GOOD MORNING. I AM GOING TO CALL
THIS HEARING TO ORDER. THIS IS
ASSEMBLY BUDGET SUBCOMMITTEE ONE
ON HEALTH. TODAY, WE WILL BE
REVIEWING THE GOVERNOR'S
PROPOSALS FROM HIS MAY REVISE
IS. THERE WILL BE A SLIGHT
CHANGE TO THE TO WHAT'S ON THE
AGENDA GIVEN THE FACT THAT WE
HAVE A SIGNIFICANT NUMBER OF
ISSUES AND THERE ARE A LOT OF
PEOPLE HERE, AND YOU MAY BE HERE
FOR ONE SPECIFIC ISSUE, WE WILL
TAKE PUBLIC COMMENT AFTER EACH
ISSUE IS COMPLETED. AND SO
INSTEAD OF WAITING UNTIL THE
VERY END OF THE HEARING, AT THIS
POINT WE CAN CALL ROLL. HERE,
SPONSOR. MISTER PATTERSON. OKAY.
WE'RE GOING TO START OUR HEARING
TODAY WITH THE DEPARTMENT OF
HEALTH CARE SERVICES, ON THE
PANEL WILL BE A REPRESENTATIVE
FROM THE DEPARTMENT OF HEALTH
CARE FINANCES, A REPRESENTATIVE
FROM THE DEPARTMENT OF FINANCE.
SORRY A REPRESENTATIVE FROM THE
DEPARTMENT OF HEALTH CARE
SERVICES. REP FROM THE
DEPARTMENT OF FINANCE, AND A
REPRESENTATIVE FROM THE
LEGISLATIVE ANALYST'S OFFICE.
YOU MAY COME UP, AND I WANT TO
BEGIN BY THANKING EVERYONE FOR
COMING. I HOPE THAT WE CAN HAVE
A VERY THOROUGH, IN-DEPTH AND
HONEST CONVERSATION TODAY ABOUT
THE MCO TAX AND OUR MEDI-CAL
RATES. I DON'T THINK LAST WEEK
WHEN WE HAD IT LAST MAY, IT WAS
AS OPEN AND HONEST AS IT SHOULD
HAVE BEEN, AND SO WITH THAT, I
WILL LET YOU BEGIN. GOOD MORNING
, MADAM CHAIR MEMBERS OR MADAM
CHAIR MICHELLE BOS, DIRECTOR OF
THE DEPARTMENT OF HEALTH CARE
SERVICES, GIVEN THE STATE'S
SIGNIFICANT FISCAL CHALLENGE
THAT WE ARE FACING A GENERAL
FUND SHORTFALL OF 27.6 BILLION
IN 24, 25 AND 28.4 BILLION IN
2526. THE ADMINISTRATION IS
PROPOSING OPTIONS TO REDUCE
GENERAL FUND EXPENDITURES AND
OPTIONS TO ACHIEVE GENERAL FUND
SAVINGS. THE DEPARTMENT HAS AN
EXPENDITURE OF GENERAL FUND OF
ABOUT 36 BILLION, AND REPRESENTS
A SIGNIFICANT PORTION OF THE
STATE'S GENERAL FUND
EXPENDITURES. THESE DECISIONS
AND PROPOSALS ARE DIFFICULT AND
NOT PUT FORWARD LIGHTLY. WE
RECOGNIZE THAT THESE ARE
PROPOSALS AND THAT THE
ADMINISTRATION AND LEGISLATURE
WILL WORK TOGETHER OVER THE
COMING WEEKS TO ACHIEVE A
BALANCED BUDGET TO SERVE
CALIFORNIA IN TERMS OF THE
MEDI-CAL MANAGED CARE
ORGANIZATION TAX. AS PART OF THE
MAY REVISION, THE DEPARTMENT
PROPOSES MODIFICATIONS TO THE
MCO TAX EFFECTIVE APRIL FIRST,
2024, TO MORE COMPREHENSIVELY
ACCOUNT FOR MEDICARE REVENUE IN
DETERMINING THE MAXIMUM
AGGREGATE TAX ALLOWABLE WHILE
MEETING FEDERAL REQUIREMENTS.
THE MAY REVISION ASSUMES 689
POINT MILLION AND NET GENERAL
FUND REDUCED GENERAL FUND
SPENDING IN 2425, 950 MILLION.
IN 2526 AND 1.3 BILLION IN 2627.
RELATED TO THIS MODIFICATION,
AGAIN, WE ARE PROPOSING TO
REVISE OUR MCO TAX MODEL TO NOW
INCLUDE REVENUE FROM MEDICARE
MANAGED CARE IN OUR MODEL,
INCREASING THE ALLOWABLE TAX
SIZE AND THE TOTAL AMOUNT OF
REVENUE GENERATED FROM THE TAX.
OUR CURRENT MCO TAX MODEL
EXCLUDES MEDICARE PLAN REVENUE
AS PART OF THE REVENUES IN THIS
REQUIRED DEMONSTRATION. THIS
ALLOWS US TO INCREASE OUR TAX ON
MEDI-CAL MANAGED CARE PLANS.
THERE IS NO IMPACT TO COMMERCIAL
PLANS, AS WE ARE ONLY PROPOSING
TO INCREASE THE TAX ON MEDI-CAL
LIVES. ADDITIONALLY, THE MAY
REVISION CONTINUES TO INCLUDE
727 MILLION TOTAL FUNDS, 291
MILLION FROM THE MEDICARE
MEDI-CAL PROVIDER PAYMENT
RESERVE FUND FOR INCREASING
RATES FOR PRIMARY CARE, NON
SPECIALTY MENTAL HEALTH SERVICES
AND MATERNITY CARE TO AT LEAST
87.5% OF THE MEDICARE RATES
EFFECTIVE. THIS WAS EFFECTIVE
JANUARY 1ST, 2024. FINALLY, THE
MAY REVISION FURTHER PROPOSES TO
USE MCO TAX REVENUES PREVIOUSLY
PROPOSED AT GOVERNOR'S BUDGET TO
SUPPORT ADDITIONAL TARGETED RATE
INCREASES AND INVESTMENTS THAT
WERE PROPOSED TO START IN 2025
AND TRANSFER THOSE DOLLARS TO
THE MEDICARE PROVIDER PAYMENT
RESERVE FUND FOR LATER USE TO
SUPPORT THE EXISTING COST IN THE
MEDI-CAL PROGRAM. THIS INCLUDES
THE REDUCTION OF THE MCO,
GRADUATE MEDICAL MEDICAL
EDUCATION AND WORKFORCE
WORKFORCE POOL FUNDING THAT WAS
PROPOSED AT GOVERNOR'S BUDGET TO
BEGIN RESPECTIVELY IN 2024 AND
2025, AND THE ELIMINATION OF THE
MCO TAX TARGETED RATE INCREASES
THAT WERE PROPOSED USED TO BE
EFFECTIVE JANUARY 1ST, 2025. SO
PHASE TWO OF THE RATE INCREASES,
AS DISCUSSED PREVIOUSLY IN THE
SUBCOMMITTEE, THE GOVERNOR'S
JANUARY BUDGET INCLUDED THE
EARLY ACTION ON A BUDGET
AGREEMENT TO INCREASE THE MCO
TAX REVENUES TO ACHIEVE AN
ADDITIONAL $1.5 BILLION IN
REVENUES. WE'VE SUBMITTED THAT
APPLICATION TO CMS AT THE END OF
MARCH AND CONTINUE IN
DISCUSSIONS WITH CMS ON THAT
PARTICULAR AMENDMENT, AS
REQUESTED, AS PART OF THE
AGENDA, JUST TO PROVIDE A BRIEF
OVERVIEW OF WHAT WAS PROPOSED AT
GOVERNOR'S BUDGET RELATED TO
2025 RATE INCREASES, PROPOSED
TOTAL ANNUAL SPEND ONCE GOES
LIVE, ABOUT 2.7 BILLION IN THE
MEDICARE MEDI-CAL PROVIDER
PAYMENT RESERVE FUND, WITH ABOUT
975 MILLION FOR PRIMARY CARE,
SPECIALTY CARE, MATERNITY CARE,
AND NON SPECIALTY MENTAL HEALTH
SERVICES, 100 MILLION FOR
EMERGENCY DEPARTMENT PHYSICIAN
SERVICES, 80 MILLION. WITH
REGARD TO ADJUSTMENTS FOR
EQUITY, 245 MILLION FOR
COMMUNITY HOSPITAL OUTPATIENT
SERVICES 255 MILLION FOR
EMERGENCY DEPARTMENT FACILITY
SERVICES 990. EXCUSE ME 990
MILLION FOR ABORTION SERVICES 50
MILLION FOR GROUND EMERGENCY
MEDICAL TRANSPORTATION SERVICES,
150 MILLION FOR OUR DESIGNATED
PUBLIC HOSPITALS, AND
APPROXIMATELY 50 MILLION FOR
SERVICES AND SUPPORTS AT OUR,
FEDERALLY QUALIFIED HEALTH
CENTERS. WITH THAT, HAPPY TO
ANSWER QUESTIONS. THANK YOU. SO,
THOUGH THOSE LAST NUMBERS THAT
YOU JUST RAN THROUGH, THEY ARE
STILL IN PLAY. THOSE WERE THOSE
WERE THOSE WERE, PART OF THE
GOVERNOR'S BUDGET PROPOSAL. AND
AS PART OF MAY REVISION, WE ARE
PROPOSING TO ELIMINATE THE 2025
RATE INCREASES AND INVESTMENTS.
YES. WHAT ABOUT EVERYTHING ELSE
YOU TALKED ABOUT THE ADJUSTMENT
FOR EQUITY, THE ER ALL OF THAT
IS THAT WAS THOSE ARE ALL PHASE
TWO OF THE RATE INCREASES THAT
WERE TO BE EFFECTIVE JANUARY
ONE, 2025. AND UNDER THE MAY
REVISION, THOSE ARE PROPOSED TO
BE ELIMINATED. OKAY. SO WHEN YOU
ALL WERE HERE FOR, LAST WEEK AND
WE WERE TALKING ABOUT MEDI-CAL
REIMBURSEMENT RATES BEING
HORRIFICALLY LOW, ACTUALLY
EMBARRASSING. LOW,
EMBARRASSINGLY LOW HERE IN THE
STATE OF CALIFORNIA. AND, WE
WERE TOLD THAT ESSENTIALLY
PROVIDERS OR MDS WOULD BE MADE
WHOLE OR DÍAS OR WHATEVER, WITH
THE 2025 AND THAT THERE WAS A
PLAN IN PLACE TO ACCOMPLISH
THAT. HOW ARE WE GOING TO DO
THAT NOW THAT YOU HAVE PULLED
THAT MONEY FROM THE MCO TAX, OR
THAT IT'S BEING PROPOSED TO
BEING PULLED BACK INTO,
RECOGNIZING THE STATE'S FISCAL
SITUATION, THIS WAS A PROPOSAL
TO ACHIEVE GENERAL FUND SAVINGS
AND REDUCE EXPENDITURES. AND SO,
YOU KNOW, WE WILL CONTINUE TO
WORK WITH OUR PROVIDERS AND OUR
PLANS TO LOOK AT OTHER WAYS TO
ACHIEVE ACCESS AND QUALITY CARE.
SO, A COUPLE OF THINGS WITH,
WITH THIS, RECOGNIZING THAT WE
ARE IN A BUDGET DEFICIT, A
SIGNIFICANT BUDGET DEFICIT, THE
MCO TAX WAS A, A DEAL, AN
ARRANGEMENT THAT, STAKEHOLDERS,
THE GOVERNOR'S OFFICE, NOT AS
MUCH AS THE LEGISLATIVE INPUT AS
THERE SHOULD HAVE BEEN. BUT YOU
KNOW, WE WERE AT THE TABLE AT
SOME POINT, YOU KNOW, WE WORKED
ON BECAUSE WE UNDERSTAND THAT
THAT WE HAVE A CRISIS IN OUR
HEALTH CARE SYSTEM, MEMBERS OF
THE LEGISLATURE TOOK SOME OF
THEM, TOOK VERY HARD VOTES TO
ONE, SUPPORT THE MCO TAX AND TO
GO BACK AND ASK FOR MORE MONEY,
WITH THE EARLY ACTION PLAN, WITH
THE UNDERSTANDING THAT THIS
WOULD GO BACK INTO OUR MEDI-CAL
SYSTEM TO HELP OUR PROVIDERS,
HELP OUR HOSPITALS DOORS TO STAY
OPEN, ESPECIALLY IN OUR RURAL
AND UNDERSERVED COMMUNITIES,
HELP OUR LABOR AND DELIVERY
UNITS TO STAY OPEN. WHAT IS YOUR
MESSAGE TO MY COLLEAGUES? SOME
OF WHO ARE QUITE UPSET AND FEEL
LIKE, THIS PROCESS HAS NOT BEEN
VERY HONEST. SO I WOULD BEGIN
THIS IS THE MAY REVISION
PROPOSAL RECOGNIZING THAT WE
HAVE WEEKS OF CONVERSATION, TO
ENACT A FINAL BUDGET AGREEMENT,
AND JUST RECOGNIZING ALSO THE
SIGNIFICANT STATE FISCAL
SITUATION WE'RE IN, THERE HAD TO
BE SOME CHOICES. BUT
UNDERSTANDING THAT THERE ARE
STILL MANY CONVERSATIONS TO
CONTINUE IN YOUR CONVERSATIONS,
ABOUT OUR HEALTH CARE, SYSTEM
HERE IN CALIFORNIA. WHAT IS THE
PLAN IF WE TAKE, YOU KNOW,
MEDI-CAL REIMBURSEMENT RATES,
INCREASING THEM OFF THE TABLE?
WHAT IS THE PLAN TO HELP OUR
HOSPITALS AND OUR PROVIDERS? HOW
ARE WE GOING TO RETAIN PROVIDERS
HERE IN CALIFORNIA? HOW ARE WE
GOING TO KEEP THESE DOORS OPEN?
AND ULTIMATELY ALLOW FOR PEOPLE
TO HAVE HOSPITALS TO GO TO, OR
CLINICS TO GO TO, TO RECEIVE THE
CARE THAT THEY NEED? I HAD A
MEETING EARLY THIS MORNING ABOUT
RIDGECREST FROM THE NAVY. RIGHT.
AND SO NOW THEY'RE, THE PEOPLE
WHO HAVE TRICARE THERE HAVE TO
DRIVE 85 MILES THROUGH A
DESERTED AREA TO GET TO THEIR
CLOSEST LABOR AND DELIVERY UNIT.
AND IF YOU DON'T HAVE TRICARE,
YOU'VE GOT TO DRIVE ABOUT 120
MILES. THAT'S NOT SAFE FOR
ANYBODY IN LABOR. SO WHAT IS THE
PLAN AS AS YOU ALL ARE TALKING
ABOUT CUTTING THESE THINGS,
UNDERSTANDING WHERE WE ARE RIGHT
NOW, YOU KNOW, WE'VE TALKED
ABOUT HOSPITALS CLOSING. WE'VE
TALKED ABOUT SERVICES BEING
TAKEN BACK FROM VARIOUS
HOSPITALS AND CLINICS. WE'VE
TALKED ABOUT LABOR AND DELIVERY
UNITS CLOSING, PEDIATRIC WARDS
CLOSED. I MEAN, WE'VE TALKED
ABOUT ALL OF THESE THINGS. SO WE
KNOW IT'S HAPPENING, THIS WAS
ONE PART OF THE SOLUTION TO THAT
ISSUE, AND WE'RE TAKING THAT
AWAY. SO IN YOUR CONVERSATIONS
IS SAYING, OKAY, WE'RE GOING TO
TAKE THIS AWAY TO HELP OUR
BUDGET. WHAT IS THE SOLUTION?
AGAIN, I THINK THESE ARE
DIFFICULT DECISIONS, AND I DON'T
KNOW THAT WE HAVE A SOLUTION
THAT CAN REPLACE WHAT WE WERE
PROPOSING AS PART OF THE PART
TWO OF THE RATE INCREASES IN
2025, GIVEN JUST THE STATE'S
FISCAL SITUATION IN TERMS OF
RATE INCREASES. AND SO, YOU
KNOW, WANTING TO WORK WITH OUR
PROVIDERS AGAIN AND OUR PLANS TO
THINK ABOUT HOW ARE THERE OTHER
WAYS WE CAN SUPPORT THEM TO
ACHIEVE KIND OF THE ACCESS THAT
WE NEED FOR THE MEDI-CAL
PROGRAM? BUT RECOGNIZING THAT
THIS IS WAS A KEY COMPONENT OF
THAT PLAN. OKAY. SO SINCE WE
DON'T HAVE A PLAN, WHAT DO WE
THINK WILL HAPPEN IF WE CONTINUE
DOWN THIS ROAD? HAVE WE THOUGHT
ABOUT THAT? I THINK, YOU KNOW,
WE ARE REQUIRED TO MAINTAIN
NETWORK ADEQUACY TO SERVICES AND
SUPPORTS BY THE FEDERAL
GOVERNMENT. AND SO I THINK, YOU
KNOW, WORKING TO, TO ACHIEVE
THAT, IT'S GOING TO BE SOMETHING
THAT WE'RE GOING TO HAVE TO WORK
TOGETHER OVER THE COURSE OF THE
COMING WEEKS AND MONTHS TO
ADDRESS IF THERE ARE ACCESS
ISSUES WHERE THEY MIGHT BE AND
WHAT ARE OTHER WAYS TO ACHIEVE
WAYS TO IMPROVE THAT. OKAY, SO
CLEARLY WE KNOW THERE ARE ACCESS
ISSUES. SO LET'S TALK ABOUT SOME
OF THE ISSUES THAT WE HAVE NOW.
WHAT IS THE SOLUTION NOW FOR
PEOPLE WHO WERE GOING TO DELIVER
AT RIDGECREST AND NOW HAVE TO
DRIVE 85 OR 120 MILES TO DELIVER
THEIR BABIES? WHAT IS THE
SOLUTION THAT WE HAVE TALKED
ABOUT SINCE WE UNDERSTAND THAT
THIS IS A CURRENT ISSUE, NOT A
HYPOTHETICAL ONE. I MEAN, I
THINK THIS IS PART OF THE
DISCUSSION IN TERMS OF THESE ARE
PROPOSALS. AND YOU KNOW, WHAT IS
FINALLY ENACTED AS PART OF THE
JANUARY OR, EXCUSE ME, THE JUNE
BUDGET. I THINK, YOU KNOW,
COMING TO CONVERSATIONS ABOUT
HOW TO ADDRESS THE ISSUES THAT
YOU ARE RAISING. LEO, DID YOU
HAVE ANYTHING YOU WANTED TO ADD,
YEAH. JASON SEYARTO LEO, SO YOU
HAVE TWO, PROPOSALS REALLY IN
THIS ITEM. THE FIRST IS
INCREASING THE TAX, AND THE
SECOND IS, CHANGES IN HOW THOSE
STATE WOULD USE THE TAX
PRIMARILY TO USE IT TO OFFSET
GENERAL FUND SPENDING, INSTEAD
OF SUPPORTING MANY OF THE
AUGMENTATION THINGS THAT WERE
PROPOSED IN JANUARY ON THE ON
THE FIRST PROPOSAL TO INCREASE
THE TAX. YOU KNOW, GENERALLY
THAT THAT SEEMS REASONABLE. BUT
AS WITH ANY INCREASE IN THE MCO
TAX, WE RECOMMEND THE
LEGISLATURE GET ADDITIONAL
INFORMATION FROM THE
ADMINISTRATION, INCLUDING THE
PROPOSED NEW TAX RATES, THE
MULTIYEAR PLAN, THE NEW
MULTI-YEAR PLAN AND AN UPDATED
ANALYSIS DEMONSTRATING THE TAX
INCREASE WOULD MEET FEDERAL
RULES. AND THE ADMINISTRATION
HAS INDICATED THAT IT INTENDS
TO, GET THIS SOLUTION, ENACTED
RELATIVELY SOON SO THAT IT CAN
SUBMIT IT TO THE FEDERAL
GOVERNMENT IN TIME FOR IT TO
START ON APRIL 1ST. SO WE'D
RECOMMEND DIRECTING THE
ADMINISTRATION TO GET THE
LEGISLATURE LEGISLATURE THAT
INFORMATION RELATIVELY QUICKLY
SO THAT IT CAN FULLY ASSESS THAT
PROPOSAL. ON THE SECOND, PART OF
THE PROPOSAL, WHICH IS TO, YOU
KNOW, RESCIND MANY OF THE
AUGMENTATION IS, WHICH IS WHAT
YOU WERE ASKING QUESTIONS ABOUT
EARLIER, YOU KNOW, THIS IS THIS
IS ONE THAT RAISES A DIFFICULT
TRADE OFFS FOR THE LEGISLATURE.
ON THE ONE HAND, THEY IT WAS
REASONABLE FOR THE LEGISLATURE
TO EXPLORE, CHANGES TO THE
PACKAGE WHEN THE WHEN THE
PACKAGE WAS ENACTED IN LAST
YEAR'S BUDGET, THE FULL
MAGNITUDE OF THE BUDGET PROBLEM,
WASN'T YET KNOWN. AND ALSO MANY
OF THE, YOU KNOW, THERE WERE
SOME FISCAL UNCERTAINTIES WITH
THE GOVERNOR'S PROPOSAL THAT WE
RAISED HAVING A SMALLER SET OF
AUGMENTATIONS COULD HELP MANAGE
SOME OF THOSE FISCAL
UNCERTAINTIES. ON THE OTHER
HAND, THIS IS A KEY AREA OF
INTEREST FOR THE LEGISLATURE. AS
WE DISCUSSED LAST WEEK THERE
THERE ARE DOCUMENTED ACCESS
ISSUES IN MEDI-CAL, AND RATE
INCREASES ARE ASSOCIATED WITH
IMPROVEMENTS TO ACCESS TO CARE.
SO THIS IS AN AREA THE
LEGISLATURE COULD EXPLORE AND
THINK OF ALTERNATIVES. AND WE
RECOMMEND TO START DOING THAT.
AS THE LEGISLATURE THINKS OF
ALTERNATIVES, WE RECOMMEND
KEEPING A COUPLE OF PRINCIPLES
IN MIND. THE FIRST WOULD BE TO
FOCUS ON RATE INCREASES WHERE,
THE INCREASE IS, YOU KNOW,
RELATIVELY KNOWN AND SIMPLE AND
NOT NOT SORT OF CONCEPTUAL IN
NATURE. SO IF YOU REMEMBER SOME
OF THE ADMINISTRATION'S
PROPOSALS WERE ON THE MORE
CONCEPTUAL SIDE, THEY WERE STILL
DETERMINING KEY DETAILS. OTHERS
WERE WERE EASIER TO UNDERSTAND
AND COULD BE IMPLEMENTED MORE
QUICKLY. SO YOU KNOW, FOR
EXAMPLE, SETTING RATES AS A
PERCENT OF MEDICARE, SAY, 80% OF
MEDICARE, FOR EXAMPLE, A LOT OF
THE ADMINISTRATION'S PROPOSAL
FOCUSED ON THAT OR APPLYING AN
INFLATIONARY ADJUSTMENT. THOSE
ARE THINGS THAT POTENTIALLY
COULD BE ACHIEVED RELATIVELY
QUICKLY. SOME OF THE MORE
COMPLEX, COMPLEX ASPECTS, LIKE
CHANGING THE PAYMENT METHODOLOGY
OR HAVING PROSPECTIVE PAYMENT
SYSTEMS FOR HOSPITALS, THOSE
WOULD BE EXAMPLES OF THINGS THAT
ARE MORE COMPLEX AND WHERE THE
WHERE THE EFFECTS ARE LESS
CERTAIN, WE'D ALSO NOTE THAT THE
ADMINISTRATION IS PROPOSING A
NEW AUGMENTATION IN THE MCO TAX
PACKAGE, WHICH WOULD BE A
SUPPLEMENTAL PAYMENT FOR
CHILDREN'S HOSPITALS. SO THERE
ARE SOME AUGMENTATIONS, BUT THEY
ARE NEW. MORE INFORMATION IS
STILL FORTHCOMING. THAT WOULD BE
THE KIND OF AUGMENTATION THE
LEGISLATURE WOULD WANT TO GET
MORE INFORMATION ON, AS IT AS IT
ASSESSES THAT IN WAYS THAT
AGAINST OTHER POTENTIAL
AUGMENTATIONS. AS AN ADDITION TO
THAT, WE RECOMMEND THAT THAT.
OH. I SORRY, I GOT MY NOTES.
NOW, WE ALSO RECOMMEND THE
LEGISLATURE FOCUS ON RATES THAT
ARE THAT ARE PARTICULARLY LOW OR
HAVE NOT BEEN INCREASED IN MANY
YEARS. THAT WOULD BE A
REASONABLE PLACE TO PRIORITIZE
AUGMENTATION. AS WE DISCUSSED
LAST WEEK, SOME RATES THAT
HISTORICALLY HAVE BEEN HAVE BEEN
LOW RELATIVE TO MEDICARE. THERE
ARE OTHER RATES THAT THAT, THE
ADMINISTRATION HAS FOUND HAVE
BEEN RELATIVELY HIGH COMPARED TO
MEDICARE. AND SO IT'D BE
REASONABLE TO TARGET RATE
INCREASES WHERE THEY'RE WHERE
THEY'RE PARTICULARLY LOW OR
WHERE THEY HAVEN'T BEEN
INCREASED IN MANY YEARS. AND
THEN FINALLY, WE DO RECOMMEND
THAT THE LEGISLATURE KEEP THE
BUDGET PROBLEM IN MIND AS IT
WEIGHS ALTERNATIVES. IF THE
LEGISLATURE DOES PURSUE A
GREATER AMOUNT OF AUGMENTATIONS
IN THE MCO TAX PACKAGE THAN
WHAT'S BEFORE YOU IN THE MAY
REVISION, THAT WOULD RESULT IN,
IN SORT OF A SMALLER BUDGET
SOLUTION. AND SO THAT WOULD
ENTAIL, LOOKING ELSEWHERE IN THE
BUDGET TO, TO FIND THOSE
SOLUTIONS. THANK YOU. THANK YOU.
SO CAN YOU, JUST GO DOWN FOR ME,
WHICH RATES IN THE MCO TAX WILL
BE MAINTAINED. SO THE RATES THAT
BEGAN JANUARY 1ST, 2024. AND
THESE ARE THE RATES FOR PRIMARY
CARE, MATERNITY CARE AND NON
SPECIALTY MENTAL HEALTH
SERVICES, BRINGING THOSE RATES
TO 87.5% OF MEDICARE. AND AGAIN
THOSE STARTED JANUARY ONE 2024
OKAY. NOW LAST WEEK OR ACTUALLY
BEFORE WHEN WE WERE HAVING
CONVERSATIONS AROUND THE, YOU
KNOW, THE ADJUSTMENT FOR EQUITY,
THERE WAS DISCUSSION THAT THERE
WAS AN IDEA, BUT IT WOULD COME
OUT WITH MAY REVISE. BUT SINCE
IT'S BEEN PULLED BACK, MY
QUESTION TO YOU IS, DO YOU HAVE
THAT IDEA, LIKE, DO YOU KNOW
WHAT YOU HAD PLANNED OR WAS THAT
NOT SO BASED ON, YOU KNOW, WE
SUBMITTED OUR PROPOSAL,
GOVERNOR'S BUDGET AND RECEIVED
SIGNIFICANT FEEDBACK FROM
STAKEHOLDERS WITH REGARD TO OUR
EQUITY ENHANCEMENT, OUR EQUITY
RATE ADD ON. AND THE FEEDBACK
WAS DEFINITELY NOT CONSISTENT.
LOTS OF CONCERNS ABOUT HOW
COMPLICATED IT WAS AND HOW BROAD
IT WAS, AND MAYBE NOT BEING ABLE
TO ACHIEVE THE KIND OF THE GOALS
OF WHAT WE WERE TRYING TO
ACHIEVE WITH THAT EQUITY
ENHANCEMENT. AND SO, YOU KNOW,
AS WE'VE BEEN THINKING ABOUT IT
AND IF, IF SOMETHING WERE TO
HAVE MOVED FORWARD, WE WOULD
HAVE PROBABLY HAVE DEFINED A
MORE NARROW SET OF SERVICES BY
WHICH WE WOULD HAVE APPLY THIS
EQUITY ENHANCEMENT AND ALSO NOT,
WE HAD THIS EQUITY INDEX THAT
INCLUDED MULTIPLE FACTORS SUCH
AS HEALTH, PROFESSIONAL SHORTAGE
AREAS, GEOGRAPHIC AREAS, HEALTHY
PLACES INDEX TO SIMPLIFY THAT AS
WELL, TO JUST BE A LITTLE BIT
MORE CLEAR AND CONCISE, WITH,
WITH REGARD TO HOW THESE EQUITY
PAYMENTS WOULD BE DISTRIBUTED.
OKAY AND ALONG THAT SAME LINE
LAST WEEK, YOU HAD STATED THAT
THERE WAS A PLAN FOR, MAKING ALL
PROVIDERS WHOLE. SO DO YOU HAVE
THAT LANGUAGE OR OR I DON'T
RECALL SAYING THAT ALL, ALL
PROVIDERS WOULD BE MADE WHOLE SO
THAT I DON'T RECALL SAYING,
WELL, SOMEONE SAID THAT ALL LIKE
PHYSICIANS AND NOT EVERYONE IN
THE HEALTH CARE SPACE, BUT ALL
SPECIALTIES WOULD BE MADE WHOLE
WITHIN THE MEDICARE SYSTEM. WE
INDICATED THAT WE WOULD BE
PROPOSING TO BRING, THEY WOULD
ALL BE COMING IN AND THEY WOULD
ALL BE INCLUDED IN THE PROPOSAL
AND THAT THEY WOULD WE WOULD BE
BRINGING THEIR RATES TO BETWEEN
80 AND 100% OF MEDICARE BY MAIL.
OKAY. SO DO YOU LIKE WAS THAT AN
ACTUAL WRITTEN PLAN OR WAS THAT
STILL THEORETICAL? THAT WAS PART
OF OUR GOVERNOR'S BUDGET
RELEASE. WE HAD A 20 PAGE POLICY
PAPER THAT OUTLINED ALL OF THOSE
DETAILS. AND SO THAT'S INCLUDED
IN THE POLICY PAPER. OKAY. THANK
YOU. NOW, TO THE DEPARTMENT OF
FINANCE, YOU KNOW, WHAT WAS THE
BASIS OF DETERMINING WHAT WAS
GOING TO END UP ULTIMATELY
GETTING CUT IN OUR SPACE AND
WHAT AND WHAT YOU WERE GOING TO
ACTUALLY FUND OR ADD? BECAUSE
YOU'VE GOT SOME THINGS THAT ARE
NOT YET STARTED, BUT YOU'VE
CHOSEN TO ADD IN THIS BUDGET,
WHICH I WAS SURPRISED ABOUT
GIVEN THE FACT THAT BEFORE WE
HAD TO GO THROUGH AND CUT SOME
THINGS THAT HADN'T BEEN ACTUALLY
STARTED. SO WHAT WAS THE THOUGHT
PROCESS BEHIND WHAT YOU WERE
GOING TO REMOVE AND WHAT YOU
WERE GOING TO MAINTAIN OR ADD,
YEAH, A DEPARTMENT OF FINANCE,
SO NONE OF THESE SOLUTIONS, I
JUST WANT TO REITERATE THAT NONE
OF THESE SOLUTIONS WERE TAKEN
EASILY OR LIGHTLY, BUT THE
OVERALL GOAL WAS TO MAINTAIN
CORE PROGRAMS AND BASE BENEFITS
IN MEDI-CAL AND TO MAINTAIN
ESSENTIAL HEALTH BENEFITS. AND
THAT'S SORT OF WHERE, THAT'S
LIKE THE OVERALL GOAL WAS TO
SORT OF MAINTAIN BENEFITS AND
ELIGIBILITY, AND WE ALSO, YOU
KNOW, LIKE THE, THE, THE, NEW
THING THAT WAS PROPOSED, THE 115
MILLION, ANNUALLY TO SUPPORT
DIRECT PAYMENTS FOR CHILDREN'S
HOSPITALS WAS SO THAT WE COULD
PROVIDE CARE TO THE STATE'S,
LIKE, SICKEST CHILDREN. SO TO
TRY AND MAINTAIN CORE, BENEFITS
AND ELIGIBILITY, DID THE ISSUE
OF HAVING CORE BENEFITS, BUT NO
PROVIDERS OR HOSPITALS TO GO TO
EVER COME INTO THE DISCUSSION?
YOU WANT TO TAKE IT? MEGAN SAU
B¢O DEPARTMENT OF FINANCE, TO
KIND OF REITERATE WHAT MY
COLLEAGUE ADITYA BELLETTI JUST
NOTED, WE REALLY WERE FOCUSED ON
ON MAINTAINING CORE BENEFITS
WITH THIS PACKAGE, WE CERTAINLY
RECOGNIZE THAT THAT THESE ARE
TOUGH DECISIONS, AND THESE ARE,
THESE ARE DIFFICULT SOLUTIONS.
AND WE LOOK FORWARD TO, FURTHER
CONVERSATIONS WITH THE
LEGISLATURE AS WE MOVE THROUGH
THE NEGOTIATION PROCESS. I LOOK
FORWARD TO FURTHER CONVERSATIONS
AS WELL. I'M NOT SURE HOW MANY
MORE CONVERSATIONS WE NEED TO
HAVE ABOUT SOME OF THE CRISIS
THAT WE HAVE WITHIN OUR HEALTH
CARE SPACE. I MEAN, WE KIND OF
TALKED ABOUT IT A LOT, AND SO I
WAS JUST WONDERING IF ANY OF THE
DISCUSSIONS THAT WE HAVE HAD
ABOUT THE SHORTAGES, THE
CLOSURES, THE ISSUES THAT WE
HAVE ON THE GROUND, WORKFORCE
SHORTAGES, IF ANY OF THOSE
THINGS CAME INTO THE THOUGHT AS
YOU WERE TRYING TO PRESERVE
THESE CORE SERVICES, WHICH IS
IMPORTANT. BUT AGAIN, IF YOU
DON'T HAVE PROVIDERS TO GO TO,
WHAT HAVE WE DONE? I CERTAINLY
APPRECIATE YOUR COMMENTS AND I
WILL TAKE THEM BACK. I WILL SAY
THAT WE DEFINITELY LOOKED AT THE
PACKAGE AS A WHOLE AND ITS
IMPACT ON ON PROVIDERS AND
PATIENTS AND, WE DIDN'T TAKE ANY
OF THESE DECISIONS LIGHTLY. I'M
GOING TO TURN IT OVER TO MY
COLLEAGUE, ASSEMBLY MEMBER BONTA
. I'LL JUST BUILD ON THE KIND OF
QUESTION AROUND, MORE BROADLY,
WORKFORCE, AND PARTICULARLY AS
IT RELATES TO THE, CLAWBACKS AND
THE MCO RELATED TO THE
BEHAVIORAL HEALTH COMPONENT.
CGRTS, IT SEEMS LIKE THERE'S
JUST A GENERAL NOTION THAT
THERE'S GOING TO BE SOME
BACKFILLING THAT'S HAPPENING
WITH PROP ONE DOLLARS. IS THAT
AT ALL IMPACTING THE CUTBACKS ON
THE WORKFORCE COMPONENTS THAT
WERE PULLED FROM MCO, FOR
PROPOSITION ONE? NO RELATION TO
ANY OF THE KIND OF THE MCO
PROPOSALS THAT WERE PROPOSED AS
PART OF MAY REVISION. WE DO HAVE
PROPOSITION ONE. BC AND LOCAL
ASSISTANCE THAT WE CAN SPEAK TO
NOW OR LATER, BUT NO RELATION TO
THE MCO. AND FOR THE, AGAIN, I
FIND IT HIGHLY PROBLEMATIC THAT
WE ARE COMPLETELY ELIMINATING
THE REIMBURSEMENT RATES THAT WE
WERE COUNTING ON TO BE ABLE TO
SUPPORT, SO MANY HEALTH CARE
WORKERS ARE WAS THERE ANY OTHER
KIND OF FORMULA THAT WAS USED TO
FIGURE OUT WHETHER OR NOT WE
COULD NOT DO A COMPLETE CLAWBACK
OF THAT AMOUNT? AND TO A
RELATIVE LESS LESSER PERCENTAGE?
YEAH. I THINK I WOULD JUST
REITERATE THAT WE LOOKED AT
EVERYTHING AS A WHOLE AND, YOU
KNOW, JUST TRIED TO MAINTAIN THE
CORE BENEFITS AND ELIGIBILITY
THAT HAVE ALREADY BEEN
IMPLEMENTED. WHEN WE RELEASE
THIS PROPOSAL AND WE'RE LOOKING
FORWARD TO, YOU KNOW, OUR
WELCOME FURTHER DISCUSSION FROM
THE LEGISLATURE ON OTHER
ALTERNATIVES OR OTHER PRIORITIES
. DID YOU ALL GO INTO DEPTH SO
FAR? SORRY I MISSED IT AROUND
THE CHILDREN AND YOUTH
BEHAVIORAL HEALTH INITIATIVE AT
ALL YET. OKAY, GREAT. SO SOME
QUESTIONS AROUND THAT, THE
SCHOOL LINKED PARTNERSHIP AND
CAPACITY GRANTS WAS SOMETHING
THAT WAS, DO WE WANT TO MOVE TO
THE NEXT ITEM? OH, SORRY. WE
WON'T DO. OKAY. ALL RIGHT. YEAH
I'M GOOD THEN. THANK YOU.
ASSEMBLYMEMBER BONTA, BEFORE I
OPEN IT UP TO A PUBLIC COMMENT,
JUST WANT TO PIGGYBACK ON WHAT
ASSEMBLYMEMBER BONTA SAID. SO AS
YOU ALL FINANCE WE'RE GOING
THROUGH THIS THERE WAS NO OTHER
MODELS, NO OTHER THOUGHT PROCESS
TO SAY, WELL, MAYBE IF WE, YOU
KNOW, SLIGHTLY TRIM THE MCO TAX
SO WE CAN MAINTAIN SERVICES, BUT
ALSO DO LIKE PROVIDER
REIMBURSEMENT RATES TO YOU KNOW,
TO A LARGER GROUP, MAYBE NOT
EVERYBODY LIKE THERE WAS NO
THOUGHT IT WAS JUST WE'RE GOING
TO COME IN AND JUST SLICE THE
WHOLE THING. MEGAN SABO,
DEPARTMENT OF FINANCE I DON'T
KNOW THAT I WOULD CHARACTERIZE
OUR PROCESS AS AS NOT PUTTING
THOUGHT INTO IT. WE THE REALITY
IS THAT WE HAD A CERTAIN A
LIMITED AMOUNT OF TIME TO REALLY
LOOK AT THE PACKAGE, TRY AND PUT
FORWARD, SOMETHING THAT PROTECTS
CORE BENEFITS, AND, AND REALLY
DO LOOK FORWARD TO, TO FURTHER
CONVERSATIONS AS WE MOVE THROUGH
NEGOTIATIONS. WE CERTAINLY HEAR
YOU AND WE APPRECIATE THE
GRAVITY OF THE SITUATION HERE.
OKAY. SO NO, YOU DIDN'T LIKE, DO
WHAT THE LAO HAD KIND OF
SUGGESTED TO LOOK AT. OKAY, WHAT
ARE SOME OF THE OTHER CORE
SERVICES THAT WE COULD INCREASE,
BESIDES MATERNITY CARE,
BEHAVIORAL HEALTH AND PRIMARY
CARE, IT WAS JUST KIND OF LIKE
AN ALL OR NONE APPROACH. THAT'S
WHAT I'M HEARING. OKAY. ALL
RIGHT, WELL, AT THIS POINT, WE
WILL OPEN IT UP TO PUBLIC
COMMENT ON ISSUE ONE ONLY, WE
WILL GIVE YOU ONE MINUTE PER
YEAR. SPEAKER. THANK YOU. GOOD
MORNING, MADAM CHAIR MEMBERS
DENNIS CUEVAS. ROMERO WITH THE
CALIFORNIA PRIMARY CARE
ASSOCIATION ADVOCATES STATEWIDE
ASSOCIATION REPRESENTING FQHCS
AND FREE CLINICS, COMMUNITY
CLINICS ARE DEEPLY DISAPPOINTED
IN THE CUTS, THIS WAS AN
OPPORTUNITY FOR A HISTORIC
INVESTMENT IN MEDI-CAL, IT IS
REALLY CHALLENGING WITH SOME OF
THE CONVERSATIONS THAT WE'VE HAD
THIS THIS PAST YEAR. I WILL JUST
SAY, YOU KNOW, IN THE JANUARY
PROPOSAL, ABOUT 60% OF THE MCO
REVENUES WERE ALREADY GOING TO
THE GENERAL FUND. SO THIS IS
PARTICULARLY CHALLENGING. THE
OTHER THING I'LL MENTION, RIGHT,
THAT THIS IS ONE OF THE MOST
REVENUE THAT WE'VE RECEIVED
THROUGH THE MCO TAX, PRIMARILY
BECAUSE IT WAS GOING TO FUND
PROVIDER RATE INCREASES. AND
THAT WAS AT LEAST OUR
UNDERSTANDING OF THE REASON WHY
THERE WAS AN INCREASED REVENUE
INCREASE. SO IT IS UNFORTUNATE,
AND WE'RE HOPING THAT THE
ADMINISTRATION RECONSIDERS.
THANK YOU. THANK YOU. GOOD
MORNING, KELLY LARUE WITH
RESILIENT ADVOCACY HERE ON
BEHALF OF TWO CLIENTS, ONE BEING
THE CALIFORNIA OPTOMETRIC
ASSOCIATION, YOU KNOW, WE
UNDERSTAND, BUT DON'T
NECESSARILY AGREE WITH THE SWEEP
OF THE 2025 RATE PACKAGE. WE
WERE INCLUDED IN THAT, BUT
PIVOTING. WE ARE HOPEFUL THAT
DCS CAN INCLUDE US AS A PROVIDER
THAT CAN BILL UNDER THE 2024
PACKAGE, WE PROVIDE A LOT OF
THOSE SERVICES, PRIMARY CARE,
INCLUDING PINK EYE AS AN
EXAMPLE, SO THERE WON'T BE MORE
PINK EYES. SO IT'LL BE, YOU
KNOW, A NET A NET NEUTRAL. IF WE
WERE INCLUDED AS BEING ABLE TO
BILL UNDER THAT PACKAGE. ALSO
HERE ON BEHALF OF THE AIR
AMBULANCE COMMUNITY, THERE WAS A
FEE ON ALL MOVING VIOLATIONS IN
THE STATE THAT WAS ENDED. SO
THAT SPECIAL FUND THAT PROVIDED
AN AUGMENTED RATE IS NOW
EXPENDED. AND SO THE RATE
PROVIDED TO ALL MEDI-CAL
TRANSPORTS IS ONLY ABOUT 20% OF
THE COST. SO ESPECIALLY IN THE
RURAL NORTH, WE'RE HOPEFUL THAT
THAT CAPACITY CAN BE MAINTAINED
IN THE FACE OF, YOU KNOW, SUMMER
FIRES OR LANDSLIDES OVER THE
FALL AND WINTER. THANK YOU.
THANK YOU. MADAM CHAIR AND
MEMBERS RANCH, MARTIN, ON BEHALF
OF AVIAN HEALTHCARE AND PINCH
HITTING FOR THE CALIFORNIA
ASSOCIATION FOR HEALTH SERVICES
AT HOME, WITH ALL DUE RESPECT TO
THE VERY DIFFICULT SITUATION WE
FIND OURSELVES IN, IT SHOULD BE
OBVIOUS TO ANYONE THAT IF YOU'RE
SPENDING, $662 A DAY TO TAKE
CARE OF A CHILD WITH COMPLEX
MEDICAL CONDITIONS IN THEIR
HOME, INSTEAD OF PAYING 7 TO
$10,000 A DAY IN A HOSPITAL THAT
YOU'RE GOING TO SAVE A WHOLE LOT
OF MONEY, IT'S PERPLEXING TO US
THAT GIVEN THE SEVERITY OF THE
SITUATION THAT WE'RE SCROUNGING
IN COUCH CUSHIONS, COUCH
CUSHIONS, FOR ADDITIONAL SAVINGS
THAT WE CAN'T GO AHEAD AND
REALIZE THE $175 MILLION THAT
THIS CHANGE IN THE IN THE RATE
FOR PBN WOULD, WOULD ACHIEVE FOR
THE STATE OF CALIFORNIA, MONEY
THAT COULD BE USED FOR OTHER
SERVICES THAT ARE ALSO BEING
CUT, ENCOURAGE YOU TO, TO LOOK
AT THIS AGAIN. THANK YOU. THANK
YOU VERY MUCH. VANESSA KEENAN,
ON BEHALF OF THE CALIFORNIA
ACADEMY OF FAMILY PHYSICIANS IN
OPPOSITION TO THE REALLOCATION
OF THE MCO TAX FOLLOWING THIS
YEAR, DE INVESTING IN PRIMARY
CARE, PARTICULARLY PRIMARY CARE
PHYSICIANS WHO TEND TO STAY IN
THE COMMUNITY, IS A HUGE CUT TO
THE KNEES OF WHERE WE WERE
TRYING TO GO WITH MEDI-CAL
REFORM AND HEALTH EQUITY. ALSO,
ON BEHALF OF THE CALIFORNIA PAN
ETHNIC HEALTH NETWORK, THE SHIFT
OF THE MCO WITHOUT HAVING AN
EQUITY METRIC YET APPRECIATE THE
CHAIR'S COMMENTS ON THAT. AND,
WE'LL OPPOSE THAT. TO. YOU,
MADAM CHAIR AND COMMITTEE
MEMBERS, NORLAND ASHBROOK,
REPRESENTING PRIME HOME HEALTH
AND TEAM SELECT, BOTH PROVIDERS
OF PRIVATE DUTY NURSING
SERVICES, JUST ECHO THE COMMENTS
OF MY COLLEAGUE RAND MARTIN,
JUST WANT THE COMMITTEE TO
CONSIDER THE PROPOSAL FOR A RATE
INCREASE THAT WOULD GENERATE A
COST SAVINGS OF $175 MILLION. I
UNDERSTAND THAT THIS IS A
DIFFICULT, BUDGET TIME, BUT FOR
CONSIDERATION OF THIS REQUEST.
