ITEMS ON THE AGENDA ITEM NUMBER
THREE SP NINE NINE SEVEN MINING.
HE'S A CONSENT ITEM.
TODAY'S HEARING WILL BE
FOLLOWED BY A JOINT
INFORMATIONAL HEARING WITH THE
SENATE HEALTH AND THE SENATE
EDUCATION. REGARDING HEALTH
INSURANCE COVERAGE AND ACCESS TO
CARE FOR COLLEGE STUDENTS WITH
THAT.
I BELIEVE WE MIGHT AS WELL GO IN
AND STAB US A QUORUM OF LOOKS
LIKE WE HAVE FIVE WHICH COLOR
MEMBERS PLEASE FERNANDEZ HERE AN
END IS HERE WHEN.
LAVER MITCHELL MINING NEWMAN.
NEWMAN HERE NELSON NELSON HERE
HAND. HAND HERE ROSS.
OFF HERE.
FROM HIS BEEN ESTABLISHED I SEE
SENATOR BELL IS IN THE AUDIENCE
WHEN THE GOING GETS START WITH
ITEM NUMBER ONE. SP NINE ZERO
SIX.
CAL MENTAL HEALTH SERVICES HERE
PARENT TRANSITION.
AGE AND FAMILY SUPPORT
SPECIALIST CHILL CERTIFICATION.
MISTER CHAIRMAN IT'S A PLEASURE
OF OUR PRESENT SP.
NINE OH SIX AND THEN. THE
SECOND BILL I HAVE TWO PERCENT
AS OF TEN NINETEEN.
THAT'S YOUR PREFERENCE BACK.
MEMBERS.
MISTER CHAIRMAN.
GOOD AFTERNOON AND TODAY I
PRESENT.
SP NINE OH SIX THERE'S A BILL
WHICH ESTABLISHES CERTIFICATION
PROGRAM FOR PEER SUPPORT
SPECIALIST. NOW IT'S A REALLY
IMPORTANT NO THERE WERE KIND OF
BEHIND THE EIGHT BALL IN TERMS
OF OTHER STATES SINCE FORTY SIX
STATES. HAVE ALREADY DONE THIS.
AND THE THE FEDERAL GOVERNMENT
HAS ALREADY SENT A LETTER.
THAT STATES THAT.
THIS IS ELIGIBLE FOR FEDERAL
FEDERAL REIMBURSEMENT FUNDS.
SO I'M JUST POINTING OUT TO YOU
THAT RIGHT GETTING. SO THAT WE
AS WE UNDERSTAND. THAT JOB THIS
IS BEEN A LONG TIME COMING.
OF THE FEDERAL GOVERNMENT.
ISSUES SUPPORT SYSTEM AS A BEST
PRACTICE IN TERMS OF HELPING
BOTH. MENTAL HEALTH. AND
SUBSTANCE ABUSE.
IT'S IT'S A IT CAN BE REALLY
BENEFICIAL IN TERMS OF.
HELPING.
PEOPLE WITH SUBSTANCE ABUSE SO
IN TERMS OF THIS PROPOSAL IT
WILL COVER BALLS OKAY SO. I WANT
TO MAKE THAT REALLY CLEAR LAST
TIME THIS BILL WAS SUBMITTED.
THERE WAS A.
DISCUSSION ABOUT SPLITTING OUT
SUBSTANCE ABUSE.
AND.
MENTAL HEALTH AND NOT HAVING
SUBSTANCE ABUSE I DO NOT ACCEPT
THAT I THINK THAT THE MALE
HEALTH AND SUBSTANCE ABUSE ARE
SO INTERTWINED. THAT IT IS
NECESSARY THAT WE KEEP ON
TOGETHER OKAY THAT'S. SO.
APPEARS PROVIDER. IS A PERSON
WHO HAS THE LIVED EXPERIENCE
WITH A MENTAL ILLNESS OR
SUBSTANCE ABUSE DISORDERS. WHO
DRAWS ON THAT EXPERIENCE ALONG
WITHSKILLS LEARNED IN TRAINING?
TO PROVIDE CRITICAL SUPPORT TO
CLIENTS IN TREATMENT PROGRAMS.
OFTEN PEERS ARE NOT JUST SHARED
LIVING EXPERIENCE BUT
NEIGHBORHOOD LANGUAGE CULTURE ON
ONE ON WITH THE PEOPLE THAT THEY
SERVE SO. IT IS A WAY OF
REACHING DEEP INTO THE COMMUNITY
AND GETTING. PEOPLE SUPPORTING
ONE ANOTHER.
EVEN THOUGH THEY'VE HAD SOME
ADVERSE EXPERIENCE ALLOWING THEM
TO BE PEER SUPPORT.
FOR THE COMMUNITY.
OUR PEERS CAN INCLUDE PEOPLE WHO
HAVE LIVED EXPERIENCES CLIENTS
FAMILY MEMBERS.
CARETAKERS.
OF INDIVIDUALS LIVING WITH
MENTAL ILLNESS AND SUBSTANCE
ABUSE.
MOST OF YOU KNOW THAT I HAVE
DEVOTED MUCH MY CAREER TO
IMPROVING MENTAL HEALTH IN
CALIFORNIA.
SO I SPEAK WITH EXPERIENCE WHEN
I TELL YOU THAT THIS
LEGISLATION.
IS LONG LONG OVERDUE.
OUR STATE AND EXPLOSIVES FALLING
BEHIND THE REST OF THE NATION.
THE FEDERAL GOVERNMENT WILL
CONTINUE AND HOUSE FOR QUITE
AWHILE. URGE STATES TO ADOPT
CERTIFICATION PROGRAMS BECAUSE
IT STANDARDIZES BEST PRACTICES.
MEDICARE OR MEDICAID REIMBURSES
FIFTY PERCENT OF THE COST.
AS I SAID THERE'S A LETTER.
THAT HAS BEEN SINCE A GUIDANCE
LETTER.
MISTER CHAIRMAN YOU KNOW THE
GUIDANCE SERVICE SINCE TWO
THOUSAND SEVEN.
WE'RE NOW TEN YEARS AND WE
HAVEN'T DONE THIS IN CALIFORNIA
FORTY SIX OTHER STATES HAVE DONE
IT. WERE BEHIND.
LET'S GET GOING ON THIS THE
RESEARCH IS CLEAR. BECAUSE WE
ALREADY HAVE TEN TEN YEARS OF
EXPERIENCE RATHER STATES AND I
KNOW WHAT THE RESULTS OF THEM.
SUFFER FROM MENTAL ILLNESS AND
SUBSTANCE ABUSE HAVE BETTER
OUTCOMES. IF THEY CAN BOND WITH
THE TRAIN SUPPORTERS DURING
TREATMENT.
MY BILL WILL MAKE SURE APPEARS
GET THE TRAINING THAT THEY NEED.
TO DO THEIR BEST WORK. WILL
ENSURE THAT THEY GET PAID FOR
THAT WORK IT'LL HELP GROW OUR
MILL HEALTH. WORKFORCE IT RESULT
IN BETTER CARE.
WE HAVE.
.
TWO IN THIS IS A TERM OF THE
WHISPERS GERMAN. OPERA URGES
SUPPORT FOR THE BILL TURN WITH A
SINK YOU OF THE STATION NAME
YOUR POSITION THANK YOU. ADRIAN
SULTAN WITH THE STEINBERG
INSTITUTE OUR MISSION IS TO
ADVANCE SOUND PUBLIC POLICY AND
INSPIRE LEADERSHIP ON ISSUES OF
MENTAL HEALTH. CYBER INSTITUTE
IS THE PROUD SPONSOR OF SB NINE
ZERO SIX WHICH WILL ESTABLISH A
COMPREHENSIVE FRAMEWORK TO
CERTIFY AND TRAIN PEERS WITHIN
CALIFORNIA'S MEDICAL PROGRAM. AS
THE US SENATOR BILL STATED
APPEAR PROVIDER IS SOMEBODY USES
THEIR LIVED EXPERIENCE. EITHER
DIRECTLY AS A CLIENT OR AS A
FAMILY MEMBER OR AS A CARETAKER
APPARENT COUPLED WITH TRAINING
ON MENTAL HEALTH AND SUBSTANCE
USE TO PROVIDE CARE TO
COMMUNITIES IN NEED. CALIFORNIA
AMAZINGLY DOES NOT HAVE A
STANDARD DEFINITION OF A PEER
SUPPORT PROVIDER DESPITE THE
FACT. THAT PEERS ARE CURRENTLY
UTILIZED IN MANY SETTINGS AND
USE VERY WELL ACROSS THE STATE.
YOUR SUPPORT IS AN EVIDENCE
BASED MODEL OF CARE WITH A
SPECIFIC DEFINITION OF SERVICE
THAT'S OPERATED WITH AND A CODE
OF ETHICS. LIKE OTHER MENTAL
HEALTH PROVIDERS THAT SERVE THE
PUBLIC WE BELIEVE THAT THERE
SHOULD BE STATE OVERSIGHT OF THE
QUALITY OF THIS PROVIDER TYPE.
SB NINE OH SIX PROVIDES THE
FRAMEWORK TO DO THIS.
TO CERTIFY AND TRAIN PEERS AND
FAMILY MEMBERS IT WILL DEFINE
THE SCOPE OF SUPPORT. AND
ENABLES CALIFORNIA TO OBTAIN THE
FEDERAL FINANCIAL PARTICIPATION
THAT CAN BEDRAWN DOWN FOR THESE
SERVICES. IT'S REALLY A MORE
COMPREHENSIVE APPROACH TO TRAIN
AND CERTIFY THIS VALUABLE WORK
FORCE.
AS SENATOR BILL STATED OVER
FORTY STATES ACT CURRENTLY HAVE
CERTIFICATION AND THERE'S BEEN
RESEARCH DONE ABOUT THE VALUE OF
CERTIFICATION IN THOSE STATES.
THIS BILL WOULD ALSO IMPLEMENTS
FEDERAL REQUIREMENTS.
AS THE LETTERS FROM OUR CENTER
FOR MEDICAID AND MEDICARE AND.
MEDICAID AND MEDICARE SERVICES
HAS SENT TO ALL OF THE STATE
MEDICAID DIRECTORS I NOTICE.
THAT STATES SHOULD BE SETTING UP
COMPREHENSIVE. CERTIFICATION
PROGRAMS AS PART OF THEIR
SYSTEMS OF CARE.
IN ADDITION THIS BILL
INCORPORATES POLICY WORK THAT
HAS BEEN DONE BY STATEWIDE
ORGANIZATIONS REPRESENTING.
CLIENTS IN FAMILY MEMBERS AND
PARENT PARTNERS AND ADVOCACY
GROUPS AND REALLY THIS BILL IS
SETS UP THE FRAMEWORK TO DO WITH
THIS POLICY WORK. PUT FORWARD.
I'M SO OUR COALITION HAS BEEN
WORKING TOGETHER FOR SOME TIME
AND THEY'RE ALL HERE TODAY.
TO ALSO VOICED SUPPORT FR THE
BILL. SO IT'S REALLY TIME FOR
CALIFORNIA TO EMBRACE THIS
EVIDENCE BASED MODEL OF CARE
THIS BILL MAKES SENSE FROM OUR
PERSPECTIVE FISCALLY. FROM A
POLICY PERSPECTIVE AND REALLY
CAN BETTER IT CAN PROVIDE A MORE
COMPREHENSIVE LEVEL SERVICE FOR
CLIENTS WHO SO DESPERATELY NEED
THESE SERVICES APPEAR IS
SOMETIMES THE FIRST POINT OF
CONTACT. FOR EXAMPLE FOR A
HOMELESS POPULATION WHO
STRUGGLES WITH MENTAL ILLNESS
AND ADDICTION ISSUES.
WE ALSO WOULD SAY THAT THIS
LEGISLATION GOES A LONG WAY
TOWARD ELIMINATING THE STIGMA
ASSOCIATED WITH MENTAL ILLNESS.
SOME VERY PLEASED NOW TO TURN
THIS OVER TO MY COLLEAGUE JAIME
WORKS RIGHT WHO IS A PROVIDER
AND TRAINER. IN ALAMEDA COUNTY.
AND. I WOULD LIKE TO THANK THE
CHAIR VICE CHAIR AN HONORABLE
MEMBERS OF THE SENATE.
FOR ALLOWING ME TO SPEAK ON
BEHALF OF THE CONSUMERS IN PEER
SPECIALISTS PROGRAMS FOR THE
STATE HI MY NAME IS JAMIE WORKS
RIGHT I WORK FOR THE ALAMEDA
COUNTY NETWORK OF MENTAL HEALTH
CLIENTS. WHICH IS A CONSUMER RUN
AGENCY AND HAS BEEN AROUND SINCE
NINETEEN EIGHTY EIGHT. I AM THE
PROGRAM MANAGER FOR THE BEST NOW
SPECIALIST TRAINING IN ALAMEDA
COUNTY.
AND HAS TRAINED CONSUMER PAIR
PROVIDERS SINCE NINETEEN NINETY
EIGHT. AND HAS OVER THREE
HUNDRED AND FIFTY CONSUMERS.
HAVE GRADUATED FROM OUR POGRAM
AND THEY HAVE BEEN TAUGHT ON THE
TOPICS THAT ARE LISTED IN THE
BILL. I WOULD LIKE TO SHARE THAT
I HAVE PERSONAL EXPERIENCE WHAT
UTILIZING THE MENTAL HEALTH
SYSTEM AND I WAS GIVEN THE
OPPORTUNITY TO CONNECT WITH THE
PEER WHO EMPOWER. ME JUST BY
UNDERSTANDING MY CHALLENGES AND
THIS PIER WHICH THIS PERSON
WHICH WAS UP HERE.
HAS CHANGED MY LIFE AND HAS
SUPPORTED ME ON MY ROAD TO
RECOVERY.
A PASSING THIS BILL WOULD MEAN
SO MUCH FOR THE MENTAL HEALTH
COMMUNITY AND CONSUMERS FOR THE
ENTIRE STATE OF CALIFORNIA. FOR
THE PROGRAM I RUN WE OFFER
CONSUMERS TWO HUNDRED AND THIRTY
HOURS OF TRAINING. FOUR HUNDRED
AND EIGHTY HOURS OF INTERNSHIP
HOURS WHERE THEY LEARN PRACTICAL
PEER SUPPORT SKILLS AND THEY
COLLABORATE.
WITH THE COMMUNITY AND COMMUNITY
OF THE COUNTY AND THE COMMUNITY
BASED ORGANIZATIONS.
FOR THE STATE THERE OVER FIFTY
OTHER PROGRAMS SIMILAR TO WHAT
WE DO AND THEY.
ALL HAVE DIFFERENT APPROACHES
AND REQUIREMENTS ESTABLISHING A
CERTIFICATION WHAT HOLDS ALL
ACCOUNTABLE FOR PROVIDING A
STANDARDIZED CURRICULUM SO THERE
ARE CORE COMPETENCIES THAT ARE
RECOGNIZED AND UNDERSTOOD
STATEWIDE.
I HAVE PROVIDED HIS PEER
SPECIALISTS TRAINING FOR OVER
EIGHT YEARS AND I HAVE SEEN A
SHIFT IN OUR WORKFORCE PROVIDERS
ARE ADVOCATING AND CREATING
POSITIONS THAT REQUIRE.
THE CERTIFICATES FOR MENTAL
HEALTH CONSUMERS AND I HAVE
HEARD PERSONALLY WITNESS
CLINICAL AGENCIES ADVOCATE FOR
PEER POSITIONS BECAUSE THEY
BELIEVE IN INCLUSION. AND THE
COLLABORATION APPEAR SO SPECIAL
IS AS A PART OF THEIR TREATMENT
TEAM. THE RELATIONSHIP APPEAR
HAS WITH ANOTHER PIER IS A HEART
TO HEART CONNECTION. IN BEING
ABLE TO SAY I TRULY UNDERSTAND
RESONATES WITH SO MANY CONSUMERS
OR LOOKING FOR EXPLANATIONS AND
UNDERSTANDING TO THE CHALLENGES
THAT THEY FACE. MANY PEOPLE WHO
DECIDE TO WORK IN THIS
PROFESSION. ARE PEOPLE THAT COME
WITH THE TITLE L. E. WHICH
STANDS FOR LIVED EXPERIENCE IN
THIS WORK IS PERFECT IS
PERSONAL.
JUST LIKE MANY OTHER HELPING
PROFESSIONS THIS BILL WOULD
BRING VALIDITY AND
PROFESSIONALISM TO THE FIELD.
RECOGNIZING THE IMPORTANCE OF
SOMEONE EXPERIENCE A MENTAL
HEALTH CHALLENGES. AND THEN
ACCEPTING AND LEARNING ABOUT
THEIR ISSUES TO BECOMING THE
EMPOWER LEARNING TO WALK IN
THEIR PURPOSE. THEN DECIDING TO
GIVE BACK AND OFFER A WHOLE BY
MODELING RECOVERY TO THEIR PEERS
WE BELIEVE THAT THIS IS A.
BEAUTIFUL TRANSFORMATION AND
THAT IT SHOULD BE RECOGNIZED BY
THE STATE OF CALIFORNIA THANK
YOU.
WE WOULD ALSO SUPPORTED THE
MEASURE.
NICOLE WORTMAN.
NICOLE ORNAMENT ON BEHALF OF THE
NATIONAL ALLIANCE ON MENTAL
ILLNESS AND SUPPORT THANK YOU WE
CAN JUST PLEASE STATE YOUR NAME
AND POSITIONALLY THANK YOU.
THANK YOU MR CHAIRMAN MEMBERS
MARK WINDOWS ON BEHALF OF SEIU
IN STRONG SUPPORT.
MISTER CHAIRMAN COMMITTEE
MEMBERS HAULING MICHON BEHALF OF
THE CALIFORNIA ASSOCIATION OF
ALCOHOL DRUG PROGRAM EXECUTIVES
CAT PEE IN SUPPORT.
HEIDI STRONG WITH THE CALIFORNIA
ASSOCIATION OF SOCIAL
REHABILITATION AGENCIES IN
SUPPORT. AS WELL AS CHAIR OF THE
CALIFORNIA COALITION OF MENTAL
HEALTH IN SUPPORT THANK YOU.
GOOD AFTERNOON MAYOR THERE WITH
THE COUNTY BEHAVIORAL HEALTH
DIRECTORS IN SUPPORT.
GOOD AFTERNOON MY GOOD DOCTOR
OFF ON BEHALF OF THE ACLU OF
CALIFORNIA AND SUPPORT.
CLEARLY UNDER COURT CARVEY ON
BEHALF OF THE CALIFORNIA COUNCIL
OF COMMUNITY MENTAL HEALTH
AGENCIES AND SUPPORT.
IT'LL FORD CONSUMER AFFAIRS
LIAISON FOR SOMEONE A COUNTY
BEHAVIORAL HEALTH IN SUPPORT AND
I HAVE LETTERS FOR THE SENATORS
THAT I'D LIKE TO LEAVE.
THANK YOU.
HI JERRY HEARING AS OFFICE
SUPPORT FOR ONE'S RECOVERY ENDED
ITS LONG ACCOUNTING AND I'M
SUPPORT.
MARTY MOTO CALIFORNIA
DISPLEASING YOUR COMMUNITY
ACTION NETWORK ON A FAMILY
MEMBER.
MY FAMILY SOLVED IN EXPERIENCE
THE VALUE OF PEER SUPPORT EVEN
THOUGH BACK THEN IT WASN'T
COMPENSATED. WE THINK THAT GOOD
POLICY MAKING THEM GOOD POLICY
MAKING IS ALWAYS TIED TO GOOD
OUTCOMES AS BEING ON ALL SIX
ACTUALLY WOULD DO THAT THANK
YOU.
REBECCA GONZALES NATIONAL
ASSOCIATION OF SOCIAL WORKERS
CALIFORNIA CHAPTER IN SUPPORT.
JOSEPH ROBINSON WITH EACH MINE
MATTERS IN SUPPORT.
DAVE NELSON CALIFORNIA LINE TO
CHILD AND FAMILY SERVICES IN
SUPPORT.
AND A WISE MAN WITH THE
CALIFORNIA BEHAVIOR HEALTH
PLANNING COUNCIL IN SUPPORT.
HE CALMLY WITH THE LA COUNTY
BOARD OF SUPERVISORS IN SPORT.
LINDA WAY WITH WESTERN CENTER
ONLINE POVERTY IN SUPPORT.
KELLY BROKE SOME BEHALF OF THE
ASSOCIATION OF CALIFORNIA
HEALTHCARE DISTRICTS PLEASED TO
BE HERE IN SUPPORT.
YES CAN ALAN CHILDREN'S DEFENSE
FUND AND SUPPORT.
HER CHILD DISABILITY RIGHTS
CALIFORNIA WE STRONGLY SUPPORT.
OKAY DEPUTY DIRECTOR FOR THE
COMMITTAL HEALTH SERVICES
OVERSIGHT AND ACCOUNTABILITY
COMMISSION AND THE COMMISSION
STRONGLY SUPPORT SB NINE OH SIX.
SALLY'S BEEN EXECUTIVE DIRECTOR
OF THE CALIFORNIA ASSOCIATION OF
MENTAL HEALTH RUN ORGANIZATIONS
WOULD TOTALLY SUPPORT ESPIANDO
SIX BECAUSE IT WILL LEGITIMIZE.
FIGHTERS AS AS BETTER HAVE
PROFESSIONALS THANK YOU.
VIRGINIA HALL ALAMEDA COUNTY.
BEHAVIOR HEALTHCARE SERVICES I'M
WITH ALAMEDA COUNTY PULL
CONSUMER CHAMPIONS I SUPPORT THE
BILL. THANK YOU.
HI GORDON REID ALAMEDA COUNTY
POOL CONSUMERS CHAMPION.
I SUPPORT THE BILL.
IT IS READ ALAMEDA COUNTY POOL
OF CHAMPIONS PUBLIC CONSUMES
HAPPENED THAT SUPPORT THE BILL.
CHRISTOPHER BARTON SACRAMENTO
COUNTY CONCERNED CONSUMER FOR
TWENTY YEARS FULL SUPPORT.
PATRICIA WENT SO I AM CURRENTLY
WORKING AS A PEER ADVOCATES.
PART TIME IN THE PRIVATE SECTOR
AND I WOULD REALLY LIKE TO SEE
AN ADVOCACY FOR THIS PROGRAM
BECAUSE I THINK. THAT ANYONE WHO
WALKS INTO A ROOM.
AND WORKS WITH PEOPLE THE WAY I
DO.
DESERVES TRAINING AND THEY
DESERVE AND SHOULD BE EXPECTED
TO BE HELD TO A CODE OF ETHICS.
AND I THINK THOSE THINGS ARE
REALLY IMPORTANT FOR A PROGRAM
TO PICK SUCCESSFUL.
JASON ROBINSON PROGRAM DIRECTOR
FOR SHARE THE SELF HELP IN
RECOVERY EXCHANGE IN LOS ANGELES
COUNTY RUN ORGANIZATION IN
SUPPORT.
SUSAN GALLAGHER I'M THE
EXECUTIVE DIRECTOR OF NOR CAL
MENTAL HEALTH AMERICA. AND WE
ARE THE OLDEST CONTINUOUSLY
OPERATING CARE RUN ORGANIZATION
IN CALIFORNIA. WE FULLY SUPPORT
THE BILL WE ALSO EMPLOY OVER
FIFTY FULL TIME SUPPORT WORKERS
IN VARIOUS COUNTIES WORKING ON
MULTI DISCIPLINARY TEAMS ALSO WE
HAVE PEERS THAT ARE WORKING AT
KAISER PERMANENTE E.. INTEGRATED
WITHIN THEIR OUTPATIENT CLINICS
SO THIS IS DEFINITELY AN
EVIDENCE EVIDENCE BASED
PRACTICE.
WOULD LIKE TO SEE AN ELEVATED
HERE IN CALIFORNIA THANK YOU.
HI ANDREA CORRECT DIRECTOR OF
ADVOCACY WITH ACCESS CALIFORNIA
AND NOR CAL MHA AND WE ARE IN
SUPPORT.
TERENCE'S KELLY SENIOR BETTER
KNOWN AS CHUCKIE I AM ALSO A
PARTNER KO MH A AS WELL AS
ACCESS AMBASSADOR FOR THE
CENTURIES IN COUNTY FOR SAN
JOAQUIN. AND I AM A CONSUMER AND
I AM IN FULL SUPPORT THANK YOU.
THANK YOU MY NAME IS LESLIE
NAPPER SUPERVISING COORDINATOR
FOR DISABILITY RIGHTS CALIFORNIA
SELF ADVOCACY UNIT WE PROVIDE
EDUCATION AND TRAINING. LED
ACROSS THE STATE OF CALIFORNIA
WE SUPPORT THE BILL.
GOOD AFTERNOON EVERYONE MY NAME
IS CATHERINE KILLION EXECUTIVE
DIRECTOR FOR THE ON THE COUNTY.
NETWORK OF MENTAL HEALTH CLIENTS
WE ARE WE ARE AN AGENCY THAT'S
BEEN AROUND FOR ALMOST THIRTY
YEARS IN ALL OF OUR STAFF ONE
HUNDRED PERCENT ARE FOLKS WITH
LIVED EXPERIENCE. FROM THE TOP
TO THE BOTTOM IN THE MIDDLE WE
ARE WHO WE SERVE IF WE SUPPORT
THIS BILL THANK YOU. ANYONE IN
OPPOSITION TO THE MEASURE.
QUESTIONS OR COMMENTS FROM ANY
OF THE MEMBERS.
WOULD YOU LIKE TO CLOSE CENTER
BELL BERJAYA VOTE THANK YOU HAVE
A MOTION BY A SENATOR ROTH SONS
THAT ITEM NUMBER ONE SP NINE OH
SIX BELLE. I DO PASS TO
APPROPRIATIONS COLUMN MEMBERS
PLEASE COMMANDERS. AND AS I
WENT.
WHEN I LABOR.
MITCHELL. MOANING NIGHT MORNING
I NEWMAN. NEWMAN I NIELSEN.
NELSON I PAN. CAN I BROUGHT. UP
ROTH I.
WE CURRENTLY HAVE SEVEN WE'RE
GOING TO PLACE A BILL AND CALL A
MOVE TO ITEM NUMBER FOUR.
AS THE ONE ZERO ONE NINE BELL.
I USE MENTAL HEALTH AND
SUBSTANCE USE DISORDER SERVICES.
THIS CHART OFFER SEE WITH THIS
BILL THANK YOU VERY MUCH. AND.
THIS IS THIS BE.
TEN NINETEEN A BILL THAT
CREATES PARITY. IN CRISIS
INTERVENTION DOLLARS ALLOCATED
THROUGH INVESTMENT IN MENTAL
HEALTH WELLNESS ACT OF.
TWENTY THIRTEEN AND POSTERS THE
MENTAL HEALTH CARE PARTNERSHIPS.
BETWEEN.
OUR SCHOOLS AND REGIONAL MENTAL
HEALTH AGENCIES. THE MENTAL
HEALTH OF SERVICES
ACCOUNTABILITY AND OVERSIGHT
COMMISSION. OF.
FOUND THEIR CHILDREN ARE MORE
LIKELY TO EXPERIENCE OF.
OR EXPRESS A MENTAL HEALTH
CRISIS OF IN SCHOOL SAID IN A
SCHOOL SETTING THE SCHOOL BASED
PROGRAMS. CANADA ACTUALLY
EFFECTIVELY RESPONDING SUPPORT.
THE SHARED. GOALS OF PROMOTING
MENTAL HEALTH. AND THE CHEESE
CHEATING ARE DESIRED TO ALL.
EDUCATIONAL OUTCOME FOR USE WITH
MENTAL HEALTH NEEDS.
INTO OUR CENTER FOR DISEASE
CONTROL AND PREVENTION UP TO
TWENTY PERCENT. OF AMERICANS
UNDER AGE EIGHTEEN SUFFER FROM A
MENTAL HEALTH BEHAVIOR OR
EMOTIONAL DISORDER.
TRANSLATES INTO.
FIFTEEN MILLION CHILDREN ACROSS
THE COUNTRY.
THE CHILDREN ARE WITH MENTAL
HEALTH PROBLEMS. ARE VASTLY LOT
MORE LIKELY TO DEVELOP SUBSTANCE
ABUSE PROBLEMS BECOME INVOLVED
IN CRIMINAL ACTIVITY DROPPED OUT
OF SCHOOL.
AMONG AFRICAN AMERICANS.
TEN TO TWENTY FOUR SUICIDE IS
THE THIRD LEADING CAUSE OF DEATH
FOR THOSE THAT CATEGORY. DESPITE
THESE GRIM RECORDS CRISIS MENTAL
HEALTH FUNDING FOR YOU SOON
CENTRIC PROGRAMS RECEIVED JUST
OVER ABOUT FIFTEEN PERCENT OF
THE TOTAL AVAILABLE FUNDS. WITH
THE REMAINING EIGHTY FIVE
PERCENT OF THE ALLOCATED TO
ADULTS.
UNDERSHIRTS BETWEEN SCHOOL AND
COMMUNITY MENTAL HEALTH HEALTH
PROFESSIONALS. OFFER OUR
STUDENTS AND FAMILIES AND
EXTENDED NETWORK OF MENTAL
HEALTH PROGRAMS AND SERVICES
THAT ARE EASILY ACCESSIBLE.
THIS WILL GET US DEEPER INTO
THE COMMUNITIES. WENT WHEN
PROGRAMS ARE ABLE TO IDENTIFY
AND ADDRESS STUDENT MENTAL
HEALTH AND BE REAL CHALLENGES
EARLY. STUDENTS ARE MORE LIKELY
TO GAIN RESILIENCY SKILLS AND BE
SUCCESSFUL IN SCHOOL AND LIFE
WHILE THE THREAT OF LATER HARM
IS REDUCED. ALTHOUGH TO USE
MENTAL HEALTH OUTREACH HAS
DEMONSTRATED WAR BENEFITS TO
CHILDREN. ONLY A HANDFUL OF
SCHOOLS ACTUALLY HAVE PARTNERED
WITH COUNTY MENTAL HEALTH
AGENCIES AN EXISTING CRISIS
INTERVENTION. FINES ARE
PRIMARILY UTILIZE FOR ADULTS OF
MENTAL HEALTH SERVICES. ARE
COMMISSIONED THE MALE HEALTH
COMMISSION IN THE FIRST ROUND OF
CRISIS INTERVENTION GRANTS FIFTY
APPLICATIONS WERE PROGRAM FUNDS
RECEIVED. ONLY SIX PROGRAMS WERE
SPECIFIC TO YOU. AND ONLY THREE
MATTER EXCEED THE MINIMUM
THRESHOLD ACTUALLY GET FUNDING.
OR ARE ACTUALLY TO BE CONSIDERED
FOR FUN.
THAT.
IN ORDER IN ORDER FOR
CALIFORNIA SCHOOL AGE CHILDREN
TO BE ADEQUATELY.
SERVED PARITY IN THE CRISIS
INTERVENTION GRAND FUN
ALLOCATIONS NECESSARY FIRST UP.
THE BILL SP TEN NINETEEN
CODIFIES THE COMMISSION'S
RECOMMENDATION. TO ALLOCATE AT
LEAST HALF THE CRISIS
INTERVENTION GRANT FUNDING FOR
SERVICES TARGET TO USE. EIGHTEEN
YEARS OF AGE OR YOUNGER IN ORDER
TO GENERATE MORE PARTNERSHIPS
BETWEEN SCHOOLS AND REGIONAL
MENTAL HEALTH AGENCIES. ARE WE
HAVE OUR EXECUTIVE DIRECTOR TOBY
YELLING. FROM OUR MENTAL HEALTH
SERVICES AND OVERSIGHT
ACCOUNTABILITY COMMISSION. I
RESPECTFULLY ASK FOR YOU. THANK
YOU VERY MUCH WE DO HAVE SUPPORT
ON BOTH SIDES I APPRECIATE WE
CAN JUST MAKE A BRIEF PLEASE
PROCEED THANK YOU.
THANK YOU MISTER CHAIR AND
MEMBERS MY NAME IS TOBY DOING
I'M THE EXACT ADDRESS FOR THE
MENTAL HEALTH SERVICES OVERSIGHT
AND ACCOUNTABILITY COMMISSION I
GUESS TO BE BRIEF I WOULD JUST
ECHO WHAT THE SENATOR'S COMMENTS
WHEN WE LOOKED AT CHILDREN IN
CRISIS WE TALK WITH THE FOLKS
WHO MANAGE. THE CRISIS HOTLINES.
WHAT THEY SHARED WITH US IS THAT
THE NUMBER OF CALLS THEY GET
PRIMARILY ARE COMING FROM
CHILDREN IN SCHOOL BASED
SETTINGS?
AND ALTHOUGH THE STATE DOES MAKE
SOME TOOLS AVAILABLE THROUGH THE
SPD TO GRANTS WHEN WE MAKE THOSE
AVAILABLE ON A COMPETITIVE
BASIS.
QUITE OFTEN PROGRAMS FOR ADULTS
ARE PRIORITIZED OVER PROGRAMS
FOR CHILDREN AND SO THIS BILL.
MAKES SIMS AND SIGNIFICANT
CHANGES AND THAT IT WOULD MAKE
SURE THAT THE TOOLS THE STATE
HAS TO INCENTIVIZE OPPORTUNITIES
TO ADDRESS THE NEEDS OF KIDS.
THE CHICKENS KOBE SETTINGS ARE
THERE AND AVAILABLE AND SO WE
ARE THRILLED TO BE ABLE TO WORK
WITH SENATOR BELTS A SPONSOR ON
THIS LEGISLATION WE ASK YOUR
RIVAL.
IT WOULD ALSO SUPPORT.
ANY QUESTIONS COMMENTS FROM ANY
OF THE MEMBERS OF THE BILL.
OF CENTER BALANCE LIKE TO CLOSE.
UP WE GOT SOME SUPPORT I'M
ASSUMING PLEASE. STATE YOUR NAME
AND POSITION. BASKIN ALLAN
CHILDREN'S DEFENSE FUND
CALIFORNIAN STRUCK SUPPORT.
LINDA WAY WITH WESTERN VENOM ON
POVERTY IN SOME SPORT.
HER CHILD DISABILITY RIGHTS
CALIFORNIA STRONG SUPPORT.
IT'LL FORTS ONE CAN BEHAVIORAL
HEALTH STRONG SUPPORT.
MARTY MODEL CALIFORNIA DISPLACED
IN YOUR COMMUNITY ACTION NETWORK
TV CAN STRONG SUPPORT. THANK
YOU.
DO HAVE A MOTION BY CENTER RAS I
WOULD LIKE TO CLOSE OF THANK YOU
LETTERS AND I VOTE FOR THIS
WHERE ITEM NUMBER FOUR SP ONE
ZERO ONE NINE DO PAST EDUCATION
CALL THE MEMBERS PLEASE LANDED
I.
LEARNED AS I WENT. WHEN I LABOR.
MITCHELL.
MORNING. MORNING I NEWMAN NEWMAN
I'D NIELSEN. I NIELSEN I PAN.
AND I ROSS. ROSS I.
IF CURLY OF SEVEN WERE IN A
PLACE THAT BILL AND CALL. IT
SHOULD GET OUT WITHOUT ANY
PROBLEMS WE'RE GOING TO ADD TO
THE CONSENT ITEM NUMBER THREE SP
NINE NINE SEVEN.
THIS'S MONEY AND BUILD THE PAST
APPROPRIATIONS RECOMMENDATION TO
CONSENT CALENDAR.
SO MOVED CALL THE.
MOVED BY A.
CENTER PAN.
WE'LL GIVE IT TO THE SIDE CENTER
PANNED. CALL THE MEMBERS PLEASE
HERNANDEZ HI FERNANDEZ I WIN.
WHEN I LABOR.
MITCHELL MINING. MINING I
NEWMAN.
NEWMAN I NIELSEN. NIELSEN I CAN.
AND I ROSS. ROSS I.
CURLY AS SEVEN WE'RE GONNA PLAY
SAID BILL IN CALL WERE AN ITEM
NUMBER FIVE HE'D BE FOUR ONE
SEVEN ANYMORE ON A CUTE
PSYCHIATRIC HOSPITAL. KIND OF
INTER OPERATION MENTAL HEALTH
SERVICES URGENCY. THANK YOU
CHAIR AND THE MEMBERS THE THOMAS
FIRE IGNITED ON DECEMBER FOURTH
AND BURNED ABOUT TWO HUNDRED
EIGHTY ONE THOUSAND ACRES
DESTROYING MORE THAN A THOUSAND
STRUCTURES AND DAMAGING ANOTHER
TWO HUNDRED EIGHTY BUILDINGS IT
WAS ONE OF THE IS THE LARGEST
FIRED. IN CALIFORNIA HISTORY
AMONG THOSE STRUCTURES WERE TWO
BUILDINGS OUT A ROAD VISTA DEL
MAR AND ACUTE PSYCHIATRIC
HOSPITAL LOCATED A MENTOR A
COUNTY. VISTA DEL MAR WAS ONE OF
THE LARGEST PRIVATE PSYCHIATRIC
HOSPITALS IN THE REGION ITS
CLOSURE RESULTED IN THE LOSS. OF
SEVENTY FIVE PERCENT OF ALL
AVAILABLE SECTOR ACT PSYCHIATRIC
BEDS IN THE COUNTY AND A HUNDRED
PERCENT OF THE ADOLESCENT BEDS
ON THE CENTRAL COAST. VISIBLE
MAR IS WORKING TO RE OPEN THEIR
INPATIENT BEDS THE SUMMER
HOWEVER THEY ARE EIGHT HOWEVER
THEY ARE ABLE TO OPEN THEIR
OUTPATIENT SERVICES IMMEDIATELY
INCLUDING ADOLESCENT SERVICES
UNFORTUNATELY. THERE ARE
STATUTORY BEARS THAT REQUIRE THE
HOSPITAL RE OPEN THE INPATIENT
BEDS PRIOR TO RE OPENING THE
OUTPATIENT SERVICES. EIGHTY FOUR
SEVENTEEN IS A VERY NARROWLY
CRAFTED LEGISLATION THAT ALLOWS
THE CALIFORNIA DEPARTMENT OF
PUBLIC HEALTH TO AUTHORIZED
OUTPATIENT BEHAVIORAL HEALTH
SERVICES FOR A SHORT PERIOD OF
TIME WHILE THE HOSPITAL'S
INPATIENT SERVICES. OR SUSPENDED
BECAUSE OF THE FIRE DAMAGE WE
HAVE WORKED WITH THE GOVERNOR'S
OFFICE AGENCIES STD PH AND
STAKEHOLDERS TO CRAFT THIS
NARROW SOLUTION. THIS UNTIL MAR
IS A CRITICALLY IMPORTANT
PROVIDER OF INPATIENT AND
OUTPATIENT MENTAL HEALTH
SERVICES WITHIN THE REGION THE
LOSS OF BOTH INPATIENT AND
OUTPATIENT SERVICES HAS HAD A
RIPPLE EFFECT THROUGHOUT THE
COMMUNITY. AS ONE JENNIFER AND I
HACE CEO BESTED
ON MY HOSPITAL. BED AFTER YOU
MISTER CHAIR AND MEMBERS. AS AS
MENTIONED ABOVE IS STILL A BAR
WAS. THE ONLY PRIVATE
FREESTANDING ACUTE PSYCHIATRIC
FACILITY AND ALL OF THE INTER
COUNTY AS WELL AS EIGHTY SEVEN
BEDS THAT WE HAD AT THE FACILITY
MADE UP. FOR THREE FOURTHS OF
THE BEDS INVENTOR COUNTY AS WELL
AS THE ONLY ADOLESCENT BAD
INVENTOR COUNTY SANTA BARBARA
COUNTY SAN LUIS OBISPO COUNTY.
.
THE TIME IS FIRE DESTROYED AS
MENTIONED TWO OF OUR BUILDINGS
AS WELL AS UTILITIES POWER LINES
OTHER UTILITIES GOING TO OUR
CAMPUS WHICH CAUSES TO
IMMEDIATELY HAVE TO CLOSE ALL OF
OUR SERVICES BOTH INPATIENT AND
OUTPATIENT. WHERE WERE WE WE ARE
CURRENTLY WORKING TO RE OPEN
FIFTY FIVE APPROXIMATELY FIFTY
FIVE ACUTE PSYCHIATRIC BEDS
INCLUDED ADOLESCENT BEDS?
HOWEVER IN THE MEANTIME WE ARE
READILY ON.
AVAILABLE AND OPEN TO BEGIN OUR
OUTPATIENT SERVICES INCLUDING
PARTIAL HOSPITALIZATION AND
IMPATIENT AND I'M SORRY AND I'M
INTENSIVE OUTPATIENT SERVICES
FOR ADOLESCENTS AND ADULTS.
AND THOSE SERVICES PROVIDED
WOULD.
INCLUDE A LICENSED THERAPISTS
SOCIAL WORKERS REGISTERED NURSES
CLINICAL PSYCHOLOGIST PROVIDING
GROUP THERAPY AND FAMILY GROUP
SUPPORT.
