.
MY CALL TO ORDER THIS HEARING OF
THE BUDGET BUDGETS ARE SENATE
BUDGET THAT'S GOING VIEW
SUBCOMMITTEENUMBER THREE ON
HEALTH AND HUMAN SERVICES AND
WELCOME.
I'M WILL GO TODAY WE HAVE
SEVERAL ITEMS FOR DISCUSSION.
INCLUDING EMERGENCY MEDICAL
SERVICES DOUGHERTY THE OFFICE OF
STATEWIDE HEALTH PLANNING
DEVELOPMENT DEPARTMENT MANAGED
HEALTHCARE.
AND FARM HEALTH YOUR SERVICE IN
THE PARK PUBLIC HEALTH.
WE'RE NOT COVERING ALL ITEMS
RELATED TO THOSE SOME OF THOSE
DEPARTMENTS US SO WE'LL BE BACK
TO HEAR ABOUT OTHER THINGS IN
THOSE APARTMENTS BUT.
WE ARE GOING COVER MANY ITEMS
THAT YOU SHOULD SEE ON THE
AGENDA I DO WANNA MAKE NO.
AND TERMS OF THE AGENDA I AM
GOING TO TAKE ONE ITEM OUT OF
ORDER WHICH IS.
.
IN THE PART HEALTHCARE SERVICES
ISSUE NUMBER SEVEN OF WE'RE
GOING TO MOVE THAT TOWARD THE
FRONT OF THAT SECTION ON THE
PART HEALTHCARE ERVICES TO
UNDERSTAND MANY OF THE STAFF.
WHO WILL BE TESTIFYING WILL ALSO
BE TESTIFYING IN THE PRIOR ITEM
THAT WAS THE JOINT DEPARTMENT
HEALTH CARE AND BY HEALTHCARE
SERVICES OF THOSE STAFF DON'T
HAVE TO WAIT?
UNTIL THAT ISSUE COMES UP SO
WILL.
FOOT THAT.
AROUND SO THE STAFF CAN GET BACK
TO DOING THE WORK OF THE PEOPLE.
IN THEIR OFFICE.
.
WE'RE GOING TO AS WE TAKE THE
ITEMS I AM WHAT WE'LL DO IS I
AYE MATE GROUPS SOME OF THEM.
AND THEN WE'LL.
SO INDICATE WHEN WILL DO PUBLIC
COMMENT.
WHEN IT COMES PUBLIC COMMENT
APPRECIATED IF PEOPLE KEEP THEIR
COMMENTS TO A MINUTE ARE.
BUS AND.
AND THEN.
WE WILL THEN TAKE WHATEVER
ACTIONS WITH SCI FI TO TAKE SO.
I WITH THAT WILLIAM BEGIN WITH
THE ITEM FORTY ONE TO GO MERCY
MEDICAL SERVICES AUTHORITY SELF
ARE THE FOLKS WHO COME UP AND
FROM THE AGENCY IN LA JOH AND
FINANCE.
AND THEN WHAT WE WILL DO IS.
WILL HAVE A BECAUSE THEY BRIEF
OVERVIEW WE DO HAVE THAT
WRITTEN.
INFORMATION ABOUT THE DEPARTMENT
SO. NO NEED TO REPEAT ALL OF
THAT I THINK JUST SERVE GIVEN
THE HIGHLIGHT OF SERVE THE
IMPORTANT ISSUES.
THAT HAVE HAPPENED THE PAST YOUR
DATA RELATED TO THE BUDGET AND
THEN.
WE WILL ALSO I'M.
THE COMMENT FROM LA ON FINANCE
AND SO BEFORE YOU BEGIN JUST FOR
THE RECORD IT JUST LIKE EVERYONE
TO INTRODUCE THEMSELVES SO
STARTING WITH. THE AGENCY.
NUMBER MORNING.
CHAIRMAN PAN AND COMMITTEE
MEMBERS I I'M A DOCTOR HOWARD
BACK OR AN EMERGENCY PHYSICIAN
AND THE DIRECTOR OF THE
EMERGENCY MEDICAL SERVICES
AUTHORITY. IMAGES THAT DO
INTRODUCTIONS IN AND YOU CAN
LOOK AT JUST THE RIGHT IT
ALRIGHT. AGAINST MILEY CHIEF
DEPUTY DIRECTOR MERCHANTS
MEDICAL SERVICES OKAY ELIA.
BERNIE PETTITTE ILIO YOU
FINANCE.
LINA GRANT BERMAN FINANCE.
FOLLOW DEPARTMENT FINANCE FAQ
MCCARTY MAYBE AND THANK YOU OF
OUR DEPARTMENT EMERGENCY THE EMS
AUTHORITY AS A STATE AGENCY
RESPONSIBLE FOR THE COORDINATION
INTEGRATION OF ALL STATE
ACTIVITIES CONCERNING EMERGENCY
MEDICAL SERVICES.
TO ENSURE THE PROVISION OF
EFFECTIVE AND EFFICIENT
EMERGENCY MEDICAL CARE. BEEN IN
CALIFORNIA.
THERE ARE OVER FOUR MILLION
NINE ONE ONE REQUEST FOR
EMERGENCY CARE ANNUALLY. WE HAVE
THREE MAJOR AREAS OF
RESPONSIBILITY FIRST WE WILL
LICENSE AND.
TWENTY THREE THOUSAND
PARAMEDICS AND DISCIPLINE THE
LICENSES WHEN NECESSARY. AND WE
SET THE SCOPE OF PRACTICE
TRAINING STANDARDS AND
REGULATIONS FOR ALL LEVELS VIA
MASS INCLUDING PUBLIC SAFETY
FIRST AID.
SECOND THE EMS AUTHORITY
DEVELOPED GUIDELINES AND
APPROVES PLANS FOR EMERGENCY
MEDICAL SYSTEMS BETTER
IMPLEMENTED AND OPERATED BY THE
THIRTY THREE LOCAL EMS AGENCIES.
THE AND THE EMS AUTHORITY
DEVELOPS REGULATIONS FOR DESIGN
AND QUALITY OF SPECIALTY CARE
SYSTEMS.
THAT INCLUDE THE TRAUMA SYSTEM
THAT CURRENTLY WITH EIGHTY ONE
DESIGNATED CENTERS. PEDIATRIC
EMERGENCY CARE WITH A HUNDRED
ELEVEN CENTERS.
STROKES SYSTEM WITH A HUNDRED
FIFTY FOUR CENTERS. AND A
CARDIAC HER STEMI SYSTEM WITH A
HUNDRED AND FORTY FIVE SENATORS
AND THE CALIFORNIA POISON
CONTROL SYSTEM.
AND OUR THIRD MAJOR AREA
RESPONSIBILITIES TO MEDICAL
RESPONSE TO ISASTER. WHERE WE
PARTNER WITH THE DEPARTMENT OF
PUBLIC HEALTH AND FEDERAL AND
LOCAL PARTNERS?
THE BILL TO PUBLIC HEALTH AND
MEDICAL EMERGENCY SUPPORT
FUNCTION.
THE PLAN AND RESPOND TO THE
MEDICAL IMPACT OF ANY TYPE OF
DISASTER OR HEALTH EMERGENCY.
THE GOVERNOR'S PROPOSED BUDGET
FOR TWENTY EIGHTEEN NINETEEN
INCLUDES EXPENDITURE AUTHORITY
IN AMOUNT OF THIRTY SEVEN POINT
FOUR MILLION DOLLARS AND SEVENTY
PERMANENT POSITIONS. AND OF THIS
AMOUNT FORTY FOUR PERCENT IS
DELEGATED THE STATE OPERATIONS
AND FIFTY SIX PERCENT TO LOCAL
ASSISTANCE.
WE HAVE ONLY ONE NEW WORKLOAD
ADJUSTMENT UNDER CONSIDERATION
BY THE LEGISLATURE.
WE ARE REQUESTING ONE PERMANENT
POSITION AND A GENERAL FUND
AUGMENTATION IN FISCAL YEAR
TWENTY EIGHTEEN NINETEEN.
TOTALING THREE HUNDRED FIFTY SIX
THOUSAND DOLLARS WHICH INCLUDES
ONE TIME FINDING OF A HUNDRED
AND NINETY SIX THOUSAND DOLLARS
FOR IT INFRASTRUCTURE
IMPROVEMENTS.
AND ONGOING FUNDING OF A HUNDRED
AND EIGHTY NINE THOUSAND.
THEY REQUESTED TO ADDRESS THE
FINDINGS OF THE REQUIRED
INDEPENDENT SECURITY ASSESSMENT
AS PART OF A B. SIX SEVENTY BY
THE CALIFORNIA MILITARY
DEPARTMENT CYBER NETWORK DEFENSE
TEAM. THAT WAS DONE IN DECEMBER
OF TWENTY SIXTEEN.
THIS COMPREHENSIVE REVIEW
DEMONSTRATED THAT M. SO LACKS
SUFFICIENT IT INFRASTRUCTURE IN
SUPPORT STAFFING LEVELS TO MEET
STATE POLICY AND PROCEDURAL
REQUIREMENTS NECESSARY TO
ENSURE.
IT INFRASTRUCTURE SECURITY AND
PARTICIPATION IN STATE LEVEL AN
AGENCY WIDE I. T. INITIATIVES.
THANK YOU.
I THINK YOU'VE TOOK ON BOTH
THAT THEIR REVIEW AND.
THESE ISSUE NUMBER TWELVE WHICH
WAS AYE AND THAT'S ALRIGHT WE'LL
JUST DO THEM TOGETHER.
COMES FROM ILLEGAL. DON'T
FINANCE.
AND SUPPORTS THE PROPOSAL FOR
AND SAID IMPROVE ITS SECURITY
CAPABILITIES.
COMMITTEE MEMBERS AND. ACTUALLY.
SO FIRST OF ALL IT'S THE TO
TOUCH ON.
.
I IN TERMS OF.
PREPAREDNESS SUBS AND WE'VE HAD
THE WILDFIRES MUDSLIDES NAM.
ADVERTISED COME TO TALK ABOUT
THE NEW NORMAL.
AS WELL.
BUT IN TERMS OF PREPARATION FOR
THAT.
OBVIOUSLY ó YES HAS A LEADING
ROLE BUTTA. AND WAS AS.
NEIGHBORHOODS WERE BURNING DOWN
HOSPITAL'S HAD TO BE EVACUATED
OTHER FACILITIES.
.
I'VE SEEN PEOPLE NEED HELP.
TERMS OF I AM SAYS ROLE AND
PREPAREDNESS AND THAT BEING SURE
PEOPLE HAVE ACCESS TO OF
EMERGENCY MEDICAL CARE.
DO YOU SEE.
THAT YOU HAVE SUFFICIENT
RESOURCES TO ADDRESS.
THE NEW NORMAL IS THE
GOVERNOR'S.
SAID.
I AM.
THAT'S A LOADED QUESTION.
WE.
WHO WELL ALL I CAN SAY THE THAT
OUR RESPONSE?
AND NOT JUST HIM SO BAD I A
RESPONSE OF THE.
EMERGENCY SERVICES FUNCTION FOR
OUR SUPPORT FUNCTION FOR PUBLIC
HEALTH AND MEDICAL I THINK WAS
HIGHLYSUCCESSFUL.
WE LEVERAGE ALL OF OUR PARTNERS
AND IT IT'S THE IT GOES BEYOND
PUBLICHEALTH AND AN A AND M.
SAY INTO OUR OF THE OTHER
DEPARTMENTS OF OUR AGENCY. AND
WE UTILIZE A M. SO UTILIZED
IT'S.
A RESPONSE CAPABILITIES
ESPECIALLY OUR AMBULANCE STRIKE
TEAMS.
WE USED DE ARE ALWAYS THIRTY
AND ON STRIKE TEAMS DE WOULD
MATEO EVACUATED MULTIPLE
FACILITIES
AND HUNDREDS OF OF PATIENTS IN
THAT SYSTEM OF MUTUAL AID.
WORKED VERY WELL.
REGIONALLY ACROSS THE STATE WE
ALSO UTILIZED ARE A DISASTER
VOLUNTEER SYSTEM WE MOBILIZED DE
THE LOCALS USED TO MEDICAL
RESERVE COURSE MULTIPLE MEDICAL
RESERVE CORES. INCLUDING
VETERINARY.
RESERVE COURSE WHICH OR ARE
ROSTERED WITH OUR DISASTER
VOLUNTEERS.
THIS SO WE WERE ABLE TO PULL UP
THE ISSUE OF PERSONNEL REQUESTS
AS WELL THAT RANGE FROM DIRECT
HEALTH CARE TO. OTHER SUPPORT IN
THE EMERGENCY OPERATION CENTER
AND OUR OUR.
AS AN AGENCY WE COORDINATED.
THE.
A COORDINATED LOOK TAKE A
LOOK IN AND AND AND MAKING SURE
THAT WE KNEW THE STATUS OF ALL
THE FACILITIES NOT JUST ACUTE
CARE HOSPITALS AND NURSING
HOMES.
BUT EVERY LICENSE FACILITY BY
BOTH A PUBLIC HEALTH AND.
OUR A AND OUR SOCIAL DEPARTMENT
OF SOCIAL SERVICES AND WE
EVALUATED THE STATUS OF EVERYONE
OF THOSE AND AND WE KNOW IT'S OF
THEIR LEVEL OF OPERATION
IF THEY EVACUATED WHERE THERE.
WHERE THE PATIENTS WINTER WHERE
THEY'RE THEY'RE THE PEOPLE THEY
SERVE WHEN WE HAVE A A DIRECT
ROLE IN SAID A DIRECT ROLE IN
SUPPORTING THE EVACUATION AND
SUPPORT OF OUR CINEMA
DEVELOPMENTAL CENTER AS WELL?
AND AND FOR THAT PURPOSE
ACTUALLY WE ENDED UP USING.
MANY OF OUR MOBILE MEDICAL
SHELTERS WHICH IS THE.
IS THE EQUIPMENT LEFT OVER FROM
THE DEEMED IT KIND OF THAT THE
DEMOBILIZATION OF OUR.
BAR MOBILE HOSPITAL AND THE
SYSTEM. WHICH WE NOW THAT
UTILIZE A AYE AS MEDICAL.
SHELTERS ARE MULTI PURPOSE AS
SHELTERS AND IN THIS CASE WE USE
THAT.
NOT A TO HOUSE PATIENTS AND
BECAUSE THEY HAD A HARD SHELTER
FOR THAT BUT WE USED TO FOR ALL
THE ANCILLARY SERVICES STAFF.
AND OTHERS.
I APPRECIATE THAT AND THE FACT
THAT YOU KNOW WE FUND OF THE.
ISSUE THE MOBILE HOSPITALS HAS
BEEN THE SUBJECT OF DISCUSSION
PREVIOUS BUDGET HEARINGS AND.
.
NOTING THAT IT'S NOT JUST IT'S
EVEN SOMETIMES EQUIPMENT
ALTHOUGH I I DO KNOW THAT YOU
DIDN'T EXACTLY ANSWER MY
QUESTION WAS DO YOU HAVE
SUFFICIENT RESOURCES.
YES.
WELL THERE YOU KNOW PERMIT THE I
THINK THAT THERE'S THERE'S TWO
THINGS THERE'S THERE'S.
FISCAL RESOURCES LIKE ARE.
ARE AM TO STRIKE TEAMS IN THE.
YOU KNOW THAT THE SHELTERS.
WHICH WE HVE AND AND YOU KNOW
THAT WE ADVOCATED FOR.
YOU KNOW THAT THAT THE THE
CAPABILITY OF EVERY Q. CARE
HOSPITALS BUT WE ARE.
WHO WE ARE WE ARE HAVE
REGROUPED AND AND RE PURPOSED
AND THE THE EQUIPMENT AS FAR AS
PERSONNEL GOES I THINK THEY WERE
REASONABLY STAFFED AND NOW WE WE
DID JUST HAVE TO?
ARE HAVING TO ABSORB A CUT IN
THE FEDERAL HEALTH HOSPITAL
PREPAREDNESS GRANT.
IN WHICH WILL.
IT IMPACT YOU KNOW OUR OUR
STAFF AND.
AS WELL AS OVER IN PUBLIC
HEALTH AND THAT'S THAT'S A
FEDERAL DECISION.
MEAN SO I HERE WE WE CAN ONLY
WE PRIORITIZE OUR OUR PLANNING
AND. ACCORDING TO OUR OUR
STAFFING LEVELS AND WHEN A
DISASTER HAPPENS EVERYTHING ELSE
STOPS AND EVERYBODY FOCUSES ON.
RESPONDING TO THE DISASTER.
ALRIGHT WELL.
IT'S FUNNY SURE THAT.
WE'RE STAYING ON TOP OF THIS
SIZE AND COURSE WE WANT TO WORK
PARTNER WITH THE ADMINISTRATION
AND.
VARIOUS ENTITIES AS WELL AND
WELL I'M SURE WE HAVE THE
APPROPRIATE RESOURCES.
AS A MAKE NOTE THAT AND YOU
KNOW WE TALKED PUBLIC HEALTH AND
OTHER FOLKS IS THAT YES I
UNDERSTAND WINTERS DISASTER YOU
PULL EVERYONE TOGETHER AND FOCUS
ON DISASTER BUT THE WORK THAT
THEY WERE DOING BEFORE THE
DISASTER OFTEN HAS IMPORTANCE AS
WELL MAY NOT. MAYBE NOT THIS
URGENT.
AS WHAT'S HAPPENING AT THE TIME
OF THE DISASTER AND THAT'S WHAT
WE DO THAT BUT.
NOW WHEN WE TALK ABOUT STAFFING
YOU NEED TO BE ABLE TO RAMP UP
YOU KNOW WHAT SURGE CAPACITY
THINGS LIKE THAT AND SO I HOPE
THAT.
THERE ARE DISCUSSIONS GOING ON.
WITHIN THE ADMINISTRATION TO BE
SURE THAT WE ARE READY.
FOR.
OR EVENTS IN THAT WE HAVE THE
NOW SUFFICIENT SURGE CAPACITY
OBVIOUS.
NOTES THIRDS CAPACITY TO HANDLE.
AT LEAST EVENT SO WE CAN NO
REASONABLY ANTICIPATE AS AS THE
GOVERNOR'S RACE DECLARED NO
THERE'S A NEW NORMAL SO WE HAVE
TO. WE SHOULD BE PREPARING FOR
THE NEW NORMAL APPRECIATE THAT
AND CARE OF THE OTHER QUESTION I
DO HAVE IS THIS REGARDING THE.
THE.
A PROPOSAL FOR INFORMATION
IS SECURITY ASSESSMENT WAS DONE.
.
BACK AND AT TWENTY SIXTEEN AND
WERE RESPONDING TO THAT ASSURING
WE HAVE SECURE SYSTEM.
DOING QUESTION I DID HAVE IS
HOW.
HOW FREQUENTLY ARE REDOING THE
SECURITY ASSESSMENTS OFFICE THE
LAST ONES TWENTY SIXTEEN WERE
NOW DOING A RESPONSE TO THAT?
IS THIS SOMETHING THAT CAN BE
DONE ON THE ONGOING REGULAR
BASIS I KNOW THOSE.
DE I GUESS WAS DONE BUT
CYBERSECURITY TEAM OVER AND
ANOTHER.
THE OTHER ANOTHER DEPARTMENT
BUT. IN TERMS OF WHAT'S THE
ANTICIPATED REGULARITY OF OF
BEGAN ASSESSING ARE ARE I IT
SECURITY AND IN THIS APARTMENT.
LET ME SEE IF DANCE MILEY HAS
THE ANSWER TO THAT.
BOB THANK YOU.
DANCE MILEY AND CHIEF DEPUTY
DIRECTOR FOR EMSA. OF THE PLAN
RIGHT NOW IS THAT WE ARE WORKING
WITH THE CALIFORNIA MILITARY
DEPARTMENT AND WORKING WITHIN
THEIR SCHEDULING PROCESS WE
ANTICIPATE ANOTHER ASSESSMENT
WITHIN APPROXIMATELY TWO YEARS.
ADDITIONALLY THE DEPARTMENT OF
TECHNOLOGY ARE ALSO HAS A VERY
OF SECURITY AUDIT UP PROCEDURES
AND WERE ACT CURRENTLY TRYING TO
FIGURE OUT WHEN THAT SCHEDULES
GOING TO OCCUR. OF THEY HAVE NOT
YET PUBLISHED THAT YET BUT WE DO
KNOW THAT WHAT WE WANT WITH THIS
IS THAT.
PART OF THE STAFF PERSONS A
RESPONSIBILITY AND.
THE INFRASTRUCTURE THAT WERE
GOING TO BE PURCHASING AS PART
OF THIS. THEIR WHOLE GOAL IS TO
GET READY FOR THAT NEXT STEP
SECURITY ASSESSMENT PROBABLY IN
THE
THAT TWO TO THREE YEARS.
OKAY THANK YOU.
ANY OTHER QUESTIONS REMEMBER CSS
OUR SON. BACK YOU ARE MISTER
CHAIR AND UP.
THIS IS BEEN A VERY BUSY YEAR
FOR YOUR DEPARTMENT I WANNA
JUST.
THANK YOU FOR. REALLY DOING A
GREAT JOB AND HELPING A LOT OF
PEOPLE IN NEED.
AND.
I THINK OUR OUR MUTUAL AID
SYSTEM IN THE STATE OF
CALIFORNIA WHICH I ASSUME YOU
HELP MOBILIZE.
WAS VERY HELPFUL AND I MEAN WE
HAD.
.
FIRE DEPARTMENTS EVEN OF THE
PECHANGA TRIED.
CENTER FIRE DEPARTMENT OF TWO
FIRES TO HELP OUT AND IT'S NICE
TO SEE THAT COLLECTIVE EFFORT
WHEN. WE HAVE AREAS OF THE STATE
THAT ARE IN NEED.
I ALSO KNOW THAT I ASSUME THAT
MANY OF THE SERVICES THAT YOU
PROVIDE WHEN THERE IS A STATE
DISASTER THAT IS FEDERALLY
RECOGNIZED THAT WE ARE GOING TO
BE THE BENEFICIARY OF FEMA
FUNDS.
AND SO DO YOU HAVE ANY IDEA WHAT
THE THEME I REQUEST IS GOING TO
BE FOR YOUR DEPARTMENT WHAT THE
TIMEFRAME IS FOR US TO GET THAT
MONEY. AND HOW DOES IT REALLY
GET REFLECTED INTO YOUR BUDGETS.
AGAIN ABITTER HAVE DAN ANSWER
THAT BUT I WILL MAKE ONE OR TWO
POINTS.
THAT I'M DO THE PUBLIC HEALTH
AND MEDICAL HAVE.
IT AID THEY ARE A UNIQUE.
A MUTUAL AID SYSTEM THAT IS
THAT FEEDS INTO THE STATEWIDE
AND STEM SYSTEM BUT WE ACTUALLY
I BASED ON STATUTE HAVE A. OF A.
THE DISASTER MEDICAL AND HEALTH.
IT YOU KNOW SPECIALIST IT EACH
COUNTY AND IN IN A REGION THAT
THEY ARE THE ONES OF FUN ALL THE
REQUESTS UP AND TRY TO MEET THE.
THE MUTUAL AID WITHIN THE REGION
AND IF THEY CAN'T DO THAT THEN
THAT THE TICKET TO THE STATE AND
AND WILL BE.
AND DEPENDING ON THE ON THE
RESOURCE REQUEST O. REAL ENGAGE
THE STATEWIDE SYSTEM WE WE DON'T
REALLY GET INVOLVED IN THE
MUTUAL AID TO RESPOND TO THE TO
THE FIRES HIS THE FIRE AGENCY
HAS THEIR OWN MUTUAL AID SYSTEM
AT AS WELL.
AND THEN THE OTHER THING IS IT
YEAH THE. HAVE RELATED TO
REIMBURSEMENT FROM FEMA.
AND THE ONE THING THAT MAKES IT
WHO MORE CHALLENGING ENOUGH FOR
ME MEDICAL AND HEALTH IS AT FEMA
DOESN'T REIMBURSE MEDICAL CARE.
AND SO WE SOMETIMES OF BIG I'VE
GOTTEN INTO CHALLENGES IN TERMS
OF GETTING THE REIMBURSEMENT
FOR.
FOR AMBULANCE TRANSPORT WHICH
KIND OF FALLS A LITTLE BIT DE
HIM BETWEEN A AT ALL IT'S
GENERALLY COVERED.
BY HEALTH THE INSURERS AND SO.
WE WE HAVE HAD SOME CHALLENGES
WITH THAT DAN DO YOU HAVE MOTHER
COMMENTS I WOULD JUST SAY THAT
THIS IS ALL PART OF UP. THAT YOU
KNOW IN TERMS OF OUR PLANNING OF
THIS IS IN COORDINATION WITH THE
ADMINISTRATION DEPARTMENT OF
FINANCE.
AND CAL YES BECAUSE IT THIS IS
ALL PART OF A LARGER DISCUSSION.
PRIORITIZATION AS PART OF THE
AFTER ACTION REPORTS ON UP ON
WHAT ACTUALLY WENT ON IN IN AND
WHAT THE MISSION REQUESTS WORK.
WITH RESPECT A REIMBURSEMENT PAN
THAT AT THIS POINT I'M NOT SURE
THAT WE HAVE AN EXACT UMBER.
WE KNOW THAT WE HAVE SUBMITTED.
EIGHT YOU KNOW SOME PARTICULAR.
REQUEST SUCH AS FOR AND DON'T
STRIKE TEAMS USE THE MOBILE
MEDICAL SHELTER STAFFING TO
CALLOW YES WERE SORTING OUT THE
MISSION NUMBERS OF BECAUSE YEAH
EVERY REQUEST FOR REIMBURSEMENT
HAS TO HAVE AN APPROPRIATE
MISSION NUMBER.
AND DETERMINED NATION FOR
ELIGIBILITY AND WHETHER THAT'S A
LOCAL VERSUS STATE COST-A.
A WE ARE HOPEFUL THAT.
IT AGAIN I'M GET A PUNT TO
CALLOW YES ON THE EXACT TIME
OF THIS BECAUSE.
THAT THE ENTIRE RECOVERY AND
REIMBURSEMENT PROCESSES IS ALL
CENTERED AROUND THEIR WORK WITH
THE DEPARTMENT OF FINANCE ON
THAT.
.
A OVERALL I DON'T THINK I'M
SAYING KURD THAT MANY DIRECT.
MY COSTS
OTHER THAN WITH THE AMULET
STRIKE TEAMS IN THE MOBILE
MEDICAL SHOP.
OKAY MY HOPE THAT.
WOULD ONE LEAVING THE MONEY ON
THE TABLE IF YOU WE NEED A
COMPREHENSIVE ANALYSIS OF
WHATEVER. YOU'RE ELIGIBLE TO TO
GET BACK WE CERTAINLY WANT TO
SEE YOU GET IT BACK AND.
HELP YOUR AGENCY OUT SO AGAIN
THANK YOU.
AND QUESTIONS SAY NOT ALL RIGHT
UP PUBLIC COMMENTS ON ITEMS ONE
INTO REGARDING HIMSELF.
SAYING NO ONE AT THE MICROPHONE.
.
ALRIGHT SO I SEE FIRSTHAND THIS
INFORMATIONAL SECOND ORDER SO.
WE WILL UPHOLD OPEN.
ISSUE NUMBER TWO I THINK IT'S
YOU KNOW NEVER IT WAS THIS THE.
ALICE'S INFORMATIONAL SELF I
THINK USM.
BUT THANK YOU VERY MUCH FOR YOUR
PRESENTATIONS AND.
LOOK FOR TO.
.
TOUCH BASE AGAIN WITH A REVISED
THANK YOU HOPEFULLY PEOPLE TALK
ABOUT SURGE CAPACITY. ALRIGHT.
OKAY SO NEXT I AM UP TO IS A
FOUR ONE FOUR OH OFFICE OF
STATEWIDE HEALTH PAIN
DEVELOPMENT.
WE WILL HAVE.
.
ISSUE NUMBER ONE IS THE
OVERVIEW.
AND SO WE CAN HAVE THE AGENCY LA
OWN FINANCE.
HERE THAT.
SO WE HAVE TO ISSUES IN THIS
CATEGORY.
AND I UNDERSTAND WE HAVE A
STAKEHOLDER PROPOSAL RELATED TO
THE OVERVIEW SELLABLE TO ISSUE
ONE.
HERE AND THEN SHARED
STAKEHOLDER PROPOSAL. SO WELL
BEFORE WE BEGIN.
LET'S GO AHEAD HAVE EVERYONE
INTRODUCE THEMSELVES FOR THE
RECORD.
ROBERT DAVID DIRECTOR OFFICE OF
STATEWIDE HEALTH PLANNING
DEVELOPMENT MOURNING MOURNING
YOU.
STACEY WALKER AND DEPUTY
DIRECTOR AT THE OFFICE OF
STATEWIDE HEALTH PLANNING AND
DEVELOPMENT. KEEP.
GOOD MORNING SCOTT CHRISTMANN A
DEPUTY DIRECTOR CHAU OFF
STATEWIDE HEALTH PLANNING
DEVELOPMENT. I KEEP ELLIOT.
BRIAN MATTES CARRILLO AND
FINANCE.
NO JOHNSON DEPARTMENT FINANCE.
ANDERSON DEPARTMENT FINE IT'S A
THANK YOU WELCOME. RIGHT TO VOTE
SO WHEN WE GO AHEAD AND BEGIN
WITH THE OF REVIEW AND I THINK
WE'RE GOING TO HEAR A LITTLE
MORE SPECIFICALLY SOME REQUESTS
ABOUT THE. THE WHAT PROGRAM SO
YOU MEAN IF YOU WANT DRILL IN A
LITTLE MORE ON ON THAT IF YOU
HAVE ANYTHING MORE TO SAY BUT.
WE DO HAVE THE WRITTEN DOCUMENTS
SO I'D SEARCH SEARCH AT THE
HIGHLIGHTS.
AND JUST A QUICK OVERVIEW AT THE
DEPARTMENT.
.
POSH PAIRED DATA HAS THREE
MAJOR AREAS HEALTHCARE
CONSTRUCTION FINANCING
HEALTHCARE WORKFORCE DEVELOPMENT
AND HEALTH CARE DATA COLLECTION
REPORTING.
OUR TWENTY NINETEEN A PROPOSED
BUDGET IS A HUNDRED AND FORTY
FIVE MILLION. NUMBER FUNDED
PRIMARILY BY SPECIAL FUNDS OF
MANY THAT MURPHY SUPPORTED.
AND WE HAVE A SMALL AMOUNT OF
FEDERAL FUNDING ABOUT ONE POINT
FIVE MILLION FOR WORKFORCE
PROGRAMS.
BEGINNING WITH HEALTHCARE
CONSTRUCTION FINANCING.
AS YOU KNOW SENATORS WERE THE
BILLING DEPARTMENT FOR
CALIFORNIA'S HOSPITALS.
AND SKILLED NURSING FACILITIES.
IN TWO THOUSAND ONE FORTY
PERCENT OF CALIFORNIA'S HOSPITAL
BUILDING INVENTORY OVER THOUSAND
BUILDINGS.
WAS CLASSIFIED IT BEING UP
POTENTIALLY AT RISK FOR COLLAPSE
IN A MAJOR EARTHQUAKE.
AND TODAY I AM PLEASED TO REPORT
THAT NINETY FOUR PERCENT. OF
CALIFORNIA'S ACUTE CARE HOSPITAL
BUILDINGS IN THE STATE NOW
COMPLY. WITH THE SEISMIC SAFETY
ACCESS TWENTY TWENTY STANDARDS.
WE'VE ALSO PROMULGATED A NEW
SEISMIC PERFORMANCE CATEGORY
CALLED S. B. C. FOUR D..
THAT'LL ALLOW ON HOW OLDER
HOSPITAL BUILDINGS TO UPGRADE TO
A STANDARD THAT'LL KEEP THEM
SEISMICALLY COMPLIANT.
PAST TWENTY THIRTY.
UP TO DATE FORTY TWO HOSPITAL
BUILDINGS IN TWENTY TWO
HOSPITALS HAVE APPLIED FOR THOSE
UPGRADES.
AND THIS IS A VERY COST
EFFECTIVE AND GOOD OPTION
PARTICULAR FOR HOSPITALS THAT
WOULD OTHERWISE HAVE TO BE
REPLACED REMOVED FROM SERVICE.
IN TWENTY SEVENTEEN NINETY FIVE
PERCENT OF ALL PROJECT
APPLICATIONS TO AJ BUT WERE
DIRECTLY SUBMITTED
ELECTRONICALLY INTO OUR E.
SERVICES PORTAL.
AND ALSO LAST YEAR NINETY SEVEN
PERCENT OF OVER FIFTEEN THOUSAND
TOTAL PROJECT REVIEWS. WERE
COMPLETED ON SCHEDULE.
AND WE ALSO HAVE A PROGRAM
CALLED CAL MORTGAGE WHICH
PROVIDES A NONPROFIT AND PUBLIC
HEALTH FACILITIES. ACCESS TO LOW
COST FINANCING OUT BY OFFERING
LOAN INSURANCE.
I SINCE TWENTY THIRTEEN THAT
PROGRAM IS INSURED FORTY SIX
LOANS.
TOTALING OVER ONE POINT FOUR
BILLION DOLLARS TO THESE
FACILITIES. AT NO COST TO THE
GENERAL FUND.
RELATED TO HEALTH CARE
WORKFORCE DEVELOPMENT AND WE
HAVE TO PROGRAMS OUR HEALTHCARE
WORKFORCE DEVELOPMENT DIVISION.
AND THE HEALTH PROFESSIONS
EDUCATION FOUNDATION.
OF ONE OF OUR PRIMARY
HEALTHCARE WORKFORCE PROGRAMS IS
A SONG BROWN PROGRAM.
SONG BROWN AWARDS FUNDING.
TO HEALTH CARE TRAINING.
AND RESIDENCY PROGRAMS TO
INCREASE ACCESS TO HEALTHCARE
PROVIDERS.
IN UNDERSERVED AREAS I'M THROUGH
THE RECRUITMENT OF UNDER
REPRESENTED MINORITIES A
CLINICAL TRAINING IN AREAS OF
UNMET NEED. AND GRADUATE
PLACEMENT.
AND LASTLY THE HEALTH
PROFESSIONS EDUCATION FOUNDATION
IS NOT NOT FOR PROFIT. BUT ONCE
HE THREE WHICH IS HOUSED WITHIN
US BID TO PROVIDE LOAN
REPAYMENTS AND SCHOLARSHIPS TO
THOSE WILLING TO WORK. IN
UNDERSERVED AREAS I MIGHT NOTE
IT'S A VERY POPULAR PROGRAM.
PARTICULARLY AS AS THE CHAIR
KNOWS SARAH IS A LOT OF MEDICAL
SCHOOL DEBT OUT THERE AND DIE
AND IT'S A REAL REAL BIG HELP.
AND THEN HEALTHCARE DATA
COLLECTION REPORTING WE COLLECT
HEALTHCARE DATA FROM NEARLY SIX
THOUSAND FACILITIES LICENSED BY.
DEPARTMENT OF PUBLIC HEALTH.
I'M WE PRODUCE MEASURES AND
ANALYSES AND REPORTS ON HEALTH
CARE OUTCOMES AND QUALITY SAN.
RELATED HEALTH TOPICS.
I'M FINALLY ASH PIT IS A AND
YOU'LL BE HEARING A LITTLE MORE
ABOUT THIS LEADERS IMPLEMENTING
SENATE BILL SEVENTEEN.
WERE CALLING THIS PROGRAM COST
TRANSPARENCY ARE EX.
I S. B. SEVENTEEN SEEKS TO
INCREASE PRESCRIPTION DRUG COSTS
TRANSPARENCY. REQUIRING ADVANCED
NOTIFICATION TO PUBLIC AND
PRIVATE PURCHASERS.
BEFORE SPECIFIED COST INCREASE
OCCURS AND MAKING PUBLIC CERTAIN
INFORMATION.
ASSOCIATED WITH THAT INCREASE.
AS OF JANUARY FIRST.
OF THIS YEAR AYE WE'RE PROVIDING
A DATABASE OF PURCHASERS WHO
WISH TO RECEIVE SIXTY DAY.
ADVANCE NOTIFICATIONS FROM
PRESCRIPTION DRUG MANUFACTURERS
WHEN THE COST RISES ABOVE A
CERTAIN LEVEL.
AS IS SAYS STATED IN THE LAW.
STARTING IN TWENTY NINETEEN I
WILL BE RECEIVING ADDITIONAL
DATA FROM THE MANUFACTURERS.
GIVING THE RATIONALE FOR THE
INCREASES AND WILL BE PUBLISHING
THAT INFORMATION ON OUR WEBSITE
IN THE SECOND QUARTER OF TWENTY
NINETEEN.
I'M THIS LAW NEW LAW HAS ADDED
IN KILEY NEW GROUP OF
STAKEHOLDERS FOR US AND
RESPONSIBILITIES TO OUR
DEPARTMENT.
AND WE'RE MOVING QUICKLY TO
IMPLEMENT ITS PROVISIONS.
I'M DEPUTY DIRECTOR SCOTT
CHRISTMAS A TO MY RIGHT WILL BE
PRESENTING A BUDGET CHANGE
PROPOSAL ON THIS TOPIC SHORTLY.
I'M THAT CONCLUDES MY INITIAL
PRESENTATION CENTERS I'M HAPPY
TO ANSWER ANY QUESTIONS OR WE
CAN MOVE ON TO THE REQUESTED
UPDATE ON OUR PRIMARY CARE
WORKFORCE PROGRAMS.
I THINK YOU'RE A KITTEN THAT I
YOU KNOW THAT.
WE'RE GONNA BE HAVING A
SEPARATE PRESENTATION ON.
THE S. B. SEVENTEEN
IMPLEMENTATION SO PEOPLE WHO ARE
INTERESTED THAT WILL PUT UP WE
DELVE INTO THAT A LITTLE MORE WE
GET ISSUED NUMBER TWO.
LA OWE ANY COMMENTS AND.
FINANCE
NO ALRIGHT QUESTIONS REMEMBERS
CENTER STONE BUT YOU OF
APPRECIATE YOUR YOUR
PRESENTATION.
ONE OF THE CONCERNS THAT I'VE
HAD IS.
TALKING WITH SOME MY LOCAL
HOSPITALS IS THE TURNAROUND TIME
FOR EXPANSIONS LE CONSTRUCTION.
ONE OF OUR LOCAL HOSPITALS THAT
CA IS NEWARS HAVE AN APPLICATION
WELL OVER A YEAR NOW.
A WHAT DO YOU DOING IN YOUR
DEPARTMENT A TRY TO EXPLAIN SOME
OF THESE PLANS BECAUSE WE HAVE A
STRONG NEED IS YOU KNOW IN THE
INLAND EMPIRE. RIVERSIDE COUNTY
IN PARTICULAR WHICH IS THE
FASTEST GROWING COUNTY IN THE
STATE. THEY WANTED LIBERTIES
MEDICAL SERVICES BUT THEY CAN'T
DO IT UNTIL THEY GET YOUR
APPROVALS.
SO.
COULD YOU TELL ME WHAT YOU DO
INTO AN EXPERT AYE PLANS AND
WHAT IS THE AVERAGE TURN AROUND
TIME NOW WITH A LARGE PART TO
TRY TO GET SOME.
MAJOR HOSPITAL EXPANSION STUNT
AT AT AVERAGES DIFFICULT BECAUSE
WE WE HAVE PLANS IN UP FROM ANY
SIZE FROM FIFTY THOUSAND TO.
THE BIGGEST PROJECT ACTUALLY WE
HAVE IS ISN'T IT IN THE INLAND
EMPIRE IS LOW MULLIN THAT WHICH
IS ALMOST A TWO BILLION DOLLAR
PROJECT.
AND DOES THAT PROJECT ACTUALLY.
.
WHERE? WE ARE LA OFFICE IS.
VERY VERY HEAVILY FOCUSED ON
THAT PROJECT AND THEY WERE THEY
WERE BEHIND SCHEDULE. THEY'RE
ACTUALLY AS A DOING QUITE WELL
NOW.
IN TERMS OF.
SOME OF THE STRATEGIES THAT
WE'VE DONE. ELECTRONIC PLAN
REVIEW IS ONE.
THAT WE'VE THAT I MENTION THAT
WE'VE IMPLEMENTED DEATH FAIRLY
RECENTLY WE ALSO ENCOURAGE
HOSPITALS.
PARTICULARLY.
OF A PROJECT OF MAJOR PROJECTS
A OVER A TWENTY MILLION DOLLARS
TO ACTUALLY COME IN AT THE
BEGINNING OF THAT.
PROCESS WITH OUR DESIGN TEAM AND
MEET WITH US AND WE WILL.
I MEAN LITERALLY SAT ACROSS
FROM A TABLE AND AGREE ON TIME
FRAMES
AND I AGREE THAT THEY'LL BE
SUBMITTING THINGS TO US AT A
CERTAIN TIME FRAME AND THAT WILL
RESPOND IN IN A CERTAIN TIME
FRAME. AND SO IT'S A IT'S A KIND
OF A COLLABORATIVE REVIEW
PROCESS.
AND THAT'S THAT'S PROVEN PRETTY
SUCCESSFUL AND THEN WERE I'M
ALWAYS A INTERESTED IN HEARING
FROM HOSPITALS IF A PROJECTS
GOING OFF THE RAILS. IT WE WANT
TO GET IT BACK ON AND I REALIZE
THAT TIME IS MONEY. AND THE I'M
WE WANT FOLKS THAT WE WANT TO
COST EFFECTIVE HEALTHCARE SYSTEM
AND WHATEVER WHATEVER I CAN DO
TO HELP THAT I'M HERE TO HELP.
OKAY APPRECIATE THAT I'LL
PROBABLY BE CONTACTING YOU TO DO
IS I'D LIKE TO SEE THIS A LOCAL
HOSPITAL GET THE EXPANSION OF
THE NEED.
NOT BECAUSE TIME IS MONEY IS
BECAUSE IT'S TIME TO COMPENSATE
LIVES SO AND MAKE SURE THOSE
MEDICAL SERVICES ARE VAILABLE
TO BUY.
APPRECIATE YOUR ANSWERS.
THEIR MONEY.
THANK YOU I JUST WANNA COMMENT
ON THE SONG BROWN RESOURCES AND.
GLAD TO SEE THAT THAT IS ONGOING
THE THREE YEAR COMMITMENT IS
THAT CORRECT SO WE'RE IN THE
FIRST YEAR OF THAT WHEN THE
SECOND. WHERE IN THE SECOND AS
RIGHT?
WE'RE IN THE FIRST GOING TO THE
SEC WE IMPLEMENT COULD HAPPEN
I'M GONNA ASK A. DEPUTY DIRECTOR
WALKER TO THANK YOU WHERE WHERE
ACTUALLY IN THAT FIRST
IMPLEMENTATION YEARS THAT WE
HAVE THE FIRST ROUND OF FUNDING
AND NOVEMBER.
AND WHAT WE'RE LOOKING AT IS
THAT CONTINUED.
SECOND YEAR OF A THREE YEAR
COMMITMENT.
I KNOW IN THE PAST THERE WERE
SOME CONTRIBUTION FROM THE
CALIFORNIA ENDOWMENT.
A THIS IS ALL GENERAL FUND
ALLOCATION OF THIS POINT.
IS THERE ANY SOURCE OF THAT
FUNDING THAT COMES INTO THE
GENERAL FUND OR SUGGESTS.
ST GENERAL FUND ALLOCATION.
IN IN OTHER WORDS ARE WE DOING
ANY ARE THERE ANY FEES THAT
SUPPORT THIS.
WELL.
BUT THE BASE FUNDING FOR THE
SONG BROWN PROGRAM IS FROM.
OF THE CALIFORNIA THAT DATA
FUND.
AND IT'S HOW MUCH YEARS ABOUT
SAYS ABOUT HIM MALL AT ABOUT TWO
POINT SEVEN FOR. UP PRIMARY
CARE.
WE ALSO RECIEVE A SMALL AMOUNT
OF MONEY WITCHES HAD DONATION.
BETS AT POSITIONS COULD PROVIDE
THROUGH THE ATOM.
BUT AFFORD NAY COLLECTIVE FEET
FORESTS AND BAIT THEY UPDATE US
ANNUALLY ON WHAT THAT THAT.
CLIENTS LIKE IT'S A SMALL
PERCENTAGE OF AREAS WERE WRONG
COMMITMENT.
AND.
THE PLAN IS.
THIS IS THE SECOND YEAR
COMMITMENT AND THE COMMITMENTS
THERE FOR.
A THIRD YEAR.
OF THE HUNDRED MILLION.
SAT ACCURATE.
MY MISTER MEMBERS.
YES SO THE GOVERNOR'S BUDGET
DOES INCLUDE. THE ASSUMPTION
THIRTY THREE POINT ONE MILLION
GENERAL FUND FOR THE SECOND YEAR
THE PROGRAM.
THANK YOU.
AND THEN IS THERE ANY.
DATA CAPTURED THEIR SOME IN HERE
ABOUT THE NUMBER OF POSITIONS
SAYS SEVENTY TWO NEW RESIDENCY
SLOTS SUPPORTED BY THE SONG
BROWN PROGRAM. FOR SEVENTEEN
EIGHTEEN. ON.
WELL THAT NUMBER STAY.
STAY THE SAME WILL IT WILL BE
INCREASED OVER THE NEXT
TWO YEARS.
THE WAY THE FUNDING ALLOCATED
AND THE WAY IT WORKS IN OUR
PROGRAM IS.
NEXT YEAR.
IF THERE ARE ADDITIONAL NEW
PROGRAMS THAT ARE COMING ONLINE
THEY CAN APPLY FOR THOSE AWARDS.
AND THEN WE WE WOULD EVALUATE
THE PROGRAM AND WHAT THE FUNDS
ACCORDINGLY SO THERE THERE COULD
BE ADDITIONAL EXPANSION BEYOND
THE SEVENTY TWO.
FIRST YEAR RESIDENT SLOTS THAT
WE SAW THIS YEAR.
THANK YOU IN IS THERE ANY OTHER
ADDITIONAL DATA THAT IS CAPTURED
IS THE PROGRAM MOVES FORWARD.
CLEARLY RESIDENCY SLOTS IS EASY
TO MEASURE USERNAME MEASUREMENT.
OF BY CREATION OF THESE IN
UNDERSERVED AREAS THE NUMBER OF
RESIDENTS WHOSE CONTINUE TO
PRACTICE IN THAT UNDERSERVED
AREA.
WE HADN'T DATA ON THE NUMBER OF
SITES IN UNDERSERVED AREAS WE
ALSO HAVE DATA ON THE NUMBER OF
FIRST YEAR RESIDENTS.
IN THE PROGRAMS THAT WE WANTED
TO SO THERE WERE FIVE HUNDRED
AND FIFTY EAST I KIND OF BREAK
THE FUNDING INTO TWO DIFFERENT
THINGS ONE IS.
STAINING THE CURRENT INDUSTRY
AND THE SECOND IS GROWING IN THE
INDUSTRY WHICH IS WHAT YOU.
ALLUDED TO EARLIER BUT AS FAR AS
SUSTAINING THE INDUSTRY WE.
AWARD FUNDS TO PROGRAMS THAT
SUSTAINED FIVE HUNDRED AND FIFTY
SEVEN FIRST YEAR RESIDENTS.
GREET ONE THAT'S HELPFUL I'M.
VERY SUPPORTIVE OF THIS PROGRAM
I THINK IT WOULD BE HELPFUL WHEN
WE GET THROUGH THESE THREE YEARS
TO MAKE A CASE.
FOR CONTINUATION IF DATA COULD
BE COLLECTED THAT DOES SHOW.
LONGITUDINALLY HOW MANY OF THESE
SUPPORTED RESIDENTS
CONTINUE TO WORK AFTER THEIR
RESIDENCY. IN THAT UNDERSERVED
AREA I KNOW AT THE COUNTY
HOSPITAL IN SALINAS AND
ACTIVIDAD THERE'S A HIGH RATE.
OF.
MEDICAL STUDENTS WHO DO THEIR
RESIDENCY THERE WHO CONTINUE TO
PRACTICE
IN THE UNDERSERVED REGION I
THINK THAT WOULD.
BE SUPPORTIVE EVIDENCE FOR HOW
THIS INVESTMENT SERVICE HEALTH
CARE NEEDS BEYOND THE
EXPENDITURE.
SAID IS ONE OF OUR CRITERIA AND
WE TO COLLECT THAT DATA RATE WE
BE MORE THAN HAPPY TO GET THAT
TO YOU AT THE END OF THE. CAN BE
GREAT. THANK YOU VERY MUCH THANK
YOU MISTER CHAIR.
BUT SHE OUT MY HAVE
A FEW QUESTIONS AND NOW FIRST
FOLLOW UP WITH CENTER MINING
CERTAINLY SONG BROWN PROGRAMS
EXTREMELY PORTENT ASSURE WE
HAVE.
PROPIA WORK FORCES WE.
SAID AS A STATE GOAL TO EXPAND
HEALTH CARE COVERAGE OF.
EVENTUAL
THE REACHING OF HEALTH X. NO
ACCESS TO HEALTHCARE FOR ALL
CALIFORNIANS.
STATE WILL BE HEARING MORE ABOUT
THAT LATER.
WHERE THINGS AIDS THE ALSO WANT
TO? AS WE STARTED THIS PROGRAM
I'M A FORMER RESIDENCY PROGRAM
DIRECTOR AND US OF FAMILY
MEDICINE RESIDENCY A PRIVATE
RESIDENCIES USING THREE YEARS
RIGHT.
AND WHEN YOU START.
A RESIDENT YOU DON'T WANT OF LAY
THEM OFF IN THE MIDDLE I MEAN
THAT FACT THAT'S NOT CONSIDERED
ACCEPTABLE BY THE ACCREDITATION
BODY.
SO.
.
ARE YOU IN TERMS OF GETTING
SOBER IN THE FIRST YEAR WERE
PLAYING THE FIRST YEAR MY
CONCERN IS IS WE GET TO THE
SECOND YEAR AND THEN THE THIRD
YEAR.
WHERE?
I PROGRAMS MAY BE RELUCTANT TO
MAKE COMMITMENTS
FOR ADDITIONAL PROGRAMS IF THEY
REALIZE THE ONLY HAVE A YEAR
LEFT AND MEANWHILE. THEY YEAR
THEY HAVE A COMMITMENT TO THAT
RESIDENTS.
FOR THREE YEARS
YOU CAN'T JUST SAY WELL OUR
FUNDING RAN OUT SO I'M LAID OFF.
ALRIGHT AND YOU CAN'T GO TO THE
ACCREDITATION COUNCIL WHICH I
USE TO SIT ON THE BOARD AND SAY
WELL WE'LL HAVE THE RESIDENTS
ONE YEAR AND.
YOU KNOW WE DON'T HAVE A PLAN
FOR THE SECOND THIRD YEAR YOU
ARE EXPECTED TO.
ALLOW THEM CLIP COMPLETED
TRAINING ARE THERE SOME
CONVERSATIONS ABOUT.
THAT THAT ISSUE OUR YOU HEAR
ANYTHING ABOUT THAT PARTICULAR
ISSUE.
ARE CONCERNED FROM RED SEA
PROGRAMS FOR THIS FUNDING STREAM
I APPRECIATE THAT THE GOVERNMENT
MAY TAKE.
YOU KNOW WE COULD NEGOTIATE THAT
FOR THREE YEARS AND.
BUT IN TERMS OF.
MOVING BEYOND THAT I HOPE I
DON'T WANT SOMEONE TO GO LOOK AT
SAID WELL YOU KNOW WHAT TREAT
PROGRAM MADE A GOOD START AND
THEN IT TAPERED OFF THAT MEANS
PEOPLE ARE INTERESTED ANY MORE.
SO I'D.
YES I KNOW IT'S I JUST LIKE TO
KNOW WHETHER WHAT KIND OF
FEEDBACK OR CONVERSATIONS YOU'VE
HAD WITH.
RESIDENCY PROGRAMS HOSPITAL
SPONSORING ORGANIZATIONS
HOSPITALS COMMITTEE HEALTH
CENTERS AROUND THAT PARTICULAR
ISSUE.
HISTORICALLY I DO KNOW THAT THE
RESIDENCY PROGRAMS HAVE BEEN AT
CASH STARVED INDUSTRY.
.
EACH PROGRAM OF COURSE BRAIDS
OWN FUNDING AND PROBABLY HAS YOU
KNOW.
EACH EACH PROGRAM PROBABLY HAS A
UNIQUE SET OF CIRCUMSTANCES.
SOME OF THE THINGS THAT WE DO IN
THE SONG BROWN PROGRAM TO HELP
SUPPORT THE STATE
SUSTAINABILITY.
IS FOR THE POTS OF MONEY SUCH AS
THE EXISTING PRIMARY CARE
RESIDENCY SLOTS.
WE ACTUALLY BREAK THE FUNDING UP
THAT WE AWARD OVER THREE YEARS
SO INSTEAD OF JUST RECEIVING ALL
THE MONEY UP FRONT THE FIRST
YEAR. THEY RECEIVED OVER THE
LIFE OF THE RESIDENTS
SO THAT.
HELPFUL OF THE OTHER THINGS THAT
COULD SO JUST CLARIFY.
AND I APPRECIATE THAT YOU DO
THAT AND I'VE HEARD ABOUT THAT
SO AM IS THE RESIDENTS SO. IT IN
TERMS OF AUTHORIZATION.
OUTPUTS FOR YOU ARE FINANCE.
SO.
THEN YOU'RE THREE OF THIS
FUNDING PROGRAM.
WE KNOW THAT DOBIE GRANTS OR
WHATEVER WE CALL THEM YOU'LL
FUNDING GIVEN NOW BUT THAT
FUNDING IS NOT EXPECTED BE
EXPENDED ALL THAT ONE YEAR IT
WOULD BE.
OVER THAT BECAUSE THE STATE'S
FOR RESIDENCY POSITION IN THE
PROGRAM SAYS I NEED TO HAVE IT
OVER THREE YEARS.
THAT AND I'M NOT SURE EXACTLY
YOUNG YOU DO TO THE POSSIBLE
NEEDS.
SPREAD OVER THREE YEARS ARE
EXACTLY HOW THAT'S HOW THAT'S
ACCUNTED FOR BUT. THAT'S ONLY
GONNA BE A VERY IMPORTANT TO BE
SURE THAT PEOPLE ARE INTERESTED
IN THAT PROGRAM SO I MEANS ON
YOUR THREE.
IT'S FOR THAT YEAR AND TWO MORE
YEARS FOR THAT SAME AMOUNT OF
MONEY BUT IT'S GOING TO BE.
PAID OUT OVER OR JUST HARPER
MANAGE OVER THREE YEARS SO THEY
SURE THAT WE HAVE THE PROGRAM
SO.
IS SO THAT THE WAIVER THE
UNDERSTANDING OF HOW WE'RE GONNA
HANDLE THESE FUNDS.
SO I WOULD NOTE THAT THE
PROVISIONAL LANGUAGE THAT IS
ATTACHED TO IT THE THIRTY THREE
POINT ONE MILLION PASS. IT DOES
HAVE AN EXTENDED.
LIQUIDATION PERIODS SO.
IN TERMS OF HAVING A LONGER
TIMELINE TO TO LIQUIDATE IT IS
INCLUDED IN THE BUDGET.
SO I CAN AND ADD TO THAT WE'VE
ACTUALLY TAKEN THAT INTO
CONSIDERATION AND HAVE AWARE
AWARDING AND. STRUCTURING THE
FUNDING.
.
WE HAVE SIX YEARS TO AWARD THOSE
FUNDS.
WE UNDERSTAND THAT THERE'S BEEN
A THREE YEAR COMMITMENT AND
TYPICALLY IN OUR PROGRAM WE HAVE
RULE OVER FUNDING.
WE'VE GOT.
LAST YEAR DURING THE AWARD CYCLE
THERE WAS A SMALL AMOUNT THAT WE
WILL BE ROLLING OVER.
AND WE WILL BE ABLE TO HAVE A
SMALL AMOUNT OF ROLLOVER FOR A
FOURTH YEAR OF FUNDING.
SHOULD THERE BE NO COMMITMENT
BEYOND THAT THREE YEARS SO IT
WILL BE LESS OF AN IMPACT ON THE
RESIDENCY PROGRAMS.
IF THOSE IF FUNDS WERE TO BECOME
AVAILABLE IN THE FOURTH YEAR.
THE COMMISSION COULD GO AHEAD
AND RECONSIDER THE AWARD
STRUCTURE AND ADJUSTED
ACCORDINGLY.
IT IS A SURE WE HAVE THE
ELEMENTS IN PLACE TO.
TO.
GIVE CONFIDENCE TO THE AWARDEES.
WHO ALSO HAVE TO MAKE THEIR OWN
COMMITMENTS?
AS WELL THAT.
THAT.
THEY'RE GONNA BE SUCCESSFUL AND
THAT AS WELL SO I APPRECIATE
THAT.
THE OTHER QUESTION I ACTUALLY
ALSO HAD IS IS THAT.
I NOTE THAT THE OVERALL AND.
AUTHORIZED POSITIONS. AND AND
SEVENTEEN EIGHTEEN WE ABOUT
THRICE FOUR HUNDRED FORTY SEVEN.
I CERTAINLY UNDERSTAND
SOMETIMES THERE'S VACANCIES AND
SO.
THAT THE REVISED OFFICE
POSITIONS IS FOUR HUNDRED THIRTY
THREE POINT FIVE AND WHAT'S BEEN
BUDGETED FOR TWENTY EIGHTEEN
NINETEEN IS FOUR HUNDRED THIRTY
POINT FIVE.
SO. YOU KNOW DROPPED OF.
PROBABLY APPROXIMATELY.
YOU KNOW SEVENTEEN HOURS
SIXTEEN HAVE POSITIONS.
I JUST.
DODD OF COURSE IN YOUR PRESENT
OVERVIEW PRESENTATION IT SEEMS
LIKE ACTUALLY YOU PRY HAVE MUCH
MORE WORK THAN LESS.
SO I JUST WANT TO CHECK IN AS
FAR AS YOUR STAFFING AND DEL THE
FACT WE'RE JUSTIN DOWNWARD BY
SEVENTEEN OR SIXTEEN AFTER
ASSERTIONS THAT.
.
BUT THOSE POSITIONS I MEAN THEIR
DATES.
BUT IN TERMS OF WORK WORK FLOW
AND DE HAVING SUFFICIENT STAFF.
AT THE RATIONALE FOR THE
REDUCTION.
IN THOSE POSITIONS.
BY IT.
SO A PART OF THIS IS THAT PART
OF A STATEWIDE EFFORT MORE.
ACCURATELY DAD DISPLAY E. NUMBER
POSITIONS THROUGHOUT* THAT
DEPARTMENT SO.
.
YES THAT IS PART OF THAT. DOWN
GOING FOR.
SO.
.
THEN I'M SURE WILL HAVE THIS
CONVERSATION PERHAPS BUT WILL.
BUILD A LITTLE MORE DEEPLY
JUST BECAUSE THE ISSUE AND TRUCK
SO I APPRECIATE THAT YOUR MAKING
THOSE ADJUSTMENTS IN SOME WAYS
THOUGH OF COURSE WHENEVER WE
HAVE PEOPLE COMING UP FOR BC
FEES AND SO FORTH YOU KNOW WE.
THERE'S WORK THAT.
PROPOSED THAT IT THAT ARE NEEDED
FOR THE POSITION.
I WOULD SO BE SURE THAT WHEN
THEY'RE VACANCIES YOU'RE MAKING
GAL THAT ADJUSTMENT THAT THE
WORK THAT WAS TO SPEED DONE BY
THOSE VACANCIES IS THAT BECAUSE
YOU COULDN'T RECRUIT AND WE NEED
TO DO A BETTER JOB RECRUITING
ARE. BETTER SALARIES OR
SOMETHING ELSE THAT WE'RE NOT
COMPETING IN UP TO THE PRIVATE
SECTOR. I DON'T JUST WRITE OFF
POSITIONS THAT ACTUALLY ARE
NECESSARY TO DO WORK.
OUR IS IT THAT YOU KNOW WELL WE
RECOGNIZE IN LOOKING AT THAT WE
USE
BEEN REALLY NEED THAT WAS SO I
XIV VERY CAREFUL ABOUT AND I
APPRECIATE THAT WE ARE TRYING
MORE ACTUALLY FLIGHT TO THE MIX
FROM.
MORE ACCURATE BUDGETING BUT I
ALSO.
ONE YEAH WE WE SIT HERE WE TALK
ABOUT AND WE'RE GONNA TALK ABOUT
THIS YOU TO REACT Y. RECRUIT ONE
PERSON TO PEOPLE CETERA. THAT WE
ARE AT THAT.
POSITIONS ARE VACANT.
.
THAT WE ARE ALSO ENSURING THAT
WE HAVE THE RIGHT CUT HIM THAT
WE'RE COMPETITIVE IN GETTING THE
PEOPLE WE NEED TO DO THE WORK OF
THE PEOPLE CALIFORNIA I'M.
AFTER ALL CALIFORNIA ACTUALLY
HAS WON THE LOWEST RATIOS OF
STATE EMPLOYEES THE TOTAL
POPULATION SO.
THIS IS WHAT WE SURE THAT WERE
BUT THE VACANCIES. TO BE CAREFUL
ABOUT THE VACANCIES AND.
AND BE SURE THAT THOSE
VACANCIES ARE YOU KNOW WE'RE NOT
JUST SAYING WELL BECAUSE THEY'VE
BEEN TAKEN BEAT.
BOATS BIKE. MINE ABOUT SO.
WE WOULD NOTED THAT.
THERE'S NOT ACTUALLY FEWER
PEOPLE THAT THESE POSITIONS WERE
FILLED AND WE ARE ATTEMPTING TO
MAKE IT. A MORE EFFECTIVE AND
EFFICIENT WHEN WE'RE ANALYZING
BCP'S.
AM I HAVING THE ACCURATE LEVELS
OKAY ANY COMMENT FROM THE
DIRECTOR. I'M WERE MANAGING IT
CAREFULLY. AND WE THINK WE HAVE
THE RESOURCES WE NEED I
CERTAINLY APPRECIATE YOUR
CONCERN ANTI ASSURE THE
CONCERNED.
WEREN'T CONTINUAL CONVERSATIONS
WITH FINANCE ABOUT IT
OKAY. WELL WE WANT TO BE SURE
YOU HAVE THE TOOLS THAT YOU NEED
TO DO THE WORK YOU DO BECAUSE
IT'S EXTREMELY IMPORTANT. THAT.
AND SO WELL HOPEFULLY WE WILL
CONTINUE TO HAVE LIKE TO HAVE
ACCURATE BUDGETS ENACTED
STAFFING AND.
BUT.
AND ALSO TO BE SURE THAT.
WE ARE.
BEING COMPETITIVE IN RECRUITING
THE PEOPLE WE NEED.
TO DO THE WORK THAT PEOPLE.
CALIFORNIA.
OKAY.
.
THE OTHER SENIOR.
AND ANNOUNCED.
OKAY WELL I THINK MAYBE WILL DO
IS.
MOVE ON WE HAVE A.
.
TERMS OF THAT WORKFORCE
EDUCATION TRAINING PROGRAM.
WE DO HAVE SOME FOLKS WHO HAVE
A.
QUEST
SO MAY WELL DO SUPPORT.
THE HAVE YOU SHIFT THE SIDE AND
DELTA HAVE GONE OUT SO WE CAN
MAKE SOME ROOM UP FRONT A TABLE.
AND.
TO ME IT'S OKAY LA IF YOU HAVE
YOUR BACK TO ME THAT'S FINE.
SO WE STAKEHOLDER PROPOSAL.
AND SEE.
APPRECIATE IT IF YOU CAN KEEP
YOUR PRESENTATION TO THREE
MINUTES.
YOU HAVE SOME WRITTEN
INFORMATION AS WELL.
CRITICA.
WHAT YOU TO DO IT YOURSELF FOR
THE RECORD FIRST AND THEN NASA
WILL TAKE UP YOUR TIME AND AND I
WILL GO UP AGAIN SO MUCH
INTRODUCED YOURSELF FIRST?
LET'S SEE AN ADVOCACY IT UP WITH
FAMILY SERVICES.
