THE SENATE BUDGET IN FISCAL
REVIEW COMMITTEE WILL KNOW IF
ANYBODY HEARD THAT GAVEL THE
FIRST TIME WILL NOW COME TO
ORDER- AARON WE WILL BE HOLDING
HEARING HERE IN ROOM TWELVE
HUNDRED AND WE WILL TAKE PUBLIC
COMMENT BOTH FROM PEOPLE WHO ARE
HERE IN THE HEARING ROOM AND
ALSO ON A PHONE LINE- SO THE
TELECONFERENCE PARTICIPATION
NUMBER AND ONE SECOND I'M NOT
SURE IF I HAVE THE RIGHT ONE-
THE LISA. BECAUSE I AM LOOKING
AT MY OLD SCRIPT HERE WE GO OKAY
IT'S COOL I GOT IT NOW I JUST
WANNA MAKE SURE A THE CORRECT
NUMBER THE PURCHASE NUMBERS.
877-226-8163 THE ACCESS CODE IS
. FOUR FOUR ZERO ZERO FIVE NINE
FIVE. AND I WILL MAINTAIN
DECORUM AS IS CUSTOMARY ANYONE
WHO IS DISRUPTIVE COULD BE
REMOVED FROM THE REMOTE MEETING
SERVICER HAVE THEIR CONNECTION
MUTED- THE FOLKS WHO ARE
PROVIDING TESTIMONY TODAY TO US
ARE PARTICIPATING REMOTELY AND
REMOTE PARTICIPANTS YOU KNOW THE
DRILL PLEASE SAY YOUR NAME YOU
HAVE TO AND MEET YOURSELF PLEASE
IDENTIFY YOURSELF BEFORE YOU
SPEAK. AND THEN OUR- TAX WILL.
WELL NEW Q. WHEN YOU'RE FINISHED
AND IF YOU WISH TO RESPOND TO
ANY OF OUR MEMBERS QUESTIONS USE
THE RAISE YOUR HAND FEATURE. AND
I WILL. SEE THAT AND- CALLING-
WE WILL HAVE A PUBLIC COMMENT
AFTER ALL THE DISCUSSION ITEMS
HAVE BEEN PRESENTED. AND MEMBERS
ALL EXPLAIN HOW I WANT TO HANDLE
THIS TODAY BECAUSE YOU CAN SEE
WE HAVE A NUMBER OF PANELS AND A
LOT OF SPEAKER SOLVED- DISCUSS
THAT IN A MOMENT LET ME SEE IF I
HAVE A QUORUM YET. OKAY SO LET
US CALL THE ROLL. SENATOR
SKINNER I'M HERE NILA. BAKER
CARRIERA DOLLY- ALSO. AT GROWTH
FLARED. WIRE FINANCIAL OUR- MEN
. NEWMAN FOUR TWO. HERE TO DHEA
BROUGHT. SEE ARTICLE HERE SMALL
GROUP SMALL WOULD QUIT. WE HAVE
A CORE WE HAVE QUORUM- SO LET ME
GIVE SOME LITTLE OPEN. COMMENTS
SO WE KNOW HOW WE'RE PROCEEDING
TODAY THIS IS OUR THIRD
INFORMATION OR OVERSIGHT
HEARING. OF OF THE BUDGET
COMMITTEES THAT WE'VE
CONVENIENCE SO FAR THIS MONTH
AND- AS WE'RE ALL AWARE LAST
YEAR THE LAST TWO YEARS THE
STATE'S REVENUES WERE-
SUBSTANTIAL WHICH ENABLED US TO
DIRECT HIGHER THAN USUAL AMOUNT
OF FUNDS TO A VARIETY OF
PROGRAMS AND WE'VE BEEN HOLDING
THESE HEARINGS TO. A LITTLE BIT
YOU KNOW IN MORE IN DEPTH ON
THOSE THINGS THAT WE HAVE BEEN
INCREASING THE FUNDING FOR SO
THAT WE- CAN SEE HOW IT IS BEING
IMPLEMENTED WITHIN OUR
COMMUNITIES AND ALSO IDENTIFY
ANY ISSUES THAT ARE AGENCIES OR
OTHERS ARE CONFRONTING IN DOING
THIS MONEY NOW ONE OF THE LARGE.
VERY SUBSTANTIAL THINGS THAT WE
DID IN THE LAST COUPLE OF YEARS
IS EMBRACE A NEW INITIATIVE OF
MEDIC CAL CALLED HELLO HM WHICH
IS THE CALIFORNIA ADVANCING AND
INNOVATING MEDICARE. AND
TRANSFORMATIVE RE ORIENTATION OF
MEDIC HEALTH. IS A HEALTHCARE
PROGRAM THAT ADDRESSES THE NEEDS
OF THE WHOLE PERSON IT'S BEEN
UNDER DEVELOPMENT FOR MORE THAN
FOUR YEARS- BUT WHICH REALLY
BEEN LAUNCHED IN TERMS OF OUR
PROVIDERS BEING ABLE TO ACCESS
IT. OUR MEDICARE RECIPIENTS
BEING ABLE TO BENEFIT FROM IT
MUCH OF A VERY RECENTLY. SORRY
HEARING TODAY WILL PROVIDE
UPDATES TO IMPLEMENTATION OF THE
KEY COMPONENTS OF CAL AIMS WITH
A PARTICULAR FOCUS ON THE NEW
ENHANCED CARE MANAGEMENT AND
COMMUNITY SUPPORTS BENEFITS. SO
THOSE COMMITTEE SPORTS BENEFITS
INCLUDE THINGS LIKE BEING ABLE
TO PROVIDE SIX MONTHS RENT FOR
SOMEONE FOR EXAMPLE. OR IF IN
FACT A PRESCRIPTION FOR FOOD IF
THAT IS WHAT- THAT- MEDICARE
RECIPIENT MOST NEEDS IN TERMS OF
DEALING WITH THEIR HEALTH
CONDITIONS SO THERE'S A VARIETY
OF THINGS LIKE THAT WHICH WE
WILL LEARN ABOUT. CAL AIM IS
WIDE RANGING AND AMBITIOUS. AND
SO WE ARE TRYING TO GET INTO THE
WEEDS A BET ON IT. AND THAT'S
WHY WE HAVE SUCH A- LARGE NUMBER
OF PANEL PANELS AND A LARGE
NUMBER OF PANELISTS SO WHAT I'M
GOING TO ASK TODAY. IS THAT YOU
HOLD YOUR- UNTIL WE HEARD FROM
THE PANELS. AND THAT YOU THINK
CAREFULLY AS YOU LISTEN TO THEM
AND THAT ONE NIGHT CALLING YOU
WHEN WE DO QUESTIONS I'LL ASK
YOU TO DO TO QUESTIONS ONLY IN
THAT INITIAL TAKE. SO THAT WE
CAN GET EVERYBODY AND THEN I'LL
COME BACK TO YOU IF YOU HAVE
MORE QUESTIONS. SEPT HELP NOT
HOPEFULLY THEN WE CAN GET
THROUGH EVERYONE THAT WE HAVE IN
MIND TODAY. ALL RIGHT SO. NOW WE
WILL GO TOO. OUR FIRST PANEL
SORRY A LOT OF PAPERS IN FRONT
OF ME- ALRIGHT SO THIS INITIAL
PANEL IS AN OVERVIEW OF CAL AIMS
IMPLEMENTATION. AND WE HAVE ON
THE PANEL LAURA SIMON WHO IS THE
ASSOCIATE DIRECTOR OF PEOPLE
CENTRED CARE FOR THE CALIFORNIA
HEALTH CARE FOUNDATION. AND I
JUST NOTE MEMBERS. THAT AT
EITHER AFTER THIS- HEARING IF
YOU WANT TO GET A LITTLE MORE IN
DEPTH FOR READY THINGS RELATED
TO CAL AIM FOR. THE CALIFORNIA
HEALTH CARE FOUNDATION WEBSITE
HAS A NUMBER OF REPORTS RELATED
TO CAL AIM SO I RECOMMEND THAT
IS A RESOURCE- SO WE WILL HEAR
FROM MOLORI SIMON. WILL ALSO
HEAR FROM MICHELLE BASS WHO IS
THE DIRECTOR OF THE DEPARTMENT
OF HEALTH CARE SERVICES AND IN
THIS INITIAL PANEL SO JUST GIVE
INTRODUCTORY REMARKS. AND THEN
G. C. COOPER WHO IS THE CHIEF
DEPUTY DIRECTOR IN CALIFORNIA
MEDICAID DIRECTOR FROM THE
DEPARTMENT OF HEALTH CARE
SERVICES. SO LET US START WITH
SMALL OR SIGN. DO IT. THANK YOU
. GOOD MORNING MADAM CHAIR
MISTER VICE CHAIR AND MEMBERS OF
THE COMMITTEE THANK YOU FOR
INVITING ME TO SPEAK TODAY ON
THIS IMPORTANT TOPIC. MY NAME IS
MILLER SIMON AND I WORK AT THE
CALIFORNIA HEALTH CARE
FOUNDATION. WHERE I AM AN
ASSOCIATE DIRECTOR ON THE
ADVANCING PEOPLE CENTER CARE
TEAM. FOR THOSE OF YOU NOT
FAMILIAR WITH THE FOUNDATION.
THE STAFF IS AN INDEPENDENT
NONPROFIT PHILANTHROPY THAT
WORKS TO IMPROVE THE HEALTH CARE
SYSTEM SO THAT ALL CALIFORNIANS
HAVE THE CARE THEY NEED. FOR
SPECIALLY FOCUSED ON MAKING SURE
THAT ALL SYSTEM WORKS FOR
CALIFORNIANS BUT LOW INCOMES AND
FOR THE COMMUNITIES WHO ARE
TRADITIONALLY FACE THE GREATEST
BARRIERS TO CARE. TODAY. I'M
GONNA PUT CALLIN IN CONTEXT BY
TALKING ABOUT OUR MEDICAL
DELIVERY SYSTEMS. AND THEN I'M
GONNA GO A LITTLE BIT DEEPER ON
HEALTH AND HOMELESSNESS GIVEN
ITS IMPORTANCE IN THE STATE FOR.
LET'S START WITH MEDICARE. IT'S
PROBABLY RATHER ON MY-
SACRAMENTO PROGRAM. IS AFTER THE
AFTER MEDICARE AND THE VA. THE
BIG PUBLIC HEALTH PROGRAM IN THE
COUNTRY IT COVERS ONE IN THREE
CALIFORNIANS. HALF OF BIRTHS
HALF OF SCHOOL AGE CHILDREN. THE
PEOPLE WITH DISABILITIES AND TWO
THIRDS OF LONG TERM CARE DAYS.
AND THERE TWO THINGS ARE
IMPORTANT TO KNOW ABOUT MEDIC
CAL ONE IT'S VERY COMPREHENSIVE
WHEN IT COMES TO HEALTH CARE.
AND TO IT'S NOT A SINGLE PROGRAM
. SERVER PHYSICAL HEALTH CARE.
MANY HELL IS MOSTLY ADMINISTERED
BY MEDICAID MANAGED CARE PLANS.
UNLESS OF COURSE. YOU'RE ONE OF
THE ONE POINT SIX MILLION
CALIFORNIANS THAT ARE DULY
ELIGIBLE FOR BOTH MEDICARE AND
MEDI CAL. THEN YOUR PHYSICAL
HEALTH CARE IS COVERED BY
MEDICARE. FOR MENTAL HEALTH CARE
. SERVICES ARE SPLIT. BETWEEN
MANAGED CARE PLANS WHICH HANDLE
NON SPECIAL MENTAL HEALTH CARE.
AND COUNTY MENTAL HEALTH PLANS
WHICH HANDLE SPECIALLY MENTAL
HEALTH CARE. COUNTY BEHAVIORAL
HEALTH ALSO HANDLES SUBSTANCE
USE SERVICES OFTEN THERE IS
SEPARATE MANAGED CARE PLAN. BUT
SOME THINGS ARE HANDLED
CENTRALLY. LIKE PRESCRIPTION
DRUGS AND DENTAL CARE. PERSONAL
CARE SERVICES KNOWN IN
CALIFORNIA AS I HSS. ARE HANDLED
BY YET ANOTHER STATE AGENCY
ADMINISTERED BY COUNTIES AS OUR
SERVICES FOR KIDS WITH SPECIAL
HEALTHCARE NEEDS. AND THERE ARE
MANY SMALL SPECIALIZED PROGRAMS
DESIGNED TO HELP PEOPLE WHO
MIGHT OTHERWISE BE IN NURSING
HOMES STANDING COMMUNITY MOST OF
THESE ARE MANAGEMENT BEAVER
SERVICE SYSTEM. THOUGH A FEW
CRITICALLY LONG TERM CARE
NURSING HOMES- AS OF TWENTY
TWENTY THREE ARE HANDLED BY
MANAGED CARE PLANS. SO MANY FOR
INCOMES TO MIND ME WITH MEDIC
CAL IS THAT. AN INCIDENT TO ESTÁ
STORE TO GO TO SHOPPING. YOU
HAVE TO NOT ONLY GO TO DIFFERENT
STORES TO GET PROTEINS FRUITS
GRAINS AND VEGETABLES. YOU HAVE
TO PAY WITH DIFFERENT CARDS AND
NAVIGATE DIFFERENT RULES ABOUT
WHAT YOU COULD BUY WHEN AND FROM
. AND NOT ALL STORES WOULD TAKE
YOUR CARDS. AND THAT WOULDN'T BE
SO BAD IF YOU'RE MAKING
SOMETHING SIMPLE LIKE A GRILLED
CHICKEN DINNER. BUT NOW I'M
TRYING TO GET EVERYTHING YOU
NEED TO FEED YOUR FAMILY FOR A
WEEK. AND YOU'RE TAKING PUBLIC
TRANSPORTATION IN A WHEELCHAIR.
AND ENGLISH ISN'T YOUR FIRST
LANGUAGE. IN ADDITION MANY
MEDICARE BENEFICIARIES SPACE
OTHER SOCIAL RISK FACTORS THAT
WE KNOW ARE VERY IMPORTANT TO
OUR OVERALL HEALTH AND WELL
BEING. THAT SOMETIMES RESULTS IN
OUR SYSTEM PAYING MORE
DOWNSTREAM. RATHER THAN MAKING A
SMALL UP FRONT INVESTMENT. THE
CLASSIC EXAMPLE IS THAT BEFORE
KILLING. CAL WOULD PAY FOR THE
ER VISIT TO RESOLVE AN ASTHMA
ATTACK BUT NOT THE MOLD REMOVAL.
THAT WOULD ELIMINATE THE
ALLERGENS THE TRIGGERED THE
ATTACK. SO WHAT DOES THIS
COMPLEX SYSTEM DELIVER IN TERMS
OF ACCESS. WHEN MEDICARE MANAGED
CARE MEMBERS ARE SURVEYED ABOUT
THEIR EXPERIENCE FOR ONE IN
FOUR. SAYS THEY CAN'T
CONSISTENTLY GET WHAT THEY NEED
IN A TIMELY MANNER. THIS PUTS
OUR MANAGED CARE SYSTEM IN THE
BOTTOM QUARTILE NATIONALLY.
THESE TEAMS ARE ON ACCESS ALSO
SHOW UP WHEN WE HEAR DIRECTLY
FROM CONSUMERS. C. H. C. M.
BELIEVES THAT OUR HEALTH CARE
SYSTEM ESPECIALLY PUBLIC
PROGRAMS LIKE MEDICAID I'LL
SHOULD REFLECT THE NEEDS
EXPERIENCES AND PRIORITIES OF
THE PEOPLE THEY SERVE. WITH THAT
IN MIND WE ENGAGE WHAT WE CALL
LISTENING WORK TO HELP
POLICYMAKERS AND HEALTHCARE
PARTNERS UNDERSTAND THE
EXPERIENCES AND ATTITUDES OF
HEALTHCARE CONSUMERS. THESE
QUOTES COME FROM THAT WORK.
LIVING AWAY FROM ACCESS AND
TALKING ABOUT THE QUALITY.
CALIFORNIA ACTUALLY PERFORMS
VERY VERY WELL ON MOST QUALITY
MEASURES HOWEVER. WHEN YOU LOOK
AT MEASURES THAT REQUIRE
COORDINATION OR PROACTIVE
OUTREACH FOR HANDOFFS BETWEEN
SYSTEMS LEADING HOW FALLS BELOW
NATIONAL BENCHMARKS. ON THIS
CHART THE BLUE BAR YES
CALIFORNIA'S PERFORMANCE AND THE
GRAYBAR IS HOW FAR WE ARE FROM
THE NATIONAL MEDIAN. FOR EXAMPLE
ONLY SEVEN POINT 60% OF PEOPLE
WHO ARE SEEN IN THE E. D. FOR
SUBSTANCE USE DISORDER HAVE
FOLLOW UP WITHIN SEVEN DAYS. THE
NATIONAL MEDIAN IS DOUBLE THAT.
THEN WHEN YOU START TO BREAK
DOWN THE QUALITY. BY RAISING
ETHNICITY. THEY'RE SAYING ENACT
. IN THE QUALITY OF MENTAL
HEALTH CARE. AND PREVENTIVE CARE
AND IN PHYSICAL HEALTH CARE FOR
CHRONIC DISEASES LIKE DIABETES.
