THREE ON HEALTH AND HUMAN
SERVICES.
TODAY -- WE
WILL HAVE SEVERAL ITEMS FOR
DISCUSSION BECAUSE NO ACTIONS
ARE BEING TAKEN ON ITEMS FOR
THIS HEARING.
WE MAY SOLICIT --
PUBLIC COME AFTER COMPLETION
MAJOR DIVISIONS --
INDICATE WHEN --
JELLY FOR EACH ITEM --
WE WILL HAVE THE ADMINISTRATION
PRESENT WILL HAVE LA --
AND THE DIED FINANCE COMMENTS
AND THEN --
AGAIN WE'RE NOT TAKING ANY VOTES
TODAY.
I WITHIN NOTE THAT WE HAVE --
WE'RE GONNA BE HEARING ABOUT
SEVERAL --
PROPOSALS THAT --
I THINK GOVERNOR --
INDICATED IN ANNOUNCEMENT THAT I
THINK PEOPLE ARE PRETTY EXCITED
ABOUT AROUND MEDI CAL EXPANSION
AND SO WE'RE GONNA HAVE SEVERAL
PANELS TO DISCUSS SOME OF THOSE --
PROPOSALS IN MORE DEPTH AS WELL --
SO BUT TODAY WE'RE BASICALLY
GOING TO BE WE'RE GONNA BE DOING
THE MATH DEPARTMENT HEALTH CARE
WHAT PLAN TO DO IS --
WILL HAVE --
I HAVE AN OVERVIEW AND THEN THAT
THREE DIGITAL ISSUES SO WE'LL
HEAR ALL OF THOSE ITEMS --
AND THEN WE'LL TAKE PUBLIC
COMMENT ON THE PART MANAGE
HEALTH CARE.
AND THEN WE COME TO THE PART OF
HEALTH CARE SERVICES --
WE HAVE A SECTION ON THE HEALTH
BENEFITS CHANGE COVERED
CALIFORNIA WHAT WE'LL DO IS. FOR
THOSE ISSUES AND THEN --
THE SECTION ON MEDI CAL OVER ALL
WE WILL TAKE KERR A PUBLIC
COMMENT AFTER EACH SEGMENT SO.
DON'T WORRY IF YOUR SEGMENT
ISN'T BEING PRESENTED YOU CAN
WAIT TILL THE SEGMENT WHICH IS
PRESENTED TO GIVE PUBLIC COMMENT.
SO YOU HAVE MULTIPLE
OPPORTUNITIES --
TO DO THAT SO ALL RIGHT --
SO WITH THAT LET'S START WITH
THE SO LET'S AND THEN WE CAN
HAVE FINANCE AND LA --
COME UP AND WILL DO THE
INTRODUCTORY ROUND ROBIN FIRST
BEFORE WE BEGIN.
THE WELCOME EVERYONE.
OKAY SO FOR THE RECORD IS FIRST
INTRODUCTION FROM THE AGENCY.
GOOD MORNING MISTER CHAIR AND
MEMBERS I'M SHELLEY REALART IN
THE DIRECTOR OF THE DEPARTMENT
OF MANAGED HEALTHCARE AND I HAVE
WITH ME MORE TO GREEN OUR CHIEF
DEPUTY DIRECTOR AND JENNY
PHILLIPS WHO'S OUR DEPUTY
DIRECTOR FOR LEGISLATIVE AFFAIRS --
ALL THAT WE CAN DO IT
INTERNATIONAL EVERYBODY ALEJO.
AND RAN WILL SEE LEGISLATIVE
ANALYST'S OFFICE THE KEY FINANCE.
LIVING CHEN DEPARTMENT FINANCE
JACOB LAMB DEPARTMENT OF FINANCE
OKAY THANK YOU ALL RIGHT SO
LET'S GO AHEAD BEGIN WITH --
ISSUE ONE WHICH IS THE OVERVIEW
OF THE DEPARTMENT --
WE DO HAVE FAIRLY EXTENSIVE
DESCRIPTION OF WHAT THE
DEPARTMENT DOES HAVING JUST AT
THE HIGHLIGHTS AND ACTIVITIES A
BEEN INVOLVED IN THANK YOU.
HAVE YOU TO THANK YOU I'M HAPPY
TO BE HERE TODAY ON BEHALF OF
THE DEPARTMENT TO DISCUSS OUR
THREE BUDGET CHANGE PROPOSALS
THAT WILL HELP THE DEPARTMENT
ACHIEVE ITS MISSION.
WHICH IS TO PROTECT CONSUMERS
HEALTHCARE RIGHTS AND ENSURE A
STABLE HEALTHCARE DELIVERY
SYSTEM --
BRIEFLY THE DEPARTMENT LICENSE
AND REGULATES APPROXIMATE
HUNDRED TWENTY SEVEN HEALTH
PLANS THAT THAT PROVIDE COVERAGE
TWENTY SIX MILLION CALIFORNIANS.
WE REGULATE MORE THAN 96% OF THE
COMMERCIAL AND GOVERNMENT HEALTH
COVERAGE IN THE STATE.
ARE PROPOSED TWENTY NINETEEN
TWENTY BUDGET FOUR HUNDRED
SEVENTY ONE AUTHORIZED POSITIONS
THE DEPARTMENT IS SPECIALLY
FUNDED THROUGH ASSESSMENTS ON
HEALTH PLANS AND WE RECEIVE NO
GENERAL FUND MONEY.
A FEW PROGRAMS I JUST WANT TO
HIGHLIGHT FOR YOU FIRST AND
FOREMOST AS OUR HELP CENTER THAT
HELPS.
CONSUMERS --
WE EDUCATE THEM ABOUT THEIR
HEALTHCARE RIGHTS WE HELP THEM
RESOLVE CONSUMER COMPLAINTS SEMI
HELP THEM NAVIGATE AND
UNDERSTAND THEIR COVERAGE AND
ENSURE ACCESS TO APPROPRIATE
HEALTH CARE SERVICES.
WE IT SINCE TWO THOUSAND WE HAVE
ASSISTED MORE THAN TWO POINT ONE
MILLION CALIFORNIANS --
I SHOULD MENTION ALSO THAT WE
ADMINISTER THE INDEPENDENT
MEDICAL YOU PROGRAM AS WELL.
OUR OFFICE OF PLAN LICENSING --
RICK --
REVIEWS ALL OF THE APPLICATIONS
FOR LICENSURE FROM HEALTH PLANS
AND ALL ASPECTS OF THEIR
OPERATIONS INCLUDING BENEFITS
AND COVERAGE CONTRACTS WITH THE
DOCTORS AND HOSPITALS AND
PROVIDER NETWORKS AND COMPLAINT
AND GRIEVANCE SYSTEMS.
OUR OFFICE OF PLAN MONITORING --
HAS TWO DIVISIONS ONE THAT
CONDUCTS --
SURVEYS OF HEALTH PLANS TO MAKE
SURE THEY'RE OPERATIONALLY --
ABLE.
TO ENSURE THAT THEY MEET THEIR
OBLIGATIONS AND CARE.
AND PROVIDER NETWORKS WHERE WE
MONITOR THE NETWORKS OF THE OF
THE PLANS AND ANNUALLY REVIEW
THEM.
OUR OFFICE OF FINANCIAL REVIEW
CONDUCTS MEDICAL LOSS RATIO --
EVALUATIONS OF THE HEALTH PLANS
WE CONDUCT FINANCIAL SOLVENCY
EXAMS AND CLAIMS EXAMS AND ALSO
REVIEW PROPOSED PREMIUM RATE
INCREASES IN THE INDIVIDUAL AND
SMALL GROUP MARKETS.
AND SINCE TWENTY ELEVEN WE HAVE
SAVED MORE THAN TWO HUNDRED
SECOND TWO HUNDRED TWENTY SIX
MILLION DOLLARS IN HEALTHCARE
PREMIUMS THROUGH OUR RATE REVIEW
PROGRAM.
LAST BUT NOT LEAST OUR OFFICE OF
ENFORCEMENT PROSECUTE VIOLATIONS
OF THE KNOX KEN ACT.
AND WE HAVE A VARIETY OF TOOLS
TO USE TO ENFORCE THE LAW SUCH
AS CORRECTIVE ACTION PLANS
SETTLEMENT AGREEMENTS FINANCIALPENALTIES CEASE AND DESIST
ORDERS AT CETERA.
SELL ANY QUESTIONS ON THE
OVERVIEW.
NO I THINK --
ALSO WE CAN AND I THINK WITH
SOME QUESTIONS SPECIFICALLY
ABOUT THE TIMELY ACCESS REPORT
FOR TWENTY SEVENTEEN AND PUSHES
AND DRUG COSTS TRANSPARENCY
REPORT FOR TWENTY SEVENTEEN SO
CAN GO OVER SOME OF THOSE --
FINDINGS WE HAD A TWO THANK YOU --
SO WITH RESPECT TO TIMELY ACCESS
PASSED IN TWENTY FOURTEEN
REQUIRE THE DEPARTMENT TO
IMPLEMENT MORE STRINGENT
OVERSIGHT OF HEALTH PLANS
COMPLIANCE WITH STANDARDS MEANT
TO ENSURE TIMELY ACCESS TO CARE.
THE REGULATION WHICH BECAME
EFFECTIVE IN TWENTY TEN INCLUDE
SPECIFIC TIME FRAMES UNDER WHICH
AND RELEASE MUST BE ABLE TO
OBTAIN CARE.
THESE STANDARDS INCLUDE WAIT
TIMES FOR URGENT AND NON URGENT
CARE APPOINTMENTS AS WELL AS THE
AVAILABILITY OF TELEPHONE TRIAGE
OR SCREENING SERVICES DURING AND
AFTER REGULAR BUSINESS HOURS.
SO TO DEMONSTRATE COMPLIANCE
WITH THE TIMELY ACCESS STANDARDS
HEALTH PLAN SUBMIT ANNUAL
COMPLIANCE REPORTS TO THE
DEPARTMENT --
IN DECEMBER WE RELEASED OUR
MEASUREMENT YOUR TWENTY
SEVENTEEN REPORT ON THE HEALTH
PLAN DATA.
OF THE AGENDA ITEM DESCRIPTION
SUMMARIZES THE KEY FINDINGS FROM
THE PORT SO I'M NOT GOING TO
REPEAT THEM HERE BUT IF YOU HAVE
ANY QUESTIONS ABOUT THEM I'M
HAPPY -- TO
RESPOND --
SO FOR MEASUREMENT YOUR TWENTY
SEVENTEEN HEALTH PLANS CONTINUE
TO IMPROVE THEIR PERFORMANCE AND
DATA ACCURACY COMPARED TO
PREVIOUS MEASUREMENT YEARS.
THIS ALLOW THE DEPARTMENT TO
DISPLAY MORE DETAILED DATA
INITIAL C. ON THE REPORT WE HAVE
THIRTY SIX CHARTS AND YOU KNOW
THAT BREAK DOWN THE DATE IN
DIFFERENT WAYS.
THAT SAID WE STILL SEE SOME
ERRORS IN THE DATA WHICH WE ARE
WORKING WITH THE HEALTH PLANS TO
CORRECT -- I
JUST WANT TO CONCLUDE BY SAYING
THAT PROVIDING TIMELY ACCESS IS
ONE OF THE PLANTS FUNDAMENTAL
DUTIES TO ITS ENROLLEES.
I WANT TO ASSURE YOU THE
DEPARTMENT TAKES THIS ROLE VERY
SERIOUSLY AND WE WILL.
CONTINUE TO OVERSEE AND MONITOR
THE PLANS AND TAKEN FORSMAN
ACTION WHERE NECESSARY. TO THAT
END WE ENGAGE IN MANY ACTIVITIES
TO THAT THEY CAN MEET THESE
REQUIREMENTS.
AND THESE INCLUDE ANALYZING THE
HEALTH PLANS ANNUAL REPORTS THAT
DETAIL THEIR COMPLIANCE WITH THE
TIME LAPSE STANDARDS.
TRACKING AND REALLY COMPLAINTS
SUBMITTED TO THE DEPARTMENT AND
HELPING AND RELEASE OBTAIN
TIMELY CARE.
ANNUALLY EVALUATING NUMEROUS
HEALTH PLAN NETWORKS IN THE
COMMERCIAL INDIVIDUAL AND MEDI
CAL -- LINES
OF BUSINESS.
BUT IN HEALTH PLAN OPERATIONS
THROUGH ROUTINE MEDICAL SURVEYS.
ENSURING HEALTH PLANS HAVE THE
CAPACITY TO BE ABLE TO TRANSFER
ENROLLEES AND ENSURE ACCESS TO
CARE WHEN CONTRACTS BETWEEN
HEALTH PLANS AND PROVIDERS
TERMINATE.
AND AS I SAID TAKING ENFORCEMENT
ACTION AGAINST HEALTH PLANS OF
VIOLATE THE TIMELY ACCESS
REQUIREMENTS SINCE TWENTY
THIRTEEN THE DEPARTMENT HAS
LEVIED SIX POINT FIVE MILLION
DOLLARS IN PENALTIES.
AGAINST SIXTY FIVE HEALTH PLANS
FOR FAILURE TO MEET THE TIMELY
ACCESS TO CARE BOTH IN SPECIFIC
INSTANCES AND WHERE WE HAVE
FOUND PATTERNS OF ACCESS
PROBLEMS.
HAPPY TO ANSWER ANY QUESTIONS.
DO I TOUCH ON THE PRESCRIPTIONS
MARK IS GOING TO DO THE
PROTECTION TRY.
AND THEN WE'LL WE'LL HAVE FUN
DON'T THEY QUESTIONS.
GOOD MORNING TERRY MEMBERS AGAIN
MY NAME IS MARTY GREEN CHIEF
DEPUTY DIRECTOR AT THE
DEPARTMENT OF MANAGED HEALTHCARE.
SO DAMAGE SEE IN THE END OF
DECEMBER DID RELEASE IT OUR
FIRST REPORT UNDER SB SEVENTEEN
THE PRESCRIPTION DRUG COSTS
TRANSPARENCY.
AS A REMINDER IT REQUIRED HEALTH
PLANS TO REPORT TO THE DAMAGE
SEAT THE TWENTY FIVE MOST
FREQUENTLY PRESCRIBED DRUGS.
THE TWENTY FIVE MOST COSTLY
DRUGS BY TOTAL ANNUAL PLAN
SPENDING AND TWENTY FIVE DRUGS
WITH THE HIGHEST YOUR EVERY YEAR
IT ANNUAL INCREASE IN TOTAL
ANNUAL PLAN SPENDING --
IT DID SB SEVENTEEN HAD A NUMBER
OF OTHER REQUIREMENTS ON DRUG
MANUFACTURERS BUT THEY DO NOT
INVOLVE OUR DEPARTMENT THEY
INVOLVE A SISTER DEPARTMENT.
SO WE ARE REQUIRED UNDER SB
SEVENTEEN TO SUMMARIZE THE DATA
SUBMITTED BY THE HEALTH PLANS
AND PUBLISH AN ANNUAL REPORT AND
OUR FIRST ONE AS I SAID CAME OUT
IN LATE DECEMBER.
COUPLE OF LIMITATIONS TO THE
REPORT XIN DRUG COSTS ASSOCIATED
WITH THE PHARMACY BENEFIT UNDER
THE HEALTH PLAN IT DOES NOT
INCLUDE PRESCRIPTION DRUG COSTS
FOR INPATIENT DRUGS IS
ADMINISTERED IN A HOSPITAL.
PRESCRIPTION DRUG COSTS OR
PRESCRIPTION DRUG COSTS BORNE BY
DELEGATED ENTITY LIKE A MEDICAL
GROUP THAT'S ADMINISTERING DRUGS
ON BEHALF OF THE HEALTH PLAN.
IT ALSO DOES NOT INCLUDE
PRESCRIPTION DRUGS FOR SELF
FUNDED ARRANGEMENTS THAT ARE NOT
REGULATED BY THE DEPARTMENT MEDI
CAL MANAGED CARE MEDICARE
ADVANTAGE OR OTHER PLANS
INSURERS IN ORGANIZATIONS ARE
REGULATED BY THE DAMAGE CITY.
THE REPORT REPRESENTS TWENTY
FIVE HEALTH PLANS AND ONE EIGHT
ONE HUNDRED AND FORTY EIGHT
POINT ONE MILLION MEMBER MONTHS
WHICH IF YOU ANNUAL AS THAT
NUMBER THAT'S APPROXIMATELY
TWELVE POINT THREE MILLION
CALIFORNIANS.
THE CALIFORNIA DEPARTMENT OF
INSURANCE ISSUES A SEPARATE
REPORT FOR THOSE BUT THOSE
ORGANIZATIONS THAT THEY REGULATE.
SOME OF THE KEY FINDINGS HEALTH
PLANS PAID NEARLY EIGHT POINT
SEVEN BILLION FOR PRESCRIPTION
DRUGS ADMINISTERED THROUGH THE
PHARMACY BENEFIT.
PRESCRIPTION DRUGS ACCOUNTED FOR
THIRTEEN POINT 1% OF TOTAL
HEALTH PLANS ARE PREMIUMS AND
MANUFACTURE DRUG REBATES EQUALED
NINE HUNDRED AND FIFTEEN MILLION
OR ABOUT TEN POINT 5% OF THE
EIGHT POINT SEVEN BILLION SPENT
ON PRESCRIPTION DRUGS.
AND WHILE SPECIALTY DRUGS
ACCOUNTED FOR ONE POINT 6% OF
ALL PRESCRIPTION DRUGS THEY
ACCOUNTED FOR OVER HALF OR FIFTY
ONE POINT 5% OF TOTAL ANNUAL
SPENDING ON PRESCRIPTION DRUGS.
FOR THE TWENTY FIVE MOST
FREQUENTLY PRESCRIBED DRUGS
ENROLLEES PAID APPROXIMATELY 3%
OF THE COST OF SPECIALTY DRUGS
AND OVER HALF OR FIFTY SIX POINT
6% OF THE COST OF GENERICS.
THANK YOU --
COMES FROM ELIA [inaudible]
RIGHT FINANCE.
COMMITTEE MEMBER COMMENTS.
ALL RIGHT TIME SO.
THAT RESULT THANK YOU I DIRECTOR
LARD FOR FOR BEING HERE AND ALSO --
APPRECIATE THE THE IMPORTANT
WORK THAT OUR HEALTH CARE
DEPARTMENTS HEALTH CARE --
PERFORMS BECAUSE BASICALLY WHEN
PEOPLE PURCHASE INSURANCE --
THE PROMISES ARE MADE RIGHT --
AND AND US SOMETIMES IF THEY'RE
NOT BEING THAT THAT'S WHAT
YOU'RE --
THE DEPARTMENT THAT NEEDS TO BE
SURE THAT.
NOT THAT THOSE PROMISES ARE KEPT
AND AS CONSEQUENCES FOR FOR WHEN
WHEN THAT DOESN'T HAPPEN AND SO
THAT'S WHY WE HAVE TIMELY ACCESS
BECAUSE VIEW.
WHAT'S THE USE OF THE INSURANCE
CARD WE CAN'T FIND A DOCTOR AND
THEY DON'T HAVE THE PEOPLE YOU
NEED THERE AND WHEN THINGS I
KNOW THAT I'VE EXPRESSED SOME
FRUSTRATION THE PAST --
WAS IS THAT --
I THINK THAT WHAT YOU'RE TRYING
TO COLLECT THE SURVEY DATA OF
FORTY THE FIRST ROUND WE DON'T
HAVE GOOD DATA SELL WHEN THERE'S
THEN I UNDERSTAND.
JOHN THERE'S SOME CHALLENGES IN
TERMS OF TIME AND ALSO RACES
YEAH TAKE TIME TO COLLECT THE
DATA THEY HAVE TO ANALYZE THE
DATA SO WE ALWAYS LOOKING ABOUT
TWO YEARS BACK.
SO I APPRECIATE THIS IS NOW THE
FIRST YEAR WHERE WE ACTUALLY
HAVE SOME GOOD DATA SITE AND
SHARING THIS COMMITTEE NOW THIS
IS MY THIRD YEAR SO FINALLY WE
HAVE SOME GOOD DATA --
WHAT KIND OF PARTICULAR --
INSIGHTS TO CAN YOU SHARE IN
TERMS OF HOW THE STATE IS GOING
TO HELP YOU AND FORCE THE THE
THE THE THE TIMELY ACCESS RULES.
IT'S GONNA BE BETTER INFORMED
THEIR CHANGE THE APPROACHES THAT
YOU MIGHT HAVE IN TERMS OF
FEATURE WE IN.
FOR AND FORCE THE THE ASSEMBLY
ACCESS RULES --
NOW THAT WE HAVE SOME ACCURATE
DATA FROM THE SERVICE.
SO WE ARE STILL IN THE PROCESS
OF OPERATING UNDER AN
ADMINISTRATIVE PROCEDURES ACT
WAIVER SO WHEN ARE STILL
TWEAKING.
THE DIRECTION THAT WE GIVE THE
PLANS ON HOW TO DO --
THE TIMELY ACTS AT THE SURVEYS --
AND EACH TIME AS I SAID IT GETS
BETTER AND BETTER SO --
WE'RE LEARNING A LOT ALONG THIS
PROCESS WE'VE WE'VE MADE A LOT
OF EFFICIENCIES IN THE WHOLE
PROCESS OF COLLECTING THE DATA
AND OUR OUR TASK NOW IS TO COME
UP WITH WHAT IS A REASONABLE
RATE OF COMPLIANCE THAT WE CAN --
THAT THE PLANTS CAN UNDERSTAND
THAT IT'S AND THAT WE CAN-ENFORCE AGAINST AND WHEN I TALK
ABOUT IN FORCE NINETEEN
ENFORCING IN A COURT OF LAW
BECAUSE WE HAVE TO BE ABLE. TO
PROVE THAT THE PLANS HAVE DONE
SOMETHING I'M SAID THAT.
SO THAT IS OUR CHARGE THIS YEAR
WE NEED TO HAVE A REGULATION --
BY THE END OF THE YEAR AND WE
WERE WORKING ON DRAFTING THAT --
WE'VE INVOLVED A LOT OF
STAKEHOLDERS IN THIS PROCESS --
A LOT OF FEEDBACK AND INTACT OR
SOME AT INDEPENDENT ACTIVITIES
GOING ON TO HELP ADVISE US ABOUT
WHAT THAT METHODOLOGY SHOULD BE --
AND SO WE'RE WORKING REALLY HARD
TO MEET OUR TIME FRAMES AND
EXPECT TO HAVE A REGULATION
READY TO GO AT THE END OF THE
YEAR.
AND BUT IN TERMS YOUR APPROACH
TO HEALTH PLANS THAT --
THAT.
OUR MEETING TO TIMELY ACCESS
STANDARDS I APPRECIATE YOU SHARE
WITH US THE SOME OF THE
ENFORCEMENT ACTIONS THAT YOU'VE
TAKEN IN THE PAST --
WHAT DO YOU SEE IS BEING THE
MOST RAPID WAY TO GET I MEAN
ULTIMATELY LETS US I MEAN WE CAN
AND THEN YOU NEED TO DO THIS YOU
KNOW WE HAVE FINES AND OTHER
TYPES OF?
PUNISHMENTS FOR PEOPLE DOWN --
WHAT'S THE BUT HE SEES THE BEST
WAY TO MORE RAPIDLY BE SURE THAT.
HEALTH PLANS ARE IN COMPLIANCE
AND AND ULTIMATELY THE PATIENTS
ARE ACTUALLY ABLE TO GET THE
CARE THEY NEED TO ARE THERE
OTHER TOOLS THAT YOU SEE NOW
WE'VE TALKED A PROVIDER
DIRECTORIES AND CONSIDER HOW TO
CONSOLIDATE THOSE AND OTHER
TYPES OF APPROACHES.
ORDER TO WORK AT THINGS YOU'RE
LOOKING AT SHOULD YOU HAVE TO GO
TAKE THEM TO COURT AND THAT'S
ALWAYS TAKE SOMETIME TO HAVE
SOMETHING COME OUT SO OFTEN
TRYING.
WE'RE TRYING TO CHECK ALWAYS
PLAYING CATCH UP IN THAT REGARD
BUT IN TERMS OF WHAT OTHER TYPES
OF APPROACHES MIGHT TAKE --
TO GET THE PLANS TO THAT MEANS
BETTER I I PREFER OF THE I'LL
JUST FOLLOW THE RULE AND WE'D
HAVE TO PUSH ANYBODY SAID.
OKAY SO IN NOT THROUGH OUR
ANNUAL NETWORK REVIEW PROCESS --
WE DO LOOK AT THAT THE CAPACITY
OF THE NETWORK OVERALL AND
REALLY BUT THE TIMELY ACCESS --
PROCESS IS MEASURING IS IS THE
NETWORK AS A WHOLE ADEQUATE TO
SERVE THE ENROLLEES AND IT'S NOT
JUST ABOUT A SPECIFIC PROVIDERS
OFFICE.
SO --
BECAUSE THERE'S ALWAYS GOING TO
BE TIMES WHEN A PROVIDER ISN'T
AVAILABLE YET BECAUSE OF YOU
KNOW POPULARITY OR CERTAIN KIND
OF SPECIALTIES WHATEVER SO AS WE
LOOK AT THE NETWORK'S OVERALL
WE'RE MEASURING UNLIKE HOW
WHAT'S THE CAPACITY OF THE
NETWORK TO BE ABLE --
TO INSURE THAT TIMELY ACCESS SO
THAT'S ONE THING --
AND WHEN OUR SURVEYS TEAM GO OUT
AND LOOK AT THE PLANS PROCESSES
FOR HOW THEY EVALUATE NETWORKS
THAT'S ANOTHER AREA THAT WE WE
ALSO LOOK AT AND SO AS I SAID IN
OUR REAL GOAL IS TO GET TO A
STANDARDIZED METHODOLOGY AND
RATE OF COMPLIANCE THAT.
IS UNIFORM AND WE CAN REALLY
ENFORCE AGAINST.
ALL RIGHT SO IN USE WE'RE
TALKING ABOUT TRY EXPAND AND
YEAH -- SAYS
HERE AND I KNOW THAT YOU DON'T
MISS ARE DIRECTLY OVERSEE THE
DTS PLANS WHILE THE CONVERSATION
I SEE DIRECTOR CANCER HERE.
ABOUT SOME OF THAT WE CERTAINLY
WON'T BE SURE ON THE PRIVATE
SIDE THAT THAT --
PEOPLE ARE PURCHASING THROUGH
COVERED CALIFORNIA WHO ARE
PURCHASING THROUGH THEIR
EMPLOYER ARE ARE YOU KNOW YOU
KNOW WHATEVER THAT THAT.
THAT WE HAVE THE STANDARD.
THAT STANDARDS ARE BEING
FOLLOWED ABSOLUTELY AND WE LOOK
AT EACH OF THE QUESTION ABOUT
THE PRESCRIPTION SO THAT THIS
VERY INTERESTING DATA.
NOW WE EASY MENTION THERE'S A
THERE'S A WHOLE GROUP OF PEOPLE
WHO ARE HERE THE DATA DOESN'T
COME TO YOU AT LEAST FOR YOUR
REPORT.
CAN YOU GIVE ME A SENSE OF HOW.
I GUESS REPRESENTATIVE THE
PEOPLE THAT ARE IN YOUR REPORT
AND OTHER WORDS COMPARED TO THE
PEOPLE WHO ARE ARE THEY ARE THE
SAME ARE THE SICKER OLDER OR
WHATEVER ANY DAYS IS IS THERE.
AND IS THERE SOME SORT OF A AS
THE HOW REPRESENTATIVE IS ANY OF
A LARGE NUMBER OF PEOPLE
OBVIOUSLY BUT ALSO YOU KNOW YOU
YOU DON'T COUNT YOU SAID YOU'VE.
TRIED ALL DIFFERENT CATEGORIES
OF PEOPLE WHO ARE WHO WOULD BE
IN YOUR REPORT --
SO CAN YOU GIVE ME A SENSE OF
LIKE WHAT WE LOOK AT THIS DATA
WHICH WE MIGHT IT BE SKEWED.
IT'S GOING TO SKEW TOWARDS THE
COMMERCIAL POPULATIONS OF THE
INDIVIDUALS IN COMMERCIAL
COVERAGE WHICH GENERALLY TEND TO
BE THOSE FROM.
THE AGE RANGE UP UNTIL MEDICARE
ELIGIBILITY WHICH IS OF COURSE
SIXTY FIVE SO YOU'RE GONNA HAVE
A GENERALLY SPEAKING.
YOU THROUGH WORKING AGE ADULTS --
AND IT WILL SKEW TO A SLIGHTLY
HIGHER INCOME BECAUSE THE MEDIC
HOW POPULATIONS EXCLUDED SO IT'S
GOING TO BE GENERALLY THAT.
OF CHILDREN TO WORKING AGE
MIDDLE INCOME AND ABOVE
GENERALLY SPEAKING OKAY AND IF
THEY DO FIND IT INTERESTING WHEN
YOU SAID THAT --
SPECIALLY DRUGS.
WHICH NOT SURPRISINGLY ARE THE
MOST EXPENSIVE --
THE REPRESENT ACTUALLY OVER HALF.
OF THOSE IT ONLY REPRESENT WHAT
ONE POINT 6% OF THE
PRESCRIPTIONS AND THEN EACH
TRIED DEL THE IDEA OPTING TO
DELVE IN THAT LITTLE DEEPER AND
SEE HOW --
WHAT TO TO THAT ONE POINT 6%
ISN'T?
THAT WHAT THEY COME FROM YEAH
THE DATE OF THE TIMES TO THE
DEPARTMENT ISN'T ENOUGH I THE
PATIENTS ARE NON IDENTICAL
PATIENTS BUT I DON'T KNOW IF YOU
HAVE ANY MORE INFORMATION ABOUT
WHO YEAH SO.
NO WE HAD JUST HAVE VOLUME OKAY
SO BY PLAN HOW MANY
PRESCRIPTIONS WERE FILLED OKAY --
AND THEN THE PER COST PER
PRESCRIPTION COST AND SO WE CAN
AGGREGATE THAT AND LOOK ACROSS
PLANS AND UNDERSTAND.
HOW MUCH BOTH WAS SPENT AND HOW
MANY PEOPLE RECEIVED ABOUT
DORADO BUT WE CAN'T DEL BEGIN
WHICH DRUG IT WHICH DRUGS THEY
ARE YES AND YOU CAN SEE --
AND THE LESS THAT WE PROVIDE AND
ON THE SPECIALTY TEAR WHICH ARE
THE ONES ARE IN THE TOP
[inaudible]
TWENTY FIVE ALL RIGHT.
AND I GUESS THE OTHER QUESTION
IS I KNOW YOU'RE REGULATORY
AGENCY --
WHAT DO YOU SEE ANY --
WELL THAT WHETHER IT'S YOUR
DEPARTMENT OTHER DEPARTMENTS
THAT.
THIS INFORMATION MIGHT BE
HELPFUL IN TERMS OF POLICY
MAKING.
I CERTAINLY THINK IT'S HELPFUL I
MEAN AS YOU KNOW THE THE
GOVERNOR HAS AN INITIATIVE
RELATED TO PRESCRIPTION DRUG
COSTS AND I'D AND AS A MEMBER OF
THE CALIFORNIA PHARMACEUTICAL
COLLABORATIVE.
NOW WE ARE CONSIDERING BOTH OF
THE INFORMATION OUR REPORT THE
INFORMATION IN THE CALIFORNIA
DEPARTMENT OF INSURANCE REPORT
AS WELL AS PRESCRIPTION DRUG
INFORMATION AVAILABLE FROM OTHER
STATE PURCHASERS ON DIFFERENT
WAYS AT THE MINISTRATION CAN
APPROACH A REDUCING PRESCRIPTION
DRUG COSTS SO I THINK IT IS.
USEFUL INFORMATION FOR MANY
PARTIES THEN I GUESS THE OTHER
FINAL QUESTION ABOUT IT
CERTAINLY ON ONE LEVEL OF COURSE
WE WERE CONCERNED ABOUT HOW THE
PHARMACEUTICAL COSTS --
I DON'T KNOW IF THERE AND THIS
IS MY LESS SO WITH THE SPECIALLY
DRUGS BUT ALSO THE HOUSE THAT
MATCH UP WITH SUPPLY --
SO WHERE YOU MIGHT BE SHORTAGES --
YEAH I THINK MY CONCERN IS IS
THAT SOMETIMES --
WELL CERTAINLY WERE CONCERNED
ABOUT HOW THERE MAY BE.
CERTAIN PHARMACEUTICALS WHERE
THE COST IS GUNS ARE THE PRICES
GOTTEN SO LOW YOU BASICALLY NOW
BOIL DOWN TO A SINGLE SUPPLIER.
AND THEN WHAT HAPPENS THAT
SUPPLIER BECOMES A TARGET OF THE
HEDGE FUND SOME INVESTORS
SOMEONE WHO SEES AN OPPORTUNITY.
TO THAT SWOOP AND BUY A CHEAP
JACK THE PRICE UP TO MAKE A
QUICK BUCK.
AND SO I THINK WE NEED TO LOOK
AT INTO THE PRICING INFORMATION
IS IMPORTANT BUT ALSO LOOKING AT
WHERE MIGHT BE VULNERABILITIES
AND LOOKING AT WHERE WE MAY HAVE
SHORTAGES AS WELL ALSO WE CAN
GET RELIABLE SUPPLY OF THE
MEDICATION.
WHAT IS THAT SUPPOSED TO MEAN AS
WELL SO HOPING WE CAN LOOK AT
BOTH OF THOSE AND BECAUSE IN THE
END WHAT WE WANNA DO IS HAVE?
YOU KNOW --
MEDICATION THAT SET THE BILL
WITH THE RIGHT PRICE.
AT ALSO AVAILABLE WHEN YOU NEED
IT RIGHT --
SO IF THERE'S A PROBLEM EITHER
SIDE AND THERE'S THAT AND THEN
PEOPLE ARE BEING SERVED WELL.
ABSOLUTELY SO OKAY AND THEY
REALIZE THAT THAT FLIES BY BID
OUT THE SCOPE OF YOUR AGENCY BUT
I'M THINKING THAT THIS
INFORMATION MIGHT BE USEFUL
THINKING ABOUT WHICH AGENCY
WHERE THAT MIGHT BE --
THEY MY MY LOOK AT THAT AND I'LL
ABSOLUTELY OKAY ALL RIGHT.
YEAH YES AS THEIR STONE THANK
YOU MISTER CHAIR --
THANK YOU FOR YOUR PRESENTATION.
COUPLE QUESTIONS A ABILITY TO
HAVE AN APPROPRIATE NUMBER OF
PHYSICIANS --
WITHIN THEIR PLANS ARE YOU
SEEING OKAY SEE ANY SHORTAGES
ANNIE ANNIE ABILITIES --
TO NOT PROVIDE SERVICE AND
SPECIALLY AND MAYBE SOME OF THE
MORE RURAL AREAS.
I THINK YOU KNOW EVERYBODY YOU
UNDERSTAND THAT THERE IS A
PROVIDER SHORTAGE IN CALIFORNIA
AND IT IS MORE ACUTE IN RURAL
AREAS -- AND
THAT'S WHY THE DEPARTMENT HAS A
PROCESS --
FOR APPROVING ALTERNATE ACCESS
STANDARDS IF THERE ARE AREAS
WHERE THE THE TIME AND DISTANCE
STANDARDS AREN'T.
ABLE TO BE MET BECAUSE THERE
JUST AREN'T THE PHYSICIANS THERE
SO -- THAT'S
ONE OF THE WAYS IN WHICH WE LOOK
AT WE DO A LOT OF VERY DETAIL
GEO DEAL MAPPING ANALYSIS OF
WHERE PROVIDERS ARE AND WHERE
THE MEMBERS ARE AND HOW WE CAN
BEST --
MATCH THEM UP AND ALSO THE PLANS
ARE UNDER AN OBLIGATION TO
PROVIDE MEDICALLY NECESSARY CARE
SO IF THERE IS IF THERE ISN'T A
SPECIALIST IN THE IMMEDIATE AREA
THAT THE SO MANY TO SEE.
ANY TO MAKE SURE THEY CAN GET
THEM TO A PLACE WHERE THAT THAT
PERSON AS OKAY THAT'S COMFORTING
TO KNOW --
ALSO IN RE IN RESPONSE TO SB
SEVENTEEN OR NEW --
INFORMATION --
READ MS AND DRUG DISCOUNTS --
BUT I DIDN'T SEE A WHOLE LOT OF
INFORMATION ON THAT IN MY REPORT
CAN YOU CUT TO LET MEKNOW --
ABOUT WHAT'S BEEN REPORTED TO
YOU ABOUT THE COST OF THE PBM
ISN'T.
IN COMPARISON TO THE REBATES UP
AND WHICH RECEIVED THE
INFORMATION AS REQUIRED TO BE
REPORTED TO US WAS AT WHETHER
NOT THEY USE A P. B. M. AND THAT
THE NAME OF THE PAY BE ARE NOT
SPECIFICALLY COSTS ASSOCIATED
WITH THE PDM.
BECAUSE OFTENTIMES IT'S
REFLECTED IN WHATEVER THE
NEGOTIATED PRICE IS NOT
SEPARATELY FROM SO IT'S YOU
DON'T OFTEN SEE IT AS A P. B. M.
PRICE PLUS THE PRESCRIPTION DRUG
PRICES AND SO WE DON'T HAVE THAT
LEVEL OF DETAIL BUT WE DO
UNDERSTAND.
WHICH PLANS ARE CONTRACTING WITH
WHICH P. B. M.'S AND THEN
SEPARATELY WE DO HAVE THE REBATE
INFORMATION WHICH I BRIEFLY WENT
OVER THE NINE HUNDRED AND
FIFTEEN MILLION APPROXIMATELY
OKAY.
YEAH THE THE IN THE KIND OF
OPERATING A BLACK BOX I WAS
HOPING THAT THROUGH THAT --
THEM THE BILL THAT WE WOULD
BEGIN TO SEE SOME OF MORE
TRANSPARENCY WITH THE PBM SEND.
WHAT THEY'RE WHAT THEY'RE TAKING
OUT OF THE HEALTHCARE MARKET?
WE DO HAVE ANOTHER BILL THAT
WE'RE WORKING TO IMPLEMENT --
THREE FIFTEEN WHICH IS ABOUT PM
TRANSPARENCY AND SO WE JUST
RECENTLY SENT OUT A SOLICITATION
FOR TASK FORCE THAT'S GOING TO
HELP IDENTIFY ADDITIONAL --
INFORMATION THAT WE CAN COLLECT
FROM THE HEALTH UNDERSTAND THE
ROLE OF THE P. B. M.'S AND THE
HEALTHCARE MARKETPLACE IT'S NOT
PART OF IT BERMAN AT EMAIL AND
SUPPORTED AT NIGHT AND LOOK
FORWARD TO THOSE RESULTS AND
AGAIN AS FOR YOUR PRESENTATION.
RIGHT THANK YOU CENTER STONE --
ACTIVATE BIG INTELLIGENCE
COMMITTEE --
I RECOGNIZE A GOOD FRIEND OF
MINE DOCTOR STUART COLLINS HERE
WITH THAT.
THE SEVENTH GRADE CLASS HE COULD
SEE YOU.
AT TELL YOU THIS IS THE MOST
INTERESTING COMMITTEE OF ALL.
ACTUALLY THIS IS.
OKAY -- JUST
ONE OTHER QUESTION BEFORE WE
MOVE ON TO THE NEXT ISSUE --
IN TERMS OF I KNOW ONE OF THE
THINGS WE'VE TALKED ABOUT VALUE
BASED PURCHASING AND I KNOW THAT
YOU ARE REGULATED PLANS AND AND
ALSO CAN YOU TELL ME A LITTLE
BIT ABOUT PERHAPS --
WHAT KIND OF WORK YOU DO IN
TERMS OF LOOKING AT NOT ONLY
PLANS BUT SIR THE SUBCONTRACTS
THE ABBEY HAVE WITH MEDICAL
GROUPS HOSPITALS AND OTHER?
ENTITIES MY COMES THE RISK
BEARING.
SO AS PART OF OUR LICENSING
PROCESS WE LOOK AT BASICALLY
TEMPLATE CONTRACTS BETWEEN THE
HEALTH PLANS IN THE PROVIDER
GROUPS.
AND AS ENTITIES MEDICAL GROUPS
FOR EXAMPLE I WANT TO COME IN
FOR LICENSURE THAN WE DO LOOK AT
WHAT THOSE ARRANGEMENTS ARE AND
THE RISK THAT'S GOING TO BE
PASTOR SHARED WITH THOSE
ENTITIES SO.
WE HAVE --
REGULATION AS YOU KNOW THAT WAS
JUST -- WHEN
ENTITIES NEED TO COME IN FOR
LICENSURE --
IT INCLUDES AN EXEMPTION PROCESS
FOR THOSE ENTITIES THAT DON'T
FEEL LIKE THEY MEET THOSE THE
DEFINITION ARE THE ROAD FOR THE
REQUIREMENTS OF THE HEALTH PLANS --
WE ALSO HAVE ANOTHER REGULATION
IN THE WORKS THAT WOULD ALSO --
IMPROVE THE FINANCIAL SOLVENCY
REQUIREMENTS FOR WHAT WE CALL
RISK BEARING ORGANIZATIONS WHICH
ARE BASICALLY MEDICAL GROUPS
THAT TAKE ON RISK --
SO THAT WE CAN STRENGTHEN THE
FINANCIAL STABILITY OF THOSE
GROUPS THAT ARE TAKING ON RISK
AND BETTER UNDERSTAND HOW RISK
IS BEING SHARED AND AND ENSURING
THAT THE ENTITIES THAT ARE
TAKING IT ON ACTUALLY HAVE THE
CAPACITY TO BE ABLE TO MANAGE IT
AND NOT --
AND TO DELIVER ON THE CARE THAT
THEY NEED TO FOR MEMBERS AND NOT
GO.
BECOME FINANCIALLY SOLVENT.
RIGHT AT THE INTERESTED IN DOES
YOU WILL PRESS THIS FALLS ON AND
ON HOW THAT SEX IS GOING TO WORK
BUT CERTAINLY AGREE WITH YOU
THAT WE NEED TO BE SURE THAT --
IN THE END THE FISHERY WHO PAID
THE PREMIUM.
IT'S GONNA BE OKAY GET THE CARE
THEY NEED RIGHT SO WHATEVER
SUBCONTRACTS HAPPEN IT'S A ROAD
THAT THEY'RE NOT LEFT STRANDED
AND SOMEONE SAYS WELL THAT WAS
SUPPOSED BE THAT PERSON'S
RESPONSIBILITY THAT GROUP'S
RESPONSIBILITY BECAUSE WE HAVE A
CONTRACT WITH THEM BUT I PAY MY
PREMIUM TO USE THE HEALTH.
PLAN SO.
WE NEED TO BE SURE THAT THOSE
ARRANGEMENTS THAT THE PATIENT IS
PROTECTED SO.
SHE DAY LOOKING INTO THAT OKAY --
SO LET'S MOVE ON THEN TO IF
THERE'S ANY OTHER QUESTIONS ON
THIS OKAY SO WE'LL MOVE ON THE
ISSUE -- TO
SO I WHEN I GET DOUBLE LITTLE
MORE INTO SOME THE RESOURCE YOU
NEED THE DIVISION OF PLAN
SERVICE WORKLOAD.
CERTAINLY SO IN ACCORDANCE WITH
THE KNOX KEEN ACT OUR DIVISION
OF PLAN SURVEYS PERFORMS MEDICAL
SURVEYS OF LICENSE PLANS TO
EVALUATE THE REGULATORY
COMPLIANCE.
IT FUNCTIONS MUCH LIKE AN
OPERATIONAL AUDIT.
IN ADDITION TO PERFORMING
ROUTINE SURVEYS --
THE LAW REQUIRES US TO CONDUCT
FOLLOW UP SURVEYS AND NON
ROUTINE SURVEYS WHEN NECESSARY.
A FOLLOW UP SURVEY IS PERFORMED
WHEN THERE'S A DEFICIENCY OR
DEFICIENCIES IDENTIFIED IN A
ROUTINE SURVEY REPORT AND THEY
REMAIN UNCORRECTED AT THE TIME
OF THE FINAL REPORT.
NON ROUTINE SURVEYS MAYBE
PERFORMED WIND DEFICIENCIES
REMAIN UNCORRECTED AT THE AGE
ISSUE AND SO THE FOLLOW REPORT
OR IF THE DEPARTMENT HAS GOOD
CAUSE TO BELIEVE THAT THERE MAY
BE SOME COMPLIANCE ISSUES.
THE NUMBER OF HEALTH PLANS THAT
HAVE BEEN SUBJECT TO MEDICAL
SURVEYS HAS INCREASED BY 23%
SINCE THE NINE NINE TEN FISCAL
YEAR.
FROM APPROXIMATELY ONE HUNDRED
PLANS TO A ONE HUNDRED AND
TWENTY THREE PLANS.
IN ADDITION AT THE SAME TIME THE
MARKET RATE FOR CLINICAL
CONSULTING SERVICES HAS
INCREASED SIGNIFICANTLY.
AND AS AS A RESULT OF BOTH OF
THOSE FACTORS BOTH MORE PLANS AS
WELL AS HIGHER A CLINICAL
CONSULTING RATES WE ANTICIPATE A
FUNDING SHORTFALL DUE DUE TO
THOSE TWO FACTORS.
AND IT THERE ARE CURRENT FUNDING
LEVELS ARE INSUFFICIENT TO
PROVIDE THE ADEQUATE CONTRACT
MANAGEMENT AND TIMELY WRITING OF
REPORTS.
SO AS A RESULT WE ARE REQUESTING
FOR PERMANENT POSITIONS AND
EXPENDITURE AUTHORITY IN THE
AMOUNT OF TO JUST SHY OF TWO
POINT ONE MILLION DOLLARS FOR
FISCAL YEAR. NINETEEN TWENTY TWO
MILLION DOLLARS FOR FISCAL YEAR
TWENTY TWO TO ADDRESS THE
INCREASED WORKLOAD AND INCREASE
RATES CHARGED BY THE CLINICAL
CONSULTANTS.
OKAY THANK YOU COMMENTS FROM
OHIO.
WE REVIEW THE PROPOSAL BUT HAVE
NO CONCERNS FINANCE.
PHONES ALL RIGHT QUESTION FOR
COMMITTEE MEMBERS.
OKAY.
ALL RIGHT CERTAINLY MORE MORE
WORK NEEDS MORE PEOPLE ALL RIGHT --
ISSUE NUMBER THREE IS WHICH IS
THE CONVERSION OF BLANKET
POSITIONS TO PERMANENT.
CERTAINLY IN FISCAL YEAR TWELVE
THIRTEEN GOVERNMENT CODE SECTION
THIRTY ONE IN BUDGET LETTER
TWELVE POINT NO --
THREE WAS ISSUED ON MARCH
TWELFTH AND REQUIRED DEPARTMENTS
ALL DEPARTMENTS NOT JUST
IMMENSELY TO MAKE ADJUSTMENTS TO
REFLECT EXPENDITURES AND
POSITIONS --
DIFFERENTLY --
FOR ENDEAVOR TO BE MORE
TRANSPARENT.
THE DAMAGE SEE AS A RESULT
ELIMINATED SIXTEEN PERMANENTLY
AUTHORIZED POSITIONS AT AS A
RESULT OF THIS DIRECTIVE THE
MAJORITY OF THOSE COMING FROM
THE OFFICE OF ADMINISTRATIVE
SERVICES.
AND THESE HAD BEEN VACANT FOR
SOME PERIOD OF TIME WHICH IS WHY
THAT THEY WERE ELIMINATED --
THE DEPARTMENT RETAIN THE THE
CASH RESOURCES ASSOCIATED WITH
THOSE POSITIONS BUT LOST THE
POSITION OF AUTHORITY --
IN ORDER TO MEET OUR OPERATIONAL
NEEDS WE USED OUR BLANKET SO WE
USE THE CASH AND WE AUTHORIZES
POSITIONS OUT OF OUR BLANK
ADMINISTRATIVE TO TASKS
ASSOCIATED WITH THE CITIES OF
THINGS LIKE HUMAN RESOURCES
BUSINESS SERVICES AND THE LIKE.
THEY WERE REQUESTING TO CONVERT
THOSE SIXTEEN BLANKET POSITIONS
TO PERMANENT AUTHORIZE POSITIONS
WE BELIEVE TO ENHANCE BUDGET
TRANSPARENCY BY ACCURATELY
REFLECTING OUR STAFFING NEEDS.
CONVERTING THESE POSITIONS
REQUIRES NO ADDITIONAL RESOURCES
IT'S SIMPLY A CONVERSION OKAY --
SOUNDS GOOD ALEJO COMMENTS.
THIS IS JUST A TECHNICAL
ADJUSTMENT IN OUR VIEW AFTER
RECEIVING SMART FROM IS FROM THE
DEPARTMENT I HAVE ANY CONCERNS
THANK YOU FINANCE COMMENTS OKAY
SILENCE SILENCE.
RIGHT QUESTIONS WE COMMITTEE
MEMBERS [inaudible]
OKAY.
ALL RIGHT SINCE SINCE OUR IS
MOVE ON THE ISSUE NUMBER FOR
HEALTH CARE SERVICES PLANNED
MERGERS AND ACQUISITIONS.
EIGHTY FIVE NINETY FIVE THE
ASSEMBLY FOR FIVE NINETY FIVE
PROVIDES AUTHORITY TO THAT TO
THAT IMAGE SEE TO DISAPPROVE A
HEALTH PLAN MERGER ACQUISITION.
UPON THE DAMAGE TO FINDING THAT
THE MERGER EITHER VIOLATES THE
KNOCK KNOCKS KEEN ACT
SUBSTANTIALLY LESSENS
COMPETITION IN THE HEALTH CARE
SERVICE PLAN PRODUCTS OR CREATES
A MONOPOLY IN THE STATE.
PRIOR TO THE PASSAGE OF AB NINE
FIVE NINETY FIVE THE HEALTH BUT
DO ME SEIZE MERGER REVIEW DID
NOT INCLUDE REVIEW FOR THE
IMPACT ON COMPETITION AS THOSE
CONSIDERATIONS WERE OUTSIDE OF
OUR AUTHORITY.
HEALTH PLANS ARE REQUIRED TO
GIVE NOTICE TO AND PROVIDE ALL
THE NECESSARY INFORMATION AND
RECEIVE PRIOR APPROVAL FROM THE
DAMAGE SEE WHEN THE INTENT TO
MERGE OR CONSOLIDATE WITH OR
ENTER INTO ANY SORT OF AGREEMENT
RESULTING IN ITS PURCHASE
ACQUISITION OR CONTROLLED BY ANY
ENTITY.
THIS BILL ALLOWS THE DAMAGE HE
TO CONDITIONALLY APPROVED THE
TRANSACTION OR AGREEMENT
CONTINGENT ON THE HEALTH PLANS
AGREEMENT TO VOTE FOR PHIL
VARIOUS CONDITIONS WE CALL THEM
UNDERTAKINGS. TO BENEFIT
ENROLLEES OR PROVIDE FOR A MORE
STABLE HEALTH CARE DELIVERY
SYSTEM.
SO WE WILL ENGAGE STAKEHOLDERS
IN DETERMINING THE MEASURES FOR
IMPROVEMENT --
WE ARE REQUIRED TO OBTAIN AN
INDEPENDENT ANALYSIS OF THE
IMPACT OF THE TRANSACTION
AGREEMENT ON SUBSCRIBERS ARE
ENROLLEES.
THE STABILITY OF THE HEALTHCARE
SYSTEM AND OTHER RELEVANT
PROVISIONS OF THE ACT FOR ALL
WHAT ARE DEEMED MAJOR
TRANSACTIONS OR AGREEMENTS.
THE BILL ALSO ALLOWS THE IMAGE
SEATED DISAPPROVE THE
TRANSACTION IF IF FOR ANY REASON
IT FAILS TO SATISFY THE LAW.
IF IT SUBSTANTIALLY LESSENS
COMPETITION AND HEALTH CARE
SERVICE PLAN PRODUCTS OR CREATES
A MONOPOLY IN THE STATE
INCLUDING BUT NOT LIMITED TO
HEALTH COVERAGE PRODUCTS IN A
SPECIFIC LINE OF BUSINESS.
WE WILL OBTAIN AN OPINION OF
FROM AN EXPERT CONSULTANT TO
ASSESS THE COMPETITIVE IMPACT TO
THE TRANSACTION AND PERFORM THE
INDEPENDENT ANALYSIS.
WE WILL HOLD A PUBLIC MEETING ON
ALL AND PROPOSALS PRIOR TO
APPROVING CONDITIONALLY
APPROVING OR DENYING THE
TRANSACTION.
AND AS A RESULT OF ALL THIS
ACTIVITY WE REQUEST EXPENDITURE
AUTHORITY IN THE AMOUNT OF ONE
MILLION DOLLARS FOR FISCAL YEAR
NINETEEN TWENTY AND THE SAME
AMOUNT ANNUALLY THEREAFTER TO
ADDRESS THE ADDITIONAL
CONSULTING AND ADMINISTRATIVE
COSTS TO MEET THE REQUIREMENTS.
OKAY THANK YOU.
HELLO COMMENTS.
THE REQUESTED RESOURCE IS A PAIR
CONSISTENT WITH WHAT'S NEEDED TO
IMPLEMENT THE NEW LEGISLATION WE
HAVE NO CONCERNS THANK YOU
FINANCE.
MY QUESTION COMMITTEE MEMBERS IT
IS TO BE CLEAR THINK THIS IS A
WERE DISSIPATING.
ON AVERAGE TEN A YEAR SO WHAT
THE SPACE ON AVERAGE WE HAVE --
TEN WHAT WE CALL CHANGE OF
CONTROL OF THE THE THE PLAN SUCH
ISN'T CONTROLLED BY DIFFERENT
ENTITY A YEAR.
VERY GOOD OKAY THANK YOU.
ALL RIGHT --
SEEN ALL THE QUESTIONS WILL GO
AHEAD AND TAKE PUBLIC COMMENT ON
THE PART IN MATCH HEALTH CARE
PLEASE PLANT BUT THE FACT
MICROPHONE AGAIN REQUESTED IF
YOU CAN TRY TO KEEP YOUR AYE
COMMENTS WITHIN A MINUTE WOULD
BE APPRECIATED AND WELCOME.
HELLO ON BEHALF OF HEALTH TAXES
CALIFORNIA IS THE SPONSOR OF
MOST THE LEGISLATION YOU'RE
DISCUSSING TODAY WE'RE PLEASED
TO SUPPORT THE DEPARTMENT'S
REQUEST WE AND WE ARE ALSO
PLEASE THE CHAIRS OVERSIGHT OF
TIMELY ACCESS WE FOR SPONSORED
LEGISLATION IN THIS AREA IN.
NINETEEN NINETY EIGHT SO WE'RE
GLAD TO FINALLY HAVE USEFUL
REPORTS.
WE WOULD ADD TO THE DISCUSSION
ON SB SEVENTEEN THERE'S A WIDE
VARIATION AND HOW MUCH PLAN
SPEND ON DRUGS WHICH WAS ALSO OF
INTEREST TO US.
WITH RESPECT TO PLAN SURVEYS WE
ARE IN DISCUSSION WITH THE
DEPARTMENT ABOUT HOW TO ASSURE
OVERSIGHT OF THE DELEGATED
GROUPS BECAUSE OF OUR CONCERNS
ABOUT SINNER BED.
AND FINALLY I WOULD ADD THAT WE
ARE PLEASED TO SEE THE
IMPLEMENTATION OF FIVE NINE FIVE
THANK YOU.