PAUL CURTIS EXECUTIVE DIRECTOR
THE CALIFORNIA COUNCIL OF
COMMUNITY BEHAVIORAL HEALTH
AGENCIES.
ASSEMBLY SLAUGHTERS LOW CHAIR OF
THE MFT CONSORTIUM OF
CALIFORNIA.
AND ARE I WANT TO O AND BEGIN
OUCH KEEP THREE MINUTES TOTAL.
GOOD MORNING NOT CHAIR IN
SENATORS MY NAME'S PAUL CURTIS
EXECUTIVE DIRECTOR CBH A WE ARE
AN ORGANIZATION REPRESENTING
SEVENTY BEHAVIOR HEALTH AGENCIES
ACROSS CALIFORNIA. WE HEAR TO
REQUEST THAT YOU CONSIDER
SUPPORTING OUR FUNDING REQUEST
TO EXTEND THE WORK FORCE AND
EDUCATION FOR THE TRAINING
PROGRAM KNOWN AS WELL. INITIATED
UNDER PROP SIXTY THREE FOR AN
ADDITIONAL YEAR THIS PROGRAM WAS
SLATED TO BE FUNDING FOR TEN
YEARS BUT IT'S ONLY BEEN FUNDED
FOR NINE YEARS. DUE TO A CHANGE
IN OVERSIGHT OF THE PROGRAM
AFTER ITS FIRST FIVE YEARS IT IS
CRITICAL THAT WE PUT THE STOP
GAP FUNDING IN PLACE TO ENSURE
LOAN FORGIVENESS AND EDUCATIONAL
STIPEND PROGRAMS. CONTINUE TO BE
FUNDED.
A CONTINUING FUNDING TO ALLOW
FOR CONTINUITY OF CARE FOR YOUR
CONSTITUENTS WHO WE PROVIDE MUCH
NEEDED BEHAVIORAL HEALTH
SERVICES TO. IT IS IMPORTANT
NOTE THAT THIS FUNDING REQUEST
IS FOR ONE YEAR. DURING THIS
YEAR WE ARE COMMITTED TO WORKING
WITH US TED AND THE REST OF THE
PAPER HEALTH COMMUNITY TO CREATE
A LONG TERM PLAN A NEW PLAN. FOR
CONTINUING THIS PROGRAM WITH ME
TODAY ARE TWO WITNESSES WHO CAN
SPEAK THE IMPACT OF. THESE
PROGRAMS AND THE STUFF THAT THEY
REPRESENT NOT GIVE THEM THE REST
OF MY TIME.
AGAIN GOOD MORNING ABOUT THAT US
A SENIOR DIRECTOR OF POLICY AND
ADVOCACY AND APPLY FAMILY
SERVICES WHEN AGENCY PROVIDING
BEHAVIOR HEALTH AND CHILD
WELFARE SERVICES. TO
APPROXIMATELY THIRTY THOUSAND
CHILDREN AND FAMILIES ACROSS THE
STATE.
OUR AGENCY RELIES ON WEBSITE AND
FUNDS TO HIRE AND TRAIN GRADUATE
INTERNS WHO BECOME SKILLFUL AT
PROVIDING INNOVATIVE AND
EFFECTIVE. EVIDENCE BASED
PROGRAMS FOR CHILDREN AND
FAMILIES EXPERIENCE MENTAL OR
BEHAVIOR HEALTH CHALLENGES.
MOST IN TERMS BECOME.
EMPLOYEES AND CONTINUE TO
pPROVEN NOW COMES TO THOSE WE
SERVE.
WE ARE EXTREMELY CONCERNED THAT
WITHOUT CONTINUATION OF THE WHAT
PROGRAM THE MENTAL HEALTH
WORKFORCE SHORTAGE WILL PERSIST
OR WORSE GROW EXPONENTIALLY OVER
THE NEXT FEW YEARS IMPACTING
SERVICES TO THOSE IN NEED OF.
CRITICAL MENTAL HEALTH SERVICES
ESPECIALLY VULNERABLE CHILDREN
AND YOUTH WHO HAVE EXPERIENCED
TRAUMA IN THEIR LIFE. ALLOWING
THIS FUNDING TO EXPIRE WOULD
CAUSE IRREPARABLE HARM TO A
PROGRAM THAT IS A VALUABLE
RESOURCES FOR PROVIDERS ACROSS
THE STATE. AND THE CLIENTS WE
SERVE I RESPECTFULLY ASK THAT
YOU SUPPORT THIS REQUEST.
YES GOOD MORNING. VIETNAM OF TO
CONSORTIUM OF CALIFORNIA
CONSISTS OF NINETY TWO. PUBLIC
PRIVATE AND NONPROFIT GRADUATE
SCHOOLS.
THAT UP PROVIDE DEGREES TO TO
MARRIAGE AND FAMILY THERAPIST.
THE CONSORTIUM HAS ADMINISTERED
THE EDUCATIONAL STIPENDS FUNDED
THROUGH THE METAL SERVICES ACT.
THAT PROVIDE INCENTIVES TO TWO
MAJOR FAMILY THERAPY STUDENTS.
TO PURSUE A CAREER IN PUBLIC
MENTAL HEALTH.
THE SCHOOLS OF THE CONSORTIUM
HAVE AWARDED THE STIPENDS.
TO ADMIT TO SCHOOLS DEVOTEE
STUDENTS WHO ARE TRAINED. AND
COMMITTED TO PUBLIC MENTAL
HEALTH CARE.
AS OF TODAY SEVEN HUNDRED NINETY
SIX BE ZERO HEALTH AGENCIES IN
FORTY COUNTIES.
HAD EMPLOYED THE USE OF STEP
RECIPIENTS UPON GRADUATING.
MOST ARE EMPLOYED AND THE HARD
TO HIRE RULE IN URBAN.
I COMMUNITIES WHERE THEY RECITE.
IN FACT SEVENTY FIVE SEVENTY
FOUR PERCENT OF OF THESE
RECIPIENTS PROVIDE CARE. IN A
SECOND LANGUAGE.
AND EIGHTY FOUR PERCENT REMAIN
IN PUBLIC MENTAL HEALTH SYSTEM.
ON BEHALF OF THE PROVIDERS AND
THE COMMUNITIES THAT HAVE
BENEFITTED BY THIS SO WHAT
PROGRAM. I WANT TO THANK DESERVE
SUBCOMMITTEE FOR FAVORABLE
CONSIDERATION.
TO CONTINUE FUNDING THE WHAT
PROGRAMS FOR ANOTHER YEAR THANK
YOU.
THANK YOU THANKS MUCH PER
PRESENTATION.
ANY COMMENTS FROM OCCUPIED.
TO THIS REQUEST.
I WOULD JUST SAY WE DON'T HAVE A
POSITION ON THE ON THE FUNDING
AT THIS POINT AND WE DO HAVE THE
INFRASTRUCTURE IN PLACE IF THE
DECISION IS TO MOVE FORWARD ON
IT OFFICIALLY HERE. OKAY.
LA JOH INCUMBENTS DON'T FINANCE.
JUST NOT THE DISPOSAL IS NOT
INCLUDED IN THE GOVERNOR'S
BUDGET.
OKAY I I DO KNOW THAT. ANY OTHER
COMMENTS ON IT.
NO. OUT ALRIGHT WELL.
SO THAT THE PRESENTERS SADDAM
DEL MADE NOTE THAT.
THIS WAS ORIGINALLY A TEN YEAR.
.
THAT GIVEN SOME I GUESS AWAY
QUOTE THEM. GETTING THINGS GOING
WE'RE SHORT ONE YEAR.
DE DEBTS TO CLARIFY I MEAN WHAT
KIND OF COMMITMENTS
WERE ITSELF WE DON'T DO THIS ARE
WE LEAVING PEOPLE HANGING THAT
WORK MINUTES THAT WERE MADE
BECAUSE THE EXPECTATIONS FIVE
YEARS. ADS FOR CLARIFY THAT
ISSUE.
UP FINANCED IT REQUEST.
OKAY I THINK CLEARLY THERE'S A
NEED IT'S THAT THE DIFFICULTY IS
THE FUNDING SOURCES GOING AWAY
IN ELLIS'S A SPECIAL FUND UP
PROP SIXTY THREE MONEY.
ANDA.
SO YOU KNOW IT'S IT DIFFICULT
DIFFICULT SITUATION.
AND IT'LL BE UP TO.
THE LEGISLATURE THE GOVERNOR TO
DECIDE ON PRIORITIES TERMS OF.
WHAT GETS FUNDED DEBT GOING
FORWARD?
SO I GUESS MY QUESTION IS THIS
IS THAT SO WE HAVE FOLKS WHO ARE
CURRENTLY GETTING STIPENDS AND
OTHER TYPES OF THINGS.
THE ARE ARE WE IN THE NEWS I
MEAN I DO WE HAVE PEOPLE WHO
SUPPOSEDLY WERE COMMITTED TO FOR
ANOTHER YEAR THAT SELF THE
FUNDING SOME THE FALLS OFF.
I MEAN WE HAVE PEOPLE WHO ARE
EXPECTING THE FUNDING FOR ONE
MORE YEAR BECAUSE IS ORIGINALLY
A TEN YEAR PLAN THAT NOW FALL
OFF OR.
EVELYN SAID LIKE WHAT WE'D LIKE
TO HAVE ANOTHER YEAR BUT. WE'VE
NEVER MADE A COMMITMENTS PASSED.
NOT THIS YEAR WE'VE MADE NO
COMMITMENTS PASSED THIS YEAR.
SOME OF THE CONTRACTS WILL GO ON
BEYOND THIS YEAR BUT AS FAR AS
THE FUNDING.
IT ENDS AT ALL ARE AND
COMMITMENTS END.
JUNE THIRTIETH.
SO THERE'S NO FUNDING
COMMITMENTS BEYOND.
CRACKED RIGHT.
WHY DO OF SMUGGLING BITES ONCE
IT'S COMMITTEE MEMBER QUESTION?
OKAY UP THEN AND HOW MANY AND I
DON'T LIKE THAT NO I MISSED IT
WHEN YOU SEE MATCHING YOUR
TESTIMONY SO. RESEMBLE THE
STIPEND SIXTEEN POINT TWO
MILLION HOW MANY POSITIONS ARE
BEING FUNDED WITH THE STIPENDS.
DOESN'T KNOW WHAT THEY'RE
SEVERAL STIPEND SO SEVERAL ON MY
TOP PROFESSIONALS THAT RECEIVE
STIPENDS. WE REPRESENT PRIMARILY
THE MARRIAGE AND FAMILY THERAPY
PROGRESS BUT THEY WILL KNOW HOW
MANY WERE BEING SUPPORTED WITH
THOSE STATEMENTS.
THESE PROGRAMS ARE STILL ONGOING
AND WE ARE STILL AWAITING FUNDS
THROUGH JUNE THIRTIETH SO WE'RE
NOT QUITE SURE HOW MANY STIPENDS
BUT TO DATE.
I AM NINE HUNDRED AND FIFTY
STIPENDS OF UP TO TWENTY ONE
THOUSAND DOLLARS.
WENT TO MENTAL HEALTH
PROFESSIONS IN EXCHANGE FOR
WORKING IN THE PUBLIC MENTAL
HEALTH.
PAST SYSTEM FOR TWELVE MONTHS.
AND BE LOAN ASSUMPTION PROGRAM
WHICH IS ALSO A VERY POPULAR
PROGRAM. AND THOSE FUNDS
SUPPORTED. MORE THAN EIGHT
THOUSAND HAVE MENTAL HEALTH
PROFESSIONALS BY PROVIDING A TEN
THOUSAND DOLLAR.
A LOAN REPAYMENT EXCHANGE FOR
WORKING TWELVE MONTHS IN THE
PUBLIC MENTAL HEALTH.
BUT IT SOUNDS LIKE A LOT OF
PEOPLE.
OKAY. ALRIGHT.
OKAY.
.
QUESTIONS
SO WHILE WE GO AHEAD AND TAKE
PUBLIC COMMENT ON BOTH THE
OVERVIEW AND THIS ALSO
SPECIFICALLY ON THE WHAT PROGRAM
PROPOSAL.
SO WELCOME. INTRODUCE YOURSELF
AND.
AND THEN.
BUT YOU THE MORNING SENATORS MY
NAME IS JANE ADCOCK I'M THE
EXECUTIVE OFFICER FOR THE
CALIFORNIA BEHAVIORAL HEALTH
PLANNING COUNCIL WE HAVE A ROLE
TO PLAY MY COMMENTS ARE
SPECIFICALLY TO THE REQUEST. FOR
THE WAY ADDITIONAL WET FUNDING
FOR THE FINAL YEAR. THE
COUNCIL'S SUPPORTS THIS REQUEST
AND HOPES THAT THE SENATOR'S
SUPPORT THIS REQUEST AS WELL.
WELCOME MICHELLE CAPITA WITH A
CA YOU CALIFORNIA IN LIGHT OF
ALL THE MEANS AND ATTENTION TO.
BEHAVIORAL HEALTH ISSUES THAT
FACE BY THE LEGISLATURE IN
CALIFORNIA.
WE ARE HAPPY TO SUPPORT THE
PROPOSAL FOR ADDITIONAL WEB
FUNDING FOR ONE YEAR THANK YOU.
THANK YOU ANY OTHER QUESTIONS.
SO I GUESS THE OTHER QUESTION I
HAVE IS OKAY YOU'RE ASKING FOR
ONE YEAR.
.
YOU I YEAR TO A DO YOU HAVE SOME
THOUGHTS OR PLANS OR IDEAS ABOUT
WHAT WILL HAPPEN THE FOLLOWING
YEAR ASIDE FROM ANOTHER REQUEST
FOR ANOTHER YEAR I MEAN I GUESS
I WOULD BUY IT YOU'RE
REQUESTING.
SUCH A FOR A ONE YEAR.
TIME PERIOD TO KIND OF SPEND
THAT SORT OF REPRESENTS THE LAST
YEAR OF THEIR ORIGINAL YOU KNOW
IMUS CALL COMMITMENT ARE DEAD
ANTICIPATED PLAN WHEN WE STARTED
PROP SIX
THREE.
AT THE.
WHAT DO YOU PERHAPS TALK A
LITTLE BIT ABOUT WHAT YOU EXPECT
TO GOT BILL ACCOMPLISHED IN THE
YEAR TO TRY TO DEVELOP TO THAT
FIVE FUNDING STREAM?
OF.
FIRST WE BELIEVE OF BOTH OF
THESE PLANTS WERE DEVELOPED
SOMETIME AGO THERE NEEDS TO BE A
NEW FIVE YEAR PLAN. BASED ON
CURRENT DATA AND THE CHALLENGES
THAT WE FACE FOR US WITH THE
BEACH A ONE OF THE CRITICAL
ELEMENTS WE BELIEVE WE NEED. AS
A CAREER PATHWAY FROM HIGH
SCHOOL THROUGH THE COMMUNITY
COLLEGES
THE UNIVERSITY.
FOR BEHAVIORAL HEALTH CARE
THERE'S CRITICAL SHORTAGES THAT
ARE DOCUMENTED AT THE LICENSED
PROFESSIONAL CATEGORIES A
PSYCHOLOGIST PSYCHIATRIST AB OF
TEAS BUT THERE'S FOR OUR MEMBERS
THERE'S. THEY CAN HIRE PEOPLE
AND ALL THE LEVELS CLERICAL
LEVELS AND AND EVERYWHERE ELSE
THE UNFUNDED POSITIONS GOING
OPEN ALL THE TIME. THERE'S WORK
THERE WAITING FOR PEOPLE IN HIGH
SCHOOL THE NEVERS AS A AS UP A
REAL GOOD CAREER PATHWAY BUT WE
HAVE TO DEVELOP THAT PATH WE
DON'T HAVE THE RIGHT NOW.
COLLECT BUT THE NURSES DID ABOUT
FIFTEEN TO TWENTY YEARS AGO AND
AND REALLY LOOKING AT ALL THE
SHORTAGES AT ALL THE LEVELS. YOU
KNOW WE'D LIKE TO BE ABLE TO
WORK WITH US PET BUT ALSO WITH
THE REST TO BE ABLE HEALTH
COMMUNITY TO DEVELOP A NEW PLAN.
THAT ADDRESSES THE CRITICAL
ISSUES WE FACE NOW WORK FIRST
DEVELOPMENT IS THE MOST CRITICAL
ISSUE FOR OUR MEMBERS THAT
CANNOT FILL THE POSITIONS ACROSS
THE BOARD. AND THAT GOES TO A
SHORTAGE OF TREATING THE PEOPLE
FACING MENTAL HEALTH AND
SUBSTANCE USE DISORDER ISSUES
AND SERVICE IN THE AND THE
SERVICES THAT THEY NEED.
AND I UNDERSTAND THAT ACTUALLY
IN TERMS OF THE FUNDING REQUESTS
DOVE. WE'RE NOT LOOKING FOR
FUNDING FOR THE NEXT FIVE YEAR
PLAN AS TO HOW I DO. IT AND IS
THAT SOMETHING THAT YOU'LL BE
DOING WITH OSSIFIED ARE.
.
S. FIVE YEAR PLAN GOING TO BE
PUT TOGETHER.
AND HOW THAT CAN BE SUPPORTED.
AND.
IN STATUTE.
HOSPITALS REQUIRED TO DEVELOP.
A FIVE YEAR PLAN EVERY FIVE
YEARS OF THE NEXT ONE IS DOING
TWENTY NINETEEN. I AM RIGHT NOW
WE HAVE SEVERAL INTERNAL
INITIATIVES WHICH WERE FUNDED
THROUGH THE EXISTING FIVE YEAR
PLAN.
WHICH INCLUDED AT PROJECTIONS
OF DEMAND THROUGHOUT THE STATE.
WE HAVE A CONTRACT WHERE WE'RE
GOING TO BE GATHERING
STAKEHOLDER INPUT ON WHAT THE
NEEDS ARE THROUGHOUT THE STATE.
AND WE HAVE A CONTRACTOR ON
BOARD TO EVALUATE OUR CURRENT
PROGRAMS.
THAT'S ALREADY COULD BE
SUPPORTED. MAY ACTUALLY ALRIGHT
AND.
THAT IT IN TERMS OF BOTH THOSE
AT HOME BOTH PARTIES TO
QUESTIONS HERE SO. THE PRIOR
FIVE YEAR PLAN ADDRESSED THE
FUNDING ISSUE I MEAN OUT OF
PEOPLE DISSIPATED THAT IT WILL
BE SURE. THAT THAT THE MONEY WAS
GONNA RUN OUT FOR YEARS AND THAT
IN TERMS OF THE FUTURE FIVE YEAR
PLAN THAT YOU'RE OBLIGATED TO DO
UNDER STATUTE.
AS ACTED ALSO DRESSED FUNDING
FUNDING SOURCES.
AS WELL FOR. ADDRESSING THE
WORKFORCE.
SO I WOULD NOTE THAT IN THE
ORIGINAL.
TWENTY FOURTEEN TO TWENTY
NINETEEN PLAN THE BUDGET ALWAYS
BEEN A DISPLAY THAT LASTING
UNTIL THE END OF TWENTY
SEVENTEEN. I EIGHTEEN. AND THAT
TIME AT THIS TIME WE DO NOT KNOW
IF THE NEXT PLAN WILL INCLUDE
PAN.
D. THAT SPECIFIC FUNDING
BUDGETED AND I WOULD ALSO NOTE
THAT A PLAN.
DOESN'T NECESSARILY INCLUDE.
SPECIFIC FUNDING FOR PROGRAMS
THERE'S ALSO ADDITIONAL
ACTIVITIES IN A PLAN SUCH AS
CREATING AT A STRATEGIC
FRAMEWORK FOR THE FOR THE STATE
BUT NOT NECESSARILY. A SPECIFIC
OUT OF FUNDING. BOTTOM.
THANK YOU.
I CERTAINLY UNDERSTAND PLAN
DOESN'T HAVE TO INCLUDE FOR NEXT
FIVE YEAR PLAN BUT
WITHOUT. ANY.
WOULDN'T DO PLEDGES DO ATTEND TO
IT DICE TRY TO ADDRESS THAT SOME
OF THE AT LEAST SOME OF THE
FUNDING ISSUES THAT THAT WOULD
BE NECESSARY TO IMPLEMENT.
WHATEVER PLAN YOU COME UP WITH
THE FOLLOWING FIVE YEARS.
AB RECEIVE FINANCE I I JUST
DON'T KNOW THAT WERE IN A
POSITION RIGHT NOW TO COMMIT
FUTURE GOVERNORS AND
LEGISLATURES TO THE I MEAN YOU
KNOW.
USING THIS FUNDS SOURCE I'M IN A
WAYS THAT BUT ARE NOT IN VISION
RIGHT NOW THOUGH I AM BOATS OF
THIS WHY I'M NOT ASKING THAT WE
MAKE A COMMITMENT TODAY I'M JUST
ASKING THAT IN THE DEVELOPMENT
OF A PLAN.
WELL AS POINTED OUT IT'S NOT
NECESSARY TO DRESS FUNDING.
IF YOU REALLY WANT TO IMPLEMENT
A PLAN YOU NEED TO IDENTIFY
RESOURCES SO. I ASSUME THAT
SOMETHING THAT WOULD BE DONE BY
OUR SPOT AND STAKEHOLDER SILLY
THAT'S BEING DONE LATEST RATIONS
SO I'M NOT AND ON THAT PRE
DECLARING THE PLAN RIGHT UP
HERE.
ARE SAYING THAT WE SHOULD BE
PUTTING INTO THE BUDGET EXACTLY
THE FOR
A SOURCE FOR THE NEXT FIVE YEAR
PLAN WHICH HASN'T EVEN BEEN PUT
TOGETHER YET I'M
IT'S ASKING WHETHER THE
INTENTION IS OF. THE.
I'VE FOUGHT AND THE
ADMINISTRATION AND THE
STAKEHOLDERS TO ACTUALLY TRY TO
DRESS FUNDING ISSUES WHEREVER
THE FUNDING MAY COME FROM A NOT
NECESSARY BE FROM THE STATE IN
THE. NEXT FIVE YEAR PLAN THAT
THEY'RE OBLIGATED PERFORMED BY
STATUTE. I I GUESS I WOULD AND I
WOULD URGE THAT THEY DO BUT
ABSENCE ASKING WHETHER THEY PLAN
TO.
YEAH I THINK THAT.
WE JUST HAVEN'T.
WE HAVE GOTTEN THERE YET SO WE
DON'T WE DON'T KNOW IF IT WILL
INCLUDE A FUNDING PLAN AT THIS
POINT.
AND WELL I I WOULD I WOULD I
WOULD SUGGEST THAT FOR PLAN TO
TO TO TO.
TO HAVE.
THREE IMPLEMENTABLE THAT AT
LEAST SOME IDENTIFICATION EFFORT
TO ADDRESS RESOURCES AND
DEDICATE RESOURCES AND THEY MAY
NOT ENOUGH MAY NOT NECESSARILY
BE FROM THE STATE AND MAYBE.
BUT IT'S
ONE THING TO SAY WE NEED X. Y.
AND Z. AND THEN SAY WELL IT'S
EVERYONE ELSE'S PROM THE FIGURE
OUT HOW WE GET THERE. AND.
I HOPE THAT.
IN IN DEVELOPMENT THE NEXT FIVE
YEAR PLAN AS WELL.
TO TRY JUSTICE RESOURCE ISSUES
AND THAT'S ALSO WHY AFTER THE
LAST FIVE YEAR PLAN ALSO ADDRESS
RESOURCE ISSUES AS WELL BECAUSE
I THINK WE. DON'T WANT PLANNED
THEY SHOULD SIT ON SEATS SHELVES
WE WANT PLANS THAT CAN BE
IMPLEMENTED SO AS WELL.
I GUESS WE'LL LEAVE IT AT THAT.
THING MILLER QUESTIONS
ALRIGHT.
OKAY WELL WE WILL HOLD THIS
ITEM OPEN AND TERMS OF THAT
STAKEHOLDER PROPOSAL.
SO I APPRECIATE YOUR
PRESENTATION THANK YOU VERY MUCH
THANK YOU. OKAY SO LET'S GO
AHEAD AND MOVE ON TO.
ISSUE ITEM NUMBER
TO.
WHICH IS A.
RELATED TO IMPLEMENTATION OF S.
B. SEVENTEEN.
THANK YOU THANK YOU SCOTT
CHRISTMAS ADOPTED WRITER OFTEN.
AS THOSE DIRECTOR DAVID
OUTLINED.
THAT WERE WERE NOW ANDASIAN
IMPLEMENTING SP SEVENTEEN
PROVISIONS OF OF OF THE NEW LAW.
THE PROPOSAL SPECIFICALLY FOR
THREE POSITIONS IN FISCAL YEAR
EIGHTEEN NINETEEN.
REALLY INTENDED TO TO WORK ON
REGULATIONS SYSTEMS AND
PROCESSES FOR THE COLLECTION.
MANAGEMENT MOSTLY PUBLICATION
OF A COST INCREASE.
DATA FOR PRESCRIPTION DRUG.
RIGHT ANY COMMENTS THAT
FAMILIAR.
NOPE FINANCE.
IT IS NOT THAT THAT WE YOU
SUPPORT AT THIS BUDGETARY
PROPOSAL. IN AS A THAT
ACCOMPLISHES THE GOALS OF THE
LEGISLATION.
OKAY THANK YOU QUESTIONS FROM
COMMITTEE MEMBERS.
COUPLE QUESTIONS.
IN TERMS OF FIVE PRESHEAF THE
TIMELINE.
.
THEY JUST SAID. IF YOU COMPLETED
THE PUBLIC WORKSHOP THE DATA
USERS AGAINST THAT WOULD HAVE
BEEN. A FEW DAYS AGO OF LAST
WEEK CORRECT AND HOW THAT GO. BY
IT WENT DOING VERY WELL SO WE
HAD A GOOD DISCUSSION AROUND
DEFINITIONS THAT WILL BE.
AND THE REGULATIONS PACKAGE AS
WELL AS.
DATA ELEMENTS TO BE INCLUDED IN
A.
AROUND COST INCREASES AND IT
WILL ALSO WORK TO SOME. USE
CASES HOW HOW MY TUESDAY TO BE
USED IN ANALYSIS AND AND
INFORMING THAT PERSON DECISIONS.
OKAY AND THE OTHER QUESTION I
HAD IS IS THAT.
SO IN TERMS OF NOTIFICATION I
UNDERSTAND YOUR YOU PUT TOGETHER
A SERVER DATABASE OF PURCHASERS.
I MEAN IS THAT.
THIS BUT SO DO.
IN TERMS OF PEOPLE WHO WANT
NOTIFICATION IS THERE SOME SIR
REVIEWS TO BE SURE THAT THE
PURCHASERS PURDAH LA. THE JUST
OPEN ENDED TIME WHAT KIND OF
PROCESSES I SPIED USING IN TERMS
OF. NOT BEING SURE THAT THE
INFORMATION IS GOING TO
APPROPRIATE PEOPLE AND.
.
SO YEAH.
IF THEY THINK THEM SO YEAH AT
THIS TIME WE WE BASICALLY.
YOU SET UP UP A BASIC ONLINE
REGISTRY.
OUTLINED AS BASELESS SELF CERT
IN PROCESS
LANGUAGE APPROPRIATE TO
SO.
BEFORE CATEGORIES OUTLINED.
IN IN THE LAW ARE SORT OF.
DE PROVIDED THERE AND AND MEDIA.
THE REGISTRANT IS ASKED TO
VOICE WAS LIKE ONE OF THOSE
STATE PURCHASER.
HEALTH SERVICE PLAN HEALTH
INSURER OR OF A PHARMACY BENEFIT
MANAGER.
SO THEIR SELF IDENTIFY IS THERE
ANY FORM OF VERIFICATION OF ANY
SORTS.
HOURS EACH ASSEMBLY ITSELF
EDUCATION AND YOUR IN THE
DATABASE.
YEAH I'M THE REQUIRED FIELDS
INCLUDE A YOU KNOW COMPANY AND
AND CONTACT SO YOU KNOW BY
COMPANY NAME WE DO THAT AND THEN
ACTUALLY WE'RE WE'RE KIND OF
MOVING NOW TO DO A LITTLE BIT
MORE CURATION.
YOU KNOW WITHOUT BEING.
HEAVY HANDED.
IN TERMS OF OF YOU KNOW
VALIDATING THAT THOSE COMPANIES
ARE ACTUALLY ONE OF THOSE
CATEGORIES A PURCHASER.
OKAY NOTE THAT WE DO CERTAINLY
DON'T WANT TO GO SCOURGE PEOPLE
WHO WHO ARE LEGITIMATELY NEED
THAT INFORMATION THAT I MAKE IT
TOO ONEROUS BUT I THINK.
I THINK THERE IS OF BOYS WERE
ABOUT THE SECURITY AND OTHER
TYPES OF THINGS AND SO JUST BE
SURE THAT.
.
WE WE KNOW WHO'S GETTING WHAT
CELL.
OKAY EXCELLENT. ALRIGHT.
.
OF TAKE PUBLIC COMMENT.
WELCOME.
MISTER CHAIR MEMBERS SARAH
FLOCKS IN THE CALIFORNIA LABOR
FEDERATION WE ARE ONE OF THE CO
SPONSORS OF S. B. SEVENTEEN AND
WE ARE HERE IN VERY STRONG
SUPPORT OF THE BCP FOR US PETTIT
TO IMPLEMENT THAT SPELL. AND
THIS WAS A GROUNDBREAKING
BREAKING PIECE OF LEGISLATION TO
BRING TRANSPARENCY TO
PRESCRIPTION DRUG PRICES WE KNEW
WOULD BE A NEW ISSUE AREA FOR I
SPED. AND THEY HAVE GONE ABOVE
AND BEYOND IN THEIR
IMPLEMENTATION OF THE BILL AND
YOU CAN SEE ON PAGE SIXTEEN THAT
THEY HAVE A VERY EXTENSIVE
TIMELINE. WE'VE BEEN INVOLVED
SINCE NOVEMBER.
IT IS BEEN VERY THOROUGH VERY
RIGOROUS WE'VE BEEN BEEN
IMPRESSED SO FAR AND LOOK
FORWARD TO SEEING. MORE OF THE
PRODUCT IN WORKING FOR THEM.
SINCE I HAVE TO LEAVE I ALSO DO
A PLUG FOR DEBATE SEIZE
INCREDIBLE WORK AND I AM ALSO
HERE IN SUPPORT OF THEIR BCP FOR
S. B. SEVENTEEN THANK YOU.
THANK YOU.
WELCOME TO MORNING MISTER
CHAIRMAN MEMBERS MARY ABOUT IS
WITH HEALTHAXIS CALIFORNIA WHERE
THE SATE WHAT HEALTH CONSUMER
ADVOCACY COALITION ADVOCATING
FOR AFFORDABLE QUALITY
HEALTHCARE FOR ALL A WE ALSO
WANT TO ECHO.
THE COMMENTS FROM OUR CO
SPONSORS AT THE CALIBER OF FAT
CAT AND HEALTH ACCESS WITH A
PROUD CO SPONSOR OF THE MEASURE
ONE I THINK I WAS PAID FOR ALL
OF THE WORK TO IMPLEMENT THE
BILL WE ARE ALSO. VERY HAPPY
WITH THE PROGRESS AND.
LOOK FORWARD TO CONTINUE
WORKING WITH YOU.
I THINK YOU'RE WELCOME.
I GOTTA TELL ON BEHALF OF TO THE
OTHER CO SPONSORS OF THIS
HISTORIC MEASURE TEAMSTERS AND
UNITE HERE TECAU THE OTHER
COMMENTS AND ALSO ON BEHALF OF
SEA PEN WITH SUPPORTERS OF THE
MEASURE THANK YOU.
THANK YOU WELCOME. LINDA AWAY
WITH WESTERN CENTER ON LAW AND
POVERTY WE SUPPORTED THE
LEGISLATION IN SUPPORT THE PCV.
MICHELLE CAPITA WITH SEIU
CALIFORNIA AND WE WOULD LIKE TO
ALIGN OURSELVES WITH THE AYE THE
COMMENTS OF THE CO SPONSORS OF
S. B. SEVENTEEN WHICH WE ALSO
SUPPORTED. AND SUPPORT THE BCP
THANK YOU.
ALRIGHT THANK YOU KNOW THE
QUESTIONS REMEMBERS NOT.
OKAY WELL I THINK WE WILL LEAVE.
THAT ITEM ON HOLD BUT OTHERS
PAY LESS OBVIOUS AGENCY
OBVIOUSLY BUT.
CERTAINLY.
WANT TO
SURE THE.
THE THE PARK OCCUPIED HAS THE
RESOURCES THEY NEED TO IMPLEMENT
THIS VERY IMPORTANT BILL AND
JUST BEFORE YOU GO WHAT.
THINK US BUT FOR ALL THE HARD
WORK YOU DO YOU ARE TO THE
AGENCY DENTURES WE HAVE THE CAT
INFRASTRUCTURE WE NEED TO THAT
TRY TO LIVE OUR PROMISES OTHERS
ARE HOSPITALS ARE WORKFORCE.
MANY OTHER THINGS AND I NOW
PRESCRIPTION DRUG PLAN
TRANSPARENCY SO I APPRECIATE THE
WORK THAT YOU DO AND THANKS SO
MUCH FOR BEING HERE. AND YOU.
I THANK YOU. ALL RIGHT.
SO NEXT UP IS SAID THE FARMING
MANAGE HEALTH.
HERE ACTUALLY YES
PERMITS HEALTH CARE VIBO WELCOME
.
SO I JUST BEFORE WE START LET'S
DO THE ROUND ROBIN INTRODUCTIONS
FOR THE RECORD.
GOOD MORNING.
GOOD MORNING MARTA GREEN CHIEF
DEPUTY DIRECTOR DEPARTMENT
MANAGED HEALTH CARE.
JENNY PHILLIPS DEPARTMENT
MANAGED HEALTHCARE DEPUTY
DIRECTOR FOR LEGISLATIVE
AFFAIRS.
RAMBLES ELIO.
ORANGE ON DEPARTMENT OF FINANCE.
ADAM TO RECEIVE FINANCE IF YOU
ARE.
WE BEGIN WITH THE.
OVERVIEW AND.
CAN TAKE THE HIGHLIGHTS SO IF
YOU.
THANK YOU OTHER MISSION OF THE
DEPARTMENT MANAGED HEALTH CARE
IS TO PROTECT CONSUMERS HEALTH
CARE RIGHTS AND ENSURE A STABLE
HEALTH CARE DELIVERY SYSTEM. WE
DO THAT THROUGH LICENSING AND
REGULATING APPROXIMATELY ONE
HUNDRED AND TWENTY FOUR HEALTH
PLANS THAT PROVIDE COVERAGE TO
MORE THAN TWENTY SIX MILLION
QUE.
WE REGULATE APPROXIMATELY NINETY
PERCENT OF THE COMMERCIAL
COVERAGE MARKET. ARE PROPOSED AT
TWO THOUSAND EIGHTEEN TWO
THOUSAND NINETEEN BUDGET AS
SEVENTY NINE POINT TWO MILLION
DOLLARS AND DECREASE OF
APPROXIMATELY ONE MILLION OR ONE
POINT TWO PERCENT FROM THE
CURRENT YEAR SPENDING AUTHORITY.
AND WE HAVE FOUR HUNDRED AND
FIFTY ONE AUTHORIZED POSITIONS
WE ARE SPECIALLY FUNDED BY
ANNUAL ASSESSMENTS ON HEALTH
PLANS WITH NO GENERAL FUNDS I
CAN GIVE MORE DETAIL BUT ALL
POTS THERE IF YOU WOULD LIKE.
WHAT DID BUT YOU WANTED COVER
SOME OF THE PROGRAM AREAS ARE
JUST KINDA KEEP IT AT THAT HIGH
LEVEL?
?
OKAY WHAT I THINK WE CAN. THEIR.
ALRIGHT WELL WE KEEP ONE GUY AND
KEEP IT THE HIGH LEVEL AND WHAT
WILL DRILL DOWN SOME QUESTIONS.
THANK YOU OKAY.
SO THE RESEARCH A NUMBER OF
QUESTIONS OUTLINED IN THE
AGENDA.
FOR THE OVERVIEW SECTION
SOLDIERS KIND OF JUMP INTO THOSE
THE FIRST RELATED TO THE TIMELY
ACCESS REPORT AND A SUMMER.
ENDINGS.
AND SO AS A RESULT OF
SIGNIFICANT EFFORTS UNDERTAKEN
BY BOTH THE DEPARTMENT AS WELL
AS THE HEALTH PLANS THAT WE
REGULATE TIMELY ACCESS STATIST
SUBMITTED IN TWENTY SEVENTEEN
FOR CALENDAR YEAR TWENTY
SIXTEEN.
CONTAINED FAR FEWER ERRORS IN
THE TWENTY FIFTEEN DATA SO THE
DAMAGE HE WAS ABLE TO CREATE
SOME CHARTS COMPARE POINT
AVAILABILITY TIMES ACROSS HEALTH
PLANS. AND BEHAVIORAL HEALTH
PLANS FOR THE CALENDAR YEAR OF
TWENTY SIXTEEN. SO ACROSS ALL
APPOINTMENT TYPES THE PERCENTAGE
OF AVAILABLE APPOINTMENTS
AVAILABLE WITHIN THE WAY TIME
STANDARDS.
FOR ALL THE DIFFERENT PROVIDER
TYPES AN APPOINTMENT TYPES
RANGED FROM A HIGH OF NINETY
FIVE PERCENT TO A LOW OF THIRTY
TWO PERCENT.
BUT DEPOSITS BRIEFLY THERE TO
SAY THAT THIS DOES NOT MEAN THAT
ONLY THIRTY TWO PERCENT OF THE
ENROLLEES WERE ABLE TO GET AN
APPOINTMENT WHAT IT MEANS IS
THAT. FOR ANY GIVEN NETWORK FOR
ANY GIVEN PROVIDER TYPE THIRTY
TWO PERCENT OF THE PROVIDERS
THAT WERE SURVEYED HAD
APPOINTMENTS AVAILABLE WITHIN
THE TIME LAPSED STANDARD. I CAN
ALSO PROVIDE YOU A MORE DETAILED
SUMMARY OF SOME OF THE SPECIFIC
FINDINGS IF YOU WOULD LIKE KERN
OR PAUSE THERE.
ACTUALLY OF BE IT WOULD BE
INTERESTED KNOWING LOW MORE
BECAUSE THIS IS CERTAINLY AN
ISSUE THAT WE HAD A GREAT
INTEREST IN LAST. YEAR AND OF
COURSE THAT WAS VERY UNFORTUNATE
THAT THAT THAT POINT NOSE
POINTED OUT THAT NINETY PERCENT
OF THE PLANS DO NOT HAVE. DATA
SUBMITTED IN THE FORM THAT
ALLOWED YOU TO DO THE ANALYSIS
SO.
SO WOULD LOVE TO KNOW WHAT YOU
HAVE RIGHT NOW. IT WAS MUCH
BETTER THIS YEAR SO FOR THE
VARIOUS DIFFERENT CATEGORIES FOR
URGENT APPOINTMENTS THE
SENATE DEMOCRATS
AVAILABLE.
A LAB STANDARDS FOR ALL SURVEYED
PROVIDE
S. RANGE FROM A HIGH OF NINETY
FOUR PERCENT TO A LOW OF
EIGHTEEN PERCENT.
FOR NON URGENT APPOINTMENTS THE
PERCENTAGE OF APPOINTMENTS
AVAILABLE WITHIN THE STANDARDS A
RANGE FROM NINETY SEVEN TO
THIRTY SIX PERCENT. FOR PRIMARY
CARE PHYSICIAN APPOINTMENTS
MEETING THE WAIT TIMES STANDARDS
FOR BOTH URGENT AND ARE NON
URGENT CARE RANGE FROM A HIGH OF
NINETY FIVE PERCENT TO A LOW OF
FORTY FOUR PERCENT. WELL
SPECIALIST APPOINTMENTS MEETING
THE WAY THAMES STANDARDS RANGED
FROM NINETY SIX PERCENT TO
TWENTY ONE PERCENT.
WITHIN.
BEHAVIORAL HEALTH PLANS SO THE
USER POWER PLANTS ARE
SUBCONTRACTED FROM FULL SERVICE
HEALTH PLANS TO DO THE FULL
SUITE OF BEHAVIORAL SERVICES.
SURVEYED PROVIDERS REPORTED
APPOINTMENT AVAILABILITY ACROSS
ALL PROVIDER TYPES WITHIN THE
WAIT TIMES STANDARDS FOR BOTH
URGENT AND NON URGENT
APPOINTMENTS FROM SEVENTY TWO
PERCENT TO SIXTY SEVEN PERCENT.
AND FOR URGENT APPOINTMENTS THE
RANGE WAS FROM FIFTY NINE
PERCENT TO FIFTY THREE PERCENT
SO THAT MEANS THAT FOR NON
URGENT APPOINTMENTS THE RANGE
WAS EIGHTY TWO EIGHTY THREE TO
SEVENTY TWO PERCENT.
AND SO ALL THAT PORTION OF THE
DATA A REFLECTS THE RESULTS OF
THE SURVEY SO ALL PLANS BUT ONE
CONDUCT A SURVEY TO ASSESS.
APPOINTMENT AVAILABILITY WITHIN
THE TIME LAPSED STANDARD KAISER
PERMANENTE DOESN'T AUDITED
METHOD METHODOLOGY FOR THE
MAJORITY OF ITS POSITIONS.
SO WHAT KAISER REPORTED FOR THE
FOLLOWING IS THAT THE PERCENTAGE
OF AUDITED PROVIDERS MEETING
APPOINTMENT WAIT TIME STANDARDS
ACROSS ALL PROVIDER TYPES AND
ALL APPOINTMENT TYPES BOTH
URGENT AND NON URGENT WAS EIGHTY
THREE PERCENT.
AND THE PERCENTAGE OF ALL
AUDITED PROVIDERS MEETING URGENT
APPOINTMENT STANDARDS WAS EIGHTY
PERCENT AND THE PERCENTAGE OF
ALL ADDED PROVIDERS MEETING NON
OR. NON URGENT APPOINTMENT
STANDARDS WITH EIGHTY TWO
PERCENT. AUDITED APPOINTMENT
WAIT TIMES DENTERS ACROSS BOTH
URGENT AND NON URGENT
APPOINTMENT WAS NINETY FIVE
PERCENT FOR PC PEAS AND EIGHTY
TWO PERCENT FOR SPECIALIST.
IT'S THE FULL SUMMARY THE DATA.
WOULD YOU LIKE ME TO JUMP TO THE
NEXT LEVEL YEAH OKAY GREAT
RIGIDITY GOING YES SIR SO.
THE NEXT QUESTION RELATED TO
THE STEPS THAT WERE TAKEN TO
ENSURE THAT THE TWENTY SEVENTEEN
TIMELY ACCESS REPORT APPROACH
REPORTS PROVIDE USEFUL
INFORMATION.
SO. REWINDING A LITTLE BIT
FOLLOWING THE RELEASE OF TH
TWENTY FIFTEEN REPORT ABOUT A
YEAR AGO WE TOOK A NUMBER OF
STEPS TO ENSURE ACCURATE
REPORTING INTO THE FUTURE. THE
STEPS INCLUDING REQUIRING THE
PLANS TO RETAIN DATA VALIDATORS
TO REVIEW AND AUTHENTICATE THE
TIMELY ACCESS DATA BEFORE SOME.
SEEN AND TWENTY SEVENTEEN
COMPLIANCE REPORTS TO THE DAMAGE
SAY.
WHEN WE ISSUE THE REPORT.
ON THE TWENTY FIFTEEN DATA AND
FEBRUARY TWENTY SEVENTEEN THE
HEALTH PLANS HAD ALREADY
COMPLETED THE SURVEYS FOR TWENTY
SIXTEEN SO THE REPORT WE JUST
RELEASED THOSE SURVEYS HAD
ALREADY BEEN COMPLETED.
AND THE SERVICE THAT WERE
CONDUCTED FOR TWENTY SEVENTEEN
WAS SO OBVIOUSLY DONE LAST YEAR
WERE COMPLETED AFTER WE PUT A
LOT OF THESE MEASURES INTO PLACE
SO WE ANTICIPATE THERE WILL BE
VERY SIGNIFICANT IMPROVEMENT
OVER THIS YEAR'S REPORT. WHICH
WAS ALREADY SIGNIFICANT
IMPROVEMENT OVER LAST YEAR'S
REPORT. SO THROUGHOUT TWENTY
SEVENTEEN WE TOOK THE FOLLOWING
ADDITIONAL STEPS TO MEN MITIGATE
SOME OF OUR ISSUES WE HOSTED BY
WEEKLY WORK GROUP MEETINGS.
WE IMPROVE DATA ACCURACY IN THE
TIMELY ACCESS COMPLIANCE PROCESS
WE GATHERED FEEDBACK TO IMPROVE
OUR METHODOLOGY AND IMPROVE THE
DATA ACCURACY AND WE PROVIDED
MULTIPLE.
TRAININGS AND WEBINARS FOR
PLANTS AND OTHER PEOPLE THAT
WORK IN COMPLIANCE.
WE DEVELOPED A TECHNICAL
SOLUTION WITHIN THE DAMAGE CITY
WITH A FOCUS ON A DATA
SUBMISSION VALIDATION.
IS THAT PERFORMANCE UP FRONT
CHECK FOR CERTAIN FIELDS AND
THESE PROCESSES ABOUT REDUCE THE
NUMBER OF ERRORS THAT WE SAW IN
THIS YEAR'S DATA AND WILL
CONTINUE TO DO SO IN THE FUTURE.
AND.
SO THE NEXT QUESTION HAD TO DO
WITH RESPECT TO HOW FREQUENTLY
DO NON CONTRACTING PROVIDERS
OFFER SERVICES AND BECAUSE.
SPINDLES AND WHETHER OTHERS
CHANGES IN CONTRACT PRACTICING.
WITH RESPECT INCREASING THE
NUMBER OF CONTRA TO PROVIDERS
AND HOSPITALS WE DON'T HAVE A
CLEAR METHOD IT TO MEASURE
CHANGE IN THIS AREA HOWEVER WHEN
THE TWENTY SEVENTEEN AND OO
NETWORK FILINGS COMING ON MARCH
THIRTY FIRST OF THIS YEAR. WE
COULD COMPARE THE TOTAL NUMBER
OF HOSPITAL BASED SPECIALIST
THAT HEALTH PLAN HAS CONTRACTED
WITH WHAT THEY HAD A YEAR PRIOR
IT'S IT'S A BIT OF A BLUNT
INTEREST INSTRUMENT BUT WE COULD
DO THAT COMPARISON.
IT IT WOULD BE A LITTLE
SIMPLISTIC AND WOULDN'T TAKE
INTO ACCOUNT ANY OTHER PATTERN
CHANGES LIKE WHETHER THEY
WITHDREW FROM SERVICE AREAS AND
THAT'S ARE. CAUSING PART OF THE
CHANGE IN CONTRACTING PRACTICES.
OR IF THEY EXPANDED INTO A
SERVICE AREA THAT'S ACTUALLY
WHAT INCREASE THE NUMBER.
ALSO SINCE AB SEVENTY TWO BECAME
EFFECTIVE IN JULY WERE REALLY
WILL BUT ONLY BE SEE CHANGES
FROM THE LAST SIX MONTHS OF
TWENTY SEVENTEEN SO I'M NOT SURE
HOW GOOD OF A MEASURE WOULD BE
BUT WE COULD PERFORM THAT
ANALYSIS ONCE THE DATA COMES
AND.
SO AND THEN WE HAVE HOW DO WE
LOOK AT NON CALL HOW DOES THE
USE OF NON CONTRACTING PROVIDERS
AND CONTRACT HOSPITALS FACTOR
INTO THE EVALUATION OF A PLANS.
NETWORKS ABILITY TO PROVIDE
TIMELY ACCESS TO CARE. THE
LINKAGE TO TIMELY ACCESS TO CARE
AT LEAST THAT THE SURVEY THAT WE
CONDUCT OR THAT THAT HEALTH
PLANS CONDUCT AND IS A LITTLE
BIT OF A WEEK TIED BECAUSE
THEY'RE LOOKING AT APPOINTMENT
AVAILABILITY. AND A LOT OF THE
NON CONTRACTING PHYSICIANS AT
WORK IN HOSPITALS THEY DON'T IF
YOU DON'T QUALITY
ANESTHESIOLOGISTS FOR AN
APPOINTMENT AND SO THEY'RE NOT
SURVEYED IN THAT SAME WAY.
SO IT'S THE RELATIONSHIP ISN'T
AS STRONG FOR THE HOSPITAL BASED
PROVIDERS.
AND THAT'S I THINK A AND OTHER
QUESTIONS IN THE AGENDA.
NO THANK YOU AYE COME IT'S ON
THE OVERVIEW FROM BELIAU.
FINANCE.
OKAY COMMITTEE MEMBERS.
I HAVE A FEW QUESTIONS HERE.
.
AND TERMS OF THE.
SO.
AS YOU MENTIONED.
THE MAIL WE HAVE A BIT OF A LAG
ABOUT ONE TIME YOU DO THE SURVEY
AND SO I ANTICIPATE THAT NEXT
YEAR.
.
ARE YOU HAD MENTIONED BUT.
.
AT THAT.
WHEN WHEN WE PRESENT THE RESULTS
FOR NEXT YEAR I'M NOT GOING TO
HEAR ANYTHING ABOUT WELL SOMEONE
DIDN'T SUMMIT THE WRONG DATA DID
KNOW A FORMAT THAT'S ALL FIXED
RIGHT I AMFEELING QUITE
CONFIDENT THE PLANS ARE WELL ON
THEIR WAY TO HAVE VERY CLEAR
TODAY.
OKAY AND.
AND I GUESS IF THERE'S ANY
PLANS ARE YEARS IF YOU FEEL
DIFFERENTLY PLEASE LET ME KNOW
BUT.
MY EXPECTATION IS IS THAT
WHATEVER DATA WE HAVE NEXT YEAR.
IS.
IT IS THE IT IS MIS STATED THAT
WERE GONNA YOU KNOW THAT THERE'S
IN MANAGUA HAVE ANY ISSUES ABOUT
WHAT WE DO KNOW WHICH WAS A FILE
THAT WAS AND NOW WE ARE NOT
CLEAR IT'S ERA SO EXPECT A
HUNDRED PERCENT COMPLY.
IT'S RIGHT I EXPECT THAT WE WILL
HAVE IF NOT A HUNDRED PERCENT
DARN NEAR THEIR DUNURE OKAY.
SO THE OTHER QUESTION I HAVE IS
THAT.
.
NOW EVEN WITH YOUR IMPROVEMENTS
I YOU MAY KNOW TO THOSE RANGES.
THAT.
AND REALIZING THERE SOME
IMPERFECTIONS IN THE DATA BUT.
YELLS GOOD THAT WHEN SOMEONE'S
AT THAT NINETY SEVEN PERCENT.
AND I WOULD NOTE THOUGH THAT
THE STANDARDS ARE.
IN STATUTE CORRECT.
I MEAN WHAT STANDARDS ARE THERE
ANY DEBTS TIMELY BETTER
REGULATION OKAY BUT.
BY STATUTE NEAR ACTUALLY
REQUIRED TO MEET THAT IS RIGHT.
FOR THE WHOLE HOST HEALTH PLAN
NETWORK NOT EVERY PHYSICIAN AND
A HEALTH PLAN NETWORK IS
REQUIRED TO HAVE AN APPOINTMENT
AVAILABLE WITHIN THIS RIGHT.
IT'S JUST THAT WITHIN THE
NETWORK YOU HAVE ACCESS WITHIN
THAT TIME FRAME AND SO ONE OF
THE QUESTIONS THAT WE WILL BE
ENGAGING IN AS WE MOVE FOR NOW
THAT WE.
THE DATA IS WHAT IS AN
APPROPRIATE RATE A COMPLIANCE SO
WHAT PERCENTAGE OF THE NETWORK
SHOULD HAVE AN APPOINTMENT
AVAILABLE WITHIN THE TIME LAPSED
ENTERED TO ENSURE ACCESS TO
ENROLLEES. AND WE'RE THINKING
ABOUT THIS IN A LOT OF DIFFERENT
WAYS A ONE OF THE WAYS WE'RE
CONTEMPLATING IS AT SHOULD IT BE
THAT WITHIN TWO PHONE CALLS ARE
WITHIN THREE PHONE CALLS TO.
ECCLES SPEAKING WILL FIND A
PROVIDER THAT HAS AN APPOINTMENT
AVAILABLE TO YOU WHEN THE TIME
LAPSED ENTERED FOR SOME A LITTLE
BIT A CHALLENGES SO WE THINK
THROUGH THAT BECAUSE NOT ALL
HEALTH PLANS OPERATE THE SAME
WAY. FOR EXAMPLE CERTAIN HMO
PRODUCTS.
A LOT OF THE REFERRALS ARE DONE
PHYSICIAN TO PHYSICIAN AND NOT
THE AND REALLY MAKING A PHONE
CALL IT SO THERE MAY BE.
DIFFERENT METHODS OR DIFFERENT.
RATES OF COMPLAINTS STANDARDS
SHOULD BE APPLIED TO DIFFERENT
PRODUCT TYPES.
BUT THAT'S THAT'S THE NEXT STEP
IN THIS PROCESS IS TRIGGERING
NIGHT SO WHEN DO YOU ANTICIPATE.
TO WORK NOW WHEN DO YOU
ANTICIPATE HAVING THOSE.
STANDARDS ARE AT THAT PROCESS
AND IN PLACE.
THE FINAL REGULATION IS REQUIRED
TO BE COMPLETED BY TWENTY TONY.
SO WE WILL BEGIN A STAKEHOLDER
PROCESS THIS YEAR WITH THE FINAL
REGULATION COMPLETED IN TWENTY
TWENTY OF QUE. SE SAID TWENTY
TWENTY IS NOW TWENTY EIGHTEEN.
SO I GUESS THE OTHER QUESTION IS
SO BY DOING SO NEXT YEAR WHEN WE
GET THE THIS.
NEAR PERFECT DATA.
.
WHAT STANDARD DURING APPLY?
AND TO ENSURE THAT THE PEOPLE
OF CALIFORNIA HAVE.
APPROPRIATE ACCESS BECAUSE
BUT YOU'RE TELLING ME RIGHT NOW
IS GOING TO HAVE A STANDARDS OF
WEB DATA BUT WE DON'T HAVE A
STANDARD NEXT YEAR. SO THAT THE
TIME ACCESS REPORT IS ONE METHOD
THAT WE USE TO TRACK COMPLIANCE
AND FORCED TIMELY ACCESS
REQUIREMENTS I WITH HEALTH PLANS
WE ALSO LOOK AT.
OUR ON SITE SURVEY PROCESS TO
LOOK AT THE CONSUMER EXPERIENCE
WE HAVE OUR HELP CENTER WITH THE
COMPLAINTS THE CUMIN IN
RESOLVING THOSE AND SO. IS SO
IT'S THIS ISN'T THE ONLY TOOL
THAT WE HAVE IN THE TOOLBOX
I'M IT'S A VERY IMPORTANT TOOL
BUT WE DON'T HAVE A SPECIFIC
STANDARD TO SAY OKAY IF YOU
DON'T HAVE EIGHTY PERCENT THEN.
WE WE CAN PROSECUTE EASILY SO IN
THE AREA IN QUESTION AND AT WHAT
POINT WOULD SOMEONE STUDENT
PERFORMANCE BE SO POOR THAT YOU
WOULD ACTUALLY TAKE ACTION TO.
TO.
.
FOR LOVE PROSECUTION WHATEVER
ELSE I MEAN IF WE HAVE SPECIFIC
CASES OF OF LACK OF ACCESO WE
HAVE AN ENROLLEE WHO WAS NOT
ABLE TO SEE A CERTAIN
SPECIALIST.
WITHIN THE TIME.
AS A RESULT
WE WOULD PROCESS
YOU THAT OKAY SO YOU SAID
SPECIFIC EXAMPLES BUT SO OKC GET
THE DATA NEXT YEAR I KNOW YOU
HAVEN'T ESTABLISHED STANDARD THE
PLANS THAT.
FIFTY PERCENT.
FORTY PERCENT.
TWENTY PERCENT TEN PERCENT
WHERE'S THE LINE WHERE'S WHERE'S
WHERE'S WHERE'S THE MINIMUM LINE
I MEAN IT'S THAT IF IT DID WE IT
SO. WE DO WE SAIL WE DON'T HAVE
A STANDARD SO YEAR AT FIVE
PERCENT WERE STILL OKAY WE WON'T
DO ANYTHING UNTIL NEXT YEAR. WE
WOULD CERTAINLY FIND ANY OF
THOSE THE FIGURES TO BE
SOMETHING TO WORK WITH THE PLAN
DIRECTLY ONTO WE HAVE.
PACIFIC STANDARD THAT WE CAN
PROSECUTE AGAINST NO BUT WE
COULD WORK WITH THE PLAN ON A
ENSURE THAT THERE'S ACCESS SO
HOW LOW IS.
TO LOW.
THAT'S WHAT OUR ARE CREATING THE
RATE OF OUR COMPLAINTS.
STANDARD IS GOING TO DEFINE
WHAT IS TOO LOW BUT AT THE END
OF THE DAY OF HEALTH PLAN
DOESN'T HAVE A CONTRACTED
PROVIDERS THAT CAN PROVIDE THE
SERVICE WITH IN THE TIME LAPSE
STANDARD THAN THE HEALTH PLAN IS
REQUIRED TO FIND A NON CONTRACT.
PROVIDER AND ENSURE THAT THE
ENROLLEES ONLY SUBJECT TO AND
NETWORK CULTURE.
SO THAT THAT RIGHT NOW THAT IS
OUR BACKSTOPS.
OKAY I'M NOT FEELING VERY
CONFIDENT RIGHT NOW.
PAT BECAUSE FRANKLY A LOT THINGS
HINGE ON OUR STANDARDS OF FOR
BECAUSE WHAT HAPPENS IS THAT
SOMEONE SIGNS UP FOR HEALTH
PLAN.
THERE AND THE OTHER NOT JUST
SIGNING UP TO PAY PREMIUMS ARE
SAYING UP TO GET HEALTHCARE
RIGHT AND SO THEY HAVE. AND
THAT'S WHY WE HAVE NOT SCHEME.
AND SO IF THE PLAN AND WE HAVE A
LOT PEOPLE DOING THEIR OWN
NETWORKS.
AND IF SOMEONE CAN'T GET EN.
.
YOU WERE TELLING EVERYONE THAT
EVEN THOUGH WE HAVE SYSTEMS AND
THE PROBLEM IS THAT FOR EACH
INDIVIDUAL THERE NOT ONLY SURE
LIKE OKAY WELL WHAT SO YOU'RE
SAYING THAT WE WAIT FOR COMPLAIN
BUT ALSO WE SYSTEMATICALLY NO
THERE'S A PROBLEM THAT'S
INSANELY. YOU KNOW YOU GET DATA.
IF SOMEONE'S.
DOWN AT FIFTY PERCENT. THIRTY
PERCENT TEN PERCENT FIVE PERCENT
YOU KNOW I MEAN.
DID.
THAT'S
THAT SOUNDS LIKE THAT THE BIG
PROBLEM I MEAN IT'S GREAT YOU
WHY DO A CORRECTIVE ACTION PLAN
IT'S ONE THING IF YOU'RE CLOSE
BUT IF YOU'RE FAR FAR AWAY.
AND YOU HAVE SYSTEMATIC DATA
SHOWING THAT.
SO WE IN ADDITION TO THE TIMELY
ACCESS REPORT WHICH IS WHICH IS
REALLY MEASURING THE PERCENTAGE
OF PROVIDERS THAT HAVE
AVAILABILITY WITHIN THE SPECIFIC
TIME WINDOW WE'RE ALSO
CONDUCTING AN IN DEPTH ANALYSIS
ON. THE QUANTITY PENETRATION AND
AVAILABILITY OF THE WHOLE
PROVIDER ROSTER WITHIN THE
NETWORK SO DO YOU ARE YOU
MEETING THE STATUTORY AND
REGULATORY STANDARDS AB ONE TO
TWELVE HUNDRED.
FOR OVERALL PHYSICIAN
PENETRATION ONE TO TWO THOUSAND
FOR THE PRIMARY CARE WITH THE
WITH THE ALLOWED PHYSICIAN
EXTENDERS WE'RE ALSO LOOKING AT
GEOGRAPHIC ACCESS STANDARDS SO
THAT. IT IS ONE DATA POINT IT IS
A VERY SERIOUS MEASURE THAT WE
ARE COMMITTED TO ENSURING WE
HAVE A VERY STRONG COMPLIANCE
STANDARD FOR WE JUST DON'T HAVE
ESTABLISHED YET SO WE WILL
CONTINUE TO RELY. ON THE OTHER
WAYS THAT WE MEASURE ACT
CONSUMER ACCESS A WHILE THAT
STANDARD IS BEING CREATED.
ALRIGHT WELL I AT THE DATE ON
THE PEPPER NUMBERS LOOK GOOD
WHEN YOU'RE NINETY SEVEN NINETY
FIVE BUT. WE ARE SAID TO RANGE
GIVES AVOID THIRTY SIX FORTY
FIVE MINUTES FOR A FIFTY PERCENT
NOW. NOW.
SO WHAT YOU'RE TELLING AND AND
WHAT ARE THE THINGS WE'RE DOING
IS LOOKING AT A WORKING WITH A
STATISTICAL.
AB. STATISTICIAN EXCUSE ME TO
DETERMINE WHAT DOES THAT FROM
CONSUMER EXPERIENCE WHAT DOES
SIXTY PERCENT MAIN
WHAT DOES FIFTY PERCENT MEANS.
HOW MANY PHONE CALLS WOULD YOU
HAVE TO MAKE TO FIND
STATISTICALLY SPEAKING TO FIND A
PROVIDER THAT HAD AN APPOINTMENT
WITHIN THE TIME LAPSED STANDARD?
I'M AND I THINK THOSE ARE THE
TYPES OF QUESTIONS THAT WE'RE
GOING TO BE ASKED IN IS IT GONNA
BE STATIC ACROSS THE STATE
DEPENDING ON HOW MANY DIFFERENT
PROVIDER TYPES SERVE DIFFERENT
COMMUNITIES I MEAN WE ALL KNOW
THAT THERE'S A NUMBER OF
COMMUNITIES IN CALIFORNIA THAT
HAVE.
LOW PENETRATION OF SPECIALIST
SIR RIGHT AND SO IN THAT
PARTICULAR COMMUNITY IS IT GOING
TO BE THAT THE THREE
CARDIOLOGISTS OR WHATEVER THE
SPECIALTY TYPE IS THAT'S DEBTS
SERVING THAT AREA. THEY'RE
BOOKED HOW TWO MONTHS SO IS THE
STANDARD GONNA BE IDENTICAL IN
ALL OF THE GEOGRAPHIC REGIONS OF
THE STATE AND THAT SOME OF THE
VARIANTS HERE SAYING IN THE
REPORT. AND THAT'S WHY IT WE'RE
GOING TO HAVE SUCH AS ROBUST
STAKEHOLDER PROCESS TO DETERMINE
AN APPROPRIATE RATE OF
COMPLIANCE OR RATES OF
COMPLIANCE DEPENDING ON HOW WE
SLICE THIS DATA.
WELL. AND MARK MY CONCERN AND I
APPRECIATE YOUR DOING IT IS
THAT'S FAR OUT HIM I MEAN I
REALLY TAKE SOME TIME.
AND.
YEAH.
PEOPLE LEFT HEALTH PROBLEMS I
CAN'T WAIT AND WE WE KNOW THAT
AND I REALIZE IS IN PERFECT DATE
OF THE NEXT YEAR HOPEFULLY WE
HAVE NEAR PERFECT DATA.
SO WE VERY WAITED FOR TWO YEARS
TO GET TO THE POINT WHERE WE
ACTUALLY HAVE DATA I MEAN I JUST
FOUND IT SHOCKING LAST YEAR THAT
NINETY PERCENT.
RIGHT AND FOR WHATEVER REASON WE
WE WENT THROUGH SOME OF THOSE
REASONS OKAY.
