I MUST SAY I AM SO IMPRESSED
THAT EVERYBODY IS HERE TIMELY I
LOVE THAT --
I'M GONNA GO AHEAD AND CALL THE
FEBRUARY TWENTIETH --
RULES COMMITTEE MEETING TO ORDER
AND MADAM SECRETARY WILL YOU
ESTABLISH A QUORUM.
YES SENATORS GROWTH MINING.
MINING HERE ROTH ROTH HERE WILK
PRESENT WILK HERE ATKINS HERE
ATKINS HERE.
THANK YOU VERY MUCH --
WE'RE GOING TO GET RIGHT INTO IT --
IT LOOKS LIKE I WOULD BE HAPPY
TO ENTERTAIN A MOTION FROM ANY
MEMBER OF THE COMMITTEE --
WE COULD SET A CONSENT CALENDAR
IT UNLESS PEOPLE DISAGREE IT
LOOKS LIKE WE COULD.
MOVE ITEM TWO THREE AND FOUR
THROUGH EIGHT SO.
OKAY SEEING NO ARE.
OPPOSITION TO THAT MADAM
SECRETARY WILL YOU CALL THE ROLL
ON ITEMS TWO THROUGH.
EIGHT SENATORS GROW MONNING
MONNING AYE ROTH.
ROTH AYE WILK WILK AYE ATKINS
AYE ATKINS AYE AND A MADAM
SECRETARY I WOULD ASK THAT WE
LEAVE THE ROLE OPENED SO THAT
OUR CARLY CAN WAY ENSURE WE'LL
GO AHEAD AND MOVE TO ITEM NUMBER
ONE GOVERNOR'S APPOINTMENTS
REQUIRED TO APPEAR.
AND LET ME INVITE SUSAN FANELLI
WHO IS THE CHIEF DEPUTY STATE
DEPARTMENT OF PUBLIC HEALTH.
APPOINTEE FORWARD.
AND WELCOME YOUR ARE ACTUALLY
FIRST.
A REQUIRED TO APPEAR APPOINTMENT
IN TWENTY NINETEEN SO --
WE WANT TO WELCOME YOU.
AND GIVE YOU THE OPPORTUNITY IF
YOU'D LIKE TO INTRODUCE YOURSELF.
ANY FRIENDS AND FAMILY THAT
MIGHT BE WITH YOU AND MAKE YOUR
OPENING STATEMENT AND THEN WE
WILL GO RIGHT INTO COMMENTS AND
QUESTIONS FROM THE COMMITTEE.
I HAVE WITH ME TODAY MY PARENTS --
LORRAINE AND TO SEE THE FANELLI
AND MY PARTNER JOE DAVIS AND OUR
DAUGHTER JESSICA FINITELY DAVIS.
WELCOME.
AND BEFORE YOU STARTED YOUR
COMMENTS LET ME FOR THE RECORD
RECOGNIZE THAT MISS GROVE IS
HERE -- AND
WE WILL COME BACK AND LET YOU
VOTE --
AFTER WE TAKE UP OUR APPOINTEE
GO AHEAD MISS FINALE.
THE GOOD AFTERNOON MADAM CHAIR
AND MEMBERS ARE DEBBIE DIRECTOR
OF POLICY AND PROGRAMS FOR THE
CALIFORNIA.
DEPARTMENT OF PUBLIC HEALTH I
WOULD LIKE TO FIRST THANK THE
GOVERNOR FOR THE OPPORTUNITY TO
SERVE AT THE CALIFORNIA
DEPARTMENT OF PUBLIC HEALTH.
AND ALSO TO THANK THE RULES
COMMITTEE AND LEGISLATIVE STAFF
FOR THEIR ROLE IN THE
CONFIRMATION PROCESS.
THE CHALLENGING AND EXCITING
TIME FOR PUBLIC HEALTH.
WITH A STRONG COMMITMENT TO
ADDRESSING THE SOCIAL
DETERMINANTS OF HEALTH IN ORDER.
TO IMPROVE THE HEALTH OUTCOMES
AND RESILIENCY OF OUR PEOPLE OUR
FAMILIES AND OUR COMMUNITIES I
PLAN TO WORK DILIGENTLY TO
SUPPORT AND CONTRIBUTE TO THE
MISSION OF THE DEPARTMENT OF
PUBLIC HEALTH. TO OPTIMIZE
OPTIMIZE THE HEALTH AND WELL
BEING OF THE PEOPLE OF
CALIFORNIA.
I'VE SERVED IN A VARIETY OF
LEADERSHIP ROLES IN THE FIFTEEN
YEARS THAT I'VE BEEN WITH THE
DEPARTMENT.
INCLUDING THE DEPUTY DIRECTOR OF
THE MARGINS HE PREPAREDNESS
OFFICE AS THE ASSISTANT DIRECTOR
OF THE DEPARTMENT AND FOR THE
PAST TEN MONTHS AS THE CHIEF
DEPUTY OF OUR POLICY AND
PROGRAMS.
I SEE MY PRIORITIES AS WORKING
ACROSS OUR MANY PROGRAMS TO
BETTER MEET THE NEEDS OF OUR
LOCAL JURISDICTIONS AND THE
COMMUNITIES THEY SERVE.
PARTICULARLY DURING EMERGENCIES
SUCH AS WILD BY FIRES AND OTHER
INFECTIOUS DISEASES. TO ALIGN
THOSE PROGRAMS AROUND A SINGLE
ORGANIZATIONAL CULTURE AND
CENTER SHARED PRIORITIES AND
FINALLY TO ENSURE THAT THE
DEPARTMENTS BURKE IS INFORMED BY
OPEN COMMUNICATION.
NOT ONLY WITH OUR LOCAL HEALTH
JURISDICTIONS BUT ALSO WITH THE
MANY STAKEHOLDERS AND THE PEOPLE
WE REPRESENT.
I'M COMMITTED TO OUR MISSION TO
OUR TEAM AND THE HEALTH OF THE
PEOPLE OF CALIFORNIA AND WANT TO
THANK THE COMMITTEE MEMBERS FOR
YOUR TIME TODAY [inaudible]
KEEP.