THANK YOU. GOOD MORNING, MADAM
CHAIR AND MEMBERS. CONNIE
DELGADO, ON BEHALF OF THE
DISTRICT HOSPITAL LEADERSHIP
FORUM, THESE ARE THE 33 DISTRICT
AND MUNICIPAL HOSPITALS IN THIS
STATE. WE ARE WE UNDERSTAND THAT
THIS IS A VERY DIFFICULT BUDGET
YEAR, BUT WE ARE DEEPLY
DISAPPOINTED OF THE SWEEP OF THE
MCO FUNDS AND THE PROMISE TO
INCREASE MEDI-CAL PROVIDER RATES
AS PART OF THAT DEAL, A DECISION
TO SWEEP THOSE FUNDS MEANS THAT
DISTRICT HOSPITALS WILL HAVE TO
LOOK AT TOUGH DECISIONS, LIKE
POTENTIALLY CUTTING SERVICES AND
A TIME WHEN WE WOULD PREFER TO
EXPAND AND INCREASE THE ACCESS
TO CARE FOR MILLIONS OF MEDI-CAL
BENEFICIARIES. FOR THESE
REASONS, WE RESPECTFULLY ASK
THAT YOU REJECT THIS PROPOSAL.
THANK YOU. THANK YOU. GOOD
MORNING, MOLLY ROSEN WITH
PLANNED PARENTHOOD AFFILIATES OF
CALIFORNIA, ON BEHALF OF THE
SEVEN PLANNED PARENTHOOD
AFFILIATES THAT OPERATE OVER 100
HEALTH CENTERS IN THE STATE, WE
ARE, OF COURSE, VERY
DISAPPOINTED TO SEE THE CUTS TO
PROVIDER RATES IN MCO. THIS, AS
YOU KNOW, WOULD HAVE BEEN A HUGE
INVESTMENT IN THE MEDI-CAL
SYSTEM, SPECIFICALLY 90 MILLION
NEXT YEAR FOR SEXUAL AND
REPRODUCTIVE HEALTH CARE. THE
SWEEPING OF THESE FUNDS, IN
ADDITION TO OTHER ACTIONS ON
SEXUAL AND REPRODUCTIVE HEALTH
RATES, DEEPLY AFFECT
CALIFORNIA'S SAFETY NETS ABILITY
TO MEET THE NEEDS OF PATIENTS
AND ADDRESS HEALTH EQUITY.
HEALTH EQUITY NEEDS. THANK YOU.
THANK YOU, MRS. SHORT
REPRESENTING PEACH. I JUST WANT
TO ECHO A LOT OF THE COMMENTS
YOU'VE HEARD ALREADY, WE'RE
OPPOSED TO THE REDIRECTION OF
THE MCO FUNDING, OUR SAFETY NET
HOSPITALS ARE ALREADY STRUGGLING
AND OUR PATIENTS ARE ALREADY
CHALLENGED TO ACHIEVE HEALTH
EQUITY. AND WE THINK THIS WILL
MAKE THAT EVEN MORE CHALLENGING.
AND WE URGE THE LEGISLATURE AND
THE GOVERNOR TO REJECT THIS
PROPOSAL. THANK YOU. THANK YOU,
MADAM CHAIR AND MEMBERS, THE
AIRBRIDGE, ON BEHALF OF, MAXIM
HEALTHCARE SERVICES, ONE OF THE
LARGEST PROVIDERS OF PRIVATE
DUTY NURSING CARE IN THE STATE,
ECHO THE COMMENTS MADE BY THE
OTHER PRIVATE DUTY NURSING
PROVIDERS. BUT JUST REALLY WANT
TO EXPRESS OUR CONCERN THAT A
RATE INCREASE HAS NOT BEEN
INCLUDED IN THE BUDGET FOR
PRIVATE DUTY NURSING CARE,
PARTICULARLY. WANT TO ECHO THE
COMMENTS AROUND THE
AUGMENTATIONS FOR THE CHILDREN'S
HOSPITALS? THIS IS REALLY ABOUT
GETTING SICK KIDS OUT OF
HOSPITALS AND SAVES THE STATE
THOUSANDS OF DOLLARS PER DAY AS
A CHILD SITS IN THE HOSPITAL.
OTHERWISE, THANK YOU, THANK YOU.
GOOD MORNING, CHAIR AND MEMBERS
BETH MALINOWSKI, THE SEIU
CALIFORNIA, AS AS MANY THIS
MORNING, DEEPLY CONCERNED WITH
THE PROPOSAL. THAT'S BEFORE YOU
APPRECIATE THE MANY DIFFICULT
DECISIONS YOU'LL BE MAKING IN
THE COMING WEEKS, WHEN WE THINK
ABOUT THE COMMITMENT TO MAINTAIN
MEDI-CAL COVERAGE, WE HAVE TO
CONNECT THAT COVERAGE TO TRUE
ACCESS. AND THAT ONLY HAPPENS IF
WE HAVE THE WORKFORCE TO DO
THAT. WE'RE STILL SITTING IN A
WORKFORCE SHORTFALL, ROUGHLY
500,000 WORKERS THIS MCO FUNDS.
WE'RE GOING TO BE CRITICAL TO
HELPING US ACHIEVE SOME
SIGNIFICANT MOVEMENT IN THAT
SPACE. AND WITH THAT, WE ASK YOU
TO REJECT THESE FUNDS AS YOU
REALLY CONSIDER HOW DO WE MAKE
SURE WE BRING FORWARD A TRUE
PROMISE TO ACCESS BY MAKING SURE
THE FUNDING WE NEED TO NOT ONLY
STAND UP OUR HEALTH CARE
WORKFORCE, SUPPORT OUR RESIDENTS
IN TRAINING, AND ALSO COMMIT TO
OUR PUBLIC HOSPITALS. SO THANK
YOU. THANK YOU, MADAM CHAIR.
MEMBERS TIM MADDEN, REPRESENTING
THE CALIFORNIA CHAPTER OF THE
AMERICAN COLLEGE OF EMERGENCY
PHYSICIANS. WE'RE ALSO OPPOSED
TO THE SHIFT IN THE MCO FUNDS,
AS YOU ALL UNDERSTAND, EMERGENCY
PHYSICIANS ARE IN A UNIQUE
SITUATION WHERE THEY SEE ALL
PATIENTS THAT COME INTO THE
EMERGENCY DEPARTMENT. IT DOESN'T
MATTER IF THEY'RE UNINSURED,
COMMERCIAL INSURED OR MEDI-CAL.
WE SEE MORE MEDI-CAL PATIENTS
THAN ANY OTHER PHYSICIAN
SPECIALTY. WE'RE ABOUT 42% OF
ALL OF OUR VISITS WITH SOME OF
OUR HOSPITALS SEEING AS MANY AS
75% OF ALL THEIR PATIENTS ARE
MEDI-CAL. WE WORRY WITH THE
SHIFT IN FUNDS, IT WILL BE
TAKING MONEY OUT OF THE SYSTEM
AND ACTUALLY LEADING TO MORE
PEOPLE COMING INTO THE EMERGENCY
DEPARTMENT. FOR EMERGENCY
PHYSICIANS, THOSE FUNDS ARE
REALLY IMPORTANT BECAUSE IT
ALLOWS US TO MORE ADEQUATELY
STAFF EMERGENCY DEPARTMENTS. SO
WITH THIS SHIFT, WE'RE WORRIED
WITH A LOWER COVERAGE FOR BY
EMERGENCY PHYSICIANS, INCREASED
VOLUME IS GOING TO LEAD TO WAIT
TIMES FOR EVERYBODY. THE
EMERGENCY DEPARTMENT DOESN'T
HAVE A SPACE JUST FOR MEDICAL
PATIENTS. IT IS FOR ALL OF US TO
USE. SO WITH THAT, WE APPRECIATE
THE DIRECTOR'S COMMENTS THAT
THIS IS A PROPOSAL AND THAT
THERE WILL BE DISCUSSIONS MOVING
FORWARD. AND WE WOULD ASK FOR
YOU TO KEEP US IN MIND AS THOSE
CONVERSATIONS OCCUR. THANK YOU.
THANK YOU, THANK YOU. MADAM
CHAIR AND COMMITTEE MEMBERS,
MARK FAROOQ WITH THE CALIFORNIA
HOSPITAL ASSOCIATION, ECHOING
THE COMMENTS OF MY COLLEAGUES AS
WELL AS COMMITTEE MEMBERS TODAY
REGARDING THE MCO TAX PROPOSAL,
THE SWEEPING OF THOSE FUNDS
DEEPLY DISAPPOINTED AND WHAT
THAT MEANS FOR PATIENT ACCESS,
MADAM CHAIR, AS YOU ARTICULATED,
I THINK WE WOULD ECHO THE
COMMENTS THAT YOU MADE ABOUT THE
CRISIS FACING PATIENT ACCESS,
WHETHER IT BE HOSPITALS AND
OTHER PROVIDERS. I WOULD ASK
THAT YOU REJECT THIS PROPOSAL
AND ALSO WOULD GO BACK IN TIME
TO ALSO NOTE, LAST YEAR WHEN THE
LEGISLATURE THOSE OF YOU ON THIS
COMMITTEE HELPING CREATE THE
DISTRESSED HOSPITAL LOAN PROGRAM
AND MUCH OF THE TALK AROUND THAT
PROGRAM WAS TO BUILD A FINANCIAL
BRIDGE FOR HOSPITALS TO GET THEM
TO A PLACE TO WHERE THEY COULD
SEE ADJUSTMENTS TO MEDI-CAL
REIMBURSEMENT RATES THROUGH THE
MCO TAX. GIVEN THIS SWEEP, THAT
REALLY CALLS INTO QUESTION IN
THE LONG TERM FINANCIAL
SUSTAINABILITY OF THOSE
PARTICULAR HOSPITALS AND OTHERS
THAT MAY BE AT RISK. THANK YOU.
THANK YOU, CHAIR AND MEMBERS,
KATHY MOSSBERG, ON BEHALF OF THE
LOCAL HEALTH PLANS OF
CALIFORNIA, WE WANT TO ALSO ECHO
THE COMMENTS OF OUR PRIOR
COLLEAGUES ON URGE YOU TO REJECT
THIS PROPOSAL. THIS THESE WERE
DOLLARS THAT WE CERTAINLY KNOW
ARE NEEDED FOR ALL THE REASONS
YOU'VE STATED HERE EARLIER IN
THIS COMMITTEE HEARING, BUT WE
KNOW WE HAVE PROBLEMS WITH
SPECIALTY CARE. WE KNOW WE HAVE
PROBLEMS WITH MATERNITY CARE.
THAT WAS EXACTLY WHAT THESE
DOLLARS WERE SUPPOSED TO GO TO
CREATE GREATER ACCESS TO THOSE
SERVICES. SO THANK YOU FOR YOUR
TIME TODAY. WE REALLY URGE YOU
TO REJECT. THANK YOU, MADAM
CHAIR. MEMBERS OF THE COMMITTEE,
BRANDON MAKI WITH THE CALIFORNIA
MEDICAL ASSOCIATION. WE ARE
EXTREMELY DISAPPOINTED ABOUT THE
GOVERNOR'S MAY REVISION
PROPOSAL, SPECIFICALLY THE
CLAWBACK OF THE MCO TAX DOLLARS.
UNDER THE BUDGET DEAL THAT WAS
MADE LAST YEAR, 60% OF THE MCO,
WENT TO THE GENERAL FUND. THAT
IS AN UNPRECEDENTED AMOUNT. THIS
MCO WAS THREE TIMES WHAT WE HAVE
SEEN HISTORICALLY, FAR AND AWAY,
THE LARGEST THAT WE HAVE SEEN
AND THE LARGEST ALLOCATION TO
THE GENERAL FUND. FOR
COMPARISON, IN 2009, THE GENERAL
FUND RELIEF WAS 157 MILLION, AND
IN 2016 IT WAS 1.2 BILLION. THE
CURRENT TAX PROPOSAL WOULD, SEE
AN AVERAGE ANNUAL OF $5.5
BILLION, NOT INCLUDING THE
MEDICARE PROPOSAL THAT HAS BEEN
PUT FORWARD TODAY AND DISCUSSED
TODAY. THE JUSTIFICATION FOR A
MUCH HIGHER TAX, EXCUSE ME, THAN
HAD BEEN ADOPTED HISTORICALLY,
WAS THAT A SIGNIFICANT PORTION
OF ITS REVENUE WOULD BE SPENT ON
RATES AND OTHER NEW INVESTMENTS
IN THE MEDI-CAL SYSTEM. THE MAY
REVISE THIS FUNDAMENTALLY AT
ODDS WITH THE TERM SHEET THAT
WAS SHARED DURING LAST YEAR'S
BUDGET NEGOTIATION. IN WHICH THE
AGREEMENT WAS THAT THIS FUNDING
WOULD BE INVESTED TO IMPROVE
ACCESS TO CARE IN THE MEDICAL
SYSTEM. WE REQUEST AND URGE THE
LEGISLATURE TO REJECT THE MCO
CUTS IN THE MAY REVISION TO
INCREASE ACCESS TO CARE AND
REDUCE INEQUITIES, AND
ADDITIONALLY, WE WOULD ALSO URGE
THE LEGISLATURE TO REINSTATE THE
$75 MILLION ANNUALLY IN GME
FUNDS THAT WOULD QUICKLY PUT
RESIDENTS TO WORK PROVIDING CARE
THROUGHOUT CALIFORNIA TO AND
KEEP THEM IN THOSE UNDERSERVED
AND RURAL COMMUNITIES. THANK
YOU. THANK YOU. RYAN SPENCER, ON
BEHALF OF THE AMERICAN COLLEGE
OF OB GYNS, THE CALIFORNIA
PEDIATRIC MEDICAL ASSOCIATION,
AND THE CALIFORNIA RADIOLOGICAL
SOCIETY IN OPPOSITION TO THE
GOVERNOR'S PROPOSAL TO CLAW BACK
THE MCO TAX REVENUES, THERE'S A
REASON WHY THIS THIS AGREEMENT
WAS MADE LAST YEAR, AND THAT'S
JUST GOING TO CONTINUE TO GET
WORSE FOR THE REASONS THAT THE
CHAIR STATED AND FOR ALL THE
PREVIOUS SPEAKERS. AND SO I DO
LOOK FORWARD TO THE NEGOTIATIONS
THAT GUYS WILL HAVE AND HEARING
WHAT COMES OUT OF THAT. BUT
HOPEFULLY, BRAD AND MINDS WILL
PREVAIL AND WE CAN RESTORE THIS
TAX. THANK YOU. THANK YOU. THANK
YOU, MADAM CHAIR AND MEMBERS,
RYAN PERINI, ON BEHALF OF THE
CALIFORNIA AMBULATORY SURGERY
ASSOCIATION. I WANT TO QUICKLY
ALIGN OUR COMMENTS WITH PROVIDER
GROUPS. ALREADY PREVIOUSLY
STATED, AND STAND WILLING AND
READY TO WORK WITH YOU, CHAIR,
COMMITTEE MEMBERS AND THE
ADMINISTRATION ON FINDING
ALTERNATIVE SOLUTIONS AND
PROTECTING THOSE RATE INCREASES
THAT ARE VITAL TO PROVIDE ACCESS
THROUGHOUT CALIFORNIA TO, TO
PRIMARY AND SPECIALTY CARE
SERVICES. THANK YOU. THANK YOU,
MADAM CHAIR. MEMBERS OF THE
COMMITTEE, TERRY MCHALE WITH
AARON REED AND ASSOCIATES
REPRESENTING THE CALIFORNIA
OPTOMETRIC ASSOCIATION.
OBVIOUSLY BE FULLY COGNIZANT OF
THE SITUATION WE FIND OURSELVES
IN, BUT APPRECIATE VERY MUCH,
MADAM CHAIR, THAT YOUR
WILLINGNESS TO BE MORE PRECISE
IN THE WAY WE HANDLE THIS
SITUATION. OPTOMETRY PROVIDES
85% OF THE EYE CARE IN THE STATE
OF CALIFORNIA FOR MEDI-CAL
PATIENTS. WE'RE WILLING TO BE
COLLABORATIVE. WE LOOK FORWARD
TO CONTINUING DISCUSSION. WE CAN
BE AS EFFICACIOUS AS ANY OTHER
PROVIDER, AND WE ARE MUCH MORE
COST EFFECTIVE. THANK YOU VERY
MUCH. THANK YOU. GOOD MORNING,
KATIE LAYTON. ON BEHALF OF THE
CHILDREN'S SPECIALTY CARE
COALITION, REPRESENTING OVER
3000 PEDIATRIC SPECIALTY
PHYSICIANS, WE DO WANT TO
TESTIFY IN STRONG OPPOSITION TO
THE SWEEP OF THE MCO TAX
REVENUE, LOW MEDI-CAL RATES HAVE
CONTRIBUTED TO A SEVERE
PEDIATRIC SPECIALTY PHYSICIAN
SHORTAGE. AS A RESULT, TOO MANY
CHILDREN AND YOUTH WITH COMPLEX
CONDITIONS ARE WAITING WEEKS OR
MONTHS FOR AN APPOINTMENT. LAST
YEAR, A STUDY WAS COMMISSIONED
BY THE NATIONAL ACADEMIES OF
SCIENCE AND MEDICINE, RESULTING
IN A REPORT CALLED THE FUTURE
PEDIATRIC SUBSPECIALTY PHYSICIAN
WORKFORCE. A KEY FINDING OF THIS
EXPERT ANALYSIS IS THAT RATE
PARITY WITH MEDICARE WITHIN
PEDIATRICS IS NEEDED TO ADDRESS
THIS DIRE PHYSICIAN SHORTAGE,
YOU KNOW, ALL OF THE PIPELINE
ISSUES THAT WE'RE SEEING AND THE
TARGETED RATE INCREASES MADE
POSSIBLE BY THE MCO TAX WOULD
BRING US CLOSER TO THAT GOAL,
AND SO WE URGE YOU TO REJECT THE
GOVERNOR'S PROPOSAL TO SWEEP
THESE FUNDS, ALSO, WE'RE
ENCOURAGED TO SEE SOME SUPPORT
IN THE MAY REVISE FOR CHILDREN'S
HOSPITALS. BUT REALLY WANT TO
SUPPORT THE WHOLE NETWORK. THANK
YOU. KELLY BROOKS, ON BEHALF OF
THE CALIFORNIA ASSOCIATION OF
PUBLIC HOSPITALS AND HEALTH
SYSTEMS, ALSO HERE IN
OPPOSITION, JUST A REMINDER THAT
STATEWIDE PUBLIC HOSPITALS
PROVIDE 35% OF MEDI-CAL AND
UNINSURED HOSPITAL CARE DUE TO
THE LOW RATES IN MEDI-CAL AND
HISTORICAL UNDERFUNDING OF THESE
SYSTEMS, PUBLIC HOSPITALS ARE
FACING A $4 BILLION DEFICIT
WHILE ALSO STRETCHING TO MEET AN
UNPRECEDENTED DEMAND FOR
SERVICES AND FULFILL THEIR
ESSENTIAL ROLE IN SERVING THEIR
COMMUNITIES. WE UNDERSTAND THE
STATE'S BUDGET CHALLENGES AND
THE DIFFICULT DECISIONS THAT ARE
GOING TO NEED TO BE MADE BY THE
LEGISLATURE AND THE
ADMINISTRATION OVER THE NEXT FEW
WEEKS, BUT WE URGE YOU TO REJECT
THE MCH PROPOSAL. THANK YOU.
THANK YOU. MADAM CHAIR AND
MEMBERS, NICK BROKAW FROM
SACRAMENTO ADVOCATES ON BEHALF
OF THE CALIFORNIA ACADEMY OF
AUDIOLOGY, REPRESENTING THE
STATE'S LICENSED AUDIOLOGIST
HERE, ECHOING THE COMMENTS OF
OTHERS WITH OUR CONCERNS AND
OPPOSITION TO THE REDIRECTION OF
THE MCO TAX FUNDS, TWO KEY
POINTS FROM OUR PERSPECTIVE. ONE
IS, OF COURSE, THE ACCESS ISSUES
IMPACTING SO MANY PROVIDERS IN
THE STATE, IMPACTING DEAF AND
HARD OF HEARING ADULTS. BUT THE
OTHER PIECE TO THIS IS THE
IMPACT THIS WILL HAVE ON OUR
HEARING AID COVERAGE FOR
CHILDREN PROGRAM, THE FUNDING
FOR THE MEDI-CAL REIMBURSEMENT
RATES ARE INEXTRICABLY LINKED TO
THE FUNDING WE HAVE IN PLACE FOR
THE HEARING AID COVERAGE FOR
CHILDREN PROGRAM. SO ACCESS TO
ENSURING THAT THAT PROVIDERS ARE
ABLE TO PROVIDE THOSE SERVICES
TO CHILDREN IS VERY MUCH AT
STAKE IN THIS ISSUE, TOO. THANK
YOU. THANK YOU. GOOD MORNING,
CHAIR MEMBERS JANICE O'MALLEY
WITH AFSCME CALIFORNIA. ALSO,
UNFORTUNATELY OPPOSED TO THE
CUTS TO THE MCO TAX, WE
REPRESENT, MANY MEMBERS IN THE,
PRIVATE AMBULANCE, EMS, SPACE
AND THE $50 MILLION THAT WAS
INCLUDED IN LAST YEAR'S BUDGET
ACTION, WOULD HAVE SUPPORTED, A
MEANINGFUL INCREASE TO MEDI-CAL
REIMBURSEMENT RATES THAT HAVEN'T
BEEN SEEN IN IN MANY YEARS, SO
WE WOULD APPRECIATE THE
LEGISLATURE'S, WORK ON HELPING
TO SUPPORT, THE MCO TAX, AS IT
WAS AGREED UPON LAST YEAR. THANK
YOU, THANK YOU, THANK YOU FOR
ALL WHO CAME AND GAVE PUBLIC
COMMENTS. I'M ACTUALLY GOING TO,
SEE IF MY COLLEAGUE WHO IS
JOINING US TODAY, ASSEMBLY
MEMBER DOCTOR WOOD, WHO HAS A
LOT OF HISTORICAL KNOWLEDGE AND
HAS BEEN AT THE TABLE FOR MANY
OF THESE CONVERSATIONS. IF HE
HAS ANY COMMENTS OR QUESTIONS
FOR OUR PANEL BEFORE WE MOVE ON
TO ISSUE TWO. THANK YOU. DOCTOR
WEBER, FOR THE OPPORTUNITY TO BE
HERE, MUCH APPRECIATED, QUESTION
FOR THE PANEL. SO THE, ONE TIME
EXPENDITURES IN THE MCO, THE
SPECIFICALLY THE SMALL AND RURAL
HOSPITAL RELIEF PROGRAM,
DISTRESSED HOSPITAL LOAN PROGRAM
, ARE THOSE BEING SWEPT AS WELL?
THOSE ARE MAINTAINED. THEY ARE
MAINTAINED. OKAY. OKAY, AND WITH
THROUGH THE CHAIR JUST TO
COMMENT OR A COUPLE, IF YOU
DON'T MIND, I THINK IT'S HARD TO
UNLESS YOUR PROVIDER IN THE ROOM
TO REALLY APPRECIATE THE
CHALLENGES OF, OF SERVING OUR,
OUR MEDI-CAL POPULATION. YOU
KNOW, I SERVED OUR MEDI-CAL
POPULATION FOR MANY YEARS, RATES
HAVE ALWAYS BEEN A HUGE
CHALLENGE GOING BACK TO PROP 56,
WE WERE TOLD AS PROVIDERS, WE'RE
TOLD IF YOU IF YOU WANT TO GET
MORE MONEY FOR INCREASED RATES,
YOU LOOK FOR A MECHANISM GOING
BACK TO PROP. SO PROP 56 PASSED
AND AT SOME POINT I CAN'T
REMEMBER WHAT YEAR GOVERNOR
BROWN SWEPT SOME OF THE MONEY
BECAUSE HE COULD, YOU KNOW, FAST
FORWARD TO WHERE WE ARE TODAY,
PROVIDERS, COALITION OF BROAD
COALITION OF PROVIDERS
NEGOTIATED THIS VERY ELABORATE
AND EXTENSIVE OPPORTUNITY TO
FINALLY GET SOME RATE INCREASES
TO PROTECT OUR ABILITY TO SERVE
A VERY VULNERABLE POPULATION.
AND HERE WE ARE AGAIN. THE
GOVERNOR IS SWEEPING IT BECAUSE
HE CAN'T, YOU KNOW, I ELECTED TO
SERVE, YOU KNOW, MY, THE
MEDI-CAL RECIPIENTS IN MY
PRACTICE. I WAS REIMBURSED LESS
THAN A THIRD OF WHAT MY USUAL
FEES WERE. IT ACTUALLY COSTS ME
MONEY TO SERVE THESE PEOPLE, AND
I HAPPILY DID IT AS MANY AS I
COULD. I PAID MONEY OUT OF MY
OWN POCKET FOR THE PRIVILEGE OF
TAKING CARE OF PEOPLE WHO NEEDED
CARE, NOT EVERYBODY CAN DO THAT.
NOT EVERY PROVIDER GROUP CAN DO
THAT. BUT A LOT OF PROVIDER
GROUPS HAVE BEEN ALL THEY'RE
STRUGGLING FOR IS THE
OPPORTUNITY TO MAYBE WE CAN
BREAK EVEN. MAYBE WE DON'T HAVE
TO, CONTINUE TO LOSE MONEY TO
TAKE CARE OF A POPULATION THAT
REALLY, REALLY NEEDS CARE, SO
THIS IS A, PROBABLY A LITTLE
MORE EMOTIONAL THAN I EXPECTED.
THIS IS A THIS IS A DEEP HIT.
THIS IS A REALLY DEEP HIT, AND
IT FEELS LIKE IT IT FEELS LIKE
THIS POPULATION DOESN'T MATTER
ANYMORE. AND IT'S IT FEELS LIKE
OUR HOSPITALS DON'T MATTER
ANYMORE. AND FOR ALL THE THINGS
WE WORKED ON COLLECTIVELY OVER
THE YEARS, AND WE'RE GOING TO
HEAR MORE OF THEM, I'M I'M
SHOCKED KIND OF BEYOND ALMOST
BEYOND WORDS. AND I USUALLY HAVE
A LOT OF WORDS. SO I'M I'M
HAPPY. THANK YOU FOR THE
OPPORTUNITY TO BE HERE TODAY,
LOOK FORWARD TO FURTHER
DISCUSSION HERE. BUT, YOU KNOW,
THIS COALITION CAME TOGETHER
WITH A BELIEF THAT THERE WOULD
BE AN OPPORTUNITY FOR RELIEF TO
BE ABLE TO BETTER SERVE PEOPLE.
AND THIS IS NOW THE SECOND TIME,
SECOND GOVERNOR, WHO HAS TAKEN
AN OPPORTUNITY TO SWEEP MONEY
BECAUSE THEY CAN. HOW DO YOU
EXPECT US AS PROVIDERS TO SERVE
POPULATIONS THAT NEED OUR CARE
AND NOT REIMBURSE US, EVEN TO
THE POINT WHERE WE CAN BREAK
EVEN? HOW DO YOU EXPECT THAT IS
MY QUESTION. BACK TO THE
ADMINISTRATION. SO DON'T THAT'S
I DON'T EXPECT A YOU KNOW, I
HAVE WE WORKED WELL IN LONG
TOGETHER, DIRECTOR BOSS, I
APPRECIATE YOU, I UNDERSTAND THE
DIFFICULT SITUATION YOU'RE IN.
IT'S MORE. I GUESS IT'S MORE OF
A RHETORICAL QUESTION, BUT IT IS
REALLY, REALLY TROUBLING. THIS
THE DEPTHS OF THESE CUTS. SO
THANK YOU, THANK YOU, THANK YOU,
MADAM CHAIR. THANK YOU SO MUCH
FOR THOSE THOSE WORDS. AND YOU
KNOW, I DEFINITELY ECHO YOUR
SENTIMENT. AND AS YOU'RE GOING
BACK AND TALKING WITH THE
GOVERNOR ABOUT AND THE REST OF
THE FINANCE TEAM AND THE REST OF
THE DEPARTMENTS, YOU KNOW, THE
QUESTION AGAIN IS, IS YES, WHAT
DO YOU TELL THESE PROVIDERS, BUT
ALSO MORE SO WHAT DO YOU TELL
THE PATIENTS WHEN THEY HAVE
NOWHERE TO GO? AND WE ALREADY
SEE THAT HAPPENING. AND AS I
ASKED EARLIER, WE ALSO HAVE NO
PLAN IN PLACE, TO, TO DEAL WITH
THE FACT THAT THEY WOULD HAVE
NOWHERE TO GO. SO ON ONE END,
YOU'VE DONE ALL THIS WORK TO
MAINTAIN THESE SERVICES, BUT
THEN THEY HAVE NOWHERE TO GO TO
GET ACCESS TO THOSE SERVICES.
AND AT THE END OF THE DAY, WE'VE
STILL CREATED AND WIDENED THE
DISPARITY WHEN ALL WE'VE TALKED
ABOUT OVER THE LAST COUPLE OF
YEARS IS EQUITY AND CLOSING
THESE GAPS, BUT THIS PLAN,
ACTUALLY DOES THE OPPOSITE. AND
SO AS YOU'RE GOING BACK AND
YOU'RE, YOU'RE RELAYING HOW THIS
HEARING WENT WITH YOUR
COLLEAGUES AND THE
ADMINISTRATION, I REALLY HOPE
THAT YOU TAKE INTO ACCOUNT ALL
OF THE THINGS THAT YOU'VE BEEN
HEARING IN THESE HEARINGS AND IN
THE POLICY HEARINGS FOR THE LAST
FEW YEARS ABOUT THE CHALLENGES
WITHIN THE HEALTH CARE SPACE,
THE CHALLENGES WITHIN OUR
MEDI-CAL SYSTEM. AND START TO
TAKE SOME OF THOSE INTO ACCOUNT
AS WE TRY TO FIX THIS, THIS,
PROPOSAL. AND WITH THAT, WE'LL
MOVE TO ISSUE TWO.
AND I THINK, YOU KNOW, FOR ME
AND MY COLLEAGUES, THOSE WHO ARE
HERE, BUT ALSO THOSE WHO ARE
WATCHING OR THEIR STAFF THAT'S
WATCHING AS WE'RE GOING THROUGH
AND REALLY TRYING TO GET AN
UNDERSTANDING, A BETTER
UNDERSTANDING OF WHY, THESE
PARTICULAR PROGRAMS WERE
SELECTED FOR REDUCTION. IT WOULD
BE NICE, FOR YOU TO GO THROUGH
AND JUST BRIEFLY DISCUSS WHAT
THE PROGRAM IS AND, AND WHY
THERE WAS A DECISION TO HAVE A
REDUCTION OR AN ELIMINATION SO
YOU CAN START, THE MAY REVISION
INCLUDES SEVERAL PROPOSED
ACTIONS TO REDUCE GENERAL FUND
COSTS IN LIGHT AGAIN, OF THE
STATE'S OVERALL GENERAL FUND,
SITUATION. AND I'LL GO IN THE
ORDER LISTED IN THE AGENDA OF
THE ITEMS, IN WITH REGARD TO THE
CHILDREN AND YOUTH BEHAVIORAL
HEALTH INITIATIVE, THE MAY
REVISION PROPOSES A REDUCTION OF
A TOTAL OF 337.1 MILLION TO THE
CHILDREN AND YOUTH BEHAVIORAL
HEALTH INITIATIVE. THESE
ADJUSTMENTS ARE RIGHTSIZING OF
FUNDING ALLOCATIONS AND WILL NOT
HINDER OUR ABILITY OR COMMITMENT
TO ADVANCE THIS GROUNDBREAKING
BEHAVIORAL HEALTH PROGRAMS AND
SUPPORTS IN SCHOOLS AND
COMMUNITIES AND IN A DIGITAL
ENVIRONMENT. TO DATE, THE
DEPARTMENT HAS AWARDED 248
MILLION IN CHILDREN AND YOUTH
BEHAVIORAL HEALTH GRANTS TO 424
ORGANIZATIONS ACROSS ALL 58
COUNTIES TO IMPROVE ACCESS TO
EVIDENCE BASED AND COMMUNITY
DEFINED PRACTICES AND PROGRAMS.
WE HAVE ALSO DISTRIBUTED A 110
MILLION IN CBE FUNDS TO ALL 58
COUNTY OFFICE OF EDUCATION AND
LOCAL EDUCATION AGENCIES TO
SUPPORT SOCIAL EMOTIONAL
LEARNING AND WELL-BEING AND
MINDFULNESS IN SCHOOLS WITH
REGARD TO THE BEHAVIORAL HEALTH
SERVICES, AND SUPPORTS PLATFORM,
WE ARE PROPOSING A ONE TIME
REDUCTION IN FUNDING OF 140
MILLION FOR THIS. THE PLATFORMS
AND THIS IS ESSENTIALLY A
RIGHTSIZING OF THE BUDGET FOR
THE DELIVERY OF THIS PLATFORM,
THE WAY WE HAVE STRUCTURED OUR
CONTRACT IS IT'S BASED ON
UTILIZATION AND UPTAKE. AND SO
THIS IS YEAR ONE OF THE
PLATFORM. AND SO WE ARE
RIGHTSIZING THE EXPENDITURES TO
FIT IN LINE WITH THE EXPECTED
UTILIZATION OF, OF THE
PLATFORMS, THIS REDUCTION AGAIN
IS BASED ON CURRENT USAGE
LEVELS, WHICH THE PLATFORMS WENT
LIVE IN JANUARY, WHICH ARE LOW
GIVEN AGAIN THAT THIS JUST
STARTED. AND WE'RE AT THE EARLY
ROLLOUT STAGES, WE ANTICIPATE
THESE, THESE THE UTILIZATION OF
THESE APPS WILL CONTINUE TO RAMP
UP THROUGH THE INITIAL CONTRACT
PERIOD OF JUNE 30TH, 2027, WE
WILL CONTINUE TO COLLABORATE
WITH THE THESE PLATFORM TEAMS,
AS WELL AS OTHER STATEWIDE
PROVIDERS TO DRIVE ADOPTION, AS
IN THE OUT YEARS, AS WE CONTINUE
TO SUPPORT THE PLATFORM WITH
REGARD TO THIS SCHOOL LINKED
CAPACITY GRANTS, BOTH AT THE
COMMUNITY COLLEGES AND THE CSU'S
AND UC'S, FOR THE COMMUNITY
COLLEGES, THE PROPOSED REDUCTION
OF 30,000,000 IN 23, 24 AND
70,000,000 IN 2425. AND THEN FOR
THE CSU'S AND UC'S, A REDUCTION
OF 50 MILLION IN THE BUDGET YEAR
OF 2425. WE ARE COMMITTED TO
COLLABORATE. Þ DO YOU WANT ME TO
STOP? I'M SORRY. OKAY, KEEP KEEP
GOING. WE ARE COMMITTED TO
COLLABORATING WITH OUR HIGHER
EDUCATION PARTNERS AND
PARTICULARLY WITH IMPLEMENTATION
OF THE FEE SCHEDULE, WHICH WE
ARE, PLANNING TO GO LIVE WITH
OUR COMMUNITY COLLEGES IN THE
FALL OF 2024. AND WITH OUR èC
AND CSU'S IN JANUARY 2025. SO
CONTINUING THE TECHNICAL
ASSISTANCE AND SUPPORT TO
IMPLEMENT THE FEE SCHEDULE WITH
OUR HIGHER EDUCATION INSTITUTES.
AND THEN THE FINAL I'M SORRY.
SURE OF COURSE, SO WITH YOUR
COMMUNITY COLLEGES GRANTS THIS
YEAR, YOU'RE, IT'S A 30 MILLION
REDUCTION. NEXT YEAR, 70
MILLION. AND THE REASON FOR
THAT, I'M SORRY. I MAY HAVE
MISSED THAT. THIS WAS ALSO JUST
IN TERMS OF THE KIND OF THE
STATE'S FISCAL SITUATION,
LOOKING AT OTHER OPPORTUNITIES
FOR WE ARE CONTINUING WITH THE,
TECHNICAL ASSISTANCE TO GET THEM
ON BOARD WITH THE FEE SCHEDULE
BEGINNING THIS FALL. AND SO
RECOGNIZING KIND OF A FOCUS IN
THAT AREA WITH REGARD TO THE FEE
SCHEDULE ALLOWS, OUR HIGHER ED
INSTITUTIONS TO BE ABLE TO BILL
AND DRAW DOWN DOLLARS, BOTH FROM
MEDI-CAL AND COMMERCIAL PLANS,
TO COVER THE SERVICES THAT THEY
PROVIDE AT SCHOOLS. AND SO WITH
THIS REDUCTION, ARE YOU
ANTICIPATE WHAT WILL BE THE
OUTCOME FOR THAT? THESE WERE
CAPACITY GRANTS TO BUILD SOME OF
THE ABILITIES TO DO SOME OF THIS
WORK, BUT WE WILL CONTINUE WITH
THE, THE TO IN TERMS OF
PROVIDING ASSISTANCE TO OUR
HIGHER EDUCATIONS TO GET READY
FOR THE FEE SCHEDULE AND
IMPLEMENTATION. THÀNH. OKAY. IN
WHAT YEAR? SO FOR OUR COMMUNITY
COLLEGES, THE FALL OF THIS YEAR
AND THEN FOR OUR CSU'S AND UC'S
BEGINNING IN JANUARY OF 2025.
BUT YOU'VE CUT THEIR FUNDING.
WHAT WHAT IS THE ACTUAL FUNDING
CUT? THE FUNDING IS FOR JUST
CAPACITY BUILDING. SO MAYBE
WORKFORCE OR INFRASTRUCTURE
NEEDED TO MAYBE DO SOME OF THIS
WORK. BUT WE WILL CONTINUE WITH
OUR TECHNICAL ASSISTANCE AND
SUPPORT FROM THE DEPARTMENT AND
OUR VENDORS TO GET THEM READY.
THIS WAS JUST ACTUAL DOLLARS
GOING TO THE HIGHER EDUCATION
INSTITUTES TO BE READY. SO THIS
WOULD EFFECTIVELY CREATE A
SITUATION WHERE THE HIGHER ED
INSTITUTIONS DON'T HAVE THE ON
THE GROUND CAPACITY BY WAY OF
INDIVIDUALS SYSTEMS TO ACTUALLY
BE ABLE TO ACCEPT THE ADDITIONAL
WORK, BUT THE STATE IS GOING TO
BE PROVIDING TECHNICAL
ASSISTANCE TO THEM. CORRECT. IT
SEEMS PRETTY BACKWARDS. SO I
DON'T UNDERSTAND HOW IS THAT
AGAIN GOING TO WORK IF THEY
DON'T HAVE THE SUPPORT ON THE
GROUND TO ACTUALLY. SO WE WILL
BE PROVIDING THE DEPARTMENT AS
WELL AS OUR VENDOR WHO WILL
OPERATE THE FEE SCHEDULE WILL BE
PROVIDING TECHNICAL ASSISTANCE
TO THESE INSTITUTIONS, TO GET
THEM READY. BUT THESE WOULD BE
THE DOLLARS THAT ARE PROPOSED TO
BE CUT. ARE SOME OF THE KIND OF
THE INFRASTRUCTURE DOLLARS THAT
MAY HAVE BEEN PROPOSED OR NEEDED
AT THE TIME. BUT JUST
RECOGNIZING AGAIN, THE STATE'S
FISCAL SITUATION, THIS IS AN
AREA THAT WAS PROPOSED FOR
ELIMINATION. WHAT'S INCLUDED IN
THE INFRASTRUCTURE, THESE WERE
TO, GENERALLY SOMETIMES, FUNDING
WORKFORCE PRIOR TO THE FEE
SCHEDULE BEING IMPLEMENTED,
WHICH WOULD THEN COME IN AND BE
THE ONGOING SUPPORT, SIMILAR TO
SOME OF THE CAPACITY GRANTS THAT
WE HAVE UNDER PATH FOR CALAIM,
WHERE IT IS SOME OF THOSE ONE
TIME DOLLARS THAT MIGHT BE
NEEDED TO SUPPORT THAT, THAT
INITIAL STARTUP, UNTIL THE FEE
SCHEDULE IS AVAILABLE TO THEM,
SUPPORT THE ONGOING NEEDS. IT
MIGHT LOOK DIFFERENT FROM ENTITY
TO ENTITY DEPENDING ON WHAT THE
NEEDS ARE, THOUGH. YEAH BUT IT
IS POTENTIALLY WORKFORCE. THAT'S
AN OPTION POTENTIALLY. YES
THAT'S AN OPTION. SO IF YOU
DON'T HAVE THE WORKFORCE S HOW
ARE HOW IS THIS PROGRAM GOING TO
GO INTO EFFECT? I'M REALLY VERY
THE FEE SCHEDULE WOULD PROVIDE
THE ONGOING DOLLARS FOR THE
WORKFORCE, BUT IN SOME INSTANCES
, THE TIME FOR THOSE DOLLARS TO
ACTUALLY GET TO THE INSTITUTION
TO BE ABLE TO SUPPORT THE, THE,
THE, THE WORKFORCE IN AN ONGOING
MANNER MAY, MAY TAKE LONGER. AND
SO THERE'S JUST A FEW MONTHS
THAT NEED TO BE COVERED. AND
SOMETIMES CAPACITY GRANTS ARE
USED TO COVER THOSE INITIAL
MONTHS UNTIL THE ONGOING DOLLARS
ARE AVAILABLE. SO THEN IF THE
MONEY'S NOT THERE, THEN WHAT
YOU'RE STATING IS THAT THE
UNIVERSITIES OR THE COLLEGES
WOULD HAVE TO SUPPORT IT. LIKE
WHO'S GOING TO ESSENTIALLY
SUPPORT IT DURING THOSE FIRST
COUPLE OF MONTHS WHILE WE'RE
WAITING FOR, THE MONEY TO KICK
IN? LIKE HOW WHAT'S THE PLAN? SO
I THINK WHAT MIGHT HAPPEN IS
THAT IT MIGHT TAKE A LITTLE BIT
LONGER FOR THE INFRASTRUCTURE TO
BUILD UP INSTEAD. SO THERE
WOULDN'T BE AN INCREASED COST TO
THE ENTITIES. SO, MICHELLE
TALKED A LITTLE BIT ABOUT WHAT
WE'VE SEEN IN OUR PATH, CITED
GRANTS, AND I KNOW WE'VE TALKED
ABOUT THAT TO YOU ALL BEFORE,
AND SO WHAT WE'VE WHAT WE'VE
SEEN IS THAT IN, IN WHAT WE HAVE
SEEN IS IN PLACES WHERE WE
PROVIDED GRANTS AND FUNDING,
THEN THERE'S BEEN OPPORTUNITY
FOR INFRASTRUCTURE TO BE BUILT
OUT EARLIER. AND SO THERE'S BEEN
IMPLEMENTATION AT AN EARLIER OR
A QUICKER PHASED IMPLEMENTATION.
AND SO WITH THE STATE PROVIDING
TECHNICAL ASSISTANCE, WE STILL
WILL BE ABLE TO PROVIDE THAT,
INFRASTRUCTURE ASSISTANCE TO THE
SCHOOLS AND THE ENTITIES. BUT IT
MAY BE THAT IMPLEMENTATION IS A
LITTLE BIT SLOWER THAN WAS
INTENDED ORIGINALLY. SO LOOKING
AT THE COMMUNITY COLLEGES,
THEY'RE BEING, REDUCED AND, YOU
KNOW, THIS YEAR AND NEXT YEAR.
