GOOD AFTERNOON. WE'LL CALL THE
CALIFORNIA STATE ASSEMBLY.
HEALTH COMMITTEE. ASSEMBLY?
HEALTH COMMITTEE HEARING FOR
TUESDAY, JUNE 18TH TO ORDER.
BEFORE WE BEGIN, I WOULD LIKE TO
MAKE A STATEMENT ON PROVIDING
TESTIMONY. AT THIS HEARING, ALL
WITNESSES WILL BE TESTIFYING IN
PERSON. WE ALLOW TWO MAIN
WITNESSES FOR A MAXIMUM OF TWO
MINUTES EACH. ADDITIONAL
TESTIMONY IS LIMITED TO NAME,
POSITION, AND ORGANIZATION. IF
YOU REPRESENT ONE SUB FOR
TODAY'S HEARING ONLY ASSEMBLY
MEMBER JACKSON WILL SUBSTITUTE
FOR ASSEMBLY MEMBER WENDY
CARRILLO. TODAY'S CONSENT
CALENDAR INCLUDES THE FOLLOWING
BILLS PROPOSED FOR CONSENT. ANY
MEMBER OF THE COMMITTEE MAY
REMOVE A BILL FROM CONSENT. ITEM
FIVE SB 963. ITEM 13 SB 1319.
WAHAB. ITEM 14 SB 1333 EGGMAN.
ITEM 15 SB 1382 GLAZIER. ITEM 16
SB 1397 EGGMAN. IN ADDITION,
REMOVED FROM TODAY'S CALENDAR IS
ITEM TEN, SB 1238, WHICH WE WILL
NOT BE HEARING AT TODAY'S
HEARING. WITH THAT, WE ARE
WAITING FOR BOTH COMMITTEE
MEMBERS AND AUTHORS.
AND WE HAVE OUR FIRST AUTHOR.
HOW WONDERFUL. SENATOR CORTEZ,
ITEM NUMBER 12, SB 1300.
THANK YOU, MADAM CHAIR. I'M
PLEASED TO PRESENT SB 1300,
WHICH IS A BILL SPONSORED BY
NAMI, THE NATIONAL ALLIANCE ON
MENTAL ILLNESS. I WANT TO THANK
THE COMMITTEE STAFF AND
STAKEHOLDERS FOR WORKING WITH US
SO CLOSELY ON THE AMENDMENTS. I
ALSO WANT TO THANK, THE
WITNESSES WHO WERE HERE TODAY,
AND I'LL INTRODUCE THEM IN JUST
A MINUTE. SB 1300 WILL HELP
COMMUNITIES PREPARE FOR THE
CLOSURE OF PSYCHIATRIC UNITS AND
MATERNITY WARDS AND HOSPITALS IN
MY DISTRICT ALONE, I'VE
EXPERIENCED THE CLOSURES OF BOTH
A MATERNITY WARD AND A
PSYCHIATRIC UNIT. IN LESS THAN
FIVE YEARS. THESE UNITS CLOSED
DESPITE THE HOSPITAL AS A WHOLE
REMAINING PROFITABLE. THIS
PROBLEM ISN'T UNIQUE TO MY
COUNTY. IT EXTENDS ACROSS
CALIFORNIA. AS MANY OF YOU KNOW,
ACCORDING TO CALMATTERS, WE'VE
LOST 27 MATERNITY WARDS IN THE
PAST THREE YEARS ALONE. THESE
CLOSURES RESULT IN MATERNITY
CARE, DESERTS AND PREDOMINANTLY
LOW INCOME LATINO AND OTHER AND
RURAL COMMUNITIES. THE NEGATIVE
IMPACTS ON FAMILIES, INCLUDING
DECREASED ACCESS TO PRENATAL AND
POSTPARTUM CARE, INCREASED
TRAVEL DISTANCE, WORSENING
MATERNAL MORTALITY RATES, AND
INCREASED EMERGENCY DELIVERIES.
WHEN A PSYCHIATRIC UNIT CLOSES,
IT PLACES ADDITIONAL STRAIN ON
OUR BEHAVIORAL HEALTH SYSTEM.
CALIFORNIA IS ALREADY IN A
PSYCHIATRIC BED SHORTAGE, WHICH
OVERBURDENED OUR EMERGENCY
ROOMS. PROLONGED STAYS IN
CORRECTIONAL DETENTION, AND
PUSHES PEOPLE INTO HOMELESSNESS.
THIS IS WHY IT'S IMPERATIVE FOR
LOCAL COMMUNITIES TO HAVE AN
UNDERSTANDING OF THE IMPACT THAT
A PSYCHIATRIC UNIT CLOSURE WILL
HAVE. SO WHAT SB 1300 WOULD
REQUIRE IS THAT A HEALTH
FACILITY MUST PROVIDE 120 DAY
PUBLIC NOTICE OF THE ELIMINATION
OF ITS INPATIENT, PSYCHIATRIC OR
MATERNITY WARD UNIT. IT ALSO
REQUIRES THAT HEALTH FACILITY TO
PREPARE A REPORT THAT ANALYZES
THE IMPACT OF A CLOSURE ON THE
SURROUNDING COMMUNITY HEALTH
SYSTEM. THE REPORT WILL ALLOW
THE COUNTY BOARD OF SUPERVISORS
TO ASSESS THE CLOSURES, IMPACT
ON THE PUBLIC HEALTH SYSTEM AND
IDENTIFY HOW BEST TO MITIGATE
THE LOSS. I NOTE I USE THE WORD
ALLOW. THERE'S NO MANDATE ON
COUNTY BOARDS OF SUPERVISORS TO
TAKE UP THE MATTER, BUT THEY MAY
DO SO UPON RECEIPT OF THE
REPORT. FINALLY, THE BILL
INCREASES PUBLIC TRANSPARENCY BY
STRONGLY ENCOURAGING THE COUNTY
BOARD OF SUPERVISORS TO POST THE
REPORT ONLINE AND, OF COURSE,
HOLD A PUBLIC HEARING TO PROVIDE
THE COMMUNITY AN OVERVIEW OF THE
IMPACT REPORT. JOIN US TODAY TO
TESTIFY. WE HAVE DANNY OFFER
FROM NAMI CALIFORNIA AND CAITLIN
VAN DEN VAN DINE'S FROM HEALTH
CARE HEALTH ACCESS CALIFORNIA. I
APOLOGIZE AND SHE'LL STRAIGHTEN
ALL THAT OUT WHEN SHE SPEAKS,
THANK YOU VERY MUCH. AND AT THE
APPROPRIATE TIME, I WOULD
REQUEST AN AYE VOTE. THANK YOU.
SENATOR, YOU'LL EACH HAVE TWO
MINUTES. NATIONAL ALLIANCE ON
MENTAL ILLNESS, ALSO KNOWN AS
NAMI, CALIFORNIA. ARE WONDERFUL.
AUTHOR. ALREADY OUTLINED THE
NUMBERS AND THE EFFECTS OF THESE
CLOSURES. SO, YOU KNOW, I'LL
JUST SAY THAT WE'RE LUCKY ENOUGH
TO HAVE SEEN SOME RECENT BED
INCREASES. AND THANKS TO PROP
ONE, WE'LL SEE MORE BEDS COME
ONLINE. BUT OF COURSE, THAT
TAKES TIME. AND MEANWHILE, WE'RE
STILL STILL WE'RE STILL SEEING A
LOT OF THESE CLOSURES, NOTABLY
IN OUR HONORABLE AUTHOR'S
DISTRICT. SO THIS BILL ISN'T
EXACTLY GOING TO PREVENT THE
CLOSURES. THAT'S A MUCH BROADER,
ISSUE THAN THE SCOPE OF THIS
BILL. INSTEAD, IT THIS EXTENSION
AIMS TO PROVIDE COMMUNITIES WITH
JUST A LITTLE MORE TIME TO
PREPARE, A LITTLE BIT, BUT
CRITICAL TIME, EXTENDING THE
NOTICE PERIOD ALLOWS FOR BETTER
COORDINATION AMONG LOCAL
GOVERNMENTS, PROVIDERS AND
COMMUNITY ORGANIZATIONS, AND
THIS WILL ENSURE THAT
ALTERNATIVE CARE ARRANGEMENTS
ARE IN PLACE AS STAFF
TRANSITIONS ARE MANAGED AND THE
PUBLIC IS INFORMED OF HOW
ACCESSING HEALTH CARE MIGHT BE
CHANGING IN THEIR NEIGHBORHOODS,
THIS PREPARATION CAN MAKE THE
DIFFERENCE BETWEEN A COMMUNITY
AND CHAOS, AND A COMMUNITY
THAT'S READY TO ADAPT, AS WE'VE
BEEN MEETING WITH YOUR OFFICES
ON THIS BILL, THE QUESTION WE
GET ASKED MOST IS, SO WHY THESE
TWO? WHY ARE YOU ADDRESSING
INPATIENT PSYCH AND MATERNITY
WARDS AS DISPARATE SERVICES,
WELL, IF I CAN QUOTE MY MOTHER
HERE, MADAM CHAIR, PERMISSION TO
QUOTE MY MOM, GRANTED. THANK
YOU. THAT'S SOMEBODY'S BABY
WE'RE TALKING ABOUT, YOU KNOW,
THESE CLOSURES AFFECT SOMEBODY'S
BABY. WHETHER IT'S THE JOY OF
HAVING A BABY OR THE ANGUISH OF
HAVING A LOVED ONE WHO'S IN A
MENTAL HEALTH CRISIS, THESE
EXPERIENCES ARE ARGUABLY THE
MOST SIGNIFICANT IN OUR LIVES.
HAPPENING TO THE MOST
SIGNIFICANT PEOPLE IN OUR LIVES.
AND IT'S CHALLENGING ENOUGH TO
PLAN FOR THESE SIGNIFICANT
MOMENTS EVEN WHEN THE FACILITIES
ARE OPEN AND OPERATING, LET
ALONE WHEN THEY'RE SLATED TO
CLOSE, THANK YOU. AND KATIE VAN
DINES WITH HEALTH ACCESS IS NEXT
. THANK YOU, KATIE VAN DINES
WITH HEALTH ACCESS CALIFORNIA,
THE STATEWIDE HEALTH CARE
CONSUMER ADVOCACY COALITION, AND
WE ARE PROUD TO SUPPORT SB 1300,
WHICH WILL IMPROVE TRANSPARENCY
AND HELP COMMUNITIES BETTER
PREPARE TO FILL THE GAPS IN CARE
IF THEY ARE ABLE. WHEN A
MATERNITY WARD OR INPATIENT
PSYCHIATRIC CARE IS CLOSED,
COMMUNITIES ACROSS THE COUNTRY
ARE SEEING THEIR LOCAL HOSPITALS
CLOSED LABOR AND DELIVERY CARE.
BUT CALIFORNIA HOSPITALS ARE
CLOSING HOSPITAL LABOR AND
DELIVERY SERVICES AT A
SIGNIFICANTLY HIGHER RATE. SINCE
2011, 3% OF HOSPITALS IN THE US
HAVE STOPPED DELIVERING BABIES,
BUT IN CALIFORNIA, 14% OF
HOSPITALS HAVE CLOSED THESE
SERVICES DURING THE SAME PERIOD.
SINCE 2012, 46 CALIFORNIA
HOSPITALS OUT OF CALIFORNIA'S
MORE THAN 400 HOSPITALS HAVE
CLOSED OR PERMANENTLY SUSPENDED
LABOR AND DELIVERY SERVICES. IN
27 OF THOSE CLOSURES HAVE TAKEN
PLACE IN THE LAST THREE YEARS.
JUST IN 2023, 11 HOSPITALS HAVE
ANNOUNCED EXPECTED CLOSURES OF
LABOR AND DELIVERY SERVICES.
STATE DATA SHOWS THAT THE
MAJORITY OF SEVEN CLOSURES IN
LOS ANGELES WERE WERE AT
HOSPITALS, MAKING MILLIONS OF
DOLLARS FOR THEIR INVESTORS, AND
THESE CLOSURES HAVE LEFT LARGE
SWATHS OF CALIFORNIA WITHOUT
ACCESS TO OBSTETRIC CARE AND
HAVE DISPROPORTIONATELY IMPACTED
LOW INCOME COMMUNITIES AND
COMMUNITIES OF COLOR. WHEN LABOR
AND DELIVERY SERVICES ARE
CLOSED. THIS LEAVES LONGER
TRAVEL TIMES FOR EXPECTING
PARENTS TO REACH THE CARE THAT
THEY NEED, ESPECIALLY IN RURAL
AREAS BUT ALSO IN URBAN AREAS.
AND THESE DELAYS LEAD TO IMPACTS
ON EXISTING MATERNAL, INFANT,
MATERNAL AND INFANT, SORRY.
EXCUSE ME. MATERNAL AND INFANT
HEALTH DISPARITIES SB 1300 WILL
INCREASE TRANSPARENCY AND GIVE
COMMUNITIES MORE TIME TO HELP
LOCAL GOVERNMENTS AND PATIENTS
PREPARE FOR THESE CLOSURES, AND
FOR PATIENTS TO FIND ALTERNATIVE
ACCESS TO CARE. IMPORTANTLY, THE
BILL REQUIRES THAT HOSPITALS PAY
FOR AND DEVELOP REPORTS ON THE
IMPACTS OF THESE CLOSURES,
INCLUDING THE IMPACTS ON THE
HEALTH OF THE COMMUNITY, THE
POTENTIAL COST FOR THE COUNTY TO
FILL THAT GAP IN DEMOGRAPHICS OF
THE PATIENTS SERVED AT THE
HOSPITAL. THIS WILL HELP
COMMUNITIES PREPARE, BUT ALSO
GIVE POLICYMAKERS, ADVOCATES AND
RESEARCHERS MORE INFORMATION
ABOUT THE CLOSURES HAPPENING
ACROSS THE STATE AND THIS WILL
HELP INFORM OPPORTUNITIES TO
ACT. I RESPECTFULLY ASK FOR AYE
VOTE. THANK YOU. THANK YOU, IF
THERE ARE ANY IN SUPPORT, PLEASE
COME FORWARD. STATE YOUR NAME,
AFFILIATION AND POSITION ON THE
BILL. GOOD AFTERNOON. LINDA WEI
WITH WESTERN CENTER ON LAW AND
POVERTY IN SUPPORT. THANK YOU.
VANESSA AQUINO WITH CP PUBLIC
AFFAIRS, ON BEHALF OF THE
CALIFORNIA ACADEMY OF FAMILY
PHYSICIANS AND THE CALIFORNIA
PAN ETHNIC HEALTH NETWORK HERE
IN SUPPORT. KELLY BROOKS, ON
BEHALF OF THE SANTA CLARA COUNTY
BOARD OF SUPERVISORS, HERE IN
SUPPORT. DILLON ELLIOTT, ON
BEHALF OF THE CALIFORNIA STATE
ASSOCIATION OF PSYCHIATRISTS IN
SUPPORT. THANK YOU. JUSTIN
BOWERS WITH CLEAN AIR FOR
KIDS.ORG STRONGLY SUPPORTS. IN
ADDITION, THE NORTH COUNTY
EQUITY AND JUSTICE FACTS, ECO
SUSTAINABILITY PEEPS AND NCCA
ALSO STRONGLY SUPPORTS. THANK
YOU. GOOD AFTERNOON, MADAM CHAIR
AND COMMITTEE MEMBERS, BRYANT
MIRAMONTEZ WITH THE AMERICAN
FEDERATION OF STATE, COUNTY AND
MUNICIPAL EMPLOYEES AND STRONG
SUPPORT. MADAM CHAIR MEMBER,
SARA FLOCKS, CALIFORNIA LABOR
FEDERATION, IN SUPPORT. GOOD
AFTERNOON, MADAM CHAIR. MEMBERS
OF MARTY LOPEZ WITH THE
CALIFORNIA NURSES ASSOCIATION IN
SUPPORT. THANK YOU. ARE THERE
ANY PRIMARY WITNESSES IN
OPPOSITION?
THANKS. YOU'LL EACH HAVE TWO
MINUTES. GOOD AFTERNOON. CHAIR
AND COMMITTEE MEMBERS, VANESSA
GONZALEZ WITH THE CALIFORNIA
HOSPITAL ASSOCIATION HERE WITH
AN OPPOSE. UNLESS AMENDED,
POSITION ON SB 1300. WE REALLY
APPRECIATE THE AUTHOR AND
SPONSORS WORKING WITH US OVER
THE LAST FEW MONTHS TO ADDRESS
SOME OF OUR CONCERNS. HOWEVER,
WE DO REMAIN CONCERNED WITH TWO
AREAS OF THE BILL SPECIFICALLY
RELATED TO HOW WE BELIEVE THE
COUNTY SHOULD BE INVOLVED IN THE
NEW, SERVICE CLOSURE PROCESS
THAT IS CREATED BY THE BILL,
ALSO TO HELP ALIGN IT WITH
CURRENT CLOSURE PROCESSES. AS A
CHA HAS OFFERED AMENDMENTS TO
HELP WITH ALIGNMENT OF TO HELP
MAKE THAT ALIGNMENT, AND WITH
THAT, I WILL DEFER THE REST OF
MY TIME TO MY COLLEAGUE FROM CA,
KIRSTEN BARLOW, AND ALSO
AVAILABLE TO HELP ANSWER ANY
QUESTIONS. GOOD AFTERNOON, CHAIR
AND MEMBERS KIRSTEN BARLOW WITH
CA AND WANTED TO START BY SAYING
HOW GENUINELY WE APPRECIATE AND
WANT TO HONOR OUR RELATIONSHIP,
BOTH WITH THE AUTHOR AND WITH
NAMI. CALIFORNIA. OUR HOSPITAL
ASSOCIATION HAS PARTNERED WITH
NAMI MANY, MANY TIMES TO ADDRESS
OTHER MENTAL HEALTH CRISIS
ISSUES AND AGAIN APPRECIATE THAT
SEVERAL OF THE AMENDMENTS THAT
WE'VE BEEN REQUESTING APPEAR TO
BE ON TRACK TO BE MADE TO THE
BILL, BUT THERE ARE TWO AREAS
THAT WE WANT TO EXPLAIN A LITTLE
BIT THAT WE THINK SOME
REASONABLE AMENDMENTS COULD
STILL KEEP THE ADDITIONAL TIME
AND TRANSPARENCY IN PLACE, SO,
AS YOU KNOW, 1300 WOULD REQUIRE
A HOSPITAL THAT IS CLOSING
INPATIENT PSYCH OR MATERNITY TO
BE THE ONE TO PROVIDE A REPORT
TO THE COUNTY AND TO THE STATE
ABOUT THE IMPACT OF THAT
CLOSURE. WE THINK THAT'S REALLY
INCONSISTENT WITH HOW OTHER
PARTS OF OUR LAW, UNDER EXISTING
LAW, EXPECT THE HOSPITAL TO BE
INVOLVED. SO WHAT WE'RE SIMPLY
ASKING IS FOR THE HOSPITAL'S
REPORT TO THE STATE AND COUNTY
TO REALLY ONLY INCLUDE THOSE
PIECES OF INFORMATION. WE
ACTUALLY HAVE ANY KNOWLEDGE OF.
IT WOULD REALLY BE DIFFICULT TO
IMPOSSIBLE FOR AN INDIVIDUAL
HOSPITAL TO SAY, IF WE CLOSE
THIS PARTICULAR SERVICE, HERE
ARE THE NEW COSTS. OUR LOCAL
COUNTY WILL HAVE TO INCUR.
THERE'S REALLY NO WAY FOR US TO
KNOW THAT INFORMATION,
ADDITIONALLY, WE THINK THAT
GIVEN THE IMPORTANT ROLE THAT
OUR LOCAL MENTAL HEALTH
DEPARTMENTS PLAY IN THE DELIVERY
OF INPATIENT PSYCHIATRIC CARE,
IN PARTICULAR, THERE REALLY BEST
POSITIONED TO KNOW IS THE
CLOSURE OF THIS PARTICULAR UNIT
GOING TO AFFECT THE CONTINUUM
THAT WE HAVE IN OUR COMMUNITY,
OR DO WE HAVE SOME OTHER PROJECT
UNDERWAY TO MAKE UP FOR THE
DIFFERENCE OF THIS PARTICULAR
UNIT CLOSING? SO AS SUCH, AGAIN,
OUR SUGGESTED AMENDMENTS WOULD
REQUIRE THE HEALTH FACILITIES
REPORT REALLY ONLY INCLUDE
INFORMATION THAT THE HOSPITAL
WOULD HAVE. WE'D ALSO LIKE TO
HAVE SB 1300, CLARIFY THAT THE
PURPOSE OF THE PUBLIC HEARING
THAT THE AUTHOR INDICATED
EARLIER WOULD BE OPTIONAL FOR
THE COUNTY BOARD TO HAVE, THAT
WE SIMPLY IDENTIFY WHAT THE
PURPOSE OF THAT PUBLIC HEARING
IS, WHICH IS TO IDENTIFY THE
IMPACTS AND ACTUALLY HAVE A
DISCUSSION ABOUT WAYS TO
AMELIORATE THOSE IMPACTS. THANK
YOU FOR THE OPPORTUNITY TO SHARE
OUR CONCERNS. THANK YOU. ARE
THERE ANY OTHER, INDIVIDUALS IN
OPPOSITION WHO WOULD LIKE TO
TESTIFY? SEEING NONE, I'LL BRING
IT BACK TO THE COMMITTEE FOR ANY
COMMENT. DOCTOR WEBER. THANK
YOU. CHAIR WELL, THANK YOU,
SENATOR CORTEZ, FOR BRINGING
THIS BILL FORWARD. I THINK YOU
AND I ARE WORKING ON THE SAME
ISSUE AROUND THE ISSUE OF
MATERNITY WARDS OR LABOR AND
DELIVERY UNITS CLOSING, I DO
HAVE A COUPLE OF QUESTIONS THAT
KIND OF SOMEWHAT MIRROR WHAT THE
OPPOSITION WAS SAYING. MY FIRST
QUESTION IS, WHY ARE YOU
PROPOSING THAT THE HOSPITAL DO
THE COMMUNITY IMPACT REPORT?
WELL, IT SEEMS TO ME JUST IN IN
TERMS OF MY OWN EXPERIENCE, BOTH
AS A COUNTY SUPERVISOR DOWN HERE
IN SANTA CLARA COUNTY, WHICH
WAS, IN OUR CASE WITH THIS BILL,
REALLY THE GENESIS OF THE WHOLE
THING, BECAUSE AS I MENTIONED IN
MY PRESENTATION, WE HAVE, TWO
SPECIFIC INSTANCES, THAT THAT
TRIGGERED THIS BILL, BOTH BY THE
SAME HOSPITAL SYSTEM, AND WHEN
WE HAVE, WHEN I HAVE
CONVERSATIONS WITH THEM AS TO
WHY THERE WOULD BE A CLOSURE,
WHY THEY WERE, YOU KNOW, TAKING
A UNIT DOWN, FRANKLY, THEY SEEM
TO HAVE, ALL KINDS OF ANSWERS AS
TO, WHAT, NOT ONLY WHAT THE
CURRENT IMPACT WAS, FOR THEM,
WHY THEY FELT THAT ANOTHER ONE
OF THEIR HOSPITALS COULD PICK UP
OR SOMEBODY ELSE IN THE
COMMUNITY COULD PICK UP, THE
SLACK, YOU KNOW, IF YOU WILL.
SO, YOU KNOW, THOSE THOSE
PATIENTS WHO WHO WOULD NO LONGER
BE SERVED BY THAT HOSPITAL
SYSTEM? WE HEARD THAT, YOU KNOW,
IT'S HARD FOR THEM TO GET
INFORMATION ON IMPACT THAT THE
COUNTY MIGHT PERCEIVE. BUT WE
TESTED THAT JUST LAST WEEK,
BECAUSE OF THE REGIONAL MEDICAL
CENTER CLOSURE. THAT WOULD
HAPPEN TWO MONTHS FROM NOW. IN
AUGUST, WE CONTACTED THE COUNTY
OF SANTA CLARA OURSELVES
DIRECTLY AND SAID, WHAT IS THE
FISCAL IMPACT OF THIS ON THE
COUNTY? THAT WAS LAST WEEK, WE
RECEIVED A RESPONSE TO THEM THAT
THE PROJECTED POTENTIAL
FINANCIAL IMPACT IS 9 TO $17
MILLION ANNUALLY. SO THE COUNTY
WAS READILY AVAILABLE TO, YOU
KNOW, TO PROVIDE THAT
INFORMATION TO US OR TO THEM IS
THE POINT. THEY COULD EASILY
PICK UP THE PHONE AND ASK THAT
QUESTION TO THE COUNTY, YOU
KNOW, RATHER THAN SAY, WE CAN'T
GET THAT INFORMATION. AS WE ALL
KNOW, THE COUNTY IS A PUBLIC
ENTITY AND HAS A PUBLIC MOST
COUNTIES HAVE A PUBLIC HEALTH
DEPARTMENT, I OKAY, SO THAT'S
THAT'S THE IDEA WE WE'RE TRYING
TO AVOID, WE'RE TRYING TO DO IS
REALLY THE OUTCOME OF THE BILL
THAT WE WERE TRYING TO ACHIEVE.
WE CAN'T STOP THE CLOSURES WITH
THIS BILL, WAS TO BUT TO STOP
THE INCIDENTS OF PEOPLE BEING
CAUGHT OFF GUARD, WHETHER
THEY'RE INDIGENTS THAT NEED TO
USE THE HOSPITAL OR THE
MATERNITY SYSTEM, WHETHER PEOPLE
HAVE LOVED ONES IN THE PSYCH
UNIT, WOULD TURN AROUND TO THE
COUNTY AND SAY, THIS CLOSURE IS
HAPPENING, WHAT ARE YOU GOING TO
DO ABOUT IT? ARE YOU GOING TO
HAVE A HEARING? ARE YOU GOING TO
DEMAND SOME INFORMATION FROM THE
HOSPITAL SYSTEM IN YOUR ROLE AS
A COUNTY, SO THAT YOU CAN DO
YOUR JOB FOR YOUR CONSTITUENTS
AND BEGIN FURTHER ASSESSING THE
IMPACT OF THIS IN MOST MOSTLY
WHAT WE WERE HEARING AND
EXPERIENCING WHEN I WAS DOWN
THERE AT THE COUNTY WITH THE
MATERNITY WARD CLOSURE IS, IT'S
A PRIVATE ENTITY AND WE'RE
HAVING A HARD TIME GETTING ANY
INFORMATION FROM THEM AT ALL.
AND WE DON'T REALLY KNOW WHETHER
THEY CAN AFFORD TO GIVE, TO
EXTEND THE, YOU KNOW, THE, THE
LIFE OF THE UNIT A LITTLE BIT
LONGER TO ALLOW US TO MITIGATE,
THE CASE OF, OF THE PSYCH UNIT,
THE COUNTY IS RAPIDLY TRYING TO
OPEN UP UNITS, AS YOU KNOW, OF
COURSE, AS WE ALL KNOW, THE
STATE IS TRYING TO AUGMENT THOSE
EFFORTS AND OPEN UP BEDS AS SOON
AS POSSIBLE. SO THIS IS THE IDEA
HERE IS TO GET THE COUNTY
GOVERNMENT, WHICH IS THERE ON
THE SPOT. CAPABLE OF EXPLAINING
TO THE PUBLIC OR OPENING UP
PUBLIC HEARINGS AND TAKING
TESTIMONIES LIKE WE DO HERE
TODAY, YOU KNOW, TO HAVE SOME
INVOLVEMENT AS SOON AS POSSIBLE,
AS EARLY AS POSSIBLE. YEAH.
THANK YOU FOR THAT, I THINK A
COUPLE OF THINGS. ONE, THE ROLE
OF THE COUNTY BOARD OF
SUPERVISORS IS VOLUNTARY IN THE
BILL. IT'S NOT MANDATED. RIGHT.
SO I THINK IF IT WERE MANDATED
TO SAY, OKAY, YOU HAVE TO GET
INVOLVED, THEN I COULD MAYBE
UNDERSTAND THAT A LITTLE BIT
MORE, WHAT YOU WERE SAYING, BUT
IT'S COMPLETELY VOLUNTARY, SO
THEY MAY OR MAY NOT GET
INVOLVED. THE OTHER THING IS
EVERY COUNTY IS DIFFERENT, RIGHT
? AND THAT'S ONE OF MY CONCERNS
WITH YOU PUTTING SO MUCH OF THE
WEIGHT ON THE COUNTY. I RECENTLY
HAD UNFORTUNATE OR, YOU KNOW,
THE ANNOUNCEMENT OF A CLOSURE OF
A MATERNITY WARD IN SAN DIEGO
AND CHULA VISTA AREA, THE COUNTY
BOARD OF SUPERVISORS HAS NOTHING
TO DO WITH THAT AT ALL, THAT IS
MORE OF A OF SOMETHING THAT WE
DEAL WITH AT A STATE IN TERMS OF
FUNDING, BECAUSE WE DON'T HAVE A
COUNTY HOSPITAL. SO THE COUNTY
IS NOT GOING TO BE ABSORBING ANY
OF THOSE COSTS. THEY'RE NOT ALL
OF THESE PATIENTS. THAT WOULD
HAVE BEEN DELIVERING AT THIS
PARTICULAR HOSPITAL IS NOT NOW
GOING TO GO OVER TO THE COUNTY
HOSPITAL, BECAUSE WE DON'T HAVE
THAT. RIGHT. SO I THINK THAT IS,
YOU KNOW, ALSO A CONCERN WITH
PUTTING IT ON THE COUNTY. MANY
COUNTIES DON'T HAVE A HOSPITAL.
MANY COUNTIES AREN'T INVOLVED IN
MATERNITY CARE, BEHAVIORAL
HEALTH IS VERY DIFFERENT, AND SO
I CAN SEE WHY THEY MAY HAVE A
ROLE IN THAT. BUT MATERNITY CARE
OVERALL IS DIFFERENT. AND THE
OTHER THING IS, HOSPITALS
GENERALLY HAVE GREAT INSIGHT
INTO THEIR OWN WHAT THEY DO, BUT
NOT NECESSARILY INTO WHAT THEIR
NEIGHBORS DO OR THINGS LIKE
THAT. AND SO WHEN YOU'RE TALKING
ABOUT A COMMUNITY IMPACT REPORT,
I WOULD BE A LITTLE CONCERNED AS
A RESIDENT TO HEAR FROM THE
PERSON THAT'S CLOSING, WHAT THE
IMPACT WILL BE, BECAUSE THEY
MAY. AND THAT'S NO OFFENSE TO
OUR HOSPITALS, BUT THEY MAY NOT
EITHER HAVE ALL THE INFORMATION
OR WANT TO DISCLOSE EXACTLY HOW
IT'S GOING TO BE. AND SO TO HAVE
THE ENTITY THAT'S ACTUALLY
CLOSING TELL YOU WHAT THE IMPACT
WOULD BE VERSUS SOMEONE ELSE WHO
CAN LOOK AND SEE. I THINK THAT
WOULD PROVIDE A MUCH CLEARER,
UNBIASED REPORT. THE OTHER
QUESTION THAT I HAVE IS, AND,
YOU KNOW, THIS ISSUE CAME UP
WITH MY BILL, THE NOTIFICATION,
IS THERE ANY CONCERN ABOUT THE
FACT THAT YOU'RE EXTENDING
PUBLIC NOTIFICATION FROM 90 TO
120 DAY, 120 DAYS? WHAT THAT
WOULD ACTUALLY DO TO THE ON SITE
WORKERS? BECAUSE IF THERE IS A
RISK OF CLOSURE, RIGHT. AND THEN
PEOPLE HEAR ABOUT THAT, OH,
THERE MAY BE SOME INSTABILITY,
INFORMING THEM EVEN EARLIER MAY
KIND OF PUT THAT RISK INTO
REALITY. K¾T BECAUSE PEOPLE WILL
START TO LEAVE. HAS THERE WAS
THERE ANY DISCUSSION AROUND THAT
OR THOUGHT AROUND THAT WE
HAVEN'T. FIRST OF ALL, LET ME
SAY THANK YOU VERY MUCH FOR YOUR
EXCELLENT WORK IN THIS AREA. AND
I AND THE PROCESS OF YOU KNOW,
MOVING THE BILL FORWARD. I'VE
HAD THE OPPORTUNITY TO, TO TAKE
A LOOK AT AB 1895 AND, AND TRY
TO LEARN FROM YOUR APPROACH,
KNOWING THAT YOU YOU HAVE PLENTY
OF EXPERIENCE IN THIS AREA. BUT
BUT THANK YOU FOR ALL OF THAT,
TRYING TO GO BACK THROUGH THOSE
ISSUES REAL QUICKLY. I WANT TO
EMPHASIZE WE'RE ASKING, IN THAT
TIME FRAME FOR THE HOSPITAL TO
USE ITS BEST EFFORTS TO GET A
REPORT OVER TO THE COUNTY, AND
THE COUNTY CAN, AS WE DISCUSS,
OPT IN TO, HOLDING A HEARING OR
NOT OR JUST TAKING THAT
INFORMATION UNDER ADVICE, IN
MANY COUNTIES AND I THINK IN
MANY BIG URBAN COUNTIES WHERE
THERE'S TREMENDOUS REDLINING
IMPACTS SOMETIMES FROM THESE
WHEN THESE CLOSURES. AND I'LL
GET INTO THAT A LITTLE BIT MORE
IN A SECOND, I BELIEVE THERE
WILL BE TREMENDOUS PUBLIC
PRESSURE ON THE COUNTY TO HOLD A
HEARING, TO GIVE PEOPLE AN
OPPORTUNITY TO BE HEARD, JUST
GIVE THE PUBLIC AN OPPORTUNITY
TO BE HEARD AS TO WHAT THE
IMPACT IS TO THEM, IN, IN TERMS
OF ANY NUMBER OF THINGS THAT I,
SOME OF WHICH I ADDRESSED IN THE
PRESENTATION, STILL, THE BOARD
OF SUPERVISORS MAY DO THAT, OR
MAY NOT, BUT, IF IT'S A COUNTY
THAT DOESN'T, FEEL LIKE THEY
HAVE SOCIAL ECONOMIC CONCERNS,
REDLINING CONCERNS, A HOSPITAL
SYSTEM THAT SOMEHOW THERE'S
THEIR SAFETY NET IS NOT
IMPACTED, WHICH WAS, OF COURSE,
WE OF COURSE, BEING A
SUBDIVISION OF THE STATE, AS WE
ALL KNOW, THEY'RE THEY'RE
CARRYING OUT IF THEY THINK THE
WHOLE THING IS AGNOSTIC TO THEM,
THEN MY ANSWER IS THAT'S WHY
IT'S OPTIONAL. THEY DON'T HAVE
TO DO THAT, THEIR GENERAL PUBLIC
IS UNDERSTANDING AND DOESN'T
DOESN'T ASK THEM, AS LOCAL
OFFICIALS TO CREATE THE
CONVENIENCE AND THE THOROUGHNESS
OF A COUNTY HEARING. BUT LET ME
GO BACK TO THE REDLINING. I I'VE
LIVED IN ALL MY LIFE, THE EAST
SIDE OF SAN JOSE, THE POOR SIDE
OF TOWN, FULL OF CENSUS TRACTS
OF FEDERAL COMMUNITIES OF
CONCERN. MAJORITY PEOPLE OF
COLOR, MAJORITY 40% OF OUR
POPULATION IN THE CITY OF SAN
JOSE OVERALL IN THE COUNTY ARE
IMMIGRANTS, 45% OF OUR OUR
ECONOMIC GDP, BY THE WAY, IS
PRODUCED BY THOSE IMMIGRANTS,
HARD WORKING PEOPLE. THE
MATERNITY CLOSURE THAT TOOK
PLACE BY THIS, BY THE HOSPITAL
SYSTEM THAT WE KNOW RETAIL WISE
AS REGIONAL TOOK PLACE RIGHT IN
THE MIDDLE OF THE EAST SIDE OF
SAN JOSE. SO THAT THOSE WOMEN NO
LONGER HAVE MATERNITY ACCESS. IN
WHAT IS IN EFFECT, A POPULATED
AREA THAT IS BIGGER THAN MOST
CITIES IN CALIFORNIA. THE CITY
OVERALL IS ABOUT A MILLION
PEOPLE. THERE'S ABOUT 600,000
PEOPLE ON THIS SIDE OF TOWN.