WRITING TRANSPORTATION FOR
THOSE IN OUR COMMUNITY TO COME
TO THOSE OUTPATIENT SERVICES.
IN THOSE SERVICES USE EVIDENCE
BASED CURRICULUM THAT IS.
COMMITTED TO. ESTABLISH A
TRIGGER IDENTIFICATION SELF
REGULATION COPING SKILLS.
FOR ADOLESCENTS AND ADULTS TO
CREATE A PATH OF RECOVERY.
GIVEN THE STATED CONCERNS
RELATED TO THE SEVERE LACK OF
SERVICES FOR BOTH ADULTS AND
ESPECIALLY ADOLESCENTS IN OUR
COMMUNITY.
WE'RE ASKING THAT YOU. SUPPORT
THIS BILL I EIGHTY ONE FOUR ONE
SEVEN TO RESTORE THESE VALUABLE
MENTAL SERVICES TO OUR
COMMUNITY.
WHILE ARE OUT INPATIENT
SERVICES ARE BEING RESTORED.
THANK YOU.
AT A TIME.
THE FACILITY IN HERE FOR A
TECHNICAL QUESTION.
BARBOUR GLAZED WITH THE
CALIFORNIA HOSPITAL ASSOCIATION
HERE TODAY IN SUPPORT.
I THINK ANYONE ELSE'S SUPPORT.
ONLY BROOKS HERE ON BEHALF OF
THE VENTURA COUNTY BOARD OF
SUPERVISORS URGE YOUR SUPPORT OF
THIS IMPORTANT MEASURE THANK
YOU.
THANK YOU.
THE OPPOSITION.
ANY QUESTIONS OR YOU WEREN'T
QUICK ENOUGH.
YOU WANT TO.
QUESTIONS OR COMMENTS FOR MANY
OF THE MEMBERS JULY TOO CLOSE I
RESPECTFULLY ASK FOR AN ICE BUT
WE HAVE A.
MOTION BY SENATOR ROSS ON AB
FOR ONCE SEVEN LA MONTE PAST
APPROPRIATIONS CALL THE MEMBERS
PLEASE HERNANDEZ HIGH AND AS I
WENT.
WHEN I LABOR.
MITCHELL. BONDING.
I NEWMAN.
NEWMAN I NIELSEN NIELSEN I PAN
AND I BROUGHT. ACROSS BY. YOU
THAT CURRENTLY HAS SEVEN THAT'S
ENOUGH TO GET OUT REPLACEABLE
AND COFFEE THANK YOU.
NEXT ITEM WILL BE. ITEM TWO SPD
NINE TEN MISTER CHAIRMAN.
MADAM CHAIR AND MEMBERS OF THIS
BILL SB NINE TEN MAKES IT CLEAR
THAT. SHORT TERM LIMITED
DURATION HEALTH INSURANCE MAY
NOT BE SOLD IN CALIFORNIA. THESE
POLICIES WERE DESIGNED TO FILL
GAPS IN COVERAGE IN PRE
AFFORDABLE CARE ACT HEALTH
INSURANCE MARKETS. AND IS WAS
THROUGH THAT THAT THESE PRODUCTS
WERE NOT PERMITTED IN CALIFORNIA
OUT ONCE THE AFFORDABLE CARE ACT
MARKET REFORMS WERE ENACTED.
THESE PRODUCTS OFFER NO VALUE
NOW THAT THE AFFORDABLE CARE ACT
MAKES GUARANTEED ISSUE PRODUCTS
AVAILABLE WITHIN PRE EXISTING
CONDITION EXCLUSIONS. INSTEAD
THESE POLICIES SERVE TO
UNDERMINE THE SUCCESS OF THE
CALIPHATE THAT CALIFORNIA'S HAD
ON THE IMPLEMENTATION OF THE
AFFORDABLE CARE ACT. THESE
PRODUCTS ARE CONFUSING.
MISLEADING BARELY COVERING THE
SERVICES AND GIVE PEOPLE A FALSE
SENSE OF COVERAGE. THEIR WASTE
THE MONEY. THEY ARE WHAT WE CALL
JUNK INSURANCE EXTENSIVE HEALTH
QUESTIONNAIRES ARE REQUIRED
BEFORE ANY PERSON'S OFFERED ONE
OF THESE POLICIES. AND THAT IF
THE CARRIER TO SITES OFFER THE
COVERAGE WHEN AND IF TREATMENT
IS PROVIDED THESE CARRIERS
AGGRESSIVELY TRIED TO RESEND
COVERAGE.
WITH THE AFFORDABLE CARE ACT
I'D HAVE I'M HAVING THE ARM.
SERGEANTS PASS AROUND A.
SIDE BY SIDE COMPARISON I'D
LIKE YOU TO LOOK AT ITS TWENTY
EIGHTEEN CALIFORNIA PLAN DESIGN
COMPARISON COVER CALIFORNIA
STANDARD SILVER VERSES THE.
AS TLDS.
AND WHAT I LIKE TO BRING TO NOTE
IF YOU DON'T MIND LOOKING AT IT.
GENERIC DRUGS ARE NOT COVERED
BRAND DRUGS ARE NOT COVERED YOU
FLIP TO THE BACKSIDE. AND THIS
IS FOR THE THE NON.
ACA OR THE.
COVER CALIFORNIA MATERNITY IS
NOT COVERED BUT MORE IMPORTANTLY
PRE EXISTING CONDITIONS ARE NOT
COVERED IN MANY CASES A LOT OF
THESE PATIENTS WHO HAVE PRE
EXISTING CONDITIONS ARE LOCKED
OUT OF THE MARKET. ORDER THERE'S
MANY INSTANCES WHERE PATIENTS
WHO DON'T KNOW THEY HAVE A PRE
EXISTING CONDITION UNFORTUNATELY
PURCHASE A HEALTH PLAN LIKE
THIS.
GETTING CONDITION A LOT OF TIMES
THEY'RE NOT COVERED. AND I
REALLY BELIEVE THAT THIS WILL
UNDERMINE.
WHAT WE HAVE DONE IN CALIFORNIA
AS FAR AS THE IMPLEMENTATION THE
AFFORDABLE CARE ACT IDEA DO HAVE
WITNESSES LIKE TO SPEAK IN
SUPPORT OF THAT AND WITH THAT
MEMBERS I RESPECTFULLY ASK FOR A
VOTE?
GOOD AFTERNOON MADAM CHAIR AND
MEMBERS MY NAME IS MARY JANE
FLORES AND ON BEHALF OF
HEALTHAXIS CALIFORNIA. THE STATE
WIDE HEALTH CARE CONSUMER
ADVOCACY COALITION WHERE PIECES
MONSTER AND SUPPORT SB NINE TEN
THE BILL WOULD BAN THE SALE OF
SHORT TERM INSURANCE IN
CALIFORNIA. SHORT TERM INSURANCE
POVIDES VERY LIMITED BENEFITS
AND IS NOT OFFERED THE SAME
PROTECTIONS AND ESSENTIAL HEALTH
BENEFITS AS AC PLANS TO. FOR
EXAMPLE IMAGINE YOUR SON GETS
INTO AN ACCIDENT FALLING OFF A
LADDER BECAUSE HE WAS CLEANING
THE RAIN GUTTER HE'S TAKEN TO
THE ER AND FINDS OUT HE HAS A
BROKEN LEG HAS A CONCUSSION. AND
HAS TO BE ADMITTED FOR SURGERY.
UNDER SHORT TERM INSURANCE PLAN
HE WILL HAVE TO PAY FIVE
THOUSAND DOLLARS IN DEDUCTIBLE
AND THEN A FIFTY PERCENT
COINSURANCE RATE ON THAT YOUR
VISIT THE SURGERY AND THE
HOSPITAL STAY. FOR LOCAL
SACRAMENTO HOSPITAL YOUR SONS
OUT OF POCKET COSTS WOULD BE AT
LEAST FORTY SIX THOUSAND FIVE
HUNDRED DOLLARS FOR A SURGERY
AND A FOUR DAY HOSPITAL STAY.
YOUR SON WOULD BE STUCK WITH
TENS OF THOUSANDS OF DOLLARS IN
MEDICAL BILLS BECAUSE HIS SHORT
TERM POLICY. DID NOT PROVIDE HIM
WITH THE COVERAGE HE NEEDS. IN
CONTRAST IF YOUR SON HAS AN AC
PLAN UNDER THE WORST CASE
SCENARIO HE WOULD BE PAYING SIX
THOUSAND THREE HUNDRED DOLLARS
AT HIS. OUT OF POCKET MAXIMUM.
IN A BRONZE PLAN IN THE BEST
CASE SCENARIO YOUR SON WOULD PAY
THREE THOUSAND THREE HUNDRED
DOLLARS WITH A PLATINUM PLAN.
ALSO IF YOUR SON NEEDS ANY MORE
CARE AFTER TIS ACCIDENT IT
WOULD BE FULLY COVERED THANKS TO
THE CAPS OF OUT OF POCKET COSTS
IN ACA PLANS. WHATEVER ROLE
SHORT TERM INSURANCE PLAYED PRE
ACA NOW POST ACA PEOPLE HAVE
BETTER MORE COMPREHENSIVE AND
MORE AFFORDABLE COVERAGE
OPTIONS.
EITHER THROUGH MEDIC HOW AT NO
COST OR WOULD FINANCIAL
ASSISTANCE AND COVERED
CALIFORNIA WHICH CITIZENS AND
LAWFUL RESIDENTS HAVE ACCESS TO.
CALIFORNIA SHOULD BAN SHORT TERM
INSURANCE TO ENSURE THAT
CONSUMERS BUY COVERAGE THAT
ACTUALLY COVERS IMPORTANT
SERVICES AND DO NOT LEAVE THEM
WITH. MEDICAL THAT FOR THESE
REASON WE SO STRONGLY SUPPORT SB
NINE TEN AND ASK FOR RIVAL.
GOOD AFTERNOON. THAT CM HOLDS
FROM CONSUMERS UNION THE
ADVOCACY DIVISION OF CONSUMER
REPORTS.
CONSUMERS UNION'S PROUD TO
SUPPORT THIS LEGISLATION AIMED
AT MITIGATING EXPECTED DAMAGE
FROM THE FEDERAL PLAN TO EXTEND
THE USE OF SHORT TERM. HEALTH
INSURANCE POLICIES WITH LIMITED
COVERAGE INCLUDING AN ESTIMATED
NEARLY EIGHTEEN PERCENT PREMIUM
INCREASE IN THE INDIVIDUAL
MARKET IN CALIFORNIA THAT WOULD
RESULT.
ACCORDING TO THE URBAN
INSTITUTE ESTIMATES CONSUMER
REPORTS IS CALL THESE LOW VALUE
PLANS JUNK INSURANCE FULL OF THE
DUCHESS AND GIMMICKS THAT THE
AFFORDABLE CARE ACT SOUGHT TO
ELIMINATE. AND WE'RE ALREADY
SEEING THEM AGGRESSIVELY AND
DECEPTIVELY MARKETED INCLUDING
TO THOSE WHO HAVE COMPREHENSIVE.
COVERAGE SO WHAT DO WE MEAN BY
JUNK INSURANCE HERE'S AN EXAMPLE
THAT CAME TO CONSUMERS UNION.
JUST BEFORE THE ACA WAS
IMPLEMENTED AND WHICH WOULD BE
ALSO POSSIBLE THROUGH THE SHORT
TERM PLANS.
DO THEY BELIEVE THE HEALTH PLAN
SHE BOUGHT WAS COMPREHENSIVE
INSURANCE ONLY WHEN HE WAS
DIAGNOSED WITH BREAST CANCER. IT
SHE LEARNED ABOUT IT SEVERE
LIMITATIONS ONE THOUSAND DOLLARS
FOR A LIMIT FOR OUTPATIENT
CHEMOTHERAPY. TWO THOUSAND
DOLLAR LIMIT FOR
HOSPITALIZATION.
FACING A THIRTY THOUSAND DOLLAR
HOSPITAL BILL ESTIMATE A SHE
DELAYED TREATMENT UNTIL HER
SURGEON FINALLY SAID YOU CAN'T
WAIT ANY LONGER GO IN AND HAVE
THE SURGERY.
THE TUMOR WHICH WAS THREE
CENTIMETERS WHEN SHE DISCOVERED
IT WAS NINE CENTIMETERS WHEN
THEY TOOK IT OUT REQUIRED A
DOUBLE MASTECTOMY RADIATION
RECONSTRUCTIVE SURGERY AND LEFT
HER ALSO WITH AN ESTIMATED
TWENTY EIGHT THOUSAND. DOLLAR
HOSPITAL BILL SO WE DON'T WANT
OTHER CONSUMERS TO BE STUCK IN
THIS BIND WHICH FELT EXPOSED
THEIR HEALTH AND THEIR FINANCES.
THE AFFORDABLE CARE ACT IS HAS
BEEN TALKED ABOUT UP GIVES
COMPREHENSIVE PROTECTIONS
LACKING IN THE SHORT TERM PLANS.
CARRIER SELLING THE SHORT TERM
POLICIES DON'T USE THE
QUESTIONNAIRES THAT THE SENATOR
A DESCRIBED AS WELL. AND THEY
CAN CHARGE PEOPLE EITHER DENY
PEOPLE BECAUSE OF PRE EXISTING
CONDITIONS OR CHARGE THEM MORE
IF THEY DECIDE TO COVER THEM.
THESE PLANS ARE EXPECTED
PREDICTABLY TO ATTRACT YOUNGER
AND HEALTHIER CONSUMERS PEOPLE
WHO DON'T FEEL THE NEED FOR
COMPREHENSIVE COVERAGE.
SO THAT MEANS THAT THESE HEALTHY
PEOPLE WOULD BE SIPHONED OFF
FROM THE INDIVIDUAL MARKET.
LEAVING THE RISK MEANT NEXT MUCH
LESS HEALTHY AND THEREFORE MORE
COSTLY THOSE REMAINING IN THE
INDIVIDUAL MARKET A WILL SEE
THEIR PREMIUMS RISE IN THOSE ARE
THE PEOPLE WITH CHRONIC
CONDITIONS AND OFTEN OLDER AS
WELL. FOR MANY CONSUMERS WITH
HIGH MEDICAL NEEDS THE PREMIUMS
MAY BECOME IN FACT UNAFFORDABLE
MEANING THEY'LL HAVE TO DROP
COVERAGE ALTOGETHER. THE OVERALL
RESULT OF THE SHORT TERM
POLICIES WE BELIEVE WOULD BE A
FRAGMENTED DESTABILIZED
INDIVIDUAL MARKET IN THE STATE
WITH HIGHER COSTS THAN EVER. FOR
COMPREHENSIVE COVERAGE AND
THEREFORE MORE UNINSURED
CALIFORNIANS. NINE TEN WOULD SB
NINE TEN WHATEVER THIS PROBLEM
BY BARRING THE SALE OF SHORT
TERM LIMITED BENEFIT POLICIES.
AND THAT PUT INDIVIDUALS AT
RISK MEDICALLY AND FINANCIALLY
FOR OTHER STATES BY THE WAY HAVE
ALREADY BANNED THESE POLICIES.
ON IF NOT DIRECTLY BY SAYING
THAT THEY MUST COMPLY WITH ALL
THE INDIVIDUAL MARKET RULES
WHICH IS ANOTHER. HALF BUT WE
URGE YOUR I VOTE ON SB NINE TEN
TO BOTH PROTECT INDIVIDUALS AND
THE STABILITY OF THE INDIVIDUAL
MARKET. THANK YOU.
THANK YOU MADAM CHAIR TREES TO
START WITH KAISER PERMANENTE
ALSO PLEASED TO BE HERE IN
SUPPORT TODAY I WOULD ECHO THE
COMMENTS OF MY COLLEAGUES. AND
WITH YOUR CHILDREN HAVE LIKE I'D
LIKE TO READ COVER CALIFORNIA
ACTUALLY PUT OUT A REPORT LATE
LAST WEEK WITH AN ASSESSMENT OF
OF WHAT COULD HAPPEN IN OUR
INSURANCE MARKETS AS A RESULT OF
SOME OF THE ACTIVITIES AT THE
FEDERAL LEVEL AND IT IS
RELEVANT.
RECENT HEALTH CARE ACTIONS
TAKEN BY CONGRESS AND THE
FEDERAL ADMINISTRATION INCLUDING
ELIMINATION OF THE INSURANCE
MANDATE PENALTY AND PROPOSING
GREATER FLEXIBILITY TO ALLOW FOR
SHORT TERM LIMITED DURATION
PLANS. ARE EXPECTED TO DRAW
CONSUMERS OUT OF THE INDIVIDUAL
MARKET SEWING MARKET INSTABILITY
AND RAISING THE SPECTER OF LARGE
PREMIUM INCREASES IN TWO
THOUSAND NINETEEN AND BEYOND.
MEMBERS THIS BILL IS AN
IMPORTANT PART OF A LARGER
EFFORT TO COUNTERACT THOSE
EFFORTS TO PROTECT CONSUMERS TO
STABILIZE THE AFFORDABILITY FORD
ABILITY TO STABILIZE THE MARKET
AND PROTECT AFFORDABILITY AND
MITIGATE AGAINST THE PAIN
INCREASES THAT YOU HEARD ABOUT
THE. SHORT TERM HEALTH INSURANCE
IS NOT HEALTH INSURANCE A IT
ACTUALLY TAKES US BACKWARDS AND
SO WE ARE STRONGLY IN SUPPORT OF
THIS BILL TODAY THANK YOU.
IN SUPPORT.
KAREN SAVAGE CALIFORNIA PAN
ETHNIC HEALTH NETWORK IN
SUPPORT.
JAN FLOREY WESTERN CENTER ONLINE
POVERTY AND SUPPORT.
HER CHILD DISABILITY RIGHTS
CALIFORNIA IN SPORT.
ARMONK N. SMITH WITH THE
AMERICAN CANCER SOCIETY
CONSTRUCTION NETWORK ALSO IN
SUPPORT.
ACTING ANTON BEHALF THE NATIONAL
MULTIPLE SCLEROSIS SOCIETY IN
SUPPORT.
JOE MICHAEL FOR EQUALITY
CALIFORNIA IN SUPPORT.
MARK MENDOZA WITH SEIU
CALIFORNIA AND SUPPORT.
CHRIS KELLY ON ON BEHALF OF THE
CALIFORNIA IMMIGRANT POLICY
CENTER IN SUPPORT.
CARL SUPPORT OF A BLUE SHIELD OF
CALIFORNIA ALSO IN SUPPORT.
IN THE OPPOSITION.
I AM BREAD DAVIS HERE FROM THE
CALIFORNIA ASSOCIATION OF HEALTH
UNDERWRITERS THANK YOU.
WE ARE AT WITH AN IN BETWEEN
POSITION ON OPPOSE UNLESS
AMENDED. WE APPRECIATE THE
AUTHOR BRINGING THIS BILL
FORWARD AND WERE IN FULL
AGREEMENT TO ENSURE
COMPREHENSIVE COVERAGE OF COURSE
THROUGH THE ACA. AND ENSURING
STABILITY IN THE MARKETPLACE.
HOWEVER WE ARE IN FAVOR OF
GUARD RAILS THAT WOULD LIMIT THE
SALE OF THESE RATHER THAN
COMPLETELY ELIMINATE THEM. WE
RESPECTFULLY REQUEST
CONSIDERATION OF AMENDMENTS
MAKING THESE PLANS AVAILABLE TO
THOSE WHO ARE OTHERWISE LEGALLY
PROHIBITED. FROM BUYING
COMPREHENSIVE COVERAGE IN THE
MARKETPLACE AND LIMITING THE
DURATION OF THESE PLANTS UNTIL
THE NEXT ENROLLMENT PERIOD SO
THAT WE CAN SAFELY GUIDE THEM ON
TO THE. ACA COMPREHENSIVE PLANS
AN EXAMPLE OF SOMEBODY BEING
LEGALLY PROHIBIT WOULD BE A
COVER PARTICIPANT WHOSE.
EMPLOYER CHANGES THEIR PLAN MID
YEAR A STUDENT RETURNING FROM
SCHOOL FROM OUT OF AREA. THAT
NEEDS COVERAGE IS TO GET THEM
THROUGH THE SUMMER TIME PERIOD
SOMEBODY WHO WAS CANCELED FOR
NON PAY AN EMPLOYER THAT HIRE
SOMEBODY OUT OF STATE AND IT'S
TIME TO GET A COMPREHENSIVE PPO
PLAN. OR ANYBODY WHO MISSED
THEIR THIRTY DAY QUALIFYING
ABOUT WINDOW. THANKS FOR THE
OPPORTUNITY BE HERE WE LOOK
FORWARD TO WORKING WITH YOU.
THANK YOU.
MY APOLOGIES MORGAN CARB
ALTERNATIVE STRATEGY GROUP ON
BEHALF OF THE GREEN LINING
INSTITUTE IN SUPPORT.
ANY OTHER SUPPORTER OPPOSITION.
SEEING NONE COLLEAGUES.
SENATOR ROTH THANK YOU OF.
MADAM VICE CHAIR.
I THINK I UNDERSTAND THE IMPACT
OF THE SHORT TERM PLANS ON THE
COMPREHENSIVE PLANS IN THE PLAN
PREMIUMS AND. OF COURSE THE
WHOLE SALE. USE OF THE SHORT
TERM PLANS OBVIOUSLY IS GOING TO
HAVE. A DETRIMENTAL IMPACT ON.
THE AFFORDABILITY OF INSURANCE
FOR ALL.
I AM CONCERNED ABOUT. FOLKS WHO
MAY DROP THROUGH THE CRACKS.
AND CAN ONE OF YOU OR MAYBE THE
OPPOSITION IF HE NEEDS TO COME
BACK UP.
CLARIFY.
WHETHER THERE ARE INDIVIDUALS
WHO MAY DROP THROUGH THE CRACKS
IN THIS PROCESS WHO COULD
OTHERWISE USE THESE SHORT TERM
PLANS TO BRIDGE.
GETTING FROM POINT A TO POINT
B..
WHEN HERE SHE IS UNABLE TO.
GAIN COVERAGE THROUGH A
COMPREHENSIVE PLAN.
INDIVIDUALLY PURCHASED OR AN
EMPLOYER BASED PLAN.
ARE THOSE ARE THEIR INDIVIDUALS
WHO DROP THROUGH THE CRACKS. AND
IF SO IS THERE A SOLUTION OTHER
THAN THE SHORT TERM PLAN THAT
WOULD COVER ALL OF THEM. WITH
SOME GUARANTEED ASSURANCE OF
COVERAGE. BUT I AM I MAKE TRY TO
TAKE A CRACK AT I THEN I'LL
HAVE THEM ANSWER AS WELL AND I
TRY TO WRITE DOWN THE NOTES WTH
REGARD TO. LEGALLY PROHIBITED
WHICH WERE THE CORE PARTICIPANTS
ARE STUDENTS. AND INDIVIDUALS
WHO BLUSTER INSURANCE THROUGH
THEIR EMPLOYER ETCETERA SO WE
HAVE WHAT'S CALLED SPECIAL
MOMENT IN THE SPECIAL ROMAN
TIMES. IT'S WILL ALLOW THOSE
SPECIFIC INDIVIDUALS WHO HAVE
THOSE.
LIKE CHANGING CIRCUMSTANCES
LOSS OF THEIR INSURANCE LOSS OF
THEIR JOB THEY CAN ENROLL WITHIN
COVER CALIFORNIA BUT I PERHAPS I
CAN MAKE THEM AND HAVE THEM
FOLLOW UP AS WELL.
SURE ARE WE WOULD AGREE WITH THE
SENATOR AND ALSO I'M IN TERMS
OF.
OTHER POTENTIAL CRACKS.
YOU ARE RIGHT THAT THERE MIGHT
BE SOME INDIVIDUALS THAT YOU
MISS THE ANNUAL OPEN ENROLLMENT
PERIOD.
BUT MANY OF THEM MIGHT BE
ELIGIBLE FOR MEDICAID HOW UP FOR
NO COST AND SO WE WANT TO BE
ABLE TO LET THEM KNOW THAT THE
APPROPRIATE COVERAGE FOR THEM
WOULD BE MANIC HOW. IN MANY
INSTANCES PEOPLE UNDER
QUALIFYING EVENTS WOULD ALSO
BENEFIT FROM A SPECIAL
ENROLLMENT PERIODS AND LASTLY I
THINK THE MORE APPROPRIATE
QUESTION TO ASK IS WHAT CAN THE
LEGISLATURE AND COVER CLIFORNIA
DUE TO FILL THE NICHE. IF THERE
IS FLIGHT DEMAND FOR THESE
PRODUCTS HOW CAN COVER
CALIFORNIA OFFER ALTERNATIVE
PRODUCTS THAT WOULD HAVE THE
SAME TYPE OF PROTECTIONS. AND
COMPREHENSIVE BENEFITS AS EASY
PLANTS DO WELL IS IS THE. WHAT'S
THE TIMELINE VERSE IN TERMS OF.
GAINING MEDICARE COVERAGE VERSUS
GAINING COVERAGE UNDER A.
COMMERCIALLY PROCURED HEALTH
PLAN IS THERE A DIFFERENCE IN.
IN THE TIME LINE.
FIRST SO WHAT WE'VE LEARNED A
LOT THROUGH SOME OF THE SHORT
TERM PLANS WHILE THEY MEET THEY
MAY BE MARKETED AS.
YOU WILL GET EFFECTIVE COVERAGE
MOST OF THEM ACTUALLY HAVE A
WAITING PERIOD AS WELL OF OF
THIRTY DAYS. AND SO DEPENDING ON
THE ACA PLANS DEPENDING ON WHEN
YOU ACTUALLY SIGN UP AND BUY
COVERAGE WHETHER IT'S AT THE
FIRST OF THE MONTH OR IN THE
MIDDLE OF THE MONTH WILL INFORM.
YOUR EFFECTIVE COVERAGE DATE.
SO WHAT'S THAT MEAN IN TERMS OF
TIME. IS THAT THIRTY DAYS FOR
AN.
AN ACA PLAN IS AT FORTY FIVE IS
IT SIXTY SO IF I BUY IT IF I
SIGN A MID MONTH HOW LONG DOES
IT TAKE ME TO GAIN COVERAGE. SO
IF YOU DO SIGN UP MID MONTH IT
WILL TAKE IN EFFECT NOT THE
FOLLOWING MONTH BUT THE
FOLLOWING MONTH AFTER SO THAT
COULD BE IN EFFECT FORTY FIVE
DAYS IF YOU SIGN UP. LET'S STAY
ON MARCH TODAY ON MARCH OR
TOMORROW MARCH FIFTEENTH OR
MARCH SIXTEENTH. EFFECTIVE
COVERAGE DATE WOULD BE.
ME. OKAY SO THE SHORT TERM PLAN
WILL BE A LITTLE BIT SHORTER IN
TERMS OF GAINING COVERAGE
WRITING ON WHEN YOU SIGN UP SURE
BUT MOST OF THEM DO HAVE. ACTUAL
WAITING PERIOD. OF WHEN THEY'RE
EFFECTIVE COVERAGE DATE WOULD BE
IN EFFECT SO IF YOU'RE AN IF
YOUR MEDICAL QUALIFIED AS I
ASSUME YOU MAY BE WHAT'S THE
WAITING TIME. FOR MEDICAL
COVERAGE IF YOU'VE LOST YOUR
EMPLOYMENT.
PRESUMABLY THERE IS NO WAITING
TIME IF YOU GO THROUGH A
HOSPITAL THERE IS THIS THING
CALLED PRESUMPTIVE ELIGIBILITY
FOR MEDICAID NOW WHERE YOU WOULD
QUALIFY FOR MEDICAID HOW.
THE HOSPITAL AND ALSO THE
COUNTY WORKER OULD SUBMIT AN
APPLICATION TO THE MEDIC HOW IS
ALSO HELPFUL THAT.
ANYHOW ALSO OFFERS THREE MUCH
RETROACTIVE ELIGIBILITY SO FOR
PEOPLE WHO LOSE THEIR JOB WHO
DON'T HAVE SUFFICIENT INCOME
THEY WOULD BE ELIGIBLE FOR
MEDICAID HOW.
SO IF I LOSE MY JOB TODAY IN MY
ELIGIBLE FOR MEDICARE NEXT FROM
A CAL NEXT WEEK. BECAUSE I HAVE
NO INCOME BUT IF YOU LOSE YOUR
JOB IN THEORY YOU WOULDN'T HAVE
MINIMUM ESSENTIAL COVERAGE FROM
YOUR JOB BASE INSURANCE. SO THEN
YOU WOULD QUALIFY FOR A SIXTY
DAY SPECIAL ENROLLMENT PERIOD IN
COVERED CALIFORNIA SO THAT COULD
BE. THE FIRST MEANS IN WHICH YOU
ACTUALLY GET COVERAGE IS THROUGH
COVERED CALIFORNIA AND IF YOU
REMAIN JOBLESS IDEALLY YOU WOULD
THEN BE I'M. ON MEDICARE.
AND SO ONE FINAL QUESTION I
DON'T WANT TO DOMINATE THIS ON
THE SPREAD WELL MAYBE THIS IS TO
THE AUTHOR AND THE SPREAD SHEET
THAT WAS PROVIDED. FOR COVERED
CALIFORNIA STANDARD SILVER PLAN
AND THEN THESE OTHERS WHICH I
GUESS FOR THE SHORT TERM PLANS.
OF THE PREMIUM LISTED FOREIGN
TWENTY FOUR DOLLARS VERSUS. TWO
NINETY FOUR AND ONE SEVENTY FIVE
IS THE FOR TWENTY FOUR THE
PREMIUM AFTER APPLICATION OF THE
SUBSIDIES. I MAY HAVE TO GET
SOMEBODY TO VERIFY THAT BUT JUST
AGAIN TO RE ANSWER YOUR PREVIOUS
QUESTION THERE'S NO OPEN A ROMAN
PERIODS FOR MEDICARE I'LL. I'M
JUST TOO TO ANSWER THAT BUT.
EITHER MAYBE IF ANYBODY CAN
ANSWER HIS QUESTION ON THE.
THE COST AND I JUST LISTEN I
DON'T BELIEVE THIS I JUST WANT
TO MAKE SURE THAT WHEN WE VOTE
FOR THIS I UNDERSTAND. THE
GENERAL APPLICATION OF THE SHORT
TERM PLANS AND WHAT THOSE DUE TO
THE MARKET IN PREMIUMS FOR ALL
THE REST OF US. I JUST WANT TO
MAKE SURE THAT WE. WE DON'T
IGNORE THE FACT THAT.
IT'S LIKE PAYDAY LENDING NOBODY
LIKES THAT EITHER IN THE
INTEREST RATES HUGE BUT. THE THE
THE THE PEOPLE THAT DON'T LIKE
THE PAYDAY LENDING ARE THE
SINGLE MOMS WITH TEN KIDS YOU'VE
GOT FOUR TIRES IT BLEW OUT OF
THE CAR AND NEED TO GET THE
TIRES ON THE CAR TO GET TO WORK
SO. IF YOU KNOW WHAT THIS SHORT
TERM PLAN MAY BE THE WORST THING
KNOWN TO MAN BUT IT DOES
PROVIDE.
SOME COVERAGE AND I WANT TO MAKE
SURE THAT THAT WE COVER PEOPLE
WHO MAY BE ON THE VERGE OF
DROPPING THROUGH THE CRACKS IN
SENATOR TO TREES WITH KAISER
PERMANENTE ABSOLUTELY FAIR
QUESTION AND AND I THINK TO THAT
POINT THERE THERE MAY BE FOLKS
WHO. WHO? YOU KNOW WE WOULDN'T
BE ABLE TO TO FIT INTO ANY OF
THESE SCENARIOS BUT I THINK.
SHORT TERM INSURANCE IS A BIT
LIKE. TAKING A SLEDGE HAMMER TO
CRACK THAT NIGHT AND THAT'S WHAT
WE'RE TRYING TO SAY IS THERE MAY
BE A NUT HERE AND SOME SOME
THINGS WE CAN DO WHETHER THROUGH
COVER CALIFORNIA OR SOME OTHER
YOU KNOW. TWEAKS AROUND SPECIAL
ENROLLMENT TO REALLY MAKE SURE
THAT THAT THOSE FOLKS ARE TAKING
CARE OF SHORT TERM INSURANCE IS
THE WRONG ANSWER IT'S IT'S A WAY
OVER CORRECTION TO THAT. BUT IT
ALSO I WANNA REMIND YOU THERE IT
LACKS ANY CONSUMER PROTECTION
WHATSOEVER NO CENTRAL HEALTH
BENEFITS.
THERE IS YOU KNOW UP PROBABLY
CAPS ON ON ANNUAL EXPENDITURES.
OF PRE EXISTING CONDITIONS YOU
CAN BE REJECTED THERE'S
UNDERWRITING IT REALLY TAKES US
BACK MANY YEARS AND SO WE ALSO
WANT TO MAKE SURE PEOPLE
UNDERSTAND IT IS NOT A SOUP
SUITABLE SUBSTITUTION FOR
COMPREHENSIVE ONGOING COVERAGE.
AND WE WANT TO MAKE SURE WE'RE
DOING EVERYTHING WE CAN TO KEEP
PEOPLE AND KEEP PEOPLE COVERED
IT'S GOOD FOR THEM IT'S GOOD FOR
THEIR FAMILIES AND IT'S GOOD FOR
THE OVERALL MARKET. SO IF WE
OPEN THAT DOOR WE NEED TO BE
REALLY CAREFUL. THAT WERE JUST
OPENING IT JUST A LITTLE BIT AND
AND BEING VERY SURGICAL HOW WE
DO IT AND NOT CREATING THIS
OTHER OPTION FOR FOLKS THAT IS A
REALLY POOR SUBSTITUTE WELL LET
ME JUST SAY I'M GONNA SUPPORT
THIS I'M SURE TO GET OUT OF THIS
COMMITTEE. AND ARE PROBABLY SAIL
THROUGH THIS LEGISLATURE BUT BUT
WE SHOULD AND YOU SHOULD KNOW.
THAT WE WERE IF WE REALLY
HAVEN'T FIGURED OUT WHETHER
PEOPLE DROPPING THROUGH THE
CRACKS WE'RE CERTAINLY SHUTTING
THE DOOR TODAY.
WITH THE HOPE THAT WE'RE GOING
TO IDENTIFY WHO THEY ARE AND ARE
GOING TO FIX IT LATER AND I'M
NOT SURE THAT'S THE RIGHT RIGHT
WAY TO LOOK AT THIS YEAR IN THE
BUSINESS SO YOU NEED TO HELP US.
FIGURE OUT IF THERE ACTUALLY ARE
TEND MADAM CHAIR I THINK.
BRINGING THIS FORWARD IN.
TO THOSE WHO HAVE. TESTIFIED.
I JUST HAVE A VERY BASIC
QUESTION HOW CAN THESE COMPANIES
OFFER PRODUCTS.
IT.
HAVE A MAXIMUM COVERAGE LIMITS
DON'T COVER PREVENTIVE CARE.
IN.
CAN NOT COVER YOU FOR PRE
EXISTING CONDITIONS IT'S NOT
CONSISTENT WITH LAWS WE'VE
PASSED IN IMPLEMENTING THE
AFFORDABLE CARE ACT. HOW IS THIS
NOT ILLEGAL?
WELL CURRENTLY RIGHT NOW THE
DEPARTMENT THE MHC DOESN'T ALLOW
IT THERE ARE A FEW PLANS WITHIN
CDI WHICH WERE PRE EXISTING
PLANTS PRIOR TO THE AFFORDABLE
CARE ACT. AND AS.
CDI COAST THROUGH THEM AND
FINDS THEM THEN THEY'LL EITHER
FIND OUT WHETHER OR NOT THEY'RE
ALLOWED TO BE SOLD IN HERE. BUT
AS YOU KNOW WITH THE CURRENT
PROPOSAL BY THE ADMINISTRATION
THE TRUMP ADMINISTRATION IS
TRYING TO OPEN IT UP TO WHAT WE
WOULD CALL THE JUNK INSURANCE.
AND A GUY AGAIN TO SENATOR ROSS
COMMENT.
WELL I THINK WHAT WE NEED TO DO
IS EMPHASIZE WHAT THOSE PATIENTS
ARE THAT DON'T HAVE ACCESS HOW
DO WE SOLVE THAT. BUT I THINK
THESE PRODUCTS WHAT THEY'RE
GONNA END UP DOING IF THEY'RE
ALLOWED TO CONTINUE BEING THE
MARKET. IS THERE GONNA ALLOW
INDIVIDUALS TO THINK THAT
THEY'RE BUYING INSURANCE. INDEX
IN BECAUSE IT'S A CHEAPER
PRODUCT AND THEREFORE IT'S GOING
TO UNDERMINE THE OVERALL PROCESS
SO THAT'S WHY I THINK WE NEED TO
TOTALLY. PUT IT IN STATUTE
ELIMINATED.
THANK YOU. MR AUTHOR THANK YOU
MADAM CHAIR AND LIKE TO MOVE THE
BILL AT THE APPROPRIATE TIME.
I DON'T WANT YOU TO TALK TO.
WELL MY MIKE.
PERFECT TIMING RAVE RIGHT
BEFORE THE DOCTOR SAYS
SOMETHING.
SO.
EXOTIC TO CLARIFY I UNDERSTAND
THE FEDERAL GUN THE TRUMP IN
THIS SITUATION BASICALLY.
.
IS TRYING TO PUSH SOME OF THESE
THINGS ARE BUT FUNDAMENTALLY I
THINK THE ISSUE IS NOT
NECESSARILY THE DURATION OF THE
PLAN BUT IT'S WHAT PROTECTIONS.
EITHER COM ART DON'T COME WITH
THAT SO I GUESS MY QUESTION IS
IS THAT I UNDERSTAND FEDERAL LAW
EXEMPTS.
SHORT TERM LIMIT DURATION PLANS
FOR THE DEFINITION. INDIVIDUAL
HEALTH INSURANCE HOWEVER.
TO TRY TO DRESS THE ISSUE THAT.
SARRAF BROUGHT OUT IS THERE A
WAY TO.
CHRIS REQUIRE ALL THE CONSUMER
PROTECTIONS WE FAST FOR HEALTH
INSURANCE WHILE STILL PERMITTING
SOMEONE TO HAVE A PLAN OF
REFERRED DURATION THAT CAN ACT
AS A STOPGAP FOR THE.
SMALL NUMBER PEOPLE WHO. MAY BE
IN THAT SITUATION I THINK THAT'S
I DON'T THINK ANYONE WANTS TO
SEE A JUNK HEALTH PLAN THAT
DOESN'T PROVIDE COVERAGE I MEAN
THAT UNDERMINES OUR WHOLE
INDIVIDUAL MARKET. HOWEVER IS IS
THAT FEDERAL LAW RE UPPED ALL
THE STATE LAWS IF WE PUT INTO IT
PROTECTIONS AND BASICALLY SAY NO
YOU CANNOT SELL HEALTH PLAN WITH
ALL THESE PROTECTIONS WHEN I GOT
WERE ABOUT THE DURATION AS MUCH
AS WE'RE GONNA TALK ABOUT.
PROTECTIONS REQUIRED. THAT THEY
DO THAT DUCK DEPEND THAT'S
EXACTLY WHAT NEW YRK AND NEW
JERSEY HAVE DONE IS TO SAY YOU
KNOW YOU CAN HAVE THE PLANS. BUT
THEY HAVE TO COMPLY WITH ALL THE
INDIVIDUAL MARKET RULES.
I THINK WHAT HAPPENS IS THAT IT
BECOMES A LITTLE BIT OF A
DEFECTOR BAND BECAUSE THE
PRODUCTS THEN WITH ALL THESE
PROTECTIONS BECOME MORE
EXPENSIVE.
AND YOU KNOW THE PREMIUMS RISE.
TO COVER ALL OF THOSE THINGS
AND SO I THINK THEY'RE THERE FOR
NOT OFFERED IN THOSE STATES AS
MUCH BUT IT'S DEFINITELY
SOMETHING THAT THE STATE COULD
DO. THAT'S ANOTHER WAY TO SHAPE
IT LET ME POSE A QUESTION THAT.
IN TERMS OF THIS PARTICULAR BILL
THE POLICY THE SHIN AND IT AND
PARDON ME IF I MISUNDERSTOOD THE
BELT LOOK I THINK THE BILL
BASICALLY BANDS.
PLANS ARE LESS THAN THREE
HUNDRED SIX THAT ONE YEAR RIGHT.
IS THERE A REASON WE DECIDE NOT
TO GO THE OTHER ROUTE SIMPLY
SAYING THAT I MEAN YOU MAY CALL
THE FACT A BAND BUT. ACTUALLY IT
STILL PROVIDES THE OPPORTUNITY
OF A HEALTH PLAN AS WELL AND
PROVIDE ALL THE PROTECTIONS THEY
WANNA SELL SHORT TERM PLAN. A
DECEPTIVE ALL THE PROTECTIONS
AND IT'S ACTUALLY A MARKET FOR
THAT THEY MAY END UP SELLING IT
OR NOT YOU KNOW BUT IT'S.
