BUT WE HAVE ENOUGH TO GET
STARTED AS A SUBCOMMITTEE.
COUPLE OF NONSENSE WHEN ITEM AND
CONSENT ITEMS FILE NUMBER SEVEN.
SP FOURTEEN FIFTY SEVEN
HERNANDEZ MEDICARE SUPPLEMENTAL
INSURANCE SUPPLEMENT INSURANCE.
.
I THINK WE HAVE OUR FIRST AUTHOR
ITEMS WERE AN ITEM NUMBER TWO SP
ONE ZERO ZERO FOUR WIENER. LIKE
TO COME UP.
IT'S.
I BELIEVE.
SOME ARE MORE LIKE IS THE CO
AUTHOR IS THAT CORRECT. RIGHT TO
ANOTHER CHANNEL.
THE WHOLE.
I WOULD NEVER NEVER HOLD IT
AGAINST CENTER WEINER. I.
THEN A WINNER CONNECTION THANK
YOU. MISTER CHAIRMAN CALLERS
FOR.
SCHEDULING THIS. HEARING TODAY
I WANT TO I THANK THE COMMITTEE
FOR ITS WORK ON THE BILL. AND
WE'RE HAPPY TO ACCEPT THE
COMMITTEES.
AMENDMENTS TO THE BILL I WANT
TO THANK MY DOING AUTHOR ON THE
BILL CENTER MORE LOCK UP FOR
WORKING WITH US AND FOR BEING
HERE TODAY. NINE OF COURSE
YOU'LL BE HEARING FROM US.
STEINBERG WHO PLAYED SOMETHING
OF A ROLE IN THE CREATION OF THE
SIZE. OF THIS.
ADMITS TO SAY.
FUNDING. SO OUR COLORS I'M
HONORED TO PRESENT TO THE SP ONE
ZERO ZERO FOUR.
WHOSE GOAL IS TO STANDARDIZE
THE MOST EFFECTIVE PREVENTION
AND EARLY INTERVENTION PROGRAMS
ARE FUNDED BY THE MENTAL HEALTH
SERVICES ACT. WITH A STRATEGIC
BASED MENTAL HEALTH SERVICES
AND SUPPORT. THE ACT WITH
STRUCTURED TO REQUIRE THAT
EIGHTY PERCENT OF THE EMMY TO
SAY REVENUE GO TOWARD SERVICES
FOR PEOPLE.
AFTER MENTAL ILLNESS HAS BECOME
DISABLING WHILE THE REMAINING
TWENTY PERCENT. FIVE IS TO
TARGET EARLY INTERVENTIONS AND
PREVENTION'S US SO THAT WE CAN.
I'VE STOP. THE PROGRESSION
EARLY. FOR THE.
TWENTY EIGHTEEN NINETEEN YEAR.
THE GOVERNOR'S JANUARY BUDGET
PROJECTS THERE'LL BE TWO POINT
TWO BILLION DOLLARS IN REVENUE
GENERATED FROM HSA. AND ABOUT
FIVE HUNDRED MILLION OF THAT
WILL GO INTO THE PREVENTION AND
EARLY INTERVENTION A POT OF
MONEY. SIDE EVEN WITH THESE
RESOURCES DIRECTED TOWARDS
MENTAL HEALTH WE ARE
EXPERIENCING A HUGE PROBLEM IN
THIS STATE. ONE THIRD OF
CALIFORNIA'S PRISON POPULATION
AND ONE FOURTH OF OUR HOMELESS
POPULATION ARE SEVERELY MENTALLY
ILL. SUICIDE IS THE THIRD
LEADING CAUSE OF DEATH FOR
TRANSITION AGE YOUTH. AND YOUNG
ADULTS AGE FIFTEEN TO TWENTY
FOUR. IF YOU WANT TO CHANGE HIS
NUMBERS AND SEE YOUNG PEOPLE IN
OUR COMMUNITY THRIVE. INSTEAD OF
ENDING UP IN PRISON HOMELESS OR
TAKING THEIR OWN LIVES.
WE NEED TO CHANGE OUR YOU GET TO
THESE KIDS EARLY.
WE CAN REALLY ADDRESS IN THE
LONG RUN. ARE.
MENTAL HEALTH OR MENTAL ILLNESS
PROBLEM IN THE STATE OF
CALIFORNIA.
NINE SO SOLVING THIS PROBLEM
WILL REQUIRE US TO FOCUS ON
STRENGTHENING AND IMPROVING OUR
YOUTH PREVENTION AND EARLY
INTERVENTION.
MENTAL HEALTH PROGRAM STATEWIDE.
THE SHIPS WILL ALLOW US TO
BREAK.
THE CYCLE.
CURRENTLY THERE ARE GLARING
SERVICE GAPS ACROSS CALIFORNIA
WITH SOME COUNTIES HAVING ROBUST
AND CUTTING EDGE PREVENTION AND
EARLY INTERVENTION PROGRAMS.
WHILE OTHERS DO NOT.
.
WE KNOW THAT THERE ARE PROVEN
STRATEGIES AND WE NEED TO MAKE
SURE THAT THESE STRATEGIES ARE
BEING IMPLEMENTED. THROUGHOUT
THE STATE. WE ALSO KNOW FROM
RECENT STUDIES DIED CALIFORNIA
CHILDREN WITH THE HIGHEST
PREVALENCE OF MENTAL HEALTH
NEEDS. AT LEAST ACCESS TO
SERVICE WE DON'T THINK THAT ZIP
CODE SHOULD DICTATE WHETHER
YOUNG PERSON CATS THE MENTAL
HEALTH CARE THAT THEY NEED.
SP ONE ZERO ZERO FOUR TAKES THE
FIRST AN IMPORTANT STEP OF
DEFINING WHAT SERVICES HAVE
PROVEN TO BE EFFECTIVE. AND
ENCOURAGING COUNTIES TO FOCUS ON
REACHING CHILDREN AND YOUNG
ADULTS TO DEVELOP A STATEWIDE
STRATEGY. FOR THIS HALF BILLION
DOLLARS.
NOW OF COURSE AS YOU KNOW AND I
KNOW THERE ARE OTHER BILLS IN
THIS TOPIC. AN ESTIMATED EIGHTY
TWO MILLION DOLLARS.
IN THIS FUNDING. PREVENTION
EARLY INTERVENTION FUNDING.
THAT.
IS SITTING WITH THE COUNTIES ON
SPENDS. ABOUT THIS LARGE SUM OF
MONEY THE TIME SPENT UNDERSCORES
HOW LONG CLEAR IT IS SOMETIMES
THE COUNTIES HOW THEY SHOULD
SPEND THE MONEY.
THE BILL ALSO PROVIDE TECHNICAL
ASSISTANCE AND BETTER OVERSIGHT.
BY THE THREE PRIORITIES FOR
THESE EXPENDITURES.
OUR.
TO STRATEGICALLY AIM TO HELP
SOME OF OUR MOST UNDERSERVED
POPULATIONS INCLUDING FOSTER
YOUTH. TRANSITION AS YOU THINK
COMMUNITIES OF COLOR.
OUR COLLEAGUE THIS IS A GOOD
BILL DESERVES YOUR SUPPORT. I
RESPECTFULLY ASK FOR AN IDLE AND
WITH ME TODAY AS I MENTIONED
SIZE.
MAYOR STEINBERG.
AND WHO IS A SPONSOR OF THE
BILL THROUGH THIS TIMER GETS TO
A CENTER MORE LOCK AND JANICE
LAMBERT CANAL AND OF THE
CHILDREN'S DEFENSE FUND.
WELCOME AND PLEASE PROCEED
PROCEEDS AND THEIR FORMER CENTER
AND RECURRENT MAYOR STEINBERG
THANK AND GIANT SAND AND GIANTS
FAN ABSOLUTELY.
SIR RIGHT.
FIVE IN FIVE I MIGHT REMIND YOU
MISTER JIM YOU DON'T HAVE TO
REMIND ME MISTER CHAIRMAN. IS TO
CHAIRMAN.
CENTER HERNANDEZ THANK YOU SO
MUCH. FOR HAVING ME TODAY I WANT
I WANT TO THANK SENATORS LEANER
AND MORE LOCK FOR. TAKING ON
THIS BILL.
THIS IS SPONSORED IN PART BY
THE INSTITUTE IN MY NAME AND I'M
JOINED BY BETWEEN CHILDREN WHO
IS OUR.
POLICY DIRECTOR.
I THINK THIS IS THE MOST
IMPORTANT MENTAL HEALTH BILL OF
THE YEAR IN CALIFORNIA AND I
WANT TO EXPLAIN WHY.
BRIEFLY I JUST SPENT MOST OF THE
MORNING AT WITH MY OTHER HAT ON
IS MAYOR OF SACRAMENTO WITH THE
OTHER MAYORS COMPRISING THE BIG
ELEVEN.
TO LOBBY LEGISLATIVE LEADERSHIP
FOR MORE MONEY FOR CITIES FOR
HOMELESSNESS.
AND IT'S VERY VERY IMPORTANT TO
MEASURE FOR US BECAUSE
HOMELESSNESS. AS ONE CONSEQUENCE
OF UNTREATED MENTAL ILLNESS IS
INCREASING DRAMATICALLY.
I KNOW INTUITIVELY AND FROM MY
OWN EXPERIENCE THAT. WALL THAT
IS VITALLY IMPORTANT WE ARE
NEVER GOING TO CATCH OUR TAIL.
UNLESS WE FOCUS MORE RESOURCES
ON PREVENTION EARLY INTERVENTION
ESPECIALLY WITH MENTAL HEALTH.
AND SO WHEN WE WROTE PROP SIXTY
THREE TWENTY PERCENT OF THIS
MONEY IS SET ASIDE EVERY YEAR
FOR MEN FOR FOR PREVENTION EARLY
INTERVENTION HERE'S THE PROBLEM.
WE HAVE LACKED SUFFICIENT STATE
LEADERSHIP.
TILL NOW.
I KNOW I WAS THERE AND WORKED ON
THESE ISSUES BUT WE'VE LACKED.
THE LEADERSHIP AND THE DIRECTION
TO SAY THAT THIS FIVE HUNDRED
MILLION DOLLARS A YEAR OUGHT TO
BE SPENT MORE STRATEGICALLY. BUT
JUST PASSING IT ON THE FIFTY
EIGHT COUNTIES ALL DOING. RANDOM
AND DIFFERENT THINGS.
AND THERE'S SOME GREAT MODELS
OUT THERE THERE'S NO QUESTION
SACRAMENTO WE'VE GOT. A MODEL
PROGRAM EARLY PSYCHOSIS
IDENTIFICATION AND INTERVENTION
FOR TEENAGERS TWENTY EIGHT
COUNTIES ARE DOING SIMILAR
THINGS IN LOS ANGELES COUNTY.
FOCUSED A LOT ON TRAUMA RELATED
CARE FOR YOUNG PEOPLE.
SO WHAT SENATOR WINNER IN
MORLOCKS BILL SAYS VERY CLEARLY
IS NOT THAT THE STATE SHOULD
MICRO MANAGE THE COUNTIES. BUT
WE SHOULD SET SOME STRATEGIC
OBJECTIVE SPEND THE MONEY ON ONE
OF THREE THINGS.
COLLEGE BASED MENTAL HEALTH
SERVICES OR THE SUICIDE RATE IN
THE RATES OF DEPRESSION AND.
FIRST BREAKER OFF THE CHARTS.
EARLY TRAUMA. FOR YOUNG KIDS
EXPOSED TO VIOLENCE AND THEN
THIS EARLY PSYCHOSIS
IDENTIFICATION INTERVENTION FOR
TEENAGERS WHO ARE EXHIBITING THE
SIGNS BUT DON'T YET HAVE A FULL
BLOWN. PSYCHOSIS NOW AS THIS
BILL MOVES HIS WAY THROUGH THE
LEGISLATIVE PROCESS THE AUTHOR
IN THE LEGISLATURE MAY SAY WELL
WHAT ABOUT CATEGORIES FOREIGN
FIVE.
THAT'S FINE.
WE JUST WANT THE STATE TO TAKE
LEADERSHIP.
TO IDENTIFY SOME STRATEGIC
PRIORITY UNTIL THEY CAN SPEND IT
ON THIS AND THEN EVALUATED AND
REPORT BACK SO THAT. WE'RE NOT A
MILE WIDE AND AN INCH DEEP. BUT
INSTEAD WERE MAKING A REAL
IMPACT.
AROUND THESE PRECIOUS DOLLARS
FIVE HUNDRED MILLION DOLLARS A
LOT OF MONEY. IT OUGHT TO BE
SPENT MORE STRATEGICALLY THAT IS
BEING SPENT.
TODAY AND THAT'S THE POINT OF
THE BILL THANK YOU VERY MUCH.
OKAY CENTERMAN.
THANK YOU THINK SHOULD I HAVE
WEAKENED WITH. I'M SORRY I
SHOULD HAVE WAITED FOR SENATOR
MORE LOCKED OUT NOW. THAT WAS
THAT WAS A FAUX PAS THERE WE GO
SORRY ABOUT THAT NO NO I DON'T
SEND IT. FULLY WHERE THE PECKING
ORDER RIGHT.
SO SO. FORMER SENATOR STEINBERG
AND CURRENT MAYOR STEINBERG. HE
JUST CAN'T HELP HIMSELF THAT
JUST THAT'S WHO HE IS.
ANYWAY GO AHEAD CENTER MORE LIKE
MISTER CHAIR I SERVED AS A
ORANGE COUNTY SUPERVISOR FROM
TWO THOUSAND. SIX TO TWENTY
FOURTEEN AND I SERVED AS THE
CHAIR OF THE ORANGE COUNTY
CRIMINAL JUSTICE COORDINATING
COMMITTEE. AND PROP SIXTY THREE
WAS ON OUR AGENDA EVERY MONTH
AND SO I'VE BEEN IMMERSED IN.
MENTAL HEALTH SERVICES ACT
ISSUES PERK FOR QUITE SOME TIME
AND I WANT TO THANK.
MAYOR STEINBERG FOR DOING SENATE
BILL FIVE EIGHTY FIVE FOR ME TO
ALLOW US TO ENACT LAURA'S LAW.
ANY HELP ME WITH THE SP TWELVE
SEVENTY THREE A COUPLE YEARS AGO
TRYING TO GET MORE PSYCHIATRIC
BEDS IN TWO COUNTIES AND SO
THOSE BOTH WERE SUCCESSFUL IN
MOST GRATEFUL BUT COLLEAGUES. ON
EVERY TWENTY SEVEN OUR STATE
AUDITOR.
ELAINE HOW ISSUED THIS REPORT.
IT'S GOING TO BE REVIEWED NEXT
WEEK BY J. LACK. OF BUT TO
ELAINE HOW AND I SPENT ABOUT AN
HOUR WITH HER JUST TO REVIEW THE
REPORT. FIFTY EIGHT COUNTIES IN
THE STATE OF CALIFORNIA AND
WE'VE GOT TWO AND A HALF BILLION
DOLLARS SITTING IN. BANK
ACCOUNTS NOT BEING USED TO HELP
THOSE WITH MENTAL ILLNESS WERE
SUFFERING FROM ANALYSIS
PARALYSIS IS WE ALL TRY TO
FIGURE OUT WHAT TO THE
INNOVATIVE PLAN. AND WHERE
SHOULD THIS MONEY BE GOING SO I
APPRECIATE. THE MAYORS ARE
OPENING REMARKS HE WAS SPREAD
OUT ON THE MARK AND IF WE DON'T
KNOW PRECISELY WHAT TO DO WE DO
NOTHING WE ARE LACKING SOME
LEADERSHIP. HERE IN THE STATE OF
CALIFORNIA AND NOW WE'VE GOT TWO
AND A HALF BILLION DOLLARS
SITTING IN BANK ACCOUNTS NOW MY
COUNTY I HAVE A FEDERAL JUDGE BY
THE NAME OF DAVID EARL CARTER.
WHO IS TELLING EVERYBODY IN ALL
THIRTY FOUR CITIES TO START
DOING SOMETHING ABOUT THE
HOMELESS AND HE'S CLEARED OUT
CAMPS? AND HE'S SAYING WAIT A
SECOND THIS THAT ORANGE COUNTY
HAS. HOW MANY MILLION SIX
HUNDRED MILLION OF MONEY THAT WE
SHOULD BE USING FOR ALMOST I
DON'T BELIEVE THAT'S WHAT PROP
SIXTY THREE WAS FOR BUT IT'S
SITTING THERE AND IT'S BEING?
LOOK THAT IS SOMETHING THAT
SHOULD BE UTILIZED SO SENATE
BILL ONE THOUSAND FOUR PROVIDES
SOME DIRECTION TO STRENGTHEN AND
IMPROVE PREVENTION AND EARLY
INTERVENTION PROGRAMS. THE
MIDDLE HEALTH SERVICES OVERSIGHT
AND ACCOUNTABILITY COMMISSION
NEEDS A STRATEGY THAT NEED SOME
DIRECTION AND I'VE HAD. THE
OPPORTUNITY TO MEET WITH TOBY
EWING ITS DIRECTOR TO DISCUSS
MENTAL HEALTH SERVICES ACT
ISSUES.
SP ONE THOUSAND FOUR HELPS IN
BREAKING THE LOGJAM OF MOVING
THE MIDDLE HEALTH SERVICES ACT
FORWARD WITH SO MANY NEEDS IT IS
FRUSTRATING THE RESIDENTS OF MY
COUNTY. THAT SIGNIFICANT FRIENDS
SIT IDLY DOING VIRTUALLY
NOTHING.
AT LEAST THAT IS THE PERCEPTION
SENATE BILL ONE THOUSAND FOUR
WILL PROVIDE THE TRANSPARENCY IN
STRATEGIC APPROACH THAT'S
CURRENTLY LACKING. SCIENCE IS
CLEAR THAT PREVENTION AND EARLY
INTERVENTION MENTAL HEALTH
PROGRAMS HOLDS EXTREME PROMISE
TO STEMMING SERIOUS MENTAL
HEALTH DISORDERS. FOR EVERYONE
DOLLAR.
THAT IS INVESTED IN TREATMENT OF
DEPRESSION SOCIETY SAVE SEVEN
DOLLARS.
YEAH TRICK MENTAL ILLNESS IS
REAL ONE IN FIVE YOUNG PEOPLE IN
THE UNITED STATES HAS A
DIAGNOSABLE MENTAL HEALTH
DISORDER. THIRTY SIX PERCENT OF
VISITS TO THE PEDIATRIC
PEDIATRICIAN OUR PURPOSE PURELY
PSYCHOLOGICAL REASONS. VISITS TO
AN EMERGENCY ROOM FOR
PSYCHIATRIC PROBLEMS ROSE TWENTY
SIX PERCENT BETWEEN TWO THOUSAND
ONE AND TWO THOUSAND TEN FASTER
THAN ANY OTHER DIAGNOSIS.
SUICIDE IS A THREE DIMENSION IS
THE SECOND LEADING CAUSE OF
DEATH FOR CHILDREN BETWEEN THE
AGES OF TEN AND TWENTY FOUR.
EIGHTEEN PERCENT OF IGH SCHOOL
STUDENTS HAVE CONSIDERED SUICIDE
IN THE PAST YEAR. AND HALF OF
PEOPLE WITH LIFETIME MILL TO
MENTAL ILLNESS HAVE SYMPTOMS BY
THE AGE OF FOURTEEN. SO. WE ARE
FORTUNATE IN ORANGE COUNTY WE
JUST OPENED AN AMAZING CENTER AT
THE.
AT CHILDREN'S HOSPITAL OF ORANGE
COUNTY CHALK. IT.
PROVIDES THE FIRST INPATIENT
BEDS FOR CHILDREN UNDER TWELVE
THAT JUST OPENED TWO WEEKS AGO.
CHAKA WAS FUNDED BY SOME NICE
DONATIONS FROM RECKON K. WORN. A
RAKING CAN RICK IS THE PASTOR OF
A CHURCH GOING TO SETTLE BACK
YOU WROTE THE BOOK THE PURPOSE.
DRIVEN LIFE AND HE LOST HIS
YOUNGEST SON TO DEPRESSION.
SANDY SIGNATURE MOVE SOUTH COAST
PLAZA IS ALSO A MAJOR DONOR TO
BREAK THIS HAPPEN SO WE'RE
TRYING OUR BEST IN ORANGE COUNTY
TO DO. AND PROVIDE SOLUTIONS BUT
I DO NOT NEED MORE PARENTS IN MY
OFFICE TELLING ME THEY'VE
WATCHED. A SON OR DAUGHTER TO
MENTAL ILLNESS. SP ONE OVER OH
FOUR WILL ALLOW MORE PEOPLE TO
ACCESS CRITICAL AND TIMELY
MENTAL HEALTH CARE AT THE ONSET.
OF THEIR FIRST SYMPTOMS.
WE HAVE A SOLUTION AT OUR
FINGERTIPS MISTER CHAIR SO I AM
PROUD TO JOIN SENATOR WINNER AND
THE STEINBERG INSTITUTE IN
MOVING THIS PIVOTAL LEGISLATION
FORWARD. AND I RESPECTFULLY
REQUEST AND I VOTE FOR SP ONE
ZERO ZERO FOUR.
THANK YOU VERY MUCH BEFORE WE
PROCEED WE'RE GONNA GO AND
ESTABLISH A QUORUM WE CALL THE
MEMBERS PLEASE FERNANDEZ.