THEY'RE TOLD BY THAT HOSPITAL
SYSTEM THAT THEY'RE GOING TO BE
OKAY BECAUSE THEY CAN GO ACROSS
THE VALLEY TO THE MORE AFFLUENT
SIDE OF TOWN AND GO TO THE
MATERNITY CARE THERE. THAT
THAT'S THAT'S WHAT'S CAUSING
MOTIVATION FOR THIS BILL.
ORIGINALLY, THAT'S WHAT CREATED
THE IDEA THAT THE BOARD OF
SUPERVISORS JUST MIGHT WANT TO
TAKE A LOOK AT THAT AND
ESPECIALLY IN A VERY PROGRESSIVE
COUNTY LIKE SANTA CLARA COUNTY,
TO SHED SOME LIGHT AND TO ASK
SOME QUESTIONS ABOUT WHAT'S
REALLY GOING ON HERE, IS THIS AN
ECONOMIC DECISION? IS THIS SOME
KIND OF INSTITUTIONAL RACIST
DECISION? I'M NOT AFRAID TO SAY
THAT. LIKE I SAID, I LIVE THERE,
OR IS THIS JUST ALL SOMETHING WE
SHOULD ALL FEEL AGNOSTIC ABOUT?
AND I JUST FEEL LIKE THAT
HEARING THAT DISCUSSION NEEDS TO
HAPPEN. WHERE WHERE PEOPLE WHO
ARE WORKING 2 OR 3 JOBS CAN GET
DOWN TO THE BOARD OF SUPERVISORS
AND PARTICIPATE IN THAT
DISCUSSION. AND I BELIEVE IN MY
COUNTY, THE BOARD OF SUPERVISORS
WOULD TAKE THAT ON. I DO AGREE
WITH YOU 1,000. IF THERE'S SUCH
A THING AS 1,000% THAT THERE ARE
COUNTIES IN THIS STATE, THAT
WOULD DISREGARD BOARD THE
OPPORTUNITY TO HAVE THAT HEARING
OR MAYBE EVEN INTENTIONALLY
AVOID HAVING THAT HEARING. BUT I
THINK THERE ARE PLENTY OF
COUNTIES WHERE WE HAVE PLENTY OF
GOOD LOCAL OFFICIALS, WHO WILL
SEE IT AS AN OPPORTUNITY FOR
TRANSPARENCY OR IN MY LANGUAGE,
TO FIND OUT WHAT'S REALLY GOING
ON. THAT'S REALLY THE PASSION
BEHIND THE BILL. AND IT WASN'T
TOO LONG AFTER THE MATERNITY
WARD CLOSED THAT WE HAD A PSYCH
UNIT CLOSE ACROSS TOWN. NAMI AND
OTHERS STARTED TO SEE A TREND
HERE. AND WE HAVE THIS BILL. I
THINK THERE NEEDS TO BE SOME
BILL THAT OPENS THIS UP AND
MAKES SURE IT'S NOT THIS THIS
VERY QUIET, ALMOST BEHIND THE
SCENES PROCESS THAT IT IS TODAY.
AND I SENSE FROM LOOKING AT YOUR
BILL, YOU FEEL THE SAME WAY.
IT'S MAYBE JUST A MATTER OF
EXACTLY HOW TO HOW TO GO ABOUT
IT, BUT I HOPE WE GET THERE SOON
. SOON, SO THAT THIS DOESN'T
CONTINUE. THANK YOU, SENATOR.
AND WE DEFINITELY SHARE A
PASSION IN THIS AREA. AND, YOU
KNOW, I'VE, I'VE MENTIONED MANY
TIMES THAT WHEN WE HAVE THESE
CLOSURES, THEY ARE OFTENTIMES IN
OUR MOST VULNERABLE COMMUNITIES.
THEY ARE NOT IN OUR AFFLUENT
COMMUNITIES. AND SO IT IS
EXTREMELY IMPORTANT THAT, THAT
WE DO SOMETHING ABOUT THIS. BUT
ALSO WHAT WE DO NEED TO, HAVE
SIGNIFICANT PURPOSE AND ACTUALLY
HELP OUT OUR CONSTITUENT BASE,
SO I DO THANK YOU. I AM
CONCERNED ABOUT HAVING THE
HOSPITAL DO THE IMPACT REPORT I
DON'T HAVE. I DON'T THINK THEY
HAVE THE INSIGHT, BUT I ALSO TO
YOUR POINT WITH WHAT HAPPENED
EVEN IN YOUR CITY, WITH THEM
TELLING THE RESIDENTS, OH,
YOU'LL BE FINE. YOU CAN GO OVER
THERE. I WOULD SHUDDER TO SEE
WHAT THEIR COMMUNITY IMPACT
REPORT WOULD SAY, SINCE THEY
THINK THE COMMUNITY WOULD BE
FINE. THEY CAN GO AND DELIVER IN
A MORE AFFLUENT AREA. AND YOU
KNOW, I AGREE, WE NEED TO HAVE
DISCUSSIONS AND WE NEED TO
INFORM THE COMMUNITY AND WE NEED
TO REVIEW THE COMMUNITY IMPACT
REPORT WITH THE COMMUNITY WHEN
IT HAPPENS. IT'S JUST I'M NOT
SURE IF THE HOSPITAL SHOULD BE
DOING THAT, I ALSO DON'T
NECESSARILY THINK THAT IT SHOULD
BE SOMETHING THAT THE BOARD OF
SUPERVISOR LEVEL, BECAUSE AT THE
END OF THE DAY, IF WE'RE DEALING
WITH SOMETHING, THEY'RE CLOSING
BECAUSE OF FINANCIAL REASONS,
BECAUSE OF MEDI-CAL
REIMBURSEMENT RATES, THAT'S NOT
SOMETHING THAT THE LOCAL BOARD
OF SUPERVISORS DOES. IF IT HAS
TO DO WITH WORKFORCE SHORTAGES
AND SOME CONTRACTS, THAT'S
OFTENTIMES NOT NECESSARILY AT A
LOCAL LEVEL. SO THE CONVERSATION
DOES NEED TO HAPPEN. THE
QUESTION IS WHO IS DRIVING THAT
CONVERSATION? THÀNH, BUT I
DEFINITELY APPRECIATE YOUR
INTEREST IN THIS AREA, NOT ONLY
WITH MATERNITY WARDS, BUT ALSO
WITH OUR PSYCHIATRIC UNITS, AND
LOOK FORWARD TO CONTINUING THE
CONVERSATION SO THAT WHATEVER
WE'RE ABLE TO DO THIS YEAR IS,
IS VERY MEANINGFUL AND IT REALLY
MOVES THE NEEDLE IN THE
DIRECTION WHERE COMMUNITIES WILL
NOT BE IMPACTED, THE WAY IN
WHICH THEY HAVE BEEN IMPACTED.
AND IF WE AS A STATE NEED TO BE
ABLE TO STEP IN AND INTERVENE,
WE HAVE THE KNOWLEDGE AND THE
TIME TO DO THAT. SO THANK YOU SO
MUCH. THANK YOU. VICE CHAIR
WALDRON. THANK YOU. I WAS, GOING
TO ASK THE SIMILAR QUESTIONS,
BUT I WON'T REPEAT WHAT MY
COLLEAGUE SO ELOQUENTLY SAID. I
DO, TOO, ALSO HAVE A CONCERN
ABOUT HAVING THE HOSPITAL BE
RESPONSIBLE FOR ALL OF THE
IMPACT REPORT. I WAS KIND OF
LISTING SOME OF THE ENTITIES
THAT WOULD BE INVOLVED OR COULD
BE THE NOT ONLY THE COUNTY AT
WHATEVER LEVEL, BUT WHATEVER THE
BEHAVIORAL HEALTH PROVIDERS, YOU
KNOW WHAT THEY WOULD SAY. A
LOCAL ECONOMIC DEVELOPMENT
CORPORATION. WE HAVE A VERY
ROBUST ONE IN SAN DIEGO, AS WELL
AS RIVERSIDE COUNTIES, EDC AS
WELL AS THE HOSPITAL SYSTEM. SO
I JUST WANTED TO GET THAT IN
THERE. BUT I DO APPRECIATE THE
EARLY NOTICE BECAUSE I REMEMBER
BEING EIGHT AND A HALF MONTHS
PREGNANT AND GETTING THE
NOTIFICATION THÀNH FROM MY IT
WAS WITH THE HEALTH PLAN THAT
EVERYTHING CHANGED. AND NOW I
HAD MY OBSTETRICIAN WAS NO
LONGER GOING TO BE THERE AND I
WASN'T GOING TO BE TREATED AT
THE SAME FACILITY I THOUGHT I
WAS. I'D HAVE TO GO 70 MILES
AWAY. SO THAT WAS VERY
TRAUMATIZING, SO I DO APPRECIATE
THAT, I DID WANT TO JUST BROACH
THE PART ABOUT THE STATE
DEPARTMENT OF PUBLIC HEALTH
PRIORITIZING LICENSING OF
ADDITIONAL BEDS TO REPLACE THE
NUMBER OF LOST BEDS, AND HOW
THAT WOULD BE DONE, LIKE HOW YOU
SEE THAT HAPPENING, THAT WE
COULD ACTUALLY MOVE THE STATE
DEPARTMENT TO DO SOMETHING LIKE
THAT, BECAUSE I THINK IT'S
IMPORTANT. IS THAT A QUESTION
FOR ME? WELL, I SEE IT IN THE
BILL, IN THE BILL LANGUAGE, AND
IT'S IN THE LEGISLATIVE DIGEST,
ACTUALLY. RIGHT. I MEAN, IT'S
LANGUAGE INTENDED TO ENCOURAGE.
I THINK, YOU KNOW, WE'RE ALL
AWARE OF WHAT THE OBSTACLES ARE
RIGHT NOW, INCLUDING JUST
RESOURCES, AND WHAT THE
ADMINISTRATION HAS BEEN DOING,
LEADING TO, TO TRY TO GET US IN
A POSITION TO, TO MEET THE NEEDS
IN TERMS OF BEDS, YOU KNOW, LET
ALONE RESPOND, TO BACKFILL RIGHT
AWAY, BUT BUT, OF COURSE, IN THE
DAY TO DAY, IN THE DAY TO DAY
COMMUNITY, OUR CONSTITUENTS WANT
TO ASK THAT QUESTION. YOU KNOW,
ALMOST FIRST AND FOREMOST, WHAT
IS THE STATE GOING TO DO TO, TO
REPLACE THESE BEDS? WHAT'S
ANYONE GOING TO DO TO REPLACE
THESE BEDS, WHICH I THINK IN
SOME COUNTIES IS AN APPROPRIATE
QUESTION AS WELL FOR THE BOARD
OF SUPERVISORS, THE ANSWER MAY
BE NOTHING RIGHT NOW, BUT THE
IDEA IS TO CALL THE QUESTION AND
SEE IF, THERE ARE ANSWERS
AVAILABLE. I AM HAPPY TO, TO
DEFER TO, WITNESSES TO IF YOU
WANT TO GET A FURTHER RESPONSE
FROM THEM. YEAH. I MEAN, I THINK
HAVING THEM IN THE CONVERSATION
AS THE WHOLE PROCESS IS GOING
FORWARD IS HELPFUL TO GET IT ON
THEIR RADAR, AND WE HOPE THAT
THEY WOULD LOOK AT IT. AND I
THINK YOU, SENATOR, FOR
COURTESY, FOR BRINGING THIS BILL
FORWARD. I THINK I REALLY
APPRECIATED YOU FOCUSING IN ON
WHAT DROVE YOU IN THE FIRST
PLACE TO BRING FORWARD THIS
BILL. I THINK VERY SIMILAR TO
DOCTOR WEBER, DOCTOR WEBBER'S
BILL. I GREW VERY CONCERNED WITH
THE IMPACT THAT, AND A SINGLE
HOSPITAL CLOSURE CAN HAVE. AND,
AND I THINK WE NEED TO
ACKNOWLEDGE THAT IT DOES IMPACT
THE ENTIRE COMMUNITY AND THE
ENTIRE COUNTY, COUNTY AND BEING
ABLE TO DO IT. AND I REALLY
APPRECIATED YOUR, YOUR, YOUR, IN
YOUR PRESENTATION THAT YOU
TALKED ABOUT KIND OF THE, THE
SILENCE OF THAT HAPPENING OR
KIND OF THE, THE NEED TO
SUNLIGHT. THE FACT THAT WE NEED
TO HAVE THAT BE SHARED OUT IN
THE PUBLIC, FOR THAT TO HAPPEN.
AT THE END OF THE DAY, HOSPITALS
ARE PLACES OF CARE. THEY'RE ALSO
BUSINESSES, IN YOUR LEGISLATION,
AS IT'S CURRENTLY WORDED, YOU
ARE FOCUSED ON, THAT THE
COMMUNITY IMPACT ANALYSIS BEING
ONE THAT IS INCLUDES A GOOD
FAITH ESTIMATE OF THE IMPACT OF
THE CLOSURE ON THE COUNTY. SO
THAT'S THE, THE BURDEN IS KIND
OF A GOOD FAITH ESTIMATE OF
WHAT, WHAT THAT IMPACT IS.
HOSPITALS AND WOULD FROM EITHER,
SET OF WITNESSES HOSPITALS
PROVIDE HAVE A SENSE OF HOW MANY
INDIVIDUALS ARE AVAILABLE. THEY,
THEY, THEY KNOW THEIR MARKET. SO
TO SPEAK, AND, AND THEY KNOW HOW
MUCH THEY SPEND ON, ON THAT
MARKET. AND MY READ OF THIS
LEGISLATION IS ESSENTIALLY ONE
TO BE ABLE TO HAVE THAT HOSPITAL
SHARE THE SENSIBILITY AROUND THE
UNDERSTANDING OF THAT MARKET AND
THE IMPACT OF THEIR REMOVAL OF
SERVICE ON THAT, ON THAT
PARTICULAR MARKET AND THE SECOND
PIECE, WHICH I THINK IS VERY
CRITICAL, IS TO HAVE THERE BE
SOME, COGNIZANCE AROUND IT BEING
A REGIONAL OR A COUNTY LEVEL,
HAVING A REGIONAL OR COUNTY
LEVEL IMPACT ON THAT. THIRD, IS
THAT YOUR SUNLIGHTING THESE
CONVERSATIONS THAT HAVE GRAVE
IMPACTS THAT CAUSE, AS, ASSEMBLY
MEMBER WALDRON SAID BEFORE, CAN
CAUSE A BIRTHING PERSON TO HAVE
A WOMAN TO HAVE TO TRAVEL UP TO
2 TO 3 HOURS TO BE ABLE TO GET
THE CARE THAT THEY DESERVE, TO
BE ABLE TO DELIVER THEIR BABIES.
THAT'S HAPPENING RIGHT NOW.
THAT'S A IT'S A PROBLEM THAT
NEEDS TO BE ADDRESSED, VERY
BROADLY. AND I JUST TO OFFER AS
A COUNTERPOINT, I DO BELIEVE
THAT THE BOARD OF SUPERVISORS,
THE COUNTY LEVEL LOOK, IS THE
APPROPRIATE SPACE, PUBLIC SPACE
FOR A HOSPITAL TO HAVE TO COME
FORWARD AND ESSENTIALLY PROVIDE
THEIR GOOD FAITH ESTIMATE OF THE
IMPACT OF THEIR CLOSURE OF
PARTICULAR SERVICES ON, ON, ON
THE OVERALL POPULATION THAT THEY
ARE ABLE TO SERVE WITHIN THEIR
PARTICULAR MARKET. SO WITH THAT,
I WOULD OFFER YOU AN OPPORTUNITY
TO CLOSE AND PERHAPS ADDRESS
THAT PARTICULAR ISSUE, BUT I DO
I DO BELIEVE YOU ARE ON THE
RIGHT TRACK, AND IT'S CONCERNING
TO ME NOW THAT WE HAVE 2 OR 3
BILLS THAT ARE FOCUSED ON
HOSPITAL CLOSURES, BECAUSE WE'RE
REALLY, NEEDING TO ADDRESS THE
OVERALL CONCERN, WHICH IS THAT
OUR HOSPITALS ARE CLOSING AT A
RATE THAT IS, UNTENABLE FOR
CALIFORNIA'S PUBLIC. YEAH. THANK
YOU, MADAM CHAIR. APPRECIATE
YOUR YOUR COMMENTS. IN A COUPLE
OF THINGS, AS PART OF THE CLOSE,
WE DID NOT ACCEPT ALL OF, CHAR'S
PROPOSED AMENDMENTS. WE ACCEPTED
THREE OUT OF FOUR. AND IF YOU
NEED ME TO CLARIFY WHAT THOSE
ARE, I'D BE HAPPY TO DO THAT.
WHAT? WE DID NOT ACCEPT IS WHAT
DOCTOR WEBER WAS FOCUSED ON. WAS
IS, WHO SHOULD DO THE IMPACT
REPORT THEY WOULD LIKE THE STATE
TO DO THAT, WHICH RAISES A
COUPLE OF ISSUES. CURRENTLY ONE
IS CERTAINLY A SIGNIFICANT
APPROPRIATIONS ISSUE, WHICH WE
DON'T HAVE TO WORRY ABOUT WITH
AN OPT IN AT THE COUNTY LEVEL TO
BE VERY CANDID ABOUT THAT, AND,
AND THE OTHER WE'RE CONCERNED
ABOUT IS, AT LEAST OUR COUNTY
SOURCES THAT FROM THE COUNTY
WHERE THE BILL IS, PRIMARILY
BEING SPONSORED, MEET, YOU KNOW,
REITERATE THAT THEY COULD PUT
SOMETHING ON THE AGENDA AT ANY
GIVEN TUESDAY AND IN THIS CASE,
THEY WOULD OR THEY WILL IN ORDER
TO TRY TO DIG INTO SOME OF THESE
ISSUES AND SHED SOME SUNLIGHT.
I'M NOT CLEAR. WE COULDN'T GET
CLEAR IN OUR CASE. AND, MAYBE
SOME OF THE OTHER OFFERS, LIKE
AUTHORS LIKE DOCTOR WEBER COULD,
I SHOULD TALK TO MORE TO FIND
OUT. BUT WE COULD NOT GET
CLEARER ON THE TURNAROUND TIME
HAPPENING AT THE STATE LEVEL,
TIMELY ENOUGH TO GET COMMUNITY
INFORMATION BACK, BEFORE THE
CLOSURE ACTUALLY OCCURRED. WE
BELIEVE AT THE COUNTY LEVEL, FOR
THOSE COUNTIES THAT OPT IN, THAT
THEY WOULD DO THAT, WE'RE OPEN
TO, YOU KNOW, OBVIOUSLY CONTINUE
TO WORK AND REFINE THE BILL OR,
ALIGN IT BETTER WITH, WITH OTHER
PRACTICES OR, OR OTHER PENDING
LEGISLATION, AGAIN, OUR I TRY TO
FOCUS AND FOCUS MY OWN STAFF ON,
ON OUTCOMES. WHAT IS THE OUTCOME
WE'RE TRYING TO GET TO AND THE
OUTCOME, THE OUTCOMES WE'RE
TRYING TO GET TO WOULD BE,
PRIMARILY, SUNLIGHT,
TRANSPARENCY IN THE COMMUNITY,
AN OPPORTUNITY FOR THE COMMUNITY
TO BE HEARD AND AN OPPORTUNITY
FOR LOCAL OFFICIALS TO BEGIN THE
PROCESS AS EARLY AS POSSIBLE, TO
TRY TO MITIGATE ANY ACTUAL
IMPACT THAT'S OUT THERE. IT
COULD BE AS SIMPLE AS CREATING
AN, YOU KNOW, ADJUSTED EMT OR
FIRST RESPONDER, SERVICES THAT
ARE BRIDGING THE GAP,
GEOGRAPHICALLY THAT YOU ALLUDED
TO, WE DON'T HAVE A 3.5 HOUR,
DELAY NECESSARILY, BUT I JUST I
KNOW THAT THE CHAIR IS A BAY
AREA CAUCUS PERSON. SO YOU, YOU
KNOW, AND PEOPLE WHO HAVE
VISITED MY LOVELY CITY KNOW THAT
, AT MANY HOURS OF THE DAY, MANY
HOURS OF THE DAY, MUCH LIKE THE
BEAUTIFUL CITY OF LOS ANGELES
IS, TRYING TO MAKE IT 12 TO 15
MILES ACROSS THE VALLEY, IT CAN
EASILY BE AN HOUR AND A HALF, AN
HOUR AND A HALF DELAY. IF YOU
WILL, OR AN HOUR AND A HALF
COMMUTE, EVEN IN THE BEST OF
CIRCUMSTANCES. NO ACCIDENTS, NO
OTHER ISSUES, JUST CONGESTION
ITSELF. AND, I HAVE NOT BIRTHED,
BUT I HAVE BEEN THE FATHER OF
FOUR CHILDREN AND BEEN INVOLVED
IN GETTING BACK AND FORTH TO,
LABOR AND DELIVERY SERVICES, FOR
EXAMPLE, TRYING TO DEAL WITH
THAT, AND DO IT IN A WAY THAT'S
GOING TO PROVIDE A HEALTHY
OUTCOME FOR, FOR THE PATIENTS
THEMSELVES AND INCUR DELAYS.
THAT WOULD BE AN HOUR AND A HALF
MORE THAN IF THE MATERNITY UNIT
STAYED OPEN IN THE FIRST PLACE
IS IN AND OF ITSELF, A SERIOUS
AND SIGNIFICANT IMPACT, I THINK.
AND THEN WHEN IT IN EFFECT,
DOUBLES DOWN THE IMPACT FROM,
FRANKLY, A RACIAL AND ETHNIC
STANDPOINT, TO ME, IT LOOKS LIKE
MODERN DAY REDLINING. THAT'S
WHAT IT LOOKS, A CORPORATE
ENTITY SAYING WE CAN'T DO THIS
ANYMORE BECAUSE IT'S NOT A MONEY
MAKING UNIT FOR US ANYMORE. IF
WE CONSOLIDATE IT WITH ANOTHER
HOSPITAL, THAT'S AN HOUR AND A
HALF AWAY IN TRAFFIC, IT WILL BE
FINANCIALLY AND FISCALLY VIABLE
FOR US AT SOME POINT. WE HAVE TO
HAVE A DISCUSSION ABOUT THE
SOCIAL AND CORPORATE
RESPONSIBILITY HERE AND WHAT IT
MEANS TO THE QUALITY OF LIFE FOR
PEOPLE LIVING IN THESE
DISTRICTS. YOU KNOW, IN THESE IN
THESE SERVICE AREAS, IF YOU
WILL. I DON'T THINK THERE'S FROM
WHAT I HEARD TODAY, THERE'S ANY
DISAGREEMENT ABOUT THAT, I WOULD
ASK YOU TO GIVE US AN
OPPORTUNITY TO, YOU KNOW, AS AS
CLOSE AS WE ARE TO GETTING TO
THE END OF, OF THIS YEAR'S
VOTING SESSION. BUT AS HARD AS
WE'VE BEEN WORKING AND I THINK
THE OPPOSITION ACKNOWLEDGED THAT
TO GIVE US THE OPPORTUNITY TO
KEEP WORKING, TO TRY TO GET, A
BILL TO THE GOVERNOR THAT, YOU
KNOW, SATISFIES ALL CONCERNS OR
AS MANY CONCERNS AS POSSIBLE.
AND WITH THAT, I WOULD JUST
RESPECTFULLY ASK FOR YOUR VOTE.
THANK YOU. AND WE WILL CONSIDER
THAT WHEN WE HAVE, A QUORUM,
THANK YOU FOR YOUR PRESENTATION,
SENATOR. THANK YOU. WE ARE
WAITING FOR AUTHORS.
SO, WICKS AND VINCULANTES. FOR
THIS SECTOR WILL BE CLOSED SO
THAT EACH IS PRESENTING. AND
THEN TI¾N. ESTÁ. SO.
STILL NEEDING TO BE HEARD SB
402. WAHAB SB 909 UMBERG. SB 957
WIENER. SB 963 ASHBY. ANOTHER
WAHAB BILL SB 980 SB 1120.
BECKER SB 1147 PORTANTINO, SB
1180 ASHBY SB 1266 LIMÓN SB 1319
WAHAB, SB 1333 EGGMAN SB 1382
GLAZIER SB 1397 EGGMAN SB 1447
DURAZO AND SB 26 UMBERG. WE HAVE
A COMMITTEE WAITING FOR AN
OPPORTUNITY TO HEAR YOUR BILLS.
SENATOR LIMÓN. ITEM 11 SB 1266.
YOU CAN PROCEED WHENEVER YOU'RE
READY. THANK YOU. SENATOR. ALL
RIGHT. THANK YOU. CHAIR AND
MEMBERS, SB 1266 SEEKS TO
PROHIBIT A MANUFACTURER FROM
SELLING CHILD CHILDREN, FEEDING,
SUCKING, OR TEETHING PRODUCTS
THAT CONTAIN ANY FORM OF BY
BISPHENOLS AT A DETECTABLE LEVEL
OF 0.1 PARTS PER MILLION BY
BISPHENOLS COMMONLY REFERENCED
AS BPA AND BPPS, IS A CHEMICAL
COMPOUND THAT IS USED ON A
VARIETY OF INDUSTRIAL AND
CONSUMER PRODUCTS, RANGING FROM
AUTOMOBILE PARTS TO FOOD
CONTAINERS. BPA IS CONSIDERED AN
ENDOCRINE DISRUPTOR, WHICH MEANS
IT CAN INTERFERE WITH THE
HORMONE SYSTEM IN THE BODY AND
CAN HAVE ADVERSE HEALTH EFFECTS
IN CHILDREN AND ADULTS. SINCE
2012, THE US FOOD AND DRUG
ADMINISTRATION HAS BANNED BPA
FROM BABY BOTTLES AND SIPPY
CUPS. HOWEVER, NOT ALL THE
PRODUCTS. SB 1266 STRENGTHENS
THE COMMITMENT TO PROTECT
CHILDREN FROM HARMFUL CHEMICALS
AND AUTHORIZES THE DEPARTMENT OF
TOXIC SUBSTANCES CONTROL TO
ESTABLISH STANDARDS PRIORITIZING
THE HEALTH AND WELLNESS OF OUR
CHILDREN. WITH ME TODAY IN
SUPPORT OF THE BILL, I HAVE
NANCY BIERMAIER ON BEHALF OF THE
BREAST CANCER PREVENTION
PARTNERS. YOU'LL HAVE TWO
MINUTES. THANK YOU. HELLO. OKAY
GOOD AFTERNOON, CHAIR AND
MEMBERS, NANCY BIERMAIER, ON
BEHALF OF BREAST CANCER
PREVENTION PARTNERS, THANK YOU
FOR THE OPPORTUNITY TO TESTIFY.
AND THANK YOU, SENATOR LAMONE,
FOR YOUR LEADERSHIP ON SB 1266.
THIS BILL EXPANDS THE BAN ON BPA
IN BABY BOTTLES AND SIPPY CUPS
TO ALL FEEDING, TEETHING, AND
SUCKING PRODUCTS FOR CHILDREN 12
YEARS AND UNDER, AND BANS THE
ENTIRE CLASS OF BISPHENOLS. BCP
IS A SCIENCE BASED ORGANIZATION
WORKING TO PREVENT BREAST CANCER
BY REDUCING OUR EXPOSURE TO
CHEMICALS LINKED TO THE DISEASE
BISPHENOL A, OR BPA, IS A
CHEMICAL WE ARE DEEPLY CONCERNED
ABOUT. GIVEN ITS ABILITY TO
DISRUPT OUR HORMONES, AND IT'S
LINKED TO BREAST CANCER AND
NUMEROUS OTHER HEALTH HARMS,
BCRP WORKED WITH OUR ALLIES TO
REMOVE BPA FROM BABY BOTTLES AND
SIPPY CUPS MANY YEARS AGO, AND
TODAY YOU WILL SEE BPA FREE
STICKERS ON NUMEROUS PRODUCTS.
UNFORTUNATELY, ALL TOO OFTEN,
BPA WAS REPLACED WITH AN
ALPHABET SOUP OF BISPHENOL
SUBSTITUTES BPPS BPF, BPA, EFF,
AND SO ON, BANNING THE ENTIRE
CHEMICAL CLASS ADDRESSES THIS
ISSUE OF REGRETTABLE
SUBSTITUTION THÀNH. WHILE THESE
OTHER BISPHENOL CHEMICALS ARE
OFTEN LESS WELL STUDIED, THE
MORE WE LEARN, THE BETTER WE
UNDERSTAND THAT THE ENTIRE CLASS
HAS IMPLICATIONS FOR OUR HEALTH,
INCLUDING INCREASED RISK OF
ASTHMA AND HYPERACTIVITY IN
CHILDREN AND CARDIOVASCULAR
DISEASE, FERTILITY PROBLEMS,
OBESITY, DIABETES, AND AN
INCREASED RISK OF BREAST CANCER.
BREAST AND OTHER CANCERS IN
ADULTS, ACCORDING TO THE CDC,
OVER 90% OF US HAVE BPA AND BPPS
IN OUR BODIES, AND OVER 65% OF
US HAVE BPF. THEY DISRUPT THE
VERY SENSITIVE BALANCE OF OUR
HORMONES AND HAVE PROFOUNDLY
NEGATIVE EFFECTS AT VERY LOW
LEVELS. EARLY LIFE EXPOSURES ARE
PARTICULARLY CONCERNING BECAUSE
OF THIS DEVELOPMENTAL PERIOD IS
WHEN THESE CHEMICALS HAVE THEIR
BIGGEST AND LONGEST LASTING
IMPACT AND CAN INCREASE OUR RISK
OF DISEASE. OFTEN DECADES LATER.
THIS EARLY LIFE IMPACT IS WHY SB
1266, WHICH ADDRESSES EXPOSURES
TO CHILDREN, IS SO IMPORTANT.
THANK YOU AGAIN, SENATOR. AND WE
URGE YOUR AYE VOTE. THANK YOU.
ARE THERE ANY WITNESSES IN
OPPOSITION? OH, SORRY. ARE THERE
ANY ADDITIONAL WITNESSES IN
SUPPORT? PLEASE COME FORWARD.
STATE YOUR NAME, POSITION ON THE
BILL AND AFFILIATION. GOOD
AFTERNOON, CHAIR BONTA AND
COMMITTEE. MY NAME IS LEAH
JONES. ON BEHALF OF A VOICE FOR
CHOICE ADVOCACY AND STRONG
SUPPORT OF SB 1266, THANK YOU.
HEY, FOLKS. CHRIS ARENAS WITH
CALIFORNIANS AGAINST WASTE IN
SUPPORT OF THIS BILL, AS WELL AS
CLEAN WATER ACTION IN SUPPORT.
THANK YOU. ARE THERE ANY PRIMARY
WITNESSES IN OPPOSITION? ANY
OTHER WITNESSES IN OPPOSITION?
SEEING NONE. I'LL BRING IT BACK
TO THE COMMITTEE FOR COMMENT OR
QUESTION. THANK YOU, SENATOR,
FOR BRINGING THIS FORWARD. IT'S
SO HARD FOR ME NOW TO SEE
CHILDREN WITH A BINKY OR
WHATEVER THEY CALL IT IN THEIR
MOUTH NOW, BECAUSE I'VE KNOWN
THIS FOR A WHILE OR FELT LIKE
THERE'S SOMETHING BEHIND THIS.
THANK YOU FOR BRINGING IT
FORWARD, AND LET'S MAKE SURE
THERE'S AWARENESS FOR OUR
MOMMIES AND DADDIES OF THE
CONCERNS THAT COME WITH THIS,
WITH THOSE LITTLE PRODUCTS FOR
THOSE BABIES. THANKS. GIVE THEM
A BLANKIE OR SOMETHING NEW,
RIGHT? SOME OTHER COMFORTING
THING. I WANT TO THANK THE
SENATOR FOR BRINGING FORWARD
THIS BILL. IT'S CERTAINLY, I
THINK WITHIN THE TIME FRAME THAT
MY NOW 14 YEAR OLD, 15 YEAR OLD
AND UP ARE, WE HAD THE ISSUE OF
BPAS IN BOTTLES AND SIPPY CUPS
AND, AND THE LIKE, AND, AND NOW
THE EXPANSION OF THAT TO OTHER
ANALOGS IS ABSOLUTELY CRITICAL
FOR ALL THOSE WHO WANT TO BE
ABLE TO ENSURE THAT THEIR BABIES
ARE NOT HAVING TO INGEST TOXINS
WHILE THEY ARE BEING SOOTHED OR
FED, OR HAVING BASIC NEEDS
ADDRESSED. SO WITH THAT, WOULD
YOU LIKE TO CLOSE? I
RESPECTFULLY ASK FOR AN AYE
VOTE, AND WHEN WE HAVE QUORUM,
WE WILL CONSIDER THAT. THANK YOU
SO MUCH, SENATOR. MOVE ON TO
ITEM NUMBER. 17 SB 1447 DURAZZO.
