I BELIEVE WE HAVE ENOUGH TO
ESTABLISH A QUORUM.
ACTUALLY DO THAT PLEASE.
HERNANDEZ YOUR HERNANDEZ HERE
WHEN.
LEYVA.
MITCHELL. WHO?
MITCHELL HERE. PAWNING.
HERE.
NEWMAN.
NIELSEN.
NIELSEN HERE PAN. ROTH THEIR
BROUGHT HERE WE HAVE A QUORUM
ESTABLISH ON A COUPLE
ANNOUNCEMENTS WE DO HAVE TWENTY
ONE ITEMS ON THE AGENDA.
WHICH WE ARE GOING TO BE HAVING
TIME LIMITS ON TESTIMONY WE.
WILL BE GIVING THREE MINUTES FOR
SUPPORT.
THREE MINUTES FOR OPPOSITION.
TAKE WHATEVER OR DO YOU WANT IF
YOU WANT TO HAVE TWO MINUTES
PER.
INDIVIDUAL WITH A TOTAL OF THREE
OR ANY COMBINATION OF.
IF WE HAVE A BILL THAT HAS
SUPPORT ON BOTH SIDES BECAUSE WE
HAVE SUCH A LONG.
HEARING TODAY I WOULD APPRECIATE
SOME BREVITY AND WE WILL KEEP IT
AS SHORT AS POSSIBLE I WILL
NOTIFY YOU IF SUPPORT ON BOTH
SIDES.
WE DO HAVE.
.
ITEM NUMBERS FIVE. EIGHT AND
TWENTY ONE OUR CONSENT ITEMS
ONTO WE DISPENSE WITH THAT IS
OUR MOTION ON THE CONSENT ITEMS.
MOVED BY SENATOR MITCHELL THAT'S
ITEM NUMBER FIVE SP ONE ZERO
NINE SEVEN NUMBER EIGHT SP ONE
ONE TWO FIVE IN NUMBER TWENTY
ONE SP ONE FOUR NINE FIVE CALL
THE MEMBERS PLEASE. FERNANDEZ
AYE HERNANDEZ AYE WHEN.
LEYVA MITCHELL. MITCHELL AYE
MONNING I AYE MONNING AYE
NEWMAN.
NIELSEN NIELSEN AYE PAN ROTH.
ROTH AYE HE WILL PLAY SAID BILL
AND CALLED WE'RE GONNA MOVE ON
TO ITEM NUMBER ONE S. B. NINE
FORTY FIVE. BREAST AND CERVICAL
CANCER TREATMENT PROGRAMS.
CENTER ATKINS META PRETEND.
WE HAVE WE DO HAVE SUPPORT ON
BOTH SIDES. THANK YOU BYE MISTER
CHAIR MEMBERS.
THEN JUST VERY BRIEFLY SP NAM
FORTY FIVE WILL ENSURE THAT LOW
INCOME WOMEN IN CALIFORNIA WHO
SUFER. FROM BREAST OR CERVICAL
CANCER ARE AND ARE UNINSURED OR
UNDERINSURED RECEIVE THE
TREATMENT THEY NEED. AND ARE NOT
TIME LIMITED WHICH IS TRUE UNDER
THE CURRENT CALIFORNIA PROGRAM.
OUTSIDE LIMITED TO EIGHTEEN
MONTHS FOR BREAST CANCER TWENTY
FOUR MONTHS FOR CERVICAL CANCER.
ODD THE FEDERAL PROGRAM ALLOWS
COMPLETION OF TREATMENT.
UNDER THE AFFORDABLE CARE ACT
BY IT IS REQUIRED TO HAVE
COMPLETION OF TREATMENT OUR
STATE PROGRAM SHOULD BE ALIGNED
WITH THAT.
AND I WILL IN THE INTEREST OF
TIME BECAUSE OF THE SUPPORT
SUPPORT I WILL ASK FOR YOUR
SUPPORT BUT I REQUEST THAT I.
AT LEAST BE ALLOWED TO HAVE OF
MY SPEAKER SPEAKING IT WITH YOUR
INDULGENCE I WILL TURN IT OVER
TO THEM YES BY ALL MEANS
WELCOME.
THANK YOU MY NAME IS KELLY MAC
MILLAN I'M THE EXECUTIVE
DIRECTOR FOR SUSAN G. KOMEN
BREAST CANCER ORGANIZATION FOR
NORTHERN AND CENTRAL CALIFORNIA.
SERVING TWENTY NINE COUNTIES
FROM KERN UP TO TO HAVE MY
COUNTY.
COLEMAN'S MISSION IS TO SAVE
LIVES AND FIGHT.
TING IMPRESSED CAO
RESEARCH
TO PREVENT AND CURE BREAST CAN.
I'M TWO THOUSAND SIXTEEN COMMON
LAUNCHED A BIG BOLD GOAL TO
REDUCE BREAST CANCER MORTALITY.
BY FIFTY PERCENT IN A DECADE WE
LOSE FORTY ONE THOUSAND WOMEN
AND MEN A YEAR TO BREAST CANCER.
IN CALIFORNIA WE LOSE FORTY FIVE
HUNDRED.
IN ORDER TO MEET THE MOST
CRITICAL NEED AND SERVE THE
WOMEN WHO NEED THE HELP THE MOST
WE UTILIZE THE BREAST AND
CERVICAL TREATMENT PROGRAM.
ACROSS THIS COUNTRY AND IN
CALIFORNIA IN FACT I WAS IN DC
LAST YEAR ADVOCATING FOR THIS
PROGRAM.
A TO PRESERVE THE FUNDING AT
TWENTY SEVEN POINT FIVE MOUNT
MILLION WHICH CALIFORNIA C.
SEVEN POINT SEVEN MILLION IN
SUPPORT OF THIS PROGRAM MANAGED
THROUGH THIS TIME. THE HEALTH
CARE SIR SERVICES AND THE
EVERYONE COUNTS PROGRAM.
AT THE BREAST AND CERVICAL TREAT
PRO PROGRAM IS CRITICAL TO THE
WOMEN WE SERVE OUR MOST
VULNERABLE LOW INCOME THE
UNINSURED THE UNDERINSURED AND
WOMEN OF OLOR. IT IS VITAL THAT
THE SERVICES ARE PROVIDED
ENTIRELY THROUGH THE
TEN NEWMAN CARE.
AND THE TREATMENTS ARE AS
AVAILABLE AS LONG AS THEY'RE
NEEDED IN CALIFORNIA THIS IS NOT
HAPPENING.
IN CALIFORNIA OVER TWENTY NINE
THOUSAND WOMEN WILL BE DIAGNOSED
WITH BREAST CANCER THIS YEAR.
IF YOU'RE ONE OF THOSE WOMEN TO
BE TOLD YOU BREAST CANCER IS
DEVASTATING.
TO BE ALSO BE TOLD THAT YOUR
TREATMENT WILL BE CUT OFF AT
EIGHTEEN MONTHS.
IS OVERWHELMING UNFAIR AND
WRONG.
CANCER TREATMENTS AND THERAPIES
SAVED P. PATIENTS LIVES AND TO
BE AIR ARBITRARILY CUT OFF AGAIN
IS WRONG NO INSURANCE PROGRAM
HAS THESE ARBITRARY TREATMENT
CAPS.
EVERY BREAST CANCER PATIENT IS
DIFFERENT THERE'S OVER TWO
HUNDRED DIFFERENT TYPES OF
BREAST CANCER.
AND YOUR TREATMENTS MAY EXTEND
BEYOND THE EIGHTEEN MONTHS MAYBE
YOU HAVE LANGUAGE BARRIERS
TRANSPORTATION CHILDCARE CAN'T
TAKE THE TIME OFF WORK AND YOU
NEED THAT TIME TO FINISH YOUR
TREATMENTS.
IF YOU HAVE STAGE FOR BREAST
CANCER OBVIOUSLY YOUR TREATMENTS
GO BEYOND EIGHTEEN MONTHS AND TO
BE TOLD SORRY FIGURE IT OUT IS
WRONG.
EVERY MONTH SEVEN HUNDRED AND
SEVENTY SEVEN WOMEN IN
CALIFORNIA ARE CUT OFF FROM
THEIR BREAST CANCER TREATMENTS.
THAT'S OVER NINE THOUSAND A
YEAR.
MY FATHER TOLD ME IF YOU WANT TO
DO SOMETHING YOU DO IT RIGHT
THIS IS NOT THE RIGHT WAY TO DO
IT THIS IS A GREAT PROGRAM.
COLEMAN UTILIZES THIS PROGRAM UP
AND DOWN THE STATE OF CALIFORNIA
BUT WE NEED TO MAKE SURE THAT
THE PROGRAM. FOLLOWS THESE WOMEN
ALL THE WAY THROUGH AND THEY GET
ALL THE TREATMENTS THEY CANCEL
THEIR LIVES CAN BEAT.
THAT WOULD BE SAVED
I I ASK FOR YOUR SUPPORT AND DO
THE RIGHT TING AND SUPPORT S.
B..
NINE FORTY FIVE THANK YOU.
GOOD AFTERNOON MY NAME IS ON
EVERY SENIOR.
AND I'M A TWO TIMES BREAST
CANCER SURVIVOR.
IN APRIL TWO THOUSAND EIGHT. I
WAS A SINGLE MOM WITH TWO YOUNG
BEAUTIFUL GIRLS.
I REMEMBER MY FEELINGS THAT
THEY'D I FOUND OUT I HAD BREAST
CANCER.
I WAS WITH MY MOM.
ISSUE WAS TO TRY.
SHOULD BE ASSURE ME. THAT THIS
IS CAN BE SOMETHING GOOD.
OR IT'S SOMETHING. YOU HAVE TO
WORK ON.
WHEN THEY'RE DIAGNOSED HIM BACK.
AS A STAGE TO.
THE SEA I IS WE BOUGHT CRY.
PLEASE WAS.
WHAT? I MOST FEAR HAVING
SOMETHING TO WORK ON.
WITH NO INSURANCE.
THEN I SAID LET'S CRIED TODAY.
BUT I'M NOT GONNA DIE IN I'M NOT
GONNA LET TWO BEAUTIFUL
DAUGHTERS. WITHOUT A MOM.
BECAUSE I HAD NO INSURANCE AYE
HAD TO WORK. WITH THE CARE
COORDINATORS.
GET AND ROLLED INTO THE STATE
SPONSORED TREATMENT PROGRAM
CALLED IT.
BC CTP BRACE AND CERVICAL CANCER
TREATMENT PROGRAM.
DURING THAT TIME I LEARNED ABOUT
THE EIGHTEEN MONTHS TREATMENT
CAN
A WOMAN.
DIAGNOSED WITH BREAST CANCER AND
I'M ONLY DEALING WITH.
THE RECENT DIAGNOSIS OF BREAST
CANCER.
I LEARNED.
BUT IT'S ONLY EIGHTEEN MONTHS
TREATMENT CAP FOR WOMAN.
NOT FAIR.
I HAVE TO FIGHT WITH MY DOCTORS
TO GET MY TREATMENT PLAN UNDER
THE EIGHTEEN MONTHS.
TO ENSURE A WE COMPLETELY
COVERED THROUGH THE EXTENT OF MY
TREATMENT.
MANY GO BEYOND EIGHTEEN MONTHS.
I NEED TO HAVE CONTINUE SUPPORT.
AN EX EXCEL ACCESS TO THEM B. C.
CITY BUT WHAT PROGRAM.
THE PROGRAM HELPED ME TO SAVE MY
LIFE.
BUT DO THE EIGHTEEN MONTHS
CAPITAL. OF MY TREATMENT IT WAS
DIFFICULT TO MY RECOVERY DOING
SUCH A.
SENSITIVE TIME. AND HARD TIME.
ON JUNE FOR.
TWO THOUSAND EIGHT I HAVE MY
FIRST SURGERY.
OF MANY TO COME.
MY DOCTOR REMOVED THE LUMP.
AND SOME OF MY LOOK LIVE NOT.
BUT SAVE MY BREATH AND ABOUT
MOMENT MY LIFE.
WHEN I WENT BACK FOR MY FOLLOW
UP.
THE JUNE EIGHTEEN.
MY SURGEON TOLD ME THAT I HAD TO
BUT I HAVE MORE CANCEL SALES.
AND THEY NEED TO.
PRACTICE OF FULL MASTECTOMY.
I TOLD HIM LIZ DO IT BUT I'M NOT
GONNA DIE.
ON JUNE EIGHTEENTH THEY REMOVE
MY LEFT BREAST AND I START A
ROUNDS OF CHEMO.
IN ALL. OF THIS.
WHAT'S POSSIBLE FOR THIS
PROGRAM.
BE CCTV.
IT TWENTY EIGHT THIRTEEN. MY
BREAST CANCER.
RETURN IT.
NOT ONLY I WAS FACING BREAST
CANCER AGAIN.
BUT THIS TIME.
HOLDING MY SISTER'S HAND.
WITH BREAST CANCER.
THE DOCTOR COULDN'T BELIEVE WHAT
HE WAS.
ABOUT TO FACE WHITNEY AND HER.
ALL THIS HAPPENED.
AT THE SAME TIME. THE SAME
HOSPITAL. THAT SYNDROME.
THE FRIEND BAIRD.
SAME PLASTIC SURGEON.
AND SAME DOCTORS.
I HAVE LEARNED SO MUCH FROM
HAVING BREAST CANCER.
I'M SO GRATEFUL.
FOR THE SUPPORT I RECEIVED.
I HAD SO MANY OPPORTUNITIES TO
TRY. AND MAKE A DIFFERENCE.
IN MY COMMUNITY.
WHEN I NEWLY DIAGNOSIS SPINACH
SPANISH SPEAKING.
WOMAN NEEDS SOMEONE TO TALK.
I WAS THERE.
I VOLUNTEER TO MENTOR BECAUSE IT
COMES FROM MY HEART AND I KNOW
HOW DIFFICULT IT IS.
DURING.
IT IS MY HOPE. THAT WE CONTINUE
TO PROVIDE.
A SAFE.
HEAVEN.
FOR ALL.
WOMAN. DURING AND AFTER
DIAGNOSIS.
AND THAT THEY WE WE WE ENCOURAGE
THEM.
TO GET THEIR MOM OF GROUNDS.
THE FOLLOW UPS.
FORD DOES ON. WOMAN.
BUT PROGRAM BC CTP. CAN HELP SO
MANY LIVES.
FROM THE BOTTOM OF MY HEART.
MY DAUGHTERS DEFINITELY.
I GRATEFUL.
FOR LEASE PROGRAM.
AND I HOPE.
WE PASSED.
THIS.
PROGRAM.
THIS IS WHY I HAVE TROUBLE TO
SACRAMENTO.
AND UP HERE.
TO SHARE MY JOURNEY.
BEFORE YOU THANK YOU SO MUCH.
AND TOM BLANCHARD ON BEHALF OF
SUSAN G. KOMEN FOR THE CURE
SPONSOR OF THE BILL TREATMENT
CAPS EXIST NOWHERE ELSE IN
CALIFORNIA STATUTE NOT MEDI CAL
NOT A PRIVATE INSURANCE WERE
HERE TO CLOSE THE GAP. WE
SUPPORT THE SPELL HERE TO ANSWER
ANY TECHNICAL QUESTIONS THINK
USE ANYONE ELSE IN SUPPORT
PLEASE STATE YOUR NAME AND
POSITION.
HEALTH OFFICERS ASSOCIATION OF
CALIFORNIA IN SUPPORT.
LINDA WAY WITH WESTERN CENTER ON
LAW AND POVERTY IN SUPPORT.
TO MADDEN REPRESENT THE
CALIFORNIA SOCIETY OF PLASTIC
SURGEONS IN SUPPORT.
MARY VALDEZ HEALTH ACTS OF
CALIFORNIANS SUPPORT.
KELLY BURKE SOME BEHALF OF THE
ASSOCIATION OF CALIFORNIA
HEALTHCARE DISTRICTS IN SUPPORT.
MICHELLE GIVENS OF THE COUNTY
HELP EXECUTIVES ASSOCIATION OF
CALIFORNIA IN SUPPORT.
RENDON MARGIE WITH THE
CALIFORNIA MEDICAL ASSOCIATION
ALSO IN SUPPORT.
SHANNON SMITH GROWING ON BEHALF
OF THE CALIFORNIA CHRONIC CARE
COALITION IN SUPPORT.
ALTAMONT INCIDENT WITH THE
AMERICAN CANCER SOCIETY CANCER
ACTION NETWORK ALSO IN STRONG
SUPPORT.
COUNTY MUSBURGER CENTER ACCESS
HEALTH IN SUPPORT.
ALL OF IRAQ GRAY CALIFORNIA LIFE
SCIENCES ASSOCIATION SUPPORT
THANK YOU.
KURT CHILD DISABILITY RIGHTS
CALIFORNIANS SUPPORT.
BRENT SPENCE ON BEHALF OF THE
CALIFORNIA CATATONIC POSITIONS
IN AMERICAN COLLEGE OBGYN
STRYCHNINE IN SUPPORT.
ANGELIQUE WORK WITH NATIONAL
ASSOCIATION OF SOCIAL WORKERS IN
STRONG SUPPORT.
ARENT FOX LOS ANGELES LGBT
CENTER IN SUPPORT.
COMMISSION MODELS IN SUPPORT OF
WITH SUSAN G. KOMEN INLAND
EMPIRE AND SURVIVOR WE SUPPORT.
KATIE CLEARY PRESIDENT OF PEACE
FOR ANIMALS AND WORLD ANIMAL
NEWS AND SPORT.
JUDY MANN CRUSOE'S SOCIAL
COMPASSION AND LEGISLATION IN
STRONG SUPPORT.
WE A SURGE OF SOCIAL
COMPASSIONATE LEGISLATION IN
SUPPORT.
FANA TOMLINSON OF FRIEND OF
SURVIVORS AND NOT OF IN SUPPORT.
CALIFORNIA DISABILITY RIGHTS AND
A BROTHER OF A BREAST CANCER
SURVIVOR IN SUPPORT.
CHAMBERS MITCHELL BREAST CANCER
SUPPORTER. AND SURVIVOR IN
SUPPORT.
THANK YOU VERY MUCH IS THERE ANY
OPPOSITION TO THE MEASURE.
LIVING QUESTIONS COMMENTS FROM.
ANY OF THE MEMBERS YOU JEFF
QUESTION CENTER PAN OR COMMENT
NO.
I THINK YOU ARE THEIR ACTIONS
FOR BRINGING THIS BILL FOR PROUD
TO BE A CO AUTHOR ON THIS BILL
AND WE REALLY NEED TO BE SURE
THAT WE DON'T.
WHEN AN AUTHOR ACTUALLY WHEN
THURMOND BECAUSE I'M A RIGHT
BASICALLY OFF IN THE MIDDLE
TREAT.
THIS BILL FORWARD.
HELLO.
BEFORE I ASK YOU TO CLOSE ARMY
CO BE SUPPORTING THE BILL I JUST
WANTED TO COMMEND YOU FOR YOUR
STRENGTHS.
FOR YOUR WORDS AND YOUR
TESTIMONY AND IT'S QUITE AND
RUBBLE AND THANKS FOR BEING
HERE.
CARE AND WITH THAT I WILL BE
SUPPORTING THE BILL WHICH LIKE
CLOSE MEN SPEAK BENEFIT HIM
THANK YOU AT.
THANK YOU MISTER CHAIRMAN.
VERY QUICKLY I WOULD JUST SAY I
THANK YOU SO MUCH FOR FOR THE
SUPPORT. I WANT TO ALSO THANK US
ON YOU FOR BEING HERE TODAY
BECAUSE SHE IS EXACTLY THE
EXAMPLE OF WHAT WE DO NOT WANT
TO HAVE HAPPEN TO WOMEN IN
CALIFORNIA.
AND NOBODY THAT'S ALREADY GOING
THROUGH CANCER SHOULD LIVE IN
FEAR THAT THEIR TREATMENT WILL
BE CUT OFF JUST WHEN THEY THINK
THEY HAVE FOUND A SOLUTION. AND
A LIFELINE AYE THAT IS JUST NOT
RIGHT AND I WOULD SUBMIT THAT.
OUT WHATEVER IT WILL COST TO
IMPLEMENT THIS PIECE OF
LEGISLATION IT IS FAR MORE.
COST EFFECTIVE IN THE LONG RUN
TO SAVE LIVES THAT TO DO A HALF
WAY JOB OF TREATMENT. AND AND
LIVE WITH THE RAMIFICATIONS OF
THAT AND AS YOU ALSO MIGHT
NOTICE. BY ANOTHER PART OF THIS
IS THAT WOMEN OF COLOR SUFFERED
DISPROPORTIONATELY IN TERMS OF
THE ACCESS TO TREATMENT AND ONCE
THEY GET IT. AND THEREFORE.
I WOULD SAY WE NEED TO WRITE
THIS FOR MANY REASONS BUT IN ONE
SENSE BECAUSE CALIFORNIA IS
MAJORITY MINORITY STATE NOW.
AND.
WE NEED TO SUPPORT ALL OF OUR
RESIDENTS I RESPECTFULLY. ASK
YOU FOR YOUR SUPPORT AND I THINK
YOU FOR THE TIME YOU'VE GIVEN ME
MISTER CHAIRMAN. AND WE HAVE A
MOTION BY SENATOR.
MITCHELL.
BY SENATOR MITCHELL WE HAVE ITEM
NUMBER ONE S. B. NINE FORTY FIVE
DO PASSED APPROPRIATIONS COLOR
MEMBERS PLEASE AND AND I CAN AND
AS I NGUYEN.
LEYVA. MITCHELL WHY MITCHELL AYE
MONNING AYE MONNING AYE NEWMAN.
NIELSEN AYE NIELSEN AYE PAN. PAN
AYE ROTH. ROTH AYE.
CURLY A SIX IT'S ENOUGH TO GET
OUT OR REALLY SAID BILL AND CALL
ON HOW WE'RE GONNA MOVE TO ITEM
NUMBER TWO SP ONE ZERO ZERO
EIGHT SKINNER. HEALTH INSURANCE
DOWN SERVICES MEDICAL LOSS RATIO
AYE NETWORK COVERAGE OF.
THE CLOSURES.
AFTERNOON SENATOR.
THANK YOU AND MISTER CHAIR
MEMBERS.
ALL PRESENT SP ONE. ZERO ZERO
DATE AS YOU MENTIONED.
SO FIRST I WANT TO LET YOU KNOW
THAT I AM TAKING THE COMMITTEES.
IT'S REALLY A PRETTY.
STAFF
WE WILL BE TAKING THE AMENDMENT
TO REMOVE THE DENTAL LOSS RATIO
REQUIREMENT AS OUTLINED IN
AMENDMENT A AND B. TWO IN THE
ANALYSIS. AND WE ARE ALSO
WORKING WITH THE STAFF TO
ESTABLISH A REASONABLE
IMPLEMENTATION IMPLEMENTATION
DATE AND THAT IS AMENDMENTS SEE.
BASICALLY WHAT THE BILL DOES AS
AMENDED IS.
CURRENTLY SOME INFORMATION TO
HELP CONSUMERS UNDERSTAND WHAT
THEIR OPTIONS ARE WHETHER IT'S
FOR DENTAL INSURANCE OR THESE
DENTAL PLANS THAT ALLOW YOU TO
GET A DISCOUNT. SO REQUIRES
GENERAL INSURERS TO USE A.
UNIFORM SUMMARY OF BENEFITS
IN THEIR ALREADY EXISTING
REPORTING REQUIREMENT LIKE.
SIMILAR TO WHAT'S REQUIRED
UNDER A CA FOR MEDICAL PLANS.
REQUIRES DISCLOSURES FOR DENTAL
DISCOUNT PLANS TO HELP CONSUMERS
UNDERSTAND THAT WHEN THEY
PURCHASE THAT THEY ARE
PURCHASING A REDUCTION IN DENTAL
SERVICES NOT. AN INSURANCE
PRODUCT
AND THEN IT REQUIRES DENTAL
INSURERS TO FULLY EXPLAIN THE
TOTAL BENEFIT COVERAGE TO OUT OF
NETWORK PROVIDERS.
SO THAT CONSUMERS AGAIN
UNDERSTAND IF THEY GO TO AN OUT
OF NETWORK PROVIDER WHAT WILL BE
COVERED IN WHITE NOT.
SO ALLOW ME NOW TO HAVE OF ME
WITNESSES IN SUPPORT.
ADDRESS THE ISSUE.
GOOD AFTERNOON MY NAME IS DOCTOR
NOT HARSHLY I'M A GENERAL
PRACTITIONER IN SAN FRANCISCO
CALIFORNIA AND PRESIDENT OF THE
CALIFORNIA DENTAL ASSOCIATION.
REPRESENTING TWENTY SEVEN
THOUSAND MEMBER DENTISTS IN THE
STATE OF CALIFORNIA. I WANT TO
THANK SENATOR SKINNER FOR HER
LEADERSHIP ON SB TEN I WAIT A
BILL THAT WILL PROVIDE VALUABLE
CONSUMER PROTECTION TO DENTAL
PATIENTS.
AND JUST THE LAST WEEK I'VE
HEARD FROM HUNDREDS OF OUR
MEMBERS ABOUT THE IMPORTANCE OF
S. B. TENER WAIT. PROVIDING
CLEAR CONSISTENT INFORMATION TO
DOUBLE PATIENTS IS OUR GOAL.
CLARITY AND CONSISTENCY HELPS
DENTISTS PROVIDE BETTER CARE TO
OUR PATIENTS
I BROUGHT A STACK OF LETTERS
FROM OUR FOR OUR MEMBER
DENTISTS.
RIGHT NOW.
REGULATION OF DENTAL BENEFITS
IT'S IT'S LIKE THE WILD WEST.
AND THE SOME DENTAL BENEFIT
COMPANIES PREFER TO KEEP IT THAT
WAY.
SOME DONALD BENEFIT COMPANIES
ACTUALLY AS BAIT AND SWITCH
TACTICS JUST O MARKET AND SELL
THESE PLANS TO PATIENTS
AND THEN THEY TURN AROUND AND
NOT ACTUALLY PAY THE BENEFITS
THAT THE CONSUMER HAS BEEN LED
TO BELIEVE THAT THE ACTUAL
PURCHASED.
THEY GET TO MAKE BLANKET
STATEMENTS LIKE IT'S A HUNDRED
PERCENT COVERED.
WITHOUT ACTUALLY DISCLOSING THE
MARIETTA RESTRICTIONS THAT
ACTUALLY CAN TURN ONE HUNDRED
PERCENT INTO JUST A TWENTY OR
THIRTY PERCENT PAYMENT.
S. B. TUNNEL WAIT SIX TO CHANGE
THAT PRACTICE.
IN TWENTY FOURTEEN HAS WHEN THEN
ASSEMBLY MEMBER SKINNER'S.
WITH DAN ASSEMBLY MEMBER
SKINNER'S LEADERSHIP LEGISLATION
WAS PASSED REQUIRING DENTAL
BENEFIT COMPANIES TO DISCLOSE
THE PERCENTAGE OF.
CARE PURSES WHAT IS SPENT ON
ADMINISTRATION OVERHEAD AND
PROFIT.
THIS REPORTING REQUIREMENT IS
MATERIALLY THE SAME AS THE
FEDERALLY MANDATED MEDICAL LOSS
RATIO OTHERWISE KNOWN AS THE AN
ALARM.
THAT REQUIRES HEALTH INSURERS
TO SPEND BETWEEN EIGHTY AND
EIGHTY FIVE PERCENT OF
HEALTHCARE DOLLARS ON PATIENT
CARE.
SEVERAL YEARS OF PLANNED OUT IT.
DENTAL PLAN DATA REPORTING
TELLS A COMPELLING STORY. IF
THERE'S WIDE VARIATION IN THE
PERCENTAGE OF DENTAL PLAN
PREMIUM DOLLARS BEING SPENT ON
DENTAL CARE.
DENTAL PLANS NEED TO BE HELD
ACCOUNTABLE FOR THEIR
EXPENDITURES PARTICULARLY WHEN
SOME DENTAL PLANS ARE SPENDING
LESS THAN TWENTY TO THIRTY CENTS
OF THEIR PREMIUM DOLLARS ON
PATIENT.
CONSUMERS NEED TO BE TOLD UP
FRONT. THAT SOME OF THESE DENTAL
PLANS OFFER A LITTLE MORE THAN
THE EQUIVALENT OF SMALL
DISCOUNTS THROUGH LIKE A BAY
AREA.
COUPON BOOK.
FAILING TO PROVIDE THE NECESSARY
DISCLOSURES TO CONSUMERS TO
ENSURE THAT THEY UNDERSTAND WHAT
THEY'RE ACTUALLY PURCHASING
TAKES US BACK TO THE WORLD OF
JUNK INSURANCE THAT THE ACA'S
HELPED ERADICATE FROM THE HEALTH
INSURANCE MARKET.
PATIENTS DESERVE BETTER THAN
JUNK DENTAL INSURANCE.
A CLEARCOVERAGE TEMPLATE AND
UNIFORMS SUMMARY OF BENEFITS
WILL HELP PAY HELP PATIENTS
COMPARE DENTAL PLANS AND
UNDERSTAND WHAT THEY'RE BUYING.
PRIOR TO ENROLLMENT AND THEN
ONCE ENROLLED HELP PATIENTS
UNDERSTAND THE BENEFITS THEY'RE
ENTITLED TO AND ENSURE THAT THEY
OBTAIN THE DENTAL CARE THEY
NEED.
MANY DENNIS CONTRACT WITH
MULTIPLE DENTAL BENEFIT PLANS TO
GIVE PATIENTS AS MUCH CHOICE AND
ACCESS AS POSSIBLE.
CURRENTLY PLANS PROVIDE BENEFIT
INFORMATION VARYING FORMATS AND
OFFER VAGUE INFORMATION WHICH
MISLEADS PATIENTS ABOUT AMOUNTS
PAYABLE ON THEIR BEHALF.
ASKING DOUBLE BENEFIT PLANS TO
CONFORM TO DISCLOSURE RULES
WOULD NOT BE AN ONGOING
ADMINISTRATIVE BURDEN
PARTICULARLY WHEN IT WILL RESULT
IN HIGHER LEVELS LEVELS OF
SATISFACTION FOR PATIENTS.
AND THE PROVIDERS WHO TRY IN
EARNEST TO HELP THEIR PATIENTS
UNDERSTAND THEIR OUT OF POCKET
EXPENSES PRIOR TO HAVING
TREATMENT COMPLETED.
AS A SMALL BUSINESS OWNER TAKING
THE GUESSWORK OUT OF THIS
PROCESS WILL NOT ONLY HELP
PATIENTS BUT IT WILL INCREASE
EFFICIENCY AND LOWER OPERATIONAL
COSTS THAT ARE OFTEN CARRIED ON
TO THE PATIENT IN THE FORM OF
HIGHER HEALTH CARE FEES.
CONSUMER RESEARCH SHOWS THAT THE
IMPORTANCE OF THE PATIENT
PROVIDER RELATIONSHIP REMAINS
THE TOP
PRIORITY FOR PATIENTS.
BUT SECONDS THAT IS COST
TRANSPARENCY.
PATIENTS WANT TO KNOW HOW MUCH
THE PLAN WILL PAY AND HOW MUCH
THEY'RE GOING TO HAVE TO PAY FOR
THEIR TREATMENT.
AS VETO. SUPPORTS BOTH.
LETS TAKE THE GUESSWORK OUT OF
DENTAL BENEFITS FOR PATIENTS AND
MAKE SURE THAT WE ARE BEING FAIR
TO THEM WHILE ENSURING IMPROVED
OVERALL HEALTH THANK YOU.
A BRAND APARTMENT SPENCER WITH
CALIFORNIA DOWN ASSOCIATION THE
SPONSOR OF THIS MEASURE AND HERE
TO ANSWER ANY TECHNICAL
QUESTIONS.
MANAGING FOR US ON BEHALF OF
HEALTH ACCESS CALIFORNIA THE
STATE WIDE HEALTH CARE CONSUMER
ADVOCACY COALITION. WITH SUPPORT
SB TEN OO EIGHT WITH THE
AMENDMENTS TODAY.
COVERAGE FOR ADULT DENTAL
BENEFITS IS DIFFERENT THAN
MEDICAL COVERAGE IN THAT IT IS
NOT REQUIRED TO COVER MEDICAL.
THE SERI DENTAL CARE AND CAN
INCLUDE ANNUAL DOLLAR LIMITS ON
BENEFITS COVERED.
THERE IS AN EXCEPTION FOR
PEDIATRIC DENTAL CARE ALTHOUGH
BECAUSE OF THIS.
GREAT DIFFERENCES BETWEEN
MEDICAL CARE AND DENTAL CARE
THERE IS A GREATER NEED FOR
CONSUMERS TO UNDERSTAND WHAT
THEIR ACTUAL BENEFITS ARE. A
UNIFORM THAT.
SUMMARY BENEFITS OF COVERAGE
WILL ALSO MAKE IT EASIER FOR
CONSUMERS TO COMPARE ACROSS
INSURERS AND EVEN ACROSS
MARKETS.
ON IMPORTANT FACTS LIKE COPAYS
AND COINSURANCE LEVELS.
WITH REGARD TO THE DENTAL
DISCOUNT PRODUCTS WE SHOULD
AUTHORS CONCERNS THAT DISCOUNT
PLANS ARE MISLEADING TO
CONSUMERS AND OFTEN DO NOT OFFER
MUCH VALUE AND WE LOOK FORWARD
TO WORKING WITH THE AUTHOR AND
HOW TO BEST PROTECT CONSUMERS.
AND FINALLY WE DO WANT TO
ACKNOWLEDGE AYE AND CONTINUE OUR
CONVERSATION AROUND INSTITUTING
A DENTAL LOSS RATIO FOR DENTAL
PLANS IN THE FUTURE. THIS IS AN
IMPORTANT STEP TOWARDS ENSURING
THAT MOST OF THE PREMIUM DOLLAR
DO GO TO ACTUAL DENTAL CARE AND
NOT ON ADMINISTRATIVE
RESPONSIBILITIES.
AND WITH THAT WE SUPPORT SB TEN
A WAIT AND ASK FOR RIVAL.
ANYONE ELSE IN SUPPORT OF THE
MEASURE.
KIMBERLY CHINA BEHALF THE
CALIFORNIA PET THE CAT THAT WORK
IN SUPPORT.
LINDA WAY WITH WESTERN CENTER ON
LAW AND POVERTY A MEMBER OF THE
HEALTH CONSUMER ALLIANCE WHICH
IS DIFFERENT FROM THAT CONSUMER
HEALTH ALLIANCE THAT WITH AYE. A
IN THE ANALYSIS IN SUPPORT.
BERNIE MARGIE WITH THE
CALIFORNIA MEDICAL ASSOCIATION
ALSO IN SUPPORT. THANK YOU IS
THEIR OPPOSITION TO THE MEASURE
.
GOOD AFTERNOON MISTER CHAIRMAN
AND MEMBERS I'M CHRIS YOU EASIER
TODAY ON BEHALF OF THE
CALIFORNIA ASSOCIATION OF DENTAL
PLANS. AND WE ARE IN.
IN OPPOSITION POSITION TO THE
BILL WE VERY MUCH APPRECIATE
SENATOR SKINNER'S WILLINGNESS TO
DELETE THE. PROVISIONS OF THE
BILL WHICH WOULD HAVE
ESTABLISHED A LOSS RATIO AS
WE'VE SHARED WITH MANY OF YOU.
WE BELIEVE THAT THAT WOULD
SIGNIFICANTLY.