THANK YOU VERY MUCH --
SENATOR MONNING WOULD YOU LIKE
TO USE OF YES GO AHEAD AND START
MISTER MONEY.
THANK YOU MADAM CHAIR --
WELCOME MS FENNELLY THANK YOU
FOR JOINING US TODAY IN.
THANK YOU FOR YOUR SERVICE TO
THE STATE OF CALIFORNIA TO DATE --
YOU HAD AN OPPORTUNITY WE HADAN
OPPORTUNITY TO MEET YESTERDAY IN
YOU ADDRESS A LOT OF MY
QUESTIONS I CAN ASK A FEW TODAY
JUST FOR THE BENEFIT OF THE
COMMITTEE.
AND THOSE THAT MIGHT BE
LISTENING IN ONE OF THE AREAS
THAT YOU HAVE OVERSIGHT OUR
INSPECTIONS FOR LONG TERM CARE
FACILITIES.
IN THE LOS ANGELES AREA AND
OTHERS A BACKLOG OF
INVESTIGATION OF COMPLAINTS.
I KNOW IT'S BEEN OF CONCERN TO
MANY MANY YOU GIPSON UPDATE ON
THE PATHWAY TO CLEARING SOME OF
THAT BACKLOG OF COMPLAINTS.
SO RIGHT NOW THERE ARE IS A
BACKLOG OF ABOUT FIVE THOUSAND
COMPLAINTS IN LOS ANGELES COUNTY
FOR THE FACILITIES THAT ARE
LOCATED ANDLA COUNTY.
I'M AND WE ARE WORKING
DILIGENTLY TO ADDRESS THOSE
WE'VE BEEN NEGOTIATING A NEW
CONTRACT WITH LA COUNTY TO
PROVIDE THEM WITH THE RESOURCES
THEY NEED TO TAKEON A 100% OF
THE WORK FOR THE HEALTH CARE
FACILITY LOCATED IN LOS ANGELES
COUNTY.
AND WE LAST YESTERDAY WE GOT A
SETTLEMENT ON THE FINAL ISSUE WE
I WAS WORKING ON WITH LOS
ANGELES COUNTY --
AND SO THEY WILL BE RAMPING OFF
THEIR STAFF OVER THE NEXT COUPLE
OF YEARS TO MAKE SURE THAT THEY
HAVE THE RESOURCES THEY NEED TO
ADDRESS THOSE COMPLAINTS.
IMPORTANT TO RECOGNIZE THAT WE
DEAL WITH THE MOST EGREGIOUS
COMPLAINTS VERY QUICKLY SOME OF
THESE COMPLAINTS ARE NOT IN THE
MINOR LESS LESS IMPORTANT OR NOT
IMPORTANT BUT LAST AND AGREE
JUST COMPLAINTS AND SO WHAT
WE'LL BE DOING.
OVER THE NEXT COUPLE YEARS WITH
LA COUNTY IS AS THEY GET A NEW
COMPLAINT IN THE FACILITY
THEY'LL BE LOOKING UP THE OTHER
COMPLAINTS THAT ARE IN THAT
FACILITY AND SORT OF GETTING AN
ECONOMY OF SCALE SO WHEN YOU GO
INTO A FACILITY.
YOU NOT ONLY DEAL WITH THE
COMPLAINT THAT'S NEW ON BUT YOU
ALSO LOOK AT THE OTHER
COMPLAINTS THAT MAYBE FOR THAT
SAME FACILITY AND THEREBY WE CAN
DECREASE THE BACKLOG A LITTLE
BIT QUICKER.
IN SO THE LA COUNTY WORKS ON
TRACTORS I ASSUME CERTAIN.
PERFORMANCE OBLIGATIONS ARE
TARGETS WOULD YES SO WE WE ARE
WITH THE BACKLOG.
YES AND SO AND IN THEIR CONTRACT
WE HAVE A SERIES OF WORKLOAD
METRICS QUALITY MACK TRUCKS AND
AND CUSTOMER SERVICE METRICS AND
SO.
PART OF THAT CONTRACT IS TO NOT
ONLY DEAL WITH THE NEW
COMPLAINTS WITHIN THE NEW TIME
LINE WHICH IS A SIXTY DAY
TIMELINE FOR NEW COMPLAINTS
COMING IN BUT OVER THAT OVER A
THREE YEAR PERIOD TO REDUCE THE
BACKLOG OF THOSE COMPLAINTS AS
WELL.
IN AGAIN WHEN YOU WERE MINE THE
COMMITTEE.
IF IF A COMPLAINT IS RECEIVED.
THAT REPRESENTS A THREAT TO LIFE
FOR SAFETY HOW IS THAT HANDS
THAT WE PRIORITIZE THOSE AND
WE'RE USUALLY IN A FACILITY
WITHIN A COUPLE OF DAYS TO LOOK
AT THEM --
THOSE IMMEDIATE JEOPARDY KINDS
OF A BOUNCE.
IN WOULD THERE BE A CIRCUMSTANCE
WHERE IT WOULD REQUIRE GETTING
THEIR EVEN.
MORE QUICKLY THAN EXCEPT
SOMETIMES WILL EVEN GO IN ON A
WEEKEND OR AT NIGHT HOME
DEPENDING ON HOW AGREE JUST THAT.
ISSUE AS AND IF WE WERE ARE
WORRIED WILL GO IN THERE MEDIA
ONLY.
THANK YOU AND THEN I KNOW --
OVER THE YEARS AND DURING SOME
OF OUR BUDGET CHALLENGES IN THE
PAST.
THE FIELD HOSPITALS THE MOBILE
FIELD CALIFORNIA HAD OPERATED
AND I THINK PART OF THAT IS
UNDER YOUR PURVIEW UNDER THE
EMERGENCY PREPAREDNESS OFFICE.
COULD YOU SHARE WITH US WHAT THE
STATUS IS OF THOSE EMERGENCY
FIELD HOSPITALS SO WE WORK VERY
CLOSELY WITH OUR COLLEAGUES áP
EMERGENCY MEDICAL SERVICES FOR A
PARTY AND WE RUN A JOINT
OPERATION CENTER TOGETHER.
