMMEND THE
LEGISLATURE ADOPTED TRAILER BILL
LANGUAGE THAT CLEARLY DEFINES
ITS GOALS AND PLANNED OUTCOMES
FOR CWS CARES, INCLUDING BOTH
DEFINITIONS OF PROJECT
COMPLETION AND SUCCESS. CLEAR
DIRECTION FROM THE LEGISLATURE
REMOVES ANY UNCERTAINTY ABOUT
THE PROJECT, BASELINE AND
DIRECTION, GOING FORWARD AND
SETS UP CRITERIA TO HELP THE
LEGISLATURE MONITOR PROJECT
PROGRESS. SECOND WE RECOMMEND
THE LEGISLATURE ADD ONTO AND
MODIFY THE PROVISIONAL BUDGET
BILL LANGUAGE THAT IS PROPOSED
BY THE ADMINISTRATION FOR THIS
PROJECT. THE LANGUAGE WITH HOLDS
ABOUT 20% OF THE PROJECT FUNDING
PENDING A DETERMINATION BY THE
DEPARTMENT OF FINANCE THAT QUOTE
VERIFIED SATISFACTORY PROGRESS
TOWARDS PROJECT COMPLETION IS
MADE. IT DOES NOT DEFINE
SATISFACTORY PROGRESS, HOWEVER,
AND SIMILAR LANGUAGE PROPOSED
LAST YEAR WAS NOT USED BECAUSE
THE PERCENTAGE OF FUNDING
WITHHELD WAS TOO LOW. THEREFORE
WE RECOMMEND THE LEGISLATURE
DEFINED SATISFACTORY PROGRESS
USING THE PROPOSED TRAILER BILL
LANGUAGE, SO THE ADMINISTRATION
, THE LEGISLATURE AND PROJECT
STAFF CAN MEASURE AND VERIFY
PROJECT PROGRESS GOING FORWARD.
FURTHERMORE WE RECOMMEND THE
FUNDING THAT IS WITHHELD BE
INCREASED TO 35% OVER 20. TO
ENSURE THE LEGISLATURE HAS AN
OPPORTUNITY TO VERIFY THAT
SATISFACTORY PROGRESS IS MADE.
THIRD WE RECOMMEND THE
LEGISLATURE CONSIDER ADDITIONAL
OVERSIGHT TOOLS. CURRENTLY
MONTHLY PROGRESS REPORTS AND
QUARTERLY BRIEFINGS ARE PROVIDED
TO THE LEGISLATURE. BUT THE
HISTORY OF THE PROJECT SHOWS
THAT THIS IS NOT ENOUGH. ONE
OPTION IS MONTHLY OVERSIGHT
MEETINGS BETWEEN OUR OFFICE. THE
PROJECT, THE DEPARTMENT OF
TECHNOLOGY AND OTHER RELEVANT
PARTIES TO REVIEW PROJECT
OVERSIGHT REPORTS FROM THE
DEPARTMENT OF TECHNOLOGY AS WELL
AS INDEPENDENT VERIFICATION AND
VALIDATION STAFF THAT LOOK AT
THE PROJECT ON A MORE TECHNICAL
BASIS. THIS IS AN APPROACH
THAT'S BEEN USED IN PRIOR
PROJECTS THAT ARE VERY LARGE AND
COMPLEX. ANOTHER OPTION WOULD BE
TO REQUEST THE PARTICIPATION OF
THE STATE AUDITOR TO ANNUALLY
EVALUATE WHETHER THE PROJECT IS
MAKING SUFFICIENT PROGRESS
TOWARDS COMPLETION, ACCORDING TO
THE BASELINE AND THE SPR. AND
LASTLY, THE LEGISLATURE COULD
DIRECT THE PROJECT TO IMPROVE
THE LEVEL OF DETAIL IN ITS
REPORTING, SUCH AS BY INCLUDING
MEASUREMENTS OF PROJECT COST
QUALITY AND SCHEDULE FROM THE
PROJECTS. INDEPENDENT ADVISOR.
IN SOME, THE ADMINISTRATION'S
REVISED PROJECT PLAN LOOKS
PROMISING, BUT THIS PROJECT IS
ONE OF THE COSTLIEST AND MOST
COMPLEX IN THE STATES. IT
PORTFOLIO. THE GOVERNORS MAY
REVISION PROPOSAL PRESENTS AN
OPPORTUNITY FOR THE LEGISLATURE
TO INCREASE ITS INVOLVEMENT IN
AND OVERSIGHT OF THE PROJECT AND
HAPPY TO ANSWER ANY QUESTIONS
BRING IT UP TO THE DIOCESE WILL
BEGIN WITH DR JACKSON. THANK YOU
VERY MUCH, MR CHAIR, AND IT
LOOKS LIKE THERE'S THIS IS YOUR
BIRTHDAY. TOMORROW WOW OVER THE
AGENDA. UM. THE YAHOO! I THI.
AND THIS IN OUR PORTFOLIO HAS
BEEN VERY DISAPPOINTING. AND
THIS IS NOT THE ONLY PROJECT.
AND UM, OBVIOUSLY, I THINK, MR
CHAIR WE SHOULD BE ADOPTING AS
MANY OF THE RECOMMENDATIONS OF
THE L A AS POSSIBLE. BECAUSE AT
THIS POINT IT'S GOING TO BE OUR
FAULT HAVE HAVE WE ALLOW THESE
THINGS TO CONTINUE ON. AND SO,
AT LEAST FOR THIS MEMBER, UM I
REALLY HOPE THAT WE STAY. UM ON
OUR BENCHMARKS ON THIS. BECAUSE
THIS IS THIS WILL BE THE LAST
TIME I'M SUPPORTIVE. UM OF AN
ADDITIONAL CHANGE IN ADDITIONAL
MONEY GOING TO THIS PROJECT.
WE'RE EITHER GOING TO GET THIS
RIGHT OR WE'RE NOT. BECAUSE 10
YEARS ALREADY IT'S JUST NOT
ACCEPTABLE. I MEAN, THAT'S A
FULL TERM OF A SUM OF SOME OF
OUR MEMBERS. AND SO. UH, I WISH
THE BEST OF LUCK TO YOU. AND
GETTING THIS DONE. UM BUT YOU
KNOW, THIS WILL WITHOUT
ADDITIONAL MEASURES AS THE L A.
OH UM, HAS PRESCRIBED. I KNOW I
WILL NOT BE SUPPORTIVE OF, UM OF
THIS ADDITIONAL FUNDING, AND NOR
WILL I BE SUPPORTIVE IN THE
FUTURE. UM, IF WE ARE NOT
STICKING TO THE BENCHMARKS THAT
WE DO WE GOTTA DO IT RIGHT IF I
WAS A CONTRACTOR OF THE STATE,
AND I DID THAT THE STATE WOULD
GET RID OF ME IN A SECOND. RIGHT
BUT WE DON'T HAVE THE SAME
ACCOUNTABILITY FOR OURSELVES. UM
AND SO, UM AH, IT IS MY HOPE
THAT WE GET IT RIGHT THIS TIME.
THANK YOU LIKE TO GIVE THE
ADMINISTRATION OF CHANCE TO
RESPOND TO THE COMMENTS. I WAS
PARTICULARLY DRAWN TO THE LACK
OF PROGRESS COULD THREATEN
FEDERAL FUNDING AND THE NEED FOR
US TO ENSURE THAT WE WERE DOING
THIS ON TIME AND ON BUDGET, SO I
LIKE TO GIVE YOU A CHANCE TO
RESPOND BEFORE I ASK ANY FURTHER
QUESTIONS. SURE ABSOLUTELY. I
APPRECIATE IT. AND I MEAN, WE
FULLY AGREE. WE LOOK FORWARD TO
ENGAGING ON THE RECOMMENDATIONS
FROM THE WE'VE RAISED A FEW
CONCERNS ABOUT HOW WE WORK, SOME
OF THAT SOME OF THE NUMBERS, BUT
BUT ALL IN ALL IT ALIGNS WITH
EXACTLY WHAT WE'VE BEEN DOING. I
CAME ON BOARD A YEAR AGO, THE
DAY AFTER TOMORROW AND MY
DIRECTOR ROLE, AND WE'VE SPENT
THAT TIME FOCUSING ON THIS SPR
SIX AND MAKING SURE THAT WE'RE
BUILDING IN ACCOUNTABILITY FOR
OURSELVES FOR OUR VENDORS IN A
WAY THAT CAN BE TRACKED AND
MEASURED. SO LIKE MR METZGER
TALKS ABOUT THE ADDITIONAL
ENHANCED FEATURES TO ENABLE YOU
TO MONITOR THAT WE ARE HITTING
THOSE BENCHMARKS. WE HAVE BUILT
THOSE IN FOR OURSELVES AND ARE
HAPPY TO BE SHARING THOSE
PUBLICLY AS WELL FOR OTHERS TO
TAKE PART IN. AND IN TERMS OF
THE FEDERAL FUNDING, WE FULLY
AGREE THE CURRENT SYSTEM DOES
NOT MEET FEDERAL REQUIREMENTS.
THEY'VE BEEN PATIENT WITH US,
BUT WE'RE IN ACTIVE DISCUSSIONS
WITH THEM. WE HAVE DIFFERENT
DOCUMENT BUT THE COMPARATIVE TO
THE SPR WITH THEM FOR REVIEW
RIGHT NOW, WITH THE SAME
COMMENTS IN PLACE. I WOULD LIKE
TO DIG INTO THIS SPECIFIC
RECOMMENDATIONS IS THE
ADMINISTRATION AMENABLE TO DATES
AND. SUCCESS MODELS, GOALS AND
PLANNED OUTCOMES THAT WERE
SUGGESTED BY THE L A. CAN WE
WORK WITH YOU TO ALSO INCREASE
THE FUNDING PERCENTAGE FROM 20%
TO 35% BECAUSE WE HAVE A NEED TO
MAKE SURE THAT WE HAVE
ACCOUNTABILITY WITH THESE
DOLLARS. I AGREE WITH MY
COLLEAGUE AND SO INTEND FOR US
TO ASK THE ADMINISTRATION TO PUT
PEN TO PAPER AND FIGURE OUT HOW
WE CAN WORK WITH EACH OTHER TO
ENSURE THAT WE MEET THE GOALS OF
THIS PROJECT WILL TRANSITION MY
LINE OF QUESTIONING TO THE THIRD
PARTY INDEPENDENT EVALUATOR. I
BELIEVE THAT'S DELOITTE AND SO
HOW DID. HOW DO WE MAKE SURE
THAT WE HAVE OVERSIGHT ON THOSE
WHO ARE WATCHING OUR PROGRAMS AS
WELL? WHAT'S OUR ROLE? HOW ARE
WE GETTING INPUT FROM THEM TO
DETERMINE WHETHER OR NOT WE'RE
SUCCESSFULLY MAKING THESE
CHANGES? ABSOLUTELY SO THE LLOYD
IS OUR PLATFORM AS A SERVICE.
THEY'RE DOING THE MAIN BUILDING
. THE THIRD PARTY VENDOR IS
COMPLETELY SEPARATE FROM THEM
AND MONITORING IT. AND SO THEY
HAVE AUTONOMY. AND THEN I
ACTUALLY WHAT WE'VE DONE IS THEY
REPORT TO ME AND MY AGENCY ROLE.
SEPARATE FROM THE PROJECT SO
THAT THE PROJECT LEADERSHIP
CAN'T SAY I DON'T LIKE WHAT
THEY'RE SAYING. AND MAKE CHANGES
TO IT OR PUSH THEM ON THAT. IS
THERE ANY REASON TO LEGISLATURES
NOT INCLUDED IN THAT FEEDBACK
LOOP WHEN WE BE IMPORTANT TO
HAVE THAT SAME TYPE OF
INFORMATION? I MEAN, I
UNDERSTAND THERE MAY NOT WANTS
TO HAVE THAT LEVEL OF
TRANSPARENCY, BUT WE FIND IT
NEEDED WITH WHERE THE PROJECT
IS. AND SO I WOULD ASK THAT.
SIMILARLY IF THIS, UM DELOITTE
IS GIVING YOU THE INFORMATION
THAT WE WOULD ASK THAT WE
RECEIVED THAT SAME LEVEL OF
INFORMATION, SURE. YEAH WE'D BE
HAPPY TO WORK THROUGH WHAT THAT
LANGUAGE LOOKS LIKE. UM, I DON'T
I'D HAVE TO GO BACK TO SEE WHERE
WE FOLD THAT INTO AN EXISTING
REPORTS AND NOT LIKE MR METZGER
SAID. WE ALSO HAVE AN
INDEPENDENT VALIDATION AND
VERIFICATION. WE HAVE C D. T S I
P O. SO THERE'S LOTS OF PIECES
OF OVERSIGHT TO GET FOLDED
TOGETHER, AND I THINK WE CAN
TALK THROUGH WHAT MAKES THE MOST
SENSE WHERE WE'RE NOT THROWING
EVERYTHING AT YOU. BUT WE CAN
PUT SOMETHING TOGETHER THAT
EFFECTIVELY GIVES YOU THE VIEW
THAT YOU'RE LOOKING FOR. THANK
YOU. WITH THAT WE WILL. LOOK
TOWARDS THAT TRAILER BILL
LANGUAGE, TOO, AS WE NEGOTIATE
THIS FINAL BUDGET, BUT IT WILL
BE IMPORTANT FOR MANY OF US AS
WE APPROPRIATE DOLLARS THAT WE
HAVE THAT LEVEL OF TRANSPARENCY
SO WE CAN HAVE CONFIDENCE IN
WHERE WE'RE GOING. AND I DO
AGREE WITH YOU WITH YOUR
OPERATIONAL DECISION TO ACTIVATE
ALL COUNTIES AT THE SAME TIME,
MAKES LOGICAL SENSE AND
APPRECIATE THE TRAINING AND WORK
THAT'S GONE INTO THIS LEVEL OF
TRANSFORMATION AND SO UNDERSTAND
THAT IT'S COMPLEX AND IT COST
DOLLARS, BUT WE HAVE THE
RESPONSIBILITY TO MAKE SURE
THOSE DOLLARS ARE WELL SPENT AND
LOOK FORWARD TO THE ONGOING
DISCUSSIONS WITH THE
ADMINISTRATION. LIKEWISE, THANK
YOU. THAT WE WILL MOVE TO OUR
NEXT ITEM THAT INNOVATIONS
INITIATIVE.
HELLO MR CHAIR MEMBERS. ERIN
CARRUTHERS, EXECUTIVE DIRECTOR
OF THE STATE COUNCIL AND
DEVELOPMENTAL DISABILITIES, MR.
CHAIR ONE EXTEND MY VERY
HAPPIEST BIRTHDAY WISHES TO YOU.
THANK YOU VERY MUCH PROBLEM.
GIVE ME A SECOND BEFORE WE GO TO
S C D D. WE STILL HAVE FURTHER
ITEMS UNDER CAL. THANK YOU. I
WANT TO BRING BACK THE
ADMINISTRATION FOR HELP
INNOVATIONS INITIATIVE HOME AND
CLEARLY BASED SERVICES SPENDING
PLAN CHANGES IN THE ELECTRONIC
POSITION. EQUALS. GOOD MORNING,
MR CHAIR MEMBERS. BRENDAN
MCCARTHY, DEPUTY SECRETARY FOR
PROGRAMMING FISCAL AFFAIRS WITH
KELLY HHS, SO I'M HERE TO
PRESENT ON THE HEALTH AND HUMAN
SERVICES INNOVATION ACCELERATOR
INITIATIVE. THIS IS A $10
MILLION.01 TIME GENERAL FOR FUND
PROPOSAL FROM THE ADMINISTRATION
. THE PROBLEM WE ARE TRYING TO
SOLVE HERE IS THAT THERE ARE
OFTENTIMES INNOVATIONS IN THE
HEALTH SPACE. NEW MODELS OF CARE
, NEW DRUGS, NEW TECHNOLOGIES.
THEY DON'T THEY'RE NOT ALWAYS
TRANSLATED AND SCALED UP IN OUR
PUBLIC SAFETY NET SYSTEMS AS
RAPIDLY AS WE LIKE. WHICH YOU
KNOW, AS YOU KNOW, CAN
EXACERBATE DISPARITIES AND
INEQUITIES ALREADY IN THE
SYSTEM. UM AND SO WHAT WE WANT
TO DO WITH THIS PROPOSAL IS USED
THIS MONEY TO TRANS HELP
TRANSLATE AND SCALE INNOVATIONS
OUT THERE. SO MAYBE NEW MODELS
OF CARE, FOR EXAMPLE, TREATING
DIABETES OR NEW TECHNOLOGIES SO
THAT THEY ARE MORE WIDELY
ADOPTED IN THE PUBLIC SAFETY NET
SYSTEM THAT SERVES SO MANY OF
OUR DISADVANTAGED COMMUNITIES.
UM OUR HOPE AND INTENT HERE IS
TO PARTNER WITH OUTSIDE PARTNERS
, FOR EXAMPLE, PHILANTHROPIC
ORGANIZATIONS TO HOPEFULLY
LEVERAGE THE STATE INVESTMENT
WE'RE MAKING HERE AS WELL AS TO
LEVERAGE THEIR EXPERTISE ON
THESE NEW EMERGING INNOVATIONS
THAT ARE NOT AS YET BEEN WIDELY
DISSEMINATED. AND SO HOPEFULLY
THAT PARTNERSHIP WILL ALLOW US
TO IDENTIFY NEW WAYS OF DOING
THINGS IN THE HEALTH CARE SYSTEM
THAT ARE NOT WIDELY SCALED. UM
THE INTENT HERE REALLY IS TO BE
A CONDUIT TO THE EXISTING
INNOVATIONS THAT ACADEMIC
RESEARCHERS OR, FOR EXAMPLE,
PILOT PROJECTS THAT HAVE BEEN
DONE BUT A VERY SMALL SCALE AND
IF NOT PERCOLATED THROUGH THE
REST OF THE SYSTEM THAT THAT'S
THE NICHE WE'RE TRYING TO FILL
WITH THIS INITIATIVE. AND AS I
SAID THAT THE REAL OVER ARCHING
GOAL HERE IS TO ADDRESS THE
INEQUITIES AND DISPARITIES IN
THE SYSTEM BY MAKING SURE THE
BEST AVAILABLE TECHNOLOGIES AND
MODELS OF CARE ARE AVAILABLE TO
ALL CALIFORNIANS. IN YOUR AGENDA
. THE COMMITTEE RAISED A GOOD
QUESTION ABOUT WHAT THE
CONNECTION IS TO THOSE SER FIRE.
HUMAN SERVICES PROGRAMS LIKE S S
. I P OR COW WORKS, AND WE HAD
SOME GOOD FEEDBACK FROM YOUR
STAFF. AND I THINK THIS THIS
COULD BE A REALLY GOOD
OPPORTUNITY FOR US TO LOOK AT.
WHAT ARE THE PARTICULAR NEEDS OF
FOLKS SERVED BY OUR HUMAN
SERVICES SAFETY NET PROGRAMS
THAT ARE NOT BEING MET THROUGH
THE HEALTH CARE SYSTEM AND ARE
THERE WAYS THAT WE CAN TARGET AS
WE LOOK AT SORT OF KEY AREAS TO
FOCUS ON. ARE THERE ISSUES THAT
WE CAN USE? THAT PARTICULARLY
CAN BENEFIT UNSERVED NEEDS OF
FOLKS WHO ARE ALREADY BEING
SERVED BY OUR PROGRAMS ON HUMAN
SERVICES. SO THAT WAS REALLY
HELPFUL FEEDBACK, AND THAT'S
SOMETHING THAT WE CAN LOOK AT,
AS WE'RE LOOKING TO BUILD OUT
THIS PROPOSAL. SO THAT'S THE
PROPOSAL IN THAT SHOW, AND I'M
HAPPY TO ANSWER ANY QUESTIONS.
DEPARTMENT OF FINANCE. MEDICAL
CARE FOR FINANCE. UM JUST TO ADD
ON A COUPLE OF POINTS AND I
THINK ANOTHER PART OF THIS
PROPOSAL IS TO DOVETAIL WITH
SOME FEDERAL INNOVATIONS AND
PROGRAMS, YOU KNOW, KIND OF
ALONG THE SAME THEME THAT AGENCY
DISCUSSED AND I ALSO WANT TO
POINT OUT THAT WE ARE WORKING ON
SOME ADDITIONAL WRITTEN MATERIAL
, WHICH WILL BE PROVIDED TO THE
COMMITTEE AND TO THE LAO AS
REQUESTED. LEO RYAN MILLER,
LEGISLATIVE ANALYST'S OFFICE.
WE'VE PRODUCED AN ANALYSIS OF
THIS PROPOSAL THAT'S ATTACHED TO
THE AGENDA. UM WE UNDERSTOOD
PREVIOUSLY THAT THE
ADMINISTRATION DID NOT PLAN TO
SUBMIT A BCP ON THIS ISSUE. UM,
WHILE THE INFORMATION TODAY IS
HELPFUL, WE'VE RAISED NUMEROUS
QUESTIONS THAT RANGED FROM
PRETTY BASIC QUESTIONS LIKE HOW
WOULD THE FUNDING BE USED, BUT
ALSO QUESTIONS ABOUT HOW THIS
WOULD DUPLICATE OR NOT DUPLICATE
EXISTING PROGRAMS. WHY THE
AGENCY IS THE BEST PLACE FOR
THIS TO BE HOUSED. WE LOOK
FORWARD TO RECEIVING ADDITIONAL
INFORMATION ABOUT THIS PROPOSAL
. HOWEVER ABSENT A FULL
JUSTIFICATION WE RECOMMEND THAT
THE LEGISLATURE REJECT THIS
PROPOSAL. BRING IT UP TO THE
DIESS. DR JACKSON. UH YOU KNOW,
UM. I GO BACK TO, UM OUR
ORIGINAL DISCUSSIONS IN THE VERY
BEGINNING WHEN WE STARTED TO
TALK ABOUT US HAVING A LEAN
BUDGET. AND ABOUT THERE'S A
DIFFERENCE AND DECISION MAKING
WHEN YOU HAVE A LEANER BUDGET,
AND THAT IS IT HAS NOTHING TO DO
WITH WHETHER SOMETHING IS A GOOD
IDEA. GOOD IDEA, NOT IT HAS TO
DO WITH OUR PRIORITIES. AND SO
WHEN I LOOK AT ADDITIONAL CUTS
THAT HAVE BEEN ARE BEING MADE IN
THIS BUDGET. BUT YET WE ARE
FINDING MONEY FOR THIS, EVEN
THOUGH IT'S A GREAT IDEA. I'M
JUST NOT SURE THAT THIS IS THE
BEST USE OF OUR MONEY DURING A
LEAN BUDGET YEAR. UM SO I I'M
INCLINED TO NOT BE SUPPORTIVE OF
THIS UNLESS THERE'S A
OVERWHELMINGLY PRESSING MATTER.
THAT WE'RE TRYING TO ADDRESS. AH
THAT WOULD JUSTIFY US MAKING
CUTS IN OTHER AREAS. IN ORDER TO
MAKE ROOM FOR THIS, AND SO I
LOOK FORWARD TO, UM MORE
DISCUSSIONS ON THIS. I'LL KEEP
IT HERE AT THE CHAIR. I SHARE
MANY OF THE CONCERNS THAT THE
LAO DOES AND LOOK FORWARD TO THE
LEVEL OF INFORMATION THAT COMES
BUT I'M HEARING LOUDLY AND
CLEARLY THE TONE FROM THE
MEMBERS HERE ON THE DIOCESE
WELL, WITH THAT WE WILL MOVE ON
TO HCPS. THANK YOU, MR CHAIR.
HMM. MORNING CHAIR MEMBERS HER
SCRIPT WITH THE DEPARTMENT OF
FINANCE, SO I JUST WANT TO
PROVIDE A LITTLE BIT OF
BACKGROUND AGAIN ON CBS. SO IN
2021 BUDGET ACT CONTROL SECTION
11.95 BASICALLY WAS ESTABLISHED
TO APPROPRIATE THESE $3 BILLION
IN ADDITIONAL FEDERAL FUNDING TO
ENHANCE, EXPAND AND STRENGTHEN,
UH, H CBS PROGRAMS. UM THE TOTAL
AMOUNT OF FUNDING WAS DETERMINED
ON BASE H CBS PROGRAM
EXPENDITURES FROM APRIL 1ST 2021
THROUGH MARCH 31ST OF 2022. UM
AND THIS MAY REVISION PROPOSES
TECHNICAL ADJUSTMENTS TO THAT
CONTROL SECTION TO CLARIFY THE
STATE'S EXPENDITURE DEADLINE, UM
AND THE STATE MUST EXPEND ALL
DOLLARS BY THE FEDERAL
GOVERNMENT'S DEADLINE. OTHERWISE
THE MEANINGS OF EFFORT
REQUIREMENT WOULD RENEW FOR
THESE FUNDS AND FOR ALL HCPS
DOLLARS. UM MR VISION ALSO
PROPOSES TO EXTEND THE STATE'S
EXPENDITURE DEADLINE FOR 11
PROGRAMS ACROSS FOUR DEPARTMENTS
AND TELL SEPTEMBER 30TH OF 2024.
UM AND THE REMAINING PROGRAMS
ARE STILL ON TRACK TO FULLY
EXPAND ALL THEIR DOLLARS BY THE
CURRENT DEADLINE OF MARCH. 31ST
OF 2024. ULTIMATELY, THE GOAL
AND EXTENDING THESE PROGRAMS WAS
TO REALLY JUST MAKE SURE THAT
WE'RE GETTING ALL THE MONEY OUT
INTO THE COMMUNITY AS OFFICIALLY
AS POSSIBLE WHILE MAKING SURE
ALL THE PROGRAMS MEET THEIR
STATED GOALS TO SERVE THE
COMMUNITY AS WELL. SO WITH THAT
HAPPY TO ANSWER ANY QUESTIONS
DEPARTMENT OF FINANCE. ELIO
CAROLINE. CHEW WITH ELIO. WE
JUST RECEIVED THE
ADMINISTRATION'S SECTION LEATHER
THAT OUTLINES THE SPECIFIC
PROGRAMS THAT WOULD RECEIVE THE
EXTENSION. WE'RE STILL REVIEWING
THAT, BUT AT A HIGH LEVEL OF THE
EXTENSION MAKES SENSE. WE'RE
WORKING TO UNDERSTAND HOW THE
DEPARTMENT FINANCE AND
ADMINISTRATION SELECTED THE
PARTICULAR PROGRAMS THAT IT DID
FOR THE EXTENSION. HOW THE
ADMINISTRATION PLANS TO TRACK
THAT THE FUNDS CAN BE SPENT BY
THE DEADLINE AND HOW THE
LEGISLATURE CAN EXERCISE
OVERSIGHT TO ENSURE THOSE MONEYS
ARE SPENT. WHAT'S NOW BRING IT
UP TO THE DIOCESE SEEING NO
MEMBERS, QUESTIONS. WE'LL GO TO
THE POST. IT'S THE NEXT BCP
ELECTRONIC PHYSICIAN ORDER OF
LIFE SUSTAINING TREATMENT
REGISTRY PROJECT AND THE
CALIFORNIA AMS DATA RESOURCE
SYSTEM. PROJECTED BCP IS THE
ADMINISTRATION BUT.
SO. HI GOOD MORNING. UH MR CHAIR
AND HONORABLE COMMITTEE MEMBERS.
THANK YOU FOR HAVING ME HERE
TODAY. MY NAME IS LORNA EBY, AND
I'M, THE DEPUTY DIRECTOR FOR THE
OFFICE OF SYSTEMS INTEGRATION
AND I WILL BE PRESENTING TODAY I
HAVE WITH ME, MR RICK TRUSSELL,
WHO IS THE CHIEF OF
ADMINISTRATION FOR THE EMERGENCY
MEDICAL SERVICES AUTHORITY. AND
I WILL KEEP THIS BRIEF AND THEN
WELCOME YOUR QUESTIONS. THE
OPPOSITE SYSTEMS INTEGRATION
REQUEST 665,000 IN EXPENDITURE
AUTHORITY FOR FISCAL YEAR 23 24
FOR THREE POSITIONS TO PROVIDE
PROJECT PLANNING, CONTRACT
MANAGEMENT AND VARIOUS PROJECTS
SUPPORT SERVICES FOR THE
EMERGENCY MEDICAL SERVICES
AUTHORITY. THIS PROPOSAL
SUPPORTS PROJECT PLANNING
EFFORTS FOR THE ELECTRONIC
POSITIONS ORDERS FOR LIFE
SUSTAINING TREATMENT REGISTRY
PROJECT. KNOWN AS A POST AND
PROVIDES TECHNICAL SUPPORT AND
CONTRACT MANAGEMENT OF THE
CALIFORNIA E. M S INFORMATION
SYSTEM. NOTICE CAMPUSES. THESE
POSITIONS WILL ALSO ENSURE THAT
DEPENDENCIES BETWEEN PEOPLES
CAMPS IS AND THE CALIFORNIA E. M
S DATA RESOURCE SYSTEM PROJECT,
KNOWN AS CEDARS ARE ADDRESSED
AND MANAGED. THE POSITIONS
REQUESTED ARE ONE INFORMATION
TECHNOLOGY MANAGER WHO WILL ACT
AS THE POST PROJECT MANAGER, ONE
INFORMATION TECHNOLOGY
SPECIALIST TO WHO WILL SERVE AS
THE IMPULSE PROJECT MANAGEMENT
SUPPORT ANALYST. AND ONE
INFORMATION TECHNOLOGY
SPECIALIST, THREE WHO WILL ACT
AS A TECHNICAL LEAD FOR
CAMPUSES. FUNDING FOR THE
PEOPLE'S PROJECT WAS PROVIDED
FOR IN MAYBE 1 33 AND APPROVED
IN THE 2021 BUDGET ACT AS A ONE
TIME APPROPRIATION OF $10
MILLION THROUGH JUNE OF 2024.
FUNDING PERK. EMSIS HAS BEEN
REQUESTED BY EMC FOR FISCAL YEAR
23 24 TO NOTE. KEMP'S IS A
SECURE AND CENTRALIST STATEWIDE
DATABASE FOR COLLECTING DATA
ABOUT INDIVIDUAL EMERGENCY
MEDICAL SERVICE REQUESTS.
PATIENTS TREATED AT HOSPITALS
AND EMS PROVIDER ORGANIZATIONS.
I WOULD LIKE TO NOTE THAT THE
POSITIONS REQUESTED IN THIS PCP
ARE DISTINCT AND NOT DUPLICATIVE
OF RESOURCES PREVIOUSLY
REQUESTED BY OS I IN THE FISCAL
YEAR 23 24 SEATERS, BCP. THESE
POSITIONS. REQUESTED FOR POSTING
CAMPUSES WILL BE DEDICATED TO
THOSE EFFORTS TO ENSURE THEIR
SUCCESS AND TO HELP SUPPORT
THOSE PROJECT MANAGEMENT GOALS
AND OBJECTIVES. UM HOWEVER, THEY
WILL ALSO HELP SUPPORT A UNIFIED
IN DEFINED STRATEGY AND
COORDINATED PLANNING EFFORTS
BETWEEN PULSED CAMPUSES AND THE
CEDARS PROJECTS, AND I WILL TAKE
A PAUSE THERE AND WELCOME YOUR
QUESTIONS. DEPARTMENT OF
FINANCE. DEPARTMENT FINANCE HONG
NOTHING FOR THEIR DAD. WILL
OWENS ELIO. WE HAVE NO CONCERNS
WITH THIS PROPOSAL BUT ARE
AVAILABLE FOR QUESTIONS. BRING
IT UP TO THE DIETS. SEEING NO
QUESTIONS. I'LL LEAVE IT THERE
FOR NOW. WITH THAT WE WILL MOVE
TO A CDD.
MR CHAIR MEMBERS. ERIN CAROTHERS
, EXECUTIVE DIRECTOR OF THE
STATE COUNCIL ON DEVELOPMENTAL
DISABILITIES, EAGERLY RETURNING
TO THE MICROPHONE TODAY. THE
STATE COUNCIL ON DEVELOPMENTAL
DISABILITIES IS REQUESTING AN
INCREASE IN REIMBURSEMENT
AUTHORITY BY $106,000 AND
AUTHORITY TO RE APPROPRIATE UP
TO $597,000. BOTH PROPOSALS COME
FROM OUR STRATEGIC PARTNERSHIPS
TO ADVANCE PUBLIC HEALTH NEEDS
AND SAFETY NEEDS COMING OUT OF
THE PANDEMIC. ONE PARTNERSHIP IS
WITH THE UNIVERSITY OF SOUTHERN
CALIFORNIA UNIVERSITY CENTER OF
EXCELLENCE AND DEVELOPMENTAL
DISABILITIES, AND THAT'S TO
CREATE COMMUNITY PUBLIC HEALTH
CONSORTIUMS. THE OTHER
PARTNERSHIP IS WITH THE FEDERAL
ADMINISTRATION ON COMMUNITY
LIVING, THE CENTERS FOR DISEASE
CONTROL AND THE CALIFORNIA
COMMUNITY FOUNDATION TO CONTINUE
THAT ACCESS TO VACCINE BOOSTERS
AND TO CREATE PROVIDE GO KITS AS
PART OF WILDFIRE PREPARATION AND
PROTECTION. AND I THANK YOU FOR
YOUR CONSIDERATION AS REQUESTED
AND BE HAPPY TO ANSWER ANY
QUESTIONS. DEPARTMENT OF
FINANCE. OMAR SENSES OF THE
DEPARTMENT OF FINANCE. NOTHING
FURTHER TO ADD. CAROLINE CHEW
ELIO. WE HAVE NO CONCERNS.
BRINGING IT UP TO THE DIOCESE
WILL HAVE YOU DOCTOR JACKSON.
BUT WHERE SHOULD WE BE EXPECTING
FROM THESE CONSORTIUMS?
CONSORTIUMS BRING TOGETHER
COMMUNITY GROUPS WHO WERE
BROUGHT TOGETHER AS PART OF, UM
OFTEN ACCESS TO VACCINES AND PPE
COMMUNITY GROUPS THAT WE WEREN'T
WORKING WITH BEFORE CAME
TOGETHER FOR THOSE GOALS. WE
WANT TO CONTINUE HARNESSING
THEIR INTEREST IN THEIR ENERGY
FROM THAT IT WILL BE ADVANCING
ADDITIONAL INFORMATION AROUND.
UM, THAT TRAINING AND EDUCATION
FOR HOW TO TREAT AND CARE FOR
PEOPLE WITH DEVELOPMENTAL
DISABILITIES. COMMUNITY SPECIFIC
NEEDS AROUND COMMUNITY NEEDS.
FOR ONE EXAMPLE ONE PARTICULAR
FOCUS IS AROUND PEOPLE WITH
INTELLECTUAL DEVELOPMENT
DISABILITIES, WHO ARE ALSO LGBT
. Q. I A SO LOOKING AT UNIQUE
HEALTH CARE NEEDS OF
INTERSECTIONALITY THAT HAVEN'T
BEEN ADDRESSED BEFORE. AND WHEN
WE LOOK AT THESE RECOMMENDATIONS
, WILL ANY OF THESE
RECOMMENDATIONS ACTUALLY BE
MAKING ITS WAY TO THE
LEGISLATURE? I'M SORRY. COULD
YOU REPEAT THAT THESE
RECOMMENDATIONS BE MAKING ITS
WAY TO THE LEGISLATURE OR WHO
GETS THESE TO BE ABLE TO TAKE
ACTION RIGHT NOW. IT'S FOCUSED
ON THE COMMUNITY MEMBERS
THEMSELVES, BUT THEIR, UM,
ABSOLUTELY BRING INFORMATION
BACK TO THE LEGISLATURE OF THE
LEARNINGS FROM WORKING WITH THE
COMMUNITY MEMBERS. OKAY, THANK
YOU. THANK YOU. IS THERE ANOTHER
ITEM BCP PRESENTED BOTH
TOGETHER. WE ARE GOOD. THANK YOU
VERY MUCH. MR. CHAIR WE WILL NOW
MOVE ON TO 41 20 EMERGENCY
MEDICAL SERVICES AUTHORITY.
HI. GOOD MORNING AND HAPPY
BIRTHDAY. MY NAME IS RICK
RUSSELL. I'M THE ASSISTANT CHIEF
OF ADMINISTRATION AT THE
EMERGENCY MEDICAL SERVICES
AUTHORITY AND AS REQUESTED, WE
WILL BE PROVIDING BRIEF
OVERVIEWS OF OUR TWO MAJOR
REVISION BUDGET PROPOSALS
CURRENTLY UNDER CONSIDERATION,
AND KIM LU█T, CHIEF OF EMS
PERSONNEL. PROVIDE THE FIRST
OVERVIEW. THANK YOU. GOOD
MORNING. AS HE HAS STATED I'M
KIM LU█N WITH THE CALIFORNIA YOU
MUST AUTHORITY. I AM THE
DIVISION CHIEF OF THE EMS
PERSONNEL DIVISION. UM HAMZA IS
REQUESTING TO REDIRECT 100 AND
90,000 GENERAL FUND ORIGINALLY
APPROPRIATED TO SUPPORT THE
IMPLEMENTATION OF THE CALIFORNIA
EMERGENCY MEDICAL ADVANCEMENT
PROJECT, ALSO KNOWN AS C MAP. TO
SUPPORT PLANNING EFFORTS FOR THE
CALIFORNIA EMERGENCY MEDICAL
SERVICES CENTRAL REGISTRY, WHICH
IS A APPLICATION SYSTEM THAT
MONITORS AND PROCESSES LICENSING
, PARAMEDIC LICENSING, EMT
CERTIFICATION, INVESTIGATIVE
WORK AND SOME LEGAL CASE
ACTIVITIES INVOLVING PARAMEDICS.
THE C MAP FUNDING WAS INCLUDED
IN THE 2021 BUDGET ACT,
IMPLEMENT CHAPTER 138 STATUTES
OF 2020. OR MAYBE 15 44, WHICH
AUTHORIZED THE COMMUNITY
PARAMEDIC OR CP, OR TRIAGE,
ALTERNATE DESTINATION TAD ACT OF
2020. THIS PROPOSAL IS COST
NEUTRAL AND THE REDIRECTION OF
SEE MAP FUNDING WILL BE UTILIZED
FOR THE PLANNING EFFORTS
ASSOCIATED WITH THE REPLACEMENT
OF THAT CENTRAL REGISTRY SYSTEM.
WITH THE ENACTMENT OF A B 15 44
LICENSED PARAMEDICS ELECTING TO
BE ACCREDITED IN COMMUNITY PARA
MEDICINE, SPECIALTY SERVICES.
ALSO KNOWN AS CPP, OR CHARGED TO
ALTERNATE DESTINATION. SPECIALTY
SERVICES ARE REQUIRED TO ATTEND
SPECIALIZED TRAINING. ALTHOUGH
THE STUDENT CURRENT CENTRAL
REGISTRY SYSTEM CAN RECORD CP
AND TAD ACCREDITATION BY
LICENSED PARAMEDIC RECORD ITS
FUNCTIONALITY FOR TRACKING THE
REQUIREMENTS OF A B 15 44 IS
LIMITED TO THE ACCREDITATION
TYPE. AND THE START AND END
DATES PERIODS OF THAT
ACCREDITATION AND NOTHING ELSE.
AS A RESULT, HAMZA IS UNABLE TO
ANALYZE OR REPORT BACK TO THE
LEGISLATION, ARMED CP AND TAD
ACCREDITATION OR TRAINING AND
CONTINUING EDUCATION RELATED TO
THAT, UM, LEGISLATIVE INTENT.
THAT WOULD BE TIED ALSO TO ARE
JUST TO BE CLEAR TIED TO OUR
INITIAL RENEWAL AND
REINSTATEMENT LICENSE
APPLICATION PROCESSES. ESSENTIAL
REGISTRY IS CURRENTLY COMPRISED
OF TWO INDEPENDENT SOLUTIONS. 13
YEAR OLD COMMERCIAL OFF THE
SHELF. SOLUTION THAT DOES
LICENSING AND THE ENFORCEMENT
AND LEGAL ACTIVITIES OF
PARAMEDICS AND THEN WE ALSO HAVE
A CUSTOM BUILT DATABASE THAT IS
PUBLICLY VIEWABLE FOR PEOPLE TO
SEE. CONTINUING EDUCATION
COURSES AND INITIAL TRAINING.
UM, TRAINING CLASSES AND
PROGRAMS. HOWEVER THAT SYSTEM IS
AT ITS END OF LIFE AND WE DO NOT
HAVE ANY SUPPORT SERVICES TO
MAINTAIN IT. WE CAN'T ADD.
DELETE OR MODIFY ANYTHING WITHIN
THE RECORD, SO WE ARE UNABLE TO
USE THAT SYSTEM FOR COMMUNITY
PARA MEDICINE AND TRIAGED
ALTERNATE DESTINATION
ACCREDITATION TRAINING
INFORMATION. THE 2021 2022
BUDGET INCLUDED THREE YEARS OF
FUNDING FOR A B 15 44. THE C MAP
PROJECT WAS PAUSED, HOWEVER, IN
AUGUST OF 2022 DUE TO DELAYS IN
THE REGULATORY PROCESS AND THE
NEED TO FOCUS ON OTHER
PRIORITIES, INCLUDING KANSAS,
WHICH YOU HEARD ABOUT EARLIER.
ELECTRONIC OR E PULSE, WHICH YOU
JUST HEARD ABOUT AS WELL. AND
THE CALIFORNIA VMS DATA RESOURCE
SYSTEM OR CEDARS. TO INCLUDE
CENTRAL REGISTRY. AS A RESULT,
THE CMAP PROJECT BEING PASSED
THERE IS AN AVAILABLE $190,000
IN 2023 24, WHICH WILL NOT BE
UTILIZED AND IS BEING PROPOSED
TO BE REJECTED. REDIRECTED TO
FUND THE PLANNING EFFORTS
ASSOCIATED WITH REPLACING THE
CENTRAL REGISTRY SYSTEM. THAT
CONCLUDES MY PRESENTATION AND WE
ARE OPEN FOR QUESTIONS.
DEPARTMENT OF FINANCE. OR EXCUSE
ME. DO YOU WANT TO JUST DO YOUR
SECOND ITEM AS WELL? THE
APPOINTMENT OF THE CHIEF MEDICAL
OFFICER PROPOSAL. WE CAN DO THAT
, UM, FOR THE SECOND PROPOSAL
AND IS REQUESTING $29,000 IN
GENERAL FUND AND 23 24 ONGOING
ADDITIONAL FUNDING IS REQUESTED
BECAUSE THE DEPARTMENTAL
INDIRECT COSTS WERE
INADVERTENTLY NOT INCLUDED IN
THE ORIGINAL PROPOSAL. WE'VE
ALREADY HEARD AND ENTITLED
APPOINTMENT OF CHIEF MEDICAL
OFFICER AND THAT'S THE END OF
THAT PRESENTATION. DEPARTMENT OF
FINANCE. PATEL DEPARTMENT OF
FINANCE NOTHING FURTHER. WILL
OWNS A LEO. NO CONCERN EITHER
PROPOSAL, BRING IT UP TO THE
DIOCESE TO SEE IF THERE ARE ANY
MEMBERS QUESTIONS SEEING NONE.
WE WILL THINK THIS DEPARTMENT
AND MOVE ON TO ISSUE FOR D.
THANK YOU. 1 40 DEPARTMENT OF
HEALTH CARE, ACCESS AND
INFORMATION.
GOOD MORNING, I'M VISUAL PAGANI
, DEPUTY DIRECTOR FOR THE
DEPARTMENT OF HEALTH CARE,
ACCESS AND INFORMATION. WILL BE
PRESENTING ON THE THREE ITEMS
FOR H CHI. THE FIRST ONE IS
REALLOCATE FUNDS FOR CALERA X
PHARMACEUTICAL DRUG PROCUREMENT.
UNDER THIS PROPOSAL H CHI
REQUESTS TRANSFER OF TWO MILLION
OF GENERAL FUND EXPENDITURE
AUTHORITY ORIGINALLY APPROVED IN
THE 20 TO 2022 BUDGET ACT FOR
CAPITAL INFRASTRUCTURE SECURITY.
FOR REPRODUCTIVE HEALTH CLINICS
TO INSTEAD SUPPORT PROCUREMENT
OF MEAT I PRE STONE OR MUSEO PRO
STALL THROUGH THE CALORIE X
PROGRAM. TO ENSURE CONTINUED
ACCESS TO THESE DRUGS FOR
CALIFORNIANS IN NEED OF SAFE AND
EFFECTIVE MEDICATION ABORTION.
THIS PROPOSAL IS RESPONSIVE TO
RECENT FEDERAL COURT ACTIONS AND
BUILD ON LAST YEAR'S REPORT
REPRODUCTIVE HEALTH PACKAGE.
THERE ARE SIX SUPPORTING A STATE
LEVEL EMERGENCY STOCKPILE. THE
RESOURCES WOULD SECURE ENOUGH
MEDICATIONS TO SUPPORT
MEDICATION ASSISTED ABORTIONS.
IN THE STATE DURING A ONE YEAR
PERIOD. INCLUDING BOTH THE TWO
DRUG REGIMEN AND THE MISOPROSTOL
ONLY REGIMEN. LASTLY I NOTE THAT
THE STATE WOULD ONLY USE THESE
FUNDS THIS FUNDING TO STOCKPILE
MEDICATIONS SHOULD THERE BE
MARKET SIGNALS OF A SHORTAGE OR
DISRUPTION TO THE EXISTING
SUPPLY CHAIN? UM AND WE WOULD
USE THESE FUNDS TO PROCURE
EITHER MEDICATION. I'M HAPPY TO
MOVE ON TO THE NEXT ITEM OR OR
TAKE QUESTIONS AT THE END. SO
THE SECOND ITEM IS THE CALORIE X
NALOXONE ACCESS INITIATIVE.
BEFORE I LAUNCH INTO THE
SPECIFICS, JUST WANT TO SET THE
STAGE, AS MANY OF YOU ARE AWARE,
CALIFORNIA HAS EXPERIENCED A
SHARP RISE IN OPIOID RELATED
DEBTS. AN EMERGENCY DEPARTMENT
VISITS DUE TO OVERDOSES.
NALOXONE IS AN ESSENTIAL TOOL.
IN COMBATING THIS EPIDEMIC AND
INCREASING ACCESS TO THIS
MEDICATION IS CRITICAL. COMPARED
TO A INJECTION FORMS AND NASAL
SPRAY FORM FORMULATION OF
NALOXONE. HAS BECOME POPULAR DUE
TO ITS EASE OF USE AND
EFFECTIVENESS. AND ITS ABILITY
TO BE ADMINISTERED BY
INDIVIDUALS WITHOUT MEDICAL
TRAINING. THE PRICE FOR BOTH
BRANDED AND GENERIC NALOXONE
NASAL SPRAY REMAINS ARTIFICIALLY
HIGH FOR SEVERAL YEARS, LEADING
TO ACCESS BARRIERS AND CONTINUED
GROWTH IN OVERDOSE DEATHS.
TODAY'S MARKET LACKS ACCESS TO
LOW COST NALOXONE NASAL SPRAY.
AND RELYING ON THE MARKET TO
SELF CORRECT IS UNCERTAIN.
UNDERSCORING THE NEED TO SUPPORT
DEVELOPMENT, MANUFACTURING OR
PROCUREMENT OF A LOW COST
OPTION. ACCESS TO A LOW COST
NALOXONE NASAL SPRAY IN
COMMUNITIES ACROSS CALIFORNIA
WILL REDUCE OPIOID RELATED
DEATHS. AND THIS PROPOSAL. H CHI
REQUESTS ONE TIME FUNDING OF 30
MILLION AND OPIOID SETTLEMENT
FUNDS. FOR THE CALORIE EXT
NALOXONE ACCESS INITIATIVE. THE
RESOURCES WILL BE USED TO
SUPPORT THE DEVELOPMENT,
MANUFACTURING OR PROCUREMENT OF
A LOW COST NALOXONE NASAL SPRAY
PRODUCT. THE STATE'S
CONTRIBUTION WOULD HELP FUND THE
PROJECT AND THE SELECTED
PARTNER. WE'LL CONDUCT THE
RESEARCH AND DEVELOPMENT,
INCLUDING CLINICAL STUDIES,
MANUFACTURING MANUFACTURING
PROCESS DEVELOPMENT. REGULATORY
SUBMISSIONS AND OBTAINING
APPROVAL FROM THE FDA. LASTLY A
SMALL PORTION OF THIS REQUEST,
SUPPORTS ADDITIONAL RESOURCES TO
SUPPORT H CHI WITH STATE
OPERATIONS. FUNDING THIS WOULD
SUPPORT INCREASING THE WORKLOAD
OF ADMINISTERING THE CALERA X
PROGRAM. THESE INCLUDE THREE
PERMANENT POSITIONS TO ENABLE
THE CALORIE X PROGRAM TO SUPPORT
THE PROPOSED NALOXONE ELIN
INITIATIVE AS WELL AS EXPAND TO
FUTURE TARGET DRUGS. THE NEXT
ITEM WILL BE PRESENTING ON IS
THAT THE CALORIE X TRAILER BILL
CLEANUP LANGUAGE? UM. SO THE
THERE'S A SERIES OF PROPOSED
CHANGES TO THE ENABLING STATUTE
FOR THE CALORIE X PROGRAM. OVER
THE PAST FEW YEARS, H CHI HAS
GAINED EXPERIENCE FROM
IMPLEMENTATION OF CALA REX AND
REQUESTS, CLEANUP, LANGUAGE AND
MODIFICATIONS TO ENABLE
EFFECTIVE PROGRAM
ADMINISTRATION. WITH REGARD TO
CLEAN UP LANGUAGE. SOME OF THE
CHANGES INCLUDE ADDING A
DEFINITION OF THE HEALTH AND
HUMAN SERVICES AGENCY FOR
CLARIFICATION PURPOSES.
CLARIFYING THAT THE REQUIREMENT
FOR A CALIFORNIA BRANDED LABEL
ON ANY TARGET DRUG SUPPLIES TO
MANUFACTURING PARTNERSHIPS. UM
NOT TO EXISTING DRUGS PROCURED
FOR DISTRIBUTION. GIVING HK THE
FLEXIBILITY TO ESTABLISH METRICS
FOR PARTNERSHIPS, DEPENDING ON
THE TYPE OF AGREEMENT
NEGOTIATED. AND MODIFYING
LANGUAGE TO PROVIDE FLEXIBILITY
TO H. CHI FOR ONE TO ESTABLISH A
GOVERNANCE STRUCTURE WITH A
PARTNER. UM JUST TWO MORE ITEMS
RELATED TO THIS TRAILER BILL. UM
THAT WOULD SUPPORT MORE
EFFECTIVE PROGRAM ADMINISTRATION
. THE FIRST IS RELATED TO THE
CONTRACT EXEMPTION. THIS
INCLUDES REMOVING THE EXPIRATION
DATE OF THE CURRENT CONTRACT
EXEMPTION FOR CALORIE X
PARTNERSHIP AGREEMENTS. THIS
CHANGES BECAUSE AGREEMENTS SUCH
AS PARTNERSHIPS. TO DEVELOP AND
MANUFACTURE BIOSIMILAR INSULIN
EXTEND 10 YEARS OR MORE. IN
TERMS WITHIN THE CONTRACT MAY
NEED TO BE AMENDED. AFTER THE
CURRENT DECEMBER 31 2027
DEADLINE. UM. AND AN AGREEMENT
FOR THE CALIFORNIA BASED
MANUFACTURING FACILITY MAY ALSO
REQUIRE TERMS OF 10 YEARS OR
MORE. LASTLY THE PROPOSAL WOULD
REMOVE AMBIGUOUS LANGUAGE
PERTAINING TO THE CALERA EX
PUBLIC RECORDS ACT EXEMPTION,
MAKING IT CONSISTENT WITH OTHER
PR EXEMPTIONS FOR HEALTH AND
HUMAN SERVICES PROGRAMS. THIS
ENSURES DISCUSSIONS WITH
POTENTIAL PARTNERS AS WELL AS
NON PUBLIC INFORMATION SHARED
DURING THE NEGOTIATION PROCESS
REMAIN CONFIDENTIAL DUE TO THE
HIGHLY COMPETITIVE
PHARMACEUTICAL MARKET. THAT
CONCLUDES MY OVERVIEW OF THE
THREE ITEMS AND HAPPY TO TAKE
ANY QUESTIONS. DEPARTMENT OF
FINANCE. JOSEPH DAWSON
DEPARTMENT FINANCE NO ADDITIONAL
COMMENTS BUT WILLING TO ANSWER
ANY QUESTIONS. THANK YOU, JASON
KANSEN TRIO CELIO. AS YOU CAN
SEE ON PAGE FOUR OF YOUR AGENDA.
THERE ARE THREE PROPOSALS AT
EACH CHI. UM WE HAVE NO CONCERNS
WITH THE FIRST PROPOSAL AND THE
THIRD PROPOSAL. WE HAVE SOME
INITIAL COMMENTS ON THE SECOND
PROPOSAL RELATED TO THE CALLA
RACKS AND ALLISON INITIATIVE.
FIRST. I WANT TO EMPHASIZE THAT
THE PROPOSAL WOULD USE UM OPIOID
SETTLEMENT FUND RESOURCES, SO
THE PROPOSAL IS AN IMPACTING THE
STATE'S BOTTOM LINE GENERAL
FUND. UH THAT SAID, WE HAVE
FLAGGED A FEW ISSUES TO CONSIDER
TWO KEY ONES. THE FIRST IS THAT
, BASED ON OUR DISCUSSIONS WITH
THE DEPARTMENT, THERE APPEARS TO
BE SOME UNCERTAINTY. UM OR I
SHOULD SAY THE PROPOSAL IS STILL
SOMEWHAT CONCEPTUAL. AND SO
THERE'S SOME UNCERTAINTY WITH
THE PROPOSAL. FOR EXAMPLE, SOME
OF THE ACTIVITIES ARE STILL
UNDER DEVELOPMENT. THAT PROPOSAL
COULD, UM, MANUFACTURER NEW DRUG
WAR COULD FOCUS ON ON
PROCUREMENT ACTIVITIES, SO
THAT'S STILL BEING WORKED OUT BY
THE DEPARTMENT. CONSEQUENTLY WE
UNDERSTAND THAT THE COSTS
RELATED THE PROPOSAL ARE ALSO
SOMEONE UNCERTAIN. Tð A SECOND.
WE'RE WORKING WITH THE
DEPARTMENT TO GET MORE
INFORMATION ON THE PROPOSED
POSITIONS, UM, IN PART OF ENSURE
THAT THEY ARE JUSTIFIED, BUT
ALSO TO BETTER UNDERSTAND THE
SCOPE OF THE WORK INVOLVED WITH
THE POSITIONS WERE TRYING TO
UNDERSTAND IF THEY'RE FOCUSED
NARROWLY ON THE CALORIES
NALOXONE INITIATIVE OR WOULD BE
BROADLY FOCUSED ON IMPLEMENTING
CALORIE X OF THE ENTIRE PROGRAM.
TO THE EXTENT IT'S THE LATTER.
THE LEGISLATURE WOULD WANT TO
ENSURE THAT I'M USING OPIOIDS
SETTLEMENT FUND RESOURCES TO
SUPPORT THE POSITIONS IS
JUSTIFIED. THANK YOU. BRING IT
UP TO THE DIETS WILL BEGIN WITH
DOCTOR WOULD THANK YOU QUESTION
. UM, YOU PIQUED MY ATTENTION
WHEN YOU SAID THAT THE PRICE IS
RELATED TO THE RX CALORIES AND
THE LUXAN INITIATIVE. WHEN YOU
SAID THE PRICES ARTIFICIALLY
HIGH UM, CAN YOU ELABORATE ON
THAT AND DOES HK? I HAVE ANY
INFORMATION THAT MIGHT BE
HELPFUL TO US IF SOMETHING IS
IMPORTANT IS NALOXONE IS
ARTIFICIALLY HIGH. WHY IS IT IS
IT IS IT PRODUCTION ISSUE? IS IT
SUPPLY OR IS IT PROFIT. YEAH.
THANK YOU. DOCTOR. WOULD, UM SO
THERE, THERE'S ESSENTIALLY, UH
FEW COMPANIES THAT MAKE NALOXONE
THERE'S THE BRAND NAME PRODUCT
CALLED AN ARCANE. UM THROUGH THE
NALOXONE DISTRIBUTION PROGRAM
THAT THAT'S ADMINISTERED BY DHC
S. WE DO GET A PUBLIC INTEREST
PRICE OF 47 50 FOR A TWO PACK
FOR MILLIGRAM DOSE. UM AND THEN
THERE'S ALSO A GENERIC NALOXONE
NASAL SPRAY IN THE MARKET. IT'S
PRICES ARTIFICIALLY HIGH,
RANGING FROM 100 TO $135 WITHOUT
COUPONS. UM THIS IS A THERE'S
NOT A LOT OF TRANSPARENCY IN
TERMS OF PRICING, BUT WE DID
LOOK THROUGH SOME CONSUMER
FACING WEBSITES. UM SO THE
RETAIL PRICE WOULD BE IN THE
RANGE OF 100 TO $135. AND THEN
THERE'S OVER THE COUNTER. VIRGIN
VERSION, WHICH IS THE THIRD
VERSION OF NALOXONE, WHICH HAS
ONLY RECENTLY APPROVED. UM SO
IT'S THE BRAND NAME NARCAN THAT
COULD NOW BE SOLD OVER THE
COUNTER. UM THE PUBLIC PRICE HAS
NOT BEEN ANNOUNCED, BUT IT'S
WIDELY EXPECTED TO BE FAIRLY
SIMILAR TO THE PUBLIC INTEREST
PRICE THAT I MENTIONED EARLIER
SO AROUND. AH, A LITTLE. UM
BELOW $50 FOR A TUPAC. UM SO
THAT'S STILL UM FOR, UH, LOW
INCOME CALIFORNIANS THAT STILL
QUITE AN EXPENSE FOR A TWO DOSE
, UM, PACK AND THEN ALSO FOR ANY
TYPES OF COMMUNITY ORGANIZATIONS
THAT WANT TO WIDELY DISTRIBUTE
THIS PRODUCT. IT COULD BE QUITE
AN EXPENSE. SO HOW? HOW HOW DOES
THE STATE ACQUIRE THIS DOES THE
STATE COMMUNICATE DIRECTLY WITH
THE MANUFACTURERS, UM OR MEAN AS
A CONSUMER. WE IN A HEALTH PLAN.
WE HAVE TO GO THROUGH. WE GO
THROUGH OUR PHARMACY BENEFIT
MANAGER DICTATES A LOT OF THIS.
SO HOW DOES THE STATE HOW DOES
THE STATE ACCESS SOMETHING LIKE
THIS FOR AN INITIATIVE LIKE
THIS? SO IN THIS INITIATIVE, WE
WOULD, UM WE'RE FOCUSED ON
ADDING COMPETITION TO THE
MARKETPLACE SO WE WOULD WANT TO
SUPPORT A NEW ENTRANT. THAT HAS
, UM, A MISSION THAT THAT'S
ALIGNED WITH CALIFORNIA IS UNDER
THE CALORIE X PROGRAM THAT WANTS
TO JUST PRICE. THE PRODUCT IS
CLOSE. UH, AT OR NEAR UH, NEAR
THE COST OF PRODUCTION. UM AND
THERE'S RESEARCH OUT THERE THAT,
UM THE COST AND TO MAKE NALOXONE
DOES NOT MATCH WITH THE PRICES
AT WHICH IT'S SOLD. UM SO THAT
THAT'S THE OVERALL INTENT IS TO
ADD ANOTHER COMPETITOR IN THE
MARKET AND THEN HOPEFULLY BRING
DOWN THE MARKET PRICES FOR
NALOXONE. AND WHEN I HEAR THAT A
GENERIC IS TWICE THE COST OF THE
BRAND NAME. UH KIND OF SHOCKED
BY THAT, QUITE FRANKLY, UH, AND
MAKES ME MAKES ME THINK THAT
SOMEBODY SOMEWHERE IS GETTING
REBATES ON THIS. MAYBE I'M
WRONG. BUT IN THE DRUG MARKET
OFTEN TIMES HIGHER COST PRODUCTS
OR INVOLVED WITH REBATES THAT GO
BACK SOMEWHERE. I DON'T KNOW.
YOU KNOW THIS CASE. I DON'T KNOW
WHERE BUT I JUST DON'T UNDER. I
HAVE NO. DO YOU HAVE ANY
THEORIES? WHY A GENERIC WOULD BE
TWICE THE COST OF THE BRAND NAME
IN THIS PARTICULAR CASE? I DO
WANT TO NOTE THAT THE 47 50 IS A
PUBLIC INTEREST PRICE SO THEY
DON'T IT IS ONLY AVAILABLE TO
CERTAIN TYPES OF ENTITIES LIKE
STATE GOVERNMENTS. UM BUT BUT
BUT THE STATE GOVERNMENT GETS
AND GETS A GETS A BENEFIT, BUT
THE REST OF THE WORLD PAYS TOP
SHELF PRICE. YEAH YES. FOR THE
GENERIC VERSION, IT IS STILL
ARTIFICIALLY HIGH AND EVEN THE
THIS WHAT THE STATE PAYS, UM WE
THINK THROUGH THIS TOXIN ACCESS
INITIATIVE COULD COULD GET
LOWER. THE CURRENT 50 47 50. I
DON'T KNOW. IT JUST FEELS LIKE
WE HAVE A WE HAVE A CRISIS THAT
WE HAVE A NEED AND SOMEBODY'S
MAKING HOLE OUT ON ON THAT NEED
RIGHT NOW FOR SOMETHING THAT'S
BEEN ON THE MARKET FOR A LONG
TIME. SO I WAS WHAT I WAS TRYING
TO GET TO IS THIS A PRODUCTION
ISSUE IS A SUPPLY ISSUE. OR IS
THIS JUST A PROFIT ISSUE? AND,
UM I'M STARTING TO FEEL LIKE
IT'S MORE OF A PROFIT ISSUE
RIGHT NOW. SO SOMEBODY OUT THERE
WANTS TO CORRECT US. WE'RE HAPPY
TO HAPPY TALK. WE WILL DISCUSS
THE NALOXONE DISTRIBUTION
PROJECT IN THE HCS AND A FUTURE
NUMBER. BUT I ALSO SHARE AN
INTEREST IN THIS PROPOSAL. AS I
BELIEVE WHAT THE STATE IS TRYING
TO DO IS GET COST CLOSER TO WHAT
THE ACTUAL PRICE IS. AND TO DO
THAT WE'RE INSERTING OURSELVES
IN OUR X TO COMPETE AND WOULD
LIKE TO JUST NERD OUT A LITTLE
BIT BECAUSE I THINK IT'S LESS
ABOUT THE MEDICATION AS IT IS
THE DISTRIBUTION. IT'S THE
ACTUAL NASAL SPRAY APPLICATOR.
THAT'S THE COST DRIVER WITHIN
THIS, AND SO I I'M INTERESTED
SINCE WE HAD A LARGE DISCUSSION
WITH INSULIN AND CALA REX LAST
YEAR WHERE WE STATED THAT UM THE
STATE WOULD ESSENTIALLY PAY. THE
COST IT IS TO PRODUCE IS THAT
THE SAME EXPECTATION THAT WE
WILL HAVE WITH NALOXONE? THAT
THE COST OF THE MEDICATION WILL
BE THE PRICE THAT IT IS TO
PRODUCE IT. THAT'S THE INTENT WE
WERE LEARNING ABOUT THIS MARKET
AND THE POTENTIAL ACTORS. UM WE
DO PLAN TO PUT OUT A REQUEST FOR
INFORMATION. UM SO THAT ANY
INTERESTED UM. POTENTIAL
CONTRACT PARTNERS, UM, COULD LAY
OUT HOW THEY COULD MEET THAT
INTENT OF A LOW COST OR AT COST
PRODUCT. WHEN WE HEAR ABOUT THE
NDP LATER WE CAN UNDERSTAND THE
SCALE THAT WE HAVE BEEN
PURCHASING NARCAN TO ADDRESS THE
CRISIS THAT WE HAVE BEFORE US.
