PROFESSIONS IN ECONOMIC
DEVELOPMENT THIS IS OUR HEARING
FOR APRIL NINTH.
A WE HAVE SIX BILLS ARE FILED
TODAY WE DO NOT HAVE ANY BILLS
PROPOSE FOR CONSENT.
A OUR FIRST BILL WE AND WE DO
NOT HAVE A QUORUM ESTABLISHED WE
WILL. BEGIN AS A.
SUBCOMMITTEE HOME OF THE WHOLE.
AND OUR FIRST BILL IS ITEM
NUMBER ONE S. B. NINE ZERO FOUR
BY SENATOR WIECKOWSKI WELCOME
SENATOR WIECKOWSKI GOOD
AFTERNOON CHAIR HELL AND MEMBERS
THIS IS A. THIS FALLS ON MY WORK
THREE YEARS AGO AND SP ONE SEVEN
SEVEN WHICH EXTENDED THE SUNSET
ORGANIZE A AS LIMITED LIABILITY
COMPANIES. AHEAD
WHICH
A EXPIRES ON JANUARY FIRST TWO
THOUSAND NINETEEN SO S. B. NILE
FOR. IS A SIMPLE EXTENSION OF
THE SUNSET DAY TO ADD JANUARY
NINE TWENTY TWENTY FIVE THERE
WERE OTHER TECHNICAL CHANGES
WE'VE MADE TO IT IN WITH ME I'M
BE. HALF OF THE CALIFORNIA ALARM
SO SESSION IS.
TRANSMIT.
GOOD GOOD AFTERNOON. OF ONE WHO
BRING IT BACK TO THE.
COMMITTEE I ANY QUESTIONS OR
COMMENTS SENATOR WOKE.
WHY SEVEN YEARS AGO I NOTICED
THAT THE NEXT BILL IS LIKE
REMOVING A SUNSET SO JUST
CURIOUS ON THAT WHILE I RESPECT
THE JURISDICTION OF THIS
COMMITTEE TOLD TO LOOK IT? OVER.
AT LOOK AT THESE LLC'S NO I
THINK IT'S A RATHER NEW AREA FOR
FERTILE LIMITED LIABILITY.
A FORM FOR ALARM COMPANIES AND
WE THOUGHT NUMBER SO WOULD YOU
PLEASE CALL
THE ROLL W. QUORUM HEALTH. HERE
HEALTHCARE FULLER DODD.
HERE THOUGHT HERE GALGIANI.
LASER HERNANDEZ HERE HERNANDEZ
HERE NEWMAN. NEWMAN HERE PAN
WILK PRESIDENT BURGER WE DO HAVE
A CORPSMAN SENATOR WILK MADE THE
MOTION.
WE DO HAVE A MOTION TH TO
PLEASE CALL THEYOUR ROLE AND
YOU HAVE CLOSE THANK YOU VERY
MUCH SENATOR.
QUESTION IF YOU PASSED THE
SENATE JUDICIARY COMMITTEE. AYE.
AYE FULLER.
DODD AYE DODD AYE GALGIANI
LASER.
HERNANDEZ HERNANDEZ WELCOME
SENATOR.
THE PROOF.
IF I DID KNOW ANY BETTER I'D SAY
THIS IS ANOTHER EXTENSION OF AN
LLC.
SO REMOVING AT JUST THE MOVIE AT
THIS TIME YES.
BUT HE WAS CHAIR MEMBERS S. B.
NINE TWENTY CONTINUES THE
AUTHORIZATION FOR SPECIFIC
DISCIPLINES OF DESIGN
PROFESSIONALS INCLUDING
ARCHITECTS IT ALLOWS THEM TO BE
NIMBLE IN
THE TWENTY FIRST CENTURY
ECONOMY.
ESPINO TWENTY EXTENDS A
PERMISSION THAT WAS HAS A PROVEN
SUCCESS OVER THE COURSE OF
SEVERAL DECADES. AND I'LL TELL
YOU I KNOW IT LIMITED LIE
LIABILITY.
.
SEEMS LIKE A SLOW MEAL I BELIEVE
AS A DESIGN PROFESSIONAL I'M A
REGISTERED ENGINEER I'D STILL
CARRY ALL LIABILITY SO IT'S
REALLY NO DIFFERENCE THAT I SEE
CORPORATE ESCORT. THE DESIGN
PROFESSIONAL WILL STILL BE
RESPONSIBLE IF THERE'S A PROBLEM
AND SO WE'RE NOT. DEFERRING OF
LA BILLION BILLS DESIGNED FIRST
PROFESSIONAL STILL HAS A SO WITH
THAT I HAVE A JEAN IRVINE AND
LIKE LOTE.
WITNESSES IN SPORT BURGER THANK
YOU SENATOR CANNELLA MISTER
BLOCK THANK YOU MISTER CHAIR AND
MEMBERS OF MIKE THE LOAD ON
BEHALF OF TO CLIENTS THE
AMERICAN INSTITUTE OF.
ARCHITECTS CALIFORNIA COUNCIL
AND THE CALIFORNIA LAND
SURVEYORS ASSOCIATION THESE LLP
STATUTES HAVE HAVE OF.
VARIED IN TERMS OF HOW LONG THE
SUNSETS HAVE LASTED WITH RESPECT
ARCHITECT IT'S ACTUALLY A TWENTY
YEAR PROGRAM NOW STARTED IN
NINETEEN NINETY EIGHT.
SOME OF THE OTHERS ARE NEWER SO
THIS IS I THINK A REASON. A TO
JUSTIFY ELIMINATING THE SUNSET
YOU HAVE LONG HISTORY HERE YOU
HAVE A TEMPLATE ESTABLISH
LIABILITY COVERAGE OF SENATOR
CANNELLA INDICATES IF YOU'RE
INVOLVED IN A BIG PUBLIC PROJECT
OR SOMETHING YOU'RE OBVIOUSLY
GOING TO HAVE MORE INSURANCE
THAN REQUIRED BY THE STATUTE.
TO PROTECT YOU AND THE PUBLIC
BUT WE THINK THAT.
EXPERIENCE HAS SHOWN THAT THE
PUBLIC IS PROTECTED YOU
OBVIOUSLY COULD LOOK AT THIS AT
ANY TIME IF THERE WAS EVIDENCE
OF A PROBLEM. WE THINK IT MAKES
GOOD POLICY SENSE TO ELIMINATE
THE SUNSET WE WOULD ASK FOR
NIGHT VOTE WE THANK YOU MISTER
BELOW MISTER URBAN.
JEAN AROUND THEY HAVE ON BEHALF
OF THE AMERICAN COUNCIL
ENGINEERING COMPANIES
WE SUPPORT THIS TO WE SUPPORT
ELIMINATION OF THE SUNSET.
JUSTICE YEAR I'VE BEEN
APPROACHED BY THREE OR FOUR
ENTITIES CONSIDERING
REORGANIZATION IS AN LLP NONE OF
THEM ARE GOING TO DO IT. UNTIL
THEY KNOW THE STATUS OF THIS
MEASURE THEY'RE JUST NOT GOING
TO CHANGE ORGANIZATION
FOR SIX MONTHS AND THEN PERHAPS
HAVE TO CHANGE BACK.
AND THEN YES THE MINIMUM
INSURANCE REQUIREMENTS MOST
EXCEEDED MOST PUBLIC PROJECTS
MANY PUBLIC PRIVATE PROJECTS
REQUIRE YOU TO CARRY MUCH MORE.
FOR WHICH WE GO OUT AND GET A.
PROJECT.
ARM IN ANY EVENT WE ASK FOR YOUR
YES VOTE.
WE THANK YOU MISTER WRITTEN OF
ARE THERE OTHERS HERE IN
SUPPORT.
SENATOR CANALS LEGISLATION
ANYONE HERE IN OPPOSITION.
OR HAVE CONCERNS SEEN NO ONE
BRING IT BACK BUT REAL.
THE MOTION FROM A SENATOR NEWMAN
NO WHICH AYE TO CLOSER TO
CANNELLA GET ZEST FOR AYE VOTE
VERY GOOD I THINK IT'S A GREAT
SUGGESTION I THINK AFTER TWENTY
YEARS THAT'S DESERVING OF RIGHT.
LIMITED IN THE OUT IN THE
REQUIREMENT FOR SUNSET TO HAVE A
MOTION FROM A SENATOR NEWMAN
THINGS FOR THE ROLE.
QUESTION IS DO PASSED THE SENATE
JUDICIARY COMMITTEE HEALTH FIVE.
BILL AYE FULLER AYE FULLER AYE
DODD AYE DODD AYE GALGIANI
GLAZER HERNANDEZ. HERNANDEZ AYE
NEWMAN AYE AYE NEWMAN AYE PAN
WILK FIVE WILL DIE.
WITH SIX VOTE WILL HOLD THE
ROLLOVER FOR AFTER MEMBERS THANK
YOU SENATOR CANNELLA.
WE'LL MOVE NOW TO SENATOR ROTH I
SEE YOU IN THE FRONT ROW PLEASE
THIS IS MOVING TO ITEM NUMBER
FOUR S. B. TEN OH THREE.
RESPIRATORY THERAPY.
SENATOR ROTH THE FLOOR IS YOURS
THING AS CHAIR MEMBERS.
SENATE BILL ONE ZERO ZERO THREE
IS A BILL THAT AUTHORIZES THE
RESPIRATORY CARE BOARD TO DEFINE
INTERPRET AND BASICALLY IDENTIFY
THREE LEVELS OF RESPIRATORY
CARE.
AND WHAT THEY DO BASIC
INTERMEDIATE ADVANCED.
AS YOU WELL KNOW IN THIS
COMMITTEE A RESPIRATORY CARE
PRACTITIONERS DUTIES CAN RAY
ARRANGE FROM.
EDUCATING CONSUMERS ABOUT
RESPIRATORY CARE TO ACTUALLY
ADMINISTERING PHARMACOLOGICAL
AND DIAGNOSTIC AGENTS RELATED TO
RESPIRATORY CARE TREATMENTS.
I WILL NOTE THAT THIS BILL DOES
NOTHING TO ALTER THE CURRENT
SCOPE OF PRACTICE FOR.
RESPIRATORY CARE. FOLKS IT
MERELY A ALLOWS THE BOARD TO
ADOPT THE DEFINITIONS FOR THESE
THREE LEVELS OF CARE.
RESPIRATORY THERAPY TO RESPOND
TO INCREASE FROM HOSPITALS AND
THE LIKE.
I HAVE US THAT THE KNOWN AS WITH
ME FROM THE BOARD TO CAN
CERTAINLY ANSWER ANY TECHNICAL
QUESTIONS FAR BETTER THAN I CAN
IF THERE ARE.
VERY NICE BILL OF
SENATOR REID USER BICU OF.
WITNESSES IN SUPPORT WHICH YOU
LIKE TO ASK AGUIAR THANK YOU.
WIENER.
HAVING US HERE.
BROUGH THANK YOU OTHERS IN
SUPPORT.
THAT AFRICANA HELL WITH AARON
READ AND ASSOCIATES ON BEHALF OF
THE CALIFORNIA SOCIETY FOR
RESPIRATORY CARE. AND WE ARE.
VERY SUPPORTIVE OF THE BILL
OBVIOUSLY WERE CO SPONSORING AND
WE WOULD LIKE THE BOARD TO BE
ABLE TO.
BE PREPARED FOR THE CHANGES
THAT ARE COMING AND.
TECHNOLOGY AND DAD THAT ARE
DRIVING.
SO MANY CHANGES WITHIN OUR
HEALTHCARE SYSTEM SO BY HAVING
THE BOARD OUTLINED WHAT ARE
BASIC INTERMEDIATE AND ADVANCED
TASKS AND PROCEDURES. AND WE'RE
HOPING THIS'LL ESTABLISH A NICE
FOUNDATION THAT WE CANNOT
RESPOND TO FUTURE EDUCATION
DEMAND.
THINK VERY GOOD THANK YOU. OF
OTHER OTHERS HERE IN SUPPORT.
IS THERE ANYONE HERE IN
OPPOSITION.
YOU KNOW WHEN THE.
COMMITTEE YES DOCTOR PAN.
THANK THANK YOU SORRY MUCH AND
CERTAINLY I THINK AND.
MISTER DEBBIE AND MANY OF
HEALTH PROFESSIONS WITH
INCREASING TECHNOLOGY.
THERE IS.
I NEED TO THINK ABOUT.
TRADING AND DIFFERENT LEVELS AND
APPRECIATE.
THE WORK THAT RESPIRATORY
THERAPISTS DO AS A POSITION THAT
THE.
FOR PATIENTS THAT THE QUESTION I
DO HAVE IS THAT.
SURF INDIRECTLY RELATE TO THE
BILL BUT.
.
BUT. SO I UNDERSTAND THAT THERE
ARE.
TO A CERTAIN EXTENT.
VESPIDAE THERAPY THERE SOME
PEOPLE DOING BACHELORS AT OTHERS
TO.
I THINK IS ASSOCIATE AND TO IN
TERMS OF EDUCATION.
SO I I DO HAVE ONE CONCERN I DO
HAVE A CONCERN IS NOT SECIFIC
TO RECIPROCATE THERAPY BUT THIS
IS IN GENERAL AND EVEN AND
HEALTH PROFESSIONS IS THAT. WERE
HAVING A CHALLENGE OVER TIME
WITH MICHAEL CREDENTIAL CREEK.
AND SO THE PROBLEM IS IS THAT
WHAT HAPPENS IS THAT WERE
EVERYONE'S TRYING TO BUMP UP AND
THEY REALIZE THAT WE HAVE
INCREASING TECHNOLOGY AND SO
FORTH.
YOU KNOW THE DEGREE LEVEL YOU
NEED TO ENTERED THE FIELDS WHICH
ACTUALLY IS ALSO TRYING TO
EXCLUDE PEOPLE FROM THE OLD
ENTERED THESE FIELDS AS WELL.
AND YOU KNOW CERTAINLY IT'S DONE
IN THE NAME OF FEEL WE NEED TO
HAVE CERTAIN STANDARDS THAT I I
AGENCY THIS MY OWN FIELD OF
MEDICINE WHERE WE HAVE TO WATCH
IT WE'RE TREATING YOU AND YOU
CERTIFICATIONS YOU KNOW WE HAVE
SPECIALTIES AND SUBSPECIALTIES
NOW SUB SUB SPECIALTIES.
CERTIFICATIONS.
SO I DO HAVE A QUESTION ABOUT.
IN TERMS OF WHEN THE BOARD IS
LOOKING AT THIS I HAVE NO ISSUES
ABOUT TRYING TO BE HEALTHY ABOUT
DIFFERENT LEVELS AND SO FORTH.
BUT I HOPE IT DOESN'T LEAD TO A
SITUATION WHERE ESSENTIALLY.
WE ARE THE.
IT'S STARTING TO MOVE INTO A
SITUATION WHERE BASICALLY WE'RE
GONNA BE EXCLUDING PEOPLE WHO
PREVIOUSLY COULD ENTER THE
PROFESSION.
BECAUSE WHAT HAPPENS WE'RE JUST
GONNA KEEP PUSHING UP ALL THAT
CERTIFICATIONS CREDENTIALS IN A
WAY THAT. OUR PEOPLE BASICALLY
NOW THAT THE FACE MORE SPENDING
ON.