US UNDERSTAND OUR STAND YELLED.
WHY WE CHOSE THE ROUTE OF?
JUST SIMPLY SAYING YOU CAN'T
SELL A PLAN THAT'S LESS THAN A
YEAR THAN SAYING NO MATTER WHAT
PLAN YOU HAVE NO MATTER HOW LONG
IT HAS TO HAVE ALL THE
PROTECTIONS I. DON'T DEFER TO
THE AUTHOR ON THAT OKAY MANAGES
THE. THE POLICY THIS SITE
DECISION AND DISCUSSION THAT WE
DECIDE TO GO DOWN THAT ROUTE YOU
KNOW IF YOU WANT WE CAN CAN IS
CONVERSATION AFTER.
THANK YOU I HAVE A. FEW
QUESTIONS.
THIS HAS BEEN IN PLACE SINCE TWO
THOUSAND AND SIXTEEN UNDER THE
BOMB ADMINISTRATION.
SO SINCE TWO THOUSAND SIXTEEN
AND SEVENTEEN HOW MANY
INDIVIDUALS IN CALIFORNIA ROLE
IN THIS PLAN.
I DON'T HAVE THAT INFORMATION
MAY BELIEVE SOMEBODY FROM CD I
BELIEVE IT'S ONLY A DIZER DE.
OVER IN YOUR PLAN.
BECAUSE I. MIGHT AND THEN AND
I'M I'M I'M WHERE SENATOR ROSS'S
I JUST I MEAN I UNDERSTAND THE
BIGGER PICTURE OF POTENTIALLY.
THE INCREASE IN RATES ON THE
OTHER SIDE.
BUT YOU CAN HAVE THOSE IN THE
VISUAL WHO JUST LOST THEIR JOB.
AND WE ALL KNOW MEDICARE OUT YOU
CAN'T APPLY FOR MEDICAID WE JUST
RECENTLY HAD A JOB. YOU DON'T
QUALIFY FOR IT.
I DON'T WANT ANY OF THESE
FAMILIES THESE STUDENTS THESE
INDIVIDUALS TO LOSE HEALTH
COVERAGE FOR A MONTH OR TWO
BECAUSE WE'RE DOING AWAY WITH
COMPLETELY WHY CAN'T WE GO BACK
TO THE IMAM A BOMB
ADMINISTRATION. AND DO THE THREE
MONTHS MADE IF THE TROUBLE
MINISTRATIONS AS A YEAR THEN. WE
DON'T WANT THE YEAR THE LET'S GO
BACK TO THREE MONTHS THEN WHY WE
DOING AWAY COMPLETELY.
I'M HAPPY TO TO JUMP IN SENATOR
ON THAT I THINK THAT THAT THE
THREE MONTH PERIOD UNDER THE
OBAMA ADMINISTRATION WAS ALSO
UNDER. A VERY DIFFERENT
LANDSCAPE IN THE MARKET SO THERE
ARE A NUMBER OF THINGS THAT HAVE
CHANGED SINCE THEN MOST.
SIGNIFICANTLY THE INDIVIDUAL
MANDATE PENALTY WAS REMOVED AT
THE FEDERAL LEVEL SO EVEN THOUGH
THE THREE MONTH SHORT TERM
INSURANCE WAS PERMITTED UNDER
THE OBAMA ADMINISTRATION IT WAS
ALSO NOT MINIMUM ESSENTIAL
COVERAGE BECAUSE IT DOESN'T
HAVE.
ALL OF THESE CONSUMER
PROTECTIONS RIGHT SO EVEN IF YOU
BOUGHT THAT YOU WOULD STILL PAY
THE PENALTY SO THERE WAS REALLY
A DISINCENTIVE TO BUY THAT AND
AGAIN. TO ENCOURAGE PEOPLE TO
BUY THE RENEWABLE COMPREHENSIVE
PACKAGE AND BE IN THE RISK POOL
SO I THINK THE CHANGE NOW IS
THAT. WITHOUT THAT PENALTY
YOU'RE GOING TO ENCOURAGE PEOPLE
TO LEAVE THE INDIVIDUAL MARKET
TO BUY SOMETHING THAT SUB PAR
AND TO REALLY LEAVE THE FOLKS
WHO ARE LEFT IN THE INDIVIDUAL
MARKET SEEING HIGHER PREMIUM SO
WELL THE POLICY CHANGES HAVE
MADE THAT LESS OF AN OPTION.
YEAH BUT BUT I MEAN I I DISAGREE
BECAUSE. THE NEW POLICY HE
DRUMMER MINISTRATIONS ALLOW ONE
YEAR. THE BOMBER MENSURATION
ALONE THREE MONTHS SO THAT GIVES
PEOPLE LESS OF AN INCENTIVE
FIGHT.
BEGIN TO TO GET OUT OF YOUR LONG
TERM WHEN YOUR CONTRACT FOR YOUR
HEALTH INSURANCE.
MIGHT I MEAN THIS IS BIN WHAT
PART OF.
THE. ONE I WROTE DOWN SOME.
I MEAN.
WAS IN THIS PART OF THE NINETEEN
FORTIES PUBLIC HEALTH ACT TO
ALLOW THE SHORT TERM INSURANCE
WAY BACK WHEN IT HASN'T BEEN A
PROBLEM. I GUESS IS.
FOR US TO DO AWAY WITH A PROGRAM
THAT WE DON'T EVEN HAVE A CLUE
HOW MANY PEOPLE ARE IN THAT
PROGRAM.
IT DOESN'T. SHOULD WE ASK THAT
QUESTION FIRST IS SINCE FOR THE
THREE MONTH PERIOD THAT WAS
ALLOWED ON THE BOMB
ADMINISTRATION FOR ITS TWO
THOUSAND SIXTEEN AND TWO
THOUSAND SEVENTEEN HOW MANY
PEOPLE WERE ROLE IN THAT
PROGRAM.
AND WHAT CIRCUMSTANCES WAR THERE
WHERE THEY. FORCE THEM TO ROLL
IN THOSE FOLKS IN THAT PROGRAM.
IF WE'RE STILL ME. TO PEOPLE HEY
LET'S DO AWAY WITH IT I DON'T
CARE. IF YOU'RE TELLING ME A
HUNDRED THOUSAND. A MILLION I
DON'T KNOW BUT YOU DON'T EVEN
KNOW THE NUMBER TWO NOT YES OR
NO.
BECAUSE I'VE BEEN ASKING THE
QUESTION I WOULD DEFER TO THE
AUTHOR AND I BELIEVE THAT THEY
HAVE BEEN IN TOUCH WITH. THE
DEPARTMENT OF INSURANCE. TO GET
A BETTER ACCURATE NUMBER.
SO MY UNDERSTANDING IS MY STAFF
WAS TELLING I BELIEVE IT'S TWO
THOUSAND OF.
PLANS ARE IS THE PLANTS FROM
HOLLY POLICY THERE'S TWO
THOUSAND POLICIES ARE AVAILABLE
THERE IN THAT ARE RIGHT NOW IN
OUR CD I.
SO THAT IS AT TWO THOUSAND
INDIVIDUALS OR TWO THOUSAND.
POLICIES INDIVIDUAL TELEVISION
POLICIES THAT TOOK FORTY
THOUSAND SEVENTEEN OF TWO
THOUSAND THIRTEEN.
THAT WAS THE DATA. OF. AS.
SO APPARENTLY AT ONE TIME IT WAS
TEN THOUSAND NOW IT'S TWO
THOUSAND FOUR TWENTY EIGHTEEN.
OR TWENTY SEVENTEEN.
NOW IS THAT TWO THOUSAND FOR THE
ENTIRE YEAR.
OR IS IT TWO THOUSAND WANTS THEM
IS IT JUST FOR THE THREE MONTHS
AND THEN THEY WILL OUT. WHAT?
BURN ACTIVE POLICIES ARE
AVAILABLE RIGHT NOW. FOR THE
THREE MONTHS.
SO IT COULD.
RIGHT NOW.
OKAY SO IT COULD BE BEYOND TWO
THOUSAND FOR THE ENTIRE YEAR WHO
KNOWS BUT I THINK THEY'RE NOT
RENEWABLE THEY'RE NOT GUARANTEED
RENEWABLE EITHER SO THAT'S THE
OTHER THING IS THAT IF YOU BUY A
POLICY AND THEN YOU GET SICK.
THEY MIGHT NOT RENEW YOU IN SO
IT MIGHT BE A DIFFERENT A
DIFFERENT TWO THOUSAND OR
FIFTEEN HUNDRED THAT YOU KNOW TO
THE EXTENT THEY'RE STILL SELLING
THEM. THAT'S THE OTHER THING IS
THAT THERE IS ON THAT ACTIVE IN
THAT WE JUST ANSWER MY QUESTION
THOUGH. IF LET'S JUST SAY THE
TWO THOUSAND NEW PEOPLE.
THAT'S WHY THIS PLAYED ON OF
WORKS OF ART BUT BUT BUT BUT BUT
YOU JUST RESPONDED. I MEAN YOU
JUST SAID THAT IT COULD AND I'M
NOT SAYING THAT THIS IS. THE
SAME TWO THOUSAND LEVELS IN AND
NOW I'M SO YOU'RE JUST SAY
YOU'RE SAYING THAT. IT COULD BE
TWO THOUSAND NEW PEOPLE THAT'S
WHAT THE PROGRAMS FOR IS FOR
THOSE INDIVIDUALS WHO
DESPERATELY NEEDED FOR THE FEW
MONTHS.
I'M REALLY CONCERNED THAT WE ARE
I MEANIF IF WE DON'T WANT TO DO
WHAT THE TRIAL OF TRUMP
ADMINISTRATION I GET IT.
BUT LET'S PUT IT BACK IN GIVE
THE THREE MONTHS SO THAT THESE
INDIVIDUALS MEET. AT EITHER. MY
DISTRICT. NEEDS HEALTH
INSURANCE.
AND SOME HAS FULL TIME JOB. SOME
HAVE COVERAGE. SOME DON'T HAVE A
JOB. AND OR LOOK JUST LOST A JOB
I MEAN THERE ARE SO MANY PEOPLE
EVEN IF WE EVEN IF IT'S ONE
FAMILY.
I MEAN. AS A MOM I WOULD DO
WHATEVER IT TAKES TO GET MY KIDS
INTO COVERAGE.
THAT'S MY FIRST PRIORITY I'VE
GOT A SEVEN YEAR ONE OF FIVE USE
OF YOU SEE FIVE YEAR RUN AROUND
THIS BUILDING TODAY THAT'S
PROBABLY MIGHT.
BECAUSE HE'S IN THE BUILDING
TODAY.
BUT ON. BUT I THINK.
I I COMPLETELY UNDERSTAND.
BUT WE DON'T WANT TO DO WHAT THE
TRUMP ADMINISTRATION I DON'T
EITHER.
AND I UNDERSTAND THAT THIS CAN
FLUCTUATE THE PROBLEM WITH
POTENTIALLY. THE LONG AND THE
THE INCREASE AND AND HEALTH
COVERAGE FOR OUR COURAGE AND
PEOPLE. WE DON'T WANT TO
ENCOURAGE PEOPLE THEN LET'S GO
BACK TO THE THREE MONTHS WHAT A
BOMB ADMINISTRATION PUT IN.
BUT THE ACA. ON IT AND I THINK
BECAUSE I JUST DON'T WANT ANY
IMMEDIATE MOVE EVEN IF IT'S JUST
TWO THOUSAND FOR THE YEAR THAT'S
TWO THOUSAND FAMILY THAT THAT
WILL GET COVERAGE.
AND SO I. I'M I'M NOT ASKING FOR
ANOTHER RESPONSE AND WE CAN GO
BACK AND FORTH FOREVER.
AT THIS TIME I.
MISTER CHAIRMAN.
WOULD YOU LIKE OUR MONEY MORE
MONEY MOVE THE BILL READY. UP
WOULD YOU LIKE TO CLOSELY YES I
WOULD LIKE TO CLOSE SOME JUST
FOLLOW UP ON A COMMENT YOU SAID
THAT YOUR CONSTITUENTS THAT THEY
NEED INSURANCE.
I DON'T DISAGREE.
WE NEED INSURANCE LET ME FIRST
OF ALL TELL YOU WHAT WE HAVE
DONE IN CALIFORNIA. WE'VE BEEN
EXTREMELY SUCCESSFUL WITH THE
AFFORDABLE CARE ACT.
ONE THIRD OF THE POPULATION IS
UNDER MEDICARE HOME. WE HAVE
MORE PEOPLE SIGNING UP FOR
COVERED CALIFORNIA. WE HAVE
EXCEEDED EXPECTATIONS AND WE
HAVE A SEVEN POINT THREE
UNINSURED RATE.
WHAT THIS DOES THIS IS
ESSENTIALLY JUNK INSURANCE?
AND IT GIVES CONSUMERS YOUR
CONSUMERS CENTER WHEN. A FALSE
HOPE AND FALSE SENSE OF
INSURANCE.
I'M GONNA JUST READ TO JUST
THREE EXAMPLES.
OF INDIVIDUALS WHO BOUGHT THIS
KIND OF INSURANCE.
MILAN A WOMAN WITH SHORT TERM
PLAN WAS DIAGNOSED WITH CANCER
AND WAS LEFT WITH FOUR HUNDRED
THOUSAND DOLLARS THE MEDICAL
BILL DON'T THINK YOU WANT THAT
FOR YOUR CONSTITUENTS.
WE HAVE A SAN ANTONIO MANPREET
PREMIUMS WAS AT NIGHT COVERAGE
WE HAD DEVELOPED KIDNEY DISEASE.
SAN FRANCISCO WOMAN WAS HIT WITH
A HUNDRED FIFTY THOUSAND DOLLAR
CHARGE. AFTER SHORT TERM HEALTH
PLAN REFUSE TO COVER IT.
HERE YOU HAVE PLANS THAT.
THE NIGHT BECAUSE OF PRE
EXISTING CONDITIONS.
THEY HAVE WAITING PERIODS AND
YES WE HEARD FROM THE OPPOSITION
THAT THEY WANT TO BE ABLE TO.
GET INDIVIDUALS WITH COBRA
STUDENTS INDIVIDUALS WHO'VE LOST
THEIR JOBS AND ARE NO LONGER
WILL GUESS WHAT WE HAVE WHAT'S
CALLED SPECIAL ROMAN WE ARE
DOING EVERYTHING WE POSSIBLY CAN
TO GET ALL OF OUR CONSTITUENTS
INSURED.
THAT'S WHY WE HAVE TO MAKE SURE
THAT PRODUCTS LIKE THIS AREN'T
AVAILABLE HERE IN THE STATE OF
CALIFORNIA AND WITH THAT MEMBERS
I RESPECTFULLY ASK FOR AN ABLE.
AND THE FINANCES ARE IN AND AS I
WENT.
WHATEVER. LEVEL I MITCHELL.
MITCHELL I MOANING HEY. MOANING
I'D NEWMAN. NEWMAN I NIELSEN.
PEN PEN I ROTH ROTH I.
SEVEN TO.
SEVEN ZERO SEVEN ZERO OF WILL
CLOSE EVERYBODY'S HEARING.
THAT BILL.
DO PASS TO APPROPRIATION.
OKAY WE'RE GONNA GO IN AND
GO-BACK AND WE'RE GONNA LIFT THE
CALLS ITEM NUMBER ONE SP NINE
ZERO.
SIX.
CALL THE ABSENT MEMBERS PLEASE
LABOR.
LABOR DAY MITCHELL. MITCHELL BY.
GREAT ITEM THAT HAS NINE TO ZERO
THAT BILL IS OUT. FOR IT ITEM
NUMBER THREE THE CONSENT
CALENDAR SP NINE NINE SEVEN CALL
THE ABSENT MEMBERS LLEVA. LABOR
I MITCHELL MITCHELL I.
NINE ZERO THAT BILL IS OUT.
WEIRD ITEM NUMBER FOUR SP ONE
ZERO ONE NINE THEY'LL CALL THE
ABSENT MEMBERS FLAVOR.
I'M MITCHELL MITCHELL I.
THAT VOTE COUNT IS NINE ZERO
THAT BILL IS OUT. ITEM NUMBER
FIVE EIGHTY FOUR ONE SEVENTY MON
CALL THE ABSENT MEMBERS. LABOR.
LABOR I MITCHELL MITCHELL I.
THAT'S NINE ZERO THAT BILL IS
OUT.
THAT CONCLUDES THE.
BUSINESS FOR TODAY FOR THE
SENATE HEALTH COMMITTEE WE ARE
GOING TO ADJOURN. WE ARE NOW
GOING TO MOVE ON. TO THE SENATE
HEALTH COMMITTEE THE JOINT
INFORMATIONAL HEARING. SENATE
HEALTH AND EDUCATION.
AND THIS IS OUR REGARD TO HEALTH
COVERAGE AND ACCESS TO CARE FOR
COLLEGE STUDENTS TODAY'S
WEDNESDAY MARCH FOURTEENTH
TWENTY EIGHTEEN. ALIKE TO FIRST
OF ALL THANK MIKE.
COLLEAGUE AND SENATOR TO MY
RIGHTS.
SENATOR ALAN.
I'M GOING TO NOT MAKE ANY
OPENING SATEMENTS I'M ABOUT
READY TO LOSE MY VOICE I'M GONNA
TURN IT OVER TO SENATOR ALAN C.
LIKE TO MAKE ANY OPENING
COMMENTS. TO YOU SO MUCH FOR
SHARING IDEAS APPRECIATE. THE
OPPORTUNITY FOR US TO SIT DOWN
TOGETHER HEALTH POLICY HEALTH
POLICY IN EDUCATION POLICY
COMMITTEES. TO TALK ABOUT HEALTH
INSURANCE COVERAGE AND ACCESS TO
CARE FOR OUR COLLEGE STUDENTS.
I'VE HAD THE CHANCE AS CHAIR OF
EDUCATION AND ALSO SERVING ON.
THAT'S FAIRLY INTERESTING
COMMITTEE RELATING TO THE FUTURE
THE MASTER PLAN. OVER IN THE
ASSEMBLY SIDE TO ADD TO TO SPEND
SOME SERIOUS TIME LOOKING AT.
THE EXTENT TO WHICH. A LOT OF
OUTSIDE FACTORS IMPACT STUDENTS
ABILITY TO LEARN.
AND THERE'S NO QUESTION THAT
THERE IS TO HEALTH CARE
RESULTING UNMET HEALTHCARE NEEDS
FOR COLLEGE STUDENTS. WHICH THEN
IMPACTS GOOD MENTAL AND PHYSICAL
HEALTH WHICH IS OF COURSE
FUNDAMENTAL TO ACADEMIC SUCCESS
AND SO. WE'RE REALLY JUST IN
HEARING TODAY FROM PANEL
EXPERTS.
FROM OUR PUBLIC UNIVERSITIES
TODAY WE'LL TALK TO US ABOUT.
THE SCOPE OF THE PROBLEM HOW
BEST TO MEET THE UNIQUE NEEDS OF
OUR STUDENT POPULATION WHEN IT
COMES TO ACCESSING CARE.
AND DIVE I'M CERTAINLY HOPEFUL
THAT WE'LL WE'LL GET SOME SOME
INSIGHTS THAT WILL HELP US WITH
OUR POLICY DECISIONS. IN BOTH OF
OUR COMMITTEES MOVE FORWARD SO
THANK YOU MISTER CHAIR FOR THIS
OPPORTUNITY.
THANK YOU WE'RE GOING TO GO NOW
MOVE ON TO ITEM NUMBER TWO
CORPORATE OVERVIEW OF COLLEGE
STUDENTS COVERAGE ARRANGEMENTS
AND WE HAVE NEVER KELCH.
EXECUTIVE DIRECTOR OF INSURE THE
UNINSURED PROJECT.
GOOD AFTERNOON TEARS OF THE
COMMITTEES AND THE MEMBERS ABOUT
DEBORAH CELTS. INSURE THE
UNINSURED PROJECT THANKS FOR
INVITING US HERE TODAY.
AS THE CHAIRMAN SAID MY JOB
TODAY IS JUST PROVIDE KIND OF A
FOUNDATION FOR THE CONVERSATION
ARE GONNA BE HAVING.
.
SO INSURE THE UNINSURED PROJECT
IS A NON PARTISAN INDEPENDENT
ORGANIZATION.
IN EXISTENCE FOR MORE THAN
TWENTY YEARS AND WE WORK TO
PROMOTE INNOVATIVE AND WORKABLE
POLICY SOLUTIONS THAT EXPAND
HEALTHCARE ACCESS AND IMPROVE
THE HEALTH OF CALIFORNIANS WE DO
THIS THROUGH POLICY FOCUS
RESEARCH AND BROAD BASED
STAKEHOLDER ENGAGEMENT. OUR
VISION IS THAT ALL CALIFORNIANS
WILL HAVE THE RESOURCES THEY
NEED TO PRESERVE AND IMPROVE
HEALTH. WE SEEK A HEALTHCARE
SYSTEM THAT IS UNIVERSAL
ACCESSIBLE AFFORDABLE EFFECTIVE
AN EQUITABLE.
TODAY WHAT I'D LIKE TO DO. IS TO
PROVIDE AN OVERVIEW OF.
COVERAGE AND AND COVERAGE
OPTIONS FOR COLLEGE AGE ADULTS
IN CALIFORNIA.
HI LIKE CALIFORNIA'S PROGRESS
WITH COVERAGE FOR YOUNG ADULTS
UNDER THE AFFORDABLE CARE ACT.
AND THEN HIGHLIGHT SOME OF THE
POTENTIAL ISSUES. AFFECTING
ACCESS TO HEALTHCARE FOR COLLEGE
STUDENTS WHEN THEY ARE AWAY FROM
HOME.
SO JUST A FEW CUT KEY CONCEPTS
AS WE TALK ABOUT COVERAGE. OF
EMPLOYER SPONSORED INSURANCE
COVERAGE THAT'S OBTAINED THROUGH
AN EMPLOYER YOUNG ADULTS MAY BE
COVERED EITHER AS THE EMPLOYER
IS THE DEPENDENT OF. UP TO AGE
TWENTY SIX ON A PARENT OR
GUARDIAN'S PLAN.
DEPENDENT COVERAGE IS COVERAGE
FOR QUALIFIED DEPENDENCE OF THE
PRIMARY SUBSCRIBER POLICY OVER
LIKE A CHILD OR A SPOUSE. THE
INDIVIDUAL MANDATE WHICH IS
CURRENT LAW IS THE LEGAL
REQUIREMENT FOR AN INDIVIDUAL TO
MAINTAIN A MINIMUM LEVEL OF
HEALTH COVERAGE. AS.
FOR THEMSELVES AND THEIR
DEPENDENTS A PENALTY MAY APPLY
FOR FAILURE TO COMPLY BUT AS WE
SPEAK THE.
AND THE CONGRESS HAS ELIMINATED
THE PENALTY FOR THE INDIVIDUAL
MANDATE UNDER THE AFFORDABLE
CARE ACT STARTING IN TWENTY
EIGHTEEN.
SO WHAT ARE THE COVERAGE OPTIONS
FOR STUDENTS WHEN THEY ARE AT
COLLEGE.
STUDENTS CAN HAVE DEPENDENT
COVERAGE AS I DESCRIBED. THROUGH
THEIR FAITH IN A PARENT OR AN
INVENTOR INDIVIDUAL FAMILY PLAN.
THEY CAN HAVE INDIVIDUAL
COVERAGE ON DIRECTLY THROUGH
COVER CALIFORNIA. THEY'RE
ELIGIBLE TO PURCHASE IT.
AND MAY BE ELIGIBLE FOR
SUBSIDIES AND THEY CAN ALSO
PURCHASE COVERAGE IN THE NON
EXCHANGE INDIVIDUAL MARKET. THEY
ALSO MAY BE A LOW INCOME LEGAL
RESIDENT STUDENTS MAY BE
ELIGIBLE FOR MEDICARE NOW.
UNDOCUMENTED ADULTS ARE NOT
ELIGIBLE FOR FULL SCOPE MEDICARE
WOULD DO YOU HAVE ACCESS TO
EMERGENCY AND PREGNANCY MEDIC
HOUSE. AND FINALLY STUDENTS CAN
PURCHASE A STUDENT HEALTH
INSURANCE PLAN WHICH WOULD BE
COVERAGE THAT'S OFFERED BY THE
UNIVERSITY OR COLLEGE THE
STUDENT ATTENDS.
SO LOOKING HERE NOW JUST A YOUNG
ADULTS THIS IS NOT LIMITED TO
STUDENTS BUT WE SEE. THAT REALLY
THE PROFILE OF. YOUNG ADULTS
NINETEEN TO TWENTY FIVE IN TERMS
OF WHERE THEY GET THEIR
COVERAGE.
AS IS TRUE FOR MOST
CALIFORNIANS THE MAJORITY GET
THEIR COVERAGE TO SOME FORM OF
EMPLOYER SPONSORED CARE
COVERAGE.
WE HAVE.
STUDENTS IN MEDICARE OUT WE
HAVE APPROXIMATELY THIRTY
PERCENT UNINSURED.
AND PRIVATELY PURCHASED AND
OTHER PUBLIC.
SO IN TERMS OF THE DEPENDENT
COVERAGE OPTION WHAT ARE SOME OF
THE THINGS UNDER THE AFFORDABLE
CARE ACT THAT A FACT DEPENDENT
COVERAGE. SO THE FIRST IS THAT
THE AFFORDABLE CARE ACT CHANGE
THE RULES AND REQUIRED HEALTH
PLANS TO COVER. A DEPENDENT ON A
FAMILY PLAN UP TO AGE TWENTY SIX
PRIOR TO THAT HEALTH PLANS AT
THEIR OWN WHAT WAS AT THAT TIME
CALLED LIMITING AGE SO IT COULD
BE TWENTY ONE IT COULD BE TWENTY
THREE. AND NOW IT'S CONSISTENTLY
TWENTY SIX. AND THIS IS
IMPORTANT THE ROBERT WOOD
JOHNSON FOUNDATION ESTIMATES
THAT BECAUSE OF THAT PARTICULAR
PROVISION. THE UNINSURED RATE
FOR YOUNG ADULTS DECREASED BY
FOUR POINT FIVE PERCENT
NATIONWIDE IN THE VERY FIRST
YEAR OF ACA IMPLEMENTATION.
THE OTHER RELEVANT PROVISION IS
THE EMPLOYER MANDATE.
THIS IS A REQUIREMENT THAT
EMPLOYERS OF FIFTY PLUS
EMPLOYEES MUST EXTEND GROUP
HEALTH COVERAGE TO EMPLOYEES AND
THEIR DEPENDENTS UP TO AGE
TWENTY SIX OR PAY A TAX PENALTY.
AND FINALLY THE INDIVIDUAL
MANDATE IN WHICH INDIVIDUALS
MUST MAINTAIN COVERAGE FOR
DEPENDENTS.
OR PAY OR PAY A PENALTY.
WHICH ENDS IN TWENTY NINETEEN.
SO WHAT ARE SOME OF THE
PROVISIONS THAT AFFECT THE LOW
INCOME STUDENTS.
SO WE EXPANDED IN CALIFORNIA
UNDER THE AFFORDABLE CARE ACT WE
EXPANDED MEDICAID ELIGIBILITY.
HE DIDN'T HOUSE FEDERAL FUNDING
TO DO SO FOR LOW INCOME
CHILDLESS ADULTS.
AND INDIVIDUALS WITH INCOMES OF
UP TO TWO. HUNDRED THIRTY EIGHT
PERCENT OF THE FEDERAL POVERTY
LEVEL.
ARE NOW ELIGIBLE IF THEY ARE
LEGAL RESIDENTS OF THE STATE.
IN ADDITION THE AFFORDABLE CARE
ACT PROVIDES PREMIUM SUBSIDIES
FOR LOW INCOME PEOPLE UP TO FOUR
HUNDRED PERCENT OF THE FEDERAL
POVERTY.
AN INDIVIDUAL COVERAGE THROUGH
THE AFFORDABLE CARE ACT EXCHANGE
COVER CALIFORNIA. AND THE TAX
CREDITS CAN REDUCE A PERSON'S
MONTHLY PREMIUM AND THE COST
SHARING DATA RE SUBSIDIES
AVAILABLE HELP THEM TO. REDUCE
THE COSTS OF OUT OF POCKET
COSTS.
SO WHAT ARE THE SPECIFIC
PROVISIONS OF THE AFFORDABLE
CARE ACT AFFECTING STUDENT
HEALTH INSURANCE.
SO THE DEFINITION OF STUDENT
HEALTH INSURANCE IN FEDERAL RAGS
REGULATIONS IS. THAT IT IS
COVERED OFFERED BY INSTITUTIONS
OF HIGHER LEARNING.
IT IS LIMITED TO ENROLLED
STUDENTS.
THEY MUST ACCEPT ALL STUDENTS
REGARDLESS OF HEALTH STATUS.
AND THEY MUST MEET ANY
ADDITIONAL REQUIREMENTS IMPOSED
IN STATE LAW. EXCUSE ME SET TIME
YEAR LOW BUT ALLERGIES EXCUSE
ME.
STUDENT HEALTH INSURANCE IS
CONSIDERED UNDER THE LAW TO BE
INDIVIDUAL COVERAGE.
IT IS SUBJECT TO SOME BUT NOT
ALL OF THE PROVISIONS OF THE ACA
SO FOR EXAMPLE WHAT THEY HAVE TO
GUARANTEE ISSUE AND CAN'T TERM
STUDENTS DOWN BECAUSE OF HEALTH
STATUS. THEY DON'T HAVE TO OFFER
ALL THE MULTIPLE LEVELS OF
COVERAGE THAT WE'RE FAMILIAR
WITH IN THE EXCHANGE BRONZE
SILVER GOLD THEY CAN JUST HAVE
ONE POP ON ONE LEVEL OF COVERAGE
FOR STUDENTS AT THE UNIVERSITY.
SO.
.
THIS SIDE THIS SLIDE SHOWS A
REALLY DRAMATIC IMPROVEMENT IN
THE COVERAGE OF YOUNG ADULTS
UNDER THE AFFORDABLE CARE ACT
THROUGH ALL THE PROVISIONS IN IN
PLAYER SPONSORED MEDICARE ON
INDIVIDUAL COVERAGE.
AND WHAT WE SAW AND THIS IS
REALLY I LOVE THESE.
CHARTS THAT WE GET TO PUT UP
THESE DAYS WHERE WE REALLY SEE
THAT DRAMATIC. CHANGE IN THE
NUMBER OF UNINSURED.
GRADUATE AND UNDERGRADUATE
STUDENTS DROPPING FROM TWENTY
FOUR POINT SIX TO SEVEN POINT
SEVEN AS A RESULT OF THE
AFFORDABLE CARE ACT. SO I WAS
ALSO ASKED TO TALK A LITTLE BIT
ABOUT THE COVERAGE MODELS
BECAUSE IT'S REALLY THE NATURE
OF THE COVERAGE THAT BEGINS TO
CREATE ISSUES FOR STUDENTS WHEN
THEY'RE AWAY FROM HOME. SO THEY.
HEALTH PLAN NETWORKS ARE THE
CONTRACTED PROVIDERS DOCTORS
HOSPITALS AND OTHER HEALTH
PROVIDERS.
IN A SPECIFIC HEALTH PLAN THE
SERVICE AREA IS ARE GOING TO BE
THE GEOGRAPHIC REGIONS TYPICALLY
DEFINED BY ZIP CODE WHERE HEALTH
PLAN OFFERS AND PROVIDES
COVERAGE. AND THEN STATE AND
FEDERAL REQUIREMENTS ENSURE
THAT-THAN ADEQUATE THE NETWORKS
THAT
HEALTH PLANS OFFER ARE ADEQUATE
TO PROVIDE SERVICES. SO JUST
GOING OVER. THE BASIC TYPES OF
HEALTH PLAN HEALTH MAINTENANCE
ORGANIZATIONS. HAVE CONTRACTED
NETWORKS AND LIMIT SERVICES TO
THOSE NETWORKS EXCEPT IN
EMERGENCY OR URGENT CARE. THEY
MAY AND OFTEN DO PAY PROVIDERS
ON A FIXED FLAT MONTHLY FEE. BUT
THEY CAN ALSO PAY DISCOUNTED FEE
FOR SERVICE RATES. BUT HERE IN
THE HMO MODEL TYPICALLY THE
PRIMARY CARE PHYSICIAN PLAYS A
VERY KEY ROLE IN COORDINATING
CARE AND SERVICES AND REFERRALS.
THOSE PLANTS ARE LICENSED BY THE
DEPARTMENT HEALTHCARE.
PREFERRED PROVIDER ORGANIZATIONS
ALSO HAVE A CONTRACTED NETWORK
OF WHAT.
HAVE BEEN CALLED PREFERRED
PROVIDERS BUT INDIVIDUALS
INJURED IN A PPO PLAN CAN ALSO
GET COVERAGE OUTSIDE OF THAT
NETWORK BUT THEY. PAY HIGHER
COSTS OUT OF THEIR OWN POCKET.
MOST PPL AS PLAY A DISCOUNTED
FEE FOR SERVICE RATE TO
PROVIDERS. AND TYPICALLY PRIMARY
CARE PHYSICIANS DO NOT PLAY THE
SAME COORDINATING OR FROM
MANAGEMENT ROLE. THERE ARE PPL
IS LICENSED BY BOTH THE
DEPARTMENTAL CARE AND THE
DEPARTMENT OF INSURANCE.
EXCLUSIVE PROVIDER ORGANIZATIONS
ARE PRETTY NEW BUT THEY'RE
POPPING UP IN THEIRS OFFERING IN
THE EXCHANGE THEY'RE A LITTLE
BIT OF A HYBRID BETWEEN A TWO
MILES IN PPO. SO THERE IS A
CONTRACTED NETWORK SERVICES ARE
LIMITED TO THE CONTRACTED NET
FOR NETWORK EXCEPT IN
EMERGENCIES.
THEY PAY PROVIDERS A DISCOUNTED
FEE FOR SCADS OF FEE FOR SERVICE
RATE.
AND IN GENERAL PRIMARY CARE
PHYSICIANS DO NOT.
HAVE TO APPROVE SPECIALTY
REFERRALS BUT THEY TYPICALLY
HAVE. MORE PRIOR AUTHORIZATIONS
THEN YOU MIGHT FIND IN EITHER AN
HMO OR PPO.
SO IN MEDICARE WE HAVE FOUR
MODELS OF COVERAGE ND I KNOW
MANY OF YOU COULD GIVE THIS
PRESENTATION.
AS A STARTING POINT FOR YOUR
DISCUSSION THOUGH WE HAVE THE
TWO PLAN MODEL IN COUNTIES AND
IT'S IMPORTANT TO NOTE THAT THE
WHOLE MEDI CAL MANAGED CARE
MODEL IN GENERAL. IS A COUNTY
BASED MODEL IN THAT THERE ARE
DIFFERENT PLANS IN DIFFERENT
COUNTIES. APPROXIMATELY EIGHTY
ONE PERCENT OF THE THIRTEEN
POINT FIVE MILLION MEDICARE
BENEFICIARIES ARE ENROLLED IN
MANAGED CARE. SO WE HAVE THE TWO
PLAN MODEL COUNTIES WHERE THERE
IS A LOCAL INITIATIVE.
.
AT PUBLIC PLAN AND A COMMERCIAL
HEALTH PLAN CHOICE. I'M COUNTY
ORGANIZED HEALTH SYSTEMS.
MY PUBLIC PLANS THAT SERVE ALL
THE MEDICARE OUT ENROLLEES IN
THE COUNTY.
IN GEOGRAPHIC MANAGED CARE
SEGMENT ON SAN DIEGO COUNTIES
THERE'S MULTIPLE COMMERCIAL
PLANS. AND IN OTHER COUNTIES IN
REGIONS AND COUNTY SPECIFIC
PLANS TO APPROXIMATELY TWENTY
WORLD COUNTIES THERE'S TYPICALLY
ONE CHOICE A CHOICE OF TWO
COMMERCIAL HEALTH PLANS. EXCEPT
FOR IN SAM AND YOU KNOW WHERE
THERE'S ONE COMMERCIAL PLAN OR
THE OPTION OF V. FOR SERVICE.
SO HE SAT FLOOR TALKING ABOUT
STUDENT HEALTH PLANS SOME KEY
CONCEPTS A STUDENT HEALTH
INSURANCE PLAN IS PROVIDED BY
COAT COLLEGES AND UNIVERSITIES.
OF FULLY INSURED STUDENT HEALTH
PLAN IS WHERE THE PLAN IS
PURCHASED BY THE COLLEGE OR
UNIVERSITY FROM A LICENSE OR
CERTIFICATE HEALTH INSURANCE
COMPANY. A SELF INSURED PLAN
THE.
THE UNIVERSITY MAY HIRE.
A THIRD PARTY ADMINISTRATOR OR
HEALTH PLAN TO PAY. PAY CLAIMS
CONTRACT WITH PROVIDERS BUT THE
UNIVERSITY AND COLLEGE MAINTAINS
THE RESPONSIBILITY TO PAY THE
CLAIMS.
SO SOON IN HEALTH PLANS IN
CALIFORNIA ARE REGULATED BY THE
CALIFORNIA DEPARTMENT OF
INSURANCE AS A BLANKET POLICIES.
FULLY INSURED.
STUDENT HEALTH PLANS MUST COVER
ESSENTIAL HEALTH BENEFITS AND
MEET. MOST BUT NOT ALL OF THE.
PROVISIONS OF THE ACA HOWEVER
SELF INSURE STUDENT HEALTH PLANS
DO NOT HAVE TO MEET THE MINIMUM.
IF IT REQUIREMENTS THEY JUST
HAVE TO. OFFER AT LEAST A SIXTY
PERCENT.
ACTUARIAL VALUE.
COLLEGES AND UNIVERSITIES OFTEN
REQUIRE TYPICALLY REQUIRE
STUDENTS TO PAY FOR THE STUDENT
HEALTH INSURANCE UNLESS THEY OPT
OUT. AND OFTEN THE ABILITY TO
OFF OUT IS DEPENDENT ON BEING
ABLE TO DEMONSTRATE THAT THE
STUDENT HAS SOME OTHER FORM OF
COVERAGE.
THE STUDENT HEALTH INSURANCE MAY
COORDINATE WITH STUDENT HEALTH
CENTERS. ON ON CAMPUS MORE
EASILY THAN THEY WOULD FOR
EXAMPLE WAS A MEDIC CAL. OR
PRIVATE HEALTH INSURANCE.
AND ACTUALLY HAVE A STUDENT A
TWENTY THREE YEAR OLD WHO'S BEEN
ON GOING TO COLLEGE NOW WORKING
ON A MASTER'S AT THE STUDENT
HEALTH CENTER IS COMPLETELY
SEAMLESS I MEAN SHE JUST GOES
THERE SHE DOESN'T KNOW WHO'S
WHAT. WORDS WHERE THE.
COVERAGE IS COMING FROM.
.
AND MOST STUDENT HEALTH AND SENT
US A CENTERS DON'T ACCEPT
MEDICARE OR PRIVATE INSURANCE.
SO WHAT HAPPENS WHEN A STUDENT
IS ON MEDICARE NOW AND NOW
THEY'RE AWAY AT SCHOOL.
MEDIC HOW CONTINUES TO COVER
THEM WHEREVER THEY ARE IN THE
STATE.
HOWEVER BECAUSE OF OUR COUNTY
BASED MODEL MOST STUDENTS WOULD
BE ENROLLED IN A MANAGED CARE
PLAN IN THE COUNTY OF THEIR.
THEIR HOME REGION. AND THEY
WOULD NEED TO TRANSFER TO THE
HEALTH PLAN IN THE NEW. AREA
WHERE THEY LIVE OTHERWISE THEY
WOULD BE AT RISK OF ACCESSING
PROVIDERS WERE NOT CONTRACTED
AND NOT HAVING ANY KIND OF
COVERAGE AT ALL OR PAYING HIGHER
OUT OF POCKET OR OUT OF NETWORK
RATES.
.
AND THEY WOULD ONLY BE ELIGIBLE
FOR SAY EMERGENCY AND URGENT
CARE.
SO WHAT HAPPENS TO THAT STUDENT
AND ON THEIR PARENTS PLAN WHEN
THEY GO AWAY TO SCHOOL.
SO THEY CAN BE COVERED BUT AGAIN
MOST INSURANCE AND MOST EMPLOYER
PLANS WHETHER THEY'RE FULLY
INSURED ARE SELF INSURED
EMPLOYER PLANS THEY ALSO HAVE
THESE NETWORKS OF HMOS PPO SIR
EPS. SO THE SAME PROBLEM EMERGES
FOR THE STUDENT WHEN THEY GO
AWAY FROM HOME. IF THE PLAN
THEY'RE IN DOESN'T HAVE A
NETWORK. OF CONTRACTED PROVIDERS
IN THE NEW LOCATION THERE YOU
KNOW FUNDAMENTALLY OUT OF
NETWORK RIGHT AWAY AND IF THEY
DON'T. FIND COVERAGE IN THE
REGION THEY'RE SUBJECT TO ONLY
BEING COVERED FOR EMERGENCIES
AND.