AND HOW IMPORTANT IT IS FOR US
TO MAKE NECESSARY INVESTMENT
LIKE THE STATE IS DOING HERE
WITH CAL RX SO WE CAN FIND MORE
EFFICIENT WAYS TO USE THOSE
DOLLARS. I'M APPRECIATIVE OF THE
PROPOSAL THAT'S BROUGHT FORWARD
AS IT'S BOTH TIMELY AND
IMPORTANT FOR US TO DISCUSS WITH
THAT. I WILL THANK THIS PANEL
AND WE'LL MOVE NOW ONTO FOUR E.
THE CALIFORNIA DEPARTMENT OF
AGING.
GOOD AFTERNOON, MR CHAIR, AND DR
JACKSON. I'M SUSAN DEMOREST,
DIRECTOR OF THE CALIFORNIA
DEPARTMENT OF AGING. THE
GOVERNOR'S MAY REVISION
CONTINUES THIS ADMINISTRATION
STRONG SUPPORT OF THE MASTER
PLAN FOR AGING. I WANT TO START
BY THANKING THE GOVERNOR AND THE
DEPARTMENT OF FINANCE FOR
EXTENDING THE HCPS DEADLINE OF
FOUR OF THE DEPARTMENT OF AGING
17 H CBS INITIATIVES. THAT WOULD
BE OUR NUTRITION INFRASTRUCTURE
FUNDING. WHERE WE HAVE, UM ALL
33 AREA AGENCIES IN THE STATE
WILL BE HAVE WILL BE RECEIVING A
TOTAL OF $40 MILLION. OUR COW
GROWS DIRECT CARE WORKFORCE
INITIATIVE WHERE 78
ORGANIZATIONS HAVE BEEN AWARDED
$89 MILLION AND THOSE CONTRACTS
ARE STARTING TO FLOW TO THE
LOCAL COMMUNITIES, AND THE
WORKFORCE IS STARTING TO RECEIVE
TRAINING AND ULTIMATELY, THEY
WILL RECEIVE STATEMENTS. ACCESS
TO TECHNOLOGY PROGRAM WITH THE
COUNTY COUNTY WELFARE DIRECTORS
ASSOCIATION, WHERE 40 TO 58
COUNTIES ARE PARTICIPATING. IN
OUR AGING AND DISABILITY
RESOURCE CONNECTIONS
INTEROPERABILITY FUND. WE
EVALUATED OUR PROGRESS ON ALL 17
INITIATIVES AND MONITORED THE
STATUS OF EACH EFFORT. WORKING
CLOSELY WITH OUR LOCAL PARTNERS
OR CONFIDENT THAT THE ADDITIONAL
EXTENSION OF JUST FOR JUST THESE
FOUR WILL ALLOW FOR THE FULL
IMPLEMENTATION OF ALL PROGRAMS.
IN ADDITION, WE GREATLY
APPRECIATE THE GOVERNOR AND
SECRETARY GALLEYS $50 MILLION
COMMITMENT TO OLDER ADULTS
BEHAVIORAL HEALTH. THIS PROPOSAL
REFLECTS EXTENSIVE STAKEHOLDER
WORK STARTING AT OUR DAY OF
ACTION IN SEPTEMBER THAT YOU
PARTICIPATED IN DR ARAMBULA.
WHERE WE HEARD FROM 500, AGING
AND DISABILITY ADVOCATES ABOUT
THEIR PRIORITIES. WE HEARD FROM
SEVERAL GROUPS ABOUT THE ACUTE
LONELINESS AND ISOLATION. OLDER
ADULTS ARE EXPERIENCING AS A
RESULT OF THE COVID 19 PANDEMIC.
THERE WAS A RESOUNDING CALL FROM
STAKEHOLDERS TO RESPOND WITH
TAILORED SERVICES THAT MEET
OLDER ADULTS WHERE THEY ARE IN
THE COMMUNITY. TRAGICALLY TWO
MASS SHOOTINGS THIS PAST JANUARY
IN MONTEREY PARK AND HALF MOON
BAY GALVANIZED OUR WORK. LAST
MONTH, 150 COMMUNITY MEMBERS IN
FRESNO SAN BERNARDINO. YUKIYA
AND SAN FRANCISCO SHARED THEIR
OWN LIVES AND LEARNED
EXPERIENCES AT A SERIES OF OLDER
ADULTS BEHAVIORAL HEALTH ROUND
TABLES. WE WERE PROUD TO PARTNER
WITH YOUR OFFICES, AND WE HEARD
LOUD AND CLEAR THAT OLDER ADULTS
NEED SUPPORT ACROSS THE ENTIRE
BEHAVIORAL HEALTH CONTINUUM.
SPECIFICALLY, WE HEARD HOW
STIGMA BIAS AND DISCRIMINATION
COMPOUND AND CREATE IN
INSURMOUNTABLE BARRIERS TO
ACCESS FOR PEOPLE OF COLOR. THE
L G B T Q. PLUS COMMUNITY AND
OUR RURAL COUNTIES. THESE
ROUNDTABLES UPLIFTED TRUSTED
COMMUNITY PARTNERS AS OUR ALLIES
IN OUR WORK. IF APPROVED IN THE
FINAL BUDGET. THE MAJORITY OF
THESE DOLLARS WILL FLOW TO LOCAL
COMMUNITIES TO BUILD THEIR
CAPACITY TO SUPPORT OLDER ADULT
BEHAVIORAL HEALTH. I'D LIKE TO
ASK SARAH STEEN HAUSEN DÍAS,
DEPUTY DIRECTOR OF POLICY,
RESEARCH AND EQUITY TO WALK YOU
THROUGH THE BCP. THANK YOU SO
MUCH. DIRECTOR TO MORRIS AND
GOOD MORNING, MR CHAIR AND
MEMBERS. IT'S AN HONOR TO BE
HERE AND AS DIRECTOR DEMAURICE
NOTED, CDVA HAS REALLY FOCUSED
ON ELEVATING THIS ISSUE OVER THE
PAST SEVERAL MONTHS, OLDER
ADULTS DO FACE A NUMBER OF UNMET
BEHAVIORAL HEALTH NEEDS,
PARTICULARLY AMONG BLACK LATINO
INDIGENOUS ÁP. AYE, COMMUNITIES
AS WELL AS LBGT QUÊ OLDER ADULTS
WHO REPORT HIGHER LEVELS OF
MENTAL DISTRESS AND SERIOUS
MENTAL ILLNESS AND OLDER ADULTS
IN RURAL COMMUNITIES ALSO FACE
UNIQUE CHALLENGES IN ACCESSING
MENTAL HEALTH SERVICES AND
SUPPORTS CALIFORNIA'S MASTER
PLAN FOR AGING INCLUDES
INITIATIVES FOCUSED ON
ADDRESSING THE BEHAVIORAL HEALTH
NEEDS OF OLDER ADULTS, AS
OUTLINED IN GOALS TWO AND THREE,
WHICH ARE FOCUSED ON HEALTH,
REIMAGINED AND ADVANCING EQUITY
AND INCLUSION, NOT ISOLATION.
MEDIA IS FOCUSING ON ADDRESSING
THESE ISSUES AS PART OF A MULTI
PRONGED STRATEGY. UM AS DIRECTOR
TUMOROUS NOTED THE ROUND TABLES
THAT WERE HELD THROUGHOUT THE
STATE, UM, INCLUDED SIGNIFICANT
COMMUNITY INPUT AND ELEVATED KEY
THEMES OF SOCIAL ISOLATION AND
LOANING LONELINESS, STIGMA,
WORKFORCE AND TRAINING
CONSIDERATIONS AS WELL AS
CULTURALLY RESPONSIVE SERVICES,
AMONG OTHERS. WHAT WE LEARNED IS
THAT WE REALLY NEED TO BUILD
COMMUNITY CAPACITY AMONG OUR
LOCAL TRUSTED COMMUNITY PARTNERS
AND PROVIDE SERVICES THAT MEET
OLDER ADULTS WHERE THEY ARE IN A
CULTURALLY RESPONSIVE MANNER. SO
THAT CALIFORNIA DEPARTMENT OF
AGING IS REQUESTING $50 MILLION
OVER THREE YEARS FROM THE
GENERAL FUND TO AUGMENT
RESOURCES AND HELP OUR COMMUNITY
PARTNERS MEET THE BEHAVIORAL
HEALTH AND OR SUBSTANCE USE
DISORDER NEEDS OF OLDER ADULTS
WITH A FOCUS ON UNDERSERVED
POPULATIONS. COMMUNITIES OF
COLOR. WERE RURAL PARTNERS AND
LGBT Q. PLUS POPULATIONS.
SPECIFICALLY THE RESOURCES WOULD
FOCUS ON BUILDING COMMUNITY
CAPACITY IN COMBATING ISOLATION
AND REDUCING STIGMA, INCLUDING
THE FOLLOWING APPROACH OVER A
THREE MINUTE, THREE YEAR PERIOD
. $30.3 MILLION TO LOCAL
PARTNERS FOR LOCAL COMMUNITY
CAPACITY CAPACITY BUILDING. TO
SUPPORT GRANTS FOR LOCAL
COMMUNITY CAPACITY, INCLUDING
PROGRAM DEVELOPMENT, WORKFORCE,
TRAINING AND COMMUNITY
PARTNERSHIP, AMONG OTHERS. WE
EXPECT TO PROVIDE EXTENSIVE
TECHNICAL ASSISTANCE TO OUR
LOCAL COMMUNITY AND RURAL
PARTNERS THROUGH THIS PROCESS.
2ND 10.5 MILLION FOR AN ETHNIC
MEDIA CAMPAIGN TO REDUCE STIGMA
AND RAISE AWARENESS OF AVAILABLE
RESOURCES FOR OLDER ADULTS WHO
COME FROM COMMUNITIES OF COLOR,
IMMIGRANT COMMUNITIES, VETERANS
AND PEOPLE WHO IDENTIFY AS LGBT
QUÊ. 3RD 4.5 MILLION OVER A
THREE YEAR PERIOD FOR CONTINUED
OPERATION OF A BEHAVIORAL HEALTH
WARM LINE TO PROVIDE CULTURALLY
RESPONSIVE EMOTIONAL SUPPORT FOR
OLDER ADULTS AND $44.7 MILLION
FOR STATE RESOURCES TO SUPPORT
OVERSIGHT AND TECHNICAL
ASSISTANCE FOR OUR LOCAL
PARTNERS. THANK YOU FOR THE
OPPORTUNITY TO PRESENT THIS
PROPOSAL, AND WE'RE HAPPY TO
ANSWER ANY QUESTIONS YOU MAY
HAVE. DEPARTMENT OF FINANCE AND
THE DEPARTMENT OF FINANCE. HENRY
HERE TO ANSWER ANY QUESTIONS YOU
MAY HAVE. CAROLINE SHOE L A. OH
WE'RE STILL IN THE PROCESS OF
REVIEWING THIS PROPOSAL, BUT AT
A HIGH LEVEL APPEARS TO ALIGN
WITH THE MASTER PLAN FOR AGING.
A FEW QUESTIONS THAT WE'RE
WORKING TO UNDERSTAND. AS WE
REVIEW THE PROPOSAL INCLUDE HOW
THESE PARTICULAR INITIATIVES
WERE CHOSEN, HOW QUICKLY THEY
COULD BE STOOD UP. HEALTH
PROGRAM. PARTICIPANTS WILL BE
SELECTED HOW THEY WOULD BE
EVALUATED AND THE TYPE OF
INFORMATION THAT THE LEGISLATURE
WOULD RECEIVE TO ENSURE THAT
THESE PARTICULAR PROGRAMS AND
CAPACITY BUILDING ACTIVITIES
WERE ACHIEVING THEIR GOALS.
LASTLY I WOULD JUST NOTE THAT IN
LIGHT OF THE BUDGET PROBLEM, WE
ALSO UM WHAT SUGGESTS THE
LEGISLATURE TO INQUIRE AS TO HOW
THESE PARTICULAR COST ESTIMATES
WERE ARRIVED AT AND WHETHER
SIMILAR GOALS COULD BE ACHIEVED
AT A POTENTIALLY LOWER COST.
WITH THAT I'LL BRING IT UP TO
THE DIOCESE. I'LL KEEP IT HERE
AT THE CHAIR. I'M GOING TO
FOLLOW UP ON THE VALUATION. HOW
ARE WE EVALUATE THE SUCCESS OF
THIS INITIATIVE AND WHICH
OUTCOMES WILL WE BE MEASURING?
I'M SUPPORTIVE AND CONCEPT IN
ADDRESSING THE SOCIAL ISOLATION
AND I LOVE THE WAY THAT YOU
FRAMED IT. THAT ITS EQUITY AND
INCLUSION AND NOT ISOLATION. IT
IS IMPORTANT FOR OLDER ADULTS
FOR US TO BE MEETING THEM WHERE
THEY'RE AT. BUT HOW WILL WE
DEFINED SUCCESS AND HOW WILL WE
MEASURE IT GOING FORWARD? MM
HMM. THAT'S A WONDERFUL QUESTION
AND SHOULD JUST REITERATE THAT
DATA AND EVALUATION ARE KEY
UNDERLYING TO SUPPORT THE
ADVANCEMENT OF THIS WHOLE
PROPOSAL FOR THE COMMUNITY
CAPACITY BUILDING. WE WOULD LIKE
TO SECURE WORK IN EVALUATING THE
SUCCESS OF THESE INITIATIVES AND
ENGAGING A UNIVERSITY BASED
RESEARCH PARTNER TO DO THAT. AND
FOR OUR ETHNIC MEDIA CAMPAIGN,
WE INTEND TO INCLUDE DATA AND
RESEARCH IS TO YOU KNOW HOW THE
SERVICES ARE ELEVATED AND ASSESS
OUTREACH TO THE COMMUNITY, SO
THIS WILL DEFINITELY BE AN
IMPORTANT COMPONENT OF THOSE
INITIATIVES AS WELL AS THE
BEHAVIORAL HEALTH WARM LINE THAT
WE CURRENTLY DO COLLECT DATA ON
AND WE'RE HAPPY TO WORK. WITH
THE LEGISLATURE AND THE
ADMINISTRATION TO, YOU KNOW,
WORK AND EXPLAIN AND PRESENT THE
RESULTS OF THIS WORK. BUT YOU
MENTIONED THE UNIVERSITY PARTNER
. I HAVEN'T SEEN THAT IN THE BCP
THUS FAR IS THAT SOMETHING
FUNDED THROUGH THIS BCP YEAR?
WILL THAT BE ENOUGH FUTURE
REQUEST? WELL MY UNDERSTANDING
IS THAT THROUGH THE STATE LEVEL
RESOURCES, WE WOULD BE ABLE TO,
YOU KNOW, DEVELOP SOME RESOURCES
FOCUSED ON THE EVALUATION, AS WE
HAVE IN OTHER PROGRAMS LIKE
CALIFORNIA GROWS AND OUR OTHER
GRANT PARTNERSHIPS. WITH THAT. I
WILL THANK YOU VERY MUCH FOR
THIS PROPOSAL AND YOUR FOCUS ON
EQUITY AND INCLUSION. WE WILL
NOW MOVE ON TO FOUR F 40 TO 60
DEPARTMENT OF HEALTH CARE
SERVICES.
GOOD MORNING, MR CHAIR AND HAPPY
BIRTHDAY MEMBERS. UM MY NAME IS
MICHELLE BOSS, DIRECTOR OF THE
DEPARTMENT OF HEALTH CARE
SERVICES MAY REVISION REQUESTS A
TOTAL OF 156,000,000,003 D 8 38
BILLION FROM THE GENERAL FUND
FOR DHC S FOR 23 24. I WILL
HIGHLIGHT SOME MAJOR CHANGES IN
THE DEPARTMENTS MAY REVISION AND
THEN WE WILL SPEAK TO SOME OF
THEM IN MORE DETAIL LATER IN THE
AGENDA. MAJOR PROPOSALS INCLUDE
THE RENEWAL OF THE EMCOR MANAGED
CARE ORGANIZATION TAX VIA
TRAILER VILLE LANGUAGE,
EFFECTIVE APRIL 1ST 2023 9
MONTHS EARLIER THAN PLANNED AND
GOVERNOR'S BUDGET AND THE
INCREASE IN THE SIZE OF THE
ANNUAL REVENUE AS COMPARED TO
THE GOVERNOR'S BUDGET. THE
DEPARTMENT PROPOSES TO USE THE
ADDITIONAL TOTAL NET REVENUE AS
FOLLOWS. USE 2.5 BILLION OF THE
ADDITIONAL NET REVENUE IN 2023
TO CONTINUE SUPPORTING THE
MEDICAL PROGRAM AND ACHIEVE A
BALANCED BUDGET AND USE THE
REMAINING 11.1 BILLION TO
SUPPORT MEDICAL INVESTMENTS THAT
WILL HELP SECURE ACCESS, QUALITY
AND EQUITY IN THE MEDICAL
PROGRAM OVER AN 8 TO 10 YEAR
PERIOD. INCLUDED IN THE MAY
REVISION IS A PROPOSAL TO
INCREASE RATES TO 87.5% OF
MEDICARE FOR SPECIFIED PROVIDERS
, AND THE REMAINDER WILL BE PUT
INTO A SPECIAL FUND FOR FUTURE
CONSIDERATION. THAT MAY REVISION
CONTINUES FUNDING FOR THE
IMPLEMENTATION OF THE MEDICAL
MOBILE CRISIS BENEFIT WITH
SLIGHT UPDATES TO ACCOUNT FOR
IMPLEMENTATION IN RURAL
COUNTIES. THAT MAY REVISION
CONTINUES TO FUND UH, THE
BEGINNING OF THE IMPLEMENTATION
OF THE BH CONNECT DEMONSTRATION
, WHICH IS FORMALLY THE
CALIFORNIA BEHAVIORAL HEALTH
COMMUNITY BASED CONTINUUM. SO A
MOUTHFUL, SO WE'VE CHANGED IT TO
BE CONNECT. THAT NEIGHBOR VISION
REFLECTS AN UPDATE TO THE HCPS
SPENDING PLAN AS PREVIOUSLY
DISCUSSED. ALSO A ONE TIME
ARMING AUGMENTATION OF 15
MILLION FOR A TOTAL OF 19
MILLION FOR CALIFORNIA'S 988
CENTERS. TWO MAIN OPERATION
MAINTAIN OPERATIONS AND SERVICES
IN 23 24. A $10 MILLION
INVESTMENT TO BEGIN DEVELOPMENT
AND IMPLEMENTATION OF A
STATEWIDE THIRD PARTY
ADMINISTRATOR FOR THE CHILDREN
AND YOUTH BEHAVIORAL HEALTH
INITIATIVE, SCHEDULE
IMPLEMENTATION. THE PROVISIONS
OF THE MAIN REVISION INCLUDES
THE EXTENSION OF THE CONTINGENCY
MANAGEMENT PILOT PAST MARCH 2024
WHEN IT WAS PREVIOUSLY SCHEDULED
TO END AS PART OF THE CBS
SPENDING PLAN. THIS EXTENSION
WILL BE OPTIONAL FOR COUNTIES TO
PARTICIPATE IN THE MAY REVISION
REQUESTS 40 MILLION TOTAL FUNDS
20 MILLION GENERAL FUND TO
SUPPORT THE MODERNIZATION OF THE
BEHAVIORAL HEALTH SYSTEM. THIS
ITEM AGAIN WILL BE DISCUSSED
LATER IN THE AGENDA. AND THEN A
FEW BUDGET SOLUTIONS ARE
INCLUDED IN THE MAY REVISION, IN
ADDITION TO THE TAX THAT WAS
PREVIOUSLY DESCRIBE WE SWAPPED
250 MILLION AND BEHAVIORAL
HEALTH BRIDGE HOUSING PROGRAM
AND 50.5 MILLION IN CAL HÌ
PROGRAM FROM GENERAL FUND TO
MENTAL HEALTH SERVICES FUND
DOLLARS. THE MAY REVISION
REDUCES TO ZERO THE BALANCE IN
THE MEDICAL DRUG REBATE FUND
RESERVE, FREEING UP ABOUT 220
MILLION GENERAL FUND. AND THEN
IN TERMS OF SOME TECHNICAL
ADJUSTMENTS TO THE MAY REVISION
OF THE ESTIMATE REFLECTS A
DECREASE OF 1.4 BILLION GENERAL
FUND COMPARED TO THE GOVERNOR'S
BUDGET SHIFTING, FOR EXAMPLE,
COST TO LATER YEARS FOR SOME OF
THE INITIATIVES, INCLUDING THE
BEHAVIORAL HEALTH CONTINUUM
INFRASTRUCTURE PROGRAM, BEHAVIOR
, HEALTH BRIDGE, HOUSING
CHILDREN YOUTH BEHAVIORAL HEALTH
INITIATIVE, BASED ON REVISED
IMPLEMENTATION DATES. THE PARSE
THIS IS PERSONALLY OFFSET BY
INCREASED IN COSTS RELATED TO
THE COVID PANDEMIC AND THE
EXPANSION OF FULL SCOPE COVERAGE
IN INDIVIDUALS, REGARDLESS OF
IMMIGRATION STATUS. AND THEN
FINALLY, THE MAY REVISION
REFLECTS DECREASES OF ABOUT 1.1
BILLION COMPARED TO GOVERNOR'S
BUDGET, PRIMARILY DUE TO LARGER
GENERAL FUND BENEFIT AS A RESULT
OF THE M C O INCREASED PROJECTED
DRUG REBATE SAVINGS IN THE
GENERAL FUND. UM AND THEN THE
REPLACEMENT OF THE GENERAL FUND
WITH M. H S F DOLLARS. WITH THAT
HAPPY TO ANSWER ANY QUESTIONS.
DEPARTMENT OF FINANCE. UH, HERE
TO ANSWER ANY QUESTIONS YOU MAY
HAVE HELIO. THANK YOU. LUCAS
MORROW WITH THE LEGISLATIVE
ANALYST'S OFFICE. I WANT TO TALK
ABOUT TWO AGE TOPICS RELATED TO
THE OVERVIEW FIRST ON CASELOAD
AND COVID 19 RELATED COSTS AND
PREVIOUS HEARINGS THIS YEAR WE
TESTIFIED ON THE JANUARY BUDGET
STATING THAT WE FOUND THAT THE
COSTS FOR CASELOAD AND COVID 19,
INCLUDING THAT BUDGET OR
OVERSTATED, WE ARRIVED AT THOSE
ESTIMATES, BASED ON MORE RECENT
CASE LOAD DATA THAT WAS
AVAILABLE TO US AS WELL AS
REASON. INFORMATION ON FEDERAL
COVID 19 POLICIES THAN WHAT WAS
AVAILABLE TO THE ADMINISTRATION.
WHEN THEY PUT TOGETHER THAT
BUDGET. THE ADMINISTRATION HAS
SINCE REVISED THEIR ESTIMATES.
WE FIND THESE NEW ESTIMATES TO
BE REASONABLE. UM, THE SECOND
TOPIC I WANT TO TALK ON IS
PRIMARILY COST FOR UNDOCUMENTED
RESIDENTS AND MARY VISION. IT
ROUGHLY DOUBLES THE COST OF THE
ELIGIBILITY EXPANSIONS FOR THE
UNDOCUMENTED POPULATIONS. UM
THIS IS LARGELY DUE TO A
CORRECTIVE ACTION PLAN. FROM THE
FEDERAL GOVERNMENT REQUIRING THE
STATE TO DEVELOP CAPITATED RATES
FOR UNDOCUMENTED RESIDENTS, UM,
USING ACTUAL CLAIMS DATA FROM
PAST YEARS, UM IN PREVIOUS
BUDGETS, WE'VE USED ESTIMATES
BASED ON THE COST FOR SIMILAR
POPULATIONS IN THE DOCUMENTED,
UM CASELOAD. UM, THIS HAS
RESULTED IN LARGE INCREASES
IMPORTANT REALLY COSTS. AND UM,
SIGNIFICANTLY RAISES THE COST OF
THESE ESTIMATES. WE FIND THAT
THE RECENT CLAIMS DATA MIGHT
OVERSTATE THE LONG TERM COSTS OF
THIS POPULATION, NOTABLY THIS
POPULATION HISTORICALLY HAS VERY
LIMP HAD VERY LIMITED ACCESS TO
HEALTH CARE SERVICES, AND THIS
COULD CONTRIBUTE TO HIGHER
ACUITY LEVELS AS WELL AS HIGHER
UTILIZATION AND THE YEARS
IMMEDIATELY FOLLOWING AN
EXPANSION OVER TIME AS THEY
STABILIZE INTO OTHER HEALTHCARE
SERVICES. THESE COSTS COULD WE
GET REDUCED. UM WE KNOW THAT THE
ADMINISTRATION WILL REVISIT AND
IT JUST THE CAPITATED RATES ON
AN ANNUAL BASIS GOING FORWARD.
HOWEVER, UNDER THE MAYOR
REVISION. WE KNOW THAT OVERALL
THERE ARE BUDGET DEFICITS ARE
LIKELY TO BE AROUND $15 BILLION
EACH YEAR. UM AND TO THE EXTENT
THE ADMINISTRATION SEES CONTINUE
TO RISK FOR INCREASED COSTS
RELATED TO THESE UNDER THE
UNDOCUMENTED RESIDENTS
EXPANSIONS INTO MEDICAL UM, THE
LEGISLATURE MAY WISH TO BUILD AN
ADDITIONAL BUDGET CAPACITY
ELSEWHERE IN THE BUDGET. UH UM.
AS WE NOTED, THERE IS A
POPULATED POSSIBILITIES. COSTS
WILL GO DOWN THE FUTURE, BUT THE
LEGISLATURE MAY WANT TO TAKE
THAT INTO CONSIDERATION AND AS
SUCH, THE LEGISLATION WILL BE
CLOSELY MONITORED. THE
ASSOCIATED COSTS AND FUTURE
CAPITAL RATES THANK YOU BRING IT
UP TO THE DIASPORA MEMBERS.
QUESTIONS BEGIN WITH DR JACKSON.
YOU KNOW MY QUESTIONS, SO LET ME
PUT IT IN A DIFFERENT WAY. WHAT
IN THIS BUDGET. ALLOWS US TO SEE
IMMEDIATE ONCE THE BUDGET IS
ENACTED. UM, INCREASED ACCESS.
TO BEHAVIORAL HEALTH SERVICES.
THAT IS CURRENTLY NOT BEING DONE
TODAY. SO I WOULD NOTE AND WE
WILL SPEAK TO YOU LATER IN MORE
DETAIL AS PART OF THE PROPOSAL
AND THE RELATED RATE INCREASES
WERE INCREASING TO 87.5%
MEDICARE FOR PRIMARY CARE, SO
PREVENTION SERVICES, MATERNITY
CARE AND NON SPECIALLY
BEHAVIORAL HEALTH SERVICES AT
THE MANAGED CARE UP RIGHT, AND
SO BUILDING UP THE FOUNDATION
FOR THOSE SERVICES AND ACCESS
ACROSS THE STATE FOR KIND OF
BUILDING OUT THAT FOUNDATION FOR
SOME OF OUR NON ESPECIALLY
BEHAVIORAL HEALTH SERVICES. HOW
MANY PEOPLE ARE WE EXPECTED TO
BE ABLE TO SERVE NEXT FISCAL
YEAR? AND IN TERMS OF THE CASE
IN TERMS OF CASELOAD MEETING THE
IDEA IS, IS THAT AS ALWAYS, UM,
I AM VERY PLEASED WHEN WE TALK
ABOUT BUILDING OUT THE
INFRASTRUCTURE OF BEHAVIORAL
HEALTH. THERE'S NO DOUBT ABOUT
THAT. BUT AGAIN MY ONLY
CRITICISM IS ABOUT HOW DO WE
STABILIZE THE POPULATION NOW? SO
MY QUESTION IS. WHERE IS IN THIS
BUDGET THAT ALLOWS US TO
STABILIZE OUR POPULATION NOW?
NOT JUST BUILDING UP STUFF. SO I
WOULD I WOULD THOSE RATE
INCREASES THAT WILL BE COMING
EFFECTIVE JANUARY 2024. SO THAT
IS A RATHER IMMEDIATE KIND OF
BUDGET YEAR CHANGE. I WOULD ALSO
AGAIN POINT TO OUR COMMUNITY
HEALTH WORKERS AND OUR PEER
SUPPORT SPECIALIST THAT THESE
ARE BENEFITS THAT HAVE GONE UP
IN THE LAST YEAR AND A HALF OR
SO AND SO PUSHING THOSE OUT AND
CONTINUE TO BUILD OUT. THOSE
NETWORKS WOULD ALSO ASSIST AND
PROVIDING SOME IMMEDIATE ACTION.
AHMAD TO ALSO THE GOING LIVE OF
THE MOBILE CRISIS. UM SERVICES
ACROSS THE STATE SO MANY
COUNTIES WILL BE ROLLING OUT
THROUGH THE JANUARY FOR MAJORITY
OF THE COUNTIES, AND JUST A FEW
SMALL RURAL COUNTIES WILL HAVE
UNTIL JULY OF 24, BUT WE'LL
START SEEING SOME OF THOSE
MOBILE CRISIS SERVICES GOING
LIVE THIS YEAR, WHICH WE'RE VERY
EXCITED ABOUT THOSE STARTING TO
MOVE OUT AND ACTUALLY BE
UTILIZED ACROSS THE ENTIRE STATE
. AND THEN THE OTHER PIECE, I
WOULD ADD IS THE CHILDREN YOUTH
BEHAVIORAL HEALTH INITIATIVE.
WE'VE STARTED DOING THE GREAT
GRANT FUNDING FOR EXTENSIVE
EVIDENCE BASED PRACTICES TO
PROVIDERS DIRECTLY THROUGH A
VARIETY OF RIGHTS. THE FIRST
ROUNDS ARE FOCUSED ON CHILDREN
YOUTH EARLY INTERVENTION TYPE
SERVICES. THOSE WILL CONTINUE TO
ROLL OUT THE FUNDING SIGNIFICANT
FUNDING FOR THOSE INITIATIVES
THIS YEAR AS WELL. WHICH REALLY
GETS INFORMATION OUT TO THOSE
PROVIDER NETWORKS GETS THE REACH
IN THE EARLY INTERVENTION,
REDUCING AND KIND OF GETTING
SOMEONE BEFORE THEY GET TO THAT
SEVERE LEVELS. WHAT ARE THE
FOCUS OF THOSE DOLLARS? SO THOSE
ARE SOME ADDITIONAL THINGS IN
THIS BUDGET THAT WILL HELP US
INTERVENE EARLIER FOR
INDIVIDUALS THAT HAVE BEHAVIORAL
HEALTH NEEDS? I WOULD LIKE TO
HAVE A MORE OR MORE DETAILED
DOCUMENT ON IMMEDIATE
STABILIZATION. UM IF YOU CAN
SEND THAT TO MY OFFICE, PLEASE,
BECAUSE AYE. I JUST CANNOT BE
SUPPORTIVE OF THINGS THAT ARE
NOT AH, MEETING ALSO IMMEDIATE
NEEDS AND I THINK WE NEED SOME
MORE CLARIFICATION ON THAT IF I
CAN'T REALLY UNDERSTAND THAT,
AND THIS IS MY THIS IS MY THING
. IF I CAN HARDLY UNDERSTAND IT,
I CAN'T UNDERSTAND HOW ANYONE
ELSE WOULD REALLY DO IT. I THINK
WE JUST NEED TO BE HYPER
FOCUSED. ON MAKING SURE THAT WE
GET THAT PART RIGHT? RIGHT AND
ONCE AGAIN THIS IS NOT ABOUT
WHETHER THIS IS A GOOD PROPOSAL
AND I THINK WHAT YOU GUYS ARE
DOING IS GREAT. BUT I REALLY SEE
A WEAKNESS HERE. AND MAYBE IT'S
NOT A WEAKNESS, BUT I JUST
HAVEN'T HEARD IT ARTICULATED THE
WAY I CAN UNDERSTAND IT. SO IF
YOU CAN SEND ME SOMETHING FOR ME
TO REALLY BE ABLE TO UNDERSTAND
, RIGHT, WHAT ARE WE DOING TO
MAKING SURE THAT MORE PEOPLE ARE
GETTING THE BEHAVIOR HEALTH
SERVICES THAT THEY NEED
IMMEDIATELY IN THE WAY WHERE
THEY ARE THE WAY THAT THEY
NEEDED. UM, THAT THAT WOULD BE
VERY HELPFUL FOR ME. THANK YOU.
BRING IT UP TO THE DYER'S. I'LL
KEEP IT HERE AT THE CHAIR IF I
CAN. THERE WERE A FEW, UM, ITEMS
WHICH WERE AGENDAS. I DIDN'T
HEAR PRESENTATION ON BRING UP
THE NALOXONE DISTRIBUTION
PROJECT. THE INCREASE IN CARE
ACT FUNDING AND THE CCS WHOLE
CHILD MODEL EXPANSION. IT'S A
DUMP. DO YOU WANT US TO? CAN YOU
CONTINUE THROUGH ALL THAT? OKAY
SORRY. WE WERE STOPPING AT EACH
ONE. SORRY MAYBE I'LL SPEAK A
LITTLE BIT MORE ON THE M C O
TAX. THAT WOULD BE GREAT. OK SO
AGAIN, AS I MENTIONED AT THE
BEGINNING THAT THE DEPARTMENT IS
PROPOSING TO IMPLEMENT A NEW
MEXICO TAX EFFECTIVE APRIL 1ST
2023 TO DECEMBER 31ST 2026. THE
TAX WILL PROVIDE 19.4 BILLION IN
NET REVENUE OVER THE THREE AND
THREE QUARTER YEAR PERIOD, WHICH
IS ROUGHLY THREE TIMES HIGHER
THAN THE 6.5 BILLION OVER THE
THREE YEARS PROPOSED. AT
GOVERNOR'S BUDGET. FUNDS WILL
HELP MAINTAIN THE MEDICAL
PROGRAM AND SUPPORT INVESTMENTS
THAT WILL HELP SECURE EQUITY
QUALITY IN THE MEDICAL PROGRAM
OVER AN 8 TO 10 YEAR PERIOD,
EXTENDING THE EXPENDITURES OVER
A LONGER PERIOD INSTEAD OF
MAXIMIZING ONE TIME SPENDING
WILL ALLOW THE FOCUSED
AUGMENTATIONS TO BE SUSTAINABLE
OVER A LONG PERIOD OF TIME AND
GIVE CERTAINTY TO PROVIDERS
WHILE ATTENDING TO THE STATES.
NEED OF NOT CREATING OUT YOUR
BUDGET CHALLENGES. WE WANT TO
BUILD THE FOUNDATION WITH THESE
THESE DOLLARS AND CERTAINTY FOR
OUR PROVIDERS THAT THESE RATE
INCREASES ARE SUSTAINABLE. WE
WOULD ALSO NOTE THAT IN
DISCUSSIONS BETWEEN THE
DEPARTMENT AND THE FEDERAL
CENTERS FOR MEDICARE AND
MEDICAID SERVICES, THE NOTION OF
INVESTING REVENUE GENERATED BY
THE EMC ATTACKS INTO EXPANDING
ACCESS AND QUALITY IN THE
MEDICAL PROGRAM HAS BEEN A KEY
IN CMC. CMS IS ACCEPTANCE OR
KIND OF ENGAGEMENT IN ATTACKS OF
THIS SIZE. TO SECURE THE APRIL
1ST ONE EFFECTIVE DATE, THE
LEGISLATURE MUST APPROVE THE TAX
JUST STRUCTURE AND THE
DEPARTMENT MUST SUBMIT THE FINAL
TAX PROPOSAL TO CMS NO LATER
THAN JUNE 30TH OF THIS YEAR. AH
NOTE. WE WOULD FURTHER NOTE THAT
CMS HAS DECLARED ITS INTENTION
TO CHANGE FEDERAL REGULATIONS
ASSOCIATED WITH HEALTHCARE
RELATED TAXES TO REQUIRE THAT
TAXES BE MORE PROPORTIONAL IN
THEIR MEDICAID AND NON MEDICAID
LIABILITIES. THAT'S THE
DEPARTMENT DOES NOT ANTICIPATE
THE PROPOSED MODEL WILL BE A
PROVABLE IN THE FUTURE AND
CANNOT ASSUME FUTURE TAXES WILL
PROVIDE SUCH A HIGH NET BENEFIT
TO THE STATE. IN TERMS OF THE
PROPOSED PROVIDER RATE INCREASES
EFFECTIVE JANUARY 1 2020 FOR THE
DEPARTMENT PROPOSES TO INCREASE
RATES TO AT LEAST 87.5% OF
MEDICARE AGAIN FOR PRIMARY CARE
, MATERNITY CARE AND NON
SPECIALLY MENTAL HEALTH SERVICES
SUBJECT TO ALL FEDERAL APPROVALS
. THESE INVESTMENTS SUPPORT THE
DEPARTMENT'S COMPREHENSIVE
QUALITY STRATEGY AND ITS
CLINICAL FOCUS ON CHILDREN'S
PREVENTIVE CARE. AH MATERNAL
CARE AND BIRTH, EQUITY OUTCOMES
AND BEHAVIOR. HEALTH INTEGRATION
, REALLY ALIGNING OUR EFFORTS IN
UPSTREAM PREVENTIVE PRIMARY CARE
PURPOSES. ADEQUATE ACCESS TO
THESE SERVICES IS FOUNDATIONAL
TO PROVIDE CARE THE RIGHT,
SETTING THE RIGHT TIME AND AT
THE HIGHEST QUALITY. THIS
PROPOSAL WORKS TO SECURE THAT
ACCESS TO LONG TERM GROWTH AND
PROVIDER PARTICIPATION IN THE
MEDICAL PROGRAM THROUGH HIGHER
REIMBURSEMENT THAT IS MORE
STABLE, EQUITABLE AND STREAMLINE
. THE RATE INCREASES WILL BE
MADE TO THE FIFA SERVICE BASE
AND NOT AS SUPPLEMENTAL PAYMENTS
, ALLOWING THE INCREASES TO BE
PASSED ON DIRECTLY EFFICIENTLY
AND CONSISTENTLY TO PROVIDERS.
THIS APPROACH WILL BROADLY RAISE
THE REIMBURSEMENT FLOOR FOR
APPLICABLE SERVICES TO BE CLOSER
TO MEDICARE STANDARDS ARE SURE
PROVIDERS OF SURE PROVIDERS OF
CONSISTENCY AND REIMBURSEMENT
OVER THE LONG RUN AND REDUCE AN
EVENING NOUS AND REIMBURSEMENT
LEVELS CODES WITHIN THE
APPLICABLE SERVICE AREAS. FOR
THE APPLICABLE SERVICE AREAS.
THESE RATE INCREASES WILL
INCLUDE THE ELIMINATION OF THE
HISTORIC ABBEY 97 REDUCTIONS.
THE SHIFT OF PROPOSITION 56
SUPPLEMENTAL PAYMENTS INTO THE
BASE RATE INCREASES THE
DEPARTMENT WILL ANNUALLY REVIEW
AND REVISE THE FEE FOR SERVICE
REIMBURSEMENT RATES FOR THE
APPLICABLE SERVICES BASED ON
CHANGES TO MEDICARE RATES. THE
DEPARTMENT WILL DIRECT MEDICAL
MANAGED CARE PLANS TO PAY
PROVIDERS AT LEAST THIS RATE. IN
ADDITION TO THESE RATE INCREASES
THAT WE ARE PROPOSING TO GO LIVE
IN JANUARY, 2024. WE WILL RETURN
NEXT YEAR AT GOVERNOR'S BUDGET
WITH A SET OF INVESTMENTS THAT
WILL PUT FORWARD TO THE
LEGISLATURE IN THE 24 25
GOVERNORS BUDGET WITH AN
EFFECTIVE DATE OF JANUARY. 1
2025, THE FOCUS WILL BE TO LOOK
AT ADDITIONAL AUGMENTATIONS TO
PRIMARY CARE. BEHAVIORAL HEALTH
AS WELL. SPECIALTY CARE,
OUTPATIENT CARE AND ACUTE CARE
SYSTEMS WITH ATTENTION TO HOW
THE INCREASE WILL ENSURE
COMMITMENT OF PROVIDERS TO SERVE
MEDICAL BENEFICIARIES, SUPPORT
PROVIDERS AND DISPROPORTIONATELY
IMPACTED AREAS AND BUILD ROBUST
TEAMS AND WORKFORCE TO ENSURE
THAT CARE IS PROVIDED IN THE
RIGHT, SETTING AGAIN AT THE
RIGHT TIME AND WITH THE HIGHEST
QUALITY PAUSE THERE. IF THERE
ARE ANY QUESTIONS ON M C O WAS
WORK THROUGH THEM ALL AND THEN,
OKAY? UH THE DEPARTMENT IS I
WILL NOW GO INTO THE NALOXONE
DISTRIBUTION PROGRAM. THE
DEPARTMENT IS REQUESTING
ADDITIONAL FOR YOUR LIMITED TERM
EXPENDITURE AUTHORITY FOR THE
NALOXONE DISTRIBUTION PROJECT,
AND THIS IS IN ADDITION TO WHAT
WAS IN THE GOVERNOR'S BUDGET, UM
, ACCOUNTING FOR AROUND 90
MILLION. UM, UH, SETTLEMENT
FUNDS IN 23 24. AND THEN IT
REDUCES IN THE OUT YEARS, UM,
REQUEST FOR NALOXONE HAVE
SIGNIFICANTLY INCREASED THIS
YEAR, GIVEN THE RISING OVERDOSES
ACROSS THE STATE OF CALIFORNIA
AND INCREASED USE OF FENTANYL.
TO DATE, THE NDP PROGRAM HAS
DISTRIBUTED OVER TWO POINT
MILLION UNITS ACROSS THE STATE
OF CALIFORNIA, AND WE HAVE A
REPORTED OVER 146,000 REPORTED
OVERDOSE REVERSALS THROUGH THAT
DISTRIBUTION. FOR THE CURRENT
FISCAL YEAR. NDP ANTICIPATES A
TOTAL DISTRIBUTION OF OVER 1.2
MILLION UNITS, UM, ACROSS THE
STATE AND WE ARE INTO THAT'S A
COST OF AROUND $60 MILLION AND
THEN WE ARE ANTICIPATING I DUE
TO THE DEMAND FOR NEXT YEAR 1.8
MILLION UNITS TO BE DISTRIBUTED
AT APPROXIMATELY $88 MILLION IN
THE BUDGET YEAR. THE MAY
REVISION DID NOT INCLUDE FUNDING
SPECIFIC TO THE CALIFORNIA HARM
REDUCTION INITIATIVE. HOWEVER
SOME INFORMATION REGARDING THAT
CURRENT DATA ON ENTITIES
RECEIVING NALOXONE FROM THE NDP
SHOWED THAT THE HARM REDUCTION
ORGANIZATIONS RECEIVED ABOUT 31%
OF THE KIDS DISTRIBUTED AND
REPORTED 60% OF THE OVERALL
REPORTED OVERDOSE REVERSALS. UM
AND SO HAPPY TO ANSWER ANY
QUESTIONS AT THE APPROPRIATE
TIME REGARDING THAT PROGRAM. AND
THEN IN REGARD TO THE BEHAVIORAL
HEALTH MODERNIZATION BUDGET
CHANGE PROPOSAL, THE DEPARTMENT
IS REQUESTING EXPENDITURE
AUTHORITY OF 40 MILLION TOTAL
FUNDS 20 MILLION GENERAL FUND IN
FISCAL YEAR 23 24 FOR INITIAL
SUPPORT OF THE MODERNIZATION OF
THE BEHAVIORAL HEALTH SYSTEM
THAT WE SPOKE INDEED TO IN
DETAIL A COUPLE WEEKS AGO IN THE
SUBCOMMITTEE, THE REQUEST BEGINS
THE PROCESS TO MODERNIZE THE
BEHAVIORAL HEALTH SYSTEM TO
ALIGN GOALS AND POLICIES THAT
SUPPORT DELIVERY SYSTEM
IMPROVEMENTS. THE INITIATIVE
WILL SEEK TO ADDRESS FUNDAMENTAL
CHALLENGES THE STATE EXPERIENCES
WITH THE CURRENT DELIVERY SYSTEM
AND CONNECTING THOSE WHO NEED
THE CARE TO QUALITY SERVICES
AGAIN IN THIS REPRESENTS INITIAL
RESOURCES, RECOGNIZING THAT
ADDITIONAL RESOURCES WILL BE
NEEDED AS THE STATUTE GOES INTO
EFFECT, INITIAL EFFORTS WILL BE
DEDICATED TO BEHAVIORAL HEALTH
POLICY DATA COLLECTION AND
REPORTING IMPROVEMENTS,
ENTERPRISE TECHNOLOGY, SERVICES
AND ACCOUNTABILITY, QUALITY AND
EQUITY AND BEHAVIORAL HEALTH
SERVICES. THE DEPARTMENT
ANTICIPATES AND ANTICIPATES
USING A COMBINATION OF CONTRACT
STAFF AND CONTRACT STATES STAFF
EXCUSE ME AND CONTRACT RESOURCES
FOR INITIATIVE DEVELOPMENT AND
IMPLEMENTATION ACTIVITIES. UH
THE NEED IS URGENT, AND THE
DEPARTMENT WANTS TO BE IN PLACE
TO IMPLEMENT AS QUICKLY AS
POSSIBLE. REGARDING THE CHILDREN
AND YOUTH BEHAVIORAL HEALTH
INITIATIVE, THIRD PARTY
ADMINISTRATOR DOLLARS AS YOU
KNOW AND SEE WHY BH I, THERE IS
A FEE SCHEDULE FOR ALL
INDIVIDUALS IN K THROUGH 12 AND
HIGHER EDUCATION TO RECEIVE
BEHAVIOR, HEALTH SERVICES IN
SCHOOLS OR NEAR SCHOOLS, UM, AND
THROUGH OUR WORKINGS WITH OUR
EDUCATIONAL PARTNERS. WE HAVE
IDENTIFIED THAT WE NEED AN
ADDITIONAL NEW $10 MILLION OF
GENERAL FUND IN THE BUDGET YEAR
TO BEGIN THE DEVELOPMENT OF A
THIRD PARTY ADMINISTRATOR. THIS
WOULD ALLOW FOR REDUCED
ADMINISTRATIVE BURDEN FOR
EDUCATIONAL PARTNERS TO BE ABLE
TO BUILD AND BE REIMBURSED VERY
TIMELY. IT WOULD ALLOW US TO
HAVE OVERSIGHT OF THE STATEWIDE
NETWORK OF THESE PROVIDERS, THE
QUALITY OVERSIGHT, THE
CREDENTIAL AND THAT'S NEEDED. UM
THE SCHOOLS DON'T HAVE THE STAFF
INABILITY TO DO SUCH FUNCTIONS.
AND SO IT'S REALLY ABOUT
SIMPLIFYING THAT ADMINISTRATIVE
BURDEN BUT ALSO ALLOWS US TO
HAVE SOME OVERSIGHT AND
MONITORING OF THE INITIATIVE
ACROSS THE ENTIRE STATE OF
CALIFORNIA. WE'VE BEEN WORKING
CLOSELY WITH THEIR EDUCATIONAL
PARTNERS AND FEEL LIKE THIS IS
CRITICAL IN ORDER FOR THEM TO
HAVE SIMPLIFIED CATION OF
BUILDING OF THESE SERVICES AND
US STEPPING IN MODIFYING THAT
HAPPY TO ANSWER ANY QUESTIONS
WHEN THE APPROPRIATE TIME IN
REGARDING TO THAT PROPOSAL.
REGARDING THE CARE ACT REQUEST.
UM THE REVISION INCLUDES 67
MILLION GENERAL FUND IN 23 24
121,000,024, 25 AND 100 AND 52
MILLION IN 25 26 TO FUND THE
VARIOUS REQUIREMENTS OF OUR
COUNTY COLLEAGUES COMPARED TO
GOVERNOR'S BUDGET. THIS INCREASE
ACCOUNTS FOR ADDITIONAL
ACTIVITIES REQUIRED IN THE DRAFT
RULES RECENTLY RELEASED BY THE
JUDICIAL COUNCIL. CHANGES IN THE
HOURLY RATE ASSUMED FOR EACH OF
THE ACTIVITIES PERFORMED BY THE
COUNTIES AND UPDATES OF THE
LENGTH OF TIME AND HEARINGS. THE
DEPARTMENT ALSO INCLUDED A $15
MILLION.01 TIME GENERAL FUND
AUGMENTATION FOR LOS ANGELES
COUNTY FOR STARTUP BECAUSE OF
THEIR REQUEST TO GO LIVE
DECEMBER 1 OF 2023. WE'VE BEEN
WORKING CLOSELY WITH THE COUNTY
STAKEHOLDERS TO FINE TUNE THE
ESTIMATES SINCE THE GOVERNOR'S
BUDGET AS WE INDICATED THROUGH
THAT PROCESS. UM AND, UH, I
WOULD SAY, THOUGH, WE PROBABLY
HAVE NOT COME TO AGREEMENT IN
REGARDS TO THE SIZE OF THE
POPULATION THAT THIS COULD
IMPACT. IT IS WHY THE DEPARTMENT
IS RECOMMENDING THAT THIS BE
BUILT ON AN HOURLY BASIS, AND BY
THAT IS A NORMAL PRACTICE THAT
WE DO IN REGARDS TO WIN SERVICES
ARE BEING PROVIDED TO BE
REIMBURSED FOR THOSE SERVICES AS
PROVIDED AND THAT ALLOWS US TO
LEARN IN THESE FIRST YEAR, AND
IT'S WHY WE ARE RECOMMENDING
THAT GIVEN EVEN THE LEOS
COMMENTS, WE THINK IT'S
REASONABLE TO DO IT THAT WAY SO
COUNTIES ARE BEING REIMBURSED
FOR THE SERVICES PROVIDED
REQUIRED. UNDER THE CARE ACT,
BUT IT GIVES US TIME TO
UNDERSTAND POPULATION NEEDS OF
SERVICES FIND TUNA ESTIMATES IN
THE FUTURE, WHICH WE ALWAYS DO
AND HAVE A LOT OF EXPERIENCE
DOING AT THE DEPARTMENT OF
HEALTH CARE SERVICES, SINCE A
LOT OF OUR SERVICES ARE
UTILIZATION, BASED OR SERVICE
BASED PROGRAMS THAT WOULD ALLOW
US TO FINE TUNE IN THE FUTURE.
THERE'S A LOT OF COMMITMENTS
ALREADY TO ONGOING REPORTING
TIED TO THE CARE ACT, WHICH
WE'RE FULLY COMMITTED TO, I
MEAN, DON'T RECOMMEND PUTTING
REIMBURSEMENT METHODOLOGIES AND
STATE STATUTE BASED ON SOME OF
THE COMMENTS FROM OUR L®NG
COLLEAGUES, BUT HAPPY TO ANSWER
ANY QUESTIONS IF YOU HAVE
QUESTIONS AT THAT TIME AS WELL.
THE LAST ITEM I BELIEVE TO
QUICKLY GET TOO SO YOU CAN GET
TO YOUR QUESTIONS IS THE WHOLE
CHILD MODEL ARM. A REVISION
REMOVES, UM, THE THREE SINGLE
PLANNED COUNTIES ALAMEDA, CONTRA
COSTA AND IMPERIAL COUNTIES FROM
THE WHOLE CHILD MODEL PROPOSAL
WHERE WE WERE PROPOSING TO
EXTEND IT TO THOSE SINGLE AND
NOT JUST THE COAST COUNTIES.
BASED ON SOME FEEDBACK FROM OUR
PARTNERS. THERE WAS SOME
CONCERNS WITH THAT WE WERE
ADVISED THE TRAILER BUILT TO
RESPOND TO THOSE CONCERNS WE
HAVE HEARD FROM THE COUNTY
HEALTH EXECUTIVES ASSOCIATION OF
CALIFORNIA CHECK THAT THEY HAVE
REMOVED MOVED. THEIR OPPOSITION
OF OUR TRAILER BILL WILL
CONTINUE TO ENGAGE WITH
STAKEHOLDERS IN REGARDS TO ANY
CONCERNS AROUND CONTINUED
IMPROVEMENTS OF THE WHOLE CHILD
MODEL AND HAPPY TO ANSWER ANY
QUESTIONS WHEN THE TIME IS
RIGHT. DEPARTMENT OF FINANCE.
ENDED UP THE DEPARTMENT OF
FINANCE STAFFING FURTHER, ELIO,
AND WE MAY NEED TO ROTATE JASON
. CONCENTRATE, CELIO. YEAH WELL
, WE HAVE COMMENTS THROUGHOUT.
UM SO WE'LL WE'LL MOVE AROUND AS
NEEDED SPECIFICALLY HAVE
COMMENTS ON THE TAX AND THEN
ALSO THE WHOLE CHILD MODEL
TRAILER BILL SO WITH REGARD TO
THE WHOLE WITH THE WITH REGARD
TO THE EMC ATTACKS, THERE REALLY
ARE TWO KEY ISSUES BEFORE THE
LEGISLATURE. THE FIRST IS
WHETHER TO RENEW AN INCREASE THE
TAX AND THEN SECOND ISSUE IS HOW
TO USE THE ASSOCIATED FISCAL
IMPACT. THAT TAX. WITH REGARD TO
THE FIRST ISSUE ABOUT WHETHER TO
RENEW AND INCREASE THE TAX. WE
THINK WE THINK THERE'S STILL
MERIT STRONG LEGISLATIVE
CONSIDERATION. THE TAX PROVIDES
A SIZEABLE FISCAL BENEFIT WHILE
IMPOSING A RELATIVELY SMALL COST
ON THE HEALTH INSURANCE
INDUSTRY. UM THAT SAID THE
DEPARTMENT IS STILL, UM,
PROVIDING ADDITIONAL INFORMATION
ON THE TAX AND WE'RE WORKING
WITH THE ADMINISTRATION ON
RECEIVING ADDITIONAL INFORMATION
. SOME SOME KEY PIECES INCLUDE
ANALYSIS DEMONSTRATING THAT THE
TAX COMPLIES WITH EXISTING
FEDERAL RULES AND ALSO JUST
BASIC INFORMATION ON THE ON THE
MULTI YEAR IMPACT OF THE TAX. SO
WE RECOMMEND THE LEGISLATURE
CONTINUE TO WORK WORK WITH THE
ADMINISTRATION TO GET THOSE
ITEMS. AFTER THE SECOND ISSUE
AND HOW TO HOW TO USE THE FISCAL
IMPACT OF ATTACKS AND HOW TO
SPEND THE FUNDS. WE UNDERSTAND
THE DESIRE TO WANT TO USE THE
FUNDS TO AUGMENT THE MEDICAL
PROGRAM THAT SAID, WE EMPHASIZE
THIS DOES COME WITH TRADE OFFS.
UNDER OUR INITIAL ANALYSIS, WE
ESTIMATE THAT REVENUES ARE
BILLIONS OF DOLLARS LOWER THAN
THE ADMINISTRATION FOR THE
GENERAL FUND THROUGH 23 24. AND
UNDER THE ADMINISTRATION'S OWN
MULTI YEAR PROJECTIONS. THERE
ARE DEFICITS IN THE OUT YEARS.
UH COMMITTING THE EMC ATTACKS TO
FOR AUGMENTATIONS LIMITS THE
LEGISLATURE'S ABILITY TO ADJUST
BUDGET PRIORITIES, UM, WHERE THE
STATE'S BUDGET SITUATION TO
WORSEN. UH TO THAT END WE THINK
THE LEGISLATURE COULD EXPLORE
OTHER USES. THAT WOULD BE MORE
LIMITED TERM, FOR EXAMPLE,
PROVIDING SUPPLEMENTAL PAYMENTS
OR CREATING A RESERVE FOR
SPECIFIC TO MEDICAL OR OTHER
ACTIONS THAT, UM, GIVE IT MORE
FLEXIBILITY IN THE FUTURE. AND
THEN WITH REGARD TO THE PROPOSED
PROVIDER RATE INCREASES, WE
CONCUR WITH THE ADMINISTRATION'S
DESIRE TO WANT TO STUDY THE
ISSUE MORE AND THINK THAT'S A
REASONABLE APPROACH TO TAKE. UM
THAT SAID, WE DO THINK THE
LEGISLATURE UM COULD AT THE
FRONT END, ADOPT MORE PARAMETERS
TO HELP GUIDE THE
ADMINISTRATION'S, UM STUDY OF
RATE INCREASES AND ENSURE THAT
THEY'RE IN LINE WITH THE
LEGISLATURE'S PRIORITIES ON
DETERMINING WHICH THE SORT OF
OVERALL RATE INCREASES AND THEN
MOVING TO THE WHOLE CHILD MODEL
TRAILER BILL LANGUAGE AS THIS
PROPOSAL ADDRESSES SOME OF THE
CONCERNS STAKEHOLDERS RAISED. WE
THINK IT'S A REASONABLE
MODIFICATION TO CONSIDER THAT
SAID, AS WE EMPHASIZE IN OUR
ANALYSIS ON THE PROPOSAL, THE
LEGISLATURE IS AT A CRITICAL
JUNCTURE IN TERMS OF THINKING
ABOUT THE LONG TERM OF THE CCS
PROGRAM AND HOW TO INTEGRATE IT
IN THE MEDICAL MANAGED CARE. AND
SO WE CONTINUE TO RECOMMEND
CAUTION WITH THE PROPOSAL AND
RECOMMEND THAT THE LEGISLATURE
ONLY ADOPT THE PROPOSAL TO THE
EXTENT THAT IT ALIGNS WITH ITS
LONG TERM POLICY OBJECTIVES FOR
THE PROGRAM. AND WITH THAT ALL
MOVED TO MY COLLEAGUES ON THE
REMAINING ITEMS.
THANK YOU, RYAN MILLER. ELIO WE
HAVE NO CONCERNS ON THE NALOXONE
DISTRIBUTION PROJECT AND C Y B
HIV SCHEDULE ITEMS CONCERNING
THE BEHAVIORAL HEALTH
MODERNIZATION ITEM. THIS IS A
PROPOSAL FOR $20 MILLION GENERAL
FUNDING IN NEW SPENDING
ASSOCIATED WITH THE GOVERNOR'S
PROPOSAL TO CHANGE THAT MAY JUST
SAY WE HAVE NOT REVIEWED A BCP
ON THIS PROPOSAL. YEAH, HOWEVER
, WE UNDERSTAND THAT THERE ARE
ADDITIONAL BCP HAS CONTINUED
BEING POSTED TO THE FINANCE
WEBSITE THIS WEEK. SO WE WILL
REVIEW THAT. IF IT BECOMES
AVAILABLE, HOWEVER, WE WOULD
NOTE THE QUESTION IN THE AGENDA
ABOUT WHETHER THIS PROPOSAL MAY
BE PREMATURE, GIVEN THE STATUS
OF THAT, UH, MHSC EFFORT, UH AND
ALSO GIVEN OUR OFFICES
ASSESSMENT OF THE BUDGET
CONDITION AT THIS TIME WOULD BE
THIS AS NEW DISCRETIONARY
SPENDING UNTIL YOU KNOW
LEGISLATURE WOULD POTENTIALLY
ENACT SOMETHING FOR THE BALLOT.
AH AND SO AT THAT, AT THIS TIME,
WE WOULD RECOMMEND REJECTING THE
$20 MILLION GENERAL FUND. I'LL
HAND IT BACK TO MY COLLEAGUE ON
CARE ACT. GOOD MORNING. WILL
OWENS AT LEO? SOME WILL SPEAK
BRIEFLY ON THE UPDATED CARE ACT
COST ESTIMATES SO BROADLY WE
WOULD RECOMMEND APPROVING THE
ADMINISTRATION'S UPDATED
ESTIMATES AS THIS IS AN ONGOING
LEGISLATIVE PRIORITY. UM AND WE
WOULD FURTHER YOU KNOW, JUST
LIKE TO POINT OUT AND COMMEND
THE ADMINISTRATION ON ITS
CONTINUED WORK TO UPDATE AND
REFINE THESE ESTIMATES, AS WE
HAD RAISED CONCERNS THAT BEING
SAID YOU KNOW, WE DID NOTE IN
OUR JANUARY ANALYSIS THAT GIVEN
THE CARE ACT'S IMPLEMENTATION
HAS YET TO BEGIN. THERE DOES
REMAIN SIGNIFICANT UNCERTAINTY
AS REFERENCED BY THE
ADMINISTRATION AS WELL, NOT ONLY
ONGOING COSTS, BUT CASELOAD, UM
, PARTICULARLY IN FUTURE YEARS
AS COUNTIES PHASE IN TO THE
PROGRAM, AND THE
ADMINISTRATION'S PROPOSED
INCREASE ONLY UNDERLINES THAT
CONTINUING UNCERTAINTY AROUND
COSTS. SO WE CONTINUE TO
RECOMMEND THAT THE LEGISLATURE
CONSIDERED REQUESTING THE
ADMINISTRATION TO REPORT ON COST
AND PROGRAMMATIC DATA, AS
OUTLINED IN OUR JANUARY ANALYSIS
FROM THE FIRST COHORT PRIOR TO
THE IMPLEMENTATION OF THE SECOND
COHORT. THIS WOULD GIVE THE
LEGISLATURE SUFFICIENT TIME NEXT
BUDGET. UM TO REALLY EVALUATE
THE ONGOING COSTS OF THE PROGRAM
AND TO MAKE ANY PROGRAMMATIC OR
BUDGETARY CHANGES TO BETTER
ALIGN IT WITH LEGISLATIVE
PRIORITIES. HAPPY TO ANSWER ANY
QUESTIONS. THANK YOU BRING IT UP
TO THE DIESS BEGIN WITH DOCTOR
WOULD THANK YOU, MR CHAIR, AND I
GUESS I'LL START WITH THE START
WITH THE M C O TAX. PROBABLY NOT
A SURPRISE. UM SO. OBVIOUSLY, WE
HAD THE FIRST QUESTION THE
JUSTIFICATION FOR SPREADING OUT
THE EXPENDITURES OVER 8 TO 10
YEARS SO UM I UNDERSTAND. THE
DESIRE TO HELP HELP STABILIZE
THE MEDICAL SYSTEM. AND GREATLY
APPRECIATE THAT, UM. 8 TO 10
YEARS IS A VERY LONG TIME. AND
SO IF WE'RE LOOKING AT PROVIDER
RATES OR REVENUE TO STABILIZE
THE SYSTEM. ARE WE POTENTIALLY
JUST GOING TO GIVE A LITTLE BIT
AND HELP THIS THING LIMP ALONG
OR WE REALLY GOING TO BE IN A
POSITION TO STABILIZE THE
SYSTEM? WE JUST SAW YESTERDAY
GOVERNOR SIGNED A B 1 12
HOSPITAL. AH! BILL RELATED TO
DISTRESS HOSPITALS WE HAVE WE
HAVE MULTIPLE CHALLENGES IN THE
HEALTHCARE SPACE RIGHT NOW. UM
HELP ME UNDERSTAND? WHY WE WOULD
. WE WOULD, YOU KNOW, LENGTHEN
THIS OUT. AND. TRY TO ALLAY MY
SKEPTICISM THAT A LITTLE BIT IS
GOING TO REALLY HELP. SO I'LL
START IN THEM. TURN IT OVER TO,
UH, J. C JUST WE WANT TO PROVIDE
STABILITY AND KIND OF THE
CERTAINTY THAT PROVIDERS WILL
GET THAT RATE INCREASE FOR A
LONG PERIOD OF TIME WITH THE
WITH KIND OF THEIR CONVERSATIONS
WITH CMS AND THEIR POTENTIAL
CHANGES TO FEDERAL REGULATION.
WE'VE MODELED IT TO ENSURE THAT
WE'RE ABLE TO SECURE THAT
INVESTMENT FOR A LONGER PERIOD
OF TIME, AND THERE IS NO FISCAL
CLIFF OR A KIND OF POTENTIAL FOR
THOSE RATE INCREASES TO NOT BE
SUPPORTABLE OR FUNDED BY THE EMC
REVENUE AND SO REALLY WANTING TO
PROVIDE THAT CERTAINTY TO
PROVIDE WRITERS AT THESE DOLLARS
ARE THERE THEY SHOULD INVEST AND
BE PART OF THE MEDICAL PROGRAM
BECAUSE WE WILL PAY THESE RATES
FOR THE LONG TERM. BUT LET ME SO
YOU'RE GONNA WE'RE GONNA PAY
RATES. UM BUT THOSE RATES WILL
BE FLAT FOR 8 TO 10 YEARS. WILL
THE WILL THEY OR WILL THEY NOT?