THANK YOU. SENATOR, WHENEVER
YOU'RE READY. THANK YOU, MADAM
CHAIR. AND MEMBERS, I'M HERE TO
PRESENT SB 1447, WHICH WILL
PROVIDE AN EXTENSION FOR THE
CHILDREN'S HOSPITAL LOS ANGELES
TO COMPLY WITH ADDITIONAL
SEISMIC SAFETY RETROFIT
UPGRADES. CHILDREN'S HOSPITAL OF
LOS ANGELES IS A PREMIER
PEDIATRIC HOSPITAL PROVIDING
CARE FOR SOME OF THE MOST
DIFFICULT PEDIATRIC CASES IN THE
REGION, AND THE ONLY CHILDREN'S
HOSPITAL IN THE REGION. CLA AND
THE CARE IT PROVIDES FOR
CHILDREN HAS BECOME MORE
IMPORTANT TO THE REGION, AS
OTHER HOSPITALS AND HEALTH CARE
FACILITIES HAVE BEGUN TO CLOSE
OR DOWNSIZE AS PEDIATRIC CARE
UNITS. THE HOSPITAL OFTEN
RECEIVES REFERRALS FROM OTHER
HOSPITALS AND TAKES THOSE CASES
WITHOUT REGARD TO THE ABILITY OF
THE FAMILY TO PAY. CHILDREN'S
HOSPITAL DOES NOT TURN ANYONE
AWAY. IN FACT, 70% OF THE
CHILDREN ARE INSURED BY MEDI-CAL
, MEANING VERY LOW INCOME
FAMILIES. YET THEY GET THE
HIGHEST QUALITY MEDICAL
ATTENTION. CLA TAKES ITS
RESPONSIBILITY TO HAVE A SAFE
HOSPITAL FOR ITS STAFF, NURSES,
DOCTORS, AND PATIENTS VERY
SERIOUSLY. CLA HAS ALREADY MET
THE PRIMARY EARTHQUAKE RETROFIT
STRUCTURAL STANDARDS REQUIRED BY
LAW TO ASSURE THAT ITS
STRUCTURES CAN SURVIVE A MAJOR
EARTHQUAKE AND BE FUNCTIONAL.
THE NEXT SET OF RETROFIT
STANDARDS APPLICABLE TO
CHILDREN'S HOSPITAL ARE AIMED AT
VARIOUS INFRASTRUCTURE
IMPROVEMENTS TO MAKE SURE THAT
THE HOSPITAL AND ITS CAMPUS HAVE
ADEQUATE WATER, SEWER POWER
GENERATION AND OTHER
INFRASTRUCTURE SO THAT THEY CAN
INDEPENDENTLY SUPPORT OPERATION
OF THE HOTEL OF THE HOSPITAL FOR
A MINIMUM OF 72 HOURS AFTER A
MAJOR EARTHQUAKE. THESE
STANDARDS ARE MANDATED BY 2030.
MEETING THESE STANDARDS IS
ESTIMATED TO COST APPROXIMATELY
$230 MILLION, WHILE CLA HAS BEEN
WORKING TO BOTH PLAN AND ACHIEVE
COMPLIANCE WITH THESE UPDATES,
CLA HAS A PRIMARY ROLE TO
PROVIDE ACUTE HEALTH CARE FOR
THE REGION'S CHILDREN,
REGARDLESS OF THE FAMILY'S
ABILITY TO PAY. AS A RESULT,
COMPLYING WITH THE
INFRASTRUCTURE STANDARDS BY 2030
WOULD PLACE A SEVERE HARDSHIP ON
THE HOSPITAL, PROVIDING A THREE
YEAR EXTENSION WITH THE ABILITY
TO REQUEST UP TO FIVE MORE YEARS
IF SPECIFIED. CRITERIA IS
APPROVED BY THE DEPARTMENT WILL
ALLOW FOR BOTH THE FINANCING
PLAN AND THE CONSTRUCTION TO BE
IMPLEMENTED, AND AT THE SAME
TIME ALLOW CLA TO CONTINUE
PROVIDING THE CRITICAL CARE FOR
PEDIATRIC PATIENTS FROM
THROUGHOUT THE REGION. I LOOK
FORWARD TO CONTINUING
CONVERSATIONS WITH ALL
STAKEHOLDERS, AND I WILL WORK
DILIGENTLY TO FIND POTENTIAL
SOLUTIONS TO ADDRESS CONCERNS
ABOUT EXTENSIONS AND ENSURING
THAT CHILDREN'S HOSPITAL CAN
MEET THE SEISMIC REQUIREMENTS IN
ORDER TO CONTINUE PROVIDING
CRITICAL CARE AND ENSURE THE
SAFETY OF ITS PATIENTS AND
EMPLOYEES. WITH ME TODAY I HAVE
PAUL VIVIANO, PRESIDENT AND
CHIEF EXECUTIVE OFFICER OF
CHILDREN'S HOSPITAL LOS ANGELES,
AND JOE LANG, WHO CAN HELP
ANSWER ANY TECHNICAL QUESTIONS.
THANK YOU, MADAM CHAIR. THANK
YOU. YOU'LL EACH HAVE TWO
MINUTES. THERE WE GO, JOE LANG,
REPRESENTING CHILDREN'S HOSPITAL
LOS ANGELES, THE CENTER IS
CORRECT. WE HAVE MET STRUCTURAL
BUILDING STANDARDS FROM 2020
THAT THE HOSPITALS REQUIRED TO
MEET HAD A PLAN TO COMPLY WITH
THE 2030 STANDARDS, WHICH ARE
INFRASTRUCTURE ORIENTED.
UNFORTUNATELY, IN THE PROCESS OF
BEGINNING TO IMPLEMENT THAT
PLAN, CLA WAS HIT WITH TWO
PRIMARY PROBLEMS. ONE, A FUNDING
REDUCTION OF APPROXIMATELY $80
MILLION A YEAR AS A FUNCTION OF
CHANGING THE FORMULA BY WHICH
THE CHILDREN'S SERVICES PROGRAM
REIMBURSED FOR THOSE CRITICAL
CARE. SEVERELY ILL CHILDREN.
THAT WAS ABOUT $80 MILLION A
YEAR THAT WAS INSTITUTED BACK IN
2018. AT THE SAME TIME THAT THAT
WAS HAPPENING UPWARDS NOW OF
ALMOST 30 HOSPITALS IN THE
REGION HAVE BEGUN TO CLOSE THEIR
PEDIATRIC WARDS. AS A RESULT,
CHILDREN'S HOSPITAL L.A. BECAME
MORE OF A SAFETY NET FOR THE
CHILDREN IN THE REGION. AT THE
SAME TIME, THEY WERE
EXPERIENCING THAT FUNDING
DOWNTURN. AS A RESULT. MR.
VIVIANO HERE, WHO I'M GOING TO
TURN IT OVER TO, HAD TO MAKE
DIFFICULT DECISIONS TO MAINTAIN
CARE AS THE SAFETY NET FOR THOSE
COMPLICATED AND SEVERE CASES IN
THE LA REGION, WHILE ALSO
PLANNING FOR THIS COMPLIANCE AND
, MR. VIVIANO, I'LL TURN THE
BALL TO YOU. THANK YOU VERY
MUCH, CHAIR BONTA, MEMBERS OF
THE COMMITTEE, IT'S A PRIVILEGE
TO BE HERE THIS AFTERNOON, SO A
LITTLE BIT ABOUT CHILDREN'S
HOSPITAL LOS ANGELES, WE'RE THE
LARGEST CHILDREN'S HOSPITAL IN
THE STATE OF CALIFORNIA AND
TREAT THE LARGEST NUMBER OF
MEDI-CAL BENEFICIARIES IN THE
STATE OF CALIFORNIA, AS WELL.
OUR HALLMARK IS CARING FOR THE
MOST SEVERELY ILL CHILDREN IN
THE STATE. WE HAVE FOCUSED OUR
GROWTH ON LIVER TRANSPLANTS,
NEONATAL HEART SURGERY, BONE
MARROW TRANSPLANTS, COMPLEX
EPILEPSY TREATMENTS,
CRANIOFACIAL DISORDERS, BRAIN
TUMORS, SPINAL BIFIDA,
CONGENITAL HEART CONDITIONS, AND
A VARIETY OF OTHER VERY
SIGNIFICANT TRANSPLANT
OPPORTUNITIES. WE CARE FOR MORE
THAN 50% OF THE MOST SEVERELY
ILL CHILDREN IN LA COUNTY. MORE
THAN 25% OF THE SEVERELY ILL
CHILDREN IN SOUTHERN CALIFORNIA,
AND MORE THAN 20% OF THE
SEVERELY ILL CHILDREN IN THE
STATE OF CALIFORNIA. YOU'VE
HEARD THAT 76% OF OUR PATIENTS
ARE MEDI-CAL BENEFICIARIES, AND
WE STAND PROUD WITH THE LEGACY
OF CHILDREN'S HOSPITAL LOS
ANGELES THAT WE TURN NO PATIENT
AWAY, REGARDLESS OF THEIR
FINANCIAL CIRCUMSTANCES. SO
GIVEN THE TIME CRUNCH, I WANT TO
FOCUS ON A COUPLE OF THINGS THAT
JOE HIGHLIGHTED, WE SPENT $1
BILLION, TEN YEARS AGO TO BUILD
A NEW TOWER, AND WE ACCOMMODATED
ALL THE SEISMIC REQUIREMENTS WE
HAD BUILT A TOWER BIG ENOUGH TO
CARE FOR ALL THE CHILDREN THAT
WE THOUGHT WE WOULD NEED TO TAKE
CARE OF GOING FORWARD. TWO
THINGS HAVE HAPPENED SINCE THEN.
MORE THAN 30 HOSPITALS IN L.A.
COUNTY HAVE CLOSED THEIR
PEDIATRIC UNITS, AND WE WERE
FACED WITH AN AGONIZING DECISION
DO WE OPEN REOPEN THOSE UNITS
THAT WERE CLOSED BECAUSE OF THE
SEISMIC CONDITIONS, OR REOPEN
THEM AND CARE FOR THOSE CHILDREN
? WE OBVIOUSLY CHOSE THE LATTER
TO REOPEN THOSE BEDS. WE CARE
FOR THOSE CHILDREN. AND AT THE
SAME TIME, OUR REIMBURSEMENT
DECLINED. SO WE NEED MORE TIME.
WE WANT TO BE IN COMPLIANCE WITH
THE SEISMIC REQUIREMENTS. WE
INTEND TO BE IN COMPLIANCE WITH
THEM. WE JUST CAN'T DO IT BY THE
YEAR 2030. WE WANT TO CONTINUE
TO TAKE CARE OF ALL THOSE
PRECIOUS CHILDREN IN L.A. COUNTY
, AND FAR BEYOND THAT DESERVE
THE BEST CARE. THANK YOU VERY
MUCH FOR YOUR CONSIDERATION.
THANK YOU. ARE THERE ANY OTHER
WITNESSES IN SUPPORT? PLEASE
COME FORWARD. STATE YOUR NAME,
POSITION, AND AFFILIATION. MARY
MORTON, ON BEHALF OF THE
CALIFORNIA CHILDREN'S HOSPITAL
ASSOCIATION AND SUPPORT. ARE
THERE ANY PRIMARY WITNESSES IN
OPPOSITION?
YOU'LL EACH HAVE TWO MINUTES.
THANK YOU, MADAM CHAIR. MEMBERS
OF THE COMMITTEE, MEGAN SUMMERS,
ON BEHALF OF THE CALIFORNIA
PROFESSIONAL FIREFIGHTERS AND
WITH THE MOST RESPECT IN THE
WORLD FOR THE AUTHOR, AND
ACKNOWLEDGING ALL OF THE REALLY,
IMPORTANT AND AMAZING THINGS
THAT THIS HOSPITAL DOES, CPF
REMAINS OPPOSED, UNLESS AMENDED,
TO THIS BILL AND OUR AMENDMENT
IS A REQUEST THAT THE EXTENSION
BE LIMITED TO TWO YEARS, FOR
CONTEXT ON OUR ORGANIZATIONAL
POSITION ON SEISMIC EXTENSIONS,
HISTORICALLY, WE HAVE OPPOSED
BLANKET EXTENSIONS AS, IN SOME
RARE, IN UNIQUE CASES, EPF HAS
REMAINED NEUTRAL ON EXTENSIONS
OF TWO YEARS OR LESS. SO OUR
POSITION ON THIS BILL REMAINS
CONSISTENT. AND THAT'S FOR A FEW
REASONS, FIRST AND FOREMOST,
SAFETY. IF A BUILDING IS DEEMED
A HOSPITAL IS DEEMED
NON-COMPLIANT WITH THE 2030
STANDARD, THE HOSPITAL MUST BE
EVACUATED, THAT MEANS THAT MY
MEMBERS ARE SENT TO HOSPITALS TO
EVACUATE PATIENTS, AND A FEW
THINGS COME TO MIND FOR ME. THE
SAFETY OF MY MEMBERS, BUT ALSO
THE PATIENTS AND IN THIS CASE,
CHILDREN AND THE OTHER WORKERS
AND PROVIDERS THAT ARE IN THAT
HOSPITAL, WE ARE GOING TO HAVE
MANY CALLS FOR SERVICE DURING A
NATURAL DISASTER, LIKE A, LIKE
AN EARTHQUAKE. AND SO WHILE
WE'RE TRYING TO EVACUATE A
HOSPITAL WITH ACUTE PATIENTS AND
RESPONDING TO OTHER CALLS FOR
SERVICE IN THE COMMUNITY, HOW
MANY AMBULANCES ARE AVAILABLE?
WHERE ARE WE SUPPOSED TO TAKE
THESE PATIENTS? WHERE IS THE
NEAREST CHILDREN'S HOSPITAL THAT
CAN ACCOMMODATE THE NEEDS OF
THESE PATIENTS? IN THIS
PARTICULAR HOSPITAL ARE ALL
THINGS THAT WE HAVE TO CONSIDER,
WE ALSO HAVE CONCERNS ABOUT WHAT
THIS MEANS TO PROVIDE AN
EXTENSION. HERE WE ARE IN 2024.
THERE'S STILL A LITTLE OVER FIVE
YEARS TO MEET THE 2030 STANDARD,
IF WE GIVE ANY HOSPITAL AN
EXTENSION PAST THE 2030,
DEADLINE, WHAT IS THE INCENTIVE
TO TRY TO MEET THAT 2030
DEADLINE TODAY WHEN THEY STILL
HAVE FIVE YEARS, ACCORDING TO
THE STATE TREASURER'S OFFICE,
PROP FOUR PASSED IN 2018, WHICH
PROVIDED $1.5 BILLION IN BONDS
TO CHILDREN'S HOSPITALS IN
CALIFORNIA. YOU CAN LOOK UP AND
SEE EVERY CHILDREN'S HOSPITAL
THAT HAS AVAILED THEMSELVES TO
THE MONEY AVAILABLE TO THAT
HOSPITAL, WHAT THEIR
EXPENDITURES HAVE BEEN, HOW MUCH
THEY HAVE AVAILABLE WOULD
ENCOURAGE FOLKS TO GO TAKE A
LOOK AT THAT, BUT AT THIS TIME,
FOR THOSE REASONS, WE REMAIN
OPPOSED UNLESS AMENDED. THANK
YOU. THANK YOU, MADAM CHAIR.
MEMBERS SARA FLOCKS, CALIFORNIA
LABOR FEDERATION, AND ALMOST ALL
OF OUR UNIONS, HAVE A SMALL UNIT
THAT WORKS IN HEALTH CARE, IN
HOSPITALS. EVERYTHING FROM
HEALTH CARE WORKERS TO JANITORS
TO FOOD SERVICE. AND SO WE ARE
HERE IN RESPECTFUL OPPOSITION OF
THIS BILL, MUCH RESPECT FOR THE
AUTHOR AND ALSO RESPECT AND
RECOGNITION OF THE CRITICAL ROLE
THAT CHILDREN'S HOSPITAL PLAYS
IN LOS ANGELES. THAT IS ONE OF
THE REASONS WE ARE HERE IS
BECAUSE WITH THE CLOSURES OF THE
PEDIATRIC UNITS, THERE IS
NOWHERE TO GO. THERE ARE NOT
APPROPRIATE HOSPITALS TO GO IF
THERE IS A SEISMIC EVENT, AND
CHILDREN HAVE TO BE EVACUATED.
THIS IT IS CRITICAL. IT IS
CRITICAL THAT THIS HOSPITAL
REMAIN OPERATIONAL AND THAT IS
THE GOAL OF 2030, AND WE HAVE
SEEN OVER THE DECADES THAT, AS
MY COLLEAGUE SAID, WHEN YOU GIVE
TIME, EXTRA TIME TO HOSPITALS,
THAT GIVES ROOM TO PRIORITIZE
OTHER THINGS. PATIENT CARE, MRI
MACHINES. WE'VE SEEN THIS OVER
AND OVER AND OVER AGAIN. THAT'S
WHY WE ARE RUNNING UP AGAINST
THE 2030 DEADLINE AND HOSPITALS
ARE NOT COMING INTO COMPLIANCE
TO BE FUNCTIONAL, AND WE SEE
RECOGNIZE THAT THE VOTERS HAVE
SUPPORTED THIS HOSPITAL THROUGH
BOND MEASURES, WE WOULD URGE
THAT THERE BE THAT THE HOSPITAL
BECAUSE IT'S ALSO NONSTRUCTURAL
NONSTRUCTURAL WORK THAT NEEDS TO
BE DONE. FIND A WAY IN THE NEXT
SIX YEARS TO COME INTO
COMPLIANCE. WE JUST THINK THIS
EXTENSION IS WAY TOO LONG. THANK
YOU. THANK YOU. ARE THERE ANY
OTHER WITNESSES IN OPPOSITION?
PLEASE COME FORWARD. GOOD
AFTERNOON. BETH MALINOWSKI WITH
SEO CALIFORNIA ALIGNED WITH MY
LABOR COLLEAGUES AND RESPECTFUL
OPPOSITION, UNLESS AMENDED. GOOD
AFTERNOON, MARTY LOPEZ WITH THE
CALIFORNIA NURSES ASSOCIATION.
WE APPRECIATE THE DIALOG THAT
WE'VE HAD WITH THE SENATOR, BUT
WE TO REMAIN IN OPPOSITION,
ESPECIALLY IN CONSIDERATION THAT
THIS IS A CHILDREN'S HOSPITAL.
THANK YOU. SEEING NO OTHER
OPPOSITION, I'LL BRING IT BACK
TO THE COMMITTEE FOR QUESTIONS
OR COMMENTS. MR. JONES-SAWYER
THEN SHIAVO, THEN RODRIGUEZ. AND
THANK YOU. AND, SEEING THAT,
CHILDREN'S HOSPITAL LOS ANGELES
IS IN MY ASSEMBLY DISTRICT, IT'S
ACTUALLY IN WALKING DISTANCE OF
MY HOME. AND I'VE BEEN VISITED
SEVERAL TIMES. SO I WANTED TO
START WITH COMMENDING,
CHILDREN'S HOSPITAL FOR, AT
LEAST MEETING THE SEISMIC
RETROFIT PORTION OF IT. IT'S A
DAUNTING STAFF TASK, AND IT
TAKES A LOT, I KNOW SENATOR
DURAZO AND I REMEMBER THE
NORTHRIDGE EARTHQUAKE WHERE 16
PEOPLE WERE KILLED AND, THE
NUMBER OF PEOPLE THAT WERE FOUND
UNDER SLAB OF CONCRETE DURING
THAT TIME, AND TO HAVE CHILDREN
FOUND IN THE SLABS OF CONCRETE
WOULD HAVE BEEN VERY, VERY,
UPSETTING TO THE PSYCHE OF THE
REGION TO MAYBE INTO CALIFORNIA.
AND SO I COMMEND YOU FOR, FOR
GETTING THAT THAT PART DONE. AND
MY QUESTION, BECAUSE I'M NOT
REALLY SURE WHEN YOU SAY I NEED
TO DO THE SEWER IN MY MIND, DOES
THAT MEAN YOU NEED TO GET A
PLUNGER? YOU NEED TO GET A SNAKE
. YOU NEED TO. ARE WE BUILDING
NEW SEWER LINES THAT NEED TO BE
IN? AND WHY DOES IT TAKE SO LONG
? WHEN YOU SAY, WHAT ARE THOSE
OTHER THINGS? BECAUSE THAT IS
ANOTHER PROBLEM. IF WE IF YOU
CAN'T STAY OPEN THÀNH OR YOU
CAN'T PROVIDE MEDICAL CARE FOR
DURING THE NEXT EARTHQUAKE, AND
WE WILL HAVE ANOTHER EARTHQUAKE,
THEN IT'S, OBVIOUSLY IT'S NOT AS
BAD AS IF IT COLLAPSED, BUT IT
COULD BE A CATASTROPHIC PICK, A
DIFFERENT LEVEL OF PROBLEMS.
BUT, AND I THINK IF WE HAD A
LITTLE MORE CLARITY VÆ ON WHAT
IT WILL TAKE, TO DO THIS, THIS
MAY HELP NOT ONLY US, BUT ALSO
OTHERS WHO ARE ASKING FOR SHORT
OF TIME FOR YOU TO COMPLETE IT.
BECAUSE WE'RE NOT UNDERSTANDING
THE FULL BREADTH OF WHAT IT
WOULD TAKE TO DO THAT. AND
OBVIOUSLY, YOU KNOW, I USED TO
BE IN DIRECTOR OF REAL ESTATE,
IF YOU NEED TO SIT DOWN AND TALK
ABOUT HOW WE CAN CUT SOME
CORNERS AND, AND PUT OUR FOOT IN
SOME CONTRACTORS BUTTS, WE CAN
WE CAN TALK ABOUT THAT TOO. SO
YOUR ASSESSMENT IS CORRECT. THE
STRUCTURAL RATING OF THE FOUR
BUILDINGS IN QUESTION AT
CHILDREN'S HOSPITAL LOS ANGELES
ARE SPC TWO CATEGORY, SO THEY'RE
NOT AT RISK OF COLLAPSING. SO
THE STRUCTURAL INFRASTRUCTURE
HAS BEEN TAKEN CARE OF AS YOU'VE
IDENTIFIED. SO OUR NEWEST OUR
320 BEDS ARE COMPLETELY
COMPLIANT. THE FOUR OLDER
BUILDINGS THAT HOUSED ROUGHLY 80
BEDS ARE STRUCTURALLY COMPLIANT.
BUT THERE'S INFRA STRUCTURE
NEEDS. SO THAT'S A SUPPLY OF
WATER FOR 72 HOURS PAST A MAJOR
EARTHQUAKE. AND WHAT WOULD THAT
ENTAIL? YOU NEEDING TO DO, I
GUESS, IS WHAT WE WOULD HAVE TO.
OR IS THAT SOMETHING WE NEED TO
DO OFFLINE AND TALK ABOUT? IT'S
A SUBSTANTIAL INVESTMENT FOR
ADDITIONAL WATER SUPPLY TO BE
HOUSED ON THE HOSPITAL CAMPUS.
SO THERE'S A SUBSTANTIAL
CONSTRUCTION PROJECT FOR THAT
WATER SUPPLY TO BE CREATED. AND
THEN THE SEWER LINES NEED TO BE
EXPANDED PER THE REQUIREMENTS OF
THE STATE FOR THE NONSTRUCTURAL
REQUIREMENTS, THE INFRASTRUCTURE
REQUIREMENTS, AS WAS INDICATED,
THAT'S $230 MILLION. THERE'S
ELECTRICAL REQUIREMENTS ALSO
THAT NEED TO BE ADDRESSED, $230
MILLION TO MAKE THOSE
INVESTMENTS, TO MAKE ALL THOSE
THINGS POSSIBLE AND TO KEEP
THOSE BEDS OPEN DURING THAT
PROCESS. SO THE, THE HOPE IS
THAT BY PASSAGE OF THIS BILL, WE
WOULD THEN BE ABLE TO TAKE A
PORTION OF OUR CAPITAL BUDGET
EVERY YEAR, ALLOCATE IT TO THIS
PROCESS, GET THE STATE TO
APPROVE THE PLANS, AND THEN
IMPLEMENT IT OVER THAT PERIOD OF
TIME. OBVIOUSLY, IF WE CAN DO IT
SOONER, WE WOULD DO SO. WE
BELIEVE THIS IS WHAT IT'S GOING
TO BE REQUIRED IN ORDER TO
ADDRESS THE TIMELINE. AND PLEASE
NOTE, THIS IS A THREE YEAR
EXTENSION. WE WOULD HAVE TO THEN
DEMONSTRATE TO HCAI THAT FIVE
YEARS WOULD BE NECESSARY AS WELL
TO EXTEND IF THE PROJECTS ARE
UNDERWAY AND CAN BE COMPLETED IN
THAT TIMELINE. SO THANK THANK
YOU FOR THE GREAT QUESTION AND
HOPEFULLY I'VE ADDRESSED YOUR
CONCERN, LOOK, I WILL WE'LL VOTE
ON IT TODAY AND HOLD IT WHEN WE
GET TO THE FLOOR, SO WE CAN HAVE
A DISCUSSION ABOUT IS THIS A NEW
POWER GENERATOR, THAT EMERGENCY
GENERATOR THAT YOU'RE TALKING
ABOUT, A SUPER EMERGENCY? WE
DON'T I DON'T WANT TO GET INTO
THE WEEDS NOW, BUT I WANT TO GET
INTO WEEDS LATER. COME ON OVER.
WE'LL TAKE YOU ON A TOUR. WE'LL
SHOW YOU. WE'LL SHOW YOU WHAT IT
WOULD REQUIRE. ALL RIGHT. THE
GENERATORS ARE CAPACITY. IT'S
ACTUALLY THE POWER FLOW INTO THE
BUILDINGS THAT NEEDS TO BE
UPDATED. OKAY. AGAIN, THEY'RE
THEY'RE FULLY FUNCTIONAL TODAY.
THANK YOU. THANK YOU. MACHOWA SO
JUST, A SIMILAR VEIN OF
QUESTIONS WITH MY COLLEAGUE, MR.
JONES-SAWYER. AND SO IT SOUNDS
LIKE THE ISSUE IS MORE FINANCIAL
. WELL, IT'S NOT SO MUCH ABOUT
THE CONSTRUCTION BEING ABLE TO
HAPPEN IN, IN THE TIME FRAME. IS
THAT RIGHT? YEAH. THAT'S THAT'S
PART OF IT. AND SO AGAIN, TO
REITERATE, WE SPENT A BILLION
DOLLARS COMING INTO SEISMIC
COMPLIANCE WITH ALL WITH OUR NEW
TOWER. WE REOPENED THOSE BEDS
AND SO WE'VE BEEN FORCED TO MAKE
THAT DECISION. DO WE REOPEN THE
BEDS KNOWING THAT WE CAN'T MAKE
THE 2030 DEADLINE DURING THE
PAST FIVE YEARS, MEDI-CAL
REIMBURSEMENT TO CHILDREN'S
HOSPITAL LOS ANGELES HAS
DECLINED BY OVER 25. SO THE
AVERAGE PER CASE DISCHARGE
REIMBURSEMENT TO US HAS GONE
FROM $44,000 TO $31,000. SO
THAT'S IMPACTED OUR BALANCE
SHEET AND OUR ABILITY TO AFFORD
THIS IN THAT TIMELINE. SO IT'S
BOTH A MATTER OF PLANNING,
KEEPING THE BEDS OPEN AS WELL AS
AFFORDING IT. SO YOU ARE
CORRECT. OKAY. AND I, AND I
RECOGNIZE, YOU KNOW, THE, THE
RECENT FINANCIAL HARDSHIP, I AM
WILLING TO, DO A COURTESY VOTE
TODAY AS WELL, BUT HAVE
CONCERNS, AND SO I GUESS SETTING
THE FINANCIAL PIECE OF THIS
ASIDE BECAUSE, YOU KNOW, MY
GENERAL CONCERN COMES FROM THIS
IS SOMETHING THAT'S BEEN THERE'S
BEEN REQUIREMENTS AROUND THIS
FOR DECADES NOW, AT THIS POINT,
AND IT'S BEEN A VERY, VERY LONG
TIME. AND THERE'S IT SEEMS LIKE,
YOU KNOW, EVERY FEW YEARS SINCE,
I THINK, YOU KNOW, IT'S 1994
THAT ALL OF THIS STARTED. AND
THEN THERE'S BEEN EXTENSIONS
SINCE, I THINK 2007 OR 2008,
LIKE IT'S BEEN EXTENSION AFTER
EXTENSION AFTER EXTENSION AFTER
EXTENSION. SO WHAT CAN YOU HOW
CAN YOU DEMONSTRATE OR HOW WILL
YOU DEMONSTRATE. LIKE WHAT CAN
YOU SHOW US NOW THAT'S ALREADY
IN PROCESS TO KIND OF TRUST THAT
THIS IS GOING TO MOVE FORWARD IN
EARNEST. RIGHT, AND ALSO, WHAT
WILL YOU BE DEMONSTRATING TO ME,
YOU KNOW, IF THIS IS PASSED,
WHAT WILL YOU WHAT WILL YOU BE
SHOWING, TO MAKE SURE THAT THIS
IS ACTUALLY MOVING FORWARD AND
YOU'RE NOT I MEAN, IF YOU CAN
GET IT, WE HAVE FIVE AND A HALF
YEARS, RIGHT? AND IF YOU GET
ANOTHER TWO, THAT'S SEVEN AND A
HALF YEARS, BUT THEN ANOTHER
FIVE, THAT'S 12 YEARS. YOU KNOW,
THAT SEEMS LIKE A LONG TIME. SO
AGAIN, THE FIRST DEMONSTRATION
IS WE SPENT $1 BILLION COMING
INTO COMPLIANCE. RIGHT. WHICH IS
A LOT OF MONEY, WHICH IS A LOT
OF MONEY. I AGREE WITH YOU. WE
ISSUED DEBT. WE RAISED SOME
MONEY AND DID A MAGNIFICENT NEW
PROJECT. AND ALL THOSE OLD BEDS
WERE CLOSED. AND SO THE
ENVIRONMENT 30 HOSPITALS CLOSED
THEIR PEDIATRIC UNITS IN L.A.
COUNTY OVER THE LAST SIX YEARS.
LAST WEEK, SAINT MARY'S AND LONG
BEACH ANNOUNCED THEY'RE CLOSING
THEIR PEDIATRIC AND THEIR PICU
IN A CITY WITH MORE THAN 450,000
RESIDENTS. UNTHINKABLE WHERE ARE
THOSE CHILDREN GOING TO GO?
THEY'RE GOING TO COME TO
CHILDREN'S HOSPITAL LOS ANGELES.
SO AGAIN, IT'S THIS AGONIZING
CHOICE THAT WE HAVE. WE WANT TO
KEEP NOW, 12% OF ALL THE
PEDIATRIC BEDS IN L.A. COUNTY,
THE BIGGEST COUNTY IN THE STATE,
ARE IN THOSE OLDER TOWERS.
THERE'S NO PLACE FOR THESE
CHILDREN TO GO. AND SO WE WANT
TO KEEP THEM OPEN. WE'LL GO AS
FAST AS WE CAN. WE'VE ASKED FOR
THE THREE YEAR EXTENSION PLUS
FIVE YEARS IF WE'RE MAKING
PROGRESS IN HCAI APPROVES IT. SO
THOSE THERE ARE MILESTONES IN
THE BILL THAT SENATOR DURAZO HAS
INTRODUCED THAT WOULD REQUIRE US
TO MAKE THOSE MILESTONES IN
ORDER TO GET THE EXTENSIONS. BUT
YOU'RE CORRECT. WE CAN'T AFFORD
IT TODAY BECAUSE OF THE IMPACT
ON OUR BALANCE SHEET, COVID, AS
WELL AS THE IMPACT OF REDUCED
REIMBURSEMENT. SO $230 MILLION
IN AN ORGANIZATION WITH A PRETTY
STRETCHED BALANCE SHEET IS A
VERY SUBSTANTIAL INVESTMENT. SO
WE BELIEVE IT'S GOING TO TAKE
THAT AMOUNT OF TIME TO CREATE
THOSE RESOURCES. LIKE MANY
HOSPITALS IN THIS STATE, WE HAVE
NO DEBT CAPACITY. WE CAN'T
BORROW ANY MORE RESOURCES TODAY.
THAT'S THAT'S HELPED EXPLAIN THE
CONTEXT OF IT. YOU KNOW, WE'D BE
HAPPY TO GO INTO MORE DETAIL
WITH YOU AND YOUR STAFF IF YOU'D
LIKE. YEAH. THANK YOU. AND I AND
I'M DEEPLY GRATEFUL AS SOMEONE
WHO REPRESENTS LA COUNTY AS
WELL, DEEPLY GRATEFUL FOR THE
WORK YOU DO TO TAKE CARE OF OUR
KIDS. I ALSO REPRESENT
NORTHRIDGE, WHERE THE NORTHRIDGE
EARTHQUAKE HAPPENED. YEAH, AND
SO, YOU KNOW, WE GOT TO BALANCE
THINGS, RIGHT, AND SO, SO, SO I
HEAR WHAT YOU'RE SAYING ABOUT
NOT HAVING THE MONEY NOW, ARE
YOU ABLE TO TAKE STEPS FORWARD
AS MONEY COMES IN, OR ARE YOU
GOING TO HAVE TO WAIT SEVEN
YEARS BEFORE YOU CAN START
SPENDING? YEAH, WE'RE GOING TO
RESERVE SOME OF THE MONEY EACH
AND EVERY YEAR IN ORDER TO
AFFORD IT AND START MOVING. BUT
BUT ASIDE FROM SAVING THE MONEY,
GETTING THE MONEY TO DO IT, YES,
THE WORK PART OF IT. WHEN DOES
THAT START, WE ANTICIPATE
STARTING IN ABOUT THREE YEARS,
ACTUALLY STARTING WITH THESE
PROJECTS. OKAY OKAY. THANK YOU.
THANK YOU, MR. RODRIGUEZ. THERE
YOU GO. YES. FIRST OF ALL, I
JUST WANT TO THANK, THE FOLKS
THERE FROM CHILDREN'S HOSPITAL,
I'VE BEEN THERE MANY TIMES.
TAKEN A LOT OF PATIENTS THERE.
TRAUMATIC PATIENTS, AND ALSO
BEEN PART OF THE CARDIAC TEAM
WHERE WE'RE TRANSPORTING
PATIENTS FROM, LIKE LOMA LINDA
AND OTHERS. SO FABULOUS WORK,
YOU GUYS DO COMMEND YOU FOR
EVERYTHING THAT HAPPENS THERE.
