WE'LL GET BACK HERE ALRIGHT SO
DIFFERENT PUBLIC HEALTH.
MINISTER IT OFF WITH THE ISSUE
NUMBER ONE BIRTH CERTIFICATE
PROCESSING INCREASE RELATED
COMPLAINTS BEFORE WE START E
SHOULD DO THE ROUND ROBIN OF A.
IS HERE SO AGENCY.
DR JIM GREEN DEPUTY DIRECTOR
CENTER FOR HEALTH STATISTICS
INFORMATICS CALIFORNIA
DEPARTMENT OF PUBLIC HEALTH.
OKAY ILIO ANY PARTICULAR OIL.
MARK NEWTON LA OWN FINANCE RESA
COLOR WITH FINANCE.
OKAY SO START WITH FIRST
PROCESSING. WELCOME.
BUDGET ISSUE DPH REQUEST
EXPENDITURE AUTHORITY OF SEVEN
OR NINETY SIX THOUSAND FROM THE
HEALTH STATISTICS SPECIAL FUND
FISCAL YEAR EIGHTEEN NINETEEN.
NINETEEN TWENTY AND TWENTY
TWENTY ONE.
IF APPROVED THESE RESOURCES
WOULD ALLOW DPH TO MEET TE
DEMAND FOR INCREASED NUMBER OF
PER CERTIFICATE REQUESTED REALLY.
APARTMENTS OF FEDERAL REAL ID
ACT.
DPH ALSO REQUEST BUDGET BILL
LANGUAGE BECAUSE THEIR EYES UP
TO ONE POINT FIVE NINE MILLION.
OF ADDITIONAL EXPENDITURE
AUTHORITY FROM THE HEALTH
STATISTICS SPECIAL FUND IF
NECESSARY SUPPORT ADDITIONAL
WORKLOAD.
THANK YOU.
BELIAU ANY COMMENT FINANCE
ALRIGHT.
ANY PUBLIC COMMENT.
ALRIGHT XENA AND.
THANK YOU SO MUCH. WE WILL HOLD
THIS ITEM OPEN AND CERTAINLY.
WE WANNA BE SURE WE CAN
THE PUBLIC'S DEMAND.
OKAY.
ISSUE NUMBER TWO IS THE CENTER
FOR HEALTH CARE QUALITY.
NEW FOLKS SHOWING UP HERE
SERVING INTRODUCE YOURSELVES FOR
THE. DOES THE AGENCY PEOPLE FOR
THE RECORD AND THEN.
PRESENT.
GOOD AFTERNOON I'M JEANNE I SEE
NO I'M THE DEPUTY DIRECTOR OF
THE CENTER FOR HEALTH CARE
QUALITY IN THE CALIFORNIA
DEPARTMENT OF PUBLIC HEALTH.
AND I AM SCOTT OCCURRENCES
INTERVIEW DURING HER FOR THE
SENATE HEALTH CARE QUALITY YOU
SEE JARED THE CHIEF OF POLICY
AND PLANNING FOR THE CENTER FOR
HEALTH CARE QUALITY OKAY
EXCELLENT. ALRIGHT SO MUCH GOOD
BEGIN.
OKAY SO WE WILL.
JUST JUMPED TO YOUR QUESTIONS.
NOTES COULD FEEL WHAT THE
OVERVIEW OF THE PROGRAM GIVEN
HOW YOU KNOW WHAT. WE HAVE A
VERY DETAILED DESCRIPTION AND
ARE WRITING AS YOU HAVE SOME
HIGHLIGHTS YOU WANT TO MENTION
THAT FINE BUT THE MAINLY FOCUS
ON THE QUESTIONS I THINK WERE
WERE WILL MOVE ON TO.
SO THE SECOND QUESTION HOW MANY
WAIVER SUBMISSIONS DOES THE
DEPARTMENT EXPECT FOR WORKLOAD
SHORTAGE AND SIEGES CAN ADDRESS
THAT.
THERE ARE ESTIMATES OF THE
NUMBER OF.
WAIVERS THAT WILL RECEIVE VARY
QUITE A BIT.
INDICATIONS MINISTRY THAT
UPWARDS OF HALF OF ALL THE
SKILLED NURSING FACILITIES IN
THE STATE OF CALIFORNIA WOULD
APPLY FOR A WAIVER THAT SIX
HUNDRED FACILITIES. THERE'S A
WAIVER BASE OF A PATIENT ACUITY
IS ALSO THE WAIVER FOR WORKFORCE
SHORTAGES AND SO WE COULD SEE
UPWARDS IF A FACILITY DECIDES TO
APPLY FOR BOTH WE COULD SEE
UPWARDS OF TWELVE HUNDRED OR
MORE. WAIVER APPLICATION SO IT'S
A VERY TRANSFORMATIVE MAYBE SIX
HUNDRED AND EIGHTEEN HUNDRED
WAIVER APPLICATION.
AND THEN THERE IS SOME
QUESTIONS ABOUT HOW LONG IT'LL
TAKE TO PROCESS HE WAIVER SO
FOR THE WORK FOR SHORTAGE
WAIVERS ALL OF THE WAIVERS THAT
WE RECEIVED BY SEPTEMBER FIRST
OF TWENTY EIGHTEEN FOR FISCAL
YEAR EIGHTEEN NINETEEN.
A WE MUST APPROVE OR DENY BY
SEPTEMBER THIRTIETH OF TWENTY
EIGHTEEN AND FOR THE FACILITY
THEREAFTER FACILITIES FOR FISCAL
YEAR NINETEEN TWENTY MUST SUBMIT
THE. WAIVERS BY APRIL FIRST AND
SEEPAGE MUST APPROVE OR DENY
THOSE BY APRIL THIRTIETH.
QUIT.
TAKE TIMELINE TWO OVER AN ARE
YOU GONNA BE ACHIEVED THOSE TIME
LINES.
WE'RE GOING TO HAVE TO.
WELL I I KNOW OKAY.
LET'S HER THIS WAY AND.
.
SO YES WE HAVE BUT I IN FOURTEEN
YEARS MANY EXAMPLES OF TIMES
WHEN WE EVEN THAT TIMELINE SET
LEGISLATION ARE NOT MET BY
AGENCIES SO.
.
SO BEING THIS IS A BUDGET
SUBCOMMITTEE.
DO YOU HAVE THE RESOURCES HAVE
TO RESOURCE HAS BEEN REQUESTED
SO YOU CAN MEET THAT TIME.
YES OUR OUR SPRING FINANCE
LETTER WHICH IS LATER ON THE
AGENDA DOES REQUEST ADDITIONAL
RESOURCES FOR THIS PARTICULAR
TASK WHICH WOULD THEN ALLOW US
TO MEET THOSE TIME LINES IN
REALITY AS WELL AS IN.
STATUTE.
OKAY. ALRIGHT WHAT WE JUST KEEP
GOING ON THE QUESTIONS AND HELP
MAINLY ASK QUESTIONS AT THE END
SO.
POSITIVE WHICH IS WHAT IS THE
MAXIMUM.
AMONG TIME THE STATEMENT MAY
WAIVE THE DIRECT STAFFING
REQUIREMENTS UNDER EITHER THE
WORKFORCE SHORTAGE WAIVER OR THE
PATIENT CUTIE WAIVER. OF A SILLY
MAY.
RENEW THE WORK FOR SHORTAGE
WAIVER TWO TIMES THAT B. THREE
CONSECUTIVE YEARS THAT THEY
COULD HAVE THE WORKFORCE
SHORTAGE WAIVER EFFORTS AGAINST
SERBIA COOLING OFF PERIOD OR AT
LEAST A ONE YEAR BREAK.
AND CURRENTLY RIGHT NOW THERE
IS NO LIMIT ON THE NUMBER OF
TIMES THAT A FACILITY MAY
REQUEST TO WAIVE THE TWO POINT
FOUR CM A REQUIREMENT WHILE
STILL MAINTAINING THE OVERALL
THREE POINT FIVE STAFFING
REQUIREMENT BASED OFF OF PATIENT
ACUITY.
BUT YOU JUST KEEP GOING I KNOW
YOU HAVE QUESTIONED THEM BY. THE
LAST IS.
PASSED FOR THE DEPARTMENT
DESCRIBE ITS ASSESSMENT OF
WHETHER THE WORKFORCE IS
CURRENTLY AVAILABLE ARE NOW AND
WHAT WE ARE DOING.
SO TAKE TRAINING RECRUITMENT.
SO.
.
WE HAVE GATHERED AT WE HAVE DATA
FROM ET DE ABOUT AND AND I SPENT
ABOUT WHERE SEE AN AIDS ARE
WORKING.
AND WE'VE ACTUALLY GOT SOME OF
THAT INFORMATION POSTED ON OUR
WEBSITE.
.
WE WE HAVE NOT DRAWN A
CONCLUSION ABOUT WHETHER THEY'RE
SIGNIFICANT IS SUFFICIENT
WORKFORCE AVAILABLE WE KNOW
EVERYONE IS CONCERNED ABOUT THE
AB ABOUT THE WORKFORCE.
TRAINING AND RECRUITING OF CN A
IS HOWEVER IS THE RESPONSIBILITY
OF THE INDUSTRY. BUT CD PERIOD
STANDS READY TO REVIEW AND
APPROVE APPLICATIONS FOR NEW CNA
TRAINING PROGRAM SO WE ARE.
LOOKING FORWARD TO RECEIVING
APPLICATIONS FOR PEOPLE WHO WANT
TO DEVELOP TRAINING PROGRAMS AND
THAT WE REVIEW AND APPROVE.
AND WITH THERE IS A PROJECT
PENDING.
APPROVAL WITH THE CENTERS FOR
MEDICARE MEDICAID SERVICES THE
KICKSTARTER TRAINING PROGRAM IS
FUNDED WITH.
PENALTIES THAT THE DEPARTMENT
IS COLLECTED THAT IT'S FEDERAL
MONEY MONETARY PENALTIES THAT
WOULD.
PROVIDED TRAINING IN
PARTNERSHIP WITH.
SNIFFS THROUGHOUT CALIFORNIA
AND THE INTENT OF THIS PROJECT
IS ACTUALLY TO GET MORE SKILLED
NURSING FACILITIES TO DEVELOP
CNA TRAINING PROGRAMS WITHIN THE
FACILITIES THAT WILL THEN BE
MAINTAINED OVER THE LONG TERM
AND SO THAT WERE THAT'S JUST
THAT.
PROJECT IS PENDING CMS APPROVAL.
AND THEN.
THAT. THE NEXT QUESTION ABOUT
HOW WE DEVELOP.
HOW WE MEASURE WHETHER SOME
SNIFF QUALITY OF CARE IS RELATED
TO INCREASE DIRECT CARE SERVICE
HOURS SO THIS IS PART OF THE
LEGISLATION REQUIRED THIS
EVALUATION? WE WILL.
.
AS AUTHORIZED IN THE LEGISLATION
LIKELY CONTRACT WITH A VENDOR TO
CONDUCT THE REQUIRED EVALUATION.
AND WE WILL NEED AT LEAST A
MINIMUM OF A FULL YEAR'S WORTH
OF DATA TO BE ABLE TO BEGIN TO
EVALUATE THE QUALITY OF CARE
BEFORE AND AFTER IMPLEMENTATION.
OKAY.
COMMENTS MILIEU.
TONY PARTICULARLY OVER WHICH WE
WILL HAVE SOME COMMENTS.
IN REGARDS TO THIS SPRING
FINANCE LETTER REQUEST WILL
BRING THOSE UP LATER BANKING
FINANCE.
ALRIGHT. SO I DO HAVE SOME
QUESTIONS IN RELATION TO YOUR
ANSWER IT NO WE HANDLED.
SO IN TERMS OF.
LOOKING AT THE WORK FORCE
AVAILABILITY.
.
YOU SAID THAT YOU DIDN'T HAVE
ANY INFORMATION THAT I MEAN I
THINK WE KNOW.
I MEAN THAT IT IS.
POSTERS I.
IT THINK WE KNOW HOW MANY
NURSING HOME BEDS OUR RIGHT
BECAUSE YOU LICENSE THEM SO YOU
SHOULD HAVE THAT DATA RIGHT AND.
IF YOU HAVE THAT RATIO THAT
WILL GET YOU RELEASE
THE USER NUMBER FOR HOW MANY AND
ARE TO MEET THE RATIO. ITSELF
HOW MANY CNA IS WE WOULD
ACTUALLY NEED TO HAVE IN THE
STATE CALIFORNIA I WAS THERE'S
GONNA BE ISSUES ABOUT YOU KNOW
HOW THEY'RE DISTRIBUTED AND.
NO ORDER IT YOU KNOW IT'S SO
FORTH BUT TO STEVEN ON THE FACE
OF THAT. HOW MANY SEATS
CNN YOU KNOW HOW WE RELATE TO
HOW ME SIENESE ARE OUT THERE
THAT THAT AND?
THAT CERTIFIED AND HOW MANY IF
YOU ACTION AT THE RATIO GIVEN
THE NUMBER LICENSE BED HOW MANY
DO YOU NEED.
HOW THOSE TWO NUMBERS MATCH UP?
YES SO THAT IS HOW WE DETERMINE
THERE'S.
SHORTAGE COUNTIES THAT WE
POSTED ON OUR WEBSITE IS
ESSENTIALLY IS A METHODOLOGY
VERY SIMILAR TO WHAT YOU ALLEN
WE LOOK AT THE NUMBER OF PATIENT
DAYS THAT WERE SERVED IN THAT WE
COME BACK THAT INTO THE NUMBER
OF CDNAS THAT YOU WOULD NEED.
WORKING EIGHT
OUR SHIFTS.
TO MEET THE NEED ON ANY GIVEN.
YEAH OVER THE THE PERIOD OF A
YEAR ANYWAYS AND WE CAN ALSO BE
HAVE PROXIES FOR THE NUMBER OF
SEEING A IS THAT ARE WORKING IN
INDUSTRY AND WE CAN THEN
DETERMINE WHETHER OR NOT THE.
SUPPLIES ADEQUATE TO MEET THE
DEMAND BASED OFF OF THE TWO
POINT FOUR REQUIREMENT AND SO
THOSE COUNTIES WHERE WE'VE.
I LISTED ARE DESIGNATED THEM IN
TENTATIVELY AS SHORTAGE COUNTIES.
ARE IS WHERE THERE'S NOT
ADEQUATE SUPPLY AND SO THAT'S
WHAT IS REFLECTED ON OUR OUR
WEBSITE IS THOSE THE PUBLISHED
LIST OF SHORTAGE COUNT.
SO OKAY SO AND IN THE END THERE
ARE I JUST IF YOU JUST LOOK AT
THE NUMBER OF CDNAS THAT ARE
CERTIFIED THE JUST THE TOTAL
LIST OF HIM HE SIX.
CERTIFIED NURSE ASSISTANTS.
THERE ARE MANY CN A IS THAT ARE
CHOOSING NOT TO WORK IN THAT
FIELD SO WHAT WHEN YOU LOOK AT
THE THE EDT DATA OF CNN IS
WORKING IN THE INDUSTRY. IT'S
QUITE A BIT LESS THAN SO THERE
ARE C. N. A.'S AVAILABLE THAT
ARE CHOOSING FOR WHATEVER REASON
NOT TO WORK IN ORDER TO FEEL.
OKAY.
OKAY BITS.
BUT I SEVEN GOT QUITE GOTTEN THE
ANSWER MY QUESTION SO LIMITED
RECOGNIZING THAT.
HOW ARE YOU DOING IN TERMS OF
IF WE APPLIED THERE SO OBVIOUS
THE IT ENTERS A REALITY IT'S
GOING TO COME DOWN TO BUT SAID
SOME PEOPLE ARE WORKING THE FEEL
THERE?
DO YOU GRAPHIC DISTRIBUTION ARE
MEL DISTRIBUTION ISSUES IT'S
BETTER BUT YOU SAID SO HOW MANY
BY HUESO. HOW MANY COUNTIES I
DON'T HAVE THE WHAT'S ANTHONY
HOW WE COUNTIES ARTICLE SHORTAGE
COUNTIES AND WHAT PROPORTION OF
THE
RELATIONS THE THE CALIFORNIA
DOES THAT DO THOSE COUNTIES AB
OUT ALL ADDED UP WOULD REPRESENT?
I DON'T KNOW WHAT THE NUMBERS
ARE OUT OF MY HEAD WE CAN.
IDENTIFY THE NUMBER OF COUNTIES
AND ROUGHLY WHAT PERCENTAGE OF
CALIFORNIA THAT REPRESENT THEM.
OKAY ALRIGHT SO.
.
OKAY SO WHEN IT'S SO OF COURSE
ONE OF THE THINGS THAT WE WANT
IS THE PARCHMENTS ASSESSMENT OF
FOR THE WORK FORCE COUNTY
AVAILABLE TO SUPPORT THE NEW CNA
REQUIREMENTS WHEN DO WE EXPECT
SOME KIND OF ANALYSIS.
I'M JUST ASKING LIKE THE.
NICE TO DO WORKFORCE RESEARCH I
MEAN THIS IS THIS IS NOT VERY
DETAILED QUITE IT. COURSES OF
ESCAPE OUR PRETTY SUPERFICIAL IN
TERMS OF JUST SCRATCHING THE
SURFACE OF WHAT THAT NUMBER IS.
YOU TELLING ME YOU CAME TO THIS
HEARING WITHOUT THE ONLY ANSWER
THOSE QUESTIONS.
I MEAN I JUST FEEL LOW
FRUSTRATED RIGHT NOW.
YEAH YES.
SONY PARTICULARLY.
I WOULD MENTION THAT OUR OFFICE
IS GOING TO BE RELEASING.
AN ANALYSIS EITHER TOMORROW OR
MONDAY THAT TAKES A LOOK AT ALL
OF THE ADMINISTRATION'S
PROPOSALS THAT ARE MEANT TO
ADDRESSTHE NEW STAFFING
REQUIREMENTS THAT SKILLED
NURSING FACILITIES.
.
WITHOUT CONSIDERING WHAT HOW
MANY CNA IS THERE CURRENTLY ARE
WE DID AN ANALYSIS JUST TO
ESTIMATE HOW MANY SIENESE WILL
BE NEEDED TO MEET RAISING NEW
YEAH I'M. REQUIREMENTS AND WE WE
FIGURED THAT IT WOULD BE AROUND
TWO THOUSAND.
TWO THOUSAND MORE MORE OKAY
AND OUT OF A HOME HOW ME SIENESE
ARE OUT THERE.
ROUGHLY.
WITH YOUR LIFE.
I THINK IN THE BALLPARK AS A
HUNDRED TWENTY THOUSAND PEOPLE
THAT ARE CURRENTLY CERTIFIED
THAT DOESN'T MEAN THAT THEY'RE
WORKING OKAY.
SO SAID TWO THOUSAND IS A FAIRLY
SMALL FRACTION OF THE.
PUT ALTHOUGH AGAIN WE DON'T KNOW
HOW MANY PEOPLE THE POOR
ACTUALLY ACT IS. RIGHT PROTECTS
THAT WE'VE A LOT LESS THAN THAT
THE RIGHT NOT.
DO YOU DATA THAT WE USE TO
DETERMINE TOWARDS COUNTIES WAS
LOOKING AT THE NUMBER OF PEOPLE
WHO ARE WORKING IN INDUSTRY OKAY
DO HAVE A SENSE OF HOW MANY
PEOPLE ACTUALLY ACTIVELY WORKING.
SO.
I THINK ABOUT THIRTY TWO
THOUSAND SEEING IS CURRENTLY
WORK IN SNIFFS.
AND SO THIRTY TWO THOUSAND AND
WE'RE STILL TWO THOUSAND.
AGAIN THIS IS ROUGHLY TWO. AND I
GET MAGNITUDE TWO THOUSAND LESS
SO.
SO THAT'S ABOUT WE NEED
ATTENDING THAT WORDS ARE LIKE
ATTENDED LIKE WE'RE TURNOUT TEN
TEN FIFTEEN PERCENT SHORT.
OF SORTS.
WELL THIRTY TWO THOUSAND AND
OTHER TWO THOUSAND RIGHT THAT
COMES OUT TO BE.
YEAH YEAH.
RIGHT CELL.
TENTH FIFTEEN PERCENT OKAY.
ALRIGHT.
AND.
.
ALRIGHT AND THEN TERMS OF
TRAINING PROGRAMS.
.
SO CERTAINLY WE NEED.
.
HE SAID THAT'S INDUSTRY
RESPONSIBILITY I MEAN USUALLY I
DO TRAINING BUT TRAINING ALSO
COSTS MONEY.
SO WHEN YOU HAD HAVE TRAINEES
AROUND AS ARE WE ARE WE LOOKING
AT SOME WHEN WE LOOK AT HOW WE
SUPPORT MORE TRAINING ARE WE
LOOKING AT TRYING TO FIND SOME
FINANCIAL RESOURCES FOR. A
EXPANDING TRAINING PROGRAMS FOR
FACILITIES ARE DOING TRAINING
GAS AND JUST WOULD LIKE TO NOTE
AND THE GOVERNOR'S BUDGET DOES
INCLUDE FUNNY OUTSIDE OF THE
PUBLIC HEALTH AREA BUT. FOR.
SUPPORT FOR THE STRONG WORK
FORCE PROGRAM OUT OF COMMUNITY
COLLEGES IN ALSO. FUND PROGRAMS
WITHIN ET DE SO WORKING WITH
LABOR AGENCY SO THERE ARE.