SO THE LANGUAGE AS IT READS, IT
ACTUALLY ALLOWS US TO ADJUST
MEDICARE INCREASES THEIR RATE WE
WOULD ANNUALLY PUT FORWARD IN
THE BUDGET. THAT SAME
AUGMENTATIONS THE, UM NOT
SOMETHING WE'VE HISTORICALLY
DONE, BUT I THINK GIVEN THAT WE
SEE THAT OUR RATES SIGNIFICANTLY
GO BEHIND WHEN WE DON'T THAT IS
ONE OF THE THINGS THAT WE'RE
PROPOSING. SO FOR PRIMARY CARE
OBE IN THE NON SPECIALTY, THE
ONES CURRENTLY IN THE BUDGET.
THE TRAILER BUILD DOES ALLOW US
TO MODIFY IT. SO IF MEDICARE
INCREASES THE RATE BY, SAY, 2%
WE WOULD ESSENTIALLY PUT THAT
FORWARD THROUGH CONSIDERATION
THROUGH THE BUDGET PROCESS FOR
US TO MAINTAIN THAT RATE,
ONGOING AS WELL. SO IT DOES
ALLOW FOR THAT ONGOING
MAINTENANCE. THE OTHER THING I
WOULD SAY IS FROM OUR
PERSPECTIVE. WE'VE BEEN DOING
PATCHWORK ON THE MEDICAL PROGRAM
FROM A PAYMENT POINT OF VIEW FOR
A REALLY LONG TIME,
SUPPLEMENTALS OR DOLLARS HERE
AND THERE, AND ONE OF THE
BIGGEST THINGS WE'RE HEARING IS
THAT WE NEED TO INCREASE OUR
BASE RATES. UM AND I THINK
THAT'S WHY WE STRONGLY FEEL LIKE
THIS ALLOWS US TO REALLY SECURE
THE FOUNDATIONAL PIECES OF SOME
OF OUR PROGRAMS DO A DEEP DIVE
AS MICHELLE MENTIONED EARLIER IN
REGARDS TO WHAT ARE THE REAL
HOLES IN REGARDS TO PAYMENT
RATES, WHICH, DRIVING SOME OF
THESE CORE ISSUES ACROSS THE
STATE TO INCREASE ACCESS,
IMPROVED QUALITY, GET MORE
PROVIDERS TO THE TABLE AND DO
THAT THROUGH THE SUMMER THROUGH
STAKEHOLDER ENGAGEMENT PROCESS
TO BE VERY THOUGHTFUL ABOUT HOW
WE SPEND THOSE FUTURE DOLLARS
AND SO WE SEE IT AS A REALLY
IMPORTANT MOMENT FOR US TO KIND
OF STEP BACK. LOOK AT HOW WE'RE
FUNDING THE MEDICAL PROGRAM AND
MAYBE NOT TAKE THE HISTORICAL
SUPPLEMENTAL APPROACH THAT HAS
BEEN USED BEFORE, UM, TO KIND OF
REALLY SOLIDIFY OUR PROGRAM
MOVING FORWARD. YOU MENTIONED
THE A B 97 CUTS. SO, UM HE
TURNED OUT ALL OF THOSE GOING
AWAY OR THESE SELECTED. MAYBE 97
CUTS. IT'S THE ABC 90/7 CUTS
RELATED TO PRIMARY CARE,
MATERNAL CARE AND NON ESPECIALLY
BEHAVIORAL AS WE BUT THERE'S
STILL A B 97 CUTS FOR OTHER
PROGRAMS THAT ARE STILL SITTING
OUT THERE THAT HAVE BEEN SITTING
OUT THERE FOREVER. WE HAVE, AS
YOU KNOW, IN THE LAST YEARS, TWO
YEARS REDUCED SIGNIFICANT, MAYBE
97 CUTS. THE LIST IS VERY SHORT
AND THE LARGEST ITEM WAS
PHYSICIAN SERVICES. THIS WOULD
TAKE A HUGE CHUNK OF THAT AWAY
WITH THE PROPOSAL COVERING
PRIMARY CARE, O B. AND NON
SPECIALTY MENTAL HEALTH. AND THE
AND THE. THE DURATION OF THE
TAXES OF THREE YEAR PERIOD.
CORRECT QUARTER YEARS SINCE
WE'RE STARTING APRIL? YEAH. MM
HMM. AND SO YOU THE IDEA I'M
DOING. I KNOW THE ANSWERS TO
SOME OF THESE QUESTIONS, SO, BUT
WE HAVE WE HAVE A LOT OF MEMBERS
OF THE LEGISLATURE WHO ARE
REALLY UNFAMILIAR WITH THIS.
THIS IS ONE OF THE MOST WONKY
THINGS WE DEAL WITH. QUITE
FRANKLY SO WE HAVE AN EDUCATION
ISSUE HERE. UM, AND PART OF THIS
IS HELPING ME REFRESH MY MEMORY.
A LITTLE BIT. UM SO WE'RE GOING
TO COLLECT THIS TAX FOR THREE
AND THREE QUARTER YEARS. AND
BLEED IT OUT OVER. SPEND IT OUT
OVER 8 TO 10. UM, IS THERE AN
INTENTION THEN TO NOT TRY TO
RENEW OR WILL THE FEDERAL AND
THREE EVERY INTENTION TO RENEW
AFTER THE MAKO PERIOD. IT'S JUST
THE RECOGNITION OF CMS,
INDICATING THAT THEY PLAN TO
PASS OR KIND OF MOVE FEDERAL
REGULATIONS TO ELIMINATE THAT
PROPORTIONALITY OR TO BE MORE
STRONG IN THE PROPORTIONALITY,
WHICH WOULD WOULD MEAN WE WOULD
HAVE TO REDUCE THE SIZE OF OUR
GOING FORWARD. SO YOU KNOW,
RIGHT NOW WE'RE THE PROPOSALS
ABOUT A $5 BILLION AND WE WOULD
WE WOULD, IT WOULD GO DOWN
SIGNIFICANTLY UNDER THE KIND OF
THEIR NEW RULES ESSENTIALLY WHAT
WE DID WITH THIS MODEL TO GET
ENOUGH DOLLARS TO PAY FOR AN
ONGOING RATE CHANGE IN THE
PROGRAM, WHICH ARE PROGRAMS BIG
, SO YOU NEED LARGER DOLLARS TO
DO THAT. ESSENTIALLY WE, UM,
SOMEWHAT MAX THE MODEL FOR LACK
OF BETTER DESCRIPTION. WE WORKED
WITH CMS TO UNDERSTAND HOW WE
COULD GET IT APPROVED WITH UNDER
FEDERAL REGULATIONS. IN
CALIFORNIA KNOWING THAT WE
WANTED TO, UM, INVEST THESE
DOLLARS TO SOLIDIFY THE BASE
MEDICAL PROGRAM AND TO INVESTORS
IN THE MEDICAL PROGRAM, SO AS
MICHELLE MENTIONED, IT'S ABOUT
TWICE THE SIZE OF WHAT WE'VE
DONE BEFORE, AND WE WORK VERY
CLOSELY WITH CMS TO MAKE SURE
THAT THAT WOULD WORK, BUT THEY
MADE IT VERY CLEAR THAT THEY
PLAN ON MOVING REGULATIONS THAT
WOULD ESSENTIALLY CLOSE UM, THE
POTENTIAL LOOPHOLE THAT EXISTS
OUT THERE AND FEDERAL REGS THAT
ALLOWS US TO HAVE A M CEO TAX OF
THIS SIZE, AND SO THAT'S WHY OUR
RECOMMENDATION IS TO PUT IT INTO
A SPECIAL FUND THAT THEY CAN BE
USED OVER A LONGER PERIOD OF
TIME TO PAY FOR THE NON FEDERAL
SHARED PORTION OF RATE INCREASES
ACROSS VERY CRITICAL AREAS OF
THE PROGRAM. UM, SOMETHING WE
HAVEN'T HAD A CHANCE TO DO IN
CALIFORNIA FOR VERY LONG TIME AS
YOU GUYS KNOW. SO THEN, IF IN
THREE AND THREE QUARTERS YEAR
WHEN THERE IS A DISCUSSION TO
RENEW AGAIN. UM THAT WILL BE A
SMALL WILL BE A LIKELY AS MUCH
SMALLER AMOUNT OF MONEY. YEAH
RIGHT NOW. BASED ON WHAT? WE'RE
HEARING FROM CMS, WE DON'T KNOW
WHAT WOULD BE IN THEIR RAGS. SO
WE HAD TO ESTIMATE A LITTLE OFF
OF THEM, SAYING THEY WANTED THE
MODELS MORE PROPORTIONAL TO GET
A MORE PROPORTIONAL MODEL IN
CALIFORNIA. IT SIGNIFICANTLY
REDUCES THE AMOUNT OF REVENUE
YOU CAN BRING IN WITH THE TAX ON
ALL OF OUR MODELING THAT WE'VE
SEEN. SO IT REALLY DEPENDS ON
WHAT REGS THEY DROPPED. WE WOULD
THEN MODEL BASED ON THAT. AND,
OF COURSE, CALIFORNIA AS WE
ALWAYS WOULD, BUT MOST LIKELY
STILL MOVE FORWARD WITH A
PROPOSAL AS MICHELLE MENTIONED
OR DIRECTOR BOSS MENTIONED, BUT
IT MAY LOOK VERY DIFFERENT THAN
THE MODELS THAT WE'VE HAD BOTH
HISTORICALLY AND PROPOSED IN
THIS BUDGET, SO IN ORDER TO DO
THAT, WE HAVE MODELED A CERTAIN
PORTION. ONGOING UM, BUT WE DO
THINK WE COULD SUSTAIN AT LEAST
WHAT WE'RE PUTTING FORWARD IN
THIS GOVERNOR'S BUDGET AND
PROPOSING TO PUT FORWARD IN NEXT
YEAR'S BUDGET TO COME BACK FOR
YOUR CONSIDERATION. IN AN
ONGOING WAY, REGARDLESS OF WHAT
THEY DO IN THAT PROPOSAL, UNLESS
IT WAS PRETTY DRAMATIC, IN WHICH
CASE YOU KNOW, WE WOULD PROBABLY
ADVOCATE FOR A CHANGE IN THAT
THAT FEDERAL RAG SO THE RENEWAL
AND THREE AND THREE QUARTERS
YEARS WOULD NOT IN ANY WAY UNDER
YOUR PROPOSAL. AFFECT THE
EXPENDITURES AND THE 8 TO 10
FROM THE CURRENT CYCLE, OR DO
YOU NEED THAT RENEWAL TO DO? Tð
. HOW DOES THAT PLAY? HOW DOES
THAT RENEWAL AND THREE QUARTERS
YOUR PLAY OUT WITH THE
EXPENDITURES THAT YOU'RE SURE
WE'VE KIND OF MODELED IT BOTH
WAYS WHERE WE HAVE THE EMCOR. WE
DON'T HAVE AN ECHO STARTING IN
THREE AND THREE, A NEW NEW
VERSION OF IT, SO IT DOES
SHORTEN THE TIME PERIOD TO
CLOSER TO EIGHT YEARS IF WE ARE
NOT ABLE TO RENEW AN M CEO IN
2027 IF WE ARE ABLE TO RENEW AND
IT BRINGS IT OUT A COUPLE MORE
YEARS LONGER IF WE ARE ABLE TO
RENEW AN EMC OH, YEAH EXTENDS
FAR BEYOND 10 YEARS, RIGHT? SO
IF YOU CAN, EVEN WITH A
PROPORTIONAL MODEL SAY IT WAS
SIGNIFICANTLY LESS YOU CAN
ACTUALLY FUND IT. FOR A LOT
LONGER PERIOD OF TIME. UM AND SO
WE HAVE LOOKED AT IT FROM ALL OF
THOSE ANGLES, WHICH IS WHY WE
FEEL LIKE VERY COMFORTABLE WITH
THE CURRENT PROPOSAL BEFORE THE
LEGISLATURE. OH I DON'T KNOW.
I'M JUST GONNA I'M GONNA SAY A
COUPLE OF OKAY, MR CHAIR. THIS
IS KIND OF A BIG DEAL. UM, UM
YOU KNOW, I THINK THE WHOLE
CHALLENGE WITH MEDICAL RATES AND
PROVIDE REIMBURSEMENTS HAS BEEN
BEEN A BIG DEAL. THAT'S ONE OF
THE REASONS THAT YOU KNOW THERE
WAS THERE WAS SUCH ACTIVITY
AROUND PROP 56. UM AND SO ARE
CONCERNED. MY CONCERN ARE, YOU
KNOW LOT OF PEOPLE WENT OUT ON
THE LINE ON THAT ONE. AND THEN
AND AT THE END OF THE DAY THAT
MONEY GOT SWEPT OVER TIME. NOW
MORE OF ITS GOING BACK OUT. I
KNOW BUT BUT, UM SO WE'RE UM, A
LITTLE, YOU KNOW. WELL, I'M A
LITTLE CONCERNED. YOU KNOW ABOUT
WHAT? THE DETAILS. YOU KNOW HOW
THE DETAILS ON THIS AND THIS
PLAY OUT? I THINK A LOT OF
PEOPLE ARE AS WELL. SO I THINK
WE ALSO HAVE A CHALLENGE WITH
EDUCATION MEMBERS. UM THEY HEAR
THE WORD TAX AND SUDDENLY
EVERYBODY'S YOU KNOW, AND GOT
RED FLAGS ALL OVER THE PLACE.
IT'S NOT A TRADITIONAL TAX. THIS
IS AT AND SO WE'VE GOT. WE'VE
GOT WORK TO DO THERE. UM. I
STILL THINK THERE'S GOING TO BE
SOME SKEPTICISM ON THE 8 TO 10
YEARS. I I'M A LITTLE CONCERNED
ABOUT THAT MYSELF. IF WE DO
THESE PROVIDER RATE INCREASES,
THEY HAVE TO BE AT A LEVEL TO
MAKE IT WORK TO REALLY MAKE IT
WORK TO GET PROVIDERS TO
ACTUALLY DO. TAKE TAKE THESE
PATIENTS AND KEEP TAKING THESE
PATIENTS IF WE JUST RAISE THEM A
LITTLE OR A LITTLE BIT. WE'RE
NOT GOING TO HAVE THE EFFECT. WE
ARE NOT. IT IS NOT GONNA WORK,
SO THIS HAS TO BE MEANINGFUL. I
KNOW IT'S TARGETED. UM AND I
THINK THAT'S I THINK THAT'S
SIGNIFICANT, BUT IT HAS TO BE
MEANINGFUL OR WE WILL NOT. WE
WILL NOT BE SUCCESSFUL HERE. WE
WILL. WE WILL WISH WE'D DONE IT
DIFFERENTLY. DO YOU WANT TO
UNDERSCORE THE POINT ABOUT IT
BEING TARGETED? AND THIS IS NOT
INTENDED TO GIVE EVERY PROVIDER
JUST A LITTLE BIT OF A BUMP. IT
IS INTENDED TO BE WHERE WE THINK
WE CAN REALLY MAKE AN IMPACT
WITH WITH REGARD TO INCREASING
RATES. AND SO THAT'S WHY FOR
THIS FIRST PROPOSAL, WE HAVE
JUST THOSE THREE DIFFERENT KIND
OF SERVICE AREAS, AND WE'VE
ALLUDED TO KIND OF WHERE WE'RE
LOOKING AT FUTURE INCREASES. UM
AS WE KIND OF LOOKED AT SOME OF
THE INITIAL DATA AND WHERE WE
SEE THAT, YOU KNOW, OUR RATES
REALLY NEED TO BE ADDRESSED. WE
WE HOPE EVERYONE APPROACHES.
THIS WITH DISCIPLINE IS WHAT WE
WOULD SAY, BECAUSE WE DON'T WANT
IT TO JUST BE A LITTLE ACROSS
EVERYONE AND EVERYONE GETS A
LITTLE PIECE. IF WE ARE GOING TO
DO THIS, AND IT BE MEANINGFUL
LIKE YOU'RE MENTIONING, AND WE
100% AGREE WITH THAT. WE WANTED
TO BE VERY DATA DRIVEN. WHAT ARE
THE SERVICES? WHERE THE CODES
WHERE THE GAPS WHERE IS THE
GENUINE NEED AND IT BE INFORMED
BY DATA, INCLUDING WHERE OUR
PHYSICIAN SHORTEST SHORTAGE
AREAS? WHERE DO WE HAVE THE
LARGEST DISPARITIES? HOW ARE WE
GOING TO ACTUALLY BEND THAT
CURVE? SO THAT'S HOW WE'RE
APPROACHING. IT'S WHY WE
COULDN'T COME THIS YEAR WITH A
FULL PROPOSAL BECAUSE WE WANT IT
TO BE THOUGHTFUL IN REGARDS TO
IT. WE FELT VERY COMFORTABLE
WITH WHAT WE PUT FORWARD FOR GN
ONE. WE WANT THE OTHERS TO BE
VERY INFORMED BY DATA
INFORMATION LOOKING AT THAT WITH
A GROUP OF YOU KNOW, CRITICAL
STAKEHOLDERS THAT WILL BE
IMPORTANT TO HELP INFORM THAT
AND THEN COME BACK WITH THE
PROPOSAL FOR THOSE ADDITIONAL
DOLLARS FOR GENUINE OF 25.
BECAUSE WE AGREE IT NEEDS TO BE
DISCIPLINED. WE NEED TO BE
FOCUSED IF WE WANT THIS TO BE
MEANINGFUL. IT NEEDS TO BE
DRIVEN BY DATA. WHERE ARE THE
GAPS? HOW ARE WE GOING TO
ACTUALLY START FILLING SOME OF
THOSE GAPS, AND ONE FINAL
COMMENT ON THIS IS THAT I THINK
THERE IS CERTAINLY ARE SOME
SPECIALTIES THAT ARE WERE WE
HAVE IT'S IMPOSSIBLE FOR MEDICAL
RECIPIENTS TO GET TO. I HOPE
THERE IS SOME CONSIDERATION
THERE AS WELL. THAT THAT IS ON
THE LIST FOR 25. YES. WHAT ON
THE LUXAN DISTRIBUTION PROJECT?
UM JUST I THINK YOU MAY HAVE
HEARD MY COMMENTS EARLIER, VERY
CONCERNED ABOUT THE COST OF,
ESPECIALLY AROUND WHAT WE HEAR
ABOUT NOW. THE GENERICS DO WE
DOES THE HCFC ANY LEVERS AND IN
THIS IN THIS WHOLE ARENA AROUND.
ACQUISITION PROCUREMENT AT
REASONABLE COST. SO WE'RE A
LITTLE DIFFERENT. UM, AS YOU
KNOW, I MEAN, SO WE HAVE TWO
WAYS IN WHICH WE PROVIDE NOXON
SO ANYONE CAN PUT IN A SCRIPT
AND GETTING A LUXAN FROM A
PHARMACY IN THE MEDICAL PROGRAM
. UM AND, UH AND WE HAVE
MEDICAID BEST PRICE WHEN IT
COMES TO THAT, UM, IN REGARDS TO
THE TYPES OF REIMBURSEMENT THAT
WE HAVE FOR NALOXONE IN
CALIFORNIA. UM AND THAT'S ALL
MEDICAID PROGRAMS. THAT'S NOT
JUST MEDICAL AND THEN SEPARATE.
WE HAVE THE NDP PROGRAM IN NDP
IS WHERE YOU ARE DISTRIBUTING IT
TO OTHERS WHO ARE MAYBE NOT
DON'T HAVE AN INDIVIDUAL IN
FRONT OF THEM WERE PROVIDER HAS
PROVIDED A SCRIPT OR AN ONGOING
SCRIPT WHERE THEY CAN GET THOSE
SERVICES. BUT YOU'RE DOING
COMMUNITY DISTRIBUTION OF THOSE.
SO THE NDP IS FOR COMMUNITY
DISTRIBUTION TO SCHOOLS, TOO.
PUBLIC SAFETY INDIVIDUALS TO, UM
COUNTIES WHO ARE DOING STREET
BASED WORK RIGHT? AND THEN YOU
ALSO STILL HAVE THE ABILITY TO
GET, UM THE REIMBURSEMENT ON THE
MEDICAL WITH NO COST FOR
NALOXONE. UM AND SO THROUGH THE
NDP. WE HAVE BEEN WORKING
DIRECTLY WITH THE MANUFACTURER.
THE 47 POINT IN DOLLARS AND 50
CENTS MENTIONED EARLIER IS FOR
FOUR UNITS, AND IT INCLUDES BOTH
THE DISTRIBUTION TO THE
INDIVIDUALS AND REPORTING JUST
TO BE CLEAR. I WANTED TO BE
TRANSPARENT IN REGARDS TO THAT
BECAUSE IT IS A LITTLE BIT MORE
BECAUSE IT'S A PROGRAM THAT WE
RUN SO THAT INCLUDES THE COST OF
THE DRUGS, THE DISTRIBUTION OF
THE DRUGS AS WELL AS THE
REPORTING BACK TO US, THE
REVERSALS THAT WE REPORT OUT TO
ALL OF YOU. AND SO THOSE ARE THE
TWO DIFFERENCES AND SO BUT, YOU
KNOW, I DO. UH YOU KNOW, WE DO
KNOW IT'S REALLY IMPORTANT. THAT
INCREASE OF THE COMMUNITY BASED
DISTRIBUTION IS SIGNIFICANT.
GIVEN THE OVERDOSES THAT WE'RE
SEEING ON THE STREET AND SO
WE'RE TRYING TO MAKE SURE WE'RE
BALANCING GETTING GETTING THOSE
TWO PEOPLE THAT ARE ON THE
STREET ABLE TO HAVE THOSE
REVERSALS SAVE PEOPLE'S LIVES,
REDUCE OVERDOSES, BUT ALSO
MAKING SURE PEOPLE UNDERSTAND
THERE ARE OTHER WAYS. OF GETTING
NALOXONE, ALSO THROUGH THE
MEDICAL PROGRAM FOR PEOPLE
ENROLLED IN OUR PROGRAM, AND WE
ARE BROADLY COMMUNICATING THAT
BECAUSE WE COVER ALL FDA
APPROVED DRUGS IN THIS SPACE, UH
ACROSS THE BOARD. I HOPE THAT
HELPS ANSWER SOME QUESTIONS. I
GUESS I GUESS IT APPRECIATE
APPRECIATE THAT PART OF IT. I'M
JUST THINKING ABOUT THE COST?
YEAH AND, YOU KNOW, OBVIOUSLY
WE'RE GOING TO BE A BIG BUYER
MARKET, SO I JUST YEAH. I JUST
WANNA MAKE SURE WE HAVE THE
LEVERS TO MAXIMIZE OUR DOLLARS
AND GET AS MUCH OF THIS AS WE
CAN. YEAH NO, WE, UH WE ALWAYS
WELCOME ANY LOWER PRICE OF ANY
DRUG THAT HITS THE MARKET.
EVERYONE WELCOME TO FIGURE OUT A
WAY TO MAKE IT HAPPEN. YEAH.
OKAY. I WON'T SPEAK TO H CHRIST
PROPOSAL AND I APPRECIATE THAT.
THANK YOU. THANK YOU, MR CHAIR.
SEEING NO OTHER QUESTIONS AT THE
DIOCESE WILL KEEP IT HERE AT THE
CHAIR WILL BEGIN WITH THE TAX. I
WANT TO GET AN UNDERSTANDING IF
THERE IS A MAXIMUM AMOUNT OF THE
TAX THAT WILL GO TO GENERAL
FUNDS BACKFILL. ARE WE BEING
CRYSTAL CLEAR ABOUT MAXIMUM
AMOUNT TOTAL. DO YOU WANT IT? SO
UH, IN TERMS OF THE GENERAL OF
IMPACT, WILL THE 2023 REVENUE
THE NEW REVENUE THAT WASN'T PART
OF THE GOVERNOR'S BUDGET
PROPOSAL. 2.5 BILLION OF THAT OF
THE 3.7 WILL BE GOING TO TOWARDS
TO BALANCE THE STATE BUDGET AND
THEN THE AMOUNT THAT WAS
PROPOSED AT GOVERNOR'S BUDGET.
ESSENTIALLY UM, THE 2 BILLION,
ESSENTIALLY THE KIND OF THE OLD
MODEL THAT WILL ALSO BE USED TO
BALANCE THE STATE BUDGET. SO
THAT'S KIND OF SHORT ANSWER WELL
AND JUST WANT TO MAKE SURE THAT
MORE AND MORE DOESN'T GET
GOBBLED UP OUTSIDE OF MEDICAL
CAL AS THE REAL INTEREST TOWARDS
WORKING WITH THE CEOS IS TO
PROVIDE ADEQUATE RATES TO
SERVICES. AND WHILE I HEARD
DISCIPLINE, I ALSO WANT TO MAKE
SURE WE ARE ADEQUATE AND THE L A
O HAD COMMENTED ON THE NEED FOR
THE ADMINISTRATION TO SHARE ITS
ASSESSMENT OF PROVIDER ADEQUACY
RATES. AND WOULD LIKE TO
UNDERSTAND HOW YOU DETERMINE
WHEN RATES ARE ADEQUATE AND HOW
WE, UM, CAN GAIN THOSE INSIGHTS
AND HAVE THE SAME CONFIDENCE
THAT YOU DO WOULD BE IMPORTANT
FOR US AS WE DETERMINE THE
LENGTH OF THE PROGRAM AND THE
SIZE OF THE RATES. AND SO I'M
HOPING YOU CAN COMMENT ON THAT
RECOMMENDATION. YES I MEAN, I
THINK WE WILL, UM, WE WILL HAVE.
I MEAN, WE THINK 87.5 RIGHT NOW
IS LIFTING ALL BOATS. AS WE
REPORTED IN THE GOVERNOR'S
BUDGET. SOME OF OUR STAR AT LOW
60% OF MEDICARE RIGHT NOW.
THAT'S THAT'S NOT ADEQUATE. I
CAN TELL YOU THAT PART AND SO
YOU KNOW, WE ARE TRYING TO LIFT
THE FOUNDATION. I THINK THAT IT
JUST IT IS A GOOD QUESTION IN
REGARDS TO WHAT ARE OTHER
MEDICAID PROGRAMS PAYING WHEN IT
COMES 2% OF MEDICARE IN THERE
ARE WE HAVE BEEN WORKING WITH A
LOT OF OTHER STATES IN REGARDS
TO THIS IS NOT JUST A CALIFORNIA
THING. OTHER STATES ARE ALSO
ACROSS THE NATION. REALIZING
MEDICAID HASN'T PROBABLY
INCREASE THEIR RATES IN A VERY
LONG TIME, AND A NUMBER OF
STATES ARE DOING GREAT ANALYSIS
AND STUDIES. THE GOOD THING IS
WE GET A LOOK AT WHAT OTHER IT'S
OUR DOING AND UNDERSTAND WHERE
WE ARE IN REGARDS TO THAT REALM,
AND YOU'RE GOING TO SEE
EVERYTHING FROM CERTAIN STATES
PAYING 40% OF MEDICARE TWO
STATES PAYING, YOU KNOW 80 85 OR
100% OF MEDICARE. YOU'RE GOING
TO SEE THAT SWING. UM AND I
THINK YOU KNOW, WE HAVE TO DO A
LOT OF ANALYSES. OUR FINANCING
AND MEDICAID IS SO COMPLICATED.
WE HAVE THINGS CALLED UPPER
PAYMENT LIMITS, AND I'M NOT
GOING TO GET INTO WONKY STUFF.
BUT IT'S NOT AS SIMPLE AS JUST
SAYING. WE'RE GONNA INCREASE THE
RATE HERE, AND IT HAS NO IMPACT
ON THE REST OF THE SYSTEM. WE
ACTUALLY HAVE TO ANALYZE HOW IT
HITS ACROSS VARIOUS FUNDING
STREAMS. WE HAVE MEDICARE
CROSSOVER PAYMENTS. SO IF YOU GO
OVER 80% OF MEDICARE, HOW DOES
THAT AFFECT CERTAIN PIECES IN
REGARDS TO DO INDIVIDUALS? SO WE
JUST HAVE A LOT OF FINANCING
PIECES, WHICH IS WHY IT'S
COMPLICATED AND WE WANT MORE
TIME TO BE THOUGHT. WELL IN THAT
BUT WE HAVE NO WE HAVE. WE'RE
VERY SUPPORTIVE OF BEING VERY
OPEN AROUND. WHY WE'RE
RECOMMENDING CERTAIN RATES. WHAT
IS THAT SWEET SPOT? WHAT ARE
OTHER STATES PAYING IN REGARDS
TO THIS AND CALIFORNIA'S BEGGING
COMPLEX AND WE HAVE VERY URBAN
AREAS, BUT VERY URBAN AREAS ALSO
HAVE DONUT HOLES. AS WE KNOW,
LOS ANGELES HAS DONUT HOLES.
EVEN THOUGH IT'S LOS ANGELES
COUNTY. IT'S HUGE. UM AND THEN
WE HAVE VERY URBAN. I MEAN, VERY
RURAL AND FRONTIER AREAS WHERE
WE KNOW WE NEED TO IMPROVE
ACCESS. AND SO I THINK WE WILL
BE VERY THOUGHTFUL OR TRY TO BE
VERY THOUGHTFUL IN REGARDS TO
WHAT IS THAT NATIONAL LANDSCAPE
SO WE HAVE A BENCHMARK, BUT ALSO
WHERE DO WE MAYBE NEED TO PAY
MORE AS AS DIRECTOR BOSS
MENTIONED IN REGARDS TO, UM WE
KNOW WE HAVE PHYSICIAN SHORTAGE
AREAS IN CALIFORNIA, THE CENTRAL
VALLEY. WE HAVE THE RURAL NORTH
WE HAVE EVEN ON THE CENTRAL
COAST. JUST PHYSICIAN SHORTAGES.
AND SO WE KNOW WE MAY HAVE TO
PAY A LITTLE BIT MORE IN THAT
EXAMPLE TO INCREASE ACCESS THERE
AND OR TO IMPROVE QUALITY OF
SERVICES. AND SO I THINK THAT'S
WHAT WE WOULD BE LOOKING TO DO
AND HOPEFULLY COME BACK WITH A
THOROUGH ANALYSIS FOR EVERYBODY
TO CONSIDER NEXT YEAR. YEAH I AM
APPRECIATIVE DIRECTOR ALSO ADD.
COME JANUARY 1 2024 99% OF THE
MEDICAL POPULATION WILL BE IN
MANAGED CARE AND SO WITH THAT
ALSO IS THE OPPORTUNITY FOR
MANAGED CARE PLANS AND PROVIDERS
TO ALSO NEGOTIATE RIGHTS. THE
87.5% THAT WE SPOKE ABOUT WE,
YOU KNOW THAT WILL BE THE FLOOR
PLANS WILL BE REQUIRED TO PAY
PROVIDERS THAT BUT I THINK I
WOULD JUST WOULD LIKE TO UPLIFT
KIND OF THAT NEGOTIATION BETWEEN
PLAN AND PROVIDER BECAUSE THAT
IS ALSO THE OPPORTUNITY WHERE
YOU KNOW THERE MIGHT BE
SHORTAGES OR NEEDS WERE THAT
KIND OF CONVERSATION CAN HAVE
OPEN AS WELL. I DO WANT TO
APPRECIATE THE ADMINISTRATION'S
WILLINGNESS TO BE BOLD AND TO
PUSH FOR AS LARGE OF AN M CEO AS
WE CAN, IN LIGHT OF THE NEED
THAT WE HEAR ABOUT REGARDING
RATES AND DO WANT TO BRING IN
THE L A AND SEE IF THERE WERE
ANY FOLLOW UP QUESTIONS YOU HAD
BASED ON THE CONVERSATION. WE
JUST HAD REGARDING THE PROVIDER
ADEQUACY OR ANY OTHER COMMENTS
THAT YOU MAY HAVE SURE. SO I
THINK AGAIN, THERE ARE TWO KEY.
SO SORT OF AREAS HERE. ONE WAS
JUST SORT OF AROUND THE I GUESS
THIS IS RELIGIOUS RELATED TO THE
PAYMENTS MORE JUST THE OVERALL
TAX, BUT THERE WERE STILL SOME
SOME BASIC BACKUP INFORMATION.
WE'RE STILL AWAITING FROM THE
ADMINISTRATION ON THE MULTI YEAR
IMPACT OF THE TAX, SO WE'RE
STILL AWAITING THAT INFORMATION
WITH REGARD TO PROVIDER RATES. I
THINK OUR MAIN AREA HERE WAS
JUST TO ENSURE THAT, UM WHEN,
WHEN THE ADMINISTRATION COMES
BACK NEXT YEAR THAT THERE IS A
GOOD ANALYSIS THAT THE
LEGISLATURE HAS ACCESS TO, AND
CAN SORT OF ASSESS THE
ADMINISTRATION'S PROPOSAL BUT
ALSO EXPLORE OTHER OPTIONS, TOO.
THAT'S WHY WE RECOMMENDED
CONSIDERING ADOPTING REPORTING
LANGUAGE THAT WOULD HELP SORT OF
ESTABLISHED THE PARAMETERS
AROUND THIS ANALYSIS, AND WE'RE
HAPPY TO WORK WITH THE COMMITTEE
IF THAT'S SOMETHING OF INTEREST.
TO THE EXTENT THAT COMMITTEE IS
COMFORTABLE WITH WHAT THE
DEPARTMENT SAID, TOO, THAT
WOULD. THAT WOULD BE A
CONSIDERATION THERE, TOO, BUT
THE GOAL HERE IS TO ENSURE THE
LEGISLATURE HAS RESOURCES TO BE
ABLE TO ASSESS THE PROPOSAL WHEN
IT COMES NEXT YEAR, AND I DO
SHARE THAT I WANT TO GIVE AS
MUCH FLEXIBILITY AS WE CAN FOR
YOU TO ADDRESS NEEDS WITH
RESOURCES IN THE FUTURE, AND YET
. OAN OUR RESPONSIBILITY OF
OVERSIGHT AS WELL THAT WE ARE
MEETING THE NEEDS AND SO I THINK
THAT'S WHY WE'RE ASKING FOR THIS
ASSESSMENT SO WE CAN UNDERSTAND
YOUR DECISION MAKING PROCESS. UM
AND LOOK FORWARD TO THOSE
CONTINUED CONVERSATIONS ON THAT.
DOCTOR WOULD JUST ONE MORE
QUESTION. UM I THINK I MENTIONED
PROP 60 50 56. IS THERE ANY.
POTENTIAL NOW OR IN THE FUTURE
OF ANY ADJUSTMENTS. ON PROP 56
RELATED TO WHAT YOU'RE DOING
WITH THE EMC Ó. IN OTHER WORDS.
ARE THESE PROP 56 GOING TO BE
LOOKED AT SEPARATELY. ANY ANY
SUPPLEMENTAL PAYMENTS OR
ANYTHING COMPLETELY SEPARATE
FROM THIS? OR IS THIS GOING TO
BECOME ALL KIND OF LOVE
TOGETHER? SO A FEW THINGS AS YOU
KNOW THE LAST YEAR BECAUSE OF
THE DWINDLING PROPERTY, SIX
REVENUES WE CONVERTED MANY OF
THE SUPPLEMENTALS OR PAYMENT
RATES ON WITH GENERAL FUND. SO
THE AMOUNT OF THINGS WE FOUND
WITH PROPER 56 IS PRETTY SMALL.
NOW PHYSICIAN DENTAL. UM SO
THERE WOULD BE NO CHANGES THAT
DENTAL AT THIS TIME IN REGARDS
TO PROP 56 THAT WOULD MAINTAIN
WHEN IT COMES TO THE PROPERTY 56
PHYSICIAN SUPPLEMENTAL PAYMENTS
FOR THE PROPOSAL FOR THE 87.5
WHAT WE WOULD ESSENTIALLY DO FOR
THE BASE RATE INCREASE, IT WOULD
BE AT THAT 87.5 OR HIGHER IF THE
CURRENT OF PEOPLE SERVICE PLUS
REDUCTION OF 18 97 AND PROP 56
EQUATES TO A HIGHER BASE RATE.
WE WOULD DO WHATEVER THIS IS
EQUAL TO THE HIGHER RATE. IN OUR
BASE. WE WOULD TAKE THE
PHYSICIAN SERVICES TIED TO THAT
AND WE WOULD USE THAT TO FUND
THAT BASE RATE FOR PROP 56 SO
THE REVENUE TIED TO PRIMARY
CARE, FOR EXAMPLE, IN THE PROP
56 WOULD GO TOO TOUGH ON THE
SPACE. BUT FOR EXAMPLE, WHERE
SPECIALTY PROVIDERS TODAY ARE
RECEIVING A PROP 56 PAYMENT FOR
THE VARIOUS CODES THOSE WOULD
CONTINUE IN IN OUR PROPOSAL
TELLING WHICH TIME IF WE PUT
FORWARD A PROPOSAL NEXT YEAR
THAT INCREASES SPECIALTY ABOVE
WHAT THE PROP 56 PAYMENT IS THEN
WE WOULD PROBABLY CONSIDER
SIMILAR TO WHAT WE'RE DOING WITH
87.5. BUT THAT'S SUBJECT TO OUR
ANALYSIS THAT THAT WOULD THAT
WOULD BE PRUDENT OF A
RECOMMENDATION. SO THE PHYSICIAN
ONE YOU'LL SEE IT BEING A LITTLE
DIFFERENT. SOME OF IT WILL GO
TOWARDS THE SPACE RATE FOR
PRIMARY CARE SPECIALISTS WILL
CONTINUE TO GET THEIR PROP 56
SUPPLEMENTAL PAYMENT ONGOING AND
TELL THEM WHICH THERE'S A
DECISION BETWEEN THE LEGISLATURE
AND ADMINISTRATION TO CHANGE
THAT, UM AND THEN THERE'S NO
CHANGES TO ANY OF THE OTHER
THINGS BEING FUNDED WITH PROFIT.
TWO X FAMILY PLANNING, DENTAL
ETCETERA. THERE'S NO CHANGES TO
ANY OF THOSE PROPER 56 PROPOSALS
WITHIN THIS BUDGET PROPOSAL. BY
GOING FORWARD. THERE COULD BE IF
WE PUT FORWARD A RECOMMENDATION
THAT WE ALL AGREE TO. THEN IN
THAT WE THINK IT'S PRUDENT AND
THAT IS SOMETHING THAT COULD BE
CONSIDERED. GREAT THANK YOU. MHM
I'M GONNA ASK MY NEXT QUESTION
ON THE NDP. IF I CAN. WE HEARD
ABOUT THE SUCCESS OF THE HARM
REDUCTION ORGANIZATIONS THAT
THEY HAD RECEIVED 31% OF THE
KIDS AND HAD 60% OF THE
REVERSALS. AND YET THEY HAVE A
PROPOSAL CURRENTLY TO CONTINUE
FUNDING FOR STAFFING AND
OPERATIONS THAT IS NOT BEING
DISCUSSED. AND I'M WONDERING,
SINCE THEY'VE BEEN SUCH A LARGE
PART OF OUR SUCCESS IN REVERSALS
. ARE WE WILLING TO CONSIDER
USING OPIOIDS SETTLEMENT FUNDS
FOR THAT STAFFING AND OPERATIONS
OF THESE HARM REDUCTION
ORGANIZATION? SINCE WE DO NEED
THOSE BOOTS ON THE GROUND? THE
TRUSTED MESSENGERS WHO ARE ABLE
TO SUCCESSFULLY GET THESE
MEDICATIONS TO THE RIGHT PLACE
AT THE RIGHT TIME, HOPING YOU
CAN HAVE SOME COMMENTS ON THAT
THEIR OUTCOMES ARE CLEAR. IT
ISN'T ALLOWABLE SOURCE OF OPIOID
SETTLEMENT FUNDS, AND THE
DEPARTMENT IS HAPPY TO ENGAGE IN
THOSE CONVERSATIONS. IT'S NOT
CURRENTLY THE ADMINISTRATION'S
PROPOSAL AT THIS TIME. THE
DEPARTMENT OF FINANCE YEAH, THE
REVISION IS PROPOSING TO SPEND
ALL OF THE PROJECTED REVENUES
FOR OSF IN THE NEXT FOUR YEARS.
HOWEVER TO THE EXTENT THAT THE
LEGISLATURE PRIORITIZES THE HARM
REDUCTION ORGANIZATIONS AND
THEIR STAFFING AND OPERATIONAL
NEEDS, UM WE'RE HAPPY TO
CONTINUE DISCUSSIONS ABOUT THAT.
THANK YOU AND I AM ALL UPLIFT
THE COMMENTS IF I CAN FROM THE
REGARDING THE CARE ACT, FUNDING
AND THE CONCERNS ABOUT THE COST
ESTIMATES, GIVEN THAT
IMPLEMENTATION HASN'T REALLY YET
BEGUN. AND YET I'M REALLY.
ASKING THAT WE ARE INCLUDED IN
THOSE, UM, DISCUSSIONS IN REAL
TIME SO THAT WE CAN HELP TO
DETERMINE APPROPRIATE AMOUNTS OF
FUNDING AS WE ARE. IMPLEMENTING
AND I'M HOPING YOU CAN PROVIDE
SOME COMMENTS BASED ON WHAT THE
RECOMMENDATIONS ARE FROM THE L
A. OH REGARDING REGULAR
IMPLEMENTATION REPORTS TO THE
LEGISLATURE. SO I THINK YOU
KNOW, WE, UM OUR POSITION IS
THAT WE OFTEN HAVE TO ESTIMATE
WHAT A PROGRAM IS GOING TO COST.
WE BUILD ASSUMPTIONS. WE DEVELOP
RATES. ESSENTIALLY WHAT WE'VE
BEEN DOING IS GOING BACK AND
FORTH WITH COUNTIES TO
UNDERSTAND ALL OF THE VARIOUS
COMPONENTS OF THE CARE ACT. WE
LOOKED AT PETITIONS. WE LOOKED
AT CARE, PLANNING THE NUMBER OF
HEARINGS AND REALLY JUST BROKE
IT DOWN AND INDIVIDUAL PIECES
BACK AND FORTH WITH THEM. FINE
TUNE THE RATE WE WOULD BE PAYING
. WE UNDERSTAND THE, UM YOU
KNOW, CONCERNS AROUND, NOT
UNDERSTANDING THE TOTAL NUMBER
OF POPULATIONS BOTH PETITIONS,
BUT THAT THOSE THAT WILL
ACTUALLY END UP IN THE CARE
COURT PROCESS VERSUS THOSE WILL
COME TO AN AGREEMENT. SO THERE'S
A LOT OF THOSE PIECES AND A LOT
OF IT RIGHT NOW IS ASSUMPTION
BASED, WHICH IS WHY WE ARE
RECOMMENDING TO BE MORE
THOUGHTFUL IN THAT WAY SO THAT
IT IS REIMBURSED. NOT JUST WE
THINK IT'S GOING TO COST $121
MILLION HERE COUNTIES. HERE'S
YOUR DOLLARS. LET US KNOW HOW IT
GOES. IT WOULD. WHAT OUR
PROPOSAL IS TO THE COUNTIES IS
THAT IN THE LEGISLATURE FOR
CONSIDERATION IS THAT IT WOULD
BE BILLED ON AN INDIVIDUAL BASIS
SO THAT IT ALLOWS FOR US TO
BETTER UNDERSTAND THAT
UTILIZATION. UM I THINK THE HARD
PART IS WITH THIS PROGRAM GOING
LIVE IN OCTOBER AND THEN
DECEMBER. THE FIRST COHORTS
TIMING WISE FROM A DATA
PERSPECTIVE TO THE DEPARTMENT
WILL STILL NOT BE IN PLACE WHEN
GOVERNOR'S BUDGET COMES OUT, SO
YOU DO HAVE TO HAVE AN
ASSUMPTION OF DOLLARS AND WE DO
NEED TO FUND BASED ON CURRENT
STATUTE, THE RESPONSIBILITIES OF
THE COUNTIES WITHIN THAT STATUE.
AND SO OUR RECOMMENDATION WOULD
BE TO USE THE YOU KNOW
RECOMMENDATION THAT'S IN THE
BUDGET TO FUND IT. WE WILL HAVE
MORE INFORMATION AND DATA COME
FORWARD, WHETHER IN GOVERNOR'S
BUDGET OR MAY REVISE WHATEVER WE
HAVE WE USUALLY DISCLOSED
THROUGH OUR TWEAKED ASSUMPTIONS
AS WE DO WITH ANYTHING IN OUR
PROGRAM, WHERE IT'S BASED ON
ACTUAL UTILIZATION OF SERVICES.
UM AND WE WILL CONTINUE TO
EVALUATE THAT HAPPY TO REPORT
THAT OUT TO THE LEGISLATURE.
THERE IS EXTENSIVE REPORTING FOR
THE CARE ACT. GENERALLY IT DOES
COME LATER. AS YOU KNOW, UM AND
SO HAPPY TO ENGAGE WITH HOW WE
CAN KEEP PEOPLE INFORMED IN
REGARDS TO THE NUMBERS. I WOULD
JUST COST IN PEOPLE WITH WHERE
THE COAT WHEN THE COHORTS ARE
GOING LIVE, HOW MUCH DATA WE
WILL HAVE WHEN WE'RE PUTTING
TOGETHER THE BUDGET IN THE FALL
THAT THAT I WORRY BECAUSE OF THE
TIMING LAG OF THE REPORTING TO
US, BUT WE STILL NEED TO FUND
THE REQUIREMENTS FOR OUR COUNTY
PARTNERS, AND I THINK THAT'S
WHAT WE'RE TRYING TO UNDERSTAND
IF IT BY JANUARY'S BUDGET WILL
HAVE ENOUGH INFORMATION TO MAKE
MORE ACCURATE ASSUMPTIONS OR IF
THAT WILL COME LATER IN THE
SPRING OF NEXT YEAR, MADE
REVISION. I ANTICIPATE WE
PROBABLY KNOW MORE IN MAY
REVISION OF NEXT YEAR, BUT WITH
COHORT ONE GOING IN OCTOBER AND
DECEMBER IT TAKES THERE'S A LAG
FOR US TO GET CLAIMS. BETTER
UNDERSTAND? PIECES WILL BE
STAYING CLOSE WITH OUR COUNTY
PARTNERS IN THE COHORT ONE, OF
COURSE, AND WE ALWAYS DO. WHAT
WE CAN TO PROVIDE IS MOST
CURRENT INFORMATION AS POSSIBLE
TO THE LEGISLATURE AND EVEN
WITHIN THE ADMINISTRATION FOR
WHAT WE'RE PUTTING FORWARD AND
WE'RE COMMITTED TO THAT. FINAL
QUESTION FOR THIS PANEL WILL BE
ON CCS WHOLE CHILD MODEL YOU
MENTIONED THAT SHE HAD REMOVED
THEIR OPPOSITION. I'M TRYING TO
GET AN UNDERSTANDING TO WHAT
DEGREE THAT THIS HAS ADDRESSED
THE CONCERNS OF THE OPPOSITION
OVERALL, NOT JUST CHEER BACK OR
ARE THERE OTHER CAN YOU COMMENT
ON THAT? SURE. WE ACTUALLY
RECEIVED OUTREACH YESTERDAY
TODAY FROM SOME OF THE
CHILDREN'S HOSPITALS WANTING TO
DISCUSS ADDITIONAL PIECES WE'D
OFFERED A MEETING WILL BE
MEETING WITH THEM FRIDAY TO
BETTER UNDERSTAND ANY OF THEIR
CONCERNS AND HAPPY TO CONTINUE
TO HAVE CONVERSATIONS WITH THOSE
STAKEHOLDERS. I WAS IMPRESSED
WITH THE STAKEHOLDERS, UM,
PARTICIPATION IN OUR FIRST
MEETING, AND SO WE JUST
ENCOURAGE US TO FIGURE OUT HOW
TO GET ON TO AS MUCH OF THE SAME
PAGE AS WE CAN. WITH THAT I
WILL. THANKS VERY MUCH. THIS
PANEL. WE WILL NOW MOVE ON TO
FOUR G. 40 TO 65 DEPARTMENT OF
PUBLIC HEALTH.
GOOD MORNING, MR CHAIR MEMBERS.
BRANDON NEWNESS. DEPARTMENT OF
PUBLIC HEALTH CHIEF DEPUTY FOR
OPERATIONS. I'LL GO AHEAD AND
START WITH YOUR FIRST AGENDA
ITEM OF GIVING A HIGH LEVEL
OVERVIEW THAT MAY REVISION AND
THEN WE HAVE OUR TEAM TO DISCUSS
SOME DETAILS. BUT I'LL HIT ON
THOSE A LITTLE BIT AS WELL. SOME
OF THE OTHER BULLETS BUT OVERALL
FOR OUR DEPARTMENT OF PUBLIC
HEALTH, UM MAY REVISION HAS AN
ESTIMATE OF A TOTAL BUDGET OF
5.5 BILLION. ROUGHLY SLIGHTLY
HIGHER BY ABOUT 20 MILLION FROM
WHAT WE PROPOSE THE GOVERNOR'S
BUDGET. UM SOME SLIGHT CHANGES
IN GENERAL FUND TO THAT ROUGHLY
A REDUCTION OF $20 MILLION IN
GENERAL FUND OVERALL FOR OUR
BUDGET AS COMPARED TO GOVERNOR'S
BUDGET THAT'S SPLIT ROUGHLY
BETWEEN AGAIN 2 BILLION IN STATE
OPERATIONS AND ABOUT 3.5 BILLION
FOR OUR LOCAL ASSISTANCE. UM I
WOULD HIGHLIGHT A COUPLE OF
AREAS NOT A LOT OF CHANGES FOR
OUR DEPARTMENT AS IT RELATES TO
HIS COMPARISON TO GOVERNOR'S
BUDGET, BUT, UM, A COUPLE
NOTABLE CHANGES. UM ONE. THERE
WAS A LOT OF DISCUSSION IN LAST
SESSION ABOUT THE PUBLIC HEALTH
WORKFORCE DEVELOPMENT FUNDING.
UM THAT WE THE ADMINISTRATION
DID RESTORE THAT FUNDING OF 49.8
MILLION OVER FOUR YEARS. UM AND
THEN THERE'S A REDUCTION THAT WE
DID TAKE A $50 MILLION IN COVID
RESPONSE FUNDS AS THE COVERED
RESPONSE STARTS TO WIND DOWN, UM
WE WENT FROM 101 MILLION AT
GOVERNOR'S BUDGET TO 15 MILLION
. YOU MAY RECALL THAT OF THE
101,000,050 MILLION WAS IN A
CONTINGENCY RESERVE FUND. AND SO
IT'S THAT CONTINGENCY RESERVE
FUND THAT'S BEING TAKEN DOWN.
AND THEN AS PART OF A WAY TO
SOLVE THE BUDGET SITUATION, UM
ONE OF OUR SPECIAL FUNDS WILL
PROVIDE A LOAN TO THE GENERAL
FUND. OUR AIDS DRUG ASSISTANCE
PROGRAM ALREADY HAS A
SUBSTANTIAL RESERVE. WE'RE GOING
TO BE ABLE TO PROVIDE A LOAN TO
THE GENERAL FUND OF 400 MILLION.
WITH THAT ROUGHLY $500 MILLION
FUN BALANCE REMAINS IN THAT AIDS
DRUG ASSISTANCE PROGRAM. AND
THEN TO ROUND OUT OUR BUDGET. UM
THERE'S A NUMBER OF CHANGES THAT
WE USUALLY SEE IN MAY REVISION
FOR THINGS LIKE OUR TOBACCO TAX
REVENUE CHANGES FOR PROP 56 AND
99, AS WELL AS SOME UPDATES FOR
PRIMARILY CASELOAD AND COST PER
CASE RELATED TO OUR AIDS, DRUG
ASSISTANCE PROGRAM. WOMEN
INFANTS AND CHILDREN, GENETIC
DISEASE SCREENING AND LICENSING
AND CERTIFICATION. UM SO THOSE
ARE THE MAIN CHANGES. I DID
TOUCH A LITTLE BIT ON THE FIRST
COUPLE OF BULLET ITEMS RELATED
TO THE COVID RESPONSE REDUCTION
THAT IT DID COME FROM
CONTINGENCY FUND. AND THE FUN
BALANCE IN THE EIGHT APP
RESERVE. BUT WE DO HAVE OUR TEAM
TO KIND OF DISCUSS SOME OF THE
OTHER ITEMS, SO I'LL LEAVE IT
THERE FOR THE OVERVIEW AND TAKE
ANY QUESTIONS. YOU MAY HAVE.
LET'S WORK THROUGH THE ENTIRE,
UH, PRESENTATION. IF WE CAN
BEFORE WE GO TO FINANCE IN L. A
S, SO THE REST OF THE TEAM WANTS
TO COME FORWARD. WE'LL GO TO OUR
EMERGENCY PREPAREDNESS OFFICE
FIRST AND ALL ASKING AWESOME.
THANK YOU. GOOD MORNING, CHAIR
AND MEMBERS. MY NAME IS MELISSA
RLS. I'M THE ASSISTANT DEPUTY
DIRECTOR OF OUR CENTER FOR
PREPAREDNESS AND RESPONSE. UM SO
THEY MAY REVISE DID DID MAINTAIN
51.3 MILLION IN GENERAL FAN TO
CONTINUE THE STATE'S PUBLIC
HEALTH AND SAFETY RESPONSE
EFFORTS AGAINST COVID 19 TO
SUPPORT CALIFORNIA'S MOST MOST
VULNERABLE COMMUNITIES. THE
FUNDS WILL SUPPORT PRIORITY
PANDEMIC RESPONSE EFFORTS
THROUGH JUNE OF 2024, AND THIS
WILL INCLUDE FUNDING FOR
CONSULTANTS AND REDIRECTED STATE
STAFF. ACTIVITIES RELATED TO
COUNTY MONITORING, TESTING
STRATEGIES AND SUPPORT FOR CDP
HS COVID-19 WEBSITE AND PUBLIC
INFORMATION CAMPAIGN SERVICES.
WE WILL CONTINUE TO PURCHASE
TEST KITS FOR VULNERABLE
POPULATIONS THROUGHOUT THE YEAR.
AND WE WILL CONTINUE SERVICE
AGREEMENTS. WHERE WERE OUR
MEDICAL HEALTH COORDINATION
CENTER AND THE RECEIVING STAGING
STORING WAREHOUSE THAT PROVIDES
SPECIALIZED BUSINESS AND
TECHNICAL SERVICES TO SUPPORT
RESPONSE TO AND RECOVERY FROM
THE PANDEMIC. IN ADDITION TO
LEGAL SETTLEMENTS FOR COVID 19
RELATED LITIGATION, INCLUDING
CHALLENGES TO STATE PUBLIC
HEALTH ORDERS AND GUIDANCE. AND
CD PH WILL CONTINUE TO PROVIDE
GRANT INCENTIVE PROGRAMS THAT
SUPPORT PEDIATRIC PROVIDERS AND
ADMINISTERING VACCINES FOR
CHILDREN AGES 0 TO 5. WE WILL
CONTINUE SUPPORTING THE PROVIDER
CALL CENTER THAT WILL GIVE
SUPPORT TO PROVIDERS ENROLLED IN
THE MICALE VAX PROGRAM AND
PROGRAM MANAGEMENT AND
COMMUNICATION ACTIVITIES FOR L.
HDS AND PROVIDERS. AND FINALLY,
C D PH. WILL SUPPORT IT
INFRASTRUCTURE AND PROVIDE
CONTINUED SUPPORT FOR THE CARE
TO IMMUNIZATION REGISTRY SYSTEM.
AND THEN, AS YOU KNOW THEY MAY
REVISE ALSO REFLECTED THE
DECREASE OF $50 MILLION AND THAT
WAS FOR EMERGENCY CONTINGENCY
FUNDS TO USE IN OTHER AREAS OF
EXPENDITURE. THANK YOU. IS THAT
THE CONCLUSION OF THE
PRESENTATION ON ITEMS? I HAVE
JUST THE COVID RESPONSE WILL
LOOK THE DEPARTMENT OF FINANCE,
I THINK RELATED TO THE NEXT ITEM
FOR THE AIDS DRUG ASSISTANCE
PROGRAM. GREAT THANK YOU. THANK
YOU, MR CHAIR, SONAL PATEL FROM
THE DEPARTMENT OF FINANCE. THE
MAIN REVISION PROPOSES A LOAN OF
$400 MILLION FROM THE AIDS DRUG
ASSISTANCE REBATE PROGRAM FUND
TO THE GENERAL FUND PURSUANT TO
CONTROL SECTION 13.40 INCLUDED
IN THE GOVERNOR'S BUDGET. UM AS
MENTIONED THE ESTIMATED ENDING
FUND BALANCE FOR 2022 23 OF THE
MAJOR REVISION IS A LITTLE BIT
OVER 900 MILLION. AND THIS
BALANCE IS PROJECTED TO GROW TO
970 MILLION BY THE END OF 2023
24. HENCE THE ADMINISTRATION
DETERMINED THERE WAS A SIZABLE
BALANCE TO BORROW FROM, UM IN
RESPONSE TO THE SECOND QUESTION
, YOU KNOW, SEVERAL FACTORS WERE
TAKEN INTO ACCOUNT WHEN
CONSIDERING THE SIZE OF THE
LOAN. THE ADMINISTRATION'S GOAL
WAS TO MAXIMIZE USAGE OF THIS
WOMAN TO SUPPORT THE GENERAL
FUND. UM DEFICIT WITHOUT
NEGATIVELY IMPACTING
PROGRAMMATIC EXPENDITURES OF THE
EIGHT UP PROGRAM. WE ALSO CHECK
INTO ACCOUNT ANY POTENTIAL
FLUCTUATIONS IN TERMS OF AID UP
REBATE FUND AS A REBATE
PAYMENTS. AS WELL AS FEDERAL
TRUST FUNDS. FIRST BASED ON THE
CURRENT YEAR, ESTIMATED ENDING
FUND BALANCE. AS WE MENTIONED
THE PROPOSED LOAN REFLECTS LESS
THAN A 50% IMPACT ON THE FUNDS
RESERVE. SECOND HISTORICALLY,
REBATE REVENUE FOR THIS FUND HAS
FLUCTUATED BETWEEN ABOUT 204 100
MILLION AND PROJECTED REBATE
REVENUE FOR 2023 24 IS 340
MILLION. THUS THE REMAINING FUND
BALANCE WILL BE ABLE TO ABSORB
ANY FLUCTUATIONS IN RECEIVED
REBATES. SECOND THE MAYOR
REVISION PROJECTS THE FEDERAL
TRUST FUND EXPENDITURE AUTHORITY
OF A LITTLE BIT OVER 100 MILLION
. THE SIMILARLY IF WE DO SEE ANY
REDUCTIONS IN FEDERAL TRUST
FUNDS PROJECTED IN THE BUDGET
YEAR, THE REMAINING BALANCE OF
500 MILLION COULD ABSORB THAT
REDUCTION. AND THEN FINALLY, THE
CONTROL SECTION 13.40 PROVIDES A
SAFEGUARD IN THAT SHOULD THERE
BE A NEED A PROGRAMMATIC NEED
IDENTIFIED IN THE ADA AIDS DRUG
ASSISTANCE REBATE FUND. UM AND
I'LL REPAYMENT IS REQUIRED. THE
CONTROL SECTION AUTHORIZES
REPAYMENT SO TAKEN TOGETHER.
IT'S THE ADMINISTRATION'S
PERSPECTIVE THAT THESE VARIOUS,
UH CRITERIA IN DETERMINING THE
SIZE OF THE LOAN. UM, DO YOU, IN
FACT, SAFEGUARD THE LOAN FROM
ANY PROGRAMMATIC IMPACTS UPON
THE PROGRAM. NEXT WE HAVE A LEAD
PREVENTION, REPAIR AND PAINTING
PROGRAM UPDATE. GOOD MORNING. MY
NAME IS MARIA OCHOA, ONE OF THE
ASSISTANT DEPUTY DIRECTORS AND
THE CENTER FOR HEALTHY
COMMUNITIES, AND I BELIEVE THERE
WAS AN ERROR IN THE AGENDA AND
WE'RE ACTUALLY GOING TO BE
TALKING ABOUT SB 10 76. OKAY SO
THEY MAY REVISE REFLECTS AN
INCREASE OF TWO POSITIONS AND
$546,000 IN GENERAL FUND AND
FISCAL YEAR, 23 24 TO IMPLEMENT
THE RESIDENTIAL LEAD BASED
RENOVATION REPAIR AND PAINTING
PROGRAM AS MANDATED BY SENATE
BILL SB 10 76. THIS REQUEST IS
IN ADDITION TO THE FIRST
ADJUSTMENT AND THE GOVERNOR'S
BUDGET, WHICH INCLUDED A REQUEST
FOR ONE POSITION AND 615,000 IN
GENERAL FUND AUTHORITY IN FISCAL
YEAR 23 24. THE UPDATE A REQUEST
IN MAY REVISE WILL NOW REFLECT A
TOTAL INCREASE OF THREE
POSITIONS AND 1.2 MILLION
GENERAL FUND IN FISCAL YEAR 23
24 621,000 IN GENERAL FUND AND
FISCAL YEARS 2024 THROUGH 2027
AND A TOTAL OF 31 POSITIONS AND
5.1 MILLION FROM THE LEAD
RELATED CONSTRUCTION FUND. IN
FISCAL YEAR 27 28 AND ON GOING
TO IMPLEMENT THE RESIDENTIAL,
LEAD BASED PAINT, RENOVATION
REPAIR AND PAINTING PROGRAM.
THAT INCLUDED COSTS. THE COSTS
INCLUDE M INCLUDE COST TO
PROMULGATE REGULATIONS. WHEN THE
BCP WAS SUBMITTED AT THE
GOVERNOR'S BUDGET PROGRAM, PLAN
TO LEVERAGE AND BUILD NEW
FUNCTIONALITIES ON THE CURRENT
ONLINE LEAD RELATED CONSTRUCTION
LICENSING SYSTEM. SINCE THE
SUBMISSION CD. PHS CONDUCTED
FURTHER ANALYSIS AND HAS
DETERMINED THAT THE DEVELOPMENT
OF AN ONLINE CERTIFICATION
APPLICATION PLATFORM TO ISSUE
LED OUR OUR PEACE CERTIFICATES
AND MONITOR CERTIFICATION STATUS
WILL NEED TO UNDERGO THE PROJECT
APPROVAL. PROJECT APPROVAL
PROCESS DURING WHICH PROGRAM
NEEDS TO BE EVALUATED AND A
SOLUTION WILL BE DEVELOPED.
THEREFORE THE NEW ADJUSTMENT IN
THE MAY REVISE WAS NECESSARY TO
INCLUDE THE COST TO COVER YOUR
ONE AND TWO OF THE PAL PROCESS
TO IDENTIFY A SOLUTION FOR
DEVELOPMENT OF AN ONLINE
LICENSING APPLICATION SYSTEM TO
PROCESS AND TRACK THIS LARGE
VOLUME OF CERTIFICATIONS AND TO
MAKE PERMANENT TWO ADDITIONAL
POSITIONS. BECAUSE THE REGULATED
UNIVERSE CONTAINS OVER 40,000
INDIVIDUALS AND MORE THAN 5000
COMPANIES. C D PH CANNOT PROCESS
CERTIFICATION WITHOUT AN ONLINE
APPLICATION SYSTEM AND
IMPLEMENTATION WILL BE DELAYED
UNTIL A SOLUTION IS IDENTIFIED
DURING THE POWER PROCESS.