THANK YOU. BUT I DO HAVE
CONCERNS, OBVIOUSLY, WITH THE
CONTINUED EXTENSIONS. OBVIOUSLY
IT SEEMS LIKE EVERY YEAR. MATTER
OF FACT, I THINK LAST WEEK WE
JUST HAD A EXTENSION ON ANOTHER
HOSPITAL. SO MY THINK IS WHAT DO
WE START DOING TO KIND OF HAVE
SOME TYPE OF INSURANCE BACKUP
PLAN? I'VE TALKED TO MANY TIMES
BEFORE REGARDING MOBILE FIELD
HOSPITALS THAT WE SHOULD LOOK AT
HAVING SOME MOBILE FIELD
HOSPITALS OR LOOK AT FUNDING FOR
1 OR 2. IT WOULD BE IDEAL IF WE
HAVE ONE IN SOUTHERN CALIFORNIA
OR NORTHERN CALIFORNIA, BECAUSE
ONCE AGAIN, LIKE SOME OF MY
COLLEAGUES TALKED ABOUT, THAT
NORTHRIDGE QUAKE OVER 20 YEARS
AGO, WE HAVEN'T BEEN TESTED, YOU
KNOW, AS FAR AS THINGS HAVE BEEN
DONE SINCE THEN TILL NOW. AND
OBVIOUSLY I WAS THE FIRST
RESPONDER THERE IN NORTHRIDGE,
AND I'VE SEEN SOME, SOME OF THE
DEVASTATION THAT OCCURRED,
ESPECIALLY THE APARTMENT
COMPLEXES. SO I JUST WANT TO
SEE, AS WE CONTINUE TO MOVE
FORWARD AND GRANTING THESE
EXTENSIONS, BECAUSE OBVIOUSLY,
THE REASONS YOU HAVE THAT WE
NEED TO REALLY TAKE A LOOK AT
WHAT CAN BE AN INSURANCE PLAN TO
SUPPORT IN CASE SOMETHING WERE
TO HAPPEN. AND WITHIN A YEAR,
RIGHT, SOME TYPE OF A BACKUP
PLAN BECAUSE AS, OUR
FIREFIGHTERS AND OUR WORKERS
TALKED ABOUT WHO'S GOING TO BE
MOVING THOSE PATIENTS WHEN WE'RE
GOING TO HAVE SOME CHAOS, IN
SOME CASES, DEPENDING WHERE THAT
EARTHQUAKE HAPPENS, WHETHER IT'S
IN THE SAN ANDREAS FAULT DOWN OR
UP HERE IN THE BAY OR THE AT THE
HAYWARD FAULT. RIGHT, SO TO JUST
MOVE CAUTIOUSLY ON THAT AND
MAYBE WE START LOOKING AT OTHER
ALTERNATIVES TO SUPPORT
HOSPITALS IF THEY DO GO DOWN,
WHICH THEY PROBABLY WILL,
DEPENDING ON WHERE THE
EARTHQUAKE IS, THAT WE HAVE THE
RESOURCES THERE TO TAKE CARE OF
THE FOLKS THAT ARE GOING TO BE
NEEDING THE HELP. SO I JUST WANT
TO KEEP THAT IN MIND. AND ONCE
AGAIN, THESE ARE SOME SOME OF
THESE TYPES OF BILLS ARE REALLY,
DIFFICULT FOR ME TO SUPPORT
BECAUSE I SEE BOTH SIDES. BUT
THEN ULTIMATELY WE'RE HERE TO
PROTECT THE PEOPLE, RIGHT? TO
THE BEST OF OUR ABILITY. AND IF
WE CONTINUE TO DELAY THESE,
EXTENSIONS, AND WE DON'T KNOW
WHEN THAT EARTHQUAKE IS GOING TO
HAPPEN, RIGHT. HOPEFULLY IT
DOESN'T HAPPEN IN A LONG TIME,
BUT THERE'S NO NOBODY CAN TELL
US IT MAY HAPPEN NEXT WEEK OR
TONIGHT. RIGHT. BUT LET'S JUST
REASSURE THAT WE'RE DOING OUR
BEST TO KEEP THOSE IN MIND. SO
AGAIN, THESE ARE TOUGH CHOICES
AND WE APPRECIATE IT. AGAIN, ONE
OF THE WORST ALTERNATIVES HERE
IS TO CLOSE 12% OF ALL THE
PEDIATRIC BEDS IN THE LARGEST
COUNTY IN THE STATE. AND SO THAT
THAT THAT'S THE TRADE OFF. AND
THAT'S WHAT WE'RE TRYING TO
AVOID IS TO BE ABLE TO DO BOTH
THESE THINGS IN A TIMELY WAY.
ALL RIGHT. THANK YOU. MAJORITY
LEADER, THANK YOU VERY MUCH,
I'VE BEEN HERE FOR EIGHT YEARS,
AND THIS COMES UP ALMOST EVERY
YEAR. AND IT'S SO FRUSTRATING
BECAUSE OBVIOUSLY IT'S HERE
ABOUT THE SAFETY OF OUR
COMMUNITY AND OUR PATIENTS, YOU
I HAVE FIXED ONE OF THE TOWERS
OR ONE OF THE TOWERS. CORRECT.
DURING THAT TIME THAT YOU'RE
DOING THAT, DID YOU ALREADY DO
THE PLANNING FOR THE OTHER FOUR
FACILITIES FOR THE SEISMIC? YES.
CORRECT. SO AGAIN, THE
STRUCTURAL WORK'S ALREADY BEEN
DONE. THIS IS THE INFRASTRUCTURE
WORK. WE HAVE MADE THOSE PLANS.
CORRECT. OKAY. SO I JUST WANT TO
MAKE SURE THAT THAT WAS CLEAR
AND I MUST HAVE MISSED IT. BUT I
WAS JUST CONCERNED. IS ARE WE
GOING TO START CONTINUING TO
PLAN. AND I'M HOPING IF YOU
SPEND $1 BILLION, YOU'VE KIND OF
GOT ALL THAT TAKEN CARE OF.
WELL, AGAIN, WE IT WAS TAKEN
CARE OF IN THE NEW TOWER. THE
OLD TOWERS WERE CLOSED. WE'VE
REOPENED THEM AS THE DEMAND HAS
INCREASED WITH OTHER HOSPITALS
CLOSING THEIR PEDIATRIC UNITS.
SO MY HEART GOES OUT TO YOU
BECAUSE I KNOW THIS IS A REALLY
TOUGH THING. I WORRY ABOUT MY
WORKERS BECAUSE I'VE TAKEN TOURS
OF NUMEROUS HOSPITALS IN
NORTHERN CALIFORNIA. THEY'RE
MUCH SMALLER, THEY'RE MUCH MORE
RURAL, AND I HOPE, HOPING WE'RE
NOT OPENING UP A CAN OF WORMS
OPENING THIS UP FOR A LONGER
PERIOD OF TIME. SO I JUST WANT
TO GIVE YOU THAT THERE ARE TWO
OTHER BILLS, AM I CORRECT, THAT
ARE COMING THROUGH WITH SEISMIC
CONCERNS AS WELL, SENATOR, I
WOULD IMAGINE YOU'RE GOING TO
HAVE CONVERSATIONS WITH THOSE
OTHER AUTHORS ON SEISMIC OR
BECAUSE I THINK WE SHOULD BE
DOING ONE BILL, NOT THREE BILLS.
QUITE FRANKLY, MAYBE THAT
DOESN'T WORK, BUT THERE'S
FRANKLY, I'M FOCUSED ON
CHILDREN'S HOSPITAL. I'M NOT
OPPOSED. AND I THINK
CONVERSATIONS LIKE THAT I'VE HAD
CONVERSATIONS, SOME
CONVERSATIONS ALREADY, BUT I'M
FOCUSED ON CHILDREN'S HOSPITAL
AND I IT'S NOT TO SAY THAT OTHER
HOSPITALS AREN'T IMPORTANT.
EVERY SINGLE ONE SMALL, BIG
RURAL, URBAN, THEY'RE ALL
THEY'RE ALL REALLY IMPORTANT,
THIS PARTICULAR HOSPITAL, OF
COURSE, DEALING WITH OUR KIDS
AND OUR BABIES AND, AND WHERE
THE GROWTH OF CHILDREN ARE
COMING TO THE HOSPITAL, IT'S NOT
LIKE THEY'VE BEEN ABLE TO MEET
THE, THE NEEDS AND THE, YOU
KNOW, WHAT THE SERVICES FOR THE
CURRENT, NEEDS. THEY REALLY ARE
NOW HAVING TO EXPAND THEIR
SERVICES, EXPAND THEIR NEEDS.
AND I THINK THAT'S THE PART THAT
PART OF WHAT CAUSED ME AND
COMPELLED ME TO WORK ON, ON THIS
PARTICULAR HOSPITAL. WELL I
APPRECIATE WHAT YOU'VE DONE FOR
THIS, BILL. I UNDERSTAND YOUR
CONCERN FOR YOUR DISTRICT, BUT
YOU KNOW ME. I'M ALWAYS GOING TO
BRING UP MY RURAL COMMUNITIES. I
WILL ALWAYS DO THAT. BUT THAT'S
THAT'S THAT'S FOR A DISCUSSION
LATER. BUT I'M JUST GOING TO
ENCOURAGE YOU TO CONTINUE TO
WORK ON THE BILL. I'D LIKE FOR
YOU TO SPEND SOME TIME WITH THE
OTHER AUTHORS THAT ARE DOING
SEISMIC BILLS, BECAUSE, SAFETY
IS NUMBER ONE. AND I THINK WE
NEED TO KEEP AN EYE OUR ENTIRE
STATE. SO I WANT TO COMMEND YOU.
I WILL SUPPORT YOU TODAY. AND I
HOPE TO SEE A BILL THAT MIGHT BE
A LITTLE BIT INCLUSIVE OF SOME
OF THE OTHER DISTRICTS. THANK
YOU. THANK YOU. ONE OTHER JUST
FOLLOW UP CONVERSATION THAT IS,
YOU KNOW, THE CONCERN OF
WORKERS, AS YOU'VE RIGHTLY
IDENTIFIED, THESE BUILDINGS ARE
NOT IN DANGER OF COLLAPSING.
THEY ARE RANKED SPC TWO. HCAI
HAS SAID THEY'RE NOT. THIS IS
NOT A LIFE SAFETY ISSUE FOR THE
WORKERS OR ANYBODY IN THE
BUILDING. JUST TO REITERATE THAT
, I'VE LIVED THROUGH AN
EARTHQUAKE. THANK YOU. SEEING NO
OTHER COMMENTS FROM COMMITTEE
MEMBERS, I WANT TO THANK THE
AUTHOR FOR BRINGING THIS
FORWARD. I KNOW THAT YOU ARE,
YOU KNOW, A CHAMPION OF WORKERS
AND DIDN'T TAKE THIS BILL ON
LIGHTLY AS YOU WERE CONSIDERING
BALANCING THE ABILITY TO KEEP
OUR COMMUNITY AND OUR WORKERS
SAFE, WHILE WE ALSO ENSURE THAT
WE HAVE AN OPPORTUNITY TO HAVE
THIS HOSPITAL OPEN, THAT BEING
SAID, THERE ARE TWO PIECES OF
LEGISLATION AB 869 BY DOCTOR
WOOD AND SB 1432 BY CABALLERO
THAT ARE GOING THROUGH THE
LEGISLATIVE PROCESS RIGHT NOW,
THAT TAKE A MUCH MORE HOLISTIC,
APPROACH TO CONSIDERING THESE
SEISMIC COMPLIANCE ISSUES AND
THE DEADLINES ASSOCIATED WITH
THAT. WE HAVE HAD A COUPLE OF
OTHER, ONE OFFS. I HAD ONE LAST
YEAR AROUND ALAMEDA HOSPITAL,
RELATED TO JUST KIND OF MAKING
EXCEPTIONS. I KNOW THAT THAT'S,
IN THE GOVERNOR'S, VETO MESSAGE
WHERE HE DESIRED A MORE
COMPREHENSIVE SOLUTION. I KNOW
THAT YOU WILL CONTINUE TO WORK
ON THIS BILL. SHOULD THOSE OTHER
TWO BILLS COME, COME INTO,
REVIEW AND ARE ACCEPTED BY BOTH
THE SENATE AND ASSEMBLY? AND
WITH THAT, WOULD YOU LIKE TO
CLOSE? THANK YOU VERY MUCH. AND,
I AGREE WITH WHAT EVERYONE HAS
SAID AS FAR AS OUR, OUR CONCERNS
, OUR CARE, OUR CARE FOR
EVERYONE, INCLUDING THE
EMPLOYEES WHO MAKE THE
HOSPITALS, WORK. AND IT IS
DIFFICULT, BUT WE ARE HAVING
GOOD CONVERSATIONS. WE HAVEN'T
REACHED OUR, AGREEMENT WITH,
THOSE WHO OPPOSE THIS PARTICULAR
BILL, BUT WE KNOW WE CARE ABOUT
THE SAME THING, SO WE JUST HAVE
TO KEEP AT IT. AND I HOPE FOR
TODAY AND, ALL THE WAY THROUGH
THE PROCESS, YOU CONTINUE TO
SUPPORT THIS BILL. THANK YOU,
THANK YOU. WE HAVE AN
ESTABLISHED QUORUM YET. BUT WHEN
WE DO, WE WILL REVIEW THE ITEM.
WE'LL MOVE ON NOW TO OUR NEXT
BILL, WHICH IS ITEM NUMBER TWO,
SB 402. WAHAB.
PLEASE GO AHEAD WHENEVER YOU'RE
READY. THANK YOU. CHAIR AND
COLLEAGUES AND MEMBERS OF THE
PUBLIC. FIRST, I WOULD LIKE TO
STATE THAT I ACCEPT THE
COMMITTEE AMENDMENTS CGRTS SB
402 APPROPRIATE RESPONSE TO
MENTAL HEALTH CRISIS, IS ABOUT
ENSURING PEOPLE IN A CRISIS ARE
MET WITH COMPASSIONATE RESPONSE
OF A TRAINED, LICENSED MENTAL
HEALTH PROFESSIONAL. UNDER
EXISTING LAW, COUNTIES HAVE THE
LATITUDE TO DESIGNATE WHOMEVER
THEY WANT, WHICH ALSO MEANS THEY
HAVE THE ABILITY TO RESTRICT WHO
IS DESIGNATED HOWEVER THEY WANT
BY NAMING SPECIFIED LICENSED
MENTAL HEALTH PROFESSIONALS. SB
402 ENSURES ANY RESTRICTIONS ON
WHO MAY BE CONSIDERED FOR COUNTY
DESIGNATION. DO NOT UNNECESSARY
LIMIT LICENSED MENTAL HEALTH
PROFESSIONALS WHO ARE NOT
EMPLOYED OR CONTRACTED BY THE
COUNTY. THE DECISION MAKING
PHASE OF INITIATING A 5150 DOES
NOT ALWAYS INCLUDE THE ACTIVE
INVOLVEMENT OF MENTAL HEALTH
EXPERTS, WHICH LEADS TO POOR
OUTCOMES FOR THE INDIVIDUALS IN
CRISIS AND THEIR COMMUNITIES.
MORE SPECIFICALLY, COMMUNITIES
OF COLOR OR THOSE THAT DO NOT
SPEAK ENGLISH. PROP 63 WAS
PASSED BY CALIFORNIA VOTERS AND
RESULTED IN COMMUNITY BASED
ORGANIZATIONS PROVIDING
PREVENTION AND EARLY
INTERVENTION SUPPORT, BUT
LICENSED MENTAL HEALTH
PROFESSIONALS WITHIN THESE
ORGANIZATIONS ARE LIMITED IN
THEIR ABILITY TO FULLY SUPPORT
THEIR CLIENTS IN CRISIS, EVEN
THOUGH THEY MAY BE LICENSED AND
CREDENTIALED BY THE STATE. WITH
THE HOURS THAT IS REQUIRED TO
RECEIVE THIS CREDENTIAL. WE ARE
TALKING ABOUT PROFESSIONALS WHO
HAVE ESTABLISHED TRUST WITH
THEIR CLIENTS AND COMMUNITIES
WITHIN MY OWN COMMUNITY, I HAVE
SEEN HIGHLY QUALIFIED MENTAL
HEALTH PROFESSIONALS WITH THE
SKILLS AND CULTURAL COMPETENCY
TO SUPPORT THEIR CLIENTS THROUGH
CRISIS, HAVING TO RELY ON POLICE
BECAUSE THEY THEMSELVES ARE NOT
EMPOWERED TO SUPPORT THEIR
CLIENT THROUGH THE WHOLE
PROCESS. THE UNNECESSARY POLICE
INVOLVEMENT NOT ONLY ESCALATES
MATTERS, TURNING A NONVIOLENT
SITUATION, SOMETIMES INTO A
VIOLENT ONE, OR ONE THAT
ESCALATES UNNECESSARILY. IT ALSO
CREATES TRAUMA FOR THE CLIENT AS
WELL AS THE FAMILIES INVOLVED,
AND THOSE THAT ARE BYSTANDERS.
OUR CURRENT FRAMEWORK DEFINITELY
NEEDS SIGNIFICANT HELP AND WE
PUT A LOT OF PRESSURE ON LAW
ENFORCEMENT TO INITIATE A 5150
SPECIFICALLY RESULTING IN
POTENTIAL DELAYS AND MUCH MORE.
SB 402 SEEKS TO ADDRESS THESE
ISSUES BY ENSURING LICENSED
MENTAL HEALTH PROFESSIONALS,
SPECIFICALLY LMFT LICENSED
CLINICAL SOCIAL WORKERS, LPCS
ARE ABLE TO PURSUE THE COUNTY
DESIGNATION PROCESS REGARDLESS
OF THEIR EMPLOYMENT OR CONTRACT
STATUS WITH THE COUNTY. THIS
THIS WILL ENCOURAGE COUNTIES TO
THINK MORE EXPANSIVELY ABOUT HOW
TO APPROACH THESE PROCESSES AND
HAVE THE FRONT LINE WORKERS AT
THE TABLE WHEN THEY ARE ENGAGING
WITH THOSE THAT ARE IN CRISIS.
WE KNOW WE CAN IMPROVE OUR
RESPONSE TO NONVIOLENT CRISES.
WHEN MPS INITIATE A 5150 AND
THERE'S NO INDICATION OF
VIOLENCE OR A WEAPON, THERE IS
NO POLICE INVOLVEMENT. WE SEE
THIS IN THE COMMUNITY ASSESSMENT
AND TRANSPORTATION TEAM,
OTHERWISE KNOWN AS THE CAT TEAM
AND THE HAYWARD HART TEAM, WHICH
PAIRS, EMTS WITH A LICENSED
CLINICIAN, SIGNIFICANTLY
REDUCING INVOLVEMENT OF LAW
ENFORCEMENT, WE ALSO SEE THIS IN
THE ALAMEDA COUNTY PROGRAM THAT
HAS DESIGNATED ELEMENTS WITHIN
FIVE COMMUNITY BASED
ORGANIZATIONS NOT CONTRACTED BY
THE COUNTY, AND HAS BEEN AN
OVERALL DECLINE IN 5150 AS A
RESULT, PROVISIONS ALREADY EXIST
THAT ENSURE POLICE ARE INVOLVED
WHEN THERE IS VIOLENCE. EXISTING
LAW ALSO MAKES PROVISIONS FOR
DESIGNATED PROFESSIONALS,
PERSONS AND MOBILE CRISIS TEAMS
TO TRANSPORT INDIVIDUALS WHERE
THERE IS NO VIOLENCE. SB 402
AIMS TO SUPPORT THESE FRONTLINE
LICENSED MENTAL HEALTH
PROFESSIONALS AND THEIR CLIENTS
TO ENSURE RESPONSE TO MENTAL
HEALTH CRISES ARE MORE
APPROPRIATE, HUMANE AND
COMPASSIONATE. WE'VE HAD A LOT
OF GREAT CONVERSATION ABOUT THIS
BILL, AND I WANT TO STATE THAT I
UNDERSTAND THE GRAVITY OF WHAT
IT MEANS TO TAKE AWAY SOMEONE'S
RIGHTS. WITH A 5150. I HAVE BEEN
INVOLVED WITH A NUMBER OF
COMMUNITY BASED ORGANIZATIONS
OVER THE YEARS, AND HAVE SEEN
FAR TOO MANY PEOPLE GO WITHOUT
THE HELP THAT THEY NEED. THEIR
FAMILIES STRUGGLE, LET ALONE
THEY THEMSELVES. THIS IS NOT
SOMETHING I TAKE LIGHTLY, AND I
KNOW THAT SO MANY MARGINALIZED
PEOPLE NEED THE HELP THAT THEY
TRULY WANT, TO GET LMP'S ALSO
UNDERSTAND THE GRAVITY OF A HOLD
AND THEY DO NOT TAKE IT LIGHTLY.
SB 402 IS, SIMPLY ENSURES THAT
COUNTIES CONSIDER LICENSED
MENTAL HEALTH PROFESSIONALS
REGARDLESS OF THEIR CONTRACT
EMPLOYMENT STATUS, TO AND TO
WORK WITH THE COUNTY AND SO
FORTH. I WOULD LIKE TO INTRODUCE
MY FIRST WITNESS, JUSTIN
PHILLIPS, A LICENSED MARRIAGE
AND FAMILY THERAPIST. MACK,
EXECUTIVE DIRECTOR OF OPTIONS
RECOVERY SERVICES. THANK YOU.
YOU'LL HAVE TWO MINUTES. THANK
YOU. THANK YOU, MADAM CHAIR. AND
THE COMMITTEE FOR ALLOWING ME TO
BE HERE TODAY, MY NAME IS JUSTIN
PHILLIPS. I, AS THE SENATOR
MENTIONED, I AM A LICENSED
MARRIAGE AND FAMILY THERAPIST, A
MASTER ADDICTION COUNSELOR, AND
THE CEO OF OPTIONS RECOVERY
SERVICES. WE ARE A STATEWIDE
ADDICTION AND MENTAL HEALTH
TREATMENT ORGANIZATION, I'M ALSO
HERE REPRESENTING NADAC, THE
NATIONAL ASSOCIATION OF
ADDICTION PROFESSIONALS. I SERVE
ON THE BOARD FOR THAT.
ORGANIZATION AND THAT, ADDRESSES
ADDICTION AND MENTAL HEALTH
ISSUES THROUGHOUT THE NATION.
I'VE BEEN WORKING IN THE MENTAL
HEALTH FIELD FOR OVER 20 YEARS,
IN A VARIETY OF CAPACITIES. SOME
OF THOSE EXPERIENCE IS IN LOCKED
PSYCHIATRIC FACILITIES. I'VE
WORKED IN DETOX FACILITIES. I'VE
WORKED ON THE STREETS. I'VE
WORKED IN MOBILE ENCAMPMENTS.
I'VE WORKED WITH THE HOMELESS.
I'VE WORKED IN A VARIETY OF
COMMUNITIES OF UNDERSERVED
PEOPLE. AND I CAN TELL YOU THAT
WHAT'S HAPPENING IS NOT WHAT
APPEARS TO MEET THE EYE. IN MOST
CASES, THE MOST SUCCESSFUL
INITIATION OF A 5150 IS DONE BY
A LICENSED PROFESSIONAL. WE SEE
THIS IN ALAMEDA COUNTY AND WE
SUPPORT IT. I AS A LICENSED
MENTAL HEALTH PROFESSIONAL, I'M
ALSO A PERSON WHO IS A RECIPIENT
OF BENEFITS FOR HAVING A
DISABILITY, I WAS IN THE
MILITARY AND, RECEIVED TRAUMATIC
EXPERIENCES THERE THAT ALLOWED
ME TO BE A CONSUMER. ULTIMATELY,
IT'S IMPORTANT TO MENTION THAT
WE COLLECTIVELY HAVE A DUTY TO
SUPPORT THE MOST UNDERSERVED AND
UNDERPRIVILEGED OF OUR
COMMUNITIES. IT'S THE PEOPLE
THAT ARE HELPING THESE PEOPLE IN
THE COMMUNITIES THAT NEED TO
HAVE MORE AUTHORITY TO BE ABLE
TO MAKE DECISIONS. IT CAN BE
TRAUMATIC, EXTREMELY TRAUMATIC,
AND EVEN MORE TRAUMATIC TO,
INDIVIDUALS WHO ARE IMPROPER. Kò
5150 AND NOT INITIATED,
ACCORDING TO THERAPEUTIC VALUES.
SO COMPASSION IS AT THE CENTER
OF THIS, AND I WANT TO THANK YOU
ALL FOR THIS OPPORTUNITY TO BE
HERE TODAY. THANK YOU. THANK
YOU. ARE THERE ANY OTHER
WITNESSES IN SUPPORT, PLEASE
COME FORWARD. NAME ORGANIZATION.
SEEING NONE, DO WE HAVE ANY,
WITNESS, FOR TESTIMONY IN
OPPOSITION?
NO WORRIES. HELLO? OKAY HELLO.
VICE CHAIR AND MEMBERS. MY NAME
IS RACHEL BHAGWAT, AND I'M A
LEGISLATIVE ADVOCATE AT ACLU
CALIFORNIA ACTION. I'VE ALSO
WORKED IN THE MENTAL HEALTH
FIELD FOR A NUMBER OF YEARS
BEFORE DOING THIS WORK, AND A
CONSUMER OF MENTAL HEALTH
SERVICES AS WELL. THE ACLU
DEEPLY REGRETS THAT WE HAVE TO
OPPOSE SB 402. WE'RE REGRETFUL
BECAUSE WE AGREE WITH THE
HIGHEST LEVEL OF PREMISE OF THIS
BILL THE IDEA THAT WE NEED
HEALTH FOCUSED, NOT LAW
ENFORCEMENT FOCUSED RESPONSES TO
MENTAL HEALTH CRISIS. HOWEVER,
THE APPROACH TO THIS BILL IS NOT
RIGHT. SB 402 WILL ACTUALLY
INCREASE CALLS TO POLICE FOR
MENTAL HEALTH CRISES, AND WILL
LEAD TO MORE PEOPLE BEING PLACED
IN INVOLUNTARY COMMITMENTS WHO
COULD HAVE BEEN SERVED BY
VOLUNTARY CRISIS SERVICES. IF
LAW ENFORCEMENT IS
INAPPROPRIATELY PLACING 5150
HOLDS, THEN WE NEED TO LIMIT THE
INSTANCES WHERE THEY RESPOND AND
DOUBLE DOWN ON OUR STATE'S NEW
MOBILE CRISIS PROGRAMS.
ALTERNATIVE TRANSPORTATION
PILOTS AND VOLUNTARY CRISIS CARE
DESTINATIONS. BUT SB 402 DOESN'T
COORDINATE WITH ANY OF THAT.
INSTEAD IT WOULD EXPAND THE POOL
OF PROFESSIONALS IN A SHOCKINGLY
BROAD WAY WHO CAN DETAIN PEOPLE
AGAINST THEIR WILL, WHICH WILL
LEAD TO MORE HOLDS BEING PLACED,
NOT FEWER PEOPLE ENGAGING WITH
OFFICERS OR PEOPLE GETTING
BETTER CARE. LAW ENFORCEMENT. IN
MOST NEARLY ALL CASES, WILL
STILL BE CALLED TO FORCIBLY
TRANSPORT THE PERSON TO A MENTAL
HEALTH FACILITY. SO MORE HOLDS
MORE POLICE CALLS, INTERACTIONS
BETWEEN LAW ENFORCEMENT AND
PEOPLE PERCEIVED TO HAVE A
MENTAL HEALTH DISABILITY ARE
DANGEROUS AND FREQUENTLY DEADLY.
2022 DATA FROM RIPA SHOWS THAT
THESE INDIVIDUALS WITH MENTAL
HEALTH DISABILITIES ARE
SUBJECTED TO FORCE 5.2 TIMES AS
OFTEN AS PEOPLE PERCEIVED TO
HAVE NO DISABILITIES. WE'RE
DISAPPOINTED BECAUSE IT DOES
SEEM THAT THE AUTHOR HAS HELPFUL
INTENTIONS, WHICH WE'VE EXPLORED
THROUGH MANY HOURS OF ROBUST
DISCUSSION WITH HER OFFICE ABOUT
MOBILE CRISIS FOCUSED APPROACHES
, OFFERING PROPOSED AMENDMENTS
AND MAKING REQUESTS FOR
GUARDRAILS AGAINST THIS BILL
BEING USED OVER BROADLY. BUT WE
REGRET THAT BECAUSE THE ORIGINAL
BILL LANGUAGE REMAINS, WE ARE
COMPELLED TO ASK FOR YOUR NO
VOTE. WE PLEDGE TO THE SENATOR
THAT WE'RE ALWAYS HAPPY TO WORK
WITH YOU ON REIMAGINING MENTAL
HEALTH CRISIS RESPONSE. THANK
YOU. GO AHEAD. TWO MINUTES. GOOD
AFTERNOON. MY NAME IS CLAIRE
CORTRIGHT. I'M THE POLICY
DIRECTOR FOR CAL VOICES. WE'RE A
PEER RUN ORGANIZATION, SO WE'RE
RUN BY AND FOR PEOPLE WITH
MENTAL ILLNESS. AND I'M A PERSON
WITH SERIOUS MENTAL ILLNESS. I'M
ALSO A PERSON THAT WAS INVOLVED
IN TRAINING, HOLD RIDERS FOR
COUNTY DESIGNATION IN IN SANTA
CLARA COUNTY FOR SEVERAL YEARS.
SO I'M FAIRLY FAMILIAR WITH THE
PROCESS AND THE REQUIREMENTS.
THERE WERE ALSO, YOU KNOW,
REGRETFULLY REMAIN OPPOSED TO
THIS BILL FOR VERY SIMILAR
REASONS TO THE ACLU. WE
UNDERSTAND THAT IT'S REALLY
TRYING TO GET IT. TWO PROBLEMS.
ONE, WE HAVE LAW ENFORCEMENT
THAT CAN WRITE HOLDS
CATEGORICALLY. THEY'RE PRIMARY
RESPONDERS. THOSE INTERACTIONS
DO TURN DEADLY, NUMBER TWO IS
THEY POLICE DO LACK THE SAME
LEVEL OF EDUCATION AS MENTAL
HEALTH PROVIDERS. AND SO
SOMETIMES THOSE HOLDS ARE NOT AS
OF QUALITY. AS A MENTAL HEALTH
PROVIDER, WE JUST FEEL THAT THIS
BILL GOES IN THE WRONG DIRECTION
AND FAILS TO ADDRESS EITHER OF
THOSE ISSUES AND WILL MAKE ONE
OF THEM WORSE, SPECIFICALLY,
THERE'S A FALSE DICHOTOMY
BETWEEN MENTAL HEALTH
PRACTITIONERS AND POLICE WITH
REGARDS TO THE QUALITY OF HOLDS.
OUR ENTIRE COURT SYSTEM AROUND
HOLDS IS INVOLVED WITH GETTING
RID OF THE ONES THAT WERE
WRITTEN THAT WERE NOT OF QUALITY
AND WERE WRITTEN BY MENTAL
HEALTH PROVIDERS. SO SIMPLY
EXPANDING GREATLY, THE NUMBER OF
PEOPLE THAT CAN WRITE HOLDS WILL
NOT ADDRESS THAT QUALITY
PROBLEM. EVEN WITH THE TRAINING
THAT IS REQUIRED TO HAVE
DESIGNATION. BUT SECONDLY, WE'RE
ALSO AUTHORIZING PEOPLE IN THEIR
PRIVATE PRACTICE TO WRITE HOLDS
ON ANYONE, NOT EVEN JUST
NECESSARILY THEIR PATIENTS, OUT
IN REMOTE LOCATIONS IN THE
COMMUNITY. AND WE DO NOT HAVE AN
ALTERNATIVE RESPONSE OTHER THAN
POLICE TO REALLY GO AND PICK
THAT PERSON UP, DEAL WITH THE
SITUATION AND TRANSPORT THEM TO
A FACILITY. SO ALL AUTHORIZING
UNKNOWN NEW NUMBERS OF PEOPLE TO
WRITE HOLDS IN DISPARATE
LOCATIONS IN THE COMMUNITY VERY
PREDICTABLY, RESULT IN GREATER
POLICE RESPONSE. AND THAT JUST
CAN'T BE DESIRABLE. I DON'T
THINK ANYONE HERE WOULD LIKE
THAT AS AN OUTCOME. SO WE ASK
FOR YOUR NO VOTE. THAT'S AN
UNRESOLVED ISSUE. SENATOR, WE'RE
GOING TO PAUSE SO THAT WE CAN
ESTABLISH QUORUM. PLEASE CALL
THE ROLL. BONTA HERE TO PRESENT
WALDEN. WALDEN. PRESENT EDGAR
CURRY. EDGAR CURRY, PRESIDENT
ARAMBULA. MERIMBULA. PRESENT.
JACKSON. JACKSON. PRESENT. FLORA
HANEY. CHEN SAWYER. PRESENT.
JOHN. SAWYER PRESENT. MAINTAIN.
MCCARTHY. JOE. PATTERSON
RODRIGUEZ. SANCHEZ. SANCHEZ.
PRESENT SANTIAGO. CHAVO. CHAVO.
PRESENT. WEBER WEBER. PRESENT.
WE HAVE QUORUM AT 315. ANY OTHER
WITNESSES IN OPPOSITION? PLEASE
COME FORWARD. GOOD AFTERNOON.
AMIR RASHID WITH THE COUNTY
BEHAVIORAL HEALTH DIRECTORS
ASSOCIATION OF CALIFORNIA.
REGRETTABLY IN OPPOSITION AT
THIS TIME. BUT LOOK FORWARD TO
REVIEW FUTURE LANGUAGE AND
CONTINUE DISCUSSION WITH THE
AUTHOR'S OFFICE. THANK YOU.
DANNY, THEORETICAL PUBLIC POLICY
COORDINATOR WITH MENTAL HEALTH
AMERICA OF CALIFORNIA, IN
OPPOSITION ALSO ON BEHALF OF
DISABILITY RIGHTS CALIFORNIA IN
OPPOSITION. SEEING NO OTHER
OPPOSITION, WE'LL BRING IT BACK
TO COMMITTEE FOR QUESTION AND
COMMENT. DOCTOR WEBER. THANK
YOU. CHAIR. THANK YOU, SENATOR,
FOR BRINGING THIS, THIS BILL
FORWARD SO WE CAN HAVE THIS,
THIS CONVERSATION. OUT THERE. I
ALREADY TOLD YOU I WILL VOTE FOR
IT TODAY, TO HELP ME GET OUT OF
COMMITTEE. HOWEVER, I DO HAVE
SIGNIFICANT CONCERNS. AND SO I
VERY WELL MAY NOT BE SUPPORTING
IT ON THE FLOOR IF IT CONTINUES
AS IS. I'M I'M. MY FIRST
QUESTION IS AROUND THE ISSUE OF
POLICE INCREASING POLICE
INVOLVEMENT WHEN WE EXPAND THE
NUMBER OF PEOPLE WHO CAN OAN DO
A 5150. SO ONCE YOU STATE
SOMEONE NEEDS A 5150, THAT IS
INVOLUNTARY, AT THAT POINT, IT
IS NO LONGER VOLUNTARY AND FROM
WHAT I'VE HEARD, AND ALSO IN OUR
ANALYSIS, WHEN YOU'RE DOING
TRANSPORTATION FOR AN
INVOLUNTARY HOLD, THE ONLY
INDIVIDUALS THAT CAN DO THAT IS
THE POLICE DEPARTMENT. SO HOW
ARE WE EXPANDING? YOU KNOW, IF
YOU EXPAND THE NUMBER OF PEOPLE
THAT CAN DO 5150, WHICH WOULD
MEAN THAT THEY WOULD NEED TO BE
TRANSPORTED BY POLICE, HOW ARE
WE DECREASING POLICE INVOLVEMENT
IN THESE SITUATIONS? UNLESS WHAT
YOU'RE SAYING THAT OUR ANALYSIS
IS INCORRECT. THANK YOU. I
RESPECTFULLY ACTUALLY DISAGREE
WITH THAT POINT IN THE ANALYSIS,
FIRST AND FOREMOST, I DO JUST
WANT TO HIGHLIGHT A COUPLE OF
THINGS, IN ALAMEDA COUNTY, WHEN
PEOPLE WHO PRESENT A VOLUNTARY,
PRESENT VOLUNTARILY OR ARE SENT
TO PSYCH EMERGENCY,
INVOLUNTARILY BY POLICE THAT ARE
ADMITTED, 72% DO NOT FIT THE
CRITERIA. NUMBER ONE, AND FOR A
5150, YOU KNOW, SPECIFICALLY BY
A MOBILE CRISIS TEAM, 50% DO NOT
MEET THE CRITERIA. AND YET, FOR
A 5150 WITH A LICENSED
PROFESSIONAL, 25% DID NOT MEET
THE CRITERIA. SO I DO JUST WANT
TO HIGHLIGHT JUST THAT RANGE OF
GOALS RIGHT, OVERALL LICENSED
MENTAL HEALTH, PRACTITIONERS.