FERNANDEZ HERE WHEN. WHEN HERE
LABOR. LABOR HERE MITCHELL.
MINING NEWMAN NEWMAN HERE
NIELSEN. BILLS IN HERE HAND
ROSS.
FARMER'S BEEN ESTABLISH.
PLEASE PROCEED.
THANK YOU.
GOOD AFTERNOON I'M JANICE CAN
ALAN WITH CHILDREN'S DEFENSE
FUND CALIFORNIA. CITY OF
CALIFORNIA'S THE STATE OFFICE OF
THE CHILDREN'S DEFENSE FUND A
NATIONAL CHILD ADVOCACY
ORGANIZATION. FOUNDED BY MARIAN
WRIGHT EDELMAN. THAT IS WORKED
RELENTLESSLY FOR FORTY FIVE
YEARS TO ENSURE A LEVEL PLAYING
FIELD FOR ALL CHILDREN.
WE STRONGLY SUPPORT SB TEN OH
FOUR BECAUSE IT WILL IMPROVE
ACCESS FOR CHILDREN TO MENTAL
HEALTH SERVICES. AND ENSURE
LOCAL LEVEL PLANNING FOR MENTAL
HEALTH PREVENTION AND EARLY
INTERVENTION FOR CHILDREN AND
YOUTH.
OUR STATE IS MISSING THE
OPPORTUNITY TO PROVIDE THIS
GENERATION'S CHILDREN WAS
SERVICES WE KNOW THEY NEED. TO
BECOME HEALTHY ADULTS AND ABLE
TO FULLY CONTRIBUTE TO OUR
STATE'S FUTURE.
CURRENTLY EIGHTY PERCENT OF
CALIFORNIA CHILDREN WITH MENTAL
HEALTH NEEDS ARE NOT BEING
SERVED. GET EVERY CHILD IS
ELIGIBLE FOR HEALTH INSURANCE
NINETY SEVEN PERCENT ARE
ENROLLED IN MEDICARE ALL COVERED
CALIFORNIA OR PRIVATE INSURANCE.
AND WITH MENTAL HEALTH PARITY
EVERY CHILD SHOULD BE ABLE TO
HAVE MENTAL HEALTH CARE
SERVICES.
YET WE ARE FAILING CHILDREN BY
ALLOWING THEIR CONTINUED
SUFFERING WITH MENTAL HEALTH
ISSUES. AND CONTRIBUTING TO
LIFELONG MENTAL AND PHYSICAL
HEALTH ILLNESS AND DISABILITY.
THIS CRISIS IS HAPPENING NOW
JUST AS WE ARE LEARNING FROM
NEUROSCIENTISTS ALL THE LONG
TERM RAMIFICATIONS OF NOT
RECOGNIZING AND TREATING MENTAL
ILLNESS IN CHILDREN.
WHEN CHILDHOOD TRAUMA IS LEFT
UNTREATED CHILDREN VERY OFTEN
DEVELOP PTSD AND HYPER
VIGILANCE.
MAKING LEARNING IN A TRADITIONAL
SCHOOL ENVIRONMENT ESPECIALLY
CHALLENGING.
ASKING A STUDENT WHO RARELY
FEELS PHYSICALLY OR EMOTIONALLY
SAFE TO SIT QUIETLY AND READ OR
LEARN ALGEBRA OR MANAGE CONFLICT
IS A LOT TO ASK IF YOU THINK
ABOUT IT IT'S IT'S ALMOST CRUEL
TO ASK THEM.
WE KNOW THAT A CHILD WITH FOUR
OR MORE ADVERSE CHILDHOOD
EXPERIENCES IS THIRTY TWO
PERCENT IS THIRTY TWO TIMES MORE
LIKELY TO HAVE A LEARNING OR A
BEHAVIOR PROBLEM.
EXPOSURE AND LACK OF TREATMENT
TO ADVERSE CHILDHOOD EVENTS
INCREASES THE RISKS FOR SEVEN
OUT OF TEN LEADING CAUSES OF
DEATH IN ADULTS.
THIRTY TO FORTY PERCENT OF YOUTH
THAT ARE EXPOSED TO COMMUNITY
VIOLENCE WILL DEVELOP PTSD.
INDIVIDUALS WHO WHO EXPERIENCE
SIX OR MORE ACES OR ADVERSE
CHILDHOOD EVENTS HAVE A SHORTER
LIFE EXPECTANCY OF UP TO TWENTY
YEARS COMPARED TO THOSE WITH
NONE.
MENTAL HEALTH MAKES UP TWELVE
PERCENT OF TOTAL DISCHARGES IN
HOSPITALS FOR CHILDREN MAKING IT
THE NUMBER ONE REASON CALIFORNIA
CHILDREN GET HOSPITALIZED EVEN
THOUGH TREATMENT AS POSSIBLE
WITH THE EARLY IDENTIFICATION
AND INTERVENTIONS.
SB ONE THOUSAND FOUR WILL ALLOW
MORE CHILDREN AND YOUTH TO HAVE
TREATMENT TARGETED TO HEAL THEIR
CHILDHOOD TRAUMAS.
IN ADDITION TO PRIVATIZING
TREATMENT FOR CHILDHOOD TRAUMA
AND AT REST VULNERABLE
COMMUNITIES.
SP TEN OF FOUR WILL ALSO IMPROVE
ACCESS TO EARLY DIAGNOSIS AND
TREATMENT OF PSYCHOSIS AND MOOD
DISORDERS. WHICH AFFECTS NEURAL
CONNECTIVITY AND WILL CAUSE
STRUCTURAL CHANGES IN THE BRAIN
IF LEFT UNTREATED.
EARLY INTERVENTION IMPROVES
EARLY PROGNOSIS AND INCREASES
THE LIKELIHOOD OF RECOVERY.
I'M DIAGNOSE PSYCHOSIS IN
ADOLESCENCE CAN AFFECT THE
ABILITY TO ESTABLISH AND
MAINTAIN RELATIONSHIPS. ACHIEVE
INDEPENDENCE FROM FAMILY ACQUIRE
INDEPENDENT LIVING SKILLS AND
PREPARE FOR PRODUCTIVE WORK.
EARLY MOOD DISORDERS INCREASE
THE RISK OF DROPPING OUT OF
SCHOOL AND TEEN PREGNANCY WHICH
INCREASES THE LIKELIHOOD OF
SUBSEQUENT EXPOSURE TO STRESSFUL
EXPERIENCES AS THEY GET OLDER.
EARLY INTERVENTION ENABLES
RECOVERY AND IMPROVES THE
OUTCOMES.
A TREATMENT. POSITIVE HEALTH
OUTCOMES OF INTERVENTION ARE THE
PREVENTION OF PROGRESSION TO
ADVANCED STAGES A REGRESSION TO
AN EARLIER STAGE OF DISEASE.
STANDARDIZING PREVENTION PUSHES
COUNTIES TO PRIORITIZE
PREVENTION AND EARLY
INTERVENTION WHICH INCREASES THE
LIKELIHOOD OF THIS BUILDING
RESILIENCE AND CHILDREN. AND
HAVING LONG TERM SUCCESSFUL
MENTAL HEALTH ACT OUTCOMES.
WE NEED TO DO BETTER FOR OUR
CHILDREN. AN SP TO FORCE AN
IMPORTANT STEP IN IDENTIFYING
PREVENTING AN INTERVENING MENTAL
ILLNESSES.
AND IN DISEASE AFFECTING
CHILDREN AND YOUTH.
FOR THESE REASONS WE
RESPECTFULLY URGE YOUR I'D VOTE.
ON SB TEN FOUR. THINK ANYONE
ELSE IN THE US. WOULD LIKE TO
SPEAK IN SUPPORT OF THE ISSUE.
WE CAN HAVE YOUR NAME AND
POSITION PLEASE.
MISTER CHAIRMAN MEMBERS OF THE
COMMITTEE RENTAL HAGER FOR THE
CALIFORNIA PSYCHIATRIC
ASSOCIATES. WRONGLY IN SUPPORT
OF THIS AND YOU.
BRANDON MARCHING WITH THE
CALIFORNIA MEDICAL ASSOCIATION
ALSO AND.
KATHY RAVEN FROM THE CALIFORNIA
STATE PTA STRONGLY IN SUPPORT OF
THIS.
WE ARE.
GOOD AFTERNOON MY NAME IS
SOMETHING HE AND I'M A STUDENT
AT SACRAMENTO STATE.
SEDITION HAVE TO WAIT UP TO TWO
TO THREE WEEKS. FOR THE NEXT
COUNSELOR ON TOP OF THAT FIFTEEN
OUT OF TWENTY THREE CSU CAMPUSES
ARE OVER THE CENTER COUNSELOR TO
STUDENT RATIO. ON MY CAMPUS
ALONE THERE'S ONLY THERE'S ONE
COUNSELOR FOR EVERY TWO THOUSAND
THREE HUNDRED STUDENTS BUT IS
COMPLETELY UNACCEPTABLE AND I
URGE YOU TO SUPPORT SB TEN ONE
ZERO ZERO FOUR. HE REACHES HAVE
NAMED POSITIONALLY PLEASE THANK
YOU.
WHEN EMISSIONS ON OURS AND I GO
TO CC CHICO STRONGLY IN SUPPORT
OF THIS BILL.
HI MY NAME IS RACHEL MORGAN I'M
FROM CSU CHICO AND I STRONGLY
SUPPORT THIS BILL.
THE ONE WITH THE CALIFORNIA
STATE STUDENT ASSOCIATION AND WE
STRONGLY SUPPORT THIS BILL.
AND YOUR TEAM IS CALIFORNIA
STATE UNIVERSITY OR.
BARBOUR GLASER WITH THE
CALIFORNIA HOSPITAL ASSOCIATION
AND STRONG SUPPORT.
LEXIE HOWARD ON BEHALF OF THE
JUVENILE COURT JUDGES OF
CALIFORNIA SECTION OF THE
CALIFORNIA JUDGES ASSOCIATION IN
STRONG SUPPORT.
YOUR MEMBERS TO MEN REPRESENT
THE CALIFORNIA CHAPTER OF THE
AMERICAN COLLEGE OF EMERGENCY
PHYSICIANS AND SUPPORT AND ALSO
ON BEHALF OF THE CALIFORNIA
ASSOCIATION OF VETERANS SERVICES
AGENCIES AND SUPPORT.
SARAH BENEDICT BORCHARD FOR THE
GREATER SACRAMENTO AREA CHAPTER
OF THE AMERICAN FOUNDATION FOR
SUICIDE PREVENTION AND WE
STRONGLY SUPPORT.
HER CHILD DISABILITY RIGHTS
CALIFORNIA WERE IN SUPPORT.
THANK YOU ANYONE IN OPPOSITION.
PLEASE COME UP HERE FRONT.
GOOD AFTERNOON CHAIRMAN AND
MEMBERS OF THE COMMITTEE THANK
YOU FOR HEARING MY TESTIMONY I
AM MARRIED THERE AT THE COUNTY
BEHAVIORAL HEALTH DIRECTORS
ASSOCIATION. AND WE MUST
RESPECTFULLY OPPOSE UNLESS
AMENDED THIS BILL BY SENATOR
WINNER WE APPRECIATE BOTH THE
AUTHOR AND THE SPONSORS.
ENGAGEMENT ON THE ISSUE WE'RE
TAKING IT VERY VERY SERIOUSLY.
THE MENTAL HEALTH SERVICES ACT
WE WANT TO POINT OUT HAS SAVED
LIVES AND HELPED MILLIONS OF
CALIFORNIANS. A CORNERSTONE OF
THOSE AFFECTED SERVICES ARE
THESE FUNDS THAT ARE IN
QUESTION.
AS REFLECTED IN THE COMMITTEE
ANALYSIS WE'RE VERY CONCERNED
ABOUT THE NARROW AREAS OF FOCUS
CONTAINED IN THIS BILL.
AS CURRENTLY WRITTEN IT WOULD
DENY PROGRAMMING TO COMMUNITIES
OF COLOR LGBT PEOPLE VETERANS
FOSTER YOUTH ADULTS AND OLDER
ADULTS SO WE WANT TO TAKE THIS
CHANGE VERY SERIOUSLY. IN
ADDITION WE HAVE CONCERN ABOUT
MOVING THIS LARGE AMOUNT OF
MONEY UNDER THE OVERSIGHT OF THE
OVERSIGHT AND ACCOUNTABILITY
COMMISSION WITH ISSUES WITH
DELAYING GETTING THAT FUNDING
OUT TO PEOPLE WHO ARE IN NEED.
THANK YOU.
ANYONE ELSE IN OPPOSITION FACING
HER MODEL REMCO THE RACIAL AND
ETHNIC MENTAL HEALTH DISPARITIES
COALITION RANKO DOES NOT HAVE AN
OFFICIAL POSITION ON THE BILL
BUT WE WANTED TO ACKNOWLEDGE THE
AUTHOR'S OFFICE AND SPONSORS.
SPENDING TIME WITH US SO THAT WE
CAN HOPEFULLY COME TO A
RESOLUTION ACCEPTABLE TO ALL
PARTIES. REMCO DOES REMAIN
CONCERNED ABOUT SOME OF THE SAME
ISSUES RAISED BY OTHER
STAKEHOLDERS STILL NEGOTIATING.
YESTERDAY WITH THE RELEASE OF
THE LONG AWAITED STRATEGIC PLAN
OF THE CALIFORNIA REDUCING
DISPARITIES PROJECT THE RDP. THE
RECOMMENDATIONS WITHIN THIS
REPORT WOULD SUPPORT INCREASING
P. E. I. PROGRAMS TO REDUCE
DISPARITIES FOR RACIAL ETHNIC
AND CULTURAL COMMUNITIES. WE
WANT TO MAKE SURE THIS HAPPENS
WE LOOK FORWARD TO CONTINUING TO
MEET WITH THE AUTHOR AND
SPONSORS. ON THIS BILL. VERY
MUCH.
SEEN ANY OTHER OPPOSITION.
QUESTIONS COMMENTS FOR MANY OF
THE MEMBERS.
WE HAVE NO QUESTIONS OR
COMMENTS.
WE'LL MOTION.
AS SOMEONE IS RIGHT. I I JUST
WANT TO MAKE A COMMENT I JUST
WANT TO THANK THE AUTHOR IN THE
JOINT AUTHOR. FOR THE BILL IT'S
ABOUT TIME AND I WANT TO THANK
THEM.
THE HONORABLE OF STEINBERG.
MAYOR OF MR PRO TEM. UM FOR
BRINGING THIS FORWARD AND WE
DEFINITE WE WE HAVE TO MOVE
FORWARD AND AND AND GET A
SOLUTION TO THIS IS THE RIGHT
DIRECTION SO I APPRECIATED.
WE HAVE A MOTION BY SIR LEAVE A
SINNER WINNER I WILL BE
SUPPORTING THE BILL I LIKE TO
ALSO JUST REITERATE WHAT CENTER
WIN SAID THANK BOTH THE. AUTHOR
AS WELL AS THE PRINCIPAL
PRINCIPAL COAUTHOR OR NOT JOIN
OTHER JOIN OTHER. ALSO.
I WANNA JUST PERSONALLY TAKE
SOME TIME TO THINK. BEAR
STEINBERG.
HUMAN HAIR GO WAY BACK HE'S A
GOOD FRIEND BUT I THINK WHAT I
WANT TO. EMPHASIZE IS HIS
PASSION FOR MENTAL HEALTH FOR
SETTING UP THE. FOUNDATION AND
ALL THE WORK THAT HE'S PUT INTO
IT. YOU KNOW I AM ASKED TO LOOK
PAST THE FACT THAT HE'S A HE'S A
GIANTS FAN. YOU KNOW.
BUT I I REALLY RESPECT THE WORK
THAT YOU'VE DONE AND I WANT TO
THANK YOU FOR THAT SO. WITH THAT
WOULD YOU LIKE TO CLOSE.
THANK YOU AND I WILL I WILL
MENTION NADA MIGHT KNOW WHERE
YOU COME FROM.
BUT AS FOR THE BILL ANYWAY.
YEAH.
BUT I I DO I WANT TO THANK THE
MEMBERS FOR THE.
FOR THESPORT OF COMMENTS WE
WILL OF COURSE CONTINUE TO WORK.
WITH THE FOLKS WHO HAVE. SOME
CONCERNS AND WE ARE AWAITING
SOME SPECIFIC IDEAS OFFER
AMENDMENTS CITING THE BILL THE
WAY IT'S DRAFTED NOW IS VERY
BROAD.
WE WILL ABSOLUTELY NOT
UNDERMINE. OUR IMPORT OUTREACH
EFFORTS IN MY OWN COMMUNITY LGBT
COMMUNITY COMMUNITIES OF COLOR
AND SO FORTH.
AND PARTICULARLY YOUNG PEOPLE
ON THE OTHER ALL BACKGROUNDS ARE
SUFFERING RIGHT NOW.
INCLUDING LOW INCOME YOUNG
PEOPLE. YOUNG PEOPLE WHO ARE
LGBT YOUNG PEOPLE OF COLOR
EVERYONE.
IS IS REALLY STRUGGLING AND
THIS BILL WILL HELP AND SO I
RESPECTFULLY ASK FOR MY VOTE.
INTO WE HAVE ON ITEM NUMBER TWO
SP ONE ZERO ZERO FOUR TWO PASSES
AMENDED TO APPROPRIATIONS CALLED
MEMBERS PLEASE.
AND AS I CAN AND AS I WHEN. WHEN
I LLEVA.
I MITCHELL. MOANING NEWMAN.
NEWMAN I NIELSEN.
I HAVE BILLS AND I. CAN BROUGHT.
CURRENTLY HAS FIVE THAT'S ENOUGH
TO GET OUT OF THE ROOM PLEASE
THE BILL AND CALL. WE'VE GOT
SOME APPS MEMBERS SO THANK YOU
VERY MUCH LIKE YOUR COLLEAGUES I
THOUGHT I SAW SENATOR BRADFORD
IS HE HERE STILL ALL THERE IS.
WE'RE GONNA GO ON TO ITEM NUMBER
FOUR SP ONE TWO SIX EIGHT
BRADFORD ADDICTION TREATMENT
REFERRALS PAYMENT.
SENATOR WELCOME.
WE DO HAVE SUPPORT ON BOTH
SIDES.
BEFORE WE GET STARTED I JUST
WANT TO GIVE A SHOUT OUT I
BELIEVE THERE'S SOME CSU
STUDENTS ON THE AUDIENCE IS THAT
CORRECT.
I'VE HAD THE OPPORTUNITY
SPEAKING THIS MORNING WELCOME
AND.
ENJOY YOURSELVES ANYWAY CENTERS
WELCOME. THANK YOU MISTER
CHAIRMAN AND MEMBERS I'M HERE TO
PRESENT SP TWELVE SIXTY EIGHT
WHICH PROHIBITS PATE PATIENT
BROKERING ALCOHOL AND DRUG
ADDICTION TREATMENT CENTERS. I
WILL BE ACCEPTING THE COMMITTEES
AMENDMENTS WHICH ARE ARE
CLARIFYING THE NATURE AND KEEP
THE LANGUAGE IN THIS BILL
CONSISTENT SITE THANK YOU FOR
ALL YOUR WORK ON THIS. SP TWELVE
SIXTY EIGHT ADDRESSES THE
DISCUSSING PRACTICE OF PATIENT
BROKERING. PATIENT BROKERING OR
BODY BROKERING A SETBACK ROOF
REFERRING PATIENTS TO ADDICTION
TREATMENT FACILITIES ARE
RECEIVING COMPENSATION FOR THAT
REFERRAL SPECIFICALLY SP TWELVE
SIXTY EIGHT WOULD MAKE THE ACT A
MISDEMEANOR PUNISHABLE BY TWENTY
FIVE HUNDRED DOLLAR FINE.
CURRENT LAW DOES NOT PROHIBIT
THE PRACTICE OF SELLING PATIENTS
TO TREATMENT CENTERS THAT PASS
KICKBACKS TO REFERRAL AGENCY
PATIENT BROKERING. BROKERS I
SHOULD SAY ARE NOT.
CRY TO A CREDENTIALED
PROFESSIONALS AND MAY HAVE
LITTLE TO NO COMPENSATION
IDENTIFYING AND ASSESSING
ADDICTION NEEDS UNSCRUPULOUS
INDIVIDUALS SOME
PROGRAM TO TAKE ADVANTAGE OF ONE
OF THE POPULATION. AS A RESULT
REFERRALS ARE CALMLY CALMLY
BASED ON SOLELY UPON FINANCIAL
INCENTIVES RATHER THAN
INDIVIDUALS HEALTH AND WELL
BEING. ACTIONS ARE ALREADY BEEN.
TAKEN IN OTHER STATES TO
PROHIBIT PATIENT BREAK ROKERING
BLACKSHEAR FLOW FLORIDA DECLARED
PEACE IN BROKERING A LEGAL
MAKING IT A THIRD DEGREE FELONY
TO OFFER FINANCIAL INCENTIVES.
FOR REFERRAL OF PATIENTS THIS
REFERRAL PAYMENTS ARE COMMONLY
USED BY BROKERS TO ADDICT OTHER
AT RISK INDIVIDUALS AND EVEN
READ IT DIRECT PREVIOUS TREATED
PATIENTS. THIS CREATES A CYCLE
OF ADDICTION FOR PROFIT THAT
CONTINUES UNTIL THE PATIENT
USUALLY DIE. CAST BE TWELVE
SIXTY PUTS IT INTO THESE
PRACTICES AND AUTHORIZES THE
DEPARTMENT OF HEALTH AND.