ZONE THEY'RE TOLD THAT WE HAVE
TO WAIT TWO YEARS.
AND NOW I'M HEARING IS THAT EVEN
AFTER WE GET THE DATA.
THERE WILL BE STANDARDS YET.
I MEAN THAT'S LIKE THAT. BLACKS
QUINOA IS NOT SOMETHING WE JUST
PASSED A FEW YEARS AGO I MEAN
IT'S BEEN AROUND SO WHY IS IT
TAKING SO LONG.
BUT WE WILL HAVE A DRAFT THAT.
REGULATION OF FOR CIRCULATION
PUBLIC COMMENT IN TWENTY
NINETEEN SO ALTHOUGH WE ARE
DEADLINE IS TWENTY TWENTY TO
HAVE THE FULL STANDARDS IN
EFFECT IN IN PLACE THE
REGULATION FULLY PROBLEM.
I THINK WILL HAVE A VERY CLEAR
INDICATION BEFORE THEN WHAT AN
APPROPRIATE RATE OF COMPLIANCE
OR RATES OF COMPLIANCE SHOULD
BE.
AND THEN THE OTHER THING IS IS
THAT. IT WILL SEE WHAT THE
NUMBERS ACTUALLY TURNOUT BUT FOR
RIGHT NOW WEARY NO THEIR PLANS
THAT ARE. I MEAN.
BELOW FIFTY PERCENT I MEAN FIFTY
PERCENT OR NOT. DESERT.
I MEAN THESE ARE STANDARDS THAT
ARE.
THROUGH OUR IMPLEMENTED BY
REGULATION.
.
THIS LIKE IT I MEAN IT SHOULD BE
A HUNDRED PERCENT.
I MEAN SO THERE'S GONNA BE SOME
VARIATION RIGHT BUT I MEAN
BASICALLY AND NOW ARE SAYING
THAT ALL FIFTY PERCENT OKAY I
MEAN THAT'S HARDLY .
.
THAT'S I'VE HARDLY FIND THAT
ACCEPTABLE I I I I COMPLETELY
UNDERSTAND THAT VIC KEEP IN MIND
THAT I'M A HUNDRED PERCENT MEANS
THAT A HUNDRED PERCENT.
DOCTORS IN YOUR NETWORK.
APPOINTMENTS AVAILABLE WITHIN
SOME OF THE STANDARDS ARE QUITE
SHORT YOU KNOW THEY RANGE FROM
ANYWHERE FROM SEVENTY TWO HOURS
FOR CERTAIN TYPES OF NON URGENT
APPOINTMENTS ALL THE WAY UP TO.
THE TEN OR FIFTEEN BUSINESS DAYS
FOR SOME OF THE SPECIALTY
APPOINTMENTS AND SO I DON'T KNOW
THAT ANY HEALTH PLAN IS EVER
GOING TO HAVE A HUNDRED PERCENT
OF THEIR PROVIDERS.
HAVE APPOINTMENTS AVAILABLE
WITHIN THOSE TIME FRAMES BUT
SOME SUBSET OF THAT HUNDRED
PERCENT IS GOING TO NEED TO IN
ORDER TO ENSURE THAT ENROLLEES
CAN WHEN THEY NEED AN
APPOINTMENT WITHIN THOSE TIME
FRAMES GET. THEIR ONLY CAN
ALWAYS CHOOSE TO WAIT LONGER IF
THEY WANT TO GO TO A SPECIFIC
SPECIALIST WHO'S BACKED UP BUT
THEY SHOULD HAVE A SPECIAL YOU
YEAH BUT YOU GET WHAT I'M SAYING
ANNOYANCES SAID RIGHT SO SO SO
SO I WAS THE GOALS A HUNDRED
PERCENT. ALRIGHT WE'RE NINETY
FIVE OR NINETY SEVEN.
SIXTY.
FIFTY.
FORTY.
THIRTY.
I MEAN WE'RE TALKING HERE RIGHT.
THAT.
AND WE KNOW WHAT.
I'M LIKE OKAY. WELDON KNOW WHAT
WE KNOW THIS IS THE PERCENTAGE
OF PROVIDERS WITHIN THE NETWORK
THAT HAVE AVAILABILITY WITHIN
THE TIME LAPSED STANDARDS SO
THAT MEANS IF. IF IT'S.
IT.
IT'S IT'S REALLY ABOUT HOW MY
CONTACTS YOU HAVE TO MAKE IF YOU
NEED THAT APPOINTMENT WITHIN
SEVENTY TWO HOURS OR YOU NEED
THAT APPOINTMENT WITHIN TEN
DAYS.
SO IF YOU CALL YOUR FIRST
PROVIDER AND THEY SAY I'M SORRY
I DON'T HAVE AN APPOINTMENT
WITHIN TEN DAYS I HAVE ONE
TWENTY DAYS OUT. YOU CAN AS AN
AND REALLY SAY I CAN WAIT THE
TWENTY DAYS MIKE MY HEALTH
CONDUCT MAKE THE CHOICE OR I CAN
SAY NO I ACTUALLY NEED. THAT
APPOINTMENT WITHIN TEN DAYS AND
SO I IT REASONABLE TO EXPECT
THAT IT AND THAT HEALTH PLAN HAS
TO HAVE A NETWORK THAT. WITHIN
TWO PHONE CALLS YOU CAN GET
ACCESS TO THAT APPOINTMENT IS IT
THREE PHONE CALLS MENDOZA THE
WAYS IN WHICH WERE THINKING
ABOUT THESE COMPLIANCE
STANDARDS.
AND.
SO WE HAVE BEEN TO STAKEHOLDERS
HOW MANY PATIENT GROUPS ARE IN
THAT STAKEHOLDER GROUPS.
WHAT I'M I'M SORRY I'M A PATIENT
GROUPS ARE PART OF YOUR
STAKEHOLDER PROCESS LOW WE WILL
WORK WITH ALL OF OUR CONSUMER
ADVOCATE COLLEAGUES REPRESENTING
A BROAD RANGE OF BOTH? UP
PATIENT CONSUMER ADVOCATES AS
WELL AS PROVIDERS AND THE
PROVIDER COMMUNITY AND THE
HEALTH PLAN COMMUNITY AS WE
DEVELOP THIS.
OKAY WELL I EVEN DO NOT MAKE ME
FEEL VERY CONFIDENT RIGHT NOW I
MEAN TO YOU LAST YEAR WE REALLY
HAD TO DEAL WITH NINETY PERCENT
NO DATA WE SCREWED UP IN TERMS
OF PEOPLE AND YET CETERA.
WE HAVE TO WAIT TWO YEARS
BECAUSE THAT I AND NOW YOU'RE
TELLING NOW I'M HEARING THAT
DON'T YOU HAVE STANDARDS.
SO YOU KNOW WE COULD START
STANDARD PROCESS EARLIER THIS
LAWS BEEN AROUND ON THE BOOKS
FOR AWHILE.
IT'S NOT. SOMETHING BRAND NEW
IT'S NOT LIKE GO AWAY WHEN IT
TOOK US AWHILE THAT I MEAN THE
FLAWS BEEN AROUND FOR AWHILE AND
NOW I'M HEARING THAT EVEN AFTER
WE GET THE DATA AFTER WE HAVE A
LAGGED.
WE'RE STILL GOING TO BE.
WE STILL WON'T HAVE A STANDARD
TO HOLD PEOPLE ACCOUNTABLE.
BUT WITH THE FIRST STEP IN
ESTABLISHING THAT STANDARD WAS
GETTING DATA THAT WE COULD RELY
UPON AND FIGURING OUT WHAT IS
THE PERFORMANCE OF THE HEALTH
PLAN NETWORKS TODAY. AND WHAT
IS.
WHAT IS REASONABLE TO EXPECT
ESPECIALLY IN THE RURAL PARTS OF
OUR STATE HOW?
CAN PEOPLE.
IT'S EVEN IF EVER
SINGLE PROVIDER THAT WAS SERVING
THOSE WORKING A SPECIFIC AREA
WORK TOOK ALL TYPES OF INSURANCE
WHICH WE KNOW THAT THEY DON'T
THAT THE PROVIDERS MAKE THEIR
OWN. CHOICES AND AND SO THERE
IS.
WEEK THE FIRST STEP WAS
ESTABLISHING WHAT THAT
APPROPRIATE DATA WAS AND FROM
THERE WE CAN FIGURE OUT WHAT IS
THE MEAN STANDARD AND DO WE HAVE
PLANTS THAT ARE OUT LIARS.
AND THAT ARE NOT PROVIDING THE
SAME LEVEL OF CARE AS OTHER
PLANS.
IF.
SO SO WHAT'S THE WHAT'S THE
CONSEQUENCE THEN TELL WE GET THE
DATA NEXT YEAR YOU'RE TELLING US
NO CONSEQUENCES THEN BECAUSE
THERE'S NO STANDARD.
BUT AS I MENTIONED BEFORE
TIGHTLY AT WHAT YOU'RE TELLING
ME RIGHT NOW.
YOU HAVE A LAW IN PLACE THERE'S
REGULATIONS AND AND I CAN BE
ENFORCED.
IF THERE IS ANY SPECIFIC
INSTANCE WHERE AND REALLY CANNOT
GET ACCESS TO CARE WITHIN THE
TIME LAPSED STANDARD WE WILL
PROSECUTE THAT INSTANCE
WE JUST ARE NOT ENOUGH AND SO
WHAT'S THE PENALTY IF.
FOR FOR FOR VIRUSES WE HAVE TO
DO A CASE BY CASE IS GOING TO BE
SIGNIFICANT ENOUGH TO MAKE
PEOPLE CHANGE WHAT PROCESSES IT
DEPENDS ON THE FACTS OF THE CASE
BUT YES SOME OF OUR SOME OF OUR
ACCESS TO CARE PENALTIES CAN BE
QUITE HIGH.
YOU THE PROBLEM IS IS THAT
YOU'RE TELLING EVERYONE THEY
HAVE TO DO IT ONE BY ONE YOU
HAVE DATA THAT SHOWS
SYSTEMATICALLY THERE'S A PROBLEM
BUT YOU'RE NOT GONNA DO ANYTHING
ABOUT IT. BUT WHAT WE HAVE DATA
THAT INDICATES IS THE PERCENTAGE
OF PROVIDERS WITHIN A GIVEN
NETWORK WITHIN A GIVEN
GEOGRAPHIC REGION THAT HAVE
APPOINTMENTS AVAILABLE WITHIN
THE TIME LAPSED STANDARD. NOT
WHETHER OR NOT IN ROWLEY WAS OR
WAS NOT ABLE TO GET ACCESO. FROM
THERE WE ARE GOING TO DEVELOP
THE APPROPRIATE STANDARDS TO SAY
THIS IS HOW WHAT A NETWORK IN
TOTAL SHOULD PREFER.
ALRIGHT WELL. I.
RIGHT BULLARD SAID.
WELL THINK ABOUT WHAT THAT.
WE SHOULD DO.
THE OTHER ISSUE IS.
REGARDING.
.
FIGHTERS AND HOSPITALS.
SO I KNOW IT'S NOT APPOINTMENT
TIME ISSUE BUT.
WHY THINGS OF COURSE IS IS THAT
IF YOU HAVE A CONTRACT FOR THE
HOSPITAL AND YOU HAVE CONTRACTS
WITH THE PHYSICIANS WHO PROVIDE
THE AND HOSPITAL CARE?
NOT SURPRISINGLY.
YOU'RE GONNA END UP WITH.
A BILL THAT'S NINE SO.
SO I THINK WHEN DID VERY
IMPORTANT ISSUES IS TO RECOGNIZE
IS THAT IF YOU YOU NEED CONTACT
EVERYBODY.
OTHERWISE IT DOESN'T MAKE SENSE.
RIGHT.
SO SO IT'S NOT APPOINTMENT
TIME LIKE ONCE* YA IT'S WILL
YOU CONTRACT WITH THE NC DOLLARS
TO PROVIDE AND CZ OLOGY
OTHERWISE ITEMS I HAVE SURGEON
OF THE HOSPITAL AND BOYLAN Y.
GOT THIS BILL.
RIGHT
SO.
SO I HOPE WE'RE LOOKING AT THAT.
AS WELL I APPRECIATE YOU SHARING
SOME OF THE DATA YOU HAD I THINK
THERE ARE INDICATIONS THAT THERE
ARE SEVERAL HOSPITALS WHERE
DON'T CONTRACTS WITH THE IN
HOSPITAL.
PHYSICIANS FOR AND HOSPITAL
SERVICES
THAT AND SO WE ONLY NEED TO
CLOSE THAT GAP ABSOLUTELY AND
THAT'S PART OF OUR ANNUAL
NETWORK REVIEW PROCESS WHERE WE
REVIEW THAT NETWORKS IN TOTALITY
SAID THEIR ENTIRE PROVIDER
ROSTER AND WHERE THERE ARE GAPS.
EITHER IN PROVIDER TYPES OR IN
GEOGRAPHIC COVERAGE WE WORK
THROUGH A LENGTHY PROCESS
THE WHOLE PLANT WOULD
TO CLOSE THIS GAP.
ALRIGHT WELL. PERHAPS THE
DIRECTOR MIGHT WANNA SHOW UP FOR
MAY REVISE.
NOT BE GOOD.
ALRIGHT.
OKAY NEARLY QUESTIONS.
ALRIGHT PUBLIC COMMENTS ON THE
OVERVIEW.
NOPE NO PUBLIC COMMENT.
SO WE DO HAVE A STAKEHOLDER
PROPOSAL HERE.
SO I REGARDING THE ACT THEM OUT
REGION'S SYSTEM PROGRAM.
ACTUALLY BECAUSE OF THE SITE
THERE WAS A RUMOR AT THE END.
SO.
YOU.
THREE MINUTES
IT AYE DONATING ALL THREE YOU
DON'T WANT TO WIN.
I'LL TRY TO BE SURE EVEN AWAY
WITH WESTERN CENTER ON LAW AND
POVERTY A MEMBER OF THE HEALTH
CONSUMER ALLIANCE ALONG WITH
NINE OTHER. COMMUNITY BASED
LEGAL AID ORGANIZATIONS AS
REQUESTING ADDITIONAL FUNDING
FOR THE CONSUMER OUTREACH AND
ASSISTANCE PROGRAM.
THE HELP CONSUMER ALLIANCE IS
THE ONLY STATEWIDE RESOURCE IN
CALIFORNIA FOR ALL HEALTH CARE
CONSUMERS TO OBTAIN ADVOCACY
WOULD CONFRONTING BARRIERS TO
ELIGIBILITY COVERAGE OR
OBTAINING SERVICES THROUGH FEET
PRETTY. LEGAL SERVICES A LAST
YEAR EACH CA SERVED OVER
SEVENTEEN THOUSAND INDIVIDUALS
AND CLOSE NEARLY FIFTEEN
THOUSAND CASES. WHICH ALLOW
CLIENTS TO. KEEP MAINTAINED AND
WARM PARTLY USED HEALTH COVERAGE
THEREFORE WE RESPECTFULLY ASK
FOR TWO MILLION AUGMENTATION AT
THE PROGRAM. AND FOR FUNDING TO
BE ADJUSTED ANNUALLY FOR
INFLATION.
THIS MONEY WOULD I REPLACE THE
DEBATES THE SALARY SAVINGS THAT
ARE CURRENTLY FUNDING THE
PROGRAM THEREBY INCREASING THAT
PROGRAM FUNDING FROM TWO POINT
FIVE MILLION TO TWO POINT SIX
MILLION.
THANK YOU.
THANK YOU ARE ANY COMMENT FROM
THE MITZI ON THIS PROPOSAL
BECAUSE THIS IS NOT A PROPOSAL
INTRODUCED BY THE ADMINISTRATION
WE DON'T HAVE ANY COMMENTS ON
THE PROPOSAL ITSELF HOWEVER
WE'RE HAPPY TO PROVIDE
TECHNICAL.
THANK YOU ELIA.
FINANCE.
FINANCES AND HAVE A POSITION AT
THIS TIME BUT WE CAN ALSO
PROVIDE TECHNICAL ASSISTANCE.
THANK YOU.
QUESTION COMMITTEE MEMBERS.
BOB.
ONE QUICK QUESTION IN TERMS OF.
SO CURRENTLY COOPER THE AND
ANALYSIS MENTIONS THAT.
THAT.
THEY ALSO RECEIVE.
.
AS.
FUNNY FROM SOME OTHERS DREAMS
FROM TEAMMATES SEE.
IT'S ABOUT WHAT'S THE TOTAL
FUNDING THAT COOP GETS RIGHT NOW
FROM WE CURRENTLY HAVE A LINE
ITEM IN OUR BUDGET OF SIX
HUNDRED AND SIXTY THOUSAND
DOLLARS TO SUPPORT THIS PROGRAM.
WE HAVE BEEN AUGMENTING THAT
FIGURE WITH SALARY SAVINGS AS A
RESULT OF OUR VACANCY RATE WHICH
HAS DROPPED DRAMATICALLY AND SO
ARE OUR SALARY SAVINGS ARE NO
LONGER AT THE LEVEL AT WHICH
THEY USE TO BAKER HOW MUCH IS
THAT.
WE WERE WE HAVE BEEN SO THE SIX
SIXTIES THE LINE TEM WE HAD A
CONTRACT FOR TWO POINT FIVE
MILLION SO THE SALARY SAVINGS WE
WERE USING TO SUPPORT THIS
CONTRACT WAS ONE POINT NINE
MILLION. OKAY.
YEAH ALRIGHT THANK YOU A PUBLIC
COMMENT.
MARY VALDEZ WITH HEALTHAXIS IN
CALIFORNIA IN SUPPORT.
GIVE.
RIGHT SEEN OTHER PUBLIC COMMENTS
AND ANY OTHER QUESTIONS
NOPE SAYING NONE OF OKAY WE WILL
HOLD OPEN.
THIS SETUP PROPOSAL.
RIGHT ISSUE NUMBER TWO FEDERAL
MENTAL HEALTH PARITY COMPLIANCE
REVIEW RESOURCES EXTENSION.
THANK YOU.
FEDERAL MENTAL HEALTH PARITY
REQUIRES HEALTH PLANS TO
CLASSIFY BENEFITS INTO FEDERALLY
MANDATED CLASSIFICATIONS SUCH AS
INPATIENT AND NETWORK INPATIENT
OUT OF NETWORK EMERGENCY
pONCE A BENEFITS ARE CLASSIFIED
PLANS REQUIRED TO ENSURE THAT
THE FINANCIAL REQUIREMENTS AND
QUANTITATIVE TREATMENT LIMITS
LIMITATIONS FOR MENTAL HEALTH
AND SUBSTANCE USE DISORDER. ARE
NOT MORE RESTRICTIVE THAN THE
REQUIREMENTS ARE LIMITATIONS
APPLIED TO MEDICAL SURGICAL
BENEFITS IN THE SAME.
LIMITED TERM FUNDING IN THE
AMOUNT OF FIVE HUNDRED TWENTY
NINE THOUSAND DOLLARS WAS
INITIALLY GRANTED FOR TWO YEARS
AND FISCAL YEAR SIXTEEN
SEVENTEEN. AND IS SET TO EXPIRE
ON JUNE THIRTIETH OF THIS YEAR.
TO THIS REQUEST IS TO CONVERT
THAT LIMITED TERM FUNDING TO
PERMANENT WHICH WILL ALLOW THE
CLINICAL CONSULTANTS TO CONTINUE
ASSISTING THE DAMAGE SEE. WITH
UP FRONT COMPLIANCE REVIEWS FOR
NEW PLANTS
PLANS ENTERING A MARKET SEGMENT
FOR THE FIRST TIME AND PLANS
HAVE CHANGED ASPECTS OF THE
COMPLIANCE METHODS THAT WERE
PREVIOUSLY APPROVED BY THE
DEPARTMENT.
NO POSITIONS ARE ASSOCIATED WITH
THIS REQUEST.
OKAY ARM COMES FROM ALEJO.
NO COMMENTS FINANCE.
I AND SUPPORTS THIS BUDGET
CHANGE PUZZLE ONTO ADDRESS
COMPLIANCE WITH THE MENTAL
HEALTH PARITY ACT.
OKAY.
OKAY NO QUESTIONS THAT PUBLIC
COMMENT.
CREDIBILITY HALF OF SEA PEN BUT
IN SUPPORT OF THE.
REQUEST ON MY PS IN THE WE'VE
WORKED CLOSELY MENTAL HEALTH
ISSUES ARE VERY IMPORTANT TO
COMMUNITIES OF COLOR IN THE
MENTAL HEALTH PARITY
IMPLEMENTATION HAS BEEN
IMPORTANT AS WELL. I WOULD ALSO
NOTE.
ONE ISSUE ONE ON TIMELY ACCESS
THAT WE THINK ITS VERY IMPORTANT
LANGUAGE ACCESS BE INCLUDED IN
TIMELY ACCESS IN THAT IS ONE OF
THE.
MISSIONS CURRENTLY IN THE
REPORT WE WOULD ALSO CONCUR WITH
THE. WHAT WE INFER FROM THE
CHAIR'S COMMENTS THAT IT IS NOT
THE CONSUMER'S RESPONSIBILITY TO
ASSURE TIMELY ACCESS IT IS THE
PLAN?
I THINK YOU AND I YES YOU
HANFORD CORRECTLY AFTER.
AND THAT'S WHY MY EXPECTATION IS
FROM OUR LIKE ATARI AGENCY.
OKAY SO.
.
BUT WILL CERTAINLY HAVE WE WANT
TO ENSURE THAT WE IN FORCE
MENTAL HEALTH PARITY SO.
.
BUT THAT WE WILL PUT THAT ITEM
ON HOLD FOR RIGHT NOW AND.
.
SO WE HOPE THAT FTA APPRECIATE
THAT THAT THAT IS SET APART THE
GOVERNOR'S BUDGET AND THAT.
WELL DRESSED AGAIN MAY REVISE
ALL RIGHT ISSUE NUMBER THREE.
.
PRESCRIPTION DRUG COSTS
TRANSPARENCY SP SEVENTEEN.
I SUMA NOT WAITING UNTIL LIKE
TWENTY TWENTY FIVE TO DO WITH
THIS.
THING SO OKAY THOUGH AS WE HEARD
EARLIER SENATE BILL SEVENTEEN
ADDRESSES THE HIGH PRICES FOR
PRESCRIPTION DRUGS BY CREATING
GREATER TRANSPARENCY AND DRUG
PRICING.
FOR THE DAMAGE SEE THE BILL
REQUIRES HEALTH PLANS TO REPORT
TO US THE TWENTY FIVE MOST
FREQUENTLY PRESCRIBED DRUGS
TWENTY FIVE MOST COSTLY DRUGS BY
TOTAL ANNUAL SPENDING. TWENTY
FIVE DRUGS WITH THE HIGHEST YEAR
OVER YEAR INCREASE IN TOTAL
ANNUAL SPENDING. HEALTH PLANS
MUST REPORT TO THIS THIS DATA TO
THE DAMAGE SEE BY OCTOBER FIRST
OF TWENTY EIGHTEEN AND ANNUALLY
THEREAFTER WE WILL ISSUE A
REPORT TO THE LEGISLATURE WITH
AGGREGATE DATA BEGINNING JANUARY
FIRST TWENTY NINETEEN AND
ANNUALLY. THEREAFTER. SUITABLE
SEVENTEEN IMPORTANTLY ALSO HAS
ADDITIONAL REPORTING
REQUIREMENTS IN THE LARGE GROUP
MARKET SUCH AS THE PERCENTAGE OF
PREMIUM ATTRIBUTABLE TO DRUG
COSTS FOR EACH CATEGORY OF
PRESCRIPTION DRUGS SO. FOR
EXAMPLE IS A GENERIC BRAND NAME
AND BRAND NAME GENERIC
SPECIALTY.
THE YEAR OVER YEAR INCREASES
PERCENTAGE IN A PER MEMBER PER
MONTH COSTS FOR EACH CATEGORY.
THE YEAR OVER YEAR INCREASE IN
PER MEMBER PER MONTH COSTS FOR
DRUG PRICES COMPARED TO OTHER
COMPONENTS OF THE HEALTH CARE
PREMIUM. A SPECIALTY TEAR
FORMULA REALIST.
THE PERCENTAGE OF PREMIUM
ATTRIBUTABLE TO PRESCRIPTION
DRUGS ADMINISTERED IN A DOCTOR'S
OFFICE THAT ARE COVERED UNDER
THE MEDICAL BENEFIT AS SEPARATE
FROM WHAT'S ADMINISTERED THROUGH
A PHARMACY FROM THE PHARMACY
BENEFIT. AND INFORMATION ON THE
USE OF A PHARMACY BENEFIT
MANAGER IF ANY INCLUDING WHICH
PROVIDE.
WHICH
COMPONENTS OF PRESCRIPTION DRUG
COVERAGE ARE MANAGED BY THE
PHARMACY BENEFIT BENEFIT MANNER
MANAGER.
I WON'T GET INTO ALL OF THINGS
IT REQUIRES.
THE WHOLE MANUFACTURERS REPORT
ARE SPREAD SO FOR THIS BILL THE
DAMAGE SHE REQUEST ONE PERMANENT
POSITION AND EXPENDITURE
AUTHORITY IN THE AMOUNT OF THREE
HUNDRED AND SEVEN THOUSAND FOR
FISCAL YEAR EIGHTEEN NINETEEN.
TWO HUNDRED EIGHTY ONE THOUSAND
FOR FISCAL YEAR NINETEEN TWENTY
AND THE SAME AMOUNT ANNUALLY
THEREAFTER TO A DRASTIC INCREASE
WORKLOAD.
S. COMES FROM OHIO.
FINANCE.
FINANCE SUPPORTS THESE RESOURCES
TO IMPLEMENT THE PROVISIONS OF
SB SEVENTEEN.
THANK YOU A. QUESTION FROM YES
US THEM BIG RESEARCHER.
.
AS WE A LOT OF DATA COLLECTION.
OF WHAT IS GOING TO BE THE.
.
THE NET BENEFIT THIS FAR IS.
.
DRUG PRICES IN THE STATE OF
CALIFORNIA THIS AT WITH THIS
EFFECTUALLY LOWER PRICES
INTERVIEW OR IS THIS JUST A.
A REPORTING REQUIREMENT FIRST
QUESTION SECOND QUESTION AS.
.
THERE'S OFTEN A DELAY IN.
PRICE INCREASES.
.
THAT.
ARE REPORTED TO.
P. B. M.'S.
AND MANY TIMES OUR PHARMACIES AT
HER DISPENSING.
DRUGS THAT ARE PAYING HIGHER
PRICES FOR.
IN THE PDM STONE.
REIMBURSE EXCEPT FOR THE.
LOWER PRICE SO IT IN.
THE FIRST QUESTION IS DO YOU SEE
THIS.
NEW PROVISION THAT YOU'RE
REQUIRED TO TO DO THIS DATA
COLLECTION IS A CAN HAVE AN
IMPACT ON DRUG PRICES IN THE
STATE OF CALIFORNIA IN YOUR VIEW
INTO. USING THIS WILL IMPROVE
THE COMMUNICATIONS OF P. B. M.'S
TO MAKE SURE THEY GET THOSE
INCREASES
PHARMACIES DON'T DISPENSED DRUGS
AT A LOSS.
I THINK THAT BOTH EXCELLENT
QUESTIONS.
I'D I BELIEVE THE TRANSPARENCY
CAN HAVE A POSITIVE IMPACT IN
PRESCRIPTION DRUG PRICING BUT
THE TIME WILL HAVE TO TELL
WHETHER NOTED IT HAS THE
INTENDED IMPACT BUT HOW WILL DO
THE.
WELL IF WE KNOW THE COSTS ARE ON
A. ARE THE TWENTY FIVE MOST
COSTLY DRUGS ON A YEAR OVER YEAR
BASIS WE CAN YOUR ONE WE KNOW
WHAT THAT THAT COST YOUR TO.
YOUR PSYCHE YOUR REPORTING WE'RE
GONNA WHAT WHEN WE'RE GONNA SEE
THE TREND IN BETWEEN THOSE TWO
YEARS SO WE WILL WE WILL WE BE
ABLE TO DRAW A BRIGHT LINE
BETWEEN TRANSPARENCY AND.
ACTUAL DEEP
ZORA LEVELING
DRUG PRICES MAYBE NOT BUT I DO
THINK TRANSPARENCY HELPS IN THAT
EFFORT SO WE WE ARE HOPEFUL THAT
THIS IS IMPACTFUL IN THAT WAY
BUT WE WON'T KNOW FOR SURE UNTIL
WE SEE THE DATA.
WITH RESPECT TO THE PDM
QUESTION I DON'T BELIEVE THERE'S
ANY SPECIFIC PROVISIONS IN SB
SEVENTEEN THAT ARE GONNA OF
IMPROVE THE COMMUNICATION A
RELATIONSHIP BETWEEN PBM SOME
PHARMACIES THEMSELVES. THOUGH
FOR THE FIRST TIME WE WILL HAVE
A GREATER UNDERSTANDING IT AT
THAT IMAGE SEE UP.
WHAT THE RELATIONSHIP IS BETWEEN
THE?
HEALTH PLAN AND THE PHARMACY
BENEFIT MANAGER AND WHAT.
DELEGATED RESPONSIBILITIES ARE
ARE COMING TO THE PHARMACY
BENEFIT MANAGER WHETHER THAT'S
CONSISTENT ACROSS THE INDUSTRY
OR IF THERE ARE DIFFERENT NICHE
RELATIONS.
POTENTIALLY COULD DERIVE SOME OF
THAT MISCOMMUNICATION SO IT'S
POSSIBLE BUT I DON'T THINK THAT
THERE'S A SPECIFIC PROVISION
THAT'S GONNA ADDRESS THAT
PARTICULAR ISSUE OKAY ASSERTING
OPEN HOUSE THANK YOU.
BUT A PART OF THE.
REQUEST IS A CONSULTANT FUNDING
TO AS IT ANNUALLY TO ASSIST OF
PREPARATION REPORT PUBLIC
MEETINGS AND THAT CETERA.
IS THIS WORK THAT'S GOING TO BE
DONE I MEANS THAT'S ANNUAL SO
THIS WORK THAT'S GONNA BE DONE
ON AN ONGOING BASIS YEAR AFTER
YEAR AFTER YEAR OURS AT ITS.
THING.
IT IS NOT ONE TIME IT IS WE WILL
RECEIVE THE INFORMATION
BEGINNING OCTOBER TWENTY FOR
OCTOBER FIRST OF THIS YEAR AND
THEN AND.
ON OCTOBER FIRST AT EVERY YEAR
AFTER AND THEN WE WILL HAVE THE
REPORT THAT WE WILL DO FOR THE
FIRST TIME IN JANUARY OF TWENTY
NINETEEN AND THEN ANNUALLY
THEREAFTER. AND HOLD A PUBLIC
MEETING I BELIEVE IN FEBRUARY
ANNUALLY BEGINNING AT TWENTY OO
SO WHERE WE GOTTA Y. WE HAVING
CONSULTANTS Y. NOT HIRE SOMEONE
DO THAT. IT'S A WAR IT'S REGULAR
WORK SHOULD BE THE STATE
WORKFORCE DOING IT WE HAVE BOTH
SO WE HAVE THE ON GOING.
POSITION THE SAME RIGHT YES I
GOT THAT.
AND THEN WE DO HAVE SOME SHORT
TERM WORKLOAD FOR THE PURPORT
PREPARATION WHICH WE COULDN'T
SUSTAIN A FULL TIME POSITION FOR
YOU HAVE THREE OR SIXTY FIVE
DAYS AND SO WE HAVE A
COMBINATION OF ONE FULL TIME
POSITION AS WELL AS.
THE CONSULTING SERVICES TO
AUGMENT THAT POSITION FOR THE
PORTION OF THE YEAR THAT WERE
ANALYZE.
OKAY WELL I DID I JUST WANT HIM
BECAUSE THIS IS KIND OF ON.
WORK.
AROUND.
.
YEAH I THINK OF YOU SEE I KNOW
IF IT'S ONE TIMER YOU'RE TRYING
TO START OFF AND YOU NEEDED
THAT'S ONE THING BUT ONGOING
WORK SHOULD BE DONE BY THE STATE
WORKFORCE.
RIGHT SO IT'S SOMETHING THAT
WILL BE DOING EVERY YEAR OVER
AND OVER AND.
I MEAN THAT'S PART OF LIKE THE
STANDARD OPERATING PROCEDURE
SENSUALLY SHOULD BE BROUGHT IN
HOUSE SO I I JUST WANNA MAKE
NOTE OF THAT TOM AND.
SO HOPEFULLY WE CAN TAKEA LOOK
AT THAT THOSE FUNCTIONS AND SEE
WHETHER IT'S A WAY TO HAVE THAT.
DONE.
IF IT'S GOING TO BE SOMETHING
THAT'S OF USE BY GO WHICH IS
GOING FOR THIS ONE YEAR
TEMPORARY AND WE JUST AND THAT
SPECIALIZED AND WE HAVE
STANDARDS IN PLACE FOR WHAT
SHOULD BE CONTRACTED OUT WHAT
SHOULD BE KEPT IN HOUSE BUT. I
THINK.
.
SOUNDS THIS IS TRYING TO SOUND
LIKE STUFF THAT SHOULD BE DONE
IN HOUSE BUT PERHAPS AS A CUT
FROM FINANCE.
YEAH I MEAN WE CERTAINLY.
EVALUATE THESE REQUESTS THAT
FOR THOSE STANDARDS BECAUSE
YOU'RE RIGHT TO STAY POLICY IS
TO TIRE STATE WORKERS FIRST
BEFORE CONTRACTORS SOME OF THESE
POSITIONS ARE VERY HARD TO FILL
IN PARTICULARLY FOR SOME OF THE
LIMITED TERM WORK THAT SAM.
THAT'S UP FRONT BECOMES VERY
DIFFICULT TO HIRE SOMEONE.
OFF THE STREET FOR.
SIMPSON THAT LIMITED TERM WORK.
AND PARTICULARLY WHEN IT'S A
SPECIALIZED SKILL SET WHEN YOU
CAN FIND FULL TIME EMPLOYMENT
PERMANENT BASIS ELSEWHERE AND
SO.
AND THAT IS WHY WE FELT LIKE
THIS WAS I'M MATCHING.
MATCHING UP A STATE POLICY
NICELY TO DO CONTRACT WORK IN
THIS CASE.
OKAY UP PUBLIC COMMENT.
MARY VALDEZ WITH HEALTHAXIS
CALIFORNIA WE WANT. TO THANK THE
DEPARTMENT FOR ALL THEIR WORK
ARE COLLABORATING WITH OFSHE PET
IN THE INFLAMMATION
IMPLEMENTATION OF S. B.
SEVENTEEN. I'M AS MENTIONED
BEFORE WE PROBABLY CO SPONSORED
THE BILL AND REALLY LOOK FORWARD
TO MAKING SURE THAT.
THE PUBLIC UNDERSTANDS HOW DRUG
COSTS AFFECT HEALTH PREMIUMS AND
WE REALLY APPRECIATE ALL YOUR
WORK AND SUPPORT THE BCP THANK
YOU.
WELCOME.
LINDA WAY WITH WESTERN CENTER ON
LAW AND POVERTY ALIGNING ARE A
COMMENTS OF THE PREVIOUS SPEAKER
IN SUPPORT.
IF YOU BOOK.
BETH PROPELLANT HAVE OF
TEAMSTERS AND UNITE HERE TO OF
THE CO SPONSORS OF S. B.
SEVENTEEN ALSO IN SUPPORT OF THE
BCP. IN PARTICULAR BECAUSE LAST
YEAR AND THIS YEAR AGAIN OVER A
THOUSAND WORKERS TURNED OUT THAT
PUBLIC MEETING TO TALK ABOUT THE
IMPACT OF HEALTH CARE COSTS.
INCLUDING PRESCRIPTION DRUG
COSTS ON THEIR ABILITY TO AFFORD
TO LIVE IN CALIFORNIA THINK ITS
A VERY IMPORTANT ELEMENT OF THIS
AND ALSO ON BEHALF OF SEIZE PAN
TO SUPPORT OF THE BILL THANK
YOU.
THANK YOU.
ALRIGHT ANY OTHER QUESTIONS
NEEDS ALRIGHT SO WE'RE GONNA
HOLD THAT ITEM OPEN.
BOB.
ACTUALLY I THINK FOR OUR NEXT
ITEM WE STILL NEED TO GET.
DIRECTOR SO I THINK MAYBE WE'LL
TAKE A BRIEF BREAK BUT ACTUALLY
MONIES ASK ONE QUESTION GOING
BACK TO THE OVERVIEW.
AND HEALTH.
.
SO.
RIGHT NOW I KNOW YOU HAVE A
PERFECT DATA BUT YOU HAVE SOME
PLANS FOR YOU GETTING YOU HAVE
DATA THAT SHOWS THAT THERE DOWN
AT. NUMBER FIFTY PERCENT BELOW
EIGHTY PERCENT.
AND YOU TALKED ABOUT.
LOW WHAT OUR PLAN IS IS THAT IF
SOMEONE IS IS BELOW A CERTAIN
THRESHOLD WE TRY TO DO SOME
CORRECTIVE ACTION. SO ARE YOU
GONNA SIR DID ARE YOU DOING
CORRECTIVE ACTION PLANS BASED ON
THE INFORMATION YOU HAVE THAT.
THOSE WHO ARE NOT WAITING UNTIL
NEXT YEAR FOR ANY OF THAT NO
WE'RE NOT WAITING WE JUST DON'T
HAVE A SPECIFIC STANDARD AGAINST
WHICH WE COULD.
ACUTE A PLAN BUT WE ARE
REGULARLY MEETING WITH AND
CONFERRING WITH THE PLANS AND
I'M PROVIDING COMMENTS AND OTHER
SORT OF COMMUNICATIONS WITH
RESPECT ABOUT TIMELY ACCESS AS
WELL AS.
NETWORK REVIEW AND THE ALL ALL
OF THE THINGS THAT RELATE TO.
AND REALLY ACCESS SO IT IT IS
IT'S HOLISTIC INSIDE IT LOOKS
SEPARATE WHEN WE TALK ABOUT THEM
IS INDIVIDUAL THINGS BUT WE ARE
IN ROUTINE COMMUNICATION WITH
THE PLANS ON. HOW ADEQUATE IS
THEIR NETWORK TO SERVE THE
ENROLLEES THAT NEED HEALTH CARE
OKAY WELL I HOPE MOURN JUST
COMMUNICATION BUT AND BECAUSE
THE PATIENTS CAN'T WAIT? RIGHT I
MEAN I'M A PHYSICIAN NICE
SEE THE FRUSTRATION WHEN SOMEONE
CAN'T GET THE CARE.
INDEED AND DODD AND SO THAT'S.
.
IT'S PART OF MY VERY SIGNIFICANT
FRUSTRATION THAT ONLY FIRST
TALKING TWENTY SEVENTEEN WE
DIDN'T HAVE DATA AND AS I WILL
TAKE TWO YEARS TO GET THE DATA
NOW I'M HEARING THAT WE WILL.
STANDARD
AND WHAT YOU KNOW I MEAN.
PEOPLE ARE WAITING RIGHT. AND SO
WE KNOW SOMETHING'S GOING ON AND
WE'RE JUST ABLE TO KEEP WAITING
AND WAITING WAY UNTIL THEY DO
SOMETHING ABOUT IT.
THAT'S NOT ACCEPTABLE.
ALRIGHT BUT THAT WILL TAKE P
BRIEF FIVE FIVE MINUTE BREAK AND
DOUBLES.
SEE ABOUT OUR NEXT WITNESSES
BECAUSE.
YEAH GO AHEAD RECONVENE AND
AMEND IT TEARS ARE ACTUALLY A
FEW SECONDS.
SO WE'RE GONNA TAKE UP ITEM
NUMBER FOR ITS THAT YOU FOUR ONE
FIVE.
AND FORTY SIX UP TO IT IT'S A
JOINT.
OVERSIGHT ITEM A MANAGE CARE
TIMELY ACCESS TO CARE
ENFORCEMENT.
SO I KNOW WE'VE JUST TALKED A
BIT ABOUT.
THE FACTS ON THE COMMERCIAL
SIDE.
SO.
.
SO BASICALLY I WANT TO WELCOME.
DIRECTOR CAN'T I KNOW YOU'RE
BUSY.
TESTIFY BEFORE LOU HOOVER
COMMISSION.
SO PRE SHEET THAT YOU'RE ABLE
TO RUSH DOWN HERE AND. MAKE IT
SO BUT THANKS FOR THE RECORD
THAT WE SHOULD JUST GO QUICKLY
DO THE ROUND ROBIN OF
INTRODUCTIONS.
AND THEN WE'LL GO AHEAD AND
START WITH THIS ITEM SO. I GUESS
WE'LL THEIR TEND TO US THAT
WOULD GO DOWN THE LINE FOR
AGENCIES. JENNIFER CAN'T.
DEPARTMENT OF HEALTH CARE
SERVICES AND THANK YOU FOR THAT
COURTESY EXTENDED SO THAT I
COULD GET FROM ONE FLOOR TO THE
NEXT.
GOOD AFTERNOON SIERRA BROOKS
WITH THE DEPARTMENT OF HEALTH
CARE SERVICES.
MARTA GREEN WITH THE DEPARTMENT
OF MANAGED HEALTHCARE.
JENNY PHILLIPS DEPARTMENT A
MATCH HEALTH CARE.
FELLOW AND JOHNSON.
AROUND WAS REALLY OFF A FINANCE.
JUST BECAUSE I GUESS FINANCE
MAKE YOU. WRITE A GOOD PRESENT.
SO THE WAY THE AGENDA WAS SET UP
IT HAD THE DEPARTMENT OF HEALTH
CARE LISTED FIRST SO I WILL GO
AHEAD AND GET STARTED. AS OF THE
FIRST QUESTION RELATED TO THE
DEPARTMENT'S ENFORCEMENT
ACTIVITIES AND PROCESSES FOR
TURNING DETERMINING HEALTH PLAN
COMPLIANCE WITH TIMELY ACCESS
STANDARDS.
SO THE FIRST QUESTION UNDER
THAT WAS WHAT DOC.
PLANS FOR REGARDING.
SO I TOOK A LITTLE BIT ABOUT IT
BEFORE BUT I GO TO A LITTLE BIT
MORE DETAIL HEALTH PLANS MUST
SENATOR TIMELY ACCESS.
ANNUALLY THERE DUE ON MARCH
THIRTY FIRST OF EACH YEAR EACH
REPORT INCLUDES ABOUT FIVE TO
SIX COMPONENTS.
DAY HOW THEY HAVE TO DESCRIBE
IN GREAT DETAIL THE PLAN'S
INTERNAL PROCESSES AND
PROCEDURES FOR DETERMINING
TIMELY ACCESS FOR THEIR
ENROLLEES. A LIST OF EVERY
PROVIDER CONTRACTED BY THE
HEALTH PLANS OF THAT A FULL
ROSTER.
A PLAN SURVEY RESULTS OF FROM
THEIR TIMELY ACCESS SURVEY WHICH
WAS THAT THE TOPIC THAT WERE
TALKING ABOUT EARLIER. A
PROVIDER AND REALLY SATISFACTION
SURVEY RESULTS AS WELL AS
VARIOUS OTHER INDICATORS OF
COMPLIANCE INCLUDING.
INFORMATION RELATED TO
GRIEVANCES AN APPEALS THAT
INDICATOR EITHER IN A PATTERN OF
NONCOMPLIANCE BY SPECIFIC
PROVIDER GROUPS WITHIN THE
NETWORK R INCIDENTS OF
NONCOMPLIANCE THAT INVOLVED
SUBSTANTIAL HARM.
SO THE SECOND SUB QUESTION WAS
HOW DO WE EVALUATE THIS
DOCUMENTATION.
SO WE REVIEW ALL OF THE DATA AND
INFORMATION SUBMITTED FOR
ACCURACY AND COMPLETENESS FOR
THE PLAN'S INTERNAL.
TIMELY ACCESS POLICIES AND
PROCEDURES PROVIDER AD AND
REALLY SATISFACTION SYRUP SERVER
RESULTS AND THE OTHER.
THAT I DESCRIBED WE MONITOR
COMPLIANCE AND OUTCOMES DURING
OUR REGULARLY SCHEDULED ON SITE
SURVEYS IS A FUNCTIONAL AUDITS
THAT WE CONDUCT EVERY THREE
YEARS AT THE PLANS.
AND WE LOOK AT ALL AREAS OF
HEALTH PLANS PERFORMANCE WITH
RESPECT TO ACCESSIBILITY. FOR
THE COMPLETE PROVIDE A ROSTER
THAT IS SUPPLIED THE DAMAGE SEE
USES GEO MAPPING SOFTWARE TO
ENSURE THAT THE VARIOUS PROVIDER
RATIO AND GEOGRAPHIC STANDARDS
ARE MET. AND FOR THE TIMELY
ACCESS SURVEY RESULTS THE DAMAGE
TO REVIEWS FOR ADHERENCE TO THE
STANDARDIZED METHODOLOGY AND FOR
OTHER DATA RELATED ISSUES AS WE.
WORK TOWARDS IT ARE.
COMPLIANCE DETERMINATION.
AND I I TALKED AT GREAT LENGTH
EARLIER ABOUT THE EXCEPT ALREADY
COMPLIANCE FOR THE APPOINTMENT
WAIT TIME STANDARDS AND WE'RE
WORKING WITH STANDARDS
STATISTICIANS TO QUANTIFY HOW
THE PERCENTAGE OF SURVEYED
PROVIDERS WITHIN THE APPOINTMENT
AVAILABILITY. WITHIN THE WAIT
TIME STANDARDS TRANSLATES INTO A
RELIABLE ESTIMATE OF AN AND
RELEASE ABILITY TO IT OBTAINS
ARE.
SO THE NEXT QUESTION.
.
SO HOW WE RESPONDED AFTER
REVIEW.
THEIR DOCUMENTATION INDICATES
AND SIGNIFICANT COMPLIANCE.
SO WHEN THE DME SEE IDENTIFIES
ISSUES WITH THE WAY IN WHICH THE
HEALTH PLAN CONDUCTED ITS
PROVIDERS SURVEYED THE DAMAGE HE
NOTIFIES THE PLAN AND WHERE
APPROPRIATE AND.
REFERS AT TWENTY FORCE MEANT
FOR THOSE VIOLATIONS
AND AS I DESCRIBED EARLIER MORE
SUBSTANTIVE
SUBSTANTIVELY BEGINNINGTHIS
YEAR WILL BE ENGAGED IN A ROBUST
STAKEHOLDER PROCESS TO DETERMINE
WHAT AN ACCEPTABLE RATE OF
COMPLIANCE IS FOR THE TIMELY
ACCESS.
SURVEY RESULTS.
I WILL ALSO SAY THAT WITH THE A
REVIEW OF THE PROVIDER ROSTER.
THERE IS AN EXTENSIVE.
ANALYSIS USING THE GEO MAPPING
SOFTWARE TO LOOK FOR AREAS WHERE
THERE MAY BE GAPS IN COVERAGE
FOR SPECIFIC PROVIDER TYPES OR.
WHERE HEALTH PLANS OF
PERFORMING THE SAME REGION MAYBE
PERFORMING DIFFERENTLY AND WHY
ONE PLAN HAS A LOWER
CONCENTRATION OF PROVIDERS THAN
ANOTHER PLAN?
OF SO THE NEXT QUESTION RELATED
TO ENFORCEMENT ACTIONS THAT WE
UNDERTOOK.
TO CORRECT NON COMPLIANCE.
WE HAVE A BROAD RANGE OF TOOLS
IN OUR TOOLBOX OF THE DAMAGE SEE
WE MAY ISSUE FINES WE MAY ENTER
INTO SETTLEMENT AGREEMENTS WE
MAY IMPOSE CORRECTIVE ACTION
PLANS.
FOLLOWING THE TWENTY FIFTEEN
SURVEY RESULTS THAT WE USE BOTH
FINES AND CORRECTIVE ACTION
PLANS WITH AN EMPHASIS ON
PRODUCING MORE. A RELIABLE DATA.
AND AS I MENTIONED BEFORE THIS
IS THE TIMELY ACCESS SURVEY IS
JUST ONE WAY THAT WE ARE.
YOU USING TO MONITOR AND REALLY
ACCESS
I AM I DESCRIBED OUR HELP CENTER
IS WE WE TALKED ABOUT BEFORE IN
ADDITION TO SPECIFIC PENALTIES
THAT WE IMPOSE. IF.
AN ENROLLEE CONTEXT THE HOUSE
ON THE HELP CENTER IS HAVING
DIFFICULTY GETTING.
AN APPOINTMENT A WE OFTENTIMES
WILL GET ON A THREE WAY CALL
WITH THE PLAN AND HELP THEM
SECURE THAT APPOINTMENT WORK
THAT STILL IS NOT SUCCESSFUL WE
WILL REQUIRE THE PLAN. TO.
APPROVED ACCESS TO DATA NETWORK
PROVIDER AT IT NETWORK COST
SHARING.
IF THERE IS ANY CASE WHERE AN
ENROLLEE.
CAN'T GET ACCESS OR THERE IS
SUBSTANTIAL HARM OR ANY HARM TO
AN ENROLLEE THEY WILL BE
REFERRED HER OFFICE OF
ENFORCEMENT FOR PROSECUTION.
SO THE NEXT QUESTION WAS RELATED
TO WHETHER OR NOT WE UNDERTAKEN
INDEPENDENT ANALYSIS OF
VERIFICATION OF NETWORK ADEQUACY
IN PROVIDER AVAILABILITY. SO AS
I MENTIONED EARLIER YES WE DO DO
GEO MAPPING TO DETERMINE WHETHER
PROVIDERS ARE WITHIN THE MAXIMUM
TIME.
STANDARDS FROM ENROLLEES
WE APPROACH THIS REVIEW BY
MEASURING THE DISTANCE TO A
PROVIDER FROM ALL POP POSSIBLE
POPULATION POINTS WITHIN EVERY
ZIP CODE IN THE SERVICE AREA.
AND MAKE A DETERMINATION OF
WHETHER THE STANDARD IS MEANT
FOR EACH ZIP CODE.
AND THEN WE ALSO CONDUCT AN
INDEPENDENT ASSESSMENT OF
NETWORK CAPACITY IN PROVIDER
AVAILABILITY. SO THE ACT
REQUIRES THAT ALL HEALTH PLANS
PAUL HEALTH PLAN NETWORKS
PROVIDE ONE FULL TIME EQUIVALENT
PCP FOR EVERY TWO THOUSAND AND
RELEASE AND ONE FULL TIME
EQUIVALENT PHYSICIAN FOR EVERY
TWELVE HUNDRED AND RE ENROLLEES.
WITH INPUT FROM OUR STATISTICAL
VENDOR WE USE THAT DATA
REGARDING PROVIDER PARTICIPATION
FROM ALL OF THE LICENSE PLANS.
UNDER OUR JURISDICTION TO
DETERMINE AN F. T. VALUE FOR ITS
PHYSICIANS SO AS AN EXAMPLE IF
ONE PHYSICIAN IS INTEND
NETWORKS.
THEN EACH NETWORK IS A PORTION
TEN PERCENT IT'S VERY SIMPLISTIC
CALCULATION BUT THAT'S THE WAY
WE WE CALCULATE OF TNCS.
AND THAT WE ALSO REVIEW EACH
NETWORK TO ENSURE THAT ALL
PRIMARY PROVIDER TYPES NECESSARY
TO DELIVER ALL BASIC HEALTHCARE
SERVICES ARE INCLUDED.
SO THE NEXT.
QUESTION RELATED TO HOW DO WE
EVALUATE PLAN REQUEST FOR
ALTERNATIVE ACCESS STANDARDS
UNDER THE NEXT FAD THAT ARE
ASKING ACT.
SOME OF A PLANT IS UNABLE TO
MEET THE ESTABLISH TIME AND
DISTANCE GEOGRAPHIC STANDARDS.
IT FOR PC PEAS ARE HOSPITALS
BECAUSE AS THE TWO AREAS FOR
WHICH WE HAVE
IF A SPECIFIC GEOGRAPHIC
STANDARD. THE PLAN MAY REQUEST
ALTERNATE GEOGRAPHIC ACCESS
STANDARDS SOWS SO LONG AS THE
PLANE CAN JUSTIFY THE REQUEST
ACCORDING TO FIFTEEN FACTORS
THAT WE HAVE SET FORTH IN
REGULATION. THESE INCLUDE.
CONSIDERATION OF PATTERNS OF
PRACTICE WITHIN THE REGION WORK
THE RURAL OR URBAN NATURE OF THE
SERVICE AREA THE OVERALL
AVAILABILITY AND DISTRIBUTION OF
PROVIDERS AND THE PRESENCE OF
OTHER HEALTH PLAN OPTIONS WITHIN
THE REGION. AND UNDER THE ACT
HEALTH PLAN MAY ALSO REQUEST
ALTERNATE TIMELY ACCESS SUPPORT
WAIT TIMES STANDARDS BUT TO DATE
NOT A SINGLE PLAN HAS REQUESTED
SACHA. DOES THAT ALTERNATE
STANDARD.
SO THE NEXT QUESTION RELATED TO
HOW MANY ALTERNATIVE ACCESS
STANDARDS ARE CURRENTLY IN
PLACE.
FOR GEOGRAPHIC ACCESS THERE WERE
APPROXIMATELY FIVE THOUSAND
ALTERNATIVE TIME.
STANDARDS CURRENTLY APPROVED BY
THE DAMAGE CITY.
THAT NUMBER INCLUDES THIRTY FOUR
HUNDRED APPROVED ALTERNATIVE
ACTS
OUR HOSPITAL ACCESS
AND ACROSS SEVEN HUNDRED AND
FORTY DISTINCT ZIP CODES BECAUSE
REMEMBER THIS ANALYSIS IS DOWN
TO THE ZIP CODE LEVEL. AND
NEARLY SIXTEEN HUNDRED
ALTERNATIVE ACCESS STANDARDS FOR
PRIMARY CARE PROVIDERS
IT'S FOUR HUNDRED AND THIRTY ONE
CALIFORNIA ZIP CODES.
AND THEN THE NEXT QUESTION HAD
TO DO WITH THE TIME IT IS
REQUIRED.
TO APPROVE OR DENY DENY AN
ALTERNATIVE ACCESS REQUEST.
IT CAN REALLY VARY DEPENDING ON
OF THE NUMBER OF ZIP CODESWERE
TALKING ABOUT I MEAN FOR THE
VERY SMALL REQUEST IT COULD BE A
VERY QUICK TURNAROUND TIME. THE
SUFFICIENCY OF THE PLAN'S
JUSTIFICATION FOR THE FOR THE
ALTERNATIVE STANDARD. WEATHER
THE PLANET'S REQUESTING AN
ALTERNATIVE ACCESS STANDARD FOR
A NEWLY PROPOSED NETWORK SO IT'S
GOING INTO A NEW GEOGRAPHIC AREA
OR IF IT'S WITHIN ITS EXISTING
NETWORK. AND THE EXTENT TO WHICH
PLANTS ARE SEEKING TO CONTRACT
WITH OTHER PROVIDERS OR NEW
PROVIDERS IN THE AREA.
AND WHAT OTHER NETWORK ISSUES
MAYBE IMPACT IMPLICATED IN
CONJUNCTION WITH THE FILING SO
IF. IF WE APPROVE THIS HOW DOES
THAT IMPACT THE OTHER NETWORKS
BOMB UNDER REVIEW.
SO THE NEXT QUESTION.
SAID WHAT FACTORS MUST EXIST
PREVENTING A PLAN FOR MEETING
THAT ARE SCHEME TIMELY ACCESS
STANDARDS THAT WOULD QUALIFY THE
PLAN FOR APPROVAL OF ALTERNATIVE
ACCESS.
AND SO AGAIN WE HAVEN'T YET
APPROVED ANY ALTERNATIVE ACTS
STANDARDS FOR APPOINTMENT WAIT
TIMES BUT SHOULD A HEALTH PLAN
REQUEST
SUCH.
AN ALTERNATIVE ACCESS STANDARD
WE WOULD EVALUATE THAT REQUEST
AGAINST THE FACTORS THAT ARE
FOUND IN THE IN THE LAW. BUT
THEY AND THEY INCLUDE IMPACT ON
CLINICAL OUTCOMES WHETHER THE
SERVICE AREA IS A RURAL URBAN.
AND THE NATURE OF PHYSICIAN
PRACTICES THE URGENCY OF THE
CARE SERVICES FOR SPECIFIC TYPE
OF CARE.
OTHER PROFESSIONALLY RECOGNIZED
STANDARDS OF PRACTICE.
THE ACTUAL AVAILABILITY IN
DISTRIBUTION OF PROVIDERS WITHIN
THE AREA AND PROP PATTERNS OF
PRACTICE.
WE WILL POST ON OUR WEBSITE IF
WE EVER APPROVE AN ALTERNATIVE
ACCESS STANDARD FOR TIMELY
ACCESS.
.
AND THEN OF THE NEXT QUESTION
SAYS HOW DOES WILL THE DAMAGE
SEE EVALUATE WHETHER A PLAN WILL
BE ALLOWED TO OPERATE UNDER ON
ALTERNATIVE ACCESS STANDARD AND
SO AS I MENTIONED BEFORE. WE
HAVEN'T APPROVED ANY WITH
RESPECT TIMELY ACCESS
BUT WITH RESPECT TO ALTERNATIVE
GEOGRAPHIC ACCESS STANDARDS WE
TAKEN ALL OF THOSE THOSE FACTORS
THAT I DESCRIBED EARLIER TIME
EVALUATING WHETHER PLAN WILL BE
ALLOWED.
OPERATE UNDER THAT ALTERNATIVE
GEOGRAPHIC ACCESS STANDARD.
SO I THINK.
WE'RE JUST ABOUT DON'S OF THE
NEXT QUESTION HAS TO DO WITH HOW
ARE WE CHANGING OUR PROCESS AS A
RESULT TO OF. THE DHS HAS WORK
TO IMPLEMENT AB TO A FIVE. SO IN
GENERALALL LICENSED MEDICARE
MANAGED CARE PLANS ARE SUBJECT
TO THE SAME TYPES AND SCOPE OF
REVIEW IS ALL OTHER LICENSED
HEALTH PLANS SO WE WE DON'T
TREAT MEDICAL MANAGE CARE
DIFFERENTLY THAN WE TREAT THE
COMMERCIAL POPULATION. BUT I
WOULD NOTE THAT OF COURSE WE DO
NOT CONDUCT REVIEWS OF KNOX CAN
EXEMPT UP THAT COUNTY ORGANIZE
HEALTH SYSTEM PLANTS.
SO TO THE EXTENT OF THAT DHSS
NETWORK ADEQUACY PROVISIONS IN
ITS CNTRACT WITH MEDICAL PLANS
OVER LAUGHTER INTERSECT WITH NOT
SCHEME PLANS.
WE WORK CLOSELY TO COORDINATE
OUR REVIEW SO THAT OUR FINDINGS
ARE COORDINATED THAT WE'RE
GIVING THE.
PLANS THE SAME OR CONSISTENT OR
COMPLEMENTARY DIRECT.
WHERE THE MEDICAL PLANS ARE NOT
REQUIRED TO PROVIDE SPECIFIC
SERVICES BECAUSE MAYBE THAT
SUITE OF SERVICES IS CARVED OUT
AND IS ADMINISTERED BY SOMEBODY
ELSE WE DON'T LOOK FOR THOSE
PROVIDER TYPES WITHIN? A MONTH
OF THE PLANS REVIEW.
WITH THE ADOPTION OF AB TO A
FIVE THERE ARE MANY AREAS WHERE
THE DH YES CONTRACTS INCLUDE
NETWORK ADEQUACY STANDARDS THAT
DIFFER FROM KNOX CAME
PROFESSIONS AND WHERE THE
NETWORK ADEQUACY STANDARDS
DIVERGE WE APPLY THE KNOX KING
STANDARD.
THE DAMAGE SEE AN IDIOT STAFF
WHO WORK CLOSELY DEFINED AREAS
OF OVERLAP BETWEEN KNOCKS KEEN
AND AB TO A FIVE AND WHERE THERE
IS NO IT. OVERLAPPED IDIOCY IS
PROVIDED INPUT INTO THE DITCH CS
REGARDING HOW THE DEMON.
LISTING PRICE
AS FOR NETWORK REVIEW MAY BE
USEFUL TO THAT APARTMENT.
AND SO THE NEXT QUESTION HAD TO
DO.
WITH HOW DO WE HANDLE
COMPLAINTS THE SAME WAY WE
ALWAYS HAVE SO.
MEDICAID MANAGED CARE PLANS
THAT ARE ENROLLED IN AN OX KING
LICENSED HEALTH PLAN
THE CONTACTED IMAGE SEE AT ANY
TIME AND WE WILL HANDLE THE THE
COMPLAINTS IS THAT COMMENT.
FLORA DHS BEGINS TO AYE CLARIFY
SO YOU SAID THAT THE MEAT SEE
IT'S NOT RECEIVED. ANY REQUESTS
FOR ALTERNATE ACCESS STANDARDS
PORT FOR TYLER INTO OUR TIME
TIME FOR THAT AT THE TIME LAPSED
STANDARDS AT THE TIME STATE.
OKAY SO WE HAVE A NUMBER OF
GEOGRAPHIC.
OKAY SO WHEN YOU'RE WHEN YOU'RE
SAYING THAT THERE ARE LIKE SIX
AND SIXTEEN HUNDRED I THINK
POSITION AND THEN AFTER HOW THE
HOSPITAL WAS THAT.
.
I LOOK AT MY NOTES SORRY. THIRTY
FOUR OKAY SAID THAT WAS THAT'S
DOUBTS FOR GEOGRAPHIC GEOGRAPHIC
SO THIS IS THESE ARE REALLY
CONCENTRATED AREAS THE STATE
WHERE THERE'S NO HOSPITALS IN
RURAL PARTS OF CALIFORNIA OR
THEIR ARMOR. ARE AND AND NOT A
SIGNIFICANT DISTRIBUTION OF
PRIMARY CARE FOR.
SO.
SO WE HAVE SEVERAL FOR
GEOGRAPHIC NONE NONE NONE FOR
TIME.
ARE YOU SURPRISED THAT.
NO BECAUSE I THOUGH AN ENROLLEE
MAY NEED TO TRAVEL FURTHER IF
HERE SHE LIVES IN AN AREA THAT
DOESN'T HAVE A HEAVY
CONCENTRATION OF PROVIDERS. I
WOULD EXPECT THAT THE NETWORK WE
SHOULD STILL BE ABLE TO PRINT.
SO NO I'M NOT SURPRISED I'M IT'S
JUST THAT IF YOU'RE.
FIFTY MILES FROM YOUR NEAREST
HOSPITAL. THEIR HEALTH PLAN
CAN'T CREATE HOSPITAL THAT
DOESN'T EXIST THERE BUT I STILL
EXPECT THAT THAT IN ROWLEY WHEN
THEY NEED TO SEE A PRIMARY CARE
PHYSICIAN HERE SHE MAY HAVE TO
TRAVEL SO JUST AND APPRECIATES
WHAT
CLARIFY THIS AND WHAT. BUILT
INTO THIS ISSUE LOW MORE AFTER
WE HEAR FROM THE X. YES BUT IT'S
BECAUSE.
SO WE DON'T FORGET. SIGHTS Y.
CLIFF AYE SO BASICALLY.
.
IN TERMS OF TIMELY ACCESS NOT A
SINGLE PLAN.
AS REQUESTED SO APPARENTLY
THERE'S NO ISSUES FOR EXAMPLE IN
A RURAL AREA THAT YOU KNOW WHAT
WE CONTRACT WITH EVERY DOCTOR WE
CAN CONTRACT WITH UNDERSTOOD
ALL.
ISN'T A I AM.
AND WE STILL CAN'T GET PEOPLE IN
ON TIME THAT PARENTS NOT A
PROBLEM KNOWN SUPPLYING TO SAY I
HAVE A PROBLEM THERE NO ONE HAS
REQUESTED THOUGH NOT LIKE I'VE
YOU KNOW. ALL ALL THE PEOPLE I
CAN CONTRACT WITH I FINALLY A
CONTRACT WITH THAT I STILL HAVE
A WAY TIME.