SAYING AND SO FORTH. US SO. CAN
YOU JUST ADDRESS THAT.
IS AS AN ISSUE
IN RELATION TO.
WHAT THE BOARD THAT HAD TO DO
WITH THESE DIFFERENT LEVELS?
THANK YOU VERY MUCH APPRECIATE
THOSE COMMENTS ARM.
REALLY THE CATALYST THAT DROVE
THIS WAS THE INCREASE IN OUR
SCOPE OF PRACTICE TO TECHNIQUES
SUCH AS CONSCIOUS SEDATION AND
ACT NOW. AND I YOU OF ALL PEOPLE
KNOW THAT PUBLIC REQUIRES A
DIFFERENT LEVEL OF THAT TRAINING
AND SKILL.
SO.
BUT WE HAVE A HISTORY OF NEVER
EXCLUDING ANYONE SO WHEN WE HAD
DIFFERENT EDUCATION CHANGES OR
ANYTHING WE NEVER.
LOOKED EVEN EVER STATES WE DO
NOT AIR TECH IS NOT TO ELIMINATE
THE ASSOCIATE DEGREE EVER I WILL
SAY IT WAS UNDER CONSIDERATION
HOWEVER GIVING YOUR COMMENTS
IT'S VERY IMPORTANT TO US THAT
WE. LISTEN TO THE LEGISLATURE
AND WHAT THEY WANT.
SO.
THE FACT THAT.
ARM THAT'S NOT SOMETHING YOU
WANT WE'RE NOT GONNA GO THAT
DIRECTION I CAN TELL YOU THAT
RIGHT NOW. SO IT'S MORE OF IT'S
REALLY JUST A MATTER OF MAKING
SURE THAT PEOPLE HAVE THE
TRAINING FOR THE HIGHER LEVEL
THINGS.
THAT WE'VE ADDED TO THE SCOPE OF
PRACTICE.
AND I APPRECIATE THAT ASSAD WHO
ACTUALLY. WORKED.
SEEN THE WORK THAT'S REQUIRED
THAT SOMEONE ON ECMO THAT OFFICE
IS AN EXTREMELY.
TECHNICAL AND HIGHLY SKILLED.
A WORK THAT HAS TO BE DONE TO
DO THAT WHICH IS.
AND AND SO WHILE CERTAINLY STILL
NEED SKILL AND AND AND AND.
FOR FOR A DOING OTHER TYPES OF
TESTS THERE IS THIS
DIFFERENTIATION THAT IS ACTUALLY
QUITE SIGNIFICANT SITES
CERTAINLY.
RESHAPE DOT THE NEED FOR THAT
AND THIS BILL.
IF YOU.
GOOD UP OTHER OTHER QUESTIONS OR
COMMENTS SEEN NONE NO WOULD LIKE
TO CLOSE SENATOR RUSS JUSTICE
FOR YOUR AYE VOTE THANK YOU
MISTER CHAIRMAN LADIES THAT VERY
MUCH THANK YOU TO THE BILL AND I
THINK IT'S CERTAINLY APPROPRIATE
TO DEFINE THESE DIFFERENT LEVELS
OF.
SKILL AND.
THAT SINCE THE THROUGH THE
PROFESSION HAS EVOLVED OVER THE
LAST NUMBER OF YEARS THANK YOU
VERY MUCH FOR THAT WE HAVE A
MOTION.
VERY GOOD WE HAVE MOTION FROM A
SENATOR NEWMAN PLEASE CALL THE
ROLL. MISSION IS TO PASS THE
SENATE APPROPRIATIONS COMMITTEE
HELPED AYE HILL AYE FULLER.
FULLER I DOT. DOT AYE GALGIANI.
GALGIANI AYE GLAZER.
GLAZER AYE HERANDEZ. HERNANDEZ
AYE NEWMAN. AYE NEWMAN AYE PANTS
AYE AND I WILK LOOK I.
THE BILL HAS NINE VOTES AND IT
IS OUT CONGRATULATIONS THANK YOU
MISTER SENATOR ROTH.
I SEE SENATOR STONE BACK THERE
CENTERS DON'T WELCOME. GOOD
AFTERNOON.
WE'RE NOW ON A ITEM NUMBER FIVE
S. B. TWELVE FIFTY FOUR BY
SENATOR STONE.
THANK YOU I DON'T VOTERS AARON
HONORABLE COLLEAGUES FROM
MEMBERS OF THE BOARD. COMMITTEE
I'M PRESENTING SP TWELVE FIFTY
FOUR WHICH REQUIRE A PHARMACIST
AT A HOSPITAL PHARMACY TO OBTAIN
AN ACCURATE MEDICATION PROFILE.
FOR EACH HIGH RISK PATIENTS UPON
ADMISSION. AND DISCHARGE OF THAT
PATIENT.
IT'S STARTLING THAT UP TO
SEVENTY PERCENT OF PATIENTS HAVE
ERRORS ON THEIR MEDICATION LISTS
UPON ADMISSION TO THE HOSPITAL
ENOUGH TO FIFTY NINE PERCENT OF
THOSE ERRORS. HAVE THE POTENTIAL
TO CAUSE MODERATE TO SEVERE
HARM.
THERE IS CURRENTLY A LACK OF
OVERSIGHT FOR ENSURING THAT SUCH
MEDICAL LISTS ARE ACCURATE UPON
HOSPITAL ADMISSION AND
DISCHARGE.
THIS LACK OF DEFINED
RESPONSIBILITY RESULTS IN AREAS
IN THE LIST AND ERRORS IN
MEDICATION ORDERS WHEN PATIENTS
ARE IN THE HOSPITAL. AND WHEN
THEY ARE IN FACT DISCHARGED.
NOT ONLY DOES LEAD TO
SIGNIFICANT PATIENT HARM TO THE
PATIENT BUT STUDIES HAVE SHOWN.
THAT THIS PROBLEM ALSO COST
BILLIONS OF DOLLARS TO THE
MEDICATION RELATED READMISSIONS
AN ADVERSE DRUG REACTIONS. SUB
SOME EXAMPLES OF THE SERIOUS
LIFE THREATENING. ERRORS ARE.
IN ORDER FOR CHEMOTHERAPY DAILY.
INSTEAD OF WEEKLY ON ORDER FOR
HIGH DOSE OF AN OPIOID IN A
PATIENT. THAT IS NOT. BEFORE
HOSPITALIZATION.
THE LACK OF A BLOOD THINNER IN A
PATIENT WITH A BLOOD DISORDER AT
THE RISK FOR LIFE. THREATENING
BLOOD CLOTS.
HIGH RISK PATIENTS SUCH AS THOSE
THAT ARE ELDERLY THOSE WITH
MULTIPLE CHRONIC DISEASES AND OR
RECEIVING MULTIPLE MEDICATIONS.
ARE AT HIGHER PROBABILITY OF
HAVING ERRORS HONORED MISSION
MEDICATION LISTS AT AN AVERAGE
OF. EIGHT ERRORS PER PATIENT.
ONE STUDY SHOWS THAT ONLY FIVE
POINT THREE PERCENT OF PATIENTS
SIXTY FIVE YEARS AND OLDER.
THAT ARE ON FIVE MEDICATIONS OR
MORE HAD AN ACCURATE LIST THAT'S
NINETY FOUR POINT SEVEN PERCENT
THAT WERE NOT ACCURATE.
I'VE HEARD THE CONCERN THAT S.
B. TWELVE FIFTY FOUR ASK THE
HOSPITAL'S CREATE THEIR OWN
DEFINITIONS.
A HIGH RISK.
THERE MANY HOSPITALS LIKE THE
CITY OF HOPE WHERE TREAT CANCER
IS ALL THEY DO MAKING THEM.
DEFINE HIGH RISK.
PATIENTS AS ANYTHING OTHER THAN
CANCER PATIENTS BECOMES
UNNECESSARILY BURDENSOME.
OUR HEALTH SYSTEMALREADY HAS
CHECKS AND BALANCES WITH THE
JOINT COMMISSION CALIFORNIA
DEPARTMENT PUBLIC HEALTH.
AND THE BOARD OF PHARMACY TO
ENSURE PATIENT SAFETY.
THESE ENTITIES WOULD BE AWARE OF
A HOSPITAL THAT IS NOT PUTTING.
PATIENT SAFETY FIRST BY NOT
NAMING WHAT A HIGH RISK PATIENT
IS SINCE THEY WILL BE AN OUTLINE
OR AMONGST THE OTHER HOSPITALS.
AND GARNER.
ENHANCED SCRUTINY FROM SUCH
ENTITIES.
THESE CHECKS MAKES IT IN THE
HOSPITAL'S BEST INTEREST TO NAME
WHAT HIGH RISK PATIENTS FOR
THEIR SPECIFIC NEEDS.
S. B. TWELVE FIFTY FOUR IS
MAKING SURE THAT A PHARMACIST IS
IN PLACE.
WHEN A PATIENT IS ADMITTED TO
THE HOSPITAL.
TODAY WHEN A MEDICATION LIST IS
CREATED IT IS CREATED BY A
VARIETY OF INDIVIDUALS FROM
ACROSS SETTINGS SUCH AS MEDICAL
ASSISTANCE NURSES AND
PHYSICIANS.
S. B. TAWFIK BEFORE PUTS THE
HOSPITAL PHARMACISTS AS A
FAILSAFE.
TO MAKE SURE CORRECT LISTS HAVE
BEEN ATTAINED AND THERE NEED BE.
TO ATTAIN THOSE LISTS WHEN
RECENTLY ABLE TO DO SO.
PHARMACISTS AND PHARMACY STAFF
WOULD BE EXPECTED TO GET AN
ACCURATE PATIENT PROFILE BY ALL
MEANS POSSIBLE.
SOMETIMES IT WILL BE IN THE
ELECTRONIC RECORD FROM A
PREVIOUS ENCOUNTER.
THE PHARMACIST CAN GO OFF THAT
GOT OFF TO A START IT ASK
QUESTIONS IF NEED BE.
IF A PATIENT IS INCAPACITATED A
PHARMACIST MAY LOOK AT A
PATIENT'S HISTORY MEDICATIONS
THAT ARE ELECTRONICALLY
AVAILABLE. MAY ASK A FAMILY
MEMBER OR GET THE PATIENT'S HOME
PHARMACY CONTACT AND BUILD
SOMETHING FROM THERE IF THERE'S
NOT BEEN ANY LESS JENNER. LIST
GENERATED ALREADY.
ALSO THE DEFINITION OF A
HOSPITAL PHARMACY CAN BE FOUND
IN THE CODE. AND INCLUDES
CLINICS AND OUTPATIENT
FACILITIES.
THERE'S BEEN A HUGE AMOUNT OF
SUPPORT FROM PHARMACISTS DOCTORS
NURSES PATIENTS
CASEWORKERS.
IN AND AROUND HOSPITALS TO DATE
NEARLY A HUNDRED AND FIFTY
LETTERS OF SUPPORT AS WELL AS A
HUNDRED FIFTY. SIGNATURES ON
CHANGE DOT ORG HAVE COME IN
EXPRESSING SUPPORT FOR THIS AND
THE NEED TO SEE. IN THEIR DAILY
RESPONSIBILITIES AS HEALTHCARE
PROVIDERS.
THE BOTTOM LINE IS THIS MY
FRIENDS.
THE PRIORITY REMAINS FOR THE
PATIENTS HEALTH AND SAFETY THIS
BILL WILL BETTER ENSURE THE
ACCURACY OF WHAT A MEDICATION
PROFILE IS AN ADMISSION. THEREBY
POTENTIALLY STOPPING ANY ERRORS
WHICH WILL ENHANCE PATIENT
SAFETY REDUCE PHYSICIAN AND
HOSPITAL LIVE BELOW THE.
INCLUDING AFTER THE PATIENTS
DISCHARGE.
WE'VE RECEIVED SUPPORT FROM SOME
OF CALIFORNIA'S FOREMOST LEADERS
IN MEDICINE.
DOCTOR ROBERT WALKER MD
PROFESSOR AND CHAIR OF THE UCSF
DEPARTMENT OF MEDICINE.
AN INTERNATIONAL LEADER IN
SAFETY AND QUALITY AND FOUNDER.
AND ACADEMIC LEADER OF THE
HOSPITAL LIST
SPECIALTY IN MEDICINE TODAY.
DR BRADLEY T. ROSEN MD WHO IS
VICE PRESIDENT A PHYSICIAN
ALIGNMENT IN CARE TRANSITIONS
FOR CEDAR SINAI HOSPITAL. AND
HAS LED THEM DEVELOPMENT
PROGRAMS TO ENSURE SAFE
TRANSITIONS WHEN PATIENTS ARE
DISCHARGED SKILLED NURSING
FACILITIES AND HOMES.
DOCTOR DOCTOR NAN NANCY GREEN
GOLD MD WHO IS CURRENTLY AT
SHARP GROSSMONT HOSPITAL'S CHIEF
MEDICAL OFFICER IN IT IS A
NATIONALLY RESPECTED AUTHOR. AND
RESEARCHER WHOSE CAREER HAS
FOCUSED ON EVIDENCE BASED
MEDICINE QUALITY AND SAFETY.
I WOULD ALSO LIKE TO THANK
HATTIE REEVES HANLEY MPP RIGHT
CARE INITIATIVE DIRECTOR HERE IN
SUPPORT OF THIS BILL.
AS WELL AS DOCTOR JOE SKY M. D.
F. EIGHT F. ACC CHIEF OF
CARDIOLOGY AT DAVID GRANT U. S.
A. F. MEDICAL CENTER.
I'M ALSO VERY GRATEFUL TO HAVE
HERE TODAY DOCTOR RIEDERS SHANE.
FROM CEDAR SINAI HOSPITAL RITA
IS THE CHEAP CHIEF PHARMACY
OFFICER PROFESSOR OF MEDICINE AT
CEDARS SINAI MEDICAL CENTER.
THROUGHOUT HER CAREER SHE'S BEEN
PASSIONATE ABOUT PATIENT SAFETY.
SHE'S BEEN RECOGNIZE NATURAL
NATIONALLY ON MULTIPLE OCCASIONS
FOR LEADERSHIP IN THIS PUBLISHED
OVER NINETY FIVE PAPERS.
PROVIDED TWO HUNDRED LECTURES AT
THE STATE NATIONAL AND
INTERNATIONAL LEVELS AND HAS
BEEN INVOLVED IN RESEARCH
STUDIES FOCUS ON.
PATIENT SAFETY.
THANK YOU FOR THE OPPORTUNITY TO
PRESENT HIS BILL IF I CAN
INTRODUCE DOCTOR SHANE.
I SENATOR STONE ON HONORABLE
HELL AND HONORABLE MEMBERS OF
THIS COMMITTEE IT IS REALLY A
PRIVILEGE FOR ME TO BE HERE
TODAY TO SHARE MY PASSION ABOUT
THIS THIS IS THE PATIENT SAFETY
INITIATIVE. IT'S REALLY A
QUALITY IMPROVEMENT. INITIATIVE
WORSE ARE BILL INTENDED TO
ENABLE US TO WORK
COLLABORATIVELY WITH PHYSICIANS
AND NURSES TO DO WHAT WE CAN TO
ENSURE SAFETY WHEN PATIENTS ARE
THE MOST VULNERABLE WHEN HIGH
RISK PATIENTS ARE ADMITTED TO.
