GOOD WE'LL CALL TO ORDER. THE
INFORMATIONAL HEARING FOCUSED ON
BRIGHT SPOTS AND REMAINING
BARRIERS TO REALIZING THE
POTENTIAL OF COMMUNITY HEALTH
WORKERS, PROMOTOR AND
REPRESENTATIVES TO IMPROVE
HEALTH IN CALIFORNIA. THIS IS A
JOINT HEARING OF THE ASSEMBLY
HEALTH COMMITTEE AS WELL AS
BUDGET SUB ONE HEALTH, UH,
CHAIRED BY DOCTOR WEBER WITH ME
AS CHAIR FOR THE PUBLIC, UH, FOR
UH, ASSEMBLY COMMITTEE ON
HEALTH, AND I'M VERY THANKFUL
THAT WE CAN GATHER TODAY.
BUILDING THE WORKFORCE OF
COMMUNITY HEALTH WORKERS, PROMA
TOAS AND REPRESENTATIVES AND
FINANCING THE SERVICES THEY
PROVIDE IN A WAY THAT IS
MEANINGFUL AND ATTENTIVE, ARE
PROMISING STRATEGIES TO PROMOTE
HEALTH, EQUITY AND PERSON
CENTERED, CULTURALLY COMPETENT
CARE. BY LEVERAGING THEIR DEEP
UNDERSTANDING OF AND CONNECTION
TO THEIR COMMUNITIES. èC HÌ W
S¼ PROMOTER AND REPRESENTATIVES
CAN HELP PEOPLE IMPROVE THEIR
HEALTH AND ACCESS TO CARE.
EVIDENCE DEMONSTRATES THAT CW'S
BROADLY USED TO BE ABLE TO REFER
TO ALL THREE CATEGORIES CAN
IMPROVE HEALTH OUTCOMES AND
HEALTH EQUITY IN A VARIETY OF
SETTINGS WITH DIFFERING
POPULATIONS AND WITH SPECIFIC
DISEASES AND CONDITIONS.
CALIFORNIA RECENTLY ENACTED TWO
MAJOR INITIATIVES IN THIS SPACE.
FIRST WE ADDED èC HÌ W SERVICES
AS A MEDICAL BENEFIT STARTING IN
2022, AND WE'VE DEPLOYED èC HÌ,
W, S¼ AND PIF ROLES UNDER CAL, A
SECOND. APPROVED A VERY LARGE
MULTIYEAR WORKFORCE INITIATIVE
TO PROMOTE THE èC HÌ, W, S¼
PROMOTORS AND REPRESENTATIVE
WORKFORCES $281.4 MILLION OVER
THREE YEARS TO RECRUIT, TRAIN
AND CERTIFY 25,000 NEW èC HÌ W
S¼ BY 2025. BOTH INITIATIVES ARE
STILL IN AN EARLY STAGES OF
IMPLEMENTATION. THERE IS
CERTAINLY EXCITEMENT ABOUT THESE
INVESTMENTS AND PROMISING
DEVELOPMENTS. BUT WE HAVE ALSO
HEARD ABOUT VARIOUS BARRIERS TO
EXPAND OUR èC HÌ, W PROMOTORA
AND REPRESENTATIVE WORKFORCE AND
SERVICES GENERICALLY. I ALSO
WANT TO BE CLEAR THAT WE ARE
EMBARKING ON, UH ON A PATH THAT
HAS BEEN VERY WELL LAID IN TERMS
OF A FOUNDATION. THE STATE
INITIATIVES ARE BUILDING ON A
FOUNDATION OF VERY DIFFICULT,
UNDERPAID AND OFTEN THANKLESS
WORK THAT COMMUNITY HEALTH
WORKERS, PROMO, TORES AND
COMMUNITY HEALTH REPRESENTATIVES
HAVE DONE FOR DECADES THEY HAVE
BEEN ON THE GROUND IN
COMMUNITIES THROUGHOUT THE STATE
, PUSHING FOR HEALTH, EQUITY AND
JUSTICE, TAKING CARE OF THE
PEOPLE, AND THEY ARE EXPERTS IN
HOW TO DO THIS WORK. WE ARE
ALONG FOR THE RIDE AS A STATE.
WE ARE GRATEFUL FOR THEIR
PRESENCE AND WORK. WE HONOR THEM
AND LIFT UP THEIR LEGACY AND
THEIR CONTINUED WORK AS WE MOVE
FORWARD TOGETHER BECAUSE WE CAN
BUILD ON THE INCREDIBLY STRONG
FOUNDATION THAT THEY HAVE
OFFERED US. IN A WAY THAT IS AT
SCALE AND IS ENSURED TO BE ABLE
TO SUPPORT EVERY CALIFORNIAN.
THIS HEARING AIMS TO PROVIDE
BACKGROUND ON èC HÌ, W, S¼,
PROMO, TOAS AND REPRESENTATIVES
AND RECENT STATE EFFORTS
DISCUSSING BOTH THE BRIGHT SPOTS
AND CHALLENGES IN IMPLEMENTATION
OF STATE INITIATIVES AND THE
BROADER DEPLOYMENT OF èC HÌ, W,
S¼ AND CHALLENGES. INVOLVE
SEVERAL THINGS THEY INVOLVE OUR
STAKEHOLDERS TO THINK DEEPLY
ABOUT HOW WE CAN GET MORE DONE.
AND BE MORE EFFICIENT AS WELL AS
BEING CULTURALLY CONNECTED IN
VERY MEANINGFUL WAYS. AT THE
HEART OF WHAT WE ACTUALLY KNOW
IS HELPFUL WHEN WE ARE TALKING
ABOUT COMMUNITY HEALTH WORK. AS
WELL. WE WANT TO ENSURE THAT
EVERY STAKEHOLDER CAN DO THEIR
WORK WITHIN THEIR UNIQUE ROLE TO
HELP THE STATE REALIZE THE
TRANSFORMATIVE POTENTIAL OF
COMMUNITY HEALTH WORKERS PROMA
TOAS AND, UH AND TO IMPROVE
HEALTH AND HEALTH EQUITY IN
CALIFORNIA. I WILL NOW TURN
COMMENTS OVER TO THE COMMITTEE.
IF THERE ARE ANY OPENING
COMMENTS, UH, I WILL SAY THAT WE
HAVE TWO VERY ROBUST PANELS TO
BE PRESENT. WE HAVE WONDERFUL,
UH, MEMBERS OF OUR COMMUNITY
HERE TO PRESENT INFORMATION TO
US, SO WE ARE GOING TO TRY TO
FOCUS ON, UH ENDING THIS HEARING
BY FOUR O'CLOCK. THAT IS OUR
TARGET. SO FORGIVE ME IF I UH UM
UH, GLEEFULLY MOVING US ON JUST
TO MAKE SURE THAT WE CAN MAKE
SURE TO HEAR FROM EVERYBODY
PRESENT AND THEN ALSO AND WITH
PUBLIC COMMENT WITH THAT I WILL
TURN IT OVER TO DOCTOR ARAMBULA.
SEEING NÓ FURTHER, UH, COMMENTS
AND WE'LL WAIT FOR DOCTOR WEBER
TO JOIN US. UM, SO THANK YOU
WITH THAT WE WILL ASK THE FIRST
PANEL TO COME FORWARD. AS
THEY'RE MOVING UP. WE HAVE
CARLINA HANSEN, PROGRAM OFFICER
AT THE CALIFORNIA HEALTH CARE
FOUNDATION. MAYA ALVAREZ,
PRESIDENT OF THE CHILDREN'S
PARTNERSHIP. DOCTORS, ACUNA YOU
KNOW, EXECUTIVE DIRECTOR OF THE
LATINO COALITION FOR A HEALTHY
CALIFORNIA AND WE HAD DOCTOR
MARK GLI SECRETARY, CALIFORNIA
HEALTH AND HUMAN SERVICES AGENCY
WALKING INTO THE ROOM RIGHT NOW,
UH, RIGHT ON CUE, DOCTOR GOLLY.
UH, WITH THAT WE, UH WILL MOVE
FORWARD WITH, UH, MISS HANSEN.
CARLINA HANSON I'M A SENIOR
PROGRAM OFFICER WITH THE
CALIFORNIA HEALTH CARE
FOUNDATION. THANK YOU SO MUCH
FOR HAVING ME TODAY, UM,
COMMUNITY HEALTH WORKERS. PROMA,
TORES AND REPRESENTATIVES ALSO
KNOWN AS èC HÌ W PR S¼. OUR
TRUSTED LOCAL LEADERS IN OUR
CALIFORNIA COMMUNITIES WHO OFFER
A WIDE ARRAY OF HEALTH AND HUMAN
SERVICES AND HAVE BEEN DOING SO
SINCE THE 19 SEVENTIES, AND SOME
WOULD SAY LONG BEFORE THEN. FROM
A TORRES DE SALUD LARGELY WORK
IN LATINO LATINX AND SPANISH
SPEAKING COMMUNITIES, WHEREAS
COMMUNITY HEALTH REPRESENTATIVES
CENTER THEIR WORK IN AMERICAN
INDIAN COMMUNITIES. èC HÌ W PR
S¼ ARE ALREADY PLAYING AN
IMPORTANT ROLE IN THE LIVES OF
YOUR CONSTITUENTS. THERE ARE
PEOPLE WHO HAVE THE UNIQUE
PERSPECTIVE OF HAVING BEEN ON
BOTH SIDES OF THE SYSTEMS AND
INSTITUTIONS THAT MAKE UP THE
SAFETY NET IN YOUR COMMUNITIES.
IN A HEALTH CARE CONTEXT. UM AS
UH, CHAIR, BONTA SAID THEY
PROVIDE A WIDE ARRAY OF SERVICES
, INCLUDING CULTURALLY
APPROPRIATE HEALTH PROMOTION AND
EDUCATION ASSISTANCE IN
ACCESSING MEDICAL AND SOCIAL
SERVICES, CARE, COORDINATIONS
PATIENT ADVOCACY AND SO MUCH
MORE. NUMEROUS STUDIES HAVE
SHOWN THAT THIS WORKFORCE CAN
HELP PEOPLE IMPROVE THEIR
HEALTH. ACCESSING PRIMARY CARE
MANAGING THEIR DIABETES OR
CARDIOVASCULAR DISEASE,
CONTROLLING HYPERTENSION AND
OBTAINING NECESSARY CANCER
SCREENINGS. I HAVE PERSONALLY
SEEN THE POWER OF THIS
WORKFORCE. PRIOR TO MY TIME AT
CHC F I WAS THE EXECUTIVE
DIRECTOR OF A HEALTH CENTER IN
SAN FRANCISCO, WHERE WE TRAINED
UPWARDS OF 50 èC HÌ W S¼ PER
YEAR FOR OVER 20 YEARS. OUR èC
HÌ W S¼ SUPPORTED PEOPLE IN NEED
OF SEXUAL AND REPRODUCTIVE
HEALTH CARE. AND DID OUTREACH
WITH PEOPLE EXPERIENCING
HOMELESSNESS AND PEOPLE LIVING
IN PUBLIC HOUSING. THE VAST
MAJORITY HAVE CONTINUED THEIR
WORK IN THE HEALTH CARE SAFETY
NET. AND LIKE MANY CHW PRS, THEY
HAVE A LIFELONG DEDICATION AND
COMMITMENT TO SERVING THE
COMMUNITY. WE KNOW FROM DATA AND
FROM COMMUNITY EXPERIENCES COMMU
COMMUNITY EXPERIENCE THAT HEALTH
SYSTEMS THAT ARE DESIGNED TO
SUPPORT CALIFORNIANS HAVE WORK
TO DO TO DISMANTLE SYSTEMIC
RACISM. èC HÌ W PR S¼ ARE ONE
IMPORTANT PART OF THE SOLUTION.
THAT IS WHY èC HÌ èC F HAS
PRIORITIZED INVESTING IN AND
ADVANCING THE èC HÌ W PR
WORKFORCE IN CALIFORNIA. èC HÌ
W PR S¼ ARE RACIALLY ETHNICALLY
AND LINGUISTICALLY DIVERSE. AND
THEY OFTEN HAVE OTHER
INTERSECTING IDENTITIES THAT
THEY SHARE WITH THOSE THEY
SERVE. HAVING HAD AN EXPERIENCE
OF HOMELESSNESS OR INCARCERATION
, OR HAVING A SHARED IDENTITY
AROUND GENDER EXPRESSION OR
SOCIO-ECONOMIC STATUS. THIS IS
ESPECIALLY IMPORTANT BECAUSE THE
MAJORITY OF OUR HEALTH WORKFORCE
IN CALIFORNIA DOES NOT MATCH THE
DEMOGRAPHICS OF THE STATE, LET
ALONE OF ME. FOR EXA, MP
APPROXIMATELY 7% OF CALIFORNIA'S
PHYSICIANS ARE LATINO, WHEREAS
LATINOS MAKE UP APPROXIMATELY
40% OF THE STATE'S POPULATION.
ADDITIONALLY HEALTH SYSTEMS AND
MANAGED CARE PLANS IN CALIFORNIA
ARE INCREASINGLY BEING CALLED
UPON TO PROACTIVELY REACH INTO
COMMUNITIES TO MEET PEOPLE WHERE
THEY ARE AND COORDINATE THEIR
CARE BOTH IN AND OUTSIDE OF THE
WALLS OF THE HEALTHCARE
ENVIRONMENT. THE PUSH TO GREATER
CONNECTION TO COMMUNITY
ACKNOWLEDGES THAT PEOPLE'S LIVES
ARE COMPLEX AND THAT IT IS VERY
CHALLENGING TO NAVIGATE HEALTH
AND THE HEALTH AND SOCIAL
SERVICE SAFETY NET. èC HÌ W PR
S¼, A RE SEEN AS AN IMPORTANT
PART OF THIS EFFORT, THEIR WORK
OFTEN HAPPENS IN THE COMMUNITY
AT HEALTH FAIRS IN CHURCHES IN
HOMELESS ENCAMPMENTS IN
COMMUNITY CENTERS. THEY NOT ONLY
BUILD TRUST, BUT AS ONE,
PROMOTORA SAID RECENTLY, THEY
PLAY AN IMPORTANT ROLE IN
REPAIRING TRUST. AS YOU KNOW, WE
ARE IN A TIME OF ACUTE HEALTH
WORKFORCE SHORTAGES. 11 MILLION
CALIFORNIANS THAT IS MORE THAN A
QUARTER OF OUR STATE'S
POPULATION. LIVE IN A FEDERALLY
DESIGNATED PRIMARY CARE HEALTH
PROFESSIONAL SHORTAGE AREA. THIS
MAKES IT ALL THE MORE IMPORTANT
THAT HEALTH SYSTEMS RELY ON
DIVERSE A DIVERSE INTERES TEAM
WHO ARE WORKING TO THE TOP OF
THEIR SCOPE AND CAPABILITIES TO
ENSURE THAT PEOPLE'S HEALTH AND
SOCIAL SERVICE NEEDS ARE
ADEQUATELY MET. èC W PR WORK
INVOLVES TAKING THE TIME TO
UNDERSTAND PEOPLE'S HEALTH NEEDS
AND BARRIERS AND TO ACT AS
ADVOCATES. THAT IS NOT TIME THAT
IS OTHERWISE SPENT IN THE COURSE
OF A 15 MINUTE HEALTH CARE
VISIT. BUT IT IS TIME THAT
EVIDENCE TELLS US CAN HAVE AN
IMPACT ON PEOPLE'S HEALTH
OUTCOMES AND WELL BEING.
ALTHOUGH THERE HAS ALWAYS BEEN A
DEMAND FOR èC W PR S¼, THE
COVID-19 PANDEMIC CREATED
ADDITIONAL DEMAND. THEY WERE ON
THE FRONT LINES ALREADY EMBEDDED
IN THEIR COMMUNITIES, RESPONDING
ALMOST IMMEDIATELY TO THE NEED
THAT THEY WERE SEEING. THEIR
WORK CALLED ATTENTION TO THE
INSTRUMENTAL ROLE THAT THEY PLAY
IN REACHING COMMUNITIES MOST
IMPACTED BY HEALTH DISPARITIES.
A RECENT SURVEY, CONDUCTED BY
UCSF HEALTH FORCE CENTER TELLS
US THAT èC HÌ W PR S¼ WORKING
IN CLINICS AND HOSPITALS OR
ANYWHERE FROM 5016 TO $30 PER
HOUR, DEPENDING ON THEIR
EXPERIENCE AND WHERE THEY'RE
EMPLOYED. THE SAME SURVEY TELLS
US THAT BOTH HOSPITALS AND
CLINICS WANT TO HIRE MORE èC HÌ
W PR S¼. HOSPITALS SAID THAT
THEY WOULD HIRE APPROXIMATELY 10
TIMES THE NUMBER OF èC W PR S¼
THAN THEY CURRENTLY HAVE PLANNED
HEALTH CENTERS WOULD HIRE ALMOST
THREE TIMES MORE. UNFORTUNATELY,
THEY ALSO TOLD US THAT THEY PLAN
TO HIRE FAR LESS THAN THIS DO IN
LARGE PART TO THE CONSTRAINTS
ASSOCIATED WITH THE FINANCING
AND SUSTAINABILITY OF THESE
ROLES. A CHALLENGE THAT WAS
CITED BY BOTH HOSPITALS AND
HEALTH CENTERS. THE BUREAU OF
LABOR STATISTICS TELLS US THAT
THERE ARE 6700 CWS IN CALIFORNIA
WITH A PROJECTED GROWTH TO 7900
BY 2030. THAT'S AN 18% INCREASE,
WHICH IS MUCH FASTER THAN
AVERAGE. DUE TO THE VARIETY OF
JOB TITLES AND LABOR
CLASSIFICATION CODES FOR èC W
S¼. IT IS LIKELY THAT THIS IS A
SIGNIFICANT UNDERCOUNT. RESEARCH
ALSO TELLS US THAT DEMAND
OUTWEIGHS SUPPLY FOR THIS
WORKFORCE. IN ORDER TO ADVANCE.
èC HÌ W PR S¼ NEED ADDITIONAL
SUPPORT, INCLUDING THRIVING
WAGES, GOOD TRAINING,
OPPORTUNITIES FOR ADVANCEMENT
AND RECOGNITION, SUPPORTIVE
SUPERVISION. AND GOOD WORKPLACE
INTEGRATION. IN ADDITION TO THE
VALUE OF THE SERVICES THEY
PROVIDE. THIS IS AN EMERGING JOB
OPPORTUNITY FOR YOUR
CONSTITUENTS. HELP FORCE
IDENTIFIED APPROXIMATELY 25
TRAINING PROGRAMS FOR èC HÌ W
PR S¼ IN CALIFORNIA. WHICH ARE
PREDOMINANTLY CLUSTERED AROUND
LOS ANGELES AND THE SAN
FRANCISCO BAY AREA. SEVERAL OF
THOSE PROGRA MMES OFFER TRAINING
IN OTHER PARTS OF THE STATE,
INCLUDING THE CENTRAL VALLEY.
HOWEVER THERE ARE MANY PARTS OF
THE STATE, INCLUDING THE RURAL
NORTH, WHO HAVE SHORTAGES OF
TRAINING PROGRAMS AND èC HÌ W
PR WORKFORCE. THE PAST SEVERAL
YEARS OF YEARS HAVE SHOWN A
NUMBER OF EXCITING CHANGES.
WHICH CHAIR BRONTA UH INU
ENUMERATED, WHICH INCLUDE, UH,
FINANCING TO SCALE THE WORKFORCE
AS PART OF THE STATE BUDGET THE
OPPORTUNITY TO BE REIMBURSED
THROUGH THE NEW èC HÌ W BENEFIT
AND OPPORTUNITIES IN CAL AIM.
ADDITIONALLY THERE A RE NEW
PROVIDER CODES AND REIMBURSEMENT
FOR èC HÌ W PR S¼ IN MEDICARE,
WHICH OPENS THE DOOR FOR THEM TO
PROVIDE ADDITIONAL SERVICES FOR
SENIORS AND PEOPLE WITH
DISABILITIES. SEVERAL SPEAKERS
TODAY WILL TOUCH ON THOSE
INVESTMENTS. èC F IS CURRENTLY
SUPPORTING èC HÌ W PR EXPANSION
IN FOUR REGIONS IN CALIFORNIA,
SAN DIEGO, ALAMEDA, CENTRAL
COAST AND RIVERSIDE, SAN
BERNARDINO AND ORANGE COUNTY.
THESE REGIONS ARE HELPING US TO
UNDERSTAND WHAT IT TAKES TO HELP
THIS WORKFORCE THRIVE AND WHAT
IT MEANS TO IMPLEMENT IMPACTFUL,
SUSTAINABLE PROGRAMS. YOU WILL
HEAR FROM SEVERAL OF THEM TODAY.
MY HOPE IS THAT YOU TAKE AWAY
THESE FOUR THINGS FROM THE
CONVERSATION TODAY. èC HÌ W PR
S¼, A RE TRUSTED HEALTH WORKERS
WHO ARE ALREADY WORKING TO
ADVANCE HEALTH EQUITY IN
CALIFORNIA. THEY ARE
REPRESENTATIVE OF THE STATE'S
DIVERSE POPULATION AND PROVIDE
CULTURALLY AND LINGUISTICALLY
CONCORDANT CARE. THEY AUGMENT
THE CAPACITY OF THE HEALTH CARE
TEAM IN A TIME OF ACUTE HEALTH
WORKFORCE SHORTAGES. AND THAT
DEMAND OUTWEIGHS SUPPLY AND
ONGOING SUPPORT AND INVESTMENT
ARE NEEDED TO ADVANCE THIS
IMPORTANT WORKFORCE IN
CALIFORNIA. THANK YOU SO MUCH
FOR YOUR TIME TODAY. THANK YOU
SO MUCH. WE WILL MOVE ON NOW TO
MAIRA ALVAREZ, THE PRESIDENT OF
THE CHILDREN'S PARTNERSHIP. GOOD
AFTERNOON CHAIR, BONTA AND
ESTEEM MEMBERS OF THE COMMITTEE.
MY NAME IS MYRA ALVAREZ AND I
SERVE AS PRESIDENT OF THE
CHILDREN'S PARTNERSHIP, A
STATEWIDE ADVOCACY ORGANIZATION
FOCUSED ON ADVANCING CHILD
HEALTH EQUITY THROUGH RESEARCH
POLICY AND COMMUNITY ENGAGEMENT.
WE BELIEVE THAT ALL CHILDREN
REGARDLESS OF RACE, ETHNICITY OR
PLACE OF BIRTH SHOULD HAVE THE
RESOURCES AND OPPORTUNITIES THEY
NEED TO GROW UP HEALTHY AND
THRIVE. A FUNDAMENTAL COMPONENT
OF THAT WORK IS BUILDING A
HEALTH CARE SYSTEM THAT RESPONDS
TO THE NEEDS OF CALIFORNIA'S
DIVERSE CHILDREN AND FAMILIES.
ALIGNED WITH THIS WORK. WE ARE
PROUD TO BE A PART OF THE
STEERING COMMITTEE OF
CALIFORNIA'S COMMUNITY HEALTH
WORKERS, PROMOTORS AND
REPRESENTATIVES COALITION. MY
COMMENTS TODAY SEEK TO REFLECT
THE PERSPECTIVE OF THE COALITION
AND FURTHER INFORMATION WILL BE
SHARED BY INDIVIDUAL
ORGANIZATIONS THROUGHOUT TODAY'S
HEARING. BUILDING ON CARINA'S
COMMENTS. èC HÌ W PR S¼ ARE A
LONG STANDING MODEL OF CARE IN
CALIFORNIA, THE COUNTRY AND
ACROSS THE GLOBE. IN RESPONSE TO
SYSTEMS OF CARE THAT WERE NOT
MEETING THE NEEDS OF DIVERSE
COMMUNITIES. SYSTEMIC RACISM IN
A CULTURE OF WHITE SUPREMACY
HAVE CREATED CONDITIONS WITHIN
OUR COUNTRY, STATE AND
COMMUNITIES, INCLUDING OUR
HEALTH CARE SYSTEM THAT ACTIVELY
THREATENED THE PHYSICAL AND
MENTAL WELL BEING OF PEOPLE OF
COLOR, IMPEDE THEIR ACCESS TO
HEALTH CARE AND MAKE THE HEALTH
CARE. THEY DO ACCESS,
INEFFECTIVE AND POTENTIALLY
HARMFUL. THERE ARE MORE THAN 60
YEARS OF FORMAL RESEARCH
DOCUMENTING THE EFFECTIVENESS OF
èC HÌ W PR INTERVENTIONS, BUT
IT IS CLEAR THAT THIS PROFESSION
EMERGED IN DIRECT RESPONSE TO
THE FAILURE OF SYSTEMS AND
STRUCTURES CENTURIES AGO.
COMBATING GENERATIONS OF
DISCRIMINATION, RACISM AND
DEEPLY ENTRENCHED SYSTEMIC
INEQUITIES THAT HAVE HINDERED
OPPORTUNITIES FOR HEALTH AND
WELL BEING FOR MARGINALIZED
COMMUNITIES. WHAT WE KNOW IS
THAT COMMUNITIES FOUND A WAY.
COMMUNITIES RECOGNIZE THE POWER
THAT EXISTS IN KNOWING YOU HAVE
A SUPPORT NETWORK AND FAMILIES
AND NEIGHBORS THAT WILL DO
ANYTHING TO HELP. COMMUNITIES
CREATE A CULTURE THAT NURTURES
YOU. NOT ONE OF US MADE IT TO
WHERE WE ARE ALONE. AND èC HÌ W
PR S¼ EMBODY THIS BELIEF. FOR
CENTURIES, COMMUNITIES
THEMSELVES IMPLEMENTED
SOLUTIONS. OUT OF NECESSITY.
COMMUNITIES CREATED THOSE
NETWORKS OF CARE. THEY TRAINED
COMMUNITY HEALTH WORKERS. THEY
INTEGRATED CARE INTO THE
COMMUNITY BECAUSE THE
TRADITIONAL HEALTH CARE SYSTEM
WAS NOT MEETING THEIR NEEDS OR
WORSE, MISTREATING THEM. IT IS
WITHIN THIS CONTEXT THAT èC HÌ,
W, PR, S¼ AND MORE ARE A
COMMUNITY LED ANTI RACIST
SOLUTION IN HEALTH CARE DELIVERY
FOR CHILDREN AND ADULTS FROM
PRENATAL DEVELOPMENT TO LATE
ADULTHOOD. ANTI RACIST
STRATEGIES ARE CONSCIOUS AND
DELIBERATE EFFORTS THAT ADDRESS
AND ERADICATE HISTORICAL AND
PRESENT MARGINALIZATION AND
INEQUALITY IMPACTING BY PO
COMMUNITIES. A COMMUNITY HEALTH
WORKFORCE IS AN ANTI RACIST
STRATEGY BECAUSE IT SHIFTS POWER
THROUGH PARTNERSHIPS IN WHICH
PEOPLE WHO DIRECTLY EXPERIENCE
THE CONDITIONS THAT CAUSE
INEQUITIES HAVE LEADERSHIP ROLES
AND AVENUES TO SHARE THEIR
PERSPECTIVES WITHIN HEALTH CARE
ORGANIZATIONS. SHIFTING POWER
SUPPORTS A HEALTH WORKFORCE THAT
BETTER REFLECTS THE COMMUNITY
SERVED WHILE ALSO PROVIDING
EMPLOYMENT OPPORTUNITIES IN
THOSE COMMUNITIES THAT STABILIZE
FAMILIES. IN DOING SO A BRIDGE
IS CREATED BETWEEN FAMILIES AND
THEIR COMMUNITIES TO THE HEALTH
SYSTEM SERVING THEM THAT CAN
SUPPORT INSTITUTIONAL CHANGES IN
THOSE SYSTEMS TO BE MORE
CULTURALLY, LINGUISTICALLY AND
ETHNICALLY RESPONSIVE AND
DIVERSE. CHARACTERIZED BY SILVIO
DE CORAZON, OR SERVICE FROM THE
HEART AS VISION COMPROMISO
SHARES èC HÌ W PR S¼ HAVE
SERVED CALIFORNIA COMMUNITIES
FOR DECADES. PROMOTORA CENTERED
COMMUNITY INTERVENTIONS THAT
EMBRACED A POPULAR EDUCATION
APPROACH SPREAD THROUGHOUT THE
19 NINETIES, INCLUDING EL SOL
NEIGHBORHOOD EDUCATIONAL CENTER
IN LATINO HEALTH ACCESS, AND
SHORTLY THEREAFTER, WE SAW
COMMUNITY HEALTH WORKERS BE A
PART OF COMMUNITY HEALTH CENTERS
AND THEIR WORK TO CONNECT WITH
PATIENTS IN STATEWIDE NETWORKS
SUCH AS VISION, COMPROMISO AND
OTHERS THAT ASCENDED IN THE
EARLY TWO THOUSANDS. FOR DECADES
, CALIFORNIANS HAVE BENEFITED
FROM THE TRUST EXPERTISE,
CONNECTION, RESPECT AND LOVE OF
èC HÌ W PR S¼. AND IT IS LOCAL,
STATE AND FEDERAL AGENCIES THAT
HAVE BENEFITED AS WELL.
LEVERAGING THE ABILITY OF CPRS
TO ENGAGE WITH FAMILIES THEIR
CULTURAL EXPERTISE, THEIR
CONNECTION TO COMMUNITY ABILITY
TO CULTIVATE RELATIONSHIPS AND
THEIR FLEXIBILITY AND
RESPONSIVENESS. ALL ASSETS NOT
EMPHASIZED IN TRADITIONAL
MEDICAL TRAINING. WITH THESE
INCREDIBLE STRENGTHS. èC HÌ W
PR S¼ HAVE BEEN DEPLOYED IN
CALIFORNIA THROUGH A VARIETY OF
MECHANISMS. THEY SUPPORT THE
PHYSICAL, MENTAL AND SOCIAL,
EMOTIONAL HEALTH OF CHILDREN,
FAMILIES AND COMMUNITIES. OUR
HEALTH SYSTEMS, HOSPITALS
CLINICS, PUBLIC HEALTH
DEPARTMENTS RELY ON èC HÌ W PR
S¼ TO IMPROVE THE UTILIZATION OF
PREVENTIVE SERVICES, MEDICATION,
ADHERENCE, CHRONIC DISEASE
MANAGEMENT AND CARE FOR CERTAIN
HEALTH CONDITIONS. THEY PROVIDE
EFFECTIVE ASTHMA, SELF
MANAGEMENT AND ENVIRONMENTAL
EDUCATION, BRIDGING THE GAP
BETWEEN PATIENTS AND PROVIDERS
OFFERING SOCIAL SERVICES SUCH AS
INTERPRETATION AND REFERRALS AND
PERFORMED CARE COORDINATIONS.
THEY SUPPORT THE ADULTS THAT
CHILDREN RELY ON BUILDING SELF
EFFICACY, CONFIDENCE AND HEALTH
LITERACY. THEY HELP PEOPLE
NAVIGATE COMPLEX GOVERNMENT
SYSTEMS, INCLUDING EDUCATION,
HEALTH CARE AND SOCIAL SERVICES.
THEY ARE ADVOCATES FOR SOCIAL
JUSTICE, WHO HAVE A UNIQUE
ABILITY TO IMPROVE THE
CONDITIONS IN WHICH WE ALL LIVE,
LEARN, GROW AND PLAY. MOST
RECENTLY WE CAN LOOK TO THE
PANDEMIC AS EVIDENCE OF THE
CRITICAL ROLE OF èC HÌ W PR S¼
AS THEY EMERGED ON THE FRONT
LINE EARLY ON AS ESSENTIAL
WORKERS WHILE IN PERSON VISITS
WERE RESTRICTED. èC HÌ W PR S¼
WERE ABLE TO PIVOT QUICKLY AND
CONNECT WITH FAMILIES VIA VIDEO
CONFERENCE PHONE, TEXT AND
EMAIL. IN MANY COMMUNITIES. IT
WAS èC HÌ W PR S¼, WHO TOOK
CHARGE OF CONTACT TRACING AND
FOLLOW UPS, PARTICULARLY FOR
FAMILIES WITHOUT WORKING
TELEPHONES. GIVEN THEIR TRUST
THEIR CONNECTION, THEY QUICKLY
IDENTIFIED THOSE MOST
MARGINALIZED, REACHING THOSE WHO
ARE DEEMED UNREACHABLE AND
ENSURE THAT RESOURCES MADE IT TO
THE FAMILIES WHO NEEDED THEM.
