GOOD AFTERNOON. WE WILL START
THE APRIL 2ND HEARING OF THE
ASSEMBLY COMMITTEE ON HEALTH
TODAY. SO THANKFUL TO BE HERE
TODAY BEFORE WE BEGIN, I WOULD
LIKE TO MAKE A STATEMENT ON
PROVIDING TESTIMONY AT THIS
HEARING, WE SEEK TO PROTECT THE
RIGHTS OF ALL WHO PARTICIPATE IN
THE LEGISLATIVE PROCESS SO THAT
WE CAN HAVE EFFECTIVE
DELIBERATION ON THE CRITICAL
ISSUES FACING CALIFORNIA. ALL
WITNESSES WILL BE TESTIFYING IN
PERSON. WE ALLOW TWO MAIN
WITNESSES FOR A MAXIMUM OF THREE
MINUTES EACH. ADDITIONAL
TESTIMONY WILL ALSO BE IN PERSON
AND LIMITED TO NAME, POSITION
AND ORGANIZATION IF YOU
REPRESENT ONE. ALL TESTIMONY
COMMENTS ARE LIMITED TO THE BILL
AT HAND. I WOULD ALSO LIKE TO
WELCOME MISS ASSEMBLY MEMBER
KATE SANCHEZ. THE SPEAKER HAS
APPOINTED ASSEMBLY MEMBER KATE
SANCHEZ TO THE HEALTH COMMITTEE.
WELCOME. ASSEMBLY MEMBER SANCHEZ
, WE'LL MOVE ON NOW TO, WE'LL
MOVE ON AS A SUB COMMITTEE
BECAUSE WE DON'T HAVE BECAUSE WE
DON'T HAVE THE FULL, COMMITTEE
WITH US. THE FOLLOWING BILLS ARE
PROPOSED FOR CONSENT FOR TODAY'S
HEARING. ANY MEMBER OF THE
COMMITTEE MAY REMOVE A BILL FROM
CONSENT. ITEM TWO AB 1943 WEBER
WITH AMENDMENTS AND REFERRED TO
THE COMMITTEE ON PRIVACY AND
CONSUMER PROTECTION. ITEM 17, AB
2703 AGUIAR-CURRY. ITEM 19, AB
2841. WALDRON, WITH AMENDMENTS
FOR THIRD READING. WITH THAT, WE
WILL BEGIN WITH ITEM NUMBER ONE,
AB 1926. CONNOLLY, MR. CONNOLLY,
PLEASE COME FORWARD
.
THANK YOU. CHAIR AND MEMBERS.
GOOD AFTERNOON. I WOULD LIKE TO
BEGIN BY THANKING THE COMMITTEE
AND STAFF FOR YOUR WORK AND
INPUT ON THIS BILL. VERY MUCH
APPRECIATED. AB 1926 WOULD
REQUIRE HEALTH PLANS RENEWED ON
OR AFTER JULY 1ST, 2025, TO
COVER DIETARY ENTERAL FORMULAS
FOR THE TREATMENT OF REGIONAL
ENTERITIS. THESE FORMULAS CAN BE
A SUCCESSFUL ALTERNATIVE TO
MEDICAID MEDICATION TREATMENT
FOR SEVERAL DIGESTIVE DISEASES,
INCLUDING REGIONAL ENTERITIS,
ALSO KNOWN AS CROHN'S DISEASE.
THIS THERAPY HAS SUBSTANTIAL
BENEFITS FOR ALL CROHN'S
PATIENTS, BUT MOST NOTABLY FOR
PEDIATRIC PATIENTS BECAUSE THEY
MAY NOT HAVE ACCESS TO NOR BE
ABLE TO USE CERTAIN MEDICATIONS.
ADDITIONALLY, PATIENTS WITH
CROHN'S DISEASE CAN UTILIZE
MEDICALLY NECESSARY FORMULAS FOR
NUTRITIONAL SUPPORT AND TO HELP
THEM ACHIEVE REMISSION. EARLY
TREATMENT OPTIONS FOR DIGESTIVE
DIGESTIVE DISEASES LIKE CROHN'S
HAVE PROVEN TO REDUCE HARM.
INCREASE QUALITY OF LIFE. THERE
IS NO REASON WHY CALIFORNIANS
SUFFERING FROM CHRONIC ILLNESSES
CANNOT LEAD FULL AND PRODUCTIVE
LIVES. AB 1926 PROVIDES PATIENTS
WITH A PROVEN, SUCCESSFUL
ALTERNATIVE TO CERTAIN
MEDICATIONS, WHICH HEALTH CARE
PROVIDERS MAY RECOMMEND WHEN
COMPLICATIONS SUCH AS WEIGHT
LOSS, SURGERY, OBSTRUCTION, OR
SEVERE INFLAMMATION PREVENT
PATIENTS FROM GETTING THE RIGHT
NUTRIENTS. ENTERAL NUTRITION, OR
N, IS A WAY TO GIVE THE
PATIENT'S BODY WHAT IT NEEDS TO
STAY HEALTHY. N IS USUALLY TAKEN
IN THE FORM OF NUTRIENT RICH
FORMULA, INCLUDING BOOST,
INSURER AND ORGAN. DIGESTIVE
DISEASE, INCLUDING CROHN'S
AFFECT MILLIONS OF AMERICANS,
WITH AS MANY AS 70,000 NEW CASES
OF IBD. DIAGNOSE CAUSED EACH
YEAR. ALSO, ADD AB 1926 IS A
REDO OF MY BILL FROM LAST YEAR,
AB 620, WHICH PASSED THROUGH
THIS COMMITTEE WITH NEARLY
UNANIMOUS BIPARTISAN SUPPORT. AB
620 WAS VETOED BECAUSE UNDER THE
EXCLUSIONS SECTION OF NUTRITION
OR EXCUSE ME, EXCLUSIONS SECTION
OF ESSENTIAL HEALTH BENEFITS
BENCHMARK PLAN OUTPACED ORAL
NUTRITION SUCH AS DIETARY
SUPPLEMENTS, HERBAL SUPPLEMENTS,
WEIGHT LOSS AIDS, FORMULAS, AND
FOOD ARE LISTED. HOWEVER, THERE
ARE EXCEPTIONS TO THIS
EXCLUSION, AND AFTER
CONVERSATIONS WITH THE
DEPARTMENT OF MANAGED HEALTH
CARE, THE LANGUAGE FOR AB 1926
WAS AMENDED TO MORE CLOSELY
ALIGN WITH THE LANGUAGE IN THE
BENCHMARK PLAN AND TO HELP
ADDRESS THE VETO MESSAGE. I WILL
NOW PASS IT OFF TO MY WITNESSES,
KELLY ISAACSON, A CLINICAL
DIETITIAN AT CEDARS SINAI
MEDICAL CENTER, AND RYAN SPENCER
, REPRESENTING THE CROHN'S AND
COLITIS FOUNDATION, SPONSORS OF
THE MEASURE. THANK YOU. THANK
YOU. GOOD AFTERNOON, MADAM
CHAIR, VICE CHAIR AND COMMITTEE
MEMBERS. MY NAME IS KELLY
ISAACSON. I'M A REGISTERED
DIETITIAN AT CEDARS SINAI AND
I'M ALSO A NATIONAL BOARD MEMBER
FOR THE CROHN'S AND COLITIS
FOUNDATION. THÀNH. IN MY
PRACTICE, I SEE CHILDREN AND
ADULTS SUFFER FROM MALNUTRITION
CAUSED BY THEIR INABILITY TO
TOLERATE OR ABSORB NUTRIENTS DUE
TO THEIR DISEASE. MANY PATIENTS
MAY EXPERIENCE WEIGHT LOSS
DURING FLARES, AND PEDIATRIC
PATIENTS ARE AT RISK FOR DELAYED
GROWTH AND PUBERTAL DEVELOPMENT.
MALNUTRITION IS ASSOCIATED WITH
POOR OUTCOMES IN IBD, INCLUDING
REDUCED RESPONSE TO MEDICATIONS,
HIGHER RATES OF E.R. VISITS AND
HOSPITALIZATIONS, INCREASED NEED
FOR SURGERY, AND POOR QUALITY OF
LIFE. CURRENT TREATMENT FOR IBD
CAN VARY FROM AMINOSALICYLATES,
STEROIDS, IMMUNOMODULATORS, AND
BIOLOGICS, WHICH WORK BY
REDUCING INFLAMMATION AND OR
MODULATING THE IMMUNE SYSTEM.
HOWEVER, THESE TREATMENTS ARE
NOT PERFECT. A SUBSET OF
PATIENTS DON'T RESPOND OR THEY
NEED DOSE ESCALATION. FURTHER,
THESE MEDICATIONS COME WITH
ADVERSE EFFECTS, INCLUDING BONE
DISEASE, INFECTION, AND
MALIGNANCY THAT NEED TO BE
CLOSELY MONITORED AND ENTERAL
NUTRITION FORMULA IS A MEDICAL
FOOD, AND IT'S BEEN USED IN
VARIOUS FORMS TO TREAT IBD SINCE
THE 1970S. PROVIDERS PRESCRIBE
ENTERAL NUTRITION TO PATIENTS
WHO ARE MALNOURISHED TO OPTIMIZE
NUTRITION. THEY CAN SEE THAT IT
HELPS TO AUGMENT RESPONSE TO
MEDICATIONS LIKE BIOLOGICS, AND
WE EVEN USE IT TO OPTIMIZE
PATIENTS WHO ARE GOING FOR
SURGERY. EXCLUSIVE ENTERAL
NUTRITION, OR N, IS THE CURRENT
STANDARD OF CARE FOR PEDIATRIC
PATIENTS IN REFERS TO A
TREATMENT WHERE A PERSON'S
ENTIRE DIET COMES FROM A MEDICAL
FORMULA. A PATIENT MAY INGEST
THESE FORMULAS BY MOUTH OR
THROUGH A FEEDING TUBE, AND WHEN
FOLLOWED FOR TWO MONTHS, 80% OF
PATIENTS WITH ACTIVE IBD WILL GO
INTO REMISSION. THIS IS SLIGHTLY
BETTER THAN RESPONSE TO
STEROIDS, BUT WE ALSO SEE GUT
HEALING WITH INTRA FORMULA,
WHICH WE DON'T SEE WITH STEROID
THERAPY WITHOUT THIS, MEDICALLY
NECESSARY FOOD, PATIENTS RISK
MALNUTRITION, INADEQUATE GROWTH,
COGNITIVE IMPAIRMENT, SURGERY
AND REPEATED HOSPITALIZATIONS AT
AROUND $1.80 PER BOTTLE. A 12
YEAR OLD PATIENT MAY NEED 6 TO 8
BOTTLES OF ENTERAL NUTRITION
DAILY, AMOUNTING TO A TOTAL COST
OF AROUND $800 FOR THIS THERAPY.
UNFORTUNATELY VÆ MEDICAL FORMULA
IS NOT COVERED BY HEALTH PLANS
AND FOR MANY OF MY PATIENTS, THE
COST OF THIS THERAPY IS
UNAFFORDABLE. FAMILIES SHOULD
NOT HAVE TO RECONSIDER PERFECTLY
VIABLE AND POSSIBLY EVEN
SUPERIOR TREATMENT OPTIONS
BECAUSE IT'S NOT A FINANCIAL,
REALLY REALISTIC FOR THEM. I'M
HOPING THAT WE CAN OVERCOME THIS
BARRIER TO SAFE, EFFECTIVE
THERAPY AND EXPAND COVERAGE OF
NUTRITION FORMULAS SO THAT
HEALTH AND NUTRITION CARE IS
MORE EQUITABLE. THANK YOU. RYAN
SPENCER, ON BEHALF OF THE
CROHN'S AND COLITIS FOUNDATION,
THEY ARE THE SPONSORS OF THE
MEASURE. JUST SIMPLY ASK FOR
YOUR AYE VOTE IN SUPPORT. THANK
YOU. THANK YOU. DO WE HAVE ANY
OTHER WITNESSES IN SUPPORT? IF
SO, PLEASE STATE YOUR NAME,
ORGANIZATION AND POSITION.
SOUMYA NAHARIYA ON BEHALF OF THE
CHILDREN'S SPECIALTY CARE
COALITION IN SUPPORT. DAVID
GONZALEZ, ON BEHALF OF THE
CALIFORNIA LIFE SCIENCES AND
SUPPORT ALASKA FOR THE
CALIFORNIA ASSOCIATION OF
ORTHODONTISTS IN SUPPORT. GOOD
AFTERNOON, ALEX KAHN ON BEHALF
OF THE CALIFORNIA CHRONIC CARE
COALITION IN SUPPORT. OKAY. DO
WE HAVE ANY PRIMARY WITNESSES IN
OPPOSITION?
GOOD AFTERNOON, CHAIR. MEMBERS
OF THE COMMITTEE, ROBERT BOYKIN
WITH THE CALIFORNIA ASSOCIATION
OF HEALTH PLANS. REGRETTABLY, IN
OPPOSITION TO AB 1926. WE
RESPECT AND UNDERSTAND THE
INTENT OF THE BILL. HOWEVER, WE
OPPOSE PRIMARILY BASED ON THE
FACT THAT THIS BILL, AB 1926,
WILL INCREASE PREMIUMS ON ALL
CONSUMERS. ACCORDING TO AN
ANALYSIS FROM LAST YEAR'S AB 620
IT BILL, LARGELY SIMILAR TO THIS
BILL. IT IS LIKELY TO INCREASE
PREMIUMS BY ON CALIFORNIA'S BY
24 MILLION. AB 1926 IS JUST ONE
OF MANY MANDATE BILLS INTRODUCED
THIS YEAR THAT, WHEN TAKEN
COLLECTIVELY, WILL SUBSTANTIALLY
INCREASE PREMIUMS FOR ALL OUR
ENROLLEES WHILE WE ARE. WHILE
ALL ARE WELL INTENDED, EACH OF
THE MANDATE BILLS WILL ONLY
INCREASE COSTS AND MAKE HEALTH
CARE LESS AFFORDABLE FOR
EVERYONE. THANK YOU FOR YOUR
TIME TODAY. THANK YOU. STEPHANIE
WATKINS, ON BEHALF OF THE
ASSOCIATION OF CALIFORNIA LIFE
AND HEALTH INSURANCE COMPANY. WE
TOO ARE HERE IN OPPOSITION
TODAY. WE DO LIKE TO THANK THE
AUTHOR AND SPONSOR. YOU KNOW,
WE'VE HAD A LOT OF
CONVERSATIONS. IF THE BILL DOES
MOVE FORWARD TODAY, WE'D LIKE TO
CONTINUE THOSE IN AN OPEN DIALOG
TO ADDRESS OUR CONCERNS. THANK
YOU. THANK YOU. ANY ADDITIONAL
WITNESSES IN OPPOSITION? PLEASE
STATE YOUR NAME, ORGANIZATION
AND POSITION. THANK YOU, MADAM
CHAIR. JACKIE ENOS, ON BEHALF OF
AMERICA'S HEALTH INSURANCE
PLANS, IN RESPECTFUL OPPOSITION.
THANK YOU, THANK YOU. I'LL BRING
IT BACK TO THE MEMBERS OF THE
COMMITTEE FOR ANY QUESTIONS.
MOVE THE BILL. OH THANK YOU. SO
WE'LL WE'LL HOLD THE MOVE. THE
BILL BY MAJORITY LEADER
AGUIAR-CURRY SECONDED BY DOCTOR
WEBER, THAT BILL, WE'RE MEETING
IN SUBCOMMITTEE. IT WILL BE ON
CALL. WE'LL MOVE ON TO AB 1965.
BLANCA RUBIO
.
COULD YOU PUT YOUR MIC ON? THERE
WE GO. THANK YOU, MADAM CHAIR
AND MEMBERS, FOR THE OPPORTUNITY
TO PRESENT THE AB 1965. I WANT
TO BEGIN BY ACCEPTING THE
PROPOSED COMMITTEE AMENDMENTS,
WHICH WOULD CLARIFY SPECIFIC
DUTIES FOR THE LIAISON. AND I
WANT TO THANK THE COMMITTEE
STAFF FOR THEIR HARD WORK AND
ENSURING THE MEASURE MEETS ITS
INTENDED GOALS. AB 1965 WOULD
ESTABLISH THE OFFICE OF TRIBAL
AFFAIRS WITHIN THE DEPARTMENT OF
PUBLIC HEALTH, LED BY A TRIBAL
HEALTH LIAISON, TO ADDRESS
HEALTH DISPARITIES DISPARITIES
EXPERIENCED BY OUR TRIBAL
COMMUNITIES. THE MEMBERS ON THIS
COMMITTEE ARE ALL TOO FAMILIAR
WITH THE HEALTH DISPARITIES
EXPERIENCED BY THE CALIFORNIA
NATIVE POPULATION IN
CARDIOVASCULAR DISEASE, OPIOID
OVERDOSE, CANCER, AND INFANT
MORTALITY. THE LIST IS UNMATCHED
BY ANY OTHER POPULATION IN
CALIFORNIA. THIS MEASURE WOULD
TAKE THE MEANINGFUL STEPS OF
HAVING AN ESTABLISHED
REPRESENTATIVE AND OFFICE WITHIN
THE CDF TO COORDINATE ON
REDUCING THESE DISPARITIES, THE
TRIBAL LIAISON WILL SERVE AS THE
MAIN RESOURCE ADVOCATE AND
COMMUNICATIONS LINK BETWEEN THE
DEPARTMENT OF PUBLIC HEALTH AND
THE FEDERALLY RECOGNIZED TRIBES
AND THEIR DIRECT OR INDIRECT
PUBLIC HEALTH SERVICES IN THE
STATE. THIS MEASURE PLACES A
FOCUS ON ENGAGEMENT BETWEEN THE
DEPARTMENT, NATIVE AMERICAN
COMMUNITIES, AND THEIR PUBLIC
HEALTH SERVICES. IN CALIFORNIA.
THE POSITION SHALL PROMOTE AND
COORDINATE COLLABORATIVE EFFORTS
BETWEEN THE DEPARTMENT AND
TRIBES TO IMPROVE THE
AVAILABILITY AND ACCESSIBILITY
OF QUALITY HEALTH CARE AFFECTING
THE TRIBAL POPULATIONS IN
CALIFORNIA, AS LIAISONS ALREADY
DO IN OTHER STATES SUCH AS
NEVADA AND UTAH. AN ADDITIONAL
FOCUS WILL BE STIMULATING, AND
IT WILL BE STIMULATING
ENGAGEMENT BETWEEN THE
DEPARTMENT AND THE NATIVE
AMERICAN COMMUNITIES TO ENHANCE
ACCESS OF QUALITY CARE,
AFFECTING NATIVE AMERICAN
COMMUNITIES. THIS DIRECT
COORDINATION IS ESSENTIAL TO
REMEDY THE DISPARITIES FACING
OUR TRIBAL COMMUNITIES. AT THE
AT THE MOMENT. IN ADDITION TO
THE COMMITTEE AMENDMENTS, I
WELCOME FURTHER CONVERSATIONS
WITH MEMBERS HERE TODAY ON
SPECIFIC PROFESSIONAL
REQUIREMENTS FOR THE LIAISON,
WHICH DO NOT VIOLATE PROP 209,
AS WELL AS A AS GUARDRAILS
ENSURING THE OFFICE MEETS ITS
REQUIRED DUTIES. HERE WITH ME
TODAY TO TESTIFY IN SUPPORT IS
DOCTOR MARK LEBEAU, CEO OF THE
CALIFORNIA RURAL INDIAN HEALTH
BOARD. THE SPONSORS OF THIS
MEASURE. THANK YOU. ASSEMBLY
MEMBER RUBIO. GO AHEAD. YOU'LL
HAVE THREE MINUTES. THANK YOU.
THANK YOU. CHAIR. COMMITTEE
MEMBERS, AND ASSEMBLYWOMAN
BLANCA RUBIO, ON BEHALF OF THE
59 FULLY RECOGNIZED TRIBES AND
19 TRIBAL CLINIC SYSTEMS, THAT
ARE A PART OF THE CALIFORNIA
RURAL INDIAN HEALTH BOARD WHERE
I WORK, I WANT TO THANK
COMMITTEE FOR THE CONSIDERATION
OF AB 1965 COMMITTEE MEMBERS. IN
2011, GOVERNOR BROWN ISSUED
EXECUTIVE ORDER B 1011,
REQUIRING AT THE TIME ALL STATE
OF CALIFORNIA AGENCIES TO
ENCOURAGE COMMUNICATION AND
CONSULTATION WITH CALIFORNIA
TRIBES. ON JUNE 18TH, 2019,
GOVERNOR NEWSOM ISSUED EXECUTIVE
ORDER NINE 1519, WHICH
REAFFIRMED AND INCORPORATED THE
PRINCIPLES OUTLINED IN GOVERNOR
BROWN'S EXECUTIVE ORDER. AT THAT
TIME, MULTIPLE STATE AGENCIES
AND DEPARTMENTS ISSUED TRIBAL
CONSULTATION PLANS AND POLICIES.
EXAMPLES INCLUDE THE DEPARTMENT
OF HEALTH CARE SERVICES, TRIBAL
ENGAGEMENT PLAN, WHICH WAS
APPROVED IN 2012. THE CALIFORNIA
STATE TRANSPORTATION AGENCIES
TRIBAL CONSULTATION POLICY,
ADOPTED IN JUNE OF 2014. THE
CALIFORNIA GOVERNMENT OPERATIONS
AGENCIES TRIBAL CONSULTATION
POLICY, ADOPTED IN MARCH OF
2016. HEALTH AND HUMAN SERVICES
TRIBAL CONSULTATION POLICY
FINALIZED IN JANUARY OF 2017.
DEPARTMENT OF SOCIAL SERVICE
CONSULTATION POLICY IN 2017.
PUBLIC UTILITIES COMMISSION
TRIBAL CONSULTATION POLICY
ADOPTED IN 2018 CALIFORNIA
ENVIRONMENTAL PROTECTION
AGENCIES. TRIBAL CONSULTATION
POLICY, ADOPTED IN 2020.
COMMITTEE MEMBERS. THERE IS A
NEED FOR THE CALIFORNIA
DEPARTMENT OF PUBLIC HEALTH TO
DEVELOP AND ESTABLISH ITS OWN
TRIBAL CONSULTATION PLAN AND
POLICY. A POLITICAL ARTICLE
NOTED IN 2020, NOTED THAT BOTH
FEDERAL AND MULTIPLE STATE
HEALTH AGENCIES ACROSS THE US
REFUSED TO PROVIDE TRIBES AND
THEIR ORGANIZATIONS ACCESS TO
DATA SHOWING THE CORONAVIRUS,
HOW THE CORONAVIRUS WAS
SPREADING ACROSS THEIR
COMMUNITIES, POTENTIALLY
WIDENING HEALTH DISPARITIES AND
FRUSTRATING TRIBAL HEALTH
LEADERS WORKING TO CONTAIN THE
PANDEMIC. ON BEHALF OF THE
CALIFORNIA RURAL INDIAN HEALTH
BOARD AND THE TRIBES AND THE
TRIBAL CLINICS THAT I HAVE THE
HONOR AND PRIVILEGE OF WORKING
DIRECTLY WITH, I WANT TO ASK FOR
SUPPORT FOR AB 1965, IT
DEFINITELY IS IN LINE WITH THE
GOVERNOR'S ADMINISTRATIVE ORDERS
, IT IS IMPORTANT FOR TRIBAL
GOVERNMENTS AND STATE
GOVERNMENTS TO COME TOGETHER AND
WORK COLLABORATIVELY TO PROTECT
ALL CITIZENS WITHIN THE STATE OF
CALIFORNIA. THANK YOU. THANK YOU
SO MUCH. ARE THERE ANY OTHER
WITNESSES IN SUPPORT IN THE ROOM
? GOOD AFTERNOON. ALEX ALANIZ ON
BEHALF OF THE CAHUILLA TRIBE AND
THE POMO OF UPPER LAKE IN
SUPPORT. THANK YOU. THANK YOU.
WE'LL MOVE ON TO ANY PRIMARY
WITNESSES IN OPPOSITION. ANY
ADDITIONAL WITNESSES IN
OPPOSITION? SEEING NONE. WE'LL
BRING IT BACK TO THE COMMITTEE.
DOCTOR WEBER. GOOD AFTERNOON, I
REALLY JUST WANT TO THANK THE
AUTHOR AND THE SPONSORS FOR THIS
BILL. IT'S DEFINITELY, LONG
OVERDUE. AND IF YOU WOULD BE, I
WOULD BE SO HONORED IF YOU THAT
WE WANT TO HAVE CULTURALLY
SENSITIVE, YOU KNOW, WAYS OF
ADDRESSING THE NEEDS OF THE
TRIBAL COMMUNITIES, WITH THAT
ACCESS OF CARE, THEY DEFINITELY
HAVE, THE TRIBAL GOVERNMENTS ARE
ALL DIFFERENT. WE CAN NEVER
ASSUME THAT ONE IS THE SAME AS
THE OTHER. I'VE I'VE, YOU KNOW,
GOTTEN TO KNOW OVER THE YEARS.
NOW 12 YEARS HERE REPRESENTING
THAT DISTRICT THAT THE NEEDS
VARY FROM ONE PLACE TO THE
OTHER, AND THAT THAT ACCESS IS
VERY IMPORTANT, BUT THEIR UNIQUE
NEEDS NEED TO BE INTEGRATED INTO
THE PUBLIC POLICY AND THE
PROTOCOLS OF, OF OUR STATE. SO
THANK YOU. ASSEMBLYMEMBER HANEY.
THANK YOU, CHAIR. AND I WANTED
TO THANK YOU BOTH FOR YOUR
LEADERSHIP ON THIS. AND YOU KNOW
, BRING ANOTHER, ISSUE FORWARD
THAT I HOPE CAN BE A PART OF THE
CONVERSATION AS THIS MOVES
FORWARD, WHICH IS HOW WE ARE
WORKING INTENTIONALLY AND
COLLECTIVELY. VÆ, WITH URGENCY
TOWARDS ADDRESSING THE
CHALLENGES AROUND FENTANYL AND
DRUG OVERDOSE AND DRUG
ADDICTION. WE WORKED WITH A
NUMBER OF TRIBES AND HAVING A
HEARING, ON THE ALEJO'S LAND,
AROUND THE PARTICULAR IMPACTS
AND PARTICULAR CHALLENGES AND OF
FENTANYL AND DRUG OVERDOSE AS IT
IMPACTED TRIBAL COMMUNITIES. AND
ONE OF THE CHALLENGES THAT WE
HAD WHEN WE DID THAT IS IT FELT
THAT THERE WAS NOT THE LEVEL OF
FOCUS AND COLLABORATION THAT
SHOULD BE THERE FROM OUR STATE
IN CONFRONTING THESE ISSUES
TOGETHER WITH TRIBES AND THIS
THIS COMPACT AND THIS EFFORT AND
THE BROADER FOCUS THAT THAT THIS
CAN BRING, I HOPE, CAN ALSO
EXTEND TO THOSE CHALLENGES. I
THERE ARE VERY HIGH RATES OF
OVERDOSE, AND I THINK SOME OF
THE PARTICULAR CHALLENGES AROUND
PUBLIC HEALTH AND HEALTH AS IT
RELATES TO ACCESSIBILITY OF
TREATMENT AND CARE AND CLINICS
AND ALSO SOME OF THE PARTICULAR
CHALLENGES THAT CAN EXIST WITH
COORDINATION WITH THE FEDERAL
GOVERNMENT AND SOME OF THE
OPPORTUNITIES THAT EXIST WITH
WITH CLINICS AND OTHERWISE, THAT
WE CAN USE AS A BENEFIT TO, IN
ACCESSING RESOURCES. AND SO I
HOPE THAT ALL THAT CAN BE THERE,
THERE AS WELL. IT WAS A REALLY
AN EYE OPENING EXPERIENCE FOR
ME, NOT ONLY IN THE CHALLENGES,
BUT ALSO IN, SOME OF THE MISSED
OPPORTUNITIES BECAUSE WE DON'T
HAVE THIS LEVEL OF COMMUNICATION
AND COORDINATION AND
INTENTIONALITY AS IT RELATES TO
THAT PARTICULAR, MOST DEADLY OF
HEALTH AND PUBLIC HEALTH
EPIDEMICS THAT WE'RE FACING AS A
STATE. SO THANK YOU. I WOULD
ALSO LOVE TO BE ADDED AS A AS A
COAUTHOR. AND THANK YOU SO MUCH
FOR YOUR LEADERSHIP. MAJORITY
LEADER, THANK YOU FOR BRINGING
THE BILL FORWARD, MISS ASSEMBLY
MEMBER RUBIO, I'D LIKE TO BE
ADDED AS A COAUTHOR. GOT ME.
WOULD YOU LIKE TO CLOSE? THANK
YOU, AND I WANT TO THANK THE
COMMITTEE AGAIN FOR THEIR HARD
WORK. AND THE CHAIR. I KNOW IT
WAS, A LITTLE BIT DIFFICULT
TRYING TO MAKE SURE THAT WE GOT
THE LANGUAGE CORRECT. I'M STILL,
HOPING THAT IF THERE'S ANY
ADDITIONAL CHANGES, WE CAN
CONTINUE WORKING ON IT. BUT WITH
THAT, I RESPECTFULLY ASK FOR AN
AYE VOTE. THANK YOU, I
APPRECIATE IT. WE ARE STILL A
SUB, COMMITTEE RIGHT NOW, BUT I
WANT TO THANK YOU FOR BRINGING
THIS BILL FORWARD. I THINK IT
CERTAINLY ADDRESSES SOME OF THE
INCREDIBLY CRITICAL HEALTH
DISPARITIES THAT WE KNOW EXIST
IN THE TRIBAL COMMUNITIES, AND
SO THANK YOU FOR BRINGING
FORWARD THE BILL. AND IF
POSSIBLE, I'D LOVE TO BE
CONSIDERED AS A COAUTHOR AS
WELL. WE WILL MOVE ON TO ITEM
NUMBER FIVE, AB 2081. DAVIES.
PLEASE GO AHEAD AND THANK YOU.
STAFF, I THINK YOUR MIC MIGHT
NOT BE ON. THERE WE GO. THANK
YOU. GOOD AFTERNOON. THANK YOU.
HONORABLE CHAIR AND COMMITTEE
MEMBERS, I WANT TO START BY
THANKING THE COMMITTEE STAFF AND
OUR STAKEHOLDERS FOR WORKING
WITH US SO DILIGENTLY ON THIS
BILL. UNDER CURRENT LAW,
SUBSTANCE ABUSE DISORDER
FACILITIES CANNOT OPERATE
WITHOUT FIRST OBTAINING A
LICENSE FROM THE DEPARTMENT OF
HEALTH CARE SERVICES. THIS ONLY
MATTERS FOR TREATMENT CENTERS
WITH MORE THAN SIX BEDS. AFTER
RECEIVING CERTIFICATION. SHOULD
A TREATMENT FACILITY RECEIVE A
VIOLATION THAT AFFECTS THE
STATUS OF THEIR CERTIFICATION,
IT IS POSTED TO THE DHCS
WEBSITE. THIS IS A RESOURCE THAT
MANY PEOPLE LOOK FOR TREATMENT,
EVEN KNOWING. EXCUSE ME, THIS IS
A RESOURCE THAT MANY PEOPLE LOOK
FOR TREATMENT. DON'T EVEN KNOW
ABOUT WHEN THEY'RE TRYING TO
DECIDE ON A COURSE OF TREATMENT.
THERE IS SUCH A LACK OF
TRANSPARENCY FOR THOSE LOOKING
FOR TREATMENT, AND IT'S
HEARTBREAKING TO HEAR SOME OF
THE STORIES ABOUT THESE PLACES.
WHAT MY BILL AB 2081 DOES IS IT
BEGINS TO PEEL THE VEIL BACK
FROM THESE FACILITIES SO
PATIENTS CAN START TO HAVE A
SENSE OF CONTROL IN THEIR
CHOICES. AB 2081 WILL HAVE
CERTIFIED SUBSTANCE ABUSE
FACILITIES INCLUDE A DISCLOSURE
ON THEIR WEBSITES AND ON ANY
INTAKE FORMS THAT LINKS TO THE
DCS WEBSITE. AB 2081 WILL ALSO
REQUIRE THESE ESTABLISHMENTS TO
PAY A PENALTY IF THEY ARE FOUND
TO NOT HAVE PROVIDED THE
DISCLOSURE TO POTENTIAL
PATIENTS. IN 2023, IT WAS FOUND
BY THE OC REGISTER THAT SOME OF
THESE TREATMENT FACILITIES WERE
INTENTIONALLY ENCOURAGING
PATIENTS IN RELAPSING DURING
THEIR TREATMENT. THEY DID THIS
TO ENSURE PATIENTS STAYED WITH
THEM TO CONTINUE TREATMENT FOR
LONGER. SOME OF THESE FRAUDULENT
FACILITIES THAT PROMISE CARE
WILL SELL THEIR PATIENTS THROUGH
REFERRAL PROGRAMS IN ORDER TO
GET KICKBACKS. THIS LACK OF
TRANSPARENCY FROM CARE PROVIDERS
IS WHAT LED US TO WHERE WE ARE
RIGHT NOW. THESE ARE TAKING
ADVANTAGE OF PATIENTS AND USING
THEIR INSURANCE PROVIDERS AS
PERSONAL BANKS. AB 2081 IS A
COMMON SENSE MEASURE THAT
PROTECTS OUR PATIENTS IN OUR
COMMUNITIES AND BRINGS
ACCOUNTABILITY BACK TO THE
CONVERSATION OF SUBSTANCE ABUSE
TREATMENTS. HERE TO TESTIFY WITH
ME IS TAMARA LETOURNEAU, THE
CITY MANAGER FOR LAGUNA NIGUEL,
AND CAROLINE GRINDER FROM THE
LEAGUE OF CALIFORNIA CITIES. I
RESPECTFULLY ASK FOR AN AYE
VOTE. THANK YOU, THANK YOU.
YOU'LL EACH HAVE THREE MINUTES.
THANK YOU. SO MUCH. GOOD
AFTERNOON. IT'S AN HONOR TO BE
HERE AND TO SPEAK ON THIS
IMPORTANT LEGISLATION. AS THE
ASSEMBLY MEMBER DAVEY SAID, MY
NAME IS TAMARA LETOURNEAU. I'M
THE CITY MANAGER FOR THE CITY OF
LAGUNA NIGUEL. I'M A PROUD
PUBLIC SERVANT WITH AN OVER 36
YEAR CAREER SERVING CALIFORNIA
COMMUNITIES. I HAVE EXTENSIVE
EXPERIENCE DEALING WITH
EXTREMELY WELL OPERATED RECOVERY
TREATMENT FACILITY OPERATORS, AS
WELL AS THOSE THAT FIND IT
CHALLENGING TO FOLLOW ANY RULES
AND LAWS. IT IS THESE OPERATORS
WHO FIND IT CHALLENGING TO FILE
FOLLOW THE RULES THAT CREATE
SERIOUS ISSUES FOR PATIENTS THEY
SERVE, AND THE COMMUNITIES AND
NEIGHBORHOODS THAT THEY RESIDE
IN. THE ABUSES IN THE RECOVERY
HOME INDUSTRY ARE RAMPANT AND
WELL DOCUMENTED, AND INCLUDED
SUCH THINGS AS THOSE SETTING UP
FAKE HOMES TO FALSELY CHARGE
INSURANCE COMPANIES WITHOUT
PROVIDING REAL PATIENT CARE TO
THOSE RECOVERY HOMES WHO EMPLOY
UNTRAINED AND UNLICENSED
INDIVIDUALS WHO HARM PATIENTS,
AND THOSE ARE JUST A FEW
EXAMPLES. THE LIST OF WAYS
PATIENTS ARE HARMED IS ENDLESS
AND IS VASTLY IN THIS VASTLY
UNREGULATED INDUSTRY, WHICH
INCLUDES A LACK OF TRANSPARENCY
REGARDING OPERATIONS AND PATIENT
CARE. AB 2081 PUTS CRITICAL
REGULATIONS IN PLACE WHERE
LEGAL, DISCIPLINARY AND OR OTHER
ENFORCEMENT ACTIONS BY THE
DEPARTMENT OF HEALTH CARE
SERVICES ON AN OPERATOR WOULD BE
REQUIRED TO BE DISCLOSED, AND A
VIOLATION OF THESE REGULATIONS
WOULD RESULT IN PENALTIES. IT IS
CRITICAL FOR PATIENTS AND THEIR
FAMILIES TO KNOW WHEN THEY ARE
SEEKING A TREATMENT PROGRAM THAT
THEY ARE GETTING RELIABLE AND A
REPUTABLE OPERATOR WHO PUTS
PATIENT CARE FIRST FOR THE
PROTECTION OF THE CURRENT AND
FUTURE RECOVERY HOME PATIENTS.
IT'S CRITICAL THAT RECOVERY HOME
OPERATORS BE HELD ACCOUNTABLE
FOR THEIR ACTIONS, AND THE
PUBLIC SHOULD BE ABLE TO EASILY
ACCESS, HAVE ACCESS TO CONFIRMED
SAID VIOLATIONS. SO THE PATIENTS
AND THEIR FAMILIES CAN MAKE
INFORMED DECISIONS REGARDING
THEIR CARE. IT IS FOR THOSE
REASONS I RESPECTFULLY URGE YOU
TO SUPPORT AB 2081. THANK YOU,
THANK YOU. NEXT WITNESS. GOOD
AFTERNOON, CHAIR AND MEMBERS. MY
NAME IS CAROLINE GRINDER AND I'M
HERE ON BEHALF OF THE LEAGUE OF
CALIFORNIA CITIES, WHICH IS
PROUD TO CO-SPONSOR AB 2081.
THIS IS SOME COMMON SENSE
LEGISLATION THAT WOULD REQUIRE A
HIGHER STANDARD OF TRANSPARENCY
AND GREATER PROTECTIONS FOR
INDIVIDUALS THAT ARE SEEKING
ALCOHOLISM AND SUBSTANCE USE
TREATMENT. SPECIFICALLY, AB
2081, AS AMENDED, WOULD REQUIRE
A RECOVERY OR TREATMENT FACILITY
TO PROVIDE A DISCLOSURE TO THOSE
SEEKING CARE THAT THEY CAN
CHECK. THE DEPARTMENT OF HEALTH
CARE SERVICES WEBSITE TO CONFIRM
THE FACILITY'S COMPLIANCE WITH
STATE LICENSING LAWS. COMPLIANCE
WITH STATE LICENSING LAWS
ADMINISTERED THROUGH THE
DEPARTMENT OF HEALTH CARE
SERVICES IS ESSENTIAL TO
SAFEGUARDING RESIDENTS
WELL-BEING AND MAINTAINING
QUALITY CARE. THIS MEASURE WOULD
ENSURE THAT THOSE SEEKING
TREATMENT EASILY KNOW WHAT
VIOLATIONS, IF ANY, HAVE
HAPPENED AT THAT FACILITY AND
WOULD HOLD PROVIDERS ACCOUNTABLE
BY MAKING THOSE VIOLATIONS MORE
EASILY ACCESSIBLE. BY MAKING
THIS INFORMATION MORE
ACCESSIBLE, AB 2081 EMPOWERS
PATIENTS TO MAKE INFORMED
DECISIONS ABOUT THEIR CARE.