WE HAVE A LOT OF WORK TO DO IN
EQUITY. IN THE MAIN ITS PERFORM
FAILURES. IN THE COMPLEX SYSTEM
THAT WE HAVE. CALAMUS DESIGNED
TO ADDRESS. ALLEN IS ABOUT ALL
MEDICARE ENROLLEES BUT MANY OF
ITS BEST KNOWN REFORMS FOCUS ON
PEOPLE WITH COMPLEX NEEDS. KNOWN
KALYAN PARLANCE AS POPULATIONS
OF LOCUSTS. THERE ARE MILLIONS
OF PEOPLE WITHIN THIS. CATEGORY
AND THEIR NEEDS ARE OFTEN
INTERSECTIONAL. THIS SLIDE IT
TENDS TO PUT A SIDES AROUND THEM
AND SHOW HOW THERE ARE DIFFERENT
OVERLAPS IN INTERSECTIONS
BETWEEN. YOU'LL HEAR A LOT MORE
ABOUT THE SPECIFIC ACCOUNTING
PROGRAMS FROM DH CS. TAKING A
LONG VIEW OF THE MEDICAL PROGRAM
IN ITS HISTORY. HERE ARE SOME
AREAS WHERE WE THINK CALAMP HAS
THE POTENTIAL TO ADDRESS SOME
LONGSTANDING ISSUES A MEDIC CAL
THAT ARE IMPORTANT FOR ALL
ENROLLEES. LOWER PAYMENT RATES
RELATIVE TO MEDICARE. WE CAN
CENTERS FOR MANAGED CARE
PERFORMANCE. LACK OF A
STANDARDIZED APPROACH TO
POPULATION AND MANAGED CARE PLAN
WHICH MAKES COMPARISONS AND
OVERSIGHT QUITE DIFFICULT. AN
INCONSISTENT OVERSIGHT ACROSS
SYSTEMS. ALLEN ALSO HAS THE
POTENTIAL TO ADDRESS ISSUES TO
GET IN THE WAY THE DANCING
PEOPLE CENTRED KERR. HAS A
MYRIAD OF PROGRAMS AND REFORMS
FOR PEOPLE WITH COMPLEX NEEDS.
PLEASE REFORM SEEK TO ADDRESS
THE HISTORICAL AND LACK OF
ACCOUNTABILITY FOR TWENTY THE
COMPLEX SYSTEMS THAT WE HEARD
ABOUT. IN WHICH PEOPLE OF ALL
THE CRACKS AND HAVE TROUBLE
NAVIGATING THEM. MISALIGNED
INCENTIVES ACROSS THE SYSTEM
WHERE WRONG POCKETS PROBLEMS
ARISE. THESE ARISE WHEN ONE
ORGANIZATION IS BEST PLACE TO
MAKE AN INVESTMENT BUT IT'S
ANOTHER ORGANIZATION ANOTHER
POCKET. THAT BENEFITS FROM THE
INVESTMENTS. THE END RESULT IN
UNDER INVESTMENT. POOR
COORDINATION IN TIMES OF
TRANSITION LIKE DISCHARGE FROM
THE HOSPITAL OR NURSING HOME
AFTER A HEALTH CRISIS. FOR
RELEASED FROM JAIL AFTER AN
ARREST. IT'S WORTH A REMINDER
THAT ONE MILLION PEOPLE CYCLE TO
CALIFORNIA'S JAILS AND PRISONS.
80% OF THEM ARE ELIGIBLE FOR
MEDICARE AND UPWARDS OF 40% HAD
BEHAVIORAL HEALTH NEEDS. LOSING
UNDER SECTION MEDIC HAL. AND IF
YOU SLICE THE TALK ABOUT THE
INTERSECTION BETWEEN HEALTH AND
HOMELESSNESS. OF COURSE
EXPERIENCING HOMELESSNESS ITSELF
IS DRAMATIC. BUT IT'S IMPORTANT-
MEMBER AND THEY CAN ALSO TAKE A
TERRIBLE TOLL ON PEOPLE'S
PHYSICAL AND MENTAL HEALTH. ACT
MORE THAN A HUNDRED TWENTY FIVE
THOUSAND PEOPLE ALMOST HALF OF
ALL PEOPLE EXPERIENCING
HOMELESSNESS TO TWENTY TWENTY
ONE. REPORTED HAVING A LONG TERM
DISABLING CONDITION. AND THE ON
HOUSE POPULATION WITH THESE
CONDITIONS CONTINUES TO GROW UP
79% SINCE TWENTY SEVENTEEN. AND
GROWING 50% FASTER THAN THE
GROWTH IN THE OVERALL AND HAS
POPULATION. IT'S ALSO WORTH
NOTING THAT MORE THAN 40% OF
PEOPLE EXPERIENCING HOMELESSNESS
ARE EITHER UNDER EIGHTEEN. OR
OVER FIFTY FIVE. PLEASE MENTAL
AND PHYSICAL HEALTH CONDITIONS
AMONG OTHER FACTORS CONTRIBUTE
TO THE FACT THAT PEOPLE
EXPERIENCING HOMELESSNESS ARE
HOSPITALIZED AT FIVE TIMES THE
RATE OF THEIR HOUSED PEERS.
THESE HOSPITALIZATIONS
DISPROPORTIONATELY IMPACT BLACK
AND AMERICAN INDIAN ALASKAN
NATIVE POPULATIONS. LET'S TALK
ABOUT THIS LARGELY IN TERMS OF
NUMBERS AND FACTS AT THE END OF
THE DAY IT'S ABOUT PEOPLE. WE'VE
PULLED TOGETHER SOME STORIES TO
HELP BRING THE NUMBERS TO LIFE.
AND ENCOURAGE YOU TO LISTEN TO
SOME OF THEM TO BETTER
UNDERSTAND WHY THIS WORK IS SO
IMPORTANT. THE CLOSING
SUCCESSFUL IMPLEMENTATION OF
CALENDAR IS CRITICAL TO MAKING
SURE PEOPLE LIKE ROSALIND GET
THE CARE THEY NEED WHEN THEY
NEED IT. THANK YOU AGAIN FOR THE
OPPORTUNITY TO SPEAK TO YOU
TODAY. LAURA THANK YOU- AS I
INDICATED WHEN WE OPENED THIS
PANEL IS GOING TO GIVE US. THE
HIGH LEVEL COMPREHENSIVE
OVERVIEW OF THE CAL AIM
INITIATIVE SO REALLY APPRECIATED
THE- DEBT THAT YOU WANTED TO AND
WILL NOW HEAR FROM CHAU BASS
WHO'S THE- DIRECTOR OF THE
DEPARTMENT OF HEALTH CARE
SERVICES MICHELLE. MORNING MADAM
CHAIR AND MEMBERS MACHEL BOSS
DIRECTOR OF THE DEPARTMENT OF
HEALTH CARE SERVICES THANK YOU
FOR THE OPPORTUNITY TO BE HERE
TODAY TO PROVIDE A BRIEF
OVERVIEW OF CAL AIM AND THANK
YOU FOR YOUR SUPPORT AND
PARTNERSHIP ON CALTRAIN. ALLEN
IS OUR LONG TERM INITIATIVE TO
IMPROVE HEALTH OUTCOMES AN
ACCIDENT YOUR MEDICAL DELIVERY
SYSTEM AND PAYMENT REFORMS
IMPLEMENTED OVER A NUMBER OF
YEARS. ONE OF OUR TOP PRIORITIES
IS TO THE LITTLE BIT DELIVER
HIGH QUALITY CARE BY IMPROVING
AND STREAMLINING THE MEDICAID
EXPERIENCE FOR THE CALIFORNIANS
THE PROGRAM SERVES. AS VERY
COMPREHENSIVELY OUTLINING YOUR
HEARING MATERIALS AND AS STATE
MEDICAID DIRECTOR J. C. COOPER
WILL SPEAK TO YOU IN DETAIL.
ALLEN INCLUDES INITIATIVES THAT
ADDRESS MEMBERS WITH COMPLEX
NEEDS. LOOKS UPSTREAM TO
PRIORITIZE PREVENTION AND WHOLE
PERSON CARE. STRENGTHENS THE
STATE'S BEHAVIORAL HEALTH
CONTINUUM OF CARE FOR ALL
CALIFORNIANS AND PROMOTES BETTER
INTEGRATION WITH PHYSICAL HEALTH
CARE. AND ADDRESSES POOR HEALTH
OUTCOMES AND DISPROPORTIONATE
RISK OF ILLNESS AN ACCIDENTAL
DEATH AMONG JUSTICE INVOLVED
MEDICARE ELIGIBLE ADULTS AND
YOUTH. AS THEY RE ENTER THEIR
COMMUNITIES AS JUST EXAMPLES.
MEMBERS WITH COMPLEX NEEDS ALL
HAVE THEIR HEALTHCARE AND HEALTH
RELATED SERVICES COORDINATED
THROUGH ENHANCED CARE
MANAGEMENT. I WILL ALSO HAVE
ACCESS TO COMMUNITY SUPPORTS
WHICH ADDRESS MANY OF THE SOCIAL
DRIVERS OF HEALTH. SUCH AS
HOUSING TRANSITION NAVIGATION
SERVICES DIVERSION TO ASSISTED
LIVING FACILITIES. PERSONAL CARE
AND HOMEMAKER SERVICES MEDICALLY
SUPPORTED MEALS. WERE ALSO
MOVING MEDICAL TOWARD A
POPULATION HEALTH APPROACH THAT
PRIORITISES PREVENTION AND WHOLE
PERSON CARE FOR MEMBERS
THROUGHOUT THEIR LIVES. THIS
APPROACH EXTEND SUPPORTS AND
SERVICES BEYOND HOSPITALS AND
HEALTH CARE SETTINGS DIRECTLY
INTO CALIFORNIA'S COMMUNITIES.
THE BEHAVIORAL HEALTH COMPONENTS
OF CALIBER DESIGNED TO SUPPORT
WHOLE PERSON INTEGRATED CARE AT
MOVIE ADMINISTRATION OF MEDIC
HEALTH BEHAVIORAL HEALTH TO A
MORE CONSISTENT AND SEAMLESS
SYSTEM BY REDUCING COMPLEXITY
AND INCREASING FLEXIBILITY.
THESE REFORMS COMPLEMENT THE
SIGNIFICANT INFRASTRUCTURE
INVESTMENTS SUCH AS THE
BEHAVIORAL HEALTH CONTAINMENT
INFRASTRUCTURE PROGRAM.
BEHAVIORAL HEALTH BRIDGE HOUSING
AND THE CHILDREN AND YOUTH
BEHAVIORAL HEALTH INITIATIVES.
WE ARE CHANGING THE WAY WE
PROVIDE CARE GETTING INTO THE
COMMUNITIES AND ENGAGING WITH
NONTRADITIONAL PROVIDERS WORKING
UPSTREAM AND WITH OUR COMMUNITY
PROVIDERS TO WRAP HEALTH AND
HEALTH RELATED SERVICES. TO DO
THIS WE ARE INVESTING
SIGNIFICANT RESOURCES AND THE
BUILDING UP OF THIS COMMUNITY
INFRASTRUCTURE THROUGH PATH
BECAUSE WE KNOW THAT IF WE'RE
TRULY GOING TO ADDRESS THE
SOCIAL DRIVERS OF HEALTH WE NEED
TO BRING NEW COMMUNITY BASED
PROVIDERS INTO THE PROGRAM. WE
WON'T ADDRESS EQUITY UNLESS WE
DO SELL. TOGETHER WITH OUR
MANAGED CARE PLAN PARTNERS WE
HOPE TO SET A NEW STANDARD OF
CARE THAT CAN SERVE AS A MODEL.
WE ARE CURRENTLY GOING
THROUGHOUT THE STATE ON A
LISTENING TOUR TO HEAR FROM OUR
IMPLEMENTATION PARTNERS ALL
THINGS ARE GOING AND WHAT'S
WORKING AND WHAT IS CHALLENGING.
WHAT STRUCK ME ABOUT LAST WEEK
AT ONE OF OUR MEETINGS WHICH ARE
CONVENED BUYER MEDICAID MANAGED
CARE PLANS WITH THAT IN ADDITION
TO THE NORMAL HEALTHCARE
PARTNERS HOSPITALS CLINICS
PROVIDER GROUPS THE COUNTY
SUPERINTENDENT OF EDUCATION THE
SHERIFF'S OFFICE PROBATION FIRST
FIVE THE LOCAL PUBLIC HEALTH
DEPARTMENT SOCIAL SERVICES
DEPARTMENT. COUNTY WORKFORCE
DEPARTMENT SENIOR SERVICES WERE
IN ATTENDANCE THIS
TRANSFORMATION IS PULLING
TOGETHER LOCAL PARTNERS THAT USE
DIFFERENT LANGUAGES AND HAVE
TRADITIONALLY WORKED
INDEPENDENTLY. THIS IS THE
FUTURE OF MANY CAL. AND WHY ARE
NEW MEDICAID MANAGED CARE
CONTRACT THAT GOES INTO EFFECT
IN TWENTY TWENTY FOUR IS IN
TROUBLE TO THIS TRANSFORMATION.
THE NEW CONTRACT IS RAISING OUR
EXPECTATIONS OF MEDICAID MANAGED
CARE PLANS CREATING MORE
TRANSPARENCY ACCOUNTABILITY
EQUITY QUALITY AND VALUE WHICH
WILL IN TURN TRANSLATE INTO
BETTER HEALTH OUTCOMES. FOR
CALLIE OPPORTUNITY FOR
TRANSFORMATION AND OUR NEW
CONTRACT WITH A MANAGED CARE
PLANS. WE ARE AT A PIVOTAL TIME
IN THE MEDICARE PROGRAM. WE'RE
PUSHING OUTSIDE OF HEALTHCARE
SHE FOUR WALLS AND PROMOTING
BETTER PARTNERSHIP AND
INTEGRATION WITH OTHER SECTORS.
WHICH ULTIMATELY WILL LEAD TO
BETTER OUTCOMES FROM OUR
MEMBERS. THANK YOU FOR THE
OPPORTUNITY TO BE HERE TODAY.
RESPONSE THE YOU VERY FOR THAT
AND- NOW. WE WILL HEAR FROM G.
C. COOPER WHO IS THE CHIEF
DEPUTY DIRECTOR AND CALIFORNIA
MEDICAID DIRECTOR FROM. YOUR
DEPARTMENT. GOOD MORNING- I'M
MICHELE- MENTIONED- CALAMY
COMPASSES VERY BROAD BASED THAT
DELIVERY SYSTEM PROGRAM AND
PAYMENT REFORMS I'M AND I WILL
HAVE THE OPPORTUNITY TO WALK
THROUGH WITH A HIGH LEVEL. OF
SOME OF THOSE INITIATIVES BUT I
LOOK FORWARD TO THAT THE BACK
AND FORTH DIALOGUE GIVEN THE
OVERVIEW WILL BE- HIGH LEVEL.
ONE THING I WANT TO EMPHASIZE
WHEN IT COMES TO CALAIS AND
SINCE IT IS A LARGE
TRANSFORMATION AS MICHELLE
CLEARLY OUTLINED. IT IS MEANT TO
BE IMPLEMENTED OVER MULTIPLE
YEARS. AND THAT'S AN IMPORTANT
THING FOR US TO REMEMBER- THE
INITIATIVE IS LARGE IT'S COMPLEX
IT'S REALLY MEANT TO BUILD ON
YOUR OVER YOUR POLICY. I'M SO
NOW I WILL PROVIDE AN OVERVIEW
OF THE VARIOUS KALYAN
INITIATIVES AND UPDATE OF. WHERE
WE ARE ON THIS VARIOUS
INITIATIVES. ONE OF THE
CORNERSTONES OF POWER IS REALLY
THE- HEALTH MANAGEMENT PROGRAM.
THAT USES EVIDENCE BASED
PRACTICES IN DATA ANALYTICS TO
CLOSE GAPS IN CARE AND DRIVE
DELIVERY SYSTEM ACTIVATION TO
IMPROVE OUTCOMES. IT'S REALLY
FOCUSED ON MANY OF THE THINGS
THAT WERE JUST OUTLINED BY C. H.
YES AND THAT'S REALLY THE
BACKBONE OF WHAT WE'RE DOING.
POPULATION HEALTH MANAGEMENT IS
ABOUT ENGAGING MEMBERS AS OWNERS
OF THEIR OWN CARE BROUGH
PREVENTATIVE CARE EARLY
INTERVENTIONS BURKE RISING RISK
PATIENT CENTERED DISEASE
MANAGEMENT. IN IMPLEMENTING
HOLISTIC CARE FOR HIGH RISK
POPULATIONS INCLUDING ADDRESSING
SOCIAL DRIVERS AT FAULT. IT ALSO
REDESIGNS CRITICAL TRANSITIONS
IN CARE WHETHER THAT'S FROM
JAILS OR FROM AN INSTITUTIONAL
LEVEL OF CARE BACK INTO THE
COMMUNITY MAKING SURE THAT OUR
PHONE CONTINUUM IS WORKING AS
INTENDED. TO SUPPORT THE
POPULATION HEALTH MANAGEMENT
PROGRAM DCS IS DEVELOPING A
POPULATION HEALTH PLATFORM AS
WELL ESSENTIALLY AN ANALYTICAL
BACKBONE THAT WILL GIVE MEMBERS
ACCESS TO THEIR OWN DATA. AS
WELL AS PLANS PROVIDERS AND
PARTNERS THE ABILITY TO ACCESS
INTEGRATED DEEP DATA ACROSS
MEDIC CAL AS WE ALL KNOW MEDI
CAL CAN SEEM SIDE ROAD AND
SEPARATED WE HAVE LOTS OF
DIFFERENT SYSTEMS OF CARE FOR
ONE PERSON AND WE WANT TO BRING
. ALL OF THAT DATA TOGETHER FOR
PEOPLE. THE POPULATION MAY
PROGRAM LAUNCHED JAN OF THIS
YEAR YOUR ONE FOCUSES ON MANAGED
CARE PLANS BUILDING A
COMPREHENSIVE. POPULATION HEALTH
MANAGEMENT STRATEGY UPDATING THE
POPULATION NEEDS ASSESSMENT IN
PARTNERSHIP WITH THE LOCAL HELP
JURISDICTIONS AND BEHAVIORAL
HEALTH PARTNERS. STREAMLINING
INITIAL MEDIC CALLOUS ASSONANCE
BY DELEGATING THE HEALTH
INFORMATION FORM FOR MEMBERS
VALUATION TOOL ALSO KNOWN AS THE
IF MEANT TO PROVIDERS AND
FOCUSING ON PROVIDER DRIVEN
INITIAL HEALTH ASSESSMENT. LIMON
NEEDING MULTIPLE DUPLICATE
ASSESSMENTS FOR OUR MEDICARE
BENEFICIARIES WHO SAID THAT THEY
WERE HAVING ASSESSMENT FATIGUE
IN OUR PROGRAM. THIS IS A
LIMITED THINGS LIKE THE AYE HE
BUT SHOT SOMETHING THAT WAS NOT
SEEN AS EVIDENCE BASED AND WAS A
LONG STANDING AND MEDICARE. SO
STREAMLINING THE MEMBER
EXPERIENCE AND PROVIDER
EXPERIENCE FUTURE YEARS I WILL
INCLUDE RISK TEARING AND
STRATIFICATION AS WELL AS
ADDITIONAL POPULATION FOLKS
FOCUSED STRATEGIES. DHT HAS
TWENTY SIX ALL COVER OFFICE
HOURS AND PUBLIC STAKEHOLDER
ENGAGEMENT TECHNICAL ASSISTANCE
EVENTS THROUGH TWENTY TWENTY TO
TWENTY FORM THIS WORK AND WE'RE
REALLY EXCITED TO SEE IT.