OTHER FUNDING STREAMS
CONTEMPLATED TO SUPPORT THE
TRAINING AND AND SUPPORTING THEM.
BUT FACILITIES MEETING THESE
THESE REQUIREMENTS OKAY NFC
SOUTH LIKE THOSE ARE HEARD
ANOTHER BUDGET SUBCOMMITTEE CELL
SOMETIMES THEY DON'T WE AFTER.
ALL RIGHT OKAY THAT'S HELPFUL TO
KNOW OKAY AND THEY'RE JUST THERE
IS ALSO A PROPOSAL IN FOR.
IN THE MEDI CAL AREA TO PROVIDE.
A READING TREES FOR SKILLED
NURSING FACILITIES THAT CAN MEET
THE REQUIREMENTS OKAY. YEAH.
OKAY.
ALRIGHT.
THE PUBLIC COMMENT.
CAN IMAGINE IT WOULD BE.
OKAY.
JENNIFER SNYDER BE HAVE THE
CALIFORNIA ASSOCIATION OF HEALTH
FACILITIES.
SO I MADE A COUPLE COMMENTS AND
WE DO APPRECIATE AND THE EFFORTS
AND THE. AMOUNT OF TIME AND
EFFORT THAT THE CALIFORNIA
DEPARTMENT OF PUBLIC HEALTH IS
PUT INTO ESTABLISHING THIS
WAIVER PROCESS IN THE WAIVER
CRITERIA.
AND WE HAVE APPRECIATED THE.
THERE.
OPENNESS TO TO.
FOR THE STAKEHOLDER PROCESS IN
US TO BE INVOLVED IN THAT AND I
WOULD SAY THAT WE PROBABLY HAVE
ABOUT THREE REMAINING CONCERNS.
THAT REVOLVE AROUND THE WAIVERS
AND ALSO OBVIOUSLY REVOLVE
AROUND THE NEW STAFFING
REQUIREMENTS FOR SKILLED NURSING
FACILITIES IN CALIFORNIA THE
FIRST ITEM. IS.
BASED ON THE CRITERIA THAT THE
WAIVER REQUIRES FOR FACILITY TO
EVEN BE ELIGIBLE TO APPLY FOR A
WAIVER ON THEIR CERTAIN CRITERIA
THAT WOULD AND. IN A SENSE
ELIMINATE THE ABILITY FOR
CERTAIN FACILITIES TO EVEN APPLY
FOR THE WAIVER AND A LOT OF
CASES THOSE FACILITIES ARE THE
ONES THAT ARE ALREADY STRUGGLING.
UNDER STRUGGLING I'M.
TO FIND STAFFING AND AND THEY
WILL JUST NOT EVEN HAVE THE
ABILITY TO APPLY WE'VE CONTINUED
TO HAVE.
EXPRESSED CONCERNS WITHOUT I'M
SECOND IS AND WE KNOW THAT THE
DEPARTMENT HAS HAD TO WORK WITH
FAIRLY LIMITED DATA I'M TRYING
TO FIND.
.
GENERAL INFORMATION ABOUT WORK
FOR SOME WORKFORCE SHORTAGES AND
WE KNOW THAT THEY WERE DEALING
WITH A LOT OF LIMITED DATA BUT
WITH THAT BEING SAID. THE DATA
THAT THEY HAVE PUT TOGETHER THIS
THAT SHOW SHORTAGE AREAS WE
THINK. ART DON'T ADEQUATELY SHOW
WHERE THERE ARE COUNTIES IN
AREAS THAT HAVE.
AND PROBLEMS WITH FINDING WORK
FORCE AND ESPECIALLY WITH
CERTIFIED NURSING ASSISTANTS.
THIRD IN OVW AND PROBABLY THE
MOST IMPORTANT.
.
IS THAT WE ARE CONCERNED THAT
THE DEPARTMENT'S GOING TO HAVE.
I WOULD SAY AT LEAST FIVE
HUNDRED IF NOT MORE FACILITIES
THAT ARE GOING TO APPLYING FOR
WAIVERS I'M MORE CONCERNED THAT
THAT WILL HAVE THE ABILITY TO
PROCESS THOSE WAIVERS AND GET
THOSE WAIVERS THROUGH.
IN A IN A TIMELY MANNER.
WE APPRECIATE THE COMMENTS BY
THE ILIO. WE AGREE THAT WE HAVE.
REPEATEDLY SAID THAT WE FEEL
THAT THERE NEEDS TO BE AT LEAST
SEVENTEEN HUNDRED NEW CNA IS.
THAT ARE MOVING INTO THE SYSTEM
AND THAT CAN BE.
AVAILABLE FOR OUR FACILITIES TO
HIRE I'M OUR FACILITIES ARE VERY
VERY CONCERNED THAT THEY WON'T
FIND THOSE PRIOR TO JULY FIRST.
OF WE HAVE.
.
AT LEAST IN MANY CASES BOTH
THROUGH WRITING IN THROUGH
DISCUSSIONS WITH AND THE
ADMINISTRATION HAVE SUGGESTED
THAT THAT WE LOOK AT SOME TYPE
OF PHASE IN. APPROACH OVER THE
NEXT YEAR OR TWO TO ALLOW FOR
SUIT FOR FACILITIES TO BE AND
GET INTO COMPLIANCE.
WE HAVE A NUMBER OF PROPOSALS
THAT AS WAS MENTIONED THE
GOVERNOR HAS SOME PROPOSALS.
THAT CALPERS CESSATION HEALTH
FACILITIES HAS A NUMBER OF
DIFFERENT AVENUES THAT THEY'RE
LOOKING AT TO TRY TO GET MORE
SIENESE INTO THE WORK FORCE BUT
THAT TAKES TIME. AND THEY WANT
TO BE COMPLIANT VERY CONCERNED
THAT.
THEY'RE GONNA HAVE TOO MANY
FACILITIES REQUESTING WAIVERS
TOO MANY FACILITIES THAT WILL BE
FOUND OUT OF COMPLIANCE THAT
JUST WON'T HAVE THE TIME AND TO
GET THEIRSTAFFING UP AND
RUNNING. AND AND READY TO GO BY
JULY FIRST SO WE CONTINUE TO ASK
FOR SOME TYPE OF PHASE IN EITHER
FOR ENFORCEMENT PURPOSES OR FOR
I'M TIMING ON ON. A GRADUAL
INCREASE OF THAT STAFFING
REQUIREMENTS.
BUT AGAIN WE DO APPRECIATE THE
PROCESS THAT THE DEPARTMENT IS
GONE THROUGH AND.
WOULD LIKE TO CONTINUE TO WORK
WITH EVERYBODY ON A SOLUTION
ALRIGHT THANK YOU UP BEFORE YOU
GO SO SOUNDS LIKE YOU'RE NOT AS
CONFIDENT AS THEY WERE THAT. ALL
THE WAIVERS OF YET DONE ON TIME.
NO WE ARE NOT.
OKAY WEALTHY APPRECIATE THE
EFFORTS THAT THEY ARE.
TRYING TO ACTUALLY HA.
HIRE NEW STAFF I KNOW THAT
THERE'S GONNA BE A DISCUSSION
ABOUT SOME.
BOUNCE ADDITIONAL STAFF AND TO
BE HIRED TO ACTUALLY MAYBE
ADDRESS SOME OF THESE WAIVER
PROCESSES BUT NOW WE ARE VERY
VERY CONCERNED BECAUSE THINK
ABOUT THE TIME FRAME THAT. AND
AND FACILITIES IF THEY ARE
COMPLIANT JULY FIRST THEY'VE
TURNED IN A WAIVER BUT THEY
MAYBE NOT KNOW UNTIL SEPTEMBER
THE END OF THE YEAR WHETHER OR
NOT THEY'VE ACTUALLY.
THE WAIVERS BEEN ACCEPTED SO
WHAT HAPPENS DURING THAT PERIOD
OF TIME ARE THEY OUT OF
COMPLIANCE THEY'RE CONCERNED
THAT THE THEY ARE AND IF THEY IF
THE WAIT WAS NOT ACCEPTED.
THEN THERE'S A LOT IMPLICATIONS
THERE THAT WE DON'T KNOW THE
ANSWERS TO AT THIS POINT. AT
WORK PERHAPS DO YOU HAVE A
RESPONSE TO THIS TINY ISSUE IN
TERMS OF SOMEBODY WAIVER.
WAITING FOR THE RESPONSE.
BUT I DO YOU KNOW WE HAVE A TEN
PERCENT SHORTAGE.
WELL WE'VE WE'VE BUILT THE
TIMELINE SO IT WE REALLY HAVE
STICKING A LINE OF THE DECISIONS
WITH THE MEDI CAL RATE SETTING
APPEAR GOING FORWARD.
THAT'S WHY I WANTED YOU
MENTIONED IN THE NEXT YEAR I'LL
APPLICATION WILL BE SUBMITTED NO
LATER THAN APRIL SO THAT WE WILL
HAVE A THREE MONTH SO THAT THAT
REAPPEAR BEGINNING JULY ONE.
WELL WILL HAVE THE RIGHT PERIOD
OF TIME FOR MANY COLORS THAT THE
RATES FOR THE FACILITY.
THE CITY WILL GO FORWARD FOR
THIS CURRENT YEAR BECAUSE WE GO
TO OUR AUDITS WE'LL DO NOT AGREE
INVEST THREE MONTHS IN THE REAR
SO. WAITING UNTIL SEPTEMBER FOR
THAT DECISION MAY MAKE.
IT WILL BE FINE BECAUSE I TELL
REALLY HAVE A DECISION MADE. AND
WE DO OUR LOOK BACK PERIOD UP ON
THAT TIME WILL HAVE DECISIONS
MADE TO ALL KIND OF KNOW WHAT
WAS GOING ON SO. AGAIN WE'RE
ALTERNATE WORLD TRAINING LAND OF
THE SHIP CALL ON ON THE MOVING
DECK WITHIN THAT THIS IS
SOMETHING THAT WE HAVE WORKED
WITH OUR PARTNERS BOTH AT. TCS.
TO TO HELP THEM WITH WHAT THEY
NEED TO DO GOING FORWARD.
I SAW I MEAN I THINK ONE OF
THINGS.
WANTED TO HAVE A SITUATION WHERE
SOMEONE'S WAITING FOR SOMETHING
BECAUSE THEY DON'T GET THE WAY
HEARD THE DEL.
DAVID STILL TIED TO RECRUIT.
UNLESS YOU AND THEN LESS YOUR
TELLING PEOPLE THEY HAVE TO
RECRUIT WHILE THEIR WAIVER IS IN
PROCESS AND THEY DON'T KNOW.
ALTHOUGH I THINK SHE SHOULD BE
RECRUITING OF THEIR SHORT ANYWAY
BUT I GOT IT OUT BUT STILL IF
THE AND SUCCESSFUL YOU KNOW THEY
STILL NEED TIME IT CETERA SO.
AND AND I GUESS THE OTHER
QUESTION WAS IS THAT.
.
SO THESE TWO BASICALLY BUILDING
AND WHO ARE SHORTENED DON'T CAN
EVEN QUOTE WITH BOAT SO CAN YOU
EXPLAIN THIS.
PEOPLE READY OUT TO MAY NEED
WAIVERS.
YES SOME FACILITIES ARE NOT.
ABLE TO THEY CAN APPLY FOR THE
WAIVER BUT THEY'RE AUTOMATICALLY
DENIED BASED ON THEIR ON
COMPLIANCE HISTORY SO IF A
SKILLED NURSING FACILITY HAS
BEEN ISSUED. AN A CITATION OR
TWO A. CITATIONS OVER A THREE
YEAR PERIOD A PRIOR TO A.
APPLYING THEY ARE ARE NOT
ELIGIBLE AND AN ITEM OF THAT
SOCIETY HAS AND SOME OF THE
CITATIONS ARE NOT REALLY.
WORKFORCE RELATED.
ME AT IN THAT THE ENFORCEMENT
MIGHT HAVE.
THAT INCIDENT MIGHT OF HAPPENED
FIVE YEARS AGO BUT THE CITATION
MIGHT HAVE BEEN JUST ISSUE TO
YOUR GUY SO CAN YOU DRESS THAT
ISSUE I MEAN OF AGO ALLOW AGAIN
I.
RELATED TO
WORKFORCE YET THE NEED
RECRUITING BUT IF SO THAT'S HOW
THE CITATIONS LINED UP WITH THIS
NEED TO RECRUIT SO PART OF THE
WAIVER PROCESS IT WE WE AGREE
THAT THE WITH THERE ARE THESE
MANDATORY EXCLUSION SO TO SPEAK.
THOSE CITATIONS ARE.
.
ARE FOR QUALITY OF CARE ISSUES
AND ONE OF THE FACTORS THAT WE
WILL DETERMINE IN ISSUING
SOMEBODY A WAIVER. IS. THE
FACILITY WILL NEED TO
DEMONSTRATE TO US OR EXPLAIN TO
US HOW. EVEN WITH A WAIVER TO
NOTMEET THE NEW STAFFING
REQUIREMENTS THEY WILL PROVIDE
QUALITY OF CARE. IN OUR VIEW A
FACILITY THAT'S HAD CITATIONS AT
THIS LEVEL ARE ALREADY NOT
PROVIDING QUALITY OF CARE. AT
THE CURRENT STAFFING LEVELS
REQUIRED STAFFING LEVELS AND
THEREFORE WE SHOULDN'T BE.
GIVING BAY WHICH SHOULD BE GIVEN
A WAIVER TO NOT STAFF BECAUSE
THEY'VE ALREADY DEMONSTRATED AN
INABILITY TO DELIVER QUALITY OF
CARE.
OKAY SO CITY HIM SOMEONE LEVEL
THAT MAKES SENSE I THINK THE
CONCERN IS THAT IF THE CITATION
IS.
.
NOT RELATE TO STAFFING GUELDERS
VARIOUS REASONS YOU MIGHT DOT
AND.
I PRESUME THAT YOU HAVE AG WHO
YOU WE DEATHLY WHITISH SHOW THAT
THE FACILITY IS.
IS.
IT IS TRADED DRESSED THE
QUALITY ISSUE THE CITATION RIGHT.
AND OF THE CITATIONS NOT RELATED
TO WORK FORCE AND THEY'RE HAVING
TROUBLE RECRUITING.
BECAUSE THAT'S WHAT THE WAIVERS
FOR WAIVERS THAT BECAUSE WE'RE
SAYING THAT.
WELL YOU KNOW YOU.
YEAH BUT IT THAT WAIVERS NOT A
PASS FOR NOT RECRUITING NIGHT
THAT'S WHEEZER TOUCHED ON BEFORE
BELIEVERS REALLY ABOUT SAYING
THAT I.
I CAN'T FIND A L. I'M HAVING
TROUBLE FINDING SOMEBODY AND
THEREFORE.
.
I CAN'T MEET THE REQUIREMENT
ENOUGH TO SHUT DOWN THAT THE
OTHER ALTERNATIVES SHUT DOWN OR
CONTINUE THE SO.
SO I WAS I GUESS IT THE CITATION
ISN'T RELATED TO.
BEALL SHORTAGE OF PERSONNEL AT
SOMETHING ELSE.
BUT IT BUT AND WAITED TO QUALITY
OF RIGHT RIGHT WELL MAY NEED TO
DEMONSTRATE TO US THAT THEY'RE
ABLE TO PROVIDE QUALITY OF CARE
ASSUME.
OKAY WELL BECAUSE. AND I DO SEE
CALLING TUE MADE QUALITY COULD
BE A LOT OF DIFFERENT THINGS SO.
THAT COULD BE ADDRESSED BUT
DEPENDING ON WHAT THE ISSUE IS
INTEREST IN DIFFERENT WAYS
CLEARLY SOME THINGS ARE RELATED
TO YOU KNOW YOU JUST ON OF
PEOPLE TO DO THE WORK RIGHT AND
THAT'S WHY. THEY DID THIS THING
HAPPEN.
SOMETIMES DEPENDING ON THE
NATURE OF THE QUALITY.
THE CITATION IT COULD BE RELATED
TO SOME OTHER FACTOR HELP FOR
MANAGING THE CAP ENOUGH PEOPLE
DON'T POOR MANAGEMENT SOMETHING
ELSE AND OF COURSE THEY NEED TO
SHOW THEY MADE PROGRESS ON IT ON
THAT.
BUT IF THEY CAN'T RECRUIT THE
QUALITY ISSUES RELATED TO WORK
FORCE.
THEY ARE ADDRESSING THAT OTHER
PROBLEM.
BUT THEY'RE STILL THEY'RE HAVING
STILL HAVING TROUBLE RECRUITING
THEN AND THEY SAY THAT.
PETITIONS HAS CLOSED DOWN.
BECAUSE THAT'S THE ALTERNATIVE.
WELL IT NOT TO THE FACILITY
DETERMINE WHAT THE ALTERNATIVE
YOU KNOW YOU CAN'T BE LATE I
MEAN THAT OF. OKAY GIVE REMIND
ME THAT THIS IS A LOT SAVE YOU
DON'T MEET THAT YOU CAN OPERATE
THAT WOULD BUILD THE CLOSING
DOWN THE MAKE IT AND THEY MAKE
IT ANOTHER DEFICIENCY. THEY MADE
THE FLEA MAY ACTUALLY CHOOSE TO
LOWER THEIR SENSES TO LINE THEIR
SENSES BUT THE THING THAT THEY
HAVE SO THERE ARE CHOICES THAT.
WE ARE A CAN BE MADE BY THAT
SLOWLY. BUT.
THE FACT THAT THEY MAY NOT BE
MEETING THE STANDARDS DOESN'T
MEAN THAT WE'RE GONNA BE TAKING
A LICENSE REVOCATION ACTION TO
CLOSE THE FACILITY.
WHEN.
OKAY SET BEEN COMMUNICATED OUT
TO ALL THE FOLKS WHO THINK THAT
HALF KNOWS THAT.
INSTINCTIVELY.
OKAY.
I A COUPLE OF WHICH DECISION
HEALTH SLEAZE AND.
YES THE FIRST RESPONSIBILITY IS
GOING TO HAVE IS THAT THAT
THEY'RE NOT THEIRS THEY'RE GONNA
HAVE TO REDUCE OUR CENSUS.
EVERY FACILITY IN THE STATE OF
CALIFORNIA WE'VE AND IS
COMPLIANT WITH THE CURRENT
STAFFING REQUIREMENTS OF THREE
POINT TWO MINIMUM.
AND THEY WOULD THEY WOULD STILL
CONTINUE TO MEET THAT MINIMUM IF
THEY CAN'T MEET THE MINIMUM A
THREE POINT FIVE THERE IS AN
OPTION TO REDUCE BEDS.
FIRST OF THE FIRST CONCERN WILL
BE PATIENT ACCESS TO SEARCH
SKINNER SIMPLY BEDS ALL OVER OUR
FACILITIES ARE AT NINETY PERCENT
IF IF NOT MORE AND CAPACITY NOT
SO THAT'S THE FIRST CONCERN
SECOND IS. AT SOME POINT IF IF
IF FACILITY CAN'T FUNCTION UNDER
THE STAFFING REQUIREMENTS AND
THEY HAVE TO SHUT DOWN TOO MANY
BEDS YES THEY ARE AT RISK ABOUT
YOU SHUTTING DOWN THEIR ENTIRE
FACILITY BECAUSE YOU HAVE TO BE
AT A CERTAIN CAPACITY TO COVER
YOUR COSTS.
CORRECT.
SO ULTIMATELY YES.
WE WOULD HAVE MANY FACILITIES
THAT COULD BE AT RISK OF A
CLOSURE BUT DEFINITELY THE FIRST
THE FIRST POINT IS TO REDUCE
CENSUS.
THERE IS TO REDUCE THEIR CENSUS.
SOME SELLING THEIR SOME ISSUES
TO WORK OUT HERE
RIGHT.
I AM I BELIEVE IT'S AN AREA
WHERE WE WE.
I JUST FUNDAMENTALLY DISAGREE
AMIN WE'VE OUTLINED A WAIVER
PROCESS THERE WILL BE MORE
PUBLIC COMMENTS.
BUT.
WE WE ARE TAKING SERIOUSLY OUR
RESPONSIBILITY TO IMPLEMENT THE
LAW.
AND WE ESTABLISH A WAIVER
PROCESS WE'RE TRYING TO.
TO.
BOB ALLEN THE NEEDS TO TO GRANT
WAIVERS WHERE THEY'RE
APPROPRIATE AND ALSO IN ENSURE.
INITIAL SUPPORTED NOTE THERE
WEEKS WE CURLY HAVE A THREE
POINT TWO STATE REQUIREMENT YEAH
THINGS ARE CLOSING BECAUSE
THEY'RE NOT ME THREE POINT TWO.
THEY MAY BEING DEFICIENCIES
THAT MAY BE GETTING SOME OTHER
THINGS BUT WE DON'T SEE PLEASE
CLOSER THE WAIVERS NOW FOR THREE
POINT TWO RIGHT AYE I AM STANBIC.
BUT AGAIN THE ANALOGOUS IS THAT
RIGHT NOW WE HAVE A STANDARD NOW.
PEOPLE SOME OF THEM ARE NOT
MEDIAN THREE POINT TWO NOW THE
ARGUING CITATIONS
THEY ARE GETTING DEFICIENCIES.