RESIDENTIAL RECOVERY HOUSING
PROVIDES A WIDE RANGE OF
BENEFITS TO SOME OF CALIFORNIA'S
MOST VULNERABLE RESIDENTS, AND
IT'S CRITICAL THAT THEIR NEEDS
ARE PRIORITIZED OVER PROFITS.
CAL CITIES HAS A LONG HISTORY OF
ATTEMPTING TO PASS LEGISLATION
TO ADDRESS CONCERNS RAISED BY
CITIES ABOUT THE NEED FOR
INCREASED OVERSIGHT,
TRANSPARENCY AND ACCOUNTABILITY
FOR DRUG AND ALCOHOL RECOVERY
FACILITIES. AB 2081 IS A
PRACTICAL STEP FORWARD IN
PROTECTING RESIDENTS AND
UPHOLDING THE INTEGRITY OF THE
RESIDENTIAL TREATMENT FACILITY
MODEL. WE URGE THE COMMITTEE TO
SUPPORT THIS LEGISLATION. WE
BELIEVE IT'S GOOD FOR CITIES,
GOOD FOR THE NEIGHBORS AND MOST
IMPORTANTLY, GOOD FOR THOSE THAT
ARE SEEKING TREATMENT AND CARE.
THANK YOU, THANK YOU. ARE THERE
ANY ADDITIONAL WITNESSES IN
OPPOSITION IN SUPPORT IN THE
ROOM? STATE YOUR NAME,
ORGANIZATION AND POSITION,
PLEASE. NICOLE WATERMAN, ON
BEHALF OF THE ORANGE COUNTY
BOARD OF SUPERVISORS AND SUPPORT
, WE'LL MOVE ON TO OPPOSITION
PRIMARY WITNESSES.
REALLY BRIEF, MY NAME IS TRÊN
MURPHY. I'M WITH THE CALIFORNIA
ASSOCIATION OF ALCOHOL AND DRUG
PROGRAM EXECUTIVES. WE'VE BEEN
WORKING REALLY DILIGENTLY WITH
THE AUTHOR'S OFFICE ON
AMENDMENTS ON THIS BILL. WE WERE
OPPOSED TO THE PREVIOUS VERSION,
BUT WE'RE LOOKING FORWARD TO
REVISING AND REVIEWING OUR
CURRENT POSITION. THANK YOU. ANY
ADDITIONAL WITNESSES IN
OPPOSITION? SEEING NONE, I'LL
BRING IT BACK. Þ BACK TO THE
COMMITTEE, I JUST WANT TO
CLARIFY, MISS DAVIES, ARE YOU
INTENDING TO ACCEPT THE
AMENDMENTS OF THE COMMITTEE? WE
ACTUALLY DID. YES. OKAY, GREAT.
THANK YOU. ANY OTHER QUESTIONS
FROM THE COMMITTEE? CHAU I WANT
TO THANK YOU FOR BRINGING THIS
BILL. I ACTUALLY HEARD AN
INVESTIGATIVE REPORT ABOUT
TREATMENT CENTER THAT WAS
CHARGING FOR PATIENTS. THEY
DIDN'T HAVE DOUBLE CHARGE DOUBLE
BILLING FOR, FOR SERVICES THEY
WERE PROVIDING. AND, YOU KNOW,
AT THE END OF THE DAY, THESE ARE
TAXPAYER DOLLARS A LOT OF TIMES
THAT ARE PAYING FOR THESE
PROGRAMS TO OR SOME OF
DEFINITELY SOME OF THESE
PROGRAMS, AND I JUST WANTED A
LITTLE BIT OF CLARIFICATION, IF
YOU COULD CLARIFY WHAT THE
AMENDMENTS ARE. AND THEN ALSO, I
WAS CURIOUS, IF THERE IS A TIME
FRAME, IT LOOKS LIKE THEY HAVE
TO POST VIOLATIONS ON THEIR
WEBSITE INDEFINITELY. FOREVER. I
WAS JUST CURIOUS IF IT WAS KIND
OF A FOREVER SITUATION, OR IF
THERE'S A CERTAIN POINT WHEN
THEY GET BACK INTO COMPLIANCE,
THEY CAN TAKE THINGS OFF THE
AMENDMENT WE MADE IS TO BEGIN
WITH, WE'RE GOING TO HAVE THAT.
THE THE TREATMENT HOME WOULD
ACTUALLY HAVE THE VIOLATION
ITSELF ON THEIR WEBSITE. BUT
WORKING WITH DCFS, IT'LL BE ON
THEIR SITE. HOWEVER, THEY WILL
HAVE A LINK THAT UNDER THE
TREATMENT CENTER WILL HAVE A
LINK ON THERE SAYING THIS IS
WHERE YOU CAN GO TO SEE IF THERE
ARE ANY VIOLATIONS. SO WE
CHANGED THAT TO GO WITH THAT.
AND ALSO I THINK THEY ALSO HAVE
TEN DAYS TO 14 DAYS. I THINK
ALREADY, IN ORDER TO MAKE SURE
IT'S UP THERE, IT ALSO REMOVES
THE CIVIL PENALTY. OKAY. THANK
YOU. ANY OTHER QUESTIONS OR
COMMENTS FROM THE COMMITTEE?
WE'RE STILL OPERATING AS A
SUBCOMMITTEE, BUT I WILL ACCEPT
A MOTION IN A SECOND. OH, OKAY.
WE'LL DO IT AGAIN. THANK YOU SO
MUCH, THIS WILL BE ON CALL.
APPRECIATE IT. MR. BERMAN, ITEM
6AB 2154.
GOOD AFTERNOON, CHAIR AND
COLLEAGUES. I'D LIKE TO BEGIN BY
THANKING COMMITTEE STAFF FOR
THEIR WORK ON THIS BILL. I WILL
BE ACCEPTING THE COMMITTEE'S
AMENDMENTS, DESCRIBED IN THE
ANALYSIS. IT'D BE 2154. WOULD
ENSURE THAT IF A PERSON IS
INVOLUNTARILY DETAINED UNDER THE
LANTERMAN-PETRIS-SHORT ACT, THEN
A FAMILY MEMBER OF THE PERSON
DETAINED WOULD BE PROVIDED A
COPY OF THE DEPARTMENT OF HEALTH
CARE SERVICES PATIENT'S RIGHTS
HANDBOOK. THIS BILL WOULD
PROVIDE FAMILY MEMBERS WITH
VALUABLE INFORMATION AND
RESOURCES, INCLUDING
DEFINITIONS, TO UNDERSTAND THE
TERMINOLOGY TO ENABLE THEM TO
SUPPORT THEIR LOVED ONES DURING
A MENTAL HEALTH CRISIS. IN
ADDITION, BY UNDERSTANDING THE
RIGHTS OF THEIR LOVED ONES WHO
HAVE BEEN INVOLUNTARILY
DETAINED, FAMILY MEMBERS WILL BE
BETTER EQUIPPED TO ENSURE THAT
THEIR RIGHTS ARE REALIZED IN
PARTICULAR, I WANT TO THANK THE
CALIFORNIA HOSPITAL ASSOCIATION
AND DISABILITY RIGHTS CALIFORNIA
FOR WORKING WITH MY OFFICE IN
THE COMMITTEE ON THE AMENDMENTS
TO MAINTAIN PATIENT
CONFIDENTIALITY. I'M GLAD WE
WERE ABLE TO ADDRESS CONCERNS
AND LOOK FORWARD TO CONTINUING
CONVERSATIONS WITH THESE
STAKEHOLDERS, AND THIS BILL CAME
OUT OF DISCUSSIONS WITH FAMILY
MEMBERS WHO WANT TO IMPROVE OUR
MENTAL HEALTH SYSTEM BASED ON
THE EXPERIENCE OF THEIR LOVED
ONES. AND I'M REALLY HONORED TO
BE JOINED BY TWO OF THEM TODAY,
LAURA PALMER LOHAN, WHO'S A
FRIEND AND ALSO A PARENT WHO
INSPIRED THIS BILL AFTER SHARING
HER SON'S EXPERIENCE DURING A
MENTAL HEALTH CRISIS. AND JENNY
TRAUBE, TRAUBE TRAUBE, PARENT OF
TWO DAUGHTERS WITH SEVERE MENTAL
ILLNESSES AND A TEN YEAR
VOLUNTEER FOR NAMI PARENTS AND
YOUTH AND YOUNG ADULTS SUPPORT
GROUP. AND WITH THAT, I'LL TURN
IT OVER TO THEM. THANK YOU. EACH
HAVE THREE MINUTES. HONORABLE
CHAIR BONTA AND HEALTH COMMITTEE
MEMBERS, THANK YOU FOR YOUR
LEADERSHIP AND YOUR SERVICE. I
ALSO WANT TO THANK HONORABLE
STATE ASSEMBLY MEMBER MARC
BERMAN FOR HIS LEADERSHIP. I
EXPERIENCED ANGUISH WHEN THE
EMERGENCY DEPARTMENT TEAM
RESPONSIBLE FOR STABILIZING MY
SON DURING HIS MENTAL HEALTH
CRISIS TOLD ME TO GO HOME AND
REFUSED TO TELL ME TO WHICH
FACILITY HE WAS GOING TO BE
ASSIGNED. LUCKILY, I GLANCED AT
FIND MY FRIENDS ON MY IPHONE APP
AND WAS AT THE RIGHT TIME AND
MONITORED HIS TRANSPORT FROM THE
EMERGENCY DEPARTMENT TO THE
FACILITY. UPON ARRIVAL, THE
FACILITY STAFF REFUSED TO
CONFIRM OR DENY HIS PRESENCE.
DESPITE THAT, I HELD POWER OF
ATTORNEY FOR HIS CARE SHOULD HE
BECOME INCAPACITATED, WHICH HE
WAS MY ACCESS TO HIM WAS DENIED.
IT WAS NOT UNTIL AFTER THE
INITIAL 5150 A 72 HOUR HOLD HAD
EXPIRED, AND SEVERAL DAYS AFTER
THE EXTENDED HOLD THAT I WAS
ALLOWED TO SPEAK WITH HIS
TREATING PHYSICIANS AS A RESULT,
THEY HAD NO INFORMATION ABOUT
HIS CLINICAL HISTORY AND WHAT
TRANSPIRED IN THE MONTHS, WEEKS,
DAYS, OR HOURS BEFORE HIS
CRISIS. IN THE ABSENCE OF
INFORMATION, SEVERAL DIFFERENT
MEDICINES HAD BEEN PRESCRIBED TO
HIM RAPIDLY. WHEN I SAW HIM, I
WAS SHOCKED TO FIND THAT HIS
CONDITION HAD WORSENED
CONSIDERABLY, AND HE WAS IN A
CATATONIC STATE. HIS HOSPITAL
STAY LASTED MORE THAN SIX WEEKS.
LATER, I LEARNED THAT THIS IS
MUCH LONGER THAN A CASE SUCH AS
HIS HAD WE UNDERSTOOD HIS
RIGHTS, WE WOULD HAVE BEEN ABLE
TO PROVIDE INVALUABLE CLINICAL
HISTORY TO HIS TREATING
PHYSICIANS, WHICH IN TURN COULD
HAVE SPED UP HIS STABILIZATION
AND RECOVERY. CLINICAL DATA SHOW
THAT 80% OF PATIENTS WANT FAMILY
MEMBERS INVOLVED, AND RECOVERY
IS EXPEDITED AND MORE ROBUST.
WITH FAMILY SUPPORT. PLEASE
SUPPORT AB 2150 PROVIDING
FAMILIES WITH INFORMATION IS A
SIMPLE AND POWERFUL STEP. THANK
YOU, THANK YOU. YOU CAN GO
AHEAD, MADAM CHAIR, AND
COMMITTEE MEMBERS, I'M JENNY
TRAUBE AFTER MY 15 YEAR OLD
DAUGHTER'S SUICIDE ATTEMPT, SHE
WAS PLACED UNDER A 5150
INVOLUNTARY HOLD. UNLIKE LAURA'S
SITUATION, MY DAUGHTER WAS A
MINOR. SO WE WERE ABLE TO
COMMUNICATE WITH THE CARE TEAM,
YET STILL, IT WAS A TRAUMATIC
EXPERIENCE AND A 5150 WAS
FOREIGN TO US, AS WERE THE
RIGHTS OF OUR DAUGHTER. UNDER
THIS BILL, WE WOULD HAVE
RECEIVED A COPY OF OR ACCESS TO
THE EXISTING CALIFORNIA
DEPARTMENT OF HEALTH CARE
SERVICES HANDBOOK EXPLAINING THE
RIGHTS FOR INDIVIDUALS IN MENTAL
HEALTH FACILITIES. IN THAT
STRESSFUL SITUATION, WE WERE NOT
PREPARED TO UNDERSTAND WHAT WAS
HAPPENING AND MORE INFORMATION
WOULD HAVE BEEN BETTER. THE
HANDBOOK INCLUDES CRITICAL,
INVOLUNTARY HOLD EDUCATION AND
DEFINITIONS, AS WELL AS RIGHTS
REGARDING VISITATION, TELEPHONE
ACCESS, AND THE ABILITY TO HAVE
A PATIENT'S RIGHT ADVOCATE AND
MORE. HAVING ACCESS TO THIS
MATERIAL WOULD HAVE HELPED US
BETTER UNDERSTAND AND NAVIGATE
THROUGH A DEVASTATING SITUATION
FOR THE SUCCESSFUL TREATMENT AND
CARE OF OUR DAUGHTER. AND THIS
IS NOT ONLY PERSONAL FOR ME. FOR
THE PAST TEN YEARS, I HAVE BEEN
A VOLUNTEER FOR NAMI, THE
NATIONAL ALLIANCE OF MENTAL
ILLNESS. I CO-FACILITATE A
SUPPORT GROUP FOR PARENTS OF
YOUTH AND YOUNG ADULTS UP TO THE
AGE OF 26. I MET LAURA WHILE
FACILITATING THE SUPPORT GROUP
HERS IS ONE OF THE NUMEROUS
STORIES I HEAR OF PARENTS
FINDING THEMSELVES UNEXPECTEDLY
PLUNGED INTO THE DIRE SITUATION
OF HAVING THEIR CHILD OR YOUNG
ADULT. 5150 I SEE THEIR SHOCK,
HEAR THEIR TRAUMA, FEEL THEIR
PAIN, AND LISTEN TO THEIR
FRUSTRATION, OFTEN IN TRYING TO
HELP THEIR CHILD OR YOUNG ADULT
FAMILY MEMBERS EAGER TO SUPPORT
THEIR LOVED ONES, DESERVE TO BE
EDUCATED ON THE INVOLUNTARY HOLD
PROCESS AND DEFINITIONS, AS WELL
AS THE RIGHTS OF THEIR LOVED
ONES, REGARDLESS OF THE AGE. AND
ABSOLUTELY MORE CAN BE DONE IN
SHARING EXISTING NON HIPAA
VIOLATING RESOURCES WITH FAMILY
MEMBERS IN THEIR GREATEST TIME
OF NEED. PROVIDING ACCESS TO
INFORMATION AND RESOURCES IS A
FIRST STEP AT HELPING FAMILY
MEMBERS SUPPORT THEIR LOVED ONES
AND IMPROVE THEIR CARE AND
OUTCOME. AS A PARENT OF TWO
DAUGHTERS WITH SEVERE MENTAL
ILLNESSES AND A NAMI SUPPORT
GROUP FACILITATOR, I
WHOLEHEARTEDLY SUPPORT AB 2154
AND REQUEST YOUR I VOTE. THANK
YOU. THANK YOU SO MUCH FOR
SHARING YOUR TESTIMONY. ARE
THERE ANY OTHER ADDITIONAL
WITNESSES IN SUPPORT? DANNY OFER
WITH THE NATIONAL ALLIANCE ON
MENTAL ILLNESS, ALSO KNOWN AS
NAMI, CALIFORNIA AND STRONG
SUPPORT. THANKS. THANK YOU.
ARLENE RUSCHA, AS A CONCERNED
PARENT. KATHY PALMER LU█N
ANOTHER CONCERNED PARENT. THANK
YOU. ARE THERE ANY PRIMARY
WITNESSES IN OPPOSITION? YOU CAN
COME FORWARD TO THE TABLE.
CAN YOU HEAR ME NOW? ALL RIGHT.
AWESOME GOOD AFTERNOON, MADAM
CHAIR. COMMITTEE MEMBERS, DEB
ROTH WITH DISABILITY RIGHTS
CALIFORNIA. WE ARE CALIFORNIA'S
FEDERALLY MANDATED PROTECTION
AND ADVOCACY AGENCY. WE HAVE AN
OPPOSE UNLESS AMENDED POSITION.
AND I FEEL AWFUL COMING UP HERE
AFTER ASSEMBLY MEMBER BERMAN
JUST TALKED ABOUT WORKING WITH
US. AND I DO WANT TO ACKNOWLEDGE
THAT HIS STAFF AND COMMITTEE
STAFF WORKED WITH US. AND
THERE'S JUST ONE LITTLE THING
LEFT, BUT IT'S KIND OF IMPORTANT
, AND I WANT TO SAY THAT WE
SUPPORT THE INTENT OF THE BILL,
I HOPE I'M NOT BOTCHING YOUR
NAME, MISS PALMER. ARE THAT'S
AWFUL. WHAT YOU EXPERIENCED AT.
AND, I DON'T KNOW IF THIS BILL
WILL HELP YOU FOR ALL OF THE
THINGS THAT YOU EXPERIENCED,
ERNST, BUT WE DEFINITELY SUPPORT
HAVING MORE INFORMATION OUT
THERE. THIS IS A PUBLIC DOCUMENT
, IT IS AVAILABLE DIGITALLY, AS
WELL AS IN A IN A HARD COPY. AND
WE KNOW FAMILIES WANT TO DO ALL
THAT THEY CAN TO HELP THEIR
LOVED ONES. SO OUR PROBLEM
THAT'S LEFT OVER IS KIND OF
CENTRAL TO THE PATIENTS RIGHTS
HANDBOOK. AND IT'S ABOUT
PATIENTS EXISTING LAW GIVES
PATIENTS THE RIGHT TO THE
HANDBOOK UPON ADMISSION TO A
HOSPITAL, BUT NOT BEFORE. AND
THAT'S WHEN FAMILY MEMBERS WOULD
GET A COPY UNDER THIS BILL. WHEN
THE PATIENT IS DETAINED. SO WE
WERE PLEASED TO SEE A REFERENCE
AND IT'S IN COMMENT SIX BE IN
THE ANALYSIS, THAT THERE ARE
ORGANIZATIONS THAT PROVIDE
RESOURCES SPECIFICALLY FOR THOSE
ON AN INVOLUNTARY HOLD WHERE
AWARE OF ONE IN EACH COUNTY, AND
THAT WOULD BE THE OFFICIAL
PATIENTS RIGHTS ADVOCATE.
UNFORTUNATELY, THEY TELL US IT'S
VERY DIFFICULT TO GET COPIES OF
THE HANDBOOK. THE ADVOCATE IN
SAN DIEGO TOLD US THEY USED TO
RECEIVE THEM UPON REQUEST TO THE
STATE DEPARTMENT OF HEALTH CARE
SERVICES, BUT THAT STOPPED ABOUT
SIX MONTHS AGO. WE DO UNDERSTAND
THE AUTHORS WILLING TO CONTINUE
TO WORK ON THIS, AND WE HOPE WE
WILL BE ABLE TO REMOVE OUR
OPPOSITION. THANK YOU, THANK
YOU. ARE THERE ANY OTHER
ADDITIONAL WITNESSES IN
OPPOSITION IN THE ROOM? IF NOT,
I WILL BRING IT BACK TO
COMMITTEE FOR COMMENT OR
QUESTION. MISS WALDRON, THANK
YOU, MADAM CHAIR, I HAVE FOUND
THAT EVERY TIME I AM IN THE
DISTRICT AND GIVE AN UPDATE TO
VARIOUS GROUPS, IT DOESN'T
MATTER IF IT'S A CHAMBER OF
COMMERCE OR JUST A PARENTS GROUP
OR STUDENTS. IT DOESN'T MATTER
WHAT GROUP IT IS. WHEN I GIVE AN
UPDATE ON THE THINGS WE'RE
WORKING ON IN SACRAMENTO,
INEVITABLY I'LL GET INTO THE
DISCUSSION OF MENTAL HEALTH
BECAUSE IT'S SO IMPORTANT AND IT
AFFECTS EVERYBODY. AND I FOUND
THAT EVERY SINGLE TIME I SPEAK,
PEOPLE COME UP AFTERWARDS. A LOT
OF TIMES THEY'RE PARENTS OF
ADULT CHILDREN WHO ARE, YOU
KNOW, 22 OR 25 YEARS OLD WHO
ARE, YOU KNOW, THAT IT'S THAT
WINDOW RIGHT THERE WHERE I MEAN,
THEY'RE STILL CHILDREN TO US,
YOU KNOW, AND THEY STILL HAVE
LOST THEIR WAY IN MANY WAYS.
TIME AND TIME AGAIN IS PARENTS.
THEY DON'T KNOW WHERE TO TURN.
THEY, YOU KNOW, UNFORTUNATELY,
MANY OF THE CASES THAT THAT
ADULT CHILD HAS EITHER COMMITTED
SUICIDE OR OVERDOSED OR WHATEVER
BY THE TIME THEY WERE ABLE TO
EVEN LOCATE THEM, THERE'S SO
MANY ISSUES WITH HIPAA AND
PRIVACY AND ALL OF THESE THINGS
THAT AS A PARENT OR SOMEONE WHO
REALLY IS, INVOLVED IN A
STAKEHOLDER IN THAT PERSON'S
LIFE, CANNOT GET TO THEM, CANNOT
BE ABLE TO HELP TO HAVING THE
INFORMATION IS SO VITAL, YOU
KNOW, BECAUSE YOU'RE GOING
AGAINST THIS BUREAUCRACY AND
JUST BEING ABLE TO KNOW THAT THE
PATIENT'S RIGHTS ARE REALIZED
AND BEING ABLE TO MAKE SURE THAT
THEY RECEIVE THE APPROPRIATE
TREATMENT IS SO CRITICAL. AND
IT'S ALWAYS TIMELY, TIMELY,
TIMELY. SO THANK YOU FOR
BRINGING THIS FORWARD. I THINK
IT'S VERY IMPORTANT. I WOULD
LOVE TO BE A COAUTHOR IF I
COULD. I THINK IT'S A VERY
IMPORTANT MESSAGE THAT WE'RE
SENDING. THANK YOU VERY MUCH.
VICE CHAIR. MISS SHABO. I WANT
TO ALSO THANK YOU FOR BRINGING
THIS BILL FORWARD. AND THANK YOU
FOR SHARING YOUR STORY. IT'S
HEARTBREAKING, AND JUST WANTED
TO ASK TO BE A COAUTHOR ON THE
BILL AS WELL. THANK YOU. REALLY
APPRECIATE THAT. THANK YOU.
THINK I KNOW THAT, ENSURING THAT
A FAMILY IS EQUIPPED TO BE ABLE
TO SUPPORT AND ADVOCATE FOR
THEIR LOVED ONES IS ABSOLUTELY
CRITICAL. AND WE WANT TO MAKE
SURE THAT NO, NO FAMILY MEMBER
HAS TO ENDURE WHAT YOU ALL DID
AND ALSO RECOGNIZE THAT THE
AUTHOR IS GOING TO CONTINUE
WORKING WITH THE ADVOCATE, WITH
THE ADVOCATES FROM DISABILITY
RIGHTS CALIFORNIA, TO TRY TO
MAKE SURE THAT THERE'S A FULL
IMPLEMENTATION THAT WILL MEET
AND ADDRESS THEIR NEEDS. SO WITH
THAT, WE ARE STILL A
SUBCOMMITTEE, BUT SO WE WILL
HOLD THIS BILL OPEN. BUT THANK
YOU SO MUCH. THANK YOU
EVERYBODY. REALLY APPRECIATE THE
CONVERSATION AND THE EARLY
SUPPORT BEFORE YOUR FULL
COMMITTEE. THANK YOU. THANKS WE
WILL MOVE ON TO ITEM NUMBER
SEVEN AB 2156. BLANCA PACHECO
.
PLEASE GO AHEAD WHENEVER YOU'RE
READY. THANK YOU, THANK YOU,
MADAM CHAIR AND MEMBERS, I WANT
TO START BY THANKING THE
COMMITTEE STAFF FOR ALL THEIR
HARD WORK ON THIS BILL, AND I
WILL BE ACCEPTING THE COMMITTEE
AMENDMENTS TODAY. I, I AM
PLEASED TO PRESENT AB 2156, THE
IDENTITY INTEGRITY ACT. THIS
BILL WOULD ALLOW FOR THE USE OF
DIACRITICAL MARKS ON VITAL
DOCUMENTS SUCH AS BIRTH
CERTIFICATES, DEATH CERTIFICATES
AND MARRIAGE LICENSES. I HAVE
WORKED WITH CALIFORNIA
DEPARTMENT OF PUBLIC HEALTH TO
KEEP THIS A LOW COST BILL, AND
FINE TUNE LANGUAGE TO ADDRESS
ANY POTENTIAL CONCERNS. OTHER
STATES LIKE TEXAS, ILLINOIS,
KANSAS, HAWAII, NORTH CAROLINA,
OREGON, ALASKA AND UTAH HAVE ALL
PASSED LAWS ALLOWING FOR THE USE
OF DIACRITICAL MARKS ON VITAL
RECORDS. IN FACT, JUST 38 YEARS
AGO, CALIFORNIA TWO ALLOWED
DIACRITICAL MARKS ON VITAL KHÓ
ON VITAL RECORDS. BUT AFTER THE
PASSAGE OF PROPOSITION 63 IN
1986, ENGLISH WAS DECLARED THE
OFFICIAL LANGUAGE OF CALIFORNIA,
AND THIS WAS LOST, MINIMIZING
THE RICH MULTICULTURAL HERITAGE
OF CALIFORNIA RESIDENTS. AS THE
MOST POPULOUS AND DIVERSE STATE
IN THE NATION, CALIFORNIA SHOULD
NOT CHANGE THE SPELLING AND
PRONUNCIATION OF PEOPLE'S NAMES
ON VITAL VITAL RECORDS BY
OMITTING ACCENTS, TILDES, AND
OTHER DIACRITICAL MARKS. IN SOME
CASES, THE EXCLUSION OF A
DIACRITICAL DIACRITICAL MARK
CHANGES THE MEANING OF A NAME.
FOR EXAMPLE, THE LAST NAME PENA
WITHOUT THE DELAY, OR ALSO KNOWN
AS DIÆN. THIS WOULD BE PENA,
WHICH TRANSLATES TO SHAME IN
ENGLISH. EVEN SUPERSTAR BEYONCE
HAS A TILDE ON HER NAME ON THE E
. A CALIFORNIA SHOULD REFLECT
THE ACTUAL NAMES OF RESIDENTS,
REFLECTING PARENTAL AND
INDIVIDUAL RIGHTS, PRESERVING
CULTURAL AND ARTISTIC IDENTITY
AS EXPRESSED IN NAMES. THIS BILL
SIMPLY SEEKS TO RESTORE WHAT WAS
ONCE PREVIOUSLY ALLOWED. WHILE
PRESERVING ONE'S CULTURAL
IDENTITY. AND WITH ME TODAY TO
TESTIFY IS NANCY TITUS ESPINOZA,
MOTHER OF SEVEN YEAR OLD
NICHOLAS, WHO INSPIRED THIS BILL
AND HIS NAME HAS A DELAY MAKING
IT NICHOLAS VERSUS NICHOLAS, SO
I HAVE HERE MY WITNESS, WHO WILL
BE TESTIFYING TODAY. THANK YOU.
YOU HAVE THREE MINUTES. YES.
WRONG. ONE. IT WAS. I'M SORRY.
THANK YOU. MADAM CHAIR. MEMBERS.
NANCY TITUS ESPINOZA, IN 2016,
MY SON NICHOLAS MADE HIS DEBUT
INTO THE WORLD IN THE AFTERMATH
OF AN EMERGENCY C-SECTION. AND
IN THE MIDST OF MAKING A
MULTITUDE OF MEDICAL DECISIONS
FOR A BABY WHO WOULD SPEND WEEKS
IN THE NICU, I WAS INFORMED THAT
THE STATE OF CALIFORNIA WOULD
NOT ALLOW ME TO GIVE MY SON THE
NAME THAT HIS FATHER AND I HAD
SO THOUGHTFULLY AND LOVINGLY
CHOSEN FOR HIM. THE STATE'S
DENIAL OF THE CHILD. ONE TYPE OF
DIACRITICAL MARK IN MY SON'S
NAME CHANGE, ITS CHANGES ITS
PRONUNCIATION AND STRIPS IT OF
ITS CULTURAL HERITAGE. MY
GRANDFATHER ATTENDED SEGREGATED
MEXICAN SCHOOLS IN THIS STATE.
HE THEN WORKED THE FIELDS FROM
CALEXICO TO LAKEPORT WITH MY
FATHER. MY PARENTS CAME OF AGE
AT A TIME WHEN STUDENTS WERE
OFTEN PUNISHED FOR SPEAKING
THEIR HOME LANGUAGES AT SCHOOL,
AND WHEN EDUCATORS WOULD
ARBITRARILY ANGLICIZE NAMES THAT
THEY DIDN'T WANT TO LEARN HOW TO
PRONOUNCE. I'D LIKE TO THINK
THAT TODAY WE KNOW BETTER, THAT
WE UNDERSTAND THAT
ACKNOWLEDGMENT OF SOMEONE'S NAME
IS THE STARTING POINT FOR
INCLUSION THÀNH THAT EVEN IF WE
CAN'T PRONOUNCE IT PERFECTLY,
THAT ACKNOWLEDGMENT MATTERS,
LOOK AT WHAT A LOVELY JOB THE
PREVIOUS AUTHOR AND SOME OF THE
SPEAKERS DID IN DEMONSTRATING
THAT FOR US DOING OTHERWISE
SENDS THE MESSAGE THAT SHEDDING
OFF PARTS OF ONE'S SELF IS STILL
THE PRICE OF ADMISSION IN OUR
SOCIETY. A.B. 2156 ADVANCES SOME
OF OUR MOST TREASURED IDEALS
FREEDOM, SELF-DETERMINATION,
PARENTAL RIGHTS, AND THE VISION
OF CALIFORNIA FOR ALL AND BASIC
RESPECT FOR THE MULTITUDE OF
CULTURES THAT MAKE THIS SUCH A
SPECIAL PLACE TO LIVE. THIS BILL
GIVES YOU THE OPPORTUNITY TO SAY
TO MY SON AND TO ALL OF THOSE
WITH DIACRITICAL MARKS IN THEIR
NAMES, THAT THEY ARE AS WORTHY
OF BEING SEEN AND ADDRESSED BY
THEIR CORRECT NAMES AS THEIR
FRIENDS AND CLASSMATES. THE
ENGLISH ONLY INITIATIVE AND THE
STATE'S OVERZEALOUS
INTERPRETATION OF IT, WHICH
PRODUCED THIS PROHIBITION, ARE
PRODUCTS OF A SHAMEFUL PERIOD
DURING WHICH PROMINENT
CALIFORNIANS LED A XENOPHOBIC
MOVEMENT, WHICH THEY THEN
EXPORTED ACROSS THE COUNTRY.
THIS COMMITTEE AND THIS
LEGISLATURE DID NOT CREATE THE
DISCRIMINATORY PRACTICES IN
PLACE TODAY, BUT YOU DID INHERIT
THEM. ASK YOURSELVES WHETHER THE
PROHIBITION OF DIACRITICAL MARKS
ON THE GOVERNMENT DOCUMENTS THAT
LITERALLY IDENTIFY US REFLECTS
WHO WE ARE AS A STATE TODAY, AND
WHETHER IT ALIGNS WITH THE
FUTURE THAT WE'RE ALL TRYING TO
BUILD. I RESPECTFULLY REQUEST
YOUR AYE VOTE. THANK YOU. DO YOU
HAVE ANY OTHER WITNESSES IN
SUPPORT IN THE ROOM? CONNIE
CHAN, ON BEHALF OF CALIFORNIA
STATE TREASURER FIONA MA IN
SUPPORT. THANK YOU. DO WE HAVE
ANY PRIMARY WITNESSES IN
OPPOSITION OR OTHER WITNESSES IN
OPPOSITION? SEEING NONE, I WILL
BRING IT BACK TO COMMITTEE. I
WILL JUST GO AHEAD AND THANK THE
AUTHOR FOR BRINGING FORWARD THIS
BILL AS A AS AN INDIVIDUAL WITH
AN EGO THAT IS, UNTIL THEY ON MY
END, I'M VERY THANKFUL THAT I
HAD A BIRTH CERTIFICATE IN NEW
YORK CITY THAT HAD THAT. AND
AND, IT WAS VERY MUCH A PART OF
MY IDENTITY GROWING UP TO BE
ABLE TO INFORM AND TEACH PEOPLE
HOW TO BE ABLE TO SAY MY NAME
ALWAYS CORRECTLY. SO IT'S VERY
POWERFUL. I'M GLAD THAT YOUR SON
WILL HAVE THAT OPPORTUNITY. WE
ARE STILL MEETING AS A
SUBCOMMITTEE, SO AUTHOR, IF YOU
WANT TO CLOSE, GO AHEAD. THANK
YOU, THANK YOU AND THANK YOU
AGAIN FOR THIS OPPORTUNITY TO
PRESENT, MY BILL. WHEN THE TIME
ARRIVES, I RESPECTFULLY ASK FOR
AN AYE VOTE. THANK YOU. THANK
YOU, MISS PACHECO. WE WILL MOVE
ON NOW TO ITEM NUMBER EIGHT. MR.
LOWENTHAL, AB 2175.
LOOKING FOR MY BACKUP? HERE HE
COMES. ALL RIGHT, PLEASE GO
AHEAD WHENEVER YOU'RE READY, MR.
LOWENTHAL. THANK YOU, MADAM
CHAIR. AND MEMBERS, VERY PLEASED
TO PRESENT AB 2175, WHICH
REQUIRES THE STATE TO CREATE
HOSPITAL CAPABILITIES DATABASE
THAT IS ACCESSIBLE TO HOSPITAL
STAFF AND INCLUDES A CONTACT
NUMBER FOR THE INTER-FACILITY
TRANSFERS A LIST OF SPECIALTIES
ON THE HOSPITAL'S PHYSICIAN CALL
PANEL, AND WHETHER OR NOT THEIR
SERVICES ARE AVAILABLE. SEVEN
DAYS A WEEK. I WOULD LIKE TO
START BY ACCEPTING THE COMMITTEE
AMENDMENTS. VERY THOUGHTFUL
AMENDMENTS, AND I'D LIKE TO
THANK THE COMMITTEE FOR THEIR
WORK ON THIS BILL. CURRENTLY,
THERE ARE NO DATABASE OR SOURCE
OF INFORMATION THAT LISTS WHAT
ON CALL SPECIALISTS ARE
AVAILABLE AT ANY GIVEN HOSPITAL.
THE DATABASE WOULD BE SEARCHABLE
BY LOCATION AND SPECIALTY,
MAKING IT FASTER FOR PROVIDERS
TO IDENTIFY THE CLOSEST FACILITY
WITH THE CAPABILITY TO CARE FOR
THEIR PATIENT. IT'S BECOME
INCREASINGLY DIFFICULT TO
TRANSFER PATIENTS TO OTHER
HOSPITALS NEEDING A HIGHER LEVEL
OF CARE. PHYSICIANS AND STAFF IN
THE EMERGENCY DEPARTMENT ARE
SPENDING VALUABLE TIME CALLING
SURROUNDING HOSPITALS, TRYING TO
FIND A HOSPITAL THAT MAY HAVE AN
ON CALL SPECIALIST TO TREAT A
PATIENT. AB 2175 WILL PROVIDE
EMERGENCY PHYSICIANS AND STAFF
WITH A VALUABLE TOOL TO HELP
REDUCE THE AMOUNT OF TIME IT
TAKES TO FIND A HOSPITAL THAT
HAS ON CALL SPECIALISTS TO TREAT
A PATIENT NEEDING A HIGHER LEVEL
OF CARE, THEREBY STREAMLINING
ACCESS TO CARE. I'M PLEASED TO
BE JOINED BY TIM MADDEN,
REPRESENTING THE CALIFORNIA
CHAPTER OF THE AMERICAN COLLEGE
OF EMERGENCY PHYSICIANS, WHO IS
HERE TO TESTIFY IN SUPPORT OF
THE BILL. THANK YOU. YOU HAVE
THREE MINUTES. THANK YOU, MADAM
CHAIR. MEMBERS TIM MADDEN,
REPRESENTING THE CALIFORNIA
CHAPTER OF THE AMERICAN COLLEGE
OF EMERGENCY PHYSICIANS, PROUD
SPONSOR SPONSORS OF AB 2175,
SOME MEMBER LOWENTHAL DID AN
EXCELLENT JOB AT OUTLINING WHAT
THE BILL DOES, AS WELL AS THE
NEED FOR THE BILL. I'M MORE THAN
HAPPY TO ANSWER ANY QUESTIONS OR
PROVIDE EXAMPLES AROUND THE NEED
FOR THE BILL. I'D ALSO LIKE TO
THANK, COMMITTEE CONSULTANT FOR
HER HELP ON THE AMENDMENTS, AS
WELL AS OUR CONVERSATIONS WITH
THE CALIFORNIA HOSPITAL
ASSOCIATION, WHICH I THINK HAD
BEEN PRODUCTIVE WITH THAT, I
RESPECTFULLY ASK FOR YOUR I VOTE
. THANK YOU. ARE THERE ANY OTHER
WITNESSES IN SUPPORT, MADAM
CHAIR, MEMBERS OF THE COMMITTEE,
BRANDON MAKI WITH THE CALIFORNIA
MEDICAL ASSOCIATION IN SUPPORT.