HOSPITALS THROUGHOUT THE SITE
THROUGHOUT THE STATE OF
CALIFORNIA SIMON ASSURE MY
PERSONAL PERSPECTIVES BECAUSE
THIS IS FILE A SUBJECT NEAR AND
DEAR TO MY HEART I ALSO WANT TO
SHARE. MY PROFESSIONAL
PERSPECTIVE HAVING HAD THE
PRIVILEGE OF WORKING AT CEDARS
PRETTY MUCH MY WHOLE WHOLE
CAREER STARTING AS PEDIATRIC
PHARMACIST AND WORKING MY WAY
UP.
AND REALLY A IT'S IT'S THROUGH
THE COLLABORATION OF WORKING
WITH OUR MEDICAL STAFF
LEADERSHIP AND NURSES THAT I I I
I FEEL SO STRONGLY ABOUT HOW
IMPORTANT THIS AS.
FROM A PERSONAL PERSPECTIVE
ABOUT TWENTY YEARS AGO. IN MAY
MY FATHER WAS DIAGNOSED WITH A
AYE BRAIN TUMOR WAS METASTATIC
FROM FROM LUNG CANCER AND HE
ENDED UP HAVING TO BE READMITTED
MULTIPLE TIMES IS TRANSFERRED TO
ANOTHER HOSPITAL AND I NOTICED.
THAT ONE OF THE KEY DRUGS TO
REDUCE THE.
THAT THE SWELLING AND
INFLAMMATION IN HIS BRAIN AFTER
AFTER SURGERY ON WAS LEFT OFF
WHICH WOULD WHICH WAS REALLY A
CRITICAL ISSUE AND I WAS ABLE TO
GET THAT RESOLVED.
I VOWED TO MYSELF THAT IF I DO
NOTHING ELSE IN MY CAREER I NEED
TO FIGURE OUT HOW TO MAKE THIS.
.
MAKE THIS A KEY ISSUE AND
CALIFORNIA'S TO TO PROTECT
PATIENTS BECAUSE EVERY DAY
PATIENTS ARE HARMED BECAUSE
PEOPLE DON'T REALIZE HE LISTS
ARE CONTAMINATED. SEVENTY
PERCENT OF THE TIME THERE'S AN
ERROR ON THE LAST.
MORE RECENTLY MY ELDERLY AND WAS
IN AND OUT OF THE HOSPITAL.
ROUND DOT SUFFERED FROM
HYPERTENSION ALSO HAD A HISTORY
OF CANCER AND OTHER ON CHRONIC
DISEASES HER ON HER BREAST
CANCER TREATMENT WAS
DISCONTINUED. SHE WOULD I HAD
AND MORE MEDICATIONS ADDED ON TO
TREAT HYPERTENSION SHE WEIGHED
EIGHTY POUNDS AND WAS DIZZY AND
FALLING AND SO I FOUND
MYSELF-CALLING TO. TO FIX THE
LIST
SO THIS IS NOT ABOUT EXPANDING
SCOPE OF PRACTICE
ON A PROFESSIONAL LEVEL NOW
SPEAKING AS CHIEF PHARMACY
OFFICERS SPEAKING ON BEHALF OF
CEDARS SINAI MEDICAL CENTER.
THIS IS CLICK THIS IS A PATIENT
SAFETY ISSUE WE WE ARE WE WITH
LEAVE FINALLY YOU SAY AT CEDARS
SINAI AND I BELIEVE THIS IS TRUE
IN EVERY HEALTH CARE SETTING
BECAUSE I ALSO HAD THE PRIVILEGE
OF WORKING. WITH HEALTH
PROFESSIONALS ACROSS THE COUNTRY
THERE'S THIS THING WE CALL A
THREE LEGGED STOOL THE PHYSICIAN
IS RESPONSIBLE FOR THE DIAGNOSIS
AND TREATMENT PLAN FOR THAT
PATIENT.
THE PHARMACIST IS RESPONSIBLE
FOR ENSURING THAT THAT INTENT IS
CARRIED OUT ACCURATELY AND
SAFELY AND THE NURSE ADMINISTERS
THE MAD.
WE CONDUCTED A RESEARCH STUDY
THAT WAS PUBLISHED IN THE
BRITISH MEDICAL JOURNAL OF
CLOTTING SAFETY THE PEER
REVIEWED JOURNAL. THAT
DEMONSTRATED THAT IN A HIGH RISK
PATIENTS THERE ARE EIGHT ERRORS
ON A LIST.
ON.
EIGHT AREAS PROVIDERS PATIENT.
WHEN PHARMACY STAFF EITHER
TRAINED TECHNICIAN OR PHARMACIST
ABOUT LIST THERE WAS AN EIGHTY
PERCENT REDUCTION IN ERRORS.
AND THAT WAS BECAUSE BUSY
PHYSICIANS AND NURSES WHICH AS
USUAL CARE NEED TO TAKE CARE OF
THE PATIENT.
AND THE INDIVIDUALS WHO REALLY
UNDERSTAND THE MEDICATIONS ARE
THE FOLKS THAT WORK IN THE
PHARMACY THAT'S OUR WHOLE LIFE
THAT'S WE FOCUS ON THIS IS ABOUT
LEVERAGING EACH INDIVIDUAL TO DO
WHAT THEY DO BEST WHICH IS TAKE
CARE OF THE PATIENT. AND SO WHAT
WHAT WE HAD DISCOVERED THROUGH
THE STUDY IS THAT IF THOSE AREAS
WERE NOT CORRECTED THEY WENT ON
TO RESULT IN THREE ERRORS.
FOR THAT PATIENT PER PATIENT
WHEN THEY WERE HOSPITALIZED
I'VE THOSE ERRORS ONE POINT TWO
PER PATIENT WERE SEVERE ARE LIFE
THREATENING THAT WAS VALIDATED
BY PHYSICIANS WHO CAME TO THAT
CONCLUSION THEY REVIEWED EACH OF
THE ERRORS AND DETERMINED. HOW
MANY PER PATIENT WOULD HAVE
OCCURRED DURING THE
HOSPITALIZATION AND HOW MANY
WOULD HAVE BEEN SEVERE LIFE
THREATENING THE PRETTY
SIGNIFICANT NUMBER?
WELL IF THOSE AREAS ARE NOT
CORRECTED ARE THE ELECTRONIC
HEALTH RECORD THAT ENABLES THE
HEIRS TO BE CONTINUED CIVIL
LIABILITY ASSOCIATED WITH NOT
CORRECTING THOSE AREAS CONTINUES
NOT ONLY DURING HOSPITALIZATION
FOR EVERYONE INVOLVED THE CARE
THE PATIENT. BUT IT CONTINUES AT
DISCHARGING POSTERS CHARTS SO
THAT THE COMMUNITY PHARMACISTS
ARE NOW FOR. INTRODUCING ERRORS
INTO PATIENTS THEY MAY BE
CONTINUING PATIENTS TURNS ON
MEDICATIONS ASIAN BEYOND. SOME
OF THE THINGS WE'VE SEEN OUR A
TENFOLD DOSING ERROR UNDER DOES
IN A SEIZURE PATIENT.
A PATIENT WHO HAD AN ALLERGIC
REACTION TO A HEART MEDICATION
THAT WOULD HAVE RESULTED IN.
POTENTIAL HARM AND DEATH
BECAUSE OF SWELLING IN SHORTNESS
OF BREATH WAS CONTINUED ON
ADMISSION SO WHY DOES THIS
HAPPEN WELL IN MOST SETTINGS
LIKE DOCTORS OFFICES THE PEOPLE
TAKING THE LIST OUR MEDICAL
ASSISTANCE THEY'VE BEEN
AUTHORIZED BY CMS TO OBTAIN
LISTS.
THESE PEOPLE MAY NOT HAVE THE
TRAINING AND IN FACT THEY MAY
ONLY NEED FIVE HOURS OF COMPUTER
ORDER ENTRY TRAINING. SO JUST TO
GIVE YOU THAT BIG DATA
IMPLICATIONS BECAUSE I KNOW I'M
I'M TALKING TOO LONG.
I WANTED TO JUST I'M SHARE WITH
YOU ACTUALLY WENT THROUGH RUSH
BY DATA FROM TWO THOUSAND
FIFTEEN TO FIGURE OUT WHAT THIS
MEANT TO THE STATE OF
CALIFORNIA.
AND BASED ON DATA THAT WAS
RELEASED ON IN TWO THOUSAND
INITIATIVE TO LOOK AT DRUGS THAT
HAVE THE POTENTIAL TO CAUSE
HARM.
TWENTY ONE POINT SEVEN PERCENT
OF MEDICARE ON PATIENTS ARE
READMITTED BECAUSE OF.
DRUGS THAT CAN CAUSE HARM AND
THE AROUND NUMBER OF TWENTY
PERCENT IS WIDELY KNOWN AND
PUBLISHED IN THE LITERATURE WHEN
YOU EXTRAPOLATE THAT TO OUR TWO
THOUSAND FIFTEEN DISCHARGES THAT
IS NINE BILLION DOLLARS OF COSTS
THAT WE'RE INCURRING. AND THE
COST OF ADVERSE DRUG EVENTS IS
AROUND THREE BILLION.
THIS IS TO ME ONE THE MOST
CRITICAL THINGS WE CAN DO AND AS
AS A LEADER IN PATIENT SAFETY
WHICH I'VE ALWAYS BELIEVED
CALIFORNIA AS. OUR PATIENTS
DESERVE NOTHING LASTS VERY GOOD
THANK YOU VERY MUCH THE NEXT
THEIR WITNESS IN.
IF YOU COULD BE IS REEF ISSUE
COULD BE I'D APPRECIATE IT.
AND GOOD AFTERNOON I'M JOE SKY
I'M.
INDIAN A FELLOW OF THE AMERICAN
COLLEGE OF CARDIOLOGY IN AND
CHIEF OF CARDIOLOGY AT.
DAVID GRANT US AIRFORCE MEDICAL
CENTER.
FAIRFIELD CALIFORNIA I'M HERE
IN MY PERSONAL CAPACITY AS A
VOLUNTEER WITH THE RIGHT CARE
INITIATIVE.
THANK YOU SENATOR STONE AND.
HONORABLE CENTER HELL FOR AND
THE MEMBERS OF THE COMMITTEE FOR
ALLOWING ME TO REVIEW THIS
IMPORTANT PATIENT SAFETY ISSUE
THAT IMPACTS ALL PATIENTS
ESPECIALLY CARDIOLOGY PATIENTS
EVERYDAY THROUGHOUT CALIFORNIA.
I'M A NATIVE OF CALIFORNIA AND
I'VE BEEN LICENSED IN CALIFORNIA
MIND TIRE PROFESSIONAL CAREER.
ONE OF THE MOST VALUABLE LESSONS
I LEARNED AS AN INTERN WAS THAT
AS A PHYSICIAN I PRACTICE AS
PART OF A TEAM.
IT WAS HUMBLING TO ME TO REALIZE
EARLY IN MY CAREER THAT PATIENT
CARE AND PATIENT SAFETY ARE
IMPROVE.
WHEN WE PRACTICE AS PART OF A
TEAM WITH A TEAM APPROACH.
PHARMACIST RECEIVE SPECIALIZED
TRAINING IN MEDICATIONS AND A
CLINICAL RESIDENCY THAT MAKE
THEM AT VAL INVALUABLE AND
IMPROVING PATIENT SAFETY.
THIS IS TRUE OR EACH YEAR. AS
THE NUMBERS OF MEDICATIONS
INCREASE
ALONG WITH THE TYPES OF
MEDICATIONS THE MECHANISMS AND
THE COMPLEXITY OF THEIR
ADMINISTRATION.
HIGH RISK PATIENTS ARE ALSO AT
RISK FOR POLYPHARMACY.
HAVING THE EXPERTS IN
MEDICATIONS THE PHARMACIST
PRESENT TO IDENTIFY AND HELP
PREVENT POLYPHARMACY IN MY
OPINION IS ESSENTIAL.
AND AS WE FOCUS MORE ON THE TEAM
APPROACH FOR MEDICINE OR THE PIT
CREW IF YOU WILL I BELIEVE THE
SAFETY IS IMPROVED WITH
REDUNDANCY.
I BELIEVE THAT EVERYONE BUT
ESPECIALLY THE PATIENTS WILL
BENEFIT BY HAVING A PHARMACIST
AS AN ESSENTIAL MEMBER OF A F A
PATIENT THAT OF A HOSPITAL BASED
PATIENT CARE TEAM.
I LOOKED TO THE JOINT
COMMISSION'S CHALLENGE TO THE
HEALTHCARE INDUSTRY OVER A
DECADE AGO THAT WE SHOULD BECOME
MORE LIKE COMMERCIAL AVIATION
AND ONE OF THE SAFEST.
INDUSTRIES IF YOU WILL IS
COMMERCIAL FLYING.
AND ONE OF THE THINGS THAT WE
ALL KNOW IS THAT. TO ACHIEVE
THAT SAFETY YOU HAVE TO HAVE TWO
PILOTS AT AT ALL TIMES.
AND I WOULD COMPARE THAT TO
HAVING FULLY TRAINED PHARMACIST
AND FULLY TRAINED PHYSICIANS.
NOT THAT WE CAN'T EACH DO THIS
JOB SEPARATELY BUT BY HAVING US
AS THEY'RE HAVING US THERE
TOGETHER WILL IMPROVE PATIENT
SAFETY.
IN SUMMARY.
ADVERSELY AUG EVENTS ARE
WIDESPREAD AND NEGATIVELY IMPACT
PATIENTS AND HEALTH CARE COST
I BELIEVE PHARMACIST CAN REDUCE
THE RISK OF ADVERSE DRUG
REACTIVE FAX.
BY ENSURING ACCURATE MEDICATION
LISTS UPON ADMISSION AND
DISCHARGE.
OKAY THANK YOU OTHER WITNESSES
IN SUPPORT.
HI I'M HATTIE HANLEY OF THE
FOUNDER AND DIRECTOR OF THE
RIGHT CARE INITIATIVE.
WHICH IS HOUSED AT UC BERKELEY
ABOUT WITCHES A COLLABORATIVE
ACROSS MANY OF THE FINEST
HEALTHCARE INSTITUTIONS AND
ACADEMIC INSTITUTIONS IN THE
STATE. INCLUDING OF THE
UNIVERSITY OF SOUTHERN
CALIFORNIA THE CALIFORNIA
CHAPTER OF THE AMERICAN COLLEGE
OF CARDIOLOGY. OUT STANFORD
MEDICINE CEDAR SINAI. AYE. THE
UC'S IN GENERAL AND I COULD GO
ON WE HAVE QUITE A A LONG LIST
OF.
OF BRAINIACS I WOULD SAY
INVOLVED IN THIS PROJECT SO I AM
HONORED TO SPEAK ON THEIR BEHALF
TO SIMPLY SAY THAT OVER TEN
YEARS.
WE'VE BEEN TRYING TO TEACH THE
IMPORTANCE.
OF ADDING A PHARMACIST TO THE
CARE TEAM.
I THINK THE DATA ON THE
IMPORTANCE TO PATIENT SAFETY IS.
BOB IMMENSE THERE IS
NO DOUBT THAT.
OUR PATIENTS WILL BE BETTER OFF.