BUT SO ARE YOU STATING THAT
THEY'RE GOING TO HAVE AN EVEN
LONGER TIME FOR IMPLEMENTATION,
LIKE HOW IS THAT GOING TO IMPACT
THE PROGRAMS THERE? WELL, THEY
WE ARE PLANNING FOR THEM TO BE
ABLE TO GO LIVE IN THE FALL OF
2024, AND IT WILL BE ON A
ROLLING BASIS BASED ON COMMUNITY
COLLEGE, TO USE THE FEE SCHEDULE
AND SO DEPENDENT ON EACH
COMMUNITY COLLEGE SITUATION WHEN
THEY OPT TO GO IN. AND THAT
USING THAT FEE SCHEDULE TO AGAIN
BRING IN THE ONGOING REVENUE TO
SUPPORT, THE WORKFORCE OR THE
SERVICES THAT ARE BEING PROVIDED
ON SITE. OKAY OKAY. YOU CAN KEEP
GOING. OKAY AND THEN THE LAST
ITEM UNDER THE CHILDREN AND
YOUTH BEHAVIORAL HEALTH
INITIATIVE IS A REDUCTION IN
FUNDING OF 47.1 MILLION,
REGARDING OUR GRANTS FOR
EVIDENCE BASED AND COMMUNITY
DEFINED PRACTICES AS, DURING THE
SUMMER, WE WILL BE RELEASING
GUIDANCE ABOUT FUNDING
REIMBURSEMENT OPTIONS FOR BOTH
EVIDENCE BASED PRACTICES AND
COMMUNITY DEFINED PRACTICES
WITHIN THE MEDI-CAL PROGRAM. SO
PROVIDING KIND OF A GUIDE FOR
OUR PROVIDERS AND COUNTIES AND
OTHER ENTITIES ON HOW TO BILL
MEDI-CAL FOR SOME OF THESE
ITEMS. AND THIS IS A NEW
RESOURCE THAT WE ARE PLANNING TO
PROVIDE, REALLY RECOGNIZING THE
IMPORTANCE OF COMMUNITY DEFINED
PRACTICES, AND REALLY EXPLAINING
HOW TO USE THE MEDI-CAL CODES
AND WHAT CODES TO BILL TO
PROVIDE SOME OF THAT ONGOING,
FUNDING SOURCES. WHEN THIS
PROGRAM OR THE EVIDENCE BASED
PROGRAM GRANT PROGRAM WAS FIRST
DEVELOPED, THERE WAS THE GOAL
WITH ROUND SIX BEING JUST
EVIDENCE BASED AND COMMUNITY
DEFINED PRACTICES. HOWEVER, THE
PREVIOUS FIVE ROUNDS, THE
PREVIOUS ROUNDS OF THIS HAVE
INCLUDED THOSE AS WELL. AND SO
REALLY WE'VE BUILT OUT QUITE A
BIT OF INFRASTRUCTURE. I THINK I
MENTIONED AT THE BEGINNING ABOUT
$248 MILLION IN GRANTS TO 424
ORGANIZATIONS AND THIS DOES
INCLUDE EVIDENCE BASED AND
COMMUNITY DEFINED PRACTICES AS
WELL. OKAY JUST A QUESTION BACK
TO THE, THE OVERALL CONCEPT OF,
MAJOR REDUCTIONS WITH THE
COMMUNITY COLLEGES VERSUS CGRTS,
OVER TWO YEARS VERSUS NO
REDUCTIONS FOR CSUS AND UCS IN
THIS YEAR, AND, AND 50 MILLION
FOR, FOR THE NEXT, BUT FOR THE
24, 25 YEAR. BACK TO, I GUESS,
THE OVERALL QUESTION AROUND
EQUITY COMMUNITY COLLEGES HAVE
LESS. THEY HAVE LESS OPERATING
CAPITAL TO BE ABLE TO DIVERT
TOWARDS ESSENTIALLY KIND OF
BUILDING THEIR OWN
INFRASTRUCTURE TO SUPPORT THE
BEHAVIORAL HEALTH PROGRAMS. THE
SCHOOL BASED CLINICS THAT ARE SO
DESPERATELY NEEDED, VERY
DIFFERENT THAN PERHAPS A èC
MIGHT BE SITUATED TO BE ABLE TO
DO SO, I ACTUALLY THINK THAT THE
CSUS ARE PROBABLY MORE IN LINE
IN TERMS OF AVAILABLE RESOURCES
TO THE COMMUNITY COLLEGES THAN
THAN OUR UCS. SO ESSENTIALLY,
WHAT I'M HEARING IS THAT WE ARE
STILL, IN THEORY ON PAPER,
ALLOWING THERE TO BE
OPPORTUNITIES TO HAVE A STRONG,
PLACE BASED HEALTH PROVISION
NETWORK AROUND AND BEHAVIORAL
HEALTH IN PLACE. BUT WE ARE NOT
AT GIVING THE INSTITUTIONS THE
START UP RESOURCES THAT THEY
NEED TO BE ABLE TO ACTUALLY
FOCUS ON IMPLEMENTATION OF THOSE
, IN THE SHORT TERM, WHICH
EFFECTIVELY MEANS THAT THEY WILL
PROBABLY NOT DO THOSE PROGRAMS.
SO HOW ARE WE KIND OF SQUARING
THE FACT THAT WE ARE STILL
WANTING TO MAKE SURE THAT WE'RE
MOVING FORWARD WITH A VERY
HISTORIC INITIATIVE TO ENSURE
THAT WE WERE PROVIDING,
PARTICULARLY YOUTH BEHAVIORAL
HEALTH COMPONENTS TO OUR
NEEDIEST STUDENTS, STUDENTS THAT
ARE LIVING IN THEIR CARS,
STUDENTS THAT ARE WORKING TWO
JOBS IN ORDER TO BE ABLE TO TAKE
ONE CLASS, AND, AND NOT FUNDING
THEM THIS YEAR OR NEXT YEAR FOR,
FOR THAT PROGRAMING. SO I GUESS
THE FISCAL QUESTION IS WHY ARE
WE PROPOSING CUTS IN THIS YEAR
AND NEXT YEAR FOR COMMUNITY
COLLEGES AND NOT FOR THE CSU'S
UCS? WAS THERE ANY KIND OF
EQUITY ANALYSIS OVERLAY
CONDUCTED IN THINKING ABOUT THE
DISTRIBUTION OF EVEN THOSE TWO
CATEGORIES OF FUNDING AND, WHAT
WERE THE OPPORTUNITY COSTS THAT
YOU ALL IDENTIFIED IN TERMS OF
PARTICULARLY THE COMMUNITY
COLLEGES? AND I'LL SAY ALSO
CSU'S IN TERMS OF ACTUALLY BEING
ABLE TO IMPLEMENT THESE
PROGRAMS. NATE WILLIAMS WITH
DEPARTMENT OF FINANCE, SO THE
CUTS THAT WERE MADE FOR BOTH THE
COMMUNITY COLLEGES AND THE, THE
UCS AND CSUS WERE ACTUALLY THE
FULL AMOUNTS THAT WERE ALLOTTED
TO THOSE. SO THE DIFFERENCE WE
HAD ORIGINALLY PROPOSED 100
MILLION FOR COMMUNITY COLLEGES
AND 50 MILLION FOR UCS AND CSUS.
AND THE REASON WHY IT'S COMING
OUT OF THE BUDGET YEAR IS
BECAUSE OF THE LATER
IMPLEMENTATION FOR THE CSUS AND
UCS. THAT'S WHEN THE PLANNED
EXPENDITURES WERE. AND SO THAT'S
WHY IT'S REFLECTING 50 MILLION
IN THE BUDGET YEAR. AND THEN THE
EARLIER YEAR, KIND OF THE
EARLIER ADOPTION FOR THE
COMMUNITY COLLEGES IS WHY WE HAD
A PLANNED EXPENDITURE OF 30
MILLION IN THE CURRENT YEAR AND
THEN 70 MILLION IN THE BUDGET
YEAR. SO IN PLAIN SPEAK,
ESSENTIALLY, WE'RE ELIMINATING
THIS PROGRAM. YES, CORRECT. FOR
THE FOR THE COMMUNITY COLLEGES
AND THE AND THE UCS AND CSUS.
YEAH. SO WHY WHY ARE WE LISTING
IT AS A REDUCTION INSTEAD OF AN
ELIMINATION. SO THE BUDGET DOES
MAINTAIN 400 MILLION FOR K-12
FOR THE EXACT SAME PROGRAM, SO
AS FAR AS THE, PARTNERSHIP AND
CAPACITY GRANTS, THE K12 DOES
STILL HAVE 400 MILLION,
ALLOCATED FOR IT. RIGHT. BUT
HERE, YOU KNOW, YOU SEPARATED IT
OUT BY COMMUNITY COLLEGES AND
CSUS AS A REDUCTION. THAT MEANS
THAT YOU'VE REDUCED IT. SO THERE
ARE SOME MONEY STILL LEFT FOR
THAT PARTICULAR PROGRAM. BUT
WHAT YOU'VE JUST SAID IS THAT
THE MONEY THAT WAS ALLOCATED IS
GONE. SO IT'S NOT A REDUCTION.
THERE'S NOTHING LEFT FOR THE
COMMUNITY COLLEGE PORTION OR THE
CSU èC PORTION, RIGHT? YEAH
THAT'S CORRECT. OKAY. SO TO ME,
IT SEEMS LIKE AN ELIMINATION OF
THIS PROGRAM THAT YOU HAVE
LISTED AS A SEPARATE THING. IT'S
NOT LISTED AS ONE. IT IS TWO
SEPARATE ITEMS. SO TO ME IT'S AN
ELIMINATION I MEAN YES, YES,
THAT IS TRUE. I GUESS WE WERE WE
WERE LOOKING AT THE PROGRAM
HOLISTICALLY WHEN WE WERE KIND
OF DEVELOPING THE LANGUAGE FOR
THIS. BUT YES, YOU ARE CORRECT.
OKAY. THANK YOU. ANY OTHER
QUESTIONS? OKAY OH GO AHEAD. NO
I HAVE SOME QUESTIONS AT A
DIFFERENT PORTION. WE'LL KEEP
GOING, I THINK THAT CONCLUDED
THE CHILDREN AND YOUTH
BEHAVIORAL HEALTH INITIATIVE. SO
I DO HAVE A QUESTION ABOUT THE
PLATFORM. ALL RIGHT. SO WHAT'S
THE WHAT IS THE WHAT ARE THE
SUNK COSTS FOR THE PLATFORM
RIGHT NOW? HOW MUCH HAVE WE
ALREADY PUT INTO DEVELOPMENT OF
THESE PLATFORMS. DO YOU HAVE. I
WOULD HAVE TO GET BACK TO YOU. I
DON'T KNOW IF THE DEPARTMENT OF
FINANCE HAS THAT INFORMATION.
AND THIS IS LIKE SPECIFICALLY
FOR BRIGHT LIFE KIDS AND SOLUNA,
FOR TEENS AND STUDENTS, JUST FOR
THE GENERAL GENERAL AWARENESS OF
THE PUBLIC. THESE WERE, TOUTED
AS WAYS TO BE ABLE TO PROVIDE
ONLINE BEHAVIORAL HEALTH
PROGRAMING AND SUPPORTS FOR,
CHILDREN AND ADOLESCENTS,
PRIMARILY. CORRECT? YEAH, THEY
WOULD HAVE THE CRITICAL SUPPORT
THAT THEY NEED AS THEY ARE
CONSIDERING SUICIDE AND, DEALING
AT INCREDIBLY SIGNIFICANT RATES
WITH RATES OF DEPRESSION THAT
WE'VE NEVER SEEN IN THE STATE OF
CALIFORNIA, IN ALL OF THOSE
TERRIBLE THINGS. WHAT ARE THE
SUNK COSTS FOR THE PLATFORM?
YES, SO THE, PAST YEAR
EXPENDITURES OVER, BUDGET YEARS
21, 22 AND THEN 22 AND 23 ARE,
APPROXIMATELY 33 MILLION. AND
THEN WE ALSO HAVE ANOTHER
PROPOSED, FOR THE CURRENT YEAR
OF 110 MILLION. SO WE'RE LOOKING
ROUGHLY 143 MILLION. SO WE'VE
SPENT 143 MILLION ON BUILDING
OUT THESE PLATFORMS, CORRECT TO
DATE. AND THE RATIONALE FOR,
ESSENTIALLY REDUCING THE FUNDING
ASSOCIATE. WHAT DID YOU SAY?
WHAT'S THE REDUCTION? 140
MILLION YOU'RE REDUCING BY
ANOTHER? YOU'RE REDUCING BY A
140 MILLION. CORRECT, AND THE
RATIONALE FOR THE REDUCTION IS
THAT THERE HASN'T BEEN
UTILIZATION. THÀNH. YES. SO THE
PROJECTIONS THAT WE HAD
ORIGINALLY INCLUDED IN THE
GOVERNOR'S BUDGET INCLUDED, KIND
OF A FASTER RAMP UP PERIOD AND
SO AS WE'RE GETTING MORE UPDATED
NUMBERS, WE RECOGNIZE THAT THAT
FUNDING WILL ACTUALLY NOT BE
NEEDED BECAUSE THOSE, THAT
FUNDING WAS ORIGINALLY DESIGNED
TO, TO PAY FOR THE ACTUAL
UTILIZATION OF THE SERVICE AND
NOT KIND OF THE SUNK COST OR THE
, THE STARTUP COST TO GET IT
GOING, SO, SO, YOU KNOW, WE FELT
LIKE, THAT WAS, A VERY
REASONABLE, WAY THAT WE COULD
FIND SOME GENERAL FUND SAVINGS.
WHAT WERE THE BARRIERS TO THE
RAMP UP AND UTILIZATION? SO I
WILL SAY ALSO, IT'S JUST THE
WAY, THE WAY THE ULTIMATELY THE
CONTRACT WAS STRUCTURED INSTEAD
OF, YOU KNOW, X NUMBER OF
DOLLARS DIVIDED BY X NUMBER OF
YEARS. IT WAS BASED ON
UTILIZATION. AND SO YEAR ONE
UTILIZATION IS LESS THAN WHAT WE
WILL PROJECT IN YEAR TWO, THREE
AND FOUR UTILIZATION. AND SO AS
A RESULT OF THE WAY THE CONTRACT
IS STRUCTURED, WE DIDN'T NEED
THE FULL AMOUNT IN YEAR ONE AS
KIND OF ORIGINALLY BUDGETED. AND
SO THAT IS THE RATIONALE FOR
THE, THE KIND OF THE RIGHT
SIZING OF THE SPEND FOR BUDGET
YEAR AND THE REDUCTION OF THE
140 MILLION. OKAY. THANK YOU FOR
THE INFORMATION. YOU CAN
CONTINUE. OH, I'M SORRY ALEJO.
THANK YOU. CHAIR MEMBERS RYAN
MILLER FROM THE LEGISLATIVE
ANALYST'S OFFICE, IF I MAY, I
THINK WE WANTED TO JUST PROVIDE
SOME GENERAL COMMENTS ON THESE
TYPES OF REDUCTIONS THAT I THINK
WILL ALLOW US TO BE RELATIVELY
BRIEF ON THESE TYPES OF ITEMS
AND THE REST OF THE HEARING, THE
SIDE VÌ PROPOSALS THAT YOU'RE
HEARING RIGHT NOW, THESE ARE
REDUCTIONS THAT ARE PROPOSED TO
WHAT WERE ONE TIME OR TEMPORARY
ITEMS. LIKEWISE, THE MAY
REVISION INCLUDES A NUMBER OF,
SIMILAR PROPOSALS THAT WERE
INITIALLY PROPOSED FOR DELAY AND
THAT ARE NOW REDUCTIONS, IN
GENERAL, WE FIND THAT THESE
PROPOSALS ARE REASONABLE,
HOWEVER, THE ASSESSMENT IS NOT
SO MUCH ABOUT THE MERIT OF THE
INDIVIDUAL ITEMS, THE INDIVIDUAL
PROGRAMS, I THINK, AS THIS
DISCUSSION, ILLUSTRATES, THEY'RE
CLEARLY CONSEQUENCES FROM A LOT
OF THESE DECISIONS. BUT GIVEN
THE SIGNIFICANT FISCAL SITUATION
THE STATE IS FACING, IT'S OUR
OFFICE'S ASSESSMENT THAT BY
FOCUSING ON THESE TEMPORARY AND
ONE TIME ITEMS, WE BELIEVE THAT
THE LEGISLATURE WILL PUT THE
STATE IN A BETTER POSITION OR I
SHOULD SAY THAT THE MAY REVISION
PROPOSAL, PUTS THE PUTS THE
STATE IN A BETTER FISCAL
POSITION GOING FORWARD TO
MAINTAIN, CORE SERVICES IN
HEALTH PROGRAMS, HUMAN SERVICE
PROGRAMS, AND ACROSS THE STATE
BUDGET. AND SO, SO I WOULD JUST
CONCLUDE AND SAY THAT IN OUR
JUDGMENT, THESE FOUR, PROPOSALS
ARE REASONABLE IN LIGHT OF THE
STATE BUDGET CONDITION. THANK
YOU. YOU CAN CONTINUE. OKAY. SO
THE NEXT ITEM ON THE LIST IS THE
REDUCTION TO THE NALOXONE
DISTRIBUTION PROGRAM OR PROJECT
AND THE MEDICATION ASSISTANT
TREATMENT REDUCTION IN THE MAY
REVISION PROPOSES 57.3 MILLION
GENERAL FUND REDUCTION, FROM
LOCAL ASSISTANCE IN 2425 AND
ONGOING. THIS REFLECTS A
REDUCTION OF 35 MILLION FROM THE
NDP OR THE NARCOTIC DISTRIBUTION
PROJECT PROGRAM, AND REVERSES,
FUNDING THAT WAS ALLOCATED IN
THE 2023, 20, 2022, 23 BUDGET.
RELATED TO THE MEDICATION
ASSISTANT TREATMENT EXPANSION
PROGRAM WITH REGARD TO THE NDP
REDUCTION, WITH THE RECENT
ANNOUNCEMENT OF CALOREX AND THE
STATE'S NEW PARTNERSHIP THAT
ALLOWS THE STATE TO PURCHASE RX
BRANDED OVER THE COUNTER
NALOXONE FOR $24, ALMOST HALF
THE CURRENT MARKETPLACE PRICE.
THE PROPOSED REDUCTION IN MAY
REVISE IS REALLY REFLECTING THAT
REDUCED PRICE AND COST TO
PROCURE OR TO PURCHASE, NALOXONE
AND SO IT WILL NOT HAVE AN
IMPACT TO THE NDP PROGRAM. IT'S
JUST REALLY REFLECTING THAT WE
CAN PURCHASE, MORE WITH LESS
DOLLARS, AS A RESULT OF THE
ANNOUNCEMENT, A COUPLE OF WEEKS
AGO. AND, AND THEN WITH THE, THE
PROPOSAL RELATED TO THE
MEDICATION ASSISTANT ASSISTED
TREATMENT PROGRAM, THIS WAS A
PROPOSAL THAT WAS ADDED IN 2223,
AND THIS PROJECT PROPOSED, THIS
PROJECT SUPPORTS, STARTUP
ACTIVITIES OR ENHANCEMENT
EFFORTS THROUGHOUT CALIFORNIA
WITH INCREASED INCREASING THE
AVAILABLE SITES FOR MATT. AND
WITH THIS REDUCTION, IT WOULD
JUST IT WOULD REDUCE THE KIND OF
THE START UP DOLLARS FOR NEW
SITES. ARE WE SEEING A DECREASE
IN OUR FENTANYL DEATHS? NO, IT'S
STILL AN OVERDOSE. PROBLEM IS
STILL A SIGNIFICANT PROBLEM IN
CALIFORNIA. BUT WE'RE REDUCING
FUNDING FOR THESE TREATMENT
CENTERS TO FOR START UP
ACTIVITIES FOR TREATMENT
CENTERS. YES. AGAIN, TO THE
POINT OF JUST RECOGNIZING THE
STATE'S FISCAL SITUATION. AND SO
IF SOMEONE DOESN'T HAVE THE
FUNDS FOR WELL, LET ME ASK YOU
THIS. DO WE HAVE ENOUGH
TREATMENT CENTERS? IS THAT THE
THOUGHT PROCESS? WE'VE LOOKED IN
EVERY AREA IS PRETTY MUCH
SATURATED AND ABLE TO DEAL WITH
THE NUMBER OF INDIVIDUALS WHO
WILL NEED TO HAVE THOSE
SERVICES. ARE WE SATURATED UP
AND DOWN THE STATE WITH THESE
TREATMENT CENTERS? I DON'T KNOW
THAT WE'VE COMPLETED AN
ASSESSMENT TO DETERMINE, YOU
KNOW, IF WE'RE SATURATED OR IF
THERE ARE AREAS OF THE STATE
THAT THAT STILL NEED THESE THESE
SITES. ARE THESE FUNDS, HIGHLY
UPTAKE LIKE, ARE YOU NOTICING
LIKE AS SOON AS YOU'RE RELEASING
THEM, LIKE, PEOPLE ARE GRABBING
THEM SO THEY CAN OPEN UP THESE
TREATMENT CENTERS? OR IS IT
BEING UNUTILIZED? WE AWARD THESE
DOLLARS EVERY SINCE THEY STARTED
IN 22, 23. WE AWARD THESE
DOLLARS. THERE ARE ALSO SOME
FEDERAL STATE OPIOID RESPONSE
DOLLARS, FEDERAL DOLLARS THAT
ARE USED TO SUPPORT MEDICATION
ASSISTED TREATMENT KIND OF
EXPANSION AND USE ACROSS THE
STATE. BUT THIS IS THE GENERAL
FORM COMPONENT. GENERAL FUND
PORTION OF THOSE DOLLARS. YEAH.
NO. MY QUESTION IS, YOU KNOW,
SOMETIMES WE START A PROGRAM AND
THE FUNDS ARE UNUSED. RIGHT. SO
MY QUESTION IS, ARE THERE UNUSED
FUNDS OR ARE THESE ACTUALLY
FUNDS THAT ARE UTILIZED. THESE
DOLLARS ARE UTILIZED COMPLETELY.
YES. SO THERE'S A NEED. AS SOON
AS YOU BRING THEM OUT, PEOPLE
TAKE THEM AND THEY OPEN UP THESE
TREATMENT CENTERS BECAUSE WE
HAVE AN ISSUE WITH FENTANYL.
YES. THESE ARE, THESE DOLLARS
ARE USED. OKAY. SO, YOU'VE PUT
TWO THINGS IN ONE, THE NALOXONE
DISTRIBUTION PROJECT, WHICH
YOU'VE STATED, WE'RE NOT GOING
TO HAVE A DECREASE IN THAT
BECAUSE WE'RE ABLE TO NOW, YOU
KNOW, PRODUCE OUR OWN, WHICH IS
GREAT, BUT YOU'VE ALSO PUT THE
MEDICATION ASSISTED TREATMENT,
SO YOU'VE LUMPED THEM TOGETHER.
SO IF YOU REMOVED THE AMOUNT FOR
NALOXONE, WHAT WOULD HAVE BEEN
LEFT FOR THE MEDICATION
ASSISTANT. TREATMENT. THAT'S 22
MILLION GENERAL FUND 22 MILLION
EVERY YEAR. CORRECT OKAY. ALL
RIGHT. OKAY IS THERE A SCHEDULE
FOR WHERE THESE NEW SITES WOULD
HAVE BEEN OPENED? SO THIS WOULD
BE ESSENTIALLY STOPPING THE
PROGRAM BEGINNING IN THE BUDGET
YEAR. SO IT WOULD, NO LONGER
HAVE THESE KIND OF, CAPACITY
GRANTS, AND SO WE DON'T KNOW
WHAT WOULD WOULD HAVE BEEN
AWARDED IN THE, IN THE BUDGET
YEAR. I'M, I'M TALKING ABOUT
LOCATIONS. WHERE WOULD THESE
SITES HAVE OPENED? OH WHERE
WE'VE ALREADY AWARDED NO WHERE
IF WE WERE TO MAINTAIN MONEY FOR
NEW SITES, WHERE WOULD THESE
SITES BE OPENING? IT'S BASED ON
AN APPLICATION PROCESS. SO WE I
DON'T KNOW THAT WE KNOW WHERE
THEY WOULD GO. HAVE APPLICATIONS
PENDING NOT FOR BUDGET YEAR, NO,
NOT FOR NEW MONEY IN THE BUDGET
YEAR. WILL THESE, WITH THE
INFRASTRUCTURE DEVELOPMENT
PROGRAM BE AT ALL BACKFILLED BY
PROP ONE? NO STILL COMPLETELY
DIFFERENT. BUT THIS IS A STATE
ADMINISTERED PROGRAM. LOCALS CAN
USE THEIR DOLLARS POTENTIALLY
FOR PROP ONE FOR SIMILAR WORK,
BUT NOT AT THE STATE LEVEL. WAS
THE RATIONALE THAT ESSENTIALLY
BECAUSE OF PROP ONE BEING IN
PLACE, THIS WOULD BE A MORE
REASONABLE EXPENSE FOR US TO NOT
INVEST IN INFRASTRUCTURE. FROM A
STATE PERSPECTIVE, THAT'S NOT
COME UP AT ALL. NO RELATION TO
PROP ONE UNDER THIS PROGRAM.
OKAY, OKAY, OKAY, THE NEXT ITEM
IS THE BEHAVIORAL HEALTH
CONTINUUM INFRASTRUCTURE
PROGRAM, OR CHIP. THE MAY
REVISION PROPOSES TO ESSENTIALLY
ELIMINATE ROUND SIX OF THE B
CHIP, ORIGINAL FUNDING, THIS
ROUND HAS NOT BEEN RELEASED, AND
NO AWARDS HAVE BEEN MADE, I
WOULD NOTE THAT YESTERDAY, THE
GOVERNOR ANNOUNCED THE PROGRAM
GUIDANCE FOR THE 3.3 BILLION IN
PROPOSITION ONE BOND B CHIP
ROUND ONE DOLLARS THAT WILL GO
OUT FOR APPLICATION, THIS
SUMMER, AND SO LET'S SEE IF
THERE ARE ANY QUESTIONS ON THAT
ONE. TAKE THE QUESTION THAT I
JUST ASKED. SO THESE DOLLARS,
THE PROPOSITION ONE DOLLARS ARE
VERY SIMILAR IN TERMS OF WHAT
ROUND SIX WOULD HAVE BEEN USED
TO BUILD OUT THE BEHAVIORAL
HEALTH CONTINUUM INFRASTRUCTURE
ACROSS THE STATE OF CALIFORNIA.
AND SO, THESE, THESE, SAME
PURPOSE OR SAME USAGE OF THE
DOLLARS IN THE SAME PROGRAM.
OKAY. YOU CAN KEEP GOING. OKAY
THE NEXT ITEM IS THE, BEHAVIORAL
HEALTH BRIDGE, HOUSING DOLLARS.
THE MAY REVISION PROPOSES TO
REDUCE FUNDING BY 132.5 MILLION,
OR 50, IN 24, 25, AND 27. SORRY,
207.5 MILLION IN 2526, BUT
AUGMENTING IT WITH BEHAVIORAL
HEALTH SERVICES ACT FUNDING IN
2025, RESULTING IN A NET
REDUCTION OF 117.5 MILLION IN
BUDGET YEAR, PLUS ONE. KEEP
GOING. OKAY, SO JUST NOTING THAT
THIS, THIS PROGRAM PROVIDES
FUNDING TO COUNTIES AND TRIBAL
ENTITIES TO ADDRESS THE
IMMEDIATE HOUSING NEEDS OF
PEOPLE EXPERIENCING
HOMELESSNESS, OFTEN USED AS
RENTAL SUBSIDIES, OPERATING
SUBSIDIES, REALLY? THAT BRIDGE
IN DOLLARS UNTIL PERMANENT
INFRASTRUCTURE MIGHT BE
AVAILABLE. OKAY, OKAY. NEXT
ITEM. IS THE REDUCTION IN THE
EQUITY AND PRACTICE
TRANSFORMATION PAYMENT PROGRAM
TO PROVIDERS. THE MAY REVISION
PROPOSES TO ELIMINATE, DOLLARS
THAT ARE BEYOND THE 140 MILLION
THAT WAS APPROPRIATED IN THE
BUDGET ACT OF 2022. THIS RESULTS
IN A 280 MILLION IN REDUCTION IN
GENERAL FUND COSTS, INCLUDING
43.8 MILLION IN 2425 AS A RESULT
OF THIS REDUCTION IN FUNDING,
COHORT ONE, WHICH WAS ANNOUNCED
IN JANUARY, WE WILL NEED TO
REVISE THE PROGRAM AND
MILESTONES THAT ARE, THAT WERE
SET BACK IN THE ORIGINAL
CREATION OF THIS PROGRAM TO
REFLECT A REDUCTION IN FUNDING
FOR COHORT ONE. AND THIS PROJECT
REALLY WAS TO SUPPORT THE
DELIVERY SYSTEM TRANSFORMATION
IN SPECIFICALLY TARGETING
PRIMARY CARE PRACTICES THAT
PROVIDE PRIMARY CARE, PEDIATRIC
FAMILY MEDICINE, INTERNAL
MEDICINE, PRIMARY CARE, OB GYN
SERVICES, AND BEHAVIORAL HEALTH
SERVICES THAT ARE INTEGRATED IN
A PRIMARY CARE SETTING. OKAY
OKAY. THE NEXT ITEM IS TO
ELIMINATE THE FINAL YEAR OF THE
HEALTH ENROLLMENT NAVIGATORS
PROJECT, AND THE SUM OF THE ONE
TIME SPENDING WITH THE HEALTH
ENROLLMENT NAVIGATORS FOR
CLINICS. THE MAY REVISION
PROPOSES TO ELIMINATE 18 MILLION
GENERAL FUND, WHICH IS THE
REMAINING FUND FOR THE HEALTH
ENROLLMENT NAVIGATORS PROGRAM,
AND AN ADDITIONAL 8 MILLION IN
REMAINING FUNDING FOR THE HEALTH
ENROLLMENT NAVIGATORS FOR
CLINICS PROJECT IN 2020 2425.
THIS PROGRAM BEGAN IN JULY OF 22
AND PROVIDES FUNDING TO COUNTIES
AND COMMUNITY BASED
ORGANIZATIONS TO SERVE HARD TO
REACH, POTENTIALLY ELIGIBLE
MEDI-CAL POPULATIONS. THE COUNTY
AND CBO GROUPS PERFORM
ACTIVITIES RELATED TO OUTREACH,
APPLICATION ASSISTANCE,
ENROLLMENT, AND ACCESS
ASSISTANCE WITH ACCESSING AND
UTILIZING HEALTH CARE SERVICES,
AND THEN ASSISTANCE WITH
RETENTION AND REDETERMINATIONS,
SO WITH THIS, THE HEALTH
ENROLLMENT NAVIGATOR PROGRAM
WOULD NO LONGER EXIST. THAT IS
CORRECT. AGAIN, FINANCE. WHEN
YOU GUYS SAY REDUCTION, IT MAKES
IT SEEM LIKE THE PROGRAM IS
STILL THERE, SO WE ARE
ESSENTIALLY NOW ELIMINATING THIS
PROGRAM. YOU CAN KEEP GOING.
OKAY THE NEXT ITEM IS TO
ELIMINATE ADULT ACUPUNCTURE. THE
MAY REVISION PROPOSES TO
ELIMINATE THIS OPTIONAL BENEFIT.
AND MEDI-CAL WITH REDUCED
GENERAL FUND COST OF 5.4 MILLION
IN 24, 25, AND 13 MILLION
ONGOING, WE WILL BE PROPOSING
TRAILER BILL LANGUAGE TO
IMPLEMENT THIS. THIS BENEFIT WAS
ALSO ELIMINATED IN 2009. AND
RESTORED IN 2016. OKAY, SO THIS
IS AN ELIMINATION. ELIMINATION,
WHAT HAS BEEN THE UPTAKE FOR
THIS PROGRAM? HAVE THERE BEEN A
LOT OF PATIENTS IN MEDI-CAL THAT
ACTUALLY UTILIZE THIS? I DON'T
HAVE THE UPTAKE, BUT WITH, 5.8
MILLION IN EXPENDITURES AND 13
MILLION ANNUAL ANNUAL
EXPENDITURES, IT PROBABLY WOULD
BE A LOW UPTAKE BENEFIT. OKAY
THANK YOU. YOU CAN KEEP GOING.
THE NEXT ITEM IS TO ELIMINATE
FREE CLINICS AUGMENTATION. THIS
WAS A FOR 2 MILLION ONGOING
GENERAL FUND SAVINGS. THIS
PROGRAM WAS OR THIS FUNDING WAS
IMPLEMENTED AS PART OF THE 2021
BUDGET ACT, AND PROVIDES FUNDING
TO SUPPORT FREE AND CHARITABLE
CLINICS THAT ARE TAX EXEMPT
ORGANIZATIONS, THAT DO NOT
QUALIFY AS MEDI-CAL PROVIDERS.
THE FUNDS ARE DISTRIBUTED TO THE
CALIFORNIA ASSOCIATION OF FREE
AND CHARITABLE CLINICS, AND THAT
ASSOCIATIONS ALLOCATES THAT
THOSE DOLLARS TO THE APPROPRIATE
CLINICS. HOW MUCH OF THIS MONEY
THAT THE STATE ALLOCATES, DO
THESE CLINICS NEED TO KEEP THEIR
DOORS OPEN? WE DON'T HAVE THAT
INFORMATION. THEY'RE NOT
MEDI-CAL PROVIDERS, THIS WAS AN
AUGMENTATION AS PART OF THE 2021
BUDGET. OKAY AND THIS AGAIN, IS
BEING, ELIMINATED. CORRECT. THIS
WAS A, JUST AN AUGMENTATION THAT
WAS JUST IMPLEMENTED IN 2021. IT
WAS NOT THERE BEFORE, BUT THIS
FUNDING WOULD BE ELIMINATED.
CORRECT OKAY. OKAY, THE NEXT
ITEM IS TO FREEZE MEDI-CAL
COUNTY ADMINISTRATIVE, NOT
IMPLEMENTING A COST OF LIVING
ADJUSTMENT FOR OUR COUNTY ADMIN,
20.4 MILLION. GENERAL FUND
SAVINGS IN 2024 AND ONGOING.
THIS WAS DONE PREVIOUSLY IN
DIFFICULT BUDGET SITUATIONS IN
2008 NINE, NINE, 1010 1111, 12,
12, 13, 1415, 1516, 1617 AND
1718 AND IS BEING PROPOSED TO BE
IMPLEMENTED AGAIN OKAY. THE NEXT
ITEM IS TO ELIMINATE THE INDIAN
HEALTH GRANT PROGRAM, THIS IS A
REDUCTION OF 23 MILLION IN
GENERAL FUND COSTS BEGINNING IN
2425. THIS PROGRAM PROVIDES
GRANT FUNDS TO SUPPORT THE
DELIVERY OF PREVENTION ORIENTED
PRIMARY CARE SERVICES THAT ARE
RESPONSIVE TO THE NEEDS OF
AMERICAN INDIAN PATIENTS THAT
ARE PROVIDED IN A PRIMARY CARE
SETTING, INCLUDING FINANCIAL
SUPPORT TO IMPROVE STAFFING,
RECRUITMENT, AND RETENTION OF
PRIMARY CARE PROVIDERS, IN IN
OUR INDIAN HEALTH CENTERS, THIS
PROGRAM WAS ELIMINATED IN 2009
TEN, AGAIN AS A RESULT OF THE
STATE'S FISCAL SITUATION, AND
WAS RESTORED IN THE 23 2223
BUDGET, SO IT WAS ELIMINATED IN
2009 TEN. DURING ONE OF THE
STATE'S FISCAL CRISIS. AND WE
TOOK OVER TEN YEARS TO BRING IT
BACK, WE IT WAS RESTORED IN 22,
23. SO OVER TEN YEARS. GO AHEAD.
YEAH, I REPRESENT A LOT OF I
HAVE A LOT OF TRIBAL, TRIBES IN
MY DISTRICT. THIS IS THESE KINDS
OF PROGRAMS ARE REALLY IMPORTANT
PREVENTION BASED PROGRAMS TO
HELP PREVENT FUTURE COSTS. THIS
IS ONE OF THOSE. AND THIS JUST
THIS JUST I HAVE TO CLASSIFY
THIS AS PENNY WISE AND POUND
FOOLISH. AND THE FACT THAT IT
TOOK SO LONG TO REINSTATE IT IS,
I GUESS. AND THEN THEY WON FOR
ONE YEAR, AND NOW IT'S GONE,
REALLY CHALLENGING. OFTENTIMES
TO REACH, SOME OF OUR, OUR, OUR
INDIGENOUS PEOPLE, WHERE THEY
LIVE, THEY LIVE IN VERY
DIFFICULT TO ACCESS AREAS,
GETTING THEM TO THE DOCTOR IS A
CHALLENGE, GETTING TREATMENT IS
A CHALLENGE. AND THESE ARE THESE
ARE ESSENTIALLY PREVENTIVE
SERVICES. IN THE END, THESE
KINDS OF THINGS COST THE SYSTEM
MORE MONEY. AND I JUST CAN'T
UNDERSTAND WHY THE CONCEPT OF
THAT IS SO DIFFICULT FOR
DEPARTMENT OF FINANCE AND OTHERS
TO, TO UNDERSTAND. I WOULD KIND
OF ECHO THAT COMMENT FOR SURE,
AND ALSO INCLUDE THE ANYTHING
RELATED TO THE HEALTH ENROLLMENT
NAVIGATORS, AND THE HEALTH
ENROLLMENT NAVIGATORS FOR
CLINICS. THESE ARE FRONTLINE
OAN OPERATING ON A SHOESTRING
ALREADY, CBOS AND CLINICS, THAT
ARE SEEKING TO SUPPORT THE
HARDEST TO REACH, PEOPLE,
INDIVIDUALS. SO AT A TIME WHEN
WE ARE MAKING VERY DRACONIAN
CUTS AROUND ACCESS, AS WE JUST
TALKED ABOUT, RELATED TO THE MCO
TAX, WHAT WE NEED MORE OF ARE
PEOPLE WHO ARE GOING TO BE ABLE
TO NAVIGATE. GREAT FOR THOSE
INDIVIDUALS WHO ARE GOING TO
HAVE EVEN MORE OF A CHALLENGE
FINDING THE RESOURCES THAT THEY
NEED, AND I UNDERSTAND THAT THE
KIND OF THE BOTTOM LINE IS IT
MAKES SENSE FOR THE STATE'S
FISCAL POSITION. BUT THESE KINDS
OF CUTS ARE, WHEN THEY ARE
FOCUSED ON PREVENTION AND, AND,
ADDRESSING THE NEEDS OF THE
HIGHEST, MOST, HIGHEST RISK
INDIVIDUALS. WHAT WE'RE
ESSENTIALLY DOING IS DEFERRING
SPENDING MORE MONEY LATER ON
DOWN AS THE CONDITIONS THAT THEY
ARE NOT GETTING SUPPORT FOR
BECOME MORE ACUTE. SO WHILE IT
PENCILS OUT IN TERMS OF THE
BOTTOM LINE FOR THIS BUDGET
YEAR, IT CREATES MORE OF MORE
EXPENSE DOWN THE ROAD. SO IS
THERE IS THERE ANY ANY KIND OF
ASSESSMENT AROUND THE COSTS
ASSOCIATED WITH THESE, THESE
KINDS OF CUTS OVER THE COURSE OF
SEVERAL YEARS? AND I ALSO HAVE A
QUESTION FOR SOME OF THESE
PROGRAMS. CUTTING THIS YEAR
MAKES SENSE. CUTTING NEXT YEAR
MAYBE MAKES SENSE, BUT CUTTING
THREE AND 4 OR 5 YEARS OUT
BEYOND THIS BUDGET DON'T MAKE
ANY SENSE AT ALL. WHY ARE WE
ALLOWING OURSELVES TO DO THAT?
T I. OR DEPARTMENT OF FINANCE,
REALLY APPRECIATE YOUR COMMENTS
AND AGREE LARGELY WITH WITH THE
THINGS THAT YOU HAVE TO SAY,
JUST FOR SOME TABLE SETTING
REMINDER, YOU KNOW, THE
ADMINISTRATION, THE MAY REVISION
CONSTITUTES THE ADMINISTRATION'S
PROPOSAL TO RESOLVE THE $44.9
BILLION GENERAL FUND DEFICIT,
THAT'S $44.9 BILLION ON TOP OF
THE $32 BILLION IN SOLUTION THAT
WAS INCLUDED IN THE 2023 BUDGET
ACT, AND JUST AS A REMINDER, YOU
KNOW, THIS ISN'T A PROBLEM THAT
WE'RE EXPECTING TO GO AWAY
ANYTIME, PARTICULARLY SOON. SO
WE COULD BE HAVING MORE
DIFFICULT CONVERSATIONS ABOUT,
YOU KNOW, SOLUTIONS THAT WILL
CARRY INTO THE 20 2526 BUDGET
YEAR, SO, YOU KNOW, WE DON'T
TAKE ANY OF THESE SOLUTIONS
DECISIONS LIGHTLY, WE
DEFINITELY, UNDERSTAND IF THE
LEGISLATURE MAY WANT TO PURSUE
ALTERNATIVES, THE ADMINISTRATION
IS HAPPY TO WORK WITH THE
LEGISLATURE ON, YOU KNOW,
RESEARCHING THOSE ALTERNATIVES.
BUT AGAIN, THESE SOLUTIONS
DECISIONS AREN'T MADE LIGHTLY,
AND BROADLY SPEAKING, OUR GOAL
IS TO IDENTIFY BUDGET SOLUTIONS
THAT ALLOW US TO MAINTAIN AN,
CORE PROGRAMING AND SERVICES
SUCH AS THE MEDI-CAL, BASED
BENEFITS, SO, YOU KNOW, THAT'S
THAT'S KIND OF WHERE WE'RE AT,
AND THAT'S BROADLY SPEAKING,
AGAIN, HOW WHAT WE'RE BRINGING
INTO THIS CONVERSATION AND THESE
DECISIONS, I APPRECIATE THAT
RESPONSE, BUT IT CERTAINLY ISN'T
RESPONSIVE TO MY QUESTION, AT
THE END OF THE DAY, THERE HAS TO
BE SOME ADDITIONAL ANALYSIS THAT
CONSIDER THE IMPACT OF NOT
PROVIDING THE CORE SERVICE, LIKE
IF WE ARE ELIMINATING ACCESS AND
WE ARE ELIMINATING THE
OPPORTUNITY FOR PEOPLE TO, OR
LIMITING ACCESS, WE ARE
ELIMINATING THE OPPORTUNITY FOR
PEOPLE TO ACTUALLY NAVIGATE
TOWARDS THAT ACCESS BY CUTTING
THESE PROGRAMS. THEN WHAT WE ARE
DOING IS RAISING THE COST OF
CARE FOR THOSE INDIVIDUALS IN
THIS FISCAL YEAR. AND IN FUTURE
FISCAL YEARS. SO MY QUESTION IS,
I KNOW THAT THIS IS A VERY
CHALLENGING THING. I KNOW THAT
THE ADMINISTRATION IS TAKING
THIS VERY SERIOUSLY. NO DECISION
IS MADE LIGHTLY. MY QUESTION IS,
ARE THERE ANY CONSIDERATIONS
AROUND THE OPPORTUNITY COST AND
THE ADDITIONAL HEALTH CARE COSTS
THAT WE'RE FORCING ON OUR SYSTEM
BY ANY ONE OF THESE INDIVIDUALS,
SPECIFICALLY THE ONES, AS WE'VE
INDICATED, RELATED TO NAVIGATORS
AND THE INDIAN HEALTH GRANT
PROGRAM? YEAH, WE CERTAINLY TAKE
THAT INTO CONSIDERATION. BUT YOU
KNOW, WHAT'S THE ANALYSIS LIKE?
CAN YOU SHARE? I UNDERSTAND I
DON'T WANT THE TOP LINE I HEAR.
SURE TAKING IT INTO
CONSIDERATION, WE ARE TAKING
THESE, YOU KNOW, WE'RE NOT
MAKING THESE DECISIONS LIGHTLY.
WHAT I'M ASKING FOR IS MORE OF
THE DOUBLE DOWN INTO THE
SPECIFIC ANALYSIS CGRTS, AND
WHETHER IT CONSIDERS THE COST OF
CARE THAT'S IMPLICATED, THE
HIGHER COST OF CARE THAT'S
IMPLICATED WITH THESE,
REDUCTIONS AROUND NAVIGATION.
MEGAN SABA DEPARTMENT OF
FINANCE, THANK YOU FOR YOUR
QUESTIONS. I DON'T KNOW THAT WE
HAVE THE INFORMATION HERE TODAY
WITH US TO SPEAK TO THE LEVEL OF
PROGRAMMATIC DETAIL THAT YOU'RE
ASKING, BUT WE CERTAINLY HEAR
YOU AND DO WANT TO NOTE THAT AS
AS WE MOVE THROUGH THIS PROCESS
OF IDENTIFYING AVAILABLE MONIES,
FOR SOLUTIONS, WE DID WE DID
TAKE INTO CONSIDERATION, OVERALL
COST AND PROGRAMMATIC EFFECT TO
THE EXTENT THAT WE COULD IN THE
TIME THAT WE HAD WITH THE
AVAILABLE INFORMATION. SO IF
THERE'S FURTHER DETAIL THAT YOU
WANT ON A SPECIFIC PROGRAM,
WE'RE HAPPY TO FOLLOW UP WITH
YOU. BUT AGAIN, JUST TO
REITERATE, WE REALLY DID NOT
TAKE ANY OF THESE DECISIONS
LIGHTLY. THAT AGAIN. I
APPRECIATE THAT IT NOTED. WE CAN
JUST APPLY IT TO ALL OF THE
OTHER OTHER THINGS THAT WE'RE
TALKING ABOUT. I THINK AT SOME
POINT, IF WE'RE REALLY AS A
LEGISLATURE, ENGAGED IN
CONVERSATION AROUND WHAT ANY OF
THESE CUTS ARE, WE'RE GOING TO
NEED MORE INFORMATION THAN WE'VE
TAKEN THESE, YOU KNOW, WE'VE
TAKEN THESE ISSUES SERIOUSLY.
AND WE'VE APPLIED CONSIDERATION.
I'M ASKING FOR SPECIFIC
INFORMATION ABOUT THE ESSENTIAL
KIND OF THE PROGRAM EFFECTS OF
THESE, OF THESE PARTICULAR CUTS
AND WHETHER OR NOT THERE'S BEEN
AN ANALYSIS DONE AROUND THAT.