GOOD AFTERNOON, MADAM CHAIR.
MEMBERS DYLAN ELLIOTT, ON BEHALF
OF THE CALIFORNIA STATE
ASSOCIATION OF PSYCHIATRISTS IN
SUPPORT. THANK YOU, THANK YOU.
ARE THERE ANY WITNESSES IN
OPPOSITION?
GOOD AFTERNOON. VANESSA GONZALEZ
WITH THE CALIFORNIA HOSPITAL
ASSOCIATION HERE WITH AN
OPPOSED, UNLESS AMENDED
POSITION. APPRECIATE THE RECENT
DISCUSSIONS WITH THE AUTHOR AND
SPONSORS. WE JUST WANT TO MAKE
SURE THAT HOSPITALS WOULD NOT BE
REQUIRED TO SUBMIT DUPLICATIVE
INFORMATION, AS HOSPITALS
ALREADY PROVIDE INFORMATION ON
THE SUPPLEMENTAL AND SPECIALTY
SERVICES THAT THEY PROVIDE, SO
LOOK FORWARD TO ONGOING
DISCUSSIONS WITH THE AUTHOR AND
SPONSORS. THANK YOU. THANK YOU.
SEEING NO OTHER OPPOSITION, I'LL
BRING IT BACK TO COMMITTEE FOR
COMMENT OR QUESTION. OH, DOCTOR
WEBER. GOOD AFTERNOON. THANK YOU
SO MUCH FOR THIS, BILL. AND
THANK YOU FOR ACCEPTING THE
COMMITTEE AMENDMENTS, THAT WOULD
REMOVE THE ACTUAL PROVIDERS
INFORMATION AND JUST FOCUS ON
THE SPECIALTY THAT YOU'RE
LOOKING FOR. DO YOU HAVE A
QUESTION BASED ON THE CONCERN
FROM THE OPPOSITION, WHEN I'M
LOOKING AT THE ANALYSIS THAT WAS
DONE BY THE, HEALTH COMMITTEE,
THE CURRENT HOSPITAL DATA
COLLECTED BY H. CHI INCLUDES
TYPES OF SERVICES AVAILABLE ON
PREMISES. WOULD THAT NOT
ENCOMPASS THE INFORMATION THAT
YOU THAT YOU'RE LOOKING FOR OR
NO. THANK YOU FOR THE QUESTION,
WE'RE NOT SURE AT THIS POINT.
AND THAT'S PART OF THE
CONVERSATIONS WE'VE BEEN HAVING
WITH THE HOSPITAL ASSOCIATION,
IT'S UNCLEAR, FOR EXAMPLE, IF
WE'RE IN NEED OF AN
OPHTHALMOLOGIST, IF THAT WOULD
BE COVERED UNDER THAT LIST. NOW,
IF IT WAS A SUPPLEMENTAL
SERVICE, IF IT WAS A NEONATAL
UNIT OR A BURN UNIT, SO THAT
TELLS US ONE PIECE OF
INFORMATION, BUT IT MAY NOT HAVE
ALL THE OTHER, ON CALL
SPECIALISTS LISTED ON IT. SO
WE'VE HAD MULTIPLE CONVERSATIONS
WITH THE HOSPITAL ASSOCIATION. I
THINK WE'RE MAKING SOME
PROGRESS. BUT AT THIS POINT IT'S
NOT QUITE 100% CLEAR IF THAT
WOULD BE INCLUDED. IF IT IS
GREAT, WE AGREE WITH THE
HOSPITAL ASSOCIATION. WE'RE NOT
LOOKING FOR THEM TO REPORT
DUPLICATIVE INFORMATION, WE JUST
WANT TO BE ABLE TO KNOW WHAT OF
THOSE ON CALL SPECIALISTS ARE
AVAILABLE. MR. LOWENTHAL, YOU
CAN CLOSE NOW IF YOU'D LIKE.
RESPECTFULLY ASK FOR YOUR VOTE.
THANK YOU, WE ARE STILL A
SUBCOMMITTEE, SO WE WILL HOLD
THIS BILL, AND WE WILL MOVE ON
TO YOUR SECOND BILL. NOW. ITEM
13 AB 2402. AND WE HAVE A QUORUM
. SO WE WILL GO AHEAD AND CALL
THE ROLL. APOLOGIES FOR THE
MOMENT. WE'LL TAKE CARE FOR THE
COMMITTEE TO HEAR, TO PRESENT.
WALDEN. WALDEN, PRESENT.
AGUIAR-CURRY AGUIAR-CURRY.
PRESENT. ARAMBULA. WENDY
CARILLO. WENDY. CARILLO.
PRESENT. FLORA LARA. PRESENT.
HAYNIE. JOAN. SAWYER.
MAIENSCHEIN MCCARTY, JOE.
PATTERSON, JOE. PATTERSON.
PRESENT RODRIGUEZ. SANCHEZ.
SANCHEZ, PRESENT. SANTIAGO
SHABO. SHABO. PRESENT. WEBER
WEBER. PRESENT MR. LOWENTHAL,
WE'RE GOING TO GO AHEAD AND VOTE
ON CONSENT. NOW AGUIAR-CURRY.
MAKES A MOTION, SECONDED BY
DOCTOR WEBER. PLEASE CALL THE
ROLL. BONTA I BONTA I WALDRON.
WALDEN I AGAR AGAR CURRY I
ARAMBULA WENDY CARILLO WENDY
CARILLO I FLORA. FLORA I HANEY.
JONES-SAWYER MAIENSCHEIN.
MCCARTY. JOE. PATTERSON.
PATTERSON I RODRIGUEZ. SANCHEZ.
SANCHEZ I SANTIAGO. CHAVO. CHAVO
I WEBER. WEBER. I THAT'S A VOTE
OF NINE ZERO. THAT IS OUT. AND
WE'LL MOVE NOW TO ITEM NUMBER
ONE AB 1926. WE HAD, CONNOLLY WE
HAD A MOTION EARLIER
AGUIAR-CURRY SECONDED BY DOCTOR
WEBER. THE MOTION IS Dð PASS TO
APPROPRIATIONS. PLEASE CALL THE
ROLL. BONTA I BONTA I WALDEN
WALDEN I AGAR AGAR CURRY I
ARAMBULA WENDY CARILLO WENDY
CARILLO I FLORA LARA I HANEY.
JONES-SAWYER MAIENSCHEIN
MCCARTY. JOE PATTERSON, JOE.
PATTERSON I RODRIGUEZ. SANCHEZ.
SANCHEZ I SANTIAGO. SANTIAGO.
CHAVO NOW SAY I. CHAU. VÚI.
WEBER WEBER. I90. THAT'S A NINE
ZERO. THAT VOTE IS OUT. THAT
MOTIONS OUT. THREE. ITEM NUMBER
THREE AB 1965. BLANCO RUBIO DO
PASS AS AMENDED TO
APPROPRIATIONS AS AGUIAR-CURRY
MOVES. DOCTOR WEBER SECONDS.
PLEASE CALL THE ROLL. BONTA I
BONTA I WALDEN. WALDEN I AGAR
CURRY AGAR CURRY I ARAMBULA
WENDY CARILLO WENDY CARILLO I
FLORA LARA I HANEY. JONES.
SAWYER MAIENSCHEIN MCCARTY. JOE
PATTERSON, JOE. PATTERSON I
RODRIGUEZ. SANCHEZ SANCHEZ I.
SANTIAGO. CHAVO CHAVO I WEBER.
WEBER I90. THAT'S NINE ZERO.
THAT MEASURE PASSES AS WELL.
WE'LL MOVE ON NOW TO ITEM NUMBER
5AB 2081 DAVIES. THE MOTION IS
Dð PASS AS AMENDED TO JUDICIARY.
THANK YOU. AGUILAR CURRY
SECONDED BY SHIAVO. PLEASE CALL
ROLL BONTA I BONTA I WALDEN
WALDEN I AGUIAR-CURRY
AGUIAR-CURRY I ARAMBULA WENDY
CARILLO WENDY CARILLO I FLORA
LARA I HANEY. JONES SAWYER.
MAIENSCHEIN. MCCARTY. JOE.
PATTERSON. JOE. PATTERSON I
RODRIGUEZ. SANCHEZ. SANCHEZ I
SANTIAGO. CHAU. CHAU. VÚI.
WEBER. WEBER. I NINE ZERO. THAT
HAS NINE ZERO. THAT MOTION
PASSES AS WELL. MEASURE PASSES.
ITEM NUMBER SIX AB 2154. BERMAN
THE MOTION IS TO PASS, AS
AMENDED, TO APPROPRIATIONS. SO
MOVED BY AGUIAR-CURRY SECONDED
BY SHIAVO. PLEASE CALL THE ROLL.
BONTA I BONTA I WALDEN. WALDEN I
AGAR AGAR. CURRY I ARAMBULA
WENDY CARILLO WENDY CARILLO I
LARA LARA I HANEY JONES. SAWYER
MANGENE MCCARTY. JOE PATTERSON,
JOE. PATTERSON I RODRIGUEZ.
SANCHEZ. SANCHEZ I SANTIAGO.
CHAU CHAU. VÚI. WEBER. WEBER
I90. THAT MEASURE PASSES NINE
ZERO AND IS OUT. WE'LL MOVE ON
TO ITEM NUMBER SEVEN AB 2156.
PACHECO THE MOTION IS Dð PASS,
AS AMENDED TO APPROPRIATIONS.
PLEASE CALL THE ROLL MOTION. OH.
MOVED BY SHIAVO. SECONDED BY
SANCHEZ. PLEASE CALL THE ROLL.
BONTA, I WANT TO. AYE. WALDEN.
WALDEN AYE. AGAR. AGAR. CURRY.
AYE. ARAMBULA WENDY. CARILLO.
WENDY. CARILLO. AYE. FLORA LARA.
AYE. HANEY. JONES. SAWYER.
MAIENSCHEIN MCCARTY. JO.
PATTERSON. JO. PATTERSON. AYE.
RODRIGUEZ SANCHEZ. SANCHEZ. AYE.
SANTIAGO. CHAVO. CHAU. VÚI.
WEBER WEBER. AYE. NINE ZERO.
THAT'S MEASURES. IS OUT WITH 9
TO 0. WE'LL MOVE ON TO ITEM
NUMBER EIGHT AB 2175. LOWENTHAL
THE MOTION IS Dð PASS AS AMENDED
TO APPROPRIATIONS BY
AGUIAR-CURRY, SECONDED BY SHIAVO
. PLEASE CALL THE ROLL. BONTA
AYE. BONTA. AYE. WALDEN. WALDEN.
AYE. AGUIRRE AGUIRRE. AYE.
ARAMBULA. WENDY. CARILLO WENDY.
CARILLO. AYE. FLORA. LARA. AYE.
HAYNES. HANEY JONES-SAWYER.
FEINSTEIN. MCCARTY JO.
PATTERSON. JO. PATTERSON. AYE.
RODRIGUEZ SANCHEZ. SANCHEZ. NOT
VOTING. SANTIAGO SHABU SHABU.
AYE WEBER. WEBER. AYE THAT. THAT
MEASURES ON CALL. WE'LL MOVE ON
NOW. THANK YOU FOR THE PATIENCE
TO ITEM NUMBER 13 AB 2402. MR.
LOWENTHAL, YOU CAN BEGIN. THANK
YOU, MADAM CHAIR. AND MEMBERS, I
WOULD LIKE TO START BY THANKING
THE CHAIR AND THE COMMITTEE
STAFF FOR THE PROPOSED
AMENDMENTS TO TRANSFER
RESPONSIBILITY OF THE AWARENESS
CAMPAIGN AND THE SAFE BAR
PROGRAM FROM THE DEPARTMENT OF
PUBLIC HEALTH TO THE ABC. I
ACCEPT THE AMENDMENTS AND WILL
TAKE THEM UP PRIOR TO THE BILL
BEING HEARD IN THE GOVERNMENTAL
ORGANIZATION COMMITTEE. I AM SO
PLEASED TO PRESENT AB TWO 402,
WHICH IS PART OF A LARGER
PACKAGE OF BILLS THAT I'M
CARRYING TO ADDRESS THE ONGOING
AND UNDERREPORTED ISSUE OF
ROOFING THAT IS TAKING PLACE
ACROSS CALIFORNIA, ACROSS THE
UNITED STATES, AND ACROSS THE
WORLD. THIS IS ABOUT SEXUAL
ASSAULT. ROOFING OR DRINK
SPIKING OCCURS WHEN PERPETRATORS
INCAPACITATE THEIR VICTIMS
THROUGH THE USE OF A DATE RAPE
DRUGS SUCH AS PHENOL, GHB, AND
KETAMINE. TYPICALLY, DRINK
SPIKING IS NOT AN INDEPENDENT
CRIME. RATHER, IT IS DONE IN
ORDER TO MAKE OTHER HORRIFIC
CRIMES, SUCH AS RAPE, SEXUAL
ASSAULT, EASIER TO COMMIT. AND
WHILE ANYONE CAN TURN TO CAN
TURN VICTIM TO ROOFING, IT'S
WOMEN AND MEMBERS OF THE LGBTQ
COMMUNITY THAT ARE TARGETED THE
MOST AND DARE I SAY, IT, IS
SEXISM AND DISCRIMINATION BY ALL
OF US THAT HAVE ALLOWED THIS
PROBLEM TO PROLIFERATE THIS LONG
DRINK SPIKING CAN TAKE PLACE
ANYWHERE. HOWEVER, THE MOST
COMMON PLACES ARE RESTAURANTS,
BARS AND NIGHTCLUBS WHERE
ALCOHOL BEVERAGES ARE SERVED
WHEN SOMEONE HAS BEEN ROOFIED,
NOT ONLY DO THE DRUGS CAUSE
MEMORY LOSS, BUT ALSO PASS
THROUGH THE BODY EXTREMELY FAST,
MAKING IT VERY DIFFICULT FOR THE
VICTIM TO SEEK JUSTICE AFTER THE
FACT. THIS IS WHY PERVASIVE
MEASURE PREVENTATIVE MEASURES,
SUCH AS THOSE IN THIS BILL THAT
THIS BILL ESTABLISHES, ARE
ESPECIALLY IMPORTANT WHEN
SEEKING TO TACKLE THIS ISSUE. AB
202 REQUIRES THAT THE CALIFORNIA
STATE DEPARTMENT OF PUBLIC
HEALTH ESTABLISH TWO PROGRAMS
ONE A PUBLIC AWARENESS CAMPAIGN
ON THIS ISSUE, AND TWO A SAFE
BAR PROGRAM TO BETTER EDUCATE
AND PREPARE RESTAURANT, BAR, AND
NIGHTCLUB EMPLOYEES ON
PREVENTATIVE MEASURES AND HOW TO
HANDLE DRINK SPIKING SHOULD IT
OCCUR IN THEIR PLACE OF
EMPLOYMENT. BY THE WAY, I LIKEN
THIS TO WHERE WE WERE WITH DRUNK
DRIVING 30 YEARS AGO AND HOW WE
HAD TO EDUCATE AND, AND REALLY
TACKLE IT AS A VILLAGE TO
PREVENT IT WHEN SOMEBODY IS
ALREADY DRUNK AND GET BEHIND THE
WHEEL, IT'S TOO LATE. AND THE
SAME THING. IT'S THE SAME
PHENOMENON WITH ROOFING. ONCE
IT'S TAKEN PLACE, IT'S TOO LATE.
WE HAVE TO PREVENT IT FROM
HAPPENING. IT TAKES A VILLAGE
APPROACH THROUGH A PUBLIC
AWARENESS CAMPAIGN. THE STATE
DEPARTMENT OF PUBLIC HEALTH WILL
INCREASE AWARENESS ABOUT THE
DANGERS OF DRINK SPIKING. THE
RESOURCES AVAILABLE TO THE
PUBLIC TO PREVENT THESE CRIMES,
AND HOW THE UNFORTUNATE EVENT
THAT SOMEONE HAS HAD THEIR DRINK
SPIKED. THIS WILL NOT ONLY HELP
FACILITATE SAFER SOCIAL
ENVIRONMENTS, BUT ALSO DETER
PERPETRATORS FROM ATTEMPTING TO
ENGAGE IN THIS CRIMINAL ACTIVITY
IN THE FIRST PLACE. SECONDLY
THROUGH THE ESTABLISHMENT OF THE
SAFE BAR TRAINING PROGRAM
MODELED AFTER TENNESSEE'S STATE
BAR, THE STATE DEPARTMENT OF
PUBLIC HEALTH WILL CREATE AN
OPTIONAL PROGRAM FOR
RESTAURANTS, BARS, AND
NIGHTCLUBS TO PARTICIPATE IN TO
BETTER EDUCATE THEIR EMPLOYEES
ON PREVENTATIVE MEASURES, AS
WELL AS HOW TO HANDLE DRINK
SPIKING SHOULD IT OCCUR IN THEIR
PLACE OF EMPLOYMENT. INCREASED
TRAINING AND AWARENESS OF
EMPLOYEES AT THE INSTITUTIONS
WHERE DRINK SPIKING COMMONLY
OCCURS WILL HELP PROMOTE A SAFER
AND MORE ALERT ATMOSPHERE WITH
FEWER ACCOUNTS OF ROOFING AND IN
TURN, SEXUAL ASSAULT AND RAPE.
AS A RESTAURANT AND BAR OWNER
MYSELF, I'M EXTREMELY SENSITIVE
TO THIS ISSUE AND I KNOW JUST
HOW IMPORTANT IT IS TO BE ABLE
TO PROVIDE A SAFE AND INCLUSIVE
ENVIRONMENT FOR OUR GUESTS.
INCREASE AWARENESS AND TRAINING
WILL NOT ONLY HELP COMBAT THESE
CRIMES, BUT CAN ALSO INCREASE
BUSINESS, AS PEOPLE WILL BE MORE
WILLING TO GO OUT AND BE SOCIAL
WITH A STRENGTH STRENGTHENED
SENSE OF SECURITY. I'M VERY
PLEASED TO BE JOINED WITH BY
WEST HOLLYWOOD MAYOR JOHN
ERICKSON AS WELL AS RAUL
VERDUGO, ADVOCACY DIRECTOR FOR
ALCOHOL JUSTICE, WHO WILL BE
TESTIFYING IN SUPPORT. THANK
YOU. CAN I JUST WANT TO ASK A
QUESTION OF THE AUTHOR. ARE YOU
AGREEING TO TAKE THE COMMITTEE
AMENDMENTS ON THIS? YES. I
OPENED MY STATEMENT AGREEING TO
THE AMENDMENT. THANK YOU SO
MUCH. I APPRECIATE IT, AND I'M
GOING TO PASS THE MIC OVER TO,
OUR VICE CHAIR, WALDRON. BUT
PLEASE GO AHEAD. THANK YOU.
THANK YOU SO MUCH. HONORABLE
CHAIR. AND MEMBERS OF THE
COMMITTEE. MY NAME IS JOHN
ERICKSON. I HAVE THE GREAT
PRIVILEGE OF SERVING AS THE
MAYOR OF THE GREAT CITY OF WEST
HOLLYWOOD, WEST HOLLYWOOD IS
HOME TO MORE THAN 200
ENTERTAINMENT ORIENTED
BUSINESSES SUCH AS RESTAURANTS,
BARS AND NIGHTCLUBS IN 1.9MI².
IN FEBRUARY 2022, THE WEST
HOLLYWOOD CITY COUNCIL
UNANIMOUSLY APPROVED AN ITEM
THAT I AUTHORED FOR THE PURCHASE
AND DISTRIBUTION OF DRINKS BY
TESTING STRIPS AT BARS AND
NIGHTLIFE ESTABLISHMENTS IN
COOPERATION WITH THE LOS ANGELES
LGBT CENTER'S WEHO LIFE PROGRAM,
THE CITY OF WEST HOLLYWOOD
DISTRIBUTED MORE THAN 30,000
TEST STRIPS IN THE FIRST TEN
MONTHS OF OUR OPERATIONS. THE
CITY CONTINUES TO PROMOTE DRINK
SPIKE TEST STRIPS AS AN
IMPORTANT AND LIFE SAVING TOOL.
AS PART OF OUR WORK TO SUPPORT
AND EDUCATE SAFETY AT
ENTERTAINMENT VENUES, THE CITY
OF WEST HOLLYWOOD PROVIDES
EDUCATION ABOUT DRINKS LIKE TEST
STRIPS AND ARE REQUIRED
BYSTANDER INTERVENTION TRAINING
PROGRAM, IN WHICH MORE THAN 2000
WEST HOLLYWOOD EMPLOYEES HAVE
PARTICIPATED. WE ALSO
COLLABORATE WITH THE CITY OF LOS
ANGELES, THE COUNTY OF LOS
ANGELES, SHERIFF'S WEST
HOLLYWOOD STATIONS,
ENTERTAINMENT POLICING TEAM, A
TEAM OF DEPUTIES SPECIFICALLY
FOCUSED PRIMARILY ON OUR
ENTERTAINMENT AND ALCOHOL
RELATED LAW ENFORCEMENT AND
ISSUES LIKE, SIMPLY PUT, DRINK
SPIKE TESTING STRIPS AND OTHER
WAYS WE CAN EDUCATE THE
COMMUNITY TO SAVE LIVES. WE ARE
HAPPY TO SEE EXPANDED
EDUCATIONAL OPPORTUNITIES
STATEWIDE FOR PATRONS TO ACCESS
DRINK SPIKE TESTING STRIPS, AND
CONTINUED EDUCATIONAL OUTREACH
THAT IS SO NEEDED. WEST
HOLLYWOOD BECAME THE FIRST CITY
IN CALIFORNIA TO PASS AN
ORDINANCE IN LATE 2021 TO
REQUIRE BYSTANDER INTERVENTION,
TRAINING FOR PERSONNEL AND
BUSINESS ESTABLISHMENTS THAT
SERVE ALCOHOL FOR ON SITE
CONSUMPTION. THE BYSTANDER
INTERVENTION TRAINING PROGRAM,
LAUNCHED IN MARCH OF 2022,
PROVIDED BY THE RAPE TREATMENT
CENTER AT THE UCLA SANTA MONICA
MEDICAL CENTER. THE TRAINING IS
AN EDUCATIONAL COURSE THAT
ADDRESSES THE ISSUE OF DRUG
FACILITATED ASSAULTS AND DRAPE
DATE RAPE DRUGS. THE TRAINING
ALSO PROMOTES THE PROACTIVE ROLE
ON THAT ON SITE ALCOHOLIC
BEVERAGE SALES CAN TAKE IN THE
PREVENTION OF SEXUAL ASSAULTS
SINCE THE PROGRAM'S INCEPTION.
AGAIN, MORE THAN 2100 EMPLOYEES
HAVE PARTICIPATED IN THIS
EDUCATIONAL CAMPAIGN.
ADDITIONALLY, AS THE MAYOR OF
THE CITY, I AM ALSO A VICTIM OF
THIS EXACT CRIME. AND SO IF IT
CAN HAPPEN TO THE MAYOR OF A
CITY, IT CAN HAPPEN TO ANYONE
GOING OUT THERE ON A SATURDAY
NIGHT TRYING TO HAVE FUN WITH
THEIR FRIENDS. I RESPECTFULLY
THANK ASSEMBLY MEMBER LOWENTHAL
FOR AUTHORING THIS AND OTHER
LIKEWISE IMPORTANT BILLS, AND I
THANK YOU ALL FOR YOUR TIME AND
ATTENTION AND ASK FOR AN AYE
VOTE. HI, MY NAME IS RAUL
VERDUGO, DIRECTOR OF ADVOCACY AT
ALCOHOL JUSTICE. AND TODAY I'M
SPEAKING ON BEHALF OF THE
CALIFORNIA ALCOHOL POLICY
ALLIANCE, A PROJECT OF ALCOHOL
JUSTICE, WHERE A STATEWIDE
ALLIANCE REPRESENTING 50
ORGANIZATIONS WITH A MISSION TO
UNITE DIVERSE COMMUNITIES TO
PREVENT AND REDUCE ALCOHOL
RELATED HARM. WE SUPPORT AB TWO
402 AND THE EFFORT TO INITIATE A
CAMPAIGN THAT WILL SHINE A LIGHT
ON THIS VASTLY UNDERREPORTED
ISSUE, INFORMING THE PUBLIC ON
HOW TO PREVENT DRINK SPIKING AND
WHAT TO DO IF IT OCCURS.
DEPENDING UPON THE SURVEY, ANY
SURVEY 6% TO 20% OF RESPONDENTS
REPORT HAVING HAD THEIR DRINKS
DRUGGED AND OR SPIKED.
PREVENTION. PREVENTION IS ALWAYS
THE BEST COURSE. PREVENTING IT
FROM HAPPENING MAY REDUCE THE
CHANCE THAT PEOPLE WILL TRY IT
IN THE FIRST PLACE, REQUIRING,
EXCUSE ME, REQUIRING THE ABC TO
ADMINISTER A SAFE BAR TRAINING
PROGRAM WILL ENSURE THAT EVERY
LICENSEE HAS THE INCENTIVE TO
TRAIN THEIR RESPECTIVE STAFF
WHILE INFORMING OUR COMMUNITIES
THROUGHOUT THE STATE WITH THE
INFORMATION NEEDED TO PROTECT
PUBLIC HEALTH. FOR THESE REASONS
, WE SUPPORT AB 202 AND THANK
ASSEMBLY MEMBER LOWENTHAL FOR
BRINGING THIS LEGISLATION
FORWARD. THANK YOU. ARE THERE
ADDITIONAL MEMBERS IN SUPPORT IN
THE AUDIENCE? PLEASE COME
FORWARD. SEEING NONE, ARE THERE
WITNESSES IN OPPOSITION? SEEING
NONE. QUESTIONS FROM THE MEMBERS
OF THE COMMITTEE. OKAY, IF YOU
WOULD LIKE TO CLOSE,
RESPECTFULLY ASK FOR YOUR. I
VOTE ON THIS VERY IMPORTANT
ISSUE AFFECTING MILLIONS OF
CALIFORNIANS. THANK YOU. DO WE
HAVE A MOTION? OKAY, THE MOTIONS
DO PASS, AS AMENDED, TO
GOVERNMENTAL ORGANIZATION. MADAM
SECRETARY, PLEASE CALL THE ROLL.
BONTA. WALDEN, I WALDEN I
AGUIAR-CURRY AGAR CURRY I
ARAMBULA ARAMBULA I WENDY
CARILLO. WENDY. CARILLO I FLORA.
HANEY, JOAN. SAWYER MAIENSCHEIN.
MCCARTY. JO. PATTERSON JO.
PATTERSON, I. RODRIGUEZ. SANCHEZ
SANCHEZ, I. SANTIAGO, CHAVO.
CHAU. VÚI. WEBER. WEBER. I. WE
NEED ONE MORE. SO YOUR BILL WILL
BE ON CALL. THANK YOU
.
WE WILL MOVE TO ITEM NINE AB
2250. DOCTOR WEBER
.
YOU MAY PROCEED WHEN YOU'RE
READY. GOOD AFTERNOON. CHAIR AND
MEMBERS OF THE COMMITTEE. I AM
HERE TO PRESENT AB 2250, WHICH
WILL REQUIRE HEALTH PLANS AND
INSURERS TO INCLUDE COVERAGE FOR
SOCIAL DETERMINANTS OF HEALTH
SCREENING AND ACCESS TO
COMMUNITY HEALTH WORKERS. SOCIAL
DETERMINANTS OF HEALTH IS A
COMMONLY DEFINED, AND IS
COMMONLY DEFINED AS THE
CONDITIONS IN WHICH PEOPLE ARE
BORN, GROW, WORK, LIVE, AND AGE
IN A WIDER SET OF FORCES AND
SYSTEMS, SHAPES THE CONDITIONS
OF DAILY LIFE AND AFFECT HEALTH
FUNCTIONS AND QUALITY OF
OUTCOMES AND RISK. SOCIAL
DETERMINANTS OF HEALTH IMPACT.
ABOUT 80% OF YOUR HEALTH RISK,
HEALTH OUTCOMES AND
UNFORTUNATELY, YOUR LIFE
EXPECTANCY. Kò. IT IS HORRIFIC
THAT IN THIS COUNTRY AND IN THIS
STATE, YOUR ZIP CODE DETERMINES
YOUR LIFE EXPECTANCY. SOCIAL
DETERMINANTS OF HEALTH SCREENING
TOOLS AND CLINICAL PRACTICE HELP
IDENTIFY WHY THESE SOCIAL AND
ECONOMIC RISK OF PATIENTS THAT
ARE USUALLY UNKNOWN TO US, WHO
ARE HEALTH CARE PROVIDERS, BUT
THEY ARE A CRITICAL PIECE AND
OFTEN THE MISSING LINK TO
SUCCESSFULLY PRESENTING,
PREVENTING OR MANAGING HEALTH
CONDITIONS. FOR EXAMPLE, IF I,
AS A PROVIDER, KNOW THAT YOU
LIVE IN A FOOD DESERT BECAUSE
I'VE SCREENED FOR THAT DURING
THE SOCIAL DETERMINANTS OF
HEALTH ASSESSMENT. BUT THEN I
NEED TO ALTER MY NUTRITION
RECOMMENDATIONS TO ENSURE THAT
YOU WOULD BE SUCCESSFUL. OR IF I
KNOW THAT YOU LIVE IN A
NEIGHBORHOOD THAT IS UNSAFE
BECAUSE OF VIOLENCE, THEN I'M
NOT GOING TO RECOMMEND THAT YOU
WALK YOUR NEIGHBORHOOD AT NIGHT
TO GET EXERCISE TO MANAGE YOUR
OBESITY, OR IF YOU COME IN WITH
A CHRONIC COUGH. AND I KNOW THAT
YOU WORK OR LIVE IN AN AREA WITH
EXTREME AIR POLLUTANTS, THEN I
WOULD PUT LUNG CANCER HIGHER ON
MY DIFFERENTIAL. DESPITE THE
FACT THAT YOU ARE A NONSMOKER
ACRE. BUT I KNOW THAT YOUR RISK
FOR DEVELOPING LUNG CANCER IS
HIGHER THAN MY PREVIOUS PATIENT,
WHO IS ALSO A NONSMOKER AND THE
SAME AGE AS YOU, BUT YOU LIVE OR
WORK IN AN AREA THAT IS HIGH
RISK BECAUSE OF THE TOXINS THAT
YOU ARE EXPOSED TO EVERY DAY.
THESE SOCIAL DETERMINANTS OF
HEALTH ARE EXTREMELY IMPORTANT
TO SCREEN FOR, AND THIS
INFORMATION CAN LEAD TO HEALTH
CARE TEAMS LINKING PATIENTS TO
COMMUNITY RESOURCES OR
DISCUSSIONS ABOUT CHANGING
PATIENT TREATMENT PLANS TO
MITIGATE SOCIAL NEEDS TO IMPROVE
HEALTH OUTCOMES FOR ALL.
CALIFORNIA'S UNADDRESSED SOCIAL
DETERMINANTS OF HEALTH
EXACERBATES OF
MEDICARE AND MEDICAID SERVICES
ARE ONLY WITHIN THE MEDICARE
SYSTEM, AND DO NOT CONFLICT WITH
AB 2250, WHICH TARGETS THE
MEDI-CAL AND COVERED CALIFORNIA
POPULATION. AND WHILE ACS CAN BE
CONSIDERED AS ONE ASPECT OF
SOCIAL DETERMINANTS OF HEALTH,
THEY REPRESENT A SPECIFIC SUBSET
OF ADVERSE CHILD HOOD
EXPERIENCES THAT CAN INFLUENCE
HEALTH OUTCOMES. RAIMES SOCIAL
DETERMINANTS OF HEALTH, ON THE
OTHER HAND, ENCOMPASS A BROADER
RANGE OF SOCIAL AND
ENVIRONMENTAL FACTORS THAT
INFLUENCE HEALTH AND WELL-BEING
THROUGHOUT A PERSON'S ENTIRE
LIFE. BY REQUIRING COVERAGE FOR
SCREENINGS AND ACCESS TO
COMMUNITY HEALTH WORKERS, AB
2250 ENSURES THAT MEDI-CAL
BENEFICIARIES BENEFIT FROM THESE
ESSENTIAL SERVICES. ADDITIONALLY
IT EXTENDS SUPPORT BEYOND THE
MEDI-CAL POPULATION TO INCLUDE
OTHER VULNERABLE GROUPS, SUCH AS
THOSE UNDER COVERED CALIFORNIA
WHO ALSO FACE SOCIAL NEEDS BUT
MAY NOT HAVE ACCESS TO SUCH
SERVICES. SERVICES PREVIOUSLY
WITH ME HERE TO SPEAK IN SUPPORT
OF THIS BILL IS TAISHA WATTS
LEGISLATIVE AND POLICY ADVOCATE
AND DOCTOR SCRUB. THANK YOU TO
THE CHAIR AND COMMITTEE MEMBERS.
MY NAME IS ADELA SCRUB AND I'M A
FAMILY MEDICINE PHYSICIAN FROM
OAKLAND PRACTICING IN SOLANO
COUNTY. I LEARNED EARLY ON FROM
MY MENTORS IN MEDICINE THAT A
COMMUNITY PHYSICIAN MUST ALSO
CONSIDER THE FACTORS BEYOND THE
CLINIC WALLS TO MAKE AN IMPACT
IN SOMEONE'S CARE. I
RESPECTFULLY ASK FOR YOUR AYE
VOTE ON AB 2250, BECAUSE IT WILL
ENSURE THAT THE HEALTH CARE
PROVIDERS HAVE THE RESOURCES TO
BETTER UNDERSTAND FACTORS
IMPACTING OUR PATIENTS HEALTH,
BOTH INSIDE AND OUTSIDE OF THE
CLINIC. SCREENING FOR THE SOCIAL
DETERMINANTS OF HEALTH IS
CRITICAL TO DEVELOPING A
TREATMENT PLAN THAT IS BEST FOR
MY PATIENTS. IF I AM INFORMED
THAT A PATIENT DOESN'T HAVE
RELIABLE TRANSPORTATION, THEN I
TRY TO SELECT MEDICINES THAT
REQUIRE LESS FOLLOW UP AND
MONITORING. IF I AM INFORMED
THAT I AM THAT I HAVE A PATIENT
WHO IS AN UNHOUSED DIABETIC THAT
DOESN'T HAVE ACCESS TO
REFRIGERATION FOR THEIR INSULIN,
THEN I HAVE TO MAXIMIZE
TREATMENT WITH ORAL MEDICATIONS.
HOWEVER THERE IS A NEED TO DO
MORE THAN JUST SCREEN BECAUSE
THERE ARE OBSTACLES OUTSIDE OF
THE CLINIC THAT INTERFERE WITH A
PATIENT'S ABILITY TO COMPLETE
TREATMENT. BUT THIS BILL WILL
PROVIDE THE LINKAGE BETWEEN THE
HEALTH CARE TEAM AND COMMUNITY
RESOURCES THROUGH COMMUNITY
HEALTH WORKERS OR SOCIAL WORKERS
, THEY CAN ENSURE THAT PATIENTS
ARE RECEIVING THE DIRECT
ASSISTANCE THEY NEED TO ACCESS
FOOD, TRANSPORTATION, HOUSING
AND HEALTH CARE. AT THE END OF A
VISIT, I HAVE BEEN ABLE TO
PROVIDE THE PATIENT WITH A WARM
HANDOFF TO THE COMMUNITY HEALTH
WORKER IN CLINIC TO CONTINUE THE
DISCUSSION OF THEIR SPECIFIC
NEEDS, OR TO ENSURE THAT THEY
WILL HAVE FOLLOW UP SOON AFTER.
WHEN MY PATIENT WITH DEPRESSION
AND UNCONTROLLED DIABETES
EXPRESSED THAT SHE NEEDED
ASSISTANCE AT HOME WITH TAKING
HER MEDICATIONS, I WAS GIVEN HER
PERMISSION TO DIRECTLY DISCUSS
HER DIFFICULTIES WITH MY CLINIC
SOCIAL WORKER RIGHT AFTER THE
VISIT. THE SOCIAL WORKER THEN
LATER CALLED THE PATIENT TO
ASSIST HER WITH ENROLLING IN
IN-HOME SUPPORTIVE SERVICES.
AFTERWARDS, MY PATIENTS SUGAR
LEVELS AND DEPRESSION
SIGNIFICANTLY IMPROVED AFTER
BEING MATCHED WITH A PART TIME
CAREGIVER, MY FAMILY MEDICINE
COLLEAGUE HAD DIFFICULTIES WITH
GETTING AN UNHOUSED PATIENT A
MUCH NEEDED SURGERY BECAUSE HE
DID NOT HAVE THE ADDRESS WHERE
HE COULD BE DISCHARGED TO AFTER
THE SURGERY, A SOCIAL WORKER
WOULD HAVE BEEN ABLE TO ASSIST
THE PATIENT WITH NAVIGATING AND
OBTAINING AT LEAST SOME TYPE OF
TEMPORARY HOUSING TO BE ABLE TO
MOVE FORWARD WITH THE SURGERY. I
RESPECTFULLY ASK FOR YOUR AYE
VOTE ON AB 2250. THANK YOU. GOOD
AFTERNOON, MADAM CHAIR, AND
MEMBERS OF THE COMMITTEE. THANK
YOU FOR THE OPPORTUNITY TO
ADDRESS THIS CRITICAL ISSUE
IMPACTING OUR HEALTH CARE
SYSTEM. MY NAME IS TAISHA WATTS,
REPRESENTING THE CALIFORNIA
ACADEMY OF FAMILY PHYSICIANS.
WHILE PROGRESS HAS BEEN MADE IN
ADDRESSING SOCIAL DETERMINANTS
OF HEALTH THROUGH INITIATIVES
SUCH AS THE CAL, SUCH AS THE
COMMUNITY HEALTH WORKER BENEFIT
UNDER MEDI-CAL AND INCLUSION OF
SOCIAL DETERMINANTS OF HEALTH
CODES UNDER CAL AIM, THERE ARE
STILL GAPS THAT PERSIST THAT AB
2250 SEEKS TO FILL. ONE OF THE
PRIMARY CHALLENGES LIES IN DATA
COLLECTION AND DOCUMENTATION FOR
SOCIAL DETERMINANTS OF HEALTH.
