ON HEALTH.
WE HAVE FIFTEEN ITEMS ON OUR
AGENDA. ITEM NUMBER FOURTEEN SB
THIRTEEN SEVENTY THREE STONE HAS
BEEN PULLED FROM OUR AGENDA. AND
PUT OVER TO NEXT WEEK WE HAVE NO
CONSENT ITEMS AND WE HAVE TO WE
WILL HAVE TIME LIMITS ON OUR
TESTIMONY. AND I WANT TO
APOLOGIZE CENTER BATES I WAS
WAITING FOR YOU TO WALK THROUGH
THE DOOR THAT'S WHY I WAS JUST
WAITING AND WAITING AND THEN.
YEAH I COME INTO ANYWAY STARTED
IN SEE YOU WAITING DOWN THERE
ANYWAY SO WE HAVE ITEM NUMBER
ONE S. B. NINE NO TO BATES THIS
IS OUR CALL ISM OVER DRUG ABUSE
RECOVERY OR TREAT.
SO THESE.
A WE DO HAVE SUPPORT ON BOTH
SIDES ARE WE ARE GONNA BE
LIMITING THE TESTIMONY TO SIX
MINUTES FOR EACH SIDE BUT WE CAN
MAKE IT BRIEF ECAUSE WE HAVE A
PRETTY. LENGTHY SCHEDULE TODAY.
BUT FOR YOUR INFORMATION GET WE
HAVE SUPPORT ON BOTH SIDES
PROCEED.
THANK YOU CHAIRMAN HERNANDEZ AND
GOOD AFTERNOON ON MEMBERS I'D
LIKE TO BEGIN BY ACCEPTING THE
COMMITTEE AMENDMENT SO I THINK
YOU FOR THE HARD WORK THAT WENT
INTO AYE DRAFTING THOSE. ON THE
PART OF I YEAR CONSULTANT STAFF
FIRE SENATOR ANDERSON I'M.
SENATOR HERNANDEZ BOB. BOZELL BE
TAKEN IN THE PUBLIC SAFETY
COMMITTEE IF IT MOVES OUT OF
THIS COMMITTEE AS AMENDED S. B.
NINE OR TWO REQUIRES THAT.
CONDUCT BACKGROUND CHECKS
BEFORE AN INDIVIDUAL CAN BE
ISSUED A LICENSE TO OWNER
OPERATOR RESIDENTIAL TREAT
SO WITH THE.
OUR TREATMENT FACILITIES PROVIDE
A CRITICAL OPPORTUNITY FOR
ADULTS RECOVERING FROM DRUG OR
ALCOHOL ADDICTION HOW EVERY IT
IS IMPERATIVE THAT THE OWNERS
WHO EXERCISE CONTROL OR
MANAGEMENT OF INDIVIDUALS
SEEKING CARE. OR TREATMENT IN
THESE FACILITIES BE CLEARED
THROUGH STATE AND FEDERAL
CRIMINAL DATABASES. IN A
COMPREHENSIVE INVESTIGATION BY
THE SOUTHERN CALIFORNIA NEWS
GROUP IT FOUND. THAT THE STATE'S
DIFFICULTY IN REGULATING THE
INDUSTRY MAKES IT TOO EASY. FOR
ALMOST ANYONE TO OPEN A
TREATMENT CENTER IN CHARGE
HEALTH INSURERS FOR HUNDREDS
OF THOUSANDS OF DOLLARS PER
CLIENT WITHOUT ANY REQUIREMENTS
TO INSURE QUALIFIED PEOPLE. ARE
PROVIDED SAFE AND.
BECAUSE SAVE CARE AND TREATMENT.
THE GOAL IS.
IS TO HELP STOP THE INDUSTRY'S
BAD ACTORS NOT THOSE WITH
ESTABLISHED RECORDS OF HELPING
PEOPLE SUFFERING FROM ADDICTION.
THE BILL ALSO ALLOWS FLEXIBILITY
FOR THOSE WHO HAVE BEEN
CONVICTED OF SPECIFIC CRIMES
SIMILAR INDUSTRIES.
SUCH AS OUR COMMUNITY CARE
LICENSING RESIDENTIAL CARE
FACILITIES FOR ELDERLY. AND OUR
T. UPS THAT CARE FOR ADOLESCENTS
ALL REQUIRE BACKGROUND CHECKS
THE LEGISLATURE IMPLEMENTED
THESE POLICIES OVER THE YEARS IN
ORDER TO ENSURE THAT THESE
VULNERABLE. POPULATIONS ARE
SECURE AND SAFE AND WE WANT TO
CONTINUE IS KIND OF GUARDIANSHIP
IF YOU WILL ON THOSE WHO ARE
TRYING TO RECOVER FROM THE ARE
VERY SEVERE ADDICTIONS PETER
DEMARCO IS HERE ON BEHALF OF THE
ORANGE COUNTY BOARD OF
SUPERVISORS.
TO TESTIFY IN SUPPORT.
THANK YOU HAVE ON YOU MISTER
CHAIRMAN MEMBERS COMPUTER
DEMARCO ON THE LEGISLATIVE
AFFAIRS DIRECTOR FOR THE ORANGE
COUNTY EXECUTIVE OFFICE. LAST
WEEK THE BOARD OF SUPERVISORS
VOTED UNANIMOUSLY TO SUPPORT S.
B. NINE OH TWO BECAUSE OUR
RESIDENTS HAVE.
THE IMPACTS OF AN INDUSTRY WHERE
SOME BAD ACTORS HAVE BEEN
ALLOWED TO OPERATE WITH LITTLE
OVERSIGHT OR ACCOUNTABILITY.
GIVE FOR EXAMPLE THE CITY OF
NUMBER OF FACILITIES OPERATING
IN MANNER OF GREAT CONCERN.
CERTAIN HOMES TO GENERATE A
LARGE AMOUNT OF CALLS TO ARCH
COUNTY SHERIFF'S DEPARTMENT AND
MOST NOTABLY A SOVEREIGN HEALTH.
THIS COMPANIES UTILIZE SEVERAL
RESIDENCES FOR TREATMENT
ACCORDING TO OUR SHERIFF'S
DEPARTMENT.
AND ALTHOUGH THE SMITH THIS BILL
HAS BEEN AMENDED TODAY CUT TO
NARROW DOWN I DO THINK IT'S
IMPORTANT BRING UP TO BACK TO
ATTENTION THAT IN TWENTY.
TEEN.
TO.
EMPLOYEES OF SH OF.
SOVEREIGN WERE FOUND AN
ALARMING HISTORY.
ONE MALE EMPLOYEE WHO WAS LIVING
IN SAN CLEMENTE WITH THE STATE
OF KENTUCKY FUGITIVE FROM
JUSTICE WARRANT.
IT'S HISTORY OF CRIMINAL CHARGES
INCLUDES THE FOLLOWING MURDER
ASSAULT ASSAULT IN THE FOURTH
DEGREE. FIRST DEGREE WANTED
ENDANGERMENT. TAMPERING WITH
EVIDENCE INTIMIDATING A WITNESS.
MULTIPLE CHARGES OF NARCOTICS
POSSESSION. FAILURE TO APPEAR
WARRANT TALKIN WARRANTS
PROBATION VIOLATIONS.
OPPOSITION PRESCRIPTION DRUGS
NOT IN RACIAL CONTAINER AMONG
OTHERS.
SIMILAR EMPLOYEE ALSO HAD A
CRIMINAL INDUSTRY IN THE
CRIMINAL HISTORY.
THAT INCLUDED INTENT TO DEFRAUD
SECOND DEGREE BURGLARY THEFT.
CONTINUE DEDICATION OF OTHERS
FOR PURPOSES OF FRAUD AMONG
OTHERS.
INDIVIDUALS WHO ARE SERIOUS
ABOUT RECOVERING FROM THEIR
ADDICTIONS
EXPECT AND DESERVE A SAFE
ENVIRONMENT.
AS THEY MAKE THE DIFFICULT
JOURNEY TOWARD SOBRIETY SURELY
IT STANDS TO REASON THAT IN
ORDER TO HAVE ANY CHAT EVERY
CHANCE OF SUCCESS. FEEL CITIES
THAT WHICH THEY SEEK TREATMENT
SHOULD HAVE SOME LEVEL
ACCOUNTABILITY. IT IS IMPERATIVE
THAT THE OWNERS AND OPERATORS TO
EXERCISE CONTROL.
OF IT DID YOU INDIVIDUAL
SEEKING CARE OR TREATMENT AT
THESE FACILITIES BE CLEARED TO
STATE AND FEDERAL CRIMINAL
DATABASES BACKGROUND CHECKS ARE
SPEIDEL STEP TO ENSURING THE
SAFE CARE OF INDIVIDUAL STAYING
IN THESE RECOVERY TREATMENT
FACILITIES.
THE ORANGE COUNTY BOARD OF
SUPERVISORS STRONGLY SUPPORTS S.
B. NINE OR TWO BECAUSE IT WILL
HELP BRING MORE ACCOUNTABILITY
AND BALANCE.
TO THE NEEDS OF THOSE WHO SEEK
RECOVERY WITH THE COMMUNITIES IN
WHICH LICENSE RECOVERY
FACILITIES ARE LOCATED WE ASK
YOUR SUPPORT THANK YOU THANK YOU
VERY MUCH ANYWHERE ELSE IN
SUPPORT THE MEASURE MISTER
CHAIRMAN MEMBERS DAVID JONES
ABOUT THE CITY MARIETTA. MY
COLLEAGUES DON'T A VERY GOOD JOB
EXPLAINING THE NEAR TO THE BILL
WE AGREE WITH SENATOR BATES VERY
VULNERABLE POPULATION I WAS
REQUIRED TO BE FINGERPRINTED AND
BACKGROUND CHECK TO BE A
CHAPERONE ON THE OVERNIGHT FIELD
TRIPS OF THIS KIND OF COMMON
SENSE MEASURE IF IT MAKES A LOT.
OF SENSE VERY MUCH IS THERE ANY
UP ANY OTHER MEASURE ANY OTHER
SUPPORT FOR THE MEASURE.
ANY OPPOSITION.
THANK YOU MISTER CHAIR AND
MEMBERS ARE I'M TOM RENT FREE.
OUR DEPUTY DIRECTOR FOR
SUBSTANCE USE DISORDER SERVICES
WITH THE COUNTY BEHAVIORAL
HEALTH DIRECTORS ASSOCIATION.
WE WE DO HAPPEN OPPOSE POSITION
ON THE CURRENT VERSION OF THE
BILL. BECAUSE OF OUR CONCERN
THAT IT COULD ELIMINATE FROM OUR
AT WORKING IN THIS FIELD MANY
GOOD COUNSELORS WHO HAPPEN TO
HAVE A DRUG RELATED OFFENSE IN
THEIR HISTORY.
BUT HAVE BEEN RECOVERY OF MOVE
PASSED THE BECOME NOW VERY GOOD
COUNSELORS.
WE DIDN'T WANT TO DEVASTATE
HARD WORK FORCE OUT BY BY THIS
BUT A WE UNDERSTAND AS WE
UNDERSTAND THE AMENDMENTS THAT
THE AUTHOR HAS AGREED TO TAKE
THAT NARROW THE BILL. OUR ART
IT'S LIKELY THAT WE'RE GOING TO
REMOVE OUR OPPOSITION AT HER
CURLY THE AMENDMENTS OR TAKEN
FOR THE NARROW IT TO THOSE WHO
ARE APPLYING HAS HOME OWNERS AND
IT'S NIGHT IS THE EMPLOYEES I
KNOW THE AMENDMENTS WERE JUST
TAKEN.
SO PARTICULAR OPPOSITION IN
NOTE AND THEN OBVIOUSLY READ IT
AND IF YOU COULD THE ARE THE
OTHER DAY I'M SURE THAT WILL
THAT WILL GOV REMOVE OUR
OPPOSITION APART UPON THIS
AMENDMENTS THANK YOU OF ANYONE
ELSE IN OPPOSITION.
FAIR SHERRY DAVIS THE CALIFORNIA
CONSORTIUM OF ADDICTION PROGRAMS
AND PROFESSIONALS ARE CURRENTLY
IN OPPOSE POSITION. LIKE MY
COLLEAGUE WERE ENCOURAGED BY THE
AMENDMENTS MORE WORK IN THE
COMING WEEKS TO CHANGE OUR
POSITION TO SUPPORT THANK YOU
THANK YOU VERY MUCH.
GOOD AFTERNOON GOING BACK AS FOR
DRUG POLICY ALLIANCE AFTER
REVIEW THE AMENDMENTS WE WILL
REVIEW OUR POSITION THANK YOU.
YOU.
GOOD AFTERNOON MICHAEL DOCTOR
OFF ON BEHALF OF THE ACLU OF
CALIFORNIA WE HAVE ALSO BEEN AND
OPPOSE POSITION FOR MANY OF THE
REASONS STATED BY OUR COLLEAGUE.
ON WHERE ALSO REVIEWING THE
AMENDMENTS THANK YOU VERY MUCH
IS THERE ANYONE ELSE IN
OPPOSITE.
QUESTIONS COMMENTS FROM ANY OF
THE MEMBERS.
SEEM NO QUESTIONS AT THIS TIME
WE DON'T HAVE A QUORUM.
CENTER NGUYEN JUST LEFT WE
MISSED THAT OPPORTUNITY SINCE WE
GET A QUORUM WILL GO AHEAD AND.
HAVE SOMEONE WITH THE BILL WOULD
YOU LIKE TO CLOSE.
THANK YOU I KNOW AGAIN THANK YOU
TO STAFF FOR WORKING SO HARD ON
THE AMENDMENTS AND. WE EMBRACE
ALL OF THOSE ALSO ASK FOR I
BELIEVE AT THE APPROPRIATE TIME
THANK YOU VERY MUCH SENATOR.
IT LOOKS LIKE I SEE CENTER
PORTANTINO IN THE AUDIENCE WE
HAVE MEDI CAL BENEFICIARIES WITH
HIV AND AIDS.
THANK YOU MISTER CHAIRMAN
MEMBERS.
RIGHT.
THANK YOU MUCH CHAIR MEMBERS I'D
LIKE TO BEGIN BY ACCEPTING THE
AMENDMENTS OUTLINED IN THE
COMMITTEE ANALYSIS.
BY SENATE BILL ELEVEN FIFTY FOUR
WILL MAKE
A BENEFICIARY WITH HIV DISEASE
WHO WAS REQUIRED TO ENROLL IN A
MEDICARE AL MANAGED CARE PLAN.
ELIGIBLE TO ROLE IN A PLAY IN
ROLE IN A PLAN THAT PROVIDES
COMPREHENSIVE SERVICES.
TO PERSONS WITH HIV.
AND IN HIS OR HER COUNTY OF
RESIDENCE THE BILL WOULD DEFINE
HIV DISEASE TO INCLUDE ANY STAGE
OF HIV INFECTION. AS IDENTIFIED
BY THE FEDS FEDERAL CENTERS FOR
DISEASE CONTROL AND PREVENTION
THE BILL WOULD AUTHORIZE THE
DEPARTMENT OF HEALTH CARE
SERVICES TO DETERMINE EITHER A
SEPARATE REIMBURSEMENT RATE.
FOR EACH STAGE OF HIV OR A
BLENDED RATE THAT COVERS A
PERSON AT ANY STAGE OF THE
DISEASE.
CURRENTLY MEDI CAL CONTINUES TO
RELY ON AND THE OUTDATED AIDS
DEFINITION TO DETERMINE WHETHER
A PLANNED SERVING THAT PERSON
RECEIVES AN AIDS RIGHT OR NOT.
IF THE PATIENT DOES NOT HAVE
THAT AIDS DIAGNOSIS THE PLAN IS
PAID A BASE RATE FOR A DISABLED
PERSON WHICH CAN BE AS LOW AS
FIVE PERCENT. OF THE AIDS RATE
AS RESULT MEDI CAL MANAGED CARE
PLAN SERVING PEOPLE WITH HIV MAY
BE PAID A COUPLE HUNDRED DOLLARS
PER MONTH. FOR SERVICES THAT
COST SUBSTANTIALLY MORE. BE
SERVICES INCLUDE PRESCRIBING
EXPENSIVE BY PRESERVING DRUGS
EARLY IN THE PROGRESSION OF THE
VIRUS IN ORDER TO PREVENT THE
PATIENT FROM BECOMING SECTOR.
AS A FURTHER RESULT PATIENTS
WITH LESS ACUTE STAGES OF HIV
ARE OFTEN RECEIVING FEWER
MEDICAL SERVICES THAN PATIENTS
AND PATIENTS WITH AIDS. WITH
AIDS
SERVICES THAT CAN MEAN THE
DIFFERENCE BETWEEN EFFECTIVE AND
NOT EFFECTIVE MEDICAL CARE.
TREATMENT FOR HIV IS INVOLVED NO
LONGER DO WE SOLELY TREAT THE
OPPORTUNISTIC INFECTIONS THAT
CHARACTERIZE AGE. THE STANDARD
OF CARE NOW DEMANDS TREATMENT
INTERVENTION AT THE EARLIEST
POSSIBLE STAGE OF THE VIRUS
USUALLY WHEN THE TEST FIRST THE
TAX HIV IN ORDER TO MINIMIZE THE
ACUITY. OF THE DISEASE ARE
INTERRUPTED IMPACT ALTOGETHER
IT'S IMPORTANT CALIFORNIA
SUPPORT FOR CALIFORNIANS DEVELOP
MANAGE CARE RATES THAT REFLECT
THE COST EXPERIENCE OF TREATING
A PERSON WITH HIV NOT JUST
STATES. I HAVE HERE WITH ME RAN
MARTIN BOND ON BEHALF OF THE
AIDS HEALTHCARE FOUNDATION AND
THANK YOU FOR WORKING WITH ME
AND THE STAFF ON THEM AMENDMENTS
AND SO. I RESPECTFULLY WOULD ASK
FOR AN AYE VOTE BEFORE WE ARE
PROCEED I LIKE TO ESTABLISH A
QUORUM MOVING CALL MEMBERS
PLEASE HERNANDEZ HERE HERNANDEZ
HERE WHEN.
LEYVA. LEYVA HERE MITCHELL.
MONNING.
NEWMAN HERE NEWMAN HERE NIELSEN.
NIELSEN HERE PAN. AND HERE
BROUGHT.
BURMA'S BEEN ESTABLISH PRIEST
PLEASE PROCEED THANK YOU MISTER
CHAIR MEMBERS RAND MARTIN HERE
ON BEHALF OF THE AIDS HEALTHCARE
FOUNDATION THE. SPONSOR OF THE
BILL AND THE SENATOR HAS
OUTLINED WHAT THE BILL DOES.
ELOQUENTLY I JUST WANT TO GIVE
YOU A LITTLE CONTEXT THAT YOU
UNDERSTAND WHY THIS BILL IS
IMPORTANT I'M AHF IS IN IT IS A
UNIQUE INTERSECTION BETWEEN
PLAN%
AND PROVIDER WE ARE A MANAGED
CARE PLAN. I'M UNDER STATUTE
THAT WAS DEVELOPED WITH THE
DEPARTMENT OF HEALTH CARE
SERVICES A FEW YEARS AGO WE ARE
A THIRD PLAN IN A TO PLAN COUNTY
THAT IS LOS ANGELES COUNTY.
THAT LANGUAGE ALLOWS US TO
PROVIDE SERVICES TO PEOPLE WITH
HIV AND AIDS IN LA COUNTY ON IN
A SPECIAL NEEDS PLAN THAT WE
THAT WE OPERATE.
WHAT HAS BEEN CHALLENGING FOR
US HAS BEEN SUBSEQUENTLY
WRESTLING WITH THE DEPARTMENT
BOTH ON ON HOW TO GET ALL THOSE
PEOPLE IN A ALLOWED TO BE
ENROLLEES IN OUR PLAN AS WELL AS
GETTING A RATE? THAT COVERS THE
COST IS THE SENATOR HAS
DESCRIBED ON FOR BOTH A PERSON
WITH HIV IN A PERSON WITH WITH
AIDS. I'M AND WE HAVE BECOME
FRUSTRATED IN THAT PROCESS.
AND SO WE HAVE COME TO THE
LEGISLATURE TO ASK OF YOU TO
ENGAGE TO GIVE SOME GUY GUIDANCE
TO THE DEPARTMENT. ON TO MAKE
SURE THAT PEOPLE WITH HIV
DISEASE NOT JUST PEOPLE WITH
AIDS ARE PROVIDED ON THE RANGE
OF SERVICES THAT ARE NECESSARY
TO KEEP THEM. ON PRODUCTIVE AND
HEALTHY AND KEEP THEIR VIRAL
LOAD I'M AS REDUCED AS AS
POSSIBLE. I'M SO WE WOULD URGE
YOU TO SUPPORT THIS BILL AND I'M
OPEN TO ANY QUESTIONS THAT YOU
MAY HAVE ABOUT HOW LONG HOW WE
OPERATE THANK YOU. THINK ANYONE
ELSE IN SUPPORT OF THE MEASURE.
IS THERE ANY OPPOSITION.
BUT QUESTIONS COMMENTS DURING
THE MEMBERS.
NOW QUESTIONS ARE I'LL BE
SUPPORTING THE BILL.
YOUR MOTION MOVE BY SENATOR PAN
WHICH LIKE CLOSE CENTER. THANK
YOU FOR.
.
AFTER WORK AND. THAT'S WHEN I
VOTE. WE HAVE A MOTION BY
SENATOR PAN DISS ON ITEM NUMBER
FIVE S. B. I MEAN ONE ONE FIVE
FOUR TO PASS A MINUTE
APPROPRIATIONS CALL THE MEMBERS
PLEASE MENENDEZ AYE HERNANDEZ
AYE NGUYEN.
LEYVA.
LABOR AYE MITCHELL. MONNING.
NEWMAN AYE NEWMAN AYE NIELSEN.
NIELSEN AYE PAN AYE PAN AYE
ROSS.
CURRENTLY HAS FIVE. TWO ZERO ARE
WE SAW SOME ABSENT MEMBERS ARE
PLACER BILL AND CALL CENTER
THANK YOU LOOKS LIKE IT'S GONNA
GET OUT THOUGH
SO LET'S GO AHEAD AND IF
SOMEBODY CAN MOVE ON ITEM NUMBER
ONE S. B. NINE NO TO BATES IS
OUR MOTION.
MOVED BY CENTER NIELSEN. ARM
CHEMICAL MEMBERS PLEASE SERVICES
S. B. I ITEM NUMBER ONE S. B.
NINE OH TO DO PASSED TO PUBLIC
SAFETY CALL THE MEMBERS PLEASE
HERNANDEZ AYE HERNANDEZ AYE
WHEN.
WHEN I LEYVA.
LEYVA AYE MITCHELL. MONNING.
NEWMAN. NEWMAN AYE NIELSEN.
NIELSEN AYE PAN.
CAN I ROSS.
THEY CURRENTLY HAVE SIX ZERO
LAWS. WILL PLACE A BILLING CALL
WE STILL HAVE SOME ABSENT
MEMBERS.
I SEE ARM.
CENTER HERTZBERG WE'RE GONNA GO
TO ITEM NUMBER TWO SB NINE FORTY
FOUR.
I COMMUNITY PARAMEDIC PARA
MEDICINE ACT OF TWENTY EIGHTEEN.
BUT.
AFTERNOON SENATOR.
GOOD AFTERNOON THAT. PLEASURE
BEING HERE IS THE FIRST TIME
MONTH I HAVE APPEARED BEFORE
THIS COMMITTEE.
I THINK.
EVER VINYL THAT'S GOOD OR BAD.
THE.
I ALL THE OTHER THINGS THAT THE.
WORKING ON THE SUBJECT MATTERS
I'M TOLD THAT THERE'S BEEN
DISCUSSIONS AMONG THE. COMMITTEE
STAFF IN THE CHAIRMAN'S OFFICE
AND I'VE AGREED TO TAKE GOOD THE
AMENDMENTS BEING PASSED OUT I'M
TOLD NOW THE BEING PASSED OUT.
THE BUT TO ARE DUE TO THE DOUBLE
REFERRAL WILL BE TAKEN UP IN THE
SENATE JUDICIARY COMMITTEE.
COMMITMENTS ARE DOING THE
FOLLOWING US MET THINGS FIRST
THEIR CLARIFYING THE HOSPICE
SERVICES IN RESEARCH IN RESPONSE
TO NINE ONE ONE CALL. AND IN
COLLABORATION WITH PATIENTS A
HOSPICE AGENCY TO THEIR
CLARIFYING OR INTENT THAT THE
COUNTY EMERGENCY MEDICAL A
PATIENT HOSPICE AGENCY.
THREE THEIR CLARIFYING.
THE DISHES ME IS ESTABLISHED
WITH THE LOCAL AGENCY THREE
THEY'RE PLACING A SIX YEAR
SUNSET ON THIS MEASURE. IN
ADDITION THE AMENDMENTS WOULD
REQUIRE THAT ONE OF THE TWO IBM
TEEPEES THAT A RECORD TO BE
APPOINTED TO THE COMMITTEE
PARAMEDICS OVERSEAS PERMITS
OVERSIGHT BOARD. OR COMMITTEE
ISSUED ME BE EMPLOYED BY A
PRIVATE AMBULANCE COMPANY AND
MAKE A COUPLE OF THE TECH
CLARIFYING CHANGES HOW
TO TAKE THOSE AMENDMENTS MISS
CHAIRMAN. AS REQUESTED.
THANK YOU.
OKAY.
PLEASE PROCEED BANK YOU SO MUCH.
OR NINE ONE ONE SYSTEM RECEIVES
MORE THAN TWENTY EIGHT MILLION
CALLS JUST IN TWO THOUSAND AND
SIXTEEN THAT'S MORE THAN SEVENTY
EIGHT THOUSAND CALLS PER DAY.
WHEN I WAS HERE BEFORE I STABBED
THROUGH IN ONE SYSTEM BECAUSE SO
MANY PEOPLE THAT WERE CALLING
THE NINE ONE THE SYSTEM ARE
CALLING FOR REASONS THAT WORK
RELATED TO EMERGENCIES IN
DESPITE. THE EXTRAORDINARY
SUCCESS OF THE THREE ONE ONE
SYSTEM THROUGHOUT CALIFORNIA WE
STILL ARE. REALLY ALL.
IN A VERY DIFFICULT POSITION
AND A LARGE NUMBER OF THESE
CALLS THAT MEMBERS OF SERVICE TO
BY FIREFIGHTERS AND PARAMEDICS.
AND MAY RESULT IN A TRIP TO THE
EMERGENCY ROOM. WELL TRIP TO THE
E. R. MANY TIMES UNNECESSARY
NECESSARY THERE ARE STEPS THAT
WE CAN TAKE IT HAVE TAKEN TO
PREVENT OR DIVERT.
THE HAVE A HEAVILY RELIANCE ON
EMERGENCY MEDICAL SERVICES.
ONE WAY IS BY LEVERAGING A
TRUSTED COMMUNITY RESOURCES
FIREFIGHTERS PARAMEDICS THROUGH
COMMUNITY PARA MEDICINE.
COMMITTEE PER MEDICINE IS THE
MEMBERS KNOW TO BE DR PANOS IS A
CONCEPT THAT AIMS TO IMPROVE THE
EFFICIENCY AND DELIVERY OF
HEALTHCARE. USING TRAINING
PARAMEDICS OTHER HEALTH CARE
PROVIDERS TO DRESS LOCAL NEEDS.
COMMITTEE PARAMEDIC PROGRAMS
CONSISTS OF A SERIES OF PROGRAMS
INCLUDING POST DISCHARGE. SHORT
TERM FOLLOW UP FREQUENT DIEM S.
USERS.
DIRECTING OBSERVED THERAPY FOR
TUBERCULOSIS HOSPICE WHICH I
JUST TALKED ABOUT WITH RESPECT
TO THE AMENDMENTS ALTERNATIVE
DESTINATIONS
IN THE MENTAL HEALTH AREA
ALTERNATE DISTANT DESTINATIONS
DEALING WITH SOBRE SENATORS.
IN NOVEMBER OF TWO THOUSAND AND
FOURTEEN THE OFFICES. HEALTH
PLANNING AND DEVELOPMENT
APPROVED APPLICATION BY THE
EMERGENCY MEDICAL SERVICES
AUTHORITY FOR THE OPERATION OF
PARA MEDICINE PROGRAMS IN
VARIOUS LOCAL EMS AGENCIES
THROUGHOUT THE STATE.
FOURTEEN PROJECTS MEMBERS WERE
APPROVED THROUGHOUT THE STATE
INCLUDING PROJECTS TO SAN DIEGO
VENTURA COUNTY WHICH IN ROLE TWO
THOUSAND FIVE HUNDRED FIFTEEN
PATIENTS.
FROM JUNE TWO THOUSAND FIFTEEN
TO SEPTEMBER OF TWO THOUSAND
SEVENTEEN.
AS THE PAIR MEDICINE PROGRAMS
HAD MANY POSITIVE RESULTS IN
THESE COMMUNITIES THE POST
DISCHARGE PROJECTS REDUCED THE
THIRTY DAY RE ADMISSION RATE FOR
INDIVIDUALS WITH ONE OR MORE
CHRONIC CONDITIONS TARGETED. AND
SAVE THE POTENTIAL COST OF ONE
MILLION FOUR HUNDRED THOUSAND
DOLLARS ADDITIONALLY PATIENTS
UNDER TE OBSERVE TO TURN TO
BURKE YOU LOS IS THERE THE
PROGRAMS. ALSO RECEIVE
SIGNIFICANT ADVANTAGE.
BOB. ABSENT LEGISLATIVE
AUTHORIZATION THE CURRENT
PROGRAMS WILL SUNSET IN NOVEMBER
TWO THOUSAND EIGHTEEN OBVIOUSLY
WE'VE TALKED ABOUT THE SUNSET
HERE WITH RESPECT TO THE
AMENDMENTS. THIS MEASURE
AUTHORIZES LOCAL EMERGENCY
MEDICAL SERVICES AGENCIES TO
DEVELOP AND SEEK APPROVAL FOR
COMMUNITY PER MEDICINE PROGRAMS
TO PROVIDE ANY OF THE SIX
MENTIONED.
PREVIOUS MENTION PROGRAMS BUT
ADDITION THE BILL REQUIRES THE
STATE EMERGENCY MEDICAL SERVICES
AUTHORITY.
WITH THE ADVICE AND CONSENT OF
COMMUNITY PER MEDICINE OVERSIGHT
COMMITTEE CREATED BY THIS ACT TO
ADOPT MINIMUM MEDICAL PROTOCOLS
FOR COMMITTEE PARA MEDICINE
PROGRAM SPECIALTIES. THIS
MEASURE REQUIRES THE AUTHORITY
TO SUBMIT AN ANNUAL REPORT TO
THE LEGISLATURE AS TO ITS
EFFECTIVENESS.
AND OFTEN THIS CAN AS I SAY THE
OPENING PLAY AN EXTREMELY
IMPORTANTDRAW ROLE IN IMPROVING
CALIFORNIA'S HEALTH CARE
DELIVERY SYSTEM WHICH IT HAS
DONE TO THE PILOT PROJECT ASK
YOUR AYE VOTE WE'VE GOT TO A.
VERY IMPORTANT ISSUE TESTIFIED
BEHALF.
THANK YOU WE'RE GONNA BE
ALLOWING SIX MINUTES FOR THE
SUPPORT AND SIX MINUTES FOR THE
OPPOSITION YOU CAN USE OUR TIME
ANYWHERE YOU WISH PLEASE PROCEED
MISTER CHAIRMAN MEMBERS KRISTIE
BELL ON BEHALF OF THE CALIFORNIA
PROFESSIONAL FIREFIGHTERS.
I HAD TO LIKE TO EXPRESS MY
THANKS TO THE CHAIRMAN A
COMMITTEE TO WORK WITH US
ON THIS MEASURE I RECOGNIZE THIS
IS A SIGNIFICANT POLICY
DISCUSSION. AND BETTER FIRST
IMPRESSION IN THIS HOUSE.
OF AND IT'S BEEN A NATIONWIDE
DISCUSSION FOR PROBABLY OVER A
DECADE. BUT THIS BILL SEEKS TO
ADDRESS AND IDENTIFIED KNOWN AND
CHRONIC ISSUES FACING EMS
PROFESSIONALS AND OUR HEALTHCARE
DELIVERY SYSTEM. AND MOST
IMPORTANTLY OUR PATIENTS.
CALIFORNIA BOASTS EXTRAORDINARY
HEALTHCARE PROVIDERS AND
PRACTITIONERS ARE DEDICATED TO
THEIR.
HEALTH AND SOCIAL SERVICES.
OF.
WORK.
THE AND WE WANT TO REMAIN.
FOCUSED ON THE DELIVERY OF
ESSENTIAL CARE TO OUR
COMMUNITIES.
AND LIKEWISE I WOULD SAY THAT MY
FIREFIGHTERS AND EMTS.
PARAMEDICS FAITHFULLY CARRY
CARRY OUT THEIR DUTIES IN THE
FIELD. COMPASSIONATELY
RESPONDING TO THE EMERGING CALLS
IN THEIR COMMUNITIES OFTEN
FACING EXTRAORDINARY WAIT TIMES
IN HOSPITAL EMERGENCY
DEPARTMENTS. BUT WHEN THEY
ATTEMPT TO DELIVER THESE
PATIENTS FOR THEIR NEEDED CARE.
AND IT MIGHT NOT EVEN BE THOSE
THOSE PARTICULAR PATIENTS FIRST
VISIT OR EVEN SECOND VISIT TO
THE EMERGENCY ROOM.
AND A BAR PARAMEDICS ARE ASKING
US WHAT MORE CAN WE DO.
THE GOAL OF THIS PROGRAM IS NOT
SURE PLACER SUBSUME THE WORK OF
THESE IMPORTANT HEALTH
PRACTITIONERS THAT I MENTIONED A
BUT ALSO JUST TO BE A CONDUIT
AND TO CONNECT THESE PATIENTS
FOR THE RIGHT CARE AT THE RIGHT
TIME.
UNDER THREE THREE OF THE
PROPOSED SPECIALTIES.
OUR PARAMEDICS A SIMPLE LEAD TO
BE OPERATING UNDER VERY SPECIFIC
MEDICAL PROTOCOLS IT'S WHAT THEY
DO ON THE FIELD TODAY. IT'S WILL
BE EXPANDED MEDICAL PROTOCOLS
DEVELOPED BY THE VERY MEDICAL
PROFESSIONALS A THAT WILL
OVERSEE OUR WORK.
BUT WE WILL NOT BE EXERCISING
AND INTIMIDATE INDEPENDENT
JUDGMENT OUTSIDE OF THOSE
PROTOCOLS.
BUT OUR AUTHORED MENTION THE
VARIOUS SPECIALTIES SOLVED DO MY
BEST TO SKIP OVER THOSE OF MY
NOTES I'D WANNA BE THOROUGH BUT
I WANNA RESPECT YOUR TIME.
OF. EACH OF THESE SPECIALTIES
THAT ARE NON EVER GET RELATED
THE.
POSTED CHARGE FOLLOW UP I JUST
WANT TO BE CLEAR THIS IS CARE
WITHIN THE FIRST FORTY EIGHT
HOURS. OF A DISCHARGE AND IT IS
PARTICULARLY TO CONNECT AGAIN TO
SERVICES TO MAKE SURE THEY
UNDERSTAND THE DISCHARGE ORDERS
HAD HAVE HAD.
AND THERE'S A.
A AND IT'S MEANT TO BE A
CONNECTOR IN A BRIDGE TO WHEN
HOME HEALTH IS WHEN THE PATIENT
IS ELIGIBLE FOR HOME HEALTH CARE
NOT A REPLACEMENT. NINE ONE ONE
CASE MANAGEMENT AGAIN.
MAYBE INSTEAD OF TAKING THE SAME
PER PATIENT TO THE E. R. SIX
EIGHT TEN TIMES A YEAR WE ETTER
FIND THEM THE CERTAIN RESOURCES
THEY NEED AND THAT IS THE GOAL
OF THAT PARTICULAR.
.
THAT PROVISION SUCH AS MORE
GENERALLY BUT WE THINK THIS BILL
IS VERY STRONG CONTRACTING
PROVISIONS LEVERAGING THE
RESOURCE OF OUR FIREFIGHTERS
THIS CONCEPT WAS DEVELOPED OUT
OF THE MIND OF PHYSICIANS WHO
SAID WE OF PARAMEDICS IN OUR
COMMUNITIES TWENTY FOUR HOURS A
DAY. A THEY'RE PERFECTLY
SITUATED TO HELP BRIDGE A GAP
THAT WE MAY HAVE IN OUR
HEALTHCARE DELIVERY SYSTEM.
BUT WE HAVE STRONG ANTI
DISCRIMINATION PROVISIONS AND
ARE OPEN TO BOLSTERING THEM TO A
HIGHER LEVEL TO ENSURE THAT
THERE IS NO. A DECISION IN THE
FIELD OR OTHERWISE ABOUT WHERE
THESE PATIENTS GO BASED ON ANY.
OF THE CATEGORY A CLASSIFICATION
DISCRIMINATE DISCORDANT
DISCRIMINATING CATEGORIES. OF
AND MOST OF ALL WE ARE ASKING
EARNED BY OUR PUBLIC SERVANTS
ARE FIREFIGHTERS TO DO MORE. OF
AN ANSWER THAT QUESTION FOR
THEM.
BUT WE.
FINALLY ALL OF THE DEVELOPMENT
OF THE PROVISIONS OF THIS
PROGRAM UNDER THIS BILL MUST BE
INFORMED BY THE THREE YEARS OF
PILOT PROJECTS THE SENATOR.
MENTIONED.
AND ALSO AUTHORIZES LOCAL
AUTONOMY SO IT LEAVES IT UP TO
THESE LOCAL COUNTIES TO WORK
WITH THEIR FIRED UP.
THE OTHER.
DETERMINED.
ARE THE SERVICE IS APPROPRIATE
FOR A COMMUNITY AND HOW IN FACT
WE PAID FOR THEM.
A NO ONE IS MANDATED TO DO THIS
BUT WE THINK IT'S AN OPPORTUNITY
THAT ALL OF THE STAKEHOLDERS IN
THE HEALTHCARE DELIVERY SYSTEM
WHO MAY BENEFIT FROM THE FISH.
THE PROGRAM.
MAYBE PARTNERS MAYBE EVEN
FINANCIALLY TO MAKE SURE THE
SERVICES ARE DELIVERED WE URGE
YOUR SUPPORT TODAY.
THINK ANYONE ELSE IN SUPPORT
MITCH AMENDMENT MEMBERS DAVID
JONES ABOUT THE CITIES OF SAN
MARCOS IN MARIETTA. I'D ECHO THE
COMMENTS OF MY COLLEAGUE OF THIS
IS ABOUT APPROPRIATE CARE.
THIS IS NOT BETTER OUTCOMES
THEIR SIGNIFICANT COST SAVINGS
WITH THIS WITH THIS PILOT
PROGRAM THAT CAN DELIVER THE
STATE BOTH TO THE MEDICAL
COMMUNITY AND TO MUNICIPAL
RESOURCES WHICH ARE VERY SCARCE
SO. WOULD ECHO THE COMMENTS AND
ASK FOR LIVE. THANK VERY MUCH
ANYONE ELSE.
A CAN MISTER CHAIRMAN AND
MEMBERS MICHAEL OUT AGAIN ON
BEHALF OF THE BOARD OF
SUPERVISORS SANTA CLARA COUNTY
IN SPORT.
CARE MEMBERS CUT THE MUSTARD
WITH THE LOCAL HEALTH PLANS OF
CALIFORNIA IN SUPPORT.
MISTER CHAIR MEMBERS THREE TIMES
ABOUT THE CALIFORNIA MEDICAL
ASSOCIATION WITH SOME CONCERNS
ON THE BILL WOULD LIKE TO SEE A
MOVE BACK COMMITTEE AND THINK
THE AUTHOR MY SPONSOR FOR
COMMITTEE WORKING WITH US THANK
YOU.
ANYONE ELSE SUPPORT.
YES THANK YOU MISTER CHAIR
RUSSELL NO ACT ON BEHALF THE
CALIFORNIA FIRE CHIEFS
ASSOCIATION IN THE FIRE
DISTRICTS ASSOCIATION OF
CALIFORNIA AND SUPPORT. IN A
VERY MUCH.
SEE NO OTHER SUPPORT OPPOSITION
TO THE MEASURE.
AND AGAIN WE HAVE A TOTAL OF SIX
MINUTES ALLOWED LATITUDE SIDE OF
YOU HAVE MORE THAN THREE.
FOR SOME ODD HEAVY WISH BUT
TOTAL OF SIX MISTER CHAIR
MEMBERS CHRIS MCKINLEY ON BEHALF
OF THE CALIFORNIA AMBULANCE
ASSOCIATION AND WE DO APPRECIATE
THE TIME OF.
THE CENTER STAFF AND
PARTICULARLY THE SPONSORED A
HERE OUT SOME OF OUR CONCERNS WE
FIND OURSELVES IN A YOU
POSITION BECAUSE.
WE ARE VERY ACTIVE PROPONENTS OF
THE COMMUNITY PARA MEDICINE
PROGRAM IN FACT WE SPONSORED
LEGISLATION LAST YEAR THAT HAD.
FIVE OF THE SIX ITEMS THAT ARE
CONTAINED CENTER HERTZBERG BILL
WITH THE EXCEPTION OF THE
ALTERNATIVE DESTINATION LANGUAGE
WAS HELD ON SUSPENSE OVER ON THE
ASSEMBLY SIDE BUT WE ARE.
VERY STRONG PROPONENTS OF
COMMUNITY PARA MEDICINE AND FACT
OF THE. MORE THAN TWO THOUSAND
PATIENTS WOULD HAVE BEEN SERVED
IN THE PILOT PROJECTS SINCE MID
TWENTY FIFTEEN.
OUR ESTIMATION IS THAT SEVENTY
ONE PERCENT OF THOSE PATIENTS
HAVE BEEN SERVED BY PRIVATE.
AMBULANCE PROVIDERS.
ALSO AMONGST THE NINE ONE ONE
PROVIDERS BUT WE DO OVER EIGHTY
PERCENT OF NINE ONE ONE
TRANSPORTS AND SO WE. JUST LIKE
CPF.
OUR EMTS AND PARAMEDICS
FAITHFULLY FULFILL OUR DUTIES
WE DO APPRECIATE THE ADDITION OF
A PRIVATE SECTOR PERSON ON THE
STATEWIDE COMMITTEE. BUT OUR
FUNDAMENTAL CONCERNS ARE THAT
LINED THE BILL PROVIDES
ESSENTIALLY A RIGHT OF FIRST
REFUSAL TO THE PUBLIC SECTOR.
AND ONLY IF THEY DECLINE BUT
THEN THAT PERHAPS OTHERS CAN
COMPETE FOR IT AND WE THINK
THAT.
OF THOSE WHO RECEIVE A COMMUNITY
PARAMEDIC PILOT PROJECT SHOULD
BE BASED ON QUALITY OF CARE AND
THEIR HISTORY IN THIS. AND THE
SECOND ITEM IS IS THAT THE STATE
WHITE THE SICK WHITE COMMITTEE
ESTABLISHING THOSE PROTOCOLS WE
THINK THAT THEY SHOULD BE LEFT.
TO THE EMS MEDICAL DIRECTORS AT
THE LOCAL LEVEL A KEEP THAT
LOCAL ECONOMY THAT'S AVAILABLE
BECAUSE A ONE SIZE FITS ALL
APPROACH IS NOT THE BEST
APPROACH TO IT THANK YOU.
THINK ANYONE ELSE. MISTER
CHAIRMAN PERSEPHONE REPRESENT
THE HEALTH OF THE CALIFORNIA'S
ASSOCIATION REPRESENT OVER A
HUNDRED THOUSAND REGISTERED
NURSES ACROSS THE STATE OVER
FIFTY THOUSAND NATIONWIDE. ARE
NURSES VIGOROUSLY OPPOSE THIS
BILL AS IT THREATENS PUBLIC
SAFETY BY AUTHORIZING THE USE OF
FIRE AND AMBULANCE PARAMEDICS TO
PROVIDE HEALTHCARE SERVICES.
CURRENTLY PROVIDED BY PHYSICIANS
REGISTERED NURSES AND LICENSE
BEHAVIORAL HEALTH PROFESSIONALS
THIS BILL IS NOT ONLY DANGEROUS
BUT WE BELIEVE THAT IT GIVES
FALSE HOPE TO OUR COMMUNITIES
THAT PRIVATE AMBULANCE COMPANIES
AND FIRE DEPARTMENTS CAN
PROVIDE.
BOTH CONTINUITY OF CARE AND HIGH
QUALITY HEALTH SERVICES IN
ADDITION TO THEIR TRADITIONAL
EMS ROLES.
WE HAVE OVER FOUR HUNDRED
THOUSAND ACTIVE LICENSEES IN THE
STATE AND OVER A HUNDRED FIFTY
THOUSAND LV ENDS AND MORE THAN
SEVENTY FIVE THOUSAND BEHAVIORAL
HEALTH PROFESSIONALS WHO CAN
PROVIDE DIRECT.
CARE DIRECT ACUTE AND CHRONIC
CARE TO PATIENTS AND ALL CARE
SETTINGS THE NUMBER OF EMTS AND
PARAMEDICS NEED TIRE UNITED
STATES ABOUT TWO HUNDRED FIFTY
THOUSAND. HALF OF OUR RANKS IN
CALIFORNIA ALONE.
IN CALIFORNIA THERE OVER
NINETEEN THOUSAND EMTS AND
PARAMEDICS IN THERE ALSO
APPROXIMATELY OVER THIRTY
THOUSAND FIREFIGHTERS WHO ARE
DULY CERTIFIED. WHY WOULD SUCH A
SMALL NUMBER OF FIRST RESPONDERS
WHOSE PRIMARY ROLES ARE
RESPONDING TO FIRES STABILIZING
IN TRANSPORTING PATIENTS WITH
EMERGENCIES IN THE PRE HOSPITAL
IN INNER? HOSPITAL TRANSPORT BE
BUT DIVERTED FROM THEIR PRIMARY
FUNCTIONS IN ORDER TO ADD
PRIMARY CARE FUNCTIONS OF THE
RESPONSIBILITIES.
IN A MASS IN THEIR OWN WORDS AND
THEIR APRIL TWENTY SIXTEEN
EDITION OF OUR NEWSLETTER
DISPATCH
STATES THAT READINESS AND
MAXIMAL RESPONSE TIME IS THE
MISSION OF AMBULANCE COMPANIES.
SO AGAIN WHY WOULD THESE
EMPLOYERS FOCUS ON USING THEIR
STAFF TO PERFORM SERVICES THAT
ONE OVER NO DOUBT DIVERT THEM
FROM THAT GOAL.
TO FURTHER ILLUSTRATE THIS POINT
THE SAN DIEGO FREQUENT NINE ONE
ONE PROJECT HAD TO SHUT DOWN.
AND STOP ENROLLING NEW PATIENTS
IN THE PILOT. AND TURNED OVER
THEIR EXISTING CLIENTS TO BE
CASE MANAGEMENT ACTUAL LICENSE
HEALTHCARE PROFESSIONALS.
THIS ALL HAPPENED BECAUSE A PARA
MEDICINE TRAIN TRAINEES WERE
STRETCHED WAY TOO THIN.
DOING BOTH PRIMARY JOBS AS WELL
AS OFFERING CASE MANAGEMENT
SERVICES TO FREQUENT I ONE ONE
CALLERS THEY WERE NOT ABLE TO
MEET THEIR CONTRACT AT NINE ONE
ONE RESPONSE BENCHMARKS.
THIS PROJECT HAS SINCE BEEN SHUT
DOWN AND PROVEN NOT TO WORK SO
WHY IS THIS CONCEPT BEING
CONSIDERED IN THIS BILL. IS A
PROVEN FAILED MODEL.
THERE ARE AND TO BOT THEY'RE
ONLY SEVENTY SEVEN ENROLLEES SO
NOT ONLY DO WE BELIEVE THAT THIS
IS A FAIL PROJECT IT'S NOT OUR
WINNER WITH THE PUBLIC WHO ARE
OVERWHELMINGLY DECLINING THE
SERVICES. IT WAS ESTIMATED AT
FIVE HUNDRED SEVENTY TWO WOULD
PARTICIPATE IN THE FIRST YEAR.
AND THOSE NUMBERS ARE EVEN
CLOSE.
ANOTHER FAILED PROJECT THE
URGENT CARE ALTERNATE
DESTINATION PILOT IN UCLA ORANGE
IN CARLSBAD AND A TOTAL OF
THIRTY NINE ENROLLEES IN EACH.
TWELVE TWENTY FIVE IN TWO
RESPECTIVELY. THE NUMBERS JUMP
TO A TOTAL OF FORTY AFTER THE
SECOND YEAR REPORT CAME OUT.
I WILL NOTE THAT THE PROJECT WAS
SHUT DOWN DUE TO LOW
PARTICIPATION AND NOT SO PATIENT
FRIENDLY URGENT CARE HOURS.
ELEVEN PATIENTS WERE EITHER
TRANSFERRED TO AN ET WITHIN SIX
HOURS OF ADMISSION TO AN URGENT
CARE CLINIC THAT WAS TO PATIENTS
AND NINE WERE REROUTED TO THE E.
D. BECAUSE THE URGENT CARE
CLINIC. DECLINED TO TREAT THE
PATIENT AND THIS RESULTED IN
DELAYED TREATMENT I WANT TO BE
CLEAR THAT THS PARTICULAR
PROJECT IS NOT IN THIS BILL BUT
IT'S ANOTHER EXAMPLE OF HOW THIS
PIECE OF LEGISLATION.
COULD POSSIBLY INCLUDE THESE
CONCEPTS ARE OTHERS.
ABOUT THE REGULATORY LEVEL IT'S
QUITE POSSIBLE THAT THESE
PROJECTS AND OTHERS. COULD BE
DEVELOPED AT THE REGULATORY
LEVEL AND DO NOT ENJOY THE
SCRUTINY OF THIS BODY.