IF EVERYONE OF OUR COMPLE
PATIENTS WERE TO HAVE.
A A PHARMACIST ADDED TO THE CARE
TEAM AND I HAVE TO TELL YOU THIS
IS MY.
TEAM CARE ACROSS ITS DIFFERENT
COLORS OF STONES FOR ALL THE
DIFFERENT PEOPLE THAT NEED TO
WORK TOGETHER. TO MAKE FOR A
GOOD OUTCOME FOR THE PATIENT.
AND I'LL CLOSE BY SAYING THAT I
FIRST TUNED INTO THIS ISSUE TEN
YEARS BEFORE I STARTED THE RIGHT
CARE INITIATIVE BASED ON MY
TRAINING AT HARVARD.
WHEN MY HUSBAND WHO WAS A
FORMER LEGISLATIVE STAFFER HERE
WAS GIVEN THE WRONG MEDICATION
AND ENDED UP. AYE IN THE ICU ON
VALENTINE'S DAY TWENTY YEARS
AGO.
.
THREE DAYS IN THE UC DAVIS I SEE
YOU.
.
AND THEN THAT WAS ALL BECAUSE OF
THE MEDICATION ERROR SO WHEN YOU
ADD A PHARMACIST OF THE CARE
TEAM THE DATA IS.
ABSOLUTELY NON CONTROVERSIAL
THAT IT BENEFITS PATIENTS SO I
WOULD JUST URGE YOU ALL. TO.
.
JOINT WITH SENATOR STONE AND OUT
THIS WONDERFUL COLLABORATIVE TO.
ENSURE THAT NOT ONLY DO WE.
.
PREVENT
A.
UNNECESSARY DISABILITY AND
DEATH.
BUT THAT WE ALSO SAVE THE STATE
OF CALIFORNIA AN IMMENSE AMOUNT
OF MONEY AND WASTED CARE SUCH AS
THAT WHICH.
YOU NO THANKFULLY SAVE MY
HUSBAND'S LIFE JUST IN THE NICK
OF TIME.
BECAUSE OF A SIMPLE MEDICATION
ERROR. THAT A PHARMACIST COULD
HAVE PREVENTED.
THANK YOU VERY MUCH FOR YOUR
TIME FOR YOUR TESTIMONY IN AND
OF ALL OF THE TESTIMONY THIS
AFTERNOON.
.
OTHER WITNESSES IN SUPPORT
PLEASE COME FORWARD AND TO THE
MICROPHONE IF YOU WOULD THANK
YOU.
GOOD AFTERNOON I'M GLORIA
DEMARTINI AND THE C. E. ELF
CALIFORNIA'S IDEA HEALTH SYSTEM
PHARMACISTS.
AND WE FULLY SUPPORT THE INTENT
OF THIS BILL AND ARE HONORED TO
BE WORKING WITH THE AUTHOR.
THANK YOU.
AND COULD GO CLINICAL PHARMACIST
WITH NEO NATAL AND ADULT
CRITICAL CARE EXPERIENCE
PROFESSOR PHARMACY. I SPEAK IN
SUPPORT THANK YOU VERY MUCH
OTHERS IN SUPPORT.
NOW TO THOSE IN OPPOSITION
PLEASE COME FORWARD THEIR.
SEEING NO ONE IN OPPOSITION.
VERY GOOD THANK YOU BRING IT TO
OUR COMMITTEE THAT OCCUPANT.
THANK THANK YOU I THINK CENTER
STONE FOR BRINGING THIS BILL
FORWARD I DID HAVE SOME
QUESTIONS I WANT TO FORGET SOME
CLARIFICATIONS OF. FIRST OF ALL.
THIS ONLY APPLIES TO PATIENTS
ADMITTED TO HOSPITAL.
AND I AM SORRY A GUESS ONE
QUESTION IS IS THAT I KNOW IT'S
IT'S HIGH RISK AND IN MY MIND AT
LEAST IN THE UNITED STATES TODAY
YOU IN FACT HOW MUCH WE.
THANK YOU PEOPLE OUT OF HOSPITAL
I HONESTLY EVERY HOT EVERY
PATIENT WAS ADMITTED TO THE
HOSPITAL IS QUOTE HIGH RISK IN
SOME WAYS THAT'S WHY GOD MADE
THE FIRST PLACE.
ARE YOU ENTERTAINING THE IDEA
THAT ACTUALLY THIS.
SHOULD BE DONE FOR EVERY
PATIENT ADMITTED TO A HOSPITAL.
A ABSOLUTELY WE WE ORIGINALLY
IDENTIFIED HIGH RISK TO KIND OF
OPEN THE DOOR. BUT I THINK ALL
MY COLLEAGUES WOULD AGREE THAT.
THERE SHOULD BE A COMPREHENSIVE
MEDICATION REVIEW ON ANYONE THIS
MINUTE TO THE HOSPITAL I THINK
THAT ONCE THE HOSPITALS AND
PHYSICIANS SEE THE THE MERITS IN
IT AND STARTING WITH A HIGH RISK
POPULATION. THAT THAT QUESTION
IS GOING TO BE ASKED WHY ARE WE
DOING THIS WITH EVERYONE AND SO
WE WOULD GREATLY SUPPORT THAT.
.
AN IDEA SAID SIT THROUGH THE
FOLLOW UP QUESTION I HAVE THEN
IS IS THAT.
YEAH I APPRECIATE THE TESTIMONY
IN TERMS OF HOW THIS AND I AGREE
THAT WE SHOULD I THINK COULD BE
GREAT TO HAVE A PHARMACIST I
REVIEW. THE MEDICATIONS OF EVERY
PATIENTS ARE INDEBTED AND USE.
SOMEONE WHO'S I HAD TO AND
CLINIC TRY TO GET A MEDICATION
LIST THERE'S OBVIOUSLY MANY
CHALLENGES I'M SURE YOU KNOW
THAT AS WELL I TELL YOU I'M
TAKING THIS BLUE PILL TWICE A
DAY.
FOR AND YOU KNOW WHAT'S THAT
BLUE TELL THEM.
ETCETERA.
AND SO I GUESS THE OTHER
QUESTION THOUGH IS THAT SPECIAL
GIVEN THE DATA YOU PRESENTED. UM
I DON'T SEE IN THIS BILL AND
MANDATE FOR HOSPITALS TO DO THIS
SO YOU TALK TELLING ME HOW
IMPORTANT IT IS FOR QUALITY AND
SO FORTH. SO WHAT'S THE
CONSEQUENCE OF YOU DOING PIECE
OF LEGISLATION SO IT'S NOT
SIMPLY A YOU KNOW OH YEAH YOU
SHOULD DO THIS KIND OF THING.
IS THERE A INTENTION TO TO
ACTUALLY HAVE A REQUIREMENTS IN
THE SHOULD THERE BE SOME PENALTY
ASSOCIATES FOR HOSPITALS WHO ARE
DOING THIS.
STARK.
AND TO BE ON AT INTEGRATED INTO
THE STATE BOARD OF PHARMACY IS
REQUIREMENT FOR.
FOR.
WHEN THE HIGH RISK PATIENTS ARE
ADMITTED TO A HOSPITAL THE
PHARMACIST IS RESPONSIBLE FOR
ENSURING THE SAY THE ACCURACY OF
THE MEDICATION LIST IT'S PART
IT'S BEING INTEGRATED INTO THE
STATE BOARD OF PHARMACY LA.
SO THAT'S THE INTENT OKAY SO I
GUESS
THE QUESTION.
.
SO I GUESS WE'LL FOLLOW QUESTION
OF THAT THEN IS IS THAT.
.
YEAH YOU'VE WORKED ENOUGH A
HOSPITAL.
WHAT HAPPENS IF THE HOSPITAL SO
A SLT TO PUTTING ON THE ON THE
LAP OF THE PHARMACIST LOCATED AT
THE END YEAH SO MY CONCERN IS
AND ADDS WHAT HAPPENS IF THE
HOSPITAL IS IN FACILITATING THE
PHARMACIST BECAUSE AFTERALL AS
IT IS THE TEAM? RIGHT AS A TEAM
SOMEONE GETS ADMITTED IT'S UP
THE PHARMACIST ADMITS THAT
THERE'S THAT TEAM THERE AT THE
GROUND ATTENDING PHYSICIAN
ADMITS. AS THOUGH SOMEHOW YOU
KNOW THE HOSPITAL OBVIOUSLY
KNOWS OF THE PATIENTS BEING
ADMITTED.
.
IF THE BURDENS ON THE
PHARMACIST.
NOT THE HOSPITAL.
THEN HOW YET IF WELL I I'M
CONCERNED THAT I DON'T A
PHARMACIST GETTING CAUGHT IN A
SITUATION WHERE THEY DON'T YOU
KNOW THEY'RE NOT IN THE LOOP AND
YET THEY'RE THE ONES WHO
SUFFERING THE PENALTY. FOR NOT
GOING GETTING ABOUT DOING THE
TASK BY THE PHARMACY BOARD.
BECAUSE THAT MEANS ONE THING OF
THE PHARMACIST REFUSES TO DO
THAT THEY'RE ASKED TO DO THAT
REFUSING TO DO THAT BY THINK
IT'S MORE LIKELY A SITUATION
ADMITTED AND SOMEHOW THE
PHARMACISTS ISN'T BEING NOTIFIED
OF BEING PUT IN A LOOP FREQUENT
YOU KNOW FAST ENOUGH FOR THEM TO
GO DO THE WORK. BECAUSE
SOMETIMES HE BORN IN THE
HOSPITAL FOR VERY LONG
AS YOU KNOW READ YET SO THE
INTENT FIRST OFF ARMS IS NEVER
ACT ALONE THE INTENT.
AND AND THE WAY THAT WE'VE
DISCUSSED EVEN WITH THE STATE
BOARD JUST IN THE INITIAL
DISCUSSIONS IS THAT THIS WOULD
BE DONE IN COLLABORATION WITH
MEDICAL STAFF NURSING STAFF IN
EXECUTIVE LEADERSHIP TO DEFINE
HIGH RISK FOR THAT ORGANIZATIONS
POPULATION. AND THEN THE THE
PROCESS WOULD THEN.
BE ONE THAT'S AND THAT'S A
COLLABORATIVE BROUGHT APPROACH
THAT WOULD REQUIRE THIS TO OCCUR
FOR THE SUBSET OF PATIENTS WE
HAVE OTHER LAWS OF THEM FAN OF
PHARMACY.
WITH A PHARMACY ITSELF THROUGH
THE STATE BOARD WE ARE FOR
EXAMPLE FOR CLOUD IS A RALLY AND
HE JUST QUIT I JUST CLARIFY
BECAUSE I'D ASKED A QUESTION
EARLIER SO IN YOUR OPINION DOES
I HEARD FROM CENTER STONE.
I AND MY OPINION IS PACKED WITH
EVERY PATIENT IS ADMITTED TO A
HOSPITAL IS THAT SOME WAYS HIGH
ISK DISPLAYED VIRTUE THE FACT
THEY GOT ADMITTED AT LEAST HERE
YOU S. YOU DON'T TEND TO GET
MARRIED FOR TRIVIAL REASONS.-SO.
WOULD YOU.
WOULD YOU BE IN FAVOR OF
ACTUALLY THIS APPLYING TO EVERY
PATIENT HAS ADMITTED TO A
HOSPITAL.
I GUESS MY BELIEF IS IS THAT WE
NEED TO AND WE NEED TO START
WITH THE HIGHEST RISK WHICH
APPROVAL MIGHT NOT MIGHT NOT
EVERY PATIENT THEY'RE ALL HIGH
RISK IN MY OPINION.
I GUESS IT'S IT'S MAKING SURE
THAT ORGANIZATIONS HAVE THE
RESOURCES TO DO IT TO BEAT THE
BEYOND WELL ARAB BUT YOU'RE
SAYING THIS IS SUCH AN IMPORTANT
PATIENT SAFETY. ISSUE THAT WHY
SHOULDN'T EVERY PATIENT BENEFIT
FROM THIS OMITTED A KEY NAME
PATIENTS OR MENTAL HOSPITAL SHE
WOULDN'T THAT IF THERE ARE SOME
PATIENTS WHO ARE ADMITTED FOR
SHORT STAYS IN SURGERIES WHO'S
WHO ARE NOT ON A LOT. OF ITS ITS
PATIENTS WHO AREN'T HAVE
MULTIPLE CHRONIC DISEASES I
THINK I THINK EVERY HOUSE BILL
WOULD DEFINE IT OF ITSELF WOULD
PROBABLY CUT THERE WOULD BE KIND
OF IT. CONSISTENCY AMONG
PATIENTS WHO HAVE MULTIPLE
CHRONIC DISEASES ON MULTIPLE
MEDICATIONS QUE THERE ARE OF THE
PATIENTS DON'T NECESSARILY NEED
THIS FOR ALL LAWFUL AND LEISURE
ON THERE UNLESS THEY HAVE
CHRONIC DISEASES WELL I I THINK
THAT ACTUALLY INTERESTING ENOUGH
YOU WON'T KNOW. IF THERE ARE
MULTIPLE MEDICATIONS UNTIL YOU
DO THE MEDICATION LIST THAT'S
FOR THAT REASON WE DID.
I MEAN THAT'S WHY I ACTUALLY
WENT TO BY THE STANDARDS OF CARE
EVEN AND OUTPATIENT IS TO TRY TO
MAINTAIN ACTIVE MEDICATION.
FRANKLY THEY'RE NOT YOU KNOW OF
MANY OF THEM AR TAUGHT MULTIPLE
MEDICATIONS WILD I GUESS I'M
PEDIATRICS AND I KNOW YOU START
PEDIATRICS BUT STILL.
I I I I GUESS.
YEAH I THINK IN MY MIND IT
ESPECIALLY SINCE WE DON'T HAVE A
DEFINITION OF HIGH RISK THAT
OUTLINED IN THE LEGISLATION.
IN MY MIND WE SHOULD BE DOING
THIS AND IT HAPPENED START OUT
THERE NOT ONLY MAKE CATIONS
OUTPATIENT WELL THAT'S PRETTY
STRAIGHTFORWARD AND IS THE
MEDICATION WAS ZERO BUT IF
THEY'RE EVEN ON ANY MEDICATION.
.
YELLED P. YOU YOUR PHARMACIST
YOU KNOW THAT THERE'S ALWAYS
POTENTIAL RISK OF INTERACTION
FACTORS EVEN SOME PEOPLE
QUESTION NOT JUST PRESCRIPTION
MEDICATIONS WHEN THEIR IF THEY
TAKE ALTERNATIVE MEDICATIONS ARE
OUT PAY. OTHERS THOSE SHOULD BE
CAN'T HAVE INTERACTIONS WITH.
TIED US SOME MEDICATION TO
MEDIAN THAT A CERTAIN THE
HOSPITAL SO I APPRECIATE YOU
SAYING TO RESOURCE AND BUT TO ME
PATIENT SAFETY I THINK THAT'S
WHAT THIS BILL IS ABOUT SHOULD
COME FIRST AND. THAT SHOULD
APPLY TO EVERY PATIENT IS
ADMITTED TO THE HOSPITAL.
PROGRAM CAN WE DON'T I I I I
GREW THE I THINK THAT WE SHOULD
HAVE A PHARMACIST REVIEWING THE.