.
URGENT CARE.
SO IN SUMMARY COLLEGE AGE YOUNG
ADULTS HAVE MORE COVERAGE
OPTIONS THEM BEFORE THE ACA
REALLY GOOD EXCITING NEWS. AND
THE NUMBER OF UNINSURED YOUNG
ADULTS HAS DECLINED STEADILY.
STUDENT HEALTH INSURANCE OFFERED
BY COLLEGES AND UNIVERSITIES ARE
ONE OF THE OPTIONS BUT THEY VARY
IT BY TYPE AND LEVEL OF
COVERAGE.
STUDENTS WITH EXISTING COVERAGE
MAY LOSE ACCESS TO NON EMERGENCY
BENEFITS IF THEIR HEALTH PLAN
DOES NOT OFFER NETWORK COVERAGE
NEAR THE COLLEGE LOCATION.
STUDENT HOW CENTERS MAY NOT
ACCEPT MEDIC HOW ARE PRIVATE
HEALTH INSURANCE.
AND SO FOR.
OUR BOTTOM LINE TODAY WE KNOW
THAT STUDENTS MAY END UP HAVING
DUPLICATE COVERAGE AND COST. TO
ENSURE ADEQUATE ACCESS TO CARE
BOTH AT SCHOOL AND WHEN THEY'RE
AT HOME DURING BREAKS WHICH CAN
BE AN ESPECIALLY DIFFICULT
CHALLENGE FOR STUDENTS WITH
CHRONIC HEALTH CONDITIONS AND
ONGOING CARE NEEDS. ON WITH THAT
ID HAVE TO ANSWER ANY QUESTIONS
THAT THE COMMITTEE MIGHT HAPPEN
IS THERE ANY QUESTIONS FROM ANY
THE MEMBER CENTER PANNED.
THERE YOU ARE.
THAT ONE WORKS.
SO THANK YOU SO MUCH FOR YOUR
PRESENTATION FROM. IT.
SO I THINK YOU KNOW I REALLY
APPRECIATE YOU BRING UP THE
ISSUE OF.
STUDENTS TO IN TERMS OF THE
NETWORKS ESPECIALLY STUDENT
CHRONIC CONDITIONS I MEAN I
THINK THE ASSUMPTION IS IS
USUALLY IS IS THAT MOST PEOPLE
OF COLLEGE AGE ARE. FAIRLY
HEALTHY AND THEY DON'T HAVE MANY
HEALTH NEEDS BUT WE KNOW THAT.
IS.
CHANGING THE GOOD NEWS IS THAT.
.
THANKS TO ADVANCES IN MEDICAL
SCIENCE A MORE PEOPLE MORE
CHILDREN WHO'VE MADE HAD
DISEASES WHICH ARE CONDITIONS
WHICH MAY HAVE LED THEM TO HAVE.
EITHER DIRE OR NOT BE ABLE TO.
ADULT AS WELL AS OUR ACTUALLY
GET YOU KNOW ENTERING COLLEGE
AND AND SUCCEEDING AND AND AND
DOING SO FORTH REALLY GONE YEAH
THE OTHER THING IS THOUGH ALSO
THERE ARE SOME YOUNG PEOPLE MAY
ACTUALLY. COME DOWN WITH YOUR
CITIES LIKE CANCER.
ACTUALLY I DID A BILL OF
SEVERAL YEARS AGO WHICH IS
FOURTEEN THAT MAKE IT OUT WHICH
SAID THAT.
THIS.
THE SCHOOL BASED HEALTH PLANS.
SO THERE'S ACTUALLY A GAP IN THE
ACA WHERE BASICALLY.
SCHOOL BASED HEALTH PLANS.
I GUESS THE SELF INSURED ONCE I
DON'T HAVE THE CAN HAVE LIFETIME
LIMITS. AND SO WE'VE HAD CASES
OF UP. OF A COLLEGE STUDENTS TO
DEVELOP CANCER DIAGNOSIS CANCER
AND.
THE RISK OF RUNNING OTHER
BENEFITS.
THE OTHER ISSUES IF YOU DO COME
DOWN WITH A CONDITION LIKE
CANCER OR SOMETHING ELSE. AND.
YOU HOW HOW DOES THE HEALTH
INSURANCE THAT THAT YOU
PURCHASED THROUGH THE SCHOOL
BECAUSE THAT WAS THE OPTION YOU
HAD YOU KNOW YOU HAVE A PARENT
WHO PATCH ON THE TWENTY SIX IS
THAT RIGHT.
WHAT HAPPENS WHEN YOU'RE NO
LONGER RULED IN SCHOOL BECAUSE
YOU'RE TOO SICK STAY IN OLD
SCHOOL?
DENNIS YOU THEN SO THAT REALLY
IS KIND OF THAT I THINK WHERE
THE ATTENTION MIGHT NEED TO BE
IS ON THESE TRANSITIONS SO GOING
TO SCHOOL COMING BACK IN FOR
SUMMER OR FOR THAT AN EXTENT YOU
KNOW THE. THE UC HAS A PRETTY
EXTENDED PERIOD BETWEEN QUARTERS
AND ON DECEMBER JANUARY I MEAN
THERE ARE TIMES WHEN THESTUDENTS
ARE. SORT OF BACK AND
FORTH AND IN YOUR TO YOUR POINT
ONE OF MY DAUGHTERS CLOSE
FRIENDS AND UP IN TREATMENT FOR
CANCER SO IT'S IT'S BUSH IS FOR
SURE A REAL ISSUE AND ALSO.
THINKING ABOUT PEOPLE WITH
CHRONIC CONDITIONS.
OR MENTAL HEALTH ISSUES THAT
THEY'RE IN TREATMENT THEY'RE
DOING OKAY BUT THEY REALLY NEED
ACCESS TO THEIR ONGOING CARE. SO
IT IS A REAL ISSUE AND THE THE
STUDENT HEALTH INSURANCE CAN
WORK I THINK FOR STUDENTS.
IN THAT SITUATION WHERE THEY
MAYBE DIDN'T HAVE A PRE
ESTABLISHED.
NEED OR RELATIONSHIP FOR CARE
AND SOMETHING COMES UP IN THE IN
THE HEALTH CENTER THE STUDENT
HEALTH CENTER STARTS THE PROCESS
AND THEN THERE'S. I MEAN SO MY
DAUGHTER WENT TO A UC SO SHE'S
THERE WITH THAT ONE OF THE BEST
MEDICAL CENTERS LIKE. EVER MEET
AND SO THAT'S A GOOD THING.
BUT THE CHALLENGE I DO THINK IS
FOR THE TRANSITIONS FOR THE
FOLKS FOR THE STUDENTS WHO HAVE
ONGOING CARE NEEDS AND THEY'RE
TRYING TO NAVIGATE THAT. BACK
AND FORTH.
BETWEEN.
BEING AT HOME AND BEING AT
SCHOOL.
OKAY YEAH SO HOPEFULLY WE WILL.
FIGURE OUT HOW TO ADDRESS THAT
BACKER SPEAKERS. OKAY.
OTHER QUESTIONS ANY OTHER
QUESTIONS OKAY THANK YOU FOR
HAVING ME.
THANK YOU. ITEM NUMBER THREE
CURRENCY POLICY IN MEDICARE WE
HAVE JENNIFER CAN'T DIRECTOR
DEPARTMENT OF HEALTH CARE
SERVICES. THE OF SIR BROOKS
DEPUTY DIRECTOR HEALTHCARE
DELIVERY SYSTEMS DEPARTMENT OF
HEALTH CARE SERVICES.
AFTERNOON NOON. SO I AM I
APPRECIATED THE OVERVIEW THAT.
MISS COACH GAVE SO WE WON'T
SPEND A LOT OF TIME.
KIND OF GOING BACK OVER SOME OF
THE POINTS THAT SHE MADE BUT I
WANTED TO KIND OF TAKE TAKE A
STEP BACK BEFORE SARAH. CAN TALK
ABOUT SOME OF THE MORE AND
DETAILED WORK THAT WE DO AS HOW
WE OPERATE OUR SYSTEM SO MEDIC
HOW BROADLY SPEAKING HAS SIX
DELIVERY SYSTEMS THAT WE OVERSEE
AND I THINK A LOT OF PEOPLE ONLY
THINK ABOUT FEE FOR SERVICE
VERSUS MANAGED CARE. WHICH
OBVIOUSLY TOO BIG SYSTEMS BUT WE
ALSO OVERSEE DENTAL UM SERVICES
MENTAL HEALTH THROUGH OUR COUNTY
MENTAL HEALTH PLANS SUBSTANCE
USE DISORDER SERVICES THROUGH.
BOTH. STATE PLAN COUNTIES AS
WELL AS COUNTIES HAVE OPTED INTO
OUR NEW MEDICAL DRUG DELIVERY
SYSTEM WAIVER AND THEN
CALIFORNIA CHILDREN'S SERVICES
SO WHEN YOU TAKE A LOOK AT ALL
OF THOSE SYSTEMS WE HAVE
INDIVIDUALS THAT CAN GO.
BETWEEN TWO THREE OR FOUR OF
THOSE SYSTEMS ARE SOMETIMES
MULTIPLE SYSTEMS ON NOT
INCLUDING IF THEY'RE ALSO IN A
LANTERN AND.
ELIGIBLE TYPE OF SERVICE
CATEGORY THAN THEY WOULD BE IN
DDS OR SOMETHING ELSE.
I'M WHEN WE HAVE.
SOMEONE WHO OBTAINS MEDICAL
ELIGIBILITY.
ELIGIBILITY IS CONFERRED.
IN THE COUNTY FOR WHICH THE
INDIVIDUAL RESIDES AND I KNOW
THAT.
THE MATERIALS THAT THE STAFF
PREPARED FOR THIS HEARING DID A
NICE JOB OF LAYING OUT THE FACT
THAT.
WHEN INDIVIDUALS ARE DETERMINED
ELIGIBLE AND THEY MOVE OUT OF
THE COUNTY TO GO TO COLLEGE.
THERE ARE MECHANISMS BY WHICH
THE FAMILY CAN.
RETAIN COVERAGE FOR THAT
INDIVIDUAL STILL IN THEIR COUNTY
OR THEY HAVE THE CHOICE OF
HAVING THE INDIVIDUAL BE
TRANSFERRED INTO THE COUNTY IN
WHICH THEY ARE.
ATTENDING COLLEGE AND THEN IF
THEY ARE HOME WE CAN DO THOSE
KINDS OF TRANSFERS AND THOSE
WOULD ALL BE AFFECTION WAITED ON
THROUGH OUR COUNTY HUMAN
SERVICES DEPARTMENTS THERE ARE
ELECTRONIC MECHANISMS THAT WE
HAVE BEEN. IMPROVING UPON OVER
THE LAST COUPLE OF YEARS SUCH
THAT COUNTIES CAN DO THESE INTER
COUNTY TRANSFERS AND DO THEM
MORE EXPEDIENT LEE.
ELIGIBILITY SYSTEMS ASIDE AND
THE COMPLEXITY AROUND HOW
ELIGIBILITY IS BOTH DETERMINED
AND WHERE INDIVIDUALS ARE
DETERMINED TO BE ELIGIBLE AND
MEDIC HOW. THEY THEN BUMP INTO.
ARE MANAGED CARE ENROLLMENT
SYSTEM SO ONCE AN INDIVIDUAL IS
FOUND TO BE ELIGIBLE FOR
MEDICARE ALL. ON IT'S AN
IMMEDIATE.
AND IT WAS I MENTIONED IN A.
PREVIOUS CONVERSATION EARLIER IN
THIS COMMITTEE IS THERE'S BOTH
PRESUMPTIVE ELIGIBILITY AND
INDIVIDUALS CAN BE FOUND HAVE
RETROACTIVE ELIGIBILITY IF THEY
HAVEN'T HEARD COSTS. TO WIN AN
INDIVIDUAL IS AND ROLLED INTO
MEDIC HOW THEY ARE ALLOWED
ACCESS IMMEDIATELY INTO OUR FEE
FOR SERVICE SYSTEM.
MOST INDIVIDUALS AND MEDIC HOW
ARE ONLY IN FEE FOR SERVICE
SYSTEM FOR A VERY LIMITED AMOUNT
OF TIME I LIKE TO SAY IT'S THE
HIGHWAY TO MANAGED CARE. MEANING
THAT THEY HAVE BEEN FOUND
ELIGIBLE THEY'RE ABLE TO RECEIVE
SERVICES BUT WE ARE IN THE
ACTIVE PROCESS OF SENDING THEM
HEALTH PLAN. MATERIALS WE'RE
ASKING THEM TO MAKE A CHOICE FOR
A HEALTHCARE PLAN IN THE AREA IN
WHICH THEY RESIDE AND THEN IF
THEY DON'T MAKE A CHOICE THERE
DEFAULTED IN AND ROLLED INTO A
MANAGED CARE PLAN. THE VAST
MAJORITY.
SOMEWHERE BETWEEN EIGHTY NINETY
PERCENT DEPENDING ON THE TYPE OF
POPULATION YOU'RE LOOKING AT ARE
ENROLLED IN MEDICAL TODAY'S
APPROXIMATELY ELEVEN MILLION OF
OUR THIRTEEN AND A HALF MILLION
INDIVIDUALS. ON THE REMAINING
POPULATIONS THAT ARE IN OUR FEE
FOR SERVICE DELIVERY SYSTEM.
ARE BY AND LARGE EITHER THERE
FOR A VERY SHORT AMOUNT OF TIME
BECAUSE THEY ARE BEING.
GIVEN A CHOICE AS TO WHICH
MANAGED CARE PLAN THEY WANT TO
BE AND THEY MAY BE DUAL
ELIGIBLES SO THEY MAY OR MAY NOT
BE.
AND ROLLING INTO A COMEDY
CONNECTS PLAN FOR THEIR MEDICAID
BENEFITS ON FOSTER CARE IS NOT A
MANDATORY IN WORLD POPULATION
AND THEN.
UNDOCUMENTED.
ADULTS THERE HAVE LIMITED SCOPE
COVERAGE SO IT'S A VERY.
AND YES TWO AND A HALF MILLION
IS SMALL IN CALIFORNIA TERMS BUT
IT IS A SMALL RESIDUAL
POPULATION THAT REMAINS IN OUR
FEE FOR SERVICE PROGRAM IN THE
VAST MAJORITY ARE ENROLLED IN
MANAGED CARE.
DOES MANAGE CARE ENROLLMENTS
HAPPEN ON A MONTH TO MONTH
BASIS.
SO IT'S.
IT'S A LITTLE BIT MORE
MECHANICAL AND TECHNICAL WHEN
YOU TALK ABOUT HOW WE MOVE
SOMEONE FROM FEE FOR SERVICE
INTO MANAGED CARE WE DO NOT DO
MID MONTH ELIGIBILITY CHANGES.
IT SIMPLY FROM IT TECHNOLOGY
AND CAPACITY STANDPOINT REALLY
REALLY DIFFICULT WHEN YOU'RE
WORKING WITH ENROLLMENT FILES
THAT IN SOME CASES YOU KNOW
ELLIE CARES ENROLLMENT FILE AS
YOU PROBABLY TWO MILLION
INDIVIDUALS AND GREATER. AND SO
ON A MONTHLY BASIS THEY'RE
RECEIVING AN ELIGIBILITY FILE
FROM US SAYING HERE'S TO YOUR
MEMBERS ARE FOR THE MONTH WE
ALLOW MEDICAL MEMBERS TO CHANGE
PLANS ON A MONTHLY BASIS. SO
THERE ARE OBVIOUSLY A TON OF
FLUCTUATIONS ON A MONTH TO
MONTH.
SCALE THAT THE PLANTS HAVE TO
ACCOUNT FOR AND SO WE SIMPLY DO
NOT HAVE THE CAPABILITY OF.
PUTTING SOMEONE INTO A PLAN MID
MONTH AND THEN SHIFTING THEM YOU
KNOW AND SO IT. THERE'S THERE'S
A REASON WHY THERE IS A CERTAIN
PERIOD OF TIME IN WHICH THERE
AND ROLLED INTO MANAGED CARE.
THE THING I'D ALSO LIKE TO
POINT OUT IT'S BEEN MENTIONED
BEFORE.
BUT BECAUSE OF THE DELIVERY
SYSTEMS THAT WE OVERSEE OR
OPERATE INDIVIDUALS EVEN IF THEY
ARE IN MANAGED CARE FOR THE VAST
MAJORITY OF THEIR BENEFITS THEY
ARE ALSO. ABLE TO ACCESS CARE IN
OUR DENTAL SYSTEM WHICH IS RUN.
SEPARATELY AND NOT.
EMBEDDED WITHIN OUR MEDICAL
MANAGED CARE PLANS IF THEY HAVE.
MENTAL HEALTH NEEDS THEY ARE
SEEN AND DIAGNOSED AND TREATED
THROUGH OUR COUNTY MENTAL
HEALTH.
SYSTEM BY AND LARGE ESPECIALLY
IF THEY ARE UNDER THE AGE OF
TWENTY ONE.
IF THEY'RE ADULTS THEY HAVE
SERIOUS MENTAL ILLNESS THEY'RE
SEEN BY THE COUNTY IF THEY HAVE
A MILD TO MODERATE HEALTH
CONDITIONS ARE SEEN BY THE
MANAGED CARE PLAN. AS I TALK
ABOUT THIS YOU CAN UNDERSTAND
AND APPRECIATE THE COMPLEXITY
THAT WHEN.
STUDENTS GO AWAY FOR COLLEGE.
ITS MEDICAL BENEFITS DON'T
SIMPLY JUST KIND OF PICK UP AND
TRANSFER WITH THEM AS EASILY AS
READILY AS WE WOULD LIKE THEM TO
BE IN SO WE HAVE BEEN DOING A
LOT OF WORK SINCE THE ACA. TO
SMOOTH THOSE TRANSITIONS BUT
CERTAINLY.
ARE VERY MUCH TRYING TO IMPROVE.
HOW A STUDENT IS ABLE TO
COMMUNICATE THEIR CHOICE WHEN
THEY GO AWAY TO COLLEGE IF THEY
WANT TO ENROLL IN A MEDICAL PLAN
FOR THE COUNTY IN WHICH THEY'RE
ATTENDING COLLEGE OR IF THEY
WOULD CHOOSE TO STAY? ON WITH
THEIR COUNTY OF RESIDENCE WITH
THE REST OF THEIR FAMILY AND
JUST HAVE ACCESS TO EMERGENCY
AND URGENT CARE.
AND AGAIN WE WOULD OBVIOUSLY BE
WORKING WITH INDIVIDUALS IF THEY
NEEDED MORE SPECIALIZED CARE AS
IT PERTAINS TO SPECIAL TO MENTAL
HEALTH SERVICES BECAUSE THOSE
WOULD HAVE TO BE. PROVIDED IN
THE COUNTY IN WHICH THEY RESIDE
IN.
SO WITH THAT I WILL AND DEFER TO
SARAH FOR KIND OF SOME FURTHER
DETAILS AND THEN WE'RE HAPPY TO
ANSWER QUESTIONS THANK YOU
DIRECTOR CAN. I'M SO SORRY
BROOKS WITH THE DEPARTMENT
HEALTHCARE SERVICES JUST TO
ELABORATE A LITTLE BIT MORE ON
WHAT DIRECTOR CAN AND MISS
CELTS.
SAID EARLIER. JUST TO PROVIDE A
LITTLE BACKGROUND THERE ARE SIX
MODELS OF MANAGED CARE IN
CALIFORNIA.
BUT THREE ARE PRIMARILY USED AT
THE TWO PLANS YOU THE GEOGRAPHIC
MANAGED CARE MODEL AND OUR
COUNTY ORGANIZED HEALTH SYSTEMS.
I'M I WON'T GO THROUGH THE
DETAILS OF WHAT EACH OF THOSE
ARE BECAUSE I BELIEVE MS COUCH
PROVIDED HAT INFORMATION. ON
BUT JUST TO TALK A LITTLE BIT
MORE ABOUT HOW WE'RE STRUCTURED
IN CALIFORNIA WITH THE EXCEPTION
OF SAN BENITO COUNTY THERE IS
MANDATORY MANAGED CARE
ENROLLMENT IN EVERY COUNTY IN
CALIFORNIA. I THINK IT'S
IMPORTANT TO NOTE THAT IN KHOST
COUNTIES EVERYONE IS
MANDATORILY.
ENROLLED IN MANAGED CARE IN MOST
OTHER COUNTIES THE MAJORITY OF
OF INDIVIDUALS ARE ENROLLED IN
MANAGED CARE AS DIRECTOR KEN
SAID. AND IT'S IMPORTANT TO NOTE
THAT WHEN A MEMBER IS ATTENDING
COLLEGE IN A DIFFERENT COUNTY
THAN THEIR COUNTY OF RESIDENCE
THEY MAY MAKE A CHOICE AS TO
WHETHER THEY REMAIN A RESIDENT
AT THEIR KERNEY CURRENT COUNY
RESIDENT. RESIDENTS OR WHETHER
THEY CHOOSE TO CHANGE TO THEIR
COLLEGE COUNTY RESIDENTS.
SO MEMBERS ARE ABLE TO MAINTAIN
THEIR COUNTY OF RESIDENCE AS
LONG AS THEY ARE STILL UNDER THE
AGE OF TWENTY ONE YEARS OF AGE.
ONLY TEMPORARILY OUT OF THE HOME
AND STILL CLAIM HIS ATTACKS THAT
PENNED IN THE HOUSEHOLD.
HE IS ME. WHEN A MEMBER CHOOSES
TO MAINTAIN THEIR SAME COUNTY OF
RESIDENCE THE MEMBERS STILL
COVERED BY THEIR SAME HEALTH
PLAN. BUT RECEIVING CONTRACTED
SERVICES FOR NON EMERGENCY
SERVICES OUT OF COUNTIES MAY BE
MORE DIFFICULT. HOWEVER IT'S
IMPORTANT TO NOTE THAT THE
MEMBERS HEALTH PLAN IS
FINANCIALLY RESPONSIBLE FOR
SERVICES. THAT THE MEMBER
RECEIVES AN AM AN EMERGENCY
SITUATION OR IN AN URGENT
SETTING. I'M ALSO IMPORTANT TO
NOTE THAT IN CALIFORNIA AS IS
THE CASE IN ALL STATES. MEDICAL
MEMBER STATEWIDE ARE AVAILABLE
TO RECEIVE IT EMERGENCY SERVICES
REGARDLESS OF THEIR COUNTY OF
RESIDENCE.
IN ADDITION PRIOR AUTHORIZATION
IS NOT NEEDED FOR URGENT CARE
OUT OF THE AREA BASS IF THE
MEMBER DOES NOT CHANGE THEIR
COUNTY OF RESIDENCE THEY WOULD
BE ABLE TO GO TO THE NEAREST
URGENT CARE FACILITY TO RECEIVE
SERVICES.
FOR ALL OTHER NON EMERGENCY
SERVICES INCLUDING ROUTINE OR
PRIMARY PREVENTIVE CARE THE PLAN
CAN REQUIRE THAT THE MEMBER SEEK
CARE WITH THEIR CONTRACTED
NETWORK PROVIDERS. THOUGH IT IS
IMPORTANT TO NOTE THAT THERE ARE
SOME SERVICES SUCH AS FAMILY
PLANNING SERVICES THAT
BENEFICIARIES CAN ACCESS OUT OF
NETWORK REGARDLESS OF WHERE THEY
ARE RECEIVING THE SERVICE.
IF THE MEMBER DOES CHOOSE TO
CHANGE THEIR COUNTY RESIDENTS
WHEN THEY GO TO COLLEGE THEY
WOULD NOTIFY THEIR LOCAL COUNTY
SOCIAL SERVICES OFFICE THAT
THEY'RE GOING TO SCHOOL AND TO
CHANGE THEIR ADDRESS.
THE COUNTY WILL UPDATE THE CASE
RECORDS WITH THEIR NEW ADDRESS
IN COUNTY CODE IN THE STATES
DATABASE.
IF THE SAME PLAN IS AVAILABLE
FOR ACCESS TO CARE IN THAT
COUNTY THAN THE BENEFICIARY
WOULD BE ABLE TO CONTINUE MAY BE
ABLE TO CONTINUE TO RECEIVE
SERVICES THROUGH THAT SAME
HEALTH PLAN. HOWEVER AT THAT
SAME HEALTH PLAN IS NOT
AVAILABLE THEN THEY WOULD NEED
TO GO THROUGH THAT STRESS PASTA
A CHOICE PROCESS THAT DIRECTOR
CAN DESCRIBED. I'M INTO THE NEW
HEALTH PLAN.
I'M JUST A NOBEL ALSO THAT WHEN
MEMBERS MOVE OUT OF STATE THAT
THEY.
ONLY MAINTAIN. ACCESS TO
LIMITED SERVICES REALLY
EMERGENCY SERVICES IF THEY GO
OUT OF STATE TO COLLEGE. IF THEY
DO CHOOSE TO GO OUT OF STATE TO
COLLEGE THEY WOULD NEED TO APPLY
FOR MEDICAID OR SOME OTHER TYPE
OF HEALTH CARE COVERAGE IN THOSE
IN THAT OTHER STATE. AND I THINK
IT'S IMPORTANT TO NOTE THAT I'M.
IT'S IMPORTANT TO NOTE THAT
DIFFERENT STATES HAVE DIFFERENT
ELIGIBILITY CRITERIA FOR
MEDICAID AND SO THOUGH YOU MAY
BE ELIGIBLE FOR MEDICAID IN
CALIFORNIA YOU MAY NOT BE
ELIGIBLE FOR MEDICAID IN ANOTHER
STATE. SO WITH THAT I THINK WE
ARE HAPPY TO ANSWER ANY
QUESTIONS ANY QUESTIONS FROM ANY
OF THE MEMBERS CENTRE PAM.
IT MIGHT NOT WORK TODAY.
AS FOR THE RECORDING PURPOSES.
SO THANK YU SO MUCH FOR YOUR
PRESENTATION I GUESS I'M TRYING
TO FIGURE OUT.
.
AND THE MAY HELP WITH PROBLEM
SOLVE THE SO WHAT HAPPENS WHEN
YOU HAVE A STUDENT WHO HAS A
CHRONIC CONDITION HAVE CYSTIC
FIBROSIS OR SOMETHING AND NEEDS
ON GOING CARE.
SUPPOSE THERE FROM SACRAMENTO
AND THERE YA GO TO UC BERKELEY
RIGHT ARE YOU GO DOWN TO SAN
DIEGO. RIGHT.
AND LET'S SAY THERE ARE MEDICARE
ALSO. IS THERE A SOLUTION FOR
THEM BECAUSE THE PROBLEM IS
GOING TO BE UNLESS THEY NEVER
VISIT HOME ALL RIGHT ONE
DIRECTION. OR BECAUSE THEY THEY
NEED ONGOING CARE SO THIS IS NOT
SOMETHING LIKE A WORLD SO ONCE
EVERY SIX MONTHS CHECK UP WILL
DO IT SPRING BREAK AND SOME MAIL
AND WHATEVER OUT WHEN I GET
HOME.
THEY'RE GONNA NEED ONGOING CARE
AND THEN YOU ALSO YOU KNOW
DURING THE SUMMER TO ME WHY
SHOULD SPEND TIME WITH THE
FAMILY OR WORK AT HOME THEY CAN
SPEND. NOW YOU HAVE TWO MONTHS I
DON'T KNOW HOWEVER MANY WEEK
PERIOD.
BUT THEY MAY NEED CARE LET'S
SAY SOME KIND OF THERAPY OR
SOMETHING EVERY COUPLE.
EVERY FEW WEEKS OR SOMETHING SO
WHAT HOW. THEY'RE SO IS THERE
SOME OPTION IN THE MEDICARE
PROGRAM TO HELP THESE TYPES
THESE FOLKS HONORED THEIR STOCK
BASICALLY SAY YOU BETTER NOT
LEAVE THE COUNTY IN WHICH YOUR.
PARENTS RESIDED YOU GAVE AN EASY
EXAMPLE BECAUSE CYSTIC FIBROSIS
THE CCS RIGHT SO MOSTLY CS AND
REALLY START ENROLLED IN MANAGED
pCARE.
OTHER THAN FOR THAT LAY RIGHT
DECISIONS BECAUSE THE THT WAY.
THAT WAY UNLESS YOU'RE IN A
COUNTY ORGANIZE HOW SYSTEM. SO
THE CCS CONDITION IS CARVED OUT
AND THE PRIMARY CARE AND THE
OTHER SERVICES ARE WITH THEM
MEDICAL MANAGED CARE SO AGAIN
YOU HAVE THIS TENSION BUT IF A.
CHILD WITH CYSTIC FIBROSIS MOVES
FROM SACRAMENTO IT REALLY THAN
THIS IS WHY WE HAVE KIND OF WE
PUT OUT FREQUENTLY ASKED
QUESTIONS TO FAMILIES TO HELP
THEM KIND OF MAKE THE DECISION.
IS IT IS IT IMPORTANT ENOUGH AND
DO YOU NEED TO HAVE.
ACCESS TO SPECIALISTS PROVIDERS
THAT YOU OTHERWISE WOULDN'T
NECESSARILY NEED YOU KNOW WHICH
HELPS DETERMINE WHETHER OR NOT
THEY WANT TO TRANSFER THEIR
COUNTY OF RESIDENCE SO IF YOU
ARE A CHILD IN SACRAMENTO AND
YOU'RE GONNA BE IN THE BAY AREA.
AND YOU HAVE.
A PROVIDER THAT IS WILLING TO
OVERSEE YOUR CARE DOWN IN THE
BAY AREA SUCH AS UCSF OR IF YOU
WERE GOING TO GO TO CHOPPER AND
CHILDREN'S HOSPITAL BENNY OFF.
FAMILY WOULD NEED TO MAKE A
DECISION F ARE YOU GOING TO BE
DOWN THERE LONG ENOUGH FOR THE
SCHOOL YEAR THAT WE WANT TO
TRANSFER YOUR COUNTY OF
RESIDENCE DOWN THERE SUCH THAT
WE CAN MAKE SURE THAT YOU HAVE
AN ADEQUATE. YOU NOTE ACCESS TO
SPECIALTY CARE THAT OTHERWISE IS
NOT EMERGENCY CARE OR ARE YOU
GOING TO JUST KIND OF BASICALLY
DRIVE HOME WHEN YOU NEED TO SEE
YOUR PHYSICIAN I THINK. EACH
INDIVIDUAL DEPENDING ON THE
CONDITION NEEDS TO MAKE CERTAIN
DECISIONS AS TO WHAT THEY THINK
IS.
MOST IMPORTANT FOR THEIR THEIR
CONDITION BUT CERTAINLY FOR
SOMETHING LIKE CYSTIC FIBROSIS
THAT WOULD NEED TO BE.
PRETTY CLEARLY DECIDED BETWEEN
THE CHILD AND THE FAMILY AS TO
WHETHER THEY WANTED TO MOVE OR
NOT IN TERMS OF MOVE COUNTY OF
RESIDENCE BECAUSE. LIKE WE SAID
THAT THE PLAN IF SACRAMENTO IF
THEY'RE ENROLLED IN MOLINA HERE
IN SACRAMENTO.
AND THAT. PATIENT IS IN
BERKELEY THEY CAN HAVE ACCESS TO
EMERGENCY SERVICES THEY HAVE
ACCIDENTS ACCESS TO URGENT CARE
SERVICES BUT IF IT'S JUST KIND
OF A ROUTINE. I NEED TO CHECK IN
WITH MY.
PULMONARY SPECIALIST HERE IN
SACRAMENTO.
THEY WOULD EITHER HAVE TO COME
BACK UP HERE OR THERE LIKE I
WANT TO FIND A NEW PULMONARY
SPECIALIST DOWN IN THE BAY AREA.
THE PLAN WOULD HAVE TO DECIDE
WHETHER OR NOT THEY WANT TO
PROVIDE COVERAGE FOR THAT OR IF
THEY WANT THAT PATIENTS TO
RETURN BACK INTO THE CONTRACTED
NETWORK. WELL FIRST OF ALL I
APPRECIATE THAT YOU UNDERSCORED
THE IMPORTANCE OF
REGIONALIZATION OF CARE FOR
HIGHLY SUB SPECIALIZED CARE SO I
HOPE WE CAN CONTINUE THAT
CONVERSATION. ABOUT CCS. THE
OTHER ISSUE THOUGH IS THAT.
THE.
I'M NOT SURE WE GOT FIGURE A WAY
TO HELP. THESE FAMILIES OUT.
BECAUSE I'M NOT SURE TELLING
SOMEONE WELL YOU KNOW IF YOU
WANT TO GO TO UC SAN DIEGO AND
YOU HAVE TO LIVE IN SACRAMENTO.
AND DO YOU NEED TO HAVE LET'S
SAY I'M GOING SOME KIND OF
THERAPY OR SOMETHING THAT'S
ONGOING AND I WAS A WEEKLY BASIS
OR YOU KNOW EVERY BY WEEKLY.
THAT.
SUMMER BREAK YOU HAVE TO FLY
BACK TO SAN DIEGO. AND THE
SUMMER FROM SACRAMENTO BECAUSE
YOU WANNA SPEND YOUR SUMMER
SACRAMENTO MAY BE WORKING A JOB
THAN THE OTHER STAY AT HOME.
DURING THAT PERIOD SO IN ORDER
TO GET YOUR THERAPY BECAUSE
SINCE HE'S I'M SPENDING MOST MY
TIME IN. SAN DIEGO RIGHT BECAUSE
I'M GOING TO SCHOOL THERE BUT IN
THE TIMES WHEN I'M OFF I STILL
HAVE TO FLY BACK TO GET MY
THERAPY ME I'D JUST.
IT'S I MEAN I THINK WE NEED TO
COME UP WITH BETTER SOLUTIONS
BECAUSE THAT I THINK THAT DOES
CREATE REAL BARRIERS FOR FOR
THOSE FAMILIES AND CERTAINLY I'D
MEDICALS NOT COVERING THE FLIGHT
I THINK.
SO WELL AND WE ALLOW FOR AND WE
SAY THIS IN OUR FREQUENTLY ASKED
QUESTIONS WHICH WERE HAPPY HAPPY
TO PROVIDE TO THE COMMITTEE
WHICH IS IF THE. STUDENTS
RETURNING HOME FOR SUMMER BREAK
THE SAME PROCESS CAN RE REVERSE
ITSELF RIGHT YOU CAN PUT
YOURSELF BACK INTO THE
SACRAMENTO COUNTY.
EXAMPLE WHERE THE FIX THE TIME
RIGHT TO I MEAN THERE'S A BACK
IN THE AT THE SWITCH TO
SACRAMENTO AND THEN AT THE END
THE SUMMER BREAK TO SWITCH BACK
TO SANDY. HOOK. AND I'LL TELL
YOU PEOPLE MOVING BECAUSE AFTER
ALL IF PEOPLE WHO'VE LET'S SAY
BETWEEN JUST ACROSS THE RIVER IN
ANY OTHER COUNTY THERE OVER
SACRAMENTO. THAT TRANSITION
DOESN'T HAPPEN INSTANTANEOUSLY
THERE'S USUALLY ABOUT THIRTY DAY
LAG SO. OF SORTS IN A BETWEEN
FILING PAPERWORK ETCETERA
ETCETERA BEFORE THEY ACTUALLY
GETS FLIPPED OVER. SO BAD. SO
ANYWAY I I HOPE THAT WE CAN.
THINK THIS THROUGH AND THINK
ABOUT IS THERE A WAY WE CAN HELP
OUT AND THEN I GUESS THE OTHER
RELATED THING IS SO HERE TECHNO
IF GMC.
IF THE STUDENTS ATTENDING.
COLLEGE AND.
NOW THERE SOMETIMES OUR
TRANSPORTATION OPTIONS ARE MORE
LIMITED.
AND THEY MAY TRY TO SEEK CARE.
ABOUT CS STUDENT HEALTH CENTER
SO FORTH.
.
YEAH I REALIZE YOU CAN SEARCH A
WELL YOU CAN PICK THE PLAN BUT.
.
I THINK THE OTHER ISSUE IS WHAT
HAPPENS IF YOU HAVE LET'S SAY
YOU.
MULTIPLE PLANS SUMMER CLOTHES
SUMMER MOLD YOU KNOW BUT IN
TERMS OF TRYING TO INDUCE THE
PLANTS TO ACTUALLY CONTRACT
WITH.
SCHOOL BASED COLLEGE BASED
HEALTH PROVIDERS WHO WOULD WHO
CAN IMPROVE THE ALL ACCESS. AS
IT'S GREAT TO HAVE A CARD BUT IF
YOU CAN'T GET TO THE CLINIC ARTS
A VERY TROUBLESOME AND YOU'RE
TRYING TO CALL THE CLASSES. THAT
THAT BECOMES A PROBLEM TO SELL
OF COURSE IN OUR GMC COUNTIES
THEY HAVE SEVEN PLANS TO ALL
SEVEN WILL ALL SEVEN CONTRACT
WITH SACKS STATES HEALTH.
SERVICE HILARY RIGHT YEAH AND I
THINK WE TRY REALLY HARD AS A
DEPARTMENT AND AS.
AS WE SIT AND CONTRACTING
DISCUSSIONS WITH THE PLANS AND
THE PROVIDERS AS WE.
MAKE EVERY EFFORT TO REMAIN
KIND OF NEUTRAL.
ARBITERS IN TERMS OF WE TRY NOT
TO TIP HANDS TOWARDS THE PLANS
OR TOWARDS THE PROVIDERS WE HAVE
ALWAYS SAID.
THAT WE WANT PLANS TO BE
CONTRACTING WITH PROVIDERS AND
VICE VERSA WE WANT PROVIDERS TO
BE CONTRACTING WITH HEALTH
PLANS.
.
IF YOU ARE A STUDENT HOUSE
INTERNET THINK THE MATERIAL SAY
THIS IS A LOT OF THEM DON'T TAKE
INSURANCE BE IT MEDICAL OR
COMMERCIAL INSURANCE AND SO.
YOU%
KNOW. THAT IS A DECISION THAT
THE STUDENT HEALTH CENTERS HAVE
MADE.
AND WE CAN'T FORCE SOMEONE INTO
A CONTRACTING RELATIONSHIP WE
WOULD CERTAINLY THINK THAT.
IN SOME CASES. BEING ABLE TO
ACCESS THE STUDENT HEALTH CENTER
IS. IS FANTASTIC FOR STUDENTS IS
HIGHLY ACCESSIBLE IT'S
CONVENIENT.
IF THEY'RE NOT BUILDING TODAY
AND THE STUDENTS ARE ALREADY
PAYING FOR IT WE'RE NOT QUITE
SURE WHAT THE ONTRACTUAL
NATURES ANYWAY IN TERMS OF THE.
ADDITIONAL SERVICES THAT WOULD
OTHERWISE NOT BE PROVIDED TO
SOMEONE BUT I THINK WE WOULD
ALWAYS ENCOURAGE OUR PLANS TO
CONTRACT WITH.
BROAD NETWORKS OF PRIMARY CARE
SO THAT THERE'S ACCESS
INAPPROPRIATE ACCESS BUT.
ASIDE FROM.
FROM THAT WE CAN'T MICHAEL TELL
PEOPLE TO CERTAINLY DIDN'T IT
DEPENDS ON THE NATURE SOON
HELTER BUT THEY ARE ONES THAT
FRIED MORE COPS OR THE CARE THAT
DO HAVE CONTRACTS WITH HEALTH
PLANS INCLUDING MEDICAL PLANS.
WELL CERTAINLY UNDERSTAND YOU
WANT TO PUT A HAND ON THE
PROVIDER WE SHOULD ALSO THINK IT
BUT WE SHOULD TIP THE HAND IN
FAVOR OF ACCESS AND THE AND AND
THE BENEFITS AND THE PEOPLE ARE
IN THE PROGRAM AND IF THERE'S AN
ACCESS ISSUE FOR A SUBSET
POPULATION BECAUSE. THEIR
COLLEGE STUDENTS WHERE THEY HAVE
MORE LIMITED ISSUES. OF OUR
MEDICAL SYSTEM OVERALL IS MORE
DESIGNED AROUND THIS BROADER
POPULATION AND OF COURSE WE DO
HAVE MORE. YOU KNOW PROVIDERS OR
CONTRACTOR IN THE TATE LOWER
INCOME AREAS WHICH ARE MORE
ACCOMMODATIONS BUT ALSO
RECOGNIZING SOMETIMES YOU HAVE
SUBPOPULATIONS THAT MAY HAVE
PARTICULAR NEEDS. AS WELL THAT
WE SHOULD THINK ABOUT HOW THE
PLANS DEAL WITH THOSE AS WELL SO
THAT WE DON'T LEAVE ANYONE AND
FALLING BETWEEN THE CRACKS.