AND SOME WHAT SIX PROJECT
DISCIPLINES OVER THIRTY PILOT
SITES ACROSS THE STATE.
THERE WERE A WHOPPING FOURTEEN
HUNDRED IN THE FIRST PILOT
PROJECT RUN NOT ENOUGH.
WE'RE STILL HAVING DIFFICULTY
OBTAINING THE MOST RECENT OUT ON
THIS SO WE CAN'T FULLY
SCRUTINIZED THE SECOND YOUR
REPORT WE'VE MADE SEVERAL
ATTEMPTS TO TALK TO MS A. UCSF
TO GET THE RAW DATA BUT WE DO
NOT HAVE THAT.
IT IS IMPORTANT TO NOTE THAT THE
FORMER CEO OF PMR WEST
ONE OF THE LEADING PRIVATE
AMBULANCE COMPANIES. IT'S ALSO
THE CURRENT PARA MEDICINE
PROJECT MANAGER OF THE STEEL WE
BELIEVE THAT THIS IS A AND SHARE
PUBLIC VERSUS PRIVATE FIGHT.
BETWEEN FEIERN AND WINCED BUT
IT'S HER FIGHT AND OUR PATIENTS
SHOULD NOT BE IN THE MIDDLE OF
THIS THIS IS A WAGED WAR ON OUR
PATIENTS.
SO WE HAVE LEARNED IN THE LAST
IN THIS MEETING THAT THERE ARE
CURRENTLY CONSIDERING A PROTOCOL
THAT ANTHEM BLUE CROSS WILL
REIMBURSE AND LET'S PROVIDERS
EVEN IF THEY DO NOT. TRANSPORT
PATIENTS TO THE HOSPITAL FOR
THIS IS EVEN A MORE PERVERSE
INCENTIVE TO DIVERT PATIENTS
FROM THE E. ARE.
AS A LOT MORE WANT TO SAY BUT
I'M GONNA CLOSE AND INTERESTS OF
TIME BYPASS HELD SOME COMMENTS
FOR YOU ALL TO TAKE A LOOK AT.
THE PLEASE DO THAT.
.
I WANT TO GET TO SOME OF THE
SOLUTIONS HERE.
AND I WISH THE ARE DOTS WERE
HERE BUT I I DON'T THINK THEY
ARE.
.
DILLON JUST A SECOND HERE.
SO JUST FOR YOUR INFORMATION WE
ALREADY GONE OVER. WELL ALMOST
OVER A MINUTE BY MINUTE LET YOU
OKAY CLOSE I APPRECIATE YOUR
INDULGENCE SIR.
SO WE DO BELIEVE ULTIMATELY AS I
CLOSE AT THEIR FINAL CHANGES AND
THE TAP
SYSTEM ABSOLUTELY YES AND I WANT
TO ALSO KNOW THAT FIRE EMS
TRANSPORT THEY SERVE A VERY
NECESSARY FUNCTION AND DELIVERY
OF HEALTHCARE WANNA SEE THAT
RIGHT NOW. WE'RE NOT DISPARAGING
THAT WORK.
BUT WE MUST STOP THE MASSIVE IN
CHRONIC HOSPITAL CLOSURES
THEY'RE LEAVING OUR COMMUNITIES
DEVASTATED WE MUST INVEST IN
PUBLIC HOSPITALS INCREASE BED
CAPACITY ROBUST MENTAL HEALTH
SERVICES AND OTHER ITEMS THAT IS
A SOCIAL IMPERATIVE THAT WE NEED
TO TAKE UP.
THIS IS AS A REAL TIME SOLUTION
I WANT TO KNOW THAT THE
EMERGENCY ROOM PHYSICIANS HAVE A
ROBUST BUDGET PROPOSAL RIGHT NOW
THAT WE SUPPORT. THAT WILL
INCREASE FUNDING FOR DRUG AND
ALCOHOL COUNSELLORS TO BERT TO
DIRECT SERVICES IN THE ET. UC
DAVIS PILOTED THIS PROGRAM.
AND AS A RESULT THERE WAS OVER
SIXTY PERCENT DECREASE IN ET
UTILIZATION AFTER INTERVENTION
UCS F. HAS QUOTED AMONG CHRONIC
ALCOHOLICS THE NEED FOR MEDICAL
DETOX. IT'S SOMETIMES DIFFICULT
TO PREDICT INITIALLY A PATIENT
MAY ALSO HAVE TAKEN ANOTHER DRUG
THAT A PARAMEDIC COULD NOT
DETECT WHEN HERE SHE EXAMINES A
PATIENT IN THE FIELD WITH THIS
BEING SAID WE APPRECIATE YOUR
NOBLE THANK YOU. THANK YOU VERY
MUCH SO WE HAVE GONE WAY OVER
IT'S ALREADY EIGHT EIGHT
MINUTES.
MAY GIVE YOU MORE THAN THE
AMPLE AMOUNT OF TIME TO SORT OF
MY RESPECT FOR YOU I WILL GIVE
YOU EACH COMBINED ONE MINUTE
HOWEVER THAT ONE MINUTE WILL
GIVE YOU TO NINE TOTAL. IN ALL
FAIRNESS TO THE UP PROPONENTS OF
IT I'M GONNA GIVE THEM EQUAL
AMOUNT OF TIME BEFORE WE MOVE ON
TO OVER HERE AS WELL.
MANAGED TENANTS A VERY
CONTENTIOUS BILL BUT ONE MINUTE
BETWEEN YOU TWO.
RIGHT NOW PRESS HIM HAVE THE
CALIFORNIA ASSOCIATION HEALTH
SERVICES AT HOME OPPOSE THANK
YOU THANK YOU. THANK YOU TO
PETER TELL US ON BEHALF THE
CALIFORNIA HOSPICE AND
PALLIATIVE CARE ASSOCIATION
SLIGHTLY DIFFERENT POSITION
ILLICIT AS OPPOSED A POSITION AS
OPPOSED LESS AMENDED THE
HOSPICE.
THE HOSPICES TIM IS A MUCH
DIFFERENT ONE WHERE THE PATIENTS
ARE TERMINALLY ILL IT'S A
CAPITATED SYSTEM THE HOSPICE
PROGRAMS ARE AT RISK
FINANCIALLY.
THE BILL BLURS THE LINES BETWEEN
ON TERMS OF LIABILITY
REIMBURSEMENT I WOULD NOTE THAT
IN VENTURA COUNTY WHERE THE
PILOT FOR HOSPICE WAS CONDUCTED
IT IS OUR UNDERSTANDING THAT
THERE WERE TWO HOSPICE PROGRAMS
THAT DID PARTICIPATE THERE ARE
SIXTEEN IN THE COUNTY. THAT
CHOSE NOT TO WE WOULD LIKE TO
SEE HOSPICE PERKED UP CARVED OUT
OF THE BILL. THANK YOU VERY MUCH
WE ARE IT EIGHT MINUTES FORTY
FOUR SECONDS TO THE PROPONENTS
OF YOU'D LIKE TO GO AHEAD AND
AND AND.
YEAH BUT.
TWO MINUTES BUT YOU CAN MAKE
SOME.
UNLIKE YOU MISTER CHAIRMAN OF I
WOULD JUST SAY A COUPLE THINGS I
APPRECIATE THE TESTIMONY OF
OPPOSITION AND PARTICULARLY ARE.
OF SISTERS AND BROTHERS THE
CALIFORNIA NURSES ASSOCIATION.
.
I THINK THAT THE COMMENTS
IDENTIFY THE ISSUE ABOUT WHAT
YOU HAVE AN ARCH PET PILOT
PROGRAM WHICH HAS BEEN. THE
OPERATING FOR THREE YEARS.
THAT ALL OF THE.
AFFECTED ENTITIES WHETHER IT'S
HOSPITAL'S PLANS A MIDDLE HEALTH
PROVIDERS IT CETERA. AND FRANKLY
OUR FIRE DEPARTMENTS.
THE LEGISLATURE THE THE DECIDES
TO AUTHORIZE A PROGRAM OR IT
GOES AWAY AND SOME OF THESE
PROGRAMS YOU SEE WITHOUT
FUNDING.
THEY HAD AT THE A DOUCHE SHRINK
AWAY IT YOU KNOW THIS NOTHING IS
FOR FREE AND SO THAT'S IS THIS
BILL IS ESSENTIALLY. HOPING TO
DRIVE THOSE CONVERSATIONS A TO
THE DEVELOPMENT PROGRAMS IT WILL
RECEIVE FUNDING FROM THOSE WHO.
SEE THIS AS A BENEFIT TO THE
PATIENTS AND THEIR COMMUNITIES
TO GET THEM TO THE CARE THAT
THEY NEED I THINK ALSO.
.
I WOULD NO. SINCE WERE
CHEERLEADING THE EMERGENCY ROOM
DUCKS WE HAVE ALSO SUPPORTED
THEIR BUDGET PROPOSAL BECAUSE WE
THINK PRACTITIONERS SHOULD BE
PRESENT IN BOTH PLACES BECAUSE.
US FUNDAMENTALLY AS EMS
PROVIDERS IF THERE IS A HEALTH
PHYSICAL HEALTH ISSUE THAT
REQUIRES TRANSPORT TO THE
EMERGENCY DEPARTMENT THAT'S
WHERE THESE PATIENTS WILL GO IT
DOESN'T MEAN THAT THEY DON'T
STILL HAVE. A OF CO MORBIDITY OF
SOME MENTAL HEALTH ISSUE THAT
NEEDS TO BE TREATED HAVE.
A PROPERLY IT WITHIN THE
EMERGENCY DEPARTMENT OF THE
HOSPITAL SO WE THINK ACTUALLY
THAT'S A COMPLEMENTARY EFFORT
RATHER THAN A COMPETITIVE EFFORT
TO WHAT SENATOR HERTZBERG IS
TRYING TO DO HERE SO WE
APPRECIATE THE EXTRA TIME. TO
ANYONE ELSE IN SUPPORT BACK
THERE WOULD LIKE TO MAKE SOME
ADDITIONAL COMMENTS SUPPORTER
NOT.
BUT THAT.
OKAY JUST STATE YOUR NAME
POSITION THEN.
I JIM GARRISON MEDICARE MONTHS A
POST AND THINK YOU KNOW I HAVE A
LITTLE.
ANYONE ELSE IN OPPOSITION.
UP MISTER CHAIR MEMBERS MICHELLE
HABIT I WITH A SAY YOU
CALIFORNIA WE HAVE CONCERNS BUT.
LOOK FORWARD TO CONTINUING TO
WORK WITH THE SPONSOR AND AUTHOR
ON ADDRESSING THOSE CONCERNS
THANK YOU VERY MUCH.
ANYONE ELSE LIKE TO.
ANY OPPOSITION ANYONE ELSE ANY
COMMENTS QUESTIONS FROM ANY OF
THE MEMBERS.
ON CENTER PAN.
NO THANK YOU I THINK YOU
CENTERED SPIRIT FOR BRINGING
THIS BILL FORWARD.
ENOUGH AT CONVERSATIONS WITH
ACTUALLY MY FIRE CHIEFS AT FIRE
FOLKS ABOUT THE ROLE THAT.
THEY CAN PLAY IN.
AND WAS TRANSPORT AND SO YOU
KNOW BASICALLY THEY SYMBOLIZE
THE TRANSPORT BUT ALSO GIVEN
THAT THERE ON THE FIELD AND THEY
CAN HELP TO ESSENTIALLY SOME
BASIC TRIAGE I MEAN THAT'S
REALLY WHAT WE'RE TALKING ABOUT
RATES ON HIS HOSPICE.
OTHERWISE IT'S EVERYONE TODAY ER
RIGHT AND YOU KNOW THE HER
HOSPICE.
WHY TRANSPORT OF THAT IF IF THEY
DON'T HAVE PHYSICAL HEALTH
PROBLEM?
I DON'T GIVE A QUESTION THOUGH
BECAUSE I KNOW THERE'S A. LITANY
OF DIFFERENT THINGS IN THE
ANDERSON FROM PILOTS COUPLE
THEM.
TO ME.
THAT REALLY FIT THE.
I GUESS EMERGENCY THE.
CALLED THE IT'S IT'S MORE.
BUT PUBLIC HEALTH THAT PERHAPS
AND NOT THAT WE DON'T WANT.
FIREFIGHTERS A REPAIR MAKES TO
BE INVOLVED PUBLIC HEALTH BUT.
IT'S IT'S AROUND THE MYSTERY
TUBERCULOSIS MEDICATION AND AND
ALSO THE POST
SPITTLE FOUGHT FOR I THINK.
THIS SUPPORTS A BABY YOU CAN
COMMENT ON TERMS OF THIS BILL.
AND WHAT YOU'RE TRYING TO DO
AND THAT WHAT'S THE INTERFACE
BETWEEN DIEM* AND I THINK
PUBLIC HEALTH AND VISITING
NURSES BECAUSE THERE IF YOU KNOW
WHAT WE DON'T WANT TO STAND
ALONE SYSTEM SO AT THAT POINT
THEY ARE ACTUALLY STARTING TO
YOU KNOW. WHAT'S THAT INTERFACE
THERE ARE COMMUNITY HEALTH
WORKERS RIGHT
SO WHY WHY IS IT THAT THE. I
THINK YEAH THANK YOU VERY VERY
MUCH A CENTER PANDA JAPAN BOMBED
AND I I I AM COMPLETELY IN THAT
HAD A NUMBER OF MEETINGS WITH IT
WILL CONTINUE TO MEET WITH. SOME
OF THE OPPONENTS WITH RESPECT TO
THIS BUT I THINK IT ALL GIPSON
MORE DETAIL TO THE TO THE
SPONSOR BUT.
IT REALLY IS INFORMED BY THE
NATURE OF THE CALLS THAT ARE
THAT THEY GET RIGHT SO A FEW
YEARS YOU'RE IN LOS ANGELES AND
THE COMMUNITY WHERE I LIVE. AND
AND THE AMBULANCE COMES FROM THE
FIRE DEPARTMENT RIGHT WILL WHAT
ARE WE GETTING ON THOSE I WON
BECAUSE IT'S NOT INFORMED BY
WHAT THE NATURE OF IT IS. AND
WHEN THEY SEE REPEATED PATTERNS
OR SOBRE ISSUE SOME THESE OTHER
ISSUES.
SHE INFORMED BY THAT THINKING
AND AND I I THINK THAT WHAT'S
IMPORTANT IN THIS IS THAT THE
SENSITIVITY OF THIS WHAT WE'RE
DOING IS WE'RE CREATING. THIS
COMMUNITY PARAMEDIC OVERSIGHT
COMMITTEE WITH NURSES AND
PHYSICIANS SURGEONS AND ALL
WE'RE TRYING TO DO IS TO GET
THEIR BEST THINKING.
AND SPAN MAKE RECOMMENDATIONS
THESE PROTOCOLS IF YOU WILL SO
THAT IF WHAT YOU SAY IS IN IT
SHOULD SHOULD NOT BE PART OF THE
PROTOCOL THEY WILL RECOMMEND IT.
AND THEN THE OUTLINE THOSE
PROTOCOLS WHAT DOES BEST MINDS
AND THEN LOCAL JURISDICTIONS CAN
MAKE THE DETERMINATIONS OF THE
BILL SPECIFICALLY SETS FORTH
THEIR ACCORDING TO DOTHAT.
SALUTE THIS RECOMMENDATIONS
BASED UPON WHAT APPEAR TO BE A
REASONABLY SUCCESSFUL PROGRAM
AND I KNOW THAT.
THAT IT WAS MENTIONED THAT THE
URGENT CARE. ARE ON.
THE CHALLENGES THERE BUT IT'S
NOT PART OF THIS BILL BECAUSE IT
WAS PROVEN NOT TO BE VIABLE SO
IF YOUR POINT IS WELL TAKEN THEN
I THINK THAT THE. PEOPLE OF THE
EXPERTS ARE GONNA MAKE THAT
DETERMINATION BUT IF YOU WANT TO
SUPPLEMENT WHAT I WANT WHAT'S
BEEN SAID HERE. ESPUMA
APPRECIATED SOUTH PACIFIC YOU
SENATORS RICK I MOVE WOULD JUST
ADD THAT UP NOT UNLIKE THE
HOSPICE CONVERSATION WE HAD WITH
THE COMMITTEE.
A WE WANT TO BE CONNECTED WITH
THOSE COMMUNITIES TO PROVIDE
THOSE PUBLIC HEALTH SERVICES
BECAUSE THIS IS NOT MEANT TO BE
AN OVERLAPPING SERVICES IS MEANT
TO BE. A CONNECTING SERVICE SO
NO PATIENT GETS RE ADMITTED TO
THE HOSPITAL BECAUSE.
SOMETHING OCCURRED PRIOR THEIR
ELIGIBILITY FOR HOME HEALTH
SERVICE AND INNER SITS AT HER
BUT WE COMMIT TO KEEP WORKING ON
THAT.
A PREPAID PRE SHAPE THAT I THINK
THIS IS AN IMPORTANT.
VEHICLE MOVE FORWARD I ACTUALLY
ALSO SHARE SOME CONCERNS OF
SOMEONE WHO'S WORKED WITH THE
FIREFIGHTERS ON TRYING TO GET
BETTER REIMBURSEMENT FOR
AMBULANCE TRANSPORT EMT
SERVICES.
THAT IT'S GREAT THAT WE'RE GOING
TO DO SOME OF THESE AYE MASALAH
CONCERNS SPECIALLY ON FROM THE
MORE DIRECT SERVICE ASPECTS
WHERE YOU PRY NOT GONNA GET HOW
DO YOU GET PAYMENTS AND I DON'T
WANT TO. DIVERT FIREFIGHTER
RESOURCES AWAY FROM BUT I SEE
THAT MANY OF THEM WHERE IT'S
REALLY INVOLVING.
WE'RE MAKING TRIAGE DECISIONS
THAT HELPS THE COMPRESSED THE
HOSPITAL AND AND MORE
APPROPRIATELY.
GETS PEOPLE TO THE PLACE THEY
SHOULD GO I THINK A IS CERTAINLY
SOMETHING THAT'S IN LINE AND
PROBABLY. THE ALSO BE ABLE BE
SUPPORTED AS WELL FINANCIALLY
THE SURE FIRE SERVICE GETS THE
ADEQUATE FINANCIAL SUPPORT AS
WELL SO.
I APPRECIATE YOU BRING THIS
FORWARD I THINK I HOPE THAT YOU
CAN CONTINUE TO WORK ON SOME OF
THOSE ISSUES BUT I CERTAINLY I
AM I AM PLEASED TO SUPPORT THE
BILL AND THAT WOULD. MOVE IT AT
THE APPROPRIATE TIME.
ANY OTHER QUESTIONS COMMENTS
HERE SENATOR NEWMAN AT THANK
THING WAS CHAIR SO.
THIS IS CLEARLY AN INTERESTING
AND WORTHY CONCEPT I'M A BIT.
CONFUSED HER THERE SEEMS TO BE A
VERY WIDE AMOUNT OF DISTANCE
BETWEEN THE ASSESSMENTS OF THE
PILOT PROGRAM PASSED BETWEEN.
THE PROPONENTS AND AND FEE
DOCUMENTATION THAT. TIME IS
ROBUST AND PROVIDED SO. I GUESS
YOU THE SENATORS FOR GOODNESS
BEHALF HOW WOULD YOU AS SPEAK TO
THAT BECAUSE IT GETS AND
THERE'S.
BUT IT CAN'T BE BOTH.
A FAIR POINT.
.
SO THE ULTRA ANSWER THE QUESTION
WITHOUT PUTTING WORDS IN EITHER
SIDE'S MOUTH BUT I YOU KNOW THAT
WAS REQUIRED THAT THESE PROGRAMS
HAVE AN INDEPENDENT EVALUATOR.
AND YOU KNOW.
.
MY GRANDPA ALWAYS TAUGHT ME
FIGURES LYING LIARS FIGURE SO
YOU CAN TAKE THE NUMBERS. DOWN A
PARTICULAR PATH TO TELL THE
STORY THAT YOU'RE LOOKING TO
TELL THAT'S THE CASE FOR
EVERYONE IN THIS IN THIS
BUSINESS MODEL BUT I WOULD. I
WOULD REMIND YOU THAT HONORED
OFSHE BUT PILOT. THESE PATIENTS
HAVE TO AGREE VOLUNTARILY ON THE
UPTAKE
SO IN A THREE YEAR OF OPERATION.
A I CAN'T SEE THE GUESTS WHY.
THAT PROPONENTS OF THE PILOTS
WHICH WAS THE IN THE EMERGENCY
MEDICAL SERVICES AGENCY IN CAL
ORNEA.
OVER ESTIMATED AS MS ROBERTSON
MENTIONED THE UPTAKE BUT I I
MEAN THEY'RE GUESSING ABOUT WHAT
A PATIENT'S RESPONSES.
AND ALL I CAN SAY IS.
IF YOU WERE IN STUDENT OF IT
THEN THE FEET OF THE PATIENTS
AND THEY ASKED YOU KNOW YOUR
THIS IS WHAT WE'D LIKE TO DO BUT
THIS IS A VOLUNTARY PROGRAM. AND
YOU MAKE TO SAY NO I WANT TO GO
TO THE ER IT'S IN THIS IS AN
UNKNOWN TERRITORY UNITS IT
SIGNIFIED BY THAT THE DIALOGUE
TODAY AND.
BUT ALSO I THINK THE THE
SUPPORT THAT WE'RE HEARING THAT
WE NEED TO MOVE FORWARD AND
HAVING THESE DISCUSSIONS BECAUSE
NO ONE. HAS SUGGESTED THAT THE
CURRENT
SYSTEM OF TRANSPORTING EVERYONE
TO THE MERCHANT SEE ROOM UNDER
ALL CIRCUMSTANCES IS SERVING OUR
COMMUNITIES AND OUR PATIENTS.
I APPRECIATE THAT BECAUSE THE
THE SOME OF THE DATA MEASURE
YOU'VE SEEN IT FROM FROM THE
NURSES SAID ASSOCIATION. MAKES
KIND AGGRESSIVE CASE THAT NOT
ONLY IS IT QUALITATIVELY.
DIFFERENT THAN THOSE TO
REPRESENTED BUT THAT THE COST
SAVINGS.
AMONG OTHER THINGS HAVE BEEN
MISREPRESENTED.
AND THAT THE.
RECIDIVISM RATES OR A
READMISSION RATES I SHOULD SAY.
ARE MUCH LOWER THAN EITHER
PRESUMED I THINK REPRESENTS AYE
AYE IT'S JUST AND I I'M LOOKING
AT THE DATA HERE I'M NOT SURE
YOU'VE SEEN IT.
AND IT IT DOESN'T IF YOU TAKE
IT AT FACE VALUE DOESN'T SPEAK
WELL I TO THE MERITS OF THE
PILOT PROGRAM. AND SO NEVER SURE
WHAT TO DO WITH THAT OTHER THAN
I THINK THE CONCEPT'S
INTERESTING BUT.
AND I MIGHT AS FROM ISRAEL
RISEN TO SPEAK TO THAT BRIEFLY
IF WE COULD ISSUE IF YOU STILL
HERE.
WE'LL BE REALLY QUICK SCI FI
APPRECIATE.
YEAH I. I MEAN I THINK THE GOOD
THING TO SAY HIS THE DATA IS IN
BETA I MEAN WE ACTUALLY TOOK THE
RAW NUMBERS FROM ME FROM UCSF WE
TOOK THE WRONG NUMBERS FROM. THE
AND SURPRISE CHECK WITHIN FORD'S
INFORMATION
UCSF
AND LITERALLY BROKE DOWN THE
DATA AND THIS IS THE DOCUMENT
THAT YOU HAVE
FOR YOU.
AND THIS DOES NOT MAKE A
COMPELLING CASE IN TERMS OF FOR
INSTANCE.
THE POST DISCHARGE.
CASE THE WHOLE POINT OF THAT
PILOT WAS TO TRY TO DECREASE RE
ADMISSIONS TO THE HOSPITAL.
THERE WAS A TWENTY FIVE POINT
SIX RETURN. TO THE ET I MEAN YOU
JUST LOOK AT THE DATA AND THE
DATA DOESN'T SUPPORT. YOU KNOW
WHAT THE PROPONENTS SAY THESE
PROJECTS IN OF SEEK TO DO SO NOT
ONLY DO WE LOOK AT THE DATA WE
ARE ALSO NOT GETTING IN.
CSI.
SO.
THIS BODY CAN'T FULLY BE
INFORMED AS TO WHAT THEY'RE
VOTING ON BECAUSE WE ARE STILL
RIGHT NOW TRYING TO GET THAT
DATA SO. I'M I DON'T KNOW WHAT
ELSE TO SAY ABOUT THE NUMBERS
THEY ARE WHAT THEY ARE WE SPENT
A LOT OF TIME LOOKING AT THIS.
WERE ON THE GROUND LEVEL WHEN
THE H. A WPP PROJECT WAS FIRST
IMPLEMENTED. AGAIN THIS IS THE
FOURTH TIME THIS THING HAS BEEN
STANDARD THAT'S ONE THING.
THIS
TO EXPIRE NOVEMBER THIS YEAR SO
THERE IS.
YOU MORE TIME TO PERHAPS TAKE A
LOOK AT THIS BUT. THE DATA IS
WHAT T IS FROM THE FIRST AND
SECOND PHASE PHASES AND WE CAN
GET YOU ALL THE CITATIONS AND WE
ARE STILL TRYING TO GET THE RAW
DATA WE HAVE THE UCSF REPORT WE
KNOW HOW THE RUN NUMBERS EVEN
FURTHER EVALUATE. IF THE
ADDITIONAL NUMBERS TEASE OUT I
THINK THAT THE PROBLEM.
THANK YOU.
ANY OTHER QUESTIONS
COMMENTS.
SENATE HERTZBERG ARM.
LET ME.
UNDER TO BE SUPPORTING THE BILL.
I UNDERSTAND THEY KNOW THAT
THESE ARE SPREAD PILOTS THAT
HAVE BEEN STARTED AT VARIOUS
TIMES.
BUT I WOULD AIR OBVIOUS IN THE
SIGHT OF TRYING TO STREAMLINE
BUT MORE IMPORTANT HOW DO WE
MAKE THE SYSTEM. MORE EFFICIENT
ARM.
WHEN THE BILL FIRST CAME TO ME
AND THANK YOU FOR TAKING THE
AMENDMENTS.
SO THAT IT WOULD BE IN
PERPETUITY I ASK FOR THE SUN
SAID TO MAKE SURE THAT ALL THIS
CAN BE FLESHED OUT SO WE CAN
KIND OF MONITORED.
AND I GUESS THE ONLY QUESTION I
WOULD HAVE OR IS THE THING THAT
WE CAUTIOUS IS TO MAKE SURE THAT
THERE ISN'T ANY UNINTENDED
CONSEQUENCES TO ANY PATIENT
HEALTH AND. I'M CONFIDENT THERE
HASN'T BEEN SO THAT'S WHY I'M
PREPARED TO SUPPORT THE BILL SO
WITH THAT WOULD YU LIKE TO MAKE
A CLOSING STATEMENT THANK YOU
AND THANK YOU FOR THE
GRACIOUSNESS THANKS EVERYBODY
FOR COMMENTS I ALL I CAN SAY IS
I WILL. TAKE THE THE THE DATE I
TOOK NOTES THAT WITH RESPECT TO
THE OPPOSITION'S THINKING AND
CERTAINLY I'M NOT HERE TO
PRIVATIZE I'M HERE TO. TRY TO
CREATE A SYSTEM THAT.
VOICE IN THE DUPLICATION
INCLUDES COMMUNITY INCLUDES
VARIOUS PLAYERS AND SEE IF WE
CAN YOU KNOW IT IN THE LAST. TEN
TWENTY YEARS LOOK WHAT'S
HAPPENED WITH MEDICINE IT WOULD
MEETING VERY BIG CHALLENGES AND
WHAT'S GONE ON HOW WE FUNDED
WHAT WE DO WITH TECHNOLOGIES
HAPPENED. AND I JUST THINK THAT.
THERE'S JUST NO OBLIGATION.
TO A CONTINUE THAT DILIGENCE
AND.
PART OF THAT WILL BE SCOIL SCRUB
THOSE NUMBERS ALL TAKE THE TIME
TO TAKE A LOOK AT THAT IN THE
INTO WHAT THEY'VE DONE BECAUSE
I.
OR TO MAKE SURE THAT WE'RE CLEAR
ON THIS ASK YOUR SUPPORT THIS
MISSION I THINK SOME REAL
ACCUSER MOTION.
MOVED BY CENTER PAN WERE AN ITEM
NUMBER TWO S. B.. NINE FORTY FOR
THE CITY PASSED TO JUDICIARY
WHERE WE WILL BE TAKING THE
AMENDMENTS ON CALL THE MEMBERS
PLEASE HERNANDEZ AYE HERNANDEZ
AYE WHEN.
WHEN I LEYVA. LEYVA AYE
MITCHELL.
MITCHELL AYE MONNING.
NEWMAN.
I. NIELSEN.
PAN. AND I ROSS.
THE CURLY AT SIX WE DO HAVE SOME
ASSN METALS WILL PLACE A BILL
AND CAUGHT CAN MEMBERS LIKE AN
INTERESTING MISTER.
CENTER LARA WHERE IT ITEM NUMBER
EIGHT SP ONE TWO TWO EIGHT.
SUBSTANCE USE DISORDE LICENSE
AND CERTIFY TREATMENT PROGRAM.
THANK YOU MISTER CHAIR AND
MEMBERS AND WE DO HAVE SUPPORT
ON BOTH SIDES WE HAVE A PRETTY
PACKED SCHEDULE SO APPRECIATE
BEVERLY I HEAR YOU.
.
THANK YOU MEMBERS.
CALIFORNIA'S FACING A SUBSTANCE
ABUSE CRISIS AS WE ARE NOW.
FUELED BY OVER PRESCRIPTION
OPIOIDS HERE IN THE LEGISLATURE
WE PASSED NUMEROUS LAWS TO AND
OVER PRESCRIBING HAVE DANGEROUS
DRUGS. BULLFIGHTING THE OPIOID.
PRESCRIPTION CRISIS WE CANNOT
IGNORE THE TREATMENT CRISIS THAT
WE FIND OURSELVES IN. ONLY ONE
IN FIVE PEOPLE NOW WHO NEED
TREATMENT OF OPIOID USE
DISORDERS CURRENTLY RECEIVE IT
ACCORDING TO THE U. S. SURGEON
GENERAL. PATIENTS AND THEIR
FAMILIES ARE DESPERATE FOR HELP
AND MANY ARE BEING SCAMMED BY
UNSCRUPULOUS TREATMENT.
BUSINESSES WHO DON'T CARE ABOUT
THE RECOVERY THESE OPERATORS ARE
IN IT FOR THE MONEY.
THEY CALL THAT PATIENT
BROKERING AND IT IS LAVING
CALIFORNIA DOWN A PATH TO
MISSOURI THE BILL FAT DOES
SEVERAL THINGS MEMBERS. UP FOR
THE FIRST TIME IN CALIFORNIA LAW
S. B. TWELVE TWENTY EIGHT
DEFINES AND BANDS PATIENT
BROKERING WHICH MEANS REFERRING
A PATIENT IN EXCHANGE FOR A
KICKBACK. COMMISSION OR ANY KIND
OF ECONOMIC BENEFIT S. B. TWELVE
TWENTY EIGHT ALSO A RAISES
STANDARDS FIRST THAT SUBSTANCE
USE DISORDER CONTINUUM OF CARE
INCLUDING CENTERS OUTPATIENT
FACILITIES AND RECOVERY
RESIDENCES.
AGAIN S. B. TALK TO ME REQUIRES
A FISCALLY THE HAVE NOTS KNOWN.
THE OVERDOSED PARA PREVENTION
MEDICATION AVAILABLE WITHOUT A
PRESCRIPTION. AND S. B. TWELVE
TWENTY EIGHT ALSO REQUIRES OTHER
NON CLINICAL STANDARDS FOR
RECOVERY RESIDENTS SINCE THE
STANDARDS ARE CONSISTENT WITH
THE NATIONAL ASSOCIATION. OF
RECOVERY RESIDENTS STANDARDS AND
S. B. TALK TWENTY EIGHT ALSO
REQUIRES LICENSED RECOVERY
PROGRAMS TO REFER. PATIENTS ONLY
TWO FACILITIES THAT PROTECT
PATIENTS PHYSICAL AND FINANCIAL.
A.
PROTECTED FROM PHYSICAL AND
FINANCIAL ABUSE BY RESEARCH
YASSER AYE VOTE.
NOW PLEASE PROCEED WE DO HAVE
SUPPORT BOTH SIDES.
THANK YOU MISTER CHAIRMAN
MY NAME IS RYAN HAMPTON I'M A
PERSON IN RECOVERY FROM OPIOID
AND HEROIN. LIKE TO THANK THE
COMMITTEE AND SENATOR LARA FOR
INVITING ME ON BEHALF OF
RECOVERY REFORM NOW.
IT IS AN HONOR TO SPEAK ABOUT
THE IMPACT.
A TWELVE TWENTY EIGHT
WILL HAVE ON CALIFORNIANS WITH
SUBSTANCE USE DISORDER. WE CAN
DO THIS BY SUPPORTING ETHICAL
GUIDELINES FOR RECOVERY HOUSING
SUPPLY NALOXONE TO SOBER LIVING
HOMES. AND AND PATIENT
BROKERING.
I'M HERE TODAY BECAUSE MY FRIEND
TYLER DIED OF A HEROIN OVERDOSE
SIX MONTHS AGO.
A SOBER LIVING HOME.
BECAUSE THERE IS NO NO OXEN ON
SITE AND BECAUSE THE HOME STAFF
WERE NOT TRAINED TO DEAL WITH
OVERDOSES MY FRIEND LOST HIS
LIFE.
COMMON SENSE MEASURES LIKE THE
LOCSIN AND SOBER LIVING HOMES
ETHICAL STANDARDS
AND PROTECTION FOR PEOPLE WHO
ARE TRYING TO RECOVER ARE
CRUCIAL IF WE WANT TO SAVE
LIVES.
MY FRIEND'S DEATH WAS ONE
HUNDRED PERCENT PREVENTABLE. AND
SP TWELVE TWENTY EIGHT ADDRESSES
THE CHANGES WE NEED IN ORDER TO
ENSURE. THAT RECOVERY HOMES ARE
SAVING LIVES AND NOT ENDANGERING
THEM.
WE MUST HAVE BEST PRACTICES IN
RECOVERY HOUSING IMPLEMENTED
ACROSS OUR STATE.
THAT INCLUDES HOW PEOPLE ARRIVE
AT TREATMENT AS WELL.
AS I SIT HERE A PATIENT BROKER
IS LURING AN UNSUSPECTING
BRIGHTON PERSON EXCHANGE FOR
HEADHUNTING FEET.
THE QUALITY OF CARE THAT THAT
PERSON WILL RECEIVE IS ANYONE'S
GUESS.
MOST LIKELY THEY'LL BE
DISCHARGED AFTER THEIR HEALTH
INSURANCE IS BLED DRY AND TURNED
OUT.
JUST TO SICK AS THEY WERE
BEFORE.
IF THEY DO NOT DIE IN THE
PROCESS.
WE NEED TO END THIS EXPLOITATION
AND ENSURE THAT PEOPLE HAVE A
WAY TO TELL THE REPUTABLE FROM
THE PREDATORY.
A RECENT STUDY BY HARVARD'S
RECOVERY RESEARCH INSTITUTE
FOUND THAT BECAUSE IT CAN TAKE
SOME.
AFTER ABSTINENCE
HAS BEEN INITIATED FOR THE BRAIN
SYSTEMS TO RE CALIPARI AND TO
ADAPT TO THE ABSENCE OF DRUGS.
SERVICES SHOULD BE PROVIDED IN
AN ONGOING WAY AFTER AN ACUTE
RESIDENTIAL OR OUTPATIENT
TREATMENT.
WE NEED TO TAKE AS MUCH CARE
WITH SOBER LIVING HOMES AS WE DO
WITH TREATMENT LIVES ARE AT
STAKE.
WITHOUT THESE MEASURES IN PLACE
WILL CONTINUE TO LOSE PEOPLE
LIKE MY FRIEND TYLER.
PEOPLE WHO ACCESS CONTINUING
CARE ASK FOR HELP IN GOOD FAITH.
WE MUST ENSURE THAT THEIR SAFETY
NET IS STRONG SAFE AND READY TO
CATCH THEM THANK YOU.
THINK ANYONE ELSE IN SUPPORT.
HI THANK YOU FOR HAVING ME MY
NAME IS ROSE STALL I AM ALSO A
PERSON RECOVERY.
MY INTRODUCTION TO THE VERY
REAL AND VERY DARK GRAY AREA OF
THE TREATMENT INDUSTRY CAME. UP
IN CALIFORNIA WAS DURING THE
COURSE OF DELIVERING EVIDENCE OF
FROM.
TO AN INJURY.
GATOR IN EARLY TWO.
FIFTY.
THE EVIDENCE SHOWED THAT MY
EMPLOYER COMMUNITY RECOVERY. LOS
ANGELES A LARGE NETWORK.
OF TREATMENT CENTERS RANGING
FROM SIX TO SIXTEEN SO WE'RE
LIVING RESIDENTIAL RESIDENCES
AND TREATMENT FACILITIES
THROUGHOUT.
THROUGHOUT CALIFORNIA WAS
BILLING PRIVATE HEALTH INSURANCE
INSURERS FRAUDULENTLY ON A
MASSIVE SCALE AND WAS PROVIDING
UNLICENSED TREATMENT AS WELL AS
EMPLOYING UNLICENSED THERAPISTS
AND HELP PROVIDERS.
CLIENTS WERE DYING AT AN
ALARMING RATE WITHIN TWENTY FOUR
HOURS TO WEEK OF LEAVING THE
FACILITIES AND REPORTS AND
EVIDENCE OF SEXUAL ABUSE WERE
SURFACING.
COMMUNITY RECOVERY PUBLICLY AND
AGGRESSIVELY ADVERTISE ITS
TREATMENT SERVICES AND HOUSE AN
AVERAGE OF FOUR HUNDRED CLIENTS
AND STAFF AT ANY GIVEN TIME.
THE GRAY AREAS WHERE THIS
COMPANY WAS ABLE TO GROW AND
EXPAND INTO ONE OF THE LARGEST
HEALTH INSURANCE SCHEMES AND
CALIFORNIA HISTORY WITHOUT PUSH
BACK AT ALL.
LAST MONTH BY FORMER EMPLOYER
COMMUTER RECOVERY WAS CONVICTED
OF THIRTY THREE CAL.
RANGING FROM FURNISHING DRUGS TO
SEXUAL EXPLOITATION TO RAPE.
MR ABOUT THEM PROVIDED TRAUMA
THERAPY TO HIS VICTIMS BEFORE
AND AFTER THE SEXUAL ASSAULT THE
BEFORE AND AFTER SEXUALLY
ASSAULTING THEM IN SOME CASES.
WHY I'M HERE TODAY IS THAT?
EVEN STILL. IF TO DAY I BROUGHT
THE SAME EVIDENCE AND THE SAME
PEOPLE WERE OPERATING THE SAME
UNLICENSED TREATMENT.
AND DURING THE SAME ABUSE.
.
IF I REPORT TO D. H. THE S. THEY
WOULD HAVE THE SAME ANSWER THAT
THEY DID THREE YEARS AGO WHEN I
RECORD IT BUT I REPORT ABOUT THE
MAN COMMUTER RECOVERY TO THEM.
WHICH WAS THAT THE LEVEL OF CARE
BEING PROVIDED DID NOT MEET THE
REQUIREMENTS FOR LICENSURE. AND
YET BECAUSE HE IS NOT LICENSE
THE
CSUS ARE COME.
DESPITE WHAT APPEAR TO BE A
SINCERE DESIRE BY THE DEPARTMENT
TO INTERVENE THEIR HANDS WERE
TIED. AS RESULTS WHEN IT IS A
BEGINNING I BELIEVE IN AS
INDIVIDUALS WITH ADDICTIONS HAVE
BECOME A COMMODITY THE SELF
GOVERNMENT OF THIS OVER LIVING
INDUSTRY HAS BUCKLED UNDER THE
PRESSURE. AND THOSE SUFFERING
AND RECOVERING FROM ADDICTION
DESERVE OUR ATTENTION NOW MORE
THAN EVER THANK YOU THANK YOU
ANYONE ELSE.
HI PERSON LIKE TO THING CENTER
LARA AND THE ENTIRE COMMITTEE
FOR ALLOWING ME TO SPEAK HERE
TODAY. MY NAME IS GARY HATE AND
I'M A PERSON IN RECOVERY FROM
HEROIN ADDICTION.
THE PUBLIC IS LARGELY UNAWARE OF
THE DEGREE TO WHICH PEOPLE
NEEDING TREATMENT ARE TARGETED
TRAFFIC TO AND REWARDS GIVEN FOR
PLACEMENT IN SERVICES.
THIS IDEA OF BROKERING IS
RAMPANT AND UNETHICAL BUT MOST
IMPORTANTLY DOES NOT WIND UP
MEETING THE NEEDS OF THE PATIENT
RESULTING IN WASTED MONEY.
RELAPSE AND DEATH.
I HAVE SEEN FIRSTHAND THE
DEVASTATING EFFECTS PATIENT
BROKERING HAS HAD ON MY
COMMUNITY PEOPLE ARE BALL SOLD
AND TRADED LIKE COMMODITIES.
BOILER ROOM OPERATIONS ARE ALL
OVER OUR STATE. THE ONLY INTAKE
ASSESSMENT QUESTION THAT MATTERS
TO THESE BROKERS IS WHAT TYPE OF
INSURANCE POLICY DO YOU HAVE.
THEY ALREADY KNOW WHERE THEY
WILL BE SENDING THAT PERSON
BEFORE THE CALL EVEN COMES AND.
YOUR NEEDS AND AGREE ON THE
LEVEL OF CARE IS IRRELEVANT.
PRETTY AGREED UPON PAYMENTS PER
CLIENTS HAVE ALREADY BEEN
NEGOTIATED BETWEEN THE BROKER
AND USUALLY UNETHICAL PROVIDER.
IN THESE SITUATIONS MORE OFTEN
THAN NOT ONCE AN INSURANCE
POLICY HAS BEEN COMPLETELY DRIED
UP THE PERSON IS ASKED TO LEAVE
THE FACILITY OR SOBRE HOME.
NOW BECOMING HOMELESS IN AN
UNFAMILIAR STAY AN EXTREMELY
HIGH RISK OF REAL.
OVERDOSE AND DEATH.
IN THE LAST THREE YEARS I'VE
LOST EIGHTEEN FRIENDS MY
COMMUNITY MANY OF WHOM WERE
TARGETED AND MISLED INTO
FACILITIES NOT BASED ON
INDIVIDUAL NEEDS BUT FINANCIAL
INCENTIVES.
THIS BEHAVIOR IS COMPLICIT IN
THE DEATH TOLL NUMBERS WE
CONTINUE TO SEE RISE.
I URGE YOU TO PASS SENATE BILL
TWELVE TWENTY EIGHT TO PROVIDE
THE NECESSARY OVERSIGHT OF THE
ADDICTION TREATMENT INDUSTRY IN
RECOVERY HOUSING. THOUSANDS OF
VULNERABLE LIVES DEPEND ON YOU
TO INTERVENE. THOSE SOULS
SUFFERING WITH ADDICTION DESERVE
THE SAME RIGHTS PROTECTIONS AND
CIVILITY AS EVERYONE ELSE WHO
USES OUR HEALTH CARE SYSTEM.
AND THOSE WHO PROVIDE ANY SORT
OF SERVICES WHETHER THAT BE
ANCILLARY SUPPORT OR CLINICAL
MUST BE HELD TO THE SAME
STANDARDS OF CARE AND ETHICS AS
THE REST OF THE HEALTHCARE.
THANK YOU THANK YOU ANYWHERE
ELSE IN SUPPORT NAME AND
POSITION ONLY.
MARK BEGAN ABOUT THE
SHATTERPROOF FOR NATIONWIDE
NONPROFIT DEDICATED TO OP WOULD
ABUSE WHO SUPPORT THE BILL WE'RE
ALSO WORKING WITH THE AUTHOR IN
HIS STAFF TO CLARIFY TO MAKE
SURE THAT.
THERE ARE TREATMENT STANDARDS
TO MAKE SURE THAT.
THE FACILITIES ARE USING BEST
PRACTICES IN TERMS OF TREATMENT
AND THAT THEY ADOPT ANY NATIONAL
GUIDELINES WHEN THEY WERE
CREATED THANK YOU YOU.
TOM RAN FREELY ARE WITH THE
COUNTY BEHAVIORAL HEALTH
DIRECTORS IN SUPPORT.
THANK YOU THEIR OPPOSITION.
KURT CHILD DISABILITY RIGHTS
CALIFORNIA WE ARE IN OPPOSE.
ON THE BILL. MOSTLY BECAUSE OF
THE RESTRICTIONS AND AS THIS
COMMITTEE HAS HEARD.
ME SAYING A NUMBER OF TIMES THE
RESTRICTIONS THAT OF
CERTIFICATION OR OTHER
LIMITATIONS ON THE SIX AND UNDER
HOME.
IT THAT BEING SAID WE ARE
MEETING WITH THE SPONSORS AND
THE AUTHORS OFFICE AND HAVING A
VERY CONSTRUCTIVE
CONVERSATIONS WERE WHOLLY
BUT INSTEAD WE WILL.
SORT THIS ONE OUT AND WE DO
SUPPORT THE PROVISIONS IN THE
BILL FOR PATIENT BROKERING AND.
IN FURTHER TRANSPARENCY AND
OVERSIGHT IN TREATMENT PROGRAMS
THANK YOU THANK YOU ANYONE ELSE
OPPOSITION AYE CERRITOS
CALIFORNIA CONSORTIUM OF
ADDICTION PROGRAMS AND
PROFESSIONALS. WE AS WELL HAVE
SUGGESTED SOME AMENDMENTS
THERE'S A BIT OF CONFUSION ABOUT
WHERE THE LINE BETWEEN TREATMENT
AND. RECOVERY RESIDENTS ARE SO
WE'RE LIVING A LITTLE WOULD BE
CUT SO WE'RE HOPEFUL THAT WE CAN
WORK THAT OUT THANK YOU THANK
YOU.
QUESTIONS REMAIN IN THE MEMBERS.
WE HAVE US I'LL BE SUPPORTIVE
BILL CENTER LARA WE'VE MOTION BY
COMING A CENTER LEYVA.
WOULD LIKE TO CLOSE THEY CAN I
JUST FORGOT TO MENTION THAT WE
WILL ACCEPT THE TECHNICIAN
TECHNICAL AENDMENTS RECOMMENDED
BY THE COMMITTEE. I FORGOT TO
SAY THAT MY STATEMENT AND WILL
BE TAKEN UP IN PUBLIC SAFETY IT
WILL DO AND PUBLIC SAFETY THANK
YOUR FOR FAST FOR A VOTE WE OWE
ITEM NUMBER EIGHT SP ONE TWO TWO
EIGHT THIS IS TO PASS TO PUBLIC
SAFETY CALL MEMBERS PLEASE.
HERNANDEZ AYE HERNANDEZ AYE
WHEN.
WHEN I LEYVA. LEYVA AYE MITCHELL
AYE MITCHELL AYE MONNING.
NEWMAN. NEWMAN AYE NIELSEN.
NIELSEN AYE PAN. AND I ROSS.
EARLIER SEVEN.
WILL PLACE A BILL IN CALL.
LOOKS LIKE I SEE HERE WIENER
THANK YOU CENTER CENTER WIENER
ON THE AUDIENCE.
AND WE DO HAVE SUPPORT ON BOTH
SIDES SENATOR.
THANK YOU MISTER CHAIRMAN.
SO HAVING OUR NEIGHBORS ABOUT
THIS ROOM FROM LAST NIGHT BUT I.
BUT I DO KNOW THAT WOULD HAVE.
YES THANK YOU.
OUR DIFFERENCES ARE ALWAYS.
SO.
.
WELCOME TO THE CALIFORNIA STATE
SENATE.
BUT HURRICANE CITY.
WE WALKED ROCK AND ROLL HERE
RIGHT I SUSPECT IT'S HEARING
WILL BE A LITTLE LITTLE CALMER
WELL I GUESS IT WE HAVE. WE HAVE
WE.
RIGHT NOW WE HAVE SUPPORT ON
BOTH.
SHE.
BUT A WE COULD. KEEP IT BRIEF
BICU BE GREAT HER GREAT.
BUT I DO.
MISTER CHAIRMAN AND.
AND MEMBERS I WANT TO THANK THE
COMMITTEE FOR ITS.
ANALYSIS AND WHILE I DO ACCEPT
OF THE COMMITTEES AMENDMENTS
BUT TODAY I AM HONORED TO
PRESENT. SP FOURTEEN SIXTY FOUR.
TO IMPROVE THE HEALTH AND WELL
BEING OF SOME OF CALIFORNIA'S
MOST VULNERABLE PEOPLE WHO HAVE
BEHAVIORAL MEDICAL.
OR OTHER OR DEVELOPMENTAL
DISABILITIES AS TO FOURTEEN
SIXTY FOUR I WILL INCREASE
ACCESS FOR IDENTICAL PATIENTS
WITH SPECIAL NEEDS.
SO THEY CAN ACCESS TO DENTAL
CARE THAT THEY SO DESPERATELY
NEED.
ACCESSING DENTAL CARE IS
INCREDIBLE A BURDEN OFF AND
HURDLE FOR THIS POPULATION.
ONE STUDY THAT SURVEYED FORTY
SEVEN HUNDRED ADULTS WITH
INTELLECTUAL AND DEVELOPMENTAL
DISABILITIES I FOUND THAT ABOUT
ONE THIRD HAVE UNTREATED
CAVITIES. EIGHTY PERCENT HAVE
SEVERE GUM INFECTION AND ELEVEN
PERCENT ARE MISSING TEETH.
