WE WILL CALL TOGETHER THE
INFORMATIONAL HEARING OF
DIVERSITY IN CALIFORNIA'S HEALTH
WORKFORCE TODAY. I WANNA WELCOME
MY, UH COLLEAGUES AND THE
ESTEEMED PANELISTS WHO WILL BE
PRESENTING ON SUCH AN IMPORTANT
ISSUE TO THE STATE OF
CALIFORNIA. THIS AFTERNOON. WE
HAVE AN OPPORTUNITY TO TALK
ABOUT THE WORST KEPT SECRET THAT
CALIFORNIA NEEDS MORE HEALTH
CARE PROFESSIONALS THAN WE
CURRENTLY HAVE THAT THE CURRENT
WORKFORCE DOES NOT MATCH THE
DIVERSITY OF THE STATE AND THAT
THE LACK OF WORKFORCE DIVERSITY
CREATES HEALTH DISPARITIES. THE
LEGISLATURE AND THE
ADMINISTRATION HAVE PUT A LOT OF
TIME AND MONEY INTO EFFORTS TO
INCREASE BOTH THE WORKFORCE AS
WELL AS IT AS ITS DIVERSITY. I'M
EXCITED TO HEAR FROM OUR
PRESENTERS TODAY TO LEARN MORE
ABOUT OUR COMMUNITY'S NEEDS AND
WHAT CAN BE DONE TO ADDRESS
THEM. WITH THAT I WILL OFFER.
UH, MY FELLOW COLLEAGUE ANY
OPENING REMARKS? OPPORTUNITY TO
ADDRESS. THANK YOU, DOCTOR
ARAMBULO WITH THAT WE WILL MOVE
FORWARD WITH THE FIRST PANEL. IF
YOU COULD PLEASE COME FORWARD.
THE CALIFORNIA HEALTH CARE
FOUNDATION IS GOING TO PROVIDE
US WITH AN ASSESSMENT OF
CALIFORNIA'S HEALTH WORKFORCE
CHALLENGES AND NEEDS.
THANK YOU WILL WELCOME OUR
COLLEAGUE. REGINALD JONES,
SAWYER. AS WELL.
WE HAVE EACH, UH, MEMBER OF THE
PANEL INTRODUCE THEMSELVES PRIOR
TO SPEAKING AND WE WILL BEGIN
WITH MISS PHILLIPS. KATHERINE
PHILLIPS I'M AN ASSOCIATE
DIRECTOR AT THE CALIFORNIA
HEALTH CARE FOUNDATION. UH,
THANK YOU FOR HAVING ME. WE HAVE
A LOT TO COVER TODAY. UH, IF YOU
REMEMBER JUST THREE THINGS.
PLEASE HEAR THIS. CALIFORNIA
DOES NOT HAVE ENOUGH HEALTH CARE
WORKERS AND THE WORKFORCE WE
HAVE DOESN'T MATCH OUR
POPULATION'S ETHNICITY, THEIR
LANGUAGE OR THEIR GEOGRAPHY.
INVESTING IN EDUCATION AND
TRAINING PROGRAMS CAN HELP WITH
BOTH OF THESE CHALLENGES, AND
CALIFORNIA IS MAKING STRIDES.
AND A WELL SUPPORTED AND
REPRESENTATIVE. WORKFORCE MEANS
PATIENTS, YOUR FAMILY, YOUR
FRIENDS, YOUR NEIGHBORS CAN
RECEIVE HEALTH CARE IN THEIR
HOME COMMUNITY. CHIRP ON TO ASK
ME TO BEGIN WITH AN OVERVIEW.
UH, THERE ARE MANY CHALLENGES
IMPACTING CALIFORNIA'S HEALTH
WORKFORCE. THE TWO GREATEST
CHALLENGES ARE LACK OF SUPPLY
AND LACK OF DIVERSITY IN
REPRESENTATION. CALIFORNIA'S
HEALTH WORKFORCE SHORTAGES HAVE
BEEN IN THE NEWS AS PEOPLE
ACROSS OUR STATE AND THOSE WITH
ALL TYPES OF HEALTH CARE
COVERAGE STRUGGLE TO FIND A
PROVIDER WHEN THERE'S RETIRES,
OR THEY MOVE AND MORE AND MORE,
WE'RE GETTING REPORTS OF PEOPLE
HAVING A HARD TIME FINDING A
TIMELY APPOINTMENT, EVEN FROM A
PROVIDER WHO SERVED THEM FOR
DECADES. THESE SHORTAGES ARE
PERVASIVE AND THEY ARE
WIDESPREAD. FIVE OF CALIFORNIA'S
NINE GEOGRAPHIC REGIONS NOW FAIL
TO MEET MINIMUM NATIONAL
STANDARDS FOR THE NUMBER OF
PRIMARY CARE PROVIDERS PER
CAPITA AND TWO MORE ARE HOVERING
AT JUST ABOVE THE MINIMUM
THRESHOLD. SHORTAGES ARE NÓ
LONGER AN ISSUE IN JUST RURAL
COMMUNITIES. THEY ARE IMPACTING
PATIENTS ACROSS THE STATE AND
VERY LIKELY IN YOUR DISTRICT.
THE SHORTAGE OF PRIMARY CARE
PROVIDERS IS A NATIONAL PROBLEM,
BUT CALIFORNIA'S SUPPLY IS
DECLINING FASTER THAN OTHER
STATES. AND THERE ARE TROUBLING
TRENDS IN SEVERAL MEDICAL
SPECIALTIES AS WELL, INCLUDING
GENERAL SURGERY, OBSTETRICS AND
EMERGENCY MEDICINE. THESE
SHORTAGES AREN'T NEW, AND THEY
WEREN'T SUDDEN. THE SHORTAGES
WE'RE EXPERIENCING TODAY ARE THE
RESULT OF DEMOGRAPHIC TRENDS.
OUR CLINICIAN WORKFORCE IS AGING
AND IT'S AGING MUCH FASTER THAN
OUR GENERAL POPULATION. TODAY.
THE MEDIAN AGE OF A PHYSICIAN IN
CALIFORNIA IS 50, THREE. THAT'S
59 IN THE RURAL NORTH. THE
PERCENTAGE OF PROVIDERS ABOVE 60
CONTINUES TO INCREASE. HOW DID
WE GET HERE? UM. CALIFORNIA HAS
UNDER INVESTED IN HEALTH AND
EDUCATION FOR DECADES. WELL, WE
HAVE WELL, UH, WORLD RENOWNED
MEDICAL INSTITUTIONS AND MANY
CAMPUSES. THEY HAVEN'T KEPT PACE
WITH OUR RAPIDLY GROWING
POPULATION. TODAY WE RANK 46TH.
AMONG THE 47 STATES AND
TERRITORIES WITH MEDICAL SCHOOLS
FROM MEDICAL SCHOOL ENROLLMENT
PER CAPITA AND LAST YEAR WE
TURNED AWAY 75. 75% OF QUALIFIED
APPLICANTS FOR BACHELORS OF
NURSING PROGRAMS BECAUSE WE DID
NOT HAVE THE CAPACITY TO TEACH
THEM. WE LOSE STUDENTS AND
ESPECIALLY LATINO STUDENTS TO
OTHER STATES, WHO HAVE GREATER
CAPACITY. AND ONLY A PORTION
RETURNED TO US. SEVERAL RECENT
FACTORS HAVE MADE THESE
SHORTAGES MORE PRONOUNCED.
CALIFORNIA'S HIGH COST OF LIVING
IS DRIVING HEALTH CARE WORKERS
TO OTHER INDUSTRIES AND TO
NEIGHBORING STATES AND COVID-19
LED TO BURNOUT. EARLY
DEPARTURES, ESPECIALLY IN
NURSING. I FOCUSED SO FAR ON
PHYSICIANS AND NURSES, BUT MANY
OF THESE DYNAMICS ARE OCCURRING
ACROSS THE HEALTH PROFESSIONS,
INCLUDING AMONG OUR CRITICAL
SUPPORT STAFF, SUCH AS MEDICAL
ASSISTANCE. LAST YEAR, FOR
EXAMPLE, THE CALIFORNIA PRIMARY
CARE ASSOCIATION, WHICH
REPRESENTS FEDERALLY QUALIFIED
HEALTH CENTERS, REPORTED
INCREASED TURNOVER AND LONGER
VACANCY TIMES FOR NEARLY ALL
POSITIONS. THE IMPACT OF
WORKFORCE SHORTAGES ON COMMUNITY
IS SIGNIFICANT. 11 MILLION
CALIFORNIANS. THAT'S MORE THAN A
QUARTER OF OUR STATE ENTIRE
POPULATION. NOW LIVE IN A
FEDERALLY DESIGNATED PRIMARY
CARE HEALTH PROFESSIONAL
SHORTAGE AREA. WORKFORCE
SHORTAGES CAN IMPACT QUALITY AND
OUTCOMES AND THEY CREATE ACCESS
CHALLENGES. NÓ CARE LONG WAIT
TIMES OR LONG DRIVES. WELL.
CALIFORNIA RANKS HIGHLY FOR
INSURANCE COVERAGE. WE ARE AT
THE VERY BOTTOM NATIONALLY ON
MANY IMPORTANT MEASURES OF
HEALTHCARE QUALITY. LAST YEAR,
WE RANKED 44TH IN THE NATION FOR
PREVENTION AND TREATMENT AND
50TH THAT'S DEAD LAST FOR
CHILDREN WITHOUT A MEDICAL AND
DENTAL PREVENTIVE CARE VISIT.
WHILE THERE ARE MANY FACTORS
ASSOCIATED WITH QUALITY RATINGS,
WORKFORCE LIMITATIONS ARE SURELY
A PART. WITHOUT A PERSON TO SEE
CARE IS HARD TO GET. IN ADDITION
TO, UH, INSUFFICIENT NUMBER OF
HEALTHCARE WORKERS, OUR CURRENT
HEALTH WORKFORCE DOESN'T REFLECT
THE RACIAL, ETHNIC OR LINGUISTIC
DIVERSITY OF OUR STATE. AND HERE
THE NUMBERS ARE REALLY
STARTLING. NEARLY HALF OF
CALIFORNIA RESIDENTS IDENTIFY AS
LATINO OR BLACK. YET ONLY 14% OF
OUR MEDICAL SCHOOL GRADUATES AND
LESS THAN 9% OF OUR PRACTICING
PROVIDERS DO WHILE THESE
PRESENTED, UH PERCENTAGES A RE
TRENDING UP, THEY NEED TO MOVE
MUCH FASTER AND MUCH FURTHER.
THE GAP IS GREATEST AMONG
LATINOS, WHO ARE UNDER
REPRESENTED AMONG EVERY LICENSED
HEALTH PROFESSION IN OUR STATE,
AND EVERY REGION 47 IN ALL.
REACH POPULATION PARITY FOR
PHYSICIANS WE WOULD NEED TO
PRODUCE MORE THAN 37,000 MORE
LATINO PHYSICIANS TODAY FROM ALL
BACKGROUNDS WE PRODUCE JUST A
LITTLE OVER 1700. WHY IS
DIVERSITY AND REPRESENTATION SO
IMPORTANT BECAUSE THERE ARE
BENEFITS TO CONCORDANCE? WHEN
PATIENTS SHARE THE RACE OR
ETHNICITY OF THEIR PROVIDER.
THEY REPORT GREATER TRUST.
GREATER SATISFACTION AND CARE.
THEY HAVE BETTER COMMUNICATION
AND ADHERENCE TO TREATMENT. AND
IN SOME INSTANCES, THEY RECEIVE
MORE EFFECTIVE CARE. THE ABILITY
TO SPEAK THE SAME LANGUAGE WITH
A PROVIDER OR A HEALTHCARE TEAM
MEMBER FURTHER ENHANCES TRUST
AND DECREASES POOR CLINICAL
OUTCOMES DUE TO
MISCOMMUNICATION. LINGUISTIC
SKILLS ARE IMPORTANT ACROSS OUR
COUNTRY, BUT THEY'RE
PARTICULARLY IMPORTANT IN
CALIFORNIA, WHERE 44% OF
HOUSEHOLDS SPEAK A LANGUAGE
OTHER THAN ENGLISH. PROVIDERS OF
COLOR ARE ALSO MORE LIKELY TO
PRACTICE IN MEDICALLY
UNDERSERVED AREAS AND TO ACCEPT
ME. IN 2019 LEADERS FROM ACROSS
HEALTH, EDUCATION, LABOR AND
GOVERNMENT PRIORITIZE
RECOMMENDATIONS TO EXPAND AND TO
DIVERSIFY THE HEALTH WORKFORCE
IN CALIFORNIA. THE FINAL REPORT
OF THE CALIFORNIA FUTURE HEALTH
WORKFORCE COMMISSION HAS BECOME
A BLUEPRINT FOR ACTION IN OUR
STATE AND A ROLE MODEL ACROSS
THE COUNTRY. AND WE'VE SEEN
SUBSTANTIAL PROGRESS IN SOME
AREAS, MANY OF WHICH WE'RE GONNA
HEAR FROM PANELISTS TODAY,
INCLUDING THE ESTABLISHMENT OF
THE DEPARTMENT OF HEALTH CARE,
ACCESS AND INFORMATION. UH WHO
PLAYS A KEY ROLE IN WORKFORCE
INVESTMENT AND WORKFORCE DATA
COLLECTION AND REPORTING. WE'VE
SEEN THE EXPANSION STATEWIDE OF
PRIMARY CARE AND PSYCHIATRY
RESIDENCIES. AND THE ENGAGEMENT
OF COMMUNITY HEALTH WORKERS AS
WELL AS OTHER CRITICAL ROLES
SUCH AS DOULAS PEERS AND
WELLNESS COACHES. THESE EXAMPLES
HIGHLIGHT THE POWER OF STATE
ACTION AND THE BENEFITS OF CO
ORDINATED AND SUSTAINED STATE
INVESTMENT. OUR HEALTH WORKFORCE
IS CRITICAL INFRASTRUCTURE AND
WE NEED TO PROTECT IT. MUCH MORE
IS NEEDED. LET ME END THERE.
I'LL PASS IT ALONG. UH, AND I'LL
BE BACK ON A FURTHER PANEL TO
SPEAK MORE ABOUT SOLUTIONS.
THANK YOU. A GREAT THANK YOU SO
MUCH, UH, CATHERINE, AND THANK
YOU SO MUCH. THE CHAIR AND
MEMBERS, UH, FOR HAVING ME
TODAY. MY NAME IS KAREN SAVAGES.
I'M THE EXECUTIVE DIRECTOR OF
THE CALIFORNIA PAN ETHNIC HEALTH
NETWORK OR èC. P I DO HAVE A
POWERPOINT. UM, BUT I'LL JUST
KEEP GOING. UH AND IT'LL GET
THERE. UM SO, UH, AS YOU ALL
KNOW, WE LIVE IN A VERY DIVERSE
STATE. THE MAJORITY OF
CALIFORNIANS ARE PEOPLE OF COLOR
AND ONE IN EVERY FIVE
CALIFORNIANS. UH UH. IS LIMITED
ENGLISH PROFICIENT, MEANING THEY
SPEAK ENGLISH? LESS THAN VERY
WELL, UM, AND, UH, OUR LANGUAGE.
AND SERVICES ARE CRITICAL. UM.
IT'S A LITTLE DELAYED, CATHERINE
SAYS, OK. UM OK, COOL. ALL RIGHT
. GREAT UM, SO, UH, AS WE KNOW,
AND AS WAS ALREADY SHARED OUR
OUR HEALTHCARE WORKFORCE IS NOT
REPRESENTATIVE OF THE STATE'S
DIVERSE POPULATION, PARTICULARLY
STRIKING AGAIN FOR THE LATINO
POPULATION. 39% OF CALIFORNIANS
ARE LATINO, BUT ONLY 20% OF ALL
ACTIVE HEALTH WORKFORCE LICENSES
AND EVEN MORE STRIKING ONLY 8%
OF PHYSICIANS. UM AND, UH, ASIAN
AND WHITE CALIFORNIANS. WHEN YOU
LOOK AT THE DATA DO APPEAR TO BE
SORT OF OVER REPRESENTED, BUT I
WOULD PUT A REAL CAVEAT,
PARTICULARLY ON THE ASIAN
POPULATION WHERE WE DON'T HAVE
DESEGREGATED DATA, SO WE
PROBABLY DO HAVE A REAL MISMATCH
FOR SMALLER ASIAN AND PACIFIC
ISLANDER POPULATIONS. THAT'S A
MASKED BY OUR CURRENT DATA. A
LITTLE OVER HALF OF ALL LICENSED
PROVIDERS SPEAK ENGLISH ONLY,
BUT THOSE DISPARITIES ALSO VARY
BY LICENSE, TYPE AND REGION AND
LANGUAGE IN PARTICULAR, UM AND
WE HIGHLIGHT THE DATA BECAUSE IT
IS A FIRST STEP TO ACHIEVING A
MORE INCLUSIVE WORKFORCE IS
REALLY HAVING THAT BASELINE DATA
ON PATIENT AND PROVIDER
CONCORDANT BY LANGUAGE
PROFICIENCY, DISABILITY, SEXUAL
ORIENTATION, GENDER IDENTITY AND
RACE. UH IN 2014. WE AT èC P
WORKED TO PASS WHAT WAS THEN A B
21 02 WITH THE LATINO COALITION
FOR A HEALTHY CALIFORNIA AND
THAT REQUIRE THE DEPARTMENT OF
CONSUMER AFFAIRS TO COLLECT
DEMOGRAPHIC DATA ON ALLIED
HEALTH PROFESSIONALS AND PROVIDE
THAT DATA TO WHAT IS NOW HÌ. UH,
IT DID ONLY REQUIRE DATA FROM A
LIMITED NUMBER OF HEALTH CARE
OCCUPATIONS. UH, SO IN 2021, WE
CAME BACK AND WHAT BECAME
TRAILER BILL REQUIRED ADDITIONAL
REPORTING, UM FROM HÌ Kò AROUND,
UM, THE DEMOGRAPHIC DATA OF
REGISTERED HEALTH PROFESSIONALS
UNDER THE DEPARTMENT OF CONSUMER
AFFAIRS. UH, SO NOW WE ARE ABLE
TO SORT OF TAKE A FIRST LOOK AT
THAT DATA FAIRLY RECENTLY, AND
THAT'S WHAT'S CONTAINED IN UM,
SLIDES HERE. UM SO HERE YOU SEE
A CHART THAT COMPARES THE RACE
AND ETHNICITY OF THE ESTIMATED
PERCENTAGE OF ALL ACTIVE
LICENSES COMPARED TO THE
POPULATION PERCENTAGE FOR EACH
GROUP. AND AGAIN. I WOULD
REALLY, UM, KIND OF CALL IT THE
BIG CAVEAT IN THE SORT OF IN THE
ASIAN COMMUNITY THAT YOU SEE
HERE AS WELL AS WHEN YOU LOOK AT
THE BLACK AND PACIFIC ISLANDER
COMMUNITY. YOU MIGHT SAY, OK,
THOSE ARE VERY CLOSE, BUT I
THINK WE ALSO HAVE TO REMEMBER.
THOSE ARE VERY SMALL AND
DISPERSED POPULATIONS SO
DEPENDING ON WHERE THOSE
PROVIDERS ARE LOCATED AND WHERE
THE COMMUNITIES ARE LOCATED,
PEOPLE CONTINUE TO STRUGGLE TO
FIND A PROVIDER. UM, WHO, UH, IS
CONCORDANT UM, THE
REPRESENTATION ALSO VARIES
ACROSS WORKFORCE CATEGORIES, SO
THIS TABLE IS A LITTLE BUSY BUT
BASICALLY GREEN AND RED, UH,
WHICH SHOWS THAT THE PERCENTAGE
POINT DIFFERENCES BETWEEN THE
POPULATION AND THE ESTIMATED
PERCENTAGE OF ACTIVE LICENSES
FOR EACH OF THESE WORKFORCE
CATEGORIES, SO THE GROUPS IN
GREEN HAVE A PERCENTAGE OF
ACTIVE LICENSES THAT ARE GREATER
THAN THE POPULATION PERCENTAGE.
AND THE GROUPS IN RED ARE THE
REVERSE. RIGHT UM, THE
PERCENTAGE OF ACTIVE LICENSES IS
LESS THAN THE POPULATION
PERCENTAGE. AND THIS SHOWS A
DEEP DIVE ON BEHAVIORAL HEALTH
TO SORT OF TAKE ONE AND
PARTICULARLY FOCUSING ON
LANGUAGE BECAUSE WE KNOW THAT
LANGUAGE CONCORDANCE IN
PARTICULAR IS CRITICAL TO
ADVANCING QUALITY BEHAVIORAL
HEALTH SERVICES. SO THIS LOOKS
AT LANGUAGES SPOKEN IN THE
BEHAVIORAL HEALTH WORKFORCE AND
COMPARES THEM TO POPULATION
ESTIMATES FOR THE STATE, AND YOU
CAN SEE THAT API LANGUAGE
SPEAKERS MAKE UP ALMOST 10% OF
CALIFORNIA'S POPULATION, BUT
ONLY 3.6% OF BEHAVIORAL HEALTH
PROVIDERS AGAIN NOT DESEGREGATED
, BUT EVEN AGGREGATED LIKE THIS,
WE CAN SEE THE MISMATCH. STUDIES
HAVE FOUND THAT A LACK OF A
DIVERSE MENTAL HEALTH WORKFORCE
THE ABSENCE OF CULTURALLY
INFORMED TREATMENT OPTIONS AND
STEREOTYPES ASSOCIATED WITH
POOR, MORE POOR MENTAL HEALTH
CONTRIBUTED TO LIMITED MENTAL
HEALTH TREATMENT AMONG PEOPLE OF
COLOR. UM AND CATHERINE TALKED A
LITTLE BIT ABOUT CULTURAL
CONCORDANCE, WHICH WE UNDERSTAND
TO BE A REALLY IMPORTANT PART OF
QUALITY OF CARE IN HEALTH CARE.
IT CONTRIBUTES TO PATIENTS
HAVING POSITIVE EXPERIENCES WITH
THEIR CARE PROVIDERS TO
IMPROVING COMMUNICATION AND
TRUST, ESPECIALLY AMONG GROUPS
THAT HAVE EXPERIENCED
DISCRIMINATION HISTORICALLY AND
PRESENT DAY WHICH CAN IN TURN
IMPROVE CARE AND OUTCOMES. UM,
AND A COUPLE OF STUDIES JUST TO
HIGHLIGHT ABOUT, UH, WHY
CULTURAL CONCORDANCE IN HEALTH
CARE IS REALLY SO IMPORTANT. ONE
STUDY IN OAKLAND RANDOMIZED A
MALE BLACK PATIENTS TO MALE
DOCTOR, MALE BLACK DOCTORS AND
MALE NON-BLACK DOCTORS AND FOUND
THAT PATIENTS WERE MORE LIKELY
TO ACCEPT PREVENTIVE CARE FROM A
BLACK DOCTOR. THE RESEARCHERS
ESTIMATE THAT THIS DIFFERENCE IN
ADHERENCE TO CARE COULD ACTUALLY
REDUCE THE BLACK WHITE
CARDIOVASCULAR MORTALITY GAP BY
19. A SYSTEMATIC REVIEW OF
STUDIES OF LANGUAGE CONCORDANCE
SHOWED THAT IN THE MAJORITY OF
STUDIES, PATIENT PHYSICIAN
CONCORDANCE IMPROVED CARE,
INCLUDING PATIENT SATISFACTION,
DIAGNOSIS, UNDERSTANDING AND
MANAGEMENT OF CHRONIC DISEASE,
SUCH AS BLOOD PRESSURE AND
GLYCEMIC CONTROL FOR DIABETES
PATIENTS. NATIONALLY AMERICAN,
INDIAN AND ALASKAN NATIVE
POPULATIONS HAVE THE LOWEST LIFE
EXPECTANCY AND A HIGH DISEASE
BURDEN COMPARED TO OTHER RACES
AND ETHNICITIES. CULTURAL
CONCORDANCE HAS OFTEN BEEN
RECOMMENDED IN THAT COMMUNITY AS
A WAY TO IMPROVE OUTCOMES. I
THINK IT'S ALSO IMPORTANT TO
CONSIDER WORKFORCE DIVERSITY
FROM AN ECONOMIC OPPORTUNITY
PERSPECTIVE AND TO CONSIDER
WORKFORCE SOLUTIONS THAT COUNTER
RACIALIZED POVERTY. HEALTH CARE
IS A MAJOR ECONOMIC ENGINE FOR
THE STATE AND THE LARGEST
EMPLOYER IN MANY COMMUNITIES. IS
IMPORTANT THAT THE STATE ENSURE
THAT HEALTH CARE WORKERS,
PARTICULARLY LOW WAGE WORKERS,
WHO ARE MOST LIKELY TO BE PEOPLE
OF COLOR, ARE TREATED WITH
DIGNITY AND PAID A LIVING WAGE.
WE AT èC PEN ROUTINELY SPEAK
WITH HEALTH CARE WORKERS WHO ARE
UNABLE TO AFFORD THEIR OWN
HEALTH CARE AND SKIP NEEDED
SERVICES. AND THEN FINALLY, UM
ON RECOMMENDATIONS. UH, SINCE
2019, CALIFORNIA HAS INVESTED
SIGNIFICANT DOLLARS WITH YOUR
LEADERSHIP IN REDUCING OUR OUR
SEVERE WORKFORCE SHORTAGES WE'VE
CREATED NEW REIMBURSABLE
PROVIDER TYPES SUCH AS COMMUNITY
HEALTH WORKERS. UM BUT IN ORDER
TO REALLY MAKE BEST USE OF
TARGETED INVESTMENTS, WE HAVE A
COUPLE OF RECOMMENDATIONS. ONE
IS TO RECOGNIZE AND COUNTER THE
IMPACTS OF ANTI RACIAL EQUITY
INITIATIVES SUCH AS PROPOSITION
209 AND THE RECENT SUPREME COURT
DECISION ON AFFIRMATIVE ACTION.