SERVICES TO INVESTIGATE AND TAKE
ACTIONS AGAINST THOSE PERSON FOR
PROGRAMS THAT ENGAGE IN THIS
HORRIBLE PRACTICE. AND IN THIS
ABUSE. WELL WITH ME HERE TODAY
IS DANIELLE OFF FORMS WERE
STRONG DIRECTOR OF UTILIZATION
REVIEW AND RISK MANAGEMENT
REPRESENTING SOBER LIVING BY THE
SEA AND A CHARADE DAILY SENIOR
GOVERNMENT AFFAIRS DIRECTOR FOR
THE CALIFORNIA CONSORTIUM.
DICTION PROGRAM TO PROFESSIONALS
THEY'LL BE HERE ANSWERING OF THE
TACTICAL QUESTIONS IN ON THAT
MEMBERS ARE RESPECTFULLY ASK FOR
YOUR VOTE THANK ANYONE LIKE TO
SPEAK IN SUPPORT OF THE MEASURE.
SHAWN FLANAGAN ON BEHALF OF
AMERICAN ADDICTION CENTERS
INSTRUCTS SUPPORT WHEN I THINK
THE AUTHOR IN THE COMMITTEE AND
THE STAFF FOR ALL OUR WORK IN
THIS BILL. THANK YOU ANYONE
ELSE.
HONORABLE CHAIRMAN MEMBERS MY
NAME IS DANIEL FOR INTEREST I'M.
I'M THE DIRECTOR OF UTILIZATION
REVIEW AND RISK MANAGEMENT FOR
SUPPER LIVING BY THE SEA
INCORPORATED A RESIDENTIAL
TREATMENT CENTER THAT WAS
FOUNDED OVER THIRTY YEARS AGO.
I'VE WORKED IN ADDICTION
TREATMENT FOR OVER FIFTEEN YEARS
AND I HAVE A DAUGHTER IN
RECOVERY AND I LIVE IN A
COMMUNITY THAT IS AFFECTED BY IT
PATIENT BROKERING. THE
PREVALENCE OF PATIENT BROKERING
ISN'T EXAGGERATED BY THE MEDIA
THEY'RE JUST REPORTING THE
FACTS.
VISION BROKERING IS THE PRIMARY
MARKETING STRATEGY FOR SOME
TREATMENT PROVIDERS. AND IT
OFTEN INCLUDES SENDING IMPATIENT
SENDING PATIENTS AND OTHER
TREATMENT CENTERS PAYING THEM TO
RECRUIT. PATIENTS ABOUT
TREATMENTS THAT ARE TO COME THEN
TO THEIR OWN TREATMENT CENTER.
FACEBOOK BUT FAKES BOOK GROUPS
ARE TARGETED AT BY THOSE
TROLLING TO ASSIST. OTHER PEOPLE
WANTING TO COME INTO TREATMENT.
TWELVE STEP MEETINGS HAVE BECOME
A MAGNET FOR REFERENCE
SOLICITING PATIENTS TO COME TO
THEIR TREATMENT CENTER WITH
LOADED HYPODERMIC NEEDLES. IN
THEIR VEHICLE TO HELP WITH THE
INDUCEMENT.
OF WHEN INSURANCE PUSHES FOR A
STEP DOWN A LEVEL OF CARE
FRIENDS OFTEN WILL TAKE PATIENTS
AWAY HAVE THEM RELAPSE AND THEN
GET PAID AGAIN WHEN THE PATIENT
RE ADMITS.
PATIENTS QUICKLY CATCH ON AND
THEY BECOME STUCK IN THE CYCLE
AS WELL THEY POST ADS ON
CRAIGSLIST. FACEBOOK OFFERING.
FREE FLIGHTS. AND.
.
AND PAYMENT FOR COMING INTO
TREATMENT.
WHEN QUESTIONED ABOUT PAYING FOR
REFERRALS TO MANY TREATMENT
OPERATORS FLIPPANTLY RATIONALIZE
THAT EVERYONE'S DOING IT AND
IT'S WHAT THEY HAVE TO DO TO
STAY VIABLE IN THE MARKETPLACE.
NOW WE'RE IN A CRISIS DRIVEN
INDUSTRY NO ONE COMES SKIPPING
INTO TREATMENT NO ONE DECIDES
THAT THEY'RE GONNA PUT
THEMSELVES FROM THEIR HOUSE
THEIR JOB THEIR FAMILY UNLESS
THERE'S A MAJOR PROBLEM.
I CAN'T IMAGINE HEARING THAT MY
DAUGHTER'S LIFE WAS BOUGHT AND
SOLD TO THE HIGHEST BIDDER.
AND.
THE ISSUE IS IT AS HORRIFYING AS
THAT MAY SEEM.
FAMILIES WILL STILL DO IT
THEY'RE THAT DESPERATE TO GET
THEIR CHILD HELP ON THERE SO
VULNERABLE AND THAT'S THE REASON
WHY WE HAVE TO ACT NOW TO
PROTECT THEM FROM EXPLOITATION.
OF THE NEGATIVE CONSEQUENCES OF
HAITIAN BROKERING ARE SPILLING
INTO OUR COMMUNITIES PATIENTS NO
LONGER MEETING MEDICAL NECESSITY
CRITERIA THEY'RE DISCHARGED
POLICY PREMIUMS STOP GETTING
PAIN. RETURN FLIGHTS AREN'T MADE
ALL THESE FACTORS CONTRIBUTE TO
CURBING OPEN DRUG USE PATIENTS
USING DRUGS THE NEIGHBOR'S
BACKYARD I PERSONALLY LIVING
BECAUSE THE MESA. AND I FOUND
LOADED NEEDLES AND HALF EMPTY
VODKA BOTTLES IN MY YARD.
RECOVERY FROM A CHRONIC
PROGRESSIVE AND FATAL DISEASE
SUCH AS ADDICTION IS AMAZING TO
WITNESS. THE SACRED PROCESS AND
IT'S OUR MORAL AND ETHICAL
OBLIGATION TO PROTECT THOSE
SUFFERING FROM ADDICTION AGAINST
THE VULTURES SEEKING TO EXPLOIT
THEM.
IT'S OUR OBLIGATION TO OUR
COMMUNITIES AS WELL ABOVE ALL WE
NEED TO REMEMBER WE'RE NOT
SELLING HAIR DRYERS HERE WITH
THESE ARE HUMAN BEINGS.
THINK ANYONE ELSE PLEASE PRESENT
HIGH ARBEL CHAIR MEMBERS SHARE
DAILY WITH THE CALIFORNIA
CONSORTIUM ADDICTION PROGRAM
SOME PROFESSIONALS REPRESENTING
OVER FIVE HUNDRED TREATMENT
PROGRAMS. AND RECOVERY RESIDENTS
OF THE STATE AS WELL AS TWENTY
THOUSAND COUNSELORS WHO WORK THE
DICTION FIELD. I WANT TO THANK
THE CHAIR AND HIS STAFF AND
MEMBERS FOR THE. INTERIM
COMMITTEE HEARING OR THE EARLIER
COMMITTEE HEARING WE HAD THIS
YEAR IT WAS GREAT TO BRING ALL
THESE ISSUES TO THE TABLE WANT
TO THANK THE AUTHOR FOR CARRYING
THE BILL. AND JUST TO POINT OUT
THAT THIS BILL IS IS NARROWLY
FOCUSED ON WHAT WILL WORK BEST
WHEN IT A AND AN OWNER OPERATOR
OR PROFESSIONAL FACES THE
POSSIBILITY OF LOSING THEIR
LICENSE IN THERE FOR THEIR
ABILITY TO CONTINUE DOING
BUSINESS. OR TO TREAT PEOPLE THE
THE.
INCENTIVE NOT TO CONTINUE THIS
BEHAVIOR WILL BE A GREATER THAN
ANY FINE COULD EVER BE SO WE
APPRECIATE THE AUTHOR CARRYING
THIS WE THINK IT IS A GOOD
SOLUTION. AN URGENT ABOUT. THANK
YOU ANYONE ELSE SO PLEASE STATE
YOUR NAME AND POSITION.
I ALSO KNOW A PRESIDENT OF THE
CALIFORNIA ASSOCIATION OF
ALCOHOL AND DRUG PROGRAM
EXECUTIVES A LARGE STATEWIDE
ORGANIZATION. HERE TO SPEAK IN
SUPPORT OF TWELVE SIXTY EIGHT
IT'S LONG OVERDUE. THE PROVIDERS
THAT ENGAGE IN THIS BROKERING.
ACTIVITY GIVE THE ENTIRE FIELD
A BAD NAME. VERY MUCH FOR.
TOM RAN FREE WITH FEET
CALIFORNIA BEHAVIORAL HEALTH
DIRECTORS ASSOCIATION ARE IN
SUPPORT.
THANK YOU.
GREGORI PRIVATE CITIZEN AND
CERTIFIED SUBSTANCE ABUSE
COUNSELOR AND STRONG SUPPORT.
MICHAEL PRITCHARD EMMA STAFF
ANALYSTS AN STD SERVICES IN THE
CENTRAL VALLEY AND. MY STRONG
SUPPORT.
THE NELSON WITH CALIFORNIA
CONSORTIUM ADDICTS PROGRAMS
PROFESSIONALS AND SUPPORT. THANK
YOU VERY MUCH IS THERE ANY
OPPOSITION FOLKS SORRY SUPPORT
OF DRONE WE HAVE THE NATIONAL
UNION OF HEALTHCARE WORKERS IN
EGYPT'S TREATMENT CENTERS AND
SUPPORT THANK YOU VERY MUCH ANY
OPPOSITION TO THE MEASURE.
QUESTIONS COMMENTS OR MANY OF
THE MEMBERS.
WE HAVE SUPPORT ON BOTH SIDES
SIDE OBVIOUSLY WILL BE
SUPPORTING THE BILL WANT TO
THANK YOU FOR BRINGING IT
FORWARD TO SINCE. I WAS IN THAT
CELL NEEDED TO BE TO HAPPEN WE
HAD A SIGNIFICANT HERE AND I
KNOW YOU'RE IN THE AUDIENCE AND
I BELIEVE EUROPE IN THE DEAD. OF
WINTER IN THE DAY AS AN OUT OF
THE OVERALL INDUSTRY AS A WHOLE.
BUT IS OUR MOTION.
SOME OF MY CENTER LABOR AND
CENTER WOULD YOU LIKE TO CLOSE
UP THANK YOU MEMBERS AND I WANT
TO THANK MY WITNESSES AS WELL.
.
THIS ISSUE OF PATIENT PROGRAM IS
NOT UNIQUE TO CALIFORNIA IS
SOMETHING THAT HAS GROWN OVER
THE LAST TEN TO FIFTEEN YEARS AS
YOU KNOW THERE'S BEEN A WAR ON
DRUGS ORAL LOTS FORTY YEARS BUT
NOW THAT. THE DIRECTIONS OF
CHANGE FROM CRACK COCAINE TO
OPIOID TO I'M GLAD WE'RE NOW
FOCUSING ON TREATMENT VERSUS.
INCARCERATION BUT TREATMENT
FACILITIES HAVE TO BE FAIR THEY
pTO BE. COMMITTED TO HELPING
INDIVIDUALS THAT HAVE A
PROFITEERING OFF OF THAT AND ON
THAT NOTE NOTION I RESPECTFULLY
ASK FOR A VOTE. YOUR IT ITEM
NUMBER FOUR SP ONE TWO SIX EIGHT
TWO PASSES AMENDED
APPROPRIATIONS CALL THE MEMBERS
PLEASE. HERNANDEZ HIGH AND AS I
WENT. WHEN I LABOR. LABOR I
MITCHELL. MINING NEWMAN. NEWMAN
I NIELSEN I USE IN MY HAND
BROTH.
EARLYAS FIVE THAT'S ENOUGH TO
GET OUT WE'RE GONNA PLAY SAID
BILL AND CALL WE HAVE SOME MAPS
OF MEMBERS. THANK YOU I BELIEVE.
MISTER.
THERE YOU ARE.
WHERE AN ITEM NUMBER SIX SP ONE
THREE THREE SIX MORALE? PUBLIC
HEALTH IN THE LIGHT OPTION ACT.
YEAH. BEFORE WE. KEVIN WHO HAVE
YOU COME UP WE'RE GONNA GO AHEAD
AND DO THE CONSENT CALENDAR ITEM
NUMBER SEVEN IS OUR MOTION.
SOME OF MY CENTER LABOR THIS IS.
SP ONE FOUR FIVE SEVEN TO PASS
APPROPRIATIONS WITH A
RECOMMENDATION.
TO THE CONSENT CALENDAR CALL THE
MEMBERS PLEASE FERNANDEZ I AND
AS I WHEN. WHEN I LABOR. LABOR I
MITCHELL MINING NEWMAN. NEWMAN I
NIELSEN. MEALS AND I CAN ROCK.
THE US FIVE ZERO REPLACEABLE AND
CALL WE'RE BACK TO ITEM NUMBER
SIX SP ONE THREE THREE SIX
MORALE PUBLIC HEALTH IN THE LIFE
OPTIONS PLEASE PROCEED.
I HAVE A GOOD AFTERNOON MISTER
CHAIR AND MEMBERS.
WOULD LIKE TO THANK THE
COMMITTEE CONSULTANT FOR THE
THOROUGH ANALYSIS.
SP. THIRTEEN THIRTY SIX WOULD
IMPROVE THE QUALITY OF DATA.
COLLECTED.
AND PUBLISHED RELATING TO THE
IMPLEMENTATION. OF THE END OF
LIFE. OPTION. ACT OF TWO
THOUSAND AND FIFTEEN.
BOB PLEASE HEAR THIS.
NEXT SENTENCE CLEARLY THIS BILL
IS IN NO WAY.
ADD ANY ADDITIONAL BARRIERS FOR
PATIENTS. AGAIN THIS BILL IN NO
WAY ADDS ANY ADDITIONAL BARRIER.
AREAS FOR PATIENTS. SEEKING AID
IN DYING PRESCRIPTION. IN FACT
THIS BILL DOES NOT REQUIRE ANY
ADDITIONAL INFORMATION. FROM THE
PATIENT AT ALL.
REALLY REQUIRES TWO PIECES OF
INFORMATION. THAT ARE ALREADY
COLLECTED.
UNDER CURRENT LAW.
WHICH WILL ACTUALLY BE INCLUDED
THEN IN THE CALIFORNIA
DEPARTMENT. OF PUBLIC HEALTH AND
YOUR REPORT AND HEAR THOSE TWO.
PEACE IS THE FIRST.
A NUMBER OF PATIENTS THAT WERE
REFERRED FOR A MENTAL HEALTH
SPECIALIST. ASSESSMENT PRIOR TO
RECEIVING THE AID. IN DYING
DRUG.
AND SECOND OF ALL.
AND THERE'S ACTUALLY TWO PARTS
TO THIS AND THAT'S THE PATIENT'S
MOTIVATED IN MOTIVATING REASONS
FOR REQUIRE NO DRUGS. AND SO THE
ONLY ADDITION TO THAT THEN OF
COURSE IS ASKED BY HIS ASSET
PHYSICIANS AND NOT PATIENCE.
THAT WHAT IS THE POSITIONS AREA.
BUT PRACTICE.
IN ACCORDANCE WITH CURRENT LAW
THIS BILL WOULD CONTINUE TO
ENSURE THE PROTECTIONS OF
PATIENCE PRIVATE INFORMATION SO
AGAIN.
THEIR PRIVATE INFORMATION.
WILL BE PROTECTED PERIOD. WE
HAVE ALREADY BEEN PROVIDED.
THE CALIFORNIA DEPARTMENT OF
PUBLIC HEALTH AND REPORT THEN IT
IS CLEAR. THAT IMPORTANT DATA IS
SIGNIFICANTLY LACKING.
IMPROVING OUR UNDERSTANDING OF
SUCH AN IMPORTANT LAW IS
ESSENTIAL TO RESPONSIBLE.
IMPLEMENTATION.
SP THIRTEEN THIRTY SIX IS A
VERY SMALL STEP.
VERY SMALL TO IMPROVING OUR
UNDERSTANDING OF THE END OF LIFE
OX OPTION ACT. COLLECTING
INFORMATION RESPONSIBLY.
WILL HELP POLICY MAKERS
RESEARCHERS AND METAL MEDICAL
COMMUNITY ACCESS IS. THE CURRENT
STATE OF LAW. MY OFFICES WERE
DILIGENTLY WITH THE STAKE
HOLDERS WHO CAME FORWARD. AND WE
TOOK THEIR SUGGESTED AMENDMENTS.
THIS HAS SIGNIFICANTLY NARROWED
THE SCOPE OF THE BILL.
WHILE ALSO IMPROVING THE
PUBLIC'S UNDERSTANDING. OF THE
ACT LET ME REITERATE THIS BILL
DOES NOT REQUIRE ANYTHING NEW.
OF THE PATIENT IN ONLY SIX TO
REPORT DATA. RESPONSIBLY. AN
INNOVATOR VERY NEAR AWAY WE
SHOULD ASK OURSELVES WHY SHOULD
THIS INFORMATION CONTINUES TO GO
ON REPORTED.
AND IS THERE ANYTHING TO HIDE.
ISN'T MORE INFORMATION ALWAYS ON
HOW THIS LAW. IS WORKING TO GET
BETTER FOR ALL STAKEHOLDERS
GOING FORWARD.
WITH ME TODAY ARE QUESTIONS IS
DAVID. MAJOR AN ATTORNEY. AND
WITH HIM AS PAUL RAMSEY.
URBAN WELL I'M SORRY DAVIS WITH
THE POWER RAMSAY INSTITUTE IN
THE CALL SHOULD RELY.
WHO IS A HOSPITAL ARM HOSPICE
AND PALLIATIVE? MEDICAL
POSITION.
SO THANK YOU VERY MUCH AND.
MISTER DAVID MAJOR IF HE'D LIKE
TO.
SHARE THANK YOU VERY MUCH.
WELCOMING PLEASE PROCEED.
THEN GENERATE GOOD AFTERNOON
SENATORS AND MY NAME IS DAVID
MAJOR I'M AN ATTORNEY
BIOETHICISTS AND FELLOW WITH THE
PAUL RAMSEY INSTITUTE. I'M HERE
TO SPEAK ON BEHALF OF SB
THIRTEEN THIRTY SIX AND MODEST
PUBLIC HEALTH MEASURE TO ALLOW
HEALTH RESEARCHERS IN THE PUBLIC
THE OPPORTUNITY TO BETTER
UNDERSTAND CALIFORNIA
EXPERIENCE.
WITH THE PRESCRIPTION OF
INTENTIONAL LIFE ENDING DRUGS OR
BILL PATIENTS. WILL SHED SOME
LIGHT ALLOWING THE CALIFORNIA
PART OF PUBLIC HEALTH TO
DISCLOSE. BASIC ANONYMIZED AN
AGGREGATED INFORMATION WHAT
COMPLETELY RESPECTING PATIENT
PRIVACY AND CONFIDENTIALITY.
THIS REASONABLE NON INTRUSIVE
APPROACH TO RECEIVE BIPARTISAN
SUPPORT REGARDLESS OF ONE'S
VIEWS ON THE PRACTICE. IF WE ALL
AGREE THAT APPLICATIONS CURATIVE
IN PALLIATIVE CARE IS ALWAYS
PRESERVE THE PREFERRED RESPONSE
FOR PATIENTS IT'S VITAL THAT
RESEARCHERS GET THE INFORMATION
WHICH MIGHT REVEAL TREND SHOWING
UNMET NEEDS WHETHER IT BE GOOD
MENTAL HEALTH CARE PALLIATIVE
CARE. ARE STRONGER SOCIAL
SUPPORTS THESE MAY VERY WELL BE
ANSWERS TO LIFE OR DEATH
QUESTIONS.
THE USER TRIED METHOD FOLLOWED
BY FALLING ORGAN WASHING HIS
APPROACH AND DATA REPORTING. YOU
CAN SEE HOW THOSE STATES REPORT
OUTPATIENT MOTIVATION MENTAL
HEALTH REFERRAL AND EVEN SOME
THINGS THAT HAVE BEEN REMOVED SB
THIRTEEN THIRTY SIX LIKE THE
DURATION OF THE PATIENT
PHYSICIAN RELATIONSHIP. THERE IS
NO CLEAR REASON MY CALIFORNIA
SHOULD BE THE ANOMALY AND IGNORE
THESE IMPORTANT QUESTIONS NOR IS
THERE ANY EVIDENCE THAT THE
COLLECTING THIS PUBLIC HEALTH
INFORMATION CREATES A BARRIER TO
ACCESS.
I'D IKE TO UNDERSCORE HOW SB
THIRTEEN THIRTY SIX CANNOT BE
SEEN AS A BURDEN TO PATIENTS IS
PHYSICIAN REPORTED AND AT LEAST
IN THE CASE OF THE MOTIVATION
FORM. REMOTE MOTIVATION
INFORMATION THAT FORM IS
SUBMITTED AFTER THE PATIENTS
ALREADY DIED. THAT DOCTORS DON'T
HAVE AN INKLING OF WHY THEIR
PATIENTS WANT IT LIKE MANY DRUGS
THAT'S A PROBLEM. A RECENT
TESTIMONY IN JANUARY.