RIGHT. LESS 5150 ACROSS THE
BOARD SPECIFICALLY BECAUSE THEY
CAN IDENTIFY EXACTLY WHAT
CONSTITUTES, INVOLUNTARY HOLD
AND MUCH MORE. AND SPECIFICALLY,
TWO CONDITIONS NEED TO BE MET
WITH A 5150, A MENTAL HEALTH
DISORDER AND PRESENTING AS A
DANGER TO OTHERS OR THEMSELVES
OR AS GRAVELY DISABLED. RIGHT
WITH THAT SAID, MORE
SPECIFICALLY, THIS IS TO HAVE
MORE LICENSED MENTAL HEALTH
THERAPISTS ON THE FRONT LINES
DEALING SPECIFICALLY WITH CASES
THAT ARE ESCALATING, WITH A, YOU
KNOW, MENTAL HEALTH CRISIS OF
SOME SORT. WE HAVE ACTUALLY HAD
THE CALIFORNIA CHIEFS, SUPPORT
THIS BILL, AND SPECIFICALLY IN
OUR CITY OF THE CITY OF HAYWARD,
WE DID AN INTERNAL SURVEY WITH
OUR POLICE DEPARTMENT
IDENTIFYING WHAT DO YOU GUYS
WANT TO BE TASKED WITH AND NOT
TASKED WITH. AND THE MAJORITY OF
OUR POLICE OFFICERS SPECIFICALLY
STATED IN THAT SURVEY THAT THEY
DO NOT WANT TO HANDLE MENTAL
HEALTH AND HOMELESS CRISIS
CALLS. RIGHT. AND PERSONALLY, I
DON'T BELIEVE THAT THEY NEED TO
HANDLE IT. RIGHT. THEY ARE NOT
NECESSARILY TRAINED TO THE LEVEL
THAT A CREDENTIALED LICENSED
MENTAL HEALTH THERAPIST IS, AND
THE OTHER PIECE IS RIGHT NOW
THERE ARE ACTUALLY,
TRANSPORTATION BEING DONE BY NON
POLICE OFFICERS, AMBULANCE, I
BELIEVE EMTS AND A NUMBER OF
OTHER FOLKS. THERE'S ALSO
DIFFERENT MODELS THAT ARE BEING
DEPLOYED AS PILOT PROJECTS AND
MUCH MORE. SO REALISTICALLY, THE
SAD REALITY IS THAT OUR SYSTEM
AS A WHOLE, FROM THE COUNTY TO
THE CITY LEVEL, HAS BEEN OVER
RELYING ON POLICE TO DO
EVERYTHING IN REGARDS TO SOCIAL
SERVICES, AND THAT'S WHAT WE'RE
TRYING TO CHIP AWAY AT. AND
ANYBODY THAT CAN HAVE THAT
CONVERSATION AS TO, OKAY, WHAT
ELSE CAN WE DO? WHO ELSE CAN WE
FUND TO DO THESE THINGS, BOTH
VOLUNTARILY AND INVOLUNTARILY,
WITH THE PROPER, VEHICLE AND
MUCH MORE? YEAH. AS A HEALTH
PROFESSIONAL MYSELF, I AM VERY
WELL AWARE OF THE FACT THAT
THOSE OF US WHO ARE ACTUALLY
TRAINED PROBABLY DO A MUCH
BETTER JOB THAN THOSE WHO ARE
NOT TRAINED. SO I'M NOT
SURPRISED BY THOSE STATISTICS.
AND THAT REALLY WASN'T WHAT I
WAS GETTING AT WITH MY QUESTION.
RIGHT, THE ISSUE RIGHT NOW, WHEN
YOU'RE DEALING WITH 5150 IS THAT
FOR INVOLUNTARY TRANSFER, THAT
HAS TO BE DONE BY THE POLICE.
AND IF THIS BILL TAKES AWAY THE
POLICE ABILITY TO DO A 5150 AND
ONLY PROVIDES THAT FOR
PROFESSIONALS, I THINK THAT'S
GREAT. BUT THAT'S NOT WHAT IT
DOES. IT SAYS POLICE. YOU CAN
STILL DO IT. EVERYBODY WHO
CURRENTLY DOES IT, YOU CAN STILL
DO IT. AND NOW WE'RE GOING TO
EXPAND IT TO ALLOW FOR MORE
PEOPLE TO BE ABLE TO DO IT. AND
THEREFORE FOR AN EFFECT OF THAT
IS MORE INTERACTION FOR THIS
POPULATION WITH POLICE OFFICERS,
BECAUSE ONCE YOU DECLARE THAT
THIS IS NOT A VOLUNTARY HOLD, IF
WE HAVE A LICENSED THERAPIST AND
THEY'RE ABLE TO COME IN AND
REALLY KIND OF TALK THAT PERSON
DOWN AND THAT PERSON AGREES TO
GO IN, THEN IT'S NO LONGER A
VOLUNTARY HOLD. AND SO THEN,
YES, YOU CAN SAY AN AMBULANCE OR
SOME OTHER KIND OF TRANSPORT,
BUT WHEN YOU'RE TALKING ABOUT AN
INVOLUNTARY HOLD AND HAVING TO
TRANSPORT THAT PARTICULAR
INDIVIDUAL TO A HOSPITAL, THAT
IS THE DUTY, THE SOLE DUTY, OF
THE POLICE AGENCIES, THOSE ARE
THE ONLY ONES THAT I KNOW OF, AT
LEAST IN MY AREA, AND ALSO IN
OUR ANALYSIS THAT ARE ABLE TO
TRANSPORT. AND SO I DO HAVE, I
DO HAVE SIGNIFICANT CONCERNS
ABOUT THAT PART, YOU KNOW, I
KNOW YOU DON'T WANT FURTHER
INVOLVEMENT WITH THE POLICE. I
DEFINITELY DON'T WANT FURTHER
INVOLVEMENT. POLICE. I DON'T
THINK POLICE SHOULD BE DOING
THIS. BUT THIS BILL DOES NOT
NECESSARILY REMOVE THEIR ABILITY
TO PROVIDE INVOLUNTARY HOLD. SO
I DO HAVE CONCERNS ABOUT THE
EXPANSION FOR MORE PEOPLE, WHICH
WOULD INCREASE INTERACTION WITH
OUR POLICE DEPARTMENT. SO LIKE I
SAID BEFORE, I WILL SUPPORT IT
TO HELP GET IT OUT OF THE
COMMITTEE. HOWEVER, IF IT'S
STILL AS IS, I CANNOT AGREE THAT
I CANNOT GUARANTEE THAT I WOULD
SUPPORT IT ON THE FLOOR. I
DEFINITELY APPRECIATE THAT. AND
AGAIN, I DO WANT TO HIGHLIGHT
THAT WE HAVE SEEN MOBILE CRISIS
TEAMS THAT DON'T RELY ON POLICE,
EVEN FOR AN INVOLUNTARY HOLD,
AND THEY HAVE RETROFITTED AND
PURCHASED VEHICLES AND MUCH
MORE, IN THE CITY OF HAYWARD,
OUR FIREFIGHTERS, FOR EXAMPLE,
ARE ALSO PARAMEDICS, WHICH THE
HEART TEAM ALSO WORKS WITH. SO
THERE'S A NUMBER OF DIFFERENT
OPTIONS THAT ARE ON THE TABLE
THAT WE ARE NOT INVESTING DEEPER
IN. AND THAT EVENTUALLY IS THE
END ALL BE ALL GOAL. SO I AGREE.
THANK YOU, MAJORITY LEADER.
THANK YOU, SENATOR WAHAB. I
DON'T TAKE THIS LIGHTLY. YOU
KNOW, IT'S REALLY IMPORTANT WE
FIGURE OUT HOW WE GET THE BEST
CARE, MY MAIN THING TODAY, THAT
I'M CONCERNED ABOUT IS HOW
YOU'RE GOING TO IMPLEMENT THIS.
HOW IS THIS GOING TO BE
IMPLEMENTED ON THE LOCAL LEVEL?
EVERY COMMUNITY IS DIFFERENT.
EVERY COUNTY IS DIFFERENT. AND I
DON'T WANT TO BE LEFT BEHIND. I
WANT TO MAKE SURE WE ALL GET THE
SAME TREATMENT OR A POSITIVE
BEHAVIORAL HEALTH, CONCERNS. AND
TAKEN CARE OF. SO I JUST WANTED
TO THROW THAT AT YOU. IS THAT I
WILL SUPPORT IT TODAY. AGAIN,
I'M GOING TO BE ASKING YOU THE
SAME QUESTION IN 2 OR 3 WEEKS.
WHENEVER WE COME UP WITH THIS
BILL AGAIN, IS THAT I NEED TO
MAKE SURE WE HAVE IMPLEMENTATION
AT THE LOCAL LEVEL. DEFINITELY.
SO WE HAVE BEEN WORKING WITH THE
COUNTY BEHAVIORAL HEALTH
DIRECTORS, NUMBER ONE, ACROSS
THE BOARD, AND CURRENTLY SANTA
CLARA COUNTY AND ALAMEDA COUNTY
ARE DOING VERSIONS OF THIS, SO
THERE IS A MODEL OUT THERE AND,
YOU KNOW, SANTA CLARA COUNTY AND
ALAMEDA COUNTY, BOTH COUNTIES I
REPRESENT, NUMBER ONE, SANTA
CLARA COUNTY IS VERY MUCH A
LEADER IN THE SPACE. WE'RE
HOPING THAT THOSE MODELS ARE
COPIED AND PASTED ACROSS THE
STATE. BUT AS YOU KNOW, AND WE
ALL KNOW THAT AS WE REPRESENT
DIFFERENT AREAS, NOT EVERY
SINGLE COUNTY, FOCUSES ON MENTAL
HEALTH SERVICES OR SOCIAL
SERVICES OR DO IT IN THE SAME
WAY. SO THAT IS VERY MUCH A
PROCESS QUESTION AS WELL. AND
THE RESOURCES THAT EACH COUNTY
HAS IS VERY DIFFERENT, RIGHT?
YOU KNOW, YOU HAVE WEALTHY
COUNTIES AND POORER COUNTIES AND
MUCH MORE. SO WE WANT TO MAKE
SURE THAT THE COUNTIES, YOU
KNOW, HAVE STILL AT THE END OF
THE DAY, THE AUTHORITY. AND
THAT'S HOW WE'VE VERY MUCH
MODELED THIS PARTICULAR BILL. SO
AT THE END OF THE DAY, IT'S THE
COUNTY'S JUDGMENT AND PROCESS.
MR. JONES-SAWYER AND THEN I AND
I REALLY DO APPRECIATE, SENATOR,
YOUR COMMENTS, BECAUSE I KNOW
YOU BEGAN BY TALKING ABOUT
TRYING TO ENSURE THAT WE HAVE AS
LIMITED NUMBER OF INTERACTIONS
WITH LAW ENFORCEMENT AS
POSSIBLE. AND I THINK THEY'RE
THE PURPOSE, THE GOAL OF WHAT
YOU WERE TRYING, WHAT YOU ARE
TRYING NOT TO. WE'RE TRYING TO
DO WHAT YOU ARE TRYING TO DO IS
LIMIT THAT WITH THE NUMBER OF
MEDICAL PROFESSIONALS DEALING
WITH THAT. AND I THINK WHAT
YOU'RE HEARING FROM MY
COLLEAGUES, YOU GET DIFFERENT
RESPONSES TO THAT WHEN YOU
INVOLVE LAW ENFORCEMENT IN
DIFFERENT AREAS, NOT TO PICK ON
ANYBODY ELSE'S AREA, BUT I WILL
TELL YOU IN LOS ANGELES WITH THE
LOS ANGELES POLICE DEPARTMENT,
WHERE SOMEONE IS NOT WELL
TRAINED OR WAS RETRAINED IN A
DIFFERENT WAY, SOMEONE THAT HAS
A MENTAL HEALTH CRISIS COULD
FIND THEMSELVES BEATEN AND
PHYSICALLY HARMED. IF THERE IS A
LAW ENFORCEMENT. I MEAN, IF YOU
HAVE LOS ANGELES POLICE
DEPARTMENT INDIVIDUAL WHO IS
AFRAID OF THEIR LIVES AND THAT
MENTAL HEALTH INDIVIDUAL WILL
NOT BE ALIVE TODAY, AND THAT'S
WHAT YOU'RE HEARING, FROM
MEMBERS HERE. AND IT'S ABOUT HOW
DO YOU PROTECT THEM IF YOU START
TO BRING IN OR USE THEM TO
TRANSPORT INDIVIDUALS,
ESPECIALLY IF THEY SHOW UP TO
THE SCENE AND IT'S PRETTY
CHAOTIC BECAUSE THEIR FIRST
TRAINING OR THEIR FIRST RESPONSE
IS NOT WHAT YOU'RE TALKING ABOUT
FROM A CLINICAL PSYCHIATRIST
PERSPECTIVE, BUT A LAW
ENFORCEMENT PERSPECTIVE, WHICH
IS NOT WRONG. IT'S JUST
DIFFERENT. AND THEN IT TURNS OUT
TO BE WRONG BECAUSE IN THAT
CASE, IT UNFORTUNATELY WE MAY
HAVE SOME DEVASTATING IMPACTS ON
INDIVIDUALS. AND THERE'S CASES
AFTER CASES AFTER CASES IN MY
CITY OF THAT, AND SO I, I MAYBE
I WOULD SUGGEST YOU LOOK AT
THOSE BECAUSE I THINK THAT'S
WHAT YOU'RE HEARING, I DON'T
WANT TO SPEAK FOR MY OTHER
COLLEAGUES, BUT THEY MAY BE A
LITTLE BIT OF WHAT YOU'RE
HEARING THAT WHAT YOU'RE TRYING
TO DO IS ADMIRABLE. BUT IF YOU
COULD JUST TRY TO FIGURE OUT A
WAY TO MAKE SURE WE DON'T HAVE
UNINTENDED CONSEQUENCES. AND I
DO APPRECIATE THAT. AND I ALSO
WANT TO HIGHLIGHT A COUPLE OF
THINGS. NOT ALL INVOLUNTARY
HOLDS ARE VIOLENT, I DO JUST
WANT TO HIGHLIGHT THAT, AND NOT
ALL PEOPLE WITH A MENTAL HEALTH
CRISIS TEND TO BE VIOLENT.
RIGHT, AND GRANTED, WHEN YOU DO
A 5150, IT'S NOT ALWAYS PRETTY,
YOU KNOW, THAT'S THE HONEST
TRUTH OF IT. THESE ARE NOT, YOU
KNOW, HAPPY GO LUCKY INCIDENTS
OR CALLS OR THESE ARE CRISES,
AND I DO WANT TO HIGHLIGHT SOME
OF THE CONCERNS THAT YOU GUYS
HAD, FOR EXAMPLE, THE PMT, FOR
EXAMPLE, IN LA PROVIDES NON-LAW
ENFORCEMENT BASED MOBILE CRISIS
RESPONSE FOR CLIENTS
EXPERIENCING A PSYCHIATRIC
EMERGENCY IN THE COMMUNITY. PMTS
CONSIST OF, THE LA COUNTY'S
DEPARTMENT OF MENTAL HEALTH
CLINICIANS DESIGNATED TO PERFORM
EVALUATIONS FOR INVOLUNTARY
DETENTION OF INDIVIDUALS ALS,
DETERMINED TO BE A RISK OF
HARMING THEMSELVES OR OTHERS, OR
WHO ARE UNABLE TO PROVIDE, YOU
KNOW, FOR EXAMPLE, FOOD, SHELTER
, ASSISTANCE AND THINGS LIKE
THAT FOR THEMSELVES, SO GRAVELY
DISABLED IN THAT CONTEXT. BUT
PMTS ALSO ENABLE SUCCESSFUL
TRIAGE OF THE DIFFERENT
SITUATIONS INVOLVING MENTAL
ILLNESS OR VIOLENT OR HIGH RISK
INDIVIDUALS, SO THEY ARE ABLE TO
IDENTIFY THAT FIRST AND
FOREMOST, QUICKLY, THE LICENSED
MENTAL HEALTH PROFESSIONALS,
NUMBER TWO IS THAT THEY ARE
DEEPLY TRAINED IN DE-ESCALATION
TACTICS. NUMBER ONE, AND
SOMETIMES YOU'LL HAVE AN
INDIVIDUAL THAT IS SEEING THINGS
OR HEARING THINGS AND SO FORTH.
AND THESE INDIVIDUALS CAN SPOT
THAT AND BE ABLE TO DE-ESCALATE
AT A MORE PATIENT LEVEL, IF YOU
WILL, THAN A LAW ENFORCEMENT
AGENT. AND I DO ALSO WANT TO
HIGHLIGHT THAT THIS BILL DOES
NOT REMOVE LAW ENFORCEMENT IN
REGARDS TO EVERY SINGLE TYPE OF
5150, NUMBER ONE. NUMBER TWO IS
THAT IT IS THE LICENSED MARRIAGE
AND FAMILY THERAPIST OR THE
CLINICAL SOCIAL WORKER OR THE
LPCC THAT MAKES THAT CALL. 911
IS ALWAYS AN OPTION ON THE
TABLE, BUT WE WANT TO MAKE SURE
THAT THERE'S OTHER OPTIONS ON
THE TABLE AND NOT THE END ALL BE
ALL OF LAW ENFORCEMENT COMING
IN. AND YOU KNOW, WITH THEIR
SIRENS AND MAKING A LOUDER AND
BIGGER SCENE, SO THAT IS REALLY
KIND OF WHAT THE GOAL IS. BUT I
THINK THAT THERE'S A LOT OF,
MISUNDERSTANDING OF EXACTLY WHAT
HAPPENS, WHEN A CALL IS REALLY
MADE, JUST QUICKLY, THE REASON
WHY WE'RE MOVING FROM PMTS AND
AWAY FROM LAPD, IT'S EXACTLY
THAT REASON. YEAH YEAH.
ASSEMBLYMEMBERS. BROUGH ALSO
WANTS TO COMMENT ON THIS. I JUST
WANT TO CLARIFY, FOR THE SAKE OF
THE COMMITTEE, THAT THIS BILL
HAS NOTHING TO DO WITH POLICE
OFFICER INVOLVEMENT, JUST SO YOU
KNOW, THE, I JUST WANT TO
HIGHLIGHT THAT WE SPENT A LOT OF
TIME ON THIS BILL WITH THE
AUTHOR, OUR COMMITTEE STAFF AND,
AND THE ANALYSIS IS, SPOT ON AND
VERY REPRESENTATIVE OF MY
PARTICULAR POINT OF VIEW AS
WELL. TO BE CLEAR, THIS BILL
DOES TWO THINGS. ONE IS IT ADDS
THE LMP AS DEFINED TO THE LIST
OF THOSE THAT ARE AUTHORIZED TO
INITIATE INVOLUNTARY HOLDS. AND
TWO, IT DEFINES WHAT AN MHP IS
TO BE A PSYCHIATRIST, A
PSYCHOLOGIST, A LICENSED
CLINICAL SOCIAL WORKER, OR A
LICENSED MARRIAGE AND FAMILY
THERAPIST, OR A LICENSED
PROFESSIONAL CLINICAL COUNSELOR,
THE AMENDMENTS THAT WE PUT INTO
THIS BILL ACTUALLY, TAKES A STEP
BACK, WHICH PROVIDES A LOT MORE,
WILL PROVIDE THE LEGISLATURE
WITH A LOT MORE INFORMATION THAN
IT CURRENTLY HAS RIGHT NOW. THE
REALITY IS THAT WE DON'T
ACTUALLY KNOW WHAT COUNTIES ARE
DOING. WHO'S DESIGNATED, TO DO,
BECAUSE THE REALITY IS COUNTIES
CAN ACTUALLY DESIGNATE, THESE
THESE TYPES OF LICENSED MENTAL
HEALTH PROFESSIONALS AND OTHERS.
THERE'S ALREADY A DESIGNATION
PROCESS AUTHORITY WITHIN
COUNTIES, AND WE ALSO DON'T HAVE
ENOUGH INFORMATION ABOUT HOW,
HOLDS ARE INITIATED BY DESIGNEES
OR PEACE OFFICERS OR WHAT THE
BALANCE OF THAT IS. SO THE
AMENDMENT THAT WAS OFFERED TO
THE AUTHOR THAT SHE ACCEPTED
ESSENTIALLY LAYS OUT A MUCH MORE
SAU, OPPORTUNITY FOR US TO HAVE
A MUCH MORE DATA INFORMED
FRAMEWORK FROM WHICH TO BE ABLE
TO MAKE THESE CRITICAL DECISIONS
, ABOUT HOW WE, ARE ABLE TO MOVE
FORWARD WITH 5150. THE AUTHOR
HAS HEARD MY CONCERNS ABOUT
THIS. AD INFINITUM. THANK YOU
FOR YOUR ENGAGEMENT IN OUR
CONVERSATION, AS WE CONSIDER
THIS BILL, I DO HAVE AN I
RECOMMENDATION ON THIS BILL. AS
IT STANDS NOW, AND WITH THE
AUTHOR ACCEPTING THE AMENDMENTS
WITH THIS BILL, WITH THAT
ASSEMBLY MEMBER QUIRK-SILVA, DID
YOU HAVE ANY OTHER COMMENTS, I
JUST WANTED TO ADD I'LL ALSO BE
DOING A COURTESY VOTE TODAY AND
WANT TO SEE HOW THE
CONVERSATIONS PROCEED, AS THE
BILL MOVES ALONG, I, REALLY
APPRECIATE THE COMMITTEE'S WORK
AND THE CHAIR'S WORK ON THIS AND
THE AUTHOR'S, WORK AND REALLY
INTENT, AND I THINK YOU KNOW,
THE CONCERN IS NOT AT WHAT IS IN
THE POLICY, BUT WHAT MAY BE AN
UNINTENDED CONSEQUENCE OF THE
POLICY, AND WHILE WE DO HAVE,
YOU KNOW, I KNOW YOU YOU BROUGHT
UP THE PMTS IN LOS ANGELES,
WHICH WE HAVE. THERE'S 33, TWO
PERSON TEAMS AS THIS IS A
COUPLE, A COUPLE OF YEARS OLD.
SO HOPEFULLY IT'S MORE NOW. I'D
HAVE TO DOUBLE CHECK, BUT, AND
THEY GET 1700 CALLS A MONTH, AND
SO I THINK THE CONCERN IS, IS
THERE THE CAPACITY. AND I HEAR
WHAT YOU'RE SAYING IS LIKE,
YOU'RE TRYING TO KIND OF BUILD A
PATH, RIGHT? IS WHAT I BELIEVE
YOU'RE SAYING, RIGHT? YOU WANT
TO OPEN THIS UP AND BUILD A PATH
IN ANOTHER DIRECTION, AND WE
CAN'T BUILD IT IF THERE'S NOT A
PATH TO IT. RIGHT. AND SO I
APPRECIATE WHAT YOU'RE TRYING TO
DO, I ALSO HEAR THE CONCERNS OF
MY COLLEAGUES AND UNDERSTAND
WHERE THEY'RE COMING FROM,
BECAUSE WHERE THOSE PATHS DON'T
I MEAN, SOME CITIES AND COUNTIES
DON'T HAVE ANYTHING LIKE THE PMT
, RIGHT? AND SO IT WOULD BY
DEFAULT BE, YOU KNOW, IT COULD
BE LAW ENFORCEMENT OR
POTENTIALLY, FIREFIGHTERS AS
WELL, OR EMTS, BUT, SO I THINK,
YOU KNOW, I, I SHARE SOME OF THE
CONCERNS OF MY COLLEAGUES. I
HOPE THAT THERE WILL BE MORE
DISCUSSIONS WITH OPPOSITION AS
THE BILL MOVES FORWARD TO PUT
SOME ADDITIONAL GUARDRAILS
AROUND THIS. BUT, BUT APPRECIATE
YOUR INTENT AND WHERE YOU'RE
REALLY TRYING TO GO WITH THIS
AND, AND THAT'S WHY I'LL SUPPORT
IT TODAY. THANKS MR. JACKSON,
I'M ONLY A VISITOR ON THIS
COMMITTEE, SO I'M GOING TO SHOOT
MY SHOT. NOW, BEFORE YOU ALL
KICK ME OFF AFTER THIS, I'M.
OBVIOUSLY. I LIKE THE BILL
BECAUSE IT, IT SIMPLY SAYS THE
STATUS QUO IS NOT ACCEPTABLE.
AND WE'RE STILL IN A
EXPERIMENTATION MODE WHERE, WHAT
DO WE AS WE REIMAGINE WHAT THIS
HAPPENS? WHAT DOES IT FINALLY
LOOK LIKE IN A WAY THAT THAT
MAKES THINGS WORK? AND I WOULD
LOVE TO WORK WITH YOU, NEXT YEAR
ON A MORE COMPREHENSIVE SET OF
BILLS, PARTICULARLY WITH OUR,
SELECT COMMITTEE FOR MENTAL
HEALTH, TO THINK ABOUT WHAT ARE
THOSE OTHER PIECES? BECAUSE
THERE STILL NEEDS TO BE MORE
DONE FOR, YOU KNOW, IN THE
INLAND EMPIRE, WE UNFORTUNATELY
HAD A DEATH OF SOMEONE, WHO, WAS
EXPERIENCING, A MANIC STATE AND
LOST THEIR LIFE. AND AS I READ
THROUGH WHAT HAPPENED AND IN MY
MIND, EVEN THROUGH THROUGH A
SOCIAL WORKER LENS, AND I KNOW
YOU'RE GOING THROUGH YOUR
TRAINING AS WELL, TO BEGIN TO
LOOK AT WHAT ARE ALL THOSE
POINTS THAT WE COULD HAVE DONE
TO PREVENT THAT FROM HAPPENING.
RIGHT. AND SO I THINK THAT THIS
IS DEFINITELY NOT THE END ALL,
BUT WE GOT TO KEEP ON DOING THIS
UNTIL WE GET THIS RIGHT. AND IT
MIGHT TAKE US A WHILE, BUT I
COMMEND YOU FOR CONTINUING TO
TRY TO FIND WAYS TO, TO GET AT
IT. WITH THAT, SENATOR, WOULD
YOU LIKE TO CLOSE? YES FIRST AND
FOREMOST, I JUST WANT TO SAY
THAT THE MAJORITY OF COUNTIES DO
NOT INVEST IN MENTAL HEALTH AND
SOCIAL SERVICES TO THE LEVEL
THAT I PERSONALLY BELIEVE IS
NEEDED, AND THE OPTIONS FOR ANY
RANDOM SITUATION THAT IS NOT
BEING HANDLED CURRENTLY AT THE
COUNTY OR SOMEBODY THAT THEY
DESIGNATE WITHIN COUNTY AND
USUALLY MOSTLY EMPLOYED BY THE
COUNTY. SO MEANING THE
HOSPITALS, AND SOMEBODY OUT ON
THE STREET, AN AVERAGE PERSON
WILL CALL 911 AND LAW
ENFORCEMENT SHOWS UP AND USUALLY
AN INCIDENT TAKES PLACE THAT IS
MAKES THE NEWS. AND THAT'S WHEN
WE'RE ALL UPSET THAT SOMETHING
MORE SHOULD HAVE BEEN DONE. AND
IT'S LARGELY COMMUNITIES OF
COLOR THAT SUFFER THE MOST. AND
AT THE END OF THE DAY, WHEN WE
INITIATED PROP 63 TO HAVE
PREVENTION AND EARLY
INTERVENTION THÀNH DONE BY
COMMUNITY BASED ORGANIZATIONS,
COMMUNITY BASED ORGANIZATIONS
THAT HIRE PEOPLE THAT LOOK LIKE
THEM AND SPEAK THEIR LANGUAGE.
WHAT IS THE POINT OF DOING THAT
AND INVESTING IN THAT IF THEY
ARE NOT ABLE TO INITIATE A
PROCESS THAT CAN PROTECT PEOPLE,
THAT CAN SAVE PEOPLE'S LIVES AND
ALSO LIMIT AS MUCH AS POSSIBLE
POLICE INVOLVEMENT. SO I
RESPECTFULLY ASK FOR AN AYE
VOTE. I APPRECIATE ALL OF THE
DISCUSSION HERE. I WILL CONTINUE
TO TALK TO OTHER STAKEHOLDERS AS
WE HAVE FOR THE PAST YEAR. SO
THANK YOU. WITH THAT, WE WILL
TAKE A VOTE ON, CAN I HAVE A
MOTION? MOTION BY ARAMBULA,
SECONDED BY. VÌ JACKSON, WITH
THAT, PLEASE CALL THE ROLL AND
THE MOTION IS DUE. PASS AS
AMENDED TO JUDICIARY. BONTA I
BONTA I WALDEN WALDEN I
AGUIAR-CURRY AGUIAR-CURRY I
ARAMBULA ARAMBULA I JACKSON
JACKSON I FLORA. HANEY. HANEY I
JONES-SAWYER JOHN SAWYER I
MAIENSCHEIN MCCARTY. MCCARTY. I
JOE. PATTERSON. RODRIGUEZ
SANCHEZ. SANCHEZ. I SANTIAGO.
SHABO CHAU. VÚI. WEBER WEBER. I.
THAT MOTIONS OUT 11 TO 0. THANK
YOU. WE'LL MOVE ON TO YOUR
SECOND ITEM, SENATOR WAHAB.
WHICH IS ITEM NUMBER SIX, SB
980. OKAY.
SO THIS IS A LESS CONTROVERSIAL
BILL. SO, I APPRECIATE IT. I
APPRECIATE, YOU KNOW, THE CHAIR
AND MY COLLEAGUES HERE AND
MEMBERS OF THE PUBLIC, WE JUST
ACTUALLY HAD OUR, LITTLE PRESSER
THAT HIGHLIGHTED THE BYPASS, AN
EFFORT OF THIS BILL. SO, SB 980
OR THE SMILE ACT IS A BIPARTISAN
STEP TOWARD FAIR AND EQUITABLE
ACCESS TO DENTAL SERVICES FOR
ALL CALIFORNIANS. IT DOES TWO
THINGS. FIRST, IT SIMPLY ALIGNS
STATUTE TO REGULATIONS FOR LAB
PROCESSED CROWNS BY LOWERING THE
STATUTORY AGE OF 21 TO 13, AS
LISTED IN REGULATIONS. AND
SECOND, AND THE MOST IMPORTANT
PIECE OF THIS BILL IS THIS BILL
ADDS DENTAL IMPLANTS TO BE
COVERED, BENEFIT UNDER THE
MEDI-CAL DENTAL PROGRAM, 40% OF
THE STATE, WHICH IS ROUGHLY 15.3
MILLION PEOPLE, ARE ENROLLED IN
MEDI-CAL. AND IN ORDER TO
QUALIFY FOR MEDI-CAL, A FAMILY
MUST BE AT THE 138% OF THE
POVERTY LEVEL. THE MEDI-CAL
DENTAL PROGRAM'S CURRENT POLICY
MIGHT ALLOW FOR DENTAL IMPLANTS
IN VERY EXTREME CASES LIKE
CANCER OF THE MOUTH, SEVERE LOSS
OF UPPER AND LOWER JAW BONE,
SKELETAL DEFORMITIES, OR
TRAUMATIC DESTRUCTION OF THE JAW
, FACE, OR HEAD. BUT DENTAL
IMPLANTS ARE NOT A COVERED
BENEFIT FOR THE AVERAGE PATIENT
IN THE DENTAL CAL PROGRAM, YET
THE PROGRAM DOES COVER THE
REMOVAL OF TEETH AS WELL AS
EXISTING DENTAL IMPLANTS DOES.
BUT PATIENTS DO NOT HAVE AN
OPTION FOR REPLACING THEM. THIS
LEAVES PATIENTS WITH HOLES IN
THEIR MOUTH, LEADING TO LOSS OF
BONE DENSITY, LACK OF JAW
STIMULATION, AND WEAKER
SURROUNDING TEETH. MISSING A
TOOTH CAN ALSO LEAD TO ORAL
DISEASE. POOR NUTRITION, AND IS
LINKED TO SYSTEMIC DISEASES LIKE
DIABETES AND CORONARY HEART
DISEASE. THE SMILE ACT WILL SAVE
MILLIONS IN HEALTH CARE COSTS
THROUGH ITS PREVENTATIVE AND
EARLY INTERVENTION EFFORTS, AND
ALLOW FOR A BETTER QUALITY OF
LIFE. THE SMILE ACT HAS A
CONSIDERABLE COALITION OF
BIPARTISAN, BICAMERAL COAUTHORS
AND SUPPORT, WITH OVER 30
COAUTHORS BETWEEN BOTH HOUSES.
THIS IS A COMMON SENSE MEASURE
THAT WILL NOT ONLY TRANSFORM THE
LIVES OF MILLIONS OF
CALIFORNIANS, BUT ENSURE THE
STATE IS PROPERLY EQUIPPED FOR
ITS GROWING, AGING POPULATION.
THE SMILE ACT WILL ALLOW PEOPLE
TO HAVE THE DIGNITY OF HAVING A
FUNCTIONAL REPLACEMENT TO BE
ABLE TO SMILE, TO BE CONFIDENT
IN THAT JOB INTERVIEW OR ON A
DATE OR IN A FAMILY PORTRAIT, OR
TO DO SOMETHING AS BASIC AS
CHEWING FOOD, ALL OF US KNOW
SOMEONE WHO IS ON MEDI-CAL AND
WILL BENEFIT FROM THIS BILL, AND
TODAY I HAVE TWO WITNESSES BOBBY
MOSK, A MEMBER OF THE CALIFORNIA
ALLIANCE FOR RETIRED AMERICANS,
AND CINDY YOUNG, VICE PRESIDENT
OF THE CALIFORNIA ALLIANCE FOR
RETIRED AMERICANS. THANK YOU.
