GOOD. BEFORE WE BEGIN I'D LIKE
TO MAKE A STATEMENT ON ON
PROVIDING TESTIMONY HERE AT THIS
HEARING TODAY AND- OBVIOUSLY-
WE'RE STARTING LATER THAN OUR
NORMAL ONE THIRTY- BECAUSE OF-
OUR NEED TO VOTE ON- IMPORTANT
BUDGET BILLS THAT WERE BEFORE US
SO- SO WE ARE CERTAINLY
APOLOGIZE FOR THAT- AND ACTUAR
WE WILL BE WAITING FOR SENATE
AUTHORS AND WE DON'T HAVE ANY
YET SO WE CAN'T DO BILLS IF WE
DON'T HAVE AUTHORS TO PRESENT
THEMSELVES BUT WE CAN'T DO IS
GET A GET SOME OF SOME
PRELIMINARIES OUT OF THE WAY SO
OUT OF THE WAY SO. SO FOR
BEGINNER LIKE TO MAKE A
STATEMENT- WE SEEK TO PROTECT
THE RIGHTS OF ALL WHO
PARTICIPATE IN THE LEGISLATIVE
PROCESS SO WE CAN HAVE AFFECTED
DELIBERATION ON THE CRITICAL
ISSUE ISSUES FACING CALIFORNIA A
WITNESSES ARE ARE TESTIFIED IN
PERSON WITHOUT TWO MAIN
WITNESSES FOR A MAXIMUM OF THREE
MINUTES EACH ADDITIONAL
TESTIMONY WILL ALSO BE IN PERSON
AND LIMITED TO NAME POSITION AN
ORGANIZATION IF YOU REPRESENT
ONE ALL CANTAB TESTIMONY
COMMENTS ARE LIMITED TO THE BILL
AT HAND. I WE DO HAVE A TWO
BILLS PROPOSED FOR CONSENT
CALENDAR TODAY. ANY MEMBER OF
THE COMMITTEE MAY REMOVE A BILL
FROM CONSENT. THE ADDAMS
PROPOSED OUR ITEM NUMBER NINE SB
FORTY FIVE BY SENATOR ROTH WITH
AMENDMENTS. ITEM NUMBER TEN SB
THREE FORTY FOUR BY SENATOR
RUBIO- TO BILLS HAVE BEEN
REMOVED TODAY FROM THE CAP FOR
TODAY'S COUNTER TO REQUEST THE
AUTHORS ITEM NUMBER FIVE SB
THREE FORTY. AND ITEM NUMBER
ELEVEN S. B. SET OF SEVEN
SEVENTEEN. THAT LEAVES US WITH.
TOTAL OF THIRTEEN BILLS TO HEAR
TODAY- AND WHEN WE HAVE A SENATE
AUTHOR WE CAN BEGIN BUT- IN THE
MEANTIME. YES YOU CAN GET TO
KNOW ONE ANOTHER BETTER OR PLAY
CARDS ON YOUR PHONE OR WHATEVER
SO ANYWAY THANK YOU. WE'LL START
AS SOON AS WE CAN.
YEAH.
YEAH HELLO. YEAH.
YEAH.
WELL WELL.
OKAY I KNOW THAT'S RIGHT.
WELCOME OUT APPROACH HERE OUR
ATTEMPTS IS ME. THANK YOU SO
MUCH AND I AM SO SORRY TO THE
COLLEAGUES AND MISTER CHAIR TO
KEEP YOU WAITING- BUT THANK YOU
SO MUCH FOR THIS COURTESY I I'M
HERE TO PRESENT SB FOUR EIGHTY
SEVEN WHICH IS FOCUSED ON
ABORTION PROVIDER PROTECTIONS
IT'S A CRITICAL COMPONENT OF
CALIFORNIA'S EFFORTS TO SHIELD
AND ENHANCE ACCESS TO
REPRODUCTIVE SERVICES IN
ABORTION CARE THIS BILL IS
NEEDED TO HELP PROTECT PROVIDERS
WHO PROVIDE ABORTION AND GENDER
AFFIRMING CARE TO PEOPLE FROM
OUT OF STATE. ESSENTIALLY IT
WOULD HELP SAFEGUARD CALIFORNIA
PROVIDERS FROM ADDITIONAL
SANCTIONS THE AFTERMATH OF THE
DOGS DECISION OVERRULING ROE NOT
ONLY ELIMINATED FIFTY YEARS
REPRODUCTIVE FREEDOM BUT ALSO
EMBOLDEN STATES TO ENACT THEIR
OWN BANS AND RESTRICTIONS WITH
MANY PASSING LAWS TO TARGET
PROVIDERS. HOW MANY OF THE
STATE'S WITH ABORTION BANS DO
HAVE LIMITED EXCEPTIONS
PROVIDERS ARE BECOMING
INCREASINGLY WARY AND
DISCOURAGED FROM ENTERING THE
REPRODUCTIVE HEALTH FIELD
ALTOGETHER. WITH A SHORTAGE OF
ACCESS TO CARE AND OTHER STATES
PEOPLE WHO NEED ABORTION CARE
ARE COMING TO OUR STATE BECAUSE
THEY CAN'T FIND A PROVIDER ARE
THEY CAN'T FIND ONE WILLING TO
TAKE THE RISK IN THEIR HOME
STATE. WE'RE ALSO SEEING SOME OF
OUR PROVIDERS TRAVELING TO OTHER
STATES TO PROVIDE ABORTION CARE
SERVICES THE PURPOSE OF SB FOUR
EIGHTY SEVEN IS TO PROTECT
CALIFORNIA'S HEALTH CARE
PROVIDERS WHO ARE WILLING TO
TAKE RISKS BY PROVIDING ABORTION
CARE AND GENDER AFFIRMING CARE
IN OTHER STATES FROM ADDITIONAL
SANCTIONS. AS WELL AS PROVIDERS
WHO PROVIDE THOSE SERVICES IN
CALIFORNIA OR PEOPLE FROM OUT OF
STATE THIS BILL WOULD SHIELD
PROVIDERS FROM RETALIATION AND
REPERCUSSIONS SO THAT THERE IS
NO DISRUPTION. IN THEIR ABILITY
TO PERFORM ABORTION CARE IN
CALIFORNIA FOR ABORTION CARE IS
LEGAL AND ENSHRINED IN OUR STATE
CONSTITUTION. SB FORTY SEVEN IS
NARROWLY CRAFTED IN THIS IS
IMPORTANT. AND IN NO WAY LIMITS
OUR RISK OR RESTRICT OUR
EXISTING CONSUMER PROTECTIONS.
OR THE ABILITY OF THE MEDICARE
PROGRAM TO TERMINATE PROVIDERS
FOR OTHER NON ABORTION HEALTH
CARE REASONS. AND CALIFORNIA
ABORTION CARE IS HEALTHCARE AND
OUR PROVIDERS DESERVE PEACE OF
MIND NOT PERSECUTION OR
PROSECUTION. SO I RESPECTFULLY
ASK FOR YOUR AYE VOTE I'M HAPPY
TO TAKE COMMENTS OR QUESTIONS I
HAVE TO KEEP WITNESSES. WITH
YOUR PERMISSION MISTER CHAIRMAN
YES PLEASE GO AHEAD WHEN YOU'RE
READY. GOOD AFTERNOON CHAIR WED
AND MEMBERS MY NAME IS UPON A
LOFTY AND I AM A FAMILY MEDICINE
DOCTOR FROM CINEMA COUNTY. AND A
BOARD MEMBER OF THE MY AND
NETWORK. I'M HERE IN SUPPORT OF
SENATE BILL FOUR EIGHTY SEVEN
WHICH WILL PROTECT CALIFORNIA
HEALTHCARE PROVIDERS FROM
ADVERSE ACTIONS ON OUR
LICENSURE. BASED ON ANOTHER
STATE'S LAW WHICH INTERFERES
WITH THE RIGHT TO ACCESS CARE IN
HERE IN CALIFORNIA. ONE YEAR
SINCE THE FALL OF RO TWENTY
STATES HAVE BANNED OR SEVERELY
RESTRICTED ACCESS TO SAFE AND
LEGAL ABORTION. I TRAVEL TO
KANSAS REGULARLY TO PROVIDE
ABORTION FOR PATIENTS WHO COME
FROM ALL OVER THE MIDWEST AND
TEXAS. WHILE ABORTION IS LEGAL
IN KANSAS THE ATTORNEY GENERAL
IS ANTI ABORTION AND THERE IS A
REAL POSSIBILITY THAT THEY WOULD
SUPPORT AN ACTION ON MY KANSAS
LICENSE FROM HOSTILE STATE. WHEN
I AM IN KANSAS I AM VERY
CONSCIOUS THAT A FELLOW FAMILY
DOC MEDICINE DOCTOR GEORGE
TILLER WAS MURDERED THERE. I
TAKE THE RISK KNOWINGLY BUT I
REALLY APPRECIATE CALIFORNIA
HAVING MY BACK WHEN I RETURN
HOME. IT IS IMPORTANT FOR
PROVIDERS TO BE ABLE TO CARE FOR
PATIENTS WITHOUT FEAR OF
RETALIATION AS A RESULT OF
ANOTHER STATE'S HARMFUL POLICIES
WHICH INTERFERE WITH ACCESS TO
CARE. SB FOUR EIGHTY SEVEN WILL
PROTECT PROVIDERS WHO ARE
OFFERING CRUCIAL LIFESAVING CARE
TO PATIENTS TO ENSURE I CAN
CONTINUE TO DO MY JOB I URGE YOU
TO SUPPORT THIS BILL TODAY.
THANK YOU SO MUCH THANK YOU
PLEASE. GOOD AFTERNOON ALEXIS
RODRIGUEZ FOR THE CALIFORNIA
MEDICAL ASSOCIATION REPRESENTING
NEARLY FIFTY THOUSAND PHYSICIANS
AND MEDICAL STUDENTS ACROSS THE
STATE PROUD BECAUSE MONSTER AND
THAT'S BEFORE EIGHTY SEVEN.
SINCE THE DOBBS DECISION WAS
ISSUED ABORTION PROVIDERS AND
THEIR PATIENTS HAVE FACE AN
INCREASE OF NEW AND
UNPRECEDENTED ATTACKS. ON
ABORTION INCLUDING EFFORTS TO
CRIMINALIZE IS SAFE AND
EFFECTIVE HEALTHCARE PROCEDURE.
TODAY TWENTY STATES HAVE ENACTED
TOTAL OR SEVERE BANS ON MOST
ABORTION SERVICES. AND UP. NONE
THIS NUMBER CONTINUES TO CHANGE
AS NEW STATES INTRODUCED FANS
AND CRIMINALIZE HEALTH CARE.
WITH THE LEGAL UNCERTAINTY IN
CALIFORNIA MUST DO EVERYTHING WE
CAN TO ENSURE THAT OUR PROVIDERS
IN THE STATE CAN CONTINUE TO
PROVIDE COMPREHENSIVE HEALTH
CARE INCLUDING ABORTION AND
GENDER AFFIRMING CARE. SB FOUR
EIGHTY SEVEN WOULD PROVIDE
ADDITIONAL SAFEGUARDS FOR
CALIFORNIA'S ABORTION PROVIDERS
AND PROTECT THEIR ABILITY TO
SERVE PATIENTS THAT MAY RESIDE
IN STATES WITH WHOLESALE WORSEN
LOS. THIS BILL WOULD ENSURE THAT
PROVIDERS ARE NOT PUNISHED FOR
PROVIDING CARE THAT IS A
FUNDAMENTAL RIGHT IN THE STATE.
IT PROTECTS THE PATIENTS IN MOST
NEED OF AFFORDABLE AND
ACCESSIBLE CARE ENSURING WE CAN
CONTINUE TO RECEIVE IT FROM
TRUSTED PROVIDERS WITH THAT
RESPECTFULLY ASK YOUR SUPPORT
TODAY THANK YOU. YOU VERY MUCH
OTHERS IN SUPPORT. THIS YOUR
NAME AND ORGANIZATION IF YOU
REPRESENT ONE PLEASE. HELLO A
KAREN'S OUT ON BEHALF OF NARAL
PRO CHOICE CALIFORNIA AS WELL AS
THE CALIFORNIA NURSES
ASSOCIATION IN SUPPORT THANK YOU
. HI TIFFANY MATTHEWS ON BEHALF
OF ATTORNEY GENERAL ROB BONTA
SUPPORT THANK YOU. AS CHAIR
MEMBERS PULLIAM HAVE THE
CALIFORNIA STATE ASSOCIATION OF
PSYCHIATRISTS IN SUPPORT THANK
YOU. RIGHT SPENCER ABOUT THE
AMERICAN COLLEGE OF OBGYN FOR CO
SPONSORS OF THIS MEASURE IN
SUPPORT THANK YOU. RED PULSE
FROM BEHALF OF A QUALITY
CALIFORNIA IN SUPPORT THANK YOU
. NOW WE ON BEHALF OF THE LENNY
CLOCK IS LIEUTENANT GOVERNOR IN
SUPPORT THANK YOU. TIM MADDEN I
REPRESENT CALIFORNIA CHAPTER OF
THE AMERICAN COLLEGE OF
EMERGENCY PHYSICIANS IN SUPPORT
THANK YOU. CHANGES FROM THE
UNIVERSITY OF CALIFORNIA AND
SUPPORT THANK YOU. RUN EVERY DAY
ON BEHALF OF THE CALIFORNIA
HOSPITAL ASSOCIATION IN SUPPORT.
THANK YOU. HE MUST PERCENT TO
ACCESS HELP AND SUPPORT THANK
YOU. MATT WAS A WITH SEIU
CALIFORNIANS SUPPORT THANK YOU.
TAYLOR JACKSON ON BEHALF OF
CALIFORNIA HEALTH PLUS ADVOCATES
REPRESENTING CALIFORNIA'S
THIRTEEN HUNDRED COMMUNITY
HEALTH CENTERS IN STRONG
SUPPORT. THANK YOU. THREE IN
IRAN ON BEHALF OF PLANNED
PARENTHOOD AFFILIATES OF
CALIFORNIA CO SPONSOR IN STRONG
SUPPORT THANK YOU. JONGE
ABANDONED BY ON BEHALF OF
CALIFORNIA NURSES ASSOCIATION
SUPPORT. THANK YOU. IS THEIR
OPPOSITION TO THE BILL. SEEING
NONE WE WILL BRING IT BACK TO
THE COMMITTEE FOR QUESTIONS OR
COMMENTS ANY QUESTIONS OR
COMMENTS FROM THE COMMITTEE.
AFTER WEBER. AFTERNOON I AM
PROUD TO MACINNES I REALLY JUST
WANNA SPEAK UP AND THANK YOU SO
MUCH FOR INTRODUCING THIS BILL.
AS ONE OF THOSE PROVIDERS WHO IN
MY FORMER LIFE PROVIDED-
ABORTION CARE I KNOW THAT IT IS
EXTREMELY IMPORTANT FOR US TO BE
ABLE TO DO OUR JOBS. PROVIDE THE
BEST CARE NOT NECESSARILY WORRY
ABOUT WHETHER OR NOT WE WILL
HAVE SERVE ANY REPERCUSSIONS AND
THAT'S GREAT STATE OF CALIFORNIA
SO THANK YOU SO VERY MUCH.
ANYONE ELSE. SEE NO ONE- WE ARE
SHORT A QUORUM. IT'S NOT UNUSUAL
BUT IT IT USUALLY RESOLVES
ITSELF AT SOME POINT- AND- THE
BILL DOES ENJOY A DO PASS
RECOMMENDATION WOULD YOU LIKE TO
CLOSE. JUST TO SAY THANK YOU SO
MUCH MISTER CHAIRMAN THANK YOU-
JUST SUPPORT THIS ASK FOR EUROPE
THOUGH. THANK YOU SHOULD THE
BILL PASS OUT OF COMMITTEE I'D
LOVE TO BE ADDED AS A CO AUTHOR
IF YOU TAP ME. THANK YOU THANKS
VERY MUCH. OKAY. SEE WE HAVE
MISTER WINNER PRESENT WE DON'T
HAVE ANY OTHER AUTHOR SO MISTER
WINNER YOU'RE WELCOME TO COME UP
THANK YOU SIR. YOU HAVE MORE
THAN ONE BILL SO. NO NOT AT ALL
NOT AT ALL. SO WE'RE DOING NOW
WILL START IN AND FILE ORDER SO
I'D ITEM NUMBER TWELVE SB
SEVENTY. AS HE WAS VERIFY IF
IT'S POSSIBLE- HONESTLY TWO
THIRTY EIGHT I HAVE A WITNESS
WHO- AS A TRAVEL ISSUE SO I KNOW
IT'S POSSIBLE TO GO OUT OF ORDER
YEAH WE CAN DO THAT OKAY
APPRECIATED. THANK YOU IT'S BEEN
AN UNUSUAL DAY SO IT WILLING TO
DO ALMOST ANYTHING HAHA. THANK
YOU VERY MUCH. MISTER TEARING
AND COLLEAGUES- I'M PRESENTING A
CYNICAL TO THIRTY EIGHT. SB TWO
THIRTY A- IS DESIGNED TO EXPAND
ACCESS TO. BEHAVIORAL HEALTH-
TREATMENT FOR YOUNG PEOPLE- AND
SPECIFICALLY- OUT WHAT IT WILL
DO IS THAT IF A HEALTH PLAN THE
KNIVES OF MENTAL HEALTH
TREATMENT COVERAGE- FOR A YOUNG
PERSON- ON AN INDEPENDENT
MEDICAL REVIEW WILL BE
AUTOMATICALLY TRIGGERED- WE KNOW
THAT- TODAY WHEN. I AM OURS OUR
REQUESTED- BY A FAMILY FOR THEIR
CHILD CARE OVERWHELMINGLY US THE
FAMILIES OUGHT OVERWHELMINGLY
SUCCESSFUL IN OVERTURNING THE
HEALTH PLAN THE NILE.
UNFORTUNATELY MANY FAMILIES DO
NOT EVEN KNOW THAT THEY HAVE
THIS OPTION AND OVERWHELMINGLY I
AM OURS ARE REQUESTED IN.
ENGLISH AND SO WE KNOW THAT
THERE ARE MAJOR INEQUITIES IN
TERMS OF DIFFERENT COMMUNITIES
OUGHT NOT REQUESTING IS I AM
OURS- SO THIS WILL AUTOMATICALLY
TRIGGER THE I AM ARE WE GOING TO
EXPAND ACCESS. TO MENTAL HEALTH
CARE FOR YOUNG PEOPLE WHO HAVE
BEEN STRUGGLING SO MIGHTILY IN
RECENT YEARS- AND I RESPECTFULLY
ASK FOR YOUR- I VOTE. WITH ME
TODAY ARE TO NOW- PATEL YEAH- A
SOCIAL WORKER FROM SAN DIEGO AND
SAN DIEGO CENTER FOR CHILDREN
I'M CALLING CORRIGAN- FROM
CHILDREN NOW. HE'S PLEASE GO
AHEAD. IF THE PUSH THE BUTTON
THERE THE- GOOD AFTERNOON CHAIR
WOULD AND MEMBERS OF THE
ASSEMBLY HEALTH COMMITTEE MY
NAME IS JANELLE D'ITALIA. I'M
HERE IN STRONG SUPPORT OF SB TWO
THIRTY EIGHT I'M A LICENSED
CLINICAL SOCIAL WORKER AND THE
DIRECTOR OF BUSINESS DEVELOPMENT
AT SAN DIEGO CENTER FOR
CHILDREN. WE PROVIDE A RANGE OF
MENTAL HEALTH SERVICES FOR
FAMILIES INCLUDING A TWENTY FOUR
HOUR RESIDENTIAL TREATMENT
CENTER FOR THOSE WITH THE
HIGHEST LEVEL OF MENTAL HEALTH
NEED. SAN DIEGO CENTER FOR
CHILDREN IS ALSO A MEMBER OF THE
CALIFORNIA ALLIANCE OF CHILDREN
AND FAMILY SERVICES A SUPPORTER
OF SB TWO THIRTY EIGHT. FROM OUR
VANTAGE POINT OF A NONPROFIT
ORGANIZATION WORKING WITH
VULNERABLE CHILDREN YOUTH AND
FAMILIES WITH MENTAL HEALTH
NEEDS. WE HAVE SERVED MORE
FAMILIES THAN WE CAN COUNT WHO
HAVE BEEN DENIED COVERAGE BY
THEIR INSURANCE COMPANY. AND I'M
HERE TO SHARE ONE FAMILY'S
STORY. I'VE CHANGED THE USERNAME
AND CERTAIN DETAILS TO PROTECT
HIS PRIVACY. MATTHEW IS A
FOURTEEN YEAR OLD BOY WHO CAME
TO OUR RESIDENTIAL PROGRAM LAST
YEAR AFTER THREE BACK TO BACK
HOSPITALIZATIONS FOR ATTEMPTING
SUICIDE. HE WAS HEARING VOICES
TELLING HIM HE WAS WORTHLESS AND
SHOULD KILL HIMSELF. BEFORE
BEING ADOPTED BY A RELATIVE HE
CALLS MOM AT AGE FIVE. MATTHEW
HAD BEEN TERRIBLY ABUSED BY HIS
BIOLOGICAL PARENTS. SUFFERING
FROM PTSD MATTHEW WAS TAKING
FIVE DIFFERENT MEDICATIONS.
AFTER THREE WEEKS AND ARE
PROGRAM MATTHEWS INSURANCE
COMPANY DENIED ANY ADDITIONAL
DAYS. STATING THAT HE NO LONGER
MEET MEDICAL NECESSITY DESPITE
HIS PSYCHIATRIST RECOMMENDING
FURTHER TREATMENT. HOPING THE
APPEAL PROCESS WITH HER
INSURANCE COMPANY WOULD CHANGE
THAT RESULT. MATTHEW'S MOTHER.
TOOK OUT A LOAN AWAITING THE
OUTCOME OF THE APPEAL PROCESS.
HOWEVER AFTER TWO WEEKS THE
MOTHER HAD EXHAUSTED HER
FINANCIAL RESOURCES AND WITHOUT
OTHER OPTIONS SHE TOOK MATTHEW
HOME. AFTER WAITING ANOTHER WEEK
MATTHEW'S MOTHER LEARN THE
APPEAL WAS UNSUCCESSFUL. ONLY
THEN COULD MATTHEW'S MOM FILED A
COMPLAINT WITH THE DEPARTMENT OF
MANAGED HEALTH CARE. WHEN I
REACHED OUT TO HELP HER WITH
THIS PROCESS I LEARNED MATTHEW
HAD JUST BEEN RE HOSPITALIZED.
FOLLOWING ANOTHER INCIDENT OF
HARMING HIMSELF WHICH INVOLVE
THE POLICE AND A TRIP TO THE
EMERGENCY DEPARTMENT. THE MOTHER
TOLD ME SHE NEEDED TO FOCUS ALL
OF HER EFFORTS AND KEEPING
MATTHEW SAFE AND FINING
OUTPATIENT TREATMENT THAT WOULD
BE COVERED BY HER INSURANCE.
THESE IMMEDIATE NEEDS WERE ALL
SHE COULD FOCUS ON HAVING A FULL
TIME JOB IN SUPPORTING TWO OTHER
CHILDREN. MATTHEW'S MOM IS STILL
PAYING BACK HER LOAN AND SHE
BELIEVES THAT MATTHEW HAD BEEN
ABLE TO STAY IN OUR RESIDENTIAL
PROGRAM FOR THE RECOMMENDED
AMOUNT OF TIME. HE WOULD NOT
HAVE BEEN HOSPITALIZED AGAIN.
STORIES LIKE MATTHEWS ARE
UNFORTUNATELY NOT UNCOMMON IN
THE MENTAL HEALTH FIELD. WE
FREQUENTLY SEE PARENTS FACED
WITH AN AWFUL CHOICE AFTER
DENIAL AND TREATMENT AND TAKE
THE RISK OF THEIR CHILD'S
CONDITION WORSENING. FOR TAKE ON
SIGNIFICANT FINANCIAL HARDSHIP
TO CONTINUE TREATMENT. PLACING
THE ENTIRE RESPONSIBILITY ON
FAMILIES TO INITIATE AND I AM
ARE AS A RECIPE FOR FAILURE. AND
ALL THAT RARE EXCEPTIONS
FAMILIES IN CRISIS SIMPLY DO NOT
HAVE THE RESOURCES. SB TWO
THIRTY EIGHT REPRESENTS ONE
SOLUTION THAT WOULD HAVE A
DIRECT AND POSITIVE IMPACT ON
CHILDREN LIKE MATTHEW AND SO
MANY OTHERS THANK YOU. THANK
YOU. PLEASE GO AHEAD. GOOD
AFTERNOON MY NAME IS COLLEEN
CORRIGAN ANIMATE PETER HERBAGE
FELLOW THIS YEAR WITH CHILDREN
NOW A STATE BASED RESEARCH AND
ADVOCACY ORGANIZATION FOCUSED ON
CHILDREN'S HEALTH EDUCATION AND
WELFARE. HAVING WORKED IN
BEHAVIORAL HEALTH FOR YEARS
ORGANIZATION AS HEARD FROM
COUNTLESS PROVIDERS AND
FAMILIES. ABOUT THE DIFFICULTIES
IN NAVIGATING THE INDEPENDENT
MEDICAL REVIEW PROCESS. WELL I
AM OURS ARE AN IMPORTANT
CONSUMER PROTECTION IT PLACES
THE BURDENS ON ENROLLEES AND
DELAYS OR PREVENTS YOUTH. IN
CALIFORNIA FROM RECEIVING
CRITICAL TIMELY MENTAL HEALTH
TREATMENT. IT IS DIFFICULT TO
ACCESS FOR FAMILIES WHO SPEAK
OTHER LANGUAGES OTHER THAN
ENGLISH AND WHO DO NOT HAVE THE
HEALTH LITERACY OR TIME TO
SUBMIT A GRIEVANCE AND
SUBSEQUENTLY FILE IN OUR MORE.
CHILDREN ARE MOST SUSCEPTIBLE TO
THE LONG TERM EFFECTS OF
UNDIAGNOSED AND UNTREATED MENTAL
HEALTH. INCLUDING UNNECESSARY
DISABILITY UNEMPLOYMENT
HOMELESSNESS. INAPPROPRIATE
INCARCERATIONS SUICIDE AND
BILLIONS OF DOLLARS LOST IN
PRODUCTIVITY. MENTAL ILLNESS IS
KILLING CALIFORNIA'S YOUTH
SUICIDE IS THE SECOND LEADING
CAUSE OF DEATH IN YOUTH BETWEEN
FIFTEEN AND TWENTY FOUR. AND
SUICIDE RATES AMONG BLACK YOUTH
DOUBLE TO BETWEEN TWO THOUSAND
FOURTEEN IN TWO THOUSAND TWENTY.
CALIFORNIA'S YOUTH MENTAL HEALTH
CRISIS BECOME A FULL BLOWN
EMERGENCY AND SB TWO THIRTY
EIGHT AIMS TO PROTECT MORE KIDS.
FROM FALLING THROUGH OUR SAFETY
NETS. YEARS OF IMR
DETERMINATIONS DEMONSTRATE THAT
THE MAJORITY OF MENTAL HEALTH
AND I'LL THREE YOUTH ARE LATER
OVERTURNED BY IMR. WE HAVE NO
WAY OF ESTIMATING HOW MANY YOUTH
ARE DENIED CARE BECAUSE PLANS
ARE NOT REQUIRED TO REPORT THOSE
NUMBERS. OUR TEAM HAS HAD MONTHS
OF CONVERSATIONS WITH ADVOCATES
AND PROVIDERS. THE DRAFT
LEGISLATION THAT IS CONSUMER
FRIENDLY AND CONSISTENT WITH
EXISTING LAW AND WILL CONTINUE
TO DO SO IN REGARD TO PATIENT
PRIVACY. OF PLANES ARE ONLY TO
NINETIES TREATMENTS BECAUSE THE
SYSTEM CURRENTLY ALLOWS IT WE
NEED TO ASK FOR ACCOUNTABILITY
FROM HEALTH PLANS. AND HOW THEY
DENY IT APPROVED THIS LIFESAVING
CARE. WE MUST ACT NOW TO ADDRESS
RACIAL AND ECONOMIC INEQUITIES
IN MENTAL HEALTH BECAUSE EARLY
INTERVENTION IS THE KEY TO
RECOVERY. THANK YOU. THANK YOU-
OTHERS IN SUPPORT. YOUR NAME AND
ORGANIZATION IF YOU REPRESENT
ONE. AS CHAIR MEMBERS PLAYER WE
HAVE THE CALIFORNIA ACADEMY OF
CHILD AND ADOLESCENT PSYCHIATRY
IN THE CALIFORNIA STATE
ASSOCIATION PSYCHIATRIST AND
SPORT. THANK YOU. IT RESULTED ON
BEHALF OF THE CALIFORNIA
ALLIANCE OF CHILD AND FAMILY
SERVICES AND SUPPORT. THANK YOU
. THE MIND HER ON BEHALF OF MCG
HEALTH IN SUPPORT. THANK YOU.
LISA GARDNER ON BEHALF OF THE
COUNTY BEAVER HEALTH DIRECTORS
ASSOCIATION IN SUPPORT. THANK
YOU. RANDALL HAGER ON BEHALF OF
THE PSYCHIATRIC PHYSICIANS
ALLIANCE CALIFORNIA THANKS.
GREAT THANK YOU. ANY THEY'RE
GOING TO HAVE A METAL AMERICA
CALIFORNIA AND THE CALIFORNIA
DEPARTMENT I WORKED IN SUPPORT.
THANK YOU. REBECA GONZALEZ
NATIONAL ASSOCIATION OF SOCIAL
WORKERS CALIFORNIA CHAPTER IN
SUPPORT THANK YOU. HE AND I AND
WITH HOW ACCESS CALIFORNIANS
APART THANK YOU THANK YOU.
TARGET BUT YES MA'AM WITH THE
STEINBERG INSTITUTE AND THE
COUNTY FORMS THANK YOU. JENNIFER
ALLEY WITH A CALIFORNIA
PSYCHOLOGICAL ASSOCIATION
SUPPORT THANK YOU. AWESOME IS
WITH THE DEPRESSION AND BIPOLAR
SUPPORT ALLIANCE OF CALIFORNIA
IN SUPPORT THANK YOU. RACHEL
MILLER ON BEHALF OF WIDENING
GROUP WITH THE CALIFORNIA
SOCIETY OF HEALTH SYSTEM
PHARMACISTS IN SUPPORT THANK YOU
. RENDON MARTY WITH THE
CALIFORNIA MEDICAL ASSOCIATION
IN STRONG SUPPORT THANK YOU.
INTERFERE WITH CAPITAL ADVOCACY
ON BEHALF OF THE CALIFORNIA LIFE
SCIENCES IN SUPPORT THANK YOU.
YOU HUNKER THAN THOSE WITH THE
CALIFORNIA PAN ETHNIC HELP
NETWORK IN SUPPORT THANK YOU.
GOOD AFTERNOON LINDA WAY WITH
WESTERN CENTER ON LAW AND
POVERTY IN SUPPORT. IF NICOLE
WATERMAN ON BEHALF OF THE
CHILDREN'S PARTNERSHIP AND
SUPPORT. THANK YOU. TO MAD
REPRESENT THE CALIFORNIA CHAPTER
OF THE AMERICAN COLLEGE OF
EMERGENCY PHYSICIANS IN SUPPORT
THANK YOU. DARCHINYAN BIRD ON
BEHALF OF ASK ME CALIFORNIANS
SUPPORT. THANK YOU VERY MUCH. IS
THEIR OPPOSITION TO THE BILL.
PLEASE COME ON UP.
MISTER CHAIRMAN PER SEVENTY
WALKEN'S ON BEHALF OF THE
ASSOCIATION CALIFORNIA LIFE AND
HEALTH INSURANCE COMPANIES
UNFORTUNATELY WE DO HAVE AN
OPPOSE UNLESS AMENDED POSITION
WHICH IS A RESET. I'M CHANGE
FROM ORIGINAL POSITION I'M WHILE
IT GOES WITHOUT SAYING THAT
MENTAL HEALTH IS A KEY COMPONENT
TO A PERSON'S OVERALL WELL BEING
AND HEALTH PLANS AND INSURERS
REMAIN STEADFAST IN OUR EFFORTS
TO PROVIDE SAFE EVIDENCE BASED.
BEHAVIORAL HEALTH CARE IN
ACCORDANCE WITH EXISTING STATE
AND FEDERAL REQUIREMENTS. WE
APPRECIATE THE OVER ARCHING GOAL
OF ENSURING ENROLLEES INSURANCE
HAVE ACCESS TO IMPORTANT
MEDICALLY NECESSARY MENTAL
HEALTH SERVICES WE ARE CONCERNED
ABOUT THE BILL AS DRAFTED IS
MISSING SEVERAL KEY
CONSIDERATIONS THAT COULD RESULT
IN ALL PATIENT ACCESS TO
HEALTHCARE BEING DELAYED. WITH
THAT IN MIND WE HAVE PROPOSED
AMENDMENTS TO ADDRESS SOME OF
OUR OUTSTANDING CONCERNS
REGARDING PROCESS AND PATIENT
PRIVACY. OUR GOAL WITH THE
PROPOSED AMENDMENTS IS TO RETAIN
BUT WE UNDERSTAND THE AUTHOR'S
INTENT IS TO ALLOW ENROLLEES AND
ENSURE THE OPTION OF ACCESSING I
AM OUR PROCESS SOONER WHILE ALSO
PROTECTING THE INTEGRITY OF THE
SYSTEM. I'M GENERALLY WHAT WE
ARE SUGGESTING WE WOULD ENJOY-
FUTURE DIALOGUE IN CONVERSATIONS
WE'VE HAD SOME GOOD
CONVERSATIONS SO FAR IS THE
POSSIBILITY OF THE PROVIDER
VERSES THE PLAN SITTING IN THE
ROLE OF MAKING THAT
DETERMINATION WHETHER OR NOT TO
GO TO DIRECTLY TO IMR VERSUS
GOING. TO THE NORMAL GRIEVANCE
PROCESS. THE CA WE HAVE IS IF
EVERYTHING GOES DIRECTLY FROM
THE DEPARTMENT TO I AM ARE- FOR
THE PLAN TO IMR WE'RE GOING TO
BOG DOWN THE IMR SYSTEM WITH
THINGS THAT INEVITABLY MAY BE
CANCELED AT THE BACKEND WHICH IS
A CONCERN AND WE THINK THAT.
WILL DELAY IN OVER RUN THE IMR
SYSTEM. SO OUR GOAL WOULD BE TO
LOOK TO PROVIDERS WHO WE THINK
ARE UNIQUELY QUALIFIED. AND ALSO
WITH THE DIRECT RELATIONSHIP TO
THE PATIENT TO MAKE THOSE
DETERMINATIONS IF SOMETHING
SHOULD GO DIRECTLY TO IMR.
VERSES GO THROUGH THE NORMAL
GRIEVANCE PROCESS WE THINK THAT
ADDRESSES THE PRIVACY CONCERNS.
AS THE PATIENT WOULD THEN SIGN
OFF WITH THE PROVIDER TO SUBMIT
ON BEHALF OF IMR. WOULD LOVE TO
CONTINUE THOSE CONVERSATIONS WE
THINK IT'S A KEY COMPONENT AN
IMPORTANT PIECE OF IT. WE LOOK
FORWARD TO THE POSSIBILITY OF
THE AUTHOR AND THE SPONSORS
CONSIDERING AS AS WE MOVE
FORWARD. THANK YOU THANK YOU
PLEASE GO AHEAD GOOD AFTERNOON
MR MEMBERS OF THE COMMITTEE
CHAIRED HAMPTON WITH CALIFORNIA
ASSOCIATION OF HEALTH PLANS. WE
ARE ALSO AN OPPOSE UNLESS
AMENDED POSITION. LIKE OUR-
COLLEAGUES OVER ACT CLICK- AGAIN
WOULD LIKE TO THINK THE AUTHOR-
AND THE SPONSORS- AND THE
COMMITTEE STAFF WE HAVE HAD
SEVERAL CONVERSATIONS- YOU KNOW
ON THIS BILL OVER THE PAST
SEVERAL MONTHS- AND AS MY
COLLEAGUE MENTIONED YOU KNOW WE
DID. RECENTLY SETTLE ON. A
SERIES OF PROPOSED AMENDMENTS
AYE WE REALIZE THAT- YOU KNOW
THEY WERE. JUST A MINUTE VERY
RECENTLY SO THERE'S STILL SOME
MORE TIME THAT THIS DISCUSS
THAT- BUT BUT IT WOULD HAVE
APPRECIATED THE- THE AUTHOR'S
OFFICE AND THE SPONSORS- MAYBE
TAKING A LOOK AT SOME OF THOSE
IN JUST A AGAIN. FIND A WAY TO
ADDRESS SOME OF OUR CONCERNS
AROUND PRIVACY IN PROCESS WHILE
ENSURING THAT THE INTENT OF THE
BILL REMAINS INTACT. SO FOR
THOSE REASONS THAT AS OF NOW WE
ARE PUTTING US INTO THE BILL.
THANK YOU. THANK YOU OTHERS IN
OPPOSITION. JOHN WENGER IBF
AMERICA'S HEALTH INSURANCE PLANS
ALSO OPPOSE UNLESS AMENDED.
THANK YOU. IN NO ONE ELSE HAVING
OF BACK TO THE COMMITTEE
QUESTIONS OR COMMENTS FROM THE
COMMITTEE. I DO HAVE A COMMENT-
AGAIN ACTUALLY QUESTION OR OR OR
SUGGESTION. WHEN I MET WITH-
THIS IS TO SENATOR- CENTER
WINNER WHEN I MET THE OPPOSITION
I THINK ONE OF THE THINGS THAT.
CAME UP IS THAT SOMETIMES- READ
. WE CALL THEM. ADVERSE- ADVERSE
CLAIMS EXPERIENCE. WHICH I
COVERED THE NILE BUT ANYWAY-
SOMETIMES THOSE ARE ON.
TECHNICALITIES SO ANOTHER WORDS
UP A BOX MAY HAVE BEEN NOT
FILLED IN AND OR SOMETHING OR
SOMETHING VERY SIMPLE TO
RECTIFY. AND IF THAT HAPPENS
THEN THAT GOES TO I AM MORE THAT
IN MY COULD ACTUALLY DELAY THE
PROCESS. SO THERE NEEDS TO BE
SOME MECHANISM FOR A SIMPLE.
DATUM BOX MISSING OR SOMETHING
TO BE ABLE TO. MAKE SURE THAT
THAT DOESN'T HAPPEN BECAUSE I
THINK THAT WOULD UNDERMINE WHAT
YOU'RE TRYING TO DO. SO IS THAT
PART OF THE DISCUSSIONS. OR IF
IT'S NOT IT IT SHOULD BE. YES
THERE WERE AND ARE WE'VE BEEN IN
REGULAR DISCUSSION WITH- WITH
THE PLANS AND THAT WILL CONTINUE
ON THE MOST RECENT- CONCERN THAT
THEY'VE REYES WERE ACTUALLY IN
DISCUSSION WITH THE DIFFERENT
PROVIDER GROUPS BECAUSE THEY'RE
SUGGESTING THE PROVIDERS. HAVE A
PARTICULAR INVOLVEMENT IN
TRIGGERING I AM MARS AND
OBVIOUSLY WE WANT TO KNOW HOW
THAT WORKS ON THE GROUND AND SO-
YES AND WHAT WERE WERE HAPPY TO.
TAKE THAT INTO CONSIDERATION AS
WELL BEFORE AN ONGOING
CONVERSATION- WITH THE FUNDS WE
WANT TO GET THIS RIGHT- AND WE
APPRECIATE YOU KNOW THAT THERE
ARE YOU'RE COMING UP WITH AT
LEAST SOME POTENTIAL A CONSTRUCT
OF OUR. THOUGHTS AND WILL
CONTINUE TO HAVE THAT DIALOGUE.
I GUESS THE OTHER CAN I WOULD
HAVE IS THAT- THERE ARE SO MANY
CHANGES SOMETIMES IN. LAW AND
POLICIES THAT HOW DO WE ENSURE
IF YOU WERE TO GO AS THE
OPPOSITION IS SUGGESTING HAVING
THE PROVIDER INITIATE THE I AM
ARE- PROCESS. HOW WE HOW WE MAKE
SURE THAT THE PROVIDERS ACTUALLY
NO- THESE OPTIONS EXIST AND I SO
THERE IS AN ONUS I BELIEVE ON
EDUCATION. IN THIS AND A PART OF
THE PROCESS I'M NOT TRYING TO
MICROMANAGE YOUR BILL BUT I'M
TRYING TO- AT THE END OF THEIR I
THINK THERE'S ABOUT WITH THINGS
THAT HAVE COME UP HERE AND-
THERE'S IT'S SEEMS TO BE A
WILLINGNESS TO CONTINUE TO WORK
TOGETHER SO I THOUGHT I'D- HAVE
TO SENSE I WANNA THROW MEN AND-
WHERE THEY LAND. AND NOW IT'S A
TWO WAY STREET WERE. DEFINITELY
GOING TO CONTINUE TO HAVE
DIALOGUE AND LIKE I SAID WE-
WERE TALKING THE CMA AND OTHER
PROVIDER GROUPS ABOUT. JUST
MAKING SURE THAT WERE AGAINST OF
GROUND TRUTH THING HELD THIS
WOULD WORK IN PRACTICE. OKAY
GREAT OKAY. THANK YOU- THE BILL
WE DON'T HAVE A QUORUM ACTUALLY
WE HAVE SHRINKING NUMBER SO IT.