DEMONSTRATED THAT THOSE SEEKING
A PHYSICIAN ASSISTED SUICIDE ARE
MAKING A DIFFERENCE IN REQUESTS
FOR HELP THAT MUST BE FURTHER
UNPACKED. AND MY COLLEAGUE DR
CHARLOTTE AS A A PALETTE OF
EXPERT AND WE'LL HAVE MORE TO
SAY ABOUT THAT. AND I CAN GO ON
TO TELL YOU ABOUT HOW THE BILL
WILL HELP US LEARN WHETHER
DOCTORS TRAINING EXPERTISE IS
SUITED THE PATIENT'S UNDERLYING
ILLNESS OR PALLIATIVE NEEDS. IT
WOULD HELP US UNDERSTAND HOW
MANY HEALTH MENTAL HEALTH
REFERRALS ARE BEING MADE TO RULE
OUT TREATABLE ISSUES WITH THE
HELP OF MENTAL HEALTH
SPECIALISTS. IF ANYTHING IS
BEING THIRTEEN THIRTY SIX IS TOO
MINIMALISTIC. A RESEARCHER WOULD
ALSO WANT TO KNOW WHICH KIND OF
TREATMENTS WERE BEING USED TO
IMPROVEMENT PALACE IN THE
APPLICATION PACKET OF CARE CAN
BE DISCERNED. MORE DETAILED
QUESTIONS WOULD BE HELPFUL TO BE
GLAD TO GIVE YOU SOME
SUGGESTIONS ABOUT THAT. BUT.
END WITH REGARD TO THE RECENT
AMENDMENTS AND.
BUT I CAN SAY THAT FOR DATA
ACCURACY IT BEST IF WE HAD.
INFORMATION RECORD BY BY
PATIENTS AS WELL.
BUT THERE ARE CONCERNS OF OTHER
STAKEHOLDERS WE UNDERSTAND THAT.
I WOULD LIKE TO POINT OUT THAT
THERE IS A RISK OF UNDER
REPORTING THE DEATH PART IN A
PUBLIC HEALTH DID NOT RECEIVE A
SIGNIFICANT NUMBER OF THESE
FORMS.
FOR CUTTINGS ABOUT THIRTY
PERCENT OF CALIFORNIA TO
PRESCRIBE LETHAL DRUGS IN RECENT
TESTIMONY ABOUT INCOMPLETENESS
OF POSITION.
A REPORTS COMING OUT OF THE
PRIVATE PUBLIC HEALTH AND IT'S
BEEN TESTIFIED TO IN FRONT OF. A
OF A.
A MEETING OF OF THIS
LEGISLATURE I'M ON THIS POINT
OVER ALL I WOULD LIKE TO ECHO A
RECENT CALL MADE IN THAT
HEARING.
FOR BETTER DATA AND MORE
TRANSPARENCY.
NEVERTHELESS AS BEING THIRTEEN
THIRTY SIX IS AN IMPORTANT PIECE
OF THE PUZZLE FOR UNDERSTANDING
THE PRESCRIPTION OF
INTENTIONALLY LIFE ANY DRUGS IN
CALIFORNIA. IS JUST GOOD PUBLIC
HEALTH IS A LITTLE MORE LIGHT
WHICH WHICH SHOULD BE WELCOMED
BY ALL. THANK YOU.
THANK YOU ANYONE ELSE AND
SUPPORT PROCEDURE NAME. YES MY
NAME'S NO CULTURAL A I'M A
HOSPICE AND PALLIATIVE
PHYSICIAN.
THANK YOU SUFFERING NEAR THE END
OF LIFE MAY ARISE FROM MANY
SOURCES INCLUDING LOSS OF SENSE
OF SELF. LOSS OF CONTROL FEAR OF
THE FUTURE AND OUR FEAR OF BEING
A BURDEN UPON OTHERS. AS WELL AS
REFRACTORY PHYSICAL AND NON
PHYSICAL SYMPTOMS.
MY WORK IN PALLIATIVE CARE
INCLUDING HOSPICE IS TO RELIEVE
SUFFERING AND TO ENHANCE QUALITY
OF LIFE FOR PEOPLE WITH SERIOUS
INCLUDING TERMINAL ILLNESS.
THE ENTERING THE ENDING OF
SUFFERING BY ENDING LIFE HAS
BEEN HELD AS DISTINCT FROM
PALLIATIVE CARE WHICH RELIEVE
SUFFERING WITHOUT INTENTIONALLY
HASTENING DEATH.
MORE BROADLY INTENTIONALLY
HASTENING DEATH HAS HISTORICALLY
NOT BEEN WITHIN THE DOMAIN OF
STANDARD MEDICAL PRACTICE.
THE AMERICAN ACADEMY OF HOSPICE
AND PALLIATIVE MEDICINE POSITION
STATEMENT ON THIS PRACTICE HAS
NOTED THAT SUCH A CHANGE RISKS
UNINTENDED LONG RANGE
CONSEQUENCES. THAT MAY NOT YET
BE DISCERNIBLE INCLUDING A FAX
ON THE RELATIONSHIP BETWEEN
MEDICINE AND SOCIETY. THE
PATIENT AND PHYSICIAN AND THE
PERCEIVED AND OR ACTUAL
INTEGRITY OF THE MEDICAL
PROFESSION.
ANY STATUTES LEGALIZING THIS
PRACTICE AND RELATED REGULATIONS
MUST INCLUDE SAFEGUARDS TO
APPROPRIATELY ADDRESS THESE
CONCERNS.
SAFEGUARDS ARE INFORMED BY DATA.
ON THE INDIVIDUAL LEVEL THE
INITIAL RESPONSE OF PROVIDERS
SUCH AS MYSELF TO REQUEST FOR
HASTEN DEATH. OUR BEST APPROACH
SYSTEMATICALLY INCLUDING
DETERMINING THE NATURE OF THE
REQUEST CLARIFYING THE CAUSES OF
SUFFERING AND EXPLORING
EMOTIONAL SUCH AND SITUATIONAL
FACTORS THAT MAY BE. UNDERLYING.
ONE PATIENT I REMEMBER
DISTINCTLY FIRST SPOKE ABOUT. IT
TO ME ABOUT HIS WORRIES OF
PAYING.
AND ULTIMATELY ALSO DISCLOSED
THAT HE HAD A LARGE LIFE
INSURANCE POLICY EXPIRING ON A
CERTAIN DATE AND WAS CONSIDERING
THE END OF LIFE OPTION. IN ORDER
TO LEAVE THIS MONEY BEHIND HIS
FAMILY.
ANOTHER MAN SHARED WORRY TO
BURDEN HIS WIFE DUE TO HIS
PROGRESSIVE LOSS OF FUNCTION
WITH HIS TERMINAL CONDITION.
AS WE SPOKE AT LENGTH TOGETHER
ABOUT HOSPICE AND PALLIATIVE
CARE SERVICES. IS AVAILABLE AT
ONE POINT HIS WIFE BEGAN CRYING
AND SAID. THIS WAS EXACTLY WHAT
I WAS HOPING TO HEAR WOULD BE
AVAILABLE. AND SAID HER HUSBAND
I DON'T WANT YOU TO DO THIS AND
THE THOUGHT OF IT IS ALREADY
CAUSING ME TO STRESS.
NEITHER MAY BE DIFFERENT. THAN
WHAT YOU MAY HAVE HEARD ABOUT
THIS PRACTICE ALL THE FORMULAS
FIRE. THERE FACTS THAT NEED TO
BE EXPLORED HEARD AND BETTER
UNDERSTOOD.
BETTER DATA THROUGH SP THIRTEEN
THIRTY SIX I BELIEVE COULD
ALLOW.
THE PALETTE OF CARE IN THE
MEDICAL COMMUNITY IS THE
OPPORTUNITY TO BETTER UNDERSTAND
THE NEEDS AND THE CONCERNS OF
THE PATIENTS IN THE COMMUNITIES
THAT WE SERVE THANK YOU.
ANYONE ELSE IN SUPPORT.
YOU KNOW OTHERS SENSIBLE. SORRY
INTO.
AFTERNOON BLESSED SHEPHERD
REPRESENTING THE ALLIANCE OF
CATHOLIC HEALTHCARE THE
ASSOCIATION OF NORTHERN
CALIFORNIA ONCOLOGISTS AND A
MEDICAL ASSOCIATION. OF SOUTHERN
CALIFORNIA IN SUPPORT. THANK YOU
IS THERE ANY OPPOSITION TO THE
MEASURE.
HELLO MY NAME IS ERICA RUIZ ON
THE PUBLIC OUTREACH MANAGER FOR
COMPASSION AND YOU IF YOU WANT
WE CAN HAVE. IF THERE'S
INDIVIDUALS WANT TO MAKE A
STATEMENT WILL ALLOW THE SAME
AMOUNT OF TIME FOR THE
OPPOSITION IN SUPPORT OF YOUR
INCOME UP HERE.
HIS FOOT DOWN WHEN YOU COME OVER
HERE.
TELL HER NOT TO LEAVE.
AND JUST.
OVER THERE. IS.
THANK YOU WELCOME AND PLEASE
PROCEED.
THANK YOU.
NUMBER.
YEAH OFTEN PROGRAM INSTRUCTOR
FOR COMPASSIONATE CHOICE AS THE
NATION'S OLDEST AND LARGEST NON
PROFIT ORGANIZATION WITH WORKING
TO IMPROVE CARE. AND THE QUALITY
OF END OF LIFE FOR TERMINALLY
ILL PATIENTS. WE AFFIRM
LEGISLATION WHICH DETERMINES
PATIENTS RIGHTS. TO CHOOSE THEIR
OWN MEDICAL TREATMENT OPTIONS AS
THEY. AS THEY NEAR THE END OF
LIFE TODAY WE'RE HERE TO EXPRESS
OUR STRONG OPPOSITION TO SB ONE
THREE THREE SIX.
IT'S ABOUT TO BE ONE THREE THREE
SIX JUST ATTEMPTED TO RELITIGATE
THE ORIGINAL BILL FRIEL. WE'RE
HERE TODAY TO TALK DIRECTLY
ABOUT ONE THREE THREE SIX NOT
THE END OF LIFE CARE OPTIONS ACT
IN ANOTHER ITSELF.
WE FEEL WE FAIL TO SEE HOW THIS
BILL IS GOING TO IMPROVE CARE.
THE CALIFORNIA AND OF LIFE
OPTIONS ACT ACTUALLY WENT INTO
EFFECT ON JUNE NINETEENTH TWO
THOUSAND AND SIXTEEN IT
AUTHORIZES THE RIGHT FOR
MENTALLY CAPABLE TERMINALLY ILL
ADULTS. TO REQUESTS FROM THEIR
PHYSICIAN A PRESCRIPTION FOR AID
IN DYING MEDICATION TO SELF
ADMINISTER IF THEY'RE SUFFERING
BECOMES UNBEARABLE. THE LOT IS
WORKING AS INTENDED AS PROMISED
TO THE PEOPLE OF CALIFORNIA.
TODAY WE BELIEVE THAT AT LEAST
FIVE HUNDRED TERMINALLY ILL
INDIVIDUALS HAVE RECEIVED
PRESCRIPTIONS WITHOUT ANY OF THE
PROBLEMS THAT OPPONENTS. TO OR
CRITICS OF THIS LAW HAVE
PREDICTED. HOWEVER AS THE
ASSEMBLY HEALTH SELECT COMMITTEE
ON END OF LIFE HEALTH CARE HEARD
IN TESTIMONY.
FROM PATIENTS PHYSICIANS AND
HEALTHCARE SYSTEM
REPRESENTATIVES DURING THE
PUBLIC HEARING ON JANUARY TWENTY
FOURTH WHILE THE LAW HAS BEEN
COMPASSIONATELY IMPLEMENTED. THE
PROCESS FOR TERMINALLY ILL
PATIENTS TO OBTAIN THE
MEDICATION IS ALREADY TOO
COMPLICATED AND BURDENSOME.
PHYSICIANS ARE REPORTING THAT
THE EXCESSIVE PAPERWORK IS
CAUSING THEM AND THEIR GROUP
PRACTICES ALIKE TO OPT OUT OF
PROVIDING THIS END OF LIFE CARE
FOR THEIR PATIENTS. THAT AS A
RESULT.
IT'S THE PURELY LIMITING ACCESS
TO THOSE. PATIENTS.
WHO ARE FINDING IT DIFFICULT TO
FIND A PHYSICIAN WHO WILL
PRESCRIBE THE MEDICATION?
LIKEWISE THE PATIENTS DO WHO DO
EVENTUALLY FIND A PHYSICIAN
EXPERIENCE LONG WAITING PERIODS
AND DEAL WITH A LARGE AMOUNT OF
PAPERWORK THEMSELVES.
REQUIRING PHYSICIANS TO IDENTIFY
THEIR AREA OF PRACTICE CREATES
AN ADDITIONAL BURDEN AND IT
CREATES PRIVACY ISSUES FOR THEM
WHICH WILL ONLY FURTHER TO TURN
THEM FOR PARTICIPATING UNDER THE
LAW. THUS FURTHER LIMITING
ACCESS FOR TERMINALLY ILL
PATIENTS.
AND PUBLICATION OF A PATIENT'S
DEEPLY PERSONAL AND PRIVATE
REASONS FOR WHY THEY WOULD
CHOOSE THIS OPTION IS
UNNECESSARY IN AN INVASION OF
PRIVACY.
SP ONE THREE THREE SIX WILL ONLY
EXACERBATE THE HURDLES THAT
PATIENTS MUST ALREADY CLEAR TO
QUALIFY FOR AND OBTAIN A
PRESCRIPTION FOR AID IN DYING
MEDICATION.
DYING PEOPLE SHOULD BE ABLE TO
SPEND THEIR LAST DAYS WITH THEIR
LOVED ONES NOT DESPERATELY
SEARCHING FOR A PHYSICIAN. AND
POSITION SHOULD BE ABLE TO
PRACTICE SIX THIS COMPASSION AND
OF LIFE CARE OPTION WITH CARE
RATHER THAN CONCERN OVER THE
COMPLETION OF UNNECESSARY ISTERI
REGULATORY PAPERWORK. LET'S KEEP
THE END OF LIFE OPTIONS ACT
ABOUT COMPASSION AND NOT
INTRUSIVE GOVERNMENT OR
RESEARCHER CURIOSITIES AN OVER
REACH WE URGE YOU TO OPPOSE SB
ONE THREE THREE SIX THANK YOU
ANYONE ELSE NOW YOU. LIKE TO
SPEAK IN OPPOSITION GOING TO
STATE YOUR NAME AND POSITION
PLEASE THOUGH MY NAME IS ERICA
RUIZ ON THE PUBLIC OUTREACH
MANAGER FOR COMPASSION AND
CHOICES CALIFORNIA AND PLEASE
VOTE NO ON SB ONE THREE THREE
SIX. THANK YOU.
HELLO I'M DR SYRUP HINDER HOSPET
REPRIEVE MIGHT COORDINATOR AND
PARTICIPANT. IN THE ASSEMBLY OF
THE SELECT COMMITTEE IN JANUARY
WHERE MULTIPLE MEDICAL DOCTORS
WITHIN THE STATE.
COMMENTED ON THE ENCUMBRANCES
ALREADY EXISTING WITH THE END OF
LIFE OPTION ACT I URGE YOU TO
RESPECT THEM AND VOTE AGAINST.
THIRTEEN THIRTY SIX THANK YOU.
I AM DEBORAH DA COSTA.
AND I URGE YOU TO VOTE NO ON SB
THIRTEEN THIRTY SIX.
I'M DORIS I TELL IF I'M A NURSE
FOR SIXTY YEARS AND SPENT MANY
YEARS CARING FOR DYING PATIENTS.
I'M ALSO A NURSE PRACTITIONER
AND I HAD TO PRACTICE FOR TWENTY
FOUR YEARS.
I.
STRONGLY OPPOSE THIS.
MEANINGLESS NEED FOR DATA THAT
IS ALREADY. A PROVIDED AND FOR
CERTAINLY OF INVADING PEOPLE'S
PROPERTY PRIVACY BUT TALK. OF
WHY THEY CHOOSE THIS OPTION IS
STRICTLY BE TUNE THEMSELVES AND
THEIR PHYSICIAN AND NOT NEEDED
BY THE PUBLIC.
I AM BUT NEED A BOLLINGER AM
FROM SACRAMENTO AND I'M A
CLINICAL SOCIAL WORKER I OPPOSE
THIS BILL.
MY NAME IS SANDRA COMMONS I LIVE
IN SACRAMENTO CALIFORNIA I AM
OPPOSITION TO THIS BILL AS A
SENIOR. THANK YOU.
MY NAME IS BILL PIPER I LIVE IN
SENATOR PANS DISTRICT HERE IN
SACRAMENTO. I OPPOSE THIS BILL
AT EVERYTHING I'VE HEARD TODAY
TELLS ME THAT IT'S A SOLUTION IN
SEARCH OF A PROBLEM IS JUST NOT
NEEDED.
GOOD AFTERNOON I'M RITA POPPING
FROM DIFFERENT CAN.
I OPPOSE SB THIRTEEN THIRTY SIX.
I AM DEXTER BARKER FROM UNION
CALIFORNIA UNION CITY
CALIFORNIA.
AND I OPPOSE.
SB THIRTEEN THIRTY SIX.
KAREN GAYLE FROM SACRAMENTO I
OPPOSE THIS BIL IT RISKS MORE
SUFFERING THANK YOU
COMPASSIONATE CHOICES.
I THINK ANY MORE OPPOSITION.
THE. SCENE IS ANY QUESTIONS
COMMENTS FROM MANY OF THE
MEMBERS.
CENTENNIAL SOME.
THERE WAS A CONVENING.
SACRAMENTO ABOUT A HUNDRED. I
GUESS I'D COLUMN. STAKEHOLDERS.
AND THE.
GENERAL COULD YOU COMMENT ON
THE.
RESULTS OF THAT CONVENING IEP
INDICATED THAT THERE WOULD BE IF
IT WERE SOME ADDITIONAL NEEDS
THAT WOULD BE HELPFUL. IF ALL
HERE'S A YEAH THAT'S A GOOD
QUESTION.
IN FACT. IT WAS HELD JUST
RECENTLY IN SEPTEMBER TWO
THOUSAND SEVENTEEN.
OVER A HUNDRED STAKE HOLDERS
THEY WERE DOCTORS THEY WERE
NURSES. FAMILY.
EXPERTS. EXPERTS IN IN THE LIFE
CARE ETHICS DISABILITY RIGHTS
AND OTHERS ALL CAME TOGETHER TO
DISCUSS THE IMPLEMENTATION OF
THIS ACT. IN THE EXPERIENCE OF
PATIENTS CARE GIVERS HEALTH
PROVIDERS TO IDENTIFY THE BEST
PRACTICES. FOR THESE PATIENTS
AND SO THESE OF AN ORGAN A.
ORGANIZER'S FROM THE UCLA
HEALTH AND A COALITION FOR
COMPASSIONATE CARE.
WHAT THEY SAID THEY SAID PARTIES
OF ALL SIZE POLITICAL STRIPES?
EXPRESSED AGREEMENT ON THE NEED.
FOR D. PH TO BE MORE TRANSPARENT
IN THE SHARING OF THE DATA. ON
IT COLLECTS IN REQUESTED DATA TO
BE SHARED EITHER THROUGH AN
UPDATE OR ADDITION REPORT FROM
THE P. H. OR DE IDENTIFIED ROT
THAT DATA THAT COULD BE RELEASED
TO INDEPENDENT RESEARCHES
SEARCHERS FOR ANALYSIS ALL
PRIVATE BY THE WAY. NO NAMES ARE
DISCLOSED THE DATA ELEMENTS
REQUESTED ARE WHETHER OR NOT THE
PATIENT INFORMED THE FAMILY
WHETHER A MOTIVATION AND
MOTIVATED THE REQUEST WHAT
MOTIVATED REQUEST WEATHER
EMERGENCY MEDICAL SYSTEM WAS
CALLED. AND WHETHER POSITION OR
TRAIN HEALTHCARE PROVIDER WAS
PRESENT AT THE TIME ANYWAY MAKE
A LONG STORY SHORT LET ME JUST
JUMP DOWN TO WHAT THEIR
CONCLUSION WAS. THEY THEY SENT
OUT TWO LETTERS WHICH HAVE BEEN
SUBMITTED TO THE DPH FROM A VAN
ORGANIZER'S.
NOT MY IDEA THESE AGAIN THESE
ARE EXPERTS IN THE MEDICAL
FIELD.
ETHICS DISABILITIES AS WELL AS.
PEOPLE WHO WHO LOST FAMILY
MEMBERS SO THESE TWO LETTERS
WERE SUBMITTED TO THE DPH. I'M
FROM EVENT ORGANIZER'S
REQUESTING THE RELEASE OF
ADDITIONAL DATA.
I THOUGHT THAT WOULD BE WISE
MORE DATA MAKES THINGS BETTER
AND GIVE US A SUB A CLEARER.
PATHWAY ON YOU KNOW HOW TO
IMPLEMENT THESE THINGS IN THE
WATCH OUT FOR PEOPLE.
WELL THESE ARE ISSUES OF. GREAT
MAGNITUDE.
I'VE DEALT WITH SEVERAL DURING
MY CAREER.