THANK YOU.
THEIR LABOR.
THANK YOU MISTER CHAIR GOOD
AFTERNOON LADIES THANK YOU FOR
BEING HERE I'M I'M GONNA ASK YOU
THIS QUESTION I'M ALSO GOING TO
ASK OUR NEXT PANEL THIS QUESTION
CALIFORNIA STATE UNIVERSITY
CAMPUSES AND UC CAMPUSES
ELIGIBLE. TO ENROLL IN MEDICARE
WILL MEDICARE PRESUMPTIVE
ELIGIBILITY AND FAMILY PACKED AS
A LICENSE EXEMPT OUTPATIENT
SETTING UNDER SECTION TWELVE OF
SIX J.. OF THE CALIFORNIA HEALTH
AND SAFETY CODE.
WOW HE JUST THREW OUT SOME
HEALTH AND SAFETY CODE.
REALLY AWESOME STAFF.
I'M SO. IT'S A COUPLE THINGS AS
PLANS ARE REQUIRED TO CREDENTIAL
AND ROLL ALL OF THEIR
CONTRACTING PROVIDERS AND THEY
HAVE A CREDENTIALING PROCESS
THAT THEY HAVE TO GO THROUGH.
AND IT IS.
IT CAN BE SIMILAR OR SLIGHTLY
DIFFERENT THAN WHAT WE REQUIRE
THE STATE IN ORDER TO BE AN
ENROLLED MEDICAL PROVIDER.
WE HAVE A DIVISION WITHIN THE
DEPARTMENT FEDERAL INTERVENTION
THAT MAINTAINS.
ESSENTIALLY OUR FEE FOR SERVICE
PROVIDER MASTER FILE SO NOT JUST
CLINICS NOT JUST PHYSICIANS BUT
ALL OTHER KINDS OF ANCILLARY
PROVIDERS OPTOMETRISTS.
LICENSED CLINICAL SOCIAL
WORKERS CLINICAL LABS DURABLE
MEDICAL EQUIPMENT PROVIDERS AND
IN ORDER TO BE AN AND ROLLED
MEDICAL PROVIDER WITH US YOU
HAVE TO GO THROUGH THAT
ENROLLMENT DIVISION.
WE ASK FOR A LOT OF BACKGROUNDS
AND KIND OF REQUIRED THINGS
AROUND YOUR BUSINESS AND LICENSE
AND INSURANCE AND PLACE OF.
LOOK YOU KNOW MULTIPLE
LOCATIONS IF YOU HAVE THEM AN
NPI NUMBER.
AND F. PACT IS THE SAME KIND OF
THING IS YOU HAVE TO COME
THROUGH US AS A DEPARTMENT IN
ORDER TO BE ENROLLED AS PACKED
PROVIDER YOU HAVE TO SIGN A
PROVIDER CONTRACT. IN WHICH YOU
AGREE TO ABIDE BY ALL THE CON
YOU KNOW CONTRACTUAL RULES AND
REQUIREMENTS.
PLANS HAVE A CHOICE AS TO
WHETHER OR NOT THEY REQUIRE ALL
OF THEIR CREDENTIAL PROVIDERS TO
ALSO BE ENROLLED WITH US AS A.
AS A MEDICAL PROVIDER OR IN SOME
CASES OUR MEDIC CALLIN ROMAN
STANDS AS A PROXY FOR THE PLAN.
WHEN THE CREDENTIAL SO IT'S A
LITTLE BIT OF A COMPLICATED
QUESTION AND EACH PLAN IS
ALLOWED TO MAKE SOME OF THOSE
DETERMINATIONS FOR THEMSELF. BUT
YOU CAN'T JUST SAY I'M A STUDENT
HEALTH CENTER I'M ACCEPTING
MEDIC CAL. THEREFORE IT LET THE
PAYMENT FLOW TO ME AS A MEDICAL
PROVIDER IN MEDIC HOW YOU COULD
BE ENROLLED. IN MEDICAL AS A
PROVIDER YOU WOULD BE ALLOWED TO
AND BILL ON A FEE FOR SERVICE
BASIS IF THE PATIENT WAS A
MANAGED CARE ENROLLEES.
WE WOULD DENY THE CLAIM ON THAT
BECAUSE WE WOULD YOU KNOW YOU
WOULD LOOK INTO THE ELIGIBILITY
DATA BASE AND SAY SIR BROOKS IS.
AN ENROLLEE IN.
ALAMEDA LINE ALAMEDA ALLIANCE
WERE MAKING THIS UP AS WE GO
ALONG.
AND SO THEREFORE ALAMEDA
ALLIANCE IS RESPONSIBLE FOR
PAYING ALL OF SEARS BILLS AND SO
WE WOULD DENY THAT FEE FOR
SERVICE CLAIM BECAUSE FEE FOR
SERVICE AND MANAGED CARE SHOULD
NOT OVERLAP UNLESS THERE'S A.
CARVE OUT BUT THERE'S A THERE'S
A MECHANISM BY WHICH THE STUDENT
HEALTH CENTERS COULD DO THAT BUT
IT WOULD BE. A FAIRLY SMALL
POPULATION THAT WOULD BE
ELIGIBLE FOR FEE FOR SERVICE
JUST BASED ON OUR MANDATORY
ENROLLMENT CODES FOR THE
POPULATIONS DO YOU KNOW OF ANY
C. ISSUER UC'S THAT ARE MEDICARE
ELIGIBLE. I WOULD HAVE TO GO IN
AS OKAY. YEAH OKAY THANK YOU.
I JUST WANT TO FOLLOW UP ON THE
QUESTIONS AND WITH REGARD TO THE
MEDICARE MANAGED CARE OR THE
STATEMENTS YOU MADE. THAT IF A
STUDENT IS IN ACCOUNTING AND
GOES TO A DIFFERENT COMPANY THAT
THE AFTER APPLYING AT THAT
COUNTY SWITCH DRAMATIC CAL. ON A
FOLLOW UP WITH DOCTOR PAN SAID
THAT WHEN THEY'RE THERE THEN
THEY COME BACK IN THE SUMMER
BREAK OR WHATEVER.
HOW EASY IS IT ASSUMING THE
STUDENT KNOWS THEY'VE GOTTA DO
THAT NUMBER ONE? HOW EASY IS IT
FOR THE STUDENT TO BE ABLE TO GO
BACK AND FORTH ON A REGULAR
BASIS AND HOW QUICKLY CAN? YOU
TURN THAT OVER TO ALLOW THEM TO
DO THAT SO THEY CAN GET CUT
CONTINUATION OF CARE BETWEEN THE
TWO COUNTIES.
I'M SO YOU.
ARE ASKING ME A MORE DETAILED
QUESTION ON OUR INTER COUNTY
ELIGIBILITY TRANCE LIKE
SPECULATE ANSWERED I KNOW.
WE RECENTLY ISSUED GUIDANCE TO
THE COUNTIES ON HOW THEY DO AND
THEY'RE CALLED I SEE TEAS AND
ACCOUNT TRANSFERS AND IT'S NOT
JUST FOR COLLEGE STUDENTS BUT
IT'S FOR ANY.
BENEFICIARY THAT IS
TRANSFERRING BETWEEN COUNTIES.
AND SO I CAN PROVIDE THE
GUIDANCE THAT WE SAID BUT THERE
ARE CERTAIN DATES AND TIME
FRAMES THAT WE ARE ASKING THE
COUNTIES TO ME WHEN THEY DO
THOSE.
TRANSFERS I'M SUCH THAT IT
TRIGGERS OFF ALL THE OTHER
MECHANICS THAT HAVE TO FLOW ONCE
YOU TRANSFER THEM INTO THE NEW
COUNTY THAN OUR OTHER SYSTEMS
PICK THEM UP AND SAY OKAY YOU'RE
ELIGIBLE YOU KNOW DO YOU WANT TO
CHOOSE A PLAN. ON OUR GOAL OF
MAKING THIS MORE ELECTRONIC AND
MORE AUTOMATED AS IT HAPPENS
FASTER AND DOESN'T TAKE AS LONG
BUT I'LL HAVE TO GET BACK TO YOU
ON THE KIND OF SPECIFICS OF WHAT
AND I'M JUST FOLLOWING UP
BECAUSE OF THE QUESTION TO
DOCTOR CAN ASKS. WHO THE GUARD A
PATIENT THAT HAS A CHRONIC
CONDITION THAT NEEDS TO GO BACK
AND FORTH?
DO YOU HAVE ANY. EVIDENCE OR
COMPLAINTS BY STUDENTS THAT ARE
HAVING THIS PROBLEM AT ALL AT
THIS POINT.
NOT THAT I CAN THINK OF I KNOW
THERE WERE.
DISCUSSIONS LAST YEAR WHERE.
I THINK IT WAS THE I THINK
SENATOR MINING HAD A BILL OR A
AT BUILD CONCEPT WHERE.
STUDENTS.
ESSENTIALLY WANTED TO DO KIND
OF MID MONTH ELIGIBILITY AND
THEY SAID IF I MOVE TO THE
COUNTY AND. ON MARCH FIFTEENTH I
WANT MY BENEFITS TO BE YOU KNOW
AND ROLLED AND FLOWING ON MARCH
FIFTEENTH IN THE MANAGED CARE
PLAN AND SO WE HAD TO SPEND A
LOT OF TIME WITH. THE SPONSORS
OF THAT BILLAND SENATOR MINING
STAFF TO KIND OF EXPLAIN FROM A
TECHNICAL STANDPOINT. HOW WE
NEEDED TO CONTINUE TO STAY ON A
MONTH TO MONTH ELIGIBILITY BUT
WHAT COULD BE DONE AND I THINK
THAT IN OUR COUNTY TRANSFER?
ITEM THAT I JUST REFERENCE WAS
ON ONE OF THE DIRECT. OUTGROWTHS
OF THAT DISCUSSION IN TERMS OF
HOW DO WE BETTER FACILITATE AND
AND SHORTEN THE TIME FRAMES ON
HOW WE TRANSFER INDIVIDUALS SUCH
THAT THE COVERAGE. DOESN'T LABS
AND YOU KNOW JUST AN IMPORTANT
POINT IS WHEN INDIVIDUALS ARE
TRANSFERRING BETWEEN. COUNTIES
AND BETWEEN ENROLLMENT OF
PLANNED SO IF YOU HAVE. MOVED
OUT OF SACRAMENTO AND YOU'RE NO
LONGER COVERED BY A GMC PLAN AND
YOU HAVE MOVED ALAMEDA COUNTY
AND YOUR AWAITING ENROLLMENT
INTO ALAMEDA ALLIANCE FOR
EXAMPLE.
YOU HAVE ACCESS TO FEE FOR
SERVICE BENEFITS SO I I WANTED
TO STRESS THAT ON IS THAT YOU
DON'T HAVE A LAP IN COVERAGE AND
YOU ARE IT'S NOT THAT YOU'RE NOT
ABLE TO ACCESS CARE THAT YOU ARE
IT'S JUST IN A DIFFERENT
DELIVERY SYSTEM IN THOSE ARE
REFINEMENTS. THAT WE'RE STILL
TRYING TO AND THAT LEADS TO MY
NEXT QUESTION AND KIND OF
FALLING APART CENTER LEAVE A
MANSION WITH REGARD TO. THE
FACILITIES AT THE UNIVERSITY'S
TEAM MEDICAL PROVIDERS. IS THERE
A MECHANISM FOR A STUDENT.
TO BE TOLD INSTEAD OF BEING
UNDER THE MEDICAL MANAGED CARE
TO JUST PUT THEM IN FEE FOR
SERVICE OF THIS WAY WHEREVER
THEY'RE AT THEY CONNECT ACCESS
SERVICES WHILE THEIR STUDENTS IS
THAT A POSSIBILITY.
SEEM LIKE THAT WOULD BE THE
EASIEST BECAUSE NOW YOU'RE A FEE
FOR SERVICE IF THERE'S ANY
PROVIDER THROUGHOUT THE ENTIRE
STATE THAT'S A FEE FOR SERVICE
PROVIDER INCLUDING IF A. HEALTH
CENTER AT A UNIVERSITY CHOOSES
TO BE SO THEN THEY CAN NOW GO
ANYWHERE THEY WANT THROUGHOUT
THE WHOLE CITY CALIFORNIA AND
THEN ONCE THEY GRADUATE FROM
COLLEGE IF THEY'RE STILL A
MEDICAL THEN GO BACK TO THE
COUNTY. TO THE MEDICAL MANAGED
CARE OF SORTS I'M JUST CLOSING
THAT IS A QUESTION THAT'S AN
OPTION. I'M I THINK THAT.
WE MADE CERTAIN POLICY
DECISIONS AS A STATE AROUND THE
ENROLLMENT OF INDIVIDUALS IN THE
MANAGED CARE BECAUSE WE BELIEVE
IT'S A BETTER DELIVERY SYSTEM IN
TERMS OF ACCOUNTABILITY
OVERSIGHT. ACCESS TO A
CONTRACTED NETWORK YOU KNOW
PLANS ARE REQUIRED TO PROVIDE
ACCESS TO SPECIALTY PROVIDERS
THERE'S TIMELY ACCESS STANDARDS
NONE OF THAT EXISTS IN FEE FOR
SERVICE. SO. I WOULD JUST SAY WE
DON'T FEEL THAT FEE FOR SERVICE
IS AN APPROPRIATE NETWORK FOR.
COORDINATION OF CARE BECAUSE
THE INDIVIDUALS NOW LEFT TO FIND
A PROVIDER ON THEIR OWN.
COORDINATE THEIR CARE ARRANGE
FOR YOU KNOW ALL OF THEIR OTHER
BENEFITS AND SO FROM A POLICY
STANDPOINT I THINK WE WOULD.
PROBABLY HAVE A HARDER TIME
HAVING THAT KIND OF A
CONVERSATION BUT AND AND I DON'T
DISAGREE AND I KNOW WITH EIGHTY
FIVE OR EIGHTY PERCENT OF.
MANY CAL'S MANAGED CARE WE WERE
TRYING TO PHASE OUT THE FEE FOR
SERVICE WHEN YOU'RE DEALING WITH
A PATIENT IT DOES HAVE A RARE
CHRONIC DISEASE OR MAYBE. JUST
THE ABILITY TO GO BACK AND FORTH
AND GOING FROM DIFFERENT COUNTY
SYSTEM TOWARDS CLOSER TO PLAN
MODEL.
THAT I'M JUST POSING AS ANOTHER
OPTION I'M JUST QUESTIONING.
AND CAN.
DO YOU GUYS HAVE ANY OTHER
SUGGESTIONS ON HOW WE CAN
STREAMLINE THIS FOR STUDENTS AND
UP BE MY LAST QUESTION AND CAN
BE ASSISTANCE ASSISTIVE
TO THE. STUDENTS IN TERMS OF
UNDERSTANDING WHAT THAT PROCESS
IS.
AND THEN OF COURSE ARE WORKING
WITH THE SCHOOLS TO GET THAT
INFORMATION OUT AS WELL BUT
OTHER THAN THAT I DON'T KNOW
THAT WE HAVE ANYTHING ADDITIONAL
TO ADD. ANY OTHER QUESTIONS.
THANK YOU VERY MUCH APPRECIATED
WE'RE GONNA NOW MOVE ON TO ITEM
NUMBER FOR COLLEGE AND
UNIVERSITY POLICY AND PRACTICE.
WE HAVE ON BREAD.
.
YEAH. OKAY SO WE. READ ABOUT. IT
AS CHIEF MEDICAL OFFICER FOR THE
YOU SEE. SOON HELP AND
COUNSELLING NOT FROM YOU SEE
OFFICE OF THE PRESIDENT WE ALSO
GOT OUR CAMAROS VICE PRESIDENT
EXTERNAL RELATIONS.
FROM OUR ASSOCIATION OF
INDEPENDENT CALIFORNIA COLLEGES
UNIVERSITIES TO TALK ABOUT THE.
PRIVATE SCHOOLS DO NOT
EXPERIENCE MEMORY MARIO WHO'S
THE DIRECTORS TO PROGRESS FOR
THE CAL STATE UNIVERSITY SYSTEMS
OFFICE OF THE CHANCELLOR WERE
HAPPY TO HAVE ALL THREE OF YOU
HERE WOULD LIKE TO.
START WITH YOU MISTER BUCKET.
DEFINITION CHAIRMAN ALAN
INTERMENT HERNANDEZ AND MEMBERS
OF THE SENATE HEALTH AND
EDUCATION COMMITTEE.
IT'S A PRIVILEGE TO BE ABLE TO
TESTIFY TODAY ON THE THE STATUS
OF OF THE UNIVERSITY OF
CALIFORNIA PROGRAM. I'M GONNA
GIVE YOU AN UPDATE ON OUR
STUDENT HEALTH INSURANCE
PROGRAM.
OUR SYSTEM OF STUDENT HEALTH AND
COUNSELLING CENTERS AVAILABLE ON
EACH CAMPUS AND THE INTER
RELATIONSHIP OF THOSE CENTERS
WITH OUR INSURANCE PROGRAM.
AND THEN I'M GOING TO CLOSE WITH
THE PROPOSITION THAT WE HAVE TO.
POTENTIALLY SOLVE SOME SOME OF
THE PROBLEMS THAT HAVE BEEN
DISCUSSED SO FAR THIS AFTERNOON.
FIRST OF ALL.
THE UC REGENTS MANDATED THAT
ALL STUDENTS AT THE UNIVERSITY
OF CALIFORNIA HAVE.
ADEQUATE HEALTH INSURANCE AS A
NON ACADEMIC A CONDITION OF
ENROLLMENT AND FOR
UNDERGRADUATES THAT MANDATE WAS
PUT IN PLACE OF ALMOST TWENTY
YEARS AGO AND FOR GRADUATES
ABOUT TEN YEARS AGO. SO ALL
STUDENTS ARE REQUIRED TO ENROLL.
IN A S. TUNE HEALTH INSURANCE
PROGRAM AS THEY ENROLL IN YOU
SEE BUT THEY HAVE THE OPTION TO
WEIGH ABOUT IF THEY CAN
DEMONSTRATE THAT THEY HAVE AN
ADEQUATE INSURANCE PROGRAM THAT
WILL WORK IN THE AREA OF THE
CAMPUS THAT THEY'RE ATTENDING.
AND SO.
THROUGH THAT PROCESS ABOUT
FIFTY PERCENT OF OUR STUDENTS
WAY ABOUT WITH EITHER THEIR
PARENTS INSURANCE PROGRAM THEIR
OWN EMPLOYER BASED INSURANCE
PROGRAM. MEDIC HOW COVERED
CALIFORNIA PROGRAMS AS LONG AS
THAT INSURANCE MEETS THE
THRESHOLDS THAT ARE DEFINED. BY.
A STUDENT HOPE INSURANCE FORUM
THATINCLUDES OUR DIRECTORS OF
OUR STUDENT HEALTH CAMPUS
CENTERS.
THE INSURANCE MANAGERS ACROSS
THE SYSTEM AND STUDENTS FROM THE
STUDENT HALTED BY THREE
COMMITTEES.
ON EACH CAMPUS SO ABOUT FIFTY
PERCENT OF OUR STUDENTS.
USE THIS TERM HEALTH INSURANCE
UP A PROGRAM THAT WE OFFER ABOUT
FIFTY PERCENT WAVE OUT OF IT. OF
THE FOOD FIFTY PERCENT THAT WAY
OF ABOUT TWENTY PERCENT OF THOSE
STUDENTS.
HAVE MEDICARE. AND THAT COMES
OUT TO ABOUT. TWENTY ONE
THOUSAND STUDENTS.
WHO HAVE MADE A CAL WHO ARE
ATTENDING UC?
FROM OUR CAMPUS HEALTH CENTERS
ARE EACH OF OUR CAMPUSES HAS A
STUDENT HALT AND COUNSELING
CENTER SOMETIMES THOSE ARE
SEPARATE SOMETIMES ARE
INTEGRATED. A NUMBER OF CENTERS
HAVE. A MOVE TOWARDS INTEGRATED
CARE BY EMBEDDING MENTAL HEALTH
CARE WITHIN PRIMARY CARE WHICH
IS IN A VERY EFFECTIVE MODEL.
EACH OF THESE CENTERS IS PRE
FUNDED BY THEIR CAMPUS THROUGH
STUDENT REGISTRATION FEES TO
SOME DEGREE. AND SO.
WHAT THAT ALLOWS YOU TO OUR
CAMPUS CENTERS TO DO IS TO BE
ABLE TO PROVIDE PRIMARY CARE
SERVICES AND MENTAL HEALTH
SERVICES? AT VERY LOW COST COST
TO ESSENTIALLY ALL OF OUR
STUDENTS REGARDLESS OF WHAT KIND
OF INSURANCE THEY HAVE. WHETHER
IT'S MEDICARE ALL HEALTH NET FOR
OUR OWN INSURANCE PROGRAM.
MOST OF OUR CENTERS ALSO ARE
ABLE TO PROVIDE ADDITIONAL
SERVICES.
AND BILL AGAINST ARE YOU SEE
SHIP INSURANCE PROGRAM. AND THAT
MIGHT BE SPECIALISTS LABS XRAYS.
PHARMACY PRESCRIPTIONS OF
PHYSICAL THERAPY. OF SPECIALTY
VISITS OR PROCEDURES AND SO FOR
STUDENTS WHO HAVE YOU SEE SHIP.
DATE MANY OF OUR CAMPUSES
PROVIDE MORE SPECIALIZED MORE
COMPREHENSIVE SERVICES THAT WE
BILL AGAINST YOU SEE SHIP ARM TO
ALLOW THE STUDENTS TO REMAIN ON
CAMPUS AND GET THAT KIND OF CARE
EASILY.
FOR STUDENTS WHO DO NOT HAVE
SHIP.
ABOUT HALF OF OUR CAMPUSES
OFFER WHAT WE WOULD CALL A
BRIDGE PROGRAM AND THOSE
PROGRAMS US STUDENTS AGAIN WITH
ANY OTHER INSURANCE CAN PAY AN
ADDITIONAL FEE PER. QUARTER OR
PER SEMESTER AND THAT ALLOWS
THEM TO RECEIVE THOSE ADDITIONAL
SERVICES THAT STUDENTS WITH CHIP
RECEIVED. COVERED AT THE SAME
LEVEL SO.
STUDENTS HAVE A VARIETY AND
PARENTS HAVE A RIGHT A VARIETY
OF WAYS TO CHOOSE HOW THEY MIGHT
WANT TO GET CARE. SOME PARENTS
ALSO.
ELECTED TO ENROLL IN UC SHIP
AND MAINTAIN THEIR COVERAGE FROM
THERE AND ON EMPLOYER EXCEPT
AROUND WHICH WE THINK IS
UNNECESSARY.
AND.
BUT THAT THAT DOES HAPPEN TO
SOME DEGREE AND SOME MEDICAL
PATIENTS OF ACTUALLY.
ENROLLED IN BOTH.
.
NEXT I WANT TO JUST. MENTION. IT
SO WE DO PROVIDE A I'M GONNA
TALK ABOUT COLLEGE HELP JUST FOR
ONE SECOND AND AND AND REALLY
THE THE THE FOUNDATIONS THAT WE
KIND OF.
THRIVE ON.
HIGHLY ACCESSIBLE CARE IS
CRITICAL.
I HAVE TWO KIDS IN COLLEGE AND
ONE ABOUT TO GO AND THEY'RE NOT
THE BEST NAVIGATORS OF OF.
LEADING THEMSELVES THROUGH A
HEALTHCARE SYSTEM AND SO ONE
THING WE DO IS REALLY PROVIDE
HIGHLY ACCESSIBLE SERVICE AT
MOST OF OUR CAMPUS STUDENT
STUDENTS CAN BE SEEN THE SAME
DAY. OR AT WORST THE NEXT DAY.
WE ALSO SERVE AS A MEDICAL HOME
FOR OUR STUDENTS IF THEY ELECT
TO. TO TO GO WITH THAT OPTION A
NUMBER OF OUR CAMPUSES ARE
ACCREDITED AS A.
PATIENT CENTERED MEDICAL HOME
AND WHAT THAT ALLOWS OUR PRIMARY
CARE DOCTORS TO DO IS TO
COORDINATE CARE AND DO SOME CASE
MANAGEMENT. FOR STUDENTS WHO
NEED SPECIALTY CARE EITHER IN
THE LOCAL PROXIMITY TO THE
CAMPUS OR IF THEY'RE RECEIVING
SPECIALTY CARE.
AT HOME.
ENDED SO OUR INSURANCE PROGRAM
IT HELPS PROVIDE ADDITIONAL
SERVICES AT OUR STUDENT HOUSE
CENTERS BUT IT ALSO PROVIDES.
ANY NEEDED SPECIALTY CARE
OUTSIDE OF OUR STUDENT HEALTH
CENTERS BOTH LOCALLY AND IT ALSO
IS THIS PORTABLE SO WHEN A
STUDENT COMES. TO A CAMPUS IN
THE FALL AND THEY'RE GOING TO GO
HOME FOR A ONE MONTH BREAK AT
THE SAME YOU SEE SHIP INSURANCE
THAT THEY CAN USE LOCALLY. AT
OUR CAMPUS AND IN THE
SURROUNDING COMMUNITY CAN BE
USED IN THEIR HOME COMMUNITY AS
A PREFERRED PROVIDER.
A PRODUCT AND THEY CAN GO
DIRECTLY TO ACCESS CARE AT THEIR
AT THEIR HOME COMMUNITY AND THEY
CAN DO THE SAME THING IN THE
SUMMERS. SO WHAT IT ALLOWS OUR
STUDENTS AND PARENTS TO DO IS TO
SIGN UP FOR THE INSURANCE ONCE
REGARDLESS OF WHERE STUDENTS ARE
TRAVELING. HOME FOR A HOLIDAY
BREAK FOR HOME FOR THE SUMMER
THEY CAN CAN YOU CONTINUE TO
HAVE ACCESS TO THEIR INSURANCE
PROGRAM.
SO OUR OUR PROPOSAL THAT WE
WANTED TO MENTION TODAY IS IS.
IT PROPOSAL TO.
ASSIST SOME OF OUR MEDICAL
STUDENTS AND AGAIN ABOUT TWENTY
PERCENT OF OUR STUDENTS TO WAIVE
OUR UC SHIP PROGRAM HAVE MADE A
CALLIN THAT'S ABOUT TWENTY ONE
THOUSAND STUDENTS. AND OUR
PROPOSAL IS TO.
.
HAVE A PREMIUM ASSISTANCE
PROGRAM SO THAT SOME OF THESE
MEDICAL STUDENTS COULD BE SIGNED
UP AND WE COULD CREATE A
PARALLEL YOU SEE SHIP INSURANCE
PROGRAM. THAT'S EXACTLY LIKE OUR
CURRENT UC SHIP PROGRAM VERY
HIGH LEVEL PROGRAM.
IT'S WE VOLUNTARILY RECEIVED A
MINIMUM ESSENTIAL COVERAGE
CERTIFICATION. IT IT'S
ESSENTIALLY A PLATINUM OR GOLD
LEVEL PROGRAM THAT WE ARE ABLE
TO PRICE AT ABOUT A BRONZE
LEVEL.
PROGRAMS. WE HAVE ROBUST
COVERAGE THROUGHOUT THE STATE
BOTH LOCALLY AT EVERY CAMPUS AND
AND AND THROUGHOUT THE STATE.
AND SO WHAT THIS WOULD OFFER TO
TO MEDICAL STUDENTS IS IF THEY
ENROLLED AND WE WERE ABLE TO.
WORK OF OF WE COLLABORATE WITH
THAT WITH THE. THE THE MEDICARE
ALL THE TEAM IS TO PRODUCE A
PROGRAM THAT WOULD. ALLOW
STUDENTS TO HAVE THE SAME KIND
OF COVERAGE THAT ARE YOU SEE
SHIPS STUDENTS HAVE.
MEDICARE HOW. THROUGH A PREMIUM
ASSISTANCE PROGRAM COULD HELP.
PROVIDE THAT COVERAGE TO OUR
STUDENTS IT SOLVES THE
PORTABILITY PROBLEM AND ALLOW
STUDENTS TO SEEM THE SAME KIND
OF.
VERY HIGH LEVEL ACCESS ON
CAMPUS THE SAME ENHANCED
COVERAGE OF TWO ADDITIONAL
SERVICES ON CAMPUS AS WELL AS
LOCALLY. AND THEN GET THE
COVERAGE THEY NEED WHEN THEY'RE
HOME ON BREAKS ARE OVER LET ME
JUST FOLLOW UP AND I WANT TO ASK
YOU A QUESTION IS FOR THE
PREMIUM MRS PROGRAM. FOR FOUR
HOW DOES IT SOLVE THE
PORTABILITY PROBLEM IF US
STUDENTS GOING TO SCHOOL UP IN
BERKELEY BUT THEY LIVE IN SAN
DIEGO IN A DIFFERENT COUNTY IN
SAN DIEGO TO GEOGRAPHIC REGION.
THEREFORE WHEN THEY HAVE TO NOW
REAPPLY DOWN IN SAN DIEGO IN THE
SUMMER. I WAS AT THE CASE AND
YET SO FAR WE HAVE A SELF
INSURED PROGRAM AND THEN WE USE
A A THIRD PARTY ADMINISTRATOR
TO.
A CONTRACT WITH A NETWORK OF
PROVIDERS AND THOSE PROVIDERS
ARE THROUGHOUT THE STATE AND
THEY ARE. LOCALLY AROUND EACH
CAMPUS BUT ALSO OF IN NORTHERN
AND SOUTHERN CALIFORNIA AND SO
STUDENTS. WE PREFERRED THEM TO
IF THEY'RE ON CAMPUS WE TRY TO
SEE THEM AS FAST AS THEY AS WE
CAN IF THEY NEED ADDITIONAL
SPECIALTY HELP THAT WE'RE NOT
OFFERING IMMEDIATELY OUT OUR
HEALTH CENTER. WILL WORK FOR
ABOUT IF THEIR HOME THEY CAN GO
SEE THEIR OWN PRIMARY CARE DOC
IF THEY'RE WITHIN THAT NETWORK.
IF THEY NEED TO SEE A SPECIALIST
THEY CAN DO THAT TOO AND FOR THE
CHRONIC CONDITIONS THAT WE WERE
TALKING ABOUT THEY COULD
CONTINUE TO SEE RECEIVE CARE.
FROM UP FOR MY PRIMARY
SPECIALIST AT HOME AND THEN TRY
TO COORDINATE THAT CARE WITH OUR
TALKS. ABOUT THE SCOPE OF
SERVICES BECAUSE THEY KNOW IF
SOMEBODY'S A MEDIC HELL I DON'T
CARE WHERE THEY'RE IN A WHEREVER
THEY HAPPEN TO BE A EVEN IF IT'S
A MANIC MEDICAL MANAGED CARE.
IT'S FROM A TO Z. THE COVERAGE
AND I CAN'T IMAGINE SURE YOU
WILL NOT ASK FOR A
WRAP AROUND FROM THE STATE OF
CALIFORNIA.
WELL LET ME LET ME OF WHAT WE
WOULD LIKE TO DO IS PROVIDE
CREATE A PARALLEL PROGRAM THAT
PROVIDES THE SAME LEVEL OF
BENEFITS THAT ARE CURRENT
TUDENTS ENJOY. BUT FOR THE
MEDIC HELL ELIGIBLE STUDENTS WE
WOULD LIKE TO CREATE A PROGRAM
WHERE THERE'S NO COST SHARING
FOR THEM.
AND TO PROVIDE THE SAME NETWORK
AS OUR STUDENTS THAT IT CAN'T BE
COST SHARING BECAUSE IF IT'S A
MEDICAL ELDERLY PATIENT YOU
CAN'T CHARGE THEM A PENNY RIGHT
BUT I'M SAYING FOR AN EXTREME
CASE OF LET'S SAY CANCER. YOU
WOULD BE TOTALLY RESPONSIBLE FOR
THAT PATIENT'S SO YOU'RE SAYING
YOU WILL NOT ASK FOR A WRAP
AROUND FROM THE STATE OF
CALIFORNIA THAT'S MY FIRST
QUESTION AND STATEMENT I NEED TO
VERIFY. THEN SECONDLY I'M GOING
TO ASK YOU IF THAT'S THE CASE
ARE YOU GONNA DO A PM PM LIKE
THE MANAGED CARE PLANS WOULD BE.
IN WHICH BECOME COMPETING FOR
THOSE AS WELL.
NOW THE WRAPAROUND I DO. THIS IS
ENOUGH WATER SHE IS OUR DIRECTOR
OF OUR INSURANCE PROGRAM IS USED
BECAUSE THE STATE OF CALIFORNIA
IF YOU HAVE A MEDICARE MANAGED
CARE PATIENT OR A FEE FOR
SERVICE THEY ARE COMPLETELY
RESPONSE FOR THAT PATIENT I
DON'T CARE WHAT THEY HAVE. SO BY
YOU TAKING THIS PATIENT IF IT'S
A PM PM YOU'RE GONNA BE TOTALLY
RESPONSIBLE FOR THE QUESTION IS
DO YOU ARE YOU GOING TO ACCEPT
ALL TOTAL RESPONSIBILITY OR YOU
CAN HAVE A WRAP AROUND FROM THE
STATE OF CALIFORNIA.
I'M FROM A FROM A PM PM TOTAL
RESPONSIBILITY SO AGAIN WE'RE A
MANAGED IF YOUR PLAN. WE ASSUME
WHATEVER CLAIMS EXPERIENCE ANY
PATIENT GOING TO HAVE TO GET THE
MIKE IS THE MIKE. MIKE SO
EVERYBODY CAN HEAR OUR I'M
SORRY.
SO AGAIN IT'S A MANAGED PPO
PLAN.
WE ASSUME FULL RESPONDENTS
RESPONSIBILITY FOR ANY CARE THAT
STUDENTS NEED TO RECEIVE NO
LIFETIME MAX ON CONDITIONS. AND
SO. FOR CANCER PATIENT X.
FEDERAL YES WE ARE ASSUMING ALL
ALL OF THE CARE THAT NEEDS TO BE
GIVEN I MEAN HAVE. YOU SEEN A
COLUMN ON THERE FOR NOW AND NOT
HAVE ANY WRAP AROUND FROM THE
STATE OF CALIFORNIA OKAY. MISTER
CHAIRMAN I WILL DO WANT TO
CONFIRM THAT YOU SEE SHIP IS A
COMPREHENSIVE PLAN OFFERING
MEDICAL DENTAL VISION. BOTH
MENTAL HEALTH AS WELL AS
PHARMACY SERVICES SO WE WOULD
ASSUME ALL RESPONSIBILITY FOR
MEDICAL CARE I'M NOT SAYING THAT
THERE AREN'T ANY SERVICESTHAT
NOT WRAP AROUND FOR EXAMPLE WE
DON'T PROVIDE IN HOME SUPPORT
SERVICES. SERVICES BUT WE
PROVIDE COMPREHENSIVE MEDICAL
VISION DENTAL MENTAL HEALTH
PHARMACY SERVICES.
JUST ANSWER MY QUESTION.
FULL RESPONSIBILITY WITH NO WRAP
AROUND FROM CITY CALIFORNIA AND
THESE ARE ALL THIS AND I GUESS
AGAIN ASK ALL THE CALL THE
SERVICES ARE PROVIDED TO THAT
SAME PATIENT. AS A MEDICARE
RECIPIENTWILL BE PROVIDED BY
YOU GUYS AREK PROGRAM THAT WE'RE
PROPOSING IS A FULL. OF ONE
HUNDRED PERCENT COVERAGE COVERED
BY THE PLAN WITH NO OUT OF
POCKET COSTS TO THE STUDENTS FOR
IN NETWORK SERVICES ARE YOU
PROPOSING TO DO THAN A.
COMPETITIVE BID LIKE ALL TO PLAN
MODELS OR.
CLOTHES WERE TO PM PM FOR THESE
PATIENTS AND.
YES OKAY RIGHT ANSWER MY
QUESTION THANK YOU.
GOOD AFTERNOON SHE REMEMBERS
THANK YOU FOR THE OPPORTUNITY TO
SPEAK TODAY FOR THE ASSOCIATION
OF INDEPENDENT CALIFORNIA
COLLEGES AND UNIVERSITIES ARE A
ICU. WE REPRESENT OVER SEVENTY
FIVE PRIVATE NOT FOR PROFIT
INSTITUTIONS IN THE STATE.
INCLUDING NINE GRADUATE ONLY
INSTITUTIONS.
AS A SECTOR WE ENROLL ALMOST ONE
HUNDRED EIGHTY NINE THOUSAND
UNDERGRADUATE STUDENTS IT'S
COMPARABLE TO THE UNIVERSITY OF
CALIFORNIA IN SIZE. AND OVER ONE
HUNDRED SIXTY FIVE THOUSAND
GRADUATE STUDENTS IT'S OVER
FIFTY PERCENT OF ALL THE
GRADUATE STUDENTS IN THE STATE.
ONE OF THE GREATEST STRENGTHS OF
OUR SECTORS ARE DIVERSITY. FROM
OUR COMPREHENSIVE INSTITUTIONS
TO FAITH BASED COLLEGES TO A
LIBERAL ARTS CAMPUSES IN ART AND
MUSIC CONSERVATORIES. OUR
SMALLEST CAMPUS IS JUST UNDER
ONE HUNDRED STUDENTS AT THE
UNDERGRADUATE LEVEL. OUR LARGEST
CAMPUS ENROLLED OVER EIGHTEEN
THOUSAND UNDERGRADUATE STUDENTS.
AND SO THE DIVERSITY OF THE
SECTORS ALSO REFLECTED IN THE
HEALTHCARE PLANS AND
REQUIREMENTS.
THE FOLLOWING INFORMATION IS THE
RESULT OF SELF REPORTED DATA
FROM A SURVEY WE SENT OUR MEMBER
INSTITUTIONS.
THE REQUIREMENTS RUNNING HEALTH
INSURANCE VERY FROM CAMPUSES WHO
DO NOT REQUIRE STUDENTS TO
PROVIDE PROOF OF COMPREHENSIVE
INSURANCE FOR ENROLLMENT.
TO THOSE WHO REQUIRE IT ONLY
OTHER INTERNATIONAL STUDENTS ON
STUDENT VISAS. TO SOME REQUIRED
OF ALL THEIR UNDERGRADUATE
STUDENTS TO THOSE WHO REQUIRE IT
OF UNDERGRADUATE AND GRADUATE
STUDENTS. ANSWER FOR THOSE
CAMPUSES TO PROVE THAT REQUIRE
PROOF OF INSURANCE. THE CAMPUSES
ARE IN DIFFERENT AS TO WHO
PROVIDES THE INSURANCE SO LONG
AS IT'S COMPARABLE TO THEIR OWN.
CAMPUSES OFFER ONLY ONE CAMPUS
CHOICE FOR THEIR INSURANCE
THOUGH THE INTERNATIONAL
STUDENTS HAVE THEIR OWN PLACE.
FOR THE OVERWHELMING MAJORITY OF
CAMPUSES THAT REQUIRE COVERAGE
THEIR HEALTH CARE PLANS HAVE AN
OPT OUT OPTION.
IF THE STUDENT HAS COMPARABLE
COM COVERAGE. ONE CAMPUS CHANGED
TO AN OPT IN SYSTEM BECAUSE
STUDENTS WERE COMPLAINING ABOUT
HAVING TO OPT OUT. BUT WITH OVER
TWENTY PERCENT OF THEIR STUDENTS
STILL FAILING TO REPORT WHETHER
OR NOT THEY HAVE INSURANCE.
THEY'LL BE GOING BACK TO OPT OUT
AND SHOOT UP FOR THE INSURANCE
COVERAGE.
THE CAMPUS IS DO NOT HAVE A
METHOD FOR PROVIDING PREMIUM
ASSISTANCE TO THEIR STUDENTS
THOSE SCHOLARSHIPS AND FINANCIAL
AID CAN BE USED TO PAY FOR THE
HEALTH INSURANCE PROGRAM.
FOR THOSE WHO OFFER INSURANCE
PLANS AS LONG AS THE PREMIUMS
ARE KEPT CURRENT THE COVERAGE IS
PROVIDED TO STUDENTS YEAR ROUND.
WITH HE SPRING SEMESTER PREMIUM
COVERING SOME.
AND AS FOR STUDENTS WERE
ELIGIBLE FOR MEDICAL.
THE REQUIREMENTS ALSO VARY BY
CAMPUS. AND AT LEAST ONE
INSTANCE THE INSTITUTION WILL
ONLY ALLOW STUDENTS TO OPT OUT
OF THE REQUIRED INSURANCE IF
META COLORS FROM THE SURROUNDING
COUNTIES. OTHERWISE THEY ARE
REQUIRED TO SUBMIT. THEIR
MEDICAL COVERAGE TO THE BROKER
OR INSURANCE PROVIDER TO ENSURE
THAT IT IS COMPARABLE IF IT IS
NOT COMPARABLE TO THE STUDENT IS
REQUIRED TO PARTICIPATE IN THE
STUDENT HEALTH INSURANCE
PROGRAM.