MOST. IN LOS ANGELES, THE UNITED
AMERICAN INDIAN INVOLVEMENT èC
HÌ W PR S¼ QUICKLY MOBILIZED TO
DELIVER PERSONAL PROTECTIVE
EQUIPMENT FOOD, TAKE HOME TESTS
AND ASSISTED WITH TELEHEALTH
APPOINTMENTS, PROMOTING
VACCINATIONS AND PROVIDING
SOCIAL AND EMOTIONAL SUPPORT TO
THE CITY'S URBAN INDIAN
POPULATION. IT IS WHY THE
FEDERAL GOVERNMENT ALLOCATED
OVER THREE BILLION DOLLARS TO
AID COMMUNITY BASED
ORGANIZATIONS AND PUBLIC HEALTH
DEPARTMENTS IN HIRING èC HÌ W
PR S¼ THROUGH THE AMERICAN
RESCUE PLAN TO LEVERAGE THAT
VERY EXPERTISE BECAUSE
THROUGHOUT THESE VARIOUS EFFORTS
èC HÌ W PR S¼ ARE STRUCTURED
DIFFERENTLY. IT OFTEN IN DIRECT
RESPONSE TO WHAT COMMUNITY
SPECIFICALLY NEED. THEY HAVE A
LONG HISTORY OF WORKING IN
COMMUNITY WE WITHIN HEALTH CARE
AS WELL AS OUTSIDE OF HEALTH
CARE AND ARE HAVING MORE
OPPORTUNITY TO BE INTEGRATED
INTO TRADITIONAL SETTINGS
BECAUSE OF OPPORTUNITIES LIKE
THE èC HÌ W BENEFIT. HOWEVER.
AS THIS WORKED TO FURTHER
INTEGRATE èC HÌ W PR S¼
CONTINUES, THERE IS A NEED TO
SUSTAIN THE EXISTING WORKFORCE
AND NOT JUST EXPAND ON WHAT WE
KNOW IS NOT WORKING. THE HÌ W PR
S¼, AS CARLINA MENTIONED, OFTEN
WORK IN HOURLY POSITIONS THAT
PAY LESS THAN A LIVING WAGE.
THEY HAVE DRASTICALLY LOWER
SALARIES DESPITE THEIR MANY
CONTRIBUTIONS. THERE'S ALSO A
HIGH NUMBER OF VOLUNTEER
POSITIONS, BOOSTING THE WAGES OF
èC HÌ W PR S¼ CAN HELP THEM
OVERCOME CHALLENGES WITH
TRANSPORTATION. AGAIN MUCH OF
THIS ECONOMIC INJUSTICE IS
ROOTED IN SYSTEMIC RACISM. AS
SHARED BY OUR PARTNER, EL SOL
AND THEIR RECENT REPORT, MANY
ORGANIZATIONS HAVE EXPERIENCED
THE CHALLENGES OF NOT HAVING THE
ORGANIZATIONAL READINESS OR
SUPPORT SYSTEMS IN PLACE TO
RESPOND TO èC HÌ W PR S¼.
ACHIEVING HEALTH EQUITY FOR OUR
CHILDREN AND FAMILIES REQUIRES
OUR HEALTH CARE SYSTEM TO
UNCOVER, ACKNOWLEDGE AND ADDRESS
SYSTEMIC BARRIERS TO COMMUNITY
FOCUSED EFFORTS THAT CENTER AND
MEANINGFULLY ENGAGE PEOPLE WHO
COME FROM COMMUNITIES THAT HAVE
BEEN HISTORICALLY OPPRESSED. WE
SEE THIS HAPPENING THROUGH POMO
TOAS THROUGH COMMUNITY HEALTH
REPRESENTATIVES, DOULAS PEER
COUNSELORS, THERE IS A WIDE
VARIETY OF COMMUNITY HEALTH
WORKERS MAKING A DIFFERENCE. THE
STATE OF CALIFORNIA IS IN THE
MIDST OF A TRANSFORMATION OF OUR
HEALTH CARE SYSTEM WITH MULTIPLE
EFFORTS TO STRENGTHEN ME AND
REFORM DELIVERY. AS THAT WORK
CONTINUES, LET US LIMIT OR
ELIMINATE THE HARMS UPON OUR
COMMUNITIES AND PRIORITIZE
SOLUTIONS THAT CHALLENGE THE
STATUS QUO. BRING CARE TO THE
COMMUNITY INITIATIVES THAT
REFUSE HEALTH CARE TO BE
TRANSACTIONAL AND FINALLY, A
VALIDATION OF THE BRILLIANCE OF
COMMUNITY LEADERS, RECOGNIZING
THAT THOSE CLOSEST TO THE
PROBLEM ARE CLOSEST TO THE
SOLUTION, AS THE QUOTE GOES. VÆ
HÌ W PR S¼ ARE BORN NOT MADE A
CALL TO ACTION TO STAY TRUE TO
THE SPIRIT OF THE MODEL WHILE
OPENING DOORS TO THE SERVICES
THAT WE KNOW ARE SO ESSENTIAL.
THERE'S NÓ BETTER TIME THAN NOW.
THANK YOU FOR THE OPPORTUNITY.
THANK YOU. AND I JUST WANNA
WELCOME UH, MR REGINALD JOHN
SAWYER, THE THIRD OUR HEALTH
COMMITTEE. UH, MEMBER AND OUR
MAJORITY LEADER, MISS AGUIAR,
WHO HAS BEEN LEADING US IN THIS
SPACE IS IN THE LEGISLATURE FOR
QUITE A WHILE. SO THANK YOU FOR
PARTICIPATING, AND WITH THAT WE
WILL MOVE ON TO DOCTOR AQUINO,
EXECUTIVE DIRECTOR OF THE LATINO
COALITION FOR HEALTHY
CALIFORNIA. THANK YOU SO MUCH
CHAIRWOMAN BONTA AND ESTEEMED
MEMBERS OF THE COMMITTEE. IT IS
A JOY TO JOIN YOU ALL TODAY. I
AM DOCTOR S¼. AQUINO AND I SERVE
AS EXECUTIVE DIRECTOR AT THE
LATINO COALITION FOR A HEALTHY
CALIFORNIA. AT L èC èC. WE ARE
COMMITTED TO ADVANCING AND
PROTECTING LATINA AND MESO
AMERICAN INDIGENOUS HEALTH
THROUGH POLICY CHANGE. WE PRIDE
OURSELVES IN TRANSLATING
COMMUNITY SOLUTIONS INTO
EQUITABLE POLICY AND LASTING
SYSTEMIC CHANGE. OUR POLICY WORK
IS ROOTED IN COMMUNITY AND LED
BY OUR STATEWIDE PROMOTORA
NETWORK FROM OUR ANNUAL
LISTENING TOUR TO OUR PASA LÀ
VOS COMMUNITY PLATICA TO THE
ADVOCACY OF OUR LEGISLATIVE
PRIORITIES PROMOTORS LEAD THE
WAY. I ACTUALLY STARTED MY
JOURNEY IN PUBLIC HEALTH AS A
PROMOTORA. SO THIS TOPIC IS NEAR
AND DEAR TO MY HEART. NOW THERE
IS NÓ DENYING THAT THE ROLE OF
THE PROMOTORA èC HÌ W PR IS NOT
ONLY WIDELY ACCEPTED BUT LOVED
AND RESPECTED. UNFORTUNATELY THE
ROLE CONTINUES TO BE TREATED AS
A CONTRACTED PHYSICIAN. THE
REALITY OF A CONTRACTOR ROLE IS
THAT JOBS ARE TIME LIMITED AND
LACK EMPLOYEE BENEFITS SUCH AS
HEALTH INSURANCE. THE WORK.
WE'RE CURRENTLY DOING ACROSS THE
STATE TO INCREASE ACCESS TO èC
HÌ W PR S¼, INCLUDING OUR Dð,
HÌ, èC, S¼ AND HÌ Kò EFFORTS
HELPS US INCREASE ACCESS TO THE
ROLE AND THUS MOVES THE NEEDLE
FORWARD TO EQUAL AND THAT'S
GREAT. LET'S KEEP DOING MORE OF
THAT. BUT IT IS TIME NOW TO
ENVISION THE FUTURE WE MUST
BEGIN TO ADAPT ADDITIONAL
STRATEGIES THAT WILL HELP US
ADVANCE FROM EQUALITY TO EQUITY
AND EVENTUALLY, JUSTICE. THE
MAJORITY OF èC HÌ W PR RULES
ARE HELD BY WOMEN AND WOMEN OF
COLOR AT THAT. WOMEN OF COLOUR
AND SPECIFICALLY, LATINAS HAVE
BEEN HISTORICALLY
DISENFRANCHISED, AND THAT HAS
HAD A COMPOUNDING EFFECT IN
INCREASING HEALTH AND SOCIO
ECONOMIC DISPARITIES. THESE
DISPARITIES CAN ONLY BE
ADDRESSED BY INTENTIONALLY
INVESTING AND INCREASING ACCESS
TO OPPORTUNITIES THAT CAN RAISE
US BACK TO PARITY. ONE OF THOSE
ADDITIONAL STRATEGIES IS TO
TRANSFORM THE PROMOTORA ROLE
FROM CONTRACTOR ROLES TO FULL
TIME POSITIONS. FULL TIME
POSITIONS WITH BENEFITS,
SALARIES AND CAREER GROWTH
OPPORTUNITIES. FROM A SYSTEMS
PERSPECTIVE, INTEGRATING THE
ROLE INTO EXISTING SYSTEMS SUCH
AS OUR STATE AGENCIES AND
DEPARTMENTS IS THE MOST
SUSTAINABLE WAY TO GROW AND
DEVELOP THE ROLE. A
COMPREHENSIVE INTEGRATION OF
PROMOTORS IN STATE LEADERSHIP
AND MANAGEMENT POSITIONS WILL
FACILITATE SUCCESSFUL MONITORING
AND EVALUATION OF THE WORK.
INCORPORATING PROMOTORA VALUES
AND STRATEGIES AND TO ALL LEVELS
OF OUR EXISTING SYSTEMS WILL
ENSURE THAT THIS IS NOT
PERCEIVED AS AN ADDITIONAL STEP
TO OUTSOURCE, BUT RATHER AS AN
INTEGRAL COMPONENT OF OUR
STATE'S STRATEGIC FRAMEWORK.
THIS IS A STRATEGY THAT WILL NOT
ONLY TRANSFORM OUR WORKFORCE,
BUT WE ACTIVELY INVEST IN LATINX
COMMUNITIES. LATINAS ARE
POWERFUL ECONOMIC FORCE, AND
WHEN WE CHOOSE TO INVEST IN
LATINAS, WE SUCCESSFULLY CREATE
AN ECONOMIC RIPPLE EFFECT THAT
WILL IN TURN PROTECT FAMILIES,
COMMUNITIES AND FULL NETWORKS
ACROSS THE STATE. ECONOMIC
PROSPERITY AND HEALTH ARE
INTRICATELY LINKED, THEREFORE,
HIRING PROMOTOR FOR FULL TIME
POSITIONS IS NOT ONLY AN ANTI
POVERTY STRATEGY BUT A PUBLIC
HEALTH, ONE THAT WILL IN TURN,
IMPROVE THE HEALTH OF OUR STATE.
THANK YOU. THANK YOU SO MUCH.
DOCTOR AQUINO. WE'LL MOVE ON TO
DOCTOR GOLLY, OUR SECRETARY OF
CALIFORNIA HEALTH AND HUMAN
SERVICES. GOOD AFTERNOON. THANK
YOU, UH, CHAIR BANTA AND OTHER
MEMBERS OF THE COMMITTEE FOR
INVITING ME TODAY AND THANK YOU
FOR THE FELLOW PANELISTS. I, UH
REALLY STAND ON THEIR WORDS. I
THINK THAT WHAT THE SHAPING OF
THIS CONVERSATION A VITAL OUR
MOVE INTO èC HÌ W PR. UH UH,
ROLES IS REALLY CRITICAL AS ALL
OF YOU KNOW, YOU'VE BEEN AROUND
CALIFORNIA HEALTH CARE A LONG
ENOUGH. UH WE HAVE A REAL NEED
TO RE INVENT THE SYSTEM. THAT IS
DELIVERING CARE TO 40 MILLION
PEOPLE. UH, AND THAT REINVENTION
HAS A LOT TO DO WITH THE
WORKFORCE THAT WE'RE ASKING TO
DO THE WORK. AND UH, SIMILAR TO
SOME OF THE STORIES YOU HEARD,
UH, MY OWN EXPERIENCE WORKING
WITH COMMUNITY HEALTH WORKERS IN
MY FIRST JOB AFTER RESIDENCY IN
THE BAYVIEW HUNTERS POINT,
COMMUNITY OF SAN FRANCISCO
REALLY BUILT MY BELIEF THAT WE
HAVE, UH, A LOT OF BENEFIT TO
GAIN FROM REALLY EXPLORING THE
RICHNESS OF WHAT I CALL THIS,
UH, COMMUNITY PROFESSIONAL ROLE.
I KNOW I WALK AROUND AS A HEALTH
PROFESSIONAL, A TRAINED M Dð.
UM, BUT THIS ROLE OF COMMUNITY
PROFESSIONAL IS REAL. AND I
APPRECIATED THAT CONCEPT OF
BRIDGING, UH WHILE IN MEDICAL
SCHOOL, I REALIZED EARLY THAT
MEDICINE IS, UH 10% DIAGNOSIS 90
SE 90% PLAN. AND IN SO MANY
SETTINGS. WE MISS HOW HARD IT IS
TO COME UP WITH THE PLAN. AND I
HAVE IN MY WORK AS A
PEDIATRICIAN, IS AN ADOLESCENT
PROVIDER DEPENDED ON COMMUNITY
HEALTH WORKERS, IN PARTICULAR IN
THE BAYVIEW HUNTERS POINT
COMMUNITY LATER IN SOUTH LOS
ANGELES TO REALLY TRANSLATE AND
CREATE ROBUST PLANS THAT MADE A
DIFFERENCE AND MOVED THE NEEDLE
UNHEALTH. AND THOSE INDIVIDUALS
THAT I HAD THE PRIVILEGE OF
WORKING WITH IN A TEAM BASED
MODEL. UM WE EXACTLY THE SPECIAL
SAUCE THE SECRET INGREDIENT THAT
REALLY TURNED. WHAT MIGHT HAVE
BEEN, UM, UH, A SET OF ONGOING
APPOINTMENTS WITHOUT A LOT OF
MEANINGFUL MOVEMENT, WHETHER
IT'S A DIABETES INDICATOR OR AN
ASTHMA INDICATOR OR COUNSELING
AROUND VIOLENCE INTO SOMETHING
THAT WAS ACTUALLY MEANINGFUL AND
CHANGE THE LIVES OF THE PEOPLE
THAT I HAD THE PRIVILEGE OF
SERVING. UH, WE DID THIS IN A
COUNTY HEALTH SYSTEM. WE WERE
ABLE TO IDENTIFY AND BUILD
COMMUNITY HEALTH WORKER ROLES.
NOT EVERY COUNTY GAVE THAT
OPPORTUNITY BUT BUILT IT AS PART
OF THE SYSTEM. AND I THINK THE
PRIOR PANELISTS, UM GIVE HOPE
THAT WE'RE ABLE TO DO THAT, IN
AN EVEN BIGGER WAY TO HEAR,
FRANKLY, II. I LIKE THAT. WE'RE
GROWING BY 18% OVER THE NEXT
MANY YEARS, BUT THE SMALL NUMBER
GIVEN OUR POPULATION OF
CURRENTLY IDENTIFIED AND
EMPLOYED PROMOTORS, COMMUNITY,
HEALTH WORKERS AND HEALTH
REPRESENTATIVES IS TOO LOW FOR A
STATE THIS SIZE AND I'M PROUD OF
THE WORK THAT WE'VE DONE OVER
THE PAST COUPLE OF YEARS WHETHER
IT'S OUR WORK AT HÌ Kò ON
BUILDING UP THE WORKFORCE AND
IDENTIFYING THE ELEMENTS OF A
CERTIFICATION PROGRAM OR THE
REALLY IMPORTANT WORK ON
BUILDING A COMMUNITY HEALTH
WORKER BENEFIT FOR MEDICAID.
THESE ARE IMPORTANT STEPS, BUT
NOT ENOUGH. WE NEED TO CONTINUE
TO BUILD THOSE. SO THIS NOTION
THAT THERE ARE THESE ARE WELL
RESPECTED, IMPORTANT JOBS THAT
THEIR PROFESSIONAL ROLES IN ARE
BOTH COMMUNITY HEALTH SYSTEM AND
HEALTH SERVICES SYSTEM IS KEY.
AND YOUR ROLE IN HELPING LEAD
THE WAY WORKING HAND IN HAND
WITH OUR DEPARTMENTS IN HEALTH
AND HUMAN SERVICES. THE
ADMINISTRATION AT LARGE REALLY
ADVANCE THIS NOTION THAT WE CAN
DO MORE AND DO BETTER IN THIS
SPACE. UH, I THINK IS VERY
CRITICAL. WE KNOW THAT THIS IS A
NEW JOURNEY FOR, UH, US IN STATE
GOVERNMENT TO FIGURE OUT HOW TO
REALLY TAP INTO THE EXPERTISE OF
OUR COMMUNITIES. THOSE WHO ARE
DOING THE WORK TO CREATE ROLES
AND RESPONSIBILITIES THAT FIT
THE CHALLENGE. I DON'T SEE A
ROAD FORWARD IF WE CONTINUE TO
DEPEND ON OUR CURRENT STABLE OF
HEALTH PROFESSIONALS TO GET THIS
WORK DONE IN THE WAY THAT LIFTS
UP NOT JUST THE HEALTH CARE
OUTCOMES, BUT THESE IMPORTANT
SHIFTS IN POWER THAT COMMUNITIES
THAT TOO LONG HAVE BEEN
OVERLOOKED SUFFER FROM TODAY.
AND SO, UH, AS WE CONTINUE TO
SEE A ROAD FORWARD, AND WE WORK
WITH THE DOZENS, HUNDREDS,
FRANKLY OF PARTNERS AND
COMMUNITY TO FIGURE OUT THE BEST
WAY TO DO THIS, AS WE PUSH
OURSELVES TO EXPLORE HOW TO MAKE
THE JOBS MEANINGFUL, NOT ONLY
FROM THE ROLE AND IMPACT BECAUSE
THAT HAS BEEN THERE ALL THE TIME
. BUT AS A TRUE SPRINGBOARD TO,
UH, YOU KNOW, LIFE SUSTAINING
JOBS AND ROLES THAT ARE VERY
DEEPLY RESPECTED, NOT JUST
OUTSIDE OF THE HEALTH CARE
SYSTEM, BUT WITHIN IT AND HOW
THEY BECOME PILLARS OF OUR
HEALTHCARE DELIVERY TEAMS. I
THINK IT'S IMPORTANT THAT WE
CONTINUE TO HAVE THESE
CONVERSATIONS NÓ LONGER SHOULD
WE JUST LOOK TO THE HOLES OF
MEDICAL SCHOOLS AND NURSING
SCHOOLS? BUT TO THE COMMUNITIES,
THE BACKYARDS THE STOREFRONTS
FOR THE PEOPLE WHO CAN REALLY
MOVE THE NEEDLE ON HEALTH. AND
WE SEE THAT IN THE EVIDENCE THAT
WAS PRESENTED BY PRIOR PANELISTS
AND EVEN IN THOSE WONKY RETURN
ON INVESTMENT ARTICLES THAT COME
OUT OF ACADEMIA THAT SHOW FOR
EVERY DOLLAR INVESTED IN A
PROMOTORA COMMUNITY HEALTH
WORKER OR REPRESENTATIVE, WE GET
AT LEAST $2.5 BACK IN RETURN. SO
UH, AS BOTH SOMEBODY WHO
BENEFITED AS A DIRECT, UH,
PHYSICIAN IN SOME OF OUR MOST
COMPLEX COMMUNITIES IN
CALIFORNIA AS SOMEBODY WHO'S HAD
THE PRIVILEGE OF SITTING IN THIS
ROLE AS HEALTH SECRETARY, AND,
UH, SEEING THE CHALLENGES IN
FRONT OF THIS STATE. I CAN'T SEE
HOW WE GET TO THE SORT OF
OUTCOMES. I KNOW. ALL OF. YOU
EXPECT US TO GET TO WITHOUT NOT
JUST A SERIOUS CONVERSATION HERE
ABOUT OUR ONGOING INVESTMENT IN
IN THESE AND MAKING SURE THAT
THEY DON'T JUST LIVE GRANT TO
GRANT BUDGET CYCLE TO BUDGET
CYCLE BUT THAT THEY'RE HARDWIRED
INTO THE WAY WE EXPECT TO
DELIVER CARE INTO THE FUTURE.
THANK YOU. THANK YOU, DOCTOR.
GOLLY I WILL OPEN IT UP FOR
QUESTIONS FROM THE COMMITTEE AT
THIS POINT. DOCTOR AMBU. THANK
YOU, MADAM CHAIR. UM FIRST, I'M
GONNA GIVE MY APPRECIATION TO
THE STAFF FOR THE WRITE UP TODAY
. I THOUGHT IT WAS VERY WELL
DONE. I THOUGHT THE ANALOGY
ABOUT BUILDING A FOUNDATION IS
THE APPROPRIATE ANALOGY FOR US.
AS A STATE. WE HAVE DONE A LOT
OF THE HARD WORK AND LEG WORK TO
GET US TO THIS POINT, BUT WE DO
NEED TO MAKE SURE THAT WE'RE
MEETING THE NEED, AND SO I
REALLY WANNA TALK ABOUT THAT IF
I CAN, BECAUSE AT THE MOMENT, IT
DOESN'T SEEM THAT WE'VE BEEN
TRAINING ENOUGH èC HÌ W PR S¼
AND THAT WE HAVE TRAINING
DESERTS ALL OVER OUR STATE. UM,
I COULDN'T HELP BUT NOTICE ON
YOUR MAP. UH UM CARLINA HANSEN
THAT THERE WAS ONLY BAKERSFIELD
COMMUNITY COLLEGE IN THE CENTRAL
VALLEY UP TO SACRAMENTO. WE HAVE
5 MILLION PEOPLE IN THE FIVE
HOURS BETWEEN THOSE PLACES AND
HAVE TO BELIEVE THERE ARE MORE
OPPORTUNITIES FOR US TO FIND
TRAINING THAT I QUESTION WHETHER
WE'VE LOOKED TOWARDS ADULT
EDUCATION OR IF WE NEED A
COMMUNITY COLLEGE DEGREE. IS
THERE AN OPPORTUNITY FOR US TO
MEET? E S¼ L ADULTS WHERE
THEY'RE AT AND GIVE THEM THAT
BRIDGE TO EMPLOYMENT THAT WAS
MENTIONED HERE. UM WHAT WOULD BE
REQUIRED FOR US TO DO JUST THAT?
BECAUSE EXCUSE ME, UM, WONDERFUL
QUESTION. AND UM, YOU'RE RIGHT.
WE DO HAVE A LOT OF TRAINING
DESERTS IN THE STATE OF
CALIFORNIA AND A GREAT AMOUNT OF
NEED THAT. I THINK THE PANEL HAS
SPOKEN TO. UM WE ARE SEEING SOME
EXPANSION SINCE THE RELEASE OF
THAT REPORT. I THINK DRIVEN IN
PART BY DEMAND AND EXACTLY IN
THE PLACES THAT YOU'RE
MENTIONING, AND COMMUNITY
COLLEGES. WE ALSO HAVE WONDERFUL
REPRESENTATION HERE TODAY FROM A
NUMBER OF ORGANIZATIONS WHO HAVE
YEARS AND YEARS OF EXPERIENCE.
IN COMMUNITY HEALTH WORKERS AND
PROM TORRES, UM, AND COMMUNITY
HEALTH REPRESENTATIVES THAT ARE
ORGANIZATIONS THAT ARE VERY
CONNECTED TO THEIR COMMUNITIES,
AND NOT UNLIKE THE WORKFORCE. I
THINK IT'S IMPORTANT THAT WE
SUPPORT UM AND SHORE UP THOSE
ORGANIZATIONS WHO HAVE BEEN
DOING THIS FOR SO LONG AND WHO
KNOW THE NEEDS OF THEIR
COMMUNITIES WELL AND KNOW THE
WORKFORCE. WELL UM, VIC
COMPROMISO, EL SOL, ET CETERA.
UM THOSE ARE WONDERFUL
ORGANIZATIONS, BUT I DO THINK
THAT THERE IS A COMPLIMENT OF
EXPERT THAT CAN BE PROVIDED AND
TRAINING THAT CAN BE PROVIDED BY
OUR COMMUNITY COLLEGE SYSTEM AND
I. I DO THINK THAT THAT'S
HAPPENING AND EXPANDING. DOCTOR
ALI. YEAH, I'LL ADD, UM I THINK
YOU KNOW, OVER THE LAST COUPLE
OF BUDGET CYCLES. WE'VE HAD
INVESTMENTS THROUGH HÌ Kò IN
BUILDING UP THE INFRASTRUCTURE.
I THINK THERE IS THIS REALLY
IMPORTANT COMPLEMENT OF BUILDING
UP OUR EXISTING VERY EXPERIENCED
GROUPS. WITHIN COMMUNITIES.
YOU'VE HEARD THEIR NAMES.
THERE'S OTHERS, BUT ALSO LOOKING
TO SEE WHAT'S THE ROLE OF OUR
FORMAL, MAYBE COMMUNITY COLLEGE
SYSTEM. OTHER PARTS OF OUR
SYSTEMS. UH I DO BELIEVE AS WE
MAKE THE BUT èC HÌ W BENEFIT
WITHIN MEDICAID MORE ROBUST.
HOPEFULLY SEE INCREASED UPTAKE
AT WITH TIME OBVIOUSLY START
SLOW, BUT THAT WILL DRIVE SOME
OF THE OPPORTUNITY THERE. I MEAN
, YOU YOU KNOW THIS. YOU ALL
KNOW THIS VERY WELL. YOU PROVIDE
THE RESOURCES. YOU CAN START TO
BUILD SOME OF THE PROGRAM TO
BUILD SOME OF THE PROGRAM.
WITHOUT THE RESOURCE. IT OFTEN
FALLS FLAT. SO I DO THINK THAT
THE NEXT MANY MONTHS AND YEARS
ARE GONNA BE A TESTIMONY TO
BUILDING THAT CAPACITY UP AND
HOPEFULLY IN A YEAR OR TWO. YOU
SEE A VERY DIFFERENT MAP WHERE
THE TRAINING OPPORTUNITIES ARE
BECAUSE THEY'RE REAL LIFE
PIPELINES INTO JOBS THAT THROUGH
OUR MANAGED CARE SYSTEMS THROUGH
OUR HEALTH SYSTEMS THROUGH OUR
PUBLIC HEALTH SYSTEMS WERE
ACTUALLY LIFTING THEM UP AND
MAKING THEM AVAILABLE. AND I DO
WANT TO UPLIFT THE WORK OF THE
èC B Ó S¼, WHO ARE THE TRUSTED
MESSENGERS WHO HAVE BEEN IN
COMMUNITY WHO HAVE LONG
ESTABLISHED TRUST I. I WANT TO
UPLIFT THE COMMENT ABOUT NEEDING
TO REPAIR THE TRUST THAT FOR SO
MANY OF OUR COMMUNITIES WAS
EARNED. AND SO I LOOK FORWARD TO
HOW WE CAN SUPPORT THOSE GROUPS
WHO HAVE BEEN ON THE GROUND.
PART OF YOUR ANSWER, THOUGH DR
GOLI WAS ABOUT REIMBURSEMENT,
AND SO I'LL THEN FOCUS IF I CAN
ON OUR FQ HÌ èC S¼ EXPLICITLY
AND THEIR INABILITY TO, UM UH,
CONTRACT WITH èC HÌ W S¼ AT THE
MOMENT BECAUSE OF PP S¼ VERSUS
FIFA SERVICE AND WOULD HIGHLIGHT
IN THE AGENDA THAT THERE WERE
THREE STATES THAT ARE FINDING
WAYS TO WORK AROUND THIS. I
BELIEVE IT WAS MICHIGAN, KANSAS
AND RHODE ISLAND. WHO INSTEAD
ALLOW US TO DO THAT FEE FOR
SERVICE. OUTSIDE OF THE PP S¼
RATE, I WILL SAY WITHIN
CALIFORNIA THERE ARE EXAMPLES.
PRECEDENTS FOR THIS. I'D UPLIFT
OUR CAL AIM E èC M AS WELL AS
OUR SUPPORTIVE SERVICES AS
EXAMPLES WHERE WE'VE ALREADY
DONE THIS TO QUESTION CAN WE
LOOK TOWARDS CREATING A
WORKAROUND OR CAN WE DIRECTLY
FUND THOSE èC B S¼ TO MAKE SURE
THAT THEY'RE BEING REIMBURSED
FOR THE COMMUNITY HEALTH WORKERS
WHO WILL BE SEEING PEOPLE WITHIN
OUR FQ HÌ èC. AS YOU KNOW, WE,
THE PPR SYSTEM HAS SOME RIGIDITY
TO IT AND DOESN'T ALLOW CERTAIN
THINGS TO HAPPEN. BUT YES, WE
HAVE DONE WORK ROUNDS. WE COULD
CONTINUE TO EXPLORE THAT AND SEE
HOW WE WORK WITH OUR FQ HÌ èC
PARTNERS, OUR COMMUNITY PARTNERS
TO UPLIFT THIS. I DO BELIEVE
THAT AS THE BENEFIT THIS èC HÌ
W BENEFIT IN MEDICAID BECOMES A
LITTLE BIT MORE, NOT JUST ROBUST
BUT EXPERIENCED THAT THIS IS A
VERY NATURAL PLACE TO GO. IT'S
HARD FOR ME TO CLOSE MY EYES AND
IMAGINE THE HEALTH DELIVERY
SYSTEM IN CALIFORNIA WITHOUT FQ
HÌ. IS BENEFITING FROM THE
IMPORTANT WORK THAT èC HÌ W PR
S¼ KID. BRING SO FIGURING THAT
PIECE OUT, I THINK IS PART OF
THE PUZZLE MOVING FORWARD AND
REIMBURSEMENT. FRANKLY THE FACT
THAT WE'RE TODAY TALKING ABOUT
REIMBURSEMENT AND WE'RE NOT JUST
TALKING ABOUT, UH, WHAT'S THE
NEXT BIG GRANT PROGRAM FOR èC?
HÌ W PR S¼, I THINK IS A BIG
LEAP FORWARD AND NOW WE HAVE TO
EXECUTE ON SOME OF THE IMPORTANT
QUESTIONS YOU'RE RAISING. I'M
GONNA MOVE ON TO OUR MAJORITY
LEADER. GOOD AFTERNOON. THANK
YOU VERY MUCH. AND I WANT TO
ALSO THANK THE AUDIENCES HERE.
WE ALL KNOW WHAT AN IMPORTANT
TOPIC THIS IS. UM MY MAIN THING
IS II. I REALLY WANNA MAKE SURE
WE HAVE ONGOING INVESTMENT.
BECAUSE THIS IS SUCH AN
IMPORTANT PROGRAM THE PROGRAMS
AND TO SEE THE MOMENTUM GOING
AND I'M SOMEONE THAT DOESN'T
LIKE TO SEE ANYTHING LEFT AT THE
TABLE. AND I'M AFRAID IF WE
DON'T KEEP THE MOMENTUM, AND WE
TAKE A COUPLE STEPS BACKWARDS,
SO I LOVE THE WORDS THAT YOU USE
THIS THIS AFTERNOON TRUSTED THE
VERSE. AR AUGMENT THE CAPACITY
OF THE HEALTHCARE TEAM. AND
REMEMBER THE DEMAND OUTWEIGHS
SUPPLY. WE NEED TO CONTINUE TO
WORK WITH OUR PEOPLE TO MAKE
SURE WE GET THE HEALTH ACCESS
THAT WE NEED IN ALL OVER THE
STATE, BUT PRIMARILY IN OUR
RURAL AREAS. I'VE SEEN THE WORK
YOU'VE DONE. I'VE SEEN HOW IT'S
CHANGED PEOPLE'S LIVES, AND SO
UNFORTUNATELY, AS WE'VE COMMENT,
A COUPLE OF TIMES WHEN COVID
CAME, IT HIT US AND WE REALLY
TAPPED INTO, UM, OUR HEALTH CARE
WORKERS. AND SO I WANNA JUST
THANK YOU ALL TODAY FOR COMING
BUT LOOK FORWARD TO THE REST OF
THE CONVERSATION. THANK YOU. AND
GET IT. I'LL MOVE ON TO MR JOHN
SAWYER. THE BOTTOM ONE. OK THANK
YOU. UH, I JUST WANTED TO
QUICKLY MAKE SURE THAT I
COMMEND, UM DOCTOR, GALLEY AND
OTHERS. UM BUT DURING THE
PANDEMIC UH, I REPRESENT SOUTH
CENTRAL LOS ANGELES. UM, AS YOU
KNOW, WE DON'T HAVE HOSPITALS.