THEREFORE TRAILER BILL LANGUAGE
IS SUBMITTED TO ADDRESS SB 10 76
STATUTORILY REQUIRED
IMPLEMENTATION DATES THAT CANNOT
BE MET BY JULY 1 2023 FOR
EDUCATION AND OUTREACH AND
JANUARY 1 2024 FOR
CERTIFICATION. THE TRAILER BILL
WILL NOW EXTEND THE
IMPLEMENTATION DATES TO JULY. 1
2026 FOR EDUCATION AND OUTREACH
AND JULY 1 2027 FOR
CERTIFICATION. THE TRAILER BILL
WILL ALSO ADDRESS CONSISTENCY IN
TERMINOLOGY WITH EXISTING
STATUTES AND FEDERAL
REGULATIONS. THANK YOU. NEXT. WE
HAVE A PRESENTATION ON I T DATA
SCIENCE AND INFORMATICS
FRAMEWORK. YEAH. GOOD MORNING.
I'M JOHN RUSSELL, CHIEF
INFORMATION OFFICER OF CD PH. I
MAY HAVE YOU PULL THE MIC JUST A
LITTLE CLOSER. SURE. I SPEAK
QUIET. THANK YOU. CALIFORNIA
DEPARTMENT OF PUBLIC HEALTH
REQUEST THE RE APPROPRIATION OF
15.8 MILLION OF GENERAL FUND TO
CONTINUE PLANNING EFFORTS FOR
THE PUBLIC HEALTH INFORMATION
TECHNOLOGY, INFRASTRUCTURE AND
DATA ASSOCIATED WITH THE
CRITICAL FOUNDATIONAL ACTIVITIES
, AS DESCRIBED IN THE
INFORMATION TECHNOLOGY, DATA
SCIENCE AND INFORMATICS
FRAMEWORK FOR 21ST CENTURY
PUBLIC HEALTH SYSTEM. INCLUDING
URGENTLY NEEDED DOLLARS RELATED
TO DATA INITIATIVES, WHICH ARE
KEY ENABLERS FOR DATA SHARING
AND ANALYTICS, SUCH AS ASSESSING
THE CURRENT STATE OF OUR DATA
ECOSYSTEM. UNDERSTANDING STATE
AND FEDERAL DATA POLICIES AND
STANDARDS. AND STANDING UP
ENTERPRISE DATA GOVERNMENTS. THE
COMPONENTS OF THE 15.8 MILLION
INCLUDE DOCUMENTING DATA
SOURCES, OWNERS AND USERS ACROSS
CD PH RELATED TO SURVEILLANCE
LICENSING INVITED RECORDS.
ESTABLISHMENT OF ENTERPRISE
DATA, GOVERNANCE, DEFINING DATA
POLICY STANDARDS AND LIMITATIONS
ON USE ACROSS THE ECOSYSTEM.
DETERMINING PRIORITIES OF
ENTERPRISE DATA SETS AND
WORKSPACES. DEFINING CLOUD
MIGRATION CRITERIA. VIABILITY
MATRIX AND THE BEGINNING OF
CLOUD MIGRATIONS. DEVELOPED DATA
INTEGRATION STRATEGIES BASED ON
THE CALIFORNIA HEALTH AND HUMAN
SERVICES AGENCY DATA FRAMEWORK,
AND MAYBE 1 33 PRIORITIES. AND
DEFINE INTEROPERABILITY
IMPLEMENTATION ACTIVITIES ACROSS
THE ENTERPRISE. THANK YOU. THE
DEPARTMENT OF FINANCE. I WOULD
JUST ADD TO MR RESULTS.
COMMENTARY UM, AS THE COMMITTEE
MIGHT REMEMBER, THE SUBCOMMITTEE
MIGHT RECALL THIS LANGUAGE THAT
IS BEING PROPOSED WAS ALSO
INCLUDED IN LAST YEAR'S BUDGET.
UM THE 2022 23 BUDGET FOR THE
DEPARTMENT OF PUBLIC HEALTH WAS
NOT AUGMENTED BY THE 15.8
MILLION AH, THIS PROPOSAL SIMPLY
RECREATES THE SAME LANGUAGE AND
WOULD AUTHORIZE AN AUGMENTATION
OF 15.8 MILLION UP TO 15.8
MILLION SHOULD THE DEPARTMENT
MEET THE PLANNING MILESTONES
OUTLINED IN THE PROVISIONAL
LANGUAGE, BUT IT IS NOT
CURRENTLY IN THE DEPARTMENT'S
BUDGET. IT JUST AUTHORIZES AN
AUGMENTATION UP TO 15.8 MILLION.
ELIO. UM, YES. SO HAPPY TO TALK
ABOUT THE PROPOSALS REGARDING
THE COVID RESPONSE OF REDUCED
REDUCTION ON THE CONTINGENCY
FUNDING, WE FIND THAT REASONABLE
AND NO CONCERNS WITH THAT
PROPOSAL. IN ADDITION FOR THE
AIDS DRUG ASSISTANCE PROGRAM
ESTIMATE, WE FIND THAT THE
RESERVES AH SEEMS SUFFICIENTLY
LARGE AND WE HAVE NO CONCERNS
WITH THAT PROPOSAL CURRENTLY, UM
AND THEN JUST ON THE SP 10 76 AS
WELL AS THE INFORMATION
TECHNOLOGY LANGUAGE. WE RAISED
NO CONCERNS WITH THOSE EITHER.
BRING IT UP TO THE DIOCESE FOR
ANY MEMBERS, QUESTIONS. I'LL
KEEP IT HERE AT THE CHAIR JUST
FOR A SECOND. I LOVE INFORMATICS
. I SPENT PART OF MY TIME AS AN
E R DOCTOR STUDYING DATA TO
DETERMINE HOW WE CAN MAKE
IMPROVEMENTS TO OUR SYSTEM. AND
SO I SPENT PART OF YESTERDAY
DISCUSSING WITH CCS TÌM CONCERNS
THAT THEY HAVE ABOUT OUR CURRENT
DATA ECOSYSTEM THAT I'D LIKE TO
KNOW IF WE CAN WORK WITH THAT
STAKEHOLDER GROUPS SINCE THEY
HAVE A SUBCOMMITTEE FOCUSED ON
HOW TO MAKE IMPROVEMENTS SO THAT
WE COULD COORDINATE WITH THE
SCIENTISTS THAT WE HAVE ACROSS
OUR STATES TO MAKE IMPROVEMENTS
TO THE SYSTEMS THAT WE HAVE, AND
I'M ASKING FOR A STAKEHOLDER
STAKEHOLDER INVOLVEMENT ON THEIR
BEHALF SINCE I ENJOYED THE
CONVERSATION AND FELT THAT THEY
HAD A LOT TO ADD, UH, WE WOULD
BE VERY OPEN TO ANY STAKEHOLDERS
, ESPECIALLY, YOU KNOW THOSE IN
, UH, THE OUTLINING INSTEAD OF
JUST OUR LOCAL HEALTHCARE
JURISDICTIONS. I THINK IT'S
IMPORTANT TO GAIN ALL SORTS OF
INPUT THROUGH THIS SO WE CAN
CREATE A HOLISTIC SYSTEM THAT
MEETS EVERYBODY'S NEEDS SO
DEFINITELY WOULD BE OPEN TO THAT
. AS AN EXAMPLE, THEY HAD
RECOMMENDATIONS OUT OF THE
PUBLIC HEALTH WORKFORCE DOLLARS
THAT GOT REINSTATED. THAT WOULD
WE NEED MORE POPULATION HEALTH
MANAGERS DO WE NEED TO BE
FOCUSING CERTAIN AMOUNTS OF THAT
FUNDING TOWARDS THOSE WHO DO
LIKE AND FROM HEADACHES AND OUR
SPECIALISTS IN IT, AND SO I
WOULD ENCOURAGE THOSE
CONVERSATIONS AS I BELIEVE IT
WOULD ADD A LOT TO US AS A STATE
GOING FORWARD AND UM, WITH THAT
I WILL THANK VERY MUCH THIS
DEPARTMENT AND WE WILL MOVE ON
TO FOUR H 4300.
AS A REMINDER BEFORE WE BEGIN ON
THIS ITEM, WE ARE TAKING A
SCHEDULED BREAK AT NOON. AND SO
WE MAY NOT BE ABLE TO GET
THROUGH THIS ENTIRE PANEL, BUT I
JUST WANTED TO GIVE THAT
REMINDER AT THE OUTSET. THANK
YOU, MR. CHAIR, CARLA. JUST ANY
OTHER DEPARTMENT OF
DEVELOPMENTAL SERVICES. UM WE'LL
GO THROUGH THE ITEMS IN THE
AGENDA IN THE ORDER. THEY ARE.
GENERALLY THERE'S A NUMBER OF
LANGUAGE ITEMS THAT BOTH ADDRESS
OVERSIGHT ISSUES AS WELL AS
PROVIDE IMPROVED SERVICE, ACCESS
AND EQUITY AND A COUPLE OF ITEMS
RELATE TO PRIOR PROPOSALS.
YOU'VE HEARD SO THE FIRST ITEM
IS OUR PROVISIONAL ELIGIBILITY
PROPOSAL IN 2021 THIS PER IT WAS
ESTABLISHED FOR CHILDREN THREE
AND FOUR YEARS OLD. THE MAYOR
VISION PROPOSES TO EXPAND THAT
TO 0 TO 2 YEAR OLDS. UM, WHAT
THIS DOES IS IT WOULD PROVIDE 13
MILLION IN IN FEDERAL FUNDING
BEGINNING JANUARY. THAT WOULD BE
OUR ESTIMATE. UH, IN
CONVERSATIONS AS WE EXPLORE THE
OPPORTUNITY FOR FFT WITH THE
CENTERS FOR MEDICARE AND
MEDICAID SERVICES. UM, THEY
EXPRESSED SOME CONCERNS WITH
THAT BIFURCATION OF THE CHILDREN
FROM 0 TO 2 AND 3 TO 4. SO THE
LIKELIHOOD OF GETTING FEDERAL
FUNDING FOR JUST 3 TO 4 YEAR
OLDS AND NOT LIKELY BUT
EXPANDING THAT SHE ZERO TO WHAT
THAT EFFECTIVELY DOES IN OUR
BUDGET. UM THAT DOESN'T
NECESSARILY TRANSLATE TO MORE
CHILDREN IN OUR OVERALL SYSTEM.
AS THE ELIGIBILITY REQUIREMENTS
FOR EARLY START WHERE 0 TO 2
YEAR OLDS GENERALLY ARE, UM,
WOOD IS BROADER. SO UM, WE HAVE
A SLIGHT INCREASE IN OUR
PROJECTION OF THE CHILDREN IN
ATLANTA IN PROVISION
ELIGIBILITY, AND THAT'S ABOUT
1.1 MILLION. UM, IN THE TRAILER
BILL JUST EXPANDS THAT AGE
GROUP. THE NEXT ITEM IS OUR
COMMUNITY PLACEMENT PLAN
FUNDING. THESE ARE DOLLARS THAT
REMAIN FROM 2021 BUDGET YEAR. UM
THE DEPARTMENT ALLOCATES THOSE
FUNDS TO REGIONAL CENTERS BASED
ON THE REGIONAL CENTERS, ANNUAL
PLANS, UM WITH A NUMBER OF
CHALLENGES FROM THE RELATED TO
THE PANDEMIC, BOTH IN DELIVERY
OF ITEMS AND CONSTRUCTION
ACTIVITIES THAT ABOUT 10.8
MILLION REMAINS. AND THE
DEPARTMENT WAS ABLE TO WORK WITH
REGIONAL CENTERS AND IDENTIFY
APPROXIMATELY SIX PROJECTS WHERE
THESE DOLLARS COULD SUPPORT
NEARLY 100 UNITS OF HOUSING FOR
INDIVIDUALS WITH DEVELOPMENT
DISABILITIES. THE NEXT ITEM IS
FOR INDEPENDENT LIVING SERVICES
. RIGHT MODELS. UM THE MAIN
REVISION INCLUDES 15 MILLION
TOTAL FUNDS TO ASK THESE HOLD ON
JUST FOR A SECOND. I WANT TO
GIVE THE CHANCE TO COMMENT ON
SOME OF THESE AS WE'RE GOING
THROUGH SOLELY TO MAKE SURE THAT
WE FOCUS ON THEM SO I WILL ASK
DEPARTMENT OF FINANCE TO COMMENT
ON THE FIRST TWO AND THEN WE'LL
BRING IN ELIO. THANK YOU, MR
CHAIR CHRISTOPHER O'NEILL
DEPARTMENT OF FINANCE NOTHING
FURTHER TO ADD AT THIS TIME.
HELLO YES. GOOD MORNING, MR
CHAIR, AND MADAM, MR CHAIR AND
MEMBERS MARK NEWTON WITH THE
ELIO JUST ON THE ITEM THAT THE
DEPARTMENT WAS JUST MENTIONING
THE INDEPENDENT LIVING SERVICES
RAPED MODEL. UH UPDATE THAT OUR
OFFICE HAS DONE SEVERAL ANALYSES
OF ON THE RATE REFORM SORT OF
ISSUES, AND WE HAVE IDENTIFIED
THROUGH THE ORIGINAL RATE SET
FOR INDEPENDENT LIVING SERVICES
AS BEING INAPPROPRIATE GIVEN THE
SERVICES FUNDED AND THAT'S WE
THINK THE RATE FIX THAT IS
PROPOSED HERE IS CONSISTENT. THE
LEGISLATURE'S INTENT FOR DDS
RATE REFORM. GREAT THANK YOU.
WE'LL HAVE THE ADMINISTRATION
BEGIN WITH THE NEXT ONE. THANK
YOU. UM THE NEXT ITEM IS THE
COORDINATED FAMILY SUPPORT
SERVICES, AND THIS IS A PILOT
PROGRAM THAT WAS INCLUDED IN THE
HOME AND COMMUNITY BASED
SERVICES SPENDING PLAN. UM AS WE
EVALUATED THE PROGRAM AND BEGAN
IMPLEMENTATION, WE HAVE REVISED
THE ANNUAL ESTIMATE OF THE COSTS
. UM SO THE MIRROR VISION
INCLUDES GENERAL FUND AND
REIMBURSEMENT COMPONENT
BEGINNING IN JANUARY OF 2023.
AND WHAT EXTEND THE PROGRAM, THE
PILOT PROGRAM THROUGH THE END OF
THE BUDGET YEAR. UM I'M GONNA GO
BACK. I WANT TO MAKE SURE THAT
WE'RE ANSWERING THE QUESTIONS
THAT WE HAVE WITHIN THE AGENDA.
I BELIEVE UNDER THE COMMUNITY
PLACEMENT. THERE WERE QUESTIONS
AND UNDER ISLES S AS WELL. UM
HIS TRAILER BILL LANGUAGE
REQUIRED FOR THIS PROPOSAL. I'M
HOPING YOU CAN JUST ANSWER THE
QUESTIONS WE HAVE WITHIN THE
AGENDA AS YOU'RE GOING THROUGH
THE ITEMS, PLEASE, OF COURSE, SO
NO TRAILER BILL IS NEEDED FOR
THE ILLS PROPOSAL. UM WHAT THE
MODEL IS DOING IS UPDATING THE
CLASSIFICATIONS THAT ARE
INCLUDED IN THAT. COMMUNITY
PLACEMENT PLAN. UM, I THINK JUST
CONFIRMING THAT THERE WERE NO
REMAINING BALANCES. THANK YOU.
THAT'S VERY HELPFUL. JUST TRYING
TO MAKE SURE WE OKAY, WHEN WE
HAVE OUR OPPORTUNITY TO SEEK
ANSWERS THAT WE GET THEM.
ABSOLUTELY. THANK YOU. UH THE
NEXT ITEM IS THE ANNUAL FAMILY
PROGRAM FEE AND FAMILY COST
PARTICIPATION PROGRAMS. UM THE
CURRENT BUDGET HAS THE
DEPARTMENT EVALUATING THOSE FOR
POTENTIAL ADMINISTRATIVE
EFFICIENCIES AND COMPLIANCE
IMPROVEMENTS. UH THE DEPARTMENT
HELD A NUMBER OF STAKEHOLDER
DISCUSSIONS IN MARCH AND IS
FINALIZING THAT PLAN. WHAT THE
MAYOR VISION PROPOSALS IS TO
EXTEND THAT SUSPENSION THROUGH
DECEMBER. 2023 THIS PROVIDES
ADDITIONAL TIME FOR THE RAMP UP
AND IT'LL WHAT THE LANGUAGE WILL
PROVIDE. PROPOSED UM IS THAT
EXTENSION THROUGH 2023? SO THE
QUESTION ABOUT COULD THAT BE
EXTENDED FOR THE ENTIRE YEAR?
ANY SUSPENSION CHANGE WOULD BE
REQUIRED IN STATUTE. UM. AND IN
THE LANGUAGE WOULD ALSO INCLUDE
DIRECTOR OF AUTHORITY FOR THE
DEPARTMENT TO HELP IMPROVE THOSE
STREAMLINED PROCESSES. IT BEGS
THE QUESTION WHY WE DIDN'T THEN
DECIDE TO EXTEND IT FOR THE
ENTIRE BUDGET YEAR AND FOCUS
SOLELY ON THE CALENDAR YEAR AS
WE WON'T HAVE AN OPPORTUNITY TO
HAVE THAT DISCUSSION PRIOR TO
THE EXPIRATION OF THAT FAMILY
FEE. HOPING YOU CAN COMMENT ON
THAT. SURE. THANK YOU, MR CHAIR,
CHRISTOPHER O'NEILL DEPARTMENT
OF FINANCE. SO UM, AS MISS
CASTANEDA NOTED, UM, STAKEHOLDER
FEEDBACK HAS BEEN VERY
PRODUCTIVE AND WORK IN THE
ADMINISTRATION AND DDS WERE
COMMITTED TO ONGOING
CONVERSATIONS AROUND
IMPROVEMENTS TO BOTH PROGRAMS.
AFTER HAVING BEEN SUSPENDED FOR
OVER THREE YEARS. UM DURING
DURING THE PANDEMIC, AND GIVEN
CHANGES IN BOTH THE SIZE AND
REACH OF THE SYSTEM. DURING THAT
TIME, IT'S BEEN CHALLENGING TO
DETERMINE WHAT UM CERTAIN
STRATEGIES WOULD WOULD WOULD BE
APPROPRIATE GIVEN THE
INFORMATION. WE HAVE OUR
HISTORICAL TRENDS PRE PANDEMIC.
AND SO WE'RE PROPOSING THE
ADMINISTRATION IS PROPOSING
EXTENDING THE RELIEF THROUGH THE
END OF THE CALENDAR YEAR INSTEAD
OF THE FISCAL YEAR IN LINE WITH
, UM, THE CONCLUSION OF THE
GOVERNOR, STATE OF EMERGENCY,
THE FEDERAL PUBLIC HEALTH
EMERGENCY HAVING ENDED AND OTHER
PROGRAMS COMING BACK ONLINE IN
OTHER AREAS AS WELL AND AGAIN,
UM. AS PART OF THAT PROCESS AS
PART OF THE TRAILER TRAILER BILL
LANGUAGE THERE BE DIRECTED
AUTHORITIES SITE TO, UM, WHERE
APPROPRIATE TO STREAMLINE SOME
OF THOSE ADMINISTRATIVE UM,
ADMINISTRATIVE PROCESSES TO
ENHANCE CONSISTENCY OF
IMPLEMENTATION OF THE PROGRAMS
AND I THINK, JUST ON THE ON THE
FISCAL ASSOCIATED WITH US THE,
UM PRE PANDEMIC THE PROGRAM
BROUGHT IN APPROXIMATELY 900,000
TO $1.3 MILLION PER YEAR, SO
THERE IS A REVENUE IMPACT IN THE
LONG TERM, THE LONGER THAT THE
PROGRAMS ARE SUSPENDED, SO THAT
IS A CONSIDERATION. UM, BUT
WANTED TO FLAG THAT AT THE
MOMENT, THOUGH, THERE IS NO IS
THERE A COST ASSOCIATED WITH US
EXTENDING IT BEYOND DECEMBER OR
WE NEEDING TO SCHEDULE THAT INTO
OUR BUDGET, OR THESE ARE THESE
PROJECTED FEES THAT WE WOULD
RECEIVERS IN LIGHT OF IT, AND SO
I'M JUST TRYING TO FIGURE OUT IF
WE HAVE THAT FLEXIBILITY TO BE
ABLE TO EXTEND IT THE ENTIRE
BUDGET YEAR RATHER THAN THE
CALENDAR YEAR IF POSSIBLE, THE
MIRROR VISION REFLECTS THE
EXPENDITURE TRANSFER PROGRAMS
AND THESE FEES, BUT THE ANNUAL
FAMILY PROGRAM FREE WOULD
PROVIDE A REVENUE OFFSET SO
THAT'S NOT REFLECTED IN THE
CURRENT NUMBERS, SO THERE IS NO
COST THEN FOR US TO EXTEND THE
LONGER THE PROGRAMS WERE
SUSPENDED. THERE'S THERE IS A
REVENUE CONSIDERATION, UM, WITH
THE PHONE, WHICH WOULD TRANSLATE
THE PHONE IS PRIMARILY USED TO
OFFSET GENERAL FUND COSTS. SO
THE LONGER REVENUES HELD OFF
FROM GOING INTO THE FUND, BUT,
UM LONGER DOES BEFORE THOSE
SAVINGS ARE REALIZED. UNDERSTAND
WE'LL MOVE TO THE NEXT ITEM. THE
NEXT ITEM IS TRAILER BELL
LANGUAGE TO CLARIFY ACCESS TO
GENERIC RESOURCES. UM THIS THIS
CLARIFIES THAT REGIONAL CENTERS
HAVE THE AUTHORITY WHILE
INDIVIDUALS ARE PURSUING GENERIC
RESOURCES THROUGH THAT DENIAL
AND APPEALS PROCESS, IT DOES NOT
REMOVE THE LANGUAGE THAT HAS
THAT PROHIBITION. GENERALLY UM,
WE EXPECT THAT LANGUAGE TO BE
AVAILABLE LATER THIS WEEK. AND
CURRENTLY DON'T ANTICIPATE COSTS
RELATED TO THAT WHEN, WHEN THE
INITIAL, UM STATUTE HAD
CLARIFIED INDIVIDUALIZED FAMILY
SERVICE PLAN AUTHORITY FOR THIS
, UM, BUT WE DID NOT SEE
MEASURABLE COSTS IDENTIFIED MAY
ASK DUE TO THE TIMING OF IT.
HAVE WE BETTED THIS? UM,
PROPOSAL WITH STAKEHOLDERS HAVE
WE'VE DONE OUR DUE DILIGENCE AS
DUE TO THE LATENESS OF THE
PROPOSAL, HOPING YOU CAN PROVIDE
SOME COMMENTS ON IT. SURE IT
DOES. ADDRESS AN ISSUE THAT
WE'VE HEARD FROM A NUMBER OF
STAKEHOLDERS REGARDING
CONSISTENCY THAT THAT SOME
REGIONAL CENTERS CAN ARE DOING
THAT AND OTHERS HAVE CHOSEN NOT
TO PURSUE IT. ARE YOU GOING TO
HAVE AN OPPORTUNITY TO BET THIS
WITH STAKEHOLDERS AFTERWARDS
RELEASED TO UNDERSTAND IF THERE
ARE IMPROVEMENTS THAT CAN MAKE.
I'M JUST TRYING TO MAKE SURE WE
HAVE AN ITERATIVE PROCESS WITH
THIS PROPOSAL, SURE, AND THE
DEPARTMENT IS COMMITTED TO
ONGOING STAKEHOLDER ENGAGEMENT
ON MANY OF OUR PROPOSALS, SO
THOSE WILL ALWAYS BE
OPPORTUNITIES TO HEAR ANY
CONCERNS THAT WE'VE MISSED.
THANK YOU. WE CAN MOVE ON TO THE
NEXT ONE. THE NEXT ITEM IS, UM,
TRAILER BILL LANGUAGE FOR A
COMPLEX NEEDS RESIDENTIAL
PROGRAM. UM THIS PROPOSAL WAS
INCLUDED IN THE GOVERNOR'S
BUDGET FOR THE DEVELOPMENT IN
THE BUDGET YEAR. THE MULTIYEAR
PLAN INCLUDES THE RESOURCES FOR
THOSE OPERATIONS WHEN THE HOMES
ARE OPEN. UM THIS WAS LARGELY IN
RESPONSE TO STAKEHOLDER AND
LEGISLATIVE REQUESTS FOR
DOCUMENTS CODIFYING SOME OF
THOSE PROCEDURES. UM, THIS IS
MODELED AFTER THE CURRENT ACUTE
CRISIS PLANS AND HAS THAT
EXTENDED PERIOD THAT WE PROPOSED
AT GOVERNOR'S BUDGET OF 18
MONTHS. UM I THINK THAT NO
ADDITIONAL COST BEYOND WHAT WAS
PLANNED IN THE MULTIYEAR
QUESTION WITHIN THE AGENDA IS
WHEN WILL THE LANGUAGE BE
AVAILABLE FOR US? ANTICIPATED
THIS WEEK. SORRY. THURSDAY
FRIDAY, TRYING TO. IT WILL BE
BEFORE THE END OF THE WEEK. MR
CHAIR? YEAH. THANK YOU. TIME IS
OF THE ESSENCE AS WE'RE WORKING
ON THIS BUDGET. WE CAN MOVE ON
TO THE NEXT ITEM, PLEASE. THE
NEXT ITEM IS TRAILER BELL
LANGUAGE FOR THE PARENTAL
PARTICIPATION REQUIREMENT
CURRENTLY IN THE APPLIED
BEHAVIORAL ANALYSIS AND
INTENSIVE BEHAVIORAL
INTERVENTION STATUTES, UM IN THE
REGIONAL CENTER SYSTEM. THIS
LANGUAGE REQUIRES THAT PARENTAL
PARTICIPATION WHICH CAN DELAY
SERVICES FOR CHILDREN IN FOSTER
CARE, FOR EXAMPLE, BECAUSE THEIR
PARENTS MAY NOT BE AVAILABLE FOR
SOME OF THAT SERVICE. THIS IS
ALSO INCONSISTENT WITH MANAGED
CARE PLANS WHERE THAT PARENTAL
PARTICIPATION IS NOT REQUIRED TO
RECEIVE SERVICES. SO THE
LANGUAGE WOULD HAVE THAT, UM,
ENCOURAGING THAT PARENTAL
PARTICIPATION, BUT IT'S NO
LONGER A BARRIER. NEXT ONE,
PLEASE. THE NEXT ITEM IS A
STATUTORY LANGUAGE ADJUSTMENTS
TO EXTEND THE REMOTE SERVICES
REMOTE MEETINGS FOR
INDIVIDUALIZED FAMILY SERVICE
PLANS AND INDIVIDUAL PROGRAM
PLAN MEETINGS. UM DURING THE
PUBLIC HEALTH EMERGENCY, THIS
FLEXIBILITY WAS PROVIDED. UM,
BUT DEFINITELY VALUING THE
IMPORTANCE OF THAT THAT
ENGAGEMENT OF IN PERSON MEETINGS
AND BUILDING TRUST BETWEEN THE
SERVICE COORDINATOR AND THE
FAMILIES. WHERE MANY OF THESE
MEETINGS HAD TRADITIONALLY
OCCURRED IN THE FAMILY HOME. UM
WE WOULD JUST EXTEND THIS
THROUGH DECEMBER, SIMILAR TO
OTHER EXTENSIONS THAT WE'VE DONE
IN THE IN THE RECENT MONTHS. UM
SOMETHING WE'VE HEARD FROM
STAKEHOLDERS HAS BEEN HAVING
THAT ADDITIONAL SUPPORT FOR OUR
FAMILY AT THOSE MEETINGS. UM
STATUTORY LANGUAGE IS NOT
PROHIBIT THAT PARTICIPATION IF
THEY CHOSE TO PARTICIPATE WITH
BOWLING. HMM GOING TO ASK THE
SAME QUESTION REGARDING WHETHER
THIS EXTENSION COULD BE MADE
THROUGH THE ENTIRE 23 24 FISCAL
YEAR RATHER THAN ENDING IN
DECEMBER. ARE THERE ANY
LIMITATIONS FROM US BEING ABLE
TO DO THAT? ANY EXTENSION WOULD
REQUIRE STATUTORY CHANGES. UM NO
. NO PROHIBITIONS JUST AGAIN,
REITERATING THAT THE VALUE OF
THOSE IN PERSON MEETINGS PETS AT
NO COST. I WOULD JUST ENCOURAGE
US TO PROVIDE THOSE
FLEXIBILITIES AS WE'RE GOING
FORWARD. WE CAN MOVE ON TO THE
NEXT ONE. OKAY THE NEXT ITEM IS
THE RIGHT STUDY UPDATE FOR THE
FAMILY HOME AGENCY. THIS IS
TRAILER, BRO LANGUAGE CORRECTING
THE AUTHORITY FOR PERMITTING
RATES FOR THE FAMILY HOME
AGENCIES THAT WOULD BE
CONSISTENT WITH FOUR BED ADULT
RESIDENTIAL MODEL FACILITIES.
THIS IS ONE OF THE MARK LISTS OF
RESIDENTIAL MODELS, SO THIS JUST
ALLOWS THAT TO HAVE A MORE
SUSTAINABLE RATE. HOLD MY
QUESTION ON THAT ONE UNTIL WE'VE
CONCLUDED THE PANEL. THEN THE
NEXT ITEM. UM THIS WOULD BE ITS
STATUTORY LANGUAGE EXPANDING
PARTICIPANT DIRECTED SERVICES TO
INCLUDE SOCIAL RECREATION AND
CAMPING SERVICES DURING THE
PUBLIC HEALTH EMERGENCY. THERE
WERE A FEW ADDITIONAL SERVICES
THAT WERE EXPANDED AND THEN
LATER ON, ADDED TO REGULATORY
AUTHORITY. UM IN OUR RECENT
EXPERIENCE WITH SOCIAL
RECREATION IN CAMPING SERVICES.
RESTARTING THAT HAS BEEN A
CHALLENGE FOR SOME REGIONAL
CENTERS, BUT THEN ALSO SOME OF
THE MORE INCLUSIVE COMMUNITY
ACTIVITIES IN OTHER SYSTEMS HAVE
NOT BEEN AVAILABLE BECAUSE OF
THE VENDOR IZATION PROCESS. SOME
OF THOSE OTHER ACTIVITIES, UM,
HAVING THIS AS A PARTICIPANT
DIRECTED SERVICE WOULD BOTH
EXPAND THE OPPORTUNITIES FOR
INDIVIDUALS. BUT THEN THAT ALSO
ALLOWS THOSE OTHER SERVICES TO
BE ELIGIBLE FOR FEDERAL FUNDING.
LET'S MOVE ON TO OUR FINAL TWO
ITEMS, AND THEN WE'LL BRING IN
FINANCE AND ELIO. THANK YOU. UM
THE NEXT ITEM IS TRADABLE
LANGUAGE TO IMPROVE THE
DEPARTMENT'S REGIONAL CENTER
OVERSIGHT AUTHORITY. QUESTION WE
RECEIVED MANY TIMES WAS WHAT THE
DEPARTMENT HAS AUTHORITY TO
ENFORCE. UM THIS WOULD BE THE
ABILITY TO ESTABLISH STATEWIDE
STANDARDS. FOR THE INTAKE
PROCESS FOR ELIGIBILITY
DETERMINATIONS. UM FOR COMMUNITY
ENGAGEMENT, OF COURSE, HEARING
HOW INDIVIDUALS INTERACT WITH
THE SYSTEM AND THEN ALSO FOR
THAT VENDOR IZATION PROCESS TO
HELP MAKE THAT MORE CONSISTENT
BECAUSE THAT HAS BEEN A
CHALLENGE FOR SOME PROVIDERS. UM
. MAKE SURE THAT MISS A QUESTION
ON THAT ONE. AND THEN THE LAST
ITEM IS TRAILER BILL LANGUAGE
THAT'S RELATED TO AN APRIL
SPRING FINANCE LETTER, UM FOR
THE DEPARTMENT OF STATE
HOSPITALS. CURRENTLY THE
DEPARTMENT OF DEVELOPMENTAL
SERVICES AND THE DEPARTMENT OF
STATE HOSPITALS COORDINATE SOME
OF THIS TRANSITION TRANSFER OF
FUNDS. UM, THIS LANGUAGE, UM.
REMOVED CHANGES THAT TO THE
DEPARTMENT OF STATE HOSPITALS
AUTHORITY FOR THEIR THEIR
INDIVIDUALS THAT ARE IN
COMMUNITY SCHOOL PROGRAMS, AND
THAT IT ALSO INCLUDES ADDITIONAL
CHANGES THAT COOK EXPLAINED THE
CURRENT PROCESSES FOR THE
REIMBURSEMENTS OF THE COUNTY
OFFICE OF EDUCATION. DEPARTMENT
OF FINANCE. CHRISTOPHER NEIL
DEPARTMENT OF FINANCE. NOTHING
FURTHER TO ADD AT THIS TIME, MR.
CHAIR MR. CHAIR MEMBERS MARK
NEWTON ELIO, JUST COMMENTING ON
BRIEFLY ON THE FIRST OF THE LAST
GROUP OF ITEMS, THE COORDINATED
FAMILY SUPPORT SERVICES. UM THIS
IS ONE OF THE FEW GENERAL FUND
AUGMENTATIONS THAT YOU COULD
CONSIDER THAT DISCRETIONARY IN
THE IN THE DEPARTMENT'S BUDGET.
OUR OFFICE HAS A GENERAL VIEW
THAT, UM DISCRETIONARY GENERAL
PHENOMENA, NATIONS OR SUBJECT TO
A VERY HIGH BAR IN APPROVAL AND
WOULD WE HAVE A GENERAL
RECOMMENDATION OF REJECTION? UM,
WITHOUT PREJUDICE. WE DO NOTE ON
THIS ITEM. THE DEPARTMENT
ARTICULATED A LITTLE EARLIER
THIS MORNING THAT THIS GENERAL
FUND AUGMENTATION IS THE RESULT
OF A VERY COMPLICATED SERIES OF
FUNDING SWAPS. THAT UH UM WERE
DESIGNED TO LEVERAGE SORT OF
FEDERAL FUNDING UNDER THE
AMERICAN RESCUE PLAN ACTS SO
THAT WOULD GIVE US SORT OF PAUSE
FOR UH, REJECTION OF THIS
PROPOSAL. BRING IT UP TO THE
DIASPORA MEMBERS. QUESTIONS WILL
BEGIN WITH DR JACKSON. I JUST
WANT TO REITERATE THE IMPORTANCE
OF HAVING REMOTE, UM,
PARTICIPATION AND THE INDIVIDUAL
FAMILY SERVICE PLANS AND THE
INDIVIDUAL PROGRAM PLAN. UM
OBVIOUSLY AND MANY CASES AS A
SOCIAL WORKER, YOU'RE RIGHT. UM
EVEN THOUGH THAT PERSON MIGHT BE
PREFERRED, THAT DOESN'T MEAN
THAT IT'S UNIVERSALLY. BEST FOR
EVERY CLIENT RIGHT? SO HAVING
THAT ABILITY TO PROVIDE REMOTE
SO THEY CAN HAVE ADDITIONAL
ASSISTANCE. HOW TO MAKING SURE
THAT THE RIGHT QUESTIONS ARE
BEING ASKED, MAKING SURE THAT
PEOPLE UNDERSTAND THE TECHNICAL
LINGO AND ABOUT THE VARIOUS
SERVICES RIGHT? CAN BE ALSO
CRITICAL AND MAKING SURE THAT A
FAMILY AND INDIVIDUAL GETS WHAT
THEY NEED. UM ARE ARE YOU SAYING
THAT IN ORDER TO, UM CONTINUE TO
EXPAND, UM. THE AVAILABILITY OF
REMOTE THAT THIS NEEDS TO BE
DONE STATUTORILY THAT CAN'T BE
DONE IN A TRAILER BILL. THE
CURRENT STATUTE EXPIRES AND JUNE
30TH SO TO EXTEND THAT WOULD
NEED ADDITIONAL CHANGES. AND WE
CAN'T DO THAT IN A TRAILER BILL
. IT CAN BE DONE IN TRAILER
BILLS, OKAY? OKAY WELL, I WOULD
URGE US TO MAKING SURE THAT WE
MAKE THOSE CHANGES WITHIN THE
TRAILER BILL SO THAT WE CAN MAKE
SURE THAT WE DO THAT, UM I'VE
HEARD IT IN MY DISTRICT AS WELL.
JUST HOW CRITICAL THIS IS, UM
AND WE DEFINITELY WANT TO MAKE
SURE THAT WE, UH AH, THAT WE
KEEP THIS AVAILABLE. THANK YOU.
I'LL BEGIN IF I CAN APPRECIATING
THE ADMINISTRATION, INCLUDING
THE FIX TO THE AISLES RATES
WITHIN THE MAY REVISION. THAT
WAS AN IMPORTANT PART OF THE
CONVERSATION THAT WE HAD THROUGH
THE SUBCOMMITTEE PROCESS AND
APPRECIATE THE ADMINISTRATION
BEING AMENABLE TO THAT AFFECTS.
I'M GONNA FOCUS ON THE RATE
STUDY UPDATE IF WE CAN, AS THERE
WASN'T NO COST PROPOSAL
REGARDING A BASELINE RATE FIXED
THAT I'M WANTING TO DIG IN A
LITTLE BIT MORE ON HOW DO WE
ASSURE THAT RATES DON'T DECREASE
TO LEVELS THAT EXISTED PRIOR TO
THE IMPLEMENTATION OF THESE RAPE
MODELS? AND ARE WE ABLE TO
CREATE THAT BASELINE RATE FIX?
AS MANY OF US IN THE LEGISLATURE
ARE HESITANT OR CONCERNED ABOUT
POTENTIAL CUTS THAT MAY COME IF
WE DON'T CREATE THAT BASELINE
RATE FIX, HOPING YOU CAN COMMENT
ON THAT. I MAY NEED THE
QUESTION. REPHRASE. I'M NOT SURE
I UNDERSTAND THAT. IT'S THE 90
10 SPLIT THAT YOU GET AND
PROVIDERS THAT GETS STARTED NEXT
YEAR AND THAT THE 10% REDUCTION
WOULD THEN LEAD TOWARDS A
DECREASE IN THEIR RATES AND
REIMBURSEMENT AND WOULD BE A
PENALTY THAT, UM IT THERE'S A
RISK IN HARM, SO I'M HOPING WE
CAN COMMENT ON WHETHER OR NOT WE
ARE WILLING TO ACCEPT A BASELINE
RATE FIX THAT WOULDN'T CREATE
THAT, BUT HOPING TO HEAR MORE
FROM THE ADMINISTRATION, THANK
YOU FOR THE CLARIFICATION AND WE
ARE OPEN TO MORE DISCUSSIONS OF
THE ISSUE BECAUSE WE HAVE MET
WITH STAKEHOLDERS. SHE TRIED TO.
I IDENTIFY WHAT SUM UP WHAT
OPTIONS MAY BE AVAILABLE AND
SOMETHING WE HAVE BEEN LOOKING
AT. OF COURSE, AS EVEN SOME OF
THE STAKEHOLDER SHIP PROVIDED IS
BEING AWARE OF WHAT SOME OF
THOSE, UM, OPTIONS FOR
INCENTIVES ARE THAT MAY ADDRESS
THAT CONCERN. UM BUT STILL
LOOKING AT WHAT? THAT 90 BASIS.
SO, UM, OPEN TO MORE
CONVERSATION. FINANCE ANY
COMMENTS THAT YOU MAY HAVE ANY
LIMITATIONS, AND THAT'S CREATING
THAT BASELINE RATE FIX OR IS THE
INTENT FOR US TO POTENTIALLY
REDUCED SPECIFIC RATES? UM,
THANK YOU, MR CHAIR. UM WE? WE,
UM. I THINK WE WE'VE BEEN. WE'VE
BEEN MEETING WITH THE DEPARTMENT
ON ON ON THIS ISSUE, AND I THINK
WE WOULD NEED TO CIRCLE BACK
WITH YOU ON THE PARTICULARS. I
WOULD APPRECIATE IT AND, UM,
WOULD JUST STAYED. WE HAVE BEEN
WANTING TO WORK ON THIS FOR A
WHILE AND WE'LL SAY IT IS A
PRIORITY FOR THE LEGISLATURE
THAT WERE BEING ADDITIVE AND NOT
SUBTRACTING TO THE SYSTEM
OVERALL AND BELIEF. IT'S BETTER
FOR US TO USE A CARROT WITH THIS
APPROACH. AND SO WE JUST
ENCOURAGE JUST TO HAVE THOSE
NECESSARY CONVERSATIONS ALL TURN
MY NEXT QUESTION TO SOCIAL WRECK
AND CAMP SERVICES HAVE BEEN A
BIG FAN OF THIS FOR A WHILE AND
WANT TO KNOW HOW WE CAN PROMOTE
EQUAL ACCESS. TO THESE SERVICES.
UM ARE THERE ANY CHANGES THAT WE
CAN MAKE THAT WILL HELP THESE
REGIONAL CENTERS AS WE'RE
PROVIDING MORE STANDARDIZATION
ACROSS THE REGIONAL CENTERS THAT
WOULD ALLOW BETTER UPTAKE OF
THIS PROGRAM SPECIFICALLY ME TO
GO? YEAH BRIAN WOULDN'T FILLED
WITH DDS. THANK YOU FOR THE
QUESTION. WE HAVE BEEN WORKING
WITH REGIONAL CENTERS AND
LISTENING TO STAKEHOLDERS SINCE
SOCIAL REC HAS BEEN RESTORED.
ALL OF THE REGIONAL CENTERS HAVE
OUTREACH PLANS AND WAYS THAT
THEY'RE HELPING THEIR
COMMUNITIES TO ACCESS TO
SERVICES. THE DEPARTMENT IS ALSO
CONTINUING TO EXPLORE WAYS THAT
WE CAN HELP INDIVIDUALS TO
ACCESS SOCIAL REX SERVICES TO
INCLUDE THE PARTICIPANT DIRECTED
SERVICES. IS WHERE FAMILIES CAN
HAVE SOMEONE THAT THEY TRUST WHO
CAN ASSIST. THEY'RE AN
INDIVIDUAL TO ACCESS THESE
SERVICES. AND WE RECENTLY
GRANTED $10 MILLION IN FUNDS FOR
DIFFERENT PROJECTS TO MAKE
ACCESS TO SOCIAL SERVICES TO
INCLUDE LOCAL Y M C. A S AND
CITY PARKS AND REC AND DIFFERENT
PROGRAMS LIKE THAT, SO I BELIEVE
THAT THAT'S GOING TO GO A LONG
WAYS. UM WE'RE ALSO BRINGING IN
REGIONAL CENTERS TOGETHER TO
TALK THROUGH BEST PRACTICES IN
THE AREA OF HOW ARE THEY
REACHING UNDERSERVED COMMUNITIES
? HOW ARE THEY REALLY ENSURING
THAT THEY ARE BEING AS
CONSISTENT AS POSSIBLE
THROUGHOUT THE STATE AND MAKING
SURE THAT PEOPLE HAVE ACCESS, SO
THERE'S A NUMBER OF THINGS WE
HAVE DONE AND ARE CONTINUING TO
DO AND WILL CONTINUE TO LISTEN
TO STAKEHOLDER INPUT TO MAKE
ACCESS BETTER. YEAH I WOULD JUST
ENCOURAGE US SINCE WE KNOW WE
HAVE DISPARITIES AND POS FUNDING
THAT THIS IS A REAL OPPORTUNITY
FOR US TO ADDRESS SOME OF THOSE
INEQUITIES AND TO ENCOURAGE
POPULATIONS TO PARTICIPATE AS
WE'RE GOING FORWARD. IF WE ARE
INTENTIONAL ABOUT HOW WE SPEND
THOSE RESOURCES UM DO YOU WANT
TO UPLIFT THE LITTLE HOOVER
COMMISSION'S RECOMMENDATIONS WE
HEARD DURING MAY REVISION ABOUT
THE NEED FOR STATEWIDE STANDARDS
AND SPECIFICALLY TO FOCUS ON THE
INTAKE PROCESS AND APPRECIATIVE
OF THE TBL THAT WE RECEIVED. AS
I BELIEVE IT ALLOWS US TO
ADDRESS SOME OF THOSE INITIAL
CONCERNS THAT WE HAD WITH THAT
AND SEEING NO FURTHER QUESTIONS
FROM THE DIETS. WE WILL
CONCLUDE. I WILL ASK ONE LAST
QUESTION. SORRY WE DIDN'T HAVE
CORE STAFFING FORMULA PRESENTED
TO US. DESPITE US ASKING
MULTIPLE TIMES FOR US TO ADDRESS
THIS ISSUE, AND I'M TRYING TO
UNDERSTAND WHY THIS REMAINS
UNADDRESSED AND WHY WE HAVEN'T
UM, BEEN ABLE TO PROVIDE THAT
INFORMATION TO THE LEGISLATURE.
THANK YOU FOR THAT, UM, WE HAVE
BEEN WORKING WITH ARCA AND
EVALUATING THAT AND IT REALLY
TURNED OUT TO BE MORE
COMPLICATED THAN ANY OF US.
THOUGHT SO, UM, ARE YOU HAD
SHARED THEIR METHODOLOGY AND
FORMULAS. WE HAVE GONE BACK AND
FORTH AND IDENTIFIED POLICIES
THAT WERE INCLUDED OR EXCLUDED.
SO WE'RE CONTINUING THAT EFFORT,
BUT WE HAVEN'T WRAPPED IT UP.
YEAH. UM. IT HAS BEEN A MULTI
YEAR PROCESS FOR US TO GET HERE,
SO I HOPE WE CAN COME TO SOME
CONCLUSION RAPIDLY SO WE CAN
ADDRESS IT WITHIN THE NEXT
BUDGET YEAR. WITH THAT I WILL.
THANKS VERY MUCH. THIS ENTIRE
PANEL AND WE WILL TAKE OUR
SCHEDULED RECESS NOW UNTIL ONE
PM WE ARE ON RECESS.
SECURE BED CAPACITY PROJECT. THE
DEPARTMENT STATE HOSPITAL
REFLECTS AN ADDITIONAL ONE TIME
SAVINGS OF 3.9 MILLION GENERAL
FUND AND 2022 23, BRINGING THE
TOTAL ONE TIME SAVINGS TO 15.1
MILLION AT THE AT THE MAY
REVISION. AT THE GOVERNOR'S
BUDGET. WE REPORTED THAT THE
PROJECT WAS COMPLETED AND TWO
UNITS WERE ACTIVATED TO SERVE
ADDITIONAL AND COMPETENT TO
STAND. TRIAL PATIENTS AND THREE
UNITS WERE DELAYED BECAUSE THEY
WERE BEING USED FOR EITHER COVID
19 ISOLATION SPACE AND TO
PROVIDE TREATMENT FOR TSH
METROPOLITAN SKILLED NURSING
FACILITY PATIENT POPULATION AS
THAT BUILDING IS UNDERGOING A
ROOF REPLACEMENT AND BUILDING
REPAIRS THAT'S ANTICIPATED TO BE
COMPLETE IN JULY, 2023.
PROVIDING A QUICK UPDATE ON THE
ENHANCED TREATMENT PROGRAM. THE
DEPARTMENT IS REPORTING AN
ADDITIONAL ONE TIME SAVINGS OF
3.2 MILLION GENERAL FUND IN 2023
24. IN ADDITION TO THE 4.8
MILLION REPORTED AT THE
GOVERNOR'S BUDGET, AND THIS IS
ASSOCIATED WITH AN ACTIVATION
DELAY AT TSH PATTERNS PROGRAM
DUE TO CONSIDER UPDATING THE
CONSTRUCTION SCHEDULE. AT THE
GOVERNOR'S BUDGET. THE
DEPARTMENT DID REPORT THAT THE
ATASCADERO 13 BED UNIT WAS
ACTIVATED IN SERVING PATIENTS
WHO ARE AT THE HIGHEST RISK OF
VIOLENCE WITHIN OUR SYSTEM OF
CARE. FOR A MISSION BASED REVIEW
INITIATIVES COVERING DIRECT CARE
, NURSING PROTECTIVE SERVICES
AND TREATMENT TEAM AND PRIMARY
CARE AT THE MAY REVISION. YES,
IT REFLECTS AN ADDITIONAL
SAVINGS IN THE CURRENT EUROPE.
$1 MILLION FOR DIRECT CARE.
NURSING 4.8 MILLION FOR
PROTECTIVE SERVICES AND 3.9
MILLION FOR TREATMENT TEAM AND
PRIMARY CARE COMPONENT. THE
SAVINGS REPORTED ARE DUE TO
DELAYS AND CHALLENGES
EXPERIENCED WITH HIRING THE NEW
POSITIONS THAT WERE AUTHORIZED
IN THE BUDGET. THREE MORE ISSUES
ON THE OVERVIEW, PATIENT DRIVEN
OPERATING EXPENSES AND EQUIPMENT
. THE DEPARTMENT REQUESTS AN
ADDITIONAL 2.5 MILLION IN THE
CURRENT YEAR AND 6.1 MILLION IN
THE BUDGET YEAR AND ONGOING TO
SUPPORT THE INCREASE IN PATIENT
DRIVEN SUPPORT COSTS WITHIN THE
DSHS SYSTEM. THIS INCLUDES, BUT
NOT LIMITED TO PATIENT CLOTHING,
LAUNDRY, PERSONAL SUPPLIES,
MEDICATION OUTSIDE MEDICAL
EXPENSES. THE ADDITIONAL FUNDING
THAT MAY REVISION REFLECTS THE
PROJECTED INCREASE IN CENSUS IN
THE CURRENT YEAR AND THE BUDGET
HERE. FOR D S H COOLING IS
INTERMEDIATE CARE FACILITY UNIT
CONVERSION SET REFLECTS AT ONE
TIME SAVINGS OF 2.9 MILLION IN
THE CURRENT YEAR FOR PERSONAL
SERVICES ASSOCIATED WITH A TWO
MONTH ACTIVATION DELAY FOR
CONVERTING A RESIDENTIAL
RECOVERY UNIT TO AN IMMEDIATE
CARE FACILITY UNIT DUE TO FIRE
SUPPRESSION SYSTEM REPAIRS. LAST
UPDATE AS IT RELATES TO OUR
CASELOAD ADJUSTMENTS, REFLECTING
A ONE TIME DECREASE AT 13.5
MILLION IN THE CURRENT YEAR DUE
TO ACTIVATION ADJUSTMENTS FOR
THE STEP DOWN TRANSITIONAL
PROGRAMS IN THE CONDITIONAL
RELEASE PROGRAM. THAT CONCLUDES
THE FIRST BULLET POINT, BUT
HAPPY TO MOVE ON, IF SURE.
SPEAKING TO THE SECOND BULLET
POINT NOTED, AND THEN IN THE
AGENDA AS OF THE 2023 24 MAY
REVISION TSH REQUESTS TO
DECREASE ITS GOVERNOR. BUDGET
REQUEST FOR THIS ITEM BY 9.2
MILLION IN 2023 24 1 TIME IN
19.7 IN THE CURRENT YEAR TO
REFLECT ADJUSTMENTS IN COVID 19
INFECTION, CONTROL MEASURES AND
PRACTICES BASED ON CHANGES IN
PROTOCOL FROM CD PH AND THE CDC.
SOME OF THE COVID 19 INFECTION
CONTROL MEASURES AND PRACTICES
THAT WERE NEEDED AND INITIALLY
IN THE PANDEMIC HAVE SINCE BEEN
MODIFIED, WHICH REFLECTS
COMMENSURATE ADJUSTMENT AND OUR
PRACTICES IN THE RESOURCES
REQUIRED TO MAINTAIN INFECTION
CONTROL MEASURES. FOR EXAMPLE,
TSH HAS TRANSITIONED AWAY FROM
SHIFTING FROM THE USE OF
ADMISSION OBSERVATION UNITS,
WHICH SERVED AS A COHORT
ADMISSIONS PROCESS. THAT WE
UTILIZED EARLY IN THE PANDEMIC,
AND WE'VE NOW SHIFTED BACK TO
DIRECT ADMISSION PROCESSES THAT
ALLOW FOR D S H TWO MORE QUICKLY
ADMIT AND GAIN CENSUS WHILE
STILL MAINTAINING SOME INFECTION
CONTROL MEASURES SUCH AS TESTING
UPON ADMISSION, HOWEVER, TSH
DOES STILL NEED TO KEEP SOME
UNITS AVAILABLE AT EACH FACILITY
FOR ISOLATION SPACE THAT WILL
CONTINUE TO IMPACT SENSES SO
LONG AS A GUIDANCE CONTINUES TO
REQUIRE ISOLATION UPON POSITIVE
CASES. OVERALL THE RESOURCES ARE
NEEDED TO CONTINUE TO SUPPORT
TESTING SEARCH CAPACITY, PUBLIC
HEALTH RELATED PERSONNEL AND PPE
INDEPENDENT OF THE END OF THE
STATE OF EMERGENCY IN OUR
CONGREGATE CARE FACILITIES AS
INFECTION CONTROL MEASURES, SUCH
AS ISOLATION ARE STILL REQUIRED
. THAT CONCLUDES THE FIRST TWO
ISSUES NOW HAND IT OVER TO MY
COLLEAGUE FOR THE THIRD BULLET
POINT. HI CHRIS EDEN'S CHIEF
DEPUTY DIRECTOR FOR PROGRAM
SERVICES. I'LL TAKE ISSUE NUMBER
THREE ON THE INCOMPETENT TO
STAND TRIAL SOLUTIONS RE
APPROPRIATIONS. UM AS OF THE MAY
REVISION, THE DEPARTMENT OF
STATE HOSPITALS PROPOSES SEVERAL
ADJUSTMENTS TO OUR IST SOLUTIONS
RELATED FUNDING, INCLUDING A RE
APPROPRIATION OF UP TO 24
MILLION IN SUPPORT OF THE FELONY
MENTAL HEALTH DIVERSION PILOT
PROGRAM THAT WAS ORIGINALLY
PROPOSED OR ORIGINALLY
APPROPRIATED IN THE 2018 BUDGET
ACT. THIS WILL ALLOW OUR
COUNTY'S ADDITIONAL TIME TO
EXPEND THE REMAINING BALANCE OF
THEIR PILOT DIVERSION PROGRAM
FUNDING AND TO MEET THEIR
CONTRACT ID NUMBER OF
INDIVIDUALS TO BE DIVERTED.
ADDITIONALLY THE INCOMPETENT FOR
INCOMPETENT TO STAND TRIAL
SOLUTIONS A RE APPROPRIATION OF
UP TO 100 MILLION FROM THE 2021
BUDGET ACT AND 107 MILLION FROM
THE 2022 BUDGET ACT OR REQUESTED
TO SUPPORT UPDATED
IMPLEMENTATION TIMELINES ACROSS
ISTEA RELATED PRO PROGRAMMING,
INCLUDING COMMUNITY INPATIENT
FACILITIES. COMMUNITY BASED
RESTORATION, PERMANENT DIVERSION
PROGRAMS, EARLY ACCESS AND
STABILIZATION SERVICES AND JAIL
BASED COMPETENCY TREATMENT. THIS
WILL ALLOW ADDITIONAL TIME FOR
THE DEPARTMENT TO CONTINUE
NEGOTIATIONS AND IMPLEMENTATION
OF IST SOLUTIONS ACROSS ALL
COUNTIES WILL ALSO ALLOW TIME
FOR THE COMPLETION OF SEVERAL,
UM INFRASTRUCTURE PROJECTS THAT
WE CURRENTLY DO HAVE UNDERWAY.
AND ARE IN NEGOTIATION WITH
PROVIDERS TO DEVELOP AND PROVIDE
FUNDING TO SUPPORT THE ONGOING
OPERATION OF THE BEDS ONCE
CONSTRUCTION IS COMPLETE. IN
ADDITION, THE DEPARTMENT IS ALSO
REQUESTING POSITION AUTHORITY
FOR FIVE NEW POSITIONS TO BE
ADDED ON GOING TO SUPPORT THE
INCREASED IN I S T REFERRALS IN
THE CURRENT YEAR, THE DEPARTMENT
OF STATE HOSPITALS HAS RECEIVED
ON AVERAGE ABOUT 500 S T
REFERRALS PER MONTH, WHICH IS A
21% INCREASE OVER THE PRIOR
YEAR. AH TSH PROPOSES TO FUND
THE NEW POSITIONS WITH EXISTING
IST SOLUTIONS FUNDING BY
SHIFTING 1.5 MILLION FROM OUR
CONTRACT INPATIENT SERVICES TO
PROGRAM ADMINISTRATION. HAPPY TO
TAKE ANY QUESTIONS YOU MIGHT
HAVE DEPARTMENT OF FINANCE.
DEPARTMENT OF FINANCE NOTHING
FOR THEIR DAD. ELLIOT WILLOW AND
SALIO. WE HAVE NOT RAISED
CONCERNS AT THIS TIME WITH THE
PROGRAM CASELOAD UPDATES THE
COVID 19 UPDATE OR THE S T
PROGRAM RE APPROPRIATIONS BRING
IT UP TO THE DIOCESE SEEING NO
MEMBERS, QUESTIONS. WE WILL
THANK THIS PANEL AND MOVE ON TO
FORGE A REGARDING THE NHS.
GOOD AFTERNOON, MR CHAIR AND
MEMBERS. VERY NICE TO SEE YOU
TODAY AND HAPPY BIRTHDAY. UM UH
, THE ITEM IN FRONT OF YOU IS
WITH REGARD TO THE COMMISSION'S
PARTNERSHIP UNDER THE TRAVEL
BEHAVIOR HEALTH INITIATIVE. AND
TO DISSEMINATE SOME OF THE
EVIDENCE BASED PRACTICE MONEY AS
OUTLINED, AND AS YOU RECALL
DURING THE BUDGET NEGOTIATIONS,
IT WAS POINTED OUT THAT THE
COMMISSION, UH, DURING THE
DEVELOPMENT OF THE C I B H I
PROPOSAL WAS OPERATING PROGRAMS
WERE VERY CONSISTENT WITH THE
EVIDENCE BASED PRACTICE FUNDS
THAT WERE BEING PUT FORWARD BY
THE ADMINISTRATION. AND SO
THROUGH THE DISCUSSIONS WITH
BUDGET COMMITTEE, THE
ARRANGEMENT WAS TO HAVE THE
COMMISSION DISTRIBUTE ABOUT 10%
OF THOSE FUNDS AS PART OF THE
EVIDENCE BASED AND COMMUNITY
FIND EVIDENCE PRACTICES
RESOURCES. THE COMMISSION'S
INTEREST IN THAT WAS SPECIFIC TO
THE ALL COVID DROP IN PROGRAMS
THAT WE HAVE BEEN SUPPORTING FOR
THE LAST FEW YEARS THAT FALL
INTO THE CATEGORY OF YOUTH
DRIVEN AND THE EXPANSION OF
COORDINATED SPECIALTY CARE
PROGRAMMING THAT THE COMMISSION
HAS BEEN PROMOTING AS PART OF
THE EARLY INTERVENTION PHASE. OF
C Y B H I OVER THE PAST YEAR AND
A HALF AND I AND I'LL DEFER TO
MY COLLEAGUE AND HCS. WE'VE BEEN
TALKING WITH THE DEPARTMENT TO
MAKE SURE THAT WE CAN PROVIDE A
SERVICE AS PART OF THE BROADER
INITIATIVE THAT'S CONSISTENT
WITH THE COMMISSION'S ROLE AND
MISSION BUILDS OFF OF THE
EXPERTISE AND EXPERIENCE THAT WE
HAVE. UM AND THAT ALSO
INTEGRATES WITH THE WORK THAT
THE DEPARTMENT IS DOING. THE
FUNDING THAT WE'RE ASKING FOR IS
$15 MILLION THAT WOULD ALLOW US
TO OPERATE A SERIES OF
PROGRAMMING THAT WOULD BE FUNDED
WITH SOME OF THE C Y B H I MONEY
AND THAT WOULD SUPPORT TECHNICAL
ASSISTANCE FOR BOTH THE YOUTH
DROP IN STRATEGY AND THE
EVIDENCE BASED COORDINATE
SPECIALTY CARE STRATEGY. UM THE
ASK IS TO ALLOW US TO HIRE STAFF
TO DO THE OUTREACH AND
ENGAGEMENT AND THE TECHNICAL
ASSISTANCE UNDER THE RECOGNITION
THAT THESE ARE ONE TIME FUNDS,
AND WHAT WE'RE REALLY TRYING TO
DO IS TO FACILITATE UPTAKE OF
HIGHLY EFFECTIVE IN MOST CASES,
REIMBURSABLE PRACTICES THAT ARE
EVIDENCE BASED RECOGNIZED AROUND
THE WORLD. BUT ARE LARGELY
UNAVAILABLE IN CALIFORNIA. AND
SO WE WANT TO USE THESE ONE TIME
FUNDS TO INCENTIVIZE LOCAL
PARTNERS TO TAKE UP THESE
EFFECTIVE PRACTICES, PROVIDE
THEM WITH SUFFICIENT TECHNICAL
ASSISTANCE AND SUPPORT THAT THEY
CAN SUSTAIN THEM OVER TIME. AND
SO THE FUNDING REQUEST THAT YOU
HAVE IN FRONT OF YOU IS TO
SUPPORT THE STAFFING THE
COMMUNITY ENGAGEMENT. THE
OUTREACH. AND REALLY, TO BUILD
THE CAPACITY OF OUR LOCAL
PARTNERS TO BE SUCCESSFUL IN
THESE TWO AREAS DEFER TO THE HCS
IN TERMS OF THE BROADER
QUESTIONS THAT ARE OUTLINED IN
THE AGENDA AROUND THE STEPS THAT
THE DEPARTMENT IS TAKING IN
TERMS OF THE BROADER INITIATIVE
WERE INVOLVED IN TWO OF THE SIX
PHASES OF EVIDENCE BASED
PRACTICE FUNDING THAT THE
DEPARTMENT HAS OUTLINED THANK
YOU. SO I KNEW WE PROVIDED
PREVIOUS UPDATES ON CR BHS ALL
FOCUS ON OUR INTERACTIONS HERE,
SO WE'VE BEEN WORKING VERY
CLOSELY WITH TOBIN THE
COMMISSION FOR QUITE SOME TIME
TO FINALIZE THE INTERAGENCY
AGREEMENT. WE WILL BE FOCUSING
ON ROUND FOUR AND ROUND FIVE,
WHICH ARE VARIOUS THE EARLY
INTERVENTION PIECES AND ALCOVE
THINGS LIKE EARLY PSYCHOSIS,
ALCOVE AND I'M GIVEN THE
EXPERIENCE WITH THE COMMISSION.
WE THINK THAT THAT THOSE WHICH
WE MUTE MUTUALLY AGREED UPON
WOULD BE THE BEST SUITED FOR
THEM, PROVIDING BOTH THE
TECHNICAL ASSISTANCE, THE
ADMINISTRATION DECIDED TO KEEP A
PORTION WHERE THE GRANT DOLLARS
ARE GOING OUT THROUGH A THIRD
PARTY ADMINISTRATOR BECAUSE I
THINK ADMINISTRATIVELY, I THINK
WE MUTUALLY AGREED THAT WAS THE
EASIEST WAY TO ADMINISTER. THOSE
FUNDS WERE VERY CLOSE TO
EXECUTING THE INTERAGENCY
AGREEMENT. UM AND, UH, WE FEEL
LIKE WE'VE BEEN DOING IT IN
GREAT PARTNERSHIP IN REGARDS TO
HOW WE CAN MOVE THESE THINGS
FORWARD, AND I WILL DEFER ANY
QUESTIONS REGARDING THE BCP TO
THE DEPARTMENT OF FINANCE
DEPARTMENT ATTENDANCE. DIANNA
VASQUEZ DEPARTMENT OF FINANCE,
SO WE HAVE BEEN ASKED TO COMMENT
ON HOW THE COMMISSION WILL BE
APPROPRIATELY RESOURCED SHOULD
THE MOU BETWEEN TH CS AND THE
COMMISSION BE EXECUTED. FOR THE
ADMINISTRATION OF A PORTION OF
THE CHILDREN NEED BEHAVIORAL
EVIDENCE BASED AS NOTED IN THE
AGENDA. THE 2022 BUDGET ACT
INCLUDES REIMBURSEMENT AUTHORITY
IN THE CURRENT YEAR TO SUPPORT
THE MOU SHOULD IT BE SIGNED IN
THE CURRENT YEAR. TO THE EXTENT
THAT THE MOU IS EXECUTED IN THE
BUDGET YEAR, THERE ARE EXISTING
MECHANISMS TO PROVIDE THE
REIMBURSEMENT AUTHORITY NEEDED
IN THE BUDGET YEAR. AND IN
ADDITION, UM IF THE COMMISSION
UM DOES NEED POSITION AUTHORITY
. UM THESE COULD BE
ADMINISTRATIVELY ESTABLISHED TO
SUPPORT THE WORKLOAD IN THE
BUDGET YEAR AS NEEDED IN ANY
REIMBURSEMENT AUTHORITY NEEDED
OR POSITION AUTHORITY IN THOSE
OUT YEARS WOULD LIKELY BE
REQUESTED THROUGH OBESE BUDGET
CHANGE FOR PHOTO. HELLO. WILL
OWNS ELIO. WE HAVEN'T HAD A
CHANCE TO LOOK AT THIS PROPOSAL.