WE HAVE SEEN THE IMPACT OF
PROPOSITION 209 IN TERMS OF
DIVERSITY. EDUCATION UM AND SO
WE UNDERSTAND THAT WE HAVE TO BE
CREATIVE, AND WE HAVE TO THINK
ABOUT HOW TO CONTINUE TO ENSURE
DIVERSITY AND EQUITY IN OUR
HIGHER EDUCATION AND TRAINING
PROGRAMS. UM OUR VARIOUS
DEPARTMENTS AND AGENCIES, UM,
SHOULD CONTINUE TO ADDRESS
WORKFORCE TRAINING, NEEDS AND
OPEN, EARN AND LEARN PROGRAMS TO
A BROADER, MORE RACIALLY AND
ETHNICALLY DIVERSE POOL. AND
WHILE WE UNDERSTAND THE
CURRENTLY AVAILABLE DATA LIMITS,
UH, IN THE ESTIMATES THAT HÌ Kò
CAN PRODUCE, WE'RE HOPEFUL THERE
WILL BE IMPROVEMENTS IN DATA
COLLECTION METHODS SO THAT WE
CAN SEE DATA AT A MUCH MORE
GRANULAR LEVEL FOR OUR
POPULATION. WE ALSO UNDERSTAND
THAT IT'S NOT ONLY ABOUT
TRAINING PEOPLE TO BECOME
PROVIDERS, BUT IT'S ABOUT
RETAINING OUR HEALTH CARE
WORKFORCE PROVIDERS AND THAT
PROVIDERS OF COLOR OFTEN
STRUGGLE IN BOTH EDUCATIONAL AND
PROFESSIONAL SETTINGS BECAUSE OF
BOTH IMPLICIT AND EXPLICIT
RACIAL BIAS, AND SO WE SHOULD BE
WORKING TO ENSURE THAT ALL
WORKPLACES AND TRAINING AND
EDUCATIONAL INSTITUTIONS ARE
ACTIVELY WORKING TO ADVANCE
DIVERSITY, EQUITY AND INCLUSION
AND THEN FINALLY, REALLY MAKING
SURE THAT WE ARE PROVIDING
ADEQUATE WAGES, DIGNIFIED
WORKING CONDITIONS AND
LEADERSHIP OPPORTUNITIES FOR
ALLIED HEALTH PROFESSIONALS SUCH
AS HEALTH WORKERS, DOULAS AND
PEER SPECIALISTS WERE FILLING
MANY OF THESE GAPS TODAY. THANK
YOU SO MUCH. HELLO. MY NAME IS
MARON, A GOER? I'M THE POLICY
AND LEGISLATIVE AFFAIRS MANAGER
WITH THE CALIFORNIA BLACK HEALTH
NETWORK. THANK YOU FOR THE
OPPORTUNITY TO BE A PART OF THIS
DISTINGUISHED PANELISTS TO
DISCUSS THE IMPACT OF THE LACK
OF DIVERSITY IN HEALTH,
WORKFORCE AND BLOCKS. THIS ISSUE
HAS SIGNIFICANT IMPLICATIONS FOR
OUR STATE OVERALL HEALTH AND
EQUITY. LET'S START BY LOOKING
AT SOME DATA, ACCORDING TO THE U
S¼ CENSUS BUREAU, BLACK
INDIVIDUALS COMPRISE AROUND 6.5%
OF CALIFORNIA'S POPULATION,
HOWEVER. WHEN WE LOOK AT THE
HEALTH WORKFORCE, THE
REPRESENTATION OF BLACK
PROFESSIONALS IS LAW. A
CALIFORNIA HEALTHCARE FOUNDATION
REPORT FOUND THAT 3% OF
PHYSICIANS ARE BLACK, THE
CALIFORNIA BOARD OF REGISTERED
NURSING 2020 SURVEY OF
REGISTERED NURSES REPORTED THAT
4% OF NURSES IN CALIFORNIA ARE
BLACK. THE MARCH 29TH 2021
PUBLISHED ANALYSIS AND NEW
ENGLAND JOURNAL OF MEDICINE,
NOTED THAT BLACK MEDICAL SCHOOLS
HAD PLAYED A SIGNIFICANT ROLE IN
TRAINING THE CURRENT NUMBER OF
BLACK HEALTHCARE PROFESSIONALS
ENROLLING 14.2% BLACK WOMEN
14.9% OF BLACK MEN IN 2019,
WITHOUT THEIR EFFORT. THE
PERCENTAGE OF BLACK CLINICIAN
WOULD BE EVEN LOWER. WE HOPE
EVERYONE HAS SEEN THE REPORT
PUBLISHED BY THE CALIFORNIA
HEALTHCARE FOUNDATION, LISTENING
TO BLACK CALIFORNIANS, WHICH
PRESENTS THE DISTURBING FACT
THAT ONE IN FOUR BLACK
CALIFORNIANS AVOID SCARE BECAUSE
OF FEAR OF BEING MISTREATED OR
DISRESPECTED. ADDRESS THIS
MISTREATMENT OF BLACK PATIENTS.
CALIFORNIA BLACK HEALTH NETWORK
LAUNCHED THE HOW DO I CAMPAIGN
THANKS TO THE GENEROUS SUPPORT
OF THE CALIFORNIA HEALTHCARE
FOUNDATION. OUR CAMPAIGN ENGAGED
BLACK COMMUNITIES IN TARGETED
COUNTIES TO EMPOWER THEM WITH
THE INFORMATION AND RESOURCES
THEY NEED TO NAVIGATE AND
ADVOCATE FOR THEMSELVES, THEIR
FRIENDS THEIR FAMILIES ON HOW TO
TAKE ACTION WHEN FACED WITH
DISCRIMINATION AND DOCTOR'S
OFFICE. THEN HOW DO I CAMPAIGN
ADDRESSES THE IMPACT OF
STRUCTURAL RACISM IN HEALTHCARE
HEAD ON? THROUGH THIS PROGRAM.
WE HAVE LEARNED THERE IS MUCH
WORK AHEAD TO DIVERSIFY THE
HEALTH CARE WORKFORCE. THE
UNDERREPRESENTATION OF BLACK
PROFESSIONALS IN HEALTHCARE
PERPETUATE EXISTING HEALTH
DISPARITIES. STUDIES HAVE SHOWN
THAT RACIAL AND ETHNIC
COMMONALITIES BETWEEN PATIENTS
AND PROVIDERS LEAD TO BETTER
COMMUNICATION, INCREASE TRUST
AND IMPROVED PATIENT
SATISFACTION. WHEN BLACK
INDIVIDUALS ARE UNABLE TO SEE
HEALTH CARE PROFESSIONAL WHO
SHARE THEIR RACIAL OR ETHNIC
BACKGROUND. IT CAN CONTRIBUTE TO
A LACK OF TRUST IN THE HEALTH
CARE SYSTEM, RESULTING IN
DELAYED OR POOR CARE. CALIFORNIA
MUST EXPAND THE NUMBER OF HIGHER
LEARNING INSTITUTIONS COMMITTED
TO ADDRESSING DISPARITIES IN THE
MEDICAL WORKFORCE. CHARLES DREW
UNIVERSITY IS A POSITIVE
DEVELOPMENT. WE COMMEND GOVERNOR
NEWSOM IN CALIFORNIA LEGISLATURE
FOR WORKING TOGETHER TO APPROVE
$50 MILLION TO CONSTRUCT THE
FACILITY TO HOUSE THE NEW
MEDICAL DEGREE PROGRAM. 70% OF
THE GRADUATES ARE PEOPLE OF
COLOR AND THE UNIVERSITY
ACCEPTED ITS 1ST 60 MEDICAL
STUDENTS AND TO THE PROGRAM IN
2020 THREE. THIS IS ONE PIPELINE
TO EXPAND THE NUMBER OF BLACK
CLINICIANS AND THE STATE SHOULD
CONTINUE TO SUPPORT IT. BUT THIS
IS NOT ENOUGH. ALL MEDICAL
SCHOOLS IN CALIFORNIA MUST
INCREASE THEIR EFFORT TO RECRUIT
TALENTED AND QUALIFIED STUDENTS
FROM UNDERREPRESENTED
MINORITIES. HOW ABOUT THE
UNIVERSITY OF CALIFORNIA èC B
HÌ N STRONGLY BELIEVES THE
UNIVERSITY OF CALIFORNIA AS THE
TOP STATE FUNDED HIGHER
EDUCATIONAL INSTITUTION AS A
VITAL ROLE TO PLAY IN EXPANDING
THE NUMBER OF BLACK CLINICIANS
YOU èC HAS SIX P SCHOOLS, WHICH
CAN PLAY AN IMPORTANT ROLE IN
ADMITTING AND TRAINING BLACK
MEDICAL PROFESSIONALS. I WOULD
LIKE TO BRING TO YOUR ATTENTION
AN EXCELLENT REPORT PREPARED IN
SEPTEMBER 2020 BY THE U èC
HEALTH SCIENCES, DIVERSITY
EQUITY AND INCLUSION TASK FORCE.
DISRUPTING THE STATUS QUO, WHICH
IS GEARED TOWARD IMPROVING
DIVERSITY THROUGH THE U S¼ THE
MEDICAL SCHOOL. ACCORDING TO
THAT REPORT IN 2018 AND 2019,
THE PERCENTAGE OF BLACKS AND THE
U èC HEALTH SCIENCES STUDENT IS
NEARLY AT THE BOTTOM JUST ABOVE
AMERICAN INDIAN ALASKA NATIVE.
FORTUNATELY THAT REPORT OFFERS
CRITICAL RECOMMENDATION TO
IMPROVE U èC STUDENT DIVERSITY
AND HEALTH SCIENCES. WE
ENCOURAGE YOU TO CONSIDER
WORKING WITH U èC OFFICE OF THE
PRESIDENT FOR THEIR
IMPLEMENTATION. HIGHLIGHTS FROM
THE TASK FORCE RECOMMENDATION
INCLUDE TO DIVERSIFY THE
APPLICANT POOL THEIR RECOMMEND
PARTNERING WITH CALIFORNIA
COMMUNITY COLLEGES. CALIFORNIA
STATE UNIVERSITIES, HISTORICALLY
BLACK COLLEGES AND UNIVERSITIES
SINCE THEY ENROLL IN DIVERSE
STUDENT BODY THERE ARE 101 HBCUS
IN THE U S¼ AND YOU SEE, CAN
ATTRACT TRAIN MENTOR RETAIN. TOP
STUDENTS FROM THIS QUALITY
SCHOOLS. EXPAND THE PRIME MODEL,
WHICH OFFERS SPECIALIZED
EDUCATION, TRAINING AND SUPPORT
FOR U èC MEDICAL STUDENTS WHO
WISH TO SERVE UNDERS POPULATIONS
IN URBAN AND RURAL COMMUNITY.
CRIME IS UNDERFUNDED, AND THE
LEGISLATOR SHOULD PUSH FOR
DEEPER INVESTMENT IN THIS
EFFECTIVE PROGRAM. THE REPORT
ALSO RECOMMENDS REPLICATING THE
PRIME MODEL FOR OTHER UC HEALTH
PROFESSIONS SUCH AS NURSING
PHARMACY AND PUBLIC HEALTH. THIS
EFFORT WILL MAKE AN IMPORTANT
CONTRIBUTION TO INCREASING THE
NUMBER OF BLACK HOLES
PROFESSIONALS. OR BEHAVIOR HOLDS
PROFESSION. èC B N IS WORKING
WITH ASSEMBLY MEMBER CORY
JACKSON TO EXPAND THE MEDICAL
CERTIFIED PEER SUPPORT SERVICES
THROUGH THE CALIFORNIA BEHAVIOR
HALT OF CARE. WE BELIEVE THIS
WILL BE MORE EFFECTIVE THAN A
SELF FUNDED COUNTY OPTION. A
DIVERSE AND INCLUSIVE BLACK
WORKFORCE IN THE HEALTHCARE
SECTOR WOULD NOT ONLY LEAD TO
IMPROVED BLACK PATIENT CARE BUT
CAN OFFER SIGNIFICANT COST
SAVINGS FOR CALIFORNIA BY
PREVENTING AND MANAGING DISEASE
IN EARLY STAGE WITH CULTURALLY
COMPETENT CARE. THANKS TO THE
EXTENSIVE SURVEY DONE BY
CALIFORNIA HEALTHCARE FOUNDATION
, CALIFORNIA BLACKS HAVE CLEARLY
EXPRESSED THEY ARE MORE LIKELY
TO SEEK CARE AND HER TO
TREATMENT PLANS IF THE HEALTH
CARE IS PROVIDED BY THOSE WHO
LOOK LIKE THEM AND REFLECT THEIR
COMMUNITY. RESEARCH LED BY
SANFORD UNIVERSITY SCHOOL OF
MEDICINE, FOUND THAT BLACK MEN
SEEN BY BLACK DOCTORS AGREED TO
MORE AND MORE INVASIVE
PREVENTIVE SERVICES THAN THOSE
SEEN BY NON BLACK DOCTORS. THIS
EFFECT. SEEM TO BE DRIVEN BY
BETTER COMMUNICATION AND MORE
TRUST. SUGGESTING THAT IMPROVED
INTERACTIONS WITH BLACK DOCTORS
CAN LEAD TO BETTER ADHERENCE TO
MEDICAL RECOMMENDATIONS. TO
CONCLUDE A DIVERSE HEALTHCARE
WORKFORCE BRING UNIQUE
PERSPECTIVE AND EXPERIENCES THAT
CAN CONTRIBUTE TO INNOVATIVE
APPROACH IN HEALTHCARE DELIVERY.
èC B A N URGED THE LEGISLATOR
TO INVEST IN EXPANDING THE
MEDICAL PROGRAM AT CHARLES DREW
UNIVERSITY AND TO ALSO IMPLEMENT
THE SEPTEMBER 2020 UC HEALTH
SCIENCES, DIVERSITY EQUITY AND
INCLUSION TASK FORCE
RECOMMENDATION, WHICH EMBRACED
SUPPORTING AND EXPANDING THE U
èC PRIME PROGRAM. I WANT TO
THANK YOU. THE CHAIR AND
COMMITTEE MEMBER FOR INVITING ME
TO SPEAK AT THIS INFORMATIONAL
HEARING. THANK YOU. THANK YOU.
AND UH, WE WILL WELCOME UH,
ASSEMBLY MEMBER PILAR SCHIAVO
AND ASK IF SHE HAS ANY OPENING
REMARKS FOR US. UM, I JUST
WANTED TO THANK THE PANEL. ALL
THE PANELISTS WHO ARE HERE
TODAY. THIS IS SUCH AN IMPORTANT
ISSUE. UM AND YOU KNOW, I MEAN,
JUST FROM WHAT I'M HEARING
ALREADY, IT SEEMS LIKE THERE'S A
REAL PROBLEM WITH THE PIPELINE.
UM AND YOU KNOW, THIS IS, UM.
IT'S SO FRUSTRATING BECAUSE I
THINK IT'S REALLY SHORT SIGHTED
BECAUSE WE KNOW THAT THESE ARE
THESE ARE GOOD JOBS, RIGHT IF
WE'RE ABLE TO PUT MONEY IN UP
FRONT TO FUND TRAINING PROGRAMS,
WE KNOW THAT CERTAINLY IF IT'S
PUBLIC MONEY THAT THAT PUBLIC
MONEY IS GOING TO COME BACK TO
US, BECAUSE THESE ARE GOOD JOBS
THAT FOLKS ARE GONNA HAVE FOR
THE REST OF THEIR CAREERS. UM
AND YOU KNOW, AT A TIME WHEN WE
KNOW THAT TOO MANY PEOPLE ARE
UNDEREMPLOYED, WHERE THEY HAVE
TO HAVE A COUPLE JOBS,
ESPECIALLY IN USE OF COLOUR, UM,
AND LOW WAGE AND SERVICE SECTOR
JOBS THAT THESE ARE JOBS THAT
TYPICALLY HAVE RETIREMENT PLANS
AND, UM, LIVING WAGE JOBS WHERE
PEOPLE CAN ACTUALLY PUT THEIR
KIDS THROUGH SCHOOL AND KEEP A
ROOF OVER THEIR HEAD. UM THAT
THESE ARE EXACTLY THE KINDS OF
JOBS THAT WE NEED TO BE DRIVING
FOLKS INTO AND MAKING SURE THAT
WE CREATE PATHWAYS FOR FOLKS TO
GET INTO THESE KINDS OF, UM,
JOBS IN THE HEALTH CARE FIELD. I
THINK THAT, UM YOU KNOW, ONE OF
THE THINGS THAT REALLY CONCERNS
ME ABOUT THE RECENT, UM. EXODUS
OUT OF HEALTHCARE, WHICH
INCLUDES A LOT OF PEOPLE OF
COLOR. UM IS THAT YOU KNOW,
THOSE ARE THINGS THAT CAN BE
REMEDIED NOW, RIGHT? WE CAN WE
CAN PREVENT THE BLEEDING NOT TO
SORRY. NÓ PUN INTENDED. UM BUT
YOU KNOW WE CAN. WE CAN PREVENT
THAT THROUGH MAKING SURE THAT,
UM, THAT WE'RE SUPPORTING
WORKERS IN THE WORKPLACE THAT
WERE APPROPRIATELY STAFFING SO
THAT PEOPLE ARE NOT AND UNDUE
BURDEN. UM WHICH I THINK IS A
LOT OF WHAT HAS TO DO WITH THE
BURNOUT THAT'S HAPPENING. UM
WITHIN HOSPITALS, AT LEAST. AND
UM AND I THINK THAT YOU KNOW,
THERE'S A REAL CONCERN THAT I
HAVE ALSO AROUND TRAVELERS AND
THE HEAVY HEAVY USE OF TRAVELERS
, WHICH ARE SO EXPENSIVE IN OUR
HEALTHCARE SYSTEM. UM AND YOU
KNOW, IT'S UM IT'S NOT ALWAYS
FOLKS FROM OUR COMMUNITY.
THEY'RE PEOPLE FROM OUT OF
STATE. THESE ARE NOT, YOU KNOW.
ALWAYS PEOPLE WHO A RE COMING
FROM OUR COMMUNITY, SO THERE'S
NOT. THESE ARE NOT HIGH PAID
JOBS, NECESSARILY GOING BACK
INTO INTO OUR COMMUNITIES, UM
AND NOT AS INVESTED IN OUR
COMMUNITY. AND SO I THINK, YOU
KNOW, MAKING SURE THAT WE'RE
ABLE TO STAFF APPROPRIATELY WITH
LOCAL HIRES IN THESE GOOD JOBS
AND CREATING THE PATHWAYS TO BE
ABLE TO GET PEOPLE FROM OUR
COMMUNITY INTO GOOD JOBS. UM, IN
THE HEALTH CARE FIELD IS
INCREDIBLY IMPORTANT. UM
IMPORTANT TO ME AND I KNOW TO
THE TO THE COMMITTEE HERE, SO
JUST REALLY HAPPY. THANKFUL TO
THE CHAIR FOR RAISING THIS ISSUE
AND MAKING SURE THAT WE
HIGHLIGHT THIS AND KEEP FOCUSED
ON IT. AND AS WE GO FORWARD IN
THIS LEGISLATIVE SESSION TO, YOU
KNOW, ADDRESS THE CONCERNS THAT
I KNOW EXIST. THANK YOU. THANK
YOU. ASSEMBLY MEMBER. WE'LL MOVE
ON NOW TO DOCTOR AQUINO. THANK
YOU SO MUCH. MY WHEN I STARTED
THIS, THANK YOU, CHAIRWOMAN
BANTA, AN ESTEEMED MEMBERS OF
THE COMMITTEE. IT IS A PLEASURE
TO JOIN YOU ALL TODAY. AND
DOCTORS. AQUINO AND I HAVE THE
HONOR OF SERVING AS THE
EXECUTIVE DIRECTOR AT THE LATINO
COALITION FOR A HEALTHY
CALIFORNIA. A Tð L èC HÌ èC.
WE ARE COMMITTED TO ADVANCING
AND PROTECTING LATINA AND MESO
AMERICAN INDIGENOUS HEALTH
POLICY CHANGE AND ADVOCACY. WE
PRIDE OURSELVES IN TRANSLATING
COMMUNITY SOLUTIONS INTO
EQUITABLE POLICY AND LASTING
SYSTEMIC CHANGE. LATINAS MAKE UP
A POWERFUL MAJORITY IN
CALIFORNIA. PRICING 40% OF OUR
STATE'S POPULATION. THAT TOTALS
A STAGGERING 60 MILLION
INDIVIDUALS REPRESENTING OUR
CALIFORNIA POOL OF PATIENTS,
CONSUMERS AND STRONG MEMBERS OF
THE WORKFORCE ITSELF. AND YET,
DESPITE OUR SIGNIFICANT PRESENCE
, WE CONTINUE TO FACE SYSTEMIC
CHALLENGES THAT HINDER OUR
ABILITY TO FULLY ADDRESS HEALTH
INEQUITIES IN OUR COMMUNITIES.
THE ENDURING IMPACTS OF SYSTEMIC
DISENFRANCHISEMENT AND CHRONIC
UNDER INVESTMENTS, COUPLED WITH
THE AFTERMATH OF THE RECENT
PUBLIC HEALTH EMERGENCY. HAVE
LED OUR COMMUNITIES TO CONFRONT
ONGOING CHALLENGES, INCLUDING
ACUTE COVID-19 CASES. LONG COVID
AND THE SOCIO-ECONOMIC AFTERMATH
OF THE PANDEMIC. LEAVING OUR
COLLECTIVE HEALTH STATUS
INCREASINGLY FRAGILE. WINE
GLARING ISSUE THAT DEMANDS YOUR
ATTENTION IS THE
UNDERREPRESENTATION OF LATINA
HEALTHCARE PROFESSIONALS IN OUR
WORKFORCE. THE SPY BEING A
SUBSTANTIAL PORTION OF OUR STATE
POPULATION AND THOSE UTILIZING
HEALTH CARE SERVICES ONLY 6% OF
PRIMARY CARE. PHYSICIANS AND 6%
OF PRACTICING DENTISTS ARE
LATIN. AS WE DIG DEEPER INTO THE
DATA BY REGION AND SPECIALTY.
THE NUMBERS, UNFORTUNATELY,
CONTINUE TO DWINDLE.
ADDITIONALLY A GROWING ME POOL
INCREASES OUR DEMAND FOR LATINO
HEALTHCARE PROFESSIONALS.
CURRENTLY MEDI COVERS 15.28
MILLION PEOPLE. AND OVER 50% OF
THOSE ENROLLED ARE LATINA. BUT
JUST THIS YEAR WITH THE LATEST
MEDICAL EXPANSION, THE PATIENT
POOL HAS THE POTENTIAL TO GROW
BY AN ESTIMATED 700,000
UNDOCUMENTED ADULTS. A MAJORITY
OF THOSE BEING LATINOS BETWEEN
THE AGES OF 26 TO 49. THE LACK
OF LATINA HEALTH CARE
PROFESSIONALS POSES A MAJOR
BARRIER TO ADEQUATE CARE FOR OUR
COMMUNITY. TO ADDRESS HIS
DISPARITY. WE MUST INVEST IN
CULTIVATING A HEALTHCARE
WORKFORCE THAT REFLECTS THE
DIVERSITY OF OUR COMMUNITY. THIS
ENTAILS NOT ONLY RECRUITING MORE
LATINA HEALTHCARE PROFESSIONALS
BUT ALSO ENSURING THAT THEY
POSSESS VARYING LIVED
EXPERIENCES HAVE LANGUAGE
PROFICIENCY AND I REPRESENTATIVE
OF INTERSECTIONAL IDENTITIES,
INCLUDING BUT NOT LIMITED TO
INDIGENOUS MESOAMERICAN. LATINAS
AFRO LATINAS L GB Tð QI, A TWO
S¼ PLUS UNDOCUMENTED, LOW
INCOME. AND THOSE FROM RURAL
COMMUNITIES. ONLY THEN WILL WE
EFFECTIVELY CATER TO THE NEEDS
OF OUR DIVERSE LATINX COMMUNITY.
AND TODAY I'D ACTUALLY LIKE TO
EXPAND OUR DEFINITION OF HEALTH
CARE TO ALSO INCLUDE OUR PUBLIC
HEALTH SYSTEMS. THAT IS A
DEFINITION THAT GOES BEYOND THE
HEALTHCARE DELIVERY SYSTEM TO BE
INCLUSIVE OF A SAFETY NET THAT
ADDRESSES SOCIAL DETERMINANTS OF
HEALTH. SUCH AS OUR CAL HÌ HÌ S¼
DEPARTMENTS, INCLUDING BUT NOT
LIMITED TO èC Dð S¼ S¼, THE
DEPARTMENT OF PUBLIC HEALTH AND
HÌ Kò. IN ORDER TO SERVE
CALIFORNIA CALIFORNIANS
EFFICIENTLY AND EFFECTIVELY, IT
IS ESSENTIAL TO INCREASE OUR
LATINA WORKFORCE ACROSS
DEPARTMENTS IN CALIFORNIA STATE
AGENCIES. FROM DIRECTORSHIP
ROLES TO SENIOR LEADERSHIP TO
MANAGEMENT AND ENTRY LEVEL
POSITIONS. INCREASING LATINA
REPRESENTATION WILL ENSURE WE
ADVANCE FROM CULTURALLY
COMPETENT TO CULTURALLY INNATE
SOLUTIONS. WHEN WE HAVE LATINAS
INDIGENOUS MESO AMERICANS AFRO
LATINAS L GB Tð Q I TWO S¼ PLUS
AN UNDOCUMENTED COMMUNITY
MEMBERS LEADING, IMPLEMENTING
AND EVALUATING OUR PROGRAMS. WE
ARE LESS LIKELY TO OVERLOOK THE
UNIQUE CHALLENGES AND NEEDS OF
OUR COMMUNITIES. OUR WORKFORCE
SHOULD BE A TRUE REFLECTION OF
OUR DIVERSE POPULATION AND
ACHIEVING THIS REQUIRES THE
IMPLEMENTATION OF INTENTIONAL
INTERAGENCY STRATEGIES AIMED AT
ENSURING DIVERSITY THROUGHOUT
THE ENTIRE EMPLOYEE LIFE CYCLE.
FROM THE INITIAL RECRUITMENT
PHASE TO RETAINING TALENT. IT IS
IMPERATIVE THAT WE SCRUTINIZE
AND ADDRESS THE BARRIERS THAT
PREVENT EQUITABLE
REPRESENTATION. THIS ENTAILS
EXAMINING ACCESSIBILITY IN THE
APPLICATION PROCESS,
DIVERSIFYING APPLICANT POOLS,
EXPANDING RECRUITMENT NETWORKS,
SCRUTINIZING HIRING PRACTICES
AND ENHANCING INTERNAL GROWTH
AND PROMOTION OPPORTUNITIES. WE
MUST TAKE A MOMENT TO REFLECT
AND IDENTIFY THE SYSTEMS
PRACTICES AND CULTURES THAT
PERPETUATE BIASES AND
DISPARITIES FACED BY LATINAS IN
OUR PUBLIC HEALTH WORKFORCE. I
DELIBERATELY FOSTERING
INCLUSIVITY AND REPRESENTATION
IN DECISION MAKING PROCESSES. WE
CAN EFFECTIVELY BRIDGE EXISTING
GAPS IN OUR SERVICES AND
POLICIES. THEREBY FOSTERING A
MORE EQUITABLE CALIFORNIA FOR
ALL. I WOULD BE REMISS NOT TO
MENTION A POWERFUL PART OF OUR
PUBLIC HEALTH WORKFORCE HERE.
ROMO TORE IT IS IMPORTANT TO
RECOGNIZE THE GREAT STRIDES WE
HAVE BEEN MAKING IN TRYING TO
INCORPORATE PROMOTOR AS INTO OUR
HEALTH CARE DELIVERY SYSTEM.
DRAT. BUT NOW IT IS TIME THAT WE
TAKE THIS GREAT EXAMPLE AND
APPLY IT TO OTHER SAFETY NET
PROGRAMS SUCH AS CALF, FRESH CAL
WORKS AND CALI. I èC WE MUST BE
INTENTIONAL TO INCORPORATE
PROMOTORS INTO PAYMENT MODELS
AND INTENTIONALLY CREATE JOBS
AND CAREER PIPELINES FOR THEM
WITHIN OUR DEPARTMENTS AND
AGENCY WORKFORCE. FINALLY IT IS
IMPERATIVE TO RECOGNIZE THAT THE
HEALTH OF OUR LATIN POPULATION
IS INTRICATELY LINKED TO THE
STRENGTH OF OUR ECONOMY. IN 2020
THREE, THE LATINO G Dð. I
REACHED AN IMPRESSIVE 682
BILLION WITH KEY SECTORS SUCH AS
EDUCATION AND HEALTH CARE,
PROFESSIONAL AND BUSINESS
SERVICES AND GOVERNMENT PLAYING
PIVOTAL ROLES. ACCORDING TO THE
L, Dð èC REPORT. CALIFORNIA'S
LATINA ECONOMY ALONE WOULD RANK
AS THE 21ST LARGEST IN THE
WORLD. SITTING BETWEEN THE
ECONOMIES OF POLAND AND
SWITZERLAND. THE ECONOMIC THEORY
OF HUMAN CAPITAL REINFORCES THE
NOTION THAT A HEALTHY WORKFORCE
IS A PRODUCTIVE WORKFORCE,
HIGHLIGHTING THE CRUCIAL INNER
PLAY BETWEEN HEALTH AND ECONOMIC
PROSPERITY. ESPECIALLY IN A YEAR
MARKED BY A BUDGET DEFICIT.