GETTING OFF THE GROUND BUT THIS
YEAR. AND WEBER. A WHOLE LIST
HERE- AS A MENTION FOR HIGH RISK
POP. ARE YOUR DH YES IMPLEMENT
AND HAND CARE MAN THREE OF. YOU
HEARD. BOTH PANELISTS PRE. TALK
ABOUT HOW IMPORTANT THESE ARE
I'M CALLIN IS REALLY TO BREAK
DOWN THE FOR WALLS OF. NEED
PEOPLE WHERE THEY ARE WHICH CAN
INCLUDE ON THE STREET IN A SHOW.
IN SOME HOME. OUR APPROACH WAS
BUILT OFF OF PERSON CARE PILOT
AND THE HELP HOME AND ISSUED
ACROSS STATE. AN INDEPENDENT
EVALUATION OF THE PILOTS
DEMONSTRATED THAT THESE
INVESTMENTS- DECREASED EMERGENCY
DEPARTMENT VISITS INPATIENT
SERVICES CONNECTED MEMBERS WITH
NEEDED CARE IN REDUCED OVERALL
****. TWENTY TWENTY TWO DH CS
TRANSITION WITH THE WHOLE PERSON
CARE AND HELP COMES POPULATIONS
TO ECM COMMUNITY SUPPORTS WE
WENT LIVE STATEWIDE WITH ADULTS
EXPERIENCING HOMELESSNESS SERIES
BEHAVIORAL HEALTH CONDITIONS AND
HIGH UTILIZED ERRORS. IN TWENTY
TWENTY THREE WE IMPLEMENTED
ENHANCE CARE MANAGEMENT FOR
INDIVIDUALS A LONG TERM CARE
SETTINGS AS WELL AS PREVENTING
THOSE SKILLED NURSING FACILITY
ADMISSIONS IT'S JUST WATCHED.
FROM JULY WE WILL BE LAUNCHING
POPULATIONS OF FOCUS FOR
CHILDREN AND IN TWENTY TWENTY
FOUR WILL BE FOCUSED ON BURKE
EQUITY AND. OUR JUSTICE INVOLVED
POPULATIONS. ORDER THREE OF
TWENTY TWENTY TWO WE HAVE NINE
HOW AND FIFTY SIX. ECM PROVIDERS
ACROSS THE OF CALIFORNIA AND
PROVIDED SERVER TO OVER EIGHTY
EIGHT THOUSAND UTILIZED EARS OF
ENHANCE CARE MANAGEMENT. FIRST
TIME MEMBER- ECM IN THE WORLD
THAT HAS INCREASED SINCE EASY A
BENEFIT WENT LIVE AND WE KNOW
THAT IT WILL CONTINUE TO
INCREASE IBM SAID IT IN INTO OUR
DELIVERY SYSTEM. ALSO THREE
QUARTERS OF TWENTY TWENTY TWO WE
HAD ONE THOUSAND TWO HUNDRED AND
TWELVE COMMUNITY SUPPORT
PROVIDERS AND OVER TWENTY SEVEN
THOUSAND MEMBERS RECEIVING AT
LEAST ONE COMMUNITY SUPPORT.
SERVICE AT LEAST SIX COMMUNITY
SUPPORTS ARE AVAILABLE IN EACH
COUNTY ACROSS THE ENTIRE STATE
OF CALIFORNIA. AND THEY'RE
THIRTY EIGHT COUNTIES WITH AT
LEAST TEN OF THE FOURTEEN
COMMUNITY SUPPORT IN THIRTEEN
COUNTIES ALREADY OFFERING ALL
FOURTEEN COMMUNITY SUPPORT
AVAILABLE THROUGH CALAIS. WE
THINK THIS IS A GREAT EXPANSION
FOR THE FIRST YEAR OF LAUNCHING
BUT WE KNOW THAT WE HAVE A LOT
OF GROUND TO COVER. THERE HAVE
BEEN LESSONS LEARNED FROM WHOLE
PERSON CARE THIS TYPE OF
TRANSFORMATION TAKES TIME MANY
OF OUR PILOTS NEEDED A YEAR OR
TWO TO REALLY FINE TUNE THEIR
PROCESS SEES. THEIR
IMPLEMENTATION AND THE MODELS OF
CARE AND SO WE ARE COMMITTED TO
WORKING WITH OUR PARTNERS TO
MAKE SURE THAT WE- BRING THOSE
LEARNING STATEWIDE AND THAT WE
BUILT THAT. TO RECOGNIZE THAT A
DH CS PRODUCED SEVERAL GUIDANCE
DOCUMENTS TO HELP EASE THE
TRANSITION INTO CALAIS. WE
RELEASED A GUIDANCE ON BILLING
AND INVOICING PROVIDER
ENROLLMENT CODING GUIDANCE THE
TO SHARE AND GUIDANCE. TO REALLY
TRY TO PROVIDE COMPREHENSIVE
TECHNICAL ASSISTANCE FOR OUR
PROVIDERS THIS IS A HUGE WHAT
ESPECIALLY FOR SOME OF OUR
PROVIDERS WHO ARE NONTRADITIONAL
MEDICAL PROVIDERS. SO THEY'RE
LEARNING MEDICAID AT THE SAME
TIME AND THAT IS A HUGE LEFT WE
HAVE DONE POSTED SPOT SPOTLIGHT
SERIES. AND PUBLIC WEBINARS
OBTAINING REALLY TO REVIEW AND
REINFORCE OUR POLICY GUIDANCE WE
HAVE IDENTIFIED AN AMPLIFIED THE
BEST PRACTICES AND LESSONS
LEARNED FOR MANY OF OUR
PROVIDERS. BRINGING THOSE PEOPLE
ON THE GROUND TO SHARE THAT
INFORMATION AND LEARNINGS BUT
BOTH MANAGED CARE PLANS AS WELL
AS OTHER PROVIDERS. WE'VE BEEN
RESPONDING TO EMERGING QUESTIONS
FROM THE FIELD AND PROVIDING
FEEDBACK LOOPS WITH OUR
PROVIDERS AND AS MICHELLE
MENTIONED WE KICKED OFF A
STATEWIDE LISTENING TOUR. TO GO
AROUND THE STATE IN HERE HOW ARE
THINGS GOING AND WHERE DO WE
NEED SOME IMPROVEMENT.
TRANSFORMATION THIS LARGE I NEED
THAT OF ON THE GROUND LISTENING
WE ARE. CAN TO THAT. SOME OF THE
EARLY I. CHALLENGES THAT WE HAVE
HEARD FROM ON THE PROVIDERS AND
PLAN SB GONE AWRY THE STATE. AND
IN A PROVIDER GROUP. IDENTIFYING
THAT THERE ARE PRETTY LARGE
WORKFORCE SHORTAGES. HEARING
THAT SOME THE TEAM ARE STRONG TO
FIT HIRES. TO MEET THE NEEDS
ACROSS. WE ALSO WE'RE HEARING IN
THE NO ROUTE ON THAT THEORY IS
HOUSING AND HOMELESSNESS
HEARINGS HAVE TAKEN PLACE. THERE
IS A LACK OF AFFORDABLE HOUSING
FOR THE THREE PRO. OF SOME OF
THE SERVICES AND WE'RE WORKING
VERY CLOSELY WITH OUR PARTNERS
TO MAKE THOSE CONNECTIONS.
TRINITY BATES ORGANIZATIONS ARE
UNFAMILIAR WITH BUILDING IN THAT
ACCOUNT AND SO WE'VE DONE
EXTENSIVE TECHNICAL ASSISTANCE
TO HELP WITH SOME OF THAT. BUT
THERE'S STILL A SCARCITY OF
INFRASTRUCTURE AND RESOURCES IN
CERTAIN PARTS OF THE STATE.
WHERE THERE ARE ADDITIONAL YOU
KNOW DEMAND THEN WE ARE ABLE TO
SERVE AND SO WE ARE WILL WORKING
TO BUILD THAT INFRASTRUCTURE AND
I WILL WALK THROUGH SOME OF THE
WAYS IN WHICH WE'RE DOING NOW.
AND MISS- COOPER- JAKE TIME FOR
THE OTHER PAN. IF YOU DON'T
WANT- ACCELERATE A BIT BECAUSE
YOU WE WILL BE ABLE CALL AND- AS
QUESTION COME. LATER ALSO
SEPARATE. SO I WILL WALK THROUGH
OF THE PIECES I WILL ALSO JUST
BY- WE HAVE- IN CENTER PROGRAMS
THE CAL CENTER PROGRAM- WAS
REALLY FOCUS. ON IT BILL UP THAT
. IN AND THE COMMUNITY SUPPORT-
ALL MANAGED CARE PLANS TO SUBMIT
A NEED JUST. ONE THING I WOULD
POINT OUT WHICH I THINK IT'S
IMPORTANT WE ALSO REQUIRED ALL
PLANS TO IDENTIFY POPULATIONS-
BUT DISPARITIES. AND ALL OF OUR
MANAGED CARE PLANS FIRST
REPORTED DISPARITIES- OF
INDIVIDUALS WHO IDENTIFIED IT AS
AS BLACK. A MEMBERS. OTHERS HAD
SAID THAT THEY ALSO SAW
DISPARITIES AROUND HISPANIC OR
LATINO NATIVE AMERICAN AND MIXED
RACE. HOWEVER WHAT WE'RE SEEING
IN OUR EARLY DATA IS THAT BLACK
MEMBERS BOB HAVE AN APPROXIMATE
7% OF MEDIKAL POPULATION- IN FOR
EXAMPLE CAN OFTEN SHOPPERS BACK
MEMBERS OF. 3240% OF OUR
HOMELESS POPULATION EARLY DATA
SHOWING THAT 22% OF OUR ECM IS
BEING PROVIDED TO INDIVIDUALS
WHO ARE. BLACK AND 33% OF OUR
COMMUNITY SUPPORTS SO WE'RE
REALLY FEELING LIKE THERE HAS
BEEN A FOCUS IN REGARDS TO
CLOSING SOME OF THOSE
DISPARITIES TO ENSURE PEOPLE ARE
GETTING ACCESS TO SOME OF THESE
SERVICES. I'M AN ADDITIONAL WAY
THAT WE ARE GETTING- DOLLARS OUT
TO PROVIDERS TO GROW THAT
CAPACITY IS THROUGH A PATH. THAT
WE HAVE A LEARNING
COLLABORATIVES WE HAVE GRANT
FUNDING AND WE HAVE WHAT'S
CALLED A T. A MARKET PLACE I'M
SOME OF OUR EARLY PIECES WE HAD
TWO HUNDRED THIRTY SEVEN
APPLICATIONS. A TOTAL OF FIVE
HUNDRED AND FIFTY NINE MILLION
IN AROUND ONE. OBVIOUSLY WE ONLY
HAD AROUND A HUNDRED MILLION TO
GRANT SEVEN IN JANUARY THIRTY
FIRST BE ANNOUNCED- ONE HUNDRED
AND NINETEEN MILLION TO NINETY
EIGHT ORGANIZATIONS IN MARCH
WILL BE ANNOUNCING ANOTHER FORTY
ONE- GRANTS FOR IT NOT AN
ADDITIONAL HUNDRED MILLION
DOLLARS. TO REALLY GETTING
DOLLARS TO PROVIDERS- ALSO GIVE
SOME UPDATES QUICKLY ON OUR DUAL
ELIGIBLES SO WE- ARE- OUT OF
TIME. BUT OKAY BUT THEN WILL IT
BE MORE THAN HAPPY TO ANSWER.
SORRY CAROLINE IS EXTREMELY
CONFIDENT COMPANIES. ASSET TO
GIVE INFO. OF ALL THE- THAT HAVE
TO ANSWER QUESTION. THAT YOU
HAVE. I APPRECIATED VERY
CONCRETE- I KNOW- MEMBERS OF THE
COMMITTEE WILL HAVE LOTS OF
QUESTIONS AND WE STILL HAVE TWO
MORE PANELS SO- AND I THERE WAS
MORE YOU- DEFINITELY TELL US IN
. PRECAP THAT WE ARE HALF THIS
LIMITED TIME BUT I KNOW I AM
EXPECTING THAT PEOPLE WILL ASK
YOU QUESTIONS. ALL RIGHT WE WILL
NOW MOVE TO THE NEXT PANEL. AND
THAT IS ON ENHANCE CARE
MANAGEMENT A COMMUNITY SUPPORTS.
AND THE FOLKS THAT ARE ON THIS
PANEL. ARE BASICALLY- WITH. THE-
IS. THE INSTITUTE OR THE
ENTITIES THAT ARE IMPLEMENTING.
DELIVERING THE CARE OR FOR BEING
THE ADVOCATES FOR THOSE WHO ARE
DELIVERING THE CARE SO WHAT-
THEY'RE BASICALLY THE ONES WHO
ARE PROVIDING THE COORDINATION
OF CARE FOR HIGH NEED
POPULATIONS AND THE CONNECTIONS
TO SERVICES. AS YOU'VE ALREADY
HEARD THERE'S NOW THE ABILITY TO
USE MEDICARE TO FIND SOME OF
THOSE SERVICES. SO LET ME
INTRODUCE QUICKLY WHO IS ON THIS
PANEL AND THEN I WILL HAVE- THE
FIRST SPEAKER STARTS WE HAVE
LINEA COUPONS WHO IS THE CHIEF
EXECUTIVE OFFICER OF LOCAL
HEALTH PLANS OF CALIFORNIA. WE
HAVE GREG GARRETT WHO IS THE
CHIEF OPERATING OFFICER OF THE
NATIVE AMERICAN HEALTH CENTER IN
. OAKLAND WE HAVE LINDA. NEWEY
AND I HOPE YOUR CORRECT SENIOR I
FROM THE WESTERN CENTER ON LAW
AND POVERTY AND KIERAN SAVAGE
THING ONE WHO IS THE EXECUTIVE
DIRECTOR OF THE CALIFORNIA PAN
ETHNIC HEALTH NETWORK AND LET US
START WITH. F. GLAD LEN S. RIGHT
GOOD MORNING CARING COMMITTEE
MEMBERS. PLANNING COULD MEAN FOR
THE LOCAL HEALTH PLANS OF
CALIFORNIA POLICE PC REPRESENTS
THE SIXTEEN LOCAL COMMUNITY TAKE
MEDIC HAL. CARE PLANS SECKEL
ACTIVELY SERVE OVER 70% OF
MEDICARE MANAGED CARE
BENEFICIARIES. DURING FOREIGN
IMPLEMENTING TALLYING OVER THE
LAST YEAR HAS A TRUE. EFFORT
INVOLVED MULTIPLE. AT A LOCAL
LEVEL. I'LL SHARE SOME OF OUR
EXPERIENCES INCLUDING A
SUCCESSFUL TRANSITION FROM WHOLE
PERSON CARE AND HEALTH AND. RYAN
REAL MAN AND BEAST AND SUPPORT
OVER THE LAST YEAR. REALIZING
THE VISION BEHIND CALLING MULTI
BE OKAY EFFORT. I ALLEN
LAUNCHING TWENTY THE STAR POINT
LOCAL PLAN TO DEVELOP NETWORKS
EACH THE AND CAN. PARKS BUT IF
THE A REALLY. AND INTERESTS.
THAT'S REQUIRED CLOSE WORK WITH
THAT OPERATE PERSON PILOT. ARE
PLANNED FOR TODAY AND HEALTH
FROM. IT ALSO IN. WITH THESE
PROVIDE CAN AND THINK HOW. PRIOR
TO MANY LOW PLANNED FOR BY AGREE
PROGRAMS DELIVER STERN BETTER
NOW CAN YOU SUPPORT. INCLUDING
INCLUDING HOUSING REAL SERVICE.
CUNNINGHAM RELATIONSHIP WITH THE
COMMUNITIES TO TRUMP. THE
EXPANDED. TO DELIVER EACH AND
COMMUNITY LOCAL PLAN I DON'T
WHICH- ARE ALREADY SERVING AND
MAN. AND HER CAN YOU SUPPORT
LOCAL PLANS CAN THE COMMUNITY OR
- AND PROVIDER BUT THE LIVE TO
ME SUPPORT THIRD. THAT HAVE
HISTORICALLY THE SERVICES
OUTSIDE OF. THE IN THAT
INCLUDING THE AND COUNTRY
PAYMENT PROGRAMS AND HOUSING AND
HOW. AND PAINTED PROGRAM AND
ALSO BANNED LOOK INTO TO BE
INTERNET AND KERR TO DO AND
CAPABILITIES. THE CONTRACT TO
PROVIDE SERVICES. TO GET IPP
DOLLARS OUT INTO THE CAN YOU.
WELCOME HAVE AWARDED GRANTS TO
PROVIDER PARTNERS HELP SUPPORT
STAFFING COSTS EIGHT EIGHT AND
FIRST. AND TRAINING. AND WITH
EIGHTY IP THE IMPACT OF PROGRAM
THE IS A PART STATE HOW AND CAN
YOU BASED PLAN. I FIND HAS
SUPPORTED STRENGTHENING THE
RELEASE COURTNEY AND NEED TO
BETWEEN HOUSING FOR AND PLAN. IN
ORDER TO THAT A MEMBERS AND I
COMMUNITY SERVICES WILL GO PLANS
IDENTIFY OLD LOW MEMBERS THROUGH
THE DATA AND SHARE THESE
ELIGIBLE LIST BUT CONTRACT
PROVIDER TO CONNECT OUTREACH.