IT WOULD APPEAR THAT.
THIS WOULD NOT BE SO BURDENSOME
AS I UNDERSTAND THAT.
.
OF THE. AGGREGATED DATA THAT'S
NOW USED THERE'S ONLY ONE.
QUESTION AND THAT BE THE AREA OF
A PRACTICE AND THAT.
IS NOT ALREADY AVAILABLE AND
TAKE. SO I WONDER WHAT THE
BURDEN IS ON THE OTHER.
ON THE PATIENT YEAH THERE IS
THERE'S ABSOLUTELY FROM WHAT I
CAN SEE FROM WHAT THESE HUNDRED
PLUS PEOPLE STATE. AS WELL AS
THE INFORMATION THAT WE'VE DONE
AND. MY FRIEND HERE THAT.
THE DOCTORS CAN CAN REPORT ON
THIS. BUT WERE ONE HUNDRED
PERCENT ACCURATE ON ON THE
FOLLOWING SO LET ME REITERATE
THIS BILL DOES NOT REQUIRE
ANYTHING NEW OF THE PATIENT
WHICH THAT SOMEONE ARE MOST
CONCERNED WITH. IT ONLY SEEKS TO
REPORT DATA RESPONSIBLY AND IN A
VERY NARROW WAY WE WANT TO MAKE
SURE DOCTORS ARE UNDERSTANDING
WHAT THEY'RE DOING. LET ME READ
THE SECOND THING THIS BILL IN NO
WAY ADDS ADDITIONAL BARRIERS FOR
PATIENTS SO ANY OF MY FRIENDS
OUT HERE THAT WE'RE CONCERNED.
THERE SHOULD BE NO CONCERN AGAIN
THIS BILL IN NO WAY ADDS
ADDITIONAL BARRIERS FOR PATIENTS
SEEKING THE AID IN DYING
PRESCRIPTION IN FACT. THIS BILL
DOES NOT REQUIRE ANY ADDITIONAL
INFORMATION FROM THE PATIENT
ALSO AGAIN.
THERE ALMOST NOT PART OF THE
EQUATION WE'RE LOOKING FOR
INFORMATION FROM THE EXPERTS ON
THIS TO MAKE SURE. IT'S BEEN
IMPLEMENTED RIGHT AND. AGAIN
WE'RE LOOKING FOR ANSWERS IN.
COULD YOU ADD YOU. MISTER DOCTOR
MAJOR.
THANK YOU CENTER THAT'S THAT'S
VERY WELL SAID I WOULD LIKE TO I
WOULD ONLY ADD. UP UPON THAT
WITH REGARD TO IT WAS NOT JUST
THE THIS SEPTEMBER MEETING
YOU'RE TALKING ABOUT BUT THE
HEARING THE SPECIAL THEY HEAR
THE THE SPECIAL SELECT
COMMITTEE.
IN JANUARY AT THE HEARING DID
NOT SAY THAT THIS DATA WAS IN IT
WAS INAPPROPRIATE OR WRONG TO
GATHER TOGETHER. IN A HEALTH
SYSTEM AT PRESENT IT IS
TESTIFYING THERE AB THERE SAID
IN THAT IN THAT FORM OR ANOTHER
FOR A. THAT BETTER DATA AND MORE
TRANSPARENCY IS WHAT IS NEEDED
SO I I'M I THINK THAT. EVEN
THOUGH THERE WERE MANY OF RIGHT
IF. ISSUES WITH REGARD TO THE
THE THE VARIETY OF VOICES THEY
WERE PRESENT AT HEARING EVEN
THOSE MOST FRIENDLY. TO THIS
PRACTICE AND WE WERE IN
AGREEMENT THAT MORE DATA AND.
AND BETTER TRANSPARENCY WAS
NEEDED. DOES ANY OF THE
OPPOSITION LIKE TO MAKE IS TO.
CONTRADICT STATEMENT ALONE EVEN
PLEASE STATE YOUR NAME.
YES MARK WHITEMAN ON BEHALF OF
COMPASSION CHOICES THANK YOU
CHAIRMAN HERNANDEZ.
JUST TO BE CLEAR THAT THIS
INFORMATIONAL HEARING WAS HELD.
IN THE SELECT COMMITTEE IS NOT
ASKING FOR THIS INFORMATION
TODAY SENATOR MORALE ASKING FOR
THIS INFORMATION TODAY.
AND THE PEOPLE THAT ARE
SUPPORTING THIS REQUEST FOR THE
ADDITIONAL INFORMATION ON THE
PEOPLE THAT SUPPORTED. OUR THAT
OPPOSED THE END OF LIFE OPTION
ACT.
SO WE HAVE A SITUATION TODAY
WHERE INFORMATION IS BEING
REQUESTED IT'S NOT ON BEHALF OF
THE SELECT COMMITTEE.
DPH IS NOT HERE SAYING WE'D LIKE
TO COLLECT ADDITIONAL
INFORMATION.
SO WE LOOK CLOSER KIND OF AND
PEEL THE ONION BACK ON WHAT THE
MOTIVES HERE.
ARE FOR THIS BILL AND THE
CONCERN WE HAVE IS THAT THERE
ARE ADDITIONAL REQUIREMENTS.
COMMENT ON WHY PEOPLE ARE
ENGAGED IN THIS PROCESS WHERE
THEY'RE DOING THIS THEY THEY CAN
BE INVASIVE TO THE PROCESS. AND
THIS IS A PROCESS THAT IS LESS
THAN A YEAR.
UNDER WAY IN CALIFORNIA AND IT'S
A PROCESS THAT AT THIS
INFORMATIONAL HEARING WAS
CRYSTAL CLEAR IS WORKING TODAY.
SO IF WE START LAYERING
ADDITIONAL REQUIREMENTS ON.
THIS EARLY IN THE PROCESS WE
WORRY THAT I WILL HAVE A
DETERRENT EFFECT.
ON THE USE OF THIS LAW. AND WE
DON'T THINK THAT'S APPROPRIATE
AT THIS EARLY TIME WE THINK WE
NEED TO LET THIS PLAY OUT. AND
LISTEN TO THE REGULATORS WHO ARE
NOT ASKING FOR THIS ADDITIONAL
INFORMATION.
THANK YOU THANK YOU.
I BELIEVE SENATOR NEWMAN HAD A
QUESTION. YES THANK YOU MISTER
SO TO TO JUST TO FOLLOW. FOR
CLARITY'S SAKE. AND I WRASSES
AGAINST GENERAL OF YOUR WITNESS.
REALLY CARE WHAT ARE THE.
BENEFITS OF THE TRANSPARENCY
THAT YOU'RE SEEKING SO. LET'S
ASSUME WE COLLECT DATA. WHAT
PART IT WILL VIA THE
PRESCRIPTIONS ARE THE CHANGES
THAT THIS DATA MAY YIELD OTHER
THAN AS NOTED HAVING AN
INHIBITING OR DETERRENT EFFECT
ON THOSE WHO MIGHT PURSUE THIS
OPTION?
LET ME GIVE YOU ONE ANSWER ME
GONNA REFERRED WHEN YOU GUYS TO
MY FRIEND WHO JUST THE SMOKER
HERE SAYING THIS IS MORALES
IDEA.
IT IS MY IDEA BASED ON THE
SELECT COMMITTEE THEIR
INFORMATION DO YOU UNDERSTAND
THAT. SO YOU SORT OF.
YEAH MISLED ON SAYING IT WAS
JUST MY IDEA MIKE I TOOK THIS
INFORMATION FROM THIS WHAT.
COMMITTEE HEARING OVER A
HUNDRED DOCTORS NURSES. FAMILY
CARE AND IN THEIR TWO LETTERS.
TO THE PH SO THAT'S WHERE THE
SUGGESTION COME FROM SO
HOPEFULLY. I AM IS AT THAT I
CLEAR ME CLEARLY COMMUNICATE
THAT WITH YOU.
SENATOR MY POINT WAS THIS IS NOT
A REQUEST OF THE SELECT
COMMITTEE. BUT THAT'S MY POINT
OKAY AND MY POINT IS THEY'VE
GIVEN TO LETTERS THEY SPENT A
NUMBER OF DAYS THINKING OF
WORKING THROUGH THESE THINGS
OVER A HUNDRED PEOPLE THAT
POSSESS A SUPERIOR WISDOM ON
THESE THINGS. THAN WHAT I HAVE
AND THIS IS WHAT THEIR
RECOMMENDATIONS WERE SO WE THINK
IT'S A GOOD IDEA THOSE OLD WHITE
WHITE WHITE WHEN WE DO THIS IT
EITHER WE'RE NOT HERE FOR YOU TO
TO HAVE INTERACTION IN DISAGREE.
WHILE WE WAIT WAIT. IF I AM I
GET IT I GET A BUT WHAT WE HEAR
IS TO HEAR THE MEASURE THE
POLICY. AND WE HAVE A QUESTION
THAT'S BEEN POSED BY A MEMBER TO
YOU IF YOU CAN'T ANSWER THE
QUESTION THAT HAS THAT WAS PART
OF THE ANSWER OKAY REGARDED
ANSWER. DIRECTLY TO THE SENATOR
AND THE THOUGHT HAVE A BANTER
BACK AND FORTH HERE. AND I'LL
I'LL REPEAT WHAT HAS YOU SO JUST
TO BE CLEAR.
I'M CURIOUS AS TO. THE.
INTENDED OR FORESEEN BENEFITS OF
THE TRANSPARENCY OR THAT FROM
THE DAY. EITHER YOU'RE PROPOSING
TO COLLECT AS TO WHAT WE HAVE IS
A IS A LAW. RECENTLY IMPLEMENTED
BY ALL INDICATIONS SATISFACER
THOSE TO ITS ADVOCATES FROM LAST
YEAR. IN SO I'M CURIOUS AS TO
WHAT THE DATA YOU'RE SEEKING
WOULD ALLOW US TO DO BY WAY OF.
JOB IMPROVEMENTS TO THIS ACT.
WELL I DID READ PART OF THAT BUT
IF YOU'D LIKE TO GO TO MAJOR IN
AND THEN OFF FOLLOW UP ON THAT.
CERTAINLY THAN.
THANK SENATORS THE.
AND.
PART OF THE QUESTION I GUESS IS
IT IS IT IS NOT AN ENDING ANY
INTENTION TO INTERFERE. WITH
ANYONE CHOOSING TO DO WHAT THEY
WISH UNDER THE ACT. HOWEVER IF
THERE IS A TREATABLE ISSUE THE I
MEAN I THINK THAT MY
UNDERSTANDING IT REGARDS THE
DEBATE SURROUNDING.
AT THE END OF LIFE OPTION ACT
WITH THAT THERE WAS A GENERAL
AGREEMENT THAT IF THERE WAS AN
OF AN EFFECTIVE CURATIVE A
PALLIATIVE TREATMENT COULD BE
AVAILABLE TO SOMEONE. THAT WOULD
BE NOT THAT THAT SHOULD THAT
SHOULD BE A PREFERENCE FOR THEIR
EXPLORATION OF THAT OPPORTUNITY
SHOULD BE MADE AVAILABLE TO
THEM.
NOW IF.
DEAD DATA WERE TO SHOW FOR
EXAMPLE THAT THE MAJORITY OF THE
REASONS FOR.
IT.
WE HAVE HAVE PAIN IS IS NOT THE
REASON BUT IT'S EXISTENTIAL.
AN EXISTENTIAL CRISIS AN
EXISTENTIAL.
SUFFERING DOES SEEM TO MERIT X.
EXPLORATION I THINK THAT ONE OF
THAT WAS ONE OF THE MOTIVATING
FEATURES OF THE THE FIRST TIME.
HE SAID THE FIRST BIT OF
LEGISLATION WAS THAT DISCUSSED
IN THIS CHAMBER WAS ABOUT GIVING
PEOPLE A MENTAL HEALTH OPTION
AND SO IF THERE IS. IF THERE
WOULD BE JOE IF THERE ARE AS A
VERY VERY LOW NUMBER OF MENTAL
HEALTH REFERRALS GOING OUT THERE
THAT COULD BE A PROBLEM I MEAN
IT SEEMS KIND OF IT SEEMS TO ME
PRETTY OBVIOUS. THAT IF SOMEONE
TO HAVE A TERMINAL AND USE AN
ILLNESS AND HAVE UNDERLYING OF
VULNERABILITIES FOR. MENTAL
ILLNESS AND IF THAT IF THERE WAS
A IF THAT COULD BE DONE
DISCOVERED AND IDENTIFIED THE
THAT WOULD BE AN OPTION TO
SOMEONE ALSO MIGHT WANT TO
CHOOSE. AND IF THEY AREN'T
BEING.
GIVEN THE OPPORTUNITY TO SEE THE
SPECIALIST BECAUSE WE ALL KNOW
THAT. THE THE MENTAL HEALTH IS
NOT.
ACCESS IS NOT EASY THAT MIGHT
HELP AND THIS. THIS IN AUGUST
BODY TOO AND COME UP WITH BETTER
MENTAL HEALTH SOLUTIONS TO
ASSIST THOSE PEOPLE WITH
TREATABLE MENTAL HEALTH. ISSUES.
THAT WOULD ALLOW THEM THE
OPPORTUNITY TO MAKE IT TO MAKE A
DIFFERENT CHOICE WITHOUT
INHIBITING THEIR CHOICE IN
EITHER WAY WHAT WHAT WE DO KNOW.
UNDER THE
ACT WOULD PROBABLY FIND IS THAT
A PATIENT SUFFERING FROM A
TERMINAL ILLNESS.
WHO CONSULTS WITH A PHYSICIAN? A
DULY LICENSED PHYSICIAN WITHIN
THE PARAMETERS THAT PHYSICIAN
PATIENT RELATIONSHIP. IS MAKING
AN INFORMED CHOICE AS TO HOW TO
END THEIR LIFE.
IN A IN A DID A. HUMANE CHOSEN
WAY GIVEN THE FACT THAT THEY ARE
IN A TERMINAL POSITION. SO IT'S
UNCLEAR TO ME OTHER THAN I THINK
YOU AGREE THERE IS SOME LEVEL OF
IN ADDITION THAT COMES INTO
PLAY.
WHEN IF WE START TO SEEK
ADDITIONAL DATA THAT WOULD THAT
WOULD.
RESPECTIVELY INTERFERE WITH THAT
RELATIONSHIP. OF THE DOCTOR AND
THE PATIENT A AND I'M STILL
UNCLEAR AS TO THE BENEFITS I
THINK I UNDERSTAND THE THE
INHIBITING.
QUALITY TO IT BUT TO THE
BENEFITS AS THEY PERTAIN TO THE
PERSON SUFFERING.
AND IF YOU COULD CLARIFY I'D BE
GRATEFUL.
YES SIR THANK YOU YOU RAISE A
REALLY INTERESTING QUESTION WHAT
ABOUT INFORMED CHOICE THE PART
OF ONE OF THE GOALS WITH REGARD
TO DETERMINE THE AREA PRACTICE
OF THE POSITION OF THE
PRESCRIBING PHYSICIAN
PRESCRIBING PHYSICIAN ACCORDING
TO THE LAW. HAS THE PRIMARY
RESPONSIBILITY FOR ALL HEALTH
CARE FOR THAT PARTICULAR PATIENT
NOW THAT THAT. PARTICULAR AT
THAT POSITION DOESN'T HAVE. AN
EXPERTISE IN THE AREA OF THAT
PERSON'S.
ILLNESS AND IT BRINGS UP A
REALLY IMPORTANT QUESTION ABOUT
WHETHER THAT. IS REALLY AN
INFORMED CHOICE AND WHETHER
THEY'VE BEEN ABLE THEY'VE BEEN
AT PRESENT THEY WHETHER THEY'VE
BEEN INTERACTING WITH HIM WHO
PRESENTED IT THEN THOSE ARE
THOSE THOSE THOSE OPPORTUNITIES
SO I THINK THAT THAT INFORMED
CHOICE FEATURE OF HIS REPORT.
THE THE.
YOU'RE THE CHAIRMAN IS AN
OPTOMETRIST AND IF I HAVE IN MY
PROBLEM I WOULD GO TO. AN
OPTOMETRIST I WOULDN'T
NECESSARILY GO TO A PODIATRIST
IF THERE WAS INDEED A SAYING
THAT A VARIETY OF PEOPLE ARE
GOING OUT TO AND THEY WERE
GETTING. PRESCRIPTIONS RELATED
TO.
I ISSUES FROM PODIATRIST THAT
MIGHT BE IT THAT'S A PRETTY
IMPORTANT ON PUBLIC HEALTH
SITUATION SO I. AM I I THINK
I'LL LEAVE THIS TO THE CHAIR.
AND I THINK YOUR TESTIMONY HIS
VISION THANK YOU THINK WE HAVE A
CENTER PAN QUESTION COMMENT. YES
THANK YOU ADDICTION ONE TO
FOLLOW UP ON SIR NEWMAN THE
ANSWER WELL FIRST OF ALL. IF I
MUST SAY REMEMBER THE ACTING
CORRECTLY YOU HAVE TO BE A
LICENSED PHYSICIAN AM DEAR DO SO
I'M. AND THEN I'M NOT SURE WHAT
THE SPECIALTY.
REALLY ARE I'M NOT AS IT IS THE
AREA OF PRACTICE SO I MEAN THAT
SURVEY. EXACTLY WHAT IS THAT
SUPPOSED TO MEAN AND ARE YOU
CONJECTURE IN THINGS FROM LIKE
.
IF THE PERSON IS A FAMILY
PHYSICIAN ARE YOU SAYING THEY'RE
NOT QUALIFIED.
THEY MAY BE A LONG TIME PRIMARY
CARE PHYSICIAN FOR THAT PATIENT.
EVEN THOUGH THEY MAY BE
SUFFERING FROM CANCER.
ARE YOU SAYING THAT A YOU KNOW
AN INTERNIST WHO IS NOT A
NEUROLOGY WHO'S NOT A
NEUROLOGIST. CAN'T HELP A FOOD A
PATIENT WHO HAS A TERMINAL
NEUROLOGICAL CONDITION THAT ONLY
IN AN UROLOGIST COULD ACTUALLY
BE ABOUT BECAUSE. THESE
DECISIONS NOT JUST ABOUT THE
DISEASE ENTITY ITSELF IT'S ABOUT
THE LARGER YOU KNOW AND THAT
THAT'S ACTUALLY HOW THE. THE THE
THE THE THE THE LAW IS CRAFTED
NO I HAVE I WILL SAY THIS AS
SOMEONE WHO ACTUALLY I. MYSELF
HAD SOME MORE RESERVATIONS AND
DID NOT ACTUALLY VOTE FOR THE
BILL BUT I JUST DON'T SEE
ANYTHING GOING BACK TO WHAT
SENATOR NEWMAN SAID I JUST DON'T
SEE HOW THIS INFORMATION
ACTUALLY SHEDS ANY LIGHT IN A
WAY THAT ACTUALLY IS HELPFUL.
TO PASS AND THEN THIS THAT THE
OTHER IS MOTIVATING REASON. I
MEAN AGAIN WHO WHO'S DECIDING
THE MOTIVATING REASON IS THAT
SOMETHING THAT REQUIRED PATIENCE
TO FILL OUT AND CERTIFIED TO IS
THAT THE PHYSICIAN GASSING OR
DETERMINING I MEAN WHO'S. WHO'S
THIS WHAT'S MOTIVATING REASON
AND IS THIS SOMETHING.
THAT BECOMES PART OF THE PUBLIC
RECORD.
BEFORE THEY AT SO I MEAN I
THINK DOESN'T PRIDE MAJOR
PRIVACY CONCERNS ABOUT. THE
MOTIVATING REASON BEING
SOMETHING THAT HAS TO BE
REPORTED CERTAINLY I'M SURE
DISCUSSIONS LEADING UP TO ANY
DECISIONS THE PATIENT MAKE THAT
THEY INVOLVE MOTIVATION BUT.
AND THEN SO SO I'M JUST NOT
SURE AND THEN I THINK THE THE
THE FINAL PART IS YOU KNOW THE
FINAL QUESTION ABOUT.
YOU KNOW MENTAL HEALTH
SPECIALISTS IN ASSESSMENT.
THAT'S AGAIN I THINK THERE'S
CERTAIN I I FIND A CERTAIN
ASSUMPTIONS UNDERLYING THESE
QUESTIONS. THAT MAY NOT NOT TO
REFLECT WHAT'S ACTUALLY
HAPPENING AND I'M NOT SURE AGAIN
GOING BACK TO WHAT SENATOR
NEWMAN SAID. WHERE IN THE END IS
COLLECTING ANY OF THESE PIECES
OF DATA ACTUALLY?
A BENEFIT TO THE PATIENT ARE TO
OUR POLICY MAKING.
I'M JUST I I AND THERE'S
SOMEONE WHO DOES HEALTH SERVICES
RESEARCH AND USUALLY YOU KNOW
LIKE YES WE WANT TO GET MORE
DATA BUT I'M NOT SURE WHY THESE
QUESTIONS SEEM TO BE
PARTICULARLY ILLUMINATING IN
THAT REGARD. SO IF YOU CAN HELP
ME WITH THAT THAT BE GREAT BUT
I'D PLEASE RIGHT NOW AS A
PHYSICIAN MYSELF AND WHO. I AM
AND I'M JUST I DON'T SEE THIS
BEING PARTICULARLY HELPFUL.