AND THE MOBILE FIELD OFF
HOSPITALS ARE NOW --
ON THEIR UNDER I'M SAYS
JURISDICTION AND WHAT THEY HAVE
DONE IS TO PUT THEM OUT IN THE
FIELD SO THAT WE BROKEN UP WHAT
WERE ONCE LARGE MOBILE FIELD
HOSPITALS AS WE LOST FUNDING.
AND PUT THEM IN THE SIX
MUTILATED REGIONS WITHIN SOME OF
OUR COUNTIES AND WE'VE BEEN ABLE
TO USE THEM DURING THE WILD
FIRES AS SORT OF A MEDICAL
SHELTERS AND SO IN LOVE MOST
RECENT BUTTE COUNTY FIRES WERE
ABLE TO SET SOME OF THOSE TENTS
UP IN ORDER.
TO ISOLATE THOSE WHO BECOME ILL
AND TREAT THEM --
OUTSIDE OF THE GENERAL
POPULATION SHELTERS AND SO I
THINK IT'S BEEN A A GOOD SUCCESS
STORY THERE WERE.
MORE CLOSELY --
LOCATED IN EACH OF THAT --
MUTUAL AID REGION SO WE CAN GET
THERE QUICKER.
THANK YOU THAT'S REASSURING I'M
SORRY WE'RE NEEDING TO DEPLOY
THEM BUT IT'S IMPORTANT THAT
THEY ARE AVAILABLE --
I THINK MY FINAL AREA OF
QUESTIONING YOU HAVE OVERSIGHT
OVER MULTIPLE PROGRAMS YOU
OFFERED SOME REASSURANCE
YESTERDAY THAT MANY OF THOSE.
CANDACE PROGRAMS ARE WITHIN
CONSOLIDATED UNDER DIFFERENT --
ADMINISTRATIVE.
COMBINATIONS ONE OF THE AREAS
THAT WE TALKED ABOUT.
IS THE CURRENT PROGRESS
CONSCIOUS IN THE INFECTIOUS
DISEASE SECTOR PARTICULARLY
UPTAKE OF VACCINATIONS IN
SCHOOLS COULD YOU PROVIDE US A
CURRENT UPDATE OF BOTH PROGRESS
AND CONTINUED CHALLENGES SURE SO
WITH THE PASSAGE OF SB TWO
SEVENTY SEVEN WHICH ELIMINATED
THE PERSONAL BELIEF EXEMPTION WE
WORKED REALLY HARD.
ACROSS THE STATE TO EDUCATE AND
TO PROVIDE INFORMATION ON THE ON
HEALTH THAT LOG WE SHOULD BE
IMPLEMENTED AND WE REALLY STILL
AN INCREASE IN THE NUMBER OF
VACCINATION THROUGHOUT THE STATE.
AND THAT.
REALLY WAS A PROTECTIVE FACTOR
AND NOW I'M ONLY RECENTLY WE'VE
SEEN AN UPTICK IN MEDICAL
EXEMPTIONS AND SO WE'RE
CONCERNED ABOUT THAT BECAUSE
ALTHOUGH.
IT'S A SMALL UP TAKE A BIT DOES
OCCUR IN SOME SCHOOLS WHERE IT
LEAVES A LARGE NUMBER OF
UNVACCINATED CHILDREN AND SO
LOOKING FOR THE PUBLIC HEALTH
RISK OF THAT WE WANT TO IDENTIFY
THOSE SCHOOLS WHERE.
THE VACCINATION RATE IS UNDER
THE 95% WHICH WE THINK IS SORT
OF WHAT YOU NEED TO PROTECT THE
POPULATION AND SO BECAUSE SOME
SCHOOLS AND DO YOU HAVE A LARGE
NUMBER OF UNVACCINATED CHILDREN.
WE ARE COLLECTING DATA THAT THEY
HAVE TO REPORT EACH SCHOOL IS
REQUIRED TO REPORT ON THEIR
VACCINATION RATE AND WILL BE
LOOKING OUT OF SCHOOLS WHERE
THEY HAVE A LOWER VACCINATION
RATE COLLECTING THE MEDICAL
EXEMPTIONS.
AND LOOKING AT WHETHER THERE ARE
PARTICULAR LOCATIONS ARE DOCTORS
THAT MIGHT BE.
IN NEED OF SOME SPECIAL
EDUCATION OR SOME --
MOVE THE M. FURTHER INFORMATION
FROM SEE IN THE NEED FOR
VACCINATION AND IN THE EVENT
THAT THERE ARE BAD ACTORS THAN
WE CAN TAKE OTHER ACTIONS.
IN OUR THEIR STANDARDS OR
CRITERIA. FOR FOR DOCTORS TO BE
ABLE TO ANA --
SIGN IN A MEDICAL EXEMPTION
THERE ARE THE STATUTE IS IS
SPECIFIC ABOUT SPECIFIC
REQUIREMENTS THAT THEY NEED TO
MEET IN ORDER --
TO MEET THE MEDICAL DEFINITION
IT WOULD BE UNDER THE PURVIEW OF
THE DEPARTMENT OF PUBLIC HEALTH.
TO PERIODICALLY REVIEW THE
ISSUANCE OF THOSE MEDICAL
EXEMPTIONS.
IF WE WOULD GO THROUGH THE
SCHOOLS SO WE WOULD IDEA WE
DON'T.
LOOK AT ALL OF THEM BUT WHAT WE
WOULD LOOK AT IS THE PUBLIC
HEALTH RISKS SO WHERE WE BELIEVE
THE VACCINATION RATE IS LOW
ENOUGH THAT IT PRESENTS A PUBLIC
HEALTH RISK WE WOULD LOOK AT IT
FROM THAT PERSPECTIVE WE WHEN.
WE'RE NOT THE MEDICAL BOARD
WOULD BE MORE APT IN TERMS OF
THE ACTUAL.
PARTICULAR DOCTORS AND LOOKING
AT THAT.
WELL THANK YOU I APPRECIATE YOUR
ANSWERS AND I WAS.
IMPRESSED WITH YEAR COMMAND IN
KNOWLEDGE OF MULTIPLE PRAGUE
PROGRAMS WITHIN THE DEPARTMENT
OF PUBLIC HEALTH AND THANK YOU
FOR YOUR SERVICE THANK YOU.