MIGHT BE AWHILE- WOULD YOU LIKE
TO CLOSE RESPECTFULLY ASK RIVAL
OKAY THE BILL DOES ENJOY DO PASS
RECOMMENDATION SO WHEN WE HAVE A
QUORUM IN A MOTION. WILL BRING
IT UP FOR A VOTE. THANK YOU TO
YOUR WITNESSES. THANK YOU. SO
HOW ABOUT. SB SEVENTY NOW READY
FOR THAT OKAY. THANK YOU. THANK
YOU MISTER CHAIR I COLLEAGUES
ARE SENATE BILL SEVENTY THE
MEDICATION ACCESS OCT IS A
NARROWER- BUT STILL VERY
IMPACTFUL- REINTRODUCTION OF
LAST YEAR'S SENATE BILL EIGHT
FIFTY THREE WHICH IT DID PASS.
THROUGH THIS COMMITTEE. ON SB
SEVENTY STRENGTHENS CALIFORNIA'S
PROHIBITION ON NON MEDICAL
SWITCHING. WHICH IS WHEN A
HEALTH PLAN. FORCES A PATIENT TO
SWITCH OFF FROM A PRESCHOOL OF
PRESCRIBED DRUGS BY PROVIDER. TO
A DIFFERENT DRUGS FOR NON
MEDICAL REASONS SUCH AS COST
IT'S AN EXISTING PROTECTION IN
CALIFORNIA LAW. SB SEVENTY WOULD
ADD TO THAT PROTECTION DOES
LEVEL AND DOSAGE FORM. FOR THE
SAME DRUG- SO THAT OFFER
PROVIDER DECIDES THAT A
PARTICULAR DOES. OR PARTICULAR
DOSAGE FORM- IS APPROPRIATE- THE
HEALTH PLAN WOULD NOT BE. ABLE
TO FORCE ON A DIFFERENT DOSAGE
FORMER DIFFERENT THOSE. ARE I AM
NOT A MEMBER OF THE AMENDMENTS
THAT WE ARE- POSING AND
ACCEPTING TODAY OUR TECHNICAL IN
NATURE. AS PROPOSED BY THE
CALIFORNIA DEPARTMENT OF
INSURANCE- TO MAKE SURE THAT WE
HAVE- LITTLE INCISION BETWEEN.
THE I. AND DHEA- DAMAGE CITY.
I'M MANY WE KNOW THE MANY
CALIFORNIANS EXPERIENCE ARE
CHRONIC ILLNESS- AND RELY ON
PRESCRIPTION MEDICATIONS TO LIVE
FUNCTIONAL LIVES I'VE BEEN VERY
TRANSPARENT I'M ONE OF THOSE
PEOPLE AT CROHN'S DISEASE AND-
AND THANKFULLY I'M- ABLE TO HAVE
ACCESS TO MEDICATION THAT GIVES
ME A GOOD. OF QUALITY OF LIFE-
FOR SOME OF THESE- ILLNESSES ARE
LIKE INFLAMMATORY BOWEL DISEASE
THERE'S A LIMITED NUMBER OF
TREATMENTS AVAILABLE AT
OPTIMIZING THE DOES- CAN HAVE
HUGE POSITIVE IMPACTS OFFER A
PATIENT'S LIFE AND IF THEY'RE
FORCED TO SWITCH. TO A DIFFERENT
DRUG OR A DIFFERENT DOSE OR.
DIFFERENT DOSAGE FORM IT CAN BE
DEBILITATING. ASO MATTER. UP
FOR- DO HELLO OF WORK TO ALL-
THE MEDICATION AND THOSE ARE.
DECISIONS SHOULD BE RESPECTED-
SB SEVENTY WILL STRENGTHEN OUR
PATIENTS ABILITY AND WELL BEING.
AND I RESPECTFULLY ASK FOR AN
IPO I WOULD BE TODAY IS RYAN
SPENCER TESTIFYING ON BEHALF OF
OUR SPONSOR THE CROHN'S AND
COLITIS FOUNDATION. PLEASE GO
AHEAD THANK THIS CHAIR- RIGHT
SPENCER MAP THE CROHN'S AND
COLITIS FOUNDATION OF THE
SPONSORS SB SEVENTY FIRST LIKE
TO THANK THE SENDER OF AUTHORING
THIS IMPORTANT MEASURE I WON THE
KEY MISSIONS OF THE FOUNDATION
WHAT YOU'LL HEAR FOR ME THE MOST
IS HELPING IBD PATIENTS FIND
MEDICATIONS THAT WORK. AND MAKE
SURE THEY STAY ON THE DRUG FOR
AS LONG AS THEY'RE STABLE IS
BECAUSE NOT ONLY OF THE SCARCITY
OF MEDICATIONS BUT BECAUSE OF
THE PATIENT'S RESPONSE TO A
PARTICULAR MEDICATION. FINDING
THE RIGHT MEDICATION THAT KEEPS
A PATIENT STABLE AT THE CENTER
MENTION THIS COLD AND THAT IS
WHY POSITIONS WILL DO WHATEVER
THEY CAN TO MAKE SURE THE
PATIENTS ABLE TO STAY ON THAT
DRUG. THIS BECOMES AN ISSUE WHEN
AFTER A PERIOD OF TIME THE
EFFECTIVENESS OF THE MEDICATION
BEGINS DIMINISH DUE TO CHANGES
IN TOLERANCE WHEN THIS OCCURS
PROVIDERS LEFT A FEW OPTIONS.
ONE IS TO FIND A NEW MEDICATION
WHICH AS MENTIONED. IS THE REST
THE NEW DRUG MADE NOT BE AS
EFFECTIVE EFFECTIVE AT ALL AS
ONE TRULY PRESCRIBED SO IDEALLY
THE POSITION WANT TO. OPTIMIZE
EXISTING DRUG TO ITS FULLEST
EXTENT. AND THIS CAN BE ACHIEVED
BY INCREASING THE DOSE ALSO
KNOWN AS DOSE OPTIMIZATION. IN
THE CASE OF CROHN'S PATIENTS
THIS COULD MEAN INSTEAD
RECEIVING A MEDICATION A FUSION
EVERY EIGHT WEEKS. AGO EVERY SIX
WEEKS. WHEN THIS OCCURS THE
PATIENT'S RESPONSE TO THE DRUG
TYPICALLY INCREASES. ALLOWING
THEM TO REMAIN STABLE FOR A
LONGER PERIOD OF TIME. EVEN
THOUGH CURRENT LAWS PRESCRIBING
THE NONMEDICAL SWITCHING
PROVISION PROTECTS PATIENTS FROM
LOSING THEIR CURRENTLY
PRESCRIBED. AND COVER DRUG IT
DOES NOT. APPLY WHEN MANAGING
THE DRUGS DOES. M. CHANGE IN THE
DAY OF THIS. PRESCRIBING
CURRENTLY COVERED DRUG MUST BE
APPROVED BY THE HEALTH PLANS AS
WE HAVE SEEN. THESE REQUESTS
ROUTINELY DENIED. ONCE DENIED
THE PATIENT MUST GO THROUGH THE
APPEALS PROCESS FIRST THE PLAN'S
INTERNAL PEEL AND THEN THE
DEPARTMENT OF MANAGED HEALTHCARE
INDEPENDENT MEDICAL REVIEW. THIS
PROS PROCESS AND GO ON FOR
WEEKS. WHAT PATIENT WAIT AND
HOPE THE CONDITION DOES NOT
WORSEN. WAS FRUSTRATING AND
RESULT IN THE TWENTY TWENTY ONE
UNOFFICIAL INTERNAL AUDIT OF THE
IMR. THIS AUDIT FOUND THAT
EIGHTY SEVEN HAVE PERCENT OF IBD
PATIENTS WHO APPEALED THEIR
INSURANCE MEDICATION THE NILES
EVENTUALLY HAD THE REQUEST
APPROVED. THIS MEANS THAT DURING
THE REVIEW PERIOD WHEN THEY
SHOULD HAVE THEIR ACCESS TO A-
DRUG TO ADOPT JEFF ACCESS TO
OPTIMAL DOSE. THEY DIDN'T. AS
THEY WAITED THE CONDITION MAY
HAVE WORSENED. FORCING A SWITCH
TO POTENTIALLY LESS EFFECTIVE
DRUG AND RISK INSTABILITY. IT
SHOULD BE NOTED THIS WHICH IS
NOT TEMPORARY ONCE YOU SWITCH
FROM A DRUG. THERE'S NO GOING
BACK TO IT. KEEP IN MIND THIS IS
ONLY FOR THOSE WHO EVEN KNOW
WHAT THAT APPEALS EVEN AVAILABLE
TO THEM. THE GOAL OF SB SEVENTY
A SIMPLE STRENGTH THE NONMEDICAL
SWITCHING LAW. SO THAT CAN KEEP
PATIENTS ON A CURRENTLY
PRESCRIBED AND CURRENTLY COVER
DRUG. WHICH MEANS THAT IF AN
INCREASED DOSES NATIONAL
ACCOMPLISHES GOAL THAT DOES
SHOULD BE PROTECTED TOO. WE'RE
NOT TALKING ABOUT EXPERIMENTAL
DRUGS WE'RE TALKING ABOUT A DRUG
THAT THE PLAN ALREADY AGREED TO
COVER. FOR THAT CONDITION. SB
SEVEN IS A REGIONAL APPROACH.
AND WE ASK FOR AYE VOTE. THANK
YOU. THANK YOU VERY MUCH I AM A
IN SOME. OF THE. TEMEN REPRESENT
THE CALIFORNIA RHEUMATOLOGY
ALLIANCE IN SUPPORT. IF EMILY
WOULD AT CHAIR OF THE CALIFORNIA
STATE ASSOCIATION OF
PSYCHIATRISTS IN SUPPORT THANK
YOU. MY AND HER ON BEHALF OF THE
CHILDREN SPECIALTY CARE
COALITION IN SUPPORT THANK YOU.
RENDON MARCH WITH THE CALIFORNIA
MEDICAL ASSOCIATION IN SUPPORT
THANK YOU. JUST K. WITH A
CALIFORNIA SCHOOL EMPLOYEES
ASSOCIATION AND SUPPORT IF
YOU'RE- OUR EMPLOYEES MEMBER THE
STEINBERG INSTITUTE SUPPORT. IF
YOU'RE- INTERFERE WITH CAPITAL
ADVOCACY ON BEHALF FOR
CALIFORNIA LIFE SCIENCES IN
SUPPORT. THANK YOU. ASK OUR FOR
THE CALIFORNIA ASSOCIATION OF
ORTHODONTIST IN SUPPORT. THANK
YOU. THIRTEEN BIRD ASKED ME
CALIFORNIA IN SUPPORT THANK YOU
. THE SHOW RIVAS CALIFORNIA
PHARMACISTS ASSOCIATION IN
SUPPORT. THANK YOU. ANYONE ELSE
. SEE NO ONE IS THEIR OPPOSITION
TO THE BILL.
AFTERNOON SHARE MEMBERS OF THE
COMMITTEE JEFF HANSON WITH THE
CALIFORNIA ASSOCIATION HEALTH
PLANS I REGRETTABLY WE ARE HERE
IN OPPOSITION- SB SEVENTY WHICH
WOULD INDEFINITELY LIMIT HEALTH
MANAGERS ABILITY TO REVIEW ANY
CHANGES THAT ARE MADE TO AN
INCREASE IN MEDICATION. OR
CHANGE THE DOSAGE FORM AN
EXISTING PRESCRIPTION FOR OUR
ENROLLEES. I WOULD LIKE TO THANK
THE AUTHOR THE SPONSORS IN THE
COMMITTEE STAFF AGAIN WE'VE HAD
SEVERAL- SEVERAL GOOD
CONVERSATIONS AROUND THIS BILL
OVER THE PAST YEAR AND A HALF US
REALLY APPRECIATE THE- OPENNESS
TO DISCUSS. ALL HEALTH PLANS ARE
A HEALTHIER LIFE ON SEVERAL
CRITICAL UTILIZATION MANAGEMENT
PROTOCOLS TO ENSURE THAT
PATIENTS RECEIVE THE RIGHT CARE
AT THE RIGHT TIME THE RIGHT
PROVIDER. THESE PROTOCOLS ARE
CRITICALLY IMPORTANT PROMOTING
SAFE EFFECTIVE AFFORDABLE CARE
FOR PLAN ENROLLEES.
UNFORTUNATELY FROM MY
PERSPECTIVE SB SEVENTY WOULD
REMOVE OUR ABILITY TO REVIEW
CLINICALLY APPROPRIATE USE OF
PRESCRIPTION DRUGS WHEN THE
DOSAGE OF A MEDICATION IS
INCREASED OR THE DOSAGE FORM HAS
CHANGED I WHICH WE BELIEVE WILL
LEAD TO SEVERAL UNINTENDED
CONSEQUENCES. A STRIPPING HEALTH
PLANS OF THE ABILITY TO PROVIDE
CLINICAL OVERSIGHT WHEN THESE
CHANGES ARE MADE COULD LEAD TO
AN INCREASE POTENTIALLY ADVERSE
REACTIONS ASSOCIATED WITH THE
CHANGES AND DOSAGE OR DOSAGE
FORM. AND BY JUST FORM I MEAN
THINGS ARE GOING FROM A PILL FOR
MEDICATION TO US OFTEN INSERTED
IN INJECTABLE. I IN INSTANCES
WHERE HEALTH PLANS CHOOSE TO
LIMIT A DOSE OF A DRUG OR THE
DOSE FORM- IS GENERALLY TO
ENSURE THAT THESE MEDICATIONS
ARE USED SAFELY CONSISTENT WITH
FDA APPROVED LABELING AND
PRESCRIBING DOSES THAT I'VE BEEN
STUDY TODAY OR SHOWN TO BE
EFFICACIOUS. I'M WHILE WE
APPRECIATE THAT THE ATTEMPT THIS
BILL ATTEMPTS TO CONSTRUCT A
FRAMER TO ENSURE THAT THE
CHANGES AND DOESN'T DOESN'T
FORMER PRESCRIBE SAFELY WE ARE
CONCERNED THAT THIS BILL DOES
NOT CONSIDER THE FULL CLINICAL
COMPENDIA CONDITIONS. ESPECIALLY
AROUND OFF LABEL USES AND DOSES
. ADDITIONALLY WE ARE CONCERNED
THAT TAKING AWAY OF THE HEALTH
PLANS ABILITY TO PROVIDE
CLINICAL OVERSIGHT COULD
ENCOURAGED. THE USE OF EXPENSIVE
SPECIALTY AND BRAND NAME DRUGS
WHEN A GENERIC OR LOWER COST
BRAND EQUIVALENT IS AVAILABLE
AND CLINICALLY APPROPRIATE- YEAH
WE DO ACKNOWLEDGE THAT- THAT
THIS BILL IS PRIMARILY FOCUSED
ON- CROHN'S AND COLITIS BUT WE
WOULD POINT OUT THAT THAT THIS
BILL DOES NOT IS NOT LIMITED TO
CROHN'S AND COLITIS FOUNDATION
THIS IS ALL DRUGS ALL
PRESCRIPTIONS. A SO WHEN WE TALK
ABOUT INCREASES IN DOSAGE OR
DOSAGE FORMS- THAT'S GENERALLY
OUR OUR OVERARCHING CONCERN.
ALAS THE WITH SB SEVENTY WILL
LEAD TO INCREASED COSTS AND
HEALTHCARE DELIVERY. ON THE
CALIFORNIA HEALTH BENEFITS
REVIEW PROGRAMS ANALYSIS OF SB
SEVENTY MADE SEVERAL KEY
ASSUMPTIONS IN THE ANALYSIS.
THAT MAY POTENTIALLY COMPLEX
WITHOUT CONFLICT EXCUSE ME WITH
OUR UNDERSTANDING OF THE INTENT
OF THIS BILL. THE TERM ANALYSIS
SINCE THE HEALTH PLANS INSURERS
WOULD STILL BE ABLE TO USE
UTILIZATION MANAGEMENT PROTOCOLS
THE CHANGES ARE MADE TO THE DOES
YOUR DOSAGE FORM. IN OUR
UNDERSTANDING OF. IT THAT THE
INTENT OF THIS BILL. IS TO
REMOVE OUR ABILITY. TO UTILIZE
THESE PROTOCOLS WHICH WOULD HAVE
THE IMPACT THAT I PREVIOUSLY
MENTIONED- WHILE AMENDMENTS
WERE- I WAS USING ADDITIONALLY-
THAT'S RITTENHOUSE ALSO SINCE
THE HEALTH PLANS WE HAVE THE
ABILITY TO ADJUST COST SHARING
YOUR YEAR BASED UPON THE
RENEWAL. OF THE POLICY OR
CONTRACT. A WALL AMENDMENTS WERE
TAKEN THE SENATE ATTEMPTED TO
ADDRESS THIS ISSUE. WE BELIEVE
THAT THE CURRENT LANGUAGE WOULD
STILL OFFER THE MANIPULATION OF
COST SHARING AMOUNTS WITHIN THE
PLAN YEAR. WE SHOULD WE COULD
STILL INCREASED OTHER PREMIUM
IMPACTED THIS BILL. COULD BE
LARGER THAN THE TWENTY SEVEN
MILLION HEARTY. MENTIONED FOR
THE THREE WE ARE POSTING. SEARCH
MEMBER STEPHANIE WATKINS ON
BEHALF OF THE ASSOCIATION OF
CALIFORNIA LIFE AND HEALTH
INSURANCE COMPANIES IN THE
INTEREST OF TIME I WILL OCCUR MY
COLLEAGUES COMMENTS I'D ALSO
LIKE TO POINT OUT. THAT WE HAVE
REACHED OUT TO CITY I KNOW THEY
PROVIDED SEVERAL SETS OF
TECHNICAL ASSISTANCE. AND ONE OF
THE GOALS TO IS TO ENSURE THAT
HOUSE CDI IS INTERPRETING THAT
POTENTIAL USE OF UTILIZATION
MANAGEMENT IS CONSISTENT WITH
THE DMH SEES POSITION. YOU KNOW
IT'S A LITTLE AWKWARD BECAUSE
THEY KNOW THE INTENT OF THE
AUTHOR IS SLIGHTLY DIFFERENT
FROM THAT SO- AS WE CONTINUE TO
HAVE THESE CONVERSATIONS ONE
THING. TO NOTE IS. ON IT WOULD
BE HARMFUL TO THE SYSTEM IF CITY
I HAD ONE INTERPRETATION THAT
DEFERRED. AND SO THAT WAS
APPLIED TO THE CITY I REGULATED-
PRODUCTS VERSUS ANOTHER WOULD BE
TO THE TEAMMATES THE REGULATED
PRODUCTS SO. WE ARE LOOKING FOR
CLARIFICATION ON THAT AND ALSO
TO THE POINT ON COST SHARING. TO
ENSURE THAT- WE'D LIKE TO HAVE
SOME FURTHER DISCUSSIONS ABOUT
THE POTENTIAL- COST IMPACT. OF
SOME MANIPULATION WITHIN THE
SYSTEM OF SOMEBODY MOVED SOMEONE
FROM A TIER ONE TO TIER THREE
DRUGS WITHIN THE CURRENT POLICY
YEAR. WE THINK THAT THAT WE
WOULD BE FROZEN AT THE COST
SHARING OF THAT INITIAL SCRIPT-
WHICH WOULD CERTAINLY HAVE
ACOSTA IMPACT TO THE- PROCESS.
SO FOR THOSE REASONS WE ARE
OPPOSED. THANK YOU OTHERS
OPPOSITION. JOHN MY GRUBBY F.
AMERICA'S HEALTH INSURANCE PLANS
ARE JUST ECHO THE COMMENTS A
CAPTAIN ACT. GREAT THANK YOU-
SEE NO ONE ELSE TO RING BACK TO
THE COMMITTEE QUESTIONS OR
COMMENTS. BUT WEBER. THANK YOU
AS SENATOR WIENER- I AM GOING TO
SUPPORT THIS BILL TO GET IT OUT
OF COMMITTEE I DO HAVE SOME
CONCERNS- WITH. YOU KNOW EVEN AS
A PROVIDER WITH THE ABILITY TO
JUST KIND OF PUT CONTINUE TO
PRESCRIBE MEDICATION OR GO UP OR
DOWN OR WHATEVER. SPECIALLY FOR
A MEDICATION THAT IS OFF LABEL.
WITHOUT HAVING ANOTHER ICE SET
ON IT- SO YOU KNOW I'M I'M GOING
TO KEEP LOOKING AT THIS BILL BUT
I THINK. THE- THE FOUNDATION
YOUR THOUGHT PROCESS BEHIND IT
IS JUST TO ALLOW IT TO CONTINUE
TO MOVE- YOU KNOW. THOSE WITH
COLITIS I DEFINITELY HAVE A VERY
SPECIAL. ARE THERE ANY SPECIAL
CATEGORY BUT THIS ALSO LOOKS AT
ALL CHRONIC CONDITIONS NOT JUST-
COLITIS AND SO- I AM GOING TO
KEEP MY IDOL BUT WE'RE DIGGING A
LITTLE BIT MORE- RESEARCH ON
THIS BUT BECAUSE IT DOES MAKE ME
A LITTLE BIT UNCOMFORTABLE BUT I
WILL SUPPORT. THANK ANYONE ELSE
. I'M I PLAN TO SUPPORT THE BILL
TODAY AS WELL AND I WOULD
ENCOURAGE CONTINUE WORKING WITH
THE OPPOSITION I HAVE A COUPLE
QUESTIONS THE COUPLE THINGS THAT
CAME UP I THINK IT WAS- FROM OUR
WITNESSES- CONCERNED ABOUT
ADVERSE REACTIONS AND I'VE GOT A
PUZZLED BY THAT BECAUSE- DOCTORS
PURPOSE PRESCRIBE MEDICATIONS
AND I MY IMPRESSION IS THIS
REALLY THE RESPONSIBILITY OF THE
DOCTOR TO MONITOR. ADVERSE
REACTIONS NOT THE INSURANCE
COMPANIES SO. CAN YOU EXPLAIN
THAT BECAUSE I'M SORRY THAT
FEELS LIKE AN OVER REACH YET I
THINK AFTER WHAT WE WERE LOOKING
AT RISK REACTIONS- YOU KNOW I
THINK. YOU KNOW FIRST AND
FOREMOST WHO SAID THAT THAT YOU
KNOW PROVIDERS PLANS NOBODY IS
INFALLIBLE RIGHT SO THAT THE
HAVING AN EXTRA SET OF EYES THAT
LOOK LIKE TALKED WEBER MENTION I
THINK IT'S ALWAYS. IMPORTANT
COMPONENTS TO ENSURING SAFETY
WITH OUR HEALTH CARE SYSTEM. I
WE WERE TALKING ABOUT INCREASES
IN DOSAGE OR CHANGES IN DOSAGE
FORM I MEAN WE CERTAINLY
UNDERSTAND APPRECIATE THE
CONTEXT AROUND THE PROVIDER YOU
KNOW. IN THE PROVIDER. I THINK
THERE ARE- YOU KNOW EXAMPLES
THAT WE CAN POINT TO- YOU KNOW
AROUND PRESCRIPTIONS THAT HAD
BEEN MADE AND THE PASSWORD DOES
JUST HAVE INCREASED. OR
PRESCRIBED I IN A WAY WHICH- YOU
KNOW CAN LEAD TO ADVERSE
REACTIONS I THINK YOU KNOW WHEN
WE LOOK AT. SITUATIONS LIKE ON
THE OVER PRESCRIPTION OF OPIOIDS
IN THE REALIZATION OPIOIDS YOU
KNOW. AND THE FIFTEEN YEARS AGO
YOU KNOW ABOUT TO NOT REALLY
STARTED TAKING OFF. THAT I THINK
FOR US IS A IS A TYPE OF EXAMPLE
WHERE- YOU KNOW IF DOSAGE.
DOSAGES ARE INCREASED IN
PARTICULAR AND THAT SORT OF
SCENARIO WHERE DOES A TWENTY
CHANGED AGAIN WHEN YOU'RE GOING
FROM UNTIL FORMED DRUGS OR
PROPER MEDICATION TO INJECTABLE
MEDICATION. EITHER DOES COME
THERE DOES HAVE SOME RISK WITH
THAT SO. IT'S NOT TO SAY THAT
THAT YOU KNOW WE THINK THAT WE
SHOULD BE OVERRIDING THE
PROVIDERS THAT'S THAT'S NOT THE
CASE AT ALL I THINK OUR OUR
PERSPECTIVE IS THAT YOU KNOW
WHEN ARE OUR MEDICAL TEAMS ARE
ARE REVIEWING THOSE DECISIONS
ESPECIALLY WHEN IT COMES TO
MEDICATION. IT'S ALWAYS HELPFUL
TO HAVE AN EXTRA SET OF EYES ON
THAT ENSURING THAT THAT. IT TO
BEING PRESCRIBED AND CLINICALLY
APPROPRIATE. YEAH I'D I CAN
UNDERSTAND OPIOIDS I'M NOT SURE
ABOUT. MEDICATIONS FOR CROHN'S
DISEASE BEING ABUSE BUT- LIKE. A
TAKEN WHAT YOU'RE- YOU'RE SAYING
AND UNDERSTAND OUR STAND THAT. I
AND I ALSO HEARD YOU SAY EUROPE
OR YOU'RE CONCERNED ABOUT THE
OFF LABEL- USE OF. MEDICATIONS
WELL I'D AND I'D- SO I WOULD
HOPE YOU CONTINUED HAVING THIS
DISCUSSIONS AROUND AROUND THOSE-
AND ADDED OF ELEVEN. I SEE THE
AUTHOR WANTS TO WHAT'S OF. A
COMMENT PLEASE GO AHEAD NO I
MEAN I AM A FIRST ON SOME OF THE
TECHNICAL ISSUES INCONSISTENCY
BETWEEN TWO DEPARTMENTS OF
COURSE. WILL CONTINUE TO. ENGAGE
IN THAT I DO I DO WANT TO NOTE
THAT PAIN KILLERS ARE NOT PART
OF THIS. BILL THOUGH AND IF AND
IF THERE'S SOME OF THE SOME
LANGUAGE IN THE BILL THAT
SOMEONE THINKS THEY ARE INCLUDED
I. WANT TO SEE A CONCERN THIS
THIS IS NOT LIKE A- OF.
OXYCONTIN MORPHINE BILL THAT'S
NOT INCLUDED- I IN THIS BILL. I
AND I ALSO- YOU KNOW. IN TERMS
SECOND SET OF EYES. ON THIS
ISN'T JUST. SUCH WITH INJURY
COMPANY SAYS. JUST WANT TO KNOW
FOR YOU WE YOU KNOW WE'RE
TALKING ABOUT WE A LOOK AT. YOU
MIGHT WANT TO CONSIDER THIS A
RIDICULOUS THIS IS ABOUT LIKE
THE NINE COVERED. RIGHT SO IT'S
NOT AS SECOND SECOND SET OF EYES
GIVING YOU MORE INFORMATION.
IT'S A SECOND SET OF EYES
OVERRULING THE DOCTOR. AND
SAYING. WE'RE GOING TO DO AND WE
AND WE'VE- YOU KNOW SIERRA
ASSIST GIVEN EXAM FROM MY OWN
EXPERIENCE NOT IN THIS CONTEXT
BUT A SIMILAR WHEN I FIRST WENT
ON TO A BIOLOGIC. TEN YEARS AGO
WHICH WAS TRANSFORMATIVE FOR ME.
ON THE INITIAL RESPONSE FROM THE
HEALTH PLAN. WAS YOU HAVE TO TRY
AND FAIL ON PREDNISONE BEFORE
YOU GO ON THE BIOLOGIC ANYONE
WHO KNOWS ANYTHING AND MY DOCTOR
KNEW THIS. YOU DON'T TRY
PREDNISONE LONG BIKE REGULAR
LONG TERM PRESIDENT AS A FIRST
RESORT THAT IS LIKE A LAST.
DESPERATION OCONNOR RESORT BUT
THAT WAS THE SECOND SO THE
SECOND SET OF EYES ARE NOT YOU
KNOW WHICH WAS DENYING COVERAGE
AND ULTIMATELY TOOK. QUITE SOME
TIME TO GET THAT REVERSE THAT
SECOND SET OF EYES. WERE
POTENTIALLY HARMFUL FORM
FORTUNATELY I WAS NOT IN AN
EMERGENCY SITUATION BUT THAT'S
HAPPENING. YOU KNOW ON A REGULAR
BASIS AND THERE SOMETIMES GREAT
EXPERIENCES WITH HEALTH PLANS
HEALTH PLANS ARE GREAT THEY'RE
ON IT IT'S NOT A PROBLEM. FOR
YOU HAVE THESE ARE SITUATIONS
AND ULTIMATELY THIS IS A- YOU
KNOW FOCUSING ON THE DOCTOR. YOU
KNOW KNOWS THE PATIENT AND
THAT'S WHAT. THE FOCUS OF THE
BILL AS- YOU I GUESS I GUESS THE
OTHER THING IS ABOUT THE HEALTH
I'VE- IN M. SOME INSTANCES ARE
YOU NOT SAY THIS IS REAL. THIS
IS YOUR FORMULA IN THE PBM IS
THAT IT IS THE OTHER SET OF EYES
I MEAN. SO IT IS OR IS IT
ACTUALLY THE HEALTH PLAN YEAH I
WAS SO THE PER FOR UTILIZATION
REVIEW- YOU KNOW GENERALLY
SPEAKING THE UTILIZATION REVIEW
WOULD BE CONDUCTED. THE HELP.
IT'S DIFFERENT DEPENDING ON WHAT
THE RELATIONSHIP IS SOMETIMES
THE PLAN CAN CONTACT WITH THE
PBM TO DO UTILIZATION MANAGEMENT
OR A SECOND. THAT I THINK ONE OF
THE PIECES AND I THINK YOU
MENTIONED EARLIER THIS BILL IS
MUCH BROADER THAN CROHN'S AND
COLITIS. OR TALKING PSYCHOTROPIC
FOR KIDS. THINGS WHERE CERTAINLY
THE INCREASE IN DOSAGE. WITHOUT
IT WITHOUT. MAYBE SOMEONE ELSE
WHO MIGHT BE LOOKING TO ENSURE
THAT. NOT ONLY THE BEST INTEREST
OF THE PATIENT BUT THE EFFICACY
AND SAFETY. I MEAN IT'S A
PARTNERSHIP WITH PROVIDERS AND
PLANS I MEAN I KNOW THAT'S
PROBABLY NOT A SUPER POPULAR.
OPINION BUT- I THINK FROM OUR
PERSPECTIVE PRIOR AUTHORIZATION
OR- REVIEW. PROVIDES A GUIDANCE
AND ASSISTANCE AND I THINK THE
NARRATIVE UNFORTUNATELY IS THE
IT'S ALWAYS MEANT TO BE PUNITIVE
AND I THINK THE GOAL AT TIMES IN
OUR X. IS A MUCH FASTER PROCESS
OFTENTIMES IT'S A TWENTY FOUR
AND SEVENTY TWO HOUR PROCESS-
PRIOR AUTHORIZATION. I THINK THE
FRUSTRATION IS THAT. IF LEFT
UNCHECKED I MEAN WHAT THEN
HAPPENS WHO WHO THEN. IS THE
PROVIDER CONSIDERED INFALLIBLE
WITH ANY DOSAGE CHANGE FOR ANY.
ANY CHRONIC CONDITION AND WHAT
DOES THAT LOOK LIKE FOR THE
HEALTH CARE SYSTEM. RIGHT
RICHARD .COM. THANK YOU A- YES
AND NO OTHER COMMENTS- THE BILL.
DOES ENJOY DO PASS
RECOMMENDATION WHICH I COULD
CLOSE UNDER RESPECTFULLY ASK
FROM LEVEL OKAY WILL- GOT COUPLE
MORE MEMBER SINCE THE LAST BILLS
OVER FOR MAKING PROGRESS SO.
I'LL GO AHEAD YOU'VE GOT- A SB.
THREE THIRTY NINE. I THANK YOU
AYE MR TERRORISTS I'D LIKE TO
START BY ACCEPTING THE
COMMITTEES AMENDMENTS TO REMOVE
AMENDMENT TO REMOVE THE ONE
HUNDRED PERCENT. POSITION RATE
REIMBURSEMENT AND INSTEAD USE
THE CONTRACTED RATE. A
REIMBURSEMENT WE PACIFIC
COMMITTEE WORKING WITH US- SB
THREE THIRTY NINE WHICH I PASSED
THE SENATE FORTY TO NOTHING-
WILL RESOLVE IMPLEMENTATION
ISSUES WITH A PREVIOUS BILL THAT
I AUTHORED IN TWENTY NINETEEN.
SB ONE FIVE NINE- SP ONE FIVE
NINE WAS THE FIRST LAW OF ITS
KIND. IN THE COUNTRY- AND WHAT
IT DID WAS ALLOW PHARMACISTS TO
PROVIDE PREP AND PAP ARE
INCREDIBLY POWERFUL ANTI HIV
PREVENT OR ITS EVERY PREJUDICE.
WITHOUT A POSITION- PRESCRIPTION
A SIMILAR TO- BIRTH CONTROL
PILLS- FOR THOSE WHO DON'T KNOW
CRAP- IS A- ONCE IN A DAY PILL
OR PERIODIC NOW PERIODIC
INJECTION THAT'S RECENT- DOT.
COM'S EXCEPTIONALLY CLOSE TO
ELIMINATING RISK OF HIV IT'S
ALMOST IMPOSSIBLE TO CONTRACT
HIV ARE WHEN YOU ARE ON PROP AND
TAKING IT OUT REGULARLY. IT IS
AN ABSOLUTE GAME CHANGER. I AND
IF EVERYONE AT RISK FOR HIV WERE
TAKING PROP WE WOULD QUICKLY
ELIMINATE NEW HIV INFECTIONS
PERIOD. AND THEN WE CAN FOCUS
EXCLUSIVELY ON MAKING SURE
PEOPLE LIVING WITH HIV AT THE
HEALTH CARE AND SUPPORT THAT
THEY NEED AND WE WOULD ENVISION
OF A FUTURE WITHOUT HIV WOULD
LITERALLY WIPED OUT. NEW
INFECTIONS- THAT'S NOT
HAPPENING. AND WE AND THE ACCESS
THERE IS A LACK OF ACCESS TO HIV
ONE OF THE PIECES OF THAT- ARM
IS THAT IT IS ODD THERE ARE SOME
OBSTACLES- FOR PEOPLE AND WE
KNOW THAT NEIGHBORHOOD
PHARMACIES ARE. ARE PROVIDERS
THAT PEOPLE ENTER RON WITH ALL
THE TIME- AND ALLOW FOR. TO
ADMINISTER BY. PROP BOB. THEY
BROKEN OR STARBUCKS WILL
DRAMATICALLY WE BELIEVE INCREASE
ACCESS- AND THAT ACCESS IS
PARTICULARLY NEEDED OUTSIDE OF
URBAN CENTRES AND PARTICULARLY
IN COMMUNITIES OF COLOR. WHEN WE
ARE MOVED SB ONE FIFTY NINE WE
MADE A- TOOK A PARTICULAR
AMENDMENT- BASED ON DIALOGUE
WITH ART WITH SENATE- BMP. I AND
ALSO- SOME OF THE OPPONENTS OF
THE BILL. LIMITING THE ABILITY
OF THE PHARMACIST PROVIDE PREP
TO ONLY A SIXTY SIXTY DAY SUPPLY
EVERY TWO YEARS WITH THE IDEA
YOU WOULD THEN GO SEE A
PHYSICIAN AFTER THAT. THAT HAS
BEEN A FAILURE I IT HAS NOT
WORKED ARM AND- NOT BECAUSE FOR
FARM. THE IDEA OF YOUR ONLY
GONNA DO SIXTY DAYS YOU'RE A SET
UP ALL THESE THE STRUCTURE TO DO
THIS AND YOU CAN ONLY DO THE
SIXTY DAYS IT DOESN'T WORK IN
ADDITION THE PHARMACY DO NOT
RECEIVE ANY INSURANCE
REIMBURSEMENT FOR THE TIME
BECAUSE AFTER. ORDER OF- LABS
AND- HIV TEST AND SO FORTH THIS
THAT AND THE AND IN THE
MEANTIME. I OTHER STATES HAVE
TAKEN CALIFORNIA'S WORK WITHOUT
THOSE PROBLEMS VARIOUS OTHER
STATES HAVE ADOPTED WHAT WE
ADOPTED BUT WITHOUT THE SIXTY
DAY LIMITATION AND REQUIRING
INSURANCE REIMBURSEMENT. AND
THEY ARE SUCCEEDING- SO THIS
BILL IS TWO THINGS THAT REMOVES
THE SIXTY DAY CAP. AND IT
REQUIRES A REIMBURSEMENT BOB
SUBJECT TO THE MOMENT THAT WORK
SOMETHING OUT TODAY- SO I
RESPECTFULLY ASK FOR AN AYE
VOTES- AND WITH ME TODAY TESTIFY
OR A DOCTOR MARIA LOPEZ- WHO'S
THE PRESIDENT OF MISSION
WELLNESS PHARMACY IN SAN
FRANCISCO. AND PURPLE SERVER
PULLS OVER THE LEGISLATIVE.
DIRECTOR OF QUALITY CALIFORNIA.
HI MY NAME IS MARIA LOPEZ AND- I
AM A PHARMACIST I MISSION WELL
THIS IS A COMMUNITY PHARMACY IN
THE HISPANIC LATINO. MISSION
DISTRICT IN SAN FRANCISCO WHERE
WE HAVE EXPERIENCED ESTABLISHING
TRUST AND SERVING DIVERSE
COMMUNITIES I ALSO SERVICE
CAPACITY BUILDING ASSISTANT
CONSULTANT FOR HIV PREVENTION
WHICH IS FUNDED BY THE CDC-
COMMITTEE PHARMACIES OFFER
CONVENIENT LONGER HOURS AND
MEDICAL OFFICES AND OUR STAFF BY
PHARMACISTS WHO KNOW THE
MEDICATIONS MAINTAIN ESTABLISH
RELATIONSHIPS WITHIN THE
COMMUNITIES. THEY SERVE IN HARD
EXISTING REPORT AND THIS IS A
KEY TO ADHERENCE. BASED ON
PUBLISHED MODELS WHICH MISSION
WILLIS'S ONE PHARMACIST CAN
SAFELY AND EFFECTIVELY PROVIDE
PREP AND PAP AND THAT IS WHY THE
CDC AND FEDERAL PARTNERS
SUPPORT. PHARMACIST FURNISHING
PROPPANT PAP. WELL SB ONE FIVE
NINE WAS THE FIRST BILL NATION
GRANTEE PHARMACISTS THE THIRTY
IT IS AMONG THE MOST RESTRICTIVE
SB THREE THREE NINE WILL ADDRESS
THESE BARRIERS FOR PHARMACIST-
AS A SENATOR POINTED OUT THE
SIXTY DAY SUPPLY- IS NOT WORKING
IT'S NOT IN LINE WITH THE CDC
GUIDELINES WHICH RECOMMEND
NINETY DAYS. AND THE ONE TIME
SUPPLY EVERY TWO YEARS DOES
NOTHING TO INCREASE PROP ACCESS
BECAUSE THERE IS A SHORTAGE OF
PROVIDERS AND PATIENTS CANNOT
ACCESS ONGOING PROP. LACK OF
REIMBURSEMENT REMAINS A MAJOR.
BARRIER FOR CALIFORNIA
PHARMACIST. BOB WEILER PROGRAM
SAN FRANCISCO HAS REACHED
LIMITED SUPPORT THE MERE FACT WE
CANNOT BILL FOR SERVICES GREATLY
HINDERS OUR ABILITY TO PROVIDE.
SERVICES FOR ALL PATIENTS WHO
SEEK PROP AT OUR SITE AND WE
HAVE HAD TO TURN PATIENTS AWAY
DUE TO THIS BARRIER. TO BE CLEAR
WE HAVE APPROACH INSURANCE
COMPANIES ABOUT PAYMENT FOR
SERVICES AND HAVE BEEN
REPEATEDLY TOLD THEY DO NOT HAVE
A MECHANISM TO PAY US.
PHARMACIST AT THIRTY TO ORDER
LABS FOR MEDICATION MANAGEMENT
AND SB THREE THREE NINE
OUTLINES- LABS IN ACCORDANCE
WITH CITY PARK I LINES AND THE
NATIONAL PHARMACY SCHOOL
TRAINING STANDARDS REQUIRE
PHARMACY STUDENTS TO INTERPRET
LABS. AND TEST PRIOR TO
GRADUATION. FINALLY THIS BILL
TAKES INTO ACCOUNT THE VARYING
LEVELS OF PHARMACY CITING. SOME
SITES CAN PROVIDE ONE NINETY
SUPPLY WHILE OTHER SITES CAN
PROVIDE ON GOING PRACTICE THEY
HAVE LABORATORY SETUP AND FOLLOW
UP. I RESPECTFULLY REQUEST YOUR
SUPPORT OF THIS IMPORTANT PUBLIC
HEALTH BILL TO ENSURE PATIENTS
HAVE ACCESS. TO THESE LIFESAVING
MEDICATIONS THANK YOU. A GOOD
AFTERNOON CHAIRMAN MEMBERS CRIED
PULSE FOR ON BEHALF OF THE
QUALITY CALIFORNIA PROUD CO
SPONSOR. AS YOU ALL KNOW
PREPPING PAP ARE ESSENTIAL TOOLS
TO AND IN THE HIV EPIDEMIC CAN.
CALIFORNIA HAS REALLY BEEN ON
THE CUTTING EDGE IN TERMS OF
EXPANDING ACCESS. IN TWENTY
NINETEEN WE WERE PROUD TO CO
SPONSOR S. B. ONE FIFTY NINE
WHICH MADE CALIFORNIA. THE FIRST
STATE IN THE NATION TO AUTHORIZE
PREP AND PAP- TO FURNISH PREP
AND PAP WITHOUT A PHYSICIAN'S
PRESCRIPTION. HOWEVER WHILE THIS
BILL IS A MAJOR STEP FORWARD.