INVESTING IN OUR LATINO
WORKFORCE IS NOT ONLY A MORAL
IMPERATIVE, BUT ALSO A STRATEGIC
MOVE TO BOLSTER THE CALIFORNIA
ECONOMY FOR YEARS TO COME. IN
CONCLUSION. LET US NOT OVERLOOK
THE CRITICAL ROLE THAT LATINAS
PLAY IN SHAPING THE PRESENT AND
FUTURE OF CALIFORNIA. BY
PRIORITIZING THEIR HEALTH AND
REPRESENTATION IN THE WORKFORCE.
WE NOT ONLY UPHOLD OUR MORAL
OBLIGATION BUT ALSO PAVE THE WAY
FOR A STRONGER, MORE PROSPEROUS
STATE. THANK YOU. THANK YOU.
WE'LL MOVE ON. GOOD AFTERNOON
CHAIR AND MEMBERS TARA GAMBA
EASTMAN, DIRECTOR OF GOVERNMENT
AFFAIRS WITH THE STEINBERG
INSTITUTE. WE'RE AN INDEPENDENT,
NONPROFIT PUBLIC POLICY
INSTITUTE DEDICATED TO
TRANSFORMING CALIFORNIA'S MENTAL
HEALTH AND SUBSTANCE USE CARE
SYSTEMS. TODAY CALIFORNIA IS
FACING A CRISIS. SUBSTANCE USE
RATES HAVE SKYROCKETED. TENS OF
THOUSANDS OF PEOPLE ARE
STRUGGLING WITH ADDICTION AND
MENTAL ILLNESS, UNABLE TO ACCESS
THE CARE THAT THEY NEED TOO.
MANY ARE CYCLING THROUGH OUR
STREETS, EMERGENCY ROOMS AND
JAIL CELLS. AT THE SAME TIME,
OUR BEHAVIORAL HEALTH WORKFORCE
IS OVERWHELMED AND UNDERSTAFFED.
AS A STATE. WE'RE ALREADY UNABLE
TO MEET THE GROWING DEMAND FOR
BEHAVIORAL HEALTH SERVICES DUE
TO THE WORKFORCE SHORTAGE.
HOWEVER ATTRITION ACROSS THE
INDUSTRY IS GOING TO EXACERBATE
THE SHORTAGE IN THE YEARS TO
COME. PROFESSION CHANGES WORKERS
MOVING OUT OF STATE AND
RETIREMENT ARE ALL CONTRIBUTING
TO THE EVER GROWING SHORTAGE OF
PROFESSIONALS. TO INTERVENE IN
THE MENTAL HEALTH AND SUBSTANCE
USE CRISIS GRIPPING CALIFORNIA.
WE MUST BUILD OUR WORKFORCE TO
MEET OUR CURRENT AND FUTURE
DEMAND FOR SERVICES. BUT
INCREASING THE SHEER NUMBER OF
WORKERS ISN'T ENOUGH. AS WE GROW
OUR WORKFORCE. WE MUST ENSURE
THAT WE'RE EXPANDING, WHO IS A
PART OF IT? RIGHT NOW. OUR
BEHAVIORAL HEALTH WORKFORCE DOES
NOT REFLECT WHAT CALIFORNIA
ACTUALLY LOOKS LIKE. FOR EXAMPLE
, 70% OF OUR MEDI POPULATION ARE
PEOPLE OF COLOR YET 70% OF OUR
MEDIC. HEALTH PROVIDERS ARE
WHITE. RESEARCH HAS CONSISTENTLY
SHOWN THAT THERE IS GREATER
CLIENT SATISFACTION AND BETTER
OUTCOMES WHEN CLIENTS HAVE
ACCESS TO PROVIDERS WHO SHARE
THEIR BACKGROUND, LIFE
EXPERIENCES AND LANGUAGE. TO GET
A HANDLE OF THIS ISSUE. THE
STEINBERG INSTITUTE RECENTLY
DEVELOPED A PROGRAM OR TOOL
EXCUSE ME THAT ESTIMATES CURRENT
DEMAND AND A 10 YEAR ESTIMATE OF
FUTURE HIRING NEEDS FOR THE
BEHAVIORAL HEALTH WORKFORCE IN
CALIFORNIA. LEVERAGING FEDERAL
BUREAU OF LABOR STATISTICS DATA
AT THE COUNTY LEVEL. THIS TOOL
ALLOWS THE STATE AND INDIVIDUAL
COUNTIES TO LOOK AT OCCUPATION
SPECIFIC NEEDS BECAUSE OF GROWTH
AND DEMAND AND ATTRITION RATES.
BASED ON OUR ESTIMATES,
CALIFORNIA NEEDS TO ADD
APPROXIMATELY 375,000 BEHAVIORAL
HEALTH PROFESSIONALS TO MEET
CURRENT AND GROWING DEMAND AND
ACCOUNT FOR THE ATTRITION OVER
THE NEXT 10 YEARS. THIS IS
AROUND 32,000 PEOPLE PER YEAR
ACROSS THE SYSTEM OF CARE AND
PROFESSIONS. WHEN WE'RE THINKING
ABOUT HOW TO DIVERSIFY OUR
WORKFORCE AND GROW IT TO MEET
CURRENT AND FUTURE DEMANDS WE
CAN THINK OF SHORT AND LONG TERM
STRATEGIES. IN THE SHORT TERM,
WE CAN FOCUS ON RECRUITING
PROFESSIONALS WHO CAN BE TRAINED
AND BEGIN WORKING IN THE FIELD
QUICKLY PEERS, COMMUNITY HEALTH
WORKERS AND SUBSTANCE USE.
COUNSELORS UH, REQUIRE FEWER
YEARS OF TRAINING THAN MANY OF
OUR OTHER BEHAVIORAL HEALTH
PROFESSIONALS AND ALSO TEND TO
REPRESENT MORE DIVERSE
BACKGROUNDS. TO ADDRESS OUR LONG
TERM NEEDS. WE NEED TO BUILD A
PIPELINE TO BACKFILL POSITIONS
OVER THE NEXT DECADE AS OUR
AGING WORKFORCE CONTINUES TO
RETIRE, WE HAVE AN OPPORTUNITY
TO BUILD A MORE DIVERSITY INTO
OUR MASTERS AND DOCTORS LEVEL
CLINICIANS. BECAUSE THESE JOBS
REQUIRE UP TO 12 YEARS OF
EDUCATION AND TRAINING. WE NEED
TO BEGIN RECRUITING MORE DIVERSE
CANDIDATES INTO OUR SCHOOLS OF
SOCIAL WORK, THERAPY, PSYCHOLOGY
AND PSYCHIATRY NOW. RECRUITING
MORE DIVERSE STUDENTS WILL
REQUIRE ADDRESSING STRUCTURAL
BARRIERS TO EDUCATION, SUCH AS
THE COST OF EDUCATION AND UN
UNPAID INTERNSHIP REQUIREMENTS.
THE STATE HAS ALREADY TAKEN SOME
STEP FORWARDS TO DO THIS,
INCLUDING OFFERING STIPENDS FOR
SOCIAL WORK STUDENTS AND SOME
LOAN REPAYMENT PROGRAMS, BUT
MORE MUST BE DONE TO CONTINUE TO
EXPAND ACCESS TO THESE PROGRAMS.
TO RETAIN A MORE DIVERSE
WORKFORCE NOW AND IN THE FUTURE.
WE'RE GOING TO HAVE TO ADDRESS
ISSUES OF PAY BURNOUT AND
DISCRIMINATION THAT DRIVE PEOPLE
OUT OF THE PROFESSION AND MAKE
THEM RELUCTANT TO ENTER IN THE
FIRST PLACE. THE STEINBERG
INSTITUTE WILL BE ADMINISTERING
A WORKFORCE SURVEY IN THE COMING
MONTHS WHERE WE HOPE TO INFORM
THE CONVERSATION ABOUT WHAT
KEEPS PEOPLE IN THE BEHAVIORAL
HEALTH WORKFORCE. WE HOPE THAT
THIS QUALITATIVE WORK WILL HELP
US BETTER UNDERSTAND WHAT WE
HAVE TO DO TO COLLECTIVELY MEET
OUR SHARED GOALS OF A DIVERSE
AND STABLE WORKFORCE. OUR FINAL
RESEARCH PROJECT WILL INCLUDE
RECOMMENDATIONS FOR SHORT AND
LONG TERM WORKFORCE SOLUTIONS.
THANK YOU SO MUCH FOR HOLDING
THIS IMPORTANT CONVERSATION AND
INVITING US TO BE A PART OF IT.
WE'RE HOPEFUL THAT TOGETHER WE
CAN CONTINUE TO ADDRESS OUR
HEALTH WORKFORCE SHORTAGES AND
THE LACK OF DIVERSITY IN OUR
WORKFORCE TO PROVIDE
CALIFORNIANS WITH THE CARE THEY
DESERVE. THANK YOU, AND I WANTED
TO WELCOME OUR MAJORITY LEADER,
CECILIA AGUIA CURI. HØI EVERYONE
. UM THANK YOU VERY MUCH. UH,
SOME MEMBER BONTA FOR PUTTING
THIS ON. STRUCK ME ON SOMETHING
THAT DRIVES ME NUTS. BEHAVIORAL
HEALTH IS A REALLY DIFFICULT
FIELD. AND MANY PEOPLE START
WITH GOOD INTENTIONS, AND
THEY'LL DO THAT FOR QUITE SOME
TIME. AND ALL OF A SUDDEN IT
DOESN'T MATTER IF IT'S
RETIREMENT WITH THE PAY IS
THEY'RE JUST SIMPLY BURN OUT. SO
I THINK WE HAVE TO LOOK A Tð.
THIS IS LIKE WHAT'S A REAL FULL
TIME JOB DOING? THIS IS IT A 30
HOUR WEEK? IS IT A TW? WHATEVER
THE CASE, IT'S JUST I'VE JUST
SEEN IT WITH TOO MANY FRIENDS
AND FAMILY THAT HAVE BEEN IN
THIS. THEY JUST SAID I CAN'T GO
BACK. THEY'VE BEEN OFFERED LOTS
OF MONEY TO COME BACK. AND
THEY'RE NOT INTERESTED IN DOING
IT. IT'S NOT BECAUSE THEY DON'T
LOVE THE WORK. IT'S JUST THAT IT
WEIGHS A LOT ON YOU. AND I THINK
YOU KNOW HOW MUCH CAN YOUR
SHOULDERS CARRY? RIGHT SO, UM,
THANK YOU, AND I LOOK FORWARD TO
HEARING MORE ABOUT WHAT
EVERYONE'S DOING WITH THE DATA
IS REALLY IMPORTANT. THANK YOU.
I'LL JUMP IN WITH THE QUESTION
AND THEN OFFER UP TO MY
COLLEAGUES. UH, SO AS I, UH,
HAVE BEEN TAKING IN WHAT YOU ALL
HAVE SHARED, WHICH HAS BEEN
PHENOMENAL AND THANK YOU ALL FOR
PARTICIPATING IN THIS
CONVERSATION. THERE ARE THREE
ISSUES THAT WE'RE FACING ONE
ISSUE AROUND JUST PURE SCALE. UM
I THINK COMBINED YOU OFFER THAT
THERE ARE ABOUT 375,000
BEHAVIORAL HEALTH PROFESSIONALS
THAT WE NEED TO BE ABLE TO
SOURCE IN THE COMING YEARS AND
DEPENDING ON, UH, THE FRAMEWORK
THAT YOU'RE USING ANYWHERE
BETWEEN 32. 37,000 PROFESSIONALS
ACROSS, UH, THE HEALTH CARE
SYSTEM THAT WE NEED TO SOURCE.
THAT'S A SCALING ISSUE OF EPIC
PROPORTIONS. IF YOU REALLY THINK
ABOUT IT, UH AND ALSO FRAMING
THAT WITHIN THE CONTEXT OF IT
BEING AN ACTUAL GROWING FIELD
WITH INCREDIBLE OPPORTUNITIES,
SO WE HAVE AN ISSUE OF SCALE. UM
YOU ALSO TALKED SPECIFICALLY
ABOUT ISSUES RELATED TO PIPELINE
. UM THE SOURCING OF THE
EDUCATIONAL PROGRAMS AND
CERTIFICATION PROGRAMS THAT
WOULD ALLOW US TO BE ABLE TO I
COME ANYWHERE NEAR MEETING THAT
SCALE IN A WAY THAT IS, UH,
FEASIBLE. I DEFINITELY WANNA
DIVE INTO THAT A LITTLE BIT WITH
WITH SOME OF YOUR COMMENTS, AND
THE THIRD ISSUE IS JUST AROUND
RETENTION. UM AND I WILL ADD A
SUB ISSUE IN THERE THAT I HEARD
FROM DOCTOR AQUINO, WHICH IS AN
OPPORTUNITY TO REALLY BE ABLE
TO, UH ENSURE THAT, UM WE ARE
PAY WE OFFER PAYMENT MODELS THAT
ACTUALLY SUPPORT THE RETENTION
OF THAT PIPELINE, WHETHER IT'S
AROUND, UH, PROMOTING OUR
PROMOTORS OR, UH, ENSURING THAT
WE'RE VALUING AT THE RIGHT LEVEL
. UH, PARTICULAR, UH, AREAS OF
THE PROFILE OF A OF A WORKFORCE
MEMBER LIKE LANGUAGE PROFICIENCY
. UH AND UM, AND CULTURAL
BACKGROUND, CULTURAL CONTEXT,
EXPERIENCE AND EXPERTISE. UH,
THAT SHOULD ACTUALLY BE UH,
REWARDED AND ACKNOWLEDGED AND
VALUED, UH, WITHIN OUR PAYMENT,
SKILL SYSTEM. SO, UM WHAT? I'M
GLEANING FROM YOUR, UH, VERY APT
PRESENTATIONS FOR THE SAKE OF
TIME. I WOULD JUST WANNA, UH,
TOUCH INTO THE SPACE OF HOW WE
ENSURE THAT OUR PIPELINE IS MUCH
MORE ROBUST THAN IT NEEDS TO BE,
AND WOULD ASK ANY OF THE
PANELISTS TO JUST CONTRIBUTE TO
THAT CONVERSATION AROUND HOW WE
ADDRESS UM SUPPORTING OUR
EDUCATIONAL INSTITUTIONS AND OUR
CERTIFICATION PROCESS TO BRING
ON MORE PEOPLE. SURE. THANK
THANK YOU FOR THAT QUESTION
CHAIR. I THINK IT'S A REALLY
IMPORTANT ONE. SO I WOULD SAY A
COUPLE OF THINGS. SO I THINK ONE
IS THAT I THINK WE NEED TO START
THINKING OF OUR HEALTH CARE
WORKFORCE MUCH MORE BROADLY, AND
WE'RE STARTING TO DO THAT. WITH
COMMUNITY HEALTH WORKERS WITH
PEERS. THESE ARE NOT NEW
PROFESSIONS, BUT THEY HAVEN'T
BEEN INCORPORATED INTO OUR
DELIVERY SYSTEMS IN THE WAY THAT
THEY COULD BE. BECAUSE I DON'T
THINK WE'RE EVER GONNA TRAIN
ENOUGH PSYCHIATRISTS, FOR
EXAMPLE, RIGHT TO GET TO THE
NUMBERS WE NEED IN TERMS OF WHO
NEEDS BEHAVIORAL HEALTH
SERVICES. SO THINKING ABOUT WHO
CAN BE A PROVIDER MUCH MORE
BROADLY, AND TYPE OF TRAINING
THAT THEY NEED, WHICH IS A LOT
OF TIMES TRAINING BASED ON LIVED
EXPERIENCE AND TRAINING THAT
THEY CAN ALSO HAVE ON THE JOB
RIGHT SO WE CAN BE SORT OF DOING
THESE THINGS TOGETHER. I THINK
THE OTHER THING THAT'S REALLY
IMPORTANT AND, UM ASSEMBLY
MEMBER SHIAVO BROUGHT THIS UP,
BUT REALLY THINKING THIS IS AN
INTERGENERATIONAL PROBLEM, RIGHT
? THIS IS NOT PROBABLY GOING TO
BE SOLVED IN IN MY LIFETIME. AND
I THINK WHEN WE THINK ABOUT AN
INTERGENERATIONAL APPROACH WE
START TO THINK ABOUT HOW DO WE
TREAT OUR OUR LOW WAGE
HEALTHCARE WORKERS TODAY AND HOW
CAN WE DO BETTER BY THEM SO THAT
THEIR CHILDREN ARE IN A POSITION
TO GO TO MEDICAL SCHOOL RIGHT TO
START OVERCOME SOME OF THIS
DEEPLY ENTRENCHED POVERTY IN
FAMILIES AND SO THAT WE CAN
CREATE SOME OF THOSE
OPPORTUNITIES, SO I REALLY THINK
IT'S IMPORTANT TO LOOK AND THEN
THE THIRD AND FINAL THING I
WOULD SAY IS, YOU KNOW I DON'T
HAVE THE NUMBERS OFF THE TOP OF
MY HEAD, BUT WE HEAR A LOT AND
THERE THERE ARE STUDIES ABOUT
HOW MANY PEOPLE OF COLOR DROP
OUT OF MEDICAL SCHOOL, FOR
EXAMPLE, RIGHT. WE ARE LOSING
PEOPLE IN WAYS WE DON'T NEED TO
BE LOSING PEOPLE. IF WE CAN
REALLY THINK ABOUT HOW TO HAVE
THAT WRAP AROUND SUPPORT AND A
CULTURE THAT REALLY VALUES I
THINK DIVERSITY AND EQUITY
THROUGHOUT OUR TRAINING AND
THROUGHOUT OUR, UM HEALTH CARE
INSTITUTIONS. I'M SURE ASSEMBLY
MEMBER DR ARAMBULA COULD TALK
MORE ABOUT HIS RIGHT, BUT I
THINK REALLY MAKING SURE WE'RE
NOT LOSING PEOPLE IN WAYS THAT
WE DON'T NEED TO BE AS IMPORTANT
TO AND IF I CAN JUST JUMP IN FOR
THE LATINO COMMUNITY, IT'S THE
TRICK IS TO START EARLY, RIGHT
IF WE WAIT UNTIL WE HAVE
STUDENTS IN UNIVERSITY AND
MEDICAL SCHOOL TO THEN TRY TO
RETAIN THEM WITHIN THE PIPELINE.
IT'S TOO LATE. WE NEED TO START
FROM ELEMENTARY SCHOOL, RIGHT?
JUST GIVING OUR OUR STUDENTS
THIS DREAM THAT THEY CAN ACHIEVE
AND THAT THERE WILL BE SYSTEMS
OF SUPPORT THAT WILL HELP THEM
GET THROUGH EACH STEP OF THE WAY
AND SEE THEMSELVES GRADUATING
FROM A PROFESSIONAL SCHOOL AT
THE END, SO WE NEED TO START
PARTNERING WITH OUR EDUCATIONAL
PARTNERS TO MAKE SURE THAT WE
CAN BUILD THAT INFRASTRUCTURE TO
HELP OUR KIDS TODAY AND OUR KIDS
TO COME. MHM. THE THREE THINGS
THAT COME TO MY MIND WHEN I
THINK ABOUT PIPELINE AND
PATHWAY, AND THEY BUILD ON EACH
OTHER, AND ONE IS THE ATTRACTION
ISSUE. WE HAVE A GENERATION OF
SCHOOL KIDS WHO GOT STEM THE M
WAS FOR MATH, NOT MEDICINE. SO
HOW IS IT THAT WE CAN INSPIRE
THE NEXT GENERATION TO WANT TO
BE CAREGIVERS, SO THAT'S A PIECE
OF IT, AND THE SECOND EXACTLY IS
ALREADY SHARED WITH SUPPORTING
THOSE WHO SHOW APTITUDE. THERE
ARE INCREDIBLE PROGRAMS ACROSS
THE STATE WITH POST BACK
PROGRAMS THAT HELP THOSE WHO DID
GO TO COLLEGE BUT MIGHT NOT HAVE
GOTTEN THE MATH OR SCIENCE THEY
NEED TO MOVE ON TO PHARMACY OR
MEDICINE. THERE ARE PROGRAMS
THAT SUPPORT HIGH SCHOOL
STUDENTS WHO COME OUT SHOWING
INTEREST AND APTITUDE BUT MIGHT
NEED MENTORSHIP MIGHT NEED
FINANCIAL SUPPORT MIGHT NEED
HAND TO SHOW THEM THE WAY
BECAUSE THEY COME FROM A FIRST
GENERATION COLLEGE, UM TO
COLLEGE FAMILY, AND THE PROCESS
OF BECOMING A HEALTH
PROFESSIONAL IS LONG AND ARDUOUS
, AND THEY NEED THAT
NAVIGATIONAL SUPPORT. AND THAT
GOES ALL THE WAY TO THE COMMENTS
WE HEARD EARLIER ON BURNOUT
ACROSS THE PROFESSION, SO
THERE'S THAT SUPPORT ACROSS THE
JOURNEY, AND THIRD IS REDUCING
THE BARRIERS THAT ARE TURNOFFS.
WE HAVE REAL CHALLENGES IN OUR
STATE WITH LICENSURE WITH
CERTIFICATION WITH THINGS TAKING
TOO LONG WITH PAYMENT. WHEN WE
HEAR A LOT FROM PROVIDERS ABOUT,
UM, WHETHER IT'S BEHAVIORAL,
HEALTH OR MEDICINE OR OTHERS
FACING MORAL INJURY, IT'S
BECAUSE THEY DON'T HAVE THE
RESOURCES THEY NEED TO DELIVER
THE CARE. THEY KNOW THEIR
PATIENT NEEDS, AND THAT'S VERY
MUCH ABOUT BUILDING UP A CARE
TEAM THAT CAN PROVIDE ALL THE
DIFFERENT TYPES OF SOCIAL
SUPPORTS, UM, THAT PATIENTS
BENEFIT FROM SO I THINK ALL
THREE OF THOSE PIECES ARE
IMPORTANT TO MAKE SURE YOU HAVE
A HEALTHY PIPELINE, UM, WITH
ABSOLUTE MINIMAL ATTRITION.
THANK YOU. WELL WHEN I STARTED
THIS, AND I COULD STAY ALL NIGHT
, AND SO I'M APPRECIATIVE OF THE
CHAIR FOR HOLDING THIS HEARING
AND FOR ALLOWING THIS
CONVERSATION TO HAPPEN. UM, I'M
HAPPY TO JUMP IN AND ASK
QUESTIONS, BUT BELIEVE THE
FOLLOWING PANELS WILL HAVE SOME
OF THE SOLUTIONS. BUT I'D LIKE
TO DO IS UPLIFT SOME OF THE
COMMENTS THAT I'VE HEARD TODAY
SHARE SOME OF THE LIVED
EXPERIENCE THAT I'VE BEEN ABLE
TO HAVE AND REALLY FOCUS ON
WHICH DIRECTION WE AS A STATE
CAN GO TO ADDRESS THIS CRISIS.
ULTIMATELY I'M GONNA BE ASKING
WHETHER OR NOT WE'VE BEEN
PROVIDING ENOUGH URGENCY TO THE
CRISIS THAT WE HAVE. WHILE
ACKNOWLEDGING THAT WE'VE MADE
SIGNIFICANT STRIDES OVER THE
LAST SEVERAL YEARS. I'LL BEGIN
IF I CAN, WITH THE STRATEGIC
MOVE TO BOLSTER THE CALIFORNIA
ECONOMY, AND I WILL BRING AND
LIVED EXPERIENCE HERE HAVING A
GRANDFATHER WHO NEVER LEARNS TO
READ SITTING HERE AS OUR FIRST
LATINO PHYSICIAN. THERE ARE
BARRIERS THAT WE HAVE IN
COMMUNITIES TO BE ABLE TO ACCESS
HIGHER EDUCATION. AND SO WE HAVE
TO FIGURE OUT FOR OUR STATE TO
MAKE ADVANCES. HOW WE'RE MAKING
INVESTMENTS INTO THE PEOPLE
RIGHT NOW WHO ARE CARING FOR OUR
COMMUNITY MEMBERS? AND SO I
STRUGGLE WITH THE DATA POINT
THAT WE'RE 46 OUT OF 47TH IN
MEDICAL SCHOOL ENROLLMENT PER
CAPITA TO BELIEVE THAT WE'RE
ADEQUATELY TRAINING ENOUGH
PROVIDERS OF TOMORROW. AND THE
FACT THAT WE HAVE WORKFORCE
SHORTAGES WHICH CONTRIBUTE TO
POOR POPULATION. HEALTH SHOULD
BE AN IMPETUS FOR US AS A STATE
TO MAKE SURE THAT WE'RE MAKING
THOSE INVESTMENTS INTO OUR
WORKFORCES. BUT WE DON'T HAVE
ENOUGH WORKERS. AND THEY'RE NOT
REFLECTED IN RACE AND LANGUAGE
AND GEOGRAPHY. AND WE NEED TO
HAVE THAT BETTER COMMUNICATION
SO WE CAN ESTABLISH BETTER TRUST
THAT I'D LIKE TO REALLY ASK THIS
PANEL. ARE WE DOING ENOUGH? ARE
WE BRINGING ENOUGH URGENCY TO
THIS CRISIS? AND HOW DO WE MAKE
ENOUGH STRIDES SO THAT WE'RE NOT
TALKING ABOUT THIS A GENERATION
FROM NOW BUT ARE ABLE TO SOLVE
THIS WITHIN OUR LIFETIMES. AND
WE'LL HEAR FROM ONE OR TWO
PEOPLE SO THAT WE CAN MOVE ON TO
THE NEXT PANEL. THANK YOU. I
COMPLETELY AGREE. I THINK WHAT
WE ARE DOING IS ALMOST ALL THIS
CRISIS AFTER CRISIS WILL TAKE IT
FOR GRANTED. WE'RE NOT TAKING IT
AS A AS A. YOU KNOW AS THE
ATTENTION IT DESERVES THE
FUNDING THAT REQUIRES AND THAT
DEFINITELY FROM Kò TO 12. WE
NEED TO INVEST MONEY. WE CANNOT
IGNORE THE FACT THAT SO MANY
BLACK AND BROWN COMMUNITIES HAVE
REALLY LIVED IN THIS VERY MUCH
ISOLATION AND THE STRUCTURES IN
PLACE A CENTRAL ROLE, THE SOCIAL
DETERMINANT OF HEALTH PLAY AN
IMPORTANT ROLE, AND I THINK
INSTEAD OF HAVING THAT SOMEWHAT
LIP SERVICE TO THE REAL PROBLEM.