LIKE ZERO NONE. AND WHEN THE
PANDEMIC HIT ALL RESOURCES WERE
GOING TO HOSPITALS. AND WHEN, UM
, MY COLLEAGUES AND I BROUGHT TO
UM, THE STATE'S ATTENTION THAT
THEY WEREN'T VACCINES GOING TO
SOUTH CENTRAL LOS ANGELES. THERE
WEREN'T TESTING GOING TO SOUTH
CENTRAL LOS ANGELES. UH FIRST
PEOPLE WERE SAYING THEY NEED TO
GO TO THEIR LOCAL HOSPITALS AND
SAID WELL THAT'S SOME OF THAT'S
NOT PRACTICAL. BUT ALSO THE
SEEK. HÌ W S¼. THEY WERE TO
TRUSTED MESSENGERS. THERE WERE
PEOPLE WHO WERE UNDOCUMENTED.
THEY WERE NOT GOING TO A
HOSPITAL. THEY WOULD GO TO A
CLINIC. I HAVE A PLETHORA OF
CLINICS IN SOUTH LOS ANGELES,
SOUTH CENTRAL LOS ANGELES AND
PEOPLE WERE GOING TO THEM EVERY
DAY EVERY WAY SEVEN DAYS A WEEK,
AND THAT THAT WAS THEIR THAT WAS
THEIR HEALTH CARE. PROFESSIONAL.
AND THEY TRUSTED THE èC HÌ W S¼
AND TO PROVIDE THAT, AND SO ONCE
WE GOT FUNDING FOR CLINICS,
WHICH WASN'T PROVIDED AT FIRST.
ONCE YOU GOT FUNDING I THINK OUR
NUMBERS STARTED TO GO DOWN AS
THE NUMBER OF PEOPLE WHO WERE
SUFFERING FROM COVID-19. AND IT
WAS BECAUSE WE RECOGNIZE WHERE
THERE WERE WHERE THE WHERE THERE
WAS A HOLE OR DEFICIENCY. WE
WERE MAKING THESE ASSUMPTIONS
THAT ALL PEOPLE COULD GO TO
KAISER AND CEDAR SINAI AND ALL
OF THESE WONDERFUL MEDICAL
CENTERS WHEN THAT WAS NOT THE
FACT AND I AND I WANNA THANK UH
THE STATE FOR RECOGNIZING THAT
AND, UH BE ABLE TO PROVIDE THAT
BECAUSE AT THE END OF THE DAY
WHEN IT COMES TO PEOPLE WITH
GOOD COMMUNICATION SKILLS WHEN
IT COMES TO PEOPLE WHO HAVE
INTERPERSONAL SKILLS DEALING
WITH PEOPLE, UM, SERVICE
COORDINATIONS, UM THE CAPACITY
TO BUILDING BUILDING SKILLS.
OUTREACH SKILLS BECAUSE THEY
OUTREACH TO THE COMMUNITY EVERY
DAY ANYWAY. UM PROFESSIONAL
SKILLS AND CONTACT EVALUATION
AND RESEARCH SKILLS. BUT MOST
IMPORTANT THEIR KNOWLEDGE BASE
THEY KNEW. PEOPLE. IN MY
DISTRICT, AND THEY KNEW WHAT IT
TOOK. TO GET THEM TO KIND OF
MEDICAL CARE THAT THEY NEEDED SO
THEY COULD PROTECT THEMSELVES
AND THEIR FAMILY. THERE WERE
PEOPLE WHO WOULDN'T GO OUT OF
THEIR HOME AND WOULDN'T LET
ANYBODY COME INTO THEIR HOME.
WITH THAT LEATHER èC HÌ W N.
SO I I'M GLAD THAT THAT WE
RECOGNIZE THAT AND WE RECOGNIZE
THAT EARLY THANK YOU, UH, I'LL
ASK A COUPLE QUESTIONS AND THAT
WE NEED TO WIND DOWN ON THIS
PORTION OF OUR HEARING TODAY,
AND I'LL IN THE FLOOR OVER TO MY
COLLEAGUE, DR WEBER. UH, I JUST
WANTED TO ONE ACKNOWLEDGE AND
REALLY APPRECIATE. UH UH. MISS
ALVAREZ FOR PUTTING THIS THE
CONTEXT OF WHAT THE INTENTION OF
HAVING COMMUNITY HEALTH WORKERS
BROUGHT AND REPRESENTATIVES ARE
WHICH IS TO REALLY BE ABLE TO
COMBAT THE DEEPLY ROOTED
SYSTEMIC INEQUITIES THAT HAVE
EXISTED FOR GENERATIONS,
CREATING THE KIND OF DISPARITIES
THAT WE HAVE, UH AND REALLY
BEING ABLE TO LIFT UP, UH,
CULTURAL PRACTICE THAT HAS MADE
A BIG DIFFERENCE FOR PEOPLE, UH,
BOTH LINGUISTICALLY AND WHEN
WE'RE KIND OF CONNECTED WITH
EXPERIENCE, UH TO INDIVIDUALS
AND COMMUNITIES FOR THEIR CARE,
UH, AND PART OF WHAT I SEE IS
HAPPENING, AND I'LL JUST KIND OF
OFFER A AN FOR ALL OF YOU TO
MAKE COMMENT ON THIS IS THAT,
UH, WE HAVE THIS WONDERFUL
OPPORTUNITY TO BE UH, COGNIZANT
OF THE SYSTEMIC INEQUITIES, BUT
WE'RE DOING THAT WITHIN THE
CONTEXT OF STATE INITIATIVES
THAT WERE QUITE FRANKLY ARE
GONNA AGENCIES ARE KIND OF I
DON'T KNOW. CULTURE WHATEVER IT
MIGHT BE, UH, THAT IS REALLY,
UNFORTUNATELY GROUNDED IN
SYSTEMIC INEQUITY, SO WHETHER
IT'S REIMBURSEMENTS, WHETHER
IT'S CONTRACTING VERSUS UH UH,
PROMOTING FULL TIME WORKERS, UH,
POSITIONS, WHETHER IT'S UH
ENSURING THAT WE HAVE AN
OPPORTUNITY TO FULLY ADDRESS AND
EMBRACE THIS KIND OF INTEGRATION
. WE'RE GOING TO RUN INTO
INCREDIBLE. UM I WILL SAY NICELY
IS STUMBLING BLOCKS. REALITY IS
FOR PEOPLE ON THE FRONT LINES.
INCREDIBLE BARRIERS. SO MY
QUESTION, REALLY, FOR ALL FOUR
OF YOU TO BE ABLE TO ADDRESS IS
WHAT ARE THE THINGS THAT WE NEED
TO DO? UH FROM A STATE LEVEL,
GIVEN YOUR EXPERIENCE TO REALLY
BE ABLE TO BE FOCUSED IN
ADDRESSING SOME OF THE SYSTEMIC
BARRIERS THAT ARE JUST INHERENT
TO AND TO OUR SYSTEM. AND WE GO
THIS WAY. AND WITH DR CARLEY
THANK YOU, UM WELL. FIRST OF
ALL, THANK YOU SO MUCH FOR
STATING THAT, AS WE THINK ABOUT
THE LASTING ROLE AND THE IMPACT
OF THE ROLE RIGHT. WE DO NEED TO
SYSTEMATIZE THE ROLE BUT TO YOUR
POINT WHEN WE SYSTEMATIZE WE'RE
ENTERING A SYSTEM THAT ALREADY
WASN'T CREATED FOR US OR BY US,
AND SO WE NEED TO BE EXTREMELY
INTENTIONAL TO THOSE BARRIERS TO
ENTRY, SO SOMETHING THAT
ADVOCATES TALK ABOUT RIGHT IN IN
OUR WORK IS MAKING SURE THAT WE
ARE THINKING ABOUT LANGUAGE
ACCESS, IMMIGRATION STATUS AND
BARRIERS TO EDUCATION, SO
CREATING MORE FLEXIBLE
GUIDELINES TO MAKE SURE THAT
COMMUNITY MEMBERS WHO MIGHT NOT
HAVE THE LEVEL OF INCOME OR
OPPORTUNITY TO GET HIGHER
EDUCATION TO INVEST IN A
CERTIFICATE PROGRAM ARE ABLE TO
ENTER THAT WORKFORCE AND FOR A
LOT OF OUR LOWER INCOME
COMMUNITY MEMBERS THAT MAKES A
HUGE DIFFERENCE AND SO BEING
VERY INTENTIONAL TO INCLUDE THAT
AND TRANSFORM THE SYSTEM THAT'S
CURRENTLY LEAVING A LOT OF US
OUT. THANK YOU. CHAIR BONTA FOR
THAT QUESTION AND BUILDING ON MY
COLLEAGUE'S COMMENTS. I THINK
IT'S IMPORTANT TO CONSIDER THE
ROLE OF CONSISTENT COMMUNITY
VOICE AND INPUT IN THE PROCESS
ALREADY WITH IMPLEMENTATION OF
THE CW BENEFIT, AS WELL AS THE
TRAINING OPPORTUNITIES THAT HÌ
èC, UH, WORK TO MOVE FORWARD,
THERE'S BEEN CHALLENGES BECAUSE
èC HÌ W PR S¼ HAVE NOT BEEN AT
THE TABLE IN A FORMAL WAY, AND
THAT'S FOR ANY NUMBER OF REASONS
. THE INTENTION MAY HAVE BEEN
THERE, BUT THE SPACE WAS NOT
CREATED. THERE WAS NÓ FORMAL
STRUCTURE FOR THAT. INPUT AND
COMMUNICATION. UM I CAN GIVE YOU
A COMPARISON. THE DOULA BENEFIT
THAT WE ARE EXCITED TO SEE MOVE
FORWARD, HAD A FORMAL
STAKEHOLDER WORK GROUP THAT
SHOWED MEANINGFUL PROGRESS IN
THE LAST COUPLE OF YEARS. IN
IMPLEMENTATION OF THAT BENEFIT.
IT'S STILL THE STORY TO BE TOLD
AS FAR AS IMPLEMENTATION AND ITS
SUCCESS, BUT IT HAD A FORMAL
WORK GROUP èC HÌ W PR S¼ DO NOT
HAVE THAT, AND THANKFULLY, THE
DEPARTMENT HAS OPENED MANY LINES
OF COMMUNICATION AND CREATED
MANY MEETINGS. BUT WHERE IS THE
OPPORTUNITY TO HAVE THAT FORMAL
CONNECTION TO THE EXPERTS? THESE
ARE THE FOLKS THAT KNOW HOW TO
GET THINGS DONE. THEY CAN SHARE
WHAT ARE THE CHALLENGES AT THE
LOCAL LEVEL? UH, THE INTENTION
IS THERE. HOW CAN WE MAKE SURE
THAT THE IMPACT IS SUCCESSFUL?
AND WHAT WE NEED TO DO IS REALLY
CENTER THE EXPERIENCES OF THESE
PEOPLE AND GIVE THEM THE
FORMALITY. THE VALIDATION THAT
THERE ARE EXPERTS. THEY ARE
LEADERS AND THAT THEY SHOULD BE
TREATED AS SUCH IN OUR SYSTEM.
THANK YOU SO MUCH FOR THE
QUESTION. CHAIR. BONTA, UM SO I
THINK ONE OF EXTREMELY IMPORTANT
THING IS THAT WE NEED TO BE
CAUTIOUS NOT TO CREATE POVERTY
JOBS WE'VE TALKED ABOUT HOW
IMPORTANT THESE ROLES ARE. UM
AND WE NEED TO THINK ABOUT WHAT
IS DRIVING THE WAGES THAT
SUPPORT THIS WORKFORCE. UM AS
CIA SAID, THESE ARE
PREDOMINANTLY LATINAS WHO, UM,
ARE FROM THE COMMUNITY AND
ROOTED IN THE COMMUNITY. AND SO
WE NEED TO MAKE SURE THAT THEY
AND THEIR FAMILIES CAN, UH, CAN
THRIVE. THEIR HEALTH AND WELL
BEING, UM, WHILE THEY ARE
SUPPORTING OTHERS AND THRIVING
UM, I WOULD SAY ALSO SO MUCH OF
OUR ATTENTION HAS FOCUSED ON
SORT OF THE SUPPORT OF THE èC B
S¼ AND ENTITIES THAT, UM, ARE
SUPPORTING AND TRAINING AND
HIRING. UH, èC HÌ W S¼, AND
THAT DEFINITELY NEEDS TO
CONTINUE. I THINK IT'S ALSO
IMPORTANT THAT WE SUPPORT OUR
MANAGED CARE PLANS, OUR HEALTH
CARE SYSTEMS AND OTHERS IN TRULY
UNDERSTANDING WHAT THIS
WORKFORCE IS ABOUT, SO THAT THEY
CAN BE SUPPORTED WELL IN THEIR
JOBS AND AGAIN THRIVE IN THEIR
LIVES, BUT ALSO IN THEIR ROLES.
AND THEN I WOULD SORT OF ECHO
YOUR COMMENTS ABOUT INVESTMENT
IN TRAINING. I THINK WE NEED TO
CONTINUE TO INVEST IN TRAINING
PROGRAMS. IF WE TRULY WANT TO
SUPPORT THIS WORKFORCE, IT'S NOT
JUST ABOUT INITIAL TRAINING.
IT'S ABOUT ONGOING TRAINING THAT
IS AFFORDABLE, ACCESSIBLE. UM
AND THAT IS GONNA HELP THEM
ADVANCE IN THEIR ROLES. THANK
YOU. UH I THINK THIS IS THE
CRITICAL QUESTION. CAN WE
ACTUALLY DO THIS? IN A WAY THAT
IS AUTHENTIC AND LIFTS UP THE
VOICE OF THOSE WHO ARE THE
EXPERTS AND I WILL SAY THAT A
FEW MONTHS AGO, UH WE WERE
CLEARLY NOT ON THAT ROAD TO
DOING IT. I THINK THE COMMENTS
OF MS ALVAREZ WERE SPOT ON. UH,
DESPITE INTENT TO GET THERE. WE
WEREN'T UM, SINCE THAT POINT, I
THINK THROUGH SOME INSISTENCE IN
WORKING WITHIN OUR OWN
GOVERNMENT STRUCTURES AND
WORKING WITH THE COMMUNITY,
WE'VE CREATED SOME MORE SPACE TO
DO THIS. IT'S A START. IT HAS TO
CONTINUE. IT CAN'T SORT OF REST
WHEN THE FIRST TASK IS COMPLETED
. I THINK IT REALLY DOES HAVE TO
BE HAND IN HAND WORK AND ONE OF
THE THINGS I'M REALLY PROUD OF
BOTH HÌ Kò AND Dð HÌ èC S¼ OVER
THE LAST YEAR OR TWO IS REALLY
CREATING THE MUSCLE MEMORY OF
HOW TO DO THIS KIND OF
ENGAGEMENT ON A NUMBER OF ISSUES
. YOU KNOW, WE HEAR A LITTLE BIT
ABOUT THE PROCESS AROUND THE
DUAL BENEFIT, BRINGING A SIMILAR
APPROACH WHERE IT'S A LOT OF
LISTENING. WE'RE INVITING THE
RIGHT PEOPLE INTO THE ROOM AND A
LOT OF PEOPLE INTO THE ROOM. SO
I HOPE THAT THAT WILL BE ONE WAY
TO PROTECT AGAINST US TURNING
THIS INTO A SORT OF BUREAUCRATIC
BENEFIT THAT DOESN'T ADVANCE THE
TRUE BENEFITS OF THE LAW, WHICH
I THINK THE OTHER PANELISTS
HIGHLIGHTED SO VIVIDLY
INACCURATELY SO UH, I WOULD SAY
THAT WE NEED TO BE HELD
ACCOUNTABLE TO DO THAT. WELL UH
AND THERE'S WAYS TO DO THAT THAT
WE KNOW AND THERE'S OTHER WAYS
THAT I HOPE YOU'LL PUSH US ON IN
THE FUTURE. BUT I THINK THAT'S
REALLY WHAT'S GONNA MATTER. AND
YES, IT HAS TO DO WITH. UM HOW
DO WE STRUCTURE THIS ENTIRE
BENEFIT AND PROGRAM IN A
THOUGHTFUL WAY, BUT ULTIMATELY
ARE WE MOVING THE NEEDLE ON
HEALTH THROUGH THE ROLES AND
RESPONSIBILITIES OF èC HÌ W PR
S¼ IN THE WAY THAT WE WOULD
EXPECT THE HEALTH CARE DELIVERY
SYSTEM AND OUR PUBLIC HEALTH
SYSTEMS TO DO, UM, IN A HIGH
QUALITY WAY. WELL, THANK YOU,
DOCTOR. KLI THANK YOU TO ALL OF
OUR PANELISTS. UH, FOR YOUR
INSIGHTS, WE'RE GOING TO MOVE
NOW TO OUR SECOND PANEL. REALLY
APPRECIATE YOUR, UH TIME AND
COMMITMENT TO HELPING TO RAISE
THIS ISSUE AND WITH THAT, WHILE
OUR SECOND PANEL IS MOVING UP,
I'M GOING TO PASS THE MIC OVER
TO, UH, MY COLLEAGUE, DOCTOR
WEBER. WELL, THANK YOU. CHAIR
BONTE, AND I DO APOLOGIZE TO
EVERYONE FOR BEING A LITTLE
TARDY AND MISSING THE FIRST
PANEL. I HAD A FEW BILLS OF MY
OWN THAT I HAD TO PRESENT IN
ANOTHER COMMITTEE. UM AND AS THE
SECOND PANEL IS COMING UP, I
JUST KIND OF WANNA ECHO
SOMETHING THAT DR GOLLY JUST
SAID, WHICH IS, YOU KNOW, WITH
THIS PROGRAM WITH THE CREATION
WITH THE, UH, DESIGN. WE WANNA
MAKE SURE THAT WE ARE MOVING THE
NEEDLE, UH, WITH A LOT OF THE
HEALTH DISPARITIES THAT WE'RE
SEEING HERE. UNFORTUNATELY HERE
IN CALIFORNIA, AND SO AS THESE
PROGRAMS ARE DESIGNED, UH,
REALLY WANT PEOPLE TO KEEP THAT
IN MIND THAT WE WANT THESE
INDIVIDUALS TO BE ABLE TO DO THE
BEST THAT THEY CAN, UH, TO
IMPROVE THE DISPARITIES AND IN
ORDER TO DO THAT WE HAVE TO LOOK
TO SEE WHERE THE DISPARITIES
OCCUR, ARE OCCURRING AND ENSURE
THAT WE ARE GETTING, UH,
COMMUNITY WORKERS FROM THOSE
COMMUNITIES TO ACTUALLY BE ABLE
TO GO AND IMPROVE MATERNAL.
MORBIDITY OUTCOMES IMPROVE, UH,
OUR RATES OF DIABETES AND STROKE
AND THINGS LIKE THAT, AND SO NOT
JUST KIND OF LOOKING AT WHO
LIVES IN CALIFORNIA BUT ALSO
LOOKING TO SEE WHO IS THE
SICKEST UH, AND WHAT GAPS WE
NEED TO CLOSE AS FAR AS OUR
HEALTH CARE DISPARITIES WHEN
WE'RE LOOKING AT THIS PROGRAM,
SO OUR NEXT PANEL IS ON
STAKEHOLDERS, PERSPECTIVE,
SUCCESSES, CHALLENGES AND
OPPORTUNITIES. AND WE WILL HEAR
FROM THE FOLLOWING SPEAKERS. UH,
WE WILL HEAR FROM MARIA LEMUS,
THE EXECUTIVE DIRECTOR OF
VISION, Y COMPROMISO. KATIE
ANDREW, DIRECTOR OF GOVERNMENT
AFFAIRS, QUALITY AND BEHAVIORAL
HEALTH, LOCAL HEALTH PLANS OF
CALIFORNIA. ALEX. CORRADO EX
FERRAO, EXECUTIVE DIRECTOR FOR
EL SOL NEIGHBORHOOD EDUCATIONAL
CENTER. DENITA HUDSON, PROGRAM
DIRECTOR FOR ALAMEDA COUNTY
HEALTH COACH PROGRAM. FROM
ALAMEDA COUNTY HEALTHCARE
SERVICE AGENCY DOCTOR DU QUAT,
PRESIDENT ASIAN HEALTH SERVICES
ON BEHALF OF CALIFORNIA PRIMARY
CARE ASSOCIATION DOCTOR MARK LAB
CHIEF EXECUTIVE OFFICER FOR
CALIFORNIA RURAL INDIAN HEALTH
BOARD, AND ANDREA MACKIE, SENIOR
POLICY MANAGER AND LEAD èC WP
SLASH P SLASH R COALITION
CALIFORNIA PAN ETHNIC HEALTH
NETWORK AND WE WILL BEGIN WITH
MARIA LIMAS. THANK YOU. THANK
YOU. YOU VERY MUCH. MADAM CHAIR.
IT'S A PLEASURE TO BE HERE AND
TO PRESENT BEFORE ALL OF YOU. UM
MY NAME IS MARIA LEMOS AND I'M
FOUNDING EXECUTIVE DIRECTOR OF
VISION AND COMPROMISO. I'M A
PROMOTORA. MY GRANDMOTHER WAS A
PROMOTORA. MY MOTHER WAS A
PROMOTORA MY TIA MY, YOU NAME
IT. MY WHIM. THE WOMEN IN MY
FAMILY WERE PROM TOAS. AS MANY
OF YOU MAY HAVE A PROM. PERSON
WITH ESPIRITO SERVICIO IN YOUR
FAMILY. IT'S NOT A NEW CONCEPT.
IT EXISTS IN EVERY COMMUNITY.
WHETHER WE'RE AFRICAN AMERICAN.
WE'RE EUROPEAN. WE'RE LATINOS.
WHATEVER THERE IS SOMEBODY IN
YOUR FAMILY WHO HAS THAT SPIRIT
OF SERVICE WHO'S ALWAYS HELPING
24 YEARS AGO, WE CAME TOGETHER
AT A CONFERENCE WHERE I MET
OTHER PROMOTORS. BEFORE THEN WE
WERE ALL SCATTERED. WE WERE
KNOWN AS AS COWS. WE WEREN'T
COMMUNITY HEALTH OUTREACH
WORKERS. WE WERE KNOWN AS UM,
UNDER DIFFERENT TITLES. THE 24
YEARS AGO, WE HAD THE
OPPORTUNITY TO COME TOGETHER AND
WE FOUND EACH OTHER. WE FOUND
LIKE-MINDED, MOSTLY WOMEN. AND
THOSE WOMEN ABOUT 100 OF US. LED
BY FIVE OF US IS WHERE WHO
FORMED THE NETWORK OF PROMOTORS
AND COMMUNITY HEALTH WORKERS.
LARE PROMOTORA. WE STARTED TO
MEET FIVE WOMEN TURNED INTO 100
TURNED INTO 200. NOW WE'RE
THOUSANDS ACROSS CALIFORNIA AND
ACROSS THE NATION IN 15 STATES.
IT'S NOT A IT'S NOT A MIRACLE
THAT THIS EXISTS. WE FOUND A
SPACE WHERE WE COULD COME
TOGETHER. WE COULD LEARN, SHARE
AND BUILD COMMUNITY. IT IS AT
THE REQUEST OF THOSE PROMOTORS
THAT THE VISION IN COMPROMISO
WAS FORMED. AND IT IS THE
REQUEST OF THOSE PROMOTORS THAT
WE CONTINUE TO TRAIN, PROVIDE
LEADERSHIP AND ADVOCACY, INFORM
AND EDUCATE OUR COMMUNITIES.
THOSE PRINCIPLES 24 YEARS AGO
STILL HOLDS TRUE. WHERE THE
CONVENOR OF THE NATIONAL NETWORK
OF PROMOTORS THAT INCLUDES 15
STATES, OUR COALITION LÀ LIANA
OF COMMUNITY BASED ORGANIZATIONS
WHO HAVE BEEN AROUND LONGER THAN
I HAVE, AND VISION, AND
COMPROMISO HAS 24 YEARS THERE
ARE MANY ORGANIZATIONS HAVE BEEN
DOING THIS WORK MUCH LONGER AND
GO UNRECOGNIZED THEIR SMALL AND
MEDIUM SIZED ORGANIZATIONS
ACROSS CALIFORNIA AND ACROSS THE
UNITED STATES. AND THEY HAVE A
LONG HISTORY OF TRAINING, HIRING
AND SUPPORTING PERMA TOAS. IN
2009 WE SOON COMPROMISO WAS
ACKNOWLEDGED BY THE CALIFORNIA
ASSEMBLY WITH THE RESOLUTION FOR
ITS PARTNERSHIP WITH THE PROMO
COMMUNITY HEALTH WORKER
WORKFORCE. FOR ITS UNIQUE
UNDERSTANDING OF COMMUNITY
ISSUES, AND IT IS POSITIONED TO
ADDRESS THE ONGOING EVER
CHANGING SOCIAL AND
ENVIRONMENTAL DETERMINANTS OF
HEALTH AND COMMUNITY WELL BEING.
I WAS A THAT WAS A BENCHMARK FOR
US IN 2009. IT ALSO ESTABLISHED
OCTOBER AS PROMO THURMAN. TO
WHICH WE CELEBRATE EACH YEAR.
TODAY, PROMOTOR AND COMMUNITY
HEALTH WORKERS AND COMMUNITY
LEADERS ARE RECOGNIZED AS
ESSENTIAL WORKERS. ARE NOT
STAKEHOLDERS OR ESSENTIAL
WORKERS. WE ARE THE CORE OF THE
CONVERSATION. WE ARE THE BRIDGE.
WE ARE THE COMMUNITY SOLUTION.
WE HAVE SHOWN THAT YEAR AFTER
YEAR AFTER YEAR AND PROBABLY
HIGHLIGHTED DURING THE COVID
PANDEMIC. AS WE AS WAS REFERRED
TO EARLIER WHO WOULD GO INTO THE
FIELDS WHO WOULD GO INTO OUR
NEIGHBORHOODS? IT WAS PROMOTORS
IN COMMUNITY HEALTH WORKERS
WITHOUT WITHOUT A CARE THAT FOR
THEIR OWN SAFETY, THEY WERE
THERE. EVEN THOUGH THEY COULDN'T
GET VACCINATED BECAUSE THEY
WEREN'T RECOGNIZED AS COMMUNITY
HEALTH WORKERS FROM TOAS
AFFILIATED WITH èC B Ó S¼ HAD
A DIFFICULT TIME YET THEY WERE
THERE THEY WERE THE FIRST ONES.
AND THE LAST ONES, FIRST ONE TO
BE THERE AND LAST ONES TO LEAVE.
CHANGING TODAY WE SPEAK OF AN
OPPORTUNITY THAT WILL IMPACT
MANY COMMUNITIES, AGENCIES AND
AGENCIES. CHANGING OUR MEDICAL
PROGRAM IS A BIG LIFT. AND WE
APPLAUD THE STATE FOR
INTENTIONALLY BRINGING THE
VOICES OF COMMUNITY BASED
ORGANIZATIONS AND INDIVIDUALS.
TO SHAPE THIS WORK. ON BEHALF OF
THOUSANDS A PROMOTOR IN
CALIFORNIA AND THE PARTNERS OF A
LAZA SERVING OUR PREDOMINANTLY
IMMIGRANT RESIDENTS. I WOULD
LIKE TO SHARE THREE REFLECTIONS
AND ONE RECOMMENDATION. ENGAGING
THE COMMUNITY AND STATEWIDE
POLICY DECISIONS IS COMPLICATED,
TAKES TIME. WE WANT THIS
POLICIES TO BE EFFECTIVE. WE
HAVE TO INVOLVE THOSE WHO ARE
MOST IMPACTED. DOING SO WILL
OPENNESS AND CULTURAL HUMILITY,
BRINGS TRUST AND WILL LEAD TO
BETTER WORKING RELATIONSHIPS IN
THE LONG RUN. LOOK TO THE
EXPERTS. COMMUNITY BASED
ORGANIZATIONS HAVE BEEN DOING
THIS WORK. WELL, 30 YEARS AND
MORE LOOK TO THE EXPERTS.
BUSINESS AS USUAL WON'T WORK. IF
WE WEREN'T OUR CARE SYSTEM TO
CHANGE. WE HAVE TO CHANGE HOW WE
APPROACH OUR WORK. THE MEDICAL
PROGRAM IS INVESTING IN PROMO
TOAS BECAUSE IT'S A SYSTEM THAT
WORKS. THE MEDICAL PROGRAM
SHOULD CHANGE TO MEET COMMUNITY
NEEDS, NOT THE OTHER WAY AROUND.
WE TALKED EARLIER, IT WAS
MENTIONED ABOUT HOW THE SYSTEM
HAS BEEN AROUND FOR A LONG TIME.
AS A FORMER STATE WORKER. IN A
RECOVERING STATE WORKER. I THINK
THAT IT TAKES TIME TO CHANGE. IT
TAKES TIME TO MOVE YOUR
PERSPECTIVE THAT YOU'RE THE ONE
WHO KNOWS WHAT WHAT IS BEST FOR
THE COMMUNITY. TOOK TIME FOR ME
TO CHANGE MY PERSPECTIVE AND TO
BECOME TO BE HUMBLED ENOUGH. TO
KNOW THAT I DON'T KNOW ANYTHING,
AND I IN THE COMMUNITY FRAMEWORK
THE STATE IS NOT THE EXPERT. THE
COMMUNITY IS THE EXPERT SO WE
SHOULD LOOK TO THE COMMUNITY
MEMBERS. THE WORK OF PROMO TOAS
GOES BEYOND SURFACES COVERED IN
THE NEW BENEFIT. BEING A
PROMOTORA IS VALUED AND AN
IMPORTANT CAREER, WHETHER IT IS
A STEP ON A LONGER JOURNEY ON A
LONGER JOURNEY JOURNEY OR IF IT
IS A VOLUNTEER. IN VISION AND
COMPROMISO. WE SAY THAT A
PROMOTOR CAN BECAUSE OF OUR
CURRICULA AND OUR TRAININGS AND
OUR LEADERSHIP. A PROMOTORA CAN
BE THE BEST PROMOTORA VOLUNTEER
PROMOTORA THEY WANT TO BE OR
THEY CAN APPLY FOR A JOB. THEY
CAN BRING INCOME INTO THE
FAMILY. THE LARGEST IMPACT, THE
LARGEST ISSUE THAT CAN IMPACT
THE FAMILIES. WELL BEING IS A
JOB. YOU CAN BUY WITH MONEY. YOU
CAN BUY FOOD YOU CAN
TRANSPORTATION HOUSING, BUT IF
WE DON'T ALLOW THAT OPPORTUNITY
FOR PROMOTORS, WHO MAY NOT FIT
THE TRADITIONAL MOLD. I DO WANT
TO SPEAK TO ONE THING ABOUT THE
COMMUNITY COLLEGES? WELL, IT IT
IS A GOOD AVENUE. MOST OF OUR
COMMUNITY MEMBERS DON'T AREN'T
ABLE TO ATTEND A COMMUNITY
COLLEGE. THERE ISN'T ONE NEARBY,
WHERE THEY DON'T HAVE THE FUNDS
TO APPLY. OR THE LITERACY RATE
IS AN ISSUE. WE KNOW BY EXAMPLE,
THAT VISION PROMIS BRINGS IN A
PROMO MAYBE YESTERDAY WAS IN THE
FIELDS. THEY MAY NOT HAVE A HIGH
SCHOOL DEGREE, AND THEY MAY NOT
HAVE 100% ENGLISH, BUT THEY ARE
THE PERSON THAT YOU WANT,
BECAUSE THEY ARE IN THE
COMMUNITY. THEY CAN REACH THE
PEOPLE THAT YOU WANT TO REACH,
AND THEY ARE AS SMART AS HECK.
MY MOTHER DIDN'T SPEAK ENGLISH
TILL THE DAY SHE DIED. AND IF
YOU WERE TO PUT A JOB
DESCRIPTION OUT THAT SAID MUST
HAVE A HIGH SCHOOL DEGREE. SPEAK
ENGLISH. YOU WOULD NOT GET MY
MOTHER. YOU WOULD PROBABLY GET
AS WE HAVE GOTTEN BEFORE. AN
ENGLISH SPEAKING NON LATINA. AND
THAT THAT DEFEATS THE PURPOSE.
SO HOW DO WE BRING THOSE PEOPLE
IN? LATINOS HAVE A HIGH
ATTRITION RATE IN HIGH SCHOOL.
WELL HOW DO WE BRING THOSE
PEOPLE IN OFFER THIS AS AN
OPPORTUNITY TO TALK ABOUT
WORKFORCE? WE'VE BEEN WRITING
ABOUT WORKFORCE FOR PROBABLY 10
YEARS. NOW OPEN THE DOORS LOOK
AT A DIFFERENT WAY. IT DOESN'T
HAVE TO BE THE WAY THAT IT HAS
BEEN. FOREVER. UM THE
COMPENSATION MUST REFLECT THE
VALUE THEY BRING TO THE
COMMUNITIES AND TO OUR HEALTH
CARE SYSTEM. THIS IS ALSO A
WOMAN'S EQUITY ISSUE. MOST
PROMOTORS ARE WOMEN. MOST
ACCORDING TO OUR DATA ARE
BETWEEN 35 AND 50. THE HEAD OF
HOUSEHOLD OR THEY BRING INCOME
INTO THE HOUSEHOLD. WE WANT
EQUITY AND PAY. WE WANT, UM,
COMPENSATION FAIR COMPENSATION.
