GOOD EVENING. WE'RE GOING TO
CALL THIS COMMITTEE, BUDGET
SUBCOMMITTEE NUMBER ONE ON
HEALTH TO ORDER. WE'LL START BY
CALLING ROLL DOCTOR WEBER HERE
TO PRESENT MR. PATTERSON. SO,
JUST TO REFRESH EVERYONE'S
MEMORY, THE JANUARY BUDGET
INCLUDED OVER 5.4 BILLION IN
TOTAL SOLUTIONS IN SUBCOMMITTEE
NUMBER ONE, MOST OF WHICH
REFLECTED THE EARLY ACTION
PROPOSAL TO EXPAND THE SCOPE OF
THE MCO TAX AND TO CAPTURE
PROJECTED MCO REVENUE FUNDING.
HOWEVER, THE MAY REVISION
INCLUDED MANY NEW COMPLEX AND
DIFFICULT PROPOSALS THAT
DIRECTLY IMPACT CALIFORNIA'S
HEALTH, WITH OVER $15 BILLION IN
SAVINGS OVER FOUR FISCAL YEARS,
THE PROPOSAL ASSUMES 11.2
BILLION OF THE SAVINGS RESULTING
FROM 35 DIFFERENT REDUCTION OR
COMPLETE ELIMINATION PROPOSALS,
WITH MANY HAVING A DIRECT IMPACT
ON CURRENT LEVEL OF SERVICES.
LAST WEDNESDAY, MAY 15TH, THIS
SUBCOMMITTEE HELD A VERY
THOROUGH EVALUATION OF THESE
PROPOSALS. TODAY, WE WILL MAINLY
FOCUS ON THE VOICES OF THE
COMMUNITY AND STAKEHOLDERS. BUT
BEFORE WE OPEN IT UP TO PUBLIC
COMMENT, IF THERE ARE ANY
REMAINING QUESTIONS THAT THOSE
OF US ON THE COMMITTEE HAVE, WE
WILL BEGIN WITH THOSE ASSEMBLY
MEMBER BONTA. THANK YOU. CHAIR.
I FIRST WANT TO JUST TALK ABOUT
THE MCO REVENUE SOLUTIONS. WE'RE
BEING ASKED IN A MATTER OF A
COUPLE OF WEEKS TO MAKE SOME
VERY DIFFICULT DECISIONS ABOUT,
CUTS THAT I BELIEVE WILL HAVE
DEVASTATING IMPACTS. AND WHILE
WE CAN ACCEPT NEEDING TO MAKE
THESE TOUGH DECISIONS, WE DON'T
WANT TO HAVE TO MAKE THOSE
DECISIONS WITHOUT UNDERSTANDING
THAT WE HAVE AN OPPORTUNITY TO
PERHAPS LESSEN THE IMPACT THE
ADMINISTRATION HAS PRESENTED A
TWO YEAR BUDGET, BUT THE BUDGET
WILL BE ADOPTED BY JUNE 15TH, IS
ONLY FOR ONE YEAR. WITH SOME OF
THESE HIGH PRIORITY INITIATIVES,
WE SHOULD CONSIDER PURSUING SOME
DELAYS SO WE CAN STILL BALANCE
THE BUDGET FOR THIS YEAR AND NOT
COMPLETELY GIVE UP ON THESE
IMPORTANT INITIATIVES. WE KNOW
THAT RATES REALLY MATTER FOR
ACCESS TO CARE. I DON'T WANT US
TO JUST COMPLETELY GIVE UP AT
THIS POINT, AND WE DO HAVE SOME
CHOICES. SO WITH THAT, I WANTED
TO BE ABLE TO DIVE INTO SOME OF
THE IMPACTS ON THE REDUCTIONS ON
PROVIDER AND ON THE REDUCTIONS
WILL HAVE ON PROVIDER
PARTICIPATION IN MEDI-CAL AND
ACCESS TO CARE RELATED TO THOSE
CUTS. SO ON THE MCO TAX, WE'VE
ESSENTIALLY ROLLED BACK
COMPLETELY THE RATE
REIMBURSEMENTS, WHICH IS A VERY
IT'S VERY SIGNIFICANT. I DON'T
KNOW IF THERE'S ANY OPPORTUNITY
TO BE ABLE TO, AGAIN, ASK
WHETHER THERE'S AN OPPORTUNITY
TO DO A PROPORTIONAL AMOUNT OR
SOME OTHER THING THAT MIGHT NOT
HAVE US HAVE TO CUT ENTIRELY
THOSE RATE REIMBURSEMENTS. NOW,
THE LEGISLATURE WASN'T INVOLVED
SIGNIFICANTLY IN THOSE INITIAL
NEGOTIATIONS, BUT IT'S PRETTY
DAUNTING TO CONSIDER HAVING THAT
COMPLETE CLAWBACK OF THOSE RATE
REIMBURSEMENTS. IS THERE ANY IS
THERE ANY NEW INFORMATION THAT
CAN BE PROVIDED TO US? IS THERE
ANYONE FROM THE DEPARTMENT OF
FINANCE THAT IS HERE THAT CAN
ADDRESS ASSEMBLY MEMBER BONTA'S
QUESTION.
THANK YOU. ASSEMBLY MEMBER
ANDREW DUFFY, DEPARTMENT OF
FINANCE. MY COLLEAGUES ARE STILL
MAKING THEIR WAY OVER. I WOULD
JUST NOTE THAT, A NUMBER OF
TOUGH DECISIONS, HAD TO BE MADE
IN THIS BUDGET. IN NO WAY DO THE
DECISIONS REFLECT THE
ADMINISTRATION'S, OR REFLECT THE
VALUE OF THESE PROPOSALS, BUT,
GIVEN THE SIGNIFICANT, BUDGET
PROBLEM, WE WERE DEALING WITH,
SIGNIFICANT, SOLUTIONS AND, I
COULD ASK A SPECIFIC QUESTION IF
IT WOULD BE HELPFUL TO YOU. CAN
YOU DESCRIBE WHAT YOU EXPECTED?
THE AUGMENTATIONS AROUND THE
RATE INCREASES WOULD HAVE DONE
TO ENCOURAGE PROVIDERS TO TAKE
ON MEDI-CAL BENEFICIARIES AND TO
IMPROVE ACCESS TO CARE? AND WHAT
THEN, IN THE ABSENCE IT WOULD
HAPPEN IF THE IMPACT IS LIMITED.
OH YEAH. IS THERE ANYONE FROM
DEPARTMENT OF FINANCE OR DCS WHO
CAN SPEAK ON THE MCO TAX
PROPOSAL SPECIFICALLY? WHAT IS
THE IMPACT OF ELIMINATING THESE
AUGMENTATIONS ON ACCESS TO CARE?
DO YOU HAVE ANY PROJECTIONS? WE
DON'T HAVE PROJECTIONS ON THE,
THE IMPACT TO ACCESS. I WILL
NOTE THAT THE 2024 RATE
INCREASES WILL REMAIN IN EFFECT
IN THOSE GET PRIMARY CARE,
MATERNITY CARE AND NON SPECIALTY
MENTAL HEALTH SERVICES TO 87.5%
OF MEDICARE VÀ. SO LIFTING UP
THOSE SERVICES THAT WE
PRIORITIZE AS PART OF LAST
YEAR'S BUDGET. AND THERE'S NO
WAY FOR US TO DO ANY KIND OF
ADDITIONAL TRACKING TO CARE IN
THE MEANTIME TO TRACK THE
DIFFERENCE IN UTILIZATION AND
PROVIDER PARTICIPATION. SINCE
THE RATE INCREASES WENT INTO
EFFECT IN JANUARY, WE'RE NOT
ABLE TO CAPTURE THAT TYPE OF
INFORMATION BECAUSE WE PAY
ESSENTIALLY, WE PAY THE PLANS.
WHO THEN PAY THE PROVIDERS, AND
SO I'M NOT AWARE OF ANY WAY WE
CAN REALLY TRACK HOW PROVIDER
PARTICIPATION CHANGED SINCE
JANUARY. WELL SO I THINK THAT
THERE IS A WAY IN WHICH YOU CAN
TRACK IT, BECAUSE YOU CAN LOOK
AT THE, NUMBER OF PROVIDERS WHO
ARE CURRENTLY ACCEPTING,
MEDI-CAL OUTSIDE OF THE THREE
SUBSPECIALTIES. RIGHT? BECAUSE
WHAT WE'RE TALKING ABOUT IS THE
OTHER PROVIDERS WHO WERE GOING
TO BE PULLED INTO THE MCO TAX IN
2025 NOW NOT BEING PULLED INTO
THAT. AND SO I THINK WHAT
ASSEMBLYMEMBER BONTA IS, IS
ASKING IS SINCE WE'RE NOT
PULLING THOSE OTHERS IN THAT WE
HAD TALKED ABOUT WHAT IT'S GOING
TO BE THE IMPACT, BECAUSE WE
UNDERSTAND THAT ALTHOUGH, IT IS
EXTREMELY IMPORTANT TO LOOK AT
OUR PRIMARY CARE PROVIDERS, TO
LOOK AT OUR BEHAVIORAL HEALTH
PROVIDERS, TO LOOK AT THOSE WHO
ARE PROVIDING MATERNITY CARE.
THEY ARE NOT THE ONLY ONES
WITHIN THE HEALTH CARE SYSTEM,
AND I'VE SAID THIS BEFORE, IF
YOUR PRIMARY CARE PROVIDER AND
YOU TELL YOUR PATIENT THAT THEY
NEED TO GO SEE A CARDIOLOGIST,
BUT YOU HAVE BEEN MADE SOMEWHAT
WHOLE THROUGH THE MCO TAX AS A
PRIMARY CARE PROVIDER, BUT THE
CARDIOLOGIST HAS NOT. AND
THEREFORE ACCESS TO THAT
CARDIOLOGIST FOR YOUR MEDI-CAL
PATIENT IS STILL SIGNIFICANTLY
LIMITED. AND REDUCED. AND
ULTIMATELY, LIKE THE PATIENT IS
NOT GOING TO GET ANY BETTER
BECAUSE WE HAVE NOT EXTENDED
THAT TO OTHER, MORE SPECIALTY
PROVIDER SERVICES. SO I THINK
HER QUESTION IS, WHAT CAN WE
EXPECT TO SEE? WHAT DID YOU
PROJECT? WHAT HAPPENED, WITH
THESE PROVIDERS LEAVING THE
MEDI-CAL SYSTEM SINCE THEY'RE
NOT BEING REIMBURSED, WHAT WOULD
BE THE IMPACT ON HEALTH? YOU CAN
YOU CAN GUESS, MAKE AN EDUCATED
GUESS BASED ON THE LOW NUMBERS
OF MEDI-CAL PARTICIPATION THAT
WE CURRENTLY HAVE. WE DON'T HAVE
FORECAST IN TERMS OF PROVIDER
PARTICIPATION THAT WOULD HAVE
BEEN WOULD HAVE GROWN OR,
EXISTING PROVIDERS WHO WOULD
HAVE TAKEN ON MORE MEDI-CAL
MEMBERS AS A RESULT OF THE 2025
RATE INCREASES. WE DON'T HAVE
THAT LEVEL OF INFORMATION. THÀNH
WHAT? I'LL JUST RESTATE THAT I
THINK IT'S VERY PROBLEMATIC THAT
WE HAVE NO ABILITY TO ACTUALLY
UNDERSTAND THE PROJECTIONS OR
THE, THE, THE IMPACT THAT NOT
BEING ABLE TO RECEIVE THE
AUGMENTATION AROUND THE
REIMBURSEMENT RATES WILL HAVE.
AND, AND SWEEPING BACK AND
CLAWING BACK THE ENTIRETY OF THE
MCO TAX. INCLUDING THE RATE
REIMBURSEMENTS, IS BEYOND IS
PROBLEMATIC. I'LL MOVE ON, THE
BEHAVIORAL HEALTH THROUGHPUT. SO
AN AREA THAT WE HAVE FOR A VERY
LONG TIME, KIND OF NOT HAD THE
KIND OF CAPACITY THAT WE SHOULD
HAVE AROUND ADDRESSING OUR
BEHAVIORAL HEALTH SYSTEM NEEDS
AND ENSURING THAT CALIFORNIANS
DON'T LANGUISH IN THE EMERGENCY
ROOM. WE THROUGH THE MCO
PACKAGE, WE'RE FINALLY GOING TO
BE ABLE TO MAKE SOME PROGRESS ON
THAT, BUT NOW WE AREN'T GOING TO
HAVE THOSE RESOURCES. WHAT IS
THE ALTERNATIVE? IS THERE AN
ALTERNATIVE SOLUTION PROPOSED BY
THE ADMINISTRATION WITH THIS
ELIMINATION TO ENSURE THAT WE
STILL HAVE SOME CAPACITY AND IS
PROP ONE AT ALL ENGAGED IN? SO I
WOULD SAY DEFINITELY PROPOSITION
ONE AND JUST BE CHIPPED IN
GENERAL, BUILDING OUT THE
CONTINUUM OF COMMUNITY BASED
CARE, INCLUDING PLACES WHERE
INDIVIDUALS WHO MAY BE IN A
HOSPITAL COULD BE DISCHARGED TO.
WE ALSO HAVE OUR CONNECT WAIVER.
THAT'S BEFORE THE FEDERAL
GOVERNMENT THAT REALLY WORKS ON
IMPROVING TRANSITIONS AND
DISCHARGES FROM OUR ACUTE
SETTINGS. AND SO THOSE
PROPOSALS, I THINK, YOU KNOW,
ARE HELPFUL IN THIS SPACE AND
WOULD WOULD HAVE BEEN
COMPLEMENTARY AND STILL KIND OF
SERVE THE SAME PURPOSE IN TERMS
OF REALLY TRYING TO REALLY
ENSURE INDIVIDUALS ARE SERVED IN
THE MOST APPROPRIATE SETTING,
REALLY THE LEAST RESTRICTIVE,
THE LEAST INSTITUTION SETTING,
FOR OUR MEMBERS. RIGHT. IT'S
GOOD TO KNOW THAT THERE'S GOING
TO BE SOMETHING TO BE ABLE TO
LEAN LEAN ON THERE. THE MAY
REVISION INCLUDED STILL ON THE
MCO AUGMENTATION. THE MAY
REVISION IS PROPOSING A $115
MILLION OF MCO FUNDS DIRECTED
TOWARDS CHILDREN'S HOSPITALS
OVER THE NEXT THREE FISCAL YEARS
. TO DATE, THE LEGISLATURE
HASN'T REALLY RECEIVED ANY
EXPLANATION OR JUSTIFICATION FOR
THIS FUNDING. THIS NEW FUNDING
BEYOND THAT, IT'S INTENDED TO
IMPROVE ACCESS TO QUALITY HEALTH
CARE FOR CHILDREN WITH SERIOUS
DISEASES. CERTAINLY SOMETHING
THAT I, KNOW IS VERY IMPORTANT.
AND ALSO IT WAS A NEW LINE ITEM
WITHOUT MUCH EXPLANATION. CAN
YOU PROVIDE SOME ADDITIONAL
EXPLANATION ABOUT WHY THIS
APPEARED? SO THIS NEW DIRECTED
PAYMENT IS IN RECOGNITION THAT
OUR CHILDREN, CHILDREN'S
HOSPITAL REALLY TAKE THE REALLY
HIGH SPECIALIZED, HIGH ACUITY
CHILDREN AND RECOGNIZING KIND OF
THE EXCEPTIONAL COSTS FOR THAT
CARE. AND SO THIS IS A DIRECTED
PAYMENT THAT WOULD BE BASED ON
UTILIZATION FOR, AT CHILDREN'S
HOSPITALS, REALLY TO REFLECT THE
COST, AGAIN, OF THAT EXCEPTIONAL
CARE, AND, YOU KNOW, HIGH COST
CARE FOR THESE HIGH ACUITY
PATIENTS. IS THERE ANY REASON
WHY IT WASN'T A PART OF THE
ORIGINAL NEGOTIATION? SO,
CHILDREN'S HOSPITALS WOULD BE
WOULD HAVE RECEIVED PART OF THE
2025 RATE INCREASES. THEY WOULD
HAVE BEEN ELIGIBLE FOR THE
COMMUNITY OUTPATIENT PROCEDURES.
AND ALSO THE EMERGENCY, BUCKET
AS WELL. SO THEY WERE PART OF
THE 2025 RATE INCREASE, AT AS
PART OF THE 25 PROPOSALS. SO WE
ESSENTIALLY KIND OF CARVED THEM
OUT OF THE CLAWBACK, I'LL MOVE
ON TO, TO LOOKING AT THE
PROGRAMS RELATED TO HEALTH
ENROLLMENT NAVIGATORS. I RAISED
THIS AT THE LAST HEARING. THE
FACT THAT WE ARE GOING TO BE
REDUCING THE LEVEL OF ACCESS
MAKES THOSE POSITIONS EVEN MORE
CRITICAL. ARE THERE ANY IS THERE
ANY OPPORTUNITY TO REALLY THINK
ABOUT THE NAVIGATORS, AND THE
PROVISION OF OUTREACH? ANY OTHER
, PROGRAMS OR INITIATIVES THAT
WE BELIEVE WILL BE ABLE TO
PROVIDE SOME RESOURCE FOR THE
HEALTH ENROLLMENT NAVIGATORS AS
WE CONSIDER TO MAKE MAKING THOSE
CUTS? SO I THINK, WE HAVE OUR
COVERAGE AMBASSADORS PROGRAM,
WHERE WE HAVE ABOUT 6000
INDIVIDUALS WHO SIGNED UP SINCE
KIND OF THE BEGINNING OF THE
UNWINDING PERIOD. AND THESE ARE
COMMUNITY BASED ORGANIZATIONS,
PROVIDERS, DIFFERENT ENTITIES
THAT THE STATE HAS BEEN WORKING
WITH, REALLY TO UPLIFT, THE
IMPORTANCE OF THE
REDETERMINATION PROCESS, THE
EXPANSION. AND SO REALLY USING
THIS, THIS COHORT, OUR
AMBASSADORS TO REALLY, HELP
INDIVIDUALS ENROLL, HELP
INDIVIDUALS UNDERSTAND THEIR
COVERAGE OPTIONS AND REALLY
TRYING TO TAKE ADVANTAGE OF THAT
GROUP, WITH THIS REDUCTION. I'LL
MOVE ON TO RELATED AREA
COMMUNITY HEALTH WORKERS. WE
KNOW THAT THIS IS ANOTHER AREA
WHERE WE NEED TO DESPERATELY
LOOK FOR ALTERNATIVES. IT'S A
VERY CRITICAL ISSUE. WE SPENT
HOURS IN MARCH DISCUSSING THIS
CRITICAL ISSUE AT A COMMUNITY.