BUT NO ONE IS CLOSING COUSIN NOT
ME THREE POINT TWO BECAUSE THEY
COULD RECRUIT OKAY WELL I'M
HEARING AS WE HAVE OF ROUGHLY.
TEN PERCENT I MEAN. YOU KNOW
SHORTAGE.
WE HAVE A WAIVER PROCESS THAT
WAS FED INTO THE LAW AND ORDER
TO TRY TO ADDRESS THAT BECAUSE.
AND HOW HAVE ANY NEW NURSING
HOME BEDS THAT WE OPEN THE LAST
FIVE YEARS.
I MEAN WE HAVE A GROWING AGING
POPULATION WE HAVE LICENSED.
AT LEAST ONE EL IN THE LAST TWO
YEARS AND WE ARE AWARE THAT SOME
THIRTY SIX POINT EIGHT OR NINE
MORE SLEAZE BEING BUILT.
NOT IN CALIFORNIA BUT. OKAY SO I
AM NOT MILLION LAST YEAR'S OZONE
ALERTS SO I MEAN I I THINK. AND
ACTUALLY INTEREST ENOUGH WE JUST
HEARD AND MY THE THINGS WE WANT
TO DO AND PREVIOUS HEARING WE'RE
TALKING AGING AS WE WILL LOOK AT
THAT.
CHANGES IN WHERE WE ARE RIGHT.
BECAUSE A AND THAT OF COURSE
YOU KNOW WE WANNA BE SURE ALL
THE BEDS OR QUALITY RIGHT WE
WANT A SHARON SICILY'S EQUALITY
WOULD NOT SACRIFICE QUALITY FOR
QUANTITY.
.
BUT I THINK WE OFFICE SO. BUT
WEEK KNOWLEDGE THAT LAST YEAR.
WAS IS THAT WE WANT TO TRY TO
GET EVERYONE TO THIS NEW
STAFFING STANDARD. RIGHT WITH
THE RATIOS IN A.
WE ALSO ACKNOWLEDGE THAT THERE
AND LOOKS LIKE A B. IS BEARING
OUT THERE IS A SHORTAGE OF CNA
SO WE NEED TO APPROVE THE
PIPELINE.
AND THAT WE ALSO HAVE A LITTLE
PUT IN A WAIVER PROCESS BECAUSE
WE DEADLINE DO IS GIVEN THEFACT
THAT OUR EXISTING FACILITIES ARE
NOT. NUMBER ISN'T QUITE KEEPING
UP AS IT IS
THAT WE DON'T WANT TO KNOW THAT
WE WANT TO FIGURE OUT THE RIGHT
BALANCE SO THAT WE DON'T END UP
WITH FACILITIES THAT. YOU KNOW
WE OF THE LAS OF CAPACITY.
ACHILLES. THAT AND MUSTARD
OBVIOUSLY THERE'S SIR
SIGNIFICANT QUALITY ISSUES AND
WE DON'T WANT POOR QUALITY BEDS.
BUT DON'T WORRY Y. GIVEN
OPPORTUNITIES THAT WILL LOSE
CAPACITY AS WELL.
THAT'S BECAUSE THERE'S A SHEET
SHORTAGE I MEAN IT'S A IT'S HARD
ENOUGH TO FIND.
NURSING HOME BEDS AS IT IS.
CELL ONE OTHER FACT TO KEEP IN
MIND IS THAT WHO'S NEXT THE
OUTFIT FISCAL YEAR. THERE WILL
BE NO MONETARY PENALTIES THAT WE
WILL ASSESS ON INVEST PER THE
STATUTE SO. THEY WILL HAVE IT
WHEN MORE ADDITIONAL YEAR. THAT
IN ESSENCE TO RAMP UP AND AND
EITHER GET MORRIS A SCENE IS IN
THE PIPELINE OR TWO TO THE
RECRUITMENT. WILL STILL DO OUR
JOB TO STE NO SURVEY AND IF THEY
ARE NOT COMPLIANT WILL ISSUE
DEFICIENCY BUT THERE WILL BE NO
MONETARY PENALTIES FOR THOSE
FIRST YEAR.
OKAY.
ALRIGHT WELL THE.
WELL.
TRY TO MAKE THE THING WORK
ALRIGHT.
OKAY.
WE DO HAVE TO STAKEHOLDER
PROPOSALS.
ONE FOR THE CALIFORNIA HOSPITAL
ASSOCIATION FOR APPLICATION DATA
METRICS FOR CENTRALIZED
APPLICATION UNIT.
SO ACTUALLY IF.
MUCH COME UP OF FINER.
I THINK THERE'S A CHAIR OVER
THERE.
YEAH MUCH THIS.
VERY OF.
A.
YOU CAN DO IT WITHIN THREE
MINUTES OR LESS AND BE GREAT I
THINK I CAN DO THAT THANK YOU
SENATOR BARBARA GLAZER WITH
CALIFORNIA HOSPITAL ASSOCIATION.
WE DO HAVE A REQUEST THAT THE
SUBCOMMITTEE CONSIDER ADOPTING
BUDGET TRAILER BILL LANGUAGE
THAT WOULD REQUIRE THE
DEPARTMENT OF PUBLIC HEALTH TO
PUBLICLY POST INFORMATION ON THE
CENTRALIZED APPLICATION UNITS
WORKLOAD VOLUME. AND TIMELINESS
OF PROCESSING HELP FACILITY
APPLICATIONS.
IN TWENTY FOURTEEN SEVERAL
SIMILAR LANGUAGE WAS ADOPTD AND
WE THINK THIS LANGUAGE COULD
EASILY BE INCORPORATED INTO THAT
LANGUAGE.
THIS IS FOR ON. A VARIETY OF
ITEMS WHERE HOSPITALS AND OTHER
HEALTH FACILITIES MUST SUBMIT
APPLICATIONS AND THEN GET
APPROVAL. FOR EXAMPLE IF THEY'RE
TRYING TO EXPAND AN EXISTING
SERVICE INCREASE THE SIZE OF
THEIR EMERGENCY ROOM. THEY NEED
TO SUBMIT THE APPLICATION IT CAN
TAKE EIGHT TO TEN MONTHS FOR AN
APPLICATION EVEN BE.
ACKNOWLEDGED AND ME AND THEN
EVEN LONGER.
BUT WE THINK HAVING THESE
METRICS WILL HELP ALL OF US
TRACK ALL OF THAT.
OKAY THANK YOU.
ANY COMMENT FROM PART PUBLIC
HEALTH FROM THAT YES SO WE AGREE
THAT THE THAT THE METRICS AND
THE PUBLIC POSTING OF THEM IS.
INCREDIBLY VALUABLE WE HAVE
ALREADY DEVELOPED A WEBSITE.
WE ARE JUST AWAITING FINAL
REVIEW OF THE DATA BEFORE THAT
WEBSITE GOES LIVE SO WE DON'T
SEE A NEED FOR TRAILER BILL
LANGUAGE TO REQUIRED BECAUSE
WERE.
VERY SHORTLY IT'S GOING TO BE IN
EXISTENCE.
IT WILL IT WILL HAPPEN YES OKAY
EXCELLENT PARA LA JOH.
I GUESS WITHOUT BURDEN BUT
MAKING A COMMENT ON THE
PARTICULAR.
PROPOSAL BY THE CALIFORNIA
HOSPITAL ASSOCIATION.
.
I GUESS A QUESTION I'D MAYBE
RECOMMEND YOU ASK THE DEPARTMENT
IS WHETHER THAT NEW WEBSITE WILL
ALSO INCLUDE. INFORMATION ABOUT
PROCESSING TIMES FOR
PROFESSIONAL CERTIFICATION
APPLICATIONS BECAUSE WE RAN INTO
SOME TROUBLE.
IN DOING OUR ANALYSIS IN IN
GETTING. YOU KNOW CLEAR METRICS
AND AGGREGATED INFORMATION ON
THE THE PROCESSING TIMES FOR
CERTIFICATIONS.
OKAY. ARE WE HAVE NOT YET
DEVELOPED BOMB METRICS ARE
WEBSITE FOR THE PROFESSIONAL
CERTIFICATION BRANCH.
OKAY IZZARD TENSION TO DO THAT.
IT'S IT'S OUR INTENTION TO
PROVIDE MORE TRANSPARENCY IN
MORE METRICS FOR PUBLIC POSTING
IN EVERY AREA AS WE MOVE LONG I
DON'T KNOW THAT WE HAVE A
PROPOSED THAT WE ARE.
THAT WE HAVE SOMETHING IN
PROCESS TO DEVELOP THAT WEBSITE
AT THIS MOMENT.
SO. IT'S BEING SUGGESTED WOULD
CHOOSE THEN SAY THAT THERE'S AN
ATTENTION TO DO THAT.
WE WEEKENDS HELLISH CERTAINLY
RECOGNIZE THE NEED AND AND AS I
SAID WE'RE WE'RE ALWAYS WORKING
TO GET MORE DATA UP UP ON THE
WEBSITE ALRIGHT WELL WHY DON'T
KNOW THE LEVEL THAT IT RELATES
TO HAVE A PLAN YET. THE GOOD IF
HE JUST SAID WE INTEND TO DO
THAT.
THAT PLAN HOUSE THAT.
WE CAN PUT TOGETHER PLAN OKAY
AND THEN FROM A PLAN WILL DO IT
RIGHT.
OKAY. ALRIGHT FINANCE.
OKAY ALRIGHT WELL BATES CLEARLY
A DEFICIENCY THAT'S AND THEN IF
I ONLY HOPE I HOPE WE CAN PURSUE
THAT AS WELL AND I APPRECIATE
THAT YOU'RE GOING TO BE HEADS I
HAVE ACTUALLY ANY COMING FROM
POSSIBLE CESSATION.
DEPARTMENTS IT'S DON'T NEED TO
KNOW THE LANGUAGE AND DO IT
ANYWAY.
WELL I I THINK WOULD LIKE MORE
INFORMATION ON THAT.
WHEN THEY THINK.
THEY'LL BE GOING LIVE WITHOUT
INFORMATIONS BEAT.
I I'M NOT.
QUITE SURE WHAT TO SAY WITHOUT
MORE INFORMATION OKAY.
ALRIGHT SO TALK UNDERSTOOD SO.
.
AND I KNOW WE WE WE WE'VE BEEN
TALKING FOR QUITE SOMETIME ABOUT
THE METRIC SUCCUMBING METRICS
ARE COMING IN IT IT HAS TAKEN
SOME TIME. BUT AS I SAID.
WE'VE.
WE'VE ALREADY BETA TESTED THE
WEBSITE IT'S IT'S JUST.
.
WE WE WILL WE INTEND TO POST THE
NEW CA YOUR METRICS AT THE SAME
TIME THAT WE OPPOSED.
THE SECOND QUARTER METRICS FOR
ALL OF THE METRICS THAT WE
ALREADY POSTING SO THERE THOSE
ARE MOVING TOGETHER FOR APPROVAL.
WELL PAID MAYBE MAYBE MAYBE YOU
CAN SHARE WHAT YOU HAVE THAT THE
GUYS CAN TALK YOU CAN SHARE WHAT
YOU HAVE AND WE'LL SEE BY THE
TIME MAY REVISE SINCE ANYTHING
WE TASSEL VETOED JUNE WHETHER
HOW NECESSARY IT IS SAID THAT IT
TURNS OUT.
SATISFIED
AND THAT THEY WILL BE POSTED
BEFORE.
THAT HOW CAN WE WILL SOON LET
YOUR CONSULTANT KNOWN WE DO POST.
OKAY AND BENT AND THE HOSPITAL
ASSOCIATION I AGREE WE PRETTY
WELL DEFINED THANK YOU. OKAY
ALRIGHT.
I'M GLAD TO KNOW WHAT'S GOING TO
HAPPEN.
BUT IF THE PRISON THE PUTTING
THEM. OKAY. ALRIGHT AND THEN WE
ALSO MARCUS MCKINNEY FROM THE
CALIFORNIA ASSOCIATION PLEASE
COME UP AND THE OF PHOTO FROM
TRUTH INTEGRITY EFFORTS FACILITY
AND.
I THANK YOU GOOD EVENING MISTER
CHAIR. COLUMN WE APPRECIATE THE
OPPORTUNITY TO PRESENT ON THE
PROPOSAL ANONYMOUS MARKSMEN
KILLING WITH THE CALIFORNIA
NURSES THIS.
.
ORGANIZATION FILLED THE PROPOSAL
TO MOVE THE WILL IMPROVE THE
INTEGRITY OF HOSPITALS
AFFECTIONS IS CURRENTLY
CONDUCTED BY THE DEPARTMENT OF
PUBLIC HEALTH. UNDER CURRENT LAW
DPH IS MANDATED TO DEPLOY
HOSPITAL SPECTER'S
IN ORDER TO CONDUCT THE
INSPECTION OF HOSPITALS FOR
SPECIFIED PURPOSES GENERALLY
THESE INSPECTIONS.
ARE INTENDED TO FOR INSPECTORS
TO MAKE FINDINGS AS WELL AS
RESPOND TIMELY INAPPROPRIATELY
TO ISSUES IDENTIFIED DURING THE
INSPECTIONS PROCESS.
HOWEVER WE'VE HEARD FROM OUR
MEMBERS THE PRESENCE OF
MANAGEMENT DURING THESE
INSPECTIONS HAS HAD A STIFLING
EFFECT ON HOSPITAL PERSONNEL.
OFTENTIMES INTIMIDATING
PERSONNEL SO MUCH THAT THE
DOCTOR FOR PROVIDING MEANINGFUL
FEEDBACK ABOUT PATIENT SAFETY
ISSUES AND POTENTIAL REGULATORY
VIOLATIONS.
THEREFORE IS NOTED IN THE
SUBCOMMITTEE'S AGENDA HAVE WE
WILL LIKE TO RESPECTFULLY
REQUEST THE SUBCOMMITTEE DUMP
TRAILER BILL LANGUAGE AMENDING
SECTION TWELVE SEVENTY EIGHT
POINT FIVE OF THE HEALTH THE
SAFETY CO. TO ALLOW EMPLOYEES OF
ENTITIES EXPECTED BY DBAS TO
HAVE THE RIGHT TO DISCUSS
POSSIBLE REGULATORY VIOLATIONS
OR PATIENT SAFETY CONCERNS WITH
INSPECTOR PRIVATELY DURING THE
COURSE OF AN INVESTIGATION. OUR
INSPECTION BY DPH.
IS ALSO NOTED.
THIS PROVISION WOULD BE
CONSISTENT WITH LABOR CODE
SECTION SIXTY TO REPORTING WHICH
ALLOWS EMPLOYEES TO SPEAK FREELY
WITH THE SPECTRES AT THE
DIVISION OF OCCUPATIONAL SELF
AND SAFETY.
UNDER EXISTING LAW HAVE A CAL
OSHA INSPECTOR COMES INTO A
HOSPITAL.
TO CONDUCT AN INSPECTION THE
NURSES AND OTHER PERSONNEL CAN
ACTS THEN INSPECTOR SPEAK
PRIVATELY BENEFIT DPH INSPECTOR
COMES AND. THEY DON'T HAVE THE
SAME LIBERTY OR TO SIMPLY ACCENT
FOR PARITY.
THE PRESENCE OF MANAGEMENT AND
THESE INSPECTIONS ALSO HAS NO
CORRELATION THAT WE KNOW OF TO
IMPROVE OUTCOMES.
HAS A CHILLING EFFECT ON
PERSONNEL AND IF ANYTHING IS
ONLY RESULTED IN THE OMISSION OF
POTENTIALLY IMPORTANT ISSUES
PERSONNEL MAY SEEM TO ADDRESS.
WE ALSO FELIZ ALL ADOPTING THESE
PROVISIONS WILL POTENTIALLY
IMPROVE EFFICIENCY IS HOSPITAL
MANAGEMENT WILL HAVE THE
OPPORTUNITY TO BE REASSIGNED
TASKS RELATED TO THE DELIVERY OF
CARE. INSPECTORS WILL HAVE A
MORE ACCURATE DEPICTION OF WHAT
THE STATE OF AFFAIRS ARE AT ANY
GIVEN HOSPITAL WHICH MAY ALSO
LIKELY RESULT IN CURBING THE
NUMBER OF ADDITIONAL OR FOLLOW
UP INSPECTIONS BEING CONDUCTED
BY DP H.. BROUGHT THE BY
ANONYMOUS CALLS FROM PERSONNEL
OR OTHERWISE.
I'M SO WE APPRECIATE YOUR
CONSIDERATION THIS IMPORTANT
PROPOSAL AND WE ASK FOR YOUR
SUPPORT AND ADOPTED A TRAILER
BILL LANGUAGE.
OKAY THANK YOU ARE COMMENTS FROM
THE PUBLIC.
ONLY TO SAY THAT WE FIRST
LEARNED ABOUT THIS PROPOSAL.
IN THE COMMITTEE AGENDA A BUT I
DO BELIEVE THAT WE HAVE WERE
SETTING UP A MEETING TO TO
DISCUSS AND LEARN MORE ABOUT IT
OKAY AT ELLIOTT COMMENTS.
FINANCE
OKAY A THAT I I WOULD JUST SAY
AND WE HAVE. NOT BEEN DIRECTLY
YOU KNOW I'VE BEEN AT THE
RECEIVING END OF HOSTILE
INSPECTIONS.
NOT AS OF.
ACCREDITATION
WHERE WE.
VIEW WELL THE RESIDENCY PROGRAM
TRAINING PROGRAMS WERE OF
COMPLYING WITH OUR ACCREDITATION
STANDARDS AND. CONSIDERED A BEST
PRACTICE AND AND THE REQUIREMENT
THAT WHEN.
DE IN THE SO CALLED SPECTRUM
BUT THE PERSON THAT YOU CAME TO
DO THE REVIEW THAT THEY ACTUALLY
MET WITH THE TRAINEES WITHOUT.
FACULTY AROUND TO TO GET
ACTUALLY ONE OF THE TRICKY PARTS
THOUGH IS IS THAT. FOR EXAMPLE
SOMETIMES THE PROGRAM LIKE WE
WANT TO PICK WHICH RESIDENTS
ACTUALLY ARE THE ONES WE TALKED
TO. ARE WE ONE DOVE WHICH ONES
ARE IN THE ROOM BECAUSE THEN
THEY KNOW IF SOMETHING COMES OUT
WHICH ONES WERE AND SO I MEAN. I
THINK IT'S IMPORTANT THAT NOT
ONLY THAT INSPECTOR BE ABLE TO
MEET PRIVATELY WITH EMPLOYEES
BUT DONE IN A WAY THAT DOESN'T
MAKE IT EASY TO IDENTIFY WHICH
EMPLOYEES BY BEEN THE ONES WHO
TOLD INSPECTOR SOMETHING THAT.
THAT TURNED OU AGAIN THAT
SPECTER OF COURSE TAKES THAT IS
A PIECE OF INFORMATION TO THEN
FURTHER EXAM AND AND.
AS WELL SO MEANS IDEAS TO BE
SURE THAT
THE INSPECTOR IS FULLY IMPACT
AND IN ABLE TO IDENTIFY. ISSUES
AND AND AND AND.
WORK WITH THE INSPECTED
INSTITUTION TO BE SURE DURING
THE REMEDIATED ARTHUR.
OTHER APPROPRIATE CONSEQUENCES
HAPPENED SO I I HOPE THAT THAT
IS SOMETHING THAT.
TO ME IT'S A BEST PRACTICE SO.
CYPRESS LOW PLEASE THAT
DIALOGUE WILL LEAD TO USE.
SOMETHING ALONG THOSE LINES.
OKAY WELL LET'S TAKE PUBLIC
COMMENT ON THIS. SEXUAL WEEDS
THE OVERALL SO WE HAVE TO TO ABS
WHO POSES BUT WE ALSO HAVE THE.
OVERALL ISSUE AROUND THE WAIVERS
AND.
AB RATIO SO YES.
CHAIRMAN FRED MADE ON BEHALF OF.
CALPERS THE STATEWIDE
ASSOCIATION FOR THE PROGRAM.
FOR THE ALL INCLUSIVE CARE FOR
THE ELDERLY. A WE WANT TO
SUPPORT THAT CALIFORNIA HOSPITAL
ASSOCIATIONS.
A PROPOSAL FOR PUTTING THE.
METRICS ONLINE UNDERSTANDING
THAT.
DEPARTMENTS OUR COMMITMENT TO DO
THAT. PICK PROGRAMS ARE.
RIGHT NOW ABOUT.
BUT EIGHTEEN MONTHS BEHIND IN
KNOWING WHERE THEIR APPLICATIONS
ARE PACE IS EXPANDING QUICKLY
THROUGHOUT THE STATE. AND THE DP
H. LICENSING PROCESS IS ONE OF
THE BIG.
STEPS SLOWDOWNS IN THAT PROCESS
SO WE'RE GLAD TO HEAR THAT
THEY'RE DOING THAT.
THANK YOU A SAY NO THE PUBLIC
COMMENT WE WILL HOLD.
THOSE ITEMS OPEN.
NEXT ISSUE IS ISSUE THREE
LICENSE CERTIFICATE.
THE BUS AND
COUNTY CAR
EXTENSION.
THIS PROPOSAL REQUESTS AN
INCREASE IN EXPENDITURE
AUTHORITY OF ONE POINT NINE
MILLION DOLLARS FROM THE STATE
DEPARTMENT OF PUBLIC HEALTH
LICENSE IN CERTIFICATION PROGRAM
FUN THIS INCREASE WILL AUGMENT
THE LOS ANGELES COUNTY CONTRACT
FOR A ONE YEAR EXTENSION OF THE
EXISTING CONTRACT.