BENEFITS AND RETIREMENT. DO YOU
KNOW THAT MOST DO NOT EVEN GET
BENEFITS? THE HISTORICALLY THEY
WOULD DO IT FOR FREE. OR THEY
WOULD GET A BUS. UH, A CARD.
GIFT CARD. IT'S AN INEQUITABLE
SITUATION. MEDIC MEDICAL IS ALSO
NOT THE ANSWER TO SUSTAINABILITY
. THERE HAS TO BE OTHER
RESOURCES. BECAUSE MOST
COMMUNITY BASED ORGANIZATIONS
WHO PROMOTE THEIR AFFILIATED
WITH ARE NOT MEDICAL PROVIDERS.
SO WHILE IT IS A PATH, IT HAS TO
BE OTHER WAYS, AND WE THINK THAT
BY OPENING UP THIS OPPORTUNITY
IN ALL DEPARTMENTS WHETHER THEIR
MEDICAL THERE'S A MEDICAL STREAM
OR NOT, IS A WAY TO OPEN
EMPLOYMENT OPPORTUNITIES AND
FUNDING FOR èC B Ó. SO THE èC
B Ó S¼ CAN HIRE ROMO TOAS. AND
MOST OF MOST IMPORTANTLY, ROMA
TORA SHOULD BE PART OF THE
DISCUSSION. THEY SHOULD SIT AT
THE TABLE. THEY SHOULD BE OUT
AND THEIR ORGANIZATIONS THE ONES
WHO'VE BEEN, UH SUPPORTING PROMO
TORA FOR 2025 30 YEARS WHO ARE
THE EXPERTS IN THE FIELD SHOULD
BE REPRESENTED IN REPRESENTED IN
THIS DISCUSSION. THIS IS OUR
CHANCE TO BUILD A SUSTAINABLE
SYSTEM OF COMMUNITY BASED CARE
AND SUPPORT THAT HAS BEEN PROVEN
EFFECTIVE OVER THE DECADES. WE
RECOMMEND THAT THERE BE A
STANDING WORK GROUP FOR AT LEAST
THE FIRST YEAR. OF THE BENEFIT
ROLL OUT TO ENSURE THAT
COMMUNITY INPUT CONTINUES TO BE
CENTRAL TO THIS WORK. THIS IS
SIMILAR TO THE DOULA BENEFIT
THAT WAS MENTIONED EARLIER.
CREATING A BENEFIT AND WORKFORCE
INFRASTRUCTURE BUILT BY AND FOR
COMMUNITIES IS EQUITY IN ACTION.
WE'RE EXCITED TO BE
PARTICIPATING IN THIS EFFORT,
AND WE ENCOURAGE YOU TO LOOK TO
TOWARDS THE EXPERTS IN THE
FIELD. UM WE ARE SPONSORING A B
3149 BY ASSEMBLY MEMBER EDUARDO
GARCIA WOULD ESTABLISH A PROTO
ADVISORY COMMITTEE AT THE HÌ èC
S¼ SIMILAR TO THE DUAL ADVISORY
COMMITTEE. WE ENCOURAGE YOU TO
LOOK AT THAT AS AN OPTION AND
ALSO TO LOOK AT THE AND THE
PROMOTORA AS AS MULTICULTURAL.
DON'T LOOK AT IT JUST AS A
LATINA THING, A LATINO THING. IT
IS THE HEART OF SERVICES AND
EVERYONE THIS SOLUTION THE
COMMUNITY HEALTH WORKER. THE
PROMOTOR IS THE SOLUTION IN OUR
COMMUNITIES. WE SHOULD SUPPORT
IT EVERYWHERE WE CAN. THANK YOU
VERY MUCH. THANK YOU. THANK YOU.
UH, WE WILL NEXT HEAR FROM, UH,
KATIE ANDREW, AND I JUST WANNA
REMIND EVERYONE TO PLEASE TRY
TO, UH, STICK TO YOUR ALLOTTED
TIME. THANK YOU. GOOD AFTERNOON,
MADAM CHAIRS AND DISTINGUISHED
MEMBERS. MY NAME IS KATIE ANDREW
AND I AM HERE ON BEHALF OF THE
LOCAL HEALTH PLANS OF CALIFORNIA
, WHICH REPRESENTS 17. MISSION
DRIVEN NOT FOR PROFIT COMMUNITY
BASED LOCALLY GOVERNED PLANS
THAT DELIVER EQUITABLE AND
ACCESSIBLE HEALTH CARE TO OVER
70% OF THE 15 MILLION MEDI
MEMBERS THROUGHOUT THE STATE OF
CALIFORNIA. LOCAL PLANS ARE VERY
SUPPORTIVE OF THE COMMUNITY
HEALTH WORKER BENEFIT IN ME
VIEWING èC HÌ W S¼ AS A
COMMUNITY EMBEDDED IN EXTENSION
OF THE BROADER HEALTH CARE TEAM
THAT REFLECTS THE DIVERSITY OF
THE COMMUNITIES THAT THEY SERVE.
PRIOR TO THE LAUNCH OF THE
BENEFIT. LOCAL PLANS UNDERSTOOD
THE IMPORTANCE OF èC W SERVICES
AND SUPPORTED THE EDUCATION AND
TRAINING OF THE èC HÌ W
WORKFORCE AND DIRECTLY EMPLOYED
CWS TO SUPPORT CARE
COORDINATIONS AS ONE EXAMPLE.
LOCAL PLANS UNDERSTAND THAT CWS
ARE COMMUNITY MEMBERS AND
TRUSTED SOURCES OF INFORMATION,
ALLOWING THEM TO REACH AND
CONNECT WITH ME MEMBERS IN WAYS
THAT HEALTH PLANS AND PROVIDERS
OFTEN CANNOT. THEY CAN MEET
MEDICAL MEMBERS WHERE THEY ARE
TO PROVIDE CULTURALLY AND
LINGUISTICALLY APPROPRIATE
HEALTH, EDUCATION, ASSESS NEEDS
AND NAVIGATE MEMBERS TO THE CARE
THAT THEY NEED. SINCE CHW
SERVICES HAVE BECOME A MEDICAL
COVERED BENEFIT, AND KNOWING THE
VALUE THAT èC HÌ W SERVICES CAN
PROVIDE TO THE MEMBERS. LOCAL
PLANS HAVE BEEN ENGAGING WITH
èC HÌ, W S¼ AND èC B S¼ IN THE
COMMUNITIES THAT THEY SERVE TO
DEVELOP A ROBUST èC HÌ W
NETWORK. WHILE LOCAL PLANS ARE
DRIVEN TO ENSURE THEIR MEMBERS
HAVE ACCESS TO èC HÌ W
SERVICES. THERE HAVE BEEN A
NUMBER OF CHALLENGES SINCE THE
BENEFIT WENT LIVE IN JULY OF
2022 THAT ARE CONTRIBUTING TO A
SLOW UPTAKE IN èC HÌ W
SERVICES. ONE CHALLENGE IS THERE
IS A GENERAL LACK OF FAMILIARITY
AMONGST PROVIDERS AND èC B Ó
S¼ OF THE BENEFIT THE SERVICES
COVERED WITHIN THE BENEFIT AND
HOW TO UTILIZE THEM TO ADDRESS
THIS LOCAL PLANS HAVE UNDERTAKEN
SEVERAL EFFORTS TO SOCIALIZE THE
BENEFIT AMONGST PROVIDERS AND
èC B S¼ ALIKE, INCLUDING
DELIVERING TRAINING AND SENDING
OUT COMMUNICATIONS TO PROVIDERS
TO HELP THEM UNDERSTAND THAT èC
HÌ W SERVICES IS A COVERED
BENEFIT UNDER ME AND HOW THEY
CAN REFER THEIR PATIENTS TO
SERVICES. PROVIDING INFORMATION
TO èC B S¼ TO HELP THEM LEARN
ABOUT HOW THE èC HÌ W BENEFIT
IS CONSTRUCTED THE RULES AND
PARAMETERS OF THE BENEFIT AND
HOW TO BECOME A CONTRACTED
PROVIDER WITH LOCAL PLANS.
ADDITIONALLY SOME PLANS ARE
UTILIZING IN HOUSE èC HÌ L BE
USED TO BUILD RELATIONSHIPS WITH
LOCAL èC B S¼ TO PROMOTE èC HÌ
W SERVICES AND ENCOURAGE MEMBER
CONNECTIONS FROM LOCAL
PROVIDERS. FOLLOWING THE
IMPLEMENTATION OF èC HÌ W
SERVICES, MEDICAL BENEFIT THE
DEPARTMENT OF HEALTH CARE ACCESS
AND INFORMATION BEGAN A
STAKEHOLDER ENGAGEMENT PROCESS,
DEVELOP GUIDANCE AND
REQUIREMENTS FOR èC HÌ W
CERTIFICATE PROGRAM, WHICH WAS
PAUSED IN NOVEMBER OF 2023. AS
EACH Kò CONTINUES TO CONDUCT
STAKEHOLDER DIALOGUE SESSIONS ON
èC HÌ W CERTIFICATION, MANY
LOCAL PLANS HAVE FORGED AHEAD,
TAKING THE INITIATIVE TO
IMPLEMENT EFFORTS AND BUILD
PARTNERSHIPS TO TRAIN AND
CERTIFY èC HÌ W S¼ OFTEN
INCENTIVIZING CANDIDATES THROUGH
NÓ COST PROGRAMS OR
CERTIFICATION, STENS AND
SCHOLARSHIPS. SOME LOCAL PLANS
ARE ALSO WORKING TO LAUNCH èC
HÌ W PLACEMENT PROGRAMS AND OR
OFFER SALARY STIPENDS TO ENTICE
POTENTIAL SUPERVISING PROVIDERS
WHO MAY NOT WHO MAY BE HESITANT
TO EMPLOY èC HÌ W S¼ OUT OF
CONCERNS AROUND SUSTAINABILITY.
AS AN EXAMPLE OF THIS WORK. ONE
LOCAL PLAN IS ABOUT TO ISSUE A
$1.4 MILLION GRANT THROUGH THEIR
COMMUNITY REINVESTMENT FUND TO
INCREASE THE AVAILABILITY OF èC
HÌ W CERTIFICATION PROGRAMS
THROUGH A PARTNERSHIP WITH
CALIFORNIA STATE UNIVERSITY. THE
èC HÌ W TRAINING GRANT WILL
FOCUS ON CERTIFYING 270
COMMUNITY MEMBERS IN THE PLANNED
SERVICE AREAS THROUGH THREE YEAR
TRAINING GRANTS. AN ADDITIONAL
$7 MILLION GRANT WILL SUPPORT
THE RECRUITMENT OF èC HÌ W S¼,
INCLUDING ONE YEAR SALARY AND
BENEFITS COSTS. LOCAL PLANS HAVE
ALSO EXPERIENCED ADDITIONAL
CHALLENGES ENGAGING WITH èC B
S¼, WHO HISTORICALLY HAVE NOT
CONTRACTED WITH MANAGED CARE
PLANS, AND YOU HAVE LIMITED
KNOWLEDGE AND EXPERIENCE WITH
ME, INCLUDING PROV, UH, PROVIDER
ENROLLMENT. BILLING CLAIMS AND
OTHER PROCESSES. YOU NEED TO
MANAGE CARE PLANS TO ASSIST MANY
LOCAL PLANS HAVE INVESTED
SIGNIFICANT TIME AND RESOURCES
TO BUILD RELATIONSHIPS WITH
THESE ORGANIZATIONS AND THEIR
LEADERSHIP AND PROVIDE BOOTS ON
THE GROUND SUPPORT THROUGH
TRAINING AND TECHNICAL
ASSISTANCE FROM CONTRACTING
THROUGH CLAIMS SUBMISSION. THERE
IS ALSO THE CHALLENGE OF
LOWERING AND REIMBURSEMENT RATES
, WHICH HAS LED SOME CBOS TO
CONCLUDE THAT THE RATES DO NOT
ALIGN WITH THE ADMINISTRATIVE
REQUIREMENTS OF BEING A MEDICAL
PROVIDER. UM AND AMONGST èC HÌ
W S¼. THERE IS A NEED FOR
ADDITIONAL SUPPORT AND TECHNICAL
ASSISTANCE AROUND REQUIREMENTS
FOR BECOMING A MEDICAL PROVIDER.
AS AN EXAMPLE, SOME CONFUSION
REGARDING THE PROVIDER
APPLICATION AND VALIDATION FOR
ENROLLMENT OR PAY PATHWAY HAS
BUBBLED UP FOR SOME èC, B S¼
AND LOCAL HEALTH JURISDICTIONS.
FOR WHOM THESE NEW THESE ARE NEW
PROCESSES. ADDITIONALLY FOR SOME
CPOS THAT MAY EMPLOY
UNDOCUMENTED èC HÌ W S¼.
THERE'S HESITANCY TO ENROLL AS A
MEDICAL PROVIDER BORN OUT OF UM,
DISTRESSED OF GOVERNMENT
ENTITIES AND AN INSTINCT TO
PROTECT THEIR EMPLOYEES
INFORMATION FROM GOVERNMENT
SYSTEMS. STREAMLINING ENROLLMENT
PROCESSES, ADMINISTRATIVE
REQUIREMENTS AND REINFORCING HOW
THE STATE WILL PROTECT THOSE WHO
ARE UNDOCUMENTED WILL HELP TO
ALLEVIATE MANY PERCEIVED BURDENS
OR HESITANCY TO PROVIDE SERVICES
UNDER THE MEDICAL BENEFIT.
LASTLY WHILE FEDERALLY QUALIFIED
HEALTH CENTERS IN RURAL HEALTH
CLINICS HAVE LONG HIRED AND
UTILIZED CWS FOR THEIR SERVICES.
RESTRICTIONS FOR FQ HÌ, èC S¼
AND R HÌ èC S¼ UNDER THE èC HÌ
W MEDICAL BENEFIT IMPEDES THESE
CLINICS FROM LEVERAGING THE
BENEFIT TO INCREASE èC HÌ W
CAPACITY AND THEREFORE GROW A
STATEWIDE èC HÌ W NETWORK FQ HÌ
èC S¼, WHO ARE CONTRACTED WITH
LOCAL PLANS AND ALREADY ENGAGED
IN THE DELIVERY OF KEM SERVICES
ARE BEST EQUIPPED TO ADD èC HÌ
W SERVICES TO THEIR CLINICAL
SETTINGS. THIS IS PARTICULARLY
TRUE FOR IN AREAS WHERE
COMMUNITY HEALTH CLINICS ARE THE
PRIMARY PROVIDER. IN CONTRAST
UNDER KAI CLINICS ARE ALLOWED TO
BILL FOR ENHANCED CARE
MANAGEMENT SERVICES OUTSIDE
THEIR PP S¼ RATE, ESSENTIALLY
INCENTIVIZING CLINICS TO
PARTICIPATE IN PROVIDING THESE
SERVICES WHILE SOME CLINICS
DIRECTLY EMPLOY CWS. NOT ALL DO,
ALLOWING THEM TO BUILD FOR èC W
SERVICES OUTSIDE OF THEIR PP S¼
RATE, WITH SIMILARLY
INCENTIVIZED COMMUNITY CLINICS
TO INCREASE THEIR èC HÌ W
CAPACITY AND INCREASE THE NUMBER
OF èC HÌ W S¼ THAT MANY LOCAL
PLANS CAN THEN IN THEIR NETWORK
TO SERVE ME MEMBERS. IN CLOSING
L HÌ P èC ENCOURAGES THE STATE
TO EXPLORE WAYS TO INCLUDE
COMMUNITY CLINICS IN THE èC HÌ
W BENEFIT TO FURTHER THE GOALS
OF KI¾M AND POPULATION HEALTH
MANAGEMENT. UM, WE ALSO
ENCOURAGE THE STATE TO YOU. I'M
SORRY. YOU CAN WRAP UP YOUR
COMMENT. I'M ALMOST THERE.
PROVIDE STATE RESOURCES FOR
TECHNICAL ASSISTANCE PROVIDE
ORGANIZATIONS WHO MUST ENROLL
AND PAVE AND ENSURE THAT
PROVIDER ENROLLMENT PROCESSES
ARE STREAMLINED. FINALLY èC HÌ
W TRAINING AND CERTIFICATION
REQUIREMENTS AND CLEARLY
ARTICULATE THOSE TO COLLEGES,
UNIVERSITIES AND TECHNICAL
SCHOOLS THROUGHOUT THE STATE
THROUGH A CO ORDINATED AND
COMPREHENSIVE COMMUNICATION
CAMPAIGN AND FINALLY ENSURE
COMPREHENSIVE, CLEAR AND
PERIODIC COMMUNICATION AROUND
PROGRAMMATIC AND GUIDANCE
UPDATES FOR BOTH PLANS AND CHW
PROVIDERS. THANK YOU. THANK YOU
BEFORE WE HAVE THE NEXT SPEAKER.
I JUST WANT TO ACKNOWLEDGE THAT
ASSEMBLY MEMBER SHIAVO IS WITH
US. UM AND, UM. ALL RIGHT, SO
WE'LL MOVE ON TO OUR NEXT
SPEAKER. AND I'M JUST GONNA ASK
AGAIN TO PLEASE STAY WITHIN YOUR
FIVE MINUTE ALLOTTED TIME FRAME.
WE'VE GOT A LOT OF PEOPLE ON THE
PANEL TODAY. THANKS. HELLO.
HELLO CHAIRS AND COMMUNITY
MEMBERS. UM I WILL TITLE TITLE.
UH, HAVE A TITLE FOR TODAY.
ADVANCING THE DREAM. èC HÌ, W,
PR, S¼ AND HEALTH FOR ALL IN
CALIFORNIA. MY NAME IS ALEXANDER
FAJARDO. I REPRESENT EL SOL
NEIGHBORHOOD EDUCATIONAL CENTER.
ONE OF THE OLDEST COMMUNITY
BASED ORGANIZATION WORKING WITH
PROMO TORE SINCE 1991 IN THE
STATE OF CALIFORNIA. I WANT TO
SHARE THE WORK OF A REGIONAL
CAPACITY COLLABORATIVE IN
SOUTHERN CALIFORNIA, SAN
BERNARDINO, RIVERSIDE, ORANGE
COUNTY AND SURROUNDING AREAS.
THIS COLLABORATIVE WAS
ESTABLISHED IN IN THE YEAR 2022
TO ADVANCE THE DREAM OF èC HÌ W
S¼ PROMO TORE, CONTRIBUTING THE
GOAL OF A HEALTH FOR ALL IN
CALIFORNIA. THIS INCLUDES 80
PROVIDERS REPRESENTING PUBLIC
HEALTH AND PRIVATE HEALTH
SECTORS AND MORE THAN 200 èC HÌ
W S¼. THESE COLLABORATIVE WAS
FORMED WITH TWO AIMS. FIRST
CONTRIBUTE THE SOCIAL JUSTICE
LENS INTO THE èC HÌ W PROMO,
TORE REPRESENTATIVES INTEGRATION
OPPORTUNITIES REFLECTED IN THE
CAL AND THE MEDICAL èC HÌ W
BENEFIT. AND SECONDLY, TO
ADDRESS A CONCERNING TREND. AS
WE CELEBRATE THE GROWING EMBRACE
OF èC HÌ W S¼ BY THE HEALTH
CARE ESTABLISHMENT. WE WANT TO
ADDRESS A CONCERNING TREND.
INSTEAD OF LETTING CWS TO BE CWS
. WE SAW INSTITUTIONS TRYING TO
MAKE èC W S¼ RESEMBLE A PRE
EXISTING PROFESSION. THAT THE
ESTABLISHMENT IS MORE
COMFORTABLE WITH. IF THIS
STRENGTH IS NÓ MITIGATED THE
DREAM OF CW'S PROMO IS PLAYING A
KEY ROLE IN THE HELP FOR ALL
MOVEMENT IN CALIFORNIA MAY BE
REPLACED WITH A NIGHTMARE. OF
CW'S WORKFORCE, DRIFTING AWAY
FROM THE SOCIAL JUSTICE AND
SYSTEM CHANGE ROUTES. INSTEAD
INSTEAD, THEY WILL BECOME MORE
ACCOUNTABLE AND ALLIED WITH THE
INSTITUTION. THEY WORK IN AND NÓ
WITH THE WITH THE COMMUNITY THEY
ARE WORKING IN. UM UH, FOR
INFORMING THIS POWERFUL
PARTNERSHIP WE HAVE UNITE AND
SHARE VALUES. AND WITH THE
FOLLOWING, UH, ROUTES BELIEFS.
UH, FIRST OF ALL, èC HÌ TO AND
PROMOTERS ARE COMMUNITY EXPERTS.
THE BASIS OF THE EXP EXPERTISE
IS THEIR VOCATION. NOR THEIR
CERTIFICATE OR CREDENTIALS,
NEITHER IF THEY ARE BILINGUAL.
BEYOND CONVENTIONALLY ROLES AS A
SERVICE PROVIDERS, HEALTH
EDUCATORS OR COORDINATORS. èC
HÌ, W S¼ PROMOTERS AND
REPRESENTATIVE ARE
TRANSFORMATIVE FORCES. CAPABLE
OF RESHAPING SYSTEMS AND
STRUCTURE. OUR COLLABORATION IS
FOUNDED IN THE PRINCIPLE OF CO
LEARNING AND CO TEACHING.
EMPHASIZING THE KNOWLEDGE IS A
COLLECTIVE JOURNEY, AND THAT'S
WHAT WE'RE DOING. NÓ DISTINCTION
BETWEEN THOSE WHO KNOW AND THOSE
WHO DOESN'T KNOW LIKE THE
DOCTORS VERSUS èC HÌ W S¼. I
WOULD LIKE TO MENTION A COUPLE.
UH UH, PRICE FAST, GIVING THE
HEALTH DISPARITIES THAT WE WERE
HIGHLIGHTED DURING THE COVID-19
PANDEMIC. MORE HE OR
ORGANIZATIONS ARE WORKING ON
HEALTH EQUITY INITIATIVES.
INTEGRATING èC HÌ W S¼ INTO
HEALTH INSTITUTIONS IS IN AQUI
STRA STRATEGY, ADVANCING THIS
HEALTH EQUITY EFFORTS. BUT ALSO
THIS COLLABORATIVE IS WORKING TO
ADDRESS THE REMAINING CHALLENGES
. MANY INSTITUTIONS HAVE BEEN
SEEN CAL AND MEDICAL BENEFIT AS
ANOTHER FUNDING STREAM TO
SUPPORT THE EXISTENT, NÓ FUNDED
WORKFORCE. SUCH MEDICAL
ASSISTANCE, HEALTH SERVICE
ASSISTANCE, OR NAN AIDS, AND NOT
TO HIRE OR TO SUSTAIN A
TRANSFORMATIONAL OPPORTUNITY
THAT ONLY A TRUTHFUL èC HÌ W
CAN CAN BRING FOR ORGANIZATIONS
ARE MAKING èC HÌ W S¼. AND
SPEED INTO PRE EXISTING
INSTITUTIONS MODELS. AND WE HAVE
TO TRANSFORM THAT èC HÌ W S¼
WORK IS MORE THAN A SET OF
ROLES, TITLES OR EVEN A DELIVER
A SERVICE. THIS IS A MOVEMENT.
TO CARRY THE HOPES OF
MARGINALIZED COMMUNITIES, THIS
MOVEMENT AS A HEALTHY EQUITY AND
THE GUIDING VALUE AND LEGACY. IN
THE NAME OF THE OF THE REGIONAL
COLLABORATIVE. WE WANNA THANK
YOU FOR HOLDING THIS HEARINGS,
AND WE OFFER OUR WILLINGNESS TO
WORK TOGETHER TO ADVANCE THE
DREAM. OF èC HÌ. W IS PLAYING A
KEY ROLE IN THE HEALTH FOR ALL
MOVEMENT IN CALIFORNIA, AND WE
HOPE THAT THIS MODEL CAN BE
RECUPERATED WITH A PROPER
RESOURCES AND SUPPORT TO ENSURE
THIS COLLABORATIVE AND TO HAVE A
STATEWIDE IMPACT. THANK YOU.
THANK YOU NEXT SPEAKER. SORRY
ABOUT THAT. GOOD AFTERNOON AND
GREETINGS, SHONA AND ASSEMBLY
MEMBERS. I AM DANTA HUDSON WITH
THE ALAMEDA COUNTY HEALTHCARE
SERVICES AGENCY AS A PUBLIC
HEALTH, PROFESSIONAL DOULA AND
LACTATION CONSULTANT. I AM
PASSIONATE ABOUT THIS WORK. I
WILL SHARE OUR EXPERIENCE THAT
IS BASED ON A èC HÌ W TRAINING
PROGRAM IN EXISTENCE FOR OVER A
DECADE APPEAR ADVISOR PROGRAM AS
WELL AS COLLECTIVE IMPACT WORK.
WE CREATED THIS PROGRA MME
BECAUSE OF OUR PASSION TO
DIVERSIFY THE HEALTH WORKFORCE.
DESPITE THE INNOVATION WE HAVE
MADE WITH TECHNOLOGY AND IN THE
A I AND WITH A I AND THE HEALTH
SECTOR, THE HEALTH DISPARITY GAP
HAS WIDENED A 15 MINUTE OFFICE
VISIT WILL NOT SUFFICE. WE MUST
MEET THE MOST VULNERABLE
INDIVIDUALS WHERE THEY ARE
SOMETIMES OUTSIDE OF THE
CONFINES OF INSTITUTIONALIZED
MEDICINE. I HAVE DIRECTLY SEEN
THE IMPACT ON COMMUNITIES OF
COLOR DIS DISPROPORTIONATELY
IMPACTING BLACK WOMEN IN
MATERNAL HEALTH. EXAMPLE èC HÌ
W S¼ ARE A SOLUTION TO HEALTH
DISPARITIES. WE INTENTIONALLY
HIRE STAFF THAT REFLECT THE
STUDENTS AND PATIENTS IN OUR
COMMUNITY WITH A BLANKET OF
MENTORSHIP. WE DID ALL OF THIS
PRIOR TO CAL A BENEFITS KNOWING
YEARS AGO, THE NEED FOR THIS
ROLE TO CURB DISPARITIES. WE ARE
AN EXISTING MODEL AS AN
APPRENTICESHIP THAT IS HOUSED
UNDER SHABO COLLEGE THAT SERVES
INDIVIDUALS WITH LIVED
EXPERIENCE. HIA PROVIDES PIVOTAL
INFRASTRUCTURE SUPPORT AND A
PATHWAY TO EMPLOYMENT WITHIN THE
AGENCY. WE ALSO PARTNER WITH FQ
HÌ, èC S¼ AND ALAMEDA COUNTY
VIA THE COMMUNITY HEALTH CENTER
NETWORK COMMUNITY CLINICS AND
OUR LOCAL COUNT COUNTY HOSPITAL
AND èC B Ó S¼ FOR EMPLOYER
PLACEMENT OVER 100 PARTICIPANTS
HAVE BEEN TRAINED TO DATE ALL
WITH LIVED EXPERIENCE AND
CULTURAL RELATABILITY. THEY
RECEIVE COMMUNITY COLLEGE CREDIT
AND PAY NÓ FEES FOR COURSEWORK.
WE ALSO PROVIDE THEM WITH AN
$1800 A MONTH STIPEND AND
GUARANTEE ON THE JOB TRAINING.
TO MANIFEST THE PATIENT IMPACT
IN 2021 DURING THE PANDEMIC. WE
WERE EXPERIENCING VACCINE
HESITANCY AND MULTIPLE
COMMUNITIES. OUR HEALTH COACH
èC HÌ W S¼ WERE TRAINED ON
COVID AND DEPLOYED TO TWO
POPULATIONS, A PREDOMINANTLY
SPANISH SPEAKING SCHOOL WITH
LESS THAN 20% OF STUDENTS
VACCINATED AND A PACIFIC
ISLANDER POPULATION WAS LESS
THAN 40% OF ADULTS VACCINATED
AFTER A MONTH OF CROSS TRAINING
BY COACHES, THE PERCENTAGES
CHANGE FROM 20% TO 80% FOR THE
STUDENTS VACCINATED AND 40% TO
9% IN THE PACIFIC ISLANDER
COMMUNITY. AT HIGHLAND HOSPITAL.
WE CONDUCTED A STUDY ON HOW
TIERS IN THE EMERGENCY ROOM THE
COACH HAS SERVED OVER 280
FREQUENT TIERS AND CONNECTED
THEM TO A MEDICAL HOME WITH ONE
ON ONE SUPPORT, THEY DECREASE ER
UTILIZATION AND INCREASE
MEDICATION COMPLIANCE FOR 80% OF
USERS. THEY WORKED WITH RECENTLY
INCARCERATED FOLKS WHO UPON
RELEASE STRUGGLE TO NAVIGATE
CHRONIC MEDICAL ISSUES THAT WERE
PREVIOUSLY MANAGED FOR THEM. THE
ASSEMBLY HEALTH COMMITTEE ASKED
FOR PATIENT IMPACT EXAMPLES. WE
HAVE NUMERAL NUMEROUS CASE
EXAMPLES ON HOW BECOMING A èC
HÌ W HAS CHANGED THE LIVES OF
THOSE WE'VE TRAINED. NOT ONLY
DOES BEING A èC HÌ W LEAD TO A
CAREER THAT THEY LOVE WITH
SUSTAINABLE WAGES, THOUGH, FROM
SOME IN THE BAY AREA, MORE
COMPETITIVE WAGES ARE NEEDED. IT
PROVIDED A TRAINING MEDIUM FOR
FIRST GEN STUDENTS WHO NEEDED A
CAREER EXPOSURE OR PRIOR OR
HOURS PRIOR TO APPLYING TO
NURSING P AND MEDICAL SOCIAL
WORK SCHOOL. THIS IS THE IDEAL
CAREER ENTRY TO PROVIDE VERTICAL
MOVEMENT WITHIN THE HEALTH
SECTOR. SOME RECENT EXAMPLES
INCLUDE BM, AN AFRICAN AMERICAN
FEMALE SINGLE MOM WHO WAS LAID
OFF IN 2022. SHE ENROLLED IN OUR
PROGRAM SECURED ON THE JOB
TRAINING WITH THE COMMUNITY
CLINIC AND THEN A FULL TIME JOB
WITH THE LOCAL FQ HÌ èC MAKING
23 AN HOUR, THEN 25 AND 2020
THREE AFTER A YEAR SHE IS NOW A
èC HÌ W MANAGER AT A èC HÌ AT
A èC B Ó, MAKING 80,000 A YEAR
SHE HAS PERSONALLY ASSISTED OVER
500 PATIENTS. ANOTHER PERSON. Dð
èC, A FIRST GEN LATINO STUDENT
WITH NÓ CAREER EXPOSURE, WANTED
TO BE A SOCIAL WORKER, BUT HAD
NÓ EXPERIENCE. AFTER COMPLETING
THE PROGRAM, HICKS A HIRED HIM
AND THAT EXPERIENCE LED HIM TO
BE HIRED AS A SUBSTANCE USE
NAVIGATOR WITH THE BRIDGE
CLINIC. HE NOW ASPIRES TO GO TO
P A OR MEDICAL SCHOOL DO THE
EXPOSURE HE HAS HAD WHILE ON THE
JOB. MOST OF OUR GRADUATES HAVE
A GAGE Dð. YET THEY'RE WORKING
AS COMPLEX CARE TEAM ADVOCATES
èC HÌ, W MANAGERS AND SUBSTANCE
USE NAVIGATORS, HELPING
THOUSANDS OF PATIENTS A YEAR. WE
SHOULD NOT CREATE EDUCATIONAL
BARRIERS FOR THOSE WHO ARE
REALLY WHO REALLY UNDERSTAND THE
COMMUNITY, SPEAK THE SAME
LANGUAGE AS OUR COMMUNITY AND
PREVENT THEM FROM CONTINUING TO
ENTER THE èC HÌ W ROLES. PIXEL
WAS FORTUNATE TO PARTICIPATE IN
èC HÌ èC F S¼ REGIONAL èC HÌ
W COLLABORATIVE BASED ON OUR
EFFORTS THROUGH A LEARNING
COMMUNITY ON èC HÌ W
INTEGRATION AND DIRECT
EXPERIENCE, THE STATE SHOULD
CONSIDER THE FOLLOWING SEED
MONEY FOR DEVELOPING NEW
PROGRAMMING AT EMPLOYER SITES,
INFRASTRUCTURE SUPPORTING èC HÌ
W INTEGRATION, INCLUDING
TRAINING FOR SUPERVISORS FOR
THIS UNIQUE ROLE DIRECT SUPPORT
FOR èC HÌ W S¼, WHO MAY HAVE
INCREASED NEEDS ADJUSTING TO THE
WORKFORCE OR EXPERIENCE
VICARIOUS TRAUMA. COUNTY AND
STATEWIDE MARKETING SUPPORT TO
BOLSTER RECRUITMENT PROGRAMMING
FOR COMMUNITY FOR COMMUNITY
HEALTH CENTERS. WE HAVE HELPED
HUNDREDS OF PEOPLE WHO ALREADY
DO THIS WORK. WE ALSO SUGGEST
ADVOCATING FOR HIGHER
REIMBURSEMENT RATES FOR MEDICAL
BENEFIT TO SUPPORT LIVING WAGES
IN CALIFORNIA, INCENTIVIZE
HEALTH DEPARTMENTS TO CREATE A
SUSTAINABLE PATHWAYS AND ALSO,
UM THAT'S IT. THANK YOU FOR THIS
OPPORTUNITY. THANK YOU NEXT
SPEAKER. GOOD AFTERNOON CHAIRS
AND COMMITTEE MEMBERS. MY NAME
IS TU QUAT, AND I AM THE
PRESIDENT AT ASIAN HEALTH
SERVICES IN ALAMEDA COUNTY WERE
PROUD TO BE LOCATED IN THE èC
BONTA DISTRICT. UM, THANK YOU SO
MUCH FOR INVITING ME TO SPEAK
TODAY. ASIAN HEALTH SERVICES IS
A FEDERALLY QUALIFIED HEALTH
CENTER AND FQ HÌ èC THAT WAS
FOUNDED 50 YEARS AGO, PROVIDING
MEDICAL, DENTAL AND BEHAVIORAL
HEALTH TO OVER 50,000 PATIENTS
IN 12 ASIAN LANGUAGES. WE ARE
ALSO A PROUD MEMBER OF THE
CALIFORNIA PRIMARY CARE
ASSOCIATION, WHICH REPRESENTS
1270 COMMUNITY HEALTH CENTERS
ACROSS THE STATE. AS A REFUGEE
FROM VIETNAM. I WAS DRAWN TO
THIS TO WORK HERE BECAUSE OF MY
OWN LIVED EXPERIENCE AS A CHILD
INTERPRETER FOR MY PARENTS AS
THEY NAVIGATED THE HEALTH CARE
SYSTEM, THE VERY COMPLEX HEALTH
CARE SYSTEM. I WAS AMONG THE
VERY FIRST COMMUNITY HEALTH
WORKERS HARD FOR THE YOUTH
PROGRAM OVER 25 YEARS AGO AT
ASIAN HEALTH SERVICES. WE'VE
BEEN ENCOURAGED BY THE STATE'S
RECENT IMPLEMENTATION OF èC W
S¼ AS A MEDICAL BENEFIT. MANY
HEALTH CENTERS HAVE BEEN LEADERS
IN DEVELOPING AND INCLUDING èC
HÌ W S¼ IN OUR STAFFING MODELS,
EVEN THOUGH WE'VE BEEN
HISTORICALLY UNABLE TO BE
REIMBURSED FOR THESE SERVICES.