THE MEDICATION PROFILE OF
ANYBODY IN
TO THE HOSPITAL.
WE UNDERSTAND THAT.
RESOURCES COULD BE AN ISSUE.
WE FELT AN INITIAL DRAFTING OF
THIS BECAUSE WE WEREN'T SURE OF
THE RESOURCES THAT WOULD BE.
.
BASICALLY ALLOCATED BY BY
HOSPITAL FOR EXAMPLE OF THAT WE
BE ABLE TO TAKE CARE OF ALL
PATIENTS SO WE WANTED TO START
WITH A HIGH RISK. BUT I WOULD BE
WELCOME I'D LOVE WELCOME YOUR
PARTICIPATION IN LOOKING TO
AMEND THE BILL. AND IF WE CAN
ACCOMMODATE.
A REVIEW. ALBEIT I MIGHT BE A
SUMMARY FOR SOME PEOPLE TO COME
AND WOULDN'T.
YOU KNOW NOT MULTIPLE DISEASE
STATES IN VERY SMALL MEDICATION
PROFILES MIGHT BE A TEN MINUTE
REVIEW.
SO.
WE WOULD BE DELIGHTED TO WORK
WITH YOU ON THAT.
I THINK IT ALL DEPENDS SENATOR
GALGIANI WITHIN THE HOTTEST
EITHER RAISE CONCERNS AS
SOMEBODY WHO ARE TO HOSPITAL NOT
AS A PHYSICIAN BUT AS A PHYSICAL
THERAPY A BY WORKED WITH.
MANY MANY PATIENTS FOR EIGHT
YEARS AND WAS FAMILIAR WITH
LOOKING THRILL.
THEIR THEIR MEDICAL
DOCUMENTATION I WOULD HAVE TO
REPORT ON WHAT I DID WITH THEM
BUT THEY'RE THEY'RE WALKING
THEIR EXERCISES AT TETRAD
SATRAP.
AND I KNOW THAT PEOPLE COME
INTO HOSPITAL SOMETIMES.
BY AMBULANCE SOMETIMES URGENT
THINGS HAPPEN SOMEBODY FALLS
BREAKS HIP THIS OF THAT HAPPENS
MAYBE FAMILIES NOT AROUND
PATIENTS NOT COHERENT ENOUGH TO.
KNOW AND BE ABLE TO EXPRESS ALL
THE MEDICATIONS THAT THEY TAKE
IN THERE ALL KINDS OF INCIDENTS
THAT HAPPENED. SO WHAT CONCERNS
ME IS HAVING THE LICENSE OF THE
PHARMACIST ON THE LINE WHEN.
THERE ARE THESE OUTLINED
FACTORS ANY AND SOME CASES.
A PATIENT COMES EN AND.
I THINK THAT THE HOSPITAL'S I
THINK THAT ON INTAKE THEY ALWAYS
ASK
WHAT MEDICATIONS ARE BEING
TAKEN.
AND I KNOW RECENTLY SOMEONE I
CARE ABOUT WHEN IN THE HOSPITAL
ON AND THE QUESTIONS WERE%
CERTAINLY ASK. BUT SOMETIMES THE
MEDICATION GETS ADDED TO THE
MEDICAL.
REPORT.
LATER IN THE STATE AND SO THEN
THERE'S THE ISSUE OF AT WHAT
POINT THE PHARMACIST LOOKS AT
THE MEDICAL RECORDS.
AND TAX AND AND ALL OF THAT SO.
IT'S
IT'S A GREAT IDEA IN THEORY BUT
I I HAVE CONCERNS THAT IN
PRACTICE IT IT WON'T WORK
BECAUSE IT'S NOT FLESHED OUT ALL
THE WAY. AND I HAVE CONCERNS
ABOUT PUTTING THE PHARMACIST
LICENSE AT RISK I AM ALSO. AND
IT'S HARD FOR ME BECAUSE I DON'T
KNOW WHERE THE HOSPITAL
ASSOCIATION IS ON THE BILL AND I
IRAQ. AND WHAT THEIR CONCERNS
ARE.
THANK YOU SENATOR GALGIANI UM AS
WAS MENTIONED BEFORE IN ALL%
SAFETY IS IMPROVE THROUGH
REDUNDANCY A HAVING MORE
PHARMACISTS INVOLVEMENT AT THE
BEGINNING OF THE PROCESS AND
THROUGH THE PROCESS AND THEN.
WHEN THEIR DISCHARGE IT CAN ONLY
BE ADVANTAGEOUS.
YOU KNOW A PHARMACIST CAN ONLY
GATHER AS MUCH INFORMATION AS
THEY POSSIBLY CAN I DON'T THINK
THAT THE STATE BOARD OF PHARMACY
WOULD DISCIPLINE A PHARMACIST
BECAUSE YOU HAVE A NINETY.
UNCONSCIOUS PATIENT COMES INTO
AN EMERGENCY ROOM.
WITH AN UNKNOWN ETIOLOGY ANDERS
NOT A WHOLE LOT KNOWN ABOUT THEM
INTO YOUR FAMILY HISTORY AND THE
FAMILY THING SO I THINK ON THIS
MEDICATION I THINK ON THAT
MEDICATION THAT WE.
REFINE OUR SEARCH FOR FURTHER
AND FIND OUT WHAT COMMUNITY
PHARMACY THEY'RE GOING TO CALL
THE COMMUNITY PHARMACY TO GET A
MORE ACCURATE.
DESCRIPTION OF WHAT THEY'RE
USING OR RECALL THEIR PHYSICIAN
THAT THEY NORMALLY CD AGAIN A
MEDICATION LESS FROM THEM IT'S
JUST A WORK WE CAN WE CAN WE CAN
BE PROACTIVE NAY OUT THERE
GATHERING ACCURATE INFORMATION
SO THAT WE CAN PROVIDE THE BEST
TREATMENT. AND ARE AND NOT
DUPLICATE THE.
THE ERRORS WITHIN WITHIN THEIR
HOSPITAL STAY IN NOT CERTAINLY
DISCHARGE THEM.
BUT THOSE BUT ALSO LIMITS SAY
THAT.
WE'RE WORKING WITH THE HOSPITAL
ASSOCIATION.
EVER WORKING COOPERATIVELY WITH
THEM.
AND THE STATE BOARD OF PHARMACY
AND AN EIGHTH A CALIFORNIA
PHARMACISTS ASSOCIATION SO.
WE'RE LOOKING FORWARD TO
ADDRESSING ANY CONCERNS IF THEY
HAVE AYE IF THIS BILL WERE TO
GET OUT OF COMMITTEE.
THANK YOU SENATOR GALGIANI
SENATOR NEWMAN AND THENCE DR
HERNANDEZ AND SENATOR GLACIER
ZERO EIGHT THANK YOU MISTER SO
I'M. I THINK A COUPLE OF US ARE
HERE ARE ITS THIS ISSUE
COMMITTEE CAN ALWAYS LEARN A
LITTLE ABOUT A LOT ON ANY GIVEN
DAY BMP. BABYLISS STARTLING TO
HEAR THAT THIS IS SUCH A SERIOUS
PROBLEM. A AND.
I MEAN IT'S GOOD THAT IS
BROUGHT TO US TODAY MY QUESTION
FOR YOU WOULD BE IS THERE A
STATE. OF THE CALIFORNIA FROM
WHICH WE CAN LEARN ARE THE BEST
PRACTICES IN ANY OTHER PART OF
THE U. S. WHERE BE SOME OF THESE
LESSONS HAVE BEEN APPLIED AND WE
CAN LEARN FROM THEM.
I HAD. A HEADACHE IN THE
LITERATURE THAT I SEEN I HAVEN'T
SEEN ANY EXAMPLES OF THIS TYPE
OF LEGISLATION. AND.
WE ALL TAKE PRIDE IN CALIFORNIA
THAT WHAT HAPPENS IN THE STATE
OF CALIFORNIA IT'S USUALLY
SPREAD TO OTHER STATES WE'VE
BEEN A LEADER AND. A LOT OF
PHARMACY ISSUES IN THE STATE OF
CALIFORNIA SO I THINK THIS WOULD
BE A LANDMARK. PIECE OF
LEGISLATION WERE IT TO.
PASSING IT SIGNED BY THE
GOVERNOR.
AGAIN IT'S A EMPHASIZING THAT
THAT TRY AT THE TRIAD OF
POSITION THE PHARMACIST AND THE
PATIENT.
HERE WE'RE GOING TO BE.
WORKING AND WHO YOU FOR THE
WORD TEAMWORK WERE WORKING AS A
TEAM AND THE BEST INTERESTS OF
THIS PATIENT TO ELIMINATE.
ERRORS THAT.
BECAUSE MORBIDITY AND MORTALITY
TWENTY ONE PERCENT OF MEDICARE
PATIENTS BEING READ A BIT OF
HOSPITAL WHICH IS A SIGNIFICANT
COST. TO THE TAXPAYERS OF THIS
COUNTRY AND CERTAINLY EVEN
MEDICAL PATIENTS IN THE STATE OF
CALIFORNIA SO. I HOPE THAT THIS
BECOMES A MODEL PIECE OF
LEGISLATION THAT OTHER STATES
CAN CAN EMBRACE UNCERTAINTY THE
FEDERAL GOVERNMENT AND.
AND I'M VERY PROUD TO SAY IT
HAPPENED HERE IN THE STATE OF
CALIFORNIA.
THANK YOU VERY MUCH THAT
AFTERNOON.
YEAH I ARM I'M A MICHIGAN TO GET
TO SOME QUESTIONS BUT I'D LIKE
TO JUST FIRST MAKE A COMMENT
THAT.
IN A PERFECT WORLD WHERE WE HAVE
AN INTEGRATED SYSTEM WERE A
PATIENT HAS AN ELECTRONIC COMBAT
RADICAL RECORDS IN THE UTILIZED
A PRIMARY CARE PROVIDER
SPECIALIST IN THE HOSPITAL
SYSTEM.
THAT ALL OF THESE PROBLEMS
SHOULD BE TAKEN CARE OF.
AND IF YOU HAVE A PHARMACIST
AGAIN IN THE PERFECT WORLD THAT
LOOKS AT THAT LIST YOU CAN LOOK
AT ANY KIND OF PROBLEMS AND
SOLVE THEM IMMEDIATELY.
BUT A FORTUNE WE DON'T HAVE A
SYSTEM WE HAVE A VERY
DYSFUNCTIONAL SYSTEM WHERE YOU
CAN HAVE A PATIENT THAT HAS.
YOU NEUROLOGISTS THE
CARDIOLOGISTS A PRIMARY CARE
DOCTOR GO TO THE HOSPITAL AND I
CAN GUARANTEE EVEN WITHIN THE
HOSPITAL. WHEN YOU HAVE A
MEDICAL ASSISTANT.
ASK THE QUESTIONS BY THE PATIENT
PATIENT MEAN FORGET WHAT THEY
HAVE.
THE IDEAL SITUATION IS WE HAD
SOME SORT OF.
WIKIPEDIA SYSTEM WHERE ALL
HEALTH RECORDS ARE SHARED IN
THAT WHEN YOU. INTERACT WITH IT
EVERYONE HAS ACCESS TO
EVERYTHING THAT'S THE IDEAL
WORLD OKAY.
SO I WANNA KINDA REITERATE
WOULD.
CENTER PAN SAID.
MY CONCERN IS.
AGAIN I THINK YOU MADE A
STATEMENT IS THE RESOURCES AND I
THINK THAT'S WHY YOU'RE LOOKING
AT PHARMACY TECHNICIAN AND
PHARMACY IN TERMS.
SO I WOULD QUESTION OF THE
PHARMACY TECHNICIAN HAS ANYMORE.
VALUE OR IS.
AND DO A BETTER JOB THEN A
MEDICAL ASSISTANCE SO I WOULD
JUST QUESTION THAT SO.
BUT I STILL I STILL AIR ON THE
SIDE OF. IF YOU'RE GONNA LEAVE
IT UP TO THE PHARMACIST TO PUT
IT WITHIN THE PHARMACY BOARD
STATUES TO OVERSEE IT.
THEN THAT'S WHERE MY CONCERN IS
THEICED I STILL DON'T THINK
YOU'RE GOING TO HAVE A.%
A SYSTEM THAT'S GOING TO BE
EFFICIENT SO THAT'S THAT'S MY
CONCERN. BUT I GUESS AND I'M
STILL MAKING A STATEMENT I MEAN
I'M GONNA.
CAN BUT HERE'S THE OTHER THING
TOO IS. AN IDEAL WORLD.
STAND IN A QUEUE THIS SHOULD BE
STANDARD HE CARE AND THIS IS
WHERE I I WANT TO POSE A
QUESTION.
AND HERE'S WHERE I WOULD HAVE A
CONCERN.
IF YOU PUT THIS IN STATUTE.
SHOULD WE BE PUTTING STAT A
STANDARD OF CARE INTO STATUTE.
AND I THINK THEY SHOULD BE
STANDARD OF CARE JUST FROM.
PHYSICIANS INTERACTING WITH
PHARMACISTS INTERACTING WITH THE
HEALTH SYSTEM.
FOR THE CONCERN I HAVE AND SO
THE QUESTION I HAVE FOR YOU IS.
AREN'T YOU HAD DN'T YOU HAVE A
CONCERN THAT BY PUTTING THE
STATUE THAT HE COULD BE A BECOME
A STANDARD OF CARE AND THEN THAT
WOULD SPLIT UP. SET UP A
LIABILITY ISSUE FOR A
PHARMACIST.
CAN I RESPOND SO WITH RESPECT TO
MEDICAL ASSISTANCE VERSUS
PHARMACY TECHNICIANS I'M MEDICAL
ASSISTANCE ARM HAVE LIMITED.
TRAINING AND MEDICATIONS THEY
HAVE TWO TO SIX UNITS IN THE
STATE OF CALIFORNIA AND A
MEDICAL ASSISTANCE CAN BE ON
CREDENTIAL TO PROVIDE TO ENTER
MEDICATION ORDERS PERCY EMMAUS
WITH FIVE HOURS OF COMPUTER
TRAINING NOT OF WITCHES
MEDICATIONS. THAT RESEARCH STUDY
WE'VE DONE THERE MULTIPLE
STUDIES THE ROOM PUBLISHED IN
THE SCIENTIFIC PEER REVIEWED
LITERATURE DEMONSTRATE THAT
TRAIN PHARMACY TECHNICIANS WHO.
CAN DO THIS ACCURATELY AND SAVE
ME AND MORE ACCURATE THAN
STANDARD OF CARE IS THE NURSES
AND PHYSICIANS AND EDIE SO I
WOULD SAY THAT TECHNICIANS ARE.