WELCOME GOOD MORNING LINDA WAY
WITH WESTERN CENTER ON LAW AND
POVERTY WE APPRECIATE THE
DEPARTMENT FOR THE FIRST TIME
AFTER TWO YEARS OF INACCURATE
DATA ARE BEING ABLE TO REPORT --
DATA TIMELY ACCESS DATA BY LINES
OF BUSINESS SO THAT WE CAN
COMPARE ACROSS MEDI CAL
COMMERCIAL AN INDIVIDUAL MARKET.
A WE ENCOURAGE THE DEPARTMENT AS
A DETERMINE AN APPROPRIATE RATE
OF COMPLIANCE THAT THEY CONSIDER
80% AS WELL AS WE'D LIKE TO SEE
pMETHODOLOGY AS WE THINK THAT
DATA IS.
MORE ACCURATE AS IT ACTUALLY --
BOB REPORTS BASED ON FROM --
FROM REQUESTED APPOINTMENT TO
ACTUAL APPOINTMENT AND FINALLY
RELATED --
TO WE LIKE THE DEPARTMENT TO
MOVE TOWARD RETURN BACKTO
LOOKING AT OF COMPLIANCE BY A
PROVIDER GROUP --
AS OUR MEDI CAL MANAGED CARE.
ENROLLEES HAVE REPORTED
DIFFICULTY.
ACCESSING --
PROVIDERS --
THAT MAYBE IN THE HEALTH PLAN
BUT NOT THE PROVIDER GROUP I AM
THAT IS IN ESSENCE --
WHAT IS AVAILABLE TO THEM I AND --
ON ISSUE TO IN FOR IT WE DO
SUPPORT.
THE INCREASED WORKLOAD FOR
SURVEYS AS WELL AS THE MERGERS
AND ACQUISITIONS THANK YOU.
THANK YOU.
WELCOME.
MR CHAIRMAN MEMBERS MARK WINDOWS
WITH US HERE YOU CALIFORNIA JUST
WANNA LANDER SUPPORT FOR ISSUE
NUMBER FOUR THANK YOU.
THANK YOU.
ALL RIGHT SEEN OTHER PEOPLE
MICROPHONE OR ANY FOR THE
QUESTIONS FROM COMMITTEE MEMBERS
NO ALL RIGHT.
WELL I THANK YOU SO MUCH --
DIRECTOR LARD FOR FOR BEING HERE
AND YOUR STAFF AS WELL AS PRE
SHEET TO PRESENT OPEN --
ITEMS TWO THREE AND FOUR UNTIL
AFTER MAY BUT THAT THANK YOU SO
MUCH FOR BEING HERE AND FOR
SHARING WITH US WHAT YOUR
DEPARTMENTS DOING I THINK WE'RE
VERY INTERESTED IN THAT THE
CONTINUING SUCCESS OF YOUR
DEPARTMENTS --
I THINK --
SAID DID YOU PLAY A VERY
CRITICAL ROLE ENSURING THAT THE
PEOPLE CALIFORNIA I GET THE
HEALTH CARE THEY NEED SO THANK
YOU SO MUCH FOR BEING HERE.
THANK YOU OKAY.
ALL RIGHT SO WE ARE GOING TO NOW
MOVE ON TO OUR HEALTH CARE
SERVICES IN THE CALIFORNIA
HEALTH BENEFIT EXCHANGE BETTER
KNOWN AS COVERED CALIFORNIA.
AND SO WE CAN BRING UP THE
PEOPLE.
FOR THIS I THINK SHE DESERVES
WE'RE JUST GONNA HAVE OKAY. TO
TO JUST LOWEST YEAH OKAY SO THE
FROM OKAY THE ACTUAL AN OPEN UP
WITH ACTUALLY PRESENTATION BY
LARA LET'S SEE --
HIS ATTRACTIVE HEALTHCARE
PROGRAM UC BERKELEY LABOR CENTER
WHO HAS A PRESENTATION
[inaudible]
SO [inaudible]
ABNORMAL [inaudible]
OKAY.
SO WE HAVE AN AGENCY THANKS FOR
THIS -- A
REVIEW. FOR OKAY.
OKAY SO WE'RE GONNA START OFF
WITH THE A A PRESENTATION FROM A
ASSOCIATE WHO'S NOT REPRESENT
AGENCY FURS GONNA GIVE US A
OVERVIEW OF A BRIEF PRESENTATION
ON THE CHARACTERISTICS OF THE
REMAINING UNINSURED IN
CALIFORNIA SO GOOD TO SEE YOU
AGAIN WELCOME.
OUR RESEARCH AGAIN.
THAT IS THAT BETTER.
THE A AND A SOME OF WHAT I'LL
PRESENT TODAY IS NEW BUT I WILL
ALSO BE RECAPPING SOME OF OUR
RESEARCH THAT I SHARED WITH YOU
IT EARLIER HEARINGS IN FEBRUARY --
SO I'LL TRY TO BE BRIEF SINCE
SOME OF THIS IS IS A REVIEW --
BUT I AM GOING TO GIVE A BRIEF
OVERVIEW OF WHO --
AND SOME OF THE REASONS.
THAT PEOPLE REMAIN UNANSWERED.
SO IN NOVEMBER ALONG WITH OUR
COLLEAGUES AT UCLA WE PUBLISHED
THE PROJECTIONS OF THE TEENS IN
THE UNINSURED RATE IN CALIFORNIA
OVER TIME.
AS YOU ALL KNOW WE SEEN GREAT
GAINS IN TERMS OF THAT INSURANCE
RATE IN CALIFORNIA UNDER THE
AFFORDABLE CARE ACT --
BUT WE PROJECTS THAT THE
INSURANCE RATE COULD START TO
CREEP BACK UP. 213% AND TWENTY
TWENTY THREE PRIMARILY AS A
RESULT OF THE ACA INDIVIDUAL
MANDATE PENALTY GOING AWAY --
WE PROJECTS THAT THE BIGGEST A
FAX OF NOT HAVING A FEDERAL
PENALTY WILL BE THE INDIVIDUAL
MARKETS.
IN TERMS OF THE SHARE OF
ENROLLMENTS DROP WE'RE LIKELY TO
SEE AND THAT MARKETS.
THE WE PROJECTS THAT BY. 202314%.
FEWER PEOPLE COULD BE ENROLLED
IN THE CALIFORNIA INDIVIDUAL
MARKET AND LEFT THE STATE TAKES
FURTHER ACTION.
AND THAT SOLELY DUE TO THE
ELIMINATION OF THE PENALTY WE
CAN ALSO SEE LOWER MEDI CAL
ENROLLMENTS --
EVEN THOUGH IT PEOPLE WITH MEDIC
HOLLER GENERALLY EXEMPT FROM
PAYING THE FEDERAL PENALTY OR
WHERE EXEMPTS.
THE MANY OF THEM DID NOT KNOW IT --
SERVED AS A MOTIVATION FOR
PEOPLE TO FIND OUT WHAT COVERAGE
THEY ARE ELIGIBLE FOR AND THEN
ROLL AND SOME PEOPLE WHO ARE
ELIGIBLE FOR MEDIC HOW DON'T
REALIZE IT.
AND GO TO COVER CALIFORNIA TO
SHOP FOR COVERAGE AND FIND OUT
THAT THEY CAN ENROLL IN MEDICARE
OUT WITH NO PREMIUMS.
AS THE THE LACK OF A PENALTY.
WOULD WOULD REDUCE THAT
MOTIVATION TO FIND OUT WHAT
THEY'RE ELIGIBLE.
FOR AND THEN AS WE COULD SEE
SOME SMALL CHANGES IN EMPLOYER
SPONSORED INSURANCE BUT THEY'RE
NOT.
AS A SIGNIFICANT CHANGE AS A
SHARE OF OF THE NUMBER OF PEOPLE
IN TOPICS CONFERENCE.
SO COMBINING.
THE FACTS OF THE INDIVIDUAL
MANDATE PENALTY GOING AWAY
FEDERALLY WITH OTHER TRENDS LAKE
POPULATION GROWTH PREMIUM GROWTH.
WE PROJECTS THAT FOUR MILLION
CALIFORNIANS COULD.
BE UNINSURED IN TWENTY TWENTY
GROWING TO FOUR POINT FOUR
MILLION IN.
TWENTY TWENTY THREE AND THE
LARGEST GROUP OF UNINSURED --
WILL CONTINUE TO BE UNDOCUMENTED
CALIFORNIANS --
THE NEXT BIGGEST GROUP WOULD BE
THOSE ELIGIBLE FOR COVERED
CALIFORNIA EITHER WITH OR
WITHOUT SUBSIDIES --
BUT NOT AND ROLES.
THE PEOPLE THE PROJECT TO BE
ELIGIBLE FOR MEDI CAL BUT NOT
AND ROLLED.
AND THEN SAM WHO HAVE AN OFFER
OF EMPLOYER COVERAGE BUT DON'T --
ENROLLED PRIMARILY DUE TO
AFFORDABILITY CONCERNS SO I'M
GONNA TALK VERY BRIEFLY ABOUT --
A FEW OF THESE GROUPS.
SO I AS WE TALKED ABOUT AT THE
THE OF THE FULL COMMITTEE
HEARING IN FEBRUARY.
THE LOW INCOME UNDOCUMENTED OLD
HAVE A PARTICULARLY HIGH AND
INSURANCE RATE. 90% ALMOST --
COMPARED 211% AN INSURANCE RATE
FOR CITIZENS AND DOCUMENTED
CALIFORNIANS OF THE SAME INCOME
LEVEL.
AND THAT'S BECAUSE THEY'RE
EXCLUDED FROM MEDICAID
ELIGIBILITY UNDER FEDERAL POLICY.
THEY'RE EXCLUDED FROM.
ENROLLING IN COVERED CALIFORNIA
EVEN WITHOUT SUBSIDIES THEY
COULDN'T THEY COULD PURCHASE
COVERAGE DIRECTLY FROM AN
INSURER BUT AT THIS INCOME LEVEL --
THAT IS GENERALLY AND AFFORDABLE.
AND EVEN THOUGH THEY MAKE UP
ALMOST 10% OF THE WORKFORCE
UNDOCUMENTED.
WORKERS ARE LESS LIKELY TO BE
OFFERED JOB THIS COVERAGE
BECAUSE OF THE INDUSTRIES AND
OCCUPATIONS AID TEND TO WORK ON
TURNING TO THE THE FORD ABILITY
CHALLENGES.
A IT.
THERE ARE EVEN THOUGH WE'VE MADE
SOME WHAT ABOUT CARE ACT IN
IMPROVING INDIVIDUAL MARKET
AFFORDABILITY THERE ARE STILL
SIGNIFICANT CONCERNS FOR THOSE
EVEN ROLLED AND THOSE WHO ARE
UNINSURED. FOR THOSE WHO ARE
ELIGIBLE FOR A CA SUBSIDIES FOR
THOSE HEARING TOO MUCH AND IT'S
A PROBLEM --
THE PREMIUM SIDE BUT ALSO IN
TERMS OF WHAT PEOPLE PAY OUT OF
POCKET.
AND THE STATUS SPECIFICALLY IS
FROM IT A STUDY BY HARVARD
RESPECT SURVEY BY HARVARD
RESEARCHERS OF CALIFORNIANS WHO
ARE ENROLLED IN THE INDIVIDUAL
MARKET.
AND ROUGHLY FOUR OUT OF TEN THAT
HAD HAVE SOME OR A LOT OF
DIFFICULTY AFFORDING PREMIUMS
AND THEIR SURVEY SHOWS THAT THIS.
LEVEL OF DIFFICULTY IS
RELATIVELY SIMILAR ACROSS INCOME
LEVELS.
OF THE ROUGHLY THREE OUT OF TEN
HAD DIFFICULTY AFFORDING OUT OF
POCKET COSTS WITH A SLIGHTLY
LOWER PERCENTAGE IN THE HIGHER
INCOME GROUPS.
FACING THIS DIFFICULTIES.
THERE IS NOT SIMILAR AT THE DATA
AVAILABLE AT THIS LEVEL OF FOR
THE UNINSURED WHO ARE ELIGIBLE
FOR COVERAGE CALIFORNIA BUT WE
DO KNOW FROM THE CALIFORNIA
HEALTH INTERVIEW SURVEY.
THAT COST AS THE TOP REASON FOR
THAT GROUP TO REPORT LACKING
COVERAGE AND THAT'S TRUE
REGARDLESS OF WHAT.
INCOME LEVEL YOU'RE LOOKING AT
SO TO GIVE TWO EXAMPLES OF THE
AFFORDABILITY CHALLENGES.
AT FIRST IT TAKE A FULL TIME
WORKER IN LA WHO'S EARNING
MINIMUM WAGE OR ABOUT THIRTY
THOUSAND DOLLARS A YEAR BASED ON
THE UPCOMING LA MINIMUM WAGE.
AND THIS IS A SINGLE WORKER NO
KIDS.
HE WOULD PAY TWO HUNDRED DOLLARS
A MONTH FOR PREMIUMS FOR THE
SECOND LOWEST SILVER PLAN WITH
THE TWENTY TWO HUNDRED DOLLAR
DEDUCTIBLE.
A HUNDRED DOLLARS A MONTH --
FOR A BRONZE PLAN WITH A SIXTY
THREE HUNDRED DOLLAR DEDUCTIBLE
OR HE COULD GO WITHOUT INSURANCE
AND DEPENDING ON HOW MUCH HE'S
PAYING FOR THESE.
AMOUNTS THAT COULD BE AN
AFFORDABLE.
A THIS IS AN EXAMPLE HE TALKS
ABOUT AT THE AFFORDABILITY
HEARING IN FEBRUARY.
A MARRIED COUPLE EARNING.
EARNING ABOUT SEVENTY FOUR
THOUSAND DOLLARS BOTH EACH FIFTY
FIVE LIVING IN SAN MATTEO.
BUT THIS COUPLE WOULD FACE SOME
HARD CHOICES A IT.
PAYING THIRTEEN HUNDRED DOLLARS
A MONTH FOR A BRONZE PLAN WHICH
WOULD BE 22% OF THEIR INCOME
BEFORE THEY PAY ANY OUT OF
POCKET COSTS UNDER THE SIXTY
THREE HUNDRED DOLLAR DEDUCTIBLE.
OR IF THEY WANTED TO REDUCE
THEIR OUT OF POCKET RISK TO A
TWENTY FIVE HUNDRED DOLLAR
DEDUCTIBLE IN A SILVER PLAN THEY
WOULD PAID TWO THOUSAND DOLLARS
A MONTH FOR THE SECOND LOWEST
COST SILVER PLAN.
THAT'SALMOST A THIRD OF THEIR
INCOME ON PREMIUMS ALONE.
THE OR THEY COULD GO WITHOUT
INSURANCE AND SAID THESE LAKE
THE THE MINIMUM WAGE WORKER
EXAMPLE --
IN BOTH OF THESE EXAMPLES THEY
WOULD FACE VERY DIFFICULT
CHOICES.
ON TUESDAY WE RELEASED A NEW
BLOG POST ON THE GROUP OF
CALIFORNIANS WHO'S UNINSURED BUT
ELIGIBLE FOR MEDI CAL.
AND THERE THE THESE ARE A FEW
EXAMPLES OF WHY THIS GROUP STILL
EXISTS --
WE'D AND I WANNA START UP A
NOTING THAT WE DO HAVE A TAKE
OPERATE OF MEDI CAL IN THE STATE
OF MORE THAN 90%.
WHICH IS A A GREAT
ACCOMPLISHMENT AND A BIG
IMPROVEMENT FROM PRIOR TO THE
AFFORDABLE CARE ACT'S --
BUT BECAUSE SO MANY PEOPLE ARE
ELIGIBLE FOR MEDIC HOW --
AT A EVEN IF EVEN TAKING UP
MEANS A LOT OF PEOPLE AND ENSURE.
A AND SOME OF THE REASONS FOR
THAT ARE SOME PEOPLE ARE NOT
AWARE THAT THERE ELIGIBLE FOR
MEDI CL OR THAT THEY WOULDN'T
PAY PREMIUMS FOR MEDI CAL.
OTHERS ARE UNINSURED FOR SHORT
PERIODS OF TIME WHEN THEY'RE
BETWEEN JOBS OR GOING TO OTHER
LIFE TRANSITIONS AND THERE'S
DATA FROM THE CALIFORNIA HEALTH
INTERVIEW SURVEY THAT SHOWS.
THAT A SUBSTANTIAL FRACTION OF
THIS GROUP.
DID HAVE SOME KIND OF INSURANCE
FOR PART OF THE YEAR.
AS SOME MAY ENCOUNTER
DIFFICULTIES AND ROLLING OR
RENEWING THEIR COVERAGE AND
OTHERS MAY WORRY ABOUT THE
CONSEQUENCES THAT AND ROLLING
COULD HAVE FOR THEIR OWN
IMMIGRATION STATUS ARE FOR
FAMILY MEMBERS.
THERE IS A RECENT SURVEY BY
CALIFORNIA HEALTHCARE FOUNDATION
AND KAISER FAMILY FOUNDATION
THAT INDICATED THAT 40% OF ALL
AN INSURED.
THE CALIFORNIA ADULTS THAT ALL
INCOME LEVELS AND WE'RE VERY OR
SOMEWHAT WORRIED ABOUT WHAT
SIGNING UP FOR HEALTH INSURANCE
WOULD NEED FOR THEIR FAMILY IN
TERMS OF IMMIGRATION STATUS.
IT'S UNCLEAR WHAT EFFECT THIS
HAS HAD ALREADY ON ON MEDI CAL
ENROLLMENT RATES BUT IT IT WILL
BE EVEN MORE OF A CONCERN IF THE
TRUMP PUBLIC CHARGE PROPOSAL IS
FINALIZED --
LASTLY IN TERMS OF WHO IS
UNINSURED AND ELIGIBLE FOR
MEDICARE I'LL USING THE
CALIFORNIA HEALTH INTERVIEW
SURVEY DATA AND WE LOOK AT THE
DEMOGRAPHICS.
AND AMONG ADULTS IN THIS GROUP
ABOUT TWO THIRDS ARE LATINO.
THE MORE THAN 40% OR IMMIGRANTS.
AND ABOUT TWO THIRDS LIVE IN THE
HOUSEHOLD.
WHERE AND A LANGUAGE OTHER THAN
ENGLISH IS SPOKEN SOLELY OR IN
ADDITION TO ENGLISH?
AND AND THESE TRENDS ARE A
RELATIVE MEDI CAL SO THESE
TRENDS ARE.
NOT SO MUCH A REFLECTION OF OF
WHO'S BEEN.
LEFT OUT BUT A REFLECTION OF WHO
IS ELIGIBLE FOR MEDI CAL IN THE
FIRST PLACE BUT I THINK THE
DEMOGRAPHICS REALLY --
POINT TO THE IMPORTANCE OF
CULTURALLY AND LINGUISTICALLY
APPROPRIATE OUT REACH
[inaudible]
AND THAT'S ALL FOR TODAY I
WELCOME YOUR QUESTIONS I THANK
YOU THANKS VERY MUCH FOR BEING
HERE AND THANK YOU FOR YOUR
PRESENTATION --
ANY COMMENTS FROM LA --
ON THIS NOW FINANCE NO ALL RIGHT
QUESTION CAN YOU MEMBERS.
SO WELL THANK YOU SO MUCH FOR
YOUR PRESENTATION I THINK.
THE I THINK IT'S GIVING US A
GOOD PLATFORM FOR OUR OUR NEXT
DISCUSSIONS WHICH IS ABOUT --
THE OTHER FOUR WD ISSUE WHICH
YOU'VE POINTED OUT --
AND FORTUNATELY --
DO SOME FEDERAL ACTIONS --
ALSO WE'VE HAD LESS MONEY FOR
AFFORDABILITY --
AND THEN OF COURSE THE ISSUE
THEY'LL EXPANSION OF MEDIC HOW
THE GOVERNOR'S PROPOSING YOUNG
ADULTS I THINK THERE'S A BILL
THAT JUST PASSED OUT HEALTH
COMMITTEE.
TO GET TO HAVE.
BEEN EVEN MORE BUT IT BUT ISSUE
I SHE CAME UP IN OUR HEALTH
COMMITTEE WHICH YOU BROUGHT UP
AS WELL AS YOUR PRESENTATION
ABOUT THE THE IMPACT PUBLIC
CHARGE AS WELL SO.
I EVEN IF WE PROVIDE THE
COVERAGE --
PEOPLE MAY NOT TAKE IT OUT
BECAUSE OF OTHER FEARS AND AND
SO.
I NEED TO ALSO THINK ABOUT.
OTHER AVENUES BY WHICH PEOPLE
CAN GET CARE BUT CERTAINLY. FOR
THOSE WHO --
ACTUALLY --
WHO WANT THE COVERAGE RIGHT --
WHO WHO HIT AT THAT --
WE NEED TO HAVE THE OPPORTUNITY
AS WELL AND I THINK --
IT'S DIFFERENT ONE IT'S JUST NOT
THERE I MEAN AND THEN PEOPLE YOU
HAVE A CHOICE WHETHER TO A
CONSIDERABLE CHARTER DOT SO.
APPRECIATE THAT OKAY --
RIGHT SEEN OTHER QUESTIONS I
THINK YOU KNOW IT ALWAYS OF
EXCELLENT PRESENTATION FAIRLY
THOROUGH SO I HOPE YOU DON'T
MIND WE SHOULD STILL HAVE A LOT
OF QUESTIONS AGO DRILL INTO THIS
TIME SO.
ALRIGHT THANK YOU THANKS VERY
MUCH THANK YOU THANK YOU SO MUCH
FOR TAKING TIME TO COME OVER
PRESENT TO US IT'S BEEN BRAVE.
REPORT INFORMATION THANK YOU.
ALL RIGHT SO WHAT WE'RE GONNA DO
NOW IS -- WE
HAVE FLAT --
TWO PANELS --
SO THE FIRST PANELS ON EXPANDING
AFFORDABILITY INDIVIDUAL HEALTH
INSURANCE MARKET VERY IMPORTANT
PROPOSALS THAT THE GOVERNOR'S
MADE AND THE AND AND IS --
JANUARY BUDGET PROPOSALS --
AND ALSO AND LOOKING FORWARD
BECAUSE WE HAVE IN OUR PANELS --
MEMBERS FROM THE PART OF FINANCE
SCHOOL LAB RATE PERHAPS MORE
DETAIL THAN WE'VE GOTTEN IN THE
PAST ABOUT EXACTLY WHAT THE
SPECIFIC THE POLLS WILL BE.
SO WAS THAT THE TWO BIG
PROPOSALS ARE EXPANDING
AFFORDABILITY AND WHERE THAT'S
CA IN START WITH ISSUE TO AND
THEN LATER THE NEXT ONE WILL BE
ISSUE THREE WHICH IS THE FULL
SCOPE MEDICAID EXPANSION FROM
DOCUMENT YOUNG ADULTS SO FOR
THIS PANEL --
WE'RE GONNA HAVE JACOB LAMB
PRINCIPLE PROGRAM BUDGET ANALYST
FOR THE PART OF FINANCE --
ALEXANDER --
KIP CLINIC THEY PRONOUNCE IT
CORRECTLY --
FINANCE BUDGET ANALYST FOR THE
FAR FINANCE --
CAPELLA FOR THAT POLICY OF
GIVING HELD ACCESS SO I
CALIFORNIA AND CHEN FLORI POLICY
ADVOCATE FROM WESTERN CENTER ON
LAW AND POVERTY AND WHY DID JUST
RATTLE OFF THE NAMES WE WILL DO
IS.
SINCE I MAY KNOW ALL OF YOU BUT
NEVER AS MUCH EACH INTRODUCE
YOURSELVES OF PEOPLE ATTACH THE
FACE TO THE NAME.
SO WHEN WE JUST GO START THIS
AND ALCHEMIC DEPARTMENT FINANCE.
TAKEN LAND APARTMENT FINANCE.
THE BELL HEALTHAXIS NOT BE
SHARING MY TIME WITH CLEAR HAAS.
GEN FLOOR WITH WESTERN CENTER ON
LAW AND POVERTY.
KATIE RAVEL COVER CALIFORNIA.
AND JUST FOR THE RECORD IF WE
ALWAYS I RECOGNIZE LA --
I WILL THE FROM THE ELIA OKAY
WELCOME ALL RIGHT SO ONLY BE GO
AHEAD BEGIN WITH A FINANCE --
WITH MISTER LAMB CLINIC WELCOME.
THE I HAVE MY THREE THREE MINUTE
RULE -- CELL
AND THE LEVY WAY OF QUESTIONS
YOU HAVE MORE OPPORTUNITIES TO
COLLABORATE EVEN MORE I'M SURE
TO WILL BE SOME QUESTIONS SO.
I'M SURE ALL MR SURE THANK YOU
FOR HAVING US TODAY TO PRESENT
THE GOVERNOR'S PROPOSAL ON
AFFORDABILITY.
AT FIRST NO BY.
BUT FIRST NOTE THAT WE POSTED
THE TRAILER BILL FOR THIS
PROPOSAL ON A PUBLIC WEBSITE
THIS MORNING AND HAPPEN TO
DISCUSS FURTHER DETAILS WITH
YOUR STAFF.
OF WITH THAT I'D LIKE TO BEGIN
BY SAYING THIS PROPOSAL AIMS TO
MAKE HEALTH INSURANCE MORE
AFFORDABLE AND ACCESSIBLE. FOR
INDIVIDUALS WHO PURCHASE HEALTH
KERR CARE COVERAGE THROUGH COVER
CALIFORNIA.
THIS PROPOSAL CONTAINS TWO MAIN
COMPONENTS FIRST AS THE
INDIVIDUAL MANDATE A NEW STATE
SUBSIDY PROGRAM.
WE BELIEVE THAT THESE TWO
COMPONENTS WILL WORK IN TANDEM
TO INCREASE ACCESS AND
AFFORDABILITY TO HEALTH CARE
COVERAGE.
AND GROW UPON THE SUCCESS OF THE
AFFORDABLE CARE ACT.
REGARDING THE MANDATE WE'VE
MODEL OR PROPOSAL CLOSELY OFFER
THE FEDERAL LAW.
THE MANDATE WOULD BE
ADMINISTERED BY THE FRANCHISE
TAX BOARD IN PARTNERSHIP WITH
THE CALIFORNIA WITH COVER
CALIFORNIA.
AND THE DEPARTMENT OF MANAGED
HEALTHCARE.
THE PENALTY WOULD BE SCALABLE
BASED ON INCOME AND FAMILY SIZE.
AND MAINTAIN THE FEDERAL
EXEMPTIONS AS CODIFIED TODAY OUR
PROPOSAL WOULD ALSO JUST
AUTOMATICALLY IF THE FEDERAL
GOVERNMENT WERE TO REINSTATE THE
FEDERAL PENALTY --
BASED ON DISCUSSIONS AND
FEEDBACK WE'VE HAD WITH
STAKEHOLDERS AND COMMITTEE STAFF
WE ARE.
PROPOSING TO DEPOSIT ANY PENALTY
REVENUE DIRECTLY INTO THE
GENERAL FUND.
NEXT IS THE STATE'S SUBSIDY
PROGRAM.
OUR PROPOSAL WOULD OFFER STATES
LEVEL SUBSIDIES TO INDIVIDUALS
WITH INCOMES BETWEEN TWO HUNDRED
FIFTY AND 60% OF THE FEDERAL
POVERTY LEVEL FOR A FAMILY FOR
THIS WOULD BE. 620-002-0050.
THOUSAND THIS WOULD MAKE
CALIFORNIA FIRST STATE IN THE
NATION TO PROVIDE STATE LEVEL
SUBSIDIES THE AND TO MIDDLE
INCOME CONSUMERS.
SPECIFICALLY THE PROPOSED
PROGRAM WOULD BE SUBJECT TO AN
ANNUAL GENERAL FUND
APPROPRIATION BEEN MISTER BY
COVERED CALIFORNIA.
PROVIDE ADVANCED PREMIUM
ASSISTANCE AND SUNSET DECEMBER
THIRTY FIRST.
TWENTY TWENTY TWO BASED ON
APPROPRIATE FUNDS COVER
CALIFORNIA WOULD DESIGN A
SUBSIDY PROGRAM ON ANNUAL BASIS.
FOR THE ANNUAL OPEN ENROLLMENT.
PERIOD THE FINAL SONG OF PROGRAM
DESIGN WOULD BE SUBJECT TO
ADMINISTRATIVE AND LEGISLATIVE
APPROVAL.
CONSUMERS WILL RECEIVE THEIR
ESTIMATES SUBSIDY AMOUNT WHEN
THEY ENROLL FOR COVERAGE FOR
THAT COVERAGE HERE.
AND AGAIN THIS PROCESS IS
SUBSTANTIVELY SIMILAR TO WHAT IS
CURRENTLY IN PLACE AT THE
FEDERAL LEVEL.
SO I'LL NOTE A FEW KEY DESIGN
CHOICES WE MADE WHEN DESIGNING
THIS PROPOSAL.
FIRST I'LL NOTE AGAIN THAT THIS
VERY CLOSELY MON MIR'S THE
FEDERAL FRAMEWORK THAT'S IN
PLACE THIS WAS --
Q. DESIGN CHOICE AND THAT IT
WILL ALLOW FOLKS TO BE MORE
FAMILIAR WITH WHAT'S CURRENTLY
IN PLACE AND BUILD UPON.
WHAT IS ALREADY BEEN?
PIONEERED BY THE AFFORDABLE CARE
ACT.
NEXT IS THE INTEL ON THE
ADMINISTRATION THAT ANY SUBSIDY
AMOUNT APPROPRIATE ON ANNUAL
BASIS CLOSELY NEARS THE REVENUE
THAT WE GENERATE FROM THE
PENALTY.
IN PLACE.
WE HAD PREVIOUSLY SHARED
ESTIMATES OF ABOUT FIVE HUNDRED
MILLION DOLLARS ON AN ANNUAL
BASIS BASED OFF.
INFORMATION FROM THE IRS FOR TAX
YOUR TWENTY SIXTEEN FROM THE
FEDERAL PENALTY.
WE'LL UPDATE THIS REVENUE
ESTIMATE AT ME REVISION ENSURE
DETAILS AT THAT TIME HOWEVER WE
WILL NOTE THAT.
THE CALIFORNIA FILING THRESHOLD
IS HIGHER THAN THE FEDERAL
FILING THRESHOLD SO FEWER PEOPLE
WILL BE SUBJECT TO THE PENALTY --
NEXT WOULD LIKE TO KNOW THAT
THIS WILL NOT BE A NEW
ENTITLEMENT PROGRAM HOWEVER WE
ACKNOWLEDGE THAT AROUND US MS
MAY VERY SIGNIFICANTLY ON A YEAR
TO YEAR BASIS.
IT'S NOT OUR INTENT THAT FOLKS
TO RECEIVE A GET A DIFFERENT
AMOUNT.
ONCE OF REVENUE AMOUNT COMES IN
BUT ON A SUBSEQUENT YEAR THE NOT
APPROPRIATE FOR THAT PROGRAM MAY
DECREASE OR INCREASE WHICH WILL
CHANGE THEMSELVES IN OUT FOR
THOSE INDIVIDUALS.
I'LL ALSO NOTE THAT WE DO NOT
INTEND THE SUBSIDIES PROVIDE TO
FOLKS BELOW 210050% OF THE
FEDERAL POVERTY LEVEL TO BE
HIGHER THAN INDIVIDUALS ABOUT
210050% OF THE FEDERAL POVERTY
LEVEL.
AND AFFECT OUR PROPOSAL WOULD.
SLOW THE DECLINE THAT IS
CURRENTLY SEEN ON THE FEDERAL
MARKETPLACE FOR THE SUBSIDIES
RECEIVED BY THESE INDIVIDUALS.
AND I WOULD JUST LIKE TO NOTE
OUR PROPOSAL TO SUNSET THE
SUBSIDY PROGRAM ON DECEMBER
THIRTY FIRST.
TWENTY TWENTY TWO AS KNOWN BY
THE GOVERNOR WHILE THIS PROPOSAL
WOULD MAINTAIN MARKET STABILITY.
THE GOVERNOR HAS CALLED ON THE
FEDERAL GOVERNMENT TO OF ALL THE
FORMAL CHARACTER ENSURE
CONTINUES TO MEET THE NEEDS OF
ALL AMERICANS.
WITHOUT FEDERAL SUPPORT
CALIFORNIAN OTHER STATES ARE
SEVERELY LIMITED IN THEIR
ABILITY TO FULLY ADDRESS THE
REMAINING AFFORDABILITY
CHALLENGES IN THE INDIVIDUAL
MARKET.
SOMETHING THIS PROGRAM AFTER
THREE COVERAGE YEARS WILL
PROVIDE THE FEDERAL GOVERNMENT
TIME TO REVISIT AND ADDRESS THE
AFFORDABILITY CHALLENGES FOR ALL
AMERICANS.
AND THE LAST THING ON NOTE IS
OUR PROPOSAL WILL ALLOW DATA
SHARING BETWEEN THE FRANCHISE
TAX BOARD AND COVER CALIFORNIA'S
THAT COVER CALIFORNIA CAN TARGET.
ENROLLMENT EFFORTS FOR FOLKS WHO
ARE UNINSURED AND PAYING THE
PENALTY.
AND WITH THAT WERE HAPPY TO TAKE
ANY QUESTIONS.
THE QUESTIONS AT THE END OF THE
PANEL BUT THANK YOU.
THEM NO OKAY SEE SERVE BREAK
NICK DID IT AT ALL OKAY.
ALL RIGHT WELL THANK YOU TO
REBEL.
WELL THANK YOU THE MORNING THANK
YOU MISTER CHAIRMAN MEMBERS FOR
THE OPPORTUNITY TO PARTICIPATE
IN TODAY'S HEARING.
THE AFFORDABLE CARE ACT PROVIDED
A STRONG FOUNDATION FOR A STABLE
INDIVIDUAL MARKET THROUGH A
COMBINATION OF MARKET REFORMS AN
INDIVIDUAL MANDATE.
SUBSIDIES TO MAKE PREMIUMS AN
OUT OF POCKET COSTS MORE
AFFORDABLE AND PROGRAMS TO
BALANCE RISK BETWEEN HEALTH
PLANS.
SINCE TWENTY FOURTEEN
CALIFORNIA'S MADE REMARKS
CORRECT IN REDUCING THE RATE OF
THE UNINSURED BUT DESPITE THESE
GAINS AFFORDABILITY OF COVERAGE
REMAINS A VERY REAL CHALLENGE
FOR CALIFORNIANS.
AND ACROSS THE NATION AND RECENT
FEDERAL POLICY ACTIONS THREATEN
TO TAKE US BACKWARDS MISS LUCY A
PROVIDED AN EXCELLENT OVERVIEW
OF THESE CHALLENGES AND HER
PRESENTATION.
PURSUANT TO OUR LEGISLATIVE
MANDATE COVER CALIFORNIA
DEVELOPED AND SUBMITTED A SET OF
POLICY OPTIONS TO THE
LEGISLATURE GOVERNOR.
AND THE COUNCIL ON HEALTH CARE
DELIVERY SYSTEMS TO ADDRESS
THESE CHALLENGES AND IMPROVE
PORTABILITY FOR LOW AND MIDDLE
INCOME CONSUMERS.
IS OPTIONS WERE DEVELOPED
THROUGH A COLLABORATIVE PROCESS
WITH THE STAKEHOLDER WORK GROUP
COMPRISED OF CONSUMER ADVOCATES
HEALTH PLANS PROVIDERS
ASSOCIATIONS AND LEGISLATIVE
STAFF.
AND WE WERE ASSISTED IN MODELING
BY ECONOMIST DR WESLEY ANY UCLA
AND DOCTOR NECKLACE TELL MEN AT
THE UNIVERSITY OF ILLINOIS.
OUR WORK GROUP CONSIDERED A
VARIETY OF OPTIONS BUILDING ON
THE TOOLS OF THE AFFORDABLE CARE
ACT NAMELY PREMIUM CARSHARING
SUPPORT AN INDIVIDUAL MANDATE
AND REINSURANCE.
WE PROVIDE OPTIONS UNDER TWO
DIFFERENT APPROACHES UNDER THE
FIRST APPROACH WE MODELED
ENHANCE PREMIUM AND COST SHARING
SUPPORT.
THAT WOULD PROVIDE --
ENHANCE SUPPORT TO INDIVIDUALS
WHO ARE ELIGIBLE TODAY AND WOOD
LAMINATE THE TAX CREDIT CLIFF
WITHIN LAYERED ON AN INDIVIDUAL
MANDATE AND PENALTY AND THEN
FINALLY WE LAYERED ON
REINSURANCE.
THESE OPTIONS WERE DESIGNED TO
BUILD ON EACH OTHER.
AND TO INCREASE AFFORDABILITY
FOR EVERYONE PURCHASING COVERAGE
IN THE INDIVIDUAL MARKET --
I WOULD NOTE THAT THE FIRST TWO
OPTIONS CAN BE ADOPTED BY THE
STATE IN THE THIRD WOULD REQUIRE
WORK WITH THE FEDERAL GOVERNMENT
THROUGH A WAIVER.
AND APPROACH TO WE DEVELOPED A
SERIES OF DISCRETE OPTIONS
TARGETED TO SPECIFIC INCOME
GROUPS AND WE DID THIS OUT OF
RECOMMEND RECOGNITION THE POLICY
MAKERS WOULD NEED TO MAKE TRADE
OFFS DUE TO BUDGET CONSTRAINTS.
OF THE GROUPS WE FOCUSED ON
WHERE INDIVIDUALS UNDER 4100%
INDIVIDUALS UNDER 6100% IN
RECOGNITION OF OUR CHARGE UNDER
THE STATUTE.
INDIVIDUALS ABOVE 4100% AND THEN
WE ELATION.
MOST OF THESE OPTIONS ARE
PROJECTED TO COST LESS THAN FIVE
HUNDRED MILLION EACH YEAR OR IN
THE FIRST YEAR.
SOMEWHERE BETWEEN FIFTY THOUSAND
AND A HUNDRED TWENTY FIVE
THOUSAND LIKE ALL OF THE OPTIONS
THEY WOULD ALSO REDUCE COSTS FOR
INDIVIDUALS PURCHASING TODAY.
THE STAFF ANALYSIS DOESN'T
EXCELLENT JOB SUMMARIZING THE
IMPACTS OF THE OPTIONS IN DETAIL.
TO RATHER THAN RECEIVING THEM
AND IN THE INTEREST OF TIME ALL
CLOSE WITH SOME HIGH LEVEL TAKE
AWAYS FROM OUR WORK.
REINSTATEMENT OF THE INDIVIDUAL
MANDATE PENALTYDOES HAVE A
SIGNIFICANT IMPACT WHEN PAIRED
WITH POLICIES THAT MAKE PLANS
MORE AFFORDABLE.
IN ADDITION TO GENERATING
OFFSETTING REVENUE AND INDUCES A
SIGNIFICANT AMOUNT OF NEW
ENROLLMENT WHICH IN TURN CAN
HAVE POSITIVE IMPACTS ON
PREMIUMS.
IT ALSO INDUCES MORE FEDERAL
FUNDING FOR INDIVIDUALS UNDER
4100% OF THE FEDERAL POVERTY
LEVEL.
WHO NEWLY SIGN UP AND GAIN NOT
JUST NEW STATE TAX CREDITS BUT
FEDERAL TAX CREDITS THAT ARE
AVAILABLE TODAY?
AS WE KNOW PREMIUMS AND COST
SHARING SUBSIDIES MAKE COVERAGE
MORE AFFORDABLE AND CREATE
SIGNIFICANT GAINS AND ENROLLMENT.
POLICIES THAT ADDRESS THE TAX
CREDIT CLIFF WOULD HELP PEOPLE
ABOVE 4100% OF THE FEDERAL
POVERTY LEVEL WITH BUYING
INSURANCE FOR THE FIRST TIME.
A THE IMPACT OF THIS POLICIES
PARTICULARLY STRIKING FOR
INDIVIDUALS AND HIGH COST
REGION'S WHO ARE APPROACHING
MEDICARE ELIGIBILITY AND WE
HEARD THAT MISS LUCY IS
PRESENTATION. FOR THOSE UNDER
4100% OF THE FEDERAL POVERTY
LEVEL BIGGER SUBSIDIES DO MATTER
AND GENERATE SIGNIFICANT NEW
ENROLLMENT.
AS EXPECTED ARE MODELING SHOWS
THAT BY PROVIDING PREMIUM
SUBSIDIES YOU WOULD HAVE MORE OF
AN INCREASE IN ENROLLMENT AND
COST SHARING SUBSIDIES.
BUT COST SHARING SUBSIDIES TO
ALLOW PEOPLE TO MY MORE GENEROUS
COVERAGE.
WITH THAT I WILL CLOSE WE HOPE
THESE OPTIONS ARE HELPFUL TO
INFORM THE DISCUSSIONS AND WE
STAND READY TO WORK WITH YOU AND
THE ADMINISTRATION.
THANK YOU VERY MUCH WELL.
HI MY NAME IS CLAIRE HAAS --
I LIVE IN OAKLAND.
SO BEFORE THE ACA WENT INTO
FACTS I A NEEDED TO HAVE A JOB
THAT GAVE ME HEALTH CARE I HAVE
MITRAL VALVE PROLAPSE WHICH IS A
WOMAN.
THAT DOESN'T DO ANY THE HOMES TO
ME -- BUT IT
IS A PRE EXISTING CONDITION UPON
WHICH I WAS DENIED COVERAGE AS A
YOUNG ADULT SO ONCE THE ACA WAS
PASSED THAT ALLOWED ME TO HAVE
SOME OPTIONS ON THE LAST YEAR I
LEFT MY JOB --
AND STARTED MY OWN BUSINESS
WHICH IS SOMETHING I'VE JUMPED
OF DOING FOR A LONG TIME --
AND I KNEW THAT COVER CALIFORNIA
WOULD GIVE ME THE HEALTH CARE
THAT I NEEDED.
MY HUSBAND IS AN ADJUNCT
PROFESSOR HE RECENTLY GOT HIS
PHD FROM UC BERKELEY AND HE WAS
ABLE TO FIND A TEACHING JOB BUT
AS AN ADJUNCT AND IF YOU KNOW
ABOUT ADDS ON JOBS.
THEY DON'T PAY VERY WELL AND
THEY DEFINITELY DO SO THAT MEANS
WERE BOTH ON THE EXCHANGE --
IF WE WANT MARY.
BOTH OF US INDIVIDUALLY WOULD
COVER QUALIFY FOR SUBSIDIES IN
THE STATE OF CALIFORNIA.
BUT BECAUSE WE'RE MARRIED OUR
JOINT GROSS INCOME IS JUST OVER
ABOUT SIXTY FIVE THOUSAND DOLLAR
LIMIT.
AND SO WE DON'T QUALIFY FOR ANY
SUBSIDY ONE OF THOSE FAMILIES
THAT'S FACING THOSE DIFFICULT
THE CHOICE.
AND THE RATES KEEP GOING UP --
I ACTUALLY ENROLLED IN COBRA
BECAUSE IT WAS A BETTER VALUE
COSTS THEN THE EXCHANGE FOR ME --
AND MY PARTNER IS ON THE LOWEST
COVERED CALIFORNIA PLAN SO WE
HOPE WE DON'T HAVE TO USE IT
BECAUSE THE OUT OF POCKET COSTS
ARE REALLY HIGH --
TOGETHER WE PAY ABOUT NINE
HUNDRED DOLLARS A MONTH IN
INSURANCE PREMIUMS WHICH COMES
OUT TO TEN THOUSAND DOLLARS A
YEAR.
ON IT'S ABOUT 15% OF OUR INCOME
AND THAT'S JUST FOR PREMIUMS
IT'S NOT ACTUALLY FOR THE HEALTH
CARE ITSELF IT'S JUST PAYING.
THE INSURANCE COMPANY SO THAT
THEY CAN MAKE A PROFIT --
WE OFTEN TALK ABOUT JOINING THAT
ESTIMATED 13% IN THE
PRESENTATION IN A COUPLE YEARS
OF NOT BEING INSURED WE OFTEN
TALK ABOUT TO STOPPING PAYING --
ANY PENALTY THAT WOULD EXIST
WOULD BE FAR LESS THAN THE TEN
THOUSAND DOLLARS WE'RE PAYING
NOW -- BUT
IN ADDITION TO THAT WE OFTEN
TALK ABOUT GETTING DIVORCED SO
THAT WE CAN GET SUBSIDIES TO PAY
FOR A HEALTHCARE --
WE TALK ABOUT THAT LIKE EVERY
MONTH WHEN WE PAY THE BILL.
HEALTHCARE IS A GREAT AND IT
SHOULD BE FREE AND IT SHOULD BE
QUALITY AND IF IT CAN'T BE FREE
AT LEAST NEEDS TO BE AFFORDABLE --
AND SO I'M HERE TAKING THE DAY
OFF -- BEING
HER TO TALK TO ENSURE THE STORY
IMPLEMENT THESE MEASURES TO MAKE
HEALTHCARE MORE AFFORDABLE AND
WHEN YOU DO IT DON'T WAIT UNTIL
THE NEXT OPEN ENROLLMENT.
PERIOD I'M PAYING NINE HUNDRED
DOLLARS EVERY MONTH I WOULD URGE
YOU TO DO IT NOW [inaudible]
THANK YOU [inaudible]
AS FOR THANK YOU MISTER CHAIRMAN
COMMITTEE FOR THE OPPORTUNITY TO
PRESENT THIS MORNING OF CHEN
FLORI WITH WESTERN CENTER ON LAW
AND POVERTY.
WE DO APPRECIATE THE GOVERNOR'S
ATTENTION TO MAKING HEALTH
COVERAGE MORE AFFORDABLE FOR
THOSE WHO PURCHASED IT DIRECTLY
AND COVER CALIFORNIA'S WORK ON
MODELING THE DIFFERENT
AFFORDABILITY MODELS.
WE ARE CONCERNED WITH THE
ADMINISTRATION'S CURRENT
PROPOSAL THAT IT DOESN'T CONTAIN
ADDITIONAL ASSISTANCE FOR PEOPLE
BELOW 210050% OF THE FEDERAL
POVERTY LEVEL.
WE HAVE A GROUP OF PEOPLE BELOW
ONE HUNDRED AND 38% OF THE
FEDERAL POVERTY LEVEL WHO CANNOT
AFFORD TO PAY ANYTHING FOR THEIR
HEALTH COVERAGE.
MANY OF THESE ARE INDIVIDUALS
WHO EARN LESS THAN FOURTEEN
HUNDRED DOLLARS A MONTH ONCE
FOOD RENT AND UTILITIES ARE PAID
FOR THERE'S SIMPLY NOTHING LEFT
TO PAY FOR HEALTHCARE.
THE MAJORITY OF THESE ARE PEOPLE
WHO WOULD BE ELIGIBLE FOR
MEDICARE --
BUT THEY HAVE A TEMPORARY
IMMIGRATION STATUS AND A VERY
SMALL AMOUNT OUR SENIORS WHO
FIND THEMSELVES NEITHER ELIGIBLE
FOR MEDICARE NOR MEDI CAL DUE TO
VARIOUS PROGRAM RULES.
HOWEVER BECAUSE THESE PEOPLE
ALREADY A ELIGIBLE FOR LARGE
FEDERAL SUBSIDIES THEY'RE ALSO
THE CHEAPEST TO HELP. FOR THOSE
EARNING JUST ABOVE 138% MOVING
FROM MEDICAID TO COVER
CALIFORNIA CAN FEEL LIKE FALLING
OFF A CLIFF.
THEY GO FROM BEING ELIGIBLE FOR
FREE CARE TO HAVING MONTHLY
PREMIUMS AND OUT OF POCKET COSTS
WHEN THEY ACCESS CARE YET
THEY'RE STILL STRUGGLING TO PAY
RENT AND PUT FOOD ON THE TABLE.
AND THEN FINALLY THERE'S ANOTHER
CLIFF WHEN THE OUT OF POCKET
ASSISTANCE RUNS OUT BESIDES THE
ONE THAT CLEAR JUST MENTIONED --
WHICH IS NOT IT TOO IT 50% WHEN
IT OFFICIALLY RUNS OUT BUT AT
2100% WHEN IT FUNCTIONALLY RUNS
OUT GIVEN THE ASSISTANCE
AVAILABLE --
IN OTHER WORDS THE WAY THE
ASSISTANCE IS METED OUT ITS
THERE'S YOU EITHER GET THAT PLAN
WAS 70% ACTUARIAL VALUE OR 73%
ACTUAR VALUE AND THERE'S VERY
LITTLE DIFFERENCE BETWEEN THEIR
SUDDENLY THE INDIVIDUAL OUT OF
POCKET MAXIMUM MORE THAN DOUBLES
FROM TWENTY SIX HUNDRED A YEAR
TO SIXTY THREE HUNDRED A YEAR.
AND THE INDIVIDUAL DOCTOR VISITS
RANGE FROM THIRTY FIVE TO
SEVENTY FIVE DOLLARS AND THAT'S
JUST FIVE DOLLARS THIS.
LESSON FOR PEOPLE WHO DON'T HAVE
ANY OUT OF I'D LIKE TO EMPHASIZE
THE SIDE THAT MISS LUCY AT
SHARED PREVIOUSLY ON THE
DIFFICULTY INDIVIDUAL MARKET AND
RELEASE REPORT IN AFFORDING
PREMIUMS AND OUT OF POCKET COSTS.
PEOPLE EARNING LESS THAN 250%
REPORT THE SAME DIFFICULTY IN
AFFORDING PREMIUMS ARE USING
THEIR CARE DESPITE ALL THE EXTRA
SYSTEMS THAT'S AVAILABLE BECAUSE
THEY SIMPLY HAVE LESS MONEY.
PARTICULARLY IF WE ARE PLANNING
ON REINSTATING THE INDIVIDUAL
MANDATE WE CANNOT IGNORE THE
AFFORDABILITY CHALLENGES THAT
THESE GROUPS SPACE [inaudible]
THANK YOU.
ALCATEL BUT JUST YET.
THANK YOU MISTER CHAIR FOR THE
OPPORTUNITY TO TALK TODAY --
WE APPRECIATE THE GOVERNOR'S
PROPOSAL AND THE WORKER COVER
CALIFORNIA I THINK WHEN YOU.
REVIEW ISSUE HAVING NOW AND
SEVERAL HEARINGS THE WORK BUT
COVER CALIFORNIA TO REALLY MOVED
THE NEEDLE ON THE UNINSURED TO
CUT THE UNINSURED IN HALF.
WE NEED TO LOOK OVER THE NEXT
FEW YEARS OF THE PROPOSAL MUCH
BIGGER THAN THE ONE THE
ADMINISTRATION HAS PRESENTED TO
US TODAY.
WE NEED TO BE IN A PLACE WHERE
NOBODY'S PAYING THIRTY OR 40% OF
THEIR INCOME FOR COVERAGES MISS
LUCY A PRESENTED OR 15% OF THEIR
INCOME IS.
MISS HAAS PRESENTED WE WANT TO
ELIMINATE THE CLIFFS YOU JUST
HEARD ABOUT WE WANT TO HELP
PEOPLE UP AND DOWN THE INCOME
SCALE.
AND STARTING WITH THOSE
INDIVIDUALS UNDER A 138% OF
POVERTY THE MISS FLORI JUST
TALKED ABOUT.
WE DO APPRECIATE THE TBL WITH
THAT WE RECEIVED AT NINE TWENTY
FIVE THIS MORNING AND WE'LL LOOK
FORWARD TO REVIEWING IT --
WHEN WE HAVE A TOUCH MORE TIME?
WE REALIZE THAT WE MAY NOT
ACHIEVE ALL OF WHAT WE HOPE TO
ACHIEVE IN TERMS OF APPROVING
AFFORDABILITY IN CUTTING THE
NUMBER OF REMAINING AN UNINSURED
IN HALF THIS YEAR.
AND WE LOOK FORWARD TO IMPROVING
THE GOVERNOR'S PROPOSAL --
THE LIMITATIONS OF THE PENALTY
REVENUE ON A YEAR TO YEAR BASIS
I KNOW MISTER CHAIR AS YOU KNOW
AND HAVE DISCUSSED.
IDEALLY THE PENALTY REVENUE LIKE
THE TOBACCO TAX WOULD BE --
ZERO BECAUSE EVERYBODY WOULD
HAVE AFFORDABLE CARE.
AND SO WE LOOK FORWARD TO
WORKING WITH YOU IN THIS
COMMITTEE AS WE MOVE FORWARD TO
IMPROVE ON THE GOVERNOR'S
PROPOSAL AND ALSO OVER THE NEXT
SEVERAL YEARS TO GET TO A PLACE
WHERE WE ARE AT UNIVERSAL
COVERAGE.
AND COVERAGE IN THE AFFORDABLE
IN THE INDIVIDUAL MARKET IS NOT
CAUSING PEOPLE TO GO WITHOUT
FOOD OR RENT MONEY THANK YOU
[inaudible]
THANK YOU.
ALL RIGHT --
QUESTIONS FROM COMMITTEE MEMBERS --
CENTER STONE.
THE FUTURE --
TO THE DEPARTMENT OF FINANCE
THANK YOU FOR YOUR REPORT.
AND I'M --
BUT CAN I JUST PAUSE FOR ONE
MOMENT -- TO
ANY COMES FROM ALEJO.
YES THANK YOU MISTER CHAIR JUST
BRIEFLY --
OUR OFFICE RELEASED A REPORT
WITH PRELIMINARY COMMENTS ON THE
GOVERNOR'S PROPOSALS RELATED TO
THE INDIVIDUAL MANDATE AND
INSURANCE SUBSIDIES EARLIER IN
FEBRUARY AND WE PRESENTED OUR
COMMENTS FROM THAT REPORT AT THE
PREVIOUS --
JOINT HEARING THAT THIS
COMMITTEE PARTICIPATED IN --
I'M HAPPY TO GO THROUGH THIS
AGAIN IN YOUR DIRECTION BUT
WANTED TO FOCUS ON A FEW
COMMENTS --
WE RECEIVED AS WAS MENTIONED
EARLIER THIS MORNING A COPY OF
THE TRAILER BILL WHICH HAS SOME
MORE DETAILS ABOUT THE PROPOSAL
WE'RE STILL REVIEWING THAT --
BUT WANT TO HIGHLIGHT A COUPLE
OF THINGS THAT WE WILL BE
LOOKING AT AND THINK WE'LL BE
DECISION POINTS FOR THE
LEGISLATURE TO PAY ATTENTION --
TO ONE IS THE EXTENT TO WHICH
THE LEGISLATURE WILL HAVE
INVOLVEMENT IN --
CRAFTING THE PARAMETERS OF THE
THE FINAL --
DECISION IN SOME WAYS WOULD BE
WITH --
COVER CALIFORNIA IS AN
ADMINISTRATIVE --
DECISION BUT THEY'RE STILL OTHER
OPPORTUNITIES THERE --
FOR THE LEGISLATURE TO
CONTRIBUTE ITS THOUGHTS IN TERMS
OF THE WHERE TO PUT THE FUNDING
AND ANOTHER PARAMETER SO WE'LL
BE LOOKING TO TO SEE THE EXTENT
TO WHICH LEGISLATURE HAS
APPROPRIATE --
INVOLVEMENT ON THAT --
ANOTHER ISSUE THAT THAT THE
LEGISLATURE MAY WANT TO PAY
SPECIAL ATTENTION TO IS THE
EXTENT TO WHICH THE ASSISTANCE
MIGHT VARY FROM YEAR TO YEAR AND
HOW MUCH UNCERTAINTY THAT COULD
INTRODUCE FOR CONSUMERS THAT
RECEIVE IT --
LASTLY -- IT
APPEARS THAT THE CREDITS AT THE
SUB THESE WOULD BE STRUCTURED
SIMILAR TO THE A. P. T. C. WHERE
THEIR RECONCILED THROUGH THE
INCOME TAX SYSTEM AT THE END OF
THE YEAR.