YET UNFORTUNATELY, HOWEVER, EVEN
WITH THIS NEW BENEFIT IN PLACE,
THERE ARE MANY BARRIERS FOR OUR
FQ HÌ èC S¼ TO ACCESS MEDICAL
PAYMENTS EVEN NOW. SOME OF THE
CHALLENGES INCLUDE THAT MEDI CAL
HAS ME HAS IMPLEMENTED èC HÌ W
S¼ AS A BILL WILL PROVIDER
EXCEPT FOR WHEN THE CW IS
WORKING AT ACCIES, OR RURAL
HEALTH CENTERS. FOR OUR FQ HÌ
èC IS ONLY REIMBURSEMENT FOR
èC HÌ W IS ACCESSED BY
UNDERGOING WHAT IS CALLED A
CHANGE IN SCOPE OF SERVICES
REQUESTS. THIS REQUEST SEEKS TO
ADJUST OUR RATE PAYMENT RATE
FROM THE STATE FOR ALL VISITS TO
INCLUDE THE COST OF èC HÌ W
SERVICES. THE PROBLEM WITH THIS
IS THAT THE CHANGE IN SCOPE
PROCESS IS NOT A VIABLE OPTION
FOR MANY OF OUR FQ HÌ èC S¼
BECAUSE IT REQUIRES THAT THE FQE
èC TO SUSTAIN THE COST OF èC
HÌ W SERVICES WITHOUT ANY RATE
INCREASE FOR OVER A YEAR,
SOMETIMES MANY YEARS WHILE THE
DEPARTMENT AUDITS AND FINALIZES
THE RATE ADJUSTMENT. I ALSO LIKE
TO NOTE THAT THE DEPARTMENT
CONTINUES TO HAVE WHAT'S IN
PLACE A 20% HAIRCUT POLICY ANY
TIME WE UNDERGO AAA RATE CHANGE,
WHEREBY ANY RATE THAT THE
AUDITOR DEEMS APPROPRIATE, THE
DEPARTMENT WILL THEN REDUCE IT
BY 20. THAT'S A LOT GIVEN THESE
CHALLENGES, WE'RE REQUESTING THE
FQ HÌ èC S¼ HAVE THE OPTION TO
BUILD MEDI CAL FOR èC HÌ W
SERVICES OUTSIDE OF OUR EXISTING
RATES. èC P èC A HAS
PREVIOUSLY PRESENTED THIS OPTION
, WHICH STATES SUCH AS MICHIGAN,
KANSAS AND RHODE ISLAND ALLOW
BUT WERE UNABLE TO GET ANY
TRACTION. I ALSO LIKE TO NOTE
THAT THE CURRENT REIMBURSEMENT
RATE FOR èC B Ó S¼ IS WAY TOO
LOW AS WELL. HISTORICALLY FQ HÌ
Dð IS NEEDED TO HEAVILY RELY ON
GRANT FUNDING TO PAY FOR
SERVICES RENDERED BY èC W S¼.
SOME HAVE BEEN ABLE TO BUILD
ROBUST PROGRAMS THAT OFFER
CAREER LADDER FOR F FOR OUR èC
HÌ W S¼, BUT MOST OF US FIND
OURSELVES HAVING A èC HÌ W FOR
A FEW YEARS. UM THEN BEING
FORCED TO LET THEM GO DUE TO
INADEQUATE FUNDING AND THEN
STARTING ALL OVER AGAIN WHEN
WE'RE ABLE TO SECURE MORE
FUNDING. I NOW LIKE TO TELL YOU
A FEW SUCCESSFUL èC HÌ W
PROGRAMS AT OUR HEALTH CENTER.
THE UH, COMMUNITY HEALTH CENTER
NETWORK HÌ Dð N OF EIGHT HEALTH
CENTERS IN ALAMEDA COUNTY
CREATED CARE NEIGHBORHOOD, WHICH
WAS ACTUALLY THE PILOT THAT LED
TO THE ENHANCED CARE MANAGEMENT
E èC M WITHIN CAL AM NOW ECM IS
A PROGRAM THAT TARGETS HIGH
TIERS OF HOSPITALIZATION AND
OTHER COSTLY SERVICES IN THIS
PROGRAM, OUR HEALTH CENTER OUR
èC HÌ W S¼ WORK CLOSELY WITH
THESE PATIENTS TO PROVIDE CARE
COORDINATIONS AND UM AND OTHER
SERVICES. AND IN A RECENT
ANALYSIS, WE FOUND THAT THOSE
SERVED BY èC HÌ W S¼ ACTUALLY
ARE LESS LIKELY HALF AS LIKELY
TO ENTER INTO THE EMERGENCY ROOM
OR HOSPITALIZATION. THE
EXCEPTION HERE IS THAT THROUGH
THIS COW IN PROGRAM, WE'RE ABLE
TO GET A PER MEMBER PER MONTH
REIMBURSEMENT WHICH ARE REALLY A
GAME CHANGING JOURNEY AND ALLOWS
US TO REALLY BUILD èC HÌ W
PROGRAM. ANOTHER EXAMPLE IS THE
ASIAN HEALTH SERVICES HAVE
STARTED USING COMMUNITY HEALTH
WORKERS BECOME LAY COUNSELORS
GIVEN THE MENTAL HEALTH
WORKFORCE SHORTAGE. AND, UH AND
THE HIGH DEMAND FOR SERVICES
AFTER THE PANDEMIC THERE A 63
HOUR LAY CONCERT ACADEMY
TRAINING R èC FW S¼ ARE ABLE TO
PROVIDE BASIC MENTAL HEALTH
COUNSELING. AS THE SIEGE. WW S¼
ARE MORE CULTURALLY AND
LINGUISTICALLY LINED WITH THE
PATIENTS. UH, WE'VE SEEN THAT
IT'S SIGNIFICANT ALLEVIATED SOME
OF THE ACCESS BARRIERS AND WE'RE
FINDING THAT OUR PATIENTS ARE
CONNECTING WITH THIS èC W S¼
MUCH BETTER. WE'RE ASKING FOR
YOUR SUPPORT TO ALLOW FQ HÌ èC
S¼ TO BE ABLE TO BUILD FOR THESE
COUNSELING SERVICES. ON A
BROADER NOTE. I WANT TO
EMPHASIZE THE FQ HÌ Dð S¼ PLAY A
CRITICAL ROLE IN BEING THE
FIRST, UH, BEING THE SAFETY NET
FOR MEDICALLY UNDERSERVED
COMMUNITIES, ESPECIALLY AS WE
SERVE ONE THIRD OF ALL THE MEDIC
BENEFICIARIES. WE WOULD LOVE TO
HAVE MORE INPUT DURING THE
PLANNING PROCESS OF THESE
PROGRAMS AS AS THEY'RE BEING
DEVELOPED, AND IT WOULD BE
GREATLY HELPFUL, UH, WITH THE
IMPLEMENTATION RATHER THAN
HAVING US ASK FOR IT AFTERWARDS.
THANK YOU VERY MUCH. THANK YOU.
THE NEXT SPEAKER. YEAH. JIMMY
SOON WE A COMMITTEE MEMBERS. UM,
CHAIR BONTA. STAFF. MY NAME IS
DOCTOR MARK LEBEAU. I'M THE èC
E Ó OF THE CALIFORNIA RURAL
INDIAN HEALTH BOARD. UH, WE
REPRESENT 19 TRIBAL CLINICS
THROUGHOUT CALIFORNIA AND 59.
PHILLY RECOGNIZED TRIBES, UH,
THROUGHOUT THE STATE FROM THE
OREGON BORDER ALL THE WAY DOWN
TO THE CALIFORNIA MEXICO. UH,
BORDER. CRAB IS A WORKFORCE, UH
OF STAFF, PROVIDING PLANNING,
ADVOCACY, FUNDING, TECHNICAL
ASSISTANCE, EDUCATION AND
DEVELOPMENT OF TRIBAL HEALTH
PROGRAM CAPACITY ACROSS THE
STATE. WE SEEK TO PROMOTE UNITY
AND FORMULATE COMMON POLICIES ON
INDIAN HEALTH CARE ISSUES. THE
COMMUNITY HEALTH REPRESENTATIVE
PROGRAM. PROVIDED THROUGH THE
FEDERAL INDIAN HEALTH SERVICE
WAS ESTABLISHED BY CONGRESS ONE
YEAR BEFORE I WAS BORN IN 1968.
IT WAS ESTABLISHED BACK THEN TO
HELP ADDRESS THE NEEDS OF TRIBAL
COMMUNITIES ACROSS THE COUNTRY.
BACK THEN WERE INITIALLY FOCUSED
ON OUTREACH TO AMERICAN INDIAN
ALASKAN NATIVE PATIENTS. TODAY
CRS ARE TRAINED IN DISEASE
CONTROL AND PREVENTION, REDUCING
HEALTH DISPARITIES AND HELPING
TO REMOVE BARRIERS TO CARE AND
TRIBAL COMMUNITIES. èC R S¼,
OUR FRONT LINE WORKFORCE FOCUSED
ON IMPROVING SOCIAL DETERMINANTS
OF HEALTH USING A COMMUNITY
BASED APPROACH. WHILE THE
FEDERAL INDIAN HEALTH SERVICE
PROVIDES TRIBAL COMMUNITIES
LIMITED èC HÌ R RESOURCES AND
FUNDING TRIBES IN CALIFORNIA
CONTINUE TO BE AMONG THE LEAST
RESOURCED IN THE NATION. CRIB
WAS EXCITED TO HEAR ABOUT THE
PROSPECT OF STATE PROVIDING
REIMBURSEMENTS FOR èC HÌ R
SERVICES. UNFORTUNATELY THE
REIMBURSEMENT LEVEL FOR èC HÌ R
CARE DOES NOT COVER THE COST OF
ADMINISTERING THE PROGRAM AND
BILLING FOR THESE VITAL
SERVICES. IN OTHER WORDS, THE
TRIBAL HEALTH PROGRAMS COST FOR
èC R S¼ TO PROVIDE SERVICES
TRACK THESE EFFORTS REPORT TO
OUR BILLING DEPARTMENTS AND BILL
FOR THESE SERVICES AS FAR
GREATER THAN THE $26. HER UNIT
THE STATE CURRENTLY PROVIDES.
OTHER STATES SUCH AS NEVADA AND
OREGON PAY TRIBAL HEALTH
PROGRAMS QUITE A BIT MORE.
THERE'S A TERM CALLED ALL
INCLUSIVE RATE 719 PER QUALIFIED
ENCOUNTER FOR èC HÌ R TYPE
SERVICES. WHY NOT? ALL CLINICS
CAN BUILD AT THE ALL INCLUSIVE
RATE. SOME STATES HAVE
ACKNOWLEDGED THE SEVERE HEALTH
DISPARITIES THAT EXIST ACROSS
TRIBAL COMMUNITIES AND HAVE
STRENGTH IN THIS WORKFORCE TO
HELP ADDRESS THESE CHALLENGES,
CRIB HAS ADVOCATED FOR THE ALL
INCLUSIVE RATE FOR èC R
SERVICES HERE. WE CONTINUE TO
DIALOGUE WITH OUR A DEPARTMENT
OF HEALTH CARE SERVICE PARTNERS
ON THAT TOPIC. YOU MAY BE AWARE,
BUT TRIBAL COMMUNITIES ARE
GENERALLY LOCATED IN RURAL AND
FRONTIER PARTS OF THE STATE,
CONTRIBUTING TO OUR SIGNIFICANT
WORKFORCE CHALLENGES BESIDES THE
SMALL POPULATIONS AND TRIBAL
COMMUNITIES, RURAL TRIBAL HEALTH
PROGRAMS ARE AMONG THE MOST
UNDERFUNDED HEALTH CARE
FACILITIES ACROSS INDIAN
COUNTRY. WHILE TRIBAL HEALTH
PROGRAMS ARE EXEMPT FROM S¼ B
525. UH, GIVEN THEIR ABILITY TO
UTILIZE SOVEREIGNTY IN THAT
REGARD, THEY STILL FACE EXTREME
CHALLENGES WITH COMPETITION. UM
STAFF MOVING TO OTHER OTHER
CLINIC PROVIDER TYPES. UH THE
SUPPORTIVE AND ALL INCLUSIVE
RATE WOULD GO A LONG WAY TO
HELPING TO SHORE UP THE DELIVERY
OF TRIBAL HEALTH SERVICES IN
RURAL CALIFORNIA. JUST WANNA
UNDERSCORE THAT, UM, YOU KNOW,
I'VE HAD THE DIRECT EXPERIENCE
OF BEING SERVED BY èC HÌ R S¼
GROWING UP. MY MOTHER WAS A CR
OF THE REDDING RANCHERIA. UH,
SHE WAS AN ELDER LATER ON IN HER
LIFE, AND I KNOW THAT WHEN AN
ELDER UM IS IN A COMMUNITY AND
AS AS A èC HÌ R THE INDIAN
HOMES OPEN. WE'RE TRAINED TO
HONOR RESPECT, ADHERE TO THE
DIRECTIVES OF OUR ELDERS. SO
WHEN YOU HAVE, UH OLDER ADULTS
SERVING IN THAT CAPACITY THAT
GOES A LONG WAY TO THE DELIVERY
OF CARE. THAT BEING SAID, LIKE
TO ENCOURAGE COMMITTEE TO
ENCOURAGE OUR HÌ èC S¼ PARTNERS
TO WORK WITH CRIB AND ALL TRIBAL
CLINICS IN IN THE DELIVERY OF AN
ALL INCLUSIVE RATE. THANK YOU.
THANK YOU. AND FINALLY, GOOD
AFTERNOON. UH, MEMBERS AND
CHAIRS. UM MY NAME IS ANDREA
MACKIE, SENIOR POLICY MANAGER
WITH THE CALIFORNIA PAN ETHNIC
HEALTH NETWORK. èC P IS A
STATEWIDE MULTICULTURAL ADVOCACY
ORGANIZATION DEDICATED TO THE
ELIMINATION OF RACIAL
DISPARITIES AND IMPROVEMENT OF
HEALTH OUTCOMES FOR COMMUNITIES
OF COLOR. I'M REALLY PROUD TO
SAY THAT I LEAD THE COMMUNITY
HEALTH WORKER ROMA TORA AND
REPRESENTATIVES POLICY COALITION
ALONGSIDE, UH, CALIFORNIA
CONSORTIUM FOR URBAN INDIAN
HEALTH, THE LATINO COALITION FOR
A HEALTHY CALIFORNIA. THE
CHILDREN'S PARTNERSHIP
TRANSITIONS, CLINIC NETWORK
ROOTS COMMITTEE HEALTH CENTER
AND VISIONING COMPROMISO. WE ARE
STATEWIDE GRASSROOTS
ORGANIZATION WITH OVER 1000 èC
HÌ W PR S¼, MANY OF WHICH SOME
OF IN THE ROOM TODAY ADVOCATES
AND ALLIES TO ADVANCE POLICIES
THAT IMPACT OUR WORKFORCE. OUR
MAKE SURE THAT THEY'RE ROOTED IN
COMMUNITY HEALTH WORKER
PROMOTORA VOICE. UM AS WE SEEK
TO STRENGTHEN HEALTH CARE
QUALITY, INCREASE EQUITABLE
HEALTH OUTCOMES, IMPROVE
FINANCIAL SUSTAINABILITY AND
PRIORITIZE WORKFORCE DIVERSITY.
MY COMMITMENT TO COMMUNITY.
RESPONSIVE WELLNESS IS ROOTED IN
MY EXPERIENCES AS A MIXED
FILIPINA COMMUNITY HEALTH WORKER
. I PROVIDE DIABETES MANAGEMENT
AND EDUCATION, UH, AND
CONNECTION TO COMMUNITY
RESOURCES FOR MY KABAYAN ACROSS,
UH, LOS ANGELES FROM SAN
FERNANDO VALLEY TO HISTORIC
FILIPINO TOWN, FOLLOWING IN THE
LEGACY OF MY MOM AND MY GRANDMA,
WHO WERE BONGI HEALTH WORKERS IN
THE PHILIPPINES. IN MY CULTURE.
THERE'S A LOT OF SHAME TO BE
QUITE HONEST WITH DIABETES, YOU
KNOW, AND OFTEN PEOPLE AREN'T
SEEKING CARE BECAUSE THE MONEY
THAT GETS PUT INTO MEDICATION IS
GETTING SENT BACK HOME TO THE
PHILIPPINES, OR IT'S GOING
TOWARDS RENT OR FOOD. AND SO I'M
PROUD TO SAY THAT WHEN WE
CULTURALLY AND LINGUISTICALLY
TAILOR PROGRAMS FROM THE èC Dð
èC LINK PEOPLE TO HOUSING AND
MEDICATION ASSISTANCE, I'M WE
WERE ABLE TO DECREASE EMERGENCY
DEPARTMENT VISITS BY 22% REDUCE
HOSPITALIZATIONS BY 68% I SAW A
ONE èC S¼ GO STARTING OFF FROM
1412 10. THESE ARE DANGEROUS
LEVELS DROP ALL THE WAY TO SEVEN
EVEN 6.5. AND WITHOUT US, YOU
KNOW, PEOPLE WOULDN'T HAVE
GOTTEN THEIR BLOOD SUGARS
CONTROLLED FOR KIDNEY
TRANSPLANTS, THEY WOULD HAVE
LOST THEIR VISION LOST A LIMB
DUE TO AMPUTATION, THEY HONESTLY
WOULD HAVE DIED. AND MY WORK.
ISN'T THAT SPECIAL IN THAT
REGARD, YOU SEE IT IN SAN DIEGO
WITH THE NEIGHBORHOOD NETWORKS.
THEY'RE ADDRESSING HOUSING AND
FOOD AND SECURITY AT 70 3%
OAKLAND ROOT COMMUNITY HEALTH
CENTER, YOU KNOW, DISTRIBUTED
JUST LAST YEAR ALONE 10,000
COVID-19 TEST KITS. YOU KNOW, SO
AS A POLICY ADVOCATE, AND AS A
èC HÌ W IS POWERFUL TO SEE
PEOPLE TRANSFORM FROM BEING
PASSENGERS TO DRIVERS OF THEIR
HEALTH. THAT'S THE ENERGY OF
THIS WORKFORCE. THE
TRANSFORMATION OF COMMUNITY
HOWEVER, AS CALIFORNIA CONTINUES
TO INVEST AND DEVELOP POLICIES
FOR OUR WORKFORCE, IT IS
IMPERATIVE THAT WE DEVELOP OUR
OWN NEEDS AND RIGHTS. AND SO
THIS YEAR, THE COALITION
DEVELOPED A POLICY AGENDA FOR
STATE LEADERS WITH FOUR KEY
THEMES. WORKFORCE DEVELOPMENT.
INTEGRATION. WE NEED ACCESS TO
CH LB PR RESOURCES SERVICES AND
ECONOMIC EQUITY AS A CULTURALLY
AND LINGUISTICALLY DIVERSE
WORKFORCE. WE ARE CHALLENGING
RACISM IN THE MEDICAL FIELD.
HOWEVER OUR ABILITY TO FULLY
SERVE COMMUNITY IS BEING STIFLED
FROM PROVIDERS FROM STATE
LEADERS FROM HEALTH CARE TEAMS
WHO DO NOT UNDERSTAND THE WORK
AND SCOPE OF WHAT WE DO. AND IF
WE WANNA SEE TRUE SUCCESS OF THE
MEDICAL BENEFIT, WE NEED TO
REMEMBER THE MANTRA THAT THERE
IS NOTHING ABOUT US WITHOUT US.
THERE IS A NEED TO EXPAND OUR
SERVICES FURTHER WHERE CURRENT
HEALTH CARE SYSTEMS HAVE EITHER
IGNORED OR HARMED US WHETHER IT
BE BLACK, NATIVE INDIGENOUS
ASIAN AMERICAN L GB, Tð Q, PLUS,
SPECIFICALLY, TRANS AND LATIN X
AND RURAL COMMUNITIES, AND MOST
IMPORTANTLY, èC HÌ WB PR S¼
DESERVE ECONOMIC EQUITY. WHEN
YOU ASK MEMBERS OF OUR COALITION
ONLY 10% SAY THAT THEIR CURRENT
SALARY COVERS THEIR BASIC
EXPENSES, LET ALONE THE ABILITY
TO THRIVE IN OUR PROFESSION.
MOST OF US ARE DOING THIS AT THE
SERVICE OF OUR HEART OR THE BION
AND THE COMMUNITY SPIRIT. BUT
THE BON SPIRIT IS NOT PAYING FOR
MY GAS. IT'S NOT PAYING FOR MY
RENT AT THE END OF THE DAY. SO
WHILE THE NEW MEDICAL BENEFIT
OFFERS THIS OPPORTUNITY WITH
SUSTAINABLE LONG TERM FUNDING,
THE PROPOSED PAYMENT RATES ARE
BARE, BARELY GETTING US MINIMUM
WAGE. A RECENT STUDY FOUND THAT
THE OUR CURRENT CALIFORNIA RATES
ARE COVERING JUST 38% OF ACTUAL
COST. ONE FILIPINO I WAS TALKING
TO RECENTLY IS WONDERING, YOU
KNOW, WHEN ARE HER WAGES ARE
GOING TO GO UP? YOU KNOW, AS THE
PROMISE OF THIS NEW BENEFIT,
SHE'S CURRENTLY FACING EVICTION
WITH HER SON. THE RESOURCES. SHE
WAS TELLING ME THAT SHE IS USING
WITH COMMUNITY SHE HAS TO USE
WITH HERSELF, AND THIS IS NOT AN
UNCOMMON STORY, PARTICULARLY IN
LOS ANGELES. WE ARE ALREADY
PAYING OUT OF POCKET FOR
MATERIALS AND TRANSPORTATION.
YOU WERE ASKING THE SAME PEOPLE
WHO EXPERIENCE INEQUITIES AND
POVERTY TO SHOULDER THE BURDEN
THAT THE STATE SHOULD BE PAYING.
SO THAT'S WHY WITH 1000 PLUS
COMMUNITY HEALTH WORKERS AND
MEMBERS, WE ASKED THE
LEGISLATURE TO RAISE èC HÌ W PR
RATES TO AT LEAST 87.5% OF
MEDICARE. AS WE END THIS
FANTASTIC PANEL, YOU KNOW, I'D
LIKE TO END WITH A TUG
SOLIDARITY PHRASE ISANG BACK,
WHICH MEANS ONE DOWN, ONE FALL
ON TO THE NEXT TODAY IS A
HISTORIC MOMENT FOR CALIFORNIA
AND THE REST OF THE NATION IS
WATCHING WHAT WE DO HERE. AND
HOW WE RESPECT OUR èC HÌ W PR
S¼ SO TOGETHER WITH èC HÌ W PR
S¼ AT THE FRONT ARE COMMUNITY
RESEARCH AND POLICY MAKERS.
LET'S PLANT THE SEEDS TO
CULTIVATE REAL CHANGE HERE TO
IMPROVE HEALTH FOR ALL
CALIFORNIANS AND RISE UP
TOGETHER. THANK YOU. THANK YOU.
I WANNA THANK ALL OF OUR
PANELISTS, UH TODAY AND ASK IF
ANY OF MY COLLEAGUES ON, UH HAVE
ANY QUESTIONS FOR THIS PANEL? SO
I JUST WANTED TO, UH, NOTE AND
ACKNOWLEDGE THAT, UH, ASSEMBLY
MEMBER WALDRON IS WITH US TODAY.
WELL, I WANNA THANK THE
PANELISTS FOR, UH, OFFERING SUCH
INCREDIBLE INSIGHTS AND AGAIN
JUST TO KIND OF REITERATE MY
EARLIER POINT ABOUT THE
DISCONTINUITY IF YOU WILL,
BETWEEN THE OPPORTUNITY THAT WE
HAVE, AND, UH AND BEING ABLE TO
WORK ON THE FOUNDATION THAT HAS
ALREADY BEEN BUILT BY YOUR WORK
OVER SO MANY GENERATIONS. REALLY
I WANNA PUT SOMETHING IN CONTEXT
FOR US. SO IN JULY 2022 THE èC
HÌ W SERVICES, UH, HAVE BEEN
COVERED BENEFIT IN ME FOR A FEE
FOR SERVICE AND MANAGED CARE,
AND THE GOVERNOR'S BUDGET
ASSUMES THAT THERE WOULD BE A
TOTAL EXPENDITURE OF ABOUT $91.9
MILLION FOR THE èC HÌ W.
BENEFIT WE'VE ALL HEARD YOU
SPEAK TO THE INCREDIBLE
IMPORTANCE OF THIS IN TERMS OF
THE ADVANCEMENTS AND DISPARITIES
AND I LOVE HEARING EXA B¢O AS A
AS A WAY TO BE ABLE TO REALLY
LIFT THAT UP. THE REALITY IS,
UH, THAT, UH BECAUSE OF THESE,
UH I DON'T KNOW. FRICTION POINTS
OR OPPORTUNITIES, GROWTH
OPPORTUNITIES FOR US. UM WE HAVE
ONLY BEEN ABLE TO SPEND OUT
THREE $0.4 MILLION OR I HAVE A
HEAVY UTILIZATION OF $3.4
MILLION FOR FEE FOR SERVICE AND,
UH LESS THAN $1 MILLION FOR
MANAGED CARE, SO THE OPPORTUNITY
FOR US TO REALLY BE ABLE TO
FOCUS ON INTEGRATION IS
INCREDIBLY GREAT. WE WANNA SEE
US HITTING THAT 91.9. DOLLARS OF
UTILIZATION LEVELS. SO, UM, I
WOULD PROBABLY, UH, JUST UH,
ORIENT THIS QUESTION TO A COUPLE
OF PANELISTS JUST TO BE ABLE TO
GET, UH SOME TALK ON THIS. AND I
WANT TO THANK MY DISTRICT. UH,
PANELIST, UH, MISS KUO AND QUAT
AND, UM AND THE ALAMEDA COUNTY
HÌ èC S¼ S¼ S¼ HÌ èC S¼ A FOR
PARTICIPATING WITH, UH, MISS
HUDSON AS WELL, UM WHERE A RE WE
FALLING SHORT IN TERMS OF
ENSURING THAT THE MANAGED HEALTH
PLANS ARE PROVIDING THE KIND OF
ACCOUNTABILITY OR HOW ARE WE
FALLING SHORT ON ACCOUNTABILITY
IN TERMS OF ENSURING THAT YOU
HAVE THE TRAINING THE ABILITY TO
FULLY REIMBURSE UH, THE ABILITY
TO STRUCTURE YOUR FUNDING FOR
COMMUNITY HEALTH CARE WORKERS IN
A WAY THAT IS A THRIVING WAGE.
UH HOW CAN WE SHORTEN OR I
SHOULD SAY ACCELERATE THE
OPPORTUNITY TO DEAL WITH SOME OF
THESE FRICTION POINTS THAT YOU
ALL HAVE LAID OUT THAT'S KEEPING
US FROM PROVIDING THIS CRUCIAL
OPPORTUNITY FOR PEOPLE. AND IT
JUST MAYBE TWO OR THREE PEOPLE,
AND I THINK ANYONE CAN ANSWER
THAT. I WOULD LOVE TO, UH, THIS
IS MARIA AND I THINK
HISTORICALLY, THE PLANS IN THE
INSTITUTIONS RELY ON WHAT
THEY'VE KNOWN. I THINK I
MENTIONED THAT BEFORE. THIS IS
AN OPPORTUNITY TO ENGAGE
COMMUNITY, THE COMMUNITY EXPERTS
IN SOLUTIONS. IMMUNITY HAS BEEN,
UM, PROVIDING SOLUTIONS FREE OF
CHARGE WHEN I WALK OUT THE DOOR
AND I NEED A, UH I NEED A
RESOURCE FOR EXERCISING OR I
NEED A RESOURCE FOR INFORMATION.
I GO TO A COMMUNITY BASED
ORGANIZATION. THEY EXIST ACROSS
CALIFORNIA, AND I THINK WE CAN
THE AGENCIES PLAN STATES CLINICS
NEED TO REALLY REACH OUT. AND
EMBRACE THE COMMUNITY AS A
PARTNER AS A AS A DOTTED LINE
TO, UH NOT ONLY TO WORKFORCE AS
WE INCREASE THE NUMBERS OF
EXPERTISE AND WITH PROMOTERS AND
COMMUNITY HEALTH WORKERS, BUT
ALSO AS A LINK TO RESOURCES AND
TO SOLUTIONS. LINUX PLANS AT
HOSPITALS CAN'T DO IT ALL.
THERE'S JUST TOO MANY OF US AND
SO WE HAVE TO REACH THE
COMMUNITY AND ALSO TO LOOK AT
DIMINISHING THOSE BARRIERS TO
INCLUDING COMMUNITY MEMBERS, UM,
LOOKING IN WHO WE ARE. AND THE
GIFTS THAT WE COME. AND HOW CAN
WE ACCOMMODATE THOSE PERSONS
WITHOUT THE MAIN, THE MAINFRAME
THAT WE'VE USUALLY LOOKED AT?
AND ASK US WHAT THAT SHOULD LOOK
LIKE. ASK US COMMUNITY ALL AT
THE TABLE. WHAT SHOULD IT LOOK
LIKE? HOW CAN WE GET MORE MORE
COMMUNITY INTERESTED? HOW CAN WE
GET MORE TO BE HIRED? HOW CAN WE
TRAIN MORE? HOW CAN WE REACH
MORE? COMMUNITY SHOULD BE A
PARTNER IN THAT. I WANTED TO ADD
, UH FOR AN FQ HÌ èC. I SPOKE
ABOUT US BEING RENT OUT AND
REALLY TRYING TO GO FOR A SCOPE
CHANGE. AND I THINK THAT JUST
DOESN'T WORK. I, I WE HAVE THE
JOB DESCRIPTIONS. WE'RE PAYING
THEM, YOU KNOW, HIGHER THAN
MINIMUM WAGE MUCH HIGHER. THEY
ARE PART OF THE FABRIC OF
COMMUNITY HEALTH CENTERS. BUT WE
ARE RELYING ON PHILANTHROPY TO
FUND A LOT OF THAT. AND I THINK
WHERE THE EXAMPLE THAT HAS BEEN
VERY SUCCESSFUL THAT I SPOKE OF
IS THE E èC M, WHERE THERE IS A
WORK AROUND WHERE THERE IS A PER
MEMBER PER MONTH AND I'M TELLING
YOU THAT, YOU KNOW. NOW WE'RE
ACTUALLY DOUBLING THE NUMBER OF
èC HÌ, W S¼ AND FEELING VERY
CONFIDENT ABOUT THAT, AND WE'RE
SHOWING THAT THEY'RE KEEPING
THEM OUT OF THE HOSPITAL,
KEEPING THEM OUT OF THE
EMERGENCY ROOM. SO I BUT, YOU
KNOW, E èC M IS VERY LIMITED.