NO ONE'S SAYING A I NEED TEN
APPLICATIONS A LOOK AT THE ON
EVERYTHING I CAN.
OKAY SO BE VERY CLEAR ABOUT THAT
OKAY ALRIGHT BUT SOME OKAY THANK
YOU
A.
THANK YOU DTS EUROPE BUT US AIR
BOX WITH THE DEPARTMENT
HEALTHCARE SERVICES SO ARE JUST
READ.
A STATEMENT THAT RESPONSE TO
THE VARIOUS QUESTIONS WHY OVER
THE PAST FIVE PLUS YEARS D. H.
YES HAS WORKED TO SIGNIFICANTLY
STRAIGHT.
TWENTY FOUR MEDI CAL
IT'S CARE HEALTH PLANS.
DH YES OVERSEE SIX DIFFERENT
MODELS OF MANAGED CARE HEALTH
PLANS ALL OF WHICH ARE ARE
REQUIRED TO OBTAIN A NOT SCHEME
LICENSE THIRTY INMATES THE WITH
THE EXCEPTION OF COUNTY
ORGANIZED HEALTH SYSTEMS AS MISS
GREENE STATED.
THOUGH IT IS IMPORTANT TO NOTE
THAT CODES ARE BOUND BY THE SAME
NOT SCHEME REQUIREMENTS IS NON
KOS THROUGH THE D. H. SIESTA
HEALTH PLAN CONTRACT.
IN ADDITION MONITORING AND
OVERSIGHT OF KOS AND NON BECAUSE
PLANS ARE TREATED THE SAME BY DH
CS.
PARENTS USING.
DH YES WORKS IN PARTNERSHIP WITH
THE IMAGE SEE ONE OVERSEEING
MEDI CAL MANAGED CARE HEALTH
PLANS WITH KNOX KY LICENSES.
THOUGH THIS IS A CASE IT IS
IMPORTANT TO NOTE THAT WE HAVE
SEPARATE RESPONSIBILITIES AS
DEPARTMENT.
WELL DH YES WORKS UNDER THE
AUSPICES OF STATE STATUTES AND
ITS RESPONSIBILITIES TO THE
FEDERAL GOVERNMENT.
THE IMAGE THE IS RESPONSIBLE FOR
THE ENFORCEMENT OF THE KNOCKS
CAN ACT AS MISS GREENE ALSO
SPOKE TO.
TO PROVIDE A LITTLE BACKGROUND
ABOUT EACH YES AND OUR OVERSIGHT
ACTIVITIES BUT DEPARTMENT NOW
ANNUALLY COMPLETES A MEDICAL
AUDIT OF ALL OF OUR MANAGED CARE
HEALTH PLANS.
THESE AUDITS ARE ON SITE AT THE
HEALTH PLAN AND CAN RESULT IN
ANYWHERE FROM ONE TO SAY AROUND
TEN FINDINGS.
OVER THE PAST THREE YEARS THE
NUMBER OF FINDINGS HAS DECREASED
PER HEALTH PLAN FROM AN AVERAGE
OF TWENTY FIVE IN TWO THOUSAND
SIXTEEN TO SEVEN IN TWO THOUSAND
EIGHTEEN. INDICATING THAT THE
DEPARTMENT STRENGTHENED
OVERSIGHT IS DECREASING HELP
PLANT EFFICIENCY'S.
AT TIMES THESE FINDINGS CAN BE
RELATED TO NETWORK ADEQUACY
WHICH MAY INCLUDE SOMETHING
SIMPLE LIKE UPDATING A POLICY
AND PROCEDURE TO IDENTIFICATION
OF A POTENTIAL SHORTAGE OF A
TYPE OF A PROVIDER.
FOLLOWING EACH AUDIT SHOULD
THERE BE A FINDING D. H. YES
IMPOSES A CORRECTIVE ACTION PLAN
AND WORKS WITH THE PLANET FOR A
PERIOD OF TIME TO AMELIORATE ANY
IDENTIFIED DEFICIENCIES.
DHS HAS ALSO WORKED OVER THE
PAST YEARS TO IMPLEMENT MORE
ROBUST DATA SYSTEMS WHICH HAVE
BETTER AT THE DEPARTMENT'S
ABILITY TO COLLECT BALADI AND
ANALYZE DATA THAT ARE SUBMITTED
TO US BY THE HEALTH PLANS.
THIS IS INCLUDED THE
IMPLEMENTATION OF NEW AUTOMATED
DATA SYSTEMS WHICH PROVIDE FOR
UP FRONT AND IT'S ON BOTH IN.
PROVIDER DATA SET.
THESE NEW DATA SYSTEMS PROVIDE
DHS WITH NEW ABILITIES TO
OVERSEE HEALTH PLANS ALLOWING
JCS ENGAGE IN MORE TIMELY
RESPONSES TO DATA QUALITY ISSUES
AND MAKING DATA AVAILABLE WHICH
PREVIOUSLY WERE NOT.
WITH RESPECT OVERSIGHT OF
NETWORK ADEQUACY DEEDS CS
FACILITATES THIS PROCESS IN
SEVERAL WAYS REGARDING
APPOINTMENT APPOINTMENT
AVAILABILITY OR TIMELY ACCESS.
SO AS NOT TO SOLELY RELY ON
HEALTH PLAN DATA THAT'S REPORTED
TO US ONLY WE'VE ENGAGED OR
EXTERNAL QUALITY REVIEW IT
ORGANIZATION OR EAT CROW AN
INDEPENDENT ENTITY. TO CONDUCT
QUARTERLY TIMELY ACCESS SURVEYS
ON THE DEPARTMENTS BEHALF.
THIS INCLUDES THE COLLECTION OF
DATA QUARTERLY THROUGH A
STATISTICALLY SIGNIFICANT
TELEPHONE SURVEY FOR EACH HEALTH
PLAN IN EACH GEOGRAPHIC AREA
THAT IT OPERATES AND.
THE SURVEY WILL COLLECT DATA
ABOUT WE TIMES FOR THE NEXT
THREE APPOINTMENTS FOR PRIMARY
CARE PROVIDERS COURSE
SPECIALISTS NON PHYSICIAN MENTAL
HEALTH PROVIDERS. OBDII ENDS.
AND SOME ANCILLARY SERVICES
DECIMATED SAMPLE SIZES TWENTY
EIGHT THOUSAND THREE HUNDRED
FIFTY FIVE PROVIDERS FOR TWENTY
EIGHTEEN ALONE.
RESULTS FROM THE SURVEY ARE
pPURPORTEDLY DASHBOARD THAT THE
DEPARTMENT ISSUES ON A QUARTERLY
BASIS.
I'M REGARDING TIME AND DISTANCE
DHS IS REQUIRING HEALTH PLANS TO
SUBMIT TIME DISTANCE REPORTS
THROUGH ITS ANNUAL NETWORK
CERTIFICATION PROCESS.
THROUGH THE ANNUAL NETWORK
SEARCH PROCESS DCS WILL CERTIFY
TIME AND DISTANCE FOR THE EIGHT
WRITER TYPES AS REQUIRED UNDER
THE MANAGED CARE FINAL RULE.
DHL'S ALSO HAS THE ABILITY TO
RUN TIME AND DISTANCE REPORTS
USING ARCGIS SOFTWARE BY WHICH
DATA IS OBTAINED THROUGH A
MONTHLY FILES SUBMITTED TO THE
DEPARTMENT BY THE HEALTH PLAN.
THE DEPARTMENT IS ABLE TO RUN
THESE REPORTS THROUGHOUT THE
YEAR AS NEEDED SHOULDN'T AREA OF
CONCERN BE IDENTIFIED.
SHOULD HELP WENT BE FOUND TO BE
OUT NOT COMPLY WITH ANY NETWORK
ADEQUACY STANDARD A VARIATION OF
OVERSIGHT ACTIVITIES ARE
AVAILABLE TO TEACH YES. WE MADE
TO STARE DATA PROVIDE TECHNICAL
INS ASSISTANCE.
WHICH WOULD INCLUDE SPECIFIC
MILESTONES AND TIMELINES TO
MILITARY ISSUES
AND OR IMPOSE SANCTIONS AND OR
PENALTIES.
THE DEPARTMENT HAS BROAD
SANCTION AUTHORITY AND JUDGES
EACH SANCTION ON A CASE BY CASE
BASIS.
SINCE.
TWO THOUSAND FIFTEEN WE HAVE
ISSUED SEVEN DIFFERENT SANCTIONS
THE SANCTIONS TYPES INCLUDE A
REDUCTION AND DEFAULT
ENROLLMENT.
MONETARY PENALTIES AND THE
MANDATES TERMINATE A
SUBCONTRACTOR.
REGARDING HOW DH YES WILL
EVALUATE PLAN REQUEST FOR
ALTERNATIVE ACCESS STANDARDS
UNDER THE NEW MANAGED CARE FINAL
RULE REQUIREMENTS. HEALTH PLANS
ARE REQUIRED TO SUBMIT
ALTERNATIVE ACCESS STANDARD
REQUEST USING A DEPARTMENT
DEVELOP TEMPLATE.
INFORMATION IN INFORMATION
SUBMITTED MUST BE SPECIFIC TO
ZIP CODE AND COUNTY AND INCLUDE
THE DRIVING TIME AND OR DISTANCE
IN MILES BETWEEN THE NEAREST IN
NETWORK PROVIDER FROM THE MOST
REMOTE BENEFICIARY.
THE REQUEST MUST INCLUDE THE
DESCRIPTION OF THE HEALTH PLANS
CONTRACTING EFFORTS IN THE TIME
AND DISTANCE AREA INCLUDING A
LIST OF PROVIDERS WITH WHICH THE
HEALTH PLANETARIUMS AND AN
EXPLANATION WHY THE CONTRACT WAS
NOT EXECUTED.
SHOULD D. H. YES A PROVEN
ALTERNATIVE ACCESS REQUEST THE
REQUEST IS VALID FOR ONE
CONTRACT YEAR MUST BE RENEWED IN
THE NEXT CON
CHAIR.
AB TWO OH FIVE OUTLINES THE
FACTORS THAT MUST EXIST PREVENT
A HEALTH PLAN FOR MEETING THE
STATUTORY AND REGULATORY
STANDARDS THAT WOULD QUALIFY FOR
APPROVAL OF ALTERNATIVE ACCESS
STANDARDS.
EITHER A HEALTH PLAN MUST HAVE
EXHAUSTED ALL OTHER REASONABLE
OPTIONS TO OBTAIN PROVIDERS TO
MEET HE APPLICABLE STANDARD. OR
THE DEPARTMNT DETERMINES THE
HEALTH PLAN HAS DEMONSTRATED
THAT IT'S DELIVERY STRUCTURE IS
CAPABLE OF DELIVERING THE
APPROPRIATE LEVEL OF CARE AND
HOW.
DHS DOES COORDINATE WITH YOU MAY
SEE DURING THE ALTERNATIVE
ACCESS APPROVAL PROCESS AND WILL
DO SO MOVING FORWARD AS WELL.
FOR EXAMPLE THE DEPARTMENT HAS
MANDATED THROUGH ITS NETWORK
CERTIFICATION ARE PLANNED LETTER
THAT AN ALTERNATE ACCESS REQUEST
MUST BE SUBMITTED TO BOTH
DEPARTMENTS TO KEEP THE
COMMUNICATION GOING.
TO DATE DHS HAS RECEIVED AND
PROCESSED ALTERNATIVE ACCESS
REQUESTS FROM THE TO HELP PLANS
THAT HAVE IMPLEMENTED RECENTLY
IN SACRAMENTO AND SAN DIEGO
COUNTY AT NINE UNITED.
WE'RE IN THE PROCESS OF
RECEIVING ALTERNATIVE ACCESS
REQUESTS FROM HEALTH PLANS FOR
THE UPCOMING CONTRACT YOUR IN SO
THAT IT WAS RECENTLY SUBMITTED
TO US SOME.
OFFICE OF PROCESSING AT THIS
TIME.
AND THAT CONCERNS THAT CONCLUDES
MY TESTIMONY WERE HAPPY TO
ANSWER ANY QUESTIONS.
ACTUALLY AND THAT I THAT THEY
THINK IS IN THERE OF ITS KIND
LIKE UNDER BOTH OF YOU SO HOW
HOW DID.
THE TO AGENCIES TO VIEW
COORDINATE IN TERMS OF WHEN
YOU'RE DEALING WITH.
.
I GUESS
OF MAYBE THE SAME PLAN MADE
ABOUT SAME PLAN SAME COMPANIES
SO.
SOAKING JUST THAT SPEAK THAT
THE COORDINATION BETWEEN.
TO AGENCIES CERTAINLY IT SO.
THERE'S IT HAPPENS A LOT OF
DIFFERENT WAYS AND XTERRA AND
DID.
DESCRIBE ONE OF THE WAYS
THROUGH ONE OF THE CONTRACT
PROVISIONS WHERE'D THE
ALTERNATIVE ACCESS. REQUESTS ARE
FILED SIMULTANEOUSLY SO WHERE
BOTH NOTIFIED
SAME TIME WE HAVE A ROUTINE
PHONE CALLS BETWEEN THE TWO
DEPARTMENTS AND WORKING GROUPS
THAT TACKLE THESE ISSUES.
JOINTLY.
WE HAVE ALIGNED A LOT OF OUR
FILING REQUIREMENTS SO THEY COME
IN AT THE SAME TIME SO THAT WE
CAN REVIEW THEM AT THE SAME TIME
AND THEN. TALK TO ANY SPECIFIC
ISSUES THAT WE HAVE SO WE HAVE
BOTH FORMAL AND INFORMAL
PROCESSES FOR US TO DO THAT.
I MEAN THE ONLY THING I WOULD
SAY TO IS WE ALIGN OUR AUDIT
SCHEDULES. THOUGH YOU KNOW WE
JUST RECENTLY ENOUGH.
FINALIZED OUR AUDIT SCHEDULE
WHERE WE GO OUT TO THE PLANS AND
WE TRY TO DO IT AS A.
AS A COMBINED EFFORT SO THAT
WE'RE NOT HITTING A PLAN
DIFFERENTLY SO IT THERE'S A OT
OF DIFFERENT LAYERS OF
COORDINATION ACROSS.
OKAY THANK YOU. A COMMENCEMENT
LEO.
THE PRINTING NO FINANCE.
IT'S TIME OKAY THURMOND AND.
THANK YOU I HAVE A QUESTION FOR
THE AGE CSU MADE REFERENCE TO
SANCTIONS AND PENALTIES.
COULD YOU ILLUSTRATE A LITTLE
BIT MORE QUICK.
AN EXAMPLE OF A SANCTION AND
WHAT'S THE RANGE OF PENALTIES
ARE THE MONETARY PENALTIES
FINES.
AT LEAST SO WE ARE ABLE TO STOP.
THE FALL ENROLLMENT TO HELP
PLAN WE ALSO WERE ABLE TO IMPOSE
SANCTIONS.
IN THE WAY IN MONTH IN THE WAY
OF MONETARY FINES SO AN EXAMPLE
THAT IS WE DID.
IMPOSE A SANCTION OF OF
APPROXIMATELY FIVE MILLION
DOLLARS ON ONE OF OUR HEALTH
PLANS OF THE LAST YEAR HERE.
AND.
IN ADDITION TO THE PAYMENT OF
THE FINE.
DO YOU MONITOR ARE THEY ELIGIBLE
TO CONTINUE PROVIDING SERVICES.
YES A BURIAL ELIGIBLE TO
CONTINUE PROVIDING SERVICES
OBVIOUSLY IT DEPENDS ON WHAT THE
ISSUE IS THAT WE'VE IDENTIFIED
IN THIS CASE IT WAS RELATED TO
ENCOUNTER DATA.
WE WOULD.
EVALUATE THE ISSUE
INDETERMINATE WOULD PROVIDE
TECHNICAL ASSISTANCE ORPHALI
WOULD IMPOSE A CORRECTIVE ACTION
PLAN.
IN WITH THE CORRECTIVE VAN
ACTION PLAN I THINK YOU
MENTIONED. IF CERTAIN MILESTONES
THAT YOU MONITOR THAT ABILITY
TO.
TO COMPLY YES THAT'S CORRECT
MOVEMENT AND.
THE ONE WITH A LARGE FINE TELL
ME AGAIN WHAT WAS WHAT WAS THE
NON COMPLIANCE ISSUE IT WAS
ACTUALLY RELATED TO.
REPORTING OF ENCOUNTER DATA SO
HEALTH PLANS ARE REQUIRED TO
REPORT MONTHLY TO DCS ALL
ENCOUNTERS AND WE FOUND
DEFICIENCIES IN THE HEALTH
PLANS.
REPORTING AND SO DID WORK WITH
THEM UNDER CORRECTIVE ACTION
PLAN WHEN THEY DIDN'T COME INTO
COMPLIANCE THAT WE DID IMPOSE A
FINANCIAL SANCTION.
THANK YOU IN THEM.
THANK BACK TO EARLIER TESTIMONY.
pFROM DAMAGE SEEN.
HE SAID THERE'D BEEN NO TIMELY
ACCESS
COMPLAINTS BUT THERE YOU CITED.
ME WAS DAMAGE SEE BUT THIS THE
CITATION OF.
.
FAILURE TO PROVIDE GEOGRAPHIC.
COMPLIANCE.
SO WE WE HAVE.
AND I I HAVE TO ADMIT THAT BUT
BUT WE'VE NEVER APPROVED A
TIMELY ACCESS STANDARD FIVE WERE
A DEVIATION WE MAY HAVE RECEIVED
ONE I'M
YOU'RE PURE.
DOCTOR AND WAS VERY POINT I WANT
TO MAKE SURE I'M VERY ACCURATE
WE MAY HAVE RECEIVED ONE WE HAVE
NEVER APPROVED ONE SO
IN CERTAINLY GO BACK AND. AT
WEST.
I MAY HAVE RECEIVED ONE EVERY
SEED ONCE ABOUT IT BUT WE HAVE
NOT AT THE FOOT ONE THAT THEY
NEVER PROVED LAND BUT THE NUMBER
REQUEST IS ACTUALLY VERY VERY
SMALL YET IT IT BUT WE COULD
HAVE LEGAL DIGITS. SINGLE DIGIT
OF.
SAMPLES ON THE GEOGRAPHICAL.
.
SO THIS IS SHIRTS CERTAINLY SAID
THE GEOGRAPHIC ACCESS STANDARD
IS FIFTEEN MILES OR THIRTY
MINUTES FROM ENROLLEES HOME OR
THEIR WORKPLACE I'M SO.
A COMMON ACCESS STANDARD WITH
WOULD BE LIKE THE NEAREST
HOSPITAL IS FORTY SIX MY.
AND SO THEREIS NO PHYSICAL
HOSPITAL THAT'S WITHIN THE
FIFTEEN MILES THIRTY MINUTES AND
SO A WE'RE REQUESTING AN
ALTERNATIVE ACTS
STANDARD TO THE NEAREST PHYSICAL
HOSPITAL WHICH IS FORTY SIX
MILES AWAY.
AND THEN WITH THE PRIMARY CARE
PROVIDER I UNDERSTAND THE
HOSPITAL YOU CAN'T REQUIRE THEM
TO BUILD A HOSPITAL.
WITH PRIMARY CARE PROVIDERS.
GIVE ME AN EXAMPLE OF OF THAT
IT WOULDN'T LOOK THAT DIFFERENT
SO IF THE NEAREST PRIMARY CARE
PRACTICE LOCATION IS ALSO NOT
WITHIN A FIFTEEN MILES OR IF
THEY'VE HAD A PRIMARY CAC THAT
PRACTICE LOCATION THAT HAS.
DID TO ONLY ACCEPT.
AS AN EXAMPLE AND THEY'RE NOT
INTERESTED IN PARTICIPATING IN
THE COMMERCIAL MARKET.
WHATEVER THE CASE MAY BE THEY
WOULD THEY WILL SAY THAN THE
NEAREST PRACTICES THAT I HAD TO
THESE VARIOUS PORTIONS OF THE
ZIP CODES. ARE ACT IN AN ACCESS
OF THE FIFTEEN MILES IN THIRTY
MINUTES AND SO I'M REQUESTING A
STANDARD THAT.
WORKS FOR WHERE THE PRACTICES
ARE BUT IN THE BASE OF THIS
THE.
THE HEALTH CARE NETWORK HAS TO
COMPILE THAT INFORMATION
APPROACH TO SAY THIS IS WHAT WE
CAN ACHIEVE OUR WE CAN'T
ACHIEVE.
AND I WOULD EXPECT THIS IS
PARTICULARLY CHALLENGING IN
RURAL AREAS. THAT THE VAST
MAJORITY OF THE ALTERNATIVE
ACCESS REQUESTS THAT COME INTO
THE DEPARTMENT ARE IN RURAL
CALIFORNIA AND IT REALLY HAS
PRIMARILY TO DO WITH THE.
DENSITY OF PROVIDERS IN THOSE
AREAS THAT YOU DO INDIAN ALICE'S
OF THE PROVIDER WHO.
WON'T PROVIDE SERVICES.
HOW LONG CONTRACT IT WON'T
CONTRACT TO THE PLAN BECAUSE THE
PLANT'S REIMBURSEMENT? IS TOO
LOW WE REQUIRE THE PLAN TO
PROVIDE DOCUMENTATION ABOUT
THOSE NEGOTIATIONS WRITTEN.
ROOM IN OUR THEIR STANDARDS SET
BY.
REGION THEN BY RURAL AREA OF
WHAT'S CONSIDERED.
.
REQUIRED REIMBURSEMENT LEVELS
NOW THERE'S NO SPECIFIC
STANDARDS BUT WE DO REQUIRE THEM
TO HAVE MADE A GOOD FAITH EFFORT
TO TO NEGOTIATE.
IS THERE DATA THAT SHOWS THEM.
HOW MANY PROVIDERS ARE NOT?
?
CONTRACTING WITH.
NETWORKS NOT SPECIFICALLY THAT
YOU CAN KIND OF GET THERE SO.
WE HAVE THE DATA DOWNLOADED
FROM THE DEPARTMENT OF CONSUMER
AFFAIRS THAT LISTS EVERY SINGLE
LICENSE.
OR IN THE STATE.
AND AT WHICH WILL HAVE A PRIMARY
PRACTICE LOCATION NOT EVERY
PRACTICE LOCATION WHERE HEAR ME
HERE SHE MAY PRACTICE AND YOU
CAN OVERLAY THAT WITH THE DATA
FILE THAT CONTAINS EVERY MANAGED
CARE. AND.
CONTRACTED PROVIDER AND IT'S
NOT A HUNDRED PERCENT MATCH
THERE ARE PROVIDERS THAT FOR
WHATEVER REASON ARE NOT
CONTRACTED WITH MANAGED CARE
PLANS AND SO WE LOOK AT BOTH OF
THOSE FILES WHEN WE ARE ON
DETERMINING WHETHER OR NOT WE'RE
GONNA PROVE AN ALTERNATIVE ACTS.
STANDARD.
THANK YOU BECAUSE I KNOW SOME OF
MY DISTRICT IS A LOT OF MY
DISTRICT IS RURAL IN. COMPLAINTS
WE GET FROM CONSTITUENTS IS THEY
CAN'T FIND.
PROVIDERS UNDER THEIR PLAN WHO
WILL ACCEPT THEIR PLAN.
YEAH PEN AND THERE'S.
THERE'S NO WAY WE CAN HELP THEM.
OPEN THERE'S THERE'S NO RESPONSE
WE CAN PROVIDE THEY JUST HAVE TO
KEEP LOOKING
WELL WE COULD ALWAYS SEND THEM
TO US AND WE WILL GET ON THE
PHONE WITH THAT PLAN AND WE WILL
ENSURE THAT THEY GET OUT.
TO CARE SO I WILL BY WICCANS.
OUR COLLATERAL IN INCOME TAX
INFORMATION SENT HERE DISTRICT
OFFICE SO THAT WE CAN REFER THEM
DIRECTLY TO US AND WE LOT. I
APPRECIATE THAT WOULD BE VERY
HELPFUL THANK YOU.
SO. BIG YOU CAN PRESERVE THE
PRESENTATION SHARE SOME OF THE
SAME CONCERNS AS MY FRIEND US
SENATOR MONEY DOES HAVING SOME
RURAL AREAS WHERE.
WE HAD A CASE WHERE SOMEBODY
WAS SUPPOSED TO GO AND FOR SOME
ONCOLOGICAL SURGERY AND WAS
REFERRED ONE INSTITUTION WAS
CONTRACTED TO SAID IT COULDN'T
TAKE IT THEY DON'T REFER TO
ANOTHER ONE SAID IT COULD TAKE.
IT'S IT'S FRIGHTENING ENOUGH
WHEN YOU'RE DIAGNOSED WITH
CANCER AND YOU DO GO TO SEARCH
AND YOU CAN FIND A. AN
APPROPRIATE FACILITY TO DO IT WE
REACHED OUT TO OTHER
REPRESENTATIVE HERE IN
SACRAMENTO WHICH.
WE SOLVE THE PROBLEM BY HAVING
TO GO TO YOU WHICH WAS PROBABLY
GOOD.
.
IF I LET HIM BACK TO THE
SANCTIONS FOR SECOND IF I COULD.
WHAT IS THE INCIDENCE OF
SANCTIONS IN THE STATE OF
CALIFORNIA COMMON PLACE THAT WE
FIND PLANS THAT ARE NOT
COMPLYING WITH A?
THE DEPARTMENT OR IS THIS BRED
THE EXCEPTION RATHER THAN THE
RULE.
THAT'S VERY HARD TO ANSWER I
MEAN I CAN KIND OF DO TRACKING
AND TRENDING OVERTIME ACCOUNT
CARE PLANS AGAINST EACH OTHER
BUT AN ENTIRE INDUSTRY. AND THAT
IS IT'S IT'S HARD TO SAY SO FOR
EVERY CASE THAT COMES INTO THE
HELP CENTER THE PLAN MAY OR MAY
NOT.
TREATED APPROPRIATELY AND SO
FOR EVERY CASE THAT'S NOT
TREATED APPROPRIATELY WHERE THEY
DIDN'T RESPOND TO THE IN RELEASE
ISSUES WHERE THEY DIDN'T PROCESS
THE GRIEVANCE CRY
KLAY WHERE THEY DIDN'T THEN
WE'RE GOING TO HAVE SOME LEVEL
OF MONETARY PENALTY ASSOCIATED
WITH THAT.
THE SAME THING WITH OUR SURVEY
RESULTS SO WHAT WE DO IS WE LOOK
AT.
MARKERS ACROSS PLANS TO TRY TO
SEE WHERE WE HAVE OUT LAYERS OF
PERFORMANCE SO WE LOOK AT
COMPLAINTS ON A PRETEND THOUSAND
BASIS SO IT NORMALIZES LARGE
PLANTS AND SMALL PLANS. AND WE
LOOK AT.
SPECIFIC STANDARDS FOR ON SITE
FUNCTIONAL AUDITS MUCH VERY
SIMILAR TO THE AUDITS THAT THE
DEEP SEA ES CONDUCTS YOU SEE HOW
MANY OF VARIOUS.
A DEFICIENCIES ARE DISCOVERED
WHETHER OR NOT THEY'RE SERIOUS
DEFEAT DECISION DEFICIENCIES OR
PROCEDURAL DEFICIENCIES WHETHER
OR NOT THE REPEATED. AND SO
THAT'S HOW WE MONITOR PLAN
PERFORMANCE AGAINST THE
STANDARDS REALLY AT NOT ISN'T
INDUSTRIES A WHOLE BUT EACH PLAN
ON ITS OWN SO WITH RESPECT TO
THE FIVE MILLION DOLLAR EXAMPLE
THAT YOU GAVE BEFORE WAS. WAS
AFTER A SANCTION IT BECAUSE.
OF COMPLAINTS.
OF THE PLAN NOT FULFILLING
THEIR RESPONSIBILITIES ARE WHAT
WAS THE NATURE IF YOU GET MORE
DETAIL OF WHAT THE. FINALISTS
FOR.
MEASURE INITIALLY TRY AND GIVE A
LITTLE BIT MORE DETAIL SO WE HAD
A PLAN SO ALL PLANS HAVE TO
SUBMIT IN CANADA SO HOW MANY
PRIMARY CARE FOR VISITS DID YOU
GET. HOW MANY DRUGS THAT HAD A
REBATE ASSOCIATED WITH IT YOU
KNOW JUST IT WASN'T DATA
SEBASTIAN ISSUE AND WE HAD WORK
WITHOUT PLAN? OVER THE COURSE
OF.
.
PRETTY EXTENSIVE PERIOD OF TIME
AND THEY JUST WERE UNABLE TO
SUBMIT THAT DATA. BUT WHICH.
DOESN'T EXIST WE CAN'T FIND IT
WE CAN'T GET IT AND WE KIND OF
COME BACK AND SAY NO WE REALLY
NEED A AND THEY BELIEVE THAT.
WE'RE TRYING BUT WE CAN GET IT
AND SO WAS KIND OF A AFTER THE.
A LOT OF OTHER TOOLS AND A LOT
OF OTHER MECHANISMS HAD BEEN
TRIED. I'M AND FINALLY THAT PLAN
WAS SANCTIONED FOR FIVE MILLION
DOLLARS. AND I THINK WE ARE NOW
FINDING THEM TO BE IN COMPLIANCE
WITHIN CANADA SUBMISSIONS.
BY CYNICALLY THE FIVE MILLION
DOLLAR DEAD ANIMAL THEY DON'T
PAY IT WE TAKE IT OFF THEIR
CLAIM
SO.
BECAUSE RIPPING THE COMPETITION
WE HAVE A SLIGHTLY DIFFERENT WAY
IN WHICH WE CAN ACHIEVE
COMPLIANCE WITH THAT FAIRLY
QUICKLY. AND I THINK I WOULD
ALSO JUST LIKE TO SAY WHY I'M WE
DO NOT GOOD OF FINANCIAL
PENALTIES AS OUR FIRST.
COURSE RIGHT WE TRY TO WORK
WITH THE PLAN ON A TECHNICAL
BASIS IN A SERIOUS SAID WHEN WE
GO IN ON OUR ANNUAL AUDITS AND
DO A CORRECTIVE ACTION PLAN AND
WE SAY YOU KNOW YOU DID HAVE
THIS POLICY AND PROCEDURE
UPDATED OR. WE YOU KNOW WE WERE
UNHAPPY WITH HOW OLD FAST
RIPPING CLAIMS ACCORDING TO THE
WAY THAT THE CONTRACT REQUIRES
OR YOU KNOW WHATEVER. ON THE
PLANS ARE USUALLY PRETTY
RESPONSES AND COMING BACK TO US
AND WANTING TO.
.
CORRECT THAT BECAUSE CORRECTIVE
ACTION PLANS ARE EVENTUALLY MADE
PUBLIC AND SO THEY'RE VERY
MINDFUL OF. HOW THAT LOOKS AND
CERTAINLY WE DON'T GO TO
FINANCIAL PENALTIES AS OUR FIRST
WAY OF DOING BUSINESS I THINK
THE MORE OTHER DRAMATIC THINGS
THAT WE HAVE HAD TO DO IN THE
PAST FOR PLANS?
INVOLVED US WORKING CLOSELY
WITH THE DEPARTMENT OF MANAGED.
CARE ON A PLANET HAD.
NOT ACCEPTABLE LEVELS OF
TANGIBLE THE EQUITY SO WE NEEDED
TO PUT A TEMPORARY MANAGER INTO
THAT PLAN AND THAT WAS DONE IN
COOPERATION THAT'S A PRETTY
DRAMATIC.
ACTION AND WE ALSO SUSPENDED
ENROLLMENT AND DEFAULT
ENROLLMENT INTO THAT PLANTS WE
BASICALLY CUT OFF.
NEW MEMBERS FLOWING INTO THAT
PLAN UNTIL THEY CAN GET
STABILIZE IN SO THERE'S A
VARIETY OF MECHANISMS THAT WE
TRIED TO. USE BEFORE WE GO TO A
FINANCIAL PENALTY AND THEN THE
OTHER ONES ARE MUCH SMALLER
AROUND USUALLY ROUND ENCOUNTER
DATA AND. VIDEO ID JUDE YOU HAVE
ANY IDEA WHAT AND TWO THOUSAND
SEVENTEEN WHAT THE SANCTION
AMOUNT WAS THAT THE STATE DUH.
ASSESSED.
IS IT IS IT WOULD FIVE MILLIONS
OF A LOT OF MONEY YOU KNOW OF
THIS IS WHAT WE CALL IT A
HUNDRED BILLION DOLLARS A TEN
MILLION DOLLARS FIVE MILLION
DOLLARS RIGHT BECAUSE THAT WAS
IT. FOR SEVENTEEN WITHOUT ONE
PLANNED SO THAT'S IT FOR US AND
I HOPE I CAN LOOK AT.
AND I DON'T KNOW OFF THE TOP OF
MY HEAD.
BUT I WILL SAY THAT OVER TIME
ARE ANNUAL. AVERAGE SANCTION
AMOUNT IS A BIT HOVERS JUST
ABOVE A MILLION DOLLARS
SO IT GOES UP WITH VERY
SIGNIFICANT PENALTIES DROPS DOWN
WHEN WE DON'T HAVE.
THERE'S ALSO A DISTINCTION FOR
US BECAUSE WE DON'T HAVE A
DIRECT COLLECTION METHOD AS THE
WAY THAT THE DH CS DOES WE
IMPOSE IT AND WE MAY GO THROUGH
BOTH AND ADMINISTRATIVE AS WELL
AS A CORK BASED PROCESS WITH
EVERY THURMOND STREET JUDGE IT'S
ONLY WANTED TO APPEAL THAT.
REALLY HAVE ADMINISTERED
PROCESS AND THEN.
IF THE PLAN IS STILL
DISSATISFIED WITH THE OUTCOME OF
THE ADMINISTRATIVE PROCESS THAN
THEY CAN WE GO TO SUPERIOR
COURT.
AND DO YOU SANCTION FOR.
A QUALITY OF CARE OF THAT.
THESE PLANS.
.
PUT FORWARD AND IF THERE IS A
CONCERN ABOUT THE QUALITY OF
CARE. AND THEY ARE SANCTIONED IS
AT A PUBLIC OF THAT PUBLIC
PUBLIC INFORMATION.
YES INDEED CS WOULD IN AN
INSTANCE THAT SOMETHING MORE
EGREGIOUS SANCTION FOR QUALITY
OF CARE ISSUES.
AS THE DIRECTOR STATED WE DO
TRY TO WORK WITH THE HEALTH
PLANS AND PROVIDE TECHNICAL
ASSISTANCE
START A BUT THAT WOULD BE MADE
PUBLIC GAS.
IN AN EVER HAD TO DO THAT SO BUT
IF WE DID WE WOULD CERTAINLY AND
I KNOW IT'S PROBABLY OUTSIDE THE
SCOPE OF THIS AGENDA ITEM BUT I
WAS JUST CURIOUS DOES SIDE YOU
DEPARTMENT DO YOU. IN ANY WAY.
RATE THE HEALTH CARE PLANS ON A
AND A WAY IN WHICH A CONSUMER
CAN MAKE A COMPARATIVE ANALYSIS.
KNOW THE WORDS OF AYE AYE HE
TOOK COMMITTED TO COMPARE THEM
TO RESTAURANTS YOU GO TO
RESTAURANT YOU GOT AN A RATING
OF THE RATINGS SEE RATING.
YOU UNDERSTAND YOUR RISK OF
GOING TO SEE RATED RESTAURANT
WELL.
.
EVALUATING HEALTHCARE PLAN
SOMETIMES CAN BE VERY
COMPLICATED I DID NOT THERE WAS
ANY TYPE OF AN EVALUATION TOOL
THAT ISSUES THAT THE PUBLIC CAN
NOW READILY DEPEND ON. WE DON'T
HAVE AN EIGHT BC SOMETHING THAT
SIMPLE.
IT WHICH WOULD OF COURSE BE
MUCH MORE A CONSUMER FRIENDLY
BUT WE DO HAVE A DASHBOARD THAT
RATE HEALTH PLAN PERFORMANCE
ARE.
S. A VARIETY OF METRICS.
THAT CONSUMERS CAN USE IT ALSO
BREAKS IT DOWN BY LINES OF
BUSINESS SO IT'LL TELL YOU HOW
MANY COMPLAINTS PRETEND THOUSAND
WITHIN THE. THE COMMERCIAL
MARKET AND SO ON AND SO FORTH SO
ANY LICENSE PLAN WHO GO SEE HOW
THEY'RE DOING AGAINST AS VARIOUS
BENCHMARKS BUT THAT IS NOT THEN
TRANSLATED INTO. THIS MEANS IT'S
AN A. AIR THIS MEANS IT'S A BE I
WOULD MENTION THAT ONE OF OUR
SISTER STATE DEPARTMENTS THE
OFFICE THE PATIENT ADVOCATE DOES
PUBLISH A. UP QUALITY REPORT
CARD OF ALL OF THE PLANS IN THE
MEDICAL GROUPS UNDERNEATH THOSE
PLANS AT THAT IT MAKES AVAILABLE
ON ITS WEBSITE AND IS A STAR
RATING. AND SO IT IS A LITTLE
BIT MORE CONSUMER FOCUSED AND A
LITTLE BIT MORE READILY
ACCESSIBLE AND THEN WHAT IS A
PROCESS FOR. YOU TO COMMUNICATE
TO PATIENTS THAT IF THERE IS A
PROBLEM. THAT YOUR AGENCY IS A
WANT TO BE CALLED ISOMER
SOMETHING A STATUTE THAT A
HEALTH PLAN MUST PROVIDE. FOR A
CONSUMER IF THERE'S ANY ISSUES
YOU'RE GONNA CALL THIS NUMBER
BECAUSE.
MAYBE ALL THE COMPLAINTS DON'T
GET YOU. WE ARE CERTAIN THAT NOT
ALL THE PUT COMPLAINTS GET TO US
BUT THERE'S A VARIETY OF PLACES
WITHIN THE ACT THAT HEALTH PLANS
ARE REQUIRED TO USE. LANGUAGE IT
SPECIFICALLY REFERS TO OUR
WEBSITE AND OUR HELP CENTER.
FOR EXAMPLE IN ANY.
AT DENIAL OF SERVICES AND THE
HEALTH PLAN HAS TO GIVE
INFORMATION ABOUT IT BOTH ITS
INTERNAL GRIEVANCE PROCESS AS
WELL AS THE.
AS ONE EXAMPLE ALSO IN THEIR
EVIDENCE OF COVERAGE BOOKLET
IT'S ALSO REQUIRED TO BE IN
THERE.
THANKS EDUCATION. AND ANSWER
WON'T TAKE CREDIT FOR IT SO I
WILL DO IT FOR HER.
IN THAT SHE WAS THE LEAD PERSON
THAT DOES AND DESIGNED OUR.
.
DASHBOARD FOR OUR MANAGED CARE
PLANS AND SO IT'S BEEN AN EFFORT
THAT WE HAVE BOTH REFINED AND
CERTAINLY I THINK BEEN A
NATIONAL LEADER ON FOR MEDICAID.
STATES IN GENERAL AND THAT ARE
ALL OF OUR PLANS ARE PUT ON A
QUARTERLY DASHBOARD.
USING OF YOU KNOW DIFFERENT
METRICS FOR EACH QUARTER SO THAT
YOU CAN KIND OF GET A FLAVOR AND
THAT EACH PLAN ISKIND OF STOCKS.
ACCORDING TO THOSE METRICS AND
THEN THERE'S OTHER INDICATORS ON
IN TERMS OF GRIEVANCES APPEALS.
ANY KIND OF OTHER THINGS BUT.
UTILIZATION BUT YES THERE WAS
THE. CREATOR OF OUR DASHBOARD
AND SO SHE'S NOT GONNA TAKE
CREDIT FOR SOME TO GIVE IT TO
OUR FIRST BEFORE SHE.
I DON'T THINK ANYTHING OF.
AND NO I THINK.
SIMILAR TO THE D. INMATES SEE
WE HAVE SIMILAR PROCESSES
WHEREBY WE MAIL LA INFORMATION
AND WE LOOKED AT THE EVIDENCE OF
COVERAGE TO PROVIDE INFORMATION
TO OUR BENEFICIARIES ABOUT WHERE
THEY CAN.
COMPLAIN OR MAKE A COMPLAINT
ABOUT AN ISSUE THAT THEY MAY
HAVE IDENTIFIED I'M ALSO WHEN
THERE'S A DOWN DAY NOW THAT
OCCURS WE ALSO MAIL OUT
INFORMATION AND WE WORK WITH
TEAMMATES SEEM COORDINATION TO
INCLUDE THEIR INFORMATION.
IN OUR MAILINGS SHOULD THERE BE
A DENIAL FOR A HEALTH PLAN THAT
THEY'RE ALSO RESPONSIBLE FOR
OVERSEEING WOULD YOU SAY THAT'S
WHEN YOUR BIGGEST COMPLAINTS IS
TOMORROW FOR COVERAGE FOR
CERTAIN PROCEDURES.
WITH THE HEALTH CARE PLANS.
BUT FOR US THAT IS THE DE WE CAN
BREAK IT DOWN BIT AND IT CHANGES
YOUR FOR YEAR RIGHT SO.
I THINK IN MOST RECENT YEARS
ARE.
LARGEST COMPLAINT VOLUME WAS
WITH RESPECT TO.
PROCESSING CANCELLATIONS OF
COVERAGE FOR NON PAYMENT OF PRE.
WE GOT A.
AND US.
BECAUSE THERE WAS A LOT OF
CONFUSION AND HOW THE.
SAYS THAT HAS RAINED DOWN
SIGNIFICANTLY YEAR OVER YEAR BUT
I WOULDN'T SAY THAT IT'S NILE.
OF CARE IS THE HIGHEST.
TYPICALLY
I AGREE WITH THAT. FIGURE MUCH.
THANK YOU.
.
QUESTION MYSELF.
SO EXCUSE OF FOR THE APPRECIATE
THAT DETEST DOING THAT VIA
DASHBOARD.
.
IT WAS OF MOST RECENT TO.
DATE IN WHICH CAPS SURVEYS WERE
DONE FOR THEM MEDI CAL MANAGED
CARE PLAN.
I IN TWO THOUSAND SIXTEEN WERE
GETTING READY TO CONDUCT ANOTHER
ONE AND TWO THOUSAND NINETEEN
OKAY ALL RIGHT SO IT'S A
STANDARDIZED MEASURE OF MATCH IT
AS YOU USED IN THE COMMERCIAL AS
WELL AS MEDICAL SPACE I KNOW
THAT THE PASSIVE AT SOME
CHALLENGES IN TERMS OF
PERFORMANCE.
IT IS A CONSUMER BASED SURVEY SO
IT'S NOT.
I.
SUITS WILL RECOGNIZE THAT.
DATA PLANS ALSO USE.
PETERSON INTO.
EVER.
PLANS BILL MEDICAL PLANS DO
FAIRLY WELL ON THE CUTEST
MEASURES.
WELL MORTALITY ON THE CAPS AND
I THINK THERE SOME ISSUES THAT
THAT INDICATES WE NEED TO
ADDRESS THEIR.
IN TERMS OF.
FOR DEBATE SEE.
.
YET WHEN THE QUESTIONS WAS
ABOUT.
YA IN THE PENTHOUSE
VERIFICATION WE HEARD FROM DCS
THAT ACTUALLY DO LIKE PHONE
CALLS TO FIND OUT FIGHT
AVAILABILITY MENTIONED GEO MATCH
BEING BUT YOU DIDN'T ADDRESS DO
YOU DO SECRET SHOPPER OR.
VERIFICATION PHONE CALLS
WITHOUT PATIENTS AWAY TO A CROSS
CHECK DATA. ON.
ON AXIS NOT AS A ROUTINE PART
OF OUR REGULATORY OVERSIGHT
THOUGH AS WE'VE THOUGHT ABOUT
TIMELY ACCESS WE'VE CONSIDERED
THAT.
BUT RIGHT NOW WE ARE RELYING ON
THE EXTERNAL VENDORS HIRED BY
THE PLANS TO DO THAT SURVEY.
WE HAVE IN DISCREET INSTANCES
WHERE WE HAVE EVIDENCE THAT
THERE IS A PROBLEM DONE WHAT WE
CALL A NON ROUTINES.
SO IT ISN'T ON ANNOUNCED AUDIT
OF HEALTH PLANS MOST NOTABLY IN
TWENTY FOURTEEN WHEN WE RECEIVED
WORD THAT BOTH BLUESHIELD AND
BLUE CROSS WHO WERE OPERATING IN
THE INDIVIDUAL MARKET THAN A
RELEASE THAT WERE NEWLY COVERED
UNDER THE NEW THEN COVERED
CALIFORNIA. WERE NOT ABLE TO
FIND PROVIDERS WHO WERE.
DE TAKING COVER CALIFORNIA'S
THEY WERE HEARING WE DID DO.
A SECRET SUCH SHOPPER SURVEY
THAT DID SHOWN ON COMPLIANCE
RATES OF TWENTY IVE PERCENT WE
THEN SANCTIONS OUR FIND THOSE
PLANS.
PUT THEM ON CORRECTIVE ACTION
THEY HAVE COMPLETED THOSE
CORRECTIVE ACTIONS THAT WE HAVE
DONE IT THAT ONLY WHEN THERE IS
EVIDENCE THAT WE ACTUALLY HAVE A
PROBLEM NOT AS A MATTER OF
ROUTINE COURSE.
OKAY SO WHAT WOULD TRIGGER.
SUCH A THING SO ASIDE FROM
COMPLAINTS.
OTHER OTHER ISSUES THAT WOULD
OTHER THINGS THAT WOULD TRIGGER
THAT AS A RESULT OF AN ON SITE
AUDIT.
SO WE DO THE ROUTINE AUDITS
EVERY THREE YEARS AND THEN WE
HAVE THIS NON ROUTINE.
OPPORTUNITIES SO IF WE FOUND UP
PATTERNS OF ISSUES IN THE PLANTS
DOCUMENTATION OR.
WHERE WE THOUGHT WE NEEDED TO DO
A LITTLE DEEPER WE COULD DO IT
THAT WAY AS WELL? PERHAPS DOING
A SURVEY THAT SHOWS THAT PEOPLE
CAN'T GET INTO THEIR DOCTORS
WOULD SEE SOMETHING A TRIGGER
SOMETHING IT COULD YES.
BECAUSE.
WHETHER IT WILL.
AT LIKE FIVE I I UNDERSTAND WHAT
YOU'RE SAYING IT WILL TAKE THAT
BACK.
OKAY.
SO IN TERMS OF ENFORCEMENT
ACTIONS I AM I KNOW THAT.
DETESTED TALK ABOUT THIS.
SOME OF THEIRS BUT AFFIDAVIT
SEE SO HOW MANY. HOW MANY
CORRECTIVE ACTION PLANS HAVE
BEEN?
ARE IMPLEMENTED ARE ACTUALLY
REQUIRED.
FOR.
ACCESS BECAUSE OF ACCESS
STANDARD ISSUES I DON'T OFF THE
TOP OF MY HEAD BUT IT'S NUMEROUS
BECAUSE WE IF WE DO HAVE ACCESS
RELATED DEFICIENT.
SURVEY REPORTS ALL OF THOSE
REQUIRED.
TIONS AND WE ARE DO IT WE HAVE A
HUNDRED AND TWENTY FOUR LICENSE
THOUGH YOU CAN USE AYE YOU YOU
CAN PROVIDE THAT TO MY. ABSOLUTE
I AND AND HOW MANY TIMES IN
TERMS OF ENFORCEMENT ACTIONS
I MEAN FOR SOME ACTIONS OF
TAKING PLACE YEAH WE WOULD HAVE
TO DO A DATA CALL OF OUR
ENFORCEMENT ACTIONS BUT THERE
ARE THERE MULTIPLE.
MANY OF WHICH ARE IN THE CASE
OF SPIN
I CAN RELEASE.
OKAY SO I WOULD LIKE THAT AS
WELL.
YOU ONE BE SURE STANDARDS ARE
ACTION FORCED.
OKAY.
I'M.
AND IN TERMS OF.
.
CURIOUS.
ALRIGHT SO IN TERMS OF.
.
SURE IN TERMS OF THE I KNOW THAT
THIS SOME OF THE KNOX KEEN
STANDARDS ARE DIFFERENT FROM THE
ONE CMS ARE IMPOSING.
AND.
AND THERE MAY BE INSTANCES
WHERE.
.
DOWN SAME PLANTS DOING BOTH O..
SO I KNOW YOU'RE TRYING TO
FIGURE OUT HOW TO COORDINATE SO
HOW YOU'RE HANDLING THOSE
DIFFERENCES OF THE JUST LIKE THE
EIGHT CS GOES AFTER I KNOW YOU
SAID THAT YOU ENFORCE KNOCKS
KEEN.
IT'S THE SAME ARE RELATED PLAN
HOW HOW HOW DOES THAT WORK
BETWEEN THE TWO AGENCIES.
BUT I THINK WE TRIED REALLY HARD
WHEN WE WERE.
SETTING OUT THE STANDARDS TO
MAKE SURE THAT WE USE KNOCKS
KEEN AS THE FLOOR AND THEN IF
THERE WERE ADDITIONAL CHANGES
THAT WERE REQUIRED BY THE
FEDERAL. MANAGED CARE RULE THAT
WE.
.
MADE THOSE ADJUSTMENTS BUT I
THINK YOU KNOW KNOCKS HIM WAS
KIND OF OUR. BOTTOM LINE IN
TERMS IF WE HAD TO MEET IT ON
OBVIOUSLY THAT HELPS WITH THE
CONSISTENCY ACROSS THE
DEPARTMENT OF ENFORCEMENT BUT I
KNOW THAT WE ALSO SHARED A LOT
OF OUR. DOCUMENTS IN METHODOLOGY
WITH DB SEE AND HAD THEM TAKE A
LOOK TO A KIND OF UNDERSTANDS.
WHAT IF WE WERE DIVERGING OR
DOING A MORE?
RESTRICTIVE TYPE OF REQUIREMENT
YOU KNOW HOW IT WAS UNDEVELOPED
IN SO THAT THEY'RE AWARE OF THAT
GOING FORWARD.
IN TERMS OF.
TURN OF ACCESS STANDARDS ANY
TALK A LITTLE ABOUT THAT FOR A
D. EX CS NAM.
.
BUDGET.
ARE YOU FINDING ISSUES RELATED
TO.
YOUNG.
THERE ARE PROVIDERS THERE BUT
THEY'RE JUST NOT GOING TO
CONTRACT WITH MEDI CAL AND TERMS
OF SIZE AMENDED DESIGNS PLANS
COME BACK AND SAY WE WANT
ALTERNATE ACCESS BECAUSE YOU
JUST GET ITS OLYMPIC CONTRACT
BUT YET YOU. KNOW THEIR PEOPLE
THERE.
BETTER FOR WRITERS THERE. YEAH I
WOULDN'T SAY.
THAT THAT'S THE MAIN REASON I
MEAN WE DO YOU SURVEYED THE
HEALTH PLANS AND AS.
MISS GREENE STATED WE ENSURE
THAT
THE HEALTH PLANS TO MAKE A GOOD
FAITH EFFORTS TO CONTRACT WITH
PROVIDERS THAT ARE AVAILABLE.
I'M WHEN WE'VE SURVEYED IN AND
GOTTEN INFORMATION FROM HEALTH
PLANS ARE FOR SEES ME FROM
PROVIDERS I THINK INDICATIONS
HAPPENED THEN GENERALLY THEY
DON'T WANT.
MANAGED CARE AND THAT'S BEEN THE
REASON THAT WE'VE IDENTIFIED
THAT THERE HASN'T BEEN A
CONTRACT IN A FEW DATA THAT WHEN
I THINK.
IN THE RURAL AREAS IN THERE
RELIEVED WORLD AREAS OF.
LIKE INLAND EMPIRE FOR EXAMPLE
THERE'S A COUPLE OF ZIP CODES
THAT WE'VE EXEMPTED FROM MANAGED
CARE ENROLLMENT ALTOGETHER RIGHT
BECAUSE.
AN INDIVIDUAL LIVES
TWO HUNDRED MILES FROM
EVERYTHING AND THE TOWNS THIRTY
PEOPLE.
SO IT'S AND IF YOU ARE PROVIDER
IN THAT AREA YOU COULDN'T AFFORD
TO NOT CONTRACTS BECAUSE THEN.
BUT I THINK THOSE ARE THE KINDS
OF INSTANCES THAT I THINK.
MISS GREENE WAS REALLY
REFERRING TO IS THEY ARE SO
REMOTE AND SO RURAL THAT ON THE
PLAN HAS TO COME AND SAY I NEED
AN ALTERNATIVE ACCESS BECAUSE
THERE'S LITERALLY NOTHING TO
CONTRACT WITH AS OPPOSED TO THEY
WON'T COME.
WITH ME I THINK YOU SEE MORE
RESISTANT PROVIDER PATTERNS IN.
YOU'RE MORE URBAN AREAS WHERE
THEY HAVE A CHOICE ON THEY HAVE
COMPETING LINES OF BUSINESS
THERE IT MAY BE EXCLUSIVELY
TAKING MEDICARE PATIENTS THEY
MAY ONLY WANT COMMERCIAL
PATIENT.
THEY MAY BE ABLE TO HAVE A YOUR
CONCIERGE PRACTICE WHERE THEY
DON'T NEED TO TAKE INSURANCE AT
ALL BUT THAT REQUIRES. ON ENOUGH
OF THE POPULATION IN ORDER TO
MAKE THIS BUSINESS DECISIONS AND
SO I THINK AS WE GET.
REQUEST FROM PLANS AROUND
ALTENATIVE ACCESS.
DISLIKE ID IMAGE SEE WE WILL
REQUIRE THAT THE PLANS PROVIDE
US DOCUMENTATION TO SHOW THAT
THEY MADE GOOD FAITH EFFORTS TO
CONTRACT.
IF THERE'S A CRITICAL PROVIDER
IN THAT AREA.
THAT IS SEEKING A YOU KNOW A
CERTAIN PERCENTAGE OF MEDICARE
RATES AND THE PLAN HAS GONE BACK
TIME AND TIME AGAIN TO SAY YOU
KNOW WHAT ABOUT THIS OR COULD WE
DO A DIFFERENTIAL. YOU KNOW.
ARRANGEMENT AND THE PREDATOR
SAYS NO WILL TAKE ALL THAT INTO
ACCOUNT BUT WE HAVEN'T HAD TO.
MAKE THOSE DECISIONS YET BUT I
THINK THAT'S.
YOU KNOW WHAT WE'RE PREPARED TO
DO AND I WOULD JUST.
.
I'D BE REMISS TO SAY THE
ALTERNATIVE ACCESS IN THE
NETWORK CERTIFICATIONS ARE NOT
ONLY OCCURRING.
IN THE MANAGED CARE.
ENVIRONMENT BUT WE ALSO HAVE TO
CERTIFY NETWORKS FOR DENTAL
MANAGED CARE COUNTY MENTAL
HEALTH PLANS AN STD SYSTEM AND
SO REPUBLICAN TO BE SENDING AND
VALIDATING.
OVER A HUNDRED NETWORK
CERTIFICATIONS ON BY JULY FIRST
AND ALL OF THOSE DIFFERENT AREAS
AND I WOULD THINK. ON IN THE
COUNTY MENTAL HEALTH PLANS THAT
WE MIGHT SEE MORE ALTERNATIVE
ACCESS REQUESTED THE INITIAL
OUTSIDE JUST BECAUSE THAT'S A
FAIRLY NEW PROCESS FOR THEM.
SO WHEN IT COMES TOACCESS
SOMEONE SAYS OKAY WELL I'M
HAVING TROUBLE GETTING SOMEONE
THE CONTRACT I MEAN DO YOU OFFER
TO.
MAKE ADJUSTMENTS THE RATES THEY
CAN PAY HIGHER RATES.
AND SO YOU SAY WHAT.
THE THIS IS WHY NAM WE CONTRACT
WITH THE PLANS RIGHT AND WE PAY
THEM A CAPITATED AMOUNT AND WE
CERTAINLY KNOW THAT THE RATE
THAT WE ARE PAN ACROSS ALL THOSE
DIFFERENT ELIGIBILITY CODES.
SHOULD ALLOW THEM WITHIN ACTUAR
EARLY APPROPRIATE.
MECHANISMS THAT THEY HAVE THE
EDITOR IF THEY'RE SITTING THERE
SAYING I WANT ME.
I CAN'T FIND SOMEONE.
THEY HAVE RESERVES AND THEY
HAVE RESOURCES AND SO WE LOOK TO
THEM FIRST I WOULD SAY. I AM IT
IS VERY RARE AND WE HAVEN'T HAD
TO DO IT FOR A WHILE WE HAVE
DONE MID YEAR RATE ADJUSTMENTS.
FOR CERTAIN PLANS.
THE LAST ONE WAS SEVERAL YEARS
AGO IN WHICH THERE WAS A
ONCOLOGISTS.
I'M WORRIED THAT WASN'T ACTUALLY
THAT IT WAS I TOO MUCH OF A
CONTRACTING GOOD THING RIGHT THE
ONCOLOGIST LOVE THAT PLAN.
NOT ALL OF THEIR PATIENTS TO
DISHONORABLY OTHER MANAGED CARE
PLANS
AND DROVE THERE AND ALL ARE UP
TO HUNDRED FIFTY PERCENT. AND
ONCOLOGY AND SO THAT PLAN WAS
CERTAINLY HAVING AN ISSUE BUT
I'M IN GENERAL WE DON'T WANT TO
BE PART OF A NEGOTIATION BETWEEN
PLANS AND PROVIDERS.
WE PAY THE PLANS AN APPROPRIATE
RATE IT'S THEIR JOB TO MANAGE
THE MONEY TO NEGOTIATE THE RATES
WITH THEIR PROVIDERS.
AND WE THINK IT WOULD SET A BAD
PRECEDENT IF YOU BASICALLY HAD
PROVIDER SAYING I'M JUST GONNA
HOLD OUT. AND THEN MAKE THE PLAN
GO BACK TO THE STATE TO GET MORE
MONEY AND THEN IT IT'S NOT
SOMETHING THAT WERE.
INTERESTED IN DOING.
OKAY WEALTH WITH THAT'S A
SOMEWHAT SEPARATE ISSUE BUT
WE'VE HAD AND WE WILL CONTINUE
TO HAVE HEARINGS AROUND THE RATE
SETTING PROCESS AND DATA.
ENSURING THAT THE RATES ARE.
IT WILL NOT BAKING AND ACCESS
PROBLEMS.
RIGHT THAT WE HAVE ACCESS
PROBLEM AND WE.
JUST KEEP EACH YEAR AFTER YEAR.
PICKING THAT AND AND.
BEING SURE THAT THAT THAT'S
ADDRESSED SO.
THAT WE'RE NOT JUST
PERPETUATING.
I'M GOING ACCESS PROBLEMS GIVEN
THE METHODOLOGY THAT WAS USED TO
DEVELOP WHATEVER RAIDEN. OUT SO
TO SPEAK WE MAKE NOTE THAT IN A
PREVIOUS HEARING THAT THE PLANS
THAT DIDN'T SEEM AN AXE FUNDS OR
PAYING MEDICARE RATES THAT SO
THEY TESTIFIED.
BECAUSE OF WHY NOW THAT DO THAT
UNIVERSALLY BUT WE SHALL BE FOR
ANOTHER HEARING.
THANK YOU. ALL RIGHT A PUBLIC
COMMENT.
LINDA WAY WITH WESTERN CENTER ON
LAW AND POVERTY WE APPRECIATE A
LARGE UNDERTAKING THAT
DEPARTMENT OF HEALTH CARE
SERVICES IS UNDERTAKING. WITH
THE IMPLEMENTATION OF AB TWO
ZERO FIVE BUT AS THE CHAIR NOTED
THE TIMELY ACCESS REGULATIONS
HAVE BEEN IN PLACE SINCE TWO
THOUSAND TEN. AS WELL AS IN THAT
TEACH THE S. CONTRACTS OF HEALTH
PLANS.
WHILE BOTH DEPARTMENTS DETERMINE
THE APPROPRIATE TIMELY ACCESS
COMPLIANCE RATE THE ULTIMATE
RESPONSIBILITY TO PROVIDE TIMELY
ACCESS TO CARE FALLS WITH HEALTH
PLANS AND DEEDS CS AS THE
ADMINISTRATOR OF THE MEDI CAL
PROGRAM. NOT THE CONSUMER WE
URGE BOTH DEPARTMENTS TO INFORM
MEMBERS OF THE TIME THEIR TIMELY
ACCESS RIGHTS AND REQUIRE HEALTH
PLANS TO NOTIFY CONSUMERS OF
THEIR RIGHT TO GO OUT OF
NETWORK.
WHEN THERE'S NO AVAILABLE
PROVIDER WHO MEET THE TIMELY
ACCESS STANDARDS OR THE TIME AND
DISTANCE STANDARDS IF NO
ALTERNATIVE ACT.
STANDARDS HAVE BEEN APPROVED.
IN REGARDS TO A NETWORK
CERTIFICATION WE APPRECIATE THE
GUIDANCE DE HTF HAS RELEASED
I'M.
A.
BUT A BETTER GCF TO A CERTIFIED
DELEGATED NETWORKS BY JULY OF
NEXT YEAR AND WORK WITH THE
LEGISLATURE TO BUILD THE
CAPACITY TO DO THAT.
IN REGARDS TO MR MINING'S
QUESTION UP FOR AT LEAST THE
MEDI CAL PLANS UP MEMBERS WHO
RESIDE IN COAST COUNTY MONTEREY.
ASSEMBLY WAS A DISCO AND AYE
SANTA CRUZ AYE DEET D. M. H. C.
AS NOT. AN OPTION FOR THEM TO
TURN TO THANK YOU.
THANK YOU WELCOME.
MITCHELL BACK WITH THE
CALIFORNIA MEDICAL ASSOCIATION.
INTENT OF PREVIOUS ACT TIMELY
ACCESS LEGISLATION WAS TO ENSURE
THAT KNOCKS WHEN KNOX KEEN IT
REGULATED PLANS FOR PROVIDING AB
ADEQUATE ROBUST PROVIDER
NETWORKS. THAT PATIENTS WOULD
HAVE APPROPRIATE ACCESS TO CARE.
WE HAVE SIGNIFICANCE CONCERNED
WITH WHETHER THIS IS ACTUALLY
TAKING PLACE.
SOME PLANS OF NARROW THEIR
PROVIDER NETWORKS AND SOME WHO
ACTUALLY CLOSER PANELS TO NEW
POSITIONS.
AND FOR THE ACCESS EXACERBATING
THIS PROBLEM IF THE MHC ISSUES
AN ENFORCEMENT ACTION AGAINST
THE PLANS. AND WE HAVE CONCERNS
AS TO WHETHER THE PENALTIES ARE
ACTUALLY HAVING THE APPROPRIATE
DETERRENT EFFECT.
CLEARLY MORE WORK NEEDS TO BE
DONE IN THIS AREA TO ADDRESS THE
CONTINUE CHALLENGES
ACKNOWLEDGING THE WORK THAT THE
DEPARTMENT IS DOING. TO WORK
TOWARDS MEETING A STANDARD.
RELYING ON CONSUMER COMPLAINTS
AND ONLY REQUIREMENT PLANS
REPORT ACCURATELY AND NOT NEED A
STANDARD FOR COMPLIANCE IS NOT
GOING TO ENSURE THAT PATIENTS
HAVE APPROPRIATE ACCESS TO CARE
THANK YOU.
AND YOU.
WELCOME.
DO YOU AT MARYVALE THOSE WITH
HEALTH ACCESS AND WE'D LIKE TO
THINK THE COMMITTEE AND THE
ADMINISTRATION FOR THEIR
OVERVIEW OF TIME ACCESS CARE
ENFORCEMENT. AND WE WANNA ECHO
OTHER CONCERNS MORE PARTNERS
THAT WESTERN CENTER AND JUST
WANNA TOUCH IN A FEW I'M.
HIGHLIGHT A FEW OF THOSE ISSUES
AS WELL THERE ARE SEVERAL STEPS
THAT THE DEPARTMENT CAN TAKE TO
IMPROVE ENFORCEMENT OF BOTH
TIMELY ACCESS AND ALONG WITH IT
NETWORK ADEQUACY.