AND WE NOTED OUR EARLIER --
OTHER STATES LIKE --
MASSACHUSETTS AND OTHER STATES
THAT HAVE A SUB THESE LIKE THIS
DON'T ACTUALLY TRIP THEIR
CREDITS THEY'RE NOT ACTUALLY
CREDITS THIS JUST ASSISTANCE IS
PROVIDED. TO INSURANCE COMPANIES
IN THEIR TRADE UP THROUGH THE
YEAR -- WITH
THE INSURANCE COMPANIES BUT
THERE IS NO INCOME TAX INVOLVED
AND SO.
THE LEGISLATURE MIGHT WANT TO
ASK THE ADMINISTRATION FOR MORE
COMMENTARY ON THE BENEFITS AND
DRAWBACKS OF THAT SORT OF AN
APPROACH --
AS AS THAT'S CERTAINLY SOMETHING
NAY I THINK THEY WOULD LOOK AT
AS THEY DEVELOP THEIR PROPOSAL.
OKAY THANK YOU.
I ASSUME FINANCE PRESENTED
THERE'S NO ADDITIONAL COMMENTS.
AT THIS POINT OKAY CENTER SO I
APOLOGIZE --
NOT A PROBLEM --
WITH REGARD TO THE TRAILER BILL
LANGUAGE CHU REVEALED --
TODAY --
IT'S GOING TO GENERATE ABOUT
FIVE HUNDRED MILLION DOLLARS
WHAT THE ESTIMATE HAS BEEN BASED
ON FEDERAL --
EXAMINATIONS --
THE THE THE BIGGEST CONCERN I
HAVE IS HOW WHY IS IT BEING
DEPOSITED INTO THE GENERAL FUND
I THOUGHT THE PURPOSE OF THE THE
INDIVIDUAL MANDATE WAS TO NUMBER
ONE GET PEOPLE TO BUY INSURANCE
TO EQUALIZE THE POOL.
AND TO PROVIDE FOR SUBSIDIES AND
AND I REALLY APPRECIATE --
THE YOUNG LADY FOR COMING AND
SPEAKING AND EXPLAINING YOUR
PLIGHT.
HI I HOPE YOU DON'T GET DIVORCED
BECAUSE OF OF THE STATE'S --
COVER CALIFORNIA PROGRAM YOUR
MESSAGE HAS BEEN HEARD LOUD AND
CLEAR -- MY
CONCERN IS THAT --
YOU KNOW THE GENERAL FUND YOU'RE
YOU'RE BASICALLY PUTTING IN THE
FREE FOR ALL ACCOUNT YOU KNOW
THERE'S A LOT OF A LOT OF ASKS
IN A LOT OF NEEDS OF THE STATE
AND EVERYBODY'S GONNA HAVE THEIR
HAND IN THAT.
IN A GENERAL FUND --
ESPECIALLY AFTER THE MAY REVISE
AS WE GET CLOSER TO THE
CONSUMMATION OF A BUDGET AND I
THINK IT WOULD MAKE THE
GOVERNOR'S ARGUMENT FOR
IMPLEMENTING AN INDIVIDUAL
MANDATE --
MAYBE MORE PALATABLE TO PEOPLE
MIGHT FIND IT UNPALATABLE --
WHEN HE DISCOVERS SHE'S GOING
INTO THE GENERAL FUND WHICH
MEANS BASICALLY CAN BE USED FOR
ANYTHING?
SO THAT'S THAT'S THE FIRST
QUESTION THE SECOND QUESTION IS --
DEPENDING ON THE REVENUE STREAM
THAT COMES FROM ALL OF THIS IS A
ARE ARE WE SEEING AND MAYBE --
OTHERS CAN ANSWER THIS QUESTION
IS A SUBSIDY IS AT THE SAME
EVERY YEAR OR IS IT VARYING
EVERY YEAR SO WHEN YOU'RE
GETTING A SUBSIDY YOU DON'T KNOW
FROM YEAR TO YEAR WHETHER OR NOT
IT'S GOING TO BE MORE AFFORDABLE
OR LESS AFFORDABLE FROM YEAR TO
YEAR LIKELY --
Là BUT MORE ABOUT THAT.
BALL ADDRESSED THE GENERAL FUND
QUESTION I THINK FROM OUR
PERSPECTIVE THE PENALTY AND SO
THE PROGRAM WOULD BOTH BEGIN
JANUARY FIRST --
TWENTY TWENTY WE'RE RECOMMENDING
DEPOSITED DEPOSITING IT INTO THE
GENERAL FUND BECAUSE IT WILL BE
ADMINISTRATIVELY SIMPLER.
TO HAVE THE PENALTY REVENUE FALL
INTO THE GENERAL FUND AND PAID
OUT OF THE GENERAL FUND BECAUSE
WE WILL NOT HAVE THE ACTUAL
REVENUE AMOUNTS UNTIL APRIL
TWENTY FIRST OF APRIL OF THE
TWENTY TWENTY TAX YEAR.
AND SO I THINK IN ORDER BEGIN
THE SUBSIDY PROGRAM IT MADE MORE
SENSE.
TO BEGIN IMMEDIATELY PAYING IT
ALL THE GENERAL FUND BUT WE'RE
HAPPY TO CONSIDER COMMENTS FROM
THE COMMITTEE.
BY RAP PRETTY SURE THAT I KNOW
AND I HOPE YOU'LL CONSIDER --
WORKING OUT WITH --
COVER CALIFORNIA AND DEPOSIT
INTO AN ACCOUNT THAT.
PROVIDES THE ABSOLUTE NEXUS FOR
THE SUBSIDY AND THE HELP F
PEOPLE THAT HAVING TROUBLE TO
AFFORD INSURANCE.
PREMIUMS AND AND THE STATE OF
CALIFORNIA I THINK IT WOULD IT
WOULD CERTAINLY GIVE ME A MARK
OF A COMFORT LEVEL --
AND THEN IT CAN IT CAN NOW THIS
MEANS.
YOU DISCUSS THE THE THE VARIABLE.
SUBSIDIES EVERY YEAR AND WHEN
WHAT ONE OF MY CONCERNS.
I'M SORRY I'M NOT BEEN CUT A
DEAL FOR THE PAST MONTH SORRY
YOU KNOW THE PHARMACIST COULD
BETTER GET HIMSELF WELL BUT THIS
VIRUS HAS BEEN ABOUT
[inaudible]
ONE OUR I'M CONCERNED AT THE OUR
OUR STATE --
PROJECTIONS OF REVENUE ARE ARE.
COMING IN LOWER THAN ANTICIPATED.
AND THAT I'M CONCERNED THAT --
IF THERE'S NOT ENOUGH MONEY OF
YOU KNOW LOOKING AT REDUCING
SUBSIDIES AND I DON'T KNOW HOW
THE NEXUS WORKS WITH OUR INCOME
STREAMS.
MAYBE CAN ELABORATE ON THAT BUT
THAT.
WOULD IT WOULD SPEND THAT THE
DELTA YEAR TO YEAR THAT PEOPLE
CAN EXPECT TO SEE --
WHETHER THE PREMIUM SUBSIDIES
ARE GOING UP BREWING DOWN AND
AND I I CERTAINLY WANT TO
MINIMIZE THE ANXIETY THAT MANY
OF OUR OUR RESIDENTS HAVE BEEN.
KNOWING FROM WE HEAR TO YOUR
THAT THEY CAN LOOK FORWARD TO
HAVING COMPREHENSIVE HEALTHCARE.
THE CURRENT OF FEDERAL SCHEME
FOR HOW TE SUBSIDIES ARE
DISTRIBUTED IS BASED ON A
MAXIMUM CONTRIBUTION.
THE MAXIMUM REQUIRED
CONTRIBUTION THAT AS A
PERCENTAGE OF YOUR INCOME SO IT
IS A SLIDING SCALE AND SO IF
YOU'RE.
UP 24100% SO IF YOUR INCOME DOES
NOT CHANGE YOU WOULD BE PAYING A
FIXED PERCENTAGE OF YOUR INCOME
IN PREMIUMS IF YOU CHOSE THE
SECOND LOWEST COST SILVER PLAN.
NOW DEPENDING ON WHAT OTHER
PLANS ARE AVAILABLE YOU MAY SEE
FLUCTUATIONS IN WHAT YOU ARE
PAYING --
BUT IT IS A FIXED PERCENTAGE OF
YOUR INCOME NOW WE SHARE THE
SAME CONCERNS IF THE STATE IS
PLANNING ON YOU KNOW HAVING
DIFFERENT AMOUNTS BASED ON
WHAT'S AVAILABLE --
BUT IT IS A SLIDING SCALE TIED
TO A PERCENTAGE OF INCOME.
IT IS DIFFERENT PLEASE THANK YOU
A BEST CAL HEALTH TEXAS.
IT.
WOULD BE UNFORTUNATE IF THE
PENALTY AMOUNT OR PERCENTAGE IS
THE SAME YEAR TO YEAR BUT THE
HELP THAT PEOPLE GET BOUNCES
AROUND.
THAT I THINK WOULD NOT ACTIVE
THAT WE SINKS TO THIS COMMITTEE
AND THE ADMINISTRATION CHAIR OF
TRYING TO PROVIDE ADDITIONAL
HELP TO PEOPLE --
IN FOR SOME PEOPLE WHO WERE IN
THE INDIVIDUAL MARKET FOR YEARS
BECAUSE THEY ARE.
ARE SELF EMPLOYED AND RUNNING
THEIR OWN BUSINESS.
THEY WOULD NEED TO BE ABLE TO
PLAN AND BUDGET THERE ARE MANY
OTHER PEOPLE FOR WHOM THE
INDIVIDUAL MARKET IS SOMETHING
THAT THEY USE IN BETWEEN JOBS
SERVE DIVORCE.
CHILD TURNED TWENTY SIX AND SO
THEY'RE THEY'RE SHORT BUT FOR
MANY PEOPLE TO NEED TO BE ABLE
TO PLAN.
AND SO TO HAVE THE MONEY BOUNCE
AROUND.
WHICH SEEMS TROUBLING AND IT
WILL WILL LOOK AT THE LANGUAGE
AND WORK WITH THE ADMINISTRATION
AND WITH YOUR COMMITTEE ON THAT
AS WE MOVE FORWARD THANKS
APPRECIATED THANK YOU VERY MUCH
[inaudible]
THANK YOU.
ALL RIGHT --
WELL I HAVE SEVERAL QUESTIONS --
SO AND AGAIN I WANT FOR SO I
WANT TO THANK THE GOVERNOR --
FOR TRYING JUST --
THIS ISSUE AND SUPPORTING AN
INDIVIDUAL MANDATE AND ALSO THE
THE IF --
SUBSIDIES FOR EXPANDING WANT --
TO BUT THAT OUT FRONT TO REALLY
APPRECIATE THE GOVERNOR --
PUTTING MAKING THIS A A A VERY
IMPORTANT PART OF HIS EFFORTS TO
TOWARD --
HEALTH FOR ALL --
NOW THAT WE HAVE SOME DETAILS
THOUGH I DO WANT DAHLE AND AND
AND EXTRA AND AND THAT'S YOU
SOME QUESTIONS AND SEE WITH AND
HOPEFULLY WE CAN --
AS WE TRY --
TO IMPROVE ON THE PROPOSALS --
THAT YOU'RE PUTTING FORD --
SO FIRST OF ALL LET ME START
WITH THE INDIVIDUAL MANDATE
PORTION BECAUSE EVEN THOUGH
WE'RE MAINLY TALKING ABOUT
SUBSIDIES I THINK THERE'S THOSE
TWO SIR GO TOGETHER AND IN A FOR
SOMEONE I THINK THE GOVERNOR --
FOR FOR SUPPORTING INDIVIDUAL
MANDATE SOMETIMES IS THAT IT'S
PUT THE POLITICALLY LEAST
POPULAR --
BUT FRANKLY THIS WEEK KNOWLEDGE
THAT IT'S IT'S IT'S EXTREMELY
NECESSARY TO MAKE THE SYSTEM
WORK RIGHT --
THE MORE PEOPLE THAT ARE IN --
THE MORE EFFICIENT THE SYSTEM IS --
THE THE BETTER AS IN FACT --
THE FACT THAT THE FEDERAL
GOVERNMENT --
OURS CONGRESS AND THE TRUMP
ADMINISTRATION SIDE TO ZERO OUT
THE PENALTY ITSELF.
HEALTHY SO THERE'S STILL MANDATE
BUT ZEROED OUT THE PENALTY
ESSENTIALLY IS CAUSED A COVERED
CALIFORNIA UNDERSTAND TO HAVE TO
RAISE PREMIUMS WHILE THESE 5% OF
THAT PREMIUM RAISES RELATE IS
RELATED TO ACTIONS TAKEN BY THE
ADMINISTRATION TO DESTABILIZE
MARK INCLUDING BEHOLD INDIVIDUAL
PENALTY.
SO I MEAN IT'S COSTING PEOPLE
WHEN THAT HAPPENED SO I'M GLAD
TO KNOW THAT WE'RE LOOKING AT
REVERSING THAT.
I CERTAINLY UNDERSTAND THE
ADMINISTRATION'S DESIRE TO
PERHAPS THAT DIRECTLY PARALLEL
WITH THE FEDERAL GOVERNMENT I
MEAN THERE'S SOME SIMPLICITY
THERE -- BUT
I I DO JUST WANT MAKE NOTE THAT
THERE IS ONE EXCEPTION TO THE
INDIVIDUAL MANDATE THAT I THINK
IS A LITTLE TROUBLING TO ME --
I UNDERSTAND POLITICALLY WHY
IT'S IN THE FEDERAL ONE BUT I'M
NOT SURE WHAT WE WOULD DO IN
CALIFORNIA.
AND WHICH IS ALSO SAYING THAT IF
YOU'RE IN A HEALTH CARE SHARING
MINISTRY AND UNFORTUNATELY --
THOSE PRODUCTS IT'S ONE THING IF
IT'S REALLY WITHIN THE CHURCH I
THINK THERE'S STILL SOME SHOWERS
BECAUSE THEY ARE THEY'RE NOT
ACTUALLY INTERESTING UP THIS
FOLLOWS.
THE PRESENTATION BY THE PART
MANAGE HEALTHCARE WHICH IS THE
POINTED OUT NAY EMPHASIZES THE
IMPORTANCE OF BEING SHARED PLANS
THERE WHEN YOU NEED IT I THINK
THAT'S ONE THE MOST IMPORTANT
COMPONENTS OF THE ACA.
YEAH WE PUT A LOT OF REGULATIONS
OF PLANS TO BE SURE THAT IT'S
THERE WHEN YOU NEED IT AND WE
SEE THE EXCEPTION IS YOU CAN BE
ESSENTIALLY IN A FORM OF WHILE
ON A CALL COVERAGE OR NOT.
IT'S NOT REALLY COVERAGE BUT THE
PROBLEM IS IS RESERVE
REQUIREMENTS THEY DON'T HAVE TO
HAVE NETWORKS IT CETERA AND AND
I UNDERSTAND POLITICALLY WIFE
AND FEDERAL LEVEL THAT'S AN
EXCEPTION I'M NOT SURE WHY WE
WOULD HAVE THAT EXCEPTION AND IT
IN CALIFORNIA BECAUSE I THINK
IT'S UNFORTUNATE IT'S A LOOPHOLE.
AND UNFORTUNATELY WE SEE PEOPLE
GOING ON MARKETING THEM SO
BEYOND JUST ANY PARTICULAR
CONGREGATION SO --
SO CAN YOU PERHAPS --
SPEAK TO THE THAT PARTICULAR
ISSUE.
SURE AND AGAIN I THINK.
IN DROUGHT IN THIS TRAILER BILL
WE TRIED TO HE WAS CLOSELY AS
POSSIBLE TO THE FEDERAL STATUTE
THAT EXIST TODAY I THINK
ADMINISTRATIVELY IT'S SIMPLER
FOR US.
TO IMPLEMENT A PROPOSAL THAT
BEGINS CHAIR ONE TWENTY TWENTY
FOLLOWING THE FRAMEWORK THAT'S
ALREADY BEEN DEVELOPED --
WE DEFINITELY HEAR CONCERNS ARE
HAPPY TO TAKE HIM BACK AGAINST
THEIR OWN BUT GENERALLY SPEAKING
ARE INTENT INTO DRAFTING THIS
PROPOSAL WAS.
TO KIND OF MATCH AS CLOSELY WHAT
IS CURRENTLY IN PLACE AT THE
FEDERAL LEVEL AND NOT KIND OF
RELITIGATE SO THOSE ISSUES THAT
HAVE BEEN BUILT INTO THAT LAW
BUT AGAIN HAPPY.
TO CONTINUE DISCUSSIONS OKAY SO
I THINK AT A MINIMUM.
LOS WAS A I THINK IT'S BY BETTER
OFF OF WE DON'T BUY HEAR WHAT
YOU'RE SAYING ANDERSON INDUSTRY
COMPLEX THE AT THE STATE MINIMUM
WE NEED TO MONITOR THIS AND IF
PEOPLE GOING AROUND MARKETING.
THESE THINGS AND BASICALLY
TURNING IS SO --
AND DID MISTER COMPLEX TO MAKE
HIM WITH IT.
THE OTHER --
I GUESS EXCEPTION WHICH IS LESS
TROUBLESOME --
IS -- AND IT
AND CERTAINLY OPEN TO IS --
I THINK IF YOU BELONG TO CERTAIN --
RELIGIOUS GROUPS SO I THINK
CHRISTIAN SCIENTIST BUT I THINK
FOR EXAMPLE CITY MASSACHUSETTS
DAM PERSIAN SAYING THAT FINE BUT
IF YOU ACTUALLY END UP USING.
IT OUT WHICH BASICALLY WOULD
INDICATE.
WELL IF YOU ACTUALLY ARE PERMITS
ARE TO SAYS YOU DON'T BELIEVE IN
HEALTH CARE BUT THEN YOU
ACTUALLY END UP USING HEALTHCARE
WELL THEN MAYBE YOU SHOULD BE
REQUIRED COVERAGE BECAUSE
ULTIMATELY WHAT HAPPENS IS THAT
EVERYONE IS THE UNINSURED AND
THAT'S WHAT WE'LL GET MORE
PEOPLE COVERAGE.
WE STILL PAY FOR ITS JUST THE
GETS SUBSIDIZED ANOTHER WAY SO --
SO PERHAPS AND SOME FINE WITH
THAT FEDERAL PART BE IN THERE
BUT MAY THINK ABOUT PROVISION OF
THAT SOMETHING LIKE WHAT
MASSACHUSETTS DID SOME STUFF
THROW THAT OUT THERE.
OKAY SO LET'S MOVING ASIDE OFTEN
THE INDIVIDUAL MANDATE IN TERMS
OF THE SUBSIDIES I I KNOW THAT --
AND I APPRECIATE DAILY --
BRING THIS UP TO AND LEARN ABOUT
THE IDEA THAT WE'RE GONNA HAVE
SUBSIDIES VARYING FROM YEAR TO
YEAR.
RIGHT AND PEOPLE NOT ACTUALLY BE
ABLE TO PREDICT WHAT'S GOING TO
BE BECAUSE IT'S BASED ON YOU
KNOW I MEAN PEOPLE OF ALL OUR
BUDGET THAT CLOSELY.
AND SO THEY'RE THEY'RE NOT GONNA
KNOW HOW MUCH AND IT IN BECAUSE
ACTUALLY IS IS THAT THE THE
COLLECTOR TOBACCO TAX I MEAN
ULTIMATELY ACTUALLY WOULD I'D BE
THRILLED IF THE PENALTY WAS ZERO
THEY AT ME AND THAT WE HAVE
EVERYONE SIGNED UP RIGHT I MEAN
THAT THAT THAT.
THAT WOULD BE THAT THE WONDERFUL --
AND SO THE CHALLENGE THEN IS IS
THAT I COULD IMAGINE THAT WILL
HAPPEN IS YOU WE SET FIVE
HUNDRED MILLION WE SAID A
SUBSIDY A CERTAIN LEVEL.
AND ACTUALLY PEOPLE SAY OKAY
THAT'S OF THE LOOKS PRETTY GOOD
IT'S ON A BY HEALTH INSURANCE
RIGHT PENALTY WILL GO DOWN.
RIGHT BECAUSE THE CELL THE RATES
OF MORE PEOPLE SIGN UP.
THE NEXT YEAR I HAVE THIS OF
PEOPLE SIGN UP AND NOW WE HAVE A
SMALLER POOL AND WE SAID WELL
NOW YOUR SUBSIDY SHRINKING AND
THEY HAVE A BUNCH OF PEOPLE
GOING WELL THE SUBSIDIES LESS
I'M GONNA TAKE THE PENALTY AGAIN.
AND SO WE'RE GONNA HAVE THIS UP
AND DOWN AND UP AND DOWN AND
PEOPLE TRYING TO FIGURE OUT HOW
TO PREDICT IN GAME THIS IS THEY
ARE THAT IT'S AN GAMES ISM
SURVEY RATED THEY'RE TRYING TO
MAKE FINANCIAL DECISIONS FOR
THEMSELVES.
AND SO I DO THINK THAT THAT
THAT'S REALLY.
THAT'S GOING TO CREATE SOME --
BONELLI INSTABILITYIT MAY
ACTUALLY CREATE THIS TRUST I
MEAN TRUST IS A REAL IMPORTANT
PART ABOUT HEALTHCARE RIGHT.
AND SO WE DON'T WANT TO HAVE
THIS.
SO I'M I'M CONCERNED THAT HAVING
THAT KIND IT'S GOING TO BE
REALLY PROBLEMATIC IN TERMS HOW
DO WE COMMUNICATE TO PEOPLE
RIGHT SO I YEAH THIS WAS.
THE GOVERNOR'S GOING OUT THERE
SAYING WE ARE BOTH GONE REQUIRE
YOU HAVE HEALTH INSURANCE BUT
WE'RE GOING TO MAKE IT
AFFORDABLE.
BUT WE CAN'T TELL YOU HOW
AFFORDABLE IT'S GOING TO BE
BECAUSE I DON'T KNOW HOW MUCH
MONEY'S GOING TO COME IN FROM
YEAR TO YEAR RIGHT.
ANY OF YOU HOW HOW HOW MUCH LEAD
TIME REAL WARM PEOPLE I'LL TELL
YOU RIGHT NOW WE'RE SITTING
THERE GOING WELL YOU KNOW.
WORDS WILL THE REASON WE DO MAY
REVISE AS WE DON'T KNOW HOW MUCH
MONEY HE IS GOING TO HAPPEN
UNTIL IF SO HOW MUCH LEAD TIME
GIVE GIVE PEOPLE TO PLAN WHEN
THEY PURCHASE RATE AND AND THEN
WHAT HAPPENS --
WOOD.
SO ANYWAY THE KEY CAN YOU.
HAPPY TO ADDRESS ALL THOSE
QUESTIONS SO WE HAVE DEFINITELY
HEARD THOSE CONCERNS I THINK THE
FIRST THING TO NOTE THAT WE'RE
PROPOSING A SUBSIDY PROGRAM TO
SINCE THE DECEMBER THIRTY FIRST
TWENTY TWENTY FIVE THREE
COVERAGE YEARS.
AGAIN AS MENTIONED IN MY
PRESENTATION I THINK THE INTENT.
IS TO CALL UPON THE FEDERAL
GOVERNMENT TO STEP IN AND HELP
CALIFORNIANS OTHER STATES
ADDRESS THESE LARGER
AFFORDABILITY QUESTIONS THAT MAY
TAKE ANOTHER ELECTION --
RELATED TO THE VOLATILITY OF THE
REVENUE ESTIMATES I THINK FOR
THIS FIRST YEAR IT'S GOING TO BE --
VERY CLOSE COLLABORATION BETWEEN
FRANCHISE TAX OARD AND COVERED
CALIFORNIA AND FINANCING THIS
BUDGET COMMITTEES TO KIND OF
SETTLE ON THE REVENUE NUMBER AND
I DON'T THINK THAT NUMBER WILL
BE ADJUSTED IN THE FIRST TWO
YEARS BECAUSE OUR ADDITIONAL
INFORMATION IS NOT GONNA COME IN.
UNTIL APRIL.
TWENTY TWENTY ONE OF WHICH WILL
LIKELY HAVE A SO WILL LIKELY
HAVE A SIMILAR REVENUE
PROJECTION FOR THE FIRST AND
SECOND YEAR OF THE PROPOSED
PROGRAM [inaudible]
OF AGAIN THE EFFECTS OF THAT MAY
BE FELT IN THE THIRD YEAR OF THE
PROPOSED COVERAGE YEARS BUT
AGAIN WOULD NOTE THAT.
THE INTENT OF THE PROPOSAL IS TO
MAKE COVERAGE MORE FORMAL TO THE
EXTENT POSSIBLE.
WHILE ALSO IMPLEMENTING THIS BUT
BY WILD TYING IN THE SCHOOLS HIS
PENALTY REVENUE.
IN THE CONTEXT OF OUR BROADER
BUDGET DISCUSSIONS [inaudible]
I AND THAT WE HAVE IN THIS
COMMITTEE PROCESS THESE.
AND CAN YOU JUST ALSO CLARIFY
UNDERSTAND THE PART THE PROPOSAL
ALSO IS BECAUSE WE HAVE TWO
GUESTS RATE A LITTLE BIT IN THE
BEGINNING.
DURING A PROJECT X. AMOUNT OF
DEAL FIVE FIVE HUNDRED MILLION
OR SOME AMOUNT OF MONEY.
AND IF IT TURNS OUT WHAT WE
COLLECT IN THE PENALTY IS NOT AS
MUCH AS WE EXPECT ARE WE PLAYING
TO THE AND SUBS IT FILL THAT IN
WITH GENERAL FUND OR DRAW DOWN
IN FUTURE YEARS NOW WE HAVE EVEN
SMALLER PULL IN THE FUTURE YEAR.
TO PROVIDE SO WHAT IS THE THE
WHY IS.
THE AMOUNT SPECIFIED FOR EACH
COVERAGE YOUR WOULD BE.
DEBATE IN NEGOTIATING THESE
BUDGET COMMITTEE IS COVERED
CALIFORNIA RCEIVE THAT NUMBER.
IN JUNE WHEN THE BUDGET IS
PASSED AND THEY WILL DESIGN
THEIR SUBSIDY PROGRAM BASED ON
THE NUMBER AND THAT.
WILL INFORM THE SUBSIDIES
AVAILABLE FOR INDIVIDUALS TO
PURCHASE COVERAGE DURING OPEN
ENROLLMENT OCTOBER TO JANUARY.
ONCE THOSE INDIVIDUAL SET THEIR
SUBSIDY AMOUNT IS NOT OUR INTENT
THAT THAT AMOUNT FOR THAT
COVERAGE YOU'RE BE ADJUSTED
DOWNWARD UPWARD.
HOWEVER YOU ARE CORRECT THAT IF
[inaudible]
THE PROGRAMS ARE OVER EXTENDED
IN THAT COVERAGE HERE BECAUSE WE
DO NOT.
WE UNDERESTIMATED REVENUES --
UNDERESTIMATE EXPANSIONS WE
WOULD LIKE THE PROPOSED TO
REDUCE THE SUBSEQUENT FUNDING
AMOUNT AND THE NEXT YEAR BASED
OFF THOSE ACTUAL THAT WE'VE
RECEIVED OKAY SO --
SO AGAIN I AM FIRST OF ALL I A
AGREE IN SUPPORT THE IDEA THAT
WE OBVIOUSLY DON'T WANT CHANGE
IT WITHIN THE PLAN YEAR.
WHY I'M CONCERNED ABOUT SORRY I
WAS A PHYSICS MADE BY A PHYSICS
MAJOR SO --
SO WHAT I SEE IS A ESSENTIALLY
CREATING THIS OR WAVE A FACT
BECAUSE WILL HAPPEN IS IS THAT.
WE DELIVERY TALKING ABOUT
PERTURBATIONS IN THE SYSTEM
WHERE OKAY WHAT WILL HAPPEN IS
IS THAT WE PROVIDE A SUBSIDY
MORE PEOPLE HOPEFULLY I MEAN
THAT'S THE INTENT.
ARE ABLE TO SIGN OFF.
THAT IS THE PENALTY GOES DOWN.
I AND WE OVER GUESS HOW MUCH
AGAIN THE PENALTY THAT WILL
HAPPEN IS NOW ONLY OF COURSE
WILL THE SUB TO GO DOWN THE
FOLLOWING YEAR EVERY ESSAY WILL
NOW GOING.
BRING BACK SOME OF THAT MONEY TO
FILL IN THE BACK FILL THAT POOL
GETS EVEN SMALLER NOW THAT
SUBSIDY DROPS EVEN MORE.
AND THEN WILL HAPPEN IS THAT I
APPRECIATE THAT WE'RE NOT A
CHANGE WITHIN YOUR BILL WHEN
THEY LOOK AT THAT YEAR TING I
LIKE WAIT A MINUTE WHAT HAPPENED
TO THE SUBSIDY RIGHT AND I WAS
PLANNING ON BECAUSE THAT'S WHAT
I'VE GOT RIGHT NOW.
WHAT HAPPENED TO THE PLAN I HAVE
NOW?
I'D LIKE TO KEEP IT BUT NOW
YOU'RE TELLING ME THE ONLY
ALTERNATIVE I HAVE A SOMETHING
THAT'S GOING TO BE [inaudible]
A LOT.
LESS MANAGEABLE BECAUSE THE
SUBSIDIES ARE MUCH LESS RIGHT.
AND I THINK I THINK TO BE A LOT
OF PEOPLE BE VERY CONCERNED
ABOUT THAT RIGHT MEAN IT THE S.
SO.
I'M NOT SURE WE'RE SENDING THE
RIGHT MESSAGE THEN AND AND I'M
AFRAID THAT ACTUALLY BY.
SAYING THAT WE'RE GOING TO THEN
TAKE MONEY AWAY FROM A FUTURE
YEAR.
WE'RE ACTUALLY MAGNIFYING THIS
EFFECT RIGHT SO --
NOW I I THINK ALL TOGETHER I
WOULD THINK OF A MORE STABLE
FUNDING BASE FUNDING SOURCE SO
LET'S PUT THAT ASIDE FOR JUST A
MOMENT WHEN WE COME BACK TO THAT.
BUT I WOULD ALSO SAY IS THAT WE
WOULD MAKE A HELL OF BEST GAS
BUT IT TURNS OUT WE GOT CLOUD
BACK.
THAT'S GOING TO BY DESIGN
MAGNIFIED THE VERY PROBLEM THAT
WE'RE TALKING ABOUT SO WE'RE
COMPOUNDING IT BY SAYING THAT
NOT ONLY OF COURSE WE'RE GOING
TO BASE IT ON WHAT THE PENALTY'S
GOING TO BE.
WE'RE THEN GOING TO IF WE GUESS
WRONG AND WE OVER ESTIMATED
WE'RE GONNA TAKE EVEN MORE MONEY
FROM THE FUTURE YEAR AND
THEREFORE SHRINK THE SUBS EVEN
MORE.
AND I THINK THE THE RESPONSE
FROM PEOPLE ARE PURCHASING
INSURANCE IS GOING TO BE WELL
I'M NOT SURE I WANT TO BUY
SOMETHING WHERE I CAN'T GET
THERE.
I MEAN I GUESS PEOPLE CANNELLA
BY THIS YEAR WILL BY NEXT YEAR
BY THE END FOLLOWING YEAR BUT I
I JUST THINK THAT --
THAT INVOLVED THAT VOLATILITY IS
GOING TO UNDERMINES PEOPLE'S.
DESIRE TO LOSE WELL THAT'S FOR
THIS WAY COVER CALIFORNIA ANSWER
THIS U AND A ONE THE CHALLENGES
BEEN COVERED CALIFORNIA IS IS
THAT -- IF
YOU ACTUALLY TRIED AND BOOKED
EACH YEAR IS IT JUST RENEWED
YOUR SAME PLAN AND LOOKED AT THE
PREMIUMS AND WE HAVE
STANDARDIZED BENEFITS THAT YOU
COULD ACTUALLY THE V. ACTUALLY
THE AMOUNT THAT THE PLAN COSTS
EACH YEAR ACTUALLY DOESN'T GO UP.
QUITE AS MUCH RIGHT BUT ACTUALLY
INTERESTING PEOPLE COMPLAIN
ABOUT HOW FAST THE PLAN GOES UP
IS BECAUSE THEY GENERALLY WE
ACTUALLY TRY TO STICK TO THE
SAME PLAN THEY DON'T ALWAYS SHOP
AGAIN THEY SERVE THE SHOP THE
FIRST YEAR.
AND THEN THEY KIND OF AND THEY
GO WELL LOOK MY PLAN WHAT BUT
GUESS WHAT THERE'S ANOTHER
PLANTS A LITTLE CHEAPER OH OH
WELL I DIDN'T REALLY AND HOW CAN
THAT IT'S RIGHT IS THAT
SOMETHING THAT PEOPLE END UP
DOING A LOT.
THE THERE ARE DYNAMICS AND SO
THE TAX CREDITS TIED TO THE
SECOND LOS COSTS OVER PEOPLE
OBVIOUSLY DON'T KNOW THAT SO
THEY THEY FEEL THE DYNAMICS OF
THEIR PLANS DISTANCE GOING UP OR
DOWN RELATIVE TO THAT SECOND LOS
COSTS OVER AND THEN IT IT CAUSES
THEM TO RETHINK AND SHOP.
OKAY SO BUT BY A OF THE BEING
FAIRLY.
WE'RE NAMING CONSTRAINING IT TO
A CERTAIN.
WINDOW SO THAT LEAST SO WHAT WHO
KNOWS WHAT HAPPENED THIS OF
THESE GOING TO BE CUT IN HALF.
IT'S GOING TO GO DOWN TWO THIRDS
IS A TO COME 210% I MEAN IF IT'S
SMALL OKAY.
BUT IT'S YEAR TO YEAR BUT IT'S A
BIG DROP YOU KNOW A BIG IS.
NOW OF COURSE TO THE OUTSIDE OF
THE HOLDER BUT 25% 33% THAT
PEOPLE MIGHT GO WELL WHAT'S
GOING ON HERE.
RIGHT SO.
I DEFINITELY HERE CONCERNED WE
WOULD JUST KNOW THAT THIS IS
PROPOSING TO BUILD UPON THE
EXISTING FEDERAL FRAMEWORK AND
THOSE FEDERAL SUBSIDIES WOULD
STILL BE AVAILABLE FOR THOSE
CONSUMERS WHO ARE PURCHASING
COVERAGE ON THE HEALTHCARE
MARKET.
BUT AGAIN NO YOU CONCERNING HAVE
TO TAKE IT BACK.
OKAY SO --
CAN I GET NOW I'M GONNA GO AND
MY PART TO FOR SIDE SO WHAT
ABOUT A MORE STABLE FUNDING BASE --
SO.
AND THEN AGAIN I UNDERSTAND --
YOU YOU PRIDE DON'T HAVE THE
AUTHORITY TO IT BUT SINCE YOU
GOT BRING STUFF BACK --
SO SO FIRST FIRST OF ALL THIS
THE SUMP THE SON AND WE'VE WE'VE
WE'VE DISCUSSED THIS ACTUALLY WE
HAD OUR INFORMATIONAL HEARING
WHAT WAS THE JOINT.
NOT ONLY HEALTH COMMITTEES BUT
BUDGET SUB COMMITTEES CAME
TOGETHER.
AND AND SO CERTAINLY YOU KNOW
FIVE HUNDRED DOESN'T.
YEAH ON TERMS OF THE LEVEL OF
SUBSIDY WE SAW THE REPORT FROM
CURRENT CALIFORNIA I'D THINK IT
SHOULD BE SOMEWHAT MORE SUB THAT
IF -- AND
ALSO MORTARS TABLE AS WELL AND
SO WAIT THEY THINK WHEN THE
THINGS WE MIGHT WANT TO CONSIDER --
AND CERTAINLY I KNOW THAT --
IT IS THE LEGISLATURE PATENT
THAT PASSES THE BUDGET IN THE
GOVERNOR SIDES FOR SIGN OR NOT
BUT I'M GONNA BUT WE WANT TO
WORK WITH YOU --
IS AND I APPRECIATE YOU IS IS
MAYBE PERHAPS LOOKING AT THE MCO
TAX RATE WHICH I'VE.
READ THAT THE GOVERNOR DECIDED
THE LEAST IN THIS IN THE GENERAL
BUDGET PROPOSAL NOT.
TO RENEW AND YOU KNOW WE'LL TRY
TO HAVE SOME DISCUSSION LATER ON
ABOUT THE ABOUT THE LIKELIHOOD
OF CONTINUING ED BUT YOU KNOW I
I IN SOME SENSES IN PRINCIPLE
RIGHT IT'S A TAX ON ALL MANAGED
CARE ORGANIZATION.
ALL PLANS RIGHT AND SO WE'RE
DOING SUBSIDY THROUGH CAR
CALIFORNIA EVERY PLAN HAS AN
OPPORTUNITY FOR MOST PART TO
PARTICIPATE.
RIGHT NOW AS WELL SO IT SORT OF
BATCHES AND MAKES SOME SENSE
THERE AND ALSO COOL HELD A STRAW
DOUBTS MORE MONEY FOR MEDI CAL
PROGRAM INCLUDING OUR MEDICAL
EXPANSION --
BUT I THINK THAT CERTAINLY I
REVENUE MAKES SENSE BUT THAT
BEING THE PRIMARY ARE TYING THE
ENTIRE SUBSIDY TO THAT.
I WOULD SAVE ALL TAL INCOME
SOURCE UNTIL IT'S PROVEN AS YOU
CAN -- UNTIL
IT WAS IMPROVE IS NOT GONNA BE
SO VOLATILE --
I THINK IS PROBABLY NOT THE BEST
STRATEGY WE WANT PEOPLE WHEN
THEY SEE THEIR PLAN WHEN WE SEE
THEM ON EIGHT WHEN GOVERNOR
NEWSOME GOES AND ANNOUNCES AND
SAYS LOOK YOU KNOW WE ARE TAKING
IT WE ARE GOING TO MAKE THIS
THING HAPPEN NOW RIGHT I PROMISE
THIS IS.
THE BEGIN MY TERM WE'RE GONNA
MAKE THIS THING HAPPEN THERE ARE
PEOPLE THE NEXT THE FOLLOWING
YEAR GOING WHEN WHAT HAPPENED.
RIGHT ARE YOU PULLING BACK FROM
THIS BECAUSE WE'VE TIED THIS
ENTIRELY --
TOO SO --
SOMETHING TO THINK ABOUT.
I KNOW YOU CAN'T SAY YES OR NO
RIGHT NOW I DON'T HAVE ANY
ADDITIONAL INFORMATION IS SHOWN
THE MCO TAX AT THIS TIME BUT
AGAIN WE WILL TAKE IT BACK.
THAT'S I GUESS THAT'S ALL I CAN
ASK RIGHT NOW.
BUT IN NAY WILL BE VOTING ON
STUFF SO.
OKAY -- IT'S
OTHER ISSUES AND AND THEN I SEE
I CAN YOU ADDRESS THE THE LA --
BROUGHT UP THE ISSUE AROUND TAX
CREDIT VERSES.
THAT WAS IT THE ON GOING TO YOU
CAN REPEAT THAT.
SURE IT'S IT'S OUR UNDERSTANDING
THAT IN OTHER STATES THE
SUBSIDIES PROVIDED TO THE
INSURER SIMILAR TO AN ADVANCED
CREDIT BUT THERE'S NO TRUE UP AT
THE END THROUGH THE TAX SYSTEM
INSTEAD IT'S ADJUSTED AS THE
YEAR GOES ON FOR EXAMPLE THE
PLAN MIGHT GET SOME INFORMATION
OR COVER CALIFORNIA.
MY GET SOME INFORMATION ABOUT
CHANGES IN INCOME THEY WOULD
ADJUST THE SUBSIDY PROSPECTIVELY
AND THAT WOULD SORT OF BE THE
END OF THE STORY SO IT'S IT'S
BOUNCING BETWEEN --
PER MENTALITY VERSUS SIMPLICITY
THE WOULD BE GOOD TO TALK ABOUT
WHAT WE KNOW ABOUT THE THAT THE
TRADE OFF THEIR OKAY AND THE
SPELL YOU HAVE AND DOES SOME.
YELLING IS ABOUT THAT AND WE'LL
LET FINANCE ALSO WHAT THEY THINK
THE TRADE OFFS OR SO ONE OF THE
ONE OF THE THINGS THAT HAS MADE
PEOPLE FRUSTRATED WITH THE
AFFORDABLE CARE ACT IS
RECONCILIATION.
IT'S THAT IF YOU DON'T KILL SURE
INCOME CORRECTLY AND I FOR ONE
DON'T KNOW WHAT MY MODIFIED
ADJUSTED GROSS INCOME IS AND I
BET MOST PEOPLE WITHIN THE SOUND
OF MY VOICE DO NOT.
IF YOU GET A GAS INCORRECTLY
THEN YOU HAVE WHAT IS USUALLY
FOR A MAJORITY OF PEOPLE IN
UNHAPPY SURPRISE AT TAX TIME.
PEOPLE TEND TO UNDERESTIMATE
THEIR INCOME RISES IN
OVERESTIMATED SO RATHER THAN
CALIFORNIA THERE'S MUCH TO
COMMEND THE AFFORDABLE CARE ACT
I THINK EVERYBODY KNOWS WE'RE
VERY SUPPORTIVE OF IT BUT
CALIFORNIA HAS CONSISTENTLY
IMPROVED ON THE AFFORDABLE CARE
ACT.
IN THIS WOULD BE AN AREA WHERE
WE WOULD HOPE WE WOULD IMPROVE
RATHER THAN REPLICATE SOMETHING
THAT WAS.
AFTER ALL DESIGNED TO THE U. S.
SENATE FINANCE COMMITTEE THE TAX
WRITING COMMITTEE RATHER THAN
THE HEALTH COMMITTEE OF THE OF
THE CONGRESS THANK YOU.
ALL RIGHT FEATURE YOUR THOUGHTS
ABOUT.
THE DIFFERENT THE DIFFERENT
OPTIONS AND HOW YOU THIS EITHER
LAND AND HOW YOU DID OR YOUR
OPENNESS TO CONSIDERING AN ALTAR
IS OPTION YOU MY IS FOR YOUR
PERSPECTIVE I THINK FOR OUR
PERSPECTIVES AGAIN TO MODELS
CLOSELY TO THIS FOUNDATION
THAT'S ALREADY IN PLACE --
HAVING THE ABILITY TO RECONCILE
IS AN IMPORTANT TOOL TO MAKE
SURE THAT.
FOLKS ARE RECEIVING THE
APPROPRIATE SUBSIDY AMOUNT THAT
WE ARE DEVELOPING WITH THE STATE
SUBSIDY PROGRAM.
I THINK ADMINISTRATIVELY THERE'S
ALSO QUESTIONS THAT WE HAVE TO
WORK THROUGH REGARDING WHETHER
OR NOT COVER CALIFORNIA WOULD BE
ABLE TO MAKE THOSE ADJUSTMENTS.
MONTHLY THROUGHOUT THE COVERAGE
HERE.
ANY COMMENTS FROM COVER
CALIFORNIA.
I WOULD JUST SAY THAT WERE READY
TO WORK CLOSELY ON THIS WE DO DO
THIS TODAY THROUGH THE FEDERAL
SYSTEM OBVIOUSLY --
AT CONSUMERS ARE ALLOWED TO
APPLY FOR SUBSIDIES BASED ON A
PROJECTED ANNUAL INCOME SO
TRIMMING UP AT THE END OF THE
YEAR TO WHERE THE DOLLARS LAND
IS.
WHY THAT HAPPENS AT THE FEDERAL
LEVEL?
OKAY AND THEN FINALLY A I THINK
ONE OF THE THINGS THAT --
IN TERMS OF THE PROPOSAL --
SO FOR THE PEOPLE WHO DO END UP.
HAVING TO PAY THE PENALTY --
WE WOULD LIKE TO BE SURE THAT
THEY ARE FULLY AWARE OF THEIR
VARIOUS OPPORTUNITIES TO GET
ENROLLED SO THEY DON'T HAVE TO
PAY THE PENALTY --
THAT INCLUDES PERHAPS PEOPLE WHO
MAY EVEN QUALIFY FOR MEDI CAL WE
WILL BE SURE TO SIGN UP.
RIGHT THERE'S NO COST THAT TO
THEM --
RIGHT AS WELL AS BEING SURE THAT
CALIFORNIA WOULD.
WHERE OF COURSE IN THAT CASE --
THEY WOULD HAVE TO AGREED.
TO BE THE SITE FOR THE PLAN OR
PAY THE PENALTY SO --
DOES SO.
WE CAN THAT --
BY THINGS THAT THE BIGGEST.
TRY TO THINK ABOUT HOW THAT
INFORMATION GETS FROM HIS AT THE
FRANCHISE TAX BOARD WOULD HAVE
THAT.
TO COVERED CALIFORNIA.
THIS WAS A I I THINK COVER
CALIFORNIA'S TRY BETTER IN A
BETTER PLACE TO FIGURE OUT IF I
GAVE A DATA FILE ALL THE PEOPLE
GOT THE PENALTY TO FIGURE OUT
WHICH ONES I SEE.
YOU SENT FOR TO DTS FOR MEDI CAL
AND WHICH ONES YOU WOULD HANG ON
TO TO THAT AND FOR ITEM
INFORMATION ABOUT.
THAT AND SAID THE FANTASTICKS
WHICH I TO FIGURE OUT THOSE TWO
THINGS KICKING YOU JUST SPEAK TO
HOW WE CAN MAKE THIS.
AN EFFECTIVE WAY OF TRYING TO AT
LEAST.
ALL KNOW WHAT THEIR
OPPORTUNITIES TRULY ARE.
ABSOLUTELY WE'VE HAD GOOD
PRODUCTIVE INITIAL CONVERSATIONS
WITH THE FRANCHISE TAX BOARD
ABOUT THEM SHARING DATA WITH US
NOT ONLY ON PEOPLE WHO PAID THE
PENALTY BUT PEOPLE WHO QUALIFIED
FOR EXEMPTION SO THAT WE COULD
DO EXACTLY AS YOU SAY --
PROVIDE THEM THEIR OPTIONS --
WILL HAVE TO CONSIDER WORKING
WITH PEACE WE WOULD OBVIOUSLY
WANT TO TIME WHAT WE'RE DOING
WITH OPEN ENROLLMENT --
BUT WE THINK THERE'S A GOOD
PARTNERSHIP THERE I WOULD JUST
SAY IN TALKING TO MY COLLEAGUES
IN OTHER STATES --
THAT HAVE MANDATE STATE THEM
WOULD LIKE TO HAVE THE DATA THAT
WE'RE PROPOSING TO GET ACCESS TO
SO THEY COULD DO THIS TYPE OF
TARGETED --
OUT REACH BUT WE WOULD A
PROPOSED TO TEST IT AND SEE WHAT
THE MOST EFFECTIVE METHODS ARE.
IN THIS PART OF THE GOVERNOR'S
PROPOSAL THAT SEND ALL THAT
INFORMATION THAT'S INCLUDING THE
GOVERNOR'S PROPOSAL OKAY ALL
RIGHT THANK YOU SO I THINK AGAIN
I AND I UNDERSTAND THAT IT'S NOT
JUST THE COVER CALIFORNIA PIECE
IT'S ALSO I MEAN WE PEOPLE MIGHT
[inaudible] FOR YES.
OKAY YES THIRTY PEOPLE --
FOR FOR FOR MEDI CAL AS WELL
CORRECT.
OKAY I JUST I HEARD SOMETHING
LOOK AT HER DIFFICULTY
CALIFORNIA'S IDEA TO DE DE MEDI
CAL PIECE.
SO I THINK THAT'S NEAR WILL WILL
NEED TO COORDINATE OKAY
EXCELLENT AND ARE INTERESTED
APPLICATION FOR COVER CALIFORNIA
IS AN APPLICATION FOR MEDI CAL
AS WELL.
LET US MAKING IT MADE SENSE IS
THE SEND THE FILE TO DISCOVER
CALIFORNIA BECAUSE I CAN'T
IMAGINE FRANCHISE TAX BOARD
GOING OKAY.
WHO FITS IN THE WHICH PADRE THAT
THE SORTING HAPPENS PERHAPS A
COVERED CALIFORNIA?
OKAY.
RIGHT.
OTHER QUESTIONS WE COMMUTERS
OKAY ARE.
EIGHT SO WE HAVE A LOT OF
MESSAGES TO GO BACK --
A LOT OF MESSAGES WAITING TO
HEAR ABOUT AND AGAIN I I DO WANT
TO THANK AGAIN THE GOVERNOR --
FOR PUTTING THIS FORD SO I'D AT
IT IS THAT THESE ALSO THE FIGURE
OUT HOW WE CAN WORK.
TOGETHER WITH THE GOVERNOR TO
REALLY MAKE THIS VISION --
WORK OUT BECAUSE I ONLY BE SURE
THAT SEVERAL YEARS FROM NOW --
WE'RE GONNA HAVE SOMETHING I
KNOW YOU DO TOO AS WELL AND
WHERE --
PEOPLE AT THE RECOGNIZE AND AND
AND AND PRECIADO THE THE THE
BENEFITS THEY'RE WHAT THE
GOVERNOR'S LEADERSHIP IS IT WILL
RESULT IN CELL THANK YOU.
SO MUCH ALL RIGHT THANK YOU.
OKAY NEXT ISSUES ISSUE NUMBER
THREE AS FULL SCOPE MEDI CAL
EXPANSION TO UNDOCUMENTED YOUNG
ADULTS AND WE HAVE A PANEL AND
OTHER PANEL HERE WE HAVE FIVE
JENNIFER CAN'T DIRECTOR
DEPARTMENT HEALTH CARE SERVICES --
SO IS ALWAYS WELCOME THIS
COMMITTEE --
GUADALUPE MEN BECAUSE FRANCE
WILL PROGRAM BUDGET ANALYST FOR
THE PART OF FINANCE LARA AYE
ALOT STAFF FINANCE BUDGET
ANALYST WITH APARTMENT FINANCE
RONALD COLMAN DIRECTOR POLICY
LED TO THE ACSI FOR HEALTH
ACCESS CALIFORNIA.
DEEP IN A A TECHNICIAN.
DOES NOT SEPARATELY OKAY A
SENIOR LET'S LEAVE ADVOCATE FOR
CALIFORNIA IMMIGRANT POLICY
CENTER AND DOCTOR ROB AT PETER
FEELIN SEND DIRECTOR OF SECULAR
COUNTY HEALTH SERVICES
DEPARTMENT ALWAYS GOOD TO HAVE
DIED HAVE YOU YEARS.
AS WELL SO --
SO WELCOME AND THAT WILL DO IS --
WILL GO AS IT START WITH THAT.
DIRECTOR KENT WHO WILL BE
PRESENTING THE MINISTRATIONS SO
I GIVE YOU AT THE WHATEVER TIME
YOU NEED TO FULLY PERCENT THE
ADMINISTRATION'S PROPOSALS FIRST.
SO THANK YOU AND WELCOME.
GREAT SO GOOD MORNING JENNIFER
CAN'T WITH THE DEPARTMENT OF A
HEALTH CARE SERVICES --
SO CONSISTENT WITH THE
GOVERNOR'S BUDGET IN JANUARY --%
WE ARE PROPOSING TO INCREASE
FULL SCOPE COVERAGE FOR
INDIVIDUALS WITHOUT SATISFACTORY
DOCUMENTATION STATUS UP THROUGH
THE AGE OF TWENTY FIVE WE
ESTIMATE THAT THIS WILL --
PROVIDE COVERAGE TO
APPROXIMATELY A HUNDRED AND
THIRTY EIGHT THOUSAND ADDITIONAL
INDIVIDUALS IN THE STATE OF
CALIFORNIA AND IT WOULD COME AT
A COST OF ABOUT A HUNDRED NINETY
FOUR MILLION DOLLARS IN GENERAL
FUND -- WITH
ABOUT SIXTY THREE MILLION
DOLLARS IN FEDERAL FUNDS AND SO
I KNOW THAT SOMETIMES --
PEOPLE ARE UNCLEAR AS TO HOW WE
GET FEDERAL FUNDS FOR
INDIVIDUALS THAT ARE OTHERWISE
NOT ELIGIBLE FOR MEDI CAL SO.
IN MEDI CAL TODAY WE HAVE --
APPROXIMATE ONE POINT TWO
MILLION INDIVIDUALS THAT GET
LIMITED SCOPE OR EMRGENCY
MEDICAL COVERAGE ON THAT IS
ALLOWED TO THE FEDERAL
GOVERNMENT THERE ARE FEDERAL
FUNDS --
PROVIDED FOR THAT --
SO WE WHEN WE PUT INDIVIDUALS
AND FULL SCOPE COVERAGE THE
OTHER WAYS ARE NOT ELIGIBLE FOR
F. P. WE DO CLAIM ON THE BACK
AND FOR THAT COMPLIMENTS OF THE
PREMIUM THAT ARE OTHERWISE.
ELIGIBLE FOR A FIVE PIECE THAT'S
WHERE THE FEDERAL FUNDING I
THINK THAT --
THE YOUR AGENDA DOES A NICE JOB
OF I'M TALKING ABOUT THE
PREVIOUS EXPANSION OF FULL SCOPE
COVERAGE FOR ALL CHILDREN UP
THROUGH THE AGES --
EIGHTEEN WE ARE --
ON TARGET I GUESS YOU WOULD SAY
IN TERMS OF WHAT OUR ENROLLMENT
PROJECTIONS WERE WHEN WE DID
THIS A COUPLE OF YEARS AGO --
WE SAID THAT APPROXIMATELY TWO
HUNDRED FIFTY THOUSAND CHILDREN
WOULD BE ENROLLED IN RIGHT NOW
WE'RE CITY ABOUT TWO HUNDRED
SIXTY EIGHT THOUSAND I THINK OF
THOSE IS CRAFTS.
YET TURN --
SIXTY EIGHT THOUSAND SO --
HOW THAT OCCURRED BACK IN TWENTY
SIXTEEN WAS WE SPENT --
SIX TO NINE MONTHS WORKING WITH
THE COUNTIES AND R. I. T. VENDOR
TO MAKE THE ELECTRONIC --
CHANGES TO OUR COLLECTIVE
ENROLLMENT SYSTEMS IN WHICH WE
IDENTIFIED INDIVIDUALS IN IN THE
APPROPRIATE AGE RANGES IN THOSE --
LIMITED SCOPE EIGHT CATEGORIES
AND WE ESSENTIALLY PUT THEM INTO
FULL SCOPE AID CODES AND SO A
LOT OF IT WAS AN AUTOMATED
PROCESS THAT DID TAKE SOME TIME
TO BOTH PROGRAM AND TEST THE
SYSTEM.
WE HAD TO WORK WITH THE COUNTIES
TO PROVIDE --
THE APPROPRIATE --
TRAINING AND TECHNICAL
ASSISTANCE THAN THAT A FISHERIES
WE HAD TO IF THAT CHANGES
CONTRACT FOR THE RULES.
AND SO WE HAVE SINCE THE
GOVERNOR MADE THIS PROPOSAL IN
JANUARY BEEN WORKING ON ALL OF
THOSE VARIOUS ADMINISTRATIVE
FUNCTIONS AND SO PART OF THE
GOVERNOR'S BUDGET ALSO PROPOSES
I'M PROVIDING US WITH STAFF AND
RESOURCES --
TO CONTINUE THIS WORK --
ANNUALLY NON GOING IN TERMS OF
ELIGIBILITY STAFF AS WELL AS
NINETY SPECIALIST AS WELL SOME
CONTRACT DOLLARS TO HELP
EFFECTUALLY THE I. T. SYSTEM
CHANGES AND SO WITH THAT I'M
HAPPY TO ANSWER QUESTIONS AS AS
YOU.