THIS WILL UPDATE THE INDIRECT
COSTS THREE THE EMPLOYEE
BENEFITS RATE PERSONNEL COSTS
AND LEASE COSTS.
IS ONE WAY NINE IS IN ADDITION
TO AN EIGHT HUNDRED THOUSAND
DOLLAR BASELINE ADJUSTMENT THAT
WAS BUILT INTO LAST YEAR'S
BUDGET. POSSIBLY. ACTUAL
INCREASE OF OF THE CONTRACT
COMPARED WITH CAREER WILL BE TWO
POINT SEVEN MILLION DOLLARS. A
AND ADDITIONAL CITY PAGES FOR
POSING TRAILER BILL LANGUAGE TO
ASSESS A SUPPLEMENTAL FEE ON
WILL.
I FACILITIES LOCATED WITHIN LA
COUNTY TO OFFSET THE ADDITIONAL
COST NECESSARY TO REGULATE THESE
ENTITIES IN LA COUNTY.
.
DESCRIBING HOW THE DEPARTMENT
WILL DETERMINE THE CORRECT
AMOUNT OF THE SUPPLEMENTAL FEE.
SO IT IS WITH THE CALCULATION IS
BASED ON THE DIFFERENCE IN COST
BETWEEN WHAT THE ACTUAL COST OF
THE LA COUNTY CONTRACT IS AND
WHAT IT WOULD COST THE STATE
WHERE THE STATE TO PERFORM THOSE.
THE BUDGET COST OF THE LA COUNTY
CONTRACT AND WHAT THE BUDGET
WOULD BE WHERE THE STATE TO
PERFORM THOSE FUNCTIONS. WE TAKE
THAT DIFFERENCE AND THEN WE.
ALLOCATE THOSE DOLLARS BASED
OFF OF THE CURRENT CONTRACTED
WORKLOAD SO IF THE.
SKILLED NURSING FACILITIES
REPRESENT EXPERTS SENT OF THE LA
COUNTY CONTRACTED WORKLOAD THAN
THEY WOULD PAY EXPERTS SENT OF
THAT THAT DIFFERENCE AND THAT
WOULD SPREAD THOSE BASED OFF OF
THE NUMBER OF. LICENSED BEDS IN
LA COUNTY A AND THEN WE CAN
MITIGATE ANY LARGE FLUCTUATIONS
BY USING PROGRAM RESERVES TO
OFFSET LARGE. INCREASES THAT MAY
OCCUR FROM ONE YEAR TO THE NEXT
AS WE CURRENTLY DON'T OUR FEES.
BUT THE THE PRINCIPLE THERE IS
THAT IT'S THE DIFFERENCE BETWEEN
WHAT IT WOULD COST US AND WHAT
IT DOES COST
TO CONTRACT DELICATELY.
IT ALSO ASKED A WHAT KIND OF
PERFORMANCE METRICS REMOVED
INCLUDING THE NEXT CONTRACT UP
THAT'S TO BE DETERMINED THIS
POINT TIME WERE ONLY AT THE
INFANCY STAGES WITH OUR
DISCUSSIONS AND NEGOTIATIONS
WITH ELLICOTT.
A ON WITH IT NO THREE YEAR
CONTRACT MIGHT LOOK LIKE IN
TERMS OF PERFORMANCE METRICS
BUT CONCEPTUALLY HOW RIPPER
THINKING ABOUT.
PUTTING IN METRIC SET A CENTER
ON QUALITY QUANTITY AND CUSTOMER
SERVICE OTHERS OF THREE BUCKETS
THAT WERE KIND OF CONSIDERING A
AND THE ACTUAL DETAILS WILL BE
PART IN NEGOTIATIONS THAT WE
HAVEN'T YET FLESHED OUT FULLY
WITH OUR.
A LA COUNTY PARTNERS.
BUT ALAS IT THE. ISSUE AROUND
WHETHER OR NOT THERE'S CONCERNS
ABOUT THE FISCAL IMPACT THAT THE
SUBMIT OF YOU'D HAVE ON LA
COUNTY FACILITIES. AND THE
PURPOSE OF THE SUBMIT A FEE IS
OBVIOUSLY TO ENSURE THAT
FACILITIES ARE PAIN.
.
FEES ARE COMMENSURATE TO THE
REGULATORY COSTS SO IT'S TAKEN
INTO CONSIDERATION NOT JUST THE
FISCAL IMPACTS OF THE FEES ON LA
COUNTY FACILITIES BUT THE FISCAL
IMPACTS OF.
THE FEES STATEWIDE TO MAKE SURE
THAT.
FACILITIES AGAIN OUR OUR PAIN
AND EQUITABLE SHARE BASED OFF OF
WHAT WE ACTUALLY SPEND TO
REGULATE THEM.
OKAY COMES FROM ELIO.
YES SONYA PEDIGO LEO WE'VE
REVIEWED THE DEPARTMENTS
PROPOSAL FOR THE LA COUNTY
CONTRACT EXTENSION AND WE'VE
ALSO REVIEWED LA COUNTIES I
REQUEST WHEN THEY SUBMITTED
THEIR COST INFORMATION.
TO TRY TO NEGOTIATE AN INCREASE.
THERE'S THAT THERE IS A
DISCREPANCY BETWEEN WHAT LA
COUNTY REQUESTED AND WHAT THAT
APART
IS PROPOSING THAT DISCREPANCY IS
ONE POINT NINE.
REQUESTING ONE POINT NINE
MILLION MORE THAN WHAT THE
DEPARTMENT IS PROPOSING. THE
DISCREPANCY IS LARGELY THE
RESULT OF TWO FACTORS ONE THAT
THE DEPARTMENT IS USING A
DIFFERENT INDIRECT COSTS RATE
THAN LA COUNTY.
AND TWO THAT THERE ARE DIFFERING
ASSUMPTIONS ABOUT WHAT THE
STAFFING VACANCY RATES AND
SALARY RANGES WILL BE.
IN REGARDS TO THE FIRST ISSUE
ABOUT THE INDIRECT COSTS THREE
WE RECOMMEND GOING WITH THE
INDIRECT COSTS RATE THAT'S BEEN
APPROVED BY LA COUNTY THE LA
COUNTY AUDITOR CONTROLLER AND
THE ONE THAT LA COUNTY WOULD
PREFER TO.
WE HAVE SEVERAL REASONS FOR
RECOMMENDING THIS
ONE THIS IS THE INDIRECT COSTS
RATE HAT'S BEEN USED IN THE
PREVIOUS THREE YEARS OF THIS
CONTRACT SO THERE'S PRECEDENT IN
THIS PARTICULAR CONTRACT FOR
USING THAT LA COUNTY.
AUDITOR CONTROLLER RE.
SECOND.
MANY OF THE OTHER CONTRACT
ELEMENTS ARE BASED ON CONDITIONS
PACIFIC TO LA COUNTY SO WHETHER
THAT BE STAFFING BECAUSE SIMPLY
BENEFITS REACHED THE WORK OF
FUNCTIONAL WORK HOURS PER
STAFFING POSITION.
SO WE THINK IT MAKES ANALYTICS
SENSE TO USE ALL FACTORS THAT
REFLECT THE CAN THE CONDITIONS
IN LA COUNTY. AND FINALLY WE
WOULD JUST NOTE THAT IF THE
LEGISLATURE WERE TO APPROVE THE.
PROPOSE TRAILER BILL LANGUAGE
TO ASSESS A SUPPLEMENTAL FEE IN
LA COUNTY.
THAT SHE COULD BE USED TO COVER
THIS ADDITIONAL COST WHICH.
WOULD BE ROUGHLY NINE HUNDRED.
THOUSAND DOLLARS TO USE THE LA
COUNTY INDIRECT COSTS RATE OUR
OFFICE ALSO RECOMMENDS APPROVING
THE TRAILER BILL LANGUAGE TO
ALLOW THE DEPARTMENT TO ASSESS
ASSESS
LUMINAL FEE IN LA.
BECAUSE.
CURRENTLY.
FACILITIES ALL ACROSS THE STATE
OF OUR ESSENTIALLY PAYING FOR
THE HIGHER COST
TO REGULATE.
.
FACILITIES IN LA COUNTY.
FINANCE
DON'T.
OKAY.
ALRIGHT.
.
WHEN IT COMES TO THOSE SO FIRST
OF ALL I GUESS THE QUESTION OF.
THE INDIRECT RATE I THINK YOU
KNOW WHAT.
BUT ALEJO'S SEEMS TO MAKE SENSE
OF THIS IS PUBLIC EVER TALK
ABOUT RATES IN LA COUNTY AND LA
COUNTY HAS AN INDIRECT WAY BASED
ON THAT WE COUNTY COSTS
AND SO FORTH.
REALIZING THAT IS SOMETHING THAT
GETS PASSED ON TO LA COUNTY.
NOW LICENSEES Y. IS SO SO DO YOU
PERHAPS TALK ABOUT YOUR
RATIONALE FOR REGARDING IN
GREAT.
OR IT SAID THAT THE DEPARTMENT
OF ELVES WITH EACH COUNTY AND
THE STARTED I BELIEVE IN TWENTY
FOURTEEN DEVELOPED A DIFFERENT
ROUTE AND INDIRECT COSTS RATE
METHODOLOGY. THAT IT WOULD USE
WITH EACH A LOCAL HEALTH
DEPARTMENT SO WE CERTIFY AN
INDIRECT COST RATES THAT WE USE
WITH MOST CONTRACTS WITH MOST OF
THE LOCAL HEALTH WITH ALL OF OUR
DEPARTMENTS HAVE EACH. ALLOW THE
BERMAN HAS ITS OWN METHODOLOGY
SO.
AND THIS IS THIS IS MAKING IT
MORE CONSISTENT WITH HOW WE
WOULD MANAGE ANY OTHER CONTRACT
WITH LA COUNTY FROM HERE FORWARD
IS THAT WE. POINTED THIS RATE
THAT WE ESTABLISH WITH CECIL
ITSELF.
AND OTHER STAKEHOLDERS BACK IN
TWENTY FOURTEEN AND IT WAS JUST
A TIMING ISSUE AS TO WHY DIDN'T
GET INCORPORATED IN THE CURRENT
CONTRACT THAT WE HAVE.
OKAY SO BUT YEAR RATE IS THAT
BASED ON LA COUNTY EXPENSES OR
IS THAT LIKE EXPENSES SO WE SORT
ALONE SO NOT IT'S NOT LIKE FOR
GREAT FOR EACH LOCAL HEALTH
DEPARTMENT OF THE PLANET'S
PUBLISHED ON OUR WEBSITE AS WELL.
OKAY PRETTY COMING FROM MILIONA.
I WE WERE TO SAY THAT.
GIVEN THAT THIS IS AN EXTENSION
OF THE CURRENT CONTRACT IN THE
CURRENT CONTRACT.
DOES IT THIS WAY REGARDLESS OF
WHETHER IT WAS A TIME ISSUE OR
NOT IT MAKES SENSE TO CONTINUE
THE CURRENT CONTRACT WITH THE
CURRENT METHODOLOGY. AND IN THAT
CONTRACT NEGOTIATIONS FOR THE
NEW CONTRACT RECONSIDER WHICH
INTERCUTS REACH USE OKAY.
AND THE OTHER QUESTION IS SADDAM
YOU MENTIONED WITH THE
PERFORMANCE METRICS YOU'RE
NEGOTIATING WITH LA COUNTY.
BUT I GUESS.
TO WHAT DEGREE ARE OTHER
STAKEHOLDERS INVOLVED I MEAN FOR
PERFORMANCE METRICS THERE'S PART
OF OVERSIGHT SO THE PERSON BEING
OVER CITED MAY NOT NECESSARILY
ONE THAT MEASURE CERTAIN THINGS
AS VIGOROUSLY AS OTHERS SO. CAN
YOU TELL A TALK TO ME ABOUT.
THIS PERFORMANCE METRICS AND
THAT NAY AND NEGOTIATION GOING
ON.
WHICH STAKEHOLDERS ARE INVOLVED
IN THAT NEGOTIATION.
SO.
AGAIN AS AS MY COLLEAGUE
MENTIONED EARLIER WE ARE REALLY
IN IN THE EARLIEST STAGES OF
THIS OF THIS NEGOTIATION. AND IT
IS A CONTRACT NEGOTIATIONS SO
YOU DON'T NORMALLY BRING
STAKEHOLDERS INTO COUNTRY WEEK
WE CERTAINLY HAVE CONVERSATION
THE METRICS INSERT RIGHT YEAH.
YES AND AND SO AS WE MOVE
FORWARD.
THOSE KINDS OF ENGAGE AND WE ARE
ALWAYS IN DIALOGUE WITH.
STAKEHOLDERS ABOUT PERFORMANCE
METRICS BOTH FOR THE APARTMENT
AND AND WHATEVER PERFORMANCE
METRICS.
.
WE APPLIED TO LA COUNTY.
WOULDN'T GENERALLY SPEAKING ON
ON THE CONCEPTUAL LEVEL AGAIN WE
HAVEN'T NEGOTIATED THEM WE WOULD
NOT EXPECT.
.
DIFFERENT TYPES THE PERFORMANCE
THAN WE WOULD EXPECT OF UP THE
REST OF OUR DISTRICT OFFICES SO
THEY WOULD BE PERFORMANCE
METRICS THAT THE DEPARTMENT
WOULD. LIVE UP TO AS WELL.
OKAY PARENTS JUST WHEN YOU SAID
NEGOTIATION LIKE OKAY HOW MUCH
LATITUDE ARE YOU GIVING THE
PERSON YOU'RE OVER SO YOU KNOW
IT IS JUST.
THAT THE SOME OF THE ISSUES ARE.
DO YOU MEASURE CERTAIN THINGS
HOW DO YOU MEASURE QUALITY AND
AND WHAT WHAT ARE GOING TO BE
THE THINGS THAT WE USED TO I
MEAN THAT WE ALL WE ALL HAVE TO.
EITHER I BELIEVE WITH WITH OUR
COLLEAGUES IN LA COUNTY. WE'RE
ALL COMMITTED TO CUSTOMER
SERVICE QUALITY AND GETTING THE
WORK DONE SO IT IT'S JUST THEM
IT'S IT'S ABOUT MEASURING IT HOW
HOW DO YOU MEASURE THAT AND WHAT
WE'RE GONNA BE VIEW RE POND
METRICS.
OKAY ALRIGHT.
OKAY PUBLIC COMMENT ON THIS ITEM.
FOR SENATOR BEHALF BECOME FREE
ASSOCIATION HOPE FACILITIES.
WANT TO POINT OUT THAT.
LICENSING FEES FOR SKILLED
NURSING FACILITIES IN THE LAST
FOUR YEARS HAVE ALMOST DOUBLED.
SO THERE'S BEEN QUITE INVESTMENT
FROM THE FACILITIES THEMSELVES
IN.
IN THEIR LICENSING FEES.
INTO SURVEYING BOTH YOU KNOW
FROM THAT DEPARTMENT PUBLIC
HEALTH AND NOW WITH THESE NEW
ADDED FEES ON FOR LA COUNTY SO.
WE WOULD CONTINUE TO.
.
REALLY BUT SUPPORT THE
LEGISLATURE'S I REQUEST FOR SOME
TYPE OF MATRIX
TO MAKE SURE THAT AS WE CONTINUE
TO INVEST.
OUR LICENSING FEE DOLLARS THAT
WE'RE SEEING SOME RESULTS FROM
THAT.
THINK I.
THANK YOU.
BARBARA GLAZER THE CALIFORNIA
HOSPITAL ASSOCIATION OUR
FRUSTRATION IS THE SAME AS CAPS
WERE FRUSTRATED THAT OUR PEACE
HAVE INCREASED AND THEY HAVE
VIRTUALLY DOUBLED IN THE LAST
FOUR YEARS NOT. AND NOT JUST IN
LA COUNTY BUT STATEWIDE BUT WE
HAVEN'T SEEN A CORRESPONDING
IMPROVEMENT IN SERVICES.
OKAY THANK YOU.
ANGELO BELOW DEPUTY DIRECTOR
HEALTH PROTECTION LA COUNTY
PUBLIC HEALTH.
WELL GOOD AFTERNOON AND DAHLE
LET ME JUST TAKE A JUST A COUPLE
OF MINUTES HERE.
AYE YOU HAVE ONE MINUTE. ONE
MINUTE.
OKAY.
WELL I THINK GO WE'VE ALREADY
HEARD THE RECOMMENDATIONS OF LA
O. WHEN THE WHAT THE DEPARTMENT
IS PREPARED TO DO AS WELL AS THE
GOVERNOR AND WE. WE THANK EACH
OF THOSE PARTIES FOR THEIR
RECOMMENDATIONS ON OUR BUDGET.
BUT STILL VOTE THOUGH DOES LEAVE
US WITH A SHORT FALL.
OF IT MIGHT BE A MILLION DOLLARS
WE HAVE A COST REIMBURSEMENT
CONTRACT CURRENTLY. WERE VERY
EAGER TO TO DEVELOP A
PERFORMANCE BASED CONTRACT.
BUT CURRENTLY THE.
DEFICIT THAT WE'RE TRYING TO
FILL HER THE GAP THAT WE'RE
TRYING TO PLUG IS SO THAT OUR
COSTS ARE FULLY RECOVERED.
AS THE CONTRACT THAT'S THE TYPE
OF CONTRACT IT IS.
TOM I WANT TO MENTION THAT.
BY THE END OF THIS FISCAL YEAR
THE COUNTY WILL BE REPORTING.
ALL ON ITS PROGRESS OVER THE
LAST THREE YEARS AS YOU REMEMBER
THE LEGISLATURE THE.
ADMINISTRATION AND THE COUNTY
PLACED A LOT OF INVESTMENTS INTO
THIS PROGRAM STATEWIDE INCLUDING
LA COUNTY. AND WHAT WILL BE
REPORTING AT THE END OF THIS
FISCAL YEAR IN JUNE THIRTIETH.
IS THAT WE HAVE MET IN IN MANY
CASES EXCEEDED ALL OF OUR
CONTRACTUAL REQUIREMENTS THROUGH
EACH YEAR OF THAT THREE YEAR
CONTRACT.
THAT'S VERY IMPORTANT FROM OUR
PERSPECTIVE AND YOU DON'T ALWAYS
GET THAT PICTURE WHEN YOU LOOK
AT THE STATE DPH WEBSITE. AND WE
THINK THAT HAS TO BE TRULY
REFLECTED IN THE WEBSITE
INFORMATION BECAUSE IT IT WE
NEED TO KNOW WHERE THE PROBLEMS
ARE.
OR ELSE WE'LL NEVER KNOW HOW TO
CORRECT THOSE PROBLEMS.
I WANTED TO JUST CLOSE WITH A
THREE RECOMMENDATIONS NUMBER ONE.
WE BELIEVE THAT THE ONGOING
BACKLOG THAT EXISTS WITHIN THE
STATE NEEDS TO BE DEALT WITH
BECAUSE UNTIL WE DEAL WITH THAT
BACKLOG. WE'RE GONNA BE PLAGUED
WITH UNRESOLVED COMPLAINTS WE
ALSO NEED TO MAKE SURE THAT WE
HAVE SUFFICIENT STATE FUNDING SO
THAT WE DON'T GENERATE NEW
BACKLOG. EACH YEAR OF THE
CONTRACT THIS DOES HAPPEN YEAR
AFTER YEAR.
AND THEN LASTLY. WE WANT TO MAKE
SURE THAT. WE ARE ESTABLISHING
THE KINDS OF GOALS AND THE
PERFORMANCE METRICS THAT OTHERS
HAVE BEEN MENTIONING HERE I KNOW
YOU YOU.
.
ASSEMBLY MEMBER HAVE TALKED
ABOUT THIS YOURSELF AND WE THAT
ACTUALLY HAD THIS INPUT FROM
OTHERS WE WANT THAT KIND OF
PERFORMANCE METRICS SO THAT WERE
ACTUALLY SEEING IMPROVEMENTS IN
THE PHYSICAL CONDITIONS. THE
OPERATING PRACTICES AND THE CARE
THAT'S PROVIDED TO THE PATIENT
POPULATION THANK YOU VERY MUCH
FOR CONSIDERING OUR REQUEST.
THANK YOU AND ACTUALLY BE TWO
MINUTES.
CRIER.
MISTER CHAIR MARK PRINDLE THE
WITH US HERE YOU CALIFORNIA.
WE ARE IN SUPPORT OF THE
STATE'S PER PROPOSAL OF A TWO
POINT SEVEN.
MILLION IN SUPPLEMENTAL FUNDING
ALONG WITH THE LA COUNTY REQUEST
FOR AN ADDITIONAL ONE POINT NINE.
MILLION JUST A COUPLE COMMENTS
I AM I WON FIRST COMING ON THE
ISSUE OF THE GROWING BACKLOG OF
THE FACILITY REPORTED INCIDENTS
IN LA COUNTY.
WHEN THE STATE INVESTED IN
HIRING MORE STAFF WE KNEW THAT
THE RATE OF SOFT REPORT
INCIDENTS WOULD CLIMB AND SO LA
COUNTY REQUESTED ADDITIONAL
FUNDING LEVELS. TO ALIGN WITH
THAT WORKLOAD.