HEALTH WORKERS, PROMOTORAS AND
REPRESENTATIVES HEARING. I'M
VERY INTERESTED TO UNDERSTAND
AND KNOW WHAT THE ALTERNATIVES
ARE ASSOCIATED WITH THAT. IS IT
POSSIBLE AT ALL TO DELAY AS
OPPOSED TO COMPLETELY ELIMINATE,
THE MAJOR INVESTMENT THAT WE'VE
MADE THERE? SO AT THE DEPARTMENT
OF HEALTH CARE SERVICES, THERE
IS NO REDUCTION TO THE COMMUNITY
HEALTH WORKER BENEFIT THAT IS
MAINTAINED, AND SO NO REDUCTION
IS PART OF MAY REVISION. I
BELIEVE THERE MIGHT BE CHANGES
AT DEPARTMENT OF HEALTH CARE
ACCESS AND INFORMATION, BUT NOT
AT DCS. CAN ANYONE SPEAK. TO.
I'M SORRY. CAN YOU REPEAT THE
QUESTION, PLEASE? THE QUESTION
IS AROUND THE COMMUNITY HEALTH
CARE WORKERS. WE SPENT A LOT OF
TIME LOOKING AT WORKFORCE NEEDS.
AND GIVEN THE FACT THAT WE NEED
TO ENSURE MORE FRONTLINE,
CULTURALLY CONCORDANT CARE IS IT
POSSIBLE TO CONSIDER DELAYING
THE MAJOR INVESTMENTS AS OPPOSED
TO ELIMINATING THEM ENTIRELY?
YEAH. MATT AGUILERA, DEPARTMENT
OF FINANCE, SO IN THE WORKFORCE
AREA, WE ARE PROPOSING ONGOING
REDUCTIONS JUST DUE TO THE
OUTYEAR, FUNDING ISSUES WE'RE
TRYING TO SOLVE FOR BUDGET YEAR
AND BUDGET YEAR ONE. AND YOU
KNOW, THE THINKING IS THAT ONCE
THAT PUTS THE STATE BACK IN A
BETTER POSITION, THEN WE COULD
CONSIDER, YOU KNOW, ADDING BACK
SOME OF THESE, SERVICES THROUGH
THE BUDGET PROCESS AND SUBJECT
TO COMPETING PRIORITIES THROUGH
THE BUDGET PROCESS, BUT, THAT'S
KIND OF THE APPROACH. SO IT
GIVES THE STATE ADDITIONAL
FLEXIBILITY TAKING THAT APPROACH
, GIVEN THE FACT THAT IT'S VERY
CHALLENGING TO, KIND OF NOT MOVE
FORWARD WITH THE INFRASTRUCTURE
THAT'S ALREADY BEEN DEVELOPED
WHEN YOU CUT THESE PROGRAMS.
REASON FOR A DELAY VERSUS
ELIMINATION OR ELIMINATION
VERSUS DELAY AND ITS DELAY AT
ALL AN OPTION. YEAH. I THINK,
STATEWIDE FROM THE COMMUNITY
HEALTH WORKERS PERSPECTIVE, IT
IS, YOU KNOW, A BENEFIT ON THE
MEDI-CAL SIDE. SO THERE ARE
INVESTMENTS AND LEVERAGING OF
FEDERAL FUNDS HAPPENING ON ON
THE MEDI-CAL SIDE. WELL, ON THAT
, THERE IS AN ASSUMPTION
ESSENTIALLY THAT, WELL, THAT'S
ACTUALLY OKAY. SO IF THERE ISN'T
THE COVERAGE, THOUGH, IN WITH
THE FEDERAL FUNDING, THEN IF THE
FEDERAL GOVERNMENT MAKES ANY
CHANGES IN FUNDING, THEN WE JUST
WILL NOT BE ABLE TO FUND THOSE
PROGRAMS. MADAM CHAIR, SO ON THE
MEDI-CAL SIDE, IT REMAINS A
BENEFIT IN THE MEDI-CAL PROGRAM
DELIVERED BY OUR MANAGED CARE
PLANS. AND THEN IT'S ALSO
PROPOSED TO BE A BENEFIT UNDER
BCNF FOR OUR COUNTY BEHAVIORAL
HEALTH PLAN. SO THERE'S NO
CHANGE TO IT BEING A BENEFIT IN
THE MEDI-CAL SPACE. OKAY COVERED
CALIFORNIA. I'M SWITCHING TOPICS
. OKAY. MOVING ON TO COVERED
CALIFORNIA. SO WE ARE,
ESSENTIALLY WE MADE, MAY REVISE
ASSUMES THAT THE AARP FEDERAL
SUBSIDIES WILL BE EXTENDED AND
THEREFORE PROPOSES TO SWEEP MOST
OF THE COVERED CALIFORNIA HEALTH
CARE AFFORDABILITY RESERVE FUND
FOR, GENERAL FUND RELIEF. WHAT
HAPPENS IF THE FEDERAL
GOVERNMENT DOES NOT EXTEND THE
FEDERAL SUBSIDIES? IS THERE ANY
OPPORTUNITY TO STRUCTURE IN A
TRIGGER OR OR A DEFAULT IN THE
EVENT THAT THE FEDERAL SUBSIDY
ENDS UP NOT BEING AT THE LEVEL
THAT WE EXPECTED, MATT AGUILERA,
DEPARTMENT OF FINANCE, YES. SO
YOU HAVE IDENTIFIED A RISK
THAT'S INHERENT IN THE BUDGET,
THE STATE HAS BEEN FORTUNATE
THAT THE FEDERAL GOVERNMENT HAS
EXTENDED THIS IN THE PAST. AND
SO, YOU KNOW, WE'RE WE'RE,
TRYING TO MAKE SURE THAT THAT
EXTENSION CONTINUES INTO THE
FUTURE, THE FUNDS, THE 62
MILLION THAT IS PROPOSED AS A
LOAN IS, COMES OUT OF THE
RESERVE SO THAT, YOU KNOW, I
THINK THAT'S NOT GOING TO HINDER
US TOO MUCH IN TERMS OF WHETHER
OR NOT THE FEDERAL GOVERNMENT
EXTENDS, THEIR SUBSIDIES SINCE
IT COMES OUT OF THE RESERVE,
ALSO, THE ENABLING CONTROL
SECTION FOR THESE VARIOUS
STATEWIDE LOANS, ALLOWS THE
GENERAL FUND TO REPAY THE MONEY
IN THE EVENT THAT IT'S NEEDED
FOR ONGOING PROGRAM ACTIVITIES.
SO THERE'S ESSENTIALLY SOME
POTENTIAL, MITIGATION. YEAH,
THERE'S A SAFEGUARD. OKAY I
WANTED TO MOVE ON TO PUBLIC
HEALTH. SO WE. DO YOU HAVE ANY
KIND OF. IS IT GOING TO BE YOU?
OKAY. CAN YOU PROVIDE ANY IMPACT
ANALYSIS OF THE PROPOSED $300
MILLION CUT DESCRIBED, AND
DESCRIBE WHAT ACTIVITIES ARE
BEING CONDUCTED AT THE STATE AND
LOCAL LEVEL NOW THAT THIS WITH
THIS FUNDING WILL NO LONGER BE
AVAILABLE, WILL. YOU JUMPED
RIGHT IN. OKAY GIVE ME A MINUTE,
SORRY. JUST AN OVERVIEW OF THE
PROPOSAL, SPECIFICALLY THE
IMPACT ANALYSIS. I DON'T WANT
THE PROPOSAL. SURE. SO THE
PROPOSAL IS TO CUT $300 MILLION?
YEP HAVE YOU CONDUCTED AN IMPACT
ANALYSIS TO FULLY UNDERSTAND
WHAT IT WILL MEAN FOR US TO NOT
HAVE THE PUBLIC HEALTH RESOURCES
THAT WE NEED? YEAH, WE'RE WE'RE
WORKING THROUGH A LITTLE MORE
DETAIL ON THAT. HOWEVER, I CAN
SAY THAT OBVIOUSLY 100 MILLION
WAS, SORRY, BRANDON NUNES. CHIEF
DEPUTY DIRECTOR FOR OPERATIONS
AT THE DEPARTMENT OF PUBLIC
HEALTH, SO 100 MILLION WAS
PROVIDED FOR STATE OPERATIONS,
200 MILLION FOR LOCAL ASSISTANCE
ON THE LOCAL ASSISTANCE SIDE, WE
KNOW THAT 70% OF THAT FUNDING
WAS, REQUIRED TO BE SPENT ON
PERSONNEL. AND SO FROM THE
PERSONNEL PERSPECTIVE, THE LOCAL
HEALTH JURISDICTIONS WERE
PLANNING TO USE THAT FUNDING TO
SUPPORT ABOUT 1350 POSITIONS, OF
WHICH 82% OR 1100, ROUGHLY, ARE
FILLED WITH THE FUNDING THAT
THEY RECEIVED, AT THE STATE
LEVEL, WE WERE LOOKING TO FUND A
ROUGHLY 400 POSITIONS WITH THAT
FUNDING, OF WHICH ABOUT 78% OR
ABOUT 320 POSITION ARE FILLED.
OBVIOUSLY KIND OF AT THE LOCAL
LEVEL, NOT IT'S GOING TO VARY
JURISDICTION BY JURISDICTION AS
FAR AS IMPACT, BUT LOCAL HEALTH
JURISDICTION FUNDING WAS MEANT
TO SUPPORT STAFF, INCLUDING
EPIDEMIOLOGISTS, PUBLIC HEALTH
PHYSICIANS AND NURSES.
LABORATORIANS POLICY AND PROGRAM
ANALYSTS, COMMUNITY HEALTH CARE
WORKERS, ADMINISTRATIVE SUPPORT
AND LEADERSHIP AND MANAGEMENT
WITHIN THE LOCAL HEALTH
JURISDICTIONS. AND OBVIOUSLY,
THOSE PERSONNEL WERE GOING TO BE
SUPPORTING SOME CORE PUBLIC
HEALTH FUNCTIONS IN THE AREAS OF
CHRONIC DISEASE PREVENTION,
THÀNH, COMMUNICATIONS, EMERGENCY
PREPAREDNESS, MATERNAL CHILD AND
ADOLESCENT HEALTH, PUBLIC HEALTH
LABS, AND VITAL RECORDS. SO IT
KIND OF RAN THE GAMUT OF
DIFFERENT PUBLIC HEALTH AREAS
BASED ON THE PLANS THAT THE
LOCAL HEALTH JURISDICTION
SUBMITTED, ON OUR SIDE, FROM THE
STATE OPERATIONS PERSPECTIVE,
AGAIN, WE, FILLED ROUGHLY 317 OF
THE 404 POSITIONS. AND A LOT OF
THAT, AGAIN, WAS WAS FOR STAFF
THAT WERE RELATED TO EMERGENCY
PREPAREDNESS. WE STOOD UP, A
REGIONAL PUBLIC HEALTH OFFICE
THAT HAD A LOT OF COMMUNICATIONS
WITH LOCAL HEALTH JURISDICTIONS,
WE BOLSTERED SOME EMERGENCY
PREPAREDNESS ACTIVITIES, WE
STOOD UP OUR OFFICE OF POLICY
AND PLANNING, WITH THESE FUNDS,
WHICH PROVIDED THE STATE OF THE
STATE OF PUBLIC HEALTH REPORT TO
THE LEGISLATURE LAST YEAR, OR,
SORRY, THIS YEAR, AND SO BROADLY
, THE IMPACT IS KIND OF THESE
AREAS THAT I KIND OF OUTLINED AS
FAR AS WHERE STAFF ARE LOCATED.
AGAIN, THE VAST MAJORITY OF THE
FUNDING WAS FOR, FOR STAFFING AT
THE LOCAL LEVEL. AGAIN,
APPROXIMATELY 70. I'LL LEAVE IT
THERE AND SEE IF DOCTOR ARAGON
WANTS TO MAKE ANY COMMENTS. YES,
DOCTOR THOMAS ARAGON, CDPH
DIRECTOR AND STATE PUBLIC HEALTH
OFFICER, WHAT I WANT TO DO IS
JUST SPEND A FEW MINUTES. I KNOW
IT'S BEEN A LONG DAY AND
EVERYONE'S REALLY EXHAUSTED, SO
I WANT TO TRY TO FRAME THE
FUTURE PUBLIC HEALTH INITIATIVE
IN A WAY THAT, IT'LL I THINK
IT'LL MAKE IT A LITTLE BIT
EASIER, EASIER TO UNDERSTAND.
AND ONE THING I WANT TO JUST
START OFF BY SAYING IS THAT WE
KNOW CALIFORNIA IS A LARGE,
DIVERSE, COMPLEX STATE, ALMOST
40 MILLION PEOPLE WERE BIGGER
THAN MOST COUNTRIES, AND SO THE
FUTURE PUBLIC HEALTH INITIATIVE
WAS REALLY TO BEGIN TO SHORE UP
AND STRENGTHEN OUR BASIC PUBLIC
HEALTH INFRASTRUCTURE. SO WHEN
WE STARTED LOOKING INTO THIS, WE
WORKED WITH NATIONAL EXPERTS WHO
HAVE DECADES OF RESEARCH THAT'S
REALLY TRYING TO FIGURE OUT WHAT
ARE THE CORE ESSENTIAL SERVICES
THAT PUBLIC HEALTH SHOULD BE
OFFERING AND THAT EVERYBODY
SHOULD BENEFIT FROM THOSE FROM
THOSE, CORE CORE SERVICES. AND
SO WE'VE IF YOU RECOGNIZE THE
WAY PUBLIC HEALTH EVOLVES, WE'RE
ALWAYS REACTING TO DISASTERS.
AND THEN WE GET A SHOT OF
FUNDING THAT TENDS TO BE VERY,
VERY CATEGORICAL. SO WE BASED
BASED ON THE THIS RESEARCH AND
NATIONAL MODEL, IT WAS CALLED
PUBLIC HEALTH FOUNDATIONAL
SERVICES. AND IT'S REALLY TO
MAKE SURE THAT WE HAVE THAT CORE
INFRASTRUCTURE. AND IT'S ABOUT
PROMOTING A CULTURE OF HEALTH,
WELL-BEING AND THRIVING FOR ALL
IN CALIFORNIA. AND WE FOCUS ON
THE CONCEPT OF PROTECTION,
PREVENTION AND PROMOTION,
BUILDING RESILIENCE, RESPONSE
AND RECOVERY, AND OF COURSE,
MAKING SURE THAT WHAT WE DO IS
EFFECTIVE, EFFICIENT, ETHICAL
AND EQUITABLE. SO THOSE CORE
SERVICES ARE BROKEN UP INTO TWO
AREAS. THE FIRST AREA IS CALLED
FOUNDATIONAL CAPABILITIES.
CROSS-CUTTING INFRASTRUCTURE,
NATURE TO SUPPORT ALL OF THE
ACTIVITY THAT WE'RE DOING. SO
WHEN YOU LOOK AT THE CUTS,
YOU'LL SEE THEM HAPPENING IN
SOME SOME OF THESE EIGHT
DIFFERENT AREAS. I'M JUST GOING
TO LIST THEM. I'M NOT GOING TO
GO, YOU'VE HEARD YOU'VE HEARD
SOME OF THE SPECIFICS ASSESSMENT
AND SURVEILLANCE OKAY. WE'RE
LIKE RIGHT NOW WE'RE FOCUSED ON
AVIAN AVIAN INFLUENZA AND MOVING
THROUGH CATTLE COMMUNITY
PARTNERSHIPS. DEVELOPMENT IS
NUMBER TWO. NUMBER THREE IS
EQUITY AND HEALTH EQUITY. NUMBER
FOUR IS ORGANIZATIONAL
COMPETENCY. THAT'S WORKFORCE
DEVELOPMENT DEVELOPMENT DATA
SCIENCE DATA MODERNIZATION IT
BECOMING MORE EFFECTIVE IN OUR
OPERATIONS POLICY DEVELOPMENTS
AND SUPPORT. WE CDF THIS IS THE
FIRST TIME CDF HAS HAD A OFFICE
OF POLICY AND PLANNING FOR A
STATE AS LARGE AS CALIFORNIA.