MADAM CHAIR.
THANK YOU SENATOR GROVE.
THANK YOU I APOLOGIZE FOR BEING
LATE WELCOME AND WELCOME.
I IT DID NOT HAVE THE
OPPORTUNITY TO SPEND TIME WITH
YOU YESTERDAY OR THE COUPLE OF
DAYS AGO BECAUSE OF SCHEDULING
CONFLICTS BUT I I WOULD LIKE TO
SCHEDULE TIME WITH YOU IN THE
FUTURE BECAUSE I DO HAVE A
SERIES OF QUESTIONS THAT AFFECT
THE VALLEY.
ESPECIALLY DEALING WITH VALLEY
FEVER THAT I WOULD LIKE TO KNOW
YOUR OPINIONS ON IN YOUR THOUGHT
PROCESS AND HOW WE'RE GOING TO
ADDRESS THAT.
BUT JUST TO START AND LAST
YEAR'S BUDGET PROVIDED FUNDING
FOR RESEARCH AND OUTREACH ON
VALLEY FEVER CAN YOU TELL ME THE
STATUS OF THOSE FUNDS AND IF
THEY'VE BEEN DISTRIBUTED FOR
RESEARCH.
THE RESEARCH FUNDS DIDN'T
ACTUALLY COME TO US THE RESEARCH
FUNDS WENT TO THE KERN MEDICAL
CENTER WE GOT FUNDING TO RUN A
PUBLIC.
INFORMATION EDUCATION CAMPAIGN --
AND WE CONTRACTS THE BIDS THAT
CAME IN AND WE'LL BE WARDING A
CONTRACT --
NEXT MONTH.
I'M IN OKAY.
AT SPECIFICALLY THE THINGS THAT
I WANT TO TALK TO YOU ABOUT NINE
AND WE'LL TALK TO YOU ABOUT IT
IN PRIVATE BUT JUST SO YOU KNOW
KIND OF WHERE I'M GOING WITH
THIS IS THE DEPARTMENT OF PUBLIC
HEALTH ME TO STATEMENT REGARDING --
TITLE EIGHT SECTION FIFTY ONE
FORTY FOUR AN ENDEMIC AREAS FOR
VALLEY FEVER.
AND I MEG GREATLY CONCERNED
ABOUT THOSE THOSE STATEMENTS AND
I'D LIKE TO HAVE A PRIVATE
CONVERSATION IF WE COULD GET
TOGETHER I'D REALLY REALLY
APPRECIATE THAT.
AND THEN --
I HAVE A QUESTION I DON'T KNOW
IF THE CHAIR AND IS --
THE MAN PER TIM ARE YOU GOING TO
TALK ABOUT SAN DIEGO IN THE
OUTBREAK --
I JUST WAS CURIOUS ABOUT --
I AM BUT FEEL FREE TO ASK THE
QUESTIONS I'LL ASK WHATEVER I
FEEL I NEED TO THAT YOU DON'T
OKAY PLEASE GO RIGHT SO I GUESS.
MY QUESTION WAS IS IT --
IN IMPLEMENTING THE STATE
AUDITOR'S RECOMMENDATIONS ON THE
RECENT REPORTED THE HEPATITIS A
OPERATE IN SAN DIEGO --
WHERE ARE YOU OUT I APOLOGIZE I
NEED TO SLOW DOWN?
THAT WAS VERY DESCRIPTIVE SOAP.
MISS FINALE WHERE ARE YOU AT IN
IMPLEMENTING THE AUDITOR'S
RECOMMENDATIONS FOR ITS RECENT
REPORT ON THE HEPATITIS A
OUTBREAK IN SAN DIEGO.
SO WE HAD TO FEW TO FINDINGS
OKAY AND ONE WAS --
TO UPDATE OUR EMERGENCY
OPERATIONS MANUAL WHICH IS
BASICALLY TO PUT A LITTLE BIT
MORE DETAIL ON THE EMERGENCY
POWERS THAT PUBLIC HEALTH
OFFICERS HAVE AND SO THAT HAS
BEEN DONE AND WE'VE UPDATED OUR
EMERGENCY PLAN.
THE SECOND WAS TO CREATE AN
OUTBREAK RESPONSE PLAN WITH A
LITTLE MORE DETAIL AND WE HAVE
DONE NOT AS WELL AND WHAT THEY
WANTED WAS TO HAVE SOME SPECIFIC
PARAMETERS AROUND --
AND WHAT ARE THE STRATEGIES HELP
SO THAT IN OUR CONVERSATIONS
WITH OUR LOCAL JURISDICTIONS
THAT WE FROM THE GET GO SORT OF
HAVE A PROJECT PLAN ALMOST IN
TERMS OF THE SPECIFIC --
ACTIVITIES THAT WILL BE
UNDERTAKEN AND SO WE HAVE
COMPLETE AT THAT AS WELL.
THANK YOU I APPRECIATE YOUR
ANSWERING THOSE QUESTIONS.
THANK YOU SENATOR SENATOR ROTH
HUMAN PRO TEM.
SLOWLY FIRST CONGRATULATIONS
THANK YOU.
YOU KNOW I NOTED IN THE IN OUR
RULES COMMITTEE NOTES THAT YOU
HAVE IDENTIFIED OBESITY DIABETES
AND MENTAL HEALTH IS KEY
PRIORITIES FOR THE DEPARTMENT
MOVING FORWARD IN THE FUTURE.
AS FAR AS SOME OF US ARE
CONCERNED PARTICULAR WITH
RESPECT --
TO TYPE ONE DIABETES.
THERE IS A SIGNIFICANT NEED FOR
A FURTHER EDUCATION EFFORTS IN
THE STATE TWO TWO INCIDENCES OF
MISDIAGNOSIS AND THE LIKE
PARTICULARLY WITH YOUNG.
CHILDREN AND IN THE AREA OF
MENTAL HEALTH.
DUE.
TO A FAIRLY SIGNIFICANT
DISPARITY AND MENTAL HEALTH
FUNDING PARTICULARLY UNDER THE
NINETEEN NINETY ONE REALIGNMENT.
FOR MENTAL HEALTH FUNDING IN
VARIOUS AREAS OF THE STATE.