YOU KNOW THAT THEIR LIMIT THREE
DELTA LEFT AT NINE CRITERIA FOR
BOTH AND.
AS ELIGIBILITY REQUIREMENTS AND
REFERRAL PATHWAYS FOR WARM
HANDOFF IS KEY AND WILL LIKELY
BE THE BEST STRATEGY FOR MEMBER
ENGAGEMENT. FINALLY IT'S
IMPORTANT TO ACKNOWLEDGE THE
REALITIES AND CHALLENGES WITH
IMPLEMENTING CAL. FIRST ALLEN IS
NOT IN THE INTO THE WORKFORCE
CHALLENGES EXPERIENCED BY ALL
OTHER SECTORS AND SYSTEMS. AND
MANY CASES WORKFORCE SHORTAGES
HAVE IMPACTED PROVIDERS ABILITY
TO CONTRACT OR IF THEY DO
CONTRACT IT INTACT HOW MANY
BENEFICIARIES ARE ABLE TO CARE.
I CAN'T RURAL AREAS THAT HAVE
HISTORICALLY HAD ACCESS ISSUES
AND LIMITED COMMUNITY RESOURCES
LIKE QUITE HAS VERY FEW
PROVIDERS OR CDOS. THE SERVICE
DELIVERY AND THE CHALLENGING AND
WILL REQUIRE. CREATIVITY AND
FLEXIBILITY. NATIONALLY ALTHOUGH
SEE AN COMMITTEE THE COURT ARE
TO AND- THANK FIFTEEN NEWS AND
ACCOUNT MAY CARE. EACH THAT
REQUIRED COMMUTE RESOURCE AND
PHYSICAL IN. THE RAMPING UP
STATE WILL TIME AND LOOK
DIFFERENT BASED ON LOCAL FOR.
INCLUDE THE WAY AND WHEN EVEN IF
AND SERVICES IS CREDIT AND IT
ALL THE DIFFICULT AND OFTEN
PARTNERS FIFTEEN AND RESEARCH.
LOCAL I THEY CALLING IMPLEMENTOR
AND THERE. THAT ARE COMING
PARTNERS SUPPORTING TO THE
TALENT THE IN THE YEARS AHEAD
THANK YOU. THANK YOU VERY MUCH
NEXT UP IS- GEAR- THE NATIVE
AMERICAN HEALTH. I OF OAKLAND.
THANK YOU. YES I AM AS ON
REGULAR ON THE CHEAP OPERATING
HERE AT NEW AMERICAN HEALTH.
OKAY WEEK. IF IT DOESN'T HAPPEN
TO SERVE NATIVE A- AND ALASKA
NATIVES AND- OVER TWELVE
THOUSAND MEMBERS ABOUT TEN
PERCENT- ABOUT HERITAGE. WE HAVE
A- POPULATION- RIGHT NEXT UNITY
MEMBERS HERE IN THE PROGRAM
DISTRICT AND THAT CAN CRISIS ARE
A COUPLE OF OUR MEMBERSHIP- 10%
AFRICAN AMERICAN AND IN THE
MIDST OF A TRAVERSE COMMUNITIES.
THE NEW AMERICAN HEALTH CENTER
WE CONSIDER OURSELVES AN EARLY
ADOPTER OF CARE COORDINATION.
AND HAVE REALLY BEEN BENEFITTED
FROM BEING HERE NOW WE TO
COUNTING WHICH HAS A VERY STRONG
INTEGRATED NETWORK BETWEEN OUR
HEALTHCARE SERVICES AGENCY OUR
LOCAL INITIATIVE ALAMEDA
ALLIANCE FOR HEALTH. AND THE
HEALTH CENTER STUFF THAT
REPRESENT. THE MATTER PROPERTIES
BECAUSE OF OUR COMMUNITY. WE
HAVE HAD THIS PROCESS TO OF THAT
LEAD HAS LED UP TO INTERCOM HAS
CARE MANAGEMENT THAT'S REALLY
BENEFITTED FROM AN EVOLUTION OF
PROGRAMS HERE IN OUR COUNTY. WE
FIRST STARTED NEARLY TEN YEARS
AGO WITH A WHOSE STAFF MEMBER ON
OUR CLINIC FLOOR WHO STANDS FOR
WARM HAND OFF. AND NOT BE HERE
HEALTH CLINICIAN IS ON THE IT
STILL TO THIS DAY ON THE CLINIC
FLOOR SO THEY CAN RECEIVE WARM
HANDOFFS. FROM PROVIDERS TO FIND
NEED FOR BEHAVIOR HEALTH
SERVICES WHEN YOU'RE INTERACTING
WITH MEMBERS IN THE EXAM ROOM.
THAT WARM HANDOFF OCCURS BROWN
THE CLINIC FLOOR THAT LEADS TO
INTEGRATE IT I'M HEALTH
SERVICES. THAT PROCESS THEN
EVOLVED. IN OUR COUNTY. WITH THE
PROGRAM THE BUCK LAURA MILLER ON
THE ONLINE MILLER- CREATED FOR
CALL CARE NEIGHBORHOOD. YEAH
THAT WAS FORMED AT OUR LOCAL.
REGIONAL SO. CHTN WITH THE
SUPPORT OF SEATS. FROM OUR LOCAL
AND OUR A LINE AND THE YOU TO
SCOTT AND I CEO THERE. WHO THE
BENEFIT OF THESE. CALLS CARE
COURT PROGRAMS. CLOSE KNIT CARE
COORDINATION PROGRAM SO YOU'RE
CARE NAY. ANY INTO HER FROM
OTHER SPEAKER IN HELL HOW PILOT
AND THEN. THE WHOLE PERSON CARE
PA NOT PROGRAM YOU CAN THAT THE
FACT. FOR THE CORDON. IN END
THOUGH STATE STREET DMCS
PROGRAMS EXCELLENT PROGRAM BY
THE WAY. AND AS NOTED THE SPEECH
THE EVIDENCE PROVED ADVANTAGE
CLEAR HERE OUR OUR FOR. THAT
THESE PROGRAMS DO IN FACT DIVERT
INDIVIDUALS FROM THE EMERGENCY.
ROOM AND IMPROVE HEALTH
OUTCOMES. BOTH PROGRAMS THAT THE
WORLD IT INTO WHAT WE NOW CALL.
ECM SO WE'VE BEEN AND IN IN THIS
COLLISION OF CARE COURTNEY OCT
AND WITH IN THIS VERY PROUD NOW
. THAT WE'VE GONE FOR JUNE
COURTNEY ST- THROUGHOUT THE
PROCESS TO WITH HALF SIZE
FUNDING SO WE'RE VERY VERY VERY
CRITICAL FUNDING PROVIDED
THROUGH CALAIS. WE WERE ABLE TO
RAMP UP AND NOW WE HAVE SIX
COORDINATORS WE'VE GONE FROM
SERVING JUST OVER SIXTY MEMBERS
AND NOW WE'RE SERVING NEARLY TWO
HUNDRED AND FIFTY MEMBERS. SO
KATHLEEN HAS TREMENDOUSLY
IMPACTED OUR ABILITY TO SERVE
OUR MEMBERS AND STRIP AWAY. AND
JUST TO GIVE AN EXAMPLE. OF HOW
IMPORTANT IS THIS PROGRAM IS.
PREVIOUSLY WE WERE CHASING GRANT
DOLLARS. TO FUND THESE SERVICES
. AND WE WERE PROVIDE UNDER
UNCONFERENCE CARE BECAUSE THESE
S. T. O. H. CONNECTION PROGRAM.
ARE CRITICAL TO OUR MEMBERS WILL
BE ABLE TO THEIR HEALTH AND TO
THEIR TO THEIR OUTCOMES. NOW WE
HAVE CALTRAIN AND THROUGH THE
EVOLUTION HOMES AND LOW PERSON
CARE WE'RE NOW ABLE TO BUILD A
SUSTAINABLE CARE COORDINATION
SYSTEM WITHIN OUR AGENCY AND ONE
AS WE'RE WATCHING IT BUILD
WITHIN OUR COUNTY. AND THIS
SYSTEM IT IS CRITICALLY
IMPORTANT BECAUSE THESE ARE
SERVICES THAT UNFORTUNATELY OUR
PROVIDERS HAD TO PROVIDE. WE
HAVE DOCTORS WE HAVE NURSES WE
HAD MEDICAL ASSISTANCE MAKING
LINKAGES TO TRANSPORTATION
SERVICES TO ME ALL PROGRAMS.
COMPLEX AND- SINCE. TO GET INTO
CALFRESH TO GET IN MY ACCOUNT TO
GET AN STI. X. PRESENTATION BY
C. AFTER IN THE COMP.
HEALTHCARE'S THAT OUR PATIENTS
HAVE TO NAVIGATE AND THAT WAS
TAKING AWAY TIME FROM OUR
PROVIDERS BEING IN THE EXAM ROOM
PROVIDING THE CRITICAL CLINICAL
SERVICES. THAT THAT ALLOWS THEM
TO PROVIDE HEALTH BENEFITS TO
OUR MEMBERS SO WE CALLED OUR
CARE COORDINATORS FORCE
MULTIPLIERS BY OUR PROVIDERS
BEING ABLE TO PROVIDE WARM
HANDOFFS TO THESE. CARE
COORDINATORS. IT ALLOWS THE
PROVIDER TO FOCUS ON THE
EXCELLENT CLINICAL CARE THAT OUR
PROVIDERS PROVIDE AND ALLOWS
CARE COORDINATORS TO PROVIDE
THE- VERY IMPORTANT CRITICAL.
SERVICE IS- TO CONNECT OUR
MEMBERS TO SB WHICH- THESE DAYS
. THAT ARE PROVIDED MORE
UPSTREAM PREVENT THE DOWNSTREAM
SUFFERING AND COSTS THAT BOTH
THE PATIENT AND THE STATE
BUDGET- ARE HAVING TO PAY FOR
SO. THESE PROGRAMS I COULD SEE
SO MUCH MORE BUT LET ME END WITH
JUST SAYING THAT. JACK WE ARE IN
ALSO CONTACT. IN SAN FRANCISCO
ACCESSIBLE HEALTH PLAN TO EXPAND
OUR ECM PROGRAMS THERE CAN WE
EXPECT A SIMILAR SIZE PROGRAM TO
BE OPERATING THERE AS WE OPERATE
THE MISSION COMMUNITY MISSION
DISTRICT COMMUNITY THERE WHICH
HAS VERY HIGH NEED FOR SUCH
SERVICES. ARE PROUD AND HONORED
TO BE HERE SPEAKING TO YOU
MEMBERS OF THE COMMITTEE THANK
YOU MADAM CHAIR FOR MEETINGS AND
BY FOR US TO BE HERE. LOOK
FORWARD TO SHARING OUR
EXPERIENCE AND TO ANSWERING. ANY
FURTHER QUESTIONS YOU MAY HAVE.
THANK YOU- GREAT PRE SHAKE THAT
. AND WE WILL HEAR FROM LYNN WAY
. WHO IS THIS PAUL ADVOCATE FROM
WESTERN ON LAW AND POVERTY LINDA
GO AHEAD. GOOD MORNING LINDA WAY
WITH QUESTIONS AN ONLINE POVERTY
. ENHANCE CARE MANAGEMENT
COMMUNITY SUPPORTS CAT AND HAS
IMPROVED THE LIVES OF MEDI CAL
MEMBERS BY BY PROVIDING
COORDINATED CARE THAT ADDRESSES
THE NEEDS OF THE WHOLE PERSON
WHEREVER THEY ARE LOCATED.
HOWEVER OUR LEGAL AID ADVOCATES
REPORT CHALLENGES ACCESSING BOTH
ENHANCE CARE MANAGEMENT AND
COMMUNITY SUPPORT. I HAVE
CLIENTS ON WAIT LISTS WITH NO
TIME FRAME ON WHEN THEY WILL
MOVE ON. THEREFORE IT'S UNDER.
THAT THE NUMBER OF MEMBERS
RECEIVING COMMUNITY SUPPORTS THE
JOB FROM QUARTER ONE TO QUARTER
TWO OF LAST YEAR INSTEAD OF
INCREASING DUE LARGELY TO THE
NUMBER OF WHOLE PERSON CARE
PILOT PARTICIPANTS RECEIVING
COMMUNITY SUPPORTS DURING THIS
TIME. BEING CUT IN HALF. THIS IS
REPORTED AS A GRADUATION OF THE
WHOLE PERSON CARE PARTICIPANTS
NO LONGER NEEDING COMMUNITY
SUPPORT. BUT WE SUSPECT THIS
COULD BE DUE TO LOWER RATES THAT
RESULT IN PARTICIPANTS SHOPPING
OUT FOR NARROW ELIGIBILITY
CRITERIA THE PLANS INVOLVED. IN
ADDITION CLIENTS REPORT
DIFFICULTY ASSESSING AND BEING
ASSESSED FOR ENHANCE CARE
MANAGEMENT WHICH DIFFERS FROM
COMMUNITY SUPPORTS IN THAT IT IS
A BENEFIT NOT A PLAN OPTION. ANY
MEMBER WHO QUALIFIES. PLANS TAKE
REFERRALS FOR ASSESSMENT AND
CLIENTS REPORT NO RESPONSE EVEN
THOUGH IT HAS CARE MANAGEMENT
MIGHT BE URGENTLY NEED IT. WE
APPRECIATE IT TAKES TIME TO
BUILD PROVIDER CAPACITY BUT
CONSIDERING SIGNIFICANT
INVESTMENTS TO DO JUST THAT HOW
LONG MEMBERS EXPECTED TO WAIT.
TO RECEIVE NEEDED SERVICES. HOW
SUPPORTS. WHICH IS INTO THE X.
HOME. WITH HOW. THROUGH HOW
ADVOCATES. ENSURE SERVICE
HOLLAND. AT TENDENCIES. SERVICES
HAPPEN JOHN TO IMPROVE HEALTH.
OUTCOMES IN ORDER TO IMPORTANT
CONSIDERING THE RISING
HOMELESSNESS AND THOSE
EXPERIENCING HOMELESSNESS WITH A
DISABILITY. I'VE BEEN HAS SHARED
ITS GOAL IS TO MAKE ALL
COMMUNITIES A STATEWIDE MEDIC
CAL BENEFIT WITH HOUSING SUPPORT
SERVICES BEING THE HARDEST OF
ALL. WE RECOMMEND REQUIRING THE
STATE REQUEST FEDERAL APPROVAL
TO MAKE HOUSING SUPPORT SERVICES
BENEFIT WITH EIGHTY TEN EIGHTY
FIVE BY ASSEMBLYMEMBER
MAIENSCHEIN BEING THE
LEGISLATIVE VEHICLE. IN ADDITION
WE ALSO RECOMMEND THE DEPARTMENT
ARTICULATE SPECIFIC MEASUREABLE
TARGETS DEFINED A MECHANISM TO
HOLD CLIENTS ACCOUNTABLE AND
PUBLICLY REPORT ON CONGRESS WHEN
THERE'S TARGET. THESE MEASURES
SHOULD AT MINIMUM INCLUDE
PROVIDERS SPECIFICALLY TRUSTED
COMMUNITY PARTNERS WHO HAVE
EXPERIENCE PROVIDING SERVICES
AND THE NUMBER UNIQUE MEMBERS
PROCEEDING AND HAS CARE
MANAGEMENT AND COMMUNITY
SUPPORT. THANK YOU. THANK YOU
FOR AND NOW WE WILL GO CARE SAID
SAN JUAN WHO SPEAKS DIRECTOR OF
THE CAL. PAN ETHNIC HEALTH
NETWORK. GREAT THANK YOU CHAIRED
MEMBERS KAREN SAVAGE THAN ONE
WITH THE CALIFORNIA CAN I THINK
HEALTH NETWORK OR C. PAN THE
FIRST WE WERE ASKED ABOUT. ADDED
YOU ON EXTENT TO WHICH
PRINCIPLES OF EQUITY HAVE BEEN
INCORPORATED INTO IMPLEMENTATION
EQUITY IS CERTAINLY A GUIDING
PRINCIPLE FOR CAL AIMS HOWEVER
WITHOUT INTENTIONALITY IN EVERY
ASPECT OF DESIGN AND
IMPLEMENTATION AND THE IMPACT OF
KELLY WILL NOT BE EQUITABLE. AT
THIS POINT OUR BIGGEST CONCERN
IS THE INADEQUACY OF THE
UNDERLYING SERVICE NETWORK WELL
APPROPRIATE REFERRALS MAY BE
MADE IF THE SERVICES AREN'T
AVAILABLE OR AREN'T RESPONSIVE
TO THE UNIQUE CULTURAL LANGUAGE
AND OTHER NEEDS OF THE MEMBER
IMPLEMENTATION WILL FALTER. WE
ARE ENTHUSIASTIC SUPPORTERS AT
THE COMMUNITY HEALTH WORKER
BENEFIT A POTENTIAL GAME CHANGER
FOR RACIAL EQUITY IN MEDIC CAL
BUT COMMUNITY HEALTH WORKERS BY
THEMSELVES CANNOT SOLVE THE
PROBLEM OF LACK OF AVAILABLE
RESOURCES AND SERVICES WITHOUT
THE RIGHT MARKET INCENTIVES. UP
FOR EASY I'M AND COMMUNITY
SUPPORTS TO ACHIEVE EQUITABLE
OUTCOMES THERE MUST BE A ROBUST
AND COMMUNITY BASED SERVICE
NETWORK THAT REQUIRES
TRANSPARENCY IN A LEVEL PLAYING
FIELD FOR SMALLER RACIALLY AND
ETHNICALLY DIVERSE CBO'S.