ARE NURSES EXPERIENCE IS THAT
WHEN WE PUT BOOTS ON THE GROUND
AND INSPECTORS ARE VISITING MORE
FACILITIES MORE REGULARLY.
FACILITIES ARE ARE BETTER AT
SELF REPORTING AND THE VOLUME
AYE GOES UP UNFORTUNATELY THOUGH
THAT STATE CONTRACTED WITH THE
COUNTY AT LESS THAN HALF THE
ESTIMATED VOLUME OF FACILITY
REPORTED INCIDENTS.
THE RESULT IS THAT WHILE LA
COUNTY HAS MET AND EXCEEDED THE
CONTRACTED INVESTIGATIONS OF
YOUR EYES THE ACTUAL LEVELS OF
YOUR EYES IS IN FACT MUCH HIGHER.
THE STATE BEARS RESPONSIBILITY
FOR PICKING UP THE NON
CONTRACTED WORKLOAD AND SO EACH
YEAR WE'RE NOW CREATING A NEW
BACKLOG OF CASES WHICH WITH NO
PLAN FOR ADDRESSING THIS ISSUE.
WE WOULD ALSO URGE THE STATE TO
MAKE A SIGNIFICANT ONE TIME
INVESTMENT. IN GETTING THROUGH
ALL THE BACKLOG THE HISTORIC
WHICH IS A HISTORIC BACKLOG.
WHICH WERE MAKING PROGRESS ON
WIGGLING DOWN AS WELL AS THE NEW
BACKLOG THAT IS ACCRUING AND ONE
LAST POINT.
I JUST LIKE TO CLOSE WITH THEM
WE ALSO CONTINUE TO BE ARE WE
HAVE TO CONTINUE TO BE CONCERNED
ABOUT THE UNDER FUNDING. OF OUR
STATE PUBLIC HEALTH NURSES IN
THE PROGRAM.
WHILE THE STATE CREDITS THEIR
CONTRACTOR WITH HELPING TO
REDUCE THEIR VACANCY RATES FOR
THE STATE PROGRAM THE STATE
STAFF TURNOVER RATE IS STILL
INCREDIBLY HIGH WHICH MAKES THIS
QUESTION HOW EFFECTIVE THE
STATE'S STRATEGIES WILL BE. IN
THE LONG RUN.
TO SHED SOME LIGHT ON THIS
PROGRAM LA COUNTY HAS A STAFF
TURNOVER RATE OF TWO PERCENT.
COMPARED WITH THE STATE'S
TURNOVER RATE OF TWENTY PERCENT
OF FIFTH OF ALL NEWLY TRAINED P.
CHANCE.
THE TRAINING OF A THOUSAND TWO HUNDRED THOUSAND
PER PERSON.
AND IT'S INEFFICIENT TO
UNDERPAID THEM SO SIGNIFICANTLY
THINK I MISTER CHAIR AND YOU.
MY NAME IS CAN A YOUNG AND I'M
WITH AS TO USE SEVEN TWO ONE
NONA THINK ON THE CHAIR FOR HIS
THOUGHTFULNESS ON THIS ISSUE.
OUR MEMBER HAD TO LEAVE TO CATCH
A FLIGHT SO HE ASKED ME TO READ
HIS STATEMENT SO RADICALLY. MY
NAME IS NOT IN TUNE AND I'M A
HEALTH FACILITY EVALUATOR NURSE
FOR FANTASY COUNTY. OF OVER
THIRTY FIVE YEARS OF EXPERIENCE
AS A RN IN FOR THE LAST SEVEN
YEARS HAVE BEEN A HEALTH
FACILITY EVALUATOR.
AT A TIME WHEN FACILITIES TO
ENSURE THAT PATIENTS ARE SAFE IN
GETTING THE BEST CARE POSSIBLE.
IF FACILITIES PROVIDE
SUBSTANDARD CARE PER RESIDENTS
LIVES AT RISK OR CAUSE THEM HARM
WHO THEM ACCOUNTABLE BY WRITING
DEFICIENCIES AND OR CITATIONS SO
THEY CHANGE HOW THEY DELIVER
CARE. EVALUATORS INVESTIGATE
COMPLAINTS OF ABUSE NEGLECT AND
SUBSTANTIATE THE CASES FOR BOND
FORSMAN.
AS EVALUATOR NURSE I AM
COMMITTED TO USING MY EXPERIENCE
TO BUILD HEALTHCARE SYSTEM SO
PEOPLE CAN TRUST THEM. MEANING
THEIR PUBLIC OUR PARENTS AND OUR
CHILDREN.
AND THEY HAVE CONFIDENCE THAT
THE FACILITIES ARE BEING SANDERS
BY STATE AND FEDERAL GOVERNMENT.
WE'VE MADE IMPROVEMENTS WILL
SANDERS COUNTY OVER THE LAST
SEVERAL YEARS SINCE THE
LEGISLATOR TOOK ACTION TO
ADDRESS HOW SEVERELY UNDERFUNDED
WE WERE WE HAVE MET OR EXCEEDED
OUR OUTCOMES IN AREAS BEING
CONTRACTED TO PERFORM. HOWEVER
LOS ANGELES COUNTY IS NOT
CONTRACTED BY THE STATE TO
PERFORM ALL THE WORK IN THE
COUNTY AND WE SHOULD HAVE A
STATE PLAN TO ADDRESS THE WORK
NOT BEING PERFORMED. BECAUSE
LIVES ARE AT RISK WE NEED TO
WORK TOGETHER TO FIND A SOLUTION
TO ADEQUATELY STAFFED THE
LESSENING CERTIFICATION PROGRAM
I RESPECTFULLY ASK THE
LEGISLATOR.
SURE AND ADMINISTRATION TO
ADDRESS THE ROOT OF THE PROBLEM
AND GET US ON THE RIGHT TRACK TO
IMPROVE THE PROGRAM AND PROVIDE
NEEDED SERVICES TO THE
VULNERABLE MEMBERS OF OUR
COMMUNITIES. THANK YOU.
OKAY THANK YOU.
AND SO.
GIVEN THE TESTIMONY CAN YOU
SPEAK TO WHAT'S GOING ON TERMS
OF THE BACKLOG AND. WHERE WERE
AT WHAT THAT?
SO.
THREE YEARS AGO.
WE RECEIVED AND AN AUGMENTATION
TO OUR BUDGET.
TO ENABLE US TO HIRE TWO HUNDRED
THIRTY SEVEN ADDITIONAL STAFF
FOR THE FIELD. AT THAT TIME WE
WERE TESTIFYING WE.
STATED THAT IT WOULD TAKE US.
FOUR YEARS FROM THE TIME THAT WE
FILLED ALL OF THOSE NEW
POSITIONS TO CLEAR THE BACKLOG.
MORE THREE YEARS AND WE HAVE A
CLEAR THE BACKLOG NOR HAVE WE
FULLY FILLED ALL OUR POSITIONS.
BUT WE DO HAVE.
PLANS ON HOW WE WORK ON OLDEST
CASES AND WE ARE WORKING
DILIGENTLY TO REDUCE THE BACKLOG.
BUT YES THERE IS STILL A
SIGNIFICANT BACKLOG AND WE DID
ALSO AT THE TIME.
ALERT PEOPLE THAT THE BACKLOG
WOULD PROBABLY GROW BEFORE IT
REDUCED AND THAT HAS IN FACT
HAPPENED.
OKAY SO ARE WE AT THAT REDUCTION
PHASE YET ARE WE STILL ON THE
GROWTH PHASE IN THE BACKLOG.
IT'S I DON'T KNOW THE EXACT
ANSWER THE QUESTION THAT THAT'S
PART OF OUR POSTED METRICS AND
WE CAN CERTAINLY LOOK THAT UP
FOR YOU AND AND GET BACK TO YOU
WITH THAT. OKAY SO YOU CAN'T
TELL ME RIGHT NOW THERE'S A
BACKLOG SINCE THAT TIME HAS
GOTTEN SMALLER OR LARGER SINCE
SINCE IT IT HAS GROWN IN THE YES
OKAY SAID I DON'T KNOW I GUESS I
DON'T KNOW IF THE IF LIKE IN IN
THE MOST RECENT YEAR THE TREND
IS. MOVING ABOUT YES OKAY SO SO
THE BACKLOG SEXY LARGER THAN IT
WAS WE INITIATED THIS THAT IS
LIKE WHEN YOU'RE NOT SURE
WHETHER TO TRAJECTORY AT THIS
POINT IS.
DOWNWARD ARE STILL GOING UPWARD
AND. CORRECT I MEAN YOU KNOW
LIKE IN THE MOST RECENT QUARTER
SO AND AND ONE THING I THINK WAS
SORT OF MENTIONED IN THE.
TESTIMONY IS THAT WE'VE ALL
EXPERIENCED LOS ANGELES COUNTY
IN AND STATEWIDE.
AN INCEASE IN THE NUMBER OF
COMPLAINTS OVER THE LAST THREE
YEARS EACH EACH YEAR THE NUMBER
OF INCOMING COMPLAINTS HAS GROWN.
AND THEN THERE'S THERE'S
TESTIFIED ALSO TO TURN OVER THE
STATE.
STAFFING AND BE ABLE TO.
YEAH I DON'T HAVE A I'M NOT SURE
WHERE THE FIGURE THAT OUR
TURNOVER RATE IS TWENTY PERCENT.
AND IS BASED OFF OF WE'VE.
WORKED WITH THEY HAVE
RECRUITMENT AND RETENTION.
EQUIPMENT ONBOARD AND RETENTION
CONTRACTOR UP OUR TURNOVER RATE
IN A JIFFY AND CLASSIFICATION.
TO MY KNOWLEDGE IS CLOSER TO
ROUGHLY TEN PERCENT NOT THAT
THAT'S GREAT BUT.
AND IT IS NOT TWENTY PERCENT. A
AND SOME OF THE TURN OVER THAT
WE DO HAVE WITHIN THAT IS PEOPLE
WHO ARE.
.
PROMOTING WITHIN THE PROGRAM OR
LATERALLY AND EVEN WITHIN THE
PROGRAM TO JUST ACCOUNT THE
NUMBER OF PEOPLE THAT WE MAY
HAVE HIRED OVER A GIVEN POINT OF
TIME INCIDENT THAT IT'S TWENTY
PERCENT I DON'T THINK THAT
THAT'S REALLY WHAT WE.
HELLO.
MUCH LOWER THAN WHAT WAS
REPORTED INDIAN YOU MADE MENTION
THAT GIVEN BILL FILL ALL THE
POSITIONS BUT WHAT PERCENTAGE
POSITIONS HAVE YOU BEEN ABLE TO
FILL.
VERY EASILY WE ALSO MADE A LOT
OF PROGRESS IN THAT AND JUST IN
THE LAST SEVERAL MONTHS.
IN APRIL.
.
NOW TO IT'S BEEN A YEAR AGO SO
YEAR AGO OUR VACANCY RATE WAS
UPWARDS OF TWENTY TWO OF THE IT
IS TWENTY ONE TWENTY TWO PERCENT.
AS OF JUST A WEEK AGO IT WAS
DOWN TO TEN PERCENT SO WE HAVE
CUT THE AND HALF A WE ARE STILL
TRENDING DOWN ON THAT WHERE WE
ARE CONTINUING TO.
HIRE MORE PEOPLE THAN RETURNING
OVER.
AND WE'RE FILL IN THOSE
POSITIONS AND WE'RE TRAINING
THEM TO SERVE QUICKLY AS WE CAN.
US SO THAT WE CAN HIM MAKE A
DENT INTO THAT BATTLE THAT WE'VE
ADDRESSED IS ALSO IMPORTANT NOTE
THAT'S.
OR TRAINING PROGRAMS A TIME FOR
US TO TRAIN STAFF IS GETTING
SHORTER AND SHORTER AND IN A
LARGE PRESS BECAUSE SEE MASS OF
OUR CONTRACTOR WHO WE HAVE TO
GET. OUR TRAIN FROM HAS PUT
THEIR TRAINING UP PROGRAMS MORE
ON AN ON AN ONLINE BASIS AS
OPPOSED TO A FLYING AND NURSE
FROM CALIFORNIA TO A TO A PLACE
IN BALTIMORE TO DO ATTENDING.
WHERE YOU HAVE A VERY LIMITED
NUMBER OF CONFERENCE THE?
WHO CAN WHO CAN ATTEND SO THE
TIME TO DO THE TRAINING IS A
EVER POINT WAS ABOUT TWELVE
MONTHS NOW IS FINE BUT LESSEN
THAT IT'LL GET EVEN LESS AS THEY
PUT MORE MORE TRAINING ONLINE?
OKAY.
ALRIGHTWELL.
THE PRIDE CAN'T REALLY DELVE
INTO THIS TOO DEEPLY RIGHT NOW
ESPECIALLY GIVEN THE TIME.
I DO HAVE ONE AS CHAIR OF THE
SENATE HEALTH COMMITTEE.
BIG BIG PROBLEM I KNOW THAT TOOK
A COUPLE YEARS AFTER TO TRY TO.
BUT THE. IF THEY WANNA FOLLOW UP
TO IN MARIN THE SPECIFICS ON HOW
HOW PROGRESS WE'RE MAKING ON ON
THESE ISSUES. SELF.
OKAY.
IT'S MOVE ON TO ISSUE NUMBER
FOUR ITEMS THAT WILL LEAD THE
THIS ITEM OPENED.
ISSUE NUMBER FOUR IS THE VICE
CERTIFICATION HEALTH CARE
LICENSING OVERSIGHT.
NO SOME OF THE DEPARTMENT.
I'M IS REQUEST ENTRY TO
POSITIONS AND EXPENDITURE
AUTHORITY OF TWO POINT FOUR
MILLION DOLLARS FLUENCY PROGRAM
FUND FUND THIRTY NINETY EIGHT.
AND TO INTERNET FOR THOUSAND
DOLLARS FROM THE INTERNAL OF
DEPARTMENT QUALITY HAS IMPROVED
COUNTY EIGHT ACUITY. OF FOR
TWENTY EIGHTEEN NINETEEN AND
ONGOING UP TO IMPROVE OF THE
EFFECTIVENESS AND AND OTHER OF
QUALITY PRUDENT PROJECTS. WITHIN
THE CENTER.
DO.
OF MINNESOTA ALSO PROVIDE SOME
NEEDED RESOURCES FOR US TO DRAW
SOMETHING SO I KNOW THE LA ONCE
IT NOW. COMMENT ON ALSO IN TERMS
OF OF THE WAIVER PROSECUTIONS A
IT WILL PROVIDE SOME RESOURCES
ON HOW QUICKLY WE OF THE CERTIFY
NEW ASEAN DAYS AS WELL AS TO THE
VOTING PROCESSES FOR THOSE UNITS
WHO MAY HAVE HAD.
ENCOUNTERS WITH LAW ENFORCEMENT
AGENCIES THAT WE NEED TO COME TO
CLEAR THEIR RECORDS.
AND SO OF THE POSITION THAT
PROVIDE SOME OTHER. RESOURCES
FOR US TO DO SOME DATA METRICS
SO ARE WE CAN CLEAR POETRY OUR
DATA AND USE IT TO OUR ADVANTAGE
AND ON HOW WE CAN. MOVE FORWARD
SO THAT ADDRESSES THE PROPOSAL.
COMMENCEMENT LEO SONYA PEDIGO
LEO.
WE'VE REVIEWED THE DEPARTMENT'S
PROPOSAL FOR TWENTY TWO NEW
POSITIONS.
FIFTEEN OF THOSE POSITIONS ARE
LARGELY IN RESPONSE TO THE NEW
STAFFING REQUIREMENTS AND
SKILLED NURSING FACILITIES IN
THE ANTICIPATED DEMANDS.
THEY ANTICIPATED INCREASE IN
DEMAND FOR CERTIFIED NURSING
ASSISTANTS.
AND TRAINING PROGRAMS.
WE THINK IT'S IMPORTANT FOR THE
LEGISLATURE TO NOTE THAT THE
THESE FIFTEEN POSITIONS ARE PART
OF A LARGER PACKAGE TO ADDRESS
THE. BOTTOM.
THE NEW STAFFING REQUIREMENTS IT
SNAPS
AND THIS PACKAGE OF PROPOSALS
AFFECTS LABOR AGENCIES COMMUNITY
BECAUSE.
I WOULD NOTE THAT OUR OFFICE IS
TRACKING THE PACKAGE OF
PROPOSALS AS A WHOLE. AND WILL
BE AS I MENTIONED WILL BE
RELEASING AN ANALYSIS EITHER
TOMORROW OR MONDAY ABOUT THE
OVERALL PACKAGE.
ESSENTIALLY OUR RECOMMENDATION
IS THAT THIS PROPOSAL AND ALL
THE OTHER PROPOSAL SHOULD NOT BE
CONSIDERED IN SILOS AT THAT IT
THAT THE PACKAGE OF PROPOSALS
SHOULD BE CONSIDERED.
AS A WHOLE.
THAT WAY THE LEGISLATURE CAN
DECIDE WHAT ITS PROGRAMMATIC
PRIORITIES ARE IN THAT ALIGN
FUNDING AND STAFFING DECISIONS
BASED ON THOSE.
FOR EXAMPLE IS IF SOME OF THE
RECOMMENDATIONS WE HAVE FROM
THAT ANALYSIS ARE TAKING IN IT
COULD
AS WE REDUCE THE NUMBER OF
POSITIONS NEEDED.
AT THE DEPARTMENT OF PUBLIC
HEALTH.
FINALLY WE WOULD JUST NOTE THAT
REGARDING THE PUBLIC.
DEPARTMENT OF PUBLIC HEALTH
SPECIFIC PROPOSAL WE DO HAVE A
SEVERAL CONCERNS.
PRIMARILY STEMMING FROM THE
FACT THAT WE THINK IT LACKS
COMPLETE JUSTIFICATION FOR WHY
FIFTEEN PERMANENT FULL TIME
POSITIONS ARE NEEDED. SO FOR
EXAMPLE.
Y. FIFTEEN POSITIONS WE JUST
LEARNED YESTERDAY THAT THE
DEPARTMENT. IS HOPING TO RELEASE.
A ROLL OUT THIS YEAR THIS
CALENDAR YEAR AN ONLINE SYSTEM
FOR SUBMITTING PROFESSIONAL
CERTIFICATION APPLICATIONS AND.
TRAINING PROGRAM APPLICATIONS.
IS CONSISTENT SUBSTANTIALLY
SPEED UP THE PROCESS AND
POTENTIALLY REDUCE THE NEED FOR.
STAFFING POSITIONS IF THE
PROCESS IS MORE AUTOMATED.
IN ADDITION WE DOES SUSPECT
THAT SOME OF THE WORK.
.
MAY BE MORE TEMPORARY IN NATURE
SO WE'RE NOT CONVINCED THAT ALL
OF THESE POSITIONS NEED TO BE
PERMANENT. SO FOR EXAMPLE WE
ANTICIPATE THAT THERE WILL BE AN
INCREASE IN THE NUMBER OF
WAIVERS REQUESTED.
AS WELL AS.
.
CERTIFIED NURSING ASSISTANT
APPLICATIONS SUBMITTED IN THE
FIRST COUPLE YEARS IN THAT THAT
COULD TAKE TAPER OFF.
AND AN.
AND I WOULD JUST NOTE THAT IF
THE WEAVER APPLICATIONS DON'T
TAPER OFF AFTER THE FIRST FEW
YEARS AT.
SO WE LIKELY HAVE A LARGER
PROBLEM.
SO.
SO THAT ARE ULTIMATELY OUR
RECOMMENDATION IS TO CONSIDER
THE PACKAGE AS A WHOLE.
FINANCE.
SURE WE WOULD KNOW AND I DON'T
THINK WE WOULD TAKE ISSUE WITH
THAT UNCERTAINTY SURROUNDING
WHAT WE WISH WILL COME AND HOW
THAT WILL. ROLL OUT BUT AS YOU
HEARD CONCERNS FROM.
SOME OF THE PUBLIC COMMENT
EARLIER WE WANT THE DEPARTMENT
TO BE READY TO MAKE SURE THAT
THIS WORKS AND I ARE ADEQUATELY
RESOURCE TO MAKE SURE THAT THE
DIFFERENT COMPONENTS REGARDING
CNA TRAINING. CNA CERTIFICATION
AND THE WAIVER REVIEW THAT
THEY'RE PROPERLY RESOURCE AND
READY TO GO.
SO I GET.
.
SO CERTAINLY AGREE WITH THAT WE
HAVE JERRY HAD THE CONVERSATION
ABOUT BE SURE WE HAVE ENOUGH
PEOPLE THAT LOT WAIVERS BUT THE
HOUSE AND NOTE THAT THAT.
LIKELY A WAVE OF PEOPLE COMING
INITIALLY SO THAT HOPEFULLY IT'S
NOT PERMANENT WORK IN THE SENSE
THAT THIS
WILL PROBABLY BE THE SAME
SITUATION THREE YEAR OR YEARS
FROM NOW. AND I THINK AS EARLIER
MENTIONED IT IS I THINK WE HAVE
A MORE FUNDAMENTAL PROBLEM ABOUT.
YOU KNOW HOW THAT OF THESE
RATIOS VIABLE ARE ARE NOT AND IT
IS AS A SPINSTER USUAL STANDARD
OF CARE. I MEAN THESE ARE
PERMANENT POSITIONS IS THERE
SOME THOUGHT ABOUT.