DESTABILIZE THE DENTAL INSURANCE
MARKET AND RESULTING PREMIUM
INCREASE OF SOMETHING THAT I
DON'T THINK ANYONE IN THIS
COMMITTEE WHAT'S CAUSING WANTS
TO SEE HAPPEN SO WE APPRECIATE
HER. REMOVING THOSE PROVISIONS
FROM THE BILL I AM CERTAINLY THE
DENTAL PLANS ARE VERY SUPPORTIVE
OF TRANSPARENCY WE DON'T WANT TO
SEE OUR PLAN ENROLLEES. STRUGGLE
TO UNDERSTAND OUR COVERAGE AND
SO WHILE THERE ARE STILL SOME
PROBLEMS WITH THE LANGUAGE IN
THE BILL. WE LOOK FORWARD TO
HAVING ADDITIONAL CONVERSATIONS
AND TRYING TO WORK THROUGH
THOSE.
THINK ANYONE ELSE IN OPPOSITION.
I JEFF ALBUM I'M VICE PRESIDENT
PUBLIC IN GOVERNMENTAFFAIRS FOR
DELTA DENTAL OF CALIFORNIA.
ALSO A MEMBER OF THE BOARD FOR
THE CALIFORNIA ASSOCIATION OF
DENTAL PLANS. ARE STILL IN
OPPOSITION ADD TO THE BILL BUT
WILLING TO TALK ABOUT THE ISSUE
TRANSPARENCY. IT'S ABOUT
SOMETHING THAT IS IN A.
AND OBJECTIVE OF DENTAL PLANS
AND IN OUR BEST INTERESTS TO
MAKE SURE IN RELEASE KNOW WHAT
THEY HAVE. I WANT TO INVITE
EVERYONE HERE WHO IS A DELTA
DENTAL MEMBER SOMETIME AFTER
THIS CALL A AFTER THIS COMMITTEE
MEETING.
MAYBE NOT RIGHT AFTER BUT
SOMETIME AFTER TO GO TO YOUR
WEBSITE DELTA DENTAL I AM EST
DOT COM.
AND LOG INTO YOUR CUSTOMIZED IN
ROWLEY PORTAL. AND LOOK AT YOUR
SUMMARY OF BENEFITS YOU'LL FIND
IN.
AYE INCREDIBLY DETAILED
EXPLANATION OF WHAT'S COVERED
HOW IT'S COVERED HOW THE HOW IT
WORKS.
AND WE MAKE A SIMILAR PORTAL
AVAILABLE TO DENTISTS
BOTH IN OUR NETWORKS AND OUT OF
OUR NETWORKS.
I KNOW THAT MANY OF MY
COLLEAGUES AROUND THE CALIFORNIA
ASSOCIATION DEL PLANS OFFER SOME
SIMILAR I WON'T SIT HERE AND
VOUCHED FOR ALL NINETEEN PLANTS
BETTER MEMBERS OF C. ATP. AND I
THINK THAT'S WHY THERE'S AN
OPPORTUNITY FOR US TO WORK WITH
THE AUTHOR.
AND THE SPONSOR OF THE BILL I
DO WANT TO SAY THERE IS ONE
ELEMENT STILL IN THE BILL RIGHT
NOW THAT HAS A DEAL OUR
COMPONENT TO IT WHICH WE FIND TO
BE.
WHOLLY INAPPROPRIATE AND OF NO
VALUE TO THE TO THE CONSUMER
WHERE T WOULD BE DISCLOSED AS
PART OF THIS UNIFORM SUMMARY.
BUT ON ALL THESE OTHER ELEMENTS
LET'S LET'S TALK AND SEE WHERE
WHERE WE CAN GET.
TO ANYONE ELSE THERE IS ANOTHER.
DEAD JOHN WINGER ON BETH ANTHEM
BLUE CROSS IN AMERICA'S HEALTH
INSURANCE PLANS.
WOULD ALIGNER COMETS WITH COPY.
FAITH WHEN BORDERS ON BEHALF OF
THE CALIFORNIA ASSOCIATION OF
HEALTH UNDERWRITERS WHO THAT
ALIGN OUR COMMENTS AT THOSE TO
SHARED AND APPRECIATE THE RECENT
AMENDMENTS.
STEPHANIE WATKINS ON BEHALF OF
THE ASSOCIATION OF CALIFORNIA
LIFE AND HEALTH INSURANCE
COMPANIES ALSO WOULD LIKE TO
THANK THE AUTHOR FOR THE MOST
RECENT AMENDMENTS BETTER STILL
REMAIN OPPOSED TO THE.
TIM LYNCH ON BEHALF OF LIBERTY
DENTAL WE TO I THINK THE AUTHOR
FOR REMOVING THE DEAL ARE
COMPONENTS OF THE BILL LOOK
FORWARD TO CONTINUING WORKS MAKE
IT A BETTER A CONSUMER BILL.
JENNIFER AUTHER WITH THE
CALIFORNIA ASSOCIATION HEALTH
PLANS ALSO REVIEWING THE AMEND
AMENDMENTS BUT CURRENTLY REMAIN
OPPOSED THINKING.
KEVIN TO DRY REPRESENTING AT THE
DENTAL OF SAME POSITION AS
EVERYBODY ELSE.
LOOK FORWARD TO WORKING WITH
THE AUTHOR ON THE BILL.
ENTER GOVERNOR OPPOSING LISTA
MEN NUMBER HALF THE CONSUMER
HEALTH ALLIANCE WHICH IS THE
NATIONAL ASSOCIATION
REPRESENTING DISCOUNT HEALTHCARE
COMPANIES LOOK FORWARD TO
CONTINUING DISCUSSIONS WITH THE
SPONSORS OF THE AUTHOR.
ANY QUESTIONS COMMENTS HERE
SENATOR ROTH.
THANK YOU MISTER JUST.
LOW.
JUST WANNA MAYBE I MISSED IT
COULD SOMEBODY IDENTIFY FOR ME
THIS THE SIGNIFICANT STICKING
POINT THAT GENERATES THE
CONTINUED OPPOSITION DOES IT
HAVE TO DO WITH DISCOUNT.
PLANS NO FOR TODAY I'M FOR THE
DENTAL PLANS WE. WE UNDERSTAND
THE INTENTION THAT THE AUTHOR OF
A SPONSOR HAS OF INCREASING
TRANSPARENCY BOTH IN THE.
UNIFORM BENEFIT DISCLOSURE FORM
AND OUT OF.
NETWORK LANGUAGE.
THOSE AMENDMENTS WERE PUT INTO
THE BILL VERY LATE IN THE
PROCESS AND THERE ARE A NUMBER
OF.
ISSUES WITH THE LANGUAGE THE WAY
IT'S DRAFTED.
OFF OF THE MEDICAL PLAN MODEL
THAT ARE NOT. ANALOGOUS TO THE
DENTAL PLAN MODEL ADDITIONALLY
THERE IS.
ONE AMENDMENT THAT THE
COMMITTEE FLAG.
WHICH WOULD BE TO REMOVE THE
LOSS RATIO PROVISION FROM THE
FORUM SENATOR SKINNER AS I
UNDERSTAND IT. IS NOT TAKING
THAT AMENDMENT TODAY AND WE
WOULD LIKE TO SEE THAT LANGUAGE
COME OUT OF THE FORM.
SO. THERE ARE A NUMBER OF
TECHNICAL ISSUES IN THOSE TWO
PROVISIONS THAT WE NEED TO
CONTINUE TO WORK ON. TO REMOVE
OFTEN OPPOSE POSITION I SEE
THANK YOU THAT'S VERY VERY
HELPFUL THANK YOU VERY MUCH
THANK YOU MISTER CHAIR.
YES SASSER NIELSEN ON THAT
ISSUE.
THE.
RETENTION OF THE LANGUAGE.
THE CLUB LOSS RATIO.
UNDER THE ET UNIFORM BENEFITS
PLAN IS YOUR CONCERN THAT ITS
CONCLUSION THERE.
STILL GIVES AN IMPLIED.
IT IT IS A CONCERN ABOUT IT HOW
IT IMPLIES WHERE THE NOT MAYBE
SPECIFICALLY MANDATE.
IF THEY WANT EVEN AND THEN THAT
GOT SENT THE CONCERN IS THAT THE
NUMBER SAYS NOTHING ABOUT THE
VALUE OF THE PLAN TO THE
CONSUMER. TO THE AVERAGE PERSON
WILL ASSUME AT HIGHER NUMBERS
BETTER. WHY AND THAT A LOWER
NUMBERS WORSE WHEN IN FACT
BECAUSE DONALD SO DIFFERENT THAN
MEDICAL YOU CAN HAVE A HIGH DEAL
ARE?
PLAN THAT'S VERY EXPENSIVE THAT
ACTUALLY PROVIDES LESS COVERAGE
THAN A LOW DLR PLAN THAT'S
ACTUALLY LESS EXPENSIVE I COULD
GIVE YOU A SPECIFIC DETAILS BUT
I WANT TO. BORE YOU WITH THEM
NOW BUT HAPPY TO AT ANY POINT.
THANK YOU DID DID YOU HAVE
SOMETHING TO SAY ON THAT MAP.
YEAH.
SO ONE OF THE REASONS THAT WE
JOIN A FIRE SELF A CYPRIOT
APARTMENTS FUNDS ARE WITH THE
CALIFORNIA DENTAL ASSOCIATION SO
ONE OF THE REASONS WE WANTED
THAT'S A MAIN IN REMAIN IN
THERE.
IS WE DO THINK THAT'S AN
IMPORTANT PIECE FOR CONSUMERS TO
KNOW AND WE DO RECOGNIZE IT WILL
NEED TO PUT SOME LNGUAGE IN
THAT.
EXPLAINS WHAT AT A DEAL ARE
AMONG OUR IS AND WHY THAT'S
IMPORTANT AND I THINK PUTTING IT
ON THE BENEFIT FOR YOU KNOW SOME
BENEFIT US SOME REFORM IS THE
APPROPRIATE PLACE FOR IT BECAUSE
IT PUTS IT IN THE CONTEXT OF ALL
THE OTHER.
THE ALL THE OTHER BENEFITS THAT
THE PLAN WILL PROVIDE AND SO
WHEN SOMEONE IS LOOKING AT.
THE PLAN IN OF COMPARING TO
SERVE APPLES TO APPLES THAT THAT
MAY BE ONE OF THE THINGS BUT NOT
THE ONLY THING THAT THEY WOULD
LOOK AT BUT WE DO AGREE THAT
THERE NEEDS TO BE SOME.
EXPLANATION OF WHAT THAT MEANS.
IT IS CENTER SKINNER WOULD YOU
BE WILLING TO WORK WITH THEM ON
SUCH AN AMENDMENT OR IS THAT
JUST A.
A NO WELL WE ARE.
AS.
THE COMMITTEE CAN SEE BY OUR
REMOVAL OF THE MANDATE FOR
DENTAL LOSS RATIO AND IF THE
CHAIR IS AND.
PERMISSIBLE.
EXPLAIN WHY WE HAD IT IN THERE
IN THE FIRST PLACE.
THE BILL THAT WAS REFERENCE THE
BILL I CARRIED WHEN I WAS IN THE
ASSEMBLY WHICH ENABLED US TO GET
THIS DATA.
SHOWED THAT THERE ARE A LARGE
NUMBER OF PLANS DENTAL PLANS
THAT IF YOU'RE AYE PURCHASE
HAVE MET A MAN DENTAL LOSS
RATIOS AS LOW AS TWENTY. THIRTY
PERCENT.
NOW INTERESTINGLY.
THE.
.
BOARD MEMBER FORD THAT PLANS WHO
SPOKE DELTA DENTAL HAS A SEVENTY
PERCENT.
I MET BY DENTAL LOSS RATIO AND
THE DEMON WHILE THEY ARE NOT
IDENTICAL DENTAL LOSS RATIOS ARE
NOT IDENTICAL TO MEDICAL LOSS
RATIOS. THE AFFORDABLE CARE ACT
REQUIRES AN EIGHTY PERCENT
MEDICAL LOSS RATIO. NOW IT'S
INTERESTING WHEN.
MOST CALIFORNIANS. WERE A LARGE
NUMBER OF CALIFORNIANS WHO HAVE
DENTAL PLANS DO HAVE DELTA
DENTAL. AND THEY HAVE WHAT WOULD
BE CONSIDERED A VERY GOOD
GENERAL LOSS RATIO.
BUT THERE OTHER CALIFORNIANS
HAVE PLANTS THAT ARE DIFFERENT
AND. OUR PURPOSE WE'VE IT
INITIALLY WAS TO TRY TO
STANDARDIZE SO THAT ALL
CONSUMERS AND JUST IN THE WAY OF
UNDER A HEALTH CARE. WOULD HAVE
A STANDARD. BUT KNOWING THAT
THAT.
WAS.
A.
IT PROBABLY ASKING TOO MUCH AT
THIS POINT IN TIME. WE THOUGHT
ALRIGHT BEST JUST TO LET
CONSUMERS KNOW TO ALLOW THEM TO
BE ABLE TO COMPARE IN THE SAME
WAY NOW WITH THE MARKETPLACE
WHEN YOU'RE BUYING AND.
PLAN UNDER THE AFFORDABLE CARE
ACT YOU GET TO SEE IN DETAIL
WHAT THE DIFFERENT PLAN BENEFITS
ARE WHAT YOUR CHARGES AND THAT
SORT OF THING SO THAT'S REALLY
WHAT WE'RE TRYING TO ACCOMPLISH.
YOU OBVIOUSLY WE'RE GOING TO
CONTINUE OUR CONVERSATIONS WITH
THE STAKEHOLDERS LET ME LET ME
RESPOND TO YOUR COMMENT ABOUT
THE TOTAL LOSS RATIO COMPARING
IT TO MEDICAL PLANS OBVIOUSLY
IT'S LIKE IT'S LIKE COMPARING
APPLES TO ORANGES BECAUSE.
HOW WITH REGARD TO MEDICAL LOS
YOU'VE GOT TEN CENTS OFF
BENEFITS HAVE ONCE SAID OF
STANDARDS?
AND YOU CAN COMPARE AND HAVE A
MEDICAL LOSS RATIO WHEN YOU DEAL
A DENTAL HE'S GOT.
A VARIETY OF TYPES OF DIFFERENT
TYPES OF PLANS IN THERE. SO IT'S
REALLY DIFFICULT TO PIGEON HOLE
THE SPECIFIC DATA LOSS RATIO
GUESSING.
SO I WANTED ADDRESS THAT FOR
IRWIN AYE AYE APPRECIATE THAT I
CLERK SO SO THERE ISN'T SO. SO
THAT THERE'S A CLEAR DISTINCTION
BUT WRITER TALKING ABOUT HIS.
THE.
THE LISTING OF IT ON THE.
INFORMATION NO I KNOW THAT
WHETHER IT WAS GONNA BE IT RIGHT
BECAUSE WILL THE CONSUMER. WILL
BY INCLUDING IT IN OUR
DISCLOSURE MISLEAD THE CONSUMER
IN THE SAME WAY THAT RIGHT SO.
AND I THINK JUST FOR.
WHEN.
THE REASON THAT THEY'RE NOT SO
SIMILAR IS BECAUSE WE REQUIRE.
CERTAIN THINGS IN ANY MEDICAL
PLAN WE DO NOT REQUIRE IN A
DENTAL PLAN YOU CAN GET A DENTAL
PLAN THAT DOESN'T FOR EXAMPLE
COVER CERTAIN THE LIFESAVING.
PROCEDURES RIGHT SO IN THAT
RESPECT.
IT IS ABSOLUTELY CORRECT THAT
YOU CAN'T REALLY COMPARE.
SO WE MAY TRY TO FIND A
DIFFERENT.
INFORMATION A DATA POINT THAT
WOULD HELP THE CONSUMER TO BE
ABLE TO COMPARE BECAUSE THAT'S
REALLY WHAT WE'RE OVER AND OTHER
DIFFERENT SAID IN DENTAL IT'S
NOT REQUIRED FOR EVERYONE ONLY.
CHILDREN WERE RIGHT IN CHILDREN
IT IS BUT.
CORRECT YOU'RE THE DIFFERENCE IS
THAT WORDS AND HEALTH OBVIOUSLY
IT'S REQUIRED ALL THOSE.
ESSENTIAL BENEFITS
PERHAPS MAYBE NOT IN THIS BILL
BUT ANOTHER CONVERSATION IS
STANDARDIZED TESTS OF THE
PUBLIC.
THE BENEFITS ARE JUST NOW YOU
CAN ACTUALLY HAVE A CONVERSATION
ABOUT A DENTAL LOSS RATIO BUT.
OBVIOUSLY THAT'S NOT THIS BILL I
THINK CENTER HAND HAVE A COMMENT
OR QUESTION IS THAT CORRECT.
YEAH OKAY.
NO I THANK YOU CENTER SKINNER.
DURING THE BILL.
HAVING DONE SOME SIMILAR
LEGISLATION AS SOME THAT.
AND THEY WANT TO KNOWLEDGE THE
FACT THAT.
A YELL DENTAL PLANS BECAUSE
GENERALLY THEY.
ARE.
I GUESS IN TERMS OF FOOT HAVE
TO PAY OUT IS JUST FOR DENTAL
SERVICES LESS BUT YET HAVE THE
SAME OVERHEAD.
MAKE IT MORE DIFFICULT TO
ACHIEVE THE SAME MEDICAL LOSS
RATIOS AS MEDICAL PLANS MAY HAVE
BECAUSE.
FUGITIVES OF LARGER MEDICAL
EXPENSES ARE OVER I WOULD ALSO
MAKE NOTE THOUGH IS THAT THE
PROVIDING INFORMATION TO
CONSUMERS.
IS HELPFUL IT'S DOESN'T TELL
YOU EVERYTHING SO FOR EXAMPLE
YOU.
PEOPLE ADVISE THAT WHEN YOU'D
SIZE DONATE TO A CHARITY THAT
YOU LOOK UP WHAT PORTION PERSON
ACTUALLY GOES TO THE TERRIBLE
PURPOSE PERSONS ARE OVERHEAD
DOES THAT MEAN THAT. BAD CHARITY
THAT MIGHT HAVE A HIGHER
OVERHEAD IS A WORKS CHARITY OR
DOES LESS.
NOT NECESSARILY.
BUT YOU KNOW THE CIRCUIT TO THE
POINT WHERE WELL WAIT A MINUTE
YOU KNOW SEVENTY PERCENT EIGHTY
PERCENT OF THE DOLLARS NOT GOING
TO LET'S FOR. YOU MIGHT WANT ASK
MORE QUESTIONS ABOUT WHY THAT'S
THE CASE OR YOU NOTICE THAT
WHILE MOST OF THE PLANS ARE HERE
BUT THAT ONE'S OVER THERE AT
LEAST THAT GETS YOU TO ASK A
QUESTION DOES THAT MEAN THAT
THAT'S PLANS NOT RIGHT FOR YOU.
WELL NOT NECESSARILY BUT I THINK
IT.
FOR PEOPLE TO KNOW WHEN YOU'RE
TRYING TO JUDGE WHAT A PAYMENT
PREMIUMS
SO I I THINK.
BUT IS SO I APPRECIATE YOU I
THINK THERE NEEDS TO BE
CONTINUED CONVERSATION TO BE
SURE REPEAT WE TARGET PEOPLE
YELLED THE MOST ACCURATE
INFORMATION USABLE ACTIONABLE
INFORMATION POSSIBLE.
BY THINK I IT IS IMPORTANT THAT
WE HELP EMPOWER OUR CONSUMERS TO
HAVE A BETTER AND.
WHAT THE PURCHASING WHAT THE
VALUE IS WHAT THE THE MONEY TO
SPENDING ON THIS?
AND SO WITH THAT CERTAINLY I
WOULD BE HAPPY TO MOVE TO BUILT
APPROPRIATE TIME TAKING HIS
SAUCER NEWMAN. COMMENT QUESTION
A THANK YOU RICHARD CHAU
BERGSON'S GARY I DON'T WANT TO
COME BACK TO.
THIS NOTION OF THEM DIDN'T
DENTAL LOSS RATIO AND IN DOWN
EVEN MORE CRAP SIMPLISTIC LEVEL.
I THINK IT'S TRUE IS NOTED THAT
AS A SEMANTIC MATTER IT IS
REALLY HARD FOR PEOPLE
UNDERSTAND.
THE DID YOU KNOW THE
CONNOTATION OF LOS A IS IS THIS
IS A TERM OF ART THAT IS UNITS
CONFUSING WITH RESPECT TO THE
ACA. I THINK IT'S EVEN MORE
CONFUSING WHEN IT COMES TO
DENTAL.
ANSWER MY ISSUE WITH THIS IS
REALLY AROUND THE SEMANTICS BUT
PARTICULAR ROUTE IT WILL HOW IT
WILL BE RECEIVED INTERPRETED BY.
THE DENTAL PUBLIC IF YOU WILL SO
IF THERE WERE SOME WAY. TRIED TO
GATHER DATA DIED THAT WAS NOT
CODIFIED AROUND THIS CONCEPT I'D
I'D PROBABLY BE MORE SUPPORT
BECAUSE I I TRULY BELIEVE MOST
OF US DON'T REALLY FRANKLY YOU
UNDERSTAND HOW OUR INSURANCE
WORKS WHEN IT'S OPEN ENROLLMENT
PERIOD. CLARA AND SO BUT I WILL
ADMIT TO THAT THAT ENDED THE I
DO YOU KNOW IF IF IT'S ABOUT
SOMETHING CALLED A LOSS RATIO.
LOSSES LAWS TO MOST PEOPLE AND
AND SO THAT THAT'S IT'S
CONFUSING AND I THINK THAT IS.
TOUCH ON BY THE CHEER DOT
DENTAL COVERAGE YOU SOMETHING
CLOSER TO A SERVICE PLAN.
THERE IT IS IT TRUE INSURANCE
BUT PARTLY BECAUSE IT'S NOT
STANDARDISED APART BECAUSE IS A
LIMITED RANGE OF THINGS THAT
TYPICALLY YOUR EMPLOYER IS
PAYING FOR. THE AND SO I THINK
IT'S YOUR MIND IS IS IF PEOLE
START TO CLOUD REFERRED TO
ILLUSTRATION NUMBER SOME OF THE
NUMBER. THEY'RE NOT TYPICALLY BY
THE END BUYER IN IN IN MOST CASE
HAVING MAJORITY IT'S EMPLOYER
WHO'S PER PROBE BUYING THAT CARE
SHE STILL OF INDIRECT PROBLEM
WARY WHERE WE'RE ACTUALLY TRYING
TO. INSTIGATE SUCH TERRIBLE
THING BUT THE THE THAT THE
PATIENT THAT WOULD HAVE TO GO TO
HIS OR HER EMPLOYER I.
MEDICATION POURS DON'T OFFER A
RANGE OF OPTIONS SURELY NOT THE
SAME LEVEL OF OPTIONS HAT YOU
GET WITH HEALTHCARE. AND AGAIN I
THINK THESE THINGS NEED TO BE
DISCUSSED AND WRESTLE WITH SO
THAT WE CAN GET TO SOME LEVEL OF
STANDARDIZATION. BY A TRUE
UNDERSTANDING OF THE POOR THE
PUBLIC IS AS RACES CONCEPT.
FACING THE OTHER QUESTIONS OR
COMMENTS I BELIEVE CENTER PAN
MOVE THE BILL.
THE CRACK.
I'M I WILL BE SUPPORTING IT.
WOULD YOU LIKE TO CLOSE SENATOR
SKINNER THANKS SO MUCH AND I
THINK THE COMMENTS THAT. THE
COMMITTEE MEMBERS OF BRAZEN
SPECIALLY YOU THE CHAIRS Y. WE
TOOK OUT THE MANDATORY DENTAL
LOSS RATIO BECAUSE IT IS IN OUR
PAULSON ORANGES.
BUT I THINK WE ALL KNOW THAT
GENERAL HEALTH IS ESSENTIAL TO
OUR PHYSICAL HEALTH AND THAT.
IMPROPER EARNED.
INADEQUATE OR NOT GETTING DENTAL
CARE CAN JEOPARDIZE A PERSON'S
ENTIRE PHYSICAL HEALTH.
AND SO REALLY I I THINK ALL THE
COMMENTS AND WE MAY WANT TO LOOK
AT FUTURE LEGISLATION TO
STANDARDIZE THE TYPE OF CARE
THAT OUR DENTAL INSURANCE PLANS
PROVIDE AND THAT IS NOT WHAT
THIS IS DOING. I REALIZE BUT WE
ARE CERTAINLY TRAINING KIT AT A
BETTER UNDERSTANDING SO WE
UNDERSTAND WHAT WE'RE
PURCHASING.
SO WITH THAT I ASKED FOR AN AYE
VOTE THANK YOU THIS IS ITEM
NUMBER TWO SP ONE ZERO ZERO
EIGHT SKINNER HE PASSES A MINUTE
APPROPRIATIONS CALL THE MEMBERS
PLEASE HERNANDEZ AYE HERNANDEZ
AYE WHEN.
LEYVA. LEYVA AYE MITCHELL.
MITCHELL AYE MONNING.
MONNING AYE NEWMAN.
NEWMAN.
NIELSEN.
NIELSEN NO HAN HI CAN I ROTH.
ROTH I.
CURLY A SIX NOT TO GET OUT WE
HAVE SOME ABSENT MEMBERS A PLACE
EVELYN CALL THINK IT WOULD YOU
LIKE TO TAKE UP ITEM NUMBER
NINE.
YES THINGY THAT'S S. B. ONE ONE
THREE EIGHT. FOOD OPTIONS PLANT
BASED MEALS.
THANK YOU CHAIR MEMBERS SB
ELEVEN THIRTY EIGHT PURELY
RECOGNIZES THAT.
THOSE WERE THOSE OF US WHO HAVE
DIETARY PREFERENCES FOOD
SENSITIVITIES WHAT HAVE YOU.
IN MOST OF OUR SETTINGS CAN
EITHER BRING OUR OWN MEAL
PREPARE MILLER BY.
AND IT IS IN INSTITUTIONAL
SETTINGS LIKE A NURSING HOME OR
HOSPITAL WHERE PRISON WHERE YOU
DON'T HAVE THAT OPTION SO WHAT
ELEVEN THIRTY EIGHT DOES IS
ENSURE THAT IN SUCH SETTINGS.
THERE ARE PLAN A PLANT BASED
MEAL OPTION IS PROVIDED AND THAT
IS SIMPLY WHAT IT DOES NOT ALLOW
ME WITNESSES TO SPEAK IN SUPPORT
THANK YOU.
WE HAVE A MONTH PROMOTION THANK
YOU VERY MUCH.
PLEASE PROCEED.
GOOD AFTERNOON COMMITTEE MEMBERS
MY NAME IS ANNA HERBIE I'M A
REGISTERED DIETITIAN WITH THE
PHYSICIANS COMMITTEE FOR
RESPONSIBLE MEDICINE.
AS A REGISTERED DIETITIAN MY
MOST POWERFUL TOOL IS EDUCATING
PATIENTS ON THE BENEFITS OF
EATING MORE PLANT BASED MEALS.
TO HELP THEM LOSE WEIGHT
DECREASED NEEDS FOR MEDICATIONS.
AND PREVENT AND REVERSE CRYING
DISEASES LIKE DIABETES HEART
DISEASE.
OBESITY AND SOME FORMS OF
CANCER.
I HAVE BEEN LUCKY ENOUGH TO WORK
AT A HOSPITAL. THAT PRIORITIZES
SERVING PLAN BASED MEALS TO
THEIR PATIENTS AND STAFF
MEMBERS.
THE DIFFERENCE THIS MAKES AN
OVERALL PATIENT EXPERIENCE AND
IN MY ABILITY TO TEACH PATIENTS
ABOUT FOOD AS MEDICINE IS
PROFOUND.
IT ENCOURAGES THEM TO GO HOME
AND INCORPORATE THESE PLAN MAYES
NAILS INTO EVERY DAY EVERYDAY
LIFE.
DURING THEIR HOLD AROUND AND
PREVENTING FUTURE HOSPITALS IT
HOSPITALIZATIONS.
BUT MANY OF MY COLLEAGUES AT
OTHER HOSPITALS THIS IS NOT THE
CASE PATIENTS CONTINUE TO BE
SERVED MEALS THAT ARE HARMFUL TO
THEIR HOUSE. FOR A LOT OF PEOPLE
BEING IN THE HOSPITAL FOR AN
CONTROL DIABETES OR HEART.
IS A PIVOTAL MOMENT IN THEIR
LIVES.
THERE OFTEN SEARCHING FOR
ANSWERS ABOUT THEIR HEALTH.
AND RIGHT NOW WE'RE MISSING THE
OPPORTUNITY FOR PATIENTS TO TRY
PLAN B. SMILES AND TO LEARN THE
BENEFITS OF FOOD IN REVERSING
DISEASE.
THIS BILL WOULD EMPOWER
INDIVIDUALS TO MAKE HEALTHIER
CHOICES BOTH IN AND OUT OF THE
HOSPITAL SETTING. IT WOULD HAVE
A FAR REACHING EFFECT IN TERMS
OF HEALTHCARE COSTS
ENVIRONMENTAL IMPACT.
THE BOOK OVERALL WELL BEING OF
OUR POPULATION IT WOULD ALSO
PROVIDE PAVE THE WAY FOR OTHER
STATES TO ADOPT SIMILAR
MEASURES.
AND A POTENTIALLY CHANGE THE
FACE OF HEALTH CARE IN THE
UNITED STATES THANK YOU.
GOOD AFTERNOON COMMUNION WITH
COMMITTEE MEMBERS ON MY NAME IS
TO NOW PLUS YOUR BUTLER AND
THESE ARE MY TWO CHILDREN SCION
IN ENESIS.
IN JULY TWO THOUSAND SIXTEEN I
WAS A BIT TOO LONG BEACH
MEMORIAL HOSPITAL TO GIVE BIRTH
TO MY FOURTH CHILD.
BEFORE LABOR I INFORM THE
HOSPITAL THAT WHAT I WAS VEGAN
FOR ETHICAL REASONS ARE
REGARDLESS OF THE REASON FOR MY
DIET THE FACT THAT I HAD NOT
EATEN MEAT OR DAIRY IN MANY
YEARS AND WAS NOT CERTAIN HOW MY
BODY WOULD REACT IF I HAD. EATEN
IT EVEN IF I WAS WILLING.
AFTER BEING TOLD BY THE
HOSPITAL THAT THEY WOULD SEE
THAT WHAT THEY CAN DO MY FIRST
NO AFTER GIVING BIRTH WAS OREOS
POTATO CHIPS A SODA. AND COFFEE.
BOB.
OBVIOUSLY BUT THIS WAS NOT
NUTRITIOUS A WHO A NUTRITIOUS
MEAL.
YOU WOULD IMAGINE A MOTHER
WOULD.
EAT AFTER GIVING BIRTH UP AGAIN
AFTER REQUESTING A MORE COMPLETE
AT BASE MIL I WAS GIVEN TWO
SLICES OF WHITE BREAD WITH
ICEBERG LETTUCE A SLICE OF
TOMATO. WITH CHEESE ON IT. ON
NOT ONLY DID THIS SANDWICH HAVE
CHEESE BUT I CAN TELL IT HAD ME
IN THE HAD JUST TAKEN THE MEAT
OFF.
YEAH IT WAS REALLY GROSS
PERFECT TO ME BECAUSE YOU JUST
IT WAS JUST NOT GOOD AT ALL I
TOLD TEM I'M SORRY AND I WAS
VERY POLITE. GIVE IT BACK TO
THEM BE SENT ME CHICKEN BROTH
NEXT.
TOLD THEM CHICKEN BROTH IS NOT
VEGAN THEY SO THERE'S NO CHICKEN
IN THE SUIT.
AND. YES.
NOT PLANT BASE BEEN JELLO JELLO
ACTUALLY IS NOT PRINT BASED
EITHER IT'S MADE OUT OF.
FIRST HOOVES
I FINALLY AFTER TWO MIL CYCLES I
WAS GIVEN STEAMED BROCCOLI AS MY
ENTIRE MIL.
AT THE END OF THIS ORDEAL I WAS
TOLD BY THE HOSPITAL
ADMINISTRATOR AND I QUOTE WE
DON'T GIVE VEGAN MEALS PEOPLE
WHO I'M VEGAN JUST CAVE IN IN
THE EAT WHAT I GET WHAT WE GIVE
THEM.
I KNOW MANY OF THEM ALSO TO
YEARS LATER MY DAUGHTERS I AND
ENDED UP IN THE HOSPITAL WITH A
BROKEN ELBOW I THOUGHT.
IT LONG BEACH IS PROGRESSIVE WHO
PROBABLY HAVE MORE VEGAN BUT AT
LEAST ANOTHER VEGAN OPTION FOR
US. NOT THE CASE SHE WENT IN
THERE SHE WENT TO MIL CYCLES
WITH NO FOOD AT ALL WENT O THE.
OUR CAFETERIA AND ALL THEY HAD
THAT WAS VETO WAS GREASY FRENCH
FRIES CHILDREN LEFT FRENCH FRIES
BUT SHE WON'T EVEN TOUCH HIM.
SO.
AFTER THAT THE FINALLY GIVER
HER FIRST MEAL OF THE DAY AFTER
BEING TRAUMATIZED WITH HER
BROKEN ELBOW AND IT WAS A PLAYED
A WHITE RICE.
BY ONE INTRODUCED MY DAUGHTERS
GENESIS AND MY DAUGHTERS I AM.
IT JUST MAKES SENSE TO HAVE A
PLANT BASED MEALS AND HOSPITALS
ESPECIALLY PEOPLE ARE SICK
BECAUSE THEY SHOULD HAVE FRESH
FRUITS AND VEGETABLES AFTER
THEY'RE SICK.
AND IT'S A WIN WIN BECAUSE IT'S
HELPING THE PLANET.
THANK YOU THANK YOU KNOW WHAT
AND WHAT'S YOUR NAME.
WHAT'S YOUR NAME.
LYING ON.
FREE PROBATIVE BMO BANK YOU VERY
MYERS.
AMY THANK YOU. SO. SO MOM LET ME
LET ME COMMITTEE HAVE SOME
INCREDIBLE BRIGHT YOUNG LADIES
AND I WANT TO THANK YOU FOR
BRINGING THEM VERY NICE
TESTIMONIES.
GOOD GOOD JOB AND GAIL.
OKAY ARM.
ANYONE ELSE IN SUPPORT PLEASE
STATE YOUR NAME AND POSITION HI
JUDIE MANCUSO SPONSOR OF THE
BILL AND I TOO HAVE BEEN SINGED
IS SUBJECTED TO.
SIMILAR THINGS IN THE HOSPITAL
WE THINK SENATORS SKINNER AND
THANK YOU FOR YOUR AYE VOTE
TODAY.
I'M KATIE CLEARY PRESIDENT OF
PEACE FOR ANIMALS A MORE
RELIABLE NEWS OUT OF LOS ANGELES
AND I SUPPORT THE BILL THANK
YOU.
CAROLINE TRAP DIABETES NURSE
PRACTITIONER AND DIABETES
EDUCATOR AMERICAN ASSOCIATION OF
DIABETES EDUCATORS PLANT BASED
NUTRITION SUPPORT GROUP. AND.
THE PHYSICIANS COMMITTEE FOR
RESPONSIBLE MEDICINE I URGE YOU
TO SUPPORT THE SPELL THANK YOU.
FUNDED TOMLINSON SPEAKING FOR
MYSELF IT'S JUST COMMON SENSE.