ACCOUNTABILITY AND PERFORMANCE
MEASURE MANAGEMENT IS NUMBER
SIX. EMERGENCY PREPAREDNESS AND
RESPOND IS NUMBER SEVEN. AND
THEN COMMUNICATIONS AND PUBLIC
EDUCATION IS NUMBER EIGHT. SO
THOSE ARE FOUNDATIONAL CORE
CAPABILITY THAT EVERY HEALTH
DEPARTMENT IN THE COUNTRY SHOULD
HAVE, ESPECIALLY, STATES SUCH AS
CALIFORNIA. THEN THERE ARE WHAT
ARE CALLED FOUNDATIONAL AREAS,
AND THOSE ARE AREAS THAT YOU'RE
ALREADY FAMILIAR WITH. THEY'RE
VERY CATEGORICAL COMMUNICABLE
DISEASE CONTROL, CHRONIC DISEASE
AND INJURY PREVENTION,
ENVIRONMENTAL, PUBLIC HEALTH,
MATERNAL CHILD AND FAMILY
HEALTH. AND THEN THE OTHER AREA
THAT WE'RE MOVING INTO IS MENTAL
HEALTH AND SUBSTANCE USE. SO
WHAT I WHAT I WANT Tð FOLKS TO
RECOGNIZE IS THAT THIS CORE
INFRASTRUCTURE ARE LIKE THE
ROOTS OF A TREE. YOU CAN'T SEE
THEM MOST OF THE TIME, BUT IT
REALLY DETERMINES THE ABILITY
FOR US TO DO WHAT YOU DO SEE,
WHICH ARE THOSE FOUNDATIONAL,
FOUNDATIONAL AREAS THAT I JUST
MENTIONED. SO REMEMBER, THIS IS
THIS IS CORE INFRASTRUCTURE,
CORE INFRASTRUCTURE. AND I LIKE
TO TELL PEOPLE IT'S A LITTLE BIT
MORE LIKE PUBLIC SAFETY BECAUSE
WE'RE NOT DELIVERING INDIVIDUAL
FEE FOR SERVICES. WE DON'T GET
TO GET REIMBURSEMENT. WE RESPOND
TO ANYTHING THAT HAPPENS IN
CALIFORNIA. WE'RE EVERY EVERYONE
IN CALIFORNIA IS WHO WE
REPRESENT, WITH AN EMPHASIS, OF
COURSE, ON EQUITY AND VULNERABLE
POPULATIONS. BUT THAT'S PART OF
THE CHALLENGE OF PUBLIC HEALTH
IS THAT WE HAVE TO BE WE WE'RE
WORKING EVERY SINGLE DAY. WE'RE
RESPONDING TO EVENTS EVERY
SINGLE DAY, AND WE'RE PREPARING
AND EXERCISING FOR BIG EVENTS
THAT WE KNOW ARE GOING TO COME
AND HAVE BEEN COMING FOR DECADES
NOW. SO I WANT TO JUST GIVE YOU
THAT FRAMEWORK JUST TO
UNDERSTAND A LITTLE BIT. SO LET
ME LET ME END THERE AND SEE IF
THERE'S OTHER QUESTIONS. AND WE
HAVE OTHER STAFF HERE FROM THE
DIRECTORATE'S OFFICE THAT CAN
ALSO ANSWER QUESTIONS. I JUST,
FIRST OF ALL, WANT TO THANK YOU,
DOCTOR ARAGON, FOR BEING HERE,
VERY HAPPY TO SEE YOU WALK
THROUGH THE DOOR. CAN YOU
EXPLAIN TO US? AND FOR THE
PEOPLE WHO ARE WATCHING, WHAT
WOULD HAPPEN, WITH THESE
PROPOSED CUTS TO OUR PUBLIC
HEALTH INFRASTRUCTURE, TO THE TO
THE ROUTES THAT YOU'RE REFERRING
TO, THAT REALLY STAND UP OUR
PUBLIC HEALTH COUNTIES
THROUGHOUT OUR COUNTIES AND OUR
STATE. WELL, IT'S PROVIDES THE
FUTURE PUBLIC HEALTH
INITIATIVES, FUNDS CORE PUBLIC
HEALTH INFRASTRUCTURE FOR THESE
PARTS THAT JUST FALL THROUGH THE
CRACKS. IT'S NOT JUST THAT THE
STATE LEVEL. IT'S ALSO AT THE
LOCAL LEVEL. SO IT WOULD REALLY
IT WOULD IT WOULD INHIBIT SOME
SOME OF THE WORK THAT WE'RE
DOING. OFFICE OF POLICY AND
PLANNING, WE NEED TO BE
STRATEGIC IN HOW WE PLAN TO
ADDRESS PUBLIC HEALTH, HOW WE
PLAN FOR THE FUTURE, HOW WE
HELP, SELECT THE EVIDENCE THAT'S
GOING TO BE NOT JUST EFFECTIVE,
BUT MOST COST EFFECTIVE. SO WE
CAN SAVE WE CAN SAVE RESOURCES.
WE NEED. WE NEED TO WORK WITH
THE LOCALS. OFTENTIMES PROBLEMS
CROSS BOUNDARIES CROSS
JURISDICTIONS, WHICH IS MORE
COMMON THAN NOT. AND WE NEED TO
BE. WE'RE THE ONES WHO COME IN
AND ORGANIZE OUTBREAK
INVESTIGATIONS THAT ARE
MULTI-JURISDICTIONAL. WE WORK
VERY CLOSELY WITH FEDERAL HEALTH
OFFICIALS AND THE CDC, HHS, TO
REALLY ORGANIZE WHAT'S HAPPENING
NATIONALLY AND TO WHAT'S
HAPPENING HERE AT LOCALLY. SO IT
WOULD IT WOULD HAVE AN IT WOULD
HAVE AN IMPACT ON THAT CORE
INFRASTRUCTURE. WE DO HAVE THOSE
CATEGORICAL THINGS THAT, YOU
KNOW, THAT ARE FUNDED IN OTHER
WAYS, LIKE THE WICK WICK PROGRAM
, HOME, HOME VISITING, RADIATION
HEALTH. WE HAVE A WHOLE TEAM
THAT JUST FOCUSES ON RADIATION.
BUT IT'S REALLY THESE THINGS
THAT ARE CROSS-CUTTING AND
SUPPORTIVE OF ALL OF THIS, WHICH
WOULD BE IMPACTED. SO
ESSENTIALLY, YOU'RE SAYING THAT
THE ROOTS ARE GOING TO BE A BIT
ATTENUATED ACROSS THE ENTIRETY
OF THE PUBLIC HEALTH SYSTEM. IT
WOULD BE IMPACTING US AT THE
STATE LEVEL IN OPERATIONS, AND
IT ALSO WOULD BE IMPACTING THE
LOCALS AS WELL. SO IMAGINE FOR
EVERY EVERY HEALTH DEPARTMENT IS
GOING TO BE DIFFERENT DEPENDING
ON THEIR COMMUNITY AND THEIR
PROBLEMS THAT THEY FACE. AND SO
THEY'RE GOING TO HAVE DIFFERENT
INFRASTRUCTURE GAPS. AND SO
EVERY EVERY LOCAL HEALTH
DEPARTMENT TOOK THE FUNDING THAT
THEY THAT THEY GOT AND FOCUSED
ON. HOW DO THEY FILL THEIR
INFRASTRUCTURE GAPS. AND THEN WE
DID THE SAME THING AT THE STATE
LEVEL. AND THEN WE WORKED
CLOSELY TOGETHER AGAIN, WORKING
FROM THESE FOUNDATIONAL,
FOUNDATIONAL CAPABILITIES AS
REALLY OUR ROADMAP ROADMAP FOR
HOW TO MAKE SURE THAT WE DELIVER
CORE PUBLIC HEALTH SERVICES. ARE
THERE ANY NON-PERSONNEL
INITIATIVES THAT ARE FUNDED BY
THE COMBINED $300 MILLION
ALLOCATION THAT ARE GOING TO BE
ESSENTIALLY DEFUNDED, OR WE'RE
NOT GOING TO BE ABLE TO AFFORD
WITH? DO YOU HAVE SOME SOME
EXAMPLES SO WE CAN, I'D ASK THE
I KNOW THAT, LIKE I MENTIONED,
THAT ROUGHLY SEVEN AGAIN, I'LL
JUST SAY AT THE TOP THAT ROUGHLY
70% OF THE FUNDING IS MEANT TO
BE FOR STAFFING, PARTICULARLY AT
THE LOCAL HEALTH JURISDICTION
LEVEL. I KNOW AT THE STATE
LEVEL, WE DO HAVE SOME CONTRACTS
THAT ARE SUPPORTING OUR
OPERATIONS, I IMAGINE, AND I'M
SURE THERE ARE SOME CONTRACTS AS
WELL THAT ARE SUPPORTING THE
LOCAL HEALTH JURISDICTIONS IN
THAT REMAINING 30. I DON'T KNOW
IF THERE ARE SOME THAT POP TO
MIND. YEAH, I'LL MENTION ONE.
WHILE SUSAN FINLEY AND SOME
OTHER STAFF COME UP. SO ONE OF
THE EXAMPLES, WHEN PROPOSITION
ONE PASSED, WE DID NOT ASK FOR
ADDITIONAL MONEY. WE SAID WE
HAVE THIS FUTURE OF PUBLIC
HEALTH INITIATIVE. WE HAVE AN
OFFICE OF POLICY AND PLANNING.
AND SO WE STARTED TO DO ALL OUR
PLANNING EXIST WITH THAT
EXISTING FUNDING AND EXISTING
STAFF. SO THAT WAS A KEY
EXAMPLE, A KEY EXAMPLE. SO YEAH.
AND CHRISTINE SHAW, ASSISTANT
DIRECTOR, CDF, WE DO HAVE
CONTRACTS LIKE THOMAS SAID
REGARDING BEHAVIORAL HEALTH WITH
UC BERKELEY TO DO OUR LANDSCAPE
ANALYSIS, TO PLAN FOR PROP ONE.
AND SO THERE ARE OTHER
CONTRACTS. THE WHOLE EVALUATION
OF FUTURE PUBLIC HEALTH. WE DO
HAVE A CONTRACT FOR THAT TO MAKE
SURE THAT WE ARE BEING
EFFECTIVE. AND, AND, YOU KNOW,
REALLY WHEN YOU ASK THE QUESTION
, WHAT WOULD BE THE MAJOR
IMPACT? I THINK THE YOU KNOW,
FOR ME, I WOULD JUST SAY THAT IT
WILL REDUCE OUR PREPAREDNESS AND
RESPONSE CAPABILITY. AND I'LL
JUST ADD TO THAT, HAVING BEEN
THROUGH THE WHOLE OF THE COVID
RESPONSE AND WORKING THROUGH
THAT FOR MANY YEARS, I THINK IT
WOULD PUT US BACK TO WHERE WE
WERE AT THE BEGINNING OF THE
PANDEMIC AND THAT WE WOULD NOT
HAVE THE SURVEILLANCE AND THE
MODELING, ALL OF THESE TEAMS
THAT WE PUT TOGETHER, WE
WOULDN'T HAVE OUR RECOVERY
SECTION AND OUR EMERGENCY
PREPAREDNESS OFFICE AND CENTER.
SO I THINK IT WOULD REALLY FOR
ALL OF THOSE AREAS THAT WERE
INVOLVED IN RESPONSE. THIS IS
REALLY SOLIDIFYING THE GAPS. OUR
COMMUNICATIONS TEAM THAT BEFORE
THIS WAS REALLY JUST REACTING TO
MEDIA. AND NOW WE KNOW WE HAVE A
WHOLE MARKETING AND DIFFERENT
TYPES OF COMMUNICATION EFFORTS
THAT NEED TO BE PART OF OUR
RESPONSE. AND THAT ALSO MEANS
THAT AS WE'RE DEALING WITH AVIAN
FLU, DENGUE FEVER, FOOD RECALLS,
MEASLES, M-POX, SILICOSIS,
TUBERCULOSIS, VALLEY FEVER,
RIGHT. SEVERAL OF THE FOLKS
WORKING ON THAT ARE FUNDED
THROUGH THE ARE GOING TO
ESSENTIALLY BE COMPROMISED AS WE
DEAL WITH THOSE. MADAM CHAIR, I
WANTED TO ADD A COUPLE POINTS
FOR THE RECORD. SO, YEAH, AS YOU
KNOW, THESE, INVESTMENTS WERE
MADE DURING, BETTER RELATIVELY
SPEAKING, BETTER FINANCIAL
TIMES. AND THE FUNDS THAT WERE
PROVIDED WERE INTENDED TO
ENHANCE THE SERVICES THAT
EXISTED AT THAT TIME. BUT I DID
WANT TO NOTE THAT THE MAYOR OF
VISION, MAINTAINS 4.8 BILLION
TOTAL FUNDS. THAT INCLUDES, 1.7
BILLION AND, ROUGHLY 5000
POSITIONS FOR STATE OPERATIONS
AND 3.1 BILLION FOR LOCAL
ASSISTANCE. THAT'S TOTAL FUNDS
FOR ALL OF PUBLIC HEALTH
ACTIVITIES. SO THIS GOES BEYOND,
JUST THIS SPECIFIC PROGRAM THAT
WE'RE TALKING ABOUT HERE, BUT IT
DOES PROVIDE SOME CONTEXT, SO
THERE, THERE WOULD BE ADDITIONAL
RESOURCES IN THE BUDGET, EVEN IF
WE WERE TO, DO AWAY WITH THIS
PROGRAM, I HAD A COUPLE OTHER
POINTS. I WANTED YOU TO BE AWARE
OF. SO, FOR THE STATE OPERATIONS
COMPONENT SPECIFICALLY, WE WOULD
WORK WITH THE DEPARTMENT TO
IMPLEMENT THE VARIOUS REDUCTIONS
IN THE FALL, WE WOULD LOOK
TOWARDS, PRIORITIZING
ADMINISTRATIVE WORK AND FINDING
EFFICIENCIES, USING EXISTING
VACANCIES TO ABSORB IMPACTED
STAFF AND RECLASSIFY VÌ
POSITIONS AS NEEDED. AND SO WE
DO NOT ANTICIPATE THAT THE
LAYOFFS WOULD RESULT, ON THE
LOCAL ASPECT, WE DON'T HAVE AS
MUCH VISIBILITY INTO THE LOCAL
RESOURCES AND HOW THEY SPEND
THEIR FUNDS, SO, YOU KNOW, THAT
WOULD BE SUBJECT TO THE LOCAL
PROCESS THERE. AND A COUPLE
OTHER POINTS, SO THE BUDGET ALSO
MAINTAINS, 1.4 BILLION, IN THE
FOR THE CENTER FOR INFECTIOUS
DISEASES, OF WHICH 214.6 MILLION
IS GENERAL FUND AND 945.2
MILLION WOULD GO TO THE LOCAL
HEALTH DEPARTMENTS. AND IN
ADDITION, WE HAVE, 26.9 MILLION
FOR THIS, THE SURVEILLANCE AND
PUBLIC HEALTH INFORMATION
REPORTING AND EXCHANGE SYSTEM,
WHICH IS USED TO PROCESS LAB
DATA AND HELP STATE AND LOCAL
OFFICIALS, ADDRESS, OUTBREAKING,
INFECTIOUS DISEASE. THANK YOU.
CAN I JUST ASK DOCTOR ARGON AS A
GENERAL PRINCIPLE IN PUBLIC
HEALTH, WHEN, THERE IS DECREASED
ACCESS TO PREVENTATIVE CARE, AS
WE'VE UNDERSTOOD, IS LIKELY
GOING TO BE WHAT HAPPENS WITH
THE REDUCTION OF THE
REIMBURSEMENT RATES, WHAT
GENERALLY HAPPENS FROM A PUBLIC
HEALTH PERSPECTIVE FOR THE
SPREAD OF COMMUNICABLE DISEASES.
YEAH. SO YOU KNOW, PRIMARY
PRIMARY PREVENTION IS A CORE
PUBLIC HEALTH APPROACH. IT'S
MUCH MORE EFFECTIVE AND MUCH
LESS EXPENSIVE TO PREVENT
DISEASES FROM HAPPENING EVERY,
EVERY HIV INFECTION THAT OCCURS
ENDS UP BEING HUNDREDS OF
MILLIONS OF DOLLARS, SORRY,
HUNDREDS OF THOUSANDS OF DOLLARS
PER INDIVIDUAL. THEIR LIFETIME
COSTS. WHEN WE PREVENT AN HIV
INFECTION, WE SAVE. WE SAVE THE
HEALTH SYSTEM AND WE SAVE AND
COMMUNITIES MONEY AND SUFFERING.
SO PRIMARY PREVENTION IS VERY IS
A IS CORE. AND YOU SAW THAT ALSO
WITH COVID. SO VACCINE VACCINE
PROGRAMS ARE AN EXAMPLE OF
PRIMARY PREVENTION. IT'S MUCH
EASIER TO KEEP PEOPLE HEALTHY
THAN IT IS TO TAKE CARE OF THEM
AFTER THEY'VE THEY'VE SUFFERED
AN ILLNESS THAT MIGHT RESULT,
FOR EXAMPLE, IN LONG COVID AND
ONGOING COSTS. THANK YOU. THANK
YOU. SO, QUESTION FOR THE
DEPARTMENT OF FINANCE, YOU JUST
MENTIONED, FUNDING AND OTHER
PARTS OF THE DEPARTMENT OF
PUBLIC HEALTH, SO UNDERSTANDING
THE IMPORTANCE OF THIS PROGRAM
AND, YOU KNOW, WHEN WE HAD THE
HEARING ON WEDNESDAY, WE HEARD
FROM THE LAO THAT, YOU KNOW, OUR
PUBLIC HEALTH DEPARTMENTS
WEREN'T EVEN AT PAR PRIOR TO,
THE INITIATION OF COVID. AND SO
THIS PROGRAM AND THIS FUNDING
JUST KIND OF BRINGS THEM KIND OF
TO WHERE THEY SHOULD BE
UNDERSTOOD, FUNDING THE
SIGNIFICANCE AND THE FACT THAT
WHAT HAPPENED IS GOING TO HAPPEN
AGAIN, WHY IS IT THAT THE
DECISION WAS MADE TO CUT THIS
FUNDING INSTEAD OF LOOKING IN
OTHER AREAS, SINCE YOU SAY
THERE'S FUNDING IN OTHER PLACES,
WHAT WAS THE RATIONALE BEHIND
CUTTING THIS PROGRAM, WHICH IS
EXTREMELY IMPORTANT TO THE
FUTURE HEALTH OF CALIFORNIANS
AND THE ABILITY FOR US TO
RESPOND TO THE NEXT PANDEMIC? I
THINK, YOU KNOW, IT'S CONSISTENT
WITH SOME OF THE TESTIMONY
YOU'VE HEARD ELSEWHERE, WHICH IS
THAT, YOU KNOW, WE TRIED TO
FOCUS ON ONE TIME, INVESTMENTS
OR AREAS WHERE FUNDS HAD NOT YET
GONE OUT OR PROGRAMS STARTED UP.
AND SO, YOU KNOW, THIS AND ALSO
TRIED TO MAINTAIN THE CORE CORE
SERVICES AND MEDI-CAL AND
ELSEWHERE. AND SO, YOU KNOW, WE
LOOK, WE TRIED TO LOOK UNDER
EVERY PILLOW AND, AND MATTRESS,
AS YOU SUGGESTED. I BELIEVE. SO
YOU KNOW, AND THESE ARE JUST
SOME OF THE CHOICES THAT ARE
NECESSARY TO GET TO THE TYPES OF
NUMBERS THAT, YOU KNOW, WE NEED
TO SOLVE THE BUDGET PROBLEM.
YEAH. AND AND UNDERSTANDING THAT
WE ARE IN A SIGNIFICANT BUDGET
DEFICIT, DID YOU HAPPEN TO SIT
DOWN WITH THE DEPARTMENT OF
PUBLIC HEALTH AND SAY, HEY, WE
NEED TO MAKE SOME CUTS? WHERE
WOULD YOU SUGGEST WE DO THEM? OR
WAS THIS JUST KIND OF SOMETHING
THAT THE DEPARTMENT OF FINANCE
DECIDED ON ITS OWN? YEAH WE, WE
WORK COLLABORATIVELY. AND YOU
KNOW, THE ADMINISTRATION IS
WORKING TOGETHER TO COME UP WITH
WITH THE BEST SOLUTIONS THAT WE
COULD FIND, BUT AS HAS ALSO BEEN
INDICATED, WE'RE OPEN TO, YOU
KNOW, OTHER OR BETTER IDEAS THAT
ANY OTHERS, PUT ON THE TABLE.