WOULD LIKE OKAY THANK YOU WILL
TAKE QUESTIONS AT THE END AND
ACTUALLY.
I APOLOGIZE WILL TAKE PUBLIC
COMMENT FOR BOTH ISSUE TWO AND
THREE AND I GUESS ONCE ARE TIED
INTO IT AT THE END OF THIS PANEL
SO.
ARE --
THAT'S MOVE ONTO A LUPE MEN
REACHES FROM FINANCE.
JENNY WENT TO COURT AND A
FINANCE --
SO INCONSISTENT WITH THIS ISSUE
BY EXPANDING HEALTH CARE TO
UNDOCUMENTED ADULTS AGE NINETEEN
TO TWENTY FIVE WE ARE EXPECTING
THAT COUNTIES COSTS AND
RESPONSIBILITIES WILL BE REDUCED --
THEREFORE IN NINETEEN TWENTY THE
ADMINISTRATION IS PROPOSING
TRAILER BILL LANGUAGE TO
INCREASE THE REDIRECTION AMOUNT --
FROM THE COUNTY MEDICAL SERVER
INDIGENT CARE HEALTH REALIGNMENT
REVENUES.
THIS WOULD RESULT IN SIXTY THREE
MILLION DOLLAR GENERAL FUND
SAVINGS IN THE COW WORKS ACCOUNT
IN THE POWERS PROGRAM --
WE HAVE HEARD THE CONCERNS
AROUND OUR PROPOSAL WE NOTE THAT
AS PART OF THE MEDICAID
EXPANSION TO THE UNDOCUMENTED
ADULTS WE THOUGHT IT WAS
APPROPRIATE TO MAKE ADJUSTMENTS.
TO EIGHTY EIGHTY FIVE THE
ADDITIONAL REDIRECTION REDUCES
THE GENERAL FUND COSTS TO THE
EXPANSION.
IN ON THE PUBLIC HEALTH CONCERNS
WE ARE WE ARE RECEIVING DATA --
ON HOW MONEY IS SPENT BETWEEN
HEALTH AND MENTAL HEALTH
SERVICES AT THE COUNTY LEVEL AND
WE WILL BE ASSISTANCE COUNTIES --
FEEDBACK.
OKAY.
THANK YOU LARA AYE ELLA.
LORI L. A DEPARTMENT OF FINANCE
IN HERE TO ANSWER ANY QUESTIONS
ON THE DOCK OF FISCAL AS
NECESSARY.
THANK YOU --
SCARMAN.
IS IS OKAY.
ALL RIGHT TWENTY TWO ACTUALLY
WHAT YOU SWING AROUND.
OKAY BRIEFLY.
SURE THERE SIX MONTHS
[inaudible]
THE TWO OKAY BUT HE'S GOT.
A SHARE OKAY [inaudible]
ALL [inaudible]
OKAY.
HI MY NAME IS MERRY CAM I AM THE
CAMPAIGN MANAGER OF THE CREAM
RESOURCE CENTER WE ARE AN
IMMIGRANT RIGHTS GROUP THAT WORK
IN SOUTHERN CALIFORNIA IN BOTH
LOS ANGELES AND FULLER --
TEN AND I WANTED TO BE ABLE TO
SHARE THE STORY OF MY COWORKER
WHO IS OUR PARENT ORGANIZER IN
IS PERSONALLY --
AND IS IN A DOCUMENT APPARENT
PERSONALLY IMPACTED IF HEALTH
FOR A WHICH WERE TO EXPAND --
SHE'S NOT ABLE TO JOIN US TODAY
SO I'LL BE SHARING HER STORY FOR
HER IN A FIRST PERSON
PERSPECTIVE.
MY NAME IS ERICA CAM AND I'VE
LIVED IN BORN APART CALIFORNIA
FOR TEN YEARS AND MY HUSBAND AND
I ARE BOTH UNDOCUMENTED.
MY HUSBAND IS A LIVING AS A
HOUSE PAINTER AND HE SPENDS LONG
HOURS LABORING TO BEAUTIFY
PEOPLE'S HOMES AND PROTECT THEM
FROM CORROSION. THREE YEARS AGO
HE BEGAN TO PERIODICALLY
COMPLAIN OF INDIGESTION BUT DUE
TO OUR FINANCIAL SITUATION WE
CANNOT GO TO SEE A DOCTOR.
AFTER A FEW MONTHS IN THAT
CONDITION I RECEIVED A CALL FROM
MY HUSBAND'S BOSS ONE DAY SAYING
THAT HE SUDDENLY STARTED
THROWING UP BLOOD WHILE WORKING
AND HAD COLLAPSED.
I REST MY HUSBAND'S WORKPLACE
AND WHEN I ARRIVED HE HAD LOST
SO MUCH BLOOD THAT HE COULD NOT
EVEN WALK.
ON THE WAY TO THE HOSPITAL HE
COMMITTED CONTINUE TO VOMIT
BLOOD AND EVENTUALLY BEGAN TO
LOSE CONSCIOUSNESS.
I WANTED TO CALL 911- BUT EVEN
AS HE WAS LOSING CONSCIOUSNESS
MY HUSBAND INSISTED THAT I NOT
CALL AN AMBULANCE BECAUSE OF OUR
IMMIGRATION STATUS.
I FELT SO FRUSTRATED IN THAT
MOMENT IT SO MUCH BECAUSE HE
COULDN'T SEE A DOCTOR TO A POINT
WHERE HE COULD POTENTIALLY DIE
BUT JUST BECAUSE OF HIS STATUS
HE WAS STILL AFRAID OF ANY
CONSEQUENCES THAT WOULD COME
WITH SEEKING MEDICAL ATTENTION.
HOWEVER I CAN ONLY THINK OF
SAVING MY HUSBAND'STHE DESPITE
HIS PROTESTS I CALL 911-2 HELP
TAKEN TO THE HOSPITAL.
WHEN WE ARRIVED TO THE EMERGENCY
ROOM THE NURSE SAID HE HAD LOST
SO MUCH BLOOD THAT IF WE ARRIVED
EVEN JUST MOMENTS LATER HE WOULD
HAVE DIED?
WHILE YOU'RE LUCKY ENOUGH THAT
AT THE TIME HE WAS OFFERED
EMERGENCY SERVICES CURRENTLY WE
ARE BACK AT SQUARE ONE BECAUSE
WE STILL HAVE NOT BEEN ABLE TO
ACCESS ANY HEALTH CARE SINCE HE
HAD BEEN RELEASED FROM THE
EMERGENCY ROOM.
I AM AFRAID EVERYDAY THAT A
SITUATION LIKE THIS WILL OCCUR
AGAIN.
MY HUSBAND AND I WORK HARD AND
PAY TAXES LIKE EVERY CALIFORNIAN
BUT BECAUSE OF OUR STATUS WE ARE
INELIGIBLE FOR PREVENTATIVE CARE
THAT WOULD HAVE HELPED US AVOID
SITUATIONS LIKE MY HUSBAND.
I URGE YOU TO SUPPORT THIS
INVESTMENT BECAUSE IT IS A
MATTER OF LIFE OR DEATH FOR
PEOPLE LIKE US [inaudible]
THANK YOU.
GOOD MORNING MY NAME IS RONALD
COMING HERE ON BEHALF OF HEALTH
HEALTH ACCESS CALIFORNIA WE
THANK DOCTOR PAN IN THE SUB
COMMITTEE FOR ALLOWING US TO
PRESENT ON THE EXPANSION OF FULL
SCHOOL MEDI CAL TWIN BACK MANY
CALIFORNIANS.
HEALTHAXIS CALIFORNIA'S THE
STATE WIDE HEALTH CARE CONSUMER
ADVOCACY COALITION COMMITTED TO
QUALITY AFFORDABLE HEALTHCARE WE
WHOLEHEARTEDLY SUPPORT GOVERNOR
GAVIN NEWSOM'S PROPOSAL TO
EXPAND FULL SCOPE MEDI CAL TO
ALL UNDOCUMENTED YOUNG ADULTS UP
TO AGE TWENTY SIX WITH
INVESTMENT OF TWO HUNDRED
MILLION DOLLARS FROM THE GENERAL
FUND.
BUILDING ON HEALTH FOR OUR KIDS
IN COVERING UP TO LIKE A HUNDRED
AND THIRTY EIGHT THOUSAND MORE
LIVES IN OUR STATE UNDER THIS
PROPOSAL CALIFORNIA WOULD BE THE
FIRST STATE IN THE NATION TO
EXPAND. TO UNDOCUMENTED
IMMIGRANT ADULTS IN THEIR PUBLIC
HEALTH CARE PROGRAM WE ARE
THRILLED THAT DH CS HAS BEGUN TO
WORK ON IMPLEMENTATION AND WORK
ON IDENTIFYING THE NEEDS AND
PROCEDURAL HURDLES FOR THE
VARIOUS SUBPOPULATIONS AMONG THE
YOUNG ADULT POPULATION IN ORDER
TO OPEN ENROLLMENT.
AS SOON AS POSSIBLE AFTER JULY
FIRST TWENTY NINETEEN HOWEVER AS
PART OF THE YOUNG ADULTS
EXPANSION THE GOVERNOR HAS
PROPOSED THAT SIXTY THREE
MILLION OF THE TOTAL FUNDING FOR
THIS EXPANSION BE OFFSET.
FROM REDUCTION OF FUNDING TO
COUNTIES TO COVER MEDICALLY
INDIGENT REMAINING UNINSURED
POPULATIONS THE REVISION OF
EIGHTY EIGHTY FIVE REALIGNMENT
WELL SOME COUNTIES PROVIDE
LITTLE OR NO CARE THERE ARE ALSO
MANY COUNTIES THAT HAVE OFFERED
TO EXTEND MEDICAL HOMES.
AND ACCESS TO CARE FOR THIS
PARTICULAR POPULATION WE BELIEVE
THAT ANY NEW FORMULA MUST MAKE
CERTAIN THAT IS PROPORTIONATE TO
THE DECREASING COSTS OF THE
REMAINING UNINSURED.
AT THE COUNTY LEVEL BUT ALSO
LEAVES COUNTIES IN THE TO THE
MEDICALLY INDIGENT REMAINING
UNINSURED INCLUDING THE END
DOCUMENT WHILE ALSO BEING ABLE
TO CONTINUALLY RESOURCE THEIR
PUBLIC HEALTH PROGRAMS WE
APPRECIATE THE GOVERNOR'S VISION
AND COMMITMENT TO ACHIEVE
UNIVERSAL HEALTHCARE.
AND ENCOURAGE THE LEGISLATURE TO
BUILD ON THIS PROPOSAL WITH THE
TWO BILLION DOLLAR INVESTMENT AS
WE KNOW ALL UNDOCUMENTED
IMMIGRANTS CONTINUE TO SUFFER
FROM THESE UNJUST EXCLUSIONS
UNDOCUMENTED ADULTS.
OVER TWENTY SIX ARE OFTEN TO THE
CARETAKERS PARENTS GRANDPARENTS
AND GIVE ME UNDOCUMENTED ADULTS
OVER TWENTY SIX OFTEN THE
CARETAKERS PARENTS GRANDPARENTS
OF THE KIDS AND YOUNG ADULTS WHO
WOULD BECOME ELIGIBLE BUT WHO
WOULD STILL NOT HAVE ACCESS TO
CARE THEMSELVES.
EXPANDING MEDICAL TO ALL LOW
INCOME UNDOCUMENTED ADULTS.
WOULD EXPAND ELIGIBILITY TO
APPROXIMATELY ONE POINT ONE FIVE
MILLION ADULTS BY TWENTY TWENTY
REDUCING CALIFORNIA'S UNINSURED
RATE BY A QUARTER. ONE MILLION
PEOPLE WOULD BE EXPECTED TO
ENROLL IMMEDIATELY BECAUSE THEY
ARE CURRENTLY ENROLLED IN.
RESTRICTED CODE MEDI CAL TODAY
HOWEVER ACCORDING TO THE LATEST
REPORT BY THE UC BERKELEY LABOR
CENTER DEPENDING ON HOW PUBLIC
CHARGE RULES ARE FINALIZED
PROJECTED ENROLLMENT COULD GET
BY AS MUCH AS 30%.
DOWN TO ABOUT SIX HUNDRED EIGHTY
THOUSAND PEOPLE WHICH MAY MEAN
THAT THERE COULD BE LOWER STATE
COSTS CERTAINLY THAT ALSO MAKES
THE POINT THAT SENATOR HOLLY
MITCHELL TRYING TO MAKE
YESTERDAY AND OR THE THE POINT
THAT SENATOR HOLLY MITCHELL.
MADE YESTERDAY AND SENATE HEALTH
COMMITTEE ABOUT THE NEED TO
INSURE --
COUNTIES --
CONTINUED WOULD BE A PLACE FOR
ENROLLMENT FOR INDIVIDUALS THAT
MAY DESCEND ROLE FROM THE
STATE'S OFTEN OVERLOOKED MANY
UNDOCUMENTED IMMIGRANTS ACTUALLY
HAVE EMPLOYMENT BASED JOB
COVERAGE HOWEVER FOR LOW WAGE
WORKERS LIKE THEY'RE LAWFULLY
PRESENT COUNTERPARTS THEY'RE NOT
OFFER JOB BASED COVERAGE. FOR
LOW INCOME UNDOCUMENTED
IMMIGRANTS 89% ARE UNINSURED
COMPAREDTO NINE FIRST 11% OF
THEIR LAWFULLY PRESENT
COUNTERPARTS AS WITH OFTEN IS
WITH THESE PRESENTATION ACCESS
TO HEALTH CARE IS EXTREMELY
LIMITED IN COMPREHENSIVE CARES
DESPERATELY NEED NEEDED.
CURRENTLY AT THE UNDOCUMENTED OR
READY ELIGIBLE FOR ALL IT
DOESN'T STABILIZE YOU IT DOES
NOT TREAT YOU FOR WHAT MAY
ACTUALLY BE A CHRONIC DISEASE.
IT DOESN'T COME WITH PRIMARY
CARE PROVIDER A MEDICAL HOME
PREVENTIVE CARE SERVICES FOR
PRESCRIPTION DRUGS DEPENDING ON
WHERE THEY LIVE.
SOME UNDOCUMENTED IMMIGRANTS MAY
ACTUALLY HAVE ACCESS TO COUNTY
HEALTH PROGRAMS AS WE MENTIONED
HOWEVER IN RURAL AREAS --
THIS IS A DOCUMENT POPULATION
OFTEN DOESN'T HAVE A LOT OF
ACCESS SOME SIMPLY GO WITHOUT
CARE OR RESORT FEW HOME REMEDIES
PEOPLE ARE OFTEN LIVING SICKER
DYING YOUNGER AND HAVE POOR POOR
HEALTH OUTCOMES LACK OF HEALTH
INSURANCE ALSO MEANS THAT YOU
COULD BE ONE SICKNESS OR INJURY
AWAY FROM.
FINANCIAL CALAMITY DUE TO HIGH
MEDICAL BILLS OR FINANCIAL DEBT
CALIFORNIA WILL LIKELY NEVER BE
ABLE TO ADDRESS THE ISSUE OF
POVERTY IN OUR STATE WITHOUT
ENSURING THAT ALL CALIFORNIA
RESIDENTS HAVE ACCESS TO PUBLIC
PROGRAMS AND ECONOMIC SUPPORT.
FOR THESE REASONS WE URGE YOU TO
MAKE AN INVESTMENT THAT BUILDS
ON THE GOVERNOR'S PROPOSAL TO
ENSURE THAT NO ONE IN OUR STATE
SUFFERS OR DIES FROM EASILY
TREATABLE ILLNESS SIMPLY BECAUSE
OF WHERE THEY WERE BORN.
THANK YOU THANK YOU --
ASSUME STRUGGLING MAJOR THAT
YOUR WITNESS WAS YOUR TESTIMONY
I SEE IS ALL YOUR TIME.
EXTREMELY SHORT OF THOUGHT SO
VERY SHORT THANK YOU I'M SECOND
DIPPING AGNETHA COUGHING AROUND
POLICY CENTER --
WOULD LOVE TO UPLIFT WHAT --
MISTER COLEMAN JUST SAID BY AN
INVISIBLE CRITIC BUT CRITICAL
RESEARCH ASKING FOR THIS
COMMITTEE SUPPORT TO EXTEND TO
ALL THIS YEAR IS BECAUSE OF THAT
SUBSTANTIAL CONTRIBUTION THE
IMMIGRANT COMMUNITIES MAKE TORSO
ECONOMY TO THEIR WORK.
HI IN FROM.
AGRICULTURE TO CONSTRUCTION
DOMESTIC WORKERS TO CAROL
CARETAKERS TO SERVICE WORK THERE
HI ON THE JOB IN A HIGH ENTRY
FIELDS AND WE THINK THAT.
THE CONTRIBUTIONS THEY MAKE ARE
REALLY CRITICAL TO OUR STATE AND
FOR THESE REASONS WE ASK FOR
YOUR SUPPORT TAKES ON HEALTH
CARE COVERAGE TO ALL ADULTS
THINK.
THANK YOU A DOCTOR BILLS AND
DOCTOR PAN I SEE YOU AGAIN
CENTER --
NOT PETER BEYOND CINEMA
DIRECTORS SACRAMENTO COUNTY
DEPARTMENT OF HEALTH SERVICES
TALKING TO SOME OF THE
UNINTENDED CONSEQUENCES OF THE
SEVENTY FIVE TWENTY FIVE CHANGE
IN THE SIXTY FORTY REALIGNMENT.
AS THE DEPARTMENT OF FINANCE
PEOPLE TALKED ABOUT IF COUNTIES
INCLUDING IN OURS AT A TIME WHEN
CALIFORNIA HAS SPIKING
COMMITTEES HONOREE AND SURPLUS
RATES.
SOME OF THEM THREE FOLD GREATER
THAN THEY WERE THREE OR FOUR
YEARS AGO WE DON'T WANNA HAVE TO
CLOSE STD CLINICS AND DISEASE --
INVESTIGATORS AND PROGRAMS LIKE
THAT WHEN I'M TALKING TODAY.
ABOUT HOW IT AFFECTS US IN
SACRAMENTO COUNTY AND AGAIN
ALTHOUGH THIS IS A VERY LAUDABLE
GOAL.
THERE ARE UNINTENDED
CONSEQUENCES.
THE TOTAL LOSS TO SACRAMENTO
COUNTY IS APPROXIMATELY SEVEN
POINT FIVE MILLION DOLLARS WHICH
FUNDS CRITICAL COUNTY HEALTH
SERVICES INCLUDING PRIMARY
BEHAVIORAL HEALTH SERVICES AS
YOU KNOW CENTR. FOR FOUR
THOUSAND PEOPLE PATIENTS AND ARE
HEALTHY PARTNERS UNDOCUMENTED
PROGRAM IN SACRAMENTO COUNTIES
FQHC PAID FOR BY SACRAMENTO
COUNTY --
AND WITH THIS WAS START IN
TWENTY FIFTEEN AS YOU KNOW --
WALLY Là THE GOVERNOR FOR HIS
DESIRE TO PROVIDE FULL SCOPE
MEDI CAL TO ADULTS NINETEEN TO
TWENTY FIVE IRONICALLY.
THIS RESULTS IN A DECREASED TO
NINETY SEVEN POINT 5% OF OUR
UNDOCUMENTED POPULATION THAT
WERE SERVING BECAUSE ONLY A
HUNDRED OF OUR FOUR THOUSAND
PATIENTS.
ACTS OR TWO POINT 5% ARE
ACTUALLY NINETEEN TO TWENTY SIX
NINETEEN TWENTY FIVE AND AS YOU
ALL KNOW.
THEY ARE THE LEAST EXPENSIVE.
THE MOST LIKELY EXPENSIVE
CONDITION AND CONDITIONS ON A
GOOD WORD CAN SERVICE THEY'RE
LIKELY TO GET IS --
WE CARE WHICH THEY ARE ALREADY
ELIGIBLE FOR SO YOU'RE BASICALLY
BITING OFF YOUR NOSE TO SPITE
YOUR FACE OR WHATEVER THE
APPROPRIATE ANALOGY AS IN
ADDITION AS AS YOU KNOW CENTER
WE HAVE A NEW --
AT A NEW CONTRACT WITH UC DAVIS
TO PROVIDE A MEDICARE A SEASON
TO PROVIDE PRIMARY CARE
BEHAVIORAL HEALTH CARE SERVICES
TO FIVE THOUSAND NEW MEDI CAL.
RECIPIENTS AND THE CUTS IN OUR
FOR FQHC FOR THIS BILL IN TERMS
OF UC DAVIS PROVIDERS WILL ALSO
BE HAVE A DRAMATIC EFFECT ON
THOSE FOLKS AS WELL.
SO FOR THAT REASON ALTHOUGH WE
THINK IT'S A LOT OF GOALIE
REGRETTABLY WANT TO OPPOSE THIS
[inaudible]
THANK YOU.
RIGHT --
QUESTION OF ELIA COMMENTS YES.
A BEN JOHNSON WITH THE LA SHOW --
WE HAVE --
PERFORMED AN ANALYSIS OF THE
GOVERNOR'S PROPOSAL TO EXTEND
COVERAGE --
TO UNDOCUMENTED IMMIGRANTS AGES
NINETEEN TO TWENTY FIVE AND
WE'VE WE'VE WE FIND THAT THIS
RELIGIOUS PRESENTS LEGISLATURE
WITH.
AN OPPORTUNITY CHOOSE AMONG ITS
PRIORITIES POPULATION TO EXPAND --
EXPAND COVERAGE TO AND WHERE
DEVOTE ITS RESOURCES THERE --
WE DO --
RAISE A COUPLE OF QUESTIONS --
AND CONCERNS AROUND THE ESTIMATE
IT THE ESTIMATED COST OF THE
EXPANSION --
FIRST WE WOULD NOTE THAT AT
LEAST IN THE FIRST YEAR THE
COSTS ARE LIKELY OVERSTATED --
FOR ONE IMPLEMENTATION IS LIKELY
NOT TO OCCUR ON JULY FIRST BUT
IS LIKELY TO TAKE SOME TIME TO
ULTIMATELY IMPLEMENT SO --
THERE MIGHT BE HALF YOUR COSTS
ARE THREE FORCE HERE COSTS OR SO
FORTH IN THE FIRST YEAR.
SECOND WE FIND THAT THE CASELOAD
ESTIMATE --
FROM THE ADMINISTRATION IS
LIKELY SOMEWHAT OVERSTATED --
THE ASSUMPTION THEY THEY SUMA
RATHER THE ADMINISTRATION
ASSUMES A RATHER HIGH TAKE UP
RATE THAT WE DON'T THINK IT'S
PARTICULARLY LIKELY TO OCCUR.
AND SO WE WOULD --
ADVISE THAT THE LEGISLATURE --
GIVEN THIS ASSUMPTION BY
PROBABLY AROUND TWENTY MILLION
DOLLARS --
WE ALSO --
IT BOTH IN OUR ANALYSIS OF THE
MEDICAL BUDGET AS WELL AS A
SUBSEQUENT REPORT --
THAT WE RELEASED TO ANALYZING --
THE GOVERNOR'S PROPOSED CHANGES
TO NINETEEN NINETY ONE
REALIGNMENT --
WE RAISE A NUMBER OF QUESTIONS
AROUND THE PROPOSED REDIRECTION
OF ADDITIONAL FUNDING FROM
COUNTY INDIGENT --
HEALTH FUNDING AND SO.
AND WE FIND WHILE WE FIND THAT
SOME REDIRECTION IS LIKELY
APPROPRIATE GIVEN ONE THERE IS
GOOD THERE ARE LIKELY TO BE
SOMEWHAT LOWER COSTS WHILE FOR
INDIGENT CARE FOLLOWING THIS
PROPOSAL.
AND TO THAT WE WHEN WE SET THE
THE RATE AT 60% WE DIDN'T
NECESSARILY GET THAT RIGHT AS A
STATE --
THAT WOULD THAT WAS A PROJECTION
AND SO THE ACA UNDER THE ACA
TAKE UP FOR MEDI CAL COVERAGE AN
OLD AND OTHERWISE HAS BEEN QUITE
HIGH.
AND SUBSEQUENTLY WE ALSO
EXPANDED COVERAGE TO
UNDOCUMENTED CHILDREN THROUGH SB
SEVENTY FIVE WE DID NOT --
TIES THAT EXPANSION FUNDING SO
WE DO THINK THAT SOME REDUCTION --
OR SOME REDIRECTION OF FUNDING
FROM --
COUNTY HEALTH REALIGNMENT TO THE
GENERAL FUND TO OFFSET THE COST
OF THIS THIS AND OTHER
EXPANSIONS COULD BE APPROPRIATE
BUT WE DO QUESTION THE MAGNITUDE
AND SCOPE. FOR ONE WE THINK THAT --
THE THE RE DIRECTION AT THIS
LEVEL LEASE FOR CERTAIN COUNTIES
IS LIKELY --
TO IMPACT EXISTING FUNDING FOR
PUBLIC HEALTH ACTIVITIES AS
OPPOSED ENGINE CARE HOW HEALTH
INDIGENT CARE ACTIVITIES AND SO
THAT -- IS
SOMETHING THAT THE LEGISLATURE
MIGHT CONSIDER --
IN ADDITION IT RAISES QUESTIONS
ABOUT THE ONGOING VIABILITY OF
COUNT OF COUNTY INDIGENT HEALTH
FOR THOSE COUNTY STATE --
RUN THROUGH THE COUNTY MEDICAL
SERVICES PROGRAM AS THIS
PROPOSAL IS IT WOULD LIKELY
RESULT IN IN THAT COUNTY MEDICAL
SERVICES UP PROGRAM NOT
RECEIVING ANY FUNDING WHAT --
FOR OVER THE NEXT SEVERAL YEARS
AND SO FORTH AND SO WHILE THEY
DO HAVE RESERVES THAT THEY COULD
SPEND DOWN --
IT DOES RAISE THE QUESTION OF
THEIR ONGOING VIABILITY --
IN LIGHT OF THIS --
THIS PROPOSED [inaudible]
THANK YOU THANK YOU.
RISEN THIS --
YOU GAVE A PRESENTATION FINANCE
THERE'S ANY OTHER COMMON.
HELLO MISTER WHAT ALBUM AND
TICKETS WITH THE DEPARTMENT OF
FINANCE SO THE INCREASE RE
DIRECTION WILL RESULTS LIKE MY
COLLEAGUE SAID IN A AN
ADDITIONAL SIXTY THREE MILLION
GENERAL FUND SAVINGS WHICH IS.
APPROXIMATELY ONE THIRD OF THE
COST -- TO
COVER THE YOUNG ADULT EXPANSION
ON THE MEDI CAL SITE AND SO THE
ADMINISTRATION BELIEVES THAT --
THIS IS REASONABLE LIKE MY
COLLEAGUE ALSO MENTIONED --
WE ARE RECEIVING DATA FROM THE
COUNTIES AND LOOKING AT THE
PUBLIC HEALTH EXPENDITURES
COMPARED TO THEIR HEALTH
INDIGENT EXPENDITURES SO --
WE ARE TAKING THAT FEEDBACK.
OKAY THANK YOU.
RIGHT QUESTIONS FROM COMMITTEE
MEMBERS [inaudible]
ALL RIGHT.
OKAY WELL I ALWAYS HAVE SOME
QUESTIONS SO --
THANK YOU.
FOR PRESENTATIONS AND FIRST OF
ALL I APPRECIATE THE GOVERNOR'S
LEADERSHIP AND DESIRE TO BUILD
ON WHAT WE FOR YOU SEE DID YOUR
AND CITY CALIFORNIA TO BE SURE
WE GOT ALL OUR KIDS COVERAGE AND
MOVE ON TO TO NOW EXPAND.
TO A YOUNG ADULT AGE NO JUST
YESTERDAY IN THIS VERY ROOM --
WE ALSO --
PASSED FOR THE BILL --
TO TRY TO GO EVEN BEYOND THAT --
ALTHOUGH I'D MAKE NOTES SAID
THAT IS A POLICY COMMITTEE
DIDN'T HAVE TO WRESTLE WITH THE
FISCAL ISSUES AND THIS IS NOW A
FISCAL COMMITTEE THAT WE'RE
TALKING HERE --
SO BUT FIRST OF ALL LET ME --
ASK I DO NEED TO TOUCH ON THE
REALIGNMENT ISSUE --
BECAUSE AS A AND I APPRECIATE.
IT'S BEEN BECAUSE THAT YOU
MENTION IT THIS IS A THIRD OF
THE FUNDING THAT SAID IS
REQUIRED BUT ALSO WHAT I HEARD
FROM DOCTOR BILL ANSON WHO AS
THAT SECOND COUNTY AND I'M SURE
WE CAN ASK OTHER COUNTIES.
OF THE FOUR THOUSAND THAT HE'S
COVERING WITH C. MICE P. ONLY
ONE HUNDRED AND HEY ARE
PROBABLY THE BY I DON'T KNOW THE
I DON'T KNOW THAT MY NAME AND
KNOW EXACTLY CONDITIONS THEY
HAVE BUT PROBABLY STATISTICALLY --
LESS LIKELY TO THE PROBABLY ARE
LOW.
AS INDIVIDUALS FRY ON AVERAGE.
LESS COSTLY AS WELL SO --
SO EIGHT SEE IS THIS I ACTUALLY
DISPROPORTIONATELY IMPACTING
NOTES FOR THIS WAY IF WE
ACTUALLY MOVED AND WE SAID WE
COVERED EVERYONE I WAS
UNDOCUMENTED --
THEN.
OKAY THEN WHAT HAPPENS IS THAT'S
A MUCH BIGGER --
REPLACEMENT FOR PEOPLE IS FOR
ALL THE AND DOCUMENT OR SEEN AS
HE AND I GAS COUNTY OF THE FOUR
THOUSAND OF YOU TO CALL EVERYONE
WHO WAS UNDOCUMENTED BUT WE'RE
ONLY DOING.
UP TO TWENTY SIX IT SEEMS TO ME
THAT TAKING THAT MUCH MONEY IS
DISPROPORTIONATE AND WE'VE BILL
HAD PRESENTATIONS ABOUT NINETY
ONE REALIGNMENT BECAUSE IT'S NOT
JUST.
SEE MY SP IT'S PUBLIC HEALTH WE
HAD A HEARING ON PUBLIC HEALTH
INFRASTRUCTURE AND THE ACTUALLY
THE UNDERSTAFFED TING OVER
PUBLIC HEALTH DEPARTMENTS WHICH
HAVE NOT RECOVERED SINCE THE THE
GREAT RECESSION --
MENTAL HEALTH RIGHT AND THAT'S
PART OF NINE ONE REALIGNMENT HSS
HEART OF NINE ONE REALIGNMENT.
SO -- I AM
EXTREMELY CONCERNED --
ABOUT THIS IN PLEASE AND THEIR
ABILITY TO CARRY OUT THEIR
DUTIES --
THEIR PUBLIC HEALTH AND MENTAL
HEALTH DUTIES IF --
PARTICULAR FOR THE SIXTY FORTY
COUNTIES WE MOVE IT UP 275% I
DON'T SEE.
HOW US PROVIDING HEALTHCARE
COVERAGE?
TO UP TO AGE.
TWENTY SIX IS THE FINANCIALLY
EQUIVALENT --
TO TO THAT PORTION THAT SUCH A
LARGE PROPORTION OF THE
REALIGNMENT BEING THEN CALL BACK
TO THE STATE.
SO I MEAN IS IT WAS AT THAT AND
I AM NOT SURE WHO DID THE
ORIGINAL CALCULATION I DOESN'T
JUST THE MAKES SENSE TO ME FROM
THE FROM THE FACE OF IT SO.
CAN YOU GET IT IS THERE A
COMMITMENT FROM THE
ADMINISTRATION FOR HALF OF IT AT
LEAST THAT MINIMUM WIND THIS UP
SO THAT THERE IT'S THERE ARE
SOME A BETTER FINANCIAL COURSE.
FUNDING --
ISSUE THERE.
THE MISTER CHURCH THANK YOU FOR
YOUR COMMENTS --
TO CLARIFY THE CM IS P. COUNTIES
THEMSELVES WILL BE IMPACTED BY
THE INCREASE FOR DIRECTION --
JUST THE CMS BE BORED --
AND WE NOTE LIKE THE ALLEY --
NOTED THAT THERE --
SITTING ON A VERY SICK OVER
THREE HUNDRED AND SIXTY MILLION.
TO CLARIFY THE THE CMS BE
COMPONENT THE OTHER FIVE
COUNTIES --
THEY WILL BE IMPACTED SACRAMENTO
COUNTY --
PLASTER I BELIEVE YEAH WELL FIVE
COUNTIES --
SO TO HAVE THAT REPRESENT ONE OF
THEM YES.
YEAH AND SO --
LIKE DAILY --
NOTED WE DIDN'T --
MODIFIED THE RE DIRECTION NOW
WHEN WE EXPANDED TO THE YOUNG
ADULT POPULATION --
WHICH AS DIRECTOR CAN'T MENTION
THAT WAS TWO HUNDRED AND SIXTY
THOUSAND CHILDREN PLUS A HUNDRED
AND THIRTY THOUSAND SO BUT WE
HAVEN'T DONE --
I WENT TO AN ANALYSIS BY COUNTY
OR BY POPULATION AGAIN WE ARE
GOVERNOR'S BUDGET --
PROPOSAL AT SEVENTY FIVE SEEMS
RE.
OKAY WELL FOR FIRST OF ALL I'D
SAY THAT SOMEONE HAS A LARGER
RESERVE LANDS YOU'RE CHANGING
THE ACTUAL FORMULA SO EVEN ONCE
THAT RESERVE GOES YEARS SO I
MEAN IT'S GREAT SAY WELL SIR
THERE'S A POOL OF MONEY THERE
MAYBE SHOULD JUST TALK ABOUT
NEGOTIATE HOW MUCH THAT PULL.
GETS PUT IN AND NOT MAKE A
FORMAL ONGOING BASIS --
BUT I MEAN IT'S A DEGREE THE
SIXTY FORTY AYE AYE AND BECAUSE
WE'LL THE PROBLEM IS AND WE'VE
START PEELING AWAY AT NINETY ONE
REALIGNMENT --
YELL LAST HEARING WILL TALK WAY
TO ASSESS WILL BE LOOKING AT IT
AGAIN -- I
THINK.
TO YEAH I I THINK WE NEED TO BE
REALLY CAREFUL ABOUT HOW WE'RE
TEAM THREE OTHER DISAPPEAR SO
MANY THINGS TIED TO THIS RIGHT.
AND AND SO --
I AM VERY CONCERNED ABOUT THE
IMPACT THIS HAS.
NOT JUST ON THE COUNTY BUT THE
COUNTY'S ABILITY DELIVER TO KIND
OF SERVICES WE NEED TO PROTECT
THE PUBLIC I MEAN THAT'S A
PUBLIC HEALTH ABOUT.
RIGHT IT'S OUR IT'S OUR POLICE
FORCE AGAINST DISEASES.
AND WE HAVE A STD OUT BILL WE
HAVE SED CRISIS RIGHT NOW WE
HAVE CHILDREN BEING BORN WITH
SYPHILIS.
SHOULD THAT BE HAPPENING CITY
CALIFORNIA IT'S A TREATABLE
DISEASE.
RIGHT BUT PEOPLE CAN'T GET THEIR
STD CARE.
RIGHT BECAUSE WE'VE UNDER CUT
THAT.
WE HAVE OUR PUBLIC HEALTH PEOPLE
NEED TO TAKE YOUR OUTBREAKS WITH
IT I'LL TELL YOU --
THE RECENT POLLS SAID IT SAID
SAID THAT MENTAL HEALTH IS ON
THE TOP CONCERNS RATE ACTUALLY
EVEN TERMS OF FEEL WHAT THE
PEOPLE WANTED PEOPLE SITTING ON
HEALTH CARE ACCESS WAS HE WON
WELL IT'S ACTUALLY MENTAL HEALTH.
WELL THAT'S NINE ONE REALIGNMENT
AGAIN [inaudible]
RIGHT.
SO YOU KNOW ALSO I IT IS I THINK
THERE'S A REAL CONCERN THAT THE
WAY THE FAN AND ACTUALLY I POSE
AND THAT THE ART DIRECTOR CAN'T
HEAR AND I APPRECIATE HER
ANSWERS LIKE.
SO HOW IT HOW IS IT BY THE WAY
ON THE MEDI CAL SIDE WE DO THE
MENTAL HEALTH PIECE HOUSE THE
THE MAN DIDN'T EACH COUNTY
LIGHTING UP THE AMOUNT OF MONEY
THEY HAVE BECAUSE WE SIR SAID
OKAY WILL GUESS WHAT YOUR LINE
ON THE LINE IT DOESN'T OUT.
OF MONEY YOU HAVE TO WORK WITH
WILL YEAH.
YOUR YOUR SALES TAX SENIOR
LICENSE VEHICLE LICENSE FEES NOT
EXACTLY TIED TO THE NUMBER OF
CARS YOU HAVE AND HOW MANY HOW
MUCH PEOPLE SHOP MAYBE MAYBE IF
YOU'RE BORED TO PASS YOU SHOT
MORE I WHO KNOWS.
MAYBE THERE'S SOME CORRELATION
WITH THE MENTAL HEALTH DEMAND
PROBABLY NOT TO THE PROPER.
AND THE AMOUNT OF RESOURCES ARE
ACTUALLY AVAILABLE --
FOR MENTAL HEALTH IN EACH OF THE
COUNTIES BASIN THAT COMPARED TO
WHAT THE DEMAND IS I KNOW IT'S
COMPLEX QUESTION THAT THAT'S
WHAT DIRECTORS AND I AGREE WITH
HER THERE.
THAT'S A COMPLEX QUESTION YOU
KNOW WHAT IS THE ACTUAL DEMAND
BUT DO YOU KNOW WHAT THE
CONNECTION BETWEEN THE TWO SO.
BEFORE WE START TINKERING AROUND
WITH THIS THING AND AND IT DID
IT DID IT LIKE THAT THE SIX
SIXTY THREE MILLION A LOT OF
MONEY.
IN THE GRAND SCHEME OF THINGS WE
MIGHT THINK THAT IS THAT THE
RIGHT POT TO GO FOR TO TRY TO
FIGURE THAT OUT SPECIALLY GIVEN
ALL THE OTHER THINGS THAT
IMPACTS SO.
SAYS TO FOR THAT.
SOME HOPING THAT WE CAN REVISIT
THIS PARTICULAR ISSUE BECAUSE
I'M CONCERNED THAT THIS HAS AN
IMPACT GOOD BECAUSE THERE'S ALL
AYE A SUPPORT AND I REALLY
APPRECIATE THE GOVERNOR
PROPOSING THAT WE PROVIDE THE
COVERAGE THAT TWENTY SIX I'M
HOPING WE CAN EVEN GO FARTHER.
I THE CONCERNED AT THE FINANCING
MECHANISM INCLUDES A PIECE THAT
HAS WIDE RANGING IMPLICATIONS
ACTUALLY FOR THE VERY SAME
PEOPLE.
AND THE REASON COVERAGE AGAIN
NEED TO GET RIGHT WILLIAM
PROVIDE THEM COVERAGE AND DO WE
KNOW YOUNG ADULTS ARE MORE
LIKELY WITH THAT'S WHEN THEY
START DEVELOPING THEIR MENTAL
HEALTH NOW SCHIZOPHRENIA OTHER
TYPES MENTAL HEALTH CONDITIONS
BUT YET.
NOW IT'S GOING TO IMPACTTHE
MENTAL HEALTH RIGHT.
NOW IT'S GONNA HAVE IMPACT ON
THE PUBLIC HEALTH INFRASTRUCTURE
WE HAVE TO PROTECT THEM AGAINST
STDS AND OTHER TYPES OF THINGS
SO.
AT THE WE NEED TO BE A LOT MORE
CAREFUL ABOUT.
ABOUT THIS AND AND WORK OUT SOME
THESE OTHER ISSUES BEFORE
SOMEONE TO TAKE MONEY OUT OF THE
SPOT WHICH AT LEAST AT THIS
POINT IS NOT.
I'M NOT SURE WHAT I CAN SAY WITH
CONFIDENCE THAT WE HAVE.
THE RIGHT RESOURCES THERE YET.
DOES THAT MAKE SENSE.
OKAY AS ITS OWN AND DOES IS
ADMITTED IN AND MY CONCERNS OR
DID YOU THINK.
I KELLY ON NOTED THERE ARE SOME
CONSIDERATIONS --
FOR THIS PROPOSAL AND WE ARE I'M
LOOKING AT LIKE WE SAID LOOK --
LOOKING AT DATA ON PUBLIC HEALTH
VERSUS COUNTY INDIGENT ALSO WE
ARE -- YOU
KNOW LOOKING AT OUR HEARING THE
FEEDBACK THAT WE'RE GETTING ON
THIS PROPOSAL.
WELL THERE'S NO COMMITMENT TO
CHANGE OUR GOVERNOR'S BUDGET
STANDS AS IT IS.
WE ARE WE ARE HEARING THE
CONCERNS.
OKAY WELL I HOPE THAT --
THERE'D BE SOME RECONSIDERATION
WE SEE THIS COME BACK IN.
AND DAY IN AND AND ACTUALLY --
I REALIZE WHERE YOU'RE TALKING
ABOUT AND AGAIN BUT AND I DON'T
KNOW I SERVE PULLED IN A LOT OF
OTHER ISSUES BUT THERE I THINK
THERE IS THIS LARGER QUESTION
WE'RE NOT PUTTING AND DO IT.
DEAL WITH IN THIS BUDGET
ENTIRELY BUT I THINK WE NEED TO
LOOK AT WHERE ARE FUNDING
STREAMS ARE GOING AND HOW DO
THEY LINE UP WITH THE NEEDS THAT
ARE THERE AND SO.
AND I MEAN IN SOME SENSE IS A
MICROCOSM OF THIS BECAUSE I
THINK I'M ALSO HEARING IS THAT
LEASE FOR SOME COUNTIES THE
AMOUNT OF MONEY THAT'S GONNA BE
CLAWED BACK IS MUCH LARGER THAN
THE AMOUNT OF BODY.
THAT'S ACTUALLY THE THEY'RE
READY YEAH SO THAT THAT THERE'S
A DISCONNECT THERE BUT AS ONE OF
THE MANY DISCONNECTS THROUGHOUT
THE SOUL [inaudible]
SYSTEMS UP [inaudible]
OKAY [inaudible]
ALL RIGHT [inaudible]
OTHER QUESTIONS.
OKAY ALL RIGHT IN THE MEANTIME I
GUESS WE CAN TALK ABOUT TRYING
TO FIND SOME MORE RESOURCES.
FOR SEE WORKING IT'S MORE PEOPLE
ALL RIGHT.
OKAY ALL RIGHT WITH THAT AND ONE
THAT.
NIGHT INDEED THANK YOU THANKS
VERY MUCH SO WHAT BEFORE
EVERYONE GOES WELL WE GO AHEAD
TAKE PUBLIC COMMENTS ON THE
ISSUE WELL WE HAVE THE OVERVIEW
AND AND THEN WE HAVE ISSUE TO
WHICH IS THE INDIVIDUAL MANDATE.
AND THE FOR TWENTY FOUR ABILITY
AND THEN THE MEDICAL EXPANSION
ALL COME TOGETHER IN A PACKAGE
SO.
WELCOME.
I THANK YOU I'M SORRY WITH THE
CALIFORNIA IMMIGRANT POLICY
CENTER -- I
JUST WANNA PICK UP ON WHAT MY
COLLEAGUE DEPEND WAS STARTING TO
TALK ABOUT WITH RESPECT TO
UNDOCUMENTED WORKERS AND THEIR
LABOR I KNOW THERE'S BEEN A LOT
OF QUESTIONS ABOUT.
WHAT ARE THE COST SAVINGS IF YOU
PROVIDE PREVENTIVE CARE TO THIS
POPULATION WILL THEY USE THE E.
ARE LESS WILL WE SEE LESS
CHRONIC CONDITIONS AND WILL WE
SAVE HEALTHCARE DOLLARS BUT?
I WON ACT A HIGHLY --
THE BROADER ECONOMIC PICTURE THE
PRODUCTIVITY --
THESE THESE PEOPLE THAT WE'RE
TALKING ABOUT UNDOCUMENTED
ADULTS ARE ONE IN TEN WORKERS IN
OUR STATE --
AND OFTEN THEY WORK IN AN
UNDERGROUND ECONOMY THAT PAYS
THEM LESS THAN WHAT CITIZENS
WOULD ACCEPT --
AND THE EMPLOYERS ROUTINELY
FAILED TO PROVIDE HEALTH CARE OR
OTHER BENEFITS --
AND THEN WE COLLECT TAXES FROM
THESE WORKERS WHILE EXCLUDING
THEM FROM ALMOST ALL PUBLIC
PROGRAMS --
AND EGGS A PERFECT EXAMPLE OF
THAT IS OUR ORGANIZATION
ACTUALLY SPOKE WITH COMMUNITY
BASED ORGANIZATIONS IN THE WAKE
OF THE WILD FIRES.
WHO WERE TAKING IT AGAIN
COMPOSED SMALL GRASSROOTS
COMMUNITY BASED ORGANIZATIONS
TAKING IT UPON THEMSELVES TO GO
OUT AND DELIVER MASKS TO
AGRICULTURAL WORKERS THAT WERE
STILL OUT THERE AND NOXIOUS AIR
QUALITY?
PICKING BLUE STRAWBERRIES IN
VENTURA COUNTY PICKING
BLUEBERRIES OUT IN A LOW DIE WE
HAVE.
MANY EXAMPLES OF THIS --
AND SO I JUST WANT TO REALLY
TOUCH ON THE FACT THAT THE SEE
THE COST SAVINGS ARE NOT JUST IN
HEALTHCARE DOLLARS ARE ALSO IN
WORKER PRODUCTIVITY --
AND THAT WE NEED TO CONSIDER THE
INTERSECTION OF THE LABOR AND
ALSO THE HEALTH CARE ISSUES
THANK YOU.
THANK YOU [inaudible]
WELCOME.
CHU REMEMBERS ALTAMONT IN SMITH
WITH THE AMERICAN CANCER SOCIETY
CANCER ACTION NETWORK AND WE
WOULD LIKE TO EXPRESS SUPPORT
FOR THE AFFORDABILITY MEASURES
WE THINK THAT --
THE MANDATE PIECE ALONG WITH THE
SUBSIDY THE INCREASED SUBSIDIES
WILL GET MORE PEOPLE INSURED AND
IT WILL ALSO BE CRITICAL
ENSURING THAT CANCER PATIENTS.
CAN AFFORD THEIR MEDICATIONS --
AND NOT HAVE TO WORRY ABOUT
PAYING JUST.
FURTHER PREMIUM SO THANK YOU
THANK YOU [inaudible]
WELCOME.
THANK YOU GOOD MORNING ALISON
VIEWS FROM THE CHILDREN'S
DEFENSE FUND OF CALIFORNIA
SPEAKING ON BEHALF OF THE UNITED
WAYS OF CALIFORNIA AND ALSO THE
CALIFORNIA COVERAGE IN HEALTH
INITIATIVES --
WE CONTINUE TO BE VERY CONCERNED
ABOUT AFFORDABILITY FOR CHILDREN
AND FAMILIES IN CALIFORNIA --
AND WHILE WE SUPPORT GOVERNOR
NEWSOME'S FORD ABILITY WE ARE
CONCERNED THAT THE
ADMINISTRATION'S PROPOSAL WOULD
COMPLETELY BY PASSED THE FIVE
HUNDRED NINETY THOUSAND CHILDREN
AND SPOUSES IN CALIFORNIA WHO
FALL INTO THE FAMILY GLITCH --
WE ALSO DO SUPPORT INVESTMENT --
IN AFFORDABILITY ON ON THE SCALE
NEEDED -- AS
I THINK YOU KNOW THE FAMILY
WHICH OCCURS WHEN ONE PERSON IN
THE HOUSEHOLD I HAS AN
INDIVIDUAL OFFER OF COVERAGE IT
IS AFFORDABLE BUT FOR HIM FAMILY
COVERAGE WOULD NOT BE
UNAFFORDABLE.
IN CALIFORNIA THAT'S CHILDREN
WITH INCOMES FROM 210067% OF
FEDERAL POVERTY LEVEL 24100% AND
SPOUSES WITH INCOMES WITH FROM A
HUNDRED AND 3924100%.
AND THESE CHILDREN AND SPOUSES
ARE CURRENTLY COMPLETELY BARRED
FROM FEDERAL SUBSIDIES BECAUSE
THE DEFINITION OF AFFORDABILITY
IS TIED TO INDIVIDUAL AND NOT
FAMILY COVERAGE --
THE ADMINISTRATION'S
AFFORDABILITY PROPOSAL WOULD NOT
PROVIDE ANY ASSISTANCE TO THESE
GLITCH AFFECTED CHILDREN AND
SPOUSES WHILE EXTENDING
SUBSIDIES TO HIGHER INCOME
INDIVIDUALS RAISING CLEAR ISSUES
OF EQUITY --
WE ARE NOT PROPOSING THE
CALIFORNIA COMPLETELY BACK FILL
THE MISSING FEDERAL SUBSIDIES
BUT RATHER THAT PEOPLE --
WE PROPOSE MAKING WHICH AFFECTED
FAMILIES ELIGIBLE FOR STATE
ASSISTANCE IN THE SAME AMOUNT AS
SIMILARLY SITUATED INDIVIDUALS
WHO DO GET FEDERAL SUBSIDIES.
AND WE HOPE WE CAN CONTINUE
THESE DISCUSSIONS TO ENSURE THAT
TODAY AREN'T COMPLETE
CAPRICIOUSLY AND EXCLUDED FROM
BOTH FEDERAL AND STATE
ASSISTANCE --
POSSIBLY WITH A MORE EQUITABLE
APPROACH LIKE PREMIUM STOCKING.
WE'RE ALSO ALL STRONGLY
SUPPORTIVE OF EXPANDING FULL
SCOPE MEDI CAL TO ALL INCOME
ELIGIBLE CALIFORNIANS AND DO
SUPPORT THE GOVERNOR'S PROPOSAL
TO SUPPORT TO EXPAND IT TO M..
PEOPLE UP TO AGE TWENTY SIX
WHICH WILL BUILD ON SB TWENTY
FOUR OF SEVENTY FOUR AND ENSURE
THAT YOUNG PEOPLE DON'T LOSE
COVERAGE WHEN THEY TURN --
NINETEEN TO BE GOOD FOR
CALIFORNIA C. PANS OUT REGION.
WE HAVEN'T GOTTEN TO THE PHOTOS
YET -- SO
THANK YOU VERY MUCH ASKED YOU
CAN TRY TO KEEP REMARKS TWO
MINUTES THANK YOU.
WELCOME MORNING I AM REACH OLDER
READY ON BEHALF OF CALIFORNIA
COVERAGE AND HEALTH INITIATIVES
AS WELL AS THE CHILDREN'S
DEFENSE FUND AND UNITED WAY --
CCH I REPRESENTS FORTY MEMBERS
SIX HUNDRED TWENTY FIVE
AFFILIATES WITH OVER 95% OF
CALIFORNIA'S POPULATION HANDLING
FIVE HUNDRED THOUSAND MEDI CAL
AND COVERED CALIFORNIA ROMANS
PER YEAR AND FORTY TWO COUNTIES --
WE'RE THE PREMIERE ASSOCIATION
FOR COMMUNITY BASED
ORGANIZATIONS PROVIDING
FRONTLINE ENROLLMENT SUPPORT
SERVICES MEDI CAL AND COVERED
CALIFORNIA.
AND THE NEXT WEEK FISCAL YEAR
CALIFORNIA WILL EXPAND MEDICAL
COVERAGE BY A HUNDRED FIFTY
THOUSAND TO TWO HUNDRED THOUSAND
OVER SIX HUNDRED CALIFORNIA'S
INS CALIFORNIANS WILL.
NEED OUR REGION MOMENT RETENTION
AND UTILIZATION SERVICES THE
VAST MAJORITY OF WHICH ARE
LATINO OUR CBO MEMBERS ARE
MOSTLY LATINO GOVERNMENT AND
STAFF.
AND WE WANT TO ENSURE FUNDS ARE
DISBURSED IMMEDIATELY TO CBO IS
WORKING WITH MEDI CAL
BENEFICIARIES.
WE'RE ON THE FRONT LINES IN THE
TRENCHES OF ENROLLMENT SUPPORT
AS CALIFORNIA EXPANDS COVERAGE.
WE SUPPORT THE BUDGET ASK OF THE
PEN IN ITS COALITION COUNTIES
WILL NEED TO SUPPORT.
THE SUPPORT TO EXPAND A ROMAN
STAFF WE HAVE A SIMILAR REQUEST
WE SEEK THIRTY MILLION FOR TWO
YEARS. FIFTEEN FIFTEEN MILLION
PER YEAR FROM THE GENERAL FUND
FOR FISCAL YEARS TWENTY TWENTY
AND TWENTY TWENTY ONE RESULTING
IN THIRTY MILLION TOTAL.
FEDERAL DRAWDOWN WE ARE HOPEFUL
TO BE IN THE FINAL STAGES OF
DISCUSSION WITH THE C. PEN GROUP.
TO MERGE THE TWO PROPOSALS AT
THE REQUEST OF PROPOSALS SUCH AS
REDUCE THE SIZE AND START FOR
NONPROFIT SERVERS AS AN TRIMMING.
THANK YOU.
THANK YOU WE WILL BE HEARING
STAKEHOLDER PROPOSALS AND WE
WILL ALLOW PUBLIC COMMENT AFTER
THOSE SO --
SO JUST THOUGHT YOU KNOW OKAY
THANK YOU WELCOME.
THANK YOU MISTER CHAIR AND
MEMBERS MY NAME IS ELENA SANTA
MARIA WITH NEXT IN CALIFORNIA --
NIXON CALIFORNIA PRIMARILY
FOCUSES ON UP LIFTING THE
MILLENNIAL VOICE WE ARE IN
ELEVEN DIFFERENT STATES ON THREE
HUNDRED FIFTY DIFFERENT COLLEGE
CAMPUSES AND OUTSIDE OF STUDENT
DEBT.
MEDICAL ISSUES AND HEALTH ISSUES
ARE NUMBER ONE ISSUE FOR OUR
STUDENTS AND WE JUST LIKE.
TO WE'RE VERY GRATEFUL FOR THE
GOVERNOR'S FOR FULL PROPOSAL TO
YOUNG ADULTS BUT LIKE TO ECHO --
OUR COMMENTS PER THE COMMENTS OF
HEALTH ACCESS AND C. P. I SEE
THAT WE WOULD LIKE TO COVER THE
REST OF THE A DOCUMENT
POPULATION.
WE BELIEVE IT'S THE FISCALLY
RESPONSIBLE THING FOR CALIFORNIA
TO DO TO GET US CLOSER UNIVERSAL
COVERAGE THANK YOU.
MISTER CHAIR AND MEMBERS MARK
MENDOZA WITH US HERE YOU
CALIFORNIA ON BEHALF OF OUR
SEVEN HUNDRED THOUSAND MEMBERS
JUST ONE A LENDER SUPPORT ON THE
INDIVIDUAL MANDATE.
WAS ALL --
EXPANDING AFFORDABILITY
SUBSIDIES TO FOX AND COVERED
CALIFORNIA --
AND AS WELL EXPANDING MEDICAID
ELIGIBILITY TO ALL UNDOCUMENTED
ADULTS THANK YOU.