ULTIMATELY HEALTH PLANS ARE
RESPONSIBLE FOR ENSURING THAT
THEY HAVE ENOUGH TO PROVIDERS IN
THEIR NETWORKS SO CONSUMERS CAN
HAVE TIMELY ACCESS TO CARE. BOTH
DEPARTMENTS NEED TO MAKE SURE
THAT DELEGATED ENTITIES MEET
NETWORK ADEQUACY STANDARDS AS
WELL ESPECIALLY IF THE CONSUMER
IS LIMITED TO A MUCH SMALLER
NETWORK WITHIN A DELEGATED
ENTITY.
ALSO IF PLANS CANNOT SHOW THAT
THEY CAN PROVIDE TIMELY ACCESS
TO CARE WE MUST ASSUME THEY ARE
NOT PROVIDING TIMELY ACCESS TO
CARE.
THE STATE SHOULDN'T BE WAITING
FOR A CONSUMER TO FILE A
COMPLAINT IN ORDER TO ENSURE
TIMELY ACCESS
SO THE DEPARTMENT SHOULD ALSO
REQUIRE HEALTH PLANS. TO ARRANGE
FOR CONSUMERS TO GO OUT OF
NETWORK IF THAT'S WHAT'S NEEDED
TO ENSURE TIMELY ACCESS.
I'M FINALLY WE ALSO ASK THAT
BOTH DEPARTMENTS IN FORCE AT
LANGUAGE ACCESS RATES FOR OUR
COMMUNITIES. WHO SPEAK ENGLISH
AS A SECOND LANGUAGE OR ARE
LIMITED ENGLISH PROFICIENT
HEALTH PLANS MUST MAKE SURE THAT
INTERPRETER SERVICES ARE
AVAILABLE AT THE TIME OF THE
APPOINTMENT THANK YOU?
THANK YOU WELCOME.
I KAREN SAVAGE CALIFORNIA PAN
ETHNIC HEALTH NETWORK AT ECHO
THE COMMENTS OF OUR PARTNERS AT
WESTERN CENTER AND BUT ALSO WANT
TO TOUCH A LITTLE BIT MORE IN
THE LANGUAGE ACCESS AND I'M SURE
THAT YOU ON NO OVER ONE THIRD OF
OUR MEDI CAL ENROLLEES ARE
LIMITED ENGLISH PROFICIENT. AND
SO THIS IS A VERY SIGNIFICANT
ISSUE. WHEN WE THINK ABOUT.
TIMELY ACCESS NETWORK ADEQUACY
AND AND WE.
THE AS OUTSIDE THE SPEAKER FROM
HEALTHAXIS SAID I'M APPOINTMENTS
CAN'T CANNOT BE DELAYED BECAUSE
OF A NEED FOR INTERPRETER
SERVICES AND SAID SOMETHING THAT
WE WOULD STRONGLY RECOMMEND. A
BOTH DEPARTMENTS CAN TO FIGURE
OUT HOW TO MEASURE AND ENFORCE
AND WE DO APPRECIATE THE
CONVERSATIONS THAT WE'VE HAD
WITH YOU MIGHT SEE ON THIS
ISSUE.
BUT AGAIN I THIS IS A THIRD OF
OUR MEDICARE POPULATION AND SO
WE REALLY NEED TO MAKE SURE
THAT'S TAKEN INTO CONSIDERATION.
AND I WOULD ALSO NOTE SORT OF ON
THE COMPLAINTS ISSUE FROM THE
LITTLE BIT OF DATA WE HAVE ABOUT
BOTH CALL CENTERS.
THERE ARE VERY VERY FEW AND
LET'S HAVE A PEOPLE SPEAK A
LANGUAGE OTHER THAN ENGLISH
CONTACTING OUR CALL CENTERS SO
COMPLAINTS ARE REALLY NOT GIVING
US THE INFORMATION WE NEED ON
THIS POPULATION THANK YOU.
THANK YOU. WELCOME.
I AM I WAS ABUSED FOR THE
CHILDREN'S DEFENSE FUND A
CALIFORNIA AND.
WE WANTED TO REQUEST CONTINUED
MONITORING AND ENFORCEMENT OF
THE TEN DAY I TIMELY ACCESS
STANDARD FOR PEDIATRIC WELL
VISITS AND AND MEDI CAL WE KNOW
THAT CHILDREN AND. FAMILIES IN
SOME RURAL AREAS HAVE TO MAKE UP
TO SIX LONG CALLS TO GET
APPOINTMENTS WITHIN THE
STANDARD.
THERE SOMETIMES TOLD THAT IS
BACK TO SCHOOL TIME ARE THEY
HAVE LOTS OF SPORTS PHYSICALS
AND SO.
THOSE SHOULDN'T BE PROBLEMS FOR
THE FAMILIES TO FACE. WE ALSO
ASK THE DATA BE DISAGGREGATED BY
AGE SO THAT WE KNOW AND SO WE
CAN DETERMINE SPECIFICALLY HAVE
CHILDREN OR.
FAIRING AND WE ASK THAT THERE
IS SOME A CLEAR PLAN FOR HOW D.
H. YES WILL MONITOR.
CHILDREN'S SEPARATELY FROM
ADULTS BECAUSE MY UNDERSTANDING
IS AS OF NOW THEY'RE THEY'RE
THEY'RE.
INTENDING TO CONTINUE TO
AGGREGATE THEM.
THANK YOU.
WELCOME.
I AM I'M. CHRISTIAN DOES KRISTIN
GOLDEN TEST WITH THE CHILDREN'S
PARTNERSHIP AND I WANTED TO
ALIGN MYSELF WITH THE COMMENTS
MADE BY MY PARTNER AT THE.
CHILDREN'S DEFENSE FUND ON AND
ALSO NOTE WE REALLY APPRECIATE
THAT YOU'RE HAVING THIS HEARING
CONSTANT A CONVERSATION AROUND
THE MONITORING. AND WE ARE BUT
ENGAGE WITH DID SEE US IN THEIR
ADVISORY GROUP.
AROUND THE NEW MEDICAID MANAGED
CARE MONITORING RULES
PARTICULARLY AROUND TIMELY
ACCESS WE.
WITH OUR PARTNERS HAD DONE A
LITTLE MANY.
SECRET SHOPPER SURVEY I'M
FOCUSING ON.
ON PRIMARY CARE FOR PEDIATRICS
AND FOUND IT WAS EXTREMELY LOW.
AROUND LIKE TWENTY FOUR PERCENT
AGAIN IT WAS A VERY SMALL SAMPLE
BUT AND IT WAS.
OF FLAG FOR US THAT THERE WAS A
CONCERN IN MEDICAID PARTICULARLY
AROUND PEDIATRIC CARE SO AGAIN.
AS WERE SAYING TO D. H. CS ON
WE WOULD LIKE TO SEE THAT THE.
AS REQUIRED BY AND FEDERAL LAW
AND STATE STATUTE NOW THAT THAT
IS BROKEN OUT BY PEDIATRIC CARE
SO THAT WE DO SEE HOW CHILDREN
ARE FARING UNDER THOSE STANDARDS
AND TIMELY ACCESS.
THANK YOU.
WELCOME.
BELOW THIRTY ABOVE THAT'S WITH
MATERNAL AND CHILD HEALTH ACCESS
AND LOS ANGELES WE'D LIKE TO
SUPPORT THE COMMENTS MADE BY
WESTERN CENTER ON LAW AND
POVERTY. AND JUST EXPRESS THAT
ON THE RESPONSIBILITY OF TIMELY
ACCESS DOES FALL ON THE PLAN.
AND FOR AN ENTITY WHO WORKS A
LOT ON ENROLLMENT. WE SPEND OVER
NINETY PERCENT OF OUR TIME
ADVOCATING FOR ACCESS ON ACCESS
ISSUES FOR MEDI CAL
BENEFICIARIES.
AND.
I JUST LIKE TO STATE THAT
COVERAGE HEALTH COVERAGE MEANS
NOTHING IF YOU CANNOT ACCESS
SERVICES.
THANK YOU.
USSO COUPLE THINGS ARE BROUGHT
THE PUBLIC COMMENT I HAVE THE
CAN COMMENT ON TO ONE IS
LANGUAGE.
SO CERTAINLY IN MY COMMUNITY IS.
THE ASIAN PACIFIC ISLANDER
QUEEN WE'VE THERE'S MANY
DIFFERENT LANGUAGES COURSE.
EXPANSION LATINO COMMUNITY HAVE
A WHAT WE DOING TO.
LANGUAGE ACCESS AND WHEN YOU
LOOK AT ACCESS STANDARDS SO.
I DON'T WANNA.
FOR ANY MEDI CAL THEN STILL EVEN
VERY.
FROM THE DEPARTMENT HEALTH CARE
SERVICES I'M FIRST OF
UNDERSTANDING.
THERE ARE REQUIREMENTS AS YOU
KNOW THAT.
LANGUAGE ACCESS BE PROVIDED
TWENTY FOUR HOURS A DAY SEVEN
DAYS A WEEK BY OUR HEALTH PLANS
AND THAT DOES INCLUDE LANGUAGE
ASSISTANCE LINE.
I'M SO THAT IN THAT IS AVAILABLE
TO OUR BENEFICIARIES AND IN
ADDITION TO THAT THOUGH WE HAVE
WE DO THINK THAT IT IS IMPORTANT
TO COLLECT INFORMATION ON
LANGUAGE ACCESS AND IN OUR NEW
MONTHLY.
DATA PROVIDER FILE THAT OUR
HEALTH PLANS ARE SUBMITTING TO
US WE ARE COLLECTING THAT
INFORMATION WERE IN THE PROCESS
RIGHT NOW OF CLEANING THAT UP AS
I WOULD SAY TO MAKE SURE THAT WE
HAVE ACCURATE INFORMATION BUT WE
BELIEVE THAT THAT WILL. GIVE US
NEW DETAILS ABOUT.
WHAT IS AVAILABLE TO OUR
BENEFICIARIES AS WE MOVE FORWARD
INTO THE FUTURE?
CERTAINLY SO THERE'S TWO WAYS TO
MAIN WAYS IN WHICH WE LOOK AT A
LANGUAGE ACCESS ISSUES ONE IS
DURING OUR ARE FUNCTIONAL ON
SITE AUDITS WERE POLLING. DATA
FILES THAT RELATE TO.
CONSUMERS WITH DIFFERENT.
SLATE LANGUAGES SPOKEN AT HOME
THE OTHERS WE'VE BEEN RIPPED
MEETING REGULARLY WITH.
PAN ETHNIC
IF NETWORK AND OTHER OUT
SEE ORGANIZATIONS ON HOW WE'RE
GOING TO INCORPORATE LANGUAGE
ACCESS
ACTIONS IN THE TIMELY ACCESS
SURVEY METHODOLOGY AND THERE
WILL BE A QUESTION FOR THE
TWENTY EIGHTEEN METHODOLOGY.
AND TERMS OF SOMEONE ALSO
MENTIONED THE LANGUAGE ACCESS
FOR OUR RESPECTIVE COMPLAINT
LINES ARE REPORTING LINES AND
ALSO JUST THE CLERK ALSO DECLARE
FIND DISH INTO LANGUAGE THAT.
WHEN PEOPLE.
MAKE A CALL THEY'RE NOT TOLD
WELL TALK TO THE HEALTH PLAN
FIRST DON'T TELL ME ANYTHING
UNTIL YOU TALK TO THEM FIRST SO
IT'S LIKE YOU DRESS BOTH
LANGUAGE ACCESS.
YOU KNOW TRIES TO MAKE A PHONE
CALL.
YOU DON'T SPEAK THE LANGUAGE AND
HEALTH RAPIDLY CAN THEY GET
SOMEONE TO HELP THEM AND DOES.
NOT BEING SENT TO OTHER PLACES
WHERE SO ON THEM SOMEONE ELSE
MAY NOT HAVE LANGUAGE ACCESS. TO
COMMIT TO HAVE FRUSTRATING I CAN
BE FOR SOME FAMILIES SO PERHAPS
DOES THAT. IF OUR MEDI CAL
MANAGED CARE.
OMBUDSMAN LINE WE DO HAVE
LANGUAGE ACCESS I'M BOTH IN
TERMS OF A TICKLER UP FRONT WHEN
YOU CALL AND AN INDIVIDUAL CAN
INDICATE THAT THEY NEED
ASSISTANCE.
FOR SOMEBODY WHO MAKES IT
THROUGH WHO MIGHT NOT.
FOR EXAMPLE I UNDERSTAND THAT
THEY NEED TO PRESS ONE TO GET
THROUGH FOR LANGUAGE ASSISTANCE
THAN.
OUR.
STAFF ARE TRAINED TO
IMMEDIATELY CONTACT THE
LANGUAGES IT SINCE LINE AND PULL
SOMEBODY AND SO THAT THEY CAN
ASSIST THAT INDIVIDUAL.
SIMILARLY AT THE DEPARTMENT
MANAGE HEALTHCARE'S CALL CENTER
WE HAVE ACCESS TO A LANGUAGE
LINE WE'VE ALSO DONE A VERY.
INTENSIVE EFFORT TO RECRUIT.
SPEAKERS OF DIFFERENT LANGUAGES
SO WE HAVE THEM ON STAFF SEE
DON'T HAVE THE DELAY OF THE
LANGUAGE LINE.
WE HAVE NOT BEEN SUCCESSFUL IN
RECRUITING WE STILL DO RELY UPON
THE LANGUAGE LINE UP WE REQUIRE
THAT THE HEALTH PLAN SIMILARLY
HAD.
CAPABILITY AND LANGUAGE
ASSISTANCE WITH AND WHATEVER THE
THRESHOLD LANGUAGES FOR EACH OF
THEIR PLAN.
BUT I THINK ONE OF THE THINGS
THOUGH IS IS THAT I JUST HEARING
FOOT ADVOCATES ARE TESTIFYING
WITH MY MISERY.
MAYBE GET COLLECT SOME DATA ON
ACTUAL CUSTOMER EXPERIENCE SO
YOU THINK OF A MECHANISM PLACE
MAY NOT BE WORKING AS WELL AS
MAY BE PERCEIVED UP. TOYS
CHALLENGE RIGHT SOMEONE THEY
CALL. SOMEONE IN ENGLISH START
SAYING WELL IF YOU SPEAK ENGLISH
PRESS ONE LES ASPIN OPUS TO
GREAT AND EXACTLY HOW THAT
ACTUALLY OPERATIONALIZE IS FOR.
SOMEONE WHO'S ACTUALLY CALLING
SO.
SO HOPEFULLY YOU CAN THAT WORK
WITH FOLKS THAT AND THEN.
SURE YES YES A CEREMONY THANK
YOU MISTER CHAIR JUST ON THE
LANGUAGE ISSUE WE WORKED ON SOME
OF THIS WITH.
OFFICE OF PATIENT ADVOCATE AND.
I THINK AS YOU SUGGESTED.
MOST PEOPLE ACCESSING COMPLAINT
LINES ARE ENGLISH SPEAKING.
AND SO. YOU NEED TO TAKE A STEP
BACK FROM YOU MIGHT HAVE THE
CAPACITY.
TO PROVIDE INTERPRETATION.
BUT.
IT'S
IT'S REACHING THE COMMUNITY.
I'M WITH INFORMATION THAT.
THERE IS.
A MULTI LINGUAL SERVICE
AVAILABLE COULD YOU COMMENT AS
TO HOW. THAT INFORMATION GETS TO
A COVERED.
PATIENT SO THAT THEY KNOW THAT.
THERE'S LANGUAGE CAPACITY.
MANY NON ENGLISH SPEAKERS
RELYING ON.
COMMUNITY NAVIGATORS THROUGH
LEGAL SERVICES OR. A.
CAN I JUST AN INFORMAL.
PROMONTORY IN THE COMMUNITY BUT
HOW ARE YOU TRYING TO GET WORD
TO THE COVERED.
PATIENT COMMUNITIES IT.
THERE IS LANGUAGE A CAPACITY AT
THE OTHER END.
YOU ARE SO WE DO HAVE.
NEW FEDERAL REQUIREMENTS THAT
WERE PUT INTO PLACE THAT WE HAVE
IMPLEMENTED AND THAT DO REQUIRE
US TO INCLUDE I BELIEVE IT'S
SIXTEEN DIFFERENT TACK.
TO ARE BENEFICIARIES SO IF OF
FOR EXAMPLE.
AND LET A LETTERS MAILED IN
ENGLISH BUT THE INDIVIDUAL DOES
NOT SPEAK OR READ ENGLISH THAN
THAT INFORMATION. IS INCLUDED IN
THE TAG LINE THAT LETS THEM KNOW
WHO THEY NEED TO CALL
ACT AND HOW THEY CAN GET THAT
INFORMATION IN THEIR LANGUAGE
THAT THEY MAY READ OR SPEAK.
AND THAT WOULD ADD TO THAT.
WHEN YOU WERE TALKING ABOUT THE
BOOTS ON THE GROUND KIND OF THAT
LOCAL COMMUNITY WE DID IT WE DO
HAVE THE CONSUMER ASSISTANCE
PROGRAM THAT WE SUPPORT IT WAS.
A DISCUSSED EARLIER IN THE
CONSUMER PAPA PROPOSAL RELATED
TO OUR BUDGET WHERE WE HAVE
CONTRACTS WITH THAT IS THAT
CURRENTLY THE COMPETITIVELY BID
BUT THE CRIME.
BASICALLY THE LEGAL AID
ORGANIZATIONS ARE OUT HOW.
THROUGH.
DOES HEALTH CONSUMER ALLIANCE
TO DO OUTREACH IN THE LOCAL
COMMUNITY.
WE HAVE A HEAVY FOCUS ON A.
LANGUAGE BECAUSE OF THE LOW
CONTACT RATE OF THOSE THAT ARE
NOT PART.
SPEAKERS.
I KNOW THE OFFICE OF PATIENT
ADVOCATE IS ONE PORTAL.
I'M IN YOU ALSO RECEIVE BECAUSE
DIRECTLY.
A TEAR AGENCIES ON.
IS THERE AGGREGATED DATA THAT
YOU CAN SHARE WITH US THAT SHOW
THE NUMBER.
TOTAL NUMBER OF.
COMPLAINING COURSEWORK CAME
INTO.
OFFICE PATIENT ADVOCATE DIRECTLY
THE. DAMAGE SEEING I'M IN HAVE
YOU SHARE INFORMATION WITH EACH
OTHER PARTLY SO I WILL SAY THAT.
I'M NOT IS INTIMATELY FAMILIAR
WITH THE OFFICE THE PATIENT
ADVOCATE IS COLLECTING ALL OF
THE COME
DATA FROM.
THE TWO THAT ARE REPRESENTED
BEFORE YOU WAS WAS THAT
CALIFORNIA DEPARTMENT OF
INSURANCE AND COVER CALIFORNIA
AND AGGREGATING ALL OF THAT
INFORMATION INTO AN ANNUAL
REPORT IT DOES NOT GET TO THE
GROUND YOUR LEVEL OF LIKE. DID
THEY CALL THE DAMAGE THE FIRST
AND THEN WE REALIZED IT WAS A
COUNTY ORGANIZED HEALTH SYSTEM
PLAN SO WE WARM TRANSFERRED OVER
TO THAT IT DOESN'T IT DOESN'T
GET DOWN TO THAT GRANULARITY.
WE CAN CERTAINLY THE SEEN OUR
OWN DATA FOR THOSE THAT ARE
CONTACTING US.
DID THE CONTACT US DIRECTLY WAS
A WARM TRANSFER FROM SOMEWHERE
ELSE DID WE WARM TRANSFER IT TO
ANOTHER LOCATIONS WE NAY ASSUME
THAT.
DATA WOULD INCLUDE IF IT WAS A
LANGUAGE OTHER THAN ENGLISH WE
CAPTURE ON EVERY SINGLE PHONE
CALL IN EVERY SINGLE
COMMUNICATION THAT WE HAVE THE
PREFERRED LANGUAGE OF THE
INDIVIDUAL WERE INTERFACING
WITH.
WE SIMILARLY HAVE THE SAME
PROCESS IN PLACE.
THANK YOU BUT IT IS OH PA THAT'S
KIND OF PULLING THAT ALTOGETHER
FROM ALL THE. AGENTS
AGGREGATING.
THANK YOU
.
BOB SO THE OTHER THING CAME UP
PUBLIC COMMENT BEING A
PEDIATRICIAN I HAVE TO ASK. OF
KIDS SO THIS AGGREGATING BY AGE
SO THAT WE CAN THAT A FIRE
SPECIFICALLY ACCESS FOR
PEDIATRICS.
IT'S SO IT IS A REQUIREMENT IN
THE MANAGE CARE FINAL RULE AND
IN AB TWO OH FIVE THAT WE DO TO
SEGREGATE BY.
PEDIATRIC AND ADULT FOR
SPECIALTY CARE IN PRIMARY CARE
SO THAT IS SOMETHING THAT THE
DEPARTMENT HEALTHCARE SERVICES
WILL BE ENGAGING AND EFFECTIVE
JULY ONE.
BUT STILL I GUESS THIS JULY ONE
TWENTY EIGHTEEN CRACK THANK YOU.
I THINK IN IN OUR TIGHTLY ACCESS
SURVEY WE DO IDENTIFY CERTAIN
SPECIALTY TYPES THAT BOMB LIKE
PEDIATRICIAN THAT ARE
SPECIFICALLY TOWARDS KIDS FOR
PROVIDER TYPES THAT SERVED BOTH
IT'S MUCH MORE DIFFICULT FOR.
TWO ON.
NO
WHETHER NOT THERE'S A SPECIFIC
PEDIATRIC ISSUE BUT FOR THE
SPECIALTY TYPES WHERE THEY
SPECIFICALLY HAVE A PEDIATRIC
SUBSPECIALTY OF WHATEVER THE
SPECIAL
THE TYPE IS THEN WE CAN CAPTURE
THAT BUT IT'S HARDER WHEN WE'RE
DEALING WITH PROVIDERS THAT DEAL
WITH BOTH.
ADULTS AND JUVENILES WAS AN
EXPERT PEDIATRIC WORKFORCE I CAN
GIVE YOU SOME ADVICE THEY'RE I
WOULD LOVE IT. OKAY.
BECAUSE THE UNDER CERTAIN
CONDITIONS IT BY SOME THAT
ADULTS CAN TAKE CARE OF BUT
COSTS CERTAIN ONES YOU HAVE TO
HAVE A PEDIATRIC.
SPECIALIST.
AND WORKED ON.
OKAY.
ANYTHING ON.
OKAY SO I THINK.
THAT.
.
PEPCID. THIS.
I AM OVERSIGHT ITEM.
SO WHAT WE'RE GOING TO TO
ACTUALLY.
IS IS THAT SO I THINK WE'RE.
DOWN THE MEAT SEE WE HAVE SOME
STUFF WE NEED TO FOLLOW UP ON
AND US SO I LOOK FORWARD TO
GETTING THE INFORMATION.
.
AND.
I THINK. WHAT WE'RE GOING TO DO
IS SO WE'RE GOING TO ACTUALLY
SKIP TO DEMAND SEE ISSUE NUMBER
NINE BECAUSE AND BECAUSE IT
DEALS WITH MANAGED CARE SO
FIGURE JUST THAT WAY WE GET THAT
OUT THE WAY AND THEN WILL FLIP
OVER TO THE? OVER SEVENTY EIGHT
CSI.
SO.
NUMBER SEVEN OLYMPIC NUMBER
SEVEN START THAT HAS TO DO WITH
THE.
IMPLEMENTATION OF THEM FEDERAL
MANAGED CARE REGULATIONS.
.
SELL IT WILL GO BACK AND DO THE
OVERVIEW BECAUSE.
SUCH AS ALL SINCE THESE ALL HAVE
TO DEAL WITH TIMELY AT A GUESS
ACCESS STANDARDS.
ALRIGHT SO I KNOW WE HAVE A FEW
PEOPLE AROUND THE TABLE SOLD
JUST THAT QUICKLY DO THE
ROUNDABOUT INTRO AND THEN.
WILL GO INTO ISSUE NUMBER SEVEN
RELATED TO THIS APARTMENT OF.
HEALTH CARE SERVICES.
NOW.
THE AGENCY OUR.
H. AGENCY OF SORRY WE'RE JUST
GOING AROUND OUT IN INTRODUCTION
CN. THEN FOR KENT PARK AND
HEALTH CARE SERVICES IF YOU ARE
BROOKS DEPARTMENT OF HEALTH CARE
SERVICES ALEJO.
BRENT METZ CARRILLO.
BRIAN WAS THE LA ON.
FINANCE.
DISCUSSING HIS FINANCE.
WELL ABOVE MONDAY BECAUSE
FINANCE THANK YOU ALL RIGHT SO
WE PRESENT ON ISSUE NUMBER
SEVEN.
RANKS THE FEDERAL MATCH CARE
REGULATION OF PETITIONS
THINKING.
SURE SO.
THE PREVIOUS CONVERSATION LEADS
RIGHT INTO THIS AND THAT WE ARE
REQUESTING ONGOING EXTENSION FOR
NINE.
LIMITED FOR TERM POSITIONS WITH
AN EXPENDITURE AUTHORITY OF
APPROXIMATELY ONE AND A HALF
MILLION DOLLARS GENERAL FUND AND
MATCHING FEDERAL FUNDS.
THESE ARE POSITIONS THAT ARE.
GONNA CONTINUE TO HELP
IMPLEMENT SOME OF THE MANAGED
CARE RULES AND THEN WE HAVE
ADDITIONAL FUNDING REQUESTS FOR.
AN EXTERNAL QUALITY REVIEW FIVE
CONTRACT SO THAT WE CAN HAVE AND
SOME OF THOSE.
REQUIREMENTS BUT COMING FROM
ELIOT.
FINANCE.
DEPARTMENT FINANCE SUPPORTS THIS
PROPOSAL BELIEVE THESE RESOURCES
ARE APPROPRIATE FOR THE OUR WORK
FORCE NEEDED TO CONTINUE THE.
EFFECTIVE EFFICIENT
IMPLEMENTATION OF THE FEDERAL
MANAGED CARE REGULATION THANK
YOU. THANK YOU. ARE QUESTIONS
FROM COMMITTEE MEMBERS.
OUR PUBLIC COMMENT ON THIS ITEM.
SEEING NONE ALRIGHT SO.
.
SO WE WERE GOING TO.
HOLD THAT OPEN.
BUT THAT CERTAINLY AND WE WANT
TO BE SURE THAT. YOU KNOW THAT
THERE'S A STAFF NEEDED TO
COOPERATE THOSE CHANGES.
.
BUT I THINK CERTAINLY AS THE
VOTE SINCE MY DISTRICT IS A AT
WHAT ONE THE COUNTIES MIGHT.
IS A IG.
THE I I HOPE WE CAN HAVE A FOR
THE DIALOGUE ABOUT.
THE.
OBVIOUSLY THIS WILL IMPACT BUT
ALSO GIVEN THE STATE'S ROLE FOR
OUR GEOGRAPHIC WHICH WILL
DIFFERENT THAN SOME BECAUSE
COUNTIES AND SO FORTH.
AROUND.
WHO'D WHO'S RESPONSIBLE FOR
OVERSEEING.
.
MEDI CAL OVERALL AND IN
SACRAMENTO COUNTY AND WE HAVE
SEVEN PLANS AND SEVEN INDIVIDUAL
PLANS BUT.
WE NEED MORE COMPREHENSIVE.
YEAH. WE NEED TO HAVE SOME
DIRECTIONS THAT WE CAN ACTUALLY.
MAKE A MEDICAL SYSTEM WORK
BETTER NEBULOUS SO. THAT THAT'S
NOT TOTALLY RELATE TO THAT
FEDERAL BUT SOME OF THE SUBTLE
STUFF MAY IMPACT AS WELL.
SO APPRECIATE YOUR HELP THERE.
OKAY SO WITH THAT WE'RE GOING TO
HOLD THAT ITEM OPEN AND WE'RE
GOING TO GO BACK TO ITEM NUMBER
ONE THE OVERVIEW.
SELF.
RIGHT CONSIDERABLE SAME PEOPLE
AT THE TABLE WHAT'S GOING TO
BEGIN THE INTERVIEW.
SO AND THINK YOU VERY MUCH.
SO THE GOVERNOR'S BUDGET IS
PROPOSING FOR A TOTAL OF A
HUNDRED AND FOUR POINT FIVE
BILLION DOLLARS FOR THE SUPPORT
OF THE DEPARTMENT.
APPROXIMATELY TWENTY ONE POINT
NINE BILLION A STATE GENERAL
FUND SIXTY SEVEN POINT NINE
BILLION IS FEDERAL FUNDS AND
FOURTEEN POINT EIGHT BILLION IS
IN SPECIAL FUNDS.
OBVIOUSLY A SIGNIFICANT.
PORTION OF THAT IS RELATED
DIRECTLY TO THE MEDICAL PROGRAM
BUT THOSE.
NUMBERS IN WHICH I JUST
MENTIONED ALSO INCLUDE SOME OF
THE OTHER SMALLER PROGRAMS THAT
WE OFFER I'M IN CALIFORNIA SUCH
A CCS G. HPP. SOME OF THOSE.
.
NOTABLE CHANGES IN THE
GOVERNOR'S BUDGET OR.
INITIATIVES.
I WILL START FIRST WITH
CASELOAD FROM THE STANDPOINT
THAT WE'RE PROPOSING.
AND SEEN THAT WE EXPECT ABOUT
THIRTEEN AND A HALF MILLION I
CALIFORNIANS WILL BE ON THE
PROGRAM.
WHICH MEANS WERE ESSENTIALLY
KIND OF AT A FLAT
GROWTH AND THERE HAVE BEEN SOME
CHANGES IN INCREASES IN THE A CA
OPTIONAL EXPANSION POPULATION.
AS WELL AS AND SENIORS AND
PERSONS WITH DISABILITIES BUT WE
CONTINUE TO SEE DECREASES AND
THE FAMILY AND CHILDREN EIGHT
CODES.
I WOULD SAY YOU KNOW GIVEN THAT.
LOW UNEMPLOYMENT RATE IN
CALIFORNIA I THINK THAT'S
PROBABLY ONE OF THE KEY REASONS
BUT AND YOU KNOW WE'RE
CONTINUING TO TRACK THAT BUT SEE
NOTE MAJOR CHANGES IN CASELOAD.
HOLDING ALL OTHER ON THINGS.
STEADY.
A.
IN THE PROPOSITION FIFTY SIX.
ALLOCATION FOR THE GOVERNOR'S
BUDGET THERE'S A ADDITIONAL TWO
HUNDRED AND THIRTY TWO MILLION
DOLLARS PROPOSED.
TO BE AND PROVIDED IN BOTH
POSITION AND DENTAL RATES WILL
BE OBVIOUSLY WORKING AND COMING
FORWARD WITH A MORE REFINEMENT
AND THAT.
IN THE MADE GOVERNOR'S ME
REVISION.
WE'RE ALSO PROPOSING A FIFTY
PERCENT RATE INCREASE AND HOME
HEALTH AGENCY RATES USING
PROPOSITION FIFTY
IT'S MONEY. THAT'S ABOUT SIXTY
FOUR AND A HALF MILLION DOLLARS
TOTAL FUNDS OF WHICH THIRTY ONE
WOULD BE ON PROPOSITION FIFTY
SIX.
I WOULD LIKE TO JUST MAKE SURE
THAT THE COMMITTEE.
UNDERSTANDS THAT THESE RATE
INCREASES ARE ONLY IN THE FEE
FOR SERVICE AND IN THE WAIVER
PROGRAMS THAT WE OPERATE NOT IN
MANAGED CARE.
WE ARE.
AS I SAID COULD BE PROVIDING AS
MUCH DETAIL AS WE CAN.
AROUND THIS PROPOSITION FIFTY
SIX SUPPLEMENTAL PAYMENTS ON
WITH THE GOVERNOR'S MAY
REVISION.
SPECIFICALLY WERE LOOKING AT
HOW THAT DATA IS COMING AND IN
TERMS OF UTILIZATION AND.
HOW THE PAYMENTS HAVE GONE OUT
TO THAT PROVIDERS WHETHER IT'S
CHANGED ANY KIND OF UTILIZATION
OR ACCESS?
?
CHIP FUNDING OF THE GOVERNOR'S
BUDGET WAS DONE AT A POINT IN
WHICH CONGRESS HAD NOT YET
REAUTHORIZE THE CHILDREN'S
HEALTH INSURANCE PROGRAM SO THEY
WILL BE AN ADJUSTMENT. IN MAY
AND TO ACCOUNT FOR THE FACT THAT
IT WAS REAUTHORIZED BUT I'D AND
EIGHTY EIGHT PERCENT.
I FEDERAL LEVEL AS OPPOSED TO
THE LEVEL THAT'S CURRENTLY
REFLECTED IN THE BUDGET AT AT
SIXTY FIVE SO FROM A GOOD NEWS
PERSPECTIVE. THEY REAUTHORIZED
THEY BOTH REAUTHORIZE THE
PROGRAM BUT THEY REAUTHORIZED AT
A HIGHER MATCHING I RATE WILL BE
ACCOUNTING FOR THAT AND THE MAY.
PROPOSAL.
THERE ARE SOME.
CHANGES.
THAT WE WOULD NO AND I THINK
YOU'RE.
STOPS RIGHT AT DID A VERY NICE
JOB OF ST AND WE'RE GONNA. WERE
PROPOSING RIGHT NOW AND THERE'S
ABOUT A HALF A BILLION DOLLARS
AND.
INCREASES IN SPENDING THAT WERE
NOT OTHERWISE ACCOUNTED FOR IN
THE ESTIMATE.
SUMMER AROUND MANAGED CARE I'D
CHANGES OF WHICH IS ABOUT THREE
HUNDRED AND TWENTY EIGHT MILLION
DOLLARS. THE BULK OF WHICH THESE
ARE INDIVIDUALS.
.
THAT WORD TOOL ELIGIBLE THAT
WERE OTHERWISE PLACED INTO EIGHT
CATEGORIES THAT ARE AT HIGHER
MATCHING LEVELS SO WE HAD TO
WORK CLOSELY WITH THE COUNTIES
TO IDENTIFY WHO THOSE PEOPLE
WERE. PUT THEM INTO A DIFFERENT
EIGHT CODE AND NOW WE'RE HAVING
TO PUT THAT MONEY BACK TO THE
FEDS BECAUSE WE MASTER DATA. AT
A RATE THAT WAS NOT APPROPRIATE
ON SOME OF THE OTHER CHANGES IN
THE ESTIMATE THAT ARE OF NOTED
IN THAT.
AGENDA AROUND DRUG REBATES SAME
ISSUE.
WHEN WE RETURN AYE REBATES TO
THE FEDERAL GOVERNMENT WE
USUALLY DO IT ON A FIFTY PERCENT
MATCHING BASIS WHEN WE.
SORT OUT.
THAT ADULT.
EXPANSION EIGHT CODES WHICH ARE
MATCHED AT A MUCH HIGHER RATE AS
WELL AS IF THERE'S AND CHILDREN
IN THE CHIP PROGRAM ALL OF THOSE
FEDERAL AND MATCHING PERCENTAGES
CAN THROW OUR REBATES OFTEN SO
THERE CERTAINLY.
AN INDICATOR THAT WERE HAVING
TO PAY BACK.
SOME REBATES TO THE FEDERAL
GOVERNMENT THAT WE SHOULD HAVE
AND.
DONE LAST YEAR.
AND THEN.
SOME OF THE OTHER KIND OF KEY
CHANGES THAT I WANTED TO PUT A
HIGHLIGHT ON AND ARE AROUND.
THAT THREE FORTY BE PROPOSAL
WHICH WE WILL TALK ABOUT IN MORE
DETAIL LATER ON IN THE AGENDA.
AND THEN WANT TO MAKE SURE THAT
WE AND.
DON'T FAIL TO MENTION THE
ONGOING IMPLEMENTATION OF THE
DRUG.
MEDICAL ORGANIZED DELIVERY
SYSTEM.
INITIATIVE SAID THIS IS
CONSISTENT WITH OUR ELEVEN
FIFTEEN WAIVER AND THE.
GOVERNOR'S BUDGET NOTES THAT WE
EXPECT HAVE FORTY COUNTIES
PARTICIPATING.
BY THE END OF TWENTY EIGHTEEN
NINETEEN.
OF A SIGNIFICANT NUMBER OF
THOSE COUNTIES.
NINE I BELIEVE ARE EXPECTED TO
COME IN THREE PARTNERSHIP HEALTH
PLAN SO VERY RURAL COUNTIES THAT
WOULD OTHERWISE NOT BE ABLE T
REALLY KIND OF. CREATE THAT FALL
INTO AND.
SPECTRUM OF SERVICES AND SO
WE'RE VERY EXCITED TO BE WORKING
AND NOT.
PARTNERSHIP.
MODEL WHICH WILL BE CERTAINLY
KNEW FOR THE COUNTIES AS WELL
AND I'M HAPPY TO ANSWER
QUESTIONS ON THE OVERVIEW.
SO SOUNDS LIKE ACTUALLY BECAUSE
WE HAVE NUMBER TWO ITEM NUMBER
ISSUE NUMBER TWO WAS JUST THE
MEDICAL ESTIMATES ONLY COVERED
MOST OF THAT AS WELL SO YOU CAN
AND YOU GAVE ME AN OPPORTUNITY
AND I TO ERICA OKAY SO WHERE
WERE ACT SO WE'RE ACTUALLY
GOING.
TOGETHER.
AT IT ANY COMMENTS FROM LA OVER
AN ISSUE ONE AND TWO.
THANK YOU MISTER CHAIR OUT WE
REVIEWED.
THE BUDGET FOR THE DEPARTMENT
HEALTHCARE SERVICES AND THE
MEDICARE PROGRAM AND.
HAVE SEVERAL COMMENTS IN OUR
ANALYSIS OF THE HEALTH AND HUMAN
SERVICES BUDGET REPORT. WITH
RESPECT TO THE CASELOAD
ESTIMATES.
WE FEEL THAT THOSE ARE
REASONABLE AT THIS TIME IT WILL
BE REVISITING THEM.
WHEN UPDATED ESTIMATES ARE
PROVIDED THEM A REVISION WE HAVE
COMMENTS ON SEVERAL OTHER ISSUES
THAT WE UNDERSTAND WILL BE
ADDRESSED LATER TODAY OR A
DIFFERENT HEARING SINCE IT WILL
HOLD OUR COMMENTS.
ON THOSE UNTIL THAT TIME OKAY SO
NO OTHER ISSUES ON WHAT INTO
OKAY.
RIGHT FINANCE.
ALL RIGHT OF CENTER MONEY.
SEE YOU DRESSED AS THE SHIP
PROGRAM ADJUSTMENT. THAT WAS
GOOD NEWS ARM.
THE PROJECTED FEDERAL
CONTRIBUTION IS THERE.
ANY CONCERN ABOUT LACK OF.
FEDERAL GOVERNMENT.
.
SUPPORT FOR THESE ONGOING
PROGRAMS.
WELL AND CHIP WAS REAUTHORIZED
FOR TEN YEARS SO I THINK THAT
WAS CERTAINLY.
GOOD NEWS FROM THE STANDPOINT
THAT THAT'S A STABLE.
ACKNOWLEDGEMENT AND YOU KNOW
OBVIOUSLY SPEAKS TO THE
IMPORTANCE ON THAT BOTH YOU KNOW
STATES IN THE FEDERAL GOVERNMENT
PLACE NOT PROGRAM. I KNOW THAT
WE CONTINUE TO OBVIOUSLY MONITOR
FEDERAL.
ACTIVITY AROUND THE GLOBE ON
THE PRESIDENT'S BUDGET.
ANY POTENTIAL CHANGES TO THE
MEDICAID PROGRAM BUT AT THIS
POINT ON THE GOVERNOR'S BUDGET
IS.
REFLECTING WHAT IS EXISTING
FEDERAL AND STATE LINE AND SO
ALL OF OUR BUDGET IS PREDICATED
ON THE.
THANK YOU SO IT'S.
IF YOU SAY PREDICATED ON THE
STATUS QUO EN.
KEEPING OUR FINGERS CROSSED
THAT.
IT DOESN'T GET CHANGED
RIGHT.
THANK YOU.
THANK YOU SO MUCH FOR YOUR
PRESENTATION IN TERMS ACTUALLY.
BECOMES THE OVERVIEW I KNOW
THAT.
WE MAINLY TALK ABOUT MEDI CAL
AND.
THE.
SO OF THE GENERAL FUND PART BUT
THERE'S OF SEE SUBSTANTIVE.
AMOUNTS OF.
FUNDS.
GOING THROUGH THIS SPECIAL
FUNDS.
.
SO I JUST WANTED JUST CHECKING
ON US.
COUPLE HERE.
.
SO WHERE SHE ONE THEY JUST WANNA
MAKE NOTES UPS LAST YEAR IS A
PRESENTATION AROUND.
THE GENIE SPECIAL FUND FOR
PUBLIC HOSPITALS AS AN
OPPORTUNITY FOR A MATCH AND I
SEE THAT IT'S NOW IN THE BUDGETS
I ASSUME WE WERE SUCCESSFUL IN
DRAWING DOWN THIS FUN.
FOR THAT.
EITHER DOESN'T IT TOUGH PUBLIC
ALSO JIMMY SPECIAL FUND THAT
THINK WE ARE WORKING ON TO
SECURE FEDERAL APPROVAL OKAY I
DON'T ADDITIONAL FUNDS BUT I
THINK. WE WORSE KIND OF.
PUTTING IT IN THE BUDGET TO THE
EXTENT THAT IT'S APPROVED OUT
OKAY I EXISTS IDEA STATUS CHECK
SO IT'S STILL PENDING ALRIGHT
I'D VISIT THROUGH THE NUMBER
MEANT YOU GOT IT OR NOT SO OKAY
IT THAT'S PENDING ALRIGHT SO
THAT'S.
DOES Y. CLARIFY THAT.
AND THEN I.
THE CHILDREN'S HEALTH AND HUMAN
SERVICES FUND.
I UNDERSTAND IS ACTUALLY KIND
OF BEING TRANCE
FOR OVER TO ANOTHER FUND.
IS IT GOES FROM NO FOUR HUNDRED
SOME MILLIONS ZERO.
AND THEN.
.
SO.
KEYED TO SPEAK TO WHAT YEAH
FINANCE YEAH YEAH SO WELL AND
NOT GIVE A DEADLY DIRECTORS LIKE
RATINGS IN GODRICH SPECIAL FOR.
HER WELCOME INDICATES DEPARTMENT
OF FINANCE AND THE CHILDREN'S
HEALTH AND HUMAN SERVICES FUND
IS THE FUNDS FOR THE. PREVIOUS
MCO TAX AND RIGHT NOW WE HAVE A
NEW FUND.
WHICH IS AND I KNOW THE NUMBER
BUT THE FINE NAME IS A LITTLE
TRICKY SO. THREE THIRTY TWO
TWENTY THREE I BELIEVE BUT.
THE NEW MCO TAXES IS ANOTHER
FUND NOW SO WE'RE ASSUMING THAT
ALL OF OUR OBLIGATIONS FOR THE
PREVIOUS MCO TAX WILL BE TAKEN
CARE OF. IN.
SEVENTEEN EIGHTEEN OKAY BUT I
WOULD ALSO NOTE THAT THE.
THE GOES FROM FOUR HUNDRED
MILLION TO ZERO BUT THE INCREASE
IN THERE AND THIRTY TO NINETY
THREE WHICH I BELIEVE IS
TRANSFERRED ACTUALLY.
ONLY GOES UP BY ABOUT.
A ABOUT A HUNDRED FIFTY MILLION
SO SOUNDS LIKE IT'S LIKE THREE
HUNDRED MILLION ARE.
OKAY TUTOR FIFTY MILLION DOLLAR.
LOS OR SOMETHING THERE AND THAT
I MEAN I JUST WONDERING HOW IT'S
BECAUSE THAT'S WHAT MONEY.
SO WHAT HAPPENS IS THAT AT
THIRTY ONE FIVE THREE THE
CHILDREN'S HEALTH AND HUMAN
SERVICES FUND I UNDERSTAND GETS
TRANSFERRED OVER FROM THE MC
ATTACK.
IT'S CURRENTLY ANALYSTS FOUR
HUNDRED TWENTY EIGHT MILLION I'M
NOT GO THROUGH ALL THE DIGITS.
BUT AND THEN IT GOES AYE AND
STAND IN TWO THREE TWO NIGHTS
THREE IS HEALTH AND HUMAN
SERVICES SPECIAL FUND.
WHICH AT LEAST FOR.
THE UPDATED NUMBER FOR THIS
YEAR'S TWO POINT THREE SIX
SEVEN BILLION.
AND THEN THAT'S ONLY BUDGETED
FOR TWO POINT FIVE ONE NINE
BILLION.
SO THE INCREASE IS MUCH SMALLER
THAN THE DROP.
AND THESE CHILDREN WHAT
BASICALLY THE ABOUT THE
CHILDREN'S FUND WAS BEFORE SO I
WONDER IF YOU COULD SPEAK TO
THAT. DIFFERENCE THAT'S TWO
HUNDRED FIFTY MILLION. THAT
SEEMS LIKE IT THE.
SOME THAT WERE NOT GETTING
ANYMORE WILL ITSELF VIA.
THE ONLY THING I'LL AND WE CAN
THAT WE FOLLOW UP WITH YOUR
STAFF IS THAT THERE'S THE NEW
MCO TAXES ENROLLMENT BASE AND
OUR TIME PLEASE I PARK ME IF I'M
WRONG.
SO THERE'S
SORT OF A DIFFERENT STRUCTURE.
IN TERMS OF HOW WE BUDGET FOR
THE NEW MCO TAX BUT WE'RE HAPPY
TO FOLLOW UP WITH YOUR STAFF TO
GET YOU MORE AND SPECIFIC
INFORMATION OKAY. SERVICES.
LOOKING AT THESE PARTIALLY
BECAUSE OF THE FRANK WHAT
HAPPENS IS THAT PEOPLE COMING UP
HERE AND.
THEY ARE TWENTY FIVE MILLION
DOLLAR REQUEST A TWO MILLION
DOLLAR REQUEST AND NOT TWO
HUNDRED FIFTY MILLION I'M NOT
SURE WHAT HAPPENED TO.
ACT FUND A LOT OF REQUESTS YET
SO. I NEED I'M SURE DOES A GOOD
EXPLANATION BUT. YOU KNOW I JUST
DELTA OBVIOUSLY MEDI CAL IS A
PRETTY LARGE PROGRAM IN THESE
FUNDS AND SO.
BUT AND AS A MATTER OF SCALE.
I JUST THOUGH WE WILL I LOOK AT
WHERE WORTH WORTH THINGS ARE.
LATER THINGS ARE GOING SO.
.
DON'T WORRY I'M NOT ABOUT TO GO
THROUGH EACH ONE OF THESE.
BUT.
BUT I DO WANT TO BE SURE WE PAY
ATTENTION TO THEM I MEAN
I KNOW WE SPEND MOST OF THE TIME
TALK ABOUT THE GENERAL FUND BUT
WE ALSO AND FREQUENTLY THEIR
PROPOSALS THEY WILL NOT TAKE
SOME MONEY FROM THE SPECIAL
FUNDS AND MOVE IT OVER SO.
AND THAT YOU KNOW.
WHEN YOU ADD IT ALL UP. THAT'S
NO THERE'S A LOT THERE'S A LOT
STUFF GOING ON THERE NOW SPECIAL
FUNDS ARE DOZEN A FIRST
PARTICULAR PURPOSES SO WE HAVE
TO RESPECT THAT TO SELL NOT
SAYING. BUT I THINK IT'S
IMPORTANT UNDERSTAND BECAUSE.
THERE'S PURPOSES MAY NEED BACK
FILLING THEY MAY BE VERY ITS ERA
SO WE JUST.
MY FUNNY BE CAREFUL BE SURE THAT
THEY'RE MEETING THE NEEDS.
OKAY.
.
AND THEN.
IN TERMS OF.
OVERALL APPRECIATE THAT WILL
GET THE UPDATE ON THE CASE AND.
BARRING ANY RECESSION WHERE WILL
HAVE A BUMP UP IN CASELOAD
HOPEFULLY WE KEEP THE ECONOMY
GOING I'M SURE GOVERNOR BROWN
WORK HARD TO MAKE THAT HAPPEN.
I KNOW THAT WE'RE GONNA HEAR
SOME MORE ABOUT THE PROP FIFTY
SIX FUNDING THAT'S A VERY
IMPORTANT AND I THINK WE'LL
PRIDE DELVE INTO THAT MORE IN A
FEW.
HEARING.
.
THE OTHER THING I JUST WANT
TOUCH ON BECAUSE I DON'T THINK
WILL PRY TALK ABOUT IT VERY MUCH
AGAIN SO SCHOOL BASED MEDI CAL
THE MA AND ALLEY A AYE LOOKS
LIKE WORKERS THE STATE'S
STEPPING AND ESSENTIALLY.
KIND OF BACK ARE FILLING IN FOR
THE GAP BUT BASICALLY THIS FEDS
CAME DOWN AND SAID NO WE'RE NOT
COUNTING THIS AND SO WE'RE
STEPPING AND SO THAT WE DON'T
HAVE TO HIT OUR SCHOOL
DISTRICTS.
FOR SOME OF THESE THINGS RIGHT
ARE. I NOTICED THE.
US WE ARE YES AND NO I MEAN.
DCS THE SINGLE STATE AGENCY HAS
A RESPONSIBILITY TO.
MANAGE THAT THE FEDERAL FUNDS
WITH THE WITH THE FEDERAL
GOVERNMENT AND SO WHAT THE
BUDGET.
ASSUMES I'M WITH THE.
THE CLAIMS THAT WERE CONSIDERED
YOU KNOW NOT ALLOWABLE. IS THAT
DCS ADDED THEIR BUDGET WILL USE
GENERAL FUND TO REPAY THE
FEDERAL GOVERNMENT.
AND THEN THE OUT OF THE TRIP
DOLLARS OUT OF THE PROP NINETY A
CALCULATION.
THERE IS A POT OF FUNDS THAT
WILL BE USED FROM ELEAZAR WHERE
THEY OVER THE FEDS MONEY.
IT BASICALLY WILL WILL COME OUT
OF THAT POT AND SO THERE'S A NET
ZERO IMPACT ON THE GENERAL FUND.
AT THE END OF THE YEAR AS WELL
TO WANT THINGS THAT I JUST
WANTED TOUCH ON STICKLEY ROUTE
SO. I ALSO SERVE ON THE
EDUCATION COMMITTEE AND I KNOW
THAT MAY MY COLLEAGUES.
AS WE'RE LOOKING AT THE NEED
FOR.
.
MENTAL HEALTH SERVICES OTHER
HEALTH CARE SURVEY OF PEOPLE
ONLY A CHILDREN'S CHRONIC
CONDITIONS WE WANT THEM TO GET
EDUCATED TEND SCHOOL SO
SOMETIMES A HEALTH CARE
SERVICES.
HE'D BE TAKING CARE OF IN SCHOOL
SETTINGS AND SO FORTH.
THAT WE ACTUALLY TRY TO FIGURE
HOW WE MAXIMIZER OPPORTUNITIES
FOR FEDERAL AND.
FUNDS THAT THROUGH THE MEDICARE
PROGRAM FOR HEALTH SERVICES THAT
MAY BE DELIVERED THROUGH SCHOOL
SETTINGS.
I HOPE WE CAN.
THE L..
FEE MORE RIGOROUS ABOUT TRYING
TO FIGURE OUT THOSE
OPPORTUNITIES. WE.
DON'T DO SO WELL AS A STATE
COMPARED TO OTHER PLACES AND I
KNOW THAT WE JUST WENT THROUGH
THIS WHOLE.
AND IT WILL GO THROUGH IT HERE
ISSUE AND SO I THINK PEOPLE GET
A LITTLE GUN SHY ABOUT FIGURED
SAYING WELL. BUT I MEAN THIS IS
PAYING FOR SCHOOL NRSES
PSYCHOLOGISTS THERE'S A LOT.
AND.
THIS IS ALSO MORE IMPORTANTLY
ALLOWING CHILDREN GET AN
EDUCATION AND SO GETTING NOW BE
SURE THEY CAN DO THAT.
IN A WAY.
DESPITE.
OTHER ISSUE SO I HOPE THAT.
.
YOU KNOW WE CAN LOOK INTO MORE
CLOSELY.
.
HOW WE CAN BETTER DRAWDOWN
FEDERAL FUNDS FOR?
THROUGH LEN AND AN MA AND SO WE
HAD TO GET OVER SORTING OUT THIS
WHOLE THING WITH CMS ABOUT
BILLION HOW THEY WERE BILLING
AND.
AND I THINK THE IN.
THERE'S A PART OF ME THAT THINKS
THAT PERHAPS WE GO LIVE RYAN TO
DEAL FROM CMS IN THAT.
IN THAT ENDEAVOR YEAH AS WELL
BUT I HOPE WE CONTINUE TO PUSH
ON THE FED'S ABOUT TRYING TO GET
BETTER MATCH IT IN TERMS OF OF
BEING ABLE TO.
DRAW DOWN FOR FACE BASICALLY STE
YELL STATE EXPENDITURES HAVE FOR
HEALTH CARE SERVICES OF FOR.
KIDS WHO ARE ON MEDICARE. I MEAN
THAT'S WHAT WE SHOULD BE ABLE TO
DO SO WE SHOULD THE US I HOPE
WE.
HAVE SOME.
MAKE SOME EFFORT IN TRYING TO.
.
TO TO TO TO TO FIGURE THAT OUT.
I WOULD JUST SAY THAT I THINK.
YOU KNOW IT'S AN ENTITLEMENT
PROGRAM RIGHT SO IT'S NOT A
CAPPED ALLOCATION US THAT WE
HAVE BEEN COMMITTED TO WORKING
WITH THE SCHOOLS AND THE SCHOOL
DISTRICTS AND TO. IMPROVE THE
AUDIT STANDARDS TO MAKE IT CLEAR
THAT THERE ARE CERTAIN
REGULATIONS AND DOCUMENTATION
REQUIREMENTS OF THE FEDERAL
GOVERNMENT. REALLY HAS AND
TIGHTENED UP ON THEIR OVERSIGHT
AND SO WE HAVE BEEN WORKING YOU
KNOW IN A RELATIONAL AND
PERSPECTIVE TO WORK WITH THE
SCHOOLS TO MAKE SURE THEY
UNDERSTAND WHAT THOSE RULES ARE.
THE MONEY THAT IS AT ISSUE HERE
ON THOSE ARE JUST DISALLOWED
CLAIMS IN THE FEDERAL GOVERNMENT
HAS SAID WE ARE JUST NOT GOING
TO. YOU KNOW WHERE A WE'RE NOT
GOING TO GIVE YOU THE MONEY AND
IF YOU. IF WE INAPPROPRIATELY
GIVE YOU MANY WE HAVE TO GIVE IT
BACK AND SO I THINK ON A GOING
FORWARD BASIS WERE CERTAINLY
COMMITTED TO WORKING.
WITH ALL THE DIFFERENT ON
ENTITIES TO MAKE SURE THAT WE'VE
DONE OUR PART IN TERMS OF THE
TECHNICAL.
EXPERTISE AND AS MANY DIFFERENT
WAYS THAT WE CAN PROVIDE THAT TO
THE SCHOOLS TO MAKE SURE THAT
THEY UNDERSTAND THAT WHEN THEY
ARE.
.
EITHER BRINGING AND ARE
IMPLEMENTING SERVICES THAT
THEY'RE DOING IT THE RIGHT WAY
SO THAT IF WE HAVE TO GO IN AND
AUDIT. BUT THEN THEY PASSED
THOSE AUDIT STANDARDS BOWER IT
WELL I HOPE THAT AND. THEN
FRANKLY YOU KNOW MY PREVIOUS
EXPERIENCE. SPENT IS THERE'S
BEEN SOME RELUCTANCE TO HAVE A
BETWEEN.
FOLKS SAID.
DCS WHO WERE INVOLVED IN THIS
PROGRAM TO HAVE SERIOUS
CONVERSATIONS WITH.
SCHOOL DISTRICTS AND WHEN A
FAMILY START HAPPENED WAS PRETTY
MUCH AROUND.
THE ISSUES THAT WERE TAKEN CARE
OF HERE IN TERMS OF CO THE
DISALLOWED BUILDINGS AND SO
FORTH BUT HOPEFULLY NOW THAT.
HOPEFULLY THAT'S NOW UNDER
RESOLUTION.
AND VITAL HAVE TO YELL FOR THE
PAST ONES MOVING FOR WE CAN SEE
A MUCH CLOSER COLLABORATION
BETWEEN DE EIGHT CS AND EDUCATE.
TRY TO FIGURE.
STRIKE DOWN
THAT WAS THE PART OF IT IS NOW
HAVING.
DIETZ YES. WORK WITH THE
SCHOOLS TO NOT ONLY EDUCATE BUT
ALSO PARTNER WITH THEM TO FIGURE
OUT HOW.
ANYWAY THAT'S COMPLIANT WITH THE
BEYOND THE FEDERAL REGULATIONS
TO DRAW DOWN THOSE FUNDS.
AYE BY I THINK CREATED AND I
THINK. WE'VE HAD A CHALLENGE
WHERE THEY'RE IN TWO SEPARATE
WORLDS AND ONE WORLD'S OVER HERE
MINERALS AND YOU'RE NOT.
WORKING WITH EACH OTHER NOT
PARTNER WITH EACH OTHER THERE'S
MAYBE A LOS LIKE SOMEONE SENT A
MEMO OVER TO SOMEONE ELSE LIKE
DON'T DO THIS OR DO THIS AND SO
ON SAYS I CAN I DO NOW SO IT'S
JUST.
I'VE WE WE NEED TO WORK MORE
CLOSELY TOGETHER TO MAKE THAT
HAPPEN
I REALIZED THERE
SOMETIMES THEY SEEM LIKE TWO
VERY DIFFERENT SPHERES BUT IN
THIS PLACE WE GOTTA WORK
TOGETHER.
FIGURE OUT TO MAKE THAT HAPPEN.
AND THEN UP FINALLY WITH THE
CHIP AUTHORIZATION AGAIN GOOD
NEWS I AM. I I WOULD ALSO MAKE
NOTE THAT.
YOU KNOW WE HAVE CHALLENGES OF
THROUGH WE'VE TEKTRONIX
CHALLENGES RECRUITING P. EXCEPT
SPECIALISTS TO.
TO CALIFORNIA DESPITE OUR
WONDERFUL YOU KNOW STATE AND.
I HOPE THAT.
SIS'S. THIS IS MONEY FOR KIDS
THAT WE CAN DEVOTE SOME OF THAT
TOO IMPROVING. AND AND BUILDING
OUR.
PEDIATRIC.
TAXES THE SUBSPECIALTIES AND
AND BRIAN LARGER CONTEXT OF
LOOKING AT NOTRE CCS PROGRAM BUT
ENSURING THAT OUR PEOPLE YOU
KNOW GETS TO HAVE VERY
SPECIALIZED NEEDS WHO OFTEN.
HAVE FAIRLY BARE CONDITIONS SO
THERE.
AND YOU NEED VERY SPECIALIZED
CARE.
YOU NEED A LOT OF PEOPLE YOU
NEED A LARGE POPULATION BASE TO
SUPPORT ONE PEDIATRIC SUB
SPECIALIST IS FORTUNATE BECAUSE
SOME THE CONDITIONS ARE FAIRLY
RARE. THAT WE ENSURE THAT WE
HAVE ADEQUATE.
REIMBURSEMENT THAT'S MORE
REFLECTIVE OF WHAT IS NEEDED AND
WE'VE HAD THE PAST SO YOU KNOW I
MEAN MEDICARE'S NOT THE BEST
PLAYER IN THE WORLD BUT.
WE'RE STILL WAY BELOW EVEN THAT
ITSELF WE WE CAN THINK ABOUT%
THAT THIRTY CENSUS IS MONEY
WE'RE GETTING BACK FOR
CHILDREN'S HEALTH CARE.
NOW WILL TOUCH MORE ON THAT WE
FINALLY GET REIMBURSEMENT ISSUES
IN A FUTURE HEARING.
WELL. OKAY.
SO WITH THAT NOTED.
PICK PUBLIC COMMENT ON THIS
ISSUES NUMBER ONE AND TWO WHICH
IS THE OVERVIEW FOR DCS AND ALSO
THE.
THANK YOU WELCOME THANK YOU
MISTER CHAIRMAN MEMBERS AND
HEARING ABOUT THIS WITH HEALTH
ACCESS AND WE APPRECIATE THAT
WILL BE. A THING A LITTLE BIT
MORE ON PROP FIFTY SIX AT A
FUTURE HEARING.
BUT WE DO WANT TO HIGHLIGHT.
A COUPLE ISSUES HEALTH ACCESS
IS ONE OF THE ORGANIZATIONAL
SUPPORTERS OF PROPOSITION FIFTY
SIX
HELPED DRAFT THE INITIATIVE AND
ACTIVELY CAMPAIGNED FOR THE
MEASURE ADAM AS YOU ALL HAVE
SEEN ON THE LA O. ESTIMATES OF
THE GOVERNOR'S BUDGET MAKES FIVE
HUNDRED AND TWENTY THREE.
MILLION MORE AVAILABLE FOR RATE
INCREASES THAN LAST YEAR'S
BUDGET AND WE ASK THAT GOING
FORWARD THESE INVESTMENTS IN ANY
ADDITIONAL INCREASES IN PROVIDER
RATES. MUST BE DIRECTED TOWARD
SPECIFIC PROVIDERS SERVICES OR
GEOGRAPHIC REGIONS THAT WILL
RESULT IN SUBSTANTIVE MEASURABLE
GAINS AND PATIENTS ACCESS TO
CARE. AND IMPROVE THE QUALITY
PROVIDED TO MEDICARE
BENEFICIARIES SO WE ASK THAT THE
LEGISLATURE REQUIRE THE
ADMINISTRATION TO EVALUATE
WHETHER LAST YEAR'S RATE
INCREASES ARE THE BEST WAY TO
IMPROVE ACCESS TO CARE. AND IN
ADDITION. I'M YOU KNOW WE
REQUEST THAT THE LEGISLATURE
CONSIDER USING THESE FUNDS TO
AUGMENT AND IMPROVE THE MEDICAL
PROGRAM IN OTHER WAYS. SUCH AS
EXPANDING COVERAGE TO
UNDOCUMENTED ADULTS OR RESTORING
THE REMAINING OPTIONAL BENEFITS
THANK YOU.
WELCOME.
LINDA WAY WITH WESTERN CENTER ON
LAW AND POVERTY LINER COMMENTS
OF THE PREVIOUS SPEAKER BUT ALSO
WOULD LIKE TO MENTION IN REGARDS
TO PROP FIFTY SIX I'M
RECOGNIZING IT'LL BE HEARD IN
THE FUTURE.
HOW WE DO SUPPORT AUTHORED THE
INCREASE IN DENTAL RATES AS
WE'VE HEARD OF KNOWN ACCESS
ISSUES THERE AND WOULD ALSO URGE
OTHER DEPARTMENT TO LOOK AT A
INCLUDING PREVENTIVE? AND COME
TREATMENT IN AND.
IN SUPPLEMENTAL RATE INCREASES
AS WELL WE SUPPORT ON THE HEALTH
HOME RATE INCREASE AS OUR LEGAL
AID ADVOCATES HAVE NOTED ACCESS
CONCERNS THERE AS WELL BIG.
THANK YOU. WELCOME BRITAIN
PRETEND I HELD AARON READING
ASSOCIATES ON BEHALF OF THE
CALIFORNIA DENTAL HYGIENISTS
ASSOCIATION AND WE'VE GOTTEN CDJ
HAS A FEW CONCERNS THIS YEAR.