ARE MORE ACCURATE THAT'S WHAT
THEY'RE TRAINED TO DO SO THAT
WOULD BE MY ANSWER WITH RESPECT
TO STAND OF CARE THE PROBLEM IS
IS THAT THE LISTS ARE REQUIRED
BUT THE AMBIGUITY WITH RESPECT
TO ANSWERS THE LIST IS WHAT HAS
CAUSED ALL OF THESE ISSUES. ON
WALLSTREET JOURNAL JUST HAD AN
ARTICLE ABOUT WHEN ELECTRONIC
HEALTH RECORDS ARE DOING TO THE
PRACTICE OF MEDICINE THEY
ACTUALLY ENABLE. CONTINUATION OF
INACCURATE CONTAMINATED
MEDICATION WAS AS WELL AS OTHER
INFORMATION THAT'S ARE CUT AND
PASTED AND ARE INACCURATE SO
TECHNOLOGIES HAS HELPED US BUT
THE HUMAN INTERFACE HAS NOT
EVOLVED. YET TO BE ABLE TO DO
DID NOT INTRODUCE ERRORS INTO
THE SYSTEMS SO THE THE ISSUE
AROUND STANDARD OF CARE I
TOTALLY AGREE WITH YOU IN A IN A
PERFECT WORLD THIS SHOULD BE THE
STANDARD OF CARE AND. I'M
BLESSED THAT WE DO COLLABORATE
WITH MEDICAL STAFF BUT THERE IS
NO THE AMBIGUITY IN ANYTHING WE
DO IN LIFE. RESULTS AND THINGS
NOT BEING DONE THE WAY THEY WERE
INTENDED AND THERE IS AMBIGUITY
AROUND TO ENSURE THE ACCURACY OF
LISTS.
FOR HIGH RISK PATIENTS WHEN THEY
ARE THE MOST WANTED AND THAT'S
MY CONCERN BECAUSE YOU CAN'T
GUARANTEE YOU THROUGH STATUTORY
CHANGES THIS COULD BECOME THE
SENATE CARE AND OF A PHARMACIST
OF A TON OF THE STATE BOARD OF
PHARMACY.
ANYWAYS SPHERES OUTSIDE OF THAT
THEN THAT PHARMACISTS CAN NOW BE
LIABLE.
SO THAT'S THAT THOSE OF US WHO
HAVE HAVE
WORKED TOWARDS THIS IS IT'S
ABOUT OWNING THE AREA WHERE WE
HAVE THE EXPERTISE.
TO BE ABLE TO TAKE UP POSITIONS.
PHYSICIAN INITIATED ORDERS OR
ANY ANYONE WHO INITIATE A LIST
AND MAKE SURE THAT IT'S IT'S
ACCURATE WITH THE INTENTION FOR
THE TREATMENT OF PATIENTS IN THE
ABSENCE OF. OF IT BEING DEFINED
UNDER PHARMACY WILL CONTINUE TO
BE AMBIGUOUS AND THE NUMBER OF
ERRORS ARE GOING TO CONTINUE TO
BE PROMULGATED BY RISK I
RESPECT.
WHAT YOU'RE SAYING I JUST AB I
BELIEVE IT WAS TRYING TO PROVIDE
OWNERSHIP AND TECHNICIANS ARE
UNDER THE FARM THE STATE BOARD
OF PHARMACY AND THERE THEY HAVE
BEEN DEMONSTRATED? TO BE AT
EQUALLY I'M ACCURATE IN DOING
MATH.
SENATOR I GIVE YOU MY WORD WILL
CONTINUE TO WORK WITH ALL THE
INTEREST GROUPS INCLUDING THE
STATE BOARD OF PHARMACY TO
ENSURE THAT. WE'RE NOT PUTTING
PHARMACISTS THAT.
FOLLOWING NEW STATUTORY LAWS
WITH RESPECT TO. PERFORMING
SOMEBODY'S DUTIES AT HARM'S WAY
OF LOSING THEIR LICENSE I THINK
THAT.
PHARMACISTS THAT.
SHOWS.
INTENT THAT WHAT OF COMPLYING
WITH THE INTENT OF THE LAW.
WE WANNA MAKE SURE IS NOT GOING
TO BE UP PENALIZE ANYWAY AND
THEN ONE IMPORTANT POINT THAT
YOU BROUGHT UP. AND I REALLY
APPLAUD YOU FOR BRINGIG IT UP
IS THAT.
YOU KNOW WE DON'T HAVE A
UNIVERSAL SYSTEM OF ELECTRONIC
RECORDS WERE.
IF YOU WERE TO GO TO A RITE AID
TO GET A PRESCRIPTION FILLED YOU
TO KNOW WHAT YOU GOT AT THE
WALGREENS TWO WEEKS AGO OR
SOMETHING ELSE.
THAT BY THE WAY IS THE SUBJECT
OF ANOTHER BILL THAT ARE
BRINGING FORWARD.
THAT IS A RATHER. MUCH MORE.
ROBUST BILL IF YOU WILL BUT.
THE MORE INFORMATION THAT A
PHARMACIST HAS AT HIS OR HER
DISPOSAL THE BETTER OF A CHANCE
THAT WE CAN IDENTIFY.
DEVASTATING DRUG INTERACTIONS
DEVASTATING.
ALLERGIES. POLYPHARMACY OPIATE
ABUSE
THE MORE INFORMATION THE BETTER
AND HOW WE PUT THAT TOGETHER IN
A COST EFFECTIVE WAY IS GOING TO
REMAIN A CHALLENGE OR US HERE
IN THE STATE BUT I'M. THAT'S ONE
OF THE ISSUES THAT I'D LIKE TO
TACKLE THE FINE.
GIVEN THE OPPORTUNITY TO SERVE
YOUR FINANCE FOR SO I MEAN JUST
FOLLOW UP I THINK WOULD CENTER
GALGIANI MA'AM MERE MAY NOT HAVE
SAID.
AND I KNOW IT'S STILL EARLY ON
IN THE LEGISLATIVE PROCESS BUT
LOOKING AT THE SUPPORT I MEAN
AGENCIES THE CALIFORNIA
PHARMACISTS ASSOCIATION A HEARD
THAT THE HEALTH SYSTEM
PHARMACISTS.
MADE A COMMENT BUT I DON'T SEE
THAT THERE'S AN SUPPORT SITE OR
IF THERE'S A LETTER. SO IS THAT
OFFICIALS OF THE CALIFORNIA FOR
OUR HEALTH SYSTEM PHARMACISTS IN
SUPPORT. BECAUSE THERE'S NOTHING
IN HERE THAT SAYS AND SEE THEM
IN THAT.
IF YOU GUYS HAVE AN OFFICIAL
SUPPORT.
THANK YOU FOR CALLING ATTENTION
TO THAT WE'VE BEEN WORKING WITH
THE AUTHOR ON SOME OF THE ISSUES
REGARDING THE BILL. HOWEVER
ABORTED DIRECTORS DID VOTE THIS
SATURDAY TO SUPPORT THIS BILL AS
AN IMPORTANT MEASURE IN
REDUCING.
PREVENTABLE ADVERSE DRUG EVENTS
IN THE HOSPITAL SETTING.
WHY DIDN'T?
FEW THAT AND HOMELESSNESS.
I HAVE A.
YEAH RIGHT SENATOR LATER.
THANK YOU AND THANK YOU SENATOR
STONE FOR AYE.
BRING YOUR BILL TO US TODAY IT'S
REALLY HAS.
.
CREATE SOME IMPORTANT TO
ATTENTION TO WHAT IS APPARENTLY
A BIG BIG PROBLEM.
STILL TRYING TO UNDERSTAND SOME
OF THE BASICS I HEAR.
LITTLE SLOWER AND SO MY
COLLEAGUES ON THIS WONDERFUL
PANEL.
WHAT WHAT ARE THE BARRIERS TODAY
FROM THE PHARMACISTS?
AT ANY HOSPITAL.
FROM.
REQUESTING THE LIST OF
MEDICATIONS THAT A PATIENT
THAT'S BEEN.
I HAVE BROUGHT TO THE HOSPITAL
EYES TAKING WHAT WHAT WHAT
BARRIERS WE TRYING TO OVERCOME
WITH THIS BILL.
WELL THAT THERE'S THERE'S NOT A.
A STATUTORY REQUIREMENT THAT A
PHARMACIST TAKE A DRUG HISTORY
OR ATTACK.
TAKE A DRUG HISTORY WHEN
SOMEBODY'S ADMITTED TO A
HOSPITAL.
SO THIS IS GOING TO BASICALLY
CODIFY IT TO LAW THAT A
PHARMACIST WILL REVIEW FOR HIGH
RISK PATENTS AS THE BILL'S
WRITTEN RIGHT NOW THAT WE ARE
GOING TO BE EXAMINING THEIR.
THEIR DRUGGED UP PROTOCOLS THAT
THEY'VE HAD IN THE PAST TO MAKE
SURE THAT THOSE PROTOCOLS ARE
NOT.
IF THEY'RE NOT ACCURATE NOT
DUPLICATED IN THE HOSPITAL
SETTING AND CERTAINLY THAT
THEY'RE NOT JUST CHARGE FOR
THOSE.
.
WRONG PROTOCOLS RIGHT THOUGH BUT
WHY.
IT AGAIN.
THE PHARMACIST WANTED USE THE
BEST THEY CAN IN THEIR POSITIONS
RIGHT.
AND SO WHAT WHY WOULDN'T A
PHARMACISTS GIVEN THAT THE
ARTICULATE TESTIMONY
THAT WE FOR AWHILE I WOULDN'T
THEY SIMPLY MAKE THAT AS A AS.
PART OF THEIR PRACTICE TO DO
THAT.
WHAT'S PREVENTING THEM FROM
DOING THAT TODAY.
YOU KNOW FOR TEN YEARS WE'VE
BEEN GATHERING EVIDENCE UP
THROUGH THIS LARGE STATEWIDE
COLLABORATIVE OF CROSS ALL OF
OUR GREATEST ACADEMIC AND
MEDICAL INSTITUTIONS ABOUT WHAT
IS THE BEST PRACTICES AND HOW TO
SPREAD THEM. AND WHAT WE KNOW IS
THAT IN THE FINEST INSTITUTIONS
LIKE CEDARS SINAI LIKE UCSF YOU
DO HAVE A PHARMACIST ON THE CARE
TEAM AND THEY ARE RESPECTED IN
THE. INTEGRATED INTO THE TEAM
AND THOSE PATIENTS ARE BETTER
OFF BECAUSE OF IT.
WHAT WE HAVE IN THE STATE OF
CALIFORNIA NOW IS A VOLUNTARY
SYSTEM
WHERE ARE VERY FINEST
INSTITUTIONS KNOW FULL WELL THAT
BY ADDING A PHARMACIST TO THE
CARE TEAM? IT LOWERS THEIR COSTS
IT LOWERS THEIR
HOSPITALIZATIONS.
THEIR DAYS IN THE HOSPITAL.
WHAT I DON'T THINK I I'M WITH
RICHARD PAN?
ALL THE PATIENTS NEED THIS AND
SO WE HAVE A VOLUNTARY SYSTEM
NOW. WHERE? A. ACCORDING TO THE
LEADERSHIP OF THAT INSTITUTION
THEY CAN DECIDE WHETHER OR NOT
THE PATIENT HAS ACCESS TO THIS
TRULY LIFE SAVING.
HE BASED APPROACH OF CROSS
CHECKING.
NO A CROSS CHECK BEFORE TAKEOFF
RIGHT YOU WANT TO HAVE A TEAM OF
EXPERTS.
BEFORE YOU DO SOMETHING THAT IS
POTENTIALLY DEADLY OR DISABLING
AND SO I WOULD JUST SAY THAT.
I COMMEND SENATOR STONE AND HIS
TEAM FOR BRINGING FORTH THIS
IDEA THAT IS LONG OVERDUE. THE
DEPARTMENT OF PUBLIC HEALTH I
HAVE TO SAY.
HAS
I'D TAKEN UP THE CHARGE ON THIS
ISSUE THEY HAVE WRITTEN A WHITE
PAPER ABOUT THE IMPORTANCE OF
ADDING THE PHARMACIST OF THE
CARE TEAM. AS ALL OF US HAVE
WORKED AROUND THIS BUILDING
THESE MANY YEARS KNOW IT TAKES A
LONG TIME TO GO FROM. A
LIFESAVING LIFESAVING KNOWLEDGE
TO GETTING IT BROADLY
IMPLEMENTED.
AND SO I THERE IS A VERY
IMPORTANT.
A ROLE THAT THE LEGISLATURE CAN
PLAY HERE AND SAYING LOOK THE
EVIDENCE IS CLEAR THE PATIENTS
ARE DYING.
THROUGH THE VOLUNTARY SYSTEM
THAT WE'VE HAD SO FAR. AYE IT'S
REALLY NOT WORKING.
TO MEET THE GRANDMOTHERS TEST IS
IT GOOD ENOUGH FOR MY
GRANDMOTHER AND I'D HAVE TO SAY
THAT TODAY'S SYSTEM.
IS NOT GOOD ENOUGH FOR YOUR
FAMILY MEMBERS OR FOR YOURSELF
WHEN YOU GO INTO. YOU KNOW IF
YOU HAPPEN TO HAVE A CAR
ACCIDENT OUT IN THE MIDDLE OF NO
WHERE.
DON'T KNOW WHERE YOU'RE GONNA
LAND AND YOU WOULD LIKE TO KNOW
THAT THERE ARE LAWS IN PLACE
THAT ENSURE. THAT REGARDLESS OF
WHERE YOU ARE IN CALIFORNIA
YOU'RE GOING TO GET.
EVIDENCE BASED CARE THAT IS
GOING TO BE MOST ABLE TO SAVE
YOUR LIFE REVIEW THANK YOU. I
WOULD STILL WANT TO GET BACK TO
MY QUESTION GOOD IBM WHICH IS
THAT.
WHY WOULD NOT HOSPITAL MANDATE
THIS ON ANY PATIENT COMES END
WHAT WHAT ARE YOU SAYING THE
HOSPITALS I HAVE NO INTEREST IN
PATIENT CARE?
HOME WHAT WHY WOULDN'T A
PHARMACIST IS A PART OF THEIR.
UP PROFESSIONAL RESPONSIBILITY
WIRE THIS IF YOU COULD BE AS
BRIEF AS POSSIBLE IN THE ANSWER.
I THINK THE ANSWER IS A
APPROPRIATE STAFFING.
AND THE COST OF THAT APPROPRIATE
STAFFING.
YOU'RE SAYING THAT A HOSPITAL
DOESN'T DO THIS BECAUSE THEY
WOULD BE ASSESSED THE COSTS OF
DOING.
I WOULD SAY THAT THAT IS A
FACTOR.
AND PHARMACISTS DON'T DO IT
BECAUSE OF TE COST DOING IT NO
THE PHARMACISTS ARE. THAT THEIR.
THEIR STAFF THE OTHER OF THE
HOSPITAL THEY'RE NOT THE ONES
DICTATING THE THE STANDARD OF
CARE THAT'S BEING DELIVERED THAT
AN INSTITUTION. LEISURE LEADER
HIKE.
DOCTOR SHEENA'S.
AND AND WHAT'S TOWHAT WHAT'S TO
MAKE OF THE EFFORTS WORK THAT'S
THE CASE COST.
THEN THEN DOESN'T IT ALSO BECOME
A PROBLEM WHEN IF THEY'RE
MANDATED TO COLLECT IT. IS IN
THEIR COST OF ANALYZING IT TOO
AND THAT SEEMS TO BE SILENT IN
THIS BILL NOW THAT ONCE SAID
THAT HISTORY IS OBTAINED AT THE
ENTERED OF THE ELECTRONIC HEALTH
RECORD AND. IT THEN ENABLES THE
PHYSICIAN SO.
ORDER THE MEDICATIONS AND BE
AWARE OF WHAT THE PATIENT WAS ON
NOT ONLY DURING ADMISSION BUT A
DISCHARGE SO PHYSICIANS ACTUALLY
ASK US TO DO THIS THERE WAS A.