PRIMARY CARE PROVIDERS OFTEN
FACE BARRIERS IN SCREENING FOR
SOCIAL DETERMINANTS OF HEALTH
AND WHICH ESSENTIALLY WHICH IS
ESSENTIAL FOR DOCUMENTING
PATIENT NEEDS SUCH AS HOUSING,
FOOD INSECURITY, AND
TRANSPORTATION. WITHOUT PROPER
RESOURCES AND REIMBURSED,
PRIMARY CARE PROVIDERS ARE
UNABLE TO CONDUCT SCREENINGS
EFFICIENTLY AND CONNECT PATIENTS
WITH THE NECESSARY RESOURCES TO
ADDRESS THEIR SOCIAL NEEDS. AS
THE FIRST AND OFTEN MOST
CONSISTENT POINT OF CONTACT IN
THE HEALTH CARE SYSTEM, SOCIAL
DETERMINANTS OF HEALTH
SCREENINGS ARE TYPICALLY
CONDUCTED BY PRIMARY CARE
PHYSICIANS. HOWEVER MEDI-CAL
DOES NOT CURRENTLY COVER OR
REIMBURSE THESE SERVICES BY
COVERING BY COVERING SCREENINGS
IN THE PRIMARY CARE SETTING, AB
2250 EMPOWERS PRIMARY CARE
PROVIDERS TO EFFICIENTLY SCREEN
FOR SOCIAL NEEDS AND CLOSES THE
REFERRAL LOOPHOLE AND HENCE IN
HEALTH CARE AND ACCESSIBILITY.
AB 2250 BUILDS UPON EXISTING
INITIATIVES SUCH AS THE
COMMUNITY HEALTH WORKERS BENEFIT
WITHIN MEDI-CAL TO STRENGTHEN
INTEGRATION OF PRIMARY CARE WITH
THE CRUCIAL ROLE THAT COMMUNITY
HEALTH WORKERS PLAY IN
FACILITATING ACCESS TO ESSENTIAL
SOCIAL SERVICES. THIS
LEGISLATION FOSTERS
COLLABORATION BETWEEN PRIMARY
CARE PROVIDERS AND COMMUNITY
HEALTH WORKERS, BRIDGING HEALTH
CARE GAPS TO ENHANCE HEALTH
OUTCOMES AND ENSURE GREATER
EQUITY AND ACCESS. SIGNIFICANT
INVESTMENTS AND EFFORTS HAVE
ENHANCED THE COMMUNITY HEALTH
WORKER BENEFIT, SUCH AS THE
WORKFORCE AND PRIORITIZING
RECRUITMENT AND TRAINING.
CERTIFICATION TO IMPROVE ACCESS
TO CARE IN CALIFORNIA
COMMUNITIES. HEALTH PLANS AND
INSURERS ALSO PLAY A CRUCIAL
ROLE IN PROVIDING ACCESS TO
COMMUNITY HEALTH WORKERS THROUGH
CONTRACTING WITH COMMUNITY BASED
ORGANIZATION OR DIRECT
EMPLOYMENT. AND CLOSING AB 2250
IS A CRUCIAL STEP TOWARDS
ADDRESSING SOCIAL DETERMINANTS
OF HEALTH AND ADVANCING HEALTH
EQUITY IN OUR COMMUNITIES. I
RESPECTFULLY ASK FOR YOUR I VOTE
AND I'M HAPPY TO TAKE ANY
QUESTIONS OR CONCERNS. MOVE THE
BILL. THANK YOU, ANY OTHER
WITNESSES IN SUPPORT? PLEASE
COME FORWARD. STATE YOUR NAME,
ORGANIZATION AND POSITION ONLY.
THANK YOU. GOOD AFTERNOON, MADAM
CHAIR JUSTIN BANSAL, ON BEHALF
OF DAVITA CALIFORNIA ASSOCIATION
OF NURSING, ANESTHESIOLOGY AND
FIND HELP, ALL IN SUPPORT. THANK
YOU. MADAM CHAIR AND MEMBERS,
RANDY MARTIN, ON BEHALF OF THE
AIDS HEALTHCARE FOUNDATION, IN
SUPPORT OF THIS VERY ESSENTIAL
BILL. THANK YOU, MADAM CHAIR.
MEMBERS TIM MADDEN, REPRESENTING
THE CALIFORNIA CHAPTER OF THE
AMERICAN COLLEGE OF EMERGENCY
PHYSICIANS IN SUPPORT, MADAM
CHAIR AND MEMBERS ON BEHALF OF
WESTERN CENTER ON LAW AND
POVERTY IN SUPPORT OF SANDRA
POOLE. MARIJUANA WITH CALIFORNIA
BLACK HEALTH NETWORK CO-SPONSOR
IN STRONG SUPPORT. BRENDAN
MARKEY WITH THE CALIFORNIA
MEDICAL ASSOCIATION IN SUPPORT.
GOOD AFTERNOON. I'M LIZ HELMS,
CALIFORNIA CHRONIC CARE
COALITION IN VERY STRONG SUPPORT
OF THIS IMPORTANT BILL. JENNIFER
ROBLES WITH HEALTH ACCESS
CALIFORNIA AND SUPPORT. CHRISTY
FOYER ON BEHALF OF THE
CALIFORNIA KIDNEY CARE ALLIANCE
IN STRONG SUPPORT. CHRIS
SCROGGIN, ON BEHALF OF
CHILDREN'S CHOICE DENTAL CARE
AND SUPPORT. THANK YOU. DAVID
GONZALEZ WITH THE CALIFORNIA
LIFE SCIENCES AND SUPPORT TAYLOR
JACKSON WITH THE CALIFORNIA
PRIMARY CARE ASSOCIATION. PROUD
CO-SPONSORS. JOHAN CARDENAS WITH
THE CALIFORNIA PANETHNIC HEALTH
NETWORK IN SUPPORT. SOUMYA NAHAR
WITH THE CHILDREN'S SPECIALTY
CARE COALITION IN SUPPORT. ERIN
EVANS, ON BEHALF OF THE SAN
DIEGO HOUSING COMMISSION AND
SUPPORT. COLBY LIND WITH PLANNED
PARENTHOOD AFFILIATES OF
CALIFORNIA IN SUPPORT. RYAN
SPENCER, ON BEHALF OF THE
AMERICAN COLLEGE OF OB-GYN
DISTRICT NINE, IN SUPPORT. HI,
KIM ROBINSON ON BEHALF OF BLACK
WOMEN FOR WELLNESS AND BLACK
WOMEN FOR WELLNESS ACTION
PROJECT IN SUPPORT. MARSHALL
REYNOLDS, ON BEHALF OF
CALIFORNIA SCHOOL-BASED HEALTH
ALLIANCE AND SUPPORT. THANK YOU.
ARE THERE ANY WITNESSES IN
OPPOSITION? PLEASE COME FORWARD.
WE ALLOW TWO WITNESSES, THREE
MINUTES EACH. GOOD AFTERNOON,
MADAM CHAIR. MEMBERS OF THE
COMMITTEE. JED HAMPTON WITH
CALIFORNIA ASSOCIATION OF HEALTH
PLANS. WE CAP DOES NOT HAVE A
POSITION ON THE BILL AT THIS
TIME. WE CERTAINLY SUPPORT THE
INTENT OF THE BILL AND HAVE HAD
DISCUSSIONS WITH THE AUTHOR'S
OFFICE AND THE SPONSORS, AS WE
DO HAVE A COUPLE OF QUESTIONS
THAT WE WOULD LIKE TO CONTINUE
TO ENGAGE WITH THE AUTHOR'S
OFFICE ON, NAMELY AROUND THE
HEALTH PLAN REQUIREMENT TO
PROVIDE ADEQUATE ACCESS TO
COMMUNITY HEALTH WORKERS. WE DO
HAVE A COUPLE OF QUESTIONS THAT
WE WANTED TO WORK OUT THERE, BUT
AGAIN, WE DON'T HAVE A POSITION
ON THE BILL AT THE TIME. WE ARE
APPRECIATIVE OF THE AUTHORS
OFFICE AND THE SPONSORS FOR
CHATTING WITH US, AND LOOK
FORWARD TO ENGAGING WITH WITH
YOU ALL IN THE COMING IN THE
COMING DAYS AND WEEKS. THANK
YOU, THANK YOU. I WILL BRING THE
DISCUSSION BACK TO THE
COMMITTEE. ANY QUESTIONS? MISS
AGUIAR-CURRY, I LOVE THIS BILL,
SO THANK YOU FOR BRINGING IT
FORWARD. I'D LIKE TO BE A
COAUTHOR. ANY OTHER COMMENTS?
MR. PATTERSON? GREAT. THANK YOU.
REMEMBER THIS BILL LAST YEAR?
THANKS FOR BRINGING IT BACK
AGAIN. COMMEND ANYBODY. JUST
KEEPS TRYING, TO BRING AND
BRINGS THE BILLS BACK. I HAVE
ONE THAT I BROUGHT BACK AS WELL
THIS YEAR, BUT, YOU KNOW, I'VE
THOUGHT ABOUT IT A LOT SINCE,
LAST YEAR, AND I THOUGHT THE
EXAMPLES THAT YOU USED WERE
REALLY GOOD, YOU KNOW, I, YOU
KNOW, WHEN I WAS GROWING UP, ME
AND MY BROTHER, MY MOM DIDN'T
HAVE A CAR, YOU KNOW? SO, LIKE,
THE ACTUAL EXAMPLE YOU USE KIND
OF RESONATED WITH ME. BUT CAN
YOU HELP ME UNDERSTAND WHAT
THESE SCREENINGS LOOK LIKE OR
HOW THEY TAKE PLACE? OKAY YEAH.
SO, DEPENDING ON THE SCREENING
METHOD UTILIZED. SO CURRENTLY
THERE ARE VARIOUS, VALIDATED AND
EVIDENCE BASED TOOLS THAT ARE
BEING UTILIZED. SO THE, CMS ON
THE FEDERAL LEVEL, THEY HAVE A
SCREENING TOOL THAT MOST,
PRACTICES ARE USING AS WELL AS
WITHIN THE FQHC CENTERS. THEY
HAVE THE PREPARED TOOL THAT
THEY'RE USING. SO ON A DAY TO
DAY FOR EXAMPLE, WHEN A
PHYSICIAN IS MEETING WITH THEIR
PATIENT, THEY TRY THESE ARE
SENSITIVE QUESTIONS. SO YOU
CAN'T JUST OUTRIGHT, ASK THEM,
ARE YOU HOMELESS OR ARE YOU FOOD
INSECURE? SO WITHIN THE PRIMARY
CARE SETTING, THESE PHYSICIANS
TYPICALLY BUILD THAT
RELATIONSHIP WITH THEM. SO IT'S
MORE OF AN INFORMAL CONVERSATION
THAT STARTS FIRST. AND WHILE
THEY'RE ALSO DOCUMENTING USING
THE TOOL. SO IT WOULD USE DO YOU
HAVE ACCESS TO HEALTHY FOODS, DO
YOU LIVE IN AN AREA THAT IS,
THAT HAS, VIOLENCE? DO YOU LIVE
NEXT TO A ADEQUATE RESOURCES FOR
FOOD, OR DO YOU HAVE ADEQUATE
ACCESS TO SHELTER? SO FIRST THEY
WILL START OFF INFORMALLY TO
BUILD THAT TRUST. AND WHILE THEY
THEN WILL DOCUMENT THAT AND THEN
WITH THE PATIENT'S PERMISSION,
OBVIOUSLY, IF THEY WOULD LIKE TO
HAVE A FOLLOW UP TO GET THOSE
RESOURCES, THEN THAT'S WHEN WE
WOULD BRING IN THE COMMUNITY
HEALTH WORKER OR SOCIAL WORKER
TO CLOSE THAT GAP AND THEN TO
HAVE A HEALTHY, SEND OFF SO THAT
THEY CAN CONNECT THEM WITH THE
NEEDED RESOURCES THAT WERE
IDENTIFIED DURING THAT VISIT. SO
KIND OF YOU HAVE CHILDREN,
RIGHT? A LOT. SO YEAH. SO KIND
OF THINK OF IT SIMILAR TO WHAT
HAPPENS WHEN YOUR CHILD GOES TO
HIS OR HER ANNUAL VISIT AND YOU
FILL OUT A FORM AND IT MAY ASK
YOU SOMETHING LIKE, YOU KNOW,
HOW MANY HOURS DOES YOUR CHILD
HAVE SCREEN TIME? DOES YOUR
CHILD WEAR A HELMET? DOES IT,
YOU KNOW, DO THEY WEAR SEAT
BELTS? SO IT'S SIMILAR TO THAT,
AT GETTING AT WHAT OTHER KIND OF
RESOURCES, WHAT KIND OF
EDUCATION? WHAT OTHER KIND OF
TOOLS MAY YOU OR YOUR FAMILY
NEED? YEAH I FEEL LIKE THOSE
QUESTIONS WHEN I GO TO THE
DOCTOR ARE VERY JUDGY BY THE
WAY, SO, OKAY. ON THESE
QUESTIONNAIRES AND BECAUSE THIS
IS MEDI-CAL AND, YOU KNOW, I
THINK WE, WE HAVE SOME TYPE OF
DEFICIT IN THIS STATE THAT
STARTS WITH THE B, MANY BILLIONS
OVER. BUT LET'S SAY, YOU KNOW, I
GO TO ONE CLINIC AND I HAVE
DEVELOPED THIS RELATIONSHIP, OR
MAYBE I HAVEN'T, BUT THROUGH THE
COURSE OF THAT PARTICULAR VISIT,
THIS SCREENING TAKES PLACE OR A
PORTION OF IT, AND THEN I END
UP, YOU KNOW, GOING SOMEWHERE
ELSE OR HOW EXACTLY IS THAT
GOING TO WORK? BECAUSE IN THE
PRIVATE INSURANCE, YOU KNOW,
THAT KIND OF INFORMATION, YOU
KNOW, WITH THE PRIOR
AUTHORIZATION, YOU KNOW, THAT
WHOLE THING, IT MIGHT TRANSFER
OVER, RIGHT? YOU KNOW, MIGHT BE
ABLE TO TRANSFER TO A NEW
PROVIDER. BUT IN THE MEDI-CAL
SYSTEM WHERE, LET'S SAY I GO TO
ONE CLINIC, I DO THE SCREENING
AND THEN MAYBE I'M GO TO ANOTHER
PROVIDER SOME OTHER DAY. HOW'S
THAT? DOES THAT NEW CLINIC HAVE
TO REDO THE SCREENING OR IS
THERE SOME GOING TO BE SOME KIND
OF SYSTEM OR THIS IS MESHED
TOGETHER. RIGHT. SO YOUR MEDICAL
RECORD IS YOUR MEDICAL RECORD.
AND IF THE TWO SYSTEMS ALIGN
THEN OAN, YOU'LL BE ABLE TO SEE
WHAT'S IN THAT MEDICAL RECORD.
IT HAS NOTHING TO DO WITH YOUR
INSURANCE. YOU CAN HAVE, PRIVATE
INSURANCE. RIGHT. AND FOR
EXAMPLE, IN SAN DIEGO AND YOU GO
TO SCRIPPS AND THEN YOU CHOOSE
TO GET A DOCTOR AT SHARP. THE
QUESTION IS WHETHER OR NOT THOSE
TWO SYSTEMS CAN AUTOMATICALLY
SEE EACH OTHER. IT HAS NOTHING
TO DO WITH THEIR INSURANCE
LEVEL. AND SO OR WHETHER OR NOT
YOU HAVE COMMERCIAL INSURANCE OR
MEDI-CAL. AND THAT IS AN ISSUE
THAT WE NEED TO A SEPARATE ISSUE
THAT WE NEED TO ADDRESS WITHIN
THE STATE. BUT PEOPLE IN THOSE
SITUATIONS CAN ASK FOR A COPY OF
THEIR MEDICAL RECORDS. SO IT'S
NOT INSURANCE DEPENDENT, IT'S
WHETHER OR NOT THE SYSTEMS OR
THE CLINICS THAT YOU ARE GOING
TO CAN ACTUALLY HAVE ACCESS TO
THE OTHER SYSTEM'S INFORMATION.
YEAH, I GUESS, YOU KNOW, WE JUST
WANT TO MAKE SURE, OBVIOUSLY,
THAT, YOU KNOW, MEDI-CAL
WOULDN'T PAY FOR THIS TWICE OR
SOMETHING LIKE THAT. RIGHT,
WELL, SO THIS IS A SCREENING
TOOL, RIGHT? AND JUST LIKE YOU
HAVE ANNUAL SCREENING TOOLS FOR
YOUR CHILD WHEN THEY GO THE
JUDGY ONES. WELL, YOU MAY THINK
IT'S JUDGY, BUT IT IS IMPORTANT
FOR PHYSICIANS TO KNOW WHETHER
OR NOT THERE ARE THINGS THAT
YOUR CHILD OR FAMILY MAY NEED.
OR OTHER EDUCATION THAT THEY MAY
NEED. IT'S NOT I WOULDN'T SAY
THAT IT'S JUDGY. HOWEVER, YOU
KNOW, JUST BECAUSE YOU SCREEN ME
TODAY AND. ANY OTHER COMMENTS,
QUESTIONS FROM THE, I JUST
WANTED TO SAY THAT, YOU KNOW, WE
KNOW THAT NOW. WE KNOW THAT
ENVIRONMENTAL AND SOCIAL HAND IN HAND WITH
IDENTIFYING A LOT OF TRAUMAS
THAT, YOU KNOW, WE'RE FINDING
NOW AFFECT PEOPLE EVEN LATER IN
LIFE. AND THEN WE'RE DEALING
WITH ISSUES IN CRISIS,
ESPECIALLY AS WE KNOW, MENTAL
HEALTH, ESPECIALLY SUBSTANCE
USE, ESPECIALLY IN THE CRIMINAL
JUSTICE SYSTEM AND ALL THOSE
THINGS WHERE NOW WE'RE HAVING TO
DEAL WITH, YOU KNOW, THINGS THAT
IF WE COULD JUST WORK ON EARLY
INTERVENTION AND PREVENTION
WOULD MAKE SUCH A DIFFERENCE. SO
WE ALWAYS TALK ABOUT THAT
NEEDING THANK YOU. THANK
YOU, CHAIR, AND THANK YOU FOR
THOSE REMARKS. BECAUSE
ESSENTIALLY WHAT THIS BILL IS,
IS REALLY TRYING TO GET AT NOT
ONLY GETTING THE DATA, BUT
MAKING SURE THAT WE ARE
INTERVENING EARLY. TO NOT ONLY
HELP INDIVIDUALS HEALTH THEIR
FAMILY'S HEALTH, BUT ALSO TO
ULTIMATELY REDUCE THE CARE OF
HEALTH CARE IN THIS STATE, IT'S
A LOT EASIER TO PREVENT THINGS
LIKE DIABETES OR HIGH BLOOD
PRESSURE, MADAM SECRETARY,
PLEASE CALL THE ROLL. BONTA
WALDRON. AYE. WALDRON. AYE.
AGUIAR-CURRY AGUIAR-CURRY. AYE.
ARAMBULA. ARAMBULA. AYE. WENDY.
CARRILLO LARA. HANEY. HANEY.
AYE. JONES-SAWYER MAIENSCHEIN.
MCCARTY. JO. PATTERSON JO.
PATTERSON. AYE. RODRIGUEZ.
RODRIGUEZ. AYE SANCHEZ. SANCHEZ.
AYE. SANTIAGO. CHAU WEBER.
WEBER. AYE. YOUR BILL IS ON I AM PLEASED TO
PRESENT AB 200, A BILL THAT WILL
BAN DEHP FORM USE. AND I'VE BAGS
AND IN CERTAIN CASES, TUBING
DEHP BELONGS TO A FAMILY OF
HORMONALLY ACTIVE INDUSTRIAL
CHEMICALS CALLED. AND I ACTUALLY
DIDN'T LOOK UP HOW TO SAY THIS.
PHTHALATES. THANK YOU, WHICH ARE
USED TO MAKE PLASTIC SOFT AND
PLIABLE AND CAN BE FOUND IN A
MYRIAD OF PRODUCTS RANGING FROM
GARDEN HOSES TO SHOWER CURTAINS
TO VINYL FLOORING AND BUILDING
MATERIALS, PARTICULARLY THOSE
MADE FROM POLYVINYL CHLORIDE,
WHICH WE CALL PVC PLASTICS. DEHP
IMPACTS THE THYROID AND IMMUNE
SYSTEM. RESEARCH INDICATES THAT
DEHP PROMOTES DRUG RESISTANCE
AND INHIBITS THE EFFECTIVENESS
OF BREAST CANCER DRUGS,
INTERFERES WITH THE ABILITY OF
CHEMOTHERAPIES TO FIGHT BREAST
CANCER, AND THAT PATIENTS WITH
HIGHER LEVELS OF DEHP IN THEIR
SYSTEM HAD HIGHER RATES OF
RELAPSE AND MORTALITY. DEHP IS
COMMONLY USED TO IMPART
FLEXIBILITY TO IV BAGS AND IV
TUBING. SOME IV BAGS AND TUMMIES
CAN CONTAIN UP TO 40% DEHP BY
WEIGHT. DEHP HAS BEEN SHOWN TO
LEACH OUT OF THE IV BAGS AND
TUBINGS, AND INTO MEDICATIONS
AND OTHER FLUIDS BEING INFUSED
INTO THE BLOODSTREAM OF
PATIENTS. THE GOOD NEWS IS THAT
A SAFER ALTERNATIVE, THAT SAFER
ALTERNATIVES EXIST AND ARE
ALREADY BEING USED IN FDA
APPROVED DEHP FREE I.V. BAGS,
FOR EXAMPLE, B.BRAUN AND FRESNO
SCOBY ALREADY EXCLUSIVELY
MANUFACTURE DEHP FREE IV BAGS,
AND THEIR COMPETITORS BAXTER AND
ICU MEDICAL, ALSO OFFER A LARGE
PORTFOLIO OF FDA APPROVED NON
DEHP I.V. BAGS. TOGETHER, THESE
FOUR COMPANIES MAKE AND SELL THE
VAST MAJORITY OF THE I.V. BAGS
PURCHASED BY HEALTH CARE SYSTEMS
IN CALIFORNIA. MANY COMPANIES
ALSO MANUFACTURE I.V. TUBING
FREE OF DEHP. BUT BECAUSE THIS
SECTOR OF THE INDUSTRY IS MORE
COMPLICATED, WE HAVE GIVEN THESE
MANUFACTURERS SEVEN YEARS TO
COMPLY WITH THE BILL'S REQUIRED
PHASEOUT OF DEHP IN I.V. TUBING.
MY OFFICE HAS ALSO TAKEN
AMENDMENTS TO EXCLUDE HUMAN
BLOOD AND BLOOD PRODUCTION,
PRODUCT COLLECTION, PROCESSING
AND STORAGE BAG, INCLUDING
INTEGRAL TUBING. THIS AMENDMENT
WAS TAKEN AFTER CONCERNS WERE
RAISED ABOUT THERE NOT BEING
ALTERNATIVE TO NON DEHP BAGS. I
WOULD ALSO LIKE TO THANK ALL OF
THE STAKEHOLDERS FOR THEIR
ROBUST CONVERSATIONS THAT WE'VE
HAD OVER THE LAST FEW WEEKS.
HAPPY TO CONTINUE THESE
CONVERSATIONS. IF AB 2300 MOVES
FORWARD. NOW WITH ME TODAY IS
DOCTOR LISA BAILEY, WHO RETIRED
IN 2022 FROM A 40 YEAR SURGICAL
PRACTICE WHERE SHE SPECIALIZED
IN BREAST CANCER SURGERY, AND
TRACY WOULD WOODRUFF, PHD, MPH,
THE DIRECTOR OF THE PROGRAM ON
REPRODUCTIVE HEALTH AND THE
ENVIRONMENT AND A PROFESSOR IN
THE UCSF DEPARTMENT OF
OBSTETRICS, GYNECOLOGY AND
REPRODUCTIVE SCIENCES, THEY WILL
SPEAK MORE ON THE IMPORTANCE OF
AB 2300. AND TO HELP ANSWER ANY
QUESTIONS YOU MAY HAVE. MY NAME
IS DOCTOR LISA BAILEY, AND I'M
PLEASED TO BE TESTIFYING TODAY
IN SUPPORT OF AB 2300 PREMIUM NØ
NÓ CHERRY. FIRST, DO NO HARM.
THIS IS FROM THE HIPPOCRATIC
OATH THAT I SWORE TO WHEN I
GRADUATED FROM MEDICAL SCHOOL. I
RECENTLY RETIRED IN 2022 FROM A
40 YEAR MEDICAL PRACTICE WHERE I
SPECIALIZED IN BREAST CANCER
SURGERY. I CURRENTLY SERVE AS
THE CHAIR OF THE BOARD OF BREAST
CANCER PREVENTION PARTNERS, AND
I'M ALSO AN ACTIVE MEMBER OF
NUMEROUS MEDICAL ASSOCIATIONS,
INCLUDING THE CALIFORNIA MEDICAL
ASSOCIATION AND THE AMERICAN
SOCIETY OF BREAST SURGEONS. MY
JOB AS A BREAST CANCER SURGEON
IS TO REMOVE THE CANCER FROM A
WOMAN'S BREAST AND LYMPH NODES.
I HAVE PERFORMED THOUSANDS OF
THESE TYPES OF SURGERIES AND
HAVE COUNSELED EVEN MORE WOMEN
REGARDING THEIR RISKS OF BREAST
CANCER AND BREAST CANCER
RECURRENCE. I'VE ALSO PLACED
THOUSANDS OF CATHETERS IN WOMEN
WHOSE RECOMMENDED TREATMENT WAS
CHEMOTHERAPY. THE TIP OF THE
CATHETER IS PLACED JUST ABOVE
THE RIGHT ATRIUM OF THE HEART.
THE IV FLUID AND CHEMOTHERAPY
THEN GO THROUGH THE CATHETER
INTO THE HEART AND THEN TO THE
REST OF THE BODY. THERE IS
EVIDENCE THAT DEHP, WHICH IS A
NEUROTOXIN, MAY CROSS INTO THE
BRAIN, THOUGH THE CHEMOTHERAPY
TYPICALLY DOES NOT. I.V. BAGS
AND TUBING THAT ARE USED FOR
THIS THERAPY, IF THEY CONTAIN
DEHP, THEN CARRY THIS HORMONALLY
ACTIVE CHEMICAL THROUGHOUT THE
WOMAN'S BODY. I WAS TRAINED TO
SAVE LIVES, SO YOU CAN IMAGINE
HOW OUTRAGED I WAS WHEN I
LEARNED THAT RESEARCH CONDUCTED
IN DECEMBER OF 2021 AND
PUBLISHED IN THE JOURNAL OF
BIOMEDICINE AND PHARMACOTHERAPY,
SHOWED THAT DEHP NOT ONLY NOT
ONLY PROMOTES DRUG RESISTANCE
AND INHIBITS THE EFFECTIVENESS
OF BREAST CANCER DRUGS, IT
INTERFERES WITH THE ABILITY OF
CHEMOTHERAPY TO FIGHT BREAST
CANCER. MY PATIENTS WOULD ALWAYS
ASK ME IF THE TREATMENT WAS
SUCCESSFUL AND IF THEY WERE
CANCER FREE AND NOT AT RISK FOR
FUTURE CANCER, AND I NOW LEARN
THAT THEIR RISK OF CANCER
RECURRENCE IS HIGHER BECAUSE OF
THEIR EXPOSURE TO THE DEHP AND
THE IV BAGS AND TUBING USED AS
PART OF THEIR SURGERY AND OTHER
TREATMENTS. IN FACT, DEHP HAS
BEEN SHOWN IN LABORATORY STUDIES
TO INCREASE GROWTH OF HUMAN
BREAST CANCER CELLS AND DECREASE
THE EFFICACY OF TAMOXIFEN, A
DRUG COMMONLY USED TO TREAT
BREAST CANCER. THE SCIENTISTS
FOUND THAT DEHP TURNS ON A GENE
KNOWN TO PROMOTE PROLIFERATION,
INVASION, METASTASIS, AND DRUG
RESISTANCE IN HUMAN BREAST
CANCER CELL LINES. WHEN DEHP IS
USED IN IV BAGS AND TUBING TO
DELIVER CHEMOTHERAPEUTIC AGENTS
TO WOMEN WITH BREAST CANCER, THE
VERY ACT OF DELIVERING THE
MEDICINE WEAKENS
FEEL AS A MEDICAL PROFESSIONAL.
WONDERING IF THE TREATMENT
MEDICAL TREATMENT THAT I
AUTHORIZED MIGHT HAVE
INADVERTENTLY WORSENED THEIR
DISEASE 20 YEARS AGO, THE FDA
SOUNDED THE ALARM BUT DID NOT
ACT TO ADDRESS THIS PROBLEM. AB
23 GIVES CALIFORNIA THE CHANCE
TO DO SO, GIVEN THE
WELL-ESTABLISHED HEALTH CONCERNS
ASSOCIATED WITH EXPOSURES TO
DEHP, I URGE YOU TO SUPPORT OF
THIS COMMON SENSE HEALTH CARE
PROTECTIVE LEGISLATION. THANK
YOU. GOOD AFTERNOON. MY NAME IS
TRACEY WOODRUFF. I'M A PROFESSOR
AND DIRECTOR OF THE PROGRAM ON
REPRODUCTIVE HEALTH AT UC SAN
FRANCISCO. MY RESEARCH FOCUSES
ON HOW CHEMICALS IMPACT HEALTH,
PARTICULARLY DURING PREGNANCY,
AND HOW THAT AFFECTS FETAL AND
CHILD DEVELOPMENT AND HEALTH
INEQUITIES. I'M PLEASED TO SPEAK
ABOUT AB 2300 AND ITS PROPOSED
BAN ON DEHP, AND REGRETTABLE
SUBSTITUTES FROM I.V. BAGS AND
TUBES. THIS BAN IS IMPORTANT FOR
EVERYONE WHO IS A PATIENT IN A
HOSPITAL, AND PARTICULARLY FOR
NEWBORN BABIES AND PATIENTS WHO
LIVE IN COMMUNITIES THAT ARE
MORE BURDENED BY ENVIRONMENTAL
EXPOSURES, CHEMICALS LIKE DEHP
DISRUPT HORMONES AND ARE KNOWN
AS ENDOCRINE DISRUPTING
CHEMICALS, AND NEWBORNS ARE MORE
SUSCEPTIBLE TO HARMFUL IMPACTS
OF EXPOSURES TO THESE TYPES OF
CHEMICALS. DEVELOPMENTAL
EXPOSURES TO DEHP CAN POSE A
GREATER RISK TO DEVELOPING
FETUS, CHILD, AND PREGNANT
PARENT, AND CAUSE A HOST OF
ADVERSE HEALTH EFFECTS,
INCLUDING INCOMPLETE FORMATION
OF MALE REPRODUCTIVE SYSTEMS,
LOWER SPUM COUNT, AND PRETUM.
BIRTH. SCIENCE ALSO SUGGESTS
DEHP CAN INCREASE RISK OF
NEURODEVELOPMENTAL HARMS SUCH AS
LOWER IQ AND ADHD. DEHP EXPOSURE
CAN INCREASE THE RISK OF OTHER
DISEASES, INCLUDING METABOLIC
DISORDERS SUCH AS DIABETES.
FINALLY, PHTHALATES CAN ALSO
UNDERMINE THE IMMUNE SYSTEM,
WHICH HAS BEEN DISCUSSED SO
PEOPLE BATTLING CANCER OR OTHER
ILLNESSES ARE AT PARTICULAR
RISK. AND I WANT TO NOTE THAT
ALL OF THESE DISEASES ARE
GREATER IN HISPANIC AND BLACK
POPULATIONS. AND WE KNOW THAT
EXPOSURES TO DEHP ARE OCCURRING
FROM MEDICAL DEVICES TO
NEWBORNS. FOR EXAMPLE, STUDIES
SHOW INFANTS IN NEONATAL
INTENSIVE CARE UNITS WHO ARE
OFTEN PRETUM WHERE THERE IS MORE
INTENSIVE USE OF DEHP CONTAINING
MEDICAL DEVICES HAVE HIGHER
EXPOSURES TO DEHP. BECAUSE OF
THIS, LIFE STAGES SUCH AS
PREGNANCY, FETAL DEVELOPMENT,
PREEXISTING CONDITIONS, AND
STRESS DUE TO POVERTY AND FOOD
INSECURITY CAN MAKE PEOPLE
ESPECIALLY VULNERABLE TO ADVERSE
HEALTH EFFECTS FROM CHEMICALS,
AND PEOPLE ARE EXPOSED TO
MULTIPLE CHEMICALS, WHICH CAN
ALSO INCREASE RISK. CONSEQUENTLY
OUR RESEARCH SHOWS THERE IS NO
RISK FREE LEVEL OF EXPOSURE TO
THESE CHEMICALS ACROSS THE
POPULATION. STUDIES SHOW THAT
OVER 95% OF PREGNANT PEOPLE
ACROSS THE US ARE EXPOSED TO
DEHP, ALONG WITH DOZENS OF OTHER
CHEMICALS. THESE EXPOSURES ARE
ALSO DISTRIBUTED UNEQUALLY.
STUDIES OF OVER 6000 PREGNANCIES
FOUND HIGHER LEVELS OF THESE
PHTHALATES IN BLACK AND HISPANIC
PARTICIPANTS, COMPARED TO
WHITES. THAT'S CONTRIBUTING TO
ENVIRONMENTAL INJUSTICES.
RESEARCH AND HEALTH CARE
PRACTITIONERS ARE CONCERNED THAT
EXPOSURES TO EDCS LIKE DEHP FROM
MEDICAL DEVICES ADDS TO EXISTING
EXPOSURES TO EDCS FROM OTHER
SOURCES AND ARE UNNECESSARY.
THIS IS PARTICULARLY CONCERNING
FOR PATIENTS WHO COME FROM
HIGHLY POLLUTED AREAS, INCLUDING
PLACES LIKE FRESNO AND THE
CENTRAL VALLEY. THERE IS NO SAFE
LEVEL OF EXPOSURE, AND SO THIS
IS WHY THIS BILL IS VERY
IMPORTANT FOR THE PATIENTS IN
THE STATE OF CALIFORNIA. THANK
YOU. ARE THERE OTHER WITNESSES
IN SUPPORT? PLEASE COME FORWARD.
STATE YOUR NAME, ORGANIZATION
AND POSITION ONLY. GOOD
AFTERNOON, ANGELICA GONZALEZ
WITH KAISER PERMANENTE IN
SUPPORT. HI, JANET NOODLEMAN
WITH BREAST CANCER PREVENTION
PARTNERS. WE ARE ONE OF THE
SPONSORS OF THIS BILL AND STRONG
SUPPORT. FOR THE CALIFORNIA
BLACK HEALTH NETWORK, ONE OF THE
CO-SPONSORS AND STRONG SUPPORT.
GOOD AFTERNOON, WHITNEY FRANCIS,
WITH THE WESTERN CENTER ON LAW
AND POVERTY IN SUPPORT. GOOD
AFTERNOON. I'M ALICIA CAREY.
MICAH WITH BROWN MEDICAL. WE'RE
A MANUFACTURER OF THE DEVICES
ADDRESSED IN THIS LEGISLATION,
THE MAJOR PLANT IN IRVINE. AND
WE ARE STRONGLY SUPPORT THIS
LEGISLATION. RYAN SPENCER WITH
AMERICAN COLLEGE OF OB-GYN. WE
ACTUALLY HAVE A SUPPORT IF
AMENDED POSITION AND JUST LIKE
THE BAN ON TUBING TO BE INCLUDED
IN ALL SETTINGS, NOT JUST THE
THREE IN THE BILL, THANK YOU.
LARA LARA GILLAN, ON BEHALF OF
CLEAN WATER ACTION AND KEEP
ABREAST IN STRONG SUPPORT. THANK
YOU. OTHER WITNESSES IN
OPPOSITION, PLEASE COME FORWARD.
DOWN ON THE SIDE SO WE CAN BE
TOGETHER. OKAY. NOW I WAS GOING
TO SAY TO HELP THEM BE TOGETHER,
BUT THAT'S FINE. WE CAN SPREAD
OUT ALL THE LOVE. WE CAN FLANK
IT, VICE CHAIR, MEMBERS OF THE
COMMITTEE. MY NAME IS DARBY
GOTTLIEB. WITH ADVAMED, WE ARE
THE LARGEST TRADE ASSOCIATION
REPRESENTING MEDICAL TECHNOLOGY
MANUFACTURERS. WE HAVE OVER 450
MEMBERS NATIONWIDE IN CALIFORNIA
. IS HOME TO OVER 240 MEMBER
COMPANY SITES. WE CURRENTLY HAVE
AN OPPOSE UNLESS AMENDED
POSITION ON THE BILL, BUT
APPRECIATE THE PRODUCTIVE DIALOG
WITH ASSEMBLY MEMBER WILSON'S
OFFICE AND LOOK FORWARD TO
CONTINUING CONVERSATIONS TO
ADDRESS OUR OUTSTANDING CONCERNS
. AS CURRENTLY DRAFTED, WE ARE
CONCERNED THE BILL COULD HAVE
MAJOR OR CAUSE MAJOR SUPPLY
CHAIN CHALLENGES FOR CALIFORNIA
HEALTH SYSTEM AND NEGATIVELY
IMPACT PATIENTS WHO RELY ON
THESE PRODUCTS. OUR PRIMARY
CONCERN IS THE IMPLEMENTATION
TIMELINE. WE BELIEVE A MORE
APPROPRIATE PHASE OUT DATE FOR
BOTH TUBING AND SOLUTION
CONTAINERS IS 2035. CHANGING OR
SUBSTITUTING PRODUCT MATERIALS
IS A HIGHLY COMPLEX PROCESS AND
SUBJECT TO STRICT REGULATORY
REQUIREMENTS. THE FDA OVERSEES
THE FULL PRODUCT LIFECYCLE FROM
THE METHODS AND FACILITIES FOR
THE DESIGN AND MANUFACTURE OF
THE PRODUCT TO THE DISTRIBUTION,
AND POST-MARKET SURVEILLANCE.