IT'S FOCUSING ON THE HIGHEST
UTILIZE THOSE THOSE ARE REALLY
IMPACTED. BUT IF WE CAN GROW
THAT TO MORE OF A PREVENTIVE
LENS, I THINK YOU'LL SEE THAT
THERE'S GONNA BE A LOT MORE
MONEY SAVED. SO I THINK IN
LOOKING AT THIS, UM AT LEAST
FROM MY FQ HÌ èC POINT OF VIEW,
WE'VE ALWAYS HAD, UH, COMMUNITY
HEALTH WORKERS. PAID PART OF OUR
JOB, BUT WE NEED AN INFUSION
THAT IS SUSTAINABLE RATHER THAN
CHOPPY THROUGH PHILANTHROPY.
THANK YOU SO MUCH FOR THAT. UM
AND I WAS JUST SPEAKING WITH,
UH, CHAIR BONTA. THE NUMBERS
ACTUALLY, THREE 1000, NOT 3
MILLION, AND SO IT'S ACTUALLY
WORSE AS FAR AS OUR UTILIZATION
BASED ON THE AMOUNT OF FUNDING
THAT, UH, THAT HAS BEEN
ALLOCATED IN THIS AREA. UM I
HAVE A COUPLE QUESTIONS. UH,
DOCTOR, UH, FOR OUR ALEX FRATO
SORRY. UM YOU HAD MENTIONED
SOMETHING ABOUT THE FACT THAT,
UH, COMMUNITY HEALTH WORKERS
WERE BEING ASKED TO KIND OF
CHANGE TO KIND OF ASSIMILATE
INTO THE ENVIRONMENT RATHER THAN
ALLOWING THEM TO BE THEMSELVES
AND THEIR OWN EXPERIENCES. CAN
YOU ELABORATE ON THAT? A LITTLE
BIT MORE? YEAH. THANK YOU. THANK
YOU FOR THE QUESTION. UM YEAH,
WELL, WE HAVE NOTICED WITH THE
WITH THIS, UH, BENEFIT. IS THE
UM, HOW HAS BEEN INTEGRATED èC
HÌ W S¼ INTO THE SYSTEM BECAUSE
WHAT IS HAPPENING IS EVERYONE
RIGHT NOW, WITH THE WITH THE
FUNDING THAT IS HAPPENING IS
TRYING TO WORK OUT HOW TO USE.
SO WHAT IS HAPPENING IS THAT
MANY ARE UNFOUNDED POSITIONS
LIKE, UH, NÓ NOSE AID OR, UM, A
MEDICAL ASSISTANCE. I HAVE BEEN
GOING TO A TRAINING TO GET THE
TITLE. WELL, NOW I'M I'M SAGE DO
AND NOW I'M BILL. SO I CAN COVER
THAT POSITION. I THINK THAT'S
KIND OF WHAT WAS TRYING TO SAY.
THAT THERE HAS BEEN LOSING THE
IDENTITY OF THE èC HÌ W. SO UM,
UM A TRAINING IS, UH, IT'S
IMPORTANT TO DEVELOP THE SKILL
OF THE EXISTING HEART OF THE OF
THE PASSION THAT PERSON HAS, OR
THE RELATIONSHIP THAT PERSON HAS
IN THE COMMUNITY VERSUS JUST
HAVING THE TITLE AND DOING THE
WORK, SO I THINK THAT'S KIND OF
THE RISK THAT WE'RE SEEING. AND
AS A COALITION. WE HAVE BEEN
NOTICING, AND WE'RE TRYING TO
SEE HOW WE CAN WORK TOGETHER TO
MAKING SURE TO PROTECT THE
IDENTITY. OF THE REAL CH W. SO I
WANNA I WANNA MENTION AND ALSO,
I THINK, UH, EXPANDING A LITTLE
BIT OF THE OF THE WHITE AND I'M
ASSUMING THE MONEY IS THERE IS
BECAUSE UM IT IS NOT ENOUGH TO
COVER SO I TRAIN 100 èC HÌ W
S¼, FOR EXAMPLE. HOW HOW WE'RE
GONNA BE SUSTAINING THIS
WORKFORCE. SO I THINK THAT THE
RISK OF TRAINING TOO MANY PEOPLE
THAT WERE NOT GONNA BE ABLE TO
SUSTAIN WITH THE WITH THE
EXISTING RATE. CAN I JUST ADD TO
WHAT ALEX JUST MENTIONED? I
THINK ALSO, HISTORICALLY PLANS,
CLINICS AND HOSPITALS WILL
DEFINE THOSE POSITIONS.
HISTORICALLY THE PLANS, CLINICS
AND HOSPITALS WILL DEFINE THE
COMMUNITY HEALTH WORKER POSITION
ACCORDING TO THEIR NEEDS.
GATHERING DATA INPUT FORMS THOSE
KINDS OF THINGS THAT ARE NOT
RELATED TO THE WORK THAT THEY'RE
REALLY INTENDED FOR, WHICH IS
EDUCATION, OUTREACH, NAVIGATION
AND SUPPORT. AND I THINK THAT'S
PART OF WHAT COMPLICATES THE
ISSUE WHEN WE GET INTO WHO'S
HIRING, AND WHAT ARE THE
REQUIREMENTS FOR THAT POSITION
AND WHO GETS TO GET IN? WHO GETS
HIRED FOR THAT POSITION? THOSE
ARE BARRIERS THAT EXIST HAVE
HAVE EXISTED FOR A VERY LONG
TIME. THANK YOU SO MUCH FOR
THAT. WELL, THANK YOU SO MUCH
FOR COMING OUT TO, UH, SHARE
THIS. I THINK IT'S AGAIN. IT'S
AN INCREDIBLE OPPORTUNITY. WE
WANT TO BE ABLE TO BUILD ON YOUR
WORK. WE'RE GLAD TO BE ABLE TO
HEAR, UH FROM PRACTITIONERS
DIRECTLY. UH AND, UH AND WE'LL
CERTAINLY TAKE THIS UNDER ADVAN
ADVISEMENT AS WE CONTINUE TO
BUILD OUT BOTH LEGISLATIVELY AND
FROM A BUDGET PERSPECTIVE OUR
PROGRAMS AND PROVIDE THE
OVERSIGHT TO OUR AGENCY. SO
THANK YOU FOR COMING AND BEING
SUCH AN INCREDIBLY DIVERSE AND
EXPERT A GROUP OF PANELISTS. AS
WE ARE. GOING ON TO OUR THIRD
PANEL, WHICH IS IMPLEMENTING THE
èC HÌ W PR SERVICES AND
WORKFORCE IN CALIFORNIA
SUCCESSES, CHALLENGES AND
OPPORTUNITIES WE INVITE MICHELLE
BASS DIRECTOR OF Dð, HÌ, èC, S¼
AND RENEE MALO DIRECT, UH,
DEPUTY DIRECTOR OF DHCS TO COME
UP. I WANNA THANK THE DEPARTMENT
FOR THEIR EFFORTS IN CREATING
THE èC HÌ W BENEFIT AND FOR
YOUR ONGOING WORK TO ENSURE
THESE BENEFITS ARE REAL FOR ME
MEMBERS. OBVIOUSLY THE TAKE UP
OF THE BENEFIT HAS BEEN SLOW AND
I'M VERY AND WHAT WE ARE DOING,
MOVING FORWARD TO MAKE SURE
THESE SERVICES ARE OFFERED. IT
SEEMS LIKE MORE NEEDS TO BE DONE
TO GET PLANS TO FOCUS ON THIS
BENEFIT, AND WE WANT TO HEAR
ABOUT THAT. Dð HÌ èC S¼ HAS
SAID IT WILL CONTINUE TO
IDENTIFY WAYS TO PROVIDE FURTHER
GUIDANCE TO PLANS TO LEVERAGE
THE èC HÌ W BENEFIT. WHAT DOES
THIS LOOK LIKE? WILL THIS
GUIDANCE HAVE BLIND? UH, BINDING
REQUIREMENTS? WILL IT JUST
PROVIDE ENCOURAGEMENT OR BEST
PRACTICES? THESE ARE SOME OF THE
QUESTIONS THAT WE WANT TO BE
ABLE TO GET TO UH, WITH THAT WE
WILL BEGIN WITH, UH ELIZABETH
LANDSBURG, DIRECTOR OF HÌ Kò,
AND THEN MOVE ON TO LIBBY
ABBOTT. DEPUTY DIRECTOR OF HÌ
Kò. OH, SORRY. DIRECTOR PASCO
SORRY. GOOD AFTERNOON. UH, MADAM
CHAIR MEMBERS, MICHELLE BOSS,
DIRECTOR OF THE DEPARTMENT OF
HEALTH CARE SERVICES, UM AS
REALLY NOTED BY ALMOST EVERY
SINGLE PANELIST TODAY, UH, WE
SEE HUGE OPPORTUNITIES WITH THE
COMMUNITY HEALTH WORKER, UM,
BOTH BENEFIT AND UM AND, UM
ACTUAL WORKERS AS THEY CAN BE
EFFECTIVE WITH A VARIETY OF
POPULATIONS AS WELL AS IN
DIVERSE GEOGRAPHIC SETTINGS.
THEY CAN PROVIDE VALUABLE LINK
BETWEEN UNDERSERVED COMMUNITIES
AND THE HOSPITALS AND CLINICS.
UM AND OTHER HEALTHCARE SYSTEMS,
UM, LOCATED WITHIN THEM. DEEP
FAMILIARITY OF SOCIAL NETWORKS
AND COMMUNITY RESOURCES, WHICH
MAY BE LESS FAMILIAR, UM, TO THE
KIND OF THE CORE HEALTH CARE
PROFESSIONALS, UM AND SO REALLY
BRIDGING THAT CULTURAL AND
SOCIAL, ECONOMIC, UM GAPS
BETWEEN CLINICAL PROFESSIONALS
AND THE COMMUNITY THEY SERVE. UH
èC HÌ W S¼ HAVE BEEN PROVIDING
SERVICES TO MEDICAL MEMBERS FOR
SOME TIME, UH, FOR EXAMPLE, UH,
MANY OF OUR MEDIC MANAGED CARE
PLANS HAVE IS HISTORICALLY
EMPLOYED CWS FOR HEALTH
EDUCATION SERVICES, UM, MAY ALSO
BE MEMBER. OF CARE MANAGEMENT
TEAMS AND OTHER PROGRAMS,
INCLUDING THE COMPLEX CARE
MANAGEMENT. UH UH, SERVICE AND
THE ENHANCED CARE MANAGEMENT,
UM, AS WAS SPOKEN ABOUT EARLIER
TODAY. DO ACKNOWLEDGE THAT MORE
NEEDS TO BE DONE TO REALLY
MAXIMIZE AND ELEVATE CHW S IN
THE HOUSE OF CALIFORNIA'S HEALTH
LANDSCAPE. UH YOU KNOW, IT'S
BEEN DECADES, CREATING THE
SYSTEM WE HAVE TODAY AND REALLY
ALL OF OUR EFFORTS WITH REGARDS
TO THE TRANSFORMATION OF
MEDICALS REALLY IDENTIFYING WAYS
WE CAN BROADEN OUR HEALTHCARE
LANDSCAPE TO INCLUDE COMMUNITY
BASED ORGANIZATIONS REALLY
MEETING OUR MEMBERS WHERE THEY
ARE, AND WE REALLY SEE THE
COMMUNITY HEALTH WORKER BENEFIT
AS INTEGRAL AS PART OF THIS AS
NOTED JUST A FEW MINUTES AGO,
ACTUALLY, SINCE IMPLEMENTING THE
MEDICAL BENEFIT APPROXIMATELY
5500 MEDICAL MEMBERS HAVE
RECEIVED SERVICES FROM CHW,
RESULTING IN NEARLY ABOUT 9000
CHW. THEN IT BENEFITS WE WOULD
WANT TO NOTE THAT THIS DOES NOT
INCLUDE REALLY THAT THE
COMMUNITY HEALTH WORKERS THAT
ARE BEING UTILIZED FOR OTHER
SETTINGS SUCH AS, UM, THE
ENHANCED CARE MANAGEMENT, UH,
BENEFIT, WE KNOW THAT OUR
ENHANCED CARE MANAGEMENT
PROVIDERS ARE USED. SING
COMMUNITY HEALTH WORKERS TO
PROVIDE THE OUTREACH AND
EDUCATION SERVICES, WHICH IS ONE
OF THE CORE SEVEN COMPONENTS OF
THE ENHANCED CARE BENEFIT. AND
SO THOSE NUMBERS ARE NOT
REFLECTED IN THE PEER CHW
UTILIZATION. WE KNOW, JUST FOR
EXAMPLE, JUST CONVERSATION LAST
WEEK SITE VISITS AT THE L. A
COUNTY SOME OF OUR ENHANCED CARE
MANAGERS SUCH AS PARTNERS AND
CARE ARE REALLY LAYERING ON CHW
SERVICES AND BENEFITS AS THEY
IMPLEMENT ENHANCED CARE
MANAGEMENT. SO WE REALLY SEE A
HUGE OPPORTUNITY AS THE ENHANCED
CARE MANAGEMENT GETS BUILT OUT.
I WOULD NOTE JUST IN TERMS OF
THE ESTIMATE THAT YOU NOTED THAT
WAS BASED ON KIND OF PROJECTED
UTILIZATION OF THE COMMUNITY
HEALTH WORKER BENEFIT BACK AND
YOU KNOW 2021 AS THE PROPOSAL
WAS IMPLEMENTED. I MEAN, WE KNOW
WE STILL HAVE A LOT TO DO TO
KIND OF BUILD IT OUT TO THAT
CAPACITY. BUT THAT WAS, YOU
KNOW, A VERY INITIAL ESTIMATE OF
WHAT THESE OPPORTUNITIES MIGHT
BE. I WOULD ALSO NOTE THAT IN
TERMS OF OUR FQ HCS, REALLY THE
ALTERNATIVE PAYMENT METHOD
PROPOSAL KIND OF ABOUT PILOT
THAT PROPOSAL TO REALLY THINK
RETHINK ABOUT HOW WE PAIR OF QS
WAS INTENDED TO ADDRESS THIS TO
PROVIDE OUR CLINICS THE
OPPORTUNITIES TO PROVIDE
FLEXIBILITY IN THEIR CARE
DELIVERY MODELS AND NOT
NECESSARILY NEED TO USE BILLABLE
PROVIDERS SUCH AS PHYSICIANS TO
PROVIDE CARE IN OUR CLINICS AND
SO SEEING THAT AS AN OPPORTUNITY
WITHOUT HAVING TO DO A SCOPE
CHANGE TO REALLY RECOGNIZE THE
VALUE OF COMMUNITY HEALTH
WORKERS. IN OUR CLINICS. I WOULD
ALSO NOTE THAT SOME OF OUR
MEDICAL MANAGED CARE PLANS ARE
INTENDING AND THINKING ABOUT
PILOTING OF WHAT THEY WOULD
CONTRACT WITH COMMUNITY BASED
ORGANIZATIONS THAT WOULD SIT
WITHIN FQ HCS TO REALLY PROVIDE
SOME ENHANCED, UH, COMMUNITY
HEALTH WORKERS SERVICES IN R F Q
S. UM I WANTED JUST TO
HIGHLIGHT. I KNOW THAT MANY
MODELS OF HOW SIEGE WS CAN BE
USED IN OUR HEALTH CARE DELIVERY
SYSTEM WERE CITED IN REFERENCE
TODAY. I WANTED TO HIGHLIGHT AN
EXAMPLE THAT WE THINK IS ONE
LIKE A VERY JUST A GREAT BEST
PRACTICE IN A REALLY INNOVATIVE
WAY OF THINKING ABOUT HOW COUNTY
DEPARTMENTS CAN MAXIMIZE THEIR
USE OF C. H W S. SO RIVERSIDE
COUNTY AND INLAND EMPIRE HEALTH,
PEN AND MEDICAL MANAGED CARE
PLAN ARE REALLY PARTNERING TO
HAVE THE PUBLIC HEALTH
DEPARTMENT ESSENTIALLY SERVE AND
THAT THE HEALTH DEPARTMENT
SERVES AS A HUB FOR COMMUNITY
HEALTH WORKERS IN THE COUNTIES,
THEIR BEHAVIORAL HEALTH
DEPARTMENT PUBLIC HEALTH, UH,
THERE'S CONSIDERING AGING.
THEY'RE CONSIDERING M S
EMERGENCY SERVICES HOW THEY CAN
USE THIS BENEFIT AS PART OF
THEIR ENTIRE COUNTY DELIVERY
SYSTEM. AND YOU KNOW, JUST ONE
OF THE THINGS THAT THEY ALREADY
HAVE KIND OF STARTING TO
DEVELOP. IN TERMS OF THEIR
DEPARTMENT OF PUBLIC SOCIAL
SERVICES, SO THAT THEIR LOCAL
DEPARTMENT THAT OPERATES THAT
CAL WORKS WELFARE TO WORK
PROGRAM. DEVELOPING AN
APPRENTICESHIP PROGRAM SO THAT
INDIVIDUALS IN THE WELFARE TO
WORK PROGRAM HAVE A PATH TO
BECOME A COMMUNITY HEALTH WORKER
THEY HAVE HIRED OR THEY'RE IN
THE PROCESS OF HIRING ONE
INDIVIDUAL WHO'S GOING THROUGH
THAT PATHWAY TO REALLY SUPPORT
KIND OF WITHIN CALL WORKS AND
WELFARE TO WORK. HOW CAN WE
BUILD UP THAT WORKFORCE IN THAT
SPACE IN A IN A COUNTY? UM AND
REALLY JUST SOME INNOVATIVE
PARTNERSHIP BETWEEN THE RIVER,
RIVERSIDE COUNTY IN INLAND
EMPIRE HEALTH PLAN? JUST WANTED
TO HIGHLIGHT. THERE ARE LOTS OF
KIND OF VERY INSPIRING MODELS
OUT HERE IN THE STATE AND REALLY
LOOKING FOR WAYS TO LIFT UP
THESE MODELS. PUSH ARE MANAGED
CARE PLANS TO THINK ABOUT THIS
PUSH OUR LOCAL HEALTH
JURISDICTIONS TO THINK ABOUT
THIS AS WELL AS WE TRY TO
MAXIMIZE REALLY GREAT JOBS IN
OUR COMMUNITY AS A RESULT OF
COMMUNITY HEALTH WORKERS
SERVICES UM I WILL NOW TURN TO
MY COLLEAGUE, GRENADE. MELO
DEPUTY DIRECTOR TO REALLY TALK A
LITTLE BIT MORE ABOUT SOME OF
THE KIND OF THE QUESTIONS THAT
WERE RAISED. GOOD MORNING. GOOD
AFTERNOON, MADAM CHAIR MEMBERS.
SO AGAIN. I JUST WANTED TO
HIGHLIGHT A COUPLE OF THINGS
THAT WE'RE DOING AT THE
DEPARTMENT AND SUPPORT OF THE
COMMUNITY HEALTH WORKER BENEFIT
A LOT HAS BEEN DISCUSSED TODAY
BY OTHER PANEL MEMBERS. SO I'LL
JUST BE BRIEF IN MY REMARKS AND
WELCOME YOUR QUESTIONS AT THE
END. SO IN TERMS OF MEMBER AND
PROVIDER, RESOURCES AND
MATERIALS, WE'VE DONE A LOT OF
WORK IN TERMS OF DEVELOPING A
WEBSITE FOR INFORMATION ABOUT
CHW S. WE HAVE PUT OUT
INFORMATION AND OUR MEDICAL
PROVIDER MANUAL THAT TALKS ABOUT
THE BENEFIT THE SCOPE OF THE
BENEFIT AND HOW THOSE SERVICES
CAN BE BUILT FROM THE DEPARTMENT
. WE'VE ALSO PUT OUT A PROVIDER
BULLETIN REGARDING THE BENEFIT.
AS WELL AS AN ALL PLANNED LETTER
THAT WAS REFERENCED EARLIER THAT
GIVES DETAILED TAR MANAGED CARE
PARTNERS IN TERMS OF THE BENEFIT
THAT IS MADE AVAILABLE TO
MEDICAL MEMBERS, AND WE ALSO
HAVE A DEDICATED EMAIL INBOX, UH
, THAT CAN BE USED BY PROVIDERS,
MEMBERS AND OTHERS TO SUBMIT
QUESTIONS TO THE DEPARTMENT
REGARDING THE BENEFITS. ONE OF
THE THINGS THAT WAS STATED
EARLIER WAS ABOUT MAKING SURE
THAT WE INVOLVE THE VOICE OF THE
COMMUNITY HEALTH WORKER WHEN WE
WORKED ON THE DEVELOPMENT OF THE
BENEFIT, WE DID HOLD THE
STAKEHOLDER WORKGROUP EFFORT AND
WANTED TO HEAR FROM PEOPLE IN
TERMS OF THE BENEFIT AND HOW IT
SHOULD BE STRUCTURED HERE IN
CALIFORNIA, SO THE BENEFIT AND
ITS STRUCTURE IN TERMS OF THE
TRAINING AND THE SORT OF
OCCASION WAS INFORMED BY VOICES
FROM THE COMMUNITY DEALING WITH
COMMUNITY HEALTH WORKERS. WE
HAVE BEEN PROVIDING TECHNICAL
ASSISTANCE TO OUR MANAGED CARE
PARTNERS. UM AND WE HAVE
PROVIDED AT LEAST 60 SESSIONS TO
DATE, UM, THAT INCLUDE WEEKLY
PLAN CALLS WITH HIM AS WELL AS
SPECIFIC CHW. FOCUS WEBINARS
WITH OUR PLANNED PARTNERS. WE
WILL ALSO BE PARTNERING WITH
SEEP IN, UM, TO HOST SOME
SESSIONS FOR MANAGED CARE PLANS
AND FOR PROVIDERS TO ATTEND. ONE
SESSION WILL SHOW ABOUT THE
MANAGED CARE CONTRACTING PROCESS
OUT FAMILIARIZED PROVIDERS AND
THEN THE OTHER SESSION WILL BE
TO SHOW PROVIDERS THIS BUT THAT
PERSPECTIVE FROM SEA PENS
MEMBERSHIP IN TERMS OF THE USE
OF COMMUNITY HEALTH WORKERS, AND
THEN WE'RE ALSO HOPING TO
PARTNER WITH CALIFORNIA
HEALTHCARE FOUNDATION TO
SHOWCASE THEIR CHW TOOLKIT. WE
DO VALUE B COLLABORATION THAT WE
HAVE WITH THE STAKEHOLDERS IN
THIS SPACE BECAUSE WE DO THINK
IT'S IMPORTANT AND USING THEM TO
HELP WITH THE TRAINING
OPPORTUNITIES THAT WE OFFER TO
OUR MANAGED CARE PLANS IN OUR
PROVIDERS AND WELL, WE'RE ALSO
AS WILL BE MENTIONED HERE
SHORTLY, COLLABORATING VERY
CLOSELY WITH AGE CHI AND WITH
OUR AGENCY IN TERMS OF A SERIES
OF COMMUNITY DIALOGUE SESSIONS
THAT ARE UNDERWAY AND WILL BE
OCCURRING OVER THE NEXT SIX
MONTHS. TO BETTER UNDERSTAND AND
TO STRENGTHEN. THE CAPACITY OF
COMMUNITY HEALTH WORKERS THAT
PARAMETER AREAS AND THE
COMMUNITY HEALTH REPRESENTATIVES
AND TO HELP WITH THE UPTAKE OF
THE BENEFIT IN THE MEDICAL
PROGRAM. IT IS REALLY IMPORTANT
TO US TO HEAR THOSE VOICES SO
THAT WE CAN, THEN YOU KNOW,
PIVOT AND MAKE SOME
MODIFICATIONS AND OR ADDITIONAL
TRAINING MATERIALS AVAILABLE. SO
THAT PEOPLE CAN HELP TO
UNDERSTAND THIS BENEFIT UNDER
THE MEDICAL PROGRAM. AND I WILL
STAY BACK GIVEN THE TIME OF
IMPLEMENTATION IS DOES TAKE TIME
FOR NEW BENEFITS TO BE REALIZED
IN THE PROGRAM, BUT WE ARE
REALLY WORKING VERY DILIGENTLY
IN TERMS OF HELPING TO INCREASE
THE AWARENESS AND THEY UPTAKE OF
THAT BENEFIT. I WILL. NO ONE
QUESTION THAT WAS POSED TO US
WAS ABOUT THE USE OF THE NEW
CODES THAT ARE UNDER MEDICARE.
AND WITH THE MEDICARE CODES AS
IT RELATES TO THE MEDICAL
PROGRAM. WE BELIEVE THAT AND
WE'VE LOOKED AT THEIR CODES. WE
BELIEVE THAT IN THE WAY THEIR
CODES ARE STRUCTURED OR A BIT
MORE RESTRICTIVE THAN WHAT THEY
ARE UNDER THE MEDICAL PROGRAM,
FOR INSTANCE, ONE OF THE CODES
IS ONLY BUILD ON A MONTHLY BASIS
, WHEREAS OUR CODES ARE BILLED
BASED UPON TIME INCREMENTS, AND
THEY CAN BE BUILT UP TO A
CERTAIN AMOUNT IN A PARTICULAR
DAY FOR INDIVIDUALS. SO WE JUST
WANT TO MAKE SURE THAT AS WE'RE
LOOKING AT THIS BENEFIT THAT WE
DON'T INTRODUCE NEW POLICIES
THAT MAY BE MORE RESTRICTIVE
THAN WHAT WE ALREADY HAVE IN OUR
PROGRAM TODAY. AND WITH THAT,
THAT WILL CONCLUDE MY COMMENTS
AT THIS TIME AND LOOK FORWARD TO
ANY QUESTIONS THAT YOU WANT ME
HAVE. THANK YOU. THANK YOU. SO
NOW WE'LL HEAR FROM THE DIRECTOR
AND DEPUTY DIRECTOR,
RESPECTIVELY. ELIZABETH
LANDSBERG AND LIBYA. ABBOTT FROM
THE CALIFORNIA DEPARTMENT OF
HEALTH CARE, ACCESS AND
INFORMATION EDUCATED THANK YOU
VERY MUCH. GOOD AFTERNOON TO
BOTH TO BOTH CHAIR, WOMEN AND
MEMBERS. ELIZABETH LANDSBERG
WITH H CHI, THE DEPARTMENT OF
HEALTH CARE, ACCESS AND
INFORMATION, SO WE ARE COMMITTED
WITH ALL OF OUR HEALTH WORKFORCE
PROGRAMS TO DIVERSIFY THE HEALTH
WORKFORCE TO HAVE IT BE MORE
REPRESENTATIVE OF CALIFORNIA IN
TERMS OF RACE, ETHNICITY,
LINGUISTIC SKILLS, CULTURAL
DIVERSITY AND DIVERSE IN ITS
LIVED EXPERIENCE AND INVESTING
IN COMMUNITY HEALTH WORKERS IS
KEY TO THAT MISSION WORK. THE
AGENDA AND THE TESTIMONY WE'VE
HEARD TODAY POWERFULLY DESCRIBED
THE ROLE AND IMPACT OF CHW PRS
IN IMPROVING HEALTH OUTCOMES FOR
CALIFORNIA'S COMMUNITIES. WE
ALSO THINK THAT SUPPORTING THE
TRAINING OF CHW PRS OFFERS
HEALTHCARE EMPLOYMENT
OPPORTUNITIES TO PEOPLE FROM
MARGINALIZED COMMUNITIES WHO
MIGHT NOT OTHERWISE HAVE ACCESS
TO TRADITIONAL TRAINING PATHWAYS
INTO THE HEALTH WORKFORCE. SO WE
BELIEVE THAT BY SUPPORTING AND
EXPANDING THE CHW PR WORKFORCE
WERE BOTH ADVANCING ACCESS TO
QUALITY CARE, BUILDING THE
DIVERSE WORKFORCE THAT WE WISH
TO SEE IN CALIFORNIA AND
ADDRESSING THE SYSTEMIC, UM,
LACK OF EQUITY WE'VE EXPERIENCED
IN CALIFORNIA'S HEALTH CARE
SYSTEM. OUR OVERALL AIM IS TO
EXPAND AND SUPPORT THE CHW PR
WORKFORCE IN CALIFORNIA TO
INCREASE ACCESS TO CARE FOR
MARGINALIZED COMMUNITIES AND TO
DO SO BY SUPPORTING THE
RECRUITMENT, TRAINING AND
CERTIFICATE PROCESS FOR CHW PRS,
SO TO ACHIEVE THESE GOALS WERE
CURRENTLY UNDERTAKING A PROCESS
TO HEAR FROM STAKEHOLDERS,
INCLUDING VERY IMPORTANTLY, FROM
CHW PRS THEMSELVES ON WHAT ARE
SPECIFIC INTERVENTIONS AND
ACTIVITIES SHOULD BE WE'RE
APPROACHING THIS WITH AN OPEN
MIND AND WILLINGNESS TO INVEST
IN INNOVATIVE AND COMMUNITY
INFORMED SOLUTIONS. SO H CHI WAS
CHARGED IN THE 2022 BUDGET TO
DEVELOP STATEWIDE REQUIREMENTS
FOR CHW CERTIFICATION PROGRAMS
IN CONSULTATION WITH
STAKEHOLDERS TO APPROVE
STATEWIDE REQUIREMENTS FOR
CERTIFICATE PROGRAMS FOR CHW S
AND REVIEW AND APPROVE THE
CURRICULA FOR CORE COMPETENCIES,
THE SPECIALIZED PROGRAMS AND
TRAINING SO WE DID. WE HAVE
ALREADY ENGAGED IN SIGNIFICANT
STAKEHOLDER ENGAGEMENT AND
DESIGN PROCESS TO MEET THOSE
REQUIREMENTS. WE STARTED WITH
MEETINGS WITH 26 STAKEHOLDER
ORGANIZATIONS TO HEAR FROM THOSE
WITH EXPERTISE IN THIS SPACE,
INCLUDING MANY OF THOSE WE'VE
HEARD FROM TODAY. LAST SPRING,
WE HAD 43 STAKEHOLDER ENGAGEMENT
SESSIONS AND HEARD FROM MORE
THAN 1500 INDIVIDUALS, INCLUDING
MANY CHW PRS ACROSS THE STATE
AND GAVE THOSE FOLKS GAVE INPUT
ON THE DESIGN OF THE STATE
CERTIFICATE. ALL SESSION TYPES
EITHER OFFERED SPANISH ONLY
SESSIONS OR HAD LIVE SPANISH
TRANSLATION AND WE ALSO OFFERED
THE OPPORTUNITY FOR OTHER
LANGUAGE TRANSLATIONS. SO BASED
ON THE FEEDBACK FROM THOSE
SESSIONS WE DID LAST JULY ISSUE
A GUIDANCE LETTER WITH THE
STATUTORY REQUIREMENTS AROUND
THE CERTIFICATE PROGRAM IN THE
TRAINING. UM AND AS YOU KNOW,
THAT HAS NOW BEEN PAUSED DESPITE
THE HEAVY ENGAGEMENT THAT WENT
INTO THIS PROCESS WE HEARD FROM
SOME IN THE COMMUNITY THAT THEY
FELT THEIR FEEDBACK HAD NOT BEEN
ADEQUATELY HEARD OR ADDRESSED.
AND THAT IS WHAT LED TO THE
PAUSE AND IMPLEMENTATION OF THE
GUIDANCE LETTER THAT SECRETARY
GALLEY ELITE IT ALLUDED TO, AND
THE SECOND ROUND OF COMMUNITY
DIALOGUES THAT IS ONGOING. THANK
YOU, ELIZABETH AND GOOD
AFTERNOON CHAIRS AND MEMBERS.
I'M FOLLOWING THE PAUSE THAT WAS
ANNOUNCED IN NOVEMBER. 2023 THE
STATE TEAM COMPRISED OF
CALIFORNIA HEALTH AND HUMAN
SERVICES AGENCY, DHC S AND H.