UNDER PROP FIFTY SIX THAT
TOBACCO TAX D. H. CS IS PAYING
FOR ABOUT A FORTY PERCENT
INCREASE
TENSE AND OF AYES MANY SERVICES
AS FOLKS HAVE MENTIONED EXCEPT
PREVENTION. SO WE HAVE A BIG
PROBLEM WITH THAT EXCLUDING COST
PREVENTION OR COST EFFECTIVE
PREVENTIVE CARE FROM PROP FIFTY
SIX FUNDING IS IS POOR POLICY
AND AND OR PREVENTIVE ORAL
HEALTH CARE IS FOUNDATIONAL. TO
OVERALL HEALTH SO THAT'S AN
ISSUE FOR US A BIT DEL
HYGIENISTS OR UP PROVIDERS THAT
ARE WILLING AND ABLE TO SEE MEDI
CAL PATIENTS. ARE BEING EXCLUDED
FROM THE CARRIES RISK ASSESSMENT
UNDER THE DTI THE DENTAL
TRANSFORMATION INITIATIVE.
ADDITIONALLY THE.
INDEPENDENT HYGIENISTS RTHK
PEAS ARE NOT RECEIVING
REIMBURSEMENT FOR PLACEMENT OF
INTERIM THERAPEUTIC A
RESTORATIONS HOWEVER UNDER
PRIVATE INSURANCE THEY ARE SO WE
WANT TO GET THAT FIXED AS WELL.
AND. IF THE STATE PLANS TO MOVE
TO NYC HELP PATIENTS TO A
MANAGED CRE STRUCTURE.
ADMINISTRATIVE AREAS BARRIERS TO
THE INDEPENDENT HIGH JANICE
BEING PROVIDERS.
WITHIN THE MANAGED CARE SYSTEM
NEED TO BE REMOVED AND WE'RE
WORKING ON MULTIPLE LEVELS TO DO
THAT. AT DH CS NOW REQUIRES RTA
JP'S TO OBTAIN APPROVAL FROM THE
DEPARTMENT BEFORE TREATING THE
ELDERLY AND DISABLED PAGE.
THEY.
THAT HAVE PERIODONTAL DISEASE
ANTI HTS ALSO THOSE CUT THE
REIMBURSEMENT RATE BY OVER HALF
FOR THIS DIRE GUM DISEASE
TREATMENT.
SO IN THE RATE WAS ALREADY COULD
SIGNIFICANTLY LOWER THAN THAN.
PRIVATE INSURANCE MOST OF THESE
PATIENTS F. YOU DON'T KNOW OUR
AND HAVE COGNITIVE AND PHYSICAL
DISABILITIES THAT PREVENT THEM
FROM GOING TO A DENTAL OFFICE.
SO AYE THEY RECEIVE CARE IN THE
NURSING HOME OR I AM AT THE
BEDSIDE IF THEY'RE HOMEBOUND.
SO.
AND THIS POLICY IS DIVIDING
THEIR DRIVING UP PROVIDERS FROM
THE.
SYSTEM SO WE LOOK FORWARD TO
WORKING WITH THE LEGISLATUE ON
THAT ISSUE TO RESOLVE ALL OF
THAT LIKE A FORMER THANK YOU.
THANK YOU WELCOME.
YEAH HELLO. I'M I'M DARLA DEL
I'M A DENTAL HYGIENIST IN THAT
DAMN I JUST ALTERNATE PRACTICE
UP IN HUMBOLDT COUNTY AND JUST
KIND OF WANTED TO SHARE WITH YOU
MY EXPERIENCE IN A VERY RURAL
COUNTY WITH VERY LIMITED ACCESS
TO CARE.
WE HAVE APPROXIMATELY FIFTY TWO
THOUSAND.
MEDICAID RECIPIENTS MCCARTY
SAID.
PEOPLE IN OUR AREA
SOME MUST HAVE OVER HALF OF OUR
AND POPULATION IS ON THE MEDICAL
SYSTEM.
SEVENTEEN THOUSAND OF THOSE ARE
CHILDREN AND ZERO TO TWENTY AND
SO THE OTHER THIRTY FOUR
THOUSAND ARE ADULTS.
AND THE PROBLEM IN OUR COMMUNITY
IS.
THE MONEY IT WE WERE HAPPY TO
SEE THE REINSTATEMENT OF THE
ADULT DENTAL BENEFIT AND WERE
HAPPY TO SEE THAT MONIES BEING
POURED.
INTO THE SEVEN MILLION DOLLARS
AND MAYBE BEING POURED INTO
THAT.
THE I'M A DEMOCRAT SYSTEM THE
PROBLEM IS THE PROVIDER WE JUST
DON'T HAVE THE PROVIDERS I'M THE
ONLY OTHER PROVIDER. DEDICATE
PROVIDER IN HUMBLE COUNTY
OUTSIDE OF OUR FEDERALLY
QUALIFIED HEALTH CENTER.
I SPOKE WITH THE DEMOCRATS ARE
FOR THE RECALL OF FIGHT HEALTH
CENTER AND HE EXPLAINED TO ME
THAT THERE ARE FOUR THOUSAND
PATIENTS HER DENTIST AT HIS
CLINIC. THERE'S NO WAY THEY CAN
MEET THE NEEDS THE SYSTEM IT'S
EXTREMELY BROKEN AND I FEEL THAT
A FORTY PERCENT INCREASE EVEN
THOUGH IT'S BETTER THAN NOTHING
THAT WE REALLY NEED TO TAKE A
LOOK AT THAT AND ALSO LOOK AT
THE ALTERNATIVE.
.
HI GENEST AS A WORKFORCE THAT
CAN HELP THIS PROBLEM THERE ARE
APPROXIMATELY TEN TO TWELVE
REGISTERED IN HIGH JUST
ALTERNATE PRACTICE IN MY AND
COMMUNITY. PARTNER HEALTHCARE
SERVICES DOES NOT RECOGNIZE US
AS PROVIDERS ON CERTAIN THINGS
ARE WITHIN OUR SCOPE OF PRACTICE
THEREFORE WE CANNOT BE PAID FOR
PREVENTIVE SERVICES THAT WE CAN
PROVIDE AND I WOULD LIKE IS TO
LOOK AT THAT A LITTLE BIT
FURTHER. THINK YOU THANK YOU I
WOULD MAKE NOTE THAT WE WILL
ACTUALLY BE HAVING HEARING ON
THAT TO CAL NOW LATER ON SO THIS
IS THE OVERVIEW THAT THANK YOU.
WELCOME THEY PUT UP A BRAVE
NEBRASKA GAP OF THE CALIFORNIA
ASSOCIATION FELL SERVICES AT
HOME. I JUST REAL QUICK WHEN A
SUPPORT THE HOME HEALTH RATE
INCREASE REALLY THINK OF.
HELP WITH ACCESS TO GET HOME
HEALTH THANK YOU.
ANY OTHER QUESTIONS.
OKAY SO WITH THAT.
WE'RE GONNA HOLD.
SHE WON AND I.
YEAH SO SHE WENT IS
INFORMATIONAL ISSUE TOO OF
COURSE IS THE MEDI CAL ESTIMATE
WATER WILL HOLD OPEN UNTIL WE
FIND OUT ARE UPDATED NUMBERS
FROM A REVISED.
SO NEXT ITEM IS ITEM NUMBER
THREE WEEK.
WITCHES.
MEDI CAL UNANTICIPATED COSTS
TWENTY SEVENTEEN EIGHTEEN
DEFICIENCY.
SURE BUDGET FOR KENT AGAIN.
AS A INDICATED IN SOME OF MY
EARLIER COMMENTS I WAS SO
EXCITED TO GET INTO THE ESTIMATE
ISSUES THAT I JUMPED THE GUN A
LITTLE BIT.
THERE'S THREE KIND OF MEAN
COMPLIMENTS AND.
THE DEFICIENCY THAT WE HAVE
NOTED IN THE GOVERNOR'S BUDGET
ONE IS AROUND.
THE FEDERAL AYE REPAYMENT OF
DRUG REBATES ONE IS AROUND.
SOME INDIVIDUALS THAT WORD THAT
ARE DUALLY ELIGIBLE THAT WERE
PUT INTO A CODE THAT I GENERATED
A DIFFERENT.
FEDERAL MATCHING PERCENTAGE
AND THEN THERE WAS.
SAM ACCOUNT TEEN AROUND THE
HOSPITAL QUALITY ASSURANCE FEE
THE CALCULATION OF THE UPPER
PAYMENT LIMIT.
SO JUST VERY BRIEFLY I WANT TO
TOUCH ON THE THREE AND THEN.
OBVIOUSLY CAN ANSWER QUESTIONS
AS AND.
AS YOU WANT.
THEIR REPAYMENTS FOR THE
FEDERAL DRUG REBATES I'M IN THIS
WILL CERTAINLY BE PART OF THE
DISCUSSION AROUND THREE FORTY BE
IS HOW. WE REIMBURSE FOR.
PHARMACY AND HOW WE CALCULATE
THE REBATES THAT ARE OWED TO US
BY THE MANUFACTURERS EITHER ON
THE FEDERAL.
AND STATE SIDE OR IN THE
SUPPLEMENTAL REBATE CATEGORY ON
DEPENDING ON THE INDIVIDUAL THAT
IS HAVING THAT.
PHARMACY PRESCRIPTION PROVIDED
TO THEM DEPENDING ON THEIR EIGHT
CODE THEY MAY OR MAY NOT BE AYE
RECEIVING FIFTY FIFTY STATE
GENERAL FUND FEDERAL FUNDS THEY
MAY BE A CHIP CHILD WHICH WOULD
BE EIGHTY EIGHT TWELVE.
THERE MAY BE OPTIONAL EXPANSION
POPULATIONS THAT ARE NINETY FIVE
FIVE AND SO WHEN WE PUT ALL
THESE CLAIMS TOGETHER AND WE
SUBMIT.
MONIES BACK TO THE FEDERAL
GOVERNMENT ARE WE DRAW FEDERAL
MONEY DOWN.
SOME OF THOSE GET FAIRLY
COMPLICATED OBVIOUSLY AND SO
THERE WAS.
I'D ADJUSTMENT ON DRUG REBATES
ON IN WHICH WE HAD PAID BACK
ASSUMING A FIFTY PERCENT MATCH
AND IN FACT THOSE INDIVIDUALS
HAD HIGHER.
PERCENTAGES IN TERMS OF THEIR
OPTIONAL EXPANSION CATEGORIES
AND SO THERE'S AN ADDITIONAL TWO
HUNDRED AND FIFTY SEVEN MILLION
DOLLARS THAT WE NEED TO.
PAYBACK TO THE FEDERAL
GOVERNMENT TO ACCOUNT FOR THOSE
REBATES.
AND THE SECOND ISSUE IS SOMEWHAT
SIMILAR IN COMPLEXITY AND THAT
WE HAD INDIVIDUALS THAT ARE
DUALLY ELIGIBLE THEY WERE PUT
INTO AID CODES IN WHICH WE WERE
CLAIMING.
ENHANCE FEDERAL FUNDS FOR THEM
EVEN THOUGH THEY ARE NOT
ELIGIBLE TO RECEIVE ENHANCE
FEDERAL FUNDS BECAUSE THEY ARE
FIFTY FIFTY INSTEAD OF NINETY.
FIVE HURT NINETY TEN AND SO WE
HAVE.
WORKED VERY CLOSELY WITH THE
COUNTIES TO QUICKLY ADJUST AND
MOVE THOSE PEOPLE INTO.
APPROPRIATE CODES BUT THE
RESULTING.
ISSUE IS THAT WE NEED TO PAY
BACK ABOUT TWO HUNDRED MILLION
DOLLARS TO THE FEDERAL
GOVERNMENT TO ADJUST FOR THOSE
AND EIGHT CODES.
AND THEN LASTLY UM THE HOSPITAL
QUALITY ASSURANCE HE THIS IS
SOMETHING THAT HAS BEEN IN PLACE
FOR SEVERAL YEARS IT'S A
CRITICAL. FUNDING SOURCE ON THAT
WE WORK ON IN PARTNERSHIP WITH
ALL OF THE HOSPITALS IN THE
STATE OF CALIFORNIA. THERE OUR
CALCULATIONS THAT WE HAVE TO
MAKE WITH THE FEDERAL GOVERNMENT
WHERE I'M WE DETERMINE WHAT THE
FEDERAL UPPER PAYMENT LIMIT IS.
THOSE AND THEN WE CAN'T PAY OVER
AND ABOVE THAT AND THERE WAS
SOME CHANGES TO THE WAY THAT THE
U. PL WAS CALCULATED.
IT WAS LOWERED WHICH MEANT THAT
WE HAD TO.
PROVIDE SOME FUNDING BACK TO
THE FEDERAL GOVERNMENT BECAUSE
WE HAD PAID MORE THAN WE SHOULD
HAVE SO. THOSE IN TOTAL.
ADD UP TO ABOUT FIVE HUNDRED
AND FORTY THREE MILLION DOLLARS
IN AND IN THE GENERAL FUND
EFFICIENCY THIS YEAR AND
OBVIOUSLY I AND WE WOULD BE
WORKING. WITH THE DEPARTMENT OF
FINANCE FOR REFINEMENT OF THOSE
NUMBERS IN MAY.
I THINK YOU ARE COMES BELIAU.
BRENT METZ GALLIO JUST
ACKNOWLEDGE AT THE THIS IS THE
NET EFFECT OF CHANGES IN PROGRAM
EXPENDITURES WITHIN MEDI CAL AND
ONE THAT WE DIDN'T SEE HERE BUT
THAT WAS PREVIOUSLY MENTIONED
WAS JUST THE FACT THAT. THERE
ARE ANTICIPATED REDUCE GENERAL
FUND EXPENDITURES DUE TO THE
REAUTHORIZATION OF CHAP OF
AROUND THREE HUNDRED MILLION
DOLLARS TO JUST ACKNOWLEDGE THAT
WITHIN THE CALL.
DISCUSSION.
THANK YOU AND FINANCE.
AND IT'SOKAY QUESTIONS FROM
COMMITTEE MEMBERS A YES ANDERSON
THANK YOU MISTER.
ELITE THESE AREAS ARE SMALL IN
COMPARISON TO THE OVERALL BUDGET
VISIT BUT HOW WE GONNA.
REALLY ZERO IN IN THIS COMING
YEAR TO MAKE SURE WE DON'T WE
HAVE PEOPLE THE PROPER
CATEGORIES AND HAVE THIS KIND
OF.
AIR IN THE FUTURE RIGHT AND
THIS IS.
IT'S ALMOST LIKE YOU JUST KIND
OF WALKING INTO THE AGENDA TO
THE NEXT ISSUE.
SO WE WORK REALLY CLOSELY WITH
THE COUNTIES ON BECAUSE THEY ARE
OBVIOUSLY ARE AGENTS AS THEY
DETERMINE ELIGIBILITY. WE HAVE
TWO HUNDRED AND EIGHTY THREE
EIGHT CATEGORIES ARE AID CODES
FOR INDIVIDUALS AND SO ON IT IS
A REALLY COMPLICATED BUSINESS IN
TERMS OF WHEN YOU MAKE SOMEONE'S
ELIGIBILITY DETERMINATION THAT
YOU PUT THEM IN THE RIGHT CODE
BECAUSE.
A HIGHLY AUTOMATED SYSTEM THAT
THEN IS.
RELIANCE ON OTHER TYPES OF
INNER INFORMATION THAT WE
GENERATE AND SO. IT'S BEEN A
VERY CLOSE.
PARTNERSHIP WITH THE COUNTIES
IN TERMS OF HOW WE HAVE MATURED
OUR IT SYSTEMS BOTH THE COUNTY
ELIGIBILITY SYSTEMS. AS WELL AS
THE STATEWIDE CAL HERE'S.
ELIGIBILITY SYSTEM AND THAT WE
SHARE WITH COVER CALIFORNIA AND
SO.
.
AT THE NEXT ISSUE WILL TALK
ABOUT THE COUNTY ADMIN IN THE
COST OF DOING BUSINESS AND HOW
WE.
WORK WITH THE COUNTIES ON.
ON PRIORITIZING SOME OF OUR
ELIGIBILITY CASE WORK BUT IN
THIS CASE THESE WERE INDIVIDUALS
THAT WERE. PUT INTO THE AID
CATEGORY.
IN SOME CASES THROUGH NO FAULT
OF THE COUNTY ELIGIBILITY WORKER
MAKING THAT DETERMINATION IT WAS
A SYSTEMS AARON SO WE HAD TO
KIND OF. WORK WITH THEM TO KIND
OF BACK THOSE INDIVIDUALS OUT
AND PUT THEM IN THE RIGHT
CATEGORY BUT.
AS THE SYSTEM CONTINUES TO
MATURE THIS IS THE.
THESE ARE THE NEW RULES THAT
WE'VE BEEN OPERATING ON SINCE
THE ACA WAS IMPLEMENTED IN
JANUARY TWENTY FOURTEEN.
OVERTIME THAT HAS GOTTEN MORE
AND MORE ACCURATE AND SO. IT'S A
BIG SYSTEM WITH A LOT OF PEOPLE
BUT I THINK OUR ERROR RATE HAS
CERTAINLY KIND OF CONTINUE TO GO
DOWN AS AS THE SYSTEM'S GOTTEN
BETTER SO YOU HAVE SOME FURTHER
REFINEMENTS FOR NEXT YEAR
HOPEFULLY TO THAT NUMBER.
THERE'S A WHOLE TWENTY FOUR
MONTHS ROAD MAP OF CHANGES THAT
WE AND TO
MAKING.
HERE'S IN THOSE.
I DON'T KNOW IF THEY COME UP IN
THIS BUDGET SUBCOMMITTEE HEARING
BUT THEY CERTAINLY
UNDER THE PURVIEW.
OF SYSTEMS OF IMMIGRATION WHICH
IS OUR PROJECT MANAGER FOR THE
CAL HERE SYSTEM AND SO THERE'S A
WHOLE SERIES OF IMPROVEMENTS
THAT WE CONTINUE TO MAKE IN THAT
ELIGIBILITY PROCESS OKAY THANK
YOU.
I BELIEVE WE WILL BE HEARING
WEEKLY LSI ALSO PRESENT SOME
EXCELLENT YES SO.
ALRIGHT OF PUBLIC COMMENT.
SADDAM
OKAY SEEN ON.
WELL. I THINK DON'T.
I THINK IT SPEAKS TO THE SCALE
OF THE OF THE MEDI CAL PROGRAM
RIGHT I MEAN AS A PERCENTAGE OF
THE VERY SMALL OBVIOUSLY VERY
LARGE NUMBER.
AND.
BUT AS A PERCENTAGE IT'S FAIRLY
SMALL.
SO.
BOTH WE DO THE BEST WE CAN AND
TRY TO. GUESS WHAT WE HAVE THE
LAND AND THEY ARE JUST AS WE
MOVE ALONG SO.
ALRIGHT.
SO WILL HOLD THIS ITEM OPEN.
LET'S MOVE ON TO ISSUE MEMBER
FOR COUNTY ADMINISTRATION
ESTIMATE BUDGET PROPOSALS.
ALRIGHT AND WE HAVE A. OKAY.
I KNOW WE GOT SWAPPING OUT SO
MAYBE JUST HAVE TO SWAP OUT
PERSON CAN INTRODUCE THEMSELVES
TO THE RECORD NINE OF PEOPLE
BEEN SWAPPING OUT BUT. THAT
SEEMS OF FAMILIAR FACES AND
TRAFFIC GO TO THE NEW ONES ARE
HER ALRIGHT. SO FINANCE.
OR IOWA DEPARTMENT OF FINANCE.
ALRIGHT.
THE ADMINISTRATION THE
GOVERNOR'S BUDGET PROPOSES AN
INCREASE OF FIFTY FOUR POINT
EIGHT MILLION TOTAL FUNDS
EIGHTEEN POINT FIVE MILLION
GENERAL FUND. IN TWENTY EIGHTEEN
AT THE MICROPHONE CLOSER TO YOU
SORRY IT'S. IN TWENTY EIGHTEEN
NINETEEN AND THE GOVERNOR'S
BUDGET PROPOSES IS INCREASED
IT'S BASED ON THE CALIFORNIA
CONSUMER PRICE INDEX PROJECTION
AT THE TIME OF THE DEVELOPMENT
THE GOVERNOR'S BUDGET.
A NEW LOCATION COMBINES THE
PREVIOUS.
BASS ALLOCATION AND THE ACA
AUGMENTATION AND THEN INCREASES
IT BY THE CPI PROJECTION. WITH
THIS INCREASE AS DR CAN MENTION
COUNTIES WILL WORK.
TO PLACE BENEFICIARIES INTO THE
CORRECT EIGHT CODES INCREASE THE
PERCENTAGE OF COMPLETED AN
ACCURATE ELIGIBILITY
DETERMINATIONS AND ANNUAL WE
DETERMINATIONS AND ALSO PROVIDE
TEN TIMELY. ENROLLMENT AND
ELIGIBILITY DATA TO THE
DEPARTMENT.
THE ADMINISTRATION'S CURRENT
PLAN GOING FORWARD IS TO
REASSESS THE ALLOCATION HAS
MOVED TO AN INTEGRATED COUNTY
ELIGIBILITY SYSTEM.
AND TO ADDRESS THE THIRD
QUESTION ON THE REALLOCATION OF
FUNDS BETWEEN COUNTIES. THAN
RESTRICTIONS RATIONALE FOR NOT
REALLOCATING UNSPENT FUNDS
BETWEEN COUNTIES AT THE TIME OF
RECONCILIATION.
IS THAT HE SAID IS PROJECTED TO
GROW LESS THAN ONE PERCENT AND
CAL HERE'S STABILITY HAS
IMPROVED SO COUNTIES ARE
EXPECTED TO SPEND WITHIN THEIR.
HOT COUNTY ALLOCATION.
BUT THE TWENTY EIGHTEEN NINETEEN
COUNTY ALLOCATIONS WILL. BE SAID
TAKING INTO CONSIDERATION
PREVIOUS ACTUAL EXPENDITURES AND
WILL BE DONE IN COLLABORATION
WITH THE COUNTY WELFARE
DIRECTORS ASSOCIATION.
AND I DEFERRED TO DIRECTOR KENT
TO ADDRESS THE OTHER TO
PROGRAMMATIC QUESTIONS.
I'M SO PART OF THE.
PROCESS THAT WE UNDERWENT IN
THIS WAS PURSUANT TO SOME OF
THE.
BUDGETS OF OF PREVIOUS YEARS.
WHEN WE WANTED TO UNDERSTANDS.
WHAT REALLY KIND OF
TO THE TIME?
DIGITAL DETERMINATION HOW
TAKE AND SO WE.
COLLECTIVELY WITH OUR COUNTY
PARTNERS REALIZE THAT WE. DIDN'T
QUITE KNOW ENOUGH AND WE DIDN'T.
WE WERE SURE THAT WE COULD DO
IT AND WE WANTED TO HAVE SOME AN
INDEPENDENT PARTY DO AND SO THAT
WAS AUTHORIZATION AND FUNDS
APPROPRIATED TO HIRE SOME.
TO COME OUT WORK WITH US AND THE
COUNTIES TO DEVELOP THIS NEW
METHODOLOGY WE RELEASE AN RFP.
AND WE RECEIVED I KNOW
ACCEPTABLE.
BIDS AND SO WE WENT BACK TO THE
COUNTIES IN THE FALL AND SAID
WE'RE NOT SURE THAT. ANYBODY
ELSE CAN HELP US ON ED COUNTY BY
COUNTY BASIS MAKING A BETTER
ASSESSMENT AND SO WE.
CERTAINLY THIS PROPOSAL IS
REFLECTIVE OF THOSE
CONVERSATIONS AND ONGOING
CONVERSATIONS AROUND. YOU KNOW
HOW DO WE BEST.
PAY THE COUNTIES TO DO THE WORK
ON OUR BEHALF ON BECAUSE IT IS
IMPORTANT WORK IT IS
SIGNIFICANT.
CASELOAD THAT THEY ARE CARRYING
SO YOU HAVE.
APPROXIMATELY THIRTEEN MILLION
INDIVIDUALS THAT ARE COMING
THROUGH.
AND THEY CAN BE EASY.
IN TERMS OF THEIR CIRCUMSTANCES
MAY NOT HAVE CHANGED OR ADDED TO
ADDRESS MAY NOT CHANGE THEIR
FAMILY SIZE MAY NOT HAVE CHANGED
AND SO THAT'S A FAIRLY EASY
CASE.
BUT THEN YOU HAVE OTHER
INDIVIDUALS THAT HAVE HAD
EVERYTHING CHANGE AND SO. HOW DO
YOU KIND OF PAY FOR THAT KIND
OF?
WORK WHEN YOU HAVE SUCH LARGE
SCALE OPERATIONS TO CONSIDER AND
OBVIOUSLY LABOR AND OTHER.
IT'S GENERATIONS.
THE PROPOSAL THAT YOU SEE.
AND THE REASON THAT YOU SEE IT
IS BECAUSE WE WERE UNABLE TO
REALLY KIND OF. MORE CLEARLY
DEFINED A DIFFERENT WAY OR A
DIFFERENT METHODOLOGY AND SO WE
BELIEVE THAT THIS I'M CERTAINLY
CONTINUES TO.
GET THE JOB DONE GET THE WORK
DONE AND OBVIOUSLY RESPECT THAT.
THE WAY IN WHICH EACH COUNTY
HAS KIND OF DECIDED HOW THEY
BEST CAN ADDRESS THAT WORKLOAD
BECAUSE CERTAIN COUNTIES HAVE.
.
THE DIFFERENT WAYS THAT THEY PAY
AND SO I THINK TO WHAT AND THE
DEPARTMENT OF FINANCE JUST
MENTION IN TERMS OF WANTING TO
MAKE SURE THAT THE ALLOCATIONS
ARE MORE APPROPRIATELY SET WITH
EACH OF THE COUNTIES. IS ALSO
INDICATIVE OF SOME COUNTIES AND
USE ON. YOU KNOW CROSS TRAINED
WORKERS SON USED YOU KNOW
SPECIFICALLY YOU KNOW IDENTIFIED
IT'S JUST IT'S A IT'S A VERY
DIFFERENT MAX AND SO WE'RE
COMMITTED TO KIND OF WORKING
WITH THEM ON AND.
AND THEN AS TO THE REALLOCATION
OF UNSPENT COUNTY ADMINISTRATION
FUNDS I THINK WE ARE MINDFUL OF
THE FACT THAT CERTAIN
CIRCUMSTANCES.
COUNTIES WITH HIGH LABOR COSTS
MEANING THEY HAVE HIGH HOUSING
COSTS IN FRANCISCO FOR EXAMPLE
ON A LOT OF THOSE EMPLOYEES THAT
WORK IN THE CITY BECAUSE THEY
CAN'T AFFORD IT. SO THEY HAVE
KIND OF HIGHER THAN AVERAGE.
COSTS BUT WE ALSO FELT THAT WE
HAD CONSISTENT ON BOTH OVER AND
UNDER SPENDERS AND WE REALLY
WANT TO GET THIS METHODOLOGY
MORE ACCURATELY KIND OF GIVING
COUNTIES THE ALLOCATION THAT
THEY. NEED TO DO THE JOB WITHOUT
HAVING THIS.
KIND OF CONSISTENT OVER UDER
SPENDER SO WE ACKNOWLEDGE THAT
WE NEED TO GET IT RIGHT.
THERE WERE CERTAINLY BE
CIRCUMSTANCES IN WHICH WE
WOULDN'T BE MINDFUL OR WILLING
TO HAVE A CONVERSATION BUT.
WE'RE TRYING TO KIND OF GET OUT
OF THE BASIS BY WHICH SOME
COUNTIES.
ALWAYS OVER SPEND THEIR
ALLOCATION AND SOME COUNTIES
ALWAYS UNDERSTAND THE ALLOCATION
AND THERE WAS A. KIND OF A TRUST
THAT THEY WOULD BE ABLE TO KIND
OF NET THOSE OUT AND THERE WERE
A COUPLE YEARS WHEN THAT DIDN'T
HAPPEN AND SO WE'RE TRYING TO BE
BOTH GOOD BUSINESS PARTNERS IN
TERMS OF THE CITY ALLOCATION
THIS IS THE BUDGET THAT YOU
HAVE.
AND OBVIOUSLY IF CIRCUMSTANCES
ARE SO EXTRAORDINARY.
WE WILL BE WILLING TO TALK
ABOUT IT BUT.
WORKED WERE TRYING TO GET A
BETTER.
.
THE MINIMIZATION I THINK BECAUSE
OF THE OVERALL SPEND.
OIL.
WE WOULD JUST NOTE THAT TIME.
COUNTIES THAT ADMINISTER THE
ELIGIBILITY DETERMINE THAT
TERMINATION FUNCTIONS FOR MEDI
CAL ALSO ADMINISTER ELIGIBILITY
FIVE
FOR. OTHER MAJOR HEALTH AND
HUMAN SERVICES PROGRAMS
INCLUDING EYEQ ASSESS CAO WORKS
AND CAL FRESH.
AND WE THINK THERE'S A COUPLE
IMPLICATIONS OF THAT.
NUMBER ONE THE FLEXIBILITY TO
REALLOCATE.
AMONG COUNTIES UNDERNEATH THE
OVERALL CAP. AND IS SOMETHING
THAT'S AVAILABLE AND OTHER
PROGRAMS AND UNDER THE
GOVERNOR'S PROPOSAL. AND THAT
WOULD NOT BE CHANGING.
SO WE THINK THERE'S IT'S WORTH
THINKING ABOUT AND WHY YOU WOULD
HAVE TO FROM POLICY CENTER FOR
PROGRAMS. AND BUT BEYOND THAT
AND THERE ARE EFFORTS UNDERWAY
TO REVISIT THE BUDGETING
METHODOLOGY FOR SOME OF THESE
OTHER MAJOR HEALTH AND HUMAN
SERVICES PROGRAMS.
AND THOSE EFFORTS ARE ONGOING IN
SOME CASES AND.
IT'S PROBABLY WORTH AND
THINKING ABOUT THE SNOW MORE
COORDINATED WAY AND ARE OFFICE
WILL BE CONTINUE TO LOOK AT THAT
AS HIS OTHER EFFORTS ARE GOING
FORWARD.
NO HUNTSMAN OKAY THURSTONE MISS
CAMP.
.
WE WILL NEVER BE ABLE TO HAVE A
CRYSTAL BALL AND KNOW EXACTLY
HOW MANY CASES OUR RESPECTIVE
COUNTIES GOING TO GET THE GROWTH
AND.
DEMAND FOR.
BECKI TELL ME.
I ASSUME WE'RE LOOKING AT THE.
THE PREVIOUS YEAR
PROJECTING FOR THE FOLLOWING
YEAR IS GOING TO BE.
IS DO ALL COUNTIES RECEIVE A
PROPORTIONAL AMOUNT OF THE
FUNDING IN OTHER WORDS DOES
RIVERSIDE COUNTY GET. THE SAME
SHARE PER. BENEFICIARY THAT SAN
FRANCISCO DOES OR IS THERE A A
DIFFERENT FORMULA BECAUSE OF THE
DIFFERENT GEOGRAPHICAL AREAS.
IT'S THERE'S A METHODOLOGY THAT
HAS BEEN IN PLACE.
THAT.
IT'S NOT THAT SPECIFIC SO IT.
YOU CAN AND. YOU CAN GRIND OUT.
A BUNCH OF DIFFERENT
CALCULATIONS BASED ON CASELOAD
BASED ON COST PER CASE BASED ON
NUMBER OF ELIGIBILITY WORKERS IN
A COUNTY DEPARTMENT BASED ON.
USE OF.
OVERTIME VERSES ADDITIONAL IMEAN
WE HAVE.
COLLECTIVELY LOOKED AT IT.
A BUNCH OF DIFFERENT WAYS.
WHAT WE DO IS ON A QUARTERLY
BASIS SO EACH COUNTY HAS AN
ALLOCATION IN THE COUNTY ADMIN
BUDGET IT'S A METHODOLGY THAT
WE HAVE?
HOUSTON WE HAVE STAFF THAT
WORKS CLOSELY WITH THE COUNTY
WELFARE DIRECTORS ASSOCIATION SO
EXAMPLE RIVERSIDE AND I'M MAKING
THE NUMBER UP BECAUSE THEY DON'T
OFFICE.
HAD BUT SAID.
IN THE YEAR IN QUARTERLY
ALLOCATIONS THEY ARE SUBMITTING
THEIR COST REPORTS AND THEY'RE
DRAWING THAT MONEY DOWN AND
WE'RE PAYING THEM THAT YOU KNOW
QUARTER. PERCENTAGE NUMBER
TREATED UP AND SO ON ANY GIVEN
QUARTER WHERE SHARING BACK WITH
THEM YOU ARE WITHIN NINETY FIVE
PERCENT OF YOUR ALLOCATION FOR
THE QUARTER YEAR HUNDRED AND TEN
PERCENT OVER SO THEY CAN KIND OF
HAVE SOME SENSE OF HOW CLOSE
THEY ARE GETTING TO THEIR
ALLOCATION. BUT IT'S NOT.
BUILT ON HER CASE OR YOU HAD
FIVE HUNDRED.
SENIORS AND PERSONS WITH
DISABILITIES THAT TOOK AN HOUR
TO PROCESS AND WE'RE GONNA PAY
YOU DIFFERENTLY. WE REALLY.
BELIEVES KIND OF A
PHILOSOPHICAL BASIS IT IS ALWAYS
DRIVEN THIS METHODOLOGY IS WE
GIVE YOU THE MONEY.
WE GIVE YOU THE EXPECTATIONS
AND THE I'M KIND OF REQUIREMENTS
THAT THE PROGRAM NEEDS BUT THEN
IT'S UP TO YOU AS A COUNTY TO
KIND OF BEST DETERMINE HOW YOU
GET THAT WORK DONE AND SO THE
ALLOCATION IS REALLY MEANT TO.
THEIR CAPABILITY OF DOING THAT
WITH THE RESOURCES AND THE WAY
IN WHICH THE COUNTY IS BEST
ORGANIZED BOMB HAPPY TO HEAR
THAT YOU'RE YOU'RE KIND OF
MONITORING THAT ON A QUARTERLY
BASIS BECAUSE.
RIVERSIDE COUNTIES.
THE FASTEST GROWING COUNTING THE
STATE OF CALIFORNIA RIGHT NOW I
THINK WE'VE TOOK ON THIRTY SEVEN
THOUSAND RESIDENTS LAST YEAR.
AND A CERTAIN PERCENTAGE WAS
PROBABLY THIRD OR REQUIRING
MEDICAL SERVICES SO I'M SURE
THAT YOU'RE SEEING THROUGH THESE
QUARTERLY.
A WORK REPORTS THAT THE THE BUT
THE DEMAND FOR SERVICES IS
INCREASING AND I'M HAPPY TO HEAR
THAT YOU'RE ABLE TO TO
ADJUSTMENT STREAM AND.
THE COUNTIES HOLE AS A QUALIFY
THESE PEOPLE FOR SERVICES.
UPS.
THANK YOU FOR YOUR PRESENTATION
IT'S JUST TO CLARIFY.
.
SO WHAT YOU'RE PROPOSING IS THIS
I MEAN THAT WAS HIS FIRST COMING
BUDGET YEAR BUT IN TERMS OF
METHODOLOGY OF.
YOU SET YOUR UNSUCCESSFULLY GET
A VENDOR THERE WASN'T ANYONE
ABOUT SO.
ESSENTIALLY SAYS THAT THE FAULTS
METHODOLOGY MOVING FORWARD IS
JUST FOR THIS YEAR'S ONGOING
CONVERSATIONS WHAT ARE WE DOING
IN TERMS OF ACTUALLY TRYING TO.
LOOKS LIKE WOULD ON THE VENDOR
CAN DO THE WORK BUT UP. WHAT WAS
THE PLAN MOVING FORWARD FOR
TRYING TO ESTABLISH AND THE
METHODOLOGY AT MINNESOTA?
I MEAN OBVIOUSLY A PROPOSAL FOR
THIS COMING YEARS THIS KIND OF
LIKE THAT THE FALL PROPOSAL FOR
NOT ONLY THIS YEAR BUT.
SUBSEQUENT YEARS AS WELL AS I
JUST.
THE VOTE WHAT WHERE DEBT WHERE
WE TRY TO DO TO TRY TO ADDRESS
THAT.
GLORIA DIFFERENT FANS AGAIN AT
THIS TIME THERE'S NO PLAN TO
REASSESS
AND THE METHODOLOGY OR CONDUCT
AT TIMES STUDY BUT THE CURRENT
PLAN AS WE MOVE FORWARD IS.
BECAUSE.
THERE'S A MOVE TOWARDS A SINGLE
SAW SYSTEM THE COMPLAINTS TO
REASSESS AS WE MOVE MOVE TOWARD
A SINGLE SOLVE THEIR IMPENDING
CHANGES ON THE HORIZON.
BUT AT THIS POINT HAVE DID
GOVERNOR'S BUDGET ASSUMES THE
CURRENT CPI PROJECTION AND A
SIMILAR INCREASE FOR AT LEAST AN
ADDITIONAL TWO YEARS BUT WILL
CONTINUE CONVERSATIONS AS NEEDED
WITH.
DEMONSTRATION AND SEE WTA.
I CERTAINLY APPRECIATE THAT YOU
PUT A CPI WE COULD DO THAT MORE
PARTS OF THE BUDGET TO THINK.
ELLIOTT ACOSTA FOR ELLIOTT
BECAUSE YOU MADE REFERENCE TO I
MEAN RIGHT NOW IT'S TALK ABOUT
MEDI CAL.
OF EASY TO SUBCOMMITTEE
OVERSEES OTHER THINGS I KNOW
PASSED THE TIME SOCIAL SERVICES
TO TRY TRUSTS YOU KNOW SINGLE
OCCASION FACTOR.
I THINK THAT WOULD DO ALL THESE
THINGS INTERSECT IS THAT
SOMETHING LA IS LOOK.
SOVIET DIFFERENT YOU MADE
MENTION OF THE SEA OF DIFFERENT
PROGRAMS.
YEAH YOU HAVE.
I WAS REALLY WORKERS WHO MAY BE
YOU KNOW DEPENDING ON THE COUNTY
TO DOING SOME A. DECIDE FOCUSED
ORDERS ON EACH PROGRAM SOME THE
CROSS ITS ADDRESS.
AND THEN COURSE WITH EACH.
PROGRAMS.
DON'T STATUS HAS SOME SORT OF IT
FORMULA TO FIGURE OUT HOW MUCH
THE ADMINISTRATION THE OVERHEAD.
IS FOR THAT IS SO. IS ONLY A
LOOK AT HOW THIS CUTS ACROSS
MULTIPLE PROGRAMS THAT BECAUSE
PROBABLY EITHER THE SAME OR
SIMILAR DEPARTMENTS.
LOOKING AT THEM SO PERHAPS YOU
COULD SPEAK TO THAT. WORK SO
THERE IS CERTAINLY SOME
INTERACTION AND IN MANY
COUNTIES.
THE SAME WORKERS ARE DOING
ELIGIBILITY DETERMINATIONS FOR
MULTIPLE PROGRAMS PARTICULARLY
COW FRESHENED MEDICARE HOW.
.
WE ARE REVIEWING SOME OF THE
EFFORTS THAT ARE GOING ON IN
OTHER DEPARTMENTS AND ONE OF THE
BIG ONES IS IN CAL WORKS AND
THAT THE COMMITTEE IS AWARE OF.
I AM IN TERMS OF.
HOW THEY COORDINATE AND AS OUR
ON GOING WE WE HOPE TO LOOK AT?
WHETHER THERE'S A WAY TO BE
MORE.
CONSISTENT IN THE APPROACH
ACROSS THESE PROGRAMS
AND SO YES THAT IS SOMETHING
THAT WE'RE LOOKING AT BUT AS I
MENTIONED THOSE THOSE EFFORTS
ARE ON GOING SO WELL.
FOLLOW UP WITH ANY ADDITIONAL
COMMENTS WE HAVE WHEN WHEN WE
HAVE THEM.
AB I THINK AND PARA FINANCE LOOK
AS TO THINK THINK ABOUT SO WE'RE
HEARING ABOUT EACH PROGRAM HERE
WE'RE TALKING ABOUT HOW TO. HOW
TO FIGURE OUT WHAT THE RATE
FUNDING STREAM IS TO SUPPORT THE
COUNTIES OF THE COUNTIES CAN DO
THEIR WORK AS WELL ON?
NOW EVER TALK ABOUT MEDI CAL
SAGA CHO WORKS TAKAKO BILLY
REQUIREMENTS AND SO WHILE
WE TO THINK ABOUT THESE AND
COORDINATION WE ALSO KEEP IN
MIND. AND THE DIFFERENCES IN THE
PROGRAMS AND.
YOU ARE VERY AWARE WELL AWARE
THAT MEDI CAL IS A VERY COMPLEX
PROGRAM AND SO ELIGIBILITY
WORKERS WHEN THINKING ABOUT THE
TRAINING.
AND SO WE'RE JUST NOT THOSE TWO
POINTS.
YEAH I THINK
CLEARLY I MEAN THE PROGRAMS ARE.
THEY HAVE THEIR OWN UNIQUE
CHARACTERISTICS AND
COMPLEXITIES.
AND JUST THINKING ABOUT THE
TERMS OF
HOW THAT COME.
SO WHAT HAPPENS IS WE LOOK AT
EACH PROGRAM HAS SILOS BUT THEN
AND WE'RE REALLY TALKING ABOUT
THE CITY OVERHEAD BY BECAUSE
THEY DON'T THINK THAT I'LL
PROBABLY.
RIGHT COUNTIES TO PROPRIOCEPTIVE
TO TO DO THE JOB THAT WE'RE
ASKING THEM TO DO RIGHT FOR EACH
OF THESE PROGRAMS. HOW THOSE
THINGS SORT OF INTERSECTED
NEITHER?
TO ENERGIZE OUR BUMP INTO EACH
OTHER I JUST NOW SIDE JUST WANT
TO BE SURE THAT WE ARE TAKING A
LOOK AT THAT SO PREACHY LA
LOOKING THAT AND SURE HELL AND
FINANCES WELL.
SO WORTHWHILE WHICH IS MAINLY
TALK.
HERE AND I AM SURE THE COUNTIES
MUST HAVE SOME. OPINIONS
THEMSELVES IS THERE LOOKING AT
HOW THE MONEY'S COMING AROUND
AND TELLING ME HOW THAT MAKE
THAT ALL CANCEL OUT SO.
SO OF PERHAPS FLYNN AND WILL GO
TO PUBLIC COMMENT MAYBE SOMEONE
FROM THE COUNTIES WILL HAVE
SOMETHING TO SAY.
KELLY BROOKS I'M HERE TODAY ON
BEHALF OF THE COUNTY WELFARE
DIRECTORS ASSOCIATION AND WE
SUPPORT THE PROPOSED FIFTY FOUR
BILLION DOLLAR AUGMENTATION AND
BASED ON THE CALIFORNIA PRICE
INDEX.
WE ALSO SUPPORT THE PROPOSED
PROPOSAL TO MOVE FORWARD WITH
ANNUAL COST ADJUSTMENTS AND WE
UNDERSTAND THE PROPOSAL IS TO BE
FOR THE FORESEEABLE FUTURE AND
TELL CHANGE BY A FUTURE
ADMINISTRATION OUR FUTURE
LEGISLATURE.
BUT NOT LIMIT TIME LIMITED TO
THE SAUCE CONVERSION AS WAS
NOTED IN THE EIGHT PAGES OF THE
JANUARY BUDGET. AND WILL BE
WORKING WITH THE ADMINISTRATION
TO CLARIFY THAT AS PART OF THE
ME REVISION.
AS DIRECTOR CAN'T NOTED AND WE
DO HAVE ONE ISSUE THAT WE'RE
WORKING WITH THE ADMINISTRATION
TO ADDRESS THAT IS NOTED IN YOUR
AGENDA. AND ISSUES RELATED TO
PROPOSED ELIMINATION OF THE
ANNUAL.
REALLOCATION OF FUNDS FROM
UNDER SPENDING COUNTIES
OVERSPENDING COUNTIES.
AND WE TRY OUR BEST ALLOCATE THE
FUNDS TO COUNTIES AS THEY ARE
NEEDED AND WE'VE GENERALLY BEEN
SPENDING BETWEEN NINETY FIVE AND
NINETY SEVEN PERCENT.
OF THE OTAL AMOUNT YOU
APPROPRIATE IN THE BUDGET ACT
HOWEVER WERE NEVER PERFECT IT'S
YOU KNOW BUDGETING IS A LITTLE
BIT ARE A LITTLE BIT SCIENCE BUT
WERE NEVER A HUNDRED PERCENT
CRACKED.
AND SO THE REALLOCATION IS
NEEDED TO MAXIMIZE THE ABILITY
OF COUNTIES TO PROPERLY
ADMINISTER THE PROGRAM ON THE
STATE'S PATH UP AS ELIOT NOTED
WE DO WE DO ARE ARE WE ARE ABLE
TO REALLOCATE FUNDING AND OTHER
I'M COUNTY ADMIN PROGRAMS AND SO
WHAT WE'RE NOT SURE WHY THIS.
WOULD BE TREATED DIFFERENT.
WE'RE HOPEFUL WE CAN WORK ON
AGREEMENT BY THE MAY REVISE.
BUT WILL KEEP YOU UP TO DATE ON
HOW THOSE CONVERSATIONS PROGRESS
AND AS YOUR QUESTION ABOUT
THREAT HOW SEARCH COUNTY
ADMINISTRATION ACROSS DIFFERENT
PROGRAMS. AND. WRITE IT THIS IT
IS AN INTERESTING WITH A POINT
THAT YOU BRING UP BECAUSE I
THINK.
OVER THE TIME OF THE RECESSION
AND THRIVE COMING OUT OF IT ON.
ADMINISTRATION PROBABLY WAS NOT
FUNDED AT A HUNDRED PERCENT OF
OUR COSTS AND SO ON THAT IS
CONVERSATION WE'RE GONNA BE
HAVING A COW WORKS IT'S
CONVERSATION OR HAVING A MEDI
CAL ACCOUNT CONVERSATION WE'RE
HAVING A NICE SIZE. AND AGAIN
THE BOOK JUST AS FINANCE NOTED
THE BUDGETS ARE BUILT
DIFFERENTLY AND SO THERE'S
DIFFERENT COMPONENTS AND
DIFFERENT COST DRIVERS
ASSOCIATED WITH EACH OF THEM BUT
WE'RE HAPPY TO AND.
THANKS.
THANK YOU WELCOME.
JUSTIN GET WITH THE CALIFORNIA
STATE ASSOCIATION OF COUNTIES SO
WE ARE SUPPORTIVE OF THE ONGOING
METHODOLOGY FOR MEDICAL
ADMINISTRATION AND APPRECIATE
THE INCREASE THAT IT PROVIDES
FOR TWENTY EIGHTEEN NINETEEN. ON
THE ISSUE A REALLOCATION OF
UNSPENT FUNDS ON THIS IS
IMPORTANT AFRIKAN IS TO MAINTAIN
THIS FLEXIBILITY. AND WE ARE
ALSO HOPEFUL FOR RESOLUTION ON
THIS ISSUE IN THE CONTINUING
CONVERSATIONS.
THANK YOU.
WELCOME.
MANY ABOUT OF HEALTH ACCESS THAT
WE SUPPORT THE COUNTIES HAVING
ENOUGH RESOURCES TO DO THE
IMPORTANT WORK OF DETERMINING
ELIGIBILITY AND ENROLLING PEOPLE
INTO MEDI CAL. WE ARE AWARE OF
THE DISCUSSIONS AND THE ART THAT
ARE TAKING PLACE AND I'M JUST
ONE TECH.
EMPHASIZE THAT WE HOPE THAT IT
GETS RESOLVED THANK YOU.
I THINK YOU.
NO QUESTIONS SAYING NONE OKAY SO
WE'RE GOING TO HOLD THIS ITEM
OPENED.
WE'RE GONNA MOVE FOR.
I SHOULD ISSUE NUMBER FIVE WE
HAVE.
SERVE RULES STAKEHOLDER
PROPOSALS.
IF FOR STAKEHOLDER PROPOSAL SO.
WE GO.
HAVE.
ACTUALLY BACKED CAN'T WHAT YOU
JUST REMOVE THE DECIDER UNLESS
IT'S ON HOUSING DEPARTMENT WANTS
TO BE HERE.
ALRIGHT LET'S
THAT WILL LEAVE THE.
AT A THREATEN THE I DON'T MIND
HAVING SOMEONE'S BACK TO ME VR
MOVE AROUND THE CORNERS AND WE
CAN HAVE.
OKAY LOOKS LIKE IT ENOUGH FOR WE
HAVE WE FOR TEARS UP HERE SO
LET'S SEE WE HAVE.
.
SO HERE'S THE FIRST ONE IS
HEALTH FOR ALL AND THEN.
SO.
RIGHT.
OKAY SO LET'S SEE HERE SUFFERS
OR WE HAVE HEALTH.
IT FELT FOR ALL SO WE HAVE. GOT
SO SCREWED OKAY.
OKAY CHRIS REGALIA ALRIGHT.
YEAH.
OKAY.
ALRIGHT WERNER HOMESTRETCH.
SO ALL OF THIS IS IN ANY
COMPENSATION FOR COMING LASTS
TODAY BUT I WILL JUST BEFORE HE
STARTED TO SAY THAT THE PART
PUBLIC HEALTH I LOVE ALL THE
DEPARTMENTS OVERSEE BUT I DO
HAVE SOME FAVORITES.
ONE OF THEM. SO SORRY TO START
OFF WITH THAT AND AGAIN WELCOME
AND SO WILL DO IS JUST THAT DID
A QUICK ROUND ROBIN
INTRODUCTIONS FOR THE RECORD AND
THEN. THE.
TRAKTOR BEGINS OF YOU CAN JUST
THAT QUICK INTRODUCTION.
KAREN SMITH DIRECTOR SORT
CALTRAIN DEPARTMENT PUBLIC
HEALTH.
RENDON NEWNESS CHIEF DEPUTY
DIRECTOR FOR OPERATIONS OF THE
DEPARTMENT OF PUBLIC HEALTH
HELLO. SONYA PEDICLE AO.
MANY GREAT LENA GRANT FINANCE.
BELOW PLANTS A THANK YOU.
ALRIGHT SO ITEM NUMBER ONE IS.
THE OVERVIEW AND I THINK
THEY'LL JUST NEED TO HIT THE
HIGHLIGHTS AND THAT THANK YOU
FOR BEING HERE.
THANK YOU.
CHAIR FOR THIS OPPORTUNITY I
THINK I KNOW YOU'RE VERY
FAMILIAR WITH THE DEPARTMENT I
MEAN HIT SOME.
.
THINGS THAT HAVE HAPPENED A SOME
ACTIVITIES FROM THE PAST YEAR
THAT WERE ABOVE THE USUAL ON
SUSPECTS IF YOU WILL OF THE WORK
THAT WE DO AS A DEPARTMENT. I'M
REALLY IT'S BEEN A BANNER YEAR
FOR INFECTIOUS DISEASE OUTBREAKS
AS I SURE.
I'M INFLUENCE OF BEING THE MOST
REAL RECENT IN ADDITION TO OUR
USUAL I'M SUPPORT FOR THE HEALTH
SYSTEM I THE LOCAL HEALTH
DEPARTMENTS WE ALSO.
DISTRIBUTED OVER TWO MILLION
DOSES OF INFLUENZA VACCINE
INCLUDING ONE POINT FIVE MILLION
DOSES OF PEDIATRIC VACCINE. ON
THE HEPATITIS A OUTBREAK WE HAVE
THE UNFORTUNATE DISTINCTION OF
THE LARGEST HEPATITIS A OUTBREAK
PERSON A PERSON IN THE UNITED
STATES. OVER THE PAST YEAR.
AND THERE AGAIN PROVIDING
SUPPORT BUT ALSO TO.
DISTRIBUTING OVER HUNDRED
TWENTY THREE THOUSAND VACCINES
INCLUDING THIRTY EIGHT THOUSAND
DOSES THAT WERE STATE FUNDED I'M
DUE TO THE EMERGENCY ORDER THAT.
THAT THE GOVERNOR AND PUT OUT
BUT WE ARE ALSO STILL MONITORING
FOR ZECA AND WE CONTINUE TO HAVE
SECRET KISSES AND.
WE'VE HAD TWELVE CONGENITAL
CASES UNFORTUNATELY AS WELL.
AND WE'RE CONTINUING TO WORK
WITH VECTOR CONTROL AGENCIES ON
AND HAVE A STATEWIDE PLAN THAT
TO YOU.
CONTROLS ECA AS WELL AS REALLY
AGGRESSIVE OUTREACH AT THE
BORDER.
AND THEN I JUST WANNA IN
ADDITION TO THE COMMUNICABLE
DISEASE OUTBREAKS.
HEPATITIS BUT ALSO TO.
FETAL AM BACTERIAL MENINGITIS.
OUR.
EMERGENCY OPERATIONS CENTER
THAT THE MEDICAL HEALTH
COORDINATION CENTER HAS BEEN
ACTIVATED EVERY SINGLE DAY THIS
YEAR PRETTY MUCH.
FOR A VARIETY OF OTHER
ACTIVITIES.
INCLUDING THE.
IT TO THE EVACUATION OF ELEVEN
FACILITIES IN FOUR HUNDRED
SEVENTY PATIENTS FOR THE OR BILL
DAM A RESPONSE.
OVER TWENTY EIGHT FACILITIES
AND A THOUSAND PATIENTS
EVACUATED DURING THE NORTHERN
CALIFORNIA FIRES
THE.
FIFTY FOUR FACILITIES SOME FIVE
HUNDRED NINETY FIVE PATIENTS
EVACUATED DURING THE SOUTHERN
CALIFORNIA FIRES. AND THEN IN
JANUARY THE MUD SLIDES WHICH
WE'RE AT NOW HAVE SEVERAL
FACILITIES THAT ARE ACTUALLY ON
THEIR FOURTH EVACUATION.
DOWN IN SANTA BARBARA COUNTY SO
WE REMAIN VERY ACTIVE IN ARMOR
RESPONSE TO EMERGENCIES
THROUGHOUT THE STATE OF
CALIFORNIA. THANK YOU ALSO
FAMILIAR WITH OUR WORK ON THE
OPIATE EPIDEMIC WE CONTINUE TO
HAVE A SEVERE PUBLIC HEALTH
PROBLEM WE ALSO HAVE ONE OF THE
MOST INNOVATIVE AND BROADS BROAD
APPROACHES TO.
THE OPIATE EPIDEMIC IN THE
UNITED STATES AND WE'RE
BEGINNING TO SEE. SOME I'M
ENCOURAGING.
THAT CHANGES IN PRESCRIBING
PATTERNS IN PARTICULAR AND WE'RE
CONTINUING TO WORK ON THAT.
ACTIVELY ALSO MANAGED TO VERY
SUCCESSFULLY I THINK.
LAUNCH BOTH A REGULATORY
STRUCTURE BUT ALSO LICENSING FOR
THE MANUFACTURE OF CANNABIS AND
TO DO SO THAT'S JUST A KIND OF.
HIGH LEVEL OVERVIEW OF SOME OF
THE THINGS BEYOND OUR NORMAL
WORK THAT WE'VE BEEN DOING THIS
PAST YEAR. FAQ AND.
BRAND IT'S GONNA GIVE YOU THE
F. FINANCIAL REVIEW JUST A QUICK
OVERVIEW ON OUR BUDGET OF COURSE
WE HAVE A BUDGET THREE POINT TWO
BILLION FOR SEVENTEEN EIGHTEEN.
GOING INTO EIGHTEEN NINETEEN
IT'S RELATIVELY FLAT.
CHANGES
ABOUT A ONE PERSON
A KLEIN FROM THE SEVENTEEN
EIGHTEEN BUDGET.
COURSE WE HAVE A BUDGET THAT HAS
A.
MIX OF GENERAL FUND VERY SMALL
PERCENTAGE AND OFTEN A FOUR
PERCENT.
LARGE PROPORTION OF OUR FUNDING
COMES FROM FEDERAL FUNDS OF
ABOUT HALF AND THEN WE HAVE A
LARGE NUMBER OF SPECIAL FUNDS IN
ABOUT FORTY SIX PERCENT OR ONE
AND A HALF BILLION COMES FROM
OUR SPECIAL FUNDS SOURCES.
YOU'LL BE HEARING TODAY FROM A
NUMBER OF OUR CENTERS.
THAT.
DID THE CHANGES RELATED TO OUR
BUDGET OBVIOUSLY DRIVEN BY NINE%
BCP'S THAT WE HAVE WE HAVE FOR
ESTIMATES WILL BE PRESENTING TO
YOU THIS YEAR FROM OUR WOMEN
INFANTS AND CHILDREN ARE GENETIC
DISEASE SCREENING. OUR LICENSING
AND CERTIFICATION AND ARE HIV
ASSISTANCE PROGRAM.
YOU'LL BE HEARING MOST OF THOSE
ADJUSTMENTS THIS YEAR AND HEARD
TODAY ACTUALLY AND THEN WE HAVE
ON THE SMALL GENERAL FUND
INCREASE THAT HIGHLIGHT THIS
YEAR.
WE HAVE THREE AND A HALF
MILLION THAT'S GOING TO BOTH OUR
AL'S HYMERS PROGRAM AND OUR MEAT
SAFETY MONITORING PROGRAM YOU'LL
HEAR ABOUT BOTH THOSE AS WELL
TODAY.
THANK YOU.
THANK YOU COMES FROM ALEJO.
FINANCE.
ALRIGHT.
.
JUST YOU KNOW I THINK EVERY
SHAPE THE OVERVIEW I THINK.
WENT QUESTIONS I HAVE IS IS
THAT GIVEN THE FACT THAT.
REALLY I MEAN THE THREE POINT
TWO BILLION DOLLAR BUDGET BUT
THE GENERAL FUND PORTION IS SUCH
A SMART PORTION MOST OF THIS IS
FEDERAL MONEY DO YOU SEE THREATS
IN THE FEDERAL BUDGET TO.
TO TO OUR DEPARTMENT AND.
ARE POTENTIAL PREPAREDNESS ARE
TO BE OUT THERE ARE CARRY OUT
THERE.
DEPARTMENT
AIMS OF.
IT'S SORT OF THE TALKS ABOUT.
THE LARGE CUTS TO A TO
PREVENTION FUND PROGRAM FUNDING
AND AT THE FEDERAL LEVEL. BUT AT
THE FROM WE HAVE SEEN SOME
DECREASES IN.
SOME OF OUR PROGRAMS THAT DUST
OR WE'VE BEEN ABLE TO ABSORB
PRETTY WELL AND GOOD NEWS FROM
THIS MORNING ASSUMING THAT THE
APPROPRIATIONS BILL PASSES THAT
WENT THROUGH THE SENATE. I'M IT
LOOKS LIKE WE'RE ACTUALLY NOT
GOING TO SEE MANY OF THE LARGEST
CUTS
SO.
ALRIGHT SO BE VERY SENSITIVE THE
FACT THAT ARE. PART OF A CULT
BUDGET IS.
AND NOW THE GENERAL FUND SIDE
NAY EVEN SMALLER PORTION WHAT.
KEYS MAYBE SPIEGEL WITHOUT SO
WE HAVE THIS THREE BILLION TO
WHAT WE SPEND THE GENERAL FUND.
SLEEP.
IN TERMS OF THE.
SO AND THIS PAST YEAR OVER THE
PAST COUPLE YEARS THERE'S BEEN
SOME AUGMENTATIONS THAT HAVE
COME FROM OUR GENERAL FUND.
WE HAD TO NAPA AND SIXTEEN
SEVENTEEN ALONE WE HAD SOMEONE
SIGN UP AUGMENTATIONS OF ABOUT
TWO.
DISEASE PROGRAM.
WE HAD.
THREE MILLION THAT CAME FROM.
DRUG OVERDOSE A DRUG OVERDOSE
PREVENTION PROGRAM.
THIS PAST YEAR WE RECEIVED AND
I WENT ASIAN OF ABOUT ONE POINT
SEVEN MILLION I'M FROM PARKER
FROM OUR PARKINSON'S REGISTRY A
LARGE PROPORTION ALSO GOES TO WE
HAVE THE RICHMOND
I HAVE BEEN SO. PART OF THE THAT
THE PROCESS OF REPAINTING BONDS
GOES TO THAT.
I WOULD SAY THAT. THAT'S A AND
THEN ANOTHER STAFF PERSONNEL
COSTS ON LARGE PORTION OF IT
ACTUALLY IS WITH OUR CENTER FOR
INFECTIOUS DISEASES BECAUSE A
LOT OF OUR LAB INFRASTRUCTURE IS
GENERAL FUND.
SO THAT'S WHERE MOST OF IT.
I APPRECIATE THAT AYE AYE AYE IT
BELIEVE THAT WE'RE ACTUALLY
GOING TO HAVE A. PANEL ON ARE
THE TEXAS DISEASE ARE CONTAGION
PREVENTION THAT A FUTURE HEARING
SO I APPRECIATE YOU CITING THOSE
THINGS BECAUSE BOB EVEN AS WE'RE
DEALING WITH WILD FIRES AND MUD
SLIDES AND WORRY ABOUT
EARTHQUAKES AND FLOODS.
IT DIED THE NEW NORMALS ALSO.
SEEMS LIKE EVERY YEAR THERE'S
ANOTHER. ACTIONS DISEASE
OUTBREAK CRICHTON DUH AND HOW WE
MITIGATE THAT RIGHT SO THAT THEY
SEEK A.
YELL STDS RIGHT HERE FOR YOU TO
CITIES AROUND AYE AND WE STILL
HAVE VALLEY
EVER PLUS NINE.
AROUND.
PURPOSELY NOT ANOTHER MEASLES A
THINK AWFULLY WE HAVE POLICIES
IN PLACE THAT MITIGATE THAT BUT.
SO.
BUT IT SEEMED LIKE EVERY YEAR
THERE'S ANOTHER ONE TO TALK
ABOUT SO. ALRIGHT. RATE OF ANY
PUBLIC COMMENT ON THE OVERVIEW.
ALRIGHT SEEING NONE I WILL START
GETTING INTO SOME OF THE
SPECIFIC.
CHIU SO THAT WAS JUST
INFORMATIONAL SO I ISSUE NUMBER
TUESDAY ALZHEIMER'S DISEASE
PROGRAM GRANT AWARDS.
WELCOME AND IF YOU CAN AND JUST.
INTRODUCE YOURSELF FIRST FOR
THE RECORD AND THEN. THEN AFTER
THAT WE CAN BEGIN THE
PRESENTATION GOOD AFTERNOON THIS
IS MONIQUE UMBRELLAS AND THE
DEPUTY DIRECTOR FOR THE CENTER
FOR CHRONIC DISEASE PREVENTION
AND HEALTH PROMOTION.
AFTERNOON MARK STAR W. DIRECTOR
FOR RONALD HEALTH.
OKAY EXCELLENT HERE TO ASSIST
WITH SOME QUESTIONS IF THEY MAY
PAPA. ALRIGHT EXCELLENT OKAY
WHICH GO THEN BEGIN.
SO ISSUE NUMBER TO THE
LZHEIMER'S DISEASE UP PROGRAM
FUNDED SO ON CP IT IS REQUESTING
A ONE TIME INCREASE IN BUDGET
AUTHORITY FOR FROM THE
ALZHEIMER'S SPECIAL FIND. UP TO
SPEND AN ADDITIONAL TWO HUNDRED
FORTY TWO THOUSAND DOLLARS IN
LOCAL.
IN EIGHTEEN AND NINE.
AND THIS IS TO HONOR THE TOTAL
RESEARCH GRANT AMOUNTS THAT THE
PROGRAM I'VE PUT IN PLACE.
AND THIS PAST YEAR UNFORTUNATELY
THE PROGRAM MISTAKENLY AWARDED
A.
IN EXCESS IN OUR RESEARCH.
GRANTS AND SO THIS IS WHAT WE'RE
MAKING TO AND THE FIRST TASK FOR
THIS BCP.
ON THE SECOND ASK IS IN OF.
ONGOING DECREASE IN OPERATION
EXPENDITURE AUTHORITY. FROM THE
ALZHEIMER'S RESEARCH ACCOUNT
CONSISTING OF A HUNDRED AND
THIRTY THOUSAND DOLLARS AND THIS
IS JUST FOR US TO BALANCE OUR
EXPENDITURE WITH A LOT
PROJECTIONS FOR READING.
FULLER.
FINALLY. OF WE REQUESTED AN
EXPENDITURE AUTHORITY INCREASE
OF THREE POINT ONE MILLION
DOLLARS FROM THE GENERAL FUND.