YOU'LL EACH HAVE TWO MINUTES.
GOOD AFTERNOON. CHAIR BONITA AND
HEALTH COMMITTEE MEMBERS. MY
NAME IS BOBBY MOSK, AND I'M A
MEMBER OF THE CALIFORNIA
ALLIANCE FOR RETIRED AMERICANS.
I'M CURRENTLY ON MEDI-CAL. I'M
HERE TO SHOW YOU SOMETHING.
PLEASE DON'T BE OFFENDED. THESE
ARE THE TEETH THAT I LOST
BECAUSE DENTAL IMPLANTS ARE NOT
A COVERED BENEFIT UNDER THE
MEDI-CAL DENTAL PROGRAM. THOUGH
MEDI-CAL MAKES EXCEPTIONS IN A
VERY EXTREME RARE CASES, I'M NOT
ELIGIBLE BASED ON THAT CRITERIA
DUE TO THE LIMITED BENEFITS
OFFERED BY MEDI-CAL. OVER TIME,
I LOST OVER SIX TEETH IN TOTAL.
OF COURSE, I WANTED TO GET
IMPLANTS THE BRIDGE I'M WEARING
HAS TO BE REMOVED BEFORE I CAN
EAT. I WAS TOLD THAT IMPLANTS
WERE NOT A COVERED OPTION. I
SIMPLY WANT TO APPEAL TO YOU AS
FATHERS, MOTHERS, AND FAMILY
MEMBERS OF KIDS WHO MAY 1ST DAY
FOUND THEMSELVES IN MY POSITION.
THERE'S A TREMENDOUS NUMBER OF
PEOPLE ON MEDI-CAL WHO WILL END
UP LIKE THIS WITHOUT YOUR
SUPPORT. MY DENTIST TOLD ME THE
PROBLEMS WITH DIGESTION AND GUM
INFECTIONS WERE VERY COMMON
AFTER TOOTH LOSS, ESPECIALLY FOR
SENIORS AND THOSE WHO ARE
IMMUNOCOMPROMISED. IMPLANTS
WOULD ERADICATE THAT PROBLEM,
AND I DON'T WANT TO PRESENT
MYSELF TO THE WORLD WITHOUT OUT
ANY TEETH BEING ABLE TO INTERACT
IN SOCIETY WITH SELF-RESPECT IS
IMPORTANT, BUT SO IS STAYING
HEALTHY. PLEASE ALLOW THOSE WHO
ARE DEPENDING ON YOU TO AVOID
COUNTLESS DIGESTIVE PROBLEMS.
SINCE MOUTH INFECTIONS AND MOST
IMPORTANTLY, THE LOSS OF OUR
DIGNITY. THANK YOU FOR YOUR TIME
. THANK YOU. YOU'LL HAVE TWO
MINUTES. THANK YOU. GOOD
AFTERNOON, CHAIR BONTA AND
ASSEMBLY COMMITTEE MEMBERS. MY
NAME IS CINDY YOUNG, AND I'M A
VICE PRESIDENT FOR THE
CALIFORNIA ALLIANCE FOR RETIRED
AMERICANS, ONE OF THE STATE'S
FOREMOST GRASSROOTS SENIORS AND
DISABILITY ADVOCACY
ORGANIZATIONS REPRESENTING OVER
1 MILLION CALIFORNIANS. WE ARE A
PROUD SPONSOR OF SB 980, THE
SMILE ACT. THE BILL WILL ADD
DENTAL IMPLANTS AS A COVERED
BENEFIT UNDER MEDI-CAL DENTAL
UNDER THE MEDI-CAL DENTAL
PROGRAM. AS SENATOR WAHAB
MENTIONED, DENTAL IMPLANTS ARE
NOT A COVERED BENEFIT UNLESS
THERE IS AN EXCEPTIONAL MEDICAL
CONDITION WITH A TOOTH. WHEN A
TOOTH IS LOST, THE ABSENCE
AFFECTS MORE THAN JUST THE
VISIBLE GAP BENEATH THE SURFACE.
THE JAWBONE REQUIRES REGULAR
STIMULATION FROM TEETH TO
MAINTAIN ITS DENSITY AND HEALTH.
WITHOUT THE STIMULATION, THE
BONE BEGINS TO ATROPHY, LEADING
TO A CONDITION KNOWN AS
RESORPTION. THIS WEAKENING OF
THE JAWBONE CAN ALTER FACIAL
STRUCTURE, POTENTIALLY LEADING
TO FURTHER TOOTH LOSS AND
IMPACTS OF SPEECH AND EATING.
ACCORDING TO THE DEPARTMENT OF
HEALTH CARE SERVICES, NEARLY 40%
OF CALIFORNIANS ARE ON MEDI-CAL.
THE DEPARTMENT SHOWS THAT OVER
14% OF THESE MEDI-CAL RECIPIENTS
ARE SENIORS AND PERSONS WITH
DISABILITIES. THE SMILE ACT IS A
STEP TOWARDS SUPPORTING OUR MOST
VULNERABLE COMMUNITIES,
ESPECIALLY THE FASTEST GROWING
AGING POPULATION IN CALIFORNIA.
WE ASK THAT THE ASSEMBLY HEALTH
COMMITTEE VOTES AYE IN SUPPORT.
THE DIRE NEED FOR THE SMILE ACT.
THANK YOU, THANK YOU. ANY OTHER
WITNESSES IN SUPPORT? PLEASE
APPROACH THE MICROPHONE. GIVE
YOUR NAME, AFFILIATION AND
POSITION ON THE BILL. GOOD
AFTERNOON. LINDA WEI WITH
WESTERN CENTER ON LAW AND
POVERTY IN SUPPORT, ROBERT
COPELAND, ALLIANCE FOR RETIRED
AMERICANS STRONG SUPPORT.
SAMANTHA JOHNSON, ON BEHALF OF
THE CALIFORNIA ASSOCIATION OF
ORTHODONTISTS AND SUPPORT. GARY
COOPER, REPRESENTING THE
CALIFORNIA ASSOCIATION OF ORAL
AND MAXILLOFACIAL SURGEONS. AND
WE ARE IN SUPPORT. MONICA
KIRKLAND, ON BEHALF OF SENIOR
SERVICES COALITION OF ALAMEDA
COUNTY, WE ARE IN STRONG
SUPPORT. KELLY BROOKS, ON BEHALF
OF THE COUNTY HEALTH EXECUTIVES
ASSOCIATION OF CALIFORNIA, HERE
IN SUPPORT CHRISTINE SMITH
HEALTH ACCESS CALIFORNIA IN
SUPPORT. NYNORSK YOUTH SEO
CALIFORNIA IN SUPPORT. K¾T
WEBER, CALIFORNIA ALLIANCE FOR
RETIRED AMERICANS. YES.
SAMANTHA, ON BEHALF OF THE
CALIFORNIA DENTAL ASSOCIATION,
WE ACTUALLY HAVE A SUPPORTIVE,
AMENDED POSITION. WE APPRECIATE
THE RECENT AMENDMENTS, BUT WE
ALSO IT'S JUST, YOUR POSITION ON
THE BILL. THANK YOU. SUPPORTIVE.
AMENDED. THANK YOU. THANK YOU.
KEITH YAMAMOTO, SACRAMENTO,
CALIFORNIA ALLIANCE FOR RETIRED
AMERICANS IN SUPPORT. THANK YOU.
ARE THERE ANY PRIMARY WITNESSES
IN OPPOSITION? ANY OTHERS TO
TESTIFY IN OPPOSITION? SEEING
NONE. I'LL BRING IT BACK TO THE
COMMITTEE FOR QUESTION OR
COMMENT. MOVED BY ARAMBULA.
SECONDED. SECOND BY JONES-SAWYER
. AND HE HAS A COMMENT, THANK
YOU FOR BRINGING THIS FORWARD.
I, I HAD PERIODONTAL DISEASE. I
HAVE THE SAME PROBLEM. I KNOW
EXACTLY WHAT YOU WENT THROUGH,
AND I HAVE DENTAL INSURANCE FROM
THE CITY OF LOS ANGELES AND THE
STATE OF CALIFORNIA, AND STILL
HAD PROBLEMS GETTING THINGS
COVERED. SO I THANK YOU, SENATOR
WAHAB, FOR BRINGING THIS, AND I
THANK YOU FOR BEING BRAVE ENOUGH
TO LET PEOPLE KNOW. THANK YOU
FOR YOUR BRAVERY. ASSEMBLY
MEMBER. ANY OTHER COMMENTS FROM
THE COMMITTEE? I THANK THE
AUTHOR FOR BRINGING FORWARD THIS
BILL, WE DEFINITELY NEED TO
ENSURE THAT WE HAVE A MUCH
BROADER APPROACH TO HEALTH CARE
OVERALL, BUT SPECIFICALLY DENTAL
HEALTH CARE FOR MEDI-CAL
RECIPIENTS, AND WITH THAT, WOULD
YOU LIKE TO CLOSE? YES. I
APPRECIATE YOUR COMMENTS.
ASSEMBLY MEMBER. THIS IS
INCREDIBLY IMPORTANT. I THINK
THAT, A LOT OF THE BILLS THAT
ARE AUTHOR INITIATED BY ME
GENUINELY ARE ABOUT THE DIGNITY
OF ALL PEOPLE, AND OFTENTIMES WE
DON'T SEE IT, WE DON'T KNOW IT,
WE DON'T EXPERIENCE IT. AND SO
IT'S OUT OF SIGHT, OUT OF MIND.
AND WITH THE SMILE ACT, I THINK
THAT WE CAN BRING DIGNITY TO A
LOT OF PEOPLE WHO DON'T FEEL
COMFORTABLE ENOUGH TO SMILE. SO
I RESPECTFULLY ASK FOR A YES
VOTE ON THE SMILE ACT. THANK
YOU, THANK YOU. WE'VE HAD A
MOTION AND A SECOND. THE MOTION
IS Dð PASS TWO, APPROPRIATIONS.
WITH THAT, PLEASE CALL THE ROLL.
BONTA I BONTA I WALDRON. WALDEN
I AGUIAR-CURRY AGUIAR-CURRY I
ARAMBULA MERIMBULA I JACKSON.
LARA HANEY. JONES-SAWYER
JONES-SAWYER I MAIENSCHEIN
MCCARTY. MCCARTY. I JO.
PATTERSON. RODRIGUEZ SANCHEZ.
SANCHEZ. I SANTIAGO. SABO. CHAU.
VÚI. WEBER WEBER. I. THAT
MEASURES OUT 9 TO 0. THANK YOU,
SENATOR. WE ARE MOVING ON NOW TO
ITEM NUMBER FOUR SB 957 WIENER.
THANK YOU. SENATOR. PROCEED.
WHEN ARE YOU READY?
OKAY, THANK YOU VERY MUCH, MADAM
CHAIR, I'M PRESENTING SENATE
BILL 957 TO, ADDRESS A
SIGNIFICANT GAP IN OUR HEALTH
CARE SYSTEM, WHICH IS THE
COLLECTION, OR LACK THEREOF, OF
DATA. HEALTH DATA, RELATED TO
SEXUAL ORIENTATION AND GENDER
IDENTITY AND INTERSEX STATUS,
FIRST OF ALL, I WANT TO NOTE
THAT WE HAVE AUTHOR AMENDMENTS
THAT ARE ENUMERATED IN THE
ANALYSIS, AND WE'RE REQUESTING
THAT THE COMMITTEE BE, INCLUDE
THOSE AMENDMENTS. AND WE
APPRECIATE THAT, COLLECTING
ACCURATE DATA, HEALTH DATA, BY
DEMOGRAPHICS IS INCREDIBLY
IMPORTANT, IF WE'LL RECALL BACK
TO THE BEGINNING OF THE
PANDEMIC, WHEN WE REALIZED THAT
OLDER PEOPLE WERE MUCH MORE
LIKELY TO DIE FROM COVID, AND
WHEN WE REALIZED THAT THERE WERE
MUCH HIGHER RATES OF INFECTION
AND DEATH IN BLACK AND BROWN
COMMUNITIES, THE ONLY REASON WE
KNEW THAT WAS BECAUSE WE HAD
DEMOGRAPHIC DATA, BECAUSE WHEN
PEOPLE WOULD GO SEEK HEALTH
SERVICES, THEY WERE ASKED
DEMOGRAPHIC QUESTIONS WHAT IS
YOUR AGE? WHAT IS YOUR GENDER?
WHAT IS YOUR RACE? THOSE ARE
VOLUNTARY QUESTIONS. YOU DON'T
HAVE TO ANSWER THEM, BUT MOST
PEOPLE DO. AND BECAUSE OF THAT,
WE COULD SEE THAT DISPARITY, AND
I'M GLAD THAT WE WERE, BECAUSE
IT HELPED WITH THE PUBLIC HEALTH
RESPONSE, AND THIS IS TRUE IN SO
MANY ASPECTS OF HEALTH CARE,
UNFORTUNATELY, HISTORICALLY, WE
HAVE NOT ASKED THAT QUESTION FOR
SEXUAL ORIENTATION AND GENDER
IDENTITY, AND IT'S A MASSIVE
BLIND SPOT. IN THE SYSTEM, I'M
GOING TO BE HONEST THAT IT'S
FRUSTRATING THAT I HAD TO BRING
THIS BILL. I SHOULD NOT HAVE HAD
TO BRING IT, THERE, FORMER
ASSEMBLY MEMBER CHU AUTHORED TWO
DIFFERENT PIECES OF LEGISLATION
COLLECTING THIS TYPE OF DATA. IN
2020, I AUTHORED A LAW, TO
REQUIRE IT, AND WE QUICKLY SAW
THAT IT WAS JUST NOT HAPPENING
IN THE WAY IT NEEDED TO HAPPEN.
SO I REQUESTED AN AUDIT FROM THE
STATE AUDITOR, WHICH SHOWED THAT
IN A LARGE MAJORITY OF CDPH,
FORMS, THE QUESTIONS WERE SIMPLY
NOT BEING ASKED. AND SO WE NEED
TO JUST DEAL WITH THIS ISSUE AND
NOT HAVE TO KEEP COMING BACK TO
THE LEGISLATURE. AND SO THIS
BILL ADOPTS, ASPECTS OF THE
STATE AUDITOR'S RECOMMENDATIONS,
AND I RESPECTFULLY ASK FOR AN
AYE VOTE, WITH ME TODAY TO
TESTIFY IS DOCTOR CATHERINE
FAUBER, ASSOCIATE PROFESSOR OF
WOMEN'S, GENDER AND SEXUALITY
STUDIES AT CSU FRESNO, AND LARA
THOMAS WITH THE SAN FRANCISCO
AIDS FOUNDATION. THANK YOU.
PLEASE PROCEED. YOU'LL HAVE TWO
MINUTES. HELLO, AND GOOD
AFTERNOON, MADAM CHAIR AND
COMMITTEE MEMBERS. I'M DOCTOR
CATHERINE PHÐ BAER AND I LIVE IN
FRESNO COUNTY AND AN ASSOCIATE
PROFESSOR AT FRESNO STATE. I
STAND HERE AS A RESEARCHER AND A
COMMUNITY ADVOCATE FOR OUR
TRANSGENDER AND QUEER
COMMUNITIES, WHO ARE OFTEN
EXCLUDED FROM STATE AND FEDERAL
RESEARCH AND DATA COLLECTION. I
WANT TO FIRST THANK SENATOR
SCOTT WIENER FOR HIS EFFORTS IN
THIS HOUSE, IN THE CENTRAL
VALLEY, THERE IS VERY LITTLE
COLLECTION ON HEALTH DATA ON THE
LGBTQ COMMUNITY, MANY OF WHO ARE
LIVING IN RURAL AND
UNDER-RESOURCED AREAS, MANY OF
WHOM ARE PEOPLE OF COLOR AND
MANY WHO HAVE EXPERIENCED
HOMELESSNESS. EVEN THOUGH THERE
ARE WONDERFUL LGBTQ COMMUNITY
ORGANIZATIONS AND ACTIVISTS IN
THE AREA WITHOUT COLLECTED DATA
ON THE POPULATION'S USAGE OF
SERVICES AND THEIR EXPERIENCES
OF HEALTH CARE, SOCIAL SERVICES
AND HOUSING, FOR EXAMPLE, IT
MAKES IT NEARLY IMPOSSIBLE TO
ADVOCATE FOR POLICY CHANGE AND
IMPROVEMENTS EFFECTIVELY. AS
MUCH AS ADVOCATES TALK ABOUT
THEIR COMMUNITY EXPERIENCES, IT
CAN BE EASILY DISMISSED AS
ANECDOTAL EVIDENCE. IT BECOMES
MORE OF A QUESTION OF HOW BIG IS
THIS POPULATION AND WHETHER WE
NEED TO REALLY CONSIDER THEM
FURTHER SILENCING MARGINALIZED
COMMUNITIES FROM LOCAL AND STATE
GOVERNMENT AND POLICIES. HAVING
ACCURATE AND COLLECTED DATA ON
MARGINALIZED POPULATIONS AND
THEIR USAGE IS POWERFUL. IT
GIVES A CLEARER PICTURE OF THE
POPULATION, ONE THAT CANNOT BE
EASILY DISMISSED. BUT I HAVE
CONDUCTED SEVERAL FRESNO COUNTY
SOGIE HEALTH AND HOUSING
ASSESSMENTS TO ADDRESS THIS LACK
OF DATA. MOST NOTABLY A
TRANSGENDER HEALTH ASSESSMENT
AND AN LGBT C¯ HEALTH ASSESSMENT
OR HOUSING ASSESSMENT OF FRESNO
COUNTY, WHICH SHOWED THAT
BARRIERS TO LGBTQ AFFIRMING
HEALTH CARE LEAD DIRECTLY TO
HOUSING INSECURITY. K¾T. BOTH OF
THESE REPORTS ARE PUBLICLY
AVAILABLE THROUGH TRANS MOTION,
AN ORGANIZATION THAT I WORK
WITH. YET I'M ONE PERSON, I'M
ONE RESEARCHER, AND MY EFFORTS
ARE LIMITED IN THAT CAPACITY.
THIS BILL WILL GREATLY HELP
POLICY MAKERS, ADVOCATES, AND
HEALTH CARE RESEARCHERS LIKE
MYSELF ASSESS COMMUNITY NEEDS
AND CREATE EFFECTIVE SOLUTIONS.
SB 957 ALLOWS FOR A GREATER
VOICE FOR MANY MARGINALIZED,
SOGGY COMMUNITIES, AND I
RESPECTFULLY ASK YOUR SUPPORT
FOR THIS BILL. THANK YOU, THANK
YOU. YOU'LL HAVE TWO MINUTES
MOVED BY ARAMBULA, SECONDED BY
AGUIAR-CURRY. THANK YOU,
COMMITTEE MEMBERS FOR HEARING
THIS. BILL, I'M LAURA THOMAS.
I'M THE SENIOR DIRECTOR OF HIV
AND HARM REDUCTION POLICY, THE
SAN FRANCISCO AIDS FOUNDATION IN
SAN FRANCISCO, AND WE ARE PROUD
TO BE A CO-SPONSOR OF SB 957.
AND WE THANK SENATOR WIENER FOR
HIS LEADERSHIP ON THIS AND SO
MANY OTHER ISSUES. THIS BILL
WILL CLOSE A GAP IN THE LAW TO
ENSURE THAT CALIFORNIA IS
COLLECTING THE DATA THAT WE NEED
TO APPROPRIATELY TARGET PUBLIC
HEALTH INTERVENTIONS, SEXUAL
ORIENTATION AND GENDER IDENTITY
DATA COLLECTION AND REPORTING
ENSURES THAT LOCAL AND STATE
HEALTH DEPARTMENTS, AS WELL AS
NONPROFITS SUCH AS THE SAN
FRANCISCO AIDS FOUNDATION, HAVE
THE INFORMATION THAT WE NEED TO
IDENTIFY VÌ HEALTH DISPARITIES.
WE CAN'T ADDRESS PROBLEMS THAT
WE CAN'T SEE, AND WE HAVE TO ASK
THE QUESTIONS TO START FIGURING
OUT THE ANSWERS. THIS BILL MAY
SEEM LIKE A RELATIVELY
BUREAUCRATIC ISSUE ABOUT ADDING
A FEW BOXES TO SOME FORMS, AND
THAT IS TRUE. THAT'S A PART OF
IT. BUT IT ALSO REPRESENTS OUR
RECOGNITION THAT SEXUAL
ORIENTATION AND GENDER IDENTITY
MATTERS, THAT THESE ARE
ESSENTIAL ASPECTS OF OUR LIVES
THAT CAN AFFECT HOW WE ACCESS
HEALTH CARE, WHAT KINDS OF
VULNERABILITIES WE HAVE, WHAT
OUR HEALTH RISKS AND STRENGTHS
ARE, AND WHAT WE NEED. THIS BILL
GIVES US DATA TO ENSURE THAT
SCARCE PUBLIC HEALTH RESOURCES
ARE EFFECTIVELY TARGETED TO
THOSE WHO NEED THEM THE MOST. IN
THIS, IN THE MONTH OF JUNE,
RECOGNIZED AS PRIDE MONTH HERE
IN CALIFORNIA AND ACROSS THE
COUNTRY, I ASK FOR YOUR SUPPORT
FOR SB 957. THANK YOU. THANK
YOU. ANY OTHER WITNESSES IN
SUPPORT? PLEASE STATE YOUR NAME,
POSITION, AFFILIATION. CRAIG
PULSIPHER ON BEHALF OF EQUALITY
CALIFORNIA, PROUD CO-SPONSOR AND
STRONG SUPPORT LAN LEI ON BEHALF
OF ASIAN AMERICANS ADVANCING
JUSTICE. SOUTHERN CALIFORNIA IN
STRONG SUPPORT KATHY MOSSBERG,
APLA HEALTH IN SUPPORT. ADAM
OGDEN SMITH WITH THE AMERICAN
CANCER SOCIETY. CANCER ACTION
NETWORK IN SUPPORT. VANESSA
SHAHEEN, ON BEHALF OF THE
CALIFORNIA ETHNIC HEALTH NETWORK
HERE IN SUPPORT BRANDON MAKI
WITH THE CALIFORNIA MEDICAL
ASSOCIATION WITH THE AMENDMENTS.
WE ARE IN SUPPORT. THANK YOU.
GOOD AFTERNOON. LINDA WEI WITH
WESTERN CENTER ON LAW AND
POVERTY AND SUPPORT NICOLE
WATERMAN ON BEHALF OF THE
CHILDREN'S PARTNERSHIP AND
SUPPORT CHRISTINE SMITH, ON
BEHALF OF THE CALIFORNIA LGBTQ,
HHS NETWORK, A SPONSOR OF THE
BILL IN SUPPORT AND ALSO ON
BEHALF OF THE HEALTH ON BEHALF
OF HEALTH ACCESS CALIFORNIA IN
SUPPORT. NICOLE MORALES, ON
BEHALF OF CHILDREN NOW IN
SUPPORT. MEGAN SUBERS, ON BEHALF
OF THE LOS ANGELES LGBT CENTER
IN SUPPORT. ANDY STONE, ON
BEHALF OF THE HIV ADVOCACY
NETWORK IN STRONG SUPPORT. THANK
YOU. ARE THERE ANY WITNESSES IN
OPPOSITION? OTHER METOOS IN
OPPOSITION. SEEING NONE, WE'LL
BRING IT BACK TO THE COMMITTEE
FOR COMMENT OR QUESTION.
ASSEMBLY MEMBER WALDEN. THANK
YOU, MADAM CHAIR. I THINK THIS
IS A VERY GOOD AND NEEDED BILL,
I SERVED ON WHEN IT EXISTED, THE
SELECT COMMITTEE ON INFECTIOUS
DISEASE AND HIGH RISK
COMMUNITIES, AND, ASSEMBLYMAN
GIBSON WAS THE CHAIR I WAS THE
VICE CHAIR. AND WE TRAVELED
AROUND CALIFORNIA AND WE WENT TO
VARIOUS PLACES, ONE OF THE
BIGGEST ISSUES WE DEALT WITH WAS
, AIDS, HIV, ESPECIALLY IN SOME
OF THE URBAN SETTINGS IN L.A.
AND WHAT WE FOUND WAS PROVIDERS
WERE NOT, I THINK IT WAS ONLY
SOMETHING LIKE 30% OF PROVIDERS
WERE EVEN UP ON PREP AND PREP,
YOU KNOW, OR EVEN ANY KIND OF
ISSUE AS HOW HOW TO PROVIDE THE
BEST TYPE OF HEALTH CARE, THE
MORE DATA AVAILABLE TO HEALTH
PROVIDERS, I FEEL, THE BETTER.
WE NEED TO LOOK AT THE RISKS.
WHAT TRENDS, WHAT WHAT'S THE
BEST TREATMENT OPTIONS? HOW TO,
GET GET TO THE BEST SUCCESSFUL
OUTCOMES? BECAUSE WE'RE ALWAYS
TALKING ABOUT, DATA DRIVEN CARE
AND, YOU KNOW, PERSONALIZED
MEDICINE, AND WE CAN'T DO IT
WITHOUT THE DATA. SO I THINK
IT'S A VERY GOOD BILL, AND I'LL
BE SUPPORTIVE TODAY. THANK YOU
FOR BRINGING IT FORWARD. THANK
YOU. I'LL JUST ADD, SENATOR
WIENER, I, AGREE WITH YOU
WHOLEHEARTEDLY THAT IT'S
UNBELIEVABLE THAT WE HAVE TO BE
HERE. AND THANK YOU FOR, MAKING
SURE THAT WE'RE FOCUSED ON
IMPLEMENTATION. AND SOMETIMES IT
REQUIRES A SECOND, A SECOND LOOK
AND DIRECTION PROVIDED TO, IN
THIS INSTANCE, THE DEPARTMENT OF
PUBLIC HEALTH TO MAKE SURE THAT
THEY'RE REQUIRED, AS OPPOSED TO
JUST ALLOWING THEM TO PERMIT,
WHICH, AS WE HEARD FROM OUR
TESTIMONY, ALLOWS THEM TO NOT
PROVIDE US WITH THE VITAL
INFORMATION THAT WE NEED TO
ENSURE THAT EVERY PART OF OUR
CALIFORNIA BEAUTIFUL CALIFORNIA
TAPESTRY IS, IS SEEN. SO WITH
THAT, VERY THANKFUL FOR THE BILL
. WOULD YOU LIKE TO CLOSE? THANK
YOU, HAPPY PRIDE AND
RESPECTFULLY ASK FOR AN AYE
VOTE. THANK YOU. THE MOTION, HAS
BEEN MADE, AND THE MOTION IS TO
PASS AS AMENDED, TO PRIVACY AND
CONSUMER PROTECTION. PLEASE CALL
THE ROLL. BONTA I WALDEN,
WALDEN. I AGUIAR-CURRY
AGUIAR-CURRY I ARAMBULA.
JACKSON. LARA HANEY, JOHN.
SAWYER, JOHN. SAWYER I
MAIENSCHEIN MCCARTY. JOE.
PATTERSON. RODRIGUEZ SANCHEZ.
SANCHEZ. I SANTIAGO. SHABO CHAU.
VÚI. WEBER. WEBER. I. THAT
MEASURE IS ON CALL. IT'S NEEDS A
COUPLE MORE VOTES. THANK YOU.
THANK YOU SO MUCH, COLLEAGUES.
THANK YOU. MOVE ON TO ITEM
NUMBER SEVEN, SB 1120. SENATOR
BECKER.
PLEASE PROCEED WHENEVER YOU'RE
READY. THANK YOU. GOOD
AFTERNOON, CHAIR AND MEMBERS,
HERE TO PRESENT SB 1120. THE
PHYSICIANS MAKE DECISIONS ACT, A
BILL THAT TAKES A CRITICAL STEP
FORWARD IN ENSURING FAIR AND
ACCURATE HEALTH CARE DECISIONS
FOR PATIENTS IN CALIFORNIA. I'D
FIRST LIKE TO THANK THE CHAIR
AND THANK THE COMMITTEE STAFF
FOR THEIR WORK ON THIS BILL. I
WILL BE ACCEPTING AMENDMENTS
FROM THE COMMITTEE TODAY, PUT
SIMPLY, THIS BILL REQUIRES
PHYSICIAN OVERSIGHT WHEN
ALGORITHMS ARE USED TO DECIDE ON
HEALTH CARE PROVIDERS REQUESTS
TO OFFER MEDICAL SERVICES, WE
BELIEVE THIS IS A NECESSARY
SAFEGUARD TO ADDRESS THE GROWING
USE OF ARTIFICIAL INTELLIGENCE
IN HEALTH INSURANCE PROCESSES,
SUCH AS CLAIMS AND PRIOR
AUTHORIZATION REQUESTS. IN
RECENT YEARS, HEALTH INSURANCE
PLANS HAVE INCREASINGLY RELIED
ON AI TO STREAMLINE THE
PROCESSING OF CLAIMS AND PRIOR
AUTHORIZATION REQUESTS. CGRTS.
WHILE THESE TOOLS HAVE THE
CAPABILITY TO IMPROVE ACCESS TO
CARE, THEY FACE CRITICISM FOR
INACCURACIES AND BIASES,
PROMPTING CALLS FOR OVERSIGHT,
LAWSUITS AGAINST COMPANIES
ALLEGED THEY'VE USED ARTIFICIAL
INTELLIGENCE, INTELLIGENCE
ALGORITHMS TO WRONGFULLY DENY
ESSENTIAL CARE TO HUNDREDS OF
THOUSANDS OF PATIENTS. THESE
LAWSUITS AND CALLS FOR REFORM AT
BOTH THE STATE AND FEDERAL LEVEL
, HIGHLIGHT THE FALLIBILITY OF
ALGORITHM DECISION MAKING IN
HEALTH CARE TODAY, WE ALL AGREE
THAT CAPABILITIES ARE EXCITING,
AND THERE ARE APPLICATIONS IN
HEALTH THAT CAN BE POSITIVE, BUT
ALGORITHM CANNOT REPLACE THE
NUANCED DECISION MAKING OF A
PHYSICIAN BY REQUIRING A GREATER
DEGREE OF PHYSICIAN OVERSIGHT.
SB 1120 PROTECTS PATIENTS RIGHTS
AND ENSURES THEIR HEALTH CARE
NEEDS ARE FAIRLY, ARE MET FAIRLY
AND ACCURATELY, AND WITH ME, I
HAVE DOCTOR ANNA YAP FROM THE UC
DAVIS HEALTH EMERGENCY MEDICINE
AND FOR TECHNICAL QUESTIONS,
GEORGE SOROS FROM THE CALIFORNIA
MEDICAL ASSOCIATION. THANK YOU.
YOU'LL EACH HAVE TWO MINUTES.
GOOD AFTERNOON, CHAIR MEMBERS. I
AM DOCTOR ANNA YAP HERE
REPRESENTING THE CALIFORNIA
MEDICAL ASSOCIATION AS THE PROUD
SPONSOR OF SB 1120 RELATING TO
ARTIFICIAL INTELLIGENCE AND
HEALTH CARE. WE WANT TO THANK
THE COMMITTEE FOR HEARING THIS
BILL TODAY, AND A SPECIAL THANK
YOU TO SENATOR BECKER FOR
AUTHORING THIS IMPORTANT
MEASURE. OUR ARTIFICIAL
INTELLIGENCE IS A POPULAR TOPIC
THAT HAS GROWN IMMENSELY OVER
THE PAST COUPLE OF YEARS. BUT IN
THE PRACTICE OF MEDICINE, WE
HAVE BEEN USING AI FOR YEARS TO
ASSIST WITH DIAGNOSIS AND
TESTING, WHICH IS WHY THE
PHYSICIAN COMMUNITY OFTEN REFERS
TO ARTIFICIAL INTELLIGENCE AS
AUGMENTED INTELLIGENCE. IN
GENERAL, PHYSICIANS ARE
ENTHUSIASTIC ABOUT THE POTENTIAL
OF AI IN HEALTH CARE, BUT WE
ALSO WANT TO GUARANTEE THAT IT'S
DONE IN A SAFE, RESPONSIBLE, AND
ETHICAL MANNER FOR OUR PATIENTS.
SB 1120 TAKES A STEP IN THE
RIGHT DIRECTION BY REQUIRING
THAT ANY DENIAL OR MODIFICATION
OF CARE IN A HEALTH PLAN, PRIOR
AUTHORIZATION PROCESS MUST BE
OVERSEEN BY A HUMAN PHYSICIAN
AND THAT ANY AI TOOL THAT IS
USED TO SUPPORT PHYSICIANS IN
UTILIZATION REVIEW PROCESSES
MUST COMPLY WITH FEDERAL
STANDARDS FOR FREEDOM FROM BIAS.
THIS INCLUDES EXCLUDING BIASES
THAT DISCRIMINATE AGAINST AN
INDIVIDUAL BASED ON THEIR
GENDER, RACE, OR OTHER
IDENTIFIERS. AS AI CAN BE A
POWERFUL TOOL FOR SUPPORTING
PHYSICIANS AND MAKING CLINICAL
DECISIONS, BUT WE MUST BE AWARE
THAT THEY CAN BE DEEPLY FLAWED.
AI MODELS USED BY PHYSICIANS TO
DETECT DISEASES SUCH AS CANCER,
OR SUGGEST THE MOST EFFECTIVE
TREATMENT, ARE EVALUATED BY THE
FOOD AND DRUG ADMINISTRATION,
BUT THE AI TOOLS TARGETED IN
THIS BILL, WHICH ARE USED BY
INSURERS IN DECIDING WHETHER
THOSE LIFE ALTERING TREATMENTS
SHOULD BE PAID FOR, ARE NOT
SUBJECTED TO THE SAME SCRUTINY
AND HAVE LITTLE INDEPENDENT
OVERSIGHT, EVEN THOUGH THEY ALSO
INFLUENCE THE CARE OF THE
NATION'S SICKEST PATIENTS. NO
MATTER HOW SMART THE TECHNOLOGY
IS, IT IS DEPENDENT ON THE
UNDERLYING DATA SOURCES THAT IT
LEARNS FROM. IF THOSE UNDERLYING
SOURCES ARE FLAWED OR BIASED, IT
CAN CAUSE DISASTROUS OUTCOMES
FOR PATIENTS. THIS IS WHY WE
NEED THE KNOWLEDGE AND
EXPERIENCE OF A PHYSICIAN TO
MAKE THE FINAL DECISION. THIS
BILL BUILDS ON OTHER SIMILAR
EFFORTS AT THE STATE AND FEDERAL
LEVEL, AND A FINAL RULE ISSUED
EARLIER THIS YEAR CALLED TÔI
ONE. THE FEDERAL GOVERNMENT PUT
RULES IN PLACE FOR CERTIFIED
HEALTH INFORMATION TECHNOLOGY
TOOLS TO ENSURE THAT THEY ARE
FREE FROM BIAS. SEVERAL BILLS
CURRENTLY. THANK YOU SO MUCH,
THIS IS A KEY PIECE OF
LEGISLATION TO ALLOW US TO
PROVIDE SOME IMPORTANT SPECIFIC
RAILCARDS AS AI DEVELOPS IN
HEALTH CARE. AS THE LEADERS OF
THE HEALTHCARE TEAM, WE BEAR THE
ULTIMATE RESPONSIBILITY FOR THE
TREATMENTS THAT ARE
ADMINISTERED, AND IT IS
IMPORTANT THAT PHYSICIANS, NOT
COMPUTERS, CAN MAKE SURE OUR
PATIENTS CAN GET THE CARE THEY
NEED. THUS, I RESPECTFULLY
REQUEST AN AYE VOTE ON THIS.