OVER THE PAST SEVERAL YEARS
PHARMACISTS HAVE REPORTED
SIGNIFICANT BARRIERS TO
IMPLEMENTING THE BILL AS MARIA
NOTED. LAST YEAR THE CALIFORNIA
HIV AIDS POLICY RESEARCH CENTERS
SURVEYED OVER NINE HUNDRED
CALIFORNIA PHARMACISTS. AND
PHARMACY STUDENTS ABOUT
CHALLENGES IN IMPLEMENTING THE
BILL. AND FOUND THAT HALF OF
THOSE SURVEYED SAID ALLOCATING
STAFF TIME IS DIFFICULT BECAUSE
THE SERVICES ARE NOT REIMBURSED.
AND NEARLY HALF BELIEVE THAT THE
SIXTY DAY LIMIT IS INSUFFICIENT.
TO MAKE IT SUCCESSFUL REFERRAL
TO A PRIMARY CARE PROVIDER. AND
ENSURE THAT PATIENTS REMAIN ON
PREP BEYOND THE INITIAL SIXTY
DAY SUPPLY. AS A RESULT OF THESE
BARRIERS FEW PHARMACIES HAVE
IMPLEMENTED THIS COMPONENT OF
THE BILL. ACCORDING TO THE
SURVEY ONLY 11% OF PARTICIPANTS
INDICATED THE PHARMACISTS. I
WERE INITIATING PREP AND ONLY
13% WERE PROVIDING PAP. SB THREE
THREE NINE WILL REMOVE THESE
BARRIERS AND EXPAND ACCESS TO A
PREP AND PAP FOR CALIFORNIANS AT
RISK FOR HIV. THE QUESTIONS THAT
BEEN RAISED REGARDING PATIENT
SAFETY AND THE NEED FOR
INVOLVEMENT OF A PRIMARY CARE
PHYSICIAN. WOULD JUST NOTE THE
UNDER SB ONE FIFTY NINE ALL
PHARMACISTS ARE REQUIRED TO
RECEIVE EVEN MORE TRAINING
BEYOND THE TRAINING THEY HAVE
ALREADY RECEIVED. AND THE BILL
INCLUDES PROTECTIONS TO MAKE
SURE THAT PATIENTS RECEIVE ALL
OF THE TESTING AND FOLLOW UP
CARE. THAT IS RECOMMENDED BY THE
CDC. PHARMACISTS ARE ALSO
REQUIRED TO NOTIFY THE PATIENT'S
PRIMARY CARE PHYSICIAN IF THEY
HAVE ONE. AND AS FURTHER
EVIDENCE THAT PHARMACISTS ARE
WELL EQUIPPED TO PROVIDE THESE
MEDICATIONS. NUMEROUS OTHER
STATES ARE NOW FOLLOWING
CALIFORNIA'S LEAD AND MANY OF
THEM HAVE PASSED LAWS WITHOUT
THE RESTRICTIONS THAT WERE
INCLUDED AND SB ONE FIFTY NINE.
LAST I JUST WANT TO NOTE THAT
EVEN DESPITE THE INCREDIBLE
PROGRESS THAT HAS BEEN MADE HERE
IN CALIFORNIA. UPTAKE OF THESE
MEDICATIONS CONTINUES TO BE
EXTREMELY LOW. ONLY 25% OF THOSE
WHO COULD BENEFIT FROM PROPER
CURRENTLY TAKING AT. AN UPTAKE
IS PARTICULARLY LOW IN
COMMUNITIES OF COLOR
PARTICULARLY YOUNG PEOPLE AND IN
MORE RURAL PARTS OF THE STATE.
SB THREE THREE NINE WILL
CERTAINLY NOT SOLVE EVERY ISSUE
THAT MUST BE ADDRESSED TO REACH
OPTIMAL PREP UPTAKE. BUT IT IS
AN IMPORTANT STEP IN THE RIGHT
DIRECTION AND I RESPECTFULLY
URGE HER AYE VOTE. THANK YOU
VERY MUCH OTHERS IN SUPPORT.
TURN MEMBERS KATHY MOSSBERG WITH
THE SAN FRANCISCO AIDS
FOUNDATION APPROACH- SPONSOR AS
WELL AS A PURELY HEALTH ALSO IN
SUPPORT. YOUR DO YOU FEEL WITH
CAPITAL ADVOCACY ON BEHALF OF
CALIFORNIA LIFE SCIENCES IN
SUPPORT THANK YOU THANK YOU.
KELLY BROOKS ON BEHALF OF THE
COUNTY HEALTH EXECUTIVES
ASSOCIATION OF CALIFORNIA HERE
IN SUPPORT. THANK YOU. CLEAR
COMMON ON BEHALF OF VIACOM
CALIFORNIA IN SUPPORT THANK YOU
. MISTER MEMBERS PAUL YOUR WE
HAVE THE CITY OF WEST HOLLYWOOD
IN THE CITY AND COUNTY OF SAN
FRANCISCO IN SUPPORT THANK YOU
THANK YOU. REBECA GONZALEZ
NATIONAL ASSOCIATION OF SOCIAL
WORKERS CALIFORNIA CHAPTER IN
SUPPORT THANK YOU. GOOD
AFTERNOON SANDRA POOL ON BEHALF
OF WESTERN CENTER ON LAW AND
POVERTY IN SUPPORT. THANK YOU.
RACHEL MILLER HERE WITH
CALIFORNIA SOCIETY OF HEALTH
SYSTEM PHARMACISTS ARE
UNIVERSALLY MIXED UP MY BILLS
TONIGHT WE ARE IN SUPPORT OF
THREE THREE NINE. AND WORD TO-
AWARE OR PROVIDING ANYTHING FOR
TWO THREE EIGHT SO I APOLOGIZE
FOR MY MIX UP THANK YOU FROM
THANK YOU. SORRY THIS CALIFORNIA
PHARMACISTS ASSOCIATION CO
SPONSOR AND SUPPORT THANK YOU.
JOSH TALKING ON BEHALF OF SANTA
CLARA COUNTY IN SUPPORT. YOU.
RHINELAND ON BEHALF OF THE
CALIFORNIA RETAILERS ASSOCIATION
SUPPORT. THANK YOU. RACHEL
BHAGWAT FRONT ON BEHALF OF THE
ACLU CALIFORNIA ACTION AND
SUPPORT. THANK YOU- IN HIS THEIR
OPPOSITION TO THE BILL. NO
OPPOSITION TO THE BILL- I'M
SORRY. GIVE ME. I WASN'T
EXPECTING YOU TO. BUT BUT THERE
ARE OTHERS LURKING SO IT'S OKAY
. SPONDA THAT. IT'S OKAY.
USUALLY YEAH ANYWAY I THINK IT'S
A COMMON THEMES MISTER CHAIR-
RIGHT SPENCER BEHALF THE
AMERICAN COLLEGE OF OBGYN STITCH
OF NINE AND THE CALIFORNIA
MEDICAL ASSOCIATION I FIRST LIKE
TO EMPHASIZE THE MAIN A BECAUSE
A PRECIADO THE AUTHOR'S INTENT.
AND A STRONG COMMITMENT TO THIS
ISSUE SPENDING SAVE ACCESS TO
PREP AND PAP FOR INDIVIDUALS OF
THE HIGHEST RATES OF HIV
ACQUISITION IS INCREDIBLY
IMPORTANT IS WHY A ****
SUPPORTED IS C. MAKE COLLEAGUES
IN TWENTY NINETEEN AS IT WORKED
ON SB ONE FIVE NINE TO AUTHORIZE
PHARMACISTS TO DISPENSE A
LIMITED SUPPLY OF PREP AND PAP
FOR LIMITED TIME. WITHOUT A
PRESCRIPTION THIS COMPROMISE
BILL PROVIDED APPROPRIATE
SAFEGUARDS WHICH INCLUDED
APPROPRIATE FOLLOW UP CARE AND A
PRESCRIPTION TO CONTINUE
COVERAGE OF THE MEDICATION
UNFORTUNATELY SB THREE THREE
NIGHT NOW REMOVES THESE
IMPORTANT PATIENT PROTECTIONS
SIMILAR L. ALLOWING A PHARMACIST
CONTINUALLY DISPENSE BOTH PREP
AND PEP IN PERPETUITY. UNLESS
APPROPRIATE FOLLOW UP IS GIVEN
BUT IT'S UNCLEAR WHAT QUALIFIED
MEDICAL PROVIDER WILL PROVIDE
THAT FOLLOW UP THE PHARMACIST
MAY BE AUTHORIZED PERFORM
CERTAIN TASKS THEIR LACK OF
MEDICAL TRAINING MAY NOT AFFORD
THEM THE APPROPRIATE KNOWLEDGE
TO INTERPRET THE RESULTS OF SUCH
TASKS SUCH AS WHAT THE RESULTS
MEAN AND CERTAINLY NOT TO TREAT
THE CONDITION BEING TESTED.
WITHOUT A FOLLOW UP VISIT WITH A
QUALIFY PROVIDER SIGNIFICANT
MEDICAL ISSUES INCLUDING THOSE
RESULTING FROM THE DRUG MAY GO
UNDETECTED AND WORSEN OVER TIME.
WE'RE ASKING FOR CLARIFYING
AMENDMENTS TO ENSURE THE BILL
DOES NOT UNDULY EXPAND THE SCOPE
OF PHARMACISTS TO TEST AND TREAT
CONDITIONS. BEYOND THE CURRENT
SCOPE. AND VERY AND TO VERIFY
THE PATIENT'S FURNISHED PEP AND
PREP RECEIVE TESTING THE FAULT
CARE. FROM A QUALIFIED HEALTH
CARE PROVIDER MAY MAY NOT BE A
PHARMACIST WITHIN THEIR SCOPE OF
PRACTICE AS AUTHORIZED. UNDER
CALIFORNIA LAW. UNTIL THEN WE
MUST RESPECT WE OPPOSE THE BILL.
AND ASTRONOVA. THANK YOU. THANK
YOU OTHERS IN OPPOSITION. THEY
YOU MISTER. OF THE MAY HAVE
BEEN. ME I. TO HAVE HAVE A THE
HELP. SEVENTY TWO- JET TO THE
CALIFORNIA BECAUSE THEY HELP. I
WE HAVE A OPPOSED. POSITION ON
THE BILL- WE BELIEVE THAT THE
MINUTES ARE COMING AS COMMITTEE
I THINK COULD GO ALONG WAY
TOWARDS ONE OF OUR CONCERNS WITH
THOSE REPEATED TO THE AUTHOR AND
HIS STAFF. AND SPONSORS FOR
WORKING WITH US. I WE'RE STILL
WORKING AROUND- UP IN THE
PENDULUM THAT MEANT AROUND-
ENSURING THAT THAT THAT HELP AND
COMMUTERS- YOU KNOW GENERIC
VERSIONS OF- SPECIFIC DRUGS WHEN
APPROPRIATE- WE'RE STILL.
WORKING ON THAT LANGUAGE AND
TRYING TO AN AGREEMENT ON THAT
BUT WE APPRECIATE THE AUTHOR'S-
OPENNESS AND WILLINGNESS TO WORK
WITH US. BUT FOR NOW WE ARE BUT
MOST MINUTES THANK YOU THANK YOU
. IF THAT THE WALK SOMEBODY HAVE
THIS. CALIFORNIA LIFE AND HEALTH
INSURANCE COMPANIES ALSO WITH AN
OPPOSE UNLESS AMENDED. THANK YOU
. WE'RE GONNA MAKE A CIRCLE
MONDAY WHICH. WHAT PEOPLE CHANGE
TEAM CENTERS ARE IN OUR SYSTEM.
THE DOCTOR WEBER. OKAY THANK YOU
AT CHAIR FOR LETTING ME JUMP AND
I'M BEING SUMMONED TO ANOTHER
COMMITTEE. I'M BUT- WITH THIS
BILL- I DO HAVE FIRST OF ALL I
WANT TO THANK YOU FOR BRINGING
THIS BILL FORWARD- YOU KNOW IF.
WHAT WAS PREVIOUSLY DONE ISN'T
WORKING THEN I DO BELIEVE THAT
THE TIME TO GO BACK AND LOOK AND
SEE. HOW CAN WE MAKE THINGS
BETTER AND WE DO WANT MORE
PEOPLE HONEST. TO DECREASE THE
PREVALENCE OF HIV SO THANK YOU
SO MUCH FOR THAT. I'M TODAY I
WILL BE UPSTANDING FROM THIS
VOTE AND- I'M SORRY I AND I
THINK YOU'RE PROBABLY TALKING
ABOUT THIS I WAS- TALKED WITH
THE SERGEANTS MY CONCERN IS- THE
LACK OF REQUIREMENT FOR.
PHYSICIANS TO STEP IN AT ANY
PARTICULAR TIME SO YOU SANTA
BELL PHARMACISTS AND SHORTS. AT
THE PATIENT RECEIVES TESTING AND
FOLLOW UP CARE. CARE OF FOLLOW
CARRIAGES DO YOU HAVE AN
APPOINTMENT. NOT NECESSARILY DID
YOU GO DID YOU GET THE
TREATMENT. AND SO WHEN YOU'RE
LOOKING AT ALL OF THESE THINGS
THAT THEY'RE TESTING AS THEY
SHOULD BE FOR THESE MEDICATIONS.
YOU HAVE A PATIENT WHO GOES- FOR
THIS TEST POSITIVE FOR. YOU KNOW
CHLAMYDIA- ALL RIGHT WE'RE GONNA
MAKE SURE YOU HAVE A FAULT- WITH
YOUR DOCTOR. BUT THERE'S NO WAY
TO KNOW THAT YOU ACTUALLY WENT
AND GOT TREATED FOR IT. OR YOU
HAVE SOME ABNORMALITIES IN YOUR
RENAL OR LIVER FUNCTION I'M
GONNA MAKE SURE YOU HAVE AN
APPOINTMENT BUT I DON'T REALLY
HAVE ANY DOCUMENTATION SAY THAT
YOU ACTUALLY WENT AND YOU'RE
BEING EVALUATED FOR THAT SO. THE
WORDING HERE THE LANGUAGE IS NOT
STRONG ENOUGH TO MAKE SURE THAT-
THE PATIENTS ARE REALLY BEING
PROTECTED AND THEY'RE PUT
HALLADAY OF THEIR CARE IS BEING
TAKEN CARE OF- I'M JUST. TESTING
I SEE SOMETHING'S WRONG I'M
GONNA MAKE SURE YOU HAVE A
FOLLOW UP APPOINTMENT DOES NOT
MEAN THAT WHEN YOU COME BACK.
I'M CHECKING TO MAKE SURE THAT
YOU ACTUALLY WENT TO THE
APPOINTMENT THE YOU GOT TREATED
FOR WHATEVER THE ISSUE WAS. AND
NOW I CAN CONTINUE TO GIVE YOU
THIS MEDICATION SO- FOR THAT
REASON I'M JUST GONNA STAY OFF
AND I HOPE THAT BETWEEN NOW AND
I MEAN HIS THE FLOOR- THAT WE
STRENGTHEN THAT LANGUAGE. YEAH I
APPRECIATE THAT I THINK FOR
THERE ARE CERTAIN SITUATIONS I
MEAN OBVIOUSLY THERE'S SITUATION
SOMEONE TESTS POSITIVE FOR HIV
AND THEN THEY'RE NOT YOU KNOW
PURPOSE NO LONGER. INDICATED IF
SOMEONE HAS CHLAMYDIA. THEY
OBVIOUSLY SHOULD GET TREATED
THEY DON'T HAVE TO GO TO A
PHYSICIAN FOR THE U. GROWING
HIV- CLINIC OR IN A CITY
COUNCILOR OF TO GET THE MEDICAL
CARE UNDER THE SUPERVISION. OF A
THERE THERE ARE VERY EFFICIENT
WAYS TO BE ABLE TO GET THAT.
ADULTERY NUMBER YOU CONTINUE
RECEIVING TAKING PROP EVEN IF
YOU HAVE UNTREATED CHLAMYDIA WE
WANT YOU TO GET TREATED FOR IT
OF COURSE. BUT THAT DOESN'T
AFFECT YOUR ELIGIBILITY FOR
PROPPING FACT WE WOULD NOT WANT
SOMEONE TO STOP TAKING PROP
SIMPLY. BECAUSE THEY HAD ANOTHER
- S. T. BY ROB WE DO APPRECIATE
THAT THE- PARTICULAR. UP LAB AND
- I WERE YOU KNOW WILL
CERTAINLY. GO BACK AND TAKE A AT
THAT YEAH I WOULD APPRECIATE
THAT BECAUSE NO PATIENT STOP
TAKING PREP IF THEY HAVE.
COMMITTEE THEY SHOULD
POTENTIALLY IF THEY HAVE LIKE
LIVER. FAILURE OR KIDNEY
FAILURE- BUT AT THE SAME TIME
THAT IS ONE POINT WHERE WE CAN
MAKE SURE THAT THAT PARTICULAR
INDIVIDUAL IS SAYING A PROVIDER
TO NOT ONLY TREATED BUT COUNCIL
THEM ALSO ON. YOU KNOW SAFE SEX
PRACTICES AND DO ALL OF THE- THE
FOLLOW UP CARE AND DODD THE YOU
KNOW THE PARTNER KIND OF
SCREENING TO SEE ISLE COSTINGS
TO COME AND SO. I DO THINK THAT
THERE IS A NEED- AND I'M SURE
THAT YOU'LL CONTINUE TO THINK
ABOUT IT AND WORK ON AND I.
TRUST THE PEOPLE THAT ARE
SITTING NEXT TO YOU- AND SO I'LL
I'LL HOLD OFF TODAY BUT I AM
LOOKING FOR DISAPPOINTING THIS
ON THE FLOOR. THANK YOU THANK
YOU. VERY WELL THANK YOU- THIS
WALDRON. THANK YOU MISTER CHAIR.
A OF ALSO WANT TO THANK THE
AUTHOR FOR BRINGING THIS FORWARD
OF. SAPPHIC COUPLE YEARS AGO NOT
THAT LONG AGO I RAN A BILL LIKE
A PASSED AND SIGNED. THAT
RECOMMENDED THAT THE MEDICAL
BOARD INCLUDE. PREP AND PAP IN
THE ONGOING EDUCATION OF PRIMARY
CARE PHYSICIANS. BECAUSE IT WAS
FOUND THAT. ABOUT 33% OF PRIMARY
CARE PHYSICIANS EVEN KNEW OF
PREP AND PAP. AND VERY FEW FELT
COMFORTABLE DISCUSSING THE
ISSUES AROUND IT- AND HIV.
PREVENTION IN GENERAL- ACCESS
HAS WE TALK ABOUT ACCESS ALL THE
TIME. ACCESS IS A HUGE ISSUE FOR
HEALTH AND IN SO MANY WAYS
ESPECIALLY IN HIGH RISK
COMMUNITIES- THIS WILL HELP
ADDRESS SOME OF THOSE BARRIERS-
THE ACCESSING AND ALSO
ADHERENCE. YOU KNOW IT'S ONE
THING TO ACCESS BUT IT'S NOT THE
THING TO MAKE SURE THE PEOPLE
ARE STAYING ON IT. AND THAT'S
WITH THE PROTECTION COMES IN SO-
YOU KNOW TRYING TO GET INTO A
PRIMARY CARE PHYSICIAN IN A
TIMELY MANNER IS VERY DIFFICULT
WE ALL KNOW THAT SOMETIMES IT
COULD BE MONTHS TRYING TO GET
IN. A BECAUSE OF THE SHORTAGE
WORKFORCE SHORTAGE SO AND THAT'S
FAR LESS COSTLY TO PREVENT A
DISEASE THAN TO TREAT IT. SO I'M
YOU KNOW I THERE ARE SOME ISSUES
WITH IT I'M SURE YOU CONTINUE TO
WORK ON IT AND ALWAYS SUPPORTING
THE BILL. THANK YOU. THIS BURNER
. THANK YOU- I WANNA PUSH AGAIN
I HAVE ECHO OF MY COLLEAGUE'S
COMMENTS I APPRECIATE YOU BRING
THIS FOR MY SISTER IS ACTUALLY A
HEALTH CARE JOURNALISTS IS RIGHT
NEXT AND SOLELY ON. IMPROPER AND
I RECENTLY GOT THE CHANCE TO SEE
HER AND WE WERE TALKING ABOUT IT
AGAIN AND- ACCESS AND YOU KNOW
WHAT CALIFORNIA'S DONE SO. I
APPRECIATE THAT WE NEED TO MAKE
IT. EVEN MORE AVAILABLE I DO
SHARE THE CONCERN AT SOME POINT
YOU KNOW. PEOPLE NEED TO GO TO
THE DOCTOR TO GET PRESCRIPTIONS
WE WANT TO HAVE THIS. RIGHT AND
I THINK I QUIT A LITTLE BIT AND
MAYBE IT'S NOT A GOOD AND- I'M
NOT VERY GOOD AT ANALOGIES. BUT
I YOU KNOW I HAVE AN UNDERACTIVE
THYROID EVERY YEAR I HAVE TO GO
IN AND TO GET TESTED. ARMY T. T.
H. NOW. HE S. H. LEVELS OF
SAFETY H. C. LEVELS BUT THAT'S
THE WRONG ONE- THE ESSENTIALS.
CORRECT I'M BLESSING I'M SORRY-
AND- ARE THEY OKAY AND DO ANY
CHANGE MY DOSAGE RIGHT AND SO I
THINK. IF THERE'S A WAY TO ADD A
LITTLE BIT MORE TIENEN LANGUAGE
AROUND THAT TO ENSURE THAT
PEOPLE ARE GETTING CARE. THAT
WOULD BE HELPFUL I WILL VOTE FOR
IT TODAY I'M AN ACT BECAUSE I
THINK. YOUR OPENING LINE WAS
ABOUT HOW DO WE- REDUCE THE
PREVALENCE OF HIV AND SOMEBODY'S
FIFTY AND KNOWS PEOPLE. WHO DIED
OF AIDS HIV AND AIDS BACK IN THE
NINETIES. YOU KNOW OF THAT THIS
IS AMAZING THAT WE WOULD HAVE
THIS MEDICATION. I THINK ALL THE
DRUG DEVELOPMENT. DEVELOPERS
WHO'S GONE TO ALL THIS STUFF. IS
SURE THAT YOU KNOW MY KIDS ARE
GROWING UP WITH THE EPIDEMIC
THAT. THAT WE ALL GROW MYSELF.
THANK YOU. THANK YOU ANY ANYONE
ELSE- JUST. ANOTHER ANOTHER
QUESTION ACTION COVER QUESTION
FOR YOU I KNOW I NOTED IN THE
BACKGROUND AND- THAT YOU MENTION
THAT. OBVIOUSLY YOU THIS WITH
THE STATE WAS THE FIRST TO. YOU
KNOW MOVE FORWARD ON THIS POLICY
. WITH THE GUARDRAILS NOW WE'VE
MOVED NOW WE HAVE FROM OTHER
STATES THAT HAVE. BEEN MORE
SUCCESSFUL. SO RIGHT NOT
NECESSARILY QUESTIONS YOU MAY BE
MORE OF A QUESTION FOR MR
SPENCER OR- OTHERS WHO CAN
ANSWER THIS. OKAY- MORE
SUCCESSFUL IN OTHER STATES BUT
I'M NOT HEARING OPTIONS OTHER
THAN NO. FOR THIS PARTICULAR
BILL SO. WHAT'S GOING ON OTHER
STATES AND WHY THEY MORE
SUCCESSFUL WHAT GUARD. IS IT IS
THIS IS IT THE CRAFT IS A BILL
CRAFTED. WAIT IS ANOTHER STATES
AND IF IS BEING SUCCESSFUL IN
THOSE STATES WHY THE RESISTANCE
TO DOING IT THIS WAY. I CAN
SPEAK DIRECTLY TO WHAT'S
HAPPENED THE STATE'S WHAT I CAN
DO IS SPEAK TO BUT THEIR CONCERN
WITH THIS LANGUAGE HAVING DO
WITH THE FOLLOW UP CARE. ASIDE
FROM ALLOWING PHARMACISTS TO BE
ABLE TO FURNISH PEP AND PREP
OVER EXTENDED PERIOD OF TIME. WE
JUST WANNA MAKE SURE WHOEVER'S
PROVIDING THE FOLLOW CARE IS
QUALIFIED TO DO SO AND THAT'S
REALLY WHERE THAT'S I'M NOT SURE
IF THAT LANGUAGE EXISTS IN ANY
OTHER STATE. I HAVEN'T YET
DELVED TOO DEEP INTO THAT AS FAR
AS THE WE'VE WE'VE EVOLVED OUR-
WE DO HAVE CONCERNS ABOUT THE
LACK OF PRESCRIPTION BUT I
THINK. AFTER ARKANSAS THIS
QUESTIONS WITH THE AUTHOR AND
SPONSOR I THINK WE'RE WE'RE
REALLY PRIMARILY. REALLY
CONCERNED ABOUT THE FATHER CARE
ACCENT REALLY WHAT MATTERS HERE
TO MAKE SURE THAT THEY'RE
APPROPRIATE CANDY CONTINUE
RECEIVED THE PEP AND PREP. AND
SO WE'LL MAKE SURE THAT. OF A
PHARMACIST FRANKLY MAY NOT BE
ABLE TO IDENTIFY AND SURELY NOT
TREAT ANY CONDITION TO HAVE AND
WE BELIEVE THE WAY THE LANGUAGE
READS NOW IT'S JUST NOT CLEAR.
THAT WOULDN'T BE THE CASE AND SO
WE WANT THAT CLARITY THAT'S-
THAT'S WHERE POSITION IS ON THIS
PARTICULAR BILL AT THIS MOMENT.
THE HELP OF. KIND OF BUT A LOT
TO UP THE ROCK TO RESPOND. SO
I'M CURIOUS. I'M AT IN TERMS OF
WHY. WHAT'S DIFFERENT THE OTHER
STATES I MEAN WHAT IS YOUR BILL
CRAFTED AFTER EGGS EXACTLY
WHAT'S GOING ON IN OTHER STATES
OR IS. IT WILL BE A BIT OF THOSE
BILLS. AS I UNDERSTAND THAT WERE
BASED ON. ON ON OUR ORIGINAL
BILL WITH YOUR GUARD RAILS RIGHT
THEY DON'T HAVE THE SIXTY DAY
LIMITATION AS WE UNDERSTAND
THAT- SO. I CAN'T GUARANTEE IF
THAT'S THE ONLY REASON. I MEAN
OBVIOUSLY THEY'RE ALWAYS
COMPLICATED- BUT WE KNOW FROM
THE SURVEY THAT WAS DONE THAT
THIS IS ONE OF THAT WE ACTUALLY
THAT WE- THERE WERE A NUMBER OF
RESTRICTIONS THAT WOULD PUT INTO
THE BILL. AND ONE BY NINE AND
WE- AND WE WERE VERY EAGER TO
LOOK AT THE SURVEY RESULTS ON
ALL OF THEM. ARE AN EGG AND WE
END UP NARROWING IT DOWN TO
THESE TWO THINGS THAT THESE WERE
THE TWO PRIMARY THINGS SIXTY DAY
LIMIT. AND THE LACK OF
INSURANCE. REIMBURSEMENT AND
SOLDATO REFOCUS THE BILL WON'T
GET WE COULD'VE INCLUDED THREE
OR FOUR OTHER THINGS. WE
NARROWED IT DOWN TO WHAT WHAT WE
DO IS THE TWO. MAJOR OBSTACLES.
AND I YOU KNOW I AS SOMEONE WHO
WHEN I GOT PROBABLY GOT IT FROM
MY POSITION I WAS VERY LUCKY HE
WAS YOU KNOW. SUPER WITH IT AND
GOT IT RIGHT AWAY AND DIDN'T TRY
TO SHAME ME OR- OR ANYTHING ELSE
ARE THERE PEOPLE WHO HAD
HORRIFIC EXPERIENCES. ON IT
REALLY RUNS THE GAMUT FROM
EXCEPTIONAL TERRIFIC. ON BY. IT
THE- NEW OF COURSE IN A WHAT
EVERYONE'S OF. FOR A LOT OF
THINGS WE KNOW THAT NOT ALWAYS
HELD A- THE WORLD WORKS- IT IS
VERY HARD IF SOMEONE IS AT RISK.
WE DON'T WANT ON THE LAP OF THE
OKAY WE TOOK MY SIXTY DAYS. AND
NOW BECAUSE I DON'T HAVE A
PRIMARY CARE I COULDN'T GET IN
TO SEE MY PRIMARY CARE. ON NON
LAPSING FOR THIRTY OR SIXTY
DAYS. UNTIL AND THEN THE PERSON
AT HIV IN THE ENRON. SOMEONE'S
TAKING PROP BECAUSE THEY ARE AT
RISK- AND SO DO. I YES OF COURSE
IF SOMETHING GOES WRONG WITH IT.
HIV TEST COMES OUT POSITIVE
RETURNS OTHER LOT SOMEONE'S
WRONG WITH THEIR LIVER OF COURSE
YOU WANT TO GET THEM IN TO SEE.
A DOCTOR THE FARC KNOWN CAN FOR
SOME. TO DO THAT- BUT YOU KNOW
ULTIMATELY. NONE YOU KNOW THE
THIS IS A BALANCE AND JUST LIKE
WITH BIRTH CONTROL THAT PEOPLE
CAN HAVE TERRIBLE SIDE EFFECTS.
OFFER BIRTH CONTROL THERE SOME
WOMEN WHO REALLY HAVE PROBLEMS
WE DON'T EVER FOR SOME THE TO GO
SEE A DOCTOR GOT A PROBLEM. THE
PHARMACIST IT'S IDEALLY YOU
WOULD BE SEEING A POSITION BUT
WE THINK IT'S SO IMPORTANT FOR
PEOPLE TO HAVE EASY ACCESS AND
NOT HAVE THOSE BARRIERS. THAT
WE'VE STRUCK THAT BALANCE IT OUT
TO WERE. DOING HERE AS WELL.
THANK YOU. MISTER SPENCER. JUST
REAL QUICK AND I THAT YOUR
QUESTION SPONSORED- I THOUGHT
WHEN WE NEED TO ADD DISCUSSION
WE DID OFFER AN OPTION AND
EXTENDED PERIOD. BEYOND THE
NINETY DAYS- IT WE WENT WHERE TO
OPEN TO NEGOTIATE A HOW LONG THE
PHARMACIST WOULD BE ABLE TO
FURNISH. THE PEP AND PREP- BUT I
HAVE SOME POINT THEY WOULD NEED
TO SEE A PRESCRIBER THAT WAS
INITIALLY THE OPTION THAT WE
OFFERED. AND NOW WE'RE WORDS
RIGHT NOW WE'RE SOLELY FOCUSED
ON THE FOLLOW UP CARE BUT WE
STILL DO BELIEVE IN. AND OUR
HOPE WOULD BE THAT THEY WOULD
GET A PRESCRIPTION EVENTUALLY
BUT MISSION WE DID OFFER THE
OPTION TO A FOR AN EXTENDED
PERIOD OF TIME. THANK YOU. WELL
AS I SAID- THANK YOU TO
EVERYONE- AS I SAID THE BILL
DOESN'T IT WELL I DIDN'T SAY
THAT IT DOESN'T CHOI DO PASS
RECOMMENDATION SO- AND IF YOU
WANT TO HANG TIGHT WE ACTUALLY
HAVE A QUORUM SO WE COULD
ACTUALLY. ENTERTAIN MOTIONS.
THOUGHT YES. AND IT WAS SHOCKING
WE HAVE THE MATHEMATICAL OZONE
PLAYERS I HAD I RESPECT BEST
FRIEND I'VE A BUT THAT'S ALWAYS
THE MAGICAL TIME FOR THE CHAIR
WAS VERY MAGICAL RIGHT WHEN. YOU
HAVE NO IDEA YES YOU DO ACTUALLY
DO SO. BUT MAN SEXUALLY PLEASE
THE ROLL. WHAT YEAR. WE PRESENT
WALDRON. WALDRON PRESENT
AGUIAR-CURRY. ARAMBULA ARAMBULA
PRESENT. BURGER PRESIDENT WENDY
CARILLO. LARA VINCE FONG. IT'S
FONG PRESENT MAIENSCHEIN.
MCCARTY MCCARTY PRESIDENTIAL
PATTERSON. PATTERSON PRESENT
RODRIGUEZ. RODRIGUEZ PRESIDENT
SANTIAGO. YOU PUT WHAT. IT PUT
BY THE PRESIDENT WEBER. WE HAVE
A QUORUM- WE HAVE A MOTION AND A
SECOND ON THE BILL MOTION IS.
DUE S. AS AMENDED. TO BUSINESS
AND PROFESSIONS. AND SECRETARY
PLEASE CALL THE ROLL. WHAT I
WOULD AYE WALDRON WALDRON AYE
AGUIAR-CURRY. ARAMBULA ARAMBULA
AYE BURNER BURNER I WENDY
CARILLO LARA. VINCE FONG VINCE
FONG AYE MAIENSCHEIN MCCARTY
MCCARTY IDA PATTERSON THE
PATTERSON AYE RODRIGUEZ
RODRIGUEZ AYE SANTIAGO IT WOULD
WHAT IT WOULD WHAT I WEBER.
THAT'S NINE ZERO YOUR BILL IS
OUT LEAVE THE ROLE OPEN FOR
OTHERS TO ADD ON OF THANK YOU.
AND YOU HAVE ONE MORE BILL.
THANK YOU I'M. THERE ARE
COLLEAGUES I AM- NOW PRESENTING
SENATE BILL SEVEN SEVENTY- WHICH
WILL ESTABLISH A TANGIBLE STOPS
ON A CONCRETE TIMELINE. TOWARD
CREATING SYSTEM OF GUARANTEED
HEALTHCARE FOR ALL CALIFORNIANS
ABOUT WILL PROVIDE BETTER CARE
AT LOWER COSTS- IN THE FOLLOWING
WAYS BY DIRECTING THE SECRETARY
OF HHS. PURSUE WAIVER-
DISCUSSIONS WITH THE FEDERAL
CENTER FOR MEDICARE MEDICAID
SERVICES A TO FACILITATE THE
CREATION OF A UNIFIED HEALTHCARE
FINANCING SYSTEM. REQUIRE THE
SECRETARY TO ESTABLISH A WAIVER
DEVELOPMENT WORK GROUP OF
DIVERSE HEALTHCARE SYSTEM
STAKEHOLDERS APPOINTED BY THE
GOVERNOR AND LEADERS OF THE TWO
HOUSES ARE REQUIRING THE
SECRETARY TO PROVIDE QUARTERLY
REPORTS TO THE CHAIRS OF BOTH
HEALTH COMMITTEES ON THE STATUS
AND I'LL COME OF WE WERE
DISCUSSION. WITH THE FEDERAL
GOVERNMENT ON THE PROGRESS OF
THE WORKGROUP AND REQUIRING THE
SECRETARY TO SUBMIT A COMPLETE
SET OF RECOMMENDATIONS REGARDING
THE ELEMENTS TO BE INCLUDED IN A
FORMAL WAIVER APPLICATION BY NO
LATER THAN JUNE FIRST TWENTY
TWENTY FOUR. OUR COLLEAGUES WE
KNOW THAT THE FRAGMENTATION AND
INEQUITIES OF OUR CURRENT
HEALTHCARE SYSTEM SOME OF WHICH
WE'VE HEARD ABOUT AND THE
PREVIOUS VILLAGES PRESENTED
TODAY- PART INCLUDING VARYING
HEALTH PLAN ELIGIBILITY
REQUIREMENTS TO THE CONTINUED
LACK OF EFFECTIVE OVERSIGHT OF
PLANS. IS HARMING CALIFORNIA
RESIDENTS THE SHORTCOMINGS
RESULT IN SEVERE AND SOMETIMES
LETHAL GAPS AND MEDICALLY
NECESSARY HEALTH COVERAGE. AND
DISPROPORTIONATELY HARM
HISTORICALLY AND SYSTEMATICALLY
MARGINALIZED GROUPS. IN THEIR
FINAL REPORT OF A HEALTHY
CALIFORNIA FOR ALL COMMISSION
SUMMARIZES THE CHARACTERISTICS
OF A NEW UNIFIED FINANCING
SYSTEM IS ALL CALIFORNIA
RESIDENTS BEING ENTITLED TO
RECEIVE A STANDARD PACKAGE. OF
HEALTH SERVICES- INCLUDING LONG
TERM SUPPORT CARE SUPPORT
SERVICES- ENTITLEMENT WILL NOT
VARY BY AGE EMPLOYMENT STATUS
DISABILITY STATUS INCOME
IMMIGRATION STATUS OR OTHER
CHARACTERISTICS. AND THE
DISTINCTIONS AMONG MEDICARE
MEDICAID ALL EMPLOYER SPONSORED
INSURANCE OR ITS INDIVIDUAL
MARKET COVERAGE- WILL BE
ELIMINATED WITHIN THE US SYSTEM
OF UNIFIED FINANCING. THE REPORT
ESTIMATES THAT UNIVERSAL
COVERAGE THROUGH A UNIFIED
FINANCING SYSTEM WILL SAVE. FOUR
THOUSAND OR MORE LIVES ANNUALLY
IN CALIFORNIA. AND FIND THAT IN
THE ABSENCE OF A SHIFT UNIFIED
FINANCING. CALIFORNIA WILL OCCUR
IN THE TIONAL FIVE HUNDRED BILL
DOLLAR AMOUNT OF COSTS OVER THE
NEXT DECADE. SB SEVEN SEVENTY
FOR THE FIRST TIME ESTABLISHES-
THE SUPPORT OR IS IT WILL SHOW
THE SUPPORT OF THE LEGISLATURE
FOR THE WORK THAT THE HELP HELP
THE CALIFORNIA COMMISSION
PERFORMS ALONG WITH CLEAR STEPS
TO RESOLVE THE MANY POLICY AND
FINANCING ISSUES OF THE
COMMISSION. LEFT OPEN ON THE
APPROACH PROPOSED BY SB SEVEN
SEVENTY- WILL DEVELOP THE
REQUIRED POLICY AND FINANCING
DETAILS WHILE BUILDING POLITICAL
SUPPORT NECESSARY TO ACHIEVE OUR
SHARED GOAL GUARANTEED
HEALTHCARE FOR ALL CALIFORNIANS
AS SOON AS POSSIBLE- DESPITE
SOME CLAIMS FROM THE OPPOSITION
WE ARE COMMITTED TO WORKING WITH
EVERYONE INTERESTED IN A BETTER
HEALTH CARE SYSTEM. TO ENSURE WE
ACHIEVE THIS GOAL AND MAKE IT A
REALITY- THROUGH A STATUTORY
PATHWAY- SB SEVEN SEVENTY IS
SPONSORED BY THE HEALTHY
CALIFORNIA NOW COALITION WHICH
IS A HUGE COALITION OF LABOR
HEALTH CARE ADVOCATES CIVIL
RIGHTS ADVOCATES AND OTHERS. AND
I RESPECTFULLY ASK FOR YOUR AYE
VOTE WITH ME TODAY IT'S
TESTIFIED AS DR JOE FRAZIER
ANDY- AND ADABAS SANYO THE CO
PRESIDENT OF. UNITE HERE LOCAL
ELEVEN. THESE THESE GO AHEAD
WHENEVER YOU'RE READY. GOOD
AFTERNOON A CHAIR WOULD AND
MEMBERS OF THE COMMITTEE. MY
NAME IS JEFF FRASER AND I AM A
RETIRED NEUROLOGIST- FOR THIRTY
YEARS I PRACTICED AT SANTA CLARA
VALLEY MEDICAL CENTER A LARGE
PUBLIC HOSPITAL AND SILICON
VALLEY. I SERVED AS DEPARTMENT
CHAIR FOR FIVE OF THOSE YEARS. I
HAVE SEEN THE INEQUITIES AND THE
FOLLIES OF OUR CURRENT
HEALTHCARE SYSTEM. AND I HAVE
PERSONALLY DEALT WITH THE
PROBLEM OF PHYSICIAN BURNOUT. I
BELIEVE THAT ONLY A SINGLE PAYER
NOT FOR PROFIT HEALTH CARE
SYSTEM WITH UNIVERSAL COVERAGE.
WILL PROVIDE THE NECESSARY
FOUNDATION FOR SOLVING THE BURN
OUT PROBLEM. SB SEVEN SEVENTY
LAYS THE LAYS OUT A PATH TO
ACHIEVE THE NECESSARY REFORMS.
WITHOUT SUCH REFORMS THE BURN
OUT PROBLEM WILL ONLY WORSEN.
AND THE PHYSICIAN SHORTAGE
CRISIS WILL SNOWBALL. AS A
SENATOR WIENER INDICATED WE HAVE
A HIGHLY FRAGMENTED HEALTH CARE
SYSTEM AS A RESULT. DOCTORS HAVE
TO DEAL WITH BILLING POLICIES IN
PRIOR AUTHORIZATION PROCEDURES
THAT ARE CONFUSING CONVOLUTED.
AND OFTEN TIMES JUST PLAIN
OBSTRUCTIVE. BUT MORE GENERALLY
AND BY AND BY THE WAY THAT IS
OFTEN CITED AS A MAJOR CAUSE OF
BURNOUT. BUT JUST MORE GENERALLY
MORE FUNDAMENTALLY. WHEN
ENCOUNTERING PATIENTS WHO HAVE
TREATABLE MEDICAL CONDITIONS BUT
WHO LACK THE MEANS TO GET PROPER
TREATMENT. PHYSICIANS EXPERIENCE
WHAT IS NOW CALLED PROFOUND
MORAL INJURY. AT OUR HOSPITAL
FOR EXAMPLE PEOPLE WITH SEIZURE
DISORDERS WOULD ROUTINELY SHOW
UP IN OUR EMERGENCY ROOM. HAVING
HAD A SEIZURE BECAUSE THEY HAD
RUN OUT OF THEIR MEDICATIONS.
WHY HAD THEY RUN OUT OF
MEDICATIONS. WELL FOR EXAMPLE
BECAUSE HAVING LOST THEIR JOB
AND THEIR EMPLOYER SPONSORED
INSURANCE OR- HAVING RECENTLY
ARRIVED FROM ANOTHER COUNTY
WITHOUT INSURANCE THEY ARE
UNABLE TO ACCESS OUR- OVERWHELM
NEUROLOGY CLINIC. IN A TIMELY
MANNER. I HEALTHCARE SYSTEM THAT
CANNOT RELIABLY PROVIDE THE
SIMPLE SERVICE OF REFILLING A
LIFE SAVING MEDICATIONS ABSURD.
