TREMENDOUS APPRECIATION FOR MICE
MY VICE CHAIR WHO ACTUALLY RIGHT
BEFORE I DID.
AS WELL AS A CENTER OFF SO --
THANK YOU --
WE DO NOT YET HAVE A QUORUM BUT
WILL GO AHEAD BEGIN IS
SUBCOMMITTEE ALSO WANT TO THANK
ASSEMBLY MEMBER SALAS FOR ALSO
BEING HERE.
TIMELY MANNER AND PLEASE COME
FORTH AND PRESENT YOUR BILL SO
THAT'S AB SEVENTEEN NINETY
WELCOME.
THANK YOU MISTER CHAIR MEMBERS
THAT PRESENT BEFORE YOU ASSEMBLY
BILL SEVENTEEN NINETY AT ONCE
AGAIN BUT THIS TIME WITH.
AMENDMENTS SO THAT WE CAN MAKE
IT IMPLEMENTABLE --
SO WOULD APPRECIATE LABOR.
OKAY THANK YOU --
ANY WITNESSES IN SUPPORT.
WITNESSES IN OPPOSITION.
OCEANS FROM COMMITTEE MEMBERS.
OKAY AND DUH.
PEOPLE FIXING THE AMENDMENTS SO
--
JUST BRIEFLY THE AMENDMENT
REALLY DENNIS ABOUT IMPLEMENTING
ALLOWING US TO IMPLEMENT ACTION
WHAT WE READY PASS THOUGH THE
BUDGET PROCESS SO WE CAN NOW GO
AHEAD AND IMPLEMENT THAT.
ALRIGHT SO WITH THAT --
OF COURSE WE DO NOT YET HAVE A
QUORUM SO I CAN'T TAKE ANY
MOTION COMPOSED A CENTER ROCKY
CHAVEZ IS QASEM HELPED MOVE IT
AT THE APPROPRIATE TIME AS CHAIR
ALWAYS OKAY EXCELLENT.
ALRIGHT THE DAY THE AUSTIN OKAY
WELL THANKS SO MUCH SENATOR
SALAS AND AGAIN THANK YOU SO
MUCH FOR BEING HERE.
AND TIMELY MANNER ALRIGHT --
THE NEXT ITEM WILL BE.
ITEM IS --
SENATOR WOODS A. B. [inaudible]
ONE EIGHTY AND SO.
WHEN THE SENATOR WOODS IS HERE
WILL BE HAPPY TO HEAR THAT BILL
AND ALSO ASK THAT?
THEY'RE FREE MEMBERS OF THE SOME
OF THE SENATE HEALTH COMMITTEE
MAY WE CAN GET A SO I CAN GET A
QUORUM THAT HE APPRECIATED
.
FORUM --
SECRETARY KEY PLEASE CALL THE
ROLL FOR QUORUM.
PAN HERE AND HERE WHEN.
WHEN HERE BELL?
HERNANDEZ HERNANDEZ HERE LEYVA.
HERE I LIVE OUT HERE.
MITCHELL.
MONNING MINING HERE NIELSEN.
ROTH HERE ROTH HERE.
ALRIGHT WHAT WE DO HAVE A QUORUM
SO -- WE
CURRENTLY HAVE --
WE'VE HEARD ONE BILL THAT SAY AB
SEVENTEEN NINETY BY ASSEMBLY
EVER SALAS WAS MOVED BY SENATOR
ROTH -- SO
WAS SECRETARY CAN YOU PLEASE
CALL THE ROLL ON AB.
SEVENTEEN NINETY AND THE MOTION
IS TO PASS AND THAT MEASURE BE
RETURNED TO THE SENATE FLOOR FOR
CONSIDERATION.
CAN I AND I WHEN.
WHEN I FELL?
HERNANDEZ HERNANDEZ AYE LEYVA.
LEYVA AYE MITCHELL.
MONNING AYE AYE MONNING AYE.
NIELSEN AYE AYE NIELSEN AYE RAW.
ROTH AYE.
YEAH BILL CURLY HAS SEVEN VOTE
SEVERAL PUT THE BILL ON CALL
OTHER I SEE TWO MORE MEMBERS
HERE SO LET'S LIFT THE CALL ON
AGAIN ACT A. B. C..
IN NINETY PROSECUTE THESE CALL
THE ROLL OF ABSENT MEMBERS
[inaudible]
BELL [inaudible]
BELL I MITCHELL AYE MITCHELL
AYE.
OKAY THAT BILLS OUT --
NINE ZERO WE ARE STILL WAITING
OUR SECOND AUTHOR ASSEMBLYMAN
WOODS -- FOR
ITEM -- AB
ONE EIGHTY SO. FOR SOME THERE
WOULD STAFF IS WATCHING THE
MONITOR --
WE ARE WAITING PRESENTS WE HAVE
A FULL COMMITTEE PRESENT.