WE'RE WILLING TO CONSIDER THAT.
AND, WE LOOK FORWARD TO WORKING
WITH THE LEGISLATURE FOR THE
REST OF THE BUDGET PROCESS.
DOCTOR. OREGON, ARE THERE ANY
YOU DON'T HAVE TO ANSWER RIGHT
NOW, BUT. YOU KNOW, THIS
PARTICULAR PROGRAM IS EXTREMELY
IMPORTANT. AND IF YOU KNOW, IF
ANYONE WAS LISTENING TO THE
HEARING WE HAD LAST WEDNESDAY,
WE HAD A VERY LENGTHY DISCUSSION
ABOUT IT. AND THE IMPORTANCE OF
BEING READY FOR AND PREPARED FOR
WHAT IS TO COME IN THE FUTURE.
HAVE YOU ALL THOUGHT OF ANY
OTHER AREAS IN YOUR DEPARTMENT
WHERE WE COULD GO BACK AND SAY,
HERE'S 300 MILLION THAT CAN BE
TAKEN FROM THIS OVER HERE SO WE
CAN MAINTAIN THIS PROGRAM? YEAH,
MOST, MOST OF OUR, WE'VE LOOKED
WE WE'VE LOOKED FOR OTHER THINGS
THAT HAVE COME UP WHERE WE'VE
RUN SHORT, FOR EXAMPLE, WHEN THE
CANCER REGISTRY, THERE WERE
SHORTAGES FINDING EVEN THOSE
SMALL AMOUNTS OF MONEY ARE
REALLY TIGHT BECAUSE THE VAST
MAJORITY OF OUR FUNDING IS
CATEGORICAL. SO IT'S JUST IT'S
VERY DIFFICULT TO MOVE MONEY,
MOVE, MOVE MONEY AROUND. I DON'T
KNOW IF SUSAN HAS ANYTHING ELSE
TO ADD. NÓ OR BRANDON, MOST OF
OUR MONEY IS FEDERAL OR SPECIAL
FUND, SO IT WOULDN'T ALLEVIATE
THE GENERAL FUND. AND I WOULD
ADD THAT, YOU KNOW, IDENTIFY
SAYING GENERAL FUND IN OUR
BUDGET IS DIFFICULT,
PARTICULARLY BECAUSE EVEN SOME
OF THE GENERAL FUND ITSELF IS
CATEGORICAL OF THE DOLLARS THAT
MR. AGUILERA MENTIONED IS LEFT
OF THE 470, ROUGHLY THREE
QUARTERS OF THAT IS LOCAL
ASSISTANCE DOLLARS. AND THEN
VERY SPECIFIC FUNDING GOES FOR
THINGS LIKE, HOME VISITING IN
OUR MATERNAL CHILD, CHILD AND
ADOLESCENT HEALTH PROGRAMS, OUR
BLACK INFANT HEALTH PROGRAM HAS
RECEIVED ADDITIONAL FUNDING OVER
THE LAST YEAR'S BUDGETS. AND
THEN A LOT OF THINGS IN STD
PREVENTION AND LAB SUPPORT,
WHICH WHICH IS KIND OF WHERE THE
BULK OF OUR STATE. SO EVEN THE
STATE OPERATIONS FUNDING THAT
REMAINS IS, IS LESS THAN 100
MILLION. DID YOU KNOW FOR THE
ANOTHER A SEPARATE ISSUE? OKAY.
WELL, I WOULD RECOMMEND THAT
MAYBE YOU GO BACK AND LOOK
AGAIN, AND SEE IF THERE'S
ANYTHING, EVEN IF IT'S EVEN IF
IT DOESN'T ADD UP TO 300
MILLION. UNDERSTANDING, YOU
KNOW, WHERE THE, DEPARTMENT OF
FINANCE AND THE GOVERNOR IS, IF
YOU'RE ABLE TO FIND SOME
RESOURCES, IT WOULD BE EASIER TO
ENSURE THAT WE'RE ABLE TO
MAINTAIN THIS VERY CRITICAL
PROGRAM. I WOULD LIKE TO, TO
MOVE ON TO HEALTH CARE WORKFORCE
TRAINING. THANK YOU VERY MUCH.
THANK YOU. THANK YOU SO MUCH FOR
COMING. SO LAST WEDNESDAY, WE
HAD A CONVERSATION ABOUT THE
HEALTH CARE WORKFORCE TRAINING
CUTS THAT YOU PROPOSED. AND I
SPECIFICALLY REQUESTED KNOWLEDGE
AS TO WHETHER OR NOT ANY CURRENT
RESIDENTS WOULD LOSE THEIR SLOTS
BASED ON WHAT HAS BEEN PROPOSED.
DO WE HAVE AN ANSWER FOR ME
TODAY? YES, MADAM CHAIR, THANK
YOU, MADAM CHAIR AND
ASSEMBLYWOMAN BONTA, ELIZABETH
LANDSBERG WITH THE DEPARTMENT OF
HEALTH CARE, ACCESS AND
INFORMATION. YES. SO WE, DID
MAKE CALLS, SPENT A LOT OF THE
DAY THURSDAY AND FRIDAY REACHING
OUT TO RESIDENCY PROGRAMS. SO WE
HAVE SEVERAL DIFFERENT POTS OF
FUNDS. SO I'LL JUST GO THROUGH
THEM, SOME OF THE SONG BROWN
RESIDENCY PROGRAM FUNDS ARE FOR
SUPPORT OF EXISTING SLOTS. SOME
ARE FOR EXPANSION SLOTS, THE
FUNDS THAT WE DID AWARD, IN
MARCH OF THIS YEAR ARE FOR
RESIDENTS WHO JUST WERE MATCHED
AND ARE STARTING IN 2024. SO AS
AS YOU WELL KNOW, THERE IS A
CONTRACT, OBLIGATION BETWEEN THE
RESIDENCY PROGRAM AND THE AND
THE RESIDENT WHO'S BEEN MATCHED,
BUT WE THE PROGRAMS THAT WE
SPOKE TO INDICATE THAT SONG
BROWN FINANCING IS A KEY FUNDING
SOURCE AND THAT THEY WOULD HAVE
A DIFFICULT TIME, CONTINUING
SOME OF THEIR PROGRAMS WITHOUT
THIS CORE FUNDING THING, SO WE
HAVE, IN ADDITION, THERE'S SONG
BROWN PRIMARY CARE RESIDENCY
PROGRAM, NEW PRIMARY CARE,
RESIDENCIES. SO THE BUDGET TWO
YEARS AGO INCLUDED $50 MILLION
FOR NEW RESIDENCY PROGRAM
RAIMES. AND WE HAVE AWARDED 41
MILLION OF THAT AND STARTED
PAYMENTS FOR THOSE NEW RESIDENCY
PROGRAMS. THERE IS A TWO AND A
HALF YEAR PROCESS TO GET
ACCREDITATION. SO WE HAVE
AWARDED A QUARTER OF THOSE FUNDS
AND ADDITIONAL FUNDS ARE TO BE
MADE ONCE ACCREDITATION AND
OTHER MILESTONES ARE REACHED. SO
AGAIN, DIFFERENT TYPES OF
FUNDING. BUT ALL OF THE PROGRAMS
INDICATED THAT THERE WOULD BE
SIGNIFICANT IMPACT, IF THESE
FUNDS WERE, WERE WITHDRAWN ONCE,
GIVEN THAT THESE AWARDS HAVE
BEEN MADE. OKAY. SO LET'S. MAKE
THIS VERY CLEAR FOR ME, IF YOUR
FIRST YEAR RESIDENT, CURRENT
RESIDENT IN ONE OF THESE
PROGRAMS AND THIS CUT OCCURS, IS
THERE FUNDING TO ALLOW THAT
RESIDENT TO DO THEIR SECOND AND
THIRD YEAR AT THAT LOCATION IN
THAT RESIDENCY PROGRAM, OR WOULD
THAT RESIDENT NEED TO FIND A NEW
PROGRAM? NONE OF THE PROGRAMS
THAT WE SO WE SPOKE TO 7 OR 8
PROGRAMS THAT WE WERE ABLE TO
REACH ON FRIDAY, AGAIN, THEY
INDICATED THAT THERE WOULD BE
GENERAL DIFFICULTIES IN
BACKFILLING THESE FUNDS. AND I
DON'T HAVE A SPECIFIC EXAMPLE OF
THIS HOSPITAL OR THIS TEACHING
HEALTH CENTER. WOULD BE UNABLE
TO CONTINUE FOR THE SECOND AND
THIRD YEAR, OF THEIR, OF THEIR
RESIDENCY PROGRAM. BUT THERE IS
A CHANCE THAT THEY WOULD NOT BE
ABLE TO CONTINUE WITH THEIR
CURRENT RESIDENTS. YEAH. SCOTT
CHRISMAN WITH HCAI. YES SO THE
ISSUE WOULD BE IN EACH
INSTITUTION, WHETHER THE
SPONSORING INSTITUTION HAD
ADDITIONAL DOLLARS TO BACKFILL.
SO IT'S REALLY A CASE BY CASE
BASIS. SO THERE IS A CHANCE
THERE IS A CHANCE THAT SOME OF
THESE RESIDENTS WHO HAVE
FINISHED ALL OF THEIR TRAINING
HAVE COME TO CALIFORNIA TO DO
THEIR RESIDENCY. WE WOULD NOT BE
ABLE TO COMPLETE THEIR RESIDENCY
OR WOULD HAVE TO SCRAMBLE AT THE
LAST MINUTE TO GET INTO ANOTHER
PROGRAM OUTSIDE OF CALIFORNIA.
THAT'S CORRECT. OKAY.
ADDITIONALLY WE HAVE, BECAUSE
THIS IS WHAT APRIL, JUNE, MAY,
MAY. GOSH. SO MATCH DAY HAS
PASSED AND WE HAVE ALREADY
MATCHED AND COMMITTED TO SOME,
RECENTLY GRADUATED FOURTH YEAR
MED STUDENTS WHO PLAN ON COMING
HERE AND STARTING THEIR
RESIDENCY. AS OF JULY FIRST. FOR
THOSE RESIDENTS, THERE IS A
CHANCE THAT THEY MAY NOT BE ABLE
TO COME BECAUSE OF THIS BUDGET
PROPOSAL. CORRECT. MADAM CHAIR,
SO, THE DEPARTMENT OF FINANCE,
WHEN THE WHEN THE THOUGHT
PROCESS WENT INTO THIS
PARTICULAR RECOMMENDATION, WHAT
WAS YOUR THOUGHT AS TO WHAT
THESE YOUNG DOCTORS, FUTURE
PROVIDERS WOULD DO IF THEY NOW
HAVE NO RESIDENCY SLOT AND ALL
OF THE OTHER ONES ARE FILLED?
MATT AGUILAR, DEPARTMENT OF
FINANCE, THE WORKFORCE PACKAGE
IS A ONE TIME INVESTMENT OVER
MULTIPLE YEARS, SO IT FALLS
UNDER THAT ONE TIME INVESTMENTS.
LOOK. BUT THAT'S THAT DOESN'T
ANSWER MY QUESTION. I UNDERSTAND
THAT IT'S IN A PARTICULAR, YOU
KNOW, ONE TIME FUNDING THING.
BUT THESE ARE COMMITMENTS THAT
WE'VE MADE TO INDIVIDUALS WHO
ARE NOW HERE OR COMING TO OUR
STATE TO TRAIN THAT WE MAY NOT
HAVE THE FUNDS BASED ON THE
PROPOSAL. SO WHEN YOU WERE IN
THE PROCESS OF PROPOSING THIS
CUT, WHAT WAS THE THOUGHT
PROCESS AS TO WHERE THESE
INDIVIDUALS WOULD GO? I THINK
THAT'S THAT'S A GOOD QUESTION.
THAT YOU RAISE, AND IT'S
CERTAINLY ONE OF THE IMPACTS OF
THIS PROPOSAL, I THINK, YOU KNOW
, LIKE, LIKE ALL THE VARIOUS
BUDGET SOLUTIONS, THESE CREATE
REAL LIFE CIRCUMSTANCES, AS
YOU'RE ALL AWARE AND BASED ON
THE TESTIMONY AND, YOU KNOW, IN
THE EVENT THAT SOME ONE TIME
MONIES ARE HAVING TO BE PULLED
BACK, THEN, YOU KNOW, FOLKS ARE
HAVING TO COME UP WITH ALTERNATE
FUND SOURCES. IN THE CASE OF
SOME OF THE RESIDENCIES, WE
HEARD THAT, THE STATE MONEY IS A
PORTION, BUT NOT ALL OF THE
FUNDS SUPPORTING THOSE EFFORTS.
RIGHT BUT IT'S A SIGNIFICANT
PORTION, CLEARLY, BECAUSE YOU
NEED IT TO COME BECOME WHOLE.
AND SO IF YOU REMOVE A PART OF
IT, THEN YOU'RE NO LONGER WHOLE
AND YOU'RE NOT ABLE TO CONTINUE
THE, THE COMMITMENT, THAT YOU
AND WE AS A STATE HAD MADE, BUT
THERE WAS NO THOUGHT PROCESS OF,
OH, WE'VE GOT THESE NOW YOUNG
EARLY PHYSICIANS ÓRDENES WHO
REALLY WOULDN'T BE ABLE TO
USUALLY DO ANYTHING BECAUSE, I
MEAN, SLOTS ARE FILLED. THEY'D
HAVE TO SIT OUT FOR A YEAR DOING
NOTHING, AND HOPING THAT THEY
WOULD BE ABLE TO SCRAMBLE INTO
ANOTHER SPOT NEXT YEAR. IF
SOMEBODY HAPPENS TO DROP OUT OF
THEIR RESIDENCY PROGRAM
SOMEWHERE ELSE. THERE WASN'T ANY
THOUGHT OR BEHIND THAT POTENTIAL
. NO, I WOULD NOT CHARACTERIZE
IT AS THERE WAS NO THOUGHT,
BECAUSE WE WERE I THINK WE WERE
VERY THOUGHTFUL. WE LOOKED FOR
ALL THE POSSIBILITIES, YOU KNOW,
AND OBVIOUSLY, YOU KNOW, IF
THERE WERE EASIER CHOICES OUT
THERE, THEN WE CERTAINLY WOULD
BE BRINGING THEM FORTH, BUT, YOU
KNOW, YEAH, THIS IS, AN IMPACT
FOR THIS AREA, AS YOU'VE
IDENTIFIED. WELL, WHEN I SAY NO
THOUGHT, LIKE WHAT? WHAT WOULD
WE DO? WHAT WOULD WE OFFER THESE
INDIVIDUALS, LAST WEEK, IT
DIDN'T EVEN SEEM LIKE ANYBODY
HAD THE ANSWER. SO HAD WE NOT
EVEN CONSIDERED THAT AS A
REALITY WITH THIS PARTICULAR CUT
, I DON'T THINK, YOU KNOW, WE
DIDN'T VIEW IT, AT THAT LEVEL OF
DETAIL, ALTHOUGH WE REALIZED
THAT THAT, YOU KNOW, THAT THERE
ARE IMPACTS TO YOU KNOW, HAVING
TO PULL BACK ONE TIME FUNDS DUE
TO THE BUDGET SITUATION. OKAY.
WERE ANY ISSUES OF LIABILITY
CONSIDERED WITH THIS PARTICULAR
CUT? IT STRIKES ME THAT IF WE
ARE, HAVE ALREADY MADE OFFERS,
PEOPLE HAVE COME HAVE AN
EXPECTATION OF BEING ABLE TO
RECEIVE THESE STATE FUNDS IN
ORDER TO BE ABLE TO COMPLETE
THEIR RESIDENCIES, THAT THERE'S
KIND OF A BASIC, I THINK, OFFER
AN ACCEPTANCE IN THERE AND A
LIABILITY THAT, WE COULD
POTENTIALLY EXPOSE OURSELVES TO
WITH THESE CUTS. I KNOW IN TERMS
OF STATE CONTRACTS, AS HAS BEEN
INDICATED IN PRIOR TESTIMONY AS
WELL, YOU KNOW, THE CONTRACTS
TYPICALLY HAVE CLAUSES THAT ARE
SUBJECT TO AVAILABILITY OF
RESOURCES, SO I DON'T KNOW IF
THE DIRECTOR COULD CORRECT.
ASSEMBLYWOMAN. SO THERE IS I'M
TOLD THERE'S WE HAVE CONTRACT
LANGUAGE WITH EXTENUATING BUDGET
CIRCUMSTANCES. SO I THINK WE ARE
CONCERNED ABOUT THE REAL LIFE
IMPACT ON ON THESE INDIVIDUALS
AS. SO THAT'S THE SONG BROWN
PROGRAM. AND AS YOU KNOW, WE
ADDITIONALLY HAVE 19 INDIVIDUALS
FOR WHOM WE'VE AGREED TO GIVE,
LOAN REPAYMENTS FOR THOSE OR
PHYSICIANS. AND THERE'S UNDER
THE STEPHEN THOMPSON LOAN
REPAYMENT PROGRAM, AS WELL AS
SOME PIPELINE AND PATHWAY
PROGRAMS TO WHICH WE'VE
OBLIGATED FUNDS. AND SO FOR
THOSE INDIVIDUALS THAT WE HAD
ALREADY STATED, WE'RE GOING TO
REPAY YOUR LOAN OR, YOU KNOW,
SOME OF THESE OTHER PROGRAMS, IT
WOULD JUST STOP. CORRECT. OKAY.
ALL RIGHT. MOVE ON TO ANOTHER
ISSUE. THANK YOU, THANK YOU,
THANK YOU. I'D LIKE TO, IF
POSSIBLE, MOVE ON TO THE
BEHAVIORAL HEALTH CONTINUUM
INFRASTRUCTURE AND THE
BEHAVIORAL HEALTH BRIDGE HOUSING
FUNDING
.
IN OUR AGENDA TODAY, THE
BEHAVIORAL HEALTH CONTINUUM
INFRASTRUCTURE PROGRAM WAS
INITIALLY PROVIDED $2.2 BILLION.