I HOPE THE LEGISLATURE WOULD
REALLY TAKE UP THIS ISSUE AS A
CRISIS. AND INVEST MONEY AND
TAKE IT SERIOUSLY, SO THAT AS
THE I. I THINK AS THE SHE PUT IT
VERY NICELY IN TERMS OF THE
BEHAVIORAL HEALTH, THEIR AGING
AND SO THE NEW POPULATION, LIKE
THE BLACK AND BROWN COMMUNITY
CAN BE REPLACED. HOWEVER WHERE
IS THE PRIORITY THE STATE IS
GIVING TO ENSURE THAT THE NEXT
GENERATION OF BEHAVIORAL HEALTH
UM CLINICIANS, UM DOCTORS,
NURSES ARE BLACK AND BROWN AND
TRULY REFLECT THE CO THE
DIVERSITY OF CALIFORNIA. AND I
HOPE INVEST INVESTMENT IS ALSO
GOES BEHIND IT SO THAT WE ARE
NOT JUST GIVING A LIP SERVICE
AND, UH, CONTINUOUSLY TALK ABOUT
THE PROBLEM, AND WE ARE ALSO
PUTTING RESOURCE BEHIND IT.
THANK YOU. THANK YOU SO MUCH TO
OUR PANELISTS FOR BRINGING SUCH
A ROBUST CONVERSATION TO US, AND
WE'LL MOVE ON NOW TO OUR SECOND
PANEL, UH, WHICH IS, UH, FOCUSED
ON CURRENT EFFORTS TO INCREASE
WORKFORCE DIVERSITY IN
CALIFORNIA.
THANK YOU WILL, UH, BEGIN WITH,
UH, DIRECTOR LANDSBERG IS
EVERYONE ELSE GETS SITUATED?
GOOD AFTERNOON, MADAM CHAIR AND
MEMBERS ELIZABETH LANDSBURG. I
HAVE THE HONOR OF SERVING AS
HK'S DIRECTOR, DEPARTMENT OF
HEALTH CARE, ACCESS AND
INFORMATION AND VERY HAPPY TO BE
HERE TO START TALKING ABOUT, UM,
SOME OF THE SOLUTIONS. OKAY SO
YOU'VE SEEN DATA AND A HÌ Kò. WE
ABSOLUTELY ALWAYS START WITH THE
DATA AND THINK THAT THAT IS
IMPORTANT AND IT'S BEEN GREAT TO
SEE. UM HÌ Kò DATA USED BY SOME
OF OUR OUR OTHER SPEAKERS. UM,
AS OTHERS HAVE ALREADY
HIGHLIGHTED, UH, HEALTH. THE
HEALTH WORKFORCE IN CALIFORNIA
IS NOT EVENLY DISTRIBUTED IN
CALIFORNIA, AND WE HAVE
PARTICULARLY SIGNIFICANT GAPS IN
THE IN THE INLAND EMPIRE AND IN
THE IN THE SAN JOAQUIN VALLEY,
SO THESE FIGURES AND GRAPHS ARE
FOR PRIMARY CARE WITH A WHITE
BAR. AND IN CALIFORNIA
POPULATION, UM, THE DARKEST BLUE
PHYSICIANS, NEXT NURSE
PRACTITIONERS AND THEN P A S¼,
UM, JUST WANNA KNOW THAT WE DO
PUBLISH SIMILAR MAPS FOR OTHER
PRIMARY CARE AND BEHAVIORAL
HEALTH WORKFORCES AND SEE, UH,
THAT INEQUITABLE DISTRIBUTION
WITH OUR BEHAVIORAL HEALTH
WORKFORCE AS WELL AS HAS BEEN
NOTED. THIS MAP? UM THE BLUE MAP
SHOWS HIPS AS OUR HEALTH
PROFESSIONAL SHORTAGE AREAS,
WHICH ARE A FEDERALLY DEFINED
UNIT OF ANALYSIS TO IDENTIFY
WORK SHORTAGES. AND THEN, UM, SO
IF YOU COMPARE THE MAP ON THE
LEFT WITH THE BLUE SHOWING WHERE
OUR HEALTH PROFESSIONAL SHORTAGE
AREAS ARE TO OUR MAP ON THE
RIGHT, WHICH SHOWS THE URBAN
VERSUS RURAL AREAS, YOU CAN SEE
THAT A LITTLE MORE THAN HALF OF
OUR HIPS ARE OUR HEALTH.
PROFESSIONAL SHORTAGE AREAS ARE
RURAL OR PARTIALLY RURAL AREAS,
THOUGH WANT TO NOTE AND IT'S
IMPORTANT TO NOTE THAT THERE ARE
ALSO CERTAINLY URBAN HIPS AS
RIGHT SO WE KNOW MANY OF OUR
RURAL AREAS ARE UNDER ARE ARE
MEDICALLY UNDERSERVED. BUT THERE
ARE CERTAINLY UM, URBAN AREAS.
UM, AS KATHERINE PHILLIPS FROM
FROM THE CALIFORNIA HEALTHCARE
FOUNDATION NOTED 11 MILLION OR
MORE THAN ONE IN FOUR
CALIFORNIANS LIVE IN A SHORTAGE
AREA, AND TWO THIRDS OF THOSE
WHO DO ARE LATINX BLACK, UM OR
NATIVE AMERICAN. I'M NOT GONNA
SPEND A LOT OF TIME ON THE NEXT
COUPLE OF SLIDES WE HAVE BECAUSE
THEY'RE VERY SIMILAR TO THE DATA
THAT YOU'VE SEEN. BUT BUT, UM
AND THE POINT IS, THE VERY
IMPORTANT POINT HAS BEEN MADE
ABOUT THE LACK OF WORKFORCE
CONCORDANCE, UM, PARTICULARLY
FOR THE HISPANIC, UM, FOR THE
LATINX POPULATION. UM AT HÌ Kò.
WE'RE VERY PROUD TO HOUSE
CALIFORNIA'S HEALTH WORKFORCE
RESEARCH DATA CENTER THROUGH A
PARTNERSHIP WITH THE DEPARTMENT
OF CONSUMER AFFAIRS. WE COLLECT
DATA FOR A WIDE RANGE OF
PROVIDER TYPES THROUGH A SURVEY
THAT'S ADMINISTERED AT THE TIME
OF HER RELICS HER, SO THAT'S UM,
A NEW EFFORT THAT WAS PASSED IN
THE 2021 BUDGET. THAT THAT, UM
RECAST ASH POT IS HÌ Kò AND HAS
THIS NEW DATA AND SO WE'RE VERY
HAPPY TO BE SHOWING THAT DATA
AND TRYING TO HAVE MORE AND
MORE, UM, SOPHISTICATED, UH,
VISUALIZATION SO THAT WE CAN
REALLY UNDERSTAND AND FOCUS. UM
OUR EFFORTS IN DECEMBER OF 2023
HÌ Kò RELEASED DASHBOARDS
RELATED TO RACE AND ETHNICITY AS
WELL AS LANGUAGES SPOKEN BY
CALIFORNIA'S HEALTH WORKFORCE.
SO WHAT YOU HEAR, SEE? HERE IS A
SNAPSHOT OF THE RACE AND
ETHNICITY. DASHBOARD UM KIERAN
ALREADY SHOWED YOU THIS THIS
THIS DATA SHOWING THE MOST
SIGNIFICANT DISPARITY FOR LATINX
PRIMARY CARE PROVIDERS COMPARED
TO THE POPULATION. THESE THESE
DASHBOARDS ARE AVAILABLE ON EACH
GUY'S WEBSITE AND CAN BE
ANALYZED DYNAMICALLY BY
WORKFORCE CATEGORY BY LICENSE BY
NAME BY BY REGION SO YOU CAN
DECIDE. I WANNA SPECIFICALLY
LOOK AT MENTAL HEALTH NURSE
PRACTITIONERS IN IN, YOU KNOW IN
THE FRESNO AREA AND PULL UP THAT
DATA. WE ALSO HAVE THE DATA, UM,
LOOKING AT IT OVER TIME, AND SO
HERE, IT'S VERY HARD TO SEE UM
ON THIS ON THIS LITTLE SCREEN,
BUT WE DO LOOK AT THE DATA OVER
TIME. UM, SO THIS IS A 30 YEAR
PERIOD. AND WE CAN SEE, UH, FOR
EXAMPLE, THAT DARKER BLUE LINE
THAT'S NOTED, UM, THE AGAIN THE
PERCENTAGE OF LATINX. UM,
PROVIDERS IS INCREASING OVER
TIME. AND AGAIN WE HAVE SIMILAR
DATA. UM FOR LANGUAGE
CONCORDANCE, WHICH YOU HAVE SEEN
AS WELL AS LANGUAGE. CONCORDANCE
OVER TIME. WHERE AGAIN WE'RE
SEEING PROGRESS. NOT AS MUCH AS
WE NEED TO SEE AND WANT TO SEE,
BUT SOME PROGRESS OVER TIME. SO
STARTING WITH THAT DATA, UM HÌ
K'S MISSION, UM, IS TO EXPAND
EQUITABLE ACCESS TO QUALITY,
AFFORDABLE HEALTH CARE FOR ALL
CALIFORNIANS THROUGH RESILIENT
FACILITIES, ACTIONABLE
INFORMATION AND THE HEALTH
WORKFORCE THAT EACH COMMUNITY
NEEDS EVERY IN THAT A MISSION
STATEMENT IS VERY NEAR AND
IMPORTANT TO US. WE HAVE FOR
DECADES HAD HEALTH WORKFORCE
DEVELOPMENT PROGRAMS. BUT YOU
ALL HAVE SEEN FIT. UM IN THE
ADMINISTRATION HAS AGREED THAT
WE ARE FACING A WORKFORCE
SHORTAGE AND THAT WE NEED TO
DEVOTE SIGNIFICANT RESOURCES AND
SO WE'VE REALLY BEEN INCREASING
OUR WORKFORCE PROGRAMS VERY
SIGNIFICANTLY, UM, OVER TIME.
ALL UH, ALL OF OUR HEALTH
WORKFORCE PROGRAMS, UM AT HÌ Kò
HAVE THESE THREE GOALS AND IT'S
BEEN VERY IMPORTANT TO ME THAT
WE REALLY, UM HAVE LASER FOCUS
ON THESE SO FIRST AND FOREMOST
TO MAKE SURE THAT WE ARE HELPING
DEVELOP A HEALTH WORKFORCE THAT
REFLECTS CALIFORNIA IN TERMS OF
RACIAL AND LINGUISTIC DIVERSITY.
WE WE'VE SEEN. WE HAVE A LONG
WAYS TO GO. BUT IT'S IMPORTANT
FOR US TO STAY FOCUSED ON THAT
ALSO THAT WE DEVELOP A WORKFORCE
THAT SERVES MEDICALLY
UNDERSERVED AREAS. AND SO ALL OF
OUR ASSISTANCE TO INDIVIDUALS
COMES WITH, UM A SERVICE
OBLIGATION IN A MEDICALLY
UNDERSERVED AREA AND THEN KNOW
THAT IT'S IMPORTANT AS UM ONE IN
THREE CALIFORNIANS IS ON ME THAT
WE'RE MAKING SURE TO DEVELOP A
HEALTH CARE WORKFORCE THAT
SERVES, UM, THE MEDI POPULATION.
SO THOSE ARE OUR THREE GOALS AND
THEN WE HAVE THREE BIG BUCKETS
OF STRATEGIES THAT WE USE. THE
FIRST ONE. YOU ALL HAVE FOCUSED
ON ALREADY TODAY, WHICH IS THE
PIPELINE. WE'VE GOT TO BRING
MORE FOLKS IN MAKE THEM FEEL
THAT THEY HAVE THE OPPORTUNITY
AND ARE SUPPORTED TO BECOME PART
OF THE HEALTH CARE WORKFORCE.
AND THAT'S CRITICAL TO MEETING
UM OUR DIVERSITY GOALS. WE ALSO
SUPPORT INDIVIDUALS. UM, WHO
NEED THAT SUPPORT. SO WE HAVE
FOR DECADES HAD A LOAN REPAYMENT
SCHOLARSHIP PROGRAMS BECAUSE OF
THE RACIAL WEALTH GAP. IT'S
REALLY IMPORTANT THAT WE FOCUS
ON STIPENDS THAT WE FOCUS ON
SCHOLARSHIPS, LOANS ONLY WORK
FOR FOLKS WHO CAN AFFORD TO TAKE
OUT THOSE LOANS TO BEGIN WITH.
SO WE, UH AND YOU'LL HEAR HEAR
MORE ABOUT SOME OF OUR PROGRAMS
THAT WE HAVE. WE'RE STARTING
SOME EARN AND LEARN PROGRAMS FOR
THE FIRST TIME AND THINK IT'S
REALLY IMPORTANT TO PROVIDE THAT
SUPPORT. AND THEN, OF COURSE, WE
DO NEED TO EXPAND THE
EDUCATIONAL AND TRAINING
CAPACITY. UM IN CALIFORNIA. AND
SO WE'RE PLEASED TO PROVIDE
SUPPORT TO MEDICAL SCHOOLS TO
PRO MATURA TRAINING PROGRAMS, UM
, ALL UP AND DOWN THE HEALTH
WORKFORCE LADDER. WE'RE
CURRENTLY GOING THROUGH A
HOLISTIC ASSESSMENT OF OUR TOOLS
AND APPLICATION CRITERIA, ASKING
OURSELVES DO OUR APPLICATION
CRITERIA BEST ACHIEVE OUR GOALS.
SO WE'RE WORKING WITH, UM, WITH
THE GEORGE WASHINGTON, UM,
EQUITY CENTER THERE TO DEVELOP,
UM, WHAT WE WILL BE MAKING SOME
CHANGES TO SOME OF OUR
APPLICATION CRITERIA TO REALLY
AND, UM AND MAKE SURE WE ARE ARE
MEETING OUR GOALS. SO WITH THAT,
I'M VERY PLEASED TO TURN IT OVER
TO OUR RELATIVELY NEW BUT
WONDERFUL. UM UH, NEW WORKFORCE.
DEPUTY DIRECTOR AT HÌ Kò. UM
LIBBY ABBOTT, WHO'S GONNA TALK
IN MORE DETAIL ABOUT OUR
PARTICULAR STRATEGIES MOVING
FORWARD. THANK YOU, ELIZABETH.
AND GOOD AFTERNOON. UH MADAM
CHAIR AND MEMBERS LIBBY ABBOTT,
DEPUTY DIRECTOR FOR THE OFFICE
OF HEALTH WORKFORCE DEVELOPMENT.
WITH OUR REMAINING TIME I'LL
SPEAK BRIEFLY ABOUT WHAT WE
BELIEVE ARE HIGH VALUE
STRATEGIES FOR DIVERSIFYING
CALIFORNIA'S HEALTH WORKFORCE,
INCLUDING WHAT WE ARE PURSUING
AND IMPLEMENTING AS HÌ. I'LL
NOTE THAT MANY OF THESE
SOLUTIONS REFLECT WHAT HAS
ALREADY BEEN TOUCHED ON BY
PREVIOUS PRESENTERS. SO I'LL
SPEAK ABOUT THESE SOLUTIONS
FOLLOWING THE THREE BUCKETS OF
HK PROGRAMS THAT ELIZABETH
DESCRIBED STARTING WITH PROGRAMS
THAT FUND ORGANIZATIONS TO BUILD
THE WORKFORCE PIPELINE. ONE OF
THE SOLUTIONS WE WANT TO
HIGHLIGHT IS STARTING EARLY IN
THE LIFE CYCLE OF A FUTURE
HEALTH WORKER BEFORE THAT HIGH
SCHOOL OR COLLEGE STUDENT EVEN
KNOWS THAT THEY MIGHT WANT TO
BECOME A HEALTH WORKER. THIS IS
CRITICAL BECAUSE SOMETIMES BY
THE TIME WE INTERVENE WITH A
SCHOLARSHIP OR A LOAN OR PAYMENT
PROGRAM, WE ARE ALREADY DEALING
WITH A POOL OF CANDIDATES THAT
IS LESS DIVERSE THAN WE WOULD
WANT THEM TO BE. BECAUSE OUR
DIVERSE CANDIDATES MAY NOT HAVE
THE INSTITUTIONAL SUPPORT
KNOWLEDGE, ACCESS OR RESOURCES
THAT THEY NEED TO PURSUE A
CAREER AS A HEALTH PROFESSIONAL.
HK INVESTS UPSTREAM IN WHAT WE
CALL PIPELINE PROGRAMS REACHING
DIVERSE YOUTH TO EXPOSE THEM AND
SUPPORT THEM TO PARTICIPATE IN
PATHWAYS TOWARDS CAREERS IN
HEALTH PROFESSIONS. IMPORTANTLY
OUR PIPELINE PROGRAMMING OFFERS
WHAT WE CALL WRAPAROUND SUPPORTS
SUPPORT TO ALL THE EXTRAS THAT
WILL ALLOW INDIVIDUALS TO REALLY
FOCUS ON AND SUCCEED IN THEIR
PROGRAMS. THIS CAN INCLUDE
TRANSPORTATION AND CARETAKER
COSTS, COACHING AND ACADEMIC
SUPPORT. THIS HELPS MITIGATE FOR
ANY DISADVANTAGES THAT STUDENTS
WITH LESS RESOURCES MIGHT HAVE
SUPPORTING OUR PROGRESS TOWARDS
A SOCIOECONOMICALLY, RACIALLY
AND ETHNICALLY DIVERSE WORKFORCE
. WE ARE ALSO WORKING ON
INTEGRATING FUNDING FOR
WRAPAROUND SUPPORT INTO OUR
SCHOLARSHIP PROGRAMS SO THAT
LIKEWISE, STUDENTS IN
UNDERGRADUATE AND GRADUATE
PROGRAMS CAN COVER THE COST OF
LIFE AND WHAT IT TAKES TO
SUCCEED ACADEMICALLY. NEXT I'LL
SPEAK ABOUT THE BUCKET OF
INVESTMENTS SUPPORTING
INDIVIDUALS PURSUING HEALTH
CAREERS THROUGH SCHOLARSHIPS,
STIPENDS AND LOAN REPAYMENTS.
UM, I'D LOVE TO HIGHLIGHT THAT
HERE. AN IMPORTANT SOLUTION IS
INVESTING IN THE PROFESSIONS
THAT INHERENTLY EMPHASIZE
DIVERSITY AND LIVED EXPERIENCE.
THIS INCLUDES TWO PROFESSIONS
THAT HK IS CURRENTLY VERY
FOCUSED ON. HÌ Kò HAS $272
MILLION TO EXPAND AND TO SUPPORT
THE COMMUNITY HEALTH WORKER
PROMOTOR AND REPRESENTATIVE
WORKFORCE. COMMUNITY HEALTH
WORKERS, PROMO TORE AND
REPRESENTATIVES ARE BY
DEFINITION REPRESENTATIVE OF THE
COMMUNITY THAT THEY SERVE. AND
THESE INDIVIDUALS WORK IN A WIDE
RANGE OF COMMUNITIES, INCLUDING
LATIN ASIAN, AMERICAN, BLACK AND
TRIBAL COMMUNITIES, AND HÌ Kò
FUNDING WILL GO TO SUPPORT THE
COMMUNITY HEALTH WORKERS, PROMS
AND REPRESENTATIVES THAT WORK
ACROSS THE FULL RANGE OF
COMMUNITIES IN CALIFORNIA.
THROUGH THE CALIFORNIA YOUTH
BEHAVIORAL HEALTH INITIATIVE. HK
HAS ALSO RECEIVED 338 MILLION TO
STAND UP A NEW PROFESSION
CERTIFIED WELLNESS COACHES.
CERTIFIED WELLNESS COACHES ARE
MEANT TO PLUG A GAP IN THE
BEHAVIORAL HEALTH WORKFORCE THAT
SERVES OUR YOUTH AND CHILDREN.
WE HEARD FROM YOUTH THAT THEY
WANTED A WORKFORCE THAT LOOKED
LIKE THEM, SO WE HAVE WORKED
HARD TO BUILD DIVERSITY, EQUITY
AND INCLUSION INTO THE CORE OF
THE WELLNESS COACH ROLE AND THE
PROGRAMS THAT WE ARE ROLLING OUT
TO CREATE AND SUPPORT THAT ROLE,
INCLUDING ENSURING PARTNERSHIPS
WITH COMMUNITY COLLEGES IN
CALIFORNIA STATE UNIVERSITIES,
WHICH REACH OUR MOST DIVERSE
CANDIDATES. I'D LIKE TO NOTE
THAT THIS RECOMMENDATION IS
RELATED TO THE RECOMMENDATION WE
HEARD EARLIER FROM STEINBERG
INSTITUTE TO INVEST IN PROVIDER
TYPES THAT ARE ALREADY QUITE
DIVERSE, SUCH AS COMMUNITY
HEALTH WORKERS, PROM AUTHORITIES
AND REPRESENTATIVES. IT'S WORTH
NOTING THAT THESE WORKFORCES MAY
BE MORE DIVERSE BECAUSE THERE
ARE FEWER EDUCATIONAL AND CAREER
PATH BARRIERS TO ENTRY, WHICH
TAKES US TO OUR NEXT SOLUTION.
IT IS IMPORTANT TO SUPPORT AND
EXPAND PROFESSIONS LIKE
COMMUNITY HEALTH WORKERS,
PROMOTOR REPRESENTATIVES AND
CERTIFIED WELLNESS COACHES AND
MAKE THEM ATTRACTIVE ROLES IN
AND OF THEMSELVES BECAUSE THEY
FULFILL SUCH A CRITICAL FUNCTION
IN OUR HEALTH SYSTEM, BUT IT IS
EQUALLY IMPORTANT THAT WE PAY
ATTENTION TO AND INVEST IN
CAREER PROGRESSION SO THAT
DIVERSE CANDIDATES HAVE
OPPORTUNITIES TO PROGRESS FROM
BEING A CERTIFIED WELLNESS COACH
TO BECOMING A LICENSED SOCIAL
WORKER AS THE SLIDE SHOWS. SO
THAT WE CAN ENSURE THAT WE HAVE
APPROPRIATE LEVELS OF DIVERSITY
AND REPRESENTATION ACROSS ALL
LEVELS OF THE WORKFORCE AND NOT
JUST OUR LOW PAYING OR ENTRY
LEVEL POSITIONS. FOLLOWING FROM
THAT IT'S ESSENTIAL THAT WE MAKE
TRAINING ECONOMICALLY FEASIBLE
FOR ALL. AND THAT WE DO THAT NOT
ONLY THROUGH OUR TRADITIONAL
SCHOLARSHIP AND LOAN PAYMENT
MECHANISMS, BUT ALSO BY FUNDING
THE COMPLEMENTARY PIECES RELATED
TO TRAINING AND TRANSITION TO
PRACTICE, WHICH INCLUDES PAID
INTERNSHIPS, APPRENTICESHIPS AND
EARN AND LEARN PROGRAMS. HK HAS
IMPLEMENTED OR INTEGRATED THESE
APPROACHES INTO OUR PROGRAMS,
INCLUDING HÌ Kò, SUBSTANCE USE,
DISORDER, EARN AND LEARN
PROGRAM. WE ARE ALSO INTEGRATING
PAID INTERNSHIPS INTO OUR
RECENTLY LAUNCHED CERTIFIED
WELLNESS COACH PROGRAMMING AND
WILL BE FUNDING NURSE
APPRENTICESHIP PROGRAMS. FINALLY
ELIZABETH SHARED SOME OF THE
DATA FROM OUR RESEARCH DATA
CENTER, AND WE WERE PLEASED TO
SEE THIS IN OTHER PRESENTATIONS.
UM I WANTED TO HIGHLIGHT AN
EXAMPLE OF HOW IMPORTANT THESE
DATA ARE FOR IDENTIFYING DATA
DRIVEN SOLUTIONS RELATED TO
WORKFORCE DIVERSIFICATION. IN
NOVEMBER. HK RELEASED DASHBOARDS
LOOKING AT THE EDUCATIONAL
PATHWAYS TAKEN BY CALIFORNIA'S
NURSING WORKFORCE. WE SAW THAT
HISPANIC AND BLACK NURSES WERE
SIGNIFICANTLY MORE LIKELY TO
ENTER THE NURSING WORKFORCE,
WITH AN ASSOCIATE'S DEGREE
COMPARED TO THE REST OF THE
NURSING WORKFORCE. AND SO WE SAW
INVESTING IN ASSOCIATE DEGREE
NURSING PROGRAMS AS AN
OPPORTUNITY TO DIRECTLY ADDRESS
SOME OF THE CONCORDANCE ISSUES
THAT WE'VE SEEN IN PREVIOUS
SLIDES BY FUNDING AND EXPANDING
PROGRAMS THAT BRING DIVERSE
NURSES INTO THE WORKFORCE. OUR
FINAL BUCKET. HÌ Kò FUNDS
SEVERAL PROGRAMS RELATED TO
EXPANDING EDUCATIONAL CAPACITY.
I'LL TOUCH ON THIS BRIEFLY
BECAUSE I KNOW WE HAVE OTHER
PRESENTERS SPEAKING ABOUT THIS
FROM THE EDUCATIONAL INSTITUTION
PERSPECTIVE, UM, IN OUR AWARDS
RELATED TO EXPANDING EDUCATIONAL
CAPACITY, WE DO AWARD POINTS AND
PRIORITIZE PROGRAMS THAT, FOR
EXAMPLE, DEVELOP STRATEGIES. UM
TO RECRUIT AND SUPPORT STUDENTS
FROM UNDERREPRESENTED
COMMUNITIES AND WHICH OFFER
SUPPORT SERVICES TO STUDENTS TO
ENSURE SUCCESSFUL COMPLETION OF
THEIR EDUCATION. IN THIS WAY, HÌ
Kò IS USING ITS FUNDING TO
INCENTIVIZE INSTITUTIONAL CHANGE
IN OTHER WAYS THAT WILL SUPPORT
DIVERSIFICATION OF CALIFORNIA'S
WORKFORCE. TO CLOSE. WE JUST
WANTED TO HIGHLIGHT SOME IDEAS
ON WHAT MORE IS NEEDED TO
SUPPORT DIVERSIFICATION OF
CALIFORNIA'S WORKFORCE. UM, TOP
OF MIND FOR US IS FUTURE
FORECASTING. IT TAKES YEARS TO
TRAIN A HEALTH WORKER AND
THEREFORE YEARS TO CHANGE THE
COMPOSITION OF OUR WORKFORCE,
AND SO WE NEED TO LOOK AHEAD TO
KNOW WHAT OUR FUTURE WORKFORCE
NEEDS ARE IN ORDER TO REFLECT
THE FUTURE COMPOSITION OF OUR
COMMUNITIES. HÌ Kò IS CURRENTLY
WORKING ON SUPPLY AND DEMAND
MODELING FOR BOTH OUR BEHAVIORAL
HEALTH AND OUR NURSING
WORKFORCES. WE EXPECT FROM THAT
TO HAVE TARGETS BY PROFESSION
TYPE BY REGION AND, IDEALLY BY
RACE, ETHNICITY AND LANGUAGES.