AND DIVERT VERY EAGER TO HEAR
THE BELLS.
LISTEN I DID ANNOUNCE THAT THE
SENATE HEALTH COMMITTEE WAS
CONVENIENT ONE THIRD SO
.
I COULD NOT MATCH YOUR ELOQUENCE
AND YOUR KNOWLEDGE ABOUT THIS P
SO THE RULE IT'S WELCOME WE HAVE
THE FULL COMMITTEE HERE WAITING
YOU [inaudible]
WELL SORRY.
THANK YOU MISTER CHAIR AND
MEMBERS.
FIRST OFF THANK THE COMMITTEE
THANK YOU THE COMMITTEE FOR THE
OPPORTUNITY TO PRESENT THIS BILL
TODAY ON THE BILL SEEKS TO
ADDRESS.
AND ISSUE BROUGHT TO MY
ATTENTION BY RURAL CLINIC IN MY
DISTRICT THAT DURING RECESS.
ANDERSONVALLEY HEALTH CENTER AN
FQHC ENTERED INTO A CONTRACT.
WITH A LOCAL HEALTH PLAN FOR THE
PAY FOR PERFORMANCE PROGRAM.
WITH A QUICK RECEIVED ADDITIONAL
MONEY FOR IMPROVING HEALTH
OUTCOMES.
I LITERALLY RAN. ONE SECOND.
YOU KNOW.
NO.
I'M GOOD.
ALRIGHT WELL YOU TAKE THE
WITNESSES FIRST AND THEN HAVE
YOU I'M AFTERWARDS.
SO IT'S A RECENTLY DURING THE
RECONCILIATION OR AUDIT PROCESS.
THE DEPARTMENT HEALTHCARE SECURE
SERVICES BEGAN AGGRESSIVELY AND
INCONSISTENTLY MAKING
ADJUSTMENTS IN INCORPORATING
THESE PAYMENTS.
AS PER THE WRAPAROUND PAYMENT.
GENESYS DCS STARTED RECOUPING
THESE PAY PAY PAYMENTS AND AND
IN THE CASE OF ANDERSON VALLEY.
FORTY FIVE YEARS AFTER THE FACT.
AB ONE EIGHTY WOULD REQUIRE DE
EIGHT CS TO ESTABLISH A
STAKEHOLDER PROCESS TO DEVELOP
GUIDELINES. FOR ACUTE CAESAR OR
RURAL HEALTH CLINICS TO
DETERMINE WHETHER PAYMENT.
WOULD CONSTITUTE AN INCENTIVE
PAYMENT.
LAST OF THE BILL REQUIRES THAT
FOR THOSE YEARS THAT WERE THERE
WERE NO THERE WERE NO
GUIDELINES.
DEPARTMENT SHOULD NOT BE ABLE TO
RECOUP [inaudible]
PAYMENTS I DO HAVE WITNESSES --
BUT IN THESE CLINICS RELIED ON
OF SORRY.
THEY RELIED ON FEDERAL
REGULATIONS AND GUIDANCE WHEN
THEY ENTERED INTO GOOD FAITH
CONTRACTS WITH THE PLANS FOR
THESE TYPES OF PAYMENTS.
DEPARTMENT HAS NOT ISSUED ANY
GUIDANCE OR CRITERIA ON WHAT YOU
QUALIFIES INCENTIVE PAYMENTS.
AND IS INCONSISTENTLY USES AUDIT
AUTHORITY TO RECOUP THESE
PAYMENTS AND THE PROCESS.
DESTABILIZING THE FINANCIAL
STATUS OF THESE CLINICS WHICH
COULD EVENTUALLY IMPACT PATIENT
CARE.
I PICKED UP THE BILL'S A FAIR
SOLUTION AND PUT MUCH A CLARITY
ON THESE PAYMENTS.
I RESPECTFULLY ASK FOR A VOTE
OKAY THANK YOU UP BEFORE
WITNESSES A PORT --
CENTER MITCHELL TO CHIU WAI'S
HAPPY.
OKAY SURE OKAY VERY GOOD ALRIGHT
SIDES OF IT JUST WON'T QUIT
WITNESSES SUPPORT THANK YOU
MISTER CHAIRMAN BIRDS MAY
CONSUMERS ON BEHALF OF
CALIFORNIA HEALTH PLUS ADVOCATES
THE ASSOCIATION THAT REPRESENTS
THE HEALTH CENTER AND MISTER
WOODS DISTRICT.