WE HAVE SEARCHES SOCIAL
COMPASSION AND LEGISLATION HERE
TO SUPPORT FROM LOS ANGELES AND
I HAD A NURSE CONVINCE MY FATHER
THAT. BITE EATING HIS JELLO
SUPPLEMENT HE WAS ACTUALLY
GETTING ALL HIS WATER INTAKE.
NOTHING.
JANE VELEZ MITCHELL SUPPORTER OF
THIS BILL AUTHOR AND JOURNALIST
MAKES ALL THE SENSE IN THE
WORLD.
GOT HERTZBERG ADMINISTER OFTEN
SUPPORT.
JASON BRIGHT ON BEHALF OF THE
CALIFORNIA CATTLEMEN'S
ASSOCIATION WESTERN AYE DAIRY
MEN RESHAPE THE SENATOR WORKING
WITH US ON THE LANGUAGE THE BILL
WE ARE NEUTRAL THANK YOU.
THANK YOU IS THERE ANY
OPPOSITION TO THE MEASURE.
QUESTIONS COMMENTS.
PHOENIX.
YOU JUST SHOULDN'T HAVE.
AND JUST ONE OF THIS RE NAM
VERIFY THAT YOUR AUTHORS
AMENDMENTS WHICH WE'VE BEEN
PASSED OUT I WILL REVISE THE
FINDINGS AND DECLARATIONS THAT
CORRECT YES ABSOLUTELY. THOSE
HEARING MEASUREMENTS WERE TAKEN
I THINK AND WE DO HAVE A MOTION
BY SENATOR MITCHELL.
CHAIR WILL BE SUPPORTING THE
BILL JULY CLOSE
I ASK YOUR AYE VOTE THANK YOU
THANK YOU AND ITEM NUMBER NINE
SP ONE ONE THREE EIGHT TWO
PASSES A MINUTE APPROPRIATIONS
COLOR MEMBERS CLEAN HERNANDEZ
AYE HERNANDEZ AYE WHEN.
LEYVA LEYVA AYE MITCHELL.
MITCHELL AYE MONNING AYE AYE
MONNING AYE NEWMAN.
NIELSEN. NIELSEN AYE PAN. PAN
AYE ROTH.
CURLY OF SIX ENOUGH TO GET
OUT-WE'RE GONNA PLAY SAID BILL
AND
CALL WE DO HAVE SOME ABSENT
MEMBERS THANK YOU THANK YOU
THANK CHAIR. WE'RE GONNA MOVE ON
TO ITEM NUMBER SEVEN SP ONE ONE
ZERO NINE SENATOR BEATS
CONTROLLED SUBSTANCE SCHEDULE
TWO DRUGS THANK YOU.
SCHEDULE TWO DRUGS OPIOIDS
CELEBRATES WELCOME AND WE DO
HAVE SUPPORT ON BOTH SIDES IN
THIS MEASURE PLEASE PROCEED.
THANK YOU MISTER CHAIR.
I WAS GOING TO SAY GOOD MORNING
GOOD AFTERNOON AND.
TO CHEERING MEMBERS SAW SENATE
BILL ELEVEN NO NINE SEEKS TO
ADDRESS THE OPIOID EPIDEMIC BY
PROVIDING. PREVENTIVE EDUCATION
FOR ALL INVOLVED I WOULD LIKE TO
START BY ACCEPTING THE SUGGESTED
COMMITTEE AMENDMENTS.
THAT YOU HAVE IN FRONT OF YOU I
BELIEVE AND THINK THE CHAIR AND
CERTAINLY YOUR STAFF FILE FOR
WORKING WITH ME AND MY STAFF ON
DRAFTING THAT. THE MARKUP IN
YOUR SUPPORT IN THE SENATE
BUSINESS AND PROFESSIONS
COMMITTEE I JUST LAST WEEK THE
AMENDMENTS UPDATE CONSENT PIECE
OF THE BILL. S. B. ELEVEN OO
NINE IT WILL NOW REQUIRE JUST A
DISCUSSION BETWEEN THE PROVIDER
MINOR AND PARENT. ORIGINALLY A
CONSENT FORM WAS REQUIRED WITH
THE PARENTS SIGNATURE FOR EACH
INITIAL SCHEDULE TO PRESCRIPTION
ENTRY DISCUSSION WITH THE CHAIR
AND STAFF. WE BELIEVE THAT THE
DISCUSSION NEEDS OF THE LEVEL OF
BOB EDUCATION THAT WERE HOPING
FOR SPECIFICALLY THE MEASURE
REQUIRES THE EXISTING CONTINUING
EDUCATION REQUIREMENTS FOR
PRESCRIBERS TO INCLUDE. THE
RISKS OF ADDICTION AND OVERDOSE
ASSOCIATED WITH THE USE OF
SCHEDULED TO CONTROLLED
SUBSTANCES THAT REQUIRES A
WARNING LABEL ON ALL SCHEDULED
TO CONTROLLED SUBSTANCES
PRESCRIPTION BOTTLES. ON THE
ASSOCIATED ADDICTION OVERDOSE
RISKS IT REQUIRES A DISCUSSION
WITH THE PRESCRIBER FOR ANY
MINOR RECEIVING AN INITIAL
OPIOID PRESCRIPTION AND LASTLY.
THE BILL REQUIRES AN INFORMATION
SHEET ON THE RISKS OF OPIOIDS TO
BE SIGNED BY THE MINOR ATHLETE
AND THEIR PARENT OR GUARDIAN.
BEFORE THEY PARTICIPATE IN AN
ORGANIZED SPORTS TEAM ACCORDING
TO THE CENTERS FOR DISEASE
CONTROL FIFTY THREE THOUSAND
AMERICANS DIED. FROM OPIOID
OVERDOSES IN TWENTY FIFTEEN
WHICH TOTALS MORE DEATHS THAN.
ALL CAR ACCIDENTS IN THAT SAME
YEAR EVEN MORE ALARMING IS THE
FACT THAT THE CURRENT DEATH
COUNT EXCEEDS THE NUMBER OF
INDIVIDUALS KILLED IN THE
VIETNAM WAR. CALIFORNIA HOW JUST
SHY OF TWO THOUSAND OPIOID
RELATED DEATHS AND TWENTY
SIXTEEN WITH TWELVE PERCENT OF
THOSE BEING IN SAN DIEGO COUNTY.
IN LATE OCTOBER TWENTY SEVENTEEN
THE PRESIDENT DECLARED THE
OPIOID CRISIS THE NATIONAL
PUBLIC HEALTH EMERGENCY.
IT IS HARD TO STOMACH THE LOSS
OF THAT HAVE ALREADY OCCURRED TO
DATE BUT I DO BELIEVE. THAT S.
B. ELEVEN ON NINE MOVES US IN
THE RIGHT DIRECTION EVEN IF WE
ARE SAVING A JUST A FEW MORE
LIVES EACH ONE ACCOUNTS
DRAMATICALLY AGAIN I THINK THE
COMMITTEE STAFF. AND
STAKEHOLDERS THAT I'VE BEEN
WORKING WITH OVER THE PAST FEW
MONTHS TO GET WHERE WE ARE TODAY
AND I AM PROUD TO JOIN SAN DIEGO
DISTRICT ATTORNEY. CLAMOR
STEPHAN WHO IS SPONSORING ELEVEN
NO NINE REPRESENTING THE DA
TODAY AS DEPUTY DISTRICT
ATTORNEY. LARA TONY TO ANSWER
ANY TECHNICAL QUESTIONS AND WE
ALSO HAVE WITH US BY JUDY BARBER
HERE FROM MY HOME CITY LOGAN IN
A GAL TO TESTIFY IN SUPPORT. AND
SHARE HER SON'S PERSONAL STORY
THANK YOU VERY MUCH WELCOME AND
PROCEED.
THANK YOU ARE ATTENDING ON
BEHALF OF THE DEPUTY AYE AYE
EXCUSE ME DEPUTY DISTRICT
ATTORNEY MAURITANIA ON THE
BEHALF OF SAN DIEGO DISTRICT
ATTORNEY SUMMER STUFF ON THE
SPONSOR OF THIS BILL. WE WOULD
LIKE TO THANK SENATOR BATES FOR
AUTHORING THIS IMPORTANT
LEGISLATION AND THINK COMMITTEE
STAFF FOR WORKING WITH US TO.
REACH THE AMENDMENTS TO. ALLOW
THIS BILL TO PROCEED.
I'M HERE FOR TECHNICAL
QUESTIONS AND ASK YOUR SUPPORT
THANK YOU.
I'D LIKE TO FOR SHOW YOU THIS
PICTURE OF THIS POSTER AT THE
SINCE TWENTY FOUR FACES OF KIDS
FROM THE GOOD AND THE GALA OR
FROM ORANGE COUNTY RATHER.
.
ON THE TOP ROW IS MY SON AND.
FOUR OF THOSE VERY CLOSE FRIENDS
HE PLAYED LITTLE LEAGUE WEST
WEST AND DUBBED THEY ALL PASSED
AWAY FROM AN OVERDOSE.
SO.
GOOD AFTERNOON THANK YOU FOR
THIS OPPORTUNITY MY NAME IS JUDY
BARBER I'M FROM THE GONNA
CALIFORNIA. SB ELEVEN ON NINE IS
EXTREMELY IMPORTANT. I LOST MY
NINETEEN YEAR OLD SON AND FOUR
OF HIS CLOSE FRIENDS IN TWO
THOUSAND TEN AND SOON BECAME AN
ADVOCATE AGAINST THE OVER
PRESCRIBING A PRESCRIPTION
DRUGS.
HIS FRIEND WHO PASSED AWAY WAS
INJURED PLAYING FOOTBALL. AND
WAS PRESCRIBED SIXTEEN ARCO FOR
A MINOR INJURY THAT COULD HAVE
BEEN RELIEVED BY TAKING ADVIL
AND TYLENOL.
HE WAS JUST IN HIGH SCHOOL.
ANOTHER YOUNG MAN WHO IS NOW
GONE TOO SOON CRIED TO ME SAYING
HE WAS HOOKED. ON OUR GOES AFTER
HE TOO WAS INJURED PLAYING
FOOTBALL HE WAS A FRESHMAN ON
THE VARSITY TEAM. HE SAID TO ME
WHY DID THE DOCTOR ASK ME IF
ADDICTION RUNS IN MY FAMILY.
BOTH HIS PARENTS ARE ADDICTED TO
PRESCRIPTION PILLS.
IT IS STRANGE THAT BECOMING A
PRO FOOTBALL PLAYER WAS
SHATTERED.
ANOTHER YOUNG MAN MENTIONED HE
BROKE HIS ANKLE PLAYING
BASKETBALL AND WAS GIVEN BY
COULDN'T.
THAT'S WHEN HIS ADDICTION
STARTED AND HIS LIFE BECAME A
NIGHTMARE.
THE LIST GOES ON AND ON.
MY SON AT AGE SIXTEEN BROKE HIS
COLLARBONE WATER BIKING AND THE
NURSE GAVE HIM I COULDN'T. HE
COULDN'T STOP.
HIS FRIEND I MENTIONED WHO IS
PRESCRIBED SIXTEEN ARGO WAS SEEN
DOCTOR LISA SAYING.
HE WAS WALKING OUT OF HER OFFICE
IN LESS THAN FIVE MINUTES WITH
SCRIPTS FOR.
PADA
SAN NEXT BY GIVEN ANYTHING YOU
WANTED NINETY OXYMORPHONE IN A
BOTTLE.
MY SON AND HIS FRIENDS WERE
ADDICTED TO APADANA AND DIED
WITHOUT HIGHLY ADDICTIVE STRONG
MEDICATION INTENDED FOR TERMINAL
STAGE CANCER IN THEIR SYSTEM.
A WARNING LABEL THAT STATES
CAUTION OPIATE RISK OF OVERDOSE
AND ADDICTION. WELL IN FACT SAVE
LIVES.
I SEE SEVENTH GRADERS WITH ARMS
OR LEGS CASTS ASKING WHAT WAS
PRESCRIBED AND THE PARENTS TAMI
BIKE AND WITHOUT ANY CONCERN ON
THEIR FACES.
AS AN EFFORT TO EDUCATE STUDENTS
TEENS. ADULTS I PRODUCE A SHORT
DOCUMENTARY CALLED OVERTAKEN.
YOUNG ADULTS TALKED ABOUT HOW
THEY BECAME ADDICTED TO OPIATES
AFTER A SPORT AND JULIE.
THE FILM IS USED IN SCHOOLS
REHABS DO YOU AYE CLASSES AND
COURTROOMS.
I WOULD LIKE OVER TAKEN OF TO BE
INCLUDED IN THE EFFORT TO
CONTINUE EDUCATING PATIENTS
STUDENTS. PARENTS PRESCRIBERS.
PLEASE WATCH OVER TAKEN I NEED
TO.
EDUCATION IS KEY AND SB ELEVEN
ON NINE WILL PROMOTE THOSE I ASK
FOR YOUR AYE VOTE THANK YOU.
THINK ANYONE ELSE IN SUPPORT.
MICHAEL LEFT ON BEHALF OF
MCKESSON IN SUPPORT.
THANK YOU.
SHAWN HOP INTO THE CALIFORNIA
DISTRICT ATTORNEYS ASSOCIATION
SUPPORT.
IS THERE OPPOSITION.
PATRICIA MEMBERSHIP GROSS BOUT
THE CALIFORNIA PHARMACISTS
ASSOCIATION WE DO HAVE AN OPPOSE
UNLESS AMENDED.
AS I THINK YOU'RE AWARE WE ARE
CONCERNED ABOUT THE LABELING
REQUIREMENT.
AS OF MOST OF YOU ARE AWARE
YEAH THERE ARE REQUIREMENTS FOR
LABELS NOW WITH RESPECT TO
LANGUAGE. AND VARIOUS OTHER
THINGS AND LABELS BECOME VERY
CROWDED. AND THEY CAN BECOME
VERY DIFFICULT TO ACCOMMODATE
ANYTHING ADDITIONAL HOWEVER WE
HAVE PLEDGED TO THE AUTHOR. THAT
WE'RE GOING TO CONTINUE TO WORK
WITH THEIR WE HAVE BEEN SPEAKING
WITH THE BOARD OF PHARMACY STAFF
ON ANOTHER WAY TO DO THIS.
TO BE ABLE TO ACCOMMODATE SOME
SORT OF WARNING THAT IS ATTACHED
TO THE BOTTLE. I'M WITH YOU THE
LANGUAGE WOULD NEED BETWEEN TO
DO THAT WE WILL.
COME BACK TO THE AUTHOR WITH
OUR RECOMMENDATION LINE THAT'S
OF THAT YOU COULD EACH YEAR
VERTICAL AND WE DO NOT CREATE AN
UNTENABLE SITUATION WITH RESPECT
TO ALL THAT IS ON THE LABEL.
THANK YOU.
GOOD AFTERNOON MR CARDMEMBERS
MAKING AUTUMN BEHALF THE
CALIFORNIA. MEDICAL ASSOCIATION
HERE.
OPPOSING US AMENDED STILL BUT
REALLY APPRECIATE THE AUTHOR'S
WORK AND.
TO DISCUSS THIS WITH US AND
WE'VE GONE THROUGH A LOT OF
MOMENTS IN A LOT OF MOVEMENT ON
THIS BILL AND WE REALLY DO
APPRECIATE ALL THAT SHE IS TO
AND. I'VE.
BUT WE STILL HAVE CONCERNS
REGARDING THE UNPROFESSIONAL
CONDUCT BY.
HELMET PENALTY I'M WITH THE
LANGUAGE STILL IN THE BILL. AND
I'M
WE WOULD JUST.
BUT FOR TO CONTINUE WORKING WITH
THEM. THANK YOU.
OPPOSITION BODY OF ONE
REPRESENTING AMERICAN KENNEDY
PEDIATRICS WE REMAIN OPPOSED
UNLESS WE.
THANK YOU.
CENTER MINING QUESTION.
THANK YOU MISTER CHAIRMAN.
I FIRST WANT TO THANK.
THE WITNESS WHO SHARED HER
PERSONAL STORY OF HER LAWSON
COMMAND TURN.
TURNING THAT LOSS INTO AN EFFORT
TO. HELP OTHER FAMILY SNOT FACE
SIMILAR TRAGEDIES.
BOB MY QUESTION FOR THE AUTHOR
YOUR SUPPORT. THUMB DO YOU HAVE
ANY DATA SHOWING THE EFFICACY OF
WARNING LABELS.
OF.
SENATOR MONNING NO THAT'S NOT
SOMETHING WE PURSUED I THINK
ABOUT THE THE OF ISSUE THAT WE
HAVE DISCUSSED WITH THOSE WHO
BEYOND ARE BASICALLY AFFECTED BY
THIS HAS BEEN. THE COMPELLING
ISSUE THAT IF SOMETHING WAS VERY
PRESENT AND SHE PICKED UP THE
BOTTLE AND KNOWING THAT THIS IS
VERY DANGEROUS MEDICATION WAS
REALLY PARAMOUNT TO. THE
IMMEDIATE.
SECOND THOUGHT I BETTER NOT ME
TAKING THAT'S I BETTER CHECK
WITHIN THE PRESCRIPTION
WHATEVER.
SO IT'S IT'S FIVE SOMETHING THAT
YOU SEE ON MODEL FATTER OUT VERY
TOXIC AND WE KNOW THESE OPIOIDS
ARE VERY TOXIC SO IT SEEMS
LOGICAL TO MOVE IN THAT
DIRECTION BUT THAT'S CERTAINLY
SOMETHING. IF IT'S SOMETHING WE
NEED GOING FORWARD AS WE DEAL
WITH THE LABELING WITH OUR AYE
OPPOSITION WE CERTAINLY WOULD
LOOK AT THAT. THANK YOU I
APPRECIATE THAT I.
YOU KNOW MY GUESS IS
ONE OF THE CONCERNS OF THE
INDUSTRY OF CONSPICUOUS LABELING
ABOUT THE HEALTH RISK OF.
ADDICTION NAM OR OVERDOSE.
NAY MAY HAVE A CONCERN OF
LIABILITY ALTHOUGH I THINK IT'S
WELL DOCUMENTED THAT PIECE
NARCOTIC BASED DRUGS HAVE THAT
HAVE THAT RISK.
HOME ONCE A YOUNG PERSON OR AN
ADULT FOR THAT MATTER. IS
COOKE A REDACTED NAM.
THE WARNING LABELS MAY NOT BE
SUFFICIENT BUT I WOULD AGREE
THAT AS PART OF A BROADER
CAMPAIGN OF EDUCATION. OF
PUTTING THAT CONSPICUOUS NOTICE
HONOR TO THE CONSUMER AND
PARTICULARLY FOR YOUNG PEOPLE
WHO MAYBE THEY HAVEN'T MADE THAT
CORRELATION. ANYTHING WE CAN DO.
IF IT SAVES ONE LIFE.
IF IT IT RAISES A QUESTION FROM
ONE PATIENT.
IT SEEMS WELL WORTH THE EFFORT
SO WILL BE SUPPORTING THE BILL
TODAY I THINK YOU FOR BRINGING
IT FORWARD.
SENATE PAN.
THANK YOU. VERY MUCH AND I
APPRECIATE.
SURVEYED SAY PRESENTING THE
BILL HERE I HAD A CHANCE TO HEAR
BNP ADVOCATES WHO QUESTION FOR
THAT CALIFORNIA MEDICAL
ASSOCIATION CAN YOU ELABORATE ON
I MEAN.
JOBS ARE BATES TAKEN AMENDMENT
HERE WHAT'S THE REMAINING ISSUE.
BUT CERTAIN.
AND SENATE WENT SO THE REMAINING
AS LANGUAGE IN THE BILL THE
WHILE IT DOES TAKE OUT THE
CONSENT FORM THAT REQUIRES THE
SIGNED CONSENT. I'M IT DOES
STILL SPECIFIED THE DISCUSSION
THAT NEEDS TO BE HAD.
BY THE POSITION WITH THE MINERS
THE MINOR AND THEIR PARENT OR
GUARDIAN. I'M I'M PRESIDENT WE
OF THE FEW WISHES ABOUT SPECIFIC
TO THE PEDIATRICIANS AND.
THEY'VE EXPRESSED.
THAT THIS IS ALREADY HAPPENING
AND THAT THERE IS IT YOU KNOW
AND FOR ALL POSITIONS AS I THINK
YOU'D UNDERSTAND. ANY OF THE
CONSENT THERE ANY INFORMED
CONSENT THAT IS OBTAINED.
THE DISCUSSION HAD WITH THE
PHYSICIAN IS SPECIFIC TO THAT
PATIENT.
AND SO BY DICTATING WHAT NEEDS
TO BE IN THE LANGUAGE IT TAKES
AWAY AT.
YOU KNOW IT MAKES A KIND OF OF A
FOREIGN LANGUAGES DOES NOT.
SPECIFY WHETHER IT'S APPLICABLE
TO THAT PATIENT OR NOT.
AND THE ISSUE THAT WE HAVE WITH
HAVE.
PUTTING OUT THE THIRD TYING THAT
WITH UNPROFESSIONAL CONDUCT IS
THAT.
NOW WITHOUT THE I MEAN WITHOUT
THE CONSENT FORM THEY'RE STILL.
THERE'S A REQUIREMENT THAT THEY
HAVE THIS DISCUSSION AND THEN IF
THEY DON'T.
IT COULD BE ACTIONABLE AS
UNPROFESSIONAL CONDUCT.
AND AT THAT POINT IF THERE'S A
COMPLAINT MADE BY A PATIENT IT
BECOMES THE PHYSICIANS WORD
AGAINST THE PATIENTS WORD AS TO
WHETHER THEY HAD THIS DISCUSSION
WHETHER THEY COVERED EVERY
SINGLE POINT.
MAYBE THE POSITION HAD THAT
DISCUSSION BUT DIDN'T DISCUSS
THINGS THAT WERE RELEVANT BUT
THAT COULD STILL BE ACTIONABLE
AND SO. WE JUST WANT TO MAKE
SURE THAT THE POSITION CAN GIVE
OF THE POINTS THAT ARE RELEVANT
TO THE PATIENT AND THEIR UNIQUE
SITUATION. AND NOT.
HAVE FEAR THAT THEY'RE GONNA BE
LIABLE FOR NOT TOUCHING ON
THINGS THAT. THAT MAY NOT MATTER
AT THAT POINT.
NO I HAVE APPRECIATE THAT
CERTAINLY.
HAVING YOU KNOW BEING A
PRACTICING PEDIATRICIAN I
UNDERSTAND THAT DOWN SOME OF THE
CHALLENGES THAT AMEX IN THE SAME
ROOM AND.
AND CERTAINLY.
KNOWS THAT.
KNOWING MY COLLEAGUES IN WHAT
WE DO SO ONLY WE DO GO OVER.
SO MEDICATION.
THAT WE
SCRIBE.
PERHAPS CENTER BATES.
.
PERHAPS DIED.
AND APPRECIATE THE WORK THAT
YOU'VE DONE ON THE BILL SO FAR
IS THAT SOMETHING WE. THINK THAT
WE CAN TRY TO CLOSE THE GAP ON I
MEAN I THINK THAT IF THERE'S A
REASON WE ARE LICENSED YOU KNOW
WE'RE BEING ENTRUSTED WITH THE
GIVEN OUR TRAIN KNOWLEDGE TO BE
ABLE TO.
TO EDUCATE NOW ABOUT UP TO ITS
BUT MANY OTHER MEDICATIONS MANY
OF WHICH ARE ACTUALLY DANGEROUS
AS WELL IN THEIR OWN WAY.
AND.
AND AND AND PERHAPS NOT TRY THE
SPECIFIED. SO EXACTLY ABOUT WHAT
HE'S ALWAYS BECOME THE CHECKLIST
WHAT HAPPENS IS THAT BECOME THE
CHECKLISTS AND AND PATIENCE Y.
CHECKLIST DISCUSSION THEY WANT A
DISCUSSION OF.
WHAT'S GOING ON WITH THEIR
CIRCUMSTANCES SITUATION
AL.
AND FRANKLY THEY STOP LISTENING
MIND YOU HAVE TO GO THROUGH A
CHECKLIST SECTION ONE THE
CHALLENGE AHEAD WITH SOME YET
MARS WHERE THEY HAVE A
CHECKLIST.
THIRD YOU'RE TAKEN DOWN THE LINE
AND YOU SEE THE PATIENT'S EYES
ARE TO PARENTS EYES GLAZING OVER
A DO YOU THINK THAT'S SOMETHING
WE CAN TRY TO THE RESULTS WILL
CERTAINLY AUTUMN. WITHOUT. YOU
KNOW. DEBATING HERE TOO LONG NO
AND TIME IS OF ABSENCE I WOULD
YOU SHARE MY PERSONAL
EXPERIENCE.
IN THE LAST YEAR WITH THE A
COUPLE SERIOUS ISSUES THAT I HAD
I WAS.
BASICALLY ISSUED FROM I'M WE'RE
TALKING ALL PROVIDERS HERE.
WITH OPIOIDS WHICH ARE VERY YOU
KNOW REACTIVE ON ME ARE ONLY
BECAUSE I HAD BEEN HEARING BEEN
STUDYING THIS ISSUE DID I KNOW
THAT NORCAL FOR EXAMPLE WAS AN
OPIOID IN IT WAS CHRIS GIVEN TO
ME IN THE HOSPITAL. WITH NO
DISCUSSION AND I JUST ASKED WHAT
IT WAS WHEN I KNEW THAT HE WAS
LEAST WITH FENTANYL ON THE
STREET SO I THOUGHT I DON'T
WANT-THAT BUT NOBODY TALKED TO
ME
ABOUT I HAD ASKED THE QUESTION.
SO SOME PEOPLE I THINK THIS IS A
FUN THING THAT'S GOING TO REMIND
THE PROFESSIONALS AND MOST
PROFESSIONALS WOULD PROLLY
TALKING WHAT. PERCENT ARE DOING
THAT BUT WHAT HAPPENS IN THE
HEALTHCARE. ARENA AS YOU WELL
KNOW TIME IS SO INCREDIBLY
PRESSURED SO I THINK GOING
FORWARD WE NEED TO HAVE THE
DISCUSSION REPUBLICAN WORK ON
SOMETHING THAT. YOU KNOW WORKS
FOR EVERYBODY IN ANYTHING HILL
IT ACTUALLY WHEN WE HAD THIS
DISCUSSION AND.
AND BP IS WELL I THINK SOME THE
CHALLENGES OF LOOKING AT WAYS
AND IT'S INTERESTING BECAUSE AS
YOU'RE SHARING YOUR PERSONAL
STORY ABOUT IT HAPPEN THE HIGH
SMALL WHERE SHE PEERED OUT A LOT
NEXT EVEN THE WITNESSES RIGHT I
GOT INJURY I WAS IN HIGH.
SPITTLE AND BUT YOU KNOW THE ONE
THE THINGS THAT WE'VE BEEN
TRYING TO DRESS AS WELL BECAUSE
ORDERS. RIGHT SO.
INTERESTING ENOUGH WHEN.
BECAUSE YOU HAVE A PROVISION
THE BILL RELATED TO THIS MAN
DELTA TO TO MODIFYING THE
MANDATORY UP PAIN TREATMENT AND
I WAS IMPACTS IN CALIFORNIA WHEN
THAT WAS PASSED.
AND AT THAT TIME.
THE REASON WE THAT WE TOLD
DOCTORS THEY HAD TO TAKE YOU
KNOW A A A COREY ALSO MAKE
CREDITS IN PAIN MANAGEMENT
BECAUSE THEY'RE TELLING US THAT
WE DIDN'T PRESCRIBE HOPEFULLY TO
NOT.
YEAH WE WERE TOLD WE WERE NOT
TREATING PAIN AND US AND WE NEED
TO PRESCRIBE THESE MEDICATIONS
MORE. AND SO BY LAW WE REQUIRE
DOCTORS THE TEN COURSES WE'RE
TOLD WE WEREN'T DOING ENOUGH.
AND I THINK WE REALIZE THE
CONSEQUENCES OF THAT.
WE.
AND YOU KNOW WE NEED TO CHANGE
SO I THAT'S ALWAYS THE
CAUTIONARY TALE ABOUT. TELLING
DOCTORS YOU KNOW WE'RE GONNA WE
THINK TO PROFESSIONAL JUDGMENTS
GOOD ENOUGH AND.
PUSH YOU TO DO SOMETHING THAT
YOU MAY NOT WANT TO DO.
THAT ARE ARE LESS COMFORTABLE
IN DOING I THINK WE IS IT ME
CAUTIOUS ABOUT THAT.
I APPRECIATE THAT YOU KNOW ME
WORKING ON.
TO TRY TO GET AT THAT ESPECIALLY
AND I THINK.
SOCIAL SETTINGS IT'S WILL DEPEND
THE OFFICE SETTING WHEN YOU KNOW
YOU HAVE SINGLE DOCTORS ETCETERA
AND WE'RE DISGRACEFULLY RHODEN
ORDER AND NOW THE NURSES
FOLLOWING THE ORDER IN THE
HOSPITAL AND THEY JUST PASSED
OUT THERE NOT MAYBE. YOUNG.
SITTING DOWN AND HAVING A
CONVERSATION AND THEY HAVE
AROUND THE GETS A THE AND YES
TALK TO THE PATIENT OR THE
FAMILY MEMBER SO MAYBE WE CAN
TRY TO WORK ON THAT.
BUT I APPRECIATE THE STEPS YOU
TAKE AND I KNOW IT STATE OFTEN
BNP I'M GONNA VOTE FOR HERE
TODAY BECAUSE I KNOW THAT YOU
AND WORKING ON AND THAT'S THAT
MADE IT BUT I DO. HOPE THAT I DO
EXPECT THAT THE CONVERSATIONAL
CONTINUE I KNOW THAT YOU WILL.
AND THAT YOU HAVE BEEN TAKING
ACCOUNT OF THESE ACTUAL REAL
LIFE PRACTICE SITUATIONS IN
TERMS OF MAKING THIS WORKABLE
BECAUSE I. I I I KNOW THAT YOU
WE WANT TRIED TO ACHIEVE THE
GOAL THAT YOU SET OUT FOR THIS
BILL.
THANK YOU DOCTOR PAN APPRECIATE
THOSE COMMENTS AND WE WILL TAKE
YOU KNOW VERY SERIOUS LOOK ABOUT
BECAUSE. I DO FEEL VERY STRONGLY
THAT WE SHOULDN'T BE INTERFERING
WITH PROFESSIONALS AND THEIR
PROFESSIONAL JUDGMENT WITH EVERY
PROFESSION BUT THIS IS SOMETHING
THAT WE ON THOSE KIND OF. GONE
REAL SIDEWAYS ON BOTH SIDES OF
THE ISSUE POWERFUL WE NEED TO DO
SOMETHING.
FACING THE OTHER COMMON A
QUESTION WE HAVE A MOTION BY
CENTER MINING CHEERS RECALL.
SUPPORTING THE BILL
RECOMMENDING AND I WOULD SAY
REMEMBER SEVEN WHICH LIKE TO
CLOSE SENATOR.
I JUST RESPECTFULLY ASK FOR YOUR
AYE VOTE AND NOW I APPRECIATE
THE COMMENTS AND OUT COMMITMENT
FROM WHAT CERTAINLY ME AND MY
STAFF THAT WILL CONTINUE WORKING
ON. ALL THE ISSUES THAT WE'VE
BEEN RAISED A LOT.
WE'RE IN SP ONE ONE ZERO NINE
TWO PASSES MINUTES
APPROPRIATIONS CALL THE MEMBERS
PLEASE HERNANDEZ AYE HERNANDEZ
AYE WHEN.
LEYVA. LEYVA AYE MITCHELL AYE
MITCHELL AYE MONNING AYE MONNING
AYE NEWMAN.
NEWMAN AYE NIELSEN. NIELSEN AYE
PAN.
AND I ROTH.
APRILIA SEVEN THAT'S ENOUGH TO
GET OUT WE'RE GONNA FIX A BILL
AND CALL WE HAVE ABSENT MEMBERS.
WE MOVE ON TO SENATOR WIENER.
JEFF PULVER.
SORRY GIVE IT HIT SHIP IN THE
BILL VERY.
ITEM NUMBER FIFTEEN SP ONE TWO
NINE ZERO BEAT SUBSTANCE ABUSE
TO SORT OF TREATMENT.
THANK YOU ARE.
GERMAN HERNANDEZ AND MEMBERS I'D
LIKE TO BEGIN BY ACCEPTING THE
COMMITTEE AMENDMENTS AND THANK
AGAIN BUT STAFF FOR WORKING OUT
WITH US ON OUR ACHIEVING OUT. BY
S. B. AS AMENDED S. B. TWELVE
NINETY PROHIBITS ANY LICENSEE
OPERATOR MANAGER. CONSULTANT
EMPLOYEE OR PATIENT OF
ALCOHOLISM CLOUT ALCOHOLISM OR
DRUG ABUSE RECOVERY OR TREATMENT
FACILITY FROM OFFERING PAYING
SOLICITING OR RECEIVING A KICK
BACK. TO INDUCE THE REFERRAL OF
A PATIENT TO ARE FROM A
FACILITY.
IN ADDITION THE BILL CREATES THE
COMMISSION ON SUBSTANCE ABUSE
AND RECOVERY TO EFFECTIVELY
CONFRONT THE STATEWIDE ADDICTION
AND SUBSTANCE ABUSE CRISIS WITH
APPROPRIATE CARE AND
CONSIDERATION OF A LOCAL OF
FACTS. RESIDENTIAL TREATMENT
FACILITIES PROVIDE A SAFE
ENVIRONMENT FOR ADULTS
RECOVERING FROM DRUG OR ALCOHOL
ADDICTION AS THE OPIOID CRISIS
HAS BECOME CRITICAL. ADDICTION
HAVE SOARED AND DISHONEST
REHABILITATION OPERATORS HAVE
RUSHED IN TO TAKE ADVANTAGE OF
MANDATORY MENTAL HEALTH
TREATMENT COVERAGE.
ACCORDING TO AGAIN THE
COMPREHENSIVE INVESTIGATION BY
THE SOUTHERN CALIFORNIA NEWS
GROUP. THE STATE'S HANDS OFF
APPROACH TO REGULATING THE
INDUSTRY MAKES IT EASY FOR. BAD
OUT OPERATORS TO TAKE ADVANTAGE
OF THESE VERY VULNERABLE
INDIVIDUALS.
PATIENTS BROKERING HAS RUN
RAMPANT WITH THESE PATIENT
BROKERS BRINGING INDIVIDUALS
SUFFERING FROM ADDICTION IN FROM
OTHER STATES ENTICING THEM WITH
FREE TREATMENT. TRAVEL OR GIVE
CARDS AMONG OTHER BENEFITS ANTI
KICKBACK STATUTE'S LIKE THE
PATIENT BROKERING ACT ARE
DESIGNED TO PREVENT NUMBER ONE
INSURANCE FRAUD IN NUMBER TWO
ABUSIVE PRACTICES RESULTING.
FROM PROVIDER DECISIONS THAT ARE
BASED ON SELF INTEREST RATHER
THAN COST
QUALITY OF CARE OR NECESSITY OF
SERVICES. THE GOAL OF S. B.
TWELVE NINETY IS TO PREVENT
INDIVIDUALS WITH ADDICTION FROM
BEING TREATED AS INCOME
PRODUCING COMMODITIES. AND
REINFORCE THOSE ARRANGEMENTS AND
REFERRAL RELATIONSHIPS THAT HERE
TOO BEST PRACTICE STANDARDS I
HAVE WITH ME TODAY. KELSEY
BREWER FROM THE ASSOCIATION OF
CALIFORNIA CITIES ORANGE COUNTY
TO TESTIFY ALSO HERE TO TESTIFY
TO THE TECHNICAL ASPECTS OF THE
ACT IS CHIEF ASSISTANT STATE
ATTORNEY. AL JOHNSON FROM THE
GREAT STATE OF FLORIDA. FLORIDA
ENACTED THIS VERY SAME STATUTE
TO ADDRESS PATIENT BROKERING AND
THEY HAVE HAD TREMENDOUS REMOVED
SO SLOW TURN IT OVER TO MY.