BUT WE ARE HERE AND HAPPY TO
ASSIST THE COMMUNITY IN ANY WAY
. BRING IT UP TO THE DAIS, DR
JACKSON. UM. THIS QUESTION IS
BOTH FOR THE O. A C AND D H C S.
UM I CONTINUE TO REITERATE, UM
UNIVERSAL SCREENING. AND, UM I
THINK THAT. IF WE CAN NUMBER
ONE. ARE WE OFFICIALLY
REQUESTING THAT WE AT LEAST TO
WORK ON A PILOT PROGRAM TO SEE
HOW WE CAN MAKE UNIVERSAL
SCREENING WORK OF SOME KIND. UM
AND SO MY QUESTION IS, IS AH. UM
IS THAT SOMETHING YOU ARE WILL
BE AMENABLE TO MAKE SURE THAT WE
AT LEAST ATTEMPT UH, TO SEE HOW
WE CAN REALLY MAKE UNIVERSAL
SCREENING WORK OF SOME, NO
MATTER HOW SIZE THE PILOT IS,
BUT I THINK WE WOULD BE REMISS
Tð. JUST AH! NOT TRY IT. AND SO
IS THAT SOMETHING YOU ALL MIGHT
WELL BE WILLING TO WORK WITH ME
ON MR WITH ME. UM WE'RE MORE
THAN HAPPY TO OFFLINE AND HAVE
CONVERSATIONS WITH YOU WOULD
WANT TO BRING MY BEHAVIORAL
HEALTH TEAM WHO'S PROBABLY MORE
FAMILIAR WITH EVIDENCE BEHIND
IT. AND IF THERE'S OTHER
SUCCESSFUL PILOTS ARE VARIOUS
PIECES, BUT HAPPY TO OFFLINE
OFFLINE WITH YOU AND HAVE
CONVERSATIONS. UM THANK YOU FOR
THE QUESTION. REMEMBER UH, THE
BACKGROUND ON THE CALL, AND I'LL
REFERENCE THE ALCOVE. SITE IN
PARTICULAR BECAUSE OF THIS ITEM
ON THE AGENDA. UM THE
CONVERSATIONS THAT THE
COMMISSION HAD WITH THE
LEGISLATURE. SEVERAL YEARS AGO
WAS REALLY ABOUT BUILDING OUT. A
SYSTEM OF CARE THAT WOULD
LEVERAGE SCHOOLS AND SCHOOL
MENTAL HEALTH. AND USE DROP IN
CENTERS AS A COMMUNITY BASED
STRATEGY FOR THOSE YOUNG
CALIFORNIANS FOR WHOM SCHOOL IS
NOT A SAFE SPACE. OR FOR WHOM
HAVE GRADUATED. AND THE INTENT
WAS TO REALLY LEVERAGE THAT
CAPACITY OF OUR SCHOOLS WHICH
ARE IN, YOU KNOW, ACCESSIBLE TO
EVERY COMMUNITY, AND IDEALLY,
EVERY YOUNG PERSON UM, WITH A
DROP IN STRATEGY THAT WOULD GET
US TO THE POINT THAT WE COULD
IMPLEMENT POPULATION LEVEL.
INTERVENTIONS CONSISTENT WITH
UNIVERSAL SCREENING, AND SO I
WANTED TO SIT EASY ANSWER IS, OF
COURSE, THE MORE COMPLICATED
ANSWER IS WE'VE REALLY BEEN
WORKING TO TRY TO BUILD THE
CAPACITY THROUGH THE MENTAL
HEALTH STUDENT SERVICES ACT AND
THE PARTNERSHIPS THAT WE HAVE
BEEN FACILITATING BETWEEN COUNTY
BEHAVIOR, HEALTH DEPARTMENTS AND
SCHOOLS COMPLEMENTED WITH YOUTH
DROP IN PROGRAMS. AND I AND I
WANT TO DRAW A CONNECTION
BETWEEN THAT STRATEGY AND
PSYCHOSIS BECAUSE, YOU KNOW, AND
WE'VE PRESENTED THIS COUPLE OF
TIMES. THE EVIDENCE SUGGESTS
THAT WE ARE NOT DOING THE
SCREENING. FOR PEOPLE WHO ARE
DEVELOPING FIRST EPISODE
PSYCHOSIS AND MORE CHALLENGING
LEE. WE ARE NOT RESPONDING IN
WAYS THAT WE KNOW WORK. AND SO
THIS SUBCOMMITTEE HAS HAD
PRESENTATIONS FROM FOLKS WHO
HAVE SHARED THEIR STORY AND I
AND WE'RE HOSTING A SITE VISIT
TO THE SACKING ADEPT PROGRAM ON
FRIDAY. I THINK IT'S FRIDAY FOR
LEGISLATIVE STAFF AND OTHERS TO
REALLY UNDERSTAND WHAT IS
AVAILABLE IN THE COMMUNITY AND
THE JUST THE PROFOUND DEFICITS
IN TERMS OF OUR CAPACITY TO
RESPOND. TWO PEOPLE WHO DEVELOP
PSYCHOSIS. I KNOW YOU'RE NOT
ASKING SPECIFICALLY ABOUT
SCREENING FOR PSYCHOSIS, BUT WE
THINK THAT THESE ARE ACTUALLY
THE SAME CONVERSATIONS THAT
IDEALLY WE WOULD DO A LOT ABOUT
STREAM WORK WITH VERY EARLY IN
OUR IN OUR AND SO THEN THE AGE
SPAN, BUT RECOGNIZING THAT
PSYCHOSIS IS MOST LIKELY TO
OCCUR IN THOSE LATE TEENS, EARLY
20 YEARS AND PSYCHOSIS IS WE
BELIEVE, AND WE DO NOT YET HAVE
THE DATA TO SHOW THIS TO YOU.
BUT ANECDOTALLY, WE BELIEVE THAT
THE LAST CONVERSATION YOU HAD AT
THIS TABLE AROUND STATE HOSPITAL
AND INCOMPETENT STATE AND
INCOMPETENT TO STAND TRIAL
NUMBERS IS BECAUSE WE DO NOT
HAVE AN AGGRESSIVE STRATEGY TO
IDENTIFY PSYCHOSIS EARLY THROUGH
A SCREENING APPROACH AND TO
RESPOND RIGHT AND AGAIN, THE
RESEARCHERS, THE EXPERTS THAT
YOU HAD A COUPLE OF WEEKS AGO,
SAID AT BEST 5% OF CALIFORNIA'S
ARE DEVELOPING PSYCHOSIS OR
ACTUALLY GETTING THE EVIDENCE
BASED PRACTICE THAT CAN REDUCE
THOSE THE ESCALATION OF THOSE
SERVICES. SO YOU KNOW WHAT WE'RE
REALLY EXCITED ABOUT IN TERMS OF
THESE DOLLARS, AND IT IS PART OF
THE COMPLICATION IN THE
INTERAGENCY AGREEMENT. BECAUSE
WE'RE STILL WORKING OUT WHAT THE
DEPARTMENT IS ASKING OF THE
COMMISSION IN TERMS OF THOSE
DOLLARS THAT WOULD BE AVAILABLE
FOR EVIDENCE BASED PRACTICES OR
COMMUNITY TO FIND PRACTICES THAT
DON'T FALL INTO THE BUCKET OF
COORDINATED SPECIALTY CARE FOR
PSYCHOSIS OR YOUTH DROP IN AND
SO WE WANT TO MAKE SURE THAT WE
CAN ACTUALLY BE RESPONSIVE TO
WHAT THE DEPARTMENT IS NEEDING
US TO DO AND THAT WE CAN BE THAT
RELIABLE PARTNER FOR THEM, BUT
WE'RE STILL TRYING TO SEEK SOME
CLARIFICATION ABOUT THE DOMAINS
OF SORT OF THAT THE WHAT'S WHAT
INTELLIGENT ELIGIBLE FOR
PARTICULARLY THOSE POTENTIAL
PROGRAMS THAT WE DO NOT HAVE
EXPERTISE ON. UM THAT THE
COMMISSION IS MEETING IN TWO
WEEKS. AND HAS ASKED THE
DEPARTMENT TO COME AND EXPLAIN
THE PROCESS FOR SELECTING WHAT
IS ELIGIBLE FOR THOSE DOLLARS.
UM WE HAVE IN CONCEPT AGREED
THAT THE THIRD PARTY
ADMINISTRATOR WOULD HANDLE THE
GRANT AND CUT THAT THE
CONTRACTING AND THE MONITORING
FOR THOSE PROGRAMS THAT THAT
WHERE WE DO NOT HAVE EXPERTISE,
BUT WE WOULD LIKE TO IN HOUSE
THOSE SERVICES FOR THOSE
PROGRAMS WHERE WE DO HAVE
EXPERTISE AGAIN. YOUTH DROP IN
MEANING ALCOVE AND COORDINATED
SPECIALTY CARE. SO WE ACTUALLY
THINK THAT THE ANSWER TO YOUR
QUESTION IS ACTUALLY BUNDLED IN
WITH THIS ISSUE OF BUILDING THE
CAPACITY AT THE SAME TIME, UH,
TO RESPOND TO SCREENS WHILE
MAKING SURE THAT WE HAVE THE
SCREENING. REACH THAT YOU'RE
PERSISTENTLY IDENTIFIED AS
ESSENTIAL IF WE'RE GOING TO BE
SUCCESSFUL AND REDUCING COSTS,
IMPROVING OUTCOMES AND
PROTECTING LIVES. LET ME GIVE AN
EXAMPLE OF THE POPULATION I'M
WORRIED ABOUT AND YOU CAN
CORRECT ME IF I'M WRONG IF
ANYTHING. YOU ALL ARE CURRENTLY
WORKING ON WILL ADDRESS THIS
POPULATION. I'M A YOUNG PERSON
SITTING IN THE CLASSROOM. I
DON'T HAVE ANY DISCIPLINE
ISSUES. UM, MY GRADES ARE GOOD.
UM I SIT IN THE CLASSROOM. AND
PEOPLE FORGET I'M EVEN THERE.
BUT YET I STILL HAVE HIGH
ANXIETY OR DEPRESSION. AND I
HAVE SUICIDAL IDEATION. WHAT ARE
WE DOING TO IDENTIFY THOSE
FOLKS? DO YOU WANT ME TO? I
THINK THERE'S TWO MAIN PIECES
AROUND C Y B H I UM, THE FIRST
ONE IS THE FEAST SCHEDULE THAT
WE WERE MENTIONING EARLIER THIS
MORNING WHERE THE GOAL OF THAT
SCHEDULE IS TO MAKE AVAILABLE
FOR ANYONE K THROUGH 12,
INCLUDING HIGHER EDUCATION AS
WELL ALL THE WAY UP TO THE AGE
26 ALL PAYER. TO BE ABLE TO HAVE
ACCESS TO SERVICES ON SITE AT A
SCHOOL OR NEAR SCHOOL IF THE
SCHOOL DOESN'T HAVE SCHOOL BASED
SERVICES AVAILABLE, AND THAT
WOULD INCLUDE THE LIST OF
SERVICES INCLUDE SCREENING OF
BEHAVIORAL HEALTH SERVICES
NEEDED A PLACE WHERE A SAFE
PLACE WHERE THEY CAN HOPEFULLY
GO ON CAMPUS TO RECEIVE SOME OF
THOSE SERVICES, BOTH REAL
THERAPY SERVICES OR CONNECTION
TO HIGHER LEVEL SERVICES THAT
IT'S SOMETHING THAT ONE OF THE
SCHOOL BASED PROVIDERS CAN'T
OFFER. AND THAT TO BE FULLY
REIMBURSED, AS REQUIRED IN
STATUTE THAT THAT COMMERCIAL
PLAN DOES HAVE TO REIMBURSE FOR
THOSE SERVICES THAT ARE
AVAILABLE. IT'S AN ALL PAYER
REQUIREMENT. IT'S NOT JUST FOR
PEOPLE IN MEDICAL OR IT'S AN ALL
PAYER REQUIREMENT. AND SO, UM
THE ONCE THOSE THAT PIECE
SCHEDULE GOES LIVE AND WE'RE
STARTING TO DO A ROLL OUT OF
THAT, STARTING IN JUNE OF 24,
WITH SCHOOLS THAT ARE KIND OF
MORE ALONG, ABLE TO KIND OF
PARTICIPATE AND THEN PHASE THOSE
IN WE DO THINK THAT THAT WILL BE
AN OPPORTUNITY FOR AS WAS
MENTIONED KIDS WHO DO FEEL
COMFORTABLE IN THAT PARTICULAR
ENVIRONMENT SEEKING SERVICES TO
MAKE THEM AVAILABLE, BUT WE ALSO
WANT TO MAKE SURE THAT THERE ARE
SERVICES EITHER NEAR OR AROUND
OR ADJACENT TO ON THAT KIDS CAN
ACCESS IF THEY'RE NOT
COMFORTABLE REACHING OUT IN A
SCHOOL ENVIRONMENT FOR THOSE
SERVICES, AND SO THE EVIDENCE
BASED PRACTICE PART OF C Y B H
I, WHERE WE'RE DISBURSING GRANTS
ACROSS THE STATE IS TO FUND
PIECES AND PRO PROJECTS LIKE
ALCOVE. AS WELL AS BEING
MENTIONED BECAUSE WE WANT TO
TEST WHERE IS THE BEST PLACE FOR
YOUTH TO FEEL LIKE THEY CAN GO
BE HEARD. MAYBE THEY CAN'T BE
HEARD AT HOME OR AT SCHOOL, BUT
MAYBE A YOUTH DROP IN CENTER
WELLNESS CENTER IS ONE PLACE
WITH THE BEHAVIORAL HEALTH
INFRASTRUCTURE DOLLARS. WE'VE
FUNDED A SIGNIFICANT NUMBER OF,
UH, WELLNESS CENTER BEHAVIORAL
HEALTH WELLNESS CENTERS THAT
WE'RE HOPING WILL ALSO BE IN
COMMUNITIES WHERE KIDS CAN
CONNECT AND THEN THE LAST ONE, I
WOULD SAY UNDER C Y B H I IS THE
PLATFORM. UM SO THE VIRTUAL
PLATFORM THAT WOULD BE AN APP
THAT SOMEBODY CAN DOWNLOAD. THEY
CAN HAVE MINDFULNESS. THEY CAN
ALSO CONNECT TO COACHES. UM
THROUGH THAT VIRTUAL PLATFORM
THAT WE ARE IN THE PROCESS OF
BUILDING WHERE IF THEY NEED TO
TALK TO SOMEBODY, OR IF THEY'RE
HAVING THOSE THOUGHTS THAT YOU
MENTIONED THAT THEY CAN TALK TO
SOMEONE AND GET CONNECTED TO
HELP, UM IN AN EASY WAY, AND SO
THOSE ARE THE WAYS IN WHICH C Y
B H I IS REALLY ABLE TO HELP. WE
HAVE THE VIRTUAL PLATFORM. THE
FEE SCHEDULE ACROSS THE STATE OF
CALIFORNIA FOR SERVICES IN
SCHOOLS OR NEAR SCHOOLS AND THEN
TRYING TO REALLY BUILD UP
COMMUNITIES AND PROVIDERS WITH
THESE EVIDENCE BASED PRACTICES,
EARLY INTERVENTION AND YOUTH
FOCUS TRAUMA. FOCUSED
INTERVENTIONS TO REALLY SCALE
THOSE UP ACROSS THE STATE AND IN
TWO OF THOSE AREAS IS WHERE
WE'RE PARTNERING WITH THE
COMMISSION. ON ALCOVE AND EARLY
PSYCHOSIS. BUT THERE ARE OTHER
INTERVENTIONS AND WE'RE MORE
THAN HAPPY TO SEND YOU THE LIST
OF INTERVENTIONS AND EVIDENCE
BASED PRACTICES THAT WE'VE BEEN
TRYING TO SCALE UP, UM ACROSS
THE STATE THROUGH THOSE FUNDING
OPPORTUNITIES AS WELL, THAT THAT
WOULD DEFINITELY BE HELPFUL. AND
I APPRECIATE YOU OFFERING THAT
UM, SO ARE YOU SAYING IF I'M A
LOCAL SUPERINTENDENT, AND I
WANTED TO AH, DO UNIVERSAL
SCREENINGS THAT THAT WOULD BE
TOTALLY REIMBURSABLE THROUGH.
WHY BE A CHAI WANT TO LOOK AT
WHAT'S ON THE FEE SCHEDULE? UM
AND WE'VE BEEN VETTING THAT WITH
A VERY LARGE STAKEHOLDER GROUP
OF SUBJECT MATTER EXPERTS, BUT
THERE ARE SCREENINGS, A NUMBER
OF SCREENINGS, BEHAVIORAL HEALTH
SCREENINGS. STD SCREENINGS,
REFERRALS FOR SERVICES THERAPY
SERVICES ARE ON THAT LIST. I
DON'T WANT TO SAY SOMETHING
THAT'S NOT CORRECT, SO I'D
RATHER GO BACK TO MY TEAM ASKING
THAT DIRECT QUESTION AND WE CAN
GET YOU THAT INFORMATION FOR
SURE. THANK YOU APPRECIATE IT.
IF I MAY, UM I THINK IT'S
APPROPRIATE TO RECOGNIZE THAT
THE HAVING STREAMLINED FUNDING
IS AN ESSENTIAL ELEMENT. THIS
WILL NOT HAPPEN. THIS WILL NOT
SCALE IF THE STATE DOES NOT MAKE
IT EASIER TO PAY FOR, AND I
THINK THAT'S PART OF WHAT IS THE
ADMINISTRATION HAS REALLY BEEN
PRIORITIZING RIGHT? UM BUT BUT
BUT ON TOP OF THAT, YOU KNOW THE
STATE. WE CAN DEMONSTRATE THAT
WHEN THE STATE HAS ACTUALLY
LEANED IN AND PROVIDE TECHNICAL
ASSISTANCE AND REALLY
FACILITATED AH, THOSE
OPPORTUNITIES FOR LOCAL AGENCIES
TO LEARN FROM EACH OTHER AND
ENGAGE. THAT'S ACTUALLY WHEN
THOSE DOLLARS GET UTILIZED IN
WAYS THAT ARE MORE EFFECTIVE AND
WHETHER IT'S EVIDENCE BASED
PRACTICE AND OUR LOCAL PARTNERS
ACTUALLY HIGHLIGHT THAT THAT, UM
OFTENTIMES THE DOLLARS MAY BE ON
THE TABLE, BUT THEY DON'T KNOW
HOW TO ACCESS THEM. OR THEY
DON'T KNOW HOW TO USE THEM, AND
I'LL POINT OUT THAT UNDER MPS TT
AND THEIR MEDICAL SCREENING HAS
BEEN A COVERED BENEFIT FOR WHAT
? 40 50 YEARS VERY, VERY LONG
TIME AND IT IS A AN EXPECTED
ANNUAL SCREEN. SO, UM, UH
EMOTIONAL AND BEHAVIORAL HEALTH
SCREENING IS A STANDARD
COMPONENT OF AN ANNUAL SCREENING
REQUIRED UNDER MPS. DT IT'S NOT
REQUIRED. IT IS ACTUALLY NOT
REQUIRED. IT IS REIMBURSABLE IF
IT IS, YOU KNOW IF IT IS
PROVIDED. SO DESPITE ON THE
MEDICAL SIDE SCREENING BEING AND
ACCEPTED, RECOGNIZED FINANCIAL
INTERVENTION, SO TO SPEAK, UM,
THE PENETRATION RATE DO WE KNOW
THE PENETRATION RATE ON MPS? DT
BEHAVIOR HOUSE SCREENING FOR
MEDICAL KIDS IN CALIFORNIA? I
DON'T HAVE THE RIGHT ON TOP OF
MY HEAD. HOW DO WE INCREASE 80%
HOW DO WE INCREASE THE RATE IN
WHICH PEOPLE ARE UTILIZING IT?
SO PART OF WHAT WE REALLY LIKE
ABOUT C E H I AND PART OF WHAT
WE REALLY LIKE ABOUT THE
EVIDENCE BASED PRACTICE FUNDS,
AND THIS IS WHY THERE'S $15
MILLION IN THIS BUDGET ASK IS IN
ADDITION TO MAKING SURE THAT THE
RULES ARE AVAILABLE IS THE
ACTIVE STEP OF GOING OUT AND
TALKING TO PEOPLE AND
FACILITATING PROVIDING THAT
TECHNO ASSISTANCE AND TRAINING
SUPPORT SO THAT THE POLICY IS
THAT SO THE UPTAKE IS ACTUALLY
THERE RIGHT. THE COMMISSION.
WE'VE BEEN PARTNERING WITH THE
DEPARTMENT OF PUBLIC HEALTH AND
OTHERS TO ACTUALLY YOU MENTIONED
SUICIDE TO BRING EFFECTIVE AND
BEST PRACTICES INTO SUICIDE
PREVENTION STRATEGIES WERE
WORKING WITH SCHOOL DISTRICTS TO
ACTUALLY STRENGTHEN THEIR
SUICIDE PREVENTION. PLANNING
EFFORTS. RIGHT YOU YOU, BUT YOU
WEREN'T YOU MENTIONED MUCH MORE
THAN THAT, WHICH IS, YOU KNOW,
RECOGNIZING WHAT'S HAPPENING IN
LIVES OF YOUNG PEOPLE WHEN WE
TALK TO YOUNG PEOPLE ABOUT
WHAT'S HAPPENING IN THEIR
SCHOOLS. A FEW OF THEM WILL GIVE
US EXCELLENT EXAMPLES OF
WELLNESS CENTERS, FOR EXAMPLE,
BUT OTHERS AND I CAN TELL YOU MY
CHILDREN GO TO SCHOOL HERE. WHAT
ONE OF THEM STILL IS IN HIGH
SCHOOL. THEY HAVE A WELLNESS
CENTER TO GET TO IT. YOU GOT TO
GO THROUGH THE COUNSELING
OFFICE, WHICH IS CLOSED DURING
THE LUNCH BREAK WHEN KIDS ARE
ACTUALLY AVAILABLE AND WANT TO
WALK INTO THE WELCOME THE
WELLNESS CENTER, SO THE RULES
ARE REALLY IMPORTANT. BUT MORE
IMPORTANT THAN THAT IS THE
STRATEGY. AND SO I THINK YOU
KNOW WHAT WE'RE TRYING TO FIGURE
OUT HERE. PART OF THIS
DISCUSSION OF THIS $15 MILLION
IS, IS IT LOCAL ASSISTANCE
DOLLARS? OR IS IT LOCAL
ASSISTANCE DOLLARS WITH THE TA
TO ACTUALLY MOVE THE NEEDLE AND
, UM, WE'RE ALSO HAVE NOT YET
WORKED OUT WITH THE DEPARTMENT
CLARITY ON WHETHER OR NOT THE
ALCOVE YOUTH DROP IN CENTERS
WOULD QUALIFY FOR REIMBURSEMENT
UNDER THE NEGOTIATED FEE
SCHEDULE. UM ARE EARLY
PERCEPTION WAS, YES. ARE MORE
RECENT CONVERSATIONS SUGGEST
THAT THEY DON'T QUALIFY UNDER
THE LANGUAGE THAT IS THAT THE
DEPARTMENT HAS IN FRONT OF THEM,
AND I DON'T KNOW IF THAT'S A
STATUTORY ISSUE, BUT WE'RE
WORKING THROUGH SOME OF THOSE
ISSUES BECAUSE WE CERTAINLY
DON'T WANT TO STAND UP A YOUTH
DROP IN CENTER, WHICH BY DESIGN
IS DROPPIN, MEANING YOU DON'T
HAVE TO BE ELIGIBLE TO WALK
THROUGH THE DOOR. YOU KNOW, FOR
SOME DIAGNOSTIC REASON, YOU CAN
JUST WALK THROUGH THE DOOR. WE
WANT TO MAKE SURE WE'RE GOING TO
SUSTAIN THAT THAT WE NEED TO
MAKE SURE THAT THE FINANCING IS
ACCESSIBLE AND SIMPLE BECAUSE
THAT'S WHAT'S GOING TO TAKE TO
SCALE STATEWIDE. I HAVE. I'M
SORRY. I JUST, YOU KNOW, UM. I
KEEP PUSHING BECAUSE WE'RE IN A
MENTAL HEALTH CRISIS. AND SO I'M
TALKING AS IF WE'RE IN A CRISIS
IS NOT ME BEING THEORETICAL.
THIS IS NOT ME JUST SAYING I
THINK MY IDEA IS BETTER THAN
YOURS, RIGHT? AND I WOULDN'T
EVEN BE BRINGING IT UP AT THE U.
S. SURGEON GENERAL DIDN'T
RECOMMEND IT. I WOULDN'T EVEN BE
BRINGING IT UP FR FIRST, UH,
CALIFORNIA SURGEON GENERAL
RECOMMENDED IT. RIGHT? AND MY
CONCERN, UM IS EVERY TIME I TALK
ABOUT THIS, I ACTUALLY HAVE A
PICTURE OF A YOUNG PERSON IN MY
MIND. BECAUSE BEFORE I CAME HERE
UM I PERSONALLY DID RESTORATIVE
CIRCLES WITH YOUNG PEOPLE. AND
THE YOUNG PERSON THAT I THINK
ABOUT WAS IN MY CIRCLES WEEKLY.
LOOKED AT HIM. NOTHING WAS
WRONG. TO ME. BUT HE COMMITTED
SUICIDE. AND HE WAS IN FRONT OF
ME EVERY WEEK. THERE WAS GOOD
PEOPLE AROUND THEM. AND SO I
THINK, MY WHOLE. CONCERN IS. AND
THE QUESTION I KEEP ASKING
MYSELF. ARE WE DOING EVERYTHING
WE CAN DO? NOT. ARE WE DOING A
LOT OF GOOD STUFF? BUT ARE WE?
THIS IS MY MEASUREMENT. ARE WE
DOING EVERYTHING THAT WE CAN DO?
TO ADDRESS THIS CRISIS. AND I
CAN'T SAY YES. RIGHT NOW. AND SO
I'M JUST THE I'M MY CONCERN. IS
THAT, UM. I THINK WE CAN DO
MORE. WE MIGHT HAVE TO STEP ON
SOME TOES TO DO IT. WE MIGHT
HAVE TO CHALLENGE THE WAY WE ARE
SYSTEMS WORK TO DO IT. BUT IT
CAN BE DONE. IF WE CHOOSE. TO
I'VE BEEN TO ALCOHOL. ONE OF THE
AL COVES I THINK WAS HAVING TO
NBI EACH OR REDONDO BEACH,
REDONDO BEACH. BEAUTIFUL PLACE.
BUT THE QUESTION BECOMES MY
YOUNG PERSON. THAT I THINK ABOUT
ALL THE TIME. UM I DON'T BELIEVE
IN THE, UM. I DON'T 100% BELIEVE
IN THE F YOU CAN GET HERE WILL
HELP YOU. IF YOU CAN GET HERE.
AND. UNLESS WE ARE SAYING THAT
WE'RE GOING TO HAVE AN ALCOVE.
IN EVERY SINGLE CITY IN THIS
STATE. AND I KNOW THAT SONG
YOU'RE SANTA'S LIST. AH! BUT HOW
LONG WILL IT TAKE US TO GET
THERE? RIGHT? I'M ALWAYS
THINKING OF WHAT CAN WE DO NOW?
AND HOW CAN WE REACH THOSE YOUNG
PEOPLE? INCLUDING MY BROTHER, BY
THE WAY, WHO WAS ON THE STREETS
RIGHT NOW. HE NEVER GOT
SUSPENDED OR EXPELLED OR
ANYTHING LIKE THAT. I MEAN, HE
HAS SOME BAD GRADES. BUT WE EVEN
MISSED IT IN OUR OWN FAMILY WERE
NOW I LOOK BACK AT OUR
CHILDHOOD. SO I THINK WE HAVE
SOME COALS AND I KEEP TRYING TO
POINT OUT THESE HOLES. BUT I
STILL DON'T GET ANY ASSISTANCE
ON HOW TO FEEL THESE HOLES. AND
IT'S REALLY BOTHERING ME. UM
BECAUSE I'VE COMBED THROUGH.
PEER REVIEWED ARTICLES MYSELF.
AND THERE IS NOTHING THAT TELLS
ME THAT WE SHOULDN'T EVEN AT
LEAST TRY TO DO THIS OR FIGURE
OUT HOW TO DO THIS. IF WE'RE
REALLY GONNA DO PREVENTIVE,
EARLY INTERVENTION WORK. RIGHT
BEFORE WE START THINKING MAYBE
WE SHOULD SCREEN FOR PSYCHOSIS
RIGHT IMPORTANT. BUT WE'RE STILL
MEETING UP MISSING A WHOLE OTHER
POPULATION WHEN WE KNOW A LARGE
PERCENTAGE OF OUR YOUNG PEOPLE
ARE FACING HIGH LEVELS OF
ANXIETY AND DEPRESSION. HOW ARE
WE GOING TO SERVE THOSE PEOPLE?
AND ARE WE OKAY? I'M NOT OKAY.
BUT ARE WE OKAY WITH WAITING FOR
YET ANOTHER BUDGET CYCLE TO DO
THIS ALL OVER AGAIN? RIGHT. I
CAN DO THIS ALL DAY. I'LL DO YOU
KNOW, YOU KNOW, IT DOESN'T EVEN
HAVE TO BE ON THE AGENDA FOR ME
TO BRING IT UP. RIGHT? SO I'M
TRYING TO, UH. MY GOAL IS THAT
WE CAN WORK TOGETHER TO TRY TO
GET THERE. RIGHT? AND I DON'T
CARE IF IT'S JUST A LITTLE STEP
FORWARD. BUT TO NOT DO IT AT ALL
. IT'S JUST SOMETHING THAT I
CAN'T ACCEPT. RIGHT? AND SO I'M
TRYING TO DO ALL THAT I CAN AH.
TO MAKING SURE THAT. THOSE YOUNG
PEOPLE WHO DON'T EVEN KNOW THAT
THEY'RE IN TROUBLE. RIGHT? AND
I'VE DONE 100% SCREENINGS FOR
ACES MPH QUÊ. FOR 400 YOUNG
PEOPLE. I'VE DONE IT. AND YOU'LL
BE SURPRISED WHAT YOU BRING WHAT
YOU'LL SEE. WHEN YOU ALREADY
START DOING THAT. HOW MANY YOUNG
PEOPLE ARE LOSING THEIR
APPETITE. HOW MANY YOUNG PEOPLE
CAN'T SLEEP. HOW MANY YOUNG
PEOPLE ARE LOSING HOPE. OVER AND
OVER AGAIN, RIGHT FUNDAMENTAL.
PH Q QUESTIONS. AND SO I WILL
IMPLORE US YET AGAIN. Tð UH,
FIND A WAY TO WORK THIS IN OR TO
SEE IF IT'S EVEN BILLABLE,
RIGHT? AH! SO THAT WE CAN BETTER
PUSH. UH, TWO. EVEN HELP THOSE
YOUNG PEOPLE WHO DON'T EVEN KNOW
THEY NEED HELP. RIGHT? SO I'LL
STOP THERE. SORRY ABOUT THAT, MR
CHAIR. I DON'T THINK YOU NEED TO
APOLOGIZE. I THINK YOU NEED TO
PREACH MORE. THAT'S ALL RIGHT.
UM I'LL BEGIN IN SHARING SOME OF
THE FRUSTRATION THAT THE
INTENTION OF THE LEGISLATURE TO
APPROPRIATE FUNDS TO THE ALWAYS
BECAUSE WE FELT THEY'D BE ABLE
TO ALLOCATE THESE FUNDS. MORE
QUICKLY ARE STYMIED WHEN, AS OF
TODAY, WE STILL HAVE NO FUNDS
BEING TRANSFERRED TO THE. WHY WE
DON'T HAVE AN MOU AS OF TODAY,
AND DOESN'T THAT SPEAK TO US NOT
ADDRESSING THE CRISIS AND
DELAYING IT A BUDGET YEAR BY NOT
BEING ABLE TO AGREE UPON AN MOU
AREN'T ISN'T IT? THEN THE
ADMINISTRATION SAYING THAT WE
HAVE THE TIME TO WAIT AN ENTIRE
BUDGET YEAR TO GO THROUGH BEFORE
THESE FUNDS GO OUT THE DOOR. SO
JUST TO BE VERY FRANK. WE HAVE
BEEN WORKING VERY CLOSELY WITH
THE COMMISSION REGARDING THIS.
WE'VE BEEN WORKING ON WHAT THEY
THINK IS WITHIN THEIR BAILIWICK
TO DO AND THINGS THAT THEY DON'T
NECESSARILY THINK THAT WOULD BE
A GOOD USE OF THEM TO DO, WHICH
IS WHY WE'VE BEEN DOING
EXTENSIVE BACK AND FORTH
REGARDING WHAT THAT LOOKS LIKE
THINGS THAT THEY THINK IT WOULD
MAYBE BE EASIER FOR HAVING
TEAPOT DO FOR THESE GRANT FUNDS
BECAUSE IT'S MAYBE NOT THE BEST
USE VERSUS THEM, BUT THEY'RE
REALLY GOOD AT TECHNICAL
ASSISTANCE AND GATHERING AND
IDENTIFYING THE RIGHT PLAYERS,
ALL VERY GOOD, THESE EVIDENCE
THAT THEY HAVE AND THEY HAVE A
LOT OF EXPERIENCE. SO WE'VE BEEN
WORKING BACK AND FORTH WITH THEM
EXTENSIVELY TO MAKE SURE IT IS
WITHIN WHAT THEY THINK WOULD
THEY WOULD BE BEST AT BUT ALSO
MAKING SURE THAT THEY HAVE EVERY
FOOTPRINT IN REGARDS TO WHAT
WE'RE, UM, FUNDING. FOR EXAMPLE
, THEY'VE BEEN ABLE TO REVIEW
ALL OF OUR DOCUMENTS, ALL OF THE
F A F A R F A DOCUMENTS. THEY'VE
BEEN LOOKING AT THE EVALUATION
TOOLS, THE SCORING WE'RE DOING
BACK AND FORTH, EVEN WHILE WE
DON'T HAVE THE INTERAGENCY
AGREEMENT, BECAUSE THAT CAN BE
VERY TECHNICAL. A LOT OF LAWYERS
USUALLY INVOLVED IN REGARDS TO
DOCUMENTS AND INTERAGENCY
AGREEMENTS THAT GO BACK AND
FORTH. WE'VE BEEN WORKING WITH
THEM IN PARALLEL WHILE WE'RE
WORKING OUT THOSE VARIOUS PIECES
TO MOVE THINGS FORWARD. UM ALL
OF THE ROUNDS FOR THE EVIDENCE
BASED PRACTICES FOR CHILDREN AND
YOUTH WERE ALWAYS INTENDED TO BE
SPREAD OUT OVER A LONG PERIOD OF
TIME. THERE'S NO WAY WE CAN MOVE
THINGS OUT FAST. IN FACT, WE'VE
BEEN BEEN TOLD BY PROVIDERS
RECENTLY. WE'RE MOVING TOO FAST
BECAUSE THEY CAN'T ABSORB THE
INFORMATION FAST ENOUGH TO BE
ABLE TO RESPOND TO OUR FPS AND
OTHER PIECES. AND SO WE'RE
TRYING TO EDUCATE MASS PEOPLE
ACROSS THE STATE AT THE SAME
TIME FOR GREAT OPPORTUNITIES
AROUND BOTH THESE YOUTH, UM
DRIVEN PROGRAMS, WHICH IS AROUND
FOUR AS WE CALL THEM, AND THEN
ON THE EARLY INTERVENTIONS, AND
THERE'S CERTAIN PIECES OF THE
COMMISSION FEELS VERY
COMFORTABLE DOING AND WE WANT TO
MAKE SURE THAT THEY'RE DOING
THOSE THINGS, WHICH IS WHY
ALCOVE AND EARLY PSYCHOSIS HAS
RISEN TO THE TOP OF THINGS THAT
THEY WANT TO BE HEAVILY INVOLVED
IN. BUT WE ARE ALSO FINDING WAYS
OF HOW THEY CAN PARTNER ON SOME
OF THE OTHER THINGS AND EVEN IF
THEY'RE NOT DRIVING IT, BECAUSE
IT'S NOT SOMETHING THERE AS
FAMILIAR WITH WITHIN THOSE
CATEGORIES BECAUSE WE'RE TRYING
TO FUND A NUMBER OF PIECES
WITHIN THESE EVIDENCE BASED
PIECES, SO FROM OUR PERSPECTIVE
, WE'VE BEEN WORKING VERY
CLOSELY WITH WITH THE COMMISSION
TO COME TO A HEAD. YES, WE WOULD
LIKE IT TO COME TO A CLOSE SOON
AS WELL. I THINK THAT THIS
PROJECT INITIATIVE IS LARGE, AND
WE'VE BEEN TRYING TO MAKE SURE
THAT WE DO MASSIVE STAKEHOLDER
ENGAGEMENT TO GET IT RIGHT. IT'S
NOT JUST WHAT WE FEEL LIKE OR
THE COMMISSION FILLED. THAT
SHOULD BE FUNDED. WE'VE BEEN
TRYING TO ENGAGE HUNDREDS OF
STAKEHOLDERS AND DOMINANTLY
YOUTH. WHAT DO YOU FEEL LIKE WE
SHOULD BE FUNDING HERE, AND THAT
PROCESS HAS TAKEN A LITTLE
LONGER FOR US TO NAIL DOWN WHAT
SHOULD GO INTO THESE FUNDING
BUCKETS. SO THAT WE CAN NAIL
DOWN THE INTERAGENCY AGREEMENT.
BUT WHAT I WOULD SAY IS, THE
DEPARTMENT IS VERY COMMITTED TO
THAT PROCESS. WE FEEL LIKE WE'VE
BEEN WORKING IN A VERY GOOD
PARTNERSHIP WITH THE COMMISSION
TO COME TO A CLOSE AND WE WOULD
LOVE FOR THE INTERAGENCY
AGREEMENT TO BE FINALIZED AS
WELL. SO WE CAN GET ONTO THE
MORE IMPORTANT WORK THAT I THINK
WE BOTH WANT TO DO BUT HAPPY,
TOO. I'LL GIVE THE CHANCE TO
THANK YOU, UM. YOU KNOW, I HAVE.
I HAVE TO GIVE THE DEPARTMENT
CREDIT FOR JUST THE SIZE OF THE
LIFT. THAT IS THIS INITIATIVE
AND THE COMMITMENT THAT THEY'VE
MADE TO COMMUNITY ENGAGEMENT AND
TO WORK WITH US, AND, UM, YOU
KNOW, WE HAVE THIS SORT OF
STATEMENT IN OUR OFFICE. WE'VE
NEVER BEEN CLOSER. RIGHT TO
GETTING THIS FINALIZED. UM UM AT
THE SAME TIME, YOU KNOW, AS
REFLECTED IN SOME MEMBER
JACKSON'S COMMENTS, MR TEAR YOUR
COMMENTS ABOUT THE URGENCY,
RIGHT? WE HAVE FACED AND DELAYS.
I THINK YOU KNOW THE COMMISSION
COULD HAVE IF WE HAD SORT OF
DONE THIS SIMPLE CASH TRANSFER,
WE COULD HAVE BEEN, YOU KNOW,
RUNNING AND MAKING THIS STUFF
WORK. QUICK MORE FAT FASTER THAN
THIS, RIGHT? UM, BUT THE
DEPARTMENT HAS REACHED OUT AND
ASKED US TO PLAY A LARGER ROLE
THAN THE 10% SET ASIDE AND
POTENTIALLY ADMINISTER SOMEWHERE
CLOSER SOMEWHERE BETWEEN $150
MILLION WORTH OF THAT, AND SO
WERE, YOU KNOW, WE APPRECIATE
THE RESPECT FROM THE DEPARTMENT
ON THAT. UM YOU KNOW, AT THE
SAME TIME WE'RE ALSO CONCERNED
THAT THE ABOUT THE POTENTIAL
SORT OF MISALIGNMENT BETWEEN YOU
KNOW WHAT YOUNG PEOPLE ARE
ACTUALLY LOOKING FOR, AND WHAT
ULTIMATELY WILL BE THE LONG TERM
OUTCOMES OF THIS BROADER
INITIATIVE, PARTICULARLY UNDER
THE MODERNIZATION PROPOSAL, IF
MEDICAL BECOMES A DOMINANT
DETERMINANT OF WHAT IS COVERED,
I MEAN, THE BEAUTY OF THE MENTAL
HEALTH SERVICES ACT AND THE
BROAD USES OF P I FUNDS HAS BEEN
HAS ALLOWED THAT MONEY TO BE THE
SUPPLEMENT. RIGHT AND IN OUR
CONVERSATIONS SOME MEMBER
JACKSON WITH YOUNG PEOPLE, THEY
HAVE HIGHLIGHTED THAT ACCESS TO
A THERAPIST ON CAMPUS, SOMETHING
THAT WOULD VERY APPROPRIATELY BE
PAID FOR UNDER A NEGOTIATED FEE
SCHEDULE ARRANGEMENT. YOU KNOW,
WE IS IMPORTANT, BUT THEY'VE
ALSO SAID WE ALSO NEED TO
ADDRESS THE RACISM THAT HAPPENS
ON OUR CAMPUS. BUT THOSE THOSE
TEACHERS WHO ARE CAUSING ME TO
SIT HERE AND STRUGGLE AND NOT
SAY ANYTHING, RIGHT? AND THAT'S
NOT SOMETHING YOU DO WITH
MEDICAL. THAT IS SOMETHING YOU
DO WITH INNOVATIONS AND YOUTH
EMPOWERMENT AND THE KINDS OF YOU
KNOW, UM, ACTIVITIES YOU NEED.
YOU NEED TREMENDOUS FLEXIBILITY
AND LOCAL DISCRETION CONTROL AND
SO YOU KNOW, WE'RE VERY EXCITED
ABOUT THE BREADTH AND THE DEPTH
OF WHAT C Y B H I IS OFFERING.
BUT WE'RE ALSO CONCERNED ABOUT
THE TIMEFRAME. HAS THE DELAY IN
RELEASING DOLLARS NECESSITATED A
NEED TO SORT OF PUSH THE BACK
END OUT A FEW MORE YEARS SO WE
CAN GIVE OUR LOCAL PARTNERS WHO
HAS, AS MY COLLEAGUE HERE POINTS
OUT OF SAID ACTUALLY SLOW THIS
DOWN, SO THEY ACTUALLY HAVE A
LONG ENOUGH RUNWAY TO GET UP AND
RUNNING. AND WHAT IS THE POST? C
Y B H I STRATEGY IN TERMS OF, UM
TIME AND ATTENTION ON SCHOOL.
MENTAL HEALTH, RIGHT? WE'VE
STRUGGLED IN THESE CONVERSATIONS
OVER THE LAST FEW YEARS TO
REALLY IDENTIFY WHERE LEADERSHIP
SITS ON SCHOOL MENTAL HEALTH.
THE REASON WHY THE LEGISLATURE
GAVE THE MENTAL HEALTH STUDENT
SERVICES ACT OF THE COMMISSION'S
BECAUSE IT ACTUALLY HAS TO
EDUCATION LEADERS. THE
SUPERINTENDENT AND LOCAL
SUPERINTENDENT AND SEVERAL
BEHAVIORAL HEALTH SEATS ON THERE
. UM AND YOU KNOW, WE'LL WE'LL
STILL SORT OF PUSH THIS
ADMINISTRATION THE LEGISLATURE
TO REALLY THINK LONG AND HARD
ABOUT WHAT IS A POST C Y B H I
UH, LOOK LOOK LIKE IN TERMS OF
THE SUSTAINED EMPHASIS ON
LEADERSHIP SUSTAINED EPISODE
CYSTS ON LEVERAGING SCHOOLS NOT
JUST TO DO SCREENING, BUT YOU DO
CARE DELIVERY, RIGHT? AND SO, UM
, YOU KNOW, I HAVE NO COMPLAINTS
OR QUALMS ABOUT THE PROGRESS
WE'VE MADE ON THE INTERAGENCY
AGREEMENT. UM BUT WE RECOGNIZE
THERE ARE MANY HOLES. I WILL ADD
SOME MEMBER JACKSON IF I MAY. UM
THE COMMISSION HAS REALLY PUSHED
ON WORKPLACE MENTAL HEALTH, AND
THE SURGEON U S SURGEON GENERAL
RECENTLY DID SOME WORK THERE
BECAUSE WE BELIEVE IF WE CAN
PUSH A BROAD STRATEGY OF
AWARENESS, STIGMA, REDUCTION,
SCREENING AND ACCESS TO CARE
THROUGH BOTH SCHOOLS AND THE
WORKPLACE. WE WILL GET THE CORE
GROUP OF OUR POPULATION, NOT THE
VERY YOUNG AND NOT THE POST WORK
AGE, BUT THAT WILL JUST FILL IN
A NUMBER OF THE HOLES THAT
YOU'RE POINTING OUT ARE
ESSENTIAL TO GETTING DID YOU
KNOW ACHIEVING THE GOALS THAT
YOU AND OTHERS HAVE IDENTIFIED?
I WOULD JUST SAY THAT I TOTALLY
AGREE. UM BUT EVEN I THINK THAT
EVEN THE MOU WAS A GOOD EXAMPLE
OF HOW WE'RE NOT TREATING THIS
AS A CRISIS. AND THE FACT THAT.
OF COURSE, I DON'T KNOW YOUR
PROCESSES. OR WHAT THE HOLDUP IS
ETERNAL INTERNALLY. UM BUT I
DON'T SEE THE URGENCY. RIGHT AND
UH, I DON'T KNOW. WHOSE FAULT IT
IS. I DON'T CARE, RIGHT. I'M
JUST SPEAKING. I'M NOT SPEAKING
TO EITHER ONE OF YOU
PARTICULARLY WELL, THIS JUST
HIGHLIGHTS AN EXAMPLE. THAT IF
WE ARE AND BY THE WAY. WE TALK
ABOUT MENTAL HEALTH AS A CRISIS
IN GENERAL. BUT THE SURGEON
GENERAL AND OUR CURRENT
CALIFORNIA SURGEON GENERAL HAS
SAID SPECIFICALLY THAT YOUTH ARE
PARTICULARLY IN A MENTAL HEALTH
CRISIS. BUT YET WE CAN'T EVEN DO
AN MOU. AND SO I THINK THAT
ESPECIALLY WHEN IT COMES TO THIS
ITEM, MR CHAIR. I MEAN,
OBVIOUSLY, I THINK IT MIGHT BE
TIME TO PUT SOME DEADLINES TO
THESE THINGS. IF YOU WANT TO
HAVE THESE FUNDS YOU KNOW? BUT
WE CAN'T USE THESE FUNDS IN THE
MIDST OF A CRISIS RIGHT NOW.
SHOULD WE FIND A WAY TO USE IT
FOR A CRISIS SOMEWHERE ELSE? AND
USE IT FOR ANOTHER WAY THAT WE
SEE FIT THAT WILL ACTUALLY
ADDRESS THIS CRISIS TODAY. RIGHT
MEANING THAT THIS IS IT'S TIME.
AND UH SO I WOULD JUST URGE US
AND, UH, IF I NEED TO PUT THIS
IN RADIO MORE THAN HAPPY TO, BUT
IT'S TIME TO GET SOME DEADLINES
GOING. IT'S TIME TO PUT OUR FOOT
DOWN AND SAY, GET THIS DONE.
WE'RE IN A CRISIS AND LET'S GET
THIS MONEY OUT. IF I CAN, PLEASE
, I WOULD JUST REMIND EVERYONE I
MEAN. I THINK EVERYBODY CLEARLY
UNDERSTANDS THE CRISIS THAT WE
HAVE. I HAVE FOUR KIDS MYSELF.
TWO IN COLLEGE, ONE IN HIGH
SCHOOL, ONE IN ELEMENTARY
SCHOOL. THE IMPACT THAT COVID
HAS HAD ON CHILDREN IS PROFOUND.
THIS ADMINISTRATION, THOUGH, HAS
PUT SO MUCH IT WITH IN
PARTNERSHIP WITH THE
LEGISLATURE. MORE MONEY TOWARDS
SOLVING ALL OF THE VARIOUS
HOLES. WE COULD PROBABLY COME UP
WITH A LOT OF OTHER HOLES, TOO,
BUT THE AMOUNT OF INFRASTRUCTURE
CAPACITY WORKFORCE THAT WE'RE
PUTTING. IT WON'T CHANGE
OVERNIGHT, BUT I THINK ONE OF
THE BIGGEST FUNDAMENTAL HOLDS
THAT WE HAVE ACROSS ALL OF
BEHAVIORAL HEALTH IS
ACCOUNTABILITY. AND THAT
INCLUDES THE PROVIDER LEVEL IT
INCLUDES AT THE COUNTY LEVEL IN
AND I EVEN MEAN THAT FROM
PRIMARY CARE TO BE A CHURCH,
RIGHT, AND SO I THINK IT'S NOT
ONLY MONEY THAT IS OUR ISSUE AND
WHERE MONEY'S GOING BECAUSE
THERE'S A TON OF EVIDENCE BASED
PRACTICES. THINGS ARE BEING
PUSHED ALL OF THESE INITIATIVES
THAT ARE BEING BUILT RIGHT NOW
WILL BE SIGNIFICANT IN REGARDS
TO USE IN THE FUTURE, AND I
AGREE IT'S HARD BECAUSE IT'S NOT
IMMEDIATE. BUT I THINK ONE OF
THE BIGGEST THINGS THAT WE ALL
HAVE TO ALSO LOOK AT IS MAKING
SURE WHEN EACH OF THE ENTITIES
ARE IN FRONT OF US THAT WERE
EQUALLY HOLDING THEM ACCOUNTABLE
AT OUR LEVEL. THE STATES THE
BIGGEST THING THAT WE'RE LOOKING
AT WITH ALL OF OUR PARTNERS,
WHETHER THAT'S PRIMARY CARE ARE
PEOPLE MOVING PEOPLE ARE THEY
ACTING ON A YOUTH COMING TO THEM
AND SAYING THEY NEED HELP, AND I
THINK THERE IS A FUNDAMENTAL
ISSUE AND HEALTHCARE RIGHT NOW
WITH CAPACITY AND ALL OF THOSE
THINGS THAT IT'S NOT JUST AT
THIS POINT. IT'S NOT EVEN MONEY
AS SAID EVERYTHING'S
REIMBURSABLE AND MEDICAL RIGHT,
BUT WE HAVE TO MAKE SURE THAT
WE'RE ACTING ON THOSE PIECES AS
WELL. SO I JUST WANT TO PUT THAT
IN THERE BECAUSE THAT'S WHERE IT
HAS TO HAPPEN. NOW IT'S WITH OUR
PROVIDERS WITH OUR COUNTIES WITH
OUR PARTNERS WHO ARE SEEING
THESE YOUTH SEEN THESE
INDIVIDUALS CONNECTING THEM TO
SERVICES AND REMOVING THOSE
BARRIERS. IT'S NOT ALWAYS IT'S
NOT ALWAYS THE DOLLARS. BUT
THOSE ARE IMPORTANT, TOO, AND WE
WILL DO WHATEVER WE CAN TO
EXECUTE THIS. QUICKLY. THAT IS
NOT THAT'S NOT IN MY WE WILL. WE
WILL DO THAT. YOU GIVE US A
DEADLINE. THAT'S FINE. WE'LL
MEET IT. I THINK IT'S THERE'S
IT'S IT IS COMPLICATED. THIS IS
A DELIVERY SYSTEM THAT HAS NOT
BEEN KIND OF SAID WELL, FOR LOT
BETTER DESCRIPTION, AND I THINK
THERE'S A LOT OF OPPORTUNITIES
AND WE'RE HAPPY TO WORK ON ALL
OF THEM WITH YOU BECAUSE WE'RE
VERY COMMITTED TO THAT. AS
ADMINISTRATION. I THINK WE'VE
TRIED TO REALLY EMPHASIZE THAT
IN ALL OF THE INVESTMENTS WE'VE
BEEN TRYING TO BUILD UP OVER THE
LAST FEW YEARS IT IS EIGHT YOUR
BELIEF THAT IN THIS BUDGET THAT
WE HAVE THE NECESSARY
ACCOUNTABILITY MEASURES ALREADY
PUT IN OR DO WE STILL HAVE MORE
WORK TO DO? I THINK THAT WITH
THE UPCOMING PROPOSALS, THE
COMPLEMENTARY PROPOSALS WITH THE
BH MODERNIZATION WHERE WE'RE
VERY FOCUSED ON ACCOUNTABILITY
AT EVERY LEVEL, UM ACROSS BOTH
AND MEDICAL, COMMERCIAL AND
OTHERS THAT THERE'S A LOT OF
OPPORTUNITIES FOR A LOT OF GREAT
DISCUSSIONS THERE IN REGARDS TO
HOW WE CAN TAKE ACCOUNTABILITY.
TO ANOTHER LEVEL THAN WHERE WE
HAVE IT TODAY. AND SO I KNOW
WE'RE NOT PRESENTING ON THAT
TODAY, BUT I THINK THERE ARE A
LOT OF OPPORTUNITIES WITH THAT
THAT I THINK WE CAN ALL AVAIL
OURSELVES UP. MORE TRANSPARENCY
, MORE INFORMATION, MORE DATA
AND PUSHING PEOPLE TO REALLY GET
TO THAT NEWER LEVEL OF
ACCOUNTABILITY THAN WHAT WE HAVE
TODAY. AH! I LOOK FORWARD TO
MORE FRANK CONVERSATIONS LIKE
THIS. YEAH I ACTUALLY ENJOY
THIS, BY THE WAY, PEOPLE MIGHT
BE THINKING THIS IS HEATED, BUT
THIS IS ACTUALLY GREAT. UH, I
WOULD SAY. I'VE SEEN THE
GOVERNOR ACT. WHEN HE WANTS TO
HOLD PEOPLE ACCOUNTABLE. THE
HOUSING CRISIS, HOMELESSNESS. HE
PUT HIS FOOT DOWN MANY TIMES.
AND SAID YOU DO THIS OR YOU'RE
GONNA LOSE SOME FUNDING. YOU DO
THIS OR THIS WON'T BE APPROVED.
I WOULD LOVE TO SEE THE SAME
THING WHEN IT COMES TO THIS. AND
I WOULD AGREE. PEOPLE DON'T LIKE
TO TALK ABOUT THIS. A LOT OF IT
IS WHAT WE NEED TO DO TO PUT OUR
FOOT DOWN WITH SOMEONE WITH OUR
SCHOOLS. SOME OF THE THINGS WE
NEED TO PUT DOWN WITH ALL KINDS
OF THINGS, BUT WE'VE GOT TO DO
IT AND I'M MORE THAN HAPPY TO
PARTNER TO HELP DO SO RIGHT. I'M
NOT ONE OF THOSE PEOPLE WHO SAY
YOU SHOULD DO THIS AND THEN BUT
DON'T ASK ME TO DO NOTHING RIGHT
? I THINK THAT WE JUST NEED TO
KEEP PUSHING TOGETHER, BUT I
APPRECIATE YOU BRING IT BACK TO
THE CHAIR OF I CAN. I WILL
SUPPORT AND UPLIFT THE COMMENTS
THAT THIS ADMINISTRATION HAS
DONE MORE IN THIS SPACE THAN ANY
PREVIOUSLY HAPPENED. SO I WANT
TO MAKE SURE YOU HEAR LOUDLY AND
CLEARLY THAT WE COULDN'T BE
BIGGER FANS OF WHAT'S HAPPENING
WITHIN C Y B H I, BUT WHAT WE'RE
TRYING TO DO IS MAKE SURE THAT
BUREAUCRACIES DON'T GET IN THE
WAY AND IT SOUNDED AS IF THE O.
A C. WAS ASKING FOR POSITION
AUTHORITY THROUGH FINANCE AND
WAS DENIED THAT POSITION
AUTHORITY AND SO I'D LIKE TO
GIVE FINANCE A CHANCE TO
RESPOND. IS THERE A NEED FOR
STATUTORY? UM ABILITY TO USE
FUNDS FOR STATE OPERATIONS
INSTEAD OF LOCAL ASSISTANCE SO
THAT THEY CAN HAVE THAT POSITION
AUTHORITY. OR DO WE HAVE TO WAIT
FOR THAT? M O U TO BE SIGNED
BEFORE WE'RE ALLOWING THEM TO DO
WHAT THEY DO WELL. THANK YOU,
TERRY. I'M GLAD DIANA VASQUEZ,
THE DEPARTMENT OF FINANCE, SO
NOTWITHSTANDING THE MERITS OF
THE TWO POSITIONS. WE JUST THINK
THAT GIVEN TIMING, THE MOU
DETAILS HAVE NOT BEEN FINALIZED
, UM AND AS SUCH, WERE NOT ABLE
TO EVALUATE THE WORKLOAD,
HOWEVER, IN THE BUDGET YEAR ONCE
THE MOU IS FINALIZED, AND THOSE
DETAILS, UM OUR SHARED. UM THE
EC DOES HAVE THE AUTHORITY TO
ADMINISTRATIVELY ESTABLISHED
THOSE POSITIONS IN THE BUDGET
YEAR AND THEN TO THE EXTENT THAT
THOSE POSITIONS ARE NEEDED IN
THOSE OUT YEARS, THEY CAN
REQUEST THAT THROUGH A BUDGET
CHANGE PROPOSAL. SO WHAT I'M
HEARING FROM YOU IS THEY HAVE
THE ABILITY TODAY TO HAVE THOSE
STAFF AND DIDN'T HAVE TO ASK YOU
IN THE FIRST PLACE. NOT WITHOUT
THE INTERAGENCY AGREEMENT IN
PLACE BECAUSE THE INTERAGENCY
AGREEMENT COVERS THE TRANS. SO
NONE OF THOSE FUNDS ARE ACTUALLY
IN OUR BUDGET. I THINK WHAT YOU
ENVISIONED WAS THAT THEY WOULD
JUST SHIFT 10% OF THOSE DOLLARS
AND PUT IT IN OUR BUDGET. RIGHT
FINANCE RAISED SOME CONCERNS
THAT THAT WOULD COMPLICATE SOME
THINGS. AND SO WHAT? WE ASKED,
IS THAT ANY MONEY THAT WE SPENT
IT WOULD BE IN OUR BUDGET. BUT
LOCAL ASSISTANCE COULD FLOW
THROUGH CONSISTENT WITH THE
THIRD PARTY ADMINISTRATOR. IN
OTHER WORDS, WE WOULD SIGN THE
CONTRACT WITH THE HCS. WE WOULD
APPROVE PAYMENT, BUT DHS WOULD
MAKE THE PAYMENT AND THAT WAY
THE BULK OF THE FUNDS WOULDN'T
ACTUALLY HAVE TO TRANSFER FROM
THEIR ACCOUNT TO OUR ACCOUNT.
BUT WE WERE CONCERNED THAT
PEOPLE ARE WORKING FOR US OR IF
WE WERE CONTRACTING WITH PEOPLE
THAT WE WANTED TO BE ABLE TO
HAVE THOSE DOLLARS IN CONTROL
THOSE DOLLARS SO THAT BECAUSE WE
WOULD BE ACCOUNTABLE FOR THE
WORK THAT IS GETTING DONE, WHAT
I'M HEARING IS FINANCES,
SUGGESTING WE WAIT AND THEN
AFTER THAN THAN THE TERMS OF THE
INTERAGENCY AGREEMENT WOULD
COVER THE STAFFING. AND THAT WE
WOULD DO THAT IN THE BLANKET.
I'M GUESSING THAT'S WHAT WHEN.
WHEN FINANCE SAYS, DO THAT
ADMINISTRATIVELY THAT IT WOULD
NOT BE A POSITION ESTABLISHED
THAT THE BUDGET IT WOULD BE A
POSITION THAT IT WOULD BE SORT
OF A IT'S A TERM FOR THESE
POSITIONS, SO THERE IS A
DIFFERENCE BETWEEN, UM BLANKET
AUTHORIZATION AND
ADMINISTRATIVELY
ADMINISTRATIVELY, YOU WOULD BE
ESSENTIALLY ESTABLISHING IT
TEMPORARILY UNTIL THE BUDGET
PROCESS IN WHICH THE ALWAYS SEE
IF THERE IS A NEED FOR ONGOING
POSITION AUTHORITY. UM THAT IS
WHEN IT WOULD BE REQUESTED
THROUGH THE BUDGET CHANGE
PROPOSAL. PART OF OUR CONCERN IS
JUST THE TIME IT TAKES. I DON'T
WANT TO SIGN THAT AGREEMENT AND
THEN TAKE FOUR MONTHS TO
RECRUIT. AND IT'S NOT EASY TO
RECRUIT AND HIRE. SO AGAIN, I
DON'T HAVE ANY OBJECTIONS TO
WHAT FINANCES SAYING, BUT THE
PRACTICAL REALITY IS DELAYS
MATTER, RIGHT? DELAYS MATTER.
YEAH WELL AND I JUST POINT BACK
OUT. WE APPROPRIATED THESE
DOLLARS LAST YEAR IN THE BUDGET
DISCUSSIONS, AND IT STILL SEEMS
THAT WE'RE HAVING TO HAVE THESE
CONVERSATIONS TODAY AND I HOPE
WHAT YOU'RE HEARING IS, THE
LEGISLATURE WILL CONTINUE TO
EXERCISE ITS ROLE AND OVERSIGHT
AND MAKE SURE THAT WE'RE
UTILIZING THOSE FUNDS AS RAPIDLY
AS POSSIBLE. UM. AYE. HEARD
EARLIER. YOU WOULD BE AMENABLE
TO A DATE TO SIGN AN MOU. IT
WOULD BE NICE TO GET THAT DONE
IN THIS FISCAL YEAR PRIOR TO US,
BEGINNING IN NEW BUDGET YEAR AND
I'M WONDERING IF THE
ADMINISTRATION THINKS IT'S
POSSIBLE TO GET THAT COMPLETED
BEFORE JUNE 31ST. WE'LL DO WHAT
WE CAN AND FOR SOME REASON WHEN
CAVIL NOTIFY YOU IMMEDIATELY.
EXCELLENT. WITH THAT. I WANT TO
SWITCH GEARS JUST A LITTLE BIT.
IF I CAN AND COME BACK TO THE
AWAY, SO I'M HOPING YOU CAN
PROVIDE AN UPDATE ON SOME OF THE
IMPLEMENTATION CHALLENGES THAT
WE'VE HAD IN THE MENTAL HEALTH
STUDENT SERVICES GRANT PROGRAM
WITHIN THE CONTEXT OF THE C Y B
H I DO I GET TO SAY THAT I DON'T
HAVE ANY ENERGY LEFT TO TACKLE
THAT QUESTION. YEAH. UM YEAH.
THANK YOU. THANK YOU, MR CHAIR
FOR HIGHLIGHTING THAT. UM AND I
DO APPRECIATE THE YOU KNOW THE
FRANKNESS OF THIS CONVERSATION.
IT'S WELL, IT'S YOU KNOW,
WELCOME VERY MUCH WELCOME.