AND WHAT I'M HEARING IS NO. AND
SO AS A FOLLOW UP, I WOULD
REALLY APPRECIATE, PARTICULARLY
AROUND, PROGRAMS RELATED TO
COMMUNITY HEALTH WORKERS
NAVIGATION SERVICES, FRONTLINE
SUPPORTS, WHERE WE ARE REDUCING
ACCESS OVERALL IN THE HEALTH
SYSTEM, HOW WE ARE ANALYZING THE
EXTENT TO WHICH THOSE REDUCTIONS
IN NAVIGATION OF CARE FOR
PRIMARY CARE, PREVENTIVE CARE
SERVICES ARE GOING TO IMPACT OUR
OVERALL COST OF CARE FOR THOSE
SAME HIGH RISK, HIGH NEED
CONSTITUENTS. SO ALONG THOSE
THOSE SAME LINES. SO LET ME JUST
ASK YOU A QUESTION, BECAUSE
SOMETIMES YOU LOOK AT A PATIENT
POPULATION AND YOU'LL SAY, YOU
KNOW WHAT? THEY'RE DOING REALLY
GOOD IN TERMS OF DIABETES, HIGH
BLOOD PRESSURE, YOU KNOW,
STROKES, MATERNAL MORBIDITY,
MORTALITY. AND THEY MAY NOT NEED
AS MUCH PREVENTATIVE CARE. SO
WHERE DO YOU THINK NATIVE
AMERICANS OR INDIANS FALL IN
THAT SCOPE? ARE THEY DOING WELL
OR ARE THEY ONE OF THOSE GROUPS
THAT HAVE HIGHER RISK, HIGHER
OUTCOMES, HIGHER MORBIDITY,
HIGHER MORTALITY? DO WE DO WE
TALK ABOUT THAT? T I LARA
DEPARTMENT OF FINANCE. WE SEE
THIS POPULATION AS BEING
PARTICULARLY VULNERABLE. IF THE
LEGISLATURE WOULD LIKE TO
DISCUSS ALTERNATIVES FOR THIS
BUDGET SOLUTION, WE'RE HAPPY TO
WORK WITH YOU ON THOSE IDEAS. SO
I THINK ONE OF THE ISSUES, AND I
THINK IT KIND OF PIGGYBACKED OFF
OF, ACTUALLY WHAT EVERYONE HAS
BEEN SAYING UP HERE IS THE, THE
REASONS WHY CERTAIN PROGRAMS
WERE LOOKED AT, BECAUSE IT TALKS
ABOUT OUR VALUES AS A STATE. IF
YOU CAN SIT HERE AND TELL ME
THAT NATIVE AMERICANS OR INDIANS
ARE A HIGH RISK POPULATION, YET
WE ARE GOING TO COMPLETELY
ELIMINATE THEIR HEALTH GRANT
PROGRAM. THAT'S VERY PROBLEMATIC
FOR ME. THAT'S PROBLEMATIC
BECAUSE IT STATES KIND OF WHAT
DOCTOR WOOD WAS SAYING AT THE
BEGINNING IS THAT WE DON'T CARE
ABOUT CERTAIN POPULATIONS,
CERTAIN GROUPS OF INDIVIDUALS,
TO SAY, I KNOW THAT YOU'RE AT
HIGH RISK, EVEN IF I'M NOT IN
THE HEALTH CARE PROFESSION, I
JUST KNOW THAT YOU ARE A
VULNERABLE COMMUNITY, THAT YOUR
HEALTH OUTCOMES ARE WORSE THAT
YOU ARE. YOU HAVE BEEN PLACED
WAY OUT IN THE BOONDOCKS AWAY
FROM MAJOR HOSPITALS, AWAY FROM
SPECIALTY PROVIDERS. AND WE KNOW
THIS. AND YET WHEN WE HAVE THE
OPPORTUNITY TO GO AND LOOK AND
SEE, OKAY, WHERE IS IT THAT WE
CAN CUT, REDUCE USE IN THESE
VERY, VERY CHALLENGING TIMES?
YOU KNOW, IT'S HARD FOR US TO
UNDERSTAND AND WE'RE JUST TRYING
TO UNDERSTAND THE THOUGHT
PROCESS BEHIND IT, SOMEONE SAID
NO, WE DIDN'T GO THROUGH AND
JUST KIND OF SLASH THINGS. WE
THOUGHT ABOUT IT. IT DOESN'T
REALLY SEEM THAT WAY WHEN WE'RE
ASKING, WHAT IS THE THOUGHT
PROCESS BEHIND THIS REDUCTION?
SO WE'RE REDUCING INDIAN HEALTH
GRANT. BUT THEN AT THE SAME TIME
WE'RE SAYING, OKAY, WELL WE'RE
GOING TO, YOU KNOW, INCREASE OR
ADD DOING THINGS LIKE
PHARMACOGENETIC TESTING,
INCREASE THAT BY SIX, ALMOST
6.5, YOU KNOW, MILLION THIS YEAR
AND 11.5 MILLION ONGOING. THIS
IS A BRAND NEW PROGRAM, RIGHT.
SO NOT THAT THAT'S NOT IMPORTANT
AS WELL. BUT WHEN YOU'RE LOOKING
AT THINGS, HOW ARE YOU WEIGHING
WHAT IS NECESSARY VERSUS WHAT IS
NICE BUT MAYBE NOT NECESSARY IN
A TOUGH BUDGET YEAR. AND IT'S
JUST IT SEEMS LIKE CERTAIN
INDIVIDUALS, CERTAIN GROUPS
CONTINUE TO BE ON THE CHOPPING
BLOCK FIRST, DESPITE OUR
KNOWLEDGE THAT THEY NEED MORE OF
OUR HELP AND MORE OF OUR
ASSISTANCE. DOCTOR WOOD. THANK
YOU, DOCTOR WEBER. THANK YOU,
MISS BONTA. YOU KNOW, I GUESS I
JUST KIND OF A RULE OF THUMB
THAT PREVENTION DOLLARS HAVE
LIKE A 6 TO 1 RETURN, AND THAT'S
, THAT'S KIND OF THE POINT WE'RE
GETTING AT HERE, PART PARTLY. I
MEAN, WE THOUGHT ENOUGH OF THIS
PROGRAM TO REINSTATE IT AFTER
MANY, MANY YEARS IN 22, 23. AND
IT GETS MONEY FOR A YEAR, AND
NOW IT'S GOING TO GET I DON'T
THE QUESTION WAS, WAS THE
PROGRAM ELIMINATED IN THOSE
YEARS OR WAS IT JUST NOT FUNDED,
I BELIEVE THE PROGRAM WAS
ELIMINATED, ALTHOUGH I KNOW THAT
THERE IS FEDERAL LAW REGARDING
THIS, I JUST I DID SOME QUICK
RESEARCH, BUT IT WAS ELIMINATED
IN 20, I THINK. JUST NO FUNDING
PROVIDED STARTING IN 2009 TEN
AND THEN AS PART OF A GOVERNOR'S
BUDGET, BCP, WE PROPOSED TO
RESTORE IT IN 23, 20, 22, 23.
EXCUSE ME. SO WE THOUGHT ENOUGH
TO RESTORE IT. WE SAW THE VALUE
AND NOW WE'RE SAYING, WELL, I
GUESS THAT'S NOT THE CASE. I
GUESS WHAT I WOULD LOVE TO SEE,
I'M LOOK, I'M LEAVING AT THE END
OF THIS YEAR, AND THE
LEGISLATURE AND I HAVE BEEN
TALKING ABOUT THIS AD NAUSEAM
FOR YEARS, WHEN YOU'RE LOOKING
AT BUDGETS, TO LOOK AT
PREVENTION, WE SPEND BILLIONS
WITH A B ON THE TREATMENT OF
DIABETES IN THIS STATE. YET WE
SPEND A FEW MILLION ON
PREVENTION, NEARLY HALF OF OUR
POPULATION IS EITHER DIABETIC OR
PRE-DIABETIC. WE THOUGHT ENOUGH
ABOUT THIS THAT WE ARE ACTUALLY
GOING TO MAKE OUR OWN INSULIN TO
TREAT A DISEASE THAT CAN BE
PREVENTED, FOR THE MOST PART.
YET WE DON'T YET. HERE'S AN
OPPORTUNITY WITH A POPULATION
THAT HAS A HIGH INCIDENCE OF
DIABETES IN JUST ONE DISEASE
CATEGORY, THAT THEY ARE THAT
THIS POPULATION IS VULNERABLE TO
AND WE'RE WE'RE GOING TO CUT
THAT, CUT THAT GRANT PROGRAM FOR
PEOPLE IN GENERAL THAT ARE
REALLY HARD TO REACH, REALLY
HARD TO REACH. I ENCOURAGE YOU
TO COME TO SEE, COME WITH ME AND
SEE SOME ONE OF THE CLINICS AND
MAYBE AND MAYBE, JUST MAYBE, YOU
CAN UNDERSTAND WHY WE FEEL THE
WAY WE DO HERE WHEN IT COMES TO
THESE KINDS OF CUTS, ESPECIALLY
AROUND PREVENTION. NOBODY SEEMS
TO THINK FORWARD. IT'S A LINE
ITEM. IT'S A LINE ITEM TO YOU
GUYS IS WHAT IT FEELS LIKE TO
US. IT'S A LINE ITEM. WE'RE
GOING TO CUT THIS OUT, BUT
YOU'RE NOT THINKING ABOUT THE
DOWNSTREAM COSTS FIVE YEARS, TEN
YEARS FROM NOW. IF WE COULD
INVEST IN THAT AND BE DILIGENT
ABOUT IT, HOW MUCH COULD WE
SAVE? NOBODY STUDIES THAT
BECAUSE IT'S A LINE ITEM. IT'S A
VULNERABLE POPULATION. AND I,
WILL OWNS WITH THE LEGISLATIVE
ANALYST'S OFFICE, JUST ECHOING
COMMENTS FROM THE MEMBERS. SO
GENERALLY THIS YOU KNOW, THIS
PROPOSAL WE FOUND DOES
DEFINITELY HAVE EQUITY, CONCERNS
OPERATIONS AND THAT AMERICAN
INDIANS GENERALLY HAVE SOME OF
THE LARGEST HEALTH DISPARITIES
IN THE STATE WHEN COMPARED TO
THE GENERAL POPULATION,
SPECIFICALLY, THAT ELIMINATING
FUNDING FOR THIS PROGRAM, COULD
EXACERBATE MANY OF THE STARK
DISPARITIES IN HEALTH OUTCOMES
THAT ALREADY EXIST. AND SO THE
LEGISLATURE, MAY CONSIDER
LOOKING FOR OTHER AREAS OF THE
BUDGET IN ORDER TO MEET HEALTH
EQUITY GOALS AND OUR OFFICE IS
PREPARED TO WORK WITH THE
COMMITTEE TO FIND THOSE. THANK
YOU.
MANY OF THE PEOPLE IN IN THE
FINANCE DEPARTMENT HAVE A
BACKGROUND IN FINANCE, I GUESS.
WHO ARE YOU CONSULTING WITH WHEN
YOU'RE MAKING SOME OF THESE
DECISIONS IN THE HEALTH CARE
SPACE? MEGAN SZABO, DEPARTMENT
OF FINANCE. SO WHEN WE ARE
DEVELOPING BUDGET PROPOSALS IN
THE GOVERNOR'S BUDGET AND MAY
REVISION, WE LARGELY CONSULT
WITH THE DEPARTMENTS, THAT,
THAT, THAT PROMULGATE THESE,
THESE PROGRAMS, WE ALSO WORK
WITH STAKEHOLDERS, LOCAL HEALTH
JURISDICTIONS, WE WORK WITH AS
MANY FOLKS AS WE CAN, AS, AS WE
MOVE THROUGH THE PROCESS AND
THEN, REALLY WHEN WE MOVE INTO
THE NEGOTIATION PROCESS, WE, WE
REALLY START, YOU KNOW, ENGAGING
WITH, WITH MEMBERS AND OTHER
STAKEHOLDERS THAT WE'RE HEARING
FEEDBACK FROM ON THE PROPOSALS,
ONCE THEY'RE PUBLIC, JUST OUT OF
CURIOSITY, LIKE WHEN YOU ALL ARE
HUDDLING UP AND DECIDING, OKAY,
WE'RE GOING TO ELIMINATE THIS
PROGRAM, THIS IN THAT ROOM AT
THAT TIME. DO YOU HAVE ANYONE
THAT HAS ANY KIND OF EXPERIENCE
WITHIN THE HEALTH CARE
PROFESSION THAT MAY KIND OF
TRIGGER, LIKE, YOU KNOW, THIS IS
A VERY VULNERABLE POPULATION.
THIS IS GOING TO HAVE
SIGNIFICANT, NOT ONLY FINANCIAL
BUT HEALTH, DEVASTATING IMPACTS.
IF WE REMOVE THIS, I'M JUST
WONDERING LIKE HOW SOME OF THESE
HOW YOU CAME TO SOME OF THESE
DECISIONS, ESPECIALLY AT A TIME
WHEN EVERYBODY IS TALKING ABOUT
EQUITY. WE CERTAINLY UNDERSTAND
AND HEAR YOUR CONCERNS, AND IT
DOES NOT FALL ON DEAF EARS. I
KNOW, I KNOW THAT THAT IS
TIRESOME TO HEAR FOR SOME OF
YOU, BUT BUT WE ARE FACING A
VERY, VERY SERIOUS BUDGET
SHORTFALL, THIS WAS VERY
DIFFICULT TO IDENTIFY. MONEY
THAT WAS AVAILABLE TO, TO SOLVE
FOR THAT SHORTFALL. THESE ARE
THE PROPOSALS THAT WE WERE ABLE
TO IDENTIFY. AND YOU KNOW, WE
ARE MORE THAN HAPPY TO CONSIDER
ANY ALTERNATIVES THAT THE
LEGISLATURE HAS, TO ADDRESS THE
SHORTFALL. BUT THIS IS THE
PROPOSAL THAT WE DO HAVE IN THE
MAY REVISION. RIGHT NOW. OKAY.
MICHELLE. OKAY. SO I THINK THE
LAST ITEM ON THE REDUCTION LIST,
YEAH, SARAH BROOKS WITH THE
DEPARTMENT OF HEALTH CARE
SERVICES, I APOLOGIZE, I DIDN'T
INTRODUCE MYSELF BEFORE, THE
FINAL PROPOSAL IS TO ELIMINATE
THE MAJOR RISK MEDICAL INSURANCE
PROGRAM KNOWN AS MR. MIP. THE
MAY REVISION PROPOSES TO
ELIMINATE MR. MIP AND REDIRECT
78.9 MILLION FROM THE HEALTH
CARE SERVICES FINES AND
PENALTIES FUND, WHICH SUPPORTS
MR. MIP TO PAY FOR EXISTING
MEDI-CAL COSTS. THE DEPARTMENT
WILL BE PROPOSING TRAILER BILL
LANGUAGE. MR. MIP WAS CREATED AS
A HIGH RISK INSURANCE POOL TO
SECURE ADEQUATE HEALTH COVERAGE.
HEALTH CARE COVERAGE. EXCUSE ME
FOR INDIVIDUALS WHO ARE BEING
EXCLUDED FROM THE PURCHASING
HEALTH INSURANCE DUE TO
PREEXISTING CONDITIONS. SINCE
THE ESTABLISHMENT OF THE ACA,
THERE IS ESSENTIALLY NO LONGER A
NEED FOR THE PROGRAM. SERVICES
ARE DELIVERED THROUGH LICENSED
HEALTH INSURANCE PLANS. MR. MIPS
SUBSCRIBERS PARTICIPATE IN THE
PAYMENT FOR THE COST OF THEIR
COVERAGE BY PAYING MONTHLY
PREMIUMS AND ANNUAL DEDUCTIBLE
AND CO-PAYMENTS TO PURPOSE FOR
PURPOSES OF THE PROGRAM TO BE
ELIGIBLE FOR MR. MIP, YOU MUST
BE A RESIDENT OF THE STATE OF
CALIFORNIA. YOU CANNOT BE
ELIGIBLE FOR MEDICARE PART A AND
PART B UNLESS ELIGIBLE SOLELY
DUE TO END STATE RENAL DISEASE.
YOU CANNOT BE ELIGIBLE TO
PURCHASE ANY HEALTH CARE OR
HEALTH INSURANCE FOR
CONTINUATION OF BENEFITS UNDER A
COBRA OR CAL COBRA, AND YOU MUST
HAVE BEEN DENIED COVERAGE WITHIN
THE PAST 12 MONTHS, THE PROGRAM
ITSELF IS RELATIVELY SMALL RIGHT
NOW. THERE ARE 413 INDIVIDUALS
CURRENTLY IN THE PROGRAM, WITH
THE IMPLEMENTATION OF THE
AFFORDABLE CARE ACT, ENROLLMENT
IN MR. MIP HAS DECLINED
SIGNIFICANTLY. ORIGINALLY, MUCH
LARGER SIZE IN THE PROGRAM, IN
NEW ENROLLMENT IN THE PROGRAM IS
ESSENTIALLY NONEXISTENT AT THIS
TIME, THESE INDIVIDUALS CAN BE
COVERED UNDER OTHER ASPECTS OF
THE MARKET, SUCH AS MEDICARE AND
COVERED CALIFORNIA AT THIS TIME.
THANK YOU. YOU THINK THE NEXT
ONE OKAY. THE NEXT ITEM IS NOW
WE'RE IN THE FUND SHIFT AREA,
WITH REGARD TO PROPOSITION 56
BACKFILL, SO IN RECENT YEARS,
PROPOSITION 56 REVENUES HAVE NOT
BEEN SUFFICIENT TO FULLY COVER
THE COST OF THE PROP 56
SUPPLEMENTAL PAYMENTS. THE MAY
REVISION PROPOSES TO USE 145.4
MILLION FROM THE MCO TAX TO
SUPPORT THE MEDI-CAL FAMILY
PLANNING, WOMEN'S HEALTH AND
PHYSICIAN SERVICES SUPPLEMENTAL
PROPOSITION 56 PAYMENTS IN 24,
25 AND THEN 64 MILLION GENERAL
FUND IN 2425 TO FULLY FUND THE
DENTAL SERVICES. PROPOSITION 56
SUPPLEMENTAL PAYMENTS, THEN THE
NEXT OH, SORRY. SO I'M SORRY. SO
YOU'RE REDUCING THE AMOUNT OF
FUNDS TO BACKFILL PROP 56. SO
IT'S JUST, THERE'S LESS PROP
PROP $56 AVAILABLE. AND BASED ON
ALSO INCREASED UTILIZATION IN
THOSE SERVICES, WE DID NOT HAVE
ENOUGH PROPOSITION 56 FUNDS TO
MAINTAIN THOSE SUPPLEMENTAL
PAYMENTS. SO WE'RE USING MCO TAX
REVENUE AND ALSO GENERAL FUND.
SO THERE IS NO REDUCTION INTO
THAT. THAT LEVEL OF SUPPLEMENTAL
PAYMENT OKAY. THE NEXT ITEM IS
QUALITY SANCTIONS PENALTY, WE
ARE PROPOSING TO USE, THERE'S
ABOUT A $1 MILLION IN QUALITY
SANCTION PENALTIES THAT WE HAVE
RECEIVED OR HAVE IMPLEMENTED
WITH OUR MANICAL MANAGED CARE
PLANS, AND PROPOSING TO USE THAT
TO OFFSET GENERAL FUND COSTS IN
THE MEDI-CAL PROGRAM. THE NEXT
ITEM IS RELATED TO HOME AND
COMMUNITY BASED SERVICES. THIS
IS JUST REALLY REFLECTING THE
ABILITY TO USE THOSE DOLLARS
UNTIL THE END OF THE CALENDAR
YEAR 2024. FOR OUR HOME AND
COMMUNITY BASED SERVICES
SPENDING PLAN THAT WAS
IMPLEMENTED AS PART OF THE
AMERICAN RESCUE PLAN IN 2021
RELATED TO COVID. AND THIS IS
REALLY JUST KIND OF THE
RECOGNITION OF THOSE DOLLARS
BEING USED TO, SUPPORT, OTHER
FUNDS THAT MIGHT HAVE BEEN USED
IN ITS PLACE. AND THEN THE LAST
ITEM IN THE CHART WITH REGARD TO
REVENUE, THE MAY REVISION
PROPOSES TO INCREASE DIRECTED
PAYMENTS TO PUBLIC HOSPITALS
THROUGH PROGRAMS SUCH AS THE
ENHANCED PAYMENT PROGRAM AND THE
QUALITY INCENTIVE POOL. THIS IS
REALLY AN OPPORTUNITY TO DRAW
DOWN NON-STATE REVENUE, STATE
REVENUE, AND PROVIDE ADDITIONAL
REVENUE TO OUR PUBLIC HOSPITALS.
AND AS A RESULT OF THIS, OF THIS
FINANCING MECHANISM, PROPOSING
TO IMPLEMENT AN ADMINISTRATIVE
FEE ON THE INTERGOVERNMENTAL
TRANSFER TO ACHIEVE 37 MILLION
IN GENERAL FUND REIMBURSEMENTS
IN 2425, AND THAT FULL YEAR, 74
MILLION STARTING IN 24, 25 AND
ONGOING, SO THIS IS, REALLY
RELATED TO THE WAY WE FINANCE
OUR SOME OF THE SUPPLEMENTAL
PAYMENTS FOR OUR HOSPITALS AND
OTHERS. OTHER PROGRAMS HAVE AN
ADMINISTRATIVE FEE. SO THIS
WOULD BE A NEW FEE, TO THEM, BUT
THEY WOULD STILL GET A NET
BENEFIT OUT OF THIS PROGRAM.
OKAY THANK YOU, BEFORE WE GO TO
PUBLIC COMMENT, I WAS WONDERING
IF YOU COULD COMMENT ON UNDER
THE NEW TRAILER BILL PROPOSALS
SENT OUT BILL 525 DELAY. AS THE
GOVERNOR NOTED, ANDREW DUFFY,
OUR DEPARTMENT OF FINANCE, AS
THE GOVERNOR NOTED IN HIS PRESS
CONFERENCE, WE ARE HOPING TO
HAVE ADDITIONAL INFORMATION ON,
TO SHARE IN THE COMING WEEKS
PRIOR TO, CLOSING OUT THE FINAL
BUDGET AGREEMENT. WHEN DO YOU
THINK WE'LL HAVE THAT LANGUAGE?
WE MAY HAVE TO FOLLOW UP WITH
YOUR OFFICE ON THAT, I. IT'S NOT
. MEGAN'S DEPARTMENT OF FINANCE.
SO WE DON'T YET HAVE A TIMELINE
ON ON. SB 525 LANGUAGE, WE WILL
NOTE THAT DEPARTMENTS ARE
CONTINUING TO ASSESS THE BILL'S
REQUIREMENTS AND IDENTIFY ANY
NECESSARY AMENDMENTS, THE BILL
WAS PASSED WITH THE COMMITMENT
THAT THERE WOULD BE TRIGGER
LEGISLATION ADOPTED BEFORE THE
BUDGET YEAR, AND, AND WE ARE
WORKING TO INTENTLY WITH,
STAKEHOLDERS AND LEGISLATORS ON
FULFILLING THOSE COMMITMENTS, WE
EXPECT A BILL TO BE CONSIDERED
BY THE LEGISLATURE VERY SOON,
AND NOTE THAT ANY FUNDING FOR
THE BILL, SB 525, AND MANY OTHER
BILLS FROM LAST YEAR MUST BE
PART OF THE BROADER BUDGET
DISCUSSION. SO YOU ARE PLANNING
ON HAVING THIS FIVE, TWO, FIVE
DELAY BE A PART OF THE BUDGET
PROCESS OR TRIAL LANGUAGE WITHIN
THE BUDGET, OR IS THIS GOING TO
GO THROUGH POLICY? WELL, ANY
APPROPRIATION AS PART OF THE,
ASSOCIATED WITH THE BILL DOES
NEED TO BE PART OF THE BUDGET
DISCUSSION. SO WE'LL HAVE THE
INFORMATION SOON, CONSIDERING
THE FACT THAT WE HAVE TO PASS
THE BUDGET IN LIKE A MONTH, WE
ARE HOPEFUL, LIKE I SAID, I
DON'T HAVE A SPECIFIC DATE OR A
NARROWER TIMELINE. UNFORTUNATELY
THIS IS ALL THE INFORMATION THAT
WE HAVE TODAY. OKAY. AT THIS
POINT, WE WILL OPEN IT UP FOR
PUBLIC COMMENT ON ITEM NUMBER
TWO, EACH INDIVIDUAL WILL HAVE
ONE MINUTE. GOOD MORNING. JACKIE
ANDERSON WITH THE COUNTY
EXECUTIVE ASSOCIATION OF
CALIFORNIA. THANK YOU, GOOD
MORNING, JACKIE ANDERSON WITH
THE COUNTY HEALTH EXECUTIVES
ASSOCIATION OF CALIFORNIA,
REPRESENTING OUR LOCAL HEALTH
DEPARTMENTS. I JUST WANTED TO
PROVIDE COMMENT ON THE CHP
TRANSITION. ALONG WITH A
COALITION INCLUDING LOS ANGELES
COUNTY AND OTHERS, APPRECIATES
THAT THE GOVERNOR'S MAY REVISION
PROVIDES 24 MILLION OF THE
ROUGHLY 34 MILLION OF THE CHILD
HEALTH AND DISABILITY PREVENTION
BUDGET TO ESTABLISH THE
STANDALONE HEALTH CARE PROGRAM
FOR CHILDREN IN FOSTER CARE, OR
PICC-VIC, THIS DOES REFLECT AN
INCREASE SINCE JANUARY. HOWEVER,
WE CONTINUE TO REQUEST THAT THE
FULL 34 MILLION HDPE BUDGET BE
USED TO SUPPORT THIS TRANSITION
AND THAT THE ADMINISTRATION
DELAY INDEFINITELY. THE CS
MONITORING AND OVERSIGHT
INITIATIVE UNTIL ONE DAY ADDRESS
THE CURRENT FUNDING DEFICITS IN
THE CORE CS PROGRAM, AND TO FIND
A MORE SUITABLE FUNDING SOURCE
TO FUND THE ADDITIONAL WORKLOAD
REQUIRED TO IMPLEMENT THE CS
MONITORING AND OVERSIGHT
INITIATIVE. WE ALSO CONTINUE TO
REQUEST FLEXIBILITY FOR LOCAL
JURISDICTIONS TO STAFF THEIR
PROGRAMS AS LOCAL NEEDS INFORM.
THANK YOU. THANK YOU. STACY
HIRAMOTO WITH REMCO. THE RACIAL
AND ETHNIC MENTAL HEALTH
DISPARITIES COALITION, ALSO
REPRESENTING THE CALIFORNIA
REDUCING DISPARITIES PROJECT.
COMMUNITY PARTNERS. I REALLY
WANT TO THANK THE MEMBERS FOR
YOUR QUESTIONS. AND REALLY,
THANK YOU FOR APPRECIATING
PREVENTION AND HOW THESE
DECISIONS ARE MADE, BECAUSE WE
ARE HERE TO RAISE CONCERNS ABOUT
THE CUTS TO SEBAGAI THE CHILDREN
AND YOUTH BEHAVIORAL HEALTH
INITIATIVE, BECAUSE THAT
INITIATIVE WAS GOING TO BE A
POTENTIAL MAJOR FUNDING SOURCE
FOR PROGRAMS THAT UTILIZE CDPS
OR COMMUNITY DEFINED EVIDENCE
PRACTICES. CDPS HAVE BEEN PROVEN
TO REDUCE DISPARITIES FOR BIPOC
AND LGBTQ POPULATIONS. THEY ARE
COST EFFECTIVE, AND THE TYPES OF
APPROACHES OR PROGRAMS THAT
PEOPLE IN BIPOC AND LGBTQ
COMMUNITIES PREFER OVER
MAINSTREAM MENTAL HEALTH
PROGRAMS THAT ARE NOT CULTURALLY
APPROPRIATE. A RECENT STUDY DONE
BY LOYOLA MARYMOUNT DEMONSTRATED
THAT CDPS ARE NOT ONLY EFFECTIVE
IN KEEPING PEOPLE HEALTHY OR
EVEN IMPROVING HEALTH, BUT FOR
EVERY DOLLAR SPENT, IT SAVED THE
CALIFORNIA TAXPAYERS BETWEEN
FOUR AND $5. THANK YOU. THANK
YOU. HELLO, CHRIS RUBINO WITH
DIRECTOR OF SAN JOAQUIN PRIDE
CENTER AND GRANTEE OF THE
CHILDREN YOUTH BEHAVIORAL HEALTH
INITIATIVE, ALONG WITH
CALIFORNIA REDUCING DISPARITIES
PROJECT OUT OF STOCKTON,
CALIFORNIA. ELIMINATION. THE
ELIMINATIONS THAT ARE PROPOSED
PERPETUATE HEALTH DISPARITIES.
AND I DO APPRECIATE THE KIND OF
QUESTIONS THAT HAVE BEEN
PROPOSED AND MAKING SURE THAT
WE'RE PROTECTING THE MOST
VULNERABLE VÌ AS A COMMUNITY
DEFINED EVIDENCE PRACTICE THAT
HAS ALLOWED MY ORGANIZATION TO
SERVE OUR RURAL AND MOST
UNDERSERVED LGBT AND LATINO
COMMUNITIES. WITH THE
ELIMINATION, WE WOULD NEED TO BE
PULLING BACK INTO OUR MAIN
METROPOLITAN AREAS INSTEAD OF
GOING FOR RURAL COUNTIES. EVERY
DOLLAR SPENT IN PREVENTION AND
EARLY INTERVENTION ARE COST
EFFECTIVE. FROM $1 SPENT IS A
SAVINGS OF $5. AS HAVE BEEN
STATED, THE DEPARTMENT OF
FINANCE IS OPEN TO FINDING OTHER
AREAS OF REDUCTIONS.
ELIMINATIONS. IT IS
DISHEARTENING TO HEAR THAT THESE
WERE THE FIRST OF THE PROPOSALS
TO GO AFTER, I'M HOPING TO
CONTINUE TO HEAR OTHER AREAS
THAT WE WOULD GO AHEAD AND
REDUCE. THANK YOU. THANK YOU,
I'M AN ACTUAL NAVAJO, NATIVE
AMERICAN. I THINK IF Y'ALL ARE
GOING TO TAKE MONEY FROM US, YOU
SHOULD ACTUALLY HEAR FROM US.
BUT WHEN IT COMES TO THE TRUST
FROM THE GOVERNMENT AND NATIVE
AMERICANS, WE DON'T TRUST Y'ALL.
AND IF YOU ARE GOING TO TAKE
MONEY FROM ANYTHING YOU
SHOULDN'T TAKE, WE SHOULD BE THE
LAST PERSON ON THAT AS WE'VE
BEEN STRIPPED. WE ARE LITERALLY
AN ENDANGERED SPECIES IN OUR OWN
HOMELAND. AND SO IF YOU'RE GOING
TO DEFUND ANYTHING, I THINK
THERE'S A MILLION OTHER ITEMS ON
THAT LIST THAT YOU CAN DEFUND.
OTHER THAN THAT, ESPECIALLY WHEN
IT COMES TO HEALTH SERVICES,
BECAUSE WHEN YOU SAW FROM THE
PANDEMIC, WE HAD IT THE WORST
MORE THAN ANYBODY. WE ARE
LITERALLY ABOUT TO BE IN EXTINCT
SPECIES IN OUR IN OUR OWN
HOMELAND. AND SO IF YOU ARE
GOING TO DEFUND ANYTHING, TAKE
AWAY ANY RESOURCES, WE SHOULD BE
THE VERY LAST ONE ON THAT. SO I
SAY, AS MY NATIVE AMERICAN FOLKS
WOULD SAY TO YOU FROM MY HEART
TO ALL Y'ALL, THANK YOU FOR
LISTENING. THANK YOU. GOOD
MORNING. LINDA WEI WITH WESTERN
CENTER ON LAW AND POVERTY. WE'RE
DEEPLY DISAPPOINTED THAT SHERIFF
COST REFORM WAS NOT INCLUDED IN
THE MAY REVISION. WE THINK THE
PROPOSAL TO ELIMINATE MR. MIP
COULD ACTUALLY FUND SHERIFF COST
REFORM. THIS WOULD NOT ONLY HELP
TENS OF THOUSANDS OF SENIORS AND
PEOPLE WITH DISABILITIES, BUT
ALSO THOSE LOSING MR. MIP
COVERAGE WITH NO OTHER
AFFORDABLE, HEALTH COVERAGE
OPTION. WE'RE ALSO DEEPLY
DISAPPOINTED WITH THE MULTI-YEAR
CONTINUOUS ELIGIBILITY FOR
CHILDREN WAS NOT INCLUDED IN THE
BUDGET AND CONCERNED WITH CUTS
TO ENROLLMENT. NAVIGATORS BOTH
HELP PEOPLE KEEP THEIR COVERAGE
AT A TIME WHEN PEOPLE ARE BEING
TERMINATED DUE TO PAPERWORK
REASONS. DESPITE EVERY EFFORT TO
CONTACT THE COUNTY. AND FINALLY,
WE APPRECIATE THE COMMITTEE'S
COMMENTS ON CUTS TO INDIAN
HEALTH GRANTS. THANK YOU. THANK
YOU. GOOD MORNING, NORA LIN WITH
CHILDREN NOW, RELATED TO FDP,
OUR COALITION CONTINUES TO SEEK
THE ENTIRE $34 MILLION BUDGET
THAT WAS PROVIDED TO FDP TO
STAND UP, PICK, PICK, PICK. WE
APPRECIATE THAT THE MAY REVISION
FIGURE GETS US CLOSER TO THIS
AMOUNT. WE DO CONTINUE TO HAVE
CONCERNS ABOUT THE ADEQUACY OF
THIS FUNDING TO CARRY OUT ALL
EXISTING AND NEW ADMINISTRATIVE
RELATED ACTIVITIES FOR
STANDALONE FIC, AND THIS REQUEST
CONTINUED ENGAGEMENT WITH THE
ADMINISTRATION TO ENSURE
STANDALONE EPIC FIC RECEIVES
ADEQUATE RESOURCES AND THE
PROGRAMS ARE TRANSITIONED IN A
SMOOTH AND SEAMLESS MANNER. WE
CONTINUE TO URGE THAT DHCS
PROVIDE LOCAL JURISDICTIONS
FLEXIBILITY IN UTILIZING THEIR
FIC ADMINISTRATIVE ALLOCATIONS
TO STAFF AND STRUCTURE THEIR
PROGRAMS THAT BEST MEET LOCAL
NEEDS OF FOSTER CHILDREN AND
YOUTH POPULATIONS. THANK YOU.
THANK YOU. GOOD MORNING. RONALD
COLEMAN BAYEZA, HERE ON BEHALF
OF THE CALIFORNIA THÀNH HEALTH
NETWORK, CPAN. WE ARE VERY
FRUSTRATED THAT WE ARE SOLELY
TALKING ABOUT CUTS, GIVEN THE
GOVERNOR'S INTRANSIGENCE TO HAVE
A CONVERSATION ABOUT REVENUE, WE
SHOULD BE TALKING ABOUT REVENUE
SOLUTIONS IN A YEAR WITH AN EVER
GROWING DEFICIT WHERE WE CANNOT
MEET OBLIGATIONS FOR THE
PROGRAMS AND SERVICES THAT LOW
INCOME COMMUNITIES, LOW INCOME
COMMUNITIES AND COMMUNITIES OF
COLOR DESPERATELY NEED, WE ARE
OPPOSED TO THE CUT RELATED TO
CHILDREN AND YOUTH BEHAVIORAL
HEALTH INITIATIVES, SPECIFICALLY
AS IT RELATES TO THE COMMUNITY
DEFINED EVIDENCE PRACTICES. I
ALIGNED MY COMMENTS WITH MY
COLLEAGUE FROM REMCO. WE ARE
ALSO OPPOSED TO THE EQUITY AND
PRACTICE TRANSFORMATION CUTS. WE
ARE ALSO OPPOSED TO THE INDIAN
HEALTH GRANT PROGRAM CUTS AND
VERY MUCH APPRECIATE THE
COMMENTS BY THE CHAIR. WE ARE
OPPOSED TO THE CUTS TO HEALTH
ENROLLMENT NAVIGATORS AS WELL.
WE ARE DISAPPOINTED THAT
CONTINUOUS COVERAGE FOR CHILDREN
WAS NOT IN THE MAY REVISE ALSO
SHARE OF COSTS. ALSO
DISAPPOINTED TO SEE THE
ELIMINATION OF MR. WMIB. YES, WE
DO HAVE THE ACA, BUT
UNDOCUMENTED CALIFORNIANS CANNOT
BIND TO COVERED CALIFORNIA RIGHT
NOW. BUT WE DO THINK THAT WE
WOULD BE OPEN TO USING THE MR.
MIMS FUNDS FOR THE SHARE OF COST
MOVING FORWARD. THANK YOU. THANK
YOU, THANK YOU VERY MUCH.
VANESSA KAHINA, ON BEHALF OF THE
CALIFORNIA ACADEMY OF FAMILY
PHYSICIANS AND OPPOSITION TO THE
EQUITY AND PRACTICE
TRANSFORMATION GRANT REDUCTION,
WE ALREADY HAVE A NUMBER OF
PRIMARY CARE PROVIDERS WHO HAVE
INVESTED IN TECHNOLOGY TO HELP
THEIR PATIENTS IN PRIMARY CARE
AND TO MEET THEIR PATIENTS WHERE
THEY ARE, WITH ROLLING THIS
BACK, WE THINK THAT THIS WOULD
BE AN OPERATIONAL NIGHTMARE FOR
A NUMBER OF OUR PRACTICES. AND
FOR THAT REASON, WE HAVE TO
OPPOSE THIS AND APPRECIATE YOUR
TIME. THANK YOU. HELLO, MEMBERS
OF THE BUDGET HEALTH
SUBCOMMITTEE. MY NAME IS TANA
OPPLIGER. I'M WITH CALIFORNIANS
UNITED FOR RESPONSIBLE BUDGET OR
CURB. ACCORDING TO THE DOS MAY
REVISED REPORT, WE'RE LOOKING AT
$2.5 BILLION IN CUTS TO HEALTH
CARE PROGRAMS ACROSS DEPARTMENTS
THIS BUDGET YEAR, INCLUDING
VITAL PROGRAMS LIKE YOUTH
BEHAVIORAL HEALTH INITIATIVES
AND THE NATIVE AMERICAN HEALTH
GRANT PROGRAM. MEANWHILE, OVER
IN SUB SIX, PRISONS AND JAILS
ARE SEEING CUTS OF ONLY $116
MILLION. SO I THINK WE NEED TO
BE ASKING, WHY ARE HEALTH CUTS
MORE THAN 20 TIMES THE AMOUNT OF
CORRECTIONS CUTS? ARE WE
PLANNING TO FILL PRISONS WITH
THE YOUNG PEOPLE WHO WILL NO
LONGER BE ABLE TO RECEIVE
BEHAVIORAL HEALTH CARE BECAUSE
OF THESE CUTS, OR WITH THE
PEOPLE WHO WILL NO LONGER BE
ABLE TO RECEIVE SUBSTANCE ABUSE
TREATMENT. BECAUSE OF THESE
CUTS, CDCR CURRENTLY MAINTAINS
15,000 AND GROWING EXCESS PRISON
BEDS. MEANWHILE, AS YOU KNOW,
THE NEED FOR HEALTH CARE IS EVER
GROWING. VITAL HEALTH CARE
PROGRAMS COULD BE SAVED IF THE
STATE FOLLOWS THE LAWS
RECOMMENDATION OF CLOSING FIVE
PRISONS. THANK YOU. THANK YOU,
THANK YOU. THANK YOU. APPRECIATE
IT. HI AGAIN, BETH MONOSKIS SEO,
CALIFORNIA. I JUST WANT TO MAKE
A BRIEF REMARK AND ALIGN MY
COMMENTS WITH THOSE OF KI¾M AND
CHILDREN. NOW APPRECIATES, THE
MOVEMENT WE'VE SEEN IN THE MAY
REVISION FROM DHS AS RELATES TO
CHP TRANSITION AND STANDING UP
PICK, PICK, PICK A STANDALONE
PROGRAM WOULD LIKE TO AGAIN SEE
THAT FULL ALLOCATION 34 MILLION
GO TOWARDS STANDING UP THAT
PROGRAM, GUARANTEEING THAT
FOSTER YOUTH SEE NO LOSS IN
SERVICE. THANK YOU. THANK YOU.
NICOLE WATERMAN, ON BEHALF OF
THE CHILDREN'S PARTNERSHIP,
DEEPLY DISAPPOINTED THAT
CONTINUOUS COVERAGE FOR CHILDREN
0 TO 5 WAS NOT INCLUDED AS PART
OF THE MAY REVISION, WE ARE
HOPEFUL THAT THE LEGISLATURE
WILL DIRECT DCS TO GO AHEAD AND
SUBMIT A FEDERAL WAIVER,
REGARDLESS OF VERY CONCERNED
ABOUT THE PROSPECT OF A NEW
FEDERAL ADMINISTRATION. WE ALSO
ARE IN OPPOSITION TO CUTS TO THE
CYBER VÌ, EQUITY AND PRACTICE
TRANSFORMATION GRANTS AND
REDUCED FUNDING FOR NAVIGATORS.
THANK YOU. THANK YOU, CHAIR AND
MEMBERS KATHY MOSSBERG WITH THE
FIRST FIVE ASSOCIATION WOULD
ASSOCIATE OUR COMMENTS WITH
THOSE MADE BY NICOLE WATERMAN,
TOTALLY AGREE. IF WE COULD JUST
GET THIS WAIVER REQUESTED FROM
THE FEDS BEFORE WE SEE
POTENTIALLY A DIFFICULT
ADMINISTRATION COME IN, THAT
WOULD BE GREAT. THEN WE CAN WORK
ON ADMINISTERING. I'M SORRY,
MEDI-CAL CONTINUOUS ELIGIBILITY
FOR THOSE 0 TO 5 APOLOGIZE. WE
WERE JUST WE WERE CONCERNED IT
WASN'T IN THIS PROPOSAL. WE URGE
THIS LEGISLATURE TO CONTINUE TO
WORK ON THIS AND TO PUT THIS IN
BEFORE THE FINAL BUDGET. THANK
YOU. THANK YOU. GOOD MORNING.
YASMIN PELLETT, ON BEHALF OF
JUSTICE AND AGING, I'LL ALIGN MY
COMMENTS WITH THOSE OF MY
COLLEAGUE FROM THE WESTERN
CENTER ON LAW AND POVERTY. WE'RE
VERY DISAPPOINTED THAT THE
MEDI-CAL SHERIFF COST REFORM IS
NOT PLANNED TO BE IMPLEMENTED IN
2025. THE DEAL IN THE 2022
BUDGET YEAR WAS TO REFORM THIS
PROGRAM, THAT'S REALLY
INEQUITABLE AND CAUSES A LOT OF
HARM TO PEOPLE THAT ARE
BASICALLY FORCED TO LIVE ON $600
A MONTH IN ORDER TO GET MEDI-CAL
SERVICES. AND I DON'T THINK
ANYONE HERE THINKS THAT YOU CAN
ACTUALLY LIVE ON $600 A MONTH IN
CALIFORNIA. SO WE WOULD URGE THE
LEGISLATURE TO GET ALL
OPPORTUNITIES TO ACTUALLY
IMPLEMENT THAT PROGRAM REFORM ON
TIME, LIKE LOOKING AT THE MR.
MIP FUNDS. AND WE'RE ALSO
OPPOSED TO THE PROPOSED
ELIMINATION OF THE INDIAN HEALTH
GRANTS. CALIFORNIA HAS THE THIRD
LARGEST POPULATION OF OLDER
NATIVE AMERICANS IN THE COUNTRY.
THANK YOU. THANK YOU, MADAM
CHAIR AND MEMBERS, DENNIS ROMERO
WITH THE CALIFORNIA PRIMARY CARE
ASSOCIATION, ADVOCATES, OPPOSED
TO THE CUTS TO THE HEALTH
ENROLLMENT NAVIGATOR PROGRAM,
PARTICULARLY FOR THE CLINICS.
APPRECIATE THE DEPARTMENT'S
COLLABORATION AND WORK IN
GETTING THAT MONEY OUT. AS YOU
MENTIONED, MADAM CHAIR, YOU
KNOW, COVERAGE DOESN'T EQUAL
ACCESS. AND THIS IS CRITICAL,
PARTICULARLY AT THIS TIME, WE'LL
ALSO MENTION, WE'RE OPPOSED TO
THE CUTS TO THE EQUITY AND
PRACTICE TRANSFORMATION GRANTS.
ABOUT A THIRD OF THE GRANTEES
ARE HEALTH CENTERS THAT HAVE ARE
RELYING ON THIS TO PROVIDE
BETTER QUALITY AND ACCESS TO
CARE. SO APPRECIATE, FURTHER
CONSIDERATION. THANK YOU. THANK
YOU. HI. MY NAME IS JORDAN
ARMSTRONG. I'M A FRESHMAN AT UC
DAVIS, AND WHILE I DON'T HAVE
THE QUALIFICATIONS TO GO INTO
DEPTH ABOUT THESE TOPICS, THERE
ARE MULTITUDE OF PEOPLE IN THIS
ROOM WHO HAVE THE QUALIFICATIONS
AND THOSE WHO ARE THE ASSEMBLY
MEMBERS HERE WHO HAVE THE
QUALIFICATIONS AND THEY HAVE
SHOWED THAT THROUGH THE CRITICAL
QUESTIONS THAT THEY HAVE ASKED
YOU. AND I'M ONLY HERE TO ASK
YOU OR TO IMPLORE YOU TO LISTEN
TO THOSE VOICES IN THE ROOM AND
LISTEN TO THE VOICES WHO HAVE
SPOKEN TODAY, BECAUSE FROM WHAT
I'VE SEEN IN THE PROPOSED BUDGET
CUTS, THERE'S A LOT OF MYOPIC
THINKING AND TOPICS THAT NEED
CRITICAL THINKING. SO PLEASE
LISTEN AND TRY TO UNDERSTAND
WHAT THEY ARE SAYING AND TAKE
THAT INTO CONSIDERATION. WHEN
YOU ARE THINKING ABOUT REVISING
THESE PROPOSED, BUDGET CUTS.