THANK YOU.
WELCOME GOOD AFTERNOON CHAIR
LINDA WAY WITH WHAT MY COLLEAGUE
ALREADY DISCUSSED OUR POSITION
ON AFFORDABILITY BUT WOULD LIKE
TO HIGHLIGHT OUR SUPPORT FOR THE
INDIVIDUAL MANDATE WITH.
ADDITIONAL AFFORDABILITY
ASSISTANCE FOR INDIVIDUALS THE
BELOW 210050% OF THE FEDERAL
POVERTY LINE --
WE ALSO APPRECIATE THE
ADMINISTRATION'S PROPOSAL ON
HEALTH FOR ALL YOUNG ADULTS BUT
AGAIN URGE --
THE LEGISLATURE TO EXPAND IT TO
ALL --
INCOME ELIGIBLE ADULTS AND
RELATED TO THE TRAILER BILL
LANGUAGE ON THE CALL BACK ON HOW
WE WOULD --
RECOMMEND --
ALLOWING COUNTIES FLEXIBILITY
FOR THOSE WHO WANT.
TO PROVIDE COVERAGE FOR
INDIVIDUALS INCOME AND LOW
INCOME INDIVIDUALS WHO BUT FOR
THEIR IMMIGRATION STATUS WOULD
BE ELIGIBLE FOR MEDI CAL.
AND AS WELL AS CHAIR THE CHAIRS
CONCERNS RELATED TO THE
DISPROPORTIONATE --
REALIGNMENT CLAWBACK THANK YOU
THANK YOU [inaudible]
WELCOME.
GOOD AFTERNOON MICHELLE GIVENS
AT THE COUNTY HEALTH EXECUTIVES
ASSOCIATION OF CALIFORNIA WE
SUPPORT THE GOVERNOR'S PROPOSAL
TO EXPAND MEDICARE BUT OF COURSE
OPPOSE THE MET THE FINANCING
MECHANISM.
I THINK IT'S IMPORTANT JUST TO
KEEP IN MIND THE WAY THAT --
REALIGNMENT HEALTH REALIGNMENT
WHAT FUNDS IT FUNDS PUBLIC
HEALTH AS WELL AS THE INDIGENT
RESPONSIBILITIES --
AND ARE INDIGENT MANDATE IS FOR
ADULTS AND SO TO TRY TO WRAP --
THE CHILDREN EXPANSION INTO TRY
TO ACCOUNT FOR THAT WITHIN THIS
NEW AB EIGHTY FIVE STRUCTURE IS
IS A LITTLE AND OUTSIDE OF THE
SCOPE.
AND I JUST WANT TO REITERATE TO
THAT WHEN THE SIXTY FORTY DEAL
WAS STRUCK THAT 40% WAS MEANT TO
PROTECT PUBLIC HEALTH SERVICES
AND AT A TIME IN AND I DO WANT
TO ALSO REMIND FOLKS THAT PUBLIC
HEALTH SERVICES.
AT PROTECT EVERYBODY REGARDLESS
OF IMMIGRATION LIKE S. T.
SCREENINGS AND SERVICES OF THAT
NATURE IS PROVIDED TO ALL
INDIVIDUALS IN CALIFORNIA AND SO
WE JUST WANT TO REALLY WANT TO
PROTECT THOSESERVICES MAKE SURE
THAT THEY'RE AVAILABLE TO OUR
COMMUNITIES THANK YOU.
THANK YOU.
WELCOME I THANK YOU MISTER CHAIR
AND MEMBERS KATHY CENTER L<c.cyan&gt;G</c&gt;
WITH THE COUNTY WELFARE
DIRECTORS ASSOCIATION WE SUPPORT
THE EXPANSION OF FULL SCOPE
SERVICES TO UNDOCUMENTED
CALIFORNIANS.
DID JUST WANNA MAKE A COUPLE
NOTES ON THAT FOR YOU THAT WE
AGREE AS THE PROCESS WAS LAID
OUT BY DIRECTOR CAN WE ARE IN
SOME CONVERSATION WITH THE
ADMINISTRATION ABOUT.
THE EXPENSES FOR THE AUTOMATION
WORK THAT WOULD NEED TO BE DONE
TO OUR AUTOMATED SYSTEMS AS WELL
AS LOOKING AT SOMEONE TIME
FUNDING THAT WE'RE REQUESTING
FOR OUR ELIGIBILITY STAFF IN THE
COUNTIES.
ON EVEN THOUGH THAT SYSTEM FOR
MOVING THE INDIVIDUALS FROM.
RESTRICTED SCOPE IN THE FULL
SCOPE IS GOING TO BE AUTOMATED
TO THE EXTENT POSSIBLE THERE'S
AS WE SAW WITH SB SEVENTY FIVE
EXPANSION THERE WERE A NUMBER OF
THOSE.
CASES THAT JUST FELL OUT OF THAT
PROCESS AND MANUAL WORK WAS
REQUIRED SO WE'D LIKE TO TRY TO
GET THAT FUNDED SO WE DON'T HAVE
TO PULL THOSE --
FOLKS FROM OTHER WORK THAT NEEDS
TO BE DONE AS WELL IN THIS YOU
KNOW THIRTEEN MILLION PERSON
PROGRAM THANK YOU SO MUCH.
THANK YOU [inaudible]
WELCOME.
GOOD AFTERNOON MR TURN MEMBERS
KAREN LAYING ON BEHALF OF THE
COUNTIES OF STANISLAUS AND
PLASTER AND STRONG OPPOSITION TO
THE PUBLIC HEALTH DOLLAR TAKE I
DON'T THINK I COULD HAVE SAID IT
ANY BETTER THAN OR YOU DID AS TO
WHY.
THOSE DOLLARS ARE SO IMPORTANT
THEY ALSO DISAGREE WITH ACTUALLY
THE DOLLARS THAT WOULD BE SAVED
ON TOP OF THAT THEY DON'T
BELIEVE THAT THE NUMBERS ARE
ACCURATE.
AND ON BEHALF OF THE COUNTY
MEDICAL SERVICES PROGRAM ALSO
WITH CONCERNS ABOUT THE TAKING
AWAY OF THEIR FUNDING STREAM.
THE COMMITTEE ANALYSES DID AN
EXCELLENT JOB OF POINTING OUT
THE NEW PROGRAM THAT THEY ARE
ROLLING OUT WHICH IS PASSED ON
MY PATH TO HELP.
THE UNDOCUMENTED PERSONS BENEFIT
ALL THE WAY UP TO AGE SIXTY FIVE
WHICH THAT GOES FAR BEYOND WHAT
THE GOVERNOR'S PROPOSAL IS AND
THEY'RE USING THEIR DOLLARS TO
PAY FOR IT.
SO TAKING AWAY THE STREAM OF
REVENUE --
IS A LITTLE PUZZLING TO US SO WE
WOULD ASK FOR THAT TO BE I
REVISITED AND AS FAR AS THE SIZE
OF THE RESERVE.
AND IT WAS MAYBE FIVE OR SIX
YEARS AGO I SAID THIS MICROPHONE
ASKING FOR THE CHAIR SUPPORT AND
MAKING SURE THAT THE COUNT THAT
FAMOUS YOU CAN GET A EMERGENCY
LOAN.
FROM THE STATE TO KEEP THE
LIGHTS ON BECAUSE THEY HAD HELP
THE STATE EMPLOYMENT.
THE AFFORDABLE CARE ACT AND
SPENT A LOT OF I SPENT A LOT OF
THEIR MONEY DOING SO AND SO THE
FORTUNES CAN CHANGE VERY QUICKLY
AND WITH THE CHANGES IN
AFFORDABLE CARE ACT THE FEDERAL
LEVEL --
THEY THEIR DEMAND SOMETIMES A
LAST.
SIX THAT WAY SO WE WOULD ASK FOR
THAT ALSO TO REJECTED THANK YOU
[inaudible]
THANK YOU [inaudible]
WELCOME.
GOOD AFTERNOON MISTER CHAIR I'M
CENTER CERAM SANTANA
REPRESENTING CHINESE FOR
AFFIRMATIVE ACTION OR SUPPORTIVE
OF THE PROPOSAL THAT WOULD
INCREASE MEDICARE ELIGIBILITY TO
ALL OF CALIFORNIANS UNDOCUMENTED
POPULATIONS THANK YOU.
THANK YOU [inaudible]
WELCOME.
HELLO TURN COMMITTEE MY NAME IS
THAT THE PLACENTA HOTTEST I'M
HERE REPRESENTING A DOCU HEALTH
LEADERS AN ORGANIZATION OF
INDIVIDUALS.
AND INDIVIDUALS AND
ORGANIZATIONS ACROSS CALIFORNIA
THAT ARE DIRECTLY IMPACTED BY
THE DECISIONS OF OF HEALTH FOR
ALL IN IMMIGRANT HEALTH.
A LIVING BEING AND DOCUMENTED
AND IMMIGRANTS IN THIS COUNTRY
THESE CONDITIONS DO NOT CHANGE
WHAT DOES CHANGES WHETHER THEY
HAVE A FIGHTING CHANCE AT BEING
ABLE TO BE AT THE HOSPITAL --
LIE.
DYING AT THE HOME WHERE THERE
FIELD OR HAVING A FIGHTING
CHANCE AT THE HOSPITAL I
APPRECIATE THE CONVERSATIONS
ABOUT FIGURING OUT HOW O MAKE
THIS POSSIBLE --
SO THAT COMMUNITIES ARE
PROTECTED AND INVESTED IN IT IS.
THAT'S HEARTENING TO HEAR
CONVERSATIONS WHERE --
UNDOCUMENTED IMMIGRANT PEOPLE'S
LIVES -- ARE --
COMPARED COUNTRY --
WE ARE VERY MUCH A PART OF
CALIFORNIA AND CONTRIBUTE AND SO
MANY WAYS --
ECONOMICALLY CULTURALLY
PERSONALLY --
AND WOULD LOVE TO SEE SOME
RAPPERS RECIPROCITY --
IN OUR IN A CALIFORNIA
GOVERNMENT THANK YOU THANK YOU
[inaudible]
WELCOME.
GOOD AFTERNOON CHRISTINA
GALLAGHER ON BEHALF OF THE
COUNTY OF SANTA BARBARA BOARD OF
SUPERVISORS.
THE COUNTY AS OPPOSED TO THE
GOVERNOR'S PROPOSAL TO CHANGE
THE HEALTH REALIGNMENT FORMULA
IN AB.
EIGHTY FIVE THE PROPOSAL'S
CHANGE FROM SIXTY FORTY TO
SEVENTY FIVE TWENTY FIVE WOULD
COST THE COUNTY TWO POINT ONE
MILLION DOLLARS.
THAT IS ALL GOING TO PUBLIC
HEALTH SERVICES.
AND WE ONLY END UP SAVING
SEVENTY THOUSAND FROM THE
EXPANSION OF MEDICAL COVERAGE TO
UNDOCUMENTED YOUNG ADULTS.
THEREFORE WE RESPECTFULLY HOW TO
OPPOSE [inaudible]
THANK YOU [inaudible]
WELCOME.
ANGELA WILLIAMS OF THE
CALIFORNIA BACK HEALTH MY WORK
ON BEHALF OF THE TWO MILLION
MORE THAN TWO MILLION AFRICAN
AMERICANS AND NEARLY --
THIRTY THOUSAND ONE DOCUMENT
CALIFORNIA'S AFRICAN DESCENT WE
SUPPORT BOTH MEASURES.
PARTICULARLY HONEST
AFFORDABILITY EXPANSION OF
COVERAGE THE SAN ARE VERY
IMPORTANT.
PARTICULAR FOR AFRICAN AMERICAN
FAMILIES OF VERY IS INCOMES
WORKING CLASS MIDDLE CLASS WHO
FALL OFF A CLIFF.
I DO WANT TO MENTION AS WELL AND
YOUR SUPPORT FOR OTHER MEASURES
MEASURE THE FOCUS ON THE SOCIAL
DETERMINANTS OF HEALTH.
INSURANCE IS GREAT BUT IT IS THE
FIRST STEP [inaudible]
THANK YOU [inaudible]
WELCOME.
CHRIS FOR SIGNS OF THE CHIRLA
THE COALITION FOR HUMANE
IMMIGRANT RIGHTS REPRESENTING
IMMIGRANT FAMILIES STUDENTS AND
WORKERS ACROSS THE STATE OF
CALIFORNIA AS CALIFORNIA'S
LARGEST IMMIGRANT RIGHTS --
I ADVOCACY ORGANIZATION AND OR
ON THE GROUND --
IT'S REALLY IMPORTANT THAT WE
EXPAND --
YOU KNOW APPRECIATE THE
GOVERNOR'S PROPOSAL BUT EXPAND
ITS ALL CALIFORNIANS LEARNED
DOCUMENT.
THANK YOU WELCOME.
GOOD AFTERNOON JENNIFER ALI WITH
THE CALIFORNIA ASSOCIATION
HEALTH PLANS AND WE SUPPORT THE
GOVERNOR'S AGENDA TO MAKE
HEALTHCARE MORE AFFORDABLE AND
ACCESSIBLE FOR ALL CALIFORNIANS
WE STAND READY TO WORK WITH THE
GOVERNOR DEAN TO MIISTRATION TO
PROTECT THE SIGNIFICANT GAINS --
CALIFORNIA MADE UNDER THE
AFFORDABLE CARE ACT WE STRONGLY
SUPPORT THE ENACTMENT OF A STATE
BASED INDIVIDUAL MANDATE.
AND PROVIDING ASSISTANCE TO
INDIVIDUALS PURCHASING COVERAGE
AND TO MAKE HEALTH CARE MORE
ACCESSIBLE AFFORDABLE BY
EXPANDING MEDICAID COVERAGE TO
UNDOCUMENTED THANK YOU.
THANK YOU [inaudible]
WELCOME.
JUSTIN GARRETT CALIFORNIA STATE
ASSOCIATION OF COUNTIES --
WE ARE SUPPORTIVE OF THE
PROPOSAL TO EXPAND HEALTHCARE
COVERAGE TO ALL RESIDENTS BUT WE
ARE OPPOSED TO THE SPECIFIC
PROVISION THAT WOULD.
DIVERT COUNTY REALIGNMENT
FUNDING TO THE STATE --
AS HAS BEEN POINTED OUT MULTIPLE
TIMES DURING THIS DISCUSSION
THERE'S NO DIRECT NEXUS BETWEEN
THE AMOUNT OF COUNTY SAVINGS THE
AMOUNT OF FUNDING THAT WOULD BE
DIVERTED IN THE AMOUNT OF PEOPLE
WHO WOULD BE COVERED.
AND THIS WOULD HAVE DETRIMENTAL
IMPACTS ON LOCAL HEALTH SERVICES
AND PUBLIC HEALTH AND THIRTY
NINE COUNTY SO WE STAND READY.
TO WORK WITH LEGISLATION
ADMINISTRATION ON SO NOW THANK
YOU [inaudible]
WELCOME.
BARBARA GLAZER WITH THE
CALIFORNIA HOSPITAL ASSOCIATION
HERE TODAY IN SUPPORT OF THE
GOVERNOR'S PROPOSAL --
TO PUT AN INDIVIDUAL MANDATE IN
PLACE PROVIDE PREMIUM SUBSIDY
AND PROVIDE --
FULL SCOPE MEDI CAL TWO YOUNG
UNDOCUMENTED ADULTS THESE ARE
KEY STEPS TOWARDS UNIVERSAL
COVERAGE AND WE STRONGLY SUPPORT.
THANK YOU.
WELCOME.
AND DINNER WAS ON BEHALF OF THE
CALIFORNIA PAN ETHNIC HEALTH
NETWORK THE WE APPRECIATE AND
SUPPORT THE GOVERNOR'S PROPOSAL
TO EXPAND TO UNDOCUMENTED YOUNG
ADULTS WE WOULD URGE SUPPORT FOR
THE ENTIRETY OF THE ADULT
POPULATION WE FIND THAT THE NEED
IS VERY DIRE THANK YOU
[inaudible]
THANK YOU [inaudible]
WELCOME.
MARK HURLBERT WITH SMALL
BUSINESS MAJORITY --
WE ARE SMALL BUSINESS EDUCATION
AND ADVOCACY ORGANIZATION WE
STRONGLY SUPPORT THE
AFFORDABILITY MEASURES INCLUDED
IN THE GOVERNOR'S BUDGET
APPRECIATE THE CHAIRS COMMENTS
REGARDING A STABLE SORT OF
FUNDING SOURCE SPECIFICALLY FOR
THOSE FOLKS --
ABOVE 40% OF THE FEDERAL POVERTY
LEVEL I'M NOT TALKING TO A SMALL
BUSINESS OWNER ABOUT A WEEK AGO
I SHE IMMIGRATED TO THE US.
FROM MEXICO STARTED A SMALL
BUSINESS IN CHULA VISTA SMALL
GRAPHIC DESIGN FIRM THAT FIFTEEN
EMPLOYEES --
AND THIS YEAR I DO A CHANGE IN
THE SIZE OF THEIR FAMILY --
THERE'LL FELL OFF THE 4100%
FEDERAL POVERTY CLIFF AN HOUR
LOOKING AT PREMIUMS UPWARDS OF
SIX TIMES THE COST OF WHAT THE
COST LAST YEAR AND SO SHE AND
HER HUSBAND ARE TRYING TO DECIDE
DO WE KEEP OUR BUSINESS --
OR DO WE GET HEALTH INSURANCE WE
SHOULD BE ASKING OUR
ENTREPRENEURS TO MAKE THAT
DECISION AND SO WE APPRECIATE --
THIS CONVERSATION TODAY ONLY A
SPORT FOR BILLY MEASURES AS THE
PROPOSED.
I THANK YOU [inaudible]
WELCOME.
HELLO HI MY NAME'S ABBY YOUR
REYES WITH THE LATINO COALITION
FOR HEALTHY CALIFORNIA AND WHILE
WE SUPPORT THE GOVERNOR'S
PROPOSAL WE DO WANT TO HIGHLIGHT
THE IMPORTANCE. TO EXPAND FULL
COVERAGE MEDICAL TO ALL
INDIVIDUALS --
ADULTS --
UNDOCUMENTED INDIVIDUALS WHO
MAKE UP THE LARGEST PERCENTAGE
OF UNINSURED --
AND SPECIFICALLY LATINOS WHO ARE
ONE OF THE LARGEST POPULATIONS
IN CALIFORNIA HALF OF THEM ARE
UNINSURED AND SO CALIFORNIA DOES
HAVE AN UNINSURED CRISIS AND I
WILL.
HELP THE HEALTH CARE IS A HUMAN
RIGHT AND WE DEFINITELY HOPE TO
CONTINUE WORKING TOGETHER TO
TAKE THE APPROPRIATE STEPS TO
GET THERE.
THANK YOU THANK YOU [inaudible]
WELCOME.
HELLO MY NAME IS KAMEL COREY AND
I AM WITH THE PHYLLIS CONNECT
ORGANIZE ATION OF IN THE
COALITION FOR CALIFORNIA PAN
ETHNIC HEALTH NETWORK.
I PERSONALLY WOULD SAY.
MOST IMPORTANTLY TO I DO SUPPORT
THE GOVERNOR'S BILL AND EXTEND
IT.
TO AN UNDOCUMENTED IMMIGRANT
ADULTS AND MOST IMPORTANTLY
BECAUSE AS YOU ALL MIGHT KNOW.
WE ARE ALL STUDENTS.
I MEAN WE WERE ALL STUDENTS AT
ONCE AND IMMEDIATELY LEE
AFTERWARDS.
YOU GRADUATE.
YOU HAVE NO HEALTH INSURANCE IN
YOUR STILLS STRUGGLING WITH LIFE
OUR TO GET ON YOUR FEET SO MOST
IMPORT.
IN THE I WOULD SAY DEFINITELY
LEAVE FOR OUR AFRICAN IMMIGRANTS
AND ALSO FOR THE MUSLIM
IMMIGRANTS WHO WE DEFINITELY
NEED TO HELP SUPPORT BECAUSE I
WOULD FEAR PAINTING DEADLY WITH
NEW ZEALAND.
WHAT HAPPENED HERE?
THANK YOU THANK YOU WELCOME.
CHAIR MEMBERS KNOW AT BOTTOM ALL
WITH CALIFORNIA RURAL LEGAL
ASSISTANCE FOUNDATION.
MEDI CAL IS AN ESSENTIAL BENEFIT
FOR FARMWORKERS [inaudible]
AND THE AGRICULTURAL INDUSTRY
HAS RECEIVED A SUBSTANTIAL
BENEFIT FROM THE WORK OF THE
FARMER CHRIS THROUGHOUT THE
STATE.
YET MANY ARE LEFT OUT BECAUSE OF
THEIR STATUS SO WE NEED TO
SUPPORT.
THE ACCESS TO COVERAGE AND
AFFORDABILITY FOR ALL
FARMWORKERS SO WE STAND IN
SUPPORT OF THE GOVERNOR'S
PROPOSAL UP TO TWENTY FIVE AND
WE ALSO ASKED TO SEE TO SUPPORT
BEYOND TWENTY FIVE INCLUDING OUR
SENIORS.
AND JUST ON THE EXPANSION
PROPOSAL THE ROMAN PROPOSALS
STAND AS PART OF THAT AS WELL I
KNOW WHAT'S NEXT WHAT THANK YOU
VERY MUCH.
THANK YOU.
WELCOME I ANGER MAYES FAILURE OF
CALIFORNIA IN SUPPORT OF THE
GOVERNOR'S PROPOSAL TO PROVIDE
MEDICARE ALL TO UNDOCUMENTED
YOUNG ADULTS BUT LIKE MY
COLLEAGUES BEEN COURAGE
EXPANSION TO THE WHOLE
POPULATION.
SO THAT EVERYONE CAN HAVE ACCESS
TO HEALTH CARE AND LIVE LIVES OF
DIGNITY THANK YOU THANK YOU
[inaudible]
WELCOME.
DEBORAH DISABILITY RIGHTS
CALIFORNIA ALSO WE ARE A MEMBER
OF THE CARE FOR ALL CALIFORNIA
COALITION AND WE SUPPORT
COALITIONS PROPOSAL WOULD LIKE
TO SEE EVERYONE BE COVERED THANK
YOU.
THANK YOU [inaudible]
WELCOME.
GOOD AFTERNOON SIR HAS GETS WITH
THE CALIFORNIA ASSOCIATION OF
PUBLIC HOSPITALS IN STRONG
SUPPORT FOR THE GOVERNOR'S
PROPOSAL AS WELL AS THE BROADER
EFFORTS TO COVER.
ALL ELIGIBLE INDIVIDUALS FOR THE
MEDICARE PROGRAM ARE SYSTEM
COLLECTIVELY STILL SERVE MORE
THAN 40% OF THOSE THAT REMAIN
UNINSURED AND A NUMBER OF THEM
HAVE STARTED.
LOCAL COVERAGE PROGRAMS IN THEIR
OWN COMMUNITIES IN AS WE THINK
ABOUT COVERAGE EXPANSION WE VERY
MUCH ENCOURAGE EFFORTS TO TO TRY
TO THINK ABOUT HOW WE MAINTAIN
CONTINUITY OF CARE. FOR THOSE
INDIVIDUALS WHO WANT TO KEEP
SEEING THE PROVIDERS THEY SEE
TODAY THANK YOU.
THANK [inaudible]
WELCOME.
KELLY BROOKS I'M HERE ON BEHALF
OF THE SANTA CLARA COUNTY BOARD
OF SUPERVISORS AND OR IN SUPPORT
OF ALL PROPOSALS --
TO EXPAND FULL SCOPE MANAKALA
TELL UNDOCUMENTED ADULTS THANK
YOU.
THANK YOU WELCOME.
HI AND BYE BIGGER PATEL FROM
COMMUNITY HEALTH COUNCILS IN LOS
ANGELES ALSO ON BEHALF OF OUR
STATEWIDE COALITION COVERING
KIDS AND FAMILIES AND OUR COUNTY
WIDE COALITION.
EARLY ACCESS TO HEALTH COVERAGE
WERE IN SUPPORT OF ALL OF THE
PROPOSALS TO INCREASE
AFFORDABILITY AND ALSO TO EXPAND
FULL SCOPE MEDICAL COVERAGE
UNDOCUMENTED YOUNG ADULTS.
ENERGY ALL TO CONSIDER EXPANDING
MEDICAL COVERAGE ALL
UNDOCUMENTED ADULTS THANK YOU
THANK YOU.
WELCOME.
GOOD AFTERNOON KELLY MAC MILLAN
ON BEHALF OF THE BOARD OF
SUPERVISORS ALAMEDA COUNTY AND
THE CALIFORNIA DENTAL
ASSOCIATION WE SUPPORT THE
GOVERNOR'S PROPOSAL TO EXPAND
MEDICAID. FOR ALL UNDOCUMENTED
AND AFFORDABILITY AS WELL THANK
YOU THANK YOU [inaudible]
WELCOME.
HI THIS IS IT --
I'M CHRISTIAN GOLDEN TEST WITH
THE CHILDREN'S PARTNERSHIP AND
AS MEMBERS OF THE CARE FOR ALL
COALITION WE ALSO SUPPORT --
A HEALTH FOR ALL COVERAGE FOR
ALL ALL UNDOCUMENTED IMMIGRANTS
THAT ARE ELIGIBLE INCOME WISE --
AND THEN ALSO ON THE
AFFORDABILITY WE SUPPORT THE
AFFORDABILITY ASSISTANCE
PROGRAMS IS VERY IMPORTANT --
AND ADDING TO THE GOVERNOR'S
PROPOSAL FUNDS BEEPER --
PROVIDED THAN WATER THERE --
TO REALLY MAKE A DIFFERENCE IN
MOVING THE DIAL A MAKING IT
AFFORDABLE AND ALSO TO NOT
EXCLUDE --
THOSE CHILDREN AND FAMILIES --
THAT ARE IN THE FAMILY GLITCH
THANK YOU.
WELCOME.
HELLO SIGN LEVEL THAT'S WITH
MATERNAL AND CHILD HEALTH ACCESS
IN LOS ANGELES WE SUPPORT THE
AFFORDABILITY OF COVERAGE AND
ALSO SUPPORT THE EXPANSION. TO
AGE TWENTY SIX BUT MOST
IMPORTANTLY SUPPORT --
COVERAGE FOR ALL THANK YOU THANK
YOU.
PRIDE MONTH THANK EVERYONE WHO
TESTIFIED I DO HAVE SOME FOLLOW
UP QUESTIONS THAT RELATE TO THE
SOME OF THE PUBLIC TESTIMONY SO
FIRST OF ALL WE'VE HEARD FROM
SEVERAL PEOPLE AND I THINK ANY
MENTION THERE'S A BILL THAT TO
ACTUALLY EXPAND GO BEYOND AGE
TWENTY SIX HAS.
FINANCE DONE ANY ANALYSIS AS TO
HOW MUCH.
THAT WOULD COST SINCE WE'RE
BUDGET SUBCOMMITTEE.
A LORRY ALLEGE APARTMENT A
FINANCE THE MEDI CAL COSTS FOR
EXPANDING.
THROUGH AGE --
SIXTY FOUR IS A ONE POINT SEVEN
BILLION THAT'S JUST FOR MEDI CAL
OUR FINANCE COUNTERPARTS FOR
DEPARTMENTS OR SERVICES ARE
STILL WORKING ON THE ESTIMATE
FOR HSS COSTS THAT ONLY UPDATE
SIXTY FOUR THAT'S ONLY AND REACH.
SIXTY FOUR IS A ONE LOOKED AT
AND SIXTY FIVE AND ABOVE IS.
NINETY FOUR MILLION GENERAL FUND
OKAY IN THAT INCLUDE FULL SCOPE
INCLUDING NURSING HOME CARE
EVERYTHING ARE AT IS NOT INCLUDE
I JUST SAYS.
OKAY BUT THINGS ARE STILL BEING.
DEVELOPED OKAY DOES THAT INCLUDE
NURSING HOME CARE.
TO YEAH I KNOW YOU TO PAY FOR
MANY OF THEM YEAH.
SO THAT WOULD BE IN ADDITION TO
THE CURRENT COSTS.
SO THAT WE CAN VERIFY BUT THE
COSTS THAT DEPARTMENT OF FINANCE
HAS FOR SIXTY FIVE AND ABOVE FOR
THE COST THAT WE OTHERWISE DON'T
PAY FOR TODAY SO WE DO PAY FOR
SKILLED NURSING CARE FOR
UNDOCUMENTED IMMIGRANTS --
SO WE CAN GET BACK ON MORE
DETAILS BUT THAT'S PROBABLY THE
DELTA OF THE DIFFERENCE FOR
WHAT'S OTHERWISE NOT COVERED
OKAY AND OF COURSE WE SAID WE
WERE.
DOING TO GET FROM SOCIAL SERVICE
THE ITEMS AS CLASS CORRECT
THAT'S CORRECT OKAY.
RIGHT AND THEN THE OTHER
QUESTION I HAVE IS --
WE HEARD ABOUT THE FAMILY GLITCH.
THAT WAS --
IS THERE IN TERMS OF TRYING TO
ADDRESS THAT PARTICULAR ISSUES
THAT HAD BEEN AN EXAMINATION OF
WHETHER SOME OPTIONS TO REALIZE
THAT'S AT THE FEDERAL LEVEL --
TERMS OF THE STATE TRYING TO
HELP OUT IN ANYWAY WITH SENT.
OUT NOW.
OKAY.
THE DECLINE PART OF FINANCE
AGAIN WE'RE NEARING AS CLOSE AS
POSSIBLE TO THE FEDERAL LEVEL
RIGHT NOW SO THE FAMILY COULD
WOULD STILL BE.
REFLECTED IN OUR PROPOSAL FOR
THE STATE MANDATE AND STATES OF
THE PROGRAM.
OKAY SO --
SO THERE ISN'T ANY EXAMINATION
WHETHER JURORS.
SOMETHING THAT WE MIGHT DO TO
HELP OUT FAMILIES WHO ARE CAUGHT
IN THE FAMILY GLITCH ALL RIGHT
NOW AGAIN IT IN MIRRORS WHAT'S
IN THE FEDERAL LAW [inaudible]
OKAY.
RIGHT IT MIGHT BE GOOD.
TO LOOK AT THAT I MEAN I REALIZE
IT'S A AND UNFORTUNATELY I THINK
SOME OF THAT CAME OUT OF THE NAY
THE WAY THE ACA CAME OUT WHICH
WAS IS THAT --
WHEN THE ACA WAS GOING THROUGH
TO THE THE WORKING VERSION WAS
THE HOUSE VERSION UNTIL?
THE THE ACTION IN THE SENATE
WHICH MEANT THAT THE SENATE
VERSION BECAME THE DEFAULT
VERSION BECAUSE YOU CAN MAKE IT
AMENDMENTS TO IT SO WE HAD SOME
OF THESE THINGS LIKE.
UNFORTUNATELY THE FAMILY WHICH
IS A PRETTY BIG.
ONE SO ALL RIGHT I JUST WANT TO
PUT A LITTLE MARKER ON THAT AS
WELL AND OKAY.
RIGHT ANY OTHER QUESTIONS.
OKAY WELL THANK YOU ALL FOR FOR
BEING HERE --
WE'RE NOW GOING TO HEAR --
WE HAVE SEVERAL STAKEHOLDER
PROPOSALS RELATED TO EXPANSION
MEDICARE ELIGIBILITY ENROLLMENT.
SEE WE HAVE THREE CELL WE NEED
STILL NEED OUR LA --
AND THE APPROPRIATE FINANCE
PEOPLE HERE.
THANK YOU ALL RIGHT SO WE'LL
START THE FIRST ONE IS --
WE HAVE --
WHEN THE WIND FROM THE WEATHER
CENTER WESTERN CENTER OF LAW
POVERTY ENDEAVOR ROTH THE
DISABILITY RIGHTS CALIFORNIA FOR
VISITING PROPOSAL FOR EXPANDING
MEDICAID ALL AGES DISABILITY
EDGELL ELIGIBILITY OF 210030% OF
THE FEDERAL POVERTY LEVEL?
SO ASK YOU CAN TRY BETWEEN THE
TWO OF YOU --
AND THEN WE MAY HAVE OP THESE
ARE QUESTIONS FOR EVEN MORE
DIALOGUE SO THANK YOU WELCOME.
GOOD AFTERNOON CHAIR ACTUALLY
HOLD ON MAYBE BEFORE JUST FOR
INTRODUCTIONS SO --
DELEO WHO'S HERE FRIENDLY I'LL.
LA A A BEN JOHNSON WITH THE
ALIENS.
BROWN WAS THE LA ON OKAY FINANCE.
LARA AYE ALLEN.
WELCOME AND A GUEST OKAY THANK
YOU THANK YOU VERY VERY MUCH
COULD BEGIN.
GOOD AFTERNOON CHAIR MEMBERS LED
THE WAY WITH WESTERN CENTER ON
LAW AND POVERTY WE APPRECIATE
THE SUBCOMMITTEE CONSIDERING
RAISING THE MEDI CAL AGING
DISABLED.
INCOME LIMIT UP TO A 138% AT THE
FEDERAL POVERTY LEVEL UNDER THE
HEALTH CARE REFORM ALMOST ALL
ADULTS.
EXCEPT FOR SENIORS ARE ELIGIBLE
FOR MEDICARE OUT OF 210038% OF
THE FEDERAL POVERTY LINE. SIXTY
FIVE AND OLDER ARE SUBJECT TO A
LOWER INCOME ELIGIBILITY
THRESHOLD OF ABOUT A 123% OR
DIFFERENCE OF ABOUT A HUNDRED
FIFTY DOLLARS A MONTH.
SO IF THE SENIORS END OF IT
INCOME IS MORE THAN TWELVE
SEVENTY ONE A MONTH.
THEY CAN ONLY GET FREE MEDICARE
HOW THE CAN ONLY GET MEDI CAL
WITH THE SHERIFF COST SHARE COST
IS THE AMOUNT AN INDIVIDUAL MUST
PAY. FOR FREE MEDI CAL KICKS IN
A PERSON'S MEDICAL SARE COST IS
BASED ON THE IDEA THAT THEY CAN
LIVE OFF OF SIX HUNDRED DOLLARS
A MONTH SO ANYTHING OVER THAT.
IS THEIR SHARE OF COST --
FOOD OR THEIR MEDICAL SHERIFF
COST MANY SENIORS FOREGO NEEDED
MEDICAL X..
A SERVICES PROMPTING THEM TO
MOVE INTO SKILLED NURSING
FACILITIES AT A HIGH COST TO THE
STATE BUT AN EVEN HIGHER
PERSONAL COST TO THEMSELVES.
ARE THERE FOR A WEEK WE URGE AT
SUBCOMMITTEE --
TO IN THE SENIOR PENALTY AND
REYES THE INCOME LIMIT THANK YOU.
THANK YOU SENATOR PANDER BROTH
DISABILITY RIGHTS CALIFORNIA.
WE SUPPORTED THIS PROPOSAL LAST
YEAR'S FOR HIGH PRIORITY FOR US
THIS YEAR I THINK YOUR ANALYSIS
DID A VERY GOOD JOB OF POINTING
OUT WHY THIS DISPARITY EXISTS.
WHEN THE PROGRAM WAS CREATED THE
INCOME JUST REGARD WAS MEASURED
IN DOLLARS RATHER THAN
PERCENTAGES AND SO OVER TIME WE
NOW HAVE?
A ONE HUNDRED AND 23% --
ELIGIBILITY CUT OFF AND WHAT I
THINK IS REALLY INTERESTING
ABOUT THAT EARLIER WHEN YOU WERE
TALKING ABOUT THE INDIVIDUAL
MANDATE YOU TALKED ABOUT HOW
EVERYTHING GOES UP AND DOWN AND
UP AND DOWN UP AND DOWN.
AND IT ALL DEPENDS ON WHETHER
YOU'RE IN OR YOU'REOUT AND IN
THIS PROGRAM IF YOU'RE OUT IF
YOU FACE THAT HIGH SHERIFF COSTS
THAT LINDA WAS TALKING ABOUT.
YOU'RE MAKING A CHOICE OR YOU
CAN PAY YOUR RENT ARE YOU GOING
TO GET HEALTHCARE A LOT OF THE
TIME YOU'RE JUST GOING TO SKIP
THAT HEALTH CARE PART AND THEN
YOU END UP IN THE IN THE
EMERGENCY ROOM OR WORSE.
PRETEND THAT MY BOOK HERE THE
ROOM.
INSIDE THIS ROOM IS EVERYONE HAS
HEALTH INSURANCE I TELL YOU
SPREAD RISK EVERYBODY'S INSIDE
THE ROOM MY PEN MY PEN IS THAT
PERSON WHO DOESN'T HAVE THAT.
QUALIFICATION TO MEET THAT
MEDICAL MEDI CAL ELIGIBILITY
LEVEL ALL THOSE PEOPLE OUTSIDE
THE ROOM MAKE IT MORE EXPENSIVE
FOR EVERYONE ELSE WE WANT TO GET
EVERYBODY IN THE ROOM IN THE
SAME ROOM SPREAD THE RISK AND
MAPS FAIR.
THANK YOU.
THANK YOU OKAY COME A COMES FROM
AVAIL.
NOW FINANCE IN COMMENTS ALL
RIGHT [inaudible]
OKAY.
ALL RIGHT WELL.
THANK HIM ALL RIGHT WELL THEY
SAID WE'VE FIVE THREE SHOULD
BRING THIS BACK UP FOR US IN THE
AND HOPE THOSE.
ACTUALLY DO YOU HAVE ANY IS RENT
ANY PROJECTION AND WHAT THE
BUDGETARY IMPACT OF DOING THIS
WOULD BE IN TERMS FROM LAST YEAR
[inaudible]
FINANCE.
WE HAVE NOT EVALUATED ANY OF
THESE PROPOSALS AT THIS TIME --
FOR THE CURRENT BUDGET
DEVELOPMENT PROCESS OKAY SO --
PREPS RIGHTS AND TO A TECHNICAL
ASSISTANCE YEAH WE'RE HAPPY TO
VALUE A AND DISCUSS THE
LEGISLATURE'S PRIORITIES AS WE
MOVE FORWARD.
OKAY.
ALL RIGHT DO YOU DON'T HAVE IT
THAT.
HELLO LAST YEAR THE ESTIMATES --
WAR -- THE
THE ANNUAL ESTIMATES WERE ABOUT
I THINK A HUNDRED AND EIGHTY ONE
WHEN YOU LOOK AT THE OUT YEARS
NOT US THE FIRST YEAR BUT THE
AFTER THE THE RAMP UP --
AND WE WE'VE HAD SOME SOME
INITIAL CONVERSATIONS WE THINK
THAT'S A LITTLE HIGH BECAUSE OF
THE DIGEST AS TAKE UP AS HIGH AS
WELL AS THE THE MEDI CAL
POPULATION --
MORE BEING --
DULY ELIGIBLE AND THEREFORE
CHEAPER SO --
WE'VE HAD SOME INITIAL GOOD
CONVERSATIONS WITH --
FINANCE AND I LOOK FORWARD TO
CONTINUING THOSE CONVERSATIONS
OKAY ALL RIGHT OKAY WELL THANK
THANK YOU VERY MUCH AND WILL GET
TAKE PUBLIC COMMENT AFTER WE
FINISH ALL THE STAKEHOLDER
PROPOSALS I THINK SURAJ OKAY --
NEXT UP WE HAVE --
KRISTIN GOLDEN TESTER FROM THE
CAL GRAHAM.
OKAY SELF ACTUALLY FORGET ALL
INTRODUCE OURSELVES FIRST AND
THEN WE CAN BEGIN YOUR TESTIMONY
I WON'T COUNT THE INTRODUCTION
TIME AGAINST YOUR THREE MINUTES.
ALL RIGHT.
TOTAL THE INTRODUCTION
INTRODUCTIONS FIRST OKAY --
CHRIS GOLDEN TEST WITH THE
CHILDREN'S PARTNERSHIP ON BEHALF
OF THE CHILDREN'S COVERAGE
COALITION --
FARLEY THE CALIFORNIA WITH
ASSOCIATION OKAY --
CARES ON BEHALF OF THE MARCH OF
DIMES OKAY SO BETWEEN THE TH THE
HOWEVER MAYES TALKING YEP THREE
MINUTES RIGHT GOOD --
SO WE'RE ASKING FOR FUNDING IN
THE TO IMPLEMENT A MEDI CAL
EXPRESS LANE PATHWAY TO
ENROLLMENT HROUGH.
THROUGH THE WICKETS THAT THROUGH
WORK ON THIS IS ABOUT FIVE
MILLION GENERAL FUND IN THE
BUDGET YEAR AND AS YOU KNOW
THERE'S ABOUT TWO HUNDRED EIGHTY
THOUSAND UNINSURED CHILDREN AS
YOU HEARD --
HALF OF THEM ARE ELIGIBLE SO
REALLY OUR WORK IS TO FIND THEM
AND ENROLL THEM --
THE SMART STRATEGY WOULD BE TO
GO TO OTHER STATE PROGRAMS WHERE
THE SIMILAR ELIGIBILITY RULES
AND THOSE FAMILIES ARE WERE
LARGE NUMBER OF FAMILIES ARE.
AND ENROLL THEM FROM THEIR WHERE
WHICH IS A NUTRITIONAL PROGRAM
BUT NOT ROLE TO MEDI CAL AND
BASED ON ELIGIBILITY THEY ALL
SHOULD BE ENROLLED.
AN ELIGIBLE FOR MATT AND MEDI
CAL SIMILARLY THERE'S THIRTEEN
THOUSAND PREGNANT WOMEN AND THIS
IS A CONCERNING PROBLEM BECAUSE
WE KNOW THE NAMES AND ADDRESSES
AND PHONE NUMBERS OF THESE
FAMILIES AND YET WE'RE NOT
HELPING THEM AND ROLE.
SO -- YET
THERE'S A GOOD STRATEGY HERE
WHERE THERE'S A FEDERAL --
FLEXIBILITY THAT ALLOWS US TO
EXPRESS LANE AT THE TERMINOLOGY
EXPRESSLANE ELIGIBILITY THEM
INTO A MEDIC HELP USING THE WICK --
ELIGIBILITY FINDINGS AND SO OUR
PROPOSAL IS TO DO JUST THAT ON
TO CREATE A PATHWAY FOR NOT JUST
THOSE FOLKS THAT ARE NOW ON WORK
BUT GOING FORWARD THAT WHEN
THEY'RE SHOWING UP --
FOR WHICH NUTRITIONAL SERVICES
THEY'RE ABLE TO ENROLL --
INTO MEDICAL AT THE SAME TIME --
LOGISTICS ON DOLLARS AS I
MENTIONED FIFTY MILLION DOLLARS --
IS FIVE MILLION IS WHAT WE'RE
IMAGINING IT IS WHAT IT WILL
COST IT'S WILL BE MODIFIED THESE
ARE --
SYSTEM MODIFICATION DOLLARS AND
THEN GOING FORWARD IT'S REALLY
JUST THE ENROLLMENT COSTS OF
THESE CHILDREN TO THAT --
WE'VE ALREADY PROMISED WE'D WIN
ROLE AND AND THIS IS THIS THIS
WOULD BE FOR FILLING THE STATE
COMMITMENT --
FOR THOSE CHILDREN AND THE
GOVERNOR --
ON THE AGENCIES WE KNOW THAT
THEY SUPPORT THIS PROPOSAL --
EASING ACCESS INTO HEALTH CARE
FOR THESE WOMEN AND THEIR
CHILDREN WILL HAVE BETTER HEALTH
OUTCOMES WHICH IS A NUTRITION
PROGRAM AND JUST THAT ALONE HAS
BETTER OUTCOMES.
HEALTH OUTCOME SHORT TERM AND
LONG TERM SO CERTAINLY IF PEOPLE
CAN EASILY GET INTO HEALTH CARE.
AND THEN I HAVE THE HEALTH OF
BENEFITS WILL HAVE BETTER
OUTCOMES IN SOMETHING.
OF NOTE ABOUT THE WICK
PARTICIPANTS IS THEIR YOUNG
THEY'RE ALWAYS GOING TO BE YOUNG.
AND WHEN THEY DO USINESS THEY
EXPECTED TO BE STREAMLINED AND
THEY ARE OKAY WITH INCREASED USE
OF TECHNOLOGY SO HORIZONTAL
INTEGRATION SPEAKS TO THEM.
AND THAT'S HOW THEY DO BUSINESS
SO.
OF MODERNIZING THIS AND EXCUSE
ME HAVING DATA ON SHARING AN
ELIGIBILITY AND APPLICATION
ACCESS.
IS SOMETHING THAT WOULD REALLY
ENHANCE --
UPTAKE AND HAVE A GOOD OUTCOME
FOR THESE KIDS IN OUR FAMILIES
IN THE COMMUNITIES.
THANK YOU ORDERED AS WITH ALL
WOMEN OF CHILDBEARING AGE
PREGNANT WOMEN AND CHILDREN AND
CHILDREN SHOULD HAVE ACCESS.
TO QUALITY AFFORDABLE HEALTH
CARE REGARDLESS OF IMMIGRATION
STATUS THE BEST TIME TO HELP A
WOMAN SURE CORRECT HEALTHY
PREGNANCIES BEFORE SHE'S
PREGNANT.
WOMEN NEED TO HAVE REGULAR CARE
TO MANAGE BOTH ACUTE AND CHRONIC
CONDITIONS THAT COULD IMPACT THE
HEALTHCARE FUTURE PREGNANCIES
WOMEN HAVE COVERS ONLY
SPORADICALLY THEY CAN ACCESS THE
CARE THEY NEED TO MAINTAIN GOOD
HEALTH CARE ADDRESS NEW NEW
CONDITIONS.
STAYS ABOUT THE ACCESS TO CREATE
A CARE IS ASSOCIATED WITH REDUCE
THE RATES OF LOW BIRTH WEIGHT
INFANT DEATH IN THE EARLY
PRENATAL CARE CAN.
HELP AVOID COME COMPLICATIONS
FOR THE MOTHER SECURE
HOSPITALIZATION INSTANT
TREATMENT.
OF THE PROPOSED ASSIST WITH
IDENTIFYING POTENTIALLY ELIGIBLE
PREGNANT WOMEN AS WELL AS
MINIMIZE THE TURN OF MAINTAINING
COVERAGE OF ELIGIBLE WOMEN.
PROMOTING IS CONSISTENT COVERS
FOR ALL WOMEN IS OUT OF CHILD
BEARING AGE THANK YOU IT'S
ALWAYS HARD TO BE THE LAST ONE
BECAUSE GET YOU GET THE OTHER
PEOPLE THAT.
KEEP THAT ALL RIGHT --
COMES FROM ILLEGAL [inaudible]
THE FINANCE.
ACTUALLY DIRECTOR TED.
SINCE.
THE EARLY COMMENTS WRAPS.
THOUGH --
COMBINE.
YOU'RE WAITING --
CAN ALL RIGHT OKAY --
FRANKLY MAKES SENSE TO BE KIND
OF THE SCUM BAG UP BEFORE --
BUT SO MAYBE SEE WORK MAKING
PROGRESS ON IT THIS YEAR OKAY
THANK YOU THANKS VERY MUCH AND A
QUESTIONS.
OKAY.
ALL RIGHT.
BUT NOW WE OUR THAT WE HAVE TO
CALIFORNIA PAN ETHNIC HEALTH
NETWORK AND MATERNAL CHILD
HEALTH ACCESS CON FUNDING FOR
OUR REGION ROMAN SYSTEMS FOR
MEDI CAL ELIGIBLE INDIVIDUALS
[inaudible]
WELCOME.
AND WE'RE ASSURING PEOPLE MAKING
REMARKS OF SUPPORT AND PUBLIC
COMMENT PRIOR ITEM SO EAGER TO
HEAR WHAT YOU HAVE TO SAY.
WHAT WERE THEY ASKING SUPPORT?
FOR RIGHT AND AGAIN --
BAY JUST FOR THE RECORD AGAIN IF
YOU INTRODUCE YOURSELVES --
AND THEN WILL BEGIN THE
TESTIMONY.
A LINDA ON BEHALF OF THE
CALIFORNIA PAN ETHNIC HEALTH
NETWORK OKAY AND SAY LEVEL LESS
WITH MATERNAL AND CHILD HEALTH
AXIS ACOSTA ENGINE YOU FIGURED
OUT BETWEEN THE TWO OF YOU.
WE DID IT WE PRACTICED ALL OUR
PRACTICE THERE EVEN THE WELL
THANK YOU CHAIR MEMBERS OF FOR
HAVING US TODAY --
LINDA TENER WHAT'S ON BEHALF OF
C. PEN WE ARE A STATEWIDE HEALTH
ADVOCACY ORGANIZATION THAT WORKS
TO ENSURE THAT ALL CALIFORNIANS
HAVE ACCESS TO HEALTHY
LIVELIHOODS THE QUALITY
HEALTHCARE AND EQUITABLE
CONDITIONS.
WE THANK YOU FOR THE OPPORTUNITY
TO PRESENT OUR PROPOSAL TO FIND
HEALTH COVERAGE OUTREACH
ENROLLMENT AND NAVIGATION
ASSISTANCE IN HARD TO REACH
COMMUNITIES ARE ASK IS FOR
FIFTEEN MILLION DOLLARS FOR EACH
YEAR FOR TWO YEARS.
WHICH WOULD DROP DOWN A FEDERAL
MATCH FOR A TOTAL OF SIXTY
MILLION DOLLARS TO GO TOWARDS IS
CRUCIAL WORK.
THE FUNDING STRUCTURE FOR THIS
PROGRAM WOULD MIMIC THE AB AT TO
PROCESS WHICH WAS ADOPTED IN
TWENTY THIRTEEN WHICH DISPERSED
FUNDS TO COUNTIES BASED ON
POPULATION NEED.
COUNTIES THEN MADE GRANTS
AVAILABLE TO COMMUNITY BASED
ORGANIZATIONS THAT DO OUTREACH
WORK TO HELP FACILITY HEALTH
CARE COVERAGE AND NAVIGATION
ASSISTANCE.
UNFORTUNATELY THIS FUNDING
EXPIRED IN JUNE OF TWENTY
EIGHTEEN AND SO DID THAT MORE
ROBUST OUT REACH WORK WE HEARD
EARLIER THAT APPROXIMATELY FIVE
HUNDRED THOUSAND PEOPLE WHO WERE
ELIGIBLE FOR MEDI CAL DID NOT
ENROLLING COVERAGE IN.
TWENTY SIXTEEN TO SEVENTEEN SO
WE FEEL THAT THE TIME IS RIGHT
TO INVEST IN OUR COMMUNITY
WORKERS WHO ARE TRAINED AND
EQUIPPED TO ENSURE THAT
POPULATIONS FACING SOME OF THE
GREATEST ADVERSITY.
GET THE INFORMATION AND
ASSISTANCE THEY NEED TO STAY
COVERED.
AND I AM REPRESENTING OUR HEALTH
OUR REGION ENROLLMENT
COLLABORATIVE A FIFTEEN ALLEY
COMMUNITY ORGANIZATIONS AS WIDE
AS WELL AS A A STATEWIDE NETWORK
OF OVER FORTY ORGANIZATIONS ARE
WORK IS VERY CRITICAL ESPECIALLY
DURING THIS TIME WHEN IMMIGRANTS
FEAR THE UNKNOWN.
WHEN CALIFORNIA PLANS TO EXPAND
COVERAGE REDUCE PREMIUMS AND
REINSTITUTE A MANDATE?
ARE NOT ONLY ARE WE RECOGNIZED
FOR ENROLLMENT WORK BUT KNOWN
FOR THEIR TROUBLE SHOOTING THAT
WE DO ON COMPLEX CASES --
MISTER MARTINEZ A SEVENTY TWO
YEAR OLD MAN'S BOUND TO A WALKER
AS A RESULT OF A BRUTAL BRUTAL
ASSAULT SIX YEARS AGO.
WITH RESTRICTED SCOPE COVERAGE
CAME TO ALLAH GIMBAL FOR FULL
SCOPE COVERAGE FOR SIX YEARS WE
WORKED ON FIXING HIS CASE AND
WITHIN DAYS HE HAD FULL SCHOOL
COVERAGE.
HE CAME TO THANK US JUST TWO
MONTHS AFTER --
WALKING UNASSISTED FOR THE FIRST
TIME IN SIX YEARS HE HAD
RECEIVED HIS SPINAL SURGERY AND
WAS RECEIVING --
THERAPY IN NAME AND NAB ENABLING
HIM TO WALK WE ALSO --
HELP MS HERNANDEZ A SINGLE
MOTHER OF FOUR US CITIZEN
CHILDREN SHE HERSELF WAS IN THE
PROCESS OF AN ADJUSTMENT OF
STATUS.
WAS ILL ADVISED --
BY A NOBODY YOUR FAKE
IMMIGRATION ATTORNEY TO DROP ALL
BENEFITS INCLUDING BENEFITS FOR
HER U. S. CITIZEN BORN CHILDREN --
AND DID SO FOLLOWED HIS ADVICE
INCLUDING HER --
BENEFITS FOR HER YOUNGEST CHILD
WHO SUFFERED FROM WHO SUFFERS
FROM CEREBRAL PALSY AND WAS AND
AS A SIDE BENEFIT SHURI.
WE HELP GET HER BENEFITS
REINSTATED --
MAKE SURE THAT HER RETRO --
BILLS MEDICAL BILLS HOSPITAL
BILLS GOT COVERED AND CONNECTED
HER TO NUTRITION BENEFITS AND
HOUSING BENEFITS AND SUCH --
THE TROUBLESHOOTING AND
NAVIGATION SUPPORT SURE IS THAT
PEOPLE NOT ONLY.
GETTING ROLLED BUT UTILIZE THEIR
BENEFITS AND ACCESS SPECIALTY
CARE THAT SOMETIMES LIFESAVING
OR LIFE ALTERING.
WE APPEAL TO HEALTH PLANS TO
STATE AND LOCAL PROGRAMS LIKE
CETERA WE ARE IN NETWORK OF
HIGHLY SKILLED AND EXPERIENCED
HEALTH CARE ADVOCATES.
WHO HAVE BEEN COMMITTED TO
SERVING THIS POPULATION FOR VERY
LONG TIME WE MEET THEM WHERE
THEY ARE AND WE BRING OUR
SERVICES TO THEM WE CONNECT THEM
TO ALL TYPES OF SERVICES
INCLUDING MENTAL HEALTH --
AND SUBSTANCE ABUSE TREATMENT
PROGRAMS HOUSING AND SUCH --
AND WE HAVE A VERY HIGH OUR
RETENTION RATE --
IN THE NINETY PERCENTILE SO WE
STRONGLY URGE YOU TO CONSIDER
FUNDING --
FOR THE FOR THIS PROGRAM.
ALL RIGHT THANK YOU.
HE COMES FROM LA L. [inaudible]
FINANCE [inaudible]
THE ATS NO.
MORE PEOPLE ROLE.
L. OKAY [inaudible]
MANY MEMBERS ALL RIGHT.
OKAY THANK YOU SO MUCH FOR YOUR
PRESENTATION I THINK CERTAINLY
WE WANT TO TRY.
TO REACH OUT TO A AND M.
BASICALLY WHAT WE DO KNOW THEIR
PEOPLE QUALIFY WHO ARE NOT
ENROLLED --
SO -- WERE
AS HE CAN HERE WE'RE LOOKING AT
FRIDAY DIFFERENT PURCHASE TO TRY
TO GET TEM --
TO TO GET THE INFORMATION FRONT
OF THEM AND BUT ALSO RECOGNIZING
THEM UNFORTUNATELY --
THIS CURRENT AMOSPHERE WITH
THINGS LIKE PUBLIC CHARGE I
THINK THERE'S FEAR AS WELL --
THAT IF THE ACTUALLY.