THANK YOU, THANK YOU. YOU'LL
HAVE TWO MINUTES. GEORGE SOROS
WITH THE CALIFORNIA MEDICAL
ASSOCIATION HERE FOR ANY
TECHNICAL QUESTIONS AND THANK
THE AUTHOR AND THE COMMITTEE TO
MOVE THE BILL MOVED BY
AGUIAR-CURRY, SECONDED BY
WALDRON, OTHER TESTIMONY IN
SUPPORT, PLEASE, MADAM CHAIR,
MEMBERS TIM MADDEN, REPRESENTING
THE CALIFORNIA CHAPTER OF THE
AMERICAN COLLEGE OF EMERGENCY
PHYSICIANS, THE CALIFORNIA
RHEUMATOLOGY ALLIANCE, AND THE
CALIFORNIA CHAPTER OF THE
AMERICAN COLLEGE OF CARDIOLOGY
IN SUPPORT. MADAM CHAIR,
MEMBERS. DEAN GRAFILO WITH
CAPITAL ADVOCACY HERE ON BEHALF
OF THE CALIFORNIA LIFE SCIENCES
IN SUPPORT OF SB 1120. THANK YOU
. VANESSA. ON BEHALF OF THE
CALIFORNIA ACADEMY OF FAMILY
PHYSICIANS HERE IN SUPPORT MEGAN
LOPER ON BEHALF OF THE
CALIFORNIA HOSPITAL ASSOCIATION,
HERE IN SUPPORT. TAMBIÉN ARE
HERE ON BEHALF OF THE CALIFORNIA
DENTAL ASSOCIATION IN SUPPORT.
MEGAN SUBERS ON BEHALF OF CPCA
ADVOCATES IN SUPPORT. THANK YOU.
ARE THERE ANY PRIMARY WITNESSES
IN OPPOSITION? MADAM CHAIR
MEMBERS. STEPHANIE WATKINS, ON
BEHALF OF THE ASSOCIATION OF
CALIFORNIA LIFE AND HEALTH
INSURANCE COMPANIES. FIRST AND
FOREMOST, WE'D LIKE TO THANK THE
AUTHOR, THE SPONSORS AND
COMMITTEE STAFF FOR WORKING WITH
US, WITH ONE PRIMARY CONCERN
THAT I BELIEVE THAT THESE
AMENDMENTS ADDRESS. SO WE LOOK
FORWARD TO REVIEWING THE BILL IN
PRINT AND POTENTIALLY REMOVING
OUR OPPOSITION. THANK YOU. HI.
ROBERT BOYKIN WITH THE
CALIFORNIA ASSOCIATION OF HEALTH
PLANS. JUST ECHOING, THE
COMMENTS EBCLC EARLIER. THANK
YOU, THANK YOU. WITH THAT, I
WILL BRING IT BACK TO OR ANY
OTHER TESTIMONY IN OPPOSITION.
SEEING NONE, I'LL BRING IT BACK
TO THE COMMITTEE FOR A COMMENT
OR QUESTIONS. SEEING NONE, I
WILL SHARE, THANK YOU SO MUCH,
SENATOR BECKER, FOR BRINGING
THIS FORWARD. I KNOW THAT WE
ARE, NEEDING TO MAKE SURE THAT
WE'RE PROVIDING RELEVANT AND
HELPFUL GUARDRAILS AROUND OUR AI
USE, PARTICULARLY IN MEDICAL
SETTINGS. AND I THINK THAT THIS
STRIKES A VERY FINE BALANCE TO
BE ABLE TO DO THAT. WITH THAT.
WOULD YOU LIKE TO CLOSE? THANK
YOU. I RESPECTFULLY ASK FOR AN
AYE VOTE. THANK YOU. THE MOTION,
WE HAVE A MOTION AND A SECOND.
THE MOTION IS TO PASS, AS
AMENDED, TO PRIVACY AND CONSUMER
PROTECTION. PLEASE CALL THE ROLL
ONTO A BONTA. I, WALDRON WALDEN.
I AGUIAR-CURRY AGUIAR-CURRY I
ARAMBULA JACKSON. LARA HANEY.
JONES. SAWYER MAIENSCHEIN.
MCCARTY. JO PATTERSON.
RODRIGUEZ. SANCHEZ. SANCHEZ I
SANTIAGO. SZABO. CHAU. VÚI
WEBER. WEBER. I. THAT MEASURES
ON CALL. THANK YOU.
WE ARE A HEALTH COMMITTEE IN
SEARCH OF AUTHORS STILL
REMAINING TO BE HEARD IS SB 1147
PORTANTINO, SB 1180 ASHBY AND
TWO MEASURES BY SENATOR UMBERG.
WHILE WE ARE WAITING, WE WILL DO
SOME BUSINESS STARTING WITH THE
CONSENT CALENDAR. CAN I HAVE A
MOTION MOVED BY AGUIAR-CURRY?
SECONDED BY WALDRON. SECRETARY,
PLEASE CALL THE ROLL AND I'LL
READ OFF FOR THE SAKE OF
CLARITY. ITEM FIVE SB 963. ASHBY
DO PASS TO JUDICIARY. ITEM 11.
SO SORRY. ITEM 13 SB 1319 WAHAB,
DO PASS TO APPROPRIATIONS. ITEM
14 SB 1333 EGGMAN DO PASS TO
PRIVACY AND CONSUMER PROTECTION.
ITEM 15 SB 1382 GLAZIER DO PASS
TO APPROPRIATIONS. ITEM 16 SB
1397 EGGMAN DO PASS TO
APPROPRIATIONS SECRETARY, PLEASE
CALL THE ROLL ONTO AYE. ONTO
AYE. WALDRON. WALDRON. AYE AGAR.
CURRY. AGAR. CURRY. AYE.
ARAMBULA. JACKSON FLORA. HANEY.
JONES. SAWYER. MAIENSCHEIN.
MCCARTY JOH. PATTERSON.
RODRIGUEZ. SANCHEZ SANCHEZ. AYE.
SANTIAGO CHAU. VÚI. WEBER.
WEBER. AYE. CONSENT CALENDAR IS
ON. CALL. WILL MOVE TO ADD ONS.
NOW, WHILE WE ARE WAITING. WE
DIDN'T HAVE, YOU KNOW, 1112,
ITEM NUMBER, 11, ACTUALLY, CAN
WE HAVE A MOTION AND A SECOND
MOVED BY AGUILAR CURRY, SECONDED
BY SHIAVO. THE MOTION IS DUE
PASS TO ENVIRONMENTAL SAFETY AND
TOXIC MATERIALS. THIS IS SB 1266
LIMÓN. BONTA AYE. ONTO AYE.
WALDRON. WALDEN. AYE.
AGUIAR-CURRY AGAR. CURRY. AYE.
ARAMBULA JACKSON. FLORIDA. LARA.
HANEY. JONES-SAWYER MAIENSCHEIN.
MCCARTY. JO. PATTERSON.
RODRIGUEZ SANCHEZ. SANCHEZ. AYE.
SANTIAGO. SABO CHAU. VÚI. WEBER.
WEBER AYE. MEASURES ON CALL.
ITEM NUMBER 12, SB 1300. CORTEZ.
THE MOTION IS TO PASS, AS
AMENDED, TO APPROPRIATIONS. CAN
I HAVE A MOTION BY AGUIAR-CURRY,
SECONDED BY SHIAVO. PLEASE CALL
THE ROLL ONTO AYE. WALDRON Ó.
BONTA. AYE. WALDRON. NOT VOTING.
AGUIAR-CURRY. AGUIAR-CURRY. AYE.
ARAMBULA. JACKSON. LARA. HANEY
JONES-SAWYER. MAIENSCHEIN.
MCCARTY MCCARTY. AYE. JO.
PATTERSON. RODRIGUEZ SANCHEZ.
SANCHEZ. NØ. SANTIAGO SZABO.
CHAU. VÚI. WEBER WEBER. NOT
VOTING. MEASURES ON CALL WILL
MOVE TO CONSIDER ITEM 17. SB
1447. SO THE MOTION WOULD BE DO
PASS TO APPROPRIATIONS IS MOVED
BY AGUIAR-CURRY, SECONDED BY
SHIAVO. PLEASE CALL THE ROLL
BONTA I BONTA AYE. WALDEN.
WALDEN. AYE. AGUIAR-CURRY. IGER
CURRIE. AYE. ARAMBULA. JACKSON
LARA. HANEY. JONES-SAWYER.
MAIENSCHEIN MCCARTY. MCCARTY.
IJO. PATTERSON RODRIGUEZ.
SANCHEZ SANCHEZ. AYE. SANTIAGO
CHAU. CHAU. VÚI WEBER. WEBER.
AYE. THAT MEASURE IS ON CALL.
WE'LL MOVE ON TO ITEM ONE. SB 26
UMBERG, FOLLOWED BY ITEM THREE.
SB 909 UMBERG. SENATOR. THANK
YOU. I KNOW THAT YOU WERE
CHAIRING JUDICIARY COMMITTEE OR
STILL ARE POTENTIALLY. THANK YOU
FOR COMING FORWARD. WE NEED YOU
TO TURN YOUR MIC ON. YES, WE
SHOULD DO THAT, SHOULDN'T WE?
THERE WE GO. THANK YOU, MADAM
CHAIR. AND ESPECIALLY LARA FLYNN
FOR YOUR ASSISTANCE ON THIS
BILL. THIS BILL CONCERNS CARE
COURT SCHOLARSHIPS. WE HAVE A
DRAMATIC NEED FOR BEHAVIORAL
HEALTH CARE PROFESSIONALS IN
CALIFORNIA. AND WHAT THIS BILL
DOES IS THIS BILL BASICALLY IS
SORT OF STRUCTURED ON AN ROTC
FORMAT WHERE IF YOU GIVE A
CERTAIN AMOUNT OF TIME BACK TO
THE STATE OF CALIFORNIA IN
PARTICULAR, TO SERVE AS A
BEHAVIORAL HEALTH PROFESSIONAL
IN CONNECTION WITH CARE COURTS,
THEN WE WILL PROVIDE YOU A
SCHOLARSHIP. IT IS A RELATIVELY
SMALL, COHORT, BUT IMPORTANT.
IT'S IMPORTANT THAT WE SET THE
EXAMPLE. IT'S IMPORTANT THAT WE
PROVIDE AS WELL AS WE CAN FOR
BEHAVIORAL HEALTH PROFESSIONALS.
WITH ME TO TESTIFY IS,
UNIVERSITY OF CAL STATE. EXCUSE
ME, CALIFORNIA STATE UNIVERSITY,
SACRAMENTO STUDENT SIERRA
FISHER. YOU'RE HERE. THANK YOU
VERY MUCH, AND AS WELL AS DOCTOR
ERIKA RODRIGUEZ. SO, MISS
FISHER, GO AHEAD, IF YOU DON'T
MIND. GO AHEAD. YES GOOD
AFTERNOON. AND PLEASE PUT YOUR
MIC ON. MY NAME IS FISHER. I'M
THE CHAIR OF THE LEGISLATIVE
ADVOCACY COMMITTEE FOR CHI SIGMA
SIGMA, THE HONOR SOCIETY
ASSOCIATED WITH THE COUNSELING
PROGRAM AT SACRAMENTO STATE, SB
26 WILL CREATE AN IMPORTANT
GRANT FOR STUDENTS WORKING
TOWARDS A DEGREE IN THE MENTAL
HEALTH FIELD, AND THIS IS
IMPORTANT FOR CALIFORNIA AS A
WHOLE. OBVIOUSLY WE, AS A RECENT
GRADUATE, I CAN PERSONALLY
ATTEST TO THE NEED FOR THIS
LEGISLATION IN ORDER TO APPLY
FOR LICENSURE WITH THE BOARD OF
BEHAVIORAL SCIENCES, STUDENTS
MUST COMPLETE TWO SEMESTERS OF A
PRACTICUM OR INTERNSHIP
EXPERIENCE, AND MY PROGRAM
SPECIFICALLY REQUIRES 600 HOURS
OF THAT SUPERVISED EXPERIENCE,
MOST OF THESE INTERNSHIPS ARE
UNPAID OR INCREDIBLY LOW PAY AND
ONLY PART TIME. SO TRYING TO
AFFORD COST OF LIVING IN THIS IN
THIS STATE IS PRETTY INTENSE AT
TIMES, AND MANY STUDENTS THAT I
KNOW HAVE EXPERIENCED, HOUSING
CRISIS OR, YOU KNOW, FOOD
INSECURITY AND OTHER TYPES OF
ECONOMIC DISTRESS, MEANWHILE,
MANY COUNTIES ARE DESPERATE FOR
TRAINED MENTAL HEALTH
PROFESSIONALS AND I SEE THIS AS
A WIN WIN FOR BOTH STUDENTS AND
FOR PEOPLE SEEKING MENTAL HEALTH
SUPPORT IN CALIFORNIA. THANK YOU
FOR YOUR TIME. AND I
RESPECTFULLY REQUEST AN AYE VOTE
ON SB 26. THANK YOU. YOU'LL HAVE
TWO MINUTES. YOU HAVE TO PRESS
THE BUTTON. I HAVE TO PRESS THE
BUTTON, GOOD AFTERNOON, CHAIR.
MEMBERS OF THE COMMITTEE. MY
NAME IS DOCTOR ERIKA ELENA
RODRIGUEZ. I'M A FULL TIME
FACULTY MEMBER OF THE MARRIAGE
AND FAMILY THERAPY DEPARTMENT
AND A GRADUATE OF THE CHICAGO
SCHOOL OF PROFESSIONAL
PSYCHOLOGY PROGRAM. I'M PROUD TO
SAY THE CHICAGO SCHOOL PRODUCES
ONE IN EVERY TEN MENTAL HEALTH
PRACTITIONERS IN CALIFORNIA,
WITH CAMPUSES IN LOS ANGELES,
ANAHEIM AND SAN DIEGO. SENATE
BILL 26 IS A HISTORIC PIECE OF
LEGISLATION THAT ADDRESSES THE
MENTAL HEALTH CRISIS IN
CALIFORNIA, A CRISIS THAT WILL
UNDOUBTEDLY CONTINUE TO INCREASE
AS WE BEGIN TO SEE THE FALLOUT
OF COVID, A GLOBAL PANDEMIC THAT
DRASTICALLY DECREASED MENTAL AND
SOCIAL SUPPORT FOR EVERYONE BY
SUPPORTING THIS BILL, WE CAN
HELP ALLEVIATE THE FINANCIAL
BURDEN ON STUDENTS WHO ARE
REQUIRED TO COMPLETE ANYWHERE
FROM 3 TO 6000 HOURS OF UNPAID
PRO BONO WORK, A BURDEN THAT
STOPS MANY INDIVIDUALS FROM
ENTERING THE FIELD OR CHOOSING
EMPLOYMENT IN OUR COMMUNITIES.
INSTEAD, MENTAL HEALTH
PRACTITIONERS OFTEN CHOOSE
PRIVATE PRACTICE DUE TO THE
LIMITED FINANCIAL OPPORTUNITIES
IN OUR FIELD, IT CANNOT BE
OVERSTATED HOW IMPORTANT SB 26
TO THE POTENTIAL TO DIVERSIFY
THE MENTAL HEALTH WORKFORCE. SB
26 WILL OFFER A GREAT SENSE OF
RELIEF TO INDIVIDUALS WHO ARE
FROM LOWER ECONOMIC STATUS AS
FIRST TIME HIGHER EDUCATION
STUDENTS, FIRST GENERATION
IMMIGRANT STUDENTS WHO OFTEN
STRUGGLE WITH BEING ABLE TO PAY
FOR THEIR EDUCATION. SB 26
ALIGNS WITH COMMITMENT TO THE
CARE COURT, ENSURING THAT THOSE
WHO CANNOT, WHO CAN CONTRIBUTE
TO THE MENTAL HEALTH SYSTEM CAN
DO SO EFFECTIVELY. MANY
INDIVIDUALS COME INTO THE FIELD
WANTING TO GIVE BACK TO THE
COMMUNITIES THAT THEY ARE FROM,
BUT FIND IT DIFFICULT AND OFTEN
DO NOT HAVE A OFFER. A
SUSTAINABLE ECONOMIC PATH IN OUR
COMMUNITIES. IN CONCLUSION, SB
26 MEANS INVESTING INTO THE
FUTURE OF MENTAL HEALTH OF
CALIFORNIA. IT MEANS FOSTERING A
DIVERSE, WELL PREPARED WORKFORCE
READY TO ADDRESS THE DIVERSE
MENTAL HEALTH NEEDS OF OUR
COMMUNITIES. SB 26 WILL ALLOW
THOSE WITH A PASSION FOR THE
FIELD TO HAVE A PATH TO PURSUE
THEIR DREAMS AND TO CREATE A
SUSTAINABLE FUTURE FOR
THEMSELVES AND THEIR FAMILIES.
IN MANY WAYS, THIS BILL IS A
CULMINATION OF THE AMERICAN
DREAM OF BEING ABLE TO ACHIEVE A
HIGHER EDUCATION, GIVE BACK AND
DO MORE FOR OUR COMMUNITIES THAT
WE ARE FROM AND CREATE A
POSITIVE FUTURE FOR OURSELVES
AND OUR LOVED ONES. I URGE YOU
TO CONSIDER THE LONG TERM
BENEFITS OF THIS BILL FOR THE
STATE, THE COUNTIES, AND FOR THE
COUNTLESS INDIVIDUALS WHO NOW
RECEIVE, WHO WILL NOW RECEIVE
THE MENTAL HEALTH CARE THAT THEY
DESERVE. THANK YOU FOR YOUR
TIME, CONSIDERATION, AND GENUINE
CARE TO INVEST IN THE WELL-BEING
OF ALL CALIFORNIANS. THANK YOU.
ARE THERE OTHERS IN THE HEARING
ROOM THAT WOULD LIKE TO TESTIFY
IN SUPPORT? GOOD AFTERNOON,
CHAIR SUSAN REYES WITH THE
ASSOCIATION OF INDEPENDENT
CALIFORNIA COLLEGES AND
UNIVERSITIES AND SUPPORT. THANK
YOU. MOVE THE BILL. MOVE BY
AGUIAR-CURRY. SECONDED BY
WALDRON. ARE THERE ANY IN THE
HEARING ROOM IN OPPOSITION. OH,
THANK YOU FOR THAT. WE ARE DOING
, WE'RE DOING SB 909. OH, SORRY.
SB 26. UMMC WE'RE ALL CONFUSED.
HELLO AGAIN. CHAIR AND MEMBERS.
MY NAME IS RACHEL DOGWOOD, AND
I'M A LEGISLATIVE ADVOCATE AT
ACLU CALIFORNIA ACTION. THE ACLU
IS AT AN OPPOSING, LESS AMENDED
POSITION ON SB 26. WE DEEPLY
AGREE WITH SENATOR UMBERG THAT
WE HAVE A MENTAL HEALTH
WORKFORCE SHORTAGE AND THAT IT
CAN BE ESPECIALLY DIFFICULT TO
FILL MENTAL HEALTH POSITIONS
THAT FOCUS ON SUPPORTING PEOPLE
LIVING WITH SERIOUS MENTAL
ILLNESS. UNSTABLY HOUSED AND
FACING SAFETY CHALLENGES. THESE
ARE TOUGH JOBS. THEY'RE OFTEN
UNDERPAID, AND THEY'RE
INCREDIBLY IMPORTANT. EXPANDING
SCHOLARSHIPS FOR PEOPLE TO WORK
IN THESE JOBS AT THE COUNTIES IS
A GREAT IDEA. HOWEVER, WE WOULD
CAUTION AGAINST LASER FOCUSING
THESE RESOURCES ON CARE. CAUGHT
COUNTIES HAVE A MOUNTAIN OF
UNFILLED JOB POSTINGS FOR
LICENSED MENTAL HEALTH
PROFESSIONALS AND OTHER PROGRAMS
THAT ALSO SERVE THIS POPULATION,
LIKE MOBILE CRISIS RESPONSE,
OUTREACH AND CASE MANAGEMENT
ROLES, AND MORE. THESE PROGRAMS
SUCCESSFULLY SERVE CLIENTS IN
LESS RESTRICTIVE, MORE VOLUNTARY
AND NON PUNITIVE ENVIRONMENTS
COMPARED TO CARE COURT. THEY
ALSO HAVE EVIDENCE BASE HUGE
ENROLLMENT NUMBERS AND DATA TO
BACK THEM UP FOR ALL THE
RESOURCES THAT THE STATE HAS
SPENT ON CARE COURT
IMPLEMENTATION ALREADY, THE
PROGRAM HASN'T DEMONSTRATED MUCH
IMPACT OR DEMAND, JUST ONE DATA
POINT. ACCORDING TO THE SAN
FRANCISCO CHRONICLE, AFTER SIX
MONTHS INTO SAN FRANCISCO'S CARE
COURT IMPLEMENTATION, THE
PROGRAM HAD RECEIVED ONLY 22
REFERRALS AND NEARLY HALF OF
THEM HAD BEEN DISMISSED. THAT
MEANS IT WAS SERVING ABOUT AS
MANY PEOPLE IN THE COUNTY AS ARE
SITTING UP ON THIS DAIS. ACLU
HAS DEEP ETHICAL CONCERNS ABOUT
CARE COURT, AND ALSO WORRIES
THAT BILLS LIKE SB 26 ARE
CONTINUING TO PRIORITIZE THIS
PROGRAM ABOVE OTHERS THAT SERVE
THE SAME DEEPLY VULNERABLE
POPULATION AND COULD BE MORE
EFFECTIVE WITH MORE RESOURCES.
SO LET'S ENSURE THAT ANY NEW
RESOURCES WE ALLOCATE TO
WORKFORCE FOR THIS POPULATION
HAVE THE MAXIMUM IMPACT. BY NOT
UNDULY FOCUSING ON CARE. AS
SUCH, THE ACLU WILL CONTINUE TO
OPPOSE SB 26 UNLESS IT'S AMENDED
TO EXPAND THE APPLICANT POOL TO
FOLKS WHO AGREE TO WORK THREE
YEARS IN ALL COUNTY PROGRAMS
THAT SERVE INDIVIDUALS WITH
SERIOUS MENTAL ILLNESS AND
HOUSING INSTABILITY, NOT JUST
CARE COURT. THANK YOU, THANK
YOU. YOU'LL HAVE TWO MINUTES.
GREETINGS CHAIR AND COMMITTEE
MEMBERS. MY NAME IS DANNY
THIOKOL. I AM THE PUBLIC POLICY
COORDINATOR FOR THE CALIFORNIA
YOUTH EMPOWERMENT NETWORK, ALSO
KNOWN AS KHN. WE ARE A
TRANSITIONAL AGE YOUTH LED
PROGRAM OR LED PROGRAM OF MENTAL
HEALTH. AMERICA OF CALIFORNIA
DEDICATED TO EMPOWERING YOUTH
AGES 15 TO 26 ACROSS THE STATE
TO CREATE AND INFLUENCE MENTAL
AND BEHAVIORAL HEALTH POLICY
THAT DIRECTLY AFFECTS THEM. I'M
HERE TODAY TO OPPOSE SB 26,
UNLESS AMENDED, TO MORE
COMPREHENSIVELY ADDRESS
CALIFORNIA'S MENTAL HEALTH
WORKFORCE NEEDS. HIÆN SUPPORTS
THE AUTHOR'S EFFORTS TO PROVIDE
OPPORTUNITIES TO ENTER THE
BEHAVIORAL HEALTH WORKFORCE.
HOWEVER, THIS BILL REQUIRES
SCHOLARSHIP RECIPIENTS TO SOLELY
WORK FOR COUNTY BEHAVIORAL
HEALTH AGENCIES TO IMPLEMENT THE
CARE ACT OR CARE COURT. CARE
COURT IS NOT A DIVERSION PROGRAM
THAT BENEFITS TO OUR YOUTH,
THRIVE IN PREVENTION AND EARLY
INTERVENTION PROGRAMS THAT
PROVIDE SUPPORT AND SERVICES
THAT ARE PERSON CENTERED,
CULTURALLY RESPONSIVE, AND
VOLUNTARY. IN ADDITION, THIS
BILL OVERLOOKS THE NEEDS OF
OTHER COUNTY PROGRAMS THAT ARE
ALSO EXPERIENCING A SHORTAGE OF
BEHAVIORAL HEALTH WORKERS, SO SB
26 MUST BE AMENDED TO AVOID
RESTRICTING FUTURE BEHAVIORAL
HEALTH WORKERS TO RECEIVE
SCHOLARSHIPS TO WORK FOR
PROGRAMS THAT ARE INEFFECTIVE,
WE SHOULD BE SUPPORTING AND
UPLIFTING TALE BY ENABLING
ENABLING BEHAVIORAL HEALTH
PROFESSIONALS TO WORK WITH
COUNTIES AND CONTRIBUTE TO THE
MANY ALREADY EXISTING EVIDENCE
BASED PROGRAMS THAT PROMOTE
RECOVERY AND WELLNESS. THANK
YOU, THANK YOU. ARE THERE ANY
OTHERS IN THE HEARING ROOM, IN
SUPPORT OR IN OPPOSITION? SORRY
SEEING NONE. SORRY. I DON'T KNOW
IF I SHOULD GO UP THERE NOW ON
BEHALF OF MENTAL HEALTH AMERICA
OF CALIFORNIA ALSO OPPOSE UNLESS
AMENDED AND A DISABILITY RIGHTS
CALIFORNIA. THANK YOU. WEARING A
LOT OF HATS TODAY. APPRECIATE
IT, WITH THAT, WE'LL BRING IT
BACK TO THE COMMITTEE FOR ANY
COMMENTS OR QUESTIONS. MACHADO
SO CAN YOU, VERY MUCH APPRECIATE
THE INTENT OF THIS, BUT, YOU
KNOW, THINK THE CONCERNS RAISED
BY OPPOSITION THÀNH MAKE SENSE
AS WELL. CAN YOU EXPLAIN THE
THINKING OF NOT HAVING IT BE
MORE OPEN OR BROADER? YES. THIS
IS THIS IS A VERY LIMITED
PROGRAM, AND CARE COURT. AND I
UNDERSTAND THAT THERE'S BEEN A
CONCERNS BY SOME ABOUT CARE
COURT SINCE ITS INCEPTION. THÀNH
CARE COURT IS FOCUSED ON A VERY
LIMITED POPULATION, THOSE WITH
SCHIZOPHRENIA OR SCHIZOPHRENIA
LIKE CONDITIONS. IT IS IN ITS
INFANCY AND WE ARE TRYING TO
MAKE IT WORK. WE ARE TRYING TO
FOCUS IT ON THOSE WHO ARE IN
GREATEST NEED IN CALIFORNIA AND
THUS THAT'S WHY IT'S LIMITED
JUST TO FOCUSING ON CARE COURT.
THERE IS NO DOUBT THAT WE NEED
MORE MENTAL HEALTH CARE
PROFESSIONALS. I MEAN, THAT'S
THAT'S ABSOLUTELY CLEAR. AND
THERE'S NO DOUBT THAT IF WE HAD
UNLIMITED RESOURCES, WE WOULD
PROVIDE A SCHOLARSHIP TO
EVERYONE WHO WANTS TO BE A
MENTAL HEALTH CARE PROFESSIONAL.
WE DON'T HAVE UNLIMITED
RESOURCES. WE HAVE VERY LIMITED
RESOURCES. IN FACT, THIS DOESN'T
EVEN BECOME IMPLEMENT UNLESS
THERE'S AN APPROPRIATION. BUT WE
WANT, I WANT AND I THINK THOSE
OF US WHO VOTED FOR CARE COURT
WANT IT TO SUCCEED IN ORDER FOR
IT TO SUCCEED, WE NEED DIRECTED
MENTAL HEALTH CARE PROFESSIONALS
TO MAKE IT WORK. SO THAT'S THE
REASON. THANK YOU. SEEING NO
OTHER COMMENTS, I WANT TO THANK
THE AUTHOR FOR BRINGING THIS
FORWARD. I KNOW THAT YOU ARE
INCREDIBLY PASSIONATE ABOUT THIS
PARTICULAR ISSUE, AND I
APPRECIATE THE CONVERSATION WE
WERE ABLE TO HAVE REGARDING THIS
BILL. AND I KNOW THAT YOU AND I
ARE BOTH AWARE THAT, FUNDS ARE
VERY LIMITED. THIS BUDGET CYCLE.
AND, AND I ENCOURAGE YOU TO
CONTINUE TO WORK WITH THE
OPPOSITION ON THE CONSIDERATION
OF BROADENING THIS, TO BE ABLE
TO ENSURE THAT OUR THE ENTIRETY
OF OUR MENTAL HEALTH PROVIDER
PIPELINE IS ADDRESSED. BUT
UNDERSTAND YOUR PARTICULAR FOCUS
ON ENSURING THAT CARE COURT HAS
THE IN THE INFRASTRUCTURE IT
NEEDS. WITH THAT, WOULD YOU LIKE
TO CLOSE? I SIMPLY URGE AND I
VOTE. THANK YOU. WITH THAT, WE
ARE GOING TO MOVE ON TO YOUR
NEXT ITEM. OH, SORRY. THERE WE
HAVE A QUORUM. FINALLY, IT'S
MOVED BY IT'S ALREADY BEEN MOVED
AND SECONDED. THE MOTION IS TO
PASS TO APPROPRIATE THÀNH.
PLEASE CALL THE ROLL. BONTA I
ONTO I WALDEN. WALDEN I EDGAR
CURRY. EDGAR CURRY I ARAMBULA
JACKSON. FLORA HANEY HANEY I
JOAN SAWYER MAIENSCHEIN MCCARTY
MCCARTY I JOE PATTERSON.
RODRIGUEZ SANCHEZ. SANCHEZ I
SANTIAGO. CHAVO, CHAVO I WEBER.
WEBER I. THAT MEASURE WILL BE ON
CALL. THANK YOU, MADAM CHAIR.
WITH THAT, WE WILL MOVE ON TO
YOUR NEXT ITEM, WHICH IS ITEM
NUMBER THREE, SB 909. THANK YOU,
SB 909 IS A BILL THAT
STRENGTHENS OUR HEALTH CARE
WORKFORCE ONCE AGAIN, BY
REMOVING THE MAXIMUM LOAN AMOUNT
FOR REPAYMENT. CURRENTLY,
THERE'S A LIMIT OF $105,000 IN
CONNECTION WITH THE STEPHEN M
THOMPSON PHYSICIAN CORPS LOAN
REPAYMENT PROGRAM. JUST AS A
SIDE NOTE, I ACTUALLY NEW WORK
WITH AND GREATLY ADMIRED, STEVE
THOMPSON, THERE'S PROBABLY NOT
MANY MEMBERS OF THE LEGISLATURE
THAT RECALL HIM, BUT HE, I
ASSURE YOU, IS SMILING DOWN ON
ALL OF US. THE FACT THAT THAT WE
ARE RECOGNIZING HIS CONTRIBUTION
TO CALIFORNIA HEALTH CARE BY ONE
NAMING THIS AFTER HIM AND TWO,
SEEKING TO INCREASE THE AMOUNT
BY WHICH SOMEONE WHO WORKS IN AN
UNDERSERVED, MEDICALLY
UNDERSERVED AREA CAN SEEK
REPAYMENT FOR THEIR STUDENT
LOANS. WHAT THIS DOES IS IT
INCREASES THE AMOUNT THAT ONE
CAN SEEK REPAYMENT FROM 105,000
TO 100 AND, 150,000, AND IS
APPROPRIATE IN THAT WE HAVE A
TREMENDOUS NEED FOR MENTAL,
EXCUSE ME, FOR HEALTH CARE
PROFESSIONALS IN UNDERSERVED
AREAS. AND THIS SIMPLY, EXTENDS
AND EXPANDS THE LOAN AMOUNT
REPAYMENT. I URGE AN AYE VOTE. I
AM MY WITNESS. THANK YOU FOR
THAT. WE REALLY APPRECIATE IT.
WITH THAT. ARE THERE ANY OTHERS
IN THE HEARING ROOM IN SUPPORT?
THANK YOU, MADAM CHAIR. TIM
MADDEN, REPRESENTING THE
CALIFORNIA CHAPTER OF THE
AMERICAN COLLEGE OF EMERGENCY
PHYSICIANS, THE CALIFORNIA
RHEUMATOLOGY ALLIANCE, THE
CALIFORNIA SOCIETY OF PLASTIC
SURGEONS, AND THE CALIFORNIA
CHAPTER OF THE AMERICAN COLLEGE
OF CARDIOLOGY IN SUPPORT. THANK
YOU, MADAM CHAIR. MEGAN SUBERS,
ON BEHALF OF CPCA ADVOCATES IN
SUPPORT. BRANDON MÀ TIÂU WITH
THE CALIFORNIA MEDICAL
ASSOCIATION IN SUPPORT, MOVED BY
AGUILAR CURRY, SECONDED BY
DOCTOR WEBER. ARE THERE ANY
MEMBERS WITH PRIMARY WITNESSES
IN OPPOSITION SEEING NONE FOR
TESTIMONY OR ME? TWO FOR IN
OPPOSITION. WE'LL BRING IT BACK
TO THE COMMITTEE FOR QUESTION OR
COMMENT. SEEING NONE, SENATOR
UMBERG, THANK YOU FOR BRINGING
FORWARD THIS BILL. IT'S VERY
SIMILAR TO THE INTENTION OF YOUR
, PRIOR MEASURE. AND WITH THAT,
WOULD YOU LIKE TO CLOSE SIMPLY
URGE AND I VOTE. THANK YOU.
THANK YOU. THE MOTION IS Dð PASS
TO APPROPRIATIONS. PLEASE CALL
THE ROLL. BONTA. BONTA. AYE.
WALDEN WALDEN. AYE.
AGUIAR-CURRY. AGUIAR-CURRY. AYE.
ARAMBULA ARAMBULA. AYE. JACKSON.