THERE'S A NEED --
FOR IN MY OPINION MENTAL HEALTH
[inaudible]
FUNDING PARITY [inaudible]
SO.
GIVEN THE PRIORITIES THAT YOU'VE
IDENTIFIED FOR THE DEPRIVE
DEPARTMENT PARTICULARLY THOSE
WITH RESPECT TO DIABETES AND
MENTAL HEALTH --
WHAT ARE YOUR PLANS?
SO RIGHT NOW FOR MENTAL HEALTH
WE HAVE A A SERIES OF ACTIVITIES
THAT WE ARE DOING ONE IS THE
CALIFORNIA REDUCING DISPARITIES
PROJECT --
AND THAT PROGRAM IS AROUND FIVE
DIFFERENT POPULATION AREAS AND
REALLY WORKING WITH COMMUNITY
LEVEL FOLKS ON THE GROUND TO
LOOK AT POPULATIONS FROM --
ASIAN AND ASIAN POPULATIONS
AFRICAN AMERICAN --
LGBT Q. --
THE AND REALLY LOOKING AT THOSE
POPULATIONS AND COMMUNITIES THAT
HAVE PROMISING PRACTICES THAT
MAY NOT BE A HAVE BEEN ABLE TO
QUALIFY FOR BIG GRANT PROGRAMS
AND THINGS BUT WORKING WITH THEM.
BECAUSE WE THINK THEY HAVE GOOD
IDEAS AND LEARNING I'M ON THE
RESOURCES THEY NEED TO CONDUCT A
REAL EVALUATION AND COLLECT DATA
SO THAT WE CAN OVER TIME SEE
WHAT ACTUALLY IS WORKING ON THE
GROUND AND SO.
WE'VE BEEN WERE THE SET IN OUR
SECOND YEAR OF A FIVE YEAR SORT
OF PILOT PROJECTS AND I THINK
THAT WE WILL WE HAVE AN OVERALL
EVALUATION STRATEGY SO THAT
EVERYBODY.
REGARDLESS OF THE TYPE OF
PROGRAM THAT THEY'RE RUNNING THE
EVERYBODY WILL COLLECT SOME
STANDARD DATA SO THAT WE CAN SEE
WHAT WORKS AND WHY IT WORKS.
AND I THINK THAT'S A BIG EFFORT
THAT WERE UNDER WAY ON THE
MENTAL HEALTH SIDE MANY OF OUR
PROGRAMS AND IN OUR MATERNAL AND
CHILD.
AND ADOLESCENT HEALTH TO ALSO
ADDRESS MENTAL HEALTH SERVICES
SO OUR HOME VISITING PROGRAM
PART OF WHAT WE'RE TRYING TO DO
TO IMPROVE OUTCOMES OF MOTHERS
AND BABIES IS REALLY TO LOOK AT
NOT JUST HEALTH CARE AND ACCESS
TO HEALTH CARE ABOUT THOSE.
COMMUNITY LINKAGES THAT CAN
BUILD RESILIENCY IN OUR
POPULATION AND THINGS LIKE
STRESS MANAGEMENT AND LINKAGE TO
MENTAL HEALTH SERVICES CAN
REALLY BUILD THE AND OUR
POPULATION AND SO I THINK THOSE
ARE.
SOME OF THE THINGS WE'RE DOING
ON MENTAL HEALTH AND WE'RE ALSO
WORKING WITH ALL OUR
STAKEHOLDERS UNDER THE LET'S GET
HEALTHY CALIFORNIA PROJECT.
ARE ARE OF STATE HEALTH
IMPROVEMENT PLAN TO AND MENTAL
HEALTH COMES UP ACROSS THE BOARD
WITH MANY OF OUR STAKEHOLDERS AS
AN AREA WHERE WE WANT TO WORK
MORE CLOSELY TOGETHER TO ADDRESS
AND HOPEFULLY HAVE SOME
COLLECTIVE IMPACT AROUND THOSE
ISSUES.
ON DIABETES UNFORTUNATELY DON'T
RECEIVE A LOT OF MONEY TO DEAL
WITH DIABETES BUT WE HAVE A
PROGRAM CALLED PREVENTION
FORWARD.
ON A WHERE WE ARE TRYING TO MAKE
SURE THAT WE'RE WORKING WITH OUR
CLINICAL PARTNERS AND MEDI CAL
AND DH CS AND TO IDENTIFY AND
DIAGNOSE DIABETES MUCH MORE MUCH
EARLIER TO EDUCATE PEOPLE
BECAUSE NOT ONLY DIABETES BUT
THOSE WITH PRE DIABETES AND
TRYING TO KEEP THEM FROM GETTING.
DIABETES SO WE HAVE --
AN AWARENESS CAMPAIGN MEMBER
WEBSITE OF INFORMATION AND WE'RE
WORKING.
PARTNERING WITH HEALTH CARE TO
MAKE SURE [inaudible] TO
DIABETES EXERCISE DIET ISMUCH
DIFFERENT IN TYPE ONE WHICH IS
AN AUTOIMMUNE DISEASE.
AND VERY DIFFICULT --
TO AT TO DIAGNOSE AND FREQUENTLY
MISDIAGNOSED PARTICULARLY IN
CHILDREN.
AND SO I WOULD ASK YOU TO TAKE A
LOOK AT YET THE OPPORTUNITIES
THAT YOU HAVE IN YOUR DEPARTMENT.
TO PERHAPS --
EMBARK ON A PUBLIC EDUCATION
CAMPAIGN WHETHER IT'S THE PUBLIC
GENERALLY REALLY HEALTHCARE
PRACTITIONERS --
TO MAKE SURE THAT WE DON'T HAVE --
SOME OF THE MISDIAGNOSES THAT WE
HAVE EXPERIENCED IN THE PAST AND
WE DIDN'T GET TWO POINT FIVE
MILLION FOR A DIABETES AWARENESS
CAMPAIGN WHICH WILL BE.
COMING UP SHORTLY AND SO WE'LL.
TAKE UP BACK AND MAKE SURE THAT
WE'RE THINKING ABOUT THAT AS
WELL PERFECT CONGRATULATIONS
AGAIN MA'AM THANK YOU MA'AM PRO
TEM.