BUT IT STANDS SAME STUDY FOUND
THAT NEARLY FORTY PERCENT OF
THIS POPULATION REQUIRED SOME
FORM OF BEHAVIORAL ASSISTANCE IN
ORDER TO RECEIVE DENTAL
TREATMENT.
AND THE OTHER QUARTER OF THIS
POPULATION REQUIRED ADVANCED
BEHAVIORAL MANAGEMENT TECHNIQUES
TO RECEIVE DENTAL TREATMENT.
BUT AS ONE PARENT OF AN ADULT
WITH SPECIAL NEEDS EXPLAIN WHAT
TESTIFYING BEFORE THE LITTLE
HOOVER COMMISSION.
DURING IDENTICAL HEARING IN
TWENTY FIFTEEN. HER CHILD BITES.
HITS HIMSELF AGAINST WALLS AND
AS OTHER BEHAVIORS THAT MAKES
ADDITION AND THE SUBSIDY. I IN
ORDER TO ACCESS DENTAL CARE.
BOMBS DID CHALLENGES SAT DOWN TO
CAL WHICH ALREADY HAS HORRIBLE
REIMBURSEMENT RATES ABOUT DOES
NOT HEY. OF FOR THESE ADDITIONAL
SERVICES THEY PAY FOR OF SOMEONE
YOU CAN JUST WALK AND GET
TREATMENT AND LEAVE. BUT NOT FOR
SOMEONE WHO REQUIRES ADDITIONAL.
FOCUS TIME SERVICES BEHAVIORAL
MANAGEMENT IN ORDER TO ACCESS BY
DENTAL CARE. LAN.
AND WE NEED TO CHANGE UP.
SP FOURTEEN SIXTY FOUR OH
REQUIRES THAT THE DEPARTMENT OF
HEALTH CARE SERVICE SERVICES
REIMBURSE DENTISTS FOR THE EXTRA
TIME AND RESOURCES. THAT THEY
SPEND ON THESE PATIENTS.
BUY IT IF THEY MEET THE NARROW
DEFINITION OF SPECIAL NEEDS.
AND THEN REQUIRES THE
DEPARTMENT TO DETERMINE ADEQUATE
A REIMBURSEMENT RATE FOR THE
BEHAVIOR ON CASE MANAGEMENT.
THAT TEND TO CAL WILL NOW COVER
FOR THESE PATIENTS.
BUT WE KNOW THE DENTAL CARE
WHICH IS UNFORTUNATELY TREATED
AS A LUXURY AT TIMES IS ACTUALLY
QUIRK A TO GOOD HEALTH. THOUGHT
AND THIS BILL WILL HELP MORE
PEOPLE AT SOME OF OUR MOST
VULNERABLE RESIDENTS ATTAIN A
GOOD PLOT DENTAL CARE I
RESPECTFULLY ASK FOR AN AYE
VOTE.
AND I'VE TWO WITNESSES OF ME
TODAY THAT THE KAREN BUT SARAH
THAT CEO OF WEST HEALTH.
AND AYE JANELLE CAN WORTHY.
THE PARENT OF A DJ A CHILD WITH
SPECIAL NEEDS WHO RELIES ON DOWN
TO CAL THANK YOU VERY MUCH
PLEASE PLEASE PROCEED.
BUT AFTERNOON EVERYBODY THANK
YOU SO MUCH FOR ALLOWING ME THE
OPPORTUNITY TO BE HERE TODAY ION
THIS YOU'LL* THE GUARDIAN MY
WEST SENIOR DENTAL CENTER. A
COMMUNITY MENTAL CLINIC THAT
PROVIDES SERVICES TO LOW INCOME
SENIORS IN SAN DIEGO.
EIGHTY FIVE PERCENT OF THE
PATIENTS THAT WE SEE ARE THAN TO
GO OUT AND RELEASE
MANY OF THEM HAVE MEDICAL
COMPLEX CONDITIONS AND HAVE
SPECIAL NEEDS.
WHEN WE SEE PATIENTS LIKE GODS
WE NOTICE THE CHALLENGES THAT
THEY'RE FACING THE CHANGES LIKE
SENATOR MENTIONED THE CHAIN THE
EFFECTS SEEM REALLY BIG
CHALLENGES BECAUSE IT'S NOT EASY
FOR THEM TO FIND OTHER ENTITIES
THAT WILL. ACCEPT OR.
RECEIVED AT THE TYPE OF
INSURANCE THEY HAVE BUT ALSO IS
DIFFICULT FOR THE PROVIDERS
BECAUSE WE STILL HAVE TO THAT
KIND OF WORK AND WE CANNOT CARE
FOR SO MANY PATIENTS THAT HAVE
SO MANY NEEDS. ON I'M HERE TODAY
BECAUSE I'M NOT LOOKING FOR THEM
ABOUT LOCATING FOR PATIENTS LIKE
ACTIONS THAT I SEE EVERY SINGLE
DAY. MISTER ARE A SEVENTY NINE
YEAR OLD MAN AND HE HAS LOTS OF
MAKEUP MENTAL SOCIAL CONDITIONS
THAT MAKE IT
IT MEANT A LITTLE MORE DIFFICULT
THAN PUTTING DENTAL CARE.
IN THE MEDICAL CONDITIONS THAT
HE HAS HE HAS HYPERTENSION
DIABETES YOU HAVE COPD ASTHMA
AND HE HAS TO CARRY A KIND ALLOW
WITH HIS OXYGEN TANK. THAT'S
SOMETHING THAT WE HAVE TO
ACCOMMODATE FOR EVERY SINGLE
APPOINTMENT. JUST TO MAKE IT
EASY FOR YOU TO UNDERSTAND WHAT
PROVIDING CARE WE CANNOT
COMPLETELY TO APPLYING HIM
BECAUSE HE HAS TO CONSTANTLY
CALL.
SOMETIMES WE HAVE TO STOP
FRIEDMAN COMPLETELY AND LET HIM
RECORD BECAUSE HIS LUNGS CANNOT
TOLERATE THAT AMOUNT STRESSED OF
SEX IMAGINE WHAT HE'S TO HAVE
ALL THOSE INSTRUMENTS IN YOUR
ABOUT. DEALING WITH ALL THE
MEDICATIONS AND ALL THE KING'S
THAT YOU'RE DOING OR DOT DOT DOT
PROCESSING BUT POST PROCESSING
THROUGH ITS VERY DIFFICULT FOR
THEM. SOMETIMES BECAUSE OF THOSE
MANY MEDICATIONS THAT THEY TAKE
THE CUP TO THINK BOTTOM BRICKS
AND THERE'S NOTHING WE CAN DO WE
HAVE TO ACCOMMODATE FOR THAT. SO
IT TAKES US MUCH LONGER TO BE
ABLE TO PROVIDE THAT TYPE OF
CARE EVERY SINGLE DAY. IT IS
CRITICAL FOR OF.
THESE TYPE OF BILL TO GET
SUPPORT BECAUSE HE'S NOT ONLY
GOING TO INCREASE THE ACTS OF
THE PATIENT WITH SPECIAL NEEDS
MAY HAVE. BUT HE'S ALSO
INCENTIVIZE PROVIDERS LIKE
MYSELF AND OTHER PROVIDERS TO
INCREASE THE ACCEPTANCE AND BE
ABLE TO ACCEPT.
PATIENT THAT I DESCRIBE OF THIS
TYPE OF ISSUES.
IT IS IMPORTANT TO SUPPORT THIS
BILL BECAUSE IT'S GOING CHRIS
ACCESS AND IS HOPEFULLY GOING TO
BE PUT US IN THE RIGHT SPOT TO.
DECREES THAT.
HELL BEAST BUT IT DOESN'T LOOK
WE HAVE IN CALIFORNIA. THANK YOU
SO PLEASE PROCEED.
THANK YOU FOR INVITING ME HERE
TODAY IN MY NAME IS DANIELLE
KENWORTHY MY SON IS DJ AND MY
HUSBAND DARRYL. WE LIVE ACROSS
THE RIVER IN WHERE SACRAMENTO
PRACTICALLY IN THE SHADOW OF
THIS GREAT CAPITAL WE'RE HERE
TODAY TO SHARE OUR EXPERIENCE
WITH TEND TO CAROL. THE MEDICARE
BENEFIT FOR DAN DENTAL CARE DJ
IS NOW TWENTY TWO YEARS OLD
ALMOST TWENTY THREE HE HAS DOWN
SYNDROME AUTISM AND A HOST OF
MEDICAL CHALLENGES. THESE
INCLUDE HEART LEARN AND
GASTROINTESTINAL ISSUES THE
DOCTORS TELL US USE MEDICALLY
FRAGILE.
WHEN DD WAS BORN WE LIVED IN
HUMBOLDT COUNTY AND THERE WAS
LITTLE TO NO ACCESS TO DENTAL
CARE BECAUSE OF ALL THE TUBES
AND WIRES IN AROUND HIS MOUTH DJ
DEVELOPED A VERY STRONG ORAL
VERSION. NOT LETTING ANYTHING
INTO HIS MOUTH AND IF SO HE
VOMITED REPEATEDLY.
THAT AND IN THAT WAY HE COULD
DAMAGE HIS
EVEN FURTHER I WAS AT A LOSS
REGARDING DENTAL CARE HIS TEETH
WERE COVERED WITH PLAQUE THE
DOCTOR EXPLAINED THAT BECAUSE
THE REFLUX AND HIS G. TUBE
FEEDINGS THAT INCREASED THE
AMOUNT OF PLAQUE. THAT WOULD
ACCUMULATE THERE BY MAKING HIM
AT RISK FOR MORE INFECTIONS
INFECTIONS THAT COULD ACTUALLY
DAMAGE HIS HEART.
DJ ALSO HAS DEVELOPMENTAL AND
BEHAVIORAL CHALLENGES AND IS
CONSIDERED NON VERBAL HE CANNOT
TELL US WHEN HE IS IN PAIN. AND
WHEN HE IS IN PAIN HIS BEHAVIORS
ROCKING SELF STIMULATORY
BEHAVIORS AND HOLDING TO MUSICAL
TOYS TO HIS EARS ROCKING BACK
AND FORTH ALL DAY LONG TO BLOCK
OUT THE PAIN WERE TOO MUCH FOR
US.
AT AGE THREE WE MOVED FROM
HUMBOLDT COUNTY TO YOUR LITTLE
PROVIDERS TO WHOM WE VOICED OUR
DENTAL CARE IT CONCERNS.
THOSE CONCERNS BROUGHT
INFORMATION ABOUT A LOCAL DOCTOR
DOCTOR GALLO AND SEDATION
DENTISTRY THAT WAS AVAILABLE FOR
CHILDREN LIKE OUR SON AND WAS
COVERED BY DENTAL CAL.
DJ HAD HIS FIRST VISIT WITH THE
DENTIST WHEN HE WAS THREE
OUTSIDER UNDER ANESTHESIA WITH
DOCTOR BOOKOUT.
FROM THAT TIME ON EVERY TWO
YEARS HE WAS ALLOWED TO HAVE
SEDATION DENTISTRY TO CLEAN HIS
TEETH AND CHECK FOR ANY NEEDED
MEDICAL OUR DENTAL CARE.
WE FOUND CENTER TO BE
COMFORTABLE AND RESPONSIVE BUT
IT WASN'T VERY LONG AGO THAT
SUTTER WAS CONSIDERING CLOSING
THEIR DOORS AND I SPOKE TO THIS
VERY ISSUE BEFORE BECAUSE OF
REIMBURSEMENT COSTS AND THE COST
OF MONO ARE.
LATER DOCTOR GALLO BECAME
CONCERNED ABOUT THE AMOUNT OF
PLAQUE BUILDUP RECOMMENDING A
YEARLY CLEANING AND DENTAL CAL
ONLY COVERS ONCE EVERY TWO YEARS
SO WE HAD TO GO TO OUR REGIONAL
CENTER TO HELP MAKE UP THE
DIFFERENCE.
THERE HAVE BEEN MEMORABLE VISITS
THE VISIT THAT COINCIDED WITH
HALLOWEEN AND THE.
OUR TEAM HAD ADDED HOLIDAY
ACCESSORIES TO THEIR SCRUBS.
AND DJ SMILE THE JACKAL LEONARD
SMILE THAT YEAR WAS SEVERAL
MISSING TEETH BECAUSE HE NEEDED
EXTRACTION.
AND ANOTHER YEAR DJS BREATHING
SLOW DANGEROUSLY LOW AFTER PRE
OPERATIVE SAID SEDATIVE AND THE
TEAM HAD TO READJUST THINGS SO
THAT HE COULD BREATHE NORMALLY.
AND WAS WATCHED EVEN CLOSER AND
I THANKED GOD BECAUSE WE WERE IN
THE HOSPITAL AT THAT TIME AND
EVERYTHING WENT SMOOTHLY.
CHILDREN AND ADULTS TING SPECIAL
HEALTHCARE NEEDS
BUT THEY DESERVE TO RECEIVE
APPROPRIATE COMFORTABLE AND
COMFORTING DEMOCRAT DENTAL CARE.
SOME LIKE DJ HAVE LIMITED OR
NONEXISTENT VERBAL SKILLS AND
CANNOT SAY WHEN THEY ARE IN
PAIN.
MANY HAVE BEHAVIORAL CHALLENGES
AND THE USUAL NUMBER OF
PROFESSIONALS INVOLVED IN A
TYPICAL CASE OF DENTAL CARE IS
NOT ADEQUATE TO MEET THE NEED OF
THIS SPECIAL POPULATION.
PATIENTS AND FAMILIES ARE MADE
TO WAIT MONTHS AND SOMETIMES
YEARS WHILE AN INFECTION AND
PAIN RAGES AND THEY HAVE NO
WHERE TO TURN.
THE LITTLE HOOVER COMMISSION
REPORT AND INTO CAL IN TWENTY
SIXTEEN REFLECTED THE CHALLENGES
BEING PHASED IN ACCESSING DENTAL
CARE.
I APPRECIATE THAT SENATOR SCOTT
WEINER'S EFFORT IN EXPANDING TO
AND TRYING TO EXPAND.
FUNDING O COVER THE EXTRA
SERVICES NEEDED TO IDENTIFY THE
NEEDY AND TO MAKE COMPENSATION
FOR TREATMENT ATTRACTED TO BOTH
OLD AND NEW PROVIDERS.
IS IMPORTANT I BELIEVE THAT
ASSEMBLY BILL FOURTEEN SIXTY
FOURS THAT ARE SENATE BILL FORTY
SIXTY FOUR IS A GOOD MOVE TO
MAKE SURE MORE TIMELY ACCESS TO
DENTAL CARE IS INSURED FOR
CHILDREN AND ADULTS.
WHO DON'T OUTLIVE THEIR
DIAGNOSES?
LIKE DJ THANK YOU THANK YOU VERY
GOOD AUTO THANK YOU DEEJAYING TO
DENIGRATE JOB.
RIGHT BRIGHT AYE A.
ALRIGHT THE DAY.
THE CLAPPING FOR YOU.
FIX THAT ON.
OR ANYONE ELSE ANYONE ELSE IN
SUPPORT.
BRENT SPENCER ON BEHALF OF
WHAT'S WHAT THE WEST HEALTH
INSTITUTE THE SPONSORS OF THE
BILL IN SUPPORT THANK YOU
ANYWHERE ELSE.
GOOD AFTERNOON UMBRELLA PAYMENT
SPONSOR WITH THE CALIFORNIA
DON'T ASSOCIATION HERE IN
SUPPORT OF VERY PLEASED.
THAT THE CENTERS TAKEN ON THIS
ISSUE AND THAT THE COMMITTEE
AMENDMENTS ADDRESS OF OUR
TECHNICAL CONCERNS WITH THE
BILL.
I THE ONE REMAINING ISSUE THAT
WE HAVE IS JUST THAT WE KNOW
THAT SOMETIMES THE REGIONAL
CENTERS DO YOU WORK WITH I'M
LOCAL PROVIDERS TO BACK FILL
SERVICES THAT ARE NOT COVERED.
AND SO WE JUST WANNA MAKE SURE
THAT IN CREATING COVERAGE FOR
THESE AYE BEHAVIOR MANAGEMENT
THAT IS SO SORELY NEEDED WE'RE
NOT CUTTING OFF I'M OTHER
SOURCES OF FUNDING BUT I KNOW
THAT THE AUTHOR IS COMMITTED. TO
WORKING ON THAT AND SO WE LOOK
FORWARD TO DOING ON THIS PROCESS
THANK YOU THANK YOU SUPPORT.
EIGHT KILL HIM DAHLE SUGAR
TERRACE ON THE DENTAL
COORDINATOR FOR NORTH BAY
REGIONAL CENTER AND I HAVE
WORKED ON SERVICES FOR SPECIAL
NEEDS CLIENTS AND. I'M THE
DENTAL FIELD FOR NOW SIXTEEN
YEARS.
I. THINK THAT DJS MOTHER
ELOQUENTLY STATED QUITE QUITE A
FEW WONDERFUL POINTS I DO WANT
TO JUST MAKE SURE THAT WE
UNDERSTAND THAT THIS IS NO THIS
IS NOT.
A CHOICE ANYMORE THIS IS
SOMETHING THAT IS ABSOLUTELY
IMPERATIVE I'M AND AS A DENTAL
CORD NEAR HIS RESPONSIBLE FOR
HELPING CAN ACT PATIENTS WITH
PROVIDERS IT IS AN ALMOST
IMPOSSIBLE TASK.
OVER THE YEARS AM THE RESPONSE
THAT WE'VE CONSTANTLY GOTTEN
BACK.
FROM THE DEPARTMENT HAS BEEN.
THAT.
PARTICIPATING IN THE PROGRAM ARE
SIGNING UP FOR THE PROGRAM
DOCUMENTATION TO BE ABLE TO DO
THAT HAS BEEN A CUMBERSOME IN
THAT IS ONE OF THE BIGGEST
ISSUES. HOWEVER AS THE BOOTS ON
THE GROUND THE PERSON WHO'S
RESPONSIBLE FOR CONNECTING
SERVICES TO PEOPLE THE PERSON
WHO AT TEN O'CLOCK AT NIGHT IT'S
AN EMERGENCY PHONE CALL. SAYING
MY CHILD'S BANGING THEIR HEAD
AGAINST THE WALL OR THE REPORT
FROM PROGRAM BECAUSE THEY'RE IN
PAIN WE CAN'T FIND A RESOURCE
I'M TELLING YOU THAT
REIMBURSEMENT IS THE KEY. I HAVE
GONE FROM PROVIDER TO PROVIDER
FACE TO FACE I WORK VERY CLOSELY
WITH OUR HOSPITAL DOES START TO
BREAK OUT AND I WILL TELL YOU
FROM THE PERSON WHO'S BEEN HERE.
WITH BOOTS ON THE GROUND
REIMBURSEMENT IS THE KEY AND
WE'VE GOT TO FIND A WAY TO DO
THAT FOR THIS POPULATION AND
WE'RE DOING THAT'S REMEMBERING
THAT THESE CHILDREN BECOME
ADULTS AND WE'RE THINKING ABOUT
SERVICES.
WE OFTEN HEAR A LOT OF ADVOCATES
FOR CHILDREN BUT THESE CHILDREN
OF SPECIAL NEEDS GROW UP TO BE
ADULTS AND THEIR LARGER THEIR
MORE IMPLICATED MORE.
HEALTH COMPLICATIONS ARISE SO
PLEASE KEEP THAT IN MIND AS
YOU'RE VOTING IN Q. IT THIS
POINT TESTIMONIES NAMENS AND
POSITION ONLY.
SUPPORT.
SUPPORT PLEASE NAME A POSITION.
MY NAME OF MARTHA HANSON AND I
SUPPORT THIS BILL THANK YOU.
DANIEL CITY NO ASSOCIATION OF
REGIONAL CENTER AGENCIES ARE
STILL WORKING.
WITH THE AUTHOR AND HIS STAFF
BUT VERY ACCOMMODATING TO
ADDRESS ISSUES RELATED TO
BACKFILL AS PREVIOUSLY STATED
THANK YOU IS THERE ANY
OPPOSITION TO THE MEASURE.
WE SUPPORT.
ON I'M REGISTERED NURSE MY
SPECIFICALLY SURVEY I'M ICF
FACILITIES.
I AM I WOULD LIKE TO SUPPORT
THIS AS AN INDIVIDUAL THANK YOU.
ANYONE ELSE OPPOSITION.
IS ANY QUESTIONS I THINK CENTER
MITCHELL HAD A QUESTION OR
COMMENT.
COMMENT SIR FIRST OF ALL IF
THAT WE POINT YOU TAKE MEMBERS
I'D LOVE TO BE AT THE ARE TO BE
ADDED AS A CO AUTHOR.
ALL FOR A VARIETY OF REASONS.
THERE IS A REGIONAL CENTER IN
MY DISTRICT.
S. A DENTAL CLINIC YOU KNOW ON
SITE AND SO I'VE SEEN THE
MAGICALLY DONE ONE TWO I'M PROUD
TO BE MEMBER OF A LEGISLATURE.
ODD THAT THAT DIDN'T THAT FUNDED
DENTAL KALYAN.
TO THE CHIEF TRAVESTY THAT WE
WENT THROUGH.
A DIFFICULT FINANCIAL YEARS AS
A STATE AND WE ELIMINATED DENTAL
CALIFON PROUD TO BEEN A PART OF
THE LEGISLATURE THAT. PUT IT
BACK BUT FUNNY BACK.
AND THEN THIRDLY ALSO TOURED.
CINEMA DEVELOPMENTAL CENTER AND
AN UNDERSTOOD THE IMPACT.
BOUGHT IT WILL HAVE ON
SPECIALIZED SERVICES LIKE THAT
WHEN WE CLOSE AT FACILITY AND
NEEDING TO MAKE SURE THAT WE
CORD NAY CLOSURE OF THAT
FACILITY AT THEM AND THEY'LL
SPECIALIZED SERVICES GOING AWAY.
TO MAKE SURE THAT THEY ARE
INDEED AVAILABLE AUTOMATICALLY
LEVEL SO I'VE HEARD LOUD AND
CLEAR ON THAT REIMBURSEMENT WILL
MAKE A DIFFERENCE AND FOR THOSE
REASONS OUT THESE LIKED IT WHEN
IT'S APPROPRIATE.
MISTER CHAIRMAN I MOVE THE BILL
AND ASK TO BE ADDED AS A CO
AUTHOR. THANK YOU ARE WE HAVE
THAT NOTED DOWN SENATOR PAN THEN
SOONER NGUYEN AND CENTER NIELSEN
SAMPAN BELOW THANKS VERY MUCH
AND I WANT THANK OUR WITNESSES
FOR BEING HERE AS A P..
THE CARE LOVE FOR MANY CHILDREN
SPECIAL NEEDS TO GROW UP AND TO
ALSO AS ADULTS ARE. AND SAW HOW
DIFFICULT I KNOW HER FROM OTHER
WITNESSES HAVE.
I WOULD LOOK IN YOUR MOUTH
BEING A PEDIATRICIAN STATE THEY
NEED DENTAL CARE.
WHERE WE GET IT?
CAN FIND SOMEONE IT GETS WORSE
BEGETS MORE SEVERE.
PRICE STRIVING ANTIBIOTICS
TRIED TO TAMP DOWN THE
INFLAMMATION BUT IT'S NOT THE
ROOT CAUSE RIGHT THE.
WE DESPERATELY NEED THIS AND I
WANT THANK YOU CENTER WIENER FOR
CARING SUPPORT YOU.
THEN IRWIN.
UPDATE THANK YOU MISTER
CHAIRMAN.
CENTER WHEN ICE WANTED THANK
YOU FOR CARE OF THIS BILL AND I
WILL BE SUPPORTING IT I WOULD
ALSO LIKE TO ASK MY CAN BE CO
AUTHOR TO BRING OUT THAT THANK
YOU.
CENTER NIELSEN.
SENATOR MITCHELL'S REMARKS.
THAT.
PICK SOMETHING NOW I'VE. BEEN
DISPOSED TO SUPPORT THE BILL.
BUT I MUST FOLLOW HER REMARKS
WHICH KEEPS MENTIONED THE CINEMA
DEVELOPMENTAL CENTER.
I REMEMBER QUITE A FEW YEARS AGO
WHEN I FIRST BECAME A SENATOR IS
A. FARMER.
THE YOUNG FARMER.
AND GOING TO THE NAPA STATE
HOSPITAL.
AND THEN SONOMA.
AND IT WAS A AN AWAKENING FOR
ME.
PARTICULARLY.
SO NO.
AND WE'D COME AND.
THAT THAT TIME THAT WAS IT THAN
A LOT OF DE INSTITUTIONALIZATION
ADAM GOING ON.
BUT ALWAYS THE QUESTION THAT WAS
POSED IN MY MIND IS A YOUNG
PRETTY UNKNOWING. PERSON ABOUT
THESE ISSUES.
WHAT COMMUNITY FACILITIES WERE
TALKING ABOUT?
THIS IS SOMETHING THE DISPOSALS
ME TO BE VERY SUPPORTIVE.
OF THIS LEGISLATION MEANING.
DEALING WITH PEOPLE WITH THIS
PARTICULAR CHALLENGE.
AND NOT JUST.
THE INDIVIDUAL BUT VERY
PARTICULAR THEIR FAMILIES.
THAT'S VERY VERY COMPELLING AND
WE CANNOT EVER.
FORGET.
AND JUST SAY THIS IS NOT A
PROBLEM FOR ALL OF US IT IS A
PROBLEM FOR ALL OF US. EVEN IF
WE'RE NOT DIRECTLY AFFECTED.
THANK YOU.
SEEN NO OTHER QUESTIONS OR
COMMENTS.
.
CENTER WIENER WOULD YOU LIKE TO
CLOSE BY GIVE THANK YOU ROCK DOT
COLLEAGUES FOR THE.
SUPPORT AMONG THINKER WITNESSES
THANK YOU DAY.
.
AND.
TWO THINGS I WILL CONTINUE TO
WORK WITH THE RESULT CENTERS
WERE COMMITTED TO RESOLVING. AYE
THAT ISSUE AND I ALSO WANT TO
NOTE THIS IS ALSO NOT JUST ABOUT
YOUNG PEOPLE AND ADULTS ABOUT
SENIORS WITH DEMENTIA.
SO THAT THIS IS.
YOU KNOW IT'S A REAL ISSUE AND
I APPRECIATE THE SUPPORT AND I
RESPECTFULLY ASK YOUR RIVAL INTO
IT ITEM NUMBER FIFTEEN SP ONE
FOUR SIX.
AND SATURN NIELSEN LIKE INTERNET
AUTHORS IT'S GREAT AUTHOR BUT
VERSION BY SENATOR MITCHELL THIS
IS.
TO PASS AS AMENDED TO
APPROPRIATIONS CALL THE MEMBERS
PLEASE.
HERNANDEZ AYE HERNANDEZ AYE
WHEN.
WHEN I LEYVA.
LEYVA AYE MITCHELL.
MITCHELL AYE MONNING.
NEWMAN NEWMAN AYE NIELSEN.
NIELSEN AYE PAN.
AND I ROSS.
CRANIA SEVEN ARE LOOKS LIKE IT'S
ENOUGH TO GET OUT MUCH DIFFERENT
OUTCOME IN YESTERDAY'S HEARING.
CLOSE CLOSE.
ALL.
THANK YOU IT WAS TO PUT THAT ON
BECAUSE WE STILL HAVE SOME
MEMBERS ARE ABSENT I THINK I SEE
CENTER HUESO.
WHERE AN ITEM NUMBER TWELVE SP
ONE TWO NINE TWO ALZHEIMER'S
DISEASE?
AND WE DO HAVE SUPPORT ON BOTH
SIDES SENATOR.
WELCOME.
THANK YOU I'M SURE MEMBERS OF.
THANK YOU FOR.
ALLOW ME TO PRESENT S. B. TWELVE
NINETY TWO.
THIS IS AN IMPORTANT BILL THAT
RELATES TO.
ALZHEIMER'S TO DISEASE.
AND IT'S DISPROPORTIONATE BURDEN
ON CERTAIN.
A COMMUNITIES.
BOB THIS BILL.
WOULD.
A.
STUDIED.
A LARGE PORTION OF THE
POPULATION THAT'S UNSTUDIED
CURRENTLY. THAT HAS AN IMPACT
AFFECT.
THAT IS IS SUFFERING FROM THE
EFFECTS OF ALZHEIMER DISEASE IN
OUR STATE. THERE'S AMPLE
EVIDENCE OF THAT.
LEADS US TO BELIEVE THAT THERE'S
GOING TO BE AN ENORMOUS AMOUNT
OF GROWTH.
AND THE AMOUNT OF ALZHEIMER'S
CASES IN OUR STATE. LOT WITHOUT
HAVING ACCESS TO THIS
INFORMATION STATE OF CALIFORNIA
CAN MAKE. THE NECESSARY CHANGES
THAT THE NECESSARY ADJUSTMENTS
IN OUR MEDICAL SYSTEM.
OF THE TWENTY FIFTEEN OUT
ALZHEIMER DISEASE AND RELATED
DEMENTIAS BECAME THE THIRD.
LEADING CAUSE OF DEATH IN
CALIFORNIA TIED WOULD STROKE.
THE BURDEN ON AFRICAN AMERICANS
LATINOS AND WOMEN AS
DISPROPORTIONATE. WITH HIGHER
PREVALENCE RATES AMONG ALL THREE
POPULATIONS.
COMPARED TO THE REST OF THE
POPULATION AFRICAN AMERICANS ARE
ABOUT TWO TIMES MORE LIKELY TO
HAVE ALZHEIMER'S DISEASE AND
RELATED DEMENTIAS.
LATINOS ARE ONE POINT FIVE TIMES
MORE LIKELY AND WOMEN ARE ABOUT
TWO THIRDS OF THE POPULATION
AFFECTED.
THE CALIFORNIA WILL EXPERIENCE A
THIRTY FOUR PERCENT INCREASE
FROM TWENTY SEVENTEEN.
TWENTY FIVE TWENTY FIVE ALONE SP
TWELVE NINETY TO REQUIRE THE
OFFICE OF HEALTH EQUITY WINDS UP
THE. WITHIN THE DEPARTMENT OF
PUBLIC HEALTH TO RESEARCH AND
DETERMINE THE HUMAN BURDEN AND
ECONOMIC COSTS BELT TIMERS
DISEASE ON AFRICAN AMERICANS
LATINOS. AND WOMEN.
THE RESULTS WILL BE MADE
AVAILABLE BY THE TO THE
LEGISLATURE BY JANUARY FIRST.
TWENTY TWENTY THE RESULT BUT THE
RESULTS WILL HELP THE STATE
ESTIMATE ALZHEIMER RATES FOR THE
SPECIFIC SPECIFIC POPULATIONS.
AND HIGH RISK GROUPS
AND PROVIDE AN ASSESSMENT FOR
FUTURE ECONOMIC IMPACTS
ON HEALTH CARE SOCIAL SERVICES
AN INFORMAL. CAREGIVERS.
WE HAVE I'D LIKE TO INTRODUCE
WITNESSES.
TO OFFER SOME BRIEF BRIEF
REMARKS ON ON HOW. IMPORTANT
THIS IS TO THE FUTURE OF OUR
STATE. DOCTOR DAVID JOHNSON AND
A BARBARA MARQUEZ UP FROM
SACRAMENTO COUNTY.
THANK YOU VERY MUCH PLEASED TO
SEE.
THANK YOU FOR ALLOWING US TO
ADDRESS THE COMMITTEE.
MY NAME IS DAVID JOHNSON I AM
AN ASSOCIATE PROFESSOR OF
NEUROLOGY AT THE SCHOOL OF
MEDICINE AT THE UNIVERSITY
CALIFORNIA DAVIS.
I'M A DIRECTOR OF THE
CALIFORNIA ALZHEIMER'S DISEASE
CENTER AND WALNUT CREEK.
AND I'VE BEEN AND ALL A
ALZHEIMER'S ALL JEWS ONE FORMER
ANOTHER FOR ABOUT TWENTY SEVEN
YEARS.
.
I WOULDN'T WANT TO IMPRESS UPON.
THIS COMMITTEE THAT THE
STATISTICS THAT WE'VE BEEN
DISCUSSING.
ARE.
HIDE THE OFTEN DISPROPORTIONATE
BURDEN THAT ALZHEIMER'S DISEASE
INFLICTS
ON WOMEN AND MINORITIES.
I'D LIKE YOU TO RECALL THAT
ALZHEIMER'S DOUBLES IN
PREVALENCE EVERY DECADE AFTER
SEVENTY.
MEANING THAT THERE ARE TWICE AS
MANY EIGHTY YEAR OLDS HAVE IT
THAN THERE ARE SEVENTY YEAR
OLDS.
TOM AND THAT THIS IS A THESE
NUMBERS ARE BASED PRIMARILY ON
THE PROPONENT NUMBER OF
CAUCASIAN PARTICIPANTS IN
CLINICAL RESEARCH.
THERE IT FOR THE NUMBERS THAT WE
TALK ABOUT WHERE IT'S ONE AND A
HALF TIMES MORE PREVALENT AND
LATINOS AND ONE POINT TWO SEVEN
AM WOMEN AND TWICE AS OFTEN. IN
AFRICAN AMERICANS.
BUT I WANNA IF REALLY EMPHASIZE
THAT THESE ARE MAGNIFYING
EFFECTS FOR AN EXPONENTIAL TO
DISEASE AFFECTING THE ELDERLY
POPULATION.
AND SO ARE ALL THIS OLD DINNER
MOST INTENSIVE CARE AND TEN.
KAREN TENSE OLDER ADULT PATIENTS
AND ARE MINORITIES
AND WOMEN AND THAT THE FINANCIAL
IN CAREGIVING BURDEN THEREFORE.
OUR HIGHEST PER CAPITA WITHIN
THE MINORITY COMMUNITIES.
AT PRESENT THE ALZHEIMER'S
ASSOCIATION AND I HATE TO
INTENTLY FOCUSED ON DEVELOPING
EFFICACIOUS TREATMENT. AND NEW
PREVENTIVE STRATEGIES AND
INITIATIVES.
AND WHILE THESE ARE ESSENTIAL IN
CRITICAL. WE LACK IMPORTANT
PARTICIPATION FROM OUR MINORITY
CITIZENS.
FOR A BROAD AND COMPLEX BOB
PANOPLY OF HISTORICAL SOCIO
ECONOMIC FACTORS.
SO I WANNA CLOSE WITH TO
SPECIFIC POINTS ONE IS THAT THE
DEVELOPMENT OF THESE NEW
TREATMENTS
A CRITICAL MISSING IMPORTANT
ACTORS.
THAT ARE UNIQUE TO MINORITIES
AND CONVERSELY THAT THE
DIVERSITY IS A STRENGTH NOT ONLY
IN OUR COMMUNITIES BUT ALSO IN
SCIENCE.
ONCE WE HAVE MORE INCLUSION WE
THEREFORE START TO EXAMINE A
BROADER HORIZON OF
POSSIBILITIES.
AND DISCOVER NEW FACTORS IN THE
DISEASE.
AND RECTIFYING THESE HEALTH
DISPARITIES WILL REQUIRE EXTRA
EMPHASIS THIS IS A LONG
STANDING.
A THE HISTORY OF MISTRUST AND
MISUNDERSTANDING AND IT WILL
TAKE SPECIAL ATTENTION. BY UP
THE STATE TO RECTIFY THIS THANK
YOU VERY MUCH FOR YOUR TIME
THANK YOU ANYONE ELSE IN
SUPPORT.
POLITICAL MY NAME IS BARBARA
MARQUEZ AND THANK YOU MISTER
CHAIR IN THE MEMBERS FOR THIS
OPPORTUNITY TO ADDRESS YOU TODAY
AND FOR SENATOR WELLSTONE WHO
ARE OFFERING THIS IMPORTANT BILL
ABOUT.
WELL ALZHEIMER'S DISEASE.
AS WAS MENTIONED THIS DISEASE
IMPACTS OVER TWO POINT TWO
MILLION.
STATE YET NOT ALL WHO ARE
IMPACTED BY THIS DISEASE ARE IN
THEIR GOLDEN YEARS.
THAT'S BECAUSE IT ALSO GREATLY
IMPACTS FAMILY MEMBERS.
OVER TEN YEARS AGO MY MOTHER
FLORENCE MARK HAS.
WAS DIAGNOSED WITH ALZHEIMER'S
AND OVER THAT COURSE OF TIME
DECLINED GREATLY IN BECAME MORE
AND MORE DEPENDENT ON US FOR HER
MEDICATIONS HERE FOOD HER DAILY
ROUTINE. AT HER ALL OF HER
HEALTH AND SAFETY ISSUES.
I COULD SPEAK VOLUMES ABOUT THE
CARE DURING THIS LONG AND HARD
JOURNEY. THAT WE TOOK HAND IN
HAND WITH THEIR IN ABOUT THE
EMOTIONAL ANDFINANCIAL ECONOMIC
IMPACT OF THIS DISEASE OUR
FAMILY.
BUT BEFORE I DO THAT THE HOPE
THAT YOU WILL INDULGE ME IF I
TELL YOU A LITTLE MY MOTHER
BEFORE I TALK MORE ABOUT THE
DISEASE.
MY MOTHER FOR ITS MY KID WAS
BORN IN TEXAS TO MIGRANT
FARMWORKER FAMILY.
SHE HAD BOUNDLESS BUILDS OF
ENERGY AND A STRONG DESIRE TO
MAKE A DIFFERENCE IN THE WORLD.
HER PASSION DEDICATION LETTER TO
BECOME A TIRELESS.
COMMUNITY ORGANIZER ELECTED
SCHOOL BOARD MEMBER AND
PRESIDENT OF THE NONPROFIT THE
DEVELOPED AT THIRTY FIVE UNIT
AFFORDABLE HOUSING UNIT.
COMMUNITY IN EAST SAN JOSE. A
MAJOR TASK.
MY MOTHER ADVOCATED ON BEHALF
OF MANY OTHERS OFTEN IN PICKET
LINES AND EVEN HERE IN THIS
BUILDING.
ON ONE OCCASION SHE WAS HERE TO
RECEIVE THIS PRESTIGIOUS AWARD.
LEGISLATIVE WOMAN OF THE AIR
HERE WHICH WAS GIVEN TO HER BY
ONE OF YOUR PREDECESSORS
THE FORMER SENATOR JOHN
VASCONCELOS.
IT SAYS BE GREATLY TO SHARE WITH
YOU THAT WE LOST OUR PATRON A
YEAR. EARLIER THIS YEAR.
I ALSO HAVE A COPY OF HER DEATH
CERTIFICATE HERE. AND LISTER
CAUSE OF DEATH AS ALZHEIMER'S
DISEASE.
I'M I'M.
IT'S A DISEASE THAT.
BECAUSE YOU LOSE YOUR ABILITY TO
REMEMBER FACTS AND FIGURES AND
SOMETIMES EVEN OUR NAMES.
BUT THIS FOR IN DISEASE DID MORE
THAN THAT IT AND ROBBING THEM
MORE THAN JUST RUBBING HER
MEMORY AND EVENTUALLY KILLED
HER.
AS MENTIONED THIS IS THE SIXTH
LEADING CAUSE OF DEATH IN OUR
NATION AND IN THIS STATEAND FOR
THIRD LEADING CAUSE OF DEATH.
AND IT DISPROPORTIONATELY
IMPACTS AFRICAN AMERICANS
LATINOS AND WOMEN ARE MOTHERS.
THESE FACTS AND FIGURES ARE
ALARMING AND WE NEED TO MAINTAIN
NEED TO BE REMEMBERED AND LET
HIM PARTLY BE ACTED UPON.
YET THEY DON'T EEM TO BE AS
WELL KNOWN IN THE COMMUNITY
PARTICULARLY COMMUNITIES OF
COLOR. AND EVEN AMONG SOME
HEALTH PROFESSIONALS.
THAT NEEDS TO CHANGE.
ALZHEIMER'S DISEASE NEED TO BE
AGGRESSIVELY EMBRACED ADDRESSED
BY THE PUBLIC HEALTH COMMUNITY
AND OUR STATE.
I DID HAVE TO RETIRE EARLY IN
ORDER TO TAKE CARE OF MY MOTHER
AND I RECHARGE I'M A RETIRED
STATE WORKER.
AT A LONG CAREER IN PUBLIC
HEALTH.
WHICH FOR THE MOST PART STARTED
HERE IN SACRAMENTO IN THE MID
NINETEEN EIGHTIES.
I GOT HIRED RECRUITED AT THE
HEALTH EDUCATION CONSULTANT IN
THE NEWLY ESTABLISHED OFFICE OF
AIDS THIS WAS LIKE NINETEEN
EIGHTY FIVE.
AT THAT TIME MOVE THE EPIDEMIC
THE AIDSEPIDEMIC IS WE STILL
DON'T KNOW ALL THE FACTS.
WE DON'T EVEN KNOW IT'S BECAUSE.
AND CERTAINLY DIDN'T HAVE ALL
THE WONDERFUL SUCCESSFUL
TREATMENTS THAT ARE AVAILABLE
TODAY BUT NEVER THE LESS THE
PUBLIC HEALTH COMMUNITY WENT
INTO ACTION BECAUSE PEOPLE ARE
GETTING SICK AND DYING.
I KNOW WHAT A DIFFERENCE.
LEVINE NATIONAL AND STATE PUBLIC
HEALTH SYSTEMS IN LEADERS TAKE.
CONTROL OF THIS OR TAKE A PART
IN THIS.
THEIR EXPERIENCES HAVE SHOWN
MAJOR DIFFERENCES IN A NUMBER OF
RISK FACTORS AND DISEASES
INCLUDING SMOKING OBESITY
DIABETES AND HIGH BLOOD
PRESSURE.
ALZHEIMER'S DISEASE THE THREE
PROMINENT ON THIS LIST AND ALSO
WARRANTS CONSIDERABLE ATTENTION
AND RESOURCES.
THE BURDEN STUDY THAT'S PROPOSED
AN S. B. TWELVE NINETY TWO WITH
CERTAINLY HELPED TO ADVANCE THIS
DISCUSSION. AND MOST IMPORTANTLY
THE ACTION NEEDED TO
APPROPRIATELY ADDRESSED THE
DISPARITIES AND MAKE A
DIFFERENCE IN THE LIVES AND
HEALTH OF THOSE AT RISK IN THOSE
LIVING WITH ALZHEIMER'S DISEASE.
AND THEIR FAMILY MEMBERS.
I KNOW IF MY MOTHER CAN BE IN
THIS BUILDING ONE MORE TIME INTO
ADVOCATE FOR OTHERS SHE'D BE
RIGHT HERE NEXT TO ME ASKING YOU
DEVELOPMENT SUPPORT. THAT ON
SENATE BILL TWELVE NINETY TWO
THINKING THANK YOU VERY MUCH
ANYONE ELSE IN SUPPORT IN A
POSITION ONLY PLEASE. KIMBERLY
CHEN WITH THE CALIFORNIA PAN
ETHNIC HEALTH NETWORK IN
SUPPORT.
NICKEL THE TEARS WITH THE
ALZHEIMER'S ASSOCIATION WE ARE
UP PROUD TO COSPONSOR. ó AND
IN STRONG SUPPORT THANK YOU.
THANK YOU.
MY NAME IS BRIAN AYE HELLO BUT
AS WE ARE.
WITH THAT YOU KNOW COALITION
FOR HOW TO CALIFORNIA A STRONG
CO SPONSOR FOR THE BILL IN
SUPPORT. GIVE.
NO AYE PARAMO REPRESENTING
CALIFORNIA RURAL LEGAL
ASSISTANCE FOUNDATION IN STRONG
SUPPORT THANK YOU. OPPOSITION.
COMMENTS CONCERNS FOR MANY THE
PATIENT AND.
WITHIN THE MEMBERS.
I LOVED THAT THEY THEY USE
SECURE DIDN'T KNOW CONCERNS FROM
THIS PATIENT AYE AYE.
.
I I I WOULD LIKE TO THINK YOU
CENTER HUESO IN AND BOTH THE
WITNESSES FOR BRINGING THIS
FORWARD I I HAVE A MEMBER OF MY
FAMILY. YAHOO SEVERANCE WITH IT
LATE STAGE ALZHEIMER'S AND I AM
ALL TOO AWARE OF THE CHALLENGES
THAT CREATES A THANK YOU VERY
MUCH.
WE HAVE A MOTION BY CENTER PAN.
AGAIN CENTER HUESO THANK YOU
FOR.
PRESENT IN THE BILL I WILL BE
SUPPORTING AGAIN THANK YOU FOR
PRESENTING MY BILL BECAUSE I'M
CHAIRING THIS COMMITTEE LEADER
ON P. SHE THAT WE HAVE A MOTION
OSR PAN THIS IS TO PASS
PREPARATIONS. AND WOULD LIKE TO
CLOSE.
DISCIPLINE ASK FOR YOUR SUPPORT
THANK THANK YOU ARE NUMBER
TWELVE AYE AS BE ONE TWO NINE TO
CALL THE MEMBERS PLEASE.
HERNANDEZ AYE HERNANDEZ AYE
WHEN.
LEYVA.
LEYVA AYE MITCHELL. MITCHELL AYE
MONNING. NEWMAN I'VE NEWMAN AYE
NIELSEN.
NIELSEN AYE PAN.
AND I ROTH.
EARLIER SIX WILL PLACE A BILL
AND CALL AGAIN THANK YOU
SENATOR.
SEE.
CENTER MORE LUCK ON THE
AUDIENCE.
ITEM NUMBER THIRTEEN SP ONE
THREE TWO FIVE PEACEFUL AND
NATURAL BIG MOVIE ACTOR RATE OF
SO.
WARRANTY.
QUARANTINE
.
OKAY THANK YOU MISTER CHAIR
I'VE.
WAITING ON YOU SIR.
COLLEAGUES DURING MY CAMPAIGN
FOR SENATE THREE YEARS AGO.
SENATE BILL TWO SEVEN SEVEN WAS
THE BIG TOPIC AND WE CAME. A
CAMPAIGN ISSUE AND.
IT CAME CO OP I MADE A LOT OF
NEW FRIENDS BY IN THAT IN THAT
EFFORT SO THANK YOU. DOCTOR PAN.
.
SO.
YEAH IT WAS IT WAS FOR ME A
BAPTISM INTO THE SENATE VOTE TO
WATCH.
SO MANY RESIDENTS FROM UP AND
DOWN THE STATE. LINING UP BEHIND
THE SPORTS FLORIDA.
TO TALK ABOUT.
THIS PARTICULAR BILL IN
OPPOSITION TO FORCED
VACCINATIONS AND.
THIS THIS CONSTITUENCY.
IT ARE STATE FEARS INFRINGEMENT.
ON THEIR CIVIL RIGHTS AND
LIBERTIES INNER SENSING PERHAPS
EVEN SORT OF A METAL. BUTTONS
MILITARISTIC.
FORM OF IMPLEMENTATION OF SOME
OF OUR.
LAS SO WITH RESPECT TO THIS
CONSTITUENCY MISTER CHAIR. I
BELIEVE A PROVISION SHOULD BE
PROVIDED FOR SANCTUARY OF THE
SORTS.
SACRAMENTO DID WAS CITIES AND
THE STATE FOR IMMIGRANTS BUT.
WE SHOULD HAVE A GOOD FORM.
TO PROVIDE MEDICAL SANCTUARY AND
CHOICE FOR PARENTS WHO ARE
CONCERNED ABOUT HEALTH POLICIES
BETTER DICTATED BY INDIVIDUALS
THROUGH GOVERNMENTAL POSITIONS.
ONE MIGHT CHARACTERIZE THIS
UNIQUE DIFFERENCE OF OPINION
MAYBE THE STUBBORNNESS OR MAYBE
TO.
ARROGANCE OR MAYBE IT'S BOTH I
DON'T KNOW. BUT MY GOAL IS TO
PROVIDE SOME FORM OF BALANCE IN
REGARDS TO THIS HEALTHCARE
DEBATE. SP THIRTEEN TWENTY FIVE
PROVIDES THE ABILITY OF
RESIDENTS TO SELF QUARANTINE.
RESPECTING THE RIGHT OF PRIVACY
PER CALIFORNIA TAXPAYERS.
BASICALLY THAT CLARIFIES
EXISTING RIGHTS.
MEDICAL EMERGENCIES.
AND WHEN A CURSE IT WOULD BE
WISE TO HAVE A PROTOCOL IN
PLACE.
FOR THOSE FEW CONSTITUENTS
DESIRING TO ADDRESS THE CRISIS.
IN A VALID IMPROPER MANNER BY
PROVIDING ISOLATION AND
PREVENTING ABUSES OF
GOVERNMENTAL POWER ACCORDINGLY I
REQUEST TONIGHT VOTE. AND I HAVE
WITNESSES IN SUPPORT. THINK
YOU'RE ALLOWING A TOTAL SIX
MINUTES FOR THE SUPPORT OF THE
OPPOSITION.
I SEEN HIM USE YOUR TIME HOWEVER
YOU WISH.
SO MUCH.
OKAY I AM MY NAME IS GREG GLAZER
I'M A CALIFORNIA LAWYER. AND
I'VE BEEN A LAWYER FOR FIFTEEN
YEARS I AM THE GENERAL COUNSEL
FOR PHYSICIANS FOR INFORMED
CONSENT. DR KIMMEL AND I
SUBMITTED A LETTER WITH A
SIGNATURE OF APPROXIMATELY SIXTY
POSITIONS IN SUPPORT OF THIS
BILL.
AND THIS IS ACCORDING TO
SUPPORTERS A COMMONSENSE BUILT.
ON THE POINT IS THAT.
PANDA WE CALL THIS BILL PANDA
THE PEACEFUL NATURAL DIGNITY ACT
IT CLARIFIES RIGHTS THAT WE
ALREADY HAVE BUT THESE RIGHTS
ARE IMPORTANT. FOR A VERY
INTERESTING REASON AND I REALLY
WANT ENGAGED HERE ON WHY THIS IS
INTERESTING WHY THIS IS
IMPORTANT.