CURRENTLY COMMUNITY BASED
ORGANIZATIONS THAT WOULD BE
IDEAL ECM AND COMMUNITY SUPPORT
PROVIDERS ARE STRUGGLING TO
BECOME PROVIDERS BECAUSE OF
UNCERTAINTY WITH THE PLANS. LOW
RATES LIMITS ON THE NUMBER OF
BILLABLE VISITS AND AN
UNWILLINGNESS IN SOME CASES OF
HEALTH PLANS TO NEGOTIATE THEIR
CONTRACTS. THIS INITIATIVE IS A
HEAVY LIFT FOR THE CBO TO
ANNOUNCE AFFECTED TO CONVERT
THEIR BILLING STRUCTURES FROM A
GRANT BASED SYSTEM THAT INCLUDES
ADMINISTRATIVE OVERHEAD. DO A
PAPER SERVICES BILLING STRUCTURE
THAT IS MUCH MORE SENSITIVE TO
MARKET CHANGES. ONE COMMUNITY
BASED ECM PROVIDER SURE THAT
THEY KILL TELLING WOULD BE MORE
SICK THAN. IF COMMUNITY
PROVIDERS WERE REWARDED FOR
IMPROVING THE HEALTH OF MEMBERS.
RATHER THAN ONLY PAID FOR
PROVIDING SERVICES WHEN MEMBERS
ARE EXPERIENCING THEIR HIGHEST
NEEDS AND THEN LOSING THE
ABILITY TO PROVIDE SERVICES TO
THAT MEMBER WHEN THEIR HEALTH
IMPROVES TO THE POINT THAT THEY
NO LONGER QUALIFY FOR EASY
AVERAGE. BUT WOULD STILL BENEFIT
FROM SUPPORT. YEAH QUESTION WE
WERE ASKED TO A- THE RISKS.
CROSS AND THE CONCERN. AROUND A
POTENTIAL BIAS IN THIS. AND DATA
THAT IS BEING COLLECTED SHOULD I
TRY TO AVOID BIAS. SO WE WOULD
SAY IN GENERAL IT'S TOO EARLY TO
KNOW WHAT THE OUTCOME OF THE
RACE STRATIFICATION PROCESS
THESE WILL BE OR WHETHER THEY
ARE DISPARITIES IN ENROLLMENT SO
IT WILL BE IMPORTANT TO THE
LEGISLATURE TO CONTINUE TO
MONITOR THIS. ISSUE ON SOME OF
THE GATE AT THE WHICH TO LINDA
ALLUDED TO A REALLY PERTAINS TO
MEMBERS FOR TRANSITIONING FROM
WHOLE PERSON CARE AND HEALTH
HOMES. AND SAID THEY HAD ALREADY
BEEN IDENTIFIED AND CONNECTED
WITH CARE MANAGEMENT SERVICES.
THE RATE. ONE SECOND ACCURATE- I
DON'T KNOW IF IT'S YOUR SOUNDER
HERE ITS FIRST- YOU. VOLUME JUST
WENT DOWN I DON'T KNOW IF THERE
WAS ANY ADJUSTMENT YOU MADE ON
YOUR END THAT WE DON'T. KNOW HOW
I'M NOW MUCH BETTER MUCH BETTER
OKAY KEEP GOING OKAY I JUST
SPEAK UP. HE AND SO I DIDN'T
BREAKDOWN OF THE ECM POP. IS
SIMILAR TO THAT OF WHOLE PERSON
CARE PARTY. WITH A- THAT THERE'S
A HIGHER ENROLLMENT OF LATINO
MEMBERS IN ECM. SOME EASY
IMPROVE TO SERVE. OF COLOR 
WERE PREVIOUSLY HELP HOMES OUR
WHOLE PERSON CARE PROVIDERS.
HAVE NOTICED THAT THEIR OUT
REACH LIST FOR NEW ENROLLMENT
ARE SMALLER- COMPARED TO HELP
HOMES AND WHOLE PERSON CARE
WHICH RAISES CONCERNS THAT SOME
MEMBERS ARE BEING MISSED BECAUSE
OF THIS PROGRAM TRANSITION. AND
COMMUNITY BASED PROVIDERS HAVE
OBSERVED LIMITED OUTREACH TO
MEMBERS RELATED TO COMMUNITY
SUPPORTS. I NEED YOU SEE IN THAT
DHS'S DATA THAT THE NUMBER OF
MEMBERS RECEIVING COMMUNITY
SUPPORTS AT THIS TIME IS QUITE
LOW. WE DO APPRECIATE THAT DHS
IS PRIORITIZING ADDRESSING BIAS
IN THE RED STRATIFICATION DESIGN
PROCESS. AND HAS DETERMINED THAT
RISK HERE'S MUST BE BASED NOT
ONLY ON MEDICAL OR BEHAVIORAL
HEALTH RISK BUT ALSO ON SOCIAL
RISK. AND MOST IMPORTANTLY MUST
CONSIDER UNDER UTILIZATION OF
SERVICES. DURING UTILIZATION AND
UNDER UTILIZATION HELP TO
REVERSE BIAS IN RISK
STRATIFICATION. THIS IS BECAUSE
THE EVIDENCE SHOWS THAT BLACK
PATIENTS AND LGBTQ PATIENTS IN
PARTICULAR CONSISTENTLY GENERATE
FEWER COSTS THAN WHITE PATIENTS
AT THE SAME LEVEL OF HEALTH. THE
MEASURE STATES YES IS PROPOSING
WILL HELP US UNDERSTAND THE
EXTENT TO WHICH DIFFERENT
POPULATIONS ARE UTILIZING ARE
UNDER UTILIZING SERVICES AND THE
EXTENT TO WHICH- ARE THE
IDENTIFICATION OF MEMBERS FOR
ECM IS SUCCESSFUL OR IS
GENERATING BY S. WE HAVE JUST A
COUPLE OF RECOMMENDATIONS TO
STRENGTHEN IT WHICH WOULD BE
REQUIRING AVAILABLE YOU. NEED TO
WRAP UP SO OKAY. REPAIRING A
PUBLIC DASHBOARD MEASURING
PATIENT ACTIVATION AND MEASURING
. COMMUNITY ENGAGEMENT THANK YOU
SO MUCH. GREAT ALL RIGHT WE NOW
GOING TO OUR- FIND PANEL. AND
THE FINAL PANEL IS ON- ONE
SECOND TIME PULLING UP MY FUNDED
BEHAVIORAL HEALTH REFORMS. AND
THE- CALIFORNIA BEHAVIORAL
HEALTH COMMUNITY BASED CONTINUUM
DEMONSTRATION- WHICH IS ALSO
ANOTHER COMPONENT OF CAL AIMS SO
THE PANEL PROVIDE US
PERSPECTIVES ON THE
IMPLEMENTATION OF HOW THAT
BEHAVIORAL HEALTH SERVICES
THAT'S MENTAL HEALTH AND
SUBSTANCE USE DISORDER
TREATMENT. ARE GOING TO BE
DELIVERED TO MEDICARE
BENEFICIARIES BY COUNTY
BEHAVIORAL HEALTH DEPARTMENTS.
ASKED FOR PANEL NOW WE HAVE
MICHELLE CABRERA RECEIVED
EXECUTIVE DIRECTOR OF THE COUNTY
BEHAVIORAL HEALTH DIRECTORS
ASSOCIATION. DOCTOR LEE ANDREA
CLARK HARVEY WHO'S THE CHIEF
EXECUTIVE OFFICER OF THE
CALIFORNIA COUNCIL OF COMMUNITY
BEHAVIORAL HEALTH AGENCIES AND
KIM LEWIS WHO IS THE MANAGING
ATTORNEY OF THE NATIONAL HEALTH
LAW PROGRAM. SO MICHELLE WOULD
YOU LIKE TO START. GOOD MORNING
MADAM CHAIR AND MEMBERS MY NAME
IS MICHELLE CAPITA AND I'M THE
EXECUTIVE DIRECTOR OF THE COUNTY
BEHAVIORAL HEALTH DIRECTORS
ASSOCIATION OF CALIFORNIA. TELL
ME BEHAVIORAL HEALTH AGENCIES
ARE RESPONSIBLE FOR THE DELIVERY
OF SPECIALTY CARE FOR
INDIVIDUALS WITH MORE
SIGNIFICANT MENTAL HEALTH
TREATMENT NEEDS. AS WELL AS
THOSE WHO REQUIRE SUBSTANCE USE
TREATMENT UNDER MEDICAID HELL
HOUSE PLANS ARE COUNTY
BEHAVIORAL HEALTH AGENCIES ARE
REQUIRED TO MEET THE MANAGED
CARE RULES INCLUDING NETWORK
ADEQUACY TIMELY ACCESS AND
QUALITY STANDARDS. AND TO COMPLY
WITH THE LAWS. THE COUNTY VISION
FOR BEHAVIORAL HEALTH WAS
LARGELY DEVELOPED FREE TWENTY
TWENTY AT A TIME WHEN WE WERE
TRYING TO SOLVE FOR SOME VERY
SPECIFIC CHALLENGES THAT WERE
HOLDING US BACK. FIRST BECAUSE
OF OUR FINANCING MECHANISM FOR
COUNTIES PUT UP COUNTY FUNDING
TO DRAW DOWN FEDERAL MATCH- FOR
MEDICAL SERVICES THROUGH WHAT'S
CALLED A CERTIFIED PUBLIC
EXPENDITURE. COUNTIES WERE THEN
AND ARE STILL TO DATE REQUIRED
TO DOCUMENT OUR SERVICES TO THE
MINUTE. THIS REQUIREMENT HAS
BEEN CORROSIVE TO OUR SYSTEM.
FROM THE WORKFORCE PERSPECTIVE
IT SHIFTED OUR FOCUS AWAY FROM
PEOPLE AND ONTO PAPER WORK AND
WHILE WE HAVE MOST OF THE SAME
REQUIREMENTS IS MANAGED CARE
PLANS BECAUSE OF THE STRUCTURE
WE'VE HAD NO ABILITY TO GENERATE
THE SAVINGS THAT COULD BE
REINVESTED INTO OUR SYSTEM. SO
WELL OUR BASIC COST OF DOING
BUSINESS HAS BEEN COVERED OUR
ABILITY TO GROW HAS BEEN
STUNTED. FINALLY ARE HEALTH
PLANS AND PROVIDERS HAVE BEEN
SUBJECTED TO MULTI YEAR AUDIT
WHEREBY WE CARRY RISKS TO THE
TUNE OF HUNDREDS OF MILLIONS OF
DOLLARS EACH YEAR AS PAYMENTS
ARE EITHER RECONCILED OVER OR
UNDER COST. IN FACT WE ARE STILL
IN THE PROCESS OF SETTLING
CLAIMS WITH THE STATE THAT GO
BACK AS FAR AS TEN YEARS. FOR
THESE REASONS AND MANY MORE ARE
COUNTIES OF EMBARKED ON A MULTI
YEAR EFFORT TO OVERHAUL HOW WE
GET FUNDED. PLEASE ONE OF THIS
EFFORT IS TO MAKE THE MOVE FROM
COST BASED REIMBURSEMENT. IF YOU
FOR SERVICE. THE BEEN WORK WITH
FIGURE OUT HOW TO CA THE INFOR
WE HAVE ON BECAUSE- INTO OF.
LOADED PLAN. FOR SERVE FREIGHT
ACCOUNTS FOR COVER OUR- ALONG
WITH SOME OF. FOR INFLATION
LABOR MARKET AND OTHER FACTORS.
WE'VE COM WE HAVE TO COMMEND TO
THE STATE M. THE TEAM AT DH CS
SPECIFICALLY FOR WORKING
COLLABORATIVELY WITH US. TO
ENSURE THAT WE ACCOUNT FOR AS
MUCH AS WE CAN IN BUILDING OUT A
WHOLE NEW PAYMENT SYSTEM FOR THE
SIXTY SEVEN BILLION PLUS. OF
MEDICAL SPECIALTY BEHAVIORAL
HEALTH SERVICES THAT WE DELIVER.
AND WHILE THE STATE HAS WORKED
VERY CLOSELY AND COLLABORATIVELY
WITH US. THIS TIME IS AGGRESSIVE
. TO DATE WE RECEIVED SEVEN
STEPS OF RATES. WITH THE
MAJORITY OF THOSE COMING TO
COUNTY. AS RECENTLY AS LAST WEEK
. WE'RE STILL AWAITING FOUR SETS
. SEPARATE REACH. ONCE WE GET
THESE RATES COUNTIES NEED TO
MODEL THEM TO UNDERSTAND THE
POTENTIAL IMPACT AND WE WON'T
HAVE A COMPLETE PICTURE UNTIL
ALL OF THE RATES HAVE BEEN
RELEASED. THE JANUARY BUDGET
PROPOSES THREE HUNDRED SEVENTY
FIVE MILLION DOLLARS TO ADDRESS
THIS TRANSITION FROM C. P. EASE
TO IGT'S. WITHOUT THIS FUNDING
OUR PAYMENT REFORM GOALS WOULD
NOT BE POSSIBLE. IN ANY EVENT
THE AGGRESSIVE TIMELINE WILL
MAKE IT A REAL CHALLENGE FOR
COUNTIES AND ESPECIALLY OUR
PROVIDERS WHO WILL HAVE EVEN
LESS TIME TO TRANSITION. SOME
COUNTIES HAVE ANTICIPATED THE
CHALLENGES AND ARE LOOKING TO
BUILD AN ADDITIONAL INCENTIVES
TO HELP OUR PROVIDERS WHETHER
THAT TRANSITION. WE'VE BEEN
WORKING ALONG SIDE EACH YES AND
OUR JOINT POWERS AUTHORITY TO
PROVIDE TRAINING AND TECHNICAL
ASSISTANCE. IN MODERNIZING OUR
PAYMENTS WE HOPE TO PAVE THE WAY
FOR FUTURE- FEWER DOCUMENTATION
BURDENS AND FINANCIAL RISK. IN
ADDITION OUR PAYMENT REFORM TO
PAYMENT REFORM COUNTIES HAVE
BEEN PREPARING SET UP A
STATEWIDE NETWORK OF TWENTY FOUR
SEVEN MOBILE CRISIS. SERVICES
UNDER MEDICARE I'LL- WE UNTIL
THE OF THIS CALENDAR YEAR TO SET
UP MOBILE CRISIS CAPACITY AND
WERE EXTREMELY GRATEFUL TO THE
STATE FOR ITS INVESTMENT IN
INFRASTRUCTURE FUNDING TO HELP
US PURCHASE VEHICLES AND
EQUIPMENT RELATED TO THE
SERVICES. WHILE THIS NEW MEDICAL
BENEFIT IS EXCITING AND BUILT
UPON DECADES WORTH OF EXPERIENCE
IN SOME REGIONS. OTHER PARTS OF
THE STATE PARTICULARLY THOSE IN
RURAL CALIFORNIA HAVE NOT UNTIL
NOW HAD THE MANDATE OR THE
FUNDING TO SET UP MOBILE CRISIS
SERVICES. WORKFORCE CHALLENGES
WILL MAKE HIRING PROFESSIONALS
SKILLED IN FIELD BASED PRICES A
TO SCALE EXTREMELY CHALLENGING.
AND ALTHOUGH WE'VE HAD EMERGENCY
RESPONSES FOR FIRE PUBLIC SAFETY
AND MEDICAL SERVICES AS BROAD
PUBLIC BENEFITS WE WILL STILL
LACK REIMBURSEMENT FOR THE 70%
OF CALIFORNIANS WITH SOME FORM
OF PRIVATE INSURANCE. WHICH
MAKES IT STAND ABILITY AND
PROVIDING SERVICES TO THE
COMMUNITY MORE CHALLENGING.
FINALLY WE'RE WORKING CLOSELY
WITH THE STATE TO MAKE
SIGNIFICANT IMPROVEMENTS IN
ACCESS TO QUALITY OUTPATIENT
SERVICES THROUGH THE CAL H. CBC
DEMONSTRATION. WHICH WILL ALLOW
COUNTY BEHAVIORAL HEALTH
AGENCIES TO PAY FOR SERVICES
LIKE COMMUNITY HEALTH WORKERS TO
DO OUTREACH AND ENGAGEMENT AS
WELL AS HOUSING AND TO BE
REIMBURSED FOR SHORT TERM
RESIDENTIAL AND INPATIENT STAYS.
THAT TWO DAY ARE EXCLUDED FROM
MEDICAID BECAUSE OF THE SIZE OF
THE FACILITY. I WANT TO POINT
OUT THAT WE BELIEVE THAT THE
POTENTIAL SAVINGS GENERATED
THROUGH THE I AND D. WAIVER.
COULD BE SIGNIFICANTLY LOWER
THAN THE STATE'S ESTIMATES AS WE
UNDERSTAND THAT THE STATE
ESTIMATED. THERE THREE BILLION
PLUS NUMBER ON SAVINGS WE WOULD
ACCRUE IT ALL TYPES OF INPATIENT
STAYS RATHER THAN THE ELIGIBLE
SUBSET WERE NEW FUNDING FOR US
AS SUCH WE ASK THE STATE TO WORK
WITH US TO ENSURE THAT COUNTIES.
THAT POPPED INTO THE WAIVER HOW
THE ENOUGH SAVINGS. IN NEW
FEDERAL REIMBURSEMENT TO FINANCE
VARIOUS REQUIRE NEW BAY. THAT
WOULD COME UNDER THE CAL BEACH
CBC. FOR AB. FOR CAO. THE
PROMISE OF KELLY IS THAT BY
EXPANDING MEDICARE REIMBURSEMENT
TO TOUCH MORE OF WHAT WE ALREADY
DO YOU SYSTEM THAT FOR HAS
DECADES UP FOR DECADES HAS TOUCH
SCHOOLS CARCERAL SYSTEMS HOUSING
AND SOCIAL SERVICES. THAT ARE
MEDICAID AGENCY WILL BOTH
SUPPORT GROWTH THROUGH NEW
OPPORTUNITIES FOR FEDERAL
FEDERAL MATCH WHILE ALSO GAINING
BETTER INSIGHT INTO THE STRENGTH
OF OUR SYSTEM AND CHANGING OUR
RELATIONSHIP WITH MANAGED CARE
PLANS ARE PROVIDERS AND
ULTIMATELY OUR BENEFICIARIES
THANK YOU. THANK YOU. RIGHT NOW
WE HEAR FROM DOCTOR LEE ANDREA
CLARK HARVEY FROM THE CALIFORNIA
COUNCIL OF COMMUNITY BEHAVIORAL
HEALTH AGENCIES. THANK YOU CPJ'S
A MEMBERS ARE MENTAL HEALTH AND
SUBSTANCE USE DISORDER CLINICS
AND BUSINESSES WHO COLLECTIVELY
SERVE MORE THAN ONE MILLION
CLIENTS INCLUDING THE NATIVE
AMERICAN HELP AMERICAN HEALTH
CENTER YOU HEARD FROM DURING
PANEL ONE. KENNEL AIMS TO ALLIES
AND THEN INNOVATIVE APPROACH AND
A HUGE OPPORTUNITY TO ADDRESS
THE MULTITUDE OF DISPARITIES
THAT EXIST FOR CLIENTS IN OUR
STATE THAT'S WHY IT'S IMPERATIVE
THAT WE COUNTIES PROVIDERS AND
THE ADMINISTRATION WORKS
TOGETHER TO GET IT RIGHT.