THANK YOU SENATOR MISTER VICE
CHAIRMAN.
THANK YOU MADAM --
PRO TEN ENJOYED OUR CONVERSATION
YESTERDAY WAS VERY WIDE RANGING
AND I AGREE WITH CENTER MONEY.
YOU CERTAINLY HAVE A GRASP OF
THE ISSUES A LIKE YOUR QUESTIONS
WHICH ACTUALLY US COURSES I
WANTED ASKED I WANTED TO FOLLOW
UP ON THE VACCINATIONS.
SO -- I'VE
BEEN VACCINATED HAS AS MY WIFE
AND MY CHILDREN SO I'M PRO
VACCINATION --
I'D ADD THOUGH I HAVE A HUNDRED
WE HAD THE WHOLE SB TWO SEVEN
SEVEN I HAVE MET WITH FAMILIES.
THAT HAVE SAID HAD CHILDREN THAT
SUFFERED YOU KNOW BACK AND HE
BACKS NATION DAMAGE SO I I DO
KNOW EXIST WHEN I'M CURIOUS ON
THE DATA THOUGH.
B. E. THINK IT'S PEOPLE ARE
AVOIDING IT OR DO YOU THINK.
PEOPLE CAN'T FIND THE
DOCUMENTATION SO WISHES EASIER
ASK FOR MEDICAL EXEMPTION AND
THEN MAYBE THOSE VACCINATION
RATES ARE OF THAT ARE HIGHER
THAN WHAT WE THINK.
THIS I'M JUST CURIOUS I'M I'M I
DON'T HAVE THE EXACT DATE --
BUT I DO THINK THERE ARE PEOPLE
WHO ARE INSTEAD OF USING A
PERSONAL BELIEF EXEMPTION ARE
LOOKING TO GET A MEDICAL
EXEMPTION BECAUSE THEY DON'T
WANT THE VACCINATION --
BUT I THINK THERE ARE ALSO
PEOPLE WHO GENERALLY GENUINELY
NEED FOR MEDICAL EXEMPTION AND
SO THAT'S ONE OF THE THINGS WE
WANT TO LOOK AT AS WERE
COLLECTING THAT DATA BECAUSE ON
THE EXEMPTION IT WILL LIST WHY
THEY'VE GRANTED FOR A MEDICAL
EXEMPTION AND I THINK WE WANT TO
TAKE.
A LOOK AT THAT.
RIGHT LOGIN CONGRATULATIONS
THANK YOU.
THANK YOU VERY MUCH MR VICE
CHAIRMAN --
ADD TO FOLLOW ALONG ON THE
HEPATITIS A OUTBREAK IN SAN
DIEGO.
THAT THEN LTIMATELY THERE WERE
CASES AND SANTA CRUZ IN LOS
ANGELES.
I WANT TO UNDERSTAND --
AND I UNDERSTAND THE COUNTIES
HAVE A RESPONSIBILITY TO DECLARE
AN EMERGENCY THERE ARE ACTIONS
THAT NEED TO BE TAKEN --
HOWEVER THIS WAS A VERY LONG
PERIOD OF TIME IN WHICH THERE
WAS INACTION THERE WAS AN AUDIT
I THINK WE GOT TO READ THAT BUT
MY CONCERN.
IS THAT I KIND OF WANT TO
UNDERSTAND WINDOWS THE
DEPARTMENT OF PUBLIC HEALTH STEP
IN WHEN I COUNTY IS NOT DOING
WHAT IT NEEDS TO DO.
THIS WAS A LONG PERIOD OF MONTHS
I EVEN MADE A CALL TO THE
GOVERNOR'S OFFICE --
AS THOSE NUMBERS STARTED TO
INCREASE FROM IN THE FIVE
HUNDRED EIGHTY SEVEN CASES AND
FOUR HUNDRED TO HOSPITALIZATION
SO MY WORRY.
IS AT WHAT POINT I IT HOW DO YOU
MONITOR A COUNTIES RESPONSE WHEN
YOU BECOME AWARE OF THE PENDING
SITUATION --
AND THERE IS NOT THE MOST
RESPONSIBLE ACTION TAKEN ON THE
PART OF THE COUNTY OR
JURISDICTION.
AS SOON A I THINK IT'S IMPORTANT
TO RECOGNIZE THAT IN SAN DIEGO%
COUNTY WE WERE WORKING WITH THE
LOCAL HEALTH JURISDICTION DAILY --
THROUGHOUT PROBABLY MOST OF THAT
PERIOD AND LOOKING AT WHAT WE'RE
THE STRATEGIES THAT THEY WERE
USING FOR HYGIENE AND SANITATION
AND VACCINATION OF THE AT RISK
POPULATION AND SO.
WE WERE WORKING HAND IN HAND
WITH THE COUNTY WE WERE
STRATEGIZING THEY WERE DOING A
LOT OF WORK THROUGHOUT THAT
PERIOD.
I THINK THAT.
WE ACTIVATED ARE EMERGENCY
OPERATIONS SYSTEM UNDER OUR AND
SORT OF AN EMERGENCY PLAN WHEN
AND THAT IS WHEN WE WOULD THEN --
AND ACTIVATE OUR EMERGENCY
OPERATIONS CENTER BRINGING
TOGETHER ALL OF THE COUNTY'S
SHARE THAT INFORMATION --
MAKE SURE THAT WE'RE COLLECTING
IT IS A REPORTABLE DISEASE WE
COLLECT THAT DATA WE HAD BEEN
COLLECTING THAT DATA WORKING
WITH THEM.
AND IT BECAME MORE.
I I THINK WE CONTINUE THAT WORK
WE WORKED WITH THEM ON THE
VACCINE DISTRIBUTION --
PRIORITIZATION OF VACCINE MAKING
SURE THAT THEY HAD ALL THE TOOLS
AND KNOWLEDGE THAT THEY NEEDED.
TO GET OUT THERE AND BOXING THE
NEW POPULATION THIS WAS
SOMETHING NEW WE HADN'T SEEN
HAPPEN A IN OUR HOMELESS
POPULATION IV DRUG USERS SO I
THINK WE WERE LEARNING A LOT.