WITNESSES WITH YOUR APPROVAL BY
CHAIRMAN CURRENT FERNANDO SEND
THEM YOU MAY CLOSE YOUR THINK
YOU HAVE SENATOR WE DO HAVE
SUPPORT ON BOTH SIDES PLEASE
PROCEEDS TEACHING.
WELL SUPER. CHAIR HERNANDEZ AN
ESTEEMED MEMBERS OF THE SENATE
HEALTH COMMITTEE IT'S MY
PLEASURE TODAY TO LAND THE VOICE
OF THE ASSOCIATION OF CALIFORNIA
CITIES ORANGE COUNTY. AND BY
EXTENSION THE THREE POINT TWO
MILLION RESIDENTS OF ORANGE
COUNTY IN SUPPORT OF SB TWELVE
NINETY AUTHORED BY SENATOR
PATRICIA BATES.
S. BE TWELVE NINETY ACKNOWLEDGES
A PROBLEM THAT WE HAVE KNOWN
EXISTS NOT ONLY IN ORANGE COUNTY
BUT ACROSS THE STATE OF
CALIFORNIA. IN THE ENTIRE
COUNTRY IN VIRTUALLY EVERY
CORNER OF THE HEALTH CARE
INDUSTRY. THE PRACTICE OF
PATIENT BROKE GREEN IS ILLEGAL.
THE EXCEPTION GLARINGLY IS THE
ADDICTION RECOVERY BUSINESS.
IN ORANGE COUNTY THE RESIDENTIAL
RECOVERY INDUSTRY IS FULL OF
EXAMPLES OF FINANCIAL ABUSE AND
EXPLOITATION. AND TWO THOUSAND
SEVEN TEAM THE ORANGE COUNTY
REGISTER RELEASED A FOUR PART
SERIES ON RESIDENTIAL RECOVERY
FACILITIES.
BUT SERIES HIGHLIGHTED HOW AN
ORANGE COUNTY IN SOUTHERN
CALIFORNIA THERE ARE RE HAB
RELATED TRADES THAT INVOLVED
RECRUITING VULNERABLE ADDICTS
AND THEIR FAMILIES AND
CONNECTING THEM TO THE
RESIDENTIAL RECOVERY FACILITIES.
THIS IS PATIENT PROGRAM BUT IT
IS OFTEN REFERRED TO AS JUNKIE
HUNTING OR BODY BROKERING.
AND SOUTHERN CALIFORNIA THERE'S
EVIDENCE OF BROKERS TARGETING
ALCOHOL ANONYMOUS MEETINGS
HOMELESSNESS ENCAMPMENTS AND
DRUG COURTS TO FIND PEOPLE THAT
THEY CAN SEND TO REHAB.
IN RETURN THEY RECEIVED
KICKBACKS FROM THE CENTERS AS IF
THIS KICK BACK MODEL COULD NOT
GET WORSE OFTEN WHEN BROKERS
FIND A CANDIDATE FOR RESIDENTIAL
RECOVERY REFORM. THEY CALL
SEVERAL REHAB CENTERS AND SEEK
COMPETITIVE BIDS.
HIGHEST BIDDER GETS THE BUSINESS
NEWMAN AUCTIONING AND TWENTY
EIGHTEEN.
WE HAVE EVIDENCE OF INDIVIDUALS
BEING FUN AND ORANGE COUNTY FROM
WISCONSIN ARIZONA FLORIDA AND A
MULTITUDE OF OTHER PARTS OF THE
COUNTRY ALL WITH THE PROMISE OF
GETTING THE NECESSARY HELP THAT
THEY NEED TO FIGHT THEIR
ADDICTION.
TOO OFTEN THE SYSTEM HAS SET UP
IS SET UP TO FAIL THEM AND THEY
ARE SUBJECTED TO ADDITIONAL
STANDS A PATIENT PROGRAM PROMISE
EVERYTHING UNDER THE SUN EXCEPT
SOBRIETY.
SP TWELVE NINETY IS A NECESSARY
PIECE OF LEGISLATION THAT WILL
HELP STOP THE EXPLOITATION OF
THOSE LIVING WITH ADDICTION AND
THEIR FAMILIES.
BY SPECIFICALLY PROHIBITING THE
SPLIT FREE REIN SPLIT FEE
ARRANGEMENTS THAT WE SEE IN MANY
OF THESE FACILITIES S. B. TWELVE
NINETY ONE POWER THE DEPARTMENT
OF HEALTH CARE SERVICES. GINGER
ABOUT THESE PROVIDERS ARE
FOCUSED ON PEOPLE AND RECOVERY
NOT PROFIT AND RELAPSE ON BEHALF
OF OUR MEMBERS WE RESPECTFULLY
REQUEST AN AYE VOTE. ON SB
TWELVE NINETY THANK YOU.
THANK YOU ANYONE ELSE IN SUPPORT
PLEASE PUT.
YES LAWS THAT YOU MISTER CHAIR
MEMBERS.
MY NAME IS ALAN JOHNSON I AM A
CHIEF ASSISTANT STATE ATTORNEY.
IN PALM BEACH COUNTY OF FLORIDA
HOME WORK FOR STATE ATTORNEY
DAVE EHRENBERG.
PALM.
WE IN FLORIDA AS YOU ARE IN
CALIFORNIA OUR DESTINATIONS.
DESTINATION FOR VACATIONERS
DESTINATION FOR HEALTH CARE. OF
MY COUNTY AS WELL AS YOUR COUNTY
OR THE.
YOUR COUNTY OF ORANGE COUNTY IS
SOUGHT IS AN EPICENTER OF THIS
CRISIS BUT MAKE NO MISTAKE.
IT THE IT TRANSCENDS IS ONE
COUNTY ONE AREA THE STATE.
ALL YOUR STATE MY STATE ALL THIS
IS THE OF THE HEALTH CRISIS OF
OUR TIME.
I VERY BRIEFLY OF. TWO YEARS AGO
THE FLORIDA LEGISLATURE. AUTUMN.
ISSUED A PROVISO AND.
AND ESTABLISHED A TASK FORCE IN
PALM BEACH COUNTY. THAT WAS TO
STUDY THE ISSUE BUT NOT ONLY
STUDY THE ISSUE BUT ALSO.
THE CRIMINAL SIDE OF THE TASK
FORCE WAS TO OUR.
WAS TO.
ROBUSTLY LOOK INTO THE ABUSES.
IN THE INDUSTRY ARE IN THE LAST
EIGHTEEN MONTHS PALM BEACH
COUNTY WE'VE HAD FORTY SEVEN
ARRESTS.
I AND SIXTEEN CONVICTIONS FOR A
PATIENT BROKERING IS THE.
IS THE MAIN.
BUT IS ALSO WHERE PENSION
PROGRAM USES HIS ALSO INSURANCE
FRAUD. AND.
AND.
OTHER.
DRUG TRAFFICKING AS WELL.
OP I'M HERE IN SUPPORT OF WE'VE
GONE THROUGH THIS IN FLORIDA.
ARM HERE READY AND ABLE TO
ANSWER ANY QUESTIONS YOU MAY
HAVE.
THIS IS ONE STEP THE OTHER
OTHER OUR RECOMMENDATIONS OF THE
TASK FORCE INCLUDED. OF A TRUTH
IN MARKETING. BILL AS WELL AS A
BILL TO ENCOURAGE.
AUG THE CERTIFICATION OF SOBER
HOMES
SO THAT THERE WERE STANDARDS TO
PROTECT THE RESIDENTS WITHIN THE
SOBRE HOMES.
OF NOT GOING TO GET INTO THE.
INTO THE WEEDS ON THIS BUT
WHERE YOU HAVE SOBRE HOMES WITH
NO OVERSIGHT YOU'RE GONNA HAVE
FLOP HOUSES THAT CALL THEMSELVES
OVER HOMES.
OF.
DR YOU SEEM THE NUMBERS OF SICK
AND CALIFORNIA YOU THEY'RE GOING
TO BE AYE POPPING IN TWO
THOUSAND SEVENTEEN I GUARANTEE
COSTS ARE GOING UP.
I IN PALM BEACH COUNTY ALONE. IN
TWO THOUSAND SIXTEEN FIVE
HUNDRED AND EIGHTY NINE. DEATHS
DUE TO OPIOID OVERDOSE.
BUT MANY OF THEM ARE YOUNG OH
FIVE EIGHTEEN TO TWENTY SIX YEAR
OLDS IMPORTED INTO PRIVATE
TREATMENT FROM UP NORTH SO. WITH
THAT.
.
YEAH I'M HERE IN SUPPORT AND
I'LL ANSWER ANY QUESTIONS THAT
YOU MAY HAVE IS WE HAVE THE VERY
SAME BILL IN FLORIDA. THANK YOU.
ANYONE ELSE SUPPORT FEATURE
NAME VISION TOM RENT FREE WITH
THE CALIFORNIA BEHAVIORAL HEALTH
DIRECTORS IN SUPPORT. THANK YOU.
BUT BOILS ON BEHALF THE
CALIFORNIA CONSORTIUM ON
ADDICTION. PRETZELS AND PROGRAMS
IN SUPPORT THANK YOU IS THEIR
OPPOSITION TO THE MEASURE.
WE HAVE ANY QUESTIONS OR
COMMENTS FOR MANY OF THE MEMBERS
SEEN NONE.
CHAIR IS GOING TO BE SUPPORTING
THE BILL WOULD YOU LIKE TO
CLOSE.
SENATOR.
THANK YOU AGAIN FOR YOUR HELP ON
THEIR SIDE CHAIRMAN FERNANDO SAN
ANDREAS RELIABLE.
WE WERE MOTION. MOVED BY CENTER
PAN WORD.
ITEM NUMBER FIFTEEN SP ONE TWO
NINE ZERO TO PASS THE MINUTE
APPROPRIATIONS CALL THE MEMBERS
PLEASE.
HERNANDEZ AYE HERNANDEZ AYE
NGUYEN.
LEYVA.
MITCHELL.
MONNING.
NEWMAN. NEWMAN AYE NIELSEN.
PAN. AND I ROTH.
THE CURLIEST THREE THERE'S
ABSENT MEMBERS WILL PLACE A BILL
AND CALL AGAIN THANK YOU. NOW WE
WILL DO SENATOR WIENER
.
GOOD AFTERNOON SENATOR WIENER.
THANK YOU.
MISTER CHAIRMAN AND I THINK YOU
ARE.
FOR WORKING WITH US ON THE BILL.
AND THE I'M HAPPY TO TAKE.
TO ACCEPT THE COMMITTEES.
PROPOSED AMENDMENTS.
BUT COLLEAGUES S. B. TEN TWENTY
ONE. EXTENDS DOT AND EXPANDS
UPON THE CRITICAL.
CONSUMER PROTECTION PROVISIONS.
OF AB THREE THIRTY NINE OF A
BILL AUTHORED BY.
THEN ASSEMBLY MEMBER RICH CORD
AND.
THAT WAS SIGNED INTO LAW.
IN TWENTY THIRTEEN.
BY THE BILL.
BEFORE US BEFORE YOU TODAY
MAINTAINS OF A TWO HUNDRED AND
FIFTY DOLLAR COPAY CAP FOR A
MONTH'S SUPPLY OF A SINGLE
PRESCRIPTION DRUG.
S. PRETEND TWENTY ONE AYE
RETAINS.
STANDARDS GOVERNING A WHICH
DRUGS CAN BE PLACED ON WHICH TO
HEAR.
EVIDENCE OF HEALTH PLANS
FORMULARY AND GUARANTEES THAT
ALL OF THE DRUGS UPPERS SINGLE
CONDITION.
INCLUDING FOR EXAMPLE HIV AND
MASS OR ANY OTHER NUMBER OF
CONDITIONS CANNOT BE PLACED ON
THE HGHEST BOTH EXPENSIVE TIER
OF A FORMULARY. UP FINALLY THE
BILL MAKES SEVERAL TAR TARGETED
IMPROVEMENTS TO AB THREE THIRTY
NINE INCLUDING ADDITION OF
PREVENTIVE TREATMENTS TO THE
DEFINITIONS OF AIDS DRUG
COCKTAIL. A CODIFYING IN AN
EXISTING DEPARTMENT OF MATTERS
HEALTH CARE REGULATION. SPECOPS
DRUGS TO PAY AT ITS RETAIL PRICE
AND LIMITING INSURANCE
FORMULARIES TO ONLY FOR TEARS.
THE RECENT OCTOBER ANALYSIS BY
SHOW THE PASSAGE OF TIME AS
PRETEND TWENTY ONE WILL HAVE
LITTLE TO NO IMPACT ON INSURANCE
PREMIUMS. UP BUT WILL ENSURE
THAT CONSUMERS LIVES ARE NOT PUT
AT RISK
I'D BUY HOPE BY HIGH DRUG COPAYS
TOM WHICH HAPPENED. IN THE
RECENT PAST.
I THIS ISSUE FIRST CAME TO MY
ATTENTION WHEN I WAS A MEMBER OF
THE SAN FRANCISCO BOARD OF
SUPERVISORS. ARE BACK IN DA
TWENTY TWO OVER TWENTY THIRTEEN.
BY ONE COVER CALIFORNIA WAS
COMING INTO A FACT AND I STARTED
THE OF CALLS AND EMAILS FROM
CONSTITUENTS DOT REPRESENTING A
LARGE POPULATION OF. HIV A
POSITIVE PEOPLE ANSWERING
CONTACTED BY CONSTITUENTS
SAYING I JUST SHOWED UP AT THE
PHARMACY TODAY.
AND IT TOLD ME I HAD TO PAY A
THOUSAND DOLLARS FOR MY COPAY OF
THIS MONTH AND I'M GOING TO DIE
AND I DON'T KNOW WHAT TO DO.
SO.
IS AN ISSUE THAT IS VERY.
PERSONAL TO ME AND TO MANY
PEOPLE I REPRESENTS.
I'M IT'S OF COURSE NOT JUST
ABOUT.
PEOPLE LIVING WITH HIV.
IMPLIES TOO MANY HEALTH
CONDITIONS ARE PEOPLE WHO.
SURVIVES AND ARE ABLE TO
CONTINUE TO LIVE ON BECAUSE OF
THEIR ACCESS OUGHT TO.
PHARMACEUTICALS I DON'T WANT
THEM TO CONTINUE TO HAVE THAT
ACCESS.
AND WE NEED TO MAKE SURE.
THAT HE'S COPAYS ARE NOT
EXCESSIVE THAT'S WHAT THIS BILL
DOES SO COLLEAGUES I
RESPECTFULLY ASK YOUR AYE VOTE.
WITH ME TO TESTIFY IN SUPPORT
OF THE BILL ARE MERE IN VALDEZ
OF HEALTH ACCESS.
AS WELL AS CRITICAL SUFFER FROM
A P. LA A HEALTH AND US BUT
COMPELLED OFFER HEALTHAXIS IS
ALSO WITH US THANK YOU. THANK
YOU ARE WELCOME IN PROCEED.
GOOD AFTERNOON MISTER CHAIRMAN
MEMBERS MARY VALDEZ WITH HEALTH
ACCESS CALIFORNIA WE ARE PROUD
CO SPONSOR SPONSORS OF A THREE
TEN TWENTY ONE BY SENATOR
WIENER.
AND THIS BILL CONTINUES OUR
EFFORTS TO PROTECT CONSUMERS
FROM THE RIGHT.
A PRESCRIPTION DRUGS AT THE TIME
FOR ANYONE WILL ENSURE THAT
CONSUMERS ARE ABLE TO AFFORD
LIFESAVING PRETTY.
DRUGS AND ARE NOT CAUGHT IN THE
MIDDLE BETWEEN PHARMACEUTICAL
COMPANIES AND HEALTH PLANS AND
FORCED TO PAY THOUSANDS OF
DOLLARS FOR THE COST OF A SINGLE
PRESCRIPTION DRUG. BEFORE.
AS SENATOR WIENER MENTIONED.
I AB THREE THREE NINE AUTHORED
BY SENATOR GORDON BEFORE THOSE
CONSUMER PROTECTIONS WERE PUT IN
PLACE CALIFORNIANS WITH SERIOUS
CHRONIC CONDITIONS LIKE HIV AIDS
MULTIPLE SCLEROSIS AND LUPUS
WERE PARTICULARLY VULNERABLE. TO
HIGHER OUT OF POCKET COSTS
BECAUSE HEIKANT SPECIALTY DRUGS
WERE OFTEN PLACE ON THE HIGHEST
TIER OF A DRUG FORMULARY WITH NO
CAP ON THE COPAY. OR THE
COINSURANCE MEDICINES FOR THESE
TYPES OF CHRONIC CONDITIONS
OFTEN HAVE NO LOW COST
ALTERNATIVES TO THEIR MEDICATION
SO THESE CONSUMERS MUST RELY ON
HIGH COST SPECIALTY DRUGS FOR
WHICH THERE'S NO THERAPEUTIC
EQUIVALENT.
WITHOUT THESE PROTECTIONS
INSURERS AND HEALTH PLANS SHIFT
DRUG COSTS TO CONSUMERS BY
PLACING HIGH BECAUSE BETSY DRUGS
ON THESE HIGHER TIERS OF DRUG
FORMULARIES. AND IN AN EXAMPLE I
CAN GIVE TO YOU IS.
A PERSON LIVING WITH MULTIPLE
SCLEROSIS OR LOU.
COULD REACH THEIR OUT OF POCKET
LIMIT OF AS MUCH AS SEVEN
THOUSAND THREE HUNDRED AND FIFTY
DOLLARS WITH A SINGLE
PRESCRIPTION.
AND THIS MEANS THAT A PERSON
LIVING WITH THAT CONDITION WOULD
HAVE TO COME UP WITH SEVEN
THOUSAND DOLLARS IN JANUARY.
BEFORE THEIR HEALTH INSURANCE
WOULD KICK IN AND COVER THE REST
OF THE COST OF THEIR CARE AND
AGAIN THIS IS JUST FOR ONE. BY
PRESCRIPTION.
A PERSON LIVING WITH LIFE
THREATENING CHRONIC CONDITIONS
CANNOT SHOULDER THE FULL COST OF
THE PRESCRIPTION DRUG COST
SHARING PROTECTIONS ESPECIALLY
FOR HIGH BECAUSE THAT'S WHAT HE
DRUGS.
HELP ENSURE THAT CONSUMERS CAN
AFFORD THEIR PRESCRIPTION.
AND GET THE CARE THEY NEED AND
UNFORTUNATELY WITHOUT THIS BILL
THE PROVISIONS IN EXISTING LAW
THAT LIMIT THE COPAY TO TWO
FIFTY AND SET STANDARDS FOR
FORMULARY TEARS EXPIRE AT THE
END OF TWENTY NINETEEN. WE ASK
THAT YOU SUPPORT TEN TWENTY ONE
TO HELP ENSURE THAT ALL
CALIFORNIANS ARE ABLE TO AFFORD
AND HAVE ACCESS TO LIFE SAVING
PRESCRIPTIONS.
GOOD AFTERNOON CREEK PULSE FOR
FROM A KILL A HEALTH THING CO
CHAIR OF THE CALIFORNIA HIV
ALLIANCE HERE TODAY AND STRONG
SUPPORTER OF SP TEN TWENTY ONE.
WHICH AMONG OTHER PROVISIONS
WILL HELP ENSURE THAT PEOPLE AT
RISK FOR HIV HAVE ACCESS TO
SINGLE TABLET REGIMENS FOR
PREVENTION. INCLUDING PRE
EXPOSURE PROPHYLAXIS OR PROP.
AS YOU KNOW PREPOSITIONAL
EFFECTIVE HIV PREVENTION
MEDICATION THE KEY COMPONENT OF
CALIFORNIANS EFFORTS TO AN HIV
EPIDEMIC.
IT'S UP TO NINETY NINE PERCENT
EFFECTIVE WHEN TAKEN AS
PRESCRIBED ANTI MEDICATION
ADHERENCE ABSOLUTELY ESSENTIAL
FOR TO BE EFFECTIVE.
DECADES OF EXPERIENCE WITH HIV
TREATMENT HAVE TAUGHT US THAT
SINGLE TABLET REGIMENS ARE MOST
LIKELY TO RESULT IN INCREASED
UPTAKE AND ADHERENCE.
AB THREE THREE NINE AND TWENTY
FIFTEEN HELP TO TRIGGER PEOPLE
LIVING WITH HIV HAVE ACCESS TO
SINGLE TABLET REGIMENS FOR
TREATMENT.
S. B. TWENTY ONE AT TEN TWENTY
ONE WILL EXTEND THE SAME
PROTECTIONS TO PEOPLE AT RISK
FOR HIV. BY REQUIRING HEALTH
PLANS TO COVER SINGLE TABLET
REGIMENS FOR PREVENTION.
SOME HAVE EXPRESSED CONCERN THAT
THIS BILL REQUIRES HEALTH PLANS
TO COVER SINGLE TABLET
RECOMMENDS AT A TIME WHEN LOWER
COST GENERICS MAY BE ENTERING
THE MARKET.
JUST TO BE CLEAR WE FULLY
SUPPORT COME
CHEN HIV ADVOCATES HAVE.
STORY OF WORKING WITH GENERIC
MANUFACTURERS TO ENCOURAGE THE
DEVELOPMENT OF GENERIC DRUGS AND
NOTHING IN THIS BILL PROHIBITS
THE USE OF GENERIC SINGLE TABLET
RECOMMENDS WHEN THEY BECOME
AVAILABLE WHICH AT THE EARLIEST
COULD BE TWENTY TWENTY ONE.
NOW IS NOT A TIME WHEN WE CAN
AFFORD TO PUT UP INCREASE
BARRIERS TO PREP. RECENT DATA
INDICATE THE PROP UP TAKE IN
CALIFORNIA IS LOW ESPECIALLY
AMONG AFRICAN AMERICANS LATINOS
YOU WOMEN. ALL COMMUNITIES ARE
HIGHLY IMPACTED BY HIV WE SHOULD
BE DOING EVERYTHING IN OUR POWER
TO MAKE IT EASIER FOR ALL
POPULATIONS TO ACCESS AND ADHERE
TO PREP.
I URGE THE COMMITTEE TO SUPPORT
THIS BILL AND HELP ENSURE
CONSUMERS HAVE ACCESS TO MATE
MEDICATION THE WILL MAKE IT
EASIER FOR THEM TO REMAIN. HIV
NEGATIVE THANK YOU THANK YOU
PLEASE VISIT BETH BELFER
HEALTHAXIS JUST HERE TO ANSWER
ANY QUESTIONS THANK YOU. THANK
YOU ANYONE ELSE IN SUPPORT. IF
KIM GROSS ABOUT THE CALIFORNIA
PHARMACISTS ASSOCIATION WE DO
NOT HAVE A FORMAL POSITION BUT
WE SUPPORTED THE GORDON BILL AND
WE ALSO SUPPORT THE PROVISIONS
OF THIS BILL DEALING WITH THE.
ISSUE OF ENSURING CONSUMERS KNOW
WHAT THE PRICES FOR THE PRODUCT
ARE GIVEN THE OPPORTUNITY PAY
THE LOWEST PRICE THANK YOU.
CA.GOV IN CHEN FLORIO BEHALF OF
WESTERN CENTER ON LAW AND
POVERTY IN SUPPORT.
BRENT IF THE CALIFORNIA LANCE
RETIRED AMERICANS CALIFORNIA
SHOULD DISABILITY RIGHTS INKING
AND STRONG SUPPORT.
JIM TURNING INWARD AIR P.. WORTH
TRILLIONS FOR THE BILL.
REBEKAH GONZALEZ NATIONAL
ASSOCIATION OF SOCIAL WORKERS
CALIFORNIA CHAPTER IN SUPPORT.
KIMBERLY CHANNEL BEHALF THE
CALIFORNIA PAN ETHNIC HEALTH
ORGANS FOR.
THIRTY SIX AT THE CALIFORNIA
ACADEMY OF FAMILY PHYSICIANS IN
SUPPORT.
AARON FOX LOS ANGELES LGBT
CENTER IN SUPPORT.
BECCA KRAMER MATTER EASILY OF
CALIFORNIANS SUPPORT.
STEVEN SCHULTZ WITH ARTHRITIS
FOUNDATION AND SUPPORT.
KRISTIN LURKING CALIFORNIA
MYTHOLOGY LINES IN SUPPORT.
HELMS CALIFORNIA CHRONIC CARE
COALITION IN SUPPORT.
CHRIS LEN OF ON BEHALF OF THE
CALIFORNIA IMMIGRANT POLICY
CENTER IN SUPPORT.
THE UNDERGONE QUEST WITH SMALL
BUSINESS MAJORITY IN SUPPORT.
HE RESIDENTS SUPPORT RIGHT.
I'M NOT OPPOSITION.
YES NON WELCOME. PLEASE PROCEED
I THINK YOU MISTER CHAIR NICK
LOUISE US WITH THE CALIFORNIA
ASSOCIATION HEALTH PLANS. ON IN
RESPECTFUL OPPOSITION OF S. B.
TEN TWENTY ONE.
ILLICIT AS AMENDED.
BUT BEFORE I DIG INTO SPECIFICS
I DO WANT TO THANK THE AUTHOR
FOR BRINGING US IN EARLY TO
DISCUSS THE BILL.
IN HIS EFFORT TO LEARN MORE
ABOUT OUR CONCERNS THERE'S A
COURTESY THAT IS GREATLY
APPRECIATED.
UNFORTUNATELY WE DO STILL
OPPOSE THE BILL WHILE AT THE
SAME TIME RECOGNIZING THAT THE
AMENDMENTS THAT ARE TAKING
TODAY.
AT LEAST ACKNOWLEDGE OUR ISSUES.
MEMBERS WE OPPOSE PRICE CONTROLS
LIKE COSTS CAPS.
CULTURE CAP CENTER BENEFIT
DESIGNS BECAUSE THEY MASS THE
UNDERLYING PROP PROBLEM. WHICH
IS THE HIGH PRICE OF DRUGS.
HEALTHCARE COSTS YOU CONTINUE TO
RISE IN THAT IS IN LARGE PART
DRIVEN BY ESCALATING
PRESCRIPTION DRUG PRICES.
PRESCRIPTION DRUGS HAD THE
HIGHEST CUMULATIVE SPENDING
GROWTH ACCORDING TO SOME
ESTIMATES OF ANY SERVICE
CATEGORY.
A DURING THE STUDY PERIOD IN A
REPORT BY THE HEALTH CARE COST
INSTITUTE.
IN ADDITION SPENDING ON PER
BRAND NAME PRESCRIPTION DRUGS
INCREASE FROM TWO THOUSAND
TWELVE TO TWO THOUSAND SIXTEEN.
DUE TO CONSIDERABLE PRICE
INCREASES DESPITE DECREASES IN
UTILIZATION OF EVERY CLASS OF
DRUG.
THEREFORE MEMBERS IF THE
PERSON'S OUT OF POCKET COSTS ARE
HIGH IT'S BECAUSE THE PRICE OF
THE DRUG ITSELF IS HIGH IN BILLS
LIKE THIS DO NOT ADDRESS THE
UNDERLYING PROBLEM.
IF THERE'S NO RATIONALITY IN
PRICING IN PRICE INCREASES THERE
WOULDN'T BE A NEED FOR THE
LEGISLATURE TO INTERVENE. IN
BENEFIT DESIGN.
ULTIMATELY WHEN YOU CAP THE
SHERIFF COSTS OF THE DRUG IN
PRICES KEEP GOING UP. THE ONLY
OTHER OUTLET FOR THE PLAN IS TO
INCLUDE THOSE INCREASED COSTS
INTO THE MONTHLY PREMIUM.
FOR THESE REASONS IF A CO PAY
CAP IS TO CONTINUE. WE BELIEVE
THAT THERE SHOULD BE A SHORTER
SUNSET THAN WHAT'S BEING
PROPOSED TO PROPERLY RE EVALUATE
THE PREMIUM IMPLICATIONS.
CAPS
OR SOME SORT OF MECHANISM SHOULD
BE CONSIDERED TO JUST THE CAPS
WHEN THE PRICE OF DRUGS RISE.
AND THE CHU BOURBON ALICE'S ON
THE ORIGINAL BILL THE GORDON
BILL THAT WAS REFERENCE FROM A
NUMBER OF YEARS AGO. ON
ESTIMATED THAT AT THAT TIME THAT
THERE WOULD BE A FOUR HUNDRED
MILLION DOLLAR PREMIUM INCREASE
AS A RESULT OF THAT BILL. BUT
THE CHIPPER BEEN ALICE'S ON S.
B. TEN TWENTY ONE SHOULD HAVE
ESTIMATED WHAT THE PREMIUM
RELIEF WOULD BE. IF HE AB THREE
THREE CAPS REMOVED OR INCREASED.
BUT THAT THAT ANALYSIS IS NOT
BEEN DONE.
FINALLY MEMBERS IF THERE'S AN
EXTENSION OF THESE PRICE
CONTROLS ARE HASEBE
HARMONIZATION FOR ALL DRUGS.
UNDER CURRENT LAW HEALTH PLANS
MUST IMPLEMENT AT A COST YEAR
CAP FOR ORAL CHEMOTHERAPY DRUGS
IT IS DIFFERENT.
ON THAN ALL OTHER OUTPATIENT
PRESCRIPTION DRUGS ON THIS IS
ADMINISTRATIVELY BURDENSOME FOR
PLANS AND WE DON'T BELIEVE IS
WANTED FROM A POLICY
PERSPECTIVE.
ON SO IF THE LEGISLATURE
ADMINISTRATION X. DO EXTEND THE
COST SHARING CAPS FOR DRUGS WE
BELIEVE THAT THE DISTINCTIONS
MADE FOR SPECIFIC DRUGS OR TYPE
SHOULD BE ELIMINATED.
.
I MEAN SHORT MEMBERS ON IF THE
BILL MOVES TODAY THE AMENDMENTS
START TAKING TO PROVIDE A GOOD
SPRINGBOARD FOR FURTHER
DISCUSSION BUT THEY AT THIS TIME
WE'RE ASKING FOR A NO VOTE ON
THE BILL. THANK YOU.
THANK YOU MISTER CHAIRMAN
MEMBERS TERESA STARK ON BEHALF
KAISER PERMANENTE HEY WE ARE
HERE IN OPPOSE LET' AMENDED
POSITION AS WELL AND I WOULD
ALSO LIKE TO THINK THE AUTHOR.
AND HIS STAFF FOR A NUMBER OF
CONVERSATIONS WE HAD WITH THE
PARTICULAR SECTION THAT CAUGHT.
I'VE SIGNIFICANT CONCERN AT
WHICH IS THE ADDITION OF
LANGUAGE TO THE STATUTE THAT
WILL RESTRICT PATIENT CHOICE AND
A PRESCRIBERS ABILITY TO USE A
TWO TABLET VERSION OF PREP.
WHICH IS MUCH CHEAPER THAN THE
BRAND NAME TRUE BADA.
WHICH IS ABOUT SEVENTEEN
HUNDRED DOLLARS A MONTH
I AM IN FACT RITE NOW THERE IS A
GENERIC A PARTIAL GENERIC
ALTERNATIVES TO TRUE FATHER
THAT.
MUCH ABOUT ACTUALLY HAS TO
MEDICATIONS AND HALF OF THE
MEDICATION USED AMERICAN HALF OF
IT IS NOT. SO ACTUALLY TODAY
THERE IS A TO TABLET REGIMENT
THAT'S FIFTY PERCENT GENERIC AND
COULD SAVE ABOUT A THOUSAND
DOLLARS A MONTH BUT UNDER THE
ADDITION OF THIS LANGUAGE. OF
PHYSICIANS WOULD NOT BE ABLE TO
PRESCRIBE THAT OF FOR THEIR
PATIENTS SO THAT LANGUAGE REALLY
INTERFERES WITH PHYSICIAN
DISCRETION TO USE THE MOST
APPROPRIATE REGIMENT IN
CONSULTATION WITH THEIR PATIENT.
BUT MORE IMPORTANTLY IT
INAPPROPRIATELY USES THE STATUTE
TO PROTECT THE TURF OF THE
COSTLY BRAND NAME DRUG THAT WILL
SOON BE OFF PATENT PATENT AND
AVAILABLE IN A TWO TABLETS
GENERIC FORM. AND ACTUALLY
MEMBERS WOULD INCREASE
HEALTHCARE COSTS AND WOULD ALSO
INCREASE OUT OF POCKET COSTS BY
NOT PERMITTING THE USE OF A
GENERIC THAT WOULD LOWER
PATIENTS OUT OF POCKET COSTS.
SO THAT SECTION SHOULD BE
REMOVED FROM THE BILL A IT IS
ENTIRELY UNNECESSARY SINCE TRUE
BOT IS FULLY COVERED. ITEM FOR
EVERYBODY SO WE'RE A LITTLE
PUZZLED AS TO WHY THAT'S IN THE
BILL AND WE CAN ONLY SURMISE
THAT IT IS TO ERECT BARRIERS TO
THE USE OF THE TWO TABLETS.
GENERIC VERSION FOR THOSE
REASONS WE ARE POST.
THANK YOU. ANYONE ELSE IN
OPPOSITION.
ANYWAY I CAN ON BEHALF OF THE
ASSOCIATION OF CALIFORNIA LIFE
AND HEALTH INSURANCE COMPANIES
ALSO HAVE AN OPPOSING MUSCLE.
I THINK IT'S ANY QUESTIONS SONYA
CENTER NEWMAN.
ALRIGHT THANK YOU MISTER CHOICE
SO I BY BILL ADMIT TO NOT BEING
AN EXPERT IN THIS BUT I I WANT
TO PICK UP ON A MISS STARTS
QUESTION IF YOU WOULD MIND
ABOUT.
THAT THE DIFFERENCE IN PRICE
BETWEEN EIGHT TO TABLET
ALTERNATIVE AND A SINGLE SEVEN
AND I DON'T DISAGREE WITH. THE
ASSERTION THAT SINGLE TABLET.
PROTOCOLS HAVE SEEMED MUCH MORE
EFFECTIVE BUT WHAT IS THAT AT
WHAT POINT WHAT IS THE TIPPING
POINT I MEAN THERE SEEMS TO BE A
MATRIX OF ITS MATERIALLY. LESS
EXPENSIVE BOTH WITH THE PLAN AND
AND MOST PUT FOR THE PATIENT.
ENTITY TO TELL BUT VERSES
WANTED BUT WHAT WHAT IS WHAT'S
THE ARGUMENT AGAINST SOCIETY IT
IS FAIR TO WEAR THAT MADE LEAD%
TO SECURE IT COSTS. SO ON
PERSONAL CURRENTLY.
THIS COMEDY. ERICH VON BRAUN
NAME BROAD OUTLET ARE
PREPARATORY.
I PERSONALLY DON'T KNOW AND I
KNOW MANY MANY MANY PEOPLE WHO
TAKE PART OF KNOW ANYONE IS ON I
DON'T KNOW POSITIONS TO.
PRESCRIBE THAT.
IT WE YOU KNOW WE MAY.
START SAYING THAT IN THE FUTURE.
BUT I DON'T THINK THAT THAT IS
ACTUALLY A. BAND I'M SURE THAT
MAYBE THERE ARE SOME DOCTORS WHO
PRESCRIBE AND EVERYONE OF COURSE
HAS A CHOICE.