THESE CALLS NEEDY BE PERMANENT
DOES IT I MEAN DOUBLE TRACKED
THE OF SERVERS VERSES ONGOING
WORK.
SO WAS THERE SOME DISCUSSION
ABOUT HOW MUCH OF THIS IS
SERVICE VERSES ON GOING WORK.
AGAIN AND I WILL BE SURE YOU
HAVE THE RESOURCES TO DO IT NOW
I VERY QUIZ YOU ABOUT CAN YOU DO
ALL THE WAIVERS ON TIME SO I
WON'T BE SURE YOU HAVE THE
RESOURCES TO DO THAT BUT. TELL
ME SPEAK TO THAT.
BUT WE SIMPLY THAT THE WAIVER
POSITIONS FOR THE WHERE WILL
WILL BE AN ONGOING ACTIVITY
INCIDENT MENTIONED THAT THEY
WILL BE OUR I'M CERTAINLY
ROOSTING THEY'LL BE A ALWAYS A
CYCLE PEOPLE COMING IN AND
COMING OUT OF THE PROGRAM SO WE
WE. PRESUME THAT THAT'S
COMMITTEE AND ONGOING.
WE REQUEST THAT WILL THOSE WILL
RECEIVE TOOK MAYBE PICK
CONFLICTS BUT TO PUT IN THE
CYCLE OF THE ECONOMY OF THE
OTHER WE OF OPTIONS FOR A. MORE
OR LESS EMPLOYEES TO DIFFERENT
FIELDS WERE GONE WE SEE THAT OF
THE FLUCTUATION.
IN TERMS OF OUR PRECIOUS
CERTIFICATION BRANCH.
WHO AGAIN WE BELIEVE THAT THE
NUMBERS WILL BE CYCLICAL BASED
ON THE ECONOMY OTHERS AS A
STRONG DEMAND WE ALSO KNOW THAT
UNTIL YOU HAS RECOMMENDED THAT
THINGS CAN RELEASE? TWO THOUSAND
MORE. ASEAN NATURE OF BECOMING
INTEREST TO MEET THAT A DEMAND
OF THE OF THE WORKLOAD SO AGAIN
THOSE WHOSE COMMUTERS HUGE
CHURNING OF STAFF OF CALM IN
THIS IN THIS AND THE FLEAS.
WHICH WILL IN TURN REQUIRE US TO
DO THOSE INITIAL CERTIFICATIONS
AS WELL AS THOSE RENEWAL
CERTIFICATIONS
AND THEN AS SOON AS A
INDIVIDUALS WHO ARE CERTIFIED.
RUN INTO PROBLEMS LAW
ENFORCEMENT AND WE GET THE RAPAX
WILL HAVE TO DO THOSE REVIEWS
WITH ARE A VETTING PROCESS TO
MAKE SURE THE. OF THOSE
INDIVIDUALS ARE REMAIN UP AND UP
HELPED QUALIFY TO HOP PROVIDE
SERVICES TO.
AND INDIVIDUALS IN THESE
FACILITIES SO WE BELIEVE THAT
THESE ARE PROPOSITION THAT THE
DEMAND IS THERE HOW AND.
IN AT THE DISAPPEAR OF A FASTER
SUPPORT SET THAT NEED.
WELL CERTAINLY I THINK AND WHEN
YOU TALK ABOUT THE SCENE IS
THEMSELVES I MEAN THERE'S ALWAYS
GOING A CERTAIN TURN OVER THERE
SO THAT I THINK THAT VOLUME IS
LESS OF A YOU KNOW UP. AND BUT I
THINK IN TERMS OF WAIVER REVIEWS.
I WOULD HOPE FOR STILL NOT
LOOKING AT THE SAME VOLUME.
FOUR YEARS FROM NOW AS WE ARE
NOW SO. I THINK THOSE ARE TWO
SOMEWHAT SEPARATE.
ISSUES
BUT THAT FINANCED YOU
SOMETHING'S A.
OH YOU DIS NOTING M. FOR THE
WAIVER REVIEW SPECIFICALLY THERE
ARE THREE POSITIONS ASSOCIATED
THAT JUST TO GIVE SOME CONTEXT
NOT THAT THINGS AREN'T RELATED
TO.
KIND OF THAT SCENE A ZEN AND
THE MIX OF THE ONGOING VERSUS
NEW BUT FOR THE WAIVER REVIEW
SPECIFICALLY RETIREMENT THREE
POSITION OKAY THANK YOU.
ALRIGHT OUT PUBLIC COMMENT ON
THIS.
OKAY SEEN NONE.
WE WILL.
YEAH AND HOLD THIS ITEM OPEN.
RIGHT NEXT IS ISSUE NUMBER FIVE
FEDERAL STANDARDS FIRST USING.
USE A FEDERAL STANDS FOR STATE
REGULATION.
SO.
.
S. B. FIVE THIRTY FOUR FROM
TWENTY FOURTEEN.
PURSUANT TO THAT.
THE DEPARTMENT CONTRACTED WITH.
THE INSTITUTE FOR POPULATION
HEALTH IMPROVEMENT AT THE
UNIVERSITY OF CALIFORNIA DAVIS.
TO EVALUATE WHETHER CALIFORNIA'S
USE OF FEDERAL STANDARDS.
FOR ARE THE CERTAIN FACILITY
TYPES.
OUT PAGE CONFERENCE ABOUT
PATIENT REHABILITATION
FACILITIES AMBULATORY SURGICAL
CENTERS AND END STAGE RENAL
DISEASE FACILITIES. WAS
SUFFICIENT FOR LICENSING
PURPOSES.
OR WHETHER IT WOULD BE
ADVISABLE FOR US TO DEVELOP OUR
OWN REGULATIONS AND THE
CONCLUSION OF THAT STUDY WAS
THAT IN FACT.
THE.
FEDERAL STANDARDS WERE ADEQUATE.
WE HAD.
.
DISCUSSION OF THIS IT
STAKEHOLDER FOREMAN SOLICITED
STAKEHOLDER FEEDBACK A WE WE
RECEIVED NO CALL NO NEGATIVE
COMMENTS.
ABOUT CONTINUING TO USE THE
FEDERAL STANDARDS AND SO THIS IS
OUR PROPOSAL IS JUST THAT WITH
THAT PERFECT FEDERAL STANDARDS
FOR THESE FACILITIES. WOULD
CONTINUE TO BE USED FOR
LICENSING PURPOSES AND STATE OF
DEVELOPING SAY SPECIFIC REGULATE.
THANK YOU CONSTANTLY O. FINANCE
PUBLIC COMMENT
OKAY WILL HOLD ITS ITEM OPEN AS
WELL.
OKAY.
WE'RE MOVING ON TO ISSUE NUMBER
SIX WHICH THE AIDS DRUG
ASSISTANCE PROGRAM IT AFTER. WE
HAVE SOME.
GEN AROUND
.
SO I WILL COME INTRODUCE
YOURSELF FOR THE RECORD.
AGAIN WE DO HAVE A FAIRLY
THOROUGH RIGHT UP SO I THINK
WHICH AVE A BRIEF OVERVIEW OF
ANY MAJOR CHANGES.
TO ESTIMATE.
I'LL BE BRIEF.
AND DOCTOR KAREN MARCUM CHIEF
OF THE OFFICE OF AIDS OF THE
CALIFORNIA DEPARTMENT OF PUBLIC
HEALTH.
AM SO I'LL JUST GIVE A BRIEF.
OVERVIEW OF THE MAJOR CHANGES TO
THE EIGHT UP ESTIMATE. I'M IN
THAT THE TWO THOUSAND SEVENTEEN
BUDGET ACT INCLUDED IT UP LOCAL
ASSISTANCE FUNDING OF THREE
HUNDRED NINETY FIVE POINT SEVEN
MILLION WITH NO STATE GENERAL
FUND APPROPRIATION.
THE REVISED SEVENTEEN EIGHTEEN
BUDGET IS THREE HUNDRED NINETY
EIGHT POINT ONE MILLION AN
INCREASE OF.
TWO POINT FOUR MILLION MAINLY
DUE TO A ONE TIME NEED FOR
SYSTEM ENHANCEMENTS TO. SEE
PEACHES INSURANCE A MEDICAL
BENEFITS MANAGER PLATFORM TO
IMPLEMENT THAT EACH OF THE
PRICKS BUDGET PROPHYLAXIS
ASSISTANCE PROGRAM.
AS WELL AS AND THE COMEDY AND
INDIVIDUALS IN THAT WE HAVE
PROGRAM WITH EMPLOYER BASED
INSURANCE
AND I MEDICARE PART D..
AS WELL AS SOME OTHER
ELIGIBILITY ENHANCEMENTS.
I'M IN FISCAL YEAR EIGHTEEN
NINETEEN THE PROPOSED IT UP
LOCAL ASSISTANCE FUNDING IS
THREE HADN'T AS FOUR HUNDRED
THIRTY FOUR POINT FOUR MILLION.
WE ESTIMATE THAT EXPENDITURES
WILL INCREASE BY THIRTY EIGHT
POINT SEVEN MILLION WHEN
COMPARED WITH THE. SOME
TWO THOUSAND SEVENTEEN BUDGET
BUDGET ACT.
THIRTY SIX POINT THREE MILLION
INCREASE COMPARED WITH THE
REVISED CURRENT YEAR ESTIMATE.
WE EXPECT THAT THE OVERALL
NUMBER OF CLIENTS RECEIVING AID
UP SERVICES WILL CONTINUE TO
INCREASE EACH YEAR. AT RATES
SIMILAR TO PRE ACA
IMPLEMENTATION DUE TO PERSONS
BECOMING NEWLY INFECTED WITH HIV.
I'M AND THEN DISTANTLY
MEDICATION PRICES INCREASE
ANNUALLY.
AND THERE IS A ONE NEW IT UP
POLICY CHANGE INCLUDED IN THE
PROPOSED BUDGET. AND THE NEW
POLICY CHANGE RESULTS TO I'M A
RELATES TO FUNDING FOR IT HAPPEN
ROMAN SITES.
AND THAT TWO THOUSAND SEVENTEEN
BUDGET ACT INCLUDED ONE TIME
LEGISLATIVE AUGMENTATION OF AN
ADDITIONAL FOUR MILLION FOR
PAYMENT TO ENROLLMENT SITES FOR
A TOTAL OF EIGHT MILLION. IN
FISCAL YEAR SEVENTEEN EIGHTEEN.
BECAUSE THE TASKS PERFORMED BY
EIGHT AT THE MOMENT WORKERS HAVE
GROWN IN BOTH SCOOPING
COMPLEXITY. CITIES PURPOSE CD
PEACH PROPOSES STARTING IN
FISCAL YEAR EIGHTEEN NINETEEN
MOVING TO A MODEL IN WHICH THE
TOTAL AMOUNT OF FUNDS FOR EIGHT
UP IN ROMAN SERVICES PERFORMED.
AS ADJUSTED ANNUALLY THROUGH THE
ESTIMATE PROCESS BASED ON HE
SLOWED AN ESTIMATED SERVICES TO
BE PERFORMED EACH FISCAL YEAR.
SO FOR FISCAL YEAR EIGHTEEN
NINETEEN AYE WE PROJECT
ENROLLMENT COSTS OF SEVEN POINT
NINE NINE MILLION.
IN ORDER TO ENSURE THAT THIS.
I'M GOING INCREASE IN FUNDING
FOR A UP ENROLLMENT SITES
RESULTS IN IMPROVE CLIENT
OUTCOMES AND COST NEUTRALITY. WE
PLAN TO INCLUDE PERFORMANCE
MEASURES IN EXISTING AID UP AND
ROMAN SITE CONTRACT.
TO ENSURE ENROLLMENT SITES USE
THE ADDITIONAL FUNDING TO
TRANSITION AN INCREASED NUMBER
OF MEDICATION ONLY CLIENTS INTO
PRIVATE INSURANCE AND AWAY HIP.
AND MEET DEFINE METRICS SUCH AS
IMPROVEMENT AND BORROW
SUPPRESSION RATES IN EACH IN
ROMAN SITES.
I AM AS ALWAYS WILL REVISE THAT
NUMBERS IN THE ESTIMATE ENEMY
REVISION.
THE KILL I THANK YOU A COMPASS
MILIEU. FINANCE NO ALRIGHT OF WE
DO HAVE SEVERAL US STAKEHOLDER
PROPOSALS.
SO WE HAVE FACT CRAIG.
PULSIPHER SORRY YOUR BROWSER
OFTEN THE HIV ALLIANCE.
I THINK YOU HAVE FIVE PROPOSALS.
FOR YES SO.
I'VE BREVITY WOULD BE
APPRECIATED.
AT. BREVITY JUST UNDERSCORES HOW
MUCH MORE IMPORTANT PROPOSES
LESHY ARE.
I TELL YOU THAT I HAVE TO AS
WELL. AND.
OKAY SO WE HAVE OKAY YOU FIVE
BECAUSE WE HAD AND THEN WE ALSO
HAVE TO HAVE TIES LINES AND
WE'RE DOING THE AGE OF RELIANCE
FIRST YOU GOT YOUR FIVE AND THEN
WE ALSO HAVE HEPATITIS ALLIANCE
BE OF US ENJOY IT SO YES. SO.
YOU'RE WITH THIS ITEM LIKE A
CHEVY LINE IT'S A REALIZED OKAY
SO ALRIGHT SO IF YOU WANTED TO
YEAR FOR.
FIVE BETWEEN THE TWO.
YES CREEK PULSE FOR FROM A KILL
A HEALTH AND CO CHAIR OF THE
CALIFORNIA HIV ALLIANCE.
AND ONLY PROJECT INFORM MEMBER
OF THAT CALIFORNIA HIV LAW AND
THANK YOU ACID BEFORE I BEGIN
JUST WHEN THE HIGHLIGHT THAT
CALIFORNIA'S ANNUAL NUMBER OF
HIV INFECTIONS HAS REMAINED
PRETTY MUCH FLAT OVER THE LAST
FEW YEARS. A DECREASED ONLY
ABOUT THREE PERCENT FROM TWENTY
TWELVE T TWENTY SIXTEEN SO
THERE WERE SEEN PROGRESS IN SOME
AREAS WE REALLY NEED TO STEP UP
OUR EFFORTS IF WE WANT TO SEE
SIGNIFICANT POPULATION LEVEL
IMPACTS.
AND WE DO KNOW IT'S POSSIBLE NEW
YORK IS MAKING SOME SIGNIFICANT
INVESTMENTS NOW NOW SEEN DOUBLE
DIGIT DECREASES IN NEW HIV
INFECTIONS.
SO THREE PROPOSALS I'M
PRESENTING TODAY. RAW RELATED TO
EXPANDING PREVENTION SERVICES
ESPECIALLY PROP.
RECENT DATA INDICATE PROP UP
TAKING CALIFORNIA'S LOW
ESPECIALLY AMONG ACT
AMERICANS LATINOS YOUTH AND
WOMEN.
AND WE CURRENTLY HAVE VERY
LIMITED FUNDING SUPPORT PROP
ACTIVITIES.
CALIFORNIA HAS BEEN RECEIVING
ABOUT EIGHT MILLION A YEAR FROM
THE CDC FOR THE PAST FEW YEARS
NOT FUNDING IS SET TO EXPIRE
THIS YEAR SO WITHOUT THAT
FUNDING. WILL HAVE LITTLE TO NO
FUNDING SUPPORT PREP SERVICES.
QUIRK QUESTION TEN MILLION
DOLLARS TO SUPPORT HIV
PREVENTION SERVICES INCLUDING
PREP OUT REACHING EDUCATION. AND
HIV TESTING FOR HIGH RISK
POPULATIONS.
OUR ALSO REQUESTING ONE MILLION
ANNUALLY TO SUPPORT.
PROVIDER EDUCATION ABOUT
PERHAPS ANOTHER PREVENTION
SERVICES INCLUDING ROUTINE HIV
TESTING. OBVIOUSLY THE MAJORITY
OF INDIVIDUALS A RISK RECEIVE
THEIR HEALTHCARE FROM PRIMARY
CARE PROVIDERS
SO IT'S IMPORTANT TO TRAIN
ENGAGE. OF THIS WORKFORCE.
AND FINALLY WE'RE PROPOSING
SEVERAL CHANGES TO THE STATE'S
PURPOSES SINCE PROGRAM. OTHER
PROGRAM IS BEING IMPLEMENTED
THIS YEAR TO HELP UNINSURED AND
UNDERINSURED FOLKS ACCESS PROP.
BECAUSE THE WAY THE PROGRAM IS
WRITTEN IN STATUTE THERE SEVERAL
KEY POPULATIONS THAT WON'T BE
ABLE TO.
.
PROVIDE COMPREHENSIVE.
BENEFIT FOR PROP
AND SEWER PROPOSING SEVERAL
CHANGES TO PROVIDE MORE
COMPREHENSIVE COVERAGE FOR PROP.
I AS WELL AS POSTING SPIRITUAL
PROPHYLAXIS AND HAPPY TO ANSWER
ANY QUESTIONS YOU HAVE ABOUT
THOSE CHANGES.
SO ARE ALSO PROPOSING TWO
DEMONSTRATION PROJECTS TO SERVE
UNDERSERVED AND PROPONENT WILL
POPULATIONS. THE FIRST ONE IS TO
BUILD TWO MILLION DOLLARS FOR A
THREE YEAR DEMONSTRATION
PROJECTS TO IMPROVE LINKAGE TO
HIV CARE AND PREVENTION SERVICES
AND ECONOMIC EMPOWERMENT
TRANSGENDER INDIVIDUALS AND.
WE THINK THIS IS AN INNOVATIVE
PUBLIC HEALTH INTERVENTION THAT
ALLOWS US TO ADDRESS TWO KEY
CHALLENGES TO IMPROVING HEALTH
OUTCOMES FOR TRANSGENDERED
CALIFORNIANS.
THE FIRST ONE IS IN ADEQUATE
LINKAGE TO COMP COMPETENT HIV
CARE AND PREVENTION SERVICES
WHICH RESULTS IN LARGE
DISPARITIES IN A CHEVY HEALTH
OUTCOMES. AND ALSO NEW
INFECTIONS FOR TRANSGENDERED
INDIVIDUALS. AND ADDITION ON
SECOND CHALLENGES ECONOMIC
INSTABILITY IN THE TRANSGENDER
COMMUNITY BECAUSE OF.
SERIOUS DISCRIMINATION
HARASSMENT IN THE WORKPLACE SO
WE BELIEVE THAT AS A COORDINATED
DEMONSTRATION PROJECT THIS
REALLY GIVES US AN OPPORTUNITY
TO IMPROVE DRAMATICALLY THE ON
HEALTH AND WELL BEING FOR.
TRENTON TRANSGENDERED
CALIFORNIANS ARE SECOND PROPOSAL
IS THREE MILLION DOLLARS IN ONE
TIME FUNDING TO SUPPORT THREE
YOUR DEMO PROJECTS.
THAT ADDRESS THE HEALTH AND
PSYCHOSOCIAL NEEDS OF OLDER
OLDER CALIFORNIANS LIVING WITH
HIV. AND WE EXPECT BY TWENTY
TWENTY THAT ABOUT FIFTY PERCENT
OF PEOPLE LIVING WITH HIV WILL
BE OVER THE AGE OF FIFTY AND AND
HIGHLY IMPACTED CITIES LIKE SAN
FRANCISCO ON A LATE THE
PERCENTAGES CLOSER TO SIXTY
PERCENT.
I'M SO THEIR UNIQUE CLINICAL AND
PSYCHOSOCIAL ISSUES THAT HAPPEN
AS PEOPLE AGE WITH HIV COM HIV
SPEEDS AGING IT IT RESULTS IN
INCREASED CARDIOVASCULAR ISSUES.
LIVER AND KIDNEY PROBLEMS HIV
RELATED CANCERS DECREASED BONE
DENSITY FRAIL NESS COGNITIVE
DECLINE DEMENTIA AND OPPRESSION
AND IT ALSO ON RESULTS IN
ISOLATION DUE TO LOSS OF SOCIAL
SYSTEMS AND. FINANCIAL
INSTABILITY DUE TO LONG TERM
DISABILITY SO WHAT'S REALLY
NEEDED HERE IS A MEDICAL HOME
TYPE MODEL TO ON. THE TO PROVIDE
SERVICES TO FOLKS WHO ARE AGING
BUT WE CURRENTLY HAVE VERY
LITTLE SUPPORT FOR THAT WE'VE
ONLY HAD ONE PLACE AND
CALIFORNIANS NELSON.
TOGETHER THESE. THEY WERE ASKING
FOR ON A PROJECT THAT WOULD
ALLOW MORE DEVELOPMENT OF THESE
MODEL PROGRAMS TO SERVE OUR
AGING PEOPLE WITH HIV. WERE ALSO
ASKING THAT THEY BE EVALUATED
AND THAT THERE BE THE
DEVELOPMENT AND DISSEMINATION
LESSONS LEARNED TO SUPPORT THE
DEVELOPMENT OF FURTHER MODELS
THROUGHOUT THE STATE OF
CALIFORNIA.
THANK YOU.
ANY COMMENTS FROM THE PUBLIC
THE PUBLIC HEALTH. OF THESE
PROPOSALS OKAY LA JOH. FINANCE
NOW ALRIGHT BUT NO THANK YOU SO
MUCH FOR YOUR PRESENTATION
CERTAINLY I THINK.