BUT DON'T TAKE MY WORD FOR IT I
URGE ANYONE WHO FEELS MY
CONCERNS ARE EXAGGERATED TO READ
THE FOLLOWING TWO ARTICLES.
NUMBER ONE DOCTORS AREN'T BURNED
OUT FROM OVER WORK. WERE
DEMORALIZED BY OUR HEALTHCARE
SYSTEM BY DR ERIC REINHARDT NEW
YORK TIMES FEBRUARY FIFTH TWO
THOUSAND TWENTY THREE. AND
NUMBER TWO. THE MORAL CRISIS OF
AMERICAN DOCTORS THE COR
POSITION OF HEALTHCARE HAS
CHANGED THE PRACTICE OF MEDICINE
CAUSING MANY PHYSICIANS TO FEEL
ALIENATED FROM THEIR WORK. BY E.
ALL PRESS NEW YORK TIMES JUNE
FIFTEENTH. TWENTY TWENTY THREE
SB SEVEN SEVENTY GIVES DOCTORS
HOPE THE CALIFORNIA STATE
POLICYMAKERS WILL ADDRESS THEIR
PLIGHT AND MOST IMPORTANTLY THE
PLIGHT OF THEIR PATIENTS. SB
SEVEN SEVENTY WOULD HELP RESTORE
THE QUALITY THE DIGNITY AND THE
CORE MISSION OF THE PRACTICE OF
MEDICINE. SO THE DOCTORS WILL BE
THERE WHEN WE NEED THEM. THANK
YOU. THANK YOU. GOOD AFTERNOON
CHAIR WOULD AND ALSO MEMBERS OF
THE COMMITTEE MY NAME IS ABBY
SANYO AND I'M CO PRESIDENT OF
UNITE HERE LOCAL ELEVEN I'M ALSO
HERE SPEAKING ON BEHALF OF THE
DEMOCRATIC PARTY OF ORANGE
COUNTY. I I'VE BEEN A UNION
ORGANIZER FOR THE PAST THIRTY
TWO YEARS AND IN THAT TIME I
HAVE WATCHED. HEALTH CARE REALLY
EAT UP AT THE COST MORE AND MORE
OF THE SALARIES AND THE INCOME
OF WORKING FAMILIES. THOUSANDS
OF HOTEL WORKERS IN OUR
JURISDICTION ARE ABOUT TO
STRIKE. IF NOT THIS WEEK THE
UPCOMING WEEK AND IT'S BEEN
DRIVEN BY THE FACT THAT WAGES
HAVEN'T KEPT UP WITH THE COST OF
LIVING. HEALTHCARE COSTS ARE A
HUGE PART OF WHAT'S DRIVING THE
AFFORDABLE AFFORDABILITY CRISIS
IF PREMIUMS HAD JUST GONE UP. AT
THE RATE OF INFLATION OVER THE
LAST TWENTY YEARS LOS ANGELES
AND ORANGE COUNTY HOUSEKEEPERS
AND DISHWASHERS WOULD HAVE WELL
RECEIVED OVER A HUNDRED THOUSAND
OR MORE EACH. IN THEIR POCKETS
MONEY THAT WOULD HAVE GONE A
LONG WAY TO GUARANTEEING HOUSING
SECURITY TODAY. I'M HERE TO
APPEAL TO YOU TO GET THE BALL
ROLLING ON FIXING THIS CRISIS.
MY UNION AND THE BROAD COALITION
IS CONVINCED THAT A PATH. TO
DOING THAT IS BY CREATING A
UNIFIED FINANCING SYSTEM UP FOR
HEALTH CARE. THAT THAT KIND OF
SYSTEM WOULD MAKE SURE THAT
EVERY RESIDENT COULD COUNT ON
HEALTHCARE WHEN THEY NEED IT
REGARDLESS OF WHAT KIND OF JOB
THEY HAVE OR HOW MUCH MONEY THEY
MAKE. IT WHAT'S THE SAVE OUR
STATE HUNDREDS OF BILLIONS OF
DOLLARS OVER THE UPCOMING DECADE
AND IT WOULD SAVE PEOPLE'S LIVES
AS YOU HEARD. FOUR THOUSAND A
YEAR AND THAT'S ACCORDING TO THE
HEALTHY CALIFORNIA ALL UP FOR
ALL COMMISSION. BUT EVEN IF YOU
DON'T AGREE THAT MEDICARE FOR
ALL A MEDICARE FOR ALL LIKE
SYSTEM IS THE WAY FORWARD I HOPE
THAT YOU CAN AGREE THAT WE NEED
TO GET THE CRITICAL INFORMATION
THIS THIS LEGISLATURE NEEDS TO
MAKE AN INFORMED DECISION. THERE
ARE HUNDREDS OF DECISION POINTS
THAT WILL GO INTO DECIDING
WHETHER WHETHER AND HOW
CALIFORNIA DESIGN DESIGNS A
UNIFIED FINANCING SYSTEM WE NEED
CLARITY AS TO WHAT THE FEDERAL
GOVERNMENT IS PREPARED. TO GO
ALONG WITH SO THIS LEGISLATURE
CAN DRAFT A BILL THAT HAS THE
HIGHEST CHANCE OF SUCCESS. SB
SEVEN SEVENTY HOLD THE STATE
ACCOUNTABLE TO FOLLOWING THROUGH
THE HEALTHY CALIFORNIA FOR ALL
COMMISSIONS RECOMMENDATIONS IT
DIRECTS THE ADMINISTRATION TO
CLARIFY. WHAT THE FEDERAL
GOVERNMENT WHAT MIGHT BE
POSSIBLE AND AT WHAT COST AND IT
DOES THAT ON THE TIMELINE THAT
LETS LEGISLATORS ACT WITH
URGENCY AND THE CARE THAT THIS
CRISIS DEMANDS. PLEASE PASS
SEVEN SEVENTY THANK YOU. THANK
YOU- OTHERS IN SUPPORT OF SB
SEVEN SEVENTY JUST YOUR NAME AND
ORGANIZATION IF YOU REST
REPRESENT ONE PLEASE. BRUCE
MCLEAN NORTH STATE MEDICARE FOR
ALL I URGE YOUR SUPPORT. THANK
YOU. THOMAS BRANDON CALIFORNIA
COMPTON MACHINISTS I URGE YOUR
SUPPORT THANK YOU THANK YOU.
ORIGINALLY NATIONAL UNION OF
HEALTH CARE WORKERS STRONGLY
URGE YOUR SUPPORT THANK YOU.
FIRST HARMAN DEEP YOU CARRY
HEALTHCARE COALITION IN STRONG
SUPPORT THANK YOU. CALIFORNIA
FOR KATHY FIFTEEN US CALIFORNIA
ALLIANCE FOR RETIRED AMERICANS
WE URGE YOUR STRONG SUPPORT
THANK YOU. AMY HINES IKE WITH
WILDCAT CONSULTING REPRESENTING
UNITE HERE LOCAL ELEVEN IN
STRONG SUPPORT THANK YOU THANK
YOU. THE NEW YOUNG VICE
PRESIDENT CALIFORNIA ALLIANCE
FOR RETIRED AMERICANS WEIRD YOUR
SUPPORT YOU. HELLO ERIC LEE WAS
FROM THE INLAND EMPIRE HERE FOR
AND THEN EQUITY PARTNERSHIP AND
ANALYTICAL COMMITTEE LAND TRUST
THANK YOU. GOOD AFTERNOON LINDA
WAY WITH WESTERN CENTER ON LAW
AND POVERTY IN SUPPORT ALONG
WITH THAT CALIFORNIA PAN ETHNIC
HEALTH NETWORK. THANK YOU.
EIGHTY NINE WITH HEALTH ACCESS
CALIFORNIANS SUPPORT THANK YOU
THANK YOU. AND WE A BRONZE
VISIT. PHYSICIANS FOR A NATIONAL
HEALTH PROGRAM CALIFORNIA
CHAPTER IN STRONG SUPPORT THANK
YOU. NEVER DOMINO HEALTH CARE
FOR ALL CALIFORNIA IN VERY
STRONG SUPPORT THANK YOU. DANIEL
HODGES CO FOUNDER OF HEALTH CARE
FOR ALL CALIFORNIA STRONG
SUPPORT THANK YOU. OR DALLMAN
HEALTHCARE FOR ALL CALIFORNIANS
SUPPORT THANK YOU- ROBERT
COPELAND CALIFORNIA LIFE RETURN
MAKING STRONG SUPPORT THANK YOU
. AFTERNOON SHANE GUSMAN ON
BEHALF OF THE UNITED HERE
INTERNATIONAL UNION AND THE
TEAMSTERS AND SUPPORT THANK YOU
. GOOD AFTERNOON SASHA WHAT'S
WITH THE CALIFORNIA HAD TO BE A
FAMILY PHYSICIANS AND SUPPORT
BASED ON THE MINUTES WORK ON
WHAT THE OFFICE OFFICE THANK YOU
THANK YOU. I THOUGHT I WAS CUTE
AS YOU CALIFORNIANS SUPPORT YOU
. CAROLINE BOWDEN A WITH A
CALIFORNIA WITH THE HEALTHY
CALIFORNIA NOW IN STRONG SUPPORT
PROUD CO SPONSOR THANK YOU. GOOD
AFTERNOON IRENE GO WITH COURAGE
CALIFORNIA IN STRONG SUPPORT
THANK YOU. STEPHEN VERNON
THERAPISTS ARE SINGLE PAYER AND
PHYSICIANS FOR A NATIONAL HEALTH
PROGRAM CALIFORNIA IN SEVERE
DISMAY OF THE DISSENSION THAT
SURROUND THIS ISSUE. HI IN
STRONG SUPPORT HERE THANK YOU.
RIGHT PULSE FROM BEHALF OF
QUALITY CALIFORNIA IN SUPPORT
THANK YOU. IN NO ONE ELSE OF THE
SERVER. WE HAVE A MOTION BY
MISPERCEPTION BY MISTAKE-
CORREA'S THEIR OPPOSITION TO THE
BILL. REMINDER WE HAVE TWO
WITNESSES. TESTIFIED. HI YES AS
CHAIR WOULD WE HAD A REQUEST
FRIO- IF WE COULD HAVE- MYSELF
FROM CNA- LIKEWISE MATTER
CALIFORNIA AND TANKS- AND HEALTH
CARE FOR ALL OF US SPLIT OUR
TIME FOR TWO MINUTES WE WOULD.
ROUTE WE WOULD VERY MUCH
APPRECIATE IF IT'S OKAY WITH
YOU. HOW WILL WE WILL DO THAT WE
WILL HONOR THAT IF IN THE FUTURE
I'D APPRECIATE IF YOU'D LET US
KNOW YOU'RE BRINGING THROUGH IT
MRS THANK YOU YES YES. FOR TWO
MINUTES EACH I'M THINKING CARE
WOULD AND COMMITTEE MEMBERS I'M
COMING CONSTI LEAD REGULATORY
POLICY SPECIALIST WITH THE
CALIFORNIA NURSES ASSOCIATION
PROUDLY REPRESENTING OVER ONE
HUNDRED THOUSAND REGISTERED
NURSES THROUGHOUT THE STATE. CNA
HAS FOR DECADES CHAMPION
GUARANTEED HEALTHCARE FOR ALL
THROUGH A SINGLE PAYER SYSTEM
AND WE RECOGNIZE SENATOR
WIENER'S CONTINUE SUPPORT FOR
HEALTHCARE HOWEVER WE STRONGLY
OPPOSE SB SEVEN SEVENTY BECAUSE
THIS BILL WOULD UNNECESSARILY
DELAY CALIFORNIA FROM ACHIEVING
THIS GOAL. AS A WOMEN OF COLOR
LED UNION. CNA INTIMATELY KNOWS
THAT DELAYS IN ENDING THE PROFIT
MOTIVE IN HEALTH CARE WILL COST
US THE LIVES AND THE HEALTH OF
BLACK BROWN AND OTHER
MARGINALIZED IN INCOME IN SECURE
COMMUNITIES. THIS BILL
UNNECESSARILY WHAT TASK A NEW
INFORMAL WORK GROUP TO DUPLICATE
THE WORK OF THE HEALTHY
CALIFORNIA FOR ALL COMMISSION
WHICH I PROUDLY SERVED ON WITH
DOCTOR WHAT. FOR TWO AND A HALF
YEARS THE COMMISSION ANALYZE THE
ISSUES OF UNIFIED FINANCING
INCLUDING ON FEDERAL WAIVERS.
ARE AND WE SPENT MILLIONS OF
TAXPAYER DOLLARS IN THE PROCESS
THE FINAL COMMISSION REPORT
PROVIDES EVERYTHING YOU NEED TO
TAKE LET DECISIVE LEGISLATIVE
ACTION I'M GUARANTEED HEALTHCARE
FOR ALL CONCERNING THE HOWEVER
THIS BILL WOULD RESTRUCTURE OUR
HEALTH CARE SYSTEM. THROUGH AN
UNACCOUNTABLE WORKGROUP AND FEW
TILE WAIVER DISCUSSIONS WITH THE
FEDERAL GOVERNMENT FEDERAL
WAIVER LOS CLEAR CALIFORNIA'S
FIRST ENACTED POLICY BILL LIKE
SINGLE PAYER BEFORE. FEDERAL HHS
CAN LAWFULLY SIT AT THE
NEGOTIATING TABLE SB. SEVEN
SEVENTY IS NOT A C. WE'LL PAYER
BILL IT IS A YOU FIND BILL. THE
COMMISSION WAS CLEARED BUT
UNIFIED FINANCING COULD MEET A
MULTI PAYER SYSTEM WITH A ROLE
FOR HEALTH INSURANCE WHERE
INSURERS AND OTHER PROFIT DRIVEN
MIDDLE MEN CONTINUE TO SQUEEZE
WELL FROM OUR HEALTH. WE
CONTINUE CONTINUED DELAYS IS
UNACCEPTABLE TO THE NURSES OF
CNA WE RESPECTFULLY URGE A NO
VOTE. I DO APOLOGIZE I DID NOT
REALIZE IT. MY STAFF JUST INFORM
ME OF SOMETHING HERE SO MY
APOLOGIES WE HAVE TWO MORE
MINUTES EACH. BUT BUT THE GO
AHEAD. BLACK LIVES UP. HI I'M
SHEILA BATES AND THE POLICY
LEAVE WITH BLACK LIVES MATTER
CALIFORNIA A COALITION OF
CHAPTERS ACROSS THE STATE WHICH
IS A PART OF OUR LARGER
ORGANIZATION BLACK LIVES MATTER
GRASSROOTS. WE WORKED AND STATE
SANCTIONED VIOLENCE AGAINST
BLACK PEOPLE AND ALL OF ITS
FORMS PHYSICAL ECONOMIC SOCIAL
AND POLITICAL BLACK LIVES MATTER
CALIFORNIA SUPPORT SINGLE PAYER
HEALTHCARE. UNNECESSARY POLICY
THAT IS LONG OVERDUE THAT CAN
TRANSFORM OUR STATE AND
LITERALLY SAVE LIVES. BLACK
LIVES MATTER BELIEVES IN TEARING
DOWN SYSTEMS OF HARM WHILE
BUILDING SYSTEMS OF CARE THAT
ABSOLUTELY INCLUDES SINGLE PAYER
HEALTHCARE ACCESSIBLE TAX PAYER
FUNDED COMPREHENSIVE CULTURALLY
APPROPRIATE HEALTH CARE. AS LAID
OUT IN CAL CARE IS A FORMER
PUBLIC SAFETY DUE TO OUR
POSITIONING WE ARE IN STRONG
OPPOSITION OF SB SEVEN SEVENTY A
BILL THAT COULD NOT ONLY DERAIL.
CALIFORNIA SINGLE PAYER OUT
HEALTH CARE OUT EFFORTS BUT
SINGLE PAYER HEALTHCARE EFFORTS
THROUGHOUT THE COUNTRY. BLACK
LIVES MATTER CALIFORNIA IT'S
LEADERSHIP MEMBERSHIP AND THE
LARGER BLACK COMMUNITY HAVE
EXPERIENCED AND OR SEEN THE VERY
REAL DEVASTATING AND DEADLY
EFFECTS OF MEDICAL APARTHEID.
THIS IS NOT ONLY CLEAR THROUGH
ANECDOTAL EVIDENCE AS
DEMONSTRATED IN QUALITATIVE DATA
WHICH ARE OUR STORIES BUT ALSO
IN QUANTITATIVE DATA THAT TELLS
US THAT BLACK WOMEN. ARE THREE
TO FIVE TIMES MORE LIKELY TO DIE
IN CHILDBIRTH THAN WHITE WOMEN
OR THAT BLACK INFANTS ARE TWO
POINT THREE TIMES MORE LIKELY TO
DIE IN THEIR FIRST YEAR. IN
WHITE INFERENCE INFANTS AND
SEVERAL OTHER HEALTH DISPARITIES
CLEARLY DOCUMENTED IN THE DATA
AS A RESULT OF SOCIAL
DETERMINANTS OF HEALTH WE KNOW
THAT A TRUE SINGLE PAYER
HEALTHCARE BILL SUCH AS KELP CAL
CARE. IS ME IS MEANINGFUL
REDRESS TO MEDICAL APARTHEID
THAT CONTINUES TO STEAL LIVES
AND NEGATIVELY IMPACT THE HEALTH
OF BLACK CALIFORNIANS WE SEE SB
. SEVEN SEVENTY AS A BARRIER TO
REAL SOLUTIONS. WE DON'T NEED
MORE STUDIES THE DATA IS THERE
WE DON'T NEED MORE WORKING
GROUP'S AS PROPOSED BY SB SEVEN
SEVENTY WE NEED MEANINGFUL
ACTION NOW. WE MUST STOP SB
SEVEN SEVENTY SO WE CAN ADVANCE
OUR AND PASS A TRUE SINGLE PAYER
HEALTHCARE BILL. WE URGE THE
MEMBERS OF THE ASSEMBLY HEALTH
COMMITTEE TO SPEAK UP AND
ADVOCATE FOR RESIDENTS. WHO ARE
COUNTING ON THEIR VOTE SO THAT
WE CAN. THAT WE CAN GET TO THE
MEANINGFUL LIFE SAVING AND LIFE
AFFIRMING BURKE A PASSING CAL
CARE. A COMPREHENSIVE SINGLE
PAYER HEALTHCARE BILL WE CAN NO
LONGER WAIT TOO MANY LIVES HAVE
BEEN IMPACTED. AND CONTINUE TO
HANG IN THE BALANCE. I'M GOOD
EVENING ASSEMBLY MEMBERS MY NAME
IS CHING SOME OF THEM I'M AN
IMMIGRANT AND A TWO TIME CANCER
SURVIVOR. HAVING CANCER OPENED
MY EYES TO THE GROSS INEQUITIES
OF THE HEALTH INSURANCE SYSTEM.
AND THAT HAS TURNED ME INTO A
SINGLE PAYER ACTIVISTS SINCE
TWENTY SIXTEEN. TODAY I
REPRESENT HEALTH CARE FOR US AND
ASIAN PACIFIC ISLANDERS FOR CAL
CAL. THE STATE BE STRONGLY
OPPOSE SAID SB SEVEN SEVENTY AND
CALL IN THIS COMMITTEE TO VOTE
IT DOWN. I'M NOT A LOBBYIST A
CONSULTANT OR EVEN A PAID
STAFFER AT A NONPROFIT UNION.
SINGLE PAYER ACTIVISTS LIKE ME
ARE UNPAID VOLUNTEERS WE ARE NOT
INTERESTED IN POLITICAL GAMES.
WE HAVE NO AGENDA OTHER THAN TO
HAVE CALIFORNIA ENACT SINGLE
PAYER. PLEASE HEAR US WHEN WE
SAY SB SEVEN SEVENTY IS NOT A
SINGLE PAYER BILL. END IS IN
FACT DETRIMENTAL TO THE REAL
SINGLE PAYER BILL CAL CARE.
EVERYTHING ABOUT SB SEVEN
SEVENTY IS DISINGENUOUS IT
SPONSOR HAS CLAIMED THAT THE
BILL IS COMPLEMENTARY TO SINGLE
PAYER. WHEN THE BILL ACTUALLY
PROPOSES MORE TIME WASTING ON
WAIVER DISCUSSIONS THAT ARE NOT
EVEN SPECIFIC TO SINGLE PAYER.
BILL'S TIMETABLE GIVES COVER TO
LEGISLATORS TO SADIE CANNOT
PASCAL CARE IN TWENTY TWENTY
FOUR BECAUSE YOU HAVE TO WAIT
FOR SB. SEVEN SEVENTY MANDATE
REPORTS COMING IN NEXT SUMMER-
POSSIBLY LATER THE MOST
DISTURBINGLY WITH ITS UNIFIED
FINANCING LANGUAGE SB SEVEN
SEVENTY IF PASSED WILL SET THE
STAGE FOR CALIFORNIA TO CODIFY.
A MULTI PAYER SYSTEM WHERE
INSURANCE COMPANY INTERNET
INTERMEDIARIES HMO ISN'T A CEO'S
WILL ADMINISTER HEALTH CARE
USING PUBLIC FUNDS THIS IS
ABSOLUTELY ANTITHETICAL TO
SINGLE PAYER AND DEFEATS THE
ENTIRE PURPOSE OF HEALTH CARE
REFORM. I CALLING YOU
ASSEMBLYMEMBERS TO DO WHAT'S
RIGHT MORALLY. FINANCIALLY AND
YES POLITICALLY YOU HAVE THE
POWER TO DAY. RIGHT NOW TO SAVE
LIVES AND MONEY VOTE NO ON SB
SEVEN SEVENTY THANK ACT. THE
PATH. CARE THANK YOU. THANK YOU
I AM GOING TO GIVE ANOTHER
WITNESS AN OPPORTUNITY TO SPEAK
IN OPPOSITION. WE HAD THREE
WITNESSES. FOUR I'M SORRY. I'M
SORRY NOTICES OPPOSITION. THIS
OPPOSITION BOB SO YOU HAD THREE
WITNESSES REPRESENTING THE SAME
GROUP. CORRECT YES NOW SHE SAID
I'M HERE TO SUPPORT CAL CARE YOU
HERE TO SUPPORT CAL CARE THAT'S
WHAT I THOUGHT I HEARD FROM THE
THIRD NO I'M HERE TO- ON BEHALF
OF THE CALIFORNIA NURSES
ASSOCIATION OKAY REGARDLESS I'M
GOING TO GIVE ANOTHER WITNESS
TWO MINUTES AND THEN I'M GONNA
GIVE MISTER WIENER SENATOR
WIENER ADDITIONAL TWO MINUTES IF
HE WOULD LIKE SO. PLEASE GO
AHEAD BURKE PROPOSITION FOR
OPPOSITION CORRECT. THANK YOU I
APPRECIATE THE ACCOMMODATION
INCLUDES US ON BEHALF THE
CALIFORNIA ASSOCIATION HEALTH
PLANS WELL WE ARE POSE I DO
APPRECIATE THE ACCOMMODATION
SINCE OUR OPPOSITION'S COMING AT
THIS BILL FROM A COMPLETELY
DIFFERENT ANGLE- YOU KNOW WE
OPPOSE THE BILL BECAUSE IT
REQUIRES. THE STATE TO PETITION
THE FEDERAL GOVERNMENT FOR A
WAIVER- EIGHTY EIGHT IT'S A
FORTY TO CALIFORNIA DOESN'T
REQUIRE OR NEED TO BASICALLY
CHANGE THE SYSTEM IN A WAY TO
CALIFORNIANS DON'T WANT.
BASICALLY SB SEVEN SEVENTY IS
THE FIRST STEP FROM OUR
PERSPECTIVE TOWARD A GOVERNMENT
RUN HEALTH CARE SYSTEM- WHICH
WOULD NOT ONLY ELIMINATE
ELIMINATE MEDICARE AS WE KNOW IT
BUT THE MEDICARE PROGRAM AS
WELL- IT WOULD PROHIBIT ALL
PRIVATE COVERAGE. IN FORCE EVERY
CALIFORNIAN INTO AN UNTESTED NEW
HEALTH SYSTEM WITH NO ABILITY TO
OPT OUT- SINGLE PAYER IN
CALIFORNIA'S BEEN ALLIES IN THE
PAST IT'S GOING TO COST OVER
FIVE HUNDRED BILLION DOLLARS A
YEAR. REQUIRING LARGE TAX
INCREASES ON INDIVIDUALS
EMPLOYERS AND SMALL BUSINESSES.
AND IT DOESN'T DO ANYTHING TO
ADDRESS THE WORKFORCE SHORTAGES
THAT WE'VE SEEN HEALTH CARES OR
IT WILL DO NOTHING TO KEEP
DOCTORS AND HOSPITALS IN THE
SYSTEM- THE BILL ALSO HAS A
LEGISLATURE TO ENDORSE THE
HEALTHY CALIFORNIA FOR ALL
COMMISSION REPORT. A LONG
DOCUMENT I'M THE ONE THAT
DOESN'T ANSWER FUNDAMENTAL
POLICY QUESTIONS- COMMITTEE
MEMBERS SHOULD ASK THEMSELVES
WHETHER THEY ARE BORED WITH THAT
ENDORSEMENT OF THIS REPORT.
PARTICULARLY IF YOU HAVEN'T BEEN
BRIEFED ON ITS CONTENTS. I'M
CALIFORNIA HAS MADE INCREDIBLE
PROGRESS IN EXPANDING ACCESS TO
AFFORDABLE COVERAGE SINCE
PASSAGE OF THE AFFORDABLE CARE
ACT. ENDING DE THE BUDGET THAT
WAS PASSED TODAY- INCLUDES- YOU
KNOW SIGNIFICANT INVESTMENTS IN
ACCESS TO HEALTH CARE- AND
LOWERING OF- IN RELEASE OUT OF
POCKET COSTS SO. WE ARE MAKING
GREAT STRIDES IN CALIFORNIA. YOU
KNOW STUDIES CONTINUE TO SHOW
THE CALIFORNIANS ARE AT LARGE WE
HAVE SATISFIED WITH HEALTH CARE
THAT THEY RECEIVE I'M IN
CALIFORNIA. AND THEY DO NOT
SUPPORT THIS- TRANSITION TO THE
HEALTH CARE SYSTEM SO. WE'RE
POSE FOR THOSE REASONS AND THANK
YOU AGAIN. FOR YOUR INDULGENCE.
THANK YOU- OTHERS IN OPPOSITION
TO THE BILL. STEPHANIE WATKINS
ON BEHALF OF THE ASSOCIATION OF
CALIFORNIA LIFE AND HEALTH
INSURANCE COMPANIES ALSO
OPPOSED. THANK YOU. EIGHT FOUR
JUST ON BEHALF OF CALIFORNIA
AGENTS AND HEALTH INSURANCE
PROFESSIONALS OPPOSE FOR THE
REASONS STATED BY MR WILL BE
LESS. THANK YOU. JUST YOUR NAME
NO BANNERS PLEASE. I WE DON'T WE
DON'T WHAT WE TYPICALLY DON'T
ALLOW BANNERS IN THE IN THE ROOM
SO I'M NOT SURE WHERE YOU GOT
THE IMPRESSION COULD DO THAT BUT
PLEASE NO BANNERS JUST YOUR NAME
AND ORGANIZATION YOU REPRESENT
ONE. ISAAC LIEBERMAN- AT COUNTY
ARE IN AYE OPPOSED SB SEVEN
SEVENTY BECAUSE IT'S NOT. JUST
YOUR NAME AND ORGANIZATION
PLEASE KEEP. OUR PROCESS PLEASE
USE YOUR NAME AND ORGANIZATION.
BASICALLY BERMAN THANK YOU MAY
GOD IT THANK YOU. CAROL FOR DERA
RETIRED PEDIATRIC OCCUPATIONAL
THERAPY. HEALTH CARE FOR US.
STRONGLY OPPOSE THANK YOU. I
THINK YOU COULD T. L. A. HARM
REDUCTION NETWORK SINGLE PAYER
NOW NO MORE DELAYS. LARA'S
FLANAGAN CALIFORNIA NURSES
ASSOCIATION OPPOSED THANK YOU.
KATHLEEN AMANDUS. MLK COALITION
OF GREATER LOS ANGELES STRONGLY
OPPOSED THANK YOU. MICHAEL M. ON
BEHALF OF ASIAN PACIFIC
ISLANDERS FOR CAL CARE OPPOSE
THANK YOU. AGGIE VESCO. HARRIET
TUBMAN CENTER FOR SOCIAL JUSTICE
IN LOS ANGELES STRONGLY OPPOSE
SB SEVEN SEVEN THANK YOU-
THOMPSON PARKER COORDINATOR OF
HARRIET TUBMAN CENTER SOCIAL
JUSTICE I GOT A STROKE TWO
MONTHS.
THEN ARE AN- I REPRESENT
WELLSTONE PROGRESSIVE DEMOCRATS
OF SACRAMENTO AND- HEALTH CARE
COMMITTEE OF DSA SACRAMENTO.
THANK YOU. I AM HAVE A LITTLE
PROBLEM WITH MY AIR HAVE.
TENTATIVE SO- BETTY DUMAS TOTO.
I'M DOWN HERE FROM LOS ANGELES
I'M WITH MEDICARE FOR ALL
EVERYWHERE- I'M ELECTED LOS
ANGELES COUNTY DEMOCRATIC COUNTY
COMMITTEE MEMBER- AND I STRONGLY
OPPOSE THIS NO MORE DELAYS.
THANK YOU. JEANINE RONA LEAD TO
DELEGATE TO THE L. A. COUNTY
DEMOCRATIC PARTY AND THE
CALIFORNIA DEMOCRATIC PARTY
ASSEMBLY DISTRICT FIFTY TWO
WHICH INCLUDES EAST LA. AND
SOUTHERN VICE CHAIR OF THE
SENIOR CAUCUS OF THE CALIFORNIA
DEMOCRATIC PARTY AND A TRUE.
SINGLE PAYER ACTIVIST I STRONGLY
OPPOSE THANK YOU. HELLO
WESTERGAARD DOBSON REPRESENTING
HOLLYWOOD FOR CAL CARE STRONGLY
OPPOSED THANK YOU. CHRISTOPHER
CARLSON HOLLYWOOD FOR CAL CARE
OPPOSE THANK YOU. SARAH COLE
GROVE REGISTERED NURSE HERE WITH
CALIFORNIA NURSES ASSOCIATION
STRONGLY OPPOSE THANK YOU. THE
GROUP FORCE OF REPRESENTING CAL
READ THE REDS ON WHICH IS A CHAO
HELD UNITS UP THERE FOR THAT RED
BERRIES FOR MEDICARE FOR ALL
STRONGLY OPPOSE YOU. RACHEL
CALLAHAN CEPEDA REGISTERED NURSE
WITH A CALIFORNIA NURSES
ASSOCIATION OPPOSE THANK YOU.
PAUL NEWMAN FROM H. C. FOR US
STRONGLY OPPOSE THANK YOU.
BOXLEY COTTMAN RN STRONGLY
OPPOSE CALIFORNIA NURSES
ASSOCIATION THANK YOU. GOOD
AFTERNOON I'M ALMA KIND OF OUR
TEAM I AM BIG COMMUNITY
ORGANIZER FOR THE IMMIGRANT
EQUITY PROGRAM WITH PLUS ARE
PEOPLE OF FAITH TOGETHER- AND I
AM ALSO AN INDEPENDENT
HEALTHCARE INTERPRETER IN A
STRONGLY OPPOSE SB SEVEN
SEVENTY. THANK YOU. YOU KNOW
VIOLA WHITE PEOPLE FOR BLACK
LIVES IN A BUSINESS OWNER AND
I'M STRONGLY OPPOSED IT THANK
YOU- WATER CAMARA PUBLIC SECTOR
NURSES THE CALIFORNIA NURSES
ASSOCIATION STRONGLY OPPOSING
THANK YOU. ONE THE DUFFY FROM
HEALTHCARE FOR US MFT ASSOCIATED
OPPOSE YOU. OBEAH IF NURSE REP
BAKERSFIELD CALIFORNIA NURSES
STATION I OPPOSE THANK YOU.
EARLY TULARE REPRESENTING LOST
ON DEMOCRATIC CLUB. SACRAMENTO
DSA HEALTHCARE COMMITTEE API FOR
CAL CARE AND THE IN A NUMBER
THANK YOU PROBABLY OPPOSED.
MORNING CREWS FORMER DEPARTMENT
OF HEALTH SERVICES LOS ANGELES
COUNTY ARE AND CURRENT CO CHAIR
OF HEALTH CARE FOR US AND
MEMBERS OF DSA LA HEALTH CARE
JUSTICE COMMITTEE STRONGLY
OPPOSE THANK YOU. HELLO
STEPHANIE TROUSERS UNION UNION
WORKER AND DELEGATE FOR ASSEMBLY
DISTRICT FIFTY SIX MY
CONSTITUENTS STRONGLY OPPOSED SB
SEVEN SEVENTY THANK YOU THANK
YOU. MARK THE WESTERN EIGHTY
FIFTY SIX DELEGATES AND RETIRED
DEPUTY LABOUR COMMISSIONER WITH
THE STATE OF CALIFORNIA STRONGLY
OPPOSE THANK YOU. CANISTER
SENATORS ELECTED DELEGATE TO THE
LOS ANGELES COUNTY DEMOCRATIC
PARTY AND APPOINTED MEMBERS OF
THE CALIFORNIA DEMOCRATIC PARTY
ALSO MEMBER OF HEALTH CARE FOR
US STRONGLY OPPOSED THANK YOU.
ANTHONY MARCANO CONSTITUENT
EIGHTY FIFTY SIX I STRONGLY
OPPOSE GO COME HERE. YOU
JENNIFER PORTILLO DELEGATE
REPRESENTATIVE ON BEHALF OF
EIGHTY FIFTY SIX AND THE NURSE
IT NATIONAL NURSES ASSOCIATION
IN CONJUNCTION WITH A CALIFORNIA
NURSES ASSOCIATION STRONGLY
OPPOSED ON BEHALF OF OUR
CONSTITUENTS YOU. ALI KHAN
REGISTERED NURSES CNA STRONGLY
OPPOSE THANK YOU. WELL WHO'S FOR
A LOT VISIONARIES CNA STRONGLY
OPPOSE THANK YOU AND ALSO AS A-
BOTH THANK YOU. MICHAEL WILLIAMS
FROM BLACK LIVES MY LIFE SANDERS
A PART OF BLACK LIVES MATTER
CALIFORNIA AND I STRONGLY OPPOSE
AND WE STRONGLY OPPOSE. IT THANK
YOU. ANYONE ELSE. DID YOU ONE
ADDITIONAL TIME MISTER SENATOR
WINNER. I DON'T THINK WE DO OKAY
ALL RIGHT THANK YOU BRING IT
BACK TO THE COMMITTEE QUESTIONS
OR COMMENTS FROM THE COMMITTEE
AFTER WEBER. AND THEN MISTER
MCCARTY. THANK YOU I SENATOR
WIENER- FOR THE SPELLING THANK
YOU FOR ALL THOSE WHO SPOKE AND
I DO APOLOGIZE THAT I HAD TO
STEP OUT TO ANOTHER COMMITTEE SO
I WASN'T ABLE TO HEAR
EVERYTHING. I'M BUT MY QUESTION
. IS I'VE HEARD TALK ABOUT THIS
BILL THE LANG OR PREVENTING THE
IMPLEMENTATION OF A SINGLE PAYER
FOR FIVE YEARS- CAN YOU SHOW ME
. JUST YESTERDAY CAN YOU SHOW ME
WHERE IN THE TAX IT SAYS THAT OR
IT MANDATES THAT IT IT IT IT
DOESN'T MY UNDERSTANDING IS
THAT- SIMILAR KALRA HAS A SPOT
BILL RIGHT NOW THAT PRESUMABLY
YOU'LL PUT THE FULL BILL IN THE
PRINT ASSUME. EARLY JANUARY-
AND- AND A SOMEONE WHOSE- AND I
APPRECIATE THE OPPOSITION
KNOWLEDGE I'VE CO AUTHORED
EVERY- SINGLE PAYER BILL THAT'S
BEEN INTRODUCED INSIDE DURING
THE LEGISLATURE- HE'S I KNOW
HE'S PLANNING TO DO THAT- THIS
BILL- REQUIRES THAT THE REPORT
COME BACK VERY QUICKLY IT'S JUNE
FIRST OF NEXT YEAR OR SO IN THE
MIDDLE OF THE LEGISLATIVE
SESSION NEXT YEAR- I THINK THE
OPPOSITION HAS POINTED TO THE
FACT THAT IT. SUNSETS IN TWENTY
TWENTY EIGHT BECAUSE THEY'RE
THERE THE WAY THAT SUNSET TO
WORK AROUND WORKING GROUP'S IT
TENDS TO BE. FOUR YEARS OR
WHATEVER THE TYPICAL. RULE IS
THAT'S THE ONLY REASON THAT BEAR
THE DEADLINE FOR THEM TO REPORT
BACK. ON WHAT THE SCOPE A WAIVER
COULD LOOK LIKE- IS- IS JUNE
FIRST OF NEXT YEAR YEAH I'D SAY
THAT DOES NOT IN ANY WAY IMPEDE.
UGH AND OTHER EFFORTS FROM
MOVING FORWARD YEAH THANK YOU
FOR THAT I READ THE BILL I'VE
READ THE ANALYSIS I COULD NOT
FIND. ANYWHERE IN THE BILL FOR
THE ANALYSIS WHERE IT STATES
THAT. PASSAGE OF THIS WOULD
PREVENT THE IMPLEMENTATION OF A
SINGLE PAYER HEALTHCARE SYSTEM
SO MAYBE IF- SOMEONE IN
OPPOSITION COULD TELL ME WHERE
ITS. MANDATES THAT IN THE BILL.
BUT I'M AND I AND I JUST ASKING
BECAUSE I KNOW- ALLOW OF THE
PEOPLE WHO SPOKE TODAY KIND OF
REFERENCE THAT THIS WOULD DELAY
IT. OR PREVENTED- I THINK I READ
SOMEWHERE ELSE THAT IN IN THE
OPPOSITION HERE IN THE ANALYSIS
THAT THAT. WAS ONE OF THE
CONCERNS BUT I JUST DON'T SEE
THAT MANDATED IN THE BILL SO CAN
YOU SHOW ME WHERE THAT IS. DR
WEBER AND YOU KNOW IT IT'S A
GOOD QUESTION TO RAISE I THINK
ONE OF THE MAIN CONCERNS IS THAT
THIS BILL WOULD. TASK A WORK
GROUP TO CONSIDER FEDERAL
WAIVERS SO IF WE ARE DISCUSSING
AS A STATE M. WITH KELLY TO JUST
FEDERAL WAIVERS ON THE TIMELINE-
YOU KNOW THE FIRST REPORT IS G.
U. N. N. JUNE OF NEXT YEAR AND-
AND- THERE ARE QUARTERLY POLL.
REPORTS THERE AFTER UNTIL TWENTY
TWENTY EIGHT- IF THE FEDERAL
GOVERNMENT AND THE AND CAL HHS
ARE HAVING DISCUSSIONS AND
FEDERAL WAIVERS THIS WILL STALL-
THE LEGISLATURE HAVING TO
DISCUSS SINGLE PAYER WHICH WOULD
REQUIRE- WAIT FEDERAL WAIVERS
AND WE KNOW- AS WE TALKED ABOUT-
THAT THE LAW AND FEDERAL
WAIVERS. ERA AT REQUIRES THAT
WHEN YOU CONSOLIDATE MULTIPLE
FEDERAL WAIVERS TOGETHER- THE-
FEDERAL LAW REQUIRES THAT THAT I
BILLS PASSED SO WE'RE
ESSENTIALLY PUTTING IT BACKWARDS
WITH SB SEVEN SEVENTY WHERE.
THERE ARE DISCUSSIONS THAT ARE
INFORMAL WITH KELLY TO CHESS AND
FEDERAL HHS SO IT'S REALLY
FUNDAMENTALLY VERY CONFUSING
BECAUSE HOW CAN. OUR STATE HAVE
DISCUSSIONS WITH THE FEDERAL
GOVERNMENT THAT REALLY DON'T
HAVE ANY FINAL- COMPONENT TO IT
WHEN THEY HAVE INFORMAL
DISCUSSIONS WE'RE NEVER GOING TO
GET TO SINGLE PAYER BECAUSE- IN
PERPETUITY WILL HAVE INFORMAL
DISCUSSIONS UNTIL WHEN I THINK
THAT. THAT'S REALLY
FUNDAMENTALLY ONE OF THE BIGGEST
ISSUES I DON'T KNOW IF UP OTHER
FOLKS WANT TO TALK ABOUT THE-
POLITICAL RAMIFICATIONS THAT
THAT WE ALSO SEE. THIS IS A THIS
IS NOT WHAT THE BOOK WITH
KNOWLEDGEABLE DIVES RIGHT IN I
THINK BUT I DON'T WANNA GET
INTO. THAT A DIRECT ANSWER HER
QUESTION A QUESTION WAS WHERE IN
THE BILL. DOES IT SAY THAT SO
THAT WAS THE THAT WAS THE BUT
SHE WAS SEEKING IT AS HER ANSWER
I BELIEVE I DON'T PUT WORDS IN A
DOCTOR NO I DON'T KNOW I AND
THAT WAS THE QUESTION YEAH I AM
I'M I'M LOOKING FOR BECAUSE I'VE
I'VE HEARD THAT THAT'S WHAT THIS
BILL DOES BUT- I JUST DON'T. SEE
THAT IN THE LANGUAGE NOR DO I
SEE THAT IN THE ANALYSIS AND
WHEN I'VE SPOKEN WITH- YOU KNOW
SOME OF THE PEOPLE WHO ARE ARE
LOOKING AT THIS BILL LIKE. THEY
COULDN'T SEE IT EITHER SO I'M
I'M ACTUALLY WONDERING WHERE IS
IT BECAUSE I DON'T WANT TO DO
SOMETHING THAT HAS A- SOMETHING
IN MY FACE THAT SAYS IT'S GOING
TO HAPPEN BUT I DON'T SEE IT SO
THAT'S- WHY I'M ASKING WHERE IN
THE BILL. DOES IT MANDATE THAT
IF THIS IS PASSED. WE CAN'T HAVE
SINGLE PAYER UNTIL TWENTY
TWENTY. I'M A I THINK MY
TESTIMONY I SAID THAT- YOU KNOW
THAT- THE BILL'S TIMETABLE GIVES
COVER TO LEGISLATORS TO SAY THAT
THEY CANNOT PASCAL CARE IN
TWENTY TWENTY FOUR. BECAUSE THEY
HAVE TO WAIT FOR THE MANDATED
REPORTS TO COME IN. I IN THE
SUMMER I IN JUNE. AND I. AS I
UNDERSTAND IT. OF THE CAL CARE
BILL WHICH- ASSEMBLY MEMBER ASH
KALRA IS GOING TO- INTRODUCED
NEXT YEAR- HAS TO PASS OUT OF
THIS HOUSE OF ORIGIN WHICH IS
THE ASSEMBLY. BY LATE MAY. SO
JANUARY. THAT'S RIGHT IT'S A
JANUARY. SO JANUARY AND THEN IT
HAS TO PASS THROUGH THE ASSEMBLY
IN IN MAY CORRECT IN JANUARY IT
HAS TO PASS OUT OF HERE TO YOUR
BILL HAS TO PASS OUT OF THIS
HOUSE IN JANUARY. THE UNDERSTAND
WILL BE NOT IT TO THE BILL WOULD
BE- IF HE'S INTRODUCING A WHOLE
NEW BILL I DON'T KNOW HE HAS A
BILL THAT AS SENATOR WIENER.