SPOKEN TO ENSURE THAT HÌ Kò S¼
DOLLARS ARE BEING TARGETED TO
THESE SOLUTIONS. WILL GET US TO
OUR POPULATION CONCORDANCE THAT
WE NEED IN THE FUTURE. AND
FINALLY, I JUST WANTED TO
ADDRESS THERE WAS A QUESTION ON
THE EFFECTIVENESS OF LOAN
REPAYMENT PROGRAMS. UM IN 2020,
THREE, WE CONDUCTED AN INTERNAL
ANALYSIS OF HK STATE LOAN
REPAYMENT RECIPIENTS WHO WERE
AWARDED IN 2019. FROM THIS
SAMPLE. WE SAW THAT 76% OF
RECIPIENTS PRACTICED IN A HEALTH
PROFESSION SHORTAGE AREA ONE
YEAR AFTER COMPLETING THEIR
CONTRACTS IN 2025, WE'LL BE ABLE
TO FOLLOW UP TO FIND OUT IF THAT
TREND CONTINUES AT THE THREE
YEAR POST CONTRACT DATE. WE ARE
ALSO PURSUING AN ACADEMIC
PARTNERSHIP CURRENTLY TO LOOK AT
SOME OF OUR HISTORICAL DATA FOR
SCHOLARSHIPS AND LOAN REPAYMENT
PROGRAMS TO TRY TO UNDERSTAND
THE RELATIVE COST EFFECTIVENESS
OF SCHOLARSHIPS AND LOAN
REPAYMENTS SO THAT WE CAN
UNDERSTAND WHERE TO SHIFT OUR
DOLLARS. ALSO ADDRESSING SOME OF
THE EQUITY CONSIDERATIONS, WHICH
INCLUDE INVESTING FURTHER
UPSTREAM. THANK YOU. AND UH, WE
HAVE A VERY ROBUST PANEL HERE
AND ANOTHER ONE COMING. SO UH,
THANK YOU TO OUR PANELISTS FOR,
UH, RESERVING YOUR REMARKS ABOUT
FIVE MINUTES. IN I FORGOT TO
PUSH THE BUTTON. THEN I WILL
START WITH THAT ONE. MY NAME IS
ILAN SHAPIRO. AND THANK YOU SO
MUCH FOR THE HONOR CHAIR AND
MEMBERS. UH, FOR BEING HERE. I'M
A PRACTICING PEDIATRICIAN IN THE
COMMUNITY WORKING IN ALT. UH,
FOR THE PAST EIGHT YEARS. I
CURRENTLY SERVE AS THE CHIEF
HEALTH CORRESPONDENT AND MEDICAL
AFFAIRS OFFICER. AND THIS IS A
SPECIAL THING THAT WE'RE GOING
TO BE TALKING ABOUT THE A B 1045
AND HOW THAT MEXICAN PILOT UH,
PROGRAM WHERE WE'RE BRINGING
MEXICAN PHYSICIANS TO HELP IN
RURAL, RURAL AND URBAN AREAS
THAT ARE UNDERREPRESENTED. AND
IT'S VERY CLOSE TO MY HEART. I
AM A INTERNATIONAL MEDICAL
GRADUATE. I COME FROM A SMALL
CITY CALLED MEXICO CITY AND I
HAVE SEEN THE DISPARITIES. I
HAVE SEEN ABSOLUTELY EVERYTHING
AND WHEN I HAVE SERVED IN
ILLINOIS, ALSO IN FLORIDA, AND
RIGHT NOW IN THE PAST ALMOST 10
YEARS HERE IN IN CALIFORNIA, AND
WHEN A PATIENT ACTUALLY COMES TO
ME. AND THEY HEAR THE LANGUAGE.
AND NOT ONLY THE LANGUAGE, THEY
FEEL THE CULTURE. AND I CAN
ACTUALLY TALK ABOUT VACCINES.
TALK ABOUT THE TACITOS THE TEAS
THE REMEDIES AND ACTUALLY
CONNECT THEM NOT ONLY THE
PARENTS BUT ALSO THEIR KIDS.
THERE IS THE FUTURE OF OUR
COMMUNITIES. IT'S KIND OF THE
KEY ASPECT OF WHERE WE'RE GOING
WITH THIS TYPE OF THINGS. DO WE
HAVE A SOLUTION FOR ABSOLUTELY
EVERYTHING? SADLY NÓ, BUT I
THINK THAT WE'RE IN A PATH WHERE
BRINGING RIGHT NOW PIOUS THAT
ACTUALLY UNDERSTAND THE LANGUAGE
THEY CULTURALLY CONCORDANT CAN
MAKE A HUGE DIFFERENCE, AND I'M
GOING TO RESPOND. A COUPLE OF
QUESTIONS THAT YOU MAY HAVE YOU
KNOW WHAT ABOUT QUALITY? WAS
ACTUALLY MEASURING THIS. WHERE
ARE WE GOING WITH THIS? AS WE
KNOW RIGHT NOW, YOU KNOW IT.
IT'S VERY HARD FOR A LOT OF OUR,
UH, PATIENTS TO ACTUALLY ACCESS
PRIMARY CARE SERVICES. AND WE
ARE ON THAT SHORT LIST WHERE IF
WE A RE NOT CREATING THAT
PIPELINE OF WELLNESS. OUR
COMMUNITIES, ALL THE STUFF THAT
WE'RE DOING OF EXPANDING MEDICAL
SERVICES IS GOING TO BE VERY
HARD BECAUSE WE ACTUALLY NEED A
PHYSICIAN AT THE END. PRESCRIBE
THAT INSULIN. THAT PHYSICIAN A
Tð THE END TO PRESCRIBE THAT
VACCINE. THEN A LOT OF THESE
DOCTORS ARE MAKING A HUGE
DIFFERENCE. IF WE PUT ON
PERSPECTIVE ABOUT THE PHYSICIAN
SHORTAGE, AND I AND I SHARE THE
SAME THE SAME FEELING WITH OUR,
UH BLACK PHYSICIANS THAT WERE
NOT ENOUGH AND WHEN OUR
COMMUNITY ACTUALLY COMES TO US
AND HEAR US AND SEE US, THEY'RE
LOOKING FOR A SAFE SPACE WHERE
WE ARE FREE. AND MOST
IMPORTANTLY, THEY'RE TAKING CARE
OF ONLY LESS THAN 70% OF
PHYSICIANS HERE IN CALIFORNIA
ARE HISPANOS. THAT THAT TALKS
ABOUT A LOT OF THINGS THAT WE
CAN ACTUALLY MEASURE AND WE WERE
SHARING THE NUMBERS ON IF
DISPARITIES, HOW MANY DOCTORS WE
NEED TO CREATE FROM THE HISPANIC
COMMUNITY TO BE UNFAIR, THEN
JUST TO GIVE UP PERSPECTIVE, IT
WILL BE 500 YEARS. ACTUALLY GET
THERE AT THE PLACE THAT WE'RE
CURRENTLY ARE. THEN I'M NOT
GOING TO BE HERE FOR SURE. BUT
I, I THINK THAT WE CAN DO
SOMETHING RIGHT NOW TO MAKE SURE
THAT WE CREATE THAT PIPELINE
WITH THESE TYPE OF THINGS AS A B
1045. UM IN ALTEL. WE HAVE BEEN
SERVING THE COMMUNITY FOR THE
PAST 55 YEARS. AND IT'S ABOUT
LATINOS, M ETHNIC AND ABSOLUTELY
ANYBODY THAT NEEDED HELP TO BE
THERE. AND THAT'S WHY IT'S SO
IMPORTANT TO CREATE THIS TYPE OF
PIPELINES AND WE COMPLETELY
UNDERSTAND THE IMPORTANCE OF
ACTUALLY CREATING THAT FROM HIGH
SCHOOLS CONNECTING NURSES
CONNECTING THE PHYSICIANS AND
ALSO THE ONE OF THE GREAT
OPPORTUNITIES THAT WE'RE HAVING
IS THAT FAMILY PRACTICE? I N
THE COMMUNITY RESIDENCY AND HAS
MAKE A HUGE DIFFERENCE. RIGHT
NOW. WE ARE HAVING ALMOST 18
RESIDENTS IN OUR FIRST CLASS IS
ACTUALLY GRADUATING. THEN MORE
TO COME ON THAT ONE BECAUSE WE
HAVE SEEN THAT WHEN THEY A RE
EXPOSED TO THE COMMUNITY, AND
THEY UNDERSTAND THAT MAKES A
HUGE DIFFERENCE. MOVING TO OUR
MEXICAN PILOT PROGRAM. THE
DOCTORS ARE CERTIFIED IN MANY
TIMES. IT IS A LAW THAT IT'S NOT
NEW. UH IT HAS BEEN AROUND SINCE
2000 AND THANKS GOD OF SINCE
2021. WE REACTIVATED THIS
OPPORTUNITY. WE HAVE 30
PHYSICIAN PRACTICING FROM MEXICO
IN THE CALIFORNIA AND THERE WERE
A LOT OF QUESTIONS REGARDING,
YOU KNOW. IS THE QUALITY WILL BE
BETTER. A RE THE PATIENTS GOING
TO FEEL DIFFERENT. A RE THEY ON
PAIR WITH THE SYSTEM THAT WE
HAVE HERE. AND THE ANSWER FOR
THE THREE OF THEM IS YES, YES.
AND AFTERWARDS YES. WHEN WE
ACTUALLY HAVE HAD, UH,
INDEPENDENT STUDIES, ONE FROM U
èC DAVIS, ANOTHER ONE FROM UNAM
AND ALSO OUR INTERNAL DATA THAT
WE DO A LOT OF, UH, OUTSIDE
CONSULTING THAT COME AND DO
SERVICE FOR US. UM THE PATIENTS
ACTUALLY FEEL THAT THEY HAVE
BEEN HURT BETTER. THEY ARE
UNDERSTOOD BETTER. AND NOT ONLY
THAT, BUT ALSO THE QUALITY OF
THE OUTCOMES ARE STARTING TO
TREND A LITTLE BIT HIGHER. THEN
ALL THAT PART OF FEELINGS THAT
WE HAD REGARDING BEING AFRAID OF
WHAT'S HAPPENING RIGHT NOW. THIS
PROVES THAT IN A MATTER THAT WE
CAN ACTUALLY REGULATE IN A WAY
WHERE WE HAVE èC MA. WE HAVE
THE CALIFORNIA MAKEUP BOARD AND
ALSO A LOT OF THE ACCOUNTABLE
CLINICS THAT WE HAVE THAT WE
HAVE AROUND. UH, FOUR CLINICS,
INCLUDING AL, UH, ALTURAS
CENTERS OF HEALTH. SAN BENITO
HEALTH FOUNDATION. SALINA
CLINICS WHERE WE HAVE ALL THE 30
DOCTORS. WE'RE TOUCHING PEOPLE.
THAT WE'RE NOT GOING TO BE
TOUCHED. IF WE CONTINUE THE SAME
PATH THAT WE'RE DOING, WE'RE
GOING TO HAVE MORE THAN, UH,
28,000 VISITS PER YEAR. AND.
TOTALING AND THE ENTIRE
ENTIRETY. MORE THAN THREE
100,000. VISITS THAT WERE NOT
GOING TO BE TOUCHED PEOPLE THAT
WERE NOT GOING TO BE SEEN
CANCERS THAT WERE NOT BEING
SEEN, BUT VACCINES FOR KIDS THAT
WERE NOT GOING TO BE GIVEN THEN.
THESE PAGES A RE ACTUALLY OPEN
ACCESS TO A PLACE THAT WE'RE
HAVING THAT PART. UM I CAN TALK
ABOUT HOURS REGARDING THIS, BUT,
UM, THE NUMBERS ARE THERE GLADLY
TO SHARE. YOU KNOW WHAT WE HAVE
WITH U èC DAVIS AND ALSO LÀ
UNIVERSITY OF MEXICO. BUT THE
GAP IS THERE AND I. I REALLY
WANT TO HONE IN ONE THING. OTHER
STATES ARE DOING A LOT OF
EFFORTS TO BRING INTERNATIONAL
MAKER GRADUATES THAT IS NOT A
COMPLETE SOLUTION FOR THE STATE.
BUT TENNESSEE OR KANSAS AND
OTHER STATES ARE ALREADY
CERTIFYING INTERNATIONAL ME
GRADUATES TO PLACE THEM IN AREAS
THAT ARE NEEDED. THEN
UNDERSTANDING THAT THIS MEXICAN
PILOT PROJECT IS WORKING. AND
UNDERSTANDING THAT THOSE STATES
ARE ALREADY ENACTING LAWS. THAT
ARE BRINGING INTERNATIONAL MAKER
GRADUATES TO HELP THE COMMUNITY
OR OF NEED THAT ARE CONCORDANT
AND LINGUISTICALLY COMPETENT. WE
NEED TO FIGURE OUT HOW CAN WE
PUT AND USE THIS AND INFORMATION
THAT WE HAVE WE HAVE PATIENTS.
WE HAVE ACCESS. NOW WE NEED
PHYSICIANS TO ACTUALLY GIVE THAT
VACCINE. PRESCRIBE THAT INSULIN
AND CONTINUE HAVING AN AMAZING
CALIFORNIA STATE. THANK YOU SO
MUCH. THANK YOU, DOCTOR SHAPIRO.
WE'LL MOVE ON TO DOCTOR
HENDERSON. THANK YOU VERY MUCH
FOR THE OPPORTUNITY. UM MY NA
ME'S MARK HENDERSON. I'M THE
ASSOCIATE DEAN OF ADMISSIONS AT
THE UC DAVIS SCHOOL OF MEDICINE.
I'VE BEEN IN THAT POSITION FOR
18 YEARS. PRIOR TO THAT. I
PRACTICED PRIMARY CARE MEDICINE
AND SOUTH TEXAS NEAR THE BORDER.
UM WHAT I'M GONNA TALK ABOUT IS
HOW THE U èC Dð SCHOOL OF
MEDICINE BECAME THE THIRD MOST
DIVERSE MEDICAL SCHOOL IN THE
UNITED STATES RIGHT BEHIND
HOWARD UNIVERSITY AND OTHER
OTHER MINORITY SERVING
INSTITUTION. I WON'T GO OVER.
LET ME SEE IF I CAN ADVANCE THE
SLIDES. THIS HAS ALREADY BEEN
STATED. I'LL SAY ONE THING ABOUT
THIS SLIDE, WHICH IS THAT THE
SINGLE BEST INVESTMENT WE COULD
MAKE IS TO PUT MORE PRIMARY CARE
PHYSICIANS IN THOSE DARK AREAS.
LET ME GO BACK TO THE MAP THAT
WAS SHOWN EARLIER. THOSE DARK
AREAS THAT HAVE THE POOREST
HEALTH OUTCOMES. UH THERE ARE
ALL THESE ARE THE EIGHT. THESE
ARE THE HIPS. A THE. THE PROBLEM
IS THAT MOST MEDICAL SCHOOLS
CONTINUE TO EDUCATE SPECIALISTS.
EVEN IN CALIFORNIA, U èC DAVIS
IS THE ONLY SCHOOL THAT ACTUALLY
GRADUATES A MAJORITY OF ITS
GRADUATES THAT GO INTO PRIMARY
CARE. LET ME SEE IF I CAN
ADVANCE THE SLIDES. UH, WE'VE
SAID THIS AGAIN THAT DOCTORS
DON'T LOOK LIKE CALIFORNIA AND
IT'S HARD TO ACHIEVE A MISSION.
THE MISSION OF HEALTH EQUITY
WHEN THERE'S SUCH GAPS ABOUT THE
GAPS BETWEEN THE LATINO
POPULATION IN THE WORLD, AND YOU
KNOW, UH, THE WORKFORCE IS ST
STUNNING AND IT'S NOT GETTING
BETTER FAST ENOUGH. NOW, THIS IS
AN INTERESTING SLIDE. WE DID A
STUDY THREE YEARS AGO, WHICH
SHOWED THAT AS MEDICAL SCHOOLS
IN THE UNITED STATES EXPANDED
BECAUSE EVERYBODY'S TALKING
ABOUT THE PRIMARY CARE WORK. SO
WHAT'S THE SOLUTION? WE'LL MAKE
MEDICAL SCHOOLS BIGGER. YOU CAN
LOOK AT THIS SLIDE MEDICAL
SCHOOLS ACROSS THIS COUNTRY
INCREASED BY 50% THEY WENT FROM
19,000 TO OVER 30,000 SLOTS PER
YEAR. SO YOU THINK, OK, THAT'S
PRETTY GOOD. WELL ABSOLUTE
NUMBER OF UNDERREPRESENTED
STUDENTS WENT UP BUT ACTUAL
REPRESENTATION OF PERCENTAGE OF
THE CLASS. THE PROPORTION OF THE
CLASS ACTUALLY FELL BY 20% TO
ABOUT 13% OF ENTERING MEDICAL
STUDENTS ARE FROM ESSENTIALLY
AFRICAN AMERICAN LATINO NATIVE
AMERICAN. COMMUNITY, SO WE'RE
IT'S ACTUALLY GETTING LESS. LESS
REPRESENTATIVE LESS DIVERSE THAN
WHILE WHILE THE COUNTRY IS
GETTING MORE SO. SO WHAT A RE WE
GONNA NOW THIS IS EVEN MORE
DISTURBING TO ME. THIS IS THE
ECONOMIC DISTRIBUTION OF WHO'S
IN MEDICAL SCHOOL. THE GRAY BARS
ARE THE TOP 20TH PERCENT OF
INCOME IN THIS COUNTRY. THE TWO
TOP GREAT SO 50% OF STUDENTS IN
THIS COUNTRY COME FROM THE TOP
20TH PERCENT OF INCOME, THE
BOTTOM THE DARK RUST. THAT'S THE
BOTTOM 20TH PERCENTILE, SO
THERE'S A TENFOLD DIFFERENCE
BETWEEN WEALTHY STUDENTS AND
I'LL SAY LOWER INCOME STUDENTS,
THE AVERAGE STUDENT, THE U S¼
MEDIAN FAMILY INCOME IS THAT
ORANGE BAR OK, SO THEY'RE VERY
FEW LOW INCOME STUDENTS, VERY
FEW EVEN MIDDLE INCOME STUDENTS
IN MEDICAL SCHOOL TODAY, SO I
THINK IT'S NOT SURPRISING TO ME.
WE HAVE SO MANY DISPARITIES THAT
WHEN YOU HAVE POVERTY CUT ACROSS
ALL OF THESE, YOU KNOW, HEALTH
DISPARITIES. SO YOU KNOW THERE'S
NÓ WAY MEDICINE REPRESENTS
SOCIETY. I THINK WE SAID THAT IN
MULTIPLE DIFFERENT WAYS, BUT I
WANT TO EMPHASIZE ECONOMICALLY.
LET ME YOU KNOW, I THINK WE WITH
THIS. THIS IS ALL BEFORE THE
SUPREME COURT DECISION. OK,
BEFORE THAT, ALL OF THIS
DECREASE SO I THINK THAT'S WHY
YOU KNOW OUR SCHOOL MADE THE NEW
YORK TIMES A COUPLE LAST YEAR.
I'LL TALK ABOUT WHAT HAPPENED AT
OUR SCHOOL OVER THIS PERIOD OF
TIME. SO THIS IS THE LAST 25
YEARS SINCE WE'VE BEEN UNDER AN
AFFIRMATIVE ACTION BANAN AT OUR
SCHOOL, SO THIS IS THE
PERCENTAGE OF OUR STUDENTS
ENTERING THAT ARE FROM
UNDERREPRESENTED GROUPS, AND YOU
CAN SEE WHERE A MAJORITY
MINORITY SCHOOL AT THIS POINT
KEEP GOING. HOW DO WE DO THIS? I
THINK WE FOCUSED ON SOCIAL
ACCOUNTABILITY IN EVERY SINGLE
THING WE DO IN OUR ADMISSIONS
PROCESS, SO I WON'T GO THROUGH
THIS, BUT I'LL JUST STATE. OUR
MISSION IS TO GRADUATE
PHYSICIANS TO MEET THE HEALTH
WORKFORCE NEEDS OF OUR STATE,
WHICH IS CALIFORNIA. 98% OF OUR
STUDENTS COME FROM CALIFORNIA.
UM. UM 86% EVEN AFTER RESIDENCY
STAY IN CALIFORNIA. WE WE FOCUS
ON LIVED EXPERIENCES OF HEALTH
CARE, WHICH HAVE ALREADY BEEN
ALLUDED TO IF YOU COME FROM A
LOW INCOME FAMILY. IF YOU COME
FROM A FAMILY THAT'S BEEN ON ME.
YOU UNDERSTAND WHAT'S WRONG WITH
THE SYSTEM? YOU UNDERSTAND,
ACTUALLY, THE IMPORTANCE OF
TRUST AND A LOT OF THE THEMES
WE'VE TALKED ABOUT ALREADY, SO,
BUT THOSE ARE PRIORITIZED IN OUR
PROCESS OVER GRADES OVER TEST
SCORES ALL THAT THAT THAT STUFF
IS LESS IMPORTANT, AND AS A
RESULT, THE PROFILE OF OUR
STUDENTS IS ON THE RIGHT HERE.
45% OF OUR STUDENTS ARE THE
FIRST IN THEIR FAMILIES TO
GRADUATE FROM COLLEGE. THAT'S
THE HIGHEST PERCENTAGE OF THE
UNITED STATES. FAMILY INCOME
68,000 AGAIN THAT'S LESS THAN
THE U S¼ MEDIAN FAMILY INCOME
AGAIN. SO I THINK YOU HAVE
ECONOMIC REPRESENTATION RATHER
THAN ECONOMIC SEGREGATION, WHICH
IS WHAT MOST MEDICAL SCHOOLS
HAVE. OF COURSE THAT RELATES TO
RACE AND ETHNICITY AS WE ALL
KNOW. LET ME JUST, UH THIS IS
THE INCOME DISTRIBUTION OF èC
DAVIS. OK SO YOU CAN SEE THE
MEDIAN FAMILY INCOMES IN THE
ORANGE BAR. SO MOST 60% OF OUR
STUDENTS COME FROM THE MEDIAN
INCOME OR LESS. VERY DIFFERENT
EXPERIENCE OF LIFE, VERY
DIFFERENT EXPERIENCE OF HEALTH
CARE AND AGAIN, UNDERSTANDING
EMPATHY FOR WHAT A LOT OF OUR
PATIENTS GO THROUGH. THAT I JUST
TAKE TWO MORE SLIDES. ONE THING
YOU HAVE TO REALIZE IS THAT I
THINK YOUR MISSION HAS TO BE.
IT'S NOT JUST WHO YOU BRING INTO
YOUR SCHOOL. IT'S WHAT YOU DO
WITH THEM. SO WE'VE DEVELOPED
FIVE DIFFERENT PATHWAYS WITHIN
OUR MEDICAL SCHOOL THAT EACH
FOCUS ON A VULNERABLE OR A
HEALTH SHORTAGE AREA. IN OUR IN
OUR STATE. I'VE LISTED THEM
THERE. THESE ARE CALLED
COMMUNITY HEALTH SCHOLAR. HER
TRACKS. 30% OF OUR STUDENTS ARE
IN THEM. 80% OF THE STUDENTS IN
THESE TRACKS ARE FROM
UNDERREPRESENTED COMMUNITIES.
ONE'S A RURAL TRACK. ONE FOCUSES
ON FAIRLY QUALIFIED HEALTH
CENTERS. THE URBAN UNDERSERVED
ONE FOCUSES ON THE CENTRAL
VALLEY, THE RECENT THE MOST
RECENT ONE, WHICH IS FUNDED BY
PRIME, WHICH IS ALLUDED TO
EARLIER IS FOCUSES ON THE NATIVE
AMERICAN TRIBAL COMMUNITIES IN
THE IN IN THE STATES, SO EACH OF
THESE PROGRAMS HAVE SPECIAL WRAP
AROUND SERVICES, MENTORING
FINANCIAL SUPPORT SCHOLARSHIPS
SO THAT THE STUDENTS AGAIN
MOSTLY LOW INCOME FAMILIES HAVE
A WAY TO MAKE IT THROUGH MEDICAL
SCHOOL AGAIN THAT STARTS MUCH
EARLIER THAN MEDICAL SCHOOL, AS
WAS ALREADY ALLUDED TO MY LAST
SLIDE IS THE OUTCOMES OF THOSE
PROGRAMS. THESE ARE WHAT
SPECIALTIES OUR STUDENTS GO INTO
OVER 60 64% GO TO PRIMARY CARE.
THAT'S 25% POINTS HIGHER THAN
ANY OTHER SCHOOL IN CALIFORNIA.
WHY BECAUSE I THINK YOU HAVE THE
LIVED EXPERIENCE OF THE LACK OF
PRIMARY CARE AND WHAT THAT MEANS
TO THE FAN, THEIR FAMILIES AND
THEIR COMMUNITIES. SO I'LL END
THERE, HALF OF THEM WORK IN AN
UNDERSERVED AREA. A THIRD WORK
IN A RURAL AREA AND AGAIN I SAID
THIS BEFORE 87% PRACTICE IN
CALIFORNIA. AND NOW THIS. WE
ALREADY KNOW HOW DIVERSITY
IMPROVES HEALTH OUTCOMES, AND I
THINK THAT'S MY LAST SLIDE.
SORRY I WENT OVER FIVE MINUTES.
THANK YOU SO MUCH. DOCTOR
HENDERSON, LOOKING FORWARD TO
HEARING MORE ABOUT WHAT I THINK
IS CERTAINLY A NATIONAL MODEL.
UM, AND NOW WE'LL MOVE TO UH,
PRESIDENT FITZGIBBON. UH, GOOD
AFTERNOON AND THANK YOU FOR THE
INVITE. TODAY IT'S GREAT TO
SPEAK ABOUT OUR MODEL AND SHARE
SOME OF OUR IDEAS TODAY AND I
HOPE TO SHED THE LIGHT ON ONE
PARTIAL SOLUTION AND THEN ANSWER
YOUR QUESTION ABOUT SCALE. SO I
DON'T I'M GONNA ASSUME THAT
MAYBE NOT EVERYONE'S FAMILIAR
WITH THEIR SCHOOL, SO I'LL GIVE
YOU A QUICK SNAPSHOT FIRST, UH,
THE KAISER PERMANENTE SCHOOL OF
ALLIED HEALTH SCIENCES WAS
FOUNDED IN 1989. IN RICHMOND,
CALIFORNIA. AND IT WAS, UH ONE
PROGRAM. UH, ONE ROOM. 12
STUDENT SCHOOL. AT THE
CERTIFICATE LEVEL. AND TODAY WE
GRADUATE ABOUT THREE 150.
STUDENTS A YEAR, EVERYBODY FROM
A CERTIFICATE UP TO A MASTER'S
DEGREE. SO YOU KNOW WHEN I THINK
ABOUT SCALE I DO THINK ABOUT OUR
FOUNDERS WHO STARTED WITH 12.
AND THE POWER OF THE NUMBER ONE.
ALL OF OUR PROGRAMS ARE IN
ALLIED HEALTH. AND I THINK
SOMETIMES ALLIED HEALTH IS A
LITTLE BIT STILL MISUNDERSTOOD,
BUT A GOOD RULE OF THUMB IS IT'S
ALL OF THE PROFESSIONS THAT ARE
NOT A NURSE OR A DOCTOR. AND AS
AS I GET OLDER, YOU ENCOUNTER
MORE AND MORE ALLIED HEALTH AS A
CONSUMER. AND YOU APPRECIATE,
UH, FROM THE HEART THAT THEY'RE
VERY, VERY IMPORTANT AND THEY
HELP OUR PHYSICIANS MAKE
ACCURATE DIAGNOSIS AND PROVIDE
QUALITY CARE. AS YOU CAN IMAGINE
, KAISER PERMANENTE SINCE 1989
HAS FOUND ITSELF SHORT OF
VARIOUS ALLIED HEALTH
PROFESSIONS, AND THEREFORE WE
JUMP IN AND EDUCATE OUR TRAIN
OUR OWN. UH, FILL SOME OF THOSE
DEFICITS. WE MADE THE CHOICE
ABOUT SEVEN YEARS AGO TO BECOME
REGIONALLY ACCREDITED SO THAT WE
COULD GRANT A DEGREE. ALL THE
WAY UP TO A DOCTORAL DEGREE. AND
IF YOU WENT TO OUR SCHOOL AND
DECIDED TO GO ON AND BECOME A
PHYSICIAN OR A NURSE, OR GET A
SECOND DEGREE THAT OUR CREDITS,
UM WOULD TRANSFER WE'RE WE'RE
LUCKY TO HAVE A VERY, VERY
DIVERSE STUDENT BODY. IT'S NOT
BY ACCIDENT. AND AS I MENTIONED,
OUR FOUNDERS COULD HAVE BUILT
THE SCHOOL ANYWHERE, BUT THEY
BUILT IT IN RICHMOND, CALIFORNIA
WERE EMBEDDED IN THE COMMUNITY
THERE. WE WORK CLOSELY WITH ALL
OF THE LOCAL HIGH SCHOOLS AND AS
THE PREVIOUS PANELISTS SUGGESTED
, WE START THESE CONVERSATIONS
EARLY. WHAT WHAT IS ALLIED
HEALTH AND HOW MUCH DOES IT COST
AND HOW MUCH IS TUITION AND WHAT
TYPE OF CHOICES DO I HAVE?