THAT'S REFRESHING. UM SO THE
MENTAL STUDENT SERVICES GRANT
PROGRAM. SO CURRENTLY SO WE HAVE
57. LOCAL PARTNERS THERE TO
REMIND YOU THEIR PARTNERSHIPS
BETWEEN CANDY BEHAVIOR, HEALTH
DEPARTMENTS AND LOCAL EDUCATION
AGENCIES. THOSE DOLLARS WERE
EXPLICITLY DESIGNED TO
FACILITATE PARTNERSHIPS. WE WERE
HESITANT TO TELL THOSE PARTNERS
WHERE THEY SHOULD FOCUS THE
DOLLARS BECAUSE WE WANTED THOSE
DOLLARS TO BE FOCUSED IN AREAS
WHERE THEY WERE ENTHUSIASTIC
ABOUT INVESTING IN SUCCESS,
RECOGNIZING THE BROAD ARRAY OF
OPPORTUNITIES IN SCHOOL MENTAL
HEALTH. OUR PRIMARY GOAL WAS TO,
UM, SORT OF ADDRESS THE CONFLICT
THAT HAS CHARACTERIZED FOR IN
MANY PLACES NOT EVERYWHERE BUT
THE RELATIONSHIPS OVER WHO HAS
TO PAY FOR SERVICES. IS IT A
BEHAVIORAL HEALTH COSTARS IN AN
EDUCATION COST AND SO BY
FACILITATING COLLABORATIVE
OPPORTUNITY THAT THEY ALSO THEY
BOTH BOTH PARTIES AND IN SOME
CASES, CHARTER SCHOOLS AND
COUNTY OFFICERS OF EDUCATION, SO
MULTIPLE PARTIES. SIGNED OFF ON
WE REALLY WERE TRYING TO CREATE
A CULTURE OF COLLABORATION. THE
LAST TIME WE WERE IN FRONT OF
YOU. YOU HEARD THOSE YOUNG
PEOPLE IN IMPERIAL COUNTY. THE
COUNTY IS JUST AN PHENOMENAL
THINGS OF WRITING, BRINGING IN
ADDITIONAL PARTNERS TO INCLUDING
FOOD BANKS AND THEIR JUVENILE
JUSTICE TO REALLY EMBRACE THE
SCHOOLS OF CENTERS OF WELL BEING
, AND SO, SO THROUGH THAT WE
HAVE 57 PARTNERSHIPS. ONE COUNTY
WAS NOT ABLE TO PARTICIPATE JUST
GIVEN STAFF CAPACITY. UM 50 OF
THE 55 COUNTY OFFICERS OF
EDUCATIONS ARE PARTICIPATING IN
THOSE STRATEGIES. WE REACHED OUT
TO THEM AND SAID THE LEGISLATURE
AND THE GOVERNOR APPROPRIATELY
PROVIDED TECHNICAL ASSISTANCE
AND FACILITATION FUNDING TO
SUPPORT YOUR ABILITY TO BE
SUCCESSFUL. THE IDENTIFIED FIVE
AREAS DATA STAFFING PROGRAMMING.
UH GOVERNANCE ISSUES. HOW DO
THEY WORK OUT THINGS LIKE HIPAA
VERSUS FERPA? YOU KNOW, PRIVACY
RULES. THERE'S LOTS OF AREAS
THAT THEY HAVE TO WORK ON. AND
OF COURSE, FINANCE. UM AND SO
AND WORKING WITH THEM. WE
IDENTIFIED A GRANT STRATEGY THAT
WOULD ELEVATE ONE OR MORE
PARTNERS TO ACTUALLY TAKE THE
LEAD IN DRIVING TECHNICAL
ASSISTANCE. BECAUSE THESE ARE
SHORT TERM ONE TIME DOLLARS. WE
DID NOT WANT TO BRING OUT OUT TO
HAVE OUTSIDE CONSULTANTS SORT OF
DROP IN AND TAKE OVER AND THEN
LEAVE. WHAT WE WANTED TO DO WAS
TO FACILITATE COLLABORATIVE
LEARNING AMONG THE PARTNERS WHO
WOULD BE AVAILABLE WHO WOULD BE
THERE WHEN THE DOLLARS WERE
GONE, AND THEY COULD BRING IN
CONSULTANTS ON AN AD AS NEEDED
BASIS SO THAT WE COULD REALLY
BUILD LONG TERM CAPACITY. TO
SUSTAIN THESE EFFORTS ACROSS THE
STATE, RECOGNIZING HOW DIVERSE
THEY ARE, IN SOME CASES, IT'S
WELLNESS CENTERS. IN SOME CASES,
IT'S ACCESSING CLINICAL CARE ON
SITE. IN SOME CASES, IT'S
TEACHER TRAINING. UH, WE, WE
HAVE, UM, THE FINANCING PIECE IS
BUMPING UP. POTENTIALLY, WE'RE
NOT SURE YET. WITH SOME OF THE
WORK WITH C Y B H I E. AS WE'VE
SHARED THE TERMS OF THAT, UH,
PROPOSAL WITH THE DEPARTMENT OF
HEALTH CARE SERVICES TO MAKE
SURE THAT IT IS ALIGNED WITH C Y
B H I AND WE HAVE NOT FINALIZED
THESE CONVERSATIONS, SO I DON'T
WANT TO SUGGEST THAT THAT THIS
IS, YOU KNOW, UM UH, A FULL
ACCOUNTING OF WHERE WE ARE. WERE
CONCERNED THAT, UM, WHERE
THERE'S CONFLICT BETWEEN LOCAL
EDUCATION AGENCIES IN HOW THEY
STAFF AND OFFER SERVICES AND
NEGOTIATED FEE SCHEDULE, IF THAT
ISN'T FITTING, RIGHT AND WELL,
OUR FUNDS ARE DESIGNED TO
EMPOWER THE LOCALS TO REALLY
DESIGNED FINANCE TO MEET THEIR
NEEDS THAT WOULD BE SUSTAINABLE
AND INTEGRATED. AND THERE'S THE
POTENTIAL THAT THERE'S CONFLICT
IN SOME LOCATIONS BETWEEN THE
WAY IN WHICH THE FEE SCHEDULE IS
BEING NEGOTIATED AND HOW IT
WOULD BE IMPLEMENTED IN SCHOOLS
WERE STILL WORKING THAT OUT, BUT
THAT HAS DELAYED OUR CAPACITY TO
RELEASE THIS TECHNICAL
ASSISTANCE FUNDING AS WE SORT
THROUGH THE MATCH, SO TO SPEAK
BETWEEN WHAT OUR EDUCATION
PARTNERS ARE ASKING FOR AND WHAT
IS WHAT IS BEING NEGOTIATED ON
THE STATE SIDE. AND SO WE DON'T
WE'RE NOT ALWAYS AT THAT TABLE.
BUT THERE ARE SOME EARLY
INDICATIONS THAT THERE'S A LOT
OF WORK TO DO AND THE TIMING MAY
NOT LINE UP AS EFFECTIVELY AS
WE'D LIKE TO. WE'RE HOPING TO
MOVE FORWARD BECAUSE ULTIMATELY
WE WANT TO DO IS REALLY
FACILITATE ELEVATE THAT LOCAL
SCHOOL BEHAVIORAL HEALTH VOICE
TO BE ABLE TO JOIN THE TABLE
WITH THE DEPARTMENT OF HEALTH
CARE SERVICES AND THE COAST AND
ALL THE NEGOTIATIONS THAT THEY
DO, I WILL ADMIT I AM. YOU KNOW,
IN ALL OF MY COLLEAGUE HERE
BECAUSE I DID NOT UNDERSTAND
WHAT SHE UNDERSTANDS HALF THE
TIME. SHE SAYS THINGS THAT I GO
OVER MY HEAD AND I HAVE TO
GOOGLE THESE WORDS. UM MOSTLY,
WHAT WE WANT TO DO IS MAKE SURE
THAT OUR LOCAL PARTNERS, UM ARE
REALLY, UM THAT WHATEVER THE
STATE PUTS IN PLACE IS
RESPONSIVE. SO THAT IT CAN BE
SUSTAINED AND ADAPTED. FOR THE
VERY DIVERSE REALITIES OF A
SCHOOL IN TO HEMA. AND THE
SCHOOL IN ALAMEDA IN A SCHOOL
AND FRESNO. I AM A ASK MS COOPER
TO RESPOND AT THAT INTERFACE
BETWEEN C Y B H I AND WHAT WE'RE
SEEING WITH THE MENTAL HEALTH
STUDENT SERVICES GRANT PROGRAM.
HOW DO WE ENSURE THAT THEY ARE
COMPLEMENTARY AND SUPPORTIVE OF
EACH OTHER? SO I'M NOT IN THOSE
CONVERSATIONS, SO I MAY NEED TO
OFFLINE WITH MY TEAM. BUT THE
BIGGEST THING THAT WE'RE TRYING
TO NAIL DOWN WITH THE FEE
SCHEDULE AND IT'S NOT A
NEGOTIATION. IT'S STAKEHOLDER
ENGAGEMENT BECAUSE WE WHATEVER
WE'RE RELEASES WHAT'S
REIMBURSABLE AND THEN WE SET
RATES FOR IT, AND THEN MANAGED
CARE PLANS ARE REQUIRED TO
PROVIDE IT. SO WE'RE NOT
NEGOTIATING WITH MANAGED CARE
PLANS JUST TO BE HONEST WITH
YOU. WE'RE TRYING TO MAKE SURE
WHAT ARE THE TYPES OF SERVICES
THAT CAN BE PROVIDED IN THE
SCHOOL SETTING OR NEAR SCHOOL
SETTING. APPROPRIATELY. UM AND
THERE'S BEEN A LOT OF FEEDBACK
ON THAT. SOME PEOPLE THINK
CERTAIN THINGS CAN EASILY BE
PROVIDED IN SCHOOLS, AND SOME
PEOPLE THINK THAT'S PROBABLY NOT
THE APPROPRIATE SETTING. YOU
WANT TO MAKE SURE IT'S IN A
DIFFERENT SETTING OR IN ADJACENT
SETTING. AND SO THAT'S BEEN A
LOT OF MANY, MANY PUBLIC
STAKEHOLDER ENGAGEMENT MEETINGS
THAT WE MAKE AVAILABLE FOR
ANYONE WHO WANTS TO JOIN, MANY
OF WHICH THE COMMISSION
PARTICIPATES IN, UM AND WE'VE
BEEN TRYING TO NAIL DOWN. WHAT
IS THAT RIGHT SUITE OF SERVICES
TO MAKE SURE IT COVERS
EVERYTHING FROM SCREENING TO
SOME OF THE THERAPY SERVICES TO
MAYBE SOME HIGHER INTERVENTION,
IF POSSIBLE, UM, RIGHT, BUT
INAPPROPRIATE WAY RIGHT SO THAT
YOU HAVE AN ABILITY TO INTERVENE
IN A CRISIS. IF THERE'S ONE
THAT'S A VEILED BUT THEN GETTING
THEM TO THE RIGHT SERVICES TO
BECAUSE WE WANT TO MAKE SURE
THAT IF WE ARE PROVIDING OUR
SCREENING FOR SERVICES THAT
THOSE KIDS GET THE SERVICES THAT
THEY NEED, BECAUSE THAT IS
ANOTHER FEAR, RIGHT? YOU CAN'T
JUST SCREEN HAVE SOMEONE TELL
YOU THEY HAVE AN ISSUE AND THEN
NOT GET THEM CONNECTED TO
SERVICES. SO WE'RE TRYING TO
REALLY WORK WITH OUR SCHOOL
PARTNERS. WHAT DOES THIS LOOK
LIKE? HOW DO WE GET THE PIECES
AND THEN WE'LL SET THE SCHEDULE.
I THINK WE'RE REALLY CLOSE ON
THE FEAST SCHEDULE IN REGARDS TO
WHAT SERVICES WILL BE ON THERE.
I'M NOT QUITE UNDERSTANDING THE
IMPACT OF WHAT'S HOLDING UP ON
YOUR SIDE. TO BE HONEST WITH
YOU. I WOULD NEED TO BETTER TALK
TO MY TEAM WHO IS IN THOSE
WEEDS. BUT WE'RE HOPING THAT I
MEAN IT IS GOING TO BE A BIG
LIFT. L A UNIFIED SCHOOL
DISTRICT IS VERY DIFFERENT THAN
A SMALL RURAL AREA AND WHAT THEY
CAN OFFER EVEN IF WE COME OUT
WITH THE FULL SCALE SCHEDULE.
THEY'RE NOT MANDATED TO PROVIDE
IT. SCHOOLS GOING TO DO IT AT
THEIR OPTION. UM AND IN SCHOOLS
DON'T HAVE TO DO ALL THE
SERVICES AND SCHOOLS, UM, BUILD
IN BEHAVIORAL HEALTH SERVICES
DIFFERENTLY. SOME BRING IT IN
HOUSE. SOME PARTNER WITH OUTSIDE
PROVIDERS WHO COME ON SITE, AND
SOME WILL DO IT THROUGH PIECES.
BUT ONE THING THAT IS IN STATUTE
IS THE SCHOOL GETS TO DECIDE.
THE SCHOOL GETS A SOCIETY IF
IT'S THEIR PROVIDERS DIRECTLY,
REIMBURSING OR IF THEY'RE
PARTNERING WITH PROVIDERS AS A
SCHOOL ELECTED SITE, BECAUSE IT
HAS TO BE IN COORDINATION WITH
THE SCHOOL, SO KIDS ARE EDUCATED
ABOUT WHERE THEY CAN GO AND
GETTING ACCESS EASILY TO THOSE
SERVICES. AND SO I'D HAVE TO
FIGURE OUT MORE OF THE
INTERACTION HERE. I'M NOT AS
FAMILIAR TO BE HONEST WITH YOU,
BUT IT IS COMPLICATED TO SAY.
IT'S NOT COMPLICATED IS AN
UNDERSTATEMENT. JUST TO BE CLEAR
, BRINGING EDUCATION AND
HEALTHCARE TOGETHER IN THIS WAY
, BECAUSE THERE ARE SO MANY
DIFFERENT MANDATES THAT HIT
DIFFERENT PIECES. AND I THINK
WE'RE TRYING TO BE VERY
THOUGHTFUL, WORKING REALLY
DEEPLY WITH OUR EDUCATION
PARTNERS, WORKING VERY DEEPLY
WITH A VERY LARGE GROUP OF
STAKEHOLDERS INFORMING THAT
RIGHT MIX AND I THINK WE'RE VERY
CLOSE BUT HAPPY TO OFFLINE, UM,
WITH THE COMMISSION IN REGARDS
TO WHAT MAY THAT INTERACTION BE?
MY TEAM PROBABLY KNOWS. I JUST
I'M NOT IN THOSE WEEDS,
UNFORTUNATELY, AND I'LL JUST
SHARE UM AND GLAD WE'RE MEETING
STUDENTS WHERE THEY'RE AT. BUT
WHEN YOU HAVE 1000 DIFFERENT
SCHOOL DISTRICTS DOING IT IN
MANY DIFFERENT WAYS, IT MAKES IT
HARD TO HAVE CONFIDENCE THAT WE
CAN EFFECTIVELY BREAK DOWN THOSE
SILOS THAT WE HAVE TO DO. AND SO
I'M GLAD THAT THE ADMINISTRATION
HAS TAKEN THE CHALLENGE AGAIN
AND IS WORKING TO FIGURE OUT HOW
TO HAVE THOSE TOUGH
CONVERSATIONS WITH THE LOCAL
EDUCATION AGENCIES. BUT I HAVE
PARTICULAR CONCERN ON THE
IMPLEMENTATION OF THAT
SPECIFICALLY. BECAUSE NOT ALL
DISTRICTS ARE CREATED EQUAL. NOT
ALL COUNTIES ARE CREATED EQUALLY
AND REALLY REQUIRES OVERSIGHT
FROM US TO ENSURE WE'RE
PROVIDING AS MANY OPPORTUNITIES
TO STUDENTS AT THE END OF THE
DAY. PARENTS ARE GONNA BE
DEMANDING IT AND ASKING FOR IT
AND WANTING THEIR SCHOOL
DISTRICTS TO PERFORM, AND I'D
LIKE US TO CONTINUE TO FIGURE
OUT THESE INTERFACES SO THAT WE
CAN THEN PROVIDE AS MANY
RESOURCES AS WE CAN FOR OUR
CHILDREN. WITH THAT I WILL THANK
VERY MUCH THIS PANEL AND WE WILL
MOVE ON TO FOUR K. DEPARTMENT OF
COMMUNITY SERVICES AND
DEVELOPMENT.
GOOD AFTERNOON CHAIR, SENATOR
JACKSON. I'M JASON WIMBLEY,
CHIEF DEPUTY DIRECTOR OF THE
DEPARTMENT, COMMUNITY SERVICES
AND DEVELOPMENT. UM I'M HAPPY TO
BRIEF YOU ON THE TECHNICAL
ADJUSTMENT, INCLUDING THE MAYBE
REVISION TO AVERT THE UNEXPENDED
BALANCE OF LOCAL ASSISTANCE
FUNDING UNDER THE 2022,
CALIFORNIA VARIOUS PAYMENT
PROGRAM ALSO REFERRED TO AS THE
2022 CAP. THE 2022 STATE BUDGET
ACT APPROPRIATE AT 1.2 BILLION
IN CALIFORNIA EMERGENCY RELIEF
FUNDS FOR THE 2022 CALIFORNIA
REARS PAYMENT PROGRAM TO REDUCE
ENERGY BILL ARREARAGES INCURRED
DURING THE COVID PANDEMIC RELIEF
PERIOD FOR ANY RESIDENTIAL
ENERGY CUSTOMERS. IN THE IN
NOVEMBER, CSD DISTRIBUTED 647
MILLION IN CAP ASSISTANCE TO 33
STATE ENERGY UTILITIES,
ELIMINATING THE PAST TWO ENERGY
DEBT OF APPROXIMATELY 1.4. A
MILLION RESIDENTIAL ENERGY
UTILITY CUSTOMERS. FOLLOWING THE
DISTRIBUTION, A BALANCE OF
APPROXIMATELY 550 MILLION OF
UNALLOCATED 2022 CAP FUNDS
REMAINED THE GOVERNOR'S JANUARY
BUDGET IDENTIFIED 400 MILLION IN
2022 CAP LOCAL ASSISTANCE
FUNDING FOR REVERSION, WHICH WAS
A POINT IN TIME ESTIMATE AS
UTILITIES WERE STILL ACTIVELY
HANDLING DISPERSE FUNDS. MAYBE
REVISION IDENTIFIES AN
ADDITIONAL 149.4 MILLION IN
UNEXPENDED LOCAL ASSISTANCE CAP
FUNDS, WHICH IS BASED ON ACTUAL
CAP APPLICATIONS, AND FOR
FUNDING AND DISBURSEMENTS. SO
THIS CONCLUDES MY OVERVIEW HAPPY
TO TAKE ANY QUESTIONS FROM THE
COMMITTEE DEPARTMENT OF FINANCE
ALMOST ANGELES OF THE DEPARTMENT
OF FINANCE NOTHING FURTHER TO
ADD ELIO THANK YOU, MR CHAIR,
GINNY BELLOW WITH THE
LEGISLATIVE ANALYST'S OFFICE. WE
HAVE NO CONCERNS WITH THE
PROPOSAL. WE REALLY DO VIEW IT
AS TECHNICAL. WE KNEW THE
JANUARY PROPOSAL WAS A POINT IN
TIME ESTIMATE, AND WE EXPECTED
ABOUT THIS MUCH, UM, IN
ADDITIONAL REVERSION TO BE
PROPOSED IN MAY. WONDERFUL I'LL
BRING IT UP TO THE DOCS SEEING
NO MEMBERS, QUESTIONS. WE WILL
THANK THIS PANEL AND MOVE ON TO
OUR NEXT ONE. GREAT. Tð HAPPY
BIRTHDAY CHAIR. THANK YOU.
MONTANA. WE'RE NOW ON FOUR L
DEPARTMENT OF REHABILITATION.
DIRECTOR XAVIER WHEN YOU ARE
READY. ONE PLACE TO THE OTHER
WAY. GOOD MORNING CHAIR. THE
MICROPHONE HERE. CAN YOU HEAR
ME? OKAY. OKAY? THERE WE GO.
GOOD MORNING. GOOD AFTERNOON. I
SHOULD SAY TO EVERYONE. JONES
XAVIER, DIRECTOR FOR THE
DEPARTMENT OF REHABILITATION. UH
UM. WE HAVE A PROPOSAL TODAY,
WHICH IS BASED ON HAVING
RECEIVED ADDITIONAL VOCATIONAL
REHABILITATION DOLLARS MADE
AVAILABLE TO THE STATE OF
CALIFORNIA. WE ARE REQUESTING AN
INCREASE OF $180 MILLION OF
AUTHORITY. $60 MILLION OVER EACH
OF THE NEXT THREE YEARS. THESE
DOLLARS HAVE ALREADY BEEN
MATCHED IN OR AVAILABLE TO THE
STATE OF CALIFORNIA. AND THE
ALLOWED AND ELIGIBLE USE OF
THOSE DOLLARS WILL REMAIN THE
SAME. UM THIS WILL ENABLE US TO
CONTINUE TO ENGAGE WITH OTHER
SYSTEMS SUCH AS JUVENILE JUSTICE
, YOUTH FOSTER YOUTH TO CONTINUE
TO PROVIDE EMPLOYMENT SERVICES.
UM CERTAINLY TO CONTINUE TO
ADVANCE SERVICES TO BOTH OF THE
YOUTH AND THE ADULT POPULATIONS.
AND OBVIOUSLY FOR THOSE YOUTH
WHO WERE IN HIGH SCHOOL THAT
TRANSITION OUT OF HIGH SCHOOL
AND THEY COME TO US FOR
EMPLOYMENT SERVICES WILL ENABLE
US TO CONTINUE TO ADVANCE
SERVICES IN THAT ARENA. AND
THEN, OF COURSE, TO CONTINUE TO
WORK WITH OUR BUSINESS
COMMUNITY, SO THAT AT THE END OF
THE DAY THE INDIVIDUALS WITH
DISABILITIES OR GETTING IT TO
COMPETITIVE INTEGRATED
EMPLOYMENT SO THAT THAT IS THE
SHORT VERSION OF THE PROPOSAL
BEFORE YOU GLAD TO TAKE ANY
QUESTIONS THAT YOU HAVE. THANK
YOU. DEPARTMENT OF FINANCE.
ALMOST SANCHEZ OF THE DEPARTMENT
OF FINANCE NOTHING FOR THEIR
DAD. HELLO? LUCAS MORROW, THE
LEGISLATIVE ANALYST'S OFFICE. WE
DIDN'T HAVE ANY CONCERNS OF THIS
PROPOSAL. BRING IT UP TO THE
DIOCESE SEEING NO MEMBERS,
QUESTIONS I WILL THANK VERY MUCH
THIS PANEL. GREAT TO SEE YOU,
DIRECTOR XAVIER. THANK YOU. WE
WILL NOW MOVE ON TO FOUR M
DEPARTMENT OF CHILD SUPPORT
SERVICES.
GOOD AFTERNOON CHAIR ARAMBULA
MEMBER JACKSON NANCHANG, CHIEF
FINANCIAL OFFICER FOR THE
DEPARTMENT AND THE MAYOR
REVISION. THERE'S A TECHNICAL
ADJUSTMENT TO CAPTURE THE DELAY
OF THE FORMERLY ASSISTED, UH,
ARREARS PASSED THROUGH PROGRAM.
THE DELAY WAS FROM JULY TO
APRIL, AND WE HAD DISCUSSED THE
ISSUE PREVIOUSLY IN THE
GOVERNOR'S BUDGET HEARINGS, SO
THIS IS JUST THE BUDGET KIND OF
CATCHING UP. THE TECHNICAL
ADJUSTMENT IS EFFECTIVELY
SWITCHING, SHIFTING ABOUT $64
MILLION IN BUDGET AUTHORITY FROM
OUR 8004 FUND, WHICH IS WHERE WE
DEPOSIT THE FEDERAL SHARE OF
RECRUITMENT AND THEN A
SUBSEQUENT DECREASE IN
OFFSETTING DECREASE IN OUR 8 90,
WHICH IS WHAT WE USED TO DRIVE
DOWN THE FEDERAL GRANT FUNDS FOR
MATCHING OUR COSTS. I'M HAPPY TO
TAKE ANY QUESTIONS. THE
DEPARTMENT OF FINANCE. OMAR
SANCHEZ WITH THE DEPARTMENT OF
FINANCE NOTHING FURTHER TO ADD.
ELIO. GINNY BELLA, WITH THE
ANALYST'S OFFICE. WE AGREE THAT
THIS UH THIS ADDITIONAL REVENUE
REALLY DOES REFLECT THE UPDATED
ESTIMATED TIMELINE FOR
IMPLEMENTATION. UM I BRING IT UP
TO THE DIOCESE FOR QUESTIONS.
KEEP IT HERE AT THE CHAIR. I'M
TRYING TO UNDERSTAND THE DELAYED
IMPLEMENTATION THAT IS BEING
DISCUSSED AND HOW WE DON'T ALLOW
THAT DATE TO, UM, PASSES BY
WITHOUT IMPLEMENTING AS THE
LEGISLATURE HAD INTENDED, OR ARE
YOU ABLE TO GIVE US SOME
CONFIDENCE OR CAN YOU GIVE US
REGULAR UPDATES TO ENSURE THAT
WE'RE GOING TO MEET THAT
TIMELINE? UM SO WE'RE DEFINITELY
COMMITTED TO THE APRIL 2024
CHANGE. UM WE'VE BEEN WORKING
WITH OUR TECHNICAL TEAMS AND
EVERYONE AT THE DEPARTMENT. THE
CALL TO ARMS HAS BEEN CALLED AND
EVERYONE IS REALLY STEPPING UP.
WE'RE WE'VE BEEN REASSURED BY
OUR TEAMS THAT APRIL IS
DEFINITELY DOABLE, AND WE
UNDERSTAND THAT IT'S DEFINITELY
A PRIORITY FOR THE LEGISLATURE
AS WELL AS THE ADMINISTRATION.
IT'S A MONUMENTAL CHANGE FOR THE
DEPARTMENT. AND WE DEFINITELY
WANT TO SEE IT THROUGH AS SOON
AS POSSIBLE. I APPRECIATE THAT.
I JUST DIDN'T LIGHT OF THE
OVERALL BUDGET PICTURE. MANY OF
US WANT UPDATES REGULARLY. AND
IF THINGS DO CHANGE WOULD
ANTICIPATE THAT YOU REACH OUT
AND NOTIFY OUR SYSTEM AS
POSSIBLE. OF COURSE. WITH THAT
WE WILL THANK THIS PANEL AND
MOVE ON TO FOUR N DEPARTMENT OF
SOCIAL SERVICES.
AS THIS IS OUR FINAL PANEL. I'M
GOING TO ASK THAT WE GO THROUGH
A BULLET POINT AND THEN GO
THROUGH FINANCE AND L A SO THAT
WE DON'T HAVE 20 OF THEM FOR US
TO SUMMARIZE AT THE END, JUST
FOR FLOW. BUT IF YOU CAN BE IN
WHEN YOU'RE READY. JUST TO JUST
TO CONFIRM THAT I UNDERSTOOD.
DID YOU WANT US TO GO ITEM BY
ITEM AND THEN DO ALL ALL
COMMENTS ON EACH ITEM, OKAY.
OKAY WE'RE TOGETHER. SO THIS OFF
GOOD AFTERNOON, MR CHAIR MEMBERS
, JENNIFER TROIA ON BEHALF OF
THE DEPARTMENT OF SOCIAL
SERVICES. GOOD TO BE HERE WITH
YOU THIS AFTERNOON. YOU HAVE A
NUMBER OF ITEMS THAT YOU'VE
PULLED OUT AND ASKED US TO
ADDRESS AND WE'LL JUST GO OUT
AND BUY ITEM AND DO SO. THE
FIRST ONE IS RESPECT TO THE COW
WORKS. FAMILY REUNIFICATION.
THIS IS AUTOMATION AND COUNTY
ADMINISTRATION FUNDING. SO THIS
IS A POLICY THAT WE HAVE ALREADY
AGREED UPON IN THE PAST, UM TO
PROVIDE SERVICES AND CONTINUED
CASH ASSISTANCE TO FAMILIES
WHOSE CHILDREN ARE REMOVED
DURING THE PERIOD OF
REUNIFICATION IN ORDER TO
SUPPORT THAT REUNIFICATION
SUCCESS. WE EXTENDED THE PERIOD
OF TIME IN THE 2021 BUDGET. THE
MAY REVISION INCLUDES 3.8
MILLION GENERAL FUND FOR
AUTOMATION AND COUNTY
ADMINISTRATION TO IMPLEMENT THAT
CONTINUED CASH ASSISTANCE AS
REQUIRED BY THE PRIOR BUDGET.
DEPARTMENT OF FINANCE. JANINE
DOCTOR WITH THE DEPARTMENT OF
FINANCE. NOTHING TO ADD. WE HAVE
NO CONCERNS WITH THIS PROPOSAL.
LET'S GO TO THE NEXT. I DON'T
KNOW. THE NEXT ONE IS THE COW
WORKS, MAXIMUM AID PAYMENT OR
GRANT INCREASE. UM AND
ASSOCIATED TRAILER BILL LANGUAGE
. THIS IS AN UPDATED ESTIMATE.
WITH RESPECT TO, UM THE GRANT
INCREASED LEVEL IT IS NOW
ESTIMATED TO BE 3.6% EFFECTIVE
OCTOBER 1 2023 AT A COST OF $111
MILLION IN THE BUDGET YEAR. UM
THIS INCREASE IS FUNDED ENTIRELY
BY THE CHILD POVERTY AND FAMILY
SUPPLEMENTAL SUPPORT SUB ACCOUNT
IN THE LOCAL REVENUE FUND. IT
WILL BRING THE NONEXEMPT MAXIMUM
AID PAYMENT OR GRANT LEVEL FROM
1132 $1171 PER MONTH FOR A
FAMILY AND AN ASSISTANCE UNIT OF
THREE IN A HIGH COST COUNTY. SO
THAT'S A $41 INCREASE FROM THE
CURRENT LEVEL. AND IT EQUATES TO
57% OF THE 2023 FEDERAL POVERTY
LEVEL FOR A FAMILY, THE SAME
FAMILY SIZE AND 47% OF THE
FAMILY SIZE ONE GREATER THAN THE
ASSISTANCE UNIT. THERE'S TRAILER
BILL LANGUAGE THAT IS PURELY
TECHNICAL TO INCLUDED TO
EFFECTUATE THAT GRANT INCREASE.
DEPARTMENT OF FINANCE. JANINE
DOCTOR DEPARTMENT OF FINANCE.
NOTHING TO ADD HELLO, BELLA WITH
THE ANALYST'S OFFICE. THIS
ACTUALLY RAISES A LARGER
QUESTION FOR US AS WE'RE IN THE
EARLY STAGES OF EVALUATING THE
GOVERNORS MAY REVISION, AND IN
THAT PROCESS, ONE OF OUR MAIN
TASKS IS TO REALLY LOOK AT
CASELOAD PROJECTIONS AND REALLY
UNDERSTAND THE ESTIMATE AND KIND
OF HOW THAT'S LINING UP WITH
ACTUALS. IT'S A REALLY DIFFICULT
TASK. IT'S INHERENTLY HARD TO DO
AND TO PIN DOWN AND PARTICULARLY
WITH COW WORKS OVER THE LAST FEW
YEARS, WE'VE WE'VE STRUGGLED TO
REALLY PREDICT THE CASELOAD. WE
HAD REACHED A POINT IN JANUARY,
WHERE OUR ESTIMATES WERE VERY
CLOSE TO THE ADMINISTRATION'S
ESTIMATES WERE NOW TO A POINT
WHERE OUR ESTIMATES ARE HIGHER
THAN THE ADMINISTRATION'S AS
PROPOSED IN THE MAY REVISIONS
WERE REALLY WORKING TO BETTER
UNDERSTAND OUR MODEL IN THEIR
MODEL AND WHY THAT MIGHT BE
OCCURRING. BUT ONE OF THE
CHALLENGES THAT RAISES IS THEN
ALSO THINKING ABOUT THIS. THE
SUSTAINABILITY OF THE GRANT
INCREASE FROM THE CHILD POVERTY
ACCOUNT BECAUSE IF THAT ACCOUNT
DOESN'T HAVE ENOUGH MONEY TO
SUPPORT THE GRANT INCREASE IN
THE FUTURE, IT DOES BECOME A
GENERAL FRIEND PRESSURE, SO
THAT'S SOMETHING THAT WE'RE
LOOKING AT. SO FOR OUR
PROJECTIONS, THE ACCOUNT
COULDN'T SUSTAIN THAT LARGE OF A
GRANT INCREASE, BUT AGAIN, WE'RE
STILL WORKING WITH THE
ADMINISTRATION TO BETTER
UNDERSTAND IT. THANK YOU AND
WELCOME DIRECTOR JOHNSON. THANK
YOU. WE'RE ON THE THIRD ITEM.
UH, THE THIRD ITEM IS THE COW
WORK. SINGLE ALLOCATION. UM
THERE'S BOTH A PARTIAL REVERSION
OF FUNDING ON A ONE TIME BASIS
AND THEN 23 24 UPDATES. SO JUST
QUICK BACKGROUND AS A REFRESHER
BASED ON THE PROJECTED CASELOAD,
THE COUNTY'S GET A FIXED AMOUNT
OF FUNDING FOR ADMINISTERING THE
COW WORKS PROGRAMS AND IN
PROVIDING EMPLOYMENT SERVICES.
IT'S A SINGLE ALLOCATION BLOCK
GRANT THAT ALLOWS FOR FUND
ABILITY BETWEEN THOSE
EXPENDITURE PURPOSES, THE
CURRENT METHODOLOGIES FOR
ELIGIBILITY, ADMINISTRATION AND
EMPLOYMENT SERVICES WERE REVISED
IN 2018 AND 2019 FISCAL YEARS
RESPECTIVELY. SO THE FIRST
PROPOSAL IS A PART OF THE MAY
REVISION IS AN EARLY REVERSION
OF THE 21 22 SINGLE ALLOCATION
FUNDING. THE 21 BUDGET ALLOCATED
$1.8 BILLION FOR THE SINGLE
ALLOCATION. THE DEPARTMENT IS
PROJECTING THAT COUNTIES WILL
SPEND 1.48 BILLION. SO, UM, THE
334 MILLION THAT REMAINS WOULD
GO UNSPENT. AS A SOLUTION TO
ADDRESS THE STATE'S BUDGET
DEFICIT. WE ARE PROPOSING TO
REVERT THAT FUNDING AND AN
EARLIER TIMELINE RATHER THAN
WAITING UNTIL JUNE, 30 2024 WHEN
IT WOULD HAVE REVERTED ANYWAY ON
THE NATURAL UM, OF THAT
ALLOCATION. THERE WILL STILL
REMAIN SOME FUNDS AVAILABLE FOR
COUNTIES TO CLAIM BECAUSE THE
CLAIMING TIME DOES LAG FROM
EXPENDITURE TO FULL CLAIMING WE
WILL AND ARE ENGAGING WITH THE
COUNTY WELFARE DIRECTORS
ASSOCIATION TO DETERMINE THE
PRECISE AMOUNT AVAILABLE AND
ENSURE THAT OUR ESTIMATES ARE
CONSISTENT WITH WHAT THEY EXPECT
TO DRAW DOWN AS WELL. WE DON'T
EXPECT THIS REVERSION TO HAVE
ANY IMPACT AT ALL AND CLIENT
SERVICES AGAIN. THESE ARE FUNDS
THAT WOULD HAVE REVERTED TO THE
GENERAL FUND LATER, BUT WE ARE
UH, ACTING EARLIER IN LIGHT OF
THE BUDGET DEFICIT. YOU ASKED A
QUESTION AS WELL ABOUT THE
SINGLE ALLOCATION IN TERMS OF
THE CHANGES AND WHETHER THERE'S
A YEAR OVER YEAR DECREASE, SO
THE MAY REVISION INCLUDES 1.7
BILLION FOR THE SINGLE
ALLOCATION IN 23 24. IT IS A
DECREASE ALSO FROM THE
GOVERNOR'S BUDGET, AND THIS IS
RELATED TO SLOWER CASELOAD
GROWTH AND ALSO TO THE INCREASES
IN SHARED ELIGIBILITY COSTS.
THIS IS THE FUNDING SPLIT
BETWEEN THE COW WORKS, CAL FRESH
AND MEDICAL APPLICATIONS WHEN
YOU COME IN THE DOOR AND APPLY
FOR ALL THREE SO THAT YEAR OVER
YEAR CHANGES, A DECREASE OF 200
MILLION UM, AND THEN I THINK
IT'S ALSO IMPORTANT TO NOTE THAT
THE 2022 23 SINGLE ALLOCATION
AMOUNT THAT'S IN THE MAY
REVISION INCLUDES $251 MILLION
THAT IS MAINTAINING THE
ALLOCATION AT THE LEVEL THAT THE
GOVERNOR'S BUDGET WAS PROJECTING
FOR 22 23 DESPITE THE SLOWER
GROWTH IN THE CASELOADS, SO
ESSENTIALLY, THE COUNTIES ARE
BEING HELD HARMLESS. UM, FOR
THAT. FOR THAT REDUCTION THAT
OTHERWISE WOULD WOULD HAVE
OCCURRED. UM THERE IS ALSO THE
ONE TIME SUPPLEMENTAL
INVESTMENTS THAT HAVE BEEN
INVESTED IN THE RECENT YEARS.
THEY REMAIN IN THE SINGLE
ALLOCATION AND THEN THE FINAL
THING I WOULD NOTE WITH RESPECT
TO THE SINGLE ALLOCATION IS JUST
A REMINDER THAT WE ARE DUE TO
REASSESS THE FORMULA FOR THE
SINGLE ALLOCATION AND EXPECT
THOSE REASSESSMENT CONVERSATIONS
TO BEGIN THIS SUMMER. DEPARTMENT
OF FINANCE DOCTOR DEPARTMENT OF
FINANCE. NOTHING TO ADD. WE
CONCUR WITH THE DEPARTMENT'S
COMMENTS, ELIO WE HAVE NO
CONCERNS WITH THE EARLY
REVERSION. IT'S UNDER OUR
UNDERSTANDING THAT WE HAVE DONE
THIS BEFORE IN THE PAST. FOR US,
IT DOES RAISE LARGER QUESTIONS
ABOUT THE SINGLE ALLOCATION AND
UNSPENT FUNDING THAT WE WOULD
LIKE TO TAKE A CLOSER LOOK AT
THANK YOU. LET'S MOVE ON TO THE
NEXT ITEM. GOOD AFTERNOON, KIM
JOHNSON DEPARTMENT OF SOCIAL
SERVICES AND MOVING TO THE
COUNTY CAL. FRESH ADMINISTRATION
REBASED. WE'VE BEEN TALKING WITH
THIS COMMITTEE AROUND FUNDING
METHODOLOGIES. THIS IS A GREAT
EFFORT THAT WE'RE IN GREAT
APPRECIATION OF OUR PARTNERS
ACROSS THE BOARD AND HELPING US
TO DEVELOP. IT INCLUDED NOT ONLY
THAT ENGAGEMENT BUT ALSO A 50
COUNTY SURVEY THAT INFORMED US
GOING FORWARD AS A RESULT WITH
OUR COUNTY PARTNERS IN ADVOCATES
. THIS MAY REVISION INCLUDES AN
ADDITIONAL $406.5 MILLION 159.5
OF WHICH IS FROM GENERAL FUND.
TO REFLECT REVISED BUDGETING
METHODOLOGY FOR COUNTY, CALIF.
FRESH ADMINISTRATION ACTIVITIES
. THIS IS AN 18.6% INCREASE WHEN
COMPARED TO THE CURRENT
METHODOLOGY. THE NEW METHODOLOGY
INCLUDES UPDATES AND FUNDING FOR
APPLICATION, BOTH THOSE THAT ARE
APPROVED AND DENIED EXPEDITED
SERVICE TIMEFRAMES VARIANTS AND
REQUIRED ACTIVITIES ASSOCIATED
WITH SPECIFIED POPULATIONS. AND
REQUIRED ADMINISTRATIVE
ACTIVITIES PERFORMED BY
SPECIALIZED WORKER. IT'S AN
UPDATED FULLY LOADED CAL FRESH
ELIGIBILITY WORKER RATE AND
AVERAGE FUNDING FOR INTAKE
COMPONENT AND ONGOING CASE
MANAGEMENT COMPONENT. UM AND SO
AGAIN, WE'LL BE LOOKING TO
UPDATE THE CASELOADS ANNUALLY IN
THIS METHODOLOGY, AND WE HAVE A
COMMITMENT TO REVISIT THE
METHODOLOGY OVERALL TRY AND
ITALY DEPARTMENT OF FINANCE
DOCTOR DEPARTMENT OF FINANCE.
NOTHING TO ADD. THANK YOU. WE
WILL BE TAKING A CLOSER LOOK AT
THE REVISED METHODOLOGY
SPECIFICALLY WITH AN EYE TOWARDS
WHETHER OR NOT IT BAKES IN SOME
LESSONS LEARNED FROM OTHER
ADMINISTRATIVE METHODOLOGIES
THAT THE DEPARTMENT HAS WORKED
TO ESTABLISH OVER THE LAST FEW
YEARS. FOR EXAMPLE, IN CALL
WORKS. WE HAVE LEARNED THAT THAT
ADMINISTRATIVE METHODOLOGY THAT
WE ADOPTED A FEW YEARS AGO
DIDN'T WORK AS WELL WHEN IT WHEN
WE WERE PREDICTING VERY QUICK,
VERY HIGH CASELOAD INCREASES OR
DECREASES. SO HOW WOULD THIS
METHODOLOGY ADDRESS THOSE? SO
THOSE TYPES OF QUESTIONS? WE
HOPE TO GET A BETTER
UNDERSTANDING OF THANK YOU.
LET'S MOVE ON TO OUR NEXT ITEM
IN TERMS OF FEDERAL
REIMBURSEMENT OF FOOD BENEFIT
THEFT, THE FEDERAL CONSOLIDATION
APPROPRIATIONS ACT OF 2023
MANDATED FEDERAL REIMBURSEMENT
OF SUPPLEMENTAL NUTRITION
ASSISTANCE PROGRAM OR SNAP FOOD
BENEFITS THAT FEDERAL LAW ALSO
RETROACTIVELY INSTITUTED FEDERAL
REIMBURSEMENTS FOR SNAP
BENEFICIARIES DEFRAUDED BY
SKIMMING AND SCAMMING. BEGINNING
OCTOBER OF 2022 THROUGH
SEPTEMBER OF 2024. SO PRIOR TO
THIS LAW, CALIFORNIA WAS
REIMBURSING VICTIMS WITH STATE
GENERAL FUND. THIS POLICY ALLOWS
FOR FEDERAL REIMBURSEMENT FOR A
PORTION OF THESE COSTS. THE
MERRY VISION INCLUDES 75.7
MILLION TOTAL FUNDS, 42.9 OF
WHICH ARE FEDERAL 32.5, WHICH
OUR GENERAL FUND FOR ASSOCIATED
COSTS FOR ACTIVITIES TO ASSIST
CLIENTS WHO HAVE BEEN SUBJECT TO
FRAUD. THERE'S ALSO TWO POINT
INCORPORATED IN THAT 2.2 MILLION
RELATED TO AUTOMATION CHANGES,
30.3 MILLION RELATED TO
ADMINISTRATIVE ACTIVITIES AND
AGAIN, THE REMAINDER IS FOR THE
ACTUAL REIMBURSEMENT OF BENEFITS
. I ALSO WOULD JUST NOTE THE
MERRY VISION CONTINUES TO
INCLUDE $50 MILLION TOTAL FUNDS
TO IMPROVE OUR ET CARD
TECHNOLOGY. DEPARTMENT OF
FINANCE. JANINE DOCTOR FINANCE
NOTHING. TODD CONCERNS TO RAISE
FOR THE SUBCOMMITTEE. THANK YOU.
LET'S MOVE ON TO THE NEXT ITEM,
CPAP. I AM THRILLED TO BE IN
FRONT OF YOU IN THIS MAY
REVISION PROPOSAL WITH AN
UPDATED TIMELINE FOR C FAP AND
JUST AGAIN APPRECIATE ALL
PARTNERS WORK. ELSA'S F A. S OR
E B T VENDOR WHERE WE WENT
FURTHER AND LOOKED AGAIN IN A
DETAILED ANALYSIS AND REFINED
ARE ANTICIPATED TIMELINE PROGRAM
CAN AGAIN BE CONDUCTED
CONCURRENTLY WITH COUNSELORS
MIGRATION, AND WE ANTICIPATE
ANIMATION TO BEGIN IN JULY. OF
THIS YEAR. CDSS HAS REVISED THE
ESTIMATED IMPLEMENTATION, THEN
WITH BENEFIT ISSUANCES BEGINNING
OCTOBER 1 2025, WHICH REFLECTS A
NINE MONTH ADJUSTMENT FROM THE
ORIGINAL IMPLEMENTATION TIMELINE
, BUT AS A 15 MONTH EARLIER THAN
THE JANUARY 1 2027, WHICH WAS IN
THE JANUARY BUDGET PROPOSAL. THE
NINE MONTH DIFFERENCE IS FROM
THE ORIGINAL TIMELINE IS
ATTRIBUTED TO ADDITIONAL TIME
NEEDED TO DEVELOP AN ANTICIPATED
FORMS AND POLICY GUIDANCE AND TO
PREPARE FOR PRE ENROLMENT. WHICH
WE ANTICIPATE WILL BEGIN IN
SEPTEMBER OF 2025. WE WILL
CONTINUE TO KEEP THE LEGISLATURE
COMPRISED OF ANY ADDITIONAL
ADJUSTMENTS THAT ARE NECESSARY,
BUT AGAIN PLEASED TO HAVE THAT
UPDATE. DEPARTMENT OF FINANCE
NOTHING ELSE. HELLO THANK YOU.
WE'RE STILL WORKING TO BETTER
UNDERSTAND WHAT CHANGED TO ALLOW
FOR THE ACCELERATION OF THE
IMPLEMENTATION. AND ONE QUESTION
WE HAVE IS HOW THE LEGISLATURE
CAN SORT OF OVERSEE THIS PROCESS
AND WHETHER THERE ARE ANY KEY
BENCHMARKS. WE SHOULD BE
TRACKING, SO TO KNOW WHAT WE
NEED TO DO TO MAKE THAT DATE
HAPPEN AND HOW WE CAN OVERSEE
THAT AND BE ABLE TO MONITOR IT
CLOSELY. THANK YOU. NEXT. WE
HAVE BENEFITS, CAL. A REVISION
INCLUDES $3 MILLION 1.5 MILLION
OF WHICH IS GENERAL FUND IN 23
24 TO REPLICATE FEATURES OF THE
GET HEALTHY FRESH DOT ORG
WEBSITE WHERE, UH, CALIFORNIANS
CAN APPLY FOR CAL FRESH ONLINE
IN BENEFITS COW, WHICH IS THE
WHICH IS THE SAWS PORTAL
SIMILARLY, WHERE FOLKS CAN APPLY
ONLINE ONLINE APPLICATION
ASSISTANCE TOOL GET CAL FRESH IS
CURRENTLY ESTIMATED TO BE
SUNSETTING IN 2025. AND BY THAT
TIME BENEFITS COW IS EXPECTED TO
HAVE AVAILABLE AND TO OFFER THE
SAME LEVEL OF CLIENT SERVICE AND
EASE OF ACCESS IS GET CAL FRESH
.ORG SO WE'RE COMMITTED TO THE
SUCCESS OF BENEFITS CAROL AS A
SINGLE STATEWIDE APPLICATION
PORTAL, AND THIS IS FUNDING TO
HELP ENSURE THAT SMOOTH
TRANSITION DEPARTMENT OF
FINANCE. NOTHING DONE CONCERNS.
EXCELLENT LET'S MOVE TO CAL
FRESH ORAL NOTICE OF WORK RULES
. THIS IS A PROPOSAL FOR $9.7
MILLION TOTAL 3.4 MILLION OF
WHICH IS GENERAL FUND. IT IS
FEDERALLY REQUIRED FOR CAL FRESH
. THIS IS THE COUNTY
ADMINISTRATION FUNDING WE NEED
TO COMPLY WITH FEDERAL GUIDANCE
THAT REQUIRES COUNTY WELFARE
DEPARTMENTS TO PROVIDE A
COMPREHENSIVE ORAL EXPLANATION
OF CAL FRESH WORK RULES TO A
SPECIFIC SUBSET OF THE
POPULATION THAT INCLUDES WORK.
REGISTRANTS ABLE BODIED ADULTS
WITHOUT DEPENDENTS AND
CALIFORNIA PARTICIPANTS WERE
ELIGIBLE FOR CAL FRESH
EMPLOYMENT AND TRAINING. THE NEW
POLICY IS EXPECTED TO BEGIN IN
NOVEMBER OF 2023. DEPARTMENT OF
FINANCE, NOTHING DODD. NO
CONCERNS. OH BRING IT UP HERE,
UM ARE WE CONCERNED ABOUT A
CHILLING EFFECT THAT THIS WOULD
HAVE ON POPULATIONS? HOPING YOU
CAN COMMENT ON WHAT EFFECT WE
THINK THIS WILL HAVE APPRECIATE
THE QUESTION. UM, WE CERTAINLY
SHARE YOUR INTEREST IN MAKING
SURE THAT ELIGIBLE APPLICANTS
ARE APPLYING TO AND BENEFITING
FROM CAL FRESH. THIS IS
FEDERALLY REQUIRED, AND I THINK
THERE'S EVEN A VERY SPECIFIC
SCRIPT OF THINGS THAT WE DO NEED
TO SAY. BUT IT WILL COME IN THE
CONTEXT OF THE CASEWORKERS
LARGER INTERACTION WITH THE
PERSON. WHO IS APPLYING IN
CERTAINLY STILL, HOPEFULLY
ENCOURAGING THAT APPLICATION AND
USE OF THE BENEFITS THAT THEY
ARE ELIGIBLE FOR. WE'LL MOVE ON
TO WORK NUMBER CONTRACT. THE
WORK NUMBER IS A CONTRACT THAT
THE DEPARTMENT HOLDS WITH A
THIRD PARTY EMPLOYMENT AND
INCOME VERIFICATION SERVICE.
COUNTY WELFARE DEPARTMENTS USE
THIS SERVICE TO MAKE KELLY WORKS
IN CALIFORNIA ELIGIBILITY
DETERMINATIONS. THERE WERE
RECENT CHANGES IN STATE POLICY
TO REDUCE PAPERWORK BURDEN.
BURDEN'S FOR BENEFICIARIES, AND
AS A RESULT, OUR COUNTY PARTNERS
ARE UTILIZING THIS SERVICE MORE
OFTEN TO TAKE THAT BURDEN OFF OF
THE CLIENTS. BECAUSE THE VENDOR
CHARGES THROUGH THAT CONTRACT
BASED ON USAGE THAT ANTICIPATED
INCREASE IN THE USE OF THE
SERVICES IS ALSO RESULTING IN AN
INCREASE OF COSTS. SO AS A
RESULT, THE MAY REVISION
INCLUDES AN ADDITIONAL $11
MILLION IN THE BUDGET YEAR TO
AUGMENT THE CONTACT CONTRACT.
DEPARTMENT OF FINANCE. NOTHING
GOD. HELLO, CONCERNS. WILL NOW
MOVE ON TO SUMMER PROGRAM. WE
ARE VERY PLEASED TO BE GEARING
UP TO IMPLEMENT THIS NEW PROGRAM
OF THE PANDEMIC E B. T PROGRAM
IS SUNSETTING WITH THE PUBLIC
HEALTH EMERGENCY AND THE FEDERAL
GOVERNMENT IS NEWLY ALLOWING US
TO PROVIDE SUMMER MBT BENEFITS
WE EXPECT TO BEGIN PROVIDING
THEM IN THE SUMMER OF 2024. SO
THE MAY REVISION INCLUDES $47
MILLION TOTAL 23.5 MILLION OF
WHICH IS GENERAL FUND FOR
OUTREACH AND PAYMENT SYSTEM
AUTOMATION COSTS SO THAT WE CAN
BEGIN TO PHASE IN THE SUMMER
EMPTY PROGRAM. THE PROGRAM
ITSELF WILL PROVIDE $40 PER
MONTH IN SUMMERTIME FOOD
BENEFITS TO CHILDREN IN
HOUSEHOLDS THAT QUALIFY FOR FREE
OR REDUCED PRICE SCHOOL MEALS.
DEPARTMENT OF FINANCE. NOTHING
TO THANK YOU. HELLO WE'RE STILL
REVIEWING THIS PROPOSAL. BUT NO,
I HAVE NO ISSUES TO RAISE RIGHT
NOW. NEXT WE HAVE 2023 WINTER
STORMS. SO ON JANUARY 14TH 2023
IN APRIL 3RD 2023 PRESIDENTIAL
MAJOR DISASTER DECLARATIONS WITH
INDIVIDUAL ASSISTANCE WERE
DECLARED, WHICH ACTIVATED FOR
THE DEPARTMENT DISASTER. CAL
FRESH THE DISASTER CASE
MANAGEMENT PROGRAM IN THE STATE
SUPPLEMENTAL GRANT PROGRAM. THE
MERRY VISION INCLUDES
ADMINISTRATIVE FUNDING OF ONE
POINT, $1,540,000 OF WHICH IS
GENERAL FUND FOR COUNTIES TO
ASSIST INDIVIDUALS AND FAMILIES
WHO WERE NOT ELIGIBLE FOR
REGULAR CAL FRESH BENEFITS TO
RECEIVE TEMPORARY THE FOOD
BENEFITS AT THE TIME OF THE
DISASTER. THE ESTIMATED BENEFITS
ARE 3.1 MILLION FEDERAL FUNDS
FOR FAMILIES IMPACTED BY THESE
DISASTERS. THE MAYOR VISION ALSO
INCLUDES 20.5 MILLION FEDERAL
FUNDS IN CURRENT YEAR AND $39
MILLION IN FEDERAL FUNDS IN
BUDGET YEAR FOR THE DISASTER
CASE MANAGEMENT PROGRAM TO
PROVIDE CASE MANAGEMENT SERVICES
IS THAT DISASTER SURVIVORS AND
FINALLY, THE MAYOR VISION
INCLUDES 2.5 MILLION GENERAL
FUND IN CURRENT YEAR IN $125,000
IN BUDGET YEAR FOR THE STATE
SUPPLEMENTAL GRANT PROGRAM TO
AID SURVIVORS WITH REBUILDING,
REPLACING OR RENTAL ASSISTANCE.
SINCE FOLLOWING MAJOR DISASTERS
IF OTHER SOURCES OF ASSISTANCE
ARE INADEQUATE. DEPARTMENT OF
FINANCE NOTHING TO ADD CONCERN.
WE WILL NOW GO TO I ADJUST S
PROVIDER ELIGIBILITY FOR MINOR
RECIPIENTS. GLAD ALSO TO BRING
THIS PROPOSAL FORWARD TO THE
COMMITTEE. AS WE HAVE CONTINUED
OUR CONVERSATIONS RELATED TO
ADDRESSING INEQUITIES IN THE
SYSTEM THIS IS INTENTIONALLY
LOOKING TO ADDRESS THAT THE MARY
VISION INCLUDES 60 POINT,
7,000,027, 60.0.9 OF WHICH IS
GENERAL GENERAL FLYNN AND GOING
FOR THE ELIMINATION OF SPECIFIED
I. H S S MINOR RECIPIENT
PROVIDER ELIGIBILITY
REQUIREMENTS TO BETTER SERVE.
THE HSS PROGRAMS, MINOR
RECIPIENTS AND THEIR FAMILIES.
THIS PROPOSAL IMPACTS CURRENT
AUTHORIZED CASES THAT ARE UNABLE
TO HIRE A PROVIDER DUE TO
CURRENT PARENT ELIGIBILITY RULES
FOR MINOR RECIPIENTS. AFTER
DETERMINING ELIGIBILITY FOR
SERVICES. SOCIAL WORKERS ARE
REQUIRED TO ASSESS THEIR
PARENTAL ABILITY AND
AVAILABILITY TO PROVIDE I H S S
TO THEIR MINOR CHILD UNDER
CURRENT RULES AND REGULATIONS
APPARENTLY ONLY BECOME A PAID
PROVIDER FOR THEIR MINOR CHILD
IF THERE ARE NO SUITABLE
PROVIDERS AVAILABLE. AND THE
PROVIDERS PERMITTED FROM FULL
TIME EMPLOYMENT DUE TO THE CARE
NEEDS OF THE CHILD. THESE RULES
ARE COMPLEX AND CAN RESULT IN
THE UNINTENDED CONSEQUENCE OF
NEITHER A PARENT OR A NOT NON
PARENT BEING ELIGIBLE TO WORK AS
THE PROVIDER. WITH THIS CHANGE,
MINOR RECIPIENTS WILL HAVE THE
ABILITY TO CHOOSE THEIR PROVIDER
WITHOUT ADDITIONAL REQUIREMENTS
AT THIS AGAIN ENSURES THAT MINOR
CHILDREN HAVE ACCESS TO THE
PROVIDER OF CHOICE, LIKE ALL
OTHER HSS RECIPIENTS AND WILL
ADDRESS THE DISPARITY, UH, THAT
HAS BEEN STANDING ON THIS ISSUE.
DEPARTMENT OF FINANCE, AND I'M
CALLING TO PERMANENT FINANCE.
NOTHING FURTHER. THANK YOU.
WE'RE STILL REVIEWING THE
TRAILER BILL LANGUAGE. WE ARE
HOPEFUL THAT WE CAN GET SOME
DATA THAT CAN REALLY HELP US
IDENTIFY THE UTILIZATION OF
SERVICES FOR MINORS. WE CAN
BETTER UNDERSTAND THE SCOPE OF
THE PROBLEM AND HOW THE LANGUAGE
ADDRESSES IT AND WHETHER IT IS
NARROWLY TAILORED TO ADDRESS
THAT PROBLEM OR WHETHER IT MIGHT
HAVE BROADER IMPLICATIONS FOR
THE PROGRAM, SO THAT'S SOMETHING
WE'RE LOOKING INTO. WE ALSO ARE
LOOKING AT WHETHER OR NOT THERE
WILL BE IMPLICATIONS AT THE
COUNTY LEVEL IN TERMS OF THAT
ADMINISTER. STRAY SHIN OF THE
PROGRAM. I WILL SHARE YOUR
EXCITEMENT FOR THIS AND I REALLY
WANT TO KNOW HOW QUICKLY WE CAN
GET THIS POLICY CHANGE UP AND
RUNNING, BUT WE'LL ALSO JUST, UM
ASK IF I CAN. HOW WE WILL
MEASURE THE IMPACT AS I BELIEVE.
THAT'S WHAT THE LAO IS
REFERENCING RIGHT THERE. SURE
AND I THINK AGAIN WE CAN LOOK
SPECIFICALLY AT THE RISK.
SPECIFICALLY THE PROVIDERS
NUMBERS OVER TIME FOR THIS
POPULATION, SO WE'LL BE ABLE TO
FOLLOW UP ON THAT. UH WE JUST
NOTE THAT THERE IS ADDITIONAL
WORKLOAD FOR COUNTY STAFF. BUT
IT'S ACTUALLY IN A WAY OF ALSO
SIMPLIFYING THESE CASES BECAUSE
THE COUNTY SOCIAL WORKER DOES
NOT HAVE TO DO THE ADDITIONAL
ANALYSIS TO DETERMINE IF THE
PERSPECTIVE PROVIDERS ELIGIBLE.
UM AND THERE'S $4 MILLION FOR
ADMINISTRATION IN THIS SPACE, SO
WE DO BELIEVE THAT WE CAN
IMPLEMENT THIS QUICKLY WILL HAVE
AN OAK COUNTY LETTER THAT IS
ISSUED WITH THE GUIDANCE. UM AND
WE LOOK AT TOWARDS THE FALL OF
BEING ABLE TO PUT THIS IN PLACE.
BH CONNECT. THE BH CONNECT ITEM
WE HAVE PREVIOUSLY TALKED ABOUT
THE BEHAVIORAL HEALTH COMMUNITY
BASED CONTINUUM DEMONSTRATION
WAIVER. IT HAS BEEN RENAMED
UNDER THE DEPARTMENT OF HEALTH
CARE SERVICES, WHICH I BELIEVE
YOU HAVE PREVIOUSLY DISCUSSED TO
THE BH CONNECT WAIVER. A
REVISION PROPOSES TO SHIFT THE
IMPLEMENTATION DATE OF ONE OF
THE POLICIES OF THAT WAIVER THAT
IMPACTS THE DEPARTMENT OF SOCIAL
SERVICES. MORE SPECIFICALLY, WE
HAVE A PROPOSAL RELATED TO CHILD
AND FAMILY TEAMS THAT WILL NEWLY
BE REQUIRED FOR FAMILIES IN THE
FAMILY MAINTENANCE PROGRAM THAT
MAY REVISION IS SIMPLY SHIFTING
THE TIMING AND THE FUNDING OF
THAT PROPOSAL, NOT THE SUBSTANCE
OF IT. PERMANENT FINANCE.
NOTHING FURTHER. HELLO? THANK
YOU. GOOD AFTERNOON, ANGELA.
SHORT WITH THE L A. OH WE DON'T
HAVE A SPECIFIC CONCERN WITH THE
PROPOSED DATE CHANGE. HOWEVER WE
WOULD JUST NOTE SIMILAR TO, UM,
AN ISSUE WE RAISED FOR OUR
ANALYSIS OF THE BROADER PROPOSAL
AT THE TIME OF THE GOVERNOR'S
BUDGET. THE ADMINISTRATION HAS
NOT PROPOSED DETAILED A DETAILED
IMPLEMENTATION PLAN. OR
MONITORING, EVALUATION AND
REPORTING REQUIREMENTS FOR THIS
PROGRAM, SO WE WOULD SUGGEST
THAT THE LEGISLATURE MAY WISH TO
REQUIRE D H CS AND DS S TO
PROVIDE THESE DETAILS FOR THE
OVERALL BH CONNECT PROGRAM PRIOR
TO DECIDING WHETHER TO APPROVE,
MODIFY OR REJECT THIS PROPOSAL.
THANK YOU. I'LL FOLLOW UP IF I
CAN AS THE ADMINISTRATION
AMENABLE TO PROVIDING DRAFT TBL
LANGUAGE SO THAT WE CAN UM, BE
KEPT IN THE LOOP. WE DON'T HAVE
ANY PROPOSALS FOR TBL LANGUAGES
THIS TIME, BUT OF COURSE,
THEY'RE HAPPY TO CONTINUE TO
DISCUSS WITH THE COMMITTEE. OKAY
WITH THAT WE WILL MOVE ON TO SEE
KELSO'S BIDIRECTIONAL WITH CWS
CARES. HELLO AGAIN. SELINA CHOW
DEPARTMENT OF SOCIAL SERVICES.
SO THIS PROPOSAL IS REQUESTING
25 MILLION GENERAL FUND TO
DEVELOP A SINGLE STATEWIDE
FOSTER CARE ELIGIBILITY.
DETERMINATION SOLUTION THAT
WOULD BE BASED IN CAL SAWS, AND
THIS WOULD BE A TOOL THAT WOULD
INTERFACE WITH CARES THE PROGRAM
AND PROJECT THAT WE HAD TALKED
ABOUT THIS MORNING DURING THE
TELLY DO JUST SEGMENT. IT WOULD
BE A BIDIRECTIONAL DATA EXCHANGE
BETWEEN THE TWO SYSTEMS SO THAT
BOTH ELIGIBILITY WORKERS AND
CHILD WELFARE WORKERS CAN CAN
UTILIZE THIS. THIS INTERFACE IS
IN ADDITION TO SEVEN, THE SEVEN
MILLION GENERAL FUND FOR
DEVELOPMENT AND TESTING OF THE
SOLUTION THAT WAS PREVIOUSLY
BUDGETED AND IN THE BUDGET YEAR.
WE HAVE ABOUT THREE MILLION
GENERAL FUND FOR THAT PORTION.