THIS IS TO ENSURE THAT PRODUCTS
ARE SAFE AND EFFECTIVE FOR
PATIENTS TO ABIDE BY THESE
STANDARDS. SWITCHING THE
MATERIALS FOR A SINGLE PRODUCT
TAKES YEARS OF EXTENSIVE
VALIDATION, BIOCOMPATIBILITY,
AND PERFORMANCE TESTING, AND AB
2300 WILL IMPACT HUNDREDS OF
PRODUCTS. THOUGH DEHP IS BEING
PHASED OUT IN OTHER COUNTRIES,
IT'S IMPORTANT TO NOTE THAT THE
MANUFACTURING PROCESSES,
PRODUCTS AND SUPPLY CHAIN ARE
DIFFERENT BASED ON THE COMPANY
AND LOCATION AND WHETHER
SUITABLE ALTERNATIVES ARE
READILY AVAILABLE IN THE
DIFFERENT JURISDICTIONS. LAST
YEAR, THE EU EXTENDED THE DEHP
PHASE OUT BY ANOTHER FIVE YEARS,
TOTALING 13 YEARS OF
IMPLEMENTATION. THÀNH. WE WOULD
ALSO LIKE TO SEE A THRESHOLD
ADDED TO THE DEFINITION OF
INTENTIONALLY ADDED DEHP. THIS
WILL ALLOW MANUFACTURERS TO TEST
PRODUCT COMPLIANCE WHILE
ENSURING COMPANIES ARE NOT
PENALIZED FOR TRACE AMOUNTS THAT
MAY BE OUT OF A MANUFACTURER'S
CONTROL, WHICH IS CONSISTENT
WITH OTHER JURISDICTIONS LIKE
YOU'RE IN EUROPE AND CANADA AS
WELL. AGAIN, I APPRECIATE THE
OPPORTUNITY TO PROVIDE aMENTS
AND WANT TO THANK THE AUTHORS
OFFICE FOR THE CONTINUED DIALOG.
WE LOOK FORWARD TO CONTINUING TO
WORK WITH THE OFFICE AND THE
COMMITTEE AS THE BILL MOVES
THROUGH THE PROCESS. THANK YOU.
GOOD AFTERNOON AARON FRIDAY
PROTECT KIDS BALLOT INITIATIVE.
OUR DUTY. WE OPPOSE THIS BILL
UNLESS AMENDED, TO ALSO PROHIBIT
PUBERTY BLOCKERS, CROSS-SEX
HORMONES AND GENDER SURGERIES
FOR MINORS LIKE SWEDEN. THE UK,
FINLAND AND FRANCE ARE DOING
TESTOSTERONE IN FEMALE BODIES.
CAUSES. LIVER CANCER. PUBERTY
BLOCKERS CAUSE BRAIN DEVELOPMENT
AND WEAKNESS IN BONES. PLEASE
CHECK OUT THE W PATH EXPOSÉ ON
MICHAEL FROM MICHAEL
SHELLENBERGER. THANK YOU. THANK
YOU. ARE THERE OTHER WITNESSES
IN OPPOSITION? PLEASE COME
FORWARD. JEREMY. MEMBERS, THIS
IS DEAN TALLEY WITH THE
CALIFORNIA MANUFACTURERS AND
TECHNOLOGY ASSOCIATION. WE HAVE
OPPOSED, UNLESS AMENDED
POSITION. THANK YOU. GOOD
AFTERNOON, CHAIR AND MEMBERS.
OBED FRANCO, ON BEHALF OF THE
AMERICAN CHEMISTRY COUNCIL, WE
HAVE OPPOSED, UNLESS AMENDED,
POSITION. GOOD AFTERNOON, MADAM
CHAIR AND MEMBERS. MOIRA TOP ON
BEHALF OF BIOCOM CALIFORNIA,
WITH OPPOSING LAST AMENDED
POSITION. I'M MEG SNYDER ON
BEHALF OF THE VINYL INSTITUTE
OPPOSED. NICOLE YOUNG PART OF
PROTECT KIDS CALIFORNIA OPPOSE
UNLESS AMENDED AARON FRIDAY'S
AMENDMENTS. THANK YOU. YVETTE
CORCORAN, A REGISTERED NURSE,
AND OPPOSE THIS BILL UNLESS
AMENDED TO AARON FRIDAY'S
REQUEST THAT. THANK YOU. OTHER
QUESTIONS OR COMMENTS FROM THE
COMMITTEE? ASSEMBLY MEMBER, I
APPRECIATE YOU BROUGHT THIS BILL
FORWARD FOR NUMEROUS REASONS.
BEING A WOMAN AND WE'VE ALL HAD
OUR ISSUES AS WELL. BUT A LITTLE
BIT DISTURBED AT THE MOMENT,
FROM COMMENTS THAT HAVE BEEN
MADE, I JUST WANTED I KNOW THAT
YOU'RE GOING TO CONTINUE TO WORK
ON THIS BILL, AND I KNOW WE'RE
THE FIRST COMMITTEE THAT YOU'VE
HEARD. SO I ENCOURAGE YOU TO
CONTINUE TO DO SO. AND I'LL BE
SUPPORTING YOUR BILL TODAY.
THANK YOU. I APPRECIATE THAT
SUPPORT. AND JUST IF THE CHAIR
WOULDN'T MIND, I'LL NOTE THAT,
YOU KNOW, WE ARE WORKING WITH
OPPOSITION IN REGARD TO TIMING,
THERE'S LOTS OF IT AS IT RELATES
TO NOT DISRUPTING SUPPLY CHAIN
AS WELL AS, YOU KNOW, FDA
APPROVALS. AND SO WE'LL FIGURE
OUT WHAT THE GREAT LANDING SPOT
IS. AND SO, AND WE ARE DUAL
REFERRED. AND SO WE'LL MAKE SURE
WE GET THOSE CHANGES IN BY THE
NEXT COMMITTEE. WELL, BEFORE WE
GET TO THE FLOOR. Ó YOU'RE HERE
ANY OTHER COMMENTS, I WILL JUST
MAKE A COMMENT AND THEN GET IT.
THE MIKE PASSED OVER. BACK OVER
THIS WAY. I WANT TO JUST
CLARIFY, AND QUITE FRANKLY,
APOLOGIZE TO THE AUTHOR, BUT
CLARIFY THAT, THE INTENTION OF
THE BILL IS TO REALLY, REMOVE
DEEP DEHP FROM, FROM, THESE FROM
FROM THESE, NUTRITION INFUSION,
THE BLOOD BAGS. RIGHT. NOT THE
BLOOD BAGS, THE, IV BAGS AND
TUBING THAT WE TOOK OUT. THE
BLOOD BAGS IN PARTICULAR,
BECAUSE THERE IS NO WAY RIGHT
NOW, SCIENTIFICALLY OR
TECHNICALLY, TO BE ABLE TO HAVE
A REPLACEMENT TYPE BAG FOR
BLOOD. YOU WON'T BE ABLE TO, WE
WON'T BE ABLE TO. THEN DO BLOOD
INFUSIONS. IF WE GOT RID OF
DEHP. SO ONE OF THE THINGS I
KNOW THAT YOU'RE GOING TO
CONTINUE TO WORK ON IS JUST TO
ENSURE THAT THE TECHNOLOGY WILL
BE ABLE TO CATCH UP WITH THE
REQUIREMENT. ABSOLUTELY. BECAUSE
WE DON'T, YOU KNOW, THESE ARE
LIFE SAVING MEDICATIONS, YOU
KNOW, HAD TO DEAL WITH THIS
ISSUE LAST YEAR, PERSONALLY. AND
WAS THANKFUL THAT, ON THIS
PARTICULAR ISSUE AS IT RELATES
TO DEHP, I DIDN'T MY PARTICULAR
PROVIDER, HEALTH CARE PROVIDER
HAD ALREADY TRANSITIONED TO THE
NEW BAGS. HOWEVER, I HAVE
FRIENDS WHO ARE RECEIVING CARE
AND THEY ARE PART OF HEALTH CARE
PROVIDERS WHO HAVE NOT
TRANSITIONED. AND SO THIS IS TO
BE ABLE TO, ALLOW THEM TO, YOU
KNOW, GET CARE WITHOUT HAVING TO
WORRY ABOUT THIS ISSUE. AND THEN
ALLOW TECHNOLOGY AND, SUPPLY TO
CATCH UP IN ALL ASPECTS, WHETHER
IT RELATES TO BLOOD BAGS OR TO,
JUST THE STANDARD BAGS THAT WE
USE OR TUBING. OKAY. THANK YOU.
ANY OTHER COMMENTS FROM THE
COMMITTEE? THE AUTHOR. YOU MAY
CLOSE. ALL RIGHT. WITH THAT, I
RESPECTFULLY ASK FOR YOUR AYE
VOTE TO ENSURE THAT THESE
VULNERABLE POPULATIONS ÓRDENES
RECEIVE THE LIFE, SAVING CARE
THAT THEY NEED WITHOUT
ENDANGERING THEIR LIVES IN THE
FUTURE. AGUIAR-CURRY MOVES THE
BILL. DOCTOR WEBER. SECONDS. I
JUST WANT TO THANK THE AUTHOR
FOR BRINGING THIS FORWARD. AND I
KNOW THAT GIVEN THE CONCERNS
AROUND MANUFACTURING, THAT YOU
HAVE NOTED THAT YOU'LL CONTINUE
TO WORK WITH THE OPPOSITION TO
CONSIDER ADJUSTING THE
IMPLEMENTATION TIMELINE OF THE
BILL AND INCLUDING A THRESHOLD
TO ALLOW MANUFACTURERS TO TEST
COMPLIANCE, MY RECOMMENDATION ON
THIS IS AN I WITH THAT, THE
MOTION IS DUE PASS TO
ENVIRONMENTAL SAFETY AND TOXIC
MATERIALS. PLEASE CALL THE ROLL
BONTA I QUANTA I WALDEN
AGUIAR-CURRY AGUIAR-CURRY I
ARAMBULA WENDY CARILLO LARA
HANEY. JONES. SAWYER. NO. JONES.
SAWYER. NO MAIENSCHEIN.
MAIENSCHEIN I MCCARTY. NO.
PATTERSON RODRIGUEZ. RODRIGUEZ
I. SANCHEZ SANCHEZ. NOT VOTING.
SANTIAGO SABO. WEBER WEBER. I.
THAT. IS THAT MEASURES ON CALL.
WE WILL MOVE TO ITEM NUMBER. 11
AB 2319.
AUTHOR. YOU CAN GO AHEAD
WHENEVER YOU WANT. THANK YOU.
ALL RIGHT. WE GOT THE FULL SQUAD
HERE. READY TO GO. THANK YOU,
MADAM CHAIR. MEMBERS I'M PLEASED
TO PRESENT AB 2319, A BILL THAT
AIMS TO REDUCE THE ALARMING AND
DISPROPORTIONATE MATERNAL
MATERNAL MORTALITY RATE OF BLACK
WOMEN AND OTHER PREGNANT PERSONS
OF COLOR BY ENSURING SUCCESSFUL
IMPLEMENTATION OF SB 464 BY THEN
SENATOR MITCHELL, THE CALIFORNIA
DIGNITY AND PREGNANCY AND
CHILDBIRTH ACT, I MEAN ACT OF
2019, A RECENT STUDY BY THE
CALIFORNIA DEPARTMENT OF PUBLIC
HEALTH FOUND THAT WOMEN OF COLOR
IN PARTICULAR BLACK WOMEN, DIE
OF PREGNANCY RELATED
COMPLICATIONS AT A MUCH HIGHER
RATE THAN WHITE WOMEN IN
CALIFORNIA. THIS DISPARITY
EXISTS ACROSS ALL INCOME LEVELS.
EVIDENCE SUGGESTS. ONE KEY CAUSE
OF THIS DISPARITY IS THE
IMPLICIT BIAS OF HEALTH CARE
PROVIDERS. A PROVIDER'S LEVEL OF
BIAS, WHETHER CONSCIOUS OR
UNCONSCIOUS, CAN INFLUENCE THEIR
INTERACTIONS WITH PATIENTS AND
THEIR DIAGNOSIS AND TREATMENT OF
THE PATIENT'S PAIN, AND CAN
UNDERMINE PATIENTS TRUST AND
ENGAGEMENT AND CARE. TO ADDRESS
THIS, THE CALIFORNIA STATE
LEGISLATURE PASSED THE ACT IN
2019, WHICH REQUIRES HOSPITALS,
ALTERNATIVE BIRTH CENTERS, AND
PRIMARY CARE CLINICS, WHICH ARE
THE FACILITIES COVERED UNDER THE
ACT TO CONDUCT EVIDENCE BASED
IMPLICIT BIAS TRAINING FOR ALL
HEALTH PROFESSIONALS WHO PROVIDE
CARE DURING A PATIENT'S
PREGNANCY, CHILDBIRTH, AND
IMMEDIATE POSTPARTUM PERIOD. IN
AUGUST 2021, THE DEPARTMENT OF
JUSTICE LAUNCHED AN
INVESTIGATION TO ASCERTAIN
COMPLIANCE WITH THE ACT. WHILE
SOME FACILITIES WENT ABOVE AND
BEYOND THE REQUIREMENT OF THE
ACT, THERE IS STILL WORK TO BE
DONE TO ENSURE FULL COMPLIANCE.
DOJ'S INVESTIGATION REVEALED
THAT THERE IS A NEED FOR AN
ENFORCEMENT MECHANISM, PUBLIC
TRANSPARENCY OF COMPLIANCE, DATA
FIRM COMPLIANCE DEADLINES AND
ADDITIONAL SPECIFICITY AND
CLARITY SO THAT FACILITY ARE
BETTER EQUIPPED TO KNOW WHICH
PROVIDERS NEED TO BE TRAINED. I
AM A MOTHER GRANDMOTHER. I HAVE
SISTERS, AUNTS, NIECES, AND
FRIENDS THAT LOOK JUST LIKE ME.
AND AS BLACK WOMEN, THESE
STATISTICS HIT TOO CLOSE TO
HOME. THEY ACKNOWLEDGE THE
SOBERING REALITY OF BEING A
PREGNANT WOMAN OF COLOR IN THE
STATE AND HIGHLIGHTS THE NEED TO
CORRECT THE COURSE. WE ARE ON
THIS IS WHY THE CALIFORNIA
LEGISLATIVE BLACK CAUCUS AND ITS
ENTIRETY HAVE SIGNED ON AS
COAUTHORS TO THIS BILL,
INCLUDING DOCTOR WEBER, WHO IS A
JOINT AUTHOR. WITH ME TODAY IS
TIFFANY MATTHEWS FROM THE
ATTORNEY GENERAL'S OFFICE. AND
GABRIELLE BROWN, GABRIELLE
BROWN, MATERNAL AND INFANT
HEALTH PROGRAM MANAGER AT BLACK
WOMEN FOR WELLNESS ACTION
PROJECT, TO SPEAK MORE ON THE
IMPORTANCE OF THIS BILL AND
ANSWER ANY QUESTIONS YOU MAY
HAVE. GO AHEAD. YOU HAVE THREE
MINUTES EACH ON THE SUPPORT.
GOOD AFTERNOON, CHAIR AND
MEMBERS. MY NAME IS TIFFANY
MATTHEWS, DEPUTY ATTORNEY
GENERAL AND LEGISLATIVE ADVOCATE
AT THE CALIFORNIA DEPARTMENT OF
JUSTICE. I'M HERE TODAY ON
BEHALF OF ATTORNEY GENERAL ROB
BONTA, WHO IS A PROUD SPONSOR OF
AB 23, 19, ALONG WITH OUR
CO-SPONSORS, BLACK WOMEN FOR
WELLNESS ACTION PROJECT, WESTERN
CENTER ON LAW AND POVERTY,
REPRODUCTIVE FREEDOM FOR ALL,
THE CALIFORNIA NURSE MIDWIVES
ASSOCIATION, AND CALIFORNIA
BLACK WOMEN'S COLLECTIVE. WE'D
LIKE TO THANK THE AUTHORS
ASSEMBLYMEMBER WILSON AND DOCTOR
WEBER AND THE LEGISLATIVE BLACK
CAUCUS, FOR THEIR LEADERSHIP IN
CARRYING THIS IMPORTANT PIECE OF
LEGISLATION. THE UNITED STATES
HAS THE HIGHEST MATERNAL
MORTALITY RATE IN THE DEVELOPED
WORLD. IN CALIFORNIA, PEOPLE OF
COLOR, PARTICULARLY BLACK WOMEN,
CONTINUE TO DIE AT 3 TO 4 TIMES
THE RATE OF WHITE WOMEN. AB 2319
AIMS TO REDUCE THIS ALARMING
DISPARITY BY ENSURING THAT
HEALTH CARE FACILITIES COMPLY
WITH THE ANTI-BIAS TRAINING
REQUIREMENTS SET FORTH IN THE
CALIFORNIA DIGNITY, DIGNITY AND
PREGNANCY AND CHILDBIRTH ACT. AS
ASSEMBLY MEMBER, WILSON
MENTIONED IN AUGUST OF 2021, DOJ
LAUNCHED AN INVESTIGATION TO
ASCERTAIN COMPLIANCE WITH THE
ACT AND ONCE DOJ BEGAN ITS
INVESTIGATION, COMPLIANCE
IMPROVED FROM 17% TO 81. WE
ALONG WITH ALL THE OTHER
STAKEHOLDERS INVOLVED, WANT TO
GET THAT NUMBER TO 100. SO TO
BETTER EQUIP HEALTH CARE
FACILITIES TO COMPLY WITH THE
REQUIREMENTS SET FORTH IN THE
ACT, AB 2319 WOULD PROVIDE
CLARITY ON WHICH HEALTH CARE
FACILITIES NEED TO ADMINISTER
THESE TRAININGS. IT WOULD
REQUIRE IT WOULD PROVIDE CLARITY
ON WHICH EMPLOYEES NEED TO BE
TRAINED. IT WOULD ESTABLISH
DEADLINES FOR WHICH TRAININGS
NEED TO BE COMPLETED, AND IT
WOULD CONFER ENFORCEMENT POWERS
TO THE CALIFORNIA DEPARTMENT OF
PUBLIC HEALTH. AND THE ATTORNEY
GENERAL HERE WITH ME FROM DOJ IS
CARLY EISENBERG, SUPERVISING
DEPUTY ATTORNEY GENERAL, WHO IS
PART OF THE DOJ INVESTIGATION TO
ANSWER ANY TECHNICAL QUESTIONS
THAT YOU MAY HAVE, WE THANK YOU
FOR YOUR TIME AND RESPECTFULLY
ASK FOR AN AYE VOTE. GOOD
AFTERNOON, AND THANK YOU, MADAM
CHAIR AND COMMITTEE MEMBERS. MY
NAME IS GABRIELLE BROWN, AND I
AM THE MATERNAL AND INFANT
HEALTH PROGRAM MANAGER AT BLACK
WOMEN FOR WELLNESS. WE ARE A
REPRODUCTIVE JUSTICE, COMMUNITY
BASED ORGANIZATION COMMITTED TO
IMPROVING THE OVERALL HEALTH
STATUS AND WELL-BEING OF BLACK
WOMEN AND GIRLS. I AM HONORED TO
APPEAR BEFORE YOU TODAY TO
EXPRESS OUR STRONG SUPPORT FOR
ASSEMBLY BILL 2319. THIS BILL IS
OF PARAMOUNT IMPORTANCE AS IT
ADDRESSES THE CRITICAL ISSUES
NECESSARY TO IMPROVE BLACK,
MATERNAL AND INFANT HEALTH
OUTCOMES BY ENSURING THE
SUCCESSFUL IMPLEMENTATION OF
SENATE BILL 464, SB 464
REPRESENTS A SIGNIFICANT
MILESTONE IN OUR STATE'S EFFORTS
TO IMPROVE MATERNAL HEALTH
OUTCOMES BY REQUIRING HOSPITALS
TO IMPLEMENT IMPLICIT BIAS
TRAININGS. THE MINIMUM EFFORT
WITH TREMENDOUS PROMISE TO
ADDRESS AND ESTABLISHED ROOT
CAUSE OF DISPARITIES IN MATERNAL
HEALTH OUTCOMES. HOWEVER, THE
SUCCESS OF THIS LEGISLATION
HINGES UPON THE COMPLIANCE BY
COVERED FACILITIES. WITHOUT THE
PROPER OVERSIGHT AND
ACCOUNTABILITY MEASURES IN
PLACE, THE INTENDED BENEFITS OF
SB FOUR SIX 4TH MAY REMAIN
UNREALIZED, LEAVING COUNTLESS
MOTHERS AT RISK OF PREVENTABLE
HARM. THE URGENCY OF THIS
SITUATION CANNOT BE OVERSTATED.
WE KNOW THAT IN CALIFORNIA,
BLACK WOMEN ARE 3 TO 4 TIMES
MORE LIKELY TO DIE FROM
PREGNANCY RELATED CAUSES THAN
WHITE WOMEN. THESE DISPARITIES
PERSIST ACROSS INCOME LEVELS AND
EDUCATIONAL ATTAINMENT,
HIGHLIGHTING THE PERVASIVE
NATURE OF IMPLICIT BIAS WITHIN
HEALTH CARE. FINDINGS BY
MATERNAL MORTALITY REVIEW
COMMITTEES REVEAL THAT THE
MAJORITY MORE THAN 80% OF THESE
DEATHS, ARE PREVENTABLE. THIS IS
BOTH DEVASTATING AND
UNACCEPTABLE. WORKING IN A
COMMUNITY WHERE BLACK, MATERNAL
AND INFANT HEALTH DISPARITIES
ARE PREVALENT, I HAVE SEEN THE
DEVASTATING CONSEQUENCES OF
IMPLICIT BIAS IN HEALTH CARE
WITHIN THE FIRST THREE MONTHS OF
LAST YEAR. WITHIN LOS ANGELES
COUNTY ALONE, APRIL VALENTINE
AND BRIDGET CROMER DIED
TRAGICALLY WHEN IN THE HOSPITAL
TO GIVE BIRTH. THE TRAGIC
STORIES DETAILING THEIR
PREVENTABLE DEATHS ARE STARK
REMINDERS OF THE PROFOUND AND
DEVASTATING IMPACT THAT IMPLICIT
BIAS CAN HAVE ON THE LIVES OF
BLACK WOMEN, BIRTHING PEOPLE AND
THEIR FAMILIES. THROUGH MY
INTERACTIONS WITH THEIR
PARTNERS, I'VE WITNESSED
FIRSTHAND THE IMMENSE BURDEN
PLACED UPON THEM AS THEY ASSUME
THE SOLE RESPONSIBILITY FOR
THEIR FAMILY'S WELL-BEING,
NAVIGATE THROUGH GRIEF AND
TRAUMA, AND STRIVE TIRELESSLY TO
SEEK ACCOUNTABILITY AND JUSTICE
FOR THEIR LOVED BELOVED SPOUSES.
THESE EXPERIENCES HAVE FUELED MY
COMMITMENT TO ADVOCATING FOR
POLICIES THAT ADDRESS THE ROOT
CAUSES OF THESE DISPARITIES. THE
PASSAGE OF AB 2319 IS A MATTER
OF LIFE AND DEATH FOR COUNTLESS
MOTHERS AND FAMILIES ACROSS OUR
STATE. BY SUPPORTING THIS BILL,
YOU HAVE THE OPPORTUNITY TO MAKE
A TANGIBLE DIFFERENCE IN THE
LIVES OF MOTHERS AND INFANTS,
ENSURING THAT ALL MAMAS AND
BIRTHING PEOPLE RECEIVE THE
QUALITY CARE AND SUPPORT THEY
DESERVE BEFORE, DURING, AND
AFTER CHILDBIRTH. THANK YOU FOR
YOUR TIME AND CONSIDERATION. I
RESPECTFULLY URGE YOUR AYE VOTE
FOR THIS IMPORTANT BILL. THANK
YOU. ARE THERE ANY OTHER
WITNESSES IN SUPPORT COURT?
PLEASE COME FORWARD. STATE YOUR
NAME, ORGANIZATION AND POSITION
ONLY. DEBORAH. DISABILITY RIGHTS
CALIFORNIA AND SUPPORT. GOOD
AFTERNOON, SANDRA POOLE ON
BEHALF OF WESTERN CENTER ON LAW
AND POVERTY, CO-SPONSOR AND IN
STRONG SUPPORT. HI. CAROL
GONZALEZ HERE ON BEHALF OF HOPE
HISPANAS ORGANIZED FOR POLITICAL
EQUALITY AND STRONG SUPPORT.
THANK YOU. DYLAN ELLIOTT, ON
BEHALF OF THE BOARD OF
SUPERVISORS OF THE CITY AND
COUNTY OF SAN FRANCISCO AND THE
CALIFORNIA STATE ASSOCIATION OF
PSYCHIATRISTS, BOTH IN SUPPORT.
THANK YOU, NORA LIN, ON BEHALF
OF CHILDREN NOW IN SUPPORT.
MADONNA WITH CALIFORNIA BLACK
HEALTH NETWORK IN STRONG SUPPORT
. JENNIFER ROBLESS WITH HEALTH
ACCESS CALIFORNIA AND SUPPORT.
ERIN EVANS, ON BEHALF OF TWO
PROUD CO-SPONSORS OF THIS
IMPORTANT BILL, BOTH
REPRODUCTIVE FREEDOM FOR ALL,
WHICH IS FORMALLY NARAL
PRO-CHOICE CALIFORNIA, AS WELL
AS THE CALIFORNIA NURSE MIDWIVES
ASSOCIATION. THANK YOU. MICHELLE
TURAN, WOOLFALK, WITH THE
CALIFORNIA COMMISSION ON THE
STATUS OF WOMEN AND GIRLS IN
STRONG SUPPORT. THANK YOU TO THE
AUTHOR, CRAIG PULSIPHER,
EQUALITY CALIFORNIA, IN SUPPORT.
KELBY LANDE WITH PLANNED
PARENTHOOD AFFILIATES OF
CALIFORNIA IN SUPPORT. KIMBERLY
ROBINSON WITH BLACK WOMEN FOR
WELLNESS AND BLACK WOMEN FOR
WELLNESS ACTION PROJECT, WHO IS
ALSO A CO-SPONSOR FOR IN STRONG
SUPPORT. THANK YOU. ARE ANY
WITNESSES IN OPPOSITION
?
YOU'LL HAVE THREE MINUTES, AND
THE COMMENTS OBVIOUSLY NEED TO
BE PERTINENT TO THE BILL. THANK
YOU. CHAIR AND MEMBERS, MY NAME
IS SOPHIA LARA AND I'M WITH
CALIFORNIA FAMILY COUNCIL.
ACCORDING TO THIS COMMITTEE
BILLS ANALYSIS, AB 2319 SEEKS TO
REDUCE THE EFFECTS OF IMPLICIT
BIAS IN PREGNANCY, CHILDBIRTH
AND POSTNATAL CARE AND THAT THE
LEGISLATURE RECOGNIZES ALL
BIRTHING PEOPLE, INCLUDING
NON-BINARY PERSONS AND PERSONS
OF TRANSGENDER EXPERIENCE. YET
HOW IS IT IMPLICIT BIAS TO
BELIEVE ONLY WOMEN CAN GIVE
BIRTH? THE BIOLOGICAL SCIENTIFIC
TRUTH IS ONLY WOMEN CAN GIVE
BIRTH DURING CHILDBIRTH. THE
CERVIX EXPANDS SO THE BABY CAN
TRAVEL FROM THE UTERUS THROUGH
THE VAGINA. A MAN DOES NOT HAVE
A CERVIX, A UTERUS, OR A VAGINA.
HOW COULD A MAN GET PREGNANT?
HOW WOULD A BABY COME OUT OF A
MAN? THE BILL ANALYSIS
ACCIDENTALLY ACKNOWLEDGED THIS
IN A SECTION TITLED MATERNAL AND
INFANT HEALTH OUTCOMES IN
CALIFORNIA. IT DOESN'T SAY
PATERNAL HEALTH, BUT MATERNAL
HEALTH. SOUNDS LIKE YOUR
COMMITTEE STAFF KNOWS ONLY WOMEN
CAN GIVE BIRTH. DOES YOUR STAFF
NEED IMPLICIT BIAS TRAINING TO
WOMEN ARE NOT BIRTHING PEOPLE,
AS THIS BILL STATES, AND WE MUST
STOP USING BELITTLING LANGUAGE
TO ERASE THE REALITY OF THINGS
ONLY WOMEN CAN DO. LASTLY THE AB
2319 FACT SHEET DISCUSSES HOW
IMPLICIT BIAS IS CAUSING AN
INCREASE IN THE BLACK MATERNAL
MORTALITY RATE. I BELIEVE WE ALL
WANT TO SEE THE BLACK MATERNAL
MORTALITY RATE DECREASE, BUT WE
MUST UNITE IN A SEARCH FOR THE
REAL CAUSES. A 2019 HARVARD
STUDY FOUND THAT OVER THE PAST
DECADE, IMPLICIT BIAS BASED ON
RACE HAS DECREASED BY 17% AND
EXPLICIT BIAS HAS DECREASED BY
37. IF THIS IMPLICIT RACIAL BIAS
REPORTED IN THE HARVARD STUDY
WERE THE SOLE CAUSE OF MATERNAL
MORTALITY, WE WOULD EXPECT
PREGNANCY RELATED MORTALITY IN
THE BLACK COMMUNITY TO DECREASE.
THAT IS NOT WHAT IS OBSERVED
NATIONALLY. IT IS TIME TO LOOK
DEEPER AT THE FACTORS THAT MAY
BE UNIQUE OR OVERREPRESENTED IN
BLACK COMMUNITIES, TO DISCOVER
THE SOURCES OF THE DISPARITIES.
THIS BILL NEEDS TO EXPLORE OTHER
REASONS BESIDES IMPLICIT BIAS TO
EXPLAIN BLACK MATERNAL MORTALITY
RATES. AND IT IS NOT IMPLICIT
BIAS TO KNOW THAT MEN CANNOT GET
PREGNANT. IT IS A FACT. FOR
THESE REASONS, I URGE A NO VOTE
ON AB 2319. THANK YOU. YOU HAVE
THREE MINUTES. THANK YOU. GOOD
AFTERNOON. AARON FRIDAY, LAWYER,
EXECUTIVE COMMITTEE FOR PROTECT
KIDS, CALIFORNIA BALLOT
INITIATIVE, DEMOCRAT AND MOTHER
OF A DAUGHTER WHO USED TO
BELIEVE THAT SHE WAS A BOY. BUT
WITH LOVE AND COMPASSION,
EMBRACED HER FEMALE BODY AB 2319
WILL FORCE FEED MEDICAL
PROFESSIONAL LUNACY. WOMEN
CANNOT CHANGE INTO MEN.
DAUGHTERS CANNOT BECOME SONS.
BIRTHING PEOPLE ARE WOMEN.
NON-BINARY IS A FICTION. HUMANS
ARE A SEXUALLY DIMORPHIC
SPECIES. THE LEGISLATURE
CONTINUES TO PROMOTE A NEW
RELIGION. THE RELIGION OF
TRANSGENDERISM, THAT ONE HAS AN
ETHEREAL, FLUID, INTERNAL SENSE
OF SELF, A GENDERED SOUL, IF YOU
PLEASE, THAT MUST BE ACCEPTED BY
ALL, EVEN THOUGH THERE IS NO
SCIENTIFIC BASIS FOR ITS
EXISTENCE. THIS BILL REQUIRES
THAT ANYONE WHO MIGHT INTERACT
WITH A PREGNANT WOMAN BE
EDUCATED, THAT WOMEN CAN BECOME
MEN WITH SYRINGES OF
TESTOSTERONE OR A SLICE OF THE
SCALPEL TO THE BREASTS. IT
MANDATES THAT CORRECTIVE
MEASURES BE EMPLOYED IF THE
EMPLOYEE BELIEVES IN BIOLOGICAL
REALITY. WHAT DOES CORRECTIVE
MEASURES MEAN? IT SOUNDS LIKE
REEDUCATION CAMPS, TERMINATION
OR PERHAPS THE GULAG. NOW FOR
THE PUNISHMENTS AGAINST A
MEDICAL PROVIDER FOR NOT
COMPLYING WITH THE FORCED
TRANSGENDERISM TRAINING. IT
SHALL BE PUNISHED PURSUANT TO
THE HEALTH AND SAFETY CODE,
SECTION 12 80.3 UPWARDS TO A
COOL $75,000 FOR THE FIRST
INFRACTION AND 125,000 FOR THE
SECOND. THAT'S RIGHT. IF A
MEDICAL PROVIDER DOES NOT PUNISH
AN EMPLOYEE FOR MISGENDERING A
PREGNANT WOMAN OR REFUSING TO
BELIEVE THAT MALES HAVE VAGINAS,
IT CAN BE OUT $75,000 OR MORE
WITH THE PASSAGE OF THIS BILL,
CALIFORNIA WILL BE ONE STEP
CLOSER TO ERASING WOMEN, FORCING
A NEW RELIGION ON THE MEDICAL
COMMUNITY, AND RIPPING AWAY
FIRST AMENDMENT RIGHTS. SO I ASK
YOU AND URGE YOU TO VOTE
ACCORDINGLY. ARE THERE ANY OTHER
WITNESSES IN OPPOSITION IN THE
ROOM? SEEING NONE, I WILL BRING
IT BACK TO THE COMMITTEE FOR
COMMENT OR QUESTION. DOCTOR
WEBER. GOOD AFTERNOON, FIRST I
WANT TO FIRST START BY, REALLY
THANKING OUR ATTORNEY GENERAL
FOR DOING WHAT MANY OF US TALK
ABOUT, WHICH IS OVERSIGHT AND
HOLDING ACCOUNTABILITY,
OFTENTIMES WE PASS BILLS, AND
WE'RE NOT EVEN SURE IF THEY
ACTUALLY GO INTO EFFECT. AND SO
THE FACT THAT THE ATTORNEY
GENERAL OFFICE ACTUALLY LOOKED
TO SEE IF PROVIDERS AND
HOSPITALS WERE DOING THIS
IMPLICIT BIAS TRAINING, AND
FINDING THAT THE VAST MAJORITY
OF THEM WERE NOT, AND
UNDERSTANDING THAT WE NEED TO GO
BACK AND STRENGTHEN THE LANGUAGE
OF THE ORIGINAL BILL. I JUST
REALLY WANT TO ACKNOWLEDGE THAT
AND THANK HIM FOR THAT, I ALSO
WANT TO THANK THE STAFF ON THIS
BILL. I KNOW MY OFFICE HAS
REACHED OUT MANY TIMES TO REALLY
MAKE SURE THAT WE GET THAT
MEDICAL WORDING CORRECTLY,
BECAUSE THAT IS SO VERY
IMPORTANT TO ME. AND I WANT TO
THANK, YOU KNOW, MY CO PRINCIPAL
AUTHOR FOR PRESENTING THIS AND
ALL OF THE OTHER COAUTHORS. AND,
YOU KNOW, I WANT TO ADDRESS THE
ISSUE THAT ONE OF THE, PEOPLE
WHO SPOKE IN OPPOSITION SAID,
YES, YOU ARE CORRECT. IMPLICIT
BIAS IS NOT THE ONLY REASON FOR
THE INCREASED MORBIDITY AND
MORTALITY THAT WE SEE IN AFRICAN
AMERICAN, BIRTHING PEOPLE, AND
THAT'S WHY I TALK SO MUCH ABOUT
SOCIAL DETERMINANTS OF HEALTH,
ONE OF WHICH IS RACISM. AND WHAT
YOU SEE WITH RACISM IS THAT
BLACK WOMEN'S BODIES ARE
WEATHERED DUE TO THE CONSTANT
MICROAGGRESSIONS THAT WE HAVE TO
DEAL WITH ON A DAILY BASIS, SO
THAT WHEN WE BECOME PREGNANT,
OUR BODIES ARE ALREADY TIRED AND
WORN DOWN, BUT WORTHY IMPLICIT
BIAS COMES IN IS WHEN WE GO INTO
THAT DELIVERY ROOM, WHEN WE GO
TO THAT HOSPITAL, WHEN WE GO TO
THAT CLINIC AND AS A BOARD
CERTIFIED OB GYN, I AM ACTUALLY
THERE AND UNDERSTAND WHAT
HAPPENS. BUT WHEN WE GO THERE,
IT'S THAT IMPLICIT BIAS THAT
WHEN THEY SAY, I'M IN PAIN,
SOMETHING IS WRONG. PEOPLE DO
NOT LISTEN TO THEM. SO NO, THIS
IS NOT THE ONLY REASON, BUT IT
IS A MAJOR REASON. AND THIS BILL
WILL HELP PREVENT THAT FROM
HAPPENING SO THAT AT LEAST WHEN
THEY COME IN, EVEN THOUGH THEIR
BODIES ARE WEATHERED AND WE WILL
DEAL WITH THAT TO MAKE SURE THAT
NO WOMAN, REGARDLESS OF YOUR
RACE, WILL COME IN HAVING A
DIFFERENT, STAMINA THAN OTHERS,
BUT ONCE THEY COME INTO THAT
HOSPITAL THAT EVERYONE IS
LISTENED TO, EVERYONE IS
RESPECTED, REGARDLESS OF THEIR
RACE, THEIR GENDER, AND THAT IS
WHAT THIS BILL IS DOING. SO I
WANT TO JUST THANK THE COMMITTEE
FOR ALLOWING IT TO BE HEARD. AND
I WOULD LIKE TO MOVE IT AT THE
APPROPRIATE TIME. THANK YOU SO
MUCH. ANY OTHER COMMENTS, MR.
JONES-SAWYER? AND I WANT TO
THANK DOCTOR WEBER, ATTORNEY
GENERAL BONTA AND REALLY, THE
BLACK CAUCUS FOR, FOR, FOR
TAKING THIS UP, WE'VE TALKED
ABOUT THIS FOR FAR TOO LONG. I
WAS HERE WITH SENATOR MITCHELL,
ASSEMBLY MEMBER MITCHELL. OH, MY
GOD, WHEN SHE BROUGHT THIS UP
AND WAS TRYING TO MAKE THIS
HAPPEN AND SO, AS SOMEONE THAT
WANTED TO DEFINITELY MAKE SURE
WE SUPPORT, BLACK CAUCUS AND
BLACK CAUCUS, PRIORITIES. I
THINK IS VERY IMPORTANT THAT WE
DO THAT AND THAT, WE MOVE
FORWARD AS A BODY TO MAKE SURE
WE PROTECT ALL AFRICAN
AMERICANS, NO MATTER WHAT. AND,
I'M NOT REALLY UNDERSTANDING
WHAT THE OPPOSITION IS, BUT I'M
GOING TO GO AHEAD AND VOTE
TODAY, FOR THIS BILL. AND THANK
YOU, FOR BRINGING THIS FORWARD.
THANK YOU. DO WE HAVE A MOTION?