LOCALLY IN MY COMMUNITY. WE ARE
OPEN TO THE PUBLIC. THERE IS A
PERCEPTION THAT OUR SCHOOL YOU
HAVE TO WORK FOR KAISER
PERMANENTE. THAT'S THAT'S NOT
ACTUALLY CORRECT. SO WE'RE OPEN
TO THE PUBLIC, AND NOT ALL OF
OUR GRADUATES GO TO WORK FOR Kò
P ABOUT TWO OUT OF THREE DO. UH,
ONE OF THE REASONS IS THERE'S
SUCH A SCRAMBLE. FOR ALLIED
HEALTH TALENT ACROSS CALIFORNIA
THAT OTHER EMPLOYERS COME AND
OFFER OUR GRADUATES JOBS,
SOMETIMES AT THE GRADUATION
CEREMONY. ONE OF THE QUESTIONS I
THINK THAT HAS BEEN ASKED ABOUT
IS HOW COULD WE SCALE UP AND ONE
OF THE COMMITTEE MEMBERS
MENTIONED TRAVELERS? AS A HEALTH
CARE CONSUMER, AND I'M NOT
AGAINST TRAVELERS OR CONTRACT
STAFF. WE USE THEM OBVIOUSLY AT
Kò B, AND THEY DO A GREAT JOB.
BUT AS A PATIENT OR A MEMBER
WHEN I'M THERE, I, I DO SORT OF
SEE IT ALMOST AS A MISSED
OPPORTUNITY. HOW COME WE
COULDN'T HAVE SOMEBODY THERE
TRAINING? LEARNING THIS ROLE
THAT'S GONNA CULMINATE. AND A
GREAT JOB. AND ME MYSELF. I'M AN
EXAMPLE WAS ALWAYS A DREAM FOR
ME TO FINISH MY EDUCATION IN
CALIFORNIA AND I CAME AND I DID
IT AND I'M STILL HERE 25 YEARS
LATER, SO I DON'T THINK I'M
GOING ANYWHERE. SO I THINK WHEN
WE THINK ABOUT SCALING UP WE? WE
HAVE SO MANY OF THE INGREDIENTS
WE HAVE. THE BEST HOSPITALS, THE
BEST TECHNOLOGY. UNIVERSITIES
AND COLLEGES THAT PEOPLE DREAM
OF GOING TO FROM ALL OVER THE
WORLD. SO HOW COME WE HAVEN'T
BEEN ABLE TO MAKE A BIGGER DENT.
AND THE DEFICIT OF WORKERS. I
THINK PERSONALLY, IT'S A USEFUL
MODEL TO THINK OF IT AS A THREE
LEGGED STOOL. SO YOU NEED THE
PATIENT. FOR ALLIED HEALTH. HALF
OF YOUR TRAINING IS OUT ON THE
ROAD AND YOU NEED TO WORK WITH
RAIL CASES REAL PATIENTS. WE'RE
WE'RE NOT SHORT THERE. YOU NEED
THE HOSPITAL SYSTEMS. YOU NEED
THE TECHNOLOGY. WE'VE GOT THE
BEST. THE THIRD LEG OF THE STOOL
. I WOULD JUST ASK EVERYONE TO
THINK ABOUT IT, AND WE HAVEN'T
TALKED ABOUT IT A LOT. YET THIS
AFTERNOON IS THE CLINICAL
PRECEPTOR ARE THE INSTRUCTOR,
AND THAT'S KIND OF LIKE THE
BUDDY SYSTEM. EXAMPLE FOR OUR
RAD TECH PROGRAM. IT'S TWO YEARS
LONG. BUT YOU NEED 1850
SUPERVISED HOURS WITH QUALIFIED
PERSON. SO AS ONE OF THE
COMMITTEE MEMBERS MENTIONED. YOU
KNOW IF YOU'VE BEEN KEEPING UP
WITH HEALTH CARE, THAT'S A BIG
ASK. YOU'RE GONNA SHEPHERD A
STUDENT THROUGH UNDER YOUR
LICENSE. FOR 1850 HOURS. IT'S A
BIG COMMITMENT, AND YOU MIGHT
HAVE A LINE OF PATIENTS OUT THE
DOOR. THAT'S ALMOST UNIVERSALLY
TRUE FOR ALL OF THE ALLIED
HEALTH PROFESSIONS THAT MODEL SO
I WOULD JUST SORT OF POSE THAT
QUESTION. WHAT? WHAT ARE THE
INCENTIVES, SIR? OBSTACLES. TO
ENCOURAGING PEOPLE TO PRECEPT
THE NEXT GENERATION. AND I THINK
THERE ARE SOME MODELS NATIONALLY
. OTHER STATES ARE ARE ARE
WRESTLING WITH THIS AS WELL.
AND, UM WE'RE HAPPY TO PROVIDE
MORE INFORMATION, OUR OUR MODEL,
I WOULD SAY COINCIDENTALLY, THAT
THE MAYO CLINIC AND THE
CLEVELAND CLINIC. BOTH HAVE
SCHOOL HEALTH PROFESSIONS, JUST
LIKE THE Kò P SCHOOL AND THEY'RE
WORKING ON THIS PRECEPTOR.
CHALLENGE AS WE SPEAK. SO. I. I
WOULD HOPE SOMEDAY IF YOU THINK
ABOUT OUR SCHOOL THAT STARTED IN
1989. I THINK WE DO MY PERSONAL
OPINION. WE DO HAVE THE
INGREDIENTS. YOU FILL THESE
DEFICITS AND BECOME AN EXPORTER.
OF HEALTHCARE WORKERS. WE HAVE
ALL OF THOSE INGREDIENTS IF WE
COULD GET EVERYTHING ALIGNED AND
I THINK THAT'S A FUTURE THAT
EVERYBODY COULD COULD BUY INTO.
THANK YOU FOR THE INVITATION
TODAY. SO MUCH, I'LL OPEN IT TO
MY COLLEAGUES. UM, I'LL BEGIN.
UH, DOCTOR SHAPIRO. I WAS, UM.
SHOCKED SADDENED BUT ALREADY
KNEW THE DATA POINT REGARDING
HOW LONG IT WOULD TAKE FOR US TO
REACH POPULATION PARITY ON 500
YEARS AND ONE OF FOCUS MY
QUESTION ON DIRECTOR LANDSBURG
IF WE CAN, BECAUSE IT'S YOU.
TESTIMONY WAS THAT WE'RE MOVING
IN THE RIGHT DIRECTION THAT
WE'RE INCREASING OVER TIME. IS
THAT TRAJECTORY GOING TO LEAD US
AS A STATE TO TAKE 500 YEARS FOR
US TO REACH POPULATION? PARITY
IS THAT OK FOR US, OR SHOULD WE
BE LOOKING TOWARDS SOME OF THE
INNOVATIVE MODELS THAT ARE
UNIVERSITY OF CALIFORNIA SYSTEMS
ARE DOING REGARDING ECONOMIC
INTEGRATION AS A WAY IN WHICH WE
CAN CHANGE THAT SLOPE TO REACH
PARITY QUICKER. OF. OF COURSE,
IT'S NOT OK FOR IT TO TAKE, UM
ANYWHERE CLOSE TO THAT LONG AND
SO I THINK WE THINK WE HAVE THE
RIGHT MIX OF SOLUTIONS AND THAT
IT REALLY DOES TAKE WORKING
ALONG EVERY STEP OF THAT
CONTINUUM FROM BRINGING MORE
FOLKS IN FROM HELPING CHANGE
SOME OF THE EDUCATIONAL
INSTITUTIONS. I MEAN, UC DAVIS
AS A MODEL AND WE HAVE HAD THEM
COME PRESENT TO OUR WORKFORCE
COUNCIL AND THINK YOU KNOW, WE'D
LIKE TO SEE EVERY MEDICAL SCHOOL
ADOPTING THAT HOLISTIC APPROACH,
UM AND BRINGING IN A MORE
LINGUISTICALLY AND
SOCIOECONOMICALLY DIVERSE
STUDENT BODY. WE ALSO THINK YOU
KNOW, UM AS AS LIBBY ABBOTT
TALKED ABOUT. WE HAVE TO BUILD
THE PROFESSIONS WHERE YOU KNOW,
SOMEONE EARLIER NOTED, WE'RE
NEVER GOING TO HAVE ENOUGH
PSYCHIATRISTS, SO WE'RE REALLY
THRILLED TO BE SUPPORTING PSYCH,
PSYCHIATRIC MENTAL HEALTH NURSE
PRACTITIONERS, UM, THE WELLNESS
COACHES, UM, THE COMMUNITY
HEALTH WORKERS AND REALLY
THINKING ABOUT THOSE STACKABLE
CREDENTIALS. SO WE THINK ALL OF
THE SOLUTIONS, UM, ARE NECESSARY
. WE WILL, UM AS LIBBY NOT TO BE
DOING MORE SPECIFIC FORECAST. TO
GIVE MORE SPECIFIC ANSWERS.
WHICH WE KNOW IS IMPORTANT BOTH
TO THE STATE. UM, AND TO THE
LEGISLATURE TO REALLY UNDERSTAND
WHAT IS IT GONNA TAKE? AND HOW
QUICKLY CAN WE GET THERE? I'LL.
I'LL ELEVATE THE SUCCESSES WHICH
YOU'VE HAD WITHIN YOUR HEALTH
PROFESSION PATHWAY PROGRAM AS AN
EXAMPLE OF HOW WE CAN MAKE
IMPROVEMENTS AND HELP TO
DIVERSIFY HOLISTICALLY OUR
WORKFORCE, AND YET WE STILL PUSH
TO MAKE SURE THAT THOSE
SOLUTIONS ARE WORKING FOR ALL
PARTS OF OUR STATE. ABSOLUTELY
WE HEARD THAT THERE WERE 11
MILLION PEOPLE WHO ARE IN HEALTH
SHORTAGES, AREAS I, I COME FROM
ONE OF THEM, I. I COME FROM A
VALLEY WHERE WE DON'T HAVE A
MEDICAL SCHOOL TO TRAIN DOCTORS
AT ALL. AND IT'S HARD FOR ME TO
RECRUIT ENOUGH DOCTORS TO COME
IN. AND BELIEVE THAT THE
SOLUTION HAS TO BE WITH US
GROWING OUR OWN. SO EARLIER, WE
HEARD ABOUT HOW THERE ARE SIX S¼
THAT ARE CURRENTLY IN THE
PROCESS OF TRAINING. WITH OUR
NEWEST YOU SEE BEING MERCED.
IT'S A PRIME OPPORTUNITY FOR US
TO AS A STATE MAKING INVESTMENTS
THAT WILL BOTH DIVERSIFY OUR
WORKFORCE BUT ALSO SUPPORT UH,
HISPANIC SERVING INSTITUTION. TO
MAKE SURE THAT WE'RE PROVIDING
THAT TRAINING FOR TOMORROW. BUT
I WANT TO FOCUS ON SOMETHING
THAT HASN'T BEEN DISCUSSED MUCH
TODAY AND IT REALLY IS REGARDING
TRUST. WE'VE HEARD THE
IMPORTANCE OF COMMUNICATION. AND
SO I'M QUESTIONING THAT SINCE WE
CAN'T PRIORITIZE ADMISSIONS
BASED ON RACE ARE WE ABLE TO USE
LANGUAGE? WE ABLE TO FOCUS ON
THE FACT THAT THOSE WHO ARE
MULTILINGUAL, BRING A STRENGTH
TO THEIR APPLICATION, AND IF
IT'S ALLOWING US TO ADDRESS
DISPARITIES WE HAVE IN THRESHOLD
LANGUAGES FOR THOSE WHO ARE
SERVING ME, WOULDN'T WE BE
BENEFITED AS A SYSTEM? TO BE
PRIORITIZING ADMISSIONS FOR
THOSE WHO SPEAK MULTI LANGUAGES.
WELL, IW. I WON'T SPEAK FOR THE
MEDICAL SCHOOLS. BUT I WILL JUST
SAY FROM THE HÌ HIGH PERSPECTIVE
THAT WE ABSOLUTELY THINK
LANGUAGE IS DIRECTLY TIED TO THE
ABILITY TO PROVIDE SERVICES. SO
UM, LANGUAGE OF THOSE SPOKEN IS
SOMETHING THAT WE TAKE INTO
ACCOUNT AND THAT DOCTOR
HENDERSON AS IT AS IT'S AS IT
PERTAINS TO THE SUPREME COURT
DECISION ABSOLUTELY A SKILL
BASED CRITERIA LIKE LANGUAGE IS
ABSOLUTELY FINE. AND I THINK
AGAIN 45% OF HIGH SCHOOL
GRADUATES IN THE STATE ARE
LATINO. EVERY OF PUBLIC SCHOOLS
SHOULD BE A HISPANIC SERVING UP
SCHOOL, SO I DON'T I DON'T GET
WHEN PEOPLE SAY. WHERE ARE WE
GONNA GET THE PEOPLE FROM? ARE
YOU KIDDING ME? THEY'RE
EVERYWHERE. THEY'RE IN OUR LOCAL
COLLEGES IN OUR COMMUNITY
COLLEGE ANYWAY, I'M TALKING
ABOUT LATINO. I'M TALKING ABOUT
SPANISH SPEAKING WITH WRITERS,
SO I MEAN, IT CAME FROM THE
SOUTH TEXAS. WHEN I CAME HERE, I
WAS BLOWN AWAY HOW DIFFERENT IT
WAS. I CAME FROM A PLACE WHERE
MOST OF THE PEOPLE WERE LATINO.
BUT MOST OF THE PHYSICIANS AND
NURSES WERE TOO. THAT'S NOT TRUE
HERE ANYWAY. I MEAN, I. I KNOW
IT CAN DONE. I KNOW THIS IS AN
INFORMATIONAL HEARING AND FOR US
NOT TO TALK ABOUT BILLS, BUT I
WOULD THE REMINISCENT IF I DON'T
MENTION A B 2080 DEALING WITH
MULTILINGUAL AND A B 3081
FOCUSED ON U èC MERCED MEDICAL
SCHOOL FUNDING THANK YOU, MADAM
CHAIR. THANK YOU, DOCTOR RAMBLA,
MR JOHN SAWYER AND THANK YOU.
I'M SORRY. I MISSED THE
BEGINNING AND THE OTHER. SO THIS
IS, UH THIS IS REALLY PERSONAL
TO ME. UM UH, AS AN AFRICAN
AMERICAN MALE. WHO HAS WHO HAD
DIABETES. UM WHEN I WENT IN TO
KAISER. TO GET, UM DIAGNOSED. UM
THEY WERE PUSHING PILLS.
METFORMIN. UH, LIPIDE, UM AND
THEN TRY TO PUT ME ON. ON, UM
HAVING ME STICK MYSELF WITH A
NEEDLE. EVERY DAY. AND, UM. ONE
DAY, AN AFRICAN AMERICAN FEMALE
NURSE. CALLED ME INTO THE ROOM.
AND THAT BROTHER. I'M JUST TIRED
OF THIS. I'M TIRED OF SEEING ALL
THESE BROTHERS COMING IN HERE
AND THEY'RE PUSHING ALL THESE
DRUGS ON YOU. YOU JUST NEED TO
YOUR FAT JUST NEEDS TO LOSE SOME
WEIGHT. AND I SAID IT NOT TO BE
VULGAR, BUT SHE SAID IT IN A WAY
THAT IT GOT TO ME AND I
UNDERSTOOD. AND I LOST WEIGHT.
AND MY A ONE èC IS NOW I'M NÓ
LONGER DIABETIC. WE TALKED ABOUT
BEANS AND GREENS AND WHAT TO
EAT. AND ALL OF A SUDDEN I'M
EATING RIGHT? SHE KNEW WHAT MY
DIET SHOULD BE. THAT PERTAIN TO
ME. THAT I COULD UNDERSTAND. AND
I WAS NOT GETTING THAT FROM MY
DOCTOR WHO WAS NOT OF AFRICAN
AMERICAN CULTURE. TO BE ABLE TO
EXPLAIN THAT TO ME. SO THAT'S
WHY I A ONE èC S¼ IN THE FIVES
NOW INSTEAD OF IN THE 10TH. AND
SO, UH, I, I I'M A FIRM BELIEVER
THAT WE'VE GOT TO GET MORE
PEOPLE THAT ARE THAT UNDERSTAND
THE CULTURE. UM, A LOT BETTER.
THE OTHER EXAMPLE. I WILL GIVE
YOU IS THERE WAS A STATE
SENATOR. HERE. WHO HAD PROBLEMS
WITH THEIR PROSTATE, AND HE KEPT
PUTTING IN OVER AND OVER AGAIN,
NOT GETTING IT TAKEN CARE OF. I
SAY HIS NAME BECAUSE HE HE WENT
OUT AND STARTED TALKING ABOUT
PROSTATE CANCER. THAT'S RIGHT,
SENATOR ROD WRIGHT. AND, UM ONE
DAY A BLACK DOCTOR WAS TELLING
HIM ABOUT HIS PROSTATE PROBLEMS.
AND HE LOOKED HIM IN THE EYE AND
SAID, BROTHER, YOU'RE GONNA DIE
IF YOU DON'T TAKE CARE OF THAT,
FOR SOME REASON, THEY JUST STUCK
TO HIM IF IT WASN'T FOR THAT
BLACK DOCTOR ROD WRIGHT WOULD
NOT BE WITH US TODAY. HE
IMMEDIATELY TOOK CARE OF IT.
THAT'S WHY IT'S SO IMPORTANT TO
HAVE SOMEBODY THAT CAN TALK TO
YOU IN A MANNER. SOMETIMES NOT
AS DELICATE. AS YOU AS YOU WOULD
LIKE TO IN YOUR PROFESSION, BUT
IT CAN GET TO YOU MAKE SURE YOU
UNDERSTAND WHAT YOU NEED TO DO.
AND THEN ON THIS SUB, AND SO IF
WE CAN THE NEED FOR THAT IS SO
IMPORTANT. IF WE CAN START
TALKING ABOUT WHY THAT IS SO
IMPORTANT, AND THAT NOT TALK
ABOUT A CEREBRAL SENSE, BUT
BREAK IT DOWN. SO THAT OTHERS
WILL WANT TO COME INTO THE
PROFESSION AND WANT TO BE ABLE
TO TALK. THE SAME WAY. AND ON
THE THEME FOR WORKFORCE
DIVERSITY. UM, MY NIECE. IS IN
HER FINAL YEAR. OF MEDICAL
SCHOOL. AND, UM AT MOREHOUSE. UM
BUT SHE HAS A FAMILY. HER
MOTHER'S A DENTIST. OR OR FOR
AUNT OR ALL TEACHERS. AND SO SHE
HAS THAT. INFRASTRUCTURE. THE TO
PUSH HER ALONG ALONG THEY'RE IN
A SORORITY CALLED DELTA SYNCOPE
THETA, AND THERE IS A FAMILY OF
DOCTORS WITHIN THAT SORORITY.
THAT WHEN SHE GOT STUCK OR WHEN
SHE WASN'T DOING WELL IN SCHOOL.
SOMEBODY WOULD MAKE A PHONE CALL
AND SAY HELP HER WITH THIS. WITH
ANATOMY OR WHATEVER. AND THEN
THAT FAMILY WOULD COME IN. AND
HELP HER GET THROUGH. THAT
PROCESS. AND SO IF WE COULD
CREATE THAT, YOU KNOW YOU YOU'RE
TALKING ABOUT GETTING PEOPLE IN.
BUT YOU ALSO GOTTA HAVE A GROUP
OF A MENTORS AND INSTRUCTORS AND
OTHER PEOPLE WHO CAN THEN TALK
TO THESE YOUNG UM MINORITY
STUDENTS AND MAKE SURE THAT THEY
CAN MAKE IT THROUGH AND GIVE
THEM THE KIND OF BUOYANT THAT
THEY NEED TO BE ABLE TO GET TO
BECAUSE YOU KNOW, IT'S A
STRUGGLE. TO GET TO MEDICAL
SCHOOL, AND I KNOW THERE'S A
BUNCH OF TIMES I WASN'T SURE SHE
WAS GONNA MAKE IT. WELL, I'LL
I'LL BE HONEST, THOSE WOMEN WERE
NOT GONNA MAKE GONNA MAKE SURE
SHE WAS NOT GOING TO FAIL AND
SHE'S AND SHE'S GRADUATING THIS
SUMMER BECAUSE OF ALL THOSE
WOMEN WHO STOOD BEHIND HER. AND
MADE SURE SHE GOT THERE. THAT
POINT IS SO IMPORTANT, AND I
THINK THAT'S ONE OF THE REASONS
WHY SCHOOLS DON'T CHANGE THEY
DON'T IT'S EASIER TO KEEP DOING
IT THE SAME WAY AND EDUCATING
THE USUAL SUSPECTS. WHAT YOU'RE
TALKING ABOUT IS A FAMILY AN
AUNTIE, BUT THAT THAT'S CRITICAL
. AND I THINK THAT YOUR STORY
ABOUT THE DIABETES WE SEE THAT
EVERY DAY WHEN YOU SEE A BLACK
EVEN A BLACK MEDICAL STUDENT. I
ALWAYS HAD A BLACK MEDICAL SUIT
ME THE OTHER DAY WITH A BLACK
WOMAN WHO HAD ALL KINDS OF
PROBLEMS REALLY HAVING A
DIFFICULT TIME? I MEAN, SHE HER
I? WE GOT SO MUCH FARTHER IN
THAT VISIT, BECAUSE SHE SHE SHE
JUST SHE SAW, THE STUDENT SAID
AT THE END OF IT SAID, CAN SHE
BE MY DOCTOR? I SAID, WELL, SHE
CAN IN ABOUT FIVE YEARS, BUT I
I'M JUST TELLING YOU, YOU IT'S
TRUST WE IN PRIMARY CARE. WE ASK
PEOPLE TO CHANGE THEIR LIFE,
CHANGE THEIR BEHAVIOR. TAKE THIS
MEDICINE DO THIS. AND IF WE
HAVE, I DON'T TRUST YOU. WHY AM
I GONNA I MEAN, WHY AM I GONNA
DO THAT? ANYWAY THEN THE LAST
THING I'LL LEAVE YOU WITH. THERE
WERE A BUNCH OF DENTISTS AND
DOCTORS THAT WENT TO MAHRI
MOREHOUSE. HOW THAT WERE IN
THEIR THIRD YEAR. AT MY AT MY
ALMA MATER, U, S¼, èC, AND ALL
OF A SUDDEN THEY WERE IN MEDICAL
SCHOOL, AND THEY WERE ABLE TO
COMPLETE THEIR UNDERGRADUATE
DEGREE AND GO TO MEDICAL SCHOOL
AT THE SAME TIME, BECAUSE WE
WERE IN A IN A RUSH IN THE
SEVENTIES. TO PRODUCE AS MANY
DENTISTS AND DOCTORS AS
POSSIBLE. AND SO I THINK WE HAD
A WHOLE BUNCH OF PEOPLE WHO
BECAME DOCTORS AND DENTISTS
DURING THAT TIME OF AFRICAN
AMERICAN PERSUASION, BECAUSE
THERE WAS THAT LADDER. THAT GOT
HIM THERE. UM AND I DIDN'T FIND
OUT ABOUT IT UNTIL AFTER I HAD
GRADUATED BECAUSE I PROBABLY
WOULD HAVE GONE TO THAT PROGRAM,
BUT NOBODY KNEW ABOUT THAT. AND
IT WAS KIND OF A SECRET. BUT
THERE WAS THE PEOPLE WHO DIDN'T
KNOW ABOUT IT JUMPED ON IT AND
WENT THROUGH THE PROGRAMS AND
THEY ALL ARE NOW RETIRED.
DOCTORS AND DENTISTS. AND SO I
DON'T KNOW HOW WE'RE GONNA
REPLENISH THAT BECAUSE I THINK
THAT AVENUE HAS BEEN CUT OFF.
UM, UM, TO BE ABLE TO DO THAT.
THERE ARE THERE ARE A COUPLE OF
GROUPS I MENTIONED NATIONALLY
WORKING ON DIVERSITY AND
PRECEPTOR SHIPS AS WELL. SO WE'D
BE HAPPY TO SHARE THAT
INFORMATION. BUT TO YOUR POINT
IF YOU HAVE A PRECEPTOR THAT
YOU'RE SPENDING 1800 HOURS WITH
THAT YOU IDENTIFY WITH IT'S MUCH
MORE LIKELY YOU'LL FINISH YOUR
DEGREE. GO INTO THE WORKFORCE.
AND IF I MAY SHARE ONE OF THE
THINGS THAT WE HAVE LOVED DOING
IS WE PARTNER WITH THE NATIONAL
MEDICAL FELLOWSHIP. WHERE UH,
COMMUNITIES OF COLOR ACTUALLY
GET ACCESS TO A PAID INTERNSHIP
DURING SUMMER. AND WE LOVE DOING
THAT PART. THE OTHER ONE IS MY
MENTOR THAT, ACTUALLY IT. IT'S
VERY SPANISH. BUT THAT DOESN'T
MEAN THAT IT'S ONLY HISPANIC.
THEN IT'S ACTUALLY FOR ANYBODY
THAT IT'S ON THAT PATHWAY WHERE
THEY NEED THE FAMILY THAT THAT
THAT TRUST OF LIKE NÓ NÓ NÓ,
THIS IS THE NORTH DON'T GO THAT
WAY. UM AND THE OTHER THING IS
THAT PAY THE INTERNSHIPS THAT
WE'RE OFFERING ON SUMMER BECAUSE
A LOT OF THE STUDENTS ACTUALLY
NEED THAT THAT GAP YEAR TO
ACTUALLY ESTABLISH GET BETTER
GRADES. UNDERSTAND WORDS. UH YOU
KNOW WHAT? WHAT WHAT'S HELD FOR
THEM AND EVERYBODY WANTS A
INTERNSHIP. BUT THERE'S NOT A
LOT PAY THE OPPORTUNITIES. THEN
WE ACTUALLY OPEN THAT SPACE
WHERE THEY COME WITH US. THEY
ESTABLISH A CLINICAL ROLE. THEY
GO. THEY SEE OTHER PERSON PART
OF THE CLINICS, NURSES, DENTISTS
AND THAT ACTUALLY MAKES A
FAMILIAR FAMILY WHERE WHEN THEY
ARE ON THAT THOSE HORRIBLE
NIGHTS WHERE THEY CANNOT SLEEP
OR THEY HAVEN'T EXAM AND THEY
EVERYTHING IS LIKE COLLAPSING.