IS MY UNDERSTANDING. THE MAYOR
REVISION PROPOSES A TOTAL CUT OF
450.7 MILLION, AND LEAVES 1.75
BILLION OF THE INITIAL 2.2
BILLION REMAINING, THE GOVERNOR
ANNOUNCED LAST WEEK. THE PROGRAM
GUIDANCE FOR THE 4.4 BILLION IN
PROP ONE BOND FUNDING FOR, THE
CIP ROUND ONE AND ROUND TWO
FUNDING. CAN YOU, THE
ADMINISTRATION, EXPLAIN THE
RATIONALE OF MAINTAINING 1.75
BILLION OF THE INITIAL GENERAL
FUND ALLOCATION WHEN WE HAVE 4.4
BILLION COMING DOWN THE PIKE
THROUGH PROP ONE BOND FUNDING,
SO THAT THE 1.75 BILLION HAS
BEEN AWARDED, THOSE WERE ROUNDS
ONE THROUGH FIVE THAT HAVE BEEN
AWARDED. SOME PROJECTS HAVE
STARTED, SOME HAVE ALREADY
PROVIDING SERVICES. SO THAT'S
THAT'S THOSE DOLLARS. SO THEY'VE
ALREADY AWARDED SPENT OKAY. IS
THE ADMINISTRATION CONSIDERING.
WELL I GUESS IF THEY'VE ALREADY
BEEN AWARDED THEY CAN'T BE
REALLOCATED. FAIR TO SAY. I MEAN
PROJECTS HAVE STARTED. YEAH. GOT
IT, TODAY'S AGENDA ALSO DETAILS
THE BEHAVIORAL HEALTH BRIDGE
HOUSING HAS OVERALL PROPOSED
REDUCTION OF 250 MILLION OF THE
INITIAL 1.5 BILLION ALLOCATED.
THIS PROGRAM ALSO HAS A PROPOSED
90 MILLION IN BEHAVIORAL HEALTH
SERVICES ACT FUNDING FOR 2526.
CAN THE ADMINISTRATION EXPLAIN
WHY THE MAY REVISION ONLY
PROPOSES 90 MILLION OF THE BèC
FUNDING TO BACKFILL THIS
PROGRAM? GUADALUPE MANRIQUEZ
DEPARTMENT OF FINANCE SO THE 90
MILLION FOR THE BEHAVIORAL
HEALTH BRIDGE HOUSING IS THE
AMOUNT AVAILABLE, FROM THE GMSF
REVENUE. SO THAT 90 MILLION IS
THE AMOUNT THAT THE RESERVE
BALANCE CAN SUSTAIN. SO IN
THEORY, YOU COULD REALLOCATE
THAT SO THAT 90 MILLION BECAUSE
OUR PROPOSAL WAS TO MAINTAIN.
132 YEP. SO IF THE, IF WE WANT
TO MAINTAIN THE SAME LEVEL OF
FUNDING AND BUDGET YEAR ONE FOR
BEHAVIORAL HEALTH, BRIDGE
HOUSING, THE TRADE OFF IS THAT
IT WOULD BE ADDITIONAL GENERAL
FUND IN LIEU OF MENTAL HEALTH
SERVICES. WHY WOULD IT NOT BE
PART OF THE FAST TRACK PROP ONE
BOND FUNDING FOR BEHAVIORAL
HEALTH BRIDGE HOUSING. SO BRIDGE
HOUSING ISN'T PART OF THE BOND
STRUCTURE. IT IS PART OF
POTENTIALLY, ONCE PROPOSITION
ONE, THE REVISION TO THE LOCAL
CATEGORIES OF FUNDING WHEN
THERE'S THE 30% HOUSING
INTERVENTION DOLLARS, WHICH
STARTS JULY 2026, THIS WOULD BE
AN ELIGIBLE USE OF DOLLARS FOR
THOSE TYPES OF SERVICES, SUCH AS
RENTAL SUBSIDIES, OPERATING
SUBSIDIES, ETC. IN JULY 2026.
CORRECT. SO IS IT POSSIBLE TO
DEFER $90 MILLION FOR FUTURE
BUDGET YEAR PLUS ONE, SO THAT
WE'RE ESSENTIALLY BACKFILLING
WITH THE PROP ONE? THOSE ARE
DOLLARS LOCAL DOLLARS THAT WE
DON'T CONTROL. THE STATE DOES
NOT CONTROL THOSE DOLLARS. OKAY
OH DEAR. OKAY THOSE ARE ALL MY
QUESTIONS. ALL RIGHT. SO, I WANT
TO THANK ALL OF THE DEPARTMENTS
AND DEPARTMENT OF FINANCE FOR
COMING AGAIN TODAY. YOU KNOW,
THE UNDERSTANDING THAT THIS IS A
VERY, VERY TOUGH BUDGET YEAR,
AND DECISIONS HAD TO BE MADE.
SOME OF THE DECISIONS THAT WERE
MADE ARE, ARE VERY CONCERNING
ABOUT WHAT, LIKE WE SAID LAST
WEEK, THE PRIORITIES OF OUR
STATE, BUT ALSO WHERE ARE WE ARE
GOING TO GO AS FAR AS THE HEALTH
AND WELL-BEING OF THE RESIDENTS
OF CALIFORNIA, UNDERSTANDING
THAT YOU WERE TRYING TO KEEP
SOME OF THOSE CORE SERVICES
AVAILABLE. BUT LIKE I SAID LAST
WEEK, YOU CAN KEEP THOSE. AND
YET PEOPLE STILL DON'T HAVE
ACCESS BECAUSE THEY DON'T HAVE
PROVIDERS TO GO TO, WE'VE DONE
SO MUCH IN A SHORT PERIOD OF
TIME IN TERMS OF BUILDING UP OUR
PUBLIC HEALTH DEPARTMENT, NOT
ONLY AT A STATE LEVEL, BUT A
LOCAL LEVEL, SO THAT WE CAN BE
PREPARED FOR, WHAT WE'RE SEEING
NOW AND WHAT WE WILL SEE, TO
COME. AND SO TO PULL BACK SOME
OF THOSE DOLLARS WOULD REALLY
PUT US IN A VERY DANGEROUS
POSITION, TO BE QUITE HONEST
WITH YOU, ESPECIALLY GIVEN, THE,
THE SIZE OF OUR STATE, THE
NUMBER OF RESIDENTS THAT WE HAVE
HERE, AND THE NEED TO ACT
QUICKLY ON A VARIETY OF
DIFFERENT THINGS THAT ARE COMING
OUR WAY, VERY CONCERNED, OF
COURSE, LIKE WE TALKED ABOUT
LAST WEEK WITH THE, PROPOSAL TO
ELIMINATE THE INDIAN HEALTH
GRANT. STILL DON'T UNDERSTAND
THE RATIONALE BEHIND THAT. WHEN
WE KNOW THAT WE'RE LOOKING AT
VULNERABLE COMMUNITIES, WHERE
THAT WOULD LEAD US IF WE REMOVE
THAT GRANT, AND WHERE WE WOULD
LEAVE THAT, THAT POPULATION, AND
YOU KNOW, SO WE HAVE A LOT OF
THINGS THAT WE NEED TO CLEARLY,
FROM A LEGISLATIVE STANDPOINT,
LOOK THROUGH, REEVALUATE AND SEE
WHAT WE AGREE WITH AND WHAT WE
DON'T AGREE WITH. I AM VERY
CONCERNED, OF COURSE, WITH THE
PROMISES THAT WE MADE TO OUR
FUTURE PHYSICIANS AND THE FACT
THAT WE WERE NOW PROPOSING TO
PUT THEM IN A VERY PRECARIOUS
SITUATION WHERE THEY WILL NOT,
BE ABLE TO CONTINUE TO BE
TRAINED HERE DESPITE THEM
KEEPING UP THEIR END OF THE
BARGAIN, THAT WE WOULD PULL
THIS, AWAY FROM THEM AT SUCH A
CRITICAL TIME. BUT AT THIS
POINT, I'M GOING TO OPEN IT UP
TO PUBLIC COMMENT, TO HEAR FROM
SOME OF THE STAKEHOLDERS WHO
HAVE HOPEFULLY HAD MORE OF A
MORE OF A CHANCE TO KIND OF
DIGEST SOME OF THE PROPOSALS AND
, AND, ALSO LISTEN TO THE
HEARING FROM LAST WEEK. SO WE
HAVE A LOT OF PEOPLE WHO WANT TO
SPEAK, WHICH IS GREAT. WE ARE
GOING TO GIVE EVERYONE ONE
MINUTE FOR YOUR PUBLIC COMMENT.
SO THAT OKAY, SO ONCE AGAIN
WE'RE GOING TO GIVE EVERYONE ONE
MINUTE AND WE CAN BEGIN. THANK
YOU. CHAIR AND MEMBERS, MARK
FAROOQ WITH THE CALIFORNIA
HOSPITAL ASSOCIATION, SPEAKING
BRIEFLY ASKING THE COMMITTEE TO
REJECT THE ADMINISTRATION'S
CURRENT MCO PROPOSAL AS POLICY
MAKERS AND PRACTITIONERS, YOU
HAVE HEARD FOR YEARS ABOUT THE
NEED TO ADJUST MEDI-CAL
REIMBURSEMENT RATES AND WHAT
THAT MEANS FOR ACCESS. THE
TARGETED RATE INCREASES AS PART
OF THE MCO DEAL REACHED LAST
YEAR, ARE THERE TO PROVIDE
CRITICAL AND FOUNDATION SERVICES
TO MEDI-CAL PATIENTS, MADAM
CHAIR, AS WELL AS MADAM CHAIR.
THANK YOU FOR YOUR CONTINUED
INQUIRY INTO THIS ISSUE. WE HAVE
DEEP CONCERNS, AS MANY OF YOU
HAVE EXPRESSED AND WOULD ECHO
THE COMMENTS THAT YOU'VE MADE,
AS WELL AS YOUR QUESTIONS ABOUT
THIS PROPOSAL. WHAT ASKS THAT
YOU REJECT THAT PROPOSAL? THANK
YOU. THANK YOU. I'M DOCTOR MARK
LEBEAU, CEO OF THE CALIFORNIA
RURAL INDIAN HEALTH BOARD. CRIB
HAS A MEMBERSHIP OF 68 FULLY
RECOGNIZED TRIBES AND 20 TRIBAL
HEALTH PROGRAMS THROUGHOUT
CALIFORNIA. WE RECOMMEND THE
SUBCOMMITTEE REJECT THE
DEPARTMENT OF HEALTH CARE
SERVICES PROPOSAL TO ELIMINATE
THE INDIAN HEALTH PROGRAM, WHICH
WAS ESTABLISHED IN 1975. TRIBAL
AND ADDITIONAL AMERICAN INDIAN
COMMUNITIES ENDORSED SIGNIFICANT
HEALTH DISPARITIES AND COMPRISE
ONE OF THE MOST VULNERABLE
POPULATIONS IN THE STATE. WE ARE
RECOVERING FROM
MULTIGENERATIONAL TRAUMA AND
POST-TRAUMATIC STRESS IMPOSED ON
US BY COLONIAL FORCES. OUR
CLINICS ARE CHRONICALLY
UNDERFUNDED BY THE FEDERAL
INDIAN HEALTH SERVICE, AND ARE
RELYING UPON THE STATE FOR
RESOURCES. IN LIGHT OF THIS,
TRIBES AGAIN URGE THE
SUBCOMMITTEE TO REJECT
DEPARTMENT OF HEALTH CARE
SERVICES PROPOSAL TO TERMINATE
THE INDIAN HEALTH PROGRAM. THANK
YOU. THANK YOU. THANK YOU.
STEPHANIE WELDON, UNITED INDIAN
HEALTH SERVICES I TOO ASK THAT
YOU REJECT THE CUTS PROPOSED TO
THE INDIAN HEALTH CARE PROGRAM
FOR ALL THE REASONS STATED PRIOR
TO. BUT IN ADDITION, THE
DEPARTMENT HAS FAILED TO CONSULT
WITH TRIBES ON THIS PROGRAM.
IT'S NOT A NEW PROGRAM THAT THE
DEPARTMENT IS RESPONSIBLE UNDER
THE GOVERNOR'S EXECUTIVE ORDER,
AS WELL AS LAST YEAR'S BILL THAT
REQUIRES CONSULTATION WITH THE
GOVERNMENT TO GOVERNMENT WITH
TRIBES. WE HAVE A LOT OF NEEDS.
OUR TRIBE SUPPORTS TRADITIONAL
HEALING AS WELL AS BEHAVIORAL
HEALTH, RECRUITMENT AND
RETENTION. THE COUNTIES ARE
FUNDED, YET THEY DO NOT SERVE
OUR PEOPLE, ESPECIALLY IN
BEHAVIORAL HEALTH. WE ARE
WORKING WITH DCS. HOWEVER, WE
STILL HAVE A LACK OF ACCESS TO
CULTURALLY RESPONSIVE BEHAVIORAL
HEALTH SERVICES. THIS IS THE ONE
FUNDING SOURCE THAT ALLOWS US TO
PROVIDE INCREASED ACCESS AND
CULTURALLY RESPONSIVE BEHAVIORAL
HEALTH. AND WE TALK A LOT ABOUT
EQUITY, BUT TRIBES ARE NOT
MENTIONED IN THAT. AND SO BY
CUTTING THIS PROGRAM, EQUITY IS
MERELY JUST A WORD IN A STAMP.
THANK YOU. THANK YOU. GOOD
EVENING. THANK YOU STACY
HIRAMOTO WITH REMCO, THE RACIAL
AND ETHNIC MENTAL HEALTH
DISPARITIES COALITION, ALSO
REPRESENTING THE COMMUNITY
PARTNERS OF THE CALIFORNIA
REDUCING DISPARITIES PROJECT,
FIRST, I WANT TO SUPPORT THE
REMARKS OF MARK LEBEAU AND THE
SPEAKER AFTER HIM. WE ARE VERY
CONCERNED ABOUT THE CUTS TO THE, TOO. BUT
I ALSO WANT TO COMMEND YOU FOR
THIS, POINTING OUT THE SAIBAI,
THE CHILDREN AND YOUTH
BEHAVIORAL HEALTH INITIATIVE
CUTS, ONE OF THE CUTS IN
PARTICULAR, THE CUTS THE AWARDS
HAVE ALREADY BEEN, HANDED OUT
AND THIS IS THE PUBLIC EDUCATION
CAMPAIGN. AND IN DEPARTMENT OF
PUBLIC HEALTH. SO WE REALLY ARE
CONCERNED BECAUSE THOSE ARE
GOING TO SOME OF OUR PARTNERS,
THE COMMUNITY BASED
ORGANIZATIONS THAT ARE THE
SAFETY NET. ALSO, THE ONE UNDER
DHCS. THANK YOU. THE REDUCTION
OF PROGRAMS IS, TO SCALE
COMMUNITY DEFINED EVIDENCE
PRACTICES. CDPS ARE THE SERVICES
THAT ARE PREFERRED AND ARE VERY
EFFECTIVE WITH BIPOC AND LGBTQ
COMMUNITIES. AND A RECENT STUDY
SHOWED THAT FOR EVERY DOLLAR
SPENT, YOU SAVE $5, THE STATE
DOES ON THESE PROGRAMS. SO THANK
YOU VERY MUCH. THANK YOU. THANK
YOU VERY MUCH, VANESSA KAHINA,
ON BEHALF OF THE CALIFORNIA
ACADEMY OF FAMILY PHYSICIANS IN
GREAT APPRECIATION OF YOUR
REMARKS ON THE SONG BROWN
PROGRAM UNDER HCAI. WE ARE
EXTREMELY CONCERNED ABOUT WHAT
IT WOULD DO TO CURRENT COHORTS
IN THE UPCOMING YEARS ABOUT
WHERE THEY MIGHT BE ABLE TO
PRACTICE. WE DO SONG BROWN. WE
DO THIS INVESTMENT AS A STATE.
WE'VE DONE IT FOR DECADES
BECAUSE PRIMARY CARE IS NOT
FUNDED ADEQUATELY AT THE
RESIDENCY AND TRAINING LEVEL. WE
ARE IN A PRIMARY CARE CRISIS,
AND WE URGE YOU TO REJECT THAT
CUT. WE ARE ALSO DISAPPOINTED IN
THE MCO TAX PROPOSAL TO SWEEP
THOSE SAVINGS. AN OUNCE OF
PRIMARY CARE IS WORTH A POUND OF
DELIVERY DOWN THE SYSTEM. SO WE
URGE YOU TO REJECT THAT CUT AS
WELL. AND THEN ON BEHALF OF
COMPROMISO, THE STATEWIDE
NETWORK OF PROMOTORAS AND
COMMUNITY HEALTH WORKERS, THE
INVESTMENT IN COMMUNITY HEALTH
WORKERS HAS BEEN AN EQUITY
BUILDING INVESTMENT FOR A
POPULATION OF PEOPLE WHO HAVE
HISTORICALLY BEEN SYSTEMATICALLY
EXCLUDED FROM THE HEALTH CARE
PROFESSIONS IN CALIFORNIA. WE
URGE YOU TO REJECT THAT CUT.
THANK YOU VERY MUCH. THANK YOU.
GOOD EVENING. MICHELLE GIBBONS
WITH THE COUNTY HEALTH
EXECUTIVES ASSOCIATION OF
CALIFORNIA REPRESENTING LOCAL
HEALTH DEPARTMENTS. THANK YOU
FOR THE CONCERNS RAISED AROUND
THE PUBLIC HEALTH FUNDING, WE
DON'T QUALIFY IN ANY OF THE
CATEGORIES THAT THE DEPARTMENT
FINANCE RAISED IN TERMS OF HOW
THEY CHOSE THIS CUT. IT'S NOT
IT'S ONGOING. IT'S, YOU KNOW, SO
WE DON'T QUALIFY IN THOSE
BUCKETS. IT WILL GO BACK TO WHAT
AS PREPARED AS WE WERE IN 2020,
WHICH JUST WAS NOT SUFFICIENT,
WE ALSO ARE STILL TRYING TO
FIGURE OUT WHAT THE FUNDING IS
FOR CAL CONNECT, HOW MUCH, HOW
LONG, AND IF THIS IS GOING TO
RETAIN ALL THE CAPABILITIES. SO
WE HOPE THAT THERE'LL BE ONGOING
DIALOG AROUND THAT. SYNDROMIC
SURVEILLANCE TRAILER WILL JUST
POSTED TODAY. WE ARE DIGESTING
BUT WANT TO MAKE SURE THAT WE
RETAIN OUR LOCAL SYSTEMS,
APPRECIATE THE MOVEMENT ON CHP.