AVAIL THEMSELVES OF SOME OF
THESE BENEFITS THAT MAY PREVENT
FOR A GREEN CARD OR CITIZENSHIP
OR SO FORTH ARE AT SO --
LOOK AT THAT'S GOING TO BE A
CHALLENGE.
ALL RIGHT.
THANK YOU THANKS FOR MUCH OKAY --
SO WE'LL TAKE PUBLIC COMMENTS ON
A FREE ONE WHAT'S GIVE COULD
COMMENT ON ANYONE IN --
ARE COLLECTIVELY ALL THREE OF
THESE PROPOSALS AND AGAIN ASK
THAT IF WE CAN KEEP REMARKS TO A
MINUTE [inaudible]
WELCOME.
LINDA WAY WITH WESTERN CENTER ON
LAW AND POVERTY --
WE OBVIOUSLY SUPPORT THAT THE
FIRST PROPOSAL AS WELL AS THE
THE THE NEXT TO ALL THREE
PROPOSALS ON THE THE WICKS
WRESTLING ELIGIBILITY AS WELL AS
THE OUT REACH --
WITH THE THE OUT REACH --
AS AS HAS BEEN MENTIONED WITHOUT
THE FEDERAL ENVIRONMENT AND AND
THE THREAT OF PUBLIC CHARGER
TICKETS IS SPECIALLY IMPORTANT
THANK YOU.
THANK YOU WELCOME.
MR CHAIRMAN MEMBERS MARK MENDOZA
WITH A CA YOU CALIFORNIA AS AN
ORGANIZATION THAT REPRESENTS
SOME NAVIGATORS IN LOS ANGELES
WE'VE SEEN THE DIRECT BENEFIT OF
ENROLLING FOX.
INSULTS OR SOCIAL SERVICES WHEN
THESE NAVIGATORS AROUND THE
COMMUNITY THANK YOU.
THANK YOU [inaudible]
WELCOME.
HELLO AGAIN ALISON VIEWS FROM
THE CHILDREN'S DEFENSE FUND OF
CALIFORNIA REPRESENTING CDF AND
ALSO UNITED WAYS A CALIFORNIA WE
ARE BOTH ALSO CO SPONSORING THE
WAKE -- THAT
YEARLY LEGISLATION WHICH WE
THINK IS A COMMON SENSE WAY TO
GET KIDS --
ENROLLED IN THE CARE THEY NEED
TO SURVIVE AND STRIVE SO WE ASK
FOR YOUR SUPPORT ON THAT WE ALSO --
SUPPORT --
FUNDING FOR OUR REGION
ENROLLMENT AND THE SEA PAN
REQUEST AND THERE'S ALSO A
ANOTHER REQUEST IN FROM CCH I
WHICH WE UNDERSTAND WHERE THEY
WERE HOPING WILL EMERGE SOON AND
WE FULLY UNDERSTAND THE
IMPORTANCE OF OF GETTING CAN WE
STRONGLY SUPPORT THESE THESE
FUNDS THANK YOU.
THANK YOU.
WELCOME THANK YOU MISTER TEN
MEMBERS CAPPIES UNDERLING WITH
THE COUNTY WELFARE DIRECTORS
ASSOCIATION WERE PART OF THE
COALITION ON THE C. PEN
PROPOSALS ARE VERY SUPPORTIVE OF
THAT.
HAVING A STRONG OUT REACHES AND
HELPS OUR ELIGIBILITY WORKERS DO
THEIR JOBS BETTER AS WELL --
SO APPRECIATE DOES YOUR SUPPORT
ON THAT AS WELL WERE IN SUPPORT
OF THE AGED AND DISABLED --
POVERTY LEVEL INCREASE THAT
SOMETHING OUR MEMBERS HAVE LONG
BEEN CONCERNED ABOUT AS WELL AND
WE'RE HAPPY TO SUPPORT THAT
PROPOSAL THANK YOU.
THANK YOU.
WELCOME.
HI THE CHILDREN'S PARTNERSHIP --
CHRISTEN AGAIN AND SUPPORT OF
THE OUT REACH FUNDING FOR THE
REASONS GIVEN --
AND WE ALSO APPRECIATE THAT THEY
ARE WORKING WITH C. C. H. I. TO
MAKE SURE THE THE WIND COUNTIES
WHERE THERE ON THAT MAY NOT BE.
SOME SUBMITTING A GRANT FOR ON
THIS FUNDING THAT THOSE --
COUNTIES ARE REPRESENTED AND I
KNOW THIS IS CHEATING JUST A
LITTLE BIT BUT ON THE WIKI ELLIE
I FORGOT TO MENTION TO YOU ALL
THAT THERE'S A NINETY TEN MATCH
ON MODIFICATIONS TO SYSTEM SO
THAT'S WHY THAT THAT COSTS IS
NOT GONNA BE THAT BAD BECAUSE
IT'LL BE FEDERALLY.
FUNDED OKAY THANK YOU
[inaudible]
WELCOME.
GOOD AFTERNOON FELIX WHO WOULD
POLLUTION THE CALIFORNIA PROMISE
HEALTH PLAN.
IN SUPPORT OF THE PROPOSAL TO
RAISE INCOME ELIGIBILITY FOR
NOWSHERA COST MEDI CAL FOR
SENIORS AND PEOPLE DISABILITIES
UP TO THE SAME BRIGHT LINE.
AS FOR ALL THE ADULTS IN THE
MEDICAL PROGRAM THANK YOU THANK
YOU [inaudible]
WELCOME.
GOOD AFTERNOON AND EVENING
BAGGAGE FOR THE CALIFORNIA AND
WE'RE IN POLICY CENTER IN
SUPPORT OF THE PENS NAVIGATOR
NOT RICH PROPOSAL --
ARE DECADES OF EXPERIENCE
WORKING IN MARIN COMMUNITIES TO
SHOW THAT REQUIRES A VERY
CAREFUL COORDINATION BETWEEN THE
STATE AND CBO'S I'M TO GET
IMMIGRANT COMMUNITIES AND ROLLED.
I'M ESPECIALLY WITH PUBLIC
CHARGE AS WAS MENTIONED --
AND WITH THE POSSIBLE MEDICAL
EXPANSION I'M TO NUMBER OF
UNDOCUMENTED ADULTS WE THINK
IT'S A REALLY CRITICAL COMPONENT --
AS PART OF THIS PACKAGE THANKS
SO MUCH THANK YOU.
OKAY AFTERNOON JENNIFER ALLEY
WITH CAP --
WE ALSO SUPPORT THE RAISING THE
INCOME INCOME ELIGIBILITY LEVEL
FOR H. PLAN THANK YOU.
THANK YOU.
WELCOME --
THIS EVERY AREAS WITH A LATINO
COALITION FOR HEALTHY CALIFORNIA
AND WE'RE HERE IN SUPPORT OF THE
HELP THE HELP NAVIGATORS ON WE
THINK THAT IT'S GOING TO BENEFIT.
LOW INCOME COMMUNITIES MOST
IMPACTED BY HEALTH DISPARITIES
AND OUTRAGE IS PREVENT TO SHOW --
THE INCREASE THE RATES OF
ENROLMENT SO WE WE DEFINITELY IT --
SUPPORT THIS THANK YOU.
THANK YOU WELCOME GOOD AFTERNOON
MENTAL CALLING ON BEHALF OF
HEALTH ACCESS CALIFORNIA WE
ABSOLUTELY SUPPORT THE C. PEN IN
MATERNAL CHILD HEALTH ACCESS
PROPOSAL ON OUT REACH FUNDING
FOR NAVIGATORS ALSO SUPPORT THE
WEEK EXPRESS LANE PROPOSAL
ENSURE THAT.
THAT INFORMATION CAN BE USED ON
ROLE --
INDIVIDUALS INTO THE MEDICAL
PROGRAM QUICKLY WE ALSO --
SUPPORT --
WESTERN CENTER.
ON LAW AND POVERTY THE JUSTICE
AN AGING AND DISABILITY RIGHT
COALITIONS PROPOSAL --
AROUND THE SENIOR PENALTY TO
RAISE THE INCOME LIMITS WHICH
ENSURE THAT AGE OR DISABILITY
DOES NOT IMPACT THEIR
ELIGIBILITY MEDI CAL THANK YOU.
THANK YOU WELCOME.
GOOD AFTERNOON BY THE COOPER
TELL AGAIN FROM COMMUNITY HEALTH
COUNCILS LSO ON BEHALF OF OUR
TWO COALITIONS WE STRONGLY
SUPPORT ALL PROPOSALS TO EXPAND
MEDI CAL ELIGIBILITY AND RENT
AND ENROLLMENT PARTICULARLY THE
REQUEST TO FIND.
COMMUNITY BASED IN ROMAN
ASSISTANCE AND OUTREACH WERE
MOVING TOWARDS A MORE
UNIVERSALLY COVERED CALIFORNIA
WE'RE CONSTANTLY WORKING TO
MITIGATE.
FEARS AND BARRIERS FACED BY
IMMIGRANT COMMUNITIES AND WE ARE
STREAMLINING OUR HEALTHCARE
SYSTEM THEREFORE WE ARE MORE IN
NEED OF COMMUNITY BASED HEALTH
CARE ROLLERS WHO SERVICE OUR
SYSTEM.
SECONDLY HEALTHCARE AND ROLLERS
GO ABOVE AND BEYOND THEIR NOT
JUST IN ROLLERS THEY ENSURE THAT
COVERAGE IS BEING UTILIZED AND
WORKED TIRELESSLY. TO
TROUBLESHOOT ISSUES THAT ARE
OFTEN MISSED BY THE SYSTEM THERE
CULTURALLY COMPETENT AS AND HAVE%
FORMED STRONG RELATIONSHIPS WITH
THEIR COMMUNITIES BUILDING ON
YEARS OF TRUST.
OFTEN CONNECTING THEIR CLIENTS
TO NUMEROUS RESOURCES AVAILABLE
TO THEM IN ADDITION TO THEIR
HEALTHCARE SERVICES.
THEREFORE AS NAVIGATORS OF AN
INCREASINGLY COMPLEX HEALTH CARE
SYSTEM AND ROLLERS ARE AN ASSET
TO OUR HEALTH SYSTEM.
AND THEREFORE WE NEED TO
PRIORITIZE SUSTAINABLE FUNDING
MECHANISMS TO SUPPORT THIS
VALUABLE WORK FOR THE HEALTH AND
WELL BEING OF CALIFORNIA THANK
YOU THANK YOU [inaudible]
WELCOME.
HI GALE YOUNGER CHILDREN NOW
PART OF THE JONES HEALTH
COVERAGE COLLISION WITH THE
CHILDREN'S PARTNERSHIP AND WE
ARE ALSO IN FULL SUPPORT OF THE
WEEK TO MEDI CAL EXPRESS LANE A
ROMAN CATHOLIC.
THANK YOU.
WELCOME HI MEGAN RACHEL ALREADY
ON BEHALF THE CCH I JUST WANT TO
REITERATE THAT WE SUPPORT THE
BUDGET ASK OF C. PEN IN ITS
COALITIONS. FOR THE THIRTY
MILLION --
WITH FIFTEEN MILLION PER YEAR
FOR TWO YEARS WITH FEDERAL MATCH
THE FUNDS WILL PROVIDE
OPERATIONAL SUPPORT TO COMMUNITY
BASED ENROLLMENT OF NAVIGATION
AGENCIES.
INCREASING OUR REGION ROMAN AND
POST IN ROME IT THERE FOR
MAINTAINING HEALTH COVERAGE FOR
ALL CALIFORNIANS.
WE ARE IN THE FINAL DISCUSSIONS
EMERGING THE TWO PROPOSALS WE
HAVE REDUCE THE SIZE OF OUR
PROPOSAL AS WELL AS SET UP A
NONPROFIT ENTITY TO SERVE AS THE
INTERMENT MEDIA --
LASTLY CG CCH ISAAC EXTENSIVE
EXPERIENCE OVER THE RECENT PAST
HANDLING LARGE GRANT DOLLAR
AMOUNTS TO SUPPORT OUR REGION
MOMENT RETENTION AND UTILIZATION
SERVICES OUT LOCAL COMMUNITY
LEVELS.
THANK YOU AGAIN I THANK YOU.
THANK YOU GOOD AFTERNOON
SENATORS NEED TO ONE OF THE
HIGHER WELL A. R. P. CALIFORNIA
HERE TO STAND AS WE AVE IN PAST
YEARS IN SUPPORT.
OF OUR PARTNERS PROPOSAL TO
RAISE THE ELIGIBILITY LET LEVEL
FOR AGED AND DISK DISABLED MEDI
CAL TWO HUNDRED AND 38% OF
POVERTY.
I'M AS MANY PEOPLE KNOW
QUALIFYING FOR MEDI CAL DOESN'T
TAKE CARE OF EVERYTHING.
AND ONCE --
AN INDIVIDUAL HITS THAT DOLLAR
I'M OF COURSE AS YOU'VE ALREADY
HEARD TODAY THEY EXPERIENCE AN
ENORMOUS OUT OF POCKET COSTS
WHICH MEANS EITHER THEY'RE GOING
TO FOREGO.
BASIC NEEDS LIKE FOOD OR
MEDICINE OR FAMILY MEMBER MAY
ALSO HAVE TO SPEND OUT OF POCKET
TO HELP SUPPORT THEM.
THANK YOU THANK YOU THANKS VERY
MUCH.
ALL RIGHT HELLO AND THANK
EVERYONE KNEW TESTIFIED SO --
IT IS.
NOW --
1-250- SO I'D LIKE TO DO IS AS I
USUALLY DO WILL TACKLE FIVE
MINUTE STRETCH BREAK INS IN HERE
FOR THE SOME OF THE STUDENTS IN
YOUR FOR VERY LONG TIME AND THEN
WE'LL GO AHEAD AND RESUME WITH
THAT PART OF HEALTH CARE
SERVICES.
THE ALSO BE CLEAR THAT WE ARE
HOLDING.
EACH TO THE ITEMS OPEN SO --
FOR THIS PARTICULAR SO WITH
ISSUE NUMBER TWO OF SPENDING FOR
ABILITY SHE NUMBER THREE FULL
SCOPE MEDIC EXPANSION AND EACH
OF THE STAKEHOLDER PROPOSALS ARE
GOING TO BE HELD OPEN.
THANK YOU SO WILL. SEVEN STRETCH
A LITTLE BIT AND WE'LL BE BACK
IN FIVE MINUTES
RIGHT SO --
WE JUST HAVE THE PART OF HEALTH
CARE SERVICES CLOVER.
A LITTLE PROGRAM IN STATE CALLED
MEDI CAL [inaudible]
ALL RIGHT.
SO WELCOME TO LOGIN FOR SO --
WILL FIRST DO IS --
START WITH THE REVIEWABLE FIRST
THAT EVERYONE INTRODUCE
THEMSELVES FOR THE RECORD --
SO WE'LL GO AHEAD AND START WITH
THE AGENCY PART OF HEALTH CARE
SERVICES WELCOME YOU INTRODUCE
YOURSELF FIRST.
SURE JENNIFER CAN'T DIRECTOR FOR
THE DEPARTMENT OF HEALTH CARE
SERVICES.
DC COOPER POLICY ADVISER HEALTH
CARE PROGRAMS AND ERICA'S
BURBANK CHIEF DEPUTY DIRECTOR OF
HEALTH CARE SERVICES OKAY DELEO.
BROWN WAS THE LA --
BEN JOHNSON ALEJO A FINANCE
WELCOME AND A GUEST FINANCE
JACOB I AM FINANCE OKAY THANK
YOU.
ALL RIGHT SO --
WHEN WE GO AHEAD BEGIN THE
OVERVIEW OF DEPARTMENT HEALTH
CARE SERVICES WE DO HAVE A
DETAILED WRITE UP SO --
HIT THE HIGHLIGHTS THANK YOU.
SO AS THANK YOU VERY MUCH --
AS YOU SAID IT'S A SMALL.
VERY SELF CONTAINED PROGRAM THAT
IS EASILY AND I WILL INVITE
PRESENTATION --
SO AS WE HAVE.
IN FRONT OF YOU AND REALLY GOOD
AGENDA THAT LAYS OUT OF THE
SIGNIFICANT --
COSTS AND FACTORS THAT GO INTO
THE MEDICAL PROGRAM I LIKE TO
START OFF BY EXPLAINING OUR
DEPARTMENT AS ESSENTIALLY
OVERSEEN SIX DELIVERY SYSTEMS
WITHIN THE STATE OF CALIFORNIA --
WE SERVE APPROXIMATELY THIRTEEN
POINT TWO MILLION LOW INCOME
CALIFORNIANS --
WE HAVE ALMOST FOUR THOUSAND
EMPLOYEES AND THIS YEAR'S BUDGET
IS PROJECTING TO SPEND
APPROXIMATELY A HUNDRED AND FOUR
BILLION DOLLARS TOTAL FUNDS.
ABOUT TWENTY THREE BILLION IN
STATE GENERAL FUNDS AND THEN THE
OTHER REMAINING AMOUNTS ARE A
MIXTURE BETWEEN FEDERAL FUNDS
AND OTHER TYPES OF FUNDING
SOURCES.
IN ADDITION TO THE MEDICAL
PROGRAM MOST PROBABLY WHICH IS
OBVIOUSLY OUR MOST SIGNIFICANT
PROGRAM WE ALSO OVERSEE THE
CALIFORNIA CHILDREN'S SERVICES
PROGRAM WHICH IS A SMALLER.
PROGRAM WHICH IS THE OLDEST
PROGRAM --
IN OUR DEPARTMENT STARTED IN
NINETEEN TWENTY SEVEN SERVING
APPROXIMATELY TWO HUNDRED
THOUSAND CHILDREN WITH MEDICAL
CONDITIONS THAT MEET CERTAIN
THRESHOLDS AND TREATMENT LEVELS.
WE ALSO FEE FOR SERVICE DENTAL
MANAGE CARE WE HAVE A MENTAL
HEALTH --
DELIVERY SYSTEM WHICH HAS BEEN
THE SUBJECT OF SOME
INFORMATIONAL HEARINGS WITH WITH
THE LEGISLATURE THIS YEAR WE
HAVE COUNTIES PROVIDING
SUBSTANCE USE DISORDER SERVICES
ON BOTH THE STATE PLAN BASIS AS
WE LIKE TO SAY.
AND THROUGH OUR ORGANIZED
DELIVERY SYSTEM MEDICAID WAIVER
WE ARE --
LET'S SEE FEE FOR SERVICE
MANAGED CARE DENTAL CCS A CD
MENTAL HEALTH AND THEN --
THE REMAINING PROGRAMS --
INCLUDE OUR FAMILY PLANNING --
SOME RURAL INDIAN HEALTH CLINIC
PROGRAMS AND THEN OBVIOUSLY A AS
YOUR AGENDA NOTES.
A LOT OF SIGNIFICANT --
TIME AND ATTENTION HAS BEEN
SPENT ON THE AFFORDABLE CARE ACT
AND PROVIDING COVERAGE TO
INDIVIDUALS WHO HAVE NOT
TRADITIONALLY HAD ACCESS TO
MEDICAID --
INCLUDE IN THE PROPOSAL THAT WE
JUST HEARD --
I WILL ALSO JUST SAY IN TERMS OF
AN OVERVIEW --
FROM THE BUDGETARY PERSPECTIVE --
THE GOVERNOR --
WITH THE PRESENTATION OF HIS
JANUARY REALLY TRIED TO BALANCE --
A LOT OF DIFFERENT COMPETING
DEMANDS I WITH THE FISCAL
RESPONSIBILITY OF OF MAKING SURE
THAT THE PROGRAM IS
APPROPRIATELY RESOURCE SO WHEN
YOU LOOK AT THE BUDGET PROPOSAL
MORE BROADLY YOU'LL SEE.
I'M OBVIOUSLY EXTENDING COVERAGE
TO ANOTHER SET OF POPULATION TO
MOVE CALIFORNIA CLOSER CLOSER TO
UNIVERSAL COVERAGE --
THERE WAS ALSO RECOGNITIO OF
SOME VERY SPECIALIZED
POPULATIONS THAT WE'VE BEEN
WORKING TO SERVE WITH COUNTIES
MANAGED CARE PLANS AND OTHER
PROVIDERS --
SO THERE'S A HUNDRED MILLION
DOLLAR AUGMENTATION IN OUR WHOLE
PERSON CARE PILOT PROGRAM WHICH
IS THROUGH OUR ELEVEN FIFTEEN
WAIVER.
SPECIFICALLY TO ADDRESS HOUSING
NEEDS FOR THE MENTALLY ILL AND
OTHER HIGH COST POPULATIONS IN
OUR COUNTIES WITH A WHOLE PERSON
CARE PILOT --
THERE WILL BE AND I'M SURE --
FUTURE DISCUSSIONS AROUND THE
USE OF PROPOSITION --
FIFTY SIX WE HAVE A VARIETY OF
PAYMENTS TO PROVIDERS I'M USING
THOSE ADDITIONAL --
TOBACCO TAX DOLLARS THERE ARE --
ADDITIONAL TWENTY FIVE MILLION
DOLLARS IN EARLY PSYCHOSIS
TREATMENT AND IDENTIFICATION AND
SERVICES FOR INDIVIDUALS THAT
EITHER ARE AT RISK OF OR HAVE
HAD THEIR FIRST PSYCHOTIC BREAK.
WORKING WITH THEM AND THEIR
FAMILIES TO PROVIDE AND LINKAGE
TO SERVICES AND I THINK WHEN YOU
TAKE ALL OF THOSE DIFFERENT
PROPOSALS IN TOTO --
ACROSS OUR DEPARTMENT IN ACROSS
THE PROGRAM SO SEE YOU KNOW
CERTAINLY A BOTH THE INTEREST
AND DEDICATION TO MEETING --
COMPLEX PATIENTS WITH AND TRYING
TO FILL IN COVERAGE GAPS AND
SHORTAGES IN AREAS IN WHICH WE
NOTE THAT THEY CERTAINLY NEED TO
BE ADDRESSED IN A PRIORITY ORDER.
WHILE MAINTAINING A FISCAL --
BALANCE WITH THE REST OF THE
STATE --
COMPETING TO PAY DEMANDS ACROSS
NOT ONLY OUR AGENCY BUT ACROSS
THE STATE GOVERNMENT AND HOLE SO
WITH THAT I'M HAPPY TO ANSWER
QUESTIONS.
OKAY THANK YOU ANY COMMENTS FROM
HELLO.
HEY FINANCE NO ALL RIGHT
COMMITTEE MEMBERS.
OKAY I JUST SAID A FEW QUESTIONS --
IN TERMS OF JUST SOME OF THE
FUNDING --
THINGS SO UP TO LOOK AT ONES
WITH THE LARGER VARIANCES SIGN I
KNOW THAT --
IN THE NEXT ITEM WILL ADDRESS
THE CHANGES IN THE QUALITY
ASSURANCE --
REVENUE FUND FOR HOSPITALS AND
ALSO THE PUBLIC HOSPITAL
INVESTMENT --
ACTUALLY THE LONG TERM CARE
QUALITY ASSURANCE FUND --
BUT SO X. NOTED I'D MAKE NOTE IN
THAT THEY'RE ACTUALLY LOOKS LIKE
FOR THE PROPOSED WE ARE
ESTIMATING A ACTUALLY IS SO IT'S
LIKE US.
SIGNIFICANT INCREASE ALTHOUGH
THE SKILL OF MEDI CAL PERHAPS --
BUT I NOTICED THAT THE TWENTY
EIGHTEEN REVISED GOES FROM SAYS
ESSENTIALLY ROUTE SEVENTY THREE
MILLION TWO HUNDRED TWENTY FIVE
MILLION AND THEN ON THE
PHYSICIAN SERVICES ACCOUNT FOR
TWENTY TWO MILLION TWENTY TWO
AND A HALF MILLION TO ABOUT.
THIRTY NINE MILLION AND SO I'M
JUST WONDERING WHAT WAS DRIVING
THAT.
I DON'T KNOW IF ON OF MAY
FINANCE KNOWS OR WELL DEPARTMENT
OF FINANCE SO THAT INCREASES
SIGNIFICANTLY RELATED TO THE
PROPOSITION FIFTY SIX BACK FILL
THAT POP NINETY NINE IS
RECEIVING.
AND SO BECAUSE PROP FIFTY SIX IS
HAVING AN EFFECT OF THE AFFECT.
TO DECREASE TOBACCO CONSUMPTION
ACROSS THE STATE.
PROPERTY SIX IS STATUTORILY
REQUIRED TO BACK FILL ANY LOSSES
IN REVENUE TO PROP NINETY NINE
SO THAT YEAR OVER YEAR INCREASE
IS THAT BACK FILL AMOUNT OKAY
COMING IN.
OKAY BUT THAT AND SO THAT'S THAT
THAT LARGE YEAH LOOKS FOR
SEVENTEEN EIGHTEEN THE FIRST.
SEVENTY TWO WAS THE FIRST BACK
FULL YEAR BUT THAT WAS ONLY ON A
QUARTER WORTH OF REVENUE IN OKAY
MOVING FORWARD AT THE FULL YEAR
YES OKAY SO NOW THIS IS
REFLECTING A FULL YEAR BACK SO
OKAY.
THANK YOU AND THEN ACTUALLY
ANOTHER QUESTION IS --
THE DESIGNATED HOT PUBLIC
HOSPITAL GME.
THE FUNNY NO THERE IT DOES THAT
WAIVER OR SOUNDS LIKE GOES.
PLOT PROMISE AROUND THAT --
WOULD MAKE NOTE THAT --
LAST YEAR FIVE HUNDRED SIXTY
EIGHT MILLION AND WE THEN BUT ON
THE REVISED ITS DOWN THE THREE
HUNDRED FIFTY NINE MILLION AND
NOW --
420-192-0 IT'S DOWN THE HUNDRED
FIFTY FOUR MILLION DOES THAT
MEAN THE WAIVER DIDN'T AND JUST
WONDERING WHAT WHAT THERE'S WHAT
THAT REFLECTS.
THE CITY OF PUBLIC HOSPITAL
JIMMY SPECIALLY SPECIAL FUNDS
YEAH BUT WE'VE WE'VE LOOKED INTO
THAT A LITTLE BIT BEN JOHNSON
WITH THE LA --
UNDERSTANDING IS THAT --
THE THE AMOUNT OF ESSENTIALLY --
ROOM TO FUND GM ME.
AT THESE HOSPITALS WAS --
SCRUTINIZED BY THE FEDERAL
GOVERNMENT AND ULTIMATELY WAS
REVISED DOWNWARD SO THE ROOM IS
YOU KNOW A SORT OF A REASONABLE
PAYMENT LIMIT.
PERHAPS TO TIED. TO MEDICARE --
AND OUT OF FOLLOWING ANALYSIS
FROM THE STATE AND THE FEDERAL
GOVERNMENT --
ONE DAY --
WE REALIZED WE DIDN'T HAVE AS
MUCH ROOM TO INCREASE FUNDING
THROUGH GME AS PREVIOUSLY
THOUGHT SO THAT'S MY
UNDERSTANDING OF OF AT LEAST.
WHAT'S CONTRIBUTING TO SOME OF
THAT REDUCTION.
AND WE CAN CERTAINLY PROVIDE
OKAY NO MORE YEAH I DID STEP
BECAUSE I KNOW THIS WAS A
SUBJECT OF SOME PREVIOUS BUDGET
HEARINGS I THINK PEOPLE ARE
EXCITED THAT WE WERE TALKING
LIKE EVEN OVER A BILLION DOLLARS
AND A GOOD BUT YOU KNOW THINGS
ARE WAITING FOR THINGS SO.
AND I DON'T KNOW IF THE HUNDRED
FIFTY FOUR MILLION TO SORT OF
REPRESENT THE STEADY STATE
AGREEMENT OR WHATEVER OR IS IT
GOING TO CONTINUE TO GET OUTSIDE
JUST WANTING WHAT STATUS WAS ON
THE ON THE PUBLIC HOSPITAL GMT.
I I DON'T BELIEVE IT WAS
FINALIZED AT THE TIME OF THE
BUDGET THAT --
THAT WE'VE GOTTEN THE APPROVAL
BUT WE CAN DOUBLE CHECK ALL
RIGHT BEING A STATUS UPDATE ON
WHAT'S GOING ON WITH THE PUBLIC
HOSPITAL JIMMY APPRECIATED
[inaudible]
OKAY.
RIGHT OKAY WITH THAT ANY OTHER
QUESTIONS THEN --
ACTUALLY WELL US ANY PUBLIC
COMMENT ON THE OVERVIEW.
I SEE NO AT THE MICROPHONE LET'S
MOVE ON TO ISSUE NUMBER TWO
WHICH IS THE MEDI CAL TWENTY
EIGHT NOVEMBER TWENTY EIGHTEEN
MEDI CAL ESTIMATE OVERVIEW.
GOOD AFTERNOON.
SO THE GOVERNOR'S BUDGET OF THE
REFLECTS THE TOTAL BUDGET FOR DH
CS OF A HUNDRED FOUR BILLION
DOLLARS AS MENTIONED BY A
DIRECTOR CAN'T --
ADDITIONALLY DH CS HAS AROUND
THREE THOUSAND EIGHT HUNDRED
EMPLOYEES AND IN THE JANUARY
BUDGET PROCESS --
REQUEST AN ADDITIONAL HUNDRED
AND SIXTEEN NEW POSITIONS WHICH
INCLUDES EIGHT THAT ARE
CURRENTLY LIMITED TERM --
BURKE CONVERTING TO PERMANENT
IT'S THE LARGEST PART OF THE DH
CS -- BUDGET --
IN IS IS REPRESENTATIVE OF ABOUT
A HUNDRED BILLION OF THE HUNDRED
AND FOUR BILLION DOLLARS IN
THERE.
THE NOVEMBER ESTIMATE DID
PROJECT REDUCTION NEED FROM
GENERAL FUND FOR CURRENT YEAR OF
ABOUT TWO POINT THREE BILLION
DOLLARS --
AND THAT WAS COMPRISED OF A
VARIETY OF THINGS OF WHICH IS
ABOUT FOUR HUNDRED AND EIGHTEEN
MILLION DUE TO SUCCESSFUL
RESOLUTION OF IN LOWER.
THAN ANTICIPATED FEDERAL
DEFERRALS.
ADDITIONALLY THREE HUNDRED AND
SORRY SEVEN HUNDRED AND THIRTY
FIVE MILLION FOR THE LONG TERM
CARE AND HOSPITAL QUALITY
ASSURANCE FEE.
OFFSETS DUE TO DELAYS FROM
TRANSFERS FROM THE WITH HOLD
FUND OR THE QUALITY ASSURANCE
FUND TO THE GENERAL FUND. THREE
HUNDRED NINETY MILLION OF HIGHER
DRUG REBATES IN TWO HUNDRED
FORTY EIGHT MILLION DOLLARS OF
LOWER MANAGED CARE COST
PRIMARILY BECAUSE OF THE LOWER
CASE LOAD.
GIVEN THE ONE TIME NATURE OF
NEARLY ALL OF THESE --
YOU DO SEE A NEARLY EQUIVALENT
TWO POINT TWO BILLION DOLLAR
INCREASE IN --
BUDGET YEAR AND DIRECTOR CAN'T
ARE YOU WALK THROUGH A LARGE
NUMBER OF THE THINGS THAT
CONTRIBUTE TO THAT TWO POINT TWO
BILLION SO I WON'T REPEAT THOSE
AND I WOULD IMAGINE THIS WOULD
BE DISCUSSED IN THIS HEARING OR
OTHER HEARINGS IN THE FUTURE.
THANK YOU COMPASS MILIEU.
THANK MISTER CHAIR RYAN WILL THE
WITH THE LA --
AND WE HAVE --
TAKEN A SIGNIFICANT AMOUNT OF
TIME REVIEW THE MEDI CAL
ESTIMATE --
WE HAVE VARIOUS COMMENTS TO
PROPOSALS BUT FROM THE OVER
ARCHING PERSPECTIVE.
AND JUST WANTED TO HIGHLIGHT
THAT IN TERMS OF THE
ADMINISTRATION'S CASELOAD
ESTIMATES --
DOES APPEAR ROUGHLY IN THE
REASON RANGE BUT THAT MAY BE A
LITTLE CAUTIOUS IN PARTICULAR
THE DECLINE.
IN THE FAMILIES AND CHILDREN
CASELOADS THAT WE HAVE SEEN DUE
TO THE CONDITIONS IN THE ECONOMY
AND POTENTIALLY OTHER POLICY --
WINDS THAT ARE GOING ON THE
ADMINISTRATION'S AN EXPECTATION
OF THOSE WERE FLATTENED
CONSIDERABLY IN IN THE COMING
YEAR SO WE HIGHLIGHT THAT IS
SOMETHING TO CONTINUE TO WATCH
WILL -- COME
BACK WITH ADDITIONAL COMMENTS AT
THE TME OF THE ME REVISION BUT
IT'S POSSIBLE THAT --
CASES COULD WIND UP BEING SOME A
LOWER THAN THAN EXPECTED IN IN
THE JANUARY BUDGET [inaudible]
OKAY [inaudible]
THANK FINANCE.
ONCE RIGHT QUESTIONS COMMITTEE
MEMBERS.
ALL RIGHT --
SO ACTUALLY THE I HAVE TO ASK
ABOUT PROP FIFTY FIVE PRESS
FINANCE CAN ADDRESS THAT SO WE
HAVE A CON IN ME IS ROARING --
THE COURTING TO PROP FIFTY FIVE
HOUR MEETING READ I MEAN.
THIS THIS ISN'T THE FIFTH THIS
YEAR WE DON'T HAVE ANYTHING THAT
FALLS INTO MEDI CAL OUT PROP
FIFTY FIVE I'M NOT SURE HOW YOU
CALCULATE THE FORMULA SO I KNOW
IT'S IN YOUR HANDS FINANCE CAN
YOU EXPLAIN TO ME WHY WE'RE NOT
SEEING ANY PROP FIFTY FIVE
REVENUE GOING. TO MEDI CAL AS
THE VOTERS INTENDED.
JUGGLING THE PART OF FINANCE YOU
ARE CORRECT THERE IS NO PROPERTY
FIVE SPECIFIC REVENUES GOING TO
THE MEDI CAL PROGRAM.
I WOULD DEFER TO OUR COLLEAGUES
IN OUR ARE FORECASTING AND WHO
COULD PROBABLY BETTER ADDRESS
THAT QUESTION FOR YOU BUT WE CAN
WORK TO GET AN ANSWER FOR YOU
AND YOUR STAFF.
YES LA --
PLEASE.
AS YOU MENTIONED THE THE FORMULA
IS IN THE HANDS OF THE
DEPARTMENT OF FINANCE IT'S IT'S
SAID THAT CALCULATION IS SOME OF
THE DISCRETION OF THE DIRECTOR
OF FINANCE HOWEVER --
IT'S OUR UNDERSTANDING THAT THE
APPROACH USED IN THIS YEAR'S
CALCULATION.
IS VERY SIMILAR IF NOT IDENTICAL
TO THE APPROACH USE LAST YEAR --
IN OUR OFFICE DID RELEASE ARE
WALK THROUGH THA --
CALCULATION AND OUTLINED MANY
PLACES WHERE THERE COULD BE
VARYING INTERPRETATIONS OF HOW.
THE CALCULATION IS DONE AND ONE
IN PARTIULAR.
RELATES TO THE WORKLOAD BUDGET
WHICH WOULD SERVE TO INCREASE OR
REDUCE THE AMOUNT OF FUNDING
THAT CALCULATION WOULD HAVE LEFT
OVER FOR MEDI CAL.
AND LAST YEAR WE DESCRIBED HOW
THE ADMINISTRATION'S APPROACH --
IS FAIRLY BROAD AND CONSIDERS
MANY SERVICES --
PART OF THE WORKLOAD BUDGET THAT
OTHER APPROACHES --
MIGHT NOT AND SO IT IT APPEARS
THAT THIS --
CONTINUATION OF A OF A BROAD
INTERPRETATION OF THE WORKLOAD
BUDGET HAS CONTRIBUTED --
TO AGAIN THIS YEAR --
THERE NOT BEING ANY FUNDING FOR
MEDI CAL COMING OUT OF THE
CALCULATION.
SO I GET A AC A DISEASE FOLLOW
UP.
AND I'M TO RECALL THE THEIR
DISCUSSIONS LAST YEAR --
AND IS YOU POINTED OUT THIS VERY
BROAD --
FROM DALY IS PERSPECTIVE ASISTIR
[inaudible]
I GUESS.
IT'S THAT THAT IS IN THE HANDS
OF FINANCE BUT IT ACCORDING TO
NISHA BUT I MEAN.
I GUESS THE QUESTION MIGHT BE
AND YOU CAN TELL ME YOU DON'T IS
LIKE WELL HOW ABOUT
APPROXIMATELY HOW MUCH OR WHAT
SKILL OF MONEY WE SHOULD WE BE
EXPECTING FROM PROP FIFTY FIVE I
MEAN WE'RE TALKING ABOUT THE YOU
KNOW THE THING IS.
IS WE'RE NOT A DOWN ECONOMY
RIGHT NOW WE'RE A REVENUES ARE
GOOD AND SO FORTH AND JUST
DECIDED SHE TO ME THAT.
NOTHING THERE'S THAT THAT'S IT
THAT EVEN IN A YEAR LIKE THE
PAST YEAR AND THE YEAR BEFORE WE
HAVE NOTHING THAT SHOWS UP.
AND AND AND JUST CONCERNED THAT
THE VOTERS.
LOOK AT THIS AND THEY GO WELL WE
VOTED FOR THIS.
AND Và PLAYING GAMES.
PLAYING GAMES TO BE SURE THAT
MONEY ISN'T GOING TO WHERE WE
INTENDED.
NOW.
ANY IN ANY ANY COMMENTS ABOUT
THE TERMS OF WHAT THAT'S WHAT WE
SHOULD THAT SHOULD BE EXPECTING
IN FIFTY FIVE I REALIZED THERE'S
DIFFERENT WAYS A CALCULATED BUT
YEAH EXCTLY THE WAY I DON'T
HAVE A HE LIKE ALTERNATE.
COMPLEXITY IS TO THE CALCULATION
AND I THINK IN A REPORT LAST
YEAR WEEK KNOWLEDGE THAT THERE
ARE A LOT OF THINGS THAT IT'S
UNCERTAIN HOW EXACTLY IT SHOULD
BE INTERPRETED --
BUT IT DOES APPEAR THAT WITH THE
THE CURRENT --
INTERPRETATION OF THE WORKLOAD
BUDGET AND THE SAME
INTERPRETATION INTERPRETATION
THAT WAS USED IN THE ENACTED
BUDGET LAST YEAR --
IT'S IT'S RELATIVELY UNLIKELY
THAT THAT THERE WOULD BE FUNDS
APPROPRIATED IN THE FUTURE.
AS THE NEW PROPOSALS THAT ARE
PART OF THE ADMINISTRATION'S
BUDGET SO SORT OF EAT INTO THE
REVENUES.
AND ACTUALLY AND I KNOW IF MODEL
THE SO HOW MUCH MONEY WOULD WE
HAVE TO BRING IN AN ORDER FOR
SAID ANYTHING THE FALLEN FIFTY
FIVE WOULD BE THE THRESHOLD.
GIVEN THIS KIND OF
INTERPRETATION.
I DON'T HAVE THAT NUMBER WITH ME
TODAY BUT THAT'S SOMETHING WE
CAN LOOK AT AND RIGHT BACK TO
YOU.
SO OKAY WELL I EIGHT YOU KNOW MY
MY CONCERN IS IS THAT EVERY TIME
WE GO TO THE VOTERS AND WE ASK.
VOTERS.
TO PONY UP SOME MORE MONEY.
RIGHT AND WE TOLD THE VOTERS
THIS IS WHAT'S GOING TO GO FOR
AND IT DOESN'T GO THERE.
OTHER THAN THAT THAT UNDERMINES
CONFIDENCE IN --
IF YOU AS A IN IN CONFIDENCE IN
ALL OF US HERE.
AND SO --
AND AS A THINK.
I THINK MANY PEOPLE WOULD BE
KIND OF INCREDULOUS TO THINK
THAT IN THIS ECONOMY.
THAT NONE OF IT ACTUALLY MAKES
ITS WAY.
TO BACK I MEAN IT'S ONE THING TO
HAVE A DOWN YEAR AND ARE THERE
IT'S NOT SO GOOD NO I'M
RECESSION OR OR THAT BRINK OF
RECESSION WHATEVER NOW IN TERMS
OF BUT THAT THAT'S THAT'S
CONCERNING HIS EYES THAT THEY
THINK THAT --
YEAH I MEAN WE PUT IN THE HANDS
OF FINANCE BECAUSE WE HOPE THAT
YOU KNOW EXPECT THAT THAT THAT'S
THAT THREE THINGS GOING TO BE
DONE I MEAN THAT'S WHAT THE
VOTERS THAT I MEAN IT'S MOTORS
VOTED FOR IT AT NIGHT IT'S THAT
THAT WAS DRAFTED.
BUT WHEN NOTHING SHOWS UP I MEAN
IT.
CALLING WELL WHAT'S GOING WHAT'S
REALLY GOING ON THERE.
EIGHT AND EIGHT AND JUST THE
I'VE WILL MY CONTINUE EXPRESSED
MY CONCERN THAT --
OTHER MANY PRIORITIES THAT WE
HAVE AND AND YEAH I THINK THE
VOTERS HAVE THE RIGHT TO MAKE IT
OUT TO DECIDE WHETHER THEY AGREE
WITH THE PRIORITY IN OUT AND
OFTEN TIMES THEY DO YOU KNOW THE
WEEK DAYS --
SUPPORTED A SORT OF RIGHT EVEN
BUT IF.
BUT NOW WE HEARD THIS WITH
OTHERS SB ONE AND HER.
OTHER PRIOR ONES THAT IF THEY
FEEL LIKE THE MY SIX THIRTY FEEL
LIKE THE MONEY DOESN'T GO TO
WHERE THEY WANTED TO THAT WE'RE
GONNA FIND A WAY TO SCARF THAT
MONEY MOVE IT SOMEWHERE ELSE.
YOU KNOW PLAY SOME DO SOME
TECHNICAL LEGAL THING SO I MEAN
THERE'S THE LEGAL PART.
RIGHT AND I THINK WE TALKED AS
LAST TIME AND WE CAN.
WE GO TO COURT YOU WIN BECAUSE
NOW WE SHOULD FINANCE BUT AT THE
TIME OF THE MURDERS QUE CONCERNS
ARE TRUST IN THE LEADERSHIP AND
INTENT.
AND THAT'S WHY I'M CONCERNED IS
BEING A ROAD AND THAT ALSO MEANS
ARE LESS LIKELY TO FEEL THAT THE
THE WANT TO SUPPORT --
OTHER THINGS AS WELL IT'S NOT
THAT THEY'LL SUPPORT FIND FUNNY
THOSE THINGS IS THAT THAT
THEY'RE NOT SURE YOU CAN TRUST
US.
AND THAT'S THAT'S MY BIG CONCERN.
SO I I I I REALLY I REALLY HOPE
WE THINK VERY CAREFULLY ABOUT
ABOUT THAT --
SO [inaudible]
ALL RIGHT.
OKAY ANY OTHER CULTURE.
A WELL THANK YOU.
THANK YOU SELL ALL RIGHT THE
CELL.
ALL RIGHT SO --
OKAY ANY OTHER QUESTIONS THAN
AMOUNT.
SO [inaudible]
ALL RIGHT.
AND WE'RE GONNA DALY DELVE INTO
A LOT OF THESE THINGS IN MUCH
MORE DETAIL IN PARTICULAR ITEMS --
AND BOTH LIKE FOR EXAMPLE
PROPERTY SIX IS GOING TO SHOW UP
IN THE FUTURE HEARING AND SO
FORTH SO THIS IS KIND OF THE
BROADER OVERVIEW BUT SINCE I
MEAN.
PROP FIFTY FIVE IS ABOUT MONEY
FOR MEDI CAL THIS IS. ONE THAT
IN OKAY --
IS THERE ANY PUBLIC COMMENT.
ON THIS ITEM [inaudible]
WHEN MICROPHONE [inaudible]
NO [inaudible]
OKAY.
WASN'T SURE NO ALL RIGHT HANDED
MICHAEL ALL RIGHT.
ISSUE NUMBER THREE COUNTY
ADMINISTRATIVE XIN ESTIMATES.
OKAY AND WE HAVE.
NEW PERSON FOR FINANCE MAYBE CAN
INTRODUCE YOURSELF FOR THE
RECORD BEFORE WE BEGIN THAT.
LARA YELLA DEPARTMENT OF FINANCE.
THE GOVERNOR'S WHICH INCLUDES AN
AUGMENTATION OF FIFTY THREE
MILLION EXECUTIONS OF GONNA
MISTER NAY LARA YELL.
THE PALESTINIANS.
ARE THE GOVERNOR'S BUDGET
INCLUDES A TOTAL ALLOCATION TWO
POINT ONE BILLION FOR NINETEEN
TWENTY IT'S AN INCREASE OF FIFTY
THREE MILLION FOUR COUNTY
ELIGIBILITY DETERMINATION
WORKLOAD.
COMPARED TO THE TWENTY EIGHTEEN
NINETEEN ALLOCATION THIS
INCREASES BASED ON THE
CALIFORNIA CONSUMER PRICE AND
EXCHANGE [inaudible]
RIGHT.
THANK LA --
COMMENTS NO.
MASON AGENCY THEN.
ALL RIGHT QUESTIONS REMEMBERS.
HER [inaudible]
EIGHT OKAY.
I THINK THAT THE ANY PUBLIC
COMMENT ON THAT THANK YOU MISTER
CHAIR MEMBERS KATHY SAID KNOWING
WHAT THEY COUNTY WELFARE
DIRECTORS ASSOCIATION.
JUST APPRECIATING THAT --
ONGOING METHODOLOGY THAT WE'VE --
AGREED ON NOW FOR THE
FORESEEABLE FUTURE TO JUST DO
THE COST OF DOING BUSINESS
INCREASE AND THEN.
CONTINUE TALKING AS NEEDED TO DO
INDIVIDUAL PROMISE ITEMS FOR
ISSUES THAT MAY ARISE LIKE THE
THE ITEM I MENTIONED EARLIER I
FOR THE AND DOC EXPANSION.
THAT SEEMS TO BE A GOOD APPROACH
FOR NOW GIVEN THAT IT'S PRETTY
TRICKY TO THINK ABOUT HOW TO
RESTART A METHODOLOGY FROM
SCRATCH AT THIS POINT AND WORK --
PROBABLY NOT REALLY EVER GOING
TO BE AND A STEADY STATE WITH
THIS PROGRAM GIVEN UNCERTAINTIES
THAT THAT YOU KNOW FEDERAL LEVEL
AB CA EXPANSIONS AT THE STATE
LEVEL AND THINGS LIKE THAT.
THIS SEEMS LIKE A GOOD APPROACH
MORE UNSUPPORTED THE GOVERNOR'S
PROPOSED BUDGET THANK YOU.
THANK YOU THANKS FOR MUCH.
OKAY THAT --
WHEN WE GO AHEAD AND MOVE ON TO
ISSUE NUMBER FOR MEDI CAL
OPTIONAL BENEFITS?
AND I THINK WE HAVE SEVERAL
STAKEHOLDER PROPOSALS AND SOON
THERE'S AFTER.
ANY OVERVIEW FROM AGENCY ON THAT.
OKAY OF COURSE.
WELL ACTUALLY YOU KNOW BEFORE WE
START WE DO HAVE A QUESTION
ABOUT OPTICAL BECAUSE THEY
BELIEVE IN LAST YEAR'S BUDGET --
WE HAD -- A
TWO YEARS AGO ACTUALLY SORRY TWO
YEARS AGO.
WE HAD -- WE
HAD TO PROVE DOT --
RESTORATION OF OPTICAL BENEFITS
BUT YET --
SEEMS LIKE EXACTLY IN THIS
YEAR'S BUDGET SO CAN CAN YOU.
CAN COMMENT ON THAT FINANCE.
AS GLORIA LACTOFERRIN FINANCE
REGARDING THE OPTICAL BENEFIT
RESTORATION WE'VE NOTED THE
CONCERNS OF THAT HAVE BEEN
RAISED IN THE AGENDA AND FROM
YOUR STAFF.
AND WE'RE AWARE THAT THE
LEGISLATURE EXPECTED FUNDING TO
BE INCLUDED IN THE GOVERNOR'S
BUDGET WE DO NOT HAVE ANYTHING
ELSE TO SHARE THIS TIME BUT WE
UNDERSTAND THE LEGISLATURE'S
PERSPECTIVE AND WILL CONTINUE
DISCUSSIONS AS WE MOVE FORWARD
AND TO ME REVISION.
HEY WELL I HOPE I HOPE FOR A AND
HOPEFULLY WILL DO MORE DISCUSS
IT'LL COME TUNING.
WE CAN AGREE THAT HE DID DECIDED
THAT WE PEOPLE SHOW CALLED.
CELL.
COUPLE YEARS AGO WE SHOULD JUST
FOLLOW THROUGH ON THAT SO THANK
YOU --
ALRIGHT SO WHERE OF SO WE'RE
GONNA GO AHEAD AND START WITH --
WESTERN CENTER LONG POVERTY
WELCOME.
CHAIR MEMBERS LINDA WAY WITH
WESTERN CENTER ON LAW AND
POVERTY WE WERE BECAUSE THE
RESTORATION OF MEDI CAL BENEFITS
THAT WERE CUT IN TWO THOUSAND
NINETY TWO A TRIGGER.
MECHANISM --
DUE TO THE STATE'S BUDGET CRISIS
BUT NOT YET RESTORED --
REFER TO IT OPTIONAL BENEFITS
BECAUSE THE STATE CAN ELECT TO
PROVIDE THESE SERVICES THE
SERVICES ARE NOT OPTIONAL FOR
MEDI CAL MEMBERS WHO DESPERATELY
NEED THEM.
ACCESS TO THE SERVICES PREVENT
DETERIORATION OF HEALTH AND THE
NEED TO UTILIZE OTHER --
MARGINS HE SERVICES --
THE CHAIR AND I CAN --
ALSO APPRECIATE THE NEED FOR
EYEGLASSES WHICH WE HAD EXPECTED
TO BE RESTORED IN --
TWENTY TWENTY BASED ON PREVIOUS.
BUDGET ACTION BUT REMAINS
UNCERTAIN --
IN A TIME OF RECOVERY IT'S
PARAMOUNT THAT THE STATE'S MOST
VULNERABLE RESIDENTS HAVE ACCESS
TO AUDIOLOGY PODIATRY SPEECH
THERAPY INCONTINENCE CREAM AND
WATCHES.
AS WELL AS AYE GLASSES FOR
ADULTS.
THANK YOU FROM THE PHARMACY
SERVICES OKAY ALEJO [inaudible]
FINANCE.
COMMITTEE MEMBERS YES SIR IS
THAT THANK YOU AYE AYE IS ONE OF
STATE -- THE
NICE RELATED TO SPOKEN I'M AND
1100% SUPPORT OF A RESTORING
SERVICES AFTER TEN YEARS IN
THREE DIFFERENT GOVERNOR'S AND
THE ECONOMY --
DOING VERY WELL IN REVENUE
STREAMS COMING INTO --
THE STATE OF CALIFORNIA WE
SHOULD BEGIN RESTORING SYMBOLS
OPTICAL.
OPTIONAL BENEFITS INCLUDING --
THE OCTAVE ATTACK METRIC
SERVICES THAT --
AGAIN WHAT SEEMS TO BE THERE BUT
NO MONEY ASSOCIATED WITH ANY IS
TWENTY TWO MILLION DOLLARS WHICH
IS -- BUDGET
DUSTIN AND AND THE AND THIS
BUDGET SO --
LOOK FOR TO WORKING WITH THE
CHAIR AND RESTORING SOME OF THE
SERVICES THAT --
NEED TO BE RESUMED [inaudible]
ANY OTHER.
OKAY SO YEAH NO I THINK THANKS
SO MUCH FOR YOUR PRESENTATION
CERTAINLY ONE BE SURE PEOPLEOF
ACCESS TO THE FULL RANGE OF
EVIDENCE BASED SERVICES --
AND THAT THAT WOULD BE IF TO
BENEFIT TO OUR MEDI CAL
BENEFICIARIES AND SEVEN
MENTIONED OPTICAL AND DIED IN
THAT WE'RE GOING TO HEAR ABOUT
THE DIET TREE CERTAINLY SPEECH
THERAPY IS A PEDIATRICIAN. FOR
THAT IS.
IDEOLOGY SO --
HOPEFULLY WE CAN LOOK AT SOME OF
THAT ALL RIGHT.
THANK YOU ALL RIGHT NEXT WE HAVE
DOCTOR JOHN CHISHOLM FOR THE
PRESENT THE CALIFORNIA HI YET
MEDICAL ASSOCIATION.
WELCOME BACK IT UP PAN THE
MEMBERS GOOD AFTERNOON.
YEAH MY NAME IS DOCTOR JOHN
CHISHOLM I'M HERE REPRESENTING
THE CALIFORNIA POLICE AFTER
MEDICAL ASSOCIATION AND ITS
MEMBERS.
CURRENTLY SERVING AS THAT
ASSOCIATIONS PRESIDENT THIS YEAR.
INTERESTING BUT IN PRIVATE
PRACTICE IN CHULA VISTA
CALIFORNIA FOR OVER THIRTY YEARS
SERVING ONE OF THE MOST AT THE
ETHNICALLY DIVERSE AND
UNDERSERVED AREAS OF THE STATE
FOR MY ENTIRE CAREER THIS
POPULATION RELIES HEAVILY ON THE
MEDI CAL SYSTEM FOR ITS HEALTH
CARE NEEDS. FOR THE LAST TEN
YEARS HAS SUFFERED FROM A LACK
OF NICKEL CARE THIRTY REASONS
FOR THIS FIRST SERVICES BY
PODIATRISTS HAS NOT YET BEEN
REINSTATED IN ALL HEALTHCARE
SYSTEM SYSTEMS.
AND SECOND PODIATRIC SERVICES
ARE SUBJECT TO ONEROUS AND
UNNECESSARY AUTHORIZATION
BILLING AND SERVICE REQUIREMENTS
THAT FURTHER ACT LIMIT ACCESS TO
FOOT AND ANKLE CARE.
AS YOU HEARD IN TWO THOUSAND I
PROVIDE FREE SERVICES WERE
ELIMINATING THE STATE'S MEDICAL
STATES MEDICAL PROGRAM.
THIS ELIMINATION REMOVE MEDICAID
COVERAGE FOR FOOT AND ANKLE
MEDICINE AND SURGERY BY A
CERTAIN TYPE OF PROVIDER BUT I
INTEREST BUT NOT THE SERVICES
THEMSELVES THE EXACT SAME PUT
NICKEL SERVICES IF PROVIDED BY A
POSITION.
ARE COVERED IN MEDI CAL BUT
PODIATRIST THE SPECIALISTS IN
FOOT AND ANKLE CARE ARE
PREVENTED FROM RIGHTING THE SAME
SERVICES TO MEDI CAL PATIENTS IN
CALIFORNIA.
BUT FULL RESTORATION WILL NOT
SOLVE THE PROBLEM OF ACCESS TO
PODIATRY CARE CURRENTLY SERVICES
BY PODIATRISTS ARE SUBJECT TO AN
ENTIRELY DIFFERENT SET OF
AUTHORIZATION BILLING AND
SERVICE REQUIREMENTS THAN
POSITIONS.