SO.
BUT GENOCIDE ETCETERA I THINK
YOU SERVICES AT IT WHEN THE
OTHER HALF COMES UP PATENT RIGHT
THAT IT WILL THERE WILL BE A
GENERIC TO TO TAP EQUIPMENT. AND
THAT IT IT MIGHT MORE LIKELY BE
PRESCRIBED UNLESS IT'S PRE
PROHIBITED AND THIS BILL DOES
ALLOW TEARS SO A PATIENT MAY
HAVE A CHOICE TO PAY TO HER
FIFTY DOLLARS A MONTH.
WORD.
CHIU BADA OR MAYBE THEY'RE
GOING TO OR OR TWO PILLS AT A
MUCH LOWER PREMIUM. ICE ABOUT
WILL BE THE PATIENT'S CHOICE BUT
THE KEY HERE IS IT AND THIS IS
NOT FACTUALLY DEBATABLE.
DIE. THAT THE INSURANCE FOR TWO
PILLS WILL DRAW FROM ONE CULT.
AND WE ALREADY.
HAVE CHALLENGES WITH PROP UP
BECAUSE WE ARE NEVER EVER GOING
TO A RADICALLY NEW HIV
INFECTIONS ARE WITHOUT PROPER.
IT'S AN ESSENTIAL PART OF IT BID
THERE THE COMPONENTS ARE PEOPLE
WHO ARE POSITIVE GET TESTED AND
NO QUICKLY GET ON TO THE
MEDICATION AND SUPPRESSIVE FIRE
LOOK. PEOPLE WHO ARE NEGATIVE
BUT A RISK.
USE ALL PREVENTION TOOLS
INCLUDING CRAP. AND WHEN YOU
START HAVING PEOPLE TAKE MORE
PILLS.
THEY'RE LESS LIKELY TO HEAR WE
SAW THAT WITH HIV POSITIVE
PEOPLE THOUGHT WHEN THERE USED
TO BE MORE PILLS THAT YOU HAD.
AN INSURANCE WAS MORE
CHALLENGING DEL WITH FEWER PILLS
IT'S EASIER EYES SO. WE WE LOOK
FORWARD TO THE DAY WHEN THERE IS
A ONE TOLL GENERIC AND WE THINK
IT WILL HAPPEN.
AND THAT IS GOING TO BE THE
BEST APPROACH.
AND.
I JUST DON'T THINK ALLOWING THE
HEALTH PLANS TO FORCE PEOPLE
UNDER THE TOOK TO PULL RESIDENT
WHICH IS WHAT THEY'RE ASKING FOR
THE ABILITY TO DO.
IS THE ANSWER HERE THAT IS
GOING TO UNDERMINE OUR EFFORTS
TO REDUCE AYE HIV.
INFECTIONS BUT I I GOTTA GET
SORTED SOMETHING YOU'RE SAYING
THIS IS.
.
THE INCREASE ANY INCREASED
INHERENT SHOULD HAPPEN A
MATERIAL TO COST IRRESPECTIVE
COSTS AND SO IF YOU IF YOU WOULD
MIND ME STARTED SO AGAIN NOT
EXPERT.
BUT BUT CLEARLY IF THERE IS A
SIGNIFICANT RANCHO BETWEEN IT TO
THE COST OF TRUE BONTA. AND
A TWO TABLET ALTERNATIVES
PROSPECTIVELY BUT THAT SHOULD BE
CONSIDERED IT ALSO TAKING INTO
ACCOUNT IS THE THE THE PATIENTS
TO OPTIONS SO IF IT MISCARRIED I
AND AGAIN I'M TRYING TO
UNDERSTAND THIS. IN IN IN ISN'T
ALWAYS ABOUT BECAUSE.
RIGHT SO IT'S ABOUT HAVING THE
FLEXIBILITY AND NOT ALLOWING THE
STATUE TO OVERRIDE THE PHYSICIAN
DISCRETION IN THE PATIENT
DISCRETION TREVAN IS GOING TO BE
AVAILABLE IN COVERED THE SINGLE
TABLET VERSION WILL BE AVAILABLE
AND WILL CONTINUE TO BE COVERED.
BUT IF THERE IS A TWO TABLETS
GENERIC EQUIVALENT THAT A
PHYSICIAN AND THIS CONCERN IS
NOT COMING FROM THE HEALTH PLAN
OF KAISER THIS IS COMING FROM MY
AGE I HIV PHYSICIANS.
WHO SAY THEY'RE THERE WILL BE
THERE IS RIGHT NOW AND THERE
WILL BE FULL GENERIC VERSION OF
TRUE BODY IN THE NEXT FEW YEARS
WHEN ONE OF THE MEDICATION GOES
OFF PATENT? WE'RE SIMPLY ASKING
FOR THE FLEXIBILITY TO BE ABLE
TO HAVE BOTH HONOR FORMULARY IN
THE BILL DOES NOT ALLOW FOR THAT
FLEXIBILITY BECAUSE IT. SAYS IN
HERE THAT IN ORDER FOR US TO
PROVIDE THE TWO TABLET VERSION
WE WOULD HAVE TO SHOW THAT IT
WOULD BE MORE LIKELY TO RESULT
IN APPEARANCE. THAN THE ONE
TABLET VERSION THERE ARE NO
STUDIES THAT SAY THAT THAT IS AN
INSURMOUNTABLE BARRIER BY
PHYSICIANS SAY THAT DOESN'T
EXIST AND IT WILL PREVENT US
FROM BEING ABLE TO HAVE BOTH ON
THE FORMULARY ON DIFFERENT HERE.
WE'D BE HAPPY TO WORK WITH THE
SENATOR ON SOME CLARIFYING
LANGUAGE THAT WE COULD PROVIDE
BOTH ON DIFFERENT TIERS AND THEN
IT'S UP TO THE PHYSICIAN AND THE
PATIENT. CLOSER A CENTER WITH
pDON'T BELIEVE THAT THAT IS
ACCURATE NOTHING IN THIS BILL.
IF A IF A PATIENT ONCE A TWO
COLOR VERSION IF I AND THE AND
THE PER TO MAKE IT WILL BE
COVERED.
THIS SOUTHERN EXCLUDED FROM
COVERAGE WHAT THIS PREVENTS IS
INSURANCE COMPANY FROM FORCING.
PEOPLE ON FOOD TO CO REGIMENT
AHEAD OF KAISER THINGS THAT
SOMETHING NEEDS REQUIRE FIND THE
LINE WHICH WE WE WOULD WELCOME.
THAT LANGUAGE UP BY GOOD THAT
IS NOT WHAT THE BILL DOES.
SORRY IF I I DID HEAR THAT
THERE'S A WILLINGNESS FOR YOU TO
ADDRESS THE CONCERNS.
.
WITH THIS PARTICULAR ISSUE THAT
THEY APPRECIATE THAT THINKING IF
IT WE WE DON'T THINK IT IS AN
ISSUE BUT WE'RE WILLING TO LET
YOU MAY HAVE TO BE MADE A
COMMENT THAT YOU ARE FEELING THE
NEXT I JUST WANT TO BE CLEAR
THAT THE SENATOR AND HIS
SPONSORS ARE. SAYING THAT IF
THERE IS A TO TAP
VERSION.
THAT THE INTENT IS FOR BOTH OF
THOSE TO BE AVAILABLE ON THE
FORMULARY ON DIFFERENT TIERS SO
THAT IF A PATIENT IN A POSITION
CHOOSE THE GENERIC. TWO TABLET
VERSION AND THERE'S IF THERE'S
NO ADHERENCE CONCERNS THEY CAN
CHOOSE THAT OVER THE BRAND NAME
I JUST WANNA BE CLEAR THAT THAT
IS THE INTENT IN THAT'S EASY
LANGUAGE TO WORK OUT BUT*.
IT WILL IT WILL LEAD TO SENATOR
THAT BEFORE BUT I KNOW I WOULD
LIKE HEALTH ACCESS TO. DIFFICULT
IF I COULD JUST AHEAD OF THE
PEACEFUL
MISSION.
DISCUSSION
IT'S OUR UNDERSTANDING THAT THE
OTHER THE.
WHAT IS NOW THE BRAND NAME
COMPONENT OF TRUE VATA IS NOT
LIKELY TO GO GENERIC UNTIL
SOMETIME LATER IN TWENTY TWENTY
ONE? STATES SUNSET DATE FOR THIS
PIECE THE SINGLE TABLET REGIMEN
IS JANUARY ONE TWENTY TWENTY
THREE FOR THAT REASON
I THINK WE ALL KNOW THE GENERIC
DATES GOING GENERIC SOMETIMES
SLIP AND SO. WE'VE ALREADY TRIED
TO ACCOUNT FOR THAT CHANGE AND
WILL COME WITH THE HELP OF THE
MEMBERS OF THIS COMMITTEE. AND
SENATOR WIENER BE BACK LOOKING
AT THIS ISSUE IN THE FUTURE AND
WE CERTAINLY ALWAYS COMMIT TO
WORK WITH THE OPPOSITION ON
THEIR CONCERNS.
IT SOUNDS CENTER NEWMAN MAIL
MEANS LESS QUESTION EIGHT WITH
WITH RESPECT TO THE SENSOR THING
MISTER WITH LOUISE HAS MADE THE
POINT. THAT THAT THIS WAS A
FAIRLY LONG DURATION FOR SUNSET
SO CENTERED IT IN AND AGAIN.
WE SEE A LOT OF SUNSETS LA
DIFFERENCE AREAS.
WHAT'S THE ARGUMENT AGAINST.
EN AND EARLIER SON SAID IT ON
YOU KNOW WHAT BASED ON THE
PREMISE THAT WE'RE NOT LIKELY TO
FORGO IT BUT IT JUST SEEMS LIKE
A GOOD CHECK AND. GIVEN THAT
THIS IS A VERY VERY DYNAMIC
SPACE YEAH SO THE ORIGINAL
SUNSET FROM THE.
GORDON BILL WAS FIVE YEAR.
THIS IS A FIRE SUNSET AND JUST
TO BE VERY VERY CLEAR WHEN I
EXITED HIS BILL I INTRODUCED IT
TO MAKE IT PERMANENT. MY
PREFERENCE EYES FOR THIS TO HAVE
NO SUNSET AND I HONESTLY THINK
TWO HUNDRED FIFTY DOLLAR COPAYS
TO HIDE. I THINK IT WHEN YOU
TALK ABOUT SOMEONE WHO IS NOT A
LOT OF MONEY MAYBE HAS THREE OR
FOUR PRESCRIPTIONS. AND EVEN
WITH THE TWO FIFTY IT CAN GET
EXPENSIVE IT'S NOT INSANE. LIKE
HAVING A TWELVE HUNDRED DOLLAR
MONTHLY CO PAPER ONE
PRESCRIPTION. UP BUT CAN STILL
BE EXPENSIVE I WOULD LIKE THIS
TO BE LOWER THAN TWO FIFTY AND
THE SUNSET. HOWEVER IN WORKING
WITH THE PLANS IN WORKING WITH
THE CHAIR WERE GREEN TO A FIVE
YEAR SUNSET AND TOOK MAINTAINING
THE TWO HUNDRED FIFTY DOLLARS.
BOB ABOUT FIVE YEARS IS EXACTLY
WHAT WE HAD BEFORE.
AND WE WENT INTO NEGOTIATIONS
ABOUT THE SUNSET WE SUGGESTED
SEVEN YEARS SOME UNCOMPROMISED A
FIVE YEAR.
AND IN ADDITION A BECAUSE OF THE
WAY THINGS WORK WITH COVER
CALIFORNIA THIS BILL THE CURRENT
QUARTER BILL EXPIRES A YEAR FROM
JANUARY.
YOU HAVE TO DO IT IN ADVANCE
JUST BECAUSE THE COVER
CALIFORNIA'S A MINISTER NEEDS A
FEW DID LET'S SAY A THREE YEAR.
SUNSET WE WILL BE BACK HERE.
WITH AND I ON'T KNOW A YEAR
EIGHTEEN MONTHS.
SO THAT THAT'S JUST NOT IN
ANYONE'S INTERPRETATION THAT
THANK THANK YOU MISTER.
YES SO LET LET ME JUST KIND OF
FOR YOUR EDIFICATION CLARIFY WHY
I INSISTED ON THE SUN.
AS SENATOR WIENER MENTIONED
THE REGIONAL BELL WAS HAVE NO
SUNSET.
THE BIGGEST CONCERN I HAD WAS
PUTTING IN PERPETUITY THE
ABILITY FOR ONE PARTICULAR
COMPANY THEY HAVE MARKET
DOMINANCE.
AND SO WE CAME UP WITH THAT
SUNSET FOR THAT PROVISION. LET
ME JUST.
TALK A LITTLE BIT ABOUT
COMPLIANCE YES IDEALLY. ONE PILL
WOULD BE COMPLIANT AS IT SEEMS
TO BE MORE COMPLIANT BUT I ALSO
FEEL AND I'M I'M. LEANING
TOWARDS UNDERSTANDING WHAT
KAISER SAYING THAT THERE NEEDS
TO BE SOME.
THE ABILITY FOR PROVIDER A
PHYSICIAN TO BE ABLE TO HAVE
SOME OPTIONS.
SO I DON'T ALL OF THIS BILL IS
NECESSARY DESIGN TAUGHT.
INSURANCE COMPANIES TO.
PROHIBIT.
BUT I ALSO THINK WE NEED TO LOOK
AT THE BIGGER PICTURE OF. NUMBER
ONE IS WHAT HAPPENS ONCE THEY
REACH PRESCRIPTIONS GO UP THEN
IT'S GONNA BE PASSED ON TO THE
OVERALL CONSUMER SO CENTER
WIENER I HAD THAT WELL OVER A
BIGGER CONVERSATION SO THAT'S
WHY INSIST.
BUT PERHAPS MAYBE YOU GUYS CAN
CONTINUE TO HAVE THAT DISCUSSION
TO DEAL WITH. THE OPTION THAT
THE PHYSICIAN TO CLARIFY ES DE
BILLION MAKE THAT DECISION.
AS FAR AS THE PRESCRIPTION.
ANY OTHER QUESTIONS OR COMMENTS.
XENA NO OTHER IS OUR MOTION.
MOVE MY SENTIMENT AND CENTER
WIENER WAS LIKE CLOTHES I'VE
THANK YOU VERY MUCH OF ITS
CHAIRMAN AND I AM. ARE.
I AM MINDFUL OF THE THE BIGGER
ISSUES AND THE HEALTHCARE SYSTEM
AND THE COSTS. ARE AND I AM
MINDFUL THAT NOTHING IS FREE.
AND ONE COPAYS YOU KNOW THATTHAT
WE HAVE PREMIUMS AND CO
PAYS IT'S ALWAYS A BALANCE AND I
KNOW THAT TIES WHAT THE PLANS
ARE TRYING TO ACHIEVE.
I ALSO KNOW THAT WE HAVE A
PROBLEM WITH THE COSTS OF
PHARMACEUTICALS
WHY NOT VOTE IN FAVOR OF THE
CHAIRS S. B. SEVENTEEN.
LAST YEAR I'M A SUPPORTER OF
ABOUT CONTROLLING COSTS OF
PHARMACEUTICALS IT BENEFITS
CONSUMERS A BENEFITS THE HEALTH
PLANS THE BENEFITS OF A SYSTEM.
I'VE BUT I AM ALSO VERY MINDFUL.
OF PEOPLE WHO ARE.
DO NOT HAVE A LOT OF MONEY AND
RELY. ON YOU ACCESSING THEIR
INSURANCE OUGHT TO OBTAIN
LIFESAVING POT MEDICATIONS. AND
BEEN THE ETERNAL FIGHT BETWEEN
THE PLANTS AND THE
PHARMACEUTICAL COMPANIES WHICH I
DOUBT IT IT IS WHAT IT IS AND.
I AM NOT AS PART OF THE
DISCUSSION WE HAVE ON HEALTH
CARE.
MY CONCERN IS THAT REAL PEOPLE.
ARE ARE THE SOMETIMES.
THE END UP BEING THE CASUALTIES.
MAY HEALTH PLANS HAVE A
LEGITIMATE GRIPE. WITH THE COST
OF PHARMACEUTICALS.
BUT THAT DOESN'T MEAN THAT
SOMEONE WITHOUT A LOT OF MONEY
LIVING WITH AIDS ID OR AND MASS
OR ANYTHING ELSE.
SHOULD SHOW UP REQUIREMENTS CMB
TOLD. YOUR COPAYS TWELVE HUNDRED
DOLLARS FOR THE MONTH AND GUESS
WHAT EVERY SINGLE MEDICATION
THAT YOU CAN CHOOSE.
IT'S ALL MINE DOT SPECIALTY TEAR
AND IT'S TWELVE HUNDRED MONTH
THAT'S WHAT THE COVER CALIFORNIA
PLANS. DID WITH HIV THEY PLACED.
PRETTY MUCH EVERY HIV TREATMENT
DRUG. ON THE HIGHEST SPECIALTY
TEAR. THERE WAS CURFEW IF ANY
OPTIONS TO TO PAY ANY KIND OF
LOWER COPAYS. AYE AND THAT IS
NOT GOOD POLICY IT'S NOT A GOOD
HEALTHCARE PRACTICE AND THAT'S
WHAT THIS BILL IS ABOUT AND I
RESPECTFULLY ASK YOUR I GO.
AND WE HAVE A MOTION BY SENATOR
NEWMAN WE OF ITEM NUMBER THREE
SB. ONE ZERO.
TWO ONE DO PASSAGE A MINUTE
APPROPRIATIONS COLOR MEMBERS
HERNANDEZ AYE HERNANDEZ AYE
NGUYEN.
LEYVA. LEYVA AYE MITCHELL.
MONNING. NEWMAN NEWMAN AYE
NIELSEN.
NIELSEN NO. HAN HI CAN I ROTH.
THE CURLY AS FOR WILL PLEASE
UMBILICAL.
FORT WORTH.
I AM ASSUMING BUT IT.
SO IT WOULD. SENATE MCGUIRE IS
NOT HERE SO GO AHEAD AND MOVE ON
TO ITEM NUMBER ELEVEN SP ONE TWO
ZERO SIX.
NO PLACE LIKE HOME ACT OF TWENTY
EIGHTEEN IT'S AN URGENCY.
SENATOR LEON OPEN LEANN.
YOU SURE HAVE CHANGED.
I COULD BE THAT HANDSOME.
BUT WAS IT NICE.
CENTER MCGUIRE IS STILL A
TESTIFYING IN INSURANCE
COMMITTEE MISTER CHAIR. SO.
DE HE IS TIED UP. AYE AYE
IMPRISONING AYE UP ON BEHALF OF.
SENATOR KEVIN DE LEóN SP
TWELVE OF SIX
IT'S THE NO PLACE LIKE HOME
ACTIVE TWENTY EIGHTEEN.
COLLEAGUES AB SIXTEEN EIGHTEEN
THE NO PLACE LIKE HOME BILL THAT
AUTHORIZED THE ISSUANCE OF TWO
BILLION DOLLARS IN BONDS.
WAS SIGNED BY THE GOVERNOR IN
TWENTY SIXTEEN.
THE BONDS WILL BE PAID FOR BY
PROPOSITION SIXTY THREE REVENUES
ALSO KNOWN AS THE MENTAL HEALTH
SERVICES ACT.
UNFORTUNATELY.
VALIDATION FOR THIS FINANCIAL
STRATEGY HAS BEEN STALLED. AND
IS TIED UP IN THE SACRAMENTO
COUNTY SUPERIOR COURT.
THE PROCEEDS WILL BE USED TO
CONSTRUCT PERMANENT SUPPORTIVE
HOUSING FOR MENTALLY ILL
HOMELESS PEOPLE.
WE CAN'T WAIT FOR THE COURTS.
WE MUST MOVE FORWARD ON PLAN B..
SENATE BILL TWELVE OH SIX PUTS.
RATHER RATHER.
RATIFICATION FOR THIS STRATEGY
ON THE NOVEMBER BALLOT.
COLLEAGUES.
THIS.
WELL FOR LACK OF A BETTER TERM
IS LOGJAM THAT'S HOLDING. THIS
WHOLE PROCESS UP IS EXTREMELY
FRUSTRATING. IN THE LAST YEAR
HOMELESSNESS HAS GROWN FOURTEEN
PERCENT AND LOS ANGELES COUNTY
ALONE. AND IT'S UP FIFTY THREE
PERCENT AND. ORANGE COUNTY SINCE
TWENTY THIRTEEN.
AND THE RECENT MENTAL HEALTH
SERVICES ACT AUDIT BY THE STATE
AUDITOR ELAINE HOWELL FINDS THAT
THERE'S TWO POINT FIVE BILLION
IN FUNDS.
I'LL USE THE TERM LANGUISHING
AND AVAILABLE AS COLLATERAL FOR
THE LOAN.
COLLEAGUES LET'S GET THE FUNDS
MOVING THE TOPIC OF HOMELESSNESS
IS VERY HIGH.
ON OUR CONSTITUENTS MINDS IT IS
AN EVERYDAY OCCURRENCE THAT THEY
ARE.
SEEING. THEY WILL GLADLY SUPPORT
THIS MEASURE IT BECOMES
OPERATIVE UPON ADOPTION LET'S
PROVIDE HOUSING FIRST IN
IMMEDIATE HOUSING TO THOSE IN
NEED. OF SUPPORTIVE SERVICES AND
RODE BACK TO THE MAINSTREAM I
RESPECTFULLY URGE AND AYE VOTES
AND I HAVE. A DREAM CHILDREN
FROM THE STEINBERG INSTITUTE AS
A WITNESS THANK YOU PLEASE
PROCEED. AFTERNOON MISTER
CHAIRMAN MEMBERS ADRIN SHELTON
WITH THE STEINBERG INSTITUTE OF
PROUD TO SPONSOR THIS MEASURING
WORK ALONG A SENATORS MORE LOCK
AND DE LEóN. OTHER NO PLACE
LIKE HOME INITIATIVE WHICH THE
STEINBERG INSTITUTE SPONSORED IN
TWENTY SIXTEEN REPRESENTS A
PIVOTAL OPPORTUNITY TO ADDRESS.
THE GROWING HOMELESSNESS CRISIS
IN THE COMMUNITIES ACROSS THE
STATE.
LEGISLATION SECURED A TWO
BILLION DOLLAR HOUSING BOND FOR
PERMANENT SUPPORTIVE HOUSING FOR
HOMELESS INDIVIDUALS WERE LIVING
WITH A MENTAL ILLNESS.
THE FUNDING IS GOING TO PROVIDE
HOUSING FOR UP TO TWENTY TWO
THOUSAND INDIVIDUALS. COUNTIES
ARE EAGER TO ACCESS THE FUNDS
HAVE ALREADY BEGUN ACTIVELY
PLANNING WITH THEIR COMMUNITIES
ACROSS
STATE TO DO SO.
ARE HOMELESS NUMBERS ARE RISING
IN CALIFORNIA. A RECENT REPORT
ON OF THE CRISIS PUT THE NUMBER
OF PEOPLE LIVING WITHOUT A
PERMANENT RESIDENCE AT A HUNDRED
AND THIRTY FOUR THOUSAND PEOPLE.
AND WE KNOW FROM THE RESEARCH
THAT ABOUT A THIRD OF THESE
INDIVIDUALS ARE LIVING WITH A
MENTAL ILLNESS AND ABOUT TWO
THIRDS ARE LIVING WITH ADDICTION
ISSUES.
PASSAGE OF THE NO PLACE LIKE
HOME AND IT SHOULD HAVE
OPPORTUNITY OFFERED A STORK
OPPORTUNITY TO PROVIDE LIFE
CHANGING HOUSING AND TREATMENT
OF THE MOST VULNERABLE. AMONG US
BUT THE IMPLEMENTATION OF THE
INITIATIVE HAS BEEN INDEFINITELY
DELAYED IN THE COURTS.
TWO YEARS AFTER THE PASSAGE OF
THIS HISTORIC EFFORT WE ARE NOT
ABLE TO GET THIS VITAL REVENUE
STREAM OUT TO THE COUNTIES.
WE CANNOT CONTINUE TO ALLOW TENS
OF THOUSANDS OF INDIVIDUALS.
PEOPLE WHO ARE HOMELESS LIVING
WITH SEVERE MENTAL ILLNESS TO BE
LANGUISHING.
S. B. TWELVE THOSE SIX ENSURES
THE CALIFORNIA DEDICATES.
WITH MUCH NEEDED RESOURCES
TOWARD LAW A LONG TERM SOLUTION
TO THE HOMELESSNESS CRISIS.
AND IT CAPITALIZES ON EXISTING
REVENUE SOURCE TO DO SO.
THIS IS THE TIPPING POINT MOMENT
AND MENTAL HEALTH.
AND WE CAN LEAD THE NATION AND
BRING PEOPLE OUT OF THE SHADOWS
OFF THE STREETS.
AND INTO HOMES WITH SERVICES SO
THANK YOU VERY MUCH.
THINK ANYONE ELSE IN SUPPORT.
YES MISTER CHAIRMAN MEMBERS PARA
MCDADE TING WITH THE CALIFORNIA
STATE ASSOCIATION OF COUNTIES
AND ALSO TODAY ON BEHALF OF THE
URBAN COUNTIES OF CALIFORNIA. IN
STRONG SUPPORT OF THIS MEASURE
WE.
SUPPORTED NO PLACE LIKE HOME
TWENTY SIXTEEN OR EAGER COUNTIES
ARE EAGER TO ACCESS THIS FUNDING
WILL SUPPORT THIS BILL AS
WRITTEN WITH NO OTHER ADDITIONAL
CHANGES TO THE IMPLEMENTATION OF
THE PROGRAM. THANK YOU THANK
YOU.
MCKAY CORINNE PARA BEHALF OF THE
LOS ANGELES COUNTY IN SUPPORT.
LINDA WAY WITH WESTERN CENTER ON
LAW AND POVERTY AND SUPPORT.
CRITICS CALTRANS DISABILITY
RIGHTS WERE IN SUPPORT BUT WE
WANNA MAKE SURE YOU GUYS WITH AN
AXIS AXES ACCESS. THANK YOU.
YOU.
IS THEIR OPPOSITION.
QUESTIONS COMMENTS.
FEMALE QUESTIONS OR COMMENTS WE
HAVE A MOTION BY SENATOR PAN.
HERE IS RECOMMENDING THAT I.
WOULD LIKE TO CLOSE.
THE I WOULD RESPECTFULLY ASK FOR
AN AYE VOTE THANK YOU MISTER
CHAIR INTO A ITEM NUMBER ELEVEN
SP ONE TWO ZERO SIX DE LEóN DO
PASSED APPROPRIATIONS CALL THE
MEMBERS PLEASE. HERNANDEZ AYE
HERNANDEZ AYE NGUYEN.
LEYVA.
LEYVA AYE MITCHELL.
MONNING NEWMAN.
NIELSEN NIELSEN AYE PAN. PAN AYE
ROTH.
THANK YOU RICHARD THANK YOU
COLLEAGUES PROVOKED HAS FOUR
ZERO PLEASE SAID BILL AND CALL.
I BELIEVE.
SENATOR STONE.
EUROPE YOU HAVE TOTAL OF FOUR
BILLS IS THAT CORRECT.
THREE.
BUT HE.
YEAH.
UNDER WHAT YOUR DOCTOR HERNANDEZ
AND.
COLLEAGUES.
MANY MEMBERS I'M HERE TO PRESENT
SP TWELVE SIXTY FOUR WHICH WOULD
PROVIDE MEDICAL COVERAGE
FOR HYPERTENSION MEDICATION
MANAGEMENT SERVICES PROVIDED BY
AN AND VANCE PRACTICE
PHARMACIST.
I WOULD LIKE TO THANK THE
COMMITTEE AND OUR CURRENT AND IS
FOR WORKING CLOSELY WITH ME ON
AMENDMENTS AND I WOULD LIKE TO
ACCEPT THOSE AMENDMENTS AS
AUTHOR AMENDMENTS WHICH WERE
CLARIFIED THE SERVICES.
IN WHICH A PHARMACIST MAY BILL
MEDICARE FOR HYPERTENSION
MEDICATION MANAGEMENT SERVICES.
COLLEAGUES HYPERTENSION CONTROL
IN THE UNITED STATES HAS HOVERED
AT APPROXIMATELY FIFTY PERCENT
OVER THE PAST DECADE DESPITE.
THE DANGEROUS ROLE HYPERTENSION
PLAYS IN CARDIOVASCULAR DISEASE
AND THAT THE FIRST FIVE LINES OF
MEDICATIONS FOR HYPERTENSION ARE
GENERIC. IN ARE INEXPENSIVE.
THE CALIFORNIA HEALTH BENEFIT
REVIEW PROGRAM OR C. H. B. R.
P..
AS ANALYZE THE IMPACTS OF
REQUIRING HEALTH PLAN COVERAGE
OF COMPREHENSIVE MEDICATION
MANAGEMENT AND SPECIFICALLY
NOTES.
HYPERTENSION MEN MEDICATION
MANAGEMENT WHICH IS THE FOCUS OF
S. B. TWELVE SIXTY FOUR.
C. H. BRP STATED IN THEIR STUDY
THAT THE MOST PREVALENT
CONDITION AMONG NON TOOL MEDI
CAL ENROLLEES IN TWO THOUSAND
SIXTEEN. WAS HYPERTENSION A
TWENTY SEVEN PERCENT.
THE ANALYSIS ALSO STATED THERE
IS A PREPONDERANCE OF EVIDENCE
FROM FIVE STUDIES THAT THE
RECEIPT OF COMPREHENSIVE
MEDICATION MANAGEMENT
ASSOCIATED. WITH GREATER
REDUCTIONS IN BLOOD PRESSURE
THAN THAT OF USUAL CARE. THIS
INCLUDES ONE STUDY PUBLISHED
THIS MONTH
AND THE NEW ENGLAND JOURNAL OF
MEDICINE DEMONSTRATING THAT
PHARMACISTS MANAGING MEDICATIONS
AND MOM BEAT WHAT LOS ANGELES
BARBER SHOPS. FOR PATRONS WITH
UNCONTROLLED HYPERTENSION
WE'RE NEARLY SIX
TIMES MORE EFFECTIVE THAN USUAL
CARE AND ATTENDING BLOOD
PRESSURE CONTROL.
BUT HYPERTENSION BEING ONE OF
THE MAJOR CONTRIBUTORS TO
CARDIOVASCULAR DISEASE AND
THEREBY THE GREATEST DIRECTLY
ATTRIBUTABLE RISK FOR DEATH
WORLDWIDE. SP TWELVE SIXTY FOUR
IS NEEDED TO HELP BRING DOWN
BLOOD PRESSURE AND LOWER RATES
OF DEADLY CARDIOVASCULAR
DISEASE.
ENGAGING PHARMACISTS IN THE
MANAGEMENT OF HYPERTENSION AS A
PART OF THE HEALTHCARE TEAM. IS
CRUCIAL TO ACHIEVING GOALS FOR
UNCONTROLLED PATIENTS.
AS THE SIEGE BBP ANALYSIS SHOWS
PHARMACISTS ARE HIGHLY EFFECTIVE
AT MANAGING MEDICATIONS FOR
HYPERTENSION AND ENSURING
PATIENTS REACH BLOOD PRESSURE
GOALS AND THAT'S WHY S. B.
TWELVE SIXTY FOUR. IS NECESSARY.
I'M HONORED TO INTRODUCE DR
BRIAN HOSKINS HERE WHO IS IN
SUPPORT.
BRIAN A PHARMACIST AS A LEADER
IN THE PHARMACY INDUSTRY AND THE
EXECUTIVE VICE PRESIDENT OF
OPERATIONS FOR THE DESERT OASIS
HEALTH CARE. IN PALM SPRINGS IN
THE TWENTY EIGHT DISTRICTS.
A. DOCTOR HODGKIN'S.
THANK YOU A CENTER AND HERNANDEZ
AN ASSISTANT COMMITTEE.
.
FOR A LOT ME TO SPEAK TODAY
REALLY.
FOR PATIENTS SEEKING ACCESS TO
BASIC HEALTHCARE NEEDS PROVIDED
BY FARMS IS COLLABORATING
DIRECTLY WITH PHYSICIANS. I WANT
TO BE CLEAR NOTHING THAT WE
TALKED ABOUT TODAY IN THE BILL
THAT WILL.
.
DOCTOR STONE'S PRESENTING
EXPANDS THE SCOPE OF PHARMACY
PRACTICE IN FACT THIS BILL
PHARMACY PRACTICE IS ALREADY
BEEN WELL DEFINED. AND HIS AYE
CODIFIED IN STATE REGULATION.
.
I AM A PHARMACIST I AM PENDING
RIGHT NOW TO BE AN ADVANCED
PRACTICE PHARMACIST TYPES PAID
MY THREE HUNDRED DOLLARS.
I'M A RESIDENCY TRAINED. AYE AND
THAT ROAD CLARA PRACTICE ACTS
THAT ARE TWENTY FIVE PHARMACISTS
WORK.
AT THAT IN. EASTERN RIVERSIDE
COUNTY WE TAKE CARE OF A HUNDRED
THOUSAND PATIENTS.
SIX YEARS AGO WE HAD TO
PHARMACISTS I NOW HAVE TWENTY
FIVE.
WHILE THEM RESIDENCY TRAINING
BOARD CERTIFIED ALL THE MAIN
GATES DIDN'T IN OBTAINING THEIR
ADVANCED PRACTICE PHARMACY FOR
ONE REASON ONLY. AS YOU HEARD
GENTLEMAN EARLIER SAY WE HAVE AN
ACCESS PROBLEM HEALTHCARE IN
CALIFORNIA.
ESPECIALLY RIVERSIDE COUNTY WITH
LESS THAN.
FIFTY PRIMARY CARE PHYSICIANS
PER HUNDRED THOUSAND POPULATION.
AND THAT GAP IS CERTAINLY NOT
CAN BE CLOSED ANYTIME SOON.
BUT MORE IMPORTANTLY I WANT TO
SHARE WITH YOU.
THE PROBLEM THAT I'M HERE
ADDRESSING TODAY.
HER NAME IS CAROLYN AND SHE'S A
PLEASANT FORTY NINE YEAR OLD
WOMAN AND A MOTHER OF THREE.
BECAUSE ALREADY HAD A STROKE
PRIMARILY DUE TO UNCONTROLLED
HYPERTENSION.
SHE HAS SEVERE RESIDUAL
NEUROLOGIC DEFICITS.
FELICITY ON ONE SIDE YOU CAN
BARELY CARE FOR HERSELF AND HER
THREE CHILDREN.
SHE HAS AN ABILITY.
TO GAIN TRANSPORTATION TO A
DOCTOR'S OFFICE AND IN FACT SHE
SUFFERS FROM WHAT MANY
CALIFORNIA DO SUFFER FROM. AND
THAT'S HEALTHCARE ILLITERACY SHE
DOES NOT ASK ACCESS THE SYSTEM
ENGAGE THE SYSTEM OR FIND CARE
READILY AVAILABLE TO HER. SHE IS
A MEDI CAL BENEFICIARY.
WITH LIMITED TRANSPORTATION
SUPPORT IN A RELATIONSHIP WITH A
PRIMARY CARE PHYSICIAN SHE
INSTEAD FREQUENTS THE FREQUENCY
EMERGENCY ROOM FOR CARE BY
CALLING NINE ONE ONE WHICH SHE
HAS ANY EPISODES OR CONCERNS.
AS YOU MAY BE AWARE. EVEN IN MY
AREA FINING PHYSICIANS WERE
WILLING TO ENGAGE THE MEDI CAL
FEE SCHEDULE TO TAKE CARE OF
THESE PATIENTS IS VERY
DIFFICULT.