WANT TO SEE ALL THE FUNDING
GOING OVER TO THE HEALTH CARE
PROGRAM FOR CHILDREN IN FOSTER
CARE? THANK YOU. THANK YOU. GOOD
EVENING. JEFF NEAL, FIRST, ON
BEHALF OF SAN DIEGO COUNTY, LOOK
FORWARD TO WORKING WITH, WITH
THE COMMITTEE AND THE STATE ON
LANGUAGE AROUND THE INCOMPETENT
TO STAND TRIAL, MAKING SURE AT
THE AT THE VERY LEAST, THAT THE
MONEY Kò THAT THE PENALTY MONEY
THAT IS TO BE RETURNED IS DONE.
SO MAYBE IN STATUTE WITH A
SPECIFIC DEADLINE FOR WHEN THAT
MONEY WOULD COME BACK, TO
FULFILL THAT PROMISE. AND THEN
ALSO ON BEHALF OF SAN DIEGO,
CONTRA COSTA AND LAKE COUNTIES
URGE YOU TO REJECT THE
DEVASTATING CUTS TO PUBLIC
HEALTH. THANK YOU. THANK YOU.
GOOD AFTERNOON, MADAM CHAIR
MEMBER MARTHA GUERRERO,
REPRESENTING THE LOS ANGELES
COUNTY BOARD OF SUPERVISORS, FOR
TWO REASONS, FOR THE CHILD
HEALTH AND DISABILITY PREVENTION
PROGRAM, WE REQUEST THAT ALL THE
FUNDING GO TO THE HEALTH CARE
PROGRAM FOR CHILDREN IN FOSTER
CARE. TRANSITION. AND SO ALSO,
WE ARE CURRENTLY ANALYZING THE
MAY REVISION PROPOSALS. WE HAVE
SERIOUS CONCERNS WITH THE HEALTH
AND HUMAN SERVICES AND WILL BE
PROVIDING IMMEDIATELY WITH THE
BUDGET IMPACT AS SOON AS WE ARE
ABLE TO PRESENT IT TO YOU. THANK
YOU, THANK YOU, THANK YOU, MADAM
CHAIR. ASSEMBLYMEMBER VON KATHY
MCDONALD FOR ALAMEDA COUNTY, AS
I PREVIOUSLY TESTIFIED, THIS
WILL AFFECT 40 STAFF, 39 STAFF
WHO HAVE EITHER ALREADY BEEN
HIRED OR ARE BEING RECRUITED.
AND AS WE THINK ABOUT THE
IMPACTS ACROSS THE BREADTH OF
THE SERVICES THAT THE PUBLIC
HEALTH DEPARTMENTS PROVIDE, I
THINK WE ALL KNOW THAT THE
FOUNDATION WAS VERY SHAKY BEFORE
THE PANDEMIC, AND THIS AGREEMENT
BECAME ABOUT THE FUNDING BECAUSE
WE SAW DURING THE PANDEMIC, BOTH
THE VALUE AND THE IMPERATIVE OF
BETTER PREPAREDNESS, NOT JUST
FOR A PANDEMIC OR THE NEXT
PUBLIC HEALTH CRISIS, WHICH WILL
COME, BUT FOR ALL OF THOSE
UNDERLYING FOUNDATIONAL ISSUES.
AS YOU HEARD FROM THE PUBLIC
HEALTH DIRECTOR, THAT WAS A
REALLY GOOD MOVE. AND SO WE ARE
URGING YOU TO WORK WITH US IN
PARTNERSHIP, AS WE KNOW YOU HOPE
TO, TO NOT TURN BACK THAT CLOCK.
THANK YOU. THANK YOU. GOOD
EVENING. MOLLY ROBSON WITH
PLANNED PARENTHOOD AFFILIATES OF
CALIFORNIA AT PLANNED PARENTHOOD
HEALTH CENTERS. MORE THAN 85% OF
OUR PATIENTS HAVE INSURANCE
COVERAGE THROUGH MEDI-CAL. AND
SO BECAUSE OF THAT, WE ASK YOU
TO REJECT THE MAY REVISION
PROPOSAL TO ROLL BACK THE MUCH
NEEDED INVESTMENTS IN THE HEALTH
CARE SYSTEM THROUGH THE MCO TAX.
WE NEED TO MAINTAIN INVESTMENT
IN THE MEDI-CAL SYSTEM TO HELP
STABILIZE CALIFORNIA'S SAFETY
NET PROVIDERS LIKE PLANNED
PARENTHOOD, TO MEET THE NEEDS OF
PATIENTS IN CALIFORNIA AND MAKE
A SUSTAINABLE, MEANINGFUL IMPACT
ON HEALTH CARE DELIVERY IN
CALIFORNIA, INCLUDING IN SEXUAL
AND REPRODUCTIVE HEALTH CARE.
THANK YOU. THANK YOU. CHAIR
GONZALEZ, ON BEHALF OF MY
CLIENTS, THE ASSOCIATION OF
NORTHERN CALIFORNIA ONCOLOGISTS,
OTHERWISE KNOWN AS AN KHÓ, AS
WELL AS THE MEDICAL ONCOLOGY
ASSOCIATION OF SOUTHERN
CALIFORNIA, OTHERWISE KNOWN AS
MOSK. MY CLIENTS ARE DEEPLY
CONCERNED, LEARNED ABOUT THE MAY
REVISIONS, PROPOSED ELIMINATION
FOR THE REIMBURSEMENT RATE
INCREASES TO SPECIALTY CARE
BECAUSE WE KNOW FOR A FACT THAT
TIMELY ACCESS TO CANCER CARE IS
DIRECTLY LINKED TO SURVIVABILITY
. WE THEREFORE URGE THIS
SUBCOMMITTEE TO DO WHATEVER EVER
IT IS IT CAN DO TO MAKE SURE
THAT THOSE REIMBURSEMENT RATE
INCREASES GO FORWARD AND YOU
REJECT THE MAY REVISION PROPOSAL
TO ELIMINATE THOSE RATE
INCREASES TO SPECIALTY CARE.
THANK YOU. THANK YOU. GOOD
EVENING, MADAM CHAIR AND
MEMBERS. JOLIE ONODERA WITH THE
CALIFORNIA STATE ASSOCIATION OF
COUNTIES, REPRESENTING ALL 58
COUNTIES, JUST HERE TO URGE YOU
TO REJECT THE PROPOSAL TO FULLY
ELIMINATE THE FUTURE PUBLIC
HEALTH FUNDING. I THINK IT'S THE
STATE DEPARTMENT OF PUBLIC
HEALTH MENTIONED THIS WOULD
CERTAINLY IMPACT THEIR ABILITY
TO PREPARE AND RESPOND. WE WOULD
HAVE A VERY SIMILAR IMPACT AT
THE LOCAL LEVEL AS WELL. THANK
YOU. THANK YOU. GOOD EVENING,
MADAM CHAIR AND FELLOW COMMITTEE
MEMBERS. THIS IS MY FIRST TIME
DOING A PUBLIC, COMMENT, SO
PLEASE BEAR WITH ME. MY NAME IS
CHEN BALA HØI AND I'M THE
EXECUTIVE DIRECTOR OF YOLO
COUNTY CHILDREN'S ALLIANCE. ON
BEHALF OF MY AGENCY SERVING
COMMUNITIES IN YOLO COUNTY AND
THE MEDI-CAL FOR ADULT OLDER
ADULTS COALITION, I AM HERE TO
RESPECTFULLY REQUEST YOUR
SUPPORT AND APPROVAL FOR THE
REAUTHORIZATION OF THE MEDI-CAL
FOR OLDER ADULTS PROGRAM FOR
FISCAL YEAR 2425 AND YOUR
OPPOSITION TO THE GOVERNOR'S MAY
REVISION PROPOSAL TO ELIMINATE
THE MEDICA HEALTH NAVIGATORS
PROJECTS AS PART OF THE STATE
BUDGET. SUPPORT FOR THESE TWO
CRITICAL PROGRAMS WILL ALLOW FOR
THE CONTINUED ATION OF VITAL
WORK WHICH IS HAPPENING IN MY
COUNTY, IN SOME CASES LIFE
SAVING TO PROVIDE COMPREHENSIVE
HEALTH CARE COVERAGE AND
SERVICES TO CALIFORNIA'S MOST
VULNERABLE RESIDENTS. WE THANK
YOU FOR YOUR TIME AND
CONSIDERATION OF OUR INCREDIBLY
IMPORTANT REQUESTS. THANK YOU.
THANK YOU. KELLY BROOK, SPEAKING
ON BEHALF ON TWO DIFFERENT
ITEMS. FIRST, ON BEHALF OF THE
CALIFORNIA ASSOCIATION OF PUBLIC
HOSPITALS AND HEALTH SYSTEMS, WE
ARE OPPOSED TO THE MCO TAX
PROPOSAL. PUBLIC HEALTH CARE
SYSTEMS ARE THE CORE OF
CALIFORNIA'S HEALTH CARE NET,
PROVIDING 35% OF ALL MEDI-CAL
AND UNINSURED HOSPITAL CARE DUE
TO LOW MEDI-CAL RATES AND
HISTORICAL UNDERFUNDING IN THESE
SYSTEMS, THEY ARE FACING A $4
BILLION DEFICIT AS THEY STRETCH
TO MEET AN UNPRECEDENTED DEMAND
FOR SERVICES. THEY'RE VERY
DISAPPOINTED THAT THE MCO TAX
WILL NOT BE AVAILABLE TO ADDRESS
MEDI-CAL PROVIDER RATES. SECOND,
ON BEHALF OF THE URBAN COUNTIES
OF CALIFORNIA AND THE BOARDS OF
SUPERVISORS OF RIVERSIDE,
VENTURA, AND SANTA CRUZ COUNTIES
OPPOSED TO THE ELIMINATION OF
FUNDING FOR FUTURE OF PUBLIC
HEALTH IN VENTURA COUNTY WITH A
POPULATION OF 850,000, THEY HAD
ONE EPIDEMIOLOGIST PRIOR TO THE
PANDEMIC. THEY'VE USED THE
FUNDING TO INVEST IN
EPIDEMIOLOGY. THEY'VE LAUNCHED A
COMMUNICABLE DISEASE PROGRAM TO
COMBAT THE TRANSMISSION OF
INFECTIOUS DISEASES AND ELEVATE
PREVENTION AND CONTROL PRACTICES
AND MEDICAL AND NON-MEDICAL
SETTINGS. AND SANTA CRUZ,
THEY'VE USED THE FUNDS TO UPDATE
COMMUNITY HEALTH ASSESSMENTS,
BUILD CORE INFRASTRUCTURE,
EXPAND EPIDEMIOLOGY ACTIVITIES,
SUPPORT WORKFORCE DEVELOPMENT
AND TRAINING, PARTICULARLY
TRAUMA INFORMED AND EQUITY BASED
TRAININGS. WE URGE YOU TO DO
WHAT YOU CAN TO HELP, REDUCE THE
IMPACT OF THAT CUT. THANK YOU.
HI, SARAH TO KENT ON BEHALF OF
THE RURAL COUNTY REPRESENTATIVES
OF CALIFORNIA, URGING YOU TO,
URGING YOU TO REJECT THE
ELIMINATION OF THE LOCAL PUBLIC
HEALTH DOLLARS WITH THE DECADES
OF UNDERINVESTMENT IN PUBLIC
HEALTH, COMBINED WITH THE REAL
BARRIERS AND CHALLENGES FOR
ACCESS TO CARE IN RURAL AND
REMOTE COMMUNITIES, THIS WILL BE
ABSOLUTELY DEVASTATING. WHEN YOU
TAKE THE SCOPE OF THE CUTS
PROPOSED IN THE STATE BUDGET,
ALONG WITH THE SOFTENING
REVENUES LOCALLY, THE RURAL
COUNTIES JUST WILL NOT HAVE THE
LOCAL DOLLARS TO CONTINUE TO
FUND THESE POSITIONS. SO WE URGE
YOU TO REJECT THOSE CUTS. THANK
YOU. THANK YOU. GOOD EVENING.
THANK YOU, MADAM CHAIR. MY NAME
IS ELBA GONZALEZ MÁS. I'M THE
EXECUTIVE DIRECTOR OF A
NONPROFIT ORGANIZATION CALLED
COMMUNITY HEALTH INITIATIVE.
GENEVA. JUST SPOKE IS ONE OF MY
COLLEAGUES, OUR ORGANIZATION
SERVES INDIVIDUALS IN LOS
ANGELES. SANTA CLARA, SOLANO,
AND NAPA. WE PROUDLY HAVE SERVED
OVER 40,000 INDIVIDUALS. THESE
ARE FOLKS WHO ARE VULNERABLE AND
POVERTY, WHO ARE AGE BLIND AND
DISABLED, AND DEPEND A LOT ON
THESE ESSENTIAL SERVICES THAT WE
WERE SPEAKING ABOUT TODAY, ALSO,
I'M HERE TO SPEAK ON ON BEHALF
OF MY FELLOW COLLEAGUES WHO
COULDN'T MAKE IT HERE TO TODAY'S
BUDGET HEARING, TO TALK ABOUT
THE, TO IN SUPPORT OF OUR
COALITION OF CALIFORNIA VÀ AND
THE MEDI-CAL FOR OLDER ADULTS
WORK, YOUR SUPPORT TO APPROVE
THE REAUTHORIZATION CAN IMPACT
OUR PROJECTED ASSISTANCE OF
107,000 VULNERABLE OLDER ADULTS,
WE HAVE DONE REALLY GREAT WORK
AND BUILD SOME FANTASTIC
INFRASTRUCTURE THAT REALLY
WASN'T PARTICULARLY THERE FOR
OUR FOR OUR MEDI-CAL OLDER
ADULTS AND THEN NOW. SO TO
PLEASE REQUEST YOUR SUPPORT AND
OPPOSITION OF THE OTHER
IMPORTANT INFRASTRUCTURE THAT'S
BEEN BUILT ON THAT WAS SHOWN IN
THE GOVERNOR'S MAY REVISION OF
ELIMINATING THE MEDI-CAL HEALTH
NAVIGATORS PROJECT. SO THESE TWO
CRITICAL PROGRAMS ARE, IT JUST
IT'S PART OF THAT LIFE CHANGING
ESSENTIAL CREATES EQUITY. VÆ, IT
CREATES, THAT SUPPORT AND MEET
FOLKS WHERE THEY'RE NEEDED, IN
ORDER TO ACCESS ONE OF THE MOST
IMPORTANT THINGS AS PART OF
THEIR LIVES, WHICH IS ACCESS TO
HEALTH CARE. THANK YOU. THANK
YOU SO MUCH. HI. MY NAME IS MARK
DIEHL. I'M WITH CALIFORNIA
COVERAGE AND HEALTH INITIATIVES,
AND I'M JUST HERE TO ECHO THE
COMMENTS OF ELBA AND GENEVA, WE
REALLY APPRECIATE THE
OPPORTUNITY TO SPEAK. THANK YOU,
MADAM CHAIR. WE WANT TO KEEP THE
FUNDING FOR MEDI-CAL FOR OLDER
ADULTS IN THE STATE BUDGET. IT'S
HELPING OUR MOST VULNERABLE
OLDER ADULTS, PEOPLE WHO ARE
AGED, BLIND, DISABLED AND LIVING
IN POVERTY, WE ALSO WANT TO
OPPOSE THE ELIMINATION OF THE
MEDI-CAL NAVIGATOR PROGRAM OR
ONE OF THE GRANT RECIPIENTS. WE
PARTNER WITH 12 LOCAL AGENCIES
TO GET THOSE SERVICES OUT IN
LOCAL COMMUNITIES, AND THEY'RE
REALLY CRITICAL. THEY IN TURN,
MEDI-CAL INTO A PROGRAM TO
ACTUALLY GET HEALTH CARE
SERVICES FOR PEOPLE. PEOPLE COME
TO OUR OFFICES BECAUSE THEY
DON'T KNOW WHERE TO GO. THEY
HAVE CONFUSION ABOUT THEIR
HEALTH INSURANCE. ABOUT 90% OF
THE CLIENTS THAT WE SERVE IN OUR
OFFICES ARE INSURED IN MEDI-CAL,
BUT THEY DON'T KNOW HOW TO USE
IT. THEY DON'T KNOW WHERE TO GET
HEALTH CARE SERVICES. SO IF
THEY'RE FUNCTIONALLY UNINSURED,
WE'RE MAKING SURE THAT THE
INSURANCE THAT YOU'RE PAYING
FOR, THE COVERAGE THAT YOU'RE
PAYING FOR ACTUALLY CAN BE
UTILIZED. SO THANK YOU FOR THE
OPPORTUNITY. THANK YOU. GOOD
EVENING, CHAIR WEBER AND
COMMITTEE MEMBERS, CHRIS STONER
MERTZ WITH THE CALIFORNIA
ALLIANCE OF CHILD AND FAMILY
SERVICES, WE ARE VERY CONCERNED
ABOUT SOME OF THE CUTS TO
PROGRAMS THAT DIRECTLY IMPACT
THE CHILDREN AND YOUTH IN
CALIFORNIA IN PARTICULAR, WE ASK
THAT YOU REJECT THE PROPOSED
CUTS TO YOUTH SUICIDE REPORTING
AND CRISIS RESPONSE FOR THE
DEPARTMENT OF PUBLIC HEALTH. THE
HCAI WORKFORCE GRANTS, WHICH ARE
SO CRITICAL TO SUPPORT OUR
BEHAVIORAL HEALTH WORKFORCE. AND
WE ARE DEEPLY CONCERNED ABOUT
THE CUTS TO ROUND SIX OF THE
SAIBAI COMMUNITY DEFINED
EVIDENCE PROGRAM GRANTS. THESE
IN PARTICULAR, ARE IMPORTANT TO
MANY YOUTH IN OUR COMMUNITIES
THAT NEED ACCESS TO
NONTRADITIONAL SUPPORTS AND
SERVICES. AS WE ALL KNOW, WE'RE
FACING A YOUTH MENTAL HEALTH
CRISIS NOW. WE HAVE A BUDGET
CRISIS, BUT WE CAN'T GIVE UP ON
THEM. THANKS THANK YOU. GOOD
EVENING. LINDA HèA WITH WESTERN
CENTER ON LAW AND POVERTY. WE
OPPOSE THE DEVASTATING CUTS TO
THE SAFETY NET PROGRAM AND URGE
THE LEGISLATURE AND
ADMINISTRATION TO CONSIDER
REVENUE SOLUTIONS. WERE
DISAPPOINTED THAT THE SHARE OF
COST REFORM WAS NOT INCLUDED,
WHICH MEANS CERTAIN SENIORS AND
PERSONS WITH DISABILITIES ARE
EXPECTED TO LIVE OFF OF $600 A
MONTH. AND SO REALLY DO URGE
CREATIVE SOLUTIONS. ALSO
DISAPPOINTED THAT MULTI YEAR
CONTINUOUS ELIGIBILITY FOR
CHILDREN WAS NOT INCLUDED IN.