CURRENTLY THERE IS A PROBLEM IN
CALIFORNIA LAW THE PROBLEM IS
THAT.
PUBLIC HEALTH AUTHORITIES CLAIM
THEIR RIGHTS TO BE ABLE TO
FORCEFULLY VACCINATE. PEACEFUL
AND NATURAL PEOPLE DURING AN
EMERGENCY. THAT MEANS THAT IN
THE EVENT OF A PANDEMIC IN THE
EVENT OF EMERGENCY YOU CAN BE A
PEACEFULLY NATURAL PERSON.
AT HOME.
DOING NOTHING.
AND ALL OF A SUDDEN YOU CAN BE
CONVERTED INTO A CRIMINAL HOW
FOR EXISTING.
THAT'S THE FLAW IN OUR CURRENT
LAW SO TODAY'S AN EXCITING DAY
TODAY'S A GOOD DAY IT'S AN
OPPORTUNITY IN THIS IS WHY WHEN
ENGAGE.
IT'S AN OPPORTUNITY FOR US TO
FIX SOMETHING TO PROTECT CIVIL
RIGHTS.
TO DO THE RIGHT THING AND PUT A
SAFEGUARD IN PLACE.
THAT WILL PROTECT PEACEFUL AND
NATURAL INDIVIDUALS.
IN THEIR HOME.
SO IT'S PAN IS A SIMPLE INDUSTRY
FOR THE OTHERS ALSO PRESIDENT
THIS IS ANOTHER KEY POINT I'D
LIKE TO. TO BREAK YOUR ATTENTION
THERE'S A PRECEDENT FOR THIS
BILL.
WHICH IS THAT UPON PARK
TUBERCULOSIS LA WE'VE A
TUBERCULOSIS CONTROL LAW AND IT
SAYS IT NO PATIENT EVEN IF THEY
HAVE ACTIVE TUBERCULOSIS.
CAN'T BE FORCED TO HAVE
TREATMENT NOR CAN THEY BE FORCED
INTO A FACILITY THEY'RE ALLOWED
TO QUARANTINE HOME. TO. THIS
BILL ALLOWS THAT SAME PROTECTION
THAT SAME CONSTITUTIONAL CIVIL
RIGHTS SAFEGUARD TO APPLY ALSO
TO OTHER INFECTIOUS DISEASES.
NOW HERE COMES THE BONUS THIS
IS.
ANOTHER THING THAT REALLY ONE
ENGAGE YOU ON.
THIS IS SO INTERESTING IT'S
THAT.
IN PUBLIC HEALTH.
THERE IS A A SITUATION WHERE IF
YOU FORCE A MEDICATION ON
SOMEONE. A IF IF THERE'S AN
EMERGENCY IS WHAT PUBLIC HEALTH
SCHOLARS HAVE FOUND A STILL USE
FOUND IT TOP SCHOLARS AT THE
WITH THE ACLU. TOP SCHOLARS AT
THE THE CDC HAVE HAVE FOUND AS
THEY SAY IF YOU FORCE MANDATES
BICU FORCE MEDICATION COURTING
ON PEOPLE IT ACTUALLY INCREASES
THE SPREAD OF DISEASE.
THIS IS SO INTERESTING IS IT'S
COUNTERINTUITIVE.
IT'S COUNTERINTUITIVE BECAUSE
YOU WOULD THINK THAT IF YOU WANT
TO PREVENT DISEASE WOULD YOU
MANDATE MEDICATION RIGHT YOU
MANDATE VACCINES BUT IT'S THE
IT'S THE OPPOSITE.
BUT TOP SCHOLARS HAVE FOUND IS
THAT IF YOU DO MANDATES IF YOU
TREAT PEOPLE LIKE CRIMINALS
GUESS WHAT THEY BEHAVE LIKE
CRIMINALS.
THEY FLEE THE JURISDICTION. THEY
ARE THEY LIE THEY MAKE UP STUFF
PEOPLE ACT LIKE CRIMINALS SO
WHAT TOP SCHOLARS HAVE FOUND IS
THAT IF YOU. RESPECT INDIVIDUAL
RIGHTS THIS ACTUALLY PROMOTES
PUBLIC HEALTH AND SO I AM SO
GRATEFUL THAT THERE'S GONNA BE
OPPOSITION TODAY BECAUSE IT
PROVES THE VERY POINT THAT I'D
LIKE TO MAKE. WHICH IS THAT
THEY'RE ACTUALLY PUBLIC HEALTH
SCHOLARS PUBLIC HEALTH OFFICIALS
WHO FEEL THAT THEY HAVE THE
RIGHT. OF ABSOLUTE POWER OVER
PAY ANOTHER PERSON'S BODY.
DOCTOR CAN.
GOOD AFTERNOON. MY NAME IS TINA
KIMMEL I HAVE A PHD A MASTER
PUBLIC HEALTH AND A MASTER OF
SOCIAL WELFARE FROM UC BERKELEY.
I WORKED IS A RESEARCH SCIENTIST
FOR IT EPIDEMIOLOGIST FOR THE
CALIFORNIA DEPARTMENT OF PUBLIC
HEALTH HERE IN SACRAMENTO UNTIL
I RETIRED A FEW YEARS AGO.
INCLUDING IN THE IMMUNIZATION
BRANCH IN THE DIVISION OF
COMMUNICABLE DISEASE.
I'M WHILE THEY'RE A VOLUNTEER
FOR MANY EMERGENCY TRAINING AND
PRACTICE OPPORTUNITIES.
SO I KNOW THE SUBJECT OF
EMERGENCY RESPONSE FAIRLY WELL.
I FEEL STRONGLY THAT THE NEW
PANDA LAW THIS LAW. WILL
INCREASE THE EFFECTIVENESS OF
PUBLIC HEALTH RESPONSE RESPONSES
DURING EMERGENCIES WHILE AT THE
SAME TIME ALLOWING FOR FAMILIES
CONSTITUTIONALLY PROTECTED
FREEDOM OF.
BY GIVING CITIZENS THE RIGHTS
AND RESPONSIBILITIES OF SELF
QUARANTINE.
THEY WILL FACILITATE PUBLIC
HEALTH MEASURES AND EASE THE
BURDEN ON THE PUBLIC HEALTH
INFRASTRUCTURE A ONE POINT OUT
THAT THE UP BILL ANALYSIS SAYS
BUT THIS BILL OF FORCES PEOPLE
TO TAKE SELF QUARANTINE THAT'S
THAT'S NOT TRUE. IN THE FIRST
FEW SENTENCES THAT SAYS FORCES
MUST IT'S NOT IT'S MADE PEOPLE
MAY ELECT OF. SUPPORTING.
FIVE SO HERE'S SOME EXAMPLES OF
THE WAYS THAT THIS BILL WOULD
EASE THE BURDEN ON PUBLIC HEALTH
INFRASTRUCTURE.
THIS BILL VOLUNTARILY.
BOB. INCREASES SOCIAL DISTANCING
WHICH IS THE GOAL OF ALL. O.
INFECTION CONTROL MEASURES AND
THIS REDUCES THE BURDEN ON LAW
ENFORCEMENT OFFICERS FOR EXAMPLE
ATTEMPTING TO FORCE DISEASE
EXPOSED PEOPLE OUT A PUBLIC
AREA.
IT'S BILL INCREASES THE NUMBER
OF INDIVIDUALS.
ALSO SEEKING REMOTE CARE FROM
THE DOCTOR'S.
UP ITS SPECIFICS DIVIDE IN A LOT
OF THOSE REDUCING THE BURDEN ON
HEALTH CARE OFFICES AND
PERSONNEL.
PARTICIPANTS WILL HAVE
ALTERNATIVE AFFECTED MEANS OF
CARING FOR THE HEALTH OF THE
THEMSELVES AND THEIR FAMILIES
THUS REDUCING THE BURDEN ON THE
LOCAL HEALTH DEPARTMENTS
POTENTIALLY INADEQUATE SUPPLY.
OF THE NEW VACCINES AND OTHER
PHARMACEUTICALS THAT ARE
DEVELOPED QUICKLY HOPEFULLY
UNDER EMERGENCY CIRCUMSTANCES
AND USUALLY IN SHORT SUPPLY.
PARTICIPANTS DOT IN THE PANDA.
SELF QUARANTINE ARE EXEMPT FROM
MANDATORY VACCINATION AND
MEDICATION THAT REDUCING
POTENTIAL DANGER TO LAW
ENFORCEMENT OFFICERS AND
CLINICIANS.
SELF QUARANTINE LOCATIONS. UNDER
THIS LAW ARE MORE LIKELY TO BE
THOUGHTFULLY PLANNED IN
ACCOUNTABLE THUS REDUCING THE
BURDEN ON INFECTION CONTROL
OFFICERS ATTEMPTING TO ENFORCE
THE QUARANTINING OF GOODS IN
PLACE. YOU GOT PEOPLE
PARTICIPATING WILLINGLY IN THAT
AND THEY ARE MORE LIKELY TO BE
STOCKED WITH PROVISIONS SUCH
FOR.
SUCH AS FRUITS THUS REDUCING THE
BURDEN ON PUBLIC AGENCIES TO
PROVIDE FOOD.
SO YOU'RE ENGAGING THE
POPULATION TO HELP TO
PARTICIPATE INSTEAD OF THE
CURRENT LAW WHICH FORCES THEM.
AND UP AGAINST THEIR WILL TO
HELP IN THE PUBLIC HEALTH
MEASURE PEOPLE DON'T WANT TO GET
SICK.
AND AT THE SAME TIME THIS BILL
SUPPORTS INDIVIDUAL CIVIL
LIBERTIES WHICH ARE THE
CORNERSTONE OF CALIFORNIA AND U.
S. LAW BUT WHICH WILL BE A GREAT
RISK OF BEING TRAMPLED ON DURING
THE PUBLIC HEALTH CRISIS.
THIS BILL IS A RESPECTFUL COM AN
INTELLIGENT APPROACH TO DISEASE
PREVENTION IN AN EMERGENCY.
IT FIXES PROBLEMS WHICH HAVE
BEEN INTRODUCED BY THE CURRENT
PANIC AND FEAR BASED
APPROACH TO PUBLIC HEALTH
EMERGENCIES.
PLEASE SUPPORT SB THIRTEEN
TWENTY FIVE THINK WE'VE GONE
OVER A THIRTY SEVEN MINUTES
WE'VE ONLY ALLOWING SIX PER
SIDE.
IF BELIEVE WE HAVE ONE MORE SO
I WILL ALLOW YOU FISH.
I'M BY YOUR DOCTORATE.
SO.
.
WHOEVER IS WILL GIVE THE
OPPOSITION SAME ON A TIME SO IS
THERE ANYONE IN OPPOSITION AND.
OPPOSITION TO THE BILL YES.
OR ANYONE ELSE IN SUPPORT FIRST
ANYONE ELSE IN SUPPORT.
OKAY SO NOW WERE IN OPPOSITION.
AND WE WILL GIVE THE OPPOSITION
IN FAIRNESS SEVEN MINUTES AS
WELL.
HI MISTER CHAIR AND MEMBERS MANY
WITH CAT DE BURGH PLANE THE
EXECUTIVE DIRECTOR OF THE HEALTH
OFFICER'S ASSOCIATION OF
CALIFORNIA AND WE'RE HERE TO
OPPOSE THIS BILL.
WHAT THIS BILL PRIMARILY DOES
IS CREATE A NEW THEORY OF LA
CALLED SELF QUARANTINE?
ALLOWING PEOPLE TO IGNORE HELP
THE SUPPORTERS OF ISOLATION AND
QUARANTINE.
ISOLATION IN QUARANTINE OR
PUBLIC HEALTH TOOLS THAT EXIST
AT THE FEDERAL STATE AND LOCAL
LEVELS.
AT THE FEDERAL LEVEL THE U. S.
CDC HAS QUARANTINE AUTHORITY
OVER PEOPLE ENTERING THE UNITED
STATES AND TRAVELING BETWEEN THE
STATE.
IN THE STATE IN CALIFORNIA.
THE AUTHORITY IS VESTED IN THE
CALIFORNIA DEPARTMENT OF PUBLIC
HEALTH WHICH IS HEADED BY THE
STATE HEALTH OFFICER A PHYSICIAN
WHO IS APPOINTED BY THE GOVERNOR
AND CONFIRMED BY THIS BODY.
AND AT THE LOCAL LEVEL THAT
AUTHORITIES VESTED IN THE PUBLIC
HEALTH OFFICER WHO IS A
PHYSICIAN APPOINTED BY THE BOARD
OF SUPERVISORS OR AND.
THE CITY.
AND IN MOST OTHER STATES AS IN
CALIFORNIA VIOLATION OF A HEALTH
OFFICER ORDER IS A MISDEMEANOR.
AND SURVEY OF LOCAL HEALTH
OFFICERS HAVE REVEALED THAT
FORMAL ISOLATION QUARANTINE
ORDERS ARE VERY RARE LEAVES
BUT WHEN THEY ARE CALLED UPON IS
BECAUSE THEY ARE ABSOLUTELY NO.
THESE LAWS ARE WHAT KEPT EBOLA
FROM TAKING ROOT IN OUR COUNTRY.
HELP US CONTAIN OUTBREAKS OF
INFECTIOUS DISEASES SUCH AS
MEASLES.
AND MINIMIZE THE POSSIBILITY OF
THE SPREAD OF TUBERCULOSIS.
AND TO ADDRESS THE AUTHORS
CONCERN MOST QUARANTINES ALREADY
TAKE PLACE IN AN INDIVIDUAL'S
HOME.
THE FACT THAT WE ARE ALL HEALTHY
ENOUGH TO BE HERE TODAY TO
DISCUSS THIS BILL. IS TESTAMENT
TO HOW WELL OUR PUBLIC HEALTH
LAWS WORK IN THIS COUNTRY.
WITH ME TODAY TO SHARE HER
EXPERIENCE OF ISSUING THESE
ORDERS IS DOCTOR ERIC UPON A
DEPUTY HEALTH OFFICER. AND THE
CO CHAIR OF THE COMMUNICABLE
DISEASE COMMITTEE OF THE
CALIFORNIA CONFERENCE OF LOCAL
HEALTH OFFICERS AND SHE'LL TAKE
THE REST OF MY TIME THINKING.
MR TEAR NUMBERS OF THE HEALTH
COMMITTEE THANK YOU VERY MUCH
FOR THIS OPPORTUNITY TO PROVIDE
MY EXPERIENCE.
AS MENTIONED I AM TESTIFYING
TODAY AND ABOUT HOW THE HEALTH
OFFICER SAYS HE'S OF CALIFORNIA.
AND.
HAVE SERVICE DIPPY HEALTH
OFFICER OVERSEEING CHEMICAL
DISEASE CONTROL PREVENTION AND
HEALTH WANNA.
I'D LIKE TO SHARE SOME SPECIFIC
EXAMPLES OF THE TIMES WHEN OUR
AUTHORITY AS PUBLIC HEALTH
OFFICIALS HAS BEEN DEEMED
NECESSARY TO REQUIRE ISOLATION
OR QUARANTINE.
SUMMER PROCESSES AROUND
IMPLEMENTATION AND THE
IMPORTANCE OF THESE ROLES TO
PROTECT THE PUBLIC'S HEALTH.
THE DISEASE WE MOST FREQUENTLY
USE THESE ISOLATION OR IS IT FOR
IS TO PARTICULAR CSUS OR TV.
PERSONS WITH INFECTIOUS TB NEED
TO BE CARED FOR INAPPROPRIATE
HEALTH CARE FACILITY WITH
SPECIAL RESTAURANT ISOLATION TO
AVOID INFECTING OTHERS.
ONCE TREATMENT BEGINS HEALTHCARE
PROVIDERS IN PUBLIC HEALTH
ASSESS WHETHER A PATIENT IS NO
LONGER INFECTIOUS BASED ON VERY
SPECIFIC TESTS THE CAN ALSO ONLY
BE DONE. IN A HEALTHCARE SETTING
BEFORE THEY CAN BE DISCHARGED AN
APPROPRIATE PLACE TO COMPLETE
THE SIX TO TWELVE PLUS MONTHS OF
TREATMENT.
IF A PERSON WITH TV HAS A STABLE
PLACE TO LIVE THAT IS ALREADY
WHERE HERE SHE WILL REMAIN FOR
THE REST OF THEIR TREATMENT.
DURING THE ABLE OUTBREAKS OF TWO
THOUSAND FOURTEEN IN ORDER TO
RESPOND TO A VERY SERIOUS
DISEASE THAT IS EXTREMELY
DIFFICULT TO TREAT AGGRESSIVE
ISOLATION AND QUARANTINE
MEASURES WERE CRUCIAL TO VENT AN
OUTBREAK HERE IN THE UNITED
STATES.
INDIVIDUALS WHO ARE POTENTIALLY
EXPOSED TO EBOLA WERE FREQUENTLY
ALLOWED TO BE QUARANTINED NOT
ONLY IN THEIR HOMES BUT IN
ISOLATED AREAS OF CAMPING OR
OTHER WILDERNESS LANDS.
THE CRUCIAL COMPONENT WAS
COMMUNICATION AND AGREEMENT WITH
THOSE INDIVIDUALS TO
PERIODICALLY NOTIFY PUBLIC
HEALTH OF THEIR LOCATION WHETHER
ANY SYMPTOMS HAVE DEVELOPED AND
MUTUAL PLAN FOR WHAT TO DO AND
WHERE TO GO ISN'T AS DEVELOPED.
FOR APPROPRIATE DIAGNOSIS AND
TREATMENT.
PROVIDING A WRITTEN NOTICE OF
SELF QUARANTINE TO PUBLIC HEALTH
OFFICIALS IS NOT SUFFICIENT.
ONCE WE DETERMINE SOMEONE NEEDS
TO BE QUARANTINED OR ISOLATED WE
ALSO MONITORING FOR THE
DEVELOPMENT OR PROGRESSION OF
SYMPTOMS.
IMAGINE OF RETURNING TRAVELER
FROM AN APPLE COUNTRY PROVIDED
WRITTEN NOTICE OF SELF
QUARANTINE. BUT THEN DECIDED TO
GO TO VARIOUS PUBLIC HEALTH
PUBLIC PLACES POTENTIALLY
EXPOSING OTHERS TO A DEADLY
DISEASE.
REMEMBER THE EXTREME CLEANING
ENVIRONMENTAL MEASURES THAT HAD
TO BE TAKEN FOR PUBLIC AREAS
SUCH AS AIRPLANES BOWLING ALLEYS
AND ELSEWHERE. DURING THE AMPLE
EPIDEMIC OF TWO THOUSAND
FOURTEEN.
WE ALSO IMPLEMENT ISOLATION
QUARANTINE FOR MEASLES CASES ARE
CONTACTS PREVENT ADDITIONAL
CASES AND OUTBREAKS.
OF NOTE WE HAVE RECENTLY HAD SIX
CASES OF MEASLES IN THE SENATE
SCOPE AREA ALL IN UNVACCINATED
INDIVIDUALS.
IN MY EXPERIENCE OVERSEEING THE
QUARANTINE OF HOUSEHOLD CONTACTS
WHO ARE NOT IMMUNE TO MEASLES.
FOR THIS DISEASE THAT HAS A
NINETY PERCENT ATTACK GREAT. ALL
THE QUARANTINE CONTEXT TO
DEVELOP MEASLES.
BUT WHEN THESE CONTACTS ARE
PROPERLY QUARANTINE.
THEY DEVELOP A CONTAGIOUS
DISEASE WITHOUT EXPOSING OTHERS.
OFTEN OUR PUBLIC HEALTH
SUCCESSES ARE UNSEEN BY THE
COMMUNITY BUT I CAN ASSURE YOU
THERE ARE IMPORTANT AND
EFFECTIVE.
UNFORTUNATELY ALSO SAW THE
NEGATIVE OUTCOME WHEN WE DIDN'T
ISSUE ILLEGAL QUARANTINE ORDER
AND A FAMILY KNOWINGLY ALLOWED
OTHER UNVACCINATED CHILDREN TO
BE EXPOSED TO MEASLES. WHO THEN
AS EXPECTED DEVELOP MEASLES
THEMSELVES?
ALL PEOPLE IN THIS COUNTRY
FORGETS ABOUT POTENTIALLY
DEVASTATING OUTCOMES OF MEASLES
EUROPE WITHIN THIS PAST YEAR HAS
EXPERIENCED OUTBREAKS AND ALMOST
FIFTEEN THOUSAND MEASLES CASES.
AND FIFTY SEVEN DEATHS SINCE TWO
THOUSAND SIXTEEN FROM MEASLES.
WHEN WE DO ISSUE LEGAL ORDERS
OUR PURPOSE IS TO PROVIDE CLEAR
WRITTEN INSTRUCTIONS ON HOW
INDIVIDUALS CAN SAFELY BE
ISOLATED OR QUARANTINE. TO HELP
US PROTECT OTHERS WHICH OFTEN
INCLUDES THEIR OWN LOVED ONES.
THE ORDERS ARE ISSUED TO ENSURE
PEOPLE ACKNOWLEDGE THAT WE HAVE
CONVEY THE INFORMATION NEEDED
AND AGREED TO WORK WITH US TO
PROTECT THE PUBLIC'S HEALTH.
BRITAIN LEGAL ORDERS ALSO INFORM
PEOPLE THE CONSEQUENCES OF NOT
COMPLYING WITH OUR INSTRUCTIONS
BUT ONLY IF HE'S ARE VIOLATED WE
PURSUE ENFORCEMENT. IN ORDER TO
ENFORCE WE ARE REQUIRED TO
DEMONSTRATE ALL OF THE MEASURES
WE'VE TRIED THAT A FAILED AND IN
EXTREME CIRCUMSTANCES WE MUST
GET APPROVAL FROM A JUDGE TO
PROCEED.
TO ENFORCE A RESTRICTED IN
MOVEMENT.
OUR ORDERS ARE REQUIRED TO AND
ALWAYS INCLUDE INFORMATION ABOUT
HOW TO APPEAL THE ORDER.
ALLOWING THIS BILL TO MOVE
FORWARD TO PROVIDE A DANGEROUS
PRECEDENT FOR OUR STATE AND
PREVENT PUBLIC HEALTH OFFICIALS
AND CLINICIANS FROM DOING OUR
COLLECTIVE JOB TO CONTAIN AND
CONTROL INFECTIOUS DISEASES.
THANK YOU AGAIN FOR THIS
OPPORTUNITY TO SHARE MY
EXPERIENCE AND TESTIMONY.
THINK ANYONE ELSE OPPOSITION.
A IS ME MY NAME'S TERRY WORK
NATIONAL VACCINE INFORMATION
CENTER WE ARE IN SUPPORT BUT I
WASN'T ABLE TO GET MY THANK YOU
ENOUGH THANK YOU.
MISTER CHAIRMAN MEMBERS IT DAVID
JONES ABOUT DOCTOR MICHAEL
JOHNSON ONE OF THE THREE CITIES
WITH PUBLIC HEALTH DEPARTMENTS
PASADENA. OPPOSITION.
MICHELLE GIBBONS OF THE COUNTY
HEALTH EXECUTIVES ASSOCIATION OF
CALIFORNIA REPRESENTING LOCAL
HEALTH DEPARTMENTS AND HERE ON
BEHALF OF THE SANTA CLARA.
COUNTY BOARDS OF SUPERVISORS IN
OPPOSITION TO THE MEASURE
THANK YOU.
IT EVELYN REPRESENTING AMERICAN
ACADEMY OF PEDIATRICS IN
OPPOSITION.
BERMAN BATES HANG ON BEHALF OF
THE CALIFORNIA STATE ASSOCIATION
OF COUNTIES IN OPPOSITION.
THANK YOU SEEN OTHER OPPOSITION
QUESTIONS COMMENTS FROM THE
MEMBERS CENTER PAN.
THANK YOU AND I APPRECIATE WE
HAVE.
INFECTIOUS DISEASES.
EXPERT HERE.
LET ME ASK I HAVE A COUPLE
QUESTIONS.
FOR YOU.
SO FIRST OF ALL IN THE
TESTIMONY AND.
THE AUTHOR IT MENTIONED THAT
MADE REFERENCE S. B. TWO SEVEN
SEVEN SO.
WHEN THE IMPLICATIONS.
THAT'S IN IN THE BILL.
WAS IS THAT. WHEN SOMEONE.
IS BEING WHAT'S A QUARANTINE
FOR TO SAVE DISEASE LIKE
MEASLES.
THEY WE FORTUNATELY VACCINATED
HOW MANY TIMES HAS HAVE PEOPLE
BEEN FORCIBLY VACCINATED WITHOUT
CONSENT.
AND IN THE STATE OF CALIFORNIA.
IN ITS HISTORY.
NONE THAT I'M AWARE OF EXACTLY
NEVER IT HAS NEVER NEVER
HAPPENED YOU HAVE TO YOU ALWAYS.
CAPTIVES GIVE CONSENT HARPER AND
USE CONSENT TO A DEPENDENT MINOR
IF THEY GET VACCINATED EVEN
DURING PUBLIC HEALTH
EMERGENCIES.
EVEN DURING MEASLES OUTBREAKS.
THAT'S OF THE. YEAH THAT SECOND
THING I ALSO WANT TO ASK YOU IS
IS THAT A HOME AND YOU MAY NOT
HAVE THE ANSWER TO THIS QUESTION
BUT.
YET WE'VE SIDE WE HAVE MUZAFFAR
CAN TWENTY FIFTEEN.
TEAM MAYBE DESCRIBE BECAUSE
SIDE YOU WERE.
EUROPE I THINK YEAH YOU'RE
PUBLIC HEALTH OFFICER ME COUNTY.
MAYBE SOME OF THE STEPS THAT
HAD TO BE TAKEN BY LOCAL HEALTH
OFFICERS ARE. NOT BECAUSE OF THE
SPREAD OF A DISEASE LIKE
MEASLES.
THAT AMOUNT OF TIME AND MONEY
IT COST I COUNTIES AND OTHER
PEOPLE IN THE RESTRICTION.
I'M BECAUSE WE HAD OUTBREAKS
INCLUDED
PEOPLE WRITING ON BART.
WHO?
WENT TO RESTAURANTS AND STORES
WENT CLINICS
AND SO FORTH AND.
WHAT HAPPENS WHEN SOMEONE
DECIDES THAT THEY'LL SELF
QUARANTINE BUT THEN DECIDE THEY
WANT TO RUN AN ERRAND PERHAPS
YOU CAN SPEAK TO THAT?
SURE I'M HAPPY TO SHARE A LITTLE
INFORMATION I THINK FOR EXAMPLE.
INTO THEIR SIX CASES RIGHT NOW
THE SERBS KOBE AREA AND I
REMEMBER DURING THE TWO THOUSAND
FIFTEEN DISNEY ON OUTBREAK WE
HAD SIXTIES IN OUR COUNTY ALONE
FOR EVERY SINGLE ONE OF THOSE
CASES WE IDENTIFY OVER A HUNDRED
CONTACTS. THAT IS AN INCREDIBLE
AMOUNT OF WORK FOR PUBLIC HEALTH
DEPARTMENT AND OUR.
HOSPITAL AND HEALTH CARE
PROVIDER COMMUNITY TO DO THAT
CONTACT TRACING THAN WHAT WE DO
IS WE TRY TO IDENTIFY THOSE WHO
ARE NOT ABLE TO BE IMMUNE THE
INFANTS LESS THAN TWELVE MONTHS
OF AGE OF THE PREGNANT WOMEN
AND.
THE PEOPLE WHO ARE IMMUNO
COMPROMISED WHO MIGHT HAVE
CANCER TREATMENTS OR OTHER
MEDICATIONS THAT SUPPRESS THE
IMMUNE SYSTEM. AND WE TRY TO
PROVIDE ANY PROPHYLAXIS FOR
THOSE VOLUNTARILY ADULTS ALWAYS
THIS CONSENT BUT IN A WAY TO
PREVENT PURSUE PROTECT THEM
FROM.
GETTING MEASLES BUT AGAIN SOME
OF THOSE PEOPLE CANNOT BE
VACCINATED AND CAN'T CHOOSE TO
BE VACCINATED.
WE'VE NEVER EVER AGAIN JUST TO
OF SIZE OF DOCTOR PANS QUESTION
WE'VE NEVER TO FORCE ANYONE TO
BE VACCINATED DURING EMERGENCY
BUT WE DO. REQUIRE THAT THEY BE
QUARANTINED SO THEY DON'T EXPOSE
OTHER PEOPLE.
THERE I DO HAVE SOME
CALCULATION NOT I THINK IT HAS
BEEN HAVING PROVIDE THEM TO THIS
COMMITTEE IF NEEDED ABOUT. THAT
THE COSTS ON TO BOTH PUBLIC
HEALTH DEPARTMENTS AND
HEALTHCARE FACILITIES AND
PROVIDERS OF MEASLES EVEN FOR
INDIVIDUAL CASES BUT THEY'RE
DEATHLY HUNDREDS OF THOUSANDS
DOLLARS SPENT. EMERGENCY
OPERATIONS CENTERS ARE
ACTIVATED.
HUGE NUMBERS OF OF STAFF WERE
DEPLOYED TO DEAL WITH MEASLES
DURING THE DISNEYLAND OUTBREAK
AND EVEN DURING THIS RECENT.
OUTBREAK AND OF THE BAY AREA
RIGHT NOW THERE ARE A LOT OF
SOUND WORKING VERY DILIGENTLY TO
TRY TO. CONTAIN THIS.
PARTICULAR OUTBREAK THERE ALL
CURRENTLY LINKED BUT AGAIN WE
HAVE CONCERN ABOUT PUBLIC
EXPOSURES IN THE OTHER INCHING
THING ABOUT MEASLES AND OTHER
INFECTIOUS DISEASES OFTEN PEOPLE
ARE INFECTIOUS. BEFORE THEY ARE
ACTUALLY SYMPTOMATIC THAT WE
ARE.
EVEN IF SOMEBODY DOESN'T KNOW
THAT THEY HAVE AN INFECTION LIKE
MEASLES THERE ACTUALLY
INFECTIOUS FOR FOUR DAYS BEFORE
THEY HAVE A RASH THAT WE SPEND A
LOT OF TIME TRYING TO FIGURE OUT
WHERE THOSE PEOPLE WERE AND WHO
THEY EXPOSE FOR THOSE FOUR DAYS.
WHEN THEY MIGHT HAVE THOUGHT
THEY JUST HAD A COLD MUCH LESS
IF THEY ACTUALLY ACTIVELY KNOW
THEY HAVE A DISEASE AND OUR.
INFECTING OR EXPOSING OTHER
PEOPLE AND MEASLES AGAIN AS A
JUST ONE OF SAYS NINETY PERCENT
ATTACK RATE OF PEOPLE ARE NOT
IMMUNE.
THE CENTER NEWMAN.
AT A CERTAIN SENATOR I I HAVE A
QUESTION INSTANCE HAS ZERO DO
WITH EPIDEMIOLOGY SO.
THERE IS A TRADITION DIED AS IT
WERE IN THE.
CAN CONGRESS OF OF NAMING BILLS
WITH ACRONYMS.
I DON'T SEE THAT MUCH HERE. AND
WHERE DID THE ACRONYM PANDA COME
FROM.
THAT WAS HALF FROM THE SPONSORS
SO I DON'T REALLY HAVE THE
HISTORY OF IT.
SHOWED.
THE PANDA ANIMAL WOULD SEEM TO
HAVE VERY LITTLE TO DO WITH
VACCINATIONS.
.
BUT IT DOES TEND TO HAVE AN
ETHNIC OR RACIAL TINGE TO IT.
IT ALSO INCLUDES THE FIRST THREE
LETTERS OF MY COLLEAGUES NAME.
AND I COULD SEE WHERE ONE MIGHT
TAKE OFFENSE.
THANK YOU.
I RESPONDED YES PLEASE RESPOND.
LISA LET ME JUST TO THAT. A
SINNER NEWMAN.
.
I WILL BE HONEST WITH YOU THAT
HAS NEVER CROSSED MY MIND I'VE
NEVER SEEN.
THAT THIS WAS DONE.
AND THAT PASSION THOUGHT AYE
AYE.
OKAY A I'M KIND OF SHOCKED.
TO HERE IT'S SO FORGIVE ME AYE
AYE THAT THAT WAS NOT THE
INTENTION. PARA I HOPE YOU'RE
NOT SHOCKED THAT THAT THE
REASONING WAS APPLIED RED DYE
DOT BUT I'LL TAKE YOU TO WORK.
THANK YOU.
THANK YOU SO SEEN NO OTHER
QUESTIONS COMMENTS FOR ANY THE
MEMBERS.
CENTER MORE LUCK THANK YOU
MISTER CHAIR LIKE TO CLSE.
.
JUST THE I A FEW COMMENTS.
.
APPRECIATE OF THE FACT THAT.
THE. HEALTH OFFICERS ARE
OPPOSED TO HAVE A CERTAIN HAVE A
GREAT RELATIONSHIP WITH ERIC
CANDOR FROM ORANGE COUNTY.
AND SO WE'VE HAD A GOOD CHAT ON
THIS AND I THINK HIS PREDECESSOR
EVEN CAME UP AND SERVED AS THE
STATE. HEALTH OFFICER SO THAT I
HAD A GOOD GOOD RAPPORT.
IN THAT REGARD.
IF SOMEONE VIOLATES.
A SELF QUARANTINE THAT'S A WHOLE
DIFFERENT ANIMAL THAT'S THAT'S
MAKING A MOCKERY. OF OF THS
OPPORTUNITY TO SELF QUARANTINE.
AND I BELIEVE THAT THAT SHOULD.
IT IMLY THAT THAT PERSON OR
THOSE PERSONS SHOULD HAVE SOME
KIND OF FINE OR PENALTY TO PAY
FOR THOSE COSTS.
BUT THIS IS A AN ABILITY.
TO PROVIDE SOME BALANCE
IT'S AN APPROACH TO WORK WITH
ALL OF THE PUBLIC TO HAVE BEEN
AN ADEQUATE PROTOCOL TO PROTECT
ALL THE RESIDENTS AND I.
WE JUST WANT TO AFFIRM THEIR
ABILITY TO PURSUE THEIR CIVIL.
LIBERTIES AND YOU KIND OF CAUGHT
ME OFF GUARD IN SO IF ANYTHING
WAS MEANT TO BE PERSONAL. I
APOLOGIZE FOR THAT.
AND I RESPECTFULLY ASK FOR AN
AYE VOTE.
BELIEVE CENTER PAN ME WANNA
RESPOND CENTER MRE LIKE I
APPRECIATE OUR WORK TOGETHER
AND.
I KNOW I SPOKE BRIEFLY WITH YOU
ABOUT SOME CONCERNS ABOUT THE
BILL AND OUT WELL AFTER THAT I'M
NOT GONNA BE VOTING FOR THIS
BILL TODAY IN MAY NOT LEAVE
COMMITTEE IF IT DOES I.
SURE SEEK
SENATOR.
CHANGING THE TITLE OF THE BILL
THANK YOU.
BILLY NOTED BALLISTIC IF I DID
KNOW YOU CAN FOR THE RECORD NO
HE WOULD NOT ASK THE QUESTION.
OF ZERO MOTION.
ALL OF.
PROMOTION BY SENATOR WIN.
BELIEVE YOU CLOSE IS THAT
CORRECT CENTER. I CHAIR WILL NOT
BE VOTING FOR THE BILL THIS IS
ITEM NUMBER THIRTEEN SP ONE.
THREE TO FIVE DO PASSED TO
JUDICIARY CALLING MEMBERS PLEASE
STAND AS WELL HERNANDEZ KNOW
WHEN.
WHEN NO LEYVA. LEYVA NO
MITCHELL.
NO MONNING NO MONNING KNOWN
NEWMAN. NEWMAN NO NIELSEN.
HAN.
PAN KNOW ROSS.
ROTH NO.
CLEARLY AS EIGHT.
.
THE BILL FAILS.
WHEN A NOW MOVE ON TO ITEM
NUMBER TEN SP ONE TWO FOUR EIGHT
GAINS IN GLACIER CALIFORNIA
PARTNERSHIP FOR LONG TERM
PROGRAMS
.
THANK YOU RICHARD HERNANDEZ.
AND.
JUST PRESENTING SENATE BILL
TWELVE FORTY EIGHT I WANTED TO
JUST CLARIFY THAT.
I AGREED TO TAKE THE AMENDMENT
SUGGESTED.
IN THE COMMITTEE ANALYSIS.
BUT THAT AMENDMENT WILL HAVE TO
BE TAKEN IN THE SENATE INSURANCE
COMMITTEE. WHICH WILL HEAR THIS
BILL NEXT WEEK SO I'M HOPING
THAT THAT IS ACCEPTABLE.
I. THINK YOU KNOW WE DO HAVE
SUPPORT ON BOTH SIDES.
WONDERFUL THANK YOU.
SO.
.
S. MORE BABY BOOMERS REACH THEIR
SEVENTIES AND EIGHTIES EXPERTS
ANTICIPATED SERVES IN THE DEMAND
FOR LONG TERM CARE SERVICES.
THE CALIFORNIA PARTNERSHIP FOR
LONG TERM CARE IS IS THE STATE
EFFORT INTENDED TO HELP. MIDDLE
CLASS CONSUMERS PAY FOR THAT
CARE. OF A PARTNERSHIP CERTIFIES
SPECIAL INSURANCE POLICIES THAT
PROVIDE A UNIQUE ASSET
PROTECTION FEATURE.
IF THE INSURED ACTUALLY APPLIES
FOR MEDI CAL STE NURSING HOME
BENEFIT THESE OF POLICIES HELP
POLICY HOLDERS. OF WADE
IMPOVERISHMENT BUT CURRENT
PARTNERSHIP STANDARDS REQUIRE
EXPENSIVE BENEFITS IN THE POLICY
CENTER ON AFFORDABLE.
TO MIDDLE INCOME CONSUMERS SALES
HAVE DWINDLED AND MOST INSURERS
APPLE LEFT THE PROGRAM SP TWELVE
FORTY EIGHT TAKES IMMEDIATE
STEPS TO MAKE POLICIES MORE
AFFORDABLE. BY UPDATING THE
PROGRAM STANDARDS TO ALLOW MORE
FLEXIBILITY AND DIE HAVE FIVE
TWO WITNESSES HERE THAT MIGHT BE
ABLE TO ANSWER THE QUESTIONS
THAT YOU WOULD HAVE.
LEóN LIKE TO SPEAK IN SUPPORT.
HELLO MY NAME IS LOUIS
BROWNSTONE AS CHAIRMAN OF THE US
LARGE SPECIALIST LONG TERM CARE
INSURANCE BROKERAGE. WITH TWENTY
SEVEN YEARS OF LONG TERM CARE
INSURANCE EXPERIENCE.
I KNOW THAT THE KEY TO MANAGING
A LONG TERM CARE SCENARIO IT'S
TO COPE TO CREATE A PLAN. WELL
IN ADVANCE OF THE EVENT.
AND YOU ARE THE ONES THAT CAN
MAKE THIS HAPPEN FOR MANY
CALIFORNIANS.
THE PARTNERSIP IS PHONE BE ON
HARD VERY HARD TIMES.
AND FOR MANY REASONS THE
PREMIUMS FOR A A NORMAL PLAN
HAVE. GONE ABOVE TEN THOUSAND
DOLLARS A YEAR FOR A COUPLE.
CLEARLY ON AFFORDABLE FOR PEOPLE
WITH MODERATE AB AYE ASSETS IN
INCOME WHICH WAS THE GOAL OF THE
PARTNERSHIP TO PROVIDE. A A
VEHICLE FOR PEOPLE TO ENSURE
THEMSELVES WHO HAD MODERATE
INCOME AND ASSETS.
S. B. THIRTEEN EIGHTY FOUR WHICH
BECAME LAW EIGHTEEN MONTHS AGO
WAS THE FIRST STEP IN MAKING
PARTNERSHIP PLANTS MORE
AFFORDABLE. IT'LL OUT FOR
INFLATION OPTIONS BESIDES FIVE
PERCENT COMPOUND IN THIS ALONE
REDUCE THE ANNUAL PREMIUM FOR A
FIFTY SEVEN YEAR OLD COUPLE. AT
THREE PERCENT COMPOUND INFLATION
FROM OVER FIFTEEN THOUSAND
DOLLARS. TO SEVEN THOUSAND THREE
TWELVE STILL WAY TOO EXPENSIVE
FOR MOST PEOPLE.
S. B. TWELVE EIGHTY FOUR WOULD
BECOME THE SECOND STEP IN MAKING
PARTNERSHIP PLANTS MORE
AFFORDABLE.
IT HAS BEEN PRESENTED AND WAS
WELL RECEIVED BY THE LONG TERM
CARE TASKFORCE THE ADVISORY
GROUP. FORMED TO SUPPORT OF S.
B. THIRTEEN EIGHTY FOUR IT WOULD
REDUCE THE MINIMUM NURSING HOME
BENEFIT. FROM TWO HUNDRED AND
TWENTY DOLLARS A DAY TWO HUNDRED
DOLLARS TODAY. AND WOULD CREATE
A BENEFIT LIMIT OF SEVENTY THREE
THOUSAND DOLLARS.
THESE ENHANCEMENTS WOULD MAKE
THE PREMIUM FOR A FIFTY SEVEN
YEAR OLD COUPLE LESS THAN TWENTY
ARE LESSEN HUNDRED TWENTY
DOLLARS A MONTH PER PERSON.
THESE CHANGES WOULD MAKE
PARTNERSHIP PLAN SUPERIOR TO NON
PARTNERSHIP PLANS FOR MANY
BECAUSE THEY WOULD IN FACT. OFF
FOR A LIFETIME PROTECTION.
FOR EXAMPLE IF A PERSON HAD
SEVENTY FIVE THOUSAND DOLLARS IN
ASSETS.
HERE SHE COULD USE UP THE
BENEFITS IN THE POLICY APPLY FOR
MEDI CAL.
PROTECT THE SEVENTY FIVE
THOUSAND DOLLARS IN ASSETS AND
BE COVERED FOR THE REST OF HIS
OR HER LIFE.
WITH MEDICAL WAIVERS IN WITH NEW
INVENTIONS IN ROBOTICS AND
SENSOR CYSTS OR SYSTEMS.
HERE'S SHE MAY BE ABLE TO STAY
AT HOME WITH THE MINIMUM
CAREGIVER SUPPORT AND THAT'S
WHAT WE ALL WANT IN A LONG TERM
CARE INSURANCE POLICY. LIFETIME
PROTECTION AND AFFORDABLE POLICY
PER PRESERVATION OF ASSETS IN
HOME CARE PERFECT.
S. B. TWELVE FORTY EIGHT WOULD
REVIVE THE PARTNERSHIP VINCE
AND-INCENTIVIZE INSURANCE
CARRIERS
TO FILE NEW AND IMPROVED
PARTNERSHIP POLICIES.
NEW CONSUMER EDUCATION WOULD
CREATE A ROBUST MARKET IN RESULT
IN HUNDREDS OF THOUSANDS OF
CALIFORNIANS. PURCHASING
PARTNERSHIP POLICIES.
THIS WOULD ACCOMPLISH THE
ORIGINAL GOAL OF REDUCING MEDI
CAL EXPENSE.
EVEN SO THIS EXPENSES COULD
BECOME ENORMOUS.
A INTENDED TWELVE YEARS AS BABY
BOOMERS.
I REACH THEIR EIGHTIES AND
BECOME SICK. AND MY PURPOSE HERE
IS REALLY TO PROTECT
STATE MEDI CAL EXPENSE.
A UNIT IN THE YEARS GOING
FORWARD.
IT'S URGENT TO ENACT SP TWELVE
FORTY EIGHT RIGHT AWAY. IN ORDER
TO REVIVE THE PARTNERSHIP AND
AVOID COSTLY DELAY.
THIS WILL ENABLE CITIZENS WITH
MODERATE INCOME AND ASSETS TO
PROTECT THEMSELVES WITH LONG
TERM CARE INSURANCE AND SAVE
MEDI CAL. BILLIONS IN FUTURE
LONG TERM.
CARE COSTS.
THANK YOU.
THE BILL THAT WE HAVE A MOTION
TO MOVE THE BILL ANYONE ELSE IN
SUPPORT.
GOOD AFTERNOON SHERRY MCCUE
REPRESENTING THE NATIONAL
ASSOCIATION OF INSURANCE AND
FINANCIAL ADVISORS AND SUPPORT
ABOUT.
THAT NEW I CAN THE BEHALF OF THE
ASSOCIATION OF CALIFORNIA LIFE
AND HEALTH INSURANCE COMPANY
THANK YOU OPPOSITION.
QUESTIONS COMMENTS.
YOU KNOW QUESTIONS COMMENTS WE
HAVE A MOTION BY SENATE MITCHELL
WOULD YOU LIKE TO CLOSE.
YEAH I WOULD LOVE TO HAVE YOUR
SUPPORT AND CARING THIS
LEGISLATION ALONG WITH CENTER
GLAZER. THANK YOU ARCHERS
RECKONING I REMEMBER TENNIS
SPEED.
AND I SP R. PRO FORTY TO PASS TO
INSURANCE.
COLOR MEMBERS PLEASE HERNANDEZ
AYE HERNANDEZ AYE WHEN. WIN AYE
LEYVA. LEYVA AYE MITCHELL.
MITCHELL AYE MONNING AYE AYE
MONNING AYE NEWMAN.
NEWMAN AYE NIELSEN.
NIELSEN AYE PAN AYE AYE PAN AYE
ROTH.
CURLY AS EIGHT ZERO A WORKPLACE
THAT BILL INFO IN ABSENT MEMBER
COMMITTEE MEMBERS THANK YOU
WE'RE GONNA MOVE ONTO CENTER
LEYVA BELIEVE YOU HAVE.
ONE.
TWO THREE THREE BILLS THAT
CORRECT.
THAT'S. WHAT IT?
I THINK SHE'S GOING TO DO HER.
YEAH.
MISTER CHAIR IF I COULD ASK A
FAVOR AND HAVE S. B. TWELVE
EIGHTY EIGHT HEARD FIRST TO SOME
OF MY WITNESSES HAVE TO LEAVE BY
ALL MEANS PLEASE THANK YOU VERY
MUCH ITEM NUMBER ELEVEN SP
TWELVE IMMEDIATELY OF A HEALTH
AND.
CARE FACILITIES INSPECTIONS.
PLEASE PROCEED.
GOOD AFTERNOON MISTER CHAIR AND
MEMBERS THANK YOU FOR THE
ACCOMMODATION I WOULD LIKE TO
BEGIN BY THANKING YOU AND YOUR
STAFF WORKING WITH MY OFFICE ON
THIS IMPORTANT BILL AND I WILL
BE ACCEPTING THE AMENDMENT NOTED
IN THE POLICY COMMENT.
TO CLARIFY THAT FOR PURPOSES OF
THE ESCALATING FINE SCHEDULE FOR
REPEATED VIOLATIONS.
MULTIPLE VIOLATIONS FOUND ON THE
SAME INSPECTED INSPECTION VISIT.
CONSTITUTE A SINGLE VIOLATION.
MEMBERS SB TWELVE EIGHTY EIGHT
EMPOWERS THE CALIFORNIA
DEPARTMENT OF PUBLIC HEALTH TO
ENSURE PATIENT SAFETY BY
ENFORCING NURSE TO PATIENT
RATIOS AND FINING HOSPITALS THAT
REPEATEDLY BREAK THE STANDARDS.
DESPITE MANDATED AND
LONGSTANDING NURSE PATIENT
RATIOS HOSPITALS CONTINUE TO
VIOLATE THESE VITAL
REQUIREMENTS.
FROM TWO THOUSAND EIGHT TWO
THOUSAND SEVENTEEN THERE WERE A
TOTAL OF SIX HUNDRED AND THIRTY
TWO ALLEGATIONS MADE
SPECIFICALLY. IN REGARDS TO OUT
OF RATIO DEFICIENCIES REPORT TO
THE CD P. H..
AND TWO THOUSAND SEVENTEEN ASCII
AND ONE TO ONE ARE IN A UNION
WHICH REPRESENTS NURSES AT
TWENTY SIX PRIVATE HOSPITALS.
COMPILED GENERATED COMPLAINT
FORM CALLED
ASSIGNMENT DESPITE OBJECTIONS.
AND A. B. O. THESE FORMS
DETAILED INSTANCES WHERE NURSES
VOICE THEIR CONCERNS THAT THEIR
ASSIGNMENT SUCCEEDED AND
VIOLATED NURSE RATIO
REQUIREMENTS WHICH PUT PATIENTS
AT RISK.
FORTY FIVE PERCENT OF EIGHTY
YEARS REPORTED BY NURSES SAID
THAT THEIR HOSPITALS REQUIRE
THEM TO VIOLATE RATIOS OR RISK
DISCIPLINE. SIXTY THREE PERCENT
OF EIGHT HEROES HIGHLIGHTED
CASES WERE NURSES MISTER BREAKS
DUE TO WORK OVERLOAD IN
ADDITION.
OTHER SEIU LOCALS HAVE REPORTED
HAVE REPORTED COMPLIANCE ISSUES
WITH NEXT NURSE STAFFING RATIOS.
UNFORTUNATELY THE CALIFORNIA
PUBLIC DEPARTMENT OF PUBLIC
HEALTH CURRENT ENFORCEMENT
MEASURES ARE SIMPLY NOT ENOUGH.
THE DEPARTMENT CONDUCTS SURVEYS
EVERY THREE YEARS TO ENSURE THE
HOSPITALS ARE COMPLYING WITH THE
LAW.
HOWEVER THIS PERIODIC CHECK IS
FAR TOO INFREQUENT AND ALLOWS
HOSPITALS TO PREPARE FOR CDP
EACH OFFICIALS TO CONDUCT THEIR
SURVEY.
S. B. TWELVE EIGHTY EIGHT WOULD
ADDRESS THIS PROBLEM BY
REQUIRING THAT THE DEPARTMENT
CONDUCT.