ARE THESE PATIENTS ARE VISIBLE
THEY LIVE IN THE COMMUNITY. BUT
IT'S TIME THAT WE DON'T ALLOW
THE ZIP CODE OR SOCIAL ECONOMIC
STATUS TO DEFINE. THE WELLS AND
OUTCOMES OF THESE PATIENTS
RIGHTLY DESERVE. AS I'M HERE
TODAY TO TELL YOU THIS.
EVERYTHING HAPPENED CAROLINE WAS
READILY PREVENTABLE. HAD SHE
BEEN ABLE TO SEE ANOTHER
PROVIDER THAT MANY PATIENTS SEE
MORE FREQUENTLY THAN THEY SEE.
IN THEIR PCP OR OTHER PROVIDERS
AND THAT'S THE PHARMACIST.
FOR MANY PATIENTS EITHER
PHARMACIST TWELVE TO FIFTEEN
TIMES A YEAR. AND MAY OR MAY NOT
SEE THEIR PRIMARY CARE
PHYSICIAN.
ONE TWICE OR NO TIMES HERE.
SO THAT'S WHY I AM NOW IN
SUPPORT OF THIS BILL.
AND I'D BE HAPPY TO ANSWER ANY
QUESTIONS.
I SHOULD ALSO NOTE AB ONE ONE
ONE FOUR THAT WAS SIGNED INTO
LAW ON SEPTEMBER TWENTY SIXTEEN
GOVERNOR BROWN. PARTY
ESTABLISHES.
THAT FARMS IS CAMPUS PAY.
IN THAT EIGHTY FIVE PERCENT THE
FEE SCHEDULE FOR PROVIDING SPOKE
A CESSATION AND CONTRACEPTIVES
THIS IS REALLY A LOGICAL
EXTENSION IN THE CHRONIC
CONDITIONS. THAT REALLY CAN HAVE
DEVASTATING ENVELOPED.
EVENTS AS CAROLINE IS WITNESSED
BY IF WE DON'T PROVIDE RENTAL
RENTAL.
MORE.
READILY AVAILABLE ACCESS MAKE
ANYONE ELSE IN OUR SUPPORT.
GOOD AFTERNOON TIM VALDERRAMA
WITH THE WHITEMAN GROUP ON
BEHALF OF THE CALIFORNIA SOCIETY
OF HEALTH SYSTEM PHARMACISTS WE
JUST WANT TO THANK.
THE CHAIR FOR HIS LEADERSHIP
AND OFFERING US BEFORE NINETY
THREE AND FOR ALWAYS SUPPORTING
THE PHARMACY PROFESSION WE WANT
TO THANK SENATOR STONE FOR.
FORWARD.
AND WE.
WE URGE YOUR SUPPORT THANK YOU.
THANK YOU ANYONE ELSE IN SUPPORT
IT GROWS ON THAT THE CALIFORNIA
FARMERS
SO SHE AGENTS OR.
MICHAEL TELL WITH PROVIDENCE
SAINT JOSEPH HEALTH IN SUPPORT.
OPPOSITION
.
STEPHANIE LICHENS ON BEHALF OF
THE ASSOCIATION OF CALIFORNIA
LIFE AND HEALTH INSURANCE
COMPANIES AND. PURSUED LIKE TED
THING THE MEMBRANOUS STAFFER AT
THE OPEN DIALOGUE WE'VE HAD IN
VIRTUALLY WE ARE OPPOSED TO THE
BILL.
I'M.
AS YOU READ IT STAY WE VIEW THIS
AS A POTENTIAL FOR AN ANY
WILLING PROVIDER I THINK THEY
ANALYSIS KIND OF POINTS OUT THAT
IT'S.
.
MAY BE PREMATURE AT THERE'S ONLY
TWO HUNDRED SEVENTY NINE.
.
PHARMACISTS THAT HAVE THE
SPECIAL.
RIGHT FIXING UP I'M ON THE RIGHT
CHANNELS CAN SAY.
OKAY.
SORRY.
THOUGH THEY'RE NOT IN
OPPOSITION.
THANK YOU.
UP IS THERE ANY OPPOSITION.
QUESTIONS COMMENTS DARIA CENTER
PAN. NOT THANK YOU THANK YOU
CENTER STONE FOR BRINGING THIS
BILL FORWARD AND I CERTAINLY
AGREE WITH YOU THAT PHARMACISTS
HAVE AN EXTRA.
ROLE IN HELPING
MANAGE SHOP PATIENTS CREDIT
CONDITIONS INCLUDING.
HYPERTENSION
IS ONE THAT.
.
CAN INVOLVE MULTIPLE MEDICATIONS
ARE COMBINATIONS ARE SINGLE
MEDICATION SO FORTH I DID MY
CLARIFY IN THE NOW IT'S THIS IS
THE.
MENTIONS THAT.
IN.
THAT IN A.
.
I GUESS SAY.
.
CNN DOT COVERAGE OF MEDICATION
MANAGEMENT THAT THERE'S A FORMAL
COLLABORATION BETWEEN DEL THE
PRESCRIBER AND PHARMACISTS IS
THAT THE KIND OF MODEL YOU'RE
LOOKING AT FOR EXIT.
IN THIS THAT.
FOR WORD NERDS TO DO THAT
HYPERTENSION MANAGEMENT.
ONE HUNDRED PERCENT SO WE
BELIEVE IN THE TRIAD THAT THE
PATIENT THE POSITION OF THE
PHARMACISTS COLLABORATING OF ONE
ANOTHER IN THE BEST INTEREST OF
THE PATIENT WITH BASICALLY SALE
PROTOCOLS AND SO FORTH AND THEN
I WANTED FARMS YOU REGULATIONS
CLEARLY. DEFINED THAT ONLY UNDER
THOSE TYPES OF RELATIONSHIPS CAN
ARMS AS PER PARTICIPATING
EFFECTIVE CARE. OKAY EXCELLENT I
MEAN I THINK THAT AGAIN MORE
ACCESS TO THE PATIENT.
THEFARMERS IS THOSE WORKING
WITHIN GUIDELINES
BUT THEN I BUILT THAT MANAGE
SURE THAT THE PATIENTS ON THE
RIGHT MEDICATION. AND MORE
QUICKLY YOU KNOW OF MAKE
ADJUSTMENTS SO.
IDEA UP PLEASE TO MOVE THE BILL
THAT THANK YOU.
THANK YOU OF SENIOR IS THERE ANY
OTHER COMMENT QUESTIONS SEEN AND
WE HAVE A MUCH BY SENATOR PANTS
HERE'S.
RECOMMENDING AND I WOULD LIKE TO
CLOSE.
YES OF THANK YOU DOCTOR
HERNANDEZ AND I WANNA ALSO THANK
YOU FOR YOUR LEADERSHIP AND SP
FOUR NINETY THREE.
THAT ALLOWS US TO HAVE THIS
PLATFORM WITH WHICH TO FOR THE
PARTNER WITH OTHER HEALTHCARE
PROFESSIONALS I REALLY BELIEVE
IN PASSING.
SP TWELVE SIXTY FOUR WHICH WE
HOPE WILL MAKE IT TO THE
GOVERNOR'S DESK IS GOING TO SAVE
LIVES IN THE STATE OF
CALIFORNIA.
APPLY PROCEDURE CONSIDERATION
PLEASE I I MEAN I DON'T NUMBER
TWELVE SP WILL TWELVE SIXTY FOUR
STONE DO PASSES A MINUTE
APPROPRIATIONS COLOR MEMBERS
PLEASE.
HERNANDEZ AYE HERNANDEZ AYE
WHEN.
LEYVA LEYVA AYE MITCHELL.
MONNING AYE MONNING AYE NEWMAN.
NIELSEN. NIELSEN AYE PAN PAN AYE
ROCKS.
THE CURLY AS FIVE WE HAVE SOME
MAPS MEMBERS REALLY SAID BILL
AND CALL. WE'RE GONNA MOVE NOW
AND TO ITEM NUMBER FOURTEEN SP
TWELVE EIGHTY FIVE HEALTH CARE
COVERAGE ADVANCED PRACTICE
PHARMACIST.
THANK YOU AGAIN THAT DR ANAND IS
MISTER CHAIRMAN AND MEMBERS OF
THE COMMITTEE I'M PRESENTING. SP
TWELVE EIGHTY FIVE.
WE'VE BEEN TALKING ABOUT
ADVANCED PRACTICE PHARMACISTS
WHICH WERE CREATED BY S. BEFORE
NINETY THREE AUTHORED BY THE
CHAIR AS I MENTIONED BEFORE.
TO FUNCTION INDEPENDENTLY IN
INTER DEPENDENTLY BUT PRIMARILY
WORK IN A TEAM BASE OR IN AN
ORGANIZED SYSTEM OF HEALTH CARE.
PHYSICIANS USUALLY PROVIDE
OVERSIGHT AND DELEGATE AUTHORITY
TO THE PHARMACISTS ANNIE
PROTOCOL FASHIONED APPROACH.
TO EVIDENCE BASE HEALTHCARE
IMMERSING MODELS OF THIS.
THROUGHOUT THE STATE OF
CALIFORNIA.
HOWEVER IN CURRENT LAW. THERE IS
NO REQUIREMENT FOR HEALTH CARE
SERVICE PLANS TO COMPENSATE
ADVANCED PRACTICE PHARMACISTS
BUT THE COGNITIVE SERVICES.
UTILIZING THESE PHARMACISTS WILL
HELP MEET THE HIGH DEMAND FOR
PATIENTS WITH MULTIPLE
COMPLICATED CHRONIC CONDITIONS.
THAT TAKE MORE TIME TO MAINTAIN
AND CARE FOR. THROUGH THESE VERY
SPECIFIC SERVICES.
THE SERVICES WILL HELP LOWER
OVERALL HEALTHCARE COSTS BY
ENHANCING CLINICAL OVERSIGHT
FURTHER CONDITIONS AND
MEDICATION REGIMENS WHICH WILL
IMPROVE PATIENT OUTCOMES. AND
ULTIMATELY WILL IMPROVE THE
PATIENT'S QUALITY OF LIFE.
S. B. TWELVE EIGHTY FIVE WOULD
REQUIRE EVERY HEALTH CARE
SERVICE PLAN AND MEDI CAL
MANAGED. CARE PLAN.
THAT IS ISSUED STARTING IN TWO
THOUSAND AND NINETEEN TO PROVIDE
COVERAGE FOR SERVICES PROVIDED
BY IN ADVANCED PRACTICE
PHARMACIST.
AGAIN WE BELIEVE THIS IS GOING
TO SAVE THOSE HEALTH PLANS
MONEY.
AND ALLOW FOR ENHANCED SERVICES
FOR THESE PATIENTS.
IN ADDITION THE BILL WOULD
REQUIRE ADVANCED PRACTICE
PROMISES PERFORMING WITHIN THE
SCOPE OF THEIR PRACTICE
SUCH AS COMPREHENSIVE
COMPREHENSIVE MEDICATION
MANAGEMENT SERVICES.
TO BE A COVERED BENEFIT IN A
MEDI CAL MANAGED CARE PLAN.
S. B. TWELVE EIGHTY FIVE
RECOGNIZES THE VALUABLE ROLE THE
ADVANCE PHARMACISTS.
CURRENTLY FILLED WITH IN
CALIFORNIA'S HEALTH CARE SYSTEM
BY ENSURING THAT THEY
ARE-COMPENSATED FOR THE WORK
THEY DO
AND HOPEFULLY TRACKING MORE
PHARMACIST.
TO UNDERGO THE PROTOCOLS TO
BECOMING ADVANCED PRACTICE
PHARMACISTS AGAIN WITH ME IS
DOCTOR BRIAN HAWKINS FROM DOES
IT WASTES HEALTH CARE. THEY
WOULD LIKE TO SHARE WITH YOU
SOME OF THE SUCCESSES THAT HE'S
HAVING IN THE EASTERN CULTURE
LAVALLEE DOCTOR HAWKINS.
THANK YOU.
IT'S NO SURPRISE DATA.
OUR MEDICAL GROUP IS LIBERALLY
USING PHARMACIST TO ACTUALLY
ALLEVIATE SOME OF THE CLUTTER.
AND AND DIFFICULT PATIENTS ARE
MANAGED IN THE PRIMARY CARE
OFFICE.
AND AT AMERICAN ACADEMY FAMILY
PRACTICE JOURNAL IT BASICALLY
DEMONSTRATED THAT. FOR EVERY
POORLY CONTROLLED CHRONIC
CONDITIONS SUCH AS DIABETES CHF
CA DE.
COPD IT WOULD ADD AN ADDITIONAL
THREE AND A HALF HOURS TO THE
AVERAGE PHYSICIANS.
OFFICE PRACTICE
AND SO WHAT WE'RE TALKING ABOUT
TODAY IS REALLY.
HIGHLY TRAINED PHARMACISTS
PARTICIPATING IN A COLLABORATIVE
MANNER.
TO BUY IMPROVE THE HEALTH
WELFARE AND OUTCOMES OF THESE
PATIENTS WHICH IS FREE VISIT
THAT PATIENT CAROLINE. THAT I
MENTIONED EARLIER. IN THE
PREVIOUS BILL. WHEN SHE WAS
DISCHARGED FROM E. R. G. WAS
ABLE TO PICK UP HER MEDICATIONS
AND HOSPITAL PHARMACY.
THAT'S THE ONE CLINICIAN SHE
SEES THE MOST ON A CONSISTENT
BASIS AND SHE KNOWS HIM BY NAME.
THAT PHARMACIST IS SPECIALLY
TRAINED TO MANAGE COMPLEX
MEDICATION ISSUES.
HIS RESIDENCY TRAINING BOARD
CERTIFIED.
HE HAS OWN D. E. A. N. N. P. I
PROVIDER NUMBER AND IS WORKING
UNDER CLAMOR PRACTICE AGREEMENTS
WITH PHYSICIANS AND HAS BEEN
DOING SO FOR YEARS.
UNDER EXISTING STATE LAW THAT
PHARMACISTS CAN START AND STOP
MEDICATIONS MAKE ADJUSTMENTS
ORDER INTERPRET DRUG THERAPY.
AND RELATED TESTS AND PERFORM
PATIENT ASSESSMENTS. REFER
PATIENTS TO OTHER HEALTH
PROVIDERS IN SHORT SOLVE A
PROBLEM THEM BOTH ACCESS. AND
DIFFICULT TO MANAGE PATIENTS.
IN OUR MEDICAL GROUP.
WE MANAGE PATIENTS FACE TO FACE
OR PHARMACIST TO.
ENEMY JUST TEAR THE
CONTRIBUTION THAT MAKES. WHERE A
FULL RISK ORGANIZATION?
SO WE'RE AT RISK FOR ALL PATIENT
COSTS.
WHAT THIS IS THE BEEN
DEMONSTRATED IN OUR MODEL IS
THIS? FOR EVERY.
PATIENT IN OUR DIABETIC PROGRAM
THAT WE'VE MANAGED WHICH HAD A
TWENTY THREE PERCENT REDUCTION
IN HOSPITALIZATIONS. IN E. R.
AND ALL OTHER ACUTE CARE
UTILIZATION WE KNOW THE
PHARMACISTS ARE TRAINED TO DO
THIS PREPARE PROVIDE THE
SERVICE.
AND WE ARE NOW DEMONSTRATING A
SIX TO ONE ARE A WHY. IN THESE
PHARMACISTS WORKING IN THIS
CAPACITY.
I THINK IT WOULD BE INCUMBENT
UPON US TO IMPROVE THE HEALTH
AND WELFARE OF. CALIFORNIA
CITIZENS BY INCLUDING. THIS
PRINT PARTICULAR.
.
PATIENT CARE PROVIDER UNDER THE
AUSPICES AS OUTLINED BY THE.
SENATOR STONE.
THANK YOU DOCTOR.
THANK YOU ANY ANYONE ELSE IN
SUPPORT A YES JIM GROSS ABOUT
THE CALIFORNIA PHARMACISTS
ASSOCIATION.
I DO WANT TO NOTE THAT.
WHILE WE SUPPORT THE BILL WE
ALSO BEEN WORKING DIRECTLY WITH
A NUMBER OF HEALTH PLANS. ARE ON
PRECISELY THIS ISSUE AND UP MANY
OF THEM HAVE SHOWN A STRONG
INTEREST IN USING A PHARMACIST
IN THE RULES THAT.
THE SENATOR HAS DESCRIBED WILL
CONTINUE TO WORK WITH THOSE
PLANS BECAUSE I THOUGHT I WE
THINK THEY HAVE REALIZED THAT
VALUE OF THIS. AND WORKING
WITHIN THEIR SYSTEM IS DIFFICULT
TO. BUG ENSURE THE RIGHT BILLING
CODES AND THINGS OF THAT NATURE.
BUT I I DO WANT TO NOTE THERE
THEIR INTEREST IN IT AND WE WILL
CONTINUE TO HATE THOSE
DISCUSSIONS WITH THEM THANK YOU.
OKAY UP.
OPPOSITION.
SECOND PRIMETIME ON THE RIGHT
DOWN. SEVENTY WATKINS ON BEHALF
OF THE ASSOCIATION OF CALIFORNIA
LIFE AND HEALTH INSURANCE
COMPANIES FIVE LIKE TO APOLOGIZE
FOR WHERE'S THE TRAINING OUR SIX
MONTH OLD AND CLEARLY I NEED A
NAP.
WHEN WE WOULD AGAIN LIKE TO
THANK THE AUTHOR.
HIS WE MET WITH THE STAFF EARLY
ON AND THEY WERE VERY OPEN EYES
AND WE ARE SUPPORTIVE OF THE
ADVANCED BAND PRACTICED
PHARMACISTS AND EXPANDING SCOPE
AND ACCESS UNFORTUNATELY
BECAUSE.
WE DO THINK THAT THIS BILL IS
PREMATURE THERE IS A SMALL
NUMBER A SUBSET OF PHARMACISTS
WHO HAD THIS DESIGNATION I THINK
CHIPPER PREFERENCE TWO HUNDRED
SEVENTY NINE IN THE STATE OF
CALIFORNIA.
RIGHT NOW THERE'S NOTHING IN
THE BILL THAT REQUIRES THEM TO
ACTUALLY BE CONTRACTED WITH EYES
SNORE AND IT HERE TO OUR TERMS
AND CONDITIONS IN OUR CONTRACTS
WE REALLY DO VIEW THIS IS AN ANY
WILLING PROVIDER BILL. I'M SO
FOR THOSE REASONS WE WOULD LIKE
TO WORK WITH THE AUTHOR AND IN
THE FUTURE TO ENSURE THAT OUR.
ACCESS IN THAT WE DO I'M EMBRACE
THESE TYPES OF EXPANSIONIST CHO
BUT UNFORTUNATELY TODAY WE ARE
POSTED.
GOOD AFTERNOON JENNIFER RALLY
WITH THE CALIFORNIA ASSOCIATION
HEALTH PLANS I'D LIKE TO ECHO
THE COMMENTS MADE BY MISS
HAWKINS. ON BUT FOR ME IN THE
MEDICARE MANAGED CARE PLANS YOU
KNOW THEY DO PROVIDE A LOT OF.
MANAGEMENT FOR THEIR
BENEFICIARIES.
AND THAT'S DONE INTERNALLY AT
THE PLAN LEVEL AND SO WITH THE
REQUIREMENT FOR MEDI CAL MANAGED
CARE DICK TO CONTRACT AND COVER
WITH THESE THAT WE DO HAVE SOME
CONCERNS THAT THERE COULD BE.
DUPLICATION OF SERVICES AND AND
ALSO ADDITIONAL CONCERNS.
REGARDING THE NETWORK
REQUIREMENTS WHEN THERE IS SUCH
A A LIMITED NUMBER OF THOSE
PROVIDERS.
THANK IS ANYONE ELSE IN
OPPOSITION. A JOHN WINGER ON
BEHALF AMERICA'S HEALTH
INSURANCE PLANS WOULD ECHO THE
SAME CONCERNS ON ANY WILLING
PROVIDER THANKS THANK YOU.
NOT QUESTIONS COMMENTS FROM ANY
OF THE MEMBERS.
PALM.
A. CENTER NIELSEN WITH THE BILL
I'VE.
HAVE SOME COMMENTS AND.
MAYBE POSSIBLY QUESTION
SWIMMING.
PREFERRED START OFF BY SAYING
THAT YES. OBVIOUSLY I THINK IT'S
VERY VERY IMPORTANT THAT WE
UTILIZE PHARMACISTS.
I AUTHORS BEFORE NINETY THREE
ALMOST IT WAS PUT INTO STATUTE
IN SCIENCE LAW ALMOST FIVE YEARS
AGO. THE REGULATORY PROCESS WAS
A VERY VERY LENGTHY ONE SO WAS
UNTIL I TWENTY SIXTEEN.
AND.
THE GOOD NEWS IS THAT LAWS NOW
BECOMING KIND OF A NATIONAL
MODEL FOR THE REST OF THE
COUNTRY.
.
WHAT I SAW THE ROLE OF THE
PHARMACISTS IS BEING EXACTLY
WHAT YOU SAID TO BE AN INTRICATE
PART OF THE HEALTHCARE SYSTEM?
AND WORK IN COLLABORATION WITH
ALL OF THE PROVIDERS AS WITH ANY
MEDICAL HOME.
I'M I I'VE I WAS TORN WITH YOUR
FIRST BILL. AND WAS TORN FOR A
COUPLE REASONS BECAUSE I'M NOT I
DON'T LIKE MANDATES BUT BECAUSE
THIS WAS VERY VERY NARROW AND IT
WAS DEALING WITH. HIGH BLOOD
PRESSURE AND WAS SURPRISED OF
EVIDENCE THAT SHOWED YOU KNOW
AND BECAUSE IT KIND OF MIRRORED
WHAT THE.
.
WHAT ASSEMBLY BILL DID SO I WAS
SUPPORTIVE OF IT?
OR I'M CONCERNED HERE AND.
I HAVE A REAL CONCERN WITH.
PUTTING INTO STATUTE.
PAYMENT FOR A PROFESSION.
I REALLY BELIEVE THAT THE
MARKET NEEDS TO PLAY ITSELF OUT
NATURALLY.
I BELIEVE MISTER GROSS
MENTIONED THAT THE ASSOCIATION
IS WORKING WITH THE PLANTS.
AND I THINK WHAT YOU'RE GONNA
SEE IS THAT YOU'RE GOING TO SEE
THE PROFESSION WILL BE A VALUE
TO PLANTS AND THEN THEY WILL
NATURALLY START CONTRACTING.
AND THAT'S WHERE MY MY CONCERN
Y. PUT MY PUBLIC POLICY HAD ON
HIS.
YOU KNOW WHAT WE SHOULD BE IN
THE BUSINESS HERE IN THE
LEGISLATURE TO GOVERN WHO COVERS
WHAT AND THAT'S WHERE WE'RE I'M
I'M KINDA TORN SO. BECAUSE OF
THAT. ARM I CAN'T SUPPORT THE
BILL.
AND SO WITH THAT DOM I LIKE TO
SEE LIKE A CLOSE.
WELL FIRST OF ALL THANK YOU
AGAIN FOR YOUR LEADERSHIP ON SP
FOUR NINETY THREE AND.
JUST A FEW COMMENTS TO IF I CAN.
.
I RECOGNIZE THAT WE DON'T HAVE.
A LOT OF ADVANCE PRACTICE
PHARMACISTS YET. WE HAVE MANY
THAT ARE AND RESIDENCIES CENTER
ARE GOING TO BE.
HOPEFULLY FINDING THEMSELVES TO
BE UNIQUELY.
PARTICIPATORY THE HEALTH HEALTH
CARE PROCESS AND A CALIFORNIA TO
SAY WE KNOW WE'RE CALIFORNIA
GOES THE REST OF THE NATION
GOES.
I LIKE TO BE ON THAT LEADING
EDGE ESPECIALLY WHEN IT COMES TO
THE DELIVERANCE OF A PHARMACY
SERVICES. SO I I THINK THAN THE
SMALLER NUMBER OF PHARMACISTS
SITTER. WOULD BE INCLUDED IF
THIS WERE TO PASS IS ACTUALLY.
A POSITIVE THING BECAUSE I KIND
OF SEE IT AS A DEMONSTRATION
PROJECT TO REALLY SEE.
WELL THESE HEALTH PLANS REALLY
SAVE MONEY. ADDUCTOR HAWKINS
SAYS THAT THERE'S A SIX TO ONE
RETURN ON INVESTMENT.
SO YOU HAVE PATIENTS THAT. ARE
SOMETIMES VERY DIFFICULT TO
CONTROLS DR PANOS DIABETIC
PATIENTS CAN BE EXTREMELY
CHALLENGING.
AND WHEN THEY GET RE ADMITTED TO
THE HOSPITAL TO GET RE ADMITTED
TO THE EMERGENCY ROOM IT IT
COMES AT SIGNIFICANT EXPENSE.
ESPECIALLY TO THE STATE.
WE ALSO KNOW THAT.
THERE IS NOT A LOT OF
PARTICIPATION.
WITH PRIMARY CARE PHYSICIANS IN
THE MEDICAL PROGRAM IN THE STATE
OF CALIFORNIA.
THAT IS ONE THING THAT I'VE BEEN
TRYING TO CHAMPION SINCE I'VE
BEEN SITTING ON BUDGETSOF THREE
WITH MY GOOD FRIEND SENATOR
MONNING AND DOCTOR PAN. WE DON'T
PAY OUR PHYSICIANS ENOUGH TO
CARE FOR THE POPULATIONS THAT
ARE RISK
THAT NEED THAT CARE AND I WILL
CONTINUE TO ADVOCATE. THAT THOSE
FEES GET INCREASED.
PHARMACISTS ARE WILLING TO WORK
FOR EIGHTY FIVE PERCENT OF THAT
PRESENT FEED.
TO PROVIDE FOR THAT OVERSIGHT TO
HOPEFULLY PREVENT THAT DIABETIC
FROM GOING INTO A CRISIS OR GOD
FORBID LOSING THEIR LIFE.
OR THE PHYSICIAN IS BEING PULLED
FROM THE RIGHT IS BEING PULLED
FROM THE LEFT ABOVE AND BELOW.
THEY'RE OVERWORKED YOU'RE SAYING
A LOT OF PATIENCE THIS IS JUST A
SAFETY VALVE TO ALLOW US TO
PARTNER. WITH THE PHYSICIANS IN
THE BEST INTEREST OF PROVIDING.
STATE OF THE ART.
I ADVANCE CARE.
I IN A STATE THAT ALWAYS LEADS.
SO I RESPECT THOUGH THE WILL OF
THE OF THE TOUCH CHAIRMAN.
.
I WOULD RESPECTFULLY ASK YOUR
AYE VOTE IS IN THE BEST
INTERESTS OF PATIENT SAFETY AND.
PREVENTING THEM FROM HAVING TO
GET BACK.
INTO THE HOSPITAL IN CASES
WHERE.
WE CAN POSSIBLY PREVENT THAT
MORBIDITY AND POTENTIAL
MORTALITY.
OF RESPECTFULLY ASK YOUR VOTE.
WOULD ITEM NUMBER.
FOURTEEN S. B. TWELVE EIGHTY
FIVE DO PASSED APPROPRIATIONS
CHAIR IS VOTING NO CALL THE
MEMBERS PLEASE HERNANDEZ SO AND
AND IS NO WHEN.
LEYVA.
LEYVA NOW MITCHELL. MONNING.
MONNING NO NEWMAN.
NIELSEN.
NIELSEN AYE PAN.
AND NO ROTH.
CURRENT OF O'CONNOR'S WHEN THE
FLOOR WILL PLACE A BILL AND
CALL.
FOR IT ITEM NUMBER SEVENTEEN S.
B. THIRTEEN TWENTY TWO STONE
MEDI CAL COMPREHENSIVE
MEDICATION MANAGEMENT.
THANK YOU AGAIN MISTER CHAIR
JUST PIGGYBACKING ON THE PAT
LAST TWO BILLS THIS IS A PART OF
THE TRIAD SWEET FOR.
ADVANCED PRACTICE PHARMACISTS.
COMPREHENSIVE MEDICATION
MANAGEMENT OR CCM IS A STANDARD
OF CARE THAT ENSURES HE'S
PATIENTS MEDICATIONS ARE
INDIVIDUALLY
SOUTH STE
TERMIN. THAT EACH MEDICATION IS
APPROPRIATE FOR THE PATIENT
EFFECTIVE FOR THE MEDICAL
CONDITION.
STATE GIVEN THE ILLNESSES AND
OTHER MEDICATIONS TAKEN AND.
ABLE TO BE TAKEN BY THE PATIENT
AS INTENDED.
AN ABUNDANCE OF EVIDENCE THIS
PARTICULAR IN THE PAST SEVERAL
YEARS INDICATES THAT CCM APPLY
TO PATIENTS AT RISK FOR CHRONIC
DISEASE COMPLICATIONS.
AND ASSOCIATED COSTS IMPROVES.
BUT QUADRUPLE AIM OF POPULATION
HEALTH LOWER COST
BETTER HEALTH OUTCOMES.
IMPROVE PATIENTS
AND PROVIDER SATISFACTION.
ALTHOUGH CURRENT LAW RECOGNIZES
PHARMACISTS AS HEALTHCARE
PROVIDERS IT DOES NOT MANDATE.
THE MEDIC HELP PAY FOR CLINICAL
SERVICES FROM PHARMACIST BEYOND
WHAT. OCCURS WITHIN PHARMACIES
TODAY AS AN EXAMPLE SMOKING
CESSATION SERVICES ORAL
CONTRACEPTIVES IMMUNIZATIONS
ETCETERA.
NO PAYMENT IS MANDATED FOR.
A FOR NON PAYMENT IS MANDATE FOR
MANAGEMENT OF COMPLEX MEDICATION
THERAPIES THAT ENSURE
SUCCESSFUL.
TREATMENT OUTCOMES
S. B. THIRTEEN TWENTY TO WILL
DESIGNATE COMPREHENSIVE
MEDICATION MANAGEMENT CCM AS A
COVERED BENEFIT UNDER MEDICARE
OPEN APPLY TO PATIENTS.
AT HIGH RISK FOR COMPLICATIONS
FROM POORLY CONTROLLED CHRONIC
DISEASES THE START DESPITE
RECEIVING USUAL MEDICAL CARE.
APPLYING CCM TO PATIENTS WHO ARE
NEAR THE POINT OF NEEDING
COMPLEX AND EXPENSIVE MEDICARE.
WILL HELP ENSURE BETTER HEALTH
OUTCOMES EFFECTIVE HEALTHCARE
DOLLARS IN IMPROVED PATIENT
SATISFACTION.
FOR LAST TIME TODAY DOCTOR
HAWKINS AGAIN THANK YOU FOR
FLYING ALL THE WAY UP THE
COACHELLA VALLEY.
HE IS MY WITNESS.
WELL THANK YOU VERY MUCH.
YEAH I'M.
I WISH I WISH I COULD SAY TODAY
THAT THIS IS USUAL CARE.
BUT REALLY WHAT WE'RE TALKING
ABOUT IS REALLY UNUSUAL CARE NO
CARE POOR CARE FRAGMENTED CARE.
AND THIS IS ONE WAY I THINK WE
CAN SOLVE THE PROBLEM ONCE AGAIN
WORKING IN AT COLLABORATED. A
MANNER WITH PHYSICIANS.
BOB PHARMACISTS WERE
SPECIFICALLY TRAINED TO ADDRESS
CHRONIC CONDITIONS.
ALLOWS THESE PATIENTS TO ACCESS
THE SYSTEM. AND DERIVE BETTER
OUTCOMES IN BETTER HEALTH.
BY CHANGES IN.
INCOMPREHENSIBLE MEDICATION
MANAGEMENT IT'S A LOGICAL
EXTENSION OF HYPERTENSION. ISSUE
IN THAT OUR OUR FARMERS IS
MANAGE HEPATITIS C.. DIABETES
COPD C. A. D. CHF.
AND SO THAT PATIENT CAROLINE
THAT WE'RE TALKING ABOUT IS
FULLY ADDRESSED IN A SINGLE
MODEL OF CARE ALMOST IN A
PATIENT. CENTERED HOME.
THE SOME OF THE ANALYSIS THAT
WAS DONE ALTHOUGH I CAN
APPRECIATE REFERENCED.
ARE.
RANDOMIZED CONTROL TRIALS COME
AND LOOKING AT USUAL CARE IN THE
ONE THING THAT I WOULD JUST
POINT OUT IS THAT.
IN ALL THOSE TRIALS AT THEY DID
LOOK AT. RANDOMIZED CONTROL
TRIALS THERE'S A ABUNDANT
EVIDENCE THAT DEMONSTRATES
REDUCTION IN COST IMPROVE HEALTH
CARE OUTCOMES DECREASE
HOSPITALIZATIONS. WHEN PATIENTS
GET TO THERAPEUTIC CALLS BETTER.
AND FASTER FOR EVERY DROPPING
HEMOGLOBIN A. ONE C. WHICH IS.
A SURROGATE MARKER FOR DIABETIC
CONTROL IS A FORTY PERCENT
DECREASE IN CARDIOVASCULAR.
MORBIDITY AND AND EVENTUALLY
MORTALITY.
SO FOR EVERY CALIFORNIAN
SUFFERING FROM CHRONIC
CONDITIONS OR DISEASES AMENABLE
TO PRIMARY MEDICATION DIRECTED
THERAPY BUT IS NOT GET
TREATMENT.
THE STATE SUFFERS MORE
DISABILITY COMPLICATIONS.
HIGHLY PREVENTABLE FOR DIABETIC
THAT'S BLINDNESS DIALYSIS
AMPUTATIONS FOR HYPERTENSION IT
COULD BE STROKES.
AND DISABILITY IN
CARDIOVASCULAR.
MORBIDITY MORTALITY.
THIS IS A LOGICAL EXTENSION TO
PROVIDE COMPREHENSIVE AND
FOCUSED THERAPY. ONLY UNDER THE
GUIDANCE IN IN WELL WRITTEN
PROTOCOLS WITH PHYSICIANS TO
PROVIDE A MUCH NEEDED SERVICE
AND IMPROVE THE ACCESS AND
ENHANCE THE. HEALTH AND WELLNESS
OF. BOB PATIENTS WHO WERE.
STRUGGLING RIGHT NOW TO ACCESS
THE SYSTEM IN AND GET DEFINITIVE
CARE.
NELSON SUPPORT.
MICHAEL SO PROVINCE IN JUST OF
HEALTH AND SUPPORT.
THROUGH OPPOSITION.
GOOD AFTERNOON JENNIFER ALI
AGAIN WITH CALIFORNIA
ASSOCIATION OF HEALTH OF HEALTH
PLANS. OMEN WE ARE POST THE
SPELLING AND WE'RE NOT DEBATING
THE EFFECTIVENESS OF THIS.
.
TYPE OF PROVIDER THE VANCE
PRACTICE.
PRACTICE FOUND PHARMACIST
HOWEVER WE DO HAVE CONCERNS
REGARDING THE REQUIREMENT THAT
WE COVER THIS IS A BENEFIT TO
JUST SIMPLY ISN'T ENOUGH.
PROVIDERS AVAILABLE FOR MY
MEMBERS TO MEET THE NETWORK
REQUIREMENTS THAT WOULD. BE
ASSOCIATED WITH SUCH A MANDATE.
MOM AND LITTLE BIT DIFFERENTLY
NO IN IN MEDI CAL MANAGED CARE
THERE'S A LOT OF DISEASE
MANAGEMENT SPECIALTY PROGRAMS.
AND.