OH, SORRY. APOLOGIES CHATTING
OVER HERE, ARTHUR, WOULD YOU
LIKE TO CLOSE, I WOULD JUST LIKE
TO, THANK, THE ATTORNEY GENERAL,
AS WAS STATED BY DOCTOR WEBER,
THE ACCOUNTABILITY. OVERSIGHT TO
ENSURE THAT A BILL THAT WAS PUT
FORTH, FROM THIS BODY, WITH THE
FULL SUPPORT AT THAT TIME OF THE
BLACK CAUCUS, WAS LOOKED AT AND
DETERMINED THAT THERE WERE
ASPECTS OF THAT BILL THAT WERE
NOT BEING, HANDLED CORRECTLY AND
THAT IT NEEDED TO BE MORE ROBUST
TO ENSURE NOT ONLY THAT, THE,
THE MATERNAL HEALTH OF BLACK
FOLKS IN CALIFORNIA WAS TAKEN
CARE OF, BUT REALLY ALL, BECAUSE
IMPLICIT BIAS IS NOT JUST ABOUT
RACISM, IT'S ABOUT ALL THINGS,
AND SO I'M, I'M, I'M REALLY
THANKFUL FOR THAT. I'M THANKFUL
FOR THE BLACK CAUCUS CONTINUED
SUPPORT ON THIS. AND I
RESPECTFULLY ASK FOR AN AYE VOTE
. I WANT TO THANK THE AUTHOR FOR
BRINGING FORWARD THIS
LEGISLATION AS A MEMBER OF THE
BLACK CAUCUS. AND, YOU AS CHAIR
OF THE BLACK CAUCUS, VERY
THANKFUL THAT YOU ARE ENSURING
THAT WE CONTINUE TO MITIGATE THE
EFFECTS OF IMPLICIT BIAS AND
EXPLICIT BIAS IN HEALTH CARE.
MADAM CHAIR, CAN I CAN I? I
FORGOT TO STATE ONE STATEMENT IS
THAT IT'S OKAY TO ASK, AND I
WOULD JUST LIKE TO NOTE, AND
JUST STATE FOR THE RECORD,
BECAUSE I FIRMLY BELIEVE IT, AND
I THINK IT'S IMPORTANT TO BE
SAID IN THIS MOMENT THAT
NON-BINARY PEOPLE AND MEN OF THE
TRANSGENDER EXPERIENCE GIVE
BIRTH. THANK YOU FOR, STATING
THE OBVIOUS, BUT IT DID NEED TO
BE SAID WITH THAT, PLEASE CALL
THE ROLL. THE MOTION IS DUE.
PASS TO APPROPRIATIONS TO I TO I
WALDRON. WALDRON. I AGUIAR-CURRY
AGUIAR-CURRY I ARAMBULA ARAMBULA
I WENDY CARILLO LARA HANEY, JOAN
SAWYER, JOAN SAWYER I MAINCHAIN
MAINCHAIN I MCCARTY. JOE
PATTERSON. RODRIGUEZ. RODRIGUEZ
I SANCHEZ. SANCHEZ. NØ. SANTIAGO
CHAVO WEBBER. WEBBER I. THAT
MOTION THAT MEASURES ON CALL.
WHILE WE WAIT. OH, THERE WE GO.
ORTEGA'S HERE, WE WILL MOVE TO
ITEM NUMBER 15. ORTEGA A B 2446.
YOU MAY PROCEED. ASSEMBLY MEMBER
. THANK YOU, MADAM CHAIR AND
MEMBERS, FOR THE OPPORTUNITY TO
PRESENT AB TWO 4446 TODAY, THIS
BILL WILL PROVIDE MEDICALLY
NECESSARY DIAPERS THROUGH THE
MEDI-CAL, THROUGH MEDI-CAL TO
CHILDREN 21 YEARS AND YOUNGER,
AS MANDATED BY THE FEDERAL EARLY
AND PERIODIC SCREENING DIAGNOSIS
EXPANDING ACCESS TO PRESCRIPTION
DIAPERS. MEDICAL PATIENTS WILL
NOT ONLY ELIMINATE THE CONFLICT
BETWEEN CALIFORNIA AND FEDERAL
LAW, BUT WILL LIGHTEN THE
FINANCIAL, PHYSICAL, AND MENTAL
COST OF DIAPER NEEDS FOR
MILLIONS OF CALIFORNIANS. AS A
YOUNG MOTHER, WHO HAD TWO LITTLE
BOYS BY THE TIME SHE WAS 21
YEARS OLD, I UNDERSTAND THE NEED
FOR DIAPERS AND HAVING TO MAKE
THAT DIFFICULT CHOICE OF WHETHER
TO BUY FORMULA OR A DIAPER IS
ONE THAT OUR MOTHERS OR FATHERS
SHOULD NOT HAVE TO MAKE. AND THE
FIFTH LARGEST ECONOMY IN THE
WORLD, TODAY I HAVE A WITNESS
TESTIFYING ON BEHALF OF THIS
BILL, MISS BECKY SILVA FROM THE
CALIFORNIA ASSOCIATION OF FOOD
BANKS. MOVED BY ARAMBULA.
SECONDED BY RODRIGUEZ. YOU HAVE
THREE MINUTES. THANK YOU. THANK
YOU, MADAM CHAIR. AND MEMBERS OF
THE COMMITTEE, BECKY SILVA WITH
THE CALIFORNIA ASSOCIATION OF
FOOD BANKS, CURRENTLY, A QUARTER
OF CALIFORNIA HOUSEHOLDS WITH
CHILDREN ARE FOOD INSECURE WITH
DEEP DISPARITIES FOR BLACK AND
LATINX HOUSEHOLDS. AND WE KNOW
THAT HOUSEHOLDS THAT EXPERIENCE
FOOD INSECURITY ALSO FACE
BARRIERS IN AFFORDING OTHER
BASIC NECESSITIES, IF YOU'RE
WONDERING WHY THE CALIFORNIA
ASSOCIATION OF FOOD BANKS IS SO
PASSIONATE ABOUT THIS ISSUE,
IT'S BECAUSE DIAPERS ARE ONE OF
THE MOST COMMON NON-FOOD
PRODUCTS REQUESTED BY FAMILIES
WHO VISIT FOOD BANKS, PANTRIES,
AND OTHER COMMUNITY
ORGANIZATIONS, DIAPERS ARE NOT
MERELY ESSENTIAL TO KEEPING
INFANTS HEALTHY AND SAFE. MOST
CHILD CARE FACILITIES ACTUALLY
REQUIRE PARENTS TO PROVIDE
DIAPERS FOR ANY CHILDREN LEFT IN
THEIR CARE. ACCORDING TO THE
NATIONAL DIAPER BANK NETWORK,
CLOSE TO 60% OF PARENTS REPORTED
MISSING AN AVERAGE OF FOUR DAYS
OF SCHOOL OR WORK IN A MONTH
BECAUSE THEY DIDN'T HAVE ENOUGH
DIAPERS TO LEAVE WITH THEIR
CHILD CARE PROVIDERS. THIS
FORCES FAMILIES DEEPER INTO
POVERTY. FOR EVERY DOLLAR A
FAMILY HAS TO SPEND, MATTERS,
ESPECIALLY AT A TIME WHEN ALMOST
60% OF FAMILIES IN CALIFORNIA
LIVE PAYCHECK TO PAYCHECK AND
REALLY STRUGGLE TO MAKE ENDS
MEET. THE DECISION FOR FAMILIES
TO CHOOSE BETWEEN PUTTING THEIR
MONEY TOWARDS PAYING RENT, FOOD
OR BUYING DIAPERS FOR THEIR
CHILD IS A DECISION THAT NO
CAREGIVER SHOULD HAVE TO MAKE.
THERE ARE REAL AND PAINFUL
CONSEQUENCES FOR THE BABY WHEN
PARENTS CAN'T AFFORD ENOUGH
DIAPERS, BUT THIS ISSUE IMPACTS
THE ENTIRE FAMILY. THE INABILITY
TO ADEQUATELY DIAPER AN INFANT
OR TODDLER HAS BEEN FOUND TO
INCREASE RATES OF FAMILY HUNGER
OVERALL, AND DIAPER NEED IS
LINKED TO MATERNAL DEPRESSION,
STRESS AND ANXIETY, WHICH CAN
LEAD TO HEALTH PROBLEMS FOR THE
PARENTS, LIKE HIGH BLOOD
PRESSURE AND HEART DISEASE. SO
FOR ALL OF THESE REASONS, WE'RE
REALLY PROUD TO SUPPORT THIS
BILL AND WE URGE YOUR AYE VOTE
TODAY. THANK YOU, THANK YOU. DO
WE HAVE ANY OTHER WITNESSES IN
THE ROOM IN SUPPORT? PLEASE
STATE YOUR NAME. ORGANIZATION
AND POSITION. GOOD AFTERNOON.
JOSH AUGER, ON BEHALF OF THE
CALIFORNIA ASSOCIATION OF DIAPER
BANKS AND SUPPORT. GOOD
AFTERNOON, WHITNEY FRANCIS WITH
WESTERN CENTER ON LAW AND
POVERTY IN SUPPORT. RYAN
SPENCER, ON BEHALF OF THE
CALIFORNIA ASSOCIATION OF
MEDICAL PRODUCT SUPPLIERS AND
SUPPORT. THANK YOU. DO WE HAVE
ANY PRIMARY WITNESSES IN
OPPOSITION? NO WITNESSES IN
OPPOSITION. WE WILL BRING IT
BACK TO THE COMMITTEE AT THIS
TIME. DOCTOR WEBER. GOOD
AFTERNOON. THANK YOU SO MUCH FOR
THIS VERY, VERY IMPORTANT BILL.
WHEN I WAS READING IT, I WAS
STRUCK BY THE FACT THAT URINARY
TRACT INFECTIONS AND COLIC WERE
SPECIFICALLY LISTED AS
CONDITIONS THAT WOULD BE
COVERED. AND I WAS A LITTLE
CONFUSED BY THAT, BECAUSE COLIC
ISN'T REALLY SOMETHING THAT IS
KNOWN TO CAUSE LIKE DIARRHEA OR
ANYTHING. IT'S USUALLY GAS. AND
I WASN'T REALLY SURE WHY
SPECIFICALLY THAT. AND THEN WITH
URINARY TRACT INFECTIONS, SOME
OF IT COULD BE DUE TO HYGIENE,
BUT IT COULD BE OTHER REASONS IN
INFANT AND TODDLER, SUCH AS
REFLUX AND THINGS THAT HAS
ABSOLUTELY NOTHING TO DO WITH
DIAPERS. SO BREAKING THOSE TWO
THINGS OUT SPECIFICALLY WAS A
LITTLE CONFUSED FOR ME, AND WAS
THINKING THAT IT, IT MIGHT BE
BETTER TO JUST KIND OF WORD IT
AS ANY CONDITION, NOT
NECESSARILY OF THE SKIN YOU HAVE
THE SKIN. YOU KNOW THAT IN THE
JUDGMENT OF THE CLINICIAN, IT'S
RELATED TO INADEQUATE DIAPER
HYGIENE, AT RISK OF
REOCCURRENCE, YOU KNOW, WHICH
YOU HAVE DOWN THERE BECAUSE THE
COLIC AND THE UTI. I WAS REALLY
TRYING MY HARDEST TO UNDERSTAND
THAT, SO AS YOU'RE GOING
FORWARD, AS YOU'RE MOVING THIS
BILL FORWARD, YOU MIGHT WANT TO
JUST KIND OF TWEAK THAT A LITTLE
BIT. BUT THANK YOU. ABSOLUTELY.
THANK YOU FOR THAT. AND YEAH,
WE'RE WE'LL DEFINITELY CONTINUE
TO WORK ON IT. MY GOAL HERE IS
TO MAKE SURE THAT, YOU KNOW, AS
MANY BABIES AND CHILDREN HAVE
ACCESS TO THIS CRITICAL NEED,
BUT DEFINITELY WE'LL CONTINUE TO
WORK ON IT. THANK YOU. WITH
THAT, I THINK WE HAVE A MOTION.
AND A SECOND. I WANT TO THANK
THE AUTHOR FOR BRINGING FORWARD
THIS BILL. IT'S ABSOLUTELY
CRITICAL FOR OUR FOR TO HAVE THE
KIND OF COVERAGE THAT WILL
ENSURE THAT PEOPLE DON'T
NECESSARILY NEED TO HAVE A
CRITICAL THING, LIKE DIAPERS,
NOT PROVIDED FOR THEM, AUTHOR,
WOULD YOU LIKE TO CLOSE? I
RESPECTFULLY ASK FOR YOUR AYE
VOTE. THANK YOU. MOTION IS Dð
PASS, AS AMENDED, TO
APPROPRIATIONS. PLEASE CALL THE
ROLL ONTO. AYE. ONTO. AYE.
WALDRON. WALDRON. AYE
AGUIAR-CURRY. AGUIAR-CURRY. AYE.
ARAMBULA. ARAMBULA AYE. WENDY.
CARILLO. LARA. HANEY JONES.
SAWYER. A COLICKY. YES. JOAN.
SAWYER. AYE MAINTAIN. MAINTAIN.
AYE. MCCARTY. JOE. PATTERSON
JOE. PATTERSON. AYE. RODRIGUEZ.
RODRIGUEZ. AYE SANCHEZ. SANCHEZ.
AYE. SANTIAGO CHAVO. WEBER.
WEBER. AYE. SATISFY. THAT
MEASURE HAS TEN VOTES TO ZERO.
IT IS OUT. THANK YOU. YOU HAVE A
SECOND BILL. ITEM NUMBER 18, AB
2753. PLEASE GO AHEAD AND
PRESENT. THANK YOU, ASSEMBLY
MEMBER JACKSON, FOR YOUR
PATIENCE
.
THANK YOU, MADAM CHAIR AND
MEMBERS, FOR THE OPPORTUNITY TO
PRESENT AB 2753 BEFORE YOU ALL
TODAY. THIS BILL WOULD CLARIFY
THE DURABLE, DURABLE MEDICAL
EQUIPMENT OR DME IS COVERED
ESSENTIAL HEALTH BENEFIT AND
INDIVIDUAL AND SMALL GROUP
HEALTH PLANS WHEN MEDICALLY
NECESSARY. AND PRESCRIBE BY A
HEALTH CARE PROVIDER. DURABLE
MEDICAL EQUIPMENT ENABLES AN
INDIVIDUAL'S BASIC FUNCTIONING
SUCH AS MOBILITY, BREATHING,
COMMUNICATION, THÀNH, AND IT'S
PRIMARILY USED BY PEOPLE WITH
DISABILITIES AND CHRONIC
CONDITIONS WITH ACCESS TO DME,
PEOPLE WITH DISABILITIES CAN
MAINTAIN THEIR HEALTH, PURSUE
EDUCATION AND EMPLOYMENT, AND
PARTICIPATE FULLY IN COMMUNITY
AND FAMILY LIFE. YET CURRENTLY,
PRIVATE HEALTH PLANS OFFERED IN
CALIFORNIA GENERALLY DO NOT
PROVIDE ADEQUATE COVERAGE OF DME
. MANY HEALTH PLANS COMPLETELY
EXCLUDE MOST DME ITEMS LIKE
WHEELCHAIRS, HEARING AIDS, AND
VENTILATORS. OTHER PLANS IMPOSE
A $2,000 ANNUAL LIMIT ON DME
ITEMS, WHICH ONLY COVERS A
FRACTION OF THE COST OF MOST DMS
. WITHOUT ADEQUATE COVERAGE,
MANY PEOPLE GO WITHOUT MEDICALLY
NECESSARY DEVICES AND OBTAIN
INFERIOR ONES THAT PUT THEIR
HEALTH AND SAFETY AT RISK. WITH
ME TODAY TESTIFYING ON BEHALF OF
AB 2753 ARE CARLY MYERS WITH THE
NATIONAL HEALTH LAW PROGRAM. AND
WE ALSO HAVE JIM LABRECK, A
CONSUMER WHO HAS EXPERIENCED
FIRSTHAND ISSUES WITH DME DENIAL
. THANK YOU. YOU'LL EACH HAVE
THREE MINUTES. THANK YOU. GOOD
AFTERNOON. MY NAME IS CARLY
MYERS AND I'M A STAFF ATTORNEY
WITH THE NATIONAL HEALTH LAW
PROGRAM, A NONPROFIT PUBLIC
INTEREST LAW FIRM THAT PROTECTS
AND ADVANCES THE HEALTH CARE
RIGHTS OF LOW INCOME AND
UNDERSERVED INDIVIDUALS AND
FAMILIES. MANY CALIFORNIANS DO
NOT HAVE ACCESS TO THE
WHEELCHAIRS, HEARING AIDS,
VENTILATORS AND OTHER DURABLE
MEDICAL EQUIPMENT THAT THEY NEED
. PRIVATE HEALTH PLANS IN
CALIFORNIA'S INDIVIDUAL AND
SMALL GROUP MARKETS REGULARLY
EXCLUDE OR SEVERELY LIMIT
COVERAGE OF THIS EQUIPMENT.
THESE POLICIES DISPROPORTION
HARM PEOPLE WITH DISABILITIES
WITHOUT ACCESS TO THE DEVICES
THEY NEED FOR THE BASIC
FUNCTIONS, SUCH AS BREATHING,
COMMUNICATION AND MOBILITY. A
PERSON'S HEALTH INDEPENDENCE AND
LIVELIHOOD IS COMPROMISED.
CHILDREN ARE UNABLE TO ATTEND
SCHOOL AND MAY FACE
DEVELOPMENTAL DELAYS. ADULTS ARE
UNABLE TO WORK, TRAVEL TO THE
DOCTOR'S OFFICE, OR SUPPORT
THEIR FAMILIES. SOME
CALIFORNIANS HAVE BEEN FORCED TO
QUIT THEIR JOBS OR TAKE REDUCED
SALARIES IN ORDER TO QUALIFY FOR
MEDI-CAL, WHICH DOES COVER
COMPREHENSIVE DME. OTHERS HAVE
BEEN INSTITUTIONALIZED BECAUSE
THEY CANNOT FUNCTION IN THEIR
OWN HOMES WITHOUT NEEDED DME.
FURTHER, PERVASIVE HOME USE
RULES, WHICH LIMIT COVERAGE TO
THE DEVICES AND INDIVIDUAL NEEDS
INSIDE THEIR HOME, TO THE
EXCLUSION OF DEVICES THAT THEY
MAY NEED TO TRAVEL EVEN TEN FEET
OUTSIDE, SERVED TO FURTHER
SEGREGATE PEOPLE WITH
DISABILITIES FROM THEIR
COMMUNITIES. AB 2753 WOULD
CORRECT THIS INJUSTICE. IT WOULD
CLARIFY THAT MEDICALLY NECESSARY
DME IS A COVERED ESSENTIAL
HEALTH BENEFIT IN CALIFORNIA,
AND IT WILL STOP THE
DISCRIMINATORY POLICIES THAT
HAVE ISOLATED AND DEVALUED THE
LIVES OF PEOPLE WITH
DISABILITIES FOR DECADES. THIS
BILL WOULD BE COST NEUTRAL TO
THE STATE WHEN AN ESSENTIAL
HEALTH BENEFIT IS ADDED FOR THE
PURPOSE OF COMPLYING WITH
FEDERAL REQUIREMENTS, INCLUDING
FEDERAL NON DISCRIMINATION LAW,
THEN THE STATE IS NOT
RESPONSIBLE FOR DEFRAYING THE
COST OF THAT BENEFIT. THIS THIS
BILL FALLS WITHIN THAT EXCEPTION
TO THE FRAIL PROVIDING THE STATE
A TIMELY AND PRUDENT VEHICLE TO
CORRECT THIS INEQUITY WITH NO
IMPACT ON THE STATE BUDGET. IN A
TREMENDOUS IMPACT ON THE LIVES
OF THE CHILDREN AND ADULTS THAT
NEED DURABLE MEDICAL EQUIPMENT
TO FUNCTION AND LIVE FULL LIVES
WITH EQUAL OPPORTUNITY. WE
STRONGLY URGE YOUR SUPPORT OF AB
2753. THANK YOU, THANK YOU.
PLEASE GO AHEAD. MADAM CHAIR,
AND EVERYONE ELSE, I'M
ESPECIALLY HAPPY TO BE HERE AS
ONE OF YOUR CONSTITUENTS TODAY.
I'M REALLY GRATEFUL FOR THIS
OPPORTUNITY TO SPEAK IN SUPPORT
OF THIS BILL. I'D LIKE TO SHARE
MY LIVED EXPERIENCE OF WHAT IT'S
LIKE AND WHAT IT MEANS TO ME TO
LIVE WITH THE CURRENT DOLLAR
CAPS AND HOME USE LIMITS OF DME
COVERAGE UNDER PRIVATE INSURANCE
COVERAGE USING A WHEELCHAIR HAS
BEEN PART OF MY LIFE SINCE I WAS
TWO YEARS OLD. WHEN I FIRST
UNDERSTAND STOOD THAT MY
INSURANCE WOULD ONLY PAY FOR
ITEMS USING THE HOME I WAS
HEARTBROKEN AND OUTRAGED THAT
THIS WAS THE LAW. TOLD ME HOW
MOST OF SOCIETY AND ELECTED
OFFICIALS THOUGHT OF ME AND THE
DISABLED COMMUNITY. WHY WOULDN'T
THEY PAY FOR A WHEELCHAIR THAT
WOULD ALLOW ME TO RELIABLY
TRAVEL AWAY FROM MY HOME? WHY
WASN'T IT CONSIDERED NECESSARY
FOR US TO HAVE ACCESS TO THE
WORLD AROUND US? I HAD TO ASSUME
THAT IT WAS THE POWERS THAT BE
THAT DIDN'T VALUE MY COMMUNITY'S
QUALITY OF LIFE, AND THAT THEY
DIDN'T BELIEVE THAT THE COST TO
MAKE SURE WE COULD LEAVE OUR
HOMES WAS JUSTIFIED, AS OUR
SOCIETY ONLY THINK OF THE
DISABLED AS SICK PEOPLE WHO ARE
ONLY ABLE TO LIVE AT HOME AND
NOT HOLD A JOB. DO YOU THINK WE
ARE INSIGNIFICANT OR DISPOSABLE?
WAS IT UNTHINKABLE THAT I WOULD
BE ABLE TO START MY OWN COMPANY
AND CREATE JOBS? DO YOU VALUE US
AS HUMAN BEINGS LIKE EVERYBODY
ELSE? MY LIVED EXPERIENCE IS
THIS I STARTED AN AUDIO COMPANY
AND HIRED SEVERAL SEVERAL
EMPLOYEES. I AND MY COMPANY PAID
TAXES AND PROVIDED AN AFFORDABLE
AND NEEDED SERVICE TO THE LOCAL
FILM COMMUNITY. AND WHEN THE
OPPORTUNITY AROSE, I AND DOZENS WERE EMPLOYED OVER
EMPLOYED OVER FIVE YEARS TO
CREATE OSCAR NOMINATED
DOCUMENTARY CRIP CAMP. AND WE
PAID FOR SERVICES FROM AT LEAST
A DOZEN COMPANIES. I'M TALKING
ABOUT WELL OVER $1 MILLION. I
DON'T LIKE EQUATING SOMEONE'S
VALUE TO ECONOMICS, BUT I AM
TELLING YOU THAT THE BENEFITS OF
THIS BILL FAR OUTWEIGH THE COST.
WHEN WE ALLOW SENIORS AND THE
DISABLED TO FULLY PARTICIPATE IN
DAILY LIVING, EVERYONE BENEFITS.
IT'S NOT A ONE WAY STREET. DUE
TO WEAR AND TEAR. IF I WAS
GETTING MY INSURANCE FROM AN
INSURER WHO OPERATES UNDER THESE
CAPS, I WOULD BE IN DANGER OF
LOSING MY FREEDOM. MY AND MY
INDEPENDENCE IF I COULD NOT
AFFORD TO PAY FOR AN INFERIOR,
LOW COST WHEELCHAIR. YOU WANT ME
AND MY COMMUNITY TO THRIVE,
CREATE JOBS, AND BRING THEIR
VIGOROUS SPIRIT OUT IN THE OPEN.
PUSH BACK ON THIS HORRIBLE FALSE
STEREOTYPES OF PEOPLE LIKE ME
AND CHAMPION THIS BILL. THIS IS
NOT CHARITY. WHY DO I HAVE TO
COME BEFORE YOU AND CONVINCE YOU
THAT I AND MY COMMUNITY SHOULD
BE AFFORDED THE RESOURCES THAT
ALLOW US ABILITIES YOU ENJOY BY
DEFAULT? THANK YOU SO MUCH.
THANK YOU FOR THAT. ANY OTHER
WITNESSES IN SUPPORT PLEASE COME
TO FORWARD STATE YOUR NAME,
ORGANIZATION AND POSITION.
SANDRA POOLE ON BEHALF OF
WESTERN CENTER ON LAW AND
POVERTY. CO-SPONSOR AND STRONG
SUPPORT. DEB ROTH WITH
DISABILITY RIGHTS CALIFORNIA AND
STRONG SUPPORT. THANK YOU. DÂN
OAKLAND, CALIFORNIA FOUNDATION
FOR INDEPENDENT LIVING CENTERS
IN SUPPORT. CHRISTINE SMITH,
HEALTH ACCESS CALIFORNIA FOR IN
STRONG SUPPORT. ROTHSCHILD,
CALIFORNIA ASSOCIATION OF PUBLIC
AUTHORITIES FOR IN-HOME SUPPORT
SERVICES AND SUPPORT. ADAM
ZARIN, LEUKEMIA AND LYMPHOMA
SOCIETY IN SUPPORT. BRIAN
SPENCER, ON BEHALF OF THE
CALIFORNIA ASSOCIATION OF
MEDICAL PRODUCT SUPPLIERS, IN
SUPPORT. SOUMYA NASSAR WITH THE
CALIFORNIA CHILDREN'S SPECIALTY
CARE COALITION IN SUPPORT. DAVID
GONZALEZ, CALIFORNIA LIFE
SCIENCES AND SUPPORT. JOSH
GAGER, ON BEHALF OF THE COUNTY
HEALTH EXECUTIVES ASSOCIATION OF
CALIFORNIA AND SUPPORT. NORA LIN
ON BEHALF OF CHILDREN NOW AND
LET CALIFORNIA KIDS HERE IN
SUPPORT. THANK YOU. ARE THERE
ANY WITNESSES IN OPPOSITION?
THANK YOU. YOU'LL HAVE THREE
MINUTES EACH. MADAM CHAIR AND
MEMBERS. STEPHANIE WATKINS, ON
BEHALF OF THE ASSOCIATION OF
CALIFORNIA LIFE AND HEALTH
INSURANCE COMPANIES.
UNFORTUNATELY, HERE IN
OPPOSITION TODAY, I THINK ALL OF
OUR HEARTS GO OUT TO MANY OF THE
STORIES WE HEAR AND THIS IS ONE
OF MANY MANDATES THAT YOU WILL
SEE THIS YEAR, COME BEFORE YOU
FOR CONSIDERATION. I THINK JUST
AS KIND OF TO GO DOWN HISTORY,
MANY OF YOU MAY REMEMBER IN 2012
WAS THE ACA WAS FIRST BEING
ADOPTED INTO CALIFORNIA. WE DID
CHOOSE THE BENCHMARK PLAN AND
THE KAISER 30 PLAN. THAT WAS
SOMETHING THAT WAS HIGHLY
DEBATED, DISCUSSED. IT WAS
BEFORE THE LEGISLATURE AND
MILLIMAN DID EXTENSIVE STUDIES
ON WHAT THAT BENCHMARK PLAN
WOULD LOOK LIKE. IT WAS NEVER
MEANT TO BE THE CEILING, BUT
ALWAYS MEANT TO BE THE FLOOR, AS
AFFORDABILITY AND ACCESS WAS
ALWAYS CLEARLY IMPORTANT TO
INDIVIDUALS. AS WE MOVED ON
SEVERAL YEARS LATER, WE
RE-ADOPTED THAT AND MADE
CONFORMING CHANGES RELATED TO
HABILITATIVE AND REHABILITATIVE
SERVICES TO ENSURE THAT THE PLAN
CONFORMED TO THE FEDERAL
GUIDELINES. WITH THAT, WE ARE
HERE TODAY. WE ABSOLUTELY
UNDERSTAND THAT THIS IS A BROAD
DISCUSSION. WE'VE SEEN BILLS
BEFORE ON HEARING AIDS AND OTHER
DME. WE THINK THAT THAT IS A
VALUABLE CONVERSATION TO HAVE,
BUT ONE THAT SHOULD BE HAD IN A
BROADER PERSPECTIVE, SENATOR
ROTH, THE CHAIR OF HEALTH
COMMITTEE, DOES HAVE A BILL THIS
YEAR TO REVISIT THAT DISCUSSION
OF THE BENCHMARK PLAN. AND WE
THINK THAT THIS WOULD BE BETTER
SUITED TO HAVE THAT IN THAT
BROADER CONVERSATION, ESPECIALLY
AS YOU WILL SEE MANY OTHER
MANDATES THAT ARE CRITICAL TO
INDIVIDUALS THAT THEY FEEL VERY
PASSIONATE ABOUT THAT SHOULD BE
CONSIDERED AND DISCUSSED AS
WELL. SO UNFORTUNATELY, WHILE WE
ARE IN OPPOSITION TO THE BILL
BEFORE YOU TODAY, WE ARE IN
SUPPORT AND CONCEPT OF LOOKING
AT THE BENCHMARK PLAN AND
TOTALITY AND CONSIDERING THAT AS
IT MOVES FORWARD OUT OF THE
SENATE. THANK YOU, GOOD
AFTERNOON, CHAIR, AND MEMBERS OF
THE COMMITTEE, ROBERT BOYKIN
WITH THE CALIFORNIA ASSOCIATION
OF HEALTH PLANS, WE WOULD LIKE
TO ALIGN OUR COMMENTS WITH ALEX,
TESTIMONY ON THE BILL,
REGRETTABLY, IN OPPOSITION TO AB
2753, WE RESPECT AND UNDERSTAND
THE AUTHOR'S ATTEMPT TO INCLUDE
DURABLE MEDICAL EQUIPMENT UNDER
THE ESSENTIAL HEALTH BENEFITS
BENCHMARK PLAN. AS NOTED IN THE
ANALYSIS AND AS MENTIONED
EARLIER, SENATE BILL 1290 WAS
INTRODUCED THIS YEAR AND
EXPRESSES THE INTENT OF THE
LEGISLATURE TO REVIEW
CALIFORNIA'S HB BENCHMARK PLAN
AND ESTABLISH A NEW BENCHMARK
PLAN FOR THE 2027 YEAR, WE LOOK
FORWARD TO THAT DISCUSSION AND
FEEL THAT ANY NEW MANDATES THAT
CURRENTLY EXCEED THE AHBS, WHICH
WILL LEAD THE STATE ON THE HOOK
FOR THE DEFRAYED COST, SHOULD BE
LEFT FOR DISCUSSION ON A
POSSIBLE NEW BENCHMARK PLAN FOR
THESE REASONS STATED, WE
RESPECTFULLY ASK FOR A NO VOTE.
THANK YOU FOR YOUR TIME TODAY.
ARE THERE ANY OTHER WITNESSES IN
OPPOSITION? PLEASE COME FORWARD.
STATE YOUR NAME, ORGANIZATION
AND POSITION. THANK YOU, MADAM
CHAIR. JACKIE ONIS, ON BEHALF OF
THE AMERICA'S HEALTH INSURANCE
PLANS AND RESPECTFUL OPPOSITION.
THANK YOU. THANK YOU. WITH THAT,
I WILL BRING IT BACK TO THE
COMMITTEE FOR COMMENTS OR
QUESTION. MR. JONES-SAWYER, AND
I WANT TO THANK YOU FOR BRINGING
THIS. I MEAN, I PROBABLY
MENTIONED THIS A MILLION TIMES
TO THIS COMMITTEE AND TO OTHER
COMMITTEES, THAT MY BROTHER IS
BLIND. AND WHEN HE WAS IN
ELEMENTARY SCHOOL, HE WAS TOLD
HE COULDN'T BRING HIS SEEING EYE
DOG. WE REVERSED THAT. THEN HE
NEEDED BRAILLE. THEY TOLD HIM
THEY WOULDN'T PROVIDE BRAILLE IN
THE DC SCHOOL SYSTEM. WE
REVERSED THAT WHEN HE GOT TO
COLLEGE. HE NEEDED READERS IN
THE MARYLAND UNIVERSITY SYSTEM.
THEY REFUSED TO DO THAT. WE
SUED. THEY GOT HIM THAT, THEY
PROVIDED HIM TRANSPORTATION AND
SOME OTHER THINGS, TODAY MY
BROTHER, AS A PHD FROM THE
MARYLAND UNIVERSITY OF MARYLAND,
HE'S GETTING READY TO RETIRE
FROM THE DC SCHOOL SYSTEM AS AN
ASSISTANT PRINCIPAL. AND, HE'S
PROVIDED A VALUE TO STUDENTS IN
THE DC SCHOOL SYSTEM BECAUSE
HE'S VERY KEEN AT LISTENING, AND
HE'S A DEAN OF STUDENT
DISCIPLINE, AND HE FINDS OUT
WHAT'S GOING ON AND PEOPLE TELL
HIM WHAT'S GOING ON. SO WHEN THE
KIDS COME IN AND SAY, HEY, YOU
KNOW, I HAVEN'T DONE ANYTHING,
YOU CAN'T SEE ME. HE'LL SAY,
WELL, YOU'RE IN A RED JACKET.
AND I KNOW YOU WERE SMOKING DOPE
BEHIND THE BEHIND THE BENCH.
AND, BUT THE THING THAT THAT
REALLY GETS THOSE KIDS IS WHEN
THEY START CRYING ABOUT, YOU
KNOW, DOG ATE MY HOMEWORK. I
CAN'T GET TO SCHOOL ON TIME, YOU
KNOW, I HAVE PROBLEMS AT HOME
AND EVERYTHING. MY BROTHER WILL
SAY, WELL, I'M BLIND AND I HAVE
A PHD. WHAT'S YOUR EXCUSE? SO
THERE'S ANOTHER VALUE TO PEOPLE
WHO HAVE DISABILITIES MOVING
INTO THE MAINSTREAM, BECAUSE WE
ALWAYS MAINSTREAMED HIM IN THE
SYSTEM AND INSISTED ON THAT. AND
I THINK HE'S BECOME A VERY
VALUABLE COMMODITY. AND THAT'S
JUST A TEACHER AND NOT A FILM
PRODUCER. BUT IT IS A TEACHER,
SOMEBODY THAT I THINK ALL
STUDENTS SHOULD SEE THAT AND
SHOULD KNOW THAT JUST BECAUSE
YOU HAVE A CHALLENGE OR PHYSICAL
CHALLENGE, IT DOESN'T STOP YOU.
AND THAT WE SHOULD PROVIDE ALL
THE NECESSARY, TOOLS. IF YOU
DIDN'T HAVE ANY OF THOSE TOOLS,
THINK ABOUT IT ANYWHERE ALONG
THE WAY. YOU DIDN'T HAVE ANY OF
THOSE TOOLS. I DON'T THINK YOU
WOULD HAVE MADE IT WHERE HE IS.
AND SO I'M VOTING FOR IT TODAY.
THANK YOU ALL FOR BRINGING THIS
FORWARD. MR. PATTERSON, THANK
YOU. WE HAD, WELL, EXCHANGE A
COUPLE MESSAGES ON THIS, YOU
KNOW, I THINK IT'S I'VE
SUPPORTED IN THIS COMMITTEE IN
THE PAST, LIKE, FOR EXAMPLE,
CHILDREN WITH HEARING AIDS, YOU
KNOW, BECAUSE IF A KID CAN
OBTAIN A HEARING AID, YOU KNOW,
WHEN THEY'RE YOUNGER OR IF THEY
DON'T, THEIR ABILITY TO HAVE ALL
SORTS OF OTHER, YOU KNOW, BE
ABLE TO HEAR THE TEACHER THEIR
ANXIETY IN SCHOOL AND THINGS
LIKE THAT, YOU KNOW, PROVE
OBVIOUSLY IF THEY HAVE A HEARING
AID. AND SO WE'VE HAD BILLS COME
THROUGH HERE AND, YOU KNOW, PASS
GO ALL THE WAY TO THE GOVERNOR
AND GET VETOED, AND I JUST LOOK
AT THAT AS LIKE ONE EXAMPLE IN
THIS BILL THAT IS A REALLY GOOD
THING, OBVIOUSLY, I THINK, YOU
KNOW, PEOPLE HAVING WHEELCHAIRS
AND I MEAN, IT'S PRETTY
IMPORTANT, AND NECESSARY AND
IT'S, IT'S IS KIND OF CRAZY TO
ME TO THINK THAT THAT'S NOT
AVAILABLE, YOU KNOW, FOR SOME
PEOPLE, I THINK I'M NOT QUITE
THERE YET, ONLY BECAUSE I'M NOT
GOING TO OPPOSE THE BILL, I'LL
TELL YOU THAT, I THINK WE'RE
THIS IS GOING THIS IS DEFINITELY
SOMETHING I'M INTERESTED IN
CONTINUING THE CONVERSATION, YOU
KNOW, IT'S OBVIOUSLY VERY IT'S
VERY BROAD. AND I WANT TO
UNDERSTAND THAT A LITTLE BIT
MORE, YOU KNOW, AS IT MOVES
THROUGH THE PROCESS. BUT I THINK
THERE ARE DEFINITELY THINGS OUT
THERE THAT ARE NECESSARY FOR
LIFE THAT, YOU KNOW, WE HAVE TO
CONTINUE THOSE CONVERSATIONS.
YOU KNOW, NOT ONLY IN THIS, IN
THIS BODY, BUT TO SAY THAT, HEY,
LOOK, WE'RE JUST, YOU KNOW,
WE'RE NOT GOING TO WE'RE NOT
GOING TO DO ANYTHING ABOUT THAT
IS, IS A IS A LITTLE
INTERESTING. SO YOUR BILL IS
VERY BROAD. AND, I THINK THAT'S
A GOOD THING. HEY, YOU KNOW, WHY
NOT JUST GO SHOOT FOR THE STARS,
YOU KNOW, KIND OF SEE WHERE IT
GOES, BUT LOOK FORWARD TO THE
DISCUSSIONS, YOU KNOW, AS WE
MOVE FORWARD. SO THANKS. AND I
THANK THE AUTHOR FOR BRINGING
FORWARD THE BILL. AND RECOGNIZE
THAT WE NEED TO BE ABLE TO
CODIFY THAT DMV COVERAGE WITHOUT
THIS LIMITATION, TO ENSURE THAT
INDIVIDUALS WITH DISABILITY
RECEIVE COVERAGE TO COMPLY WITH
FEDERAL AND STATE REQUIREMENTS
OF NONDISCRIMINATION PROTECTIONS
IS VERY CRITICAL. I APPRECIATED
THE TESTIMONY AROUND THIS BILL,
ESSENTIALLY, IN THAT REGARD,
BEING COST NEUTRAL BECAUSE IT
ALLOWS US TO BE ABLE TO CONFORM
TO, THE FEDERAL REQUIREMENTS.