JACKSON. AYE. FLORA HANEY.
HANEY. AYE. JONES-SAWYER
MAIENSCHEIN. MCCARTY JO.
PATTERSON. RODRIGUEZ SANCHEZ.
SANCHEZ. AYE. SANTIAGO SABO.
CHAU. VÚI. WEBER. WEBER. AYE
NINE ZERO THAT MEASURES OUT 9 TO
0. THANK YOU. I'LL SEND YOUR
COLLEAGUES BACK FROM SENATE
JUDICIARY. I WOULD VERY MUCH
APPRECIATE THAT. THANK YOU.
WE'LL MOVE ON TO ITEM NUMBER
NINE, SB 1180. ASHBY.
HELLO THANK YOU FOR HAVING ME.
AM I YOUR LAST BILL TODAY? NO.
NOT QUITE. NO. CLOSE. ALMOST.
SORRY ALL RIGHT, ALL RIGHT, SO
WE'RE HERE TO. FIRST OF ALL,
THANK YOU SO MUCH FOR LETTING US
COME IN AND TALK TO YOU FOR A
LITTLE BIT. AND THANK YOU TO
YOUR STAFF. THIS IS WE ARE
ACCEPTING AMENDMENTS. BUT IN
GRATITUDE TO YOU, THAT HAS ALSO
REMOVED THE OPPOSITION FROM THE
BILL. SO THANK YOU. WE ARE HERE
TO PRESENT SB 1180, WHICH IS AN
EMERGENCY MEDICAL SERVICE
REIMBURSEMENT ACT. THIS BILL
REQUIRES MEDI-CAL TO REIMBURSE
AND HEALTH PLANS TO ESTABLISH A
PROCESS, AND THEN BEGIN TO
REIMBURSE ESSENTIAL SERVICES
SUCH AS COMMUNITY PARAMEDICINE
TRIAGE TO ALTERNATE DESTINATIONS
AND MOBILE INTEGRATED HEALTH FOR
EMS PROVIDERS. YOU ALL PROBABLY
KNOW THIS, BUT IN YOUR
DISTRICTS, THEY'RE ALREADY DOING
THIS, BUT THEY'RE NOT ABLE TO BE
REIMBURSED. SO LOCAL GOVERNMENTS
ARE EATING THE COST SPECIFICALLY
, THIS BILL WILL ENSURE THAT EMS
PROVIDERS CONNECT PATIENTS WITH
APPROPRIATE CARE LIKE SOBERING
CENTERS AND MENTAL HEALTH
FACILITIES THAT ARE DEEMED
MEDICALLY APPROPRIATE, HELPING
US WITH THE OVERCROWDING IN
EMERGENCY ROOMS, SUBSTANCE ABUSE
CENTERS, MENTAL HEALTH
FACILITIES OFFER SPECIALIZED
ALTERNATIVES TO EMERGENCY ROOMS,
WHILE PROVIDING THE EXTENSIVE
RESOURCES NEEDED TO ADDRESS THE
ACUTE NEEDS AND PROVIDE COST
EFFECTIVE ALTERNATIVES TO
EMERGENCY ROOMS. LOCAL PROGRAMS
HAVE ALREADY SHOWN A REDUCTION
OF UNNECESSARY HOSPITAL
ADMISSIONS, FOLLOW UP
TRANSPORTS, AND EMERGENCY ROOM
OVERCROWDING. WITH THESE
PROJECTS, BUT WE NEED TO LET
THEM BILL FOR IT SO THAT THEY'LL
DO IT MORE OFTEN AND SO THAT
PEOPLE ARE APPROPRIATELY TAKEN
TO THE CORRECT MEDICAL SERVICES.
THE FIRST TIME THE
SUSTAINABILITY OF THESE PROGRAMS
IS IN JEOPARDY. BECAUSE OF THAT
LACK OF HEALTH INSURANCE
REIMBURSEMENT, WHICH IS WHAT
THIS BILL ADDRESSES. SB 1180
ENSURES THAT EMS PROVIDERS CAN
RECOUP, CAN RECOUP COSTS FOR
SERVICES PROVIDED OUTSIDE OF
EMERGENCY ROOM SERVICES, AND
OFFERS A COMPREHENSIVE APPROACH
TO DELIVERING HEALTH CARE. WITH
ME IS MY LEAD WITNESS, MEGAN
SOBERS, ON BEHALF OF THE
CALIFORNIA PROFESSIONAL
FIREFIGHTERS. THANK YOU. YOU'LL
HAVE TWO MINUTES. THANK YOU,
MADAM CHAIR. MEMBERS MEGAN
SOBERS, ON BEHALF OF THE
CALIFORNIA PROFESSIONAL
FIREFIGHTERS AND PROUD TO
SPONSOR THIS BILL AND THANK THE
AUTHOR FOR BRINGING IT FORWARD,
AS YOU'VE HEARD OUR MEMBERS TALK
TO YOU A LOT, FREQUENTLY ABOUT
HOW CARE TO THEIR COMMUNITIES
HAVE CHANGED AND NEW INNOVATIVE
MODELS MODELS USING EMS AND
PARAMEDICS IN THE IN THE
COMMUNITIES HAVE BEEN
IMPLEMENTED ACROSS THE STATE AND
DIFFERENT FORMS, SOME OF THAT IS
COMMUNITY PARAMEDICINE SOME OF
THAT IS TRIAGE TO ALTERNATE
DESTINATION, WHICH IS A
PARAMEDIC IN THE FIELD ASSESSING
A PATIENT AND DETERMINING
THERE'S NO UNDERLYING MEDICAL
CONDITION, AND KNOWING THAT THAT
PATIENT WOULD BE BETTER SERVED
AT PERHAPS A MENTAL HEALTH
CRISIS FACILITY OR A SOBERING
CENTER, MOBILE INTEGRATED HEALTH
IS SOMETHING WE'VE TALKED ABOUT
HERE TODAY AS WELL, BUT WHAT
FOLKS SOMETIMES DON'T KNOW IS
THAT THE ONLY WAY FOR EMS TO GET
REIMBURSED FOR THE SERVICES,
EVEN IF IT'S GENERATED BY A911
CALL, IS FOR THOSE PATIENTS TO
BE TRANSPORTED TO THE EMERGENCY
ROOM, SO WE THINK THAT MR.
GIBSON'S BILL FROM SEVERAL YEARS
AGO, AND MORE LOCAL
JURISDICTIONS TAKING UP THESE
OPTIONAL PROGRAMS WILL ALLOW FOR
BETTER TREATMENT IN THE FIELD,
BUT ALSO MAKE THESE PROGRAMS
SUSTAINABLE. WE'VE SEEN LA
COUNTY AND SACRAMENTO COUNTY,
SOME OF THE BIGGER COUNTIES IN
OUR STATE, BE ABLE TO IMPLEMENT
THESE FIRE DEPARTMENTS HAVE
THEIR PUBLIC AGENCIES, THEY HAVE
LIMITED BUDGETS, SO THEY OFTEN
DO IT AT A LOSS. BUT SOME OF OUR
SMALLER COUNTIES AND SMALLER
JURISDICTIONS ARE NOT ABLE TO DO
THAT. WE THINK THIS IS THE RIGHT
THING FOR PATIENTS AND THE RIGHT
THING FOR THE COMMUNITIES, AND
WOULD APPRECIATE YOUR SUPPORT AT
THE APPROPRIATE TIME. THANK YOU.
THANK YOU. MOVED BY
AGUIAR-CURRY. SECONDED BY WEBER,
OTHERS IN THE HEARING ROOM IN
SUPPORT. CHAIR MEMBERS DEAN
GRAFILO WITH CAPITAL ADVOCACY
HERE ON BEHALF OF THE CALIFORNIA
LIFE SCIENCES IN SUPPORT OF THE
BILL. THANK YOU. THANK YOU. HI.
DARBY KERNAN, ON BEHALF OF THE
EMS ADMINISTRATORS ASSOCIATION
OF CALIFORNIA, IN SUPPORT OF THE
BILL. THANK YOU. MADAM CHAIR,
MEMBERS TIM MADDEN, REPRESENTING
THE CALIFORNIA CHAPTER OF THE
AMERICAN COLLEGE OF EMERGENCY
PHYSICIANS IN SUPPORT. YOU,
MADAM CHAIR. DYLAN ELLIOTT, ON
BEHALF OF THE CALIFORNIA STATE
ASSOCIATION OF PSYCHIATRISTS,
THE CITY AND COUNTY OF SAN
FRANCISCO AND THE CITY OF
BEVERLY HILLS, ALL IN SUPPORT.
THANK YOU, THANK YOU. ARE THERE
ANY WITNESSES IN OPPOSITION?
HELLO, ROBERT BOYKIN WITH THE
CALIFORNIA ASSOCIATION OF HEALTH
PLANS. FIRST, I WANT TO THANK
THE CHAIR, THE COMMITTEE STAFF,
THE AUTHOR AND THE SPONSORS OF
THE BILL. ACCORDING TO, LIKE,
THE SORRY, THE CONVERSATION
WE'VE BEEN HAVING ABOUT THE
AMENDMENTS, SHOULD TAKE CARE OF
MOST OF OUR CONCERNS WITH THE
BILL. LOOKING FORWARD TO SEEING
THOSE AMENDMENTS IN PRINT. AND
WILL BE SUBMITTING A NEW LETTER
ACCORDINGLY. THANK YOU, MADAM
CHAIR. MEMBERS. DEBBIE WATKINS,
ON BEHALF OF THE ASSOCIATION OF
CALIFORNIA LIFE AND HEALTH
INSURANCE COMPANIES, I ECHO MY
COLLEAGUES COMMENTS. WE REALLY
APPRECIATE THE OPEN DIALOG WE'VE
HAD WITH BOTH THE AUTHOR, THE
SPONSOR, AND COMMITTEE STAFF. WE
LOOK FORWARD TO SEEING THE BILL
IN PRINT AND REEVALUATING OUR
POSITION. THANK YOU. ANY OTHERS
IN THE HEARING ROOM IN
OPPOSITION? SEEING NONE, I'LL
BRING IT BACK TO THE COMMITTEE
FOR A COMMENT OR QUESTION. THANK
THE AUTHOR FOR BRINGING THIS
FORWARD, I HAVE TWO, PARENT
COMMUNITY PARAMEDICINE PROGRAMS
IN MY DISTRICT, AND, AND I THINK
THIS BILL STRIKES THE BALANCE OF
ENSURING THAT WE ARE MAKING
INNOVATION POSSIBLE, WITHIN OUR
LOCAL COMMUNITIES. AND, BEING
MUCH MORE HOLISTIC IN THE WAY
THAT WE'RE ABLE TO ADDRESS IN
THE FIELD ISSUES. IF POSSIBLE. I
WOULD LOVE TO BE ADDED AS A
COAUTHOR TO THIS AT THE
APPROPRIATE MOMENT. WOULD BE
HONORED TO HAVE YOU. THANK YOU,
AND WITH THAT, WOULD YOU LIKE TO
CLOSE? I APPRECIATE YOUR TIME
AND YOUR HARD WORK. THIS IS
REALLY JUST MAKING SURE THAT THE
WORK YOU'VE ALREADY DONE IS
REIMBURSABLE IN YOUR COMMUNITY.
SO URGENT, I VOTE. THANK YOU,
THANK YOU. WITH THAT, THE MOTION
IS DO PASS, AS AMENDED TO
APPROPRIATIONS. PLEASE CALL THE
ROLL. BONTA I TO I WALDRON
WALDEN I AGUIAR-CURRY
AGUIAR-CURRY I ARAMBULA BRAMBLE
I JACKSON. JACKSON I FLORA HANEY
HANEY I JONES-SAWYER MAIENSCHEIN
MCCARTY. JO. PATTERSON.
RODRIGUEZ. SANT ORTEZ. SANCHEZ I
SANTIAGO. SZABO CHAU. VÚI.
WEBER. WEBER I. THAT MEASURES
OUT TO NINE ZERO. THANK YOU SO
MUCH. THANK YOU. COLLEAGUES
COMMITTEE MEMBERS, WE HAVE ONE
MORE BILL TO HEAR. ITEM EIGHT SB
1147 BY PORTANTINO. WHILE WE ARE
WAITING FOR HIM TO COME TO THE
HEARING ROOM, WE CAN MOVE ON
FORWARD WITH ADD ONS. WE'LL
START AT THE TOP. GOOD ITEM ONE
SB 26 UMBERG FOR ADD ONS. OH OH,
WE'RE WE'RE LIFTING THE CALL ON
SB 26 UMBERG ARAMBULA. ARAMBULA.
AYE. JACKSON. JACKSON. AYE.
FLORA JONES. SAWYER.
MAIENSCHEIN. JO. PATTERSON
RODRIGUEZ. SANTIAGO TEN ZERO.
ZERO. JACKSON. THAT MEASURES OUT
TEN ZERO.
ITEM TWO FOR ADD ONS SB 402.
WAHAB LARA MAIENSCHEIN. JO.
PATTERSON. RODRIGUEZ. SANTIAGO.
ITEM NUMBER THREE SB 909 FOR ADD
ONS. LARA JONES. SAWYER
MAIENSCHEIN MCCARTY. MCCARTY.
IJO. PATTERSON. RODRIGUEZ.
SANTIAGO THAT MEASURE IS NOW TEN
ZERO AND IS OUT. ITEM 4.5. ITEM
FOUR. LIFTING THE CALL ON ITEM
FOUR SB 957 WIENER ARAMBULA
ARAMBULA I JACKSON. JACKSON I
FLORA HANEY, HANEY I MAIENSCHEIN
MCCARTY. MCCARTY I JOE
PATTERSON. RODRIGUEZ SANTIAGO.
LEVIN THAT MEASURES OUT 11 TWO
ZERO. WE'LL MOVE ON NOW TO ADD
ONS FOR THE CONSENT CALENDAR.
Ó. LIFTING THE CALL ON THE
CONSENT CALENDAR. ARAMBULA.
ARAMBULA. AYE JACKSON. JACKSON.
AYE. FLORA HANEY. HANEY. AYE.
JONES. SAWYER. MAIENSCHEIN.
MCCARTY MCCARTY. AYE. JO.
PATTERSON RODRIGUEZ. SANTIAGO.
THE CONSENT CALENDAR IS OUT WITH
THE VOTE OF 10 TO 0. TO PASS THE
ADD ON FOR ITEM NUMBER SIX, SB
980 ADD ONS TO WAHAB BILL.
JACKSON. JACKSON. AYE. FLORA
HANEY. HANEY. AYE. MAIENSCHEIN.
CHO. PATTERSON RODRIGUEZ.
SANTIAGO THAT MEASURES NOW AT 11
TO 0. AYE ITEM SEVEN SB 1120
LIFTING THE CALL FOR THE BECKER
BILL. ARAMBULA ARAMBULA. AYE.
JACKSON. JACKSON AYE. FLORA.
HANEY. HANEY I JONES-SAWYER
MAIENSCHEIN. MCCARTY. MCCARTY.
AYE. JO PATTERSON. RODRIGUEZ.
SANTIAGO QUINTERO. THAT MEASURE
IS OUT NOW WITH A VOTE OF 10 TO
0. AND NOW WE WILL PAUSE TO GO
BACK TO SENATOR PORTANTINO'S
MEASURE, SB 1147, ITEM NUMBER
EIGHT.
THANK YOU, SENATOR. THANK YOU,
MADAM CHAIR AND MEMBERS, HAPPY
TO PRESENT MY BILL TODAY, I'LL
KEEP IT BRIEF. MICRO PLASTICS
ARE EVERYWHERE. WE SHOULD KNOW
WHAT THEY DO, WHAT THEY DON'T DO
, AND THE APPROPRIATE STATE
AGENCIES SHOULD HAVE A STRATEGY
TO DEAL WITH THEM. THAT'S WHAT
THIS BILL DOES. AND WITH ME
TODAY, I HAVE GRACE KISTNER,
WHO'S A BOARD CERTIFIED CRITICAL
CARE NURSE WHO WILL TALK FURTHER
. THANK YOU. YOU'LL HAVE TWO
MINUTES. HELLO. THANK YOU. AS HE
SAID, MY NAME IS GRACE KISTNER.
I'M A BOARD CERTIFIED CRITICAL
CARE NURSE WITH ALMOST 20 YEARS
OF EXPERIENCE WORKING IN HEALTH
CARE AND PROMOTION. I'M
CURRENTLY A FELLOW STUDYING
ENVIRONMENTAL HEALTH AND
RESEARCH, WORKING ON ITS
TRANSLATION FOR HEALTH. I ALSO
SERVE THE LEADERSHIP COUNCIL FOR
THE CALIFORNIA NURSES FOR
ENVIRONMENTAL HEALTH AND
JUSTICE, WHO SUPPORT THIS BILL.
AS A NURSE, I'M RESPONSIBLE FOR
PROVIDING THE HEALTHIEST, MOST
UP TO DATE EVIDENCE BASED CARE
TO MY PATIENTS. AND WHEN I
WORKED IN A CARDIOTHORACIC ICU
RECOVERING OPEN HEART SURGERIES,
THE ATTENDING PHYSICIANS HAD A
STANDING ORDER FOR THEIR
PATIENTS TO RECEIVE BOTTLED
WATER DURING THEIR HOSPITAL STAY
INSTEAD OF WATER FROM THE
DISPENSER OR NUTRITION STATION.
NOW DATA IS AVAILABLE FOR THE
DELETERIOUS HEALTH EFFECTS OF
MICROPLASTICS IN DRINKING WATER
AND WHAT LEACHES FROM THESE
PLASTIC CONTAINERS. RECENT
RESEARCH FOUND A BUILDUP OF
MICROPLASTICS AND ENDOTHELIAL
PLAQUE, THIS SAME PLAQUE THAT
CAUSED THESE PATIENTS TO NEED A
BYPASS SURGERY. THE NEW ENGLAND
JOURNAL OF MEDICINE ARTICLE
LINKED TO A FOREIGN 4.5 FOLD
INCREASE RISK ON ALL CAUSE
DEATH, HEART ATTACK AND STROKE
IN A WORLD WHERE MICROPLASTICS
EXIST FROM THE SUMMIT OF
MOUNTAINS TO THE DEEPEST OCEANS,
ANOTHER STUDY NOW FINDS THAT IN
RIVER WATER, PLASTICS HOST
BACTERIA AND VIRUSES AND
CONTRIBUTE TO ANTIMICROBIAL
RESISTANCE. THE EQUIVALENT OF
OVER 65 GARBAGE TRUCKS OF
PLASTIC WASTE IS DUMPED INTO OUR
OCEANS ON A DAILY BASIS, AND
IT'S ALREADY KNOWN THAT OVER
10,000 CHEMICALS ARE IN
PLASTICS. AND NOW FINER
PARTICLES HAVE ACCUMULATED IN
OUR ORGANS AND TISSUES,
CORRELATING WITH ADVERSE HEALTH
OUTCOMES, WHOSE DETRIMENTAL
EFFECTS HAVE BEEN STUDIED FOR
DECADES. THE CDC DATA INDICATE
THERE ARE LIKELY PRESENT IN THE
BODIES OF ALL AMERICANS, AND 40%
OF PLASTICS COME FROM DISPOSABLE
, SINGLE USE ITEMS LIKE PLASTIC
WATER BOTTLES. THIS BILL WOULD
SUPPORT THE MORE STUDIES ON OUR
EXPOSURE AS INFLUENCED BY
ENVIRONMENTAL, SOCIAL AND
ECONOMIC FACTORS DOWN TO THE
MOLECULAR LEVEL HAVING AFFECTING
ALL OF US, BUT EVEN MORE SO, THE
CUMULATIVE AND DISPROPORTIONATE
EFFECTS ON THESE SUSCEPTIBLE
COMMUNITIES. AT FIRST, WE NEED
DATA AND THEN WE NEED TO BE ABLE
TO APPLY IT. IF WE CAN'T STUDY
THE HARMS, WE CANNOT STOP THEM.
EVEN OUR MOST PRECIOUS AND BASIC
NECESSITY FOR LIFE, WHICH IS
WATER. IT IS BEYOND TIME THAT WE
NOT ONLY CONTINUE TO STUDY THIS
MASSIVE ISSUE, BUT APPLY IT TO
THE LAW, WHICH SERVES TO EDUCATE
AND PROTECT THE PUBLIC, JUST AS
I DO OF MY PATIENTS. THANK YOU,
THANK YOU. YOU'LL HAVE TWO
MINUTES. SHE'S JUST HERE FOR.
I'M JUST A PORTANTINO STAFFER
HERE TO ANSWER ANY QUESTIONS IF
I'M ABLE. THANK YOU. WITH THAT.
ARE THERE ANY OTHERS IN SUPPORT
OF THE BILL? CRYSTAL RAIN IS
WITH CALIFORNIANS AGAINST WASTE
IN SUPPORT OF THIS MEASURE. LEAH
JONES, ON BEHALF OF VOICE FOR
CHOICE ADVOCACY IN SUPPORT OF
THIS MEASURE. THANKS HI, JUSTIN
BOWERS WITH CLEAN EARTH FOR KIDS
. ORG STRONGLY SUPPORTS. IN
ADDITION, H CENTER FOR
ENVIRONMENTAL HEALTH, NORTH
COUNTY EQUITY AND JUSTICE, ECO
SUSTAINABILITY PEEPS AND NCCA
AND ACTIVIST SAN DIEGO ALSO
STRONGLY SUPPORTS. THANK YOU.
ARE THERE ANY IN OPPOSITION TO
THIS BILL IN THE HEARING ROOM?
SEEING NONE, WE WILL BRING IT
BACK TO THE COMMITTEE FOR
QUESTIONS OR COMMENTS. I JUST
WANT TO THANK THE AUTHOR FOR
BRINGING FORWARD THIS BILL.
SENATOR PORTANTINO, I KNOW THAT
YOU ARE HAVE BEEN FOCUSED ON
THIS FOR QUITE A LONG TIME AND
VERY THANKFUL THAT WE ARE
CONTINUING TO ADVANCE THE
PROTECTION OF OUR DRINKING WATER
AND THE WATER BOTTLES WITH WHICH
WE USE, WITH THAT, WOULD YOU
LIKE TO CLOSE, JUST AS IT'S BEEN
SAID, WE SHOULD KNOW WHAT WE'RE
DRINKING, WHETHER IT'S FROM A
TAP OR WHETHER IT'S FROM A
BOTTLE. AND WE SHOULD HAVE
APPROPRIATE, METHODS TO DEAL
WITH IT, AND I RESPECTFULLY ASK
FOR AN AYE VOTE AND THANK THE
CHAIR FOR YOUR INTEREST IN THE
ISSUE AND THE SUPPORT FROM THE
COMMITTEE. THANK YOU.
FUNDAMENTALLY AGREE. THE MOTION
IS TO PASS, AS AMENDED, TO
APPROPRIATIONS. DO WE HAVE A
MOTION? Þ DO PASS. YEAH. WE'LL
TAKE THE AMENDMENTS IN
APPROPRIATIONS. WHERE ARE WE?
LOVE IT. SORRY NO. OH, IT'S A Dð
PASS TO ENVIRONMENTAL SAFETY AND
TOXIC MATERIALS. BONTA MOVED BY
ARAMBULA, SECONDED BY
AGUIAR-CURRY. PLEASE CALL THE
ROLL. BONTA. AYE. BONTA. AYE.
WALDRON AGUIAR-CURRY.
AGUIAR-CURRY. AYE. ARAMBULA.
ARAMBULA. AYE JACKSON. JACKSON.
AYE. FLORA. FLORA NOT VOTING.
HANEY. HANEY. AYE. JONES-SAWYER
JOHN. SAWYER. AYE. MAIENSCHEIN.
MCCARTY JO. PATTERSON RODRIGUES.
RODRIGUEZ. AYE. SANCHEZ SANTIAGO
. SHABU SHABU. AYE. WEBER.
NEEDS ONE THAT MEASURES ON CALL.
SENATOR. THANK YOU. BROUGH.
WE'RE GOING TO MOVE TO THE
FIRST. THE ITEMS THAT ARE STILL
ON CALL. JUST TO MAKE SURE THAT
EVERYONE'S VOTED. FIRST IS ITEM
NUMBER 11, SB 1266. LIFTING THE
CALL. ARAMBULA I, JACKSON.
JACKSON. AYE. FLORA. FLORA. AYE
HANEY. HANEY. AYE. JONES.
SAWYER. JOHN. SAWYER. AYE.
MAIENSCHEIN MCCARTY. JO.
PATTERSON. JO. PATTERSON. AYE.
RODRIGUEZ RODRIGUEZ. AYE. 13
ZERO. ITEM 11 IS NOW AT 13 TO 0.
THAT MEASURE IS OUT. LIFTING THE
CALL ON ITEM 12. SB 1300.
ARAMBULA ARAMBULA. AYE. JACKSON
JACKSON. AYE. FLORA LARA. NØ.
HANEY. HANEY AYE. JONES. SAWYER.
JOHN. SAWYER. AYE. MAIENSCHEIN.
JO. PATTERSON WAS PULLED. JOE.
PATTERSON. JO. PATTERSON. NÓ
RODRIGUEZ. RODRIGUEZ. AYE.
SANTIAGO. 9 TO 3. SO THAT THAT
MEASURES OUT. 9 TO 3. MOVING ON
TO ITEM 17. SB 1447. LIFTING THE
CALL, PLEASE CALL THE ROLL.
ARAMBULA ARAMBULA. AYE. JACKSON.
JACKSON AYE. FLORA. LARA. AYE.
HANEY. HANEY AYE. CHEN. SAWYER.
CHEN. SAWYER. AYE. MAIENSCHEIN
JO. PATTERSON. JO. PATTERSON.
AYE. RODRIGUEZ RODRIGUEZ. NOT
VOTING. SANTIAGO. 13 ZERO.
STAYING WITH THE DURAZZO. BILL,
WE WILL DO ADD ONS OR CHANGES
NOW. ARAMBULA NOT VOTING. FROM
AYE AYE TO NOT VOTING. YES. SO
IT'S 12 TO 0. THAT MEASURE IS
OUT. 12 TO 0. SPERM FINALLY.
WE'RE LIFTING THE CALL ON ITEM
EIGHT. SB 1147. PORTANTINO
WALDRON. MAIENSCHEIN MCCARTY.
MCCARTY. AYE. JO. PATTERSON. JO.
PATTERSON NOT VOTING. SANCHEZ
SANTIAGO. WEBBER YES. 9 TO 1.
THAT MEASURE IS OUT. 9 TO 1. WE
WILL MOVE ON NOW TO JUST ADD ONS
AS WE'VE DISPENSED WITH OUR
CALENDAR HEARING CALENDAR TODAY.
AND WE WILL START FROM THE
BEGINNING AS ITEM ONE SB 26
UMBERG. PLEASE CALL THE ROLL.
LARA LARA. AYE. JOHN SAWYER,
JOHN SAWYER. AYE. MAIENSCHEIN.
JO. PATTERSON. JO PATTERSON.
AYE. RODRIGUEZ. RODRIGUEZ. AYE.
SANTIAGO. 14 ZERO. THAT MEASURES
NOW AT 14 TO 0. ITEM TWO SB 402.
WAHAB LARA LARA. AYE.
MAIENSCHEIN JO. PATTERSON. JO.
PATTERSON. AYE. RODRIGUEZ
RODRIGUEZ. AYE. SANTIAGO 14
ZERO. THAT MEASURES NOW AT 14 TO
0. ITEM THREE SB 909 UMBERG LARA
LARA. AYE. JOHN SAWYER, JOHN
SAWYER. AYE MAIENSCHEIN. JO.
PATTERSON. JO. PATTERSON AYE.
RODRIGUEZ. RODRIGUEZ. AYE.
SANTIAGO 14 ZERO. THAT MEASURES
NOW AT 14 TO 0 FOR ADD ONS. ITEM
FOUR SB 957 WIENER LARA LARA.
NOT VOTING MAIENSCHEIN. JO.
PATTERSON. JO. PATTERSON. NO
RODRIGUEZ. RODRIGUEZ. AYE
SANTIAGO. SANTIAGO. AYE. 13 TO 1
THAT MEASURES NOW AT 13 TO 1.
WILL TAKE THE CONSENT FOR ADD
ONS. LARA LARA. AYE. JOHN SAWYER
. JOHN SAWYER. AYE. MAIENSCHEIN.
JO PATTERSON. JO. PATTERSON.
AYE. RODRIGUEZ. RODRIGUEZ. AYE.
SANTIAGO SANTIAGO. AYE. 15 ZERO.
CONSENT IS NOW AT 15 TO 0. ITEM
NUMBER SIX, SB 980. WAHAB FOR
ADD ONS. LARA LARA. AYE.
MAIENSCHEIN. JO PATTERSON. JO.
PATTERSON. AYE. RODRIGUEZ.
RODRIGUEZ AYE. SANTIAGO.
SANTIAGO. AYE. 15 ZERO. THAT
MEASURE IS NOW AT 15 TO 0. SB
SEVEN 1120. ITEM NUMBER SEVEN.
BECKER LARA LARA. AYE. JOHN.
SAWYER, JOHN. SAWYER. AYE.
MAIENSCHEIN. JO. PATTERSON. JO
PATTERSON. AYE. RODRIGUEZ.
RODRIGUEZ. AYE. SANTIAGO
SANTIAGO. AYE. 15 ZERO. MEASURES
NOW. 15 TO 0. ITEM NUMBER EIGHT,
SB 1147 PORTANTINO WALDRON,
MAIENSCHEIN. SANCHEZ. SANTIAGO.
SANTIAGO AYE. WEBBER TEN ZERO.
MEASURES NOW AT TEN ZERO. WE'RE
ON NUMBER NINE. NO, IT HAD
PASSED. IT WAS A WAS AT NINE. AT
TEN, ITEM NUMBER NINE, SB 1180.
ASHBY ADD ONS LARA. LARA. AYE.
JOHN SAWYER. JOHN SAWYER. AYE.
MAIENSCHEIN MCCARTY. MCCARTY.
AYE. JO. PATTERSON JO.
PATTERSON. AYE. RODRIGUEZ.
RODRIGUEZ. AYE SANTIAGO.
SANTIAGO. AYE. 15 ZERO. MEASURES
AT 15 TO 0. ITEM NUMBER 11, SB
1266. LIMÓN FOR ADD ONS.
MAIENSCHEIN MCCARTY. MCCARTY.
AYE. SANTIAGO SANTIAGO. AYE. 15
ZERO MEASURES NOW AT 15 TO 0.
ITEM NUMBER 12, SB 1300 CORTEZ
FOR ADD ONS. MAIENSCHEIN
SANTIAGO. SANTIAGO. AYE. 10 TO 3
MEASURES. NOW AT 10 TO 3. ITEM
NUMBER 17, SB 1447 DURAZZO FOR
ADD ONS MAIENSCHEIN SANTIAGO.
SANTIAGO. AYE 13 TO 0 MEASURES
NOW 13 TO 0. SANTIAGO MISSED A
FEW AT THE BEGINNING. IS HE
GONE? SANTIAGO. OH, WE'LL
CONTINUE WITH ADD ONS FOR
SANTIAGO. ITEM NUMBER ONE, SB 26
UMBERG. SANTIAGO. AYE, 15 ZERO
15 TO 0. NOW. ITEM TWO, SB 402.
SANTIAGO. SANTIAGO. AYE. ITEM
SB, SB ITEM 15 ZERO. ITEM THREE
SB 909 UMBERG. SANTIAGO.
SANTIAGO. AYE 15 ZERO NOW 15
ZERO. ITEM FOR SB 957 WIENER OH.
SANTIAGO. YOU ARE RELIEVED.
WE ARE HOLDING THE ROLL OPEN FOR
ANOTHER TEN MINUTES.
YES.
GOVERNMENT.
SEVEN. PORTANTINO ITEM FOR ITEM
EIGHT. SB 1147 PORTANTINO ADD
ONS. WALDRON. MAIENSCHEIN
SANCHEZ. WEBER. WEBER AYE. 11 TO
1. THAT MEASURE IS NOW 11 TO 1.
OH YES AND NO.
AND I EVEN. YES. YES. YES. AND I
MADE IT SO. BUT I WAS LITERALLY
LIKE. A NICE LITTLE. NO, THEY
LET ME RUN. THEY'RE ALL WALKING.
OH, YEAH. SHE'S GREAT. WALKING
I'M THE OLDEST ONE. AND I'M OUT
THE DOOR. ALL RIGHT, HERE WE GO.
READY? YEAH THANK YOU. BY THE
WAY. WE WILL, MOVE FOR ADD ONS,
BEGINNING WITH ITEM ONE, SB 26,
UMBERG MAIENSCHEIN MAIENSCHEIN I
16 ZERO 16 ZERO. NOW ON THAT
MEASURE. ITEM TWO SB 402. WAHAB
MAIENSCHEIN MAIN SHRINE I 16
ZERO MEASURES NOW 16 ZERO. ITEM
THREE SB 909 UMBERG MAIN SHRINE.
MAIN SHRINE I 16 ZERO MEASURES
NOW 16 ZERO. ITEM FOUR SB 957
WIENER MAIN SHRINE. MAIN SHRINE
I. IT'S 14 TO 1, 14 TO 1. NOW
FOR THE CONSENT CALENDAR, ADD ON
MAIN SHRINE. MAIN SHRINE I 16
ZERO. CONSENT IS NOW. IT'S 16 TO
0. ITEM NUMBER SIX SB 980 MAIN
SHRINE. ITEM SIX SB 980 MAIN
SHRINE I 16 ZERO MEASURES NOW AT
16 TO 0. ITEM NUMBER SEVEN SB
1120 BECKER MAIN SHRINE. MAIN
SHRINE I 16 ZERO MEASURES, NOT
16 TO 0. ITEM NUMBER EIGHT SB
1147 PORTANTINO MAIN SHRINE.
MAIN SHRINE I 12 TO 1 MEASURE IS
NOW 12 TO 1. ITEM NUMBER NINE SB
1180 ASHBY MAIN SHRINE. MAIN
SHRINE I 16 ZERO MEASURES NOW AT
16 TO 0. ITEM NUMBER TEN SB 1238
EGGMAN OH. IT WAS PULLED. SORRY.
ITEM NUMBER 11 SB 1266 LIMÓN
MAIN SHRINE. MAIN SHRINE I 16
ZERO MEASURES NOW AT 16 TO 0.
ITEM NUMBER 12 SB 1300 ORTEZ
MAIN SHRINE. MAIN SHRINE I 11 TO
3 MEASURES NOW AT 11 TO 3 ITEMS
13 THROUGH 16 ARE ON CONSENT.
ITEM NUMBER 17 SB 1447 DURAZZO
MAIN SHRINE. MAIN SHRINE I A
MAIN SHRINE. NOT VOTING. STILL
AT 13 TO 0, THAT MEASURE IS
STILL AT 13 TO 0. OUR HEARING IS
ADJOURNED.