TO THE EXTENT THAT YOU KNOW. ON.
EITHER OF SENATE CONTINUING CARE
INITIATIVE OR YOUR LONG TERM
SICK CARE SERVICES AND SUPPORTS
YOU KNOW MEDICATION MANAGEMENT
IS A COMPONENT OF THOSE EXISTING
PROGRAMS WITHIN THE MEDICAL
FRAME
WORK.
AND.
YOU KNOW MY MEMBERS ALSO HAVE
THE ABILITY IN MEDI CAL.
TO IDENTIFY MEMBERS YOU KNOW
THEIR ENROLLEES WHO WOULD
BENEFIT FROM. A MEDICATION
THERAPY MANAGEMENT AND THIS IS
DONE INTERNALLY AT THE PLAN
LEVEL.
AND AS AN ON NEEDED. AS AN.
ON AN AS NEEDED BASIS FOR
PATIENTS DEEMED COMPLEX SUCH AS
MEMBERS ADDS A A HIGH RISK FOR
RE ADMISSION TO HOSPITAL.
MEMBERS AT HIGH RISK OF FOR
OPIATES OR CONTROLLED. BY A DRUG
OVER TILIZATION SADDAM MEMBERS
POORLY CONTROLLED ON MEDICATION
THAT WOULD BENEFIT FROM CASE
MANAGEMENT ASSISTANCE.
AND SO THE PLAN'S INTERNAL
RESOURCES CURRENTLY PROVIDE THAT
FUNCTION AND ROLE THEY WORK AND
THEY REACH OUT AND WORK WITH
THEIR UNRULY.
TO ADDRESS THAT AND THIS WOULD
YOM.
THE WRITTEN MANDATE THAT CAN
COMPONENT PART OF THIS BILL
COULD DRIVE DAILY TO PLANS
RESOURCES AND DECREASE THE
EFFECTIVENESS OF THEON GOING IN
INTERVENTIONS AT THE PLANTS ARE
INVOLVED AND.
.
AND SO YOU KNOW WE JUST HAVE
SOME CONCERNS WITH HOW WOULD
OPERATE WITHIN THE FULL SCOPE OF
THE MEDICAL PROGRAM IT FOR THOSE
REASONS THAT REMAIN OPPOSED
THANK YOU THANK YOU.
EXCUSE ME ANYONE ELSE AND UP.
OPPOSITION NOTHING MISTER CHAIR
AND MEMBERS WHO SHOPPACH WITH
THE CALIFORNIA MEDICAL
ASSOCIATION WE DO HAVE AN
OPPOSING LESS AMENDED POSITION
ON THE BILL AND. WE BELIEVE IT'S
KILEY WRITTEN TOTAL IS UNCLEAR
AS TO WHETHER.
CMM SERVICES
PROVIDED WOULD BE WITHIN THAT.
TIME SINCE CURRENT SCOPE OF
PRACTICE COMES MY UNDERSTANDING
THAT THE INTENT IS TO PROVIDE
SERVICES THAT ARE WITHIN.
CURRENT SCOPE SO LOOKING
FORWARD TO CONTINUING TO WORK
WITH THE AUTHORS OFFICE ON THIS
ISSUE AND AND WORKING ON SOME.
CLARIFYING LANGUAGE THANK YOU.
THANK YOU ANY QUESTIONS I MEAN
ANYONE ELSE IN OPPOSITION.
QUESTIONS COMMENTS FOR MANY OF
THE MEMBERS.
CENTER STONE I MEAN THIS ONE
THAT WAS TORN. WITH EMOTION BY
SIR NIELSEN I WAS AGAIN TORN BY
THIS ONE OF YOU SEE IN THE FOR
YOUR FIRST BILL CHIPPER UPON THE
STRONGEST. EVIDENCE WAS ON BLOOD
PRESSURE BUT.
YOU KNOW I THINK THE DEFINITION
WHO IS ELIGIBLE FOR CONFERENCE
OF MEDICAL MANAGEMENT IS VERY
BROAD AND.
ULTIMATELY NOT CONVINCING
EVIDENCE FOR A MEDICAL COVERED
REQUIREMENTS SO YOU KNOW I WON'T
BE SUPPORTING THIS WHEN I THERE
SO WITH THAT WOULD YOU LIKE
CLOSE.
BOB OF THE AGAINST THE THANK YOU
FOR FOR YOUR CONSIDERATION OF
ALL THREE BILLS SO CENTER
HERNANDEZ AND I'LL ALWAYS BE
GRATEFUL FOR YOUR LEADERSHIP ON
THIS BEFORE NINETY THREE.
AND.
AND WE HOPE TO.
HAVE MORE. EPIDEMIOLOGICAL
EVIDENCE TO SHOW THAT THERE IS.
BENEFIT TO INCREASING UP
PROGRAMS LIKE THIS IS FROM THE
RESPECT YOUR YOUR YOUR POSITION
A DISTANT ACCOUNT OF THE PLANS.
I PERSONALLY THINK THAT THE
PLANS ARE A LITTLE BIT SHORT
SIGHTED AND THEY DON'T LOOK TO
THE LONG TERM.
WHEN YOU TALK ABOUT.
INTERVENING IN THE FRONT AND
AND I KNOW THEY SAY THAT THEY
HAVE SOME SERVICES WHERE THEY
INTERVENE BUT.
THE THE RE ADMISSION RATE IS
STILL HIGHER THAN THEY PROBABLY
WOULD LIKE. AND IF IF IF IF
THERE WAS A PILOT PROGRAM THAT
COULD DEMONSTRATE THE RETURN ON
INVESTMENT.
OF SIX TO ONE AND SHOW THAT
THERE REDUCE READMISSIONS AND
REDUCING MORBIDITY AND
MORTALITY.
I WOULD HOPE THAT THEY WOULD BE
MORE OPEN MINDED TO THIS.
IN THE FUTURE WHICH WE FULLY
INTEND TO TRY TO BRING BACK A
LITTLE BIT MORE PERSUASIVE
EVIDENCE BUT THANK YOU FOR YOUR
CONSIDERATION. MEMBERS I GREATLY
APPRECIATE YOUR YOUR COMMENTS
HERE TODAY APPRECIATE. YOUR HELP
AND IF IT DOESN'T UP ADVANCE WE
COULD AFTER RECONSIDERATION
PLEROMA XIN BY A CENTER NIELSEN
WE HAVE ITEM NUMBER SEVENTEEN S.
B. THIRTEEN TWENTY TWO.
YOU PASS TO APPROPRIATIONS CALL
THE MEMBERS PLEASE.
HERNANDEZ THOUGH NANDO'S KNOW
WHEN.
LEYVA.
MITCHELL. MONNING NO MONEY AND
NO NEWMAN.
NIELSEN.
PAN.
ROTH.
IT'S US ZERO TWO WILL PLACE A
BILL IN CONCRETE IT'S
FEDERATION.
WE HAVE ITEM NUMBER.
THIRTEEN I S. B. TWELVE SEVENTY
EIGHT WESO. OFFICER OF.
BY NATIONAL ON BORDER HEALTH.
VETERAN SENATOR.
THANK YOU.
THANK YOU WAS CHAIR MEMBERS.
PROUD TO PRESENT S. B. TWELVE
SEVENTY EIGHT.
THIS BILL RELATES TO THE OFFICE
OF BI NATIONAL BORDER HEALTH
IMPROVING PUBLIC HEALTH
CONDITIONS ON THE BORDER REGION.
I IT WAS DONE SO TO ADDRESS.
SOME OF THE CHALLENGES OF
PROVIDING.
HEALTH SUPPORT IN AREAS THAT
HAVE.
LOTS OF.
.
A.
THE MOVEMENTS OF ACROSS ACROSS
THE BORDER.
ED THIS BILL THIS.
OFFICE.
WAS ESTABLISHED.
OVER TWELVE YEARS AGO.
AND IN THE PROCESS THEY'VE
RECEIVED FUNDING FROM THE STATE.
TO TO IMPROVE PUBLIC HEALTH.
WHERE WE'RE TRYING TO? MAXIMIZE
LIMITED STATE RESOURCES IN THIS
BILL AND RICK THIS BILL WOULD
REQUIRE THE OFFICE TO PROVIDE
THE LEGISLATURE. WITH CHANGES IN
THE LAW NECESSARY TO IMPROVE
COLLABORATION AND COMMUNICATION
BETWEEN THE WO COUNTRIES A
UNITED STATES AND MEXICO
SPECIFICALLY.
CALIFORNIA AND BROCCOLI FOR NOW.
THIS BILL ALSO SEEKS TO ADDRESS
ISSUES REGARDING TRANSPARENCY
AND ACCOUNTABILITY BY REQUIRING.
THAT OFFICE TO UPDATE THEIR SIX
STRATEGIC PLAN EVERY TWO YEARS
AT POST SEPT PLAN ONLINE.
BASICALLY.
YOU KNOW WE WE WERE PUTTING
MONEY INTO THIS PROGRAM TO
IMPROVE.
BORDER HEALTH YET.
.
THERE THERE ISN'T A A A DETAILED
STRATEGIC PLAN OF HOW TO.
WE HAVE AN AREA THAT HAS VERY
HIGH RATES OF ASTHMA WE HAVE
VERY HIGH RATES. OF OF DIABETES.
.
SEXUALLY TRANSMITTED DISEASES.
WE HAVE EVEN PROBLEMS WITH
TIMBER TUBERCULOSIS IN THE
SERIOUS AND AND.
THESE AREA THESE PROBLEMS RARE
LEASE SEE THE LIGHT OF DAY IN
TERMS OF ADVOCACY INEPT AND
ATTENTION.
FROM.
THOSE AGENCIES THAT ARE ABLE.
AND REQUIRED TO PROVIDE THE
SUPPORT TO THE PEOPLE THERE NEED
OF THESE SERVICES SO.
WE'RE TRYING TO THE IT IMPROVE
THE WAY WE DELIVER HEALTHCARE TO
THE PEOPLE THE BORDER REGION AND
THIS BILL WILL HELP US.
.
BUT TO DO THAT BY ENGAGING THIS
OFFICE A LITTLE MORE IN
FORMULATING A STRATEGIC PLAN.
SO WE ASK FOR YOUR SUPPORT FOR
THIS IMPORTANT MEASURE AND
HELPING TO SUPPORT. THAT SAID
THE HELP THE PEOPLE OF OUR
COMMUNITY. THANK YOU WHO LIKE TO
SPEAK IN SUPPORT OF THE ISSUE.
IS THERE ANY OPPOSITION.
QUESTIONS COMMENTS FOR MANY OF
THE MEMBERS.
WE.
BUT NO QUESTIONS CUT.
BUT.
WE HAVE A. MOTION BY SENATOR.
SHARES ARE RECOMMENDING AND I
WOULD LIKE TO CLOSE SENATOR.
THANK YOU JUST ASK FOR YOUR
SUPPORT BRIT ITEM NUMBER
THIRTEEN S. B. TWELVE SEVENTY
EIGHT TO PASSED APPROPRIATIONS
CALL THE MEMBERS PLEASE.
HERNANDEZ AYE HERNANDEZ AYE
WHEN.
LEYVA. MITCHELL. MONNING AYE
MONNING AYE NEWMAN AYE.
NEWMAN AYE NIELSEN. NIELSEN AYE
PAN AYE AND I ROTH.
COULD VOTE KERN IS FIVE ZERO
WILL PLACE A BILL AND CALL THANK
YOU.
SENATE HANSON'S TWENTY YEARS.
WE'VE GOTTA ITEM NUMBER SIX S.
B. ONE ONE ZERO ONE PAN MENTAL
HEALTH.
PROGRESS IN PLEASE PLEASE
PROCEED ALRIGHT THANK YOU MISS
FARAH THANK YOU CHAIR. CENTERS A
SB ELEVEN NO ONE WILL REQUIRED
TO MENTAL HEALTH SERVICES OVER
SEND ACCOUNTABILITY COMMISSION
DO ACT TO WORK WITH STAKEHOLDERS
AND EXPERTS TO DEVELOP A SERIES
OF STATEWIDE OBJECTIVES RELATED
TO MENTAL HEALTH.
DUE TO MULTIPLE FUNDING STREAMS
IN THE DISPERSAL RESPONSIBLY
CROSS COUNTIES THERE BEEN
THERE'S BEEN VERY LITTLE IN THE
WAY OF COHESIVE STATEWIDE
LEADERSHIP ON MENTAL HEALTH
SPENDING.
THIS LACK OF LEADERSHIP WAS
HIGHLIGHTED IN A RECENT REPORT
BY THE CALIFORNIA STATE AUDITOR
WHICH FOUND THAT LOCAL MENTAL
HEALTH AGENCIES HAVE ACUTELY
ABOUT TWO HUNDRED THIRTY ONE
MILLION DOLLARS IN UNSPENT FUNDS
DURING FISCAL YEAR TWENTY
FIFTEEN. TWENTY SIXTEEN AND
WHILE SOME COUNTIES HAVE
ACHIEVED SIGNIFICANT PROGRESS
TOWARD ADDRESSING TO COMMUNITIES
MENTAL HEALTH NEEDS MANY OTHERS
HAVE FAILED TO REACH YOUR
POTENTIAL. I WOULD MAKE NOTE
THAT I'M IN A HE OVER AND
HEARING ON THAT AUDIT I IT WAS
STATED.
BY.
SOME OF THE WITNESSES THAT
SUNSET THE FIRES THAT THERE IS A
NEED FOR A STATEWIDE MENTAL
HEALTH STRATEGIC PLAN THAT WE
DON'T HAVE A STATEWIDE. APPROACH
TO ADDRESSING SOME OF OUR
STATEWIDE MENTAL HEALTH ISSUES
SO BY ESTABLISHING STATEWIDE
MENTAL HEALTH OBJECTIVES ALONG
WITH CORRESPONDING METRICS TO
MEASURE PROGRESS TOWARD EACH
GOAL S. B. ELEVEN NO ONE WILL
PROVIDES FRAMEWORK IN WHICH
COUNTIES CAN BUILD. ALL
OBJECTIVE METRICS WILL BE
REVIEWED EVERY FIVE YEARS
ENSURING THAT OUR STATEWIDE
STRATEGY REMAINS UPDATED AND
RELEVANT. AT THE END OF EACH
FISCAL YEAR COUNTIES REPORT BACK
TO LEGISLATURE AND THE.
WE SEE TUMORS DESCRIBE THE
PROGNOSTIC MADE UNDER EACH
OBJECTIVE USING THEIR MHSAA
MEDICARE ALAN MEDICAID.
MEDICAL FUNDS
WE BELIEVE THAT THIS WILL HELP
SET OUR STATE MENTAL HEALTH
SYSTEM ON A COURSE THAT WOULD
LEAD TO ALL COUNTIES HAVING TO.
HAVING ABILITY WILL DIRECTION TO
LEVERAGE YOUR FUNDING IS A
TANGIBLE CHANGE FOR THEIR
COMMUNITIES INDIGESTION TO THE
OBJECTIVES OF METRICS ARE BUT
ALSO POWERS THE OTC TO DEVELOP A
REPORT A STRATEGY DEL GUIDE
COUNTIES REPORTING PROCESSES AND
DATA AMONG. AGENCIES AND ALSO ON
THE STREAMLINED YOUR EXISTING
REPORTING REQUIREMENTS.
I WOULD MAKE NOTE THAT THIS BILL
DOES NOT.
PROVIDE PREVENTIVE COUNTY FROM
IDENTIFYING THEIR OWN OBJECTIVES
BUT AGAIN ESTABLISH A STATEWIDE
GOALS AND WHICH WE CAN HELP LINE
SO TODAY WITH ME I HAVE CORDONED
DOWDY WITH FROM THE AMERICAN
FOUNDATION FOR SUICIDE
PREVENTION TO TESTIFY
RESPECTFULLY ASK WHEN I FELT.
NOT PLEASE PROCEED.
GOOD AFTERNOON CENTER HERNANDEZ
AND COMMITTEE MEMBERS I'D LIKE
TO THANK DOCTOR PAN FOR HIS
CONTINUED LEADERSHIP. ON
IMPROVING CALIFORNIA'S MENTAL
HEALTH SYSTEM. AND THIS
OPPORTUNITY TO SPEAK BEFORE YOU.
HE SAID MY NAME IS GORDON DOWDY
I'M A BOARD MEMBER THAT GREATER
SAN FRANCISCO BAY AREA CHAPTER
THE AMERICAN FOUNDATION FOR
SUICIDE PREVENTION.
I ALSO SERVE ON THREE COUNTY
MENTAL HEALTH SUICIDE PREVENTION
COMMITTEES.
AND I'M HERE TODAY TO URGE YOU
TO SUPPORT SP ELEVEN NO ONE. WE
KNOW THAT OUR MENTAL HEALTH
SYSTEM MUST RISE TO THE
CHALLENGE TO MEET ENORMOUS UNMET
NEEDS EXISTING AND OUR STATE
NATIONWIDE ABOUT ONE IN FOUR.
ADULTS EXPERIENCE A MENTAL
HEALTH DISORDER IN ANY GIVEN
YEAR.
AND HERE IN OUR STATE EVERY TWO
HOURS WE LOSE SOMEONE TO
SUICIDE.
IN FACT SUICIDES A THIRD LEADING
CAUSE OF DEATH AMONG YOUNG
PEOPLE AGED TEN THROUGH TWENTY
FOUR. AND THE SECOND LEADING
CAUSE OF DEATH FOR THOSE TWENTY
FIVE THROUGH THIRTY FOUR.
CALIFORNIA ACCOUNTS FOR NINE
POINT FIVE ALMOST TEN PERCENT OF
THE NATION'S SUICIDES.
WE ALSO KNOW THAT. DESPITE THE
SIGNIFICANT FUNDS ALLOCATED
THROUGH THE MENTAL HEALTH ACROSS
THE STATE.
WITH MENTAL HEALTH SERVICES ACT
MEDI CAL MEDICAID. MANY COUNTIES
ARE STRUGGLING TO USE THE
RESOURCES
TO BRING OUT MANY EXPELLED
CHANGE TO THEIR COMMUNITIES.
THE MENTAL HEALTH OBJECTIVES.
THAT S. B. ELEVEN A ONE CHARGE
THE OVERSIGHT AND ACCOUNTABILITY
COMMISSION WITH CREATING. WILL
PROVIDE A MEANINGFUL STATE LEVEL
ROADMAP FOR THESE COUNTIES BUT
HAVE BEEN UNABLE TO MAKE USE OF
THE MAJORITY OF THEIR.
MH ESSAY FUNDS.
WHEN I RETIRED FROM A MAJOR
CALIFORNIA CORPORATION IN TWO
THOUSAND AND NINE PART OF MY
RETIREMENT WAS THAT. THE
CORPORATION.
WENT THE WAY OF CREATING LINES
OF BUSINESS.
THOSE LINES OF BUSINESSES BECAME
ASYLUMS.
AND MY CONCERN WAS THAT NO ONE
WAS LOOKING OUT FOR THE.
CORPORATION BUT THEY WERE JUST
LOOKING OUT AFTER THEIR OWN
SILOS.
CURRENTLY OUR COUNTIES ARE
FUNCTIONING AS FIFTY EIGHT
SILOS.
WITH AN INCREASED NEED TO
STRATEGICALLY.
COMBINE THEM TOGETHER WITHOUT
THE COUNTIES LOSING THEIR
ABILITY TO SERVE THEIR UNIQUE
POPULATIONS.
SHARE BEST PRACTICES AND DO SOME
OF THOSE THINGS ARE SYSTEM KERN.
CURRENT SHORTCOMINGS WERE MADE
EVIDENT BY THE RECENT AUDITOR'S
REPORT ON MHSAA FUNDING
MENTIONED BY DOCTOR PAN. IN
ADDITION TO OVER TWO HUNDRED
MILLION DOLLARS OF UNSPENT FUNDS
THE COUNTIES ARE ALSO HOLDING
BETWEEN A HUNDRED FIFTY SEVEN IN
ON TWO HUNDRED AND SEVENTY FOUR
MILLION. MHSAA DOLLARS IN EXCESS
RESERVES.
THANKS FOR THE AUDIT WE HAVE A
MORE. CONCRETE UNDERSTANDING OF
THE DIFFICULTIES COUNTIES ARE
FACING WHEN IT COMES TO USING
THEIR FUNDS.
NOW IT'S TIME TO PROVIDE SOME OF
THE STATE LEVEL LEADERSHIP.
THAT IS REPEATEDLY CALLED FOR IN
DISCUSSIONS ON THE STAGNATED
MHS.
MH ES A UTILIZATION BY GIVING
THE OVERSIGHT AND ACCOUNTABILITY
COMMISSION THE ABILITY TO CREATE
A BROAD SET OF STRATEGIC
OBJECTIVES. THAT SPAN ACROSS THE
STATE.
AND ACROSS. ALL FUNDING SOURCES
WE HAVE THE ABILITY TO PROVIDE
OUR MENTAL HEALTH SYSTEM.
WITH A MORE COMPLETE MISSION.
OF TOUGH FOR HOW IT CAN HELP THE
COMMUNITIES AND SAVE LIVES THANK
YOU FOR YOUR TIME AND I URGE AND
I VOTE.
THINK ANYONE ELSE IN SUPPORT OF
THE BILL.
IT RESULTS IN WITH THE STEINBERG
INSTITUTE IN SUPPORT OF THE BILL
AND I THINK DOCTOR PAN FOR HIS
LEADERSHIP FOR THE WORKING WITH
AUTHORS MOVES FORWARD. THANK
YOU.
THANK YOU.
KURT I'LL DISABILITY RIGHTS
CALIFORNIANS SUPPORT OF THE
BILL.
THANK YOU.
THEIR OPPOSITION.
QUESTIONS COMMENTS.
WELL WE HAVE A MOTION BY SENATE
NEWMAN CHAIRS ARE RECOMMENDING
AND I WOULD LIKE TO CLOSE IN A
PAN ARTISTICALLY ASKED WHEN I
VOTE THANK YOU. WE HAVE ITEM
NUMBER SIX.
SP ONE ONE ZERO ONE TO PASS
APPROPRIATIONS.
HERNANDEZ AYE HERNANDEZ AYE
NGUYEN.
LEYVA. MITCHELL MONNING. NEWMAN.
NEWMAN AYE NIELSEN.
PAN AYE PAN AYE ROTH.
YES THREE WILL PLACE A BILL IN
CALL AC.
SENATOR PORTANTINO WERE AT ITEM
NUMBER SIXTEEN.
S. B. THIRTEEN SEVENTEEN.
THANK YOU MISTER CHAIR NON.
BUT MEMBER. BUT TODAY I AM
PRESENTING S. B. THIRTEEN
SEVENTEEN WHICH REQUIRES THE
STATE. DEPARTMENT OF HEALTH CARE
SERVICES DEVELOP CPAS PACIFIED
GUIDELINES
ON THE MATTER IN WHICH TO REPORT
TO THE LEGISLATURE ABOUT
UNLICENSED RESIDENTIAL ALCOHOL.
OR DRUG ABUSE RECOVERY TREATMENT
FACILITY SPECIFICALLY S. B..
THIRTEEN SEVENTEEN WOULD REQUIRE
THE GUIDELINES TO ADDRESS
CERTAIN TOPICS INCLUDING AMONG
OTHER THINGS METHODS FOR
DETERMINING. WHETHER COMPLAINTS
RECEIVED BY THE DEPARTMENT
REGARDING UNLICENSED FACILITIES
AND COMMITTEES ARE SUBSTANTIATED
OR UNSUBSTANTIATED.
AS WE ARE ALL AWARE SOBRE LIVING
IN AFFECTED PART OF SUCCESSFUL
TREATMENT PROGRAM FOR MANY
PEOPLE IN RECOVERY FROM
SUBSTANCE ABUSE.
SO LIVING HOMES WHICH THE LAW
GENERALLY TREAT SAYS RESIDENCES
RATHER THAN TREATMENT FACILITIES
ARE INTEGRAL CALIFORNIA SYSTEM.
BUT THERE ALSO NEEDS TO BE
OVERSIGHT. AND THERE NEEDS TO BE
ACCOUNTABILITY.
I THINK THIS.
HOPEFULLY WILL LEAD TO. A
GREATER UNDERSTANDING AND MORE
ACCOUNTABILITY AND TOOK THE
CHAIRS SUGGESTED AMENDMENTS AND
RESPECTFULLY ASK FOR AN AYE
VOTE.
THANK YOU IS THERE ANYONE LIKE
TO SPEAK IN SUPPORT OF THE
MEASURE.
IS THERE ANY OPPOSITION TO THE
MEASURE.
IF QUESTIONS COMMENTS.
THAT WAY THE MOTION BY CENTER
NEWMAN.
THERE PORTANTINO THINK YOU ARE
I'M.
CHAIRS ARE POLICY SUPPORTING THE
BILL WOULD LIKE TO CLOSE BECKLEY
ASPIRIN AYE VOTE WITH ITEM
NUMBER SIXTEEN SP ONE THREE ONE
SEVEN DO PASSED APPROPRIATIONS
CALL THE MEMBERS PLEASE.
HERNANDEZ AYE MENDEZ AYE NGUYEN.
LEYVA. MITCHELL.
MONNING AYE MONNING AYE NEWMAN.
NEWMAN AYE NIELSEN.
PAM. PAN AYE ROTH.
IF THEY CURRENTLY HAS FORTY ZERO
WILL PLACE A BILL AND CALL
.
ALEX.
THIRTEEN SEVENTY FINDERS. FIRST.
BUT WHAT ITEM.
TWELVE. PRIOR THIRTEEN SEVENTY
FIVE AND THEN FOURTEEN TWENTY
THREE IN THE I'M GONNA BE
PRESENTING FOR SENATOR MCGUIRE
BECAUSE.
BUT THERE OKAY IN HIS NOTES
TOGETHER SOUNDS GOOD SO WE'LL
START WITH ITEM NINETEEN S. B.
THIRTEEN SEVENTY FIVE.
THANK YOU VERY MCGEORGE
REMEMBERS A AN ASSOCIATION
HEALTH PLAN ISN'T INSURANCE IT
REFERS TO GROUPS OR EMPLOYERS.
AND INDIVIDUALS WHO ARE SELF
EMPLOYED THEY JOIN TOGETHER FOR
PURPOSES OF PROVIDING. HEALTH
INSURANCE TO MEMBERS OF THE
ASSOCIATION.
CALIFORNIA HAS LAWS IN PLACE IT
EVER REQUIREMENTS ON THESE TYPES
OF PURCHASING THE RIG
ARRANGEMENTS.
INCLUDING THAT THEY HAVE TO BE
LICENSE AND IN OPERATION FOR
SEVERAL YEARS.
AND THAT GROUPS OF SMALL
EMPLOYEES LAWYERS HAVE TO HAVE
THIS SAME SMALL EMPLOYER
PROTECTIONS IT EXECS UNDER
EXISTING CALIFORNIA LAW.
NEW FEDERAL REGULATIONS HAVE.
BEEN PROPOSED TO LOOSEN UP SOME
LONG STANDING DEFINITIONS WHAT
CONSTITUTES AN EMPLOYEE FOR
PURPOSE OF HEALTH OF ASSOCIATION
HEALTH PLANS.
THIS BILL MAKES IT CLEAR THAT
SELF EMPLOYED INDIVIDUALS ARE
NOT ELIGIBLE. EMPLOYEES OF
ASSOCIATION HEALTH PLANS.
PARTNERS IN THE FIRM ARE NOT
ELIGIBLE EMPLOYEES FOR
ASSOCIATION HEALTH PLANS UNDER
THIS BILL. CODE COVER CALIFORNIA
DEPARTMENT OF MANAGED HEALTHCARE
DEPARTMENT OF INSURANCE IN
NUMEROUS HEALTH POLICY EXPERTS.
BECAUSE HIGHER PREMIUM PRICES IN
THE INDIVIDUAL AND SMALL GROUP
MARKET.
AND MORE UNINSURED INDIVIDUAL.
THAT IS WHY I'VE INTRODUCED THIS
BILL TO MAKE THE RELEVANT
CALIFORNIA LAW.
CLEA AND CONSISTENT PAST THREE
AYE VOTE I WITNESSES SUPPORT AND
THANK YOU VERY MUCH. PINKY
WITNESSES IN SUPPORT THANK YOU
MARY JANE FORCE ON BEHALF OF
HEALTHAXIS CALIFORNIA WE ARE
PLEASED TO SUPPORT SB THIRTEEN
SEVENTY FIVE. WHICH WOULD HELP
TO MAINTAIN A HEALTHY RISKS MIX
AND A STABLE COMPETITIVE
INDIVIDUAL AND SMALL GROUP
INSURANCE MARKETS. BY ENSURING
SELF EMPLOYED INDIVIDUALS CANNOT
PROCLAIM THEMSELVES AS EMPLOYEES
FOR THE SOLE PURPOSES OF JOINING
AN ASSOCIATION HEALTH PLAN.
TO THE EXTENT PERMITTED BY
FEDERAL LAW THIS BILL WE WILL
RETAIN THE STATE'S AUTHORITY TO
REGULATE WHO IS ELIGIBLE FOR
EACH PIECE.
HP'S HAVE A HISTORY OF FRAUD
ISSUES AND FINANCIAL SOLVENCY
ISSUES THAT NOT ONLY LEAVE
CONSUMERS WITHOUT KEEP
PROTECTIONS THE INDIVIDUAL AND
SMALL GROUP
INSURANCE MARKETS.
FINANCIAL SOLVENCY IS THE BASIC
CONSUMER PROTECTION IN THE MID
NINETEEN NINETIES CALIFORNIA SAW
WE'VE OF BANKRUPTCY AT AGE PIECE
THAT LEFT CONSUMERS SMALL
EMPLOYERS AND PROVIDERS WITH
HUGE MEDICAL BILLS. BECAUSE OF
THIS CALIFORNIA HAS STRONG LAWS
IN THIS AREA.
WHILETHE TRUMP ADMINISTRATION
SEEKS TO PROMOTE THESE JUMPED
PLANTS SB THIRTEEN SEVENTY FIVE
INSURERS THAT CALIFORNIA PLANS
AND INSURERS. FOLLOW ACA
STANDARDS AND OUR STATE LAWS ON
ESSENTIAL HEALTH BENEFITS AND
CONSUMER PROTECTION WE ASK FOR
YOUR ARRIVAL.
THANK YOU OTHER WITNESSES IN
SUPPORT. CARL SUPPORTER OF BLUE
SHIELD I APOLOGIZE FIRST MARIA
AT LATE LETTER.
FOR NOT MAKING THE ANALYSIS
DEADLINE BUT WE ARE IN SUPPORT.
EMILY CHEN ABOUT THE CALIFORNIA
PAN ETHICAL THAT WORK IN
SUPPORT.
YOUNGER BLOMQUIST WITH SMALL
BUSINESS MAJORITY IN SUPPORT.
THANK YOU ANY WITNESSES IN
OPPOSITION.
SEEING NONE ANA QUESTIONS
SENATOR NEWMAN WENT.
I. HAVE A MOTION FROM SENATOR
NEWMAN ANY QUESTIONS.
SINGER THIS IS A DO PASS TWO
APPROACHES ó WE HAVE A MOTION
WOULD YOU LIKE TO CLOSE AYE
VOTE.
THANK YOU. PLEASE CALL THE ROLL
DO PASS TWO PROBES.
HERNANDEZ AYE HERNANDEZ. WHEN.
LEYVA MITCHELL MONNING AYE
MONNING AYE NEWMAN. NEWMAN AYE
NIELSEN PAN PAN AYE ROTH.
IT HAS FOUR ZERO ONE PLACE THAT
ON CALL.
THE.
SENATOR HERNANDEZ.
ITEM TWENTY SP FOURTEEN TWENTY
THREE THANK YOU MISTER CHAIRMAN
VERS.
THIS BILL IS A CLEAN UP TO SP
TWO TO THREE ATKINS FROM LAST
YEAR THAT A LINE CALIFORNIA LAW
WITH FEDERICO.
AN INTERPRETER SERVICES
DEPARTMENT OF HEALTH CARE
SERVICES REQUESTED.
SOME PROVISIONS SO ARE RELATED
TO MEDI CAL IN THOSE ARE CHANGES
CONTAINED IN THIS BILL
RESPECTFULLY ASK WHENEVER.
THANK YOU WITNESSES IN SUPPORT
EMILY GENOM HALF THE CALIFORNIA
PAN ETHNIC HEALTH NETWORK PROUD
TO SUPPORT AND SPONSOR THIS SO
WE WERE THE SPONSORS ON SP TWO
TO THREE. AND AFTER THE SIGNING
WE WORK WITH THE DEPARTMENT OF
HEALTH CARE SERVICES AND THEY
NOTED THAT THERE.
THIS BILL WOULD CRACK THAT WE
ARE VERGE AYE VOTE.
THANK YOU OTHER WITNESSES IN
SUPPORT.
THEN FLORA BEHALF OF WESTERN
CENTER ON LAW AND POVERTY WE
APOLOGIZE FOR NOT GETTING OUR
LETTER AND ALTHOUGH IF HE PAN
INDIA EACH YES AGREE ON THIS YOU
PROBABLY DON'T NEED OUR SUPPORT.
MARY VALDEZ OF HEALTHAXIS ALSO
APOLOGIZE FOR NOT GETTING OUR
LETTER AND THAT WE ARE IN A
STRONG SUPPORT.
THANK YOU ANY WITNESSES IN
OPPOSITION.
A SCENE NONE MOVE IT TO THE
COMMITTEE.
WE HAVE A MOTION FROM SENATOR
NEWMAN. ANY OTHER QUESTIONS OR
COMMENTS.
SINGLENESS IS IT DO PASSED TO
APPROPRIATIONS FELIX CLOSE. AIR.
THE PAST TWO APPROPRIATIONS AND
YOU PLEASE CALL THE ROLL.
HERNANDEZ AYE HERNANDEZ AYE
WHEN.
LEYVA MITCHELL MONNING AYE
MONNING AYE NEWMAN. NEWMAN AYE
NIELSEN PAN. FAN I'VE BROUGHT.
IT ALSO HAS POURED ZERO WILL
HOLD THAT OPEN FOR OTHER
MEMBERS.
AND.
YOUNG NOW BE PRESENTING ON
BEHALF OF SENATOR MCGUIRE ITEM
TEN SP ELEVEN FIFTY EIGHT SL
THAT'S.
CORRECT MISTER CHAIR MEMBERS.
PRESENT IN BEHALF OF SENATE
MCGUIRE S. B. ONE ONE FIVE
EIGHT.
THIS BILL WILL UPDATE THE
CALIFORNIA KIDS PLAY PROGRAM AND
CHILD HEALTH AND SAFETY FUND.
WHICH HAVE NOW BEEN IN PLACE FOR
TWENTY SIX YEARS TO INCREASE AND
REALIGN FUNDING TO MATCH CHANGES
IN OUR STATES CHILDCARE HEALTH
AND SAFETY OVERSIGHT PROGRAM
WITH THAT I HAVE INDIVIDUALS
HERE THAT LIKE TO.
TESTIFYING BELIEVE IT'S KATHY.
PERRANCE RANKIN OKAY IED FROM
AYE I COULD CALIFORNIA COALITION
FOR CHILDREN SAFETY AND HEALTH
THANK YOU VERY MUCH.
THANK YOU PLEASE PROCEED THANK
YOU MISTER CHAIRMAN FIRST KATHY
BRACKEN CALIFORNIA COALITION FOR
CHILDREN SAFETY AND HEALTH WITH
ORIGINAL SPONSORS OF KIDSPLAY
BILL ALL THOSE YEARS AGO. I WAS
TWELVE AND THE WE VERY MUCH
APPRECIATE TO HAVING THE
OPPORTUNITY TO ADJUST THIS BILL
A LITTLE BIT TO MAKE SURE THAT.