SOMEONE WILL CALL THEM THEN.
YEAH, I COMPLETELY AGREE WITH
THAT. THANK YOU SO MUCH FOR THE
VERY RICH, UH, CONVERSATION,
AND, UH, WE'RE GONNA MOVE ON TO
OUR NEXT PANEL.
OUR NEXT PANEL, UH, WHICH IS
FOCUSED ON INCREASING THE
DIVERSITY IN HEALTH CARE,
WORKFORCE, EDUCATION AND
TRAINING WILL BEGIN WITH DOCTOR
RUTH SHIM. IP MONICA SCOTT AND
THEN KATHERINE PHILLIPS. OKAY
GOOD AFTERNOON. THANK YOU SO
MUCH. JANA, AND, UM, THE OTHER
COMMITTEE MEMBERS, IT'S GREAT TO
BE HERE WITH YOU ALL TRY. I WILL
TRY TO SPEAK VERY FAST. MY NAME
IS DR RUTH SHIM. I AM THE
ASSOCIATE DEAN OF DIVERSE AND
INCLUSIVE EDUCATION AT U èC
DAVIS SCHOOL OF MEDICINE. I'M
ALSO I DISCOVERED TODAY ONE OF
THE 3% OF BLACK PHYSICIANS IN
CALIFORNIA, AND I DON'T EVEN
KNOW AS A PSYCHIATRIST. I DON'T
EVEN KNOW WHAT THAT PERCENTAGE
IS FOR ME, BUT, UM, I IMAGINE
IT'S PRETTY LOW. OK SO I WANNA,
UM FOCUS ON, UM, A COUPLE OF
THINGS. DOCTOR HENDERSON
PRECEDED ME IN THE PREVIOUS
PANEL AND TALKED, I THOUGHT,
AMAZINGLY ABOUT, UH, THE WORK
THAT WE'VE DONE IN DIVERSITY, UM
TO THROUGH OUR ADMISSIONS WORK
TO INCREASE THE DIVERSITY OF,
UH, MEDICAL STUDENTS, UM AT U
èC DAVIS. I'M ACTUALLY GONNA
ABOUT, UM THREE OTHER AREAS,
THOUGH I'M GONNA FOCUS IN ON
EQUITY INCLUSION AND BELONGING
BECAUSE WE HEAR ABOUT THESE
TERMS CLUSTERED TOGETHER. Dð EIB
DIVERSITY, EQUITY INCLUSION AND
BELONGING. UM AND, UM, ONCE WE
DO SUCH A GREAT JOB OF GETTING
THESE DIVERSE STUDENTS INTO
MEDICAL SCHOOL, UM SOME OF THE
CHALLENGES WE SEE ONCE THEY GET
INTO MEDICAL SCHOOL ARE, UM THAT
THESE ISSUES OF EQUITY INCLUSION
AND BELONGING BECOME CHALLENGES.
UM SO WE TRY TO ADDRESS EQUITY
THROUGH THE CURRICULUM. WE TRY
TO ADDRESS INC. BY IMPROVING THE
CLIMATE, AND THEN WE TRY TO
ADDRESS BELONGING THROUGH POLICY
CHANGE, AND I'LL TALK ABOUT EACH
OF THOSE VERY, VERY BRIEFLY. UM
SO IF WE ARE GONNA PROMOTE, UH
IF WE'RE GONNA FOCUS ON, UM,
PROMOTING EQUITY IN MEDICAL
EDUCATION, UM WE HAVE A NUMBER
OF WAYS THAT WE DO THAT WE HAVE
A CURRICULUM THAT FOCUSES ON
HEALTH EQUITY. WE TRY TO TEACH
STUDENTS AS THEY COME IN ABOUT
THE ROLE OF EQUITY AND INEQUITY
IN HEALTH. UM WE ASK THAT PEOPLE
UM THERE ARE ISSUES THAT COME UP
WITH EQUITY EVEN IN EDUCATION,
SO ONE OF THEM IS THAT WE HAD
ISSUES RELATED TO GRADING
INEQUITIES. WE FOUND THAT
STUDENTS FROM MINORITIZED
BACKGROUNDS. WE'RE HAVING LOWER
SCORES ON, UM, SUBJECTIVE, UH,
EVALUATIONS IN THEIR CLINICAL
YEARS. UM AND SO WE HAD TO, UH,
CREATE A PANEL TO LOOK AT. WHY
DO WE SEE THESE DIFFERENCES IN
OUTCOMES BETWEEN UM BETWEEN
STUDENTS OF COLOR VERSUS OTHER
STUDENTS? UM WE HAD TO IMPLEMENT
NEW POLICIES TO ADDRESS THAT,
UH, WE HAVE TO SUPPORT A SAFE
AND SUPPORTIVE LEARNING CLIMATE,
MEANING THAT DISCRIMINATION THAT
HAPPENS WITHIN THE HEALTH CARE
SYSTEM THAT THAT DOESN'T OCCUR
THAT THAT, UM STUDENTS AREN'T
UH, SUBJECT TO DISCRIMINATION
BASED ON THEIR IDENTITIES. WE
PROVIDE SUPPORT FOR THOSE
EXPERIENCES OF DISCRIMINATION
AND HARASSMENT, AND WE TRY TO
EDUCATE FACULTY ON HOW TO BE
BETTER AT, UH, TEACHING. SO ONE
EXAMPLE OF HOW WE'VE TRIED TO
ADDRESS THIS, UM, IN, UH,
IMPROVING EQUITY RELATES TO
SOMETHING CALLED THE RACIAL
JUSTICE REPORT CARD. UM SO THERE
ARE A LOT OF WAYS THAT MEDICAL
SCHOOLS ARE RANKED TO SEE. UM
HOW? HOW GREAT THEY ARE, UH, YOU
CAN HEAR ABOUT THE U S¼ NEWS AND
WORLD REPORT RANKINGS BASED ON
REPUTATION. UM, BLUE RIDGE
RANKINGS RANK. HOW MUCH RESEARCH
FUNDING YOU GET AS A SCHOOL OF
MEDICINE? UM BUT, UH, SEVERAL
STUDENTS, THE WHITE COATS FOR
BLACK LIVES, STUDENTS, UM
WORKING WITH SEVERAL OF OUR
ADMINISTRATION, UM MEMBERS AND
STUDENT NATIONAL MEDICAL
ASSOCIATION. THEY WORKED TO USE
A DIFFERENT RATING SYSTEM AND A
DIFFERENT RANKING SYSTEM THAT
COULD ACTUALLY BE A BETTER
RANKING SYSTEM FOR MEDICAL
SCHOOLS. IT'S A RANKING SYSTEM
ON HOW WELL DOES YOUR SCHOOL DO
ON RACIAL EQUITY AND RACIAL
JUSTICE? SO WE, UH, ISSUED THIS
RACIAL JUSTICE REPORT CARD YOU
CAN SEE. THERE WERE SEVERAL
METRICS THAT WERE USED TO SEE
HOW WELL IS U èC DAVIS DOING
AROUND RACIAL EQUITY ISSUES
ACROSS THE ENTIRE HEALTH? UM SO
IT DEALS WITH THINGS LIKE, UH,
HOW MANY MINORITIZED STUDENTS
ARE REPRESENTED, AND YOU SEE AN
A GRADE AS AS DOCTOR HENDERSON
TALKED ABOUT, UM, BUT THEN YOU
CAN SEE THINGS LIKE FACULTY
REPRESENTATION. UM, WE ACTUALLY
DO NOT DO AS WELL, UH, IN TERMS
OF HAVING DIVERSE FACULTY THAT
THAT ARE THERE TO TEACH THOSE
THOSE STUDENTS SO YOU CAN SEE,
UM, THE STUDENTS COMING TOGETHER
TO LOOK AT THESE, UH,
REPRESENTATIONS, UH, TO LOOK AT
THESE METRICS LIKE MARGINALIZED
PATIENT POPULATION, EQUAL ACCESS
FOR ALL PATIENTS. THESE ARE THIS
, I THINK IS A MORE ACCURATE AND
BETTER WAY TO SCORE AND TRACK.
HOW WELL IS IN OUR MEDICAL
STUDENTS DOING AND ACHIEVING THE
GOALS THAT WE ARE TRYING TO, UM,
TO ACHIEVE. I JUST WANT TO POINT
OUT HERE THAT IT SAYS YOU NOTICE
WE DIDN'T RECEIVE ANY SCORE
LOWER THAN A èC. UM THE PEOPLE
THAT DESIGNED THE SCORE DID NOT
GIVE OUT Dð OR F SCORES. I I
THINK THEY THEY, UM, WERE VERY
POLITICAL IN IN THAT WAY, SO THE
LOWEST GRADE YOU CAN GET ON THE
RACIAL JUSTICE REPORT CARD AS A
èC. UM OK, SO I JUST WANNA
INCLUDE THIS, UH, STATEMENT HERE
ABOUT INCLUSIVE MEDICAL
EDUCATION. UM, ITS PURPOSE IS TO
DEMONSTRATE HOW INCLUDING
DIVERSE PERS PERSPECTIVES AND
GENERAL MEDICAL EDUCATION
SCHOLARSHIP COULD PROMPT
RECONSIDERATION OF BASIC
CONCEPTS AND THE DEVELOPMENT OF
RICHER, MORE NUANCED AND
PRACTICABLE UNDERSTANDING OF WHO
MEDICAL LEARNERS ARE AND THAT'S
REALLY WHAT WE'RE STRIVING TO
DO. WE'RE STRIVING, STRIVING TO
INCREASE THE INCLUSIVITY, UM OF
OUR MEDICAL EDUCATION, AND WE
ARE REALLY TRYING TO PREVENT
OTHER RING THAT HAPPENS ALMOST
NATURALLY IN THE MEDICAL
EDUCATION EXPERIENCE. OTHER RING
IS DEFINED AS A SET OF DYNAMICS
PROCESSES AND STRUCTURES THAT
ENGENDER MARGINALITY AND
PERSISTENT INEQUALITY ACROSS ANY
OF THE FULL RANGE OF HUMAN
DIFFERENCES BASED ON GROUP
IDENTITIES, SO THIS IS THE WAY
THAT WE TRY TO BUILD INCLUSION
WITHIN OUR SYSTEMS BY PREVENTING
OTHER FROM OCCURRING. UM AND WE
ALSO UNDERSTAND THAT
INTERSECTIONALITY EXISTS FOR
MANY OF OUR STUDENTS THAT COME
INTO OUR INSTITUTION. AND THAT
BECAUSE PEOPLE HAVE MULTIPLE
IDENTITIES THAT COULD BE
OPPRESSED OR MARGINALIZED, UM,
THAT WE HAVE TO WORK EXTRA HARD
TO MAKE SURE THAT THEY DON'T
EXPERIENCE MANY OF THE DIFFERENT
WAYS THAT THEY CAN BE
DISCRIMINATED OR OPPRESSED
AGAINST. SOME WAYS THAT WE CAN
DO THAT, UM, WE TRY TO INCLUDE
INCLUSIVE EDUCATIONAL PRACTICES.
WE GOT TO TRY TO GUIDE OUR
FACULTY ON HOW TO BE MORE
INCLUSIVE IN THESE EDUCATIONAL
PRACTICES. IT INCLUDES THINGS
LIKE USING PRONOUNS AND ALL, UM
INTERACTIONS, INCLUDING
GUIDELINES FOR PRESENTING DATA
ABOUT RACE AND ETHNICITY,
DISTINGUISHING BETWEEN RACE,
GENETICS AND GENETIC ANCESTRY.
SUGGESTIONS FOR DEV DEVELOPING
CLINICAL VIGNETTES. OFTENTIMES
THESE VIGNETTES ARE VERY RACIST
AND VERY BIASED. AND SO WE TRY
TO TEACH HOW NOT TO TEACH
CLINICAL STORIES USING RACISM,
RACIST TROPES IN MEDICINE. WE
INCLUDE GUIDELINES ON DISCUSSING
BODY SIZE GUIDELINES ON
DISCUSSING SEXUALITY, UM,
SUGGESTIONS FOR BETTER LANGUAGE
AND TERMINOLOGY AROUND
STIGMATIZED POPULATIONS,
PARTICULARLY SUBSTANCE OF PEOPLE
WITH SUBSTANCE USE DISORDERS, UM
, AND GUIDELINES FOR ACCESSIBLE
LEARNING ENVIRONMENTS. UM AND SO
, FINALLY, I WANNA GET TO THIS
POINT ON BELONGING AND REALLY
BELONGING. THIS IS REALLY ABOUT,
UM, BECOMING MORE ANTI RACIST
AND MOVING INTO ANTI RACIST. UM
ORGANIZATIONS. UM, AND SO HOW WE
DO THAT, UM, IS, UM, WORK THAT
WE ARE TRYING TO DO TO ADDRESS
SOME OF THE WAYS THAT STRUCTURAL
RACISM IS BUILT INTO MEDICAL
EDUCATION. ONE OF THOSE WAYS HAS
TO DO WITH STANDARDIZED TESTS.
SO FOR EVERY MEDICAL STUDENT, UM
TO GRADUATE AND BECOME A
PHYSICIAN, THEY HAVE TO PASS. UM
WHAT THE U S¼ MLE, UM, THE
UNITED STATES MEDICAL LICENSING
EXAMINATION. THEY HAVE TO PASS.
STEP ONE. STEP TWO AND STEP
THREE. UM UH, THERE'S A
SIGNIFICANT NUMBER OF OUR
STUDENTS THAT RUN INTO
CHALLENGES AROUND PASSING THESE
TESTS. THIS LEADS TO THE
ATTRITION THAT WE SOMETIMES SEE
FOR STUDENTS OF COLOR AND
MEDICAL SCHOOL. UM, AND I JUST
WANNA POINT OUT THIS, UH, THIS
QUOTE. I'M NOT GONNA READ THE
WHOLE THING, BUT HE'S BA UH,
BASICALLY IBRAM KENDI IS TALKING
ABOUT HOW STANDARDIZED TESTS
INCLUDING THE U S¼ MLE STEP ONE
ARE IN FACT DESIGNED TO BE
STRUCTURALLY RACIST. UM AND IT
AND IT LEADS PEOPLE, ESPECIALLY
AS HE SAYS BLACK AND LATINX
STUDENTS TO BELIEVE THAT THERE'S
SOMETHING WRONG WITH THEM RATHER
THAN SOMETHING WRONG WITH THE
TESTS, SO ONE OF THE THINGS WE
HAVE TO DO IS WORK AROUND SOME
OF THE BARRIERS THAT HAVE BEEN
PUT IN PLACE THAT MAKE IT
DIFFICULT OR CHALLENGING, UM,
FOR OUR STUDENTS THAT ARE TRYING
TO BECOME PHYSICIANS AND GO BACK
INTO THEIR COMMUNITIES AND SERVE
THEIR COMMUNITIES IN CALIFORNIA.
THE BARRIERS THAT ARE ARE KIND
OF INNATE TO THE WAY THAT WE
HAVE SET UP MEDICAL EDUCATION
THAT MAKES IT CHALLENGING FOR
THEM. UM, ANOTHER WAY THAT WE DO
THAT AND I'LL END HERE IS JUST
BY TALKING ABOUT, UM, EQUITY
CENTERED TRAUMA INFORMED
EDUCATION. UM, THIS IS A BOOK
THAT WAS WRITTEN BY ALEX CHEVRON
BENNETT, WHO WE HAVE CONSULTED
WITH, UM, SHE TEACHES. UH SHE IS
A CONSULTANT IN EDUCATION
CONSULTANT FOR Kò THROUGH 12,
BUT ACTUALLY THE SAME PRINCIPLES
APPLY FOR EQUITY CENTER TRAUMA,
INFORMED EDUCATION IN THE Kò
THROUGH 12 AREA THAT IT DOES
SURPRISINGLY FOR MEDICAL SCHOOL,
AND SO IF WE CAN ADOPT SOME OF
THOSE PRACTICES PRINCIPLES IN
THE WAYS THAT WE'RE EDUCATING
OUR MEDICAL STUDENTS. WE CAN DO
A BETTER JOB OF ENSURING THAT
EVERY STUDENT THAT WE ADMIT FROM
A DIVERSE AND DISADVANTAGED
BACKGROUND FEELS LIKE THEY
BELONG IN OUR MEDICAL SCHOOL AND
FEELS LIKE WE, UM WE, UH SUPPORT
THEM AND KNOW THAT THEY'RE GONNA
BE SUCCESSFUL PROVIDERS, UM,
THAT ARE GONNA DO, UH GREAT
THINGS AND SOLVE THESE CHILD.
THESE GREAT CHALLENGES THAT WE
HAVE IN THE FUTURE. THANK YOU.
THANK YOU. SORRY I. I HAD
RECOMMENDATIONS. LET ME JUST SAY
MY RECOMMENDATIONS REALLY
QUICKLY. UM WE WANTED TO, UH,
TALK ABOUT CONS, UH, ENHANCING
THE RESOURCES FOR EDUCATIONAL
SUPPORT FOR MEDICAL STUDENTS
ACROSS CALIFORNIA. UM STAFF
SUPPORT FOR MEDICAL STUDENTS TO
INCREASE INCLUSION AND BELONGING
THIS RELATES TO SUPPORTING
STUDENTS WITH DISABILITIES AND
FIGURING OUT WAYS TO BETTER
SUPPORT STUDENTS OF LOWER SOCIO
ECONOMIC STATUS, AND CALIFORNIA
MEDICAL SCHOOLS NEED FACULTY AND
ADMINISTRATORS WITH G. GREATER
EXPERTISE AND EQUITY CENTER
TRAUMA. INFORMED EDUCATION.
THANK YOU. THANK YOU. WE'LL MOVE
ON TO MISS SCOTT. MY NAME IS
MONICA SCOTT DAVIS, AND I AM THE
CLINICAL SUPERVISOR AT UH, ROOTS
COMMUNITY HEALTH. I'VE BEEN
THERE NOW FOR ALMOST FIVE YEARS.
AND WHEN I FIRST STARTED, UM, IT
WAS JUST THREE CLINICIANS AND WE
ARE IN LOCATED IN EAST OAKLAND
ON 98TH AVENUE. UM PREDOMINANTLY
, WE'RE SERVING, UM AFRICAN
AMERICAN LATINO COMMUNITY. BUT
AS YOU KNOW, OAKLAND IS A VERY
DIVERSE CITY, PROBABLY ONE OF
THE MOST DIVERSE CITIES. AND UM,
WHEN MY COLLEAGUES AND I WE WERE
TALKING ABOUT LIKE, WOW, WE WISH
THIS COULD HAVE BEEN A PLACE
THAT WE HAD OUR INTERNSHIP AND,
UM I GUESS PEOPLE IN THE
COMMUNITY STARTED FEELING THE
SAME WAY. SO WE WERE APPROACHED
BY A LOT OF THE ACADEMIC
INSTITUTIONS LIKE HEY, DOES
ROOTS HAVE AN INTERNSHIP AND
STUDENTS WERE COMING TO US AND
WANTING TO DO THEIR SENIOR, UM,
THESIS WITH US SO ONE THING
ROOTS IS REALLY GOOD AT IS
MEETING THE NEEDS OF THE
COMMUNITY. SO WE STARTED OUR
INTERNSHIP. WE STARTED WITH ONE
B S¼ W STUDENT, AND THEN WE HAD
ONE STUDENT WHO WAS GETTING HER
MASTERS IN PSYCHOLOGY TO BECOME
A LICENSED MARRIAGE AND FAMILY
THERAPIST. SO THAT WAS OUR FIRST
TWO STUDENTS. AND AFTER THAT, WE
DEVELOPED A WHOLE TEAM RESEARCH
AND DEVELOPMENT TO HELP, UH, VET
THE STUDENTS THAT WERE
INTERESTED IN COMING TO ROOTS.
AND WE ARE CURRENTLY WORKING
WITH ABOUT FIVE INSTITUTIONS
WERE LIKE CAL STATE HAY, WHERE
MOST OF THE LOCAL ONES BUT ALSO
A LOT OF THE ONLINE INSTITUTIONS
HAVE BEEN REACHING OUT TO US. SO
WE HAVE RIGHT NOW. ABOUT FIVE M
Ó U S¼ IN PLACE. UM AS THE, UH,
CLINICAL SUPERVISOR. UM IT IS SO
IMPORTANT FOR PEOPLE ONCE THEY
GET THEIR LICENSE TO GO IN AND
TO BECOME A CLINICAL SUPERVISOR
BECAUSE YOU'RE TAKING ON THAT
RESPONSIBILITY OF TRAINING. UM,
SOMEONE BE A CLINICIAN, UM FOLKS
WHO ARE GOING TO BECOME LICENSED
MARRIAGE AND FAMILY THERAPIST OR
L èC S¼ W OR L PCC èC. THEY'RE
REQUIRED 3000 HOURS OF, UM,
EXPERIENTIAL HOURS TO TRANSFER
FROM THE ACADEMIC SETTING TO
BECOMING LICENSED CLINICIANS. WE
SO FAR WE NOW HAVE TO HAVE.
THEY'RE WORKING TWO YEARS WE
HAVE ONE CLINICIAN WHO HAS JUST
PASSED PASS LICENSURE IN, UM
NOVEMBER. UM SHE'S ALSO SPANISH
SPEAKING. WE HAVE, UH THREE
STUDENTS WHO HAVE JUST GAINED
THEIR MASTERS. UM ONE STUDENT IS
, UM FARSI SPEAKING AND HE IS
GOING ON TO GET HIS, UM, I Dð SO
THE BEAUTY OF FOLKS COMING AND
GETTING THAT EXPERIENCE,
ESPECIALLY IN COMMUNITY BASED,
UM, ORGANIZATIONS IS THAT YES,
IT COULD BE TOUGH. YOU KNOW, A
LOT OF PEOPLE DO GET BURNED OUT,
BUT THEY REALLY KNOW THAT THIS
IS THE WORK THAT THEY WANNA DO,
AND I'M ALSO HAPPY TO SAY THAT
OUT OF THE FOUR PEOPLE. WE'VE
ALSO BROUGHT THEM ON TO OUR
ROOTS TEAM, SO OUR GOAL IS TO
GIVE THEM A STRONG FOUNDATION,
WHETHER THEY STAY WITH US OR GO
OUT AND PRACTICE IN OTHER AREAS
IN THE COMMUNITY. WE'RE GIVING
HIM THAT STRONG FOUNDATION AND
ONE THING THAT WE JUST WHICH IS
SOMETHING THAT I WAS VERY
PASSIONATE ABOUT. OUR AREA HAS A
LOT OF TRAUMA. AND SO A LOT OF
TIMES, YOU KNOW, SOMETIMES TALK
THERAPY AND ENOUGH FOR A TRAUMA.
SO UM, ROOTS WAS VERY GENEROUS,
ALLOWING ME TO GO AND STUDY AND
GET CERTIFIED TO BECOME AN EM Dð
R THERAPIST, AND SO OUR NEXT
GOAL IS TO WORK AND, UM PRESENT
EM Dð R, WHICH IS USUALLY A
THERAPY THERAPEUTIC MODALITY
THAT'S USUALLY GIVEN AND MORE
FLUENT COMMUNITIES. WE WANT
THERE TO BE REPRESENTED IN OUR
BLACK AND BROWN COMMUNITIES, SO
THAT'S SOME OF THE THINGS WE'RE
DOING AT ROOTS. I DIDN'T PREPARE
A BIG POWERPOINT BUT I'M SO
PASSIONATE ABOUT, UM, MENTAL
HEALTH. I CAME INTO THE FIELD
ACTUALLY DOING A CAREER CHANGE.
I WORKED IN BIOTECH FOR 18 YEARS
AND ALWAYS VOLUNTEERED WORKING
IN THE COMMUNITY. SO UM, THIS IS
THIS IS MY CALLING, AND I THINK
IT'S MY, UH, MY, UM COLLEAGUES.
AND I WAS JUST HAPPY TO LAND
HERE AT ROOTS AND FOR US TO BE
ABLE TO START THIS PROGRAM.
THANK YOU FOR SHOWING HOW
OAKLAND DOES IT RIGHT? MISS
PHILLIPS. THANK YOU. UM I, UH
KATHERINE PHILLIPS, UM, BACK
AGAIN FROM THE CALIFORNIA
HEALTHCARE FOUNDATION. UM, I
ALSO HAD A SLIDE OF SOLUTIONS,
BUT ALL HAVE BEEN PRESENTED AND
I THINK THE DEGREE OF ALIGNMENT
THAT YOU HAVE HEARD TODAY. UM,
IS INCREDIBLY REASSURING. SO I'D
LIKE TO SPEND THE FINAL FEW
MINUTES ANSWERING A MEMBER
ARAMBULA QUESTION ON URGENCY AND
ALSO PULLING THE THREAD ON XIA'S
EARLIER COMMENT, UM, ON ACTION.
UH WE HAVE SEEN HISTORIC
INVESTMENT FROM GOVERNOR. AND
FROM THE LEGISLATURE, AND I
THINK THERE IS BROAD RECOGNITION
THAT WE ARE IN A HEALTH CARE
WORKFORCE CRISIS. UH AND MORE,
MUCH MORE IS NEEDED. THERE ARE
NÓ SPOT FIXES. UM, OUR HEALTH
WORKFORCE IS INFRASTRUCTURE.
IT'S CRITICAL INFRASTRUCTURE.
IT'S THE INFRASTRUCTURE OF CARE.
AND JUST LIKE OUR ROADS OR OUR
BRIDGES. WE NEED REGULAR
ASSESSMENT. WE NEED
INFRASTRUCTURE UPGRADES. THAT'S
DIVERSITY. IT'S REPRESENTATION.
IT'S NEW ROLES THAT WE HEARD
ABOUT EARLIER FROM HÌ Kò, AND
IT'S A CONTINUAL PROCESS. IT'S
NOT A ONE TIME FIX. UM, WE HEARD
TODAY MANY EXAMPLES OF PROGRAMS
AND EFFORTS, UM, THAT ARE TRYING
TO ADDRESS OUR SUPPLY SIDE
CHALLENGES AND ALSO TO INCREASE
DIVERSITY, REPRESENTATION,
EQUITY AND INCLUSION. ALL ARE
IMPORTANT. UM AND JUST AS MEMBER
, SHIAVO NOTED, UH, WE NEED HELP
TO SCALE THEM ALL. I ARGUE. WE
ALSO NEED GREATER CO ORDINATION.
AS A STATE. WE NEED TO WORK
BETTER TOGETHER TO BRING
RESOURCES TO THE PROGRAMS AND
THE COMMUNITIES THAT NEED THEM
MOST AND WE NEED TO BEGIN
REWARDING THE INSTITUTIONS THAT
DELIVER THE OUTCOMES OUR STATE
CARES MOST ABOUT. WE ALSO NEED
BOLD ACTION. NOT JUST
INCREMENTAL PROGRESS. UM, WHAT
WOULD IT LOOK LIKE? FOR ALL OF
THE U èC SCHOOLS OF HEALTH TO
ADOPT UC DAVIS' ADMISSION
PROCESS. OTHER STATES HAVE MADE
MEDICAL SCHOOL FREE FOR PRIMARY
CARE. WE COULD DO THAT. OTHER
STATES HOLD MEDICAL SCHOOL SEATS
AND RESIDENCY SLOTS FOR RURAL
STUDENTS BECAUSE THEY KNOW THAT
IS THE SINGLE BEST WAY TO GET
PEOPLE TO WORK AND TO LIVE AND
SERVE RURAL COMMUNITIES. OTHER
INDUSTRIES IN CALIFORNIA HAVE
EMBRACED APPRENTICESHIP MODELS
TO HELP PEOPLE OF COLOR AND
THOSE WITHOUT GRADUATE DEGREES
ADVANCED TO THE PROFESSION. FOR
EXAMPLE, THE CALIFORNIA HEALTH
LAW PROGRAM HAS FINISHED THEIR
PILOT, UM, THAT ALLOWS
PARALEGALS AND RESEARCH
ASSISTANTS WHO WORK 10 YEARS IN
THE LEGAL PRACTICE TO SIT FOR
THE BAR EXAM, AND IF THEY PASS
THAT TEST, THEY BECOME A LAWYER.