PHYSICIAN GROUP OUT OF JOHN YOUR
WHERE THEY'VE HIRED SOMEONE
WHO'S A PHARMACY TECHNICIAN
BECAUSE IT'S IT IT ENABLES THEM
TO TAKE CARE OF PATIENTS.
BY CREATING A LIST THAT THEY
FEEL COMFORTABLE THEY CAN NOW
USE NOT ONLY AS A BASIS FOR WHAT
THEY WRITE DURING HER
HOSPITALIZATION BUT IT IMPROVES
THE ACCURACY OF THE
PRESCRIPTIONS UPON DISCHARGE.
SO IT IS SOMETHING THAT IS IS.
VERY MUCH APPRECIATED BY.
OTHER PROVIDERS
THE PHYSICIAN OKAY THAT'S THAT'S
HELPFUL TO ME SO NOW YOU'RE
PINPOINTING THE PHYSICIANS IS
THE ONE.
THAT THAT A RECORD THAT SHOULD
BE REQUIRED TO TO LOOK AT THAT
LIST AND MAKE GOOD JUDGMENTS
THAT NO THE SO EVERYONE DOES
PHARMACISTS REVIEW THOSE LISTS
AS WELL AS PHYSICIANS AS WELL AS
NURSES. BUT THE INTAKE OF THAT
LIST IS CONTAMINATED SO WHAT
WE'RE TRYING TO DO WITH THIS
BILL IS.
RISK STRATIFY THE HIGH RISK
PATIENTS SO WE CAN ENSURE THAT
THEIR LIST IS ACCURATE SO THAT
INFORMATION IS AVAILABLE TO ALL
OF THE PEOPLE ON THE HEALTHCARE
TEAM.
INCLUDING THE PATIENT UPON
DISCHARGE PATIENTS GO HOME WITH
MEDICATIONS THAT WERE
DISCONTINUED DURING THE
HOSPITALIZATION THAT THEY THEN
CONTINUED WHEN THEY'RE WHEN THEY
GO HOME BECAUSE THEY DON'T
REALIZE THEY SHOULD BE ON IT
ANYMORE. THAT'S THE CURRENT
STATE AYE I KNOW YOU WOULD
BENEFIT IF SOME MORE OF THESE
PLAYERS INVOLVED IN THIS WHOLE.
CONVERSATION WE'RE HERE AT THE
TABLE AND THEN THAT IS WHAT IT
IS THEY'RE MAKING CHOICES TO TO
NOT PARTICIPATE.
I THAT MAKES IT HARDER FOR US I
THINK TO MAKE. GOOD CHOICES BUT
IF THIS BILL MOVES FORWARD I
HOPE THAT THEY WILL JOIN IN THAT
CONVERSATION.
THANK YOU ARE INFECTED CONTINUE
OUR DISCUSSIONS WITH THEM THE
SENATE ON.
YEAH I I APPRECIATE THE.
QUESTIONS THAT IN THE IN THE
COMMENTS OF SENATOR GLAZIER.
A YOU KNOW I I WAS A LITTLE
UNSURE OF THIS BECAUSE OF THE
LIABILITY ISSUE BUT I I'M TONY
JUST MY TH.
COMING BACK TO EARTH TO THOUGHTS
OF.
KNOWS A GOOD NAP YOUR OWN
FAMILY MEMBER.
I RECALL.
NOW AND IT'S KIND OF IT'S BEEN
A LONG TIME BUT.
YOU KNOW MY MOM WAS A HOSPITAL
SHE'S LOCAL IT WASN'T LIKE SHE
GOT IN ACCIDENT TIMBUKTU AND
THEY DIDN'T KNOW.
.
HAD AN ADVOCATE MY WIFE WAS
RIGHT THERE THE ENTIRE TIME YOU
KNEW EXACTLY WHAT THE
MEDICATIONS WERE AND THEY STILL
SCREWED UP.
AND SCREWED UP ROYALLY IN TERMS
OF.
YOU'RE THE INTERACTIONS ON ON
ON DRUGS
SO. FOR ME THE FIRST PART OF IT
ALL ON THE LIABILITY ISSUE.
SEEMS TO HAVE BEEN.
AT LEAST.
FOR PHARMACISTS SOLVED.
BECAUSE THE PHARMACY
ORGANIZATIONS IS IN SUPPORT OF
THIS BILL.
I THINK THIS BILL HAS A LOT OF
MERIT I STILL WOULD LIKE TO SEE
SOME OTHER PLAYERS.
YOU'RE IN THE INDUSTRY COME
EAGLE COME FORWARD AND I GUESS.
THE REALITIES OF THEY THOUGHT
THIS WAS A REALLY BAD BILL.
THEY WOULD BE HERE TODAY SO.
I I APPRECIATE.
.
THE.
THE POLICY THAT YOU BROUGHT
FORWARD.
THEN THANK YOU SENATORS DON'T
BE THE AYE AYE TO AGREE I THINK
THIS IS A.
AN EXCELLENT STEP IT'S
SOMETHING THAT'S NECESSARY AND I
APPRECIATE YOUR BRINGING IT TO
US AND UP AND UP BRING IT
FORWARD I HAVE FROM CONCERNED.
IT AND NOT WITH THE FILL IN
TERMS OF THE POLICY BUT IN THE.
IF THE ISSUES THAT HAVE BEEN
RAISED THAT WHETHER WE'RE
TALKING ABOUT ALL PATIENTS ARE
JUST HIGH RISK PATIENTS IN THAT
I THINK.
DOCTOR PAN RAISED A VERY GOOD
POINT OF WHICH WOULD FOR ONE IT
SHOULD BE GOOD FOR ALL OF THEM
IN. LIKE TO WORK ON THAT I ALSO
THE THE ISSUES RAISED BY.
BASED BY SENATOR PENN AND
SENATOR HERNANDEZ OVER THE ISSUE
OF WHETHER THIS IS A.
SOMETHING THIS A STANDARD OF
CARE AND PUTTING IT IN STATUTE
OR IS THIS SOMETHING THAT THE
PHARMACY BOARD COULD BY
REGULATION.
DETERMINE IS THE BEST PATH AND
AND AND WAY OF DOING THIS SHOW
THEIR A COUPLE QUESTION WHAT I'D
LIKE TO DO SINCE THIS IS NOT
THIS IS ONLY SINGLE REFERRED TO
US.
I'D LIKE TO IF IT'S IF THE IF
IT'S AGREEABLE TO EVERYONE TO
CONTINUE IT FOR TWO WEEKS UNTIL
THE TWENTY THINGS TO TWENTY
THIRD TWENTY THIRD OF APRIL.
A WE CAN WORK ON THESE SOLUTIONS
TO THIS AND TRIED TO AND BRING
IT IN I DON'T THINK YOU'RE
WITNESSES NEED TO. COME BACK TO
APPRECIATE THE BEING HERE IF
THEY WANT TO CERTAINLY IT'S AND
IT'S WONDERFUL TO HEAR THEM. BUT
I THINK IN THAT WAY WE COULD
KIND OF GET SOMETHING THAT.
THAT EVERYONE CAN UNDERSTAND
AND AND IS RIGHT IN FRONT OF A
SYSTEM AMENDMENTS THAT COULD
WORK AND I'D BE HAPPY TO DO THAT
WE CAN WORK WITH YOU. AND WITH
THE OTHER STAKEHOLDERS TO MAKE
SURE THAT THEIR VOICES ARE HEARD
IN THIS AND THAT AND WE WANT
SOMETHING AT THE END OF THE DAY
THAT WILL ACTUALLY WORK. AND GET
THE RESULTS THAT I THINK WE'RE
ALL LOOKING FOR SHOW IF YOU
AGREE WITH THAT WE'D BE HAPPY TO
DO THAT.
WE AGREE.
OFFER TO WORK WITH US.
THE BILL.
GOOD AS WE POSSIBLY CAN THE
BEST.
VERY GOOD SO THAT'S ALL I THAT'S
OKAY THAT WE WILL CONTINUE THIS
UNTIL APRIL TWENTY THIRD.
THEY CONCLUDED THEN THANK YOU
VERY MUCH AGAIN THANK YOU FOR
YOUR WITNESSES AND FOR THE
TESTIMONY. I DON'T KNOW WHAT THE
TIMING WISE TO HAVE TIME FOR ONE
BILL ARE WE READY FOR THE FOR.
OKAY I ASSEMBLY MEMBER WOULD
PLEASE COME FORWARD THIS IS ITEM
NUMBER SIX AB SEVEN TEN.
IN ONE HAVE YOU THANKS FOR YOUR
PATIENCE.
YEAH.
THANK YOU VERY MUCH I APPRECIATE
THE OPPORTUNITY.
.
I'M BY MYSELF I HOPE WILL BE
BRIEF SO.
.
MY PLEASURE TO INTRODUCE SO AM.
AT AB SEVEN TEN.
MISTER CHAIR MEMBERS.
EPILEPSY IS A MEDICAL CONDITION
THAT PRODUCES SEIZURES AFFECTING
A VARIETY OF MENTAL AND PHYSICAL
FUNCTIONS APPROXIMATELY ONE IN
TWENTY SIX AMERICANS WILL
DEVELOP EPILEPSY AT SOME POINT
IN THEIR LIFETIME.
THE US FOOD AND DRUG
ADMINISTRATION IS CURRENTLY
REVIEWING AT LEAST ONE
CANNABIDIOL. OR CBT DERIVE
THERAPY THAT SHOWS PROMISE FOR
THE TREATMENT OF EPILEPSY.
CBD IS A CONSTITUENT OF CANNABIS
SATIVA ON OR THE MARIJUANA. AND
HAS THEREFORE ATTAIN REPUTATION
ISN'T THE ADDICTIVE SUBSTANCE.
NEUROSCIENCE RESEARCH HAS
ESTABLISHED CLEARLY THAT THIS IS
NOT THE CASE THE PSYCHOACTIVE
EFFECTS OF MARIJUANA ARE
PRIMARILY ATTRIBUTED TO A
DIFFERENT UPON OF THE PLANT.
TETRA HYPE TETRA HYDRO
CANNABIDIOL.
KICK CANNABINOID YEAH AN EMPTY
SEAT.
YEAH.
TPC TPC CASEY OVERFLIGHT.
ONCE THE FDA APPROVES THIS
THERAPY THE NEW TREATMENT OPTION
COULD BE AVAILABLE AS SOON AS
THE SUMMER OF THIS YEAR. BUT
EVEN WITH FDA APPROVAL
INDIVIDUAL STATES WOULD NEED TO
IMPLEMENT CHANGES TO STATE
SCHEDULING LOS PROCESS THESE
THERAPIES BECOME AVAILABLE IN
THEIR STATE. IN CALIFORNIA THE
CALIFORNIA YOU KNOW UNIFORM
CONTROLLED SUBSTANCES ACT WOULD
HAVE TO BE AMENDED TO CONFORM TO
ANY CHANGES FROM THE FDA.
AB SEVEN TEN WOULD IMMEDIATELY
DOWN SCHEDULE.
CANNABIDIOL.
BASED MEDICATIONS THAT ARE
PROOF FOR MEDICAL USE BY THE US
FOOD AND DRUG ADMINISTRATION.
DESPERATELY ILL CHILDREN AND
ADULTS WITH EPILEPSY WHO ARE IN
URGENT NEED OF ADDITIONAL
TREATMENT OPTIONS WITHOUT WILL
HAVE IMMEDIATE ACCESS TO THIS
BREAKTHROUGH MEDICATION AS SOON
AS THE FDA RESCHEDULED THIS
THERAPY. I RESPECTFULLY ASK
RIVAL THANK YOUS IN REMEMBER
WOULD OF WITNESSES IN SUPPORT.
I THE WITNESSES IN OPPOSITION IN
AND BRING IT BACK TO THE
COMMITTEE FOR YOUR THOUGHTS WE
HAVE A MOTION FROM SENATOR DIED
WOULD YOU LIKE TO CLOSE. EXACTLY
ASK YOUR IVORY IT'S A GREAT BILL
AT WHICH WONDERFUL IN AND I HAVE
LEGISLATION NOW THAT.
ABOUT CHILDREN WHO HAVE THOSE
FORMS OF EPILEPSY THAT ARE USING
GETTING GREAT BENEFIT FROM CDB
SO. THIS IS OUTSTANDING THANK
YOU VERY MUCH WE HAVE A MOTION
FROM SENATOR DODD IS CALL THE
ROLL MOTION IS TO PASS THE
SENATE RULES COMMITTEE HELD. A
AYE HILL AYE FULLER.
FULLER AYE DODD.
HI DOT AYE GALGIANI GALGIANI AYE
GLAZER. GLAZER AYE HERNANDEZ
HERNANDEZ AYE NEWMAN.
AND I AND I WILL.
LOOK I.
WITH NO LINDA. EIGHT COURSE.
NOTED WITH EIGHT TO EIGHT ZERO
WILL HOLD THE ROLL OVER FOR THE
ABSENT MEMBERS THANK YOU VERY
MUCH ASSEMBLY HERE. WE. WILL NOW
TAKE A RECESS FOR OUR
LEGISLATIVE SESSION AND THE RE
ADJOURN
UPON COMPLETION FOR THE ONE
FINAL BILL FOR SENATOR DODD
PROFESSIONS IN ECONOMIC OF
DEVELOPMENT COMMITTEE HEARING
FOR MONDAY APRIL NINTH. WITH ONE
FINAL BILL ON OUR AGENDA LEFT.
ITEM NUMBER THREE SB NINE EIGHTY
ONE SENATOR DOT PLEASE PROCEED.
CAROLINE MEMBER.
CURRENT LAW SPECIFIES THAT WHEN
A CUSTOMER WISHES TO PURCHASE A
WATER TREATMENT SYSTEM FOR THEIR
HOME SALES INDUSTRIES AS THE
LARGE
COMPANIES. ARE HELD TO THE SAME
THREE DAY RIGHT TO RESCIND
CONSUMER PROTECTION STATUTE BUT
ARE NOT PROHIBITED FROM
DELIVERING MATERIALS OR
INSTALLATION DURING THESE.
DURING THIS PERIOD.
S. B. NINE EIGHTY ONE CREATES
PARITY IN THE APPLICATION THE
LAW FOR IT WATER TREATMENT
COMPANIES.
ADDITIONALLY UNDER CURRENT LAW
THE SELLER OF THE PRODUCT IS
RESPONSIBLE FOR ALL COSTS IN
REMOVING THE INSTALLED WATER
TREATMENT DEVICE WITHIN TWENTY
DAYS IT CANCEL BY THE CUSTOMER.
AND MUST RESTORE THE PROMISES TO
ITS ORIGINAL CONDITION.
I'VE TO TWENTY WITNESSES SIR I
THINK JUST ME RIGHT.
YEAH PICKING.
WE'LL SEE HOW TO QUESTION WHAT
GO AHEAD.
AND THE MEMBERS OF THE COMMITTEE
RAINY PARK IN BEHALF OF PACIFIC
WATER QUALITY ASSOCIATION. AND
WE BELIEVE THIS BILL IS VERY
SIMPLE WE'RE JUST TRYING TO
LEVEL THE PLAYING FIELD AND ANY
OTHER AREA WE HAVE.