THANK YOU. THANK YOU. HELLO,
MADAM CHAIR, AND MEMBERS OF THE
COMMITTEE. MY NAME IS EMILY
MCCLINTOCK, AND I AM WITH THE
PUBLIC HEALTH INSTITUTE. WE ARE
A NONPROFIT ORGANIZATION THAT
SUPPORTS AND BUILDS THE CAPACITY
OF COMMUNITY BASED ORGANIZATIONS
ACROSS THE STATE OF CALIFORNIA.
I'M HERE TO ADVOCATE IN SUPPORT
OF MAINTAINING CRITICAL FUNDING
FOR THE CHILDREN AND YOUTH
BEHAVIORAL HEALTH INITIATIVE OF
28. COMMUNITY BASED
ORGANIZATIONS HAVE ALREADY BEEN
SELECTED TO RECEIVE THESE GRANT
DOLLARS TO IMPLEMENT LOCAL LEVEL
, YOUTH LED CAMPAIGN PROJECTS AS
A PART OF THE SCI-FI. THESE
FUNDS ARE NOW ELIMINATED THROUGH
THIS PROPOSAL, OUR TEAM HAS
ALREADY PUT IN HUNDREDS AND
HUNDREDS OF HOURS TO LAUNCH THE
LOCAL LEVEL COMPONENT OF THIS
PROJECT, AND THE CBOS HAVE BEEN
HIRING AND TRAINING STAFF,
SOLIDIFYING WORK PLANS,
ASSEMBLING THEIR YOUTH ADVISORY
GROUPS, AND PROGRESSING ON TRACK
. THESE IMPORTANT PROJECTS ARE
ALREADY IN MOTION. WORKING WITH
YOUTH, PARENTS, CAREGIVERS, AND
COMMUNITY SERVICE PROVIDERS TO
ADDRESS MENTAL AND BEHAVIORAL
HEALTH AND TO PREVENT A FUTURE
MENTAL HEALTH CRISIS IN OUR
STATE. PLEASE HELP US TO FOLLOW
THROUGH WITH SUPPORTING YOUTH,
MENTAL HEALTH AND BEHAVIORAL
HEALTH ACROSS CALIFORNIA BY
MAINTAINING THESE IMPORTANT
FUNDINGS. THANK YOU. THANK YOU,
THANK YOU, MADAM CHAIR MEMBERS,
KATHY MCDONALD, ON BEHALF OF THE
ALAMEDA COUNTY BOARD OF
SUPERVISORS, ALIGNS THOSE
COMMENTS WITH KAYAK AND CHILDREN
. NOW REGARDING THE CDP
TRANSITION AND URGING THE
PROVISION OF THE FULL FUNDING
FOR THE PICKWICK PROGRAM AND
ALSO ENSURING THAT CS OVERSIGHT
WOULD, IT OCCURS, IS DONE SO
WITH SEPARATE FUNDING THAT'S
DEDICATED FOR THAT AT A LATER
TIME. THANK YOU. THANK YOU. AND
WITH THAT, WE WILL NOW MOVE TO
OUR THIRD ISSUE, ISSUE NUMBER
THREE, DEPARTMENT OF PUBLIC
HEALTH. YEAH.
AND YOU MAY BEGIN WHENEVER
YOU'RE READY. THANK YOU, GOOD
MORNING, MADAM CHAIR, BRANDON
NUNES, I'M THE CHIEF DEPUTY
DIRECTOR FOR OPERATIONS AT THE
DEPARTMENT, HAPPY TO KIND OF RUN
THROUGH IT. LOOKS LIKE WE'RE
GOING TO RUN THROUGH THE BUDGET
SOLUTIONS TODAY. SO HAPPY TO
KIND OF START THERE, THE FIRST
ISSUE ON OUR LIST TODAY, ISSUE
254, IS A FUND SHIFT RELATED TO
SKILLED NURSING FACILITY
STAFFING AUDITS, WE'RE PROPOSING
IN THE GOVERNOR'S BUDGET, WE HAD
ACTUALLY SHIFTED 4 MILLION FROM
GENERAL FUND OVER TO, OUR
SKILLED NURSING FACILITY,
SPECIAL FUND, THAT WAS A ONE
TIME FUND SHIFT FOR THE BUDGET
YEAR. IN THE MAY REVISION, WE'RE
ESSENTIALLY PROPOSING TO, MAKE
THAT AN ONGOING SHIFT TO THE
SKILLED NURSING FACILITY FUND.
I'LL PAUSE THERE IF THERE'S ANY
QUESTIONS ON THAT ONE. OKAY. THE
NEXT ISSUE, I'LL LUMP THE NEXT
THREE TOGETHER. ISSUES TWO, 47,
48 AND 49. THIS IS RELATED TO
BOTH THE REVERSION OF OUR PUBLIC
HEALTH FUTURE OF PUBLIC HEALTH,
FUNDING IN THE CURRENT YEAR,
THERE'S A PROPOSED REVERSION OF
$52.5 MILLION, AND THEN IN THE
ONGOING FOR, 24, 25 AND BEYOND,
THERE'S $100 MILLION PROPOSED
REDUCTION FOR STATE OPERATIONS.
AND THEN THE LOCAL ASSISTANCE
FUNDING THAT WAS PROVIDED TO
LOCAL HEALTH JURISDICTIONS OF
200 MILLION IS ALSO PROPOSED FOR
ELIMINATION. CAN YOU PLEASE
DESCRIBE A LITTLE BIT MORE THE
INTENTION OF THE PROGRAM? SURE
SO THIS GOES BACK TO, FUNDING
THAT WAS PUT IN THE BUDGET IN
22, 23, WE WORKED VERY CLOSELY
WHEN THE LEGISLATURE PUT THAT
FUNDING IN. WE WORKED VERY
CLOSELY WITH, A NUMBER OF
DIFFERENT STAKEHOLDERS, LOCAL
HEALTH JURISDICTIONS, UNION
GROUPS, SEIU, ETC, ALONG WITH
THE DEPARTMENT TO KIND OF COME
UP WITH A PLAN FOR HOW THAT $300
MILLION WOULD BE SPENT. AND WE
FOCUSED ON ON FROM THAT PLAN AND
HOW THE FUNDING WAS ALLOCATED.
WE FOCUSED ON SIX CORE AREAS,
WORKFORCE DEVELOPMENT WAS
OBVIOUSLY A LARGE AREA THAT WAS
A FOCUS FOR AT BOTH THE STATE
AND LOCAL LEVEL. SO WE LOOK TO
EXPAND AND ENHANCE THE PUBLIC
HEALTH WORKFORCE TO ENSURE
ADEQUATE CAPACITY AND
SPECIALIZED SKILLS ACROSS
VARIOUS HEALTH DOMAINS. OF
COURSE, COMING OFF OF COVID, WE
LOOKED AT EMERGENCY PREPAREDNESS
AND RESPONSE. SO ANOTHER FOCUS
OF THE FUNDING WAS TO STRENGTHEN
SYSTEMS TO RAPIDLY IDENTIFY AND
RESPOND TO PUBLIC HEALTH
THREATS. IT AND DATA SCIENCE. WE
OBVIOUSLY WERE COMING OFF OF
COVID WITH A LOT OF DIFFERENT
LEGACY SYSTEMS, ETC. AND SO WE
TOOK A LOOK AT OUR IT AND DATA
SCIENCE INFRASTRUCTURE. AND
AGAIN, ANOTHER FOCUS OF THIS
FUNDING WAS TO MODERNIZE IT
INFRASTRUCTURE AND IMPROVE DATA
COLLECTION, DATA SHARING AND
ANALYSIS, COMMUNITY PARTNERSHIPS
WAS OBVIOUSLY IMPORTANT BETWEEN
THE STATE AND LOCAL HEALTH
JURISDICTIONS AS WELL. SO AS
WELL AS OUR CBOS. AND SO,
LOOKING TO USE THIS FUNDING TO
FORGE AND SUSTAIN PARTNERSHIPS
ACROSS VARIOUS SECTORS TO
AMPLIFY THE IMPACT OF PUBLIC
HEALTH PROGRAMS AND VARIOUS
INITIATIVES, WE ALSO LOOKED AND
COMMUNICATION WAS ALSO
IMPORTANT, DURING THE PANDEMIC.
SO WE LOOKED AT WAYS TO ENHANCE
OUR COMMUNICATION EFFORTS, BOTH
HOW WE COMMUNICATE WITH LOCAL
HEALTH JURISDICTIONS, BUT ALSO
HOW WE COMMUNICATE WITH THE
PUBLIC ON PUBLIC HEALTH ISSUES.
AND THEN FINALLY, WE LOOKED AT
COMMUNITY HEALTH IMPROVEMENT,
FOCUSING ON SYSTEMIC PUBLIC
HEALTH, IMPROVING CGRTS THROUGH
COMMUNITY ENGAGEMENT AND
TARGETED INTERVENTIONS TO
ADDRESS SOCIAL DETERMINANTS OF
HEALTH. SO WHEN THE GROUP GOT
TOGETHER BACK WHEN THE FUNDING
WAS ORIGINALLY PUT IN, WE USED
THESE SIX PRINCIPLES AS KIND OF
A GUIDING FACTOR AND THEN
ALLOCATED THE 200 MILLION TO THE
LOCAL HEALTH JURISDICTIONS AND
THEN WE FOCUSED ON CERTAIN AREAS
WITH THE 100 MILLION FOR STATE
OPERATIONS. I HOPE THAT HELPS
KIND OF PROVIDE SOME FRAMEWORK.
CAN I CAN I MAKE SOME COMMENTS
ABOUT THAT? THIS ACTUALLY GOES
BACK EVEN FURTHER. THERE WAS A
REQUEST, BEFORE AND THEN THE,
THAT WAS PUT OFF. SO THERE MORE
MONEY COULD COME FORWARD AS THIS
300 MILLION YOU'RE TALKING ABOUT
, THERE HAS BEEN WORKFORCE THAT
HAS BEEN HIRED. MY UNDERSTANDING
IS SO THAT MEANS THAT THIS
WORKFORCE WILL NOW BE FORCED TO
GO AWAY OR LOCAL JURISDICTIONS
WILL HAVE TO PAY FOR IT. IS THAT
THE INTENT THERE WILL BE SOME
DECISIONS THAT HAVE TO BE MADE
ON WORKFORCE AT THE STATE LEVEL,
WHICH MEANS THAT JOBS WILL GO
AWAY, THAT'S USUALLY WHAT THAT
PHRASE MEANS. I KNOW AT THE
STATE LEVEL WE'RE LOOKING AT
VACANCIES WITHIN OUR DEPARTMENT
TO SEE IF WE CAN'T SHIFT SOME OF
THESE INTO. BUT AT THE LOCAL
LEVEL, THERE WERE ABOUT 13 TO
1400 POSITIONS THAT WE'RE
LOOKING TO BE HIRED, SO THAT
WILL LIKELY GO AWAY. SO I GUESS
MY BIGGER OVERALL QUESTION IS
ARE GOING TO BE SO WE JUST WE
JUST WENT THROUGH COVID, OUR
LOCAL PUBLIC HEALTH PROGRAM,
PROGRAMS HAVE WERE DEVASTATED.
THEY WERE ACTUALLY UNDERFUNDED
FOR YEARS, GOING INTO IT, THEY
WEREN'T PREPARED. NOBODY WAS
PREPARED. SO WE'VE GOT NOW WE'VE
GOT RAPID WE HAD SOME RAPID
RESPONSE. WE HAD SOME WE
RECOGNIZED WE HAD SOME HUGE IT
PROBLEMS, A LOT OF LOCAL
JURISDICTIONS IN MY DISTRICT
WERE WORKING OFF OF EXCEL
SPREADSHEETS, AND WE'RE LOOKING
AT CONTACT TRACING, SO I KNOW
THAT THE CALLCONNECT PROGRAMS IS
SUPPOSED TO BE CUT AS WELL. AND
FORGING SOME OF THOSE COMMUNITY
PARTNERSHIPS, I START THINKING
ABOUT SOME OF OUR HARDER TO
REACH COMMUNITIES, LIKE OUR
NATIVE AMERICAN COMMUNITIES, WHO
SUFFERED REALLY
DISPROPORTIONATELY IN THIS, IN
THIS CRISIS. SO, JUST TODAY,
PICTURES HERE, PRESS-DEMOCRAT.
SANTA ROSA, MENDOCINO COUNTY
REPORTS HIGH RISE IN SYPHILIS
AND HIV CASES. TIMES OF SAN
DIEGO AFTER A FIVE YEAR RESPITE,
SAN DIEGO COUNTY SEES THIRD CASE
OF MEASLES IN 2024. ABOUT 200
PEOPLE EXPOSED TO MEASLES AT UC
DAVIS. HEPATITIS A IS SPREADING
AMONG THE HOMELESS POPULATION.
AND MAY 10TH, JUST A COUPLE OF
DAYS AGO, POTENTIAL MEASLES
EXPOSURES AT TWO EUREKA
LOCATIONS IN MY DISTRICT. ARE WE
NOT ANTICIPATING WE HAVE AVIAN
FLU? WE HAVE A VARIETY OF
THINGS, YET WE ARE GOING TO
DECIMATE OUR COMMUNITY, PUBLIC
HEALTH PROGRAMS FURTHER GOING
BACKWARDS ARE WE? DO YOU HAVE A
CRYSTAL BALL THAT SAYS WE'RE NOT
GOING TO HAVE ANY MORE THINGS
HAPPENING? NO. DOES DOES IN ANY
WORLD DOES THIS MAKE I'M CURIOUS
WHAT THE LAO THINKS ABOUT THIS.
DOES THIS MAKE SENSE IN THE REAL
WORLD? ARE WE WANT TO GO
BACKWARD? WHAT HAPPENS IF THERE
IS ANOTHER COVID? THEN WE HAVE
GONE BACKWARDS. WE ARE THEN EVEN
LESS PREPARED BECAUSE A LOT OF
THESE OPPORTUNITIES HAVE PASSED,
PASSED US BY, OF ANYTHING. YOU
KNOW, I'M FRUSTRATED. LET'S SEE
IF I LIVE MY LIFE IN PERPETUAL
FRUSTRATION THESE DAYS. BUT BUT
THIS ONE, THIS ONE, REALLY, THIS
ONE REALLY HURTS. IT'S JUST
DOESN'T MAKE ANY SENSE, FROM MY
PERSPECTIVE. YOU KNOW, SOME OF
OUR LOCALS WERE STARTING TO USE
THE CALLCONNECT PROGRAM AS A WAY
TO TRACE OTHER, OTHER THINGS
OTHER THAN COVID. IT'S A REALLY
VALUABLE TOOL, ONE OF MY PUBLIC
HEALTH DEPARTMENTS, CONSISTS OF
ONE PERSON AND ONE NURSE. THAT'S
NOT A LOT OF INFRASTRUCTURE FOR
A COUNTY THAT MADE 80,000
PEOPLE. SO WE'RE NOT LÀ. WE'RE
NOT OAKLAND, WE'RE NOT SOME OF
THESE OTHER AREAS. AND SO THE
AMOUNT OF INFRASTRUCTURE FUNDING
IS PRETTY MINIMAL TO HELP BUILD
UP SOME OF OUR PROGRAMS AND
THINGS LIKE THE IT COULD BE
REALLY, REALLY VALUABLE, YOU
KNOW, HUMBOLDT COUNTY HAS A VERY
LOW VACCINATION RATE FOR MEASLES
. I'M A LITTLE CONCERNED THAT
THAT EXPOSURE MIGHT LEAD TO A
MEASLES OUTBREAK THERE. AND, YOU
KNOW, WE HAVE THE ABILITY TO USE
CALLCONNECT NOW TO HELP WITH
SOME OF THE TRACING OF THAT. BUT
WHEN YOU ELIMINATE IT, IT
HAPPENS TWO YEARS FROM NOW,
WE'RE NOT GOING TO HAVE THAT.
AND SO WE'RE BACK TO EXCEL
SPREADSHEETS AGAIN AND PHONE
CALLS AND, AND SUCH. SO IT KIND
OF GOES TO THE POINT OF WHEN
WE'RE LOOKING AT WHEN WE'RE
LOOKING AT THINGS TO CUT. THIS
IS A BIG LINE ITEM, BUT IS
ANYBODY THINKING ABOUT WHAT THE
FUTURE MEANS? LIKE I SAID, DO
YOU HAVE A CRYSTAL BALL THAT
SAYS WE'RE NOT GOING TO HAVE
ANOTHER PANDEMIC? COVID IS STILL
OUT THERE. THERE'S LOOKING AT A
POTENTIAL ANOTHER UPTICK, YOU
KNOW, THAT THAT SHOWED UP JUST
RECENTLY. HELP ME UNDERSTAND HOW
THIS DECISION WAS ARRIVED. THIS
DECISION FOR THESE CUTS WAS
ARRIVED AT. HELP ME ARTICULATE.
AND I DON'T WANT TO HEAR, WELL,
WE'RE IN A TOUGH BUDGET YEAR
BECAUSE I KNOW WE'RE IN A TOUGH
BUDGET YEAR, BUT ARTICULATE THAT
THE AMOUNT OF MONEY WE SPENT ON
COVID RESPONSE AND WE'RE STILL
SPENDING WAS PRETTY DRAMATIC. WE
COULD HAVE BEEN BETTER AT OUR
SURVEILLANCE POTENTIALLY COULD
HAVE BEEN HOPEFULLY BETTER
IDENTIFYING THIS EARLY ON. AND
IT JUST FEELS LIKE WITH THESE
CUTS, WE'RE JUST GOING TO GO
BACKWARDS AND PRETEND LIKE NONE
OF THIS EVER HAPPENED, PUT OUR
HEAD BACK IN THE SAND AND HOPE
THAT WE DON'T HAVE ANOTHER
PANDEMIC. SO HELP ME UNDERSTAND
HOW DECISIONS LIKE THIS MAKE
SENSE, OTHER THAN THE FISCAL
PIECE OF IT, BECAUSE I DON'T I
DON'T SEE IT. I DON'T SEE IT AT
ALL, GOOD MORNING, NICK MILLS,
DEPARTMENT OF FINANCE. THE
ADMINISTRATION'S PROPOSAL DOES
MAINTAIN FUNDING FOR THE BASE
LEVEL OF SERVICES THAT EXISTED
FOR STATE AND LOCAL HEALTH
DEPARTMENTS BEFORE THESE
ADDITIONAL INVESTMENTS WERE
MADE, BASE LEVEL FUNDING THAT
WAS INADEQUATE. THE PURPOSE OF
THIS FUNDING WAS TO BUILD UP
INFRASTRUCTURE. THE BASE FUNDING
WAS INADEQUATE. THAT'S WHY THIS
CAME TO BE. THAT'S WHY WE FOUGHT
SO HARD FOR THIS. THE BASIC
FUNDING WAS INADEQUATE TO BEGIN
WITH. I WOULD ALSO NOTE THAT THE
MAYOR OF VISION MAINTAINS BASE
FUNDING FOR, CRITICAL
INFRASTRUCTURE, SUCH AS 26.9
MILLION AND 2425 FOR MAINTENANCE
AND OPERATIONS, AND FOR THE
SAPPHIRE SYSTEM TO CONTINUE TO
RECEIVE AND PROCESS LAB DATA FOR
OVER 80 REPORTABLE HEALTH
CONDITIONS. ADDITIONALLY, THE
MAYOR VISION DOES MAINTAIN $61.8
MILLION IN 24, 25, AND 54.9
MILLION ANNUALLY THEREAFTER FOR,
FOR THE MAINTENANCE OF IT
OPERATIONS FOR DISEASE
SURVEILLANCE READINESS, WHICH
ALLOWS THE DEPARTMENT TO DEVELOP
AND DELIVER IT SYSTEMS TO
SUPPORT RESPONSE TO COVID 19 AND
OTHER FUTURE DISEASE OUTBREAKS.
BUT NONE OF THESE, DECISIONS
WERE MADE LIGHTLY AND REFLECT
TOUGH AND DIFFICULT CHOICES TO
BALANCE THE BUDGET AS REQUIRED.
YEAH, WELL, I CAN YOU DESCRIBE
THE DISEASE SURVEILLANCE PROGRAM
? IS THIS IS THIS ON? OKAY,
CHRISTINE NHîNG, DEPARTMENT OF
FINANCE, I ACTUALLY WANTED TO
ALSO ADDRESS YOUR EARLIER
COMMENT ABOUT CALCONNECT AND
JUST WANTED TO CORRECT FOR THE
RECORD THAT CALCONNECT IS NOT
BEING DISCONTINUED, IT WAS NOT
ALLOCATED GENERAL FUND IN BUDGET
YEAR, BUT THE DEPARTMENT HAS
IDENTIFIED, TRIED TO START WITH
$11 MILLION IN FEDERAL FUNDS IN
BUDGET YEAR AND ANOTHER $11
MILLION IN BUDGET YEAR ONE. TO
CONTRIBUTE TOWARDS THE COST OF
THE OF THE PROGRAM. AND, WE ARE
LOOKING INTO ADDITIONAL FEDERAL
FUNDS. THE DEPARTMENT HAS
IDENTIFIED, ABOUT $134 MILLION
IN FEDERAL FUNDS TO CONTINUE THE
MAINTENANCE AND OPERATIONS AND
DEVELOPMENT OF FOUR DIFFERENT
DISEASE SURVEILLANCE AND
REGISTRY PROGRAMS, AND WE ARE
AWARE OF OTHER FEDERAL FUNDS OUT
THERE, SO WE ARE JUST, YOU KNOW,
IN THE PROCESS OF EXPLORING ALL
OF THE AVAILABLE FUNDS, WE DON'T
WANT TO LEAVE THOSE FEDERAL
FUNDS ON THE TABLE AND WANT THEM
TO BE UTILIZED TO CONTINUE THESE
PROGRAMS. WELL, I APOLOGIZE,
WE'RE SOME OF WHAT WE HAVE IS
PRETTY SCANT ON DETAILS. AND SO
I WASN'T QUITE AWARE OF THAT,
AND I THINK WE'RE TRYING TO
PIECE TOGETHER SOME OF THE
DETAILS. SO I APPRECIATE THAT
THAT AT LEAST THE COUNT WE'RE
LOOKING FOR, FUNDING FOR
CALCONNECT, I BELIEVE, WAS $30
MILLION TO MAINTAIN THE PROGRAM.
THERE'S ADDITIONAL FEDERAL
FUNDING, THAT THAT IS A TOOL
THAT LOCALS YOU'LL USE. SO THAT
IS THAT IS SEPARATE THAT IS
SEPARATE FROM THE DISEASE
SURVEILLANCE PROGRAM YOU'RE
TALKING ABOUT. CORRECT WHICH
DISEASE SURVEILLANCE PROGRAM ARE
YOU TALKING ABOUT? WHEN YOU WERE
TALKING ABOUT, SURVEILLANCE
READINESS RESPONSE, YES, I
BELIEVE OH, YES. THAT THAT,
APPROPRIATION IS FOR A, A
COMBINATION OF PROGRAMS, THAT
WAS AUTHORIZED IN 2022 AND IS AN
ANNUAL, APPROPRIATION OF 61.8
MILLION, OF WHICH WE ARE
REDUCING, SO WE'RE REVERTING A
SAVINGS OF 3.8 MILLION IN
CURRENT YEAR, IN WORKING WITH
THE DEPARTMENT, WE ACTUALLY
WITHDREW ANY CUTS IN BUDGET
YEAR, AND ARE JUST DOING 6.9
MILLION IN, CUTS ANNUALLY AFTER
THAT AND OUT YEARS STARTING IN
FISCAL YEAR 2526, TO ADDRESS
SOME OF THE CONCERNS ABOUT THE
IMPACT ON, CURRENT CONTRACTS AND
OTHER THINGS THAT HAVE ALREADY
BEEN PLANNED FOR BUDGET YEAR.
OKAY. WELL, THANK YOU. AND I
JUST WANT TO ONE, I GUESS KIND
OF A FINAL QUESTION, TO OUR
PRESENTER, DO YOU FEEL
COMFORTABLE WITH THESE BUDGET
CUTS, THE WAY THEY'RE GOING AND
THE INVESTMENTS THAT WE'RE GOING
TO BE MADE FOR PUBLIC HEALTH
THAT WILL BE READY FOR A
PANDEMIC OR SOME MAJOR HEALTH
EVENT? DO YOU FEEL COMFORTABLE
THAT THAT CUTTING THESE HUNDREDS
OF MILLIONS OF DOLLARS FROM
HEALTH, PUBLIC HEALTH
INFRASTRUCTURE CARE WILL STILL
LEAVE US READY TO BE ON TOP OF
OUR GAME TO RESPOND TO THE NEXT
PANDEMIC OR SERIES OF THINGS
THAT ARE HAPPENING. AS I READ
OFF THOSE THAT WAS JUST TODAY,
THOSE WERE JUST TODAY'S
HEADLINES. SO ALL PUBLIC HEALTH
RELATED, ALL PUBLIC HEALTH. SO
YOU FEEL LIKE THESE CUTS ARE
STILL GOING TO LEAVE US IN A
REALLY STRONG POSITION TO
REBUILD OUR INFRASTRUCTURE FOR
PUBLIC HEALTH? I THINK, YOU KNOW
, SITTING IN THE CHAIR OF THE
CHIEF DEPUTY FOR OPERATIONS, I
THINK THAT'S DEFINITELY A
CONVERSATION THAT WE'D LIKE TO
HAVE WITH OUR DIRECTOR. I THINK
IT'S PLAIN THAT OBVIOUSLY THE
REDUCTIONS WILL HAVE AN IMPACT
ON OUR PREPAREDNESS, THAT'S
SOMETHING THAT WE'RE GOING TO
HAVE TO BALANCE IN LIGHT OF THE
BUDGET SITUATION THAT WE'RE IN.
BUT WE'RE ALSO GOING TO HAVE TO
TAKE A LOOK AT OPPORTUNITIES
SUCH AS THE FEDERAL FUNDS THAT
DEPARTMENT OF FINANCE MENTIONED,
TO SEE IF THERE'S WAYS TO BRIDGE
SOME OF THOSE UNTIL WE GET INTO
A POTENTIALLY BETTER SITUATION.
BUT THERE'S NO DOUBT THAT IT'S
GOING TO HAVE AN IMPACT TO OUR
PREPAREDNESS. SO IT WILL NOT WE
WILL NOT BE AS PREPARED BECAUSE
WE'RE NOT GOING TO BE INVESTING
IN OUR PUBLIC HEALTH
INFRASTRUCTURE, BUT WE'LL BE
WORKING ON WAYS TO TRY TO
MITIGATE THAT AGAIN, LOOKING AT
OTHER FEDERAL FUNDING SOURCES,
ETC. OKAY. ALIA. YES, WILL OWENS
WITH THE LEGISLATIVE ANALYST'S
OFFICE, SO SPECIFICALLY ON THE
PROPOSAL TO REDUCE OR RATHER
ELIMINATE THE FUTURE OF PUBLIC
HEALTH FUNDING. SO GENERALLY,
OUR OFFICE HAS RECOMMENDED THAT
THE LEGISLATURE LOOK TO RECENT
ONE TIME AND TEMPORARY
INITIATIVES TO PREVENT, CUTS TO
CORE SERVICES, HOWEVER, THIS
FUNDING SOLUTION DOES DEVIATE
FROM OTHER PROPOSED SOLUTIONS,
AND THAT IT DOES IN FACT IMPACT
CORE PUBLIC HEALTH SERVICES, AS
DOCTOR WOODEN MENTIONED, THIS
300,000,100 FOR STATE AND 200
FOR LOCAL HEALTH JURISDICTIONS.
THIS IS FUNDING THAT IS THAT WAS
MEANT TO BRING PUBLIC HEALTH
FUNDING UP TO A BASELINE LEVEL
TO MEET MINIMUM SERVICE NEEDS,
THIS COMES AFTER, AS FOUND IN
THE WORKING GROUP, REPORT AFTER
DECADES OF DECLINING AND OR
STAGNANT FUNDING FOR PUBLIC
HEALTH SYSTEMS, AS WELL AS KIND
OF A PATCHWORK FUNDING APPROACH,
POOLING FEDERAL DOLLARS AND
OTHER SPECIAL DOLLARS, KIND OF
CREATING AN INFLEXIBLE SYSTEM
THAT MADE IT DIFFICULT TO
RESPOND TO EMERGING PUBLIC
HEALTH NEEDS. SO GIVEN THE KIND
OF PROGRAMMATIC AND PLANNING
EFFORTS THAT HAVE ALREADY BEEN
UNDERWAY, THAT HAVE BEEN FUNDED
BY THE FUTURE OF PUBLIC HEALTH
DOLLARS, IN PARTICULAR, THERE
HAVE BEEN A NUMBER OF INCREASES
IN THE PUBLIC HEALTH WORKFORCE
AT THE STATE AND LOCAL LEVEL. A
REDUCTION IN FUNDING COULD LEAD
TO A SERIOUS DISRUPTION IN THE
PUBLIC HEALTH SYSTEM, FOLLOWING
THE FIRST YEAR OF FUNDING FOR
THE FUTURE OF PUBLIC HEALTH FOR
FISCAL YEAR 20 2223,
APPROXIMATELY 66% OF LOCAL HIRES
WERE ALREADY MADE, SO A
REDUCTION IN FUNDING NOW COULD
SEVERELY DISRUPT THE PUBLIC
HEALTH WORKFORCE, AND LEAVE THE
STATE VULNERABLE TO ANOTHER
CRISIS AND STRUGGLING TO MEET
JUST BASELINE CURRENT PUBLIC
HEALTH NEEDS. THE LEGISLATURE IN
PARTICULAR, MAY CONSIDER LOOKING
TO OTHER AREAS OF THE BUDGET TO
PRESERVE THIS CORE SERVICE
FUNDING LEVEL, AND OUR OFFICE IS
AVAILABLE TO ASSIST IN
IDENTIFYING ALTERNATIVES. THANK
YOU, I THINK WE ALL STAND
CORRECTED HERE BECAUSE, YOU
KNOW, WE WERE THINKING ABOUT HOW
IS THIS GOING TO HELP PREPARE US
FOR THE FUTURE, BUT WHAT WE'RE
ASKING FOR IS TO ACTUALLY JUST
BE PREPARED FOR TODAY, SO ASK
THIS OF THE PREVIOUS PANEL AND
HOPEFULLY YOU ALL HAVE SOME
OTHER, ANSWERS AS TO THE THOUGHT
PROCESS WHEN YOU'RE AGAIN,
TAKING INTO CONSIDERATION WHERE
YOU'RE GOING TO CUT, REDUCE,
ELIMINATE WHAT THAT WOULD MEAN.
SO, WHAT IS THE ASSESSMENT THAT
YOU ALL HAVE, IN TERMS OF THE
CONSEQUENCES OF ELIMINATING THIS
FUNDING ON THE STATE'S
PREPAREDNESS TO DEAL WITH
CURRENT ISSUES AND POTENTIALLY
FUTURE, PUBLIC HEALTH THREATS
LIKE OUR NEXT PANDEMIC. SO WHEN
YOU WERE AT YOUR TABLE DECIDING
WHO YOU KNOW, WHAT YOU WERE
GOING TO CUT, WHAT WHAT IS WHAT
ARE WE GOING TO DO? BECAUSE I'M
SURE YOU ALL THOUGHT ABOUT IT.
LIKE YOU HAD TO THINK ABOUT THAT
WHEN YOU MADE THIS DECISION. SO
HOW WHAT ARE YOU WHAT ARE YOUR
PROPOSALS ON HOW WE DEAL WITH
WHAT IS CURRENTLY HERE? AS
DOCTOR WOODS SAID AND WHAT IS
UNFORTUNATELY GOING TO COME JUST
GIVEN THE WAY THE WORLD MOVES
TODAY. OKAY. SO CLEARLY THAT
WASN'T THOUGHT, THE GOVERNOR
CAME OUT WITH, THE SMARTER PLAN,
WHEN WE WERE SUPPOSEDLY COMING
OUT OF COVID, HOW DOES THIS
PROPOSAL ALIGN WITH HIS SMARTER
PLAN? A LITTLE BIT OF A
DIFFERENT FUNDING STREAM, IF YOU
WILL. A LOT OF THIS WAS A LOT OF
THE 300 MILLION THAT WE'VE BEEN
TALKING ABOUT WAS TO FOCUS ON
AREAS WHERE WE DIDN'T HAVE
FUNDING AND KIND OF BUILDING UP
THAT CAPACITY, ETC, THAT WE JUST
KIND OF TALKED ABOUT, THE
SMARTER PLAN WAS REALLY
ADDRESSED WITH COVID. RESOURCES
THAT WERE PROVIDED TO THE
DEPARTMENT. I THINK SOME OF THE,
FUNDING THAT WE RECEIVED IS, FOR
THE MOST PART, GONE IN 23, 24, I
THINK WAS SOME REVERSION ITEMS
THERE. BUT WE DID HAVE SOME
FUNDING FOR, SAPPHIRE AND OTHER
SYSTEMS THAT WERE ONGOING. AND
SO, SO SOME OF THOSE RESOURCES
FOR PARTICULAR COVID AND OTHER
EMERGENCY RESPONSE PREPAREDNESS
ARE STILL THERE, FUNDED THROUGH
KIND OF A COVID FUNDING STREAM.
YEAH. BUT I THINK ONE OF THE
FOUNDATIONS OF THE SMARTER PLAN
WAS TO ENSURE THAT WE ARE
PREPARED FOR THINGS IN THE
FUTURE, AND SO, YOU KNOW,
UNDERSTANDING, HOPEFULLY, YOU
KNOW, COVID IS STILL AROUND, BUT
THE NEXT THING WILL COME. AND SO
, YOU KNOW, AS A PROVIDER, I WAS
ACTUALLY IMPRESSED WHEN HE CAME
OUT WITH THIS BECAUSE IT'S NOT
JUST FOCUSED ON COVID. IT'S A
RECOGNITION THAT WE AS A STATE
NEED TO BE PREPARED FOR WHAT
WE'RE DEALING WITH TODAY, BUT
ALSO FOR THE NEXT PANDEMIC. AND
SO HOW ARE THESE CUTS HELPING
PREPARE US FOR THE NEXT
PANDEMIC? AND THE ONE AFTER THAT
AND THE ONE AFTER THAT? YEAH, I
THINK THIS THIS FUNDING IS, IS
USED. AND OBVIOUSLY WE'LL HAVE
CONVERSATIONS AS WE GO THROUGH
THE BUDGET PROCESS ON KIND OF
WHERE WE ULTIMATELY MAKE
REDUCTIONS, I THINK THIS WOULD
HAVE KIND OF AUGMENTED SOME OF
THOSE EFFORTS, PARTICULARLY IN
WHERE WE, PUT FUNDING RESOURCES
RELATED TO KIND OF ENHANCING
SOME OF OUR EMERGENCY
PREPAREDNESS IN OUR REGIONAL
PUBLIC HEALTH OFFICE. WE
ESTABLISHED A REGIONAL PUBLIC
HEALTH OFFICE WITH THESE FUNDS
THAT HELP KIND OF BUILD THOSE
RELATIONSHIPS BETWEEN US AND THE
LOCAL HEALTH JURISDICTIONS, AND
PARTICULARLY ON COMMUNICATIONS.
SO IT'S CLEAR THAT SOME OF THIS
WOULD HAVE GONE TO ENHANCE THOSE
EFFORTS, AND JUST I KNOW DOCTOR
WOOD ASKED ABOUT THIS BEFORE,
BUT I JUST WANT TO MAKE SURE
THAT I WAS THAT I UNDERSTAND. SO
THE POSITIONS THAT HAVE BEEN
HIRED BASED ON THIS FUNDING, NOW
THAT THE PROPOSAL IS TO
ELIMINATE THE FUNDING, WHAT IS
HAPPENING WITH THOSE POSITIONS?
WHERE WHERE IS THE MONEY GOING
TO GO COME FROM TO CONTINUE TO
FUND THOSE POSITIONS? I CAN SAY
AT THE STATE LEVEL THAT WE'RE,
YOU KNOW, IT'S DEFINITELY
SOMETHING THAT WE'RE GOING TO
HAVE TO LOOK AT. WE DO HAVE
VACANCIES IN OTHER AREAS OF THE
DEPARTMENT. WE HAVE ABOUT 5000
POSITIONS DEPARTMENT WIDE. THIS
IS ROUGHLY 400 OF THOSE
POSITIONS AND ABOUT 80% OF THOSE
ROUGHLY ARE FILLED. SO 320 OR SO
POSITIONS ARE FILLED. SO WE'LL
DEFINITELY BE NEEDING TO LOOK AT
OPPORTUNITIES TO TRANSFER FOLKS
INTO MAYBE SOME OTHER AREAS OF
THE DEPARTMENT. WE ALSO HAVE
SOME OTHER FEDERAL FUNDS THAT WE
MAY LOOK AT HOW WE'RE
PRIORITIZING THOSE FEDERAL FUNDS
AND BE ABLE TO UTILIZE AND PAY
FOR SOME OF THESE RESOURCES WITH
THOSE FEDERAL DOLLARS AS WELL.
STILL, KIND OF EARLY ON, BUT
THOSE ARE SOME OF THE IMMEDIATE
LOW HANGING FRUIT TYPE THINGS
WE'RE LOOKING AT. OKAY. SO YOU
SO YOU HAVE VACANCIES AND OTHER
AREAS OF. SO WE COULDN'T TAKE
SOME OF THOSE VACANCIES AND KEEP
THESE CURRENT POSITIONS. SINCE
YOU DON'T HAVE PEOPLE WORKING.
YEAH. AND I THINK REALLY IT'S
YOU KNOW WE HAVE A LOT OF
DIFFERENT CENTERS, DIVISIONS AND
OFFICES, A LOT OF DIFFERENT
PROGRAMS. RIGHT AND SO IT'S NOT
REALLY THAT'S GOING TO BE PART
OF THE CHALLENGE HERE IS IT'S
NOT ALSO A 1 TO 1 KIND OF MATCH.
WE HAVE A LOT OF PEOPLE, FOR
INSTANCE, 1200 OR SO IN OUR
CENTER FOR HEALTH CARE QUALITY.
MOST OF THOSE ARE HEALTH
FACILITY EVALUATOR NURSES.
THAT'S NOT GOING TO BE A CLEAN
FIT TO MOVE FOLKS OVER INTO A
NURSE EVALUATOR POSITION. SO
WE'RE GOING TO HAVE TO LOOK AT
SOME OF THE GENERAL
CLASSIFICATIONS. LOOK AT, AGAIN,
SOME OF THE FEDERAL FUNDING THAT
WE MIGHT BE ABLE TO USE TO
BACKFILL SOME OF THESE. LIKE
WE'RE TALKING ABOUT WITH THE
FEDERAL SYSTEMS LIKE CALCONNECT,
ETC. BUT WE'RE STILL KIND OF
EARLY ON ON HOW THE SHUFFLING IS
GOING TO WORK. YEAH. I GUESS IF
YOU HAVE A VACANCY IN ONE AREA,
LET'S SAY YOU HAVE, YOU KNOW,
100 SLOTS AND ONLY 50 OF THOSE
ARE FILLED. RIGHT? YOU JUST TAKE
THOSE 50 OTHER SLOTS AND SAY,
OKAY, WE'RE GOING TO TAKE THESE
AND WE'RE GOING TO MAKE THIS ONE
WHOLE OVER HERE. YOU COULDN'T
SHIFTING LIKE OVER TO THIS.
YEAH, IT'S DIFFICULT BECAUSE
AGAIN, BEING THIS WAS A GENERAL
FUND. RIGHT. WHICH PROVIDED US
FLEXIBILITY TO DO THE THINGS
THAT YOU'RE MENTIONING. SOME OF
THESE SLOTS MAY BE FUNDED WITH
SPECIAL FUNDS THAT HAVE VERY
SPECIFIC PURPOSES BEHIND HOW
THOSE SPECIAL FUNDS ARE USED.
AND SO BY STATUTE, WE CAN'T
REALLY USE IT TO BACKFILL THESE
POSITIONS FOR THE MOST PART.
THERE MAY BE, AGAIN, SOME
GENERALIST CLASSIFICATIONS THAT
IT MIGHT FIT TO MOVE PEOPLE
INTO. BUT, BUT IT WON'T BE A 1
TO 1. OKAY, AGAIN, I THINK WE
ARE COMPLETELY OFF WITH THIS
ONE. I, WE IF WE START TO GO
BACKWARDS, AND REVERT BACK TO
THE INITIAL FUNDING THAT WE HAD,
WHICH WAS CLEARLY INADEQUATE,
AS, DOCTOR WOOD POINTED OUT, BUT
ALSO THE LÀ POINTED OUT, WE WILL
BE PUTTING THE RESIDENTS AT IN
CALIFORNIA AT SIGNIFICANT RISK
IN TERMS OF THE NEXT PUBLIC
HEALTH CRISIS. AND IF WE'RE
LOOKING AT FINANCE FROM A
FINANCIAL STANDPOINT, AT THE
COST, WHEN THE NEXT BIG VIRUS OR
WHATEVER HITS IS GOING TO BE
ASTRONOMICAL, TO TRY TO GET US
BACK TO THAT POINT, IN ADDITION
TO TREATING AND CARING FOR ALL
OF THE INDIVIDUALS THAT WE COULD
HAVE PREVENTED FROM GETTING
WHATEVER THE NEXT VIRUS IS. SO,
YOU KNOW, WHEN YOU GO BACK AND
YOU, YOU REEVALUATE THIS
PROPOSAL AGAIN, I THINK YOU
SHOULD NOT ONLY THINK ABOUT, YOU
KNOW, THE LIVES OF THE PEOPLE
THAT YOU WOULD BE IMPACTING,
WHETHER IT'S JOBS OR, YOU KNOW,
A PUBLIC CREATING ANOTHER MAJOR
PUBLIC HEALTH CRISIS UP AND DOWN
THE STATE, BUT ALSO JUST THE
AMOUNT OF MONEY THAT WE WOULD
HAVE TO SPEND URGENTLY, WHEN
THAT NEXT PANDEMIC COMES. YEAH.
OKAY. JUST, JUST ONE MORE
COMMENT, BECAUSE THIS IS THIS IS
MONEY. THAT'S MEANT TO GET THESE
PUBLIC HEALTH DEPARTMENTS BACK
TO BASELINE, JUST FUNCTIONAL,
ESSENTIALLY, THEY'RE JUST A LOT
OF EMERGING PUBLIC HEALTH,
DISEASE, DISEASES IN THIS STATE
THAT, THAT CONSTANTLY NEED TO
HAVE SURVEILLANCE. AND SO
WITHOUT EVEN THE BASIC LEVEL OF
FUNDING TO NOT KNOW WHAT'S GOING
ON IN A COMMUNITY AND BE ABLE TO
TRACK THAT AND PROTECT RESIDENTS
, THE AMOUNT OF MONEY THAT
POTENTIALLY IS SPENT ON THE
TREATMENT FOR THESE CONDITIONS
THAT MAY LEAD EVEN TO MORBIDITY
OR, YOU KNOW, PEOPLE MAY DIE.
THIS IS ALMOST, IN MY MIND, KIND
OF A POSTER CHILD FOR PREVENTION
AND NOT AND NOT SPENDING MONEY
IN A PREVENTION. THIS IS BASIC
DISEASE SURVEILLANCE, AND TO
THINK THAT, YOU KNOW, WE WANT TO
REPEAT HISTORY AND, AND NOT BE
READY FOR THE NEXT, THE NEXT OR
EVEN THE CURRENT EMERGING
CHALLENGES. THE RISE OF STDS IN
THIS STATE IS ALARMING. IT'S
ABSOLUTELY ALARMING. AND THOSE
LEAD TO SIGNIFICANT MEDICAL
COSTS, AND THERE ARE OFTEN
PEOPLE WHO DON'T ACCESS MEDICAL
CARE UNTIL IT'S MUCH LATER IN
THE PROCESS. SO, YOU KNOW, THIS
THIS WHOLE CONCEPT, I HATE THIS
PHRASE I KEEP USING, BUT IT'S
PENNY. PENNY WISE AND POUND
FOOLISH. IT JUST DOESN'T MAKE IT
DOESN'T MAKE SENSE. AND SO, I'M
SORRY TO BE SO ANIMATED ANIMATED
ABOUT THIS, BUT THIS IS
FUNDAMENTAL, BASIC STUFF.
BASELINE BASELINE FUNDING TO
PROTECT PEOPLE IN THE PUBLIC, TO
LET THEM KNOW WHEN THERE'S BEEN
AN EXPOSURE OF SOMETHING. THANK
YOU, MADAM CHAIR. THANK YOU. DID
YOU HAVE ANYTHING ELSE TO
PRESENT? THERE ARE A FEW MORE
ITEMS HERE IF YOU WANT ME TO RUN
THROUGH THOSE, SO OUR NEXT ITEM
IS, IS ITEM 250 AND ELIMINATION
OF THE OFFICE OF ORAL HEALTH,
GENERAL FUND BACKFILL AT
GOVERNOR'S BUDGET, WE HAD A
BACKFILL OF $4.6 MILLION, TO
MAKE UP SOME OF THE DIFFERENCE
IN, IN FUNDING SHORTAGES AND
PROP 56, THAT WAS A ONE TIME
REDUCTION AT THE TIME OR SORRY,
ONE TIME BACKFILL AT THE TIME,
THE MAY REVISION PROPOSES TO
ELIMINATE THAT PARTICULAR
GENERAL FUND BACKFILL AND JUST
LIVE WITHIN THE PROP 56, FUNDING
THAT'S PROVIDED. SO IT'S AN
ELIMINATION AND NOT A REDUCTION.