YOU KNOW WE NEED TO. A PREP
DESERVE TO SEE AN AREA THAT DOES
OPPORTUNITY THAT WE'RE NOT
TAKING FULL ADVANTAGE OF HOW TO
DO THE OUT RETAIL GIVE PEOPLE
ACCESS SO FORTH AND THEN OF
COURSE COORDINATION OF CARE.
AS WELL.
FOR FOR. PEOPLE HIV AS WELL SO
I APPRECIATE THOSE PRESENTATIONS
WILL TAKE PUBLIC COME AFTER HERE
ALL THE STAKEHOLDER PROPOSALS
FOR THE SECTION.
SO THANK YOU.
NEXT IS THE TELEPHONE HEPATITIS
ALLIANCE PROPOSAL FOR HEPATITIS
C. PREVENTION TESTING LINKAGES
TO IN RETENTION CARE SERVICES.
ALRIGHT THANK YOU.
AT ROUTE GOOD MORNING ON MY
NOTES BUT THAT WILL SAY GOOD
EVENING EVENING MY NAME IS
INSURANCE AND I AM THE HEPATITIS
C. EDUCATION MANAGER AT. PROJECT
INFORM. AND I'M THE DIRECTOR OF
THE CALIFORNIA HEPATITIS
ALLIANCE.
THE ALLIANCE IS MADE UP OF
APPROXIMATELY A HUNDRED
HEPATITIS B. AND HEPATITIS C.
ORGANIZATIONS CLINICS AND
PROVIDERS THROUGHOUT THE STATE.
PAGE FOR REVIEW AND I REQUEST
TODAY.
CALIPERS REQUESTING A SIX POINT
SIX MILLION DOLLAR ONGOING
ANNUAL INVESTMENT AND HEPATITIS
C. PREVENTION TESTING.
AND WE CATCH TO CARE AND
TREATMENT.
THIS REQUEST AS AN EXPANSION OF
THE TWO POINT TWO MILLION DOLLAR
PER YEAR DEMONSTRATION PROJECT.
THAT WAS FINANCED IN FISCAL YEAR
TWENTY FIFTEEN AND TWENTY
SIXTEEN. THIS FUNDING COVERED
TESTING OF PEOPLE WHO ARE AT
VERY HIGH RISK OF ACQUIRING AND.
THE TITISEE.
SYSTEM NAVIGATION AND LINKAGE TO
TREATMENT AND CARE. AS WELL AS
THE TRAINING OF PHYSICIANS TO
TREAT HEPATITIS C..
THIS FUNDING ENDS IN JUNE. THE
DATA COLLECTED AND PUBLISHED BY
THE CALIFORNIA DEPARTMENT OF
PUBLIC HEALTH SHOWS THAT THE
PILOT HAS BEEN SUCCESSFUL IN
MARRIAGE EXPANSION.
IN THE NEEDS URGENT.
ACCORDING TO THE CDC HEPATITIS
C. CAUSES MORE DEATHS THAN THE
NEXT FIFTY NINE INFECTIOUS
DISEASES COMBINED.
AND THAT INCLUDES
TUBERCULOSIS AND HIV.
IT'S A LEADING CAUSE OF LIVER
CANCER AND LIVER TRANSPLANTS IN
THE UNITED STATES. HEARING
CALIFORNIA YOU'VE GOT OVER FOUR
HUNDRED THOUSAND PEOPLE LIVING
WITH HEPATITIS C. AND MOST OF
THEM DON'T KNOW IT.
BE NEED TO BE CONNECTED TO
TESTING AND TREATMENT.
WHAT WE HAVE OVER THIRTY THREE
THOUSAND NEW INFECTIONS PER YEAR?
IN THE TEN YEAR PERIOD FROM TWO
THOUSAND TO TWO THOUSAND ELEVEN.
WE HAD MORE THAN THREE HUNDRED
THOUSAND HOSPITALIZATIONS FOR
HIV RELATED LIVER DISEASE LIVER
CANCER LIVER TRANSPLANTS.
AND THAT RESULTED IN HEALTH CARE.
OF OVER TWENTY BILLION DOLLARS.
IN ALL THE SUFFERING DEATHS IN
THE RELATED COSTS ASSEMBLY WITH
HEPATITIS C. ARE COMPLETELY
AVOIDABLE. WE HAVE A CURE.
THE SECURE IS SAFE AND EFFECTIVE
SECURING MORE THAN NINETY FIVE
PERCENT OF PEOPLE WITH VERY FEW
SIDE EFFECTS IN AS LITTLE AS
EIGHT TO TWELVE WEEKS.
TREATING CURING HEPATITIS C.
IMPROVES A PERSON'S HEALTH AND
QUALITY OF LIFE
IT'S COST EFFECTIVE. AND LEAST
OTHER LONG TERM BENEFITS SUCH AS
LESS HEALTHCARE UTILIZATION AND
REENTRY TO THE WORK FORCE. AND
IT'S ALSO REALLY IMPORTANT
REMEMBER THAT HEPATITIS C. IS
COMMUNICABLE COMMUNICABLE SO FOR
EVERYBODY WE CURE THAT REDUCES
THE RISK OF TRANSMISSION TO
OTHERS.
SIX POINT SIX MILLION DOLLARS IS
A LOGICAL INCREMENTAL EXPANSION
OF A VERY SUCCESSFUL
DEMONSTRATION PROJECT.
AND ITS COMPLEMENTARY OF
INVESTMENTS BY INSURERS AND
OTHERS.
THE FEDERAL GOVERNMENT IS PROVED
INCAPABLE OF PRIORITIZING THE
IRAQI REVOCATION OF HEPATITIS C..
SORTS OF THE STATE'S TOP PROTECT
THEIR COMMUNITIES.
THANKS FOR YOUR TIME.
OKAY THANK YOU IF WE ONLY HAD A
VACCINE.
RIGHT BUT I GUESS.
A HELIPAD SEE AGENCY. THE
PARAPHERNALIA.
FINANCE INCUMBENTS ALRIGHT WELL
THANK THANK YOU VERY MUCH IT'S
GOOD WE DO HAVE A CURE NOW AND.
AS IT WEEK HOPEFULLY WE CAN
HAVE A VACCINE IN THE FUTURE BUT
IN THE MEANTIME WE STILL THAT
EVEN WITH THE VACCINE WE STUFF
GIVEN ISRAELI AFFECTED SO.
RIGHT THANK YOU.
OKAY NEXT ONE UP IS ESSENTIAL
ACCESS HEALTH.
PROPOSAL STD PREVENTION
ACTIVITIES.
CHAIR MEMBERS KATHY MUST WORK
WITH THE CENTRAL ACCESS HEALTH.
HERE TO REQUEST TEN MILLION
DOLLARS FOR THE DEPARTMENT
PUBLIC HEALTH
TO BE A CONTINUE I GUESS BUT
BEGIN IN EARNEST ADDRESSING THE
PUBLIC HEALTH CRISIS OF RISING
STD RATES.
AFTER CURRENTLY CALIFORNIA'S
HIT A RECORD HIGH FOR THE THIRD
YEAR IN A ROW WE NOW RANK AS THE
FIRST NATION FOR THE MOST AS THE
NUMBER ONE.
STATE IN THE NATION FOR THE
MOST CASES OF CHLAMYDIA
GONORRHEA AND SYPHILIS
AND NOW WE CERTAINLY KNOW HOT
SPOTS COVER THE OF THE. DAMAGE
IN CALIFORNIA THE HOT SPOTS ARE
SACRAMENTO.
AS WELL AS SACRIFICE SAN
FRANCISCO LA BUT THEN ALSO THE
VALLEY IN FRESNO
SO WE KNOW THAT WE DO NEED TO
MAKE A SIGNIFICANT.
PUSHED IN THIS AREA AT OR TO
ADDRESS ARE RISING STD RATE OF
IT'S VERY SIMPLE.
EXCUSE ME BUT HER ALL DAY CON A
THIRST AND HUNGRY OF IT'S VERY
YOU KNOW IT BUT WE CAN'T BY
TESTING PEOPLE AND THEN TREATING
THEM WE CAN SAVE A MILLIONS AND
BILLIONS EVEN TO OF DOLLARS WE
SPEND A LOT OF MONEY AND CAL.
ON TREATING PEOPLE WITH ON STDS
WHEN ALL WE DO IS WE TO TEST AND
YOU PARTNER TRACING. WHICH WITH
CONTINUED RESOURCES WOULD BE
ABLE TO DO ALL WE ARE ASKING FOR
ONGOING FUNDING IN THIS CASE WE
THINK THAT THE DEPARTMENT NEEDS
THIS IN AN ONGOING FASHION
RATHER THAN PIECEMEAL. WE DID.
HAVE.
WE ADVOCATED A COUPLE YEARS AGO
ABOUT FIVE MILLION BUT IT WAS
ONE TIME.
SO THERE'S NOT A LOT YOU CAN DO.
I CONSISTENT BASIS WITH ONE
TIME DOLLAR SO WE DO ASK THIS
COMMITTEE WHEN THE TIME I
APPROPRIATE TO ALLOCATE THE TEN
MILLION DOLLARS I'M GOING TO
KEEP.
MISTER CHAIR RANDOM ARE NOT BE
HAVE THE AIDS HEALTHCARE
FOUNDATION I'M WITH OUR PARTNERS
AND ESSENTIAL ACCESS HEALTH WERE
ALSO ECHOING THAT REQUEST FOR
TEN MILLION DOLLARS. I'M TWO
YEARS AGO AS ON KATHY IS
INDICATED ON THE LEGISLATURE
APPROPRIATED FIVE MILLION
DOLLARS IN ONE TIME ONLY FUNNY
THAT WAS HELPFUL IN TERMS OF
IMMEDIATE NEEDS BUT NOT HELPFUL
IN TERMS OF DEALING WITH THE.
REAL PROBLEM WHICH IS MANPOWER
ON THE ON THE GROUND TO DEAL
WITH THINGS LIKE OP PARTNER
NOTIFICATION NAM AND AS SHE
INDICATED. NAM WE REQUESTED THIS
LAST YEAR.
UNFORTUNATELY THE LEGISLATURE
DID NOT.
AGREED TO PUT MONEY IN ON THE
FINAL BUDGET.
BUT NOT AT THE SAME TIME.
THAT THE MONEY HAS NOT BEEN
THERE WE'VE SEEN THE NUMBERS
INEXORABLY GROW. I'M SINCE
NINETEEN NINETY NINE WE HAVE
SEEN EVERY SINGLE YEAR IN EVERY
SINGLE COUNTY IN THE STATE OF
CALIFORNIA THE NUMBER OF STD
RACE JUST RISE AND RISE AND RISE.
OF THE CORAL IT CORRELATE OF
AFFECT ON THE HIV EPIDEMIC AS
WELL
I'M ONE OF THE REASONS WE'RE
SEEING STATIC NUMBERS AND HIV IS
BECAUSE WE'RE NOT DEALING WITH
THE STD.
EPIDEMIC I'M IT'S LONG PAST
TIME FOR US TO DO SOMETHING
MEANINGFUL ON AN ON GOING HOME
AND WE ENCOURAGE YOU TO.
TO APPROVE THIS THE TEN MILLION
DOLLAR PER REQUEST THANK YOU
THANK YOU A COMMENTS FROM OUR
PUBLIC HEALTH. OLEO FINANCE.
CHARGES MAKE NOTE THAT I
APPRECIATE YOU PRESENTING TODAY
WE WERE LOW UNSURE WHETHER PUT
THIS THING IN THIS SECTION ARE
SO NEXT WEEKEND OUTS ARE
MISPLACED BUT.
I AM.
IT'S ALSO GOOD HEARING OTHER
PROPOSALS THAT REALLY GO TO THE
FUNDAMENTAL ISSUE ABOUT PUBLIC
HEALTH AND.
THAT'S WHY SHE DID IT
INFECTIOUS DISEASE CONTROL SO
YOU KNOW YOU'RE HERE TALKING
ABOUT STDS IN THE FACT THAT IT'S
BEEN RISING.
IN BASIS RIGHT AND WHAT KIND OF
IT PUBLIC HEALTH INFRASTRUCTURE
DO WE HAVE TO DO THAT. IT WE'VE
HAD THAT THE TIDES A OUTBREAK
NOT RIGHT AND.
PARTY REALLY THE HOMELESSNESS
BUT ALSO AGAIN NO TRANSMISSION
SO.
WHAT WHAT'S OUR PREPAREDNESS
FOR FOR THAT SO THAT'S MORE OF
AN OUTBREAK SITUATION WORSE THIS
CITY SERVICES ON GOING BUT HE
CALLED OUTBREAK IN THE SENSE
IT'S CLIMBING CLAIMING RIGHT?
BY KNOW SOMEONE'S GOT A
PROPOSAL ROUND.
VALLEY FEVER RIGHT WHICH IS.
YOU KNOW WHAT'S A PREPAREDNESS
FOR THAT AND AND BE SURE WE CAN
TACKLE THAT.
VECTOR CONTROL AND WEST NILE
VIRUS GREAT AND. WE THE MANY
WAYS THAT WE ARE REALLY CUT BACK
ON OUR PUBLIC HEALTH
INFRASTRUCTURE SO COUNTIES MADE
SLASH PUB THAT WAY A PUBLIC
HEALTH WHEN THEY WERE SHORT.
DURING THE RECESSION
THE STATE.
AND AND YOU KNOW WHILE THE ACA
HAD A HEAD OF FUND THEY CREATED
FOR BAD HEALTH THAT WAS THE
FIRST THING EVERYONE WENT TO
WHEN THEY WANT TO CUT.
GETS MORE MONEY THEY WENT TO
THE SO WE PUT IT FUND INTO THE
CA FOR PREVENTION AND PUBLIC
HEALTH AND THEN EVERYONE STARTS.
TAKING CHUNKS OUT OF IT AND
BASICALLY STRUCK DOWN THE
NOTHING.
BECAUSE EVELYN.
THE MONEY AWAY FROM THAT AND WE
NEED TO BUT. THEN THE MEANTIME.
.
IN THE BACKGROUND RIGHT OR A CD
RATES ARE GOING UP WE'RE HAVING
INCREASING OUTBREAKS OF VARIOUS
DISEASES AND AND ACTUALLY IT'S
YOU KNOW ONE SHOULD BE SURPRISED
ABOUT OUTBREAK OF ANOTHER THING
WHETHER IT'S NO. BAD FLU YEAR
HAVE TIES A.
A BULLET REALLY WASN'T AN
OUTBREAK BUT I MEAN IT JUST
EVERY YEAR OR SO
YOU KNOW ME.
TWENTY FIFTEEN RIGHT SO.
WE'VE GOT TO GET ON TOP OF
THESE THINGS AND THAT REALLY IS
ABOUT OUR INFRASTRUCTURE NAY I
THINK STD THE INCREASING RATES
IS.
DAISY REFLECTIVE OF THE FACT
THAT OUR GENERAL PUBLIC HEALTH
INFRASTRUCTURE WHICH DALY IS NOT
THE SEXY PART THAT PEOPLE GIVE
GRANTS TO.
HAS BEEN ERODING WAS TAKEN FOR
GRANTED.
AND I THINK THAT'S THE REAL
PROBLEM IS TAKEN FOR GRANTED WE
THINK OF THE DISEASE IS A GUN
DEL DOWN THERE JUST GOT AND NOW
THEY'RE NOT GOTTEN THEIRS SLOWLY
COMING BACK BECAUSE WE'RE NOT.
PUSHING BACK AGAINST THE MANY
WATER CYPRESS SHE PRESENTING OF
THIS. AND CERTAINLY.
.
HOW MANY PEOPLE KNOW BUT YEAH
I'VE BEEN WATCHING THOSE NUMBERS
AND THEY KEEP GOING UP DISEASES
THAT PEOPLE THINK QUIRK GOT
LONGTIME AGO SELFLESS INTENT OF?
COULD YOU ALSO TRY AND YOU KNOW
SURPLUS COMING.
SURPLUS.
HIS BOOK GET SYPHILIS ANYMORE
BUT PEOPLE GETTING SYPHILIS.
AND WHAT I AM SURE WHEN THE MOST
FRIGHTENING THINGS IS THE
NUMBERS OF CASES AMONG PEOPLE
WHO ARE FIFTEEN TO NINETEEN AND
TWENTY TO TWENTY OR ARE THE
HIGHEST. AND THE PEOPLE WHO
THREE MOST CONCERNED ABOUT ARE
THE ONES WHO ARE GETTING FASTER.
RIGHT.
OKAY WELL THANK YOU SO MUCH FOR
YOUR PRESENTATION. OF FILING WE
HAVE THE DRUG POLICY ALLIANCE.
AND.
SUBSTANCE USE DISORDERS
TREATMENT NAVIGATORS HER.
PROGRAM AND THEN ALSO.
NEEDLE EXCHANGE PROGRAMS AT THE
GIFT TO YOUR.
OKAY BALLOT IN TWO WEEKS I
SHOULD SAY FOR ALL THE PEOPLE
ARE LISTENING WE'RE DOING THAT
HEARING IN TWO WEEKS NOT NEXT
WEEK. SO OKAY SEVERAL SHOWS UP
NEXT WEEK GOV WHY IS THAT
HAPPENING OKAY SORRY ABOUT THAT.
IT'S IN TWO WEEKS OKAY.
I WELCOME.
THANK YOUI'M LAURA THOMAS AN
THE INTERN STATE DIRECTOR FOR
THE DRUG POLICY ALLIANCE.
THINK YOU FOR HEARING OUR
PROPOSAL.
I HEARD THE COMMENTS ON THE
SENATE FLOOR THIS MORNING ABOUT
THE OPIOID OVERDOSE CRISIS IN
CALIFORNIA SO I KNOW YOU'RE
AWARE. OF THE DEPTH OF THE.
PROBLEMS HERE IN CALIFORNIA OUR
PROPOSAL IS FOR ELEVEN MILLION
DOLLARS TO BE SPENT OVER FOUR
YEARS TO FUND OUR SYRINGE ACCESS
PROGRAMS ACROSS THE STATE. TO
INCREASE THEIR STAFFING CAPACITY
TO ENSURE THAT THEY ARE ABLE TO
CONNECT THE PEOPLE THAT THEY
SERVE WITH SERVICES THAT THEY
NEED INCLUDING. A MEDICATION
ASSISTED TREATMENT ALIFORNIA
CURRENTLY HAS A SIGNIFICANT
FEDERAL GRANT OF NINETY MILLION
DOLLARS TO EXPAND MEDICATION
ASSISTED TREATMENT. OF FOR
OPIOID USE DISORDER ESPECIALLY
IN OUR WORLD AREAS THAT HAVEN'T
PREVIOUSLY HAD IT. THIS GRANT
WOOD UMBER THESE FUNDS WOULD
MATCH THE SERVICES AND THE
PROGRAMS OF THAT WORK MOST
DIRECTLY WITH PEOPLE WHO INJECT
DRUGS. WHO HAVE?
STRONG RELATIONSHIPS WITH THEM
AND WOULD BE ABLE TO NAVIGATE
THEM INTO A THIS EXPANDED
TREATMENT ACCESS AS WELL AS
PROVIDING NALOXONE AN OVERDOSE
EDUCATION. AND OTHER HEALTH
EDUCATION AND PREVENTION
SERVICES SO IT'S A VERY COST
EFFECTIVE WAY TO TAKE ADVANTAGE
OF THE FEDERAL DOLLARS AND
ENSURE THAT THE PEOPLE WHO ARE
MOST IN NEED OF TREATMENT ARE
ARE FIRST IN LINE AND HAVE.
ACCESS TO THOSE PROGRAMS.
AND YOU'RE GONNA TALK ABOUT THE
SUNSET EXTENSION MINIATURE. AND
SO THAT SUNSET.
A NUMBER OF YEARS AGO.
IT HAS.
THEN ASSEMBLY MEMBER SKINNER.
AUTHORED ASSEMBLY BILL SIX OH
FOR THAT GAVE THE STATE OFFICE
OF AIDS THE ABILITY TO AUTHORIZE
SYRINGE ACCESS PROGRAMS IN
COUNTIES THAT HAD HIGH NEED BUT
HADN'T PREVIOUSLY AUTHORIZED
THEM.
THAT HAD A SUNSET DE IN IT THIS
PROPOSAL WERE PROPOSING TRAILER
BILL LANGUAGE THAT WOULD LIFT
THE SUN SAT ON THIS EP SIX OH
FOR AUTHORIZATION AND MAKE A
COUPLE OF OTHER.
MINOR CHANGES ENSURING THAT THE
STATE CAN PURCHASE ALL OF THE
SUPPLIES THAT ARE NEEDED FOR
THESE PROGRAMS. AND TO
STREAMLINE THE APPROVAL PROCESS
BY REDUCING THE PUBLIC COMMENT
PERIOD I'M FROM NINETY DAYS TO
FORTY FIVE DAYS FOR THESE
PROGRAMS SO IT'S.
IT'S PRETTY STRAIGHTFORWARD IT'S
A GOING THROUGH THE BUDGET
PROCESS TO ENSURE THAT THERE'S
NO GAP. IN.
PROGRAMMATIC FUNDING BETWEEN
THE BEGINNING OF THE FISCAL YEAR
AND WHEN THE AUTHORIZATION ENDS.
THANK YOU. A COMES FROM THAT THE
PROPOSAL'S.
OKAY ILIO.
A FINANCING. BUT THAT MEAN TERMS
IF THE ELIMINATING SOUNDED
NEEDLE EXCHANGE.