THIS, UH, SOLUTION AND THE
PROPOSED INTERFACE. THEY'RE BOTH
NECESSARY TO COMPLY WITH THE
FEDERAL REQUIREMENTS. UM FOR A
AGENCIES TO HAVE A SINGLE
AUTOMATED FUNCTION FOR
ELIGIBILITY DETERMINATIONS, AND
CURRENTLY, THE INFORMATION
EXISTS IN DIFFERENT SYSTEMS. SO
OUR CAL SAW SYSTEM HAS THE
ELIGIBILITY, DETERMINATION AND
PAYMENTS AND THEN THE CASE
MANAGEMENT PLACEMENT AND
PROVIDER INFORMATION IS PLANNED
FOR CARES. SO THE STATE EXCHANGE
WOULD BE NECESSARY TO GET THE
INFORMATION OVER TO THE CARE
SYSTEM. AND THE AUTOMATION WILL
ALSO HELP ALLEVIATE MANY OF THE
MANUAL PROCESSES THAT CURRENTLY
EXIST TODAY. IT'S A VERY PAPER
HEAVY PROCESS IN TERMS OF
DETERMINING ELIGIBILITY AND
PLACEMENT CHANGES, AND SOMETIMES
THAT DOES RESULT IN
DISCREPANCIES IN PAYMENTS WHERE
YOU MIGHT HAVE AN OVERPAYMENT OR
UNDERPAYMENT IN A GIVEN MONTH
BECAUSE THE INFORMATION ISN'T
READILY AVAILABLE. SO WITH THE
SPR SIX THAT WAS APPROVED FOR
CARES, WE NOW HAVE A MORE
DEFINED TIMELINE FOR WHEN THIS
INTERFACE IS NEEDED. WE DO
ESTIMATE THAT IT WILL GO INTO
VERSION ONE. UM OF CARES, BUT
CERTAINLY THERE'S A LOT MORE
COORDINATION AND PLANNING
BETWEEN THE TWO SYSTEMS FOR BOTH
KELSO'S AND CARES AND GETTING
THE ROADMAPS TO SYNC UP.
DEPARTMENT OF FINANCE. PREVIOUS
DEPARTMENT OF FINANCE. NO
ADDITIONAL CONTENT, ELIO YES, I
KNOW. YOU ALL HEARD FROM MY
COLLEAGUE EARLIER THIS MORNING
IN TERMS OF OUR OFFICES OVERALL
COMMENTS ON THE SPR SIX FOR THE
CDOS CARES PROGRAM SO WE HAVE
NOTHING TO ADD SPECIFIC TO THE
BIDIRECTIONAL INTERFACE AT THIS
TIME. THANK YOU. LET'S MOVE ON
TO OUR NEXT ITEM. NEXT ITEM
RELATES TO THE ADOPTION IN
FASTER CARE ANALYSIS AND
REPORTING SYSTEM ALSO KNOWN AS
CARS, COMPLIANCE. WE HAVE SO
MANY ACRONYMS. MAY REVISION
INCLUDES $1 MILLION GENERAL FUND
FOR PENALTIES ASSOCIATED WITH
NON COMPLIANCE OF THESE FEDERAL
REPORTING REQUIREMENTS. THE
FEDERAL RULES REQUIRE STATES TO
COLLECT AND REPORT ON 37 NEW
DATA ELEMENTS. THE PROBLEM WE
HAVE IS THAT THOSE DATA ELEMENTS
ARE NOT CURRENTLY SUPPORTED BY
OUR CWS CMS SYSTEM. AND AS YOU
HAVE BEEN HEARING QUITE A WHILE,
TODAY WE ARE IN THE PROCESS OF
DEVELOPING THE CWS CARE SYSTEM.
SO THAT GAP PERIOD IN BETWEEN
AFTER ACROSS BENEFIT ANALYSIS
RESULTED IN A DETERMINATION THAT
THE CUMULATIVE AMOUNT OF
PENALTIES WE WOULD INCUR WOULD
BE LESS THAN THE COST OF
BUILDING THE FUNCTIONALITY INTO
THE AND THE CURRENT SYSTEM, THE
SYSTEM THAT'S ON ITS WAY OUT. SO
ON A TEMPORARY BASIS, WE ARE
INTENDING TO ACCEPT THOSE
FEDERAL PENALTIES. ESTIMATED AT
APPROXIMATELY 3.9 MILLION
GENERAL FUND WHILE WE ARE ALSO
BUILDING THE REPORTING
REQUIREMENTS INTO THE CARE
SYSTEM, AND WHEN THE CARE SYSTEM
IS ABLE TO DO SO WE WILL REPORT
AND THEN BE FINISHED WITH THOSE
FEDERAL PENALTIES. WE EXPECT THE
ADMINISTRATION ON CHILDREN AND
FAMILIES TO ASSESS THOSE
PENALTIES QUARTERLY UNTIL WE'RE
ABLE TO COME INTO COMPLIANCE
THROUGH THE CARE SYSTEM.
DEPARTMENT OF FINANCE. AARON
CARSON DEPARTMENT OF FINANCE
SOMETHING TO ADD LEO NOTHING TO
ADD. LET'S MOVE ON TO OUR NEXT
ITEM RAPID RESPONSE PROGRAM
AUGMENTATION? YES SINCE 2019.
CALIFORNIA HAS SUPPORTED
IMMIGRATION NEEDS AND
HUMANITARIAN ASSISTANCE FOR
MIGRANTS PROCESS AND RELEASED BY
FEDERAL BORDER OFFICIALS IN
CALIFORNIA'S SUPPORTER
COMMUNITIES THESE SERVICES
SUCCESSFULLY SUPPORTED OVER
370,000 PEOPLE THROUGH A
COLLABORATIVE MODEL THAT ALSO
SUPPORTS BORDER COMMUNITIES.
LAST YEAR WE SUCCESSFULLY
ADVOCATED FOR ADDITIONAL ONE
TIME FEDERAL RESOURCES TO
SUPPORT SERVICES PROVIDED BY
LOCAL GOVERNMENTS AND NGOS. THE
MERRY VISION CONTINUES
CALIFORNIA SUPPORT OF THE
HUMANITARIAN EFFORTS WITH A $150
MILLION INVESTMENT. AND A FOCUS
ON SHELTERING SERVICES FOR THOSE
WHO ARE VULNERABLE, INCLUDING
FAMILIES WITH YOUNG CHILDREN,
PEOPLE WHO ARE MEDICALLY FRAGILE
, PARTICULARLY VULNERABLE
INDIVIDUALS, INCLUDING LGBTQ,
PLUS INDIVIDUALS, OLDER
INDIVIDUALS AND INDIVIDUALS WITH
DISABILITIES WITH THE END OF THE
FEDERAL COVID 19 PUBLIC HEALTH
EMERGENCY FUNDING FOR BORDER
OPERATIONS WILL BE TRANSFERRED
FROM THE DEPARTMENT OF PUBLIC
HEALTH TO THE DEPARTMENT OF
SOCIAL SERVICES WITH A
TRANSITION TO A PRE COVID
FUNDING AND PARTNERSHIP MODEL
WITH SERVICES LED BY LOCAL
PROVIDERS. CALIFORNIA IS FACING
A VERY CHALLENGING BUDGET
SITUATION THIS YEAR. AS YOU
KNOW, WE'RE ALSO SCALING THE AND
PANDEMIC ERA SERVICES WITH THE
END OF THE STATE OF EMERGENCY.
BUT DESPITE THIS DEFICIT, THE
MAYOR VISION INCLUDES THOSE $150
MILLION. I REFERENCED. THIS IS
MORE THAN A FIVE FOLD INCREASE
FROM PRE COVID INVESTMENT IN
2019, WHERE WE INVESTED $25
MILLION TO SUPPORT MIGRANT
SHELTERING SERVICES. TODAY,
CALIFORNIA HAS INVESTED OVER
$1.2 BILLION TOWARDS THIS WORK.
THE FEDERAL GOVERNMENT IS
RESPONSIBLE FOR IMMIGRATION
POLICIES AND PROCESSING THAT
RELY ON MIGRANT SHELTERING IN
BORDER COMMUNITIES, WHILE
CALIFORNIA CONTINUES TO INVEST
IT RESOURCES CONGRESS MUST
PROVIDE PERMANENT FUNDING FOR
SUSTAINABLE MIGRANT SHELTERS.
SHELTER SERVICES EXCUSE ME AS A
CRITICAL COMPONENT OF BORDER
SECURITY INFRASTRUCTURE.
ULTIMATELY THIS NATION MUST
DELIVER AN ORDERLY AND HUMANE
PROCESS FOR THOSE FLEEING
PERSECUTION AND VIOLENCE. TO
RESPONSIBLY WELCOME THOSE
SEEKING SAFETY AND REFUGE RIGHT
HERE AT OUR OWN BORDERS. AND
EXCUSE ME. THE COMMITTEE ALSO
ASKED IF WE HAD CONCERNS AROUND,
INCLUDING BUDGET BUILDING, WHICH
IN THE PAST, WE HAVE NO
CONCERNS. THANK YOU. DEPARTMENT
OF FINANCE EMILY MARSHALL
DEPARTMENT OF FINANCE NOTHING
FURTHER TO ADD AT THIS TIME.
WE'LL BE CONTINUING TO REVIEW
THIS PROPOSAL IN THE COMING
DAYS, BUT NO CONCERNS TO RAISE
AT THIS TIME. THANK YOU. LET'S
MOVE ON TO OUR NEXT ITEM. THE
2023 GOVERNOR'S BUDGET INCLUDES
$40 MILLION GENERAL FUND TO
SUPPORT THE SERVICES FOR
SURVIVORS AND VICTIMS OF HATE
CRIMES. THE MERRY VIGEN MAY
REVISION ADDS AN ADDITIONAL $10
MILLION GENERAL FUND TO THE
PROGRAM FOR A TOTAL OF 50
MILLION TO SUPPORT COMMUNITY
BASED ORGANIZATIONS TO PROVIDE
SERVICES FOR VICTIMS OF HATE
INCIDENTS. DEPARTMENT OF FINANCE
EMILY MARSHALL DEPARTMENT OF
FINANCE NOTHING FOR THEIR CHILD
CONCERNS. LET'S MOVE ON TO OUR
NEXT ITEM. GREAT YEAH, ONLY WITH
DEPARTMENT SOCIAL SERVICES. I'LL
TAKE CARE OF THE NEXT ONE
DEPARTMENT PROPOSES TO ABOLISH
TO FIND TWO SPECIAL FROM THE
SAFETY SURRENDERED BABY FUN AND
THE SPECIAL OLYMPICS BECAUSE
THEY NO LONGER MEET THE FRENCH
FRIES, TECH SPORTS AND
LIMITATION WHICH IS $200,000
HAVE BEEN TWO YEARS. DEPARTMENT
OF FUND. IT'S NOTHING FURTHER.
ELIO CONCERNS STRAYS AT THIS
TIME. OUT OF CURIOSITY. HOW MUCH
HAVE THOSE FUNDS COLLECTED? AND
SURE SO. WHAT FOR THE SAFELY
SURRENDER FUND WITHIN THE LAST
TWO YEARS THEY COLLECTED TOTAL
$46.60 46. AND THEN FOR THE
SPECIAL OLYMPICS. FUN. AH! IT
WAS $0 FOR THE LAST TWO YEARS.
THANK YOU. I'M SORRY I FLIPPED
IT AROUND. SPECIAL OLYMPICS WAS
46 BABIES SAFELY. BABIES
SUMMONED HER BABY WAS ZERO.
LET'S MOVE ON TO THE NEXT ITEM.
COMMUNIQUE LICENSING
ADMINISTRATORS CERTIFICATIONS
SECTION TRAINING UPDATES THIS IS
TRAILER BILL LANGUAGE THAT IS
ACTUALLY LOOKING AT THINGS THAT
WORKED DURING THE PANDEMIC
COMPONENTS OF HAVING A WAIVER TO
ALLOW FOR MORE ONLINE TRAINING
OPPORTUNITIES AT THIS TRAINER
BILL LANGUAGE AND ESSENTIALLY
ALLOW FOR US TO CONTINUE IN THAT
WAY. OTHERWISE, THE CURRENT
REQUIREMENTS REQUIRE IN PERSON
AND INQUIRE A PORTION OF THE 40
HOUR REQUIREMENT TO ALSO BE A
PERSON. DEPARTMENT OF FINANCE,
AND I'M KIND, NOTHING FURTHER.
WE WERE JUST NOTE THAT THIS
TRAILER BILL LANGUAGE IS NOT YET
AVAILABLE, BUT WE WILL CERTAINLY
FOLLOW UP WITH THE COMMITTEE. IF
WE HAVE ANY CONCERNS ONCE WE'RE
ABLE TO REVIEW THANK YOU. LET'S
MOVE TO THE GUARANTEED INCOME
PILOT PROGRAM. SORRY, PERMANENT
FINANCE, JUST NOTING THAT WE
EXPECT THE TRAILER BUILDING
GUAGE TO BE POSTED TODAY. THANK
YOU. THE GUARANTEED INCOME PILOT
PROGRAM. TRAILER BUILD LANGUAGE
SEEKS TO ACCOMPLISH AN
EFFICIENCY AS IT RELATES TO ANY
JURISDICTION WHO WOULD LIKE TO
APPLY TO ENSURE THAT THE COWARD
THAT THE GUARANTEED INCOME
FUNDING DOES NOT COUNT AGAINST
THOSE WHO MIGHT BE CURRENTLY
PARTICIPATING IN COW WORKS RIGHT
NOW THERE'S A REQUEST PROCESS
THAT HAPPENS THAT HAS TO HAPPEN
FOR THE TO THE DIRECTOR TO
MYSELF, SO IT WILL BE AN
EFFICIENCY THAT WOULD BE GAINED
IN THAT SPACE. WE'VE ALSO
APPLIED FOR SOME ADDITIONAL
FEDERAL FUNDS, AND SHOULD WE BE
SUCCESSFUL IN THAT APPLICATION?
WE ALSO WANT TO EXTEND THE OFFER
OF TRIBES. TO PARTICIPATE IN THE
PILOT. UM AND SO THOSE ARE THE
TWO MAIN COMPONENTS THAT IT
SEEKS TO ACCOMPLISH. DEPARTMENT
OF FINANCE. JUSTIN PRAISE
DEPARTMENT FINANCE NO ADDITIONAL
COMMENT AT THIS TIME. HELLO. YOU
KNOW CONCERNS WITH THIS
PROPOSAL. I'LL BRING IT BACK UP.
I'LL KEEP UTILIZING THE
OPPORTUNITIES TO MENTION IF
THERE ARE GEOGRAPHICAL
DISPARITIES THAT WERE NOTICING
WITHIN THE GUARANTEED INCOME
PILOT PROGRAM AND WOULD JUST ASK
THAT WE ENSURE THAT THOSE OF US
WHO MAY NOT LIVE IN COASTAL
AREAS HAVE SIMILAR OPPORTUNITIES
TO PARTICIPATE AND RECEIVE THE
BENEFITS AS I BELIEVE WE'RE
TRYING TO LEARN. THROUGH THIS
PILOT. WHAT'S WORKING AND WHAT'S
NOT, AND THAT MEANS WE'RE GOING
TO NEED TO TRY IT OUT AND ALL
DIFFERENT TYPES OF COUNTIES AND
THANK YOU CHAIR. LET'S MOVE ON
TO THE NEXT ITEM. THE TRAILER
BILL LANGUAGE THAT WE'RE
PROPOSING RELATED TO TRIBAL
DEPENDENCY REPRESENTATION AGAIN
. THIS IS ONE ESPECIALLY THANK
ASSEMBLYMEMBER'S RAMOS FOR HIS
LEADERSHIP IN THIS EFFORT THAT
WE'VE DONE TOGETHER TO BE THE
FIRST STATE IN THE NATION TO
PROVIDE REPRESENTATION FOR
TRIBES AS THEY MIGHT PARTICIPATE
IN THE COURT PROCEEDINGS THAT
SPECIFICS HERE ARE THAT THE
METHODOLOGY WAS VERY
PRESCRIPTIVE IN STATUTE IN NOTED
THAT, UH, THE TRAVEL DEPENDENCY
REPRESENTATION MATTERS ABOVE
$15,000 PER ELIGIBLE TRIBE MUST
CONSIDER THE NUMBER. OF INDIAN
CHILDREN AND FASTER CARE
PERSPECTIVE. ADOPTIVE PLACEMENTS
THROUGH THE JUVENILE COURT. WE
PERFORMED INITIAL DATA RESEARCH
AND DISCOVERED NO RELIABLE DATA
SOURCE TO CAPTURE THIS
INFORMATION FURTHER IN OUR
GOVERNMENT TO GOVERNMENT
CONSULTATION WITH TRIBES ON THIS
MATTER. TRIBES INDICATE THAT
THIS METHODOLOGY REQUIREMENT IS
UNFAIR AND DID NOT TAKE INTO
ACCOUNT MOST TRIBES DESIRE TO
RECEIVE AN EQUAL DISTRIBUTION OF
FUNDS. LEFT OVER FROM
REALLOCATION. THEREFORE, THE
DEPARTMENT PROPOSES TO AMEND
CURRENT LAW TO STRIKE OUT THE
METHODOLOGY REQUIREMENT WHEN
DETERMINING THE REALLOCATION
METHODOLOGY. THE COMMITTEE ALSO
ASKED IF WE'VE CONNECTED WITH
TRIBES WE ARE PROPOSING. WE ARE
SHARING THE PROPOSED TRAILER
BILL LANGUAGE WITH BOTH
ASSEMBLYMEMBER'S RAMOS IS OFFICE
AS WELL AS THE SPONSORS,
CALIFORNIA TRAVELS FAMILY
COALITION AND WHAT YOU KNOW IF
THERE'S ANY CONCERNS. DEPARTMENT
OF FINANCE. CARSON DEPARTMENT OF
FINANCE NOTHING DAD. LEO.
CONCERNS TRACE. EXCELLENT. LET'S
MOVE ON CAN GAP THEY CAN GAP
PROGRAM ALIGNMENT AND TECHNICAL
CLARIFICATIONS TRAILER BILL
LANGUAGE ENSURE THAT WITH THE
RECENT LAW CHANGES IN POLICY
CHANGES THAT OCCURRED THROUGH
SENATE BILL 3 54 CHAPTER IN 2021
THAT INCLUDED COURT AUTHORIZED
PLACEMENT CHANGES THAT THAT'S
CODIFIED IN THIS PARTICULAR
SECTION OF LAW ALSO INCLUDES A
TECHNICAL TECHNICAL CLARIFYING
AMENDMENT TO REMOVE OUTDATED AND
UNNECESSARY LANGUAGE, INCLUDING
REFERENCES TO THE COW WORKS
PROGRAM IN ITS ASSOCIATED
REQUIREMENTS. AS WELL AS INCOME
AND PROPERTY LIMITS FOR
ELIGIBILITY. DEPARTMENT OF
FINANCE. NOTHING FURTHER TO ADD
YOU. NURSERIES WILL ASK IF WE
HAVE VETTED THIS WITH COUNTIES
OR CHILD WELFARE ADVOCATES.
WORKS. ANY ADDITIONAL ADVOCATES.
OKAY NOW WE HAVE. WE HAVEN'T
HEARD ANY CONCERNS YET, BUT GLAD
TO REPORT BACK IF THERE'S ANY
ADDITIONAL, THANK YOU. LET'S
MOVE ON TO SSP 2020 24 GRANT
INCREASED T BILL, SO THIS IS
REALLY A TECHNICAL CLEANUP. WE
OBVIOUSLY HAVE ALREADY AGREED TO
THE CHANGE. THE GOVERNOR'S
BUDGET INCLUDED $146 MILLION
GENERAL FUND FOR BUDGET YEAR FOR
THE GRANT INCREASE, EFFECTIVE
JANUARY 2024. THIS INCREASE
CONTINUES TO BE REFLECTED IN THE
IN THE MAYOR VISION. THIS IS THE
TRAILER BILL LANGUAGE THAT
ACCOMPANIES THAT CHANGE.
DEPARTMENT OF FINANCE. NOTHING
FURTHER. ELIO DI BELLA WITH THE
ANALYST'S OFFICE. WE HAD RAISED
CONCERNS IN JANUARY THAT THERE
WAS NOT ANY TRAILER BILL
LANGUAGE FOR THE GRANT INCREASE.
WE REVIEWED THIS LANGUAGE AND WE
AGREE THAT IT IT DOES WHAT IT'S
SUPPOSED TO DO, AND IT'S IN LINE
WITH THE LANGUAGE WE'VE DONE HAD
IN THE PAST FOR THIS. LET'S MOVE
ON TO SAFETY. NET RESERVE
WITHDRAWAL TBL. TO MY COLLEAGUE
AT THE DEPARTMENT OF FINANCE.
THANK YOU. DIRECTOR JOHNSON,
JUSTIN FRAZIER'S DEPARTMENT OF
FINANCE WHO THE ME REVISION
PROPOSES TO TWO OR 450 MILLION
WITHDRAWAL. FROM THE SAFETY NET
FUND RESERVE. TO HELP ASSIST
WITH APPROXIMATELY OR THE
ESTIMATED 3 1.5 BILLION BUDGET
SHORTFALL TO ADDRESS ANY OF THE
NECESSARY NEEDS IN THE MEDICAL
AND THE COW WORKS PROGRAM TO
RESPOND TO THE QUESTION HERE.
THE ADMINISTRATION TO LEAD THAT
THIS TRANSFER PROPOSED TRANSFERS
IN LINE WITH THE INTENDED
PURPOSE IN THE STATUTORY
LANGUAGE. HELLO. THANK YOU, MR
CHAIR, GINNY BELLA, WITH THE
ANALYST'S OFFICE. WE WOULD JUST
NOTE THAT USING THESE FUNDS NOW
MEANS THAT THEY WON'T BE
AVAILABLE TO SUPPORT CORE
PROGRAMS IN THE LIKELY EVENT
THAT THE BUDGET PROBLEM PERSISTS
. SO THAT'S JUST A CAUTION. WE
WOULD NOTE WE ARE CONTINUING TO
REVIEW THE LANGUAGE TO ENSURE
THAT IT IS IN LINE WITH THE WITH
THE INTENT OF THE SAFETY NET
RESERVE. I WILL, UM, SHARING
THOSE CONCERNS. I AM
UNDERSTANDING THE LARGER OVERALL
BUDGET CONSTRAINTS THAT WE HAVE
. AND YET WHEN WE'RE PULLING
FROM THOSE RESERVES TODAY, IT'S
LEAVING LESS FOR US TO BE ABLE
TO HAVE RESILIENCY IN THE FUTURE
AND WANT TO MAKE SURE THAT WHEN
WE'RE PULLING FROM HIM THAT WERE
ALL ALIGNED AND ON THE SAME PAGE
AND AN AGREEMENT THAT IT'S THE
RIGHT TIMING, AND SO I BELIEVE
WE WILL HAVE MORE CONVERSATIONS
AS WE'RE GOING FORWARD ON HOW WE
CAN GET THAT TIME INCORRECTLY
DONE. LET'S MOVE ON TO OUR NEXT
ITEM. SURE GANGLY DEPARTMENT
SOCIAL SEARCH. THIS IS PROBABLY
I THINK THIS IS THE LAST ISSUE,
BUT BY NOTE HAPPY BIRTHDAY, MR
CHAIR. RIGHT SO THIS IS A WEIRD
DEPARTMENT ASKING FOR A RE
PREPARATION OF VARIETY OF
FUNDING. YEAH OH, NO. NO
PROBLEM. ACCESS FROM MULTIPLE
PROGRAMS THAT SUPPORTS IMMIGRANT
COMMUNITIES, COUNTY STAFF AND
ALSO COUNTY TRIBE COUNTY INDIAN
TRIBES FOR PROGRAMS THAT SUPPORT
AND WE'RE COMMUNITIES AND COUNTY
STAFF, THE DEPARTMENT NEEDS
ADDITIONAL TIME TENDER
CONTRACTS. HèA VENDORS UTILIZED
TO FULLY REALIZE THE FUNDING
THAT AND AWARDED DEPARTMENT
NEEDS MORE TIME TO JUST SPEND
DOWN THE FUNDING FOR THE MOST
PART. AND FOR THOSE PROGRAMS AND
IMPACT OUR TRIBES DUE TO TIME
THERE, IT TAKES FOR US TO
CONDUCT APPROPRIATE
CONSULTATIONS WITH THE TRIBE
ENTRY TEAM OR USE THE TRIBE. AND
WHICH IS, WHICH IS A NEW PROCESS
FOR DEPARTMENT. FOR THE MOST
PART, OR TO ME THAT OR DEADLINES
THAT HAVE BEEN PLACED INSTEAD TO
WE BELIEVE THAT THERE'S MORE
TIMES ALSO NEEDS TO BE PROVIDED
THE FIRST SUSPEND ALL THE
FUNDING CRIMINAL. GOOD QUESTION
IN ABOUT, YOU KNOW, UH,
EXPEDIENT IMPLEMENTATION. UM I
WANT TO NOTE THAT IMPLEMENTING
NEW INITIATIVES INVOLVEMENT
PROCESSES, WHICH CAN RETIRED. 9
TO 6 OF THE NINE OR EVEN A YEAR
FOR THE MOST PART IN OUR
IMPLEMENT TO COMPLETE ALL THOSE
PROCESSES. UM THE PROCESS
INVOLVES MANY THINGS, SUCH AS
PLANNING POLICY DEVELOPMENT
CONSULTATIONS WITH STAKEHOLDERS
. I'M HIRING AND TRAINING NEW
STAFF. RELEASING R R F A REQUEST
FOR PROPOSALS VALUING US
PROPOSALS. THERE'S MANY
COMPONENTS TO DEVELOP TO
ACTUALLY IMPLEMENTING THE
PROGRAM, SO WE WANT TO BE VERY
THOUGHTFUL WITH THAT PROCESS TO
MAKE SURE THAT ALL THESE
COMPONENTS ARE INVITED BY UM
THEY'RE HAVING FLEXIBILITIES
THAT WERE PROVIDED BY THE LAST
STATION PARA YOURS, WHICH
INVOLVES WAITING PUBLIC
CONTRACTING CODES AND
ADMINISTRATIVE PROCESSES THAT
THOSE HAVE HELPED EXPEDITE SOME
OTHER, UM LIMITATION, BUT ALSO
AT THE SAME TIME WE BELIEVE THAT
THESE PROCESSES THAT ARE IN
PLACE AND IMPORTANT FOR US TO
CONSIDER AND TO ENGAGE TO ENSURE
THAT THE INTENDED AND RESOURCE
OCCUR. WE DON'T WANT TO HAVE ANY
UNINTENDED CONSEQUENCES RESULTS
SO THAT SO ALTHOUGH WE DO SHARE
YOUR CONCERNS WERE HAPPY THAT
YOU DO SHARE THE CONCERNS OF US
HAVING, UM, THAT SOMETIMES IT
TAKES A LITTLE BIT LONGER. BUT
ONE OF MAKE SURE THAT YOU'RE
AWARE OF THE PROCESS AND STUFF
AND WHAT IT TAKES. DEPARTMENT OF
FINANCE MARSHALL DEPARTMENT OF
FINANCE NOTHING FURTHER TO ADD
ELIO NOTHING FURTHER TO ADD.
BRING IT UP TO THE CHAIR AND I'M
GLAD WE WANT TO MAKE SURE WE GET
IT DONE RIGHT? AND I WOULD LIKE
TO ASK THAT WE GET AN UPDATE AT
THE JANUARY 10TH GOVERNOR'S
BUDGET ON HOW WE ARE WORKING ON
IMPLEMENTATION ON THESE SPECIFIC
ITEMS THAT HAVE BEEN MENTIONED.
HAPPY TO DO THAT. ANY FINAL
QUESTIONS FOR THIS PANEL. SEEING
NONE. I WILL THANK VERY MUCH ALL
OF OUR PANELISTS AND WE WILL NOW
MOVE ON TO PUBLIC COMMENTS. WE
WELCOME PUBLIC COMMENT ON ALL
ISSUES ON TODAY'S AGENDA, BUT
ASK YOU TO KEEP YOUR COMMENTS TO
ONLY THESE ISSUES. WE WILL BEGIN
PUBLIC COMMENT WITH INDIVIDUALS
WHO ARE HERE IN THE HEARING
ROOM, AND THEN WE WILL BE GOING
TO OUR PHONE LINES. LET'S BEGIN
WHEN YOU ARE READY. GOOD
AFTERNOON, MR CHAIR AND MEMBERS
CONNIE DELGADO ON BEHALF OF THE
DISTRICT HOSPITAL LEADERSHIP
FORUM, THE 33 DISTRICT AND
MUNICIPAL HOSPITALS AND LOCATED
IN CALIFORNIA DHF DHL. F IS
SUPPORTIVE OF THE INCREASED
FUNDING THAT WOULD BE GENERATED
BY THE RENEWAL OF THE TAX ON
MANAGED CARE ORGANIZATIONS DUE
TO THE FINANCIAL INSTABILITY IN
EXISTING AND HEALTHCARE. WHICH
WAS SIGNIFICANTLY EXACERBATED BY
THE PANDEMIC, AND IT'S LINGERING
EFFECTS. A SIGNIFICANT AMOUNT OF
GENERATED FUNDING MUST BE
DIRECTED TO THE NEEDS OF
HEALTHCARE SAFETY NET PROVIDERS
SUCH AS HOSPITALS, PROVIDING
EMERGENCY SERVICES AND OTHER
TYPES OF SERVICES MUST BE
PRIORITIZED WHEN CONSIDERING
DISTRIBUTION OF FUNDING FROM THE
M C O TAX, AND IT'S IMPORTANT
DISTRIBUTIONS OCCUR SOONER.
RATHER THAN LATER TO AVERT AVOID
FURTHER DECREASED ACCESS TO
HOSPITAL CARE FOR CALIFORNIANS.
ALMOST ALL CALIFORNIA HOSPITALS
, BUT ESPECIALLY STANDALONE
FACILITIES THROUGHOUT THE STATE,
INCLUDING THOSE IN REMOTE AND
RURAL AREAS AND SERVING
COMMUNITIES OF COLOR NEED
DEDICATED FUNDING DUE TO THE
DECADES OF UNDERFUNDING BY
GOVERNMENT PLAYERS, INCLUDING
PRIMARILY MEDICAL PROGRAM.
PRIVATE PRIVATE PROVIDERS HAVE
COBBLED TOGETHER VARIOUS
PROGRAMS, BUT THE DECADES LONG
UNDERFUNDING IS CATCHING UP. AND
UM, WE ARE SEEING THAT HOSPITAL
CLOSURES AND REDUCTION OF
SERVICES ARE DETRIMENTAL AND WE
WANT TO ENSURE THAT WE CAN KEEP
THOSE DOORS OPEN AND CONTINUE TO
SERVE THE PATIENTS OF
CALIFORNIA. THANK YOU. THANK
YOU. THANK YOU GOOD AFTERNOON
CHAIR MEMBERS, MARK FAROUK ON
BEHALF OF THE CALIFORNIA
HOSPITAL ASSOCIATION. UM CJ
APPRECIATES THE RECENT PASSAGE
OF A B 1 12 AND EARLY ACTION
BUDGET BILLS THAT PROVIDED
DISTRESS HOSPITAL LOAN FUND,
WHICH WILL HELP A SMALL NUMBER
OF HOSPITALS. HOWEVER WE
CONTINUE TO ADVOCATE FOR AN
ADDITIONAL RELIEF OF $1.5
BILLION TO PREVENT EVEN MORE
HOSPITALS FROM ARRIVING AT THE
EDGE OF THE FISCAL CLIFF WITHOUT
ADDITIONAL RELIEF, MORE
HOSPITALS WILL CLOSE OR REDUCE
SERVICES. AND AS NEARLY ONE IN
FIVE HOSPITALS ARE CURRENTLY AT
RISK OF CLOSURE IN THE STATE OF
CALIFORNIA. THIS IS WHY WE'RE
PLEASED BY THE SENATE BUDGET
BLUEPRINT, WHICH PROPOSES $400
MILLION PER YEAR FOR FOUR YEARS
, WHICH ACKNOWLEDGES THE
IMMEDIATE NEED FACING HOSPITALS
SERVING MEDICAL PATIENTS. IN
ADDITION TO THIS IMMEDIATE ONE
TIME FUNDING, WE BELIEVE THE
LONG TERM SOLUTION IS THE
REAUTHORIZATION OF THE ATTACKS,
AS WAS DISCUSSED EARLIER TODAY.
THE REAUTHORIZATION OF THE KOTEX
IS A CRITICAL OPPORTUNITY TO
INVEST IN EXCESS FOR MEDICAL
PATIENTS. AND IMPROVED PROVIDER
REIMBURSEMENT RATES. THE FUNDING
SHOULD BE UTILIZED IN THE SAME
TIMEFRAME IS THE FEDERAL PROGRAM
APPROVAL IN 3 TO 4 YEARS RATHER
THAN BEING STRETCHED OUT OVER 8
TO 10 YEAR PERIOD. WE STAND WITH
OTHER PROVIDERS TO ENCOURAGE THE
ADOPTION OF AN EMC ATTACKS THAT
ENSURES THAT PROVIDERS CAN MEET
THE NEEDS OF THEIR PATIENTS AND
COMMUNITIES. IT IS ESSENTIAL
THAT THIS FUNDING GOES TOWARD
RAISING MEDICAL REIMBURSEMENT
RATES. LASTLY WE ENCOURAGE THE
LEGISLATURE NOT TO DELAY FUNDING
PROVIDERS UNTIL FUTURE BUDGET
YEARS BUT RATHER ESTABLISHED
SPENDING PRIORITIES FOR THE M C
O FUNDING AND CATEGORIES FOR
THAT FUNDING TO BE DISCUSSED AND
ESTABLISHED. CURRENTLY
SIGNIFICANT AND IMMEDIATE
INVESTMENTS ARE NEEDED TO
ADDRESS SYSTEMATIC MEDICAL
UNDERFUNDING AND PLACE
CALIFORNIA'S HOSPITAL HOSPITALS
ON A SUSTAINABLE PATH. THANK
YOU. GOOD AFTERNOON, LINDA WAY
WITH WESTERN CENTER ON LAW AND
POVERTY OF FIRSTLY HAPPY EARLY
BIRTHDAY CHAIR RELATED TO THE
HEALTH BUDGET. WE SUPPORT A
LARGER AND ACCELERATED CEO TAX
TO ENSURE RECENT MEDICAL
ELIGIBILITY AND BENEFIT
EXPANSIONS AND PLAN INVESTMENTS
, INCLUDING SHERIFF COSTS,
REFORMS ARE IMPLEMENTED WITHOUT
CUTS OR DELAY AND TO PROVIDE FOR
FUTURE INVESTMENTS TO INCREASE
MEDICAL ACCESS, QUALITY AND
EQUITY. WE SUPPORT PROPOSED BASE
RATE INCREASES AND WITH LIMITED
RESOURCES BELIEVE MOST PROVIDE
MODERATES SHOULD BE SUPPLEMENTAL
PAYMENTS TO ENABLE TARGETED
APPROACH TO ADDRESS KNOWN ACCESS
GAPS AND TIED TO QUALITY AND
ECHOED THE MEASURES. RELATED TO
SB 10 76 UNDER THE DEPARTMENT OF
PUBLIC HEALTH. WE ARE CONCERNED
WITH THE ADMINISTRATION'S
PROPOSAL TO DELAY IMPLEMENTATION
BY THREE YEARS. RELATED TO THE
HUMAN SERVICES BUDGET. WE
APPRECIATE INCREASES IN THE COW
WORKS GRANT AND LOOK FORWARD TO
WORKING WITH THE LEGISLATURE AND
ADMINISTRATION TO REIMAGINE COW
WORKS TO FAMILY CENTERED PROGRAM
SIMILAR TO THE CHAIR. WE
QUESTION DRAWING FROM THE SAFETY
NET RESERVE, WHICH IS INTENDED
TO COVER SPIKES AND COW WORKS
AND MEDICAL ENROLLMENT DUE TO
RECESSION, CONSIDERING MEDICAL
ENROLLMENT IS EXPECTED TO DROP 1
TO 2 MILLION AND LOWER COW WORKS
CASELOADS. WE REQUEST THE STATE
HOLD OFF ON DRAWING FROM THIS
FUND. WE APPRECIATE INCREASES IN
SSP GRANT FOR 2024 WENT TO
UPLIFT THE CALIFORNIA FOR SS. I
ASKED TO RAISE GRANT LEVELS TO
THE FEDERAL POVERTY LEVEL AND
ADJUSTED ANNUALLY AS WELL AS
UPDATING NUTRITION BENEFITS,
NOTING RISING FOOD AND HOUSING
COSTS, HITS, LOW INCOME SENIORS
AND PERSONS WITH DISABILITIES
THE HARDEST. WE SUPPORT THE
SUMMER EMPTY PROGRAM AND MOVING
FORWARD FOOD BENEFITS FOR OLDER
UNDOCUMENTED IMMIGRANTS, BUT WE
STILL NEED FOOD FOR ALL,
REGARDLESS OF AGE OR IMMIGRATION
STATUS. UM NO CONCERNS WITH THE
DELAY OF CHILD SUPPORT PASSED
THROUGH, ALTHOUGH NOTE, THIS
WILL MEAN THAT FORMER COW WORKS
, FAMILIES WILL HAVE TO WAIT
LONGER AND CONTINUE TO REQUEST
FULL PASS THROUGH. UM BE
EXTENDED TO KURT COW WORKS,
FAMILIES. AND FINALLY, THE MAY
REVISION RECOMMITTED FUNDING FOR
IMMIGRANTS SEEKING HUMANITARIAN
RELIEF AND WOULD LIKE TO UPLIFT
ASSEMBLYMEMBER'S RAISED PROPOSAL
TO PROVIDE SOCIAL SERVICES TO
THE SAME IMMIGRANT POPULATION.
THANK YOU. GOOD AFTERNOON, MR
CHAIR MEMBERS AND HAPPY EARLY
BIRTHDAY, MR. CHAIR MICHELLE
GIBBONS WITH THE COUNTY HEALTH
EXECUTIVES ASSOCIATION OF
CALIFORNIA, REPRESENTING LOCAL
HEALTH DEPARTMENTS. WE HAVE
REMOVED OUR OPPOSITION TO THE
DEPARTMENT OF HEALTH CARE
SERVICES, WHOLE CHILD MODEL
PROPOSAL. WE HAD INITIALLY
RAISED CONCERNS THAT THEIR
EXPANSION WAS GOING FAR BEYOND
JUST THE EXISTING COUNTIES THAT
ARE MOVING INTO A COUNTY
ORGANIZED HEALTH SYSTEM. THEY
ORIGINALLY INCLUDED THE SINGLE
PLAN COUNTIES, BUT NOW THAT THEY
HAVE WITHDRAWN THE SINGLE PLAN
COUNTIES FROM THE PROPOSAL WE
HAVE MOVED TO NEUTRAL, BUT WE DO
LOOK FORWARD TO WORKING WITH THE
ADMINISTRATION TO CONTINUE TO
IMPROVE SOME OF THE CHALLENGES
THAT WE'VE SEEN WITH THE WHOLE
CHILD MODEL, INCLUDING THE
ANNUAL RE DETERMINATION PROCESS
AND THE BUDGET PROCESS FOR
COUNTIES THAT HAVE REMAINING
RESPONSIBILITIES. THANK YOU.
THANK YOU. REMEMBER IS ANDREW
SHANE GRACE AND SHALL POVERTY
CALIFORNIA ALIGN WITH A LOT OF
THE COMMENTS MADE BY THE WESTERN
CENTER, SO I'LL TRY AND BE BRIEF
THAT WE APPRECIATE THE MANY
ITEMS IN THE MAIN REVISION ON
CHILD SUPPORT DELAY AGAIN NOT
OPPOSING, BUT LIFTING UP. THIS
IS $70 MILLION. IT'S NOT GOING
TO FAMILIES WHERE SOME OF THE
MOST PRECARIOUS SITUATIONS AND
CALLED FOR THE FULL PASS THROUGH
ON CALL WORKS. WE APPRECIATE
OBVIOUSLY THE INCREASE TO THE
MAP, AND I THINK DIRECTOR
JOHNSON, THIS MAY HAVE BEEN IN
THE SENATE. FORGIVE ME. IT'S A
LITTLE SCHIZOPHRENIC TODAY, BUT
NAMING THAT THERE ARE STILL
HOUSEHOLDS OR 47% IN AU PLUS ONE
ONE THE LEGISLATURE'S COMMITMENT
TO END THAT OBVIOUSLY
REIMAGINING. THE PROGRAM TO BE
FAMILY CENTERED AND RACIST IS
IT'S A DEEP COMMITMENT. AND WE
THANK YOU CHAIR FOR YOUR
LEADERSHIP ON THAT. I WOULD JUST
NOTE THAT THE PROPOSAL, UM ON
THE RACIAL EQUITY AND IMPLICIT
BIAS TRAINING IS AN IMPORTANT
PART. WE WANT TO THANK THE
DEPARTMENT OF HER COUNTIES FOR
CAL OR 42 POINT. OH, FOUR. THOSE
TRAININGS THAT REALLY POSITIONS
FOR BEING READY TO REIMAGINE THE
PROGRAM. UM AND THE SAFETY NET
RESERVE AGAIN AND WE ARE
OPPOSING THE WITHDRAWAL AT THIS
TIME. WE APPRECIATE THE COMMENTS
BY THE CHAIR BY THE L. A O IN
LOOKING AT THE MAP IN LOOKING AT
THE TRIGGER. WE NEED TO MAKE
SURE THAT WE ARE HAVING THE MOST
RESILIENT PROGRAM POSSIBLE,
ESPECIALLY GIVEN THE COMMENTS BY
THE WESTERN CENTER ABOUT THE
CASELOAD TRENDS AND OBVIOUSLY WE
REALLY APPRECIATE THE
ACCELERATION AND URGE FOR
COMPLETE FOOD FOR ALL. ON SUMMER
BEAUTY. I REALLY WANT TO THANK
THIS DEPARTMENT FOR BEING READY
RIGHT OUT THE GATE. WE DO
CONTINUE TO ASK FOR A SUPPLEMENT
TO THE BENEFIT. THE USDA
EVALUATED THE BENEFIT AT $60 A
MONTH AND THERE'S SOME OTHER
PIECES TO STREAMLINE. MAKE SURE
WE'RE NOT MISSING CHILDREN. BUT
AGAIN. WE APPRECIATE THIS
GOVERNOR AND THIS ADMINISTRATION
IS READY TO GO ON DAY ONE
REIMBURSEMENT FOR THEFT AGAIN.
WE WANT TO THANK THE DEPARTMENT
FOR TRYING TO BE THE FIRST IN
THE COUNTRY TO GO TO CHIP TAP. I
THINK OUR FRUSTRATION IS WITH
THE FEDERAL GOVERNMENT. IT'S
STILL NEARLY SIX MONTHS SINCE
THE FEDERAL RESOURCES WERE
PASSED FOR REIMBURSEMENT. WE
KNOW THE DEPARTMENT'S WORKING
VERY CLOSELY WITH THEM, BUT YET
OUR PLAN IS STILL ON UNAPPROVED
AND FAMILIES ARE WAITING ON
BENEFITS CAL IT'S HARD TO
BELIEVE. MAYBE IT'S EASY TO
BELIEVE THAT I WAS ONE OF THE
STAKEHOLDERS AT THE BEGINNING.
YOU KNOW, WE DID NOT WANT TO SEE
A HARD DATE OF 2023. NO ONE
WANTS TO SEE AN IT PROJECT WITH
A DEADLINE, RIGHT? I REALLY WANT
TO THANK ALL THE STAKEHOLDERS,
YOU KNOW THAT. EISLEY HAS NOT
BEEN THE CASE. WE'VE HAD
SUCCESSFUL MIGRATIONS, BUT THE
CUSTOMER SERVICE PIECES ARE
STILL THERE, AND WE KNOW YOU'VE
HEARD THIS IN THIS COMMITTEE AND
SO WE THANK THE DEPARTMENT AND
ALL THE STAKEHOLDERS WERE
CONTINUING TO HAVE THE
ENHANCEMENTS. SO WE HAVE ROBUST
CUSTOMER SERVICE IN BENEFITS,
CAL UM, AND LASTLY, JUST GIVEN
THE HUNGER CLIFF YOU KNOW, WE
CONTINUE TO ADVOCATE FOR THE
ACCOMPLISHMENT AMONG POPULAR
BENEFIT. THANK YOU. THANK YOU.
GOOD AFTERNOON SHARON COMMITTEE
MEMBERS REBECCA SULLIVAN WITH
LOCAL HEALTH PLANS. CALIFORNIA
WE REPRESENT THE 16 LOCAL NOT
FOR PROFIT MEDICAL MANAGED CARE
PLANS IN THE STATE. I THINK THE
COMMITTEE FOR ALLOWING US TO
MAKE PUBLIC COMMENTS. AS IT
RELATES TO THE IMCO TAX. L HPC
IS SUPPORTIVE OF RENEWAL OF THE
TAX TO SUPPORT THE MEDICAL
PROGRAM, WHILE MEDICAL HAS MADE
INCREDIBLE STRIDES IN EXPANDING
COVERAGE, AS IT IS IN THE EARLY
STAGES OF TRANSFORMING HOW WE
CARE FOR THE WHOLE PERSON
THROUGH CALAIS. THE SUCCESS OF
THIS GROWTH RELIES ON EFFORTS TO
PREVENT THE SYSTEM FROM BUCKLING
AS A RESULT OF LOW MEDICAL
REIMBURSEMENT RATES. THE CEO TAX
RENEWAL IS AN OPPORTUNITY TO
MAKE IMPACTFUL INVESTMENTS TO
BOLSTER RATES AND MOVE US CLOSER
TO KALAM'S POLICY, GOALS OF
ACCESS, QUALITY AND EQUITY. WE
LOOK FORWARD TO WORKING WITH THE
LEGISLATURE AND THE
ADMINISTRATION ON THE IMPORTANT
DETAILS OF THIS PROPOSAL
PROPOSAL. ADDITIONALLY WE WOULD
LIKE TO EXPRESS OUR SUPPORT
PRODUCED YESES. ULTRA WHOLE
CHILD MODEL TRAILER BILL. THIS
WOULD EXPAND THE WHOLE CHILD
MODEL TO OPERATE IN THOSE COAST
COUNTIES UNDERGOING GEOGRAPHIC
EXPANSION THAT CURRENTLY OPERATE
THE WHOLE CHILD MODEL PROGRAM
TODAY. THANK YOU. THANK YOU.
GOOD AFTERNOON. MY NAME IS COREY
AYALA, REPRESENTING THE
PEDIATRIC DAY HEALTHCARE
COALITION PD HCS PROVIDE. TAKE
CARE EVENING AND WE CAN CARE FOR
SEVERELY DISABLED IN MEDICALLY
FRAGILE KIDS. THERE ARE 19 THC
IS IN CALIFORNIA AND, SADLY, THE
SYSTEM IT WAS ON THE VERGE OF
COLLAPSE. AND THE LAST
REIMBURSEMENT INCREASE WAS IN
2018 FROM PROP. 56 FANS AND NO
LONGER PROVIDE COMPETITIVE
SALARIES FOR NURSING STAFF
HOSPITALS ARE OFFERING SIGNING
BONUSES. BETTER PAY NON WEEKEND
WORK, MAKING OUR NURSING
RETENTION UNTENABLE. UM. THE
SYSTEM STATEWIDE IS ONLY
PROVIDING 23% OF THEIR PROVED
HOURS FOR THESE KIDS DUE TO A
LACK OF NURSING STAFF. IN THE
LAST MONTH. WE'VE HAD TWO
CENTERS IN SOUTHERN CALIFORNIA
LOSE 64% OF THEIR NURSING STAFF
AND DROPPED DOWN TO ONLY
PROVIDING 12% OF CARE. THOSE TWO
CENTERS WILL BE CLOSING IN JUNE
OR JULY WITHOUT SOME CHANGE. UM
WE HAVE REACHED OUT TO YOUR
STAFF TO LET THEM KNOW IF THIS
MOST RECENT DEVELOPMENT AND THE
DEPARTMENT AND THE SENATE STAFF
UM, YOU KNOW, EMC EMC ATTACKS
REVENUES ARE AVAILABLE, AND WE
CAN'T WAIT TILL 24 25 BUDGET
CYCLE TO BE CONSIDERED FOR A
RATE INCREASE WITHOUT LOSING
PROGRAMS, AND THERE AREN'T
ENOUGH PROGRAMS TO BEGIN WITH.
SO WE APPRECIATE YOUR
CONSIDERATION. THANK YOU. THANK
YOU. YEAH MM HMM AFTERNOON, MR
CHAIR MEMBERS OF THE COMMITTEE.
JUDD HAMPTON, WITH CALIFORNIA
ASSOCIATION OF HEALTH PLANS
REPRESENTING 43 KNOCKS SKIN
LICENSE PLAN DELIVERING CARE TO
APPROXIMATELY 27 MILLION
CALIFORNIANS APPRECIATE THE
COMMITTEE, GIVING US THE
OPPORTUNITY TO PROVIDE PUBLIC
COMMENT TODAY. SPECIFICALLY WE'D
LIKE TO DISCUSS THE PROPOSAL ON
THE M C O TAX. UM CALIFORNIA'S
HEALTH PLANS HAVE BEEN WORKING
CONSTRUCTIVELY WITH THE
ADMINISTRATION AND THE
LEGISLATURE ON THE PROPOSED
RENEWAL OF THE ATTACKS AND ARE
PLEASED TO SEE THE GOVERNOR'S
BUDGET REVISION IS PROPOSING TO
INVEST A PORTION OF THE TAX
REVENUE INTO THE MEDICAL
PROGRAM. ALTHOUGH WE ARE STILL
EVALUATING THE FULL DETAILS OF
THE GOVERNOR'S PROPOSAL AND TWO
ASSOCIATED RELATED TRAILER BILLS
, WE FUNDAMENTALLY AGREE THAT
THE EMC ATTACKS SHOULD DIRECTLY
BENEFIT AND ENHANCED SERVICES IN
THE MEDICAL PROGRAM. WE ALSO
BELIEVE THE TAX MUST BE
AFFORDABLE TO PURCHASERS OF
HEALTH COVERAGE IN THE
INDIVIDUAL EMPLOYER MARKETS. IT
MUST BE PREDICTABLE. IT MUST BE
STABLE AND IT MUST BE AS
EQUITABLE AS POSSIBLE. WE ALSO
AGREE THAT FOCUSING ON PRIMARY
AND SPECIALTY CARE IS ALSO A
VERY IMPORTANT PLACE TO START.
SO WE LOOK FORWARD TO WORKING
WITH THE LEGISLATURE AND THE
ADMINISTRATION AND FLUSHING OUT
SOME MORE MORE OF THESE DETAILS
AS THEY BECOME AVAILABLE. THANK
YOU. THANK YOU. MR SHORT
REPRESENTING PEACH, THE
ASSOCIATION REPRESENTING
CALIFORNIA'S COMMUNITY HOSPITAL
SAFETY NET. WE ALSO SUPPORT THE
CEO TAX CONTINUATION AND THE
GOVERNOR'S PLAN TO EXPAND IT.
BUT WE WANT TO HIGHLIGHT FOR YOU
ALL THAT THE THERE IS NO RELIEF
IN THE M C O TAX FOR
CALIFORNIA'S HOSPITAL SAFETY NET
IN THE CURRENT YEAR. OR EVEN IN
THE BUDGET YEAR. OUR HOSPITAL
SAFETY NET. OUR PATIENTS ARE
UNDERSERVED COMMUNITIES REALLY
CANNOT WAIT. IT'S WHY WE SUPPORT
THE $400 MILLION IN THE SENATE
AND PROTECT OUR PROGRESS PLAN
AND ENCOURAGE ONGOING
CONVERSATIONS ABOUT HOW TO
REALLY SAVE OUR HOSPITAL SAFETY
NET AS YOU ALL CONTINUE YOUR
BUDGET PROCESS AND THEN FINALLY
ON BEHALF OF LOMA LINDA
CHILDREN'S HOSPITAL AND RADIO
CHILDREN'S HOSPITAL. WE
APPRECIATE THE ADMINISTRATION'S
CHANGES TO THE WHOLE CHILD MODEL
POLICY INCLUDED IN THE MAY
REVISE, BUT WE CONTINUE HAVE
REALLY STRONG CONCERNS ABOUT THE
EVALUATION AND THE OUTCOME OF
THAT EVALUATION AND ENCOURAGE
YOU ALL TO ENCOURAGE THE
DEPARTMENT TO CONTINUE TO WORK
WITH STAKEHOLDERS TO MAKE SOME
MORE AMENDMENTS TO THAT PROGRAM
AND REALLY MAKE SURE THAT OUR
CHILDREN CONTINUE TO GET ACCESS
TO THAT QUALITY OF CARE. THANK
YOU. THANK YOU. KELLY BROOKS, UM
, HERE ON BEHALF OF TWO CLIENTS.
FIRST, THE CALIFORNIA
ASSOCIATION OF PUBLIC HOSPITALS
AND HEALTH SYSTEMS IS GRATEFUL
THAT THE GOVERNORS MAY REVISION
HAS TAKEN STEPS TO PROTECT
MEDICAL AND THE CHILDREN,
FAMILIES AND SENIORS WHO DEPEND
ON IT. WE APPRECIATE THE
PRESERVATION OF THE MEDICAL
COVERS EXPANSION, AND THE
INCLUSION OF THE EMC ATTACKS A
CONSISTENT ONGOING STATE FUNDING
SOURCE THROUGH THE M C O TEXT IS
NEEDED TO HELP ADDRESS THE
FISCAL CHALLENGES PUBLIC HEALTH
SYSTEMS ARE FACING AS PROPOSED,
THE TAX IS NOT ENOUGH TO AVOID
POTENTIAL REDUCTIONS AND
SERVICES. PUBLIC HEALTH SYSTEMS.
FOR OUR PATIENTS, MOST OF WHOM
RELY ON MEDICAL OR OR UNINSURED
ARE SYSTEMS FACE A LOOMING
FISCAL RECKONING BROUGHT ON BY
DECADES OF INSUFFICIENT FUNDING
AND RISING COSTS. PUBLIC HEALTH
SYSTEMS FUNDING NEEDS. TO BE
STABILIZED AND PRIORITIZE SO
THAT ALREADY DISADVANTAGED
CALIFORNIANS CAN CONTINUE TO
ACCESS CRITICAL HEALTH SERVICES
. SEE A PAGE LOOKS FORWARD TO
WORKING WITH THE ADMINISTRATION
AND LEGISLATURE ON THE M C O TAX
PROPOSAL. UM, SECOND ON BEHALF
OF THE URBAN CAN EASE OF
CALIFORNIA I WE CONTINUE TO
HIGHLIGHT THAT WORKFORCE FOR
PARTICULARLY IN THE HEALTH AND
HUMAN SERVICES AREA REMAINS A
PRIORITY. WE ARE WE SUPPORT THE
RESCISSION OF THE PUBLIC HEALTH
WORKFORCE CUTS. I THINK THE
ADMINISTRATION FOR INCLUDING IT
IN THE MAY REVISION. WE'RE VERY
INTERESTED IN LEARNING MORE
DETAILS ABOUT THE BH CONNECT
WORKFORCE PROPOSAL. UM AND
FINALLY WE WANT TO THANK THE
ADMINISTRATION FOR THE
CONVERSATIONS AND INCREMENTAL
IMPROVEMENTS ON THE CARE ACT.
RESOURCES FOR COUNTIES COUNTIES
ARE GROWINGLY. OUR CONCERNS ARE
GROWING CONCERNED. THAT THE
PROPOSAL LEAVES A SIGNIFICANT
GAP IN RESOURCES IN ORDER TO
SUCCESSFULLY IMPLEMENT THE
PROGRAM. THANK YOU. THANK YOU.
GOOD AFTERNOON CHAIR MEMBERS.
JANICE SOMALI WITH ASKED ME
CALIFORNIA AND HAPPY BIRTHDAY TO
YOU. THANK YOU RELATED TO ITEM
FOUR H OR FOUR F D HCS. WE
APPRECIATE THE GOVERNOR'S $5
MILLION PROPOSAL TO SUPPORT DHS.
DÍAS HCS S PILOT PROGRAM TO
STUDY CURRENT MEDICAL
INTERPRETATION. UM, SERVICES FOR
THOSE WHO ARE LIMITED ENGLISH
PROFICIENT. THIS IS A PROJECT
THAT OUR ASKED ME AFFILIATE YOU
DW AND ASKED ME YOU HAVE BEEN
WORKING ON FOR THE PAST YEAR. WE
ALSO SUPPORT THE REAUTHORIZATION
OF THE TAX BUT WOULD LIKE TO SEE
INCLUDED 3% OF THE FUNDS RAISED
BY THE ATTACKS BE USED TO
PROVIDE IMPROVED PAYMENTS FOR
911 GROUND EMERGENCY MEDICAL
TRANSPORTATION SERVICES AND HELP
CLOSE THE FUNDING GAP BETWEEN
PRIVATE PROVIDERS IN PUBLIC. E.
M S AGENCIES. WE ALSO APPRECIATE
THE GOVERNOR, RESTORING THE
PUBLIC HEALTH WORKFORCE DOLLARS
TO ADEQUATELY BUILD THE PIPELINE
OF THE PUBLIC HEALTH WORKFORCE
RELATED TO ITEM FOUR G. WE ALSO
REQUEST THE LEGISLATURE FULLY
FUND HEALTHCARE FOR STRIKING
WORKERS. MAYBE 25 30 WAS SIGNED
INTO LAW LAST YEAR, AND IT
PROVIDES TIMELY AND AFFORDABLE
ACCESS TO COVERED CALIFORNIA TO
WORKERS ON STRIKE. FOR LONGER
THAN 30 DAYS, AND IT WAS
INADVERTENTLY LEFT OUT OF THE
BUDGET. LAST YEAR. WE REQUEST $2
MILLION TO SUPPORT THIS PROGRAM.
LASTLY WE'RE DISAPPOINTED THAT
THE GOVERNOR'S BUDGET REMAINS
UNCHANGED ON IMPROVING HEALTH
COVERAGE AFFORDABILITY FOR THOSE
ON COVERED CALIFORNIA. THE CLUB
BACK OF $333 MILLION MEANT FOR
THIS PROGRAM. WHICH WAS INTENDED
TO HELP CONSUMERS ELIMINATE
DEDUCTIBLES AND LOWER CO PAGE
SHOULD NOT BE DIVERTED BACK TO
THE GENERAL FUND. THANK YOU VERY
MUCH. THANK YOU. THANK YOU.
CHAIR COMMITTEE AND STAFF RYAN
MORE MONEY WITH THE CALIFORNIA
STATE ASSOCIATION OF COUNTIES.
FIRST AS IT PERTAINS THE DHC S
AH SEE SECT APPRECIATES THE
UPDATED LEVEL OF FUNDING
PROPOSED IN THE MAY REVISE FOR
COUNTIES TO IMPLEMENT THE CARE
ACT. UM AND ACKNOWLEDGE THE
REVISED PROPOSAL REFLECTS
PROGRESS MADE DURING ONGOING
DISCUSSIONS ARE COUNTY
ASSOCIATIONS HAVE HAD WITH THE
ADMINISTRATION TO REFINE ONGOING
IMPACTS. WE HAVE SUBMITTED A
FORMAL LETTER DETAILING OUR
COUNTY ESTIMATES AND WOULD BE
HAPPY TO DISCUSS FURTHER. SECOND
AS IT RELATES TO THE DEPARTMENT
OF STATE HOSPITALS. WE'D LIKE TO
NOTE THAT THE REQUEST OF RE
APPROPRIATE FUNDING FOR THE
INCOMPETENT STANDING TRIAL
SOLUTIONS PACKAGE SHOULD ALSO BE
REFLECTED IN IMPLEMENTATION
TIMELINES FOR THE GROWTH CAP AND
PENALTY PROGRAM SO COUNTIES CAN
CONTINUE TO HELP THE STATE MEET
THE COURT ORDER REQUIREMENTS.
WE'VE SUBMITTED A LETTER ON THAT
AS WELL BUT HOPEFUL THAT WE CAN
WORK WITH TOGETHER WITH THE
DEPARTMENT TO ADDRESS COUNTY
CONCERNS. IMPROVE THE PROGRAM TO
ATTAIN OUR SHARED GOALS. THANK
YOU AND HAPPY EARLY BIRTHDAY.
THANK YOU. HAPPY BIRTHDAY, MR.
CHAIR AMY BLUMBERG ON BEHALF OF
THE CALIFORNIA CHILDREN'S
HOSPITAL ASSOCIATION. HERE TO
PROVIDE COMMENTS ON THE
DEPARTMENT OF HEALTH CARE
SERVICES. TRAILER BUILD EXPAND
CALIFORNIA CHILDREN'S SERVICES,
WHOLE CHILD MODEL WE GREATLY
APPRECIATE THE DEPARTMENT HEARD
OUR CONCERNS FROM STAKEHOLDERS
AND REMOVED ALAMEDA, CONTRA
COSTA AND IMPERIAL COUNTIES FROM
THIS PROPOSAL. THIS ADDRESS IS
ONE OF THE BIGGEST CONCERNS
WE'VE HAD REGARDING THE
FINANCIAL IMPACT ON CCS
PROVIDERS, INCLUDING UCSF
BENIOFF CHILDREN'S HOSPITAL,
OAKLAND, AND WE WANT TO THANK
THE DEPARTMENT FOR MAKING THIS
CHANGE. GIVEN THE FINDINGS FROM
THE INDEPENDENT, WHOLE CHILD
MODEL EVALUATION, WE CONTINUE TO
HAVE CONCERNS WITH THE
DEPARTMENT'S REVISED TRAILER
BUILT LANGUAGE WE WOULD LIKE
WHICH WOULD EXPAND WHOLE CHILD
MODEL AND TWO COUNTIES THAT WILL
BECOME COZ SYSTEMS NEXT YEAR.
THE MOST SIGNIFICANT PROBLEMS
IDENTIFIED AND THE WHOLE CHILD
MODEL EVALUATION ARE
SIGNIFICANTLY. A STATISTICALLY
SIGNIFICANT DROP IN CCS
ENROLLMENT AND WHOLE CHILD MODEL
COUNTIES, PROBLEMS WITH CHILDREN
AND SOME COUNTIES AND ACCESSING
CCS PROVIDERS AND SPECIAL CARE
CENTERS AND COMPLAINTS FROM
FAMILIES INTERVIEWED AND THE
EVALUATION RELATED TO CASE
MANAGEMENT. TO ADDRESS THESE
ISSUES WERE PROPOSING AMENDMENTS
THAT WOULD IMPROVE HOW CCS WHOLE
CHILD MODEL WORKS FOR ALL THE
CHILDREN AND FAMILIES WHO ARE
ALREADY IN THE PROGRAM AND
ENSURING THAT THE NEW COAST
COUNTIES ARE PREPARED TO
ADEQUATELY CARE FOR CCS PATIENTS
. WE RESPECTFULLY REQUEST THAT
THE COMMITTEE DIRECT THE
DEPARTMENT TO WORK WITH
STAKEHOLDERS ON AMENDMENTS TO
ITS TRAILER BILL LANGUAGE TO
ADDRESS FINDINGS FROM THE
EVALUATION AND STRENGTHEN THE
MODEL PRIOR TO EXPANSION. AND
I'D ALSO LIKE TO ALIGN MY
COMMENTS WITH CALIFORNIA
HOSPITAL ASSOCIATION AND SUPPORT
OF THE $1.5 BILLION REQUEST FOR
FINANCIALLY STRUGGLING
HOSPITALS. THANK YOU. THANK YOU.
GOOD AFTERNOON CHAIR AND MEMBERS
CATHERINE ON SKIS ESCAPE
CALIFORNIA APPRECIATE DEEPLY THE
MINISTRATIONS RECOMMITTING TO
PUBLIC HEALTH WORKFORCE AS A
LEGISLATURE TO GUARANTEE THAT
MONEY IS IN THE FINAL BUDGET.