AND FINALLY AS FOR ACCESS TO
CAMPUS HEALTH CENTERS SOME AICC
YOU CAMPUSES ARE TOO SMALL AND
DON'T HAVE A HEALTH CENTER. SUIT
SEVERAL REPORTED THAT THEY
REQUIRE PROOF OF HEALTH
INSURANCE BUT DON'T HAVE A
HEALTH CENTER ON THEIR CAMPUS.
OR LARGER CAMPUSES PROVIDED.
ACCESS TO HEALTH CENTERS WITH
THE FEE ALREADY BEING BUILT INTO
THE CAMPUS IS GENERAL UNIVERSITY
FEES AND EVERY STUDENT CAN
ACCESS THE HEALTH CENTER. AGAIN
THANK YOU FOR THE OPPORTUNITY TO
PROVIDE INFORMATION FOR THE
INDEPENDENT SECTOR AND WE WILL
CONTINUE TO BE A BIT STRONG
PARTNER FOR THE STATE. THANK
YOU.
BUT YOU'RE A COMMITTEE MEMBERS
SO WHEN I GIVE THE JUST BRIEF
OVERVIEW OF THE MISSION OF OUR
HEALTH CENTERS ON OUR CAMPUSES
BEFORE I ADDRESS SOME OF THE
ISSUES THAT MAY BE OF INTEREST
FOR THE COMMITTEE. IN THE
STUDENT HEALTH CENTERS ARE
ESTABLISHED TO MAINTAIN AND TO
FACILITATE THE RETENTION OF
STUDENTS MATRICULATED IN THE IN
THE IN STATE SUPPORTED PROGRAMS
AT THE UNIVERSITY. AND TO
ENHANCE THE ACADEMIC PERFORMANCE
OF THE STUDENTS. THE STUDENTS
HEALTH CENTERS EMBRACE A
HOLISTIC COLLABORATIVE APPROACH.
TO HEALTH CARE BY OFFERING BASIC
SERVICES THAT INCLUDE PRIMARY
CARE PREVENTIVE SERVICES
WELLNESS EDUCATION LABORATORY
DIAGNOSTICS X. THREE SERVICES
PHARMACY SERVICES. CONSULTING
SERVICES WITH ON CAMPUS HEALTH
ISSUES AND CONSULTATION WITH AND
REFERRAL TO OFF CAMPUS HEALTH
CARE PROVIDERS AND HOSPITALS FOR
SPECIALTY CARE.
SO I'M LIMITED ACCESS TO THESE
BASIC SERVICES ARE AVAILABLE TO
ALL STUDENTS WHO HAVE PAID THE
APPROPRIATE MANDATORY CAMPUS
BASED STUDENT HEALTH SERVICES
FEE.
SO JUST TO REITERATE HERE TO THE
STATE UNLIKE OUR PARTNERS HERE
AT THE TABLE OF THE SEATS HE
DOES NOT HAVE A MANDATORY
HEALTHCARE REQUIREMENT. BUT WE
DO OFFER AN OPTIONAL HEALTHCARE
HEALTH PLAN FOR STUDENTS. THE
DOMESTIC PLAN IS VERY VERY LOW
UTILIZED WE PROBABLY SELF OR AT
OUR BROKER SELLS PROBABLY ABOUT
EIGHT THOUSAND TO ELEVEN HUNDRED
PLANS. FOR A POPULATION OF FOUR
HUNDRED EIGHTY THOUSAND STUDENTS
ARE INTERNATIONAL PLAN IS THE
MORE ROBUST ONE. BECAUSE THE ONE
EXCEPTIONS TO THE MANDATORY
HEALTH CARE IS FOR INTERNATIONAL
STUDENTS AND OUR STUDENTS AT CAL
MARITIME ACADEMY GIVEN THE
NATURE OF THE TRAINING THAT THEY
GO THROUGH ON THE SHIP.
SO IN REGARDS TO THE MANDATORY
STUDENT HEALTHY. THE STUDENTS TO
PAY MANDATORY CAP IS BASED
HEALTH SERVICES FEE AND IT
VARIES FROM CAMPUS TO CAMPUS
DEPENDING ON THE STUDENT NEEDS.
AND THE AVERAGE SYSTEM WIDE.
FEE FOR THIS IS TWO HUNDRED
SEVENTY TWO DOLLARS ANNUALLY.
SO THERE IS IN OUR POLICY OF
UNIVERSITY HEALTH SERVICES AN
ABILITY FOR STUDENTS TO OPT OUT
OF THE FEE SO THE STUDENTS COULD
IN FACT OPT OUT OF THE FEE IS
LONG AS THE HEALTH CENTER DOES
HAVE A PROTOCOL SET UP A
PROCEDURE. AT THE APPROVAL OF
THE UNIVERSITY PRESIDENT HOWEVER
THIS DOESN'T HAPPEN VERY OFTEN
AND TYPICALLY WHAT HAPPENS ON
OUR CAMPUS IS. IS THAT A PARENT
OR STUDENT WILL CALLER HEALTH
CENTER EVEN THE CHANCES OFFICE.
STATING THAT THEY HAVE HEALTH
INSURANCE WHY DO THEY NEED TO
PAY THE CAMPUS BASED FEE AND
THEY CONFUSE OUR CAMPUS BASED
FEE WITH HEALTH INSURANCE. BUT
ONCE WE EXPLAINED THAT THE FLAT
HEALTH INSURANCE. CAMPUS BEAST
FEED GIVE THEM FULL ACCESS TO
THE HEALTH SERVICES NOT JUST THE
PRIMARY CARE BUT HEALTH
EDUCATION AND ALL THE OTHER
PROGRAMS AND WELLNESS PROGRAMS
THAT ARE PROVIDED. IN THE SEE
THE DIFFERENCE THAT USUALLY
ALLEVIATES THE REQUEST FOR A
WAIVER OF THE HEALTH SERVICES
FEET.
ALSO IN REGARDS TO INSURANCE THE
CC POLICY DOES IN FACT PROHIBIT
OUR HEALTH SERVICES CENTERS TO
BILL PRIVATE INSURANCE. SO NONE
OF OUR CENTERS DO IN FACT FOR A.
BILL FOR INSURANCE HOWEVER JUST
RECENTLY ABOUT A YEAR TO GO WE
DID PROVIDE GUIDANCE AND
CLARIFICATION FIRST CENTERS.
THAT DOES MAKE IT PERMISSIBLE
FOR OUR HEALTH CENTERS TO
DEVELOP PARTNERSHIPS WITH
GOVERNMENT AGENCIES IN REGARDS
TO BILLION AND PROVIDING
SERVICES FOR STUDENTS WHO ARE
ENROLLED OR QUALIFIED FOR
PROGRAMS SUCH AS MEDICARE.
IN THE STUDENT HEALTH CENTERS
ARE IN FACT INTERESTED IN HAVING
MEDICAL PROVIDERS BE DESIGNATED
AS MEDICAL PROVIDERS WITHOUT
BILLION OR CAPITATION PAYMENTS.
IN ORDER TO STREAMLINE SPECIALTY
CARE REFERRALS WHEN MEDICAL
NEEDS ARE BEYOND THE SCOPE AT
THE STUDENT HEALTH CENTER. IT
TYPICALLY WHAT HAPPENS IS EVEN
THOUGH OUR CENTERS THAT PROVIDE
SOME COMPREHENSIVE SERVICES
THERE ARE IN FACT MEDICAL
SITUATIONS IN WHICH THE STUDENT
NEEDS TO BE REFERRED OUT TO
SPECIALTY CARE. THOSE INSURANCE
YOU HAVE EITHER INSURANCE
THROUGH THEIR PARENTS PLAN OR
PRIVATE INSURANCE AN EMPLOYER OR
MEDICARE OFF THAT REFERRAL OR
DOES SHE JUST THE PRIVATIONS
THAT REFERRAL IS IMPORTANT THAT
WE CAN EASILY DO THAT. WITH THE
MEDIC HELL WITH THIS WOULD SAVE
AS HAVING OUR PROVIDERS
DESIGNATED AS MEDICAL PROVIDERS
IS THAT IT ELIMINATES THE NEED
FOR THE STUDENT TO GO SEE
ANOTHER PRIMARY CARE PHYSICIAN
WITH IN THE MEDICAL NETWORK. TO
GET THE SAME REFERRAL.
SO WHAT'S HAPPENED IS THAT
STUDENTS GET THE DIAGNOSIS THAT
OUR HEALTH CENTERS TO GET
WHATEVER NECESSARY CARE THEY
NEED. AND THEN WE CAN MAKE THE
DIRECTLY FOR ALL FOR THE
SPECIALTY CARE THE STUDENT WITH
VAN NEED TO FIND ANOTHER
PROVIDER WITHIN THEIR MEDICAL
NETWORK TO GET THAT REFERRAL MNC
GET OUT SO WE'RE HOPING TO
STREAMLINE THAT. AND ELIMINATE
THE STUDENT FROM HAVING THAT
MIDDLE DIAGNOSTIC THAT IS PRETTY
MUCH HOPEFULLY WOULD PROBABLY BE
CONSISTENT WITH WHAT OUR MEDICAL
PROVIDERS.
PROVIDE.
GARCIA PERMISSION TO INSURANCE
OPTIONS A FEW YEARS AGO THE CAL
STATE LA DID IN FACT GET AWARDED
TO COVER CALIFORNIA OUT REACH
GRANTS SO MANY OF OUR CAMPUSES
DID IN FACT GET DOLLARS. TO HELP
IN ROLE IN INFORM STUDENTS ABOUT
COVER CALIFORNIA THEIR OPTIONS
IS WELL AS WITH THEIR
ELIGIBILITY AND MEDICARE.
MANY OF OUR CAMPUS IS STILL
REALLY HAVE THE INSURANCE
INFORMATION ON THE WEBSITE ABOUT
COVERED CALIFORNIA MEDICARE IN
THE MARKETPLACE.
IN ADDITION THE PROBABLY ABOUT
HALF OF OUR MEDIC OUR HEALTH
CENTERS DO IN FACT HAVE CAL
COORDINATORS I'M SORRY CARE
COORDINATORS. THAT WORK DIRECTLY
WITH STUDENTS ON REFERRALS TO
SPECIALTY CARE TO IN FACT MAKE
SURE THAT THEY ARE SET UP WITH
THE PROVIDER FOR THAT SPECIALTY
CARE IN THAT THERE'S FOLLOW UP.
AS WELL AS THEIR INSURANCE
OPTIONS SO IF THEY DON'T HAVE
INSURANCE CERTAINLY WOULD GO AND
HAVE A CONVERSATION ABOUT
MEDICAID ELIGIBILITY COVERED
CALIFORNIA AND. THEY'RE OUT TO
BUILD IT THEIR ELIGIBILITY TO
PER.
PURCHASE INSURANCE TO THOSE
OPTIONS AS WELL. SO HOPEFULLY
I'VE ANSWERED MANY QUESTIONS AND
CERTAINLY OPEN MORE. ANY
QUESTION FOR ANY OF THE MEMBERS
YET QUESTIONER LABOR.
THANK YOU MISTER CHAIR. GOOD
AFTERNOON THANK YOU ALL VERY
MUCH FOR BEING HERE. IS WORKING.
IS IT WORKING CAN YOU HEAR ME OK
IT FEELS LIKE IT'S NOT ON. OKAY
VERY GOOD UP SO I SAID I WOULD
ASK YOU THE SAME QUESTION THAT I
ASKED THE PREVIOUS PANEL.
OUT HEALTH CENTERS AT THE CAL
STATE UNIVERSITY CAMPUSES AND
YOU SEES THAT YOU COULD BE
ELIGIBLE TO ENROLL FOLKS IN
MEDICARE OUT SOME DO AND SOME
DON'T. JUST CURIOUS WHY.
YOU CAN. I WHAT I WOULD LIKE TO
HEAR FROM BOTH OF YOU I DON'T
CARE WHO GOT IT FIRST THOUGH SO
WITH US SO WE DON'T AS A MENTION
WE DON'T BILL FOR PRIVATE
INSURANCE WHY IS THAT.
WELL SO WE DID LOOK AT THIS AND
SO WITH THE EXPRESSION WITH
AFFORDABLE CARE ACT WITH MANY
MANY MORE PEOPLE HAVING CARE.
AND. OPTIONS TO SEE IF IN FACT
BUILDING WOULD PROVIDE A REVENUE
SOURCE SO IT HELPS THE STANDARD
GROW OUR SERVICES WE DID HAVE A
CONSULTANT THAT WORK WITH OUR
VICE PRINCETON AFFAIRS. AND
REALLY IT WOULDN'T SO WE DON'T
HAVE THE INFRASTRUCTURE TO
SUSTAIN A ROBUST BUILDING UP
PROCESS NOT ONLY FOR ENROLLMENT
BUT ALSO THE BILLION IN
AUTHORIZATIONS. TO THE
ADMINISTRATIVE OVER HAAS FOR
COST FOR US TO UNDERTAKE THAT
REALLY WOULD BE MORE OF A CLASS
IN A BENEFIT FOR US IN THE
REIMBURSEMENT PROCESS IT WOULD
BE A BENEFIT FOR THE STUDENTS IF
YOU ACCEPTED THEIR INSURANCE.
I'M NOT THE WAY WE SEE IT
BECAUSE RIGHT NOW THE STUDENTS
COULD WALK INTO THE HEALTH
CENTERS AND ONCE THEY PAY THE
TERM FEE THEY HAVE ACCESS TO IT
WITH NO PAYMENTS NO COPAYMENTS
NO DEDUCTIBLE LIMITS OR ANYTHING
SO. IF WE'D START BILLING
INSURANCE AND WE DID EXPLORE
THIS WHEN WE'RE DEVELOPING A
MENTAL HEALTH POLICY NONE OF THE
INSURANCE THAT WE'VE TALKED TO
WERE WILLING TO GIVE UP THAT CO
PAY. SO WE SAID HE STUDENT PAYS
A FLAT RATE BUT THEY SAID NO WE
STILL WANT THE COPAY SO THERE
WOULD BE A PER VISIT COST FOR
STUDENTS IF THEY WERE TO WALK IN
THE DOOR. SO FINE I'M A PARENT
AND I'M PAYING FOR MY CHILDREN
TO HAVE HEALTH INSURANCE AND
THEY GO TO COLLEGE INSTEAD OF
BUILDING OUR INSURANCE WHICH WE
PAY FOR EVERY MONTH WE NOW HAVE
TO PAY AN ADDITIONAL FEE. SO
THEY CAN GO TO THE CAMPUS HEALTH
CENTER.
CORRECT AND THE ANNUAL COST THE
AVERAGE COST IS TWO HUNDRED
SEVENTY TWO DOLLARS BUT IT'S
JUST NOT. WHAT THAT FEE COVERS
IS NOT JUST THE DIRECT MEDICAL
SERVICES AT THE STUDENTS PROVIDE
THERE MANY OTHER SERVICES
NUTRITION AND HEALTH AND
WELLNESS EDUCATION PROGRAMS
HEALTH FAIRS? THAT THE STUDENTS
HAVE ACCESS TO THAT THAT SERVER
THAT HEALTHY DOES COVER NOT JUST
THE DIRECT MEDICAL THAT ONLY
INSURANCE WOULD BE ABLE TO BE
BUILT FOR AND DO ALL CAMPUSES
OFFER THE SAME KIND OF HEALTH
SERVICES TO HAVE A STANDARD OF
CARE TO MAKE SURE EACH HEALTH.
CENTERS PROVIDING THIS REDUCE OR
EXECUTIVE ORDER DOES OUTLINE THE
BASIC SERVICE THAT I TALKED
ABOUT ARE THE MINIMUM
EXPECTATIONS OF THE CAMPUSES TO.
PROVIDE FOR THE STUDENTS INTO
SOME CAMPUSES PROVIDE MORE.
THE CAMPS IS TO PROVIDE MORE SO
THERE IS AN OPTION FOR AUGMENTED
SERVICES OF SOME CAMPUSES DO IN
FACT. CONTRACT WITH PROVIDERS IN
ITS OF ONE ON ONE RELATIONSHIP
BETWEEN THE PROVIDER IN THE
STUDENT FOR. DENTAL AND ALSO
VISION.
BENEFITS AS WELL AS HIS PHYSICAL
THERAPY ATHLETIC TRAINING AND SO
FORTH LIKE THAT IS THERE REASON
THAT IF I GO TO ONE SCHOOL I
HAVE A BETTER BENEFIT THAN IF I
GO TO ANOTHER SCHOOL IN I DON'T.
I WAS LOOKING FOR SOME
UNIFORMITY SO THAT YOU KNOW WORK
REGARDLESS OF WHERE I CHOOSE TO
GO TO SCHOOL I HAVE THE SAME
BENEFIT.
WELL THE SAME BENEFIT IS WHAT
WE'RE COMMITTING TO THE STUDENT
IS OUR BASIC SERVICES BY AUG
VENOM. DRIVEN BY THE NEEDS OF
THE CAMPUS AND WHAT THE STUDENTS
ARE REQUESTING IN REGARDS TO
SERVICES FOR THAT PARTICULAR
AREA. THE OTHER THING THAT COMES
INTO PLAY WITH THAT IS THE IS
REALLY THE AVAILABILITY OF
PROVIDERS. SO THE AREAS THAT DO
PROVIDE THE MEDICAL THE I'M
SORRY THE VISION AND THE DENTAL
ARE MORE IT OR THE ALLEY IN SAN
DIEGO AREA. OUTSIDE OF THAT
EXPRESSION THE RULE COMMUNITIES
THEY'RE NOT AS AVAILABLE
PROVIDERS THAT HAVE THAT EXTRA
TIME AND HAVE THE SPACE WITHIN
THEIR PATIENT LOADS TO IN FACT
CONTRACT GO ONTO OUR CAMPUSES.
AND WE GOT A LITTLE OFF TOPIC DO
ALL OF YOUR CAMPUSES OR ANY OF
YOUR CAMPUSES ACCEPT MEDICARE
ALL.
CURRENTLY RIGHT NOW THEY DO NOT
ACCEPT MEDICAL. BUT WE DID GET
IN OUR GUIDANCE DID OPEN THAT
CONVERSATION UP FOR OUR CAMPUSES
TO EXPLORE THAT. HOW LONG AGO
DID YOU START EXPLORING THAT?
PROBABLY ABOUT A YEAR YEAR AND A
HALF AGO THE WHEN WILL BE WHEN
WILL THEY BE DONE EXPLORING AND
MAKE A DECISION WELL THAT'S UP
TO THE CAMPUS INDIVIDUAL CAMPUS
THOUGH IS IT SYSTEM WHAT WE'RE
INTERESTED IN WHAT I COMMENTED
ON. IS IN FACT HAVE THE
PROVIDER'S DESIGNATED AS MEDICAL
PROVIDERS FOR THOSE DIRECT
REFERRALS FOR SPECIALTY CARE.
INITIALLY BECAUSE I MENTIONED
THE OVERHEAD THE COST OF THE
OVERHEAD WERE REALLY NOT THAT
INTERESTED IN THE BUILDING OR
THE CAPITATION FEES WE'RE JUST
WORRIED ABOUT. THE CONTINUED
CARE FOR THE STUDENTS TO MAKE
SURE THAT THAT'S MORE SEAMLESS
OKAY.
UNDER YOUR BASIC CORE SET OF
HEALTH CARE SERVICES ARE
PROVIDED AT THE C. ISSUE HEALTH
CENTERS WHAT IS CONSIDERED
FAMILY PLANNING SERVICES.
THE FAMILY PLANS TO MERGE THE
TESTING I'M SORRY THE PREGNANCY
TESTING AND ALSO THE INFORMATION
OF DIFFERENT OPTIONS. GIVEN AN
UNPLANNED OR PLANNED PREGNANCY
AS WELL AS.
BIRTH CONTROL WHICH IS USUALLY
ONE OF THE BIGGEST US SERVICES.
AND IS THERE ANYTHING FOR
ABORTION MEDICATED ABORTION OF A
WOMAN FINDS HERSELF IN THAT
SITUATION.
RIGHT NOW IT'S JUST ON
CONSULTATION AND THEN WE WERE
FOR AND HAVE.
PARTNERSHIPS WITH THE LOCAL
SERVICES LIKE FLAM FAMILY.
PLANNED PARENTHOOD TO REFER
STUDENTS IF IN FACT THEY SEEK
MORE SERVICES THAT ARE BEYOND
OUR SCOPE. OKAY OKAY THANK YOU
VERY MUCH.
LET ME JUST CLARIFY SO MENACING
THE UC'S IF THE STUDENT HAS
INSURANCE THEY CAN OPT OUT OF IT
PRE TEEN THE STUDENT HEALTHY IS
THAT CORRECT.
WELL.
THE JUST TIP THE CAMPUS HEALTH
CENTERS ARE ACTUALLY FUNDED BY A
PORTION OF THE REGISTRATION FEES
AND THAT VARIES BY CAMPUS. SO
WHAT THAT DOES IS SIMILAR TO SEE
IF YOU IT PRODUCES A A. A LEVEL
OF BASED SERVICES A PRIMARY CARE
AND MENTAL HEALTH PRIMARILY AT A
VERY LOW COST.
MENTAL HEALTH CARE IS OFTEN AND
MOST OF OUR CAMPUSES FREE FOR
THE FIRST FIVE OR SIX VISITS.
AND OF ALL OF OUR PRIMARY CARE
VISITS USED TO BE FREE UNTIL
ABOUT TWO THOUSAND NINE WHEN WE
NEEDED TO START GOING CHARGING
COPAYS ABOUT THE SAME AMOUNT
THAT YOU AND I WOULD HATE TO SEE
A DOCTOR. FIFTEEN OR TWENTY
DOLLARS SO.
.
THERE ARE THERE ARE THE THE
BREACH PLANS I WAS REFERRING TO.
ALLOWS STUDENTS WITHOUT SHIP TO
HAVE A SIMILAR BENEFIT FOR FOR
SOME OF THESE.
ENHANCED SERVICES PROCEDURES
SPECIALISTS THAT MAY OR MAY NOT
BE BROUGHT TO THE CAMPUSES. LAB
XRAY ANCILLARIES PHARMACY
ETCETERA.
BUT NOT ALL STATES.
YOU SEE WORK SAMMY SO THERE ARE
INSTANCES WHERE A STUDENT CAN
OPT OUT OF PAIN THOSE STUDENT
SERVICE FEES IF THEY HAVE A SOME
KIND OF INSURANCE.
YES YES OKAY US AND IF THEY
MIGHT LOSE DID OKAY THEY CAN USE
THAT WAS THE QUESTION I WANT AND
THEY CAN USE THEIR OWN INSURANCE
ALSO QUESTION. IN THE PRIVATE
SCHOOLS. DO THEY HAVE NOT ALL
PRIVATE SCHOOLS HAVE THE OPTION
TO OPT OUT WITH THE EXCEPTION OF
A FEW IS THAT CORRECT.
SO THEY HAVE THE OPT OUT OPTION
IF IT'S REQUIRED TO HAVE A
STUDENT HEALTH INSURANCE PLAN
NOT OVER CAMPUSES REQUIRE.
HEALTH INSURERS THE CSU DOESN'T
HAVE THE OPTION TO OPT OUT IS
THAT CORRECT. WE DO HAVE AN
OPTION TO OPT OUT IT'S VERY
MINIMAL OR IT'S VERY SELDOM USE
SO. HERE'S MY CONCERN ABOUT.
MAYBE NOT MUCH LESS SO FOR THE
U. SEIZES. THE STUDENT FINANCIAL
AID THAT DOESN'T HAVE THE
ECONOMIC MEANS IS WHY ARE THEY
BEING REQUIRED IF THE VIRUS A
MEDICARE PATIENT TO PAY THE
STUDENT FEES THAT'S THE CONCERN
I HAVE. AND I THINK THAT I THINK
YASSER LABOR MADE THAT SAME
COMMENT I'M SURE. SHE CAN AFFORD
IT YOU KNOW RIGHT EXACTLY. WHERE
IS A SOMEBODY WHOSE PARENTS
DON'T HAVE THE MEANS THEIR
MEDICARE OUT AND I THINK THAT'S
A CONCERN THAT THAT I HAVE? A
WANNA GO AND FOLLOW UP BACK WITH
THE WITH THE UC. WITH REGARD TO
THE NON WRAPAROUND AND TAKING
OVER THE MEDICARE PATIENTS IN
THE CAMPEONATO RISK. SO BY THE
WAY THE STUDENTS VOTE FOR THESE
FEES THAT'S ONE THING TO ME THAT
YOU KNOW JUST FOR FOLKS OKAY I'M
JUST I'M JUST. A THEY MAY VOTE
FOR BUT YOU STILL HAVE STUDENTS
REPORTS I'VE JUST BUT IT'S A
GREAT BODY. SO SORELY IDEAL
COVER ORGAN TRANSPLANTS BLOOD
FACTOR TRANSPORTATION. SKILLED
NURSING DURABLE MEDICAL GOODS
SERIOUS MENTAL ILLNESS INCLUDING
SITE PSYCHIATRIC
HOSPITALIZATIONS SUBSTANCE ABUSE
TREATMENT.
OUR PREGNANCY DELIVER AND FAMILY
COVERAGE OUT. WHAT IS WHAT IS
THAT
THRESHOLD LOOK LIKE WHAT IS THE
REQUIREMENT?
SO AGAIN A COMMITTEE OF OF TWO
NOW DIRECTORS AND INSURANCE
MANAGERS AND STUDENTS FROM THE
STERN HEALTH ADVISORY COMMITTEES
AT EACH CAMPUS.
GLOBALLY AGREE ON WAIVER
CRITERIA THAT WE WILL APPLY
ACROSS THE SYSTEM AND THE SHORT
SUMMARY WOULD BE IT NEEDS TO BE.
AT LEAST A I BELIEVE A BRONZE
LEVEL PLAN THAT ALLOWS STUDENTS
TO GET COVERAGE LOCALLY AND WOOD
WORKING IN YOU KNOW IN THE
COMMUNITY IN WHICH THEY ARE
GOING TO SCHOOL.
AND DO ANY OF YOUR SCHOOLS ANY
CAMPUSES ACCEPT MEDIC HELL.
CURRENTLY NO AND THE MAIN THE
IMPEDIMENT IS AGAIN THE COST TO
BUILD THE INFRASTRUCTURE.
AND THEN. AGAIN IF THERE'S ONLY
A SMALL PERCENTAGE OF MEDICAL
PATIENTS WHO WERE FEE FOR
SERVICE AND MOST OF THE MANAGED
CARE. THERE MAY NOT BE MUCH OF A
RETURN ON INVESTMENT ON ON
BUILDING THAT INFRASTRUCTURE WE
DON'T HAVE A PROBATION AGAINST
BILLING THIRD PARTY INSURANCE
IS.
BUT IT'S JUST NOT SOMETHING THAT
OUR STUDENT HEALTH CENTERS ON
THE CAMPUSES HAVE EVOLVED OF TO
DO.
AND THE BRIDGE PROGRAM THAT YOU
TALKED ABOUT WHAT IS THE
ADDITIONAL FEE FOR THAT HOW MUCH
WOULD THAT COULD VERY SOON
BETWEEN CAMPUSES BETWEEN ABOUT A
HUNDRED AND EIGHTY DOLLARS AND
FOUR HUNDRED AND EIGHTY DOLLARS
PER YAR. AND THAT'S THE BEST
WAY TO DESCRIBE IT BECAUSE WE
HAVE BOTH CORNERS AND SEMESTERS
AT DIFFERENT SCHOOLS BUT THAT
THAT'S THE RANGE. OF SO FROM TWO
HUNDRED TO FIVE HUNDRED DOLLARS
AND WHAT THAT WOULD ALLOW IS A
STUDENT WITH ANY OTHER KIND OF
INSURANCE. TO RECEIVE THE ENDS
FAME ENHANCED COVERAGE AT THEIR
CAMPUS HEALTH CENTER AS IF THEY
PURCHASE THE UC SHIP PLANT.
HE.
I. ONCE HEARD ONE OTHER
QUESTION.
DO YOU HAVE A SET OF STANDARDS
FOR EACH CAMPUS AS WELL FOR
HEALTH FOR THE HEALTH CENTERS.
WE WE NOT NOT THAT I KNOW OF WE
DO NOT HAVE A A A PUBLIC SYSTEM
WIDE SET OF STANDARDS BUT I I'VE
BEEN IN THE SYSTEM FOR MORE THAN
TWENTY YEARS AND AND I WOULD SAY
THERE IS A STANDARD OF CARE.
THAT ALL OF US. UNDERSTAND AND
AND PROVIDE. TO OUR.
POPULATION OF AND IT IS FOCUSED
ON YOU KNOW THE THE THE NEEDS OF
OF THIS AGE COHORT AND THE NEEDS
OF OF OF YOUNG ADULTS WHO WERE
ON THEIR OWN FOR THE FIRST TIME
TRYING TO ACCESS HEALTH CARE.
AND IS THE STANDARD OF CARE
INCLUDE ON FAMILY PLANNING SO
ABSOLUTELY IT'S ONE OF OUR
BIGGEST LINES OF BUSINESS AT ALL
CAMPUSES.
WE FROM FROM OF CONTRACEPTION
OF ALL TYPES INCLUDING A UT
PLACEMENT MOST CAMPUSES.
EMERGENCY CONTRACEPTION.
.
THE PREGNANCY COUNSELING A
REFERRAL FOR ABORTIONS IF
NECESSARY.
WE DON'T PROVIDE ANY OF THOSE
SERVICES ON CAMPUS YET.
AS YOU KNOW THERE'S DISC
ONGOING DISCUSSIONS WHERE THAT'S
BEING EVALUATED.
BUT.
THAT IS ONE OF OUR MOST YOU
KNOW ROBUST LINES OF WORK AND
REASONS WHY WERE ON CAMPUS.
GREAT THANK YOU VERY MUCH.
I'M GONNA MISS BUT DUCKS BACK
WHEN I I CAN HELP BUT NOTICE IT
EVERY TIME.
YOU MAKE A.
OF OF. THE BRIDE BOLD IN GOOD
CLAIM ABOUT THE COVERAGE THAT'S
OFFERED TO THE YOU SEE YOUR
COLLEAGUE FROM THE O. P. FRIENDS
TO THE MICROPHONE AND THEN.
KIND OF SLOWLY WALKS BACK SO I.
HAVE. BOTH OF YOU ACTUALLY SO I
I I JUST WAS WONDERING IF
THERE'S SOMETHING THAT YOU'D
LIKE TO ADD OR CLARIFY OR.
BECAUSE THEN YOU KNOW. YOU'RE
YOU'RE TALKING ABOUT TAKING A
LOT OF RISK.
YOU HAVE ONE STUDENT.
YOU KNOW GETS VERY SERIOUSLY
ILL.
IT COULD UPSET THE APPLE CART
SIDE. I'M JUST.
WANNA MAKE SURE WE'RE ALL KIND
OF ON THE SAME PAGE WE'RE
GETTING ALL THE SAME INFORMATION
FROM FROM YOU KNOW.
DID JUST. WHAT NOW ABOVE ALL
HERE YOU'RE OUT BUT BUT WE
SHOULD HEAR FROM THEM TOO SO YES
OF DID YOU?
THANK YOU AT WE JUST WANT TO
CLARIFY THAT YOU SEE SHIP COVERS
ALL MEDICAL CONDITIONS EMERGENCY
TRANSPORTATION BE IT. PREGNANCY.
IT I'M CANCER.
ORGAN TRANSPLANT ALL OF THE
MEDICAL CONDITIONS THE SERVICES
THAT MEDICARE ELF PROVIDES THAT
WE DO NOT PROVIDE A THINGS LIKE
IN HOME SUPPORT SERVICES NON
EMERGENCY TRANSPORTATION THOSE
TYPE OF SERVICES WE DO NOT
PROVIDE YOU JUST SAID THEY WILL.
I ASKED THE QUESTION IF THEY
WILL DO. TRANSPORTATION AS WELL
I ASKED THOSE QUESTIONS AND HE
SAID THE WORDS TRANSPORTATION.
WHAT ABOUT NETWORK ADEQUACY AND
TIME AND DISTANCE?
WE DON'T CURRENTLY DO THOUGH
THAT TYPE OF REPORTING THAT A
MEDICAL PROVIDED US BUT HE SO
YOU WOULD HAVE TO ABIDE BY
EXACTLY WHAT EVERY OTHER.
MANAGED CARE PLAN WOULD WHICH
WAS TIME AND DISTANCE NETWORK
ADEQUACY. AND THAT'S WHY I ASKED
SPECIFICALLY ASKED THE QUESTION
ARE YOU GOING TO REQUIRE A
WRAPAROUND. THAT'S A LOT OF
SERVICES ARE GOING TO BE
PROVIDING THAT YOU TAKING ON
HEAT I ASKED THAT QUESTION HE
SAID YES TRANSPORTATION.
NOW THERE'S CONFLICTING.
YEAH.
AS SENATOR BECAUSE I THINK WHEN
YOU SAID TRANSPORTATION THERE'S
THERE'S. MY EXPERTS HERE
SPLITTING HAIRS IT EMERGENCY OR
NON EMERGENCY TRANSPORTATION
YOU'RE JUST SAYING
TRANSPORTATION MURDER SCENE
NUMBER CATION.
EVEN A MEDICARE PATIENTS ARE
MEDICARE MANAGED CARE. THEY GET
TRANSPORTATION COVERED ARM TO
THE DOCTOR'S OFFICES AS WELL.
THERE'S A LOT OF RISK IN THAT I
SPECIFICALLY ASKED THE QUESTION
TO BEGINNING ARE YOU GOING TO BE
REQUIRED WRAPAROUND SERVICES THE
ANSWER WAS NO. I'M SAYING YES.
SO YOU'RE GONNA BE NEEDING
WRAPAROUND SERVICES YES BECAUSE
MEDICARE COVERS THINGS THAT ARE
NOT JUST MEDICAL YOU HAVE JUST
CONTRADICTED EXACTLY WHAT THIS
GENTLEMAN SAID EVERY FIRST
QUESTION. I KNOW THE FIRST
QUESTION I ASKED YOU ARE YOU
REQUIRING WRAPAROUND SERVICES HE
SAID YES.
I THINK WELL HE SAID NOW IF WE
WOULD HAVE TO AND I THINK FROM A
MEDICAL PERSPECTIVE.
THERE ARE CERTAIN THINGS THAT
ARE NOT CONSIDERED PART OF THEM
THAT I AM THERE. THAT THE
STUDENT HEALTH INSURANCE
COVERAGE AN IN HOME SUPPORTIVE
SERVICES IS NOT.
NON EMERGENCY TRANSPORTATION IS
NOT AND THAT WOULD HAVE TO BE
ADDRESSED BUT ON YOUR EXAMPLE
ABOUT CANCER THAT'S COVERED
OTHER AND AND.
CATASTROPHIC KINDS OF ACCIDENTS
SKI ACCIDENTS CAR ACCIDENTS
THOSE KINDS OF THINGS ARE
COVERED THERE ARE NO LIFETIME
LIMITS BUT THERE ARE SOME THINGS
THAT MEDICARE WILL COVER. AND WE
WOULD HAVE TO LOOK LINE BY LINE
BUT FOR THE MOST PART MOST
THINGS IN MEDICINE WOULD BE
COVERED BY THE UNIVERSITY AND
BUT AND I APPRECIATE YOUR
HONESTY IN YOUR ANSWER THAT'S
WHY SPECIFICALLY ASKED THE FIRST
QUESTION. WOULD BE REQUIRED
WRAPAROUND SERVICES AND THE
ANSWER WAS NO. STARTED ASKING
THE QUESTIONS ABOUT
TRANSPORTATION TIME AND
DISTANCE.
NETWORK ADEQUACY BECAUSE THERE'S
A LOT OF REQUIREMENTS PUT UPON
MEDICAL MANAGED CARE EYEPIECE
PROGRAMS WHEN THEY CONTRACT WITH
SOMEBODY TO PM PM. SO WE HAVE
CONFLICTING.
IF YOU HAVE HONESTY IT'S AN
ISSUE OF UNDERSTANDING MEDICARE
OUT AND I THINK OUR STUDENT
HEALTH CENTERS ARE NOT AS IN
DEPTH AND SOME OF THE. TICKET TO
ANSWER THE QUESTION US
SPECIFICALLY SO IT WAS NOT AN
HONESTY ISSUE IT WAS A MEDIC HOW
UNDERSTANDING ISSUE OKAY AND
THAT'S WHY I ASK THAT BECAUSE I
KNOW AND UNDERSTAND WOMEN
ACCOUNT PROVIDES FOR A TIME AT
THE SITE FOR. PATIENTS WITHIN
THE STATE OF CALIFORNIA IT'S A
PRETTY ROBUST.
POLICY AND. I ASKED THE FIRST
QUESTION EDDIE ANSWERED YES WE
WOULD REQUIRE WRAPAROUND
SERVICES I WOULDN'T PUSH THE
ISSUE ANYMORE. THAT'S WHY WE
CAN'T RUN AS WELL AS RUNNING
OKAY I GET IT OKAY.
IT'S BEEN ANSWERED.
THAT.
ANY OTHER QUESTIONS FROM ANY OF
THE MEMBERS.
THANK YOU.
OKAY WE'RE GONNA MOVE ON TO
PRIVATE AND PUBLIC HEALTH PLAN
POLICIES AND PRACTICES WE HAVE
JENNIFER ELLIE AND BREANNA.
LIEBERMAN
.
I COULD JENNIFER AUTHER WITH THE
CALIFORNIA ASSOCIATION HEALTH
PLANS REPRESENTS FORTY EIGHT.
.
HM OWES IN SOME OF OUR MEMBERS
ALSO HAVE PPO COVERAGE THAT THEY
OFFER IS WELL.
AND SO I JUST STAY IN MRS
COUNTS DID A VERY GOOD JOB YOU
KNOW EXPLAINING HOW YOU KNOW THE
CURRENT.
HEALTH INSURANCE MARKET WORKS I
JUST KINDA WANTED TO ELABORATE A
LITTLE BIT ON ON WHAT SHE SAID
SO MY COMMENTS WILL BE
RELATIVELY SHORT THIS AFTERNOON.
AND IJUST KIND OF WANTED TO
TALK A LITTLE BIT MORE ABOUT YOU
KNOW THE EMERGENCY ROOM AND
URGENT CARE COVERAGE RIGHT SO.
ON ANY INDIVIDUAL THAT'S AND
ROLLED AND YOU KNOW HEALTH
INSURANCE HAS ACCESS TO
EMERGENCY IN AN URGENT CARE
REGARDLESS OF WHERE THEY ARE
WITHIN THE STATE. OM ALL MANAGED
CARE YOU KNOW REQUIRES PRIOR
AUTHORIZATION TO SEE A
SPECIALIST.
AHMED SO SOME OF OUR MEMBERS ARE
LARGE AND THEY HAVE. SYSTEMS IN
PLACE IF YOU LIVE IN SACRAMENTO
NATO TO SCHOOL AND. IN SAN DIEGO
IF THERE'S A SISTER NETWORK FOR
THE.
HEALTH INSURANCE COVERAGE THAT
YOU HAVE IN YOUR MOST LIKELY CAN
ACCESS THOSE PROVIDERS DOWN
THERE AND UTILIZE THAT NETWORK.
ON THOSE ARE CALLED VISITING
MEMBER SERVICES THAT THEY HAVE.
ON THEY CAN ALSO HAVE PRIOR AUTH
PRIOR AUTHORIZATIONS REQUIRED
FOR ALL SPECIALTY CARE.
AND SO IF SOMEBODY HAD NEEDED
FOLLOW UP CARE TO SOMETHING AND
THEY NEEDED ADDITIONAL TREATMENT
THEY CAN ALWAYS UTILIZE A PRIOR
AUTHORIZATION PROCESS TALK TO
THEIR PROVIDER TALK TO THEIR
HEALTH PLAN. AND ACCESS TO
SPECIALTY OR FOLLOW UP SERVICES
THAT WERE NON EMERGENCY OR NON
URGENT AND THAT PROCESS IS YOU
KNOW. INFORMATION ON HOW THAT
WORKS IS PROVIDED TO OUR.
ENROLLEES IN THERE SOME SUMMARY
OF BENEFITS AND COVERAGE WHICH
IS. NO THAT DOCUMENT IS
REGULATED IN STATE STATUTE. AND
REGULATION SPECIFICALLY HOW
MEMBERS CAN ACCESS SERVICES AND
SO THAT IS COVERED. ON ONE OF
THE QUESTIONS WE WERE. ASKED TO
ANSWER WAS. TO HEALTH PLANS YOU
KNOW CHECK OFFER HAVE A WAY TO
TRACK IF SOMEBODY IF ONE OF
THEIR RELEASES A COLLEGE STUDENT
YOU KNOW MAY BE LIVING AT HOME
OR NOT. IN THE ANSWERS
CURRENTLY.