I PROVIDED A HANDOUT THAT
DOCUMENTS SOME OF THOSE --
DIFFERENCES YOU CAN SEE HOW
SIMPLE IT IS FOR A POSITION OF
PRIDE PROVIDE PUT NICKEL
SERVICES AND HOW DIFFICULT AND
TIME CONSUMING IT IS FR A
PODIATRIST.
ASA MEDICAL MEDI CAL PROVIDER
FOR MY ENTIRE CAREER I CAN
ATTEST TO THE DIFFICULTY
INVOLVED IN TRYING TO MEET ALL
THESE REQUIREMENTS.
LET ME GIVE AN EXAMPLE OF HOW
THIS IMPACTS OUR LOW INCOME IN
DISABLED PATIENTS.
THERE'S AN EPIDEMIC OF DIABETES
AND DIABETES RELATED FOOT NICKEL
DISEASE IN CALIFORNIA MY OWN
COMMUNITY IS BEING DEVASTATED BY
THIS EPIDEMIC.
DIABETIC FOOT ALTERATIONS IN
AMPUTATIONS HAVE BEEN STEADILY
INCREASING SINCE TWO THOUSAND
AND TEN ONE YEAR AFTER BUT I
FREE SERVICES WERE ELIMINATED.
THE PREVENTATIVE PUT CARE THAT
COULD HAVE PREVENTED THESE
ALTERATIONS IS NOT A COVERED
BENEFIT AND EVEN IF.
PRIDE TREE IS FULLY REASSESSED
RESTORED THIS IS FOR MONTHS.
IF THE PATIENT FOR EXAMPLE
HAPPEN TO HAVE AN ACUPUNCTURE
TREATMENT ONE MONTH AND THEN
DEVELOPED A DIABETIC FOOT WOUND
HE WOULD ONLY BE ABLE TO SEE A
PODIATRIST ONE TIME THAT MONTH.
IN ONLY TWO TIMES IN THE
SUBSEQUENT MONTHS I TREAT
DIABETIC FOOT AND ANKLE ABOUT
DIABETIC FOOT WOUNDS ALL DAY
EVERY DAY IT TAKES MANY ORE
THAN JUST TWO TREATMENTS TO HEAL
THOSE WOUNDS ON A MONTHLY BASIS.
WE WOULD ALL AGREE THAT TREATING
A DIABETIC FOOT WOUND AS AN
EMERGENCY LIFE THREATENING
CONDITION.
THE MEDI CAL PROVIDER MANUAL
AGREES IN THIS PROCEDURE DOES
NOT REQUIRE PROPER IS-AUTHORIZATION FOR A PHYSICIAN.
THE EXACT SAME PROCEDURE.
IS A PRIOR AUTHORIZATION IS
REQUIRED FOR ANY PROCEDURE OR
TREATMENT THAT A PODIATRIST
PERFORMS INCLUDING LIMóN LIFE
THREATENING THREATENING FOOT
WOUNDS AND INFECTIONS.
THE PATIENT THAT APPEARS AT THE
EMERGENCY ROOM WITH A
PREVENTABLE LIMB THREATENING
ULCERATION INFECTION.
BECAUSE OF THE ISSUE OF
UNNECESSARY REQUIREMENTS FOR
AUTHORIZATION AND BILLING
THERE'S USUALLY NO PODIATRIST
WILLING TO TAKE THIS PATIENT ON
AND EVEN IF ONE DOES HE HAVE TO
STRUGGLE TO MEET ALL THE
AUTHORIZATION OF BILLING
REQUIREMENTS TO BE.
REIMBURSED FOR HIS SERVICES
INCLUDING ANOTHER PRIOR
AUTHORIZATION FOR TREATMENT
RENDERED IN THE HOSPITAL WHICH A
POSITION IS NOT REQUIRED
[inaudible]
TO OBTAIN.
THANK YOU THANK YOU THANKS FOR
MUCH OF ANY COMMENTS FROM THE DC
OKAY BELIAU [inaudible]
FINANCE.
QUESTION COMMITTEE MEMBERS SO
WHY NOT ALL RIGHT CENTER.
SEVEN WHY NOT RESTORE PODIATRIC --
SERVICES SPECIALLY WITH --
THE HIGH INCIDENCE OF THE
DIABETIC POPULATION AND MANY --
SENIORS AT CAN'T EVEN COOK THEIR
OWN TOENAILS --
WHY WHY ALL THE EXCESS OF PEOPLE
WORK TO GET THE SERVICES THEY
SPECIALIZE IN VERSUS A POSITION
THAT DOESN'T NEED TO DO THE SAME
PAPERWORK?
TO TREAT MORE PEOPLE IT'S ALL
ABOUT ACCESSIBILITY.
ARE YOU ASKING ABOUT THE PROCESS
RECLAIMING OUR DEFERRED TO THE
MY COLLEAGUES AT THE DEPARTMENT
OF HEALTH CARE SERVICES IT
WASN'T.
THAT I RESTORATION WAS INCLUDED
IN THE GOVERNOR'S BUDGET BUT
WE'RE HAPPY TO DISCUSS THE
LEGISLATURE'S PRIORITIES IN
RESTORING I THINK IT'S FOR
RHETORICAL QUESTION THAT I THINK
THE SERVICES OF A PROVIDER VERY
IMPORTANT TO THE HEALTH AND
SAFETY OF OF CERTAINLY --
DIABETICS --
PEOPLE THAT HAVE OTHER --
PARTY AFTER DISEASES IT WAS A
BENEFIT FOR MANY MANY YEARS
UNTIL WE HAVE THE ECONOMIC.
CRISIS AND I WOULD JUST URGE THE
GOVERNOR TO RECONSIDER INCLUDING
THEIR SERVICES AND NETWORK --
THE PARALLEL SOME OF VERSUS
SERVICES THE PHYSICIANS CANOE
BUT WE KNOW WE HAVE A PHYSICIAN
SHORTAGE IN THE CITY CALIFORNIA
AND IT'S ALL ABOUT ACCESSIBILITY
AND IF YOU DON'T GET TO THESE
PEOPLE WITH --
WITH ULCERS EARLY --
THE NUMBER ONE REASON FOR
AMPUTATIONS AND IN THE COUNTRY
IS BECAUSE OF DIABETES.
A NUMBER BECAUSE OF BLINDNESS IS
DIABETES AND HERE WE DON'T HAVE
OPTOMETRIC SERVICES BEYOND THAT
BUT IT SERVICES AND WE HAVE A
GROWING EPIDEMIC OF OF CHILDHOOD
DIABETES.
THE NEEDS --
NEEDS TO BE TENDED TO SO --
I WOULD STRONGLY URGE THE
GOVERNOR RECONSIDER --
ADDING THESE SERVICES AND I
DON'T THINK IT WOULD BE A BIG
BUDGET HAD TO TO RESTORE THEM --
TO THOSE LEVELS SO.
THANK YOU MISTER.
AND THANK YOU SO MUCH FOR YOUR
PRESENTATION WE DO.
HAVE A THREE MINUTE LIMIT CELL
THAT WAS A SIGNAL --
BUT IT'S JUST THAT NOW JUST TO
CLARIFY --
IN TERMS OF IF YOU MAY NOTING
THE DIFFERENT REQUIREMENTS --
IS -- SO YOU
OF THE DIGEST AS A WORKING IN
EMERGENCY ROOM RIGHT AND ARE
PART OF THE MEDICAL STAFF THEY
STILL HAVE THE SO IS THIS FOR
THE DIET SO WHAT HAPPENS IN
TERMS OF RELATION BETWEEN
PODIATRISTS ANY WE HAVE
DIFFERENT.
ARRANGEMENTS PEOPLE ARE ARE IN --
THAT'S A OF THE MEDICAL STAFF
AND THE E. R..
I SIMPLY OF IT THAN THAT THIRTY
AFTER PRACTICE YOU MAY BE PART
OF A MEDICAL GROUP.
IS AT THAT AFFECT THIS IN ANY
WAY OR WHAT WHAT HAPPENS WITH IN
TERMS OF THE REQUIREMENTS
BECAUSE HE SAID THE SERVICES ARE
COVERED BUT WHAT HAPPENS IN OR
FOR BUT DIETERS TO DO IT THEY
HAVE TO MEET.
THESE ADDITIONAL AT OWN RISK
SYSTEMS --
DIABETIC WHEN SALVAGE AND OTHER
KINDS OF FOOD MEDICAL CARE ARE
PRIMARILY PRIMARILY PROVIDED FOR
BY PODIATRISTS SO THAT SENT
THROUGHOUT THE KAISER SYSTEM ALL
OF THEM GREAT BIG MANAGED CARE
SYSTEMS BUT I THAT'S PRIDE FOR
ISRAEL.
WE RENTED A PROBLEMS IS IN THE
IN --
PRIVATE SETTINGS --
ESPECIALLY IN HOSPITALS THAT
REQUIRE THAT IS A POLICY OF
BEING ON THE EMERGENCY ROOM
STAFF FOR BEING ON THE HOSPITAL
STAFF YOU CAN'T DISCRIMINATE
BETWEEN WITH YOU TAKE MEDICARE
AWAY THEY DON'T TAKE MEDICAL.
AND SO AGAIN THE THE SERVICES
SIDE AND BESIDES THAT EVEN IF
THERE WASN'T MOST PRIDE FIRST
WOULD WITH MOST BY TRISTAN I
KNOW INCLUDING MYSELF --
REGULARLY TAKE THESE PATIENT ON
JUST BECAUSE THAT'S WHAT WE DO
WE TAKE CARE OF PATIENTS AND
THAT'S WHEN THIS ONEROUS
UNNECESSARY LAUNDRY LIST OF
REQUIREMENTS WE HAVE TO FACE.
TYPICALLY MYSELF AND OTHER --
AND OTHER --
PROVIDERS WE DO THE CASE PRO
BONO THEY DON'T SUBMIT A BILLING
THEY DON'T DO ANYTHING OTHER
THAN TAKE CARE OF THEIR PATIENTS
WHICH THEY DO BEST.
SO THE THE BEST WAY THAT I CAN
ANSWER YOUR QUESTION IS THAT --
THAT THE SERVICES ARE ARE YOU
KNOW.
IT IS IN SOME SITUATIONS WHERE
PRICES ARE NO LONGER WILLING TO
WORK UNDER THAT SITUATION THE
WORK IS BEING DONE BY OTHER
SPECIALISTS VASCULAR SURGEONS
GENERAL SURGEONS.
ORTHOPEDIC SURGEONS.
UNFORTUNATELY THEY'RE JUST NOT
IT.
IN THIS DAY AND AGE THOSE KIND
OF SERVICES ARE ALMOST ALWAYS
DONE IN MULTI DISCIPLINARY TEAMS
WITHOUT I INTEREST YOU IN THE
MAJORITY OF THE WORK.
AND WHEN THOSE PRICES ARE THERE
IT.
THE WORK IS BEING DONE BY
SPECIALISTS WHO DON'T HAVE A
PARTICULAR SKILL IN THAT
INTERVENTION SO THIS IS JUST A
CLARIFY THOUGH WHEN YOU HAVE A
GROUP FOR OUR TEAM RIGHT WITH A
PODIATRIST SUSIE RIGHTLY SAID
DOES.
SO -- THIS
SO WHEN IT COMES.
TO THESE REQUIREMENTS THAT
APPLIES TO ALL PODIATRISTS NO
MATTER WHAT THE ARRANGEMENT
DURIN. FOR FOR INSTANCE SOMEBODY
WORKING IN A LARGE MULTI
SPECIALTY GROUP YES I DO THAT
RIGHT.
YEAH LIKE THAT YEAH SO THIS WAS
A PART OF A LARGER THEIR PART OF
THE MEDICAL GROUPS WITH THE
PODIATRIST AS PART MEDICAL GROUP.
IS THIS STILL THIS.
I PARK I DON'T KNOW WHAT THOSE
GROUPS RELATIONSHIP WITH THE
MEDICAL PAYMENT SYSTEM IS OKAY
BUT I DO BUT BUT I DO KNOW THAT
AS EMPLOYEES OF THAT SYSTEM
TYPICALLY.
I'VE NEVER HEARD THAT --
THAT KIND OF ACCESS TO A
PODIATRIST WITHIN THOSE SYSTEMS
IS LIMITED IN ANY WAY.
AFFECT THOSE TEND TO BE THE
SUBSTANTIVE WORK PODIA TRICK
MEDI MOST --
THEY CAN MOST EASILY RENDER THAT
KIND OF SERVICE TO MEDICARE
BENEFICIARIES OKAY BUT DEAR TO
PERSON ON CALL FOR THE E. R. AND
SOMEONE COMES IN AND YOU GET
CALLED AND IT'S MEDI CAL
PATIENTS THEN YOU'RE LIKE.
OH RIGHT IS THAT THE WELL I I
MEAN I'M NOT I'VE BEEN THE
CHAIRMAN OF MY STUFF MY
ASSOCIATIONS MEDICAL COMMITTEE
FOR FIFTEEN YEARS I TREAT MEDI
CAL PATIENTS HI BILL FROM THEM I
GET THE DENIALS AND I KEEP A BIG
STACK MOM BECAUSE I NEED THOSE
IN ORDER. TO TO FIX THIS PROBLEM
OKAY ALL RIGHT WELL THANK YOU
THINK CERAMIC YOU VERY MUCH.
OKAY NEXT UP IS THE CALVET PAN
ETHNIC HEALTH NETWORK PROPOSAL
FOR AS MEDICATION BERMAN TOLL
REMEDIATION BENEFIT.
UP SEE TEN ON THE WAY UP ALL
RIGHT.
I'M OF THE SOCIAL.
ASPECTS OF SHOWING MAY DO IS
THEY WILL HAVE.
WE CAN PART THE WATERS SO WE CAN
THAT DROPS IN THE KOREA COME
AROUND A LITTLE BIT HERE.
WE CAN EVAN SHIFT OVER A COUPLE
CHAIRS AND WE CAN LETTER
PRESENTERS AND OKAY THERE WE GO
OKAY THANK YOU [inaudible]
HOW MANY [inaudible]
RIGHT.
OKAY HOW MANY SPEAKERS WE HAVE.
THREE OKAY GOT THREE MINUTES
TOTAL OKAY THE OF YOUR HEARST
OKAY.
ARE THE THIRD PERSON OFTEN GETS
LEFT OFF THE END ALL RIGHT.
TALK FAST I'M UNABLE CHAMBERS OF
THE COMMITTEE MY NAME IS JOE ALL
OF US WITH RAMP REGIONAL ASTHMA
MANAGEMENT PREVENTION.
WE'RE HERE TODAY TO ASK --
THAT YOU PROVIDE FUNDING FOR
ASTHMA PREVENTIVE SERVICES
MEANING AS MEDICATION AND HOME
ENVIRONMENT --
FOR ASSESSMENTS AS A COVERED
BENEFIT FOR ADDITIONALLY RASKIN
FOR RESOURCES TO SUPPORT MINOR
TO MODERATE.
AND REMEDIATION OF ENVIRONMENTAL
TRIGGERS SUCH AS PROVIDING
MATTRESS AND PILLOW CASE COVERS
AND USING TRIGGER CAPTURING
VACUUMS ALL THESE SERVICES MAY
BE PROVIDED BY QUALIFIED NON
LICENSED PROFESSIONALS.
UNDER THE SUPERVISION OF A
LICENSED PROVIDER.
NATIONALS WITH GUIDELINES
RECOMMEND THESE TYPES OF
SERVICES RESEARCH DEMONSTRATE
THE THOUSAND SERVICES IMPROVE
HEALTH OUTCOMES AND SAVE MONEY.
BY REDUCING MORE COSTLY MERSEY
EMERGENCY DEPARTMENT VISITS AND
HOSPITALIZATIONS THANK YOU.
WHEN OUR --
HONORABLE CHAIRMAN AND MEMBERS
OF THE COMMITTEE MY NAME IS
EMILY LOCUSTS AND ON MY
COMMUNITY HEALTH WORKER FOR THE
CENTRAL CALIFORNIA ASK MY
COLLABORATIVE.
I HAVE THE HONOR OF PROVIDING
HOME VISITING TO OPERATIONS WITH
A SMILE ON CONTROL US MOVE --
IN MANY CASES THEY HAVE --
FRIGHTENING BE SITS AT THE
MARGINS WHO ROOM OR TO GET
HOSITALIZED --
ORTEZ MY HOUSE BECAUSE IT TO ME
SCHOOL WORK MY JOB IS TO HELP
THEM GET THEIR ASTHMA UNDER
CONTROL.
I DO SO BY PROVIDING AS MY
EDUCATIONS THE REINFORCES A
CLINICAL GUIDANCE THEIR DOCTOR
HAS GIVEN THEM.
I ALSO HELP IDENTIFY INTEREST
READERS THE ASTHMA TRIGGERS INTO
HOMES BY PERFORMING HOME
ENVIRONMENTAL ASSESSMENT AND
GIVEN THE RECOMMENDATION THE
HAVE.
TO I REDUCE THEM --
FOR EXAMPLE I HAVE --
THINKING ATTACK --
I IS PLAYING THE ROLE THAT
TRIGGERS PLAY AND I WILL ALSO
LOOK AROUND HOME AND SEE WHAT
TRIGGERS ARE.
PRESENT -- I
ALSO PROVIDE IMPORTANT LEAGUE TO
PATIENT OUGHT TO THE PATIENTS
WITH THE DOCTOR.
ARE FOR EXAMPLE FIBRATION FILLS
HER ASTHMA IT'S GETTING WORSE I
WILL HAVE HER RECORD THERE WITH
THE DOCTOR FOR ADDITIONAL HELP --
I WRITTEN RECENTLY HAVE AN
IMPORTANT EIGHTY TO WAR --
WITH THE FAMILY --
HE'S HERE PRESS AND HE WILL GIVE
HIS OWN --
THIRTY MONEY --
I'M PROUD OF MY WORK TO HELP HIS
FATHER HIS FAMILY GET BETTER I
THINK EVERY PERSON WERE POORLY
CONTROL ASTHMA DESERVE TO GET
THE HELP THEY NEED. TO LIVE A
HEALTHY LIFE YOU YOUR SUPPORT
FOR ASTHMA PREVENTATIVE SERVICE
WILL HELP TREMENDOUSLY AND THAT
IS WHY I'M REPRESENTING THE
CENTER CALIFORNIA'S MY
COLLABORATIVE SUPPORT FOR THIS
BUDGET PROPOSAL THANK YOU. FOR
YOUR TIME --
HE SPEAK ONLY SPANISH SO I CAN
INTERPRET VERY QUICKLY FOR ALL
RIGHT THANK YOU. ONE IS THAT IS
MEAN THOSE HOSTING A BETTIS HE
ASKED ME PERCENT TODAY THAT
MOTHER THAT WOMEN FACE --
FUSSING ABOUT IS AN OPERATION
WITH US MY SINCE.
TWO THOUSAND SIX MEMBER GONZALEZ
OVER AMY BECAUSE ONLY BE ABLE.
COME WITH A SENTENCE HE SENT TO
THE INFIELD IMMENSELY IN THIS
ARTICLE THAT THAT'LL I'M BEING
WITH ASTHMA FOR THIRTEEN YEARS
AND I FELT REALLY BAD.
AND NOT KNOWING HOW TO TREAT IT.
A LITTLE TIME IN THE STATE HE
WAS THE MEMBERS IN THE MIDDLE HE
IS --
TUESDAY MALES AND AS AN EXAMPLE
ALSO MY THREE KIDS HAVE ASTHMA
AND IT'S I FEEL VERY.
BAD SCENE THEN ENTER CONDITIONS.
OVER IS IS A A LOT FOR YOU THEY
AND THEY YEAH MAY I I MEAN TO
SEE MISS INTO WHICH WOULD HOLD.
OUR THANKS TO OR THEY COM BY
OUR ORGANIZATION --
I WAS ABLE TO HELP CLEAN --
TAKING TO THE DOCTOR'S
APPOINTMENT AND GET HIM
MEDICATIONS FOR ASTHMA AND HE'S
BEEN FEELING MUCH BETTER SINCE
THEN.
ITEM INCOME ALL THAT THAT A
MONTH AND THEN LIKE I SAT CAM A
TANGLED WITH OTHER YEAH MOLE
FORGET THEM INITIAL MEDICAL YEAH
K. AS IN THE LAST MONTH.
HIS HOME HAS A HAS A LOT OF US A
LOT MORE.
SO I WAS ABLE TO GIVE HIM ON
REGULATION HOW TO REMEDIATE SO
THAT HAS HELPED ME A LOT HE
DIDN'T KNOW ANYTHING ABOUT THAT
BEFORE.
THIS WAS THE WAS AMONG THE CARE
IN THE MIDDLE WITH THE MISSION
TO PROTECT THEM AND TO BE IN A
STEP WHAT ARE YOU MISSING NOT ON
THE MONEY YEP WE JUST WEST --
HE WAS UNABLE TO GO BACK TO WORK --
IN AFTER A WEEK OF WE KNOW WE'RE
PROGRAM HE'S ABLE TO GO BACK TO
WAR SO HE'S --
IN SUPPORT OF THESE A PROPOSAL.
RIGHT THANK YOU SO VERY MUCH
OKAY ANY COMMENTS FROM.
THE C. S. HELLO [inaudible]
FINANCE [inaudible]
COMMENTS.
IS IT COMMON FOR FINANCE
[inaudible]
OKAY.
OKAY OUTSIDE BECAUSE AGAIN OKAY --
QUESTIONS FROM OKAY QUESTION
COMMITTEE MEMBERS --
SERTOLI.
THANK YOU MISTER CHAIR --
WHICH IS CRISIS PURSUIT THIS THE
ONE USING A PROTEST POOREST AKIO
E..
UM AS YOU KNOW THE CENTRAL
VALLEY HAVE SOME OF THE HIGHEST.
ASTHMA RATES FOR CHILDREN AND
ADULTS IN THE NATION NOT JUST IN
THE STATE.
AND ASTHMA HOME VISITING
SERVICES ARE CRITICAL TO THE
CENTRAL VALLEY AND THE REST OF
THE STATE.
RESEARCH SHOWS THAT THIS MODEL
SPECIFICALLY IMPROVES HEALTH
OUTCOMES AND REDUCE HEALTHCARE
COSTS BUT THE STATE.
AND SO --
MEDI CAL BENEFICIARIES IN MY
DISTRICT --
WILL POUR A WITH WITH POORLY
CONTROLLED ASTHMA WOULD BENEFIT
GREATLY FROM THIS INVESTMENT.
THANK YOU.
SO -- SO I
ACTUALLY WON THE QUESTIONS I HAD
WAS -- YOU
MENTIONED THAT --
DOING THIS KIND OF ITCHING COULD
ACTUALLY SAVE MONEY AND I
GENERALLY AGREE WITH YOU --
BUT DO YOU HAVE DO YOU HAVE SOME
DATA HOURS RESEARCH DOES THAT
WITH THAT ACTUALLY DEMONSTRATES
THIS --
CERTAINLY NO REDUCING EXPOSURES
AT HOME WILL.
DECREASE THE LIKELIHOOD THAT
THEY WILL NEED INTERVENTIONS
LIKE GOING TO THE MERCHANTS ROOM
OTHER TYPES INTERVENTIONS DO YOU
HAVE SOME DATA THAT YOU COULD
SHARE WITH US OR DO YOU HAVE
SYNDICATE SURE WITH LA --
THAT --
SHOWS THAT ACTUALLY THIS
INVESTMENT ME IF YOU HAVE TO
SEND IN ANY NUMBER OF STUDIES
HAVE SHOWN A RETURN ON
INVESTMENT --
WHERE -- YOU
YOU DO REDUCE HEALTHCARE
UTILIZATION COSTS BY REDUCING
THE NUMBER OF AMHERST PART
VISITS HOSPITALIZATIONS AND
THROUGH THE COMBINATION OF
ENVIRONMENT TRIGGER REDUCTIONS
AND THE PATIENT PATIENT ALL
RIGHT.
SO THE REASON I ASKED THAT
QUESTION THEN OF RAISED IT MANY
TIMES OF FORWARD HERE AND SOLEMN
LOOKING ELIO BUT I ALSO WE CAN
pFINANCE.
YOU WORK FOR US AS WE LOOK AT
YOU FIRST --
BECAUSE I THINK IN WE SCORE
PROPOSALS LIKE THIS ALL RIGHT
OBVIOUSLY YOU KNOW PEOPLE SAY
OKAY WELL WE YOU KNOW WE GET THE
TAKE SOME MONEY BECAUSE WE GOT A
A PEOPLE ACRE. THREE HEALTH
WORKERS AND SO FORTH --
BUT WE'RE ACTUALLY GONNA REDUCE
UTILIZATION I REALIZE WE DO LIKE
CAPITATION THEN WELL IT'S ALL
VERY IN CAPITATION BUT I MEAN
REALLY I MEAN THAT THE COMES
DOWN.
TO YOU KNOW EVEN JUST
FINANCIALLY SO I THINK OBVIOUSLY
ONE THE MOTIVATIONS ALWAYS A IS
OF COURSE WHICH I RDUCE HUMAN
SUFFERING RIGHT CELL AND GOING
TO THE EMERGENCY ROOM FOR THAT
HOW MUCH YOU PAY FOR IS BAD
ENOUGH WITHOUT.
THEN WE CAN TALK ABOUT THE BILL --
BUT OR HOW MUCH WHO PAYS THE
FIELDS TEACHERS WHO GETS ADORNS
MEDI CAL --
BUT WILL --
I'D LIKE TO SEE IS --
BUT YEAH I I ALWAYS SAY WE HOLD
TO A PRETTY HIGH STANDARD OF
WEEKENDS I MEAN THE REAL
QUESTION IS IS THIS WELL THIS
ACTUALLY.
I MEAN.
SHOULD THIS BE EVEN SCORES
ACOSTA BEYOND THE IMPLEMENTATION.
AND AND AND AND DIED BUT I WILL
DEMAND THE DATA TO PROVE IT I
MEAN WE'RE NOT JUST GOING TO SAY
OH WELL I THINK IT'S GOING TO
RIGHT BUT I MEAN THIS IS ONE OF
THE PROPOSALS I THINK WE REALLY
OUGHT TO LOOK AT AND SO I'M
GOING. TO COUNT ON YOU TO
PROVIDE THE DATA.
BECAUSE UNLIKE EXPECT AND DO ALL
THE RESEARCH THEMSELVES AND I
HOPE WE CAN LOOK AT THAT AND SAY
WELL WHAT DO WE THINK GAIL THIS
WILL WHAT WILL HAPPEN SO I MEAN
SOME OF THAT'S GONNA REALIZE
THERE'S SOME CALCULATION RIGHT
HOW MANY PEOPLE ARE GONNA BE
REACHED HOW THE PEOPLE.
WE SERVE HOW MANY PEOPLE WHO IN
THE CURRENT POPULATION THAT YOU
HAVEN'T REACHED.
YOU KNOW HOW MUCH EXPOSURE TO IS
HOW MUCH.
HOW MUCH WE ACTUALLY DECREASE
EXPOSURE WITHIN A THERE ARE?
EXAMPLES OF PEOPLE WHO DID
PROGRAM LIKE THIS ARE.
CURRENT PROGRAM THAT'S BEING
FUNDED OTHER WAYS WE CAN GET
DATA LIKE THAT --
THEN I THINK THAT'S THE WAY WE
SHOULD BE LOOKING AT THIS SO --
ANY ANY COVER FROM LA ABOUT THAT.
I MEAN WE WOULD WE WOULD WELCOME
RECEIPT OF THAT RESEARCH AND
HAPPY TO REVIEW IT --
WE WE CERTAINLY ACKNOWLEDGE --
THAT VARIOUS INTERVENTIONS CAN
PRODUCE SAVINGS IN ADDITION TO
COSTS AND SO --
WE WOULD --
WELCOME THE OPPORTUNITY TO
REVIEW SORT OF A A ROBUST
RESEARCH AND AND TO BE ABLE --
TO TRY TO INTERPRET THAT WITHIN
A WITH ENOUGH FINANCIAL CONTACTS
ONE CHALLENGE DOES ARISE IN THAT
A LOT OF TIMES THE SAVINGS MIGHT
BE YEARS OUT AND NOT WITHIN THE
BUDGET LINDA IN WHICH WERE
SCORING THE COSTS.
AND SO THERE ARE A LOT OF
COMPLEXITIES IN THIS BUT WE'RE
WE'RE DEFINITELY HAPPY TO
EXPLORE OKAY AND FINANCE ARE YOU
OPEN TO THAT.
I CAN'T MAKE YOU DO ANYTHING.
MISTER CHAIR WITH A LITTLE MAGIC
AS DEPARTMENT OF FINANCE AND SO
TO THE EXTENT SOME OF THE
SAVINGS --
ARE KNOWN FOR PROPOSALS THAT WE
LOOK AT AS DISCUSSED EARLIER IN
THE AB FIVE PROPOSAL WE DO SCORE
THOSE --
SAVINGS TO THE EXTENT THAT WE
CAN REACH A METHODOLOGY SO --
IF -- WE'D
BE HAPPY NO I APPRECIATE THAT
THANK YOU --
BECAUSE I THINK AS WE LOOK AT
VARIOUS INTERVENTIONS AND
PROPOSALS WE SHOULD BE LOOKING
AT HOW MUCH CANNELLA HOW MUCH
COST TO DO AND HOW MUCH IT COSTS
NOT TO DO THAT INCLUDING THE
FINANCIAL COSTS WE'RE BUDGET
COMMITTEE.
SO ALL RIGHT UP.
YES DID YOU HAVE.
YES SIR I JUST WILL LEAD TO ARE
VERY QUICK JUST BY LOOKING AT
THIS HOME THERE IS FOR PEOPLE
OUT OF FIVE IN THE HOME WITH US
BY WITHOUT KNOWLEDGE BEFORE HOW
TO CONTROL THAT'S MY ONLY WITHIN.
LESS THAN TWO MONTHS. TWO OF HER
KIDS TO HIS KIDS WENT TO THE
EMERGENCY HE WENT TWICE THE
MARGINS IN NOT KNOWING HOW TO
CONTROL EVEN EVEN WHEN THEY HAVE
THE HEALERS AT HOME.
SOLD ME GOING INTO THE HOME THIS
LAST TWO WEEKS THEY HAVE A STOP
GOING TO THE PURCHASE IT NOW DO
YOU KNOW HOW TO READ SO THAT'S A
GOOD LAKE.
DATA DOES BY THIS HOME.
AND IF I MAKE IT OUT CENTER AND
THAT THE THE OTHER HELPFUL SHE
WITH THIS PARTICULAR
INTERVENTIONS THAT THE COST
SAVINGS IS TYPICALLY REALIZED IN
A FAIRLY SHORT PERIOD OF TIME
YOU'RE NOT LOOKING AT SAVINGS.
YOUR YEARS OUT WITH SAY YOU KNOW
THE COUPLE I WILL COME FROM A
TALKING ABOUT --
REDUCTIONS AND IMMERSIVE HARM
USAGE OF HOSPITALIZATION A VERY
SHORT PERIOD OF TIME.
NO I APPRECIATE THAT AND I'D IN
MY PAST LIFE I AND THEY KNOW
THAT -- WE
LOOK AT THE GUIDELINES
ENVIRONMENTAL CONTROL RIGHT IT'S
NOT WHAT YOU.
JUST DO IN THE OFFICE FOR AN
EMERGENCY WHERE IN THE CLINICAL
SETTING IT IS.
GOING YEAH GOING TO PEOPLE'S
HOMES AND HELPING THEM.
HEY I CAN INTERVIEW THEM AS A
DOCTOR IN THE OFFICE AND SAY
WELL WE ON THE YOU HAVE NO PETS
DO YOU HAVE WHAT THE IT'S THAT
ARE ABOUT TO HAVE SOMEONE BE
ABLE TO GO.
HOME TAKE A LOOK AROUND WORK
WITH THE FAMILY --
AND AND SAY WELL WHAT CAN I TRY-TO DO TOO SO HE HAD GIVEN
HANDOUTS IT WILL DO ALL THESE
THINGS AND REDUCE IT BUT THEY
HAVE SOMEONE.
GO GIVE THAT ONE ON ONE AND YOU
KNOW OBSERVATION AND WORK WITH
THEM.
I THINK IS REALLY IMPORTANT AND
EIGHT AND THAT SIZE SO I
APPRECIATE WHAT YOU'RE DOING
THAT'S WHY WE NEED TO HAVE MORE
COMMITTEE HEALTH WORKERS OUT
THERE TO TO WORK WITH YOU
BECAUSE PEOPLE DON'T LIVE IN OUR
E. OURS OUR OFFICES THEY LIVE IN.
HOMES THEY WORK IN WORKPLACES
AND WE NEED TO MAKE THOSE SPACES.
HEALTHIER AND SAFER SO THANK YOU.
RIGHT PUBLIC COMMENT.
THESE.
GOOD AFTERNOON KELLY MAC MILLAN
ON BEHALF OF THAT SPECIALLY
CHILDREN'S CARE COALITION
STRONGLY IN FAVOR OF THE ASTHMA --
EDUCATION BENEFIT FOR MEDI CAL
BENEFICIARIES THANK YOU OKAY YOU
KNOW IT'S A IT'S SO I WAS GONNA
DO ALL THE PUBLIC AT THE END OF
ALL THE STAKEHOLDERS THAT ISRAEL
IS -- IF YOU
ANY ANY OTHER FOR THE CUP
[inaudible]
ALL RIGHT.
OKAY WELL DIET BECAUSE I ALSO A
BE SURE WE GIVE PUBLIC KIND OF
FOR ALL THE PREVIOUS
STAKEHOLDERS UNLIKE MIDWAY
THROUGH SO CAN WE DO THAT AT THE
END.
RIGHT OKAY BECAUSE WE HAVE TWO
MORE STAKEHOLDER PROPOSALS SO
I'M YET LET'S LET'S GO AND THEN
PEOPLE CAN DO THAT ALL RIGHT I
APOLOGIZE.
ALL RIGHT SORRY OKAY NEXT ONE WE
HAVE TWO MORE ALL RIGHT.
OKAY THANKS VERY MUCH OKAY --
NEXT ONE IS --
DE RYAN SPENCER FROM AMERICAN
COLLEGE OF OBSTETRICIANS AND
GYNECOLOGISTS --
PROPOSAL TO EXTEND MEDICARE
COVERAGE FOR UP TO A YEAR FOR
DELIVERY WOMEN SUFFERING FROM
MATERNAL MENTAL HEALTH
CONDITIONS.
TRIPPED UP.
OF LIKE HOW TO GET TO MORE.
THANK GOD PAN MEMBERS OF RICE
BEEN STRONG BEHALF THE AMERICAN
COLLEGE --
BUT YOU WEIGH INS DISTRICT NINE
THANK YOU FOR ALLOWING US THE
TIME TO TALK TO A LITTLE BIT
ABOUT THE SUPPORT PROPOSAL YET
BEFORE YOU.
AS YOU'RE WHERE WOMEN WHO ARE
PREGNANT MAY BE ELIGIBLE FOR
MEDICARE EVEN IF THEIR INCOME
EXCEEDS THE TYPICAL ELIGIBILITY
REQUIREMENTS.
UNFORTUNATELY THIS EXPANDED
COVERAGE LAST ONLY SIXTY DAYS
AFTER THE PREGNANCY ENDS THE
SHORTENED TIME FRAME BECAUSE
POTENTIALLY PROBLEMATIC FOR
WOMEN DIAGNOSED WITH A MEDICAL.
CONDITION DURING OR SHORTLY
AFTER PREGNANCY SUCH AS MATERNAL
MENTAL ILLNESS WHAT THIS
PROPOSAL WILL DO IS EXTEND THIS
COVERAGE FROM SIXTY DAYS TO ONE
YEAR FROM OTHERS DIAGNOSED WITH
A MENTAL.
MATERNAL MENTAL HEALTH CONDITION
THESE MOTHERS WILL BE ELIGIBLE
FOR FULL SCOPE MEDICAL COVERAGE
FOR ONE YEAR BY PROVIDING NOTE
FROM THE TREATING HEALTHCARE
PROVIDER OF SUCH A NOTICES IN
SIXTY DAYS FROM THE BIRTH OF
THEIR CHILD.
IF DIAGNOSED OCCURRED AFTER THE
SIXTY DAYS FROM THE CHILD'S
BIRTH BUT WITHIN NINETY DAYS
FROM THE DAY THE COVERAGE
EXPIRED WE OPPOSE AT THE WOMAN
COULD SEEK REINSTATEMENT OF
MEDICAL COVERAGE.
UNDER EXISTING LAW AND RECEIVE
THE TREATMENT SO DESPERATE
DESERVE.
A LIKE INTRODUCED ARTICLE IN THE
QUEUE LEGISLATIVE CO CHAIR FOR A
CALL DISTRICT NINE WHO BETTER
LAB AND JUST HELP POOR IN THIS
PROPOSAL IS FOR THE PATIENTS
THEY TREAT [inaudible]
THANK YOU.
THANKS -- SO
I'M A PRACTICING OBGYN HE RIGHT
HERE IN SACRAMENTO AND I WANTED
TO LET YOU GUYS KNOW THAT
MATERNAL MENTAL HEALTH
CONDITIONS A FACT.
MANY PEOPLE ABOUT FIVE HUNDRED
THOUSAND FAMILIES GIVING BIRTH
EACH YEAR IN THE US ARE AFFECTED.
AND CBC DATA SHOWS THAT OVER THE
LAST EIGHTEEN YEARS ARE SUICIDE
RATES HAVE INCREASED BY ABOUT
15% --
TREATING THESE CONDITIONS TAKES
A BIT OF TIME.
IT'S NOT UNCOMMON AS RYAN
ALLUDED --
TO LATE IN THE PREGNANCY OR
AFTER DELIVERY.
IT TAKES ABOUT EIGHT WEEKS TO
SHOW IMPROVEMENT WHEN YOU
INITIATE TREATMENT AND WHEN WE
RE EVALUATE WE FIND THAT OUR
INITIAL TREATMENT IS EFFECTIVE
ABOUT 35% OF THE TIME. FOR THE
OTHER 65% OF THE PATIENTS WE
NEED TO LOOP BACK AND CHANGE
SOMETHING AND DO SOMETHING
DIFFERENT.
SO WE'RE REALLY UNABLE TO BE
EFFECTIVE WHEN COVERAGE ENDS AT
EIGHT WEEKS.
M..
WHEN THESE CONDITIONS ARE
UNTREATED OR INADEQUATELY
TREATED IT NOT ONLY IMPACTS THE
HEALTH OF THE MOTHER BUT ALSO
THE NEW BORN IN THE OTHER
CHILDREN AND THE FAMILY?
IN A NEGATIVE WAY [inaudible]
THANK YOU.
I INCOME IS FROM PIRATES OF
SERVICES HELLO [inaudible]
FINANCE [inaudible]
ALL RIGHT.
OKAY -- ALL
RIGHT WELL CERTAINLY --
YES ANY MENTAL.
MENTAL HEALTH --
WELL FOR EVERYONE BUT CERTAINLY
AND THE POPULATION --
AFTER DELIVERY IS SOMETHING YA --
PURCELL DEPRESSIONS.
THE BIG ISSUE AND SELF PRECIADO
YOU BRING THIS BEFORE US THANK
YOU THANK YOU EXTRACTION OKAY
NEXT FISCAL PROPOSAL IS NICK
BROKAW AND CHRIS SILLY --
XTO KRING SAMPER FELT THAT
CORRECTLY FROM THE CALIFORNIA
COUNTY AUDIOLOGY.
PROPOSAL TO ESTABLISH A STAFF
THE IS ON A DTS TO MANAGE THE
IDEOLOGY BENEFIT FOR CCS
CHILDREN [inaudible]
WELCOME.
GOOD AFTERNOON RIGHT CELEBS OKAY.
ADDRESS ELEVATE YOU TO GET THE
NAME RIGHT.
THAT'S A GOOD GOOD AFTERNOON --
NICK BROKE OFF FROM SACRAMENTO
ADVOCATES ON BEHALF THE
CALIFORNIA ACADEMY OF IDEOLOGY
WHICH REPRESENTS STATE LICENSE
AUDIOLOGIST.
CALIFORNIA AUDIOLOGIST HAVE
PARTICIPATED IN THE DEPARTMENT
OF HEALTH CARE SERVICES SEE SEE
ESTHER CHILD SERVICES CALIFORNIA
CHILD SERVICES PROGRAM FOR
NEARLY FIVE DECADES PROVIDING
DIAGNOSTIC IDEOLOGY AND HEARING
AID FITTING SERVICES CALIFORNIA
CHILDREN WITH HEARING LOSS. TO
SEE AN AUDIOLOGIST OF EXTENSIVE
EXPERIENCE CARING FOR CALIFORNIA
CCS POPULATION IN A COMMITTED TO
PROVIDING TIMELY SERVICE ALL
CALIFORNIA CHILDREN WITH
IMPAIRED HEARING.
REGARDLESS OF INSURANCE STATUS
THERE'S A PROBLEM.
UNFORTUNATELY A SERIES OF LONG
STANDING CONCERN AS CREATED AN
ATMOSPHERE IN WHICH AN
INCREASING NUMBER OF AUDIOLOGIST
THE FACT WE'VE BEEN FORCED TO
WITHDRAW ITS PROVIDERS THE
PROGRAM.
THERE MANY REASONS FOR THIS NOT
HOW IT THREE CORE ISSUES NUMBER
ONE POINT INSUFFICIENT
REIMBURSEMENTS RESULTING
AUDIOLOGIST SUBSIDIZING THE COST
OF CARE FOR CHILDREN.
NUMBER TWO THE LAYS AN
AUTHORIZATION. FOR CERTAIN
TREATMENTS JEOPARDIZING ABOUT
EARLY INTERVENTION EFFORTS
NUMBER THREE INEFFICIENCIES
BETWEEN AUDIOLOGIST AND
PERSONNEL THE CCS PROGRAM.
ACT IS VERY REAL LOSING
QUALIFIED PERSONNEL CCS
PROVIDERS WHO CAN PROVIDE
DIAGNOSTIC AND REHABILITATIVE
SERVICES CHILDREN WITH HEARING
LOSS EXACERBATE EXISTING
PROBLEMS AROUND ACCESS. TO
APPROPRIATE CARE FOR CHILDREN
AND CHILDREN THEIR FAMILIES MANY
OF THE CCS PROVIDER OFFICES THAT
CAN PROVIDE SERVICES NO LONGER
DEAL.
I'LL GIVE YOU AN EXAMPLE WE
CONDUCTED A REVIEWOF THE DATA --
EARLIER THIS WEEK CALLED ALL
SEVENTY TWO CCS LISTED OFFICES
THAT HAVE AUDIOLOGY TESTING IN
HEARING AID SERVICES FOR
CHILDREN FIVE YEARS AND OLDER.
WE LEARNED THAT THE SEVENTY TWO
THAT ARE CURRENTLY THE SERVICE
PROVIDERS MAY TWENTY OF THEM OR
SO PARTICIPATING IN THE PROGRAM.
THIS UNSUSTAINABLE SHORTAGE OF
IDEOLOGICAL SERVICE PROVIDERS IS
PARTICULARLY TROUBLING MISSY
WHEN NEARLY SEVENTY SEVEN
THOUSAND CHILDREN SUFFER FROM
HEARING LOSS AND INTERFERES WITH
THE AUDIOLOGIST LEGALLY MANDATED
GOAL.
PROVIDING LEGALLY TIME PROVIDING
TIMELY SERVICE TO ALL CALIFORNIA
CHILDREN WITH IMPAIRED HEARING
REGARDLESS OF THE INSURANCE AS
SELF IT'S FOR ALL THESE REASONS
THAT WE RESPECT THE REQUEST
RESTORATION FUNDING.
THE SALVATION A POSITION WITHIN
DH CS THE SERVICE A LIAISON
BETWEEN THE APARTMENT PROGRAM
STAFF AN IDEOLOGIST PROVIDING
SERVICES THANK YOU VERY MUCH FOR
YOUR TIME CONSIDERATION OKAY
THANK YOU ANY COMMENTS FROM DCS.
LIAISON.
RIGHT OKAY.
ALL RIGHT AWAY --
NO FINANCE WELL ALL RIGHT.
OKAY WELL CERTAINLY OKAY WELL
APPRECIATE THE PRESENTATION AND
CERTAINLY --
I MEAN I THINK THE ISSUES YOU
RAISE OR SOMETHING WE WANT TO
TRY TO HELP ADDRESS.
RIGHT NOW HAVE FAITH.
PUBLIC COMMENTS WE HAVE. TWO
THREE FOUR FIVE FIVE SPEAKER
PROPOSALS OF COMMA WHICH ONES
YOU TO YOU LIKE ARE THE ONES YOU
DON'T LIKE OR YOU DON'T COME IN
THE ONES YOU KNOW OF ANY OPINION
ABOUT.
OKAY WELCOME.
WE BEING HERE BEHALF OF THE
CALIFORNIA MEDICAL ASSOCIATION
REPRESENTING OVER FORTY FOUR
THOUSAND PHYSICIANS IN THE STATE
OF CALIFORNIA --
WERE IN SUPPORT OF THE BUDGET
PROPOSAL TO REINSTATE TREATMENT
PERFORMED BY PODIATRISTS IN THE
MEDICAL SYSTEM.
REINSTATING THE SERVICES IN
UPDATING THE BILLING POLICIES
WILL LIMIT UNNECESSARY DELAYS TO
CARE WHICH RESULT IN HEALTH
COMPLICATIONS OR THIS LOW
INCOME AND DISABLED POPULATION.
AND WE'RE ALSO HERE IN SUPPORT
OF THE REQUEST BECAUSE PART OF
WOMEN DIAGNOSED WITH A MENTAL
HEALTH DISORDER THANK YOU
[inaudible]
WELCOME.
LINDA WAY WITH WESTERN CENTER ON
LAW AND POVERTY WE SUPPORT THE
RESTORATION OF CRITICAL BENEFITS
INCLUDING --
PODIATRY SERVICES AS WELL AS
ASTHMA AND SERVICE AS MUCH --
SERVICES THANK YOU THANK YOU
WELCOME.
GOOD AFTERNOON RENTAL COMMON
YOUR BEHALF OF HEALTH ACCESS
CALIFORNIA WE CERTAINLY SUPPORT
THE RESTORATION OF THE OPTIONAL
BENEFITS --
CUT IN --
TWO THOUSAND NINE ADDITIONALLY
WE ALSO SUPPORT --
FUNDING FOR C. PENS PROPOSAL ON
THE INTERVENTION SERVICES TO
ADDRESS ASTHMA THANK YOU.
THANK YOU WELCOME.
THAT AFTERNOON TERRA CATERING
FOR MID CITY CAN AND WE ARE --
IN SUPPORT OF SB.
SB TWO OH SEVEN OF THE HOSPITAL
THANKS.
THANK YOU WELCOME HI RUSSIAN
WORKING IN OAKLAND --
A NAME HERE IN SUPPORT OF THE
ASTHMA HOME --
SERVICES I TAKE CARE OF KIDS
WITH ASTHMA EVERY DAY HìNH
DIFFERENT SETTINGS IN THE CLINIC
IN THE . R. --
INPATIENT AND ALSO SOMETIMES IN
THE ICU --
AND AS WAS STATED EARLIER I
OMETIMES SEE THESE KIDS
MULTIPLE TIMES IN A WEEK IN
THOSE SETTINGS --
AND I THINK THAT THEY WOULD VERY
MUCH BENEFIT FROM HOME SERVICES
THERE'S ONLY SO MUCH THAT I CAN
DO WITH.
INHALERS AND AND RECOMMENDING
AVOIDANCE OF TRIGGERS BUT I
THINK GOING INTO THE HOME AND
ACTUALLY GETTING RID OF THE MOLD
GETTING RID OF THE DIRTY CARPET.
WOULD BENEFIT THESE CHILDREN
GREATLY [inaudible]
THANK YOU [inaudible]
WELCOME.
LINDA TERRACE ON THE HALF OF THE
CALIFORNIA PAN ETHNIC HEALTH
NETWORK INCREDIBLY HAPPY TO
SUPPORT A CO SPONSOR THE ASTHMA
ASK -- WE
THINK THAT THIS IS A A WIN WIN
FOR THE STATE IN COST SAVINGS
AND QUALITY OF LIFE FOR SO MANY
PEOPLE ARE SUFFERING WITH THAT
THANK YOU.
WELCOME GALEANO CHILDREN NOW
ALSO IN SUPER SUPPORT OF THE AS
MY FURNACE SERVICES IT WOULD
GREATLY BENEFIT THE KIDS WITH
POORLY CONTROLLED ASTHMA.
MEDICAL THANK YOU.
THANK YOU [inaudible]
WELCOME.
SOME HAVE THE MARCH OF DIMES
HERE IN THE IN SUPPORT OF THE
STATE OR PROPOSED EXTEND OPPOSE
FOREIGN COVERAGE FOR WOMEN IN
MEDI CAL [inaudible]
THANK YOU [inaudible]
WELCOME.
HI CHRIS SINGLETON TESTER THE
CHILDREN'S --
PARTNERSHIP IN SUPPORT STRONG
SUPPORT OF THE AS MASK
[inaudible]
THANK YOU.
WELCOME MR CHAIRMAN MEMBERS MARK
MENDOZA WITH US HERE YOU
CALIFORIA --
IN STRONG SUPPORT OF X. THE
EXTENSION OF THE MCO TAX THANK
YOU.
THANK YOU.
I DON'T THINK THEY'LL THE
STICKER PROPOSAL YET.
WE MAY GET TO THAT.
BECAUSE THAT'S THE NEXT ISSUE.
ISSUE NUMBER FIVE OKAY MANAGE
CARE ROMAN TAX.
JOE DIRT SEGUE.
YEAH.
IT MAY BE A STAKEHOLDER PROPOSAL
YOU YOU DON'T KNOW --
GO AND ACTUALLY YOU KNOW THAT'S
THE NEW PERSON FINANCE OF YOU
INTRODUCE YOURSELF.
HELLO JESSICA THANK US
DEPARTMENT FINANCE OKAY THANK
YOU RIGHT PLEASE PROCEED YES SO
YOUR AGENDA DOES A NICE JOB OF
LAYING OUT THE VARIOUS WAYS IN
WHICH CALIFORNIA HAS SOUGHT.
TO PUT A TAX ON MANAGED CARE A
DECADE -- WE
NOTE THAT THE STATE IS CURRENTLY
RECEIVING --
APPROXIMATELY ONE POINT THREE
BILLION DOLLARS IN GENERAL FUND --
OFFSETS AS A RESULT OF THE TAX
THAT WAS STRUCTURED BACK IN --
TWENTY SIXTEEN I THINK YOU KNOW
TO THE QUESTIONS IN THE AGENDA
AROUND WHY IT'S NOT INCLUDED IN
THE GOVERNOR'S BUDGET --
AND POTENTIAL BARRIERS FOR
FEDERAL --
EITHER APPROVAL OR NOT --
TO THE SUBSEQUENT STATES AFTER
CALIFORNIA RECEIVED APPROVAL FOR
THEIR TAX IN TWENTY SIXTEEN HAVE
BEEN.
MADE SO I WOULD SAY THAT WELL WE
CERTAINLY --
ARE OPEN TO DISCUSSION AROUND
POTENTIAL MCO TAX EXTENSION I
THINK --
SOME OF THE CALCULATION --
IN THE BUDGET DEVELOPMENT WAS
AROUND HAS FEDERAL
ADMINISTRATION --
THAN THE ONE THAT PREVIOUSLY
APPROVED THE LAST MCO TAX AND
WHEN WE THINK ABOUT THE OTHER --
TO TALLY OF THE REQUEST THAT WE
WILL BE SEEKING FROM CMS OR
OTHER ISSUES THAT WE HAVE --
THERE WAS OBVIOUSLY A CERTAIN --
CONCERN THAT OTHER THINGS THAT
CALIFORNIA IS SEEKING --
MAY OR MAY NOT BE.
VIEWED IN A FAVORABLE WAY FROM A
FEDERAL PERSPECTIVE AND SO I
THINK THOSE ARE SOME OF THE
REASONS WHY AT THIS POINT THE
GOVERNOR'S BUDGET DOES NOT
CONTAIN A MCO TALKS PROPOSAL BUT
AGAIN.
HAPPY TO TALK WITH THE
LEGISLATURE ON AN ONGOING BASIS
ANA.
OKAY --
ALEJO -- WE
WE RELEASE ANALYSIS OF THE NON
PROPOSAL OF THE AN EXTENSION OF
THE MC ATTACKS.
LAST MONTH AND WE WE DO THINK
THAT THERE IS SOME UNCERTAINTY
AROUND WHETHER OR NOT THE
FEDERAL GOVERNMENT WOULD WOULD
APPROVE ANY TAX BUT THE NEW --
BUT THE MOST RECENT TAX IN
MICHIGAN WAS APPROVED BY THE
CURRENT ADMINISTRATION IT'S VERY
WAS VERY SIMILARLY STRUCTURED TO
HOW CALIFORNIA'S IS AND SO WE
ARE NOT SURE OF WHAT RATIONALE
NECESSARILY THE FEDERAL
GOVERNMENT WOULD HAVE. FOR
APPROVING MICHIGAN'S TAX WHILE
REJECTING AND AN EXTENSION OF
CALIFORNIA'S.
MCO TAX.
WE RECOGNIZE THAT THERE'S THERE
ARE ALWAYS ISSUES THAT THE STATE
IS WORKING WITH THE FEDS ON WITH
MEDI CAL AND ANOTHER PROGRAMS --
MADE AS A SIGNIFICANT EXAMPLE IS
THE THE END OF THE THIS
ITERATION OF THE ELEVEN FIFTEEN
WAIVER --
THAT BRINGS ABOUT SEVEN HUNDRED
AND FIFTY MILLION DOLLARS
ANNUALLY INTO THE STATE.
OUR UNDERSTANDING HOWEVER IS
THAT -- THE
OUR PROSPECTS FOR RECEIVING A
SIGNIFICANT --
AND SIGNIFICANT NEW FUNDING
UNDER THE ELEVEN FIFTEEN WAIVER
ARE SOMEWHAT CURTAILED AND IN
ADDITION THE ELEVEN FIFTEEN FEET
WAIVER FUNDING THAT WE DO GET IS
AT IS ACTUALLY NOT AS GREAT AS
WE AS THE FUNDING THAT WE GET
UNDER THE MCO TAX SO. FOR THESE
FOR THESE CONSIDERATIONS WE DO
THINK AT IT IS DEFINITELY WORTH
CONSIDERING --
PURSUING AN EXTENSION OF THE M.
AND JUST RECOMMENDS THAT SHOULD
THE LEGISLATURE WHICH TO WISH TO
RENEW THAT IT DO SO IN
CONJUNCTION WITH THE APPROVAL OF
THE BUDGET.
AS A SOLE GIVE TIME FOR BOTH THE
STATE TO SUBMIT A REQUEST FOR
FEDERAL APPROVAL AND MINIMIZE
ANY IMPACT A NEGATIVE IMPACT ON
MANAGED CARE PLANS IN THE STATE.
THANK YOU FINANCE.
JUST BECAUSE I GUESS DEPARTMENT
FINANCE IT WOULD ECHO THE
COMMENTS THAT ADD DIRECTOR KENT
MADE AT THIS TIME WE WOULD NOTE
THAT THE GOVERNOR HAS PRESENTED
A BALANCED BUDGET.
AND WE DON'T HAVE ANYTHING
FURTHER TO ADD AT THIS TIME BUT
WE OF COURSE HAVE NOTED THAT OF
CONCERNS THAT WE'VE HEARD FROM
THE LA --
AND OTHERS AND WE'RE HAPPY TO
HAVE FURTHER CONVERSATIONS.
RIGHT THANK YOU.