ALONG WITH MANY OTHER STATES AND
I THINK IF YOU LOOK AT THE
MIDWEST IN MICHIGAN AND OTHER
STATES THEY WERE FACING THE SAME
THING AND AND I'M PART OF A LOT
OF VAST --
POLICY COMMITTEE AND WE WERE
COMPARING NUMBERS AND REALLY
LOOKING UP THE ABILITY.
TO TURN THE TIDE ON THE OUTBREAK
AND CAL --
THAN MOST IT'S WITH SOME SINCE I
THE OUTBREAKS BLASTED LONGER AND
WERE BAKER --
SO I THINK THAT THERE WAS A LOT
OF IMPORTANT WORK BEING DONE AND
CAN WE ALWAYS GO BACK AND SAY
COULD WE HAVE DONE A LITTLE MORE
A LITTLE SOONER I I DON'T KNOW
AND BUT I THINK THAT THEY WERE
DOING A LOT OF WORK.
ON THE GROUND.
TO MITIGATE THE IMPACT OF AND
AND LESSEN THE OUTBREAK
[inaudible]
OUT OF WELL WE'RE GONNA HAVE TO
DISAGREE ON THAT.
BY THEY FAILED MISERABLY WHICH
IS WHY THERE WAS AN AUDIT WHEN A
LEGISLATOR GETS INVOLVED TO ASK
FOR AN AUDIT ON A REAL SITUATION
NOT ONE THAT WE CONTRIVE.
WHICH I KNOW THAT WE WANT TO DO
IT TIMES --
EIGHTY A PLAN OF ACTION AND
EDUCATE.
CATION THAT CAN GO DOWN.
MAN OF ACTION IN EDUCATION DOES
NOT SUGGEST THAT YOU SEND
HOMELESS PEOPLE TO CLINICS --
WHEN THERE'S A PROBLEM YOU GOT
TO GO ON THE STREETS AND AND DO
THE WORK WHICH ULTIMATELY WE DID?
I MEAN WE'RE TALKING A PERIOD OF
MONTHS.
AT WHICH POINT.
OF I MEAN I GUESS WHEN THE
COUNTY FAILS WHEN THE CITY FAILS.
AND THE STATE IS NOT A BACKUP.
THAT CONCERNS ME AND THIS THIS
EXAMPLE I AGREE WE HADN'T SEEN
ANYTHING LIKE IT FOR SOME TIME
BUT THERE IS CLEAR DOCUMENTATION
THERE IS CLEAR EVIDENCE.
THAT PEOPLE WERE RAISED IN THE
RED FLAG.
AND AT SOME POINT.
CALL STARTED TO GO TO THE STATE
BECAUSE THE LOCAL JURISDICTION
WASN'T ACTING.
SO. FOR ME I THINK THE
IMPLEMENTATION PIECE OF THIS WAS
WHAT CONCERNS ME THE MOST --
AND AND THE FACT THAT --
COUNTIES NEED TO BE HELD
ACCOUNTABLE MY OWN COUNTY WHO
I'VE HAD A AND A WONDERFUL
WORKING RELATIONSHIP WITH --
AND THE CITY IT DID NOT GO WELL
IF SO IF THAT'S IN IT EXAMPLE I
MEAN ONCE THE VACCINATIONS GOT
THERE ONCE THEY DECIDED TO GO ON
TO THE STREETS. TO ACTUALLY FIND
THE PEOPLE AND GO INTO THE RIVER
BEDS -- I
WENT IN A SAN DIEGO RIVER
CONSERVANCY BRINGS UP THE ISSUE
OF ONE OF THEIR MEETINGS.
AND BY AND FAR THEY ARE NOT THE
ONE YOU.
ARE AT A BOARD MEETING --
I HAVE I HAVE CONCERNS ABOUT
THAT AND MAYBE THAT'S WHY
THERE'S A PIECE OF LEGISLATION
WHICH IS NOT OUR PURPOSE TO TALK
ABOUT TODAY IN TERMS OF
ACCOUNTABILITY BUT I I AM
CONCERNED ABOUT THE RESPONSE --
YOUR I WOULD JUST SAY DIFFICULT
CONCLUDE YOUR RESPONSE.
DIDN'T MAKE ME FEEL MORE
COMFORTABLE ABOUT THE SITUATION.
BECAUSE WHEN THE COUNTYFAILS TO
ACT AND WE PUT IN A CALL. TO THE
TO THE BACKUP.
AND AND TO THINK THAT THAT
RESPONSE OVER A PERIOD OF MONTHS
WAS ADEQUATE IT IT REALLY WASN'T
SO.
I HOPE THE AUDITOR'S REPORT --
WILL LINDA A LITTLE BIT --
TOO TO HELP.
A SMALL FORWARD AND AND WORK ON
SOME OF THESE ISSUES.
ON A ANOTHER TOPIC AND YOUR I'M
HAPPY TO HEAR YOUR RESPONSE TO
THAT AS WELL I I WANT TO BE FAIR --
ANOTHER AVE AREA THE OPIOID
EPIDEMIC.
I WOULD I AND I KNOW THAT THERE
IT SEEMS FROM THE RESPONSES --
TO QUESTIONS THERE'S A LOT OF
DATA BEING COLLECTED ON HOW TO
APPROACH THAT.
I I THINK I'M INTERESTED IN
IMPLEMENTATION MOVING TO AND AND
AND AND YOUR PERSPECTIVE ON WHAT
THE STATE OF CALIFORNIA IS DOING
OR NOT DOING AND HOW YOU SEE THE
NEXT STEPS RELATED.
TO HANDLE AND QUITE A CRISIS
IT'S ACROSS AMERICA NOT JUST
HERE IN CALIFORNIA. FOR THE LAST
COUPLE OF YEARS WE'VE BEEN AND
LEADING THE STATEWIDE OPIOID
WORKGROUP AND THAT IS WHERE WE
BRING TOGETHER MULTI SECTORS
FROM.
HEALTH CARE TO YOU AND PUBLIC
AND PRIVATE SO OUR SISTER
DEPARTMENTS AND AGENCIES LAW
ENFORCEMENT --
AND REALLY LOOK AT HOW WE CAN
ACT WITHIN THE LANES THAT WE
WORK AND AND COLLECTIVELY
ADDRESS SOME OF THE ISSUES SO
THAT WE HAVE BETTER.