UNANNOUNCED VISITS TO HOSPITALS
TO INSPECT FOR COMPLIANCE WITH
NURSE STAFFING REQUIREMENTS
THIS MEASURE WOULD ALSO EMPOWER
THE DEPARTMENT TO TRULY IN FORCE
NURSE STAFFING RATIOS WITH FINES
AND CASES WERE STAFFING RATIOS
ARE VIOLATED. AS THE TWELVE
EIGHTY EIGHT IT'S VITALLY
IMPORTANT SO THAT WE CAN
CONTINUE TO PROTECT PATIENT
HEALTH AND SAFETY HERE IN
CALIFORNIA.
HERE IN SUPPORT TODAY IT'S MARK
WINDOWS UP WITH FCI YOU AND GAIL
BATISTE PRESIDENT OF SEIU LOCAL
ONE TO ONE ARE AND. AND YOU'RE
GONNA BE ALLOWING SIX MINUTES
OF THE OPPOSITION YOU CAN USE IT
HOWEVER YOU WISH PLEASE PROCEED.
THANK YOU MISTER CHAIRMAN AND
MEMBERS.
MY NAME IS GILBERTESE.
AND I'M THE PRESIDENT OF SEIU
LOCAL ONE TO ONE OR AND. WE
REPRESENT REGISTERED NURSES AND
PROFESSIONALS THROUGHOUT
SOUTHERN CALIFORNIA.
I'M ALSO AN OPERATING ROOM NURSE
AT DIGNITY NORTHRIDGE HOSPITAL
BECAME A NURSE THIRTY FOUR YEARS
AGO BECAUSE I WANTED TO TAKE
CARE OF THE SICK AND THE
VULNERABLE.
I'M HERE TODAY TO ASK FOR AN AYE
VOTE.
ON S. B. TWELVE EIGHTY EIGHT.
CALIFORNIA IS THE ONLY STATE IN
THE NATION WHAT NURSE TO PATIENT
RATIOS.
THESE RATIOS ARE INTENDED TO
KEEP OUR PATIENTS SAFE AND
PRODUCED THE MOST OPTIMAL HEALTH
OUTCOMES FOR PATIENTS.
HOWEVER.
THE ENFORCEMENT MECHANISM BUT
TITLE TWENTY TWO REGULATIONS
NEED TO BE FIXED AND STRENGTHEN.
CURRENTLY THE PENALTIES FOR
VIOLATING THE LAW ARE NEARLY
NONEXISTENT.
IN FACT.
MOST OF THE TIME WHEN THE
HOSPITAL'S FOUND TO BE IN
VIOLATION OF THE NURSE TO
PATIENT RATIOS. CD AGE GIVES
THEM CITATIONS KNOWN AS PLANS OF
CORRECTION.
SURPRISINGLY THERE IS NO LIMIT
ON HOW MANY PLANS OF CORRECTIONS
HOSPITAL CAN GET AND MOST OF
ALL.
NOT ALL THE HOSPITAL EVER FIGHT.
pTO CONTINUOUSLY BREAK THE LAW
AND PUT PATIENT SAFETY AT RISK.
AS A NURSE I CAN TELL YOU THAT
FAILURE TO COMPLY WITH NURSE
STAFFING RATIOS BUT PATIENTS
ADDRESS.
THE NURSES HERE TODAY. THAT WILL
SPEAK IN SUPPORT OF THIS MEASURE
WILL ALSO ATTEST TO IMPORTANCE
OF NURSE STAFFING RATIOS. AND
HOW THEY PROTECT THE HEALTH AND
SAFETY OF PATIENTS.
FOR AN EXAMPLE IS MENTION OUR
EARLIER PRESS CONFERENCE KATHY A
RIVERSIDE NIRS DISCUSSED HOW IT
PATIENT DEVELOP SERIOUS
SECONDARY ILLNESSES. AS A DIRECT
RESULT OF DANGEROUSLY LOW
STAFFING LEVELS.
IMAGINE THAT.
IMAGINE IF THAT PATIENT WAS YOUR
MOTHER YOUR FATHER YOUR WIFE
YOUR HUSBAND YOUR CHILD OR
YOURSELF.
THIS IS WHY WE ARE HERE TODAY.
CALIFORNIA NEEDS TO PROTECT OUR
PATIENTS BETTER ENSURE THAT THEY
RECEIVE THE HIGHEST QUALITY OF
CARE.
S. B. TWELVE EIGHTY EIGHT WOULD
CREATE A HIGHER DISINCENTIVE BY
INSTITUTING REPEAT OFFENDER LIKE
LANGUAGE.
HOSPITALS THAT WILLFULLY AND
CONSTANTLY VIOLATE NURSE TO
PATIENT RATIOS WOULD BE NOW FACE
WOULD NOW FACE FINES DEPENDING
ON HOW OFTEN THEY VIOLATE TITLE
TWENTY TWO REGULATIONS.
LASTLY.
S. B. TWELVE EIGHTY EIGHT WOULD
ALLOW CITY PH INVESTIGATORS TO
CONDUCT UNANNOUNCED VISITS SO
THAT THESE REPEAT OFFENDERS
WON'T BE ABLE TO SKIRT THE LAW.
BEFORE THE STATE CAN INVESTIGATE
VIOLATIONS.
THIS MEASURE IS CO SPONSORED BY
SEIU ONE TWO ON OUR END AS HE
AYE NEW NURSE ALLIANCE AND YOU
KNOW ACT. THIS BILL IS ALSO
SUPPORTED BY CNA THE CALIFORNIA
LABOR FEDERATION THE CONGRESS OF
CALIFORNIA SENIORS AND PLANNED
PARENTHOOD OF CALIFORNIA. AS A
NURSES WE TOOK AN OATH TO
PROTECT AN ADVOCATE FOR OUR
PATIENTS.
S. B. TWELVE EIGHTY EIGHT A
SOUND POLICY THAT ALIGNS WHAT
OUR OWN.
ON BEHALF OF ALL THE NURSES AT
SEIU ONE TO ONE ARE AND AND
THROUGHOUT CALIFORNIA I
RESPECTFULLY URGE YOU TO PASS S.
B. TWELVE EIGHTY EIGHT TO
PROTECT PATIENTS THANK YOU.
YOU PLEASE PROCEED.
THANK YOU MISTER CHAIRMAN
MEMBERS MARK WINDOWS THAT WITH
US HERE YOU CALIFORNIA. AS
HIGHLIGHTED BY SENATOR LEYVA AND
PRESIDENT PETITS CALIFORNIA'S
GOING TOO LONG WITHOUT A STRONG
ENFORCEMENT MECHANISM TO ENSURE
COMPLIANCE WITH THE NURSE TO
PATIENT RATIOS.
IN TWENTY THIRTEEN CTP H.
IMPLEMENTED REGULATIONS ON
ADMINISTRATIVE PENALTIES FOR A
BROAD RANGE OF VIOLATIONS
INCLUDING VIOLATIONS OF NURSE
STAFFING RATIOS.
WELL THESE REGULATIONS WERE
INTENDED TO INCENTIVIZE
HOSPITALS TO COMPLY WITH THE
NURSES DUCKING REACHES.
THESE REGULATIONS HAVE
UNFORTUNATELY HAD THE OPPOSITE
EFFECT.
NOTABLY SINCE TWENTY THIRTEEN
WHEN THE REGULATIONS WERE
IMPLEMENTED WE HAVE SEEN SOME OF
THE HIGHEST RATES VIOLATIONS OF
TITLE TWENTY TWO REGULATIONS IN
THE PAST DECADE.
WHEN CITY PEACH DISCOVERS A
VIOLATION OF THE NURSE STOPPING
RATIOS PAID MINISTER PLAN OF
CORRECTION CITATION THAT CARRIES
NO MONETARY OR CRIMINAL
LIABILITY ATTACHED TO IT.
EVEN MORE NOTABLE IN TWENTY
TWELVE CD PEACH STATED THAT IT
DOES NOT ROUTINELY CONDUCT
FOLLOW UP SURVEYS AFTER
ADMINISTERING A PLAN OF
CORRECTION TO DETERMINE IF
HOSPITALS ARE COMPLYING WITH THE
RATIOS.
S. B. TWELVE EDA CREATES A
STRONG PROGRESSIVE FINE SCHEDULE
FOR HOSPITALS THAT REPEATEDLY
AND WILLFULLY VIOLATE BURNER
STOPPING RATIOS.
MOREOVER IT THE MEASURE ALLOWS
HOSPITALS NOT ONLY ONCE.
BUT TWO CHANCES TO COME INTO
COMPLIANCE WITH TITLE TWENTY TWO
REGULATIONS BEFORE RECEIVING A
MORE HAVE DEFINED FOR THE THIRD.
VIOLATION.
THE CONCEPT OF NURSE STAFFING
RATIOS HAS BEEN IN PLACE FOR
OVER FOUR DECADES.
AND HAS ALLOWED HOSPITALS AMPLE
TIME TO COME INTO COMPLIANCE
WITH NURSE STAFFING RATIOS.
THE CURRENT EVIDENCE IN ACADEMIC
LITERATURE AND STUDIES HIGHLIGHT
HOW BETTER NURSE STAFFING RATIOS
IMPROVE PATIENT CARE OUTCOMES
IT'S PRETTY INDISPUTABLE.
I URGE AN AYE VOTE ON S. B.
TWELVE EIGHTY EIGHT TO ALL TO
NOT ONLY PROTECT OUR NURSES BUT
ULTIMATELY TO ENSURE THAT THE
STATE OF CALIFORNIA IS DOING
EVERYTHING POSSIBLE TO
PRIORITIZE A PATIENT'S HEALTH
AND SAFETY THANK YOU. YOU PLEASE
PROCEED.
GOOD AFTERNOON MR TURN MEMBERS
ABOUT WAYLON ELSE MOST NEXT HERE
ON BEHALF OF UNITED NURSES
ASSOCIATION CALIFORNIA UNION OF
HEALTH CARE PROFESSIONALS A
PROUD MEMBER VAST ME. AND ALSO
PROUD TO CO SPONSOR.
THIS BILL.
REAL BRIEFLY AS WE OUTLINED IN
OUR LETTER THERE ARE NUMEROUS
PEER REVIEWED STUDIES INCLUDING
THOSE PUBLISHED IN THE JOURNAL
OF AMERICAN MEDICINE.
THE DEMONSTRATE UNMISTAKABLY
THAT NURSE STAFFING RATIOS
PROTECT PATIENTS ANNA IS JUST
ONE EXAMPLE STUDIES SHOW THAT
FOR EVERY EXTRA PATIENT THAT A
NURSE HAS TO CARE FOR THE RISK
OF MORTALITY INCREASES BY SEVEN
PERCENT.
WHEN HOSPITAL'S CHOOSE TO UNDER
STAFF THEY'RE CHOOSING HOSPITAL
PROFITS OVER PATIENT SAFETY.
PLEASE DON'T MAKE THAT SAME
CHOICE URGING AYE VOTE AND YOU
ANYONE ELSE IN SUPPORT OVER HERE
WE JUST OUR STATE YOUR NAME AND
YOUR POSITION.
I'M CHOICE PAL I MAY REGISTERED
NURSE AT PROVINCETOWN JUSTICE IN
THE EMERGENCY ROOM AND I SUPPORT
THIS BILL THANK YOU.
HI MY NAME IS AARON QUENTIN.
I WORK AT KAISER MARINO VALLEY.
I SUPPORT THIS BILL.
THANK YOU.
MY NAME IS TIED YEOMAN'S I AM
FORCED HEALTHCARE LAWS AND SUCH
AS THIS ADAM FORESEE PITCH WITH
THE LA COUNTY DEPARTMENT OF
PUBLIC HEALTH I SUPPORT THIS
BILL.
HI MY NAME IS. MARK GREEN THOMAS
ORIENT KENDRA ONTARIO AND I
SUPPORT THIS BILL.
I'VE MANY MEASURE ON A METZGER
COMING OUR INTO MERGING TEA ROOM
DIGNITY HEALTH NORTHRIDGE
HOSPITAL AND I SUPPORT THIS
BILL.
HI MY NAME IS KATHERINE MONTHS
NINO I AM AN ICU NURSE THAT
RIVERSIDE COMMUNITY HOSPITAL AND
I STRONGLY SUPPORT THIS BILL.
I MISCARRY HAVE ALSO SOME A
REGISTERED NURSE TWENTY EIGHT
YEARS RIVERSIDE COMMUNITY
HOSPITAL I STRONGLY SUPPORT THIS
BILL.
MY MY NAME IS FIONA HEADLINE I'M
A REGISTERED NURSE ICU AT ELLIE
C. U. S. C. FOR NINETEEN YEARS
AND I STRONGLY SUPPORT THIS
BILL.
HELLO MY NAME IS THERESA MORROW
I AM A NURSE FOR TWENTY YEARS AT
LA C. U. S. C. A TRAUMA CENTER
IN TRAUMA SURGERY I STRONGLY
SUPPORT THIS BILL.
HI MY NAME IS CELINE I WOULD BE.
FROM THE WEST SIDE UNIVERSITY
HEALTH SYSTEM BETTY YES OF MASS
EXPERIENCE. WHAT THAT LABOR
DELIVERY AS DRUM TO SUPPORT
THESE?
I MANAGEMENT TABLE TOYOTA WHICH
THE NURSE FOR TWENTY TWO YEARS I
WORK AT A SCENE HOSPITAL WHICH
SOON DEPARTMENT I STRONGLY
SUPPORT HIS BILL THANK YOU.
I AM MAPLE BOCHCO I'M FOR
MONTEREY PARK HOSPITAL I'M A
REGISTERED NURSE OR FORTY TWO
YEARS AND I SUPPORT THIS BILL.
MARK MCKINNEY WITH THE
CALIFORNIA NURSES ASSOCIATION AS
THE ORIGINAL SPONSOR OF THE LAW
WHO ENACTED NURSE TO PATIENT
RATIOS WERE PLEASED TO SUPPORT
SB TWELVE EIGHTY EIGHT WHICH
STRENGTHENS COMPLIANCE.
HELLO MY NAME IS GUARD WORRY
REGISTERED NURSE TWENTY SIX
YEARS LA SEE USC MEDICAL CENTER
HELP TRANSMISSION ADVOCATE MY
STRONG SUPPORT THIS BILL LIKE.
HI MY NAME IS LAURA GOMEZ
REGISTERED NURSE TWENTY NINE
PLUS YEARS LA COUNTY SEIU SEVEN
TWO ONE. AND AS WITH MY
CONTINUED ADVOCACY FOR ALL MY
PAST PATIENTS AND ALL MY FUTURE
PATIENTS I STRONGLY SUPPORT THIS
BILL.
GOOD AFTERNOON I'M MILTON TUNE I
AM A HEALTH AND.
HEALTH FACILITIES EVALUATOR LOS
ANGELES COUNTY A NURSE FOR
THIRTY FIVE YEARS AND IT'S.
BILL.
CRITICS CALIFORNIA LINES
RETIREMENT AMERICANS A STRONG
SUPPORT.
IN OPPOSITION
.
IF ANOTHER SUPPORT OVER THERE. A
LITTLE BIT OF LATE PREFACES PORT
YES SERAPH LOCKS CALIFORNIA
LABOR FEDERATION AND SUPPORT
THANK YOU.
IN OPPOSITION.
AGAIN SIX MINUTES IN TOTALLY
CAN USE OUR YOU WISH PLEASE
PROCEED.
THANK YOU MISTER CHAIR AND
MEMBERS FINANCED EVERY ROERS
I'M HERE ON BEHALF THE
CALIFORNIA HOSPITAL ASSOCIATION
A LONGTIME EMERGENCY DEPARTMENT
NURSE.
FAMILIAR FAMILIAR WITH THESE SO
THESE REGULATIONS. CJ OPPOSES.
THIS MEASURE BECAUSE IT REALLY.
IT'S THAT APART
IT HELPS ABILITY TO LOOK AT ALL
OF THE FACTORS THAT ARE RELATED
TO A DEFICIENT.
WHEN THERE'S A LACK OF
COMPLIANCE THE DEPARTMENT
INVESTIGATES THEY LOOK AT. ALL
DIFFERENT.
ALL KINDS OF DIFFERENT THINGS
AND THEN THE HEALTH AND SAFETY
CODE A NUMBER OF YEARS AGO
CODIFIED.
CERTAIN CRITERIA IN ORDER TO
GIVE A PENALTY AN ADMINISTRATIVE
PENALTY TO A HOSPITAL. CERTAIN
CRITERIA NEED TO BE LOOKED AT
AND THE BREATH OF THOSE FACTORS
INCLUDES EVERYTHING FROM THE
PATIENT'S MENTAL AND PHYSICAL
CONDITION WAS THERE A LOSS OF A
BODY PART WHAT'S THE SCOPE AND
NATURE.
OF THE EVENT THATHAPPENED AND
HOW SEVERE WAS IT.
THE HISTORIES THE FACILITIES
HISTORY OF COMPLIANCE.
IS THERE DEMONSTRATED WELL FOR A
LIST OF THE VIOLATION BY THE
FACILITY OR OTHER FACTORS
OUTSIDE THE CONTROL OF THE
FACILITY. THAT LED.
THAT LED TO THIS DEFICIENCY.
I THINK THE COMMITTEE ANALYSIS.
DID AN EXCELLENT JOB OF
OUTLINING BOTH THE
ADMINISTRATIVE PENALTY
REGULATIONS AND THE LAWS OF
THAT'S CURRENTLY ON THE BOOKS.
THOSE
REGULATIONS WERE ADOPTED AS WE
KNOW IN TWO THOUSAND AND
FOURTEEN THERE WAS A ROBUST UP
PUBLIC COMMENT PERIOD.
A YOU COULD IMAGINE.
AND THE LAW ALSO.
WANTED TO AND HAS CODIFIED
GIVING CD PH FULL DISCRETION.
TO LOOK AT ALL OF THE FACTORS
WHEN THEY DETERMINE AN
ADMINISTRATIVE PENALTY. SO WHAT
THIS MEASURE DOES AS IT PULLS
OUT ONE FACTOR OF ALL OF THE
REQUIREMENTS THAT HOSPITALS HAVE
TO COMPLY WITH. AND PUTS THAT ON
A DIFFERENT LEVEL AND IT
SPECIFICALLY DOESN'T ALLOW CDP
AGE TO LOOK AT ALL OF THE OTHER
ASSOCIATED FACTORS. THE SECOND
PART OF THIS BILL DEALS WITH
PERIODIC.
INSPECTIONS OF HOSPITALS WE
KNOW THAT A DECADE AGO CDP H..
DID NOT AND DO THOSE REGULAR
INSPECTIONS AS OFTEN AS THE LAW
REQUIRES HEALTH AND SAFETY CODE
REQUIRES THAT THESE INSPECTIONS
ARE CALLED RELICENSING SURVEYS.
THAT THEY BE DONE EVERY THREE
YEARS THE DEPARTMENT HAS STARTED
TO DO THOSE A RE INSPECTIONS OUT
ONCE AGAIN I'VE BEEN DOING IT
CONSISTENTLY FOR THE LAST COUPLE
OF YEARS I THINK THEY STARTED IN
TWO THOUSAND SIXTEEN. I AM I
BROUGHT JUST AS AN EXAMPLE OF
THIS IS THE ENTIRE HEALTH AND
SAFETY CODE AND TITLE TWENTY TWO
THAT RELATES TO HIGH
SPITTLE REQUIREMENTS. AND THE
SURVEY PROCEDURES THAT THE
HOSPITAL'S SURVEYORS ARE
REQUIRED TO USE ARE TOLD TO USE
BY CITY PH WHEN THEY GO IN AND
DO THESE PERIODIC INVESTIGATIONS
EVERY THREE YEARS.
SO WHAT HAPPENS IS THERE AND
THIS INCLUDES STAFFING RATIOS
THERE'S FIVE OR SIX PAGES OF
BOTH THE STAFFING RATIO
REGULATIONS AS WELL AS THE
PROCEDURES. THAT THE SURVEY TEAM
WOULD FOLLOW TO EVALUATE THOSE
STAFFING RATIOS ON FIVE TO SEVEN
SURVEYORS TYPICALLY GO INTO A
HOSPITAL AND IT LASTS FOR A
NUMBER OF DAYS.
AND JUST THIS MORNING I WAS
ACTUALLY ON A CALL WITH SEVERAL
CHIEF NURSING OFFICERS AND I WAS
ASKING THEM WILL HOW.
HOW DOES THE DEPARTMENT LOOK AT
STAFFING RATIOS AND THEY SAID
WELL THEY LOOK AT EVERYTHING
FROM STAFFING RATIOS UNIT BY
UNIT AS THIS DOCUMENT?
WOULD INSTRUCT THEM TO DO.
ONE CHIEF NURSING OFFICER SAID
TO ME WELL CITY PITCH ASKED ME
FOR MY COMPLIANCE ON STAFFING
RATIOS FOR THE LAST THREE
MONTHS.
THEY WANTED IT PRINTED OUT PUT
IN BOXES AND THE SURVEY TEAM
LEFT WITH THAT LEVEL OF
COMPLIANCE.
SO THERE IS SURVEY ACTIVITY
GOING ON I THINK WHAT.
WHAT BUT CITY PH WOULD DO WHEN
THEY GET A VIOLATION OF THIS
KIND? OR ANY KIND AGAINST A
HOSPITAL IS THEY LOOK AT THOSE
REGULATIONS THAT THEY
PROMULGATED IN TWO THOUSAND AND
FOURTEEN. AND THEY LOOK AT A
MATRIX
IT'S IT WIDESPREAD IT WAS THEIR
RISK FOR SIGNIFICANT PATIENT.
DID IT RETURN AYE JAY LEVEL
AND THERE'S OF.
MATRIX.
THAT THEY LOOK AT IN THE FIGURE
OUT WHERE THAT VIOLATION FALLS
IN THAT MATRIX AND IF THERE'S A
PANEL AND THEN THEY LOOK AT ALL
THE FACTORS WHICH RAISE THE
PENALTY HIGHER OR LOWER. AND
THEN AT THAT POINT THAT WOULD BE
A PENALTY OR NOT A PENALTY AND
SO WE FEEL LIKE BOTH SECTIONS OF
THIS BILL ARE DUPLICATIVE THE
DEPARTMENT HAS THE ABILITY. TO
REGISTER FINES IF THEY IF THEY
REACH THE CRITERIA THAT ARE IN
THE STATE LAW.
AND THEY'RE DOING THESE PERIODIC
SURVEYS NOW EVERY THREE YEARS
WHICH INCLUDE STAFFING RATIO.
THANK YOU.
BOB ROSS GOT ALSO PRESENTING
CULVERHOUSE ASSOCIATION UNITED
HOSPITAL ASSOCIATION.
I THINK.
MISS REGISTERED EXCELLENT JOB
OF EXPLAINING THE PROCESS I
THINK I I DO WANNA HIGHLIGHT
HOWEVER THAT.
THIS PROCESS THAT NURSED OF
MERGERS ARE CONSIDERED IN THE
PROCESS AS SHE POINTED OUT BUT
THIS BILL THEN PUTS HER
EXTREMELY HEAVY FINES.
ON TOP OF THAT.
SO.
WE I JUST WANT TO REMIND YOU
THAT IT TAKES IT OUT OF THE
PROCESS THEN PUT A HUNDRED
TWENTY UP TWO HUNDRED TWENTY
FIVE THOUSAND DOLLAR FINE. WE
SCHEDULE AND STAFF WOULD YOU
THINK FOURTEEN DIFFERENT UNITS A
DAY.
IN THE HOSPITAL EASILY A TWO OR
THREE DIFFERENT SHIFTS DEPENDING
ON THE FACILITY SO WE'RE DEEPLY
CONCERNED ABOUT THE NOT ONLY THE
DUPLICATE THE THAT THAT
SEPARATING OUT FROM. A MATRIX
THAT ESTABLISHES.
THE SEVERITY AND THE PATIENT
HARM BUT THEN THEY HUNDRED
TWENTY FIVE THOUSAND DOLLAR.
PENALTY THAT IS ON SUBSEQUENT
VIOLATIONS IS QUITE.
QUITE CONCERNING.
FOR THOSE REASONS WE ASK YOU
OPPOSE ABOUT ANYONE ELSE IN
OPPOSITION.
QUESTIONS
YES SERAPH.
THANK YOU RICHARD YOU KNOW.
.
I SPENT SOME TIME READING THIS
BILL OF THE OTHERS BILL ON
ACTUALLY HER.
NEXT BILL AS WELL.
I WANT TO SAY THAT I CERTAINLY
UNDERSTAND THE IMPORTANCE OF
STAFFING RATIOS AND.
I TH I KNOW ALL MY COLLEAGUES
ON THE STATUS OF THE DO.
I AND I CERTAINLY SUPPORT THEM A
VERY VERY IMPORTANT AND WE'RE
ALWAYS CONCERNED ABOUT PATIENT
SAFETY AND WERE ALSO CONCERNED
ABOUT THE WELL BEING.
OF THE HEALTHCARE PROVIDERS THAT
TO PROVIDE CARE TO PATIENTS AND
THEY DO IT VERY WELL AND THEY
WORK VERY VERY HARD.
.
BUT THERE ARE AS I THINK SOME
ISSUES THAT NEED TO BE ADDRESSED
IN THIS BILL IT'S MY
UNDERSTANDING A.
THAT THEY WILL BE ADDRESSED AS
THIS BILL MOVES FORWARD ONE HAS
ALREADY BEEN ADDRESSED.
IT WAS OF CONCERN TO ME AND
THAT WAS.
MULTIPLE VIOLATIONS FOUND IN A
SINGLE INSPECTION AND HOW THOSE.
MULTIPLE VIOLATIONS FOR GOING TO
BE TREATED AND I THINK THE
AUTHOR FOR.
ADDRESSING THOSE THERE ARE SOME
OTHER ISSUES THAT I SIMPLY WANT
TO.
HIGHLIGHT. FOR THE RECORD.
.
WITH CERTAINLY THE EXPECTATION
THAT IN SOME WAY THEY BE
ADDRESSED ONE IS THERE IS NO
RESET.
AFTER A PERIOD OF TIME FOR
EXAMPLE IF YOU HAVE OF VIOLATION
IN YOUR VOCIFEROUS VIOLATION AND
THEN THE SECOND VIOLATION AND
MAYBE EVEN THE THIRD VIOLATION.
AS THE PENALTIES ESCALATE AND IF
THERE'S A PERIOD OF TIME AND I'M
NOT SUGGESTING ANY PARTICULAR
PERIOD BUT OF TWO OR THREE OR
FOUR YEARS WHERE THERE IS.
BILL.
BOB THERE IS NO RESET AND YOU
MOVE IMMEDIATELY TO A FOURTH
VIOLATION EVEN AFTER A FIVE YEAR
PERIOD OF. OF NO VIOLATIONS.
GONNA ON INSPECTION AND I DON'T
THINK THAT'S THEM.
I DON'T FRANKLY FOR TO THE
EXTENT THAT FAIRNESS
GOVERNMENT'S ANYTHING WE DO
AROUND HERE I DON'T THINK THAT
THAT'S NECESSARILY A FAIR WAY
TO.
TO DEAL WITH THE PROCESS I ALSO
NOTE THAT.
FROM WITH THE LESS SERIOUS
VIOLATIONS IN THE TEXT OF THE
BILL THERE. APPEARS TO BE LEX
FLIPPED LESS FLEXIBILITY
ACCORDED TO THE DEPARTMENT AND
SETTING PENALTIES THAN THERE IS
FOR THE IMMEDIATE JEOPARDY
TYPE CASES IN OTHER SITUATIONS.
FOR EXAMPLE INSTEAD OF SAYING
FOR A THIRD VIOLATION.
A FINER PENALTY UP TO SEVENTY
FIVE THOUSAND DOLLARS YOUR BILL
TEXT TODAY SAYS THE FINE SHALL
BE ASSESSED AT SEVENTY FIVE
THOUSAND DOLLARS AND I THINK THE
DEPARTMENT SHOULD HAVE A LITTLE
DISCRETION IN TERMS OF
DETERMINING.
OF THE NATURE AND EXTENT OF
PANEL OF THE PENALTY PERHAPS IN
TERMS OF A RANGE.
NOW I CAN'T.
.
AND OF COURSE THIS IS ALL IN
THAT SECTION TWELVE EIGHTY POINT
THREE SO BUFF I CAN'T TELL
WHETHER. PROPOSED VIOLATIONS FOR
EXAMPLE ARE EXCUSED OR MITIGATED
IF THE STAFFING ISSUES ARE
THROUGH NO FAULT OF THE HOSPITAL
FOR.
THE LATE BECAUSE
STAFF FOR SOME OTHER OTHER
UNEXPECTED.
SERGE SITUATION THAT.
THAT OVERWHELM THE AVAILABLE
PERSONNEL AT THE FACILITY NOW I
HAVE BEEN TOLD. THE TITLE TWENTY
TWO CONTAINS.
EXCEPTIONS OR CONDITIONS ARE
MITIGATING SITUATIONS OR
FACTORS.
BUT IN THE REGULATION BUT I
WOULD CERTAINLY EXPECT THOSE TO
BE ADDRESSED IN THIS BILL. UP
PERHAPS LOSE THE PROBABILITY IN
SEVERITY THE REST OF THE PATIENT
MAY NOT BE ONE BUT CERTAINLY.
OF THE WILLFULNESS NINE NINE THE
CRIMINAL CENTS BELOW THE
WILLFULNESS OF THE VIOLATION THE
INTENTIONALITY. OF THE CONDUCT
OF THE HOSPITAL NEEDS TO BE
ADDRESSED IN DETERMINING WHETHER
IN FACT OF A FINE OR PENALTY
SHOULD BE ASSESSED PERHAPS AT
ALL.
IF YOU FOR EXAMPLE OF STAFF YOUR
HOSPITAL HUNDRED AND A HUNDRED
AND THIRTY PERCENT FOR EXAMPLE
OF. OF THEM.
BUT OF NURSING STAFFING
EXPECTATIONS SO IN OTHER WORDS
THIRTY PERCENT ABOVE
STAFFING LEVEL.
THAT YOU EXPECT IN YOUR
HOSPITAL AND THEN WE HAVE AN
EARTHQUAKE IN ALL THIRTY PERCENT
OF YOUR SPARES ARE UTILIZED AND
YOU ARE NOW.
UNDER STAFF PER THE IS STAFFING
RATIO IS THAT A FINE SITUATION
OR IS THAT A SITUATION THAT'S
OUTSIDE THE CONTROL OF THE
HOSPICE.
NOT CLEAR FROM YOUR BILL THE
BILL TAX MAYBE IT'S IN THE
REGULATIONS.
WELL MAYBE THAT'S SOMETHING OF
THAT CAN BE.
PUT INTO THE BILL IN TERMS OF
REFERENCE AND IF NOT IT'S
CERTAINLY SOMETHING THAT I THINK
NEEDS TO BE ADDRESSED SO. HAVING
SAID ALL OF THAT I'M PREPARED TO
SUPPORT THE BILL AND MOVE IT OUT
OF THE COMMITTEE TODAY. NOW BUT
I DO EXPECT THOSE.
ISSUES TO BE ADDRESSED WHEN I
NEXT SEE THE BILL.
IF YOU WANT THE SAME RESPONSE
FROM ME.
THANK YOU MISTER CHAIR.
BETTER RESPOND MISTER CHAIR NO
MEANS THANK YOU THANK YOU
SENATOR ROTH AND WE HAVE TALKED
ABOUT BUT THE RESET BUTTON WE
HAV ALSO TALKED ABOUT THE FINES
SO THOSE ARE THINGS THAT WE ARE
WORKING ON. WHAT I WOULD NOTE IS
THAT THE
OPPOSITE?
STRAIGHT TO THE HUNDRED AND
TWENTY FIVE THOUSAND.
AND THAT IS A FIFTH VIOLATION
THE FIRST AND SECOND VIOLATIONS
ARE TWENTY FIVE HUNDRED TO
TWENTY FIVE THOUSAND I WOULD
ALSO JUST SAY THAT THIS BILL
DOES NOT ELIMINATE CITY PEACHES
ABILITY TO INVESTIGATE.
I'M HAVING UNANNOUNCED
INSPECTIONS I THINK ARE
CRITICALLY IMPORTANT ANYBODY CAN
PREPARE FOR AN INSPECTION WHEN
THEY KNOW WHAT'S COMING ALL OF
YOU KNOW THAT I WORK IN THE
LABOR MOVEMENT FOR MANY YEARS
BEFORE I CAME HERE. DIFFERENT
SITUATION I REPRESENT A GROCERY
STORE WORKERS BUT WHEN WE HAD
HEALTH CODE VIOLATIONS REPORTED
TO US WE DID NOT ANNOUNCE WHEN
WE ARE GOING INTO FIND OUT
OTHERWISE WE KNOW THE STORE
WOULD BEEN CLEANED UP AND
EVERYTHING WOULD HAVE BEEN FAR.
I WHEN THE.
OPPOSITION TALKS ABOUT WANTING
TO SEE DEMONSTRATED WILLFULNESS
I WOULD SAY THAT OVER A NINE
YEAR PERIOD OF TIME THERE WERE
SIX HUNDRED AND THIRTY TWO
ALLEGATIONS OF OUT OF FOR ISSUE
DEFICIENCIES. THERE IS SOME
DEMONSTRATED WITH A WILLINGNESS
R. WILLFULNESS THERE BUT SENATOR
ROTH WE ARE ARE WE LOOKING AT
THE THINGS THAT YOU MENTIONED.
AND I HOPE THAT WILL HAVE THEM
ALL ADDRESSED WHEN YOU SEE THE
BILL NEXT TIME WELL I'M MISTER
CHAIR AND I'M NOT CONCERNED I'M
NOT TALKING ABOUT.
I'M GUESSING I AM TALKING ABOUT
WILLFUL BEHAVIOR BUT HAVING.
BEEN A MEMBER OF HOSPITAL BOARDS
OVER THE DECADES.
BUT I WAS A PRIVATE PRACTICE
ATTORNEY I KNOW I HAVE SEEN
SITUATIONS BOWS. WERE I
SUSPECTED THAT THE HOSPITAL
WASN'T BEHAVING ITSELF THE WAY
IT SHOULD BUT ALSO SITUATIONS
WHERE. OF THEIRS IS THAT THERE
ISN'T AN INADVERTENT SITUATION
THAT WAS COMPLETELY OUTSIDE THE
CONTROL OF THE HOSPITAL AND THAT
NEEDS TO BE ADDRESSED HERE I
DON'T KNOW THAT WE'RE TALKING
ABOUT WE'RE TALKING ABOUT
SITUATIONS WHERE.
THROUGH NO
FULL TO THE HOSPITAL THE
HOSPITAL WAS FALLING OF THE
STAFFING RATIO IN THE OUT.
WE NOT
BUT A MED SURGE THE TELEMETRY
WHATEVER THE UNIT IS AND I DON'T
EXPECT TO SEE THE DEPARTMENT.
BUT ASSESSING FINES AND
PENALTIES UNDER THAT
CIRCUMSTANCE AND I DON'T AND AND
WHILE I FULLY SUPPORT STAFFING
RATIOS.
AND THINK THE HOSPITALS NEED TO
GET THE MESSAGE NOW THERE WERE
SERIOUS ABOUT IT.
AND NOT TO PLAY AROUND WITH IT I
DO THINK WE NEED TO BUILD A
LITTLE FLEXIBILITY INTO THIS.
BUT PROCESS
SO THAT HOSPITALS ARE NOT
SPANKED
WHEN THEY DON'T DESERVE TO BE
SPANKED AND THAT'S WHAT I WAS
SAYING AND I DO THANK YOU FOR
WORKING WITH A SIGN THAT THANK
YOU AND THANK YOU MISTER. YOU
HAVE A COMMENT OR QUESTION TO
HIM AT ALL OR NOT.
LOOKING AT. THAT.
OKAY OTHER TERRIFY ME I'M INTO
THE CUP BRIEFLY OKAY VERY
BRIEFLY JUST WANTED TO ADDRESS A
COUPLE THE POINTS THAT YOU
BROUGHT UP.
SPECIFICALLY YOU WERE TALKING A
LITTLE BIT ABOUT THE FINE
SCHEDULE.
WHAT WE'RE SEEING HERE IS
ACTUALLY A LIGHTER VERSION OF
WHAT WE'RE SEEING IN OTHER
SETTINGS FOR EXAMPLE IN THE LONG
TERM CARE SETTING I'M I'M NOT
SPECIFIC ON THE PENALTY AMOUNT
BUT I KNOW FOR THOSE REPEAT?
OFFENDERS AT A CERTAIN POINT.
THE DEPARTMENT WILL JUST REVOKE
THEIR LICENSE AND WE'RE NOT
TRYING TO ESTABLISH SOMETHING
LIKE THAT HERE AND YOU KNOW HAVE
IT BE THAT DRASTIC.
AS WELL.
WHEN THEY YOU KNOW GO TO THE
LONG TERM CARE FACILITY IN THE
SCENE MULTIPLE VIOLATIONS. BILL
ACTUALLY YOU KNOW I'M.
CITE THEM FOR EACH INDIVIDUAL
VIOLATION HERE WE HAVE A
PROVISION.
YOU KNOW WITH AN AMENDMENT
REQUESTED BY I'M THE CHAIR THAT
IT'S ONE VISIT ONE FINE SO THAT
STRUCTURE WERE SETTING UP HERE
IS ACTUALLY MUCH LIGHTER FROM.
IN SETTINGS SPECIFICALLY IN THE
LONG TERM CARE FACILITY.
ALSO YOU MENTIONED A LITTLE BIT
ABOUT HOW YOU KNOW IF NURSES
CALLING LEAD TO OR.
YOU KNOW THEY CALL OUT LAST
MINUTE.
IN TITLE TWENTY TWO IN SECTION
A SEVENTY TWENTY ONE. THREE A
SUBSECTION .
FOR YEARS THE DEPARTMENT IS
SUPPOSED TO HAVE YOU KNOW ON THE
BOOKS SOME SORT OF RAPID
RESPONSE.
OR SOME SORT OF PLAN.
YOU KNOW ON FILE IN THEIR
POLICIES AND PROCEDURES SO THAT
STAFF IS ALWAYS KEPT.
AT THE MINIMUM OF THE RATIOS AT
ALL TIMES.
SO JUST WANTED TO MENTION A
COUPLE OF THE DIFFERENT THINGS
THAT YOU BROUGHT UP IN AND ALSO
YOU YOU MENTIONING EMERGENCY.
INSTANCES THERE IS A IN THE
LANGUAGE IN TITLE TWENTY TWO
REGULATIONS AS WELL WHEN THEIR
EAR WHEN THERE ARE.
EMERGENCIES HAPPENING.
THERE ARE INSTANCES WHERE THE
DEPARTMENT WILL WAVE AND THE
MINIMUMS ARE THAT REACHES EXCUSE
ME MISTER RICHARD ARMEY IS. WELL
LET ME JUST SAY THIS.
I I DON'T BY THE FACT THAT A
HOSPITAL HAS TO BE AND CAN BE
STAFFED AT ALL TIMES TO COVER
ALL CONTINGENCIES THAT OCCUR.
SO IF THAT'S WHAT YOU'RE SAYING
I'LL GET YOUR BILL OUT TODAY BUT
DON'T EXPECT THE SAME RESPONSE
FROM ME ON THE SENATE FLOOR. IF
YOU DON'T ADDRESS THAT ISSUE.
IF THAT'S WHAT YO'RE SAYING NO
THAT'S NOT WHAT WE'RE SAYING
OKAY JUST WANT TO MAKE CLEAR
THANK YOU MISTER MEANS. ANY
OTHER QUESTIONS COMMENTS FROM
ANY OF THE MEMBERS.
SEEN NONE.
I WILL BE SUPPORTING THE BILL
WOULD YOU LIKE TO CLOSE AIR
LEYVA THAT CLASS FOR AN AYE VOTE
IN THE MOTION.
MOVED BY A CENTER PAN ITEM
NUMBER ELEVEN SP ONE. TWO EIGHT
EIGHT TO PASS THE MINUTE
APPROPRIATIONS CALL THE MEMBERS
PLEASEHERNANDEZ AYE HERNANDEZ
AYE WHEN.
LEYVA AYE LEYVA AYE MITCHELL.
MITCHELL AYE MONNING.
MONNING AYE NEWMAN.
NEWMAN AYE NIELSEN.
NIELSEN NO PAN.
AND I'VE BROUGHT. ROTH AYE.
THE CURLY A SEVEN ONE WE HAVE AN
ABSENT MEMBER WILL SIMPLY SAID
BILL AND CALL. BETWEEN YOUR
CHAIR IN WHICH BILL GOING TO GO
TO NUMBER SIX YES.
OUR ITEM NUMBER SIX SP ONE ONE
FIVE SIX LEYVA HEALTH
CARE-SERVICE PLANS THIRD PARTY
PAYMENTS.
AND AGAIN WILL.
WE'RE GONNA BE ALLOWING SIX
MINUTES FOR BOTH SIDES.
VIEWS THE MINUTES HOWEVER YOU
WISH.
AND IF WE GO OVER IN THE SUPPORT
SIDE WILL ALLOW THE OPPOSITION
THE SAME AMOUNT OF TIME.
ALRIGHT THANK YOU MISTER CHAIR
THANK YOU MEMBERS.
SB ELEVEN FIFTY SIX WILL IN THE
PRACTICED WHERE DISHONEST
PROVIDERS TARGET VULNERABLE
PEOPLE WHO ARE SUFFERING FROM
ILLNESSES LIKE KIDNEY DISEASE AN
ADDICTION.
THIS BEHAVIOR DRIVES UP
HEALTHCARE COSTS FOR
CALIFORNIANS AND CAN PUT
PATIENTS HEALTH IN DANGER.
SINCE HE PASSAGE OF THE ACA
CONSUMERS CANNOT BE DENIED
COVERAGE BASED ON A PRE EXISTING
CONDITION. WHICH IS WONDERFUL
THIS IS A TREMENDOUS ADVANCEMENT
FOR CONSUMERS.
HOWEVER THIS PROTECTION CAN ALSO
PROVIDE AN INCENTIVE FOR
DISHONEST PEOPLE TO TAKE
ADVANTAGE OF THE SICK. AYE AND
ROLLING THEM IN COVERAGE THAT
ISN'T IN THEIR BEST INTEREST AS
A MEANS TO MAXIMIZE PROFIT.
IN SOME CASES COVERAGE THE
INDUSTRY GROUPS PUSH ON TO
PATIENTS RESULTS IN HIGHER OUT
OF POCKET COSTS AND LEADS TO
DISRUPTIONS OF CARE. EVEN THOUGH
THE CONSUMER MAY BE ELIGIBLE FOR
A PUBLIC COVERAGE OPTION THAT
BETTER SUITS THEIR NEEDS.
WE'VE HEARD FROM THE PATIENTS
THAT FROM PATIENTS BUT DIALYSIS
CLINICS HAVE TRIED TO PUSH THEM
AWAY FROM SINKING KIDNEY
WHICH IS OFTEN THE RECOMMENDED
COURSE OF TREATMENT.
AND THE PRIMARY ENTITY THAT
SOMEBODY ELSE'S COMPANIES USE TO
PAY PATIENTS PREMIUMS HAS A
DOCUMENTED HISTORY OF CUTTING
OFF PREMIUM PAYMENTS AFTER
TRANSPLANT.
IMAGINE THAT A COMPANY WOULD
ACTUALLY CUT OFF PREMIUM
PAYMENTS JUST WITH THE PATIENT
NEEDS A COVERAGE THE MOST.
BUT CERTAINLY NOT VERY
CHARITABLE.
IN THE CASE OF SOME ADDICTION
CENTERS DISHONEST DRUG TREATMENT
PROVIDERS SEEMINGLY AIMED AT
PATIENTS RELAPSE AND HOPES OF
ONGOING INSURER PAYOUTS.
THIS IS WHY INTRODUCED S. B.
ELEVEN FIFTY SIX.
I UNDERSTAND THE COMPANIES ARE
IN THE BUSINESS OF MAKING A
PROFIT.
BUT THOSE PROFIT MOTIVES SHOULD
NOT COMPROMISE THE HEALTH OF
PATIENTS.
MEMBERS LET ME BE PERFECTLY
CLEAR.
S. B. ELEVEN FIFTY SIX WOULD NOT
PROHIBIT ANY ORGANIZATION FROM
PAYING PREMIUMS ON BEHALF OF ANY
CONSUMER AND CALIFORNIA BUT ME
SAY THAT AGAIN. S. B. ELEVEN
FIFTY SIX WOULD NOT PROHIBIT ANY
ORGANIZATION FROM PAYING
PREMIUMS ON BEHALF OF ANY
CONSUMERS IN CALIFORNIA.
THE BILL WOULD SIMPLY REQUIRE
THAT PROVIDER FUNDED
ORGANIZATIONS FOLLOW DISCLOSURE
REQUIREMENTS CERTIFY THAT
CONSUMERS DON'T HAVE A BETTER
AVAILABLE OPTION. AND REQUIRES
THAT THEY PAY A CONSUMERS
PREMIUMS FOR A FULL PLAN YEAR.
S. B. ELEVEN FIFTY SIX PROTECTS
LEGITIMATE THIRD PARTY PAYERS
BUT TRULY BENEFIT ENROLLEES
REMOVES THE INCENTIVE FOR
UNSCRUPULOUS PROVIDERS TO TAKE
ADVANTAGE OF THE SYSTEM. AND
ESTABLISHES SAFEGUARDS TO RENT
PATIENTS WHO GET CAUGHT IN THE
MIDDLE OF THE SCHEMES AFTER
LOSING COVERAGE
FROM LOSING COVERAGE EXCUSE ME.
I WANT TO THANK THE CHAIR AND
STAFF FOR WORKING ON US
THROUGH THE AMENDMENTS WITH THIS
BILL WE ARE OFFERING AUTHORS
AMENDMENTS TODAY AND THEY DO THE
FOLLOWING.
ALLOW INDIVIDUALS TO RECEIVE
PREMIUM ASSISTANCE FROM FAMILY
MEMBERS.
REMOVE ALL REFERENCES TO COST
SHARING IN THE BILL SO THAT
LEGITIMATE CHARITIES CAN COVER
ANY COST SHARING REQUIRE.
CONSUMERS MAY ENCOUNTER WITHOUT
MEETING ADDITIONAL REQUIREMENTS
SET FORTH IN THE BILL.
ADDRESS AN ISSUE RAISED IN THE
POLICY COMMENTS OPIN ELSE'S THAT
WOULD EXPLICITLY PROHIBIT
ENTITIES FROM STEERING OR
DIRECTING A PATIENT INTO OR
AWAY.
FROM A SPECIFIC HEALTH CARE
OPTION OR HEALTH INSURANCE PLAN.
HERE WITH ME TODAY SHARIF ALI
AND STEPHANIE WATKINS.
THANK YOU PLEASE PROCEED.
GOOD AFTERNOON MY NAME IS SHERRY
FOLLY AND I LIVE IN SACRAMENTO.
IN NINETEEN NINETY NINE MY
KIDNEYS FAILED AND I STARTED
DIALYSIS.
BUT LIKE ALL KIDNEY PATIENTS I
WANTED A KIDNEY TRANSPLANT
INSTEAD OF GOING TO DIALYSIS
CLINICS FOR THE REST OF MY LIFE.
DIALYSIS IS AN EXHAUSTING
PROCESS THAT LEAVES YOU AT RISK
OF BLEEDING OUT OR HAVING YOUR
BLOOD PRESSURE DROPPED
DANGEROUSLY LOW.
SO I GOT ON THE TRANSPLANT LIST.
AFTER SEVEN YEARS OF WAITING I
FINALLY RECEIVED A KIDNEY
TRANSPLANT IN TWENTY ALL SIX.
FROM A YOUNG DECEASED DONOR.
THAT SAME KIDNEY HAS KEPT ME
ALIVE.
AND I'M GRATEFUL THAT I HAVE
NEVER HAD TO GO BACK TO
DIALYSIS.
PART OF THE REASON I HAVE STATE.
HEALTHY IS BECAUSE I HAVE
INSURANCE TO COVER MY ANTI
REJECTION MEDICATION.
EVERY SINCE I GOT MY NEW KIDNEY
MORE THAN ELEVEN YEARS AGO.
I NEED TO TAKE THIRTEEN PILLS
EVERY DAY TO KEEP MY KIDNEY
WORKING.
THE MEDICATION COSTS.
UP TO FIFTEEN THOUSAND DOLLARS A
YEAR.
BUT NOT EVERY KIDNEY TRANSPLANT
PATIENT IS AS FORTUNATE.
IN FACT ACCORDING TO THE MOST
RECENT FIGURES.
OF THE PATIENTS WHO RECEIVE
KIDNEYS.
FROM DISEASE.
DECEASED DONORS MORE THAN ONE
OUT OF EVERY FOR TRANSPLANTS
WILL FAIL IN THE FIRST FIVE
YEARS. AND SIXTEEN PERCENT OF
THOSE TRANSPLANT RECIPIENTS DIVE
THEMSELVES WITHIN FIVE YEARS.
FOR DIALYSIS PATIENTS WHO GET
THEIR HEALTH INSURANCE THROUGH
THE AMERICAN KIDNEY FATHER.
THEY HAVE A LOT MORE QUESTIONS
AFTER GETTING A KIDNEY
TRANSPLANT.
THAT'S BECAUSE THE SOME
INSTANCES ACCORDING TO THE
AMERICAN KIDNEY FUND. OWN POLICY
IT MAY STOP PAIN PATIENTS HEALTH
INSURANCE IN AS LITTLE AS FOUR
MONTHS AFTER THE PATIENT
RECEIVES A TRANSPLANT.
YES THEY DO THAT EVEN THOUGH
PATIENTS ARE STILL AT RISK OF
REJECTING THE TRANSPLANT IN NEED
HEALTH COVERAGE MORE THAN EVER.
AS CREWS THAT SOUNDS.
BUT AMERICAN KEEP ME FUND USED
TO DROP PATIENTS HEALTH COVERAGE
JUST ONE MONTH AFTER THEY GOT A
KIDNEY TRANSPLANT.