BUT WE ARE IN SUPPORT OF THE
MEASURE ANDWANT TO IDENTIFY
THAT THERE ARE THIRTEEN HUNDRED
COMMITTEE CLINICS AND IN
CALIFORNIA THAT WE REPRESENT ARE
PART OF ASSOCIATION WE THINK
ALTHOUGH AT THIS TIME WE THINK
THIS ISSUE IS.
SOMEWHAT ISOLATED THERE MAY ONLY
BE A HANDFUL CLINICS THAT ARE
IMPACTED IT IS REALLY IMPORTANT
THAT GUIDANCE ITS PRODUCE AT THE
STATE LEVEL TO IDENTIFY WHAT.
PAY FOR PERFORMANCE PAYMENTS ARE
WHEN THEY'RE APPROPRIATE WHEN
THEY ARE NOT APPROPRIATE AND
THAT THOSE --
GUIDED THAT GUIDANCE BE APPLIED
THROUGHOUT THE STATE --
THE SAME WAY AND WE THINK IT'S
BEEN PRETTY CLEAR ON A FEDERAL
LEVEL FROM GUIDANCE FROM CMS BUT
THESE PAYMENTS ARE SO ARE TO BE
SEPARATE AND ASIDE FROM THEIR
PPS RATE --
AND NOT RECONCILED BY THE STATE
BUT AGAIN WE ARE WE ACKNOWLEDGE
AT THE STATE IS --
WOULD LIKE TO LOOK AT THIS AREA
WITHIN THE SHOULD BE A FORMAL
PROCESS WE HOPE TO BE A PART OF
THAT PROCESS AND FOR THOSE
REASONS A WE'RE IN SUPPORT.
GOOD AFTERNOON MISTER CHAIRMAN
SENATORS ROSANNA CARVE OUT TO
HEAR ME OFTEN BREAK A HEALTH
COMMUNITY FOUNDATION PREGO IS
ONE OF THE LARGEST FQHCS
CALIFORNIA.
AND SERVES OVER A HUNDRED EIGHTY
THOUSAND PATIENTS IN --
SIMMERED IN THE YOU KNOW SAN
DIEGO AND RIVERSIDE COUNTIES --
SO WE ARE ALSO IN STRONG SUPPORT
OF AB ONE EIGHTY THINK DOCTOR
WAIT FOR TAKING ON THIS ISSUE --
WHAT YOU HEARD FROM MEGAN THAT
THIS MAY BE A LITTLE AND I WHEN
I SLATED ISSUE IT IS CERTAINLY
BEEN AN ISSUE FOR BRACO?
AND YOU KNOW THE LIABILITY THAT
WE ARE FACING IS OVER A MILLION
DOLLARS CLOSE TO TWO MILLION AYE
IN THE CURRENT AUDIT.
AND WE EXPECTED TO BE ABOUT A
MILLION ON GOING IN FUTURE YEARS
FOR US BUT I AM SO IT'S
IMPORTANT TO JUST KNOW WHAT
THOSE RULES ARE AND HOW THEY ARE
GOING TO BE APPLIED.
SO THAT YOU ARE HIT WITH THIS --
AUDIT YOU KNOW FOR FIVE YEARS IN
THE PAST WITH --
A LARGE SUM OF MONEY THAT'S DUE
TO THE STATE FOR SERVICES YOU
PARTY PROVIDED AND MONEY THAT'S
ALREADY BEEN SPENT SO FOR THOSE
REASONS WE USE WE RESPECTFULLY
ASK THE GUY ABOUT.
THANK YOU OTHER WITNESSES IN
SUPPORT.
BEING DONE WITNESSES IN
OPPOSITION.
SEEING NONE OF US CENTER
MITCHELL.
YEAH I THINK I WAS TRYING TO AND
THE ANNOUNCES ITIS.
WANTED TO BE CLEAR SO BASICALLY
WERE EXEMPTING.
THESE CLINICS FROM A CALLBACK
FROM DCS ONLY IN THE INSTANCE OF
THE INCENTIVE PAYMENT NOT.
EXEMPTED FROM A CLAWBACK ACROSS
THE BOARD.
FOR DIFFERENCES IN OPINION
ABOUT.
APPROPRIATE --
REIMBURSEMENT CRAFT.
OKAY AND SO --
I'M SCANNING AGAIN IN THE OFFICE
I SEE THAT THERE.
WHO IS A COURT CASE BETWEEN
COUNTY OF SAN MATEO AND THE
STATE DEPARTMENT OF HEALTH
[inaudible]
CARE SERVICES.
WOULD THIS BE ALL.
HOW WOULD THIS BILL IN IRAQ
WOULD EXISTING COURT CASE OR
WHAT IT?