NÓ LAW SCHOOL NEEDED NOW THAT'S
NOT APPROPRIATE OR USEFUL FOR
EVERY HEALTH PROFESSION, BUT I
THINK IT'S A REALLY POWERFUL
EXAMPLE OF THINKING OUTSIDE THE
BOX, DOING SOMETHING INNOVATIVE
TO AGAIN DO MORE THAN MOVE THE
NEEDLE. UM, I'D LIKE TO THANK
THE OTHER PANELISTS AND
CONTRIBUTORS. WE'VE HEARD A LOT
TODAY. UM AND YOU ALL FOR YOUR
INTEREST AND YOUR COMMITMENT TO
THIS TOPIC. OUR WORKFORCE
DESERVES MORE. OUR PATIENTS NEED
CARE. THANK YOU. THANK YOU. AND
UH, I REALLY APPRECIATE THAT WE
WERE ABLE TO HAVE DOCTOR SHIM
AND MISS SCOTT, UH, PRESENT
BEFORE. UH THE WONDERFUL WRAP UP
FROM, UH HÌ èC S¼ F. UM. MY
QUESTION TO DOC. UH, DOCTOR SHIM
AND MISS SCOTT, ARE YOU YOU KIND
OF OFFERED THE BOTH THE PIPELINE
ISSUE AND THE WAY THAT YOU
ACTUALLY NEED TO RESTRUCTURE THE
NOT ONLY THE ADMISSIONS PROCESS,
BUT THE CURRICULUM AND COMPLETE
ENVIRONMENT TO BE ABLE TO
SUPPORT UH PEOPLE WHO WE WANT TO
BE REPRESENTED. AND MISS SCOTT.
YOU OUTLINED THE WAY IN WHICH
YOU KNOW BEAUTIFULLY AGAIN.
OAKLAND IS KIND OF ENSURING THAT
WE'RE TAKING ADVANTAGE OF BOTH
THE PLACE AND SPACE AND THE
PROVIDERS WHO WERE THERE WHO ARE
WELL SOUGHT AFTER, UH FROM YOUR
PERSPECTIVES. ARE THERE ANY
THINGS THAT YOU ANYTHING THAT
YOU THINK WE NEED TO DO? UM HAVE
HÌ èC S¼ F DO AND, UM HÌ Kò DO
TO BE ABLE TO SUPPORT UH, A MORE
EMBEDDED IF YOU WILL, UH,
OPPORTUNITY FOR PROVIDERS,
PRACTITIONERS AND FOR ASPIRING
PRACTITIONERS. I THINK SOME OF
THE EXAMPLES ABOUT PAID
INTERNSHIPS WOULD BE VERY
BENEFICIAL. AS EVEN WHEN, UM.
FOLKS ARE STILL AT THE STUDENT
LEVEL. MANY OF UM THE PEOPLE WHO
HAVE COME TO ROOTS FOR THEIR
PRECEPTORSHIP. THEY'RE ALSO
BALANCING TO WORK JOBS AND GET
THIS TRAINING AND, UM, I CAN
REMEMBER BACK IN THE DAY. MOST
OF MY, UM INTERNSHIPS WERE
UNPAID, WHICH WAS A BIG, YOU
KNOW, FINANCIAL HARDSHIP, SO WE
NEED TO REALLY SUPPORT THE
CLINICIANS FINANCIALLY SO THAT
THEY CAN COME INTO THE WORKFORCE
. IT IS SO IT'S SO CRUCIAL,
ESPECIALLY FOR BEHAVIORAL HEALTH
TO BE ABLE COME AND SEE YOUR
REFLECTION IN YOUR PRACTITIONER
AND WHERE YOU FEEL SAFE, YOU
KNOW, AND IN ORDER TO DO THAT,
YOU KNOW, PEOPLE HAVE TO HAVE
THE MEANS FINANCIALLY TO GET
THROUGH YOUR INTERNSHIPS AND
YOUR EDUCATION. SO FINANCIAL
ASSISTANCE FOR THE STUDENTS
WOULD BE VERY IMPORTANT. YEAH, I
. I AGREE COMPLETELY WITH THAT.
AND I. I THINK YOU KNOW II. I
REMEMBER. UM DOCTOR HENDERSON.
UM MEN, UH, MENTIONED THE DATA
ABOUT THE SOCIO ECONOMIC STATUS
OF UC DAVIS MEDICAL STUDENTS
COMPARED TO OTHERS, AND I WOULD
SAY ON THE DAY TO DAY THE
BIGGEST CHALLENGES THAT COME UP
THAT GET IN THE WAY OF REALLY,
UM, SMART, TALENTED, UM, HIGHLY
EDUCATED PEOPLE FROM BEING
SUCCESSFUL FROM SUCCESSFULLY
GRADUATING MEDICAL SCHOOL ARE
THOSE SOCIO ECONOMIC SO, UM,
MORE FINANCIAL SUPPORT FOR
STUDENTS, EVEN YOU KNOW, WE
THINK OF AGAIN WE THINK OF
PEOPLE GOING INTO, UH, MEDICINE
AS BEING OF HIGHER SOCIO
ECONOMIC STATUS. UM BUT IF
YOU'RE COMMITTED TO INCREASING
THE DIVERSITY OF THE MEDICAL
WORKFORCE, THAT MEANS, UM THAT
WE WOULD WANT TO BE MORE
INCLUSIVE OF PEOPLE THAT COME
FROM DIFFERENT, UM,
SOCIO-ECONOMIC BACKGROUNDS AND
SO THEY WILL NEED MORE FINANCIAL
SUPPORT. UM, EVEN JUST THE LOANS
THAT THEY RECEIVE IS NOT ENOUGH.
UM SO THE RECOMMENDATION FOR, UM
, MEDICAL SCHOOL TO BE, UM, FREE
? UM I THINK THAT'S A HUGE THING
. UM IF WE LOOK AT THE DATA ON
MEDICAL SCHOOL SO FAR THAT HAVE,
UM HAVE BEEN FREE, UM, OFTEN
TIMES THE PEOPLE THAT, UH, GO TO
THOSE SCHOOLS ARE VERY HIGH
SOCIO ECONOMIC STATUS, SO THE
BENEFITS OF GETTING A FREE
TUITION TO GO TO MEDICAL SCHOOL
ISN'T REALLY, UM, HELPING OUT
THE POPULATION THAT IT WOULD
REALLY MAKE. HUGE DIFFERENCE FOR
SO I WOULD BE FULLY IN SUPPORT
OF ANY FINANCIAL, UM, BENEFITS
THAT WE CAN MAKE TO MAKE IT LESS
BURDENSOME FOR PEOPLE TO BE ABLE
TO MAKE IT THROUGH THROUGH, UH,
EDUCATION AND HEALTH, HEALTH
PROFESSION SCHOOLS. THANK YOU.
AND I ALSO WANNA JUST APPRECIATE
. UH MISS PHILLIPS. YOUR UH,
ANALOGY TO THIS INFRASTRUCTURE
ISSUE? UM WE'VE HAD FOR TOO LONG
, FAR TOO LONG AND UNDER
INVESTMENTS IN, UH IN OUR
MEDICAL WORKFORCE INFRASTRUCTURE
THAT WILL ACTUALLY ALLOW US TO
BE ABLE TO LIFT UP. UH, THESE
UH, CONCORDANT. UH, POINTS OF
INNOVATION, UM IN THROUGHOUT OUR
SYSTEM, SO I'M I'M GOING TO BE
LEAVING WITH THAT IDEA. UM
CERTAINLY, AND I WILL TURN THAT
THE CONVERSATION OVER TO MISTER
DOCTOR. THANK YOU, MADAM CHAIR.
I'LL BEGIN WITH DR SHAM I. I WAS
REALLY IMPRESSED WITH YOUR Dð E
I AND BELONGING CONVERSATION. I
CAN'T REMEMBER THE FIRST TIME I
ACTUALLY FELT LIKE I BELONGED IN
MEDICAL SCHOOL. AND FOR MANY
STUDENTS, I THINK THEY HAVE A
SIMILAR EXPERIENCE. SO IT SEEMS
AS IF WE'RE TURNING ASPIRATION
INTO ACTION AT U èC DAVIS AND
THAT THERE'S A GLIMMER OF HOPE
AND HOW TO DO IT EFFECTIVELY
THAT I'D LIKE TO FIGURE OUT WHAT
TYPES OF REWARDING OF
INSTITUTIONS THAT MISS PHILLIPS
WAS TALKING ABOUT. COULD WE DO
IF WE WOULD HOLD UP AN EXAMPLE
OF HOW TO DO IT RIGHT? I
FOCUSING ON SUPPORTING STUDENTS
WHERE THEY'RE AT BY PRIORITIZING
ADMISSIONS AND BY MAKING THEM
FEEL LIKE THEY BELONG. WE AS A
STATE ARE GONNA BENEFIT FROM IT,
BUT I'D LOVE TO HEAR HOW WE CAN
ADDRESS THAT. THIS. THIS IS, UM,
VERY TIMELY BECAUSE WE WERE
HAVING A CONVERSATION EARLIER
WITH OUR, UM DEAN, UH, IN THE
SCHOOL OF MEDICINE. ABOUT WHAT?
OUR METRICS THAT WE CAN LOOK AT
AND ONE OF THE THINGS THAT CAME
UP WITH STUDENT SATISFACTION. UM
SO STUDENTS, UH, MEDICAL
STUDENTS ARE, UM THEY ARE
SURVEYED AND SURVEYED AND
PROBABLY OVERY IN THEIR
EXPERIENCE, BUT ONE OF THE MOST
IMPORTANT, UM, METRICS THAT'S
USED TO SURVEY THEM IS SOMETHING
CALLED THE, UM, GRADUATION
QUESTIONNAIRE THAT THE AMERICAN
ASSOCIATION OF MEDICAL COLLEGES
PUTS OUT UM AND THAT GRADUATION
QUESTIONER HAS QUESTIONS IN IT.
LIKE UM, DID YOU EVER EXPERIENCE
IN THE COURSE OF YOUR MEDICAL
EDUCATION? DID YOU? WERE YOU
EVER DISCRIMINATED AGAINST BASED
ON YOUR RACE OR ETHNICITY? DID
YOU EVER FEEL LIKE YOUR GRADE
WAS DEPENDENT ON ON YOUR GENDER
ON YOUR SEXUALITY? UM AND, UM UM
, WE HAVE BEEN WORKING, UM, TO
IMPROVE THAT SCORE BECAUSE OUR
SCORE AS AS DIVERSE AS WE ARE AS
A MEDICAL SCHOOL. OUR SCORE
ISN'T PERFECT ON THAT, AND IN
FACT, WE'RE NOT EVEN I THINK
WHERE WE NEED TO BE IN TERMS OF
ON PAR WITH OTHER MEDICAL
SCHOOLS WHO ARE LESS DIVERSE
THAN US ACROSS THE COUNTRY. UM
SO I THINK THERE'S A WAY TO TIE
UM, REWARD. TO METRICS LIKE
THAT. THAT ASK, ASK STUDENTS
SPECIFICALLY ABOUT WHAT IS THEIR
EXPERIENCE. UH WHAT IS YOUR
EXPERIENCE? AS YOU GO TO MEDICAL
SCHOOL, WE HAVE LOTS OF SURVEYS
THAT EXIST AND TYING THAT TO A
REWARD PROCESS, I THINK COULD BE
A VERY EFFECTIVE WAY OF GETTING
AT THIS ISSUE OF BELONGING AND
WHETHER WHETHER, IF WE CAN HAVE
MORE STUDENTS FEEL LIKE THEY
BELONG. I'D LOVE TO HAVE MISS
PHILLIPS JUMP IN, BUT I FEEL
LIKE I MUST MENTION THESE
CHANGES HAPPENED AT U èC DAVIS
OVER THE LAST DECADE. BUT THESE
PROBLEMS WHILE THEY SEEM THAT
THEY'RE SO INTRACTABLE,
OFTENTIMES THEY CAN HAPPEN WHEN
YOU HAVE LEADERSHIP AT
INSTITUTIONS THAT ARE FOCUSED ON
PROVIDING REAL SOLUTIONS, SO I'D
LIKE TO HEAR HOW WE CAN REWARD
OTHER INSTITUTIONS TO FOLLOW
THAT MODEL SO WE CAN CONTINUE TO
DIVERSIFY OUR WORKFORCE. YES UM
ELIZABETH LANDSBURG AND LIBBY
ABBOTT SHARED EARLIER ABOUT
THEIR APPROACH AND UPCOMING
CHANGES THAT WILL OPTIMIZE
EQUITY IN KINDS AWARDS THAT IT
MAKES TO INDIVIDUALS FOR LOAN
FORGIVENESS FOR SCHOLARSHIPS.
UM, WHAT I WAS ALLUDING TO WERE
DOLLARS TO GO TO INSTITUTIONS AS
WE THINK ABOUT THE NEED TO
EXPAND OUR CAPACITY TO TRAIN
PHYSICIANS, NURSES, PHARMACISTS
AND ALLIED HEALTH WORKERS.
THERE'S AN OPPORTUNITY TO THINK
ABOUT HOW RESOURCES ARE
DISTRIBUTED. AND WHO IS GONNA
GET THE OF RESOURCES IF THEY
BECOME AVAILABLE IN THE FUTURE,
AND IN THE PAST, WE HAVE PUT
MOST OF THE BURDEN ON THE
INDIVIDUAL TO SERVE MEDICAL
MEMBERS TO LIVE AND WORK IN A
MEDICALLY UNDERSERVED AREA, AND
WE HAVE NOT HELD OUR EDUCATIONAL
INSTITUTIONS ACCOUNTABLE FOR THE
OUTCOMES THEY PRODUCE. SO THE
IDEA AGAIN UNDER THAT BANNER OF
INNOVATION, AND WHAT WOULD
REALLY MOVE THE NEEDLE IS TO
THINK IS THERE A WAY IN THE
FUTURE? WE COULD AWARD DOLLARS
THAT GO TO INSTITUTIONS,
EDUCATIONAL INSTITUTIONS IN A
WAY THAT PREFERENTIALLY REWARDS
THOSE WHO PRODUCE THE OUTCOMES
WE WANT THAT ARE TRAINING, MORE
PRIMARY CARE AND PSYCHIATRISTS
THAT HAVE MORE FIRST GENERATION
COLLEGE STUDENTS THAT HAVE MORE
PEOPLE OF COLOR WHO HAVE MORE
LANGUAGE CAPACITY, ET CETERA AS
A WAY TO BALANCE WHAT WE'RE
ALREADY DOING AT THE INDIVIDUAL
LEVEL. THAT THOUGHT I LOOK
FORWARD TO FOLLOWING THE TRAIL
BECAUSE OUR BUDGET IS A
REFLECTION OF OUR VALUES, AND WE
NEED TO MAKE SURE THAT WE'RE
PROVIDING THE RIGHT INCENTIVES
FOR THESE EDUCATIONAL
INSTITUTIONS TO BE TRAINING THE
PROVIDERS OF TOMORROW THAT ARE
REFLECTIVE AND CONCORDANT WITH
COMMUNITY. THANK YOU, MADAM
CHAIR. THANK YOU, DOCTOR.
RAMBLA, UH, WITH THAT, WE WILL
END OUR PANEL DISCUSSION. UH AND
REALLY APPRECIATE ALL OF YOU
COMING FROM FAR AND WIDE TO BE
WITH US TODAY AND TO PROVIDE
THIS PERSPECTIVE. WE ARE GOING
TO MOVE NOW INTO PUBLIC COMMENT,
UH, PORTION OF OUR INFORMATIONAL
HEARING. IF YOU HAVE A DESIRE TO
MAKE PUBLIC COMMENT, PLEASE COME
FORWARD. WE WILL GIVE EACH
MEMBER OF THE PUBLIC AS AS LONG
AS THEY WANT. APPARENTLY. TO
MAKE COMMENT. THANK YOU. CHAIR
BONTA. UH, GOOD AFTERNOON. MY
NAME IS JOHN SHABAN, LEGISLATIVE
ADVOCATE WITH THE CALIFORNIA
NURSES ASSOCIATION. THANK YOU
FOR HOLDING THIS HEARING TODAY.
Dð N A URGES CALIFORNIA TO
PLACE GREATER INVESTMENT INTO
ASSOCIATE'S DEGREE AND PUBLIC
NURSING SCHOOL PROGRAMS THAT
SUPPORT ACCESS TO THE NURSING
PROFESSION FOR SOCIOECONOMICALLY
DIVERSE COMMUNITIES. REGISTERED
NURSING CAN BE A PATHWAY TO GOOD
UNION JOBS FOR PEOPLE FROM
RACIAL, ETHNIC, CULTURAL AND
LINGUISTICALLY DIVERSE
COMMUNITIES, RURAL COMMUNITIES
AND OTHER UNDERSERVED
COMMUNITIES. MORE AFFORDABLE
THAN PRIVATE SCHOOL PROGRAMS,
COMMUNITY COLLEGE AND ASSOCIATES
DEGREE IN NURSING PROGRAMS HAVE
BEEN SHOWN TO INCREASE DIVERSITY
IN THE NURSING WORKFORCE. BY
PROVIDING A MORE AFFORDABLE AND
ACCESSIBLE PATHWAY INTO THE
NURSING PROFESSION. CALIFORNIA
CAN BETTER MEET THE CULTURAL AND
LANGUAGE NEEDS OF MEDICALLY
UNDERSERVED PATIENTS THROUGHOUT
THE STATE. IMPORTANTLY èC N A
LOOKS FORWARD TO CONTINUE
WORKING WITH THIS COMMITTEE TO
ADDRESS THE EMPLOYER CREATED
CRISIS OF UNSAFE STAFFING, MORAL
DISTRESS AND UNSAFE WORKING
CONDITIONS TO PROTECT AND RETAIN
CALIFORNIA'S DIVERSE NURSING
WORKFORCE AND OTHER HEALTHCARE
WORKERS. UH IN SAFE AND HEALTHY
JOBS. THANK YOU SO MUCH. THANK
YOU. GOOD AFTERNOON, MADAM CHAIR
MEMBERS, JESSICA MORAN OF THE
CALIFORNIA DENTAL ASSOCIATION. I
WILL BE QUICK. I KNOW. LAURA
SAID I HAD A MINUTE. UM AND WE
DID SEND LONGER LENGTH. UM CON,
UM COMMENTS TO THE COMMITTEE. SO
I KNOW AGAIN, YOU KNOW DENTAL
WAS NOT THE TOP PRIORITY FOR
TODAY'S HEARING, BUT èC Dð A
DOES RECOGNIZE THAT YOU DONE A
WORKFORCE IS NOT REFLECTIVE OF
CALIFORNIA'S, UM, POPULATION, SO
I JUST WANTED TO HIGHLIGHT, UH,
TWO INITIATIVES THAT WE ARE
CURRENTLY WORKING ON TO INCREASE
DIVERSITY AMONGST THE WORKFORCE.
UH, THE FIRST IS EXPANDING
PATHWAYS FOR DENTAL ASSISTANCE
TO REMOVE THE BARRIERS, UH, FOR
MINORITY POPULATIONS. SO WHAT
THAT LOOKS LIKE IS ADVOCATING
FOR THE AR R Dð A LICENSURE EXAM
WITH THE DENTAL BOARD TO BE IN
DIFFERENT LANGUAGES OTHER THAN
ENGLISH. UH, WE ARE ALSO LOOKING
AT ALTERNATIVE LICENSURE
PATHWAYS FOR DENTAL ASSISTANCE
TO MEET THEM WHERE THEY ARE IN
LIFE, WHETHER THAT'S ON THE JOB
TRAINING OR THEY'RE ABLE TO GET
PAID WHILE THEY LEARN OR, UH,
PROGRAMS THROUGH R, Ó P OR
ADULT SCHOOLS AND, UM,
ALTERNATIVE EDUCATION IS WHAT
IT'S CALLED, UM THE SECOND THING
THAT WE ARE WORKING ON IS MAKING
SURE THAT DENTAL STUDENTS WHEN
THEY ARE IN DENTAL SCHOOL, ARE
RECEIVING COMMUNITY BASED
CLINICAL ROTATION. SO WE
ACTUALLY ADVOCATED IN THE BUDGET
PROCESS TWO YEARS AGO FOR A ONE
TIME FUNDING TO SUPPORT THESE
GROW ROTATIONS UM AND U èC L A
HAS DATA ON THIS. THAT REALLY
SHOWS THAT ONCE YOU EXPOSE A
DENTAL STUDENT TO AN FQ, HÌ èC
OR UNDERSERVED AREA THERE ARE
MORE LIKELY TO GO BACK AND SERVE
IN THOSE AREAS AFTER GRADUATION,
SO WE ARE COMMITTED TO WORKING
WITH LEGISLATURE ON INNOVATIVE
IDEAS AND HOW WE CAN DIVERSIFY
THE WORKFORCE. UH, FOR ALL
CALIFORNIANS WHO RECEIVE THE
CARE THEY NEED THANK YOU SO
MUCH. THANK YOU SO MUCH. MISTER.
A MB OF ANY CLOSING. WELL I
WANNA THANK EVERYONE FOR COMING
OUT TODAY. UH, THIS IS HAS BEEN
A JAM PACKED OF INCREDIBLE, UH,
INSIGHTS AND INFORMATION. I
THINK THAT WE WILL ALL MOVE
FORWARD WITH, UH, THIS IS AN
ISSUE THAT IS A VERY PERSONAL
AND IMPORTANT TO ME. UH
THROUGHOUT THE COURSE OF THIS
PANEL, I HAD A BIT OF AN
OPPORTUNITY TO REFLECT ON MY OWN
EXPERIENCE. UH, AS A CHILD OF A
BLACK LATINA GROWING UP IN THE
CITY OF NEW YORK, UH, I DID NOT
HAVE, UH, A DOCTOR OF COLOUR
EVER. AS A PRIMARY PHYSICIAN. A
DENTIST, UH, ANYONE WITHIN THE
CITY OF NEW YORK? UM AND I
ENTERED INTO, UH, UNDERGRADUATE
WITH AN INTENTION TO BE ONE OF
THE TWO THINGS THAT I WAS
ALLOWED TO BE, UH, FROM MY, UH,
IMMIGRANT. FAMILY, A DOCTOR OR
OR A LAWYER. DOCTOR, LAWYER
DOCTOR LAWYER. UH AND I GOT
WEEDED OUT OF BIO 101. AND WAS
NOT ABLE TO BE A DOCTOR. BECAUSE
I COULDN'T MAKE IT THROUGH, UH,
BIOLOGY 101. AND SO WHEN I HEAR
ABOUT THE INCREDIBLE NEED FOR
SUPPORTS THAT WE NEED IN ORDER
TO BE ABLE TO SUSTAIN A
PARTICULARLY, UH, LATINO
PARTICULARLY BLACK AND
UNDERREPRESENTED, UH, PEOPLE IN
OUR MEDICAL HEALTH PROFESSIONS.
UH, I COULD HAVE BEEN SITTING
NEXT TO A DOCTOR OR A MÀ RIGHT
HERE. I HAD I HAD THAT KIND OF
SUPPORT. AND I REALLY
APPRECIATED THE FOCUS ON THE
AMOUNT OF SCALE THE SCALE THAT
WE NEED. THIS IS ABSOLUTELY, UH,
AN INFRASTRUCTURE CRISIS. THIS
IS AN ABSOLUTELY A HEALTH CARE
CRISIS, WHETHER YOU'RE TALKING
ABOUT, UH, WORKING AND
SUPPORTING YOUNG PEOPLE OR QUITE
FRANKLY DEALING WITH THE ELDERLY
POPULATION THAT IS COMING ONLINE
OR ADDRESSING THE INCREDIBLE
MENTAL HEALTH NEEDS THAT WE HAVE
THROUGHOUT OUR ALL OF OUR
COMMUNITIES AND THE FACT THAT WE
ARE JUST NOT MEETING THE NEED.
SO RIGHT NOW WE HAVE A SYSTEM.
WHERE WE'RE SET UP TO BE ABLE TO
PROVIDE ACCESS ON PAPER. UH, BUT
NOT ACCESS IN TRUE TO THE
MEDICAL PROVIDERS, UH, THAT WILL
ENSURE THAT EVERY SINGLE
INDIVIDUAL IS HEARD, UH, AND
SUPPORTED WITH THE BEST HEALTH
OUTCOMES THAT THEY CAN POSSIBLY
HAVE. I THINK WE HAVE SOME
SHINING LIGHTS OF OPPORTUNITY
HERE, UH, PRESENTED BY U èC
MEDICAL. UH U èC DAVIS, UH,
MEDICAL CENTER, AND, UH, SO MANY
OTHERS AND OAKLAND ROOTS, UH,
PROVIDING THE OPPORTUNITY FOR US
TO LOOK AT WHAT NEEDS TO HAPPEN
WITHIN OUR MEDICAL INSTITUTIONS
AND THEN ALSO WHAT NEEDS TO
HAPPEN. UH, JUST ON THE GROUND
FOR FRONT LINE WORKERS AND IN
OUR COMMUNITIES EVERY SINGLE DAY
, SO, UH, THIS IS AN OPPORTUNITY
FOR US TO HAVE ONE OF MANY
CONVERSATIONS AROUND ENSURING
THAT WE HAVE, UH, WORKFORCE THAT
IS GOING TO TRULY MEET THE NEEDS
OF EVERY SINGLE CALIFORNIAN. I'M
THANKFUL TO MY COLLEAGUE, DR
RAMBLA AND THE COLLEAGUES WHO
WERE ABLE TO PARTICIPATE. FROM
OUR HEALTH COMMITTEE. AND, UH,
OUR WONDERFUL, UH, CONSULTANT
WHO PUT THIS BEAUTIFUL PANEL
TOGETHER. THANK YOU, LAURA. UM
BECAUSE THIS IS A CERTAINLY JUST
A START OF REALLY BEING ABLE TO,
UH BE BOLD AS WE WERE ASKED TO
BE ABLE TO DO IN OUR LEGISLATION
IN OUR FUNDING AND MAKING THE
KIND OF INVESTMENTS THAT WE NEED
TO BE ABLE TO ENSURE THAT EVERY
CALIFORNIAN IS TAKEN CARE OF
WITH THE DIGNITY THAT THEY NEED,
AND THAT EVERY WORKFORCE MEMBER
AND WITHIN OUR HEALTH CARE
COMMUNITY IS LIFTED UP. AND UH
AND DIVERSIFIED TO THE TO THE
GREAT EXTENT, UH, THAT WE NEED
BECAUSE WE KNOW THAT WHEN WE
HAVE A DIVERSE WORKFORCE, WE
ACTUALLY HAVE BETTER CARE AND
BETTER OUTCOMES FOR EVERY
INDIVIDUAL. SO WITH THAT BE
DOING A LOT OF WORK IN THIS
SPACE. I BELIEVE DR BULA AND, UH
AND THANK YOU SO MUCH FOR YOUR
PARTICIPATION.