THAT HE HAS A BILL IS
INTRODUCED. HE COULD MOVE THAT
IN JANUARY IF NOT THEN HE GOES
TO THE NORMAL PROCESS SO I HAVE
NO IDEA WHAT MISTER KALRA HAS
PLANNED OUR UNDERSTANDING IS
THAT IT WOULD BE A NEW BILL
THAT'S INTRODUCED AND SO WE
DON'T KNOW THAT SO. THAT WITH
THAT UNDERSTANDING OF- AGAIN
UNDERSTAND LEGISLATIVE CALENDARS
SUCH IT HAS TO PASS OUT OF THE-
THE ASSEMBLY BY ME. BUT WHAT. SB
SEVEN SEVENTY DOES IS IT SAYS
THAT IT HAS TO HAVE A- REPORT
JUNE FIRST THAT'S THE MAIN
REPORT IS JUNE FIRST. SO WHAT WE
ARE SAYING IS THAT THAT GIVES
READY COVER TO LEGISLATE FORCED
TO SAY WE CAN'T PASS. A
HEALTHCARE I OUT OF THE ASSEMBLY
IN MAY BECAUSE WE HAVE TO WAIT
FOR. THE SB SEVEN SEVENTY
MANDATE REPORT IN JUNE- AND
THEN. YOU KNOW YOU DON'T KNOW
WHAT THE PROCESS COULD BE IT
COULD BE THAT THE WORKGROUP ARE
THAT'S YOU KNOW PROPOSED BY. SB
SEVEN SEVENTY WILL ASK FOR
EXTENSIONS RIGHT SO THOSE
EXTENSIONS COULD EXTEND PAST-
THAT JUNE FIRST DATE ANYWAY SO
THEY'RE ALL THESE QUESTIONS THAT
ARE NOT ANSWERING THE BILL'S
VERY BIG BILL. AND I THINK TO
ANSWER ANOTHER PART OF WHAT YOU
SAID THAT YOU KNOW HOUSES BILL
NOT SINGLE PAYER. I'D LIKE TO
DRAW YOUR ATTENTION TO ACTUALLY
SPECIFIC LANGUAGE IN THE BILL-
NO MY NO MY QUESTION IS AND HOW
IS THIS BILL NOT SINGLE PAYER MY
QUESTION IS HOW DOES THIS BILL
PREVENT. US FROM VOTING ON
SINGLE PAYER BECAUSE THAT'S WHAT
. I'M HEARING SO I'M- SO IT
SOUNDS YOU'RE THE DATE JUNE
FIRST IT'S NOT BY. YOU KNOW
THAT'S NOT A MANDATED DATA SAID
NO LATER SO THEY CAN'T GO PAST
THAT SO THEY HAVE A- IT SENATOR
WINNER IF THEY HAVE A BY MAY
FIRST COULD DALY. YES FEBRUARY
FIRST YEAH THAT YEAH THAT'S
THAT'S THE LATEST STATE AND
THAT'S A VERY SHORT TURNAROUND
RATE IF THIS IF THIS BILL WERE A
DELAY TACTIC WOULD START TURNING
REPORT IN FIVE YEARS. I MEAN THE
FACT THE FACT THAT IT THE BILL
GOES INTO EFFECT JANUARY FIRST
AND FIVE MONTHS LATER. THEIR
EXPECTED TO TURN THEIR REPORT.
SHOWS THAT THIS IS NOT A DELAY
TACTIC WE'RE NOT TRYING TO SLOW.
ANYTHING DOWN MISTER KALRA WILL
DO WHAT HE'S GOING. TO DO A LOT
OF ENORMOUS RESPECT FOR HIM- AND
THE THIS IT DOES NOT. CHANGE
THAT I THINK I JUST HAVE ONE
MORE QUESTION BECAUSE- OF THAT-
I. COULD NOT BE HEROES AND
ANOTHER. COMMITTEE THE WAIVERS-
CAN WE FULLY IMPLEMENTS
HEALTHCARE. WITH OUT THE FEDERAL
WAIVER. ARE ANY OF THE I DON'T
KNOW A LOT OF COMMITTEES AFRI
WELL I AND AGAIN I DON'T WANT TO
SPEAK. FOR ASSEMBLY MEMBER KALRA
WHAT HE MAY OR MAY NOT PUT IN
HIS BILL BUT THE TYPICAL
UNDERSTANDING IS THAT WE WOULD
NEED A FEDERAL WAIVER BECAUSE
THERE ARE THESE VERY VARIOUS
FUNDING STREAMS. ARE A LOT OF
THEM ARE CONTROLLED BY THAT ARE
GOVERNED BY FEDERAL LAW. SO WE
WOULD NEED- A FEDERAL WAIVER- I
DON'T THINK THERE'S A LOT OF A
DISAGREEMENT. ABOUT THAT-
DOCKING THE ANALYSIS DOES A VERY
GOOD JOB FOR A THOROUGH JOB OF
DESCRIBING WHAT WHO COULD GRANT
DIFFERENT WAIVERS. AND SOME FOR
SOME SOURCES LIKE MEDICAID
THERE'S AN ARGUMENT THAT IT
COULD BE DONE ADMINISTRATIVELY
FOR OTHERS LIKE MEDICARE.
THERE'S A MUCH STRONGER ARGUMENT
THAT IT MAY REQUIRE AN ACT OF
CONGRESS- AND SO THERE ARE YOU
KNOW IT'S COMPLICATED WHICH IS
ONE OF THE REASONS WHY I'M NOT
SUGGESTING THERE BEEN NO
DISCUSSIONS. BUT THIS IS US OF A
TANGIBLE STUFF TO FIGURE OUT
WHAT THE SCOPE OF A WAIVER WOULD
LOOK LIKE THE BILL DOES NOT
REQUIRE SUBMITTING THE WAIVER.
AND THAT'S WHAT IT MEANT THIS
ARGUMENT THAT WHERE YOU CAN
SUBMIT A WAIVER UNTIL YOU PASSED
A POLICY BILL THIS BILL DOESN'T
REQUIRE THE SUBMISSION OF THE
WAIVER REQUIRES. WORK TO CRAFT
WITH THE SCOPE OF THE WAIVER.
WOULD LOOK LIKE. HAVING THOSE
CONVERSATION FORMAL
CONVERSATIONS WITH THE FEDERAL
GOVERNMENT TO FIGURE THAT OUT.
OKAY SO IT'S NOT REQUIRING THAT
WE ACTUALLY APPLY OR GET A
WAIVER IT'S JUST FIGURING OUT DO
WE NEED ONE AND IF THE PROP AND
WHAT THE PROCESS IS TO GET IT
AND WHAT THE SCOPE OF THE WAIVER
WOULD BE. WHAT A WAY FOR WHAT
LOOKS LIKE. BUT NOT IT DOES NOT
REQUIRE THE FILING OF THE
SUBMISSION OR MAKING OF THE
WAIVER. REQUEST OKAY THANK YOU.
MR MCCARTY. YES THANK YOU I'M-
THIS FOLLOWING UP BUT WHAT A
DOCTOR WEBER HERE HAD SO CLEARLY
THE BILL DOESN'T SAY. THAT BY.
IMPLEMENTING THE S. CAL CARE
WOULD NOT BE ABLE TO GO. FORTH
THEY'RE JUST SAYING THE IMPACT
OF THIS PAST ITSELF. THAT I
DON'T THINK THAT'S QUITE.
ACCURATE AS YOU ALLUDED TO BUT
THE BUT THE BIG PICTURE HERE IS
THAT- YOU KNOW I ASKED TO BE ON
THIS COMMITTEE FROM THAT FOR THE
SPEAKER SIX YEARS AGO. BECAUSE
THE PRICE OF HEALTHCARE IS JUST
RIDICULOUS TIME TO MEET PEOPLE
GET LEFT BEHIND IT'S THE NUMBER
ONE REASON PEOPLE FILE FOR
BANKRUPTCY. THAT IS THE REASON
WHY DO YOU KNOW SCHOOL DISTRICTS
AND CITIES ARE FIGHTING WITH
THEIR EMPLOYEES TO PAY LIVING
WAGE AND SALARY THAT HEALTH CARE
COSTS MANY TIMES. ON SMALL
BUSINESSES CAN'T PAY THE
INCREASING PREMIUM SO DOING
NOTHING. WILL YOU KNOW THIS WILL
ALL FALL APART AT THE HOUSE OF
CARDS IF YOU LOOK AT EVER
INCREASING COST. OF PREMIUMS AND
SO. I SUPPORTED THE SINGLE PAYER
FIRST BILL LIKE LIKE YOU DID I
THINK IT WAS CENTER LARA'S THE
FIRST BILL. AND THEN- THE
WITHOUT A SECOND BILL THAT BY
SIMPLY MEMBER KALRA WHICH HOUSE
A JOINT AUTHORS LIKE YOU AS WELL
AND THERE'S A THIRD ONE WHICH-
I'M- GOING AUTHOR NOW. AT THEIR
TIME AND YOU. RIGHT NOW ARE THIS
POLICY ONLY A PRINT- SO THIS IS
A BIT COMPLICATED AND I'M TORN
BECAUSE YOU KNOW. WE HAD A
COLLEAGUE ONE OF OUR FRIENDS
HERE THE RADICANS ALL SHE HAD TO
SIGN IN OR WALL WHICH READ I
BELIEVE IN THIS IS THE MOST
AMOUNT OF GOOD. FOR THE MOST
AMOUNT OF PEOPLE. THAT'S WHAT I
THAT'S WHAT I TRIED DOING THIS
JOB. AND WE'VE BEEN INCREASING-
THE SUBSIDIES FOR AFFORDABLE
CARE ACT OBAMACARE. WE'VE
INCREASE THROUGH- BUT DOCTOR
RABBLE AS LEADERSHIP AND ARTISTS
COMMITTEE AS WELL DOCTOR WOULD
IN IN THE BUDGET TO COVER PEOPLE
AREN'T COVERED BY THAT. PEOPLE
THAT ARE UNDOCUMENTED AND- YOU
KNOW PEOPLE STILL FLIPPING THE
CRACKS SO I STILL. BELIEVE THAT
WE SHOULD HAVE- UNIVERSAL HEALTH
CARE AT ONE TIME. THE YOU KNOW.
FOCUS ON EFFICIENCIES I THINK WE
NEED TO MUCH MY LEAKS ALL THE
SYSTEM DOESN'T GO TO. THE
PROTECTING PEOPLE BUT- IT LEADS
US TO THE KEY QUESTION. WHICH I
THINK YOU'RE ASKING US IS. DO
WE- THE PERFECT FIRST THE YOU
KNOW THE PERFECT PERSON THE GOOD
. WE DON'T WANT A PERFECT BE THE
ENEMY OF THE GOOD. THAT'S I
THINK YOU'RE TRYING TO BECAUSE
IN REALITY. I DON'T AS A
SERIOUSLY A PATH. FOR THE OTHER
BILL I DON'T SEE THAT THE VOTES
FOR DRAMATICALLY SHORT. I AM OF
MY NAME'S THERE I'LL TAKE THE
HEAT FOR IT MY NAME THERE I
SUPPORTED I STAND BY IT. BUT
IT'S NOWHERE CLOSE AND SO IN THE
MEANTIME. ARE WE GOING TO BE
PURISTS. OR TRY TO GET MORE. AND
THAT'S WHAT I THINK THAT THIS
BILL IS TRYING TO DO AND SELF. I
DON'T THINK THEY ARE MUTUALLY
EXCLUSIVE. AND I WANT HAD GET
HAVE YOU. SENATOR WIENER ANOTHER
CHANCE TO KIND OF WALK THROUGH
HOW WALK THROUGH MORE. HELP US
IN MAY MORE PLAIN ENGLISH HOW
THESE ARE NOT MUTUALLY EXCLUSIVE
AND HOW THESE THINGS POTENTIALLY
CAN BE ON TWO TRACKS OF WHAT
THESE WAIVERS MEAN CAN ONE
WAIVER BE USED FOR THE OTHER.
POTENTIAL POLICY CHOICE WHERE
YOU HAVE TO FOCUS ON THE FEDERAL
LABOR WELL AS THE OPPOSITION I
THANK YOU FOR THAT ASSEMBLY
MEMBER OF THE OPPOSITION- NOTED.
ON IF CAL CARE PASSES. THEN AT
THAT POINT CALIFORNIA WILL GO.
THROUGH THE FEDERAL GOVERNMENT
AND MAKE THE WAIVER APPLICATION.
AND IT HAS FORCES SPONSOR OF THE
HEALTHCARE BILL AND SO. ON IT
YOU KNOW IT. IT AND IF THAT'S
HOW IT HAPPENS. PASS THE BILL
GETS SIGNED INTO LAW. BECAUSE OF
THE WAY RAFI. THE WORK HERE. TO
HAVE THOSE DISCUSSIONS WITH THE
FEDERAL GOVERNMENT TO FIGURE OUT
THE SCOPE AND THE STRUCTURE OF
THAT WAIVER. WILL BE HELPFUL.
AND SO IT IT DOVETAILS AND I
WANT ALSO TO STRESS THIS IS A-
MAKHOSI AND PEOPLE YOU KNOW WHO
ARE SOMETIMES- OF PARTS OF
COALITIONS AND COALITIONS HAVE
INTERNAL DISAGREEMENTS. THE
FOLKS ON BOTH SIDES OF THIS BILL
HAVE HISTORICALLY WORKED VERY
VERY CLOSELY TOGETHER. ON
EXPANDING HEALTHCARE ACCESS AND
MOVING TOWARDS A TRULY UNIVERSAL
HEALTHCARE. I AND THERE THERE'S
BEEN THIS DISAGREEMENT NOW- AND
I HOPE IN THE FUTURE THAT THAT.
RIFT HILLS ARE BUT WE ALL. WANT
THE SAME RESULT WE WANT EVERYONE
TO HAVE. TRULY GLOBAL UNIVERSAL
ACCESS TO HEALTH CARE WITHOUT
HAVING THIS FRAGMENTATION AND
HAVING THE UNIFICATION- AND SO
THAT THAT'S HOW I SEE. INTO THE
DRIVE THAT'S WIPING THE BILLS
ARE COMPLEMENTARY. YEAH I CAN
KERR AND- IT IS I THINK IT'S A
CARPORT POINT YOU MAY YOU KNOW
THIS IS A MIDDLE APPROACH THERE
ARE SOME PEOPLE ON. ON WHAT MORE
HER OPPOSED AND THIS CLEARLY
PEOPLE WE HEARD OPPOSITION. I
DON'T WANT ANY OF THESE POLICIES
ELLEN CAL CARE DON'T WANT THIS.
BUT- I DON'T KNOW BY DOING
NOTHING. WE'RE GOING TO MAKE ANY
MORE PROGRESS THERE WERE WE'RE
CURRENTLY AT SO- YOU KNOW
SOMETIMES WE HAVE TO MAKE TOUGH
CHOICES AS IT VOTING DOWN. YOU
KNOW WHAT THEY'RE ABOUT IS DOING
SOMETHING NOW. OUR RESIDENTS SO.
I KNOW THERE'S BEEN IN MOTION
SECOND I SUPPORT YOUR BILL THANK
YOU AND WE THANK YOU. ANYONE
ELSE MR RODRIGUEZ. YEAH I WANNA
THANK OF CENTER FOR BRINGING
THIS FORWARD OBVIOUSLY WE'VE
BEEN DISCUSSING FOR THE LAST
COUPLE YEARS NOW RIGHT- SO JUST
WANT TO TALK ABOUT REGARDING THE
WAIVERS- I'M KIND OF LOOKING
THROUGH THAT THE LANGUAGE OF
YOUR BILLS WELL BUT- MAYBE. AS
WE LOOK FOR THE WAIVERS DO YOU
THINK WILL BE CONFIDENT WE'LL
GET THE WAIVER FOR ONE. SO THE-
HI CAL CARE HAS YOU KNOW I MEAN
AS AS ANY THE DIFFICULT. BELL
THAT IS TRANSFORMATIONAL. THANK
YOU HAVE A LONG JOURNEY AND SO
OBVIOUSLY THE JOURNEY THROUGH
THIS LEGISLATURE. IS NOT AN EASY
ONE WE'VE SEEN THAT IN THE PAST
WEEK ALTHOUGH I SINGLE PAYER DID
PASS THE LEGISLATURE A NUMBER OF
YEARS AGO WAS VETOED- US IT'S
POSSIBLE- BUT THAT'S A TOUGH
ROAD THROUGH THE LEGISLATURE
THAT IS I THINK DOABLE- AND THEN
WORKING WITH THE FEDERAL
GOVERNMENT. AND SO THE THESE ARE
ALL- CHALLENGING- PROCESSES THAT
I THAT ARE GONNA TAKE A LOT OF
WORK- AND FOCUS AND- I CAN I
GUARANTEE YOU WE WILL BE GRANTED
NO I DON'T THINK ANYONE CAN
GUARANTEE THAT A STOCK. AND WE
DON'T KNOW WHO- IT DEPENDS ON
WHO THE ADMINISTRATION AS IT
DEPENDS ON IF AN ACT OF CONGRESS
IS REQUIRED OBVIOUSLY THAT'S ITS
OWN- SITUATION- AND SO THAT'LL
WORK FOR DOING WITH THIS BILL I
THINK WILL BE HELPFUL IN
FIGURING OUT WHAT THE OPTIONS
ARE. AND WHAT THE MOST EFFECTIVE
MOST LIKELY TO SUCCEED
STRUCTURE- IS. THERE WITH THAT.
EACH SPOKE REGARDING- THE
PROCESS OF THAT THE FEDERAL
LEVEL. OBVIOUSLY WOULD ALSO LOOK
IF WE HAVE A DIFFERENT
ADMINISTRATION REPUBLICAN
ADMINISTRATION HOW THE LOOK FOR
ONE. IN FOR TO IF WE WERE TO GET
A DIFFERENT- ADMINISTRATION.
COULD THAT NEW ADMINISTRATION
PULL THE WAIVERS BACK WHAT IF
THE IF THE BILL HAD BEEN GIVEN
RIGHT BUT ON THE RIGHT IT
DEPENDS ON BECAUSE AGAIN IF AN
ACT OF CONGRESS IS REQUIRED-
FOR. PART OF THE OF THE WAIVER
OBVIOUS HERE ADMINISTRATION
CANNOT REVOKE OUT WITHOUT A
SUBSEQUENT ACT OF CONGRESS. IF
AN ACT OF CONGRESS IS REQUIRED
DOT THIS IS. CLEARLY MORE
CEMENTED- INTO LAW I IN TERMS OF
ADMINISTRATIVELY YES DIFFERENT
ADMINISTRATIONS AND THIS IS.
SOMETHING THAT HAPPENS
DIFFERENT- MINISTRATIONS CAN
TAKE DIFFERENT. OPPOSITIONS BUT
THAT'S TRUE TODAY WE HAVE THEIR
HEALTH CARE WAIVERS ARE GRANTED
BY THE FEDERAL GOVERNMENT. TODAY
I CAN BE REVOKED BY SUBSEQUENT
ADMINISTRATION DRIVING CLEARLY
AS WE GO THROUGH THIS PROCESS IF
CAL CARE. IS ABLE TO MOVE TO THE
LEGISLATURE. WE'RE GONNA HAVE TO
BE VERY MINDFUL ABOUT HOW WE
STRUCTURE THINGS TO TRY TO
PROTECT OUR CALIFORNIA BECAUSE-
AND I'M VERY CONFIDENT THAT- OUR
ADMINISTRATION ADVOCATES. ARE
GOING TO BE EXTREMELY CAREFUL.
AND METHODICAL ABOUT MAKING SURE
THAT WE'RE PROTECTING A
CALIFORNIANS YEAH AND THEN THE
LAST ONE IS OBVIOUSLY. THE COST
RIGHT BECAUSE- FOR ME HAS BEEN
FOR THIS NO MATTER WHAT RIGHT.
END OF WHEN WE HAVE OVERSEE THE
BAD BUDGET YEARS LIKE WE'RE
EXPERIENCING NOW. ARE THAT WE
TAKE THAT INTO EFFECT RIGHT THAT
THERE IS FUNDING NO MATTER WHAT
RIGHT BECAUSE HAS GET PAID FOR
ONE WAY OR ANOTHER. SO JUST YEP
THAT'S SOMETHING THAT ONE OF THE
BIGGEST ISSUE FOR ME AS WELL AS
AS AS THE COST ESPECIALLY WHEN-
OUR STATE IS IN A IN A POSITION
LIKE WE ARE NOW WITH THE- MONEY
IS TIGHT AND WE LOOK TO CUT
POSITION TO CUT THINGS THAT. HOW
DOES ALL OF THIS IS A VERY
COMPLICATED ISSUE RIGHT THERE'S
A LOT OF MOVING PARTS WE CAN
JUST SAY IT'S HERE BECAUSE WE
GOT TO SEE HOW EVERYTHING ELSE
FALLS INTO PLACE SO. THAT WAS
JUST ANOTHER CONCERN I HAVE
REGARDING THE COST AND ALL THAT
YEAH I MEAN THE GOOD THING IS
WHAT MAKES ME PROUD TO BE PART
OF THIS LEGISLATURE RUNABOUT
BUDGET BEER THIS YEAR AND WE ARE
REALLY PROTECTING ACCESS TO
HEALTH CARE RESTORING UPPER
HOSPITALS WE ARE. WE'RE ACTUALLY
IMPROVING- PAYMENT FOR FROM FROM
MEDIC HELL WHICH IS. LONG
OVERDUE OVER DOING THAT ABOUT
BUDGET YEAR BECAUSE CALIFORNIA.
IS SO COMMITTED TO HEALTH CARE
AND WE ALSO STABILIZE OUR
FINANCES. DRAMATICALLY SINCE
THE- GREAT RECESSION WHICH WAS A
DISASTER- BUT GOD IS YOU KNOW I
THINK. IF YOU LOOK AT- WHAT
WE'RE TALKING ABOUT BUT- SINGLE
PAYER UNIFIED. FINANCING THERE
ARE. ENORMOUS OPPORTUNITIES. TO
MAKE COSTS MORE EFFICIENT. OF
THE CURRENT SYSTEM IS NOT. AN
EFFICIENT. SYSTEM IN TERMS OF
COST IT'S THE OPPOSITE. OKAY
THANK YOU. ANYONE ELSE. FINO ONE
IT'S- UP TO ME THAT WE'VE HAD.
WE'VE HAD TESTIMONY ALREADY SO
THANK YOU- SO- I WANT TO THANK
YOU A CENTER WINNER FOR
INTRODUCING THE BILL TODAY I. IT
UP. AFTER RAMBLE NYRB. VETERANS
OF THIS DISCUSSION. WERE IT NOT
FOR THE WORK WE DID THERE
WOULDN'T HAVE BEEN A HEALTHY FOR
CALIFORNIA FOR ALL COMMISSION IT
WAS OUR IDEA- AND GOVERNOR BROWN
ACTUALLY TOOK IT PUT IT IN THE
BUDGET. AND MADE IT A REALITY
AND IT WAS STARTED BY A GOVERNOR
NEWSOM SO WE'RE WELL FAMILIAR
WITH THE HEALTHY FOR ALL HEALTH
CALIFORNIA FOR ALL COMMISSION.
AND THEN SO I'M VERY FAMILIAR
WITH THE WORK I SAT ON THE
COMMISSION AND RECOMMENDATIONS
OF THE COMMISSION- ON HOW WE GO
FORWARD TO ESTABLISH A
FRAMEWORK. FOR A UNIFIED.
HEALTHCARE FINANCING SYSTEM.
THAT WAS HOW I UNDERSTOOD IT NOW
OTHERS MAY DISAGREE- BUT THAT IS
HOW I UNDERSTOOD IT- THE FORMAL
PROCESS IN THE TIMELINE THAT
YOUR BILL ESTABLISHES CREATES A
CLEAR PATHWAY TO ACHIEVE UNIFIED
FINANCING DOUBTS I BELIEVE WHAT
YOU'RE AFTER- FOR MY ART MY
INTERPRETATION. IS ALSO
CONSISTENT WITH THE COMMISSION'S
RECOMMENDATION TO DEVELOP A FULL
PROPOSAL ONE UNIFIED FINANCING.
AND THE UNIT D. O. JUNE JUNE ONE
DEADLINE. THIS OF TO A REPORT TO
THE LEGISLATURE ON ELEMENTS
NECESSARY. FOR FORMAL WAIVER
APPLICATION IS CRITICAL- FOR THE
ADMINISTRATION TO MEET ITS
OBLIGATIONS TO ACCOMPLISH AND
DELIVER UNIFIED HEALTH CARE
FINANCING FOR ALL. CALIFORNIANS
SO I PLAN TO SUPPORT YOUR BILL
TODAY- WITH THAT WOULD YOU LIKE
TO CLOSE. I THINK WE HAD A GREAT
DISCUSSION AND I RESPECTFULLY
ASK FOR AN AYE VOTE. THANK YOU.
WE HAVE A MOTION- BY MISS BURNER
A SECOND BY MISTAKE YOUR CURRY
THE MOTION IS DO YOU PASS TO.
APPROPRIATIONS MADAM SECRETARY
PLEASE CALL THE ROLL WHAT I
WOULD AYE WALDRON. WILDER NO
AGUIAR-CURRY. AGUIAR-CURRY AYE
ARAMBULA. ARAMBULA AYE BURNER
BURNER I WENDY CARILLO. LARA
IT'S FONG. MAIENSCHEIN MCCARTY
MCCARTY I JOE PATTERSON.
RODRIGUEZ RIVERSIDE SANTIAGO. IT
WOULD WHAT. IT WOULD WHAT HI
WEBER. WEBER I. YOUR BILL IS A
VOTE IS THAT A COMMITTEE WILL
LEAVE THE ROLE OPEN FOR OTHER
STAT ON THANK YOU VERY MUCH
COLLEAGUES. YOU FOR ALL THE
BILLS THAT I SHOULD.
WE WHILE WE'RE WAITING FOR THE I
KNOW CENTER EGGMAN IS GOING TO
COME UP NEXT AND MAYBE I'LL HAVE
SAID MADAM SECRETARY PLEASE CALL
THE- WHAT DO A MOTION ON THE
CONSENT CALENDAR. A CHORUS OF
MOVEMENT THERE SO MISS
AGUIAR-CURRY MR MCCARTY I WILL
GIVE THEM CREDIT THIS TIME
MOTION- FORCE CONSENT CALENDAR
WHICH IS ITEM NUMBER NINE SB
FORTY FIVE ROTH WITH AMENDMENTS.
LINE ITEM NUMBER TEN SB THIRTY
FORTY FOUR CENTER RUBIO AND
SECTOR PLEASE CALL THE ROLL ON
THE CONSENT CALENDAR WHAT I
WOULD AYE WALDRON WALDRON AYE
AGUIAR-CURRY AGUIAR-CURRY AYE
ARAMBULA RAMBLE I BURNER. WENDY
CARILLO LARA AND SONG. UNSPON
I'VE MAIENSCHEIN MCCARTY MCCARTY
IDA PATTERSON. RODRIGUEZ
RODRIGUEZ AYE SANTIAGO WHAT THE
VALLAPUDUA AYE WEBER. WEBER I.
NINETY THAT'S NINE ZERO THAT
BILLS OUT LEAVE THE ROLE OPEN
FOR OTHERS TO ADD ON. SENATOR
EGGMAN. AND PLEASE IF YOU HAVE
DISCUSSIONS PLEASE TAKE THEM
OUTSIDE IF YOU'RE NOT. THANK YOU
. IF OUR RESPECT TO A CENTER
EGGMAN PLEASE. THANK YOU VERY
MUCH MR CHAIRMAN MEMBERS IT'S-
I'M SO HAPPY TO BE HERE IN FRONT
OF YOU TODAY TO TALK ABOUT. SB
FORTY THREE WHICH IS THE LATEST
IN A LONG LINE OF BILLS ON
FOCUSING ON GRAVE DISABILITY- AS
YOU ALL KNOW GREATEST DISABILITY
WAS DEFINED IN OUR LPS LAWS IN
NINETEEN SIXTY SEVEN- AND JUST
TO ADD BECAUSE THERE'S BEEN SOME
CONVERSATION THAT THAT WE'RE
INCLUDING SUBS ABUSE THAT-
CHRONIC ALCOHOLISM WAS INCLUDED
IN THE ORIGINAL LEGISLATION AND
HAS BEEN A PART OF IT THE ENTIRE
TIME. IT REFERS TO ALSO- ITEMS
THAT ARE FOUND TO MEET THE
CRITERIA IN THE DSM WHICH IS
WHERE YOU FIND SUBS ABUSE AND
ALCOHOLISM AND SEVERE PERSISTENT
MENTAL HEALTH ISSUES- AND OF
COURSE WE WERE ALL VERY HAPPY IN
NINETEEN SIXTY SEVEN MANY OF YOU
WERE IN A LIFE YET. BUT THOSE
THAT WERE WE THOUGHT IT WAS
GOING TO BE A GRAND RE DO OF
THINGS AND WHILE THE- THE
IMPETUS WAS GOOD- THE
IMPLEMENTATION WAS HORRIBLE AND
WE HAVE SEEN. OVER THE YEARS
WITHOUT A LOT OF- INVESTMENT IN
OUR MENTAL HEALTH SYSTEM- WE
HAVE SEEN THOSE WHO ARE THE MOST
ILL. CONTINUE TO SUFFER ON OUR
STREETS IN WAYS THAT IS
DISTURBING TO I THINK EVERYBODY
WHO WALKS AROUND AND SEES IT IT
IS NOT COMPASSIONATE IT IS NOT
PROGRESSIVE. IT IS NOT HUMANE TO
ALLOW PEOPLE TO BE AS SICK AS
THEY ARE AND END UP IN COFFINS
IN OUR PRISONS IN OUR
INSTITUTIONS. IN OUR JAILS- ARE
OUR- PENAL SYSTEM IS THE LARGEST
STATE MENTAL HOSPITAL SYSTEM WE
HAVE RIGHT NOW AND THAT IS JUST
UNACCEPTABLE. SO WE ARE HERE
BACK TODAY- WITH WHAT WE THINK
IS GOING TO BE. D. THE THREAD
WE'RE ALL TRYING TO- TO DO HERE-
AND AS YOU ALL KNOWN WE HAVE
SPENT BILLIONS OF DOLLARS IN THE
LAST THREE YEARS TRYING TO
INFUSE. DOWN TO THE HOMELESSNESS
BEHAVIORAL HEALTH MENTAL HEALTH
WE HAVE STOOD UP. FOR STANDING
UP A WHOLE NEW- PROGRAM PLATFORM
FOR KIDS- AND HAVE DONE A LOT
LAST YEAR WE DID CARE ACCORDING
TO CARE COURT WITH THE GOVERNOR.
TO REALLY TRY TO HOPEFULLY
INTERVENE IN A MUCH EARLIER
WASTE THOSE WHO ARE THE MOST
ILL. AND WE'RE ALSO DOING A REDO
THIS YEAR OF THE MHSAA WERE
NICKLEBY HSA TALK TALK MORE
ABOUT BEHAVIORAL HEALTH CARE.
WHICH WILL ALSO COME WITH THE
BOND- TO BE ABLE TO PROVIDE FOR
MORE OF THOSE STEP DOWN
FINDINGS. A LOT OF PEOPLE WHEN
THEY OBJECT TO A BILL LIKE THIS
WE'LL SEE WHAT WE DON'T HAVE THE
RESOURCES BUT- WE'RE NOT MAKING
PEOPLE UP THESE ARE THE PEOPLE
THAT ARE ALREADY EXIST OR ARE WE
SUPPOSED TO BEING SIR BARS BY
OUR SYSTEMS. BUT ARE VERY
DIFFICULT AND SO OFTEN TIMES
THEY GET TO THE BACK OF THE
LINE. WERE THERE ARE THERE ON
FORTY DIFFERENT FIFTY ONE
FIFTIES BEFORE THEY CYCLE BACK
OUT AT END UP COMMITTING A
TERRIBLE CRIME. AND THEN-
DESTROYING LIVES. ALL ACROSS THE
SPECTRUM. SO I THINK WE CAN WE
CAN ALL SAY THAT THE LAW THAT WE
CURRENTLY HAVE IS NOT WORKING.
THAT THE STATUS QUO IS NOT GOOD.
THE OPPOSITION WILL SAVE
VOLUNTARY IS ALWAYS BEST
NOBODY'S ARGUMENT THAT VOLUNTARY
IS ALWAYS BEST BUT IF SOMEBODY
IS NAKED IN THE MIDDLE THE
STREET. WITH SPEECHES ON THEIR
FACE AND A RAGING INFECTION IN
THEIR BODY THEY ARE NOT GOING TO
VOLUNTARILY- AGREE TO TREATMENT
UNTIL TO LET THEM SUFFER LIKE.
THAT IS NOT GOOD FOR ANYBODY. SO
AS FORTY THREE NOW WE'VE AGREED
WITH THE CHAIR WILL GONNA UPDATE
THE DEFINITION FOR THE FIRST
TIME SINCE NINETEEN SIXTY SEVEN.
WITH THIS BILL WILL EXPAND THE
DEFINITION TO INCLUDE SOMEONE
WITH A SEVERE STEPS ABUSE ISSUE.
AT ADDITIONAL CRITERIA TO
INCLUDE THEIR INABILITY TO MEET
THEIR NEEDS FOR MESSED NECESSARY
MEDICAL CARE AND PERSONAL
SAFETY. MANY OF YOU MAY HAVE
FOLLOWED THE STORY OF MARK
RYPIEN WENT OUT MISTREATS ABOUT
WITH HIS FAMILY MULTIPLE TIMES.
ON THE STREETS FOR TWENTY YEARS
FAMILY COULD NO LONGER MAINTAIN
IT AT HOME. THE SYSTEM SENT HIM
BACK AND FORTH AND HE ENDED UP
DYING OF AN INFECTION. INFECTION
HE GOT. WHILE LIVING ON THE
STREETS IT WAS EASILY TREATED
BUT HE DID EVEN KNOW SOMETHING
WAS WRONG WITH HIM. AND THEN GO
TO THE HOSPITAL LAST MINUTE.
THAT'S ON US. THAT'S CLEARLY ON
US. HELLO TO SAY THIS BILL
REMOVES ZERO DUE PROCESS ALL THE
DUE PROCESS STEPS REMAIN IN
EFFECT THIS JUST CHANGES THE
CRITERIA. FOR WHICH SOMEBODY MAY
BE HELD. WILL THIS. INCREASE
CONSERVATIVE COULDN'T PEOPLE
BEING SENATOR WE HOPE NOT WE
HOPE THERE'S ENOUGH. CHECKS IN
IN THE PIPELINE THAT WILL. GET
PEOPLE HELP EARLIER THAT IS
REALLY THE GOAL. BUT THOSE WERE
THE MOST ILL SOMETIMES NEED THAT
EXTRA STEP WE ARE ALWAYS GOING
TO HAVE THOSE. AMONGST US. WHO
ARE NOT GOING TO BE ABLE TO LIVE
INDEPENDENTLY THAT IS JUST A
FACT OF LIFE. AND SO TO BE ABLE
TO TREAT PEOPLE AND WHAT MOST
HUMANE WAY- I THINK IS THE BEST
WAY TO DO IT. STATUS QUO IS
INCARCERATION HOMELESSNESS AND
DEATH- LEAVING PEOPLE TO DIE
WITH THEIR RIGHTS ON. IN THE
STREETS IS NOBODY'S VISION OF
COMPASSION AND NOT THE VISION
FOR CALIFORNIA. I WITH MEET HERE
TODAY TO TESTIFY AS DR EMILY
WOULD AND- TERESA PASQUINI WHO
IS A PARENT. AMABLE TALKED TO
TODAY. THANK YOU. WHAT TWENTY
OTHER I WOULD LIKE TO ADD THANK
THE CHAIRMAN FOR YOUR
THOUGHTFULNESS. I MEAN
CONSIDERING THIS LPS
MODERNIZATION BILL AND- AND THE
FORM IT SHOULD TAKE AS IT MOVES
THROUGH THE ASSEMBLY. THE
CALIFORNIA STATE ASSOCIATION OF
PSYCHIATRISTS IS CO SPONSORING
THIS BILL BECAUSE WE HAVE SEEN
TOO MANY OF OUR PATIENTS FALL
THROUGH THE CRACKS OF OUR BROKEN
SYSTEM. SB FORTY THREE CONTAINS
LIFESAVING CHANGES TO
CALIFORNIA'S CIVIL COMMITMENT
LAWS THAT WOULD BENEFIT DISTINCT
GROUP OF INDIVIDUALS AND THEIR
FAMILIES WHO HAVE BEEN IN CRISIS
FOR YEARS. BY INCLUDING ALL
SEVERE SUBSTANCE USE DISORDERS
NOT JUST ALCOHOL THIS FIFTY SIX
YEAR OLD LAW IS BEING UPDATED TO
REFLECT TODAY'S SCIENTIFIC AND
CLINICAL REALITIES WHILE
RETAINING THE DUE PROCESS STEPS
AND LEVEL OF SCRUTINY THAT
PROTECT THE CIVIL LIBERTIES OF
EXTREMELY VULNERABLE
INDIVIDUALS. BY DEFINITION
PEOPLE WHO MEET CRITERIA FOR
GREAT DISABILITY ARE UNABLE TO
WEIGH THE PROS AND CONS OF
TREATMENT VERSES THEIR
FUNCTIONING SAFETY PREFERENCES
AND VALUES. WITHOUT INTERVENTION
BE SEVERELY ILL INDIVIDUALS
SPEND MUCH OF THEIR ADULT LIFE
ON THE STREETS AND INCARCERATED
IN JAILS AND PRISONS. SUFFERING
FROM MEDICAL COMORBIDITIES BEING
TAKEN ADVANTAGE OF AND
ULTIMATELY DYING PREMATURELY.
CALIFORNIA'S BEHAVIORAL HEALTH
SYSTEM WAS ESTABLISHED ON LONG
OUTDATED VIEWS THAT SUBSTANCE
USE AS A MORAL FAILING
UNDESERVING OF MEDICAL TREATMENT
DECADES OF RESEARCH HAS SHOWN
THAT SUBSTANCE USE DISORDERS ARE
BRAIN DISORDERS ASSOCIATED WITH
FUNCTIONAL CHANGES IN BRAIN
CIRCUITS INVOLVED IN REWARD
STRESS AND SELF CONTROL. IT MAY
LAST A LONG TIME AFTER A PERSON
HAS STOPPED TAKING DRUGS. AND
REQUIRE ONGOING EFFORT TO
PREVENT RELAPSE. LIKE OTHER
MENTAL HEALTH DISORDERS. INTO
THEIR MOST SEVERE FORM SUBSTANCE
USE DISORDERS DEPRIVE
INDIVIDUALS OF THEIR CAPACITY TO
CHOOSE. FOR THIS POPULATION
EXPECTING CHANGE BY REQUIRING
THAT THEY HIT ROCK BOTTOM IS A
DEATH SENTENCE. WITHOUT QUESTION
MORE RESOURCES NEED TO BE
APPROPRIATED TO THE MENTAL TO
MENTAL HEALTH CARE INCLUDING
SUBSTANCE USE DISORDERS. AND I
THINK SENATOR EGGMAN FOR WORKING
WITH THE GOVERNOR ON THIS ISSUE
AS WELL. BUT OUR CIVIL
COMMITMENT LAW IS NOT ABOUT
FUNDING. LPS LAW IS HOW WE AS A
SOCIETY EXPRESS OUR VALUES OF
PROTECTING THE MOST. VULNERABLE
INDIVIDUALS IN OUR COMMUNITIES.
THANK YOU FOR YOUR TIME I
AVAILABLE FOR QUESTIONS. THANK
YOU CHAIR. THANK YOU SURE WOULD
AND MEMBERS OF THE ASSEMBLY
HEALTH COMMITTEE FOR THIS
OPPORTUNITY TO SPEAK. ON BEHALF
OF FAMILIES LIKE MINE WHO ARE
STRONG. AND UNITED IN SUPPORT
OF. SB FORTY THREE. I AM TERESA
PASQUINI AN ARMY MEMBER AND AN
AMBASSADOR FOR TREATMENT
ADVOCACY CENTERS CALIFORNIA
ADVOCATES. TODAY I'M A
REPRESENTATIVE VOICE OF FAMILIES
LIKE MINE. WHO ARE FAMILIES LIKE
MINE. WE ARE UNSUPPORTED CARE
GIVERS AND CURBSIDE CARE GIVERS.