THE FEEDBACK I RECEIVE FROM MY
MEMBERS THIS IS NO THEY DON'T
BUT THEY ALSO TOLD ME THAT
THEY'RE NOT GETTING A LOT OF
PLANT GRIEVANCES OR APPEALS
FILED. FOR PEOPLE THAT ARE
TRYING TO ACCESS SERVICES OUT OF
NETWORK SO. THERE EITHER AT THE
SYSTEM'S WORKING OR THAT THEY
NEED JUST ISN'T CURRENTLY BEING
SHOWN UP IN THE CURRENT
REGULATORY FRAMED AT OUR OUR
MEMBERS HAVE TO TRACK MY MEMBERS
HAVE TO POINT SIX MILLION OF THE
ROUGHLY ELEVEN MILLION ENROLLED
IN MEDICAID MANAGED CARE. SO I
JUST WANT TO HIGHLIGHT.
ADDRESS THREE THINGS TODAY IN
BUT.
DISTILL WHAT THE DEPARTMENT
SAID OF COURSE ON HOW IT WORKS
TODAY MEDICAL MANAGED CARE. GIVE
THE PLANS FIRST ON.
PERSPECTIVE ON. HOW IT WORKS
OUT THERE WITH THE STUDENT
HEALTH CENTERS AND THE UC
DELIVERY SYSTEM? AND THE GIVER
PERSPECTIVES ON THE ALTERNATIVE
SO WE JUST LEFT OFF ON THE
PREMIUM ASSISTANCE PROGRAM IS
SOME THOUGHTS WE HAVE THERE AND
HOW IT WORKS. ON HOW IT WOULD
HAVE TO WORK. SO AS YOU HEARD
EARLIER.
POWERS TODAY IN THE MEDIC
HEALTH SYSTEM IS IF ONE OF OUR.
ENROLLEES IS A STUDENT GOES AWAY
TO COLLEGE OF TWO CHOICES THEY
CAN STAY IN THEIR HOME HEALTH
PLAN OR IN THEIR CALLS COUNTY
HEALTH PLAN THEY HAVE THAT
CHOICE.
THAT CHOICE IS OUTLINED FOR THEM
IN THE MEMBER HANDBOOK SO THAT'S
AN ALL MEMBER HANDBOOKS AS
REQUIRED BY THE DEPARTMENT OF
COURSE.
PLANS FOLLOW THAT POLICY AS
REQUIRED BY THE DEPARTMENT AND
AND THE MEDICAL PROGRAM.
SO THE STUDENT CHOOSES TO STAY
AND HAS HER HEALTH PLAN IN OUR
HOME COUNTY WHAT DOES THAT MEAN
SO IF I MAY LIVE IN RIVERSIDE
MAY GO TO SAC STATE. AND I SAY
MY RIVERSIDE HEALTH PLAN WHICH
SHOULD BE IN LINDA EMPIRE HEALTH
PLAN OR FORMALLY.
I WOULD HAVE ACCESS AS FOLKS
HAVE ALREADY MENTIONED. TO MERGE
THE SERVICES URGENT CARE
SERVICES WAS URGENT CARE IT'S
CARE THE NEED WITHIN ABOUT
TWENTY FOUR HOURS SO IT COULD BE
A SCIENCE INFECTION.
A SPRAIN OR ANY OTHERTYPE OF
INJURY. FAMILY PLANNING SERVICES
AND ANOTHER.
BENEFIT ALSO EVEN IF YOU'RE OUT
OF THE SERVICE AREA IS GENERALLY
PRESCRIPTIONS.
SO ALL HEALTH PLANS HAVE
RELATIONSHIPS ITH CHAIN
PHARMACIES LIKE TO WALGREENS OR
CVS WHICH ARE STATEWIDE
NATIONWIDE. SO EVEN IF I HAVE MY
HEALTH PLAN DOWN IN RIVERSIDE
COUNTY AND I'M LIVING IN
SACRAMENTO I CAN STILL PICK UP
MY PRESCRIPTIONS. AND SACRAMENTO
SO WANT TO PUT A FINER POINT ON
THAT THAT THOSE THOSE ARE
AVAILABLE.
AND OF COURSE IT OTHER SERVICES
ARE AVAILABLE IT DEPENDS ON IF
YOU GO TO THIS YES YOU WERE THE
YOU SEE BUT GENERALLY AS YOU'VE
HEARD A LOT OF YOUR PRIMARY CARE
SERVICES ROUTINE SERVICES ARE
AVAILABLE THERE ON CAMPUS.
THEY'RE INCLUDED IN YOUR TUITION
AND FEES I THINK AS I UNDERSTAND
IT IF I WASN'T CONFUSED
REGARDLESS OF WHETHER YOU'VE
ENROLLED IN THE SHIP TO STUDENT
HEALTH INSURANCE PROGRAM.
SO PERSPECTIVES ON THE CURRENT
SYSTEM THERE IS QUITE A BIT OF
CONVERSATION ABOUT COME FORTH
ABOUT ON HEALTH SERVICES WORK
WITH THE STATE HEALTH CENTERS ON
WHETHER RELATIONSHIPS BETWEEN
HEALTH CENTERS AND HEALTH PLANS.
AND WE DON'T KNOW THE SCOPE OF
THE PROBLEM SO TO WHAT EXTENT
IS.
GOING AWAY TO COLLEGE AND HAVING
TO CHANGE PLANS ARE STAYING HOME
PLAN. CREATING A REAL ISSUE FOR
OUR STUDENTS AND AND IN OUR
MEMBERS AND ROLE IN OUR HEALTH
PLANS.
I ASKED OUR HEALTH PLANS YOU
KNOW DO YOU DO YOU HEAR ABOUT
THIS LOOK AT YOUR GRIEVANCES
LOOK AT OUT OF AREA ON PHARMACY
REQUESTS FOR EXAMPLE. WE'RE NOT
HEARING AND SEEING ANYTHING IN
AGREEMENTS LOGS ABOUT THOSE
PROBLEMS WE DON'T WE ACTUALLY
DON'T HAVE A SENSE OF THE. WEEK
WE HEAR WHAT THE POPULATION
MIGHT BE WE DON'T HAVE A SENSE
OF THE SCOPE OF AN ACTUAL
PROBLEM HERE.
BUT I THINK REGARDLESS OF
WHETHER IT'S A BIG PROBLEM ARE
NOT YOU KNOW WE WE ARE PARTNERS
WITH ALL OF YOU IN PARTS OF THE
STATE MAKING SURE.
THAT WE'RE ACCOUNTABLE TERM
MEMBERS AND WE'RE GIVING THEM
THE BEST EXPERIENCE IN THE
HEALTHCARE DELIVERY SYSTEM THAT
WE CAN'T SO.
AND TALKING ABOUT WHAT WE CAN
DO WITHIN THE CURRENT DELIVERY
SYSTEM YOU KNOW MEDICARE PREMIUM
ASSISTANCE ALTERNATIVES ASIDE
WHAT CAN WE DO BETTER TODAY.
AND I ASKED MY PLANS YOU KNOW
HOW CAN YOU BRIDGE THE DIVIDE IT
IT SEEMS FAIRLY CLEAR THAT THERE
IS A BIT OF A SILO. BETWEEN THE
HEALTH CARE YOU KNOW THE MEDICAL
DELIVERY SYSTEM ON THE MARKET
PLACE DELIVERY SYSTEM AND THE
STUDENT HEALTH PROGRAMS. IN THAT
THIS USE THE HEALTH CENTERS ARE
NOT CONNECTED TO INSURANCE AND
THEY DON'T TAKE IT INSURANCE.
AND.
DO YOU SEIZE IT HAD MANY
CONVERSATIONS ABOUT WE NEED TO
BRIDGE OTHER RELATIONSHIPS
BETWEEN MEDIC HOW END THE UC.
AND REALLY THE WORLD CLASS
MEDICAL CENTERS THAT WE COULD
REALLY BENEFIT FROM HAVING IN
OUR DELIVERY SYSTEM.
WE HAD SOME THE PLANS HAVE
TRIED TO BUILD RELATIONSHIPS
WITH THE HEALTH CENTERS HAVE
SAID THAT. OUT CREDENTIALING
REALLY IS A CHALLENGE AND.
CREDENTIALING MEANS THAT A
FOREIGN ROLLING AT PROVIDER IN
OUR NETWORK THEY HAVE TO MEET
CERTAIN REQUIREMENTS IS NOT
SPECIFIC TO THE PLANETS
ACTUALLY.
RECORDED THE PROGRAM IN MEDICAL
SO THEY HAVE TO IT FOR EXAMPLE
MEET SITE REVIEW.
IT WE HAVE TO VERIFY THE
CREDENTIALS OF THE PROVIDERS AND
THE NETWORK ENACTED HERE TO THE
AUDIT AND OTHER REQUIREMENTS FOR
PARTICIPATION IN MEDICAL PROGRAM
GENERALLY SO WE HAVE EXPERIENCED
CHALLENGES AND GETTING A HEALTH
CENTERS IN OUR NETWORKS BECAUSE
OF FAILURE TO MEET CREDENTIAL
CRITERION ABILITY. AND ALSO
RELATE TO THE BILLING ISSUES. A
SECONDARY ISSUE WITH THAT WITH
THE HEALTH CENTERS FOR THE
MEDICAL PLANS PERSPECTIVE IS
THAT THEY ACTUALLY DON'T WANT TO
TAKE THE MEDICAL MEMBERS AS
WELL.
SO ADDING THE HEALTH CENTERS TO
OUR NETWORKS WHEN THEY DON'T
WANT TO TAKE OUR MEMBERS CREATE
SOME ADMINISTRATIVE ISSUES THAT
WE HAVE TO SORT THROUGH WITH THE
STUDENT HEALTH CENTERS.
SO LASTLY TO SOME PERSPECTIVE ON
THE ALTERNATIVE SOLUTIONS SO WE
TALKED TO BEN HEARD ABOUT HIT
BIT ABOUT. I'M USING MEDICARE
MEDICAID PREMIUM ASSISTANCE AND
SO WHAT THAT MEANS AS WE
UNDERSTAND IT IS.
THE SOLUTION WOULD BE TO CARVE
THE STUDENTS SO TO SPEAK OUT OF
THE MEDICAL DELIVERY SYSTEM.
AND USE MEDIC HOW TO PAY THE
PREMIUMS TO THE UC SHIP THE
STUDENT HEALTH INSURANCE
PROGRAM.
WHEN USE MEDICAID PREMIUM
ASSISTANCE HE'S BENEFICIARIES
ARE STILL MEDICAID
BENEFICIARIES.
AND SO AS YOU PROBABLY WELL
KNOW YOU HAVE TO MEET CERTAIN
REQUIREMENTS IN ORDER TO USE
MEDICAID PREMIUM ASSISTANCE FOR
OTHER PROGRAMS AND AS OTHER
STATES TO THIS AND I THINK. THAT
WE EXPLAIN LATER. BUT HAS THE
BASIC REQUIREMENTS FOR HAS TO BE
COST EFFECTIVE AND HAS BECOME
PURPLE COVERAGE IN THERE WERE
SOME DISCUSSION OF WHETHER IT'S
COMPARABLE. AND THAT'S WHAT THE
WRAPAROUND SERVICES DISCUSSION
OF COURSE IS ABOUT ANY ISSUE
THERE IS THAT THE MEDICAL
BENEFIT PACKAGE IS QUITE ROBUST.
SO ANY ISSUES AND CONCERNS WE
HIVE WITH THIS ALTERNATIVE
SOLUTION IS WHETHER IT IS COST
EFFECTIVE SO IF WE WERE TO TAKE
ALL THESE OTHER SERVICES THAT
MEDICAL PROVIDES. CCS AND HOME
SUPPORTIVE SERVICES LONG TERM
CARE SAYS SMITH.
I'M NOT JUST EMERGENCY
TRANSPORTATION AND NOT JUST NON
MEDICAL TRANSPORT AND NOT JUST
NINE NINETY MERGE THE MEDICAL
TRANSPORTATION. TRANSPORTATION
MEDICAL MEDICAL PROVIDES
TRANSPORTATION NON MEDICAL NON
EMERGENCY TO APPOINTMENTS AS IT
HAS THE FULL ASSESSMENT AS TO
WHETHER THE SHIP'S ABILITY TO
TAKE ALL THOSE SERVICES IN.
PARTS PREMIUM IS ACTUALLY COST
EFFECTIVE AS BOUNCED AGAINST
MEDICAL SYSTEM.
AND THEN FINALLY I THINK YOU
KNOW.
AND REFLECTING ON AS A PART OF.
DISCUSSING THIS ISSUE AND.
LANDING IN THIS PLACE AS A
RESULT OF THE TREMENDOUS SUCCESS
OF ACA.
BECAUSE SO MANY STUDENTS USE TO
BUY INTO THE SHIP BUT NOW HAVE
COVERAGE AVAILABLE THROUGH THE
PARENTS.
THROUGH MARKETPLACE AND THROUGH
THE MEDICAID EXPANSION SO THIS
IS REALLY.
ALMOST REVIEW A CONSEQUENCE OF
THE SUCCESS OF THE PROGRAM AND
WE KNOW THAT IN ORDER TO MAKE
THE EXPERIENCE BETTER FOR
STUDENTS AND AS A MATTER OF THE
SCOPE OF THE PROBLEM IS OR HOW
BIG THE POPULATION IS. IS STILL
MERITS ATTENTION AND WE HAVE ONE
PARTNER IN ANY SOLUTION. AND WE
LOOK FORWARD TO SITTING AT THE
TABLE WITH ON THE CS USE AND YOU
SEE THE FIGURE OUT HOW WE CAN
BRIDGE THE GAPS.
AND ALSO A PART OF HAVING YOUR
AT A RECIPROCAL DISCUSSION OF
THE TREMENDOUS VALUE THAT THEY
COULD ALSO BRING TO THE MEDICAL
DELIVERY SYSTEM.
THANK YOU ANY QUESTIONS
REMEMBERS.
OKAY THANK YOU. WE'RE GONNA MOVE
ON TO ITEM NUMBER SIX THE
MEDICAID PREMIUM ASSISTANCE IN
COLLEGE STUDENT COVERAGE.
IN MASSACHUSETTS.
WE HAVE COLIN MURPHY ARE.
WE'RE TCO.
I THINK THIS IS GONNA BE SKY
PRESIDENT. YEAH.
WHAT
ALRIGHT WELCOME? CAN HEAR US.
I CAN HEAR YOU THANK YOU VERY
MUCH SORRY FOR THAT CONNECTION
PROBLEMS BUT A. PROBLEM WHEN.
EVEN THOUGH WE ARE INTRODUCED TO
WE'RE GOING TO TALK ABOUT THE
MEDICAID ASSISTANCE IN COLLEGE
STUDENT COVERAGE IN
MASSACHUSETTS. RIGHT VERY GOOD
THANK YOU VERY MUCH FOR THIS
OPPORTUNITY I WISH TO SHARE WITH
YOUR EXPERIENCE IN
MASSACHUSETTS.
AS YOU SAID YOU'VE INTRODUCED
ME BUT IT'S GOING TO CLARIFY TO
WORK FOR THE UNIVERSITY OF
MASSACHUSETTS MEDICAL SCHOOL. WE
DO CONSULTING FOR THE MASTERS IS
DEDICATED TO SEE AND ACTUALLY
THE PRE ASSISTANCE PROGRAM IN
MASSACHUSETTS IS ADMINISTERED BY
THE CENTER FOR HEALTHCARE
FINANCING IN THE AMOUNTS. OF
MOST RECENTLY I'VE WORKED AS A
PROJECT LEAD FOR THE SHIP
ASSISTANCE PROGRAM.
SO WHAT I'D LIKE TO DO IS GIVE
YOU THE BASICS ABOUT
MASSACHUSETTS MEDICAID. MANAGED
CARE WORKS WITH THEM OF
MASSACHUSETTS MEDICAID ALSO
OVERVIEWS TO HEALTH INSURANCE IN
MASSACHUSETTS. AND THEN I GET
INTO MORE DETAILS ABOUT THE
SPECIFIC PRE ASSISTANCE PROGRAM
HOW WE IMPLEMENTED IT INCLUDING
SOME OF THE LEGAL AUTHORITIES
WHICH WE OPERATE UNDER.
OKAY.
A LITTLE BIT OF A DELAY BUT HOPE
THEY'LL JUST KEEP TALKING.
SO THE MASSACHUSETTS OPERATES A
COMBINATION MEDICAID IN TITLE
TWENTY ONE CHIP NOT TO BE
CONFUSED OR SHIP THE STUDENT
HEALTH INSURANCE PROGRAM
STATEWIDE ELEVEN FIFTEEN
DEMONSTRATION WAIVER. PROGRAM IN
MASSACHUSETTS CALLED MASS TELLS
US MUCH SMALL THE MESSAGE TO
THEM SORRY CALIFORNIA WE HAVE
ONE POINT EIGHT MILLION MEMBERS
AND ABOUT SIX POINT EIGHT
BILLION.
RESIDENTS IN MASSACHUSETTS.
OF THOSE ONE POINT EIGHT MILLION
MEMBERS AT ANY GIVEN TIME WE
HAVE ABOUT EIGHT TO TEN PERCENT
HAVE HAVE OTHER PRIVATE HEALTH
INSURANCE. WE HAVE AN EXISTING.
ASSISTANCE PROGRAM FOR PRIVATE
GROUP COVERAGE WITH ABOUT TWENTY
FIVE THOUSAND COVERED MEMBERS.
AND NOW WE'VE EXPANDED IT WITH
THE STUDENTS HEALTH INSURANCE
PROCESS THIS PROGRAM.
COMING THROUGH OKAY.
SOME OKAY GOT A BIT OF DELAY
START APOLOGIZE. BY.
ALRIGHT SO HIGH UP IN
MASSACHUSETTS MUSCLE REQUIRES
MOST STUDENTS TO ENROLL IN
MANAGED CARE NOT STUDENTS ARE
SORRY MEMBERS GENERAL MANAGED
CARE. DIRECTOR KENT EARLIER
DESCRIBES HOW. MANAGED CARE
WORKS IN CALIFORNIA I THINK IT'S
THERE'S A LOT OF SIMILARITIES
THAT WORKS IN MASSACHUSETTS AS
WELL SO TO TRY TO HIGHLIGHT SOME
DIFFERENCES.
SOME. IN MASSACHUSETTS LIKE I
SAID WE ARE REQUIRED MOST
MEMBERS TO ENROLL IN MANAGED
CARE ONE GROUP THAT'S NOT
REQUIRED TO ENROLL IN MANAGED
CARE IS THOSE. MEMBERS WHO HAVE
OTHER HEALTH INSURANCE. SO IF WE
DO WE'LL COME ACROSS A MEMBER
WHO HAS OTHER PRIVATE HEALTH
INSURANCE THAT MEMBER BE DESYREL
FOR MANAGED CARE AND THEN THEY.
RECEIVE SERVICES FROM SL FEE FOR
SERVICE.
AND FOR BINGING ASSISTANCE
MEMBERS AND OTHER MEMBERS MASS
HEALTH PROVIDE WRAP SERVICES FOR
OUT OF POCKET COSTS AND ALSO
THOSE SERVICES THAT ARE NOT
COVERED BY THE PRIVATE HEALTH
INSURANCE PLANS. LIKE THE NON
EMERGENCY. TRANSPORTATION THE
LONG TERM CARE SERVICES AND
THINGS LIKE THAT.
SO THE PRIVATE CAN BECOME
PRIMARY.
HIM OURSELVES IN A SITUATION
MASS HEALTH AS A PAIR LESTER
DOOR BECOMES SECONDARY. WITH THE
RAP SERVICES.
HEALTH SERVICES. IT'S ACTUALLY
PROVIDED THROUGH MANAGED CARE AS
WELL MANAGED BASIL HEALTH
PARTNERSHIP IT'S A SEPARATE.
MANAGED CARE ORGANIZATION THE
JUST SPECIALIZES BEHAVIORAL
MENTAL HEALTH SERVICES.
ALL ABOUT SELF MEMBERS HAVE
ACCESS TO THEM IF THERE IS
SOMEONE WHO'S NO LONGER IN
MANAGED CARE AND. BECAUSE THEY
HAVE OTHER INSURANCE OF PEOPLE
UNDER AGE TWENTY ONE WOULD STILL
GET THE MASS OF A REAL HELP
PARTNERSHIP. HEALTH RAP.
BUT ANYONE ABOVE AGE TWENTY ONE
DOES NOT.
THE PREVIOUS SAYING MASS HEALTH
MINISTER OPTIONS INCLUDED THE
CHOICE OF FIVE DIFFERENT MANAGED
CARE ORGANIZATIONS. THEY ALL HAD
STATEWIDE NETWORK SO THAT WHEN
IT WAS ONLY ABOUT HALF THE STATE
WAS THE NETWORK BUT OTHERWISE WE
DON'T HAVE THE SAME GEOGRAPHIC
ISSUES. AFFORDABILITY ISSUES
THAT I CALIFORNIA HOUSE.
HOWEVER.
AS OF MARCH FIRST TO JUST TWO
WEEKS AGO BASALT IMPLEMENTED A
MAJOR OVERHAUL OF THEIR MANAGED
CARE PROGRAMS. WITH NOW ARE MORE
FOCUSED ON A CAPITATED
ACCOUNTABLE CARE ORGANIZATION
TYPE PLAN. THAT HAS MORE LIMITED
PROVIDER NETWORKS AND A MORE
LIMITED GEOGRAPHIC THAT WORKS SO
I THINK WE MAY BE EXPERIENCING
ARE SEEING SOME OF THE
SITUATIONS ON THE HAVE BEEN
DESCRIBED EARLIER PARTS OF THE
OTHER SPEAKERS.
NO PRESSURE AT THE MASSACHUSETTS
ARMY IS THAT IS MANDATORY ABOUT
SINCE NINETEEN EIGHTY NINE
MASSACHUSETTS HAS REQUIRED.
STUDENTS ENROLLED IN HIGHER
EDUCATION PROGRAMS TO BE COVERED
BY HEALTH INSURANCE IS REALLY
ONE OF THE FIRST TO. INDIVIDUAL
MANDATES.
SO THE LAW REQUIRES ARE ALL FULL
TIME STUDENTS HAVE ARE BRING US
A DISTURBANCE. AT ALL
INSTITUTIONS OF HIGHER LEARNING.
TO SCHOOLS OR CALL THEM I MUST
OFFER SOME TYPE OF COMPREHENSIVE
COVERAGE TO THEIR STUDENTS.
SO REALLY STIRRED ME THE
PURCHASES THE STUDENT OUT PLAN
OR THEY OPT OUT OR WAVES OUT OF
THE SHIP. AND BY SHOWING HAVE
OTHER COMPARABLE COVERAGE LIKE
AS DEPENDENT ON A PARENT PLAN OR
IF THEY HAVE BASS SELF OR SOME
OTHER TYPE OF QUALIFIED HEALTH
PLAN THROUGH OUR STATE EXCHANGE.
IN MASSACHUSETTS OUR HEALTH
INSURANCE EXCHANGE OF ALL THE
HEALTH INSURANCE CONNECTOR
AUTHORITY ACTUALLY OVERSEAS TO
HELP INSURANCE. ETCETERA
RESPONSE BEFORE THE THOSE
REGULATIONS ARE THE EMPLOYMENT
STUDENT PLANS.
ALSO OUR HEALTH CONNECTOR AXES
INSURANCE BROKER FOR ALL THE
PUBLIC COLLEGES UNIVERSITIES IN
MASSACHUSETTS. US SO THEY.
PROCURE THE INSURANCE AND THE
GROCERY RATES FOR ALL SCHOOLS.
OF THE RANGE AND PREMIUMS ARE
VERY AFFORDABLE ABOUT VERY COST
EFFECTIVE FROM A MEDICAID
STANDPOINT. IN A VERY
COMPREHENSIVE OUT WE HAVE A ONE
STATE UNIVERSITY HAS A LOWER
INSURANCE.
PREMIUM FOR THE FULL YEAR OF
ABOUT. FIFTEEN HUNDRED DOLLARS I
THINK THE HIGH RANGES UP TO
ABOUT TIRTY EIGHT HUNDRED
DOLLARS FOR THE CONCERT THERE
THEY'RE FAIRLY. INEXPENSIVE.
AMPS AND THEIR COMPARABLE TO. A
SILVER OR EVEN A GOLD PLAN.
IN REGARDS TO OUR BENEFITS
COVERED.
SO BACK IN DECEMBER OF TWENTY
FIFTEEN OF THE MASS HEALTH
PROGRAM. GOT TOGETHER WITH THE
CONNECTOR TO HAVE SOME
DISCUSSIONS ABOUT HOW THE
STUDENT HEALTH INSURANCE PROGRAM
WORKS. OUGHT TO LOOK INTO SOME
POTENTIAL OPPORTUNITIES RELATED
TO STEP.
A MASS HELD CAME OUT THIS MORE
SO TO SOLVE.
FOR A COST SAVING IS A PROBLEM
OR REALLY JUST LOOK FOR MORE
COST SAVINGS AND SO THIS IS A
POTENTIAL OPPORTUNITY.
.
BUT. THE HEALTH CONNECTOR IS
ALSO EXPERIENCING SOME PROBLEMS
AS WELL BECAUSE SINCE THE
IMPLEMENTATION OF THE ACA THEY
STARTED SEEING A REAL DIPS IN
IRAN IN THE SHIP. PLANS OF A
SHARP DECLINE IN A PARTICULAR
STATE UNIVERSITIES THERE CARING
FOR.
BECAUSE AS FAR AS FOR SOME
OTHERS STUDENTS PREVIOUSLY
ENROLLED AND SHEPHERD I WILL
REFER FOR MASS HEALTH BECAUSE
THE MEDICAID EXPANSION WITH THE
EFFORT WHAT'S YOUR ACT THE
PLANTATION.
THE AVERAGE DECLINE.
IN SHIP IN ROMANS WAS ABOUT
THIRTY THREE PERCENT OF THE
PUBLIC UNIVERSITIES.
CLINTON THAT OUR COMMUNITY
COLLEGES.
WE ACTUALLY SAW THE GREATEST
DECLINE THREE COLLEGES ABOUT
FORTY FOUR PERCENT OF THE SHIP
AND ROMANCE. WENT DOWN BY FORTY
FOUR PERCENT. I'M SO WE DID SEE
NUMBER OPPORTUNITIES HERE HOW WE
CAN PARTNER UP.
AND AFTER LEARNING MORE ABOUT
HOW EACH OTHER WORKS BUT WE DID
DECIDE TO PARTNER WITH THE
CONNECTOR AND WE AGREED TO
IMPLEMENT A FAMOUS SYSTEMS
PROGRAMS. ARE FOR THE TWENTY
SIXTEEN TO TWENTY SEVENTEEN FALL
ENROLLMENT SO THIS IS A REALLY
AGGRESSIVE IMPLEMENTATION TIME
FRAMES. AND THAT KIND OF FEEDS
INTO SOMEBODY OTHER THINGS GOING
TO TALK ABOUT ABOUT HOW OUR
PROCESS THIS PROGRAM WORKS.
SO. OUR OPERATIONS ARE BUSINESS
MODEL FROM WHAT WE DECIDED TO DO
WAS LEVERAGE THE EXISTING US TO
HEALTH INSURANCE INVOLVEMENT.
AND WAIVER PROCESS. THAT THE
SCHOOLS ARE HAVING PLACE ALL OF
THE PUBLIC UNIVERSITIES AND WE
ALSO FOCUSED ON PUBLIC
UNIVERSITIES I WAS FROM A
PILOT'S STANDPOINT. ALSO BECAUSE
YOU EXPECTED THEM BUT THEY HAVE
THEM TO HAVE MUCH HIGHER
MEDICAID. ELIGIBLE STUDENTS OR
MEDICAID ENROLLED STUDENTS GIVEN
THAT UP THERE IN MASSACHUSETTS
AND. IT'S LATE UP. AT MORE LOW
INCOME STUDENTS BECAUSE THE MORE
AFFORDABLE COLLEGE JUST.
SO WHAT WE DO IS USE THE
EXISTING ROLLER BROKERS THAT
THIS WAS DUE TO SACK THEM THEIR
PROCESS OF FROM. AN EMBEDDED
OURSELVES AND HOW THEY DID
BUSINESS. BECAUSE IT'S REALLY AT
THAT POINT WHERE EVERY STUDENT
BECAUSE IT'S REQUIRED IS TO LOG
ON TO THE SCHOOL'S WEBSITE WITH
THEIR PROBLEM BROKER. IDENTIFY
THEMSELVES AS HAVING MASS HEALTH
AND SAYING I HAVE MYSELF I DON'T
NEED TO ROLL THE SHIP AS AT THAT
POINT. WE WORKED AT THE AROUND
PURPOSE TO. ADD EDUCATIONAL
MATERIAL EXPLAIN THAT THERE'S
THIS NEW PROGRAM A PREMIUM
ASSISTANCE THAT WE CAN PURCHASE
THE SHIP FOR THEM AT NO COST TO
THEM.
THAT'S REALLY HOW WE IDENTIFY
WHO THESESTUDENTS ARE. AND IT'S
ALSO EXTREMELY STREAMLINED AN
AUTOMATED WITH SOME LITTLE
ADMINISTRATIVE BURDEN ON THE
SCHOOLS AND ALMOST AND ALL THIS.
AND ON THE STUDENTS SORRY.
SO AT THAT POINT THE ROLLER
BROKERS TO SEND INFORMATION TO
MOUSE HEALTH WE VERIFY THAT THAT
THEY'RE ACTIVE ON MASS HEALTH
AND THAT THEY QUALIFY FOR
PAYMENT SYSTEMS THAT THEY'RE AT
HARVARD'S TYPE. TO BE COST
EFFECTIVE FOR US TO PURCHASE THE
BAM.
AT THAT POINT. ONCE WE DETERMINE
THAT WE SEND OUT APPROVAL TO THE
STUDENTS WE ALSO WOULD MAKE A
ONE LUMP SUM. PREMIUM PAYMENT TO
THE AROMA BROKER WHO WOULD PAY
THE CARRIER STUDENTS PASSED.
WITH OUR OTHER* THIS PROGRAM
THAT WE HAVE IN MASSACHUSETTS.
AND PAYMENTS FOR EMPLOYER
SPONSORED PLANS ARE PAID ON A
MONTHLY BASIS THE POLICYHOLDER
WE DO NOT WANNA BE GIVING THIS
BIG CHUNK OF MONEY OFF TO THE
STUDENTS OF THAT WE WANTED TO
MAKE SURE WE CAN STREAMLINE THAT
AS MUCH AS POSSIBLE SO. THE
STUDENTS ARE REALLY OUT OF THAT
LOOP THEY JUST HAVE TO LOG ON
AND AND ROLE SO THAT PROCESS.
SO THAT'S HOW THE OPERATIONS
WORK ARE REALLY HIGH LEVEL.
I'M ONE OF THE OTHER THINGS YOU
NEED TO CONSIDER WHAT WE'RE
RUNNING TOWARDS THIS GOAL LINE
OF GETTING THIS UP AND
IMPLEMENTED. FOR THE THE FALL
ENROLLMENT WAS WHAT LEGAL
STORIES TO GRAB FOR IT UNDER. AS
I MENTIONED MASSACHUSETTS DOES
HAVE AN EXISTING BEING
ASSISTANCE PROGRAM FOR GROUP
HEALTH INSURANCE. UNDER THE HIP
FOR THE HEALTH INSURANCE PREMIUM
PROGRAM A STATUTE UNDER SECTION
NINETEEN OH SIX OF THE. ACT.
HOWEVER A WE DID NOT HAVE
AUTHORITY PURCHASE INDIVIDUAL
pSTUDENT UP PLANS TO DEFINED AS
UNDER THE AFFORDABLE CARE ACT.
SO OUR OPTIONS INCLUDED BONDS
TRYING TO OBTAIN A STATE PLAN
AMENDMENT THE MEDICAID STATE
PLAN.
THIS WOULD ALLOW FOR THE
PURCHASE OF INDIVIDUAL PLANS.
IT ALSO OFFERED A RELIABLE
PASSED TO US TO KNOW THAT THEY
WERE TIME CLOCKS ASSOCIATED WITH
A REQUEST TO SEE A MASS. OF TO
GET A STORY FOR THIS WE ALSO
KNEW THAT WE COULD GET SOME
RETROACTIVE EFFECTIVE DATES AS
LONG AS I REQUEST YOU SEND
WITHIN A CERTAIN QUARTER WE KNOW
WE COULD GO BACK AND WE COULD
HAVE IT IN PLACE. OR EXPECT TO
BE ABLE TO MEET THE REQUIREMENTS
TO GET APPROVAL FOR THE FALL
ENROLLMENT.
HOWEVER THE DOWNSIDE IS THAT A
WOMAN WOULD BE AT THE OPTION OF
THE STUDENTS ARE GOING TO
VOLUNTARY WE COULD NOT USE THIS
PROCESS REQUIRES STUDENTS TO
ENROLL. WHICH WOULD BE
CONSISTENT WITH HOW WE DO
BUSINESS ON FOUR ON THE FLOOR
SPONSORED GROUP INSURANCE.
THE OTHER OPTION WOULD LOOK THAT
WE CONSIDERED WAS TO BE ELEVEN
FIFTEEN WAIVER AS I MENTIONED
MASSACHUSETTS OPERATES UNDER
THEM FIFTEEN WAIVER WE'RE IN THE
MIDST OF RENEGOTIATING. THE
WHOLE OF OUR PACKAGE. SO WE
LOOKED AT THIS BECAUSE THE SITE
IS THE OPPORTUNITY TO BE ABLE TO
ALLOW US REQUIREMENT.
AND WHEN WE WERE COMING OUT THIS
MORE FROM A COST SAVINGS
PERSPECTIVE THAT WAS REALLY
SOMETHING WANTED TO KIND OF GO
AFTER.
BUT ONE OF THE DOWNSIDES IS
THAT.
ONCE A THIRTY IS GRANTED AS A
PROSPECTIVE AND WE DIDN'T KNOW
IF WE HAVE THIS PLACE. FOR OUR
TIME LINE FOR A FALL ENROLLMENT.
TO HAVE IT UP AND RUNNING BUT WE
ALSO WERE ON SHORE.
.
BUT WHAT OTHER TYPE OF MAYBE
MORE CONTROVERSIAL ARE
CONTENTIOUS ISSUES THAT MIGHT BE
THERE WOULD BE SOCIALLY
OURSELVES WITH WITH THE BIGGER
ALONE FIFTEEN RIVER PRACTICE.
PACKAGE THAT MIGHT DELAY THINGS
SO.
WHAT WE ENDED UP DOING?
FROM A STRATEGIC STANDPOINT UP
IS REALLY WE DID BOTH.
WE SUBMITTED A STATE PLAN
AMENDMENT GONNA TWENTY SIXTEEN.
LOOKING FOR AN OPTIONAL.
PROGRAM AT THE OPTION OF THE
STUDENTS TO VOLUNTARILY ENROLLED
IN PAYMENT SYSTEMS TIMES THAT WE
HAVE THAT UP AND RUNNING. WE'RE
ALREADY WORKING ON GETTING THE
OPERATION SET UPS.
ACTUALLY START TAKING
APPLICATIONS FOR THE PROGRAM.
WE ALSO SUBMIT A LIVE FIFTEEN
WAIVER.
FROM. WHAT IT UP HAPPENING?
WHAT IS THAT NOVEMBER TWENTY
SIXTEEN? ELEVEN FIFTEEN WAIVER
WAS APPROACHED.
BUT IT IS ALSO CONTINGENT UPON
THE STATE PLAN AMENDMENT.
BUT BEING APPROVED CMS HAD ASKED
US TO CLARIFY SOME THINGS
REGARDINGHOW WE DETERMINE COST
EFFECTIVENESS. AND THEY ALSO
HAVE SOME CONCERNS ABOUT NETWORK
ADEQUACY AND IF WE WERE GOING TO
BE REQUIRING STUDENTS TO ENROLL
INTO A SHIP NETWORK TO MAKE SURE
THAT THERE WAS ENOUGH OVERLAP.
BETWEEN THE MASS OF FEE FOR
SERVICE NETWORK FOR THE RAP
PURPOSES AND. FOR THE STUDENT
THEY WERE JUST GONNA BE KIND OF
SQUEEZED INTO A SMALL LITTLE
CORNER OF THE STATE NOT HAVE
ACCESS TO PROVIDERS ANYWHERE
ELSE.
BUT NINETY FIVE PERCENT OF OUR
STUDENT PLANS ARE ACTUALLY IN A
STATEWIDE BLUECROSS BLUESHIELD
PPO NETWORK SO IT'S REALLY
ABOUT.
NETWORKS AVAILABLE.
SALEM FIFTEEN WAIVERS GRANTED
SOME BUT WE ARE AUTHORIZED. TO
REQUIRE AN OMEN FOR ALL STUDENTS
WHO HAD ACCESS TO COST EFFECTIVE
SHIP LANDS AT PARTICIPATING
SCHOOLS.
WE ALSO WERE GRANTED AUTHORITY
TO PROVIDE CONTINUOUS BASS
HEALTH ELIGIBILITY FOR A FULL
YEAR UP TO A FULL YEAR. TO
COINCIDE WITH YOUR LONG SHIP
THEM. AND WHEN THE RESOURCES TO
DO THIS IS WE EXPECT THIS
ARTICLE FROM MINISTRY TO STAMP
QUITE. KNOWING MEDICAID
RECIPIENTS THEIR FALL ON OFF ON
I COME BACK ON AND TURN I GUESS
IS WHAT WE REFER TO IT AS SOME
IF INCOME CHANGES ARE A RESPONSE
TO SOME TYPE OF QUEST FOR
ADMINISTRATIVE. INFORMATION.
THAT CAN HAPPEN. BUT WE ALSO
WANTED TO DO THIS IF WE CAN MAKE
A LUMP SUM PAYMENT UP FRONT WE
DON'T HAVE TO CHASE DOWN. ONCE
THAT THAT MIGHT NOT BUT I'M NOT
SELF AND CAME BACK ON SO. WE
WERE GRANTED CONTINUOUS BOUTS OF
ELIGIBILITY. THE AUTHORITY UNDER
THE UPLIFTING WAIVER AGAIN THOSE
THINGS ARE ONLY PROSPECTIVE.
SO. WE WERE ABLE TO IMPLEMENT A
PILOT PROGRAM WITH THE PUBLIC
SCHOOLS FOR OUR FIRST YEAR THAT
WE ARE UP AND RUNNING. AND THEN
LOOKED FORWARD TO THIS CURRENT
ACADEMIC YEAR THE TWENTY
pACADEMIC YEAR TO HAVE IT BE A
MANDATORY PROGRAM. WE ALSO
EXPANDED IT TO MORE THAN JUST
THE PUBLIC ART COLLEGES
UNIVERSITIES IN MASSACHUSETTS.
.
SO FROM A COLLEGE PARTICIPATION
STANDPOINT IT'S NOT REQUIRE THE
COLLEGES IN MASSACHUSETTS
PARTICIPATE IN THIS IS OUR CORE
THEY OFFER SHIP PLANS. BUT IT'S
NOT MANDATORY SO WHAT WE DID
GIVEN THAT THERE'S SO MANY
BENEFITS. TO THE STUDENTS TO
HAVE. A WIDER PPO NETWORK NOT
JUST IN STATE BUT UNTRUE WIDE
AND EVEN OUT OF STATE. AND THAT
IT WOULD BE AT NO COST TO THEM.
IF YOU WITH IT COVERED MASS
HEALTH SERVICES RE WRAPPING
THOSE.
IT ALSO WOULD HELP. ADDRESS THE
CONCERNS. OF THE LOWER SHIPPING
ROMANCE TO TRY TO STABILIZE
PREMIUMS. THAT WE'RE GONNA BE
INJECTING MORE STUDENTS BACK
INTO THE SHIP.
.
THE SHIP ENROLLMENT ARBOR
SCHOOL.
SO.
IT ALSO BECAUSE THE THE ROLLER
BROKERS ARE HANDLING MAJORITY TO
WORK. THERE WAS A BIG
ADMINISTRATIVE BURDEN THE SCHOOL
SCHOOLS APART. AND NOW WE'VE
EXPANDED IT BEYOND THE THIRTY
PUBLIC COLLEGES UNIVERSITIES ON
TO INCLUDE FORTY NINE ADDITIONAL
PRIVATE INSTITUTIONS.
THERE IS A HANDFUL OF OF OUR
SCHOOLS THAT DID NOT TAKE PART
BECAUSE. OF THEY WERE STOPPED
SHORT AT A LOT OF THE.
THE ADMINISTRATIVE PROCESSES
ARE BUILT A HOUSE THEY WERE
USING IS OUR BROKERS AND WE
ALSO.
THEY DIDN'T THINK THAT THEY
HAVE THAT MANY OF MEDICAID
MEMBERS AS STUDENTS IN THEIR
SCHOOL. OR NUMBERS.