IT IS A REDUCTION, BECAUSE THERE
IS STILL ROUGHLY 24 OR SO
MILLION DOLLARS LEFT FROM THE
PROP 56 ORAL HEALTH FUNDING
THAT'S PROVIDED. THIS IS
ELIMINATE OFFICE OF ORAL HEALTH
GENERAL FUND BACKFILL. SO YOU
HAVE BACKFILL. WE DO SO TO GET
US IN I DON'T KNOW IF YOU WANT
TO GET US TO I MAY GET THIS
WRONG, BUT TO GET US TO THE 30
MILLION THAT IS REQUIRED IN
PROPERTY, SIX TO, THERE WAS
ABOUT THE PROPERTY SIX SHORTAGE.
SO DEPARTMENT OF FINANCE AT THE
TIME PROVIDED AN ADDITIONAL 4.6
MILLION TO GET US WHOLE
ESSENTIALLY THAT IS WHAT IS
COMING OUT. SO IT IS IT'S A
REDUCTION, NOT A FULL
ELIMINATION OF THE PROGRAM. I
DON'T KNOW. NO, NO, NO. BUT THE
BACKFILL FOR THE BACKFILL ITSELF
IS BEING ELIMINATED. THAT WAS
PROPOSED AT GOVERNOR'S BUDGET IS
BEING ELIMINATED. RIGHT. SO
THAT'S MY QUESTION. IT'S NOT
REDUCING THE AMOUNT OF BACKFILL.
IT'S ELIMINATING Ó. SORRY. IT'S
ELIMINATING THE BACKFILL THAT
WAS PROPOSED. YES. SORRY I
THOUGHT I SIMILAR TO PREVIOUS
QUESTIONS, I THOUGHT YOU'RE
ASKING IF IT ELIMINATED THE
PROGRAM. NO. IN TOTAL NO
APOLOGIES. YEAH. SO THAT'S A
PERMANENT ELIMINATION OF THE
BACKFILL FUNDING. I'LL DEFER TO
FINANCE DEPARTMENT OF FINANCE.
THAT'S CORRECT. SO I GUESS ORAL
HEALTH ISN'T VERY IMPORTANT
EITHER. SO OKAY. OKAY, ITEM 251,
THERE'S A REVERSION OF A COUPLE
OF DIFFERENT GENERAL FUND
APPROPRIATIONS OF 5 MILLION IN
THE CURRENT YEAR, THESE COME
FROM TWO AREAS, THE FIRST IS A
REDUCTION, OF ROUGHLY 2.5
MILLION FROM THE ALZHEIMER'S
DISEASE INITIATIVE. BACK IN
2223, WE RECEIVED $10 MILLION
THAT WAS AVAILABLE TO US THROUGH
2526, I BELIEVE IT WAS, IN ANY
EVENT, OF THAT AMOUNT, 2.5
MILLION IS BEING, SET FOR
REVERSION IN CURRENT YEAR, AND
THEN ANOTHER 2.5 MILLION, IS
BEING PROPOSED, FROM THE, THAT
WAS SUPPORTING THE LESBIAN,
BISEXUAL, TRANSGENDER AND QUEER
HEALTH EQUITY INITIATIVE, OF
WHICH WE RECEIVED SOME FUNDING
IN 22 AND 23 AS WELL. AND SO
THIS IS A REVERSION OF SOME OF
THOSE FUNDS, THE NEXT ISSUE IS
THE CHILDREN AND YOUTH
BEHAVIORAL INITIATIVE, THE
SPECIFICALLY THE REVERSION OF
THE PUBLIC OR THE REVERSION AND
REDUCTION OF THE PUBLIC
EDUCATION AND CHANGE CAMPAIGN.
THERE'S A PROPOSED $28.8 MILLION
REDUCTION, OR SORRY, REVERSION
THAT'S OCCURRING IN 23, 24 AND
THEN 40 MILLION IN THE 2425
FISCAL YEAR AND 5,000,000 IN 25,
26. THIS WAS IN TOTAL, CAME FROM
A POOL OF $100 MILLION THAT WAS
PROVIDED TO US IN 22, 23, FOR AN
EDUCATION CAMPAIGN, THAT THAT
THE DEPARTMENT OF PUBLIC HEALTH
WAS LEADING. NUMBER, ISSUE
NUMBER 255, IS A REDUCTION AN
ONGOING REDUCTION IN THE CLIMATE
AND HEALTH SURVEILLANCE PROGRAM,
WE ORIGINALLY RECEIVED
10,000,000 IN 2223 FOR A CLIMATE
, CHANGE IN HEALTH SURVEILLANCE,
PROGRAM, THIS WOULD ELIMINATE
3.1 MILLION OF THAT FUNDING
ONGOING, BEGINNING IN 24, 25. SO
USE OF THE 10 MILLION OF THE 10
MILLION. OKAY. ISSUE 256, IS
AGAIN, THE CHILDREN AND YOUTH
BEHAVIORAL HEALTH INITIATIVE,
THE YOUTH SUICIDE REPORTING AND
CRISIS RESPONSE PILOT, THIS WAS
SOME LIMITED TERM FUNDING THAT
WE HAD RECEIVED, OF WHICH
THERE'S A $13.5 MILLION
REDUCTION. THAT'S GOING TO BE
TAKEN IN THE CURRENT YEAR. AND A
$1.5 MILLION ONE TIME OR ONE
TIME REDUCTION IN THE BUDGET
YEAR, AND THIS ESSENTIALLY WAS
GOING TO BE USED FOR, SOME OF
THE SYSTEMS TO COLLECT SOME OF
THE DATA THAT ULTIMATELY WE KIND
OF DETERMINED THAT THOSE WEREN'T
THE RIGHT SYSTEMS TO BE ABLE TO
COLLECT, SUICIDE INFORMATION
FROM. SO, THIS WAS ULTIMATELY
DECIDED TO REVERT THIS, AND THE
NEXT ISSUE IS A REVERSION OF
SOME OF OUR COVID 19, FUNDS,
AGAIN, THAT HAVE BEEN PROVIDED
SINCE THE START OF THE PANDEMIC.
WE'VE IDENTIFIED THESE FUNDS,
ROUGHLY 15 MILLION THAT WON'T BE
OBLIGATED THROUGH CONTRACTS OR
OTHER ITEMS, SAME IS SIMILAR FOR
THE ISSUE IN NUMBER 258, THE
MPOX REVERSION. AGAIN, SOME
FUNDING THAT WAS PROVIDED TO US
FOR THAT RESPONSE THAT THAT
WON'T BE USED FOR DIFFERENT
CONTRACTS, ETC, SO WAS ABLE TO
BE REVERTED IN THE CURRENT YEAR
AND THEN, FINALLY THE LAST
COUPLE ITEMS WE TOUCHED ON
BRIEFLY AT THE TOP ABOUT THE
FUTURE PUBLIC HEALTH FUNDING,
THE FIRST ONE IS RELATED TO BOTH
A REVERSION OF SOME MAINTENANCE.
WE RECEIVED SOME MAINTENANCE AND
OPERATIONS DOLLARS FOR THE COVID
SYSTEMS THAT WERE STOOD UP
DURING THE TIME, THERE'S A,
REVERSION OF SOME OF THAT
FUNDING OF 3.8 MILLION IN THE
CURRENT YEAR AND THEN IN 25
BEGINNING IN 25, 26 AND ONGOING,
THERE'S AN ONGOING REDUCTION OF
6.9 MILLION FOR THAT. AND WHAT'S
THE TOTAL IN THAT FUND? I
BELIEVE THAT IS 6.9 MILLION OF,
I WANT TO SAY TEN, BUT. I CAN
GET THAT NUMBER FOR YOU. IT'S UP
61.8 MILLION 61.8. OKAY. THANK
YOU. AND THEN THE AGAIN, THE
LAST ISSUE THAT WE TOUCHED ON
WAS SOME FUNDING THAT WAS
PROVIDED FOR, THE INFORMATION
TECHNOLOGY 21ST CENTURY PROJECT
FOR IT AND DATA, INFORMATICS
KIND OF UPGRADING SOME OF OUR
SYSTEMS. SORRY, THAT WAS THE $10
MILLION REDUCTION, THAT WAS
HAPPENING BEGINNING AGAIN IN 25,
26. SO IT PROVIDES A LITTLE TIME
TO PLAN FOR KIND OF HOW THAT
REDUCTION WILL ROLL OUT. SO IT'S
A REDUCTION OF 10 MILLION. 10
MILLION. YES. ANNUALLY YES. OUT
OF HOW MUCH? OUT OF 18 MILLION
ANNUALLY, I'M SORRY, OUT OF 18
MILLION ANNUALLY. THANK YOU. SO
WHAT WILL BE LEFT IS 8 MILLION,
CORRECT? YES. AND THEN THE LAST
ISSUE, SIMILAR TO, GOVERNOR'S
BUDGET, WE HAD A PROPOSAL TO DO
A LOAN SHIFT FROM ONE OF OUR
SPECIAL FUNDS, WE'VE IDENTIFIED
OR. SORRY, NOT A LOAN SHIFT. A
LOAN FROM, SOME OF OUR SPECIAL
FUNDS, IN THIS CASE, WE'VE
IDENTIFIED, TEN DIFFERENT
SPECIAL FUNDS TOTALING $140
MILLION, WHERE WE'LL DO SIMILAR,
FUND SHIFTS TO HELP, PROVIDE
SOME CASH FLOW TO THE GENERAL
FUND, THAT WOULD BE PROPOSED TO
BE TAKEN IN 24, 25 AND THEN
ULTIMATELY REPAID IN THE 2627
FISCAL YEAR. I WON'T GO THROUGH
ALL THE FUNDS, BUT THE LARGEST
OF THE FUNDS, ROUGHLY HALF OF IT
IS COMING FROM OUR, CENTER FOR
HEALTH CARE QUALITY, OUR SKILLED
NURSING FACILITY FUND ROUGHLY 70
MILLION. THERE'S SUFFICIENT
RESERVES IN THAT FUND. WE
ANTICIPATE THERE WON'T BE
PROGRAMMATIC IMPACTS TO, TO
THESE, BUT WE WILL, OF COURSE,
BE WATCHING, THE REVENUES INTO
THE FUND CLOSELY AND WORKING
WITH DEPARTMENT OF FINANCE. AND
IF THERE ARE NEEDS FOR REPAYMENT
. OKAY. THANK YOU. AND BEFORE WE
GO TO PUBLIC COMMENT, JUST
BECAUSE I MISSED THIS PART. SO
FOR, THE ELIMINATION OF STATE
AND PUBLIC HEALTH FUNDING, IS
THAT A COMPLETE ELIMINATION? SO
YOU'RE TAKING THAT 100 MILLION
AND IT'S ONLY 100 MILLION
ALLOCATED, 100 MILLION ALLOCATED
FOR STATE OPERATIONS AND 200 FOR
LOCAL ASSISTANCE. OKAY. SO IT'S
NOT A REDUCTION IN THE CATEGORY.
IT'S AN ELIMINATION. OKAY. WE
WILL NOW OPEN IT UP FOR PUBLIC
COMMENT. YOU HAVE ONE MINUTE.
THANK YOU. SORRY THANK YOU,
MADAM CHAIR AND COMMITTEE
MEMBERS, MY NAME IS BRANDON
TATE. I'M HERE REPRESENTING THE
YOUTH MENTAL HEALTH EQUITY
COALITION. I WANTED TO SPEAK TO
ITEMS 252 AND 253, THESE ARE
BOTH FUNDED FROM THE OFFICE OF
HEALTH EQUITY. AND WHAT WASN'T
SAID, IT SAYS THAT IT WAS A
REDUCTION, BUT THESE ACTUALLY
REPRESENT $76 MILLION CUT,
ENDING JUNE 30TH OF THIS YEAR.
THEREFORE, ALL THE PROGRAMS ARE
REALLY IN ELIMINATION AS THE WAY
I WOULD CATEGORIZE THIS. SO THIS
IS REPRESENTING, 28 DIFFERENT
CBOS THAT WERE FUNDED FOR LOCAL
COMMUNITY PROGRAMS AND OUTREACH,
AS WELL AS A STATEWIDE CAMPAIGN
TARGETING LGBT YOUTH, BLACK
YOUTH, LATINO YOUTH AND NATIVE
YOUTH. THIS IS PART OF THE
STATE'S COMMITMENT TO PREVENTION
SERVICES. YOU HAVE OUR
INFORMATION HERE, AND WE WILL BE
GOING AROUND TO TALK TO YOU
ABOUT THIS. THIS IS AN URGENT
ISSUE FOR THE LGBT CAUCUS.
LATINO CAUCUS, AND OUR
COALITION. I'M JOINED TODAY BY
MEMBERS OF OUR COALITION, AND
THERE ARE SEVERAL YOUTH AND
THEIR PARENTS WHO CAME UP TODAY
TO SPEAK TO YOU ABOUT HOW
IMPORTANT THIS ISSUE IS. WE DO
NOT WANT THESE SERVICES
ELIMINATED AND WE REALLY
APPRECIATE IF YOU COULD, SUPPORT
RESTORING FUNDING TO THE OFFICE
OF HEALTH EQUITY. THANK YOU.
GOOD AFTERNOON. MICHELLE GIBBONS
WITH THE COUNTY HEALTH
EXECUTIVES ASSOCIATION OF
CALIFORNIA. WE REPRESENT LOCAL
HEALTH DEPARTMENTS ACROSS THE
STATE WHO ARE DEVASTATED BY
THESE PROPOSED CUTS, I WILL JUST
SAY THAT, WE'RE ASKING FOR THE
LEGISLATURE TO REJECT THE 200
MILLION ELIMINATION OR THE FULL
PUBLIC HEALTH FUNDING. YOU'RE
RIGHT. IT IS A FULL ELIMINATION
OF THE TOTAL AMOUNT OF FUNDING
THAT WAS DEDICATED. I WANT TO
THANK YOU ALL FOR THE VERY GOOD
QUESTIONS THAT YOU RAISED AND
THE CONCERNS THAT YOU RAISED
AROUND OUR PREPAREDNESS TODAY. I
WANT TO THANK THE LAO FOR
MENTIONING THAT THIS IS A CORE
SERVICE FOR CALIFORNIANS,
WHETHER THEY KNOW IT OR NOT,
BECAUSE MUCH OF THE WORK OF
PUBLIC HEALTH IS INVISIBLE. LET
ME ANSWER YOUR QUESTIONS
PLAINLY. PUBLIC HEALTH
PREPAREDNESS RELIES ON WORKFORCE
, AND WE WILL BE 900 POSITIONS
LESS PREPARED FOR THE NEXT
PANDEMIC. THESE DOLLARS HAVE
ALREADY HELPED OUR COMMUNITY.
THESE ARE COMMUNITY OUTBREAK
TEAMS IN LOS ANGELES THAT'S
RESPONDING TO HEPATITIS A RIGHT
NOW. THESE ARE PUBLIC HEALTH
NURSES THAT RESPONDED TO AND
CONTAIN DENGUE IN LOS ANGELES.
THESE ARE WORKERS CONDUCTING
DISEASE INVESTIGATIONS AS A
RESULT OF THE RECENT MEASLES
CASES IDENTIFIED IN CALIFORNIA.
THERE'S NO ABSORBING THESE CUTS.
THERE'S NO FLEXIBILITY IN
FEDERAL DOLLARS TO ALLOW US TO
SURGE FOR VARIOUS ISSUES.
FEDERAL DOLLARS ARE VERY DISEASE
SPECIFIC. WE COULDN'T EVEN USE
COVID DOLLARS TO ADDRESS M-POX
WHEN IT HAPPENED. THERE'S NO
STATUS QUO ON BASELINE FUNDING
BECAUSE LOCAL HEALTH DEPARTMENTS
DON'T HAVE BASELINE FUNDING.
IT'S VERY DISEASE SPECIFIC.
THANK YOU. THANK YOU. DOCTOR
WEBER, AND MEMBERS BRUCE PALMER
WITH THE CALIFORNIA ASSOCIATION
OF PUBLIC HEALTH LAB DIRECTORS,
WE ARE THE 28 LOCAL PUBLIC
HEALTH LABS AROUND THE STATE
THAT DO THE SURVEILLANCE, THE
TESTING THAT HELPS TO TRACK AND
REDUCE DISEASE. WHEN WE HAVE
LESS STAFF, IT TAKES MORE TIME.
IF IT TAKES MORE TIME, IT MEANS
MORE SICKNESS AND IT MEANS MORE
DEATH. NOW I JUST WANT ONE WANT
TO MAKE ONE COMMENT? IN 1973,
THE STATE DEPARTMENT OF PUBLIC
HEALTH WAS ELIMINATED. IT WAS
REESTABLISHED IN 2006 WITH A
BILL BY THEN SENATE HEALTH
CHAIR, DEBORAH ORTIZ. THERE WAS
A REASON FOR THAT. WE HAD BEEN
IN A DECADE LONG BATTLE THAT YOU
ALL VERY, YOU ALL UNDERSTAND A
DECADE LONG BATTLE THROUGH
RECESSIONS. PROP 13, CHANGES IN
ADMINISTRATIONS TO RESTORE
PUBLIC HEALTH. WE FINALLY, YOU
GUYS FINALLY DID IT LAST YEAR.
WE HAD TO WAIT, IF YOU REMEMBER
AN EXTRA YEAR TO GET THAT MONEY
IN THERE. BUT WE FINALLY DID IT.
THANKS TO YOUR LEADERSHIP LAST
YEAR. WE GOT TO THE TOP OF THE
HILL. NOW WE'RE GOING TO GET
KNOCKED DOWN AGAIN. MAN THANK
YOU. GOOD AFTERNOON. MY NAME IS
MELISSA LAMATTINA AND I'M A
PROUD MEMBER OF SEIU 10 TO 1
NAPA COUNTY. I'VE BEEN A SOCIAL
WORKER WITH NAPA COUNTY FOR TEN
YEARS WITH THE IN-HOME
SUPPORTIVE SERVICE PROGRAM, WHO
MY CLIENTS ARE THE MOST
VULNERABLE AND MEDICALLY
FRAGILE, WHO ALREADY HAVE
BARRIERS TO ACCESSING MEDICAL
SERVICES, ESPECIALLY BEHAVIORAL
HEALTH. AS YOU MAY OR MAY NOT
KNOW, WE HAVE A HUGE POPULATION
OF BABY BOOMERS. WHAT ARE WE
SUPPOSED TO DO WITH THEM? MY
CASELOAD HAS RISEN SO MUCH IN
THE LAST EIGHT YEARS. I CAN NO,
I CAN NO LONGER MANAGE IT TIMELY
BECAUSE WE'RE TOLD THERE'S NO
FUNDING FOR MORE SOCIAL WORKERS.
SO ARE WE JUST SUPPOSED TO LET
OUR FOLKS JUST ROT AT HOME AND
DIE? WHAT ARE WE DOING?
CALIFORNIA, STOP BEING A
BAND-AID NATION AND BE MORE
PROACTIVE AND FIX THIS PROBLEM.
THERE'S FUNDING. MAKE IT WORK.
THANK YOU. THANK YOU. GOOD
MORNING. MY NAME IS PATRICK
MULCAHY, AND I'M HERE FROM NAPA
COUNTY REPRESENTING SEIU 10 TO
1, IT SEEMS LIKE WE HAVE VERY
BAD MEMORIES BECAUSE WE JUST GOT
THROUGH THIS PANDEMIC, AND NOW
WE'RE TALKING ABOUT ELIMINATING
FUNDS. THE WRONG PLACE TO BE
CUTTING. WE NEED TO RESTORE
THESE FUNDS. THANK YOU. THANK
YOU. GOOD AFTERNOON, ESTEEMED
MEMBERS OF THE COMMITTEE. MY
NAME IS KEVIN GODWIN. I'M A
FORENSIC LICENSED MENTAL HEALTH
COUNSELOR WITH NAPA COUNTY
BEHAVIORAL HEALTH, I'M PART OF,
NAPA COUNTY, 10 TO 1 SEIU, AND
I'M HERE TO UNDERSCORE, THE VERY
POINT ABOUT CUTTING CARE TO THE
MOST VULNERABLE IN OUR
POPULATION SINCE THE COVID
PANDEMIC, WE'VE SEEN AN UPTICK
IN DEMAND FOR SERVICES, AND IT'S
OUTSTRIPPING OUR ABILITY TO
PROVIDE THOSE SERVICES. AND I
THINK IT'S INCUMBENT UPON PEOPLE
WHO, YOU KNOW, CARE ABOUT OTHER
PEOPLE'S LIVES, ESPECIALLY THOSE
THE VULNERABLE IN OUR
COMMUNITIES, TO RECONSIDER, THIS
, THIS, ELIMINATION OF FUNDS. SO
I IMPLORE YOU. THANK YOU. THANK
YOU. HELLO. MY NAME IS MOYAMOYA
WRIGHT. I'M THE VICE PRESIDENT
OF SEIU LOCAL 721. I'M ALSO A
MEMBER OF SEIU CALIFORNIA,
EXECUTIVE BOARD. I'M A VERY
PROUD CITY OF LOS ANGELES
EMPLOYEE. AND I UNDERSTAND JUST
HOW DIVERSE, DIVESTING AND
PROPOSALS AND CUTS LIKE THIS IN
PUBLIC HEALTH WILL HURT THE
PEOPLE THAT I SERVE. WE ALL SAW
THE CONSEQUENCES OF DECADES OF
DISINVESTMENT IN PUBLIC HEALTH
DURING THE OUTBREAK OF COVID 19.
DURING A PANDEMIC. AND, OF
COURSE, THE DISPROPORTIONATE
IMPACT IT HAD. OUR COMMUNITIES
OF COLOR AND CALIFORNIANS OF LOW
WAGE, INCOME HURT WORSE. WE NEED
A BUDGET THAT DOESN'T GAMBLE
WITH PUBLIC HEALTH. THAT MOVES
CALIFORNIA FORWARD, NOT
BACKWARDS, NOT NOTHING WE CAN DO
IS AS IMPORTANT OF STRENGTHENING
THE FUTURE OF US. US IN
CALIFORNIA. MADAM CHAIR MEMBERS,
WE ASK YOU TO REJECT THIS
ADMINISTRATIVE PROPOSAL. CUT OF
3 MILLION FOR THE FUTURE OF
PUBLIC HEALTH FUNDING. THE
FUTURE IS HERE NOW FOR PUBLIC
HEALTH. THANK YOU. GOOD
AFTERNOON AGAIN, CHAIR AND
MEMBERS, I WANT TO THANK YOU FOR
YOUR CRITICAL COMMENTS AND
QUESTIONS. AS, AS YOU HEARD JUST
NOW FROM SOME OF OUR SEIU, LOCAL
LEADERS AND ON BEHALF OF ALL
SEIU MEMBERS, JUST WANT TO
COMMENT ON HOW CONCERNING IS
PROPOSED LIKE THIS. RIGHT. IT'S
NOT JUST 900 OR 1000 JOBS, IT'S
THE IMPACT IT HAS TO ALL OF US,
BECAUSE EVERY SINGLE ONE OF US
GOES TO WORK EVERY DAY. SEND
YOUR CHILDREN TO SCHOOL BECAUSE
WE HAVE A PUBLIC HEALTH
INFRASTRUCTURE BEHIND US THAT
ARE KEEPING US HEALTHY AND SAFE
AND ABLE TO DO THOSE ACTIVITIES
OF DAILY LIVING, KEEP OUR
ECONOMY RUNNING, SO WITH THAT,
REALLY APPRECIATE THE REFERENCES
TO HOW CRITICAL THESE DOLLARS
ARE. THESE ARE CORE FUNDS, BASIC
SERVICES THAT ARE ABSOLUTELY
NEEDED TO NOT GET REPLICATED BY
OTHER FEDERAL DOLLARS, AGAIN,
THE FLEXIBILITY AND THE
STRUCTURE IS TRULY UNIQUE, NOT
DISEASE SPECIFIC. PROGRAM
SPECIFIC ALLOWED OUR LOCAL
JURISDICTIONS TO MAKE DECISIONS
THAT WERE RIGHT FOR THEIR
LOCALITY BASED ON WHAT THEIR
LOCAL PUBLIC HEALTH NEEDS ARE.
SO AS YOU MOVE FORWARD IN YOUR
DELIBERATIONS, REQUEST THAT YOU
REJECT THIS PROPOSAL. AND THANK
YOU FOR THE DIALOG TODAY. THANK
YOU. GOOD AFTERNOON, CHAIR
MEMBERS JESSICA MORAN WITH THE
CALIFORNIA DENTAL ASSOCIATION,
WE ARE DEEPLY CONCERNED WITH THE
ADMINISTRATION'S PROPOSAL TO
ELIMINATE THE CONTINUOUS
BACKFILL TO THE OFFICE OF ORAL
HEALTH. THE ELIMINATION OF THESE
FUNDS WILL NEGATIVELY IMPACT THE
OFFICE'S ABILITY TO OVERSEE THE
STATE ORAL HEALTH PLAN, AND WILL
ONLY BE COMPOUNDED BY THE OTHER
PUBLIC HEALTH CUTS THAT WE'RE
DISCUSSING HERE TODAY, ALSO JUST
WANT TO QUESTION THE CLAIM THAT
THE APPROPRIATION WAS MEANT TO
BE ONE TIME A PREVIOUS TRAILER
BILL LANGUAGE EXPLICITLY SAID
THE FUNDING WAS TO BE
CONTINUOUS. IT'S ALSO LISTED ON
TODAY'S AGENDA AS ONGOING VERSUS
ONE TIME, SO JUST ASKING THE
LEGISLATURE TO REJECT THIS
PROPOSAL. THANK YOU. THANK YOU,
NORA LIN. WITH CHILDREN NOW,
WE'D LIKE TO AFFILIATE OURSELVES
WITH THE COMMENTS OF CDA. THANK
YOU. GOOD AFTERNOON, MADAM CHAIR
AND MEMBERS. JOELY ONODERA WITH
THE CALIFORNIA STATE ASSOCIATION
OF COUNTIES, REPRESENTING ALL 58
COUNTIES. I'D LIKE TO ALIGN MY
COMMENTS WITH MISS GIBBONS FROM
CHIAC REGARDING THE REQUEST TO
REJECT THE PROPOSAL BY THE
GOVERNOR'S ADMINISTRATION TO
ELIMINATE THE FUNDING FOR FUTURE
OF PUBLIC HEALTH FUNDING. I VERY
MUCH APPRECIATE THE COMMITTEE
AND THE LIU'S COMMENTS AND WOULD
JUST ASK FOR CONSIDERATION OF
THE POTENTIALLY GREATER COSTS
AND FUTURE LONG TERM IMPACTS
ASSOCIATED WITH THE ELIMINATION
OF THIS FUNDING. THANK YOU.
THANK YOU. NICOLE WATERMAN, ON
BEHALF OF ORANGE COUNTY AND SAN
BERNARDINO COUNTY, ALSO IN
STRONG OPPOSITION TO THE PUBLIC
HEALTH REDUCTIONS, DURING A TIME
WHEN WE ARE STRUGGLING WITH
WORKFORCE AND INFRASTRUCTURE,
THIS IS A TERRIBLE BEALL CUT FOR
OUR COUNTIES TO HAVE TO BEAR.
THANK YOU. HI, I'M DANIELLE
JOHNSON, I'M KALIA. THIS IS
RELATED TO ISSUE 252 AND 253.
WE'RE FROM SAN FRANCISCO HERE
REPRESENTING THE YOUTH MENTAL
HEALTH ADVISORY BOARD IN WHICH
WE SERVE AS A TEENAGER. I KNOW
HOW HARD IT CAN BE TO NAVIGATE
THE UPS AND DOWNS OF HIGH
SCHOOL, SOCIAL MEDIA AND LIFE IN
GENERAL. THERE WERE MANY TIMES I
FELT OVERWHELMED AND LOST, AND
SOMETIMES IT FEELS LIKE NO ONE
UNDERSTANDS WHAT WE'RE GOING
THROUGH. BUT THE TRUTH IS, AS
MUCH AS IT FEELS THIS WAY, WE'RE
NOT ALONE. SO MANY OF US IS
STRUGGLING WITH MENTAL HEALTH
ISSUES LIKE DEPRESSION, ANXIETY
AND TRAUMA. WE KNOW THAT FOR US,
HAVING ACCESS TO MENTAL HEALTH
RESOURCES HAS MADE A HUGE
DIFFERENCE. IT'S HELPED US FIND
OUR WAY WHEN WE FELT LOST, AND
WE'VE LEARNED THAT IT'S OKAY TO
ASK FOR HELP AND SEEKING HELP.
IT'S A SIGN OF STRENGTH AND NOT
WEAKNESS. WE KNOW THAT NOT
EVERYONE HAS THE SAME ACCESS TO
RESOURCES THAT WE DO. THAT'S WHY
YOUTH MENTAL HEALTH PROGRAMS ARE
SO IMPORTANT. THEY PROVIDE A
SAFE SPACE FOR US TO OPEN UP AND
SHARE OUR STRUGGLES AND GET THE
SUPPORT WE NEED. SO LET'S KEEP
PUSHING FOR MORE MENTAL HEALTH
PROGRAMS IN OUR SCHOOLS AND
COMMUNITIES. LET'S CREATE A
WORLD WHERE IT'S OKAY TO NOT BE
OKAY. LET'S USE OUR VOICES TO
RAISE AWARENESS. THANK YOU.
THANK YOU. HELLO, MY NAME IS
ANGELA JOHNSON AND I'M. THIS IS
RELATED TO ISSUES 252 AND 253.
AS A MOTHER TO TWO TWIN TEENAGE
GIRLS, I CAN I SEE FIRSTHAND THE
EFFECTS THAT DAILY STRESS PLAYS
ON THEIR MENTAL HEALTH. MY
DAUGHTERS HAVE BEEN A PART OF
BUILDING THIS CAMPAIGN WITH THE
OFFICE OF HEALTH, EQUALITY, AND
THEIR AIM HAS BEEN TO ADDRESS
DAILY STRESSORS FOR YOUTH AND
HEALTHY WAYS TO MITIGATE THEM SO
THEY DON'T TURN INTO AN EVEN
BIGGER ISSUE. REMOVING FUNDS
FROM THIS CAMPAIGN WILL HAVE
ADVERSE EFFECT ON OUR COMMUNITY
AND ALL OF CALIFORNIA TEENS.
THIS IS WHY I'M HERE TO ASK YOU
NOT TO REDUCE THE FUNDING FOR
THESE VITAL PROGRAMS. THANK YOU.
THANK YOU. GOOD AFTERNOON. MY
NAME IS THERESA KENNEDY AND THIS
IS IN RELATION TO ITEMS 252 AND
253. I'M HERE TODAY TO SPEAK
ABOUT YOUTH MENTAL HEALTH BEYOND
JUST ADVOCATING, I SPEAK FROM
PERSONAL EXPERIENCE. HAVING
NAVIGATED THE COMPLEXITY OF
MENTAL HEALTH CHALLENGES
STEMMING FROM FAMILY DYNAMICS,
THERE IS AN URGENT NEED FOR
COMPREHENSIVE YOUTH MENTAL
PROGRAMS IN THE STATE OF
CALIFORNIA AND NATIONWIDE. I
HAVE CHOSEN TO LEND MY VOICE TO
THE ADVISORY BOARD OF THE OFFICE
OF HEALTH EQUITIES. CURRENT
CAMPAIGN BECAUSE AS A PARENT
DEEPLY IMMERSED IN BOTH
HOMESCHOOLING COMMUNITIES AND
STATEWIDE EDUCATIONAL
INITIATIVES, I HAVE WITNESSED
FIRSTHAND THE UNIQUE STRUGGLES
OUR YOUNG PEOPLE ENDURE AS A
CAREGIVER TO A TEENAGER MYSELF,
I INTIMATELY UNDERSTAND WHY
INITIATIVES LIKE THIS ARE VITAL
FOR OUR COMMUNITIES. THE IMPACT
OF COVID 19 COMPOUND BY A
PERSUASIVE INFLUENCE OF SOCIAL
MEDIA, HAS HEIGHTENED STRESS
LEVELS AMONG TODAY'S TEENS TO
UNPRECEDENTED LEVELS. IT IS
IMPERATIVE THAT WE EQUIP THEM
WITH THE TOOLS AND RESOURCES TO
NAVIGATE THIS DAILY STRESS
BEFORE IT ESCALATES INTO
SOMETHING MORE SERIOUS. THANK
YOU. THANK YOU. YA'AT'EH. MY
NAME IS CARLOS ARCHULETA. I USED
TO PLAY BASKETBALL AND I WAS
SUPPOSED TO GO PRO, BUT I WAS
SHOT AND LEFT WITH A DEAD LEG.
UNFORTUNATELY, THE GUNSHOT WOUND
THAT LEFT ME WITH A PERMANENT
LIMP WAS NOT THE WORST WOUND. IT
WAS THE MENTAL ASPECT OF THAT
WOUND THAT CREATED THE MOST
DAMAGE. LIKE MOST YOUTH WITH A
MAJOR INJURY, WE THINK ONCE THE
SCAR HEALS, EVERYTHING IS
HEALED. BUT THE REALITY IS MUCH
DIFFERENT. THIS FUNDING HELPS
THE MOST IMPORTANT WOUND MENTAL
WOUNDS WHERE THE MAJORITY OF
PEOPLE SHOT IN THE HOOD CONTINUE
TO SUFFER QUIETLY FOR YEARS
AFTER OFTEN SELF-MEDICATING
BECAUSE WE'RE TOO EMBARRASSED TO
ASK FOR MENTAL HEALTH HELP.
BECAUSE OF THE STIGMA THIS
FUNDING HELPS BUILD GROUPS TO
EDUCATE AND ADVOCATE FOR JUST
THAT ISSUE. WE'RE NOT ASKING FOR
EXTRA MONEY. WE'RE SIMPLY ASKING
THAT YOU DON'T TAKE THE MONEY
THAT HAS ALREADY BEEN BUDGETED
FOR THIS AND DO WHAT'S RIGHT FOR
THE ACTUAL COMMUNITY. RESTORE
FULL FUNDING FOR THE PUBLIC
HEALTH OFFICE OF HEALTH EQUITY,
CHILDREN AND YOUTH BEHAVIOR
HEALTH INITIATIVE. THANK YOU FOR
LISTENING. THANK YOU. THANK YOU,
MADAM CHAIR. MEMBERS. KATHY
MCDONALD FOR THE ALAMEDA COUNTY
BOARD OF SUPERVISORS, URGING
REJECTION OF THE ELIMINATION OF
THE FUTURE OF PUBLIC HEALTH
FUNDING. THIS WOULD HAVE, AND I
AGREE, WE USE WORDS THAT ARE
PRETTY EXTREME. OFTEN IN
CONVERSATIONS LIKE THIS, BUT A
TRULY DEVASTATING IMPACT, NOT
JUST IN ALAMEDA COUNTY, BUT
STATEWIDE. AS YOU'VE HEARD FROM
KEYAK AND OTHERS TODAY IN
ALAMEDA COUNTY, THEY HAVE HIRED
OR ARE IN THE PROCESS OF HIRING
39 NEW POSITIONS ACROSS THE
BREADTH OF ACTIVITIES THAT
PUBLIC HEALTH DO. THE LABS
EPIDEMIOLOGY, SEXUAL HEALTH
REPORTING AND STATISTICS, AND
LOCAL OUTREACH, AS WELL. ALL OF
THOSE WOULD HAVE TO BE
ELIMINATED IF THIS FUND THESE
FUNDS WERE ELIMINATED. THANK
YOU. THANK YOU. CHAIR AND
MEMBERS KATHY MOSSBERG WITH THE
PUBLIC HEALTH INSTITUTE WANT TO
EXPRESS OUR OPPOSITION TO THE
ELIMINATION OF THE FUTURE OF
PUBLIC HEALTH DOLLARS AT A TIME
WHERE WE SHOULD BE INVESTING
MORE. WE KNOW THIS IS JUST BASS.
WE ARE TAKING THEM ALL AWAY. SO
WE HOPE. WE HOPE YOU WILL BE
ABLE TO REJECT THIS CUT. ALSO
WANT TO MAKE COMMENTS ON THE
CALIFORNIA CANCER REGISTRY? WE
DID NOTE IN THE MAY REVISE.
THERE ARE THERE ARE REQUESTS FOR
ADDITION OF POSITIONS. AND WE
WANT TO JUST NOTE THAT THE
CALIFORNIA CANCER REGISTRY IS
NOT FULLY FUNDED. WE STILL NEED
AT LEAST 1.4 MILLION TO HAVE IT
AT BASE LEVEL. WE WANT TO
CONTINUE TO WORK WITH THE
LEGISLATURE AND OTHERS ON ALL
THE GOOD WORK THAT THE REGISTRY
HAS DONE OVER THE YEARS BEFORE
APPROVING THESE POSITIONS, AND
THEN ALSO WANT TO ASSOCIATE OUR
COMMENTS WITH THOSE FROM OUR
COLLEAGUES AT THE OFFICE OF
HEALTH EQUITY AND ALL THE GOOD
WORK THAT'S HAPPENING OVER
THERE, AND WORK WITH COMMUNITY,
COMMUNITY BASED ORGANIZATIONS.
ÓRDENES, THANK YOU FOR YOUR
TIME. THANK YOU. HELLO. ISABELLA
ARGUETA WITH THE HEALTH OFFICERS
ASSOCIATION OF CALIFORNIA, IF
THE FUTURE OF PUBLIC HEALTH
FUNDING IS CUT, WE WILL BE
PREPARING CALIFORNIA FOR A
FUTURE THAT LOOKS A LOT LIKE THE
PAST. LOCAL HEALTH DEPARTMENTS
WILL LOSE VITAL TOOLS DEVELOPED
DURING THE PANDEMIC. AND THANK
YOU TO ASSEMBLY MEMBER WOOD FOR
HIGHLIGHTING THIS. WE WILL GO
BACK TO PEN AND PAPER OR EXCEL
SPREADSHEETS TO DO CONTACT
TRACING. WE CANNOT ALLOW THESE
FUNDS TO BE CUT, OR WE WILL BE
JUST AS VULNERABLE TO DISEASE AS
WE WERE IN 2020. WHETHER THAT'S
A NEW PANDEMIC OR THE SPREAD OF
EXISTING CONDITIONS LIKE
HEPATITIS VALLEY FEVER AND
TUBERCULOSIS. THANK YOU. THANK
YOU. GOOD AFTERNOON. MY NAME IS
OTTO PACHECO. I'M A SENIOR FROM
LA MESA, SAN DIEGO, AND I'M HERE
TODAY TO OPPOSE ITEMS 252 AND
253. I'VE BEEN ON MEDI-CAL FOR
AS LONG AS I CAN REMEMBER. I'VE
WORKED WITH A FEW DIFFERENT
STATE FUNDED MENTAL HEALTH
PROVIDERS WHO HAVE BEEN
ABSOLUTELY AMAZING AND A HUGE
HELP. IN APRIL OF 2022, I WAS
TAKEN INTO RADIUS CHILDREN
HOSPITAL ON A 5150 AFTER MAKING
AN ATTEMPT ON MY LIFE. AFTER MY
HOLD, I WAS REFERRED TO
KICKSTART, A STATE FUNDED
INTENSIVE OUTPATIENT PROGRAM.
THEY FOCUS ON PSYCHOSIS IN
YOUTH, BOTH PREVENTATIVE CARE
AND SUPPORT SERVICES. I DO NOT
KNOW WHERE I WOULD BE WITHOUT
THEM. THE TEAM WHO HELPED ME GET
OFF MY FEET AFTER SUCH A DIRE
SITUATION. IF YOU WERE TO CUT
FUNDING TO SOME OF THESE
PROGRAMS, HUNDREDS OF THOUSANDS
OF YOUTH ACROSS ALL OF
CALIFORNIA COULD LOSE ACCESS TO
SUCH ESSENTIAL MENTAL HEALTH
PROGRAMS. STATE FUNDED MENTAL
HEALTH PROGRAMS FOR TEENS LIKE
THE ONES THAT HAVE HELPED SAVE
MY LIFE, ARE CRITICAL. PLEASE
CONTINUE TO SUPPORT FUNDING FOR
THESE VITAL LIFE SAVING
PROGRAMS. THANK YOU. THANK YOU.
GOOD AFTERNOON, KYLIE COSTA,
REPRESENTING THE YOUTH ADVISORY
BOARD, RELATED TO THE OPPOSING
ARGUMENT, ITEMS OF 252 AND 253
AS A SOPHOMORE IN HIGH SCHOOL, A
MEMBER OF THE FFA PROGRAM AND A
STATE DELEGATE OF FFA, I AM
HONORED TO BE REPRESENTING MY
SCHOOL LEADERSHIP ÁP MY PEERS
AND STANDING HERE BEFORE YOU,
SHEDDING THE LIGHT ON A CRITICAL
ISSUE. YOUTH MENTAL HEALTH.
MENTAL HEALTH IS NOT A BUZZER
WORD. IT IS A FUNDAMENTAL ASPECT
OF OUR WELL-BEING AND IT AFFECTS
ALL OF US INDIRECTLY AND
DIRECTLY TOUCHING THE LIVES OF
OUR CLIENTS, FAMILIES AND
FRIENDS ALIKE. YET, DESPITE THE
IMPORTANT IMPORTANCE, YOUTH
MENTAL HEALTH OFTEN REMAINS
STIGMATIZED AND OVERLOOKED. BUT
IT DOESN'T HAVE TO BE THIS WAY.
WE HAVE THE POWER TO MAKE A
DIFFERENCE, STARTING WITH THE
PROGRAMS AND RESOURCES AVAILABLE
TO US, ONE OF THOSE RESOURCES
BEING THE CALIFORNIA YOUTH
BEHAVIORAL HEALTH. WE CAN
PROMOTE MENTAL WELLNESS AND ALL
LEVELS OF OUR COMMUNITY. WE HAVE
THE OPPORTUNITY TO RAISE
AWARENESS AND DESTIGMATIZE
MENTAL HEALTH ISSUES. THANK YOU.
THANK YOU. HELLO. MY NAME IS
TIFFANY HAYES AND I AM SPEAKING
IN REGARDS TO ITEMS 252 AND 253
AND I AM A MOTHER OF AN 18 YEAR
OLD AND A 14 YEAR OLD. AND TODAY
I'M SPEAKING ON BEHALF OF MY 14
YEAR OLD WHO HAS DEFINITELY
BENEFITED FROM THE PROGRAM AND
ASSISTANCE OF HAVING MENTAL
HEALTH SERVICES. HE IS PRETTY
MUCH HIS WHOLE MIDDLE SCHOOL,
DURATION OF MIDDLE SCHOOL. I'M
SORRY HE HAS GONE THROUGH
BULLYING. HE HAS GONE THROUGH
THE PRESSURES OF BEING A PART OF
SOCIAL MEDIA AND TRYING TO KEEP
UP WITH PEERS, AND HE HAS MADE
TREMENDOUS STRIDES IN THE
SERVICES THAT ARE PROVIDED. WHEN
I WAS ABLE TO SEEK OUT MENTAL
HEALTH SERVICES FOR HIM AND LIKE
SOMEONE SPOKE BEFORE ME, OUR
KIDS DESERVE A FIGHTING CHANCE
AND TO BE GREAT MEMBERS OF
SOCIETY AND THE FUTURE. SO
PLEASE DON'T CUT THE FUNDING.
THANK YOU. HELLO, MY NAME IS
SONIA SCOTT, THIS IS RELATED TO
TWO ITEMS, 252 AND 253. I'M A
STUDENT STUDYING PSYCHOLOGY AT
SAN JOSE STATE, AND MENTAL
HEALTH IS SOMETHING THAT'S
GREATLY EMPHASIZED WITHIN MY
MAJOR AND MY SCHOOL. THE
CONVERSATION OF MENTAL HEALTH
HAS STARTED BECOMING MORE OF A
CONVERSATION, AND PEOPLE ARE
STARTING TO TAKE IT WITH MORE
PRECAUTION AND MORE SERIOUSLY.
VÆ, I'VE DEFINITELY SEEN MENTAL
HEALTH ISSUES NOT BEING TREATED
WITHIN MANY ASPECTS OF MY LIFE
AND HOW IT CAN ESCALATE IN
SOMEONE'S LIFE. AND PERSONALLY,
I'VE USED MENTAL HEALTH
RESOURCES WITHIN MY SCHOOL AND I
COULDN'T EVEN IMAGINE IT BEING
DEFUNDED AND LOWERING THE
ABILITIES OF ME AND OTHER
STUDENTS TO OBTAIN THE SUPPORT.