WHO SEARCH THE TENDER LORD OR
SKIN WROTE SKID ROW'S CALLING
OUT THE NAMES OF OUR BELOVED
ADULT CHILDREN. WE TRY TO KEEP
OUR LOVED ONES ALIVE AND PREVENT
THEM FROM BEING FORCED INTO
STREET CORNERS SOLITARY JAIL
CELLS OR COFFINS. TOO OFTEN WE
ARE UNSUCCESSFUL AND END UP
VISITING THEM AT GRAVE SITES ARE
IN JAILS. WHERE WE ARE FORCED TO
TOUCH THEM ONLY THROUGH CLASS.
WE WATCH THEM TREMBLE WHILE
TRYING TO HOLD THE PHONE DURING
A VISIT WHAT CHAINS BIND THEIR
FEET. AND HANDS. WE VOWED TO
NEVER EVER GIVE UP UNTIL THIS
INHUMANITY ENDS. I AM HERE TODAY
IS THE PROUD MOM OF AN ADULT SON
WHO LIVES HOW ROBUSTLY WITH THE
CO OCCURRING SMI IN SUBSTANCE
USE DISORDER WHICH OUR BRAIN
ILLNESSES NOT BEHAVIORAL
CHOICES. HE WAS DIAGNOSED IN HIS
TEENS FIFTY ONE FIFTY OVER FORTY
TIMES ON LPS CONSERVATORSHIP FOR
OVER TWENTY ONE YEARS. IN PLACE
IN MULTIPLE OUT OF COUNTY
PLACEMENTS. HE WAS ARRESTED AND
CRIMINALIZED AS A PATIENT DEEMED
INCOMPETENT TO STAND TRIAL. HELD
IN SOLITARY OFTEN ON FOR FOUR
YEARS BEFORE FINALLY HAVING ALL
CHARGES DROPPED AFTER BEING
DIVERTED TO A SECURE I. M. D.
THAT PLACEMENT ALLOWED HIM TO
GAIN INSIGHT A CHIEF MEDICAL AND
PSYCHIATRIC STABILITY. AND
SUCCESSFULLY TRANSFER TO A
COMMUNITY PLACEMENT WHERE HE HAS
LIVED FOR THE PAST FOUR YEARS.
WITH THE RECOMMENDATION OF TWO
DOCTORS BY HIS OUT AND BY HIS
OWN CHOICE HE IS STILL ON AN LPS
CONSERVATORSHIP. I AM HOPEFUL
THAT HIS REVOLVING THROUGH ALL
THE WRONG DOORS HAS ENDED. FOR
SOMEONE IN LPS CONSERVATORSHIP
AND I AM DO YOU LEVEL OF KERR IS
THE APPROPRIATE LEAST
RESTRICTIVE ENVIRONMENT AND MUST
BE AVAILABLE TO ALL WHO NEED
THAT LEVEL OF CARE. AND A
CLINICALLY STAFF STRUCTURED STEP
DOWN FACILITY IN THE COMMUNITY
IS CRITICAL TO CONTINUITY OF
CARE. MY SON IS ALIVE TODAY
BECAUSE HE FINALLY RECEIVED
CONTINUOUS MEDICALLY NECESSARY
TREATMENT IN A STRUCTURED
THERAPEUTIC SECURE SETTING.
AFTER TWENTY YEARS OF BEING
FAILED JAIL TREATED N. STREET
DID HE IS CURRENTLY LIVING IN
SAFETY AND RECOVERY AT A SYNERGY
PROGRAM HERE IN SACRAMENTO IT IS
WHAT I CALL HOUSING THAT HEALS.
WE MUST NO LONGER CHERRY PICK
WHICH BRAIN ALMOST DESERVES A
RIGHT TO TREATMENT. AND
DIGNIFIED HOUSING OR WHO'S LEFT
TO DIE ON THE STREETS WITH THEIR
RIGHTS ON. CALIFORNIA MUST LOWER
THE BAR FOR GREAT DISABILITY AND
REYES AT HIGHER FOR
INCARCERATION MAKE IT EASIER TO
GET TO A HOSPITAL BED AND
HOUSING THAT HEALS. RATHER THAN
A STREET CORNER OR JAIL CELL.
FAMILIES LIKE MINE OUR PARTNERS
IN CARE WHO WANT OUR LOVED ONES
TO LIVE WITH THEIR RIGHTS ON.
THIS IS OUR MOVEMENT AND THIS IS
OUR MOMENT. AND WE THANK YOU
SENATOR EGGMAN FOR YOUR FEARLESS
LEADERSHIP AND DEEP
DETERMINATION. TO BE A
PARTNERING KAREN CHANGE WITH
FAMILIES LIKE YOURS AND MINE. WE
ARE WITH YOU. WE URGE. A VOTE.
IN SUPPORT OF THIS BILL THANK
YOU. THANK YOU. OTHERS IN
SUPPORT OF THE BILL JUST YOUR
NAME AND ORGANIZATION PLEASE.
MISTER CHAIR MEMBERS OF THE
COMMITTEE RANDALL HACKER- WITH A
COUPLE HATS HERE TODAY-
REPRESENTING THE PSYCHIATRIC
PHYSICIANS ALLIANCE OF
CALIFORNIA- AS A BOARD MEMBER OF
THE TREATMENT ADVOCACY
COALITION- IN ARLINGTON
VIRGINIA- WHICH STRONGLY
SUPPORTS THIS BILL AND WELL. AS
WELL AS THE FATHER OF A SON WHO
IS CURRENTLY CONSERVE HERE IN
SACRAMENTO COUNTY. HE HAS
SCHIZOPHRENIA. THANK YOU.
ELIZABETH PINEAU HOPPER MOTHER
OF A DAUGHTER LIVING HER UGLY
WITH SKITS EFFECTIVE DISORDER
AND SUBSTANCE USE DISORDER I
LIVE IN CARMICHAEL. THANK YOU.
ALISON MUNRO. ALAMEDA COUNTY
FAMILIES ADVOCATING FOR THE
SERIOUSLY MENTALLY ILL. MOTHER
OF A LADY WAS SCHIZOPHRENIA
WHO'S ALIVE TODAY BECAUSE OF
CONSERVATORSHIP. THANK YOU. GOOD
EVENING. MELANIE CLEAN COMMAND
MOTHER ADVOCATE FOR A MISSING
DAUGHTER WHO IS WONDERING OUR
STREETS WITH A SEVERE MENTAL
ILLNESS. YOUR. MARION BERNARD
NAMI MEMBER MEMBER OF FAZE ME
FAMILY ADVOCATES FOR INDIVIDUALS
WITH SEVERE MENTAL ILLNESS IN
SACRAMENTO. THE MOTHER OF A
SEVERELY MENTALLY ILL ADULTS THE
FORMER COUNSEL TO STATE
HOSPITALS IN ANOTHER STATE THAT
HAD FAR SUPERIOR LAWS IN. VERY
HAPPY TO SUPPORT THIS. VASTLY
IMPROVED DEFINITION OF GREAT
DISABILITY. THANK YOU. GOOD
EVENING MR CHAIRMAN MEMBERS I'M
WHERE TOP HERE ON BEHALF OF SAN
DIEGO MAYOR TODD GLORIA AS WELL
AS THE BIG CITY MAYORS COALITION
WHICH IS THE COALITION OF THE-
THIRTEEN LARGEST CITIES MAYORS
IN CALIFORNIA THEY ARE THE CO
SPONSORS OF THE MEASURE IN
RESPECTFULLY ASK YOUR AYE VOTE.
THANK YOU. GOOD EVENING MISTER
MEMBERS ROSS BUCKLEY ON BEHALF
SACRAMENTO MAYOR DARRELL
STEINBERG OR THANK YOU. THE
TERROR CARE ROSS ON BEHALF OF
THE CITY OF STOCKTON. THANK YOU
. LAUREN RETALIATE ED MOTHER OF
A LOVED ONE WITH A SERIOUS
MENTAL ILLNESS AND SUBSTANCE USE
DISORDER WHO WILL NOT. TAKE CARE
AND LOOK OUT OF ALL ENTIRELY
THANK YOU CAN I SUPPORT THIS
BILL. MISTER MEMBER SPOILER
BEHALF OF SAN FRANCISCO MARYLAND
BREED IN THE SAN FRANCISCO BOARD
OF SUPERVISORS IN STRONG SUPPORT
THANK YOU. CARE OUT OF ALL
MEMBERS DAVID COMPOST ON BEHALF
OF THE COUNTY OF SANTA CLARA WE
SUPPORT THE BILL IF AMENDED AND
ARE GRATEFUL TO SENATOR EGGMAN
IN THE COMMITTEE FOR THE GREAT
WORK IN ADDRESSING CONCERNS
LISTENING I LOOK FORWARD TO
READING THE SPECIFICS THAT COME
OUT OF COMMITTEE THANK YOU THANK
YOU. REMEMBER NICK ROMA BEHALF
OF SAN JOSE MAYOR MATT MAY HANG
IN SUPPORT THANK YOU. MISTER
CHAIRMAN OF THE COMMITTEE
BRANDED MARCH WITH THE
CALIFORNIA MATTERED MEDICAL
ASSOCIATION IN SUPPORT THANK YOU
. GOOD EVENING CURLY SHALL BE
WITH THE CITY OF PALO ALTO IN
THE TRI VALLEY CITIES COALITION
IN STRONG SUPPORT THANK YOU
THANK YOU. IS THIS ONE ARE THE
SUTTER COUNTY BOARD OF
SUPERVISORS IN SUPPORT OF A MAN
THINKING THANK YOU. THANK YOU
MISTER CHAIRMAN FIRST OBSERVERS
ON BEHALF OF THE CALIFORNIA
PROFESSIONAL FIREFIGHTERS AND
SUPPORT. THANK YOU. OPPOSITION
TO THE BILL THEY WITNESSES. THIS
COMPORTED.
YOU HAVE TO SET THE PUSH A
BUTTON IT'S OUR VERSION OF THE
ZOOM YOU. THANK YOU. J. THE
INSTRUCTIONS. I'M CHAIRED
MEMBERS MY NAME IS SAMUEL JAN
ATTORNEY WITH DISABILITY RIGHTS
CALIFORNIA. WE SHARE THE
CONCERNS OF THE AUTHOR THAT
THEY'RE INDIVIDUALS WHO ARE
DYING ON OUR STREETS WITHOUT THE
SUPPORTS THAT THEY NEED TO LIVE
IN RECOVER. WE SHARE THE
AUTHOR'S URGENCY TO ADDRESS THE
SIGNIFICANT NUMBER OF PEOPLE
WITH MENTAL HEALTH DISABILITIES
IN OUR JAILS AND PRISONS WE
SHARE THE DISTRESS OF THE AUTHOR
AND SPONSORS OF SEEING OUR
FELLOW CALIFORNIANS LIVING ON
THE STREETS. THESE ARE FAMILY
MEMBERS FRIENDS AND LOVED ONES.
WE DIVERGE SHARPLY ON THE
SOLUTION. LOCKING PEOPLE UP IN
PSYCHIATRIC HOSPITALS FOR
THOUSANDS OF DOLLARS A DAY WILL
NOT FIX OUR HOUSING CRISIS IT
WILL NOT SOLVE HOMELESSNESS.
ERODING THE CIVIL RIGHTS OF
MARGINALIZED GROUPS INCLUDING
PEOPLE WITH DISABILITIES AND A
DISPROPORTIONATE NUMBER OF
PEOPLE OF COLOR WILL NOT DIVERT
PEOPLE FROM OUR JAILS AND
PRISONS. THIS STORY IS CHAIRED
BY THE AUTHOR. OF INDIVIDUALS
WHO NEED HELP RT ME CRITERIA
UNDER THE CURRENT DEFINITION OF
GREAT DISABILITY. I'VE
REPRESENTED THOUSANDS OF
INDIVIDUALS CERTIFIED ON GRAVE
DISABILITY AND I KNOW THIS LAW
INTIMATELY. THE PROBLEM IS NOT
THAT WE DON'T HAVE A WIDE ENOUGH
AND THAT. IT'S THAT WITHOUT
HOUSING THESE INDIVIDUALS ARE
DISCHARGED BACK ON TO THE
STREETS INTO THE SAME SITUATION
WITHOUT THE SERVICES AND
SUPPORTS THAT THEY NEED TO
RECOVER. OUR OWN STATE AUDITOR
SAID THE CURRENT INVOLUNTARY
CRITERIA IS SUFFICIENT. WHAT'S
NEEDED IS CONSISTENTLY
CONNECTING INDIVIDUALS EXITING
INVOLUNTARY HOLDS TO ONGOING
SERVICES WE AGREE. EXPANDING
INVOLUNTARY CRITERIA WILL ONLY
PERPETUATE THE REVOLVING DOOR OF
HOMELESS HOUSE LOOSENESS AND
INSTITUTIONALIZATION. SB FORTY
THREE WILL NOT BREAK THIS CYCLE
. WE SHARED OUR ALTERNATIVE
PROPOSAL. WITH THE CHAIRED AN
AUTHOR OUR PROPOSAL HAS THREE
COMPONENTS. FIRST WE NEED TO
MANDATE THAT HOUSING IS OFFERED
FOR INDIVIDUALS WITH SERIOUS AND
PERSISTENT MENTAL ILLNESS THE
GOVERNOR SAID HIS NEW IMAGES A
MODERNIZATION PROPOSAL WILL
HOUSE SIX THOUSAND INDIVIDUALS
WE NEED TO HOUSE FIFTY THOUSAND.
SECOND WE NEED TO ENSURE PEOPLE
HAVE THE SUPPORT THEY NEED TO
STAY IN HOUSING BY STRENGTHENING
REQUIREMENTS FOR SUPPORTIVE
SERVICES CURRENTLY THESE
REQUIREMENTS ARE TOO VAGUE.
THIRD WE NEED TO EXPAND OUR
BEHAVIORAL HEALTH CRISIS
SERVICES THESE SYSTEMS NEED THE
FLEXIBILITY TO PROVIDE
INTERVENTION AND BEAT LEE. AND
IN A WAY THAT ENCOURAGES PEOPLE
TO SEEK HELP. WE NEED TO ENSURE
OUR COUNTIES HAVE THE FUNDING TO
PROVIDE THESE SERVICES THESE ARE
EVIDENCE BASED PRACTICES BACKED
BY DECADES OF RESEARCH UNLIKE SB
FORTY THREE. SB FORTY THREE WILL
NOT PROVIDE THE SOLUTIONS
PROMISE IT WILL ONLY ADD STRAIN
TO AN ALREADY OVERBURDENED
SYSTEM AND PULL RESOURCES FROM
WHERE WE NEED IT MOST. WE URGE
THIS COMMITTEE TO VOTE NOW THANK
YOU. HI GOOD AFTERNOON MY NAME
IS CLAIRE COURT RIGHT I AM AN
ATTORNEY M. POLICY DIRECTOR AT
COWBOYS SAYS. WE ARE A MENTAL
HEALTH PEER RUN ORGANIZATION
MEANING WE ARE RUN ENTIRELY BY
AND FOR PEOPLE WITH SERIOUS
MENTAL ILLNESS- I'M ALSO A
FAMILY MEMBER- AND A PERSON WITH
LIVED EXPERIENCE OF THESE
INVOLUNTARY SYSTEMS AND WAS.
UNFORTUNATELY PRETTY
CATASTROPHICALLY HARMED BY THEM
- I'D LIKE TO THANK THE
COMMITTEE FOR ITS WORK ON THIS
BILL AND WE LOOK FORWARD TO-
BILL LANGUAGE THAT'S GOING TO
COME OUT WITH AMENDMENTS HOWEVER
WE REMAIN IN OPPOSITION-
BRIEFLY. UP A FEW THINGS THAT
WE'VE NOT HEARD DISCUSSED IN
PRIOR HEARINGS ARE REALLY IN THE
MEDIA THAT- WE THINK THERE ARE
SOME- DISCUSSION WE'D LIKE TO
TOUCH ON- M. DOT IS FIRST THE
ROLE OF POLICE IN SB FORTY
THREE. HIS SB FORTY THREE
GREATLY EXPLAINS THE ROLE OF
POLICE IN AN UNPRECEDENTED
FASHION. IN EVERY COUNTY IN
CALIFORNIA THE PEOPLE AND THE
ONLY PEOPLE WHO CAN TAKE A PRO
TESTING PERSON. PHYSICALLY INTO
CUSTODY AGAINST THEIR WELL ARE
THE POLICE AND AT A TIME WHEN
WE'RE TRYING TO GET POLICE. OUT
OF BEHAVIORAL HEALTH RESPONSE
ACROSS THE COUNTRY BECAUSE FAR
TOO MANY DISABLED PEOPLE AND FAR
TOO MANY PEOPLE OF COLOR ARE
DYING IN ENCOUNTERS WITH POLICE-
SB FORTY THREE PUTS HIM RIGHT
BACK AND- AND THE NATURE OF THE
CRITERIA AND SB FORTY THREE ARE
NOT SOMETHING THAT POLICE ARE
PARTICULARLY GOOD. OR QUALIFIED
TO ASSESS DO YOU HAVE A MEDICAL
CONDITION IS IT SERIOUS AT THE
STREET LEVEL THIS IS ALL FIRST
BLUSH AND WE'RE CONCERNED ABOUT
THE ROLE PLEASE SPECIFICALLY-
BECAUSE THIS BILL IS OFTEN
MENTIONED IN TANDEM WITH
CLEARING ENCAMPMENTS- WE'D ALSO
LIKE TO FOCUS- SOME CONVERSATION
HOPEFULLY AROUND THE INCLUSION
OF MEDICAL CARE AS A GROUNDS FOR
A HOLD. IT CREATES A LEGAL
MISMATCH- ALTHOUGH PEOPLE IN IN
IN THE- PROPONENTS OF THIS BILL
OFTEN SAY THAT A SORT OF APPLIES
TO IN HOUSE PEOPLE PEOPLE WHO
ARE INCOMPETENT- PEOPLE WHO ARE
SERIOUSLY MEDICALLY ILL EXCEPT
TRUCK- THAT'S NOT ACCURATE AND
THERE'S A MISMATCH BETWEEN. THE
MEDICAL INCOMPETENCE TO BE
PLACED ON A HOLE IN CALIFORNIA
DOES NOT INVOLVE AN EDUCATION OF
INCOMPETENCE- SO YOU'RE TALKING
ABOUT PUTTING PEOPLE ON A HOLD
FOR FAILURE TO ATTEND TO A
MEDICAL CONDITION. BUT YOU
CANNOT TREAT THOSE PEOPLE ARE
BECAUSE THEY ARE ACTUALLY NOT
DEEMED INCOMPETENT TO THOSE
PEOPLE BACK UP IN OUR E. OURS
ARE BECAUSE THEY CANNOT GO TO A
MENTAL HOSPITAL OR TO ANOTHER
FACILITY THAT DOESN'T TREAT
MEDICAL CONDITIONS- IS ANOTHER
SERIOUS CONDITION WITH X. A
SERIOUS CONSIDERATION FOR
EXPANDING AND I THINK I'M JUST
ABOUT OUT OF TIME. THANK YOU
OTHERS IN OPPOSITION. GOOD
EVENING LINDA WAY WITH WESTERN
CENTER ON LAW AND POVERTY OPPOSE
THANK YOU. SUSAN GALLAGHER WITH
EXECUTIVE DIRECTOR OF CAL VOICES
CIVIL RIGHTS MATTER WE ARE
OPPOSED THANK YOU. HI EVERYONE
RACHEL BHAGWAT WITH ACLU
CALIFORNIA ACTION STRONGLY
OPPOSE THANK YOU. AFREMOV
INTERIM POLICY DIRECTOR OF AND
ON BEHALF OF THE DISABLED
STUDENTS COMMISSION OF THE
ASSOCIATED STUDENTS OF THE
UNIVERSITY OF CALIFORNIA IN
OPPOSITION. THANK YOU. THEN IF
THEY'RE GOING TO HAVE A MENTAL
HEALTH AMERICA OF CALIFORNIA AND
THE CALIFORNIA DEPARTMENT AT
WORK IN OPPOSITION THANK YOU.
GOOD EVENING AB HOLE IN THE
CENTER I AM A PAIR WITH LIVED
EXPERIENCE I AM ALSO HERE ON
BEHALF OF CAMPOREALE CALIFORNIA
ASSOCIATION OF MENTAL HEALTH
PIRENNE ORGANIZATIONS WE ARE IN
STRONG OPPOSITION. THANK YOU.
PAUL SIMONS WITH THE DEPRESSION
AND BIPOLAR SUPPORT ALLIANCE OF
CALIFORNIA AND ALSO THE FATHER
OF A- YOUNG LADY WHO WHEN SHE
WAS YOUNGER. WAS PUT INTO. APPLE
INVOLUNTARY TREATMENT AND WHEN
SHE GOT OUT SHE BECAME HOMELESS
AND ATTEMPTED SUICIDE IT'S NOT
THE ANSWER. THANK YOU. IF YOU'RE
IN MEMBERS ROBERT HARRIS ON
BEHALF OF SEIU CALIFORNIA WE
HAVE A POSITION OF OPPOSE UNLESS
AMENDED WE WOULD LIKE SOME
FISCAL THINGS TAKEN CARE OF THAT
ALL AREN'T ADDRESSED. AND WE
THINK YOU NEED A LITTLE BIT
DEEPER UNDERSTANDING OF WHAT S.
U. D. ISN'T HOW IT WORKS. THANK
THANK YOU. IS THIS ONE ARE
BEHALF THE FRESNO KERN AND
SOLANO BOARD OF SUPERVISORS- IN
OPPOSITION THANK YOU. THANK YOU
. ANYONE ELSE. IF YOU KIND OF
TWEENER SEWER OKAY ERIC. GOOD
EVENING MISTER CHAIR MEMBERS
GIULIANA THERE WITH THE
CALIFORNIA STATE ASSOCIATION OF
COUNTIES ALSO HERE TONIGHT ON
BEHALF OF THE COUNTY BEHAVIORAL
HEALTH DIRECTORS ASSOCIATION
WITH THE POSITION OF CONCERNS I
DID WANT TO BOTH- THANK ALL OF
THE EFFORTS OF REGARDING THE
AMENDMENTS AGREED TO IN CONCEPT-
AS OUTLINED IN YOUR ANALYSIS AND
LOOK FOR TO CONTINUE
DISCUSSIONS. THANK YOU. KELLY
BROOKS I'M HERE ON BEHALF OF THE
URBAN COUNTIES OF CALIFORNIA AND
THE RURAL COUNTY REPRESENTATIVES
OF CALIFORNIA WE ALSO HAVE-
CONCERNS A LOOK FORWARD TO
WORKING WITH EVERYONE IN THE
MEASURE AS IT MOVES TOWARD.
THANK YOU. OKAY A BRING BACK TO
THE COMMITTEE AND- THIS WALDRON
HAS QUESTIONS. THANK YOU MISTER
CHAIR- I LIKE TO THANK THE
AUTHOR FOR ALL OF HER HARD WORK
IN THIS ISSUE IN THIS SPACE
THROUGH THE YEARS AND- THIS
PARTICULAR BILL- WE KNOW PEOPLE
ARE FALLING THROUGH THE CRACKS.
DUE TO THE LACK OF AN
APPROPRIATE DEFINITION
BASICALLY- THE STANDARD HAS BEEN
BASICALLY THE SAME FOR ALMOST
SIXTY YEARS. AND IT'S A SERIOUS
BARRIER TO GETTING PEOPLE THE
NEEDED HELP THEY NEED- BUT IT
ALSO. THE COMMENTS ABOUT YOUR
ADULT CHILD I MEAN WHEN I'M IN
THE DISTRICT AND I TALK ABOUT
THINGS THAT ARE GOING ON IN
SACRAMENTO I ALWAYS TALK ABOUT
MENTAL HEALTH ISSUES. AND
SUBSTANCE USE ISSUES. AND EVERY
SINGLE TIME PEOPLE COME UP TO ME
AFTER THE MEETING IN THERE YOU
KNOW AMAZED AT WHAT WE TRY TO DO
THEIR MAYES THAT I EVEN TALKED
ABOUT IT AT ALL- A LOT OF TIMES
IT'S PARENTS OF ADULT CHILDREN
BECAUSE THAT'S WHERE IT'S STILL
DIFFICULT. FOR PARENTS EVEN KNOW
WHAT'S GOING ON- YOU KNOW.
YOU'RE THE LOVED ONE OF THAT
PERSON AND JUST BECAUSE THEY'RE-
OVER EIGHTEEN. NOW ALL OF A
SUDDEN YOU CAN'T EVEN KNOW WHERE
THEY ARE. WHAT'S GOING ON WITH
THEM- YOU KNOW THE CRIMINAL
JUSTICE SYSTEM CAN NEVER ADDRESS
THE OLDMAN CAUSES. AND
ESPECIALLY WITH MENTAL HEALTH
AND COLD CURRENT DISORDERS-
REGARDING A C. D. THAT'S WHY
LIKE THESE. AMENDMENTS EVEN
THOUGH THEY'RE NOT IN PRINT AND
JUST. BEING ABLE TO NARROW DOWN
ON TO THESE AND GET THESE YOU
KNOW THE FIND. IS MAKING THIS
ACTUALLY ONE OF THE MOST
IMPORTANT BILLS WE'RE GOING TO
BE VOTING ON I THINK THIS YEAR
BECAUSE OF THE AMOUNT OF IMPACT
IT COULD HAVE IN OUR
COMMUNITIES- IT IS CIVIL I
ALWAYS SAY A CIVILIZED SOCIETY
CANNOT CONTINUE TO IGNORE THE
HUMANITY OF PEOPLE WHO ARE ON
THE STREETS AND THE CONDITIONS
THAT THEY'RE IN- WHO ARE
LITERALLY DYING. IN OUR STREETS
SO. HER SUPPORT OF THIS BILL
THANK YOU. I MISS RICARDIAN AND
DR WEBBER YES I AM THANK YOU AND
JUST WANT TO. CONTINUE WITH
WHERE ASSEMBLYMEMBER WALDRON
NOTED JUST FRANKLY THINKING-
SENATOR EGGMAN. LEADING ON THIS
ISSUES EVEN WHEN YOUR YOUR IN
OUR HOUSE AND NOW WE HAD. A
MULTI HOUR INFORMATIONAL HEARING
ABOUT THIS COUPLE YEARS AGO
DOCTOR WOULD. AND THESE ARE
THESE ARE PAINFUL PROPOSALS AND
THEY'RE NOT EASY AND STUFF I
NEED I KNOW THAT PEOPLE THAT ARE
SUPPORTING THESE PROPOSALS ARE
YOUR ALLIES OVER THE YEARS YOU
KNOW COMING UP AS THAT SOCIAL
WORKER AND SOMEBODY WANTS TO
HELP PEOPLE AND SO- BUT THERE'S
A REASON WHY THESE ARE PASSING
WITH UNANIMOUS SUPPORT OVER AND
OVER. BECAUSE WE KNOW BOTH SIDES
OF THE AISLE UP AND DOWN
CALIFORNIA FROM RURAL CALIFORNIA
TO. RIGHT OUTSIDE THE STATE
CAPITOL TO STOCKTON. THE NORTH
COAST GUARD- DOCTOR WOULD
REPRESENTS THAT THE STATUS QUO
IS JUST. NOT WORKING AND- YOU
KNOW I READ WITH GREAT- IN THAT
THE- PROFILE. WHAT'S THE
INDIVIDUAL'S NAME AGAIN. MIKE
RIPPEY REPEAT. LONG COUNTY YES.
WHEN THEY WHEN THEY PROFILE THIS
INDIVIDUAL JUST DOWN THE STREET
AND HIS FAMILY. JUST GIVE US
EXAMPLE AND HE'S JUST ONE AND I
DON'T KNOW PEOPLE'S NAMES BUT I
KNOW- IS A WOMAN RIGHT BY OUR
KIDS MIDDLE SCHOOL DOWN HERE
SATURDAY AT THE SAME. EXAMPLE
AND SHE- PASSED AWAY AFTER WE
COULD NOT GET THE HELP THAT SHE-
SHE NEEDED AND- YOU KNOW. THAT
THE LINE THAT YOU HAVE BEEN
USING IS A STICKS WITH ME THAT
YOU KNOW. WE HAVE THESE RIGHTS
THIS POLICY THAT WE CREATED
NINETEEN SIXTY SEVEN THAT WE
THOUGHT WOULD. BE WORKING IN THE
COMMUNITY WOULD RALLY AND HELP
ON A COMMUNITY BASIS GET READ
THE STATE INSTITUTIONAL
PROGRAMS. AND YOU KNOW YOU SAY
THAT PEOPLE ARE DYING WITH THE
RIGHTS ON AND THAT IS SO TRUE.
SO TRUE. AND YOU KNOW WHAT THE
TRUTH HURTS SOMETIMES. AND THIS
IS EXACTLY WHAT THIS IS ABOUT
AND I- AND IN IN IN SUPPORT I'M
GOING TO BE A CO AUTHOR AND SHE
WERE WORKING ON THIS IF NOT
PLEASE NOTE THAT STAFF- WE HAVE
THE SAME TOUGH COMMUNISM WITH
WITH CARE COURTS LAST YEAR. AND
THERE'S NOT ONE THING THAT WE
CAN DO NOBODY HAS A SECRET PLAN
TO DEAL WITH THIS ITS- INOTES
CASCADING ISSUES AND- YOU KNOW.
IT MENTAL HEALTH
INTERGENERATIONAL POVERTY
HOMELESSNESS ALL THOSE THINGS.
IN ONE BUT THIS IS MY VIEW A KEY
PIECE OF THE PUZZLE BECAUSE THE
DEFINITION. THAT I WANNA RIGHT
ALONG WITH OUR FIREFIGHTERS HERE
SECHNAILL MONTHS AGO. THE
SEATTLE YOU HAVE TO BE EITHER BE
THREATENED TO KILL SOMEBODY. OR
HE'S ACTUALLY ABOUT TO KILL
YOURSELF AND- DISCREETLY.
DISABLE THING DOESN'T REALLY
WORK YOU KNOW JUST. AND THEY DO
GIVEN HIS CAR EXAMPLES OF THAT
ARE YOU KIDDING ME WE CAN'T HELP
TAKE THAT PERSON ANY BROTHER
FAMILY WANTS TO LIKE NO. NOPE
BUT THROUGH THE CRACKS. AND TOO
MANY PEOPLE SLIP THROUGH THE
CRACKS. AND- BUT I DO THINK THAT
THERE IS ONE LEGITIMATE- THING
THAT WE NEED TO ADDRESS AND I
WANT YOU TO ANSWER I KNOW YOU'RE
ANSWERING THE CALL WITH THE
OTHER. LEGISLATION THAT YOU'RE
WORKING ON WITH A CHAIR AND THAT
IS ONCE. A SICKLY THIS BOX IS
CHECKED ON WHATEVER SELLS FORMER
AFTER PHONE THAT HATE THAT WE'RE
GONNA UTILIZE THIS TOOL. TO HELP
THIS PERSON. NOT TURN THE MEN TO
LITERALLY HELP THEM. THE
PLACEMENT AND I KNOW THE SAME
THING WITH CARE COURT SO. CAN WE
TALK ABOUT THAT FOR A LITTLE BIT
AND WHAT'S YOUR RESPONSE ON AND
HOW WE WOULD HAVE THE NUMBER OF
BEDS I HAD ONE. GENTLEMAN HERE
SAY WITH ONLY SIX THOUSAND FIFTY
THOUSAND SO. I'M NOT SURE THAT'S
ACCURATE NUMBERS BUT CAN YOU
ENLIGHTEN US ON THIS ISSUE. YEAH
SO I MEAN YOU'VE ALL BEEN HERE
AND KNOWING HOW MUCH MONEY WE'VE
BEEN SENDING DOWN RIGHT WE ARE
NOW IN OUR FIFTH ROUND OF- THE
PROGRAM TO FUND- ADDITIONAL
FACILITIES AND ALL OF THAT MONEY
HAS BEEN. SO THOSE ARE ALL THOSE
ARE ALL GOING. INTO EFFECT AS WE
SIT HERE TODAY I MEAN THERE'S
BEEN. A MAJOR FIVE BILLION
DOLLARS GOING DOWN IN THE BRIDGE
PROGRAM. WE'RE NOW GOING INTO
ROUND FIVE AND WE PUSH BACK WITH
THE ADMINISTRATION WHO WANT TO
HOLD THAT LAST ROUND. GET IT
OUT. TO ALL OF THOSE HAVE PLANS
FOR A NEW BEDS TO BE BUILT. WE
ARE WORKING. WITH THE-
ADMINISTRATION ON THE BEHAVIORAL
HEALTH. INITIATIVE WHICH WILL
COME. WITH SOME OF THE BOND AND
WITH- WITH MORE FUNDING FOR BEDS
FOR STEP DOWNS FOR VILLAGES FOR
HOUSING THE HEELS ALL OF THOSE
THINGS THAT ARE. ARE SO
IMPORTANT. I WILL ALSO ADD THAT
A FEW WEEKS AGO THIS COMMITTEE
PASSED OUT- THE BILL I DID ON
THE ONLINE ON TIME DATABASE.
THAT BECAUSE CURRENTLY IF YOU GO
TO TRY TO GET SOMEONE PLACEMENT
YOU'RE STILL LOOKING AT OLD. YOU
KNOW NOTEBOOKING TRYING TO CALL
YOU HAVE A BAD YOU HAVE A BAD TO
HAVE A BED. TO BE ABLE TO SAY I
MEAN WE HAVE A AYE WE HAVE
EVERYTHING THAT CAN TELL US.
DIRECTIONS OUT A BANKER TO DO
ANYTHING WE CAN CERTAINLY HAVE
AN ONLINE ON TIME. DATABASE IT
TELLS US WHERE IS THE BAD WORDS
ISSUE WE STEVE EDWARDS A LOCK
WHICH IS SECURE WHERE IS A STEP
DOWN. SO THAT IS GOING INTO
EFFECT AS WELL- AND WE ARE OPEN
TO JUST BECAUSE TO GIVES THE
COUNTY SOMETIME ONE OF THE
AMENDMENTS WE'VE AGREED TO WITH
THE CHAIR. IS TO HAVE SOME OF
THE SOME OF THAT. YOU'RE A- SOME
AREAS REALLY WANTED TO GO RIGHT
AWAY WITH SB FORTY THREE BUT WE
HAVE SAID. GOES INTO EFFECT ON
TWENTY FOUR BUT ANY BOARD OF
SUPERVISORS CAN TAKE. A VOTE TO
HAD TO DELAY THE IMPLEMENTATION.
UNTIL TWENTY FIVE. BUT TO GIVE
PEOPLE CHANCE FOR THE BONTA PASS
AND FOR THE MORE FACILITIES TO
COME ON BOARD. SO CAPACITY IS
ALWAYS GOING TO BE AN ISSUE BUT
WE HAVE TO START. I MEAN WE HAVE
TO START SOMEWHERE WE HAVE BEEN-
WE HAVE BEEN INCREASING
INCREASINGLY HAVE. THE WE HAD
MULTIPLE NEW FACILITIES. AND WE
HAVE TO BE ABLE TO HAVE OUR
FUNDING TO MATCH THAT. AS WITH
THE EXPANSION OF MEDICARE L. AND
WITH THE- POTENTIAL WAIVER THAT
WE HAVE COMING. IS A THING AS
LONG AS WE HAVE PAYMENT SOURCES-
WILL PUT THE BEDS THE BEDS WON'T
BE AS BIG OF AN ISSUE. AND
CURRENTLY THAT AGAIN PEOPLE ARE
JUST STAYING ON THE STREETS. AND
OR AND OR GOING TO PRISONS AND
THAT CERTAINLY IS NOT THE ISSUE.
YES OF AB TWO MORE ISSUES HERE
SO. HOW DOES THIS PROPOSAL IS
NOT THIS BILL HERE THAT YOU'RE
WORKING WITH. YOU KNOW DOCTOR
WOULD THE GOVERNOR ON CANNOT. RE
PURPOSING. MODERNIZING MENTAL
HEALTH SERVICES ACT RIGHT SO
THAT THAT'S A PIECE OF THIS BUT
NOT THE ONLY BE STRESSING THAT
DROUGHT RESISTANT THE ONLY PIECE
I MEAN THAT THAT THE PIECES ARE
THE PEACE THAT WE HAVE BEEN
PUTTING TOGETHER. FOR HOUSING
AND ME TO FOR THE HOUSING YET
FOR HOUSING FOR HOUSING AS WELL
WHAT WITH THE PUTTING TOGETHER.
TO TWELVE BILLION ON ON
HOMELESSNESS I THINK AND I
WANTED TO. PUSH BACK ON THE
OPPOSITION WHO SAYS WE'RE
TALKING ABOUT THIS IN
CONJUNCTION WITH. THEIR
ENCAMPMENTS I HAVEN'T BEEN THAT
IS NO PART ANYWHERE OF ANYTHING
THAT I'VE EVER SAID THAT WE'RE
GONNA. CLEARING CAN'T-MISS BY
CONSERVING PEOPLE THAT IS. MEAN
THAT. THAT THAT THAT DOES NOT
RING TREAT TRUMP THAT THAT DOES
NOT RING TRUE TO ME. AND ANYTIME
A POLICE OFFICER INTERVENES WITH
A PERSON A PERSON HAS BEEN TAKEN
TO A FACILITY WHERE THEY ARE.
ASSESSED AND HELD OR NOT HELD IT
IS NOT UP TO THE OFFICER ON THE
STREET. FOR THE CONTINUE
PLACEMENT OF SOMEBODY AND AGAIN
THIS TAKES AWAY NO PART. OF DUE
PROCESS- OF THE CASE. BUT YES
FOR THE PAYMENT- THE THREE POTS
ONE OF THE PARTS WILL BE. JUST
SPECIFICALLY USED. TO BE ABLE TO
HOUSE PEOPLE AND ASK TO BE ABLE
TO PAY FOR THE HOUSING FOR THE
IMPLEMENTATION. AND ALL THOSE
COMPONENTS. THE OTHER BIG POT
WOULD JUST SPOKE A SOLELY ON-
THIS DOES WITH THE MOST SEVERE.
ISSUES AND THEN THE THIRD PART
WILL THEN BE FOR. THAT EARLY
INTERVENTION TO TRY TO REALLY
GET IN ON EARLY PSYCHOSIS WE
KNOW THAT'S ONE OF THE MOST
IMPORTANT THINGS WE CAN DO. IN A
SAFE DESPITE WHAT I MANY WORKING
ON NEXT YEAR BECAUSE I DON'T
THINK THE STATE DOES A GOOD JOB
OF. DOING THAT OF THE EARLY
INTERVENTIONS ON EARLY
PSYCHOSIS. INCREDIBLY IMPORTANT.
AND THAT'LL BE IN THAT THAT
THIRD BUCKET. SO SOME OF THE UP
FRONT THINGS THAT WE'RE DOING
BEFORE THAT WE THOUGHT WERE
GOING TO BE A GOOD IDEA AROUND
INNOVATIONS WE STILL WANT SOME
OF THAT. BUT I THINK THAT WE CAN
ALL AGREE THAT FOR RIGHT NOW. WE
HAVE A MENTAL HEALTH CRISIS AS
IT. AS IT AS IT REFLECTS THOSE
WHO ARE THE MOST ILL. WHO WE
SHOULD BE TREATING FIRST AND NOT
LAST. AND I WILL I HAVE TO SAY
WAS. DOCTOR SUSAN POVERTY. R.
TOBY PART. VIS A PRACTICING IT
THE PSYCHIATRIST OF LOS ANGELES.
WHO DID THAT TERM PEOPLE ARE
DYING WITH THEIR RIGHTS ON
BECAUSE SHE WAS SAYING WE COULD
SAY. OKAY HE'S GONNA DIE
TOMORROW SHE'S GONNA DIE THE
NEXT DAY AND THEN GO BACK. AND
FIND THEM DEAD. BUT WITH THE
RIGHT TIME. OKAY AND THEN LASTLY
I'M MISTER WOULD ONE MORE
QUESTION. SO I DO APPRECIATE AND
THE RECOMMENDATION TO EXPAND-
SUBSTANCE ABUSE. ABUSE DISORDER
BECAUSE CLEARLY THERE'S THAT.
AND IT'S SEVERE IT'S OBVIOUS
THAT A LOT OF PEOPLE HAVE A
GLASS OF WATER SMOKE WEED THAT
IS NOT WHAT WE'RE TALKING ABOUT
AND THERE IS THE- COMBINATION
THERE. THANK GOD RIGHT. THERE'S
A COMBO THERE WITH YOU KNOW
PEOPLE WHO ARE HOMELESS AND
MENTAL ILLNESS ADDICTION AND ALL
THREE OF US TOGETHER. THE GREAT
ISSUES AND- EXPANDED. SO JUST
GIVE US A HYPOTHETICAL SO.
HOPEFULLY THAT WON'T ALWAYS BE
POLICE RESPONDING. SOME YOU KNOW
SOME CITIES LIKE OUR CITIES ARE
HIDING ALTERNATIVE RESPONSE OUT
THERE IT. WILL GO AND WE FUNDED
A LOT OF THAT RIGHT WAS PART OF
OUR LEVERAGED WHEN FIND
SOMEBODY. WHO TRIGGERS IT. LIKE
MR RIGBY. AND THEN- YOU KNOW
THEY TAKEN TO THIS PLACE FOR THE
EVALUATION. WHAT THEY'RE SAYING
IS THERE'S NOT GONNA BE ENOUGH.