COOLEY PUBLIC HEALTH THAT'S
PRACTICE. THIS IS SIMPLY TRAILER
BILL LANGUAGE ANY ISSUES.
THAT
FROM THE PARTNERS POINT OF VIEW
I MEAN.
NATURALLY THERE'S A.
NO ISSUES ISSUES OKAY ARE ITSELF
WITHOUT WILL BE.
STRAIGHTFORWARD MONIES ILLEGAL
TRICK HERE SELL WELL BEHOLD
THESE ITEMS OF.
SO FIVE BUCKS LIKELY HOLD THAT
CAN OPEN THAT WE TAKE PUBLIC
COMMENT.
BUT.
THEY TO SYMMETRY PRESENT INKY
OKAY SO LET'S GO AHEAD TAKE
PUBLIC COMMENT ON ISSUE NUMBER
SIX WHICH IS THAT A A AIDS.
ES DE PROGRAM AND THEN OF
COURSE THE US SPECKLED PROPOSALS
THAT WE'VE ALSO HEARD AS WELL
THANK YOU WELCOME.
GOOD EVENING BUT.
THAT ON IT'S ON. GETTING MY NAME
IS COURTNEY MOTOR PEARSON I'M
HERE FROM THE SAN FRANCISCO AIDS
FOUNDATION ALSO CO CHAIR OF THE
CALIFORNIA HIV ALLIANCE. ON THAT
A COALITION OF OVER EIGHTEEN
ORGANIZATIONS FROM ACROSS THE
STATE IN STRONG SUPPORT OF ALL
OF THESE.
THE PROPOSALS THAT YOU'VE HEARD
TONIGHT WHICH WE THINK ARE
COMMONSENSE SOUND PUBLIC HEALTH
INVESTMENTS THANK YOU. THANK YOU.
WELCOME ARENT FOX LAS ANGELES
LGBT CENTER ALSO IN SUPPORT O
ALL OF THE PROPOSALS YOU HEARD.
I THINK YOU.
OKAY. LIKE HEALTH ALSO IN THE
STRONG SUPPORT OF THE
STAKEHOLDER PROPOSALS.
THANK YOU.
OKAY DUDLEY PROJECT INFORM IN
STRONG SUPPORT OF ALL THE CYCLE
FAKE COLOR PROPOSAL WE THANK YOU.
IF YOU RENTALS FROM GALLUP ALSO
IN STRONG SUPPORT OF ALL THESE
PROPOSALS IT THANK YOU.
TIM MAD MAGAZINE CALIFORNIA
CHAPTER OF AMERICA'S EMERGENCY
PHYSICIANS IN SUPPORT OF THE
SUBSTANCE USE DISORDER NAVIGATOR
PROGRAM CONSISTENT WHAT WE WITH
WHAT WE TALK ABOUT A COUPLE
WEEKS AGO. ANYWAY WE CAN DIRECT
PEOPLE TO THE SERVICES THAT WE
NEED WILL BE HELPFUL FOR THEM
AND.
THANK YOU AND THANK YOU.
I NAMES MELINDA RIVER ON THE
EXECUTIVE DIRECTOR OF HARM
REDUCTION SERVICES HERE IN
SACRAMENTO CALIFORNIA.
ALSO COMING AYE AS THE
ORGANIZATIONAL LEADER AND THEN
ALSO SOMEONE HAS BENEFITED FROM
MEDICATION ASSISTED TREATMENT.
AND IS IN RECOVERY FROM OPIATE
USE I USE DISORDER I'D MY
SPECIAL EMPHASIS IS I REALLY
WANT TO SUPPORT THE NAVIGATION
ASSISTANCE AYE AT OUR
ORGANIZATION IN SACRAMENTO WE
SEE COUNTLESS HUNDREDS. OF FOLKS
WITH OPIATE USE DISORDERS AND.
.
NAVIGATING TREATMENT IS ONE OF
THE GREATEST NEEDS OUR COMMUNITY
HAS OUR CURRENT SYSTEMS JUST
DON'T SUPPORT THAT. I'M AND
LITERALLY FOLKS ARE DYING IN THE
STREETS SO IT WOULD HELP MY
STAFF IT WOULD HELP THE
COMMUNITY I SERVE AND IT'S AB
ONE TWO POINT TIME HELPED ME. SO
I REALLY HOPE THAT SITE THESE
PUBLIC HEALTH ISSUES GET PUSHED
THROUGH THANK YOU THANK YOU.
WELCOME.
THOMAS DRUG POLICY ALLIANCE
JUST WANT TO BE CLEAR THAT WE
SUPPORT THAT OTHER STAKEHOLDER
PROPOSALS AS WELL THANK YOU
THANK YOU.
WHEN BACK ISN'T LIKE TO TAKE A
MOMENT TO ACKNOWLEDGE WAS A
NUMBER OF ORGANIZATIONS HERE
EARLIER IN SUPPORT OF THE
STAKEHOLDER PROPOSALS FROM THE
CITIES OF LOS ANGELES SACRAMENTO.
SAN LUIS OBISPO MONTEREY SANTA
CRUZ OAKLAND SAN FRANCISCO.
RIVERSIDE AND WE HAVE ALLIES
FROM SAN DIEGO ORANGE COUNTY
WOULD LIKE TO BE REGISTERED IN
SUPPORT AND I GO TO ALL THE
ORGANIZATION NAMES WITH A NUMBER
OF CITIES REPRESENTED TODAY THAT
HAD TO GO HOME. THANK EIGHT
THANK YOU AND I APOLOGIZE
INSISTS THE OWNER TO GET THROUGH.
AND.
WELL THANK YOU.
AROUND ONE ON BEHALF OF EACH
HEALTHCARE FOUNDATION IN SUPPORT
OF THE DEMONSTRATION PROJECTS
FOR OLDER. PEOPLE WITH HIV AND
TRANSGENDER WOMEN AS WELL AS HE
HIV AYE THAT HABSI A PROPOSAL
OKAY THANK YOU.
I THINK SO MUCH. RIGHT WILL WILL
HOLD ALL THOSE ITEMS OPENED.
.
MOVED THROUGH LONG DAY ISSUE
SEVEN WHICH IS AIDS DRUG
ASSISTANCE PROGRAM ELIGIBILITY
ENROLLMENT.
AND GOOD EVENING* DOT
CAREMARK AGAIN FROM THE OFFICE
OF AIDS.
SO JUST STEP BRIEFLY.
PROVIDE AN OVERVIEW THAT
PROPOSAL THAT WAS A REQUEST TO
ENTER FIFTY THOUSAND AND EIGHT
OUT REBATE FUND EXPENDITURE
AUTHORITY TO SUPPORT. TO
ADMINISTRATIVELY ESTABLISHED
POSITIONS AND THE CURRENT YEAR
AND TWO POINT SEVEN MILLION.
IN REBATE FUND EXPENDITURE
AUTHORITY AND FIFTEEN PERMANENT
POSITIONS
FOR FISCAL YEAR EIGHTEEN
NINETEEN AN ON GOING TO MANAGE
THE INCREASED WORKLOAD INVOLVED
IN TRANSITIONING EIGHT UP
ELIGIBILITY ENROLLMENT SERVICES.
TO THE CITY PH OFFICE OF AIDS.
THESE POSITIONS WOULD INCLUDE
ELEVEN POSITIONS FOR THE EIGHT
HOUR CALL IN DATA PROCESSING
CENTER TWO POSITIONS PROVIDE
OVERSIGHT FOR ALL EAT AT DATA
RELATED ACTIVITIES ONE POSITION
TO OVERSEE AND MAINTAIN THE IT
INFRASTRUCTURE NEEDED FOR THE
ENROLLMENT SYSTEM. AND ONE
ADMINISTRATIVE POSITION FOR CDP
EACH WE BELIEVE THAT APPROVAL OF
THIS BCP WILL ENABLE US TO
CONTINUE THE HIGH LEVEL OF
CUSTOMER SERVICE THAT WE'VE BEEN
ABLE TO PROVIDE TO EAT UP
ENROLLMENT WORKERS. ANTICLINES
SINCE WE TOOK THE APP
ELIGIBILITY ENROLLMENT SERVICES
IN HOUSE ONE YEAR AGO.
OKAY THANK YOU.
COME IT'S MILLION. FINANCE.
PUBLIC COMMENT. BOTTLE KNOW
ALRIGHT. THANK YOU AND CERTAINLY
WILL HOLD THAT I AM OPEN FOR ME
REVISED BUT CERTAINLY WANT YOU
TO HAVE STAFF YOU NEED TO DO THE
WORK. INTO.
ALRIGHT ISSUE NUMBER EIGHT
RETURN LAB VIRAL RICKETS HILL
DISEASE LAB UPGRADE.
OKAY.
WELCOME I KNOW I KNOW THREE
YEARS THE VERY AND.
GOOD EVENING BUT IS NOW YOUR
TIME. OVOID.
BREVITY CELEBRATED TIMOTHY BOW
WITH THE DEPARTMENT PUBLIC
HEALTH ADMINISTRATION BEFORE USE
THAT CAPITAL THEY BUDGET HAIN
PROPOSAL THAT REVERTS THREE
POINT SEVEN NINE NINE.
OF EXISTING AUTHORITY AND WHERE
REQUEST FOR FOUR POINT EIGHT SIX
SIX THOUGHT INCREASE AT THE
LOCAL AUTHORITY WHICH IS ABOUT A
ONE POINT ALL SIX SEVEN INCREASE.
THIS INCREASE IS NECESSARY TO
FIND THE.
UPGRADE OF OUR BIO SAFETY LEVEL
THAT.
LEVELED THREE LABORATORY AT THE
RICHMOND CAMPUS. AND LET ME GIVE
YOU A QUICK A VERY VERY QUICK
HOW. OVERVIEW A BACKGROUND OF
WHY WE'RE HERE.
.
PUBLIC HEALTH HAS A LABORATORY
RICHMOND.
APSL THREE LABORATORY IT'S
CALLED THE FIRE RICK SILLINESS.
DISEASE LABORATORY DRDO.
THIS PROJECTS AND IT'S BE
ITSELF THREE LAB THAT'S USED TO
SAMPLE OF ALL PATHOGENIC VIRUSES
AND AGENTS OF BIOTERRORISM. THIS
LABORATORY UP WE STARTED IN.
ACTUALLY IN TWO THOUSAND SIX
WHEN CDC.
ENHANCE REQUIREMENTS FOR BSL
THREE LABORATORIES SO AND SEVEN
EIGHT DESI PEACH RECEIVED THE
MONEY TO FOREIGN EIGHTY TWO
THOUSAND TWO.
TO DO THE PRIMARY PLANS IN THE
WORKING DRAWINGS PHASES OF THE
PROJECT.
D. JESSUP PERFORMED THOSE TWO
AREAS AND IN FIFTEEN SIXTEEN WE
RECEIVED FOUR POINT THREE THREE
MILLION TO FUND THE PIT AND
CONSTRUCTION PHASE OF THE
PROJECT. ON THE INTENT WAS TO
GOT THE BIT IN ABOUT TWO
THOUSAND SIXTEEN HOWEVER. TIED
LOVES BUT WHAT THE HELL.
WILDFIRES AND STAY FARMERS
REDIRECTED THEIR RESOURCES TO UP
TO ADDRESS THE WHILE FAR SO.
THEY IN TURN DOES SUSPENDED ALL
THE PLAN REVIEWS AND REDIRECT
ALL THEIR RESPOND RESOURCES TO
UP FIGHT THE FIRES.
AS A RESULT WE WERE UNABLE TO
PUT IT UP TO BID IN SIXTEEN
SEVENTEEN. WE REQUESTED EVERY
APPROPRIATION OF THE REMAINING
FUNDS WHICH OF THREE POINT SEVEN
NINE NINE.
AND.
AND THEN IT TOOK IN JUNE TWO
THOUSAND SEVENTEEN THAT WE
FINALLY GOT IT OUT THAT WE GOT
THE STATE FIRE MARSHAL PROVE #
AND IN AUGUST TWO THOUSAND
SEVENTEEN. A THEY GOT OUT THE
BIT IN OCTOBER TWO THOUSAND
SEVENTEEN. PAGES RECEIVE ONE BIT
FOR THREE POINT FOUR FOUR FIVE
MILLION WHICH IS UNFORTUNATELY
TWENTY THREE PERCENT OR. ABOUT
SIX HUNDRED FORTY THREE THOUSAND
ABOVE THE UMP
TWO POINT SEVEN NINE NINE SIX
BUDGET.
THE JUST REVIEWED THE BIDS AND
THE PROJECTS ESTIMATE DETERMINED
THAT ONE. OF. THE THAT WAS
LIMITED INTEREST IN THE UP
PROJECT TO THE STRENGTH OF THE
CONSTRUCTION MARKET IN THE BAY
AREA.
TO THE SPECIALTY NATURE OF THE
PROJECT FURTHER LIMIT THE
POTENTIAL NUMBER BIDDERS.
AND THREE THE PROJECT ORIGINALLY
ASKED MEANT DID NOT ADEQUATELY
REFLECT THE. THE UP CURRENT
STRENGTH OF THE CONSTRUCTION
MARKET IN THE BAY AREA.
SO IN TURN THEY DETECT THEY
DETERMINED THAT THE ONE BID WAS
RECESS EVEN KNOWS WHAT RECEIVED
ONE BED IT REFLECTED THE CURRENT
CONSTRUCTION MARKET AND THE
STRENGTH OF THAT MARKET.
THE CURRENT REQUESTS INCLUDES A
REVISED DIGEST COST ESTIMATE
WHICH MORE ACCURATELY REFLECTS
THE CURRENT POP CONSTRUCTION
MARK IN THE BAY AREA. AND THE
SPECIALTY NATURE OF THE UP
PROJECT.
.
WITH YOUR APPROVAL WE HOPE TO.
CAP THE JESKELL PUT THAT
PROJECT BACK OUT TO BID AUGUST
OUT TO THE ON EIGHTEEN AWARD A
CONTRACT INTO THIN GELATIN
JANUARY TWO THOUSAND NINETEEN.
AND IT'S A ONE YEAR PROJECT AND
BE COMPLETE WITHOUT TWENTY
TWENTY SO IN SUMMARY. DID YOU
NOTICE THE PROJECT DELAYS WERE
BEYOND ANYBODY'S CONTROL.
AND THE PROJECT IS US STILL
NECESSARY THE ENHANCEMENTS ARE
STILL NEEDED. AND THE
LABORATORIES A VITAL FLOW PART
OF OUR MISSION.
SO YOU'RE APPROVALS PROGRESSIVE
THINKING ALRIGHT THANK YOU
ACCOUNTS MILLION.
FINANCE.
ALRIGHT.
ANY PUBLIC COMMENT.
ALRIGHT SAY NO PUBLIC COMMENT.
.
YEAH AT IS I USED TO SERVE ON
BUDGETS OF FOR SOMETHING TELLS
ME SOMEONE NEEDS TO TALK TO THE
FIRE MARSHAL ABOUT MORE STAFF
BECAUSE THIS.
HAVE I HEARD YOU
STATE HOSPITALS TODAY ALL THESE
PROJECTS IN THE LATE BECAUSE AND
I UNDERSTAND WILD FIRES.
BUT ALSO THE GOVERNOR SAID
THAT'S NEW NORMAL. AND IF ALL
OUR STATE CONSTRUCTION PROJECTS
REGAINED THE LIGHT BECAUSE THEY
CAN'T GET THE FIRE MARSHAL
APPROVAL ON TIME I THINK WE WERE
PROCESS PROBLEM BECAUSE I'VE
HEARD THIS.
STORY.
BUT IS THAT THE THIRD OR FOURTH
TIME TODAY WELL SEVERAL TIMES
OUR STATE HOSPITALS. AND NOW THE
SLABS SO SOMEPLACE WE'RE GOING
TO HAVE TO FIGURE OUT TO CLOSE
THAT LOOP ON.
STATE EITHER TO ANY DEDICATED
STAFF FOR THESE APPROVALS.
BECAUSE WE'RE HEARING THIS OVER
AND OVER AGAIN.
AND I THINK IT'S COSTING US
MONEY ALSO ON ALL THESE PROJECTS.
.
SO ALRIGHT WELL WE'RE GOING TO
HOLD THIS ITEM OPEN WAIT FOR MAY
REVISE CERTAINLY RECOGNIZE THE
IMPORTANCE AND THE NEED FOR THE
PROPER HEALTH TO HAVE THIS LAB.
SO THANK YOU THINK VERGE BOOK
THAT YOU THINK ARE.
THE NEXT ITEM IS ISSUE NUMBER
NINE BABY BIG INFANT BOTULISM
TREATMENT AND PREVENTION.
GOOD EVENING AND OTHER
PEDIATRICIANS SO YOU DON'T NEED
TO DO TO MUCH BACK.
OKAY GREAT I THINK. THIS
PROPOSAL TIME REQUEST BUDGET
BILL LANGUAGE TO AUTHORIZE THE
DEPARTMENT OF FINANCE TO PROVIDE
ADDITIONAL EXPENDITURE AUTHORITY
NEXT YEAR IN THE EVENT THAT THE
MANUFACTURER
CYCLE BABY BIG.
SLIPS INTO THE BUDGET YEAR.
I'M ESSENTIALLY THAT'S WHAT THAT
IS SO THERE'S A THERE'S A FIVE
YEAR CYCLE. NAM THERE'S ONE FDA
APPROVED MANUFACTURING
PHARMACEUTICAL COMPANY IN LOS
ANGELES AND.
THERE WERE TRYING TO NEGOTIATE
WITH THEM ABOUT TIMING COME TO
HAVE A COMPOSITE COMMERCIAL
PRODUCTS THAT A TAKE HIGHER
PRIORITY SO WE HAVE THE THE
BALANCE IN OUR FUND. AND IT'S
JUST TOO INVENTED IT SLIPS. GOOD
OKAY.
ATLEO ANY COMMENTS FINANCE.
ALRIGHT WE GO SEE THOSE BABIES
FROM BOTULISM OKAY NO HONEY
BEFORE.
IF MELODY OKAY BEFORE YOUR BATES.
THERE YOU GO ALRIGHT HOW HE'S
GOOD BUT NOT FOR BABIES
OKAY.
THAT'S A PART THAT WAS A PUBLIC
HEALTH PUBLIC SERVICE
ANNOUNCEMENTS. OKAY ISSUE NUMBER
TEN ACTUALLY ISSUE NUMBER TEN
EMERGENCY RESPONSE PUBLIC HEALTH
CRISIS RESPONSE GRANT.
OR RETAILER WOULD PERMIT A
PUBLIC HEALTH NINE YOUR LAST
ITEM TODAY. BELIEVE. SO WE'RE
REQUESTING PROVISIONAL LANGUAGE
ABOUT THE STATE UP SOME LOCAL
ASSISTANCE.
I'M FOR AN AUGMENTATION RELATED
TO THE CENTER FOR DISEASE
CONTROL AND PREVENTION'S
COOPERATIVE AGREEMENT FROM
URGENCY RESPONSE PUBLIC HEALTH
CRISIS RESPONSE GRANT.
SO THE CDC HAS PUT OUT A.
.
A GRANT APPLICATION THAT WE
APPLIED FOR AND WE RECEIVED A.
APPROVED BUT UNFUNDED STATUS SO
CDCS ATTEMPTING TO SORT OF DO
AWAY WITH GRANTS LIKE THEY'VE
DONE FOR EBOLA AND SEE.
AND INSTEAD I HAVE I'M STATE
SUPPLY ANNUALLY FOR A GRANT.
THAT PUTS YOU SORT OF.
IN A POOL. AND SHOULD THERE BE
AN EMERGENCY SUCH AS A MOBILE A
RESPONSE.
THEN YOU CAN TURN AROUND AND
JUST SORT OF APPLY WITH A BUDGET
VERSUS HAVING TO DO A FULL ON
APPLICATION AND WAIT FOR NEW
FUNDING THAT'S KIND OF A POT OF
MONEY.
THEY CAN BE AVAILABLE IN A
LITTLE BIT FASTER WITH A QUICKER
TURNAROUND.
SO THIS WOULD PROVIDE I'M THE
PROVISIONAL LANGUAGE THAT WOULD
IN TURN ALSO ENSURE THAT AS A
STATE WE COULD SPEND THIS MONEY
TIMELY WAS ONE OF THE
REQUIREMENTS.
OF THE GRANT APPLICATION WAS
THAT WE COULD DEMONSTRATE THAT
WE TOO COULD SPEND THE MONEY
FAST.
IF WE RECEIVED IT FROM CDC
QUICKLY.
BELIAU COMMENTS FINANCE OKAY
WHAT WE TALKED ABOUT NEEDS FOR
PUBLIC HEALTH. PREPAREDNESS
OUTBREAKS ACTUALLY THAT'S THE
OTHER KIND A NEW NORMAL. AS WELL
NOT TO
WILD FIRES AND OTHER STUFF SO.
I THINK YOU FOR THE PRESENTATION
ACTION ANY PUBLIC COMMENT.
OKAY SINGLE PUBLIC COMMENT WILL
HOLD THIS ITEM OPEN AS WELL OKAY.
WELL.
BELIEVE IT OR NOT AT SEVEN
FOURTEEN THIS THOSE CLUED
CONCLUDED THE AGENDA OF THE
SENATE BUDGET FISCAL REVIEWS
THE NUMBER.
AND HUMAN SERVICES.
AND BUT THAT WE ARE ADJOURNED.
THANK YOU