AND THEY ONLY CHANGED THEIR
POLICY IN THE LAST YEAR.
SENATE BILL ELEVEN FIFTY SIX
WOULD PREVENT THEM FROM EVER
DOING THAT AGAIN.
THAT'S WHY I URGE YOU TO SUPPORT
SENATE BILL ELEVEN FIFTY SIX.
IT WOULD PROVIDE MORE KIDNEY
TRANSPLANT PATIENTS WITH THE
SAME KIND OF PR RECEIVED.
INCREASE THE CHANCE OF SURVIVAL.
THANK YOU.
SEC NEW WATKINS ON BEHALF OF THE
ASSOCIATION OF CALIFORNIA LIFE
AND HEALTH INSURANCE COMPANIES
FIRST I'D LIKE TO THANK THE
AUTHOR FOR BRING FOR ITS SUCH A
REASONABLE. APPROACH TO ADDRESS
WHAT HAS BECOME A GROWING AND
COSTLY PROBLEM THAT THREATENS
THE VIABILITY INSTABILITY OF THE
INDIVIDUAL HEALTH INSURANCE
MARKET.
I WOULD ALSO LIKE TO SAY THAT
THERE ARE MANY DISEASE GROUPS
AND OTHER NONPROFITS TO DO A
FANTASTIC JOB OF PROVIDING HELP.
TO THOSE STRUGGLING WITH THE
DISEASE OR SUBSTANCE ABUSE
DISORDER BY MAKING THEIR
COVERAGE
MORE AFFORDABLE AND THIS BILL IS
NOT MEANT TO DISCOURAGE THAT
ASSISTANCE IN ANYWAY.
THE AMENDMENTS OFFERED TODAY
FURTHER UNDERSCORE THAT POINT BY
MAKING SURE THAT THEY ARE ABLE
TO CONTINUE TO PROVIDE COPAY AND
CO INSURANCE ASSISTANCE WITHOUT
COMPLYING WITH ANY NEW
REQUIREMENTS.
RATHER THIS BILL'S FOCUSED ON
THOSE NARROW AREAS OF CONCERN
WHERE THERE ARE SOME NOT ALL
TREATMENT CENTERS OR OTHER THIRD
PARTY PAYER SO.
FOR SOME OF THE MOST VULNERABLE
IN OUR POPULATION WHEN THEY HAVE
A FINANCIAL INCENTIVE TO DO SO
THEY DO THIS BECAUSE THEY
BELIEVE THAT THEY WILL EARN MUCH
MOORING CLAIMS PAYMENTS THEY
WILL AND. PAYING PREMIUM
ASSISTANCE
FOR EXAMPLE ONE OF THE PROBLEM
AREAS WE'VE ENCOUNTERED IS FROM
DIALYSIS CENTERS THAT ENCOURAGE
PEOPLE NOT TO SIGN UP FOR
MEDICARE. WHICH IS THEIR RIGHT
IF THEY MEET THE DISABILITY
ELIGIBILITY TO SIGN UP FOR
COMMERCIAL COVERAGE IN THE
INDIVIDUAL MARKET. THEIR THOSE
AFFILIATED WITH THE CENTERS WILL
OFFER TO PARADE PREMIUM
ASSISTANCE TO HELP THEM PAY
THEIR PREMIUMS THAT OUR MORE
THAN THEY WOULD BE PAYING UNDER
MEDICARE.
THE DIFFERENCE IN WHAT THOSE
PROVIDERS GET PAID BY SHIFTING
MEDICARE ELIGIBLE PERSONS TO THE
PRIVATE COMMERCIAL MARKET TELLS
ITS OWN STORY.
TYPICALLY A DIALYSIS CLAIMS
SUBMITTED TO PRIVATE INSURERS
WILL BE AS MUCH AS THREE TIMES
WHAT IS PAID BY MEDICARE.
WHEN YOU MULTIPLY THAT BY THREE
TREATMENTS A WEEK FOR MOST END
STAGE RENAL PATIENTS THE COST
GETS STAGGERING. IMPACT ON THE
REST OF THE PREMIUM PAYERS IN
THE INDIVIDUAL MARKET HAVING TO
PICK UP THE COSTS FOR SERVICES
THAT ARE ALREADY COVERED BY
MEDICARE IS OBVIOUS NEEDS TO BE
ADDRESSED.
ANOTHER AREA OF CONCERN WAS THE
SUBJECT OF AN INFORMATIONAL
HEARING BY THIS COMMITTEE IN
JANUARY REGARDING SUBSTANCE
ABUSE TREATMENT CENTERS.
WE HEARD EARLIER TODAY SEVERAL
OTHER BILLS DEALING IN THE SPACE
ABOUT BODY BROKERING PEOPLE
DOING ONE EIGHT HUNDRED NUMBERS
AND PLACING PEOPLE IN TREATMENT
FACILITIES FR WHICH THEY'RE NOT
RECEIVING REAL AND TRUE
SERVICES.
AB
THIS IS ALL PART OF THAT SAME
KIND OF MANIPULATION SERVICE TO
RECEIVE HIGHER PREMIUM PAYERS BY
PUTTING PEOPLE ON COMMERCIAL
PRODUCTS THAT THEY DON'T KNOW
THEY HAVE. AND THEN FILLING
FRANK CREDIBLY COSTLY AMOUNTS
THIS AFFECTS THE INDIVIDUAL
MARKET WHICH IS ALREADY A VERY
VULNERABLE MARKET PLACE WE HAVE
ABOUT TWO POINT FIVE MILLION
PEOPLE. AS WE'VE SEEN THE
STABILITY AND THE NEED TO
CONTINUE TO ADDRESS ON THIS
IMPORTANT PIECE OF THE
HEALTHCARE MARKETPLACE WE THINK
THAT THIS THIS BILL TAKES US IN
THE RIGHT DIRECTION TO HELP
PREVENT AGAINST. POTENTIAL FRAUD
AND ABUSE IN THAT SYSTEM AND FOR
THAT REASON WE ASK FOR AN AYE
VOTE. THANK YOU.
GOOD AFTERNOON GOING BACK IS FOR
DRUG POLICY ALLIANCE PROPOSED
ALLIANCE IS A NATIONAL NONPROFIT
WORKING AND THE DRUG WAR AND
REPLACE IT WITH POLICIES BASED
ON SCIENCE HEALTH COMPASSION AND
HUMAN RIGHTS.
IN TWO THOUSAND RC FOR PARTNER
WAS THE DRIVING FORCE BEHIND
PROP THIRTY SIX TREATMENT
INSTEAD OF INCARCERATION FOR THE
PEOPLE WHO ARE CONVICTED FOR THE
FIRST TWO TIMES OF POSSESSION.
OF A CONTROLLED SUBSTANCE
AND IN THE ACT THAT WAS A
HUNDRED AND TWENTY MILLION
DOLLARS A YEAR IN INVESTMENT. IN
DRUG TREATMENT IN THE STATE OF
CALIFORNIA WHICH CONTINUED INTO
THE SCHWARZENEGGER
ADMINISTRATION THAN DOWNTURN
ECONOMY THAT FUNDING WENT AWAY.
IN TWENTY SIXTEEN RC FOR PARTNER
WAS ONE OF THE DRAFTERS IN
DRIVING FORCES BEHIND PROP
THIRTY SIX ATARI PROP SIXTY
FOUR.
TO REGULATE AND TAX CANNABIS IN
CALIFORNIA.
THE LEGISLATIVE ANALYST'S OFFICE
ESTIMATES THAT WITHIN A FEW
YEARS IT WILL GENERATE A BILLION
DOLLARS A YEAR IN THE STATE
REVENUE.
AND PURSUANT TO THE ACT.
HUNDREDS OF MILLIONS OF THOSE
DOLLARS WILL BE DEDICATED.
THE PREVENTION AND TREATMENT.
OF SUBSTANCE USE DISORDERS
AMONGST DRUG PEOPLE YOUNG
PEOPLE.
IT TO THE OTHER ONE WHEN I WAS
WORKING ON IMPLEMENTATION THIRTY
SIX TREATMENTS OF ACCULTURATION
THEY BECAME PALEO PAINFULLY
AWARE HOW LIMITED. THE STATE
REGULATORS WERE IN THEIR POWERS
TO CONTROL.
SOME BAD ACTORS WITHIN THE
SUBSTANCE USE SERVICES AREA.
AND THOSE PROBLEMS WERE
EXACERBATED WHEN SOME LOCAL
GOVERNMENTS WOULDN'T SUPPORT THE
GOLD STANDARD FOR AIR WHEN
OPIOID TREATMENT WHICH IS AT
THAT TIME METHADONE. AND KNOWING
CONTINUES TO BE. MEDICARE
MEDICATIONS IS IT TREATMENT.
SO FOR THOSE OF US WHO ARE
CONCERNED WITH THE WELL BEING OF
PEOPLE SUFFERING PERCEPTS FROM
SUBSTANCE USE DISORDERS. WE
WORKED HARD TO SEE THAT SEVENTH
USES ORDERS WERE INCLUDED. IN
THE AMERICAN IN THE A. C. A..
AND IN CALIFORNIA'S MEDI CAL.
NOW THERE IS CLEAR THAT THERE IS
A PATTERN OF ABUSE TAKEN VENDOR
THE ACA. INVOLVING FOR PROPER
RECRUITERS IN FOR PROFIT
COMPANIES WHOSE SOLE INTEREST
SEEM TO BE RUNNING UP HIGH
BILLS.
THEY'RE PAID FOR BY TAXPAYERS
AND POLICY HOLDERS
WE WANT TO SUPPORT CENTER LEYVA
HIS EFFORTS.
TO REMOVE THAT PROFIT.
MOTIVE TO KICK
PATIENTS TO THE CURB LITERALLY
KICK PATIENTS TO THE CURRENT.
ENDING UP IN HOMELESSNESS.
WE SUPPORT THE EFFORT TO MAKE
SURE THAT PEOPLE'S INSURANCE IS
PAID FOR A YEAR WE CAN ADDRESS
THEIR SUBSTANCE USE DISORDERS
THAT MENTAL HEALTH ISSUES. OTHER
MEDICAL ISSUES.
AND PREVENT. UNSAFE DISCHARGE OF
PATIENTS WHO NEED HOUSING AND
HEALTHCARE.
FOR THESE REASONS WE SUPPORT
THIS BILL THANK YOU THANK YOU
ARMED ANYONE ELSE OVER HERE YOU
CAN JUST STATE YOUR NAME AND
POSITION ONLY.
WELL SORRY THEIR MISTER CHAIR
AND MEMBERS TIM VALDERRAMA WHAT
THE WHITEMAN GROUP ON BEHALF OF
SEIU STATE COUNCIL IN SUPPORT
I'M JOHN BY AND JOINED BY JOHN
ALLEN WHO IS. WITH THAT CA YOU
YOU HW WHO'S HERE TO ANSWER
TECHNICAL QUESTIONS IF NECESSARY
THANK YOU.
BEGIN NAME POSITION UP PLEASE.
I AM SIMPLY DOING.
CERTIFIED CLINICAL HUMAN THEIR
HOUSES TECHNICIAN TWENTY TWO
YEARS EXPERIENCE A SEVENTEEN
WOULD FOR SERIOUS AND.
TWELVE I EIGHTEEN YEARS WITH
EIGHTEEN YEARS A PERSON ISN'T
SOMETHING WITH THE VETO. I
STRONGLY SUPPORT THIS BILL.
AS OUR BOSSY BOUNCES WORKER I
STRONGLY SUPPORT THIS BILL.
HI M. EW BARRIO I'M A REGISTERED
NURSE AND WORKS AT THE VITA AND
FOR SENIORS IN OUR SOUTHERN
CALIFORNIA.
AND I STRONGLY SUPPORT THESE
WITH.
WHILE THE OTHER DO NOT ARMY
SUPPORT OF THIS BILL THEY
OPPOSITE WORKER.
VERONICA LA GORDA I'M FROM LONG
BEACH CALIFORNIA I'M THAT I
INSIST ACNE CHEN FOR ELEVEN
YEARS AYE SOME OR IF THEY'LL.
BECAUSE THE PART OF WITH BLUE
SHIELD OF CALIFORNIA AND STRONG
SUPPORT.
THREE START WITH KAISER
PERMANENTE ALSO IN SUPPORT.
JOHN LINGER ON BEHALF AMERICA'S
HEALTH INSURANCE PLANS FOR.
AN EX IN BEHALF CALIFORNIA LANCE
START AMERICANS FROM SPORT.
ORDINANCE DIA ó WAS SACRAMENTO
THAT'S IS THAT MISSION NINE
YEARS.
I SUPPORT.
MANY GONZALEZ DIALYSIS
TECHNICIAN DE VITA AND FOR
SICKNESS TWENTY YEARS I STRONGLY
SUPPORT THIS BILL.
U. MENU GONZALEZ DOUSES WERE
GREAT CENTA VALLEY HOSPITAL
WEST COVINA AND.
FOR SENIORS CAN OCCUR FONTANA
MY STRONG SUPPORT THIS BILL.
RICHARD ELLIOT. I SUPPORT THIS
BILL NOT BEEN A PATIENT FOR
FOURTEEN YEARS.
DIAL.
MARTIN JACKSON.
FORMER NURSE WROTE COMMUNITY
MEMBER OF SG I YOU KNOW HEALTH
WORKERS.
VIETNAM ERA VETERAN I STRONGLY
SUPPORT THIS BILL THANK YOU.
I.
YOU NUMBERS BECAUSE I MIGHT BE
AMISS.
SO BY THE BUS HIM VERY VERY
RARELY SEES IEP OIL REALLY THANK
YOU.
SERVE LOCKS CALIFORNIA LABOR
FEDERATION IN SUPPORT.
SHERRI DELUDE CALIFORNIA
CONSORTIUM OF ADDICTION PROGRAMS
AND PROFESSIONALS THANK YOU FOR
YOUR LEADERSHIP IN THIS AREA IN
SUPPORT.
WE PLEASES CALIFORNIA
ASSOCIATION OF HEALTH PLANS IN
SUPPORT.
CAN ANYONE ELSE IN SUPPORT WE
HAVE OPPOSITION NOW.
COMPANY.
I AM STEPHANIE RECEIVE NO AND
I'M JUST A CITIZEN. AND I HAVE
FOUR REASONS WHY I'M SO HUGELY
OPPOSED TO THIS BILL.
ONE YOU'RE CHOOSING A GROUP.
TWO DISCRIMINATED AGAINST.
TO AN OLD.
AN OLD THE.
VALUE OF AMERICA.
AND MORE WAS TO BE CHARITABLE SO
YOU'RE TELLING THE CHARITY THAT
PROVIDED A SOLUTION FOR ALL
THESE YEARS FOR SEVERAL PEOPLE.
FORGET YOU. THAT'S WRONG.
MY SON.
I LEARNED A LOT ABOUT KIDNEY
TRANSPLANT MY SON WAS A DONOR.
AND IT'S KIND OF LIKE A SLAP IN
THE FACE TOLD THE DONORS BECAUSE
WE HAVE.
A VESTED INTEREST TO.
AND
BUT THE GUY WHO GOT MY SONS LEFT
KIDNEY. HE FINDS OUT THAT HIS
INSURANCE FROM THE CARPENTERS
UNION ONLY COVERED THREE MONTHS.
OF ANTI REJECTION DRUGS AND THAT
WAS UNKNOWN SO CHARITIES ARE
COMING TO HIS RESCUE LIKE THE
ROTARY.
.
AND WHY WOULD YOU CHOOSE TO
DISCRIMINATE.
DOESN'T APPLY TO ME I'M OF THE A
PATIENT.
AS YOU CAN SEE THIS IS A BOLD
BECAUSE OF AN ILEOSTOMY THIS
WHOLE WAS A COLOSTOMY THIS WHOLE
THIS WHOLE THIS WHOLE THIS
WHOLE.
WAS PART ABOUT SURGERY FROM THE
VA.
I SPENT TO MUCH OF THE HOSPITAL
JANUARY FEBRUARY WE'RE SUPPOSED
TO BE WEAK BECAUSE THEY GAVE ME
FREE INFECTIONS.
SO I LEARNED AN AWFUL LOT.
FOR THE LAST THREE YEARS BE IN
AND OUT OF THE HOSPITAL FROM.
BUT YOU SAY MEDICAL PROBLEMS.
SO I KNOW WHAT MANAGE CARE CAN
DO WHAT NO CARE CAN DO.
ALL BE DEAD SOON ENOUGH BECAUSE
OF IT.
WHAT I'M SAYING IS WHY DO YOU
CHOOSE TO DISCRIMINATE PEOPLE
WHO WILL SUFFER THE MOST WHO ARE
THE MOST VULNERABLE?
TO ME THAT'S AN UMBRIDGE.
OR AMERICAN AND WE BELIEVE IN
CHARITY IF YOU CAN HELP SOMEBODY
HELP ON.
I DON'T CHIU SOMEONE TO
DISCRIMINATE AGAINST NO MATTER
WHAT THEIR NEEDS ARE WASN'T
THEIR FAULT THEIR KIDNEY FAILED.
WHAT'S WRONG WITH GIVEN A
HELPING HAND THAT'S WHAT AMERICA
IS ABOUT. NOT DISCRIMINATION
MAYBE SOMEBODY SHOULD SUE FOR
CIVIL RIGHTS VIOLATION.
BUT JUST REMEMBER TO THE DONORS.
I I GOT TO MEET THE GUY GOT MY
SONS LEFT KIDNEY AND HE WAS ON
DIALYSIS AND EXPLAINED HE WAS
READY TO GIVE UP.
.
AND I KNOW IT'S PAINFUL I KNOW
IT'S LONG PROCESS I KNOW IT'S
EXPENSIVE.
BUT WE HELP EACH OTHER OUT.
DON'T DISCRIMINATE AND THANK YOU
FOR THE TIME YOU THINK YOU SO
WE'RE GONNA MOVE UP HERE TO THE
FRONT WE HAVE A TOTAL OF EIGHT
MINUTES WE'VE ALREADY BEEN
COUNTING SO PLEASE.
UPLAND CALIFORNIA.
IT'S WORKING OKAY.
AND THANK YOU FOR HAVING ME HERE
TODAY FOR A I SPENT MOST OF MY
CAREER. AS A REGISTERED NURSE.
AND IS A KIDNEY TRANSPLANT
COORDINATOR.
FOR MANY YEARS I HELPED CONNECT
OTHERS.
TO LIFESAVING TREATMENTS.
BUT ALSO KNOW WHAT IT'S LIKE TO
BE ON THE OTHER SIDE.
I'M SORRY LEGALLY BLIND SO IT'S
HARD FOR ME TO READ THIS.
WITH MORE THAN NINETY ONE
THOUSAND CALIFORNIANS LIVING
WITH KIDNEY FAILURE.
ALSO NOTICE AND STAGE RENAL
DISEASE OR ESRD.
IN NINETEEN NINETY SIX I
RECEIVED A KIDNEY AND PANCREAS
TRANSPLANT.
WITH MIKE IN THE BUT MY KIDNEYS.
STOPPED FOR DIABETES WHEN I WAS
VERY YOUNG.
AND THEN IN TWENTY FOURTEEN I
LOST A KIDNEY TRANSPLANT.
A WE'RE NOT SURE WHY THAT FAILED
BUT IT IT HAD EIGHTEEN YEARS ON
IT.
I BEGAN DIALYSIS FOR FOUR HOURS
A DAY THREE DAYS A WEEK.
TO FILTER OUT THE TOXINS FROM
MY.
BODY ASKEW'S MOVE MY BODY.
NEEDLESS TO SAY IT'S A GRUELING
TREATMENTS.
SO HORRIBLE PROCEDURE.
AND MY ONLY CHANCE TO STAY
ALIVE.
DUE TO MY DIALYSIS Y. LAS MY JOB
AS A NURSE.
MY INSURANCE PREMIUMS WENT WHILE
I WAS STILL WORKING.
FROM ABOUT THREE HUNDRED DOLLARS
A MONTH
TWELVE HUNDRED DOLLARS A MONTH
ON COBRA.
SO I WAS STRUGGLING TO MAKE ENDS
MEET.
AND IT SOON BECAME CLEAR I WAS
GOING TO LOSE MY HOUSE.
BUT. A I FOUND OUT ABOUT THE
AMERICAN KIDNEY FUND.
AND THERE A NONPROFIT THAT
PROVIDES PREMIUM ASSISTANCE
INSURANCE PREMIUM ASSISTANCE.
TO NEARLY FOUR THOUSAND
CALIFORNIANS.
IT'S SAVED MY LIFE NEEDLESS TO
SAY.
HOME.
I HAVE SINCE HAD A SECOND KIDNEY
TRANSPLANT.
AND I WANT TO THANK.
REALLY THE A CHAOS BECAUSE IT
WAS BECAUSE OF THEIR.
THEIR INSURANCE COVERAGE SO I
WAS ABLE TO.
NO LONGER BE ON DIALYSIS AND
GET A KIDNEY TRANSPLANT.
A CHAOS HEALTH INSURANCE PREMIUM
PROGRAM OTHERWISE KNOWN AS HIP.
HELP ME TO COVER MY.
MY MONTHLY INSURANCE PREMIUMS
WHILE I WAS ON DIALYSIS FOR
ABOUT A YEAR AND A HALF.
THE SUPPORT KEPT.
MOUNTING MEDICAL BILLS.
FROM DIALYSIS MY MEDICATIONS
BECAUSE I STILL HAD A WORKING
TRANSPLANT IN MY PANCREAS.
AND.
SURGERIES I HAD LOTS OF THOSE
TWO AND MANY TREATMENTS.
A. MORE MANAGEABLE.
I NO LONGER HAD TO FOCUS ON.
MAKING ENDS MEET.
AND TO WORRY ABOUT LOSING MY
HOME.
I WAS ABLE TO FOCUS ON MY
HEALTH.
HELLO.
YEAH I WAS VERY SAD AND.
EVEN SHOCKED TO HEAR.
OF THAT INSURANCE COMPANIES
ACROSS THE NATION INCLUDING HERE
IN CALIFORNIA.
ARE TRYING TO DEPRIVE ESRD
PATIENTS.
OF CHARITABLE ASSISTANCE TO PAY
FOR THEIR HEALTH INSURANCE
PAYMENTS.
I AM TRULY.
TRULY TERRIFIED.
OF OF WHAT COULD HAPPEN.
BECAUSE OF THE POSSIBILITY THAT
THE CALIFORNIA STATE SENATE
MIGHT PASS.
S. B. ELEVEN FIFTY SIX.
IN SOME CASES MAKE IT IMPOSSIBLE
FOR SOME DIALYSIS AND TRANSPLANT
PATIENTS.
TO USE CHARITABLE IT ASSISTANCE
PROGRAMS TO COVER THEIR MEDICAL
COSTS.
BECAUSE I'D DO NOT QUALIFY FOR
MEDI CAL.
A CHARITABLE ASSISTANCE WAS
TRULY MY SAFETY NET.
A NOT.
SORRY.
A TO BE CLEAR. IT IS NOT A CHEAP
HENCE.
A.
IT'S NOT A CHOICE FOR ME BECAUSE
I DIDN'T QUALIFY FOR ANY KIND OF
MEDIGAP.
AND I DIDN'T QUALIFY FOR MEDI
CAL. BASED ON MY SO SECURITY.
AND.
HAVE TO SEE RAM STARTUP THAT.
BOTH.
AND THE LAST THING ANYONE IN
DIALYSIS TREATMENT NEEDS.
IS MORE OBSTACLES TO LIFESAVING
CARE.
AND PLEASE MAKE NO MISTAKE.
AND I KNOW THIS IS A TRANSPLANT
COORDINATOR OR PREVIOUS ONE
ANYWAY.
THAT WITHOUT GOOD HEALTH CARE
COVERAGE INCLUDING MEDI GAP
WHICH WE KNOW DOESN'T APPLY.
TO THE MAJORITY OF PATIENTS ON
WAITING LISTS WHO ARE UNDER
SIXTY FIVE.
IT IS MERE NEARLY IMPOSSIBLE FOR
ANYBODY WITH ESRD TO GET A
TRANSPLANT.
PLEASE DO NOT SUPPORT S. B.
FIFTY SIX
HE BAR ACCESS.
DEEPER ACCESS TO CHARITABLE
PREMIUM.
ASSISTANCE SAFE.
PHONE I'M.
DIALYSIS PATIENTS.
AND I STILL THINK OF MYSELF AS
ONE OF THE DIALYSIS PATIENTS
BECAUSE I LEFT THEM BEHIND.
I AM VERY.
THEY DON'T HAVE MANY OPTIONS.
AND SO TO COVER THEIR MEDICAL
BILLS.
AND SAW CHARITABLE ASSISTANCE
PROGRAMS CAN HELP SAVE. US FROM
BEING. FROM LOSING OUR COVERAGE.
OF ENDING UP HOMELESS OR EVEN
DEATH.
I AM REALLY FORTUNATE.
TWO HAVE MADE IT OUT OF MY
DIALYSIS UNIT ALIVE.
TRULIA.
AND.
BUT THAT IS ONLY.
BECAUSE OF THE INSURANCE
PREMIUM PROGRAM.
BEING ON DIALYSIS.
ROB IS A PATIENT OF SO MUCH.
I COULD GO ON ALL DAY ABOUT THAT
PART BUT IT WON'T.
AND PLEASE DON'T AND THE HEALTH
INSURANCE COVERAGE.
I MEAN DON'T MAKE UP PART OF
THEIR PROBLEMS.
CHARITABLE PREMIUM ASSISTANCE
GAVE ME MY HUMANITY BACK
PLEASE DON'T TAKE THAT AWAY.
THANK YOU.
IT TO WHERE AT EIGHT MINUTES.
THING I LIKE TO GO AHEAD AND
MAKE A BRIEF STATEMENT PLEASE DO
SO. I WOULD LIKE TO MYNAME IS
MELANIE CON I'M WITH THE
AMERICAN KIDNEY FUNDED AND ON
BEHALF OF THE THOUSANDS OF
PATIENTS THAT WE SERVE HERE IN
CALIFORNIA. THANK YOU FOR GIVING
US THE OPPORTUNITY TO SPEAK WITH
YOU TODAY.
I WOULD LIKE TO TO START BY
DISPELLING SOME MYTHS AROUND THE
AMERICAN KIDNEY FUNDS WHO WE ARE
AND WHAT WE
YOU.
WE ARE AN INDEPENDENT FIVE OH
ONE C. THREE NON PROFIT
ORGANIZATION THAT HAS RECEIVED
SOME OF THE HIGHEST RATINGS FROM
THE PREMIERE CHARITY WATCHDOG
AGENCIES IN THIS COUNTRY
CONSISTENTLY.
WE ARE NOT A DIALYSIS PROVIDER.
IN CALIFORNIA WE HAVE
COMPREHENSIVE PROGRAMS TO HELP
PEOPLE WITH KIDNEY DISEASE THIS
INCLUDES EDUCATION PROGRAMS FOR
EXAMPLE COMING UP. IN SAN JOSE
WE HAVE A FREE SCREENING.
WE FUNDS CLINICAL RESEARCH
INCLUDING SEVERAL OF THE MOST
PROMINENT CLINICAL NEPHROLOGIST
AT U. S. AT UCSF THAT HAVE BEEN
FUNDED BY A CHAOS.
AND WE HAVE FINANCIAL ASSISTANCE
PROGRAMS THAT HELP DISASTER
VICTIMS MOST RECENTLY HERE IN
CALIFORNIA THAT INCLUDED VICTIMS
OF THE CALIFORNIA WILDFIRES.
IN CALIFORNIA LAST YEAR WE
HELPED MORE THAN THIRTY EIGHT
HUNDRED DIALYSIS PATIENTS PAY
THEIR HEALTH INSURANCE PREMIUMS.
JUST UNDER HALF OF THOSE WERE
GRANTS FOR MEDICARE MEDIGAP OR
MEDICARE ADVANTAGE.
AND THIRTY FIVE PERCENT WERE FOR
EMPLOYER PROVIDED PLANS THE
REMAINING GRANTS THE MINORITY OF
THE GRANTS THAT WE PROVIDED WERE
FOR PRIVATE COMMERCIAL PLANTS.
I ALSO WANT TO DISPEL THE MYTH
ABOUT HOW OUR PREMIUM PROGRAM
OPERATES.
WE HELP DIALYSIS TRANCE
TRANSPLANT PATIENTS.
FOLLOWING THEIR TRANSPLANT FOR
THE FOLD POLICY YEAR.
HERE'S OUR ISSUE AND OUR
CONCERNS WITH THIS BILL IT IS
TWO FOLD.
THE FIRST IS THAT HKS.
CAN ABSOLUTELY MEET THEIR
DISCLOSURE REQUIREMENTS OF THIS
BILL.
THAT'S NOT THE ISSUE THE ISSUE
IS THAT THIS BILL ALLOWS
INSURANCE COMPANIES DESPITE BE
INFORMATION THAT WE PROVIDE TO
THEM TO DISTILL TO STILL DIRE
PAYMENTS.
AND INSURANCE HAD INTENDED TO
USE THIS EXACT SAME TACTIC OF
HAVING A K. F..
PLUS I TO SUBMIT PAYMENTS IN
ANOTHER STATE FOR EXAMPLE. AND
HAVE DENIED US REPEATEDLY
DESPITE OUR GOOD FAITH EFFORTS
TO SUPPLY THEM WITH THIS
DETAILED TRANSPARENT INFORMATION
ABOUT OUR WHERE PROGRAM.
BILL CODIFIES CHERRY PICKING OF
PATIENTS TO ENSURE THAT
EXPENSIVE PATIENTS WITH CHRONIC
DISEASES I REALLY DO BELIEVE
THAT IT IS
NAIVE TO ASSUME. THAT THEY ARE
GOING TO STOP WITH ESRD PATIENTS
WHAT OTHER CHRONIC DISEASE
PATIENTS ARE COMING NEXT.
OUR SECOND ISSUE WITH THIS BILL
OUR BIG CONCERN IS THAT THIS
BILL TAKES AWAY THE DIGNITY. OF
A PATIENT TO DETERMINE WHAT
HEALTH INSURANCE PLAN BEST MEETS
HIS OR HER INDIVIDUAL HEALTH
CARE NEEDS.
FOR EXAMPLE THOUGH MOST YEARS RD
PATIENTS DO QUALIFY FOR MEDICARE
REGARDLESS OF THEIR AGE IN
CALIFORNIA WE HAVE THIS SPECIFIC
CARVE OUT FOR ESRD PATIENTS. WHO
ARE UNDER SIXTY FIVE YEARS OLD?
THIS IS A PROBLEM FIFTY THREE
PERCENT THE MAJORITY OF THE
DIALYSIS PATIENTS IN CALIFORNIA
ARE UNDER SIXTY FIVE. MEDICARE
ONLY COVERS TWENTY PERCENT.
BY FORCING PATIENTS TO BE ON
MEDICARE.
THIS.
IT LEAVES THEM RESPONSIBLE FOR
THAT TWENTY PERCENT DIFFERENCE
AND IT COULD MEAN FINANCIAL RUIN
TO MANY OF OUR PATIENTS
INCLUDING LOWER HERE.
I JUST LIKE TO END BY ADDRESSING
STEERING.
I KNOW THIS IS.
IT CONCERN FOR ALL OF THE
MEMBERS OF THIS COMMITTEE SO LET
ME BE VERY CLEAR ABOUT WHAT A
CHAOS POSITION IS ON THE S..
WE ONE HUNDRED PERCENT.
OPPOSE THE STEERING OF ANY
PATIENTS.
INTO A PLAN THAT DOES NOT MEET
HIS OR HER HEALTH CARE NEEDS WE
FIRMLY BELIEVE THAT IT SHOULD BE
UP TO THE PATIENT.
AND THE PATIENT ALONE TO
DETERMINE WHAT'S INSURANCE IS
GOING TO BEST MEET THEIR
HEALTHCARE NEEDS.
IF THIS BILL IS PASSED INTO LAW
IN ITS CURRENT FORM.
THE PATIENTS WE SERVE WILL BE
HARMS.
AND FOR ALL OF THESE REASONS WE
STRONGLY ENCOURAGE YOU TO VOTE
NO ON THIS BILL. THANK YOU WE
WENT WELL OVER THE ALLOTTED TIME
FOR BOTH SIDES.
FINANCE THOSE ON THE SITE ONLY
STATE YOUR NAME AND POSITION. IS
WE WENT OVER BUYING.
I FOUR MINUTES I WILL ALLOW THE
PROPONENTS OF A WISH TO COME UP.
AND GIVE SOME ADDITIONAL
TESTIMONY BEFORE WE OPEN UP ANY
QUESTIONS TO ANY OF THE MEMBERS.
WITH THAT.
I MEAN SUPPORTERS I'M SORRY
SUPPORT FOR THOSE OF YOU ARE
ALONG THE WALL OF HEAT PLEASE
STATE YOUR NAME AND POSITION.
RICHARD MURPHY AND I AM OPPOSED
TO THIS BILL
THANK YOU.
UNDER MENDOZA AND I'M OPPOSED.
BRIAN GARDINER RESPECTFULLY
OPPOSED.
COUSIN HAMMER RESPECTFULLY
OPPOSED.
CHRISTIAN JOSH OPPOSED.
PUBLIC TORTILLA DIALS'S PATIENT
I STRONGLY OPPOSE.
MICHAEL ARNOLD PURPOSING THE
CALIFORNIA DIALYSIS COUNCIL.
THIS BILL IS REALLY GOING TO
HARM DIALYSIS PATIENTS WE'VE
HEARD A LOT FROM OUR SOCIAL
WORKERS.
AND TO IT'S GONNA HURT HIS HURT
THE PATIENT ENOUGH THANK YOU.
KATHERINE ALSO GOT A CALIFORNIA
HOSPITAL ASSOCIATION OF ACRE LOT
ARTICULATE OUR CONCERNS RELATE
THE THIRD PARTY PAYMENTS
THINKING.
SO LIKE TO ASK THE.
SUPPORTERS OF THE BILL IF YOU
FEEL LIKE COME UP FAN.
MAKE A LITTLE MORE TESTIMONY OR
NOT. OKAY SO WITH THAT YOU KNOW
WITH THAT WE WILL OUR ASK
QUESTIONS OF THE MEMBERS SENATE
ROTH.
IT'S MY QUESTION IS FOR THE IS
FOR A KID IF THE KIDNEY
FOUNDATION.
HAS THERE BEEN A SHIFT OVER THE
YEARS.
.
WERE YOU.
PREVIOUSLY PAID FOR THE TWENTY
PERCENT GAP COVERED THAT TEN
RELATED.
DEDUCTIBLES AND CO PAYS TOWARD
COVERING THE FULL PREMIUM FOR
COMMERCIAL INSURANCE AND IF SO
WHY.
THERE HAS NOT BEEN A SHIFT
WHATEVER INSURANCE PRODUCT OUR
PATIENTS COME TO US HAVING
ALREADY CHOSEN. IS WHAT WE COVER
TO BE SURE THE MAJORITY OF THE
PATIENTS THAT WE COVER IN OUR
HIT PROGRAM ARE ON GOVERNMENT
PLANS. AND IF THEY CHOOSE WE
WILL COVER THEIR MEDIGAP
COVERAGE.
THANK YOU THANK YOU PREMATURE.
SKIP.
IF THEY WERE TO GO WITH CENTER
NIELSEN DANCER NEWMAN ST ISN'T.
THIS KIND YOU HAD MENTIONED OF
THE CONCERN.
OF THE KIDNEY FUND AND.
I HAVE HIGH REGARD FOR THE
KIDNEY FUND AND.
SURE YOU DO WONDERFUL WORK.
BUT I SPEAK FROM THE PERSPECTIVE
OF SOMEONE WHO'S HAD LIVE THIS
FOR MANY YEARS WITH ONE MY VERY
VERY VALUED STAFF.
MEMBERS.
AND THAT KIND OF SETS THE
CONTEXT.
NOW.
IN THE PROVISIONS OF THE BILL.
WHAT? HERE IT WOULD BE SUCH A
DISCOURAGING THING THAT CAUSE
YOU TO.
BUT GIVING.
PREMIUM ASSISTANCE.
AND ONE OF THEM YOU BODIES SAID.
IS NOT A PROBLEM.
YOU GONNA COVER FOR ONE YEAR
CORRECT.
FEDERAL THE PROVISIONS ARE SO
ONEROUS.
THAT IS REALLY GOING TO BE
JEOPARDIZING YOUR ABILITY TO BE
HELPFUL.
SURE IT'S NOT AN ISSUE OF THE
PROVISIONS THEMSELVES THE ISSUE
IS PUTTING THE POWER IN THE
HANDS OF THE INSURANCE
COMPANIES.
TO DETERMINE DESPITE ALL OF THE
INFORMATION THAT WE PROVIDE TO
THEM THAT WE ARE NOT AN ELIGIBLE
THIRD PARTY PAYER AND THAT HAS
BEEN THE POSTURE. INCLUDING OF
INSURANCE COMPANIES HERE IN
CALIFORNIA AND ACROSS THE
COUNTRY SO OUR BIG CONCERN
REVOLVES AROUND PUTTING THIS
KIND OF CONTROL. IN THE HANDS OF
INSURANCE COMPANIES AND SOLELY
IN THE HANDS OF INSURANCE
COMPANIES. AND YOU KNOW. OTHER
STATES HAVE TAKEN ON THIS ISSUE
THROUGH THEIR DEPARTMENTS OF
INSURANCE AND COMMISSIONERS HAVE
PASSED BULLETINS AND DIRECTIVES
THAT TAKE THIS FROM THE REVERSE
ANGLE BECAUSE THEY SAW.
SO MANY PATIENTS LOSING THEIR
INSURANCE COVERAGE.
BECAUSE OF INSURANCE COMPANIES
REJECTING OUR PAYMENTS SAID THEY
HAVE TAKEN ACTION IN THE REVERSE
WAY TO ISSUE BULLETINS AND
DIRECTIVES AND OTHER REGULATORY
GUIDELINES TO ENSURE. THAT
PROVIDED CERTAIN QUALIFICATIONS
ARE MET
CERTAIN GUARD RAILS ARE MATT
WHICH WE FULLY UNDERSTAND THE TO
BE IN PLACE.
THAT INSURANCE COMPANIES WOULD
BE REQUIRED TO TAKE OUR PAYMENTS
NOT THE REVERSE.
IT'S JUST SO ONLY A A TURF
BATTLE COULD YOU THE ONLY ONES
UP HERE. TESTIFYING.
ARE THERE OTHER ENTITIES
SIMILARLY PLACED AS YOU AND IF
SO WHY ARE THEY HERE TO.
I.
I I I REALLY CAN'T SPECULATE. AS
TO THE MOTIVES OF THE PROPONENTS
OF THIS BILL BUT IT IS CERTAINLY
QUESTIONABLE AS TO WHY KIDNEY
PATIENTS ARE THE ONES BEING
TARGETED. THESE ARE PATIENTS WHO
ARE PREDOMINANTLY MINORITY AND
LOW INCOME AND NO OTHER CHRONIC
DISEASE IS BEING TARGETED IN
THIS MANNER.
MISTER CHAIR UNDER NIELSEN IF I
MAY ABOUT THIS BILL ABSOLUTELY
DOES NOT CHANGE A CHARITIES
ABILITY TO PAY AND IT IS A TURF
WAR AND. WHAT THIS IS ABOUT THIS
IS ABOUT COMPANIES PROVIDERS
PROFITING FROM SOMEONE'S ILLNESS
I AM SO HAPPY THAT YOU RECEIVE
THE TREATMENT YOU NEEDED AT
THRILLED THAT YOU'RE HERE TODAY?
AND NOTHING IN THIS BILL WILL
CHANGE WHAT YOU HVE RECEIVED OR
WHAT ANYONE ELSE WOULD BE ABLE
TO RECEIVE GOING FORWARD SAYS
ONE TO MAKE THAT VERY CLEAR IT
THIS BILL DOES NOT. CHANGE A K.
F. OR ANY OTHER CHARITIES
ABILITY.
IT PROVIDES COVERAGE UNDER TO
GAVE THE END AND IF YOU WANT
RESPOND WILL GO AHEAD AND FINISH
ON THAT POINT.
THAT CERTAINLY WOULD HAVE
CHANGED THE SITUATION FOR LAURIE
LAURIE WHEN SHE WAS ON DIALYSIS
WAS UNDER SIXTY FIVE AND IF SHE
WAS FORCED TO BE ON MEDICARE SHE
WOULD HAVE NO ACCESS TO A
MEDIGAP PLAN. WHICH IS WHY
LAURIE IN HER SITUATION SHOWS TO
BE ON HER COBRA PLAN THAT WE
COVERED FOR HER. AND IT QUITE
FRANKLY IS THE REASONABLE
DECISION I THINK ANYONE WOULD
MAKE AND IF YOU HAD THE
OPPORTUNITY AT THAT THIS BILL
DOES NOT PROHIBIT COMO OF COBRA
PAYMENTS TO BE PAID BY A K. F.
FOR ANY OTHER CHARITY BUT IT
REQUIRES LAURIE TO BE ON
MEDICARE.
NO IT DOES NOT DOES NOT AT ALL.
AFTER THESE NEWEST AMENDMENTS IS
DOES NOT.
SO.
THAT'S THAT'S INCORRECT. BREAK
BUT WE MAY WANT TO REVIEW THE
MINUTES AND TO HER AND TURN HER
COMMENT THAT SHE MADE. BECAUSE
SHE DOESN'T QUALIFY ME FOR MEDI
CAL SHE WOULD STILL BE A.
I'M SORRY IT I'M NOT UNDERSTAND
I'M NOT FOLLOWING WILL GET THE
AMENDMENT YOU TO MANAGE FOR YOU
TO READ THE MOST RECENT
AMENDMENTS THE LETTER THAT IS
INCORRECT FOLLOW WITH ONE MORE
THAN JUST HER NIELSEN. ANALOGOUS
XIN OR OF STATEMENT ABOUT THE
CHERRY PICKING.
THERE ARE A LOT OF.
FUNDS IN THE MOVEMENT IN THE
MARKET A LOT OF.
HOW OTHERS CHERRY PICKING UP NOW
WOULD YOU RESPOND TO THAT THE
WHICH IS SIMPLY NOT TRUE I AT
YOU KNOW I THINK THAT THERE'S A
LOT OF FEAR MONGERING THAT'S
HAPPENING WITH THIS BILL? AND IT
REALLY MAKES ME FEEL BAD BECAUSE
THE PATIENTS WHO ARE RECEIVING
THE DIALYSIS IN THE TREATMENT
THEY DON'T KNOW.
AUTHOR A BILL OR PIT PUSH A BILL
THROUGH THAT WOULD HARM SOMEONE
OF MY HUSBAND HAD KIDNEY CANCER
HE WAS DIAGNOSED THE DAY AFTER I
WAS ELECTED TO THE SENATE. SO WE
FACE SOME OF THESE ISSUES THAT
WE FACE SOME OF THESE PROBLEMS
THIS IS NOT CHERRY PICKING THIS
IS ABOUT MAKING SURE AN
INDUSTRY.
THAT IS A FOR PROFIT INDUSTRY IS
NOT PROFITING OFF OF SOMEONE
ELSE'S MISERY THE A CARROT CAKE
BAKING OVEN OTHER FIVE OH ONE C.
THREES OTHER CHARITIES CAN
ABSOLUTELY STILL PAY THOSE
PREMIUMS. AND MAKE SURE THAT
LAURIE AND OTHERS CAN GET THE
TREATMENT THAT THEY NEED.
YOU'RE WELCOME.
SURNAME.
YES I DIED. THANK YOU MISTER I
I'M ALWAYS CURIOUS IS DRUG A
LEGISLATOR FROM ONE OF FIFTY
STATES HAS TWO OF THEM AT THEIR
BEST PRACTICE OTHER STATES FROM
WHICH WE CAN LEARN.
BUT I I'VE HEARD.
GOTTEN CAPRI BUT BOTH SIDES AND
I I I'VE BEEN TOLD THAT
TENNESSEE.
IS A BEST PRACTICE STATE I
DON'T KNOW MUCH ABOUT IT BUT.
IS THERE SOMETHING THAT THEY'VE
DONE THAT WE CAN LEARN FROM IT
IF YOU WOULDN'T MIND SPEAKING TO
THAT BECAUSE IT THAT SEEMS TO BE
CITED.
UNDERRATED BASIS THANK YOU
SENATOR NEWMAN EL THAT IS
ACTUALLY A CITED BEST PRACTICE
BY A K. F. BECAUSE IN THE STATE
OF TENNESSEE AND IDAHO THIS
WOULD CODIFY THEIR PRACTICE OF
ME.
SCAM THAT WE ARE REFERRING TO
LEGAL.
EXPLICITLY LEGAL SO WE DON'T WE
DON'T PERSONALLY THINK I DON'T
PERSONALLY THINK THAT HERE IN
CALIFORNIA THAT IS.
THAT IS A BEST PRACTICE FOR US
BUT IT IS A STRONG ANSWER I
WASN'T EXPECTING THAT.
MS KONO IF YOU WOULDN'T MIND
SPEAKING OF THAT.
AND W WE ARE ABSOLUTELY ONE
HUNDRED PERCENT NOT RUNNING A
SCAM WE HAVE BEEN RECEIVING
FUNDS FROM PROVIDERS FOR OVER
TWENTY YEARS UNDER THE GUIDANCE
OF THE US DEPARTMENT OF HEALTH
AND HUMAN SERVICES OFFICE OF
INSPECTOR GENERAL. AND WHEN
MAKING GRANT DETERMINATIONS WE
SOLD WE LOOK AT THE INDIVIDUALS
FINANCIAL SITUATION. PATIENTS
APPLY FOR ASSISTANCE TO US
HAVING ALREADY CHOSEN WHAT
HEALTH INSURANCE PRODUCT THEY
WOULD LIKE WE DO NOT COMMENT ON
IT. WE DO NOT OFFER ANY OPINIONS
ON IT. ALL THAT IS REQUIRED IS
THEY MEET OUR FINANCIAL
REQUIREMENTS.
AND THAT'S RIGHT IT'S ABOUT HOW
YOU RUN. YOUR BUSINESS BUT SPEAK
SPECIFICALLY TO TENNESSEE WHAT
ARE THEY DOING DIFFERENTLY THAT
IS SAFEGUARDING THAT.
THE PATIENTS BOTH THE PATIENTS.
AND THE OTHER PARTIES INTERESTS
SURE THERE ARE ACTUALLY A AND A
NUMBER OF ADDITIONAL STATES THAT
HAVE TAKEN THE OPPOSITE APPROACH
IN TERMS OF PROTECTING PAID
PATIENTS.
FROM INSURANCE COMPANIES WHO ARE
TRYING TO NOT ACCEPT OUR
PAYMENTS ON BEHALF OF OUR
PATIENTS THOSE INCLUDE NORTH
CAROLINA IDAHO OREGON AND
OKLAHOMA AND LOUISIANA. THERE
IS%
CURRENTLY A DRAFT BULLETIN IN
THE STATE OF TENNESSEE IT HAS
BEEN PUSHED FORWARD BY THE
PRESIDENT OF THE ANY I SEE. I AM
AND WHAT THE BULLETIN DOES HE
IS.
PUT IN PLACE CERTAIN GUARD RAILS
THAT A K. F. AND OTHER
ORGANIZATIONS WOULD HAVE TO MEET
IN ORDER TO QUALIFY IS THIRD
PARTY PAYERS. THE DIFFERENCE
HERE IS IF THEY MEET THOSE
OBLIGATIONS THE INSURANCE
COMPANIES CANNOT REJECT THE
PAYMENTS THIS BILL DOES THE
OPPOSITE AND ALLOWING INSURANCE
COMPANIES TO REJECT THE
PAYMENTS.
EVEN THOUGH.
THE BILL DOES NOT ALLOW THAT
CHURNS COMPANIES TO REJECT
PAYMENT.
THAT IS OUR UNDERSTANDING IN RIO
ITSELF AND NOW I'M GETTING. MORE
INTRIGUED SO BY MISTER VELSEN
BROUGH DOT WOULD YOU MIND
SPEAKING OF THIS I SEE YOU
SHAKING YOUR HEADS.
SURE THERE'S THERE ARE NO
PROVISIONS IN THIS BILL THAT
WOULD ALLOW.
IN INSURANCE COMPANY OR HEALTH
PLAN TO TO DENY PAYMENT.
AND.
ALRIGHT DOT CENTER PAN QUESTION
COMMENT.
NO THANK YOU.
.
ACTUALLY IT'S A FIRST QUESTION
IS FOR THE CAN YOU FIND IS THAT
YOU SAID THAT YOU WITH SPACE ON
THE PATIENT'S CHOICE SO HOW THAT
THE PATIENT SHOES
WHO PROVIDE GUIDANCE TO THE
PATIENT.
PATIENTS ARE FREE TO MAKE THEIR
OWN DECISIONS ABOUT THE PLANNED
SPEECH USE MOST OFTEN. IT IS
MADE IN CONSULTATION WITH THEIR
SOCIAL WORKER FAMILY MEMBERS
FRIENDS BY EVALUATING ALL OF THE
OPTION OF NO CONVERSATION WITH.
NUMBER HEALTHCARE PROVIDER SUN
OR OR THEIR DOCTORS CERTAINLY.
YEAH ABSOLUTELY I'D SO.
SO ACTUALLY AT A GLANCE
PROVIDES IS ONE OF. THE
OPPONENTS BROUGHT UP THIS AT
THIS IT HAS NOTHING TO DO WITH
STEERAGE AND I THINK ONE OF
THINGS WE WANT TO BE CAREFUL
ABOUT IS.
THAT THE RISK FULL OF I MEAN BY
THAT IS IS THAT CERTAINLY WOULD
ONE BE SURE EVERY PATIENT GETS
THE CARE THEY NEED.
THAT ALSO MEANS THAT WE PUT IN
TO THE.
.
SHARON'S MARKET WE PUT OUR
PROTECTION THAT SAYS YOU CAN'T
DISCRIMINATE BY YOUR HEALTH
CONDITION WHICH IS EXTREMELY
IMPORTANT.