APPRECIATE THE CONVERSATION
AROUND ENROLLMENT. NAVIGATORS
BOTH HELP PEOPLE KEEP THEIR
COVERAGE AT A TIME WHEN ELIGIBLE
PEOPLE ARE BEING TERMINATED AND
CONSIDERING THE EQUITY
IMPLICATIONS. WE ALSO OPPOSE THE
CUTS TO THE INDIAN HEALTH GRANTS
AND MEDI-CAL COMMUNITY HEALTH
WORKERS IN HCAI AND THE PUBLIC
HEALTH CUTS RELATED TO COVERED
CALIFORNIA. WE'RE CONCERNED WITH
THE PROPOSAL TO DRAW HEALTH CARE
AFFORDABILITY, RESERVE AND
INDIVIDUAL MANDATE PENALTY,
TRANSFER. INSTEAD THINK THOSE
FUNDS SHOULD GO TO A MERE
EXCHANGE THAT WILL OPEN COVERED
CALIFORNIA TO INDIVIDUALS
REGARDLESS OF IMMIGRATION
STATUS. THANK YOU. THANK YOU.
MADAM CHAIR, MISS BONTA, TIM
MADDEN, REPRESENTING THE
CALIFORNIA CHAPTER OF THE
AMERICAN COLLEGE OF EMERGENCY
PHYSICIANS. WE ASK THAT YOU
REJECT THE MCO PROPOSAL TO SHIFT
THOSE. THE PROVIDER RATES, MISS
MONTE, YOU ASKED WHAT WAS THE
WHAT WOULD BE THE IMPACT OF
ELIMINATING THESE, PRO-RATA
RATES IN TERMS OF THE NUMBER OF
PHYSICIANS PARTICIPATING AND FOR
EMERGENCY PHYSICIANS, IS 42% OF
THE PATIENTS THAT WE SEE ARE IN
THE MEDI-CAL POPULATION LARGER
THAN WHAT THE STATEWIDE COVERAGE
IS FOR MEDI-CAL, WHICH IS
ROUGHLY A THIRD, IN OUR VIEW,
THAT IS THE DIRECT RESULT OF A
LACK OF ACCESS TO SERVICES. BY
SHIFTING THESE FUNDS AWAY TO
AWAY FROM PROVIDERS, WE THINK
THAT'S ONLY GOING TO INCREASE.
PHYSICIANS ARE NOT GOING TO
PARTICIPATE IN THE PROGRAM, WHEN
THEY CAN BARELY COVER THE COST
FOR SEEING THE PATIENTS. SO WE
THINK THAT'S A GOOD WAY TO KEEP
AN EYE ON WHAT THE IMPACT OF
THIS PROPOSAL WILL BE
SPECIFICALLY FOR EMERGENCY
PHYSICIANS, THE NUMBER OF
EMERGENCY PHYSICIANS WE HAVE TO
COVER THE EMERGENCY DEPARTMENT
IS LARGELY DEPENDENT ON THE
REVENUE WE RECEIVE FROM THE
MEDI-CAL POPULATION. BY NOT
ALLOWING US TO INCREASE THAT
REIMBURSEMENT, A SHIFT MAY HAVE
ONE EMERGENCY PHYSICIAN, WHEREAS
WITH THE PROVIDER RATE INCREASE,
WE MIGHT BE ABLE TO HAVE TWO
EMERGENCY PHYSICIANS COVER A
SHIFT. THAT'S GOOD FOR EVERYONE,
BECAUSE I KNOW YOU UNDERSTAND
THE EMERGENCY DEPARTMENT TREATS
EVERYONE. WE DON'T HAVE A
SPECIAL PLACE THAT'S JUST FOR
MEDI-CAL, AND EVERYONE GOES TO A
DIFFERENT PART OF THE EMERGENCY
DEPARTMENT. WE'RE ALL TRYING TO
ACCESS SERVICES THROUGH THE SAME
FRONT DOOR. SO WE WOULD THANK
YOU. THANKS. MADAM CHAIR,
ASSEMBLY MEMBER BONTA, THANK YOU
FOR THE HEARING, CHRISTIAN.
THANK YOU FOR THE CELSIUS MAY
REVISE AGENDA YET, TO BE PRESENT
, DARBY KERNAN, ON BEHALF OF
PUBLIC HEALTH INSTITUTE, WE WANT
TO EXPRESS OUR OPPOSITION TO THE
PUBLIC HEALTH, CUTS. WE AGREE
WITH THE QUESTIONS AND THE LINE
OF QUESTIONING YOU DID TODAY AND
SUPPORT THE DIRECTION THE
COMMITTEE IS LOOKING IN. IN
ADDITION, ON BEHALF OF THE LOCAL
HEALTH PLANS, WE OPPOSE THE MCO
TAX PROPOSAL USING ALL THE FUNDS
FOR THE GENERAL FUND BACKFILL
THE LOSS OF THIS MUCH NEEDED
FUNDING FOR PROVIDER RATES WILL,
BE A PROBLEM FOR EVERYONE. THANK
YOU. THANK YOU. GOOD EVENING.
CHAIR MEMBERS BETH MALINOWSKI
WITH SCA CALIFORNIA, WANT TO
THANK YOU FOR THE ADDITIONAL
CRITIQUE AND COMMENTARY TONIGHT
IN THE PUBLIC HEALTH ITEM WITH
KAYAK AND OUR COUNTY COLLEAGUES
REALLY STAND IN ALIGNMENT WITH
OUR FULL CALIFORNIA CAN'T WAIT
COALITION AND ASKING FOR YOU ALL
TO REJECT THE, TREMENDOUS CUTS
HERE TO OUR PUBLIC HEALTH
INFRASTRUCTURE. APPRECIATED
DOCTOR ARAGON'S REFERENCE TO
THIS FUNDING BEING THE ROOTS OF
OUR PUBLIC HEALTH SYSTEM. I WANT
TO TAKE MAYBE A STEP FURTHER AND
SAY, WHEN I THINK OF THE FUTURE
OF PUBLIC HEALTH FUNDING, IT IS
NOT JUST THE ROOTS OF PUBLIC
HEALTH, BUT ALSO THE ROOTS OF
OUR ECONOMY AS A WHOLE. WE SAW
IN THE PANDEMIC THAT WHEN WE
DON'T PROPERLY FUND PUBLIC
HEALTH, OUR WHOLE ECONOMY SHUTS
DOWN. OUR SCHOOLS SHUT DOWN.
NONE OF US WANT TO SEE THAT
HAPPEN AGAIN. SO REALLY STAND
WITH YOU AND TRYING TO THINK
ABOUT ANY WAY WE CAN APPROACH
THIS ITEMS THAT WE MAINTAIN THIS
INVESTMENT. THANK YOU SO MUCH.
THANK YOU. GOOD EVENING. RYAN.
SUSAN, ON BEHALF OF COMMUNITY
HEALTH WORKS IN SACRAMENTO,
FORMER, FORMERLY SACRAMENTO
COVERED. WE JUST WANT TO URGE
THIS COMMITTEE TO REJECT THE
CUTS TO THE COMMUNITY HEALTH
WORKER TRAINING PROGRAM AND
MEDI-CAL NAVIGATORS PROGRAM.
CURRENTLY, COMMUNITY HEALTH
WORKS EMPLOYS ABOUT 130
COMMUNITY HEALTH WORKERS, AND
THEY'RE SET TO EXPAND. BUT WITH
THESE CUTS, THAT ALL COMES INTO
QUESTION, AND THEY NEED A
MECHANISM TO EXPAND TRAINING AND
CERTIFICATION SPECIFICALLY FOR
COMMUNITY HEALTH WORKERS WITH
LIVED EXPERIENCE. THANK YOU.
THANK YOU. GOOD EVENING, MADAM
CHAIR AND COMMITTEE MEMBERS,
EMILY MCCLINTOCK. I'M WITH THE
PUBLIC HEALTH INSTITUTE AND HERE
TO VOICE MY CONCERNS ABOUT THE
PROPOSED CUTS TO THE CHILDREN
AND YOUTH BEHAVIORAL HEALTH
INITIATIVE. PUBLIC EDUCATION
CHANGE CAMPAIGN, THE LOCAL LEVEL
COMPONENT OF THIS PROJECT WAS
LAUNCHED IN MARCH OF THIS YEAR,
WITH 28 SELECTED COMMUNITY BASED
ORGANIZATIONS ALREADY ONBOARDED.
IT'S IMPORTANT TO NOTE THAT THIS
THESE PROJECTS ARE ALREADY IN
MOTION, AND THE 28 CBOS ARE
CURRENTLY WORKING WITH YOUTH,
PARENTS, CAREGIVERS, AND
COMMUNITY SERVICE PROVIDERS TO
ADDRESS MENTAL AND BEHAVIORAL
HEALTH. WITH OUR MOST
VULNERABLE, ELIMINATING THESE
FUNDS WILL JEOPARDIZE THAT
CRITICAL WORK AND WASTE THE
EFFORTS THAT HAVE ALREADY GONE
INTO THIS PROJECT. THESE YOUTH
LED CAMPAIGNS WILL REDUCE STIGMA
AROUND HELP SEEKING BEHAVIORS
AND OPEN PATHWAYS FOR IMPROVED
COMMUNITY UNDERSTANDING. FOR THE
CHALLENGES YOUTH ARE FACING. WE
KNOW THAT PUBLIC EDUCATION AND
REDUCING STIGMA IMPROVE HELP
SEEKING AMONG YOUTH, SO PLEASE
HELP US TO FOLLOW THROUGH WITH
SUPPORTING YOUTH MENTAL AND
BEHAVIORAL HEALTH ACROSS
CALIFORNIA BY MAINTAINING THESE
FUNDS. THANK YOU. THANK YOU,
THANK YOU, MADAM CHAIR AND
MEMBERS, BRANDON TATE WITH THE
YOUTH MENTAL HEALTH EQUITY
COALITION. FIRST, I WANT TO
THANK YOU FOR THE ADDITIONAL
WORK YOU'VE DONE IN YOUR. IT WAS
OBVIOUS IN THE ANALYSIS ON THE
AGENDA AND YOUR ADDITIONAL
HEARING TODAY THAT YOU ARE
HEARING US ABOUT HOW IMPORTANT
THIS ISSUE IS IN TERMS OF THE
ELIMINATION OF THE YOUTH MENTAL
HEALTH PROGRAMS AT THE OFFICE OF
HEALTH EQUITY IN THE SEBIHI
CAMPAIGNS. THESE PROGRAMS ARE
PROVIDE CRITICAL SUPPORT FOR OUR
MOST VULNERABLE YOUTH, INCLUDING
LGBTQ YOUTH, BLACK YOUTH, LATINO
YOUTH ACROSS THE STATE. MANY OF
THE CBOS THAT ARE DOING THIS
WORK ARE ALREADY FUNDED, AND
IT'S DISAPPOINTING TO SEE THAT
WHILE THE GOVERNOR'S PROPOSED
BUDGET LEAVES IN PLACE THINGS
LIKE AN APP THAT WE'RE NOT SURE
WITH HUNDREDS OF MILLIONS OF
DOLLARS BEING INVESTED, THAT
WE'RE NOT EVEN SURE TEENS WILL
USE, WHILE AT THE SAME TIME
CUTTING LOCAL PROGRAMS THAT WE
KNOW ARE PROVEN TO BE EFFECTIVE.
WE HOPE THAT YOU'LL REJECT THESE
CUTS AND LOOK FOR MORE EQUITABLE
WAYS TO SHARE THE BURDEN AND NOT
DOING SO AT THE OFFICE OF HEALTH
EQUITY. THANK YOU. THANK YOU.
OCO. MY NAME IS EMMA SNUGGS. I'M
A CHEROKEE NATION CITIZEN, AS
WELL AS THE EXECUTIVE DIRECTOR
OF THE TRIBAL PEOPLE'S
EMPOWERMENT PROJECT, AND A
DEPARTMENTAL SCHOLAR IN AMERICAN
INDIAN STUDIES FROM UCLA. I KNOW
YOU HAVE A LOT OF DIFFICULT
DECISIONS AHEAD OF YOU. I'VE
BEEN HERE AND LISTENED TO
EVERYONE AND THE IMPORTANT
ISSUES THAT FOLKS HAVE PRESENTED
TO YOU ALL DAY, BUT I'D LIKE TO
SHARE WITH YOU THAT WE HAVE THE
HIGHEST RATE OF OPIOID RELATED
OVERDOSE IN OUR COMMUNITY. WE
HAVE THE LOWEST LIFE EXPECTANCY.
MEMBERS OF MY COMMUNITY ARE 2.3
TIMES MORE LIKELY TO DIE OF
DIABETES THAN THEIR WHITE
COUNTERPARTS, HAVE. THE HIGHEST
RATE OF SUICIDE. AND LASTLY, 1
IN 3 NATIVE AMERICAN WOMEN
REPORT BEING RAPED IN OUR
LIFETIME, I ALSO LOST MY OWN
BROTHER TWO YEARS AGO TO A
FENTANYL OVERDOSE, AND I WORK,
TIRELESSLY TO BOTH EDUCATE ON
OPIOID REVERSAL TOOLS. WE PASS
OUT NARCAN AND FENTANYL TEST
KITS TO MEMBERS OF MY COMMUNITY,
AND I'LL LEAVE YOU WITH THIS,
THERE IS A LOT TO LOSE FOR
EVERYONE WHO'S APPROACHED YOU
TODAY, BUT IN MY COMMUNITY, A
BUDGET CUT OF THIS MAGNITUDE
WILL RESULT IN THE LOSS OF LIFE
AND THANK YOU VERY MUCH. THANK
YOU. HI. GOOD AFTERNOON. MY NAME
IS LOUIS CORTEZ. I'M WITH THE
LGBTQ CENTER HERE IN SACRAMENTO.
I'M HERE TO ADVOCATE AGAINST THE
BUDGET CUTS PROPOSED, IN
PARTICULAR THE YOUTH MENTAL
HEALTH PROGRAM AT THE OFFICE OF
HEALTH EQUITY, AS YOU KNOW,
LGBTQ YOUTH ARE ONE OF THE
HIGHEST HAD HAVE THE HIGHEST
RATE OF SUICIDE OF OVER MOST
POPULATIONS, AND NOT ONLY THIS
BUDGET CUTS WILL NOT ONLY FORCE
US TO CUT OUR PROGRAMS,
PARTICULARLY OUR SATELLITE
PROGRAMS ARE IN YOLO, PLACER,
AND EL DORADO COUNTY, COUNTY,
WHICH ARE THE ONLY ONES OF ITS
KIND. BUT WE ALSO HAVE TO LAY
OFF OUR CLINICIANS AND CUT DOWN
OUR FREE MENTAL HEALTH SERVICES.
AND WHICH, YOU KNOW, WE AND WE
HAVE WHERE WE HAVE AROUND 70%
SUCCESS RATE IN HAVING PEOPLE
OFF MEDICATION, HAVE HAVING A
THRIVING AND HAPPY LIFE. THE
BUDGET CUTS WILL BE EXTREMELY
DETRIMENTAL TO US, AND WE HOPE
THAT YOU ALL, REJECT THESE THESE
CUTS. THANK YOU SO MUCH. THANK
YOU. GOOD EVENING. RONALD
COLEMAN BSA HERE ON BEHALF OF
THE CALIFORNIA PAN ETHNIC HEALTH
NETWORK. C-PEN, FIRST AND
FOREMOST, REALLY URGE YOU TO
REJECT THE CUTS TO THE INDIAN
HEALTH PROGRAM. YOU KNOW,
CERTAINLY THIS COMMUNITY HAS
BEEN COLONIZED, ISOLATED AND
MARGINALIZED OVER THE YEARS.
THIS PROGRAM IS EXTREMELY
IMPORTANT TO MAKE SURE THAT THEY
CAN DEAL WITH THE CHALLENGES
THAT ARE COMING UP IN THEIR
COMMUNITY, SPECIFICALLY RELATED
TO HEALTH, IN THE WAYS THAT
THEIR COMMUNITY WANTS THEM TO.
AND SO PLEASE, DO NOT ELIMINATE
THE PROGRAM. WE'RE ALSO VERY
CONCERNED ABOUT THE PUBLIC
HEALTH CUTS. YOU KNOW, CERTAINLY
FOR THE FIRST TIME OVER THE LAST
COUPLE OF YEARS, WE'VE SEEN
PUBLIC HEALTH DOLLARS, GOING
INTO OUR COMMUNITIES WITH LOCAL
PUBLIC HEALTH ACTUALLY RESOURCE.
THEY'RE BUILDING BRIDGES WITH
COMMUNITY ORGANIZATIONS, TALKING
TO COMMUNITIES, WORKING WITH
COMMUNITIES TO BE ABLE TO MAKE
SURE THAT THOSE NEEDS ARE MET.
THIS IS NOT SOMETHING WE'VE SEEN
BEFORE BECAUSE OF THE LACK OF
FUNDING THAT PUBLIC HEALTH
DEPARTMENTS HAVE HAD, AND WE
NEED TO MAKE SURE THAT WE KEEP
THAT WORK GOING. THIS IS NOT
JUST A CUT TO PUBLIC HEALTH
WORKERS AND INFRASTRUCTURE. IT'S
ALSO A CUT TO LOW INCOME
COMMUNITIES OF COLOR.