CHI HAS BEEN WORKING WITH
CONSULTANTS TO DESIGN A
STAKEHOLDER ENGAGEMENT PROCESS
THAT WOULD GO DEEPER TO LEVERAGE
COMMUNITY EXPERTISE TO DETERMINE
HOW BEST TO MEET OUR STATE
REQUIREMENTS. IN FEBRUARY, WE
LAUNCHED OUR SECOND ROUND OF
STAKEHOLDER ENGAGEMENT THROUGH
WHICH WE WILL CONDUCT OVER 20
DIALOGUE SESSIONS WITH CHW PRS,
THEIR ALLIES AND EMPLOYERS
AROUND THE STATE. THE OVERALL
AIM OF THE DIALOGUE PROCESS IS
TO GET STAKEHOLDER FEEDBACK ON
TWO BASIC QUESTIONS. HOW CAN THE
STATE BEST USE ITS FUNDS FOR
RECRUITING TRAINING AND
CERTIFYING CHW PRS AND HOW CAN
THE STATE DESIGN AND IMPLEMENT A
STATE APPROVED CERTIFICATE TO
SUPPORT AND ADVANCE THE CHW PR
PROFESSION IN CALIFORNIA? WE
HAVE SELECTED DIALOGUE SITES
WITH ATTENTION TO ADDRESSING
BOTH GEOGRAPHIC DISTRIBUTION AND
COVERAGE OF THE WIDE RANGE OF
TYPES OF C H W. P R S AND THE
COMMUNITIES THAT THEY SERVE,
SUCH AS LATIN COMMUNITIES,
TRIBAL COMMUNITIES, BLACK
COMMUNITIES ON HOUSED
INDIVIDUALS AND JUSTICE INVOLVED
POPULATIONS. WE ARE PRIORITIZING
INPUT FROM CHW PRS THEMSELVES,
BUT ARE ALSO DESIGNING DIALOGUES
FOR THE CBO'S HEALTH PLANS AND
HEALTH SYSTEMS THAT WORK WITH
CHW PRS TO ENSURE THAT WE HAVE A
HOLISTIC VIEW OF WHAT IS NEEDED
TO EXPAND AND SUPPORT THIS
WORKFORCE AND INTEGRATE THEM
SUSTAINABLY TEAM BASED CARE. AN
EARLIER PANELISTS RAISED THAT WE
NEED A FORMAL SPACE FOR
CONSULTATION WITH CHW PR, SO
DRIVE OUR EFFORTS AS A STATE AND
THAT FEEDBACK IS WELL HEARD. IN
LATE FEBRUARY, WE KICKED OFF AND
AD HOC ADVISORY WORK GROUP
COMPRISED OF KEY ORGANIZATIONS
AND THOUGHT LEADERS IN THE CHW
PR SPACE, MANY OF THEM IN THE
ROOM TODAY AND COLLECTED
FEEDBACK FROM THIS GROUP ON OUR
DIALOGUE GUIDE PROCESS AND SITE
SELECTION. WE WILL CONTINUE TO
ENGAGE THE AD HOC ADVISORY GROUP
REGULARLY EVERY 4 TO 6 WEEKS
OVER THE NEXT FEW MONTHS TO
ENSURE THAT OUR PROCESSES
COMPREHENSIVE, RELEVANT AND
APPROPRIATE. WE INTEND TO
FORMALIZE A WORKING GROUP IN THE
COMING MONTHS AND WILL OPEN
APPLICATIONS TO THE GROUP,
RESERVING DEDICATED SLOTS FOR
CHW PRS THEMSELVES. IN THIS
BUDGET YEAR. H CHI HAS $15
MILLION TO SUPPORT CHW PR
PROGRAMMING. HOWEVER WE HEARD
THE MESSAGE FROM STAKEHOLDERS
THAT OUR DESIGN PROCESS NEEDED
TO BE MORE COMPREHENSIVE AND
HOLISTIC AND SO HAVE PAUSED
IMPLEMENTATION OF THAT FUNDING
WHILE WE GO THROUGH A MORE
ROBUST TO STAKEHOLDER ENGAGEMENT
PROCESS, AS I JUST DESCRIBED THE
RESULTS OF OUR STAKEHOLDER
DIALOGUES ALONGSIDE CONSULTATION
WITH THE ADVISORY GROUP WILL
INFORM THE ALLOCATION OF HK'S
$15 MILLION IN BUDGET YEAR 2324
AND REMAINING FUNDS, INCLUDING
$188 MILLION IN 2024, 25 AND
57.5 MILLION IN 2025 26. WE
EXPECT TO WRAP UP OUR DIALOGUE
PROCESS THIS SUMMER AND BEGIN
PROGRAMMING FUNDS IN LATE 2024 H
. CHI HAS EXPENDITURE AUTHORITY
THROUGH 2028 FOR THESE FUNDS.
SEPARATELY EARLIER THIS YEAR,
SONY COMPROMISO RECEIVED A $10
MILLION CONTRACT AS A ONE TIME
LEGISLATIVE AUGMENTATION THROUGH
H CHI TO STRENGTHEN THE STATE'S
INFRASTRUCTURE AND SUPPORT FOR
PROMO. TORRE'S COMMUNITY HEALTH
WORKERS AND COMMUNITY BASED
ORGANIZATIONS. INCLUDING THROUGH
BUILDING CBO HUBS AND ASSESSING
TRAINING NEEDS AT H. CHI WE HOPE
TO LEARN FROM VICHY ONLY COME
FROM ISO'S WORK AND INTEGRATE
THEIR FINDINGS LESSONS LEARNED
AND GOOD PRACTICE EXAMPLES INTO
OUR FUNDING STRATEGY. SO WE'RE
WE'RE DEEPLY COMMITTED AT AGE
KIND OF SUPPORTING THE TRAINING
OF CHW, PRS AND THEIR EFFECTIVE
INCORPORATION INTO TEAM BASED
CARE VERY HELPFUL TO HEAR FROM
THE PLANS FROM THE CLINICS FROM
THE COMMUNITY BASED
ORGANIZATIONS, AND IT'S GOING TO
TAKE DEEP COLLABORATION WITH ALL
OF THOSE GROUPS AND PRIMARILY
LISTENING TO CHW PRS TO SET UP
THE SYSTEMS THAT WE NEED TO
TRULY SUPPORT. THIS BENEFIT AS
WE NEED TO DO, MOVING FORWARD.
THANK YOU. I'LL OPEN IT UP TO MY
COMMUNITY MEMBERS. DR. ANGULAR
THANK YOU SO MUCH. I'M GOING TO
BEGIN WITH DIRECTOR BOSS AND
DEPUTY DIRECTOR HOLLOW. IF I CAN
. I WANT TO FOCUS ON THE ALL
PLANNED LETTER THAT WENT OUT.
I'M TRYING TO GET AND
UNDERSTANDING ABOUT WHETHER OR
NOT OR PLANS OR MEETING OUR
EXPECTATIONS OR WHAT
EXPECTATIONS WE'VE PLACED ONTO
HIM. AT THE MOMENT. WHAT'S OUR
EXPECTATION FOR THEM TO RAMP UP
AND HAVE CH WS AS A BENEFIT THAT
IS MEANINGFUL AS THE INTEGRATION
PLAN OR INTEGRATION PLAN SEEMS
TO NOT INHERENTLY HAVE A NETWORK
THAT THEY HAVE TO DECLARE, SO
I'M TRYING TO GET AN
UNDERSTANDING WHAT'S REASONABLE
FOR US TO EXPECT IN TERMS OF A
RAMP UP AND IN TERMS OF A
SUFFICIENT NETWORK THAT WE'RE
ASKING THE PLAN AS IT SEEMS, YOU
HAVE THE TOOLS BOTH FOR AND
CARROT AND A STICK. YOU HAVE AN
INCENTIVE PAYMENT PLAN AS WELL
AS THE OPPORTUNITY TO DO SOME
CORRECTIVE ACTION PLANS TO THESE
MM CPS THAT I'D LIKE TO
UNDERSTAND HOW ASSERTIVE OR
AGGRESSIVE ARE WE BEING AND
MAKING SURE THAT WE'RE GETTING
THIS UP AND RUNNING AS QUICKLY
AS WE CAN. SO WITH REGARD TO OUR
INCENTIVE PAYMENT PROGRAMS, SO
THESE ARE DOLLARS KIND OF BASED
ON KIND OF REPORTING OF
UTILIZATION ON CHW SERVICES. YOU
KNOW, WE THE KIND OF THE FIRST
ROUND DID NOT PRODUCE, YOU KNOW
THE SUFFICIENT DATA, THE DATA
THAT WE THOUGHT IT WOULD
PRODUCE. WE KNOW THAT THE PLANS
ARE RERUNNING THE DATA FOR THE
NEXT ROUND OF SUBMISSION, AND WE
WILL BE CLOSELY WATCHING THAT. I
MEAN, THE KIND OF THEY
UNDERSTAND THE IMPORTANCE OF,
YOU KNOW, TRUE SUBMISSION OF
THAT THOSE THAT INFORMATION WE
KNOW ENCOUNTER DATA OFTEN LAGS,
BUT THE IMPORTANCE OF REALLY
GETTING A TRUE UNDERSTAND.
ADDING OF WHAT IS AVAILABLE AND
IN THE STATE IS SOMETHING I
THINK THAT WE WILL HAVE AS
BASELINE TO REALLY KIND OF
UNDERSTAND WHERE WE'RE AT TODAY.
YOU KNOW, WE DON'T HAVE SPECIFIC
REQUIREMENTS LIKE WE HAVE FOR
SOME OF OUR OTHER PROFESSIONALS
WITH RATIO REQUIREMENTS. WE
DON'T HAVE THAT YET. I THINK
THIS IS REALLY UNDERSTANDING
KIND OF WHERE WE ARE TODAY AND
WHERE WE CAN GET TO AND HAVING
THE CONVERSATION WITH. YOU KNOW
THE COMMUNITIES IN ALL OF OUR
THE STAKEHOLDERS INVOLVED TO
UNDERSTAND WHERE WE WANT TO GET
TO, AND I THINK PART OF IT, TOO
IS UNDERSTANDING WHERE COMMUNITY
HEALTH WORKERS SERVICES. ARE
BEING PROVIDED. THAT'S NOT
REFLECTED IN THE ENCOUNTER DATA
WE KNOW THAT THERE ARE BEING
PROVIDED THROUGH ECM. WE KNOW
THAT THEY'RE BEING PROVIDED IN
CLINICS BASED ON KIND OF THEIR
THEIR PRACTICES FOR MANY YEARS
OF USING THE COMMUNITY HEALTH
WORKER SERVICES KIND OF AS PART
OF WHAT THEY PROVIDED. AN F Q.
SO THERE IS A LITTLE BIT OF
UNDERSTANDING OF YOU KNOW WHERE.
WHERE DO WE HAVE TODAY? THAT MAY
ALSO NOT BE REFLECTED AS PART OF
JUST ENCOUNTER DATA REPORTED BY
OUR MANAGED CARE PLANS. THE LAST
PANEL SPOKE SO ARTICULATELY
ABOUT THE BENEFIT THAT WE SEE
FINANCIALLY TO INVESTING INTO
OUR CH W. P R S THAT ARE PLANS
SHOULD BE WANTING AND WILLING TO
TAKE THIS UP. AND UM IT'S A BIT
SHOCKING THAT WE'RE NOT SEEING
THE IMPLEMENTATION THAT SHOULD
BE EXPECTED WITH THE BENEFITS
THAT ARE BEFORE US FROM
RESEARCH. AND SO I'M JUST TRYING
TO MAKE SURE WE'RE USING ALL THE
TOOLS THAT WE HAVE TO GET THE
PLANS TO BE IMPLEMENTING THIS AS
QUICKLY AS WE CAN. AND, UM JUST
WANT TO MAKE SURE WE'RE DOING
JUST THAT. AND I WOULD KNOW IT
ALSO JUST I THINK ABOUT OUR BOLD
GOALS. 50 BY 2025 AND THE FOCUS
ON PREVENTION AND PRIMARY CARE,
MATERNITY CARE AND BIRTH EQUITY
OUTCOMES AND BEHAVIORAL HEALTH
INTEGRATION, AND THOSE ARE KIND
OF THOSE METRICS THAT WE MONITOR
EVERY YEAR AND THAT'S WHERE WE
ARE HOLDING OUR PLANS
ACCOUNTABLE WITH REGARD TO
SANCTIONS, FINANCIAL SANCTIONS.
AND RECOGNIZING THE ONLY WAY
THEY ARE GOING TO MEET THOSE
METRICS AND MAKE IMPROVEMENTS IS
AN INVESTMENT IN COMMUNITY
HEALTH WORKERS. AND SO I THINK
THEY I MEAN, I THINK EVERYBODY
UNDERSTANDS THAT REALLY
IMPORTANT LINK THERE, AND WE
HAVE KIND OF OUR WAYS THAT WE
MONITOR OUR MANAGED CARE PLANS
IN TERMS OF QUALITY THAT WILL BE
REFLECTIVE OF THEIR USE OF CHW S
FINAL QUESTION, MADAM CHAIR. UM
SO THOSE PRIORITY AREAS THAT
WE'VE IDENTIFIED FROM THOSE BOLD
GOALS ARE WE MEETING CAPACITY
FOR CH WS IN THOSE PRIORITY
AREAS OR BEHAVIORAL HEALTH
INTEGRATION INTO PRIMARY CARE,
CHILDREN'S PREVENTIVE SERVICES
AND MATERNAL OUTCOMES. ARE WE AT
LEAST FOCUSING ON THOSE THREE
PRIORITY AREAS? INITIALLY OR ARE
WE JUST GETTING STARTED? SO IN
TERMS OF JUST OVERALL MANAGED
CARE, COMPLIANCE AND OVERSIGHT
THAT THIS IS THE SECOND YEAR OF
KIND OF QUALITY SANCTIONS THAT
WE'VE IMPLEMENTED AS PART OF OUR
KIND OF OVERSIGHT OF OUR PLANS.
AND SO THIS IS YEAR TWO. THERE'S
NO SPECIFIC METRIC RELATED TO
COMMUNITY HEALTH WORKER
UTILIZATION. BUT RECOGNIZING THE
IMPORTANCE OF COMMUNITY HEALTH
WORKERS AND ACHIEVING SOME OF
THOSE, UM THOSE GOALS,
PARTICULARLY WITH THE EQUITY
LENS, I THINK IS I THINK
EVERYBODY IS COMMITTED TO AND
UNDERSTANDS THE IMPORTANT LINK
THERE. CAN I PICK UP ON DOCTOR?
AMBULANCE QUESTION A LITTLE BIT.
SO ARE THERE SPECIFIC BENCHMARKS
THAT YOU ARE INTENDING TO ROLL
OUT RELATED TO AH, THE COMMUNITY
HEALTH CARE WORKER. GROWING OF
THE NETWORK. FOR THAT CAN BE A
LITTLE BIT MORE OF A GUIDE.
BESIDES WHAT WE HAVE, SO I THINK
WE'RE TOO EARLY TO BE ABLE TO
SET RATIOS OR TO KIND OF COME UP
WITH PURE STANDARDS LIKE WE HAVE
FOR PHYSICIANS, AND ESPECIALLY
LIKE THOSE, UM THOSE TOOK YEARS
TO KIND OF DEVELOP AND
UNDERSTAND KIND OF WHAT'S
AVAILABLE, BUT I THINK IT IS
SOMETHING THAT WE ARE THINKING
THROUGH IN TERMS OF KIND OF WHAT
DOES THE NETWORK MEAN FOR
COMMUNITY HEALTH WORKERS? WHAT
IT SHOULD UTILIZATION LOOK LIKE,
SO I THINK IT'S PART OF THESE
ONGOING DISCUSSIONS AS WE
CONTINUE TO KIND OF INCREASE
UTILIZATION OR PUSH TO INCREASE
UTILIZATION OF A SENSE OF WHAT
THE TIMELINE WOULD BE FOR YOU TO
BE ABLE TO SET THOSE BÀN. IT
BREAKS. WE DO NOT AT THIS TIME.
I THINK, AS DIRECTOR BOSS HAS
SAID, AS WE CONTINUE TO EDUCATE
AND BUILD UP THAT WORKFORCE
BECAUSE THE OTHER END AND WE
RECOGNIZE THAT THERE ARE
COMMUNITY HEALTH WORKERS OUT
THERE TODAY DOING THIS TYPE OF
WORK. WHAT WE'VE ALSO LEARNED IS
THAT THEIR ENGAGEMENT WITH THE
MEDICAID PROGRAM IS NEW. AND SO
THAT'S A BRIDGE THAT WE HAVE TO
CROSS, AND WE HAVE TO ADDRESS
THE CONCERNS THAT THEY MAY HAVE
IN TERMS OF THEIR DESIRE TO
PARTICIPATE IN OUR PROGRAMS AS
WELL AS THE WORK THAT WE'RE
DOING TO HELP SUPPORT THE USE OF
COMMUNITY BASED ORGANIZATIONS
AND LOCAL HEALTH JURISDICTIONS
IN TERMS OF ENROLLING IN THE
MEDICAL PROGRAM AS A PROVIDER
TYPE, SO AS WE HAVE LAUNCHED
THESE NEW INITIATIVES WE HAVE
ALSO DEVELOPED TRAINING TOOLS
AND AS WE'RE HEARING QUESTIONS
FROM THEM OR MAKING REFINEMENTS
AND THOSE TOOLS, BUT THAT WILL
ALL TAKE TIME BECAUSE IT IS A
PARADIGM SHIFT FOR US, AND IT'S
A NEW WAY IN WHICH WE'RE DOING
OUR BUSINESS IN THE MEDICAID
PROGRAM THAT'S OUTSIDE OF THE
TRADITIONAL HEALTHCARE SYSTEM,
BUT AGAIN IN THE COMMUNITIES
THESE HAVE BEEN SERVICES AND
SUPPORTS THAT HAVE BEEN OUT
THERE, BUT THEY HAVE NOT BEEN
FORMALLY RECOGNIZED PER SE,
SAYING IN THE MEDICAID PROGRAM,
SO THERE WAS A GROUNDSWELL
THERE, BUT IT WILL TAKE TIME. I
THINK IT MIGHT BE HELPFUL TO
THINK ABOUT SOME OF THE LEADING
INDICATORS THAT WE CAN TIE AS
SOME METRICS AROUND JUST EARLY
UTILIZATION, INCREASING THAT
NUMBER JUST CONTINUE TO KNOW
THAT WE HAVE SUCH AN INCREDIBLE
DEARTH OF CULTURALLY AND
LINGUISTICALLY CONCORDANT
HEALTHCARE WORKERS. WE HAVE AN
ABSOLUTE GOLDEN OPPORTUNITY NOW
TO BE ABLE TO TAKE ADVANTAGE OF
THIS BECAUSE IT'S A DEFINED
BENEFIT. UM AND WE KNOW THAT WE
HAVE 25,000 WORKERS THAT NEED TO
COME ONLINE. SO ANYTHING THAT
WOULD ALLOW US TO HAVE A CLEAR
ROADMAP AROUND HOW WE ARE GOING
TO DO THAT, UM, WITH SOME
METRICS WOULD BE INCREDIBLY
HELPFUL FOR US JUST TO BE ABLE
TO MARK WORK TIME. THANK YOU.
AND ALONG THAT ROUTE, DO WE HAVE
A ROAD, MAC. A ROADMAP AS TO
WHAT IS THE OUTCOME THAT WE'RE
LOOKING FOR? WHEN WE'RE TALKING
ABOUT IMPROVING HEALTH OUTCOMES
DO WE HAVE AS WE'RE PUTTING THIS
PROGRAM TOGETHER? UM DO WE HAVE
AN IDEA OF WHAT ARE THE OUTCOMES
THAT WE'RE LOOKING FORWARD TO
DETERMINE WHETHER OR NOT THIS IS
SUCCESSFUL? IF IT'S SOMETHING
THAT WE SHOULD CONTINUE TO FIND
IF WE SHOULD IN THE FUTURE FUND
MORE CONTINUE. DO WE HAVE THAT
OR IS IT JUST KIND OF A BLANK
SLATE. SO FOR THE DEPARTMENT OF
HEALTH CARE SERVICES ARE
COMPREHENSIVE QUALITY STRATEGY
WHERE WE OUTLINE OUR BOLD GOALS.
50 BY 2025. THAT IS OUR KIND OF
OUR ROADMAP ON THAT KIND OF THE
METRICS. WE WANT TO MONITOR THE
DISPARITY REDUCTIONS WE WANT TO
SEE BY, YOU KNOW A CERTAIN DATE
AND THAT IS KIND OF THE GLOBAL
FRAMEWORK FOR WHAT WE'RE TRYING
TO ACHIEVE. AND EVERYTHING WE'RE
DOING IS REALLY IN ALIGNMENT
WITH THAT. I EVEN THINK ABOUT
THE EQUITY AND PRACTICE
TRANSFORMATION GRANTS ALL OF OUR
INVESTMENTS. ALL OF OUR KIND OF
MONITORING IS IN ALIGNMENT WITH
OUR COMPREHENSIVE QUALITY
STRATEGY. SO I WOULD SAY THAT IS
OUR ROADMAP. AND SO AT SOME
POINT IN THE FUTURE, YOU'LL BE
ABLE TO COMPARE COMMUNITIES THAT
BENEFITED FROM THESE WORKERS
VERSUS COMMUNITIES THAT DIDN'T
TO SEE IF THERE'S A DIFFERENCE
IN THE HEALTH OUTCOMES. WERE
THESE SPECIFIC AREAS THAT WE'RE
LOOKING AT PRIMARY CARE,
MATERNAL HEALTH, BEHAVIORAL
HEALTH. I DON'T KNOW THAT IT'S
UH WE WOULD BE ABLE TO DRAW A
CONCLUSION THAT THE USE OF
COMMUNITY HEALTH WORKERS MEANT
MADE A DIFFERENCE BECAUSE WE'RE
MAKING INVESTMENTS IN SO MANY
PLACES WITH REGARD TO ACHIEVING
THESE OBJECTIVES AND SO
ISOLATING COMMUNITY HEALTH
WORKERS VERSUS TARGETED RATE
INCREASES FOR PRIMARY CARE
THERE'S A WHOLE HOST OF THINGS
THAT ARE GOING TO DRIVE TOWARDS
THE QUALITY IMPROVEMENTS THAT
WE'RE WORKING TOWARDS AND SO
ISOLATING EACH OF THOSE
INDIVIDUAL INITIATIVES. THINK IS
GOING TO BE DIFFICULT TO DO.
WELL, HOW WILL WE KNOW IF IT'S
SUCCESSFUL THEN? IF ALL OF THE
OTHER VARIABLES ARE THE SAME IN
A COMMUNITY AND ONE HAS THE
BENEFIT OF COMMUNITY HEALTH
WORKERS, AND THE OTHER DOESN'T
AND THAT ONE THAT DOES HAS MUCH
BETTER HEALTH OUTCOMES. LOWER
HOSPITALIZATION RATES IMPROVED,
YOU KNOW, HEMOGLOBIN, A ONE C
LEVELS BLOOD PART LIKE I DON'T
UNDERSTAND HOW YOU WOULDN'T BE
ABLE TO EXTRAPOLATE THAT. I
THINK THERE ARE A LOT THAT
THERE'S EQUITY PRACTICE
TRANSFORMATION GET GRANTS. THE
TARGETED RATE INCREASES
COMMUNITY HEALTH WORKERS. WE
HAVE DUAL AS WE HAVE THE
DIETETIC BENEFIT. THERE ARE A
LOT OF THINGS THAT WE'VE DONE
OVER THE LAST FEW YEARS THAT ARE
DIRECTLY RELATED TO WHAT WE'RE
TRYING TO ACHIEVE AND BEING ABLE
TO ISOLATE HOW MUCH EACH ONE OF
THOSE CONTRIBUTED OR DID NOT
CONTRIBUTE TO A HEALTH OUTCOME.
I THINK IT IS DIFFICULT. I DON'T
KNOW THAT WE HAVE THE CAPABILITY
AT THE DEPARTMENT TO ISOLATE IT
AND NOT SENSE BUT YOU KNOW HAPPY
TO CONTINUE CONVERSATIONS ON
THAT. AND IN TERMS OF HK'S GOALS
, IT REALLY IS A WORKFORCE
DEVELOPMENT GOALS. SO TOO, SO
THAT I JUST WANT TO SAY THE
25,000 WAS ORIGINALLY WHEN THERE
WAS A $350 MILLION PROPOSAL SO,
BUT WE ARE SETTING SPECIFIC
GOALS FOR GEOGRAPHICALLY, YOU
KNOW, FOR REACHING THE WHOLE
STATE, AND WE KNOW THAT THERE
ARE SOME TRAINING DESSERTS THAT
REALLY NEED TO BE ADDRESSED. BUT
WE ARE WORKING TO DEVELOP THAT
RACIALLY AND LINGUISTICALLY
DIVERSE COMMUNITY HEALTH WORKER
WORKFORCE FOR THE ENTIRE STATE.
THANK YOU. I'M DIRECTOR I LOOK
FORWARD TO HAVING MORE
CONVERSATIONS WITH YOU ABOUT
THIS. THANK YOU. UM AND I THINK
I JUST AGAIN WANT TO JUST
RECOGNIZE THAT WE HAVE SOME
SERIOUS UH, DESSERTS RIGHT NOW.
I'M VERY THANKFUL TO BE IN A
DISTRICT WHERE WE HAVE A LOT OF
OPPORTUNITY. UH AND HAVE A VERY
STRONG INFRASTRUCTURE. I'M VERY
CONCERNED ABOUT UM FIVE. THE
CENTRAL VALLEY IN PARTICULAR FOR
THE NOT HAVING THE KIND OF
INFRASTRUCTURE THAT WE NEED. SO
IS THERE ANYTHING THAT YOU ALL
CAN SPEAK TO AROUND, AMPLIFYING
THE NEED TO INCREASE THE
TRAINING OPPORTUNITIES IN OUR
HEALTH CARE WORKER DESSERTS?
YES, ABSOLUTELY. SO AS YOU KNOW,
MADAM CHAIR H CHI BOTH DEVELOPS.
WE HAVE THE METHODOLOGY TO
IDENTIFY THE MEDICALLY
UNDERSERVED AREAS WE ARE DO
WE'RE PULLING TOGETHER A LOT OF
THE WORKFORCE DATA PUTTING OUT
WITH OUR RESEARCH DATA CENTER,
THE AREAS THAT ARE MEDICALLY
UNDERSERVED. AND SO WE ARE GOING
TO BE FOCUSING, UM AND MISS
ABBOTT CAN TALK IN MORE DETAIL
ABOUT HOW WE'RE GOING TO BE
FOCUSING ON THOSE MEDICALLY
UNDERSERVED AREAS. AND I WOULD
JUST SAY THAT I MENTIONED
EARLIER. SOME OF THE FUNDING
AMOUNTS THAT WE HAVE AVAILABLE,
UM NOTABLY 188 MILLION FOR THE
NEXT BUDGET YEAR, AND IT'S
SOMEWHAT FLEXIBLE TO RECRUITMENT
TRAINING AND CERTIFICATION, SO
WE ABSOLUTELY DO PLAN TO ADDRESS
GAPS IN TRAINING. WE'VE HEARD
FROM SOME OF THE CBOS AND
STAKEHOLDERS IN THIS SPACE THAT
THERE THERE AREN'T ENOUGH
TRAINING OPPORTUNITIES TO
GENERATE THE SUPPLY THAT'S
NEEDED FOR THE SERVICE DEMAND SO
IT WE'RE WORKING VERY CLOSELY.
HAND IN HAND WITH THE HCS AS
THEY WORK ON THE DEMAND SIDE.
IT'S OUR RESPONSIBILITY TO
ADDRESS THE SUPPLY AND MAKE SURE
THAT THERE'S ADEQUATE TRAINING
OPPORTUNITIES SO WE'LL BE USING
OUR FUNDS BASED ON THE RESULTS
OF OUR DIALOGUES AND TARGETING
AREAS WITH GREATEST NEED. THANK
YOU WANT TO BE MINDFUL OF THE
TIME AND MY COLLEAGUES, UH,
SCHEDULES AS WELL AS WELL AS
YOURS. SO THANK YOU ALL FOR
COMING INTO PRESENTING. TO THIS
HEARING. IT'S BEEN VERY HELPFUL.
I'M GOING TO ASK MY HÌ CHAIR
HERE. IF SHE ISN'T CLOSING
REMARKS. UM I WILL BE BRIEF
BECAUSE I KNOW IT'S LATE IN THE
AFTERNOON. I JUST WANT TO THANK
EVERYONE WHO CAME OUT. I WANT TO
THANK ALL OF THE PANELIST FOR UM
, EXPRESSING YOUR INTEREST YOUR
CONCERNS AND YOUR AND YOUR IDEAS
FOR HOW WE AS A STATE CAN DO A
MUCH BETTER JOB AT ROLLING THIS
OUT SO THAT WE DON'T HAVE
DESSERTS WERE ABLE TO IMPROVE ON
A LOT OF THESE DISPARITIES
WITHIN OUR HEALTH CARE SYSTEM
AND ENSURE THAT ALL CALIFORNIANS
REGARDLESS OF THEIR OF WHERE
THEY LIVE, THEIR SOCIOECONOMIC
STATUS OR THEIR ETHNIC
BACKGROUND. UM IS ABLE TO HAVE,
UM, IS ABLE TO BE HEALTHY AND
HAVE CREATE VERY HEALTHY FAMILY.
SO I WANT TO THANK UH, BONTA
FOR, UH, WE'RE PUTTING THIS
PANEL TOGETHER AND LOOK FORWARD
TO CONTINUING CONVERSATIONS WITH
THE DEPARTMENTS TO ENSURE THAT
THEY ARE LISTENING TO THE
COMMUNITY MEMBERS. THANK YOU.
ANY COMMENTS FROM MY MANY
COLLEAGUES. WELL THANK YOU SO
MUCH. DOCTOR WEBER. THANK YOU
FOR THE PARTICIPATION AND MAKING
SURE THAT WE HAVE AN OPPORTUNITY
TO WORK TOGETHER. IT'S BEEN
QUITE FUN, ACTUALLY. YOU'RE
YOU'RE YOU'RE COOL WOMAN, DR
WEBBER. WITH THAT WE WILL
WELCOME PUBLIC COMMENT. NOW, IN
JUST A MOMENT, I WILL SAY THAT
WE'RE HOPING TO KEEP COUPLE
PUBLIC COMMENT DOWN TO ONE
MINUTE. SO AS I JUST OFFER SOME
CLOSING REMARKS, PLEASE FORM A
LINE AT THE MICROPHONE WITH ONE
MINUTE TO BE ABLE TO SHARE YOUR
THOUGHTS. I'D LIKE TO CONCLUDE
THIS HEARING TODAY ON A HOPEFUL
NOTE BECAUSE I HEAR BROAD
AGREEMENT AMONG ALL THE PARTIES
HERE ABOUT THE VALUE OF CHW PRS.
AND THE SERVICES THAT THEY
PROVIDE AND THE DESIRE TO EXPAND
AND BETTER INTEGRATE THIS
DIVERSE WORK FOR US, HOWEVER.
HOPE IS NOT ALWAYS THE STRATEGY
THAT WE CAN RELY ON. IT IS OUR
JOB COLLECTIVELY TO ENSURE THAT
WE CAN STRATEGICALLY MOVE
FORWARD AND LET'S NOT FORGET THE
WHY THE WHY IS BECAUSE WE WANT
TO DESPERATELY AND NEED TO HAVE
THE WORKFORCE THAT IS GOING TO
ADDRESS HEALTH RELATED SOCIAL
NEEDS, IMPROVE THE CULTURAL AND
LINGUISTIC IN ACCORDANCE OF THE
HEALTH CARE SYSTEM THROUGHOUT
AND IMPROVED HEALTH, EQUITY AND
OUTCOMES. AND TO BE ABLE TO
REALLY, TRULY BUILD ON THE WORK
OF THOSE THAT HAVE COME BEFORE
US AT SCALE FOR THE STATE. SO
WITH THAT I WANTED TO, UM JUST
INDICATE THAT WE WILL CONTINUE
TO WORK ON THIS AND REALLY
APPRECIATE THE PUBLIC'S
ENGAGEMENT AROUND THIS AND
UNDERSTAND THAT THERE IS GOING
TO BE A BIT OF A CELEBRATION A
LITTLE LATER TODAY, AND MY
GOODNESS IS IT ARE THE FOLKS WHO
HAVE BEEN DOING THIS WORK FOR SO
LONG DESERVING OF A CELEBRATION
TO BE ABLE TO MOVE OUR PROGRESS
FORWARD. SO THANK YOU. WITH THAT
. WE'LL START WITH OUR PUBLIC
COMMENTS. I HAVE MY LITTLE TIMER
HERE. THANK YOU SO MUCH NAME
AFFILIATION AND, UH LESS THAN
ONE MINUTE COMMENT. HI THERE.