WE'RE GRATEFUL TO SEE THE
CONTINUED COMMITMENT TO MEDICAL
EXPANSION ON THE PROPOSED
TIMELINE THAT WE'VE BEEN
COMMITTED TO FOR SOME TIME WITH
THAT WE SUPPORT THEM CO TAX
URGED THE LEGISLATURE TO USE THE
MONEY TO SUPPORT MEDIC, AL AND
ENSURE FUNDING SUPPORTS ACCESS
AND WORKFORCE. UM IN TERMS OF
OTHER DFCS ITEMS, AS OTHERS HAVE
NOTED, WANT TO COMMENT ON THE
SIGNIFICANT MOVEMENT ON FROM
ADMINISTRATION, THE CCS HOTEL
MODEL PROPOSAL? CERTAINLY WE
CONTINUE TO HAVE CONCERNS WITH
THE EVALUATION AND CONTINUE TO
EVALUATE THE NEW PROPOSAL WITH
OUR LOCALS. LASTLY I WANT TO
SPEAK TO THE NEED TO IDENTIFY $2
MILLION TO MAKE SURE COVERED
CALIFORNIA CAN BE SUCCESSFUL IN
IMPLEMENTING A B 25 30. COVERAGE
OF STRIKING WORKERS AS MY
COLLEAGUE FROM ASHLEY SPOKE TO
EARLIER, IT'S ABSENT THAT MAY
REVISE AS IT WAS IN JANUARY, AND
WE LOOK TO LEGISLATURE
LEADERSHIP TO GUARANTEE THAT
IT'S IN THE FINAL BUDGET. THANK
YOU. THANK YOU. HAPPY BIRTHDAY,
DR ARAMBULA. THANK YOU. GLENN
BACK IS FOR THE NATIONAL HARM
REDUCTION COALITION. I'M
GRATEFUL TO THIS COMMITTEE FOR
HOLDING UP THE ISSUE OF A
WORKFORCE TO DELIVER NALOXONE TO
THOSE MOST AT RISK. THERE IS
NOTHING LESS THAN A CATASTROPHE
HAPPENING IN OUR STREETS AND OUR
COMMUNITIES. THE INTERSECTION OF
HOMELESSNESS, UNTREATED MENTAL
ILLNESS, UNTREATED SUBSTANCE USE
DISORDER. AND THE INTRODUCTION
OF FENTANYL TO OUR LEGAL DRUG
MARKET HAS CREATED CATACLYSM,
NOTHING LESS. LITERALLY PEOPLE
DYING IN OUR STREETS. WE HAVE
STAFF CURRENTLY ENGAGED IN
ENCAMPMENTS, HOMELESS HOTELS,
STREETS ON HOW TO USE THE
MEDICATION. AND WITHOUT
CONTINUING THAT WORK THAT WOULD
ADD FURTHER TO OUR TRAGEDIES. WE
HAVE A WORKFORCE. WE HAVE
PROGRAMS BADLY UNDERFUNDED
PROGRAMS, BUT WE HAVE THEM
WITHOUT THE GRANTS FOR WORKFORCE
. THOSE PROGRAMS WILL BE
CRIPPLED OR CLOSED IN SOME
PLACES. THEY GOT THEIR FIRST
STAFFER FIRST PAID STAFFER IN
THE RIVERSIDE PROGRAM AFTER THE
INTRODUCTION OF THIS GRANT
PROGRAM, THE FIRST PAID STAFFER
IN THE FRESNO PROGRAM AFTER THE
INTRODUCTION OF THE SCRAP
PROGRAM. THEY WERE VOLUNTEER
PROGRAMS BEFORE THAT, TRYING TO
MEET A HUMAN CATASTROPHE WITH
VOLUNTEER PROGRAMS ONLY. WE'RE
GRATEFUL TO THIS COMMITTEE AND
WE'RE GRATEFUL TO FOR THIS
INVESTMENT. THANK YOU. THANK
YOU. CHAIR MEMBERS CATHERINE
MOSSBERG, AND SO YOU KNOW, WE'RE
GOING EVERY OTHER PERSON. HAPPY
BIRTHDAY, SO I'M NOT GONNA SIT.
UM YOU WANT TO ASSOCIATE A
COUPLE OF CLIENTS SAY FIRST ONE
ASSOCIATE MY COMMENTS WITH THOSE
OF MR BACCHUS WITH THE NATIONAL
HARM REDUCTION COALITION,
TOTALLY ALIGNED WITH HIS
COMMENTS APPRECIATE THE
DISCUSSION EARLIER ON THE ON THE
USE OF OPIOIDS SETTLEMENT FUNDS
AND HOW IF WE DO NOT FUND THE
WORKFORCE, WE ARE LOSING WHAT
WE'RE DOING ON THE STREETS AND
OVERDOSE PREVENTION. SO WE
REALLY APPRECIATE THAT CHAIR'S
COMMENTS AND WORKING WITH YOUR
STAFF ON THAT AND CAN ENCOURAGE
THAT 61 MILLION TO COME OUT OF
THAT PROPOSAL AND TO FUND
NETWORK FORCE. SO THANK YOU FOR
THAT, UNDER ALSO UNDER PUBLIC
HEALTH ON THE 400 MILLION LOAN
FROM THE ADULT PROGRAM, WANT TO
HAVE A WE HAVE TALKED TO YOUR
STAFF ABOUT THIS. WE HAVE HAD
CONVERSATIONS. UM WITH THE
ADMINISTRATION AS WELL AS THE
DEPARTMENT AND AT THIS POINT,
BOTH ON BEHALF OF THE SAN
FRANCISCO AIDS FOUNDATION AND A
P L. A HEALTH WE BELIEVE THAT WE
UNDERSTAND THAT THE LOAN IS
NEEDED AND WE ARE NEUTRAL ON
THAT ON THAT AT THIS POINT, WE
BELIEVE THAT THE CONTROL
LANGUAGE THAT SAYS YOU HAVE TO
REPAY IS ENOUGH. WE DID HAVE
CONCERNS THAT FUND DOES
FLUCTUATE. BECAUSE OF THE WAY
REBATE DOLLARS COME IN. SO WE
DID HAVE A LOT OF CONCERNS AT
FIRST THAT IT WOULD COME OUT OF
PROGRAM. BUT WE'VE BEEN ASSURED
IT WON'T COME OUT OF PROGRAM. SO
THANK YOU FOR THAT, THEN ON
BEHALF OF NOURISH CALIFORNIA, WE
ARE PLEASED WITH THE GOVERNOR'S
RE BUYS AND PUTTING FORWARD THAT
INFLAMMATION TIMELINE FOR CF APP
AND ALL THE SUPPORT OF THIS
COMMITTEE AND THE LEGISLATURE
FOR THAT SUPPORT THAT MOVING
FORWARD. WE CONTINUE TO HOPE
THAT WE CAN GET MORE FOLKS INTO
THAT PROGRAM TO FUND EVERYONE.
BUT WE'LL CONTINUE TO SUPPORT
THAT MOVING FORWARD AND THANK
YOU FOR YOUR HELP WITH THAT, UM,
ALSO ON CALLE FRESH KNOWING
WHERE WE ARE IN THE HUNGER
CLIFF. WE CONTINUE TO SUPPORT
ADDITIONAL FUNDING FOR THE CAL
FRESHWATER PILOT, FRESHWATER
PILOT SORRY WATER PILOT PROGRAM
AS WELL AS THE FRESH FRUITS AND
VEG PILOT PROGRAM AS WELL
CONTINUE TO SUPPORT. THOSE.
THOSE ARE PLACES WHERE YOU CAN
PUT MONEY IMMEDIATELY BACK INTO
THE RECIPIENTS OF CAL FRESH AND
THEY CAN PUT IT IMMEDIATELY INTO
FOOD FOR THEIR FAMILIES AND
FRIENDS, WATER THAT THEY CAN'T
GET IN THEIR CURRENT COMMUNITIES
CURRENTLY, AND THEN LAST WE ON
BEHALF OF GRACE AND CHILD
POVERTY WANTED TO HAVE MR SHANE
MISSED THIS PART WANTED TO JUST
DISCUSS ARE ARE MENTIONED OUR
CURRENT OUR CONTINUED ADVOCACY
ON IT TAKES A VILLAGE PROGRAM
THAT IS BEING SUPPORTED AND
CHAMPIONED BY ASSEMBLYMEMBER'S
BENTO. WE CONTINUE TO HOPE TO
SEE SOME FUNDS THERE AS WELL.
THANK YOU FOR YOUR TIME. THANK
YOU. DR ARAMBULA, DR JACKSON
RAND MARTIN HERE ON BEHALF OF
VIANA HEALTHCARE. MS. MARKS BERG
THREW US OFF. I DON'T KNOW
WHETHER IT'S MY TURN TO WISH YOU
A HAPPY BIRTHDAY. I'M GOING TO
DO IT ANYWAY. UM SO LAVIANA
HEALTHCARE IS ONE OF THE LARGEST
PROVIDERS OF HOME HEALTH CARE
FOR CHILDREN WITH COMPLEX
MEDICAL CONDITIONS IN THE
COUNTRY WITH VERY LARGE
FOOTPRINT HERE IN CALIFORNIA,
WE'RE VERY SUPPORTIVE, GENERALLY
THE CEO TAX PROPOSAL BECAUSE
IT'S THE ONLY PLACE WHERE MONEY
IS POTENTIALLY GOING TO BE
AVAILABLE. I DO WANT TO BUILD ON
DR WOOD'S COMMENTS EARLIER ABOUT
THE NEED TO MAKE SURE THAT THE
RATES THAT ARE INCREASED ARE
INCREASED TO A SUBSTANTIVE
ENOUGH LEVEL. THEY ACTUALLY DO
THE JOB AND THAT WE'RE GOING
AFTER WHERE THE NEED REALLY IS,
SO WE'RE TALKING ABOUT A
POPULATION THAT IS OFTEN OFTEN
ENDS UP IN THE HOSPITAL BECAUSE
THERE'S NOT ENOUGH HOME
HEALTHCARE TO BRING THEM HOME.
THE COST IS EXORBITANT.
OBVIOUSLY WHEN YOU'RE IN A
HOSPITAL, 7 TO $10,000 A DAY AS
OPPOSED TO NO MORE THAN $1400 A
DAY IN HOME HEALTH CARE, AND
THAT'S FOR 24 HOUR CARE. SO
THERE'S A COST SAVINGS TO THE
STATE, BUT FOR THE FOR THE
PEOPLE FOR THE FAMILIES FOR THE
KIDS, AND OBVIOUSLY MAKES A
WHOLE LOT MORE SENSE TO HAVE
THEM IN THEIR HOME, SO NOT ONLY
SAVING MONEY, BUT WE'RE ALSO
BEING UM, TRUE TO THE NEEDS OF
THE FAMILIES. WE ARE AT THE LOW
END OF THE HEALTH CARE DELIVERY
SYSTEM, UM, ECONOMIC LADDER LBS
ARE BEING HIRED AWAY BY PEOPLE
WITH A LITTLE BIT MORE MONEY.
AND SO IT'S BEEN VERY HARD FOR
US TO KEEP PEOPLE IN THE SYSTEM
IN ORDER TO PROVIDE ENOUGH SO
PROVIDE ENOUGH SERVICE. WE HAVE
A SMALL POPULATION, BUT WE HAVE
A WAITING LIST STATEWIDE, NOT
JUST OF THE HONOR BUT SYSTEM
WIDE ABOUT 1000 FAMILIES. AND
THAT WAITING LIST IS A MISNOMER
BECAUSE THEY GET ON THE WAITING
LIST AND THEY STAY. THEY NEVER
MOVE UP BECAUSE THERE ARE NOT
ENOUGH NURSES TO BE IN THE HOME
TO PROVIDE THE SERVICES, SO WE
THINK IT'S A VERY HIGH PRIORITY
FOR THE TAX PROPOSAL TO LOOK AT
THIS POPULATION AND PROVIDE THE
SERVICES THAT THEY NEED. THANK
YOU VERY MUCH. THANK YOU. DR
ANGELA DR JACKSON, PETER KELSON.
WE HAVE TWO CLIENTS. THE FIRST
IS THE CALIFORNIA ASSOCIATION
FOR HEALTH SERVICES AT HOME,
WHICH VIANA IS A MEMBER
ASSOCIATE. MY REMARKS WITH WHAT
MR MARTIN SAID. IT'S CLEAR THAT
THERE WAS A COST BENEFIT THAT IS
WORTH MORE THAN WORTH. THE
INVESTMENT FOR PDF PRIVATE DUTY
NURSING THE OTHER ISSUE IS FOR
THE CALIFORNIA ASSOCIATION OF
MEDICAL PRODUCTS SUPPLIERS,
MANUFACTURERS OF DURABLE MEDICAL
EQUIPMENT AND MEDICAL SUPPLIES.
THEY WOULD REQUEST THAT IN THE
CONTEXT OF THE POTENTIAL FOR
REVENUES TO REMOVE THE 10%
REDUCTION ON MEDICAL SUPPLIES
AND CENTRAL PRODUCTS TO MAINTAIN
THE 100% LEVEL OF RURAL CARE
RATES FOR DURABLE MEDICAL
EQUIPMENT AND EXPAND THAT TO
DRILL MEDICAL EQUIPMENT POINT OF
SALE SO THAT PATIENTS CAN STAY
AT HOME BECAUSE THESE PRODUCTS
ARE LITERALLY TO KEEP VULNERABLE
BABIES AND THE INFIRM AT HOME
RATHER THAN MORE COSTLY
SETTINGS. THANK YOU. THANK YOU.
GOOD AFTERNOON, MR CHAIR MEMBERS
. TIFFANY WHITE WITH S E I U
CALIFORNIA APPRECIATE THE
UPDATES MADE FOR THE CALF, FRESH
METHODOLOGY AND ESPECIALLY FOR
TAKING INTO ACCOUNT THE
ELIGIBILITY COST SUPPORT FOR COW
WORKS. MAX AID PAYMENT LEVELS,
REUNIFICATION, ADMIN FUNDING AND
IMPLICIT BIAS TRAINING. WE ALSO
SUPPORT FOR THE CHILD CARE,
CHILD SUPPORT PASSED THROUGH AND
RELATED TO I H S S. WE SUPPORT
THE HCPS EXTENSION OF THE I JUST
ASKED CAREER PATHWAYS AND THEN
GENERALLY SUPPORT THE PROPOSAL.
THE NEW PROPOSAL RELATED TO THE
MINERS, WE WERE JUST UNDERSCORE
AND TAKE INTO ACCOUNT COST TO
THE COUNTY AND MAKING SURE AS
THEY ARE CURRENTLY UNDERFUNDED
FOR A JUST AS COUNTY
ADMINISTRATION THAT THEY ARE
PROPERLY FUNDED TO DO THIS
PROPOSAL AND ACCOUNT FOR THE
MEDICAL, UH, DETERMINATIONS.
THANK YOU SO MUCH. THANK YOU.
GOOD AFTERNOON, AMY WESTLING
FROM THE ASSOCIATION OF REGIONAL
CENTER AGENCIES. WE SUBMITTED A
LETTER WITH COMPREHENSIVE
COMMENTS IN RESPONSE TO THE
GOVERNORS MAY REVISION YESTERDAY
BUT WANT TO CALL OUT A FEW ITEMS
SPECIFICALLY IN THE DDS BUDGET.
WE SUPPORT THE RE APPROPRIATION
OF UNUSED PROJECT DEVELOPMENT
FUNDS TO CREATE AFFORDABLE
HOUSING OPPORTUNITIES FOR THOSE
WITH DEVELOPMENTAL DISABILITIES
. WE ALSO SUPPORT THE PROPOSED
CHANGES TO THE SOCIAL RECREATION
PROGRAM, WHICH WILL IMPROVE
ACCESS AND FLEXIBILITY AND
SUPPORT THE CONTINUATION OF THE
COORDINATED FAMILY SUPPORT
SERVICE MODEL. WE SUPPORT THE
PROPOSED RATE ADJUSTMENTS FOR
INDEPENDENT LIVING SERVICES AND
FAMILY HOME AGENCIES. BUT DO
NOTE THAT ADDITIONAL WORK IS
NEEDED ON CLINICAL AND EARLY
INTERVENTION RATES AS WELL AS
KEEPING ALL OF THE RATE MODELS
CURRENT AND ENSURING ALL
PROVIDERS CAN EARN QUALITY
INCENTIVES. WE APPRECIATE THE
PROPOSALS TO TIE FUNDING FOR
SOME REGIONAL CENTER STAFF TO
POSITIONS FOR STATE EQUIVALENCY
EASE AND NOTE THE NEED TO DO
THIS FOR ALL SERVICE
COORDINATION POSITIONS AS A
FIRST STEP TO CORRECTING THE
OVERALL CORE STAFFING FORMULA.
WE OPPOSED THE PROPOSAL TO BEGIN
AGAIN COLLECTING THE ANNUAL
FAMILY PROGRAM FEE AND FAMILY
COST PARTICIPATION PROGRAM FEES.
AND WE LOOK FORWARD TO REVIEWING
THE TRAILER BILL LANGUAGE ON
GENERIC SERVICES BUT CONTINUE TO
ADVOCATE FOR ELIMINATION OF THE
REQUIREMENT THAT INDIVIDUALS AND
FAMILIES APPEAL DENIALS OF
GENERIC RESOURCES. WE LOOK
FORWARD TO CONTINUING THE
CONVERSATIONS DURING THE
REMAINDER OF THE BUDGET PROCESS
ABOUT HOW WE CAN ALL WORK TO
BETTER WORK TOGETHER TO BEST
SUPPORT PEOPLE WITH
DEVELOPMENTAL DISABILITIES AND
THEIR FAMILIES. THANK YOU. THANK
YOU. AFTERNOON BARRY GIARDINI
FROM THE CALIFORNIA DISABILITY
SERVICES ASSOCIATION. HAPPY
BIRTHDAY, MR CHAIR. THANK YOU.
I'M HERE TO SPEAK ON A COUPLE OF
ISSUES IN THE DDS BUDGET TODAY.
THE FIRST IS JUST TO EXPRESS OUR
APPRECIATION AND SUPPORT FOR THE
ADMINISTRATION'S INVESTMENT IN
THE INDEPENDENT LIVING SERVICES
RATE FIXED. OF COURSE, THIS HAS
BEEN A LONG STANDING ISSUE, AND
I KNOW WE'VE GOTTEN A LOT OF
LEGISLATIVE SUPPORT, INCLUDING
THE SPONSORSHIP OF AN ASKED LAST
YEAR AND THROUGH THE BUDGET
PROCESS, MR CHAIR TO ADDRESS
THAT, AND WE'RE VERY PLEASED TO
SEE IT. AND WE HOPE THAT THAT
WILL SERVE AS A MODEL TO MAKE
REVISIONS TO OTHER RATE MODELS
THAT CONTINUE TO HAVE ERRORS
ONGOING AND OTHER SERVICE TYPES
THAT ARE OMITTED IN THE FIRST
PLACE. OF COURSE, LANDMARK
COALITION PROPOSAL WOULD CALL
FOR AN ADDENDUM TO THE RATE
STUDY THAT WE THINK WOULD HAVE A
COMPREHENSIVE OVERVIEW. BUT THIS
IS A GREAT FIRST STEP, AND WE
CERTAINLY APPLAUD THE
ADMINISTRATION'S ATTENTION TO
THAT MATTER. UM THERE ARE A
NUMBER OF ISSUES THAT WE
CONTINUE TO WORRY ABOUT, AS
WELL. UM FIRST AND FOREMOST, I
WOULD JUST LIKE TO FOCUS ON THE
FACT THAT ONGOING IN ADDITION TO
THE RATE MODEL FIXES, WE WANT TO
ENSURE THAT PROVIDERS ARE GOING
TO BE SUSTAINABLE. IN THE LONG
RUN. WE'VE MADE SOME HISTORIC
INVESTMENTS IN OUR SPACE AND
THEY'RE PROTECTED THIS YEAR,
WHICH IS GREAT, BUT THERE IS
MORE WORK TO DO. IN PARTICULAR.
ONE ITEM IS MAKING SURE THAT
PROVIDERS ARE ABLE TO MAINTAIN
MONTHLY AND DAILY BILLING UNIT
RATES AS WE GET TO FINAL STAGE
OF GREAT MODEL IMPLEMENTATION.
WE ARE A SERVICE INDUSTRY THAT
IS UNDERSTANDING OUR POS. AS THE
BUDGET DOCUMENTS WILL INDICATE.
I THINK THAT NUMBER IS GOING TO
BE CONSIDERABLY HIGHER BY THE
END OF THE FISCAL YEAR AND
MOVING TO A FULLY HOURLY SYSTEM
WOULD ONLY EXACERBATE AND REALLY
KIND OF UNDERCUT THE SYSTEM
COMPLETELY. SO WE HOPE TO GET
THAT REVISED THIS YEAR. IN
ADDITION ON THE BUDGET, WE
SUPPORT THE ADMINISTRATION'S
PROPOSAL FOR DIRECTIVE AUTHORITY
TO PROVIDE SOME STATEWIDE AND
STANDARDIZED VENDORS ATION
ACROSS THE STATE. WE HOPE THAT
THAT WILL IMPROVE ACCESS. AND UH
, FLEX FLEXIBILITY, FEASIBILITY
FOR PROVIDERS TO HAVE AN
ADEQUATE NETWORK. THANK YOU.
THANK YOU. DICKHEAD ON BEHALF OF
THE RURAL COUNTY REPRESENTATIVES
OF CALIFORNIA, COMMENTING ON
ITEM FOUR F WITH THE DEPARTMENT
OF HEALTH CARE SERVICES
REGARDING CARE COURT. WE
APPRECIATE THE ADMINISTRATION'S
INCREASED FUNDING TO CARE COURT
, BUT WE BELIEVE JUST BASED ON
OUR CONSERVATIVE ESTIMATES ABOUT
IT'S ABOUT $250 MILLION SHORT OF
FULLY FUNDING. THIS PROGRAM
ACROSS ALL 58 COUNTIES WERE ALSO
CONCERNED THAT THE COUNTY
BEHAVIORAL HEALTH LEGAL COSTS
ARE NOT INCLUDED IN THE
DEPARTMENT'S BUDGET. IN ORDER
FOR THIS PROGRAM TO CPS
SUCCESSFUL WE URGE THE
LEGISLATURE TO FULLY FUND IT.
THANK YOU. THANK YOU. I WILL SEE
THAT AS THE END OF PUBLIC
COMMENT HERE IN PERSON. WE WILL
NOW TRANSITION TO PUBLIC COMMENT
OVER THE PHONE AS A REMINDER THE
PHONE NUMBER AND ACCESS CODE OR
ON THE FIRST PAGE OF THE AGENDA,
AS WELL AS ON THE SUBCOMMITTEE'S
WEBSITE AND SHOULD ALSO BE ON
YOUR SCREEN. IF YOU ARE WATCHING
THE LIVESTREAM THE PHONE NUMBER
AGAIN IS 187769. AND THE PUBLIC
ACCESS CODE IS 13151. WITH THAT
OPERATOR. LET'S BEGIN. THANK YOU
FOR PUBLIC COMMENT. YOU MAY
PRESS ONE AND THEN ZERO. OUR
FIRST LINE WILL COME FROM LINE
33. YOUR LINE IS OPEN. HI I'M
DARBY KERNAN, REPRESENTING
LEADING AGE CALIFORNIA WE
REPRESENT NONPROFIT PROVIDERS
SERVING THAT CONTINUING CARE FOR
OLDER ADULTS. UM FIRST HAPPY
BIRTHDAY, MR CHAIR, AND WE
SUPPORT THE DEPARTMENT OF AGING
PROPOSAL FOR $50 MILLION FOR
BEHAVIORAL HEALTH RESOURCES FOR
OLDER ADULTS. IT'S IMPORTANT
FUNDING FURTHERS THE GOALS OF
THE MASTER PLAN FOR AGING, AND
IN ADDITION, WE WOULD ENCOURAGE
THE LEGISLATURE TO PRIORITIZE
THE PRESERVATION OF NURSING
WORKFORCE DEVELOPMENT FUNDING IN
THE 2024 BUDGET. THE FUNDING IS
NEEDED NOW TO GROW THE
HEALTHCARE WORKFORCE. THANK YOU.
THANK YOU. NEXT CALLER, PLEASE.
THANK YOU. LINE 36 HAIRLINE IS
OPEN. GOOD AFTERNOON, JOSH
DUGGAR ON BEHALF OF THE
CALIFORNIA COMMUNITY LIVING
NETWORK WE JUST WANT TO QUICKLY
EXPRESSED THEIR ENTHUSIASTIC
SUPPORT AND APPRECIATION FOR THE
INDEPENDENT LIVING SERVICES
RATES FIXED PROPOSAL UNDER THE
DEPARTMENT OF DEVELOPMENTAL
SERVICES HAS BEEN A LONG
STANDING ISSUE THAT MANY FOLKS
HAVE INVESTED TIME AND ENERGY
AND UNDERSTANDING, INCLUDING THE
CHAIR MEMBERS AND STAFF OF THIS
COMMITTEE, THE DEPARTMENT OF
FINANCE THE LEGISLATIVE
ANALYST'S OFFICE, THE DEPARTMENT
OF DEVELOPMENTAL SERVICES AND
LEGISLATIVE LEADERSHIP BATH. WE
ALSO WANT TO PHYSICALLY BANKERS
AND REMEMBER WOOD FOR HIS
LEADERSHIP ON THIS ISSUE. FIXING
THE LS RATE WILL SAVE HCB S
COMPLIANT. I LS PROGRAMS ACROSS
THE STATE ALLOW INDIVIDUALS WITH
INTELLECTUAL OR DEVELOPMENTAL
DISABILITIES TO LIVE
INDEPENDENTLY WHILE RECEIVING
THE SERVICES THEY NEED AND
DESERVE AND SAVE THE STATE
RESOURCES IN THE LONG TERM.
THANK YOU. THANK YOU. NEXT
CALLER, PLEASE. THANK YOU. LINE
38 AIRLINE IS OPEN. GOOD
AFTERNOON CHAIR MEMBERS RITA
MEDINA WITH COALITIONS AND
HUMANE IMMIGRANT RIGHTS SHOULD
LÀ JUST WANT TO HIGHLIGHT A FEW
KEY INVESTMENTS. SOME THAT DID
APPEAR IN THE GOVERNOR'S MAY
REVISE AND THEN CUES THAT DID
NOT, AND WE HOPE THE LEGISLATURE
WILL CONSIDER AS WE CLOSE IT ON
THE FINAL BUDGET. FIRST I WANT
TO THANK THE GOVERNOR AND THE
LEGISLATURE FOR DOUBLING DOWN ON
THEIR COMMITMENT TO HEALTH CARE
FOR ALL AND THANK YOU TO YOUR
LEADERSHIP CHAIR FOR THAT WORK.
AS WELL AS THE COMMITMENT TO
FOOD FOR ALL FOR THOSE 55 OVER
AND COMMITMENT TO AN
IMPLEMENTATION DATE, AND THEN WE
JOIN OTHERS IN THE CALL FOR FOOD
FOR ALL AS SOON AS POSSIBLE,
REGARDLESS OF AGE AND STATUS.
DESPITE THE BUDGET FORECAST, WE
BELIEVE THERE WERE FEW STILL A
FEW OPPORTUNITIES FOR A FEW KEY
INVESTMENTS IN IMMIGRANT
COMMUNITIES, AND THESE INCLUDE
IMPORTANTLY, EXPANSION OF THE
EXISTING CABBIE PROGRAMS TO
UNDOCUMENTED INDIVIDUALS WHEN
THEY SPECIFICALLY BENEFIT AND
DOCUMENTED SENIORS AND DISABLED
INDIVIDUALS BEING CHAMPIONED BY
ASSEMBLYMEMBER'S JUAN CARILLO. A
COUPLE OF OTHER INVESTMENTS THAT
ARE VERY TIMELY RIGHT NOW TO
SUPPORT OUR COMMITMENT AS
CALIFORNIA IS A WELCOMING STATE.
THESE ARE INVESTMENTS TO SUPPORT
IMMIGRANT RIGHTS SERVING
ORGANIZATIONS TO PROVIDE OUT
EDUCATION AND OUTREACH TO
SHELTERS IN ORDER FOR THEM TO
BEST SERVE IMMIGRANT POPULATION
, BRIDGING THE GAP IN SERVICES
FOR VULNERABLE IMMIGRANTS AND
ALLOWING THEM TO ACCESS NEEDED
STATE BENEFITS WHILE THEY WAIT
FOR THEIR APPLICATIONS TO BE
ADJUDICATED, WHICH CAN BE A LONG
AND ARDUOUS PROCESS. AND
FINALLY, WE SUPPORT THE PROPOSAL
TO EXPAND THE NUMBER OF DAYS,
REFUGEES AND ASYLUM HAVE ACCESS
TO EXISTING CASE MANAGEMENT
SERVICES. WE SEE THE FINAL THREE
IS CRITICAL TO DOUBLING DOWN ON
OUR SUPPORT OF CALIFORNIA AS A
WELCOMING STATE FOR IMMIGRANTS
AND NEW ARRIVALS. THANK YOU SO
MUCH. THANK YOU. NEXT CALLER,
PLEASE. THANK YOU. LINE 31. YOUR
LINE IS OPEN. YES THANK YOU, MR
CHAIR AND MEMBERS OF THE
COMMITTEE KEVIN RODDY,
REPRESENTING MAXIM HEALTHCARE
SERVICES. WE ARE IN STRONG
SUPPORT OF ASSEMBLYMEMBER'S
RAMOS'S REQUEST FOR 40% INCREASE
PRIVATE DUTY NURSING SERVICES.
AS PREVIOUS, UH, WITNESSES
TESTIFIED PDM SERVICES ARE GOING
THROUGH A CRISIS RIGHT NOW, WITH
THE HIRING OF NURSES. AND WE
WOULD APPRECIATE USING SOME OF
THE CEO TAX MONIES. THE GOVERNOR
HAS PROPOSED IN HIS BUDGET FOR
THESE SERVICES. THANK YOU VERY
MUCH. THANK YOU. NEXT CALLER,
PLEASE. QUÊ LINE 39. YOUR LINE
IS OPEN. GOOD AFTERNOON, MARY
CHRISTIE ON BEHALF OF THE
CHILDREN'S PARTNERSHIP, THE
CHILDREN'S PARTNERSHIP IS
GRATEFUL FOR THE GOVERNOR'S
INVESTMENTS AND EXPANDING HEALTH
COVERAGE, STRENGTHENING MEDICAL
AND BOOSTING COW WORKS IN THE
UNIVERSAL SCHOOL MEAL, WHICH
WILL PAY DIVIDENDS IN SUPPORT OF
THE CHILDREN. A CHILD'S LIFETIME
HEALTH TCP SUPPORTS RENEWING THE
EMC ATTACKS AND REQUEST THAT
FUNDS ALSO BE USED TO INCREASE
THE RATE PAID TO COMMUNITY
HEALTH WORKERS. WE ASKED THE
LEGISLATURE REJECTED PROPOSED
DELAY OF THE COMMUNITY HEALTH
WORKER WORKFORCE CERTIFICATION
AND TRAINING. WE SUPPORT
IMPLEMENTING THE EXPANSION OF
THE SEAT BATH IN 2025, INSTEAD
OF 2027 REQUESTS THAT THE
PROGRAM INCLUDING UNDOCUMENTED
CHILDREN, 66% OF WHOM FACE FOOD
INSECURITY. WE ASKED THE
LEGISLATURE INVEST 2.4 MILLION
ANNUALLY TO EXTEND COMPREHENSIVE
PERINATAL SERVICES PROGRAMS.
SERVICES FOR 12 MONTHS PREGNANCY
, IMPLEMENTATION OF CONTINUOUS
MEDICAL COVERAGE FROM CHUCK FOR
CHILDREN, 0 TO 5 AND SUPPORT
INFANT AND EARLY CHILDHOOD
MENTAL HEALTH WITH $100 MILLION
VESTMENT. THANK YOU. THANK YOU.
NEXT CALLER, PLEASE. THANK YOU.
I'M 41. YOUR LINE IS OPEN. HELLO
THIS IS KEVIN IN SCHOOL WITH THE
FRIENDS COMMITTEE ON LEGISLATION
OF CALIFORNIA WERE A MEMBER OF
THE END CHILD POVERTY IN
CALIFORNIA COALITION AND WE'RE
IN SUPPORT OF REIMAGINING THE
COW WORKS PROGRAM, A MINIMUM COW
FRESH BENEFIT OF $50 EXPANDING
FOOD ASSISTANCE TO BE FOOD FOR
ALL AND EXPANDING THE CAPPY
PROGRAM TO UNDOCUMENTED
IMMIGRANTS. THANK YOU. THANK
YOU. NEXT CALLER, PLEASE. THANK
YOU. NEXT LINE, 46. YOUR LINE IS
OPEN. THANK YOU, MR CHAIR AND
MEMBER KATHY UNDERLING MCDONALD
FOR THE COUNTY WELFARE DIRECTORS
ASSOCIATION. WE WANT TO THANK
THE ADMINISTRATION FOR
PARTNERSHIP ON THE CALCULUS,
BUDGET METHODOLOGY AND
AUGMENTATION, WHICH WE BELIEVE
IS A GOOD FAITH EFFORT TO FUND
THIS LONGSTANDING GAP. WE ALSO
URGE CONSIDERATION OF OUR
REQUESTED FUNDING FOR ADDITIONAL
COUNTY STAFF. TO HANDLE THE
EXPECTED VOLUME OF FAIR HEARING
REQUESTS ASSOCIATED WITH THE
MEDICAL CONTINUOUS COVERAGE,
UNWINDING IF WE DO NOT RECEIVE
THESE ONE TIME FUNDS, COUNTIES
WILL FALL BEHIND AND ARE LEGALLY
REQUIRED WORK WITH THESE CLIENTS
, AND THOSE OTHER PROGRAMS WILL
ALSO SEE THEIR DUE PROCESS TO
LATE. FINALLY WE DO HAVE ONGOING
CONCERNS WITH THE TRAILER BILL
PROPOSAL. TO A FIRE MANAGED CARE
ENROLLMENT FOR FOSTER CHILDREN
IN THE NEW SINGLE PLAN MODEL
COUNTIES AND URGED THE CHOICE BE
PRESERVED FOR CHILDREN IN THESE
THREE COUNTIES. THE NUMBER OF
ISSUES THEY MIGHT COMMENT ON
WOULD TAKE MUCH LONGER THAN I
HAVE. SO I WILL ALSO DRAW YOUR
ATTENTION TO THE MEMOS THAT WE
HAVE SENT ON THE HEALTH AND
HUMAN SERVICES ISSUES OF
INTEREST AND THEN A REVISION AS
WELL AS SEVERAL UPDATED MEMBERS
. MEMOS ON OUR KEY CWB, A BUDGET
REQUESTS. THANK YOU AND HAPPY
BIRTHDAY, MR. CHAIR. THANK YOU.
THANK YOU NEXT A LITTLE LINE,
21. YOUR LINE IS OPEN. GOOD
AFTERNOON AND THANK YOU, MR
CHAIR K¾T LEIGHTON ON BEHALF OF
THE CHILDREN'S SPECIALTY CARE
COALITION. WE WANT TO THANK THE
DEPARTMENT OF HEALTH CARE
SERVICES FOR THE REVISIONS TO
THE TRAILER BILL RELATED TO HOLD
CHILD MODEL EXPANSION. WHILE WE
APPRECIATE THE REMOVAL OF THE
SINGLE PLAN COUNTIES FROM THE
PROPOSAL, WE ARE IN AN OPPOSING
LESS AMENDED POSITION BECAUSE OF
CONCERNING FINDINGS FROM THE
INDEPENDENT EVALUATION THAT NEED
TO BE ADDRESSED BEFORE FURTHER
EXPANSION. SPECIFICALLY WE WOULD
LIKE TO SEE A ONE YEAR DELAY IN
EXPANSION INTO THE COAST
COUNTIES OUTLINED IN THE REVISED
PROPOSAL, AS WELL AS ADDITIONAL
AMENDMENTS TO THE TRAILER BILL
THAT WILL HELP US BETTER
DETERMINE THE REASON FOR THE
DROP IN CCS ENROLLMENT AND HOTEL
MODEL COUNTY AND IDENTIFY WHITE
CHILDREN IN SOME COUNTIES WERE
LESS LIKELY TO SEE THEIR PCS
PROVIDER AND VISITED DESIGNATED
SPECIAL CARE CENTER AS WELL AS
STRENGTHEN THE MEDICAL CASE
MANAGEMENT FOR FAMILIES,
PARTICULARLY SINCE IT WAS
FAMILIES WITH CHILDREN WITH THE
GREATEST MEDICAL COMPLEXITY. WHO
SAID CASE MANAGEMENT WAS WORSE
AFTER THE TRANSITION. WE HAVE
SUBMITTED PROPOSED AMENDMENTS TO
THE COMMITTEE INTERVIEWED CS AND
STAND READY TO WORK WITH BOTH
THE LEGISLATURE AND THE
DEPARTMENT TO COME TO AN
AGREEMENT SO THAT WE CAN ENSURE
THAT THESE MEDICALLY VULNERABLE
CHILDREN AND FAMILIES RECEIVED
THE HIGH QUALITY HIGH TOUCHED
AND MULTIDISCIPLINARY CARE
SERVICES THAT THEY NEED AND
DESERVE. THANK YOU FOR YOUR
CONSIDERATION OF OUR POSITION ON
THE REVISED TRAILER BILL. THANK
YOU. NEXT CALLER, PLEASE. THANK
YOU. LINE 51 YEAR LINE IS OPEN.
GOOD AFTERNOON. THIS IS NICHOLAS
GAMES UNDER REGIONAL SENIOR
SERVICE FOR SOUTH CENTRAL LOS
ANGELES REGIONAL CENTER. I
WANTED TO SPEAK ON HOW VALUABLE
IT IS FOR SERVICE COORDINATORS
TO HAVE FACE TO FACE MEETINGS
WITH THE INDIVIDUALS WHO SERVED
AND THEIR FAMILIES. I THINK IT'S
VERY IMPORTANT BECAUSE
DEFINITELY DURING THE PANDEMIC,
WE WEREN'T ABLE TO DO IT FOR TWO
TO CARE. AND SO IT'S AWESOME
PORT TO MONITOR THE HOME
ENVIRONMENT, SO WE'RE ABLE TO
MAKE SURE THEY'RE LIVING IN THE
HEALTH AND SAFETY, A MUCH TO SAY
ENVIRONMENT. ALSO PROVIDES THE
OPPORTUNITY TO SIGN PAPERWORK
AND GET THAT DONE IN A TIMELY
MANNER AS OPPOSED TO HAVING THE
FAMILY'S MAIL IN THE PAPERWORK
AS THEY WOULD DO IF WE WOULD
TELL IT TO THEM, AND THEN ALSO,
THIS PROVIDES US AN OPPORTUNITY
TO IF THEY NEED ASSISTANCE WITH
GENERIC FREE COURSES WITH
READING OVER SECURITY PAPER
WORKER IN HOME. HSS PAPERWORK.
WE CAN ASSIST FAMILIES IN PERSON
, UM, WHICH WOULD BE BETTER FOR
THEM ALSO, AND ALSO, WE CAN ALSO
REVIEW BECAUSE WE ALSO PROVIDE
THEM A LIST OF REGIONAL CENTER
SERVICES SO WE CAN GO OVER THAT
LIST WITH THEM DURING THE OCCUPY
THE MEETING AS OPPOSED TO DOING
IT OVER THE FRONT, WHICH WOULD
BE MUCH HARDER FOR SOME
FAMILIES, ESPECIALLY FROM
FAMILIES. WHO STRUGGLED WITH
TECHNOLOGIES SUCH AS EMAIL OR
LOGGING ON THROUGH SILTON. OKAY
AND THEN LASTLY, WE ALSO WE CAN
PROVIDE ASSISTANCE. WHAT'S GOING
OVER 47 31 COMPLAINT FORM THAT
WE PROVIDE FAMILIES AT EACH IVP
MEETING, SO THEY QUESTION THEY
MIGHT HAVE FOR THE FORM. WE CAN
ANSWER THOSE QUESTIONS. AFTER
EATING AND ALSO AND TEAR HAPPY
BIRTHDAY. THANK YOU. NEXT
CALLER, PLEASE. THANK YOU. NEXT
WE'LL GO TO LINE 27. YOUR LINE
IS OPEN. MR CHAIR, REMEMBERS
DANIEL SANCHEZ ON BEHALF OF THE
CHILDREN'S HOSPITAL, LOS ANGELES
CALLING REGARDING THE DEPARTMENT
OF HEALTH CARE SERVICES TRAILER
BILL TO EXPAND CCF WHOLE CHILD
MODEL I WOULD LIKE TO ALIGN MY
COMMENTS WITH THOSE OF THE
CALIFORNIA CHILDREN'S HOSPITAL
ASSOCIATION. THE CHILDREN'S
HOSPITAL. LOS ANGELES GREATLY
APPRECIATE THAT DEPARTMENT
SCALED BACK THE PROPOSAL AND
REMOVE THE ALAMEDA CONTRA COSTA
AND IMPERIAL COUNTIES FROM
CONSIDERATION. HOWEVER WE REMAIN
CONCERNED ABOUT THE REVISED
TRAILER BILL THAT WILL EXPAND W
CM INTO C O. H S COUNTIES NEXT
YEAR, GIVEN THE CONCERNING
FINDINGS AND THE WHOLE CHILD
MODEL EVALUATION, WE
RESPECTFULLY REQUEST THAT
COMMITTEE DIRECTED THE
DEPARTMENT TO WORK WITH
STAKEHOLDERS ON AMENDMENTS TO
ITS TRAILER BILL LANGUAGE TO
ADDRESS FINDINGS FROM THE
EVALUATION AND STRENGTHEN THE
MODEL PRIOR Tð EXPANSION. THANK
YOU. THANK YOU. NEXT CALLER,
PLEASE. THANK YOU NEXT TO LINE
30. YOUR LINE IS OPEN. MR CHAIR
MEMBERS, ROBERT HARRIS ON BEHALF
OF THEIR SEE HOW YOU CALIFORNIA
FIRST REGARDING THE BEHAVIORAL
HEALTH THINGS. UH THE MELATONIN
BEST UNTIL $30 MILLION ON CALLE
RX IS TRULY NEEDED SO HOPEFULLY
, THEY'LL BE COME IN THE FUTURE
MORE NOW ON THE BAILABLE BECAUSE
IT'S CRAZY. NOW THERE'S MORE
DEMAND THAT THERE IS MONEY. UM,
FOR WE ALSO GRATEFUL FOR THE
CARE COURT AUGMENTATIONS FOR THE
COUNTY'S WE THINK THAT IS
NECESSARY. I LOVE IT. MAN MIGHT
BE NONE OTHER THAN NOW, AND FOR
THE $15 MILLION FOR THE L A
STARTUP. UH WE ALSO ARE GRATEFUL
DEATHS ADMINISTRATION IS
THINKING ABOUT ADDING, UH, THE
TWO BEHAVIORAL HEALTH, THE SUD
POPULATION. IN THE IN THEIR IDEA
ABOUT THREE WRITING OR
MODERNIZING MENTAL HEALTH
SERVICES ACT. AS FAR AS THE EGO
. THIS IS KIND OF WHAT WE THINK.
SO WE'RE HAPPY. HAPPY HAPPY FOR
THE I L F SEGMENTATION. WE THINK
THAT'S VERY IMPORTANT. WE'RE
ALSO GLAD THAT THE
ADMINISTRATION AND THE
DEPARTMENT THINKING ABOUT AND
WORKING ON LANGUAGE,
STANDARDIZED SERVICES AND
GENERALIZATION PREDECESSOR. WHAT
WE AREN'T REALLY HAPPY ABOUT AND
WE'RE CONCERNED ABOUT IS THE
FACT THAT CARES COORDINATORS
SHOULD BE THE WELCOMING HAND AND
THE PEOPLE WHO HELPED PEOPLE
INTO THE SYSTEM INSTEAD BECAUSE
WE HAVEN'T DONE ANYTHING ABOUT
THE CORE STAFFING FORMULA. THEY
BECOME GATEKEEPERS. THAT ISN'T
WHAT THEY WANT TO DO. THAT ISN'T
WHAT THEY'RE TRAINED TO DO. WHAT
THEY CARE ABOUT, BUT RIGHT NOW
THEY'RE GATEKEEPERS TO ASSIST
THEM. AND THAT THAT DOESN'T WORK
. AND IF YOU FIND MOST OF THE
COMPLAINTS ABOUT THE SYSTEM ALL
COME BACK TO THE FACT THERE
AREN'T ENOUGH RECORDED. SO WE
HOPE THIS YOUR COMMITMENT TO
MAKE TO IMPROVE THAT AND TO MAKE
THAT WORK. IS GOOD, AND IT
HAPPENS THIS YEAR. BECAUSE ANY
KIND OF A STEP FORWARD STOPS
EVERYBODY IN THE SYSTEM AND IF
WE DON'T HELP THE PEOPLE GET THE
SERVICES. THEN WHAT ARE WE DOING
? THAT'S IT. I WANT TO THANK YOU
FOR YOUR COMMITMENT TALKING,
JACKSON AND ALSO HAPPY BIRTHDAY.
THANK YOU. THANK YOU. NEXT
CALLER, PLEASE. THANK YOU LINE
55. AIRLINE IS GOOD AFTERNOON.
YEAH GOOD AFTERNOON, MR CHAIRMAN
, MEMBERS OF THE COMMITTEE. THIS
IS CARL LONDON, REPRESENTING THE
ALLIANCE SUPPORTING PEOPLE WITH
I'D LIKE TO ALIGN MYSELF WITH
THE COMMENTS MADE BY MR GIARDINI
FROM SEEDS EARLIER. ALSO WANT TO
THANK YOU, ESPECIALLY FOR YOUR
STRONG COMMITMENT TO MAKING SURE
THAT WE HAVE UPHELD A POSITION
OF ADMITTING RATES TO COMMUNITY
BASED PROVIDERS IN THE
DEPARTMENT. DEVELOPMENTAL
SERVICES HAS BEEN VERY
IMPRESSIVE AND IMPORTANT. I
WOULD LIKE TO RAISE A COUPLE OF
SEPARATE ISSUES REALLY QUICKLY.
ONE AGAIN, IT'S JUST TO
REITERATE THE CONCERN OVER SUB
MINIMUM WAGE EARNERS WHO ARE
BEING PUSHED OUT OF THESE
POSITIONS BECAUSE OF LEGISLATION
THAT'S BEEN PASSED. WE'VE GOT
MORE DATA ON THIS NOW, AND IT
LOOKS LIKE AS OF 16 24,000.
PEOPLE HELD SUCH POSITIONS IN
CALIFORNIA. WE'RE DOWN TO ABOUT
4900 RIGHT NOW. 13,000 OF THOSE
PEOPLE IN THAT GAP HAVE NOT
FOUND ANY NEW EMPLOYMENT
WHATSOEVER OVER THE PAST SEVEN
YEARS. THAT MEANS WE HAVE A
SIGNIFICANT PROBLEM WE ARE NOT
LIVING UP TO, OR EVEN GETTING
CLOSE TO THE STATE LEGISLATIVE
PRIORITY OF EMPLOYMENT FIRST FOR
PEOPLE WITH INTELLECTUAL AND
DEVELOPMENTAL DISABILITIES. WE
WOULD URGE THAT YOU CONSIDER
ALIGNING THE END DATE OF THE SUB
MINIMUM WAGE BAN. WITH THE
DEPARTMENT OF REHABILITATIONS
OVERSIGHT OF THE FEDERAL GRANT
MONEY THEY'VE RECEIVED EXPRESSLY
FOR THE PURPOSE OF MOVING PEOPLE
FROM SUB MINIMUM WAGE TO MINIMUM
WAGE AND HIGHER JOBS THAT WOULD
PUSH THIS OUT TO 2027. SEPTEMBER
WE THINK THAT WOULD BE
APPROPRIATE AND IN LINE WITH THE
CURRENT EFFORTS OF THE
DEPARTMENT. THE ONLY OTHER THING
I WOULD SAY IS THAT WE WANT TO
RAISE ANOTHER ISSUE OF CONCERN
AND THAT IS THAT THE DEPARTMENT
OF DEVELOPMENTAL SERVICES
CONTINUES TO PURSUE. DIRECTIVES
AGAINST COMMUNITY BASED PROGRAMS
THAT RECEIVED TPP LOAN MONIES
DURING THE BEGINNING OF THE
PANDEMIC. THAT WILL DEVASTATE
SOME OF THESE PROGRAMS. WHO HAVE
MORE OFTEN THAN NOT ALREADY
SPENT THAT MONEY ON EXISTING
CONCERNS AND CONTINUE TO SUFFER
FROM THE PANDEMIC. THERE ARE
PROGRAMS WITH GROWING WAITING
LIST BECAUSE THEY SIMPLY DO NOT
HAVE THE CAPACITY TO SERVE
PEOPLE HAVING THE DEPARTMENT
DEVELOPMENTAL SERVICES GO AFTER
THESE AGENCIES FOR LOAN MONIES
RECEIVED FROM THE FEDERAL
GOVERNMENT IS AN ABSURD IDEA. WE
URGE YOU TO URGE THEM TO DROP
THAT. THANK YOU VERY MUCH. HAPPY
BIRTHDAY TO YOU HOPE IS A GREAT
DAY IN YOUR FOR YOU. THANK YOU.
NEXT CALLER, PLEASE. THANK YOU.
I'M 56. YOUR LINE IS OPEN. HELLO
MR CHAIR AND MEMBERS JOHAN
CARDINALS WITH THE CALIFORNIA
AND ETHNIC NETWORK. UH TO ITS
PER SUPPORT FOR THE N C O TEP
PROPOSAL IN THE MAY REVIVE AND
URGED THE LEGISLATION TO
LEVERAGE DOLLARS PACIFIC
INVESTMENT. UH WHO WAS HELD IN
RACIAL EQUITY. A THIRD OF ALL
CALIFORNIANS ARE ENROLLED
MEDICAL, MEDICAL AND TWO THIRDS
OF AMERICAN MEMBERS ARE PEOPLE
COLOR. YES HELP OUTCOMES FOR
PEOPLE OF COLOR SPELLING
COMPETITION TO THE WHITE.
COUNTERPARTS IN THE MEDICAL
PROGRAM. AND IN COMPARISON TO
CALIFORNIA ENROLLMENT COMMERCIAL
COVERAGE. THAT'S WHY WE SUPPORT
THE PROPOSAL THAT WE THAT
REQUEST A LARGER TAP OF 19
BILLION TO SUPPORT BASED RATE
INCREASES IN AMERICA TO AT LEAST
87.5. BUT MEDICARE FOR PRIMARY
CARE. MATERNITY CARE IN THE
INCLUDING DUELISTS. AND NONE OF
THE SHORTY MENTAL HEALTH
SERVICES. CONSIDERATION TO
ACCELERATE SPENDING PLAN.
HOWEVER WE ALSO ASK THAT WE
RAISED RATES FOR C H W. M C O
TAX REVENUES AS WELL, LIKE OUR
ESTIMATES PRINCE ST RATES ARE
APPROXIMATELY 5% OF THE
EQUIVALENT MEDICARE. GREAT FOR
NON PHYSICIAN, EDUCATION AND
MANAGEMENT, AND WE THINK THEY
SHOULD ALSO BE RAISED TO 87.5%
COMMENSURATE. THE OTHER PROPOSED
PROVIDED RATE SERVICES. IT IS
ESSENTIAL TO ENSURE SUCCESSFUL
IMPLEMENTATION OF THE THW
BENEFIT. AND LOOKS FORWARD TO
CONTINUING THE CONVERSATION OVER
THE NEXT FEW WEEKS. AND
PURCHASED THE LEGISLATURE AND
THE ADMINISTRATION TO CONSIDER
ENHANCEMENTS TO THE PROPOSAL.
FURTHER HEALTH AND RACIAL EQUITY
THANK YOU AND HAPPY BIRTHDAY AS
WELL. THANK YOU. NEXT CALLER,
PLEASE. THANK YOU AND 57. YOUR
LINE IS OPEN. MY NAME IS JOHN
DECKER, AND I'M THE DIRECTOR OF
COMMUNITY SERVICES THAT ALTA
CALIFORNIA REGIONAL CENTER. I'M
CALLING TO SUPPORT THE
DEPARTMENT OF DEVELOPMENTAL
SERVICES RE APPROPRIATION OF
UNUSED COMMUNITY PLACEMENT,
PLANNED FUNDING FOR THE PURPOSES
OF DEVELOPING MORE MULTI FAMILY
HOUSING. INDIVIDUALS WITH
DEVELOPMENT DISABILITIES FACE
SIGNIFICANT BARRIERS IN
ACCESSING AFFORDABLE HOUSING.
ADDITIONALLY MANY ORIGINAL
SENATE CLIENTS ALSO RESIDE IN
THEIR FAMILY HOMES WITH AGING
CAREGIVERS. THESE MULTI FAMILY
HOUSING FUNDS WILL BE UTILIZED,
PROVIDE AFFORDABLE HOMES FOR
ADULTS WITH DEVELOPMENTAL
DISABILITIES TO LIVE IN
COMMUNITIES OF THEIR CHOOSING.
THIS ONE TIME INVESTMENT OF
FUNDS HAS A DECADE LONG RETURN
AS EACH MULTI FAMILY HOUSING
PROJECT HAS A 55 YEAR
RESTRICTIVE COVENANTS ON THE SET
ASIDE UNITS FUNDED BY THE
DEPARTMENT OF DEVELOPMENT
SERVICES. THANK YOU FOR THE
CONSIDERATION OF THIS REQUEST,
WHICH HELPS PREVENT HOUSING
INSECURITY AND ENABLES SO MANY
WITH DEVELOPMENT DISABILITIES TO
REACH THE HOUSING INDEPENDENCE
THAT THEY DESIRE. THANK YOU VERY
MUCH. THANK YOU. NEXT CALLER,
PLEASE. THANK YOU. I'M 50 FOR
YOUR LINE IS OPEN. THANK YOU.
GOOD AFTERNOON, MR CHAIR AND
MEMBERS BUSINESS, LORI ROMAN,
WITH A SHELL PACKARD CHILDREN'S
HOSPITAL AT STANFORD AND
DIRECTOR OF CHRIS CHILDREN'S
REGIONAL INTEGRATED SERVICE
SYSTEM. I'M CALLING ABOUT THE
DEPARTMENT OF HEALTH CARE
SERVICES TRAILER BILL TO EXPAND
CCS WHOLE CHILD MODEL CHRISTMAS
31 COUNTY COLLABORATIVE FOCUSED
SPECIFICALLY ON THE BCS PROGRAM.
WE CONCUR WITH THE COMMENTS OF
THE CALIFORNIA CHILDREN'S
HOSPITAL ASSOCIATION AND OTHER
ADVOCATES REGARDING THE TRAILER
BILL AND PROBLEMS WITH CULTURAL
MODEL. WE APPRECIATE THAT
APARTMENT, SCALING BACK THE
PROPOSAL AND REMOVING ALAMEDA
CONTRA COST AND IMPERIAL COUNTY
FROM THE LANGUAGE. THIS IS AN
IMPORTANT CHANGE FOR CHILDREN
AND CHILDREN'S PROVIDERS.
HOWEVER WE'RE STILL CONCERNED
THAT THE REVISED TRAILER BILL
WOULD EXPAND WHOLE CHILD MODEL
INTO NEW POST COUNTIES BEGINNING
NEXT YEAR. CHRIS IDENTIFIED
SERIOUS CONCERNS WITH COLD CHILD
MODEL HAS NOW IMPLEMENTED AND
THESE CONCERNS WERE CORROBORATED
BY THE WHOLE CHILD MODEL
EVALUATION. GIVEN THESE CONCERNS
WITH STRONGLY SUPPORT THE
REQUEST THAT THE COMMITTEE
DIRECT THE DEPARTMENT TO WORK
WITH STAKEHOLDERS ON AMENDMENTS
TO THE TRAILER BILL LANGUAGE
THAT WILL ADDRESS THESE
EVALUATION FINDINGS. WE NEED TO
CORRECT THE PROBLEMS WITH WHOLE
CHILD MODEL AS IT'S CURRENTLY
IMPLEMENTED AND STRENGTHEN THE
MODEL PRIOR TO ANY EXPANSIONS IN
THE FUTURE. THANKS FOR YOUR
TIME. THANK YOU. NEXT COLOR,
PLEASE. THANK YOU. LINE 40. YOUR
LINE IS OPEN. PLEASE GO AHEAD.
HI GOOD AFTERNOON CHAIR AND
MEMBERS. MY NAME IS TO GET IT
FROM THE CALIFORNIA ASSOCIATION
OF FOOD. BANKS WERE GRATEFUL FOR
THE INCLUSION OF SEVERAL
IMPORTANT INVESTMENTS PORTANTINO
100 PROGRAMS, AND THE GOVERNORS
MAY REVISE, UM, SUCH AS
MAINTAINING CAL FOOD AT 60
MILLION FUNDING TO IMPLEMENT AND
FULLY MAXIMIZED SUMMER EVP IN
2024. FUNDING TO PROTECT PEOPLE
FROM DVT STACKED AND RESTORE
STOLEN BENEFIT AND ENSURING
TIMELY IMPLEMENTATION OF BOOT
FOR ALL IN ADDITION TO THESE
WEIRD THE LEGISLATOR TO FULLY
MAXIMIZE AND STRENGTHEN THE
REACH OF CAL, FRESH BY
ESTABLISHING $50 IS THE MINIMUM
BENEFITS AND PROTECTING COUNCIL
CRASH RECIPIENTS FROM THE HARSH
FEDERAL A BODY TIME LIMIT RULES
ALSO TO FIND FOOD BANK CLIMATE
AND CAPACITY RESILIENCE, GRANTS
TO SUSTAIN AND EXPAND FUNDING
FOR DIAPERS, WIPES AND MENSTRUAL
PRODUCTS. ALSO TO PERMANENTLY
AUTHORIZED STATE DISASTER FOOD
ASSISTANCE PROGRAM. ALSO TO
INCREASE S AND B, T AND D
ALLOTMENTS FOR SFC RECIPIENTS.
PERRY WITH CAL FRESH AND FINALLY
ALSO TO RE IMAGINING HOW WORKS
TO KEEP FAMILIES CENTERED. THANK
YOU AND HAPPY BIRTHDAY CHAIR.
THANK YOU. NEXT CALLER, PLEASE.
THANK YOU NEXT TO THE LINE 45.
YOUR LINE IS OPEN. HELLO THIS IS
SUPER AND LITTLE WITH THE
ENVIRONMENTAL WORKING GROUP
CALLING THINGS TOO, OF COURSE
WITH SECURE A HAPPY BIRTHDAY BUT
ALSO TAKES EXPRESS OUR SUPPORT
FOR THE DEPARTMENT OF PUBLIC
HEALTH PROPOSAL TO REALLOCATE
$6.5 MILLION 9.5 MILLION DOLLARS
TO LOCAL CHILDHOOD BUT
PREVENTION PROGRAMS AND ALSO TO
EARTH TO EXPRESS OUR OPPOSITION
TO THE ADMINISTRATION'S PROPOSAL
TO DELAY IMPLEMENTATION OF SB 10
76. UM WE NEED TO MOVE FORWARD
AS POSSIBLE TO ADDRESS
PROBLEMATIC LEAD, PAINT REMOVAL
AND RENOVATION PRACTICE
COMMUNITIES AND DELAYING AND, UM
THREE EASIER SORT EVEN LONGER IS
NOT ACCEPTABLE. THANK YOU VERY
MUCH FOR YOUR TIME AND YOUR
INTENTIONS. THANK YOU. NEXT
CALLER, PLEASE. THANK YOU. NEXT
OVER THE LINE OF 53. YOUR LINE
IS OPEN. GOOD AFTERNOON. THANK
YOU. DUSTIN HARPER INSTITUTE ON
AGING. COMMENTING IN SUPPORT OF
THE EXTENSION OF FUNDING FOR
FRIENDSHIP LINE, CALIFORNIA
PROPOSED BY TÌM. ISOLATION AND
LONELINESS AND OUR OLDER ADULT
POPULATION DOES NOT END WITH THE
SUN SETTING OF THE PUBLIC HEALTH
EMERGENCY. WE APPRECIATE THE
DEPARTMENT'S INITIATIVE TO
PRIORITIZE BEHAVIORAL HEALTH
SOLUTIONS SPECIFICALLY TAILORED
TO MEET THE NEEDS OF OLDER
ADULTS. TO ACHIEVE OUR MASTER
PLAN FOR AGING OBJECTIVES. WE
MUST EXPAND ACCESS TO ESSENTIAL
SERVICES SUCH AS FRIENDSHIP
LINE, CALIFORNIA NOT ELIMINATE
THEM. THANK YOU APPRECIATE IT.
THANK YOU. NEXT CALLER, PLEASE.
THANK YOU LIKE 35. YOUR LINE IS
OPEN. GOOD AFTERNOON CHAIR
MEMBERS. THIS IS ADRIAN MOHAMED
, BUT THE UNITED DOMESTIC
WORKERS, ABSOLUTELY LOCAL 39,
31ST AND FOREMOST. HAPPY
BIRTHDAY, CARA ARAMBULA, UM.
WANTED TO VERY QUICKLY, UM,
ALIGN MYSELF WITH MANY OF THE
COMMENTS OF MY COLLEAGUES AND
THANK YOU AND THE GOVERNOR'S
OFFICE FOR THE MINOR RECIPIENT
ELIGIBILITY PROPOSAL IN THE MAY
REVISION. WE BELIEVE THAT IT IS
AN EXCELLENT FIRST STEP AND
FRANCHISING MINOR RECIPIENTS AND
ALLOWING THEM TO BE ABLE TO
RECEIVE CARE AND THE WAY THAT
THEY NEED, BUT ALSO BELIEVE, UH
, WE STILL NEED TO GO FURTHER IN
TERMS OF IN FRANCHISING OR
PROVIDERS. ESPECIALLY THOSE
FAMILIES, PROVIDERS AND SOME OF
THE LIMITATIONS THAT ARE
CURRENTLY UPON THEM.
ADDITIONALLY WE WANTED TO THANK
YOU ALL FOR, UM, THE EXTENSION
OF THE HOME AND COMMUNITY BASED
SERVICE SERVICES SPENDING PLAN
AND. UM THE DEDICATION AND THE
NEED FOR IT IN TERMS, ESPECIALLY
OF OUR, UM, I JESS I H S S
CAREER PATHWAYS PROGRAM AND
MAKING SURE THAT WE ARE REALLY
GIVING IT THE LEGS THAT IT
NEEDS. GIVEN THE AMOUNT OF
GROUND SWELL AND INTEREST THAT
THE PROGRAM HAS ALREADY UM AND I
WOULD BE REMISS IF I DID NOT
MENTION THIS, ESPECIALLY IN
TERMS OF THE MASTER PROBLEM
AGING AND THE COMMENTS THAT THE
CHAIR HAD FOURTH AT, UM PRIOR
BUDGET MEETING IN REGARDS TO
STATEWIDE COLLECTIVE BARGAINING.
SPECIFICALLY FOR I JUST
PROVIDERS MAKING SURE THAT WE
REALLY ARE INVESTING WITHIN
THESE THESE ESSENTIAL WORKERS.
AND SO AGAIN, JUST WANT TO SAY
THANK YOU SO MUCH AND LOOK
FORWARD TO WORKING WITH YOU ALL.
THANK YOU. NEXT CALLER, PLEASE.
THANK YOU, MR CHAIR. WE HAVE NO
FURTHER PUBLIC COMMENT AND QUÊ
THANK YOU. OPERATOR HEARING AND
SEEING NO FURTHER PUBLIC COMMENT
. I WILL TAKE A MOMENT AND
APPRECIATE ALL OF OUR PANELISTS.
THE ADMINISTRATION WILL UPLIFT
DIRECTOR JOHNSON, WHO'S STILL
HERE, PRESENT NOW LISTENING TO
PUBLIC COMMENT. DEPARTMENT OF
FINANCE, LEGISLATIVE ANALYST'S
OFFICE. SERGEANT TECH MY STAFF
BUDGET COMMITTEE STAFF. BUT MOST
IMPORTANTLY THE PUBLIC FOR
MAKING THIS THE PEOPLE'S HOUSE
AND IMPROVING OUR PROCESS WITH
THAT WE ARE ADJOURNED FOR THE
NIGHT. HAVE A GOOD NIGHT.