SO THERE WERE STILL SOME THAT
ONE'S GOING TO SEE HOW THINGS
WORKED HOURS TO TRY TO REACH OUT
TO THEM AND. BRING THEM INTO THE
PROGRAM WELL.
SO. NOW THAT WITHOUT A COMPLETE
PHONE ROLE MEANT.
WITH A MANDATORY PROGRAM I WANT
TO JUST GOING TO GIVE YOU A
LITTLE BIT FROM US SIXTEEN POINT
OF SOME NUMBERS SAW. THE PILOT
YEAR WHEN IT'S VOLUNTARY WE
ENROLLED FIFTY SIX HUNDRED
STUDENTS WITHOUT THERE'S ABOUT
TWENTY ONE THOUSAND OUT THERE.
IT FROM SOME PAST DATA ABOUT
STUDENTS WOULD WAITRESS NOT SELF
IN THE PAST. OF WHERE THIS PAST
FALL ENROLLMENT FOR TWENTY
SEVENTEEN TWENTY EIGHT YEAR OLD.
OVER TWENTY EIGHT THOUSAND
STUDENTS.
IT'S EXCEEDING THOSE PROJECTIONS
OF TWENTY ONE THOUSAND YOU THINK
MAYBE SOME STUDENTS HAD WAIVED.
THEIR MANAGED CARE PLAN THAT
THEY HAD ABOUT HEALTH VERSUS
JUST IDENTIFY THEMSELVES ABOUT
SELF AND THAT'S WHERE THE
NUMBERS WERE HIGHER.
.
IN ADDITION SOME OF THAT
POPULATION AND WE HAVE ROLLED
EIGHTY FOUR PERCENT OF OUR TRIP
RESISTANCE. MEMBERS ATTENDED
PUBLIC COLLEGES UNIVERSITIES
THAT'S REALLY WAS THAT'S REALLY
WHERE THEY ARE THEY ARE SICK AS
EVENTS AND THEY'RE LOW INCOME
AND WHERE WE REALLY FOUND THEM.
OUTS ONLY FOURTEEN PERCENT WERE
AT THE ADDITIONAL PRIVATE
SCHOOLS THAT WE INVOLVED.
TO PARTICIPATE. OF THE OTHER
INTERESTING NUMBER THEY WANT TO
SHARE WITH THE SIXTH SENSE OF
OUR RELEASE FOR PART OF THE
EXPANSION POPULATION THE
MEDICAID EXPANSION POPULATION.
.
THEY'RE INTERESTING NUMBER THAT
MIGHT BE INTERESTING HERE IS
THAT EIGHTY TWO PERCENT WERE
BETWEEN THE AGES OF SEVENTEEN
AND TWENTY SIX.
SO. REALLY IT AT THIS POINT.
OUR BIG QUESTION NOW THAT WE
HAVE LOST. A FULL YEAR
MANDATORY FOR A BELT IT WOULD
LOOK AT WHAT I'M NOT BUT THE
ACTUAL COST SAVINGS ARE WHETHER
THEY MEET OUR BETTER PROJECTION
THAT WE HAD ON ANTICIPATED.
GIVEN ARE NOT REALLY KNOWING
WHO THESE PEOPLE WERE BEFORE WE
CAN ROLL THEM OUT AND AND HOW
MUCH COST SAVINGS OF THE
COMMONWEALTH I WILL EXPERIENCE.
AND ALSO WITH THE ACTUAL IMPACT
OF THE MEDICAL LOSS RATIO WILL
BE UP TO THE SHIP PLANS TO SEE
IF IT WILL AND YOU HELP
STABILIZE PREMIUMS.
GIVEN THIS BIG INFLUX OF
STUDENTS. SO.
I THINK THAT WRAPS UP WHAT I
WANTED TO SHARE AND I'D BE HAPPY
TO HEAR ANY QUESTIONS.
THANK YOU VERY MUCH FOR.
PARTICIPATING FOR THE
INFORMATION DID YOU HAVE ANY
ANYBODY HAVE ANY QUESTIONS
BECAUSE I HAD JUST A COUPLE. OF
THOUGHT.
CORRECT ME IF I'M WRONG WHEN
YOU'RE TELLING ME WHEN YOU'RE
DEALING WITH THE MEDICAID
PREMIUM ASSISTANCE FOR COLLEGE
HARD COVERED UNDER
MASSACHUSETTS.
THE WHEN YOU'RE DEALING WITH
THE MEDICAID SERVICES. IS THE
STATE ON THE WRAPAROUND FOR YOU
GUYS AS WELL.
OR THE STATE DOING THE
WRAPAROUND FOR.
SERVICES ARE COVERED.
BY THE SCHIP PROGRAM OR BY THIS
COLLEGE PROGRAM.
YEAH I THINK I MISSED THE
BEGINNING OF A QUESTION I KNOW
IT HAS TO DO WITH. THE RAP
SERVICES FOR SERVICES ARE
COVERED. I'M SORRY TO DO THAT
YES IT WAS HARD TO HEAR THE
BEGINNING UNTIL I TURNED UP MY.
MY YEAH MY QUESTION WAS IS THE
STATE OF MASSACHUSETTS COVERING
THE WRAPAROUND SERVICES THAT THE
COLLEGES CAN PROVIDE.
YES WE ARE OF THAT WAS ONE OF
THE PIECES THAT WE NEGOTIATED
FOR A LONG TIME WITH THE CENTER
FOR MEDICARE MEDICAID SERVICES.
WE DO CURRENTLY PROVIDE RAP FOR
OUR GROUP HEALTH INSURANCE
PAYMENT SYSTEMS ON THESE MEMBERS
ARE A FEE FOR SERVICE THAT WE%
PROVIDE RAPPER SERVICES THAT ARE
NOT COVERED BY THE PRIVATE PLAN.
THE TWO BIG ONES ARE THE NON
EMERGENCY TRANSPORTATION ON.
PERSONAL CARE ATTENDANT SERVICES
HOME SERVICES. AND WE ALSO
PROVIDE RAP FOR OUT OF POCKET
COSTS OF DEDUCTIBLES COINSURANCE
THINGS LIKE THAT WE HAVE TO
PROVIDE WRAP UP TO. WHAT THAT
MEMBER WOULD OTHERWISE HAVE BEEN
RESPONSIBLE FOR IF THEY WERE
JUST ON MYSELF I'M SO WE DO HEY
THAT'S CO PAYS DEDUCTIBLES AND
THINGS LIKE THAT FOR A FEE FOR
SERVICE? NETWORK ONE THING TO
NOTE IS THAT IN ORDER TO.
EASILY WRAP THOSE SERVICES THE
PROVIDER THAT THE STUDENT SEES
HAS TO BE BOTH ABOUT SELF
PROVIDER AND. SHIP PLAN PROVIDER
IF THEIR MASS HEALTH PROVIDER
THEY WILL JUST QUARTERS BENEFITS
THE FIRST BILL ON THE SHIP PLAN
AN APPEAL BILL MASSHEALTH
SECOND.
IF IT'S NOT A MUSCLE PROVIDER A
WE HAD DO IT JUST FOR OUR
STUDENT. POPULATION HAVE A
MANUAL REIMBURSEMENT PROCESS
THAT WE GO THROUGH UPSET THAT IF
A STUDENT FEES THAT ARE PROVIDED
WAS ONLY IN. THE SHIP PLANNED
NETWORK AND AND YOU KNOW IT HAS
A THIRTY DOLLAR COPAY THE MASS
OF ROBERT SERVICE THEY CONSIDER
THAT TO US. ARE REIMBURSED AT
STUDENT DIRECTLY.
THE NICE THING IS BECAUSE THE
NETWORKS ARE ACTUALLY PRETTY
LARGE AND HAVE A LOT OF OVERLAP
WE ONLY HAD ABOUT. TWENTY FIVE
STUDENTS I THINK OF ACCESS THAT
AT THIS POINT. I'M OUT OF THE
EARTH ALMOST THIRTY THOUSAND
STUDENTS THAT ARE CURRENTLY IN
ASSISTANCE.
AND THEN I'M ASSUMING MOST OF
THESE THE REQUIREMENTS WERE DONE
THROUGH THE ELEVEN FIFTEEN
WAIVER OF. TO MAKE SURE THAT ALL
THE WRAPAROUND SERVICES WERE
COVERED IN ORDER TO DO THIS YOU
HAVE TO HAVE THAT PERMISSION
FROM THE FEDS THAT CRACK.
IT IS THAT IT'S BOTH OF YOUR
LIVES CAN WAVER IT'S ALSO DRUG
BUST EFFECTIVENESS METHODOLOGY
IN OUR STATE PLAN. WHERE WE
DESCRIBE HOW WE DID TROUBLE IT'S
COST EFFECTIVE? WITHIN THAT IS
THE COST OF RAP SERVICES MYSTERY
AND A BIG QUESTION I APOLOGIZE.
ANSWERED YOUR ANSWER AND I THINK
WHAT WHAT'S MAKING A COST
EFFECTIVE IS THE FACT THAT. THE
PROVIDERS THAT ARE SEEN THESE
PATIENTS ARE ALSO THE PROVIDERS
THAT ARE ALREADY AND MEDICAL
PROVIDERS.
YEAH IT'S.
WEEK WE ARE SAYING THAT THE
MAJORITY OF THEM ARE BOTH IN
BOTH NETWORKS.
pSTUDIES ON DATA TO SHOW THAT
WHAT THE AVERAGE PER MEMBER PER
MONTH RAP COST. IS ONLY TWENTY
FIVE DOLLARS SO.
I THINK BECAUSE WE DO HAVE A
BIG THAT WOULD OVERLAP. DAD FROM
THE AND AGAIN WHEN I SAY READ
THAT OUT OF POCKET IT'S MOSTLY
JUST READ OUT OF POCKET COSTS
NOT THE. MET MEDICAID COVERED
SERVICES ARE NOT COVERED BY.
.
BY THE HEALTH PLAN SO.
IT IS IT IS DEFINITELY A GIVEN
NOW WITH THE AFFORDABLE CARE ACT
THAT THERE AREN'T PLAN LIMITS.
AND THEY'RE REALLY
COMPREHENSIVE.
BUT SET THE BENEFITS THAT THESE
PLANS COVER.
IT'S IT'S A MUCH DIFFERENT WORK
BUT IT WAS SOME PRODUCTS THE ACA
TO TRY. TO GUESSTIMATE HOW MUCH
OF THAT THAT OUT OF POCKET COSTS
TO THAT WRAP SERVICE. WOULD COST
US.
I DON'T HAVE ANY OTHER
QUESTIONS.
YOU HAVE ANY QUESTIONS CENTER.
DO YOU ALLEN KID CAN YOU WE HAD.
YOU MAY HAVE ANSWERED AND THEN
THE PRESENTATION I'VE I'VE BUT
BY THAT BUT. CAN WE HAD SOME
SPEAKERS FROM ON BOTH THE PUBLIC
AND THE PRIVATE UNIVERSITY
SYSTEMS. I KNOW YOU HAVE A VERY
ROBUST PRIVATE UNIVERSITY SYSTEM
IN MASSACHUSETTS ON CAN YOU
SPEAK DID DESERVE. COULD YOU
TALK ABOUT THE DIFFERENCE OF OF
YOUR ROLE IN TERMS OF PROVISION
OF SERVICES. BETWEEN THOSE TWO
SYSTEMS.
WHAT THE PLANS ARE QUITE BETWEEN
THE TWO SYSTEM WHICH IS THE WAY
THAT MEDICARE THAN TIME YEAH BUT
THE WAY THAT THE MEDICAID
SERVICES?
ABOUT WORK BETWEEN THE PRIVATE
UNIVERSITIES IN THE PUBLIC
UNIVERSITIES. IN THE STATE OF
MASSACHUSETTS.
SO IN IN THE ABSENCE OF CREAM
SYSTEMS. IS A.
SO WE DON'T HAVE THE SAME TYPE
OF PORTABILITY OR ACCESS ISSUES.
THAT.
CALIFORNIA EXPERIENCES.
AT LEAST WE NOW HAVE THIS NEW.
ACCOUNTABLE CARE ORGANIZATION
MODEL THAT MANAGED CARE ON THE
MANAGED CARE GROUP JUST ROLLED
OUT JUST TWO WEEKS AGO SO I DO
THINK WE MIGHT BE SEEING SOME
MORE. OF THOSE ISSUES WHERE IF
SOMEONE LIVES DOWN ON CAPE COD
GOES TO SCHOOL OUT YOU KNOW OUT
IN NORTH ADAMS AT THE CORNER.
NEAR ALBANY. NEW YORK THERE'S
OBVIOUSLY WOULD BE AN ISSUE
THERE WITH NETWORK AT WHO THEY
GET TO SEE THEM AND YOU KNOW
WHETHER.
WHETHER THEY HAVE PROVIDERS THAT
THEY CAN SEE ON A REGULAR BASIS
I THINK WE MIGHT BE SEEING SOME
OF THOSE BUT. I'M HOPEFUL THAT
OUR SHIPPING ASSISTANCE PROGRAMS
OFFER THAT ISSUE BEFORE IT CAME
ABOUT BECAUSE IF THIS PERSON IS
AT A PARTICIPATING SCHOOL.
THAT WOULD HAVE A PPO BLUE
CROSS BLUE SHIELD NETWORK AND
BEAT THEM OUT SELFIE FOR SERVICE
WORK SO. IF THEY WERE OUT NEAR
ALBANY. ON THE CORNER
MASSACHUSETTS OR DOWN IN
PROVINCETOWN AT THE TIP OF CAPE
COD THEY SHOULD STILL HAVE
ACCESS TO.
PROVIDERS TO BOTH PROTECT ABOUT
SELF AND THE THE SHIP PPL COME.
OTHER THAN THAT.
THAT THERE ARE. A FEW I THINK
THERE WERE FOUR OR FIVE DOWNTOWN
BOSTON COLLEGE'S BIG COLLEGES
THAT DID NOT PARTICIPATE. THERE
NO PUBLIC COLLEGES THAT THAT ARE
PARTICIPATING AT THIS POINT.
SO THERE MIGHT STILL BE A
STUDENT WHO'S ON MASS HEALTH WHO
YOU KNOW LIVES OUT IN WESTERN
MASSACHUSETTS BECAUSE A SCHOOL
DOWNTOWN BOSTON.
THERE ARE SOME OTHER OPTIONS
OUT WITH IN THE MASS HEALTH
MANAGED CARE NETWORK THAT YOU
HAVE STATEWIDE NETWORK SADDAM
BUT WE'VE BEEN TRYING TO. MEET
WITH THE MANAGED CARE GROUP TO
TRY TO PICK THROUGH SOME OF
THESE ISSUES THAT WOULD THAT
WE'RE ANTICIPATING I MIGHT BUMP
INTO BUT. I'M JUST GIVEN WHERE
THEY'RE AT WITH THIS BIG ROLE
THAT WE HAVEN'T HAD THE
OPPORTUNITY TO SIT DOWN AND SEE
IF THEY HAVE A. BACK TO THIS
AND.
OKAY ARMED THANKS FOR THAT I I
GET THE OTHER QUESTIONS AS WE
HAVE YOU HERE.
WERE ALTERNATE TO FIGURE OUT
WHAT TO DO AND.
ON A LOT OF LEVELS IN OUR
HEALTHCARE SYSTEM. HI CAN YOU
pOF BROADER COMMENTS ABOUT THE
WAY THE MASSACHUSETTS IS. IS.
IS CONTEMPLATING AND.
DID HE SHIFTED ITS HEALTHCARE
INFRASTRUCTURE IN IN FINANCING
SYSTEM IN THE WAKE OF OF SOME OF
THE CHANGES GOING ON IN
WASHINGTON.
MORE BROADLY SPEAKING BEYOND
JUST THE THE COLLEGES
UNIVERSITIES.
THAT'S A GREAT QUESTION.
.
IN SOME WAYS I I FEEL LIKE
MASSACHUSETTS HAD IT HAD PUT
INTO PLACE IN TWO THOUSAND SIX
IT'S ON HEALTHCARE REFORM HAD
ITS FIRST YOU KNOW ITS OWN
INDIVIDUAL MANDATE AND REALLY
TRY TO CREATE. UNIVERSAL ACCESS
TO EVERYBODY. AND WE DO HAVE A
VERY RICH MASS HEALTH PROGRAM.
GIVEN WHAT'S GOING ON IN THE
HEALTHCARE WORLD TODAY IN JUST
THAT THE INCREDIBLE COST
INCREASES THAT THAT IT'S BEEN
SEEING. SOME IT'S BEEN A LOT OF
FOCUS ON.
COST SAVINGS WHICH IS WHEN THE
REASONS WHY WE WENT DOWN THIS
ROAD SYSTEMS FOR THAT THE SHIP
PLANS. BECAUSE MASS HEALTH IS
ALWAYS HAD A FOCUS ON.
ASSISTANCE A COST AVOIDANCE
THERE'S NOT A LOT OF STATES.
THAT WE'VE TALKED TO THAT.
PUT YOU KNOW CAN SEE THAT YOU
CAN SPEND MONEY TO SAVE MONEY I
THINK THAT'S A REAL HARD CONCEPT
TO TAKE AN EASY MONEY GOING OUT
THE DOOR VERSUS. THE SAVINGS
ACCOUNT THROUGH SO I THINK WE
HAVE A LOT OF DATA LOOK AT AND.
AND WE'RE ACTUALLY LOOKING TO
EXPAND FREE ASSISTANCE EVEN MORE
FROM THAT STANDPOINT. WERE ALSO
LOOKING TO MAKE THE MASS HEALTH
BENEFIT PACKAGE LOOK FOR SIMILAR
TO PRIVATE INSURANCE BENEFIT
PACKAGES. BECAUSE WHAT YOU KNOW
THERE'S A CONCERN OUT THERE THAT
PEOPLE ARE BUSY LEAVING. PRIVATE
PLANS TO GO INTO.
IN OUR GOVERNMENT BENEFIT PLANS.
SO WE'RE TRYING TO. YOU KNOW
STILL WANT TO KEEP REALLY HIGH
INSURANCE RATES IN MASSACHUSETTS
NOT SEE THOSE STEP BUT ALSO MAKE
SURE THAT THAT RESPONSIBLE
POSSIBILITIES BEING SHARED
ACROSS ACROSS THE BOARD IT'S NOT
JUST BEING SHOULDERED. BY THAT
ABOUT SELF PROGRAM OR ARE A
CONNECTOR CARE WHICH IS OUR.
US YOU KNOW OF.
QUALIFIED HEALTH PLAN THE IDEA
THE EXCHANGE PROGRAMS.
.
OTHER THAN THAT I THINK IT'S
JUST FOR TRYING TO LOOK TO SEE
IF WE CAN SQUEEZE SQUEEZE
DOLLARS OUT OF ANY ANY ANY AREA.
OBVIOUSLY WITH THE CHANGING TO
MANAGED CARE. IT'S ANOTHER WAY
TO TRY TO SAVE MONEY TO TO PUT
MORE.
.
MORE REQUIREMENTS AND MORE
RULES.
AND AND AND MANAGE AND
UTILIZATION UPON THE USES OF
HEALTH CARE TO MAKE SURE THAT.
THAT IT'S MOST APPROPRIATE.
EFFICIENT WAY OF RECEIVING
SERVICES FOR FOR GOOD QUALITY OF
CARE.
THANK YOU.
RIGHT THAT I SHOULD DO FOR ALL
THE QUESTIONS I APPRECIATE YOUR
TIME AND I'M SURE IT'S PRETTY
LAID BACK WHERE YOU ARE IN THE
EAST COAST. YES. THANKS FOR
BEING HERE APPRECIATED QUITE A
STORM OUT THERE RIGHT. YET I
HEAR THERE'S ANOTHER ONE COMING
TUESDAY SO.
THREE STRIKES AND WE'D BE OUT
BUT.
THANK YOU ERY MUCH THANK YOU I
APPRECIATE THE TIME.
WE WERE GONNA MOVE ON TO PUBLIC
COMMENT IS THERE ANY PUBLIC
COMMENT.
JUST.
AFTERNOON THANK YOU FOR TAKING
MY COMMENTS MY NAME IS SAM OUT
SAYING. I'M A GRADUATE UC SAN
DIEGO AT THEIR YOU'RE LOST AND
YOU SEE HASTINGS. AND IT'S DOING
COCKETTES HERE THE EXACT
OVERSIGHT BOARD OF THE
UNIVERSITY OF CALIFORNIA'S DOING
HEALTH INSURANCE PLAN. I WAS
ELECTED BY REPRESENT ALL THE
CAMPUS IS PART OF YOU SEE SHIP
AND COLLECTIVELY WE STRONGLY
ECHO STAND ALAN'S POINT. THAT
GOOD PHYSICAL AND MENTAL HEALTH
IS ESSENTIAL TO ACADEMIC SUCCESS
STUDENTS NEED HEALTH INSURANCE
DOES BOTH A SENSIBLE AND COMEDY
TO THEIR UNIQUE NEEDS. THIS
TRUER THAN EVER MEAN CREATING
TUITION COSTS OF LIVING STUDENTS
HAVE SEEN. BECOME MORE AND MORE
INSURMOUNTABLE LACK OF ACCESS TO
HOUSING LACK OF DIET LACK OF
FUNDS ARE NOT JUST THE DIRECT
AREA THAT STUDENTS FACE. THESE
PRESSURES LEAD TO LOWER HEALTH
STUDENTS WHO DON'T HAVE A PROPER
DIET GET SICK FASTER. STUDENTS
WHO DON'T HAVE HOUSING FACE NIT
PICKING PHYSICAL OR MENTAL
HEALTH ISSUES STUDENTS WHO DON'T
HAVE THE FUNDS BASE NIP AGAIN
PRESSURES AND STRESSES THAT LEAD
TO NEGATIVE PHYSICAL MENTAL
HEALTH. BECAUSE OF THESE
BARRIERS STUDENTS ARE SICKER THE
CHRISTIES MEAN LESS STUDENTS
PROPERLY LEARNING TO CHRISTINE'S
MEAN A CAREER IN THE FOURTH SET
THE BALL QUALITY HEALTHCARE
INSURANCE.
FOR ME I HAVE BEEN LUCKY TO BE
PART OF YOU THE SHIP. I'M LUCKY
TO BE PART OF PLAN THAT IS BUILT
WITH STUDENTS FOR STUDENTS AND
SERVICE THE NEEDS OF THE
STUDENTS. I'M LUCKY TO GET THAT
BENEFIT BUT THERE ARE SOME
STUDENTS BECAUSE OF THE
FINANCIAL PRESSURES I DESCRIBED
ABOVE. CAN LEAD TO DO TO BE A
MEDIC CAL READING YOU SEE*.
AND THE BIGGEST PROBLEM WITH
MEDIC CAL IS NOT. IS DIS NOT
PORTABLE ADMITS CAN THE BRIEFING
NOTES IF THE STUDENTS MAKE
COMMENTS HELPED. MANAGE CARE
PLAN DOES NOT OPERATE THE NEW
COUNTY THE STUDENT WILL HAVE TO
CHANGE HIS OR HER HEALTH PLAN.
THE AVAILABLE OPTIONS IN THE NEW
COUNTY THIS PROBLEMATIC AS WAS
NOTED HERE DURING THIS HEARING
AND MORE OFTEN THAN NOT
CALIFORNIA STUDENTS WILL NEED
INSURANCE THAT CONCURRENTLY
ACCEPTABLE IN MULTIPLE COUNTIES.
NOT JUST ONE TO ILLUSTRATE THIS
POINT THINK OF THE STUDENTS UCSF
MEDICAL STUDENT MAYBE EMITATIONS
AMATIL COUNTY I USE IT THE
PHARMACY STUDENT MAYBE IMITATION
ORANGE COUNTY. AND UC HASTINGS
LOST IN MAYBE A JUDICIAL
EXTERNSHIP. AND MARIN COUNTY
THESE EXTENSIVE EMMA CAGES MAY
pMONTHS BUT EACH TIME DECENT
WILL
HAVE TO CHANGE THEIR PLANS OR
DRIVE OR FLY. THAT'S NOT ONLY
ADDITIONAL COST BUT ALSO DELAY
IN CARE AND TIME AWAY FROM
ACADEMIC STUDIES ON TOP OF THAT
CALIFORNIA DO IS GO HOME FOR
THREE WEEKS. OR MONTHS FROM WHEN
THEY BREAK AND FOUR MONTHS FOR
SUMMER BREAK THAT MEANS TO THE
TO KEEP SWITCHING PLANS FOR
REGULAR CARE STUDENT CARE DOES
NOT AND SHOULD NOT AND AT THE
COUNTY LINE. DOING CARE SHOULD
NOT BE SUBJECT TO WHEN IT IS
CONVENIENT EXTENSION NOT BE
ASKED TO PRIORITIZE WHAT THEY
THINK THEY NEED. EITHER THIS TOO
IS HEALTHY FOR THE TWO IS NOT
HEALTHY AND REQUIRE CARE. AND
CONTINUE WITH THE CARE IS
ESSENTIAL TO STUDENTS.
I WANT TO SHARE JUST TWO STORIES
OF STUDENTS WHO DID NOT HAVE
CONTINUED TO CARE. WANTS TO IN
FROM LA WE HIT YOUR DEPRESSION
WEIGHT YOUTH THE SHIP AND
TRANSFER TO MAKE OUT TO SAN
DIEGO COUNTY. THIS PROCESS TOOK
FORTY FIVE DAYS DURING THAT TIME
THE TEAM RIGHT NOW MEDICATION
WOULD NOT ABLE TO OBTAIN
REFILLS.
WINDY DAY ESCONDIDO WHO HAS MAKE
CAL IN
SAN DIEGO COUNTY AND WE'VE USED
TO SHIP BUT BECAUSE THEIR MENTAL
HEALTH PROVIDER WAS NINETY
MINUTES AWAY BY BUS. THIS DOING
DID NOT SEE THAT PROVIDE
REGULARLY INSTEAD THE RIGHT NOW
THEIR MEDICATION AND COULD NOT
ACCESS TO PROVIDE FOR A REFILL
THEY TRIED TO FIND PROVIDES
CLOSER TO CAMPUS. BUT CANNOT
FIND ANY PROVIDERS WITH THAT
THEY MAKE CALLOUS AND CANNOT
AFFORD TO PAY FOR MEDICATION
AFTER IN HEALTH SERVICES OR
OTHER PHARMACY WITHOUT MEDICAL
COVERAGE. MADE THESE TWO HAS HAD
YOU THE SHIP THEY WOULD HAVE
PROVIDED NEARBY AND BE ABLE TO
PAY FOR MEDICATIONS. TO CONCLUDE
STUDENTS I MET A CAL ONE TO BE
UNUSUALLY SHIP THEY WANT THE
BETTER CARE LIKE THEIR PEERS BUT
FOR SOME REASON ANOTHER THEY
CANNOT AFFORD. TO BE ON YOU SEE
SHIP IF STUDENTS ARE WILLING TO
GO HOME WITH GO HUNGRY THEY'RE
BOUND TO GO WITHOUT ESSENTIAL
HEALTH CARE JUST TO SAVE MONEY.
EASY ACCESSIBLE STUDENT CATER
PLANTS ARE ESSENTIAL AND WE
BELIEVE TENSION NEVER BE DENIED
ASSESSABLE HEALTH CARE. TIRED
YOU ALL HERE TO CONSIDER YOU THE
MEDIC HOW THEY PAY COLLEGE
HEALTHCARE PREMIUMS TWENTY ONE
THOUSAND STUDENTS DESERVE THE
HIGHEST ACCESS TO CARE. THIS
PROPOSAL WILL OUT TWENTY
THOUSAND STUDENTS TAKE ADVANTAGE
OF RELATIONS BECAME VERY
INTIMATE.
JUST IN THE LAST COUPLE HOURS
ARE VERY MUCH APPRECIATED
THERE'S NOT A STUDENT BUT IT'S
IMPORTANT IN THE LAST.
MY NAME'S CODE EVEN ANY AND I'M
I'M THE PROGRAM DIRECTOR AT THE
NATIONWIDE ADVOCACY ORGANIZATION
CALLED STUDENT DEBT CRISIS. WE
REPRESENT OVER A MILLION.
MEMBERS WHO ARE EITHER IMPACTED
BY STUDENT DEBT OR HAVE IT
THEMSELVES. I'M ALSO A MEMBER OF
THE.
YOUNG INVINCIBLE HIDE YOUTH
ADVOCACY BOARD. SORRY ARMED
YOUNG ADULT BOARD.
AND THERE WE WORK ON POLICIES.
WILL THAT IMPACT YOUNG PEOPLE
INCLUDING HEALTHCARE OUT
PARTICULARLY FOR THOSE WHO ARE
MOST VULNERABLE.
SO WITH THAT SAID YOU KNOW I
JUST WANNA FIRST PAINT THE GRIM
PICTURE THAT STUDENTS ARE
FACING.
FOR US WHAT CAN BE A THREE
HUNDRED DOLLAR.
.
MEDICAL PAYMENT CAN REALLY BE
REALIZED IN OUR FINANCIAL
SUCCESS AND OUR ACADEMIC FUTURES
ARE RIGHT NOW NEARLY ONE IN TEN
STUDENTS. HOMELESS TWENTY ONE
PERCENT OF THEM HAVE FACED FOOD
IN SECURITY. AND SEVENTY PERCENT
OF US GRADUATE WITH OVER THIRTY
SEVEN THOUSAND DOLLARS IN
STUDENT DEBT. SO WE ARE IN VERY
FRAGILE FINANCIAL SITUATIONS
WHEN WE'RE IN SCHOOL AND
PARTICULARLY WHEN WE LEAVE IT.
I'M I WAS IN THE SAME BOAT I'M
I'M THE FIRST TO GRADUATE
COLLEGE IN MY FAMILY AND I COULD
NOT HAVE DONE SO WITHOUT THE
FINANCIAL SUPPORT OF MY PARENTS.
AND THAT COMES WITH ALSO THEIR
HEALTHCARE COVERAGE. MY DAD'S A
TEAMSTER AND I REMEMBER WHEN I
WAS YOUNG AND THE STRAIGHT AND
FOUGHT HARD FOR THIS HEALTHCARE
COVERAGE. AND SO IT ALWAYS MEANT
A LOT TO ME THAT I WAS ALSO
GIVEN THAT COVERAGE AND HAD
FANTASTIC HEALTH CARE REALLY MY
ENTIRE. YOUNG LIFE.
BUT WHEN I WENT TO UC SANTA
BARBARA. AND I HAD A FANTASTIC
EXPERIENCE THERE. I BECAME ILL
AND I HAD TO USE ON CAMPUS
MEDICAL SERVICES.
AND MY IT INSURANCE COVERAGE DID
NOT COVER THAT AND I HAD TO PAY
OUT OF POCKET AT THE TIME. WITH
THE PLANNED THAT.
MY INSURANCE COVER COMPANY
WOULD.
.
FIVE REIMBURSE ME FOR THAT. BUT
JUST LIKE MANY THIS YEAR ALONE
BARS I TALK TO YOU THAT MEANT
DEALING WITH A DENSE.
PAPERWORK AND BUREAUCRATIC
PROCESS TO GET THAT DONE. AND SO
WHAT STARTED AS JUST A SIMPLE
FLU TURNED INTO A THREE HUNDRED
DOLLAR MEDICAL PAYMENTS AND I
WAS NOT REIMBURSED FOR MONTHS.
AND I DIDN'T SOUND LIKE A LOT
THREE HUNDRED DOLLARS BUT.
AT A TIME WHEN I WAS LITERALLY
PULLING QUARTERS OUT OF THE
COUCH CUSHIONS TO BUY TOP ROBIN
IN COLLEGE. THIS REALLY REALLY
MEANT A LOT.
AND WHILE THAT DENIES THE DERAIL
MY SUCCESS. IT HAS A HUGE IMPACT
ON OTHER PEOPLE AND I LIKE TO
JUST SHARE A QUICK STORY WITH
YOU. ODD STUDENT DEBT CRISIS WE.
WE'VE BEEN COLLECTING OUR
TESTIMONIALS FROM STUDENTS AND
PEOPLE IMPACTED BY STUDENT DEBT
THOUSANDS OF THEM OVER THE
YEARS.
OUT AND MANY OF THEM HAVE DEALT
WITH ON CAMPUS HEALTHCARE
SERVICES WELL. THIS IS A STORY
FROM SIERRA WHO COULDN'T BE HERE
SHE'S FROM SAN JOSE.
US HERE WITH THEIR SECOND YEAR
OF MEDICAL SCHOOL WHEN SHE WAS
SEVERELY BURNED.
HER ON CAMPUS HEALTH CARE
OPTIONS WERE INSUFFICIENT AND
EVEN HER.
PRIVATE INSURANCE WILL NOT
COVER THE COSTS.
SHE HAD TO PAY A HEFTY HOW
HEALTHCARE BILLS AND DURING HER
TIME IN SCHOOL AND RESIDENCY SHE
WAS FOCUSED MORE ON MAKING HER
HEALTHCARE PAYMENTS FOR MEDICAL
PAYMENTS. THEN OR SCHOOL WORK
I'M EVEN OR STUDENT LOAN
PAYMENTS.
SHE HAD TO SKIP HER PAYMENT SHE
EVEN HAD TO DROP OUT OF SCHOOL
AND BECAUSE OF THAT HER DEBT IS
NOW FOUR HUNDRED THOUSAND
DOLLARS AND OUR MONTHLY PAYMENT
IS THREE THOUSAND DOLLARS A
MONTH. NEARBY WONDERING THIS IS
ALL ABOUT STUDENT DEBT WAS THAT
HAVE TO DO WITH IT. I JUST
REALLY WANT TO HIGHLIGHT HOW
SOMETHING AS SIMPLE AS A COUPLE
HUNDRED DOLLAR.
MEDICAL PAYMENT CAN START OFF AS
A SHORT TERM FINANCIAL
CONSEQUENCE BUT CAN SNOWBALL
INTO IT BECOMES A LIFE TIME
PROBLEM THAT STUDENTS ARE
FACING.
AND WITH THAT SAID YOU KNOW I
ENCOURAGE ANYONE WHO WANTS TO
HEAR MORE FROM THEIR
CONSTITUENTS AND MORE STORIES
LIKE THIS TO VISIT OUR WEBSITES
INTO CRISIS. WORK ON ORDER
CONTACT US SOME ARE BORROWERS
AND THE PEOPLE THAT WE'VE BEEN
SPEAKING WITH ARE IMPACTED BY
THE DECISIONS THAT YOU MAKE AND
ARE EAGER TO SHARE THEIR
STORIES.
ANSWERED THANK YOU AGAIN FOR AT
THIS. IMPORTANT DISCUSSION I
REALLY APPRECIATE IT.
GOOD AFTERNOON HERNANDEZ CENTER
ALAN I'M MARIANNE MASSENBURG. I
REPRESENT THE U. A. W. THE LABOR
UNION THAT REPRESENTS TWENTY
FIVE THOUSAND ACADEMIC STUDENT
EMPLOYEES AT UC AND CSU AND
COINCIDENTLY AT UMASS.
.
I'D LIKE TO ADDRESS A FEW POINTS
ARE MEMBERS WE REPRESENT OUR
MEMBERS IN THEIR CAPACITY AS
STUDENT WORKERS.
BUT THEY ALSO ARE ELIGIBLE AND
PARTICIPATE IN THE SHIP PROGRAMS
AT UC AND CSU.
A FEW POINTS THANK YOU SO MUCH
FOR DOING THIS WE REALLY
APPRECIATE YOUR SCRUTINY AND
YOU'RE YOU'RE WORKING YOUR STAFF
WORKS PREPARING FOR THIS IT'S
BEEN VERY INFORMATIVE.
SO FEW VERY QUICK POINTS.
ONE IS OUR EXPERIENCE THAT THE
OPTIONS FOR STUDENTS AND WAIVERS
AND OTHER ELIGIBILITY ARE NOT
WELL KNOWN OR UNDERSTOOD
UNIVERSALLY.
SO BE HELPFUL TO HAVE. MORE
MORE INFORMATION ABOUT THE
OPTIONS.
TO IT'S ABSOLUTELY CORRECT THAT
THERE ARE PROBLEMS OF DUPLICATE
COSTS AND COVERAGE.
THEIR PROBLEMS IN THESE
TRANSITIONS THAT YOU'VE HEARD
FROM MANY WITNESSES. AND THEIR
PROBLEMS WITH OUT OF NETWORK
ISSUES.
THREE MY UNDERSTANDING IS
ALTHOUGH YOU CAN WAVE OUT OF THE
STUDENT HEALTH PLANS YOU CAN NOT
WAVE OUT. OF THE STUDENT HEALTH
CENTER FEE EVEN IF YOU HAVE A
PLAN. THOSE.
I THINK ARE UNIVERSALLY
REQUIRED AND THERE'S NO WAY FOR.
FOR ANOTHER ISSUE THAT HASN'T
COME UP TODAY IS THAT THAT DOES
DEPENDENT COVERAGE. THAT IS
OFFERED IN THE STUDENT HEALTH
PLANS IS EXTREMELY EXPENSIVE AND
IS BORNE ENTIRELY BY THE
STUDENTS.
FIVE.
.
THE SELF INSURED PLANS AT UC.
DON'T HAVE TO COMPLY WITH ALL
OF ACA.
WE HAD THAT COME UP USUALLY
WITH DOCTOR PANTS BILL SEVERAL
YEARS AGO.
WHERE STUDENTS WITH?
CANCER AND CATASTROPHIC NEEDS.
HAD HIT THEIR LIFETIME MAX TO
USE HIS CREDIT.
AFTER DOCTOR PANS BILL AND SOME
ADDITIONAL LEGISLATIVE CONTACTS
UC CORRECT ABOUT.
BUT IT IS AN ONGOING PROBLEM
THAT.
THE SELF INSURED PLANS DON'T
HAVE TO COMPLY WITH THE ACA. ON
THANKS.
I SEE NO OTHER PUBLIC COMMENT.
.
ANY CLOSING STATEMENTS.
BY JUST APPRECIATE THIS I
APPRECIATE HIM COMING IN AND
AND.
.
IT'S A.
UNDERSCORES MY.
COMMENTS MY MY SENSE FOR A LONG
TIME THAT THINGS ARE WAY TOO
COMPLICATED THAN THAT YOU KNOW
THAT DAY AND TO TO QUOTE THE
PRESIDENT.
HEALTHCARE IS A MORE COMPLICATED
THAN HE THOUGHT SO.
.
I I II.
I WILL SAY THAT.
.
YOU KNOW. THAT IT SEEMS AS
THOUGH THE UNIVERSITIES ARE
TRYING HARD TO. TO TO TO MEET
ALL THE DEMAND THAT'S OUT THERE
BUT.
I AM CERTAINLY CONCERNED ABOUT.
ARE YOU KNOW.
I'M I I I GUESS THERE'S SOME
OPEN QUESTIONS ABOUT THE EXTENT
TO WHICH.
I'M.
YOU KNOW THEY'RE THEY'RE THEY'RE
TAKING ON.
I BURDENS THAT MAY END UP
BECOMING VERY. PROBLEMATIC ON
THE FINANCIAL SIDE INSIDE EYES
WHEN I GOT THE IDEA AND I I FEEL
LIKE I NEED TO FIGURE OUT A
LITTLE MORE ABOUT WHAT.
WELL WE WERE JUST DISCUSSING
WITH THE CHAIR ASKING SOME OF
THESE TOUGH QUESTIONS TO THE YOU
SEE I'M NOT SURE I'M I'M I'M
COMING OUT OF IT FULLY CLEAR AS
TO WHAT EXACTLY IS BEING COVERED
AND AND HOW. DO YOU SEE IS
THINKING ABOUT.
THE.
THE COST OF MY ABILITIES
ASSOCIATED WITH THE SYSTEM SO I
THAT'S ONE THING I LOVE TO
FOLLOW UP ON AFTER THIS.
THANK YOU LIKE HER JUST THANK
EVERYBODY FOR BEING HERE MY ONLY
CONCERN IS NUMBER ONE THE ADDED
COST TO THE STUDENT THAT IS OF
LOW INCOME.
THE ADDED FEES WHETHER IT'S THE
STUDENT HEALTH FEES THE OTHER
OPEN QUESTION I WOULD JUST HAVE
WHICH WE WILL FOLLOW UP LATER IS
THESE PARTICULAR ENTITIES AT THE
WEATHER TO SEE IS YOU USE HERE
MAYBE ON THEPRIVATE SCHOOLS.
IS WHY DON'T THEY TAKE ANY KIND
OF INSURANCE YOU KNOW WHETHER
IT'S AND I'M ASSUMING BECAUSE OF
THE OVERHEAD COSTS IN THE
BUILDING. BUT WE'LL CONTINUE TO
LOOK AT THIS ISSUE AND SEE IF
THERE'S ANY RESOLUTION BUT IT
WAS A VERY ROBUST AND.
POLICY DISCUSSION I THINK
EVERYBODY IN THAT WE'RE WE'RE
ADJOURNED