THANK YOU. GOOD MORNING. THANK
YOU, MADAM CHAIR, AND MEMBERS,
THIS IS RELATED TO ITEMS 252 AND
253. I AM DOCTOR DANNY AZUCAR
AND I AM THE LEAD RESEARCHER FOR
THE OFFICE OF OFFICE OF HEALTH
EQUITY, YOUTH AND MENTAL HEALTH
CAMPAIGN, THROUGH THE EXTENSIVE
RESEARCH THAT WE'VE DONE FOR THE
FORMULATION OF THIS CAMPAIGN,
WE'VE LEARNED THAT THE AREA WE
NEED TO FOCUS ON THE MOST IS
GIVING YOUTH THE TOOLS TO MANAGE
THEIR DAILY STRESS AND HEALTHY
WAYS, THE CAMPAIGN IS FOCUSED ON
PREVENTION, EARLY INTERVENTION,
AND ENSURES THAT THIS DAILY
STRESS DOESN'T BECOME AN EVEN
BIGGER ISSUE IF LEFT UNTREATED,
BY STOPPING THE FUNDING FOR THIS
WORK, WE'RE ALMOST GUARANTEEING
AN EVEN BIGGER MENTAL HEALTH
CRISIS FOR CALIFORNIA YOUTH,
WHICH ARE SO IN NEED OF
ASSISTANCE AS IT IS, CONTINUING
TO ADVANCE OUR UNDERSTANDING OF
CHILD AND ADOLESCENT MENTAL
HEALTH WILL ALLOW US TO PREVENT
POSSIBLE HEALTH IMPLICATIONS
THAT ARE ASSOCIATED WITH
UNMANAGED AND CONTINUOUS
EXPOSURE TO STRESS, INCLUDING
PHYSICAL, PSYCHOLOGICAL, AND
BEHAVIORAL HEALTH ISSUES. WE
KNOW THAT TEENS ARE HAVING
DIFFICULTY WITH IDENTIFYING,
DIFFERENTIATING, AND
COMMUNICATING THEIR THEIR
STRESSORS, AND TODAY, TEENS NEED
HELP TO ADDRESS CONCERNS RELATED
TO BEING JUDGED TO BEING
DISMISSED, AND TO BEING A BURDEN
TO OTHERS IF THEY SHARE THEIR
CONCERNS, THEY REQUIRE SPACE TO
PROCESS THEIR EMOTIONS, TO
DECIDE WHAT APPROPRIATE ACTION
TO TAKE. AND IT'S REALLY UP TO
US TO CONTINUE TO UNDERSTAND THE
CONTEXT OF HOW THESE STRESSORS
MANIFEST FOR TEENS TO FIND A WAY
FORWARD TO HELP THEM OUT LATER.
THANK YOU SO MUCH. GOOD MORNING.
I WILL BE SPEAKING ON ITEMS 252
AND 253. MY NAME IS RAYMUNDO
ARCHULETA. I AM A FRESHMAN AT
CASTRO VALLEY HIGH SCHOOL AND A
RESIDENT OF UNINCORPORATED
ALAMEDA COUNTY, AND A YOUTH
RESIDENT LEADER. I HAVE BEEN A
RESIDENT LEADER SINCE I WAS IN
FIRST GRADE AND HAVE BEEN
PARTICIPATING IN LA FAMILIA
YOUTH LEADERSHIP PROGRAMS FOR
FIVE YEARS. LA FAMILIA IS ONE OF
THE ORGANIZATIONS ORGANIZATIONS
THAT IS FUNDED. I AM A GRADUATE
OF LA FAMILIA'S YOUTH LEADERSHIP
ACADEMY, ATTENDED DAYS OF ACTION
OF ACTION HERE IN SACRAMENTO,
AND MET WITH LEGISLATORS AND
ATTENDED MULTIPLE CONFERENCES.
PROGRAMS LIKE THESE ARE SO
IMPORTANT BECAUSE IT TEACHES
YOUTH HOW TO ADVOCATE FOR
THEMSELVES AND ISSUES THAT
MATTER TO US. IN 2020, WE WENT
HOME ONE DAY AND LOST ALL OF OUR
FRIENDS, TEACHERS, AND FAMILIES.
WE WERE LOCKED UP FOR YEARS.
WHEN WE CAME BACK, MANY KIDS
STRUGGLED WITH MENTAL HEALTH
ISSUES. PROGRAMS LIKE CALIFORNIA
CHILDREN'S AND YOUTH. BEHAVIORAL
HEALTH HELP ADDRESS THESE ISSUES
AND EMPOWER, EMPOWER OUR YOUTH
TO LEARN HOW TO ADVOCATE FOR
OURSELVES. I HAVE MADE MANY
FRIENDS IN THESE PROGRAMS AND
GIVE US A PRODUCTIVE OUT. FOR
OUR IDEAS AND STRUGGLES. THANK
YOU. HI. GOOD AFTERNOON, CHAIRS
AND MEMBERS. MY NAME IS JAMIE
HERNANDEZ AND I'M AN ADVOCATE
COORDINATOR AT LA FAMILIA, THIS
ISSUE IS RELATED TO THIS IS
RELATED TO ISSUES 252 AND 253,
WE'RE DISAPPOINTED TO HEAR THAT
THIS FUNDING FOR CB HIGH IS
BEING CUT. AND AS SOMEONE WHO
STARTED AS A YOUTH LEADER IN AN
UNINCORPORATED AREA OF ALAMEDA
COUNTY, JOINING GROUPS LIKE THIS
HELPED ME DURING THE PANDEMIC
BECAUSE IT WAS AN ISOLATING
EXPERIENCE THAT AFFECTED THE
MENTAL HEALTH OF YOUTH IN MANY
WAYS. BUT HAVING PHÐ FUNDING
FUNDING PROGRAMS LIKE THIS WILL
HELP YOUTH TO HAVE THINGS TO DO
AFTER SCHOOL, ON THE WEEKENDS
AND EVEN DURING THE SCHOOL
SCHOOL VACATIONS, THEREFORE
IMPROVING THEIR WELL-BEING AND
OVERALL SOCIAL SKILLS. THANK YOU
. THANK YOU. HELLO, MY NAME IS
SANDRA ARCHULETA. I AM SPEAKING
ON ITEM 252 AND 253. I'M THE
EQUITY INITIATIVES PROGRAM
MANAGER FOR LA FAMILIA. WE ARE
ONE OF THE CBOS THAT IS FUNDED
UNDER THIS PROGRAM, AND I REALLY
JUST WANT TO TALK ABOUT WHAT
WILL HAPPEN IF YOU DO FUND IT,
YOU WILL CENTER THE VOICE OF
YOUTH. YOU WILL ALLOW THEM TO BE
THE MESSENGERS, TO REDUCE
STIGMA, TO EDUCATE PEOPLE OR
OTHER YOUTH AROUND MENTAL HEALTH
ISSUES. BECAUSE I SEE IT ALL THE
TIME. YOU GUYS CUT FUNDING FOR
CBOS AND THINGS LIKE THAT, BUT
YOU CONTINUE TO FUND THINGS LIKE
CONSULTANTS AND SO-CALLED
EXPERTS. AND WHAT HAPPENS IS
THESE PEOPLE COME INTO OUR
COMMUNITIES. THEY DO WHAT THE
CONTRACT SAYS. THEY CHECK THE
BOXES AND GIVE YOU A REPORT, AND
THEN THE COUNTY IS LEFT WITH
THIS GREAT REPORT, BUT IT'S NOT
ACTUALLY CENTERED AROUND THE
VOICES AND NEEDS OF YOUTH. SO
WHEN YOU CENTER THE VOICES AND
NEEDS OF YOUTH AND ALLOW THEM
AND EMPOWER THEM TO REALLY
ADVOCATE FOR THEMSELVES, WHICH
IS WHAT THIS PROGRAM ACTUALLY
DOES, TEACHES THEM HOW TO
NAVIGATE THE SYSTEM THAT IS
REALLY MADE TO EXCLUDE US. WE
TALK ABOUT IT. THE SYSTEM IS NOT
BROKEN. IT'S MEANT IT'S WORKING
EXACTLY HOW IT'S MEANT TO WORK,
WHICH IS TO EXCLUDE US TO REMOVE
US FROM THE CONVERSATION AND
WHAT WE DO, LIKE YOU SAID IN
THESE LEADERSHIP ACADEMIES AND
THESE PROGRAMS, IS TO TEACH
PEOPLE HOW TO NAVIGATE THAT
SYSTEM SO THAT WE ARE HERE TODAY
TO ADVOCATE FOR OURSELVES. THANK
YOU. AND I APPRECIATE YOUR TIME.
THANK YOU. HELLO. GOOD
AFTERNOON. MY NAME IS CASSIE
CHANDLER, AND I'M WITH THE
PUBLIC HEALTH INSTITUTE, THIS IS
IN RELATION TO ITEM 252 AND 253,
THROUGH THE LOCAL LEVEL YOUTH
LED CAMPAIGN, PROJECT 28
COMMUNITY BASED ORGANIZATIONS
ARE WORKING TO SUPPORT A WIDE
RANGE OF YOUTH ACROSS OUR STATE.
THEY'VE ALREADY BEEN AWARDED
WITH THESE GRANT DOLLARS, WHICH
ARE NOW BEING ELIMINATED. WITH
THIS PROPOSAL, OUR TEAM HAS PUT
IN HUNDREDS AND HUNDREDS OF
HOURS TO LAUNCH THIS PROJECT,
AND THE CBOS HAVE BEEN HIRING
AND TRAINING STAFF, SOLIDIFYING
WORK PLANS, ASSEMBLING THEIR
YOUTH ADVISORY GROUPS, AND
PROGRESSING ON TRACK. THESE
IMPORTANT PROJECTS ARE ALREADY
IN MOTION. WORKING WITH YOUTH,
PARENTS AND CAREGIVERS AND
COMMUNITY PROVIDERS ACROSS THE
MENTAL HEALTH CRISIS IN OUR
STATE, TO ADDRESS THE MENTAL
HEALTH CRISIS IN OUR STATE. SO
PLEASE HELP US TO FOLLOW THROUGH
WITH SUPPORTING OUR YOUTH AND
PROVIDING CRITICAL SERVICES.
THANK YOU. GOOD AFTERNOON. CHAIR
MEMBERS JANICE O'MALLEY WITH
AFSCME CALIFORNIA HERE
REPRESENTING OUR PHYSICIANS,
PSYCHIATRISTS, DENTISTS AND
OTHER HEALTH CARE WORKERS IN OUR
LOCAL PUBLIC HEALTH AGENCIES,
JUST WANTED TO MAKE NOTE OF OUR
OPPOSITION TO THE ELIMINATION OF
THE $300 MILLION FUNDING TOWARDS
PUBLIC HEALTH. A LOT OF OUR
AGENCIES ARE SEEING VACANCIES UP
TO 70% FOR SOME PSYCHIATRISTS,
AND THIS IS A BIG PROBLEM AND
WILL ONLY BE COMPOUNDED BY THE
ELIMINATION OF THIS FUNDING,
ALSO WANTED TO ALIGN MY COMMENTS
WITH THE WORKERS FROM SEIU AND
ALSO COUNTERPART AT SEIU, BETH
MALINOWSKI, AND HOPE THAT THE
LEGISLATURE CONTINUES TO WORK TO
INVEST IN PUBLIC HEALTH. THANK
YOU. THANK YOU. GOOD MORNING,
RONALD COLEMAN, BSA WITH THE
CALIFORNIA PAN ETHNIC HEALTH
NETWORK, CPAN. WE ARE OPPOSED TO
THE CUT TO $300 MILLION TO
LOCAL, STATE, PUBLIC HEALTH,
INFRASTRUCTURE AND WORKFORCE,
CERTAINLY THIS WAS FUNDING THAT
WAS FINALLY ESTABLISHED AFTER
THE DEVASTATING IMPACTS OF THE
COVID 19 PANDEMIC THAT FINALLY
TIPPED THE SCALES TO GET IT
ESTABLISHED. YET, ACCORDING TO
THE STATE'S DASHBOARD, 3351
PEOPLE HAVE DIED FROM COVID JUST
SINCE OCTOBER, JUST THE LAST SIX
MONTHS. AND THAT'S JUST ONE OF
THE THINGS THAT PUBLIC HEALTH
WORKS ON. AND SO WE DEFINITELY
CAN'T HAVE THIS FUNDING
ELIMINATED. THIS IS YET ANOTHER
CUT THAT WILL HAVE A
REVERBERATING IMPACTS ON LOW
INCOME COMMUNITIES. THESE
DOLLARS SPARKED COORDINATION AND
COLLABORATION IN COMMUNITIES
WITH PUBLIC HEALTH DEPARTMENTS
THAT WE HAD NEVER SEEN BEFORE.
THAT CAN'T CONTINUE. IF THESE
CUTS HAPPEN, AND WE URGE YOU TO
REJECT IT. THANK YOU. THANK YOU.
HI, MY NAME IS PETER G. WITH
LITTLE TOKYO SERVICE CENTER,
SPEAKING ABOUT ISSUES 252 AND
253, I REPRESENT ONE OF THE 28
ORGANIZATIONS FUNDED BY THE
SEBAGAI PROGRAM. I WANT TO
SPECIFICALLY ADDRESS SOME OF THE
QUESTIONS OF THE MEMBERS OF THE
COMMITTEE. THERE ARE REAL COSTS
WHEN WE DON'T HAVE PREVENTION
MONEY THAT SUPPORT PROGRAMS LIKE
OURS. WE OPERATE IN LA COUNTY.
AND IN 2023, AN ANALYSIS FOUND
THAT ASIAN AMERICAN NATIVE
HAWAIIAN PACIFIC ISLANDER YOUTH
ARE REPRESENTED AT A HIGHER RATE
IN MOBILE CRISIS RESPONSE
PROGRAMS AS COMPARED TO
OUTPATIENT MENTAL HEALTH
SERVICES. THIS SUGGESTS THAT
YOUTH DON'T RECEIVE CARE UNTIL
THEIR ACUITY IS HIGH. AMONG ALL
RACIAL AND ETHNIC GROUPS IN LA
COUNTY, ASIAN AMERICAN, NATIVE
HAWAIIAN PACIFIC ISLANDER YOUTH
ARE LEAST LIKELY TO RECEIVE
FOLLOW UP CARE AFTER A CRISIS.
WE URGE THE LEGISLATURE TO
RESTORE CUTS TO THE SEBAGAI
PROGRAM. EVERY DOLLAR SPENT ON
MENTAL HEALTH RESTORES AN
AVERAGE OF $7 TO OUR ECONOMY. WE
ALSO STAND IN ALIGNMENT WITH
STACY HIRAMOTO REMCO'S COMMENTS
FROM ITEM NUMBER TWO. THANK YOU.
THANK YOU, STACY HIRAMOTO WITH
REMCO. THE RACIAL AND ETHNIC
MENTAL HEALTH DISPARITIES
COALITION, ALSO REPRESENTING THE
COMMUNITY MEMBERS OF CRDP, THE
CALIFORNIA REDUCING DISPARITIES
PROJECT. AND WE JUST WANT TO
SUPPORT THE COMMENTS OF OTHERS
IN REGARDS TO THE CUTS, TO THE
SEBIHI MENTAL HEALTH PREVENTION
PROGRAM UNDER THE OFFICE OF
HEALTH EQUITY OF THIS
DEPARTMENT. AND I ALSO FEEL IT'S
IMPORTANT TO NOTE THAT IN THE
PERIOD DURING WHICH PROPOSITION
ONE WAS BEING DEVELOPED AND
ADVOCATED FOR MANY BIPOC AND
LGBTQ+ ORGANIZATIONS RAISED
CONCERNS THAT THE REVAMPED MHSA
WOULD JEOPARDIZE FUNDING
SUPPORTING CDPS OR COMMUNITY
DEFINED EVIDENCE PRACTICES. A
FREQUENT REFRAIN IN. IN RESPONSE
TO THESE CONCERNS FROM THE
GOVERNOR'S OFFICE WAS THAT
FUNDING SUCH AS SEBAGAI COULD BE
LEVERAGED FOR SUPPORTING SUCH
COMMUNITY BASED APPROACHES. YET
THE PROPOSED MAY REVISIONS
ESSENTIALLY CUT THIS FUNDING,
INCLUDING A ROUND OF FUNDING
EXPLICITLY DEDICATED TO
ORGANIZATIONS UTILIZING CDPS AND
THIS IMPORTANT LOCAL PUBLIC
EDUCATION CAMPAIGN. THANK OUT OF
THIS DEPARTMENT. THANK YOU,
KELLY BROOKS, ON BEHALF OF THE
URBAN COUNTIES OF CALIFORNIA,
THE RURAL COUNTY REPRESENTATIVES
OF CALIFORNIA, THE RIVERSIDE
COUNTY BOARD OF SUPERVISORS, AND
THE VENTURA COUNTY BOARD OF
SUPERVISORS IS HERE IN
OPPOSITION TO THE CUTS TO THE
FUTURE OF PUBLIC HEALTH. I THINK
WE'RE VERY MUCH FEELING TODAY
LIKE IT'S GROUNDHOG DAY, WHERE
THE WE THE FIRST TIME WE HIT A
REVENUE DOWNTURN, WE'RE LOOKING
AT MORE CUTS TO PUBLIC HEALTH,
WE KNEW HEADED INTO THE PANDEMIC
THAT PUBLIC HEALTH WASN'T
PREPARED BECAUSE OF THE
DEVASTATING CUTS THAT HAPPENED
DURING THE GREAT RECESSION. I
THINK WE WANT TO MAKE SURE THAT
WE DON'T REPEAT THE MISTAKES OF
THE PAST AND URGE YOU TO REJECT
THIS. THANK YOU. THANK YOU,
THANK YOU. DOCTOR WEBER. JEFF
NEEL, REPRESENTING, THREE
COUNTIES OPPOSING THE
ELIMINATION OF THE PUBLIC HEALTH
FUNDING, CONTRA COSTA COUNTY,
WHOSE LETTER YOU RECEIVED
YESTERDAY, SMALL LAKE COUNTY,
WHICH IS ALREADY BASED JUST ON
THE PROPOSAL, PULLED THE JOB
POSTING FOR AN EPIDEMIOLOGIST,
EXPECTS TO LOSE FIVE OTHER,
POSITIONS AS WELL. AND SAN DIEGO
COUNTY, WHICH WOULD LOSE $14.3
MILLION ANNUALLY. THAT FUNDS 91
POSITIONS. 57 OF THOSE POSITIONS
ARE REPRESENT AND IN SAN DIEGO
COUNTY, THAT DID JUST, CONFIRM
YESTERDAY THE THIRD CASE OF
MEASLES THIS YEAR, THE FIRST
CASE IS SINCE 2019, THIS FUNDING
WOULD AFFECT THE POSITIONS THAT
FOCUS ON BIOTERRORISM, ANTHRAX,
THE PERSON WHO IS IN CHARGE OF
ANIMAL BRAIN REMOVALS FOR RABIES
INVESTIGATIONS, BEACH WATER
TESTING, WASTEWATER TESTING. ALL
OF THESE WOULD BE AFFECTED BY
THESE CUTS. AND WE URGE THEIR
REJECTION. THANK YOU. THANK YOU.
WELL, I WANT TO THANK EVERYONE
WHO PARTICIPATED ON THIS PANEL,
ALL OF THOSE WHO CAME AND GAVE
PUBLIC COMMENT. WE ARE GOING TO
TAKE A BRIEF, VERY BRIEF RECESS
AT THIS MOMENT BECAUSE WE HAVE
TO LEAVE THIS ROOM. THERE'S
ANOTHER HEARING SCHEDULED AT
1:00, BUT WE ARE GOING TO GO
ACROSS THE HALL TO ROOM 127. SO
A FIVE MINUTE RECESS SO WE CAN
ALL PACK UP AND GO ACROSS THE
HALL. THANK YOU. YOU.
GENERAL FUND
FROM PRIOR YEAR AND CURRENT YEAR
INVESTMENTS, WHICH INCLUDES THE
MEDICINE SCHOLARS PROGRAM, THE
NURSING INITIATIVE, THE CHILDREN
AND YOUTH BEHAVIORAL HEALTH
INITIATIVE, THE SONG BROWN
PROGRAM, COMMUNITY HEALTH
WORKERS ADDICTION PSYCHIATRY
FELLOWSHIPS, AND PSYCHIATRY
GRADUATE MEDICAL EDUCATION. AND
I'LL DEFER TO MY COLLEAGUE AT
HCAI TO GO OVER THE SPECIFIC
PROGRAM DETAILS. GOOD AFTERNOON,
MADAM CHAIR ELIZABETH LANDSBERG,
THE DIRECTOR OF HCAI DEPARTMENT
OF HEALTH CARE ACCESS AND
INFORMATION. THE COMMITTEE HAS
ASKED THAT WE GO THROUGH WHAT
EACH PROGRAM DOES AND WHAT THE
CUT WOULD REPRESENT, WHICH I'LL
DO TO THE BEST OF MY ABILITY AND
FOLLOW UP WITH YOU ON ANYTHING
WE'RE NOT ABLE TO COVER. SO THE
MAJOR WORKFORCE INITIATIVE, THE
WORKFORCE FOR A HEALTHY
CALIFORNIA IN 20 2223 INCLUDED
SIGNIFICANT FUNDING FOR
COMMUNITY HEALTH WORKERS,
PROMOTORAS AND TRIBAL
REPRESENTATIVES, NURSING AND
SOCIAL WORK, AND THE VAST
MAJORITY OF THAT FUNDING IS
PROPOSED FOR ELIMINATION. AND
I'LL GO THROUGH EACH ONE OF
THOSE. ON THE COMMUNITY HEALTH
WORKERS, THERE IS A PROPOSAL TO
CUT 246 MILLION, WHICH IS THE
VAST MAJORITY OF THE FUNDING,
THIS FUNDING WAS GOING TO BE
USED TO TRAIN COMMUNITY HEALTH
WORKERS, PROMOTORAS AND TRIBAL
REPRESENTATIVES, ESTABLISH A
CERTIFICATE PROGRAM FOR CHW,
PROVIDE STIPENDS WHILE FOLKS
WERE GOING THROUGH THE TRAINING
PROGRAM AND PROVIDE SOME
EMPLOYER SUPPORT GRANTS,
INTERVENTIONS ARE CURRENTLY
BEING DESIGNED THROUGH AN
INTENSIVE STAKEHOLDER ENGAGEMENT
PROCESS. SO WE DO RETAIN WITH
THE PROPOSED CUTS, 15 MILLION
FOR THIS YEAR AND LOSE THE REST
OF THE FUNDS FOR THE FOLLOWING
YEARS. SO IT'S A VERY
SIGNIFICANT CUT ON THE NURSING
INITIATIVE, WE HAD PLANNED TO
THIS THERE ARE THIS IS A $210
MILLION CUT UNDER THE NURSING
INITIATIVE. WE WERE DEVELOPING
CONTRACTS FOR SEVERAL
INVESTMENTS, INCLUDING A
CLINICAL PLACEMENT SYSTEM TO
CREATE GREATER VISIBILITY AND
SUPPORT MATCHMAKING BETWEEN
NURSING STUDENTS AND
INSTITUTIONS, AND CLINICAL
PLACEMENTS. WE'VE HEARD
REPEATEDLY THAT ONE OF THE
BARRIERS TO NURSING EDUCATION IS
THE CLINICAL PLACEMENTS. WE HAD
PLANNED TO, FUND A PROGRAM TO
SUPPORT FIRST GENERATION RN
STUDENTS, SCHOLARSHIPS FOR
ASSOCIATE DEGREES AND NURSING
STUDENTS EDUCATION CAPACITY
EXPANSION FOR PSYCHIATRIC MENTAL
HEALTH NURSE PRACTITIONERS, AND
INTERVENTIONS TO ADDRESS BURNOUT
AND MORAL INJURY AMONG NURSES.
AND THE PROPOSED REDUCTIONS
WOULD ELIMINATE THIS INITIATIVE
IN ITS ENTIRETY. ON SOCIAL WORK,
THERE WAS A PROPOSAL AND WE
PREVIOUSLY WOULD HAVE HAD 70
MILLION IN BUDGET YEAR AND
ALMOST 52 MILLION IN BUDGET YEAR
PLUS ONE. THAT WAS GOING TO FUND
SOCIAL WORK, EDUCATION CAPACITY
EXPANSION FOR AN ESTIMATED 214
SLOTS. FUNDING FOR CLINICAL
SUPERVISION OF SOCIAL WORKERS
ESTIMATED 670 STUDENTS, SOME
SCHOLARSHIPS FOR ASSOCIATE AND
BACHELOR LEVEL SOCIAL WORK
STUDENTS, STIPENDS AND
FELLOWSHIPS FOR PRE AND POST
MASTERS IN SOCIAL WORK, CLINICAL
HOURS AND THE PROPOSED REDUCTION
WOULD ELIMINATE THIS INITIATIVE
IN ITS ENTIRETY, IN TERMS OF THE
ADDICTION PSYCHIATRY AND
MEDICINE FELLOWSHIP PROGRAM,
THIS FUNDING WOULD HAVE
SUPPORTED THE EXPANSION AND
CREATION OF NEW FELLOWSHIP
PROGRAMS FOR ADDICTION
PSYCHIATRISTS AND ADDICTION
MEDICINE PHYSICIANS. AND IT IS,
PROPOSED FOR A MORE THAN $48
MILLION FUND, LEAVING A SMALL
PORTION OF 800,000 FOR THIS
PROGRAM. QUICK QUESTION ABOUT
THAT. SO WITH THE 800,000 FROM
GOING FROM 48 MILLION TO
800,000, WHAT DO YOU, ENVISION
THAT YOU WOULD BE ABLE TO DO? I
DON'T KNOW IF THAT WAS A
PREVIOUS YEAR OR HOW THE DOLLARS
WORKED OUT EXACTLY, IN THAT WAY,
WE CAN WE CAN CERTAINLY FOLLOW
UP WITH YOU, BUT YEAH, WE WILL
BE WE WOULD BE VERY LIMITED IN
WHAT WE COULD DO WITH THOSE
FUNDS. AND IS THIS 800,000
ONGOING OR ONE TIME OR I'M WHAT,
THIS IS ALL ONE. THIS IS ALL ONE
TIME FUNDING. I BELIEVE THAT'S
RIGHT. SO ONCE YOU'VE USED THAT
FUNDING, OR MAYBE YOU ALREADY
HAVE ALREADY USED IT, THIS
PROGRAM HAS ESSENTIALLY
ELIMINATED CORRECT, THERE WAS
ALSO, AS PART OF LAST YEAR'S
BUDGET FUNDING OF 52 MILLION FOR
UNIVERSITY AND COLLEGE GRANTS
FOR BEHAVIORAL HEALTH
PROFESSIONALS THAT WOULD SUPPORT
INCREASING EDUCATION SLOTS IN
VARIOUS GRADUATE LEVEL
BEHAVIORAL HEALTH PROFESSIONS,
SUCH AS MARRIAGE AND FAMILY
THERAPISTS, PROFESSIONAL
CLINICAL COUNSELORS AND
PSYCHOLOGISTS, AND THIS CUT
WOULD ELIMINATE THE PROGRAM IN
ITS ENTIRETY. THERE WAS ALSO
FUNDING THAT THE LEGISLATURE HAD
INCLUDED IN PREVIOUS BUDGET OF
30 MILLION TO EXPAND MSW SLOTS
AT THE CSU'S AND UC'S, AND THE
CUT WOULD ELIMINATE THE PROGRAM
IN ITS ENTIRETY. THE PSYCHIATRY
LOCAL BEHAVIORAL HEALTH PROGRAM,
IS A PROGRAM THAT PROVIDES LOAN
REPAYMENT TO PSYCHIATRY CGRTS
WHO COMMIT TO WORKING IN A LOCAL
PUBLIC BEHAVIORAL HEALTH SYSTEM,
PROVIDING SERVICES TO
INDIVIDUALS WITH SERIOUS MENTAL
HEALTH ILLNESS, AND IT'S ALSO
PROPOSED FOR ELIMINATION UNDER
THE UNDER THE MAY REVISION. SO
WHEN IT SAYS DECREASED BY 7
MILLION, THAT'S THE ENTIRE
AMOUNT. YES, MA'AM. THE
CALIFORNIA MEDICINE SCHOLARS
PROGRAM IS A PATHWAY PROGRAM
SUPPORTING STUDENTS FROM
COMMUNITY COLLEGE TO GO TO
MEDICAL SCHOOL. AND THERE IS A
PROPOSED CUT OF 2.8 MILLION ONE
TIME IN EACH OF THE NEXT THREE
YEARS. THIS CUT REPRESENTS A CUT
TO CONTINUED SUPPORT FOR
STUDENTS CURRENTLY IN THE
PROGRAM, WHO ARE WORKING TOWARD
THEIR FOUR YEAR DEGREE AND
RECEIVING SUPPORT FOR MEDICAL
SCHOOL, SO WE DON'T KNOW WHETHER
THERE ARE ADDITIONAL FUNDS THAT
THE PROGRAM WOULD BE ABLE TO
SECURE OTHERWISE. OKAY, SO IT'S
2.8 MILLION, CUT OUT OF HOW MUCH
I BELIEVE I ACTUALLY DON'T HAVE
THAT INFORMATION WITH ME, JOSEPH
NIELSEN DEPARTMENT OF FINANCE.
SO FOR THE CALIFORNIA MEDICINE
SCHOLARS PROGRAM, IT WAS
INCLUDED IN THE 22 BUDGET ACT
FOR A TOTAL OF 14 MILLION AT 2.8
MILLION EACH. SO SO, THE CUT
OCCURS EACH FISCAL YEAR RELATED
TO THE AMOUNT APPROPRIATED FOR
THAT PROGRAM. I'M CONFUSED. SO
IT'S A TOTAL OF 14 MILLION. BUT
EACH YEAR YOU GET 2.8 MILLION.
CORRECT. AND SO THIS IS TAKING
AWAY THAT 2.8 MILLION. SO YOU'RE
ESSENTIALLY ELIMINATING THE
PROGRAM NOW, BASED ON THE
PROPOSAL, THIS FUNDING WOULD BE
ELIMINATED. AND WHAT YOU JUST
MENTIONED IS THAT THIS IS
FUNDING THAT'S BEING USED RIGHT
NOW FOR STUDENTS THAT ARE
ACTUALLY IN SCHOOL. CORRECT. SO
THEY WOULD ESSENTIALLY NOT HAVE
FUNDING TO CONTINUE IT, SUPPORT
IT, SUPPORT SERVICES. SO IT'S
MENTORING, IT'S REALLY TRYING TO
HELP DIVERSIFY THE WORKFORCE BY
BRINGING FOLKS FROM COMMUNITY
COLLEGES INTO THE UCS, INTO THE
UC MEDICAL SCHOOL. SO MY UNLESS
THEY'RE ABLE TO FIND FUNDING
ELSEWHERE, THIS STATE FUNDING
WOULD GO AWAY FOR THOSE SUPPORT
AND MENTORSHIP SERVICES. RS.
OKAY. I'M SORRY. YEAH. I THINK
USING CONSENT. TAURUS. LEO I
THINK THE ADMINISTRATION
CLARIFIED THAT THAT WAS THAT
THIS IS A FULL ELIMINATION OF
THIS PROGRAM, AT LEAST THE
GENERAL FUND SUPPORT FOR IT.
THANK YOU, JUST HAVE A COUPLE
MORE TO COVER THE HEALTH
PROFESSIONS CAREER OPPORTUNITIES
PROGRAM, OR H COB, AS WE CALL
IT, SUPPORTS A VARIETY OF
PROGRAMS DESIGNED TO INCREASE
THE NUMBER OF UNDERREPRESENTED
INDIVIDUALS IN HEALTH
PROFESSIONS TRAINING AND WORKING
IN HEALTH CAREERS. SO IT'S OUR
PIPELINE AND PATHWAY PROGRAMS.
SO THERE IS A PROPOSED CUT OF
MORE THAN 15 MILLION, I BELIEVE
16 MILLION FOR THAT. THERE IS
SOME FUNDING FOR THE FOR THE
E-CIGARETTE TAX REVENUE. SO 5%
OF THE VAPING TAX REVENUE COMES
TO SUPPORT OUR PIPELINE AND
PATHWAY PATHWAY PROGRAMS. SO HOW
MUCH WOULD BE LEFT? WE GET ABOUT
2 MILLION A YEAR FROM THAT. 5%
OF THE E-CIGARETTE TAX IS WHAT
I'M. UNLESS ELIO OR DOV HAS
OTHER INFORMATION. SO YOU'RE
GOING FROM AROUND 17 MILLION TO
2 MILLION. THE 2 MILLION IS AN
ONGOING SOURCE. AND THEN THIS
THESE ONE TIME FUNDS ARE
PROPOSED FOR, FOR ELIMINATION.
SO LEAVING YOU WITH JUST 2
MILLION. YES, MA'AM. AND HOW IS
THAT GOING TO IMPACT THE
PROGRAM? VERY SIGNIFICANTLY? I
MEAN, WE DO THINK THE PIPELINE
AND PATHWAY PROGRAMS ARE VERY
IMPORTANT TO, YOU KNOW, TO,
AGAIN, TO, ONE OF OUR GOALS IS
TO HAVE A HEALTH CARE WORKFORCE
THAT'S MORE REFLECTIVE OF
CALIFORNIA'S DIVERSITY AND TO
SERVE, MEDI-CAL MEMBERS AND
SERVE FOLKS IN MEDICALLY
UNDERSERVED AREAS. SO THAT WOULD
BE A SIGNIFICANT REDUCTION IN
OUR ABILITY TO SUPPORT THOSE
PROGRAMS. THERE ARE ALSO
PROPOSED SIGNIFICANT CUTS TO
SONG BROWN, BOTH FOR NURSES AND
FOR RESIDENCY PROGRAMS FOR
PHYSICIANS. SO OUR SONG BROWN
PROGRAM HAS BEEN AROUND FOR MORE
THAN THAN 50 YEARS, PROVIDING
SUPPORT FOR GRADUATE GRADUATE
MEDICAL EDUCATION SLOTS AND
NURSING TRAINING SLOTS. AND SO
THERE IS A CUT OF 15,000,001
TIME FOR NURSING FOR
RESIDENCIES, 10,000,001 TIME, SO
AGAIN, THESE THESE, THIS FUNDING
PROVIDES PRIMARY CARE RESIDENCY
PROGRAMS TO, TO EXPAND OR
MAINTAIN SLOTS, A SEPARATE ONE
TIME APPROPRIATION OF 31 MILLION
FOR A SONG. BROWN PRIMARY CARE
RESIDENCIES IS MAINTAINED FOR
THIS YEAR. SO IT WAS AROUND 40
MILLION AND NOW IT'S 30. WE YOU
LATER HAVE A QUESTION FOR US
ABOUT WHAT IS REMAINING. AND I'M
HAPPY TO GO OVER THAT. EXACTLY
MY UNDERSTANDING ABOUT ONGOING,
UNLESS FINANCE HAS HAS FURTHER
CLARIFICATION, SO YEAH, WE IF IT
PLEASES THE CHAIR WE CAN GO
THROUGH, I KNOW ONE OF THE
QUESTIONS WAS FUNDING THAT'S
RETAINED IN THE BUDGET. WE COULD
GO THROUGH THAT. NOW THAT WORKS.
YOU CAN GO AHEAD AND FINISH.
OKAY. THANK YOU. SO THE LAST
THING I, ANOTHER PIECE I WANTED
TO COVER WAS, THERE IS A
PROPOSAL THAT THAT OUR
DEPARTMENT OF FINANCE COLLEAGUES
COVERED WITH MORE THAN 300
MILLION IN CURRENT YEAR FUNDS
AND I WAS ASKED BY THE COMMITTEE
TO TALK ABOUT THE IMPACT OF
THAT. SO I WOULD NOTE THAT SOME
OF THESE FUNDS HAVE BEEN AWARDED
IN WORKFORCE PROGRAM GRANTS, BUT
THE FUNDS WERE NOT YET
ENCUMBERED. SO YOU KNOW, WE HAVE
APPLICATION CYCLES, WE GET
APPLICANTS. SO SOME OF THESE WE
HAVE ALREADY MADE AWARDS, BUT
THEY WERE NOT ACTUALLY WE DIDN'T
ACTUALLY DOLE OUT THE FUNDS. SO
IF THESE CUTS ARE MADE, WE WILL
HAVE TO WITHDRAW CONTRACTS,
INCLUDING FOR THE SONG BROWN
PROGRAM, SO OF THIS 300 MILLION
OF CURRENT AND PREVIOUS YEAR
FUNDING, THAT IS PROPOSED TO BE
ELIMINATED, 31% OF IT WAS
ALREADY OBLIGATED OR WE WERE IN
THE PROCESS OF RECEIVING
CONTRACT SIGNATURES. AN
ADDITIONAL 39% WAS IN FINAL
RECOMMENDATION STAGES AND WOULD
HAVE BEEN EXECUTED LATER THIS
SUMMER FOR SONG BROWN,
SPECIFICALLY, 74% OF IT, OR $81
MILLION WAS ALREADY OBLIGATED OR
IN THE PROCESS OF CONTRACT
SIGNATURES, THOUGH PAYMENTS WERE
NOT YET MADE TO THOSE SCHEDULES.
SO WHAT EXACTLY IS GOING TO
HAPPEN TO THOSE INDIVIDUALS, SO
THAT IS NOT FOR INDIVIDUALS.
THAT IS, FOR THE PROGRAMS, BUT
THAT DOES LEAVE, PROGRAMS WHO
ASSUME THEY WERE GETTING FUNDING
AND WITH WHOM WE HAD SIGNED
CONTRACTS. CGRTS, IF THE CUT
WERE TO GO THROUGH, THEN THEY
WOULD NOT RECEIVE THOSE FUNDS.
AND THEN WHAT HAPPENED? SO I
ASSUME EACH EDUCATIONAL
INSTITUTION WILL HAVE TO MAKE
ITS OWN DETERMINATION AS TO
WHETHER THEY HAVE OTHER FUNDS,
OR THEY MAY HAVE TO CUT BACK ON
THE NUMBER OF TRAINING SLOTS
THEY'RE ABLE TO PROVIDE. SO, IF
A PRIMARY CARE RESIDENCY PROGRAM
HAS FIVE SLOTS, RIGHT, AND THEY
BRING IN FIVE RESIDENTS PER
YEAR, WOULD THEY HAVE THE FUNDS
TO MAINTAIN THE FIVE RESIDENTS
PER YEAR THAT THEY HAVE RIGHT
NOW? BECAUSE YOU'VE GOT FIVE,
YOU KNOW, IF YOUR PRIMARY CARE
IS THREE YEARS, YOU'VE GOT YOU
KNOW, YOU CAN REDUCE IN THE
UPCOMING YEAR TO JUST HAVE THREE
SLOTS. BUT WOULD THEY HAVE THE
FUNDS TO MAINTAIN THOSE THAT
WERE ALREADY BROUGHT IN UNDER
THE FIVE YEAR RESIDENT? ONLY
FIVE SLOTS ONLY IF THEY HAD
ADDITIONAL FUNDS THAT THEY COULD
ESSENTIALLY BACKFILL THESE. THEY
HAD ADDITIONAL FUNDS ONLY IF
THEY COULD ESSENTIALLY BACKFILL
THE STATE FUNDS. YEAH. SO THE IN
TERMS OF THE, PHYSICIAN
RESIDENCY GRANTS, MY
UNDERSTANDING IS TYPICALLY THOSE
ARE ISSUED ON A COHORT BY COHORT
BASIS, THE, THE, THE THING IS,
IS THAT THAT TYPICALLY WHAT MY
UNDERSTANDING IS, THE WAY IT
WORKS IS RESIDENCY PROGRAMS RELY
ON MULTIPLE FUND SOURCES TO FUND
SLOTS. SO IN ADDITION TO SONG
BROWN, THEY RELY ON OTHER
SOURCES, INCLUDING CLINICAL
REVENUES, BUT ALSO OTHER GRANT
PROGRAMS. THERE'S A SEPARATE
GRANT PROGRAM AT UC THAT ALSO
PROVIDES FUNDING FOR RESIDENCY
SLOTS. AND SO WHEN WE'RE
THINKING ABOUT REDUCTIONS TO
PROGRAM GRANT PROGRAMS FOR
RESIDENCY SLOTS, THE KEY
QUESTION IS, YOU KNOW, KIND OF
MOVING FORWARD, CAN CAN THEY
SORT OF CAN PROGRAMS SUSTAIN
KIND OF THE LEVEL OF COHORTS
THAT THEY HAVE BEEN SUPPORTING
IN THE PAST? AND IT WOULD DEPEND
ON WHETHER THEY CAN IDENTIFY
OTHER REVENUE SOURCES. AND IF
NOT, THEN THEN THAT COULD
REQUIRE A CUT TO SLOTS. THAT'S
AN AREA OF UNCERTAINTY AS THE
LEGISLATURE IS THINKING ABOUT,
SOME OF THESE, REDUCTIONS. SO
ARE YOU STATING THAT WHEN A
RESIDENT IS BROUGHT IN THEIR
FIRST YEAR, THAT THAT
INSTITUTION ALREADY HAS ALL OF
THE FUNDS TO SUSTAIN THEM FOR
THE 3 OR 4 YEARS OF THEIR
RESIDENCY? MY UNDERSTANDING IS
THE GRANT PROGRAMS ARE ARE ISSUE
FUNDS ON A COHORT BASIS, BUT
IT'S NOT THAT'S NOT INTENDED TO
COVER THE FULL COST OF THE
PROGRAM. THERE ARE OTHER FUNDS
THAT THEY RELY ON AS WELL AND
NOT SOME OF THE FUNDS COME ON A
YEAR BY YEAR BASIS. FOR EXAMPLE,
WHEN THEY USE CLINICAL REVENUES,
THOSE ARE THOSE ARE COMING IN
MORE IN A YEAR BY YEAR BASIS. SO
ARE YOU STATING THAT THE FUNDS
THAT THEY RECEIVE FROM THIS
PROGRAM ALREADY COVER THE ENTIRE
RESIDENCY PROGRAM FOR EACH OF
THOSE INDIVIDUALS? WELL, MY
UNDERSTANDING IS THAT EACH YEAR
THERE'S A NEW GRANT CYCLE FOR
ADDITIONAL FUNDING, AND IT'S A
COMPETITIVE PROCESS. SO IT'S NOT
LIKE, IT'S NOT LIKE EACH YEAR
IT'S THE SAME EXACT PROGRAMS
GETTING THE EXACT SAME DOLLAR
AMOUNT EACH YEAR. IT'S A NEW
COHORT, THAT THEY'RE SUBMITTING
APPLICATION FOR, FOR GRANT
FUNDING. SO MY QUESTION IS IF,
IF YOU HAVE A FIRST YEAR
RESIDENT, AND A PART OF THE
FUNDING TO HAVE THAT RESIDENT,
THERE COMES FROM ONE OF THESE
PROGRAMS AND THE EXPECTATION WAS
THAT NEXT YEAR WE'LL GET THIS
MONEY FOR YOUR SECOND YEAR, AND
THE NEXT YEAR WE'LL GET IT FOR
YOUR THIRD YEAR. IF PART OF THIS
MONEY IS NO LONGER THERE AND
YOU'RE STILL USING ALL THE OTHER
GRANT MONEY THAT YOU'VE GOTTEN,
DO YOU HAVE ENOUGH MONEY TO PAY
FOR THAT RESIDENT TO BE THERE
FOR YEAR TWO AND THREE? MY
UNDERSTANDING IS THAT, YOU KNOW,
THAT ONCE THE COHORTS ARE SORT
OF ACCEPTED, THEY, YOU KNOW,
THEY THEY HAVE TO I HAVE
RESOURCES AVAILABLE, TO SUPPORT
THOSE SLOTS. THAT'S PART OF
BEING ACCREDITED AS A, AS A, AS
A GME PROVIDER. HOWEVER, MANY
PROGRAMS RELY ON, YOU KNOW,
APPLY FOR GRANT FUNDING EACH
YEAR. AND SO EVEN IF, YOU KNOW,
THEY ARE ABLE TO SUPPORT, YOU
KNOW, A GIVEN COHORT OVER THREE
YEARS NEXT YEAR WHEN THEY WHEN
THEY ENROLL THEIR NEXT COHORT,
THE QUESTION WOULD BE, WOULD
THEY BE ABLE TO ENROLL A
SIMILARLY SIZED COHORT, OR WOULD
THEY HAVE TO CUT BACK ON THE
SIZE OF THE COHORT IN FUTURE
YEARS? AND SO THAT THAT IS KIND
OF THE AREA OF UNCERTAINTY HERE
WHEN WE'RE THINKING ABOUT THESE
GRANT PROGRAMS. HAVE WE SPOKEN
WITH THE ACTUAL RESIDENCIES THAT
WOULD BE IMPACTED TO FIGURE OUT
IF THERE IS GOING TO BE ANY
IMPACT TO THEIR CURRENT
RESIDENTS WHEN YOU ALL WERE
MAKING THIS PLAN, DID YOU REACH
OUT TO THE DIFFERENT PROGRAMS
THAT ARE RECEIVING THESE FUNDS
TO ENSURE THAT THEY WOULD BE
ABLE TO MAINTAIN THE CURRENT
RESIDENTS THAT THEY HAVE NOW,
UNDERSTANDING THAT THEY'RE GOING
TO HAVE TO REDUCE THEIR VOLUMES.