THANKS FOR ALLOWING AND WHAT A
WONDERFUL HEARING TODAY. MY NAME
IS KELLY BENNETT. I'M THE CEO OF
COMMUNITY HEALTH WORKS RIGHT
HERE IN SACRAMENTO, FORMERLY
KNOWN AS SACRAMENTO COVERED, BUT
WE RENAMED OURSELVES AFTER OUR
WORKFORCE OF COMMUNITY HEALTH
WORKERS WHO WE HAVE 130 THAT ARE
WORKING IN HOSPITALS, CLINICS,
JAILS, ENCAMPMENTS. SCHOOLS
EMPLOYMENT CENTERS, ETCETERA
WE'VE JUST RECENTLY OFFICIALLY
CERTIFIED OUR 1ST 22 WITH
AMAZING TRAINING FROM EL SOL,
WHOSE WAS HERE TODAY, UM, IN
PARTNERSHIP WITH HEALTH PLAN
FUNDER. WE ARE OPERATING VERY,
UM, ROBUSTLY IN THE CALLUM SPACE
IN BOTH TÌM. AND CS AND THAT
SEEMS TO BE WITH ALL THE
HEADACHES AND BARRIERS OF THAT
PROGRAM. MOVING ALONG QUITE
WELL. WE ARE CONTRACTED WITH FOR
MANAGED CARE PLANS HERE IN
SACRAMENTO AND I ONE ITEM THAT
DID NOT COME UP IN THE
CONVERSATION TODAY IS I DO I
JUST LIKE TO MAKE A PLUG FOR THE
EXPERIENCE TRACK CERTIFICATION
OF LONG STANDING COMMUNITY
HEALTH WORKERS. WE ARE AWAITING
GUIDANCE AND A MECHANISM TO
GRANDFATHER. THOSE OF OUR
COMMUNITY HEALTH WORKERS THAT
ARE HAVE BEEN OPERATING FOR MANY
YEARS AND SERVING THE COMMUNITY
AND WE DON'T CURRENTLY HAVE A
MECHANISM FOR CERTIFYING THEM.
UM SO I JUST WANT TO MAKE A PLUG
FOR THAT AND FOR A LIVABLE WAGE.
WE ARE PAYING OUR CHW S $25 AN
HOUR PLUS BENEFITS AND
RETIREMENT TO START RIGHT OUT OF
THE GATE. WE'RE VERY PROUD OF
THAT. WE NEED A RATE STRUCTURE
THAT SUPPORTS THAT. THANK YOU
VERY MUCH. WHEN I STARTED
SENORA, PRESIDENT TO AND ROSELLE
ASAMBLEÍSTA. NUMBER HERNANDEZ
PROMOTE TORA CONDITIONING
COMPROMISO VOLUNTARY A
PHARMACIST KNOWS YES. GRACIAS
POR SU TRABAJO INCLUDE LOS
SERVICIOS. MÐI BENEFIT PACIENTES
AND MEDICAL COMPANY. FOR KAYLA'S
PROMOTER, OR A SON, MONICA'S AND
EL SISTEMA THE ATTENTION MEDICA.
FAMILIAS CHÁVEZ SPITAELS COM
PROBLEM AS THE LAST MMA ASI
RESPIRATOR. IN SEVERE CASES,
LOCAL SYSTEM NAZARIAN LA BARRERA
, NATO'S YES, THAT'S FAMILIARS.
SOON PERSONNEL HOSPITAL NÓ
FAMILIAS CONFIDENT HOSPITAL
STATUS MIGRATORY ÓRDENES.
GENERAL HOSPITAL. EMERGENCY UM
OREOS, MEDICOS. LONG COMA ME
EXPERIENCE FORTALEZA CONFIDENCE
THAT IS FAMILIAR TO SUPPORT ME,
MISMA. ME CENTRAL MEMENTOS.
CONSULTORIA S MEDICALS. I AM
EMPATHY. SARKO NESTA'S FAMILIARS
CAN ALSO CONFIDENCE. BUSKER
ATTENTION, MEDICA! EMBARGO LAST.
ARIF HAS ACTUALLY PROPONENT,
ALAS, COMPLEX CON TRACTS PSIONIC
IN FACT, AERATION DELLA
ATTENTION ADMINISTRATOR TO
PROBABLEMENTE ORGANIZATIONS,
COMMUNITARIAN PARTICIPANT IN L
BENEFICIAL GRACIAS, SENORA.
MARTHA LAST VOLUNTEER PROMOTER
FOR COMPROMISE, SO I'M THE
TRANSLATOR. HELLO MADAM
PRESIDENT AND ASSEMBLYMEMBER'S
THANK YOU FOR HAVING US TODAY
HERE. MY NAME IS ANALYST
HERNANDEZ. I HAVE BEEN A
PROMOTER WITH VISION COMPROMISO
FOR MORE THAN SEVEN YEARS. AND I
AM VERY PROUD OF THE WORK TO
WHICH I DEDICATED MYSELF. I LIKE
TO SHARE A STORY THAT WILL SHOW
WHY PROMOTE AURAS ARE UNIQUE IN
THE HEALTH CARE SYSTEM. AS A
PRIMA TORRE. I HAVE HAD TO TAKE
FAMILIES WITH THEIR BABIES TO
THE HOSPITAL WITH ASTHMA
PROBLEMS ALMOST DYING BECAUSE
THEY CANNOT BREATHE. AND WITHOUT
KNOWING THAT WHAT IS HAPPENING
TO THEIR BABY? THE BARRIER THESE
FAMILIES FACE IS THAT THAT
HOSPITAL STAFF DOES NOT SPEAK
THEIR LANGUAGE. IN THE FAMILY'S
DISTRESSED THAT HOSPITAL BECAUSE
OF THEIR IMMIGRATION STUDIES OR
FOR OTHER REASONS. I AM 69 YEARS
OLD, AND WHEN I ARRIVED AT THE
EMERGENCY HOSPITAL, THE SAME
THING HAPPENS TO ME AND IN THE
DOCTOR'S OFFICE, BUT ALTHOUGH I
DO NOT SPEAK THE LANGUAGE, MY
EXPERIENCE AS A PRIMA TORRE
GIVES ME THE STRENGTH IN THE
CONFIDENCE TO BE ABLE TO
ADVOCATE FOR THESE FAMILIES AND
FOR MYSELF. MY PREMATURE A
TRAINING HELP ME TO NAVIGATE
DOCTOR'S OFFICES AND HELP ME.
EMPATHIZE WITH THIS FAMILIES AND
GAIN THEIR TRUST SO I CAN HELP
THEM TAKE MEDICAL CARE. THANK
YOU FOR YOUR WORK TO INCLUDE
PROMOTE TORA SERVICES AS A
BENEFIT TO MEDICAL PATIENTS.
HOWEVER. THE KOREAN FEES BEING
PROPOSED IN THE COMPLEXITIES
INVOLVED IN CONTRACTING AND
BUILDING MANAGED CARE WILL
LIGHTLY PROHIBIT MANY COMMUNITY
BASED ORGANIZATIONS. FROM
PARTICIPATING IN THE BENEFITS.
WE ARE DUE TO INCLUDE COMMUNITY
BASED ORGANIZATIONS AND PROMOTE
TORAHS IN YOUR DELIBERATIONS ON
HOW BEST TO IMPLEMENT THESE
SERVICES AS WE SAW IT, DO IT IN
THE PANDEMIC. THIS ARE THE
HEALTHCARE WORKERS WHO CAN HELP.
HEALTH PROBLEMS AND INITIATIVES
TRULY RICH THAT PEOPLE THEY ARE
MEANT TO SERVE. IN OUR
COMMUNITIES. THANK YOU. THANK
YOU. THANK YOU. JUST ONE MINUTE,
PLEASE MOVING FORWARD. FOR THE
NEXT SPEAKERS. JUST REMEMBER
THAT WE'RE TRYING TO STICK TO
ONE MINUTE. THANK YOU. WHEN I
STARTED SENORES SENIORA'S
ASSEMBLY, STAS MM. PROMOTER COME
FROM MRS GRACIAS, POR
OPPORTUNITY PRESENTS JACKIE LET
ME EXPERIENCE HERE. AREA. AND
DIFFERENT ACTIVITIES THAT ACCESS
TO INFORMATION ON THE RECORD
PROGRAMMERS. BENEFICIAL
PARALYSIS PERSONAS ESPECIALMENTE
PARA WHEN IT TRAVELS TO YOU
KNOW, SOLVENT SERVICIOS SCENE
OKAY IN TOTAL AREAS. SIENDO
ESPECIALMENTE LARREA DE SALUD.
EDUCATION ARE YOU TO EMOTIONAL
BB AND TOÀN EMPATHY. AL
DESARROLLO PERSONNEL FAMILIAR TO
ESTÁN PRIVILEGE YOURSELF FROM A
TORA TORA. NO SABIA QUE. JUDAH
THEIR SERVICES TO ME. BUT I MEAN
FAMILIA UNIDA. LET'S INCIDENT,
AMOS OKAY, INCLUSION
ORGANIZATION. AND THE LITTLE
DELIBERATIONS NORMAN ERA THEY
IMPLEMENT THAT. LOS SERVICIOS.
AND BENEFICIAL. GRACIAS.
GRACIAS. WHEN PRESIDENT TIME IN
BRAZIL ASSEMBLYMEMBER'S CABLE SO
THEY'LL CONDUCT THE STAND IS
LOUD, SIENDO VOLUNTARY, A
PARABLE PROMISED FOR A FOR A
INFORMALLY PROMOTE TORA. MR. UM
FAMILIAS FAMILIAS IN AUSTRALIA
SAYS IS THIN AND MIKASA
EXPERIENCES PROMOTE TORA
MEMENTOS. DELKO FAMILIA! SEGURA
SALVO. GET ON MY YOUR DATA AND
MEHARRY ESKO OPPORTUNITY
SITUATIONS. JEREMY FAMILIAS
HARBOR. UM AND ALSO JUST PUT
ENOUGH STAND ORGANIZATIONAL
PROMISE. PROMOTE TORAHS.
MIRACULOUS PREMATURE INITIATIVE.
SALOU REAL MENTAL HAGENA LAST
PERSONAS EVEN SAID WE'D MONEY
THAT IS MARVIN MÁS BUILDING
DABBLES PAKISTAN HACIENDO
ARAMBULA GRACIAS. HELLO WHITNEY
FRANCIS WITH THE WESTERN CENTER
ON LAW AND POVERTY. WE SUPPORT
THE REQUEST TO RAISE THE MEDICAL
REIMBURSEMENT RATE FOR COMMUNITY
HEALTH WORKERS FROM A TORAHS AND
REPRESENTATIVES USING PREVIOUSLY
ALLOCATED UNSPENT DOLLARS. THESE
WORKERS PLAY A KEY ROLE AS
TRUSTED PARTNERS IN SUPPORTING
MEDICAL MEMBERS IN ADVANCING
HEALTH EQUITY. THANK YOU. THANK
YOU. GOOD AFTERNOON CHAIR AND
MEMBERS. MY NAME IS GABRIEL
GARCIA AND THE POLICY AND
ADVOCACY DIRECTOR FOR YOUTH
ALIVE, BASED IN OAKLAND,
CALIFORNIA. AND MY COWORKERS DO
THE LIFE SAVING WORK OF BEING
VIOLENCE, PROFESSIONAL
PROFESSIONALS, WE GO TO THE
HOSPITAL BEDSIDE OF FOLKS WHO
HAVE JUST BEEN VIOLENTLY
INJURED. SURVIVING A GUNSHOT
WOUNDS, STAB WOUND PHYSICAL
ASSAULT AND HELP THEM PICK UP
THE PIECES IN THE AFTERMATH OF
WHAT MIGHT BE THE MOST TRAUMATIC
MOMENT OF THEIR LIFE. YOU ARE
ADVOCACY. VIOLENCE PREVENTION
PROFESSIONALS ARE CONSIDERED
COMMUNITY HEALTH WORKERS AND
LOOKING AT WHAT OTHER STATES
HAVE DONE TO FUND VIOLENCE.
PREVENTION THROUGH MEDICAID IS
EXACTLY WHAT WE WANT TO HAVE
HAPPEN HERE IN CALIFORNIA.
UNFORTUNATELY AT $26 AN HOUR IT
IS MAYBE NOT WORTH THE COST OF
US DOING THE ADMINISTRATION TO
EVEN DRAW THOSE FUNDS DOWN.
THAT'S WHY WE STAND WITH THE
OTHER COMMUNITY HEALTH WORKER
COMMUNITY ACROSS CALIFORNIA AND
ASKED FOR AN INCREASE IN THE
RATES TO ENSURE THAT WE CAN
ACTUALLY RESPOND TO THE DEMAND
FOR OUR SERVICES, WHICH IN
PLACES LIKE OAKLAND IS,
UNFORTUNATELY FAR TOO HIGH.
THANK YOU. THANK YOU. GOOD
AFTERNOON, MADAM CHAIR AND
COMMITTEE. MY NAME IS JESSE
TARANGO WITH COMMUNITY HEALTH
PARTNERSHIP AND ALSO ASSOCIATION
OF 10 COMMUNITY HEALTH CENTERS
IN SANTA CLARA AND SAN MATEO
CANTON. IN ADDITION TO RUNNING A
CHW TRAINING PROGRAM IN SPANISH
THIS YEAR, WE ARE ALSO ONE OF
THE FEW CBOS THAT EMPLOYEES THAT
CHW IN PLACES THEM IN ONE OF OUR
HEALTH CENTERS. IT HAS BEEN A
CHALLENGE, TO SAY THE LEAST.
BUILDING THE INFRASTRUCTURE TO
SUPPORT THIS HAS BEEN VERY
DIFFICULT. WE WERE VERY GRATEFUL
FOR THE SEED FUNDING THAT WE
HAVE FROM OUR LOCAL HEALTH PLAN
AND THE SUPPORT AND TECHNICAL
ASSISTANCE. UM BUT GOING INTO
THE FUTURE, THE CURRENT
REIMBURSEMENT RATE WOULD NOT BE
ENOUGH TO SUPPORT WHAT WE'RE
DOING. UM WE ARE ALSO NOT LIVING
UP TO THE FULL POTENTIAL. THE
CHW AS MOST OF THE WORK IS DONE
THROUGH TELEHEALTH. WHEN IN
REALITY WE WOULD LOVE TO SEE OUR
CHW IS OUT IN THE COMMUNITY
SUPPORTING COMMUNITY MEMBERS
WHERE THEY'RE AT WERE IN FULL
SUPPORT OF RAISING THE CURRENT
REIMBURSEMENT RATE FOR CHW
BENEFITS. THANK YOU. GOOD
AFTERNOON. I'M ANDREW MANURE
FROM ASIAN RESOURCES INC. A
NONPROFIT ORGANIZATION DEDICATED
TO SUPPORTING MARGINALIZED
COMMUNITIES, ESPECIALLY ASIAN,
AMERICAN NATIVE HAWAIIAN AND
PACIFIC ISLANDERS, OR A NHP. I S
BOTH AND SACK AND ACROSS THE
STATE. OUR CHW PROVIDE CRUCIAL
OUTREACH, EDUCATION AND
NAVIGATION ASSISTANCE, ENSURING
ACCESS TO CENTRAL SERVICES LIKE
HEALTHCARE AND PUBLIC BENEFITS.
OUR IMPACT WAS DEMONSTRATED MOST
MARKEDLY DURING THE COVID 19
PANDEMIC WHEN WE LEAD CHW
INITIATIVES WITH OTHER A NHP
ORGANIZATIONS IN LOS ANGELES AND
SACRAMENTO, PROVIDING VITAL
COVID INFORMATION AND RESOURCES
AND NAVIGATION SERVICES THAT
MITIGATED THE EFFECTS OF THE
PANDEMIC AND SAVE THOUSANDS OF
LIVES. THESE EFFORTS HIGHLIGHT
THE INDISPENSABLE ROLE OF CHW
ZING COMMUNITIES LIKE OURS.
HOWEVER MORE SUPPORT FOR CHW S
IS NEEDED FOR THEM TO ADDRESS
PRESSING AND PERSISTING HEALTH
INEQUITIES BEYOND THE PANDEMIC.
TO THIS END, WE URGE YOU TO
RAISE THE MEDICAL REIMBURSEMENT
RATE FOR CHW, ENSURING THAT THEY
CAN SUSTAIN THEIR INVALUABLE
WORK AND ADDRESS OUR COMMUNITY'S
UNIQUE NEEDS. THANK YOU. THANK
YOU. WHEN I STARTED THIS CINEMA
RAMIREZ REMOTE AREA COMPROMISO,
SO YOU KEEP WORKING. SONA
SERVICIOS. UH THE QUAD A MEN
TAKING PERSONAL PROMOTES.
PERSONA JACKIE NECESSARY THAT IS
THE BRASSICAS COMIDA RENTA
SALUTE E. N. TOLOSA SPECTER'S
COMPROMISE THEIR FAMILY A SANA'S
VIDAK: DIGNA LARA. YOU CAN ALSO
JUST. NUESTRAS MANOS PERSONA
THAT IS, YOU KNOW FOR ASSISTED
VIDEO NOT TO BE INTERNAL ACCESS.
SO RITA'S OCUPADO SPORT.
NECESSITY. TORRE'S MOSCOW LOS
GASTOS CANNOT THE NAME OF PHOTOS
RAMOS ORGANIZATION TORRE'S ESTO
VALERIA RAMOS. BECAUSE I AM A
IMPORTANT. TO ME THAT IS SURVEY
KHORASAN GLASSES GRACIAS. GOOD
AFTERNOON. MY NAME IS ERIC
CAROZZA. I'M FIRST GENERATION
LATINO INCOMING MEDICAL STUDENT
AND I SPEAK ON BEHALF OF MY
COMMUNITY AND ALL THE ON THE
SHOULDERS OF GIANTS. REALLY I
WANT TO THANK YOU ALL FOR BEING
HERE IN YOUR TIME, AND I WANT TO
FOR YOU TO EXPRESS THAT
COMMUNITY. HEALTH WORKERS PLAY A
VITAL ROLE TOWARDS THE
CONTINUALLY OF CARE OF OUR
COMMUNITY OF OUR PATIENTS OF MY
FAMILY. AND I ASK YOU TO SUPPORT
INCREASING THE WAGES OF
COMMUNITY HEALTH WORKERS BECAUSE
WORKING CLOSELY AS A MEDICAL
ASSISTANT WITH PROVIDERS AND SEE
THE NEED AND THE URGENCY FOR
COMMUNITY HEALTH WORKERS IN A
SPACE WHERE PROVIDERS DO WANT TO
DO THE WORK, BUT THEY SIMPLY
DON'T HAVE THE TIME IN 15
MINUTES WHEN THEY'RE COMPLICATED
WITH CHARTING AND OTHER THINGS
THAT COME FROM EXECUTIVES. I
URGE YOU AGAIN TO SUPPORT THE
LIVING WAGE TO BRING ABOUT MORE
COMMUNITY HEALTH WORKERS IN THE
COMMUNITY AND TO INCREASE THE
NUMBER OF REPRESENTATION OF
LATINOS IN THE SPACE OF BLACKS
AND OTHER PEOPLE. SEE, THANK
YOU. GOOD AFTERNOON RICHARDSON
DAVIS HERE WITH THE CALIFORNIA
COUNCIL OF COMMUNITY BEHAVIORAL
HEALTH AGENCIES JUST HERE TO
HIGHLIGHT THE IMPORTANCE OF
COMMUNITY HEALTH WORKERS
EMPLOYMENT ON US. UM I WOULD
LIKE TO ALIGN MY COMMENTS WITH
THAT OF THE OTHER PANELISTS
TODAY, HIGHLIGHTING THE
IMPORTANCE OF THE CHW S AND THEY
JUST PLAY SUCH A CRITICAL ROLE
HEARING SOME OF THESE STORIES
TODAY AND ALSO WITH THE MAN WHO
JUST WAS UP HERE BEFORE ME AND
MY COMMENTS WITH HIM. UM AND
WANT TO CONCUR WITH DR WITH DR
GALLEYS. COMMENTS ABOUT
WORKFORCE. THANK YOU. THANK YOU.
GOOD AFTERNOON. MALEGAON BAFTA,
STU, CALIFORNIA REALLY
APPRECIATE THE COMMITTEE PULLING
TOGETHER BOTH COMMITTEES PULLING
TOGETHER THIS INCREDIBLE PANEL
WHERE WE CAN REALLY HEAR FROM
THE COMMUNITIES WANNA APPRECIATE
HIGHLIGHT HOW IMPORTANT
COMMUNITY HEALTH CARE WORKERS
ARE TO CLOSING OR HEALTH EQUITY
NEEDS TOTALLY SUPPORT THAT, JUST
AS WE'RE CONSIDERING FUNDING
REALLY WANT TO MAKE SURE THAT
COMMITTEE IS ALSO CONSIDERING IN
THE LEGISLATURES, CONSIDERING
WORKFORCE STANDARDS, AYE. REALLY
PROUD TO HEAR ABOUT THE
INVESTMENT THAT EVERY SINGLE ONE
OF THESE FOLKS ARE MENTIONING
AROUND, MAKING SURE IT'S A
LIVING WAGE, AND WE WANT TO MAKE
SURE THAT THAT IS CONSIDERED AS
FUNDING POTENTIALLY WOULD BE
MOVED FORWARD AND ALSO
CONSIDERING MAKE SURE THAT WE
WANT TO MAKE SURE THESE WORKERS
ARE PART OF THE CARE TEAM AND
FULLY INTEGRATED. THANK YOU VERY
MUCH. GOOD AFTERNOON. UM CHAIR
AND COMMITTEE. MY NAME IS YO,
CELINE. I'M ACTUALLY HERE FROM
BUTTE COUNTY. I'M NOT
REPRESENTING MY ORGANIZATION
TODAY AT ALL. I'M ACTUALLY
TAKING MY OWN PERSONAL TIME TO
BE HERE BECAUSE IT'S A VERY
IMPORTANT MATTER TO ME. UM I ASK
YOU TO, YOU KNOW, AS A RECEIVING
PART PERSON FROM THE SERVICES
THAT CHW S PROVIDE AND NOW BEING
IN THE FIELD HAVING IN THE LAST
YEAR, GIVEN THE OPPORTUNITY TO
ACTUALLY TRAIN PEOPLE COMING
INTO THE FIELD. I SEE THE
IMPORTANCE OF, UH, YOU KNOW,
CONTINUING THIS WORK AND THE
QUALITY OF SERVICES THAT ARE
BEING PROVIDED BY A DIVERSE
GROUP OF PEOPLE THROUGHOUT THE
STATE. UH FROM VIEW COUNTY. I'M
CONSIDERED ONE OF THOSE DESERT
AREAS THAT DOES NOT HAVE THE
CAPACITY BUILDING FOR
CONTINUING. UM SO OPENING THE
DOOR FOR COMMITTEE HEALTH
WORKERS, SO I REALLY HOPE THAT
YOU GUYS, YOU KNOW, I URGE THAT
THIS INCREASE HAPPENS AS IT WILL
CONTINUE TO, UM, YOU KNOW, OPEN
THE DOORS FOR THOSE ENTERING THE
FIELD AND JUST CONTINUE THE YOU
KNOW TO SUPPORT THOSE THAT HAVE
ALREADY BEEN WORKING AS
COMMUNITY HEALTH WORKERS OVER
THIS LAST, UM YOU KNOW, DECADE
AND EVEN FURTHER THAN THAT. UM I
REALLY THINK IT'S SUCH IMPORTANT
WORK IN THE LAST YEAR AGAIN AS A
COMMUNITY HEALTH WORKER. I'VE
BEEN ABLE TO GIVE GIFTS TO
FAMILIES IN THE HOLIDAYS AND
REMEMBER THE TIME WHERE I WAS
RECEIVING THOSE SAME GIFTS FROM
ANOTHER COMMUNITY HEALTH WORKER,
SO IT'S VERY IMPORTANT FOR ME TO
JUST SPEAK UP AND BE ABLE TO
ADVOCATE. YOU KNOW FOR THOSE
THAT HAVEN'T WEREN'T GIVEN THE
OPPORTUNITY TO BE HERE. SO I
REALLY THANK YOU GUYS FOR YOUR
TIME. UM AND I HOPE THAT THIS
IMPACT THAT'S BEING DONE HERE
GETS DOWN TO BUTTE COUNTY
EVENTUALLY AS WELL. THANK YOU.
THANK YOU. GOOD AFTERNOON CHAIR
AND COMMITTEE MEMBERS. MY NAME
IS ALICIA CROOKS, AND I'M HERE
TODAY AS A COMMUNITY PROGRAM
MANAGER FOR PEER SUITE WHERE A
DIGITAL PLATFORM DEDICATED TO
SUPPORTING BILLING TO INSURANCE
PAYERS FOR CHW WORK. WE WORK
WITH BUILDING THROUGH INSURANCE
PAYERS. UM, BUT WE WORK WITH
SMALL AND LARGE CBO SUPPORTING
THEIR EFFORT TO BUILD AND KEEP
FINANCIAL INFRASTRUCTURE FOR
THEIR COMMUNITY HEALTH WORKERS.
UM I ALSO REPRESENTED THOUSANDS
OF CHW S THAT ARE BARELY
SUPPORTING THEMSELVES TO
ACTUALLY LIVE IN CALIFORNIA. UM,
I'M JUST HERE TO URGE YOU TO
INCREASE THAT MEDICAL RATE SO
THAT THE WORKFORCE CAN ACTUALLY
THRIVE IN THE AREA THAT THEY
WORK IN LIVING AND WORKING.
THANK YOU. THANK YOU. GOOD
AFTERNOON. GOOD AFTERNOON CHAIR
AND COMMITTEE MEMBERS. MY NAME
IS ALMA MACKERRAS AND I AM WITH
THE LATINO COALITION FOR HEALTHY
CALIFORNIA. I'VE BEEN WORKING AS
A PROMO TORA FOR OVER 10 YEARS
AND THEY SERVE THE COMMUNITY OF
FRESNO. I LOVE THE WORK THAT I
DO BECAUSE IT ALLOWS ME TO USE
MY PRIVILEGE OF BEING BILINGUAL,
ENGLISH AND SPANISH AND GIVE MY
COMMUNITY ENGAGED WITH THEM AND
HELP THEM OUT AND GIVE THEM, UM,
GET BACK TO MY COMMUNITY. THE
CHW PRS CRITICAL, CRITICAL ROLE
IN THE LAND COMMUNITY, ACTING AS
AN INTERESTED VOICE TO HELP
ALLOWING TO BRIDGE THE GAP
BETWEEN THE COMMUNITY'S NEEDS
AND THE HEALTH CARE SYSTEM. WE
BUILD A RELATIONSHIP AND REGAIN
THE COMMUNITY STRESS, AND THIS
SYSTEM HAS FAILED TO INCLUDE
THEM AND HAVE BROKEN THEIR TRUST
TIME AFTER TIME. TORRE MADE ME
REALIZE JUST HOW DEMANDING THIS
JOB IS. HOW PASSIONATE YOU MUST
BE TO DO THIS. MOST OF US START
OFF AS VOLUNTEERS AND STAY
BECAUSE WE LOVE AND WE HAVE A
PASSION TO DO THIS DESPITE THE
LACK OF APPROPRIATE
COMPENSATION. WHICH FORCES MANY
OF US TO HAVE FULL TIME JOBS
OUTSIDE OF THIS. THANK YOU.
THANK YOU. WHEN I STARTED THIS,
BUT MEMBERS ARE COMMITTED, MARIA
MAHARAJAS COLLEGE IN CALIFORNIA.
TODAVÍA AND THAT'S ANOTHER.
VENTURA IS THE, UM, ALONG
FAMILIES, KAMALA'S MIA'S RECORDS
OF THOSE FAMILIES CAÑADA. UM SO
LET'S PROMOTE DONE ON SALARY OR
FORMAL RAMOS SERVICES HOMES.
WHERE ARE THE IS VIDEOS OR
KOTTARAS. LONDON MISMO IDIOMA
DONE. THERE'S A LOT OF
EXPERIENCE HERE. UM SO LEADER.
THE LAST COMMERCIAL FAMILIAR IS
NOT THE LAST PERSON IS NOT GOOD
ENOUGH LARGE VERANDA, MOREIRA'S
FAMILIARS SISTEMA IMPORTANT AND
THEY ATTENDED. GOOD SCAN. THE
LAST CALL IS NOT SERVING. UM,
NO. SOLAMENTE IS ALMOST AS A
POINT, BUT FAMILIAR TO MOST OF
US MUSLIM IMMIGRANT FAMILIES AND
THE CAMPO. UM YOUR LESSON. SITO
UM CALIFORNIA INCLUDED MOMENTO
LOC HWP ARE TO, UM, THE CHW PR.
THE MEDICAL RESPOND TO CINCO
DÍAS. YES, YES. GOOD AFTERNOON.
MY NAME IS MARVELOUS DIRECTOR OF
POLICY WITH THE LATINO COALITION
FOR HEALTHY CALIFORNIA. BORN AND
RAISED IN SOUTH CENTRAL LOS
ANGELES, PROUD FORMER OAKLAND
RESIDENT AND HERE STANDING, UM
IN SOLIDARITY WITH OUR SIEGED
GPRS. I'M REQUESTING THAT YOU
ALL SUPPORT A RATE INCREASE FOR
OUR WORKERS. THANK YOU SO MUCH.
THANK YOU. GOOD AFTERNOON. MY
NAME IS APRIL. I'M ALSO HERE
WITH PARIS SUITE. WHICH IS THE
DIGITAL PLATFORM. UM I JUST KNOW
THAT IF WE WERE TO INCREASE THE
CHW WAGE THAT WE WOULD HAVE MORE
COMMUNITY BASED ORGANIZATIONS,
NONPROFITS AND FQ HCS, I WOULD
BE WILLING TO WORK AND PROVIDE
JOBS FOR THE CHW S BECAUSE RIGHT
NOW, WHEN THEY DO COST ANALYSIS,
THEY DO NOT SEE A BENEFIT AND
THEY BASE IT ON, YOU KNOW,
COMMUNITY HEALTH WORKERS HAVING
TO HAVE A CERTAIN NUMBER FOR THE
CASELOAD WHEN THE WORK THAT
COMMUNITY HEALTH WORKERS DO
SHOULD BE BASED ON A CASELOAD,
BUT THE EFFECTIVENESS OF WHAT
THEY DO AND HOW THEY REACHED OUT
TO THEIR COMMUNITIES. SO I
REALLY DO BELIEVE THAT THIS WAGE
INCREASE WILL BRING THAT
AVAILABILITY, MORE JOBS AND MORE
SECURITY FOR THE COMMUNITY
HEALTH WORKERS AND PROMOTE
TORRES IN THE COMMUNITY. THANK
YOU. THANK YOU. GOOD AFTERNOON,
MADAM CHAIR, AND, UM, THE
COMMITTEE OF THE HEALTH
COMMITTEE. MY NAME IS CAROL WEST
. I AM A COMMUNITY HEALTH WORKER
IMMIGRATED FROM SOUTH AFRICA, UM
, LEFT EVERYTHING BEHIND FAMILY
IN KOREA. UM AND REALLY WAS THE
BENEFICIARY OF COMMUNITY HEALTH
WORKERS SERVICES LATER WENT TO A
COMMUNITY COLLEGE CAME OFF THE
PRODUCTION LINE IN 2010 AND
LOOKED FOR A JOB. AND PEOPLE
SAID, OH, YES, WE HAVE THOSE,
BUT THEY'RE VOLUNTEERS. SO I'M
HERE TO TELL YOU THAT THERE ARE
PEOPLE THAT DO THIS JOB OUT OF
THE PASSION, UM FROM THE BOTTOM
OF THEIR HEARTS. UM AND THE
COLLEAGUES THAT I GRADUATED WITH
ONE WOMAN IN PARTICULAR. REALLY
PUT A FIRE IN MY BELLY. SHE
LANDED UP ONE MORNING WITH A
TOOTH ABSCESS, THE COMMUNITY
HEALTH WORKERS, SHE SHE ALSO WAS
WORKING THREE JOBS BECAUSE OF
COMMUNITY HEALTH WORKER JOB
DIDN'T PAY ENOUGH. UM AND SHE
DID NOT HAVE HEALTH CARE TO
ADDRESS HER OWN PERSONAL
HEALTHCARE NEEDS. SO I'M HERE TO
ASK YOU PLEASE, TO RAISE THE
RATE TO 8 87.5% OF THE MEDICAID
RATE, WHICH I BELIEVE IS $53.35
PER HALF HALF HOUR. THIS WILL
NOT BE A CURE ALL FOR EVERYONE.
WE KNOW THAT COMMUNITY BASED
ORGANIZATIONS. UM, UM THERE'S A
CHALLENGE FOR THEM TO DRAW DOWN
THIS MONEY THAT WE ARE GRATEFUL
FOR THE BENEFIT, BUT WE DO HOPE
THAT YOU RAISE THE RATES. THANK
YOU. AND OUR ORGANIZATION
REPRESENTS MORE THAN 1000
COMMUNITY HEALTH WORKERS AT THIS
POINT IN TIME. THANK YOU AND, UH
, WAS UP THEN IT TO PRODUCE
YOUNG COMMENTARY. Ó. IN ENGLISH
. SEE NOW SEE LATINO. UH, LAST
TIME, LISA THAT THE SERGEANT UM,
WELL, THANK YOU SO MUCH. I WANT
TO SINCERELY THANK YOU ALL FOR
COMING TODAY TO ENGAGE AROUND
THIS CRITICAL ISSUE. WE WILL BE
BACK HERE ON TUESDAY, MARCH 19TH
FOR OUR FIRST BILL HEARING WITH
THAT THIS HEARING IS ADJOURNED.