IF I MAY OFFER RESPONSE THANK
YOU.
.
I THINK THAT'S SOMETHING THAT
WAS MENTIONED EARLIER ABOUT HOW
NEW THIS PRACTICES ESPECIALLY IN
THIS STATE IS AN IMPORTANT POINT
IN IN THIS REGARD.
AND AGAIN I WANT IT I'D LIKE TO
REFLECT BACK THE POSITIONS THAT
STATEMENT WITH THE ECONOMY OF MY
FEEL THE ACADEMY OF HOSPICE AND
PALLIATIVE MEDICINE. AND THAT
THAT. AS A MATTER OF SOCIAL
POLICY THE ACADEMY HAS CONCERNS
ABOUT A SHIFT TO INCLUDE
PHYSICIAN ASSISTED DYING IN
ROUTINE MEDICAL PRACTICE.
INCLUDING PALETTE OF CARE.
THE POINT THERE IS THAT.
SO THE ANY ANY LEGALIZATION AND
RELATED REGULATIONS MUST INCLUDE
SAFEGUARDS THEY D. IS.
IT'S A NEW IS THE SHIFT.
AND THIS IS THIS IS A NEW
PRACTICE IN THIS STATE AND I
THINK THE IDEAS IS TO.
TO WORK TO BETTER UNDERSTAND HOW
IT'S HOW IT IS BEING PRACTICED.
IT THAT IS.
I BELIEVE A LOT OF A. LOT OF
UNKNOWNS AND IT'S NOT SAYING.
THAT.
.
BUT I THINK IN PROJECTING WHAT
THE ANSWERS WERE NECESSARILY TO
IN TERMS OF.
WHAT WILL BE DISCOVERED BUT IT'S
TO BEGIN TO BETTER UNDERSTAND
THE PRACTICE?
THE MORE KNOWLEDGE AND THAT
THERE'S MORE AND. MORE FACTS AND
DATA AROUND IT SO THAT WE DO
BETTER UNDERSTAND THAT'S
RECOGNIZING THAT. THIS IS A BIG
SHIFT.
I BELIEVE CENTER LABOR HEADACHE
QUESTION OR COMMENT.
THANK YOU MISTER CHAIR. TO THE
ATTORNEY WHEN YOU WERE ANSWERING
A QUESTION FROM SENATOR NEWMAN
YOU INDICATED THAT PATIENTS WHO
CHOSE THE END OF LIFE OPTION.
POSSIBLY HAD NOT BEEN GIVEN A
MENTAL HEALTH EVALUATION AND
THEN YOU SEEM TO INDICATE AT
LEAST TO ME MAYBE TO NO ONE
ELSE.
THAT THEY HAD SOME SORT OF
MENTAL ILLNESS AND THIS IS WHY
THEY WERE CHOOSING THE END OF
LIFE SO I JUST WANT TO
UNDERSTAND IF THAT'S WHAT YOU'RE
ACTUALLY SAYING.
THE CENTER FOR THE OPPORTUNITY
CLARIFIED AND NO I I'M NOT. BY
ANY MEANS SUGGESTING THAT EVERY
PERSON WHO.
AVAILED HIMSELF OF THE END OF
LIFE OPTION ACT.
HAS A MENTAL ILLNESS BUT THE
THE.
ISSUE OF MENTAL THAT ALSO THERE
ARE FROM THE BRIGHT INFORMATION
PRESENTED ON THE MOUNTAIN.
THAT PEOPLE WHO DO AND HAVE AND
AND DEAL WITH MENTAL ILLNESS
AND.
THAT IF YOU CUT ACROSS SECTION
OF THE POPULATION THAT THAT
SOUNDS LIKE THERE MIGHT ALSO
LIKE THERE MIGHT BE PEOPLE. WHO
WILL BE AFFECTED BY MENTAL
ILLNESS WHO MIGHT BE IN THE
SITUATION AND SO?
WITH THAT IN MIND AND THE STATE
IS VERY.
DOES THIS IF IT'S A VERY MODEST
REQUEST AND DONE IT A LITTLE BIT
OF INFORMATION MIGHT HELP THE
PEOPLE WHO DO FIT. THAT SEGMENT
WHATEVER SEGMENT THAT MAY BE IT
MAY BE VERY USEFUL FOR THOSE
INDIVIDUALS. JUST CAUTION YOU.
BECAUSE IT STILL SOUNDS LIKE
YOU'RE INDICATING THAT AT LEAST
SOME OF THE PATIENTS WHO CHOOSE
THE END OF LIFE OPTION ARE
MENTALLY ILL SO JUST CAUTION
YOU.
ON THE WAY YOU PRESENT IT.
IF DR SEXUAL CORRECT ME IF I'M
WRONG. BUT IN THE SIX MONTHS.
UP UNTIL THE END OF LIFE EMINEM
PRIVAS I I GUESS THAT SOME OF
THESE THESE CALLS I THINK OF IT
IN THE END WE FOUND OUT THAT. A
SIX MONTH DIAGNOSIS OF WHETHER
SOMETHING AND. I I GUESS I DON'T
I DON'T KNOW I DON'T KNOW IT
INTO AN EVERY SCENARIO.
WHETHER WHETHER EVERY TERMINAL
DIAGNOSES THAT IS CORRECT.
INSIDE MAYBE SOME DIZZINESS
DON'T EIGHT YET DONE THAT IF I
MAY PARAPHRASE SHOWS SO PART OF.
YOUR UNDERLYING LOGIC IS THIS
QUESTION AS TO WHETHER OR NOT.
THE PATIENT IN CHOOSING TO END
ONE'S LIFE IS IN FACT FACING A
TERMINAL SITUATIONS THAT CORRECT
THERE IS SOME POSSIBILITY YOUR
MIND THAT A PATIENT USING. THE
THE END OF LIFE OPTION MAY NOT
IN FACT BE HAVE THE OPPONENTS TO
THE BUILT.
IN COULD YOU SPEAK TO THAT I DO
I DO BELIEVE THERE'S SOME LEVEL
OF RIGOR THAT HAS BEEN BUILT
INTO THE PROCESS TO LIVE HERE.
ABSOLUTELY YOU NEED TO HAVE YOU
KNOW TWO DIAGNOSES FROM TWO
SEPARATE PHYSICIANS YOU KNOW
FRANKLY I'M NOT THE BEST PERSON
TO SPEAK TO THIS WE HAVE THE
AUTHOR OF THE BILL IN THE ROOM
NOW. CAN PROBABLY SPEAK BEST TO.
THE SAFEGUARDS THAT ARE PUT IN
THAT BILL I WILL JUST NOTE THAT.
ALL OF THESE ISSUES THAT ARE
BEING TALKED ABOUT TODAY IMPORT
TALKED ABOUT THOROUGHLY WHEN
THIS BILL WENT THROUGH THE
PROCESS OF TWO THOUSAND FIFTY.
WE HAD MANY MANY HEARINGS ON
THIS ISSUE AND THESE ARE THE
SAME ARGUMENTS WE HEARD.
IN OPPOSITION TO THE FUNDAMENTAL
RIGHT.
TO BE ABLE TO END YOUR LIFE. IN
YOUR OWN MANNER. IF YOU'RE
FACING A TERMINAL DIAGNOSIS SO
THESE ARE THE SAME ARGUMENTS WE
HEARD BEFORE. AND WE AGAIN FEEL
THAT IT'S FAR TOO EARLY TO BE
TINKERING WITH THIS LAW. WE
THINK THE HEARING. THAT SENATOR
MORALES TALKING ABOUT ACTUALLY
DEMONSTRATED THE EFFECTIVENESS
OF THE LAW TODAY THAT IT'S
WORKING PROPERLY. AND WE THINK
THAT.
DPH IS COLLECTING A VERY
SIGNIFICANT AMOUNT OF DATA.
ACCESS TO THAT DATA IS BEING
MADE AVAILABLE AND I THINK WE
NEED TO TAKE SOME TIME TO LOOK
AT HOW THIS LAW IS WORKING SO
FAR SO GOOD BUT THE LAST THING
WE WANT TO DO IS THROW UP SOME
ADDITIONAL ROADBLOCKS THAT
PEOPLE ARE DETERRED. FROM BEING
ABLE TO EXERCISE THAT RIGHT
UNDER THIS LAW. WELL I JUST REAL
QUICKLY MAKE A STATEMENT BEFORE
I TURN OVER THEIR CENTER MINING
OBVIOUSLY HE'S THE EXPERT
BECAUSE HE IS ONE OF THE
PRINCIPAL COAUTHORS. AND JUST
MAYBE TO FOLLOW UP WITH YOUR
QUESTION IN YOUR COMMENT THAT
THERE IS A PROBABILITY. WELL IF
YOU LOOK AT EXISTING LAW WHICH
PERMITS A COP IN A QUALIFIED
INDIVIDUAL WHO IS AN ADULT WITH
A TERMINAL DISEASE. TO RECEIVE A
PRESCRIPTION FOR AN AID IN DYING
DRUG IF CERTAIN CONDITIONS ARE
MET. AS YOU MENTIONED SUCH AS TO
ORAL REQUEST. AT A MINIMUM OF
FIFTEEN DAYS APART. A WRITTEN
REQUEST SIGNED BY TWO WITNESSES
IS PROVIDED TO HIS OR HER
ATTENDING PHYSICIAN. THE
ATTENDING PHYSICIAN REFERS TO
PATIENT TO A CONSULTING
PHYSICIAN TO CONFIRM THE
DIAGNOSIS. AND CAPACITY TO MAKE
MEDICAL DECISIONS. AND THE
ATTENDING PHYSICIAN REFERS TO
PATIENT.
TO A MENTAL HEALTH SPECIALIST
FOR PATIENTS WHO WERE REFERRED
FOR MENTAL HEALTH EVALUATION AND
WENT ON TO OBTAIN THE
MEDICATION.
AND AS AS THE SCRIPTURES IS
COMMENTING IT SOUNDS AS THOUGH
WE'RE LOOKING TO COLLECT DATA
AND REPORT DATA ON ALL OF THE
PATIENTS WHO START THE PROCESS
IN MAY OF BEEN REFERRED FOR
MENTAL HEALTH EVALUATION. THAT'S
NOT THE WAY I INITIALLY READ IT
IN THE BILL.
BUT I I STILL FAIL TO SEE HOW
REPORTING.
ON THE INDIVIDUALS WHO HAD.
MENTAL CAPACITY CONFIRMED BY
THEIR ATTENDING PHYSICIAN.
A CONSULTING PHYSICIAN AND THEN
A TERTIARY.
MENTAL HEALTH SPECIALIST.
AND WERE ABLE TO OBTAIN THE
MEDICATION HOW REPORTING ON THAT
IS GOING TO IMPROVE THE QUALITY
OF CARE IF THEY'VE PROVEN THAT
THEY ARE CAPABLE OF MAKING THIS
DECISION. THAT DOESN'T. THAT
DOESN'T MEAN THAT MORE PEOPLE
HAVEN'T BEEN REFERRED AND THIS
FURTHER JUST DEMONSTRATES THAT
THE PROCESS WORKS AS INTENDED
BECAUSE INDIVIDUALS WHO ARE NOT
PROVEN MENTALLY CAPABLE. OF
MAKING THOSE DETERMINATIONS ARE
NOT GOING ON TO OBTAIN THE
MEDICATION.
THEY WILL TURN THIS OVER TO
CENTER MINING A BILLY WANTS TO
MAKE A STATEMENT FOR QUESTION.
THANK YOU MISTER CHAIR AND.
TO THE AUTHOR AND. THE TEST
FRIDAY I APOLOGIZE THAT IT COULD
BE FOR THE EARLIER PART I HAVE
HAD THE OPPORTUNITY TO SPEAK.
WITH THE AUTHOR ON ONE ON ONE. I
AM ENCOURAGED. THAT HE'S GONE
FROM A POSITION OF OPPOSING THE
END OF LIFE OPTION ACT TO
SUPPORTING IT IN. SO THAT SOME
PROGRESS I THINK AND I DO THINK
WITH SOME OF THE SPECIFICITY OF
THE PROPOSED AMENDMENTS.
FROM.
AS THE CHAIR POINTED OUT IS A CO
AUTHOR WE SPENT. THE BETTER PART
OF THE YEAR.
NEGOTIATING THE PROTECTIONS.
AND THE ACCESS AND TRYING TO
FIND THAT CRACKED BALANCE.
THAT DATA COLLECTION IS
ABSOLUTELY ESSENTIAL.
IN IN MOST INSTANCES I THINK OUR
NORMAL TO FALL IS THE MORE DATA
THE BETTER.
AS THIS IS DRAFTED IN PROPOSED
HOWEVER.
MY FEAR. IS THAT THE PROPOSED
COLLECTION OF MORE DATA. IS
GOING TO DO. EXACTLY THE
OPPOSITE.
IN TERMS OF CURING THE QUESTION
OF ACCESS THAT WE HEARD ABOUT IN
THE OVERSIGHT HEARING. THE
OVERSIGHT HEARING WE HEARD NO
COMPLAINTS OF ABUSE.
WE HEARD NO COMPLAINTS OF.
ANYONE WITH A MENTAL ILLNESS.
BEING PROVIDED IN END OF LIFE
MEDICATION.
IN FACT THE BILL AS WRITTEN.
DOES REQUIRE BOTH BE ATTENDING
AND THE CONSULTING A FISH IS
POSITION THEY BOTH HAVE
OPPORTUNITIES TO MAKE A REFERRAL
IN FACT A MANDATORY REFERRAL. TO
A MENTAL HEALTH PROFESSIONAL IF
THEY HAVE ANY CAUSE TO BELIEVE
THAT THERE'S A LACK OF CAPACITY
IN THE PATIENT.
WITH RESPECT TO THE PROPOSAL IN
THIS BILL TO COLLECT MORE
PRECISE INFORMATION ABOUT THE
MOTIVATING. REASON THAT THE
PERSON IS SEEKING THE END OF
LIFE MEDICATION. IF YOU LOOK AT
THE EXISTING LAW.
AND THE THOUGHT THAT WENT INTO
THIS WITH THE INVOLVEMENT OF
PHYSICIANS. OF IN COLLEGES OF
THE CALIFORNIA MEDICAL
ASSOCIATION OF END OF LIFE.
EXPERTS PEOPLE WHO WOULD HELP TO
IMPLEMENT THE LAW IN OREGON.
THERE'S NOT JUST A SINGLE
QUESTION AS TO MOTIVE THERE ARE
MULTIPLE UNDERSTANDING. THE
NUANCES IN THE LAYERS AND THAT'S
THE CHALLENGE AND HOW EVERY
PATIENT PRESENTS DIFFERENTLY.
WITH A DIFFERENT HISTORY WITH A
DIFFERENT.
DISEASE DIAGNOSIS. THE ONLY
COMMONALITY AMONG PATIENTS. IS
THEY'VE BEEN DIAGNOSED WITH A
TERMINAL ILLNESS. THEY ARE DYING
THEY ARE IN THE PROCESS OF DYING
A PREMATURE DEATH.
BUT MOST WOULD SEEK TO FORESTALL
AND HAVE SOUGHT TO FORESTALL.
THE QUESTIONS AS OPPOSED TO A
SINGLE MOTIVATING REASON.
THERE'S SIX QUESTIONS OF
DIFFERENT QUESTIONS ASKED OF THE
PATIENT AND THEN THERE'S AN OPEN
ENDED QUESTION OF OTHER CONCERNS
SO THEY'RE NOT INCLUDED IN THAT
LIST THAT LOOKS AT DIFFERENT
FACTORS. ALL OF WHICH.
WE COULD BE CHECKED YES.
ALL OF WHICH COULD BE CHECKS NO
SOME YES SOME NO IT ACTUALLY
PROVIDES MORE VALUABLE.
DATA IN WHAT WERE REQUIRING TO
BE COLLECTED AT THIS POINT. ARM.
MY BIGGEST CONCERN IN WITH ALL
DUE RESPECT TO THE AUTHOR
BECAUSE I THINK HIS. HIS
INTENTIONS ARE GOOD. BUT.
THIS IS A NEW LAW WE DID AN
OVERSIGHT HEARING THIS REQUIRED
EVERY YEAR THAT THE LAW IS IN
FACT.
WE HEARD NO COMPLAINTS. OF.
OF PROBLEMS WE HEARD NO
COMPLAINTS OF LACK OF ACCESS TO
INFORMATION FROM THE INFORMATION
THAT HAD BEEN COLLECTED. WHAT WE
HEARD OF WAS PEOPLE'S CHALLENGE
OF FINDING ACCESS TO PHYSICIANS?
WHO COULD?
IT HELPS THEM IN IN WORKING
THROUGH THIS. LAW THAT GIVES
THEM ACCESS TO CONSIDER THIS AS
AN OPTION AND WHAT WE ALSO
LEARNED FROM THE DATA COLLECTED.
IS THE OVERWHELMING MAJORITY OF
PATIENTS.
PURSUE. ACCESS TO THIS
MEDICATION ARE IN HOSPICE CARE.
IN MANY IN PALLIATIVE CARE
PROGRAMS THEY'RE NOT MUTUALLY
EXCLUSIVE IN FACT WE FOUND MORE
PATIENTS LEARN OF HOSPICE CARE
IN PALLIATIVE CARE OPTIONS.
TRUE AFTER THIS ACT HAS BEEN
INTRODUCED MOM. SO I GUESS I
WOULD JUST CLOSE MISTER CHAIR
THAT REALLY WAS A COMMENTARY I
APPRECIATE THE CHANCE TO I THINK
DEFENDED THE FURTHER
IMPLEMENTATION OF THE LAW THAT
IS IN EFFECT. IN THAT ARE
APPROPRIATE PASS. TO REVIEW DATA
COLLECTION IS WITH THE
DEPARTMENT OF PUBLIC HEALTH.
AND WITH THE MEDICAL BOARD AND
WE HAVE ACCESS TO THEM WERE IN
CONVERSATION WITH THEM REGULARLY
THAT'S THE APPROPRIATE.
THE WAY THIS POINT NOT STATUTORY
CHANGE TO A LAW THAT IS WORKING.
US SO THANK YOU MISTER CHAIR AND
YOU THINK YOU ARE THE QUESTIONS
FROM ANY OF THE OTHER MEMBERS.
CENTER WOULD YOU LIKE TO CLOSE.
I.
YES I WOULD LOVE THE CLOTHES
THANK YOU.
THANK YOU GUYS A GOOD GOOD GOOD
DISCUSSION BY THE WAY.
THIS BILL WAS ACCUSED OF OF
MORE THINGS THAN.
WHAT WAS MEANT TO BE TODAY I
THINK THERE WAS THIS MANY
ACCUSATIONS BUT AGAIN I'M JUST
GOING TO REITERATE THAT THIS
BILL DOES NOTHING?
DOES NOT REQUIRE ANYTHING NEW
WITH THE PATIENT AND ONLY SIX
REPORT DATA RESPONSIBLY AND IN
NO WAY DOES IT ADD ADDITIONAL
BARRIERS TO. THOSE SEEKING THE
AID IN DYING BUT ONE OF THE
THINGS THAT THAT I WAS CONCERNED
ABOUT.
IN OTHER STATES THERE'S BEEN
PEOPLE ACCUSED OF.
.
SORT OF WANTING THE TWILIGHT
OUT THEIR LOVED ONE SOONER THAN
LATER.
IN AND COME TO FIND OUT I THINK
ONE COUPLE GOT ARRESTED BECAUSE
THEY ARE HOME WAS IN FORECLOSURE
THERE WAS A BANKRUPTCY SO YOU
KNOW THERE'S CONCERNS LIKE THAT.
IN AND ALSO YOU KNOW YOU HEAR OF
PEOPLE TAKING THESE PILLS IN
THERE AND THAT THE COURT THE
TIME. THAT THEY THOUGHT THEY
WERE GONNA DIE THEY DON'T LEAVE
US PEACEFULLY OR SOON AS A
THOUGHT SO YOU KNOW THOSE THINGS
I THINK.
DATA IS GOOD YOU KNOW WHEN YOU.
HAVE MORE DATA SORT OF GIVES YOU
A PATHWAY. IN IN I I'M JUST IN
MY BUSINESS DAYS WHEN YOU
MEASURE THINGS YOU ONLY GET
BETTER AND SO THAT'S WHY I
THINK.
I'M JUST GOING TO CLOSE WITH
THIS LAST THOUGHT SOME OF THE
THINGS THAT THOSE HUNDRED.
STAKEHOLDERS TALKED ABOUT. WHEN
THEY HAD PATIENT CONCERNS FISHES
OUT THE TRAIN HEALTHCARE
PROVIDER WITH A PRESENT AT THE
TIME AND WHAT WAS THE TIME FROM
THE TIME THEY TOOK THE PILL TO
THE TIME OF DEATH. I THINK THOSE
ARE YOU KNOW WHY SO PRECIOUS
HIM.
YOU KNOW.
SOME OF THE THINGS WE KNOW
PEOPLE HAVE SUFFERED HERE HAD
TIME THEY WERE DYING BECAUSE IT
TOOK LONGER THAN WHAT THEY
THOUGHT. AND SO. WHEN YOU
MEASURE THESE THINGS.
I DON'T WANT TO SEE US GET
BETTER AT. EIGHTEEN PEOPLE DIE
BUT BUT I THINK THOSE QUESTIONS
GIVE US A REALLY INSIGHT ON TO
THINGS IN YOU KNOW LOOK AT AT
THE END OF THE DAY.