BASIS WHAT HAPPENS AT THAT POINT
IS THAT. THAT THAT THE
EVALUATION SAYS YES WE THINK
THAT YOU KNOW IF YOU CAN MEET
THIS DEFINITION. BUT THERE'S
NOWHERE TO GO SO WHAT HAPPENS
THAT PERSON THEN WHAT WE DO.
WELL I WOULD SAY IT'S A SYSTEMS
RESPONSIBILITY TO RESPOND I
MEAN. WE KEEP TALKING ABOUT.
THIS ISSUE AS THOUGH IT SEPARATE
FROM ANY OTHER HEALTH CARE
ISSUE. RIGHT WHEN A WOMAN IS
HAVING A BABY AND SHE GOES THE
HOSPITAL WE DON'T SAY I'M SORRY.
WE DON'T HAVE A BED FOR YOU
RIGHT NOW. YOU'RE GONNA HAVE TO
YOU KNOW GO TO THE STREETS GOING
TO GO TO JAIL THEY HAVE THEY
HAVE PLACE YOU CAN DO IT. RIGHT
WILL HAVE CANCER WILL SAY I'M
SORRY WE DON'T HAVE THE PROPER.
WE DO OUR VERY BEST TO TREAT
THEM. AND I THINK THAT'S WHAT WE
NEED TO HAVE OUR SYSTEM DO.
AGAIN WE'RE NOT MAKING THESE
PEOPLE UP THEY LIVE IN THE
COMMUNITY THEY ARE. CITIZENS OF
THE COMMUNITY. THEY ARE
DESERVING OF THE STATE OF THE
SERVICES. WHAT ELSE DR WOULD IF
SHE WANTS TO RESPOND AT ANY
FURTHER BUT- I THINK. I THINK
BEDS CAN BE FOUND IF THE
CRITERIA IS MET. AND WE AND WE
HAVE. BEEN INVESTING. IN THE
SYSTEM AND YOUR CHOICE. AND I'LL
JUST SAY. THE OPPONENTS THEY
WANT TO TALK ABOUT THE OTHERS
REPORT. THEY DID NOT SUPPORT BY
A. O. T. THEY DID NOT SUPPORT MY
A. O. T. STEP DOWN WITH DRUGS
THEY DID NOT SUPPORT. ANY OF THE
OTHER INTERVENTIONS THAT WE HAVE
DONE THAT THE- AUDITOR
SUGGESTED. SO I MEAN EITHER YOU
LOVE THE AUDITOR OR YOU DON'T. I
WAS A FORMER UNDER DOCTOR WOULD
. IF I THINK THAT THERE'S A
MISUNDERSTANDING FIRSTLY ABOUT
THE- THE- SUCH THAT THAT'S THE
SIZE OF THE GROUP WE'RE TALKING
ABOUT HERE- AT. END AND ALSO
ABOUT- HOW WE HOW WE TREAT
INDIVIDUALS WITH SEVERE. MENTAL
ILLNESS AND SEVERE SUBSTANCE.
USE DISORDERS. SO THAT WE CAN
TREAT THEM IN THE SAME
FACILITIES- THAT A PERSON WHO IS
GRAVELY DISABLED. DO THAT AND WE
MEAN VERY L. DUE TO THEIR
SUBSTANCE USE DISORDER CAN BE AN
ASSET AS A PSYCHIATRIC HOSPITAL.
UNTIL THAT THE- WE CAN FIND A
MORE SUITABLE PLACEMENT FOR
THEM- AND AS A TREE SAID KNOWS
VERY WELL WHILE THERE ARE THERE
IS A PLACE FOR SOME INDIVIDUALS
IN LOCKED FACILITIES. THERE ARE
MANY PEOPLE WHO ARE ON HOLDS WHO
DO NOT NEED TO BE UNLOCKED
FACILITIES BUT DO NEED A VERY
HIGH LEVEL. OF TREATMENT AND
SUPERVISION DURING THE TIME THAT
THEY ARE- ARE GETTING A MORE
WELL AND GETTING SOME MORE
INSIGHT BACK. SO WE ACTUALLY
RIGHT NOW WE BELIEVE WE HAVE THE
BEDS AVAILABLE. NOW FOR THESE
SICK PEOPLE AND PART OF THE
THING THAT WE ARE HAPPY ABOUT IS
THAT THEY THESE OTHER BEDS IN
THE COMMUNITY HAVE. ALREADY ARE
ALREADY COMING ON BOARD BECAUSE
THOSE ARE THE REASONS ARE
HOSPITALS HAVE BIG THINGS
STAYING FALL. IS NOT BEING ABLE
TO GET PEOPLE OUT TO THOSE
LONGER TERM HOUSING-
ALTERNATIVES. SO WE BELIEVE WE
HAVE THE CAPACITY TO- TO TAKE
CARE OF THESE VERY ILL PEOPLE
RIGHT NOW. OKAY THANK YOU. THANK
YOU DOCTOR EVER. THANK YOU-
SENATOR EGGMAN AS AS OTHERS HAVE
STATED FOR REALLY BEING A
CHAMPION IN THIS SPACE- REALLY
REALLY APPRECIATE ALL THE WORK
THAT YOU HAVE DONE ALL OF THE
BILLS THAT YOU HAVE BROUGHT FOR
IT AND ALL OF THE DISCUSSIONS
THAT YOU HAVE. INCITED AMONGST
BOTH THE ASSEMBLY AND SENATE
AROUND THIS ISSUE. I'M SO WITH
THE DEFINITION OF GRAVELY
DISABLED- WHO SPECIFICALLY WOULD
BE GIVING. A INDIVIDUAL THAT
DIAGNOSIS. THE ONLY A PROVIDER
RIGHT YES YES. YES SO- AND THE
REASON WHY I ASK IS I WANT TO
ASK THE OPPOSITION- BECAUSE YOU
STATED SOMETHING ABOUT THE ISSUE
OF ENCAMPMENTS AND- IN MY AREA I
REPRESENT- PARTS OF SAN DIEGO
AND- VERY WELL MAY KNOW ABOUT
THAT. AS AN EAGLE AND SAFE
CAMPING ORDINANCE THAT. WAS JUST
PASSED- THAT DOES DEAL WITH THE
ISSUE OF ENCAMPMENTS SO. HOW
WOULD THIS. INCREASE THE
INTERACTION OR FIVE PEOPLE
BEING. TAKEN OFF OF THE STREETS
FROM. IF SOMEONE HAS ONE OF
THESE ENCAMPMENTS MORTON'S. YEAH
I'M NOT FAMILIAR WITH THE
ENCAMPMENT ORDINANCE IN QUESTION
SO I CAN'T SPEAK TO THAT BUT I
CAN SAY THAT IN EVERY COUNTY IN
CALIFORNIA THE PEOPLE WHO CAN
CATEGORICALLY. RIGHT A FIFTY ONE
FIFTY HOLD ON THEIR OWN OUR
POLICE AND WE HAVE. HE TYPICALLY
SEEN THEM BE OUR FIRST
RESPONDERS ACROSS THE COUNTRY
AND- YOU KNOW HOWEVER EXACTING
THE LEGAL STANDARD MAY APPEAR TO
BE ON PAPER- YOU KNOW I KNOW THE
COMMITTEE PUT IN ALL OF THE DSM
MIKE. CRITERIA FOR SERIOUS
SUBSTANCE USE DISORDER A POLICE
OFFICERS JUST NOT QUALIFIED TO
DO THAT AND SO YOU KNOW THE
CONCERN IS THERE'S A REAL
TEMPTATION TO PICK UP ON HOUSE
TO PEOPLE ON THE STREETS. ALLEN
YOU KNOW I DON'T NECESSARILY
HAVE AN OPINION ABOUT IT BUT
THERE'S LOTS OF REPORTING THAT
THERE'S BEEN. YOU KNOW REALLY
AGGRESSIVE EFFORTS IN SOME
PLACES BY POLICE TOWARDS THE ON
HOUSE AND THIS PUTS A TOOL IN
THEIR HAND THEY DIDN'T HAVE
BEFORE. YEAH AND- YOU KNOW
UNFORTUNATELY WE KNOW THOSE
THOSE INTERACTIONS GO SIDEWAYS A
LOT SO NOW WHAT'S IN THEIR HANDS
IS SOMEBODY APPEARS TO BE A
SUBSTANCE USER. SOMEONE APPEARS
TO HAVE A MEDICAL CONDITION OR
SOMEONE APPEARS TO NOT BE
ATTENDING TO THEIR SAFETY NOW WE
DON'T KNOW WHAT THE FINAL
DEFINITIONS OF ALL THOSE WILL
BE. BUT I THINK IT'S CLEAR
THAT'S AN UNPRECEDENTED
EXPANSION OF THINGS POLICE CAN
DO COMPARED TO NOW. ALL ALSO SAY
THE CURRENT LANGUAGE IN THE BILL
SAYS THAT IF AN INDIVIDUAL IS
UNABLE TO UTILIZE ADEQUATE
SHELTER THEN DOT INDIVIDUALS
THAT CAN BE USED AS EVIDENCE TO
TAKE INDIVIDUALS AND ON A ON A-
FIFTY ONE FIFTY. SAID THAT
SPECIFIC LANGUAGE IS VERY
CONCERNING- IF AN INDIVIDUAL
CHOOSES NOT TO GO TO A SHELTER
AND THEIR CHOOSE INSTEAD TO STAY
ON THE STREETS THAT COULD BE
INTERPRETED AS- SOMEONE NOT
UTILIZING ADEQUATE SHELTER AND-
THAT. YOU KNOW IMPACTS- A LOT OF
A LOT OF INDIVIDUALS AND COULD
BE USED TO READ THEIR CIVIL
RIGHTS THAT IS AMENDED OUT OF
THE BILL IF YOU THINK I WAS
GOING TO SAY THINGS THAT ARE. IN
THE BILL. OKAY IN THE IN THIS
COMMITTEES AMENDMENTS YES OKAY.
ARE THERE NOT PREMISES.
OBLIGATED OKAY SO THAT PART IS
TAKEN OUT THE BEST UTILIZATION
OF ADEQUATE SOFT GOOD. I'M
BECAUSE I DID AS I WAS READING A
CIRCLE THAT ONE PART I'M
SPECIFIC TO. OUR THE ORDINANCE
THAT WAS JUST RECENTLY PASSED IN
SAN DIEGO- YOU KNOW NOW THAT. WE
WILL HAVE OUR INDIVIDUALS WHO
ARE ON- THE STREET AND
ENCAMPMENTS AND YOU KNOW
APPROACHED BY. THESE OFFICERS-
YOU KNOW I WOULDN'T WANT
SOMEONE. TO BE GIVEN THE
DIAGNOSIS AB OR YOU MUST HAVE A
MENTAL ILLNESS AND YOU'VE GOT TO
SERIOUS HARM TO YOURSELF BECAUSE
YOU DON'T WANNA TAKE THE SHELTER
THAT WE'RE ASKING YOU TO TAKE AT
THIS POINT SO- THANK YOU FOR
THAT CLARIFICATION. THE
CONDUCTOR WHEREVER ANYONE ELSE.
UNDER A MISTER RODRIGUEZ. YES I
DON'T THINK THE CENTERS WELL FOR
ALL THE WORK DONE IN AND AROUND
THE SERENE I KNOW WE SEVEN
HEALTHY I THINK AWHILE BACK AND
WE TALKED ABOUT ISSUES LIKE THIS
SO. OBVIOUSLY WERE LIVING IN
DIFFERENT TIMES NOW RIGHT. AND
LOOKING WHAT YOU WANT TO DO
DIDN'T INCLUDE- THAT SAID
SUBSTANCE USE DISORDER I THINK
IT'S- WAY OVERDUE IN RIGHT
BECAUSE WHAT WE SEE IN THE
STREETS AND- DISCERN FOR MY SON
IS YOU KNOW IT IS AN OFFICE
AUTHORS ON PATROL NEEDS A POLY.
EIGHT OUT OF TEN OF THE HOMELESS
OR SUFFERING FROM THIS RIGHT IN
THAT SOMETHING WE NEED TO DO SO.
EARLY THANK YOU FOR BRINGING
THIS FORD. AND A LOOKING FOR TO
SUPPORT IN ONCE AGAIN THANK YOU
FOR THAT YOU DO AND HOPEFULLY
THIS IS SOMETHING FOR TO.
ADDRESS THE ISSUES ON THE
STREETS WITH THE FOLKS NEEDING
THE HELP NECESSARY THANK YOU
THANK YOU. OKAY THANK YOU-
CENTER EGGMAN THANK YOU- IT'S
ALWAYS A PLEASURE WORKING WITH
YOU ALTHOUGH AT TIMES I DON'T.
WE PRIDE. GET FRUSTRATED WITH
ONE ANOTHER BUT BUT ONLY. THE
BEST REASONS SO- WE HAVE A LONG
HISTORY AND I APPRECIATE THAT.
VERY MUCH I THINK ONE OF THE
BEAUTIES OF THE CURRENT
LEGISLATURE. THE WAY IT'S BUILT
IS THAT THERE IS AN OPPORTUNITY
FOR PEOPLE BECOME. SUBJECT
MATTER ASK EXPERTS AND BE ABLE
TO USE OUR EXPERTISE TO HELP
WITH PUBLIC POLICY. AND SO- I
APPRECIATE THAT ABOUT YOU AND
ALWAYS HAVE AND- THANK YOU FOR
YOUR WORK ON THIS. PROJECT
YOU'RE WORKING THROUGH. THESE
CHALLENGING AMENDMENTS AND THEN
OBVIOUSLY WE HAVE OTHER TASKS.
AS WELL- AND SO I LOOK FORWARD
TO WORKING WITH YOU ON AS WELL
ON THAT SO THE BILL DOES ENJOY
THESE PIPAS RECOMMENDATION. AND
AS IT MOVES FORWARD SHOULD LEAVE
THE COMMITTEE I WOULD LIKE TO BE
CONSIDERED AS A CO AUTHOR YOUR
BILL. THANK YOU VERY MUCH WOULD
YOU LIKE TO CLOSE. YEAH I WOULD
JUST THINK EVERYBODY FOR THE
DISCUSSION AND EVERYBODY FOR THE
LONG TIME WORK ON THIS I KNOW I
HAVEN'T BEEN DOING THIS BY
MYSELF IT'S BEEN A REAL TEAM
EFFORT I REALLY WANT TO THANK
THE CHAIR. AND HEALTH COMMITTEE
FOR REALLY DIGGING IN WITH US
AGAIN I KNOW THESE ISSUES AREN'T
EASY BUT THAT'S NOT WHAT WE'RE
HERE TO DO WE'RE NOT HERE TO DO
EASY THINGS WERE HERE TO.
ACTUALLY MAKE LIFE BETTER FOR
CALIFORNIANS AND I THINK THIS IS
LONG OVERDUE I HAVE. I PET
ISSUES PEOPLE HEARD ME SAYING MY
OWN FAMILY- AS LONG AS I'VE BEEN
HERE MY COUSINS HAVE BEEN
SINGING AT A FIX THE SYSTEM
BECAUSE THEY'VE- THEY WERE
LOOKING FOR THEIR MOM ON STREETS
FOR. WAY TOO MANY YEARS NEVER
MISS A MY FIRST PARTNER. SHOT
HERSELF IN THE HEAD THINKING SHE
WAS GIVING HERSELF A HAIR CUT-
SERIOUSLY MENTALLY ILL AND HER
PARENTS TRIED OVER AND OVER AND
OVER TO GET HER IN AND COULD
NOT. SO IS THIS IT AND THERE IS
NOT A THOSE MY STORIES ARE
UNIQUE I MEAN EVERYBODY HAS THEM
EVERYBODY KNOWS SOMEBODY
EVERYBODY. HAS HAD SOME
EXPERIENCE LIKE THIS. SO LET'S
DO BETTER. FOR CALIFORNIA. I ASK
FOR YOUR AYE VOTE. THANK YOU
CENTER EGGMAN. WE A MOTION I
BELIEVE IT WAS FROM MISTER
VIEWPOINT. OR NOT. ASSEMBLY MR
MCCARTY. IT WAS MY SERVER. I
WILL DR RIVERVIEW TWO PEOPLE
DOWN THERE. IT WAS AFTER. THAT
BOOK. MISTER WAS MR FONG UPS.
MORE OKAY ALL RIGHT. THIS FOR.
DOCTOR ARAMBULA. MOTIONS I MEAN
I HAVE I'M HEARING VOICES-
AVOID. HORRIBLE HELLBOY- DOWN
THE FROM FROM NOW DOWN THERE AND
BE VERY CLEAR ABOUT THAT. SO-
THE MOTIONS REASONABLE SEARCHES
. THE MOTION IS TO PASS TO
JUDICIARY. AMOUNT SECTOR PLEASE
CALL THE ROLL. WHAT YES HI. WHEN
I WALDRON. WALDRON AYE
AGUIAR-CURRY. BAKER CURRY I
ARAMBULA. RAMBLE I BURNER.
BURNER I WENDY CARILLO. WENDY
CARILLO AYE FLORA. IT'S FONG.
THAT'S FINE I MAIENSCHEIN.
MCCARTY YEAH PATTERSON.
RODRIGUEZ RODRIGUEZ AYE SANTIAGO
SANTIAGO I FEAR PADILLA THE
VALLAPUDUA I WEBER. HOWEVER I.
ELEVEN VOTES YOUR BILL IS OUT
WILL LEAVE THE ROLE OPEN FOR
OTHERS ADAM THANK YOU VERY MUCH
VERY MUCH SO. SO WE'VE GOT A
COUPLE SENATORS HERE THE ORDER.
TO MISTER PORTANTINO SO I DO NOT
WANT TO GET IN THE MIDDLE OF.
BUT SO MISTER PORTANTINO YOU
HAVE A COUPLE OF BILLS BEFORE US
. IT COULD YET JUST PUSH PUSH
THE BUTTON THERE. YOUR IF WE
COULD DO EIGHT OH FIVE FIRST
MISTER CHAIR THAT WILL SURELY IS
FINE THANK YOU JUST ON FLIGHTS
AND OTHER THINGS SURE NO PROBLEM
THANK YOU. THANK YOU MISTER
CHAIRMAN COMMITTEE MEMBERS EIGHT
OH FIVE ADDRESSES A NEED IN
BEHAVIOR HEALTH ON INDIVIDUALS
WITH AUTISM YOU SEEN A SIMILAR
VERSION BEFORE IT'S PASSED THIS
COMMITTEE I BELIEVE THREE TIMES
WE JUST WANT TO CORRECT CORRECT
IN IN EQUITY IN CURRENT. AUTISM
TREATMENT AND WITH ME I HAVE
EXPERTS TO TESTIFY AND SO I'M
GONNA TURN IT RIGHT OVER TO THEM
PERFECT THANK YOU- THANK YOU
DOCTOR WOULD AND COMMITTEE
MEMBERS IN THIS LATE EVENING I'M
DOCTOR ANDREA DAVIS A LICENSED
PSYCHOLOGIST AND A DIVISION ONE
BOARD MEMBER OF THE CALIFORNIA
PSYCH ASSOCIATION AS WELL AS THE
PRESIDENT OF THE D. I. R. FLOOR
TIME COALITION CALIFORNIA THE
BILL SPONSORED. AND I SPEAK ON
BEHALF OF MY CLIENTS WHO ARE
PARENTS SEEKING DESPERATELY
NEEDED SERVICES FOR THEIR
AUTISTIC CHILDREN WHO GET
INSURANCE DENIALS SIMPLY BECAUSE
THE CHILD'S DOCTORS SAID THEY
SHOULD HAVE A DEVELOPMENTAL
APPROACH. TO BEHAVIORAL HEALTH
TREATMENT. LET ME LET ME GIVE
YOU A BACKGROUND PICTURE OF WHAT
THAT MEANS. HOW PROVIDERS
TRAINED IN A DEVELOPMENTAL
APPROACH WORK. WE EMBRACE
NEURODIVERSITY. MANY WE
CAREFULLY STUDY HOW A CHILD'S
BRAIN AND BODY WORK UNIQUELY AND
THEN HELP EVERYONE AROUND THAT
CHILD A TUNE AND WORK WITH THOSE
DIFFERENCES. WE COACH PARENTS
SIBLINGS GRANDPARENTS NANNIES
AND HOW BEST TO SUPPORT THE
CHILD'S GROWING. SOCIAL
ENGAGEMENT COMMUNICATION. AND
EMOTIONAL UNDERSTANDING OF
THEMSELVES AND OTHERS. FOR
EXAMPLE RATHER THAN FOCUS ON.
USING CONSEQUENCES TO EXTINGUISH
PROBLEM BEHAVIORS WE WORK TO
UNDERSTAND WHAT'S CAUSING THE
CHILD TO BE DYSREGULATED IN THE
FIRST PLACE. AND THEN WORK WITH
THE CARE GIVERS TO COPE REGULATE
WITH THE CHILD. TO MAKE SURE
THEY FEEL CALM AND UNDERSTOOD
AND RATHER THAN THE THERAPIST
GIVING COMMANDS. TO PRACTICE
SKILLS SUCH AS- GIVE THE DAHLE A
HUG WE HELP CHILDREN LEARN BY
PLAYING TOGETHER. IN WHICHEVER
WAYS THAT ARE JOYFUL AND
ENGAGING FOR THAT CHILD AND WE
JOINED THE CHILD'S INTERESTS IN
SUCH A WAY THE CHILD LEARNS TO
CREATE. AND COMMUNICATE THEIR
OWN IDEAS AND MOST IMPORTANTLY
LEARN TO SHARE JOY WITH OTHERS
IN OTHER WORDS WE WORK ON WHAT
ARE THE CORE ISSUES OF BEING A
HUMAN BEING. BUT FAMILIES CAN'T
GET INSURANCE COVERAGE FOR
DEVELOPMENTAL APPROACHES TO BE
H. T. EVEN THOUGH SHE BURKE
ANALYSIS DETERMINED THEY ARE
EVIDENCE BASED. THIS CREATES
GROSS INEQUITY MEANING ONLY
WEALTHY PEOPLE CAN REACH IN
THEIR POCKETS AND PAY PRIVATELY
FOR THESE THESE DEVELOPMENTAL
APPROACHES. DDS HAS ESTIMATED
COSTS FOR THE BILL BUT THAT
OVERLOOKS THE POTENTIAL
IMMEDIATE AND LONG TERM COST
SAVINGS FOR THE STATE. FOR
EXAMPLE DEVELOPMENTAL APPROACHES
ARE FAR LESS COSTLY IT'S LIKE
FOUR TO TEN HOURS A WEEK
TYPICALLY NOT TWENTY FIVE TO
FORTY HOURS A WEEK. SO SAVING SO
MUCH MONEY ALSO ALL THESE
CHILDREN SITTING ON WEIGHTLESS
GETTING HAVING NO TREATMENT
THROUGHOUT THE STATE. THE
EARLIER TREATMENT IS BEGUN THE
BETTER THE OUTCOME SO LIFELONG
COSTS FOR SERVICES ARE CUT BY
INCREASING ACCESS TO MORE
PROVIDERS. WERE EQUALLY
QUALIFIED DEVELOPMENT
DEVELOPMENTALLY BASED PHD
CURRENTLY FUNDED BY SEVERAL
REGIONAL CENTERS WOULD THEN
SHIFT TO INSURANCE FUNDING. SO
SB EIGHTY FIVE PROVIDES A CHOICE
OF B. H. T. ALL RIGHT. PLEASE
VÚI FOR FAIR AND EQUAL ACCESS TO
ALL EFFECTIVE FORMS OF PHD THANK
YOU. THANK YOU. HI MY NAME IS
CAITLYN WELCH AND I AM THE
MOTHER OF SPENCER. WHO HAS
AUTISM I'M ALSO A BOARD
CERTIFIED EDUCATIONAL
THERAPISTS. STARTING AT AGE TO
SPENCER HAD SEVERE AGGRESSION
TOWARDS OTHERS KICKING BITING
HITTING INCLUDING MY HUSBAND AND
MYSELF AND WHEN HE WENT TO
SCHOOL HIS TEACHERS. BECAUSE THE
PRESCHOOL DEMANDED WE ADDRESS
THIS OF COURSE. WE SAW A NEURO
PSYCHOLOGIST WHO HAPPENED TO BE
TRAINED IN D. I. R. A
DEVELOPMENTAL INDIVIDUALIZE
RELATIONSHIP BASED APPROACH
AFTER RECEIVING JUST ONE SESSION
IS HOUR AND A HALF TEMPER. RAGES
WHERE WE HAD TO RESTRAIN HIM
WENT DOWN TO TWENTY MINUTE RAGES
EVERY OTHER DAY AFTER THE SECOND
STATE SESSION IT DROPPED TO ONCE
A WEEK. EVENTUALLY WE NEVER HAD
TO RESTRAIN HIM D. A. I. R. WAS
THAT EFFECTIVE FOR MY KID. WHY
WOULD I WANT ANYTHING ELSE WE
WERE LUCKY ENOUGH TO GET D. I.
R. FOR SEVERAL YEARS THROUGH OUT
OF POCKET MEANS AS WELL AS
ANOTHER AGENCY WANTS FUNDING
ENDED I TURNED TO KAISER OUR
HEALTH INSURANCE PLAN. I WANTED
HIM TO CONTINUE WITH THE I. R.
BUT WAS TOLD THAT DUE TO CURRENT
LAW KAISER COULD ONLY COVER AB
EIGHT. I DIDN'T WANT HIM TO STOP
ATTACKING PEOPLE SIMPLY BECAUSE
OF CONSEQUENCES WHERE WE WOULD
WITHHOLD REWARDS THE ABA
APPROACH. I WANTED HIM TO
CONTROL HIS- HIMSELF BECAUSE HE
DIDN'T WANT TO HURT OTHER
PEOPLE. AND BY DEVELOPING HIS
AWARENESS OF OTHER PEOPLE'S
FEELINGS SO WE ASK HEISER FOR
JUST FOUR HOURS A MONTH OF DIR-
ART HI HEISER PEDIATRICIAN EVEN
RECOMMENDED IT. BUT KAISER SAID
OUR ONLY OPTION WAS TO RECEIVE
FORTY HOURS A MONTH OF ABA.
FORTY WE DECIDED TO TRY ABA AND
WITHIN TWO WEEKS MY SON WAS IN
TEARS RUNNING OUT OF THE HOUSE
DOWN THE BLOCK TO GET AWAY FROM
THE AB A PROVIDER. AND
THREATENING TO HURT HIMSELF. A
FIVE YEARS OF DIR GETTING HIM TO
A GREAT SPOT MAKING FRIENDS AND
IT ALL WAS UNDERMINED IN THE
SPAN OF WEEKS SPENCER STOP
SEEING THE ABA PERSON AND WE CUT
BACK TO JUST PARROT ABA SUPPORT.
BUT AFTER TWO YEARS OF DOING
THIS SPENCER WAS MUCH MUCH
WORSE. WE HAD ZERO RELATIONSHIP
WITH HER SON AND HIS ANGER
TOWARDS US WAS INTENT. I DECIDED
I NEEDED TO GO BACK TO D. I. R.
WHICH WORK FOR HIM IN THE PAST
EVEN IF KAISER WOULDN'T PAY FOR
IT WITHIN A MONTH OF HAVING D.
I. R. SESSIONS. FOUR HOURS. WE
WERE BACK IN HAVING A WARM
CONNECTED RELATIONSHIP WITH MY
SON. I'M NOW HE IS DOING SO WELL
HE'S FOURTEEN HE HAS TWO FRIEND
GROUPS HE WAS THE BEAST IN
BEAUTY AND THE BEAST I MEAN
WORKS TALKING HE IS. ARRIVING
AND I ATTRIBUTE THAT ALL. THANK
YOU. THANK YOU. SOME OTHERS IN
SUPPORT. THANK ON THE. I'M USED
TO BE MUTED. HEY GOOD GOOD
EVENING JENNIFER ALLEY WITH THE
CALIFORNIA PSYCHOLOGICAL
ASSOCIATIONS THANK YOU. IS THIS
ON OUR BEHALF OF THE CAL ON THE
CALIFORNIA CHILD ADOLESCENT
PSYCHIATRY ASSOCIATION THANK YOU
THANK YOU. IS THEIR OPPOSITION
TO THE BILL. THE NUN WILL BRING
BACK TO THE COMMITTEE QUESTIONS
OR COMMENTS ANY QUESTIONS OR
COMMENTS FROM THE COMMITTING.
THE DOCTOR WEBER. IT EVENING
SENATOR THANK YOU SO MUCH FOR
THE SPELL I HAVE A QUICK
QUESTION FOR YOU SO YOU'RE
EXPANDING THE SCOPE OF WHO CAN
ACTUALLY. PERFORM THE SERVICES
TO INCLUDE A PSYCHOLOGY
ASSOCIATE AN ASSOCIATE MARRIAGE
AND FAMILY THERAPIST AND
ASSOCIATE CLINICAL SOCIAL WORKER
. OR AN ASSOCIATE PROFESSIONAL
CLINICAL COUNSELOR- HOW ARE WE
SUPPOSED TO ENSURE THAT THEY ARE
ACTUALLY TRAINED IN THE METHODS
FOR IS VERY VERY SPECIAL VERY
UNIQUE CHILDREN AND IS THERE.
ARE SOME WAY. OF INSURING NOT
ONLY THAT THEY'VE BEEN TRAINED
BUT THAT THEY'RE KIND OF UP TO
DATE BECAUSE FOR OTHER YOU KNOW
PROVIDERS WE HAVE TO DO- ESSENCE
EITHER EVERY YEAR EVERY TWO
YEARS SO. ARE WE INSURING
ABSOLUTELY THESE WOULD BE
SUPERVISED BY A LICENSED
PROVIDER AND THIS WOULD BE
EQUIVALENT TO WHAT CURRENTLY
EXISTS FOR ALL BEHAVIOR HEALTH
TREATMENT BUT THERE ARE THERE
ARE SUPERVISORY LEVEL THERE'S
THAT MID LEVEL THAT YOU'RE
POINTING TO AND THEN THE DIRECT
SERVICE PARA PROFESSIONAL. AND
ALL OF THEM WOULD GET TRAINING
THAT WAY AN EDUCATION
REQUIREMENTS AND SUPERVISION
REQUIREMENTS DETAILED BY DDS
THAT'S WHAT THIS BILL WOULD COME
WOULD ACCOMPLISH. AND ART IF YOU
ARE THEIR NATIONAL STANDARDS.
ARE THERE NATIONAL STANDARDS FOR
RETIREMENTS OF YOU KNOW WHAT YOU
WHAT KIND OF CLASSES YOU NEED
KIND OF HOURS THAT YOU WOULD
NEED TO TRANSFER THEIR STATE BY
STATE. IN IN THERE FOR STATES
NOW THAT HAVE- MEDICAID COVERING
DEVELOPMENTAL APPROACHES AND
THEY HAVE. UNIQUE REQUIREMENTS
FOR SUPERVISION TRAINING AND
EDUCATION SO CALIFORNIA WOULD BE
DEVELOPING OUR OWN THROUGH THE
DDS REGULATORY PROCESS. THANK
YOU. THANK YOU ANYONE ELSE. A
SCENE NO ONE- THE BILL HAS A-
BILL DOES ENJOY DO PASS
RECOMMENDATION WE'VE MOTION BY-
MISS WALDRON A SECOND BY DOCTOR
ARAMBULA MOTIONS. TO PASS TO
HUMAN SERVICES WHICH ARE TO
CLOSE SENATOR PORTANTINO JUST
THANK YOU FOR THE QUESTIONS AND
THE TIME AND RESPECTFULLY ASK
FOR NINE. THANK YOU VERY MUCH
ABOUT SECRETARY PLEASE CALL THE
ROLL WHAT HI WHEN I WALDRON
WALDRON AYE AGUIAR-CURRY
AGUIAR-CURRY AYE ARAMBULA. REBEL
I BURGER. WENDY CARILLO WENDY
CARILLO AYE FLORA. THAT'S FONG.
IT'S FONG I MAIENSCHEIN. MCCARTY
YEAH PATTERSON. RODRIGUEZ
RODRIGUEZ I SANTIAGO. SANTIAGO I
BE A PARIAH. WEBER HOWEVER I.
YOU HAVE NINE VOTES A BILL IS
OUT WILL LEAVE THE ROLE OPEN FOR
OTHERS TO ADD ON. THANK YOU. AND
YOU HAVE ALSO SB TWO FIFTY SEVEN
SORRY I DO THANK YOU. MISTER
CHAIR AND COLLEAGUES- S. B. TWO
FIVE SEVEN IS ANOTHER BILL THAT
IS PASSED THIS COMMITTEE IN THE
PAST AS YOU KNOW- ROUTINE
MAMMOGRAMS ARE COVERED BUT THE
FOLLOW UP IMAGING PRESCRIBED BY
YOUR DOCTOR. IS NOT OFTEN
COVERED AND SO THIS BILL SEEKS
TO MAKE SURE THAT THOSE DOCTOR
PRESCRIBED FOLLOW UP IMAGES ARE
ALSO A COVERED EXPENSE WITH ME I
HAVE CONOR SWEENEY ON BEHALF OF
SUSAN COLEMAN AND RYAN SPENCER
BEHALF OF THE EVER AMERICAN
COLLEGE. OF OBSTETRICIANS AND
GYNECOLOGISTS IN SUPPORT AND
SPONSORING THE BILL THANK YOU.
PLEASE GO AHEAD. THANK YOU MR
CHAIRMAN AND MEMBERS OF THE
COMMITTEE FOR THE OPPORTUNITY TO
TESTIFY THIS AT- THIS EVENING-
MY NAMES CONOR SWEENEY I'M A
STATE POLICY MANAGER WITH SUSAN
G. KOMEN THE NATION'S LEADING
NONPROFIT BREAST CANCER
ORGANIZATION AND- PROUD SPONSOR
OF SB TWO FIFTY SEVEN. THE GOAL
OF THE BILL IS TO REDUCE
AVOIDABLE LATE STAGE BREAST
CANCER DIAGNOSES AND DEATHS FROM
BREAST CANCER BY EXPANDING
ACCESS TO DIAGNOSTIC AND
SUPPLEMENTAL IMAGING. THE TRIP
ANALYSIS OF THIS BILL INCLUDED A
PUBLIC HEALTH IMPACT ASSESSMENT
IN WHICH THEY ESTIMATED OVER
THIRTEEN HUNDRED CASES OF BREAST
CANCER COULD BE DIAGNOSED.
EARLIER DUE TO THE REMOVAL OF
COST SHARING FOR THE SERVICES-
IN THE YEAR FOLLOWING THE- POST
MANDATE. I WELL WE DON'T KNOW
FOR SURE WHAT THE MORTALITY
OUTCOMES OF THOSE CASES WOULD BE
WE KNOW FOR SURE THAT EVERY DAY
COUNTS WHEN IT COMES TO CATCHING
BREAST CANCER EARLY. AND
BEGINNING A PATIENT'S TREATMENT
RIGHT AWAY. INFORMATION FROM THE
SEER DATABASE. SHOWS THE FIVE
YEAR SURVIVAL RATE FOR THOSE
WITH. AB EARLY STAGE BREAST
CANCER IS AROUND 99% WHILE THE
FIVE YEAR SURVIVAL RATE FOR
THOSE WITH METASTATIC BREAST
CANCER. IS JUST THIRTY PERCENT-
OF FINISH UP THEIR EARLY
DETECTION SAVES LIVES WHICH IS
WHY WE BELIEVE THAT. OUR
PATIENTS DESERVE COVERAGE FOR
THE ENTIRE CONTINUUM OF
SCREENING NOT JUST THE FIRST
STEP OF THE PROCESS WHICH IS
THAT INITIAL SCREENING MAMMOGRAM
SO- AS OF STE AS OF TODAY
SIXTEEN STATES HAVE IMPLEMENTED.
SIMILAR LEGISLATION- INCLUDING
OUR NEIGHBORING STATE OF NEVADA
WHICH IS PASSED A SIMILAR BILL
EARLIER THIS MONTH IS TO HELP
CALIFORNIA WILL BE NEXT ENSURING
OUR MISSION TO. ELIMINATE DEATHS
FROM BREAST CANCER HAPPY TO
ANSWER ANY QUESTIONS WE
RESPECTFULLY ASK FOR AN AYE VOTE
THANK YOU. THANK YOU. BRENT
SPENCER BEHALF THE AMERICAN
COLLEGE OF OBGYN THIS DISTRICT
NINE CO SPONSORS OF THE MEASURE
I'LL GIVE A VERY BRIEF- PUT
SIMPLY THE COST OF COMPLETING
BREAST EXAMINATION SHOULD NOT BE
A BARRIER TO APPROPRIATE
SCREENING. PATIENTS NOT TO WORRY
ABOUT THE COST OF A DIAGNOSTIC
BREAST IMAGING PHONE ABNORMAL
ABNORMAL MAMMOGRAPHY. AB S. B.
TWO FIVE SEVEN PROVIDES THIS
RELIEF. THEN IMPORTANT MEASURE
THAT REDUCES THE BARRIER TO
CARE. ASK FOR YOUR CONSIDERATION
IN SUPPORT OF SB TWO FIVE SEVEN.
Q. THANK YOU. IT WASN'T ME.
LINDA WAY WITH WESTERN CENTER ON
LAW AND POVERTY IN SUPPORT THANK
YOU. INSTEAD I'LL BE OFF OF THE
CALIFORNIA NURSE MIDWIVES
ASSOCIATION AND SUPPORT THANK
YOU. ARMONK N. SMITH WITH
AMERICAN CANCER SOCIETY CANCER
ACTION NETWORK ALSO IN SUPPORT.
YOU THEY'RE CALLING ON BEHALF OF
VIACOM CALIFORNIA IN SUPPORT.
THANK YOU. INTERFERE WITH
CAPITAL ADVOCACY ON BEHALF THE
CALIFORNIA LIFE SCIENCES IN
SUPPORT. THANK YOU. TIM MADDEN
REPRESENT THE CALIFORNIA SOCIETY
PLASTIC SURGEONS IN SUPPORT.
THANK YOU. DOUG SERVERS AND WE
HAVE THE CALIFORNIA PROFESSIONAL
FIREFIGHTERS AND SUPPORT. RICK
RENDON MARCHING WITH THE
CALIFORNIA MEDICAL ASSOCIATION
IN SUPPORT THANK YOU. THAT NON
ASK YES HEAR CALIFORNIANS
SUPPORT. THANK YOU- THEIR
OPPOSITION TO THE BILL.
GOOD AFTERNOON CHAIR MEMBERS
HAVE JEFF HAMPTON CALIFORNIA
ASSOCIATION HEALTH PLANS THAT WE
CURRENTLY DO HAVE AN OPPOSE
POSITION ON SB TWO FIFTY SEVEN.
I WE ARE CERTAINLY SENSITIVE TO
THE ISSUE THAT THIS BILL IS
TRYING TO ADDRESS- THAT'S THAT'S
NOT THAT THE YOU KNOW
OVERARCHING. CONCERN OF OUR
CONCERN WITH THIS BILL- HOWEVER
WE ARE CONCERNED THAT THIS
PARTICULAR MANDATE WOULD
INCREASE HEALTH CARE PREMIUMS BY
ABOUT A HUNDRED AND EIGHTEEN
MILLION DOLLARS ANNUALLY- THAT
IS ALWAYS A CONCERN FOR THE
HEALTH PLANS. ADDITIONALLY WE
WOULD HIGHLIGHT THAT THAT WOULD
LEGISLATION SEEKING TO IMPLEMENT
CARSHARING PROHIBITIONS- THERE
ARE TRADE OFFS THAT SHOULD BE
CONSIDERED. A CAUTIONARY
MANDATES HAVE TO BE ASSESSED TO
DETERMINE THE IMPACT OF COVER
CALIFORNIA'S ABILITY TO SET
STANDARD BENEFIT DESIGNS. THAT
ARE COMPLIANT WITH FEDERAL AND
STATE ACTUARIAL VALUE
REQUIREMENTS. SO IN COST SHARING
PREVENT PROHIBITION BECOME LAW-
THEY DO HAVE BEEN- CONCERT WILL
IMPACT ON THOSE ACTS WERE
ACTUARIAL VALUE REQUIREMENTS.
WHICH THE NECESSITATES
CARSHARING INCREASES FOR OTHER
SERVICES SO FOR THOSE REASONS-
WE ARE GREATLY OPPOSED TO SB
FIFTY SEVEN. OKAY THANK YOU.
OTHERS IN OPPOSITION. A SIGNAL
BRING BACK TO THE COMMITTEE FOR
QUESTIONS OR COMMENTS ANY
QUESTIONS OR COMMENTS FROM THE
COMMITTEE. WE DO HAVE A MOTION
BY MISS AGUIAR-CURRY A SECOND BY
DOCTOR ARAMBULA MOTION IS TO
PASS TO APPROPRIATIONS SUB WHICH
LIKE TO CLOSE MISTER PORTANTINO
THANK YOU FOR THE OPPORTUNITY TO
PRESENT THIS BILL AND
RESPECTFULLY ASK FOR. THANK YOU
VERY MUCH MA'AM SECRETARY PLEASE
CALL THE ROLL. WHAT I WOULD AYE
WALDRON WALDRON I AGUIAR-CURRY.
AGUIAR-CURRY AYE ARAMBULA
REGULAR AYE BURNER. WENDY
CARILLO WENDY CARILLO AYE FLORA.
VINCE FONG. THE PHONE AYE
MAIENSCHEIN. MCCARTY. THE
PATTERSON. RODRIGUEZ RODRIGUEZ
AYE SANTIAGO. SANTIAGO I BE A
GOOD ONE. WEBER WEBER I. THANK
YOU. THE BILL HAS NINE VOTES OUT
OF COMMITTEE WE WILL LEAVE THE
ROLE OPEN FOR OTHERS TO ADD ON.
SENATOR BACKER OVER CENTER THE
MOAN. OF WHOEVER YOU HAVE YOUR
YOUR- MISTER WHOEVER YET.