CHILDCARE PROVIDERS GET THEIR
HEALTH AND SAFETY TRAINING AND A
LITTLE EXTRA MONEY FOR CHILDHOOD
INJURY PREVENTION.
STILL THE LEADING CAUSE OF DEATH
FOR OUR CHILDREN.
THANK YOU CAN'T DIVERT IT WITH
THE HEALTH THE HEALTH HEALTH
OFFICERS ASSOCIATION A
CALIFORNIA JUST WANT TO
HIGHLIGHT THAT THE BILL ADDS
PEDESTRIAN AND SPORTS RELATED AN
INFANT SLEEPS APPLICATION ISSUES
TO THE LIST OF ISSUES.
THEN THAT'S VERY IMPORTANT AND
WE AGREE ABOUT THE CHILD CARE
PROVIDERS GETTING THEIR
THE SAFETY TRAINING AND SUPPORT
THANK YOU.
THANK YOU AND OTHER WITNESSES IN
SUPPORT. BABY BORN REPRESENTING
AMERICAN KARAMEA PEDIATRICS
WE UNDERSTAND AS PRACTITIONERS
THE IMPORTANCE FOR PREVENTION
AND GOT AN EARLY INTERVENTION
FOR THESE PROGRAMS IN THIS
MEASURE PROVIDES LOS RESOURCE.
KELLY BRICKS ON BEHALF OF ALL
COUNTY REPRESENTATIVES OF
CALIFORNIA HERE IN SUPPORT.
THANK YOU ANY WITNESSES IN
OPPOSITION.
NOW WE HAVE A.
WE MOTIONS QUESTIONER MOTION.
A QUICK COMMENT. DOCTOR PAN
RIGHT NOW THANK YOU.
STERN AND THIS FOR PRESENTING
THE SPELL ON SEND REQUIRED TO
BRING IT FORWARD ACTUALLY AT THE
ABOUT THE OVER FIFTEEN YEARS AGO
ACTUALLY WITH SERVES AS A
PEDIATRICIAN.
THE THE GRAND COMMITTEE FOR THE
INJURY PREVENTION PROJECTS SO. I
HAD GOOD TO SEE THE PROGRAM
STILL MOVING FORWARD AND WE'RE
UPDATING IT SO.
PROPITIATE THE THE FOR THE
PRESENTATION.
THANK YOU AND I'M HAPPY TO MOVE
THE BILL OF CENTER NEWMAN HASN'T
DONE ALREADY YEAH I HAVE NOT.
AND I'D I DON'T NEED TO NOW.
AND IT'S LIKE THE DAVE AND I
COMMEND YOU BOTH ON THE WORK
THAT YOU DO.
AND HAPPY TO SUPPORT THIS BILL.
THANK YOU THANK YOU SO WILL I
TAKE THE MOTION FROM DOCTOR PM.
A IT'S TO DO PASSED TO
APPROPRIATIONS.
DOCTOR NAN THIS JACK TO CLOSE
SOME BEHALF OF SENATOR MCGUIRE
WHEN I VOTE BUT MISTER CHAIR
MEMBERS.
THANK YOU THIS IS A DO PASSED
APPROPRIATIONS PLEASE CALL THE
ROLL.
HERNANDEZ HERNANDEZ AYE WHEN.
LEYVA.
LEYVA AYE MITCHELL.
MONNING AYE MONNING AYE NEWMAN.
NEWMAN AYE NIELSEN.
PAN PAN AYE ROSS.
S. FIVE ZERO WILL HOLD THAT OPEN
FOR OTHER MEMBERS THINKING
.
YEAH.
BUT
.
SO WE HAVE ONE BILL STILL TO BE
HEARD DEBTS ITEM NUMBER FOUR S.
B. ONE ZERO THREE FOUR MITCHELL
SHE'S IN ANOTHER COMMITTEE RIGHT
NOW.
WERE.
FIND OUT SHE'S ON HER WAY.
SO IN THE MEANTIME WE'RE GOING
TO GO DOWN AND LIFT THE CALL.
WE'RE GONNA START AT THE TOP.
LAWRENCE ARE WITH A CONSENT
ITEM.
AND THAT'S ITEM NUMBER FIVE.
ITEM NUMBER EIGHT AND ITEM
NUMBER TWENTY ONE.
CAN WE CALLED THE ABSENT
MEMBERS WHEN.
LEYVA.
LEYVA AYE. NEWMAN. NEWMAN AYE.
PAN. PAN AYE.
IT.
CURRENTLY.
IT'S ONE OF THOSE.
CURRENTLY H..
I WOULD HAVE PLACE BILL BUT
THOSE BILLS BACK ON CALL.
WE'RE GONNA START OFF WITH ITEM
NUMBER ONE.
S. B. NINE FORTY FIVE TO PASS TO
APPROPRIATIONS CALLED THE ABSENT
MEMBERS.
WHEN.
LABOR LABOR AYE. NEWMAN. NEWMAN
AYE.
THAT'S EIGHT ZERO WILL PLACER
BILLING CALL.
ITEM NUMBER TWO SP ONE ZERO ZERO
EIGHT SKINNER HAD CALLED THE
ABSENT MEMBERS WHEN.
NEWMAN.
I'M NOT.
SIX TO ONE WE WILL PLACE A BILL
AND CALL.
ITEM NUMBER THREE SB ONE ZERO
TWO ONE. CALL THE ABSENT MEMBERS
NGUYEN. MITCHELL MONNING.
MONNING I.
ROTH.
AT CURRENTLY FIVE TWO ONE WE'RE
GONNA PLAY SAID BILL BECK AND
CALL.
ITEM NUMBER SIX SP ONE ONE ZERO
ONE PAN CALL THE ABSENT MEMBERS.
NGUYEN. LEYVA.
LEYVA AYE MITCHELL.
MONNING. MONNING AYE.
NIELSEN ROTH.
CRUMBLE KERN IS FIVE ZERO WILL
PLACE A BILL BECKON CALL. ITEM
NUMBER SEVEN SP ONE ONE ZERO
NINE BATES CALL THE UPS MEMBERS
WHEN. ROTH.
PLAY SEVENTH BECKONED CALL STILL
SEVEN ZERO. ITEM NUMBER NINE SP
ONE ONE THREE EIGHT.
SKINNER CALLED ABSENT MEMBERS
NGUYEN.
NEWMAN.
NEWMAN AYE. ROTH.
CURRENT BEAU COUNTY SEVEN ZERO
PLACE AT BILL AND CALL ITEM
NUMBER TEN. S. B. ONE ONE FIVE
EIGHT MCGUIRE CALL THE ABSENT
MEMBERS WHEN. MITCHELL.
NIELSEN BROUGHT.
PLACER BILLING CALL ITEM NUMBER
ELEVEN SP ONE TWO ZERO SIX
CALLED THE ABSENT MEMBERS WINS.
MITCHELL MONNING.
MONNING AYE NEWMAN.
NEWMAN I BROUGHT.
SIX ZERO.
WILL PLAY SAID BILL AND CALL.
ITEM NUMBER TWELVE IS THE ONE
TWO SIX FOUR STONE CALLED THE
ABSENT MEMBERS WHEN. MITCHELL.
NEWMAN.
NEWMAN AYE. ROTH.
CHROMEBOOK HANNAH SIX TO ZERO
PLACE SELLING CALL ITEMNUMBER
THIRTEEN SP ONE TWO SEVEN EIGHT
WESO CALL THE ABSENT MEMBERS
WHEN.
LEYVA.
LEYVA AYE MITCHELL.
ROTH.
BROUGH COUNTESS SIXTY ZERO WILL
PLACE A BILL AND CALL. ITEM
NUMBER FOURTEEN SP ONE TWO FIVE
EIGHT STONE CHAIR IS VOTING NO.
CALL THE ABSENT MEMBERS WHEN.
MITCHELL.
NEWMAN.
NEWMAN NO.
ROTH.
CURRENT VOTE COUNT IS ONE TO
FIVE WILL PLAY SAID BILL AND
CALL ITEM NUMBERS FIFTEEN. SP
ONE TWO NINE ZERO BATES CALL THE
ABSENT MEMBERS WHEN LEYVA. LIVE
UP BY MITCHELL MONNING AYE
MONNING AYE. NIELSEN ROTH.
CURRENT VOCODERS FIVE ZERO WILL
PLAY SAID BILL AND CALL. ITEM
NUMBER SIXTEEN SP ONE THREE ONE
SEVEN PORTANTINO CALL THE ABSENT
MEMBERS WHEN.
LEYVA.
LEYVA AYE MITCHELL.
NIELSEN ROCKS.
CURRENT BOOK KERN IS FIVE TWO
ZERO. PLACE A BILL IN CALL ITEM
NUMBER SEVENTEEN SP ONE THREE
TWO TWO STONE.
CHAIR VOTING NO CALLED ABSENT
MEMBERS.
WHEN. LEYVA LABOR NO MITCHELL.
NEWMAN.
NEWMAN NO. NIELSEN PAN.
ROTH.
CURRENT VOTE COUNT ZERO FOUR
WILL PLACE THAT BILL AND CALL.
ITEM NUMBER NINETEEN S. B. ONE
THREE SEVEN FIVE HERNANDEZ.
CALL THE ABSENT MEMBERS.
WHEN. LEYVA LEYVA AYE MITCHELL.
NEWMAN.
CAN'T NIELSEN ROSS.
KERBAL COUNTIES FIVE ZERO PLACE
AT BILL AND CALL ITEM NUMBER
TWENTY S. B. FOURTEEN TWENTY
THREE HERNANDEZ CALL THE ABSENT
MEMBERS WHEN. LEYVA.
LEYVA AYE MITCHELL.
NIELSEN. BROUGHT.
FIVE ZERO PLACE THAT BILL AND
CALL AND WE JUST GONNA WAIT FOR
.
WE'RE GONNA GO TO ITEM FOR.
MITCHELL S. B. TEN THIRTY FOUR
TO BE PRESENTED BY CHAIR AND
THEN THIS.
BOB FENNER I'M GONNA BE PRESENT
AND WE HAVE THE SENATE MITCHELL
BUT I'M GONNA WHAT IF YOU DON'T
MIND I'M GOING TO HAVE CENTERS
MEDIAN WHO AUTHORED THIS BILL.
MAKE SOME INTRODUCTORY REMARKS
AND.
THEY JUST GOT THE STATEMENT
HERE FOR THE FIRST TIME SO
ALTERNATE OVER CENTER SOME.
THANK YOU WELCOME BACK SENATORS
A MILLION ONCE A SENATOR. OPPOSE
THE SENATE AMOUNT MISTER
SUPERVISOR.
MR SUPERVISOR.
WELCOME HOME. THANK YOU ALL VERY
MUCH APPRECIATE THE COURTESY
APPRECIATE CENTER MITCHELL'S
WILLINGNESS TO CARRY THIS.
SUNSET ELIMINATION MEASURE FOR
THOSE OF YOU WHO DO NOT HAVE
HISTORY ON THE BILL. SIX YEARS
AGO.
I HAD THE PLEASURE OF AUTHORING
SENATE BILL FIFTEEN THIRTY
EIGHT.
SENATE BILL FIFTEEN THIRTY EIGHT
WAS A NOTICE BILL. AND ALL THE
BILL DID AND ALL THE CAUGHT
CURRENTLY REQUIRES. IS THAT
WHEN.
MAMMOGRAM IS PERFORMED ON A
WOMAN WHO HAS DENSE BREAST
TISSUE. BUT THE FACT THAT SHE
HAS DENSE BREAST TISSUE IF IN
FACT SHE DOES.
IS PLACED INTO THE LETTER THAT
GOES TO THE PATIENT
THIS IS INFORMATION THAT IS
ORDINARILY.
ALWAYS COLLECTED BY.
THE.
RADIOLOGIST SO IT'S NO
ADDITIONAL BURDEN ON THE
RADIOLOGIST IT GOES INTO A
LETTER THAT IS ALL WE SENT SO
THERE'S NO ADDITIONAL LETTER. SO
IT IS ESSENTIALLY GIVING THE
PATIENT INFORMATION THAT HE
NEEDS TO BE FULLY INFORMED ABOUT
THE RESULTS OF HER OWN
MAMMOGRAM.
ABOUT HER BODY AND ABOUT THE
RESULTS OF THE TESTS THAT SHE
PAID FOR.
AT THAT TIME THERE WERE ONLY
FIVE STATES IN THE COUNTRY
ACTUALLY FOR PREVIOUSLY I THAT
HAD PASSED SUCH NOTIFICATION
LAWS. BUT THE ARGUMENT IUSED
WITH GOVERNOR BROWN AT THE TIME
WAS THAT IF BOTH GOVERNOR MARIO
CUOMO COULD.
I SEE ME ANDREW CUOMO COULD SIGN
THE BILL AS WELL AS GOVERNOR
RICK PERRY THAT THIS WAS
PROBABLY A PLACE WHERE WE COULD
FIND COMMON GROUND. ULTIMATELY
THAT BILL PASSED SEVENTY FOUR
ZERO IN THE ASSEMBLY THIRTY SIX
TO ZERO IN THE SENATE. AND ONE
UNDERSCORE THE FACT WE HAD A
HUNDRED AND ONE CO AUTHORS I
HAVE NEVER WORKED AS HARD TO
ROUND UP CO AUTHORS AS I DID ON
THIS BILL.
WHAT'S CHANGED IF ANYTHING IN
THE LAST SIX YEARS HERE'S WHAT'S
CHANGED.
TWO THREE MILLION WOMEN HAVE NOW
GOTTEN THE NOTICE SO THEY'VE
BEEN ABLE TO HAVE INFORMED
CONVERSATIONS WITH THEIR
POSITIONS IF THEY CHOOSE TO DO
SO. I THINK THAT'S A GOOD AND
HEALTHY THING. PIERCING THIS
CHANGES THAT THIS HAS NOW BECOME
THE NORMATIVE PRACTICE WHAT WAS
FIVE STATES IS NOW THIRTY FIVE
STATES ACROSS THE COUNTRY THAT
HAVE. SAME NOTICE REQUIREMENTS
WE HAD A SUNSET IN THE BILL
BECAUSE AS YOU KNOW WHEN YOU DO
SOMETHING NEW PEOPLE ARE
SOMETIMES A LITTLE BIT ANXIOUS
ABOUT WHAT THE CONSEQUENCES
MIGHT BE. TURNED OUT THE BILL'S
WORK QUITE WELL WITHOUT INCIDENT
IS A SAY TWO THREE MILLION
PEOPLE BEEN NOTICED. THIRTY
OTHER STATES HAVE JOINED
CALIFORNIA AT THIS POINT IT'S
TIME TO REMOVE THE SUNSET THAT'S
WHAT SENATOR MITCHELL'S BILL
DOES WE THANKHER WE THANK YOU
FOR YOUR PATIENCE ON THIS VERY
LONG DAY AT RESPECTFULLY ASK
WHEN I VOTE. THANK YOU SENATOR
HERNANDEZ AND I SHOULD SAY BY
THE WAY.
CENTER NIELSEN.
I SHOULD SAY THANK YOU WAS A
PRINCIPAL CHO AUTHOR THE BILL
SIX YEARS AGO.
SENATOR MITCHELL THANK YOU WAS
A CO AUTHOR OF THE BILL.
SENATOR PAN WAS THIS A
SUPPORTER AND I VOTE AS WELL AS.
CENTER MINING AND CENTER
HERNANDEZ SO WHILE I'M HANDING
OUT THE THANK YOU'S THEY ALL
DESERVE THANK YOU SO I WANT TO.
THANK YOU AND WE'LL GO TO OTHER
WITNESSES IN SUPPORT. BOTTOM.
MY NAME'S AMY COLTON I'M FROM
SANTA CRUZ.
AND A LOT HAS CHANGED SINCE BACK
IN TWO THOUSAND AND ELEVEN WHEN
I FIRST APPROACH AND THEN
SENATOR SMITTY AND ABOUT THE
IDEA. OF MANDATING BREAST
DENSITY NOTIFICATION.
BUT.
THE ONE THING THAT HASN'T
CHANGED IS MY PARALYZING FEAR OF
PUBLICS.
SO.
PLEASE BEAR WITH ME I'M JUST
GOING TO READ MY BRIEF
STATEMENT.
OKAY.
I AM ONE OF COUNTLESS WOMEN WHO
HAVE BEEN HARMED BY LACK OF
INFORMATION REGARDING DENSE
BREAST TISSUE CONSEQUENTLY. I
ENTERED A BRUTAL BATTLE AGAINST
ADVANCED STAGE BREAST CANCER BUT
THE MOMENT I LEARNED THE TRUTH
ABOUT DENSE BREAST TISSUE I FELT
THAT NO OTHER WOMAN SHOULD EVER
SUFFER. A DELAYED BREAST CANCER
DIAGNOSIS UNNECESSARILY.
THE INTENT OF THE LAW IS TO
EDUCATE GIVING WOMEN THE
GREATEST CHANCE FOR EARLY
DETECTION.
PATIENTS NEED THIS INFORMATION
IN ORDER TO HAVE AN INFORMED
DISCUSSION WITH THEIR PHYSICIAN
ABOUT THEIR OWN PERSONAL RISK
FACTORS AND THE MOST EFFECTIVE
METHOD OF SCREENING.
IF THE LAWS ALLOWED TO EXPIRE WE
WILL GO BACK TO A TIME WHEN TOO
MANY WOMEN.
RECEIVED NEGATIVE MAMMOGRAM
RESULTS WHEN IN FACT THEY DID
HAVE INVASIVE CANCER.
ONE OF THE MOST SIGNIFICANT
BENEFITS OF THE WIDESPREAD PRESS
DENSITY LAWS ACROSS THE NATION
IS THAT MEDICAL EXPERTS NOW
ACKNOWLEDGE THAT DENSE BREAST
TISSUE IS THE MOST PREVALENT AND
COMMON RISK FACTOR.
ECLIPSING EVEN FAMILY HISTORY.
MAMMOGRAPHY IS DECREASED
ACCURACY IN DENSE BREAST TISSUE
IS NO LONGER A SECRET. AND
CONTRARY TO THE OPPOSING
ARGUMENTS WE HEARD IN TWO
THOUSAND AND TWELVE WOMEN DID
NOT PANIC AND HAVE PROVED THAT
THEY CAN HANDLE THIS INFORMATION
QUITE WELL.
WHEN CANCERS DETECTED EARLY IT
IS MORE TREATABLE AND SURVIVABLE
AND LESS COSTLY.
TO GO BACKWARDS WOULD NOT ONLY
BE A GREAT DISSERVICE BUT
POTENTIALLY FATAL FOR SOME.
FIVE YEARS AGO THE LEGISLATURE
AND THE GOVERNOR APPRECIATED THE
VALUE OF BREAST DENSITY
NOTIFICATION. AND NOW CURRENT
RESEARCH MAKES THE NOTIFICATION
EVEN MORE COMPELLING.
I AM PROUD THAT CALIFORNIA WAS
ONE OF THE EARLIEST OF THE
THIRTY FIVE STATES TO MANDATE
NOTIFICATION AND MANY OF THE
STATES THAT FOLLOWED MODELED
THEIR LIVES AFTER OUR OWN.
I AM GRATEFUL THAT SENATOR
MITCHELL AND THE CO AUTHORS
UNDERSTAND THE IMPORTANCE OF
THIS BILL AND I HOPE YOU WILL
TOO BY SUPPORTING SP TEN THIRTY
FOUR.
THANK YOU MISTER COLEMAN THANK
YOU FOR SHARING. YOUR STORY TO
HELP ADVANCE THIS NOT JUST IN
CALIFORNIA BUT BUT NATIONALLY.
OTHER WITNESSES IN SUPPORT.
RICHARD REID THURMOND AND
BREAST.
A RADIOLOGIST SPECIALIST OF
DEDICATED THE LAST EIGHTEEN
YEARS.
TO DEALING IN THIS PARTICULAR
ISSUE OF WOMEN'S HEALTH
SCREENING AN EARLY DIAGNOSIS OF
BREAST CANCER.
DURING THAT TIME I HAVE
DIAGNOSED OVER TWO THOUSAND FIVE
HUNDRED WOMEN WITH BREAST
CANCER.
I'VE SAT IN FRONT OF THEM GIVEN
THEM THE NEWS.
AND CUT ABOUT THE BUSINESS
TRYING TO HELP THEM GET
TREATMENT.
TWO QUESTIONS ARE MOST PROMINENT
AND ALL WOMEN WHO ARE DIAGNOSED
WITH BREAST CANCER.
NUMBER ONE IS WHY ME.
HIS MANY WOMEN DO NOT HAVE A
FAMILY HISTORY OF BREAST CANCER.
AND NUMBER TO WHAT IS BY
PROGNOSIS.
PROGNOSIS QUESTION I'VE HAD A
LOT TO DEAL WITH.
IN THAT MANY WOMEN HAVE AN
EXCELLENT PROGNOSIS BECAUSE OF
EARLY DIAGNOSIS.
SIZE IS VERY IMPORTANT THE
SMALLER WE DETECT BREAST CANCER
IT WOULD SPREAD TO THE LYMPH
NODES THE HIGHER THE PROBABILITY
OF ABSOLUTE HUMOR.
THE SECOND FACTOR LIKE TO DEAL
WITH IN TERMS OF PROGNOSIS IS
THAT MANYWOMEN HAVE DELAYED
DIAGNOSIS OF BREAST CANCER.
IF WE LOOK AT SCREENING
EFFECTIVENESS SCREENING
MAMMOGRAPHY.
OVER THE COURSE OF MANY STUDIES
AND MANY POPULATIONS IT'S BEEN
PROVEN TO BE EFFECTIVE IN
DECREASING.
THE PERCENTAGE OF PATIENTS WHO
HAVE LATE ONSET OF DIAGNOSIS.
IF YOU LOOK AT THE DATA IN TERMS
OF PREMENOPAUSAL AND POST
MENOPAUSAL WOMEN.
POSTMENOPAUSAL WOMEN HAVE A
HIGHER SENSITIVITY AND A BETTER
EARLY DIAGNOSIS PROFILE THAN
PREMENOPAUSAL WOMEN.
IN GENERAL IT'S NOT DUE TO THE
BIOLOGY.
PREMENOPAUSAL IT'S DUE TO THE
FACT THAT SIXTY PERCENT OF WOMEN
THAT ARE PREMENOPAUSAL HAVE
DENSE BREASTS ISSUES.
THIRTY PERCENT OF POSTMENOPAUSAL
WOMEN HAVE CLIP TENS PRESS.
SO ITS VERY CRITICAL TO
UNDERSTAND THE ISSUE OF THE
REASONS SCREENING IS LESS
EFFECTIVE.
THEN IT SHOULD BE WOMEN WITH
DENSE BREASTS BECAUSE WE DON'T
USE COMPLIMENTARY OR
SUPPLEMENTARY IMAGING TECHNIQUES
MIMI ULTRASOUND.
THE TWO LANDMARK LEGISLATION TO
THRILLED WITH IT THROUGH THE
CHAIR I'M GONNA ASK OUR WITNESS
TO BE MINDFUL OF THE HOUR IN THE
LONG DAY THAT MEMBERS WHO
ALREADY HAD.
OKAY WE'VE AFFORDED YOU MORE
THAN THE NORMAL TIME RASCHER.
HOA SO HE COULD START TRIP UP
WITH A PIE WILL WRAP UP.
I MEAN A QUOTE FROM THE CURRENT
BILL.
THIS IS HAS BEEN SAID BY THE
OTHER WITNESSES IS INFORMED
CONSENT IT'S GIVING WOMEN.
AND EMPOWERING THEM WITH
INFORMATION AND KNOWLEDGE TO
OPTIMIZE THEIR INDIVIDUAL HEALTH
CARE DECISIONS IT'S NOT A PUBLIC
HEALTH ISSUE IT'S AN INDIVIDUAL.
RIGHT FOR WOMEN TO BE EMPOWERED
WITH KNOWLEDGE TO DECIDE THEIR
OWN FATE.
THANK YOU DOCTOR NO OTHER
WITNESSES IN SUPPORT PLEASE
NAME.
AFFILIATION. I NAME IS JENNIFER
HOME MEMORY JUST HEARD NURSING
BOARD MEMBER FOR THE CALIFORNIA
NURSES ASSOCIATION AND WE
SUPPORT THE BILL.
THANK YOU.
RETURN MEMBERS BOB BACK ON WITH
A KILLER AND CALIFORNIA
RADIOLOGICAL SOCIETY THAT WE ARE
NEUTRAL IN THE BILL COUPLED WITH
A DISCLOSURE MADE OF THE
PATIENTS FIND THE VALUE IN IT. I
DID OF A FLASHBACK ON HIS NOSE
ANDERSON MILLION BUT.
ALL POSITIVE THOUGHTS THANK YOU.
THANK YOU.
AND ANY WITNESSES IN OPPOSITION.
AND THAT WAS NOT A QUEUE FOR
SENATOR MITCHELL TO COME
FORWARD.
.
PARA.
SING NO WITNESSES IN OPPOSITE
XIN WILL BRING HIM BACK TO THE.
PANEL A QUESTIONS.
WE HAVE A MOTION FROM. SENATOR
NEWMAN ANNA QUESTION FROM DOCTOR
PIANO TURN THE CHAIR BACK TO
CHAIR HERNANDEZ.
WELL THINK THANK YOU US AIR'S
MANY AND IT'S GOOD TO SEE YOU
AGAIN AND APPRECIATE YOUR PATCH
OF THE ISSUE AND I WANNA THANK
CENTER MITCHELL FOR.
BRING THIS FORWARD.
YEAH I THINK I THINK THAT.
CERTAINLY.
IF WE WANT TO TRY TO FIGURE HOW
WE.
DETECT.
MORRELL DETECT BREAST CANCER.
I THINK THE STUDIES THAT HAVE
BEEN PRESENT IN ALICE'S ABOUT
YOUR PER.
INDICATE THE TECHNOLOGY STILL
WASN'T THERE YET THAT.
AND.
SO.
BILL SO I THINK THAT. YOU KNOW
I HOPE THAT WE WILL GET TO A
POINT WHERE WE HAVE A TECHNOLOGY
THAT WILL ACTUALLY HELP US.
GET BETTER INFORMATION BEYOND
THE MAMMOGRAM.
S. POINT BUT I'D SAY ALSO WANT A
SITE NO TO CAUTION ABOUT. WHAT
WE HAVE AVAILABLE AT LEAST THE
CURRENT TIME TO BE ABLE TO?
DID FOR RIGHT ACTION WHEN
INFORMATION TO TO TO OUR PEOPLE
RECEIVING AT THIS SITE
MAMMOGRAMS SO WASN'T.
IN OTHER COMMENTS OR QUESTIONS
FROM ANY OF THE MEMBERS SIZE OUR
MOTION COULD. NOT MOVE VICE.
SNAPSORT ABOUT THAT CERTAIN MOVE
BY SENATOR NEWMAN THAT WE ARE AT
ITEM NUMBER FOUR AS WELL SWITCH
LIKE CLOSE VERY BRIEFLY AND
THANK YOU MISTER CHAIR I
APPRECIATE YOU.
I AM SURE BY WITNESSES THAT A
STELLAR JOB OF PRESENTING THE
BILL I KNOW THEY DID. AND I
WOULD JUST SAY IN RESPONSE.
PAN I THINK FROM MY PERSPECTIVE
YOU MEMBER OF ALL I THINK IT WAS
CBS THESE TO HAVE THE LITTLE
TRAILER THEY WOULD SAY THE MORE
YOU NOW. AND FROM MY PERSPECTIVE
ON THIS PERSPECTIVE ON THIS
BILL.
THE MORE YOU KNOW IS BENEFICIAL
TO WOMEN TO HELP EMPOWER US AS
SELF HEALTH ADVOCATES WITH OUR
PRACTITIONERS IN TERMS OF
KNOWING OUR BODIES AND WHAT WE
NEED TO COMMUNICATE TO OUR
PRACTITIONERS. THAT CHANGE FROM
YEAR TO YEAR AS WE HAVE.
MAMMOGRAMS SO THE GOAL IS TO
EMPOWER WOMEN TO UNDERSTAND.
THE COMPLEXITIES OF OUR OWN
BODIES TO BE PARTNERS IN THE
HEALTHCARE DELIVERY SYSTEM
THAT'S WHY WE FEEL THIS BILL IS
IMPORTANT AND I ASK FOR AN AYE
VOTE. ITEM NUMBER FOUR SP ONE
ZERO THREE FOUR DO PASS
APPROPRIATIONS COLOR MEMBERS
QUEENS
HERNANDEZ AYE HERNANDEZ AYE
NGUYEN.
WHEN I LEYVA. LEYVA AYE MITCHELL
AYE MITCHELL AYE MONNING.
MONNING AYE NEWMAN. NEWMAN AYE
NIELSEN.
PAN.
ROTH.
ROTH I
IF YOU.
THAT CURRENT VOTE COUNT IS SEVEN
TWO ZERO.
CENTER NIELSEN IS NOT HERE.
THAT FILLS OUT THAT'S THE FIRST
ONE OF THE DAY.
WHY HOW THANK YOU VERY MUCH
THANK YOU MISTER CHAIRMAN THANK
YOU MEMBERS AUTHORED THANK YOU
CENTER MEANT?
SO WE'RE GOING TO START AT THE
TOP BEGIN WE'RE GOING TO LIFT
ALL THE CALLS WERE GOING TO.
START OFF WITH CONSENT.
ITEM NUMBER FIVE.
ITEM NUMBER EIGHT AND ITEM
NUMBER TWENTY ONE. AND CAN WE
CALL THE ABSENT MEMBERS.
OKAY.
WHEN.
WHEN I.
IF THE.
THE CURRENT ACCOUNT IS NINE TWO
ZERO THOSE BILLS ARE OUT.
WE'RE GONNA START OFF WITH ITEM.
NUMBER ONE SP NINE FORTY FIVE
CALL THE ABSENT MEMBERS.
WHEN.
WHEN I.
CURRENT BOOK COUNTIES NINE TWO
ZERO THAT GOES OUT.
ITEM NUMBER TO ASK HE ONE ZERO
ZERO EIGHT CALL THE ABSENT
MEMBERS WHEN.
WHEN I NEWMAN.
CURRENT BOUT FOCUS ON A SEVEN
TWO ONE. THAT BILL IS OUT.
ITEM NUMBER THREE SB ONE ZERO
TWO ONE CALL THE ABSENT MEMBERS
WHEN.
WHEN NO MITCHELL.
I THOUGHT I ITEM NUMBER THREE SB
ONE ZERO TWO ONE WIENER.
THAT'S A LIE
MITCHELL I.
ROTH AYE ROTH AYE.
CURRENT BOOK COUNTIES SEVENTY
TWO THAT BILL IS OUT.
ITEM NUMBER SIX. S. B. ONE ONE
IS.
BUT.
ITEM NUMBER FOR AND NUMBER OF
WITH A LITTLE CLEARLY AND THAT
WAS CLOSE THOSE OUT.
ITEM NUMBER SIX SP ONE ONE ZERO
ONE CALLED THE ABSENT MEMBERS
WHEN. WHEN I.
MITCHELL. MITCHELL AYE.
NIELSEN ROSS AYE ROTH AYE.
CURRENT BOOK COUNT IS PAID TO
TWO ZERO THAT BILL IS OUT.
ITEM NUMBER SEVEN SP ONE ONE
ZERO NINE CALLED THE ABSENT
MEMBERS WHEN.
WHEN I ROTH. ROTH AYE.
CURRENT BOOK COUNTIES NINE TO
ZERO THAT BILL IS OUT.
ITEM NUMBER NINE S. B. ONE ONE
THREE EIGHT SKINNER CALL THE
ABSENT MEMBERS.
NGUYEN.
WHEN I.
ROTH BUT ROTH AYE.
CRITICAL COUNTIES NINE TO ZERO
THAT BILL IS OUT. ITEM NUMBER
TEN SP ONE ONE FIVE EIGHT
MCGUIRE CALL THE ABSENT MEMBERS
WHEN.
MITCHELL.
MITCHELL I.
NIELSEN.
ROTH AYE ROTH AYE.
EVEN.
NOBODY'S.
SEVEN CURRENT VOTE COUNT TO
SEVEN ZERO THAT BILL IS OUT OF.
ITEM NUMBER ELEVEN SP ONE TWO
ZERO SIX DELEON CALL THE UPS
MEMBERS WIN. WIN AYE MITCHELL.
MITCHELL AYE. BROUGHT. ROTH AYE.
NINE.
KERBAL COUNTIES NINE ZERO THAT
BILL IS OUT. ITEM NUMBER TWELVE
SP ONE TWO SIX FOUR STONE COLD
ABSENT MEMBERS WHEN.
WHEN I MITCHELL.
IT'S A LIE MITCHELL AYE.
BROTHER.
OKAY ROTH AYE.
NINE ZERO THE BILL IS OUT ITEM
NUMBER THIRTEEN S. B. ONE TWO
SEVEN EIGHT WEST SO CALLED THE
ABSENT MEMBERS WHEN. WIN I
MITCHELL MITCHELL AYE ROTH.
ROTH I.
CURRENT VOTE COUNT IS NINE ZERO
THAT BILL IS OUT ITEM NUMBER
FOURTEEN SP ONE TWO EIGHT FIVE
STONE CHEER VOTING NO CALLED THE
ABSENT MEMBERS. WHEN.
MITCHELL.
MITCHELL NO.
ROTH.
CURRENT BOOK COUNTY IS ONE TWO
SIX THAT BILL.
DOES NOT.
DIS IS DA RECONSIDERATION
GRANITE.
ITEM NUMBER FIFTEEN SP ONE TWO
NINE ZERO BATES CALLED THE
ABSENT MEMBERS NGUYEN.
WHEN I.
NIELSEN.
BOB MITCHELL.
WELL I OKAY MITCHELL AYE.
NIELSEN BROUGHT AYE ROTH AYE.
KERBAL COUNTY'S BEAT TWO ZERO
THAT BILL IS OUT.
ITEM NUMBER SIXTEEN SP ONE THREE
ONE SEVEN PORTANTINO CALL THE
ABSENT MEMBERS WENT.
WHEN I MITCHELL.
MITCHELL I.
NIELSEN.
ROTH
I'M ROTH AYE.
CURRENT BOOK COUNTIES A TWO ZERO
THAT BILL IS OUT.
ITEM NUMBER SEVENTEEN SP ONE
THREE TWO TWO STONE ARCH HERE
VOTING NO CALL THE ABSENT
MEMBERS WHEN.
WHEN I.
MITCHELL.
MITCHELL NO.
CURRENT BOOK BECAUSE ONE TO FIVE
THE BILL FAILS AYE
RECONSIDERATION AS GRANITE.
ITEM NUMBER NINETEEN S. B. ONE
THREE SEVEN FIVE HERNANDEZ CALL
THE ABSENT MEMBERS WHEN.
WHEN NO MITCHELL.
MITCHELL AYE. NIELSEN.
ROTH AYE ROTH AYE.
KUBO CABINET SEVEN THE ONE THAT
BILL IS OUT ITEM NUMBER TWENTY
SP ONE FOUR TWO THREE HERNANDEZ
CALL THE ABSENT MEMBERS WHEN.
WHEN I MITCHELL. MITCHELL AYE.
NIELSEN BROUGHT A ROTH AYE.
IT.
CURRENT BOOK KERN IS A TWO ZERO
THAT BILLS OUT.
AND THAT CONCLUDES THE BUSINESS
OF THE SENATE HEALTH COMMITTEE
WE ARE ADJOURNED