DESPITE ITS PROMISE I'VE BEEN
ASKED TO DISCUSS MECHANICS THAT
NEED TO BE FINE TUNED INCLUDING
PAYMENT REFORM. SEVENTY THREE
PROVIDER SHOULD BENEFIT. OPPOSE
MOVE FROM PROCEDURAL TERMINOLOGY
CPT TO INTERGOVERNMENTAL
TRANSFER I T. PAY MENTS THIS
SHOULD A LIMON THE BURDEN ON
COUNTIES AND PROVIDERS REGARDING
THE COST ONLY PROCESS WHICH CAN
OFTEN TAKE AS MY COLLEAGUE
MICHELLE SAID MULTIPLE YEARS
RECONCILE. INNOVATION IS ONLY AS
GOOD AS THE FUNDING SPECIFICS
THAT WILL STIR IT IT IS VERY
DIFFICULT TO DISCERN THE STATE
SPECIFIC BENEFITS FROM PAYMENT
REFORM GIVEN NOT PROVIDERS HAVE
NOT YET RECEIVED RATES FOR
SERVICES. WE ARE SEEING WIDE
VARIATION ACROSS THE STATE
REGARDING BUDGET INFORMATION
REQUESTED FROM THE COUNTY AND DH
THE ASK THE TIMELINE FOR
RESPONSE AND HOW THIS
INFORMATION WILL BE UTILIZED TO
DEVELOP PROVIDER RATE FOR TWENTY
TWENTY THREE TWENTY FOUR.
PROVIDERS DIRELY NEED TO
UNDERSTAND THE BILLING AND
TRANSACTIONAL CHANGES ASSOCIATED
WITH THE MOVE TO THE CPT CODES
AND STUFF. AND ALSO LINKED TO
PAYMENT REFORM IS PROVIDING CARE
AND COMMUNITY BASED STUDY. THIS
IS NOT A NEW CONCEPT FOR CDOS
WRAPAROUND PROGRAMS MENTAL
HEALTH SERVICES. IMATION STAPLES
SERVICE PARTNERSHIPS ECCENTRIC
MANY CLIENTS ARE JUST NOT ABLE
TO RECEIVE SERVICES IN A
TRADITIONAL CLEANING BASIC SPACE
SYSTEM. THAT IS QUITE
SUBSTANTIAL AT THE REIMBURSEMENT
RATES FULLY COVER STAFF TRAVEL
TIME AND TRANSPORTATION TO
PROVIDE CARE IN THE COMMUNITY.
SAYING THAT TRAVEL IS ALREADY
BAKED INTO OVERALL RATES UP FOR
ALL PROVIDERS JUST ISN'T
ADEQUATE BECAUSE IT PROVIDER
SERVICES OR DIVERSE FOR EXAMPLE
WE HAVE ONE PROVIDER TO PROVIDE
90% OF THEIR SERVICES. IN THE
FIELD AND SCHOOLS SERVICES
PROVIDED IN THE COMMUNITY OR
THOSE WHO ARE AND HOW SIX ACTRA
WE HAVE ANOTHER PROVIDER WHO
PROVIDE SERVICES TO RESIDENTS AT
CATALINA ISLAND AND TRAVELS
THREE HOURS HER VISIT. ROUND
TRIP. I THINK RELATED TO THE
CALIFORNIA BEAVER CAN YOU BASED
CONTINUE AND- PROVIDE ARE ALSO
ABOUT THE STATE. OF FUNDING HELP
COUNTIES AND HER BY IN. AND
TRAIN AND STOP ENGAGE AN AVENUE
BASED. AND IN ORDER TO AVOID I
AM DO YOU KNOW. THERE HAS TO BE
ON RE OF. ALONG OTHER OF THE OF
. I S. I DIDN'T CLOSE MY WORK
CHEN. WORK NEEDING AND- PARKING
TO WORK IN THE BEHAVIOR HEALTH.
A SPECIAL WHEN AMAZON AND BETTER
IS PAYING MORE AND A TIME LIKE
THIS WEEK OF TO BURN OUT OUR
WORK FOR SHOOTING MINISTRY
BURDEN. HIRING AND TO MANAGE
BEARING PAPERWORK REQUIRED
ACROSS. JUST TO STOP. EACH YES
THE TEMP TO SOLVE PRESS BAKER A
GROUP OF STATE. TO ADVISE ON
TRIMMING DOWN. REQUIRE BUT WE
ALL WORK STANDARD IS A ACROSS
COUNTY WERE THE SAME. NOW ALL
COUNTY ARE WILLING TO THEIR- AND
IN FACT OUT OF SEVENTY CAN UNITY
BASE OR- RESEARCH. ONLY ONE SIDE
RISK REALLY. AS A RESULT OF THE
DHC WORKER AT SUNDOWN. SO THERE
ARE LOTS OF INTENDED RECOMMEND.
BUT IF THEY DON'T HAVE T. IT
JUST WANT MORE. LAST CRISIS CARE
VIDEOS OF LAW LEAD TO WITH CALL
CENTER AND ARE CAN TO DO SO
NINETY EIGHT NORTH. FOR MORE
CRISIS SERVICES AND MANY TO
COUNTIES ARE THE STATE. THE
ABILITY TO CARRY THE SERVICE
SYSTEM LAST RECKONED INTO TO BE
AT. THANK YOU FOR THE
OPPORTUNITY TO REFLECT
PRIORITIES SB EVER PROVIDER THAT
HE H. REPRESENTS. THANK YOU DR
CLERK BEFORE THOSE- AND LET US
KNOW TO LEWIS WHO THE MAN OUR TO
AT NOW. HEALTH PRO. GOOD MORNING
SKINNER AND OF THE COMMITTEE GEN
LEWIS MANAGING TO WALK AROUND.
SO I'VE BEEN ASKED ASK ANSWER
NUMBER BUT I'LL TRY TO GET IT
TO. THOSE. ONE OF THE VERY AND
KERN TAXES AND THAT'S NOT. FOR
ALL SERVICES AND POWER CAL. THE
BEER HOLDEN- DRESS. NINE SO-
OBVIOUSLY ON SEEM TO MATTER CAL
RACES STRUCTURE ITSELF CONSUMERS
HAVE NO IDEA WHO RESPONSE. FOR
HOLD AND MANY ABOUT BY OF NEXT
HOUSE. THAT ARE COVERED
DIFFERENT SERVICES CHILDREN AND
YOUTH CENTER ONE. BETWEEN COUNTY
SYSTEM OUR FOR A DAHLE. CAN BE
COUNTY MORE CHEN FOR INDUSTRY
THIS BILL IS A FAMILY AND NOW
IT'S COVERED AND HOW TO GET. ONE
HUNDRED ARE BOTH WORLD SYSTEM
LIKE CHILD WELFARE JUST SYSTEM
WAGE CENTER OR OTHER THE
CONFUSION ABOUT WHO'S
RESPONSIBLE THE STATE TO COME
GETTING MORE. EVEN NOW AFTER
CALLIE BEGAN TO ALLOW.
IS THAT HAPPENING IN OUR
PARTICULAR CREDIT FOR MAKING I'M
GOING TO BE SURE YOU CAN NOW
SERVICE. AFTER YOU CAN IMPROVING
ACCESS OR EXPANDING AT TO FRONT
DOOR THE DELIVERIES TO SUCH NON
ALL SERVICE. OR CERTAIN DISORDER
SERVICES. BACK IN WOULD BE THE
NO DOOR. ALLOWING MANY TO SEEK
CARE FROM ALL THE COUNTY
BEHAVIORAL SYSTEMS AND- HEALTH
PLAN. POSSIBLE SURE IS. NON
SPECIALTY NOW HOW THE AMERICAN
CARE PLANNER FOR SERVICE
PROVIDER AND STUFF YOU KNOW HOW
THEY ARE NOW PLAN CONCURRENTLY
WITH ALL SERVE YOUR CALL TO
APPROPRIATE. VETERANS
COORDINATED THEM AND REYES. AND
THEN THIRD FINALLY BEGINNING IN
JANUARY ONE THREE INVITATIONAL
ST AND YOU STAY SCREENING ONE
ADULTS ONE THREE CHILDREN I
TWENTY. THAT ALL RACES IN STOCK
IN THE MIDDLE TO RETURN MY
APPROPRIATE MEDICAL MENTAL
HEALTH RACES DINNER FOR MANAGED
TO OURS NOW SERVES AND FUNDING
CON THEIR HEALTH MANAGEMENT CARE
.
FULL MANAGED CARE PLANS ALL
PLANS NEED TO COLLECT AND REPORT
DATA TO TRACK LIBERALS BETWEEN
DELIVERY SYSTEMS SO WE CAN SEE
WHAT'S HAPPENING THE BENEFICIARY
PROSPECT IN GENERAL THAT THEY'RE
ACTUALLY GETTING THE CARE
SEEKING. ARMINA COUNTY NEED TO
TRACK HOW THE NEW SPECIAL. NOW
FOR EACH YEAR YOU MENTION OKAY
WITH THOSE IN CHAU WELFARE WE'RE
GETTING JUSTICE WORKS
HOMELESSNESS ARE BETTER.
ADDRESSING THE NEEDS OF
POPULATION WONDERFUL COUNTY.
CALIFORNIA'S TO BETTER IN ALL
THAT HERE BASE IS BOTH THE
MINISTRY EARLY IF TO THE
DELIVERY LEVEL AND WE HOLDS CARE
ACROSS FACTOR. IS MONSTER BACK.
BETTER MORE TIME OF USER DATA IS
ALSO NEEDED TO TURN WHAT'S HALF
WITH THAT YOU STILL HAVE NO
TWENTY TWENTY NOW DATA AVAILABLE
THE UNITED STATES SO GOT WHERE
KNOW- WHY IS HALF AND HOW ACCESS
. QUESTIONS. SPECIFICALLY ISSUE
AROUND WHAT AND THIS WAS A OUR
CLIENTS BROWN WILL.
FOLLOWING A MEETING BASED
SERVICES INCLUDING INTENSIVE
CARE COORDINATION AND ALL BASER
INVOLVED PRICE SERVICE. ALSO
THIS OF IRANIANS YOU PARTICULAR
THE MALL IN MOST CHILD CERTAIN-
ALSO NEED. TO GET A THE GROUND
AS COUNCIL STRAW TO GET ACTUALLY
THOSE TREATING HOMESTEAD UP IN
THE SERVICES INTENDED TO PROVIDE
A BOY THE G. RATHER TREE IS SO
ALTER. DAHLE WE NEED TO- AND
THOSE ARE SPACE THE SERVICE
COMMITTEE. REPORTED EMPLOYMENT
SUPPORT SERVICE. BERMAN SAID OF
HOW. MOBILE CRISIS OR- IN
INTENSE CARE MANAGER BIRTH DON'T
GET A YOU CHEATING THOSE ARE
CRITICAL ADDITIONAL THAT SOME OF
WHICH YOU CAN THIS HAS INVESTED
IN AND ONE TO ADD AMERICA
SERVICE BUT MANY TO BE THERE
STATE. AND JUST IN OPTION. THANK
YOU VERY MUCH ALL RIGHTS MEMBERS
WEEK NOW MOVE TO YOUR QUESTIONS
OUTSIDE INTO- WHAT I'D LIKE TO
START OUT WITH THIS TO. FROM YOU
AND I WILL MAKE PHILIP- AND THEN
WE COME BACK TO PAY- FIND TO
FOLLOWED BY MY- VOICE CHAIR-
CENTER NEIL AND SAID ROTH
SENATOR LAYER THE NEW SEE WHO
OKAY- MENJIVAR. GREAT DAY ARE
STILL. OKAY DOLLY. SORRY WE CAN
OTHER AS TIME THE INTERESTING
OKAY AS- GOES ON ALL RIGHT SO-
FIVE REALLY APPRECIATE ALL OF
PANEL THIS IS CLEARLY VERY
COMPLEX. I MEAN WE'VE BEEN ABOUT
THE OF- ISSUE WE'VE LEARNING THE
- FERRETTE OF SERVICE THAT ARE-
THE DIFFERENT OF- THAT PERHAPS
NOT ENOUGH FOR MEDIA FORCE
ISSUES TO. TRYING TO OTHER A
COMMUNITY BASED TO BE PART OF
THIS NEW IN THE A LOT- BUT I
WANT TO GO BACK TO LARA SIMON
FORCE OUR FIRST PROJECT CENTER
AND MELORA IN YOUR IF YOU ARE
STILL AVAILABLE I HOPE YOU ARE-
ONE OF YOUR SLIDES THAT YOU
SHOWED HAD CALIFORNIA IN THE
BOTTOM QUARTILE. OF IT IT SHOWED
US AS HAVING THE LARGEST NUMBER
OF- YOU AMERICANS UNDER OUR
MEDICAL PROGRAM AND SO DEPENDENT
ON THIS PROGRAM BUT WE WERE IN
THE BOTTOM QUARTILE OF I'M NOT
SURE WHAT. WHAT WAS THE EXACT
METRIC THAT YOU DESCRIBED- JUST
QUICKLY TELL ME AND THEN I'LL
ASK YOU THE QUESTIONS. THAT
METRIC WAS. AND SO IT'S A S.
THAT LOOKS LIKE IT'S- X. A
MINUTE. AND THEY WERE THERE TO
ONE IS ABOUT GET NEEDED CARE.
AND THE OTHER IS ABOUT- TIMELY
ACCESS RIGHT THAT'S WHAT I
THOUGHT BUT I DIDN'T WANT TO SAY
IT WOULD BE WRONG SO IT WAS THE-
ACCESS AND TIMELY CARE- OKAY SO
- WHAT I'D LIKE TO YEARS WATER
THE ONE OR TWO THINGS THAT
CALIFORNIA WOULD NEED TO DO. IN
ORDER TO CHANGE THAT TO INCREASE
THE ACCESS AND THE TIMELINESS.
AND THAT IS THAT THAT'S A GREAT
QUESTION AND A COMPLICATED
QUESTION- AND I WISH THAT MY
COLLEAGUES TO FOCUS MORE ON
ACCESS WERE HERE. AND THAT. YEAH
I THINK AND THE NETWORK ADEQUACY
AS THAT IS A TERM THAT'S THAT'S
KIND OF THROWN AROUND. AND IT'S
ABOUT WHETHER MANAGED CARE PLANS
HAVE ENOUGH PROVIDERS AND- WAIT
OPEN PANELS- SO THAT PEOPLE CAN
GET IN. AND. AND I THINK THAT.
FOR PRECIPITATION MEDICARE IS
PROBABLY. THAN IT NEEDS TO BE
ANALYZED. TURNING ANY PARTICULAR
REASON WHY. PROBABLY HAS
SOMETHING TO DO WITH THAT WHEN
THAT WAS RATES. AND AND THE GAP
BETWEEN MEDICARE RATES AND
MEDICARE COMMERCIAL RATES. THANK
YOU APPRECIATE IT AND THEN MY
NEXT QUESTION IS FOR G. C. SO
IT'S A IT'S A SIMILAR ALONG
THESE LINES IS YOU TALKED ABOUT
THE EVIDENCE BASED RESULTS. HOW
WE DO OUR HOW WILL OUR- SERVICE
DELIVERY OR SERVICE DELIVERS
ACHIEVE THOSE RESULTS WHEN THE
RECIPIENTS ARE EXPERIENCING
SIGNIFICANT DELAYS BEFORE CARE
AND SOMETIMES NOT ACCESS TO CARE
. TO RESPOND TO THAT QUESTION DO
YOU SEE IT HAS BEEN VERY FOCUSED
ON OUR NETWORK ADEQUACY
ASSESSMENTS BOTH OF OUR MEDICARE
MANAGED CARE PLANS AND OUR
COUNTY BEHAVIORAL HEALTH
PARTNERS- WE HAVE BEEN
INCREMENTALLY INCREASING- THE
REPORTING AROUND THIS AND EVEN
ONE OF THE MEASURES THAT WE ARE
ROLLING OUT I'M TO OUR MANAGED
CARE PLANS FOCUSES ON HOW THEY
ARE. INCREASING UTILIZATION TO
PRIMARY CARE IN CLOSING THE GAP
TO NON UTILIZED EARS AND MAKING
SURE THAT PEOPLE HAVE EASIER
ACCESS WE'VE ALSO THROUGH THE
IMPLEMENTATION OF THE COMMUNITY
HEALTH WORKERS THAT WAS
MENTIONED EARLIER WE REALLY SEE
THAT AS AN ADDITIONAL ACCESS
POINT NOT EVERYONE NEEDS TO SEE
A PHYSICIAN NURSE PRACTITIONER-
OR PHYSICIAN ASSISTANT AND SO
WE'RE REALLY THINKING ABOUT THAT
AS A GREAT TOUCH POINT FOR
EDUCATION ENGAGEMENT AFTER NEW
DIAGNOSIS MAKING SURE THEY
UNDERSTAND HOW. TO NAVIGATE OUR
DELIVERY SYSTEM IT CAN BE QUITE
COMPLEX AND SO WE'RE REALLY
THINKING THAT WILL BE A VERY
CULTURALLY APPROPRIATE- WAY OF
EDUCATING PEOPLE IN THEIR
LANGUAGE IN THEIR HOME AND IN
THEIR COMMUNITIES. I'VE BEEN
REALLY CONNECTING THAT THAT
TRUST AND ENGAGEMENT WITH OUR
MEMBERS WERE REALLY EXCITED
ABOUT THAT NEW BENEFITS THAT
JUST ROLLED OUT SO WE'RE JUST
STARTING TO SEE THAT INCREASE
ACROSS THE STATE OF CALIFORNIA.