BUT BY PUTTING THAT.
BEEN THERE WHICH ARE THEN WE
ALSO HAVE TO BE SURE THAT.
WE DON'T HAVE A SITUATION WHERE
BASICALLY SILENCE IS GREAT YOU
CAN SCAN AGAINST CAN DO.
WHAT WE'RE GONNA DO IS GONNA
EIGHT PATIENTS AND THEN TRY TO
FIGURE OUT LEVERAGE THAT?
RIGHT SO I PULL LITTLE MONEY AND
BECAUSE I KNOW WHAT THAT MEANS
IS OUT FORCE ATTACKS ON EVERYONE
ELSE ESSENTIALLY.
WHO'S IN THAT RISK POOL TO HAVE
TO HELP SUBSIDIZE THAT CARE. AND
NOW I CAN CHARGE YOU KNOW CLICK
A LOT MORE MONEY SO IT'S NOT
IT'S NOT SHARED AT THAT POINT IT
IS LEVERAGING.
AND SO THAT'S I THINK THE
CONCERNED WILL BE SURE
WE'RE NOT GETTING INTO AND WIDE
DE BUT WE LAWSUIT SHOULD BE SURE
SO. SO.
.
PERHAPS.
A PROPOSED CAN SPEAK TO IS I
MEAN WORST IT'S HOW HOW HOW DO
PEOPLE GET.
THE DECISIONS MADE ABOUT WHERE
TO GO AND OUT EARLY.
HOW WE REACH?
THAT THE ISSUE ABOUT I MEAN I
USED TO SO I THINK THAT THEY'VE
DONE AND SAID THERE CONSIDER
THIS AND STEERING SO I GUESS
THERE THAT SERVICE KNOWN OUT
THERE SO I MEAN IT'S THERE'S
DURING GOING ON FROM.
PERSPECTIVE I MEAN WE WE WE
TALKED A LOT ABOUT WHAT'S GOING
ON.
SUBSTANCE USE BUT WE HAVE BEEN
TALKING ABOUT WHAT'S GOING ON
UNDER.
ON. THE OTHER SIDE.
JOHN ALLEN WITH ASCII YOU YOU HW
AND ALL SPEAK ONE PIECE OF THAT
AND WHAT OTHER SPEAK TO THE
REST.
JUST IN TERMS OF WHO IS ADVISING
A PATIENT.
TO PURSUE A NAY KF SPONSORED
PLAN.
THE SOCIAL WORKER WAS MENTIONED
AND I JUST WANT TO FOCUS FOR A
MOMENT ON THE ROLE OF THE SOCIAL
WORKER.
AND CLARIFY THAT THAT SOCIAL
WORKER WOULD BE AN EMPLOYEE OF
THE DIALYSIS PROVIDER.
AND THAT THAT SOCIAL WORKER.
WILL BE FOLLOWING THE
INSTRUCTIONS THAT THEIR EMPLOYER
HAS GIVEN WITH REGARDS TO HOW TO
INFORM PATIENTS ABOUT A CALF
COVERAGE. OF A CALF SPONSORED
COVERAGE
AND.
SO.
CALLING OUT THE SOCIAL WORKER'S
ROLE IN HELPING PATIENTS TO MAKE
THAT DECISION. REALLY IS CALLING
OUT THE DIALYSIS PROVIDERS ROLE.
AND THEN.
I'M AT.
I WOULD LIKE TO KIND OF POINT
OUT I THINK WE'RE SPENDING A LOT
OF TIMES SPECIFICALLY ON
DIALYSIS IN A CAVE BUT IN THIS
BILL IS IS. SORT OF A
COMPREHENSIVE LOOK ON ALL THIRD
PARTY PAYERS AND WHAT WE'VE SEEN
IS SINCE WE PASSED GUARANTEED
ISSUE WHICH IS. A A POLICY THAT
I THINK WE CAN ALL SUPPORT AND
MY MEMBERS WHOLEHEARTEDLY
SUPPORT. I THINK WHAT WE'VE SEEN
IS.
STEERING INTO THE INDIVIDUAL
MARKET INTO.
OFTENTIMES PP THOSE THE PLATINUM
PROUCTS SO THAT PEOPLE CAN
GARNER HIGHER REIMBURSEMENT
PROCESS AND SO THE THIRD PARTIES
PAY FOR THOSE PREMIUMS.
STEER PEOPLE INTO SERVICES AND
THEN RECEIVE HIGHER
REIMBURSEMENT SUIT SORT OF IT
IT'S A MANIPULATION OF THE
SYSTEM THE THIRD PARTY PARTY
PAYMENT PROCESS IS NOT A NEW
THING.
WE'VE CERTAINLY SEEN KIND OF IT
HEIGHTENED IN THE LAST SEVERAL
YEARS BECAUSE BEFORE YOU HAD
UNDERWRITING YOU DIDN'T HAVE
GUARANTEED ISSUE SO.
AND TO THE DEGREE WHERE WE'VE
SEEN THESE CHANGES CERTAINLY
WE'VE SEEN THEM AND THE DIALYSIS
SPACE IN THE SUBSTANCE ABUSE
BASED WE'VE WE'VE SEATED. ACROSS
THE BOARD I I DON'T THINK
ANYONE'S REALLY TRYING
NECESSARILY.
TO PICK Y. NONPROFIT OVER
ANOTHER IT'S JUST CERTAINLY
WHERE WE'VE SEEN THOSE SPACES
AND THE END STAGE RENAL DISEASE
PATIENTS ARE INCREDIBLY
EXPENSIVE AND SO YOU OFTEN DO
SEE.
WHEN OUR OUR FRAUD UNIT
INVESTIGATORS ARE LOOKING AT
THIRD PARTY OR THESE KIND OF I
THINK THEY'VE SEEN WHERE THERE'S
DEBIT CARDS OR. TWENTY PLUS
PATIENTS ON ONE PERSON'S CREDIT
CARD I MEAN THOSE ARE THE KIND
OF THINGS THAT WE'VE SEEN. THOSE
OF BECAUSE THE FRAUD
INVESTIGATIONS WHERE WE'VE
IDENTIFIED AREAS FOR WHICH WE'VE
SEEN THESE REALLY LARGE INCREASE
AND REIMBURSEMENT RATES. THAT
ARE FAR FILE FROM WHAT MEDICARE
WOULD PAY AND I THINK THIS BILL
ALSO. THAT THE ANSWER TO THAT IS
NOT TO DENY PAYMENT IT JUST
MEANS THAT IF THERE IS A THIRD
PARTY PAYMENT AND THERE'S A
PROVIDER RELATIONSHIP. IN THE
PROVIDER GETS THE MEDICARE RATES
THAT THAT'S THE ANSWER TO THIS
IT ISN'T US DENYING COVERAGE
ISN'T US HOLDING OUT PAYMENTS
IT'S US PAYING THE MEDICARE RATE
FOR THAT SO YOU TAKE AWAY THE
FINANCIAL INCENTIVE. FOR THOSE
FOLKS WHO ARE THIRD PARTY PAYERS
WITH A PROVIDER RELATIONSHIP IN
THAT FINANCIAL RELATIONSHIP.
THAT THEY WOULD ONLY RECEIVE THE
MEDICARE RIGHT.
OKAY WELL.
.
SO. I THINK WANTED SO FLAT FEE
TO ENTER SANDERS AMENDMENT TAKEN
THAT FOR EXAMPLE SOLDIERY IN THE
RISK FULL. AND THERE'S ALREADY
SOME SET RATES.
AND TO POSE A DEVELOPING
ADDITION MIKE AND STAGE RENAL
THEN.
BECAUSE THAT CASE YOU CAN'T SAY
THE STEERAGE WHAT HAPPENS AND IT
AND TO JUST.
MAYBE HAVE GONE COBRA SO I
UNDERSTAND THAT.
IT IS A LOT OF WE'RE NOT GOING
TO GO IN CERTAINLY DOWN RATE.
BANG RIGHT CORRECT AND IS THAT
OKAY.
BUT YEAH I I HAVE TO SAY THAT I.
I DO HAVE A BIT OF A PROBLEM
ABOUT THE IDEA THAT IF SOMEONE.
YOU KNOW THAT WE DOWNED IT TO
MEDICARE I THINK USUAL CUSTOMARY
WOULD BE MORE APPROPRIATE.
MAY NEED SO SO IT IS LIKE WAY
UP THERE BUT SHOULD BE MORE IN
LINE WITH WHAT SO THAT THAT.
IS THAT.
BUT.
AYE I THINK CERTAINLY THIS IS
AN ISSUE THAT NEEDS TO OUR.
YELL TO BE ADDRESSED THE NEEDS
OF THE SHIRT THE STABILITY OF OF
OF OUR.
INSURANCE MONEY WE DON'T WANT
TO HAVE PEOPLE TRYING TO
LEVERAGE THE VERY FACT THAT
WE'RE GOOD ELIMINATING OUR.
UNDERWRITING AND SO I THINK THAT
IS IMPORTANT AND SO I HOPE THAT
YOU WILL CONTINUE TO WORK WITH
THAT FOLKS IN THE BILL TO BE
SURE THAT PEOPLE.
OUR PATIENTS GET ACCESS TO CARE
AND THAT.
ACCESS CARE IS ALSO NOT JUST
COVERAGE BUT ALSO HAVING
PAYMENTS AT A LEVEL WHERE YOU
CAN FIND SPIDERS ARE GOING TO
DELIVER THAT CARE.
ABSOLUTELY. BUT NOT IN RECENT
PAINS RIGHT.
ANY OTHER QUESTIONS COMMENTS
FROM ANY OF THE OTHER MEMBERS.
SO ARE I JUST MAKE A COMMENT.
IF WE LOOK IT.
CARE THAT'S PROVIDED TO PATIENTS
IN WILL TAKE.
THREE BUCKETS WE HAVE MEDI CAL.
IT MEDICARE AND WE HAVE REACHED
THE INSURANCE MARKET.
I WOULD THINK THAT ALL CARE IS
AT THE SAME LEVEL.
WHEN SHOULD BE BETTER THAN THE
OTHER SOME A PATIENT COMES INTO
A DOCTOR'S OFFICE OR.
SILLY.
ALL THOSE PATIENTS WHO GET THE
EXACT SAME CARE.
THE REIMBURSEMENT RATES ARE
DIFFERENT.
AND.
I DEFTLY DIFFERENT.
IF A PATIENT IS ON MEDI CAL
EVERYTHING'S COVERED.
AND I CARE SHOULD BE THE SAME.
AND I WOULD HOPE THAT A MEDICARE
PATIENT WHEN BE STEERED TO A
COMMERCIAL PLAN.
TO BE ABLE GET A HIGHER
REIMBURSEMENT.
IF THE PATIENT IS ON MEDICARE A
TRADITIONAL MEDICARE PRODUCT
WHERE THEY HAVE A TWENTY PERCENT
CO PAY.
I BELIEVE BE CHARITABLE
FOUNDATION SHOULD HAVE EVERY
RIGHT TO HELP COVER THAT TWENTY
PERCENT.
BUT NOT SHIFT THEIR PATIENT TO
COMMERCIAL TO GET A HIGHER RATE.
HERE'S MY CONCERN ABOUT SHIFTING
THOSE PATIENTS THAT ARE ALREADY
COVERED THROUGH A GOVERNMENT
PROGRAM.
IS.
THE CREE INCREASE COSTS IS
SHIFTED TO ALL OF US.
IN WE HAVE TO DO EVERYTHING WE
CAN TO CONTROL HEALTHCARE COSTS.
SO I'M NOT OPPOSED TO ANY KIND
OF CHARITABLE NAM FOUNDATION
HELPING.
WITH THAT TWENTY PERCENT CO
PAYMENT YES.
BUT DON'T TAKE THAT PATIENT INTO
A HIGHER.
PRODUCT.
OR IF IT'S A MEDICARE ADVANTAGE
THAT THAT PATIENT WANTS TO STAY
IN MEDICARE ADVANTAGE YES HELP
THEM WITH THAT MEDICARE
ADVANTAGE.
SO I'M PREPARED TO SUPPORT THE
BILL BECAUSE I BELIEVE THAT
EVERY SINGLE PATIENT IS GOING TO
BE GIVEN THE YOU. THE SAME CARE
DOESN'T MATTER WHATEVER THE IN A
GIVEN EXAMPLE IN OUR OFFICE. WE
SEE PATIENTS WERE MEDI CAL
MEDICARE OR PRIVATE PAY.
EVERYBODY IS TREATED THE SAME.
I LOVE TO HAVE MY REIMBURSEMENT
RATES AT THE HIGHEST BUT THAT'S
JUST NOT THE CASE SO. WITH THAT.
.
OH YES.
HERE I APOLOGIZE I NORMALLY
DON'T PESTS. MASK ON MORE
QUESTIONS SURE BROWN MEANS I'M
LOOKING AT THESE AMENDMENTS SUCH
FOR MAKE SURE I'M CLEAR IN BY
THE REALLY MAKE THIS COMMENT I
THINK IT'S VERY VERY IMPORTANT.
AS I'M SURE THIS BILL WILL MOVE
OUT OF THIS COMMITTEE.
FOR THEIR TO BE SOME
COMMUNICATION TO THE PATIENTS
THAT ARE RECEIVING THE SERVICES.
BECAUSE IT IS EITHER.
UPON UPON ACTUAL
MISUNDERSTANDING OR DISCONNECT
WERE IT CERTAINLY PERCEIVED.
ISSUE WITH RESPECT TO WHAT'S
GOING TO HAPPEN AT THIS BILL
SAYS AND WHAT'S GOING TO HAPPEN
IF AND WHEN IT IT PASSES OUT OF
THIS HOUSE. AND SO MY QUESTION
IS A SO IF YOU'RE A TH OF.
IF YOU'RE IN AN OF UP.
A. M. UTC CARRIER INSURANCE
PROVIDER AND YOU COMPLY WITH ALL
THE. THE NOTIFICATION
REQUIREMENTS IN THIS BILL.
ALWAYS YOU HAVE TO INFORM YOU
HAVE TO DO THIS YOU HAVE TO DO
THIS.
ARE ARE YOU ENTITLED TO.
AND YOU'RE THE PROVIDER AND
YOU'RE THE PROVIDER OF THE
HEALTH CARE SERVICES ARE YOU
ENTITLED TO RECEIVE MORE THAN.
CARE OR ARE YOU
IS IT ONLY IN THE EVENT OF A
VIOLATION. OF THE NOTIFICATION
PROVISIONS THAT YOUR
COMPENSATION IS RESUMED REALLY
IS REDUCED TO THE OF. MEDICARE
REIMBURSEMENT RATE.
SENATE FOR QUESTION.
IT'S IT'S ONLY IF THERE'S A
VIOLATION SO IF YOU PROVIDE IF
YOU ARE.
A PROVIDER OF HEALTH CARE
SERVICES AND YOU COMPLY WITH ALL
OF THE NOTIFICATIONS IN HERE YOU
TOOK YOU PROVIDE THE
NOTIFICATION TO THE. TO THE
APPLICANT.
YOU PROVIDE THE NOTIFICATION
CENTER REQUIRED TO THE.
INSURANCE COMPANY.
OH YOU CAN PROVIDE THE SERVICE
AND YOU CAN OBTAIN REIMBURSEMENT
IN ACCORDANCE WITH THAT POLICY.
OKAY THAT'S THAT'S THE WAY THAT
THE BILL IS THAT CERTAINLY THE
WAY I READ THE OF THE BILL IN
THE AMENDMENTS THAT CHRIS WORLD.
SORT OF DIDN'T GET TO US I
UNDERSTAND YOUR PREDICAMENT
MEMBER ALL IN THE SAME POSITION
BUT IT'S FUN TO MAKE SURE.
MY UNDERSTANDING WAS CORRECT ON
THAT
THANK YOU MISTER CHAIR
APPRECIATE YOU PATIENCE THINKING
AND TO EMOTION.
SO MOVED BY CENTER MONEY.
AND THEN WE'RE GOING TO ASK YOU
TO CLOSE THANK YOU VERY MUCH
MISTER CHAIR THANK YOU TO
EVERYONE FOR THIS LIVELY DEBATE.
I JUST WANNA BRIANNA REITERATE A
COUPLE POINTS THIS BILL DOES
ABSOLUTELY DOES NOT CHANGE THE
CARE THAT A PATIENT WILL
RECEIVE.
IT DOES NOT CHANGE THE CHARITY'S
ABILITY TO PAY. THE BILL SIMPLY
REQUIRES FINANCIALLY INTERESTED
PROVIDERS TO COMPLY WITH
DISCLOSURE REQUIREMENTS
INCLUDING SHOWING THE PATIENTS
AREN'T OTHERWISE ELIGIBLE FOR
MEDICARE OR MEDICAID ALL AND I
WILL END WITH THIS. ONE OF THE
FOR PROFIT PROVIDERS IN THEIR
OWN PRESS RELEASE
TALKED ABOUT THE FOUR THOUSAND
PREMIUMS THAT HAVE BEEN PAID TO
THEM BY A K. F.. AND THEY SAY IN
THE PRESS RELEASE THAT THIS WAS
A FOUR HUNDREDAND FIFTY MILLION
DOLLAR PROFIT FOR THEM WHICH IS
OVER A HUNDRED THOUSAND DOLLARS
PER PATIENT.
SO THAT IS THE CONCERN I
RESPECTFULLY ASK FOR AN AYE
VOTE.
THANK YOU IT ITEM NUMBER SIX SP
ONE ONE FIVE SIXTY PASSES A
MINUTES APPROPRIATIONS COLUMN
MEMBERS PLEASE HERNANDEZ AYE
HERNANDEZ AYE NGUYEN.
WHEN I LEYVA AYE LEYVA AYE
MITCHELL.
MONNING.
I MONNING AYE NEWMAN.
NEWMAN AYE NIELSEN.
NIELSEN AYE PAN.
AND I'VE ROTH.
IF IT.
THEY'RE CURRENTLY AT SEVEN WE
HAVE SOME MEMBERS ABSENT WILL
PLACE THAT BILL AND CALL.
WE'RE GOING TO MOVE ON TO.
BUT FORTY FIVE NUMBER NINE SP
ONE TWO FOUR FIVE COVER
CALIFORNIA.
THANK YOU MISTER CHAIR AND
MEMBERS AND I AM GLAD TO REPORT
TO YOU THAT THIS MY LAST BILL
HERE TODAY.
S. B. TWELVE FORTY FIVE WOULD
ALLOW COVERED CALIFORNIA TO HAVE
EMERGENCY RULE MAKING AUTHORITY
FROM.
IT'S REGULATORY PACKAGES
UNTIL JULY JANUARY ONE TWENTY
TWENTY TWO.
THIS MEASURE WOULD ALSO ALSO
ENSURE THAT THERE WOULD STILL BE
TIME FOR THE PUBLIC TO REVIEW
AND COMMENT ON THE PROPOSED
REGULATIONS AHEAD OF IT BEING
ADOPTED BY THE COVERED
CALIFORNIA EXECUTIVE BOARD. AS
YOU MAY KNOW SINCE COVERED
CALIFORNIA BEGAN OFFERING
COVERAGE IN TWO THOUSAND
FOURTEEN THEY HAVE SERVED MORE
THAN THREE MILLION OF ALL OF OUR
CONSTITUENTS.
COVERED CALIFORNIA IS CURRENTLY
AUTHORIZED TO ADOPT EMERGENCY
REGULATION IN THE AREA OF
ELIGIBILITY AND ENROLLMENT FOR
THE INDIVIDUAL AND SMALL
BUSINESS MARKETS UNTIL JANUARY
ONE TWO THOUSAND NINETEEN.
THAT'S AUTHORITY IS GRANTED
BECAUSE IN THESE MARKETS CHANGES
TO FEDERAL ELIGIBILITY AND
ENROLLMENT RULES ARE MADE ON AN
ONGOING BASIS.
SINCE TWO THOUSAND TEN COVER
CALIFORNIA HAS MADE A DELIBERATE
EFFORT TO MOVE TO PERMANENT
REGULATIONS AND HAS APPROVED FOR
PERMANENT RULE MAKING PACKAGES.
BUT THE AFFORDABLE CARE ACT
STABILIZE IT WAS EXPECTED THAT
COVERED CALIFORNIA WOULD
CONTINUE TO EFFECTIVELY
TRANSITION TO THE PERMANENT RULE
MAKING PROCESS.
HOWEVER CURRENT FEDERAL POLICY
DISCUSSIONS REGARDING THE ACA
INDICATE THAT THERE WILL
POTENTIALLY BE SIGNIFICANT
CHANGES TO THE RULES GOVERNING
HEALTH BENEFIT EXCHANGES LIKE
COVERED CALIFORNIA. DUE TO
POTENTIAL FOR FUTURE CHANGES TO
THE ACA AND OTHER RELATED
REGULATIONS COVERED CALIFORNIA
MAY BE REQUIRED TO CREATE AND
ADAPT REGULATIONS MORE QUICKLY.
THAN IS POSSIBLE THROUGH THE
PERMANENT RULE MAKING PROCESS.
NEW FEDERAL REGULATIONS COULD
IMPACT NOT ONLY ELIGIBILITY AND
ENROLLMENT BUT POSSIBLY OTHER
AREAS OF COVER CALIFORNIA
REGULATIONS. WHICH REQUIRE
ADDITIONAL EMERGENCY RULE MAKING
AUTHORITY BEYOND JANUARY ONE TWO
THOUSAND NINETEEN. WITHOUT THIS
EMERGENCY RULE MAKING AUTHORITY
COVERED CALIFORNIA REGULATIONS
WOULD CONFLICT WITH FEDERAL LAW
WHICH HAS THE POTENTIAL TO HARM
AND PROPERLY SERVE THAT THEY'RE
MORE THAN THREE MILLION
CONSUMERS. IN ORDER TO PROBABLY
COULD RESPOND TO CHANGES AT THE
FEDERAL AND STATE LEVELS.
S. B. TWELVE FORTY FIVE WOULD
ALLOW COVERED CALIFORNIA TO HAVE
EMERGENCY RULE MAKING AUTHORITY
FOR NEARLY ALL OF ITS REGULATORY
PACKAGES. UNTIL JANUARY ONE
TWENTY TWENTY TWO.
WELL THEY DO NOT SUPPORT OR
OPPOSE ANY LEGISLATION. KELLY
GREEN FROM COLOR FOR CALIFORNIA
IS HERE TO ANSWER ANY TECHNICAL
QUESTIONS.
THANK YOU.
AND I HAVE SOME WITNESSES IN
SUPPORT MISTER CHAIR OF PLEASE
PRETTY. TAMA WITH HEALTHAXIS
CALIFORNIA PLEASED TO BE IN
SUPPORT WHAT OF THE SPELL WITH
THE AMENDMENTS AND WE APPRECIATE
THE WORK THAT THE AUTHOR AND HER
STAFF HAVE DONE ON THIS BILL.
THANKS FOR THE BREVITY.
KIMBERLY TELL THE CALIFORNIA PAN
ETHNIC HEALTH THAT WE'RE
CONCERNED SUPPORT.
GEN FOURTH WESTERN CENTER ON LAW
AND POVERTY AND SUPPORT AND WE
APPRECIATE THAT COVERED
CALIFORNIA HAS TAKEN RULE MAKING
SERIOUSLY AND HAS WORKED WITH
CONSUMER ADVOCATES TO MAKE SURE
THAT WE'RE ABLE TO COMMENT
TIMELY AND GET THOSE RAGGED ON
EMERGENCY BASIS.
THANK YOU OPPOSITION.
IF YOU PLAYED.
QUESTIONS COMMENTS FROM ANY OF
THE MEMBERS.
GETTING NO QUESTIONS OR COMMENTS
THERE'S A MOTION BY SENATOR ROTH
A CHAIR. BUT I'M SO SORRY SENATE
PASSED.
YEAH.
I REMEMBER NINE SP TWELVE WHICH
I TO CLOSE.
RESPECTFULLY ASK AND I'VE HEARD
A NUMBER NINE SP TWELVE FORTY
FIVE DAY PASSED PREPARATIONS
CALL MEMBERS PLEASE. HERNANDEZ
AYE AND AS I WHEN.
WHEN I LEYVA AYE LEYVA AYE
MITCHELL.
MITCHELL AYE MONNING.
THANK MONNING AYE NEWMAN. AYE
AYE NEWMAN AYE NIELSEN.
NIELSEN NO HAN. AND I ROCK WIRE
ROTH AYE.
IT'S GOING TO GET OUT. KISS.
THAT CURRENTLY HAS EIGHT TO ONE
THAT STUFF FIRST BILL IS KIND
OUT TODAY. YEAH. BUT YOU MISTER
CHAIR THANK YOU MEMBERS HAVE A
GOOD EVENING I WILL LEAVE YOU
UNTIL. WE BETTER LEAVE GOING TO
VOTE NO NO NO NO.
I'M NOT LEAVING THE COMMITTEE
OBVIOUSLY NO YEAH I GOTTA GO SAY
SOMETHING TO SOMEONE AND THEN
I'LL BE BACK UP.
SEVEN.
SENATOR MIND.
S. B. ONE ONE NINE TWO
CHILDREN'S MEALS.
THANK YOU MISTER CHAIR AND
MEMBERS.
CALIFORNIANS CURRENTLY FACING IN
OBESITY AND DIABETES CRISIS.
THE EFFECTS OF WHICH IMPACT THE
QUALITY OF LIFE OF OUR
CONSTITUENTS AND DRAIN THE
RESOURCES OF OUR PUBLIC HEALTH
SYSTEM.
OBESITY RELATED MEDICAL
EXPENDITURES COST THE STATE OVER
NINE BILLION DOLLARS EACH YEAR
WITH TYPE TWO DIABETES ADDING AN
ADDITIONAL. ONE POINT SIX
BILLION DOLLARS PER YEAR TO
CALIFORNIA'S HOSPITALIZATION
COSTS.
OVERWHELMING SCIENTIFIC EVIDENCE
HAS SHOWN THAT SUGAR SWEETENED
BEVERAGES ARE ONE OF THE LEADING
CAUSES OF THE INCREASE IN THESE
CHRONIC HEALTH CONDITIONS.
AS SUGARY DRINKS PROVIDE NO
NUTRITIONAL VALUE. ENTER THE
LARGEST CONTRIBUTOR OF ADDED
CALORIES IN THE AMERICAN DIET.
IF CURRENT TRENDS ARE NOT
REVERSED IT IS PREDICTED THAT
ONE IN THREE CHILDREN AND NEARLY
HALF OF LATINO AND AFRICAN
AMERICAN CHILDREN. BORN IN THE
YEAR TWO THOUSAND WILL DEVELOP
TYPE TWO DIABETES IN THEIR
LIFETIME.
CALIFORNIANS DIETARY HABITS
CHANGED GREATLY IN THE PAST FEW
DECADES WITH MORE AND MORE EVER
FOOD BUDGET SPENT ON FOOD
PREPARED OUTSIDE THE HOME.
MOST BILLS OFFERED AND MARKETED
TO CHILDREN IN RESTAURANTS
INCLUDE A SUGARY DRINK WHICH
OFTEN MEANS MORE THAN A WEEKLY
AMOUNT OF SUGAR RECOMMENDED FOR
CHILDREN.
MANY RESTAURANTS AND FAST FOOD
ESTABLISHMENTS HOWEVER HAVE
ALREADY TAKEN STEPS TO CHANGE
WHAT BEVERAGES THEY OFFER. IN
THEIR KIDS MEAL SELECTION.
RESTAURANTS LIKE MCDONALDS JACK
IN THE BOX APPLEBEE'S WENDY'S
SUBWAY PINERA. AND I HOP HAVE
ALL VOLUNTARILY MADE EFFORTS TO
OFFER MORE HELP FULL BEVERAGE
OPTIONS FOR CHILDREN.
NUMEROUS LOCAL CITIES AND
COUNTIES THROUGHOUT CALIFORNIA
HAVE ALSO TAKEN STEPS TO IMPROVE
NUTRITION STANDARDS FOR
CHILDREN'S MEALS. LONG BACH
STOCKTON DAVIS DALY CITY SANTA
CLARA COUNTY AND THE CITY AND
COUNTY OF SAN FRANCISCO HAVE ALL
ADOPTED ORDINANCES REQUIRING
HELPFUL DRINK OPTIONS IN MEALS
MARKETED TO CHILDREN.
SENATE BILL ELEVEN NINETY TWO
FOLLOWS THE LEAD OF THE
RESTAURANT INDUSTRY AND OUR
LOCAL COMMUNITY LEADERS AND
IMPLEMENTS A STATEWIDE. HEALTHY
DEFAULT BEVERAGE POLICY IN
CALIFORNIA.
SPECIFICALLY THIS BILL WILL
REQUIRE A RESTAURANT THAT SERVES
A MEAL PRIMARILY OFFERED FOR THE
CONSUMPTION OF CHILDREN. TO MAKE
THE DEFAULT DRINK OPTIONS SERVED
IN THOSE BUNDLED MEALS A HELPFUL
BEVERAGE
SUCH AS WATER.
SPARKLING WATER FLAVORED Y.
THERE WOULD NO ADDED SWEETENERS
OR UNFLAVORED MILK. IT'S
IMPORTANT TO NOTE THAT CUSTOMERS
CAN STILL EXPLICITLY ASKED TO
REPLACE THE HELPFUL DRINK WITH A
SUGARY BEVERAGE AT NO COST.
BUT THE DEFAULT BEVERAGE OFFERED
IN A CHILDREN'S MEAL MUST BE
THAT HELPFUL OPTION.
MEMBERS WHERE TO CRITICAL
JUNCTURE IN CALIFORNIA WHERE
PUBLIC HEALTH POLICIES LIKE THE
ONE FOUND IN THIS BILL. CAN HAVE
A DIRECT IMPACT IN EDUCATING
PARENTS ABOUT THE SEVERE IN
CHRONIC HEALTH IMPACTS THAT POOR
NUTRITIONAL. CHOICES HAVE ON
THEIR CHILDREN.
MEMBERS I'D REQUEST YOUR AYE
VOTE AT THE APPROPRIATE TIME IN
IT THIS POINT WOULD LIKE TO.
THROUGH THE CHAIR INTRODUCER
WITNESSES IN SUPPORT.
WELL.
PUSH.
MY NAME IS MIKE HELLO AND I'M
FROM BOTTOM PART GUY IN LOS
ANGELES COUNTY. AND I'M HERE
TODAY IS A FORMER HEALTH
EDUCATOR OCCURRING BEDSIDE.
HOSPITAL PHLEBOTOMY SAN
APPLICANT TO MEDICAL SCHOOL
ALMOST PRESENTLY THOUGH I'M HERE
AS A FATHER OF TWO BRIGHT AND
BEAUTIFUL LITTLE GIRLS.
.
UNDER THE AGE OF THREE.
I'M I WANT EXPRESS MY STRONG
SUPPORT OF SB ELEVEN NINETY TWO.
AND URGE ITS PASSING.
MY TALLER DOES NOT KNOW SODA IS
AND MY WIFE AND I HOPE TO KEEP
IT THAT WAY FOR AS LONG AS. IS
HUMANLY POSSIBLE BECAUSE COULD
SO EASILY BECOME ACCUSTOMED TO
THE SWEET TASTE.
AS A HEALTH EDUCATOR I LEARNED
THAT IF PEOPLE KNEW BETTER THEY
WOULD DO BETTER.
THIS IS WHERE COMMUTING BY MEN
OUGHT TO SUPPORT MAKING THE
HEALTHY CHOICE THE DEFAULT
CHOICE S. B. ELEVEN NINE TWO
WOULD HELP.
BALLPARK AS A PREDOMINANT LATINO
POPULATION MANY OF WHOM ARE
IMMIGRANTS OF.
OR FIRST GENERATION LIKE MYSELF.
IN TWENTY FIFTEEN I WAS A
PARTICIPANT IN ENACT DAY AND
REMEMBER HEARING THE TESTIMONY.
OUGHT TO OUR GROUP OF SOMEBODY I
KNOW FROM MY COMMUNITY I'M
IMMIGRANT AND THAT SORT OF
THOUGH. I AS HE SHARED A STORY
THAT SHE HE CHOKED UP AND TIERED
RETELLING HOW HE REMEMBERED
OFTEN GOING TO FAST FOOD DRIVE.
THRU RESTAURANTS ON HIS WAY TO
WORK AND SUPERSIZED EVERYTHING
FROM ADDITIONAL FIFTY CENTS.
I HE TOLD THE DRIVING AWAY WITH
A THIRTY TWO OUNCE SODA AND SAID
THAT IF YOU KNEW THEN WHAT HE
KNOWS NOW AS A MAN WITH
DIABETES.
THAT HE WOULD HAVE MADE BETTER
CHOICES.
THIS SPEAKS TO MY BELIEF FROM
THE GROUND IN MY COMMUNITY THAT
IF PEOPLE KNEW BETTER THEY WOULD
DO BETTER.
AS A FULL BOTANIST AYE ME
HOSPITALIZED PATIENTS EVERY DAY
WHO HAVE DIABETES
COMPLICATIONS DUE TO THIS
METABOLIC SYNDROME.
OR ARE ON DIALYSIS DUE TO KIDNEY
FAILURE IT'S A PLEASANT AND THEY
ARE THE FIRST ONES TO TELL ME.
FROM ALL MY RULES.
I'M UNIQUE POSITION FEEL IN THAT
SENSE LUCKY TO KNOW BETTER THAN
TO CONSUME SUGARY DRINKS MUCH
LESS TO ALLOW MY DAUGHTER'S.
TO BEGIN TO BECOME ACCUSTOMED TO
THE SUGARY DRINK.
DRINKS LIKE SADDAM.
I WITH A SMALL BUSINESS.
COMES GREAT RESPONSIBILITY.
RESTAURANT OWNERS SHOULD BE
INVESTED IN THEIR CUSTOMERS NOT
MERELY AS CONSUMERS BUT AS
RESIDENTS IN THE COMMUNITIES
THEY CHOOSE TO DO BUSINESS AND.
OUR DOING SO IS NOT ONLY GOOD
BUSINESS IT'S CARRYING AND AS
FOR MY FAMILY ARE DOLLARS WILL
GO TO BUSINESSES THAT CARE ABOUT
PEOPLE BY BETTER SERVING US IN
THE SMALL BUT SIGNIFICANT WAYS.
AS AN ASPIRING POSITION AND ALL
THE BEST MEDICAL ADVICE COULD
QUICKLY BECOME OF LITTLE USE.
IF OUR COMMUNITY ENVIRONMENTS
DON'T SUPPORT OPTIMAL HEALTH. BY
MAKING A HEALTHY CHOICE THE EASY
CHOICE PLEASE SUPPORT S. B.
ELEVEN NINETY TWO.
GOOD EVENING MY NAME IS DOCTOR
FLOWS ON CO FOR AND I AM THE
DIRECTOR OF STATE POLICY AND
RESEARCH FOR PUBLIC HEALTH
ADVOCATES AND I'M PLEASED TO
JOIN MY CO SPONSORS OF THE
CALIFORNIA'S THE ALLIANCE OF
YMCAS. THE LATINO COALITION FOR
HEALTHY CALIFORNIA MOMS RISING
IN THE AMERICAN HEART
ASSOCIATION AND AMERICAN STROKE
ASSOCIATION TO CO SPONSOR SB
ELEVEN NINETY TWO.
AS MANY OF YOU ARE AWARE THERE'S
AN OBESITY EPIDEMIC IN
CALIFORNIA. AND A LOT OF THIS IS
DRIVEN BY THE CONSUMPTION OF
SUGARY DRINKS.
CONSUMING JUST ONE SUGARY DRINK
A DAY INCREASES A CHILD'S
LIKELIHOOD OF BECOMING
OVERWEIGHT OR OBESE BY FIFTY
FIVE PERCENT.
AND CONSUMING ONE SUGARY DRINK A
DAY ALSO INCREASES THEIR RISK
FOR DIABETES BY TWENTY SIX
PERCENT. IT INCREASES THEIR
LIKELIHOOD OF HAVING CAVITIES BY
TWO TIMES A HUNDRED PERCENT
HIGHER FOR THOSE WHO ARE
CONSUMING THE STRENGTH EVERYDAY.
IT'S OF THIS IS REALLY IMPORTANT
AND MANY OF THE ORGANIZATIONS
WHO ARE CO SPONSORING AND
SUPPORTING THIS BILL ARE
ORGANIZATIONS THAT FOCUS ON THE
ENVIRONMENT.
AND WE CONSIDER THIS TO BE AN
ENVIRONMENTAL PROBLEM IT'S NOT
AN ISSUE OF PEOPLE HAVING WILL
POWER IT'S AN ISSUE OF WHAT IS
THE DEFAULT AND WHAT IF YOU.
AND LAST YEAR WE CROSSED A
THRESHOLD WHERE WE CONSUME OR
FOR MEALS OUTSIDE OF THE HOME
THAT WE DO IN THE HOME. AND WHAT
THAT MEANS IS THAT BUT SOMETIMES
FOODS THAT USED TO BE A TREAT
ARE NOW OUR EVERYDAY STAPLES IN
OUR DIET AND SO IT BECOMES
INCREASINGLY IMPORTANT TO MAKE
SURE THAT WE HAVE.
PROVISIONS IN PLACE
TO MAKE SURE THAT FAMILIES CAN
MAKE THE HEALTHY CHOICE THE EASY
CHOICE.
THIS IS JUST AN ASPECT OF THE
ENVIRONMENT MUCH LIKE IF I WERE
TO PLACE COOKIES OUT HERE IN
FRONT OF YOU RIGHT NOW MORE OF
YOU WOULD CONSUME COOKIES THEN
YOU WOULD HAVE IF I HAD.
PROVIDED THEM AND THAT'S SIMPLY
AN ASPECT OF THE ENVIRONMENT AND
SO THIS IS THE SAME THAT WE
ADVERTISE MILKEN WATER AS THE
DEFAULT BEVERAGE MORE PEOPLE
WILL CONSUME OPEN WATER AND FEW
OF THEM WILL SELECT SOMETHING.
MANY OF YOU WOULD HAVE ASKED ME
FOR COOKIES IF I HADN'T PLACE
THEM HERE BUT IF I OFFERED THEM
TO USE SOME OF YOU WOULD TAKE A
COOKIE.
AND THAT'S THE SAME THING THAT
THE SAME PRINCIPLE THAT'S IN
PLACE HERE SO WE STRONGLY URGE
YOUR SUPPORT BECAUSE WE
UNDERSTAND THAT MAKING THE SMALL
CHANGES CAN MAKE A BIG
DIFFERENCE IN THE LIVES OF
FAMILIES. THAT MOST PARENTS WANT
TO BE ABLE TO MAKE IT EASY
CHOICES MARIO TALKED ABOUT AND
NOT HAVE TO DEPRIVE THEIR CHILD
OF SOMETHING. THAT WE UNDERSTAND
THAT FAMILIES OF DIFFERENT
INCOMES THAT DEPRIVATION FEELS
DIFFERENT BUT WHEN A FAMILY
DOESN'T HAVE AS MUCH MONEY BUT
ONE THING THE SOMETIMES PHILIP
HE CAN'T AFFORD TO PROVIDE IS AN
UNHEALTHY BEVERAGE. WHERE IS
WHAT A FAMILY HAS MORE MONEY
THEY FEEL LIKE THEY CAN PROVIDE
TRIPS TO DISNEY LAND AND OTHER
THINGS AND SO WE FEEL MORE
COMFORTABLE SAYING NO? WE WANT
TO MAKE IT SO THAT PARENTS DON'T
HAVE TO SAY NO BUT THE NO WAS
BUILT INTO THE ENVIRONMENT IT'S
NOT A CHOICE AND THE KIDS GROW
UPNOT SEEING THESE BEVERAGES
ARE NOT BEING PRIMED TO CONSUME
THINGS. BETTER ULTIMATELY
HARMING THEIR HEALTH TO BE
STRONGLY URGE ALL OF YOU TO HAVE
AN AYE VOTE ON THIS BILL THANK
YOU THANK YOU.
CAN TAKE.
SUPPORTERS STATE YOUR NAME A
POSITION PLEASE.
CHRIS SLIPPED WOBBLY SECOND
DIRECTOR FOR THE CALIFORNIA
STATE ALLIANCE OF YMCAS WERE
PLEASED TO CO SPONSOR THE BILL
HERE IN STRONG SUPPORT THINK.
GOOD AFTERNOON COOLER KOENIG
WITH THE AMERICAN HEART
ASSOCIATION AMERICAN STROKE
ASSOCIATION AND PROUD TO
COSPONSOR THIS BILL.
EMILY TIME TO HAVE THE
CALIFORNIA PAN ETHNIC HEALTH OR
IN SUPPORT.
AUTOMOTIVES MET WITH THE
AMERICAN CANCER SOCIETY CANCER
ACTION NETWORK ALSO IN STRONG
SUPPORT.
AB ONE REPRESENTING AMERICAN
ACADEMY OF PEDIATRICS AS WELL AS
SCHOOL NURSES BOTH IN SUPPORT.
LIKE YOUNG PUBLIC HEALTH
ADVOCATES CO SPONSOR IN STRONG
SUPPORT.
IT MUST PER CALIFORNIA FOOD
POLICY ADVOCATES IN STRONG
SUPPORT.
PATTERSON SHEFFIELD THE CURRENT
MP SIGNET UC DAVIS STRONG
SUPPORT.
RENDERING WE SACRAMENTO FOOD
POLICY COUNCIL IN SLOW FOR
CALIFORNIANS STRONG SUPPORT.
MARTHA HANSON PARA THREE VERY
YOUNG CHILDREN ANA ADVOCATE FOR
CHILDREN WITH DISABILITIES IN
STRONG SUPPORT.
CRITICS CALIFORNIA'S DISABILITY
RIGHTS STRONG SUPPORT.
BRENDA HOW BUT IT'S WITH THE
LATINO COALITION FOR HEALTHY
CALIFORNIA PROTOCOL SPONSORING
SUPPORT.
CARLA GONZALEZ MS PART OF THIS
BILL ON BEHALF OF THE YOUTH OF
CALIFORNIA.
THINK USER OPPOSITION.
QUESTIONS COMMENTS DURING THE
MEMBERS.
XENA QUESTION OF CENTER NEWMAN
NOT JUST ONE THING I WANT TO SAY
TO THE DOCTOR PATENT
THERE'S-SUCH A THING AS TEST FOR
THIS TO
GOOD YOU HAD IS THINKING ABOUT
COOKIES. ARAB. AND NOTHING ELSE
FOR AWHILE BUT.
I AM HAPPY TO.
I AM HAPPY TO
SUPPORT THIS BILL.
THEIR POWER TO YOU.
YOU HAVE ADAM UNTIL COOKIES.
WELL HE HAD I'M UNTIL COOKIES.
WE HAVE A MOTION.
CENTER ROTH SORRY.
SO MOVE CENTER. CENTER ROTH NOW
ITEM NUMBER SEVEN SP ONE ONE
NINE TO DO PASSED PUBLIC SAFETY
CALL MEMBERS FERNANDEZ AYE
HERNANDEZ AYE WHEN GO I'M SORRY
WHICH LICCARDO SENATE.
I'M NOT GOING TO TAKE A LOT OF
TIME I JUST WANNA THINK ALL
THOSE WHO'VE WAITED ALL
AFTERNOON TO BE HERE IN SUPPORT.
ON A THING THESE AMAZING
WITNESSES AND THANK THE
COMMITTEE IN ADVANCE FOR YOUR
SUPPORT. AND IN THE INDUSTRY
STATE HAVE STEPPED UP TO HELP
LEAD THE WAY THIS IS AN AREA
WHERE. GOVERNMENT AND PRIVATE
SECTOR CAN FIND A PATH OF
COOPERATION AND COLLABORATION.
THANK YOU I URGE YOUR AYE VOTE.
THANK YOU ALARM CALL MEMBERS
PLEASE.
WHEN. WHEN I LEYVA. LEYVA AYE
MITCHELL.
MITCHELL AYE MONNING.
MONNING AYE NEWMAN AYE. NEWMAN
AYE NIELSEN.
PAN AYE PAN AYE ROTH AYE ROTH
AYE.
CURRENTLY HAS EIGHT TWO ZERO.
THAT BILL IS OUT.
NIELSEN.
AND. WE WERE NOW GOING TO.
ITEM THREE S. B. TEN TWENTY
THREE.
MISTER CHAIRMAN.
THANK YOU MISTER MADAM CHAIR
MEMBERS DISPEL EXPAND AXES TO
REPORT REPRODUCTIVE HEALTH CARE
SERVICES THROUGH THE USE OF
INNOVATIVE TECHNOLOGY. THAT
CONNECTS PATIENTS WITH
HEALTHCARE PROVIDERS MORE
EFFICIENTLY AND COST
EFFECTIVELY.
TELEHEALTH IS EXPANDING ITS A
VITAL PART OF OUR HEALTHCARE
SYSTEM THAT INCREASES ACCESS TO
CARE AND LOWERS THE COST OF
SERVICES IS FRICTION RURAL AND
UNDERSERVED. AREAS OF OUR STATE
RIGHT NOW CALIFORNIA'S THERE AT
LEAST FOR WEBSITES OR APPS THAT
PATIENTS CAN USE REQUEST TEST.
FOR CERTAIN STDS AND HER MORAL
BIRTH CONTROL WITHOUT AN OFFICE
VISIT.
HOWEVER THE SPONSOR OF SB TEN
TWENTY THREE FOUND THAT IN SOME
AREAS OF THE STATE. HEALTH
INSURANCE REIMBURSEMENT FOR
THESE TYPES OF TELEHEALTH
SERVICES IS LIMITED.
IT'S BILL CLARIFIES IT INSURANCE
COVERAGE IS AVAILABLE FOR
CERTAIN REPRODUCTIVE SERVICES.
DELIVERED THROUGH TELEHEALTH IT
ALSO REQUIRES OUR FAMILY PACK
PROGRAM TO PROVIDE THIS
COVERAGE.
MEMBERS HIS BILL ENSURES THAT
PEOPLE SEEKING REPRODUCTIVE
HEALTH CARE SERVICES. REGARDLESS
OF LOCATION CAN RECEIVE THE CARE
THEY NEED IN THE MOST EFFICIENT
WAY WITH THAT I RESPECTFULLY ASK
IVAN.
AND WE'VE BEEN DOING SIX MINUTES
FOR SPORT AND SIX MINUTES FOR
OPPOSITION.
GREAT STATE AFTERNOON MY NAME IS
AMY MORE AND I'M VICE PRESIDENT.
OF PUBLIC AFFAIRS AT ESSENTIAL
ACCESS HEALTH AND WE ARE PROUD
TO SPONSOR I'M AS BE TEN TWENTY
THREE AND I'LL KEEP MY COMMENTS.
FAIRLY BRIEF AND WE ARE PROUD TO
SPONSOR THIS BILL TO EXPAND
ACCESS TO SEXUAL REPRODUCTIVE
HEALTH SERVICES INCLUDING
CONTRACEPTION AN STD TESTING
PREVENTION AND TREATMENT. BY
ENHANCING ACCESS SERVICES AS THE
SENATOR SAID THROUGH MOBILE
TELEHEALTH TECHNOLOGIES LIKE
VIDEO PHONE SMARTPHONE APP AND
ME THING SENATOR HERNANDEZ FOR
HIS LEADERSHIP ON. THIS BILL.
THE CALIFORNIA HAS SIGNIFICANTLY
REDUCED ON AND HAD A PREGNANCY
RATES THANKS TO POLICY AND
PROGRAM INNOVATIONS THAT HAVE.
REDUCE BARRIERS TO ACCESSING
REPRODUCTIVE HEALTH CARE THE
STATE'S UNINTENDED PREGNANCY
RATES REMAIN NEARLY DOUBLED
THOSE IN OTHER DEVELOPED
COUNTRIES.
APPROXIMATELY NINETY FIVE
PERCENT OF ALL UNINTENDED
PREGNANCIES ARE ATTRIBUTABLE TO
WOMEN WHO DON'T USE
CONTRACEPTIVES OR WHO USE THEM
INCONSISTENTLY.
IN CALIFORNIA SIXTY FOUR PERCENT
OF UNPLANNED BURST WERE PUBLICLY
FUNDED IN TWENTY TEN AND OVER
THREE HUNDRED THOUSAND
CALIFORNIANS REMAIN IN NEED OF
PUBLICLY SUPPORTED FAMILY
PLANNING CARE.
AS MANY OF YOU KNOW AS DEE DEE
RATES ARE ALSO AT A HISTORIC
HIGH DISPROPORTIONATELY
IMPACTING YOUTH COMMUNITIES OF
COLOR AN MS M. POPULATIONS. AND
OUR STATE CURRENTLY RANKS FIRST
IN THE COUNTRY AND RATES OF
CHLAMYDIA. GONORRHEA AND
SYPHILIS INFECTIONS AND IF LEFT
UNDETECTED IN UNTREATED STDS CAN
LEAD TO SERIOUS LONG TERM HEALTH
CONDITIONS INCLUDING BLINDNESS
IN INFERTILITY AND ADD
SIGNIFICANT COSTS AND BURDENS TO
OUR WHOLE SYSTEM.
TOO MANY CALIFORNIANS STILL FACE
BARRIERS IN ACCESSING TIMELY
SENSITIVE SEXUAL REPRODUCTIVE
HEALTH SERVICES INCLUDING
GEOGRAPHIC TRANSPORTATION AND
TIME BARRIERS CONFIDENTIALITY
ISSUES AND THE LEASING CARE
BECAUSE BY WORKFORCE SHORTAGES.
WIDESPREAD SMARTPHONE USE OFFERS
NEW PATHWAYS FOR EXPANDING
ACCESS TO HEALTH CARE AND IN
TURN AN OPPORTUNITY TO IMPROVE
PUBLIC HEALTH OUTCOMES AND SAVE
PUBLIC RESOURCES.