HOWEVER I YOU KNOW I'M. I DID
NOT CALL HIM BY THE WAY SO YOU
KNOW. OKAY THANK YOU TERRY
MEMBERS. SB THREE TO FOUR
PROHIBITS PUT HEALTH PLANS AND
INSURANCE POLICIES FOR REQUIRE
PRIOR AUTHORIZATION OR
UTILIZATION REVIEW FOR ANY
CLINICALLY IN. INDICATED
TREATMENT OF ENDOMETRIOSIS
ENDOMETRIOSIS IS REFERRED TO AS
THE MISTASSINI ACCORDING TO THE
CENTER FOR REPRODUCTION
RESEARCH. DUE TO ITS VARIED
SYMPTOMS BY PATIENTS AN
INCONSISTENT DIAGNOSES BY
MEDICAL PROFESSIONALS AN
ESTIMATED ONE IN TEN WOMEN IN
UNITED STATES BETWEEN THE AGES
OF TWENTY FIVE AND FORTY ARE
AFFECTED BY ENDOMETRIOSIS ON
AVERAGE WOMEN IN THE UNITED
STATES WILL SUFFER FROM
ENDOMETRIOSIS FOR TEN YEARS
BEFORE RECEIVING A PROPER
DIAGNOSIS CURRENTLY UNDER MOST
PLANS. A LAPAROSCOPIC E. AND
OTHER DIAGNOSTIC STUDIES FOR
ENDOMETRIOSIS REQUIRE PRIOR
AUTHORIZATION BEFORE BEING
APPROVED WHICH CAN TAKE EITHER
WEEKS OR MONTHS BEFORE PROCEDURE
DATE IS SET FOR THE PATIENT
DEPENDING ON THE PATIENT'S CASE
PRIOR AUTHORIZATION HAS BECOME
AN INDIRECT DETERRENT A FEW
PATIENTS DON'T HAVE THE TIME OR
RESOURCES TO NAVIGATE A COMPLEX
PROCESS OF APPEALS. AND DELAYS
THIS BILL SEEKS TO ENSURE THAT
WE RECOGNIZE WOMEN WHO HAVE
SUFFERED IN SILENCE AND CAN
RECEIVE THE NECESSARY TREATMENT
AS DETERMINED BY THEIR PHYSICIAN
. SB THREE TO FOUR WILL EXPEDITE
THE PROCESS FOR WOMEN TO RECEIVE
PROPER DIAGNOSIS OF
ENDOMETRIOSIS IS A CURE
TREATMENT TO IMPROVE FERTILITY
AND QUALITY OF LIFE. TODAY I
HAVE RYAN SPENCER WHO WILL
PROVIDE TESTIMONY ON BEHALF OF A
COG AND DR LINDA. A GOOD EACH HE
HAD TO ACTUALLY LEAVE IT- IT
BECAUSE OF THE TIME BUT SHE WAS
A HEALTH PROFESSIONAL ESPECIALLY
SPECIALIZE IN ENDOMETRIOSIS FROM
UCSF OF WISHES STILL HEALTH
PROFESSIONALS SHE STILL
HEALTHCARE PROFESSIONAL JUST
JUST A THOUGHT. THANK YOU. A
RYAN SPENCER AND FOR THE
AMERICA'S OBGYN STRYCHNINE OUT
TO SIMPLY SAY. ASK FOR YOUR
SUPPORT AND I'LL MOVE ON TO THE
STATEMENT FOR DR- THE JUDICIARY
. IMAGE SHOWS THIS IS A COMMON
CHRONIC HORMONE DEPENDENT
INFLAMMATORY DISORDER WHERE
TISSUE SIMILAR TO THE YEAR AND
LINING EXIST OUTSIDE OF NORMAL
LOCATION CAUSE INFLAMMATION
SCARRING PAIN INFERTILITY.
ENDOMETRIOSIS HAS RECENTLY BEEN
IDENTIFIED AS A SYSTEM SYSTEMIC
CHRONIC INFLAMMATORY PAIN
CONDITION WITH MULTI SYSTEMIC
SYMPTOMS AND COMORBIDITIES
HOWEVER STILL GENERALLY
CONSIDERED STRICTLY A
GYNECOLOGIC DISORDER. IN A
MAJOR- SAYS OFTEN STRIKES TEENS
PROCESS ACROSS A REPRODUCTIVE
LIFESPAN GREATLY IMPACTING
PERSONAL FAMILY SHIPS PATIL THE
EDUCATIONAL AND EMPLOYMENT
OPPORTUNITIES AND QUALITY OF
LIFE. OVERALL ACCORDING TO JUDY
SHE- SURGICAL AND IMAGING
DIAGNOSIS OF ENDOMETRIOSIS TAKES
ANYWHERE BETWEEN TWO DAYS AND
THREE WEEKS TO TWO DAYS TO THREE
WEEKS BEFORE RECEIVING A PRIOR
AUTHORIZATION RESPONSE. THE
SCHEDULE PROCEED APPOINTMENT
WITH RESPONSE TIMES VARY BY
INSURANCE. WELL INNOVATIVE
TREATMENT OPTIONS FOR IN A
MAJOR- JUST ARE STILL BEING.
IDENTIFIED IT IS ESSENTIAL TO
ENSURE THERE'S EQUITY AND
EXPEDIENCY IN THE ACCESS TO
MEDICAL TREATMENTS FOR ALL
POPULATIONS IN ORDER TO ENSURE
THAT HEALTHCARE IS BEING
PROPERLY ADDRESSED. SB THREE
TWENTY FOUR IS A CRITICAL PIECE
OF LEGISLATION AND REMOVE
BARRIERS TO TREATMENT OF
ENDOMETRIOSIS IN ENDOMETRIOSIS
BY REMOVING PRIORITIZATION
NEEDED FOR ANY CLINICALLY
INDICATED TREATMENT FOR THE
DISEASE. ARE YOU TO VOTE IN
SUPPORT OF SB THREE TWENTY FOUR
THANK YOU. THANK YOU VERY MUCH
OTHERS IN SUPPORT. HI KAREN STOP
ON BEHALF OF THE CALIFORNIA
NURSES ASSOCIATION IN SUPPORT
THANK YOU. MISTER MEMBERS THE
COMMITTEE BRANDON MARCH WITH THE
CALIFORNIA MEDICAL ASSOCIATION
WANT TO THANK THE AUTHOR FOR
YOUR- WORKING TO EXPAND THE BILL
TO AUTOMATICALLY INDICATED
SERVICES AND IN STRONG SUPPORT.
THANK YOU. INTERFERE WITH
CAPITAL ADVOCACY ON BEHALF OF
THE CALIFORNIA LIFE SCIENCES IN
SUPPORT THANK YOU. OPPOSITION TO
THE BILL.
GOOD EVENING MISTER CHAIR
MEMBERS OF THE COMMITTEE CHEN
HAMPTON CALIFORNIA ASSOCIATION
OF HEALTH PLANS- RADLEY IN
OPPOSITION SB THREE TWENTY FOUR
ALTERNATIVELY THE BILL IS WELL
INTENTIONED- YOU KNOW I THINK
ARE THE GENESIS PROPOSITION I
REALLY IS- YOU KNOW SB THREE
TWENTY FOUR IS ONE OF SEVERAL
BILLS- EITHER RESTRICTING
REMODELING OR- OUTRIGHT BANNING.
UTILIZATION REVIEW PRIOR
AUTHORIZATION THAT HAS BEEN
INTRODUCED THIS YEAR- NO WE
UNDERSTAND APPRECIATE THIS
COMMITTEE AS WELL I IN
CONJUNCTION WITH THE SENATE
HEALTH COMMITTEE- HAS ASKED YOU
BURKE TO CONDUCT A BROAD BASE
NOW SINCE OF HOW AND WHY PRIOR
AUTHORIZATION IS USED- WE
CERTAINLY LOOK FORWARD TO
REVIEWING THAT REPORT- AND
REVIEWING THE FINDINGS IN HOPE
OF FINDING A MORE COMPREHENSIVE-
SOLUTION TO THIS ISSUE- HOWEVER
THOUGH- AS AS IT STANDS NOW- WE
ARE REGRETTABLY IN OPPOSITION-
BASED UPON. BUT I PREVIOUSLY MET
. THANK YOU THANK YOU. ANYONE
ELSE IN OPPOSITION. NO ONE BRING
BACK COMMITTEE QUESTIONS OR
COMMENTS DR WEBER. THANK YOU
CENTER LAMONT FOR BRINGING THIS
BILL FORWARD AND ALSO- HAVING
CONVERSATIONS WITH ME EARLIER
ABOUT THIS PARTICULAR BILL I
THINK I'M PROBABLY THE I DON'T
KNOW AND- THE ONLY ONE WHO IS
PROBABLY TREATED OR DIAGNOSED.
PATIENTS I. ARE YOU TAKING
SOMEONE TO THE O. R. WITH THREE
DO A DIAGNOSTIC LAPAROSCOPY TO
DIAGNOSE BECAUSE THAT'S THE ONLY
WAY IT CAN BE DIAGNOSED TO BE A
SURGERY- BUT I'M- ONE OF THE
QUESTIONS I HAD FOR YOU AND I
KNOW WE DISCUSSED IT AND- MAYBE
THE OPPOSITION. I DON'T KNOW CAN
ANSWER THE QUESTION IS. WHAT IS
THE TIME FRAME FROM. A REQUEST
FOR A DIAGNOSTIC LAPAROSCOPY-
THAT IS ACTUALLY APPROVED BY THE
INSURANCE. WHAT WAS THE NORMAL
TIME FRAME THAT YOU HEAR BACK
YEAH THANK YOU DOC RIVERS THAT
DIDN'T JUST FOR CLARIFICATION IS
THAT FROM THE TIME THAT THE
PROVIDER REQUESTED HIM TO THE
PLANET PRESENT YEAH I MEAN I
THINK THAT THAT VARIES- YOU KNOW
THERE ARE THERE ARE SPECIFIC
TIME FRAMES AND STATUTE- BY
WHICH- THOSE REQUESTS HAVE TO BE
COMPLETED BY- AND I BELIEVE THE
NUMBERS THIRTY DAYS- BUT I CAN I
CAN I CAN DOUBLE CHECK BUT- IT
THE MAXIMUM ALLOWABLE TIME
DOESN'T MEAN THAT. IT'S GOING TO
TAKE THE MAXIMUM WALL ALLOWABLE
TIME TO APPROVE THAT SO WE LOOK
AT THINGS IN AND STATUTES TO SAY
HEALTH PLANS HAVE X. AMOUNT OF
DAYS TO DO THIS FOR X. AMOUNT OF
DAYS TO DO THAT. THAT DOESN'T
NECESSARILY MEAN THAT THAT THAT
WE ARE WAITING FOR THE FULL
THIRTY DAYS OF THE FULL SIXTY
DAYS TO ACTUALLY APPROVE THAT I
MEAN I THINK IT DEPENDS YOU KNOW
ON A CASE BY CASE BASIS IN TERMS
OF THE INFORMATION THAT WE
RECEIVE- AND ALL THAT THAT WE'VE
GATHERED. UP PRIOR TO APPROVING
THE REQUEST AND AS YOU KNOW I
OFTENTIMES THAT THAT GOES ALONG
WITH SUBMITTING- SPECIFIC
INFORMATION REQUIRED- YEAH DATA.
OTHER OTHER ELEMENTS THAT THE
PLAN IS LOOKING FOR PROOF THAT
SO IT KIND OF DEPENDS ON YOU
KNOW HOW THAT PROCESS STARTS AND
YOU KNOW KIND OF DEPENDS ON YOU
KNOW. HOW LONG THAT WOULD TAKE
THEREAFTER RIGHT OKAY THANK YOU
I'M AND THE REASON WHY I ASK-
AND I'LL CONTINUE TO LOOK INTO
THIS DATA- IS BECAUSE- YOU KNOW
SENATOR LIMÓN. THERE'S SOMETHING
THAT YOU SAID AT THE BEGINNING.
OF YOUR PRESENTATION AND THAT IS
THAT ENDOMETRIOSIS IS A THAT IS
THE MISDIAGNOSIS RIGHT IS THE
CONDITION WITH THE MISDIAGNOSIS
AND THAT IS SO TRUE- BUT- IN MY
EX. FIVE ALMOST I WAS THINKING
OF IT LAST I ONLY GOT INTO AN
OVERJOYED ALMOST TWENTY YEARS.
I'M IT'S IT HASN'T REALLY BEEN
DUE TO- INSURANCE. ON IT HAS TO
DO WITH THE FACT THAT THE
SYMPTOMS ARE SO VAGUE. ON HAS TO
DO WITH THE FACT THAT IF SOMEONE
COMES IN AND THEY'RE COMPLAINING
A VERY PAINFUL PERIODS IT COULD
JUST BE PRIMARY DYSMENORRHEA IT
COULD BE- SOME KIND OF IBS THING
IT COULD BE- INTERSTITIAL
CYSTITIS. IT COULD BE- AN STI
CAN BE A VARIETY OF DIFFERENT
THINGS. AND THERE'S ALSO A
CLINICAL PATHWAY THAT THAT WE AS
PROVIDERS DO YOU TO YOUR AND
SETS PUSH A BIRTH CONTROL PILLS
AND THEN YOU KIND OF MOVE ON TO-
LIKE ADJUSTING ONLY ORIGIN ARE
EACH AGONIST OR THINGS LIKE THAT
AND SO. WHEN WE'RE LOOKING AT
THE CLINICAL PATHWAY- INSURANCE
INPUT- IS VERY LIMITED- YOU KNOW
WE OFTENTIMES HAVE TO GET PRIOR
OFF FOR A GENERATION AGONISTS
BUT THAT IN MY EXPERIENCE HASN'T
TAKEN. AN EXTENDED PERIOD OF
TIME- WE HAVE TO ALWAYS GET
PRIOR AUST FOR SURGERY IF
THEY'RE NOT EMERGENT- AND WHEN
WE DEAL WITH A PATIENT THAT HAS
IN DUBLIN LAST YOU'VE GOT LIKE A
HUGE ENDOMETRIAL MY THAT'S
POOREST. IT'S OFTEN NOT
SOMETHING THAT'S URGENT OR
EMERGENT AND SO WE PLACE THEM WE
ASK SURGEONS PLACE THEM. IN OUR
NEXT AVAILABLE OR DAY WHICH MAY
NOT BE FOR ANOTHER MONTH TWO
MONTHS THREE MONTHS DOWN THE
LINE. I'M AND BY THAT TIME WE
DEFINITELY HAVE HER BACK FROM
THE INSURANCE COMPANY SO. YES
MY- I WOULD DEFINITELY
SUPPORTING TODAY I JUST WONDER
HOW MUCH OF AN IMPACT THIS BILL
IS GOING TO HAVE ON. THE OVERALL
DIAGNOSIS OF INDO EARLY AND LIKE
WE DISCUSSED BEFORE. YOU KNOW
PEOPLE SHOW UP AT TWENTY FOUR
TWENTY SEVEN THIRTY WITH ISSUES
OF INFERTILITY BECAUSE OF INDO.
BUT THAT'S BECAUSE THEY WEREN'T
LISTENED TO WHEN THEY START
THEIR PERIODS AT THIRTEEN
FOURTEEN FIFTEEN YEARS OLD. AND
SO THAT'S REALLY BEEN THE ISSUE
WITH ENDO. I'M NOT SO MUCH THE
IN MY EXPERIENCE AND A LOT OF MY
COLLEAGUES. IT'S NOT SO MUCH THE
LACK OF APPROVAL OR
AUTHORIZATION FROM INSURANCE
COMPANIES BUT- THANK YOU FOR
BRINGING THIS FORWARD BECAUSE IT
DEFINITELY ALLOWS FOR US TO-
HAVE A CONVERSATION ABOUT
ENDOMETRIOSIS AT A STATEWIDE
LEVEL THAT RECOGNIZE THAT. WE
NEED TO HAVE THESE CONVERSATIONS
TO FIGURE OUT HOW WE CAN
DIAGNOSES INDIVIDUALS EARLIER
THANK YOU. THANK YOU I
APPRECIATE YOUR EXPERTISE IN YOU
SHARING THAT FEEDBACK I THINK IT
ADDS TO THE DISCUSSION. OF THE
YOU KNOW ALSO NEEDING TO
UNDERSTAND THERE'S DEFINITELY
MORE BEYOND THIS BILL- THAT IS
LIKELY IN THAT NEEDED TO BE DONE
SO I APPRECIATE YOUR EXPERTISE
THANK YOU. THANK YOU ANY OTHER
QUESTIONS THE MEMBERS- THE BILL
DOES ENJOY DO PASS
RECOMMENDATION THE MOTION WOULD
BE TO PASS TO APPROPRIATIONS. TO
HAVE A MOTION. YOU DID MOVE IT.
OKAY WE HAVE MOTION BY DR
EMBOLUS SECOND FIVE MISTER
RODRIGUEZ. THE MOTION TO PASTOR
PREPARATIONS WHICH ARE TO CLOSE
SENATOR I RESPECTFULLY ASK FOR
AND I HAVE A- FEW OF THEM SECTOR
PLEASE CALL THE ROLL. WOOD HERE
HI WHEN I WALDRON. SO OVERNIGHT
AGUIAR-CURRY. AGUIAR-CURRY AYE
ARAMBULA. ARAMBULA AYE BURNER.
WENDY CARILLO WENDY CARILLO AYE
FLORA. AND FAUNA. IT'S FONG NOT
VOTING. MAIENSCHEIN MCCARTY. THE
PATTERSON. RODRIGUEZ RODRIGUEZ I
SANTIAGO. SANTIAGO I BE APPROVED
WHAT THE VALLAPUDUA I WEBER
WEBER HI. YOU HAVE NINE VOTES
THE BILL'S OUT LEAVE THE ROLE
OPEN FOR OTHERS TO ADD ON THANK
YOU. SENATOR ALAN. THANK YOU SO
MUCH MISTER CHAIR MEMBERS- LET
ME START. YEAH ABSOLUTELY. MIKE
IS THE RIGHT. I'D LIKE TO START
BY ACCEPTING THE COMMITTEE
MEMBER AND SO I THINK THE
COMMITTEE STAFF FOR ITS HARD
WORK ON. THIS IMPORTANT ISSUE
FIVE OH TWO THOUGHT ABOUT
GETTING KIDS ACCESS DIVISION OF
A MOTION AND A SECOND HAVE YOUR
GAMING CAROL FRIES HARDISON.
THANK YOU CHAIRMAN COMMITTEE
MEMBERS MY NAME'S DAMIEN KERO
I'M THE NATIONAL DIRECTOR VISION
TO LEARN OUR CALIFORNIA BASED
CHARITABLE PROVIDER OF VISION
SERVICES A MOBILE SCHOOL BASED
BUSINESS SERVICES. SINCE OUR
FOUNDING IN TWENTY TWELVE VISION
TO LEARN HAS HELPED OVER ONE
MILLION CALIFORNIA STUDENTS
ATTENDING TITLE IN SCHOOLS
THIRTEEN COUNTIES RECEIVE VISION
SCREENINGS EYE EXAMS AND GLASSES
AT NO OUT OF POCKET COSTS TO
STUDENTS OR THEIR PARENTS. ABOUT
ONE IN FOUR CHILDREN STUDENTS
NEEDS PRESCRIPTION GLASSES TO
SEE CLEARLY AT SCHOOL AND THIS
FIGURE IS HIGHER IN LOW INCOME
COMMUNITIES UNFORTUNATELY WE
FIND THE VAST MAJORITY OF OUR
STUDENTS ARE GOING WITHOUT
REGULAR AND SUFFICIENT VISION
CARE. WELL OUR STUDENTS ARE
SCREEN DILIGENTLY BY SCHOOL
NURSES IN STATE MANDATED GRADES
AND MOST OF THEM ARE COVERED BY
MEDICARE HOW INNUMERABLE ACCESS
BARRIERS PREVENT THEM FROM
RECEIVING A RECOMMENDED I EXAM
WITHOUT WHICH THEY CANNOT BE
PRESCRIBED OR PROVIDED GLASSES.
THE TWENTY EIGHTEEN DHHS STUDY A
VISION TO LUNCH PROGRAM FROM
APPROXIMATELY TWO THIRDS OF
MEDICAL STUDENTS PROVIDED
CLASSES BY VISION TO LEARN AND
RECEIVE NO VISION CARE SERVICES
IN THE FOUR YEARS PRECEDING OUR
INTERVENTION. IN AN ADDITIONAL
13% OF STUDENTS SERVER
UNDOCUMENTED AND THAT'S AN
ELIGIBLE FOR MEDICARE DURING
THAT STUDY. VISION TORRANCE
PROGRAM AS PREDOMINANTLY FUNDED
BY PRIVATE PHILANTHROPY. THANKS
TO THE LEGISLATURE AS OF THIS
YEAR WE CAN NOW SUBMIT MEDICAL
CLAIMS AS APPROPRIATE. STILL
THERE REMAINS A SUBSTANTIAL POOL
OF STUDENTS WHO CANNOT BE
REIMBURSED THROUGH MEDICARE NOW.
EITHER BECAUSE THEY ARE
UNINSURED OR BECAUSE WE ARE
UNABLE TO LOCATE THEM THROUGH
THE COVERAGE DISCOVERY PROCESS.
THIS BILL WOULD HAVE CALIFORNIA
FOLLOW THE LEAD OF SEVERAL OTHER
STATES. IN UTILIZING A HEALTH
SERVICES INITIATIVE TO SUPPORT
SCHOOL BASED MOBILE VISION
SERVICES FOR THIS POPULATION OF
STUDENTS. THE FUNDING SOURCE IS
UNUSED ADMINISTRATIVE DOLLARS
FROM THE CHILDREN'S HEALTH
INSURANCE PROGRAM. AND FEDERAL
DOLLARS WOULD BE DRAWN DOWN
USING PHILANTHROPIC DOLLARS
RAISED IN CALIFORNIA SO THERE'S
NO STATE BUDGET FUNDING. THAT
WOULD BE USED FOR THIS PROGRAM.
AT NO COST TO THE STATE THIS
INITIATIVE WOULD HELP VISION TO
LEARN PROVIDE MUCH NEEDED VISION
CARE TO THOUSANDS MORE STUDENTS.
IN MORE AREAS OF THE STATE FOR
YEARS TO COME. THANK YOU FOR
YOUR CONSIDERATION OF THIS
LEGISLATION AND I URGE AN AYE
VOTE. THANK YOU VERY MUCH OTHERS
IN SUPPORT OF THE BILL. IN KNOWN
AS THEIR OPPOSITION TO THE BILL
. IT WILL BRING BACK TO THE
COMMITTEE ANY QUESTIONS OR
COMMENTS FROM THE COMMITTEE. THE
BILL HAS A- DO PASS AS AMENDED
TO APPROPRIATIONS
RECOMMENDATION. WE HAVE A MOTION
BY MR FONG A SECOND BY MR
RODRIGUEZ- AND I JUST WANNA SAY
THANK YOU TO OUR- CENTER OUT FOR
BRINGING THIS BILL FORWARD- AS
AS ACT KID WHO. HAS STRUGGLE
WITH VISION PROBLEMS WHEN I WAS
YOUNG AREA AND AS AS I SEE YOU
HAVE CLASSES THERE AS WELL-
UNRECOGNIZED- FOR A LONG TIME-
THE ABILITY TO GET. EARLY
SCREENING GET GLASSES IN THE-
YEAH IT HAS IT'S A GAME CHANGER
SO MANY KIDS SO. I APPRECIATE
YOU BEING BRING THIS BILL
FORWARD- THE MOST OUT OF KAMALA
TO BE ADDED AS A CO AUTHOR AND I
THANK YOU FOR YOUR ADVOCACY ON
THIS AND THANK YOU TO WITNESS.
WOOD SO WITH THAT WOULD YOU LIKE
TO CLOSE ON OR DID YOU. I REST
MY HAND WAVING. WELCOME FOR KERR
YEAH IT IS A BETTER RESPECT
RESTAURANT THANK YOU THANK YOU
MR ALLEN A CENTER ALLEN- MATTER
SECRETARY PLEASE CALL THE ROLL.
WHAT I WHAT I WALDRON WALDRON
AYE AGUIAR-CURRY. AGUIAR-CURRY
AYE ARAMBULA. REGULAR AYE BURNER
. WENDY CARILLO WENDY CARILLO
AYE FLORA. VINCE FONG VINCE FONG
AYE MAIENSCHEIN MAIENSCHEIN AYE
MCCARTY. PATTERSON RODRIGUEZ.
RODRIGUEZ I SANTIAGO. SANTIAGO
I'D BE A GOOD ONE. THE
VALLAPUDUA I WEBER. WEBER HI.
THANK YOU MEMBERS THANK YOU VERY
MUCH. ELEVEN ZERO WILL LEAVE THE
ROLLOVER FOR OTHERS TO ADD ON.
THERE ARE NO FOR SENATORS
ANYWHERE ELSE IN THE BUILDING
SENATOR PACKER SO. THEY'RE ALL
GONE.
THANK YOU- THE PUSH THEIR PUSH
THE BUTTON THERE PLEASE THANKS-
YES I THANK YOU. WE HAVE A
INTERPRETIVE DANCE. READY FOR
YOU TODAY SIR IS THE LAST LAST
BILL GEORGE WILL BE PERFORMING.
THANK YOU WE'RE PLEASED TO
REPRESENT THIS BILL DESIGNED TO
PROTECT HEALTH CARE PROVIDERS
INCLUDING SMALL DOCTOR'S
PRACTICES IN CUNY CLINICS FROM
PRICE GOUGING BY THE TECHNOLOGY
VENDORS. WITH ME. IS GEORGE
SOURCE FROM THE CMA. GOOD
EVENING EVERYONE THANK YOU SO
MUCH I APPRECIATE CENTER BACKERS
WORK ON THIS BILL- CENTER
BACKERS LAID OUT WITH THE MAIN
ISSUE HERE IS AND THAT'S FOR A
SB FIVE EIGHTY TWO IS SEEKING TO
ADDRESS- BRING H. ART ENTERS
INTO THE DATA EXCHANGE FRAMEWORK
THERE WAS SOME AMENDMENTS OVER
IN THE SENATE THAT. WE TOOK TO
CLARIFY THE DEFINITION LISTED IN
THE ANALYSIS OF SOME- FEDERAL
CONFORMING STANDARDS FOR- RIVAS
LEGISLATION AND WERE HAPPILY
ACCEPTING THAT AND WITH THAT
RESPECTFULLY ASK YOUR AYE VOTE
HAPPEN ANSWER ANY QUESTIONS
THANK YOU. YOU OPEN AND SHE'S.
NOT A WITNESS WITH US YES OKAY
GREAT- OTHERS IN SUPPORT. A GOOD
AFTERNOON MR CHAIRMAN BURST GEN
HIM TO THE CALIFORNIA
ASSOCIATION HEALTH PLANS THAT WE
DO NOT HAVE FORMAL POSITION ON
THIS BILL THAT WE WOULD LIKE TO
THANK THE AUTHOR HIS STAFF THE
SPONSORS AND COMMITTEE STAFF AS
WELL. FOR WORKING WITH US ON
SOME. I'M AMENDMENTS IN AND
CLEAN UP LANGUAGE THAT TO THE
FROM LAST YEAR REALLY APPRECIATE
TO THE CENTER AND AT ONE SAY
THANK YOU TO HIM AND SPONSORS.
THANKS THANK YOU. IS THIS ONE
ARE ABOUT THE CALIFORNIA STATE
ASSOCIATION OF PSYCHIATRISTS IN
SUPPORT THANK YOU THANK YOU. IS
THEIR OPPOSITION TO THE BILL.
SEEING NONE I WILL BRING IT BACK
TO THE COMMITTEE COMMITTEE
QUESTIONS OR COMMENTS FROM THE
COMMITTEE. THE KNOWLEDGE WAS A
THANK YOU. SENATOR BAKER FOR
BRINGING THE BILL FORWARD- IT
DOESN'T JOY DO PASS
RECOMMENDATION. MAYBE THIS WITH
THIS BILL WE'VE DONE ALL DAY.
BUT BUT I WOULD SAY LIKE SAY
THANK YOU AND I AND I WITH I'M
JUST GONNA MAKE AN AND IT'S ALSO
A PATH TO UNIVERSAL HEALTH CARE
AS I MENTIONED THAT THAT IS THAT
IS ONE. IS YET DON'T DON'T OPEN.
WE ALREADY TALKED ABOUT THAT
EARLIER THANK YOU- I WOULD JUST
SAY ONE OF THE THINGS THAT- AND
I LOOK I'M A BIG FAN OF-
ELECTRONIC HEALTH RECORDS WHAT
I'M A BIGGER FAN OF IS A WEEK
ONCE WE GET ALL THE SYSTEMS TO
ACTUALLY COMMUNICATE WITH ONE
ANOTHER SO THERE IS A VALUE TO
THAT. AND SO I'M ABOUT HEALTH
INFORMATION EXCHANGES FOR THOSE
RECORDS CAN ACTUALLY BE ACCESS
BY ANOTHER PROVIDER SOMEWHERE-
WHEN IS NEEDED AND SO- THIS IS
IMPORTANT PIECE OF THE PUZZLE.
OF A BIGGER PUZZLE AND I THANK
YOU FOR BRINGING BRINGING THIS
FORWARD SO- WOULD YOU LIKE TO
CLOSE AND PLEASE KNOW SING
SINGING OR DANCING. I KNOW
YOU'RE EXCITED THANK YOU WHAT
WILL STICK WITH RECOMMENDING AN
AYE VOTE THANKS THANK YOU VERY
MUCH- SO MA'AM SECTOR WE HAVE A
MOTION BY. MR BE APPROVED BY
BELIEVE FOR MR FONG- WILL GIVE
WHAT. MR BE APPROVED BY THE
SECOND TO MR FONG OR AS WE WERE
THE OTHER WAY AROUND I DON'T-
THIS POINT. THANK YOU FROM DOWN
THERE- MOTIONS TO PASS AS
AMENDED TO PREPARATIONS MADAM
SECRETARY PLEASE CALL THE ROLL.
WHAT I WHAT I WALDRON. WALDRON
AYE AGUIAR-CURRY. AGUIAR-CURRY
AYE ARAMBULA. ARAMBULA AYE
BURNER. WENDY CARILLO. WENDY
CARILLO AYE FLORA. FLORA I VINCE
FONG. THAT'S FINE I MAIENSCHEIN.
MAIENSCHEIN I'VE MCCARTY. JOE
PATTERSON. RODRIGUEZ RODRIGUEZ
AYE SANTIAGO. SANTIAGO IBM PUT
OFF. THE VALLAPUDUA I WEBER.
EVER I. THAT'S TWELVE ZERO YOU
HAVE MOST WITH ANYBODY IF THAT'S
ANY CONSOLATION SO FAR. I THANK
YOU FOR YOUR PATIENCE AND- HAVE
HAVE A WONDERFUL EVENING- OKAY-
REALLY BE LIKE TO GO THROUGH
THIS JUST ONCE BUT I DON'T
THINK. OR MAYBE. ALL RIGHT WAS
SO THERE'S THAT SO WE WILL START
FROM THE TOP OF THE ORDER- ITEM
NUMBER ONE SB FOUR EIGHTY SEVEN
BY SENATOR ATKINS- TO HAVE A
MOTION FOR THAT BILL. A MOTION
BY DOCTOR REGULUS SECOND BY.
THIS CARILLO MOTION IS TO PASS.
VOTE OUR- WAS IT I THOUGHT IT
WAS WENDY BUT WAS IT. C. YES
PLEASE STOP HIDING. M. SO
EVERYBODY WANTS TO MAKE ANYWAY-
SO MOTIONS DO PASSED YOU
JUDICIARY. OF METAL SECRETARY
PLEASE CALL THE ROLL WHAT I WHAT
I WALDRON WALDRON NO
AGUIAR-CURRY AGUIAR-CURRY AYE
ARAMBULA. ARAMBULA AYE BURNER
BURNER I WENDY CARILLO. WENDY
CARILLO AYE FLORA. LARA NO VINCE
FONG VINCE FONG NO MAIENSCHEIN
MAIENSCHEIN AYE MCCARTY. YEAH
PATTERSON THE PATTERSON-
RODRIGUEZ. I GUESS AYE SANTIAGO
SANTIAGO IDEA PUT WHAT THEY PUT
ON A AYE WEBER. WEBER I. AND FOR
THE VOTERS TEN FOR THE BILL'S
OUT LEAVE THE ROLE OPEN- ITEM
NUMBER. A TWO SB FIVE OH TWO- WE
THINK WE JUST VOTED ON THAT ONE
ANY EVENT THAT WE HAD A COUPLE
MEMBERS COME IN SO MADAM
SECRETARY PLEASE OPEN THE ROLL
CALL THE ABSENT MEMBERS BURNER.
BURNER I LAURA. LAURA I MCCARTY
- SOME. PATTERSON I FOURTEEN.
THE FOURTEENTH ZERO I REMEMBER
THREE SB FIVE EIGHTY TWO BY
SENATOR BECKER PLEASE OPEN THE
ROLL CALL THE ABSENT MEMBERS
BURNER BURNER I. MCCARTY YEAH
PATTERSON. ANDERSON AYE FOURTEEN
ZERO FOURTEEN ZERO ITEM NUMBER
FOR SB FORTY THREE BY SENATOR
EGGMAN PLEASE OPEN THE ROLL CALL
THE ABSENT MEMBERS LARA. LARA I
MAIENSCHEIN. MAIENSCHEIN AYE
MCCARTY. PATTERSON PERSON I
FOURTEEN ZERO FOURTEEN ZERO ITEM
NUMBER FIVE WAS PULLED BY THE
AUTHOR ITEM NUMBER SIX SB 324%
OF THE MON PLEASE OPEN THE ROLL
CALL THE ABSENT MEMBERS BURNER.
BURNER I FLORA FLORA NO VINCE
FONG- I HAVE IT'S NOT VOTING-
MAIENSCHEIN. MAIENSCHEIN AYE
MCCARTY. PATTERSON THE PATTERSON
NOW. ELEVEN ELEVEN TO THREE. TWO
OKAY SORRY LEVITY MY APOLOGIES-
ITEM NUMBER SEVEN S. B. TWO
FIFTY SEVEN BY SENATOR
PORTANTINO PLEASE OPEN THE ROLL
CALL THE ABSENT MEMBERS BURNER.
WERNER I LAURA LAURA I
MAIENSCHEIN MAIENSCHEIN I
MCCARTY- PATTERSON. PATTERSON I
FEEL PUT OFF IT PUT I FOURTEEN
ZERO FOURTEEN ZERO THANK YOU AB
ITEM NUMBER EIGHT SB EIGHT OH
FIVE AYE SENATOR PORTANTINO
PLEASE OPEN THE ROLL CALL THE
ABSENT MEMBERS BURNER. BURNER I
FLORA FLORA I MAIENSCHEIN
MAIENSCHEIN I'M MCCARTY SO
PATTERSON. PATTERSON IBM COULD
WALK APRIL WHAT I FOURTEEN ZERO
FOURTEEN ZERO ITEMS NUMBER NINE
AND TEN WERE THE CONSENT
CALENDAR- PLEASE OPEN THE ROLL
CALL THE ABSENT MEMBERS BURNER.
BURNER I WENDY CARILLO WENDY
CARILLO AYE FLORA FLORA I
MAIENSCHEIN MAIENSCHEIN IDA
PATTERSON YOUR PATTERSON AYE
SANTIAGO. SANTIAGO I FIFTEENTH-
ITEM NUMBER TWELVE SB SEVENTY BY
SENATOR WIENER. THANK YOU FOR
THE MOTION A SECOND BUT MOTION
BY CEMEX WALDRON A SECOND BY A
DOCTOR ARAMBULA MOTION IS TO
PASS AS AMENDED TO
APPROPRIATIONS MADAM SECRETARY
PLEASE CALL THE ROLL WHAT I
WOULD AYE WALDRON. WALDRON AYE
AGUIAR-CURRY AGUIAR-CURRY AYE
ARAMBULA ARAMBULA AYE BURNER
BURNER I WENDY CARILLO WENDY
CARILLO AYE FLORA. FLORA NO
VINCE FONG. VINCE FONG NOPE
MAIENSCHEIN MAIENSCHEIN AYE
MCCARTY. THE PATTERSON THE
PATTERSON NO RODRIGUEZ.
RODRIGUEZ AYE SANTIAGO. SANTIAGO
I'D BE A GOOD ONE THE VALLAPUDUA
AYE WEBER. WEBER I. LEVEL THREE
THE VOTERS ELEVEN THREE WILL
LEAVE THE ROLE OPEN FOR THE
ABSENT MEMBER. ITEM NUMBER
THIRTEEN S. B. TWO THIRTY EIGHT
BY SENATOR WIENER EMOTION OF
POSSIBLE. MOTION MOTION BY THE
DOCTOR EVERY THE SECOND BIVENS
BURNER OUR MOTION IS TO PASS TO
APPROPRIATIONS MADAM SECRETARY
PLEASE CALL THE ROLL WHAT I
WOULD AYE WALDRON. WALDRON AYE
AGUIAR-CURRY AGUIAR-CURRY AYE
ARAMBULA. REBEL I BURNER. BURNER
I WENDY CARILLO. WENDY CARILLO
AYE FLORA. FLORA NO VINCE FONG
IT'S FONG NO MAIENSCHEIN
MAIENSCHEIN AYE MCCARTY.
PATTERSON SONO RODRIGUEZ
RODRIGUEZ AYE SANTIAGO. SANTIAGO
I WOULD BE A GOOD ONE. IF COULD
WHAT I WEBER. WEBER I. MCCARTY I
. PHOTO THREE OF THE THREE ITEM
NUMBER FOURTEEN SB THREE THIRTY
NINE BY CENTER WINNER PLEASE
OPEN THE ROLL CALL THE ABSENT
MEMBERS. AGUIAR-CURRY
AGUIAR-CURRY I WENDY CARILLO
WENDY CARILLO AYE FLORA. FLORIDA
VOTING. MAIENSCHEIN MAIENSCHEIN
AYE SANTIAGO. SANTIAGO AYE WEBER
. WEBER NOT VOTING FOR TEENS- AT
THIRTEEN ZERO. AND FINALLY ITEM
NUMBER FIFTEEN SB SEVEN SEVENTY
BY SENATOR WINNER PLEASE OPEN
THE ROLL CALL THE ABSENT MEMBERS
WENDY CARILLO. WENDY CARILLO NOT
VOTING FLORA. LARA NOT VOTING
VINCE FONG. IT'S FONG NO
MAIENSCHEIN. MAIENSCHEIN I TO
PATTERSON. PATTERSON- SANTIAGO.
SANTIAGO I. IN THE THREE TEN TO
THREE OKAY- THAT COVERS
EVERYBODY EXCEPT MR MCCARTY SO.
GO BACK TO THE TOP OF THE ORDER
FOR MR MCCARTY AND EVERYBODY
ELSE'S DISMISSED YOU MAY GO HOME
. OR YOU CAN STAY I REALLY DON'T
CARE AT THIS POINT. THAT WAS
PULLED OUT MISTER MISTER STEARNS
BILA A SB SEVEN SEVENTEEN AS
POLL BY THE AUTHOR TODAY. READ
TODAY. OKAY SO ITEM IN. A NUMBER
ONE SB FOUR EIGHTY SEVEN PLEASE
OPEN A ROLL CALL THE ABSENT
MEMBERS MCCARTY. MCCARTY I
ELEVEN FOR SEVENTY FOUR ITEM
NUMBER TWO SB FIVE OH TWO BY
CENTER ALLEN PLEASE OPEN THE
ROLL CALL THE UPS A MEMBER
MCCARTY MCCARTY I FIFTEEN ZERO-
THIRTEEN ZERO FIFTEEN FIFTEEN
ZERO ITEM NUMBER THREE SB FIVE
EIGHTY TWO SENATOR BACKER PLEASE
OPEN THE ROLL CALL THE ANSWER
MEMBER MCCARTY. MCCARTY I
FIFTEEN ZERO FIFTEEN ZERO ITEM
NUMBER FOR SB FORTY THREE BY
CENTER EGGMAN. THESE OPEN THE
ROLL CALL THE ABSENT MEMBERS
MCCARTY MCCARTY I FIFTEEN ZERO
FIFTEEN ZERO ITEM NUMBER SIX SB
THREE TWENTY FOUR BY SENATOR
LIMON PLEASE OPEN THE ROLL CALL
THE ABSENT MEMBERS. MCCARTY
MCCARTY I. WELL TO THAT'S TWELVE
TO ITEM NUMBER SEVEN A. S. B.
TWO FIFTY SEVEN BY MISTER
PORTANTINO PLEASE OPEN THE ROLL
CALL THE ABSENT MEMBERS MCCARTY
MCCARTY I FIFTEEN ZERO FIFTEEN
ZERO ITEM NUMBER EIGHT SB EIGHT
OH FIVE BY SENATOR PORTANTINO
PLEASE OPEN THE ROLL CALL THE
ABSENT MEMBERS MCCARTY. MCCARTY
I FIFTEEN ZERO FIFTEEN ZERO
SECOND SECULAR ITEMS NUMBER NINE
AND TEN PLEASE OPEN THE ROLL
CALL THE ABSENT MEMBERS HE'S ON
THE GROUND THERE I THINK YOU'RE
ON EVERYTHING ELSE CHAU. OKAY
OKAY OFTEN. I'M SORRY WE'RE NOT
ANSWER THERE IS ONE. ITEM NUMBER
TWELVE- SB SEVENTY BY SENATOR
WIENER PLEASE OPEN THE ROLL CALL
THE UPSET MEMBER MCCARTY MCCARTY
I. FOUR THREE FOUR THREE OKAY
THAT COVERS IT. OKAY WE HAVE A
VOTE CHANGE CRAP. YES S. B. VOTE
CHANGED BY MR FOR A SB SEVEN
SEVENTY ITEM NUMBER FIFTEEN I'M
NOT VOTING TO KNOW. LARA NOT
VOTING TO KNOW. THANKS TO THE
FLOOR MAKE SET TO VOTE TEND TO
FOR. OKAY WITH THAT- WE WILL NOW
ADJOURN THE MEETING OF HEALTH
COMMITTEE THANK YOU.