THE BOTH ARE OVERSIGHT
MONITORING OF NETWORK ADEQUACY
WE HAVE DONE SOME RATE
INCREASES- AS WELL AS A
COMMUNITY HEALTH WORKER BENEFIT
REALLY BEING- THE WAYS THAT WE
ARE FOCUSING. OR ALSO-
IMPLEMENTING AN ALTERNATIVE
PAYMENT METHODOLOGY FOR OUR FQHC
PARTNERS SO THAT THEY CAN ALSO
HAVE MORE FLEXIBILITY IN THEIR
MODEL OF CARE AND LOOK FORWARD
TO SEEING THESE. REFORMS KIND OF
COME TO PARISIAN. HI THAT AND
THINK- FOR MANY US THE OBVIOUSLY
- YOUR- YOU THE PROVIDERS ARE
ALL STEEPED IN THE TERMINOLOGY
THAT YOU USE SUCH THINGS AS
NETWORK ADEQUACY AND ALL AND I
THINK FOR. MOST OF US WELL
OBVIOUSLY THE TERMINOLOGY IS
HELPFUL WE WANT TO GET IT RIGHT.
WE ALSO WOULD LIKE TO KNOW ABOUT
THAT TERMINOLOGY TRANSLATED INTO
WHAT DOES THIS MEAN IN TERMS OF.
PEOPLE GETTING CARE SO- IF AT
THE FUTURE- THOSE WHO ANSWER ANY
OF OUR QUESTIONS COULD BE MORE
SPECIFIC IN TERMS OF. THAT KIND
OF- TRANSLATION FOR US I THINK
IT WOULD BE APPRECIATIVE.
APPRECIATED RATHER ALL RIGHT SO-
LET ME- MOVE NOW TO AND SENATOR
ANNUAL- THANK YOU MADAM CHAIR-
FIVE BY. TWO POINT. I IT TOO
WELL WHICH JUST- CONCLUDED WITH.
MY FIRST WILL BE A POINT OF
PERSONAL PRIVILEGE TO SOUND LIKE
A BROKEN RECORD- THIS IS- THIS
PROGRAM IS NEW TO ME SINCE I'M-
RETURNING FROM JUST A BRIEF
TWELVE YEAR ABSENCE. AND I THINK
THIS HAS. A PROMISE TO HAVE A
GREAT EFFECT AND THAT'S A GOOD
THING- MY CONCERN IS NUMBER ONE
IN THE AREA OF HOMELESSNESS- WE-
WE CONTINUE TO BE GUIDED.
EXCLUSIVELY BY BUT THE POLICY OF
HOUSING FIRST AND- THAT. CAN
SHOW SIX F. AS IN THE FIRST-
HANDOUT THE- ROSALYN STORY-
STARTED WITH GETTING HOUSING
FIRST AS A BREAKTHROUGH. AND
THERE WAS AN ARTICLE IN THE WALL
STREET JOURNAL RECENTLY ABOUT-
HOUSING FIRST APPROACH THAT
SHOWED GREAT. FIVE FOOT
PROMISING RESULTS FOR- SOME
VETERAN GROUPS OUTSIDE OF THE
STATE OF CALIFORNIA. THE PROBLEM
IS IF ALL WE CAN USE- TO GUIDE
OUR- FUNDING DECISIONS IS
HOUSING FIRST WE ELIMINATE SOME
PROGRAMS THAT DO SHOW GREAT
SUCCESS ONE OF WHICH IS RIGHT
HERE IN SACRAMENTO THE ST JOHN'S
PROGRAM WHICH BECAUSE IT'S A
RESIDENTIAL PROGRAM OF- MOTHERS
AND CHILDREN. PASSED TO REQUIRE
SOBRIETY. AND FOR THAT REASON
THEY RECEIVE ABSOLUTELY NO
PUBLIC FUNDING WHATSOEVER THEY
RECEIVE PRIVATE FUNDING AND
THAT'S WHAT FUNDS WHAT THEY DO-
I CONTRIBUTE TO THAT MIGHT
ENCOURAGE EVERYBODY- WITHIN THE
SOUND OF MY VOICE TO CONTRIBUTE
TO THEM BUT IT IS A REAL SHAME
THAT THEY ARE TOTALLY. ON
ELIGIBLE FOR A PUBLIC FUNDING
SO- I MENTION THIS THAT ARE
HOMELESS- HEARING AND ALL
MENTION IT AGAIN I THINK IT'S
TIME FOR US TO REASSESS THAT
PROGRAM ADOPTED IN TWENTY
SIXTEEN B. SINCE WHEN WE OF
EXPERIENCE THE EXPLOSION AND-
HOMELESSNESS ON OUR STATE. MY
SECOND QUESTION- DOES HE GET AT
THE ISSUE OF RESULTS- WE WANT
THESE PROGRAMS TO RESULT IN.
BETTER HEALTH OUTCOMES FOR
INDIVIDUALS AND- WE I'M SURE
WILL DO A GREAT JOB OF MEASURING
WHAT EVERYBODY DOES- AND I HOPE
WE DO A GREAT JOB OF MEASURING
WHAT IS ACTUALLY ACCOMPLISHED.
BUT GIVEN THE NATURE OF THE
PROGRAM AND THE LARGE NUMBER OF
ENTITIES AND AGENCIES THAT ARE
INVOLVED THAT HAVEN'T
NECESSARILY BEEN A COORDINATING-
IN THE PAST- IF THE OUTCOMES ARE
THERE AND SO MANY DIFFERENT
AGENCIES HAVE. A HAND ON A
PARTICULAR OUTCOME- IF IT
DOESN'T WORK IF THE OUTCOMES
DON'T WORK. WHO'S RESPONSIBLE
FOR THAT TO PUT IT MORE CRUDELY
WHO DO WE KNOW IN THE SPECTRUM
OF SERVICES TO BLAME FOR THE
LACK OF OUTCOMES THAT'S THAT'S
REALLY MY QUESTION HOW DO WE
KNOW IF THE OUTCOMES ARE THERE-
WHO IN THE BROAD SPECTRUM OF
PARTICIPANTS WHO MIGHT BE
RESPONSIBLE FOR THAT PARTICULAR
FAILURE. I SUBJECT TO COOPER
HAPPY TO ANSWER THE QUESTION IF
I CAN ASK ONE CLARIFYING
QUESTION WHEN YOU'RE SPEAKING
ABOUT COMES ARE YOU TALKING
ABOUT ALL OF THE VARIOUS
OUTCOMES AND COMPONENTS OF
CALLIN BROADLY I JUST WANNA MAKE
SURE I ANSWER YOUR QUESTION
SPECIFICALLY. YES BECAUSE IT IS
SUCH A OR A- CAPRI AT LARGE AND
COMPREHENSIVE PROGRAM- HOW DO
WE- HOPEFULLY WILL SALAS S.
OUTCOMES HOW DO WE ASSESS. WHO
NEEDS TO DO A BETTER JOB TO GET
BETTER OUTCOMES. SURE SO HAPPY
TO ANSWER THAT QUESTION I THINK
THAT ULTIMATELY THE DEPARTMENT
OF HEALTH CARE SERVICES IS
LEADING THE IMPLEMENTATION OF
HOWLING ABOUT MEDIC CAL IS LARGE
AND COMPLEX AND DOES CROSS OVER
MULTIPLE SOURCE SYSTEMS
INCLUDING SISTER AGENCIES AND
DELIVERY SYSTEMS. FORTUNATELY WE
ARE. WORKING WITH OUR VARIOUS
PARTNERS TO IMPLEMENT THAT THAT
BEING SAID THERE ARE LARGE
COMPONENTS BEING IMPLEMENTED. BY
OUR MEDICARE MANAGED CARE PLANS
IN OUR COUNTY BEHAVIORAL HEALTH-
AT A PLANTS AS WELL AND SO THE
DEPARTMENT WORKS VERY CLOSELY
WITH OUR MANAGED CARE PLANS IN
REGARDS TO MEETING THE
EXPECTATIONS THAT HAVE BEEN
OUTLINED BY. THE DEPARTMENT OF
INCLUDING NOT JUST THAT MAKING
SURE THAT PEOPLE ARE GETTING
ACCESS TO SERVICES IN UTILIZING
THOSE SERVICES AND THE RIGHT
PEOPLE ARE BEING CONNECTED BUT
ALSO THE HEALTH OUTCOME
IMPROVEMENT. ARE WE SEEING THE
INTENDED. COME IN SO WE WILL
HAVE DASHBOARDS AND WE'VE
STARTED POSTING SOME WE WERE
ALSO BE BRINGING IN AN
INDEPENDENT EVALUATOR. I TO MAKE
SURE THAT WE ARE HAVING THAT
THIRD PARTY ALSO EVALUATE THE
SUCCESSES OF THE PROGRAM. AND
THAT WOULD BE THE SAME ON OUR
COUNTY BEHAVIORAL HEALTH SIDE
THERE HAVE BEEN SIGNIFICANT
CHANGES OF FOR THEM TO YOU TO
EMPLOYMENT AND SO WE WILL BE
HOLDING THEM ACCOUNTABLE THROUGH
DATA THAT WILL BE POSTING NOT
JUST UTILIZATION AGAIN. OUTCOMES
IN REGARDS TO CONNECTING PEOPLE
WITH SERVICES AND ENSURING THAT
THE INTENDED POLICIES ARE BEING.
IMPLEMENTED TO FIDELITY- AND SO
WE ARE LOOKING FORWARD TO
GETTING THOSE DASHBOARDS A
PUBLIC IT'S JUST OUR FIRST YEAR
IN AND WE HAVE. A DATA LAG IS. A
COMMON THING I KNOW IT'S NOT A-
YOU KNOW PEOPLE WANT TO SEE DATA
FAST- BUT WE DO NEED TO KNOW
SURE IT'S- AND THAT IT'S- AND
YOUR WORK ON GETTING A-
DASHBOARD. UP UNDER OATH. A DH
CS ARE OTHERS DEPARTMENTS AND
ARE MANAGED CARE PLANS AND
COUNTY. OLD BE INDIVIDUALS
RESPONSIBLE FOR IMPLEMENTING A
CALLIN COMPONENTS AND- AND
SEEING IT COME TO FRUITION.
COULD ANYONE ELSE- WANT TO
ADDRESS- SENATOR NEAL IS
QUESTION. GO AHEAD I APPRECIATE
THE ANSWER OKAY EXCELLENT SO NOW
WE WILL GO TO SENATOR ROSS.
THANK YOU MADAM CHAIR AND TO THE
PANELISTS THANK YOU FOR WORKING
ON THIS A RATHER COMPLICATED
KILLING ISSUE. I HAVE TWO
QUESTIONS PRIMARILY FOR I GUESS
THE STATE AND OTHERS CAN. CAN
CHIME IN. GIVEN THE REALIGNMENT
HEALTH CARE FUNDING DISPARITY
AMONG COUNTIES IN THE STATE. AND
GIVEN THE STATEWIDE SHORTAGE OF
MENTAL HEALTH PROVIDERS AT ALL
LEVELS PARTICULARLY IN THE
INLAND PARTS OF THE STATE. AND
THE SHORTAGE OF MENTAL HEALTH
TREATMENT FACILITIES
PARTICULARLY. ACUTE CARE BEDS.
ARE YOU CONCERNED ABOUT OUR
ABILITY TO MEET THE CAL AIM
PROMISE. IN THE BEHAVIORAL
HEALTH AREA. TWO IF SO WHAT
SPECIFICALLY ARE WE DOING ABOUT
THE ACUTE CARE. AND BEHAVIORAL
HEALTH WORKFORCE. SHORTAGE.
MAYBE I'LL START MITCHELL BY
SAID THE H. YES AND- IF JEEZY
WANTS TO ADD ANYTHING I WITH
REGARD TO KIND OF THE
REALIGNMENT FUND DEAN I'M WITH
THE BEHAVIORAL HEALTH A MEMBER
FORMERLY. THAT WE SEE IS
OPPORTUNITY TO PROVIDE COUNTIES
WITH MORE FLEXIBILITY IN HOW TO
USE THEIR DOLLARS I MEAN I THINK
THAT IS KIND OF A I THINK. A
PATH FORWARD TO ADDRESS SOME OF
THOSE- I KNOW SOME OF THE
DESPAIRS THAT WE TALKED ABOUT IN
THE PAST ON REALIGNMENTS. AND
WITH REGARD TO BE ACUTE.
SETTINGS AND KIND OF JUST A
BRICK AND MORTAR CAPACITY THAT'S
THAT WE HAVE THE BEHAVIORAL
HEALTH CONTINUUM INFRASTRUCTURE
. PROGRAM I THINK OVER THE LAST.
FOR ABOUT A BILLION DOLLARS HAVE
BEEN AWARDED I'M ADDING ABOUT
TWO HUNDRED THOUSAND ARE
TREATMENT SLOTS ABOUT SEVENTEEN
HUNDRED BEDS I'M SO REALLY
BUILDING UP THE CAPACITY THAT
WINDOW IS NEEDED- AND THEN JUST
INTERNET YOU KNOW WHAT WAS
ALREADY RAISED WITH REGARD TO
OUR COMMUNITY HEALTH WORKER
BENEFITS- I'M- RECOGNIZING THAT
THAT THAT WE DO NEED TO BUILD
OUT THE PIPELINE OF CLINICAL.
CLINICAL FIVE PERSONNEL AND- BUT
WE HAVE COMMUNITY HEALTH WORKERS
THE PURE SUPPORT BENEFIT AND
ENJOY WHICH IS NOT A SITE
BEHAVIOR HEALTH BENEFITS. BUT
REALLY BUILDING OUT OUR
EXTENDERS OTHER WORKFORCE THAT
WE THINK CAN HELP ADDRESS THE
WORKFORCE NEEDS THAT WE HAVE OUT
THERE TO SERVE OUR MEMBERS. WHAT
DOES. THE SENATOR SAID SENATOR
ROCKET BY NAME MICHELLE COVERED
IT UP WITH THE COUNTY BEHAVIORAL
HEALTH DIRECTORS ASSOCIATION. WE
WHAT JUST LAST WEEK PUBLISHED AN
ANALYSIS COMMISSIONED WITH A
UNIVERSITY OF CALIFORNIA SAN
FRANCISCO. I HOPE FOR CENTERS
THAT DOCUMENTS THE SIGNIFICANT-
YOU KNOW SHORTAGES THAT WE HAVE
BEEN THE PUBLIC SAFETY NET FOR
BEHAVIORAL HEALTH SERVICES THIS
CUTS ACROSS A LICENSED AND
CERTIFIED CLINICIANS AS WELL AS-
OUR SUBSTANCE USE DISORDER
COUNSELORS AND AS YOU KNOW. THE
CENTRAL VALLEY AND THE INLAND
EMPIRE FEAST THE MOST
SIGNIFICANT WORKFORCE SHORTAGES
AND I WOULD. ARGUE THAT THESE
WORKFORCE SHORTAGES ARE A
CRITICAL THREAT NOT ONLY TO
KALENDS INITIATIVES BUT TO THE
OVERALL SAFETY NET. SERVICES AND
SO ONE OF THE THINGS THAT WE'VE
BEEN LIFTING UP IS THE
IMPORTANCE OF THE STATE- NOT
DELAYING- OUR BE INVESTMENT IN
EDUCATION AND TRAINING FOR
BEHAVIORAL HEALTH WORKFORCE AS
PROPOSED IN THAT JANUARY BUDGET.
AND REALLY WE NEED TO NOT ONLY
SORT OF FAST TRACK THOSE THINGS
BUT EXPAND ON THOSE EFFORTS AND
TO YOUR POINT- THE RECIPE FOR
SOLVING OUR WORKFORCE. CRISIS IS
REALLY TWO FOLD IT'S EXPANDING
EDUCATION AND TRAINING BUT ALSO
INCREASING- DR KERR KIRBY
MENTIONED EARLIER AND IT'S VERY
TRUE WE ARE LOSING OUR PARA
PROFESSIONALS IN THE FIELD TO
THE GIG ECONOMY AND FAST FOOD-
ATA AND ALARMING RATE AND- WE'RE
HOPEFUL THAT. REFORM WILL HELP
US TO ALONG WITH KELLY MANY
SHIPS SQUEEZE MORE OUT OF THE
EXISTING STREAMS OF REVENUE THAT
OUR SYSTEM RECEIVES BUT IT
CERTAINLY IS- YOU KNOW TRYING TO
MAXIMIZE WHAT WE ALREADY HAVE
NOT ADJUSTING FOR INCREASED
DEMAND. NECESSARILY THANK YOU
I'D LIKE TO FROM THE
ADMINISTRATION SEE THE SET OF
GOALS AND OBJECTIVES AND PLAN OF
ACTION TO ADDRESS. SPECIFIC
WORKFORCE SURE. IN A OF THE
STATE IN AND THAT WILL GIVE US
SOMETHING TO SHOOT A INTER OF
THE BUDGET AND JUST A POINT OF
CLARIFICATION FROM HIS BOSS ARE
YOU SAYING THAT THE BEHAVIORAL
HEALTH INFRASTRUCTURE PROGRAM.
INCLUDES FUNDING FOR ACUTE CARE
PSYCHIATRIC BED EXPANSION IN THE
STATE I WAS NOT AWARE OF THAT.