.
THE WAY IT IS SET UP IS THAT THE
WATER TREATMENT SYSTEMS HAVE
BEEN TREATED IN A UNIQUE
SITUATION WHERE YOUR UNABLE TO
PROVIDE INSTALLATION.
HERE WHILE WE'RE TRYING TO DO AS
PER A MAKE SURE THAT PEOPLE
STILL HAVE TO PROTECTION FOR THE
THREE DAY RECISION BUT YOU HAVE
THE ABILITY TO INSTALL THE
PRODUCT DURING THOSE THREE DAYS
WITH THE FULL RIGHTS TO CHANGE
IT IF YOU WANT AND TO RESCIND
THAT CONTRACT AFTER. THE THREE
DAYS.
WELL YOU HAVE ONE OF OUR
WITNESSES HERE AND NOBODY WHO IS
FROM OF A COMPANY WHO CAN GIVE
JUST ABIT MORE INFORMATION
ABOUT THE BILL.
GOOD THANK YOU WITH RANDY
PLEASE.
MY NAME IS MELODY BULLOCK I
REPRESENT THE PACIFIC WATER
QUALITY ASSOCIATION AS PRESIDENT
AND.
ALSO AS A SPONSOR OF THIS BILL.
I ALSO. AM OPERATIONS MANAGER AT
CAL AQUA.
WHERE WATER TREATMENT AND?
WATER. EQUIPMENT AND IMPROVEMENT
COMPANY IN VACAVILLE CALIFORNIA.
WE ARE ALSO A MEMBER COMPANY OF
P. WQAD.
AND WE.
.
SPECIALIZING RESIDENTIAL
COMMERCIAL FRIEDMAN APPLICATIONS
AND SIX NORTHERN CALIFORNIA
COUNTIES.
I'M.
WATER EXCUSE ME.
BUT.
WOULDN'T.
THIRD TODAY'S CONSUMERS ARE MORE
EDUCATED AND THEY'RE MORE AWARE
OF WATER QUALITY ISSUES.
AND WITH ALL OF THE TECHNOLOGY
AT OUR FINGERTIPS WE CAN GOOGLE
AND SEARCH AND RESEARCH.
DIFFERENT WATER QUALITY ISSUES.
SO TODAY'S CONSUMERS ARE MORE
ACTIVELY LOOKING FOR WAYS TO
IMPROVE THEIR WATER. AND A LOT
OF TIMES THEY WANT TO DO THAT
IMMEDIATELY IF THEY FIND
CONSTITUENTS IN THEIR WATER THAT
ARE.
POTENTIALLY HARMFUL OR.
CONCERNING TO THEM THEY DON'T
WANT TO WAIT THREE DAYS TO
INSTALL TREATMENT.
.
INSTALLATION AND REMOVAL OF
EQUIPMENT IS.
JOHN ALL THE TIME BOTH WAYS
INSTALLING AND REMOVING.
AS WELL IS MODIFYING ADDING TO
CHANGING TREATMENT. BASED ON THE
CONSUMER'S NEEDS SO IT'S A FLUID
MOVEMENT.
OF INSTALLING IN AND REMOVING.
ADDITIONALLY.
THIS.
BEING ABLE TO HAVE THE EQUIPMENT
INSTALLED WITHIN THREE DAYS GIVE
THE CONSUMER ACTUAL REAL
EXPERIENCE WITH THE WATER
QUALITY THE BEGINNING FROM THEIR
TREATMENT EQUIPMENT.
SO WHAT THAT MEANS FOR THE
CONSUMER IS.
IF. I WANT TO EXERCISE MY RIGHT
AS A CONSUMER TO HAVE EQUIPMENT
REMOVED.
WITHIN THIS THREE DAYS AT LEAST
I KNOW WHAT I'M MAKING MY
DECISION ON.
I ALSO UNDER SB NINE EIGHTY ONE
WILL BE ABLE TO.
.
HAVE THE INSTALLER RESPONSIBLE
FOR REMOVING IT WHERE NOW THE
CONSUMER PROTECTION THE THREE
DAY PROTECTION. IF THEY CHANGE
THEIR MIND.
BUT THEY'VE ALREADY TAKEN THERE
THREE DAYS A REMOVAL MIGHT COST
THEM.
FROM THE CONTRACTOR.
FOR I THINK THAT CONSUMERS WILL
BE. MORE EMPOWERED UNDER S. B.
NINETY ONE.
TO EXERCISE THEIR RIGHT TO.
AND SO ON HAVE A QUICKLY
REMOVED.
I AM I ALSO THINK THAT THEY ARE
GOING TO FEEL EMPOWERED TO MAKE
THEIR OWN DECISIONS ABOUT THE
URGENCY OF THEIR INSTALLATION.
REALLY THANK YOU VERY MUCH OTHER
WITNESSES IN SUPPORT.
I MEAN NO ONE IS THERE ANYONE
HERE IN OPPOSITION.
WE NEED BACK TO THE COMMITTEE
FOR QUESTIONS.
DOCTRINE.
THANK YOU.
AND AND I FIRST OF ALL I THINK
GUYS ARE DODD FOR THE NIGHT
QUESTIONS.
TALKED A LITTLE BIT ABOUT THAT
EARLIER. AND AND CERTAINLY I
THINK IN MY MIND.
FOR A CUSTOMER WHO ACTIVELY
SOLICITED RIGHT THEY CALLED THEY
WENT TO A WEBSITE WHOEVER ELSE
AND ASK FOR THE SERVICE.
OF IF YOU GET IMMEDIATE SERVICE
IT'S NOT THAT WE SHOULD HAVE A
LAW SAYING THAT THEY HAVE TO
WAIT THREE DAYS.
LOW MORE CONCERNED ABOUT THE
DOOR TO DOOR WE DO HAVE.
CONTRACT LAW FOR ANYBODY GOES
DOOR TO DOOR. I GUESS
MY CONCERN IS ESPECIALLY WITH
AND I KNOW PEOPLE SAY WELL ONLY
FLIES THE WATER WITH WATER.
IS NOT SO MUCH LIKE THE STUFF
THAT SOMEBODY POSTED AT THE END
OF THE PIPE AS MUCH AS I AM
READING HERE THAT IF YOU PUT A
WATER SOFTENER AT THAT THE ENTRY
YOU'RE NOW CUTTING INTO THE PIPE
AND.
AND TO ONE LEVEL SO I GUESS ONE
QUESTION IS IS THAT.
WHAT IS THE?
I GUESS THE REDRESS FOR A OWNER
THAT IF THEY'RE NOT SATISFIED
WITH THE THEY SAY THAT THE BEAT
FOR THREE DAYS I DON'T WANT TO
SAY MORE PLEASE UNINSTALL THIS.
GIVEN THE NATURE THE FACT THAT
WATER IS KIND OF IMPORTANT THAT
AVE ACCESS TO IT AND THAT
EITHER IT'S NOT REMOVED ARTS NOT
RIP DARKEST IMAGE IT'S NOT DONE
IN THE RIGHT WAY WHAT BE DRESSED
AS THE.
OWNER HAVE IF IT'S NOT IF THE
UNINSTALLATION IS NOT DONE
PROPERLY.
NOW WHEN THEY SAY IT THREE DAYS
YOU KNOW FOR THREE DAYS I DON'T
WANT THIS ANY.
BOB I I THINK YOU.
TO TO THE POINT OF THIS WHOLE
LUCK I'D JUST MADE HERE.
THIS IS DONE ALL THE TIME YOU
KNOW WHAT I WAS.
IN THE WATER TREATMENT BUSINESS.
I HAD OVER FIFTEEN THOUSAND
RENTAL WALKOUTS AND NO CONTRACTS
SO PEOPLE CAN BUY.
INSTALL WE INSTALL.
I READ TO HIM WHEN THEY WANT TO
QUIT WE GO OUT AND WE REMOVE IT.
SO IT'S A STANDARD PRACTICE.
ACCORDING THE STATE OF
CALIFORNIA.
WATER AT PEOPLE THAT ARE
INSTALLING WATER TREATMENT
DEVICES HAVE TO BE A SEAT FIFTY
FIVE CONTRACTOR OR SEE THIRTY
SIX CONTRACTOR.
AND.
IT WILL YOU KNOW WHAT I NO I
WAS BOTH OF THOSE SO YOU.
YOUR CONTRACTORS LICENCES IT IS
ON THE LINE AND THAT.
WOULD BE SOMETHING THAT WOULD
BE WAY AYE INALL MY TWENTY FIVE
YEARS IN THE WATER AS I'VE NEVER
HEARD OF A SITUATION LIKE THAT
OKAY.
WELL I THINK YEAH.
AS THE LEAD I STILL HAVE A
LITTLE DISCOMFORT ABOUT THE IDEA
THAT SOMEONE WHO DOES A DOOR TO
DOOR SOLICITATION WHICH I
UNDERSTAND IS FAIRLY RARE NOW
AND.
AT AND THEN.
SO WE CAN START INSTALLING A
SPECIAL POINT OF ENTRY TYPE
DEVICE NAM NOT CONTRACTORS I
DON'T KNOW THE LEVEL COMPLEXITY
I. REALLY DON'T KNOW AYE STONE
AYE YOU WANNA MESSES UP WITH
PIPES ARE YOU DEFINE A PLUMBER'S
EX PAT. CAN DO IT MYSELF US I'VE
MET I STILL HAVE SOME DISCOMFORT
ABOUT THAT.
BUT.
I CERTAINLY AGREE WITH YOU THAT
ANYONE WHO ACTUALLY SOLICITS ARE
ACTIVELY SOLICITING
SHOULDN'T HAVE TO WAIT TO HAVE
ME THERE GRAD THEY'RE ASKING FOR
ORDERING IT TO CALLING HER
INQUIRING. AND THAT SOMEONE'S
AND AND THAT.
DAYS AND THE BASIN CERTAINLY
HAVE TO SHOULDN'T HAVE TO WAIT.
TO TO GET THE WATER
STOP.
WE'RE GOOD. BUT THAT WAS IT A
QUESTION OF KNOWLEDGE WE'RE GOOD
THANK YOU DOCTOR PAN OF THE
OTHER QUESTION.
GOV RESPONDED TO THE RESPONSE
WHO'S RESPONSIBLE AND AND IN
TERMS OF WHAT RESPONSIBILITY IF
THEY WERE TO REMOVE THE
EQUIPMENT AFTER THE THREE DAY OR
BEFORE THE THREE DAYS.
AND THEY DID DAMAGE TO THE
FACILITY OR DAMAGE TO YOUR
EQUIPMENT OR BUT THEN YOU KNOW
THEY ARE LICENSED
CONTRACTORS-THAT FALLS UNDER
THAT.
CONTRACTORS LICENSE REQUIREMENTS
IS JUST AS ANY OTHER CONTRACT
WORK THAT WOULD BE DONE I THINK
I I'M COMFORTABLE WITH THAT. THE
ISSUE OF TIME FRAME IN REMOVAL
THAT WAS A QUESTION IN THE
ANALYSIS.
YOU KNOW HOW LONG.
YOU KNOW THIS COULD GO.
YOU KNOW THEY'RE TOLD OVER THERE
ASKED TO REMOVE IT.
THEY THERE'S NO TARTAN NOTHING
IN THE BILL THAT SAYS THEY HAVE
TO DO IT BY A CERTAIN PERIOD OF
TIME.
AND MISTER CHAIRMAN UNDER THE
LAW WE LOOK AT HOME SOLICITATION
CONTRACT TALKS ABOUT IF YOU'RE
GONNA RETURN GOODS LIKE IF
YOU'RE SOLD SOMETHING AND YOU
WANT TO RETURN IT WITHIN THREE
DAYS.
THAT THE SELLER HAS TO PICK IT
UP WITHIN TWENTY DAYS SO WE
THINK THAT THAT'S PROBABLY A
GOOD TIME FRAME THAT THAT'S
INCLUDED ALREADY UNDER THE LAW
THAT WOULD. WOULD BE WITHIN A
TWENTY DAY TIMEFRAME.
BUT THAT FOR PICKING UP MATERIAL
AT THAT WE ACTUALLY HAVE TO
UNINSTALL IT THAT SOME FORMS
RIGHT AND WE ARE THAT THAT COULD
APPLY. THE SAME WHAT IT REALLY
WAS A LANGUAGE AND ALL WE WOULD
AMEND THE BILL TO MAKE IT
CONSISTENT WITH A CREEK CLEARER
CORRECT I THINK THAT'S
ABSOLUTELY.
THAT WOULD BE THAT WOULD BE FINE
VIEW THAT VERY GOOD.
GREATER.
ANY OTHER QUESTIONS OR COMMENTS.
IN NONE SENATOR DODD WOULD LIKE
TO CLOSE RESPECTFULLY ASK FOR A
VOTE THANK YOU SENATOR DODD. IS
THERE A MOTION.
THANK YOU SENATOR NEWMAN WE HAVE
A MOTION FOR SENATOR NEWMAN.
IT'S CALL THE ROLL.
FASHION IS TO PASS THE SENATE
JUDICIARY COMMITTEE HILL AYE
HILL AYE WITH THEM WITH WOMEN.
YEAH THANK YOU AGREE.
FULLER. AYE FULLER AYE DODD AYE
GLAD AYE GALGIANI.
GALGIANI AYE GLAZER.
GLAZER AYE HERNANDEZ. HERNANDEZ
AYE NEWMAN AYE AYE NEWMAN AYE
PAN.
I AND I WILK.
LOCI.
THE BILL HAS NINE VOTES AND IT
IS OUT THINK A JANITOR DOT.
UP WILL NOW GO BACK AND CALL THE
ABSENT MEMBERS ON ITEM NUMBER
ONE S. B. NINE ZERO FOUR SENATOR
WHITE HOUSE HE PLEASE CALL THE
AFTER MEMBER. PROFESSION IS TO
PASS THE SENATE JUDICIARY
COMMITTEE KERN VOTE IS SIX ZERO
GALGIANI.
GALGIANI AYE HERNANDEZ.
EXCUSE ME I'M GLAZER.
GLAZER AYE AND PAN I AND I.
NINE ZERO THAT PHIL IS OUT ITEM
NUMBER TWO S. B. NINE TWENTY BY
SENATOR CANNELLA PLEASE CALL THE
ABSENT MEMBERS.
SHE HAS TO PASS THE SENATE
JUDICIARY COMMITTEE KERN VOTERS
SIX ZERO. GALGIANI.
GALGIANI AYE GLAZER.
GLAZER AYE PAN.
I.
AND I. DON'T HAS NINE VOTES AS
WELL AND IT IS OUT. OF THE ROOM
AND WILL GO TO.
SENATOR WOULD AB SEVEN TEN ITEM
NUMBER SIX PLEASE CALL THE
ABSENT MEMBERS NOTION AS TO PASS
THE SENATE RULES COMMITTEE.
CURRENT BUT EIGHT ZERO NEWMAN
AYE NEWMAN AYE NINE ZERO THAT
BILL IS OUT AND WE KNOW. I
REMEMBER FIVE S. B. TWELVE FIFTY
FOUR CENTER STONE HAS BEEN
CONTINUED UNTIL APRIL TWENTY
THIRD THAT CONCLUDES THE
BUSINESS OF THE COMMITTEE TODAY
THIS HEARING IS ADJOURNED