I AM I NOT READING QUICKLY AND
OFFICE AND ASK A QUESTION.
MY UNDERSTANDING OF THE COURT
CASES THAT IT IS NOT PRECEDENT
SETTING AND THAT WAS
SPECIFICALLY AROUND SOME THERE
IS A LACK OF GUIDANCE AT THE
STATE LEVEL AROUND THESE PEOPLE
P. INCENTIVE PAYMENTS IN THEIR
TREATMENT AND FOR FQHCS DURING
THE RECONCILIATION PROCESS.
THERE'S BROAD FEDERAL GUIDANCE
IT'S VERY BROAD IS JUST LIKE
THEY SHALL BE EXTENDED IF
THEY'RE THERE SHALL BE EXISTS
EXEMPT IF THEY ARE INCENTIVES
AND THERE'S NO REAL DEFINITION
OF WHAT AN INCENTIVE IS.
AND SO THERE IS A DISAGREEMENT
AT THE STATE LEVEL IN SAN MATEO
ABOUT LIKE WHETHER.
WHAT WAS AT STAKE IN SAN MATEO
WAS AN INCENTIVE OR NOT AND THIS
BILL IS SIMPLY ASKING FOR THAT
BUT SET IT DOWN IN RULES AND
THEN PLAY BY THOSE RULES IN THE
FUTURE --
BUT WHAT DO YOU WHAT WE DON'T
WANT IS DH YES A SET A RULE NOW
AND THEN GO BACK FOR IT DIDN'T
BUT RECONCILIATIONS THAT THEY'RE
DOING RIGHT NOW WHICH IS FIVE
YEARS AGO --
AND SAY THAT THAT'S APPLICABLE
LIKE.
PROSPECT IT WITH THE EXCEPTION
OF PROTECTING YOU FROM THE
CLAWBACK EXACTLY THANK YOU THANK
YOU.
THE OTHER QUESTIONS REMEMBERS.
BUT JUST A BRIEF ABOUT QUESTION
COMING FROM MYSELF I MIGHT.
SO FROM I UNDERSTAND.
WHAT?
HAPPENED IS THAT YOU.
ACHIEVING CERTAIN QUALITY GOALS.
YOU ACHIEVE THE US.
YOUR GOT INCENTIVE PAYMENT AND
NOW THEY WANT A CLUB THAT BACK
AND ACTUALLY IRONICALLY IF YOU
DID NOT ACHIEVE THEM.
YOU WOULD NOT HAVE THIS PROBLEM
THAT TRUE.
CORRECT SO WE ARE PUNISHING
CLINICS FOR PERFORMING QUALITY
CARE.
OKAY I THINK THAT'S SOMETHING WE
NEED TO FIX --
THERE'S BEEN.
NO CASE AND MOVE AYE SARATH THAT
SUMMER WAS WOULD YOU LIKE TO
CLOSE.
JUST BRIEFLY I THINK OF FOR ME I
THINGS THAT FRUSTRATE IF IT IF
YOU KNOW WHAT THE RULES ARE.
YOU CAN FOLLOW THE RULES AND
THAT THIS SHOULD BE AN ISSUE.
BUT IF THERE ARE NO RULES YOU
SHOULDN'T BE ABLE TO GO BACK AND
SAY OH WILL THIS THE RULES AND
WE'RE GONNA GO BACK AND TAKE
WHICH MEANT FROM BEFORE THAT
JUST MAKES UPS IN A SENSE SO.
IN THE IN THE INTEREST OF
FAIRNESS --
I ASK FOR YOUR VOTE OKAY THANK
YOU I'D ALSO MAKE NOTE THAT I
ACTUALLY CARRIED A BILL THAT WAS
VETO THAT ACTUALLY REQUIRED TO
DTS RECONCILE WITHIN FIVE YEARS.
THAT'S ANOTHER STORY BUT SO THEY
CAN GO BACK MANY YEARS OKAY SO
IT'S BEEN MOVED BY SENATOR ROTH
MOTIONS TO PASS TO
APPROPRIATIONS EYE SURGERY
PLEASE CALL THE ROLL.
AND I AND I WHEN.
WHEN I FELL?
BILL AYE HERNANDEZ HERNANDEZ AYE
LEYVA.
LEYVA AYE MITCHELL.
MITCHELL AYE MONNING.
MONNING AYE NIELSEN.
NIELSEN I AM ROB BONTA ROTH AYE.
OKAY THAT BILLS OUT NINE ZERO
THEY TAKE YOUR PATIENCE ALL
RIGHT CLICK THAT WE'VE CONCLUDED
THE AGENDA OF THE THIS HEARING
OF THE SENATE COMMITTEE ON
HEALTH.
WE ARE NOW ADJOURNED