YOU KNOW I HOPE I NEVER HAVE TO
GO THROUGH THROUGH ANYTHING LIKE
THIS BUT. YOU KNOW WE ALL REACH
AT IN A LIFE BUT BUT I I DO TAKE
LIFE IS A PRECIOUS THING FROM
FROM OUR MAKER SO WHAT THAT.
I DO RESPECTFULLY ASK FOR AND
THE ONE THREE THREE SIX MORALE
TO PASS TO JUDICIARY CALL THE
MEMBERS PLEASE. AND ENDED UP IN
AND IS NOW WHEN. WHEN I LABOR.
LABOR NOW MITCHELL.
MITCHELL NOW MINING.
NO NEWMAN. NEWMAN NOW NIELSEN.
WILSON I CAN.
ROTH.
CURRENTLY HAS TO A.
TWO TO FIVE WILL PLACE THAT BILL
AND CALL AND AGAIN. MEMBERS
THANK YOU VERY MUCH GOOD
DISCUSSION. QUESTIONS THANK YOU.
YOU WERE GOING TO.
THAT'S RIGHT.
THE NEXT ITEM WILL BE ITEM
NUMBER ONE SP NINE NINE TWO TWO.
CHAIR HERNANDEZ.
AND IT.
HE KNOWS.
WHEN HE FOUND THANK YOU MADAM
CHAIR AND MEMBERS.
ONE NINE NINE TWO YOU SAID.
NINE NINE TWO AND WE HAVE
SUPPORT ON BOTH SIDES THANK YOU
VERY MUCH.
THE COMMITTEE HEARD. ABOUT SOME
TROUBLING PRACTICES.
HAPPENING SUBSTANCE ABUSE
TREATMENT INJURY DURING THE
INFORMATION HERE IN JANUARY.
MAJORITY OF TREATMENT SYSTEMS
OPERATE WITHIN THE LAW BUT THERE
ARE BAD ACTORS OUT THERE AND WE
NEED TO PROTECT THE INDIVIDUAL
THE SUBSTANCE ABUSE DISORDERS
WHO RANGE IN SERVICES FOR
SUCCESSFUL RECOVERY. THIS RANGE
INCLUDES INPATIENT TREATMENT
OUTPATIENT TREATMENT PRESENT
ROCK RESIDENTIAL CARE. AND SAFE
CLEAN SOBER HOMES TO LIVE IN.
WITH SUBSTANCE ABUSE USED
DISORDER DESERVE ACCESS TO
COMPREHENSIVE QUALITY CARE. IN
THE SAME WAY THOSE WITH PHYSICAL
HEALTH ELEMENTS HAVE ACCESS TO
THIS BILL STRING SINCE DH CS OF
THIRTY TO OVER. LICENSED
FACILITIES AND TIGHTENS CURRENT
LAW TO ENSURE THAT THOSE WHO
NEED IT MOST HAVE ACCESS TO
PROPER TREATMENT. THIS BILL WILL
ALSO HELP TO GET A HANDLE ON THE
NUMBER OF UNLICENSED RECOVERY
RESIDENTS THAT ARE OUT THERE. MY
RECORD BY REQUIRING LICENSED
FACILITIES DISCLOSE CERTAIN
BUSINESS PRACTICES INCLUDING
WHEN THEY HAVE A FINANCIAL
INTEREST IN UNREGULATED RECOVERY
RESIST RESIDENCES. AND CREATING
A VOLUNTARY REGISTRY PROGRAM FOR
THE UNLICENSED FACILITY WITH
THAT MEMBERS I RESPECTFULLY ASK
FOR NINE MONTHS. THANK YOU.
THIS ISN'T.
SUPPORT ARE ALSO KNOW OF
REPRESENTING THE CALIFORNIA
ASSOCIATION OUT FRONT DRUG
PROGRAM EXECUTIVES AS ITS
PRESIDENT AND PRESIDENT OF
TARZANA TREATMENT CENTERS.
ARCH PROVIDER ORGANIZATION.
BUT WE ARE HERE TO SPEAK IN
SUPPORT OF SB NINE NINE TWO.
IT. IS MAKING SOME OF THE
PROVISIONS THAT ARE I THINK ARE
LONG OVERDUE.
OF THE VOLUNTARY REGISTRATION
PROCESS WILL BEGIN TO GET A
HANDLE ON.
AT LEAST THE GOOD OPERATORS
THAT ARE OUT IN THE COMMUNITIES.
IT REQUIRES THE DISCLOSURE OF
FOR OWNERSHIP OF THOSE OPERATORS
WHICH IS A BIG PLUS IT SHOULD BE
DONE.
IT IS THE OTHER THINGS THAT IT
GOES AFTER WITH CURRENT
REGULATIONS MAKES CHANGES THAT
IMPROVE ACCESS AND REDUCE.
PATIENT RISK.
ON. THE GRANTS FURTHER AUTHORITY
TO THE DEPARTMENT OF HEALTH CARE
SERVICES TO DO BETTER
ENFORCEMENT. GIVES THEM MORE
LATITUDE FOR SUSPENSION AND
REVOCATION OF LICENSURE OR
CERTIFICATION FOR BAD ACTORS. TO
INCLUDE EXTENDING THAT TO OF
FACILITIES MULTIPLE FACILITIES
OF THAT THAT BAD ACTOR MIGHT BE.
OPERATING.
HOME BAND CLOSES A COUPLE
IMPORTANT LOOPHOLES OR ONE OF
THOSE BEING THE REFERENCE TO
TWENTY FOUR HOURS IN THE
RESIDENTIAL REGULATIONS. THAT
HAS BEEN USED BY SOME OF THESE
BALLOTS OPERATORS TO MANIPULATE
THE SYSTEM. OPERATE FOR JUST
UNDER TWENTY FOUR HOURS AND THEN
ARGUE OR NOT REQUIRED TO BE
LICENSED BECAUSE THE REGULATIONS
SAY TWENTY FOUR HOURS SO. WE
WOULD URGE YOUR SUPPORT THINK
IT'S A. BIG IMPROVEMENT FOR THE
FIELD.
BUT THIS IS IN SUPPORT.
TOM RENT FREE WITH THE R.
CALIFORNIA BEHAVIORAL HEALTH
DIRECTORS ASSOCIATION ARE WE WE
HAVE A MINOR ISSUE WITH ONE
PROVISION OF THE BILL BUT
THERE'S SO MANY GOOD THINGS IN
THIS BILL THAT WE ARE. WE ARE
SUPPORTING.
MADAM VICE CHAIR. DATING WITH
THE CALIFORNIA STATE ASSOCIATION
OF COUNTIES IN SUPPORT.
SHERRY DAVIS CALIFORNIA
CONSORTIUM OF ADDICTION PROGRAMS
AND PROFESSIONALS WE AS WELL
HAVE JUST A COUPLE OF MINOR
ISSUES WANT TO THANK THE CHAIR
FOR BRNGING FORWARD. A STAFFER
WORKING WITH US.
CHILD DISABILITY RIGHTS
CALIFORNIA WE CERTAINLY SUPPORT
THE THE BILL TO THE EXTENT THAT
IT BRINGS GREATER.
TRANSPARENCY AND REGULATION TO
DRUG TREATMENT PROGRAMS.
UNFORTUNATELY WE CONTINUE TO
HAVE PROBLEMS WITH THE
CERTIFICATION PROGRAM EVEN IF IT
IS A VOLUNTARY CERTIFICATION
PROGRAM WE BELIEVE THAT THAT
RUNS A FILE. ABOVE US STATE AND
FEDERAL FAIR HOUSING LAW. AND
LIMITS THE HOUSING THAT IS
AVAILABLE ON THE MARKET NOW.
PARTICULARLY.
IN A TIME OF SIGNIFICANT
HOUSING CRISIS FOR.
INDIVIDUALS WHO ARE CHOOSING TO
LIVE TOGETHER AND BE SUPPORTIVE
FILM THERE.
ALCOHOLISM OR DRUG TREATMENT
THANK YOU.
LINDA AWAY WITH WESTERN CENTER
ON LAW AND POVERTY WE ARE
NEUTRAL ON THE BILL BUT I SHARES
A CONCUR WITH SOME OF THE
COMMENTS MADE BY THE DISABILITY
RIGHTS CALIFORNIA. THANK YOU
EIGHTY WITNESSES IN OPPOSITION.
YES SEEING NONE.
COLLEAGUES QUESTIONS COMMENTS
SENATOR PENN.
THANK YOU SENATOR AND THIS I
JUST WANT TO BUT HE HAD A
RESPONSE TO DISPLAY WRITES ABOUT
THEIR CONCERNS ABOUT SCHOOLMATE
AND THEN I THINK THE ONE OTHER
ISSUES THAT ALSO HAS BEEN
RAISED.
UNDERSTANDS A VOLUNTARY
REGISTRATION THERE'S ALSO I
UNDERSTAND THAT.
THERE'S POSTING OF.
OF THE LOCATIONS AS ON THE
MONEY EITHER CONCERNS THAT'S
ALSO COME UP IS THAT. ARE WE.
CERTAINLY I THINK
THERE'S-IMPORTS FOR THAT
INFORMATION TO
PEOPLE WHO MAY BE SEEKING
SERVICES BUT I THINK THERE'S
ALSO THE CHALLENGE THAT.
SOME PEOPLE MAY ALSO SEE A LIST
AS A WAY TO.
TO DRIVE OUT ARE MAKE IT HARDER
FOR PEOPLE TO HAVE THIS.
HOMES AS WELL SO. WE CAN JUST
SAYS YES SO IT WASN'T TO. DRIVE
OUT ANY ENTITIES OBVIOUSLY WE
WANT TO MAKE SURE THAT THERE ARE
FACILITIES ARE AVAILABLE I AM
VERY WELL AWARE OF THE. FEDERAL
LAW AND THE.
DISABILITY.
ISSUES AND THAT'S WHY WE
SPECIFICALLY DIDN'T MAKE IT
MANDATORY BUT MADE IT VOLUNTARY
BUT I THINK THE REASON WHY WE
WOULD MAKE IT VOLUNTARY IS TO
HAVE THE ABILITY TO SHOW
INDIVIDUALS.
WHO WANTS TO DO SO THESE ARE
FACILITIES YOU KNOW THERE ARE
BITING THEY HAVE CERTAIN
STANDARDS THEY WANNA GO BY THE
BY ALL MEANS IT IS NOT? AT ALL
DESIGNED TO BE PUNITIVE AND IT'S
STRICTLY VOLUNTARY THAT'S WHY.
YOU KNOW I UNDERSTAND THE
CONCERN ABOUT THE FEDERAL
HOUSING ISSUES.
ANY OTHER QUESTIONS.
JULY TWO CLOSE MR RESPECTFULLY
ASK FOR AN IRA MADAM CHAIR.
AND THEY. GET A MOTION. MOTION
BY SENATOR LABOR. BUSINESS DO
PASS TO PROCREATION PLEASE CALL
FOR THE.
BOTH.
HERNANDEZ HERNANDEZ I WHEN I
WHEN I LABOR. LABOR I MITCHELL.
SO I MOANING.
NEWMAN. NEWMAN I NIELSEN.
WILSON I AM.
AND I BROUGHT.
WE'LL KEEP THE ROLL CALL OPEN A
COMMAND CHAIR MEMBERS.
NEXT ITEM A MISTER CHAIRMAN AS
ITEM THREE S. B. TWELVE FIFTY
FIVE THANK YOU MADAM CHAIR
MEMBERS THIS BILL REQUIRES.
COVER CALIFORNIA TO MINISTER
FINANCIAL ASSISTANCE TO
INDIVIDUALS WHO HAVE TO PAY.
EIGHTY PERCENT OR MORE OF THEIR
HOUSEHOLD INCOME AND HEALTH
INSURANCE. HEALTH INSURANCE
CONTINUES TO BE AFFORDABLE FOR
MANY REASONS. INSTABILITY
INSTABILITY IN THE INDIVIDUAL
HEALTH INSURANCE MARKET. BROUGHT
ABOUT BY THE CURRENT POLICIES AT
THE FEDERAL LEVEL. WHICH
UNDERMINED THE AFFORDABLE CARE
ACT WHICH CAN LEAD TO EVEN
HIGHER PREMIUMS AND FORCE
INDIVIDUALS OUT OF THE HEALTH
MARKET.
COVER CALIFORNIA'S RELEASE AN
ANALYSIS TO INDICATES THAT IN
TWENTY NINETEEN BECAUSE OF THE
FEDERAL POLICIES. PREMIUMS COULD
GO UP IN CALIFORNIA BETWEEN
TWELVE AND THIRTY TWO PERCENT.
TO MAINTAIN STABILITY IN THE
SHORT TERM CALIFORNIA SHOULD
OFFER ADDITIONAL ASSISTANCE.
WITH ME I HAVE BEST COMPEL FROM
HEALTH AXES IN JEANS FLURRY FROM
WESTERN CENTER LAWN PROPERTY IS
WITNESSES IN SUPPORT OF THE BILL
AND WITH THAT I RESPECTFULLY ASK
WHEN I WROTE.
LET'S GO FOR IT.
GOOD AFTERNOON MADAM CHAIR AND
MEMBERS FELT COMPELLED TO HAVE
HEALTHAXIS CALIFORNIA.
CALIFORNIA HAS MADE ENORMOUS
PROGRESS ON INSURING THE
UNINSURED SINCE THE AFFORDABLE
CARE ACT WAS IMPLEMENTED HERE.
OVER FIVE MILLION CALIFORNIANS
ARE HAVE ENROLLED IN MEDICAID
AND SEVERAL. MILLION MORE HAVE
GOTTEN HELP FROM COVERED
CALIFORNIA OVER THESE YEARS.
BUT THREE MILLION CALIFORNIANS
REMAIN UNINSURED LAST WEEK YOU
TOOK A MAJOR STEP BY VOTING ON
SP NINE SEVEN FOUR BY SENATOR
LARA TO COVER. TO EXTEND MEDICAL
TO LOW INCOME UNDOCUMENTED
ADULTS. TODAY WITH THE SP TWELVE
FIFTY FIVE YOU CAN TAKE AN
EQUALLY IMPORTANT STEP TO
IMPROVE AFFORDABILITY FOR THOSE
CALIFORNIAN TO BUY COVERAGE IN
THE INDIVIDUAL MARKET. THERE
ABOUT TWO POINT FIVE MILLION
CALIFORNIANS WHO BUY COVERAGE IN
THE INDIVIDUAL MARKET TODAY
THROUGH COVERED CALIFORNIA OR.
OFF COAT OFF EXCHANGE OUTSIDE
COVERED CALIFORNIA. THERE ALSO
ONE POINT TWO MILLION
CALIFORNIANS WHO DO NOT GET
COVERAGE ON THE JOB AND WHO
REMAIN UNINSURED VERY LARGE
SHARE OF THOSE THREE MILLION
REMAINING UNINSURED. SP TWELVE
FIFTY FIVE WOULD LIMIT WHAT
CONSUMERS SPEND ON PREMIUMS TO
EIGHT PERCENT OF INCOME. HELPING
BOTH THOSE WHO ARE IN THE CAR
CALIFORNIA INCOME RANGE BELOW
FOUR HUNDRED PERCENT OF POVERTY.
AND ALSO THOSE WHO ARE ABOVE
FOUR HUNDRED PERCENT OF POVERTY.
WE DON'T NORMALLY TALK A LOT
ABOUT PEOPLE MAKING FIFTY OR
SIXTY THOUSAND DOLLARS A YEAR.
BUT I WANT TO POINT OUT THE
COVERAGE IS UNAFFORDABLE IN MOST
OF CALIFORNIA FOR AN INDIVIDUAL
IN THEIR FORTIES AND FIFTIES
THEY WOULD SPEND MORE THAN EIGHT
PERCENT OF INCOME ON COVERAGE.
THAT HAS A SIX THOUSAND THREE
HUNDRED DOLLAR DEDUCTIBLE. IN
ALMOST ALL OF CALIFORNIA A
MARRIED COUPLE IN THEIR TWENTIES
OR THIRTIES MAKING SIXTY FIVE OR
SEVENTY THOUSAND DOLLARS A YEAR
WOULD AGAIN SPEND MORE THAN
EIGHT PERCENT OF CREAM OF THEIR
INCOME TRUST ON PREMIUM FOR THAT
COVERAGE WITH. OVER SIX THOUSAND
DOLLAR DEDUCTIBLE. THIS BILL
WOULD HELP BOTH ON PREMIUMS AND
ON COST SHARING WHEN WE TALK FOR
A MINUTE ABOUT THAT THOSE SIX
THOUSAND.
THREE HUNDRED DOLLAR DEDUCTIBLES
THAT'S THE BRONZE COVERAGE
THAT'S THE CHEAPEST COVERAGE
THERE IS.
THE DEDUCTIBLE SIX THOUSAND
THREE HUNDRED BEFORE THAT YOU
GET THREE DOCTOR VISITS COUNTING
ONE TWO THREE THAT'S ALL. YOU
HAVE TO PAY CASH FOR BECAUSE THE
PREMIUMS ARE CHEAP
WE CAN DO MORE TO HELP PEOPLE
OTHER STATES HAVE DONE IT. FOR
MONT NEW YORK MASSACHUSETTS
MINNESOTA EVEN SAN FRANCISCO SP
TWELVE FIFTY FIVE TAKES THAT
STEP OF HELPING. INDIVIDUALS IN
THE INDIVIDUAL MARKET BETTER FOR
COVERAGE FOR THAT REASON WE'RE
PLEASED TO BE HERE SPORT.
NEXT GOOD AFTERNOON I'M JENN
FLORES THE WESTERN CENTER ON LAW
AND POVERTY. THAT WERE PART OF
THE HEALTH CONSUMER ALLIANCE
WHICH CONTRACTS WITH COVERED
CALIFORNIA TO PROVIDE
INDEPENDENT CONSUMER ASSISTANCE
TO COVER CALORIE COVERED
CALIFORNIA ENROLLEES OR THOSE
WHO ARE TRYING TO ENROLL.
THROUGH OUR ROLE IN THAT AD ART
THE WORKED AT SEVERAL CONSUMER
ADVOCATES DO EVERY YEAR WITH
COVERED CALIFORNIA PLAN BENEFIT
DESIGN WE'VE COME TO A FAIRLY
DEEP UNDERSTANDING AS TO WHERE
COVERED CALIFORNIA ASSISTANCE
NEEDS IMPROVEMENT.
THERE'S THREE MAIN CLIFFS THAT
WE LOOK AT THAT WE'RE TRYING TO
SMOOTH OUT WITH SB TWELVE FIFTY
FIVE. FIRST OF ALL PEOPLE WHO
ARE EARNING JUST A BIT TOO MUCH.
TO GET FREE MEDICARE OUT THEY
HAVE TO START PAYING PREMIUMS
AND OUT OF POCKET COSTS.
AS MISS KAPELL SAID EVEN
CONTRIBUTING TWO PERCENT OF
THEIR INCOME IS A LOT
CONSIDERING HOW LITTLE INCOME
THEY HAVE OUR LOWEST INCOME
PEOPLE ALWAYS NEED MORE HELP.
AND THEN THE NEXT CLIFF COMES AT
PEOPLE AT JUST ABOVE TWO HUNDRED
PERCENT OF THE FEDERAL POVERTY
LEVEL THEY NO LONGER GET VERY
MUCH OUT OF POCKET ASSISTANCE
MAYBE FROM JUST BELOW TWO
HUNDRED PERCENT TO JUST OVER TWO
HUNDRED PERCENT. THE OUT OF
POCKET COSTS TRIPLE IF YOU STAY
IN A SILVER PLAN.
SO WE TAKE A FAMILY OF FOUR AND
JUST ABOVE TO IN A PERCENT HERE
IN SACRAMENTO THAT MEANS EARNING
ROUGHLY FIFTY THOUSAND A YEAR OR
FORTY ONE HUNDRED A MONTH BEFORE
TAXES. THEIR TWO KIDS ARE
PROBABLY ON MEDICARE ALSO
THEY'RE ABLE TO GET. THEIR
COVERAGE FOR THIRTEEN DOLLARS A
MONTH.
IF THEY CHOOSE A SILVER PLAN AND
THEY'RE PAYING ANYWHERE FROM TWO
TO SIX HUNDRED A MONTH BUT
THEY'D STILL FACE A TWENTY TWO
HUNDRED DOLLAR DEDUCTIBLE SO
THEN WE END UP WITH WHAT MISTER
POWELL WAS TALKING ABOUT. THEY
START USING BRONZE PLANS AT A
HIGHER RATE.
THAT LEAVES THEM WITH A SIXTY
THREE HUNDRED DOLLAR DEDUCTIBLE.
AND THEN THE THIRD CLIFF IS FOR
THOSE PEOPLE THAT ARE EARNING
OVER FOUR HUNDRED PERCENT OF THE
FEDERAL POVERTY LEVEL IT SOUNDS
LIKE A LOT BUT OLDER COUPLES ALL
OVER THE STATE OUR PAIN FIFTEEN
HUNDRED A MONTH. FOR THE
CHEAPEST POLICY OR OVER TWO
THOUSAND A MONTH FOR SLIGHTLY
BETTER CARE IT TAKES A LOT OF
INCOME TO PUT THAT IN TO REACH.
MANY PEOPLE DO BUY THIS COVERAGE
THANKS TO THE AFFORDABLE CARE
ACT BUT THEY'RE STRETCHED.