WE KNOW THAT MANY COMMERCIAL
HEALTH PLANS ARE COVERING
ESSENTIAL HEALTH SERVICES
PROVIDED BY MOBILE TELEHEALTH
MODALITIES AND NOW IT'S TIME TO
LEVEL THE PLAYING FIELD. AND
MAKE SURE THAT ALL CALIFORNIANS
CAN GET HERE WHERE THEY ARE ON
THEIR PHONES
SO FOR THOSE REASONS WE ASK FOR
YOUR SUPPORT.
THANK YOU A.
PLEASE GO AHEAD.
THANK YOU MADAM VICE CHAIR
MEMBERS OF THE COMMITTEE MAKE
CONSUMERS ON BEHALF OF
CALIFORNIA HEALTH PLUS ADVOCATES
REPRESENTING THE THIRTEEN
HUNDRED. COMMITTEE HEALTH
CENTERS AND CLINICS IN
CALIFORNIA WHO SERVE ABOUT SIX
AND A HALF MILLION PATIENTS
STATEWIDE IN VERY STRONG SUPPORT
THANK YOU.
CRITICS CALIFORNIA'S DISABILITY
RIGHTS WE CREATE WHAT SHE SAID
AND ALSO PREVENTS BLINDNESS
INFOPRINT OTHER DISABILITIES AND
THAT'S WHAT IT'S REALLY ALL
ABOUT TEAM PATRON SINCE LIGHTS
AND PROTECTING THEM. SOMEONE
STRONG SUPPORT.
PRESSMAN SO WITH THE CALIFORNIA
ACADEMY OF FAMILY PHYSICIANS AS
WAS PLANNED PARENTHOOD IN
SUPPORT.
ANY OTHER SUPPORT. ANY
OPPOSITION.
CNN BY.
THERE'S A MOTION MISTER CHAIRMAN
WOULD YOU LIKE TO CLOSE THE
NEVER.
IT'S CALLED BUT THIS ISN'T YOU
PASS TWO APPROPRIATION.
HERNANDEZ HERNANDEZ AYE WHEN I
WHEN I LEYVA. LEYVA AYE
MITCHELL.
MITCHELL AYE MONNING AYE AYE
MONNING AYE NEWMAN. NEWMAN AYE
NIELSEN.
AND I AND I ROSS.
ROTH I.
THERE EIGHT ZERO IN THE BILL'S
OUT.
THANK YOU VERY MUCH MADAM CHAIR
MEMBERS AND S. B. LEVIN FIFTY
TWO MISTER CHAIR. THANK YOU
MADAM CHAIR MEMBERS AGAIN.
WE ALL KNOW THAT WE HAVE A
HOMELESS CRISIS HERE IN THE
STATE NOW WE SEE IT EVERYWHERE I
SEE MY DISTRICT YASSINE
YOURSELVES IN YOUR DISTRICTS AS
WELL. ON THIS BILL IS TRYING TO
TACKLE JUST ONE ASPECT OF THIS
PROBLEM. WHAT HAPPENS WHEN
HOMELESS PATIENTS ARE DISCHARGED
FROM THE HOSPITAL'S?
THIS BILL SEEKS TO MAKE HOSPITAL
DISCHARGE SAFE FOR THIS
POPULATION.
WANT TO BE CLEAR THAT HOSPITALS
ARE NOT THE CAUSE OF THE
PROBLEM.
AND THAT IN MANY CASES HAVE BEEN
GONE GOING ABOVE AND BEYOND TO
HELP HOMELESS PATIENTS.
BUT THERE HAVE BEEN NUMBER OF
HIGH PROFILE CASES WERE PATIENT
BEEN DISCHARGED AN UNSAFE
MANNER.
AND FEEDBACK FROM HOMELESS
SHELTERS MAKE IT CLEAR THAT WE
NEED BETTER COORDINATION BETWEEN
HOSPITALS.
AND HOMELESS SERVICES PROVIDERS.
GETTING HOSPITAL TO WORK CLOSELY
WITH THE HOMELESS RESOURCE IN
THE COMMUNITY IS A TOP PRIORITY
OF THIS BILL.
WE NEED TO MAKE SURE THAT HOME
INTO THE HOMELESS PATIENTS ARE
DISCHARGED TO THE PLACE WHERE
THEY LIVE. OR WORK TO A SHELTER
THAT HAS SPARE THIS SPACE FOR
THEM AND NOT TAKE INTO AN
UNFAMILIAR PLACE. THAT IS
UNACCEPTABLE.
A HOSPITAL VISIT IS AN
OPPORTUNITY ASSISTIVE VULNERABLE
POPULATION MEMBER IF SOCIETY AND
PUT THESE PATIENTS IN A LITTLE
BETTER POSITION WHEN THEY LEAVE.
THERE'S A LIST OF THINGS THAT WE
WANT TO PROVIDE. BUT DEMILLE
CLEAN CLOTHES AND THE
MEDICATIONS THAT THEY NEED. I
UNDERSTAND THAT THIS BILL IS NOW
A WISH LIST AND SOME THINGS IN
THIS BILL MAY NOT BE PRACTICAL
IN ALL CASES THERE FROM WILLING
TO WORK WITH THE OPPOSITION AS
WE MOVE THIS BILL ALONG SHOULD
GET OUT OF THIS COMMITTEE
I'VE WITNESSES AGAINST BEACON
BEHALF OF THE BILL WITH THAT I
RESPECTFULLY ASK PRIVATE.
THANK YOU AND TO STAY CONSISTENT
FOR ALL DAY WILL DO SIX MINUTES
FOR SPORTED SIX MINS FOR.
OPPOSITION TESTIMONY PLEASE
GOTTEN.
WONDERFUL AND THANK YOU SENATOR
HERNANDEZ FOR HAVING ME HERE AND
THANK YOU MEMBERS MY NAME IS
JOHN AND A PROBLEM A RESIDENT
PHYSICIAN.
AND CISCO IN INTERNAL MEDICINE
I'M AND I BELIEVE CREATE THE
OPPORTUNITY TO SPEAK ON BEHALF
IN SUPPORT OF SB ELEVEN FIFTY
TWO. AM I'D LIKE TO TELL YOU A
STORY ABOUT ONE OF MY PATIENTS
WHO STORY I THINK ENCAPSULATES
AYE WHITE IS LEGISLATION IS IS
SO NECESSARY. TIME MISTER ABBAS
THIS THIRTY FIVE YEARS OLD AND
LIVES IN SAN FRANCISCO AND AND
HE'S HOMELESS AND LAST YEAR DUE
IN PART TO THE. THE HARSH
REALITY OF A OF LIFE ON THE
STREET HE DEVELOPED A SEVERE
SKIN INFECTION.
I ADMITTED INTO THE HOSPITAL AND
TO CARE FOR HIM AND AFTER
SEVERAL DAYS HE NO LONGER
REQUIRED IT ANTIBIOTICS NEED
STABILIZED BUT HE STILL REQUIRED
SEVERAL MORE DAYS OF ORAL
ANTIBIOTICS.
IN THE EYES OF THE CURRENT
HEALTHCARE SYSTEM THE HOSPITAL
HAD DONE ITS JOB AND HE NO
LONGER HAD ANY IN PATIENT NEED.
HE WAS SCHEDULED TO BE
DISCHARGED IN AN ALL TOO
FAMILIAR FASHION FOR MANY OF OUR
MARGINALLY HOUSE PATIENTS.
TO AWAITING LINE AT A JAM PACKED
SHELTER HOPING TO FIND AN OPEN
BED FOR THE NIGHT.
BUT DISCHARGED COINCIDED WITH
THAT MONEY THESE TORRENTIAL
RAINSTORMS THAT WE HAD LAST YEAR
IN IN SAN FRANCISCO AND AND THE
MORNING OF DISCHARGE.
MR AB TOLD ME THAT HE WAS
TERRIFIED OF LEAVING THE
HOSPITAL SO SOON AFTER A SERIOUS
ILLNESS.
WITH ONLY JUST HEALING SKIN
WOUNDS TO WAIT OUTSIDE DRENCHED
IN THE HOPE OF SECURING A
SHELTER BATTER FORMAT.
THE HOSPITAL HOWEVER IS ON
SYMPATHETIC TO SUCH CONCERNS
ABOUT THE SAFETY OF A DISCHARGE
PLAN FOR ONE OF OUR MOST
MARGINALIZED PATIENTS AND. THE
ARE GOING SO FAR AS THE RESPONSE
OF ONE SENIOR LEADER IN THE
HOSPITAL WAS THAT HE SHOULD BE
GIVEN TRASH BAGS TO WHERE'S
REINDEER AFTER LEAVING THE
HOSPITAL.
AND SOME BUT FORTUNATELY WE WERE
ABLE TO GET HIM A RAINCOAT THAT
FIT BUT HE STILL HAD TO LEAVE
THE HOSPITAL IN THE STORM
WITHOUT A GUARANTEE OF A PLACE
TO SLEEP OR SECURE FOLLOW UP
PLAN. SHOULDN'T BE ANY SURPRISE
THEN THAT SO MANY OF OUR
HOMES-PATIENTS LEAVE THE
HOSPITAL
AFTER AN ACUTE ILLNESS ONLY TO
COME.
WITH THE
CUTE ON THE.
NOT HAVING HAD.
THE COORDINATION OF THE OTHER
SECURE DISCHARGE.
I COULD TELL YOU HUNDREDS OF
STORIES SIMILAR TO THIS ONE AND
BECAUSE OF THIS BASED ON MY
EXPERIENCES AS A POSSESSION. I
SUPPORT SB ELEVEN FIFTY TWO I
SUPPORT THIS BILL BECAUSE IT
WOULD CREATE A SPECIAL
DISCHARGED PLAN.
ACCESS
FOR ALL PEOPLE EXPERIENCING
HOMELESSNESS WHO ARE LEAVING THE
HOSPITAL.
I WOULD ALSO ENSURE THAT BASIC
HUMAN NEEDS ARE MET BEFORE
DISCHARGE. INCLUDING HAVING HAD
A RECENT MEAL CLOTHING WEATHER
APPROPRIATE ATTIRE. IN ADDITION
TO FOLLOW UP WITH A MEDICAL
PROVIDER.
THESE RULES ARE NOT WITHOUT
PRECEDENT THE VA HEALTH SYSTEM
ENSURES THAT PATIENTS HAVE SIT
SAFE AND STABLE DISCHARGED PLANS
A REFLECTION OF OUR NATION'S
NOBLE COMMITMENT TO HOUSING
VETERANS.
WE MAY NOT BE AT A POINT WHERE
THE REST OF OUR HEALTHCARE
SYSTEM IS ABLE TO OFFER THAT
COORDINATION AND THE SUPPORT
THAT A SINGLE PAYER INTEGRATED
SYSTEM COULD OFFER BUT WE CAN
TAKE A STEP TOWARD SAFEGUARDING
THE BASIC HUMAN RIGHTS OF OUR
MOST VULNERABLE. FELLOW CITIZENS
BY SUPPORTING AT ELEVEN FIFTY
TWO TODAY THANK YOU.
MADAM CHAIR MEMBERS CAN SAVAGE
ON BEHALF OF THE CALIFORNIA PAN
ETHNIC HEALTH NETWORK WE'RE HERE
TODAY AS A SPONSOR OF S. B.
ELEVEN FIFTY TWO AND THINK THE
AUTHOR. I'M FOR HIS WORK ON THIS
ON I THINK WE'RE ALL FAMILIAR
WITH THE ISSUE OF HOMELESSNESS
IN CALIFORNIA OVER A HUNDRED AND
THIRTY THOUSAND CALIFORNIANS ARE
ESTIMATED TO BE HOMELESS IN
TWENTY SEVENTEEN. ON AND WE
RECOGNIZE THAT THIS IS A
SIGNIFICANT CHALLENGE FOR THE
STATE ON BUT ALSO TAT THE
LEGISLATURE HAS WORKED REALLY
HARD TO PUT RESOURCES INTO
HOUSING AND PARTICULARLY I'M
FINDING PLACES FOR PEOPLE ARE
CURRENTLY HOMELESS TO RESIDE.
I'M BUT MAJOR GAPS REMAIN AN SB
ELEVEN FIFTY TWO ADDRESSES ONE
GAP THAT HAS BEEN IDENTIFIED
WHICH IS THE POINT WHEN SOMEONE
ENGAGED. WILL SYSTEM AND BY
DOING THAT IT BRINGS OUR SYSTEMS
CLOSER TOGETHER SO THAT WE CAN
HAVE BETTER COORDINATION.
I'M JOHN TALKED A LOT ABOUT
PEOPLE ARE HOMELESS EXPERIENCE
SIGNIFICANT HEALTH CHALLENGES I
KNOW THAT'S NOT UNFAMILIAR TO
THIS COMMITTEE ON DIFFICULTY
MANAGING CHRONIC DISEASES
INFECTIONS POOR HYGIENE IN
ABILITY TO STORE MEDICATIONS.
I'M AND BASIC ASPECTS OF HOPE
LIKE SLEEP AND NUTRITIOUS FOOD
ARE DIFFICULT TO COME BY. I'M
ULTIMATELY HOMELESS INDIVIDUALS
HAVE THEIR LIFESPAN SHORTENED BY
AN AVERAGE OF THIRTY YEARS.
AND LAST YEAR OVER EIGHT HUNDRED
PEOPLE DIED HOMELESS AND LA
COUNTY ALONE DUE PRIMARILY TO
PREVENTABLE CAUSES.
WHEN A PATIENT IS HOMELESS
EMERGENCY DEPARTMENTS AND
HOSPITALS ARE EXPECTED TO
PROVIDE THE SAME LEVEL OF CARE
AS THEY WOULD TO ANY OTHER
PATIENT. BUT WITHOUT ADDRESSING
UNDERLYING NEEDS OF THAT PATIENT
SUCH AS FOOD CLOTHING AND
SHELTER THEIR HEALTH IS UNLIKELY
TO IMPROVE. AND WHEN A PATIENT
COMES IN WITH AN INFECTION OR
WOUND A HOSPITAL MAY TREAT THEM
MEDIA CONCERN BUT THERE CANNOT
BE A REASONABLE EXPECTATION THAT
THE PATIENT WITHOUT SHELTER WILL
BE ABLE TO CLEAN AND CARE FOR
THE WOUND. ON COMPLETE A COURSE
OF ANTIBIOTICS OR PREVENT THE
ISSUE FROM OCCURRING IN THE
FUTURE. SO THIS BILL IS REALLY
ABOUT MAKING CONNECTIONS SO THAT
PEOPLE HAVE SHELTER HAVE
RECEIVED A NUTRITIOUS MEAL OR
HAVE A SOURCE OF FOLLOW UP FOR
PREVENTIVE CARE. I'M WHICH
ACTUALLY DOES MAKE A DIFFERENCE
FOR THE HEALTH OF THE PATIENT
ON THE BILL ADDRESSES THE ISSUE
OF INAPPROPRIATE DISCHARGE OR
DUMPING OF HOMELESS PATIENTS I'M
ACKNOWLEDGING THAT HOUSING IS AN
ESSENTIAL COMPONENT OF HEALTH.
AND I JUST REALLY BRIEFLY SHARE
COUPLE EXAMPLES THAT WE'VE
RECEIVED FROM SOME OF THE FOLKS
THAT WE WORK WITH I'M IN ONE
CASE A PATIENT WAS DISCHARGED TO
A SHELTER FOR DAYS AFTER SPINAL
SURGERY. THE PATIENT WASN'T
SIGNIFICANT PAIN COULDN'T
TOLERATE THE SHELTER CONDITIONS.
AND ENDED UP RECOVERING FROM
SURGERY ON A SOFA IN AN ALLEY
I'M IN ANOTHER SERIES OF CASES
TO DO WITH AN EMERGENCY WINTER
SHELTER PROGRAM I'M A NUMBER OF
CASES THAT PATIENTS HAVE COME TO
THE SHELTER PROGRAM WHICH IS
ESSENTIALLY A SLEEPING BAG IN A
CHURCH BASEMENT HAVE COME. THERE
DIRECTLY FROM HOSPITAL ON WITH
THINGS LIKE EXTREME INCONTINENCE
DRESSINGS THAT NEEDED CHANGING
AN UNTREATED MENTAL HEALTH
ISSUES AND THEY ALSO CAN
TOLERATE THE ROUTINE OF THAT
PROGRAM. WE KNOW THERE'S A LOT
THAT HOSPITALS ARE DOING IN THIS
AREA THERE'S MODELS THAT WORK
THERE INVESTMENTS THAT ARE BEING
MADE I'M AND WE THINK THAT THIS
BILL REALLY ENCOURAGES THIS WORK
TO CONTINUE AND EXPAND IT DOES
NOT REQUIRE HOSPITALS TO BECOME
HOMELESS SHELTERS. OR HOUSING
SERVICES PROVIDERS RATHER TO BE
A PART OF THE SYSTEM THAT REALLY
REQUIRES ALL OF US TO TO DEAL
WITH THIS VERY SIGNIFICANT
HAUNTING CALIFORNIA OF
HOMELESSNESS THANK YOU.
MADAM CHAIR MEMBERS IT'S YOU
HAVE YOU CAN WRAP IT UP VERY
QUICKLY.
MICHELLE COVERED IT UP WITH A
CA YOU CALIFORNIA WHERE ANOTHER
CO SPONSOR OF THIS BILL AND.
WE REPRESENT.
AT THE OCIAL WORKERS WHO DO
THE DISCHARGE DO THE THINGS THAT
THEY KNOW
THEY NEED TO DO AND WANT TO DO
ON BEHALF OF SOME OF THEIR MOST
VULNERABLE PATIENTS.
AS IT KAREN SAID WE HAVE
EXAMPLES MICHAEL PERSON CARE
PILOTS WE HAVE EXAMPLES WERE
HOSPITALS GO ABOVE AND BEYOND.
AND WE ALSO HAVE EXAMPLES WERE
WHERE HOSPITALS ARE FALLING WELL
BELOW KIND OF A BASIC MINIMUM
STANDARD OF HUMANE TREATMENT FOR
HOMELESS INDIVIDUALS THE CURRENT
LAW IN THIS AREA IF YOU READ
WHAT IT SETS FORTH FOR HOSPITAL
DISCHARGE. IT DOES NOT
CONTEMPLATE THAT AN INDIVIDUAL
HAS NEITHER A PLACE TO GO NOR
PEOPLE TO HELP THEM OUT POST
DISCHARGE AND SO WERE REALLY
FILLING IN A GAP HERE. AND
BOLSTERING Y. OUR HOSPITAL STAFF
ALREADY WANT TO DO.
AND AGAIN IT IS ABOUT LINKING
TO.
AT EXISTING RESOURCES COMING UP
WITH A PLAN AND REALLY
EMPOWERING OUR STUFF TO DO WITH
THE NEED TO ACCEPT
WE URGE YOUR I THANK YOU.
GREAT THANK YOU.
WHO WERE? WILL GIVE FAIR TIME
FOR THE A OPPOSITION IN A MINUTE
UP.
SEE MORE SUPPORT PLEASE YOU'LL
PLEASE STATE YOUR NAME. YOU'RE
PUT DOWN YOUR ORGANIZATION YOUR
POSITION ONLY.
AND BY WHAT HEALTH THAT'S OF
CALIFORNIANS VERY STRONG SUPPORT
OF THE SPELL.
AND FLOORS WESTERN CENTER ON LAW
AND POVERTY IN SUPPORT.
ICARLY NOVI AND WITH THE HAVING
OUR STATE COALITION.
WE ARE A STATEWIDE COALITION OF
OVER THIRTY ORGANIZATIONS AND WE
STRONGLY SUPPORT THIS BILL.
DOCTOR CLOTURE CARRILLO FROM SAN
FRANCISCO GENERAL HOSPITAL IN
STRONG SUPPORT.
SCOTT GOLDBERG I'M A RESIDENT
PHYSICIAN AT UCSF AND I SUPPORT
THIS BILL.
BONUS YOU ALL RESIDENT PHYSICIAN
AT THE UC DAVIS MEDICAL CENTER
IN SUPPORT OF THIS BILL.
RIGHT NEXT CALIFORNIA'S TO
DISABILITY RIGHTS IN STRONG
SUPPORT.
MY NAME IS DOCTOR KENNY
PATTERSON ON IT IS POSITION THAT
YOU SEE SEVEN CISCO IN SUPPORT.
AFTER EMILY THOMAS AT UCSF AND
STRONG SUPPORT OF THIS BILL.
THREAD SORRY DOCTOR AT UCSF IN
AMPUTATE BE AN ADDICTION
MEDICINE STRONGLY IN SUPPORT OF
THIS BILL.
THANK YOU ANY FURTHER SUPPORT.
TESTIFY IN OPPOSITION WE. IT WAS
A.
WHERE?
IT WAS A LITTLE BIT OVER A
MINUTE. A OVER SO I WOULD GIVE
THE SAME TIME TO THE OPPOSITION
AS WELL.
SO LOST SEVEN MINUTES AND.
FIFTEEN SECONDS.
PLEASE GO FORWARD GO AHEAD.
GOOD AFTERNOON MADAM CHAIR AND
MEMBERS BARBARA GLAZER ON BEHALF
FOR THE CALIFORNIA HOSPITAL
ASSOCIATION WE DO HAVE AN OPPOSE
UNLESS AMENDED POSITION ON SB
ELEVEN FIFTY TWO. WE HAVE MET
WITH THE CONCERT IS OF THE BILL
AND TALKED ABOUT SOME OF OUR
CONCERNS THAT WE INTEND TO MEET
WITH THEM VERY SOON TOOK OVER
SPECIFIC AMENDMENTS ON BUT WE DO
LOOK FORWARD TO WORKING WITH
THEM AND THE AUTHOR ON THE BILL.
HERE WITH ME TODAY IS LIZ.
MILLER.
ON SHE'S A NURSE WITHOUT BENNIS
HEALTH SYSTEM AND.
SHE IS HERE ON BEHALF OF CA
CHECK.
THANK YOU SENATOR.
HERNANDEZ AND COMMITTEE MANNER
EMBERS ON THE SENATE HEALTH
COMMITTEE FOR THIS OPPORTUNITY
TO TESTIFY. TODAY ON SENATE BILL
ELEVEN FIFTY TWO.
FIFTY TO THE HOMELESS BILL I AM
A LIST MILLER I'M ARE AND HAVE
BEEN ONE FOR OVER FORTY THREE
YEARS. I AM AN. ADVENTIST HEALTH
EXECUTIVE. AND I AM OVER THE
TWENTY HOSPITALS IN CARE
MANAGEMENT THAT'S THE OUR ENDS
AND THE SOCIAL WORKERS AND ALSO
POPULATION HEALTH.
I REPRESENT ADVENTIST HEALTH
WEST REGION A NON PROFIT FAITH
BASED INTEGRATED HEALTH SYSTEM
SERVING MORE THAN SEVENTY FIVE
COMMUNITIES ON THE WEST COAST
AND HAWAII.
OF OUR TWENTY HOSPITALS
SEVENTEEN ARE IN CALIFORNIA.
SEVENTEEN.
SEVENTY PERCENT OUR RULE AND
EIGHTY PERCENT OF OUR PATIENTS
ARE MEDICARE AND MEDICAL COVERED
PAYERS.
ONE OF OUR FOR CRITICAL CARE
ACCESS HOSPITALS CLEARLY. IS IN
LAKE COUNTY THE POOREST COUNTY
IN CALIFORNIA.
WE SERVE A HIGH VOLUME OF
HOMELESS.
A THIRD OF OUR ENCOUNTERS IN
SOUTHERN CALIFORNIA EAST LA
WHITE MEMORIAL.
FROM NORTHERN CALIFORNIA CENTRAL
FELT CENTRAL VALLEY TO SOUTHERN
CALIFORNIA.
EACH HOMELESS PATIENTS IN PERSON
IS TREATED WITH DIGNITY.
DELIVERING WHOLE HEALTH AND
WELLNESS ACCORDING TO OUR
MISSION.
WE BELIEVE AS JESUS DID WE SERVE
AND GO WHERE N ONE ELSE WOULD
WANT TO TO CARE FOR THOSE IN
NEED.
OUR EMERGENCY DEPARTMENTS. ARE
THE GATEWAY TO OUR ACUTE CARE
HOSPITALS. AND MANY OF OUR
ENCOUNTERS DAILY ARE THE
HOMELESS POPULATION.
WE PROVIDE FOOD CLOTHING A PLACE
TO SHOWER AN ASSESSMENT AND
IDENTIFICATION IF THEY ARE
WILLING TO LOCAL RESOURCES IN
SUPPORT OF HOUSING TO MEET THEIR
INDIVIDUAL NEEDS. FORCED SAFE
APPROPRIATE TRANSITION TO THE TO
CONTINUE MIGHT CARE.
EACH HOMELESS PERSON IS A UNIQUE
INDIVIDUAL WITH UNIQUE MEANS
WITH THEIR PERMISSION WE STRIVE
TO ADDRESS THEIR INDIVIDUAL
NEEDS.
THROUGH OUR ASSESSMENT WITH OUR
PHYSICIANS ARE NURSES ARE SOCIAL
WORKERS AND OUR CARE MANAGERS.
MANY SUFFER FROM MENTAL HEALTH
AND SUBSTANCE ABUSE CHALLENGES
ALONG WITH THEIR PHYSICAL NEEDS
MAKING THE COORDINATION OF CARE
COMPLEX.
WE DO NOT WAIT FOR THEM TO ENTER
OUR EMERGENCY ROOM. IN SOUTHERN
CALIFORNIA WE STOCK A BUS WITH
FOOD CLOTHING AND INDEED THE
PHYSICIANS SOCIAL WORKERS AND
CARE MANAGERS AND OTHER HOSPITAL
PERSONNEL TO GO TO THE PARK.
AND PARKS AND UNDER BRIDGES
WHERE THE HOMELESS RESIDE AND WE
OFFER THEM CLOTHING FOOD AND AN
ASSESSMENT TO ENSURE THEY ARE
OFFERED LOCAL RESOURCES AND
SUPPORTING. AND SUPPORTIVE
HOUSING IF THEY CHOOSE.
THE CURRENT S. B. ELEVEN FIFTY
TWO AS WRITTEN CREATES A
PRESCRIPTIVE DISCHARGE PLANNING
PROCESS.
THAT DOES NOT SUPPORT THE
ABILITY OF THE TREATING
PHYSICIAN. NURSES SOCIAL WORKERS
CARE MANAGERS AND OTHER
QUALIFIED PERSONNEL TO DETERMINE
WHEN THE PATIENT IS STABLE FOR
DISCHARGE.
AND THE SPECIFIC POST ACUTE
NEEDS AND IDENTIFIED COMMUNITY
BASED PARTNERS THAT WILL BEST
SERVE THE PATIENT.
I APPRECIATE THIS OPPORTUNITY TO
TESTIFY ON THE BEHALF OF
ADVENTIST HEALTH APPROACH TO
MEET THE NEEDS OF OUR HOMELESS
PATIENTS.
AND LOOK FORWARD TO WORKING WITH
YOU ON SENATE BILL ELEVEN FIFTY
TWO.
THANK YOU. THIS CRACK.
BRADFORD FOUR MINUTES.
BOTTOM MADAM CHAIR A BELIEVE
WHEN YOU'RE SENATORS TRANSIT
JONES SAWYER SAID OF PICKUPS
ARE.
LOW AND THE IT OKAY. OLDEST TO
MADDEN REVIEWING CALVET YOU
THREE MORE MINUTES FOR THE TWO
MINUTES FOR THAT PAT YOU KNOW
YOU WANT TO GO YOU TIME.
LOOK WHO'S HERE THE BUDGET ME WE
GET OUR.
IMAGINE REPRESENTING THE
CALIFORNIA CHAPTER OF THE
AMERICAN COLLEGE OF EMERGENCY
PHYSICIANS WE ALSO HAVE AN
OPPOSE UNLESS AMENDED POSITION.
I'M FOR STARTERS WE WE
ABSOLUTELY DO NOT CONDONE THE
ACTIVITIES THAT BEEN DESCRIBED
HERE TODAY BY CENTER HERNANDEZ
THE PROPONENTS.
AND WHAT APPEARED AND.
LOCAL NEWSPAPERS.
THE HOMELESS POPULATION ARE OUR
PATIENTS AS MISS MILLER
DESCRIBED WE TAKE GREAT PRIDE IN
TREATING THEM.
I'M MORE IN THE CHALLENGES AS
YOU ALL KNOWN AS BEEN DISCUSSING
TODAY IS THE OVERCROWDED.
ASPECTS OF EMERGENCY DEPARTMENT
WE HAVE NO SHORTAGE OF PEOPLE
WHO WERE WAITING TO GET IN TO
SEE US FOR WAITING TO BE
ADMITTED INTO THE HOSPITAL.
BOARDING IS ONE OF OUR MAJOR
CHALLENGES THIS IS A SITUATION
WE HAVE A PATIENT NUMBERS AND
BERMAN WHO'S READY TO BE
ADMITTED. BUT THERE ARE NO BEDS
UPSTAIRS TO ADMIT THEM TO.
THEY STAND EMERGENCY DEPARTMENT
AND THAT'S WHERE THE BACKUP
STARTS THROUGHPUT IS ONE OF OUR
BIGGEST CHALLENGES.
WHEN WE LOOK AT THIS BILL IN
SOME OF THE PROVISIONS THAT ARE
OUTLINED IN IT IN TERMS OF
SERVICES ARE PROVIDED. THESE AND
RV OR LARGELY SERVICES ARE
NEEDED AFTER WE PROVIDED ALL THE
MEDICALLY NECESSARY CARE IN THE
MERCY DEPARTENT IN THE PERSON'S
READY TO BE DISCHARGED WITHOUT
BE GO UPSTAIRS TO ADMITTED BAD.
OR DISCHARGE OUT OF THE
HOSPITAL.
I'M OUR AMENDMENT THEY WERE
REQUESTING IS THAT THE SERVICES
ARE TO BE PROVIDED THAT THAT BE
DONE IN A NON PATIENT AREA.
WHICH WOULD ALLOW US TO MOVE THE
PATIENT TO THAT AREA AND ALLOW
US TO GET MORE PATIENTS INTO THE
MERCY DEPARTMENT IT WOULD BE
IMPORTANT THAT APPLY BOTH TO THE
MEARNS DEPARTMENT IS WILL THE IN
PATIENT AREAS. TO THE EXTENT
THAT THE SERVICES ARE PROVIDED
UPSTAIRS TO A PATIENT ONCE AGAIN
IT'S CAUSING MORE OF DELAYS AND
IMMERSE APARTMENT.
WE APPRECIATE THE TIME WITH THE
SPONSORS AND WITH THE AUTHOR AND
FORTY TO CONTINUE THE
CONVERSATION.
THANK YOU ANY FURTHER OPPOSITION
GET RESTORE TONS ABOUT THE
CALIFORNIA MEDICAL ASSOCIATION
LIKE TO ASSOCIATE MYSELF WITH
THE COMMENTS BY THE E. OUR
PHYSICIANS BUT ONE THINK THE
AUTHOR FOR BRINGING. THIS ISSUE
TO LIGHT AND THEIR COMMITMENT TO
WORK FURTHER ON THIS ISSUE THANK
YOU.
THANK YOU.
JONATHAN CLAY ABOUT THE SCRIPTS
HEALTH ALSO ARE ALSO IN
OPPOSITION.
Q..
ANY OTHER OPPOSITION.
SENATOR MITCHELL.
THANK YOU VERY MUCH.
MADAM CHAIR ON THANK YOU DR
GRANT IS FOR BRINGING THE BILL
FURTHER IF AT ANY POINT.
.
YOU MEAN THE BILL I HOPE YOU
WOULD CONSIDER ADDING ME AS A CO
AUTHOR.
.
ODD TO A ONE OF THE OPPONENTS.
I FULLY APPRECIATE THE.
ADVOCATES HEALTH SYSTEM IN YOUR
MISSION BASED EXPERIENCE QUITE
FRANKLY IS UNIQUE.
BUT I APPLAUD YOUR WORK IN THE
AREA.
BUT IT IS UNIQUE TO A FAITH
BASED SYSTEM.
I WOULD SUGGEST
AND AS I READ THIS BILL ON IT'S
CLEAR TO ME THAT DOCTOR
HERNANDEZ ON IS ATTEMPTING TO
ESTABLISH A HUMANE MORE OF
SERVICE.
I APPRECIATE THAT YOU ALREADY GO
ABOVE AND BEYOND AND SO I'M
HOPING THAT YOU CONTINUE TO.
NEGOTIATE THAT THAT SYSTEMS THAT
ALREADY PROVIDE.
.
SERVICES.
WON'T BE LIMITED IN IN THEIR
OUTREACH AND THEIR EFFORTS.
YOU KNOW I I MUST.
WE WE HEARD SOME PRETTY
EGREGIOUS STORIES FROM THE.
PROPONENTS
ALL I HAVE A SITUATION IN MY OWN
DISTRICT IS AS CONSTITUENTS. WHO
FAMILY CAME TO ME DISTRAUGHT
BECAUSE THEIR FAMILY MEMBER ARM
WAS INDEED MISSING?
FOR WEEKS.
ARE HAVING BEEN IN THE HOSPITAL
PA AND DIAGNOSED WITH DEMENTIA
DUE TO ALCOHOL ABUSE
VERY YOUNG MAN. CALMLY REFERRED
TO THE WEB BRAIN.
SO TO DISCHARGE SOMEONE WHO YOU
KNOW HAS MEMORY ISSUES WITH
OTHER VERY SERIOUS COMORBIDITY
CONDITIONS.
HE WAS DROPPED OFF AT A SHELTER.
.
LIKE OUT THE DOOR NO CONNECTION
MADE NO EXPLANATION ABOUT HIS
MEDICAL CONDITION.
OR HIS DEMENTIA.
AND CLEARLY WALKED AWAY ARE AND
WAS MISSING FOR WEEKS.
I THINK THE. ELEMENTS OF YOUR
BILL ARM ARE FAIR AND
APPROPRIATE.
.
I HEAR THE E. ARE DIOXIN AND I'M
WILL LOOK FOR IT YOU'RE CLOSING
HERE HOW.
SOME OF THOSE ISSUES CAN BE
ADDRESSED AS WE SIT HERE FROM AN
E. ARE.
PRACTITIONERS ACROSS THE STATE
ABOUT DEALING WITH TE LACK OF
BETTER ACCESS FOR MENTAL HEALTH
PATIENTS SO I GET THAT BUT LIKE
I SAID FROM MY PERSPECTIVE THIS
IS ESTABLISHING THE FLOOR
MINIMUM EXPECTATIONS FOR
HOSPITALS.
IN DEALING WITH.
A POPULATION THAT WE ALL ARE
STRUGGLING TO MANAGE AND SUPPORT
AND HELP IN A HUMANE IMPROPER
WAY SO PROBLEMS REASONS ALSO
WOULD BE SUPPORTED BILL TODAY
SIR.
THANK YOU ADOPT THE FAN.
YEAH THINK THANKS VERY MUCH IN
THE AND WHAT DATACENTER NANDO'S
FOR TRYING PRESS THIS ISSUE AND
I THINK THE BILL CERTAINLY LAKES
OUT VERY VERY WELL MANY VERY
IMPORTANT ELEMENTS. I'D I DO
SHARE SOME THE CONCERNS OF THE
EAR PHYSICIANS AND SUNSET
HAVING.
HE WORKED IN THE
IT'S ROOM THE
SPITTLE. AND KNOWING ABOUT
PATIENT FLOW ISSUES.
BECAUSE WE CAN SAY LET'S NOT
DISCHARGE
PATIENT ACCIDENTAL CERTAIN
STANDARDS ARE MET.
BUT THERE'S ALSO PATIENT AB AND
SEE WHO ARE YOU KNOW WAY TO GET
CARE AND AND SO WE HAVE.
THAT DOESN'T NECESSARY MEAN
THAT WE THEREFORE JUSTICE CHARGE
SOMEONE OUT ON THAT STREET FOR
THAT REASON BUT I THINK THAT WE
NEED TO THINK ABOUT.
.
THE TERMS OF HOW WE SET THE
RULES WHEN CERTAIN THINGS WILL
HAPPEN AND WHERE THEY HAVE TO
HAPPEN BECAUSE.
BECAUSE WE HAVE LIMITED WE DO
HAVE LIMITS IN OUR SORT OF
CLINICAL CARE SPACE AND AND HOW
THAT HAPPENS
THE OTHER THING I DID SO I DO
THIS JUST TOUCH ON AND BE SURE
LOW EXPERIENCE WE HAD HERE IN
SACRAMENTO SO WE'VE HAD SOME
CHALLENGES WITHOUT YOUR
IMPACTION.
HERE IN SACRAMENTO AND.
THE WHAT THEY DID IS THEY THEY
DEFIED CYCLE THIS DATA THAT THE
MOST FREQUENT USERS RIGHT AND
ACTUALLY MANY OF THEM WERE.
HOMELESS AS WELL AS IT YOU SEE
ENOUGH BECAUSE WHAT HAPPENS IS
WHEN THEY INITIALLY TRIED THE
DRESS THAT THIS ISSUE THEY
ACTUALLY FIRST.
.
TRIED SAYING OKAY WHAT WHAT WE
NEED IS WE NEED SOCIAL SERVICES
MORIARTY CONNECTING. THROUGH THE
EMERGENCY ROOM AND ACTUALLY
FOUND OUT THAT ACTUALLY
INCREASED E. ARGUES. AND THE
POPULATION BECAUSE WHAT HAPPENED
IS THEY SAW WELL YOU KNOW OF
THEM FORTY THERE'S A SHORTAGE
OVERALL AND THOSE TYPES OF
SERVICES
IS THAT AND.
PARTIALLY BECAUSE YOU KNOW WE
HAVE LOW FUNDING INNER AGAIN.
WHATEVER ELSE
AND AND AND THEN WHAT THE THEN
WHAT THEY DECIDE TO USE OKAY
WELL WHAT WE DO IS WAXING TO
MOVE THE SERVICES TO A PRIMARY
CARE SITE A CLINIC. HAVE A
RELATIONSHIP WITH THE CLINIC
BECAUSE IT WILL HAPPEN IS THAT
THE PATIENT SHOWS OF THE MERGERS
FROM THE MEDICALLY STABILIZE BUT
THEN THEY ACTUALLY GET
TRANSPORTED NOT JUST DISCHARGE
OUT THE DOOR BUT ACTUALLY
TRANSPORTED TO THIS CLINIC WHERE
THEY ARE CAP FORTY GOT THE
SOCIAL SERVICE COORDINATION
CARROTS. ADDRESS AND ALSO
PRIMARY CARE APPOINTMENT RIGHT
THERE AND ACTUALLY BUILT A
RELATIONSHIP WITH THAT
PARTICULAR FACILITY SO. THE
PROBLEMS THEY'RE DEVELOPING A
RELATIONSHIP WITH THAT E. R..
AND THAT WAS NOT NECESSARILY A
GOOD THING IN THE LONG RUN WE
WHY AND TO HAVE A. SOURCE OF THE
A A REAL IT A RELATIONSHIP WITH
THAT OUTPATIENT FACILITY THAT
ACTUALLY HAD MORE SOCIAL SERVICE
COORDINATION IN MY MORE ROBUST
I'LL LE MENTAL HEALTH IT'S
UTTERED. AND SO THAT THEY WOULD
THINK ABOUT GOING TO THEIR FIRST
AND CITY ARE LESS WASN'T
EMERGENCY SO. I DAHLE SOME I
DIVIDE LAY THAT OUT BECAUSE I'LL
BE SURE THAT WHATEVER PLAN WE
LAY OUT ALLOWS FOR THOSE TYPES
OF ARRANGEMENTS BECAUSE I THINK
IN THE LONG RUN WHAT WE WANT TO
DO IS.
TRY TO GET INTO A SYSTEM OF
CARE AND THEN OF COURSE THOSE OF
US HERE HAVE TO FIGURE OUT HOW
TO FUNDED ADEQUATE LEVELS SO
THAT THEY CAN ACTUALLY MEET
INDEED.
THANK YOU.
SENATOR ROTH.
BIG.
THANK YOU. BYE MICROPHONE THANK
YOU MADAM VICE CHAIR.
YOU KNOW A BASED ON SOME PRIOR
EXPERIENCE AND HAVE OUTSIDE OF
THIS PLACE I CERTAINLY.
RECOGNIZE THE HOSPITAL IN THE
EMERGENCY DEPARTMENT THROUGHPUT
ISSUES AND. I DON'T THINK ANY OF
US WANT TO.
FURTHER EXACERBATE THOSE ISSUES.
SOLVE ONE PROBLEM. AT THE SAME
TIME CREATE ANOTHER SO IDEA
CERTAINLY HAS THAT THE AUTHOR.
ATTEMPT TO ADDRESS THE ISSUES
RAISED BY THE VARIOUS HOSPITALS
IN THE EMERGENCY ROOM
PHYSICIANS.
AS WE'RE SOLVING THIS VERY VERY
CRITICAL ISSUE THAT WE HAVE IN
CALIFORNIA I WILL BE SUPPORTING
THE BILL TO TAKE THANK YOU.
ANY OTHER FURTHER COMMENTS
CNN RESEARCHER THERE'S A MOTION
BY SENATOR LEYVA.
MISTER CHAIR WHICH LIKE CLOSE
HERE'S SOME. YOU KNOW WHEN THIS
ISSUE FIRST CAME TO MY ATTENTION
I LITERALLY JUST GOT ELECTED TO
THE STATE ASSEMBLY I WAS SITTING
IN THE SENATE ARCH ASSEMBLY
HEALTH COMMITTEE AT THE TIME.
THEY BELIEVE A SENATOR STUDIO
THERE RAN A BILL. BUT HIS
APPROACH WAS THE STICK APPROACH.
AS OPPOSED TO THE CARROT
APPROACH AND THAT BILL I BELIEVE
GOD VETOED BY THEN GOVERNOR
SCHWARZENEGGER.
THERE WAS A PROBLEM AT THAT
TIME.
BUT THAT PROBLEM HAS BEEN GOTTEN
WORSE OVER THE DECADES I MEAN WE
SEE THAT IN ALL OF OUR
COMMUNITIES. AND THE HOMELESS
PROBLEMS THAT WE'RE HAVING FROM
MENTAL ILLNESS FROM DRUG ABUSE
AND YOU NAME IT.
AND WHILE WE'RE TALKING ABOUT IS
A VERY VOLATILE POPULATION THAT
WHEN THEY GET HOSPITALIZED.
AND THEY GET DISCHARGED
WE HAVE TO COME UP WITH THE
HUMAINES.
STATE WIDE POLICY SO THAT.
S. I BELIEVE CENTER PAN OVER A
BURNER SENATE MITCHELL SAID IT'S
THE FLOOR. BACK TO LET LET ME
JUST REEMPHASIZE THE VALUE THAT
I APPRECIATE THAT THE HOSPITALS
DO I UNDERSTAND THAT THERE. YOU
KNOW HAVE THEIR THEIR PROBLEMS
WITH BED ZEN. REIMBURSEMENT
RATES THE E. R. DOCKS YES WE
WILL ADDRESS IN TRYING TO
ADDRESS THAT. IN YOUR STORE SOME
INCREDIBLE SYSTEMS THAT DO ABOVE
AND BEYOND. BUT BUT THERE'S NOT
BUT THERE'S SOME SYSTEMS THAT
AREN'T DOING WHAT WE SHOULD BE
DOING. SO WHEN I LOOK AT THIS I
LOOK AT THE STATE AS THE MOST
VULNERABLE PATIENTS THAT WE HAVE
IN OUR SOCIETY. THAT WE HAVE TO
HAVE SOME VERY BASIC.
HUMAN. RIGHTS THAT WE HAVE TO
PROVIDE FOR THEM WHEN THEY
LEAVE.
LIKE SOME CLOTHING NOT TO GO
OUT.
WHEN IT'S RAINING OR ITS WINTER.
SOME HADN'T BEEN FED BEFORE THEY
LEFT YOU KNOW.
MAKING SURE THAT THEY AT LEAST
HAVE SOME MEDICATIONS AND I AND
I AM REALLY WILLING TO HAVE THE.
.
CONVERSATION WITH THE AIR DUCTS
ABOUT THE NON PATIENT AREAS
BECAUSE WE DON'T WANT TO TAKE
AWAY AND HAVE IT JAM PACKED
WITHIN THE E. OURS. BUT WE HAVE
TO COME UP WITH SOMETHING THAT
I'M BY ALL MEANS WILLING TO WORK
WITH THE HOSPITALS THE ER DOCS.
THAT.
THAT WE NEED TO HAVE A STATEMENT
IN THE STATE OF CALIFORNIA SAYS.
WE WANT TO CARE FOR ALL THESE
PATIENTS INCLUDING THE MOST
VULNERABLE. SO MEMBERS WITH
THAT.
YOU HAVE MY COMMITMENT TO WORK
WITH THE OPPOSITION.
AS IT MOVES ALONG AND I
RESPECTFULLY ASK FOR AN AYE
VOTE.
THERE'S A MOTION AND THAT'S TO
PASS TO APPROPRIATIONS PLEASE
CALL FOR THE VOTE.
HERNANDEZ AYE HERNANDEZ AYE
NGUYEN THOUGH WHEN NO LEYVA.
LEYVA AYE MITCHELL.
MITCHELL AYE MONNING. MONNING
AYE NEWMAN. NEWMAN AYE NIELSEN.
PAN. PAN AYE ROTH. ROTH AYE.
I THINK YOU HAVE IT SEVEN ONE
THE BILLS OUT.
IT.
OKAY WE ARE GOING TO.
.
LIFT THE CALL FOR ALL THE.
BILLS THAT HAVE NOT BEEN.
ACTED ON WERE GONNA START WITH
ITEM NUMBER ONE SP NINE NO TWO.
I'M BATES TO PASSED PUBLIC
SAFETY CALL THE ABSENT MEMBERS
MITCHELL.
A I NUMBER ONE.
THERE.
SWEET.
SURE.
I HAVE.
THE CHAIR VOTED AYE.
OH I'M SORRY I THOUGHT YOU WERE
IN THE BOOK ANEMONE ITEMS.
CALLED HAVE SIMILAR I THOUGHT
YOU WERE THERE MIGHT.
MONNING.
MONNING I.
ROTH AYE ROTH AYE.
THE PLACE YOU.
THAT KERN OCALA'S EIGHT ZERO
THAT BILL IS OUT.
ITEM NUMBER TWO. S. B. NINE
FORTY FOUR HERTZBERG TO PASS TO
JUDICIARY CALL THE UPS MEMBERS
MINING.
I MONNING I.
ROTH AYE ROTH AYE.
NIELSEN.
CURRENT VOTE COUNT IS EIGHT ZERO
THAT BILL IS OUT.
ITEM NUMBER THREE.
I REMEMBER FOR S. B. ELEVEN
FIFTY TWO.
THAT'S HOW.
I REMEMBER FIVE SP ONE ONE FIVE
FOUR PORTANTINO DEEP PASSES A
MINUTE APPROPRIATIONS CALL THE
ABSENT MEMBERS. WHEN. WHEN I
MITCHELL AYE MITCHELL AYE
MONNING AYE AYE MONNING AYE ROTH
AYE ROTH AYE.
THE CURRENT ACCOUNT IS NINE ZERO
THAT BILL IS OUT.
ITEM NUMBER SEVEN SP ONE ONE
NINE TWO MONTH.
I AM NUMBER SIX
S. B. ONE ONE FIVE SIX LEYVA
CALL THE ABSENT MEMBERS
MITCHELL.
WE THOUGHT WE'D MITCHELL AYE.
NUMBER SIX ROTH.
YEAH.
CURRENT BEAU COUNT AS A TWO
ZERO.
THAT BILL IS OUT.
ITEM NUMBER SEVEN SP ONE ONE
NINE TWO MINING BECAUSE.
AND I HAD NEVER.
HE WASN'T HERE. OKAY SO ITEM
NUMBER SEVEN SP ONE ONE NINE TWO
THAT'S FOR KERN IS EIGHT ZERO
THAT BILL IS OUT.
ITEM NUMBER EIGHT SP ONE TWO TWO
EIGHT.
DO PASSED THE PUBLIC SAFETY.
COLLIE UPS MEMBERS MONNING. AYE
MONNING AYE ROTH AYE ROTH AYE.
CURRENT BOOK COUNTIES NINE ZERO
THAT BILL IS OUT.
ITEM NUMBER NINE SP ONE TWO FOUR
FIVE.
THE BILL IS OUT.
ITEM NUMBER TEN.
SO COUNT WAS EIGHT TWO ZERO.
WE HAVE EVIDENCE.
ROUGH
NO.
I NEED TO VOTE YEAH. IT'S
UNKNOWN COMMITTED.
ITEM NUMBER TEN SP ONE TWO FOUR
EIGHT GAMES IN GLAZIER CALL THE
ABSENT MEMBERS SOFT. ROTH AYE.
CURRENT BOOK COUNTIES NINE TWO
ZERO.
ITEM NUMBER.
ELEVEN SP ONE TWO EIGHT EIGHT
LEYVA.
DO PASS AS AMENDED TO
APPROPRIATIONS CALL THE ABSENT
MEMBERS PLAN.
WHEN NOW.
CURRENT FOLK COUNTED SEVEN TWO
TWO THAT BILL IS OUT.
ITEM NUMBER TWELVE S. B. ONE TWO
NINE TO WEAR SO DO PASSED TO
APPROPRIATIONS CALL THE ABSENT
MEMBERS.
WHEN. WHEN I.
MONNING. MONNING AYE ROTH AYE
ROTH AYE.
CURRENT BOCO ON IS NINE ZERO IN
THAT BILL IS OUT. BECAUSE.
ITEM NUMBER FIFTEEN S. B. ONE
FOUR SIX FOUR.
DO PASS AS AMENDED
APPROPRIATIONS CALL THE ABSENT
MEMBERS MINING.
MONNING AYE ROTH CROSS I.
THAT'S CURRENT VOTE COUNT IS
NINE TO ZERO THAT BILL IS OUT.
THAT CONCLUDES THE BUSINESS OF
THE SENATE COMMITTEE ON HEALTH
AND WE ARE ADJOURNED