AND I JUST WANT TO THANK MY
CONSTITUENT AND, THE SUPERSTAR
THAT WE HAVE HERE TODAY, JUST IN
POINTING OUT THAT SOMETIMES WE
NEED TO BE VERY THOUGHTFUL IN
WHAT WE'RE CALLING MEDICALLY
REQUIRED IN ORDER FOR PEOPLE TO
HAVE A FULL, FULL LIFE IN, IN
ALL THAT THEY NEED IN THE IN THE
DURABLE MEDICAL EQUIPMENT THAT
WILL ALLOW THEM TO BE ABLE TO DO
SO. SO THANK YOU FOR THAT, WITH
THAT, ASSEMBLY MEMBER ORTEGA,
WOULD YOU LIKE TO CLOSE? I
RESPECTFULLY ASK FOR YOUR I
VOTE. THANK YOU. THE MOTION IS
Dð PASS TO APPROPRIATIONS. WE
NEED A MOTION. THANK YOU, DOCTOR
ARAMBULA AND MAJORITY LEADER.
PLEASE CALL THE ROLL. OR Dð PASS
TO APPROPRIATIONS. BONTA I,
BONTA I WALDEN. WALDEN I
AGUIAR-CURRY AGUIAR-CURRY I
ARAMBULA ARAMBULA I WENDY
CARILLO. LARA HANEY. HANEY I
JOAN. SAWYER. JOAN. SAWYER I
MAIENSCHEIN MAIENSCHEIN I
MCCARTY. JOE. PATTERSON, JOE.
PATTERSON NOT VOTING. RODRIGUEZ.
RODRIGUEZ I SANCHEZ. SANCHEZ.
NOT VOTING. SANTIAGO. CHAVEZ
CHAU. VÚI. WEBER. WEBER I. THAT
MEASURE HAS TEN VOTES AND IT IS
OUT OF COMMITTEE. THANK YOU. WE
WILL MOVE ON TO ITEM NUMBER 16,
AB 2556. MR. JACKSON
.
THANK YOU VERY MUCH, MADAM
CHAIR. AND MEMBERS OF THE
COMMITTEE, PLEASED TO BRING TO
YOU AB 2556. A REQUEST TO THANK
THE CHAIR AND THE COMMITTEE
STAFF FOR WORKING WITH US ON
THIS BILL, AB 2556 AIMS TO
ADDRESS THE CONTINUED MENTAL
HEALTH CRISIS IN CALIFORNIA'S
YOUNG PEOPLE BY INCREASING RATES
OF MENTAL HEALTH SCREENING IN
MINORS AGE 10 TO 18, THE
EMPIRICAL EVIDENCE HAS ALREADY
SUGGESTED WE SHOULD BE SCREENING
OUR YOUTH FOR THEIR POTENTIAL
BEHAVIORAL HEALTH NEEDS IN 2022,
THE US PREVENTATIVE SERVICE TASK
FORCE RECOMMENDED SCREENING FOR
ANXIETY AND CHILDREN AND
ADOLESCENTS AGED 8 TO 18 YEARS
OLD. ALSO, ACCORDING TO THE CDC,
EARLY IDENTIFICATION AND
EXPANDED EVIDENCE BASED
PREVENTION AND INTERVENTION
STRATEGIES ARE CRITICAL TO
IMPROVING PEDIATRIC MENTAL
HEALTH. BUT DESPITE THESE
RECOMMENDED ACTIONS IN
CALIFORNIA, 114,000 YOUTH WERE
NOT TREATED FOR THEIR MAJOR
DEPRESSION AND ONLY 28% OF YOUTH
WITH SEVERE DEPRESSION RECEIVE
SOME CONSISTENT TREATMENT. AB
2556 WORKS TO COMBAT THE LACK OF
INFORMATION REGARDING MENTAL
HEALTH SCREENING, AND AN ATTEMPT
TO MAKE IT MORE ACCESSIBLE AND
LESS STIGMATIZED, I RESPECTFULLY
ASK FOR AN AYE VOTE. THANK YOU.
ANY OTHER WITNESSES IN SUPPORT?
BLEND WITH PLANNED PARENTHOOD
AFFILIATES OF CALIFORNIA IN
SUPPORT. MADAM CHAIR, MEMBERS OF
THE COMMITTEE, BRANDON MARSHALL
WITH THE CALIFORNIA MEDICAL
ASSOCIATION. I WANT TO THANK THE
AUTHOR FOR WORKING WITH US ON
THE AMENDMENTS THAT HE ACCEPTED
TODAY. AND WITH THAT, WE'LL BE
MOVING TO A SUPPORT POSITION
MOVING FORWARD. THANK YOU, THANK
YOU. ANY WITNESSES IN OPPOSITION
? GOOD AFTERNOON, CHAIR MEMBERS
OF THE COMMITTEE, ROBERT BOYKIN,
AGAIN WITH THE CALIFORNIA
ASSOCIATION OF HEALTH PLANS,
REGRETTABLY, IN OPPOSITION TO AB
2556, WE UNDERSTAND AND
APPRECIATE THE AUTHOR'S INTENT
TO HELP DRIVE AND DRIVE AN
INCREASE IN BEHAVIORAL HEALTH
AND WELLNESS SCREENINGS,
ESPECIALLY AMONG TODAY'S MOST IN
CRISIS AND VULNERABLE YOUTH.
HOWEVER, WE ARE CURRENTLY
OPPOSED TO THE BILL IN PRINT, AS
MUCH OF WHAT IS PROPOSED SEEMS
TO BE DUPLICATIVE OF EXISTING
LAW. ADDITIONALLY, WE HAVE BEEN
WORKING WITH THE AUTHOR'S OFFICE
ON SOME CLARIFYING LANGUAGE TO
ENSURE THAT HEALTH PLANS CAN
FULLY COMPLY WITH THE INTENT OF
THE BILL AND BE RESPONSIBLE
PARTNERS IN THIS SPACE. WE ARE
CURRENTLY REVIEWING THE PROPOSED
AMENDMENTS OUTLINED THE
ANALYSIS, WHICH DO SEEM
ENCOURAGING. WE LOOK FORWARD TO
ENGAGING ENGAGING IN FURTHER
DISCUSSIONS WITH THE AUTHOR'S
OFFICE AS THE BILL MOVES
FORWARD. THANK YOU FOR YOUR TIME
TODAY. THANK YOU. STEPHANIE
WATKINS ON BEHALF OF THE
ASSOCIATION OF CALIFORNIA LIFE
AND HEALTH INSURANCE COMPANIES.
REGRETTABLY HERE IN OPPOSITION
AS WELL, I THINK WE LOOK FORWARD
TO WORKING WITH THE AUTHOR OF
THE BILL MOVES FORWARD TODAY. I
THINK THERE ARE SOME CONCERNS
WITH RESPECT TO LEGAL GUARDIAN
VERSUS POLICYHOLDER. WE WOULDN'T
NECESSARILY KNOW WHO THE LEGAL
GUARDIAN IS OF A CHILD, OUR
FIDUCIARY RESPONSIBILITY AND
DUTY IS WITH THE POLICYHOLDER.
IS THE INDIVIDUAL THAT WE
NORMALLY WOULD NOTIFY OF ANY
EOCS OR CHANGES. SO WE LOOK
FORWARD TO HAVING THOSE
CONVERSATIONS THAT THE BILL
MOVES FORWARD TODAY. THANK YOU.
ANY OTHER ADDITIONAL WITNESSES
IN OPPOSITION? THANK YOU, MADAM
CHAIR. JACKIE HONORS ON BEHALF
OF AMERICA'S HEALTH INSURANCE
PLANS AND REGRETFUL OPPOSITION.
THANK YOU. THANK YOU. SEEING NO
OTHER OPPOSITION OR WITNESSES,
I'LL BRING IT BACK TO THE
COMMITTEE FOR QUESTIONS OR
COMMENTS. DOCTOR ARAMBULA MOVES
THE BILL. DOCTOR WEBER SECONDS,
DOCTOR JACKSON, YOU MAY CLOSE,
THANK YOU VERY MUCH. I'VE HAD
SOME GREAT DISCUSSIONS WITH,
BOTH THOSE IN SUPPORT AND
OPPOSITION, OBVIOUSLY, AS WE
KNOW, WE CANNOT FORGET, EVEN
THOUGH WE'VE MADE SOME GREAT
GAINS IN TERMS OF MENTAL HEALTH,
THE CRISIS IS NOT OVER, AND WE
MUST CONTINUE TO, TO KEEP OUR
FOOT ON THE GAS TO ADDRESS IT,
MANY OF US RECEIVE OUR ANNUAL
TEXT MESSAGE OR EMAIL SAYING,
GET YOUR FLU SHOT. ALL WE'RE
ASKING IS, IS IF YOU HAVE A
PARENT HAS A CHILD THAT NOT ONLY
DO THEY GET A NOTICE ABOUT A FLU
SHOT, BUT THEY SAY, HEY, COME
GET YOUR WELLNESS SCREENING FOR
YOUR CHILDREN. WE'VE GOT TO GET
OUR YOUNG PEOPLE SCREENED AND
WE'RE GOING TO TRY ANY WAY AND
EVERY WAY. I'M GOING TO BE BACK
HERE AGAIN NEXT YEAR ABOUT
TRYING TO DO SOMETHING AGAIN.
RIGHT. BUT THE IDEA IS WE CAN'T
GIVE UP, WE MUST CONTINUE TO
IMPROVE THE WAY WE SERVE OUR
YOUNG PEOPLE AND SET THEM UP TO
BE ABLE TO THRIVE. I
RESPECTFULLY ASK FOR AN AYE
VOTE. THANK YOU, DOCTOR JACKSON.
CERTAINLY APPRECIATE YOUR
LEADERSHIP. ALWAYS IN THIS
PARTICULAR SPACE AROUND MENTAL
HEALTH AND WELLNESS FOR OUR
CHILDREN, WITH THAT, THE MOTION
IS Dð PASS, AS AMENDED TO
APPROPRIATIONS. PLEASE CALL THE
ROLL. BONTA, I WANT TO. AYE.
WALDEN. WALDEN. AYE, AYE. ARCURI
AGUILAR. CURRY. AYE. ARAMBULA.
ARAMBULA. AYE. WENDY CARILLO.
WENDY. CARILLO. AYE. FLORA
HANEY. HANEY. AYE. JONES.
SAWYER. JONES. SAWYER AYE.
MAIENSCHEIN. MAIENSCHEIN. AYE.
MCCARTY. JOE PATTERSON. JO.
PATTERSON. AYE. RODRIGUEZ
RODRIGUEZ. AYE. SANCHEZ.
SANCHEZ. AYE. SANTIAGO CHAVO.
CHAU. VÚI. WEBER. WEBER AYE.
THAT MEASURE HAS 13 VOTES TO
ZERO AND PASSES THROUGH
COMMITTEE. THANK YOU. OUR NEXT
BILL IS ITEM NUMBER FOUR, AB
2052. JONES SAWYER. MOVED BY
RODRIGUEZ. SECONDED BY SANCHEZ.
Ó. THIS IS SHORT AND SWEET,
GOOD MORNING, CHAIR AND MEMBERS.
I PRESENT AB 2052 THAT
STRENGTHENS THE PUBLIC HEALTH
CENTER, SUPPORT PROGRAM, SUPPORT
FUNDS THAT CONTINUE TO REACH
STUDENTS WHO EXPERIENCED A
DIFFICULTY ACCESSING MEDICAL
CARE. I WOULD LIKE TO ACCEPT THE
COMMITTEE, AMENDMENTS. SCHOOL
BASED HEALTH CENTERS GIVE
STUDENTS WHO WOULD NOT OTHERWISE
HAVE ACCESS TO PHYSICAL AND
BEHAVIORAL HEALTH SERVICES THE
OPPORTUNITY TO LEAD HEALTHIER
LIVES AND HAVE SHOWN TO INCREASE
ATTENDANCE, ACADEMIC ACHIEVEMENT
AND IMPROVEMENT, AND IMPROVED
SCHOOL CLIMATE. AB 2052 WILL
CONTINUE TO STRENGTHEN THE REACH
OF SCHOOL BASED HEALTH CENTERS,
REQUIRING THE OFFICE OF SCHOOL
BASED HEALTH TO COORDINATE WITH
THE GRANT. WITH THE GRANT
ADMINISTRATOR, THE CALIFORNIA
DEPARTMENT OF PUBLIC HEALTH
ALIGN GRANT RECIPIENTS
PREFERENCE WITH EXISTING
DEFINITIONS IN EDUCATION CODE
AND PRIORITIZING SCHOOL BASED
HEALTH CENTERS THAT INCREASE
ACCESS TO CARE FOR CALIFORNIA'S
MOST UNDERSERVED STUDENTS AND
COMMUNITIES. IN MANY
COMMUNITIES, SCHOOL BASED HEALTH
CENTERS ARE THE ONLY SOURCE OF
HEALTH CARE STUDENTS CAN ACCESS.
FUNDING IS LIMITED THIS YEAR,
BUT THIS BILL WILL SET UP SCHOOL
BASED HEALTH CENTERS TO RECEIVE
FUNDING IN FUTURE YEARS AND USE
THOSE FUNDS EFFECTIVELY AND
EFFICIENTLY WITH ME IN SUPPORT
OF THIS, RACHEL REYNOLDS AND AMY
BLACKSHAW ON BEHALF OF THE BILL
SPONSOR, THE CALIFORNIA
CALIFORNIA SCHOOL BASED HEALTH
ALLIANCE. THANK YOU. THE BILL
HAS BEEN, A MOTION AND SECONDED
ALREADY. YOU HAVE THREE MINUTES.
GOOD AFTERNOON, CHAIRPERSON
BONTA AND MEMBERS OF THE HEALTH
COMMITTEE. MY NAME IS AMY
BLACKSHAW, AND I AM HERE TODAY
TO ADVOCATE FOR AB 2052, THE
SCHOOL BASED HEALTH AND
EDUCATION PARTNERSHIP PROGRAM.
I'M CURRENTLY THE BEHAVIORAL
HEALTH PROJECT DIRECTOR AT THE
CALIFORNIA SCHOOL BASED HEALTH
ALLIANCE, AND PRIOR TO THAT, FOR
NEARLY TEN YEARS I WORKED AT LA
CLINICA DE LA RAZA, A FEDERALLY
QUALIFIED HEALTH CENTER WHERE I
MANAGED THE OPERATIONS OF EIGHT
SCHOOL BASED HEALTH CENTERS IN
ALAMEDA COUNTY. IN THAT ROLE, I
EXPERIENCED THE POWER OF THE
EDUCATION AND HEALTH SECTORS
COMING TOGETHER TO BUILD
PARTNERSHIPS THAT LEVERAGE
RESOURCES TO SUPPORT STUDENTS
AND THEIR FAMILIES. I WITNESSED
THE IMPACT OF CULTURALLY
COMPETENT, YOUTH CENTERED,
ACCESSIBLE HEALTH CARE THAT
RESULTED IN IMPROVED STUDENT
HEALTH OUTCOMES AND IMPROVED
ACADEMIC OUTCOMES. SCHOOL BASED
HEALTH CENTERS ARE WHERE YOUNG
PEOPLE FEEL COMFORTABLE GETTING
THEIR NEEDS MET FROM MENTAL
HEALTH CARE, PRIMARY CARE,
REPRODUCTIVE AND SEXUAL HEALTH
CARE, AND IN SOME CASES, DENTAL
AND OPTOMETRY SERVICES. STUDENTS
DEPEND ON SCHOOL BASED HEALTH
CENTERS FOR HEALTH INFORMATION
THAT THEY UNDERSTAND AND
SUPPORTED SUPPORTIVE, YOUTH
FOCUSED PROGRAMS, SUCH AS PEER
SUPPORT GROUPS THAT STRENGTHEN
THEIR CONNECTIONS TO THEIR
SCHOOL, COMMUNITY AND BUILD
THEIR SENSE OF BELONGING, AS
WELL AS MENTAL AND PHYSICAL
WELLNESS. AB 2052 IS AN
IMPORTANT STEP IN THE RIGHT
DIRECTION BECAUSE IT HELPS OUR
STATE'S DEPARTMENT OF PUBLIC
HEALTH AND EDUCATION IMPROVE
THEIR COORDINATION TO STRENGTHEN
THE STATE'S EFFORTS TO ADVANCE
SCHOOL BASED HEALTH CENTERS. I
RESPECTFULLY URGE YOUR AYE VOTE
TO ENABLE THESE STATE AGENCIES
TO COLLABORATE MORE EFFECTIVELY,
EMPOWERING THEM TO BETTER
SUPPORT THE VITAL WORK THAT'S
CARRIED OUT BY SCHOOL BASED
HEALTH CENTERS THROUGHOUT
CALIFORNIA. THANK YOU SO MUCH.
THANK YOU. HONORABLE CHAIR AND
COMMITTEE MEMBERS. MY NAME IS
MARCEL REYNOLDS. I'M THE
DIRECTOR OF COMMUNICATIONS AND
STRATEGIC MEMBERSHIP AT THE
CALIFORNIA SCHOOL BASED HEALTH
ALLIANCE. THE CALIFORNIA SCHOOL
BASED HEALTH ALLIANCE SUPPORTS
AROUND 400 SCHOOL BASED HEALTH
AND WELLNESS CENTERS IN K
THROUGH 12 SCHOOLS ACROSS
CALIFORNIA. SCHOOL BASED HEALTH
CENTERS PROVIDE MEDICAL AND
BEHAVIORAL HEALTH CARE, AND MANY
ALSO PROVIDE DENTAL CARE,
OPTOMETRY, AND OTHER ANCILLARY
SERVICES, ALL OF WHICH ARE YOUTH
CENTERED. ALMOST ALL CARE
PROVIDED IS REIMBURSED THROUGH
MEDI-CAL. RESEARCH SHOWS THAT
SCHOOL BASED HEALTH CENTERS HAVE
A POSITIVE IMPACT ON ABSENCES,
DROPOUT RATES, DISCIPLINARY
ISSUES, AND OTHER ACADEMIC
OUTCOMES. SCHOOL BASED HEALTH
CENTERS ENHANCE ACCESS TO HEALTH
CARE BY BRINGING MEDICAL,
MEDICALLY ACCURATE, AGE
APPROPRIATE CARE TO WHERE KIDS
SPEND THE MOST TIME IN SCHOOL.
SCHOOL BASED HEALTH CENTERS ARE
AN INVESTMENT IN THE WELL-BEING
OF YOUTH AND THEIR COMMUNITY.
WITH AB 2052, CALIFORNIA HAS THE
OPPORTUNITY TO UPDATE OUR
STATE'S STRUCTURE FOR PROVIDING
SUPPORT TO SCHOOL BASED HEALTH
CENTERS. RECOGNIZING THE
CRITICAL ROLE, THE CALIFORNIA
DEPARTMENT OF EDUCATION AND THE
CALIFORNIA DEPARTMENT OF PUBLIC
HEALTH PLAYED A BRIDGE BOTH
HEALTH AND EDUCATION, TO FULLY
SUPPORT STUDENT WELL-BEING AND
SUCCESS. CALIFORNIA IS THE STATE
WITH THE HIGHEST NUMBER OF
SCHOOL BASED HEALTH CENTERS THAT
DOES NOT PROVIDE DEDICATED STATE
FUNDING TO SUPPORT THEM. AMONG
OTHER PROVISIONS, AB 2052
STRENGTHENS THE CAPACITY OF OUR
STATE TO COORDINATE GRANTS TO
SUPPORT THE ESTABLISHMENT,
EXPANSION AND OPERATIONAL
SUSTAINABILITY OF SCHOOL BASED
HEALTH CENTERS IN THE FUTURE.
WHEN OUR STATE'S BUDGET ALLOWS
US AB 2052 BETTER POSITIONS, OUR
STATE TO SUPPORT THE CRITICAL
ROLE THAT SCHOOL BASED HEALTH
CENTERS PLAY IN CALIFORNIA'S
EFFORTS TO ENSURE ACCESS TO
HEALTH CARE FOR ALL. THANK YOU
FOR YOUR TIME, AND I
RESPECTFULLY URGE YOUR AYE VOTE.
THANK YOU. ANY OTHER WITNESSES
IN SUPPORT? NAME. ORGANIZATION.
THANK YOU, MADAM CHAIR. MEMBERS
DYLAN ELLIOTT, ON BEHALF OF THE
CALIFORNIA STATE ASSOCIATION OF
PSYCHIATRISTS AND SUPPORT. COLBY
LIND, PLANNED PARENTHOOD
AFFILIATES OF CALIFORNIA IN
SUPPORT. THANK YOU. ANY
WITNESSES IN OPPOSITION? SEEING
NONE, WE CAN BRING IT BACK TO
THE COMMITTEE. I THINK THE BILL
WAS MOVED AND SECONDED ALREADY.
AFTER YOU MAKE CLOSE, WE
RESPECTFULLY ASK FOR YOUR VOTE.
THANK YOU SO MUCH. I LOOK
FORWARD TO SEEING THIS BILL,
AROUND A CRITICAL ISSUE RELATED
TO SCHOOL BASED HEALTH CENTERS
CONTINUE TO GO THROUGH THE
LEGISLATIVE PROCESS. AND WITH
THAT, THE MOTION IS Dð PASS, AS
AMENDED, TO EDUCATION. PLEASE
CALL THE ROLL. BONTA I, BONTA I
WALTON WALDEN I AGUIAR-CURRY
AGUIAR-CURRY I ARAMBULA ARAMBULA
I WENDY CARRILLO WENDY CARILLO I
FLORA HANEY. JOAN SAWYER I JOAN
SAWYER I MAIENSCHEIN MAIENSCHEIN
I MCCARTY. JO PATTERSON. JO.
PATTERSON. NOT VOTING. RODRIGUEZ
RODRIGUEZ I SANCHEZ. SANCHEZ I
SANTIAGO. CHAVO CHAU I WEBER.
WEBER. I 11 ZERO THAT MEASURE
PASSES 11 TO 0. THANK YOU. CHAIR
AND COMMITTEE. THANK YOU. K¾T
LEADER AGUIAR-CURRY. WILL BE
PRESENTING FILE ITEM 12 AB 2339.
GOOD AFTERNOON, CHAIR AND
MEMBERS. WHEN I AUTHORED AB 32
IN 2022, MY CLEAR INTENT WAS TO
INCREASE PATIENT CHOICE AND
ACCESS TO CARE VIA ALL FORMS OF
TELEHEALTH SERVICES. THE INTENT
OF MY PAST LEGISLATION WAS FOR
MEDI-CAL TO COVER TELEHEALTH
SERVICES EQUALLY, INCLUDING
MOBILE APPS THROUGH ASYNCHRONOUS
MESSAGING. THESE APPS ARE
IMPORTANT BECAUSE WORKING
FAMILIES CAN ACCESS MEDICAL CARE
ON THEIR OWN SCHEDULE WITHOUT
HAVING TO TAKE TIME AWAY FROM
WORK OR THEIR FAMILIES. BECAUSE
AB 32 BECAME LAW. BECAUSE AB 32
BECAME LAW. CALIFORNIANS WHO
HAVE PRIVATE INSURANCE BENEFITS
FROM THESE TYPES OF CONVENIENT
APPS BECAUSE ASYNCHRONOUS
TELEHEALTH IS COVERED UNDER
PRIVATE HEALTH PLANS, HOWEVER,
MEDI-CAL BENEFICIARIES ARE
ALLOWED ASYNCHRONOUS TELEHEALTH
OPTIONS ONLY UNDER CERTAIN
CIRCUMSTANCES, WHICH CREATES
BARRIERS TO THE EQUITABLE CARE.
HEALTH CARE PROVIDERS ARE
PROHIBITED FROM ESTABLISHING A
NEW PATIENT RELATIONSHIP WITH
MEDI-CAL BENEFICIARIES VIA
ASYNCHRONOUS OR OTHER VIRTUAL
COMMUNICATION MODALITIES. UNLESS
A PATIENT REQUESTS AN AUDIO ONLY
MODALITY OR ATTEST THAT THEY DO
NOT HAVE ACCESS TO VIDEO. THIS
PARTICULARLY IMPACTS THE ABILITY
FOR MEDI-CAL BENEFICIARIES TO
ACCESS SEXUAL AND REPRODUCTIVE
HEALTH CARE SERVICES THAT CAN BE
APPROPRIATELY PROVIDED USING
ASYNCHRONOUS MODALITIES LIKE
APPS. AB 2339 WILL EXPAND ACCESS
TO SEXUAL AND REPRODUCTIVE
HEALTH CARE SERVICES THAT CAN BE
PROVIDED USING ASYNCHRONOUS
MODALITIES FOR MEDI-CAL
BENEFICIARIES, ALLOWING MEDI-CAL
BENEFICIARIES TO ACCESS THIS
FORM OF CARE WILL PROVIDE EQUAL
ACCESS TO ASYNCHRONOUS
TELEHEALTH SERVICES AND GIVE
MEDI-CAL BENEFICIARIES THE SAME
CONVENIENT CARE AS THEIR PEERS
WITH PRIVATE INSURANCE. WITH ME
TODAY TO SPEAK IN SUPPORT OF
THIS BILL IS DOCTOR JENNIFER
YEAGER WITH THE BIXBY CENTER FOR
GLOBAL REPRODUCTIVE HEALTH, AND
SHELBY LYNN, VICE PRESIDENT OF
REGULATORY AFFAIRS AT PLANNED
PARENTHOOD AFFILIATES OF
CALIFORNIA. WELCOME DOCTOR
YEAGER. YOU'LL HAVE THREE
MINUTES. GOOD AFTERNOON, CHAIR
BONTA. AND MEMBERS, MY NAME IS
JENNIFER YEAGER. I'M AN
ASSISTANT PROFESSOR AT THE
UNIVERSITY OF CALIFORNIA, SAN
FRANCISCO IN THE PHILIP R LEE
INSTITUTE FOR HEALTH POLICY
STUDIES AND THE DEPARTMENT OF
EPIDEMIOLOGY AND BIOSTATISTICS.
I AM HERE TO SUPPORT ASSEMBLY
BILL 2339, WHICH WILL IMPROVE
TELEHEALTH ACCESS FOR MEDI-CAL
BENEFICIARIES ACROSS CALIFORNIA.
NUMEROUS STUDIES HAVE SHOWN THAT
TELEHEALTH OFFERS A SAFE AND
EFFECTIVE WAY TO PROVIDE SEXUAL
AND REPRODUCTIVE HEALTH
SERVICES. TELEHEALTH CAN ENHANCE
ACCESS TO CARE, ESPECIALLY FOR
RURAL AND UNDERSERVED
POPULATIONS, BY ELIMINATING THE
NEED FOR TRANSPORTATION, CHILD
CARE, AND EXTRA TIME FOR
IN-PERSON VISITS. IN OUR
RESEARCH WITH YOUNG PEOPLE, MANY
ALSO VALUED THE PRIVACY THAT
TELEHEALTH VISITS OFFER AND FEEL
MORE COMFORTABLE COMMUNICATING
WITH THEIR PROVIDER AND ASKING
QUESTIONS COMPARED TO IN-PERSON
VISITS. HOWEVER, OUR SURVEY OF
OVER 1000 YOUNG ADULTS REVEALED
BARRIERS TO PHONE AND VIDEO
VISITS. NEARLY ONE QUARTER SAID
THAT IT WOULD BE DIFFICULT TO
USE PHONE OR VIDEO VISITS FOR
CONTRACEPTIVE SERVICES. FOOD AND
HOUSING. INSECURE YOUNG ADULTS
WERE MORE LIKELY TO REPORT
DIFFICULTY USING PHONE OR VIDEO
VISITS. LACK OF PRIVACY AT HOME
WAS A COMMON BARRIER AMONG YOUNG
ADULTS, WHO OFTEN LIVE WITH
FAMILY MEMBERS. ASYNCHRONOUS
TELEHEALTH CAN ENSURE ACCESS TO
CARE FOR THESE PATIENTS. AND TO
ILLUSTRATE, I WANT TO SHARE THE
EXPERIENCE OF A 23 YEAR OLD
WOMAN FROM LOS ANGELES WHO I
RECENTLY INTERVIEWED. SHE
DEVELOPED SYMPTOMS OF A URINARY
TRACT INFECTION, OR UTI, BUT
COULDN'T TAKE TIME OFF WORK FROM
HER JOB AT A COFFEE SHOP IN
ORDER TO GET CARE, HER UTI
PROGRESSED TO A KIDNEY
INFECTION, CAUSING SERIOUS
ILLNESS, AND SHE LOST HER JOB.
SINCE THEN, SHE HAS HAD
RECURRENT UTIS AND PREFERS
ASYNCHRONOUS CARE, WHICH SHE HAS
FOUND AVAILABLE THROUGH AN
ONLINE TELEHEALTH COMPANY.
BECAUSE IT WORKS BETTER WITH HER
SCHEDULE, SHE HAS TO PAY OUT OF
POCKET, BUT FEELS THAT THIS IS
THE BEST OPTION GIVEN HER TIME
CONSTRAINTS. NOTABLY, STUDIES
FOCUSED ON UTI CARE HAVE FOUND
NO DIFFERENCES IN QUALITY OF
CARE OR PATIENT OUTCOMES ACROSS
ASYNCHRONOUS TELEHEALTH PHONE OR
IN-PERSON VISITS. AB 2339
ENSURES THAT MEDI-CAL
BENEFICIARIES HAVE THE CHOICE OF
AN ASYNCHRONOUS VISIT, WHICH MAY
BE THE ONLY WAY TO ACCESS CARE
FOR YOUNG PEOPLE AND OTHER
VULNERABLE POPULATIONS. I
RESPECTFULLY URGE YOUR SUPPORT
FOR THIS BILL TODAY. THANK YOU.
THANK YOU ALL FOR THREE MINUTES.
THANK YOU. GOOD AFTERNOON, CHAIR
BONTA AND MEMBERS OF THE
COMMITTEE. MY NAME IS SHELBY
LIND, VICE PRESIDENT OF
REGULATORY AFFAIRS AT PLANNED
PARENTHOOD AFFILIATES OF
CALIFORNIA. WE'RE A PROUD
CO-SPONSOR OF AB 2339,
REPRESENTING SEVEN AFFILIATES
THAT PROVIDE COMPREHENSIVE
SEXUAL AND REPRODUCTIVE HEALTH
CARE, GENDER AFFIRMING CARE, AND
BEHAVIORAL HEALTH SERVICES
THROUGHOUT CALIFORNIA. I WANT TO
BEGIN BY THANKING THE AUTHOR FOR
HER CONTINUED DEDICATION AND
LEADERSHIP ON TELEHEALTH. WHEN
THE COVID 19 PUBLIC HEALTH
EMERGENCY BEGAN FOUR YEARS AGO,
PLANNED PARENTHOOD MOVED QUICKLY
TO IMPLEMENT SECURE TELEHEALTH
APPOINTMENTS FOR SENSITIVE
SERVICES SUCH AS BIRTH CONTROL,
STI TREATMENTS, PREGNANCY
COUNSELING, PREP AND PEP FOLLOW
UP AND GENDER AFFIRMING CARE.
TODAY TELEHEALTH CONTINUES TO BE
A POPULAR CHOICE FOR PLANNED
PARENTHOOD PATIENTS, EVEN WHEN
IN-PERSON APPOINTMENTS ARE
AVAILABLE, THANKS TO THE
LEGISLATURE'S LEADERSHIP. SINCE
THE ONSET OF THE COVID 19 PUBLIC
HEALTH EMERGENCY, PLANNED
PARENTHOOD PATIENTS CONTINUE TO
HAVE A CHOICE TO ACCESS CRUCIAL
SERVICES VIA TELEHEALTH WITHOUT
HAVING TO WORRY ABOUT THE
ADDITIONAL TIME AND RESOURCES
NECESSARY TO MAKE IT TO AN
IN-PERSON APPOINTMENT.
IMPORTANTLY, PREVIOUS
LEGISLATION BY THE AUTHOR AB 32
ENSURED THAT MEDI-CAL PATIENTS
CAN CHOOSE TO SEE A PLANNED
PARENTHOOD PROVIDER VIA
SYNCHRONOUS TELEHEALTH WHEN IT
IS APPROPRIATE FOR THE PATIENT'S
PRESENTING CONCERNS. AB 2339
WILL ENSURE MEDI-CAL PATIENTS
HAVE THE SAME PROTECTED ACCESS
AND CHOICE FOR ASYNCHRONOUS
MODALITIES, INCLUDING WHEN THEY
NEED ACCESS TO A PLANNED
PARENTHOOD PROVIDER FOR BIRTH
CONTROL OR TREATMENT OF A UTI.
MORE THAN 1 MILLION MEDI-CAL
PATIENTS ARE SEEN BY A PLANNED
PARENTHOOD PROVIDER EVERY YEAR,
COMPRISING 80% OF ALL PLANNED
PARENTHOOD PATIENTS IN
CALIFORNIA. IN SERVING A PATIENT
POPULATION THAT IS
DISPROPORTIONATELY LOW INCOME
AND HISTORICALLY UNDERSERVED,
PLANNED PARENTHOOD STRONGLY
BELIEVES THAT TELEHEALTH,
INCLUDING ASYNCHRONOUS
TELEHEALTH, IS CRITICAL TO
ADDRESS HEALTH INEQUITIES AND
IMPROVE ACCESS TO HEALTH CARE
SERVICES. MEDI-CAL PATIENTS
DESERVE EQUITABLE ACCESS TO THE
SAME HEALTH CARE OPTIONS
AFFORDED TO COMMERCIALLY INSURED
PATIENTS. FULL STOP AB 2339 IS
OF UTMOST IMPORTANCE TO PLANNED
PARENTHOOD BECAUSE IT WILL
ENSURE MEDI-CAL PATIENTS HAVE
EQUITABLE ACCESS TO HEALTH CARE.
ESTABLISH CONSISTENCY IN STATE
LAW WITH EXISTING PROTECTIONS
FOR SYNCHRONOUS TELEHEALTH, AND
AB 2339 WILL PRESERVE A
PATIENT'S RIGHT TO CHOOSE A NEW
PROVIDER FOR SENSITIVE SERVICES
VIA SECURE, ASYNCHRONOUS
TELEHEALTH PLATFORMS. I
RESPECTFULLY URGE YOUR AYE VOTE
ON AB 2339 TODAY. THANK YOU,
THANK YOU. DO WE HAVE ANY OTHER
WITNESSES IN SUPPORT? BRANDON
MARTY WITH THE CALIFORNIA
MEDICAL ASSOCIATION IN SUPPORT.
BRIAN SPENCER WITH THE AMERICAN
COLLEGE OF OB GYN'S DISTRICT
NINE AND OCEAN IN SUPPORT.
VANESSA GONZALEZ WITH THE
CALIFORNIA HOSPITAL ASSOCIATION
IN SUPPORT CAROLYN BEALL HUNTER
ON BEHALF OF TELADOC HEALTH IN
SUPPORT. DAVID GONZALEZ WITH
AMERICA'S PHYSICIAN GROUPS AND
SUPPORT. THANK YOU. DO WE HAVE
ANY WITNESSES IN OPPOSITION?
GOOD AFTERNOON, MADAM CHAIR, AND
MEMBERS. UNFORTUNATELY, WITH
MUCH RESPECT TO THE AUTHOR,
MADDIE LOPEZ WITH CALIFORNIA
NURSES ASSOCIATION, WE MUST
OPPOSE THE BILL. WE ARE DEAD SET
AGAINST, AND A MOBILE APP
REPLACING IN-PERSON HEALTH CARE,
AS MENTIONED EARLIER BY
WITNESSES ON ANOTHER BILL. ON
PREVIOUS BILL, IT'S REALLY
IMPORTANT THAT IN-PERSON THÀNH,
CARE IS, MAXIMIZES THE POTENTIAL
OF PROVIDING EVERYTHING THAT A
PATIENT NEEDS. THIS IS WE FEEL
THAT THIS IS CONTINUOUS MOVES BY
BIG TECH AND AI AND, HEDGE FUND
CORPORATIONS TO MOVE INTO HEALTH
CARE TO MAXIMIZE PROFIT WITH
DELIVERING LITTLE AS FAR AS
PATIENT CARE IS CONCERNED. THANK
YOU. THANK YOU. SEEING NO OTHER
OPPOSITION TO THE BILL, I'LL
BRING IT BACK TO THE COMMITTEE.
DOCTOR WEBER MOVES. MARKLEEVILLE
SECONDS. THANK YOU SO MUCH, MISS
AGUIAR-CURRY, WOULD YOU LIKE TO
CLOSE? I WOULD, YOU KNOW, I SIT
HERE AND I THINK ABOUT WHEN WE
DID AB 32 AND HOW IT WAS
CONTROVERSIAL BECAUSE IT WAS
TELEHEALTH AND IT'S CHANGED THE
WORLD. IT'S CHANGED HOW WE
DELIVER HEALTH AND HAVING ACCESS
TO EVERYTHING. AS MUCH AS YOU
WANT TO DO THE PERFECT BILL,
THERE ARE CERTAIN THINGS THAT
KIND OF GO THROUGH THE CRACKS,
AND THIS IS ONE OF THE THINGS.
AND SO AB TWO, THREE, THREE,
NINE SIMPLY CONFORMS COVERAGE
FOR APP BASED TELEHEALTH
SERVICES FOR CALIFORNIANS ON
MEDI-CAL, WITH THOSE WHO HAVE
PRIVATE INSURANCE. ESSENTIALLY,
COLLEAGUES, YOU ARE VOTING ON
WHETHER OR NOT MEDI-CAL
BENEFICIARIES CAN HAVE THE SAME
ACCESS TO SENSITIVE SERVICES
THAT YOU ALL HAVE WITH YOUR
PRIVATE HEALTH INSURANCE
PROVIDER TODAY. FURTHER, THIS
BILL ALSO ALIGNS WITH
CALIFORNIA'S EMPHASIS ON PATIENT
CHOICE IN TELEHEALTH AND
FURTHERS STATEWIDE EFFORTS TO
EXPAND ACCESS TO SEXUAL AND
REPRODUCTIVE HEALTH CARE. I
RESPECTFULLY ASK FOR YOUR YOUR
AYE VOTE. THANK YOU, MAJORITY
LEADER AGUIAR-CURRY. THE MOTION
IS DUE. PASS TO APPROPRIATIONS.