OTHERS WHETHER IT'S BECAUSE OF
HIGH RENT STUDENT LOANS OTHER
DEBTS ARE CAR REPAIRS SIMPLY
CAN'T AFFORD TO OPT IN. WHAT
THIS MEANS IS THOSE WHO NEED THE
CARE MOST ARE BUYING COVERAGE
AND FOR GOING OTHE EXPENSES
WHILE THOSE WHO THINK THEY CAN
GET BY WITHOUT IT TAKE THE
GAMBLE AND GO WITHOUT? WHEN ONLY
THE SICKEST PEOPLE BUY IN
PREMIUMS GO UP.
WE'VE COME A LONG WAY WITH THE
AFFORDABLE CARE ACT BUT IF WE'RE
SERIOUS ABOUT GETTING TO
UNIVERSAL COVERAGE IN CALIFORNIA
WE HAVE TO BUILD ON THE SYSTEM
WE DO HAVE TO PUT COVERAGE
WITHIN REACH. SP TWELVE FIFTY
FIVE ALLOWS CALIFORNIA TO PUT
ADDITIONAL FUNDING WHERE IT'S
MOST NEEDED TO SMOOTH OUT THE
SLIDING SCALES AND COVERED
CALIFORNIA AND PROVIDE EVERYONE
WITH A BIT MORE HELP. WOULD LIKE
TO THANK THE AUTHOR FOR HIS
LEADERSHIP IN THE ORIGINAL
IMPLEMENTATION OF THE AFFORDABLE
CARE ACT IN CALIFORNIA AND FOR
BEING WILLING TO LOOK WHERE THE
IMPROVEMENTS ARE NEEDED. FOR
THESE REASONS WESTERN CENTER
SUPPORTS SP TWELVE FIFTY FIVE
AND RESPECTFULLY REQUEST YOUR
IPHONE.
THANK YOU WITNESSES IN SUPPORT.
IT REALLY. CAN REALLY TELL THE
CALIFORNIA PAN ETHNIC HEALTH
NETWORK IN SPORT.
MARK MENDOZA WITH US HERE YOU
CALIFORNIA AND SUPPORT.
TIFFANY PULLEYBLANK WITH THE
NATIONAL ASSOCIATION OF SOCIAL
WORKERS AND SUPPORT.
ARMONK BUSINESS WITH THE
AMERICAN CANCER SOCIETY CANCER
ACTION NETWORK ALSO IN SUPPORT.
MISTER HERNANDEZ ON BEHALF OF
THE GREEN LINING INSTITUTE IN
SUPPORT.
TIM VALDERRAMA WITH THE WHITEMAN
GROUP ON BEHALF OF NEXT GEN AND
AMERICA WE BELIEVE THAT. THIS
BILL IS A.
IT'S A GOOD WAY TO HIM A
CONSUMER FRIENDLY WAY TO KEEP
PEOPLE HEALTHY PEOPLE IN THE
REST PULL IN A MOVE US CLOSER TO
UNIVERSAL COVERAGE OR IN STRONG
SUPPORT.
THANK YOU. ANY WITNESSES IN
OPPOSITION PLEASE COME FORWARD.
SEEING NONE BACK TO THE
COMMITTEE QUESTION SENATOR
NEWMAN. THANK YOU MADAM CHAIR
CIRCUS QUICK QUESTION SO DO I
I'M GONNA VOTE FOR THE BILL THEY
THINK IT'S IMPORTANT. I THINK
IT'S ALSO IMPORTANT REMEMBER
THAT IF WE'RE GOING TO TAKE. A
PUBLIC FUNDS AS SUBSIDIES WE'RE
IN A FORTUNE POSITION RIGHT NOW
PHYSICALLY BUT WE WON'T
NECESSARILY BE. THE INDEFINITE
FUTURE.
THERE HAS BEEN. A LOT OF TALK
ABOUT UNIVERSAL HEALTHCARE BUT
NOT. A PARTICULARLY HIGH LEVEL
TALK RUPESTRIS HE RECENTLY ABOUT
THE REPEAL OF THE INDIVIDUAL
MANDATE WHICH CLEARLY HAS HAD A
BIG IMPACT. ON THE QUALITY TE
RISK POOL AND SO I I JUST BECAME
A SHOW AT WHAT ARE YOUR
THOUGHTS.
MISSED CONUS FLORI. AS TO THE
BENEFITS TO ARGUMENTS OF FOUR
AGAINST.
ESPECIALLY HAVING AN INDIVIDUAL
MANDATE WITHIN CALIFORNIA. AS IT
MIGHT ATTEND TO THE PROVISION
HEALTHCARE.
WE THINK WE ABOUT HELEN WITH
pCAHILL ON BEHALF OF HELL TEXAS.
WE KNOW THAT IMPROVING
AFFORDABILITY INCREASES THE
NUMBER OF PEOPLE WHO TAKE
COVERAGE WE HAVE. ONE POINT TWO
MILLION CALIFORNIANS WHO ARE
UNINSURED AND COULD BENEFIT FROM
THESE SUBSIDIES INCLUDING. SEVEN
HUNDRED THOUSAND WHO ARE
ELIGIBLE FOR SUBSIDIES TO
CALIFORNIA COVERED CALIFORNIA
YOU'VE CHOSEN NOT TO TAKE
ADVANTAGE OF THOSE SUBSIDIES
DESPITE THE INDIVIDUAL MANDATE.
WE THINK IMPROVING AFFORDABILITY
IN COVERED CALIFORNIA AND FOR
PEOPLE SOMEWHAT ABOVE THAT
INCOME RANGE WOULD INCREASE THE
NUMBER OF PEOPLE WHO ARE INSURED
AND COUNTER ACT. THE EFFECT IN
PART OF THE REPEAL OF THE
PENALTY FOR THE INDIVIDUAL
MANDATE WE WOULD DISCOVER HEALTH
TEXAS CALIFORNIA HAS COME.
RELUCTANTLY TO SUPPORT THE
CONCEPT OF AN INDIVIDUAL MANDATE
WE WOULD HOPE THAT IF WE DID IT
IN CALIFORNIA WE WOULD DO WHAT
DOCTOR HERNANDEZ AND HAS DONE SO
OFTEN WITH OTHER PARTS OF THE
AFFORDABLE CARE ACT AND IMPROVE
ON IT DO A BETTER FOR A
CALIFORNIA VERSION OF IT. THAT.
LITTLE KINDER A LITTLE MORE
PROGRESSIVE A LITTLE MORE AIMED
AT HELPING PEOPLE RATHER THAN
PUNISHING PEOPLE BUT. WE WOULD
SUPPORT THAT WE THAT IS NOT THE
BILL THAT'S BEFORE YOU TODAY THE
BILL THAT'S BEFORE YOU TODAY IS
TO IMPROVE AFFORDABILITY AND WE
WE BELIEVE THAT WOULD HELP TO
COUNTER VEIL SOME OF THE AFFECT
OF THE REPEAL THE PENALTY.
SHOULD IT THANK YOU.
ANY OTHER QUESTIONS COMMENTS.
SEEING NONE WHAT ABOUT YOUR
QUESTION WITH
REGARD TO INDIVIDUAL MANDATE AND
THAT KIND OF A. LOOKED AT BOTH
ISSUES AND. WE EITHER CAN GO
THROUGH THE CARROT OR THE STICK.
AND RIGHT NOW THIS BILL IS MORE
OF THE CARROT APPROACH. IN
LOOKING AT THE SUCCESSES OF WHAT
A* COVER CALIFORNIA HAS DONE
WITH THE GREAT NUMBER OF
INDIVIDUALS THAT HAVE.
CUT INSURED WERE MOVING FORWARD
WE HAVE A ROBUST MARKET WE HAVE
NUMEROUS BRADY REGIONS THAT HAVE
A LOT OF. HEALTH PLANS BUT THE
FACT IS BECAUSE OF THE MARKET
POTENTIAL MARKET INSTABILITY
WHAT'S HAPPENED AT THE FEDERAL
LEVEL. RATES ARE GOING UP AND
COULD POTENTIALLY GO UP. SO IT
IS MY INTENTIONTO USE MORE THE
CARROT TO ENCOURAGE MORE
INDIVIDUALS BUT HELP THOSE
INDIVIDUALS WHO IN THE PAST.
WHO'VE HAD DIFFICULTIES.
AFFORDING HEALTH INSURANCE. AND
YES WE HAVE A GOOD. ECONOMIC
TIMES BUT I'M HOPING THIS WILL
RIGHT TO THAT WAVE. AND AS MAYBE
THERE'S NOT GOOD ECONOMIC TIMES
BUT THAT THE MARKET WILL
READJUST WITH REGARD TO HEALTH
INSURANCE SO THAT MEMBERS I
RESPECTFULLY ASK THE NAME OF.
BEST BE TWELVE FIFTY FIVE
HERNANDEZ DO PASS TO
APPROPRIATIONS OF ANY EMOTION.
FORGOT.
NEWMAN THANK YOU MADE THE
MOTION.
OF.
HIS CALL FOR THE VOTE HERNANDEZ
HERNANDEZ I WHEN I WHEN I LABOR.
I MITCHELL. MITCHELL I MINING.
NEWMAN NEWMAN I NIELSEN.
NO.
CAN I CAN I ROSS.
THEY WILL KEEP THE ROLL CALL
OPEN A COMMAND CHAIR MEMBERS.
ADAM MISTER CHAIRMAN. ITEM FIVE
SP TWELVE EIGHTY SIX EIGHT SEVEN
THANK YOU.
YOU HAVE SUPPORT ON BOTH SIDES
THANK YOU VERY MUCH.
WILL BE ACCEPTING OBVIOUSLY THE
MAN.
COMING OVER SEVEN ON PAGE FOUR
OF THE ANALYSIS.
MEASURE PUTS INTO STATE LAW THE
MEDICAL NECESSARY STAND FOR
CHILDREN ENROLLED IN MEDICARE
ALL CHILDREN IN MEDICARE WILL
RECEIVE BENEFITS THROUGH WHAT IS
CALLED THE EARLY AND PERIODIC
SCREENING. DIAGNOSIS AND
TREATMENT SERVICES BENEFIT OR HE
HE S. P. T. WITH THAT I HAVE.
LINDA AND WIN.
FROM WESTERN CENTER OF LAN
PARTY SPEAK ON BEHALF OF THE
MEASURE THANK YOU.
HI MY NAME IS CANDICE AND I'M A
LOT FELLOW NEIGHBORHOOD LEGAL
SERVICES OF LOS ANGELES WE SERVE
LOW INCOME COMMUNITIES COUNTY
WIDE INCLUDING THE SAN GABRIEL
VALLEY. DOESN'T HAVE A
SIGNIFICANT PORTION OF OUR WORK
RELATES TO ISSUES ARE VULNERABLE
CLANK COMMUNITIES ENCOUNTER
RELATING TO THEIR MEDICAID
ELIGIBILITY AND SERVICES.
SO THIS AFTERNOON I LIKE TO TELL
THE STORY OF A SIXTEEN YEAR OLD
CLIENT WHO I RECENTLY
REPRESENTED. AFTER HER MOTHER
CONTACTED OUR ORGANIZATION IN
UTTER DESPAIR.
HER DAUGHTER WAS CRYING IN PAIN
EVERY SINGLE DAY FROM THE ROTTEN
TOOTH LODGED IN HER PALATE.
NEARLY EVERY DAY WHILE AT SCHOOL
OTHER CHILDREN WERE PULLING HER
DAUGHTER. THE CHILD'S MOUTH
WOULD RANDOMLY BROKE PLAYED
DURING CLASS RECESS AND OTHER
TIMES WHILE AT SCHOOL BECAUSE OF
THE SEVERELY IMPACTED TEETH. THE
SINGLE MOTHER HAD WORKED WITH
MEDICARE FOR THE PAST FEW YEARS
DOING EVERYTHING IN OUR POWER
TO%
GET HER DAUGHTER PROOF FOR THESE
MEDICALLY NECESSARY DENTAL
SERVICES. THE MOTHER EVEN WENT
TO A STATE BY STATE FAIR HEARING
ALONE BUT COULD NOT GET THE
DENTAL CARE HER DAUGHTER NEEDED
BECAUSE THE BROADER AN
APPROPRIATE PST T. STANDARD WAS
NOT APPLIED. EVEN DURING OUR
CALLS I COULD HEAR THE
DESPERATION IN THE MOTHER'S
VOICE HER DAUGHTER CAN
UNDERSTAND WHY THEY COULDN'T FIX
OUR TEETH AND THE MOTHER DIDN'T
KNOW WHAT TO DO OR TO SAY TO HER
DAUGHTER.
IT'S BECAUSE BECAUSE PRESENT
STATE LAWS UNCLEAR PROVIDERS AND
PLANS AREUNDER WHERE THE
FEDERAL EPA STT MEDICAL
NECESSITY STANDARD. FOR
CHILDREN.
THEREFORE NEIGHBORHOOD LEGAL
SERVICES OF LOS ANGELES STRONGLY
BELIEVES THAT THIS BILL WILL
HAVE A PROFOUNDLY POSITIVE
EFFECT ON OUR VERY VULNERABLE
CRYING COMMUNITIES THANK YOU.
THANK YOU.
LINDA AWAY WITH WESTERN CENTER
ON LAW AND POVERTY PROUD CO
SPONSORS OF THIS IMPORTANT
MEASURE HERE TO ANSWER ANY
TECHNICAL QUESTIONS THEY MAY
HAVE BUT HERE TO VOICE OUR
STRONG SUPPORT. THANK YOU
WITNESSES IN SUPPORT.
HE LAID ON BEHALF OF THE
CHILDREN SPECIALTY CARE
COALITION AND SUPPORT.
MARY VALDEZ WITH HEALTHAXIS
CALIFORNIANS SUPPORT.
GOOD AFTERNOON RAN A PITCHMAN
SPENCER WITH THE CALIFORNIA
DENTAL ASSOCIATION WERE HERE I'M
TECHNICALLY WITH THE SUPPORT IN
CONCEPT. VERY SUPPORTIVE OF THE
IDEA OF GETTING AND CHILDREN
MEDICALLY NECESSARY SERVICES WE
HAVE HEARD OF THAT THIS IS AN
ISSUE ESPECIALLY IN THE
ORTHODONTIC AREA.
AND OUR PROVIDERS HAVE SAID
THAT THE CUT OFF IS VERY HIGH
AND THAT THEY DO OFTEN HAVE
PROBLEMS IN GETTING ORTHODONTIC
BRACES APPROVED. IN MEDICARE ALL
THE CONCERN THAT THEY RAISED IS
THAT THERE'S A VERY CLEAR
STANDARD THAT IS USED AND SO
THERE'S AT LEAST A CLEAR BRIGHT
LINE AND WHILE THEY THINK IT'S
TOO HIGH. THEY JUST WANT TO
ENSURE THAT.
HWEVER THIS IS IMPLEMENTED IT
DOESN'T BECOME OPAQUE AND AS
PROBLEMATIC AS SOME OF THAT
TREATMENT AUTHORIZATION REQUEST
PROCESSES ARE. BUT OTHERWISE
VERY MUCH IN A IN SUPPORT OF THE
CONCEPT AND HOPE TO CONTINUE I'M
SUPPORTING AND WORKING ON THIS
BILL THANK YOU.
TIFFANY PULLEYBLANK WITH THE
NATIONAL ASSOCIATION OF SOCIAL
WORKERS CALIFORNIA CHAPTER IN
STRONG SUPPORT.
VIDEO BORN WITH AMERICAN ACADEMY
OF PEDIATRICS AND CALIFORNIA
SCHOOL NURSES AND SUPPORT.
SO WE HAVE THE MARCH OF DIMES IN
SUPPORT.
A WITNESSES IN OPPOSITION PLEASE
COME FORWARD. SEEING THEN BACK
TO MY COLLEAGUES SENATOR CHUCK
VANCE.
THE SENATE HAS ITS A LOT THANK
YOU SO MUCH FOR BRINGING THIS
LEGISLATION FORTUNATELY THE
PEDIATRICIAN I KNOW HOW
IMPORTANT THE STANDARD IS
AFFECTED SPIED MUST REST THE
COUNTRY TO THEIR MEDICAID
PROGRAM SO IT'S ABOUT TIME WE DO
THAT HERE IN CALIFORNIA. THAT AT
THE TIME WOULD LIKE TO MOVE THE
BILL AS WELL.
THANK YOU WOULD YOU LIKE TO
CLOSE AS FROM A VOTE.
THANK YOU THIS IS.
DO PASS TOO APPROPRIATION.
IT PASSES AND OFF.
I DID A LOT OF TIMES. WHEN.
THE MAN. DIDN'T GIVE ME THE FIVE
I GOT SEVEN.
OKAY. THANK YOU.
IT'S DO PASS AS AMENDED SP
TWELVE EIGHTY SEVEN HERNANDEZ
PLEASE CALL FOR THE VOTE
HERNANDEZ AMANDA'S I WHEN I WHEN
I LABOR.
I MITCHELL.
HI MITCHELL I'M MINING. NEWMAN.
I NIELSEN. MEALS AND I CAN I CAN
I ROCK.
WE WILL KEEP THEIR WILL CALL
OPEN THANK YOU.
YOU.
OKAY WE STILL HAVE A FEW MEMBERS
ABSENT WE'RE GONNA GO AHEAD AND
LIFT THE CALL SO YOU LET MEMBERS
WHO WANT TO LEAVE AFTER WE DO
THAT WE'RE GONNA START WITH.
.
YEAH I WAS GOING TO START UP AN
ITEM NUMBER ONE SP NINE NINE
TWO.
.
BECAUSE WE HAVE SOME MEMBERS.
MINING.
PROF.
PLEASE DON'TCALL. ITEM NUMBER
TWO SP ONE ZERO ZERO FOUR CALL
THE UP SOME MEMBERS MITCHELL.
MITCHELL I MOANING.
HANDS FAN I CROSS.
ITEM NUMBER THREE SP ONE TWO
FIVE FIVE CALL THE UPS MEMBERS.
MINING.
ITEM NUMBER OF FOUR SP ONE TWO
SIX EIGHT CALL THE ABSENT
MEMBERS. MITCHELL.
SO I MINING. HAND. CAN I
BROUGHT.
ITEM NUMBER FIVE SP ONE TWO
EIGHT SEVEN CALL THE APPS
MEMBERS. MINING. DROP.
ITEM NUMBER SIX SP ONE THREE
THREE SIX CALL THE ABSENT
MEMBERS.
CAN.
ROTH.
HE SAID IN CALL ITEM NUMBER
SEVEN SP ONE FOUR FIVE SEVEN.
MITCHELL.
MITCHELL. I. MINING.
CAN I CAN I BROTH.
CURRENT VOTE COUNT IS SEVEN ZERO
PLACE AT BILL AND CALL
THE.
YEAH. WELL JUST TAXES OR
WHATEVER.
YEAH.
WE'RE GONNA TEMPORARILY RECESS.
AND THEN ONCE THE MEMBERS THE
TWO MEMBERS ARE ABSENT ARE
AVAILABLE THEN WE'LL RECONVENE
WE RECONVENE.
WE'RE GONNA START AT THE TOP.
WE'RE GONNA CALL OF ALL THE
ABSENT MEMBERS VERSUS ITEM
NUMBER ONE. SP NINE NINE TO CALL
THE UPS MEMBERS MINING.
RIGHT BONDING I.
ROTH ROTH I.
CURRENT ACCOUNT IS NINE ZERO
THAT BILL IS OUT.
ITEM NUMBER TWO SP ONE ZERO ZERO
FOUR CALL THE ABSENT MEMBERS
MINING. MINING I RALPH ROTH I.
CURRENT ACCOUNT IS NINE ZERO.
THAT BILL IS OUT. ITEM NUMBER
THREE SP ONE TWO FIVE FIVE
QUALITY OF SOME MEMBERS MINING.
MINING I.
ROTH ROTH I.
CURRENT VOTE COUNT IS EIGHT TO
ONE THAT BILLS OUT ITEM NUMBER
FOUR SP ONE TWO SIX EIGHT
BRADFORD CALL THE UPS MEMBERS
MINING. MINING I ROTH. ROTH I.
CURRENT ACCOUNT IS NINE ZERO
THAT BILL IS OUT. ITEM NUMBER
FIVE SP ONE TWO EIGHT SEVEN.
CALL THE ABSENT MEMBERS MINING.
MINING I ROTH ROTH I NINE. AND.
CURRENT ACCOUNT IS NINE ZERO
THAT BILL IS OUT. ITEM NUMBER
SIX SP ONE THREE THREE SIX CHAIR
THAT WAS VOTING NO CALL THE
ABSENT MEMBERS AND. ROCK. ROTH
NO.
OKAY SO THAT. NONE OF SENIOR.
CURRENT BOOK CONTEST UP TO YES
SIX NO OTHER BILL FAILS. HE
ASKED REPEATEDLY.
YEAH.
ITEM NUMBER SEVEN SP ONE FOUR
FIVE SEVEN OTHERS CONSENT CALL
THE UPS MEMBERS MINING. MINING I
ROSS ROSS I.
THAT CURRENT VOTE COUNT IS NINE
ZERO TAT BILL IS OUT. THAT
CONCLUDES THE BUSINESS OF THE
SENATE HEALTH COMMITTEE AND WE
ARE ADJOURNED