YOU KNOW, THEY'RE THEIR
RESIDENTS IN THE FUTURE OR
SOMETHING ELSE MAY HAPPEN, WHICH
WE UNDERSTAND WILL ULTIMATELY
IMPACT PATIENT CARE, WHICH, YOU
KNOW, A LOT OF THESE CUTS ARE
GOING TO DO. BUT, MY QUESTION
IS, DID YOU ALL REACH OUT TO
ENSURE THAT THOSE WHO ARE
CURRENTLY THERE WILL BE ABLE TO
COMPLETE THEIR PROGRAM, JOSEPH
DONNELLY'S DEPARTMENT OF
FINANCE, WHEN WE DEVELOPED,
PROPOSALS INCLUDED IN THE MAY
REVISE, WE COLLABORATE WITH OUR
COLLEAGUES AT HCAI, AS WELL AS
THE CALIFORNIA HEALTH AND HUMAN
SERVICES AGENCY TO UNDERSTAND,
KIND OF THE, THE, THE LANDSCAPE
OF WHAT THESE PROPOSALS WOULD BE
, WE UNDERSTAND WE UNDERSTOOD
THAT THERE WOULD BE HARD
DECISIONS TO BE MADE AND THERE
WOULD BE IMPACTS BY THESE
DECISIONS. BUT JUST TO KIND OF
LIKE JUST TO BETTER, KIND OF
ESTABLISH EXPECTATION OR NOT
EXPECTATIONS, LEVEL SET WHEN
THESE WERE PROPOSED, WE
UNDERSTOOD THAT THERE WAS A
SIGNIFICANT BUDGET PROBLEM WHEN
NOT ONLY WAS THERE A SIGNIFICANT
BUDGET PROBLEM, WE NEEDED TO
HAVE SIGNIFICANT SOLUTIONS TO
ADDRESS THAT, WHILE SOME OF
THESE PROPOSED SOLUTIONS ARE
LESS THAN DESIRED, THEY WERE
NECESSARY IN ORDER TO ADDRESS
THIS BUDGET PROBLEM. HOWEVER, WE
WOULD NOTE THAT WHILE THIS
BUDGET DOES PROPOSE SOME
REDUCTIONS TO PROGRAM FUNDING
THAT ARE LESS THAN DESIRED, WE
WOULD NOTE THAT WITHIN THE MAY
REVISE, THERE WAS AN INVESTMENT
RELATED TO PROP ONE THAT IS
SIGNIFICANTLY LARGER THAN WHAT
THE CUTS THAT ARE PROPOSED
WITHIN THE MAY REVISE.
ADDITIONALLY, BASED IN ADDITION
TO PROP ONE FUNDING OF 2.4
BILLION OUTSIDE OF HIS DIRECT
BUDGET, THERE'S 300 MILLION
FUNDING OVER A FIVE YEAR PERIOD
RELATED TO THE COMMUNITY
COLLEGES FOR SOCIAL WORKER AS
WELL. SO WHILE WE UNDERSTAND
THERE ARE SIGNIFICANT CUTS BASED
IN THE MAY REVISE THAT ADDRESS
THIS BUDGET PROBLEM, WE ALSO
FEEL THAT THERE ARE INVESTMENTS
IN THE FUTURE, THAT ARE MUCH
MORE SIGNIFICANT IN SCALE OF
WHAT SOME OF THESE CUTS MIGHT
REPRESENT. WE UNDERSTAND THAT
THIS FUNDING IS NOT APPLES TO
APPLES. IT'S NOT COMPLETELY
DOLLAR FOR DOLLAR MATCHING THOSE
POINTS. BUT NOTING THAT THE MAY
REVISE IS TRYING TO FIND THAT
HAPPY MEDIUM OF BALANCING THE
IMMEDIATE SHORT TERM NEED OF
ADDRESSING THE BUDGET PROBLEM
WHILE ALSO TRYING TO MAINTAIN
OUR LONG TERM GOALS OF INVESTING
AND WORKFORCE. I UNDERSTAND THAT
IMAGINE FOR A MOMENT THAT YOU
HAVE, DREAMED OF BECOMING A
HEALTH CARE PROVIDER, A
PHYSICIAN. YOU DO WELL IN HIGH
SCHOOL. YOU GO OFF TO COLLEGE,
YOU DO YOUR 4 OR 5. HOW MANY
YEARS PEOPLE ARE DOING NOW? THEN
YOU GO AND DO YOUR MEDICAL
SCHOOL FOR FOUR YEARS, AND YOU
GET SO EXCITED ON MATCH DAY
BECAUSE YOU GET A CHANCE TO DO
THAT INTERNAL MEDICINE PROGRAM.
YOU ALWAYS WANTED TO GIVE BACK
TO THE COMMUNITY. YOU UNDERSTAND
THE IMPORTANCE OF BEING A
PRIMARY CARE PROVIDER, AND YOU
GET ACCEPTED INTO A PROGRAM, AND
YOU MOVE ALL THE WAY TO
CALIFORNIA TO DO YOUR RESIDENCY
PROGRAM. AND A PART OF, OF THE
FUNDING FOR YOUR PROGRAM OR YOUR
SLOT OR YOUR SALARY IS
CONTINGENT UPON WHAT WE'RE
TALKING ABOUT RIGHT HERE. SO YOU
FINISH YOUR FIRST YEAR HERE. AND
NOW, MY QUESTION IS, WILL YOU BE
ABLE TO FINISH YOUR SECOND AND
THIRD YEAR, OR WILL YOU BE
LOOKING FOR ANOTHER PLACE TO
SCRAMBLE INTO? THAT'S MY
QUESTION. WE WILL HAVE ANOTHER
HEARING NEXT WEEK BETWEEN NOW
AND NEXT MONDAY. IF SOMEONE CAN
PLEASE REACH OUT TO THE PROGRAM,
MADAM CHAIR, AND FIND OUT THIS
INFORMATION, WHETHER OR NOT OUR
CURRENT RESIDENTS ARE CURRENT
PARTICIPANTS IN THESE PROGRAMS
WILL WE BE ABLE TO CONTINUE
THEIR TRAINING? THANK YOU. YOU
THANK YOU, MADAM CHAIR, BRIEFLY.
ALSO, WITH THE CURRENT PROPOSED
$30 MILLION CUTS IN $300 MILLION
CUTS IN CURRENT YEAR FUNDS, WE
HAVE ALSO AWARDED $333,000 FOR
THE STATE LOAN REPAYMENT PROGRAM
FOR PHYSICIANS. SO WE DO HAVE 19
INDIVIDUALS WHO HAD RECEIVED
AWARDS FOR LOAN REPAYMENT AND
WERE THAT CUT TO GO INTO EFFECT,
WE WOULD HAVE TO RESCIND THAT
LOAN REPAYMENT FOR THEM. SO THAT
IS THE 300. HAD THAT REPAYMENT
STARTED OR HAD THEY JUST
RECEIVED THE LETTER? THEY HAD
JUST RECEIVED THE LETTER? YEAH.
OKAY BUT YES, I HAVE THE SAME
REACTION, THERE ARE A LOT OF
DIFFICULT DECISIONS TO MAKE, THE
COMMITTEE ASKED WHAT PROGRAMS
WOULD REMAIN AFTER THESE
REDUCTIONS AND, AND WE WOULD
NOTE THAT IF ALL OF THESE
REDUCTIONS WERE ADOPTED, HCAI
WOULD STILL HAVE 267.7 MILLION
REMAINING IN ONE TIME. GENERAL
FUND FUNDING, 208 MILLION IN THE
CHILDREN AND YOUTH BEHAVIORAL
HEALTH INITIATIVE. SO YOU HEARD
A LOT ABOUT SAIBAI IN THE LAST
TWO DEPARTMENTS, OUR SAIBAI
DOLLARS, OF COURSE, ARE FOR
WORKFORCE, INCLUDING THIS NEW
WELLNESS COACH PROFESSION. SO WE
HAVE 124 MILLION, IN EMPLOYER
SUPPORT GRANTS, WE, WE ACTUALLY
HAVE 133, CALIFORNIANS ALREADY
CERTIFIED AS WELLNESS COACHES TO
GET IN THE SCHOOLS AND THE
COMMUNITY TO HELP SUPPORTING,
SUPPORTING YOUTH, SO, SO THERE
ARE $208 MILLION PROPOSED FOR
CONTINUATION, FOR THE FOR OUR
SAIBAI, INCLUDING OUR WELLNESS
COACH, EFFORTS, THE BUDGET ALSO
MAINTAINS THE REPRODUCTIVE
HEALTH CLINICAL INFRASTRUCTURE
GRANTS OF 15.8 MILLION, THAT'S
FUNDING FOR A WARM LINE WHERE
PROVIDERS CAN GET TECHNICAL
ASSISTANCE, IN DOING ABORTIONS
AND OTHER ABORTION RELATED CARE
AND SCHOLARSHIPS FOR PROVIDERS
COMMITTED TO PROVIDING
REPRODUCTIVE HEALTH CARE.
THEY'RE ALSO FUNDING FOR
PIPELINE. WE TALKED ABOUT
PIPELINE EARLIER, AND THIS
BUDGET DOES MAINTAIN 15 MILLION,
15.2 MILLION IN HEALTH CARE
WORKFORCE PIPELINE PROGRAMS. I
HAD MENTIONED THE 15 MILLION FOR
JUAREZ, THE COMMUNITY HEALTH
WORKERS, IT ALSO MAINTAINS 5
MILLION FOR PSYCHIATRIC GRADUATE
MEDICAL EDUCATION FUNDING. THE
2.8 MILLION FOR BUDGET YEAR FOR
THE MEDICINE SCHOLARS PROGRAM,
AND A LITTLE BIT IN SONG, BROWN.
SO TOTALING 267.7 MILLION, WE
WOULD ALSO MAINTAIN AT HCAI
ROUGHLY 40 MILLION PER YEAR IN
ONGOING FUNDS FROM BUDGET YEAR
FORWARD. SO WE HAVE EXISTING
FUNDS, FOR EXAMPLE, FOR, FOR, A
NUMBER OF ALLIED HEALTH AND LVNS
AND SOME OTHER PROFESSIONS, A
PORTION OF LICENSURE FEES GOES
TO FUND SOME OF OUR LOAN
REPAYMENT AND SCHOLARSHIP
PROGRAMS. SO WE WOULD CONTINUE
TO HAVE THOSE FUNDS AVAILABLE,
AS WELL AS THE STEPHEN THOMPSON
PHYSICIAN, CORPS LOAN REPAYMENT
PROGRAM OF MORE THAN 4 MILLION.
SO THOSE ARE SOME OF THAT'S SOME
OF THE ONGOING FUNDING THAT WE
WOULD CONTINUE TO HAVE. YOU
ASKED IF ANY INDIVIDUALS
CURRENTLY ENROLLED IN A TRAINING
PROGRAM WOULD BE UNABLE TO
COMPLETE THEIR CURRENT TRAINING
AS A RESULT OF THE REDUCTION?
AND THAT'S THE DISCUSSION WE
JUST HAD, WITH THESE, WITH THE
DETAILS JUST COMING OUT
YESTERDAY, WE HADN'T HAD A
CHANCE TO MAKE CALLS YET, BUT WE
CERTAINLY WILL DO SO IN THE NEXT
FEW DAYS. WE CAN'T DEFINITIVELY
SAY THAT THE REDUCTIONS WON'T
NEGATIVELY IMPACT, YOU KNOW, ANY
INDIVIDUALS CURRENTLY ENROLLED
IN TRAINING AND CERTAINLY PLAN
TO HAVE THOSE CONVERSATIONS AS
THE SUBCOMMITTEE ALSO ASKED US
TO ADDRESS IF THE MAY REVISION
CONTEMPLATES THE USE OF
PROPOSITION ONE FUNDING. AND SO
DEPARTMENT OF FINANCE, YOU KNOW,
HAS HAS SPOKEN TO THIS SOMEWHAT
AND MAY SAY MORE. I WILL JUST
NOTE THAT HCAI IS CURRENTLY
DEVELOPING A STRATEGIC PLAN FOR
OUR BEHAVIORAL HEALTH WORKFORCE
DEVELOPMENT, WHICH WILL GUIDE
THE USE OF THE PORTION OF
PROPOSITION ONE FUNDS FOR
WORKFORCE DEVELOPMENT. SO WE'RE
UNDERGOING THAT PROCESS NOW.
THAT'S GOING TO BRING IN $480
MILLION A YEAR FOR THE NEXT FIVE
YEARS. VERY SUBSTANTIAL FUNDS
THAT WE BELIEVE I CERTAINLY
ANTICIPATE WILL COVER THINGS
LIKE SOCIAL WORKERS AND
PSYCHIATRIC MENTAL HEALTH NURSE
PRACTITIONERS AND MANY OF THE
BEHAVIORAL HEALTH PROFESSIONS
THAT WE HAVE DISCUSSED, AS WELL
AS FELLOWSHIPS FOR PHYSICIANS
AND NURSE PRACTITIONERS. I
BELIEVE THOSE WERE THE QUESTIONS
THAT I WAS ASKED TO ADDRESS.
MADAM CHAIR, THANK YOU. IF YOU
HAVE ANYTHING TO ADD, MADAM
CHAIR, I THINK I WOULD ADD JUST
TO THE COMMENTS FROM THE
DIRECTOR RELATED TO THE PROP ONE
BEAVER HEALTH WORKFORCE THAT TO
BUILD ON TO THAT INCLUDE IT
WITHIN THE MAY REVISE. THERE WAS
A BCP SUBMITTED BY THE
DEPARTMENT TO BEGIN THIS
PLANNING IMPLEMENTATION PROCESS.
SO JUST TO KIND OF REITERATE, WE
UNDERSTAND THAT THE MAY REVISE
DOES CONTAIN SOME SIGNIFICANT
REDUCTIONS. BUT EVEN WITHIN THIS
VERY SAME MAY REVISE, WE'RE
PLANNING FOR THIS INVESTMENT OF
2.4 BILLION OR 480 MILLION OVER
FIVE YEARS. SO JUST REALLY WANT
TO REITERATE THAT. THANK YOU.
THANK YOU, MISS ELIO. HAVE
ANYTHING ELSE TO ADD? YEAH I
JUST WANTED TO NOTE THAT, YOU
KNOW, AS WE'VE STATED BEFORE,
OUR OFFICE HAS GENERALLY
RECOMMENDED THE LEGISLATURE
REVISIT SOME OF THE LIMITED TERM
INITIATIVES THAT WERE ENACTED IN
PREVIOUS YEARS. THIS SOLUTION
GENERALLY FOCUSES ON LIMITED
TERM SPENDING, AND SO GENERALLY
MEETS THAT FRAMEWORK. WE DID
JUST I GET MORE INFORMATION JUST
NOW ON THE ON SOME OF THE
CURRENT YEAR REVIEW AND THAT
THAT SOME OF THOSE WERE HAD BEEN
COMMITTED AND OBLIGATED BUT NOT
YET ENCUMBERED. SO THAT WOULD BE
AN IMPORTANT CONSIDERATION FOR
THE LEGISLATURE, WE WOULD ALSO
EMPHASIZE THAT THERE IS SOME
ONGOING FUNDING IN THE SOLUTION
AS WELL, THE COP PROGRAM, IT
WOULD BE AN EXAMPLE OF SOMETHING
THAT'S ONGOING THAT THE
ADMINISTRATION IS PROPOSING TO
ELIMINATE, SO THERE ARE SOME
THERE ARE SOME ONGOING ITEMS IN
HERE TOO, THAT THAT COULD TAKE
LEGISLATURE COULD TAKE A CLOSER
LOOK AT THAT AS WELL, GIVEN THAT
THOSE WERE INTENDED TO BE
ONGOING WHEN THEY WERE ENACTED.
THANK YOU. WE WILL NOW OPEN IT
UP TO PUBLIC COMMENT FOR THIS
ITEM. YOU WILL HAVE ONE MINUTE.
THANK YOU VERY MUCH, VANESSA
KAHINA, ON BEHALF OF THE
CALIFORNIA PANETHNIC HEALTH
NETWORK AND OPPOSITION TO THE
CUT FUNDING AND TO THE SOCIAL
WORK REDUCTION, ALSO ON BEHALF
OF COMPROMISO, THE STATEWIDE
NETWORK OF PROMOTORAS AND
COMMUNITY HEALTH WORKERS, THE
CHW FUNDING, WE ARE BUILDING A
REALLY, REALLY AMAZING SYSTEM
WITH THIS, AND THIS COULD BE
ABSOLUTELY TRANSFORMATIONAL. BUT
BY REDUCING THAT AND WALKING
THAT BACK, WE ARE VERY
DISAPPOINTED TO SEE THAT BECAUSE
WE'VE BEEN REALLY EXCITED TO
WORK WITH HCAI AND AGENCY ON
THIS AND IT JUST NEED TO SEE
THIS WORK CONTINUE. SO WE'LL
LOOK FORWARD TO CONVERSATIONS
WITH THE DEPARTMENT. BUT WALKING
THAT BACK WOULD BE A HUGE
PROBLEM. THEN TO YOUR POINT, ON
BEHALF OF THE CALIFORNIA ACADEMY
OF FAMILY PHYSICIANS ON SONG
BROWN, I COULD NOT HAVE
REITERATED THAT ANY BETTER
MYSELF. DEEPLY OPPOSED TO THE
$10 MILLION REDUCTION IN SONG
BROWN RESIDENCY FUNDING, WE RUN
THE CALIFORNIA RESIDENCY PROGRAM
FOR MORE THAN HAPPY TO CONNECT
WITH YOU SO THAT WE CAN DO THAT
OUTREACH TO ASSESS WHAT THE
IMPACTS WOULD BE IF WE LOSE
RESIDENCY HERE, THEY'RE GOING TO
GO TO OTHER STATES. WE'RE NEVER
GOING TO MAKE BACK THAT PRIMARY
CARE SHORTAGE. SO WE REALLY
ENCOURAGE YOU TO REVISIT THAT.
IT'S A HUGE INVESTMENT IN
KEEPING PRIMARY CARE PHYSICIANS
IN CALIFORNIA. THANK YOU. THANK
YOU. OKAY. SEEING NO OTHER
PUBLIC COMMENT, WE WILL MOVE TO
ISSUE NUMBER FIVE.
AND YOU MAY BEGIN WHENEVER
YOU'RE READY. YES. GOOD
AFTERNOON. CAROLYN BASHARA,
EXECUTIVE DIRECTOR OF THE
CALIFORNIA HEALTH FACILITIES
FINANCING AUTHORITY. ALSO KNOWN
AS CHFA. SO THE MAY REVISED
PROPOSED ELIMINATING AND NO
LONGER DELAYING THE TOTAL
FUNDING FOR THE SPECIALTY DENTAL
CLINIC GRANT PROGRAM, WHICH WAS
A NEW PROGRAM UNDER JAFFA, THE.
AS YOU MAY RECALL, THE PROGRAM
WAS FUNDED WITH $50 MILLION IN
GENERAL FUNDS THROUGH TWO BUDGET
ACTS, THE BUDGET ACT OF 22 AND
23, AND BASICALLY, THIS PROGRAM
IS TO INCREASE ACCESS TO ORAL
HEALTH CARE FOR THE SPECIAL
HEALTH CARE NEEDS POPULATIONS,
WHICH INCLUDE CHILDREN AND
ADULTS WHO HAVE PHYSICAL,
DEVELOPMENTAL OR COGNITIVE
DISABILITIES. AND THE GOAL OF
THIS PROGRAM IS TO FUND GRANTS
TO DEVELOP SPECIALTY DENTAL
CLINICS THROUGH THE PURCHASE OF
NEW PROPERTY CONSTRUCTION,
RENOVATION, AND EQUIPMENT. SO,
SINCE THE RELEASE OF THE JANUARY
10TH GOVERNOR'S BUDGET, WE
CLOSED A FUNDING ROUND ON APRIL
1ST, 2024, WE RECEIVED A 101
APPLICATIONS TOTALING $270
MILLION FOR THE REQUESTED
FUNDING OF FOR THE FUNDING
AVAILABLE OF $50 MILLION. SO
WHAT WE HAVE DONE IS WE'VE
NOTIFIED ALL THAT HAVE APPLIED,
THAT THE PROGRAM IS ON HOLD AND
YOUR APPLICATIONS ARE ON HOLD
PENDING FINAL DECISIONS ON WHAT
IS GOING TO HAPPEN WITH THE
FUNDING. SO WITH THAT, I'M HAPPY
TO ANSWER ANY QUESTIONS. THANK
YOU. THE LAO, RYAN MILLER, ELIO,
NOTHING TO ADD ON THIS ITEM.
FINANCE TY RAY DEPARTMENT OF
FINANCE NOTHING TO ADD. THANK
YOU SO MUCH FOR YOUR
PRESENTATION. I THINK WE HAD
DISCUSSED THIS IN A IN A
PREVIOUS HEARING, SO AT THIS
POINT WE WILL OPEN IT UP TO
PUBLIC COMMENT ON THIS ISSUE.
YOU WILL HAVE ONE MINUTE. GOOD.
GOOD AFTERNOON, MADAM CHAIR.
CONNIE DELGADO WITH THE DISTRICT
HOSPITAL LEADERSHIP FORUM REALLY
ON A STAKEHOLDER PROPOSAL, THAT
ADMINISTERS THE DISTRICT
HOSPITAL LEADERSHIP FORUM, HAS A
BUDGET PROPOSAL FOR A LOAN
EXTENSION FOR BRIDGE LOANS THAT
ARE ADMINISTERED THROUGH CHFA,
THEY RECEIVED $40 MILLION IN
BUDGET YEAR 2021 AND 40 AND
2022. AND LOOKING FOR AN
EXTENSION FOR THE REPAYMENT OF
THOSE LOANS FOR THE SECOND YEAR
PROGRAM. AND WHEN THE TIME IS
APPROPRIATE, WE RESPECTFULLY ASK
FOR A SUPPORT POSITION. THANK
YOU. GOOD AFTERNOON, CHAIR
MEMBERS JESSICA MORAN WITH THE
CALIFORNIA DENTAL ASSOCIATION,
HERE TO ASK THE LEGISLATURE TO
REJECT THE GOVERNOR'S PROPOSAL
TO ELIMINATE THE SPECIAL NEEDS
GRANT PROGRAM. AS THE
REPRESENTATIVE FROM CHAFFORD
MENTIONED, THERE ARE 101
APPLICANTS WHO HAVE SUBMITTED
APPLICATIONS FOR SHOVEL READY
CONSTRUCTION PROJECTS. CHFA IS
READY TO EVALUATE AND GET THAT
MONEY OUT THE DOOR ONCE THEY ARE
GIVEN THE OKAY, ELIMINATING THIS
PROGRAM WOULD HAVE DISASTROUS
EFFECTS FOR THE ACCESS TO CARE
FOR THIS POPULATION WHO ARE
ALREADY OUR MOST VULNERABLE IN
THE STATE. SO JUST WOULD LIKE TO
SEE THAT FUNDING PROTECTED.
THANK YOU. THANK YOU, NORA LYNN.
WITH CHILDREN NOW, WE'D LIKE TO
ALIGN OURSELVES WITH THE COMMENT
OF CDA. THANK YOU, KATIE LAYTON,
ON BEHALF OF THE CHILDREN'S
SPECIALTY CARE COALITION, ALSO
ALIGNING OUR COMMENTS WITH THE
CALIFORNIA DENTAL ASSOCIATION.
THIS IS ANOTHER AREA OF VERY
HIGH NEED FOR CHILDREN AND YOUTH
WITH SPECIAL HEALTH CARE NEEDS.
WITHOUT WITHOUT ENOUGH PROVIDERS
AND CLINICS TO PROVIDE THE CARE
SO OPPOSED TO THE FUNDING
ELIMINATION AS WELL. THANK YOU.
GOOD AFTERNOON, CHAIR TONY
ANDERSON, ASSOCIATE DIRECTOR OF
THE ASSOCIATION OF REGIONAL
CENTERS, REPRESENTING OVER
420,000 PEOPLE WITH
DEVELOPMENTAL DISABILITIES,
CHILDREN, YOUTH AND ADULTS. THIS
HAS BEEN A HISTORIC PROBLEM FOR
OUR OUR COMMUNITY FOR A VERY
LONG TIME. WE HAVE FAMILIES WHO
ARE WAITING FOR SOMETIMES YEARS
TO GET TO THE SERVICES THAT THEY
NEED. AND SO WE HAVE PEOPLE WITH
DEVELOPMENTAL DISABILITIES,
SEVERE BEHAVIORAL PROBLEMS AND
COMPLEX MEDICAL NEEDS WHO ARE
WAITING AND IN PAIN. AND THIS
WAS GOING TO REALLY HELP. IT'S
GOING TO BE THE BEGINNING OF
HELP THAT WAS DESPERATELY
NEEDED. SO WE PLEASE WE URGE
THAT YOU, THAT YOU REJECT THIS
THIS PROPOSAL. THANK YOU. THANK
YOU. ALL RIGHT. THANK YOU ALL SO
MUCH. SEEING NO OTHER PUBLIC
COMMENT, WE WILL NOW MOVE TO
ISSUE SIX.
YOU MAY BEGIN WHENEVER YOU'RE
READY. ALBERT PINEDA, DEPARTMENT
OF FINANCE. GIVEN THE
SIGNIFICANT BUDGET PROBLEM, THE
MAY REVISION PROPOSES ADDITIONAL
SOLUTIONS TO SOLVE THE BUDGET
PROBLEM AND BALANCE THE BUDGET.
THE MAY REVISION INCLUDES AN
ADDITIONAL HEALTH CARE
AFFORDABILITY RESERVE LOAN. THE
ADMINISTRATION PROPOSES A $62
MILLION LOAN FROM THE HEALTH
CARE AFFORDABILITY RESERVE FUND
TO THE GENERAL FUND TO 20 2425
UNDER THE AUTHORITY OF CONTROL.
SECTION 13.4 FROM RESOURCES NOT
REQUIRED FOR CURRENTLY PROJECTED
OPERATIONAL AND OR PROGRAMMATIC
USES. THIS LOAN WILL NOT IMPACT
CURRENT PROGRAMS OR SERVICES.
THE MAY REVISION ALSO INCLUDES A
DELAY OF THE REPAYMENT OF THE
HEALTH CARE AFFORDABILITY
RESERVE FUND LOAN, OF 600
MILLION. THE ADMINISTRATION
PROPOSES VIA TRAILER BILL
LANGUAGE, DELAYING THE REPAYMENT
OF THE $600 MILLION LOAN IN
INCREMENTS OF 200 MILLION OVER
THE FISCAL YEARS 2026, 2027, 28
AND 20 2829. THIS PROPOSAL DOES
ASSUME THE FEDERAL SUBSIDIES
WILL EXTEND BEYOND 20 2526, AND
THE FINAL PROPOSAL IS THE
PARTIAL INDIVIDUAL MANDATE
PENALTY TRANSFER. THE
ADMINISTRATION PROPOSES AN
ANNUAL REVENUE TRANSFER OF 109
MILLION FROM THE HEALTH CARE
AFFORDABILITY RESERVE FUND TO
THE GENERAL FUND STARTING IN 20
25, 26 AND ONGOING. THESE ARE
THE RECEIPTS OVER AND ABOVE THE
AMOUNT BEING RETAINED TO SUPPORT
THE CURRENT LEVEL OF SPENDING,
THE CURRENT PROGRAMS. THE THREE
INCLUDED SOLUTIONS FOR COVERED
CALIFORNIA DO NOT IMPACT THE
CURRENT AFFORDABILITY PROGRAMS
OR REDUCE THEIR CURRENT
OPERATIONS. THE BUDGET MAINTAINS
165 MILLION FOR A COST SHARING
AFFORDABILITY PROGRAM, AND 2
MILLION FOR HEALTH CARE COVERAGE
DURING LABOR DISPUTES, AS
AUTHORIZED BY AB 2530. THE 2
MILLION THAT YOU'RE REFERRING TO
FOR LABOR DISPUTES, THAT IS TO
COVER THEIR HEALTH CARE
INSURANCE WHILE THEY'RE ON
STRIKE. THAT IS CORRECT. SO I
KNOW THAT THERE HAVE BEEN
DISCUSSIONS ABOUT INCREASING
THAT FUND. SO IF THAT 2 MILLION
WERE INCREASED, WOULD WE STILL
HAVE MONEY IN THIS FUND TO COVER
THAT? SIR JOSEPH DALTON,
DEPARTMENT OF FINANCE THERE HAVE
BEEN PROPOSALS TO INCREASE THIS
CORPORATION, BOTH IN THE
GOVERNOR'S BUDGET AND THE MAY
REVISE. THOSE PROPOSALS WERE NOT
INCLUDED. FIRST, FOR VARIOUS
REASONS. SO AS WE NOTED IN
PREVIOUS HEARINGS, THIS $2
MILLION ONGOING FUNDING FROM
THIS FUND COVERS HEALTH CARE
COVERAGE DURING LABOR DISPUTES
DURING THE PREVIOUS, HEARINGS
AND DURING TESTIMONY, WE NOTED
THAT, AS TODAY, AS OF, CURRENT
THE CURRENT, SPINNING OF THIS
FUNDING IS ROUGHLY 40,000, SO
BASED ON THAT FUNDING, WE FEEL
THAT THE 2 MILLION STILL REMAINS
SUFFICIENT TO COVER THESE
SERVICES, IN TERMS OF WHAT'S
LEFT IN THE HEALTH CARE
AFFORDABILITY RESERVE FUND,
ASSUMING THAT THESE PROPOSALS
WOULD ULTIMATELY BE ENACTED, THE
REMAINING FUND BALANCE FOR
BUDGET YEAR WOULD BE ROUGHLY
14.5 MILLION. AND THEN IN BUDGET
OR 2526. THE, THE FUND, THE FUND
RESERVE WOULD BE ABOUT 13, $30.3
MILLION. SO, BUT ALSO
REITERATING THE FACT THAT THESE
PROPOSALS, THE THREE PROPOSALS
THAT ADMINISTRATION IS PUTTING
FORWARD, DOES NOT DIMINISH OR
IMPACT THE CURRENT,
AFFORDABILITY PROGRAMS OFFERED
BY COVERED CALIFORNIA, WHETHER
IT BE THE HEALTH CARE, COST
SHARING, AFFORDABILITY PROGRAM
OR THE HEALTH CARE COVERAGE
PURSUANT TO AB 2530. OKAY, SO
FOR THE, WHEN YOU'RE TALKING
ABOUT THE PARTIAL INDIVIDUAL
MANDATE PENALTY TRANSFER, YOU'RE
REQUESTING 109 MILLION OF THAT
BE TRANSFERRED. HOW MUCH WOULD
BE LEFT IN THAT FUND? SO, AS
NOTED THAT IF THE 109 MILLION
WAS APPROVED AND ENACTED WITHIN
THE FINAL BUDGET AGREEMENT, THE
FINAL BUDGET, FUND RESERVE OF
THE HEALTH CARE AFFORDABILITY
RESERVE FUND WOULD BE 30.3
MILLION. AND THAT IS THAT'S
FACTORING IN, THE PROPOSED LOAN
THAT'S STIPULATED AS WELL AS THE
CURRENT SERVICE LEVEL FOR THESE
AFFORDABILITY PROGRAMS. OKAY AND
WHAT WOULD BE LEFT? WHAT IS THE
14.5 MILLION THAT YOU REFERRED
TO BEFORE? THAT WOULD BE
ASSUMING THE PROPOSALS WOULD BE
ENACTED, THE, THE FUND RESERVE
OR ENDING BALANCE OF THE FUND AT
THE END OF 2425 WOULD BE 14.5
MILLION. OKAY OKAY. AND WITH THE
LOAN THAT YOU ARE REQUESTING
FROM THE HEALTH CARE
AFFORDABILITY RESERVE FUND, WHAT
IS THE TIME FRAME THAT YOU ARE
ANTICIPATING REPAYMENT OF THAT
LOAN, TO CLARIFY, YOU'RE
REFERRING TO THE 62. SO THIS
LOAN IS WILL BE INCLUDED WITHIN
CONTROL SECTION 13.4, ALONG WITH
A VARIOUS OTHER SPECIAL FUNDS
THROUGHOUT THE STATE, THE
REPAYMENT DATE WOULD BE
DETERMINED WHEN THE STATE HAS
SUFFICIENT FUNDS TO REPAY IT,
HOWEVER, MY UNDERSTANDING IS
WITHIN THE LANGUAGE OF 13.40
THAT IF THERE IS A NEED FOR THE
DEPARTMENT TO HAVE THESE FUNDS
FOR CURRENT SERVICE LEVELS OR
PROGRAMS, THAT REPAYMENT DATE
CAN BE, SORT OF EXPEDITED. BUT
AT THIS TIME, WITHIN THE
STRUCTURE OF THE CONTROL, 13.40.
SO IT'S BASED UPON WHEN THE
STATE HAS AVAILABILITY OF
RESOURCES. OKAY. THANK YOU. AND
LÀ. OH THANK YOU, CHAIR. RYAN
MILLER. LEO WE DID JUST WANT TO
OFFER SOME GENERAL COMMENTS ON
THESE ISSUES. ITEM 243, THE
ADDITIONAL LOAN IN THE IN THE
BUDGET YEAR, WE THINK THAT THAT
IS REASONABLE AND WOULD BE IN
LINE WITH SOME RECENT ACTIONS
THAT WERE TAKEN TO KIND OF
UTILIZE THESE FUNDS. FOR GENERAL
FUND BENEFIT. HOWEVER ITEMS 244
AND 245, YOU'LL NOTE IN THE
AGENDA THAT THESE ACTIONS ARE
NOT PROPOSED TO BE TAKEN UNTIL
20 2526, WHICH IS BEYOND THE
BUDGET YEAR. AND THAT'S A LITTLE
BIT UNUSUAL. YOU KNOW, MOST OF
THE ACTIONS WE'VE BEEN
DISCUSSING TODAY REALLY ARE MORE
IN THE CURRENT FISCAL YEAR OR
THE BUDGET YEAR, BECAUSE OF THE
MULTI YEAR NATURE OF THE STATE'S
PROJECTED BUDGET SHORTFALL, WE
THINK THAT IN SOME CASES THAT
COULD BE REASONABLE. HOWEVER, IN
THIS CASE, WE THINK THAT IT MAY
BE PREMATURE TO TAKE THAT KIND
OF ACTION. AND THE REASON
REALLY, RELATES TO FEDERAL
FUNDING THAT THE STATE HAS BEEN
GETTING SINCE 2021. THERE WERE
ACTIONS TAKEN BY THE CONGRESS TO
PROVIDE ENHANCED FEDERAL
SUBSIDIES ON THE EXCHANGE, THOSE
I DON'T HAVE AN ESTIMATE FOR
THOSE, UNFORTUNATELY, BUT THEY
MAY BE APPROACHING ABOUT $2
BILLION A YEAR, THEY ARE IN
EFFECT THROUGH 2025, AND IT'S
UNCERTAIN AT THIS POINT WHETHER
THE CONGRESS WILL EXTEND THOSE,
THIS RESERVE FUND REALLY WAS
CREATED. WE UNDERSTAND THE
INTENT BEING TO MAKE THOSE FUNDS
AVAILABLE SHOULD THE CONGRESS
NOT EXTEND THEM, BECAUSE THE
STATE WILL FACE A SIGNIFICANT
PRESSURE TO BACKFILL A PORTION
OR ALL OF THOSE FUNDS, SHOULD
THOSE NOT BE EXTENDED? AND SO WE
THINK IN THIS CASE, THAT WOULD
PUT THE LEGISLATURE IN A PRETTY
DIFFICULT POSITION IF IT ADOPTED
THESE PROPOSALS TO BE ABLE TO
RESPOND TO THAT KIND OF ACTION,
SHOULD IT COME, SHOULD IT
MATERIALIZE, NOW, SHOULD THE
LEGISLATURE WISH TO MAINTAIN, A
SIMILAR AMOUNT OF REDUCTIONS?
YOU KNOW, WE'RE AVAILABLE TO
HELP, YOU KNOW, TO WE'RE
AVAILABLE FOR ASSISTANCE AND,
YOU KNOW, TRYING TO IDENTIFY
ALTERNATIVES AND SO FORTH. SO
I'M HAPPY TO ANSWER QUESTIONS IF
YOU HAVE THEM. THANK YOU FOR
THAT. SO GIVEN WHAT WE JUST
HEARD FROM THE LAO, IF CONGRESS
DOES NOT. RE-APPROVE THE
BACKFILL OF THESE FUNDINGS, AND
IF WE APPROVE THIS, WHICH IS
ESSENTIALLY ONGOING, ESPECIALLY
THE TRANSFER OVER WHAT WOULD BE
THE GOVERNOR'S OR THE
ADMINISTRATION'S PLAN, AT THIS
TIME, WITHIN THE MAY REVISE, AS
NOTED, THAT THESE PROPOSALS
ASSUMED, THE EXTENSION WHILE, WE
HOPE THAT IS THE CASE, THESE
PROPOSALS ARE BASED ON THE NEED
TO ADDRESS, GROWING BUDGET
PROBLEM, IF FOR IF FOR, FOR
EXAMPLE, IF THE FEDERAL
GOVERNMENT DID NOT EXTEND THESE
BEYOND 25, 26, WE'D HAVE TO,
KIND OF REASSESS TO SEE STATE
RESOURCES OF, YOU KNOW, WHAT
MIGHT POTENTIALLY HAPPEN AFTER
THAT. BUT BASED ON THIS MAY
REVISED PROPOSAL, THIS WAS
PREDICATED ON FEDERAL, SUBSIDY
OR FEDERAL ASSISTANCE SUBSIDIES,
EXTENDING BEYOND 2526. OKAY.
THANK YOU. ALL RIGHT. AT THIS
POINT, I WILL TAKE ANY PUBLIC
COMMENT ON ITEM NUMBER SIX. YOU
WILL HAVE ONE MINUTE EACH. THANK
YOU. VANESSA KAHINA, ON BEHALF
OF THE CALIFORNIA PAN ETHNIC
HEALTH NETWORK IN OPPOSITION TO
THE TRANSFER OF THE $109 MILLION
FROM THE INDIVIDUAL MANDATE
FUND, THERE IS ONE GROUP OF
CALIFORNIANS WHO CURRENTLY STILL
DO NOT QUALIFY FOR ANY KIND OF
AFFORDABILITY IN THEIR COVERAGE,
AND THAT'S UNDOCUMENTED
CALIFORNIANS. ON BEHALF OF
C-PEN, WE HAVE BEEN ASKING THAT
THAT SHOULD BE MOVED TO A MIRROR
EXCHANGE SO THAT UNDOCUMENTED
CALIFORNIANS CAN HAVE THE SAME
KIND OF COVERAGE AS EVERYBODY
ELSE, INCLUDING OUR MEDI-CAL
POPULATION. THANK YOU VERY MUCH.
CHRISTINE SMITH WITH HEALTH
ACCESS CALIFORNIA, ALSO VOICING
SHARED COMMENTS FROM THE
CALIFORNIA IMMIGRANT POLICY
CENTER. AND WE ALSO URGE THE
LEGISLATURE TO PUSH BACK ON
GOVERNOR'S PROPOSALS TO BORROW
THE 62 MILLION FROM THE HEALTH
CARE AFFORDABILITY RESERVE FUND,
THIS BUDGET YEAR AND THEN SWEEP
THE 109 MILLION ONGOING STARTING
THE FOLLOWING YEAR, THIS FUND
COLLECTS REVENUE FROM
CALIFORNIANS UNINSURED AND HAS
BEEN PRESERVED FOR COVERED
CALIFORNIA TO MAKE COVERAGE MORE
AFFORDABLE AND ACCESSIBLE, WE
URGE THE LEGISLATURE TO INSTEAD
SUPPORT HEALTH FOR ALL COALITION
REQUESTS TO USE THESE FUNDS TO
OPEN COVERED CALIFORNIA TO
CALIFORNIANS WHO ARE
UNDOCUMENTED AND EARN TOO MUCH
TO QUALIFY FOR MEDI-CAL. THANK
YOU. THANK YOU, MADAM CHAIR.
MEMBERS SARAH FLOCKS, CALIFORNIA
LABOR FEDERATION ALSO, IN
REGARDS TO THE HEALTH CARE
AFFORDABILITY RESERVE FUND, THE
GOVERNOR, THE LEGISLATURE PASSED
AND THE GOVERNOR SIGNED AB 2530
FOR HEALTH CARE FOR STRIKING
WORKERS SO THAT WORKERS THAT ARE
EXERCISING THEIR PROTECTED RIGHT
FOR TO IMPROVE WORKING
CONDITIONS AND WAGES WOULD NOT
HAVE TO GO UNINSURED, AND THE
FUNDING THERE IS $2 MILLION IN
FUNDING. NOT ALL OF THAT HAS
BEEN USED, BUT STRIKES ARE
UNPREDICTABLE, WE HAVE A NUMBER
OF UNIONS THAT ARE AT THE TABLE
IN THE ENTERTAINMENT INDUSTRY,
IN THE GROCERY INDUSTRY, IN THE
HOTEL INDUSTRY, ACROSS THE
STATE. AND THESE WORKERS COULD
GO UNINSURED IF THERE IS NOT
ENOUGH FUNDING. AND SO WE DO
URGE FOR ADEQUATE FUNDING FOR
HEALTH CARE FOR STRIKING WORKERS
, BE PRESERVED OUT OF THE HEALTH
CARE AFFORDABILITY RESERVE FUND.
THANK YOU. THANK YOU. GOOD
AFTERNOON, CHAIR BETH MENDOCINE,
CALIFORNIA. I WANT TO SECOND THE
REMARKS MADE BY MY COLLEAGUE
SARAH FLOCK. SO THE CALIFORNIA
LABOR FED, WE CERTAINLY DON'T
WANT TO SEE THIS BUDGET BALANCED
ON THE BACKS OF STRIKING
WORKERS. THANK YOU SO MUCH.
THANK YOU. I WANT TO THANK THE
PANEL AND THANK ALL OF YOU WHO
CAME UP FOR PUBLIC COMMENT. WE
WILL NOW MOVE TO ISSUE NUMBER
SEVEN. WE WILL NOT HAVE A
PRESENTATION ON THIS ISSUE, BUT
IF LAO HAS ANY, COMMENTS, THEY
MAY MAKE THEM ON ISSUE NUMBER
SEVEN. LET'S OFTEN, WE HAVE NOT
RAISED CONCERNS WITH SOME OF
THESE PROPOSALS AND A FEW OF THE
OTHERS, WE HAVEN'T HAD A CHANCE
TO EVALUATE, BUT WE'RE AVAILABLE
FOR QUESTIONS AND CAN WORK WITH
THE COMMITTEE AS REQUIRED. THANK
YOU. AT THIS POINT, WE'LL OPEN
IT UP TO PUBLIC COMMENT. IF
ANYONE HERE IS HERE AND WOULD
LIKE TO SPEAK ON ITEM NUMBER
SEVEN, YOU HAVE ONE MINUTE.
THANK YOU. THANK YOU, MADAM
CHAIR AND MEMBERS. I'M KOBE
PEZZATI WITH THE CALIFORNIA
ASSOCIATION OF PSYCHIATRIC
TECHNICIANS AS IT RELATES TO THE
DEPARTMENT OF STATE HOSPITALS.
WE I PROBABLY MISSED MY TIME
EARLIER ABOUT THE WIPING AWAY OF
POSITIONS. WE HAVE OVER 30
VACANCIES IN THE DEPARTMENT OF
STATE HOSPITALS ALONE. WE HAVE
4300 BUDGETED POSITIONS. ONLY 3
OR 3000 OF THEM ARE FILLED. THIS
HAS CREATED A NEED FOR
OUTSOURCING OF MENTAL HEALTH
SERVICES JOBS WHICH ARE BEING
PAID AT EXORBITANT RATES. A
PSYCH TECH MAKES $38 PER HOUR,
AND AN OUTSOURCED PSYCH TECH
MAKES $59 PER HOUR, PLUS $900 A
WEEK PER DIEM WITH VERY SIMILAR
PENSION AND BENEFITS. THAT MAKES
IT IMPOSSIBLE FOR THE STATE TO
RECRUIT AND RETAIN NEW STAFF, SO
WE WOULD LIKE THE, THE COMMITTEE
TO LOOK AT THESE OUTSOURCING
CONTRACTS AS A WAY TO SAVE MONEY
AND BRING THOSE POSITIONS BACK
INTO THE STATE SERVICE. THANK
YOU. THANK YOU, THANK YOU, MADAM
CHAIR. DOUG SUBERS, ON BEHALF OF
THE CALIFORNIA PROFESSIONAL
FIREFIGHTERS, WANTED TO BRIEFLY
EXPRESS SUPPORT FOR THE TWO,
INVESTMENTS IN THE EMERGENCY
MEDICAL SERVICES AUTHORITY,
IMPLEMENTATION. FIRST, THE
COMMUNITY PARAMEDICINE OR TRIAGE
TO ALTERNATE DESTINATION ACT WAS
CO-SPONSORED BY CPF. AND WE'RE
IN STRONG SUPPORT OF SEEING
THOSE PROGRAMS, BE DEVELOPED AND
IMPLEMENTED IN COMMUNITIES THAT
PROVIDE THE RIGHT CARE AT THE
RIGHT TIME. AND THE SECOND ISSUE
IS ON PAGE 18 REGARDING THE,
INVESTMENTS TO, FOR MSA TO
SUPPORT THEIR IMPLEMENTATION OF
AMBULANCE PATIENT OFF LOAD TIME
REDUCTIONS. THIS IS A CRITICAL,
BILL, ASSEMBLY BILL 40 THAT WAS
PASSED LAST YEAR. AND WE WOULD
URGE YOUR SUPPORT FOR THOSE
INVESTMENTS. THANK YOU, THANK
YOU. AND WITH THAT, I WOULD LIKE
TO THANK EVERYONE FOR, FOR YOUR
TIME, THOSE WHO CAME TO, PRESENT
ON BEHALF OF THE DIFFERENT
DEPARTMENTS WANT TO THANK LÀ Þ,
THE DEPARTMENT OF FINANCE. I
WANT TO REALLY THANK OUR STAFF
FOR THIS COMMITTEE BECAUSE YOU
DID A LOT IN A VERY SHORT AMOUNT
OF TIME. SO THANK YOU SO MUCH
FOR ALL OF YOUR HARD WORK, AS I
STATED BEFORE, WE WILL HAVE
ANOTHER HEARING NEXT WEEK,
HOPEFULLY FOR THOSE WHO WERE
UNABLE TO ANSWER SOME OF OUR
QUESTIONS, YOU WILL BE ABLE TO
ANSWER THEM AT THAT HEARING. AND
AT THAT POINT, AT THIS POINT,
THIS, HEARING IS ADJOURNED.
THANK YOU