ADDITIONALLY, WE'RE VERY
DISAPPOINTED WITH THE CUT TO
HCAI AND ALSO THE HEALTH
NAVIGATORS PROGRAM. WE REALLY
APPRECIATE THE CHAIR, THE,
ASSEMBLY MEMBER BONTA'S
COMMENTS, PARTICULARLY AS IT
RELATES TO BOTH CHW FUNDING FOR
WORKFORCE AT HCAI, BUT ALSO, THE
ELIMINATION OF THE NAVIGATOR
FUNDING. THESE TWO PROGRAMS ARE
EXTREMELY IMPORTANT,
PARTICULARLY WITH CHW, YOU KNOW,
THE IMPLEMENTATION OF THE
BENEFIT HAS NOT ROLLED OUT AS
ROBUSTLY AS WE WOULD LIKE TO
SEE. THE WORKFORCE TRAINING
DOLLARS WERE EXTREMELY IMPORTANT
TO MAKE SURE THAT WE COULD RAMP
UP THAT BENEFIT. IF THOSE
DOLLARS ARE ELIMINATED, WE'RE
GOING TO HAVE TROUBLE ROLLING
THAT BENEFIT OUT THE DOOR MOVING
FORWARD. THANK YOU. THANK YOU. I
CæA NAKANO, VIRGINIA HEDRICK,
THE EXECUTIVE DIRECTOR OF THE
CALIFORNIA CONSORTIUM FOR URBAN
INDIAN HEALTH AND A MEMBER OF
THE YUROK TRIBE, AND URGE YOU TO
OPPOSE THE ELIMINATION OF THE
STATE INDIAN HEALTH PROGRAM
SINCE ITS ELIMINATION IN 2009,
AMERICAN INDIANS AND ALASKA
NATIVES HAVE LOST EIGHT YEARS OF
LIFE EXPECTANCY AND ALSO REJECT
THE ADMINISTRATION'S POSITION
THAT DIFFICULT DECISIONS HAD TO
BE MADE. I DON'T ACCEPT THAT AS
A RATIONALE FOR THE ELIMINATION
OF THIS BUDGET, AND AGREE WITH
FORMER COMMENTS MADE THAT
CONTINUED YEARS OF LIVES WILL BE
LOST. THANK YOU. THAT'S ALSO
KHÔNG CALVIN HEDRICK I AM A
MOUNTAIN MAIDU, AND I'M ALSO THE
DIRECTOR OF ORGANIZING FOR THE
CALIFORNIA NATIVE HOPE PROJECT,
AND I'M HERE TO EXPRESS MY
STRONG OPPOSITION TO THE
ELIMINATION OF THE CALIFORNIA
STATE INDIAN HEALTH PROGRAM
PROGRAM, THIS VITAL PROGRAM
PROVIDES ESSENTIAL HEALTH CARE
SERVICES TO OUR NATIVE AMERICAN
COMMUNITIES, ADDRESSING UNIQUE,
UNIQUE HEALTH CARE DISPARITIES
AND CULTURAL NEEDS THAT
MAINSTREAM SERVICES OFTEN
OVERLOOK. ELIMINATING THIS
PROGRAM WOULD DISPROPORTIONATELY
, EXCUSE ME, IMPACT OUR
COMMUNITIES WHO CONTINUALLY FALL
BELOW THE NATIONWIDE AVERAGES,
AND LEADING TO WORSENED HEALTH
OUTCOMES AND FURTHER
MARGINALIZATION. IT'S NOT JUST
ABOUT HEALTH CARE, IT'S ABOUT
UPHOLDING, COMMITMENTS TO OUR
NATIVE AMERICAN POPULATIONS AND
ENSURING WE HAVE THE EQUITABLE
ACCESS TO THE SERVICES OUR
COMMUNITIES DESERVE. AND WE
DEFINITELY WE DEFINITELY HAVE
SEEN IN OUR COMMUNITY, WHEN WE
CUT THINGS LIKE THIS, THINGS GET
TAKEN AWAY AND THERE IS LOSS OF
LIFE. AND SO I JUST I REALLY
HOPE THAT YOU CAN RECONSIDER AND
PRESERVE THIS PROGRAM. THANK
YOU. THANK YOU. GOOD EVENING. MY
NAME IS GABRIELA CAJANDIG AND I
AM A YOUTH PROGRAM MANAGER FOR
THE SAN FRANCISCO COMMUNITY
WELLNESS DEPARTMENT FOR THE
NATIVE AMERICAN HEALTH CENTER, I
HELP RUN A YOUTH PROGRAM. AND SO
I SEE THAT THE IMPACT THESE
PROGRAMS HAVE ON SO MANY YOUTH
AND FAMILIES AND SF, I DEEPLY
OPPOSE THE ELIMINATION OF THE
STATE INDIAN HEALTH PROGRAM. AND
THE CONSEQUENCES OF THIS FUNDING
CUT WOULD BE DEVASTATING TO
NATIVE COMMUNITIES ACROSS
CALIFORNIA. THANK YOU. THANK YOU
. THANK YOU, HEY, YOUNG KUMIKO
HOSSLER. JULIETTE, YOU MAY SEE
ME. HELLO. MY NAME IS KUMIKO
HOSSLER. I AM A YOUTH ORGANIZER
WITH THE CALIFORNIA NATIVE VOTE
PROJECT, AND I COME FROM THE
VILLAGE OF MILDEN ON THE HOOPA
VALLEY RESERVATION IN HUMBOLDT
COUNTY. I'M HERE TO ADDRESS THE
MAY REVISION, WHICH PROPOSES
ELIMINATING $23 MILLION IN
FUNDING FOR THE STATE INDIAN
HEALTH PROGRAM. THIS CUT WOULD
COMPLETELY DEFUND THE ARP,
JEOPARDIZING 27 CRITICAL HEALTH
PROGRAMS ACROSS CALIFORNIA. THE
STATE OF CALIFORNIA HAS PROMISED
SUPPORT FOR NATIVE AMERICANS
THROUGH INITIATIVES LIKE THE
TRUTH AND HEALING COUNCIL.
HOWEVER, ELIMINATING ARP FUNDING
BLATANTLY CONTRADICTS THESE
COMMITMENTS, TURNING PROMISES
INTO EMPTY WORDS. AS WE
CALIFORNIA INDIANS HAVE
HISTORICALLY EXPERIENCED FROM
THE STATE GOVERNMENT, DHP IS NOT
A BUDGET LINE ITEM. IT IS A
LIFELINE. IT PROVIDES ESSENTIAL
MEDICAL CARE, BEHAVIORAL HEALTH
SERVICES, AND CULTURALLY
SPECIFIC PROGRAMING. WITH NATIVE
AMERICAN YOUTH FACING SUICIDE
RATES OVER TWICE THE NATIONAL
AVERAGE, THE AHP'S ROLE IS
INDISPENSABLE. IT DIRECTLY
ADDRESSES THE SEVERE MEDICAL
HEALTH, MENTAL HEALTH
CHALLENGES, OFFERING CRITICAL
SUPPORT THAT SAVES LIVES.
CUTTING THIS FUNDING IS NOT JUST
A FINAL FINANCIAL DECISION. IT
IS A DIRECT ASSAULT ON THE
HEALTH AND WELL-BEING OF
THOUSANDS OF NATIVE AMERICANS.
IT EXACERBATES EXISTING HEALTH
DISPARITIES AND UNDERMINES ANY
CLAIMED COMMITMENTS TO TRUTH AND
HEALING. I CHALLENGE YOU TO
UPHOLD YOUR PROMISES AND
COMMITMENTS, REJECTING THE
PROPOSAL, THE PROPOSED
ELIMINATION OF ARP FUNDING, AND
STANDING WITH US TO SUPPORT THE
ESSENTIAL SERVICES AND PROVE
THAT YOUR WORDS ARE MORE THAN
JUST RHETORIC. THANK YOU. THANK
YOU. STONKUS JOSEPH CROSS I'M A
MEMBER OF THE SEMINOLE NATION OF
OKLAHOMA AND MUSCOGEE CREEK, AND
I'M ALSO A COMMUNITY ORGANIZER
WITH THE CALIFORNIA NATIVE VOTE
PROJECT. I STRONGLY URGE THE
DECISION TO RECONSIDER
ELIMINATING THE 23 MILLION IN
FUNDING FROM THE STATE. INDIAN
HEALTH PROGRAM. THE FUNDING
PROVIDES SO MANY VITAL SERVICES,
INCLUDING MEDICAL CARE,
BEHAVIORAL HEALTH, AND
CULTURALLY SPECIFIC PROGRAMS
THAT MYSELF, MY FAMILY, AND A
LARGE MAJORITY OF AMERICAN
INDIAN COMMUNITY MEMBERS ACROSS
THE STATE POSITIVELY BENEFIT
FROM. WITH OUR POPULATION HAVING
SIGNIFICANTLY LOWER LIFE
EXPECTANCIES, OUR YOUTH HAVING
THE HIGHEST RATES OF SUICIDE,
AND MANY OTHER HEALTH
DISPARITIES. THIS CUT WILL LEAVE
SUCH A DEVASTATING IMPACT ON THE
HEALTH SERVICES THAT ARE
AVAILABLE FOR THE COMMUNITY AND
WILL COST THOUSANDS OF PATIENTS
TO LOSE ACCESS TO ESSENTIAL CARE
THAT WOULD NOT BE AVAILABLE IF
NOT FOR THE PROVIDED FUNDING. IT
IS IMPERATIVE THAT THE DECISION
MAKERS UNDERSTAND THE GRAVE
CONSEQUENCES OF THIS FUNDING CUT
. THE 23 MILLION IS NOT JUST A
BUDGET LINE, IT REPRESENTS
LIFELINES FOR MANY INDIVIDUALS
WHO RELY ON THESE SERVICES FOR
THEIR HEALTH AND WELL-BEING.
ELIMINATING THIS FUNDING WOULD
FURTHER INCREASE THE HEALTH
INEQUITIES FACED BY OUR
COMMUNITY, AND UNDERMINE THE
PREVIOUS EFFORTS TO IMPROVE OUR
OVERALL HEALTH OUTCOMES.
THEREFORE, I STRONGLY URGE YOU
TO MAINTAIN THIS CRUCIAL FUNDING
TO ENSURE THAT THE AMERICAN
INDIAN COMMUNITY CONTINUES TO
RECEIVE THE SUPPORT AND CARE WE
DESPERATELY NEED AND DESERVE.
MIDDLE THANK YOU. GOOD
AFTERNOON, JOHN DREBINGER WITH
THE STEINBERG INSTITUTE. WE URGE
YOU TO CONSIDER REJECTING THE
CUTS TO BEHAVIORAL HEALTH
WORKFORCE INVESTMENTS IN THE MAY
REVISE. AS YOU KNOW, WE'RE IN A
BEHAVIORAL HEALTH CRISIS THAT'S
ONLY EXACERBATED BY OUR
WORKFORCE SHORTAGE AND OUR
INABILITY TO MEET EXISTING
DEMAND. STEINBERG INSTITUTE
ESTIMATES THAT WE NEED 375,000
NEW BEHAVIORAL HEALTH PROVIDERS
OVER THE NEXT TEN YEARS IN ORDER
TO MEET THAT DEMAND, SO CUTTING
AT THIS TIME COULD HAVE A YEARS
LONG IMPACT ON OUR ABILITY TO DO
SO. SPECIFICALLY THE $120
MILLION CUT TO SOCIAL WORK
EXPANSION PROGRAMS COULD FUND
3000 SOCIAL WORKER STIPENDS, BUT
OUR ESTIMATES SAY THAT WE NEED
32,000 OVER THE NEXT YEAR. SO AS
YOU CAN SEE, THESE WORKFORCE
CUTS COULD HAVE A YEARS LONG
IMPACT IN OUR ABILITY TO EXPAND
OUR CAPACITY. THANK YOU FOR YOUR
CONSIDERATION. THANK YOU. ROGER.
JOSH. GUY. HUGH. GUY. NINA. I'M
A MEMBER OF THE HO-CHUNK NATION,
AND I'M HERE TO OPPOSE THE CUTS
THAT ARE OF THE $23 MILLION THAT
ARE PROPOSED CUTS FOR THE INDIAN
HEALTH PROGRAM, AS YOU'VE HEARD
BEFORE, WE'VE WE'RE FACED WE'RE
FACING A FENTANYL CRISIS HERE.
YOU KNOW, PEOPLE ARE DYING. NOT
ONLY THAT, THEY'RE YOU KNOW, YOU
KNOW, WE GOT DIABETES PROBLEMS
AND WE HAVE OTHER BEHAVIORAL
HEALTH PROBLEMS. SO I OPPOSE
THOSE CUTS BECAUSE WE NEED
ACTUALLY MORE HELP AND NOT LESS.
THANK YOU. THANK YOU. PAMELA
LOPEZ WITH Kò STREET CONSULTING
ON BEHALF OF THE TULE RIVER
TRIBE AND THE TULE RIVER INDIAN
HEALTH CLINIC. WE ALSO OPPOSE
THE ZEROING OUT OF THE IEHP
PROGRAMS. WE WISH YOU ALL
STRENGTH AND FORTITUDE FOR THE
DIFFICULT DECISIONS THAT LIE
AHEAD, AND THAT YOU HAVE TO
MAKE. I'LL SIMPLY POINT OUT THAT
THERE ARE NEARLY 2000 PEOPLE
LIVING ON THE TULE RIVER
RESERVATION, EVEN IF THEIR
HEALTH CLINIC CLOSES THEIR NEXT
CLOSEST OPPORTUNITY TO GET BASIC
THINGS LIKE NARCAN FOR FENTANYL
OVERDOSES AND BASIC, PRENATAL
HEALTH TREATMENT IS OVER 45
MINUTES AWAY DOWN A WINDING
MOUNTAIN ROAD FOR A LOT OF
PEOPLE WHO DON'T HAVE CARS.
THANK YOU. MADAM CHAIR AND
MEMBERS, STUART THOMPSON, ON
BEHALF OF THE CALIFORNIA MEDICAL
ASSOCIATION, WE WANT TO THANK
YOU FOR THE OPPORTUNITY TO
PRESENT ABOUT THE IMPORTANCE OF
USING A PORTION OF THE MCO FUNDS
TOWARDS PROVIDER RATES AND OTHER
INVESTMENTS IN THE MEDI-CAL
SYSTEM, WE'RE ASKING YOU TO
REJECT THE PROPOSED CUTS AND THE
MAY REVISION. THANK YOU. THANK
YOU. NICOLE WATERMAN, ON BEHALF
OF ORANGE COUNTY, SAN BERNARDINO
COUNTY AND THE CHILDREN'S
PARTNERSHIP IN OPPOSITION TO THE
PUBLIC HEALTH CUTS, IT HAS BUILT
INFRASTRUCTURE OVER THE LAST
COUPLE OF YEARS. THAT CANNOT BE
EASILY REPLACED. IN ADDITION, ON
BEHALF OF THE CHILDREN'S
PARTNERSHIP, WANTED TO OPPOSE
THE HEALTH NAVIGATOR CUTS, WHICH
PROVIDE CHILDREN AND THEIR
FAMILIES ACCESS TO HEALTH CARE
THEY WOULD NOT OTHERWISE
RECEIVE. THANK YOU, CLIFTON
WILSON, ON BEHALF OF THE
COUNTIES OF KERN, FRESNO,
MADERA, NAPA, HUMBOLDT, SOLANO,
SAN JOAQUIN AND TULARE, ALL IN
STRONG OPPOSITION TO THE MAY
REVISIONS, PROPOSED CUTS OF THE
ENTIRE 300 MILLION TO THE FUTURE
OF PUBLIC HEALTH INVESTMENTS,
INCLUDING THE 200 MILLION
DEDICATED TO LOCAL HEALTH
DEPARTMENT WORKFORCE AND
INFRASTRUCTURE, AND 52.5 MILLION
IN THE CURRENT FISCAL YEAR.
THESE FUNDS ENABLE COUNTY HEALTH
AND HUMAN SERVICE AGENCIES TO
SERVE AS A FIRST LINE OF DEFENSE
AGAINST THE GROWING PUBLIC
HEALTH THREATS IN OUR
COMMUNITIES AND THE RETENTION OF
THESE FUNDS IS NOTHING SHORT OF
CRITICAL. WE URGE THE REJECTION
OF THESE CUTS AND THANK YOU FOR
YOUR SCRUTINY AND CONSIDERATION.
THANK YOU. GOOD EVENING. MY NAME
IS MIKE DUNCAN. I'M THE
EXECUTIVE DIRECTOR OF NATIVE
DADS NETWORK. WE'RE A NONPROFIT
ORGANIZATION HERE IN SACRAMENTO,
CALIFORNIA THAT RUNS A STATEWIDE
PROGRAM THAT SERVES, TRIBAL
COMMUNITIES THROUGHOUT THE STATE
OF CALIFORNIA AND REALLY HAPPY
TO BE HERE TONIGHT JUST TO URGE
THE CUT OF THE INDIAN HEALTH
PROGRAMS THIS IS SOMETHING THAT,
YOU KNOW, WORKING WITH SO MANY
DIFFERENT TRIBES, WE, WE
WITNESS, YOU KNOW, FIRSTHAND THE
IMPACTS, YOU KNOW, OF, THE
FENTANYL AND OTHER MENTAL HEALTH
ISSUES, BEHAVIORAL HEALTH ISSUES
THAT THAT OUR COMMUNITY AND
REALLY NEED SUPPORT IN. SO THESE
CUTS ARE REALLY WOULD, WOULD
REALLY HURT, YOU KNOW, FOR OUR,
FOR OUR, FOR OUR COMMUNITIES, SO
I JUST REALLY URGE THAT YOU
DON'T CUT THE INDIAN HEALTH
PROGRAMS. THANK YOU. THANK YOU.
HOLLY, TILL, MY NAME IS ALFRED
GASKINS. I'M FROM THE CHOCTAW
TRIBE OF OKLAHOMA, AND I WANTED
TO SAY THAT I PERSONALLY GO TO
THE SACRAMENTO NATIVE AMERICAN
HEALTH CENTER, ALMOST ONCE A
WEEK FOR THEIR CULTURAL
PROGRAMS, BECAUSE A LOT OF URBAN
NATIVES DON'T HAVE ACCESS TO
TRADITIONAL KNOWLEDGE, AND WE
GET IT THROUGH PROGRAMS LIKE
THESE. AND WHEN YOU DEFUND THEM,
IT'S GOING TO DISAPPEAR. AND
THAT REALLY AFFECTS OUR MENTAL
HEALTH, AND THAT CAUSES THE
SUICIDE RATES TO SHOOT UP. AND I
REALLY, REALLY SUGGEST OPPOSING
THIS BILL. YAKOKE. WELL, I WOULD
LIKE TO THANK ONCE AGAIN, ALL OF
THE DEPARTMENTS WHO JOINED US
FOR THIS HEARING TODAY REALLY
WANT TO THANK ALL THOSE WHO CAME
OUT AND GAVE A PUBLIC TESTIMONY,
DURING THE PUBLIC COMMENT
SECTION. AND WITH THAT, THIS
COMMITTEE MEETING IS ADJOURNED.
THANK YOU