PLEASE CALL THE ROLL. BONTA I
BONTA I WALDRON. WALDEN. I
AGUIAR-CURRY I AGUIAR-CURRY I
ARAMBULA. WENDY CARILLO WENDY
CARILLO I LARA LARA I HANEY.
JONES-SAWYER JONES-SAWYER I
WEINSTEIN. MAIENSCHEIN I
MCCARTY. JO. PATTERSON. JO
PATTERSON I RODRIGUEZ. RODRIGUEZ
I SANCHEZ. SANCHEZ. I SANTIAGO.
CHAVO CHAU. VÚI. WEBER. WEBER. I
. THAT MEASURE PASSES 12 TO 0.
THANK YOU, MAJORITY LEADER.
THANK YOU VERY MUCH. AND NOW
LAST BUT DEFINITELY NOT LEAST.
NO, SIR. ONE MORE, WE HAVE ITEM
NUMBER 14, AB 2435. MR.
MAIENSCHEIN
.
IN MY 12TH YEAR, I'M GETTING THE
HANG OF THIS MICROPHONE THING,
THANK YOU VERY MUCH, MADAM
CHAIR. AND MEMBERS SINCE 2012
COVERED CALIFORNIA HAS ENGAGED
IN A PUBLIC PROCESS WITH ROBUST
STAKEHOLDER ENGAGEMENT. WHEN
PROPOSING AND ADOPTING
REGULATORY CHANGES. THE
LEGISLATURE HAS GRANTED COVERED
CALIFORNIA EMERGENCY RULEMAKING
AUTHORITY BECAUSE THEY MUST ACT
FASTER THAN THE TRADITIONAL
RULEMAKING PROCESS ALLOWS TO
IMPLEMENT CHANGES IN LAWS THAT
AFFECT HEALTH CARE ACCESS FOR
CONSUMERS. THIS EMERGENCY
AUTHORITY EXPIRES ON JANUARY
1ST, 2025. CONSUMERS WILL THEN
BE AT RISK OF SIGNIFICANT DELAY
OF NEW BENEFITS OR PROTECTIONS
IF COVERED. CALIFORNIA IS NOT
ABLE TO QUICKLY CONFORM TO NEW
STATE AND FEDERAL POLICY.
COVERED CALIFORNIA HAS RECENTLY
NEEDED, OR WILL SOON NEED TO
IMPLEMENT NEW SUBSIDIES TO HELP
MORE PEOPLE AFFORD HEALTH CARE
COSTS. CREATE A PROGRAM TO HELP
WORKERS WHO HAVE LOST THEIR
HEALTH CARE COVERAGE AND
REVISING REGULATIONS IN RESPONSE
TO FEDERAL CHANGES, AB 2435
WOULD EXTEND COVERED
CALIFORNIA'S AUTHORITY TO
IMPLEMENT EMERGENCY RULEMAKING
PACKAGES UNTIL JANUARY 1ST,
2030, IN ORDER TO ADEQUATELY AND
PROMPTLY REACT TO BOTH ANNUAL
AND ONGOING CHANGES IN FEDERAL
AND STATE RULES. ONCE THE
EMERGENCY RULEMAKING PROCESS HAS
BEEN COMPLETED. COVER CALIFORNIA
MUST THEN COMPLETE THE PERMANENT
RULEMAKING PROCESS WITHIN FIVE
YEARS. THIS ALLOWS FOR ANOTHER
ROUND OF PUBLIC ENGAGEMENT
THROUGH COMMENTS AT BOARD
MEETINGS AND THROUGH THE REGULAR
RULEMAKING PROCESS. BY PASSING
AB 2435. THIS ENSURES COVERED
CALIFORNIA IS ABLE TO SERVE
CONSUMERS WHILE CONFORMING TO
NEW STATE AND FEDERAL POLICIES.
KELLY GREEN AND ALLISON PEACE
WITH COVERED CALIFORNIA ARE HERE
TO HELP ANSWER ANY TECHNICAL
QUESTIONS. THANK YOU AND I
RESPECTFULLY REQUEST YOUR AYE
VOTE. THANK YOU. YOU'LL HAVE
THREE MINUTES. THANK YOU, MADAM
CHAIR AND MEMBERS, I'M KELLY
GREEN WITH COVERED CALIFORNIA,
JOINED BY ALLISON PEASE, OUR
ASSISTANT GENERAL COUNSEL. WE'RE
NOT THE SPONSOR OF THIS
LEGISLATION, BUT WE ARE HERE TO
PROVIDE TECHNICAL ASSISTANCE TO
THE EXTENT THAT THE CHAIR OR THE
MEMBERS HAVE ANY QUESTIONS.
THANK YOU. ANY ADDITIONAL IN
SUPPORT? FAITH BRIDGES WITH
ACTING ON BEHALF OF CALIFORNIA
AGENTS AND HEALTH INSURANCE
PROFESSIONALS, AND STRONG
SUPPORT. CHRISTINE SMITH, HEALTH
ACCESS CALIFORNIA IN SUPPORT.
GOOD AFTERNOON, CHAIR AND
MEMBERS BETH MALINOWSKI, SEIU
CALIFORNIA, IN SUPPORT. THANK
YOU. ANY WITNESSES IN OPPOSITION
?
YOU'LL HAVE THREE MINUTES. THANK
YOU. THANK YOU, MADAM CHAIR.
MEMBERS OF THE COMMITTEE,
BRANDON MARTY WITH THE
CALIFORNIA MEDICAL ASSOCIATION,
AN REGRETFULLY HERE IN
OPPOSITION AND UNFORTUNATELY
NEXT TO MY FORMER BOSS, SO I
DOUBLY REGRET IT, OUR CONCERN IS
NOT NECESSARILY THAT, COVER. WE
DO NOT BELIEVE THAT COVERED
CALIFORNIA SHOULD NOT HAVE
EMERGENCY RULEMAKING AUTHORITY.
WE ACTUALLY VERY MUCH AGREE THAT
THEY SHOULD, IN ORDER TO BE IN
COMPLIANCE WITH FEDERAL LAW. OUR
CONCERN IS ACTUALLY WITH THE
BROAD, BLANKET SORT OF ABILITY
FOR THEM TO DO EMERGENCY
REGULATION PACKAGES THAT ARE NOT
NECESSARILY EMERGENCIES. RIGHT?
THE EMERGENCY RULEMAKING PROCESS
HAS ITS PLACE. WE BELIEVE THAT
IT DOES, BUT IT SIGNIFICANTLY
UNDERMINES THE PUBLIC'S
PARTICIPATION IN THIS PROCESS.
IT SIGNIFICANTLY UNDERMINES
STAKEHOLDER PARTICIPATION IN
THIS PROCESS. AND FINALLY, IT
UNDERMINES YOUR ABILITY AS
LEGISLATORS TO HAVE INPUT IN THE
RULEMAKING PROCESS TO MAKE SURE
THAT THEY ARE IMPLEMENTING LAWS
AND THAT YOU GUYS HAVE PASSED
YOU EXCUSE ME, YOU LEGISLATORS
HAVE PASSED, IT CUTS THE WINDOW
DOWN FROM ABOUT 75 DAYS TO ABOUT
TEN DAYS, THAT IS NOT A LOT OF
TIME FOR ANYBODY TO RESPOND TO,
VERY IMPORTANT REGULATORY
PACKAGES, SO IN THAT IS THE THAT
IS THE REASON FOR OUR OPPOSITION
, AGAIN, I HAVE GREAT RESPECT
FOR THE AUTHOR AND GREAT RESPECT
FOR COVERED CALIFORNIA AS WELL.
THEY'VE BEEN AMAZING PARTNERS,
AT SINCE THEIR INCEPTION, BUT DO
BELIEVE THAT THE EMERGENCY
RULEMAKING AUTHORITY SHOULD BE,
SHOULD ONLY BE USED WHEN
ABSOLUTELY JUSTIFIED AND SHOULD
BE APPROPRIATELY NARROWED TO
TRUE EMERGENCIES. THANK YOU. ANY
OTHER OPPOSITION TO THIS BILL?
SEEING NONE, WE WILL BRING IT
BACK TO THE COMMITTEE FOR
QUESTION OR COMMENT. DOCTOR
WEBER. GOOD EVENING. EARLY
EVENING, THANK YOU SO MUCH FOR
BRINGING THIS BILL FORWARD. I
THINK, YOU KNOW WHAT I'M GOING
TO ASK BECAUSE WE TALKED ABOUT
IT BEFORE. SO FIRST OF ALL, I
WANT TO THANK THE OPPOSITION FOR
ALREADY ANSWERING ONE OF MY
QUESTIONS BECAUSE ONE OF MY
QUESTIONS HAD TO DO WITH THE
NOTIFICATION AND THE TIME FRAME
DIFFERENCE FOR PUBLIC INPUT. SO
WITHOUT EMERGENCY, IT'S 75 DAYS.
WITH THIS EMERGENCY RULEMAKING,
IT'S TEN DAYS. SO, MY QUESTION
IS FOR COVERED CALIFORNIA FOR,
COMPLETELY UNDERSTAND AND AGREE
WITH THE NEED TO MOVE QUICKLY
FOR FEDERAL, CHANGES. BUT WHY DO
WE NEED THIS TO BE SO BROAD TO
ESSENTIALLY KIND OF GIVE COVERED
CALIFORNIA A BLANK CHECK TO, TO
DO ANYTHING UNDER THE EMERGENCY
RULEMAKING? WHY WHY IS THIS BILL
NOT NARROWED TO SPECIFICALLY
REFERRED TO THE THINGS THAT WE
THAT WE KNOW THAT WE NEED IN AN
EMERGENCY SITUATION, WHICH IS TO
CHANGE IT FOR FEDERAL
GUIDELINES? HUM, THANK YOU,
ASSEMBLY MEMBER WEBER. SO WE DO
APPRECIATE, BRANDON AND CMA'S
POINTS RAISED, FIRST, WITH
REGARD TO YOUR QUESTION, WE DO
NEED TO HAVE BROAD EMERGENCY
RULEMAKING AUTHORITY IN ORDER TO
BE, HAVE THE ABILITY TO ADAPT TO
FEDERAL RULES, WHICH DO CHANGE
ON AN ANNUAL BASIS. WE ALSO NEED
THE EMERGENCY RULEMAKING
AUTHORITY TO BE ABLE TO ADAPT TO
STATE LAW CHANGES. SO THAT CAN
INCLUDE ITEMS THAT ASSEMBLY
MEMBER MAIN SHINE MENTIONED,
SUCH AS STATE SUBSIDIES, FOR
EXAMPLE, IN WHICH WE HAVE HAD TO
LEVERAGE THE EMERGENCY
RULEMAKING PROCESS DUE TO
BUDGET, AUGMENT MOTIONS MADE TO
HELP SUPPORT COVERED CALIFORNIA
ENROLLEES WITH ADDITIONAL STATE
SUBSIDIES. SO THE BROADNESS OF
THE RULEMAKING DOES ALLOW US THE
FLEXIBILITY THAT WE NEED TO KEEP
PACE WITH FEDERAL AND STATE LAW
CHANGES, WE HAVE SINCE OUR
INCEPTION, BEEN DEVOTED TO
TRANSPARENCY, TO PUBLIC
ENGAGEMENT. AND WE ABSOLUTELY
RESPECT OVERSIGHT OF THE
LEGISLATURE AND OF THE PUBLIC
GENERALLY. WE HAVE A ROBUST
STAKEHOLDER ENGAGEMENT PROCESS
AND A PUBLIC PROCESS BY WHICH
OUR RULEMAKING PACKAGES ARE PUT
FORWARD AND VOTED ON BY OUR
BOARD, WHILE THERE MIGHT BE A
DIFFERENCE BETWEEN THE TIME
FRAME OF EMERGENCY AND REGULAR
RULEMAKING WITH REGARD TO PUBLIC
ENGAGEMENT, I WOULD SAY THAT AS
A RESULT OF THE PROCESS THAT WE
HAVE IN PLACE FOR STAKEHOLDER
AND PUBLIC ENGAGEMENT, WE ADD ON
AT LEAST TWO ADDITIONAL MONTHS
OF PUBLIC ABILITY TO ENGAGE WITH
COVERED CALIFORNIA BEFORE ANY OF
OUR PROPOSED RULES, GO TO THE
OFFICE OF ADMINISTRATIVE LAW. SO
IN THAT TIME FRAME THAT INCLUDES
INFORMAL STAKEHOLDER ENGAGEMENT
THROUGH VARIOUS ADVISORY WORK
GROUPS OR INFORMAL ENGAGEMENTS
WITH STAKEHOLDER GROUPS THAT WE
KNOW MAY BE IMPACTED OR WOULD
LIKE TO WEIGH IN ON OUR
RULEMAKING PACKAGES. WE HAVE ONE
BOARD MEETING THAT IS DEVOTED TO
DISCUSSING THÀNH ONLY OF ANY
RULEMAKING CHANGES THAT WE ARE
PROPOSING. SO IT GIVES AMPLE
TIME FOR THE PUBLIC TO ENGAGE
AND FOR STAKEHOLDERS TO PROVIDE
ADDITIONAL FEEDBACK, FOLLOWING
THAT, WE HAVE A SECOND BOARD
MEETING WHERE THE BOARD HAS AN
OPPORTUNITY TO VOTE. SO IT GIVES
US AN OPPORTUNITY TO MAKE
CHANGES TO THE PROPOSED RULES
BEFORE OUR BOARD TAKES ACTION.
THEN WHEN THEY DO TAKE ACTION,
IT GOES TO THE OHEL, WHICH IS
WHERE YOU WILL HAVE THE NORMAL
TIME FRAMES FOR EMERGENCY
RULEMAKING TO, COMMENCE. ONCE WE
PROVIDED THOSE IN. SO WE DO
PROVIDE AN OPPORTUNITY FOR AMPLE
PUBLIC PARTICIPATION, I WOULD
SAY THAT THIS POLICY IS ONE THAT
HAS BEEN WITH COVERED CALIFORNIA
SINCE WE STARTED AND WAS
ACTUALLY CODIFIED SOME YEARS
BACK, THROUGH SB 1245. SO IT IS
IN STATE STATUTE. IT DOES GO
BEYOND THE RULEMAKING PROCESS
THAT WE CURRENTLY HAVE UNDER THE
OHL, AND WHILE WE CAN'T SPEAK
FOR OTHER STATE DEPARTMENTS OR
THE BROADNESS OF THE AUTHORITY
THAT THE CMA HAS RAISED FOR
COVERED CALIFORNIA, IT'S MADE A
MEANINGFUL DIFFERENCE FOR US TO
BE ABLE TO KEEP PACE WITH THOSE
CHANGES AND MAKE SURE THAT
CONSUMERS ARE GETTING THE
BENEFITS THAT EITHER THE FEDERAL
ADMINISTRATION OR THIS
LEGISLATURE WOULD LIKE TO PUT
FORWARD TO THEM. SO JUST TO BE
CLEAR, YOU'RE STATING THAT YOU
WOULD ONLY USE THIS EMERGENCY
RULEMAKING TO COMPLY WITH
FEDERAL OR STATE CHANGES, AND
THAT IS IT. THAT'S WHAT YOU'RE
STATING, CORRECT. THAT IS WHAT
WE HAVE GENERALLY USED THE
EMERGENCY RULEMAKING PROCESS FOR
, THERE COULD BE, YOU KNOW,
MARKET CONDITIONS THAT MAYBE
AREN'T REGULATED THROUGH A LAW
OR A RULE, A FEDERAL RULE CHANGE
THAT IT COULD MAKE SENSE FOR
COVERED CALIFORNIA TO USE THE
FLEXIBILITY AND BE NIMBLE ENOUGH
TO IMPLEMENT, AGAIN, USING ALL
OF THE TRANSPARENT PROCESSES
THAT WE HAVE IN PLACE, OKAY, I'M
GOING TO, AS I TOLD YOU BEFORE,
I WILL, SUPPORT THIS BILL TODAY
TO GET OUT. I AM A LITTLE
CONCERNED WITH THE BROADNESS OF
THIS. IF YOU ARE SPECIFICALLY
REFERRING TO FEDERAL AND STATE
THAT NEEDS TO BE DONE
IMMEDIATELY, THEN I COMPLETELY
UNDERSTAND AND, YOU KNOW, THINK
WE SHOULD HAVE CONVERSATIONS
ABOUT NARROWING IT TO THAT, BUT
TO JUST HAVE THIS BROAD, ABILITY
TO ESSENTIALLY DECLARE ANYTHING
LIKE NEEDS TO BE UNDER THE
EMERGENCY RULE AND THEN JUST
KIND OF QUICK, I KNOW YOU'VE
SAID THAT YOU HAVE A PROCESS,
HOWEVER, IT IS SHORTENED AND
TRUNCATED WHEN YOU'RE DEALING
WITH, EMERGENCY SITUATIONS,
HOPEFULLY YOU WILL CONTINUE TO
HAVE CONVERSATIONS AND FIX THIS
BEFORE IT GETS TO THE FLOOR. SO
THANK YOU. JUST TO ADD TO MY
COLLEAGUES POINT, I WANT TO ALSO
CLARIFY THAT THE REGULATIONS BY
NATURE ARE ONLY IMPLEMENTING OR
CLARIFYING AN EXISTING STATUTE
OR FEDERAL RULE, SO THEY WOULD
NEVER THE REGULATIONS WOULD
NEVER GO OUT OF BOUNDS OF THAT
ADOPTED LAW. THANK YOU. THAT'S
HELPFUL CLARIFICATION, MR.
PATTERSON. THANK YOU. SO GO. SO,
I APPRECIATE THE LINE OF
QUESTIONING BY DOCTOR WEBER, ON
THE TWO RE ADOPTIONS. HOWEVER,
WHY IS THAT NECESSARY? I THINK
THE BILL ALLOWS UP TO TWO RE
ADOPTIONS UNTIL ALL, OF THOSE
EMERGENCY REGULATIONS UNTIL
2035. CORRECT. THAT'S CURRENTLY
IN THE GOVERNMENT CODE AUTHORITY
FOR THIS EMERGENCY REGULATION,
THE TWO ADOPTIONS ARE IN THERE
TO ALLOW FOR CONTINUED
IMPLEMENTATION OF THE POLICIES
ADOPTED. WE DO STILL HAVE THE
LIMITATION THAT THE REGULATIONS
MUST BE MADE PERMANENT WITHIN
FIVE YEARS OF THE ORIGINAL
RULEMAKING, IN ORDER TO CONTINUE
TO EXIST. YEAH, THAT ANSWERS.
BUT PRESUMABLY IF YOU ADOPTED
EMERGENCY REGULATIONS ÓRDENES,
YOU COULD CHOOSE TO MAKE THEM
PERMANENT INSTEAD OF TWO
ADDITIONAL RE ADOPTIONS THAT
COULD BE A LONG PERIOD OF TIME.
SO DURING THAT COURSE PERIOD OF
TIME, WOULDN'T YOU BE ABLE TO,
YOU KNOW, ADOPT PERMANENT
REGULATIONS AT THAT TIME?
ABSOLUTELY. AND WE ACTUALLY HAVE
TWO PACKAGES RIGHT NOW THAT WE
ARE DOING JUST THAT. OKAY.
THAT'S GREAT, I GUESS I WOULD
JUST SAY. THEN WHY DO YOU NEED I
GUESS WHAT WE'RE SAYING IS, HEY,
LET'S GIVE YOU THE AUTHORITY TO
PROMULGATE EMERGENCY
REGULATIONS. AND THEN ON TOP OF
THAT, TO ADDITIONAL RE ADOPTIONS
OF THOSE EMERGENCY REGULATIONS,
WHEN YOU COULD, OVER THAT PERIOD
OF TIME, HAVE ADOPTED THEM AS
PERMANENT REGULATIONS. SO I
GUESS WHAT I'M SAYING IS LIKE I
HAVE CONCERNS WITH GIVING YOU
THE IN ADDITION TO VERY BROAD
AUTHORITY TO ADOPT REGULATIONS.
IT, YOU KNOW, SORT OF SUCH A
BROAD AS IS THERE WRITTEN IN THE
BILL. IN ADDITION, EXTENDING
THOSE TWO MORE TIMES WHEN YOU
COULD ACTUALLY JUST MAKE THEM
PERMANENT, IF YOU CHOOSE AND GO
THROUGH THAT STAKEHOLDER
PROCESS. AND I'M HAPPY TO HEAR A
RESPONSE TO THAT IF YOU, IF
YOU'D LIKE, BUT I KIND OF, I, I
THINK IF THE INTENT IS TO. SO I
USED TO WORK IN A REGULATED
INDUSTRY AND I'M VERY CONCERNED
ABOUT EMERGENCY REGULATIONS,
I'VE SEEN THE NEED FOR THEM. SO
I UNDER I UNDERSTAND WHY THEY
NEED TO HAPPEN SOMETIMES. SO I
DON'T WANT TO BE DISMISSIVE OF
THAT. BUT I THINK NARROWING IT
TO WHAT YOU WANT TO ACCOMPLISH
IF IT BECAUSE I UNDERSTAND. I
MEAN, WHEN THE FEDERAL
GOVERNMENT COMES OUT AND SAYS,
HEY, YOU NEED TO DO THIS AND YOU
DON'T KNOW WHAT THEY'RE GOING TO
DO, I HAVE NO IDEA WHAT THE
FEDERAL GOVERNMENT'S GOING TO DO
TOMORROW. SO I UNDERSTAND THE
NEED TO, YOU KNOW, KIND OF BE
NIMBLE ON THAT. AND I'M OPEN TO
THAT. BUT IF WE SORT OF LIMITED
TO WHAT IT WAS AND THEN I DON'T
LIKE THE RE ADOPTION, JUST TO BE
HONEST WITH YOU, BECAUSE YOU
COULD ADOPT PERMANENT
REGULATIONS AND YOU COULD TELL
ME I'M WRONG AND TELL ME WHY,
AND THAT'D BE GREAT. BUT I DO
HAVE SOME CONCERNS WITH THAT. SO
THANK YOU. YEAH. UNDERSTAND. AND
I WILL NOT TELL YOU THAT YOU'RE
WRONG. I DO, I THINK COVERED
CALIFORNIA IS IN A UNIQUE
POSITION GIVEN THE ANNUAL
FEDERAL RULE CHANGES AS WELL AS
THESE AD HOC RULE CHANGES THAT
COME DOWN, OUTSIDE OF THAT
CALENDAR AND THE I TOTALLY
UNDERSTAND THE CONCERNS. I THINK
THERE RE ADOPTION AS WELL AS THE
AUTHORITY TO ADOPT THESE IN THE
FIRST PLACE IS, TRYING TO STRIKE
A BALANCE AND RECOGNIZE THAT,
YEAR OVER YEAR, THESE CHANGES
OCCUR AND SOMETIMES THEY'RE
SLIGHTLY DIFFERENT, AND
SOMETIMES THE CHANGES ARE
CONTINUED. AND IT'S, I THINK THE
INTENTION IS TO GIVE COVERED
CALIFORNIA THAT FLEXIBILITY TO
ADAPT AS NEEDED. AND WHEN THERE
IS A CLEAR INDICATION THAT THIS
POLICY IS LONG LASTING, OR AT
LEAST THROUGH ONE
ADMINISTRATION, WE DO TAKE
ADVANTAGE TO MAKE THOSE
PERMANENT AND I THINK IF SORRY,
ASSEMBLY MEMBER, I THINK IF
THERE ARE ALSO, YOU KNOW, IF
THERE'S A DESIRE TO, YOU KNOW,
YOU YOU GO THROUGH THIS PROCESS
THAT'S BEYOND WHAT THE EMERGENCY
REGULATIONS ACTUALLY REQUIRE.
YOU KNOW, THIS EXTRA STAKEHOLDER
TIME AND THINGS LIKE THAT. I
MEAN, YOU COULD PUT THAT INTO
THE BILL, RIGHT? I MEAN, IF
YOU'RE SAYING THAT'S WHAT WE DO.
SO YOU COULD ALSO PUT THAT INTO
THE BILL IN THE FUTURE, JUST,
YOU KNOW, FOOD FOR THOUGHT
OBVIOUSLY. SO I LIKE WHAT YOU'RE
DOING. I'M JUST VERY CONCERNED
WITH IT IN ITS CURRENT FORM.
AND, YOU KNOW, MR. CHAIRMAN, I
DON'T DISAGREE WITH THE POINTS
YOU'VE RAISED. I GUESS I WOULD I
WOULD SAY THIS, HOWEVER, THIS
STARTED AND EVEN THIS BILL
REFERS GENERALLY TO NOT
GENERALLY SPECIFICALLY TO POWERS
THAT WERE EXTENDED BY STATUTE
PASSED BY THIS LEGISLATURE. IN
ADDITION, YOU KNOW, AS SOMEONE
WHO HAS SAT ON THIS COMMITTEE MY
ENTIRE TENURE IN THE LEGISLATURE
, WE HAVE REVISITED THESE ISSUES
A NUMBER OF TIMES, AND THE
LEGISLATURE HAS EXPRESSED STRONG
SUPPORT FOR COVERED CALIFORNIA.
THE RESULTS WE'VE SEEN FROM
COVERED CALIFORNIA THIS BILL IS
GETTING A LITTLE BIT INTO THE
WEEDS ON SOME OF THAT, IT'S
IMPORTANT THAT THESE EMERGENCY
POWERS BE EXTENDED. I THINK IT'S
FAIR TO SAY WE CAN CONTINUE TO
WORK ON SOME OF THE DETAILS ON
MAYBE HOW FAR THAT GOES OUT, BUT
AND ON A RELATED BUT SLIGHTLY
SEPARATE ISSUE, I REMEMBER, WHEN
WE FIRST NEGOTIATED THE MCO TAX
AND I WAS ONE OF THE LEAD
REPRESENTATIVES ON THAT, WE WERE
AT VERY REAL RISK OF NOT HAVING
FUNDING FOR MEDI-CAL. AND HAD
THAT NOT PASSED, WE WOULD HAVE
BEEN IN A VERY DIFFICULT
POSITION TO SAY WE WENT OVER 50%
OF THE KIDS ARE ON MEDI-CAL. I
RAISE THAT NOT BECAUSE THAT'S
NECESSARILY DIRECTLY ON POINT,
BUT WHY IT'S SO IMPORTANT TO
HAVE SOME FLEXIBILITY AND TO
HAVE SOME OF OUR EMERGENCY
POWERS ON AN ISSUE OF THIS
NATURE AND OF THIS WIDESPREAD
IMPORTANCE. IT IS DIFFERENT THAN
SOMETHING ELSE, THAN A MORE
NARROW BILL THAT ALL OF US SORT
OF TYPICALLY DO. SO I I'M
MINDFUL OF THE POINT THAT YOU'RE
RAISING. I DON'T THINK IT SHOULD
BE EXTENDED JUST SO, SO
COMPLETELY BROADLY THAT THERE'S
NO RESTRICTIONS. HAVING SAID
THAT, THOSE THESE EMERGENCY
POWERS ARE VERY SIGNIFICANT AND
THEY NEED TO BE THERE. SO WE
DON'T RUN A RISK OF LOSING WHAT
THIS LEGISLATURE OVER THE PAST
DECADE HAS DONE TO ADVANCE
COVERAGE FOR PEOPLE IN
CALIFORNIA WHO WERE NOT
PREVIOUSLY COVERED. I MEAN, WE
REALLY I THINK WE'RE UP. I DON'T
REMEMBER JUST KIND OF OFF THE
TOP OF MY HEAD, BUT IT'S
SOMETHING LIKE 94. I MEAN, WE'RE
AT A VERY HIGH RATE THAT WHEN WE
THIS LEGISLATURE, MY CLASS FIRST
CAME IN 12 YEARS AGO WAS MUCH
LOWER. SO THE BROAD OVERALL
POINT UNDERSTOOD, WILL CONTINUE
TO WORK WITH CMA AND WITH OTHERS
ON THAT. BUT HAVING SAID THAT,
THIS, THIS, THESE EMERGENCY
POWERS ARE VERY, VERY
SIGNIFICANT. AND I THINK IT'S
NECESSARY THAT WE EXTEND THEM TO
MAKE SURE THAT WE'RE NOT AT RISK
OF LOSING HUGE AMOUNTS OF
BENEFITS. CAN WE TAKE THAT AS
YOUR CLOSE, MR. MAIENSCHEIN
YEAH, YOU SURE MAY. AND I WANT
TO THANK I DO ALSO WANT TO THANK
MY COLLEAGUE FOR RAISING THE
POINT. I WANT TO THANK MY
WONDERFUL FORMER STAFF MEMBER,
ALBEIT HIS MISGUIDED OPPOSITION.
HE DID SAY IT VERY EFFECTIVELY
COMMUNICATED IT WELL. HE HAD A
GOOD TEACHER, AT LEAST ON THAT.
SO, BUT WITH THAT, I'D
RESPECTFULLY REQUEST AN AYE VOTE
. THANK YOU. THAT DOCTOR
ARAMBULA MOVES. WENDY CARILLO
SECONDS. THANK YOU SO MUCH. THE
MOTION IS DUE. PASS TO
APPROPRIATIONS. PLEASE CALL THE
ROLL. BONTA I BONTA I WALDRON,
HAGER, CURRY HAGER CURRY I
ARAMBULA ARAMBULA I WENDY
CARILLO WENDY CARILLO I FLORA
LARA NOT VOTING HANEY HANEY I
JOHN SAWYER JOHN SAWYER I MEAN
SHINE MAY SHINE I MCCARTY JOE
PATTERSON. JOE. PATTERSON NOT
VOTING. RODRIGUEZ. RODRIGUEZ I
SANCHEZ. SANCHEZ NOT VOTING.
SANTIAGO SANTIAGO I CHAVO CHAVO
I WEBER. WEBER I. THAT MEASURE
PASSES 11 TO 0. IT'S OUT OF
COMMITTEE. THANK YOU. ALL RIGHT.
WE ARE GOING TO COMPLETE OUR
BUSINESS FOR THE HEARING BY
GOING UP TO THE FIRST FILE ITEM.
WE WILL LIFT THE CALL NOW ON
ITEMS THAT WILL PROCEED WHERE WE
DIDN'T HAVE A FULL, COMMITTEE TO
BE ABLE TO VOTE AND WE WILL MOVE
FORWARD WITH, ITEM ONE AB 1926.
CONNOLLY ARAMBULA ARAMBULA I
HANEY. HANEY. I JOAN SAWYER.
JOHN SAWYER I MAIENSCHEIN. MÀ
SHINE. I MCCARTY. RODRIGUEZ.
RODRIGUEZ I SANTIAGO. SANTIAGO I
15 ZERO. THAT MEASURE PASSES 15
ZERO. ITEM TWO AB NINE O THAT
WAS ON CONSENT. SO WE'LL DO THE
CONSENT CALENDAR NOW. ARAMBULA.
ARAMBULA I HANEY HANEY, I, JOAN
SAWYER, JOAN SAWYER I MAINE
SHINE, MAINE SHINE I MCCARTY.
RODRIGUEZ RODRIGUEZ I SANTIAGO
SANTIAGO I 15 ZERO. CONSENT
CALENDAR PASSES 15 TO 0. ITEM
NUMBER THREE AB 1965 ARAMBULA
ARAMBULA I HANEY. HANEY I JOAN
SAWYER, JOAN SAWYER I
MAIENSCHEIN MAIENSCHEIN I
MCCARTY. RODRIGUEZ. RODRIGUEZ I
SANTIAGO. SANTIAGO I 15 ZERO.
THAT MEASURE PASSES 15 TO 0.
WE'LL MOVE ON TO ITEM NUMBER
FOUR AB 2052. JOAN SAWYER, LAW.
FIRST, YOU ALREADY VOTED SECOND.
LARA. LARA FLORA I HANEY. HANEY
I MCCARTY. JO PATTERSON. JO.
PATTERSON I SANTIAGO. SANTIAGO.
I 15 ZERO. THAT MEASURE PASSES
15 TO 0. ITEM NUMBER FIVE AB
2081 DAVIES ARAMBULA ARAMBULA. I
HANEY. HANEY I JOAN SAWYER, JOAN
SAWYER I MAIENSCHEIN.
MAIENSCHEIN I MCCARTY.
RODRIGUEZ. RODRIGUEZ I SANTIAGO.
SANTIAGO I 15 ZERO. THAT MEASURE
PASSES 15 TO 0. ITEM NUMBER
SEVEN AB 2156. PACHECO OH, WAIT
A MINUTE. ARE WE ON NUMBER SIX?
I SORRY, ITEM NUMBER SIX, AB
2154. BERMAN ARAMBULA ARAMBULA I
HANEY. HANEY I JOAN SAWYER. JOAN
SAWYER I MAIENSCHEIN MAIENSCHEIN
I MCCARTY. RODRIGUEZ RODRIGUEZ I
SANTIAGO. SANTIAGO I 15 ZERO.
THAT MEASURE PASSES 15 TO 0.
ITEM NUMBER SEVEN AB 2156.
PACHECO ARAMBULA ARAMBULA I.
HANEY HANEY I JOAN SAWYER, JOAN.
SAWYER, I MAIENSCHEIN
MAIENSCHEIN I MCCARTY. RODRIGUEZ
RODRIGUEZ I SANTIAGO. SANTIAGO I
15 ZERO. THAT MEASURE PASSES 15
ZERO. WE'LL MOVE ON TO ITEM
EIGHT AB 2175. LOWENTHAL THAT
MEASURE WAS ON CALL. SO WE'LL
LIFT THE CALL AND ADD THE ABSENT
MEMBERS. ARAMBULA ARAMBULA I
HANEY. HANEY. I JOAN SAWYER,
JOAN SAWYER I MAINCHAIN
MAINCHAIN I MCCARTY. RODRIGUEZ.
RODRIGUEZ I SANCHEZ. SANCHEZ IS
NOT VOTING SANTIAGO. SANTIAGO I.
14 ZERO. THAT MEASURE PASSES 14
TO 0. ITEM NUMBER NINE. ALSO ON
CALL. CALL HAS BEEN LIFTED FOR
AB 2020 2250. WEBER BONTA I
BONTA I WENDY CARILLO WENDY
CARRILLO I FLORA FLORA I JOAN
SAWYER JOAN SAWYER I MAINCHAIN
MAINCHAIN I MCCARTY. SANTIAGO
SANTIAGO I SHABU SHABU I50. THAT
MEASURE NOW PASSES 15 TO 0.
WE'LL GO BACK TO ITEM NUMBER TEN
AB 2300. WILSON WE'LL LIFT THE
CALL FOR ANY ABSENT MEMBERS TO
VOTE. WALDEN ARAMBULA ARAMBULA I
WENDY CARILLO. WENDY CARRILLO I
FLORA LARA NOT VOTING. HANEY.
HANEY I MCCARTY. JO. PATTERSON.
JO. PATTERSON. NOT VOTING
SANTIAGO. SANTIAGO I CHAU. VÚI.
THAT MEASURE PASSES 10 TO 1.
MOVING ON TO ITEM 11 AB 2319.
LIFTING THE CALL WENDY CARRILLO,
WENDY CARILLO I LARA LARA. NOT
VOTING HANEY. HANEY I MCCARTY.
JO PATTERSON. JO. PATTERSON. NO
SANTIAGO. SANTIAGO I SABO. CHAU.
VÚI. 12 TO 2 PASSES. THAT
MEASURE PASSES 12 TO 2. WE ARE
LIFTING THE CALL ON ALL
REMAINING ITEMS. WE WILL MOVE ON
TO ITEM NUMBER. 12 ITEM NUMBER
12 AB 2339 AGUIAR-CURRY ARAMBULA
ARAMBULA I. HANEY HANEY I
MCCARTY. SANTIAGO SANTIAGO I 15
ZERO. THAT MEASURE PASSES 15 TO
0. ITEM NUMBER NINE. ITEM NUMBER
13 AB 2402. LOWENTHAL BONTA I
BONTA I FLORA LARA I HANEY.
HANEY I JOAN SAWYER JOAN SAWYER
I MAIENSCHEIN MAIENSCHEIN I
MCCARTY. RODRIGUEZ. RODRIGUEZ I
SANTIAGO. SANTIAGO I 15 ZERO.
THAT MEASURE PASSES 15 TO 0.
ITEM NUMBER 14 AB 2435. WALDRON
MCCARTY. BILL 11 TO 0. THAT
MEASURE IS STILL 11 TO 0 AND
PASSES AB 14. ARE WE AB 14? NO,
WE'RE ON, ITEM 15 AB 2446. WENDY
CARRILLO WENDY CARRILLO I FLORA
LARA I HANEY. HANEY I MCCARTY.
SANTIAGO. SANTIAGO I CHAVO SABO
I 15 ZERO. THAT MEASURE PASSES
15 TO 0. ITEM NUMBER 16 AB 2556
JACKSON LARA LARA I MCCARTY,
SANTIAGO. SANTIAGO I 15 ZERO.
THAT MEASURE PASSES 15 TO 0.
ITEM NUMBER 17 IS ON CONSENT,
ITEM NUMBER 18, AB 2753. ORTEGA
WENDY CARRILLO, WENDY. CARRILLO
I FLORA LARA NOT VOTING MCCARTY.
SANTIAGO SANTIAGO I. 12 TO 0.
THAT MEASURE PASSES 12 TO 0.
ITEM NUMBER 19 WAS ON CONSENT
AND HAS BEEN VOTED ON ALREADY.
THAT'S EVERYTHING YOU WANT TO
MOVE BACK TO ITEM YOU WANT TO
ADD ON TO ITEM FOUR. ON ITEM
FOUR AB 2052, JOAN SAWYER
PATTERSON IS GOING FROM I TO NOT
VOTING PATTERSON I TO NOT VOTING
. WE WILL, THAT CONCLUDES 14
ZERO. THAT MEASURE PASSES NOW 14
ZERO. SO WE WILL KEEP COMMITTEE
HEARING OPEN SO THAT MISTER
MCCARTY CAN COME TO POTENTIALLY
VOTE. OTHERWISE, WE ARE OTHER
MEMBERS HAVE CONCLUDED THEIR
BUSINESS WITH THIS COMMITTEE. WE
WILL HOLD THE COMMITTEE OPEN FOR
ANOTHER FIVE MINUTES FOR MR.
MCCARTY.
I'M GOING TO GO
.
THIS CONCLUDES THE ASSEMBLY
COMMITTEE ON HEALTH. APRIL 9TH
APRIL SECOND HEARING.