SO THESE CHANGES FOR ITS REALLY
ARE JUST TO CONTINUE THE WORK
THAT WE'RE DOING AROUND
SOMERS SUSIE'S IN.
THAT YOU SEE OUTLINED IN THE
AGENDA TODAY PROGRAM.
OKAY THANK YOU.
AND ANY COMING FROM ELIOT. NO
FINANCE.
LEANING GRANT DEPARTMENT OF
FINANCE AND.
ALONG WITH JUST THE.
FINANCE SUPPORTS A PROPOSAL TO
FUND ADDITIONAL AND. FROM THE
START WEST ALRIGHT AND A HOME
THE AIRED IT LED TO THE OVER THE
GRANTING OR EXPENDITURE TRAN IS
THAT WE IDENTIFIED THE ROOT
CAUSE OF THAT.
THE VALUE OF HAVING THE FUTURE
YES WE DID AND WE ACTUALLY HAVE
PUT ON STRONG SYSTEMS IN PLACE
OF ADDED DID DOUBLE.
IN A REVIEW BASICALLY OF WHAT
WE HAVE AN AUTHORITY VERSUS WHAT
WE ACTUALLY HAVE IN THE FINE.
OKAY TO.
APPRECIATE YOU COMING FORWARD
NOTING THAT THAT HAPPENED IN
WHICH I'M SURE IT.
TRY TO AVOID THOSE AND FUTURE
ABSOLUTELY OKAY ALRIGHT ANY
PUBLIC COMMENT.
WELCOME.
BLAMES JOSS WHEDON AND REPS IN
THE ALZHEIMER'S ASSOCIATION.
AND WE STRONGLY SUPPORT THIS
PROPOSAL INCREASED ARM AT THIS
TIME THERE'S NO WAY TO CURE
TREAT OR PREVENT ALZHEIMER'S
DISEASE AND ALZHEIMER'S DISEASE.
IT IS A FATAL DISEASE.
CURRENTLY AT THIS MOMENT EVERY
DOLLAR WE SPEND ON RESEARCH.
SPEND A HUNDRED DOLLARS ON CARE
AND SUPPORT RESULTING AND THE
AVERAGE LIFETIME COST OF
ALZHEIMER'S DISEASE TREATMENT
FOR BEING THREE HUNDRED FORTY
THOUSAND DOLLARS FOR EACH FAMILY
MEMBER.
SO IF WE'RE GOING TO HEAD OFF
THIS COSTS WERE SOCIETY.
AND PROVIDE CARE AND SUPPORT AND
CURE THIS DISEASE ME TO SPEND
ONE RESEARCH
THANK YOU.
I THINK YOU.
SINGLE OIL SUPPLY MICROPHONE.
BEHOLD THE SAME OPEN DATA
THANKS SO MUCH FOR YOUR
PRESENTATION.
OKAY.
NEXT ITEM.
IS ITEM NUMBER THREE IS EXPANDED
LET TESTING FOR CALIFORNIA'S
CHILDREN AB THIRTEEN SO.
AGAIN FOR THE RECORD MONIQUE
UMBRELLAS AND DEPUTY DIRECTOR
FOR THE CENTER FOR CHRONIC
DISEASE.
I'M SO THIS PC PETER CRESCENT
EXPENDITURE OF FORTY OF TO.
THOUSAND TWO HUNDRED AND
SEVENTY SIX THOUSAND IN STATE
OPERATIONS FROM THE LEAD.
THE TYPE OF LEAD POISONING.
TO CARRY AT THE NEW REGULATIONS
PERSON BILLY DALE THIRTEEN
SIXTEEN.
PACIFIC EARLY THIS FUNDS UP TO
STATE POSITIONS FOR US TO BUILD
OF THE CUT
CITY TO. FOLLOW UP ON THE NEW
REGULATIONS THE DATA ANALYSIS
THAT REPORTING THAT WILL TAKE
PLACE AND BECAUSE OF AB THIRTEEN
SIXTEEN.
CURRENT BELIAU.
FINANCE WENT. OF IT SAID ONE
QUESTION REGARDING THIS ISSUE.
AND OUR ANALYSIS IT.
THE TERMS OF REGULATORY PROCESS
IT SAID IT WAS.
GONNA TAKE A MINIMUM OF TWO
YEARS AND. LEAD THIS PRE WILL
RESEARCH SO MISS WONDERING AS TO
WHY WOULD TAKE SO LONG TO THE
ABOUT THE REGULATIONS.
THERE IS A PROTOCOL THAT WE HAVE
TO FOLLOW INCLUDING FOR EXAMPLE
OF FORTY FIVE DAY OF.
COMMENTS THE STANDARDS ALSO
WORKING WITH STAKEHOLDERS
BRINGING THEM TOGETHER. BAD AND
WE BELIEVE WILL TAKE AS AND THAT
PERIOD OF TIME THEY WERE
ACTUALLY CURRENTLY RIGHT NOW.
ACTIVE THE ALREADY A YOU KNOW IN
DESIGNING AND IMPLEMENTING AND.
WORKING WITH OUR TEAM TO KIND OF
MAKE SURE THAT WE TRY TO MEET
THAT DEADLINE.
WELL I MEAN CERTAINLY IT'S
IMPORTANT BRING TOGETHER
STAKEHOLDERS AND SO FORTH BUT
YOU KNOW FORTY FIVE DAYS SOME.
MONTH AND A HALF SO THAT. I DO I
HOPE THAT WE CAN LOOK AT AND SEE
WHAT CAN BE DONE TO SPEED THE
PROCESS.
NOW ALONG ITS.
ABSOLUTELY IT'S SPILLWAYS
CONCERNING THAT GIVEN ISSUE
OBVIOUSLY LEADS TO SERIOUS ISSUE
AND. TO HEAR THAT YOU TAKE TWO
YEARS DEVELOP REGULATIONS THEM
I'M NOT SURE THERE'S A BUNCH OF
PEOPLE WHO WANT IT'S THE
POISONED BY LEAD HIS LOBBY ON
THE OTHER SIDE BUT. YOU KNOW I
THINK THAT.
WERE HOPEFULLY THIS IS MORE
STRAIGHT FORWARD AND WE CAN WE
CAN GET WE CAN GET THERE FASTER
AND PERHAPS A.
AND IF YOU BECOME IT MAYBE YOU
NEED BABY OF A COMMENT THAT I
NEED TO CHANGE SOME LAWS OR
SOMETHING TO SPEED THE PROCESS
BUT I JUST SEEMS LIKE A LONG
TIME FOR FOR THIS SO. AND.
YEAH I COULD CHIME IN LITTLE BUT
MY CENTER FROM RUN HEALTH DOES.
A LOT OF REGULATIONS.
IN OTHER AREAS OF THE RHETORIC
PROCESS IS PRETTY WELL DEFINED
CALIFORNIAN AND THE SUPPLIED BY
ONLY ALLEN AND.
MINISTER RIGHT EXACT SO WE'RE.
WHAT OUR EXPENSES IT TYPICALLY
TAKES ABOUT THREE YEARS FOR
REGULATION PACKAGE TO BE
COMPLETED SO TOM WE CAN DO SOME
FASTER?
BUT AS A LOT OF IT'S PRESCRIBED
IN THOSE TIME LINES THAT ARE
NECESSARY NOT JUST THE FORTY
FIVE DAY COMMENT PERIOD THAT'S
ONE OF THEM.
NEITHER COME I MIGHT ADD IS THAT
WE ARE PROGRAM ALREADY DOES
ANTICIPATORY GUIDANCE FOR
PHYSICIANS HEALTH CARE PROVIDERS
ABOUT CHILDHOOD LEAD EXPOSURES
AND. ON MANY OF THE ITEMS THAT
ARE PART OF THE RISK ASSESSMENT.
WE ENCOURAGE PROVIDERS ARE TO
DO THAT AND ANY GUIDANCE.
THIS WILL REQUIRE REGULATIONS TO
HAVE SOME OF THE SAME
INFORMATION BUT. NOW WE'RE NOT
STANDING STILL RIGHT NOW LOWER
WHILE WE'RE WORKING ON THE RACE
AS WELL.
I APPRECIATE THAT AND I
PERSONALLY EXPERIENCE THAT AS
WELL AS SONOZAKI PRACTICING.
ANY PUBLIC COMMENT.
WELCOME GOOD AFTERNOON THANK
YOU.
MY NAME SUSAN LITTLE I'M WITH
THE ENVIRONMENTAL WORKING GROUP
AND I'M HERE ON BEHALF OF EWG AS
WELL AS THE CALIFORNIA COALITION
OF WELFARE RIGHTS ORGANIZATIONS.
EWG WAS A SPONSOR OF AB
THIRTEEN SIXTEEN LAST YEAR AND
I'M.
JUST INITIALLY IN IN RESPONSE TO
THE QUESTIONS ABOUT TIMING. NO
WE WOULD DEVON WELCOME ANDI
PAHS.
BRICK NAM.
INTEREST AND GETTING SOME EARLY
COMMENTS FROM OUR ORGANIZATION
OUR COALITION OF FOLKS.
BEFORE THINGS EVEN GET GOING IF
WE NEED TO. TALK ABOUT SPEEDING
UP THE PROCESS THAT WE BE HAPPY
TO DO THAT. ARM JUST WANT TO SAY
THAT WORST DEATHLY WERE VERY
MUCH IN SUPPORT OF THE
DEPARTMENT'S RECOMMENDATION THAT
THEY RECEIVE THIS FUNDING. A
MEMBER DEFTLY ASKED THE THE CAN
MEDI TO FULLY FUND THE
RECOMMENDATIONS SINCE THERE ARE
TEARS OF FUNDING OPTIONS.
YOU KNOW MOST WE HAVE WORKED
WITH ASSEMBLY MEMBER QUIRK AND
DATA.
THE STM COMMITTEE TO TAKE A LOOK
AT D. H. CS IS BILLING DATA FOR
MEDI CAL KIDS AND. AS PART OF
THAT WE FOUND OR D. H. CS IS
NUMBER ON THEIR HAND COUNT OF
THOSE NUMBERS.
FOUND THAT MOST LOW INCOME
CHILDREN WHO ARE SUPPOSED TO BE
GETTING LED TESTS ARE NOT
GETTING THOSE TESTS AND SO IN
THAT BACKS UP DATA FROM.
THE PUBLIC HEALTH INSTITUTE
WHICH INDICATES THAT WERE. AS
MANY AS SIXTY THREE PERCENT OF
KIDS
IN CALIFORNIA THERE LEAD
POISONED ARE NOT IDENTIFIED IN
SO. WE DO BELIEVE THIS IS A.
TOM AN ISSUE THAT NEEDS TO BE
ADDRESSED IN A TIMELY WAY IT'S
WERE TALKING ABOUT.
AND THAT THE LEAD TESTING
REGULATIONS NEED TO BE REVISED
AS QUICKLY AS POSSIBLE SO THANK
YOU.
THANK YOU.
ALRIGHT WELL.
.
GO TO HOLD THIS ITEM OPEN BUT
CERTAINLY WHAT THE SUPPORT
DEPARTMENT AND BE ABLE TO TO
ADDRESS THIS VERY IMPORTANT
ISSUE AND.
IMPLEMENT THAT THIS IMPORTANT
BILL THANK YOU.
ALRIGHT CIVILIAN MOVE ONTO ISSUE
NUMBER FOUR WHICH IS A PROGRAM
UPDATE THE RURAL HEALTH PROGRAM.
THAT'S WHERE.
YOU CAN INTRODUCE YOURSELF FOR
THE RECORD.
AND ACTUALLY GONNA HAVE US
STAKEHOLDER HOLES MOVES WELL SO
WE GOT ROOM THERE OKAY.
SO I SEE FEDERAL AND CAN
INTRODUCE THEMSELVES FOR THE
RECORD AND THEN.
WILL START WITH THE
PRESENTATION FROM THE PARK
PUBLIC OFFICE OF.
LARA. EXITED.
VERY GOOD DEL DIRECTOR.
WITH THE CALIFORNIA DEPARTMENT
PUBLIC HEALTH WELCOME.
MICHELLE GIBBONS AT THE COUNTY
HEALTH EXECUTIVES ASSOCIATION OF
CALIFORNIA.
BOB BREANNA PITTMAN SPENCER WITH
THE CALIFORNIA DENTAL
ASSOCIATION THANK YOU.
ALRIGHT SO THE DOCTOR YOU CAN
THEN BEGIN.
THANK YOU THANK YOU FOR THE
OPPORTUNITY.
THERE ARE THREE QUESTIONS THE
FIRST ONE IS ABOUT THE OR BRIEF
OVERVIEW OF THE ORAL HEALTH
PROGRAM SAID.
DEPARTMENT OF. PUBLIC HEALTH.
OAK OR TO HELP PROGRAM'S
MISSION IS TO PROMOTE OR HOW THE
NEWS ORDER TO SEE THIS THROUGH
PREVENTION EDUCATION AND
ORGANIZED COMMUNITY EFFORTS.
OUR PROGRAM IS FOCUSED ON
SITTING AT YOU BOTH POPULATION
HEALTH GOALS AND OUTCOME
MEASURES DEVELOPING SURVEILLANCE
SYSTEM TO TRACK PROGRESS.
ADVANCING POLICY SYSTEMS AND
ORGANIZATIONAL CHANGES TO
ACHIEVE IMPROVEMENTS.
ALIGNING OUR PROGRAMS WITH
ESTABLISHED EVIDENCE BASED
PRACTICES AND FINALLY LIVE
LEVERAGING STRATEGIC VALUE
PARTNERSHIPS AND COLLABORATION.
SO IN TWO THOUSAND SEVENTEEN BE.
PUBLISHED A BOOK STATUS OF ORAL
COUNTY IN CALIFORNIA.
NOW WATER DISEASE BURDEN AND
PREVENTION.
AND IN JANUARY THIS YEAR
REPUBLISHED BE.
CALIFORNIA OR OF HEALTH PLAN.
THIS IS A ROADMAP FOR OF WATER
HAD PRIORITIES FOR THE NEXT TEN
YEARS FOR THE STATE TO ADDRESS.
A WITH RESPECT TO OUR REGULATORY
RESPONSIBILITIES AND HEALTH AND
SAFETY CORD ESTABLISHES THE
OFFICE OF PUBLIC OFFICE OF OR
HOW. THERE ARE CERTAIN SECTIONS
IN THE CORD. THAT ESTABLISH OUR
AUTHORITY FOR SEPIA EDGE TO IT
MAINTAIN THE DENTAL PROGRAM THAT
INCLUDES. SEVERAL.
THE AREAS.
THE PROGRAM USFSA DEPARTMENTS
GENTLE A PARTY. OUT TO ISSUE
GUIDELINES AS FAR
ORGANIZATIONALLY BR INTO CENTER
FOR CHRONIC DISEASE PREVENTION
AND HEALTH PROMOTION BIAFRA
THREE DOING THAT.
ADMINISTRATION PROGRAM
INTERVENTIONS AND THEN FINALLY
SURVEILLANCE AND EVALUATION.
A OUR INITIATIVES INCLUDE AND
THE MANAGEMENT OF THE.
TOBACCO TAX OF TWO THOUSAND
SIXTEEN OR HOW OFTEN THEY SHOULD
DO.
THROUGH WHICH THE FUNDING IN
THE MIND THIRTY MILLION IS
AVAILABLE ANNUALLY TO IMPLEMENT
THE STATE OR ABOUT PLAN.
I THOUGHT I HAD THE PROGRAM IS
COMMUNITY WATER FLUORIDATION.
WE HAVE A FEDERAL HER SON GRANT.
HOW TO THE IT WITH RESPECT ORAL
HEALTH WORKFORCE EXPANSION IT'S
FOCUSED ON PILOT TESTING? TELLY
DENTISTRY PROJECT.
VIRTUAL DENTAL HOME.
WE ALSO HAVE ANOTHER GRAND FROM
HER SCENT AND IT IS SO FOCUSED
ON PREGNANT WOMEN AND YOUNG
CHILDREN SET QUALITY IMPROVEMENT
PROJECT IT'S A PILOT PROJECT IN
NASA NUMBER COUNTY.
THE SECOND QUESTION IS ABOUT THE
OR HOW THE OR HAD PROGRAM IS
MEETING DEFINED GOALS IDENTIFIED
IN THE CALIFORNIA OR OF HEALTH
PLAN.
IBM ESTABLISH TO GRANT THE GRANT
PROGRAM TO PROVIDE FUNDS TO ALL
SIXTY ONE LOCAL HIGH
JURISDICTIONS BUT PLANNING AND
IMPLEMENTING EVIDENCE BASED
PROGRAMS AND POLICIES.
SO IN PHASE ONE LOCAL HOW
JURISDICTIONS UP CONDUCTING
NEEDS ASSESSMENT AND DEVELOPING
A COMMUNITY HEALTH IMPROVEMENT
PLAN.
AND IN PHASE TWO FUNDS MAY BE
USED FOR SUCH ACTIVITIES AS
COORDINATION OF SCHOOL BASED
PROGRAMS.
PROMOTING KINDERGARTEN OR A
HOUSE ASSESSMENT REQUIREMENT AND
THEN USING THAT DATA FOR
PLANNING INTERVENTIONS.
ESTABLISHING A COORDINATE AND
BUT THIS COORDINATED SYSTEM FOR
SCREENING AND REFERRAL OF
CHILDREN AND PREGNANT WOMEN.
PROMOTING RETHINK YOUR DRINK
CAMPAIGN AND TOBACCO CESSATION
IN DENTAL SETTINGS.
AND ALSO LAUNCHING EDUCATION AND
HELP THE TO SEE CAMPAIGNS.
OTHER GRANTS AND CONTRACTS WILL
HELP COMMUNITIES TO PROMOTE.
EVIDENCE BASED INTERVENTIONS
LIKE COMMUNITY WATER
FLUORIDATION AND SCHOOL BASED
PROGRAMS.
WE HAVE ESTABLISHED THAT
CONTRACT WITH THE UC A STEP DOWN
SCHOOL TO PROVIDE TRAINING AND
TECHNICAL ASSISTANCE TO LOCAL
HOW JURISDICTIONS.
YEAH WE ARE.
WELL TO EXPLORING SEVERAL
CAMPAIGNS THAT WILL IMPROVE ORAL
HEALTH BUT TO SEE.
THE FIRST ONE IS TO ENHANCE
COMMUNICATION AND DENTAL
SETTINGS WE ARE UP PROPOSING TO
CREATE A TOOLKIT FOR DENTAL
OFFICES.
I IT'S BASED ON THE. AGENCY FOR
HEALTHCARE RESEARCH AND QUALITY
UNIVERSAL PRECAUTIONS KID. THIS
WAS HOW DENTAL OFFICES TO
CREATED A SPOT. RESPECTFUL
ENVIRONMENT.
COMMUNICATE USING PLAIN LANGUAGE
AND.
SIMPLE VISUALS AND ALSO USED TO
TEACH BACK METHOD.
A THE AMERICAN DENTAL
ASSOCIATION FOUNDATION HOUSE A
CAMPAIGN COURT TINY SMILES IT'S
DESIGNED TO ENGAGE THREE
INFLUENTIAL GROUPS EDUCATORS.
DENTAL PROFESSIONALS AND MEDICAL
PROFESSIONALS.
AND WE ARE. PLANNING TO LAUNCH
THIS CAMPAIGN AND SOME CAMINO
COUNTIES.
THERE IS NO THE CAMPAIGN YOU MAY
BE BUT A FAMILY OF Y. THE
AMERICAN ACADEMY OF PEDIATRICS.
CAMPAIGN CALLER BRAASCH BOOK IN
BED BEEN ALSO. INTERESTED IN
PROMOTING THAT CAMPAIGN IN SOME
COMMUNITIES.
WELL WE ARE ESTABLISHING A
SURVEILLANCE SYSTEM TED WILL BE
CONSISTENT WITH THE NATIONAL OR
A HOT SURVEILLANCE SYSTEM AND IT
INCLUDING QUESTIONS IN MANY OF
OUR STATE BASED SERVICE LACTIS
BEYOND A PROCESS SEND ME HA.
IN WHERE THERE ARE GAPS WILL BE
A AND WE ARE DESIGNING SPECIAL
SURVEYS TO GATHER DATA
ESPECIALLY ON THE.
OR A HOUSE OUTCOMES IN CHILDREN.
THE FINAL QUESTION IS ABOUT THE
STATUS OF CLIENTS.
WE HAVE PROCESS TO FIFTY SEVEN
APPLICATION SO FAR.
AND EXECUTED FORTY NINE
AGREEMENTS.
BE HAVE GRANTED EXTENSION BUT
THREE LOCAL HAS JURISDICTION.
A.
THE A LOCAL HOUSE JURISDICTIONS
ON IN THE PROCESS OF HIDING
STAFF AND CONSULTANTS AND ALSO
FINALIZING CONTRACTS AND
APPROACHES SAUNDERS.
MOST OF THESE CONTRACTS BECAME.
EFFECTIVE IN MARCH.
SO THIS IS A GRANT PROGRAM THAT
GIVES FLEXIBILITY TO LOCAL
HEALTH JURISDICTIONS TO DESIGN
THEIR OWN PROGRAMS BASED ON THAT
NEEDS.
IN GENERAL WE ARE ASKING THE
GRANT IS TO FOCUS ON REDUCING TO
DECAY PREVALENCE IN UNTREATED
DISEASE IN CHILDREN.
INCREASING DENTAL VISIT TRAITS
AND CHILDREN AND ADULTS
ESPECIALLY PREGNANT WOMEN PEOPLE
WITH DIABETES AND BORDER ON
THOSE.
I ALSO ADDRESSING COMMON RISK
FACTORS SUCH. BUDGET DIETARY
CHOICES AND PROMOTING TOBACCO
CESSATION IN DENTAL SETTINGS.
INTEGRATION OF ORAL HEALTH AND
PRIMARY CARE IS A HIGH PRIORITY
AT THE NATIONAL LEVEL.
THE ARE ENCOURAGING A LOCAL HOW
JURISDICTIONS TO FOCUS ON UNITED
STATES PREVENTIVE SERVICES
STUFF.
TAX FORCE RECOMMENDATIONS.
HOW FOR A?
AB AND OF WHICH RECOMMENDS THE
APPLICATION OF FLUORIDE VARNISH
AND PRIME TICKET OFFICES.
THERE'S A NATIONAL CONSENSUS
STATEMENT OVERLOOKED BY HER SON
THAT RECOMMENDS.
THAT ALL HEALTH PROFESSIONALS
PROVIDE PREGNANT WOMEN WITH
APPROPRIATE AND TIMELY ORAL
HEALTH CARE.
OF THEIR. ASKING ALL LOCAL HOW
JURISDICTIONS TO PROMOTE THIS
AND THEY'RE OUT COMMUNITIES
THANK YOU.
THANK YOU I REMEMBER SERVING ON
A CD A FOUNDATION TASK FORCE ON
ON THAT VERY ISSUE ABOUT
GETTING.
A TRAIN WOMEN ARE OF.
THE SERVICES. SURE THEY GOT
THERE WILL HEALTH CARE GREAT.
SO AND COMES FROM A LEO DEL
FINANCE.
RIGHT. AND I BELIEVE WE HAVE OUR
PANEL HAS A PROPOSAL REGARDING
FUNDING FLEXIBILITY SO.
WE CAN DO IT IN THREE MINUTES OR
LESS LESS WHEN. OKAY GREAT.
SO I HAVE ROPOSITION FIFTY SIX
INCLUDES THIRTY MILLION A YEAR
FOR THE OR.
OBSERVERS UP.
S. WE ARE VERY EXCITED THAT THE
OUT PIECES IN THERE AND WANT TO
MAKE SURE THAT THERE IS MAXIMUM
FLEXIBILITY TO GET THE MONEY OUT
THE DOOR WE REALLY SEE THIS THIS
IS A TOTAL GAME CHANGER FOR ORAL
HEALTH.
WE HAVE HAD SOME CONCERNS ABOUT
HOW WITH IMPLEMENTATION WAS
GONNA LOOK LIKE WE RAISE THOSE
WITH ON THE DEPARTMENT OF
FINANCE AND DPH AND WHERE
ESSENTIALLY STAR FILLED IN THE
STATUTE IS WHAT IT IS. MONIES
COMING EVERY YEAR.
WE HAVE THE SENSE THAT HEARD
SOME CONCERNS FROM THE LOCAL
AGENCIES WHICH I THINK MY
COLLEAGUE CAN SPEAK TO A LITTLE
BIT MORE CLEARLY. AND SO
COALITION CAME TOGETHER.
MODELED SOME LANGUAGE AFTER
OTHER PROGRAMS AND DPH THAT HAVE
A LITTLE BIT MORE FLEXIBILITY
SPECIFICALLY. THREE YEAR
SPENDING AUTHORITY IN THOSE
GRANTS JUST TO GIVE ENOUGH TIME
TO THE COUNTIES ACTUALLY GET OUT
THE DOOR SO WE KNOW IF IT'S A
IT'S A SYSTEM THAT'S BEEN USED
BEFORE AMENDED WE JUST WANNA
MAKE SURE THAT THERE ARE ANY.
ANY BARRY BARRIERS.
FOR FOLKS SPENDING THIS MONEY
BECAUSE WE ARE VERY EXCITED
ABOUT IT.
THANK YOU KNOW AND AND WE DO
APPRECIATE THE COLLABORATION
THAT'S BEEN HAPPENING WITH THE
CALIFORNIA DEPARTMENT PUBLIC
HEALTH AND PARTICULARLY WITH DR
KUMAR IN HIS TEAM. I THINK AND
JUST TO FURTHER ELABORATE ON
WHAT BEYOND A HIS SAID LOOK ALL
DEPARTMENTS ARE FACING
CHALLENGES AROUND EXPENDING THE
FUNDING PARTICULARLY IN THE
FIRST YEAR BUT WE COULD FOR SEE.
THIS BEING A NEED ON THE ONGOING
BASIS AND SO WHAT WE'RE ASKING
FOR IS THE ABILITY FOR THE
DEPARTMENT TO ROLL OVER THAT THE
FUNDING FROM ONE YEAR TO THE
NEXT.
TO MAKE SURE THAT A JURISDICTION
CAN CONTINUE TO SPEND THE FUNDS
IN THE FUTURE YEARS JUST TO GIVE
YOU HAVE IT A BIT OF AN EXAMPLE
AS DR KUMAR SAID THERE'S A
NUMBER OF CONTRACTS THAT HAVE
NOT BEEN IMPLEMENTED OR WERE NOT
AND THE.
UNTIL ON MARCH OF THIS YEAR
WHICH MEANS THAT THEY HAVE THREE
MONTHS TO ESSENTIALLY SPENT
COUPLE YEARS ALLOCATION OF
FUNDING. AND FUNDING WITHIN THE
GRANTS ARE PROVIDED TO LOCAL
HEALTH DEPARTMENTS AND THEY HAVE
AT THE SAME AMOUNT OF FUNDING
PER YEAR. AND SO WE HAVE A FULL
YEAR'S ALLOCATION SPEND IN THREE
MONTHS OR AT THE MAX IT WAS SIX
MONTHS AND SO THAT'S PRETTY
CHALLENGING AND DIFFICULT NAY
DON'T WANNA MAKE RASH DECISIONS
ON HOW THEY SPEND THE FUNDS THEY
WANT TO MAKE SURE THAT THEY ARE
DOING IT TO BUILD. AND A FIRST
IN THE EARLY PHASES TO BUILD
THAT CAPACITY AT THE LOOK AT THE
LOCAL LEVEL TO MAKE SURE THAT
THEY'RE DOIG THE NEEDS
ASSESSMENT AND DOING IT IN A WAY
THAT WILL PROVIDE MEANINGFUL
INFORMATION ABOUT HOW WE CAN
BEST MAKE THE INVESTMENTS INTO
OUR COMMUNITIES.
AND SEND AND THEN GOING FORWARD
AND ANY MONEY THAT'S ROLLED OVER
INTO FUTURE YEARS THAT ARE NOT
NEEDED FOR PLANNING WILL THEN GO
TOWARDS ADDITIONAL INVESTMENTS
THAT CAN HAPPEN. TO REALLY
FURTHER THE WORK OF THE THE ORAL
HEALTH GRANTS IN THE INTENDED
PURPOSE FOR IT SO YOU WE ARE
REALLY ASKING FOR WHAT WE
BELIEVE TO JUST BE A SIMPLE FIX
TO ALLOW FUNDING TO BE ALLOCATED
FROM YEAR TO YEAR.
ALRIGHT THANK YOU ANITA COMMENTS
FROM THE. APARTMENT ABOUT THE.
THIS REQUEST IT WE UNDERSTAND
THE CONCERNS AND WE HAVE BEEN
WORKING.
TO DISSOLVE THIS WHEN WE HAVE A
MECHANISM THROUGH THE STATE
ADMINISTRATIVE MANUAL TO ALLOW
THE FLEXIBILITY FOR LOCAL
JURISDICTIONS.
YEAH WE'LL BE PROVIDING
ADDITIONAL GUIDANCE I'M IN THE
COMING WEEKS
OKAY ILIO THE CUMMINS NOT
FINANCE.
NO ISSUES WITH THIS IDEA.
GOOD.
WELL.
AS DR KUMAR NOTED.
YOU KNOW THIS IS A NEW FUNDING
STREAM AND WE DO ACKNOWLEDGE
THAT THERE WILL BE BUMPS IN THE
ROAD AND WE'VE BEEN HAVING A LOT
OF CONVERSATIONS WITH THE.
STAND WHAT THE CONCERNS ARE AND
WE'VE BEEN WORKING WITH THEM AND
WE DO BELIEVE IT THERE'S AN
ADMINISTRATIVE MECHANISM TO DO
THIS. SO WE'RE STILL IRONING OUT
ALL DETAILS FOR THAT BUT HOPE TO
HAVE MORE INFORMATION FOR.
PROVOKES.
I LIKE THE IDEA ADMINISTRATIVE
OKAY HE HAS AND THAT'S REALLY
GOOD NEWS TO HEAR AND WE LOOK
FORWARD TO HAVING FORTHE
CONVERSATIONS WITH THE
ADMINISTRATION THE ONLY THING
THAT I WOULD NOTICE TO MAKING
SURE THAT WE'RE ABLE TO ROLL IT
OVER FOR A NUMBER OF YEARS AND
THAT. WE HAVE
THE ADVANCE NOTICE TO DO THAT SO
THE STATUTE THAT WE WERE LOOKING
A CHANGE WOULD ALLOW ROLL OVER
FOR A THREE YEAR PERIOD AFTER
AND THAT YOUR CLOSES AND WE
WANNA MAKE SURE THAT. LOCAL
JURISDICTIONS KNOW IN ADVANCE AT
THAT THEY WOULD BE ABLE TO DO
THAT ON AN ANNUAL BASIS VERSUS
HAVING IT BE SUBJECT ELEGANT
PROCREATION OR ANYTHING LIKE
THAT SO WE JUST.
I'M ASKED FOR THAT FLEXIBILITY
AS WELL.
OKAY WELL SKIES WORK IT OUT IF
TURNS OUT THERE'S SOME
LEGISLATIVE PEACEFUL FIGURE OUT
OUT TOO. ALRIGHT OF PUBLIC
COMMENT.
TIM GIVES THE AMERICAN CANCER
SOCIETY CANCER ACTION NETWORK
AND ALSO SPONSOR PROPOSITION
FIFTY SIX I WANTED TO ECHO THE.
QUESTION FLEXIBILITY ON HOW
THESE FUNDING THAT ABBAS THESE
FUNDS ARE SPENT SOME EXAMPLE
PROPOSITION NINETY NINE FUNDS
THAT CALIFORNIA TOBACCO
EDUCATION AND.
RESEARCH PROGRAMS THEY'VE THE
TWENTY FIVE YEAR HISTORY OF
MULTI YEAR SPENDING AUTHORITY
AND WITH THE PASSAGE OF
PROPOSITION FOR
THE SIX IT SEEMS AN EFFORT TO
CURTAIL THAT EFFORT WITHOUT.
ADEQUATE EXPLANATION WHY SO WE
JUST ENCOURAGE.
BOB CONTINUED.
.
CONVERSATION AND ENDS MAXIMUM
FLEXIBILITY SO WE CAN SPEND
THESE TOBACCO TAX FUNDS AS THEY
WERE INTENDED.
THANK YOU.
WELCOME.
RATHER THAN THE FATE IS A THE
AMERICAN LUNG ASSOCIATION IN
CALIFORNIA AND SUPPORTING THE
PROPOSAL ON AT GOING WHAT MY.
FRIEND FROM THE CANCER SOCIETY
SAID. I IT'S REALLY IMPORTANT
THAT THESE FUNDS HAVE THIS
FLEXIBILITY AT SOMETHING THAT
HAS BEEN BUILT INTO IT AND IN
FACT PROPOSITION FIFTY SIX
OUTLINED TO CONTINUE ITS
APPROPRIATION FOR THESE FUNDS
AND SO. I WE NEED TO MAKE SURE
THAT WE YOU KNOW BY BY THE WILL
OF THE VOTERS AND DO WHAT NEEDS
TO BE DONE SOMETHING CAL. THANK
YOU.
WELCOME. GOOD AFTERNOON COOL
CUTTING WITH THE AMERICAN HEART
ASSOCIATION AMERICAN STROKE
ASSOCIATION I'M ALSO WERE CO
SPONSORS OF PROPOSITION FIFTY
SIX A ECHO THE SENTIMENTS OF MY
COLLEAGUE FROM. CANCER CITING
AMONG WE SUPPORT THE STAKEHOLDER
PROPOSAL TO ALLOW FOR MAXIMUM
FLEXIBILITY IN HOW THESE FUNDS
ARE SPENT THANK YOU. THANK YOU.
WELCOME.
AFTERNOON KATIE ANDREW CHILDREN
NOW.
EYES ONE ECHO AS IS SENTIMENTS
OF THOSE WHO CAME BEFORE ME.
WE ARE ALSO IN STRONG SUPPORT
OF THIS PROPOSAL TO PROVIDE
LOCAL HEALTH JURISDICTIONS THE
FLEXIBILITY.
THANK YOU.
WELCOME.
AFTERNOON DOUG VICTOR CHRISTY
WITH CALIFORNIA HELPLESS
ADVOCATES REPRESENTING COMMUNITY
HEALTH CENTERS US SOMETIMES A
COMMITTEE HEALTH CENTERS ARE THE
ONLY PROVIDER IN TOWN. ALSO
HAVING THIS OF FLEXIBILITY WOULD
REALLY ALLOW US TO WORK WITH OUR
PROVIDERS TO I'M.
REALLY MEET THE NEEDS. OF THE
EVOLVING OUR.
MEET THE NEEDS OF PATIENTS IN
THE COMMUNITY SO THE GUITAR IN
SUPPORT.
OKAY THANK YOU.
RIGHT.
APPRECIATE THE PRESENTATION I DO
JUST BEFORE WE. MOVE ONTO THE
NEXT ITEM.
FROM YOUR WORLD DISEASE BURDEN
REPORT.
ONE THIRD OF CHILDREN HAVE
UNTREATED TOOTH DECAY.
FORTY FOUR PERCENT OF
BENEFICIARIES.
AND.
MEDIC CAO.
CABIN ROLE FOR LEASE NINETY
CONTINUOUS DAYS
ONLY FORTY FOUR PERCENT
RECEIVED.
AT LEAST ONE.
THAT SERVICE.
SO WE HAVE SOME WORK TO DO HERE.
THANK YOU. SO. WILL HOLD THIS
ITEM OPEN AND HOPEFULLY WE CAN
WORK SOMETHING OUT FOR.
ME REVISE.
SO THANKS SO MUCH PRESENTATION
OKAY.
I NEXT ISSUES ISSUE NUMBER FIVE.
PUBLIC BEACHES PUBLIC BEACH
INSPECTIONS FOR TEN MINUTES
INFLATION SP THIRTEEN NINETY
FIVE.
WELCOME BACK.
SO HAVE YOU INTRODUCE YOURSELF
FOR THE RECORD AGAIN IS FOR THE
SIDE.
THANK YOU VERY MUCH MR SHARE HIT
AFTERNOON MARK STAR W. DIRECTOR
FOR RONALD HEALTH IN THE FORM OF
PUBLIC HEALTH.
BUT THIS REQUEST IS TO ENABLE
THE DEPARTMENT OF PUBLIC HEALTH
A FINALIZED IMPLEMENTATION OF
MANDATED PER. PROVISIONS OF
SENATE BILL THIRTEEN NINETY FIVE
WHICH WAS CHAPTER IN TWENTY
FOURTEEN.
AND IT'S ABOUT THE APPROVAL OF
THE USE OF NEW RAPID TEST
METHODS FOR BEACH WATER TESTING.
YOUR AGENDA PACKET HAS NIXON
RIGHT OPPOSE PROPOSAL SOLVES
PROVIDE A VERY QUICK OVERVIEW.
THE CONTEXT HERE IS THAT LOCAL
DEPARTMENTS ARE RESPONSIBLE FOR
BEACH WATER SAFETY TESTING FOR
CONTAMINATION.
BACTERIAL CONTAMINATION FROM
OVER USE OR FROM NEARBY US
SOURCES.
AND THEY'RE ALSO RESPONSE FOR
POSTING OR CLOSING BEACHES AS
NECESSARY.
OUR ROLE THE STATE IS TO
DETERMINE THE TESTING METHODS
AND STANDARDS FOR THAT TESTING
AND THAT SPECIFIED IN
REGULATIONS.
THE CURRENT GOLD STANDARD IS
BACK TO LOGIC CULTURE.
REQUIRES ABOUT TWO DAYS OF TURN
AROUND TIME. AND THERE'S
POTENTIAL HEALTH OF IMPACTS OF
THAT BECAUSE YOU MAY HAVE A
BEACH IS CONTAMINATED BICU
DON'T ACTUALLY IDENTIFIED FOR
TWO DAYS.
THERE'S ALSO ECONOMIC IMPACTS IN
REOPENING BEACHES AND DELAYING
THAT ON THAT ARE IMPORTANT FOR
TOURISM.
SO THE NEW RAPID PCR TEST BECAME
AVAILABLE EARLIER THIS DECADE
AND.
THEY HAVE ABOUT A FOUR HOUR
TURNAROUND TIME.
YEAH SO S. B. THIRTEEN NINETY
FIVE CAME INTO PLAY AFTER THAT
WHICH REQUIRES US TO DEVELOP
INVALIDATE THE NEW TEST METHODS
AND THE COMPLEX PROCESS THEIR
SITE SPECIFIC.
TESTING THERE'S INTERFERING
SUBSTANCE IS A DIFFERENT
LOCATIONS THAT'S MUCH MORE
DIFFICULT EMPLOYMENT AND
CULTURE.
BUT TO DO SIDE BY SIDE
COMPARISON WITH THE CULTURE
TESTING. AND ULTIMATELY PREPARE
TESTING STANDARDS GUIDELINES DO
TRAININGS AND AND SO ON.
SO THE FIRST BUDGET PROPOSAL.
IN TWENTY FIFTEEN AND SIXTEEN
PROVIDED THREE YEARS RESOURCES
FOR ONLY THE INITIAL LAB WORK.
WHICH HAS OF BEEN US VERY
SUCCESSFUL AND THE PROGRESS IS
DESCRIBED IN YOUR AGENDA PACKET
INCLUDING OUR CLOSE
COLLABORATION WITH STAKEHOLDERS.
THIS PROPOSAL REQUEST THE
RESOURCES NEEDED TO COMPLETE THE
JOB BASICALLY THERE'S TWO TASKS
COMPLETE THE LAB WORK. AND IN
THE SECOND ONE IS TO THEN WRITE
THE REGULATIONS.
WE VERY TALK ABOUT REGULATIONS
ARE. A IN ORDER TO.
ALLOW LOCAL JURISDICTIONS TO BE
ABLE TO UTILIZE THIS TEST THIS
IS ALL NECESSARY BEFORE LOCAL
HEALTH DEPARTMENTS CAN USE THE
RAPID TESTS. FOR THEIR BEACH
MANAGEMENT DECISIONS.
THANK YOU SO WENDY ANTICIPATE
REGULATIONS BEING AVAILABLE FOR
OUR OUR BEACH COUNTIES TO BE
ABLE TO USE THIS.
THE ARE SCHEDULED FOR COMPLETION
IS FIVE YEARS.
FIVE MORE YEARS WE HAVE THROUGH
THROUGH THREE YEARS OF LAB OF
FINISHING LABOR AND THEN THERE'S
AN OVERLAP YEAR. THE THIRD YEAR
AND THEN AFTER THAT THERE'S TWO
MORE YEARS.
TO COMPLETE THE RATE VERY
PROCESS BUT ALSO THERE'S
GUIDELINES TECHNICAL ASSISTANCE
EDUCATIONAL WORKING TRAIN TO BE
PART OF THAT I'M KINDA JUST.
ARE TRYING TO SUMMARIZE THIS
QUICKLY FOR IT I APPRECIATE THAT
AND I DON'T I KNOW THIS CASE YOU
HAVE TO GATHER SOME DATA. YEAH
YOU'RE DOES FROM THE LAB WORK
AND SO FORTH.
JUST THINKING LIKE WE GOTTA FIND
A WAY TO MAKE WITH THESE THINGS
FASTER BUT ANYWAY. OKAY WELL
HOPEFULLY IN FIVE YEARS WE CAN
OPEN OUR BEACHES MORE QUICKLY
THAN ALRIGHT.
COMES FROM ELIO. NO FINANCE
BELT.
ANY BEACH COMMENTERS OUT THERE.
NO SO FOR THE NEXT FIVE YEARS
THESE CLOTHES FOR TWO DAYS YOU
KNOW WHY. IT'S WERE WAITING.
OKAY.
BOHO THIS ITEM OPEN THANKS MUCH
FOR YOUR PRESENTATION NOW IS THE
BY THIS. VERY PORTANT TRIES
DELUDE FOR ITSELF THANK YOU.
ALRIGHT ISSUE NUMBER SIX
OVERSIGHT. CALIFORNIA SAFE
COSMETICS FOR.
WE.
HAVE FUN A SOME STAKEHOLDERS TO
HAVE A PROPOSAL SO OKAY FEAR WE
CAN JUST MAKE LITTLE ROOM FOR
THEM ON THE SIDE THERE.
AT SEA.
SO WE HAVE.
TWO PRESENTERS I FLICK WITH TWO
CHAIRS OR GOOD THERE OKAY SO.
ALRIGHT. AND THE.
WE'LL DO IS WE'LL HAVE THAT PART
OF PRESENT AND AND IF THE UPDATE
AND THEN YOU CAN INTRODUCE
YOURSELVES AFTER WE.
IS THAT ALRIGHT SO.
I TRIED AGAIN.
GOOD AFTERNOON FOR THE RECORD
THIS IS MONEY COME AROUND THIS
DEPUTY DIRECTOR FOR THE CENTER
FOR CHRONIC DISEASE PREVENTION
AND HEALTH PROMOTION. THERE
SPECIFICALLY TO QUESTIONS FOR
ISSUE NUMBER SIX OF THE
DEPARTMENT WILL BE ANSWERING.
WILL START WITH THE FIRST ONE
WHICH IS REGARDING THE DATA
COLLECTION REPORTING ACTIVITIES
OF THE SIX COSMETICS PROGRAM.
ON.
OUR PROGRAM CURRENTLY MANAGES AN
ONLINE SYSTEMIC OR COMPANY
FREEPORT PRODUCTS CONTAINING
INGREDIENTS IDENTIFIED OR
SUSPECTED. OF HAVE COURT AND TO
BECOME A CARCINOGENS FOR FIVE
REPRODUCTIVE TOXINS.
IN ADDITION WE MANAGE A PUBLIC
DATABASE WHERE CUSTOMERS CAN
ACTUALLY LOOK UP THESE PRODUCTS
THAT THESE COMPANIES ARE
REPORTING. PART OF THE DATA
COLLECTION THAT WE DO AND TELLS.
YOU KNOW COLLECTING PRODUCT
NAME TYPE OF PRODUCT BRAND OR
COMPANY NAME.
AND REPORTABLE INGREDIENTS.
IN TERMS OF QUESTION NUMBER TO A
HOW WE VERIFY THAT THE COSMETIC
PRODUCTS OF THAT ARE BEING
REPORTED. CURRENTLY THE PROGRAM.
IT HAS A VERY DIFFICULT TIME
DETERMINE AT ANY POINT ATONE
NUMBER OF COMPANIES WHO HAVE TO
REPORT THE PRODUCTS.
IN WHO MEET THE CRITERIA PER.
SAFE COSMETICS ACT.
AND IT'S VERY DIFFICULT FOR US
BECAUSE IT IS ANY BALL BEING A
BUSINESS FORMULATIONS ARE
CONSTANT BEING DEVELOPED.
SO IT'S IT MAKES IT DIFFICULT
FOR US TO ACTUALLY KNOW AND
COMPANIES ARE WE DON'T HAVE ANY
EXISTING LIST OF ALL THE
COMPANY'S HAN. SINCE IT'S A
MOVING TARGET.
IN TERMS OF QUESTION NUMBER
THREE OF PRODUCTS THAT ARE NOT
BEING REPORTED TO THE PROGRAM
AND HOW WE GO ABOUT IT. I'M A
DIDN'T YOU KNOW THAT
CALIFORNIA'S OF COSMETICS ACT OF
TWO THOUSAND FIVE DID NOT
PROVIDE ANY SPECIFIC GUIDANCE ON
HOW THE.
WOULD IN FORCE REPORTING AND SO
THEREFORE WE HAVE YOU KNOWN
KNOWN FORSMAN CAPABILITIES.
HOWEVER I WHEN WE DO FIND OUT
THAT OF PRODUCT NEEDS TO BE
REPORTED WE DO FOLLOW UP WITH
THE COMPANY. AND WE SEND ALSO
LETTERS A ANNUALLY WE SING
MOUSE SOME.
OKAY THANK YOU UP COMES LA YOU.
KNOW FINANCE.
ALRIGHT.
OKAY SO ONE SANDERS A PROPOSAL
HERE SO HE CAN KEEP FOR TOGETHER
WITHIN THREE MINUTES.
APPRECIATED.
AND ACTUALLY POINT YOU'VE UP
BEFORE WE START THE CLOCK WANT
TO JUST INTRODUCE YOURSELVES
EACH FOR THE RECORD.
MY NAME IS DOCTOR JEAN CONNIE
AND I'M AN OBSTETRICIAN
GYNECOLOGIST FROM ROSA
CALIFORNIA HAS PRESIDENT OF THE
AMERICAN COLLEGE OF
OBSTETRICIANS. AND
GYNECOLOGISTS.
GOOD AFTERNOON MY NAME IS JANET
MIDDLEMAN I'M WITH A BREAST
CANCER PREVENTION PARTNERS AND
WE ARE ONE OF THE STAKEHOLDER. A
PROPOSAL PROPOSERS ALONG WITH
BLACK WOMAN FROM WELLNESS OKAY
NICE EVEN GO IN BEGIN THANK YOU
I SERVE ON THE EXECUTIVE BOARD
OF THE INTERNATIONAL FEDERATION
OF OBSTETRICIANS.
AND GYNECOLOGISTS AND LEAD A
GLOBAL TASK FORCE AND HOW THE
ENVIRONMENT IMPACTS ARE HOOKED.
SORRY. AND A CUT IS THE LEADING
I AM PROVIDER FOR WOMEN'S HEALTH
CARE AROUND THE UNITED STATES
WERE MEMBERSHIP ORGANIZATION
FIFTY EIGHT THOUSAND WOMEN A
FIFTY THOUSAND POSITIONS. AND
THE WOMEN WE SERVE ACROSS UNITED
STATES FIVE THOUSAND POSITIONS
HERE IN CALIFORNIA.
I'M GRATEFUL FOR THIS
OPPORTUNITY TO SPEAK TO THE
SUBCOMMITTEE. AND TO
CONGRATULATE OUR LEGISLATIVE
BODY AND A VERY SUCCESSFUL
EXISTING CALIFORNIA'S SAFE
COSMETICS PROGRAM.
WE ARE PROPOSING A FEE BASED.
FUNDING INCREASE TO SUPPORT THAT
EXISTING PROGRAM SO WE'RE NOT
QUESTIONING THE EXISTENCE WE DO
APPRECIATE HOW DIFFICULT IT IS.
ADAM WITH WHAT YOU'VE OUTLINED
TODAY.
FIVE YEARS AGO A COG AND
PRESENTED A MAJOR COMMITTEE
OPINION.
AND REAFFIRMED IT THIS YEAR THAT
THE ENVIRONMENTAL IMPACTS OF
TOXIC CHEMICALS CAN IMPACT OUR
HEALTH WHETHER WE'RE TALKING
ABOUT THE HEALTH OF WOMEN OR THE
FETUS.
AND THE GO IN THREE YEARS AGO
ISSUED A SIMILAR OPINION TO
SUMMARIZE SOME OF THE IMPORTANT
POINTS THEIR. NUMBER ONE. WE
RECOGNIZE THAT THE IMPORTANCE OF
REDUCING AND PREVENTING
EXPOSURES
TO TOXIC CHEMICALS IS A CRITICAL
AREA FOR PRACTICING CLINICIANS.
AND ALL THE PATIENTS THAT WE
SERVE.
NUMBER TWO PREGNANCIES A
PARTICULARLY VULNERABLE TIME.
FOR WOMEN BECAUSE THE CHEMICALS
THAT THEY ARE EXPOSED TO CAN BE
CUMULATIVE CAN BE ADDITIVE. AND
THE TIMING OF THE EXPOSURE CAN
IMPACT THE EFFECT ON THE FETUS.
THE PREGNANCY IS A PARTICULARLY
VULNERABLE PERIOD. AND THIRD
UNDERSERVED WOMEN ARE ESPECIALLY
VULNERABLE BECAUSE THEY HAVE AN
EXPOSURE TO HIGHER POTENTIAL
TOXICS SO THOSE ARE THREE
UNDERLYING AREAS OF CONCERN.
AS A PHYSICIAN I APPRECIATE THE
FORESIGHT OF OUR LEGISLATIVE
BODY THAT LED TO THE CALIFORNIA
SAFE COSMETICS
PROGRAM IT IS AN IMPORTANT TOOL
FOR PHYSICIANS.
CONSUMERS AND WORKERS.
WITH THE INFORMATION THAT THEY
NEED TO AVOID EXPOSURE TO
POTENTIAL CARCINOGENS
REPRODUCTIVE TOXIC.
WE ALSO REALIZE THE CONSUMERS
WORKERS HAVE A RIGHT TO KNOW.
POSITIONS HAVE A NEED TO KNOW.
IF WE'RE GOING TO PROVIDE THE
RIGHT GUIDANCE FOR OUR PATIENTS.
THIRTY SEVEN YEARS AGO I HAD MY
FIRST CHILD AND I REMEMBER
ASKING MY POSITION ABOUT A CREAM
THAT I USED AND HE SAID FOR
GOD'S SAKE YOU'RE NOT EATING UP
WHY ARE YOU WORRIED.
THAT'S NOT HOW WE SHOULD RESPOND
TODAY.
THIS IS A VERY SIMPLE PROPOSAL
THAT CREATES A FEE BASED
STRUCTURE TO PROVIDE ONGOING.
AND FUNDING FOR IMPORTANT
PROGRAM THAT HELPS GUIDE OUR
PATIENTS AND PHYSICIANS THANK
YOU.
I'M ACTUALLY HERE TODAY GOD JUST
TO TO RESPOND TO QUESTIONS THAT
YOU MIGHT HAVE I KNOW HOW LONG
THAT THEY HEARINGS GONE ALREADY
SO. I'LL.
SKIP ANY ADDITIONAL COMMENTS AT
THIS TIME. AND EXACTLY THREE
MINUTES MAKING.
PERFECT.
OF.
SO JUST TO CLARIFY THE. TO
YOU'RE. A FEE FOR EACH PRIDE HOW
MUCH
REVENUE EXPECTING TO RAISE WITH
THE CITY.
WELL IN THE LAST ROUND OF
REPORTING THAT WAS CONDUCTED BY
THE THE SAFE COSMETICS PROGRAM
SIXTY FIVE THOUSAND PRODUCTS
WERE REPORTED TO THE PROGRAM.
BETWEEN TWO THOUSAND AND NINE
AND TWO THOUSAND AND FIFTEEN SO
WE USE THAT NUMBER.
TO.
IT TO COME UP WITH A
RECOMMENDED FEE OF THIRTY
DOLLARS PER REPORTABLE PRODUCT
WHICH WOULD GENERATE ABOUT ONE
POINT FIVE MILLION DOLLARS AND
AN ADDITIONAL REVENUE.
AND DOES.
YOUR CONCERN IS THAT THERE ISN'T
SUFFICIENT STAFFING CURRENTLY TO
IMPLEMENT THE CURRENT LAW WILL
ARE OUR BIGGEST CONCERN I HAVE
IS THAT THE PROGRAM HAS BEEN
CHRONICALLY UNDERFUNDED.
AND THAT'S NO ONE'S FAULT THERE
ARE SO MANY COMPETING PRIORITIES
FACING THAT.
BUT SINCE ITS INCEPTION THE
PROGRAM HAS BEEN CUT TWENTY FIVE
PERCENT IN FUNDING IT NOW HAS A
BUDGET OF ABOUT THREE HUNDRED
SEVENTY THOUSAND DOLLARS IT'S
ONLY ABLE TO EMPLOYEE TO STAFF.
SO WITH ADDITIONAL FUNDING
THOUGH PROGRAM WOULD BE ABLE TO
HIRE ADDITIONAL STAFF AS WELL AS
FULLY COMPLY THE LAW BY HIRING
AN ENFORCEMENT OFFICER.
ANY COMMENTS FROM THE PUBLIC
BECAUSE.
NO NOT CURRENTLY THINKING OKAY
LA JOH DOESN'T FINANCE.
YES OTHER STAKEHOLDERS HAVE
REACHED OUT TO US IN AT THIS
TIME ARE STILL ASSESSING THE
PROPOSAL WE DON'T OF A POSITION
OR HAVE IT RIGHT TECHNICAL
SUPPORT.
OKAY.
AND I THINK WE'RE PUBLIC
COMMENT.
WELCOME.
GOOD AFTERNOON MISTER CHAIR
CORBULO SOME HALF OF BEST CANCER
PREVENTION PARTNERS.
S. CANCER ACTION IN.
AND KEEP ABREAST IN SUPPORT.
OKAY
THANK YOU WELCOME.
WELCOME.
WHEN SPENCER ON BEHALF OF THE
AMERICAN COLLEGE OBSTETRICIANS
AND GYNECOLOGISTS THE
ASSOCIATION SUPPORT THE STICKERS
PROPOSAL THANK YOU. THANK YOU.
WELCOME.
GOOD AFTERNOON MAYOR DALEY ON
BEHALF OF THAT PERSONAL CARE
PRODUCTS COUNCIL.
.
I WANNA WE OPPOSE THE THE THIS
BUDGET REQUESTS AND I WANNA SAY
AT THE OUTSET THAT.
ON BEHALF OF THE COSMETICS
INDUSTRY WE OBVIOUSLY CARE ABOUT
THE SAFETY OF CONSUMERS.
AND SAFETY IS A PRIORITY FOR
INDUSTRY OTHERWISE OUR BRANDS OF
BE EXTREMELY COMPROMISE.
I'M.
WE ARE OPPOSE WE WERE OPPOSED TO
SB FORTY FOUR THAN THAT CREATED
THIS DATABASE BACK THEN AND WE
ARE OPPOSED TO. THE EXPANSION OF
THE DATABASE TODAY.
BASED ON THIS FEE BASED
APPROACH TO FIND AND EXPAND THIS
PROGRAM.
IT'S RATHER BAFFLING THAT WE
HAVE A STATE FUNDED AND STATE
RUN PROGRAM THAT PROVIDES
INFORMATION THAT'S READILY
AVAILABLE ON THE PRODUCT LABEL.
IT WAS ASKED AT THE ASSEMBLY
HEARING WHETHER THERE WOULD BE
ANY DIFFERENT INFORMATION THAT
WOULD BE FOUND ON THIS DATABASE
THAT COULDN'T BE FOUND ON THE
PRODUCT LABEL AND THE ANSWER IS
NO NOTS THE REALITY.
WE ARE NOT HERE ASKING FOR THE
ELIMINATION OF THE PROGRAM BUT
WE ARE VERY MUCH OPPOSED TO THE
EXPANSION OF THIS PROGRAM ON THE
BACKS OF MANUFACTURES.
THE REALITY IS THAT THE INDUSTRY
IS COME A REALLY LONG WAY WE
HAVE EMBRACED TRANSPARENCY IN
MANY WAYS LIKE I SAID WE LIST
ARE INGREDIENTS HONOR LABELS
THOSE OF THE PRODUCTS THAT ARE
AVAILABLE DIRECTLY TO CONSUMERS.
AND LAST YEAR WE DID SOMETHING
THAT WAS RATHER UNPRECEDENTED
WHERE WE EMBRACED
A TRANSPARENCY MEASURE TO
PROVIDE INGREDIENT DISCLOSURE
FOR. PROFESSIONAL COSMETICS AND
WE UNDERSTAND THAT BACKING TWO
THOUSAND FIVE MINUTES BEFORE HE
FOUR WAS ENACTED. THE THE ONE OF
THE MAJOR COMPONENTS OF THE BILL
WAS TO PROVIDE SAFETY AND
INFORMATION TO SALON WORKERS AND
SO THERE WAS A BILL LAST YEAR A.
B. FIFTEEN SEVENTY FIVE KALRA.
THAT CALLED FOR IN GREETING
DISCLOSURE OF THOSE CATEGORIES
OF PRODUCTS WE CAME WE SUPPORTED
THAT BILL WE REMAIN COMMITTED TO
SUPPORTING AGAIN THIS YEAR.
THE STATE HAS ALSO COME A LONG
WAY WE'VE ENACTED A NUMBER OF
PROGRAMS TO REGULATE THESE
PRODUCTS.
AND I KNOW THIS IS BEEN A
REALLY LONG HEARING MISTER
CHAIR.
SO I WOULD JUST KEEP IT BRIEFLY
WE'VE ENACTED GREEN CHEMISTRY
BACK IN TWO THOUSAND EIGHTEEN
EXTENSIVE REGULATORY AUTHORITY
THEY'VE NAMED OUR PRODUCTS AS
PART OF THE TWO THOUSAND
EIGHTEEN TWO THOUSAND TWENTY
WORK PLANS THEY WILL BE LOOKING
AT. OUR PRODUCTS THEY WILL HAVE
REGULATORY AUTHORITY TO MANDATE
SAFER FORMULATIONS THAT AS A
MEANS TO AN END. NOT A DATABASE
THAT REPLICATES WHAT YOU CAN
ALREADY FIND ON PRODUCTS FOR
THOSE REASONS.
WE OPPOSE.
OKAY CAN I GIVE YOU SOME EXTRA
TIME AND FAIRNESS
THROUGH SINCE THE PRISONERS HAD
CHANCE TO GIVE A.
PRESENTATIONS SO BUT IF WE CAN
ASK EVERYONE ELSE TO KEEP TO A
MINUTE.
IF YOU MISTER SIERRA DAWN KEPT
HERE ON THE Q. CAPTAIN
ASSOCIATES ON BEHALF THE
CALIFORNIA MANUFACTURERS AND
TECHNOLOGY ASSOCIATION ALSO
REGRETTABLY OPPOSED
PUZZLE. ADEN WOULD ECHO THE
COMMENTS BY MISLEAD EYES WHILE
IT JUST INDICATES ON THAT
RELATED TO THE CHEMICALS
REQUIRED VIA. NOTIFIED ONTO
DEPARTMENT UNDER THIS PROGRAM
THOSE ARE CHEMICALS THAT ARE
ALSO COVERED UNDER PROP SIXTY
FIVE I MEAN ALTHOUGH PROP SIXTY
FIVE IS NOT UNNECESSARILY ON
SOMETHING YOU OFTEN DISCUSS AS
PART OF THIS SUBCOMMITTEE. I
CERTAINLY IDEAS RELEVANT
RELATIVE TO THE CARCINOGENS AND
REPRODUCTIVE TOXICANTS AT THE
PROGRAM COVERS UNDER THAT
PROGRAM AS YOU WELL KNOW OUR
REQUIREMENTS TO WARREN HI
RELATIVE TO. AYE EXPOSURES AND
WE THINK THAT AS FAR AS ON THAT
PROGRAM GOES THERE IS OVERLAP
AND POSSIBLY DUPLICATION WITH
THIS PARTICULAR PROGRAM FURTHER
THAT PROGRAM UNDER A NEW
APPROACHES THAT THEY'RE TAKING
BASED ON RECENTLY ADOPTED
REGULATIONS. ARE PROVIDING MORE
CONTEXT FOR THOSE CHEMICALS
RATHER THAN JUST A NAME
AND I KNOW FOR THE CONTEXT AS TO
WHAT THERE. ARE PARTICULAR
BENEFIT A REASON FOR A CHEMICAL
BEING INCLUDED SUCH AS A
SUNSCREEN PROTECTION MIGHT HOW
BILL AS A BELLOWS REASONS
ANOTHER SO WE APPRECIATE YOUR
TIME AND MUST OPPOSE. THANK YOU
THANK YOU WELCOME. IDENTICAL
KENYATTA'S ON BEHALF OF THE
HOUSEHOLD AND COMMERCIAL
PRODUCTS ASSOCIATION AND THE
INTERNATIONAL FRAGRANCE
ASSOCIATION OF NORTH AMERICA WE
ARE ALSO OPPOSE I JUST ONE MORE
POINT ONE I'D APPRECIATE THAT
THE PROPONENTS. HAVE.
OFFERED A THIRTY DOLLAR FEE
SORT OF.
AS PART OF PROPOSAL HOWEVER THE
LANGUAGE THAT'S BEEN OFFERED TO
THE COMMITTEE I AM IS MUCH MORE
BROAD AND SIMPLY STATES THAT THE
DEPARTMENT OF FINANCE COULD
ASSESS A FEE ANNUALLY OR WOULD
REQUIRE THEM TO SAYS AVI
ANNUALLY WITH NO CAP SO. I'M
SIMILAR COMMENT THANK YOU.
THANK YOU.
WELCOME.
I CARE BANKING ON THE FOUNDER OF
A JUICE BEAUTY IN ORGANIC
BEAUTY.
PRODUCTS COMPANY THANK YOU FOR
THE CALIFORNIA BALLOT PRODUCTS
ACT WOULD LOVE THAT. AND I'M
HERE IN SUPPORT OF.
THAT THE.
SAFE COSMETICS ACT IT IS
POSSIBLE TO.
FORMULATE IN A HEALTHIER WAY
WITHOUT ALL THE CHEMICALS THAT
ARE OUTLINED IN PROP SIXTY FIVE
SO WE USE THE DATABASE
EXTENSIVELY. OF BEAUTY COUNTER
WAS ALSO HERE FROM SOUTHERN
CALIFORNIA BUT THEY HAD TO LEAVE
SO.
THEY ARE ALSO IN SUPPORT OF THE.
ACT THANK YOU THANK YOU THANK
YOU.
WELCOME.
I DO WE SET THAN FLEET ON BEHALF
OF A NUMBER OF ORGANIZATIONS
HAVE ALREADY HAD TO LEAVE.
SO IN BRIEF.
NATURAL RESOURCES DEFENSE
COUNCIL CLEAN WATER ACTION
WOMEN'S VOICES FOR THE EARTH
TEENS TURNING GREEN. THE HEALTH
A NAIL SALON COLLABORATIVE WORK
SAFE POSITIONS FOR SOCIAL
RESPONSIBILITY SAN FRANCISCO BAY
AREA BLACK WOMEN FOR WELLNESS
AND THE CALIFORNIA LEAGUE OF
CONSERVATION VOTERS IN STRONG
SUPPORT OF THIS PROPOSAL.
AND JUST VERY QUICKLY FOR THOSE
PEOPLE SHOPPING ONLINE THE
PROPOSITION SIXTY FIVE WARNINGS
AND THE INGREDIENT LABELS ARE
NOT ALWAYS VISIBLE SO THIS
DATABASE IS EXTREMELY IMPORTANT
FOR THOSE DOING COMPARISON
SHOPPING AND RESEARCH. TO GET
INFORMATION
ABOUT TOXIC CHEMICALS IN THESE
PRODUCTS THANK YOU. THANK YOU.