SAFE PRESCRIBING A AND TWO
PHYSICIANS WE HAVE --
MEDICALLY ASSISTED TREATMENT
OPTIONS WE HAVE ABOUT TWO
THOUSAND DEATHS IN CALIFORNIA
FROM OVERDOSES EVERY YEAR MAN
70% OF THEM ARE MORE ARE RELATED
TO PRESCRIPTION OPIOIDS AND SO
REALLY LOOKING AT SAFE
PRESCRIBING.
AWARENESS --
MANY TIMES --
FOLKS DON'T EVEN KNOW THAT WHAT
THEY'RE TAKING OUR OPIOIDS AND
SO THERE BEEN SOME EFFORTS IN
OTHER STATES TO LOOK AT HOW DO
WE AND AND WITH OUR PUBLIC
INFORMATION CAMPAIGN. TO MAKE
SURE THAT PEOPLE REALLY DO
UNDERSTAND WHICH OF THE DRUGS
THAT THEY MIGHT BE TAKING OUR
OPIOIDS --
AND THEN REALLY AND WORKING
TOGETHER TO MAKE SURE THAT WE
ARE WORKING AT THE LOCAL LEVEL
TWO YOU UNDERSTAND YOU.
KNOW LOCKS ON DISTRIBUTING THE
LOCKS ON AS THE COUNTERMEASURE
TO AN OVERDOSE --
MAKING SURE WE HAVE ON OUR
WEBSITE A STANDING ORDER FOR
NALOXONE SO THAT PEOPLE CAN MORE
READILY GOT ACCESS TO NALOXONE
FOR THEIR LOVED ONES WERE IN
PLACES WHERE THEY MIGHT.
AND SEE SOMEBODY WITH AN
OVERDOSE SO WE'RE WORKING
COLLECTIVELY WE ARE BUILDING
WE'VE GOTTEN SOME FEDERAL
FUNDING WE ARE REALLY THINK THAT
WHAT WE NEED IS TIMELY AND
ACTIONABLE DATA SO THAT WE CAN
BRING.
TOGETHER EMS STATE I'M REAL TIME
ALONG WITH --
OUR HEALTH CARE UTILIZATION DATA
AND WHERE THIS SO WE CAN TARGET
SINCE OUR PUBLIC I AM SO I THINK
WE SO LOOKING AT LABORATORY
TESTING AND ENHANCING OUR
LABORATORY TESTING FOR THINGS
LIKE FAN ALL.
ON TO MAKE SURE THAT WE
UNDERSTAND WHEN THERE IS A
PROBLEM OR CRISIS SOMEWHERE IN
THE STATE --
WELL THANK YOU --
QUESTIONS OR COMMENTS FROM
ANYONE ELSE.
OKAY THANK YOU ARM ACTUALLY WE%
SHOULD GO TO SPEAKERS --
WHO MAY BE HERE IN SUPPORT?
I'LL HOLD THAT MOTION FOR A
MOMENT SENATOR.
IS THERE ANYONE HERE WHO WOULD
LIKE TO COME FORWARD AND SPEAK
IN SUPPORT OF THE A A PLUS
APPOINTMENT.
IT GIVE ME YOUR NAME AND EIGHT
MICHELLE GIVENS OF THE COUNTY
HEALTH EXECUTIVES ASSOCIATION OF
CALIFORNIA REPRESENT LOCAL
HEALTH DEPARTMENTS THROUGHOUT
THE STATE WE HAVE HAD THE
PLEASURE OF WORKING WITH MISS
FINALE AND IN A VARIETY OF
CAPACITIES AND ALL THE RULES
THAT SHE IS.
AS DESCRIBED BEFORE YOU WE FIND
THAT SHE'S HIGHLY CAPABLE OF THE
LEVEL OF PARTNERSHIP AND
COMMUNICATION THAT SHE HAS WITH
THE LOCAL LEVEL HAS BEEN MUCH
APPRECIATED WE'VE HAD TO
TROUBLESHOOT SOME REALLY TOUGH
ISSUES --
BETWEEN OUR THEIR DEPARTMENT AND
OUR LOCAL HEALTH DEPARTMENTS --
AND WE JUST HAVE RECOGNIZE THAT
THE LEVEL OF COMMUNICATION --
AND THE OF THE ACCOUNTABILITY TO
FOLLOW UP WITH US HAS ALWAYS
BEEN THERE SO.
AND WE WOULD URGE YOUR
CONFIRMATION THANK YOU.
THANK YOU VERY MUCH.
YES MA'AM ASSOCIATION OF
CALIFORNIA ECHOING EVERYTHING
THAT MY COLLEAGUE JUST SAID --
SUSAN FINALES THAT BREADTH OF
KNOWLEDGE IS ASTOUNDING AND WE
ARE REALLY GRATEFUL TO BE
WORKING WITH HER.
THANK YOU VERY MUCH ANYONE IN
SUPPORT ANYONE IN OPPOSITION.
SEEING NONE --
I WILL ENTERTAIN YOUR MOTION NOW
SENATOR ROTH.
MAN SECRETARY PLEASE CALL THE
ROLL SENATORS GROWTH.
GROVE AYE MONNING MONNING AYE
ROTH.
ROTH AYE WILK AYE WILK AYE
ATKINS ATKINS SIGN.
ZERO THANK YOU VERY MUCH
CONGRATULATIONS YOU.
AND I MADAM SECRETARY LET ME --
FOR MS GROSS PURPOSES REAL
QUICKLY LIFT THE CALL.
ON ITEMS ONE THROUGH. TWO I'M
SORRY ITEMS TWO THROUGH.
EIGHT HI SENATOR GROW.
FIVE THANK YOU CLOSE THE ROLE.
ARE FIVE ZERO ON THOSE OF THE
CONSENT ITEMS FOR AGENDA.
AND I THINK WE ARE GOING TO TAKE
A MOMENT ADJOURN INTO EXECUTIVE
SESSION SO I'LL GIVE US A FEW
MINUTES WHILE WE MAKE THAT
TRANSITION