SYSTEM NINE UP HERE --
SO I GUESS WHAT I WOULD SAY IS
IS THAT --
APPRECIATE --
THIS SOME OF THE CHALLENGES THAT
THE DEPARTMENT MAY BE LOOKING AT
WE HAVE MULTIPLE WAIVERS ARE
PENDING --
SAME TIME I I THINK I WOULD AND
AGAIN I'M NOT THE ONE WHO HAS TO
DEAL WITH CMS DIRECTLY --
HOWEVER I WOULD DO WOULD MAKE
NOTICE --
THE LA --
DID THAT --
FIRST OF ALL --
THE SIZE OF THE FIRST OF ALL
THAT OUR WORLD.
THAT IS AN EXTENSION OF AN
EXISTING WAIVER THAT.
HAD AND OTHER STATES HAVE HAD
SIMILAR WIVERS APPROVED BY THIS
ADMINISTRATION SO IT I THINK IT
RAISES --
SOME QUESTIONS ABOUT THE THE
LIKELY DID DENY THIS PARTICULAR
WAIVER NOW THAN YOU MIGHT THINK
IT WAS THAT THIS DOES THAT PUT
SOME FUTURE WAIVER AT RISK --
AND WELL AGAIN I'M IS THIS WAY
I'M NOT THAT CONFIDENT THIS
ADMINISTRATION WON'T WORK FOR
EVERY EXCUSE TO DO IT WHETHER WE
PUSH THIS ONE FOR NOT AND THIS
ONE'S AT LEAST.
IN LINE WITH PREVIOUS ONE SEVEN
APPROVED.
I GUESS THE OTHER ISSUES ALSO
EVEN THE MAGNITUDE RIGHT SO --
THIS.
TAXES ACTUALLY LARGER THAN THE
EXISTING LEVEL FIFTEEN WAIVER --
SO EVEN IF THEY SHRINK IT.
NOW THIS IF YOU THINK ABOUT
TRADE OFFS.
I'D TAKE.
THE TAKE THE GREATER AMOUNT OF
MONEY I GUESS --
AND SO -- SO
I REALIZE THERE'S A THERE'S A
LITTLE BIT OF A MAYBE CHESS GAME
THAT YOU'RE TRYING TO FIGURE OUT
AND NAVIGATE.
AND OUR RELATIONSHIP WITH THE
WITH THE FEDERAL GOVERNMENT BUT
IT IN IN.
MY OPINION IS THAT WE SHOULD
CERTAINLY CONSIDER --
CONTINUING THIS ON I THINK EVER
EXPRESSED --
SOME THOUGHTS ABOUT WHERE THE
MONEY SHOULD GO HAND IN TERMS OF
HELPING ENHANCER SUBSIDIES --
THAT --
SINCE IT IS A TAX OF ALL HEALTH
PLANS IT'S NOT HILL AS REQUIRED
BY LAW --
CMS HAS PREVIOUSLY SAID SO IN
SOME SENSES IN TERMS OF TRYING
TO PUT SOME OF THE BENEFITS BACK
TO THE LARGER POPULATION CHAI
CHIEF OUR OVERALL --
GOALS FOR GETTING COVERAGE
OBVIOUSLY WHEN WE NEED A COMEDY
GO TO MEDI CAL AS WELL.
AND SO TO TO BUT THE THINKING SO
EVEN THOUGH WE DON'T HAVE A
FORMAL STAKEHOLDER PROPOSAL I
WOULD INDICATE MY INTEREST IN
PURSUING --
CONTINUATION AND TOPSY THAT
WOULD INVOLVE DISCUSSIONS A VERY
STAKEHOLDERS AS WELL --
BUT CERTAINLY OPEN TO ANY MAIL
THOUGHTS ARE FEEDBACK ABOUT.
WHAT OTHER ISSUES YOU KNOW THAT
THAT THIS IS ENTANGLED IN?
RIGHT ANY OTHER COMMENTS THERE
ARE.
EIGHT PUBLIC COMMENT.
LINDA WAY WITH WESTERN CENTER ON
LAW AND POVERTY WE URGE THE
ADMINISTRATION AND LEGISLATURE
TO CONSIDER EXTENDING THE NCO
TAX THAT FOR THE POINT THAT THE
LA -- RAISED
I WOULD ALSO LIKE TO KNOW THAT
THIS --
RAISES OVER A BILLION DOLLARS.
ANNUALLY THAT COULD BE USED TO
EXPAND SERVICES AND BENEFITS IN
THE MEDICAREPROGRAM THANK YOU.
THANK YOU.
OKAY MISTER CHAIR MARK WINDOWS
WITH SCA YOU CALIFORNIA AGAIN
HERE TO SUPPORT AN EXTENSION OF
THE MCOTAX. FOR THE REASONS
MENTIONED BY THE LA --
AND THE CHAIR --
AND AS WELL THAT --
THESE MONIES HELP SORT OF GROUND
AM AND THEY HAVE FOUNDATION FOR
MEDI CAL BENEFICIARIES SO THEY
HAVE ACCESS TO CERTAIN VITAL
HEALTH CARE SERVICES THANK YOU.
THANK YOU.
RONALD COLMAN RONALD COLMAN HERE
MAY HAVE A HEALTH ACCESS
CALIFORNIA ALSO ECHO THE
COMMENTS OF THE CHAIR AND THE LA --
WE ABSOLUTELY SUPPORT --
AN MCO TAX AND THINK THE
ADMINISTRATION LEGISLATURE
SHOULD ABSOLUTELY MOVE IT
FORWARD WE DEFINITELY THINK THAT
THIS MONEY COULD ABSOLUTELY BE
USED TO THE CHALLENGES PEOPLE
ARE FACING AROUND AFFORDABILITY
AND ALSO IMPROVEMENTS IN THE
MEDICAL PROGRAM PARTICULARLY THE
OPTIONAL BENEFITS THAT STILL
NEED TO BE RESTORED.
THANK YOU.
OKAY THANK YOU.
ALL RIGHT SOME MOVE ON TO ITEM
NUMBER SIX NUMBER SIX
CYBERSECURITY PROGRAM
AUGMENTATION.
THANK YOU MISTER CHAIR OF
ERIKA'S FOR RECKLESS HEALTHCARE
SERVICES SO REQUESTING THREE
PERMANENT POSITIONS AND ONE
POINT TWO MILLION DOLLARS --
50% GENERAL FUND AND IS
BASICALLY TO FULLY REMEDIATE --
RECENT AUDIT FINDINGS THAT WE'VE
HAD RELATED TO OUR CYBERSECURITY
PROGRAM AND WE HAD A TOTAL OF
FORTY AUDIT FINDINGS WE CAN
REMEDIATE TWENTY THREE WITH AN
EXISTING RESOURCES --
THESE RESOURCES WILL ALLOW US TO
REMEDIATE THE REMAINING
SEVENTEEN FINDINGS.
OKAY THANK YOU ALL RIGHT LA --
BUT FOR THIS PC P. AND THOSE UP
UNTIL STRENGTHENING FISCAL
OVERSIGHT --
THE BCP WE WE'VE WE'VE REVIEWED
THEM AND HAVE NO CONCERNS AND SO
JUST GET THAT THEY'RE OUT THERE
NOW.
THANK YOU --
FINANCING INTRODUCE YOURSELF AS
WELL RYAN MILLER DEPARTMENT
FINANCE WE SUPPORT THE
GOVERNOR'S BUDGET.
OKAY.
I'D BE SURPRISED IF.
WHAT?
IT WOULD BE ON A VISA IS OKAY.
I'M WAITING FOR SOME OF THE
SURPRISE ME.
OKAY ALL RIGHT --
YEAH I MEAN CLEARLY SIDE THE
SECURITY.
SECURING OUR IT SYSTEMS AND
PROTECT OURSELVES CYBERSECURITY.
I THINK IN THIS ENVIRONMENT
EXTREMELY IMPORTANT SO --
APPRECIATE THAT ALL RIGHT.
ANY PUBLIC COMMENT ON THIS.
SEEING NONE --
I GUESS OFFICIALLY THAT IS A
PROPOSAL SO THAT WOULD. TO JUST
TO BE SURE I DO THIS RIGHT I
HOLDING THIS ITEM OPEN WE'RE
ALSO GONNA HOLD OPEN ISSUE
NUMBER FIVE THE WORKING
BACKWARDS A LITTLE BIT AND ALSO
ISSUE NUMBER FOR THE STAKEHOLDER
PROPOSALS. FOR THE RECORD OKAY
LET'S MOVE ON TO ISSUE NUMBER
SEVEN WAS ELECTRONIC HEALTH
RECORD INCENTIVE PROGRAM OUT ITS
SIR SO WE'RE REQUESTING A TWO
HUNDRED NINETY FOUR THOUSAND
HERE AND THIS IS 90% FEDERAL
FUNDS -- BUT
BASICALLY FOR THREE YEAR LIMITED
TERM FUNDING EQUIVALENT TO TWO
POSITIONS THE THIS PROGRAM
ACTUALLY ENDS AT DECEMBER TWENTY
TWENTY ONE BUT THE AUDITS THAT
ARE REQUIRED BY THE BY CMS WILL
CONTINUE THROUGH SEPTEMBER.
TWENTY TWENTY THREE OKAY ANY
QUESTIONS A CONSERVE ALEJO
COMMON SNOW FINANCE NO ALL RIGHT.
OKAY I HAVE BIG NOTE THAT IF WE
CAN REDUCE ONE HOSPITALIZATION
WE GOT THIS ONE COVERED. ONE BIG
HOSPITALIZATION BUT STILL.
JUSTICE FOR IN PERSPECTIVE OKAY.
OUR RATES --
SO WILL HOLD THIS ITEM OPEN AS
WELL --
ISSUE NUMBER EIGHT EVERY WOMAN
COUNTS PROGRAM STAFFING --
ACTUALLY ANY PUBLIC COMMENT ON
THIS. NINETY NINE WILL HOLD THIS
ITEM OPEN MICHU NUMBER EIGHT
EVERYWOMAN COUNTS PROGRAM STAFF.
YOU'RE THE DEPARTMENT IS
REQUESTING TO CONVERT ONE
LIMITED TERM POSITION TO A
PERMANENT POSITION --
THIS POSITION WOULD HELP WITH
ONGOING CRITICAL AND POLICY
DECISION THE PROGRAMS FOR THE
EVERY WOMAN COUNTS PROGRAM WHICH
PROVIDES FREE CERVICAL AND
BREAST CANCER SCREENING AND
DIAGNOSTIC SERVICES.
EXCELLENT HELLO COMMENTS.
ALL RIGHT AND I JUST MAKE NOTE
I'D APPRECIATE THE THE THE
PROPOSAL --
I'VE WE ARE NOW FOR WOMEN
EVERYWOMAN COUNTS --
WE'RE NOT LIMITING IT ANYMORE BY
TIME RIGHT.
THERE WERE CHANGES MADE IN LAST
YEAR'S BUDGET AND THAT IS
CORRECT OKAY SO THAT'S A GOOD
THING HE CUTTING PEOPLE OFF AT
THE KNEES OTHERS ALL RIGHT SO
I'M GLAD TO KNOW WE'RE MOVING
FORWARD ON THAT.
OKAY EXCELLENT ANY PUBLIC
COMMENT ON THIS.
SEEING NONE WE WILL HOLD THIS
ITEM OPEN THANK YOU ISSUE NUMBER
NINE OFFICE OF LEGISLATIVE AND
GOVERNMENT AFFAIRS STAFFING.
HERE THE DEPARTMENT IS
REQUESTING TO CONVERT TO LIMITED
TERM POSITIONS TO PERMANENT
POSITIONS A TO MAINTAIN LGAS NEW
BASELINE WORKLOAD IN TWO
THOUSAND SEVENTEEN AND EIGHTEEN
THERE WERE ALMOST FIFTEEN
HUNDRED TOTAL LEGISLATIVE
INQUIRE EASE [inaudible]
OKAY [inaudible]
COMMENTS RAIL.
FINANCE NO ALL RIGHT.
OF ANY PUBLIC COMMENT.
OKAY SO I I THE FIRST WAS A NOTE
THAT -- YOU
DIRECTED TO SUCH AN EXCELLENT
JOB ON THE WAY NEED MORE PEOPLE.
FINANCES REALLY RESPONSIBLE FOR
THE OTHER.
FIFTEEN US THAT WE DID OKAY ALL
RIGHT.
SO -- NOW
THAT WE KNOW WE'RE GONNA IF WE
DECIDE TO FIND MORE POSITIONS
I'M GONNA TELL MY COLLEAGUES CAN
ASK MORE QUESTIONS OKAY ALL
RIGHT VERY GOOD.
OKAY.
ALRIGHT SO WE WILL HOLD THIS
ITEM OPEN AS WELL.
ISSUE NUMBER TEN WHOLE CHILD
MODEL EVALUATION CONTRACT
FUNDING.
UP TO THE SIDE IN THE DEPARTMENT
REQUESTS REAPPROPRIATION OF ONE
POINT SIX MILLION DOLLARS IN THE
UNEXPECTED EXPENDITURE --
SORTIE FROM FISCAL YEAR --
EIGHTEEN NINETEEN WITH THE
REAPPROPRIATION DH CS WILL
SECURE THE CONTRACTOR TO PERFORM
THE INDEPENDENT VALUATION FOR
THE WHOLE CHILD MODEL PROGRAM --
AND WOULD JUST NOTE THAT THE RE
APPROPRIATED FUNDS WOULD BE FOR
TWO FISCAL YEARS.
OKAY HELLO.
IT'S FINANCE.
RIGHT ANY PUBLIC COMMENT ON THIS.
OKAY SO --
CERTAINLY --
ALL RIGHT APPRECIATE THE
CERTAINLY IT'S GONNA BE
IMPORTANT TO DO A A A FAIR AND
GOOD EVALUATION OF THIS SITE IT
WILL PROBABLY WANT DEL LITTLE
MORE IN THE C. C. S. AS HE SAID
THE OLDEST PROGRAM AS FOR THE
PART OF YOU --
AND LATER ON CONCERNED ABOUT
BEING SURE THAT WE HAVE --
THE CHILDREN HAVE A FULL ACCESS
I KNOW THAT.
ACTUALLY BE INTERESTED IN --
YOU KNOW WHERE WE'RE GOING --
IN TERMS OF BEING SURE THAT ALL
CHILDREN --
WHO HAVE SPECIAL NEEDS ARE ABLE
TO GET THE HEALTH CARE ANY
THROUGH CCS?
AND I KNOW THAT WE'VE DONE THIS
WHOLE CHILD MODEL FOR SOME
COUNTIES IN --
BUT I'M ALSO HEARING SOME
CONCERNING STUFF FROM PEOPLE OUT
IN THE FIELD SO.
I WAS MORE AT THIS IS ABOUT JUST
THE VALUATION PEACE BUT WE MAY
DELVE INTO THAT MORE LATER
HEARING.
OKAY -- SEEN
NO OTHER COMMENT THEN WE WILL
HOLD THIS ITEM OPEN AND MOVE ON
TO CALIFORNIA DENTAL MEDICAID
MANAGEMENT INFORMATION SYSTEM
CONTRACT MANAGEMENT STAFFING.
AS THANK YOU THE DEPARTMENT IS
REQUESTING TO CONVERT FOR
LIMITED TERM POSITIONS TO
PERMANENT POSITIONS TO CONTINUE
THE SUPPORT.
ON AN ONGOING WORKLOAD
ASSOCIATED WITH TRANSITIONING
FROM ONE FISCAL INTERMEDIARY --
TO TO CONTRACTORS ONE FOR THE IS
GOING AND THE ADMINISTRATIVE
SERVICE ORGANIZATION THE TWO
CONTRACTS ARE NEEDED TO SUPPORT
THE ONGOING WORKLOAD IN POLICY
AND SYSTEM --
INITIATIVES.
OKAY --
COMES FROM ILLEGAL [inaudible]
FINANCE.
PUBLIC COMMENTS I SEE SOMEONE
COMING [inaudible]
DON'T TRIP.
AFTER GOOD AFTERNOON KELLY
MCMILLAN AND ON BEHALF OF THE
CALIFORNIA DENTAL ASSOCIATION.
ARE WE APPRECIATE THE WORK DONE
BY DH CS TO SPLIT THE FISCAL IN
AMERICANA RACKED INTO TWO
CONTRACTS.
ON THE CALIFORNIA ASSOCIATION
CONTINUE TO WORK CLOSELY WITH DH
CS AND DELTA.
AS PART OF THE A. S. O. CONTRACT
IN THEIR EFFORTS HAVE BEEN PART
OF A NUMBER OF MINISTRY OF
CHANGES.
THAT HAVE IMPROVE THE MEDI CAL
DENTAL PROGRAM.
IN ORDER TO CONTINUE TO SUFFER
THE CALIFORNIA DENTAL
ASSOCIATION STRONGLY SUPPORTS
THE PROPOSAL FOR DECISIONAL
BUDGET AND STAFF.
OKAY THANK YOU I WAS GONNA ASK
HOW'S IT GOING BUT IF THE DENNIS
ARE SAYING GOODNIGHT SO IT'S
ALWAYS GOOD NEWS ALL RIGHT.
OKAY WELL SEEN NO ONE ELSE AT
THE MICROPHONE WE WILL HOLD THIS
ITEM OPEN AS WELL --
THE EVENING ON THE ISSUE TWELVE
CHILDHOOD LEAD POISONING
PREVENTION SB.
TEN FORTY ONE SERVICES FOR A ONE
AND A NEW PERMANENT POSITION --
TO IMPLEMENT THE REQUIREMENTS OF
SB TEN FORTY ONE AND ACTED LAST
YEAR -- WE
HAVE HISTORICALLY CAR PUBLIC
HEALTH ON THE CHILDHOOD LEAD
POISONING PREVENTION PROGRAM
THESE RESOURCES AND WILL ENHANCE
THAT COLLABORATION --
INCLUDING COLLECTING AND
ANALYZING DATA ON BLOOD LEVEL
SCREENING TESTS FOR CHILDREN AS
WELL AS ADDITIONAL REPORTING.
EXCELLENT ELIA COMMENTS FINANCE.
PUBLIC COMMENT YES.
NO WAY WITH WESTERN CENTER ON
LAW AND POVERTY AT THE STATE
CANNOT DEFINITIVELY STATE HOW
MANY MEDI CAL CHILDREN HAVE BEEN.
I TESTED FOR BLOOD LEAD --
BUT WE DO KNOW THAT THE NUMBERS
TO LOW AND SO WE DO SUPPORT THIS
PROPOSAL ESPECIALLY CONSIDERING%
THE LIFELONG HARM THAT LEAD
POISONING CAUSES THANK YOU.
ALL RIGHT THANK YOU SO --
RIGHT BOTH.
SO I THINK [inaudible]
HEY THEY FIGURED THE NEED FOR
URGENCY AND APPRECIATE THAT --
THAT WE NEED THAT --
THE POSITION TO TO MOVE THIS
ALONG SO --
SEEN OTHER PUBLIC I WILL HOLD
THIS ITEM OPENS WELL THANK YOU.
ALL RIGHT WE'RE MOVING ON TO
ITEM NUMBER.
THIRTEEN STRENGTHENING FISCAL
ESTIMATES AND CASH FLOW
MONITORING NOT IS NOT AN ISSUE
WITH THE PROGRAM OF THIS TINY
SIZE. EIGHT OUT SIT SO GIVEN THE
SIZE AND SIGNIFICANCE ALL SPEND
A LITTLE BIT MORE TIME ON THIS
I'M ACTUALLY GONNA COVER ISSUE
THIRTEEN AND FOURTEEN JUST IN
TERMS OF BACKGROUND GIVEN THE
SIGNIFICANT VARIANCES THAT WE'VE
EXPERIENCED IN THE MEDI CAL
ESTIMATE AND BUDGET --
OVER THE LAST COUPLE YEARS --
WE INITIATED APARTMENT WHITE
EFFORT SOURCES ARE PROCESSES
THAT ARE SYSTEMS FOR FISCAL
MANAGEMENT AS DIRECTOR CAMP
POINTED OUT YOU KNOW MEDIC HOW
ISN'T OVER HUNT ONE HUNDRED
BILLION DOLLAR PROGRAM --
IT'S GROWN IN BOTH SIZE AND
COMPLEXITY OVER THE YEARS
WITHOUT THE COMMENSURATE
ADMINISTRATIVE RESOURCES TO KEEP
PACE.
AND THE DISCIPLINES ON A CASH
BASIS OF ACCOUNTING WHICH MAKES
PAYMENTS AND RECEIPTS AS WELL AS
REPORTING ON THOSE THINGS
DIFFICULT TO MANAGE AT TIMES AND
JUST FOR CONTEXT.
A 1% FLUCTUATION IN OUR BUDGET
RESULTS IN A CHANGE OF A OF
BILLION DOLLARS INTO IT OR TWO
HUNDRED MILLION DOLLARS --
GENERAL FUND.
SO IN TERMS OF THE COMPLEXITIES
THAT WE FACED --
MANAGE CARE PAYMENTS HAVE
INCREASED RATE 80% MORE THAN 80%
OF THE POPULATION IS NOW IN
MANAGED CARE WHICH ISOLATES BIG
PAYMENTS INTO RELATIVELY FEW --
AND THE SOME OF THE THINGS
RELATED TO THOSE ARE OUTSIDE OF
OUR CONTROL IN TERMS OF RATES
AND APPROVAL BY THE FEDERAL
GOVERNMENT ADDITIONALLY AND WHEN
OPERATIONAL ISSUES --
ASSOCIATED WITH --
THE MANAGED CARE PAYMENTS WE
ALSO -- HAVE
SUPPLEMENTAL PAYMENTS AND WE
TALKED ABOUT THE MC A TAX WILL
BIT EARLIER BUT THINGS LIKE THE
VARIOUS COSTS --
THEIR LARGE SUMS OF MONEY AND
THEY CREATE COMPLEXITIES IN --
ADMINISTERING THOSE PROGRAMS --
ALSO WOULD HIGHLIGHT DRUG REBATE
IN AND A HALF PER YEAR THE
TIMING OF THOSE REBATE RECITE
REBATE RECEIPTS --
IS OFTEN UNKNOWN AND OUTSIDE OF
OUR CONTROL.
SO IN TERMS OF WHAT WE'RE
REQUESTING IN THIS PROPOSAL AND
WE'RE ASKING FOR TWENTY FIVE NEW
POSITIONS TO STRENGTHEN OUR
FISCAL MANAGEMENT AND CASH FLOW
MONITORING.
OF THE RESOURCES INCLUDE A A NEW
CHIEF FINANCIAL OFFICER --
TO OVERSEE OUR COMPLEX FISCAL
OPERATIONS BOTH IN TERMS OF
ESTIMATING BUDGETING AND
ACCOUNTING FOR RESOURCES --
FOR ALSO ALSO REQUESTING
POSITIONS FOR OUR CENTRAL FISCAL
SHOPS --
THAT WE HAVE TO DEVELOP THE
ESTá MEN AND MONITOR CASH FLOW.
BUT EQUALLY AS IMPORTANT
REQUESTING POSITIONS AND
THROUGHOUT THE DEPARTMENT FOR
PROGRAMS BECAUSE THAT'S WHERE
EXPENDITURES HAPPENED THAT'S
WHERE RECEIPTS COME IN AND SO
INCREASING THAT.
THAT THE RESOURCES AVAILABLE IN
THOSE PROGRAMS AND TO MAKE SURE
THAT AND EVERYBODY UNDERSTANDS
IT FISCAL MANAGEMENT IS
EVERYONE'S RESPONSIBILITY.
OF THE RESOURCES THAT WERE
REQUESTING HERE OR TO ADDRESS
IMMEDIATE WORKLOAD --
TO TO IMPROVE.
OUR FISCAL INTEGRITY WERE ALSO
LOOKING AT LONG TERM SOLUTIONS
THE SYSTEMS THAT WE USE TO
ACCOUNT FOR THE HUNDRED BILLION
DOLLARS OUR OLD IN AN ADEQUATE
IN IN MANY CASES --
SO IT ADDITIONALLY REQUEST TO
ESTABLISH THE MEDI CAL DRUG
REBATE FUND --
I TOUCHED ON THE DRUG REBATES
WHAT WE'RE SIMPLY PROPOSING IS
TO ESTABLISH A FUND TO ISOLATE
THE RECEIPT OF THOSE FUNDS SO
THAT WE CAN BETTER MANAGE THE
TIMING OF OFFSETTING.
PAYMENTS IN THE PROGRAM.
OKAY THANK YOU ALEJO TREATMENTS
HAVE SOME COMMENTS ABOUT THIS WE
DO THANK YOU MISTER CHAIR --
WE WOULD JUST WANT TO UNDERSCORE --
HOW SERIOUS THIS ISSUE IS --
THE THE MAGNITUDE OF THE
FLUCTUATIONS.
WHILE THEY MAY BE SMALL IN SOME
CASES IN TERMS OF MEDI CAL
BUDGET THAT THEY'RE ACTUALLY
PRETTY SIGNIFICANT FOR THE
OVERALL GENERAL FUND BUDGET.
AND BAM IN OUR VIEW THEY MAKE IT
DIFFICULT FOR THE LEGISLATURE TO
ESTABLISH LONGER TERM PRIORITIES --
FOR ALLOCATING RESOURCES BECAUSE
THOSE PRIORITIES CAN BE UPSET
AND DISPLACED BY BY CHANGES
UNEXPECTED CHANGES IN MEDICAL
COSTS --
SECOND THING ONE UNDERSCORE IS
THAT -- IN A
LOT OF WAYS THE THE SWINGS ARE A
SYMPTOM OF THE GROWING
COMPLEXITY OF THE PROGRAM AS WAS
MENTIONED.
AND THIS COMPLEXITY --
HAS MADE IT DIFFICULT --
FOR OUTSIDE STAKEHOLDERS
INCLUDING THE LEGISLATURE TO
OVERSEE THIS PROGRAM AND REALLY
UNDERSTAND CLEARLY.
OUT WHAT'S WHAT'S GOING ON OFTEN
THE INFORMATION THAT --
OUTSIDE STAKEHOLDERS --
WOULD NEED IS NOT PUBLICLY
AVAILABLE EVEN BE DIFFICULT FOR
THE DEPARTMENT TO PROVIDE.
AND WE THINK THAT THE GOVERNOR'S.
EXCUSE ME STAFF IMPERFECT
STAFFING PROPOSAL.
HAS MERION WE RECOMMEND THAT IT
BE APPROVED --
HOWEVER WE THINK IT'S ALSO
IMPORTANT TO TAKE ACTION TO
IMPROVE THE TRANSPARENCY OF THE
MEDI CAL BUDGET FOR OUTSIDE
STAKEHOLDERS.
THIS IS GOING TO BE A LONG TERM
PROCESS --
AND WE AGREE WITH THEM THE
DEPARTMENT'S APPROACH IF YOU
KNOW CONTINUING TO LOOK AT THIS
IN THE SHORT TERM --
WE THINK IT WOULD.
MAKE SENSE FOR THE DEPARTMENT TO
PROVIDE ADDITIONAL INFORMATION
THAT --
COULD BE GAINED FROM THE
APPROVAL OF THESE POSITIONS ONE
EXAMPLE COULD BE --
ADDITIONAL INTERIM INFORMATION
ON CHANGES IN CASH FLOWS --
SINCE THIS IS THE FOCUS OF WHAT
THESE POSITIONS WOULD BE WORKING
ON IN THE LONGER TERM --
TO ENSURE THAT THE LEGISLATURE
IS A PURPLE INVOLVED AND WE
WOULD RECOMMEND THAT THE
LEGISLATURE DIRECT THE
DEPARTMENT TO COME FORWARD WITH
A PLAN THAT WOULD HAVE SPECIFIC
STEPS --
WATER TERM MORE STRUCTURAL --
ANOTHER THING THAT COULD BE DONE
IS IS PERHAPS THE ESTABLISHMENT
OF A WORKING GROUP THAT WOULD
INCLUDE THE DEPARTMENT
LEGISLATIVE STAFF OTHER
STAKEHOLDERS. TO GENERATE IDEAS
AND PRIORITIZE ONE OF THE WAYS
TO TO BEST GO ABOUT IMPROVING
THE TRANSPARENCY OF THE BUDGET
IMPROVING FISCAL MANAGEMENT --
ON THE ISSUE OF THE SPECIAL FUND
FOR DRUG REBATES WE THINK THAT'S
A PROMISING CONCEPT THEM
RECOMMENDED THE LEGISLATURE
PROVE THAT AND AND DEPENDING ON
HOW THAT.
WORKS -- IT
COULD POTENTIALLY BE SOMETHING
THAT'S EXPLORE FROM OUR BROADER
APPLICATION IN THE PROGRAM.
THANK YOU FINANCE [inaudible]
COMMENT.
I THANK YOU OF FINANCE WE WOULD
JUST LIKE TO KNOW GOOD FOOD I
WORKED WITH THE DEPARTMENT ON
THIS FOR AT THIS PROPOSAL FOR A
VERY LONG TIME WANT TO THANK
THEM FOR THEIR EFFORTS AND THEIR
CONTINUED EFFORTS.
ON THIS IT WAS A VERY
COLLABORATIVE PROCESS I THINK.
OF FINANCE PLEASE AT THIS
PROPOSAL.
AND THESE RESOURCES WILL GO A
LONG WAY TOWARDS ENHANCING THE%
DEPARTMENT'S EFFORTS AND HANSON
THE PROGRESS THEY'VE ALREADY
MADE IN --
MONITORING THIS AREA.
AS OUR PUBLIC COMMENT WOULD
TAKING ON BOTH ISSUE THIRTEEN
AND FOURTEEN A SINGLE PUBLIC
COMMENT -- I
WOULD SAY THAT FIRST OF ALL --
I APPRECIATE --
MORE -- THAT
YOU'RE TRYING TO TAKE THIS ON I
MEAN THIS THIS IS BEEN AS MY
THIRD YEAR CHERRY THIS BUDGET
SUBCOMMITTEE.
IT'S KIND OF FUNNY I'LL HAVE
PEOPLE COME UP AND WILL HAVE
PROPOSALS YOU KNOW --
THAT THEY REMEMBERED THE ON
BUTTON AND COMING UP MILLION
DOLLARS YOU KNOW THAT I THINK
THERE ARE NOW MORE LIKE --
SEVEN MILLION ETCETERA YEAH
THESE PROPOSAL RIGHT THERE.
LIKE. TWO THREE MILLION SOME WE
COME.
TO BETTER CAL IN RIGHT THE DRUG
REBATE ALL SUDDENLY WERE OFF BY
ONE POINT SOMETHING BILLION
RIGHT.
ALABAMA STILL ONE POINT ONE THAT
SHOWS UP RIGHT WE CAN HAVE A ONE
POINT.
BILLION TO BILLION SWAYING.
AND IT'S FRUSTRATING BUT SAME
TIME I REMIND MY COLLEAGUES LIKE
WELL YEAH THAT'S LIKE ONE OR 2%
OF THE TIRE.
MEDI CAL BUDGET RATE EVEN SO
WHEN YOU THINK ABOUT CAN WE KEEP
SOMETHING TO WITHIN ONE OR 2%
THAT'S WHAT MEANS I MEAN WE HAVE
BILLION DOLLAR YEAH WE HAVE
BILLION TO BILLION DOLLARS
SWINGS.
YET THAT REPRESENTS I MEAN THINK
ABOUT ALL THE PROPOSAL EVER BY A
TWO BILLION DOLLARS WOULD PAY
FOR UP.
TO SIXTY FOUR FOR MEDI CAL FOR
ALL.
I MEAN THEY'LL BE HUGE.
ABOUT THE RIGHT.
YET THAT'S THE SWING WE GET EACH
YEAR SO FIGURE OUT HOW TO BETTER --
IT'S A MANAGE THAT IT'S ACTUALLY
TO UNDERSTAND AND HAVE THE
TRANSPARENCY I THINK AND I
APPRECIATE THE ALEJO'S STATEMENT
IS.
AS I GUESS ONE QUESTION I HAVE
THOUGH IS I MEAN I APPRECIATE
WHAT YOU'RE PROPOSING HERE --
L. IS SUGGESTING NIGHT KIND OF
THINKING ALONG THE SAME LINES IN
TERMS OF I MEAN.
THEY SOON THIS IS NOT THE LAST
SET OF STEPS BECAUSE IT'S A VERY
COMPLICATED THING LIKE MAYBE WE
NEED TO FIGURE OUT HOW WE CAN
COME TOGETHER I REALIZE THAT YOU
KNOW IT'S CERTAINLY BIG PART
ADMINISTRATION BUT THE EIGHT CS
WITH LA --
FINANCE ME LEGISLATURE THINK
ABOUT LIKE HOW WHAT'S THE BEST
WAY.
TO ORGANIZE THIS IN A WAY THAT
WE CAN MAKE BETTER DECISIONS
MORE TRANSPARENT DECISIONS THAT
WE CAN DO THAT AND THAT ALSO
THERE'S A COMMON UNDERSTANDING
AND EXPECTATION ABOUT WHAT'S
SUPPOSED TO HAPPEN.
RIGHT BECAUSE AS BECAUSE IT DOES
THAT MEAN --
FUND BUDGET BILLION DOLLARS IS
ALSO I MEAN THE THING IS OUR
MEDI CAL PROGRAM BECAUSE IT YEAH
YES MOST A LOT OF ITS FROM THE
FEDERAL GOVERNMENT THE ACTUAL
GENERAL FUND PARTS ONLY.
WAS A TWENTY EIGHT BILLION EIGHT
THREE THREE THREE SORRY EVEN
HIGHER OKAY TWENTY THREE BILLION
RIGHT BUT NOT ENTIRE GENERAL
FUND BUDGET IS REALLY ABOUT THE
SAME SCALE WERE A LITTLE LESS IT
DOES AREMEDI CAL BUDGET NOW
AFTER YOU PUT ALL THE CELLS OF
SO.
SO WHAT HAPPENS IS YOU SEE THIS
THESE NUMBERS RUNNING ARE GOING
GOING BACK AND FORTH AND AND
SAID WITH THE CASH BASIS SO
FORTH.
MAKE HAVE HAPPY WAS LIKE OH JEEZ
HOW WHAT'S THE OVER OR OR OR
ACTUALLY TWO BILLION DOLLARS A
TWO BILLION OPERATE AND THAT'S
ONLY SO --
BUT I THINK REALLY TRYING TO
FIGURE THAT OUT.
AND SO I THINK THIS IS AN
IMPORTANT FIRST STEP AND WE WANT
TO GIVE YOU THE RESOURCES TO BE
ABLE TO DO THAT BUT I ALSO THINK
THAT.
BY COULD WE HAVE A LIKE A LARGER
CONVERSATIONS LA A SUGGESTED IT.
REALLY IS MUCH TO FIGURE OUT HOW
THIS HOW TO DO THIS IN A WAY SO
WE CAN SET APPROPRIATE
EXPECTATIONS I MEAN INTERNAL
FINANCIAL WORKINGS OF THE
ADMINISTRATION I UNDERSTANDS
GOING TO BE.
BETWEEN FINANCE AND THE AGENCY
AND SO FORTH BUT I THINK IN
TERMS OF TRAFFIC HOW DO YOU
REPORT OUT THE INFORMATION I DO
SUPPORT INFORMATION AND A WHAT
YOU KNOW IT AT APPROPRIATE TIMES
NOW AT THE OUGHT TO JUST DO IT
ONCE A YEAR IS THAT MAKES THAT
THAT.
MAY NOT MAKE SENSE RIGHT AND
THEN YOU KNOW HOW WE BETTER
COMMUNICATE --
HOW THE MONEY IF DOES FLOW AND
WHAT WHAT WHAT WE EXPECTING?
FROM ALL THOSE DIFFERENT POTS
EVERY WAIVERS SOMETHING CHANGES
RIGHT EVERY THIS SOMETHING
CHANGES RIGHT SO HOW HOW WE IT'S
AS THOUGH THAT WERE MADE MAKING
SENSIBLE.
DECISIONS IN NUMBER MAKING
POLICY BASED ON NOT YOU KNOW --
POTENTIALLY WRONG ASSUMPTION WE
DON'T HAVE THAT KIND OF
UNDERSTANDING WHICH IS A KNOWS
PRETTY COMPLICATED.
I MEAN I'LL I'LL START AND THEN
CERTAINLY LET ERICA CHIME IN I
THINK -- YOU
KNOW I HAVE TO THE COMMAND POST
ERICA AND MARY CAN'T WELL RIGHT
THAT BOTH CHIEF DEPUTIES FOR YOU
KNOW BOTH SIDES OF THE
ORGANIZATION AND TO ERICA'S
POINT EARLIER IN THAT WHAT WE'RE
REALLY --
TRYING TO SEXUALLY IS A CULTURAL
CHANGE ACROSS THE DEPARTMENT
MORE BROADLY IN TERMS OF THINGS
HAPPEN AT A PROGRAM LEVEL --
THAT FROM A TIMELY COMMUNICATION
STANDPOINT TO THE OTHER SIDE OF
THE DEPARTMENT IN TERMS OF THE
BUDGETING AND ACCOUNTING AND
FISCAL FORECASTING --
AND DEPENDING ON THE TIME FRAMES
IN WHICH WE ARE CLAIMING FEDERAL
FUNDS TO THE TIMING IN WHICH
FEDERAL APPROVALS ARE COMING TO
THE TIMING IN WHICH ARE A T.
SYSTEMS CAN ACTUALLY GENERATE
THE PAYMENTS OUT THE DOOR.
AND THEN YOU THROW A CASH VERSUS
ACCRUAL BASIS ACCOUNTING I MEAN
IT'S A REMARKABLY COMPLEX --
PROGRAM AND THE FACT THAT BOTH
MERION ERICA HAVE BEEN LEADING
THEIR RESPECTIVE TEAMS TO SIT
TOGETHER TO YOU KNOW IDENTIFY
AREAS WHERE WE CAN IMPROVE.
BUT ALSO WORKING AS YOU KNOW
FINANCE WOULD NOTE WITH FROM THE
FINANCING THAT LEO AND THE
LEGISLATURE WE RECOGNIZE THE
IMPORTANCE OF OUR ESTIMATE.
BE KNOWS INFORMATION THAT WE
KNOW WHEN WE KNOW IT I'M BUT
BECAUSE OF THE FACT THAT SO MUCH
OF THE REST OF THE BUDGET IS
INDICATIVE AS TO WHETHER OR NOT
WE ARE ACCURATE IN OUR
ASSUMPTIONS --
I THINK WHEN YOU HEAR --
MERRY TALK ABOUT HER VISION FOR
WAIVER RENEWALS AND YOU KNOW THE
FIVE TEN FIFTEEN YOUR PLAN THAT
JC IS WORKING WITH HER ON YOU
HERE -- HER
TALK ABOUT THE NEED TO CHANGE
OUR RATE SETTING PROCESS WE SET
SIXTEEN HUNDRED RATE CELLS A
YEAR FOR EACH OF OUR MANAGED
CARE PLANS ACROSS DIFFERENT
POPULATIONS --
THE COMPLEXITY OF JUST THE RATE
IN AND OF ITSELF WHEN YOU THEN
TAKE IT TO THE CASH IN THE
ACCOUNTING AND THE APPROVALS AT
THE FEDERAL LEVEL.
THERE'S GOT TO BE --
A BETTER WAY GOING FORWARD IN
TERMS OF HOW WE STRUCTURE THOSE
RATES AND THOSE PAYMENTS AND ALL
THE OTHER KINDS OF INITIATIVES
AND ADD ONS AND SUBLIMINAL --
ITEMS THAT WE DO FOR HOSPITALS
AND SKILLED NURSING FACILITIES
AND YOU KNOW.
IT JUST REALLY COMPOUNDS AND SO
I THINK YOU KNOW I WOULD LIKE TO
RECOGNIZE THE FACT THAT WE HAVE
A DEPARTMENT LEADERSHIP TEAM
THAT IS REALLY COMMITTED.
TO DOING THIS IN A THOUGHTFUL
AND KIND OF PROGRESSIVE WAY I
THINK THAT YOU TO THE COMMENTS
AROUND THE ALLEY --
AROUND --
BRINGING MORE PEOPLE.
MORE PEOPLE TO THE TABLE TO HELP
US THINK IDENTIFY FOR US WHAT WE
NEED TO KNOW FROM A MANAGEMENT
STANDPOINT BUT ALSO WHAT OTHER
PEOPLE NEED TO KNOW IN ORDER TO
HELP YOU KNOW EFFECTUATE THEIR
LEADERSHIP AND NOTIFICATIONS.
YOU KNOW WE'RE CERTAINLY
COMMITTED TO SO YOU KNOW WE NEED
TO PUBLICLY CALL OUT YOU KNOW
BOTH ERA CAN MERRY'S LEADERSHIP
IN THE DEPARTMENT AS WELL ON
THIS.
THANK YOU AND I THE ONLY THING I
WOULD ADD TO THAT YOU KNOW
COMMITTED TO THE THE STAKEHOLDER
IN PARTNER INPUT WE HAD ALWAYS
ENVISIONED THAT WE JUST HAVEN'T
GOTTEN THERE --
AND THE SICKENING TRANSPARENCY
COMPLETELY COMMITTED TO
TRANSPARENCY AYE YOU KNOW WE DO
CASH FLOW MONITORING NOW WHERE
YOU MIGHT HAVE EXPECTED TO SPEND
THIS MUCH AND TURNS OUT WE'RE
ABOUT THERE YOU GO AWESOME.
AND THEN YOU DRILL DOWN AND EACH
OF THE THOUSAND LINE ITEMS THAT
THAT MAKE UP THIS.
ARE OFF BY A COUPLE HUNDRED
MILLION HERE AND FOUR HUNDRED
MILLION THEIR ONES UP IN ONE'S
DOWN IN THE OFFICE THAT YOU'RE
ABOUT RIGHT IT'S IT'S SUPER
COMPLICATED SO.
AS I LIKE TO THE THE THE WITHOUT
TALKING POINT THAT I PUT IN
MARY'S THERE ALL THE TIME TO
SIMPLIFY.
SIMPLIFY THE PROGRAMS --
WHICH I THINK WE'RE WORKING ON
IT BUT THE SYSTEMS ARE WHOLLY
INADEQUATE AND THAT'S GOING TO
TAKE SOME TIME TO GETTING THAT
INPUT TO UNDERSTAND --
WHAT PEOPLE WANT AND NEED AND I
MEAN WE EVEN HAVE VISIONS GOING
FORWARD IF YOU KNOW RUNNING
DIFFERENT MODELS DIFFERENT
SCENARIOS --
WERE NOT THERE YET SO.
JUST TODAY WHEN WE WERE GOING
OVER TO ALL THE IT IS SPECIAL
LIKE WELL HOW COME THIS ONE UP
THIS NOW I HAVE A LOOK AT THE
BIGGEST.
THE BIGGEST MOVEMENTS AND WAS
GONE THEY PICK UP ALL THE LITTLE
ONES RIGHT NOW.
WE APPRECIATE THAT.
BECAUSE YOU KNOW I HAVE REYES.
IS HE GAY.
RIGHT OKAY ALL RIGHT WELL.
INFORMED FIRST STEP I THINK
OBVIOUSLY AN ONGOING EFFORT AND
OF IT HAS BIGGER IMPLICATIONS
NOT ONLY FOR THIS BUDGET
SUBCOMMITTEE FROM OUR BUDGETING
PROCESS AS WELL SO I KNOW YOU
HAVE A MANAGEMENT THINGS YOU
NEED TO DEAL WITH.
THAT AND AND BUT ALSO IT.
AND IN THE END WE'RE ALL IN IT
TOGETHER WHETHER WE AGREE OR
DISAGREE.
SOMETHING'S PARTICULAR THINGS
OKAY.
ALL RIGHT SO WILL HOLD OPEN BOTH
ITEM THIRTEEN AND FOURTEEN SO
WE'LL MOVE ON TO ITEM NUMBER
FIFTEEN WHICH IS THE MEDICARE
I'LL CHECK RIGHT CONTINUES THE
PAYMENTS.
WERE PROPOSING A TRAILER BILL
LANGUAGE HERE --
SIMPLY TO AUTHORIZE US TO MAKE
CONTINGENCY PAYMENTS TO HEALTH
CARE PROVIDERS --
ONLY IF WE HAVE A DISRUPTION IN
OUR MEDICAL MEDICAL --
FISCAL INTERMEDIARY SERVICES
JEANETTE FOR OUR WEEKLY A FEE
FOR SERVICE PAYMENTS OF ABOUT
THREE HUNDRED FIFTY MILLION A
WEEK.
ALL RIGHT --
COME LA --
COMMENTS.
FINANCE MY INTRODUCE YOURSELF
AGAIN RIGHT NOW IT'S COMING
DEPARTMENT FINANCE RIGHT NO
COMMENT.
IT'S A MEASURE.
OKAY WELL THE IDEA THAT --
PROVIDERS STILL GET PAID EVEN
WHEN YOUR SYSTEM GOES DOWN IS
PROBABLY SOMETHING WE SHOULD.
THE GOOD YOU SHOULD DO IS OUR
EIGHT AND IF OUR SYSTEM GOES
DOWN THAT'S RIGHT IF REYES
SHOULDN'T GO DOWN EVER HAS.
I I WILL POINT OUT THAT I HAVE
NO CONFLICT OF INTEREST BECAUSE
I VOLUNTEER I DON'T ACTUALLY
HAVE BILL.
SOMEONE ELSE MAY BILL FOR ME BUT
I'M NOT THE ONE GETTING THE
MONEY.
ALL RIGHT --
ITEMS AS A MEDICAL PROVIDER --
OKAY -- SO
ANY OTHER PUBLIC COMMENT ON THIS
AND WILL HOLD THIS ITEM OPENED --
ISSUE NUMBER SIXTEEN HEALTH
HOMES PROGRAM FUNDING EXTENSION.
OF WE ARE PROPOSING TRAILER BILL
THAT WOULD EXTEND THE A AND THE
APPROPRIATE EXPENDITURE
AUTHORITY FOR THE HELP HOMES
PROGRAM FROM JUNE THIRTY TWENTY
TWENTY TWO JUNE. THIRTY TWENTY
TWENTY THREE TO ALIGN WITH
PROGRAM IMPLEMENTATION TIMELINES
AND TO COMPLETE THE HEALTH HOMES
EVALUATION YOU ALSO HAD AN
ADDITIONAL QUESTION IN YOUR
AGENDA AROUND OF FUNDING THE
PROGRAM AFTER TWENTY TWENTY
THREE GIVEN THE STATUTORY
REQUIREMENT TO USE NON GENERAL
FUND -- THE
RESPONSE THERE WOULD BE AS WE
GET CLOSER TO TWENTY TWENTY
THREE THE DEPARTMENT WOULD LOOK
AT OPTIONS --
BASED ON THE EVALUATION IN THE
SUCCESS OF THE PROGRAM --
AND THEN COME FORWARD WITH
RECOMMENDATIONS AT THAT TIME
[inaudible]
OKAY ALEJO.
THE COMMENTS FINANCE
[inaudible]
INTRODUCE YOURSELF.
CAME BACK TO THE TABLE.
DISCUSSING THIS DEPARTMENT OF
FINANCE --
THANK YOU AND WE SUPPORT THE
GOVERNOR'S BUDGET AND THIS
TRAILER BILL LANGUAGE OKAY THANK
YOU I AM STILL WAY FOR YOU SEE
DISAGREED GOVERNOR'S BUDGET.
ALL RIGHT --
OF PUBLIC COMMENT.
LINDA WAY WITH WESTERN CENTER ON
LAW AND POVERTY AS ONE OF THE
ORIGINAL CO SPONSORS OF THE
HEALTH HOMES PROGRAM --
WE SUPPORT THE TRAILER BILL
LANGUAGE TO ACCOUNT FOR DELAYED
IMPLEMENTATION --
NATIONAL EVALUATORS OF SIMILAR
PROGRAMS AND OTHER STATES FOUND
COSTS OUTCOMES IMPROVED
DRAMATICALLY ONE TO TWO YEARS.
AFTER IMPLEMENTATION --
BUT THE STATE THAT HAS NOT BEEN
AS IS NOT AVAILABLE UNTIL YEARS
AFTER IMPLEMENTATION SO WE DO
BELIEVE THAT THAT BENEFIT WILL
YIELD IMPROVEMENTS.
AND STABILITY OF PROGRAM
PARTICIPANTS AS WELL AS LOWER
THAN MEDI CAL COST THANK YOU.
THANK YOU. NINETY FILE COMING.
AGAIN JEWELERS WITHOUT RAMP
REGIONAL ASTHMA MANAGEMENT
PREVENTION WE ALSO SUPPORT THE
PROPOSAL SINCE --
COMES ASTHMA CARE COORDINATION
CAN BE AT THE BIG PART OF A
PROPER TREATMENT THIS IS A
HELPFUL PROGRAM TO MOVE THINGS
FORWARD THANK YOU.
THANK YOU ALL RIGHT SO --
CERTAINLY THE SUPPORT GRAHAM --
YEAH WE'VE BEEN TALKING ABOUT
THE IMPORTANCE OF BETTER CHRONIC
DISEASE MANAGEMENT --
MEDICAL HOMES BETTER
COORDINATION CARE BETTER ACCESS
TO PRIMARY CARE A LOT OF
RESEARCH SHOWING THAT THIS
INCLUDES QUALITY REDUCE COSTS
AND SO WERE --
SO CERTAINLY.
WANT TO CONTINUE THIS --
THIS EFFORT WITHIN DEPARTMENTS
AND OUR MEDICAL PROGRAM --
TO CONTINUE SO BUT AT THIS POINT
WE WILL.
DO WAY THOME AND HOLD IT OPEN
NOW.
OKAY -- SO --
FOR ISSUE NUMBER SEVENTEEN
FAMILY HEALTH ESTIMATE BILL
REVIEW.
OF THE FAMILY HEALTH THE LOCAL
SINCE ESTIMATE PROVIDES
INFORMATION AND STATE ONLY COSTS
FOR FOR PROGRAMS THE CALIFORNIA
CHILDREN'S SERVICES PROGRAM.
THE CHILD HEALTH AND DISABILITY
PREVENTION PROGRAM THE
GENETICALLY HANDICAPPED PERSONS
PROGRAM IN EVERY WOMAN COUNTS.
OF THE FAMILY HEALTH ESTIMATE
PROGRAM EXPAND FIFTY MILLION FOR
CURRENT YEAR INTO ENGINE FIFTY
SEVEN MILLION IN BUDGET YEAR THE
NEVER AT NOVEMBER ESTIMATE FOR
CURRENT YEAR IS TWENTY FOUR
POINT THREE MILLION LASSEN
GENERAL FUND COSTS THAN THE TWO
THAT ARE.
THE NEW TWO THOUSAND EIGHTEEN
NINETEEN BUDGET APPROPRIATION --
THE FAMILY HELD THE GENERAL FUND
COSTS ARE ESTIMATED TO INCREASE
BY EIGHT POINT FOUR MILLION
DOLLARS FROM KERN YOUR TO BUDGET
YEAR.
THE SIGNIFICANT CHANGES INCLUDE --
RATE INCREASES FOR BOTH THE HOME
HEALTH AND PEDIATRIC DAY HEALTH
CARE OF PROGRAMS AS WELL AS
LOWER BLOOD FACTOR REBATES.
OKAY THANK YOU --
COMES VALUE.
FINANCE NO IRATE PUBLIC COMMENT
THE ITEM.
OKAY SO I APPRECIATE THE
OVERVIEW --
OBVIOUSLY THESE ARE VERY
IMPORTANT PROGRAM CERTAINLY IS A
PEDIATRICIAN --
CCS AS A MENTION WILL HAVE SOME
FURTHER CONVERSATIONS ABOUT CCS.
I GUESS SEATS DP IT'S REALLY
JUST THE OUR THAT THREE THOUSAND
I MEAN ACTUALLY.
GOING DOWN THE NOTHING RIGHT.
EIGHTY TWO WE'RE SHOWING TWENTY
TWO ENTITIES FLOWED LIKE A CELL
TWENTY TWO PEOPLE RIGHT.
OKAY.
ELENA IS THERE SOME CONFERENCE
CONVERSATION ABOUT WHAT DO YOU
DO SEE VENTRALLY WHEN THERE'S A
WIND DOWN I GUESS I THINK I
THINK IT'S A FAIR CONVERSATION
FROM THE STANDPOINT THAT.
OBVIOUSLY CALIFORNIA WHEN THE
PROGRAM WAS ENACTED IN --
NINETEEN SEVENTY THREE WE WERE
IN A DIFFERENT PLACE IN WHICH
CHILDREN MAY OR MAY NOT HAVE HAD
ELIGIBILITY FOR MEDI CAL AND
CERTAINLY YOU KNOW THE
SIGNIFICANT DROP IN THE CASELOAD
HAS BEEN AS A RESULT OF
CALIPHATE.
CALIFORNIA TAKING OTHER STEPS TO
PROVIDE FULL SCOPE CAM UP TO THE
AGE OF NINETEEN SO.
HI AND I ACTUALLY Y. ALSO
KNOWLEDGE G. H. P. P. BECAUSE
CCS ONLY GOES UP TO A CERTAIN
AGE IN THE ME WE NEED TO FIGURE
OUT WHAT TO DO WITH.
WELL THIS IS THE WORST THAT THE
GOOD NEWS IS THAT THANKS
PROGRAMS LIKE CCS --
CHILDREN SPECIAL NEEDS ARE NOW --
NO LONGER CHILDREN WITH SPECIAL
NEEDS TO BECOME.
ADULTS WITH SPECIAL NEEDS AND
THAT DISCONTINUITY IS THINK IS
IS A CHALLENGE FOR MANY FAMILIES
AND SO I KNOW IT'S A LARGER.
ISSUE THAN JUST DOING THE FAMILY
S. BETTER VIEW BUT I AND I KNOW
I HAD SOME FEES LEGISLATION
AROUND SOME CONDITIONS AND
FORTUNE WAS VETOED BUT I DO
THINK WE NEED TO THINK ABOUT.
THIS TRANSITION ISSUES SO WE
FELL Là CONVERSATION ABOUT
HEALTHCARE COVERAGE AND WILL.
BE SURE OF GET NOW PEOPLE THAT
FOR ALL BUT ALSO RECOGNIZING
THAT WE HAVE PEOPLE WITH
PARTICULAR CONDITIONS WHO NEED
ADDITIONAL SUPPORTS AND SO I
MEAN OF WRAPS INTO A HOLE YEAH
WE TALKED BACK TO SAYS AND WE
HAVE A LOT OF OTHER COMPONENTS
BUT CERTAINLY YOU KNOW HOW.
THOSE PIECES.
COME TOGETHER DON'T COME
TOGETHER --
FOR FOR THERE'S A REASON CCS WAS
ESTABLISHED WAY BACK WHEN AND
AND WHITE CONTINUES TODAY AND WE
MIGHT WANT TO THINK ABOUT HOW
THAT MODEL WORKS.
FOR ADULTS ESPECIALLY.
INCLUDING ONES WHO USED TO BE IN
THE CCS PROGRAM CELL.
OKAY ALL RIGHT --
ANY PUBLIC COMMENT ON THIS.
ALL RIGHT IS IS AN OVERVIEW I
GUESS IS NOT REALLY ANY ITEM
HOLD OPEN --
SO WITH THAT.
OKAY I THINK --
THE WE HAVE A COMPLETED THE
AGENDA.
FOR THIS HEARING OF THE SENATE
BUDGET FISCAL REVIEW
SUBCOMMITTEE NUMBER THREE ON
HEALTH AND HUMAN SERVICES I
THANK ALL THE PEOPLE WHO
PARTICIPATED IN THE HEARING AND
TO THIS HEARING IS NOW ADJOURNED