WELCOME.
GIVE CATHARINE BATES
REPRESENTING INVESTOR
ENVIRONMENTAL HEALTH NETWORK IN
STRONG SUPPORT.
THANK YOU.
THANK YOU WELCOME. THOUGH SUSAN
LITTLE WITH THE ENVIRONMENTAL
WORKING GROUP ALSO HERE ON
BEHALF OF THE CAP ON COALITION.
TO MAKE HELP HEARD THE
CALIFORNIA PRODUCT STEWARDSHIP
COUNCIL. AND THE.
CENTER FOR ENVIRONMENTAL HEALTH
ALSO IN SUPPORT THINK.
THANK YOU.
SO I ACTUALLY JUST HAVE A GOOD
SELF OFTEN I'VE REALIZED
DEPARTMENT. DIDN'T REALLY HAVE A
COMMENT ON THE PROPOSAL BUT IN
TERMS OF THE CAPACITY OF THE
DEPARTMENT TO PERFORM THE
FUNCTION.
DOES REFERENCE SERVICE SAY HEY
BUDGET CUT.
.
YEAH THAT THERE WASN'T THE BCP
FROM THE DEPARTMENT ON THIS SO
WAS THAT CAN CAN PERHAPS COMMENT
ON ON THE CAPACITY OF THE
DEPARTMENT TO PERFORM THE
FUNCTION NOW. TERMS OF THE
STAFFING NECESSARY TO CARRY OUT
THE FUNCTIONS OF.
OF THE ACT OF THE ACT.
YES SIR AND FOR THE RECORD THIS
IS A MONEY COME AROUND AS YOU
KNOW WE HAVE TO STAFF THAT WORK
IN THIS PROGRAM AND AND YOU KNOW
THE WE ARE ACTIVELY JUST TRYING
TO MANAGE THE DATABASE. FOR THE
COMPANIES AND FOR THE CUSTOMERS
ON THAT ONE TO ACTUALLY GO
ONLINE AND SEARCH THE DATABASE
SO. AT THIS POINT WE YOU KNOW.
.
TRIED EXIST IT TROUBLESHOOT SOME
OF THE ISSUES THAT WE'RE FACING
WITH THE WEBSITE.
I'M IN REPORTING AND WORKING
WITH OUR IT TO ALSO TRY TO FIND
SOME OTHER ON SOLUTIONS TO
UPGRADE OUR CURRENT IT OF THE
SYSTEM SO.
I THINK YOU KNOW TOGETHER WITH
THE TO STAFF WE WERE TRYING OUR
HARDEST JUST KIND OF MEET THE
DEMAND.
BUT THAT WASN'T EXACTLY AN
ANSWER TO THE QUESTION.
BUT.
ARE A.
.
SO ONE OF THE COMMENTS WAS MADE
WAS THAT ESSENTIALLY LUIS IS THE
SAME AS YOU CAN FIND ON THE
BOTTLE.
ARE ON THE LABEL OR WHATEVER I
KNOW SOMEONE TESTIFIED TO SAYING
THAT WELL MAYBE HARD TO READ IT
BUT CAN YOU COMMENT ON THAT.
YEAH THAT'S A HOME AT THIS THIS
PROGRAM WAS CREATED SPECIFICALLY
TO PROVIDE CONSUMERS AND WORKERS
AND THE DEPARTMENT OF PUBLIC
HEALTH ANOTHER STATE AGENCIES
AND REGULATORS. WITH INFORMATION
ABOUT.
SIXTY FIVE CHEMICALS IN PRODUCTS
AND WELL THEY MIGHT APPEAR ON A
PRODUCT LABEL MOST OF US EVEN
THOSE OF US UNDER FORTY HAVE A
VERY HARD TIME FINDING. THOSE
INGREDIENTS ON THE PRODUCT LABEL
TO BEGIN WITH I MEAN THEY'RE
THEY'RE VERY SMALL IF YOU LOOK
AT SOME MAKE UP PRODUCTS.
YOU CAN BARELY EVEN SEE THE
PRODUCT LABELS YOU NEED A
MAGNIFYING GLASS TO DO SO.
PROFESSIONAL SALON PRODUCTS
AREN'T EVEN REQUIRED BY LAW TO
BEAR A DECLARATION OF THE
INGREDIENTS ON THEIR PRODUCT
LABELS.
THE PROP SIXTY FIVE CHEMICALS IN
THESE PRODUCTS ARE ALSO REPORTED
TO THE DATABASE WHICH WHICH
PROVIDES A REALLY IMPORTANT
RIGHT TO NO FUNCTION FOR THAT
COMMUNITY AS WELL.
THE OTHER THING I DO HAVE ONE
MORE THING.
ACTUALLY I'M SORRY AND THAT IS
THE A REALLY IMPORTANT FUNCTION
OF THE DATABASES TO AGGREGATE
ALL OF THIS INFORMATION SO
WHILE.
YOU AND I MIGHT IF WE HAVE THE
THE THE GOOD EYESIGHT TO DO SO
BE ABLE TO FIND THE INGREDIENT
ON THE PRODUCT LABEL. BUT THAT
THE DATABASE DOES IS IT IS IT
PRESENTS A SNAPSHOT OF THE
OVERALL. A USE OF THESE PROP
SIXTY FIVE CHEMICALS IN PRODUCTS
SOLD IN THE STATE AND THEN THE
NUMBER OF PROP.
USING PROPS SIXTY FIVE CHEMICAL
SOLD IN THE STATE AND THERE'S
TWO NUMBERS THAT JUST REALLY I
FIND MIND BOGGLING. ESPECIALLY
IN RESPONSE TO WHAT THE
OPPOSITION SIDE WHICH IS THAT
THERE IS NO PROBLEM REAL PROBLEM
THAT PROGRAM IS TRYING TO
ADDRESS AND THAT IS THE FACT
THAT. SIXTY FIVE THOUSAND
PRODUCTS WERE REPORTED TO THE
SAFE COSMETICS PROGRAM BETWEEN
TWO THOUSAND AND NINE AND TWO
THOUSAND AND FIFTEEN.
CONTAINING EDTA INDIVIDUAL
UNIQUE PROP SIXTY FIVE CHEMICALS
AND I HAVE THIS FACT SHEET WHICH
I COULD LEAVE WITH YOU.
IT SHOWS.
THERE'S ONE PRODUCT HERE THAT
CONTAINS TEN DIFFERENT PROP
SIXTY FIVE CHEMICALS.
IT THEY'RE END NUMEROUS
CHEMICALS MANY CONSUMERS DON'T
KNOW WHICH OF THE CHEMICALS THE
PROP SIXTY FIVE CHEMICALS THAT
THEY SHOULD BE CONCERNED ABOUT
SO IT SHINES A LIGHT ON THE
PRESENCE OF THESE.
PARTICULARLY TOXIC CHEMICALS.
AND I WOULD ECHO THAT I WOULD
SAY MOST PATIENTS ASSUME
EVERYTHING IS SAFE WE A CUT
BECAME INVOLVED WITH THIS WHEN
THE LEGISLATORS PHONE DOESN'T
SAID. WHAT'S A CUT POSITION
UNLEADED LIPSTICK AND OUR
RESPONSES WE HAD NO IDEA THERE
WAS LETTING LIPSTICK. THAT WAS
JUST THE TIP OF THE ICEBERG
PATIENTS DON'T READ A LABEL ON
LIPSTICK NOR DO THEY READ MOST
OF THE LABELS NOW YES WE CAN SAY
THAT'S THEIR PROBLEM THEY SHOULD
KNOW. THAT THERE ARE ALL THESE
CHEMICALS IN IT.
BUT IF WE HAVE A MEANS OF
LETTING THEM KNOW THAT THERE'S
THEY SHOULD BE AWARE THAT SOBRE
COMPLICATING.
IT IS ONE OF THE COMMON AS IT
MAKES AND I REALIZE IT.
THE OBVIOUS TEXAS EAST BASED ON
DOES RIGHT IT'S NOT JUST NEARLY
EASE THE EXISTENCE OR LACK IN
THEIR THINGS A VIOLENT OF IRON
ANDSO I'VE SIMILAR WE'RE
TALKING ABOUT IS.
THE ABSORPTION RATES ARE YOU
KNOW EXPOSURE AT AT DOSES THAT
THAT WOULD ACTUALLY BE
CONCERNING.
IN THE IN THE IN A CONCISE IS
PROBABLY THE MOST IN DEPTH
ANALYSIS OF THAT M. PUBLISHED
NOW TWICE WHEN THEY TALK ABOUT
AND IT CAN DISRUPTING. CHEMICALS
THAT WE SHOULD BE AWARE OF WHAT
THEY WERE TALKING ABOUT THE
LIBRARY DISEASE ADAM
INFERTILITY.
CHANGING IN SPERM COUNTS A
NUMBER OF DIFFERENT CONCERNS.
CAN YOU SHOW CAUSE AND EFFECT
THAT ONE PERSON USING THIS HAIR
PRODUCT WILL DEVELOP CANCER NO.
NO THAT'S NOT POSSIBLE BUT CAN
WE LOOKED IN AGGREGATE AND SAY
THAT WE'VE SEEN DISEASE
PROCESSES INCREASE OVER TWENTY
TO THIRTY YEAR TYPE BEARD WITH
THOSE CHEMICALS ARE BEING
PRODUCED WEEKEND.
AND WE ALSO DO KNOW THAT BUT
THERE IS A GROWING BODY OF
EVIDENCE THAT SHOWS THAT
CUMULATIVE EXPOSURES TO THESE
CHEMICALS ARE IN FACT GETTING UP
TO HARM.
AND NONE OF US LIVE IN A BUBBLE
SO AN INDIVIDUAL A BABY IS AND
EXPOSED TO FORMALDEHYDE JUSTIN
HER BUBBLE BATH SHE MIGHT BE
EXPOSED TO THE SAME CHEMICAL. IN
NAM IN A BODY WASH AND IN A
SHAMPOO AND ALSO IN THE CLEANING
PRODUCTS USED IN HER HOME. AND
IN THE THE FLOORING AND THE
BUILDING MATERIALS SO THE LIST
REALLY GOES ON AND ON WE'VE SEEN
NOT ONLY CUMULATIVE EXPOSURES
LINK TO HARM BUT ALSO THE TIMING
OF EXPOSURES.
A RESULTING IN AN INCREASED RISK
OF DISEASE LATER IN LIFE.
BUT OUT OF SOME BIG NOTE THAT
FOR EXAMPLE FORMALDEHYDE IS
ACTUALLY A NATURAL METABOLIC
PRODUCT OF THE BODY AS WELL I
MEAN IT DEPENDS ON THE DOES HOW
MUCH EXPOSURE YOU HAVE THEN IT
YES IT CAN BE CUMULATIVE TO
SELL.
SO I THINK WE HAVE TO GO BEYOND
JUST SIMPLY SAYING ó LOOK
THERE'S SOMETHING WITH THE SCARY
NAME IN THE.
THEN AND WE HAVE TO THINK ABOUT
LEVEL EXPOSURE ON YOUR RIGHT TO
LIVE EXPOSURE IS SOMETHING WE
SHOULD THE.
THAT IS SOMETHING THAT. NEEDS
TO BE ADDRESSED AND I WOULD
ARGUE THAT THE THERE ARE I MEAN
WE DON'T HAVE THE RESEARCH
STUDIES THAT WE CAN WE CAN GIVE
THEM TO YOU. BUT THERE CERTAINLY
ARE A NUMBER OF STUDIES THAT
HAVE LOOKED AT NOT JUST
CUMULATIVE BUT THE IMPACTS ON
HEALTH NATIONAL INSTITUTE OF
ENVIRONMENTAL HEALTH SCIENCES.
IS BY THE MOST IMPORTANT
ORGANIZATION FOR PROVIDING SOME
OF THAT RESEARCH FOR US
ON CAREER DR CONNERY WAS
REFERRING TO SOME OF THE NEW
SCIENCE TALKING ABOUT LOW DOSE
EXPOSURES BECAUSE DOCTOR PAN
YOU'RE RIGHT. NOT EVERY EXPOSURE
IS GOING TO RESULT IN A IN A
DISEASE.
TO THAT THE HOUSE OR TRADE
ASSOCIATED WITH THAT CHEMICAL ON
THE OTHER SIDE.
BUT THE DOSE MAKES THE POISON
HAS REALLY BEEN TURNED ON ITS
HEAD WHEN IT COMES TO THESE
ENDOCRINE DISRUPTING COUNT
POUNDS. BETTER TOXIC AT
SOMETIMES AT PARTS PER BILLION
OR PARTS PER TRILLION. BPA FOR
EXAMPLE CAN CROSS.
THE PLACENTA AND IMPACT THE
MAMMARY GLANDS OF THE DEVELOPING
FETUS AT PARTS PER BILLION OR
PARTS PER TRILLION.
PREDISPOSING THAT THAT FETUS
THAT DEVELOPING FETUS TO AN
INCREASED RISK OF BREAST CANCER
OF LATER AND I WAS LIKE A
SENSUAL OILS HAVE JUST BEEN AND
THAT IDENTIFIED AS YOU KNOW
CAUSING KIND OF PANIC.
POTENTIALLY PERHAPS GANIC MASIUS
SELF WILL AND THAT'S A GOOD
POINT BECAUSE THE OTHER THING
THE SAFE BECAUSE.
AUTHORIZES IS FOR THE SAFE
COSMETICS PROGRAM TO
INVESTIGATE.
BOTH THE CHEMICALS AND THE
PRODUCTS AND THE EXPOSURE
POPULATIONS AND THEN MAKE
RECOMMENDATIONS TO OTHER STATE
AGENCIES AS TO HOW TO PROVIDE A
HARD.
WORKERS FOR EXAMPLE OR TO TO
YOUNG PEOPLE INFANTS PREGNANT
WOMEN EXCITE AURA.
I THINK WE JUST HAVE TO BE
CAREFUL ABOUT OUR LANGUAGE.
AND I I WOULD SAY THAT A COG IN
THE A CUT IN THE WORLD COLLEGE
CAME OUT WITH THEIR COMMITTEE
OPINION IN THE SAME YEAR. AND
BOTH OF US MET AND SAID. WE HAVE
TO.
INCREASED AWARENESS WITHOUT THE
ALARM AND AS OBSTETRICIANS WE
KNOW ANYTHING WE SAY CAN SCARE
PATIENTS THAT HAVE TO BE
CAUTIOUS AND HOW YOU SAY IT. BUT
I'LL TELL YOU THE QUESTION I GET
ASKED ALL THE TIME IS.
WHAT SHOULD I BE DOING WHILE I'M
PREGNANT?
WHAT CHEMICALS YOU KNOW WHAT
PRODUCTS WITH SAFE?
WELL.
THE PEDIATRICIAN IDEA THAT'S THE
ROCKETS TO SELL. THAT'S GREAT
AND THAT'S A REALLY NICE
CONCLUDING THOUGHT WHICH IS THE
SAFE COSMETICS PROGRAM ISN'T
USED.
FORNEY CONSUMERS AND.
IT'S IT'S SEEN AS A NATIONAL
TREASURE BY BY PEOPLE THROUGHOUT
THE COUNTRY THAT ARE REALLY
CONCERNED.
ABOUT INCREASING EXPOSURES TO
TOXIC CHEMICALS AND THE LINK
BETWEEN INCREASING RATES OF
DISEASE AND WANT TO DO SOMETHING
ABOUT THE PROBLEM.
OKAY WELL WE'RE GONNA HOLD ITEM
OPEN. AND.
.
GO AHEAD AND MOVE ONTO.
THANK YOU FOR YOUR TIME THANK
YOU AND GIVE.
ISSUE NUMBER SEVEN.
WHEN INFANTS CHILDREN LOOK
LISTEN ESTIMATE
.
ONE.
HELLO I'M CONNIE MITCHELL.
OKAY.
I'M THE DEPUTY DIRECTOR OF THE
CENTER FOR FAMILY HEALTHY AND
YOU'RE GOING TO BE HEARING TODAY
FROM NOW ON EACH OF OUR
DIVISIONS WE HAVE THREE
DIVISIONS OF THE CENTER FOR
FAMILY HELPED. BY THE WEAK
DIVISION WILL BE PRESENTING
THEIR ESTIMATE.
WICCAN AT SUB AT THAT SRONG
FOCUS ON PROVIDING ACCESS TO
HEALTHY FOODS HILL HERE FROM OUR
HOME VISITING PROGRAM WHICH IS
EARLY UPSTREAM INTERVENTION FROM
ALL THE ROLE WOMEN. AND FINALLY
OUR GENETIC THE SECURITY PROGRAM
TAX AMERICAN JUST DO
INTRODUCTIONS FIRST.
LESLIE CALLOUSLY CHIEF OF THE
NCA EACH DIVISION.
RICHARD ONLY CHIEF OF THE JOHNS
THE SCREENING PROGRAM.
CHRISTINA OLSEN CHIEF OF THE
WEAK DIVISION OF PUBLIC HEALTH.
THANK YOU AND WE CAN PROCEED
SHOULD NUMBER SEVEN ACCESS ISSUE
NUMBER SEVEN PLEASE ACT
THINKING.
SO YOU HAVE ASKED THREE
QUESTIONS ABOUT THE WITH PROGRAM
AND THEY WILL LEAD WHAT
PERFECTLY ONE INT THE OTHER
SELF ON DISK PRIME GIVE YOU A
QUICK UPDATE.
I'M THE WOULD PROGRAM WE OF
COURSE HIS YOU KNOW RECEIVES
FEDERAL DOLLARS FROM THE US
DEPARTMENT OF AGRICULTURE AND WE
HAVE SUFFICIENT FEDERAL FUNDING
TO CONTINUE TO OPERATE THE
PROGRAM WITH NO IN.
GENERAL FUND.
IN ADDITION TO FEDERAL DOLLARS
FROM USDA WE ALSO RECEIVE A
REBATE FUNDS FROM THE CONTRACTED
INFANT FORMULA MANUFACTURER AND
WE MUST SPEND THOSE REBATE
DOLLARS FIRST ON OUR FOOD BEFORE
WE CAN TAP INTO FEDERAL DOLLARS
FOR FOOD.
COST DRIVERS FOR THE PROGRAM FOR
FOOD COSTS ARE PROGRAM
PARTICIPATION AND INFLATION ON
FOOD COSTS.
AB FOR THE BUDGET YEAR SUE ME
FOR THE IN THE BUDGET ACT WE HAD
ESTIMATED THAT WE WOULD SPEND
EIGHT HUNDRED SEVENTY FOUR
MILLION DOLLARS ON FOOD. AND
THIS ESTIMATE REVISE IS THAT THE
CURRENT YEAR FIVE TO EIGHT
HUNDRED AND THIRTY TWO MILLION
FOR FOOD AND EIGHT HUNDRED AND
NINETEEN MILLION IN THE BUDGET
YEAR.
THE BUDGET YEAR THAT ESTIMATE
INCLUDES FIVE HUNDRED EIGHTY
EIGHT MILLION DOLLARS FROM THE
FEDERAL FUND AND TWO HUNDRED AND
THIRTY ONE DOLLARS FROM OUR
REBATE FUNDS.
THERE IS NO CHANGE YOUR ESTIMATE
FOR OUR A LOCAL SERVICES THAT
HAVE THREE HUNDRED ONE MILLION
DOLLARS AND A MINOR ADJUSTMENT
TO OUR STATE OPERATIONS.
CALIFORNIA WHICH SERVES JUST
OVER ONE MILLION PARTICIPATION
PARTICIPANTS EACH MONTH AND THAT
NUMBER HAS BEEN DECLINING SINCE
TWENTY TWELVE.
I'M EACH YEAR THE US DEPARTMENT
OF AGRICULTURE PREPARES A REPORT
ESTIMATING THE WITH ELIGIBLE
POPULATION AND COMPARES THAT
ACTUAL NUMBER OF PRETTY
DEPENDS SERVED.
AND THE RESULTING PERCENTAGES
CALLED THE PROGRAM REACH.
CALIFORNIA CONTINUES TO HAVE THE
HIGHEST PROGRAM REACH OF ALL
DECLINING IN THE PAST YEARS.
THE MOST RECENT REPORT FROM USDA
WAS JUST RELEASED AND OF
FEBRUARY AND IT'S LOOKING AT
TWENTY FIFTEEN DATA.
CALIFORNIA'S PROGRAM REACH WITH
SIXTY FIVE PERCENT OF THE
ELIGIBLE POPULATION WHILE THE
NATIONAL AVERAGE WAS FIFTY TWO
PERCENT.
AT LAST YEAR'S REPORT WE WERE AT
SEVENTY ONE PERCENT ARM PROGRAM
REACH SO NOT ONLY ARE NUMBERS
DECLINING BUT OUR PROGRAM
REACHES DECLINING WHICH. IS A
SIGNIFICANT ISSUE FOR US.
THE USDA REPORT AB PRODUCES THIS
REPORT JUST AT THE STATE LEVEL
AND WE WANTED TO DIG DOWN DEEPER
SO A FEW YEARS AGO WE PARTNER
WITH MATERNAL. CHILD AND
ADOLESCENT HEALTH THEY HAVE A
GREAT EPIDEMIOLOGISTS TEAM. AND
THEY'D PREPARED A METHODOLOGY TO
TAKE THAT USDA PROCESS AT THE
LOCAL LEVEL WITH IN CALIFORNIA
SO WE WERE ABLE TO. ESTIMATE THE
PROGRAM REACH MORE AT THE COUNTY
LEVEL.
THE LAST TIME THAT WE DID THAT
WAS LOOKING AT BELIEVE IT WAS
TWENTY ELEVEN DATA AND SO WERE
UPDATING IT THIS YEAR TO LOOK AT
MORE RECENT DAVIS WILL ALSO HAVE
TWENTY FIFTEEN DATA. TO BE ABLE
TO CONNECT WITH THE USDA REPORT.
AND ONE LAST THE LAST TIME THAT
WE SAW WE SAW QUITE A VARIATION
ACROSS THE COUNTIES. IN
CALIFORNIA SO IT'S REALLY
IMPORTANT FOR US AND HOW WE
TARGET OUR OUR EFFORTS TO
IMPROVE PARTICIPATION.
WE'D LOOK WHEN WE DO OUR WORK
TO INCREASE PROGRAM
PARTICIPATION WE LOOK AT THREE
DIFFERENT CATEGORIES OF
INDIVIDUALS.
THE FIRST IS RETAINING OUR
ACTIVE PART
OFFENSE.
SECOND IS RE ENGAGING FAMILIES
THAT ARE CURRENTLY CERTIFIED IN
WHAT PROGRAM BUT NOT COMING IN
ACTIVELY TO RECEIVE THEIR TAX.
SO WHAT THE USDA COUNTS AS A
PARTICIPANT IS SOMEBODY THAT IS
NOT JUST CERTIFY BUT ACTUALLY
COMING IN ON A BREAK.
IT'S TO THE
TO PICK UP THEIR CHECKS.
AND ALASKA A CATEGORY IS
RECRUITING ELIGIBLE FAMILIES AND
IT'S IMPORTANT TO NOTE THAT
THOSE FAMILIES THAT ARE ELIGIBLE
NOT CERTIFIED. THEY MAY BE
COMPLETELY NEW TO WORK OR THEY
MAY HAVE BEEN PREVIOUS WITH
PARTICIPANTS PERHAPS THE CHILD
IS NOW THREE OR FOUR YEARS OLD
AND THEY'VE DROPPED OUT OF THE
PROGRAM OR THEY'VE.
.
SO THAT'S IT IMPORTANT THING
WHEN WE TALK ABOUT OUR OUTREACH
MESSAGING.
ARE THREE KEY STRATEGIES.
THE FIRST AREA IS DATA AND
RESEARCH.
SECOND AS OUTREACH AND THIRD IS
REVIEWING THE PROGRAM TO IMPROVE
UPON.
HALF OF THE PROGRAM THAT.
SO LOOKING AT DATA THERE'S A
NUMBER OF THINGS THAT WE'VE BEEN
DOING ANALYZING TRENDS
CONDUCTING STUDIES TO UNDERSTAND
THE REASONS WHY PEOPLE DO NOT
COME. TO WAKE OR STAY IN WAKE
AND THERE'S ALSO A NUMBER OF. OF
OUR PARTNERS OF DIFFERENT ABBASI
GROUPS AND FEDERAL PARTNERS THAT
ARE LOOKING AT THE SAME
QUESTIONS.
WE'VE PROVIDED DATA AND GEO
MAPPING TOOLS TO OUR LOCAL
AGENCIES. WE'VE FUNDED LOCAL
AGENCY PROJECTS WHO CONDUCTS AND
EVALUATE INNOVATIVE PROJECTS AS
WELL SO A FEW YEARS AGO YOU STA
OFFERED A GRANT FOR THAT. WAS A
VERY SMALL.
LEVEL OF NUMBER OF OF GRANTS
THEY WOULD GIVE NATIONALLY IN A
VERY SMALL DOLLAR AMOUNT AND
WE'VE KIND OF TOOK THAT.
PROCESS AND REPLICATED IT TO BE
MUCH BROADER WITHIN CALIFORNIA.
WE'RE ALSO DOING A LOT OF WORK
IN OUTREACH TO CONTINUE TO
SUPPORT LOCAL LOCAL OUTREACH
EFFORTS AND EXPANDING OUR STATE
LEVEL OUTREACH EFFORTS.
WE'VE DEVELOPING NEW
PARTNERSHIPS AND MESSAGING
ENSURING THAT WE'RE RESPONSIVE
TO WHAT WE LEARN FROM THE
RESEARCH ABOUT REASONS WHY
PEOPLE DON'T COMMERCE STAY IN
THE WITH PROGRAM. AND WE'RE
CONTINUE TO PARTNER WITH THE COW
FRESH PROGRAM ON OUTREACH
STRATEGIES AS WELL.
LASTLY WE'VE BEEN MAKING THE OF
REVIEWING OUR PROGRAM AND MAKING
FOR IMPROVEMENTS TO REDUCE
BARRIERS. OR MAKING ENROLLMENT
PROCESS MORE EFFICIENT REVIEWING
STATE POLICIES AND PROCEDURES TO
REDUCE ACCESS TIME WHILE
MAINTAINING MAINTAIN PROGRAM
INTEGRITY. MODERNIZING
COMMUNICATION WITH FAMILIES M.
ACCRETING NEW OR UPDATING
NUTRITION EDUCATION CLASSES A
MATERIAL SO THAT ONE FAMILIES
COMING TO WAKE THEY'RE NOT
SAYING THE SAME COSTS THAT
PERHAPS THEY SAW A YEAR AGO OR
TWO YEARS AGO WITH THE PREVIOUS
TROUT. AND CONTINUE TO FOCUS ON
TRAINING ON THE LOCAL AGENCY
STAFF SO THAT THE CUSTOMER
SERVICE THAT CLIENTS RECEIVED
IS.
IS OF UTMOST QUALITY WHILE.
THANK YOU A INCOMES ILIO
FINANCE.
SO.
JUST
SO.
GIVEN THE DATA MAYBE I MISSED IT
WHEN HE SAID THAT WHAT IS THE
FORTY THINK IS THE BIGGEST
FACTOR IN THE DECLINE AND
PARTICULARLY THE UP PERCENTAGE.
YOUR REACH FACTOR AND. THERE'S
A NUMBER OF REASONS AND
UNFORTUNATELY IT'S NOT ONE.
REALLY CLEAR ANSWER THERE WASN'T
THERE HAS BEEN SOME STUDIES
ABOUT WHITE PEOPLE THAT WERE
ELIGIBLE FOR WAKE DID NOT IN
ROLL. THAT BATES TO QUESTIONS
THERE IS THE BIGGEST RESPONSE
THE MOST COMMON RESPONSES OR. I
DIDN'T THINK I WAS ELIGIBLE SO
ONE OF THE THINGS THAT WE WANT
TO FOCUS ON IS WORKING FAMILIES
MAKING SURE THAT THEY KNOW THAT
THEY MIGHT THEIR OWN SELF
PERCEPTION OF JAIL OUR OWN SELF.
AND THEN THE SECOND PIECE WHICH
IS REALLY INTERESTING IS THEY
DIDN'T FEEL THAT THEY NEED AT
THE PROGRAM OWE IT AND.
THE ME HA MATERNAL INFANT
HEALTH ASSESSMENT QUESTIONNAIRE
THAT ALSO MC H. CONDUCTS.
THEY ASKED THE QUESTION OF
PREGNANT WOMEN OR WOMEN THAT
HAVE GIVEN BIRTH.
THAT WERE WITH THEIR. DELIVERY
WAS COVERED BY MEDICARE SO WHY
DID YOU ENROLL IN WAKE WHEN YOU
WERE ELIGIBLE FOR WAKE.
AND THEY SOME OF THEM SAID THEY
DIDN'T NEED THE PROGRAM BUT THEY
ALSO MIGHT ANSWER ANOTHER
QUESTION THAT SAYS YES THEY DO
EXPERIENCE FOOD INSECURITY.
SO THAT'S VERY.
PROCESS VERY INTERESTING
RESPONSE THERE SO WE NEED TO
CONTINUE TO MESSAGE TO FAMILIES
THAT WORKING FAMILIES ARE.
ELIGIBLE FOR THE PROGRAM HOW DO
WE AND HOW DO WE CREATE.
.
RESOLVE THOSE MANY PEOPLE HAVE
TIME DATE I MEAN IS THAT AND
BECAUSE HE SAID IT'S DECLINING
SO IT'S THEIR SHIFTING ATTITUDE
THAT'S CHANGING OUR AYE OF ARE
YOU ONLY HAVE ONE POINT TIMES
THAT'S WHEN THAT INTERVIEW THAT
WAS A THAT WAS ONE PARTICULAR.
SURVEY ASKING OKAY PRIVATELY
OWNED Y. THEY DIDN'T ENROLL
ANOTHER PIECE THAT HAS BEEN
CHANGING AS THAT GAP OF.
FAMILIES THAT ARE CERTIFIED BUT
NOT COMING IN FOR THE CHECKS
THAT THAT GROUP IS GROWING AS
WELL.
OKAY.
ALRIGHT I DECIDED EMPATHIZES
WITH REDUCTION IS HAPPENING ALL
ACROSS THE COUNTRY SO ALL OTHER
STATE SAY HOW'RE YOU DOING SO
GOOD.
DON'T THINK THAT WE THINK
THERE'S A LOT OF ROOM FOR
IMPROVEMENT BUT THAT'S THE SAME
PHENOMENA ALL ACROSS THE COUNTRY
THERE'S A SOLELY IN SOME KIND OF
SECULAR TREND THAT'S GOING ON.
THAT'S OKAY THAT MAY BE
HAPPENING ACROSS THE COUNTRY IN.
BIRTH
SO ARE DECLINE SIMILAR TO THAT
OF OTHER STATES INTERNET RATE.
OKAY.
ALRIGHT WELL GET SOME WORK TO DO
THERE.
ALRIGHT.
AT ANY COMMENTS. OKAY PUBLIC
COMMENT.
BUT HEARING FARLEY WITH THE
CALIFORNIA WITH ASSOCIATION
ASSOCIATION FOR THE EIGHTY THREE
AGENCIES.
AND WE APPRECIATE THIS
DISCUSSION ON THE DECLINE IT'S
VERY CONCERNING AND SOMETHING
THAT WE HAVE TO REMEMBER IS WITH
ASSOCIATED WITH A VERY
IMPORTANT.
HEALTH OUTCOMES.
AND THESE ARE PROBABLY ALREADY
ERODING IF WE'VE HAD FIVE YEAR
DECLINE.
LOW BIRTH WEIGHTS PRETERM BIRTHS
ANEMIA. CHILDHOOD OBESITY THESE
ARE THINGS THAT WHAT REALLY
CREDITED WITH IT WITH IMPROVING.
VOTE RELEVANT TO YOUR COMMITTEE
WHAT I'D LIKE TO POINT OUT. IS A
LOCAL AGENCIES ARE VERY
CONCERNED ABOUT THE TYPE OF
CONTRACT THEY HAVE WITH THE
STATE DEPARTMENT OF PUBLIC
HEALTH IT'S QUITE RESTRICTIVE.
AND WITH DECLINING PARTICIPATION
WE HAVE TO BE REALLY AWARE THAT
WE'RE PROTECTING THOSE FEDERAL
DOLLARS IN THE LOCAL AGENCIES
CAN FULLY USE THOSE CONTRACTS
AND SPEND THEIR MONEY. WERE
AWARE.
THAT THE STATE USES SOME OTHER
CONTRACTS FOR OTHER PROGRAMS
THAT ARE PERHAPS MORE FLEXIBLE.
YOU WOULD ASK THAT SOME A
INVESTIGATION BE AYE.
HE PUT ON THIS TOPIC SO THAT.
THE LOCAL AGENCIES CAN BE
REASSURED THAT THEY CAN FULL USE
THEIR DOLLARS AND WE WOULD
RESPECTFULLY SUGGEST.
AN URGENCY TO THE US AND THAT
THE TRAILER BILL MIGHT BE A AN
AVENUE FOR ADDRESSING THIS
VEHICLE VERY SOON.
THANK YOU.
THANK YOU ANY COMMENTS FROM THE
DEPARTMENT ABOUT FLEXIBILITY AT
CHALLENGES THERE.
SO WE CERTAINLY HAVE HAD THIS
DISCUSSION FOR AWHILE WITH OUR
LOCAL AGENCIES AND.
ITEM WE FOLLOW AT THE CONTRACT
MODEL THAT IN A PUBLIC CONTRACT
CODE FOR CONTRACTS THAT ARE NOT.
ALLOCATED THROUGH COMPETITIVE
BID PROCESS AND MANY OF OUR
LOCAL AGENCIES ARE NOT COUNTY
HEALTH DEPARTMENTS AS WELL SO
THAT DOES.
CREATE AN ADDITIONAL CHALLENGE
WHERE THERE ARE SOME CONTRACT
MODELS THAT ARE ALLOWABLE IF ALL
THE AGENCIES ARE COUNTY HEALTH
DEPARTMENTS BUT WE ARE NOT ABLE
TO FOLLOW THOSE.
BECAUSE WE HAVE A LOT ABOUT HALF
OF OUR CONTRACTS ARE NOT WITH
COUNTY HEALTH DEPARTMENTS.
IN THIS MODEL OF CONTRACTING IS
THAT SOMETHING THAT'S RECENT
ARTS AND EVEN DOING THE SAME WAY
FOR EVER.
BETWEEN.
WE JEFF WE HAD TO CHANGE THAT
MODEL ABOUT FOUR YEARS AGO.
BEFORE YEARS OUT OF FOUR YEARS
AGO.
OKAY.
EN WELL AS IF THERE'S A SECULAR
TREND FOR DECLINE BUT THE THINK
IT HAS ANYTHING.
THE THINK THERE'S AN IMPACT OF
THAT TO CHECK ON WHAT THE
PREVIOUS MODELS BEFORE IS
CHANGED AND WHETHER IT WAS MORE
FLEXIBILITY HERE.
SO THE NEW I HAVE TO LOOK AT
THE NEW CONTRACT MODEL CAME
AFTER THE DECLINE HAD ALREADY
STARTED AND THE DECLINE AS
CONNIE HAD SAID THEY'D DECLINE
IS HAPPENING IN OTHER STATES AS
WELL.
IT'S
DOES NOT THINK ABOUT WHETHER YOU
KNOW.
MAYBE IT DOESN'T THAT I MEAN I'M
NOT SAYING TO THE CLIENTS
BECAUSE JUST BY THIS BUT YOU
KNOW THIS EXACERBATED DOES IT
CAUSE ANY ISSUES ARE WHATEVER
ELSE.
PAGE GOT TO RECOGNIZE IS ALWAYS
CHALLENGES WHEN YOU PUBLIC
DOLLARS IN.
ACTUALLY HAVE I GUESS IS A SOLE
SOURCE CONTRACT OF SORTS RIGHT.
NOW THAT THERE ALWAYS PRESENTS
SOME CHALLENGES TO IN TERMS OF
ACCOUNTABILITY AND SO FORTH BUT.
.
AND ASSURING THE PUBLIC.
BUT VIA ALSO LOOKS MORE.
MY THINK SINCE THEY. THINK ABOUT
THAT STUFF ALRIGHT.
A DESPITE WANTED OUT OF AT THE
TIME. I THINK THAT WE REALLY
NEEDED TO LEARN WHAT MIGHT BE
CONTRIBUTING TO THE DECLINE AND
SELL THE IDEAS FIRST TO REALLY
UNDERSTAND WHO IS A FIVE MINUTE
POPULATION THAT WE NEED TO
ADDRESS. HOW DO WE BEST REACH
THEM ONE OF THE KEY MESSAGES AND
THEN?
HAVE A COORDINATED APPROACH
THROUGHOUT THE WHOLE STATE THERE
IS SOME CONCERN THAT GET PEOPLE
DOING KIND OF THEIR OWN THING
THAT YOU'RE NOT REALLY
ADDRESSING THE REAL PROBLEM.
THEM IN A COMMENT TO SINCE CAN
PARLAY THE CALIFORNIA
ASSOCIATION VERY STRONG PARTNER.
BY THEY REFERRED TO THE TBL THAT
CAME UP I'M PREVIOUS OF THE THE
OBSTACLE TO PROPOSAL.
WE ARE VERY MUCH IN FAVOR OF
TRYING TO FIND HUESO CROPPING
APPEASING CROSS ELIGIBILITY
BETWEEN MEDI CAL ON LIKE WE JUST
NOT HAVE HAD THE OPPORTUNITY TO
EVALUATE THE FISCAL IMPACT FOR
OUR PROGRAM IN IMPLEMENTING THAT
I WANT TO MAKE SURE THAT. WE
HAVE THAT ON THE RECORD OKAY
THANK YOU.
ALRIGHT OF CIVIL HOLD THAT ITEM
OPEN AND LET'S MOVE ON THE ISSUE
MEMORY EARLY IN AND. INFINITE
EARLY CHILDHOOD HOME VISITATION
PROGRAM.
THANK YOU SO MUCH THE MATERNAL
CHILD AND ADOLESCENT HEALTH
DIVISION REQUEST TO CONVERT
TWENTY SEVEN LAMENTED TERM
POSITIONS INTO PERMANENT
POSITIONS.
HE'S TWENTY SEVEN POSITIONS ARE
FUNDED BY FEDERAL FUNDS.
AND AS OF FEBRUARY NINTH PIECE
THE FEDERAL FUNDS THAT WE KNOW
THE FEDERAL GOVERNMENT PASSED IN
THEIR THEIR RESOLUTION MONEY TO
SUPPORT THESE HOME VISITING
PROGRAMS. FOR ANOTHER FIVE YEARS
SO WE KNOW THAT THAT THE FUNDING
IS SOLID FROM THE FEDS WE GET
ABOUT TWENTY TWO MILLION DOLLARS
FOR THESE TWENTY SEVEN
POSITIONS.
AND THAT A ENABLES US TO CARRY
OUT HOME VISITING PROGRAMS IN
TWENTY THREE COUNTIES ACROSS
CALIFORNIA.
WE HAVE TODAY'S MADE OVER ARE
CLOSE TO A HUNDRED AND FIFTY
THOUSAND HOME VISITS WE SERVED
NEARLY EIGHT THOUSAND FAMILIES
AND CURRENTLY WE CARRY CASELOAD
OF AROUND TWO THOUSAND.
THANK YOU ANY COMES FROM ALEJO.
FINANCE.
BUT IT'S JUST KNOWS THAT WE
SUPPORT THE PROPOSAL.
OKAY THANK YOU WELL I APPRECIATE
THE GOVERNORS THAT COMMITMENT TO
HOME VISITATION WE'D THERE'S ALL
THAT DATA AND THEY BILLS MODEL
ALL THAT.
MILLER THAT AND SO.
ANY PUBLIC COMMENT.
CASEY NO PUBLIC COMMENT.
WE WILL. ALSO PUT THAT.
I WASN'T ON HOLD A.
LEAVE IT OPEN.
BUT CERTAINLY WANTED SUPPORT
CONTINUING OUR CHILDHOOD SOME
VISITATION PROGRAMS.
AND I'VE ANY COMMITTEE MEMBERS
HERE OF A RUNNY THINKS THE
MOMENT BUT.
MAY REVISE WOLF OKAY AYE AYE
ISSUE NUMBER SIX GENETIC
SCREENING PROGRAM LOCAL
ASSISTANCE ESTIMATES.
I'M NOT NINE A CITY.
EIGHTEEN NINETEEN THE GDP SP
ESTIMATE IN THE GOVERNMENT'S
BUDGET LISTS A TOTAL OF JUST
UNDER HUNDRED AND THIRTY THREE
MILLION DOLLARS WHICH IS AS YOU
KNOW FEE SUPPORTED THROUGH THE
GENETIC.
STING FUN.
AND THIS REPRESENTS AN INCREASE
OF ABOUT A HALF MILLION OVER THE
SEVENTEEN EIGHTEEN ESTIMATE AND
ABOUT ONE AND A HALF MILLION
OVER THE SEVENTEEN EIGHTEEN
BUDGET ACT.
THEY'VE ONLY BEEN SLIGHTCHANGES
IN OUR SCREENING CASELOAD THIS
INCREASE IN OUR BUDGET FOR
EIGHTEEN NINETEEN IS LARGELY DUE
TO EXPENDITURES REQUIRED TO
COMPLY WITH THE NEWBORN
SCREENING EXPANSION. PREVENTS
ENACTED IN TWENTY SIXTEEN.
THROUGH LEGISLATION AND
INITIATED BY THE CHAIR.
WHICH WILL EFFECTIVELY A TWO
NEW NEW DISORDERS TO THE
CALIFORNIA NEWBORN SCREENING
PANEL IN TWENTY EIGHTEEN.
DUE TO THE RECENT ADDITION
THE FEDERAL BURKE.
SCREENING PAN ON THOSE DISORDERS
ARE POMPEII DISEASE AND IM PS
ONE.
THE INCREASE IN EXPENDITURES
WILL BE REQUIRED FOR EXPANSIONS
AND TESTINGS IN OUR LABORATORY
IN RICHMOND. OF FOR THE NEW
DISORDERS A WHICH IS REQUIRED TO
BEGIN BY AUGUST TWENTY EIGHTEEN.
THESE ADDITIONAL COSTS WILL
REQUIRE A NEWBORN SCREENING FEE
INCREASE OF TWELVE DOLLARS PER
SPECIMEN FOR THE NEW DISORDERS.
OF SO LITTLE GO FROM AROUND
HUNDRED THIRTY DOLLARS TWO
HUNDRED FORTY TWO DOLLARS AND
TWENTY FIVE CENTS EFFECTIVE IN
JULY THIS YEAR.
BY THE FEE INCREASE WILL
PRIMARILY COSTS BECAUSE OF.
COVER THE COSTS OF ROUTINE
TESTING WITH OUR LABORATORY
DEVELOPED TESTS.
AND EVENTUALLY THE COSTS OF
PROCESSES INVOLVED WITH ROLLOUT
OF FDA APPROVED TEST KITS.
THAT COULD BE USED IN OUR
REGIONAL LABORATORIES.
ARE APPROVALS BY THE FDA ARE
PROJECTED TO OCCUR LATER THIS
YEAR OR AND TWENTY NINETEEN THEN
WE WOULD PLAN TO IMPLEMENT
SCREENING OVER TWO OR THREE
YEARS AFTER THAT.
THANK YOU.
ALEJO SUMMITS FINANCE
I PUBLIC COMMENT.
OKAY THANK YOU FOR YOUR HARD
WORK ON THIS.
SAVING LIVES AND ACTUALLY WE'RE
SAVING I THINK WILL BE SAVING
MONEY TO BECAUSE WELL IT'S NOT
THE PUBLIC HEALTH SIDE. AMEND
HER COLLEAGUES IN MEDI CAL WILL
HOPEFULLY BE HAVING TO PAY FOR.
CARE DATA WAS BECAUSE MY CITIES
DISEASES WE CAN PREVENT THEM SO
THANK YOU.
YES OKAY ISSUE NUMBER TEN NEW
GENETIC DISORDERS SP TEN NINETY
FIVE AND SECOND YOUR TESTING.
BUT SO THIS IS ARE OF A NEWBORN
SCREENING BCP AND WE HAVE AROUND
TWO MILLION DOLLARS.
REQUESTED AN ONGOING
EXPENDITURE AUTHORITY FROM THE
GENETIC DISEASE TESTING FUN. OF
THIS IS WHAT WITH FIFTEEN NEW
POSITIONS FOR PERSONNEL WHO WERE
PERFORMED SCREENING FOR THE NEW
DISORDERS AND ARE A RICHMOND
LABORATORY.
WORD MEANING EXPECTED TIMELINE
SO THERE ARE NO CONCERNS ABOUT
THE EXPECTED LAUNCH OF THE NEW
DISORDER SCREENING IN OUR AND
AUGUST.
OTHER NEW PERSONNEL WILL BE
REQUIRED TO CARRY OUT CARRY OUT
THE ONGOING PROCESSES OF
SCREENING.
FOR THE NEW DISORDERS IN OUR
LAB.
AND ALSO IN THE BCP WE'VE LISTED
A FOUR HUNDRED SIXTY THOUSAND
DOLLARS AND A STATE OPERATIONS.
EXPENDITURE AUTHORITY AND THREE
POSITIONS FOR ONGOING SECOND
TIER TESTING.
SECOND YOUR TESTING IS
PERFORMING A SECOND SCREEN ON
THE SAME BLOOD SPOT THAT'S A
COLLECTED. ORIGINALLY TO REDUCE.
FALSE POSITIVE RESULTS.
BUT I'M WE ALREADY DO THIS A
LITTLE BIT OF SECOND TIER
TESTING FOR A CONDITION SUCH AS
ADRENAL CATASTROPHE.
AS DISPLAYED IN THE ESTIMATE
THIS.
FOUR HUNDRED SIXTY THOUSAND
DOLLAR INCREASE WILL BE OFFSET
BY A DECREASE ARE OF THE SAME
AMOUNT IN LOCAL ASSISTANCE
FUNDING.
AND THAT AND HAPPENS BY
DECREASING OUR COSTS FOR FOLLOW
UP OF FALSE POSITIVES SCREENS
AND FOR UNNECESSARY CONFIRMATORY
TESTING.
I THANK YOU COMES ALEJO FINANCE.
AND SUPPORTS A PROPOSAL OF
BECAUSE IT ACCOMMODATES AND THE
EW TESTING THAT IS REQUIRED BY
THE FEDERAL RUST.
THANK YOU BYE PUBLIC COMMENT.
SEEING NONE.
THANK YOU. AGAIN AND IT WILL
HOLD THIS ITEM OPEN.
THAT THE GUYS NEVER SAID THE
PREVIOUS ITEM AS WELL SO. LIVES
NINE INTERNAL HELD OPEN. RIGHT
THANK YOU SO NEXT THAT IS
FINALLY IS ISSUE NUMBER ELEVEN
WE HAVE TO.
PROPOSALS FOR INVESTMENT.
WHAT'S ONE.
DON'T ENOUGH GREAT OKAY SO I
GUESS RESERVE ONE TO HEAR TODAY
WITCHES.
FOR WAS A DIFFERENT OF THE CARE
FOR A LS.
WELCOME.
IT.
ACTUALLY SIR SOMEONE FROM THE
PART PUBLIC HEALTH WHO.
BIRD THIS WOULD FALL UNDER WANTS
TO BE A FABLE LAWLER.
THANK YOU.
WE ALSO GIVE THE DEPARTMENT
OPPORTUNITIES SAY SOMETHING THEY
HAVE A THING TO SAY ABOUT IT AND
IF YOU DON'T MOTHER WAS. LISTENS
WELL ALRIGHT THANK YOU.
OKAY US SO FOR THE RECORD OF YOU
TO PLEASE INTRODUCE YOURSELVES
AND THEN I'LL ASK IF YOU CAN TRY
TO.
I KEEP REMARKS TWO. TOTAL THREE
MINUTES I APPRECIATE ITSELF WAS
FIRST INTRODUCED INTRODUCTIONS
FIRST BUT THANK YOU MISTER
CHAIRMAN AND MEMBERS I'M FRED
NOWHERE IN OUR FROM REPRESENTS
THE ALICE'S.
THANK YOU.
SEC VOLUNTEER I WITH THE ELLIS
ASSOCIATION ALSO ON THE BOARD OF
THE GOLDEN WEST CHAPTER OF THE
ALS ASSOCIATION OF YOUR BUT YOUR
NAME AGAIN FOR THE RECORD LINDA
DELA. RIGHT OF BY FUNDS OFF WITH
A TIME PAMELA JACOBSEN I'M THE
VICE PRESIDENT OF CARE SERVICES
FOR THE ALS ASSOCIATION.
OKAY WELL WELCOME EVERYONE.
YOU WANT OF IT BEGIN.
THANK YOU MISTER CHAIR IT'S A
VERY NICE BEARD WE WOULD VERY
MUCH APPRECIATE THE OPPORTUNITY
PRESENTS PROPOSAL.
AND BEEN BRIEFED THE LS
ASSOCIATION IS REQUESTING THREE
MILLION DOLLARS.
TO SUPPORT THE ONGOING WORK.
OF ITS ACTIVITIES AND DIRECT
CARE FOR PATIENTS WHO HAVE BEEN
DIAGNOSED WITH LOU GEHRIG'S
DISEASE.
AND JUST A BIT OF BACKGROUND IN
TWO THOUSAND A THE ASSOCIATION
SPONSORED SENATE BILL FIFTY NO
THREE SIGNED BY THEN GOVERNOR
SCHWARZENEGGER THAT PUT INTO THE
IS HEALTH AND SAFETY CODE. THE
OPTIMAL MODEL OF CARE FOR ALS
PATIENTS NAMELY AND THE
SUBCOMMITTEE ANALYSIS DID A VERY
NICE JOB DESCRIBING IT. AND
EVIDENCE BASED MULTI
DISCIPLINARY WRAPAROUND SYSTEM
OF CARE THAT COMBINES MEDICAL
COMMUNITY AND HOME BASED
SERVICES.
THEY'LL ASSOCIATION CERTIFIES
THE SITES AROUND THE STATE KNOWN
AS CENTERS OF EXCELLENCE WHERE
ALS PATIENTS RECEIVED THIS CARE.
ALL OF THE MONEY THE ASSOCIATION
RAISES FOR ITS PROGRAMS COMES
FROM PHILANTHROPIC SOURCES AND
WE'RE HERE TODAY BECAUSE. THE
ASSOCIATION CANNOT KEEP PACE
WITH THE GROWING DEMAND FOR CARE
FOR THREE ESSENTIAL REASONS
NUMBER ONE.
MORE AND MORE PATIENTS WITH THE
DISEASE ARE AVAILING THEMSELVES
OF THE CARE IS AT THE CENTERS.
REFERRALS FROM GENERAL
NEUROLOGISTS TO THE CENTERS ARE
GROWING AND THE GOOD NEWS IS
MORE PATIENTS ARE COMING TO THE
CENTERS AT AN EARLIER STAGE IN
THEIR DIAGNOSIS.
NUMBER TWO.
CALIFORNIA HAS MORE PATIENCE
THAN ANY OTHER STATE DIAGNOSED
WITH LOU GEHRIG'S DISEASE. AND
WITH THE GROWING GENERAL
POPULATION IN THE STATE. THE
OVERALL CASELOAD AVAIL AS
PATIENTS IN CALIFORNIA IS ALSO
GROWING.
AND ONE OF OUR WITNESSES WILL
SPEAK TO THIS IN A MINUTE.
AND AND NUMBER THREE BECAUSE OF
THE QUALITY OF CARE RECEIVED AT
THE CENTERS AND AGAIN MORE
PEOPLE ARE AT THE CENTERS.
AND I AS WELL AS IN THE
COMMUNITY IN THE SERVICES THAT
THE ASSOCIATION PROVIDES PEOPLE
WITH THE DISEASE ARE LIVING
LONGER.
I THINK WAS VERY NOTABLE THAT
STEPHEN HAWKING PASSED AWAY BUT
TEN DAYS AGO HE HAD EXEMPLARY
CARE AND THERE'S NO DOUBT THE
EVIDENCE SHOWS. LIFE IS LONGER
WHEN YOU HAVE BETTER CARE.
WE HAD ONE EXPLORATORY MEETING
WITH THE DEPARTMENT OF PUBLIC
HEALTH AND WHAT FINANCE. AND WE
SIMPLY WANT TO THANK YOU AGAIN
FOR YOUR ATTENTION. TOWARD
REQUEST TO KEEP THEM HIS PROGRAM
GOING IN THE IN LIGHT OF THE
GROWTH OF THE NUMBERS.
THE CURRENT FINANCIAL STRUCTURES
UNSUSTAINABLE WE REALLY HAVE
NOWHERE ELSE TO GO SO THANK YOU.
ALRIGHT THANK YOU HOUSTON ALMOST
ALL THE TIME BUT. MEDICAID. AND
LINDA AND AYE LINDA DANO
REPRESENT PATIENTS AND FAMILIES
WITH A LS ON. AND I'M ALSO HERE
IN MEMORY OF MY HUSBAND WHO WAS
THE CHIEF CONSULTANT FOR THE
SENATE ENERGY. ENERGY COMMITTEE
FROM US TWENTY YEARS HE PASSED
AWAY IN TWO THOUSAND EIGHT WITH
A LS.
BUT A LOT OF PEOPLE DON'T KNOW
ABOUT ALS IS THAT IT'S SUCH A
COMPLICATED DISEASE THAT ANYONE
DOCTOR USUALLY DOESN'T KNOW WHAT
TO DO. AND EVEN IN THE MOST
NEUROLOGISTS I KNOW YOUR DOCTOR
MOST UROLOGISTS MAYBE ONLY SEE
ONE LS PATIENT IN THEIR ENTIRE
CAREER.
SO WE ARE VERY DEPENDENT UPON
THE CENTERS THAT ARE DEVELOPED
BY THE LS ASSOCIATION.
TO JUST SUSTAIN LIFE AND
EVERYBODY'S ELLIS IS DIFFERENT
SO THESE ARE LIFE SUSTAINING A.
CENTERS THAT NEED YOUR SUPPORT
AND I WOULD LIKE TO UNDERSCORE
THAT THANK YOU VERY MUCH FOR
YOUR FOR ANY SUPPORT AND YOU.
CORD OF THIS MODEL OF CARE OUR
CLINIC COORDINATORS CASE
CONFERENCING TO DEVELOP CARE
PLANS AND CARE MANAGEMENT TO
IMPLEMENT THESE CARE PLANS NONE
OF WHICH IS CURRENTLY FUNDED.
THEY'RE ALL TAKING CARE OF
THROUGH PHILANTHROPIC DOLLARS
WHICH WERE RAISED FROM THE LS
COMMUNITY. SO ALS THE ATLAS
COMMUNITIES FUNDING THEIR OWN
CARE.
THAT'S WHERE THE ELLIS
ASSOCIATION COMES AND. BAYLISS
ASSOCIATION OFFSETS THE COSTS OF
THESE CLINICS THROUGH
PHILANTHROPIC DOLLARS PROVIDES
CARE MANAGEMENT TO SERVE AS A
BRIDGE BETWEEN THE CLINIC THE
HOME AND THE COMMUNITY SETTINGS
TO IMPLEMENT CARE PLANS.
AND THIS IS A VERY EXPENSIVE
DISEASE THIS IS A DISEASE WHERE
PEOPLE CAN NO LONGER WORKING
OFTENTIMES THEIR SPOUSES NEED TO
QUIT WORK IN ORDER TO CARE FOR
THEIR LOVED ONE. THE FINANCIAL
IMPACT IS DEVASTATING ASKING THE
ANALYST COMMUNITY TO COMPETE
CONTINUE TO FIT THE UP FOR THE
BILL. IS DEVASTATING. MEANWHILE
THIS WRAPAROUND MODEL OF CARE IS
THE ONLY THING CURRENTLY PROVEN
TO HELP PEOPLE LIVE LONGER WITH
A LS
SO WE APPRECIATE YOUR TIME TODAY
IN HER OPEN DIDN'T QUESTIONS YOU
MAY HAVE.
I THINK YOU. ANY COMES FROM THE
TOP OF THE GULF.
NO WE DID.
HAVE AN OPPORTUNITY TO MEET
WITH THEY'LL ASSOCIATION AS WE
MENTIONED TO THEM WE DON'T
CURRENTLY HAVE AN ALICE PROGRAM.
AT THE DEPARTMENT OVER HERE TO
FIGHT TECHNICAL ASSISTANCE AS
NEEDED OKAY A ALEJO.
ONCE FINANCE.
DEPARTMENT BONE WE MET WITH THE
ADVOCATE SUMMER SAYS MR WERE
STILL ASSESSING THE PROPOSAL BUT
WE DON'T HAVE A POSITION AT THIS
TIME.
SO I GUESS FROM I UNDERSTAND THE
PROPOSAL I MEAN THE REQUESTS FOR
FUNDING TO SUPPORT THE CENTERS
ARE PROVIDING WELL CLINICAL
WELL.
CLINT CRITICAL SUPPORT
COORDINATION OF CARE EIGHT.
OF SO I GUESS.
CERTAIN IN ADDITION OUTSIDE FROM
THE OUT THE OUT OF THE NEED FOR
FOR THE SERVICES.
I GUESS ONE QUESTION IS THAT IT
IS WORTH HEARING INTO CONTEXT
THE PART OF PUBLIC HEALTH IS THE
PRIME PUBLIC HEALTH OPERATE ANY
SIMILAR TYPES CENTERS ARE
SERVICES FOR OTHER CHRONIC
DISEASE ENTITIES OURS IS.
BETTER ALONG IN A MORE CLINICAL
THE FIRELIGHT WELL AS IT COULD
BE LIKE PCS ACTUALLY FUNDS
CLINICAL CARE. ARE OR SOME OTHER
AGENCY AND FOR THE RECORD THIS
IS MONICA WELL AS UPS.
A SIMILAR PROGRAM OF THE YEAR
ALZHEIMER'S PROGRAM ACTION HONEY
WHERE WE FIND.
AND THE DEBTS AT GUN ALZHEIMER'S
CENTERS ACROSS THE STATE THERE'S
TEN OF THEM AS YOU REMEMBER
RIGHT YEAH YEAH. SAID THAT'S
SOMETHING SIMILAR THAT WE HAVE.
INVESTIGATOR THAT'S SOMETHING WE
LOOKED AT IN DEVELOPING A
PROPOSAL. UP I'M GONNA AND AGAIN
THERE'S THERE'S A CENTER OF
EXCELLENCE ELEMENT BUT THERE'S
ALSO THE COMMUNITY A OF WORK
THAT'S DONE AND HASN'T JUST AS A
QUICK EXAMPLE. PEOPLE WHO HAVE
FAILED US IS YOU KNOW ULTIMATELY
LOSE THEIR ABILITY TO USE THEIR
LAMBS.
RIGHT AND SO MANY PATIENTS HAVE
A HOIST IN THEIR BEDROOM TO TO
PUT THE PATIENT IN BED AT NIGHT.
QUESTION WHERE IS ALWAYS COME
FROM WHO MAINTAINS IT WHO
TEACHES THAT FAMILY MEMBERS HOW
TO USE IT THAT'S WHAT THESE
FOLKS DO.
SO
IT'S A GOOD EXAMPLE.
SO I MEAN I THINK A PART OF FINE
SIR MENTALLY THINKING ABOUT IS
THAT WE THINK ABOUT OUR SYSTEM
OF CARE. AND THEY KNOW YOU'RE
COMING FOR THIS PROPOSAL.
MIKE WHERE WHERE DID THE
DIFFERENT PARTS SAID RIGHT SO.
NO WEAR OUT AND THAT YOU KNOW
WELL.
THE UGLY FUND COORDINATION OF
CARE YOU KNOW WHO DO THAT THAT
THE OUT THE RANGER EDUCATION OR
ARE OUR OUR OUR TRAINING OF. THE
FAMILY MEMBERS OF THE CARE
GIVERS.
THEY'RE NOT SO YEAH.
YEAH GREAT POINT.
FOR THE RECORD I I SHOULD SAY
THAT WE FUND AL SUMMERS RESEARCH
THAT.
YEAH SO WE WERE NOT CURRENTLY
FINDING CARE COORDINATION AND
UP.
THROUGH THE ALZHEIMER'S FUNDING.
AND PROGRAM SO IT IS DIFFERENT
IN TERMS OF THE CLINICAL ANGLE
THAT THIS SPECIFIC PROPOSAL HAS.
ALRIGHT
OKAY.
OKAY AND ANY PUBLIC COMMENT.
YOU.
ALRIGHT.
SO A BIG CERTAINLY YEAH I.
THIS IS A A.
.
I MEAN THIS IS A VERY IMPORTANT.
ISSUE OF THOSE FOR.
.
YOUR COMMUNITY THIS.
PEOPLE OF THE DUTIES ALSO I
THINK WE DO HAVE SERVER.
LARGER QUESTION.
ABOUT.
.
THERE ARE NUMEROUS BACK CRANK
DISEASE ENTITIES THE GOOD NEWS
IS THAT THERE ARE MEDICAL CARE
IS GOTTEN BETTER BUT IT HASN'T
DEVELOPED THE CURIA AT.
SO WE HAVE PEOPLE WHO
FORTUNATELY OUR LIVE
UNDER
MORE PER
OF LIVES
BUT WHO NEED THESE VITAL
SERVICES AND. FIGURE OUT WHERE
THEY FIT IN GO EN AND THE
PROBLEM IS IS OUT TO OFTENTIMES
THE VERY SERVICE YOU TALK ABOUT
HALF ALL THE CRACKS IN LIKE
WELLS THAT REIMBURSED HERE IS
THAT COVER THAT PROGRAM SO PLACE
SO. WE DO NEED TO FIGURE OUT
THE.
BEST OF THE PLACE THE WHERE
WHERE IT LANDED AND DIVE
APPRECIATE THAT ACTUALLY THE
PART PUBLIC HEALTH IS LOOKING
AT.
POTENTIALLY BEING.
AT LEAST THAT A PLACE WHERE WE
CAN NOW PUT THIS JOB BUT I THINK
MOVE WE DO HAVE TO THINK A
LITTLE BIT ABOUT.
HOW WE CAN ALSO MAXIMIZE THE
RESOURCES AS WELL SO EVEN AS
YOU'RE LOOKING AT A GENERAL
FUND?
?
I REQUEST YOU KNOW WE SHOULD BE
LOOKING AT IS. WHO HAS THE
EXPERTISE TO SEE WHETHER WE CAN
USE THAT AS A CORE TO LEVERAGE
SOME OTHER FUNDS ARE RESOURCES
AS WELL?
TO TRY TO GET GET MORE SO SINCE.
SIGHTS Y. KEEP DOWN THE BACK OF
MY MIND AS WELL. AND THINKING
ABOUT IT THERE'S NO OF SOME OF
THE SERVICES THAT ARE THAT WOULD
BE DONE BY THE CENTERS ARE COULD
BE.
YOU KNOW COULD WE COULD FIND A
WAY TO LEVERAGE SOME FEDERAL
MONEY OR SOME OTHER TYPES OF
RESOURCES WHILE IN. HOW HOW WE
WOULD DO THAT? AS WELL THOUGH.
OKAY WELL I WANNA THANK YOU SO
MUCH FOR YOUR PRESENTATION NOW
WE'RE GONNA HOLD THAT THIS ITEM
OPENED. AND ON THE.
BUT.
APPRECIATE. THE PRESENTATION
AND ALSO.
TRYING TO HELP US FIGURE
FIGURES OUT THE NEED HERE ITSELF
WE CAN FIGURE SOMETHING OUT. A
REVISED. FIGURE THANK YOU THANK
YOU THANKS VERY MUCH.
OKAY.
WITH THAT I THINK WE'VE
CONCLUDED OUR AGENDA.
SELL.
I WAS PROUD FARM WHERE ONLY
DESPITE THIRTY FIVE.
THAT'S A PHYSICAL OR ANY.
SILENT AGAIN THANK EVERYONE FOR
BEING HERE.
.
AND THE.
SO WE WILL ADJOURN THIS HEARING
AT THE US SENATE BUDGET FISCAL
REVIEW COMMITTEE NUMBER THREE.
ON HEALTH AND HUMAN SERVICES
THANK YOU