YES THE DOWNS. IN THE PREVIOUS
ROUNDS WERE ELIGIBLE FUNDING
TYPES. WILL BE TIGHT YES
SEPARATE AND APART FROM THIS
HEARING CAN YOU PROVIDE ME WITH
THE- THE NUMBER OF ACUTE CARE
PSYCHIATRIC BED- BEDS THAT WERE
ADDED AS A RESULT OF THE
BEHAVIORAL HEALTH
INFRASTRUCTURE. FUNDING PROGRAM
THAT WOULD BE HELPFUL AS OPPOSED
TO COMMUNITY AND RESIDENTIAL
TREATMENT SLOTS THANK VERY MUCH
MEANT. GREAT THANK YOU- SENATOR
ROSS SO NOW WE'LL GO TO CENTER
LAYERED. THANK YOU VERY MUCH
MADAM CHAIR- WHEN WE HAD THE
HOMELESS HEARING. DR KELLY SAID.
THAT THIS WAS THE ONE PROGRAM
THAT WOULD BRING NEW RESOURCES
TO THE TABLE. FOR SERVICES TO
THE ON THE HOUSE. AND SO I'M
INTERESTED- CAME UP THROUGH THE
THEIR HEARING WITH- MICHELLE
BOSS TALKING ABOUT PUSHING DOWN
THE WALLS OF THE PROGRAM'S
OVERLAP WITH OTHER PROGRAMS AND
I THINK THE WESTERN CENTER. AND
EVEN THE BEHAVIOR HEALTH
DIRECTOR SAID. IT IN FOR DIS SO
MY QUESTION AND I GUESS I'LL
START WITH MACHEL BOSS. IS HOW
DOES THIS SPRING MORE. RESOURCES
TO THE TABLE AND HOW DO THE
PEOPLE THAT MIGHT READ GET THE
RESOURCES KNOW ABOUT. I WILL
START AND THEN TURN IT OVER TO
JC IT IS BRINGING ADDITIONAL
FEDERAL DOLLARS AND STATE
GENERAL FUND WITH REGARD TO OUR
COMMUNITY SUPPORTS THE BALLOT
THAT. COMMITTEE SUPPORTS RELATED
TO HOUSING AND HOMELESS SERVICES
I JUST WANT TO MAYBE TAKE IT.
WITH MORE DETAIL YEAH AND THE
MORE DETAIL MIGHT BE WHAT
COMMUNITY SUPPORTS OUR THAT IT
GOES TOO. FAR YES HAPPY TO
PROVIDE THE INFORMATION SO I'M
SPECIFICALLY FOCUSING ON HOUSING
AND HOMELESSNESS WE'RE DOING TWO
THINGS WE HAVE BOTH EIGHT AND IN
FUSION OF ONE KIND DOLLARS AND
THEN ONGOING I THINK THE ON
GOING PART IS REALLY IMPORTANT
SOFT FOCUS ON BOTH FOR YOU
REALLY QUICK- SO WHEN IT COMES
TO THE ONE TIME DOLLARS WE
AREN'T USING SIGNIFICANT DOLLARS
TO BUILD. UP THE INFRASTRUCTURE
OF THESE PROVIDERS THAT CAN DO
HOUSING NAVIGATION SERVICES
HOUSING TRANSITIONS SERVICES
DEPOSITS. RECUPERATIVE CARE BUT
THE UPPER COMMITTEE BECAUSE WHEN
SOMEONE EXPERIENCING HOMELESS IS
LANGUISHING IN AN INPATIENT BED
I'M OFTENTIMES FOR A VERY
SIGNIFICANT TIME IN THE HOSPITAL
TEAM THAT'S ON A DISCHARGED INTO
THE STREET THAT LANGUAGE THERE
RETRIBUTIVE CARE ALLOWS SOMEONE
EXPERIENCING HOMELESSNESS TO BE
DISCHARGED TO A- MEDICAL RESPITE
RECRUITED CARE BED. OR TO A
SHORT TERM POST HOSPITALIZATION
AND EVENTUALLY GET CONNECTED TO
THOSE HOUSING TRANSITION
SERVICES WE'RE BUILDING FOR THE
FIRST TIME WE WILL CONTINUE OUR-
HOUSING SERVICES AND SUPPORTS.
AND BEFORE THEN BEFORE THEN YOU
GO TO THE ON GOING MONEY. LET ME
ASK ABOUT THAT BECAUSE YOU
DESCRIBE THE SERVICES. BUT YOU
DIDN'T DESCRIBE WHO THE MONEY
WOULD GO TO DELIVER THE SERVICES
AND FOR EXAMPLE. THE THERE'S A
NON. HOMELESS PROGRAM MY HOME
TOWN. THAT DOESN'T WHAT YOU'RE
DAY DAY PROVIDE REHAB FOR PEOPLE
OUT THE HOUSE. WITH THE BE
ELIGIBLE FOR THIS MONEY ON THIS
DIRECTLY TO THEM. YES SO WE'D
HAVE BEEN RELEASING WHAT WE CALL
PASSED DOLLARS MONEY GOES TO THE
BASE ORGANIZATIONS NONPROFIT
PUBLIC HOSPITALS COUNTY AGENCIES
TRIBAL ENTITIES. AND WE'RE DOING
THAT GRANTS DIRECTLY FROM THE
DEPARTMENT TO THOSE- COMMUNITY
BASED ORGANIZATION IT IS
COMPETITIVE FOR EXAMPLE IN
JANUARY- ABOUT A HUNDRED
NINETEEN MILLION THAT WENT OUT
IN SEVENTY EIGHT ABOUT NINETY
EIGHT AWARDS WERE SPECIFICALLY
FOR HOUSING AND HOMELESSNESS
PROVIDERS EXACT PROVIDERS LIKE
YOU ARE DESCRIBING. TO BUILD UP
THEIR INFRASTRUCTURE ACROSS THE
STATE THIS IS BRAND NEW WE HAVE
TO BUILD THIS INFRASTRUCTURE
ORDERS GREAT PROVIDERS LIKE YOU
JUST MENTIONED DOING THIS IN THE
COMMUNITY. IDENTIFYING THEM AND
CONNECTING THEM WITH GRANTS TO
BE ABLE TO. SCALE UP OF FOR
EXAMPLE WE DID FUND IS PRETTY
SIGNIFICANT NUMBER OF NEW KIND
OF RETRIBUTIVE CABINETS ONCE
KIND OF SIMILAR TO WHAT YOU'RE
REFERRING TO IN THIS ROUND SO WE
HAVE ANOTHER ROUND OF FUNDING
COMING UP- SOON ROUND TWO WILL
BE ANNOUNCED AND SO INDIVIDUALS
WILL BE ABLE TO GET THOSE.
INFRASTRUCTURE DOLLARS IN ORDER
TO SCALE UP THE NEED THE NEED
FOR THESE SERVICES SO I WILL
CONTINUE TO AND NOW SAYS AND
WILL MAKE SURE PEOPLE ARE
TRACKING WITH THOSE ARE YOU ALSO
PROVIDING A LOT OF. TECHNICAL
ASSISTANCE WE HAVE WHAT'S CALLED
THE T. A MARKET PLACE TO MAYBE
THAT PROVIDER IT IS USED TO
BILLING MEDICAL SERVICES. AND WE
ARE PAYING FROM THE STATE
FOURTEEN VENDORS TO BE AVAILABLE
ACROSS THE ENTIRE STATE OF
CALIFORNIA WE DID A STATEWIDE
FOR GERMANY AT DIFFERENT VENDORS
IN DIFFERENT PARTS OF THE STATE
BECAUSE IT'S- HARD. TO PROVIDE
TECHNICAL ASSISTANCE FOR- FOR
THE PROVIDERS LIKE YOU WERE
SAYING- NO OTHER SENATORS WANT
TO ASK QUESTIONS SO LET ME JUST
ASK A FOLLOW UP QUESTION AND TRY
TO. ROUND THIS OUT. EARLIER WE
DID ASK FOR TWO QUESTIONS ONLY
FOR EACH. MEMBER AT THIS POINT
AND ANNOY ANSWERING ONE AND I'M
TRYING TO GET K. FOLLOW UP
ANSWER- IT BECAUSE IT'S
BASICALLY. YOU CAN USE THAT.
THAT THIS IS COME. AND YET IT
PROBABLY ON EVERY. IT AND
THERE'S A TECHNIQUE SYSTEM. UPON
BUT HOW DO REALLY KNOW HOW DO
THEY KNOW TO BE ABLE TO APPLY
FOR THIS. SO WE ARE TRYING TO
COMMUNICATE THAT ACROSS THE
ENTIRE STATE OF CALIFORNIA WE
HAVE DEPLOYED WHAT WE'RE
CALLING. KIND OF. BERRIES GOD
COLLABORATIVE PLANNING GROUP
HUBS ACROSS EACH COUNTY WE HAVE
ANNOUNCED THOSE THERE ON OUR
WEBSITE. AND THAT'S REALLY DRIVE
PEOPLE TO BEING ABLE TO HAVE A
LOCAL SOURCE TO GET INFORMATION
THE OTHER PLACE I WOULD SAY IS
OUR MEDICARE MANAGED CARE PLANS.
MANAGED CARE PLANS SHOULD BE
DOING A FULL NETWORK ASSESSMENT
IS THEIR RESPONSIBILITY TO DO
WITH GAP ASSESSMENT IDENTIFY
PROVIDERS IN THEIR COUNTIES THAT
CAN ALSO REACH OUT REACH OUT TO
THEIR LOCAL MEDICARE MANAGED
CARE PLAN. THAT PLAN CAN GUIDE
THEM TO THE VARIOUS TECHNICAL
ASSISTANCE LINKS THEIR
PERMISSION AVAILABLE THOSE WOULD
BE THE BEST POINTS TO GET PEOPLE
DIRECT TIME WILL FOLLOW UP WITH
YOU OFFLINE. THANK YOU VERY MUCH
FOR THE RESPECT. THANK YOU
SENATOR I MAY GOING YEAH YOU
MALE REFINED YEAH LIVING AT
MANAGEMENT WITHOUT H. P. AND I
THINK THAT A LOT. AND ON AND-
THE DIRECTORS TO NOW THE FIVE
BETTER FOR. MANAGED CARE. JUST
ONE TO FLY IT NOW. WE THE
CALLING AND INTENDED PROGRAM HOW
AND HOW. INTENDED PRO. FIRST YOU
ADDITION FUNDING FOR THAT
FLOWING THROUGH. IN THEIR LOCAL
COMMUNITY SO AND TO THAT THE
HOLLER THAT THE ACT WELCOME-
NEEDS ARE OUT. AND I PLAN
LARGELY COMPETITIVE GRANTS-
PROCESS. BUT THEY'RE REACHING
OUT LOCAL TO THEIR PER PROVIDER
CAN- AND HOUSING AND- AS WELL
ENSURE THAT THERE A LEARNING.
DOLLARS AND CAN SUPPORT THE- IN
AND FIRST THE- CAN YOU TAKE IT
TO ENCOURAGE KIDS TO BE IN THE
SERVICE THING REALLY SKILLED AT
. AND DISTURBED THE NUMBER OF
MEMBERS NEED. GREAT YOU IF
THERE'S OTHER P. WHO WANTED TO
ANSWER CENTER LURCH QUITE PLEASE
IF I DON'T YOURSELF AND YOU.
MISTER TRANSACTION ONLINE.
INVITES MIGHT AS- ON. IT IS TO
AS AS MENTIONED BY THE LOCAL
PLANS THERE ARE INSTEAD OF CLASS
WHICH WE HAVE BEEN HERE FROM THE
- CRITICALLY AROUND THE IN
SUPPORT SERVICES. LADIES- GOD
PARTNERS THAT WORK DIRECTLY WITH
INDIVIDUAL EXPERIENCE HOMELESS
BY. OUTREACH ON THE STREETS-
THAT THEY THEY HAVE BY THAT THE
INTERNET RIGHT A PROVIDING THESE
. THAT ARE COST EXCEEDED- OF
THAT IT THE THAT THE COST OF THE
DAY ARE BEING PROVIDED AND SO-
AS A COMMUNITY SUPPORT TAKING
THAT THAT'S ONE OF THE
CHALLENGES BECAUSE- IT IS- IT
HAS TO BE COST NEUTRAL AND SO
MOVING TOWARDS A MEDIC CAL
BENEFIT. IS CRITICAL- IN IN
PROVIDING IN ACTUALLY BEING ABLE
TO WRAP UP THE SERVICES AND
BUILD OUT THE PROVIDER NETWORK
AND SO THAT THAT IS SOMETHING
THAT WE WOULD WOULD LIKE TO SEE
IS MAKING ARE MOVING TOWARD-
EIGHT EIGHT BENEFIT FOR
PARTICULARLY. THE HOUSING
SUPPORT SERVICES. WE HONOR
CONCORD WHICH TV WOULD COMPLETE
AGREE WITH THIS WAY COMMENT AND
ALSO HAD THAT IS ORDER WHEN
PROVIDING THESE GRANTS SERVICE
THAT WE THINK ABOUT IT A GREAT
RIGHT SO NOT TO HOUSING AND NOT
JUST GOING TO FOR ARE FROM.
HEALTH SERVICES BUT THEY WERE
WITH OTHER COMMUNITY BASED
ORGANIZATIONS THAT ARE REALLY
SPEAKING TO THE WHOLE PERSON AND
ALL OF THE VARIOUS NEEDS AGAIN
ACCOUNT IS REALLY ABOUT
INTEGRATING CARE AND PROVIDERS.
SO EVEN IN IT YOU KNOW-
OPPORTUNITIES FOR HOUSING
SERVICES WE HAVE TO LOOK AT HOW
THAT WORKS WITH OTHER PARTS OF
THE SECTORS THAT IT'S TRULY-
DEFINITION AND I HAVE GOOD FOR
THOSE THAT ARE. IN NEED OF THE
SERVICES. ALL RIGHT YOU FOR
THOSE ADDITIONAL ANSWERS
EMPLOYEES AS WE KEEP GOING- IF
OTHER PANELISTS HALF WANT TO
ADDRESS THE QUESTION THAT ANY OF
OUR SENATORS ARE ASKING PLEASE I
WILL CALL YOU. SO SENATOR
MANCHIN FOR. THANK YOU MADAM
CHAIR. MY FIRST QUESTION SIMILAR
TO THE SENATOR TO MY LEFT HERE-
AND IT'S DIRECTED TO LINDA. AND
I KNOW WE ARE DOCUMENTING OUT
REGION ENGAGEMENT IN TIMES THE
MODALITIES WE HAVE THAT DATA I
JUST WANTED TO GO A LITTLE BIT
MORE INTO HOLLOW THE STRATEGIES
WHAT ARE THEIR STRATEGIES WERE
EMPLOYED TO GET. TO IDENTIFY
MEMBERS WHO WILL BENEFIT FROM
SUPPORT SERVICES AND THE
ENHANCED CARE MANAGEMENT ELSE
THAT'S MY FIRST QUESTION. THANK
YOU FOR THE QUESTION PREDATOR SO
. D. C. OUR REGION ENGAGEMENT-
HE SAID THAT IS BOTH REALLY
IMPORTANT AND ALSO VERY
CHALLENGING I KNOW ONE OF THE
THINGS THAT- ARE MY NUMBERS ARE
HEARING FROM THEIR PROVIDER IS
THAT IT OFTEN TAKES MANY AT
TIMES AN ONGOING- ENGAGEMENT.
AND IT CAN NUMBERS INTO TAKE
CARE AND ENROLLED IN EASY AND OR
COMMUNITY SUPPORT. TERMS OF A
STRONG TO DO THAT I THINK IS. A
FEW- MECHANISM AND I WON
ELABORATED ON A COUPLE OF THINGS
THAT HAVE DONE AND I HAD MANY IN
PLACE FOR. PLANS ARE PROACTIVELY
I'M TRYING TO. MEMBERS WHO MAY
BE OUT. FOR THE- AND SO WHAT
WHAT THEY DO IF YOU KNOW THEY'LL
GO THAT AND THEN SHE THOSE TO
THE LEFT I'M WITH THEIR CONTACT
PROVIDER. SO THEY CAN MAKE OUT
OTHER THAT IN PERSON. ALLOPHONIC
LEE- OR CARE SAID I'M- ACTUALLY
ENDED AND I SERVICE. AND I SAY
IN THE LIMIT. TO ELIGIBLE LAST.
I'M ARE THAT HAS THE CRITERIA
QUALIFY FOR HIM MANAGED OR CAN
YOU SUPPORT. IT IS LAW RELIANT.
SOCIAL WHETHER YOU ARE AND HOW
OLD OR OTHER OF THAT SOCIAL
DRIVERS HEALTH. WE DON'T HAVE
THAT NEED. IT CAN BUT IT WILL
TIME SO FOR EXAMPLE- PLANS ARE
START. TO AND GET HOUSE DATA.
THROUGH THEIR LOCAL AND HER
SYSTEMS AND THAT'S BEING IN
LARGE PART SUPPORT- BY THE HOUSE
AND HOME IN SAN PRO DOLLAR TO
HELP THE CAN THANK THAT'S
BECAUSE- BUT AGAIN JUST HIM AND
FOR THE LOW. TO THE DALLAS LET
SATURDAY TO PROVIDE. WAITING WHY
OVER TIME THE EDUCATION AND- AND
HOW REACHED PROVIDERS DELIVER
CHARACTER MEMBERS. AND PC AND
OTHERS ABOUT THE FACT THAT THE
NEW SERVICES BENEFITS- COULD I
FOR THEM AND THEN REFERRAL. IT'S
GOING TO BE ONE OF THE BAD WE
HEY YOU WITH MEMBERS WHO ARE
RISK CARE- AND GET OVER. AND A
WARM- FROM THERE PROVIDE. SO IF
IT'S OF A MOLD. MULTIPLE AT VERY
NOT THANK KIND OF. TO REACH THE
NUMBER IN GETTING THEM ENGAGED
IN CARE. THANK YOU PLACE
QUESTIONS MICHELLE OKAY- WE TALK
ABOUT SUPPORT. IN YOU KNOW I'M A
HUGE OF THE WHAT WERE CALLED THE
WHAT I CALL HOLISTIC CARE BUT WE
COULD. FULL PURSE CAN APPROACH.
IN A MORE. YOU KNOW THE- SORRY
SO. THAT'S ANOTHER QUESTION
WONDER QUITE AND ADDED TWO
HUNDRED TO THE TO SOME OF THE
QUESTIONS USE IS GOING TO SHOW-
I WANT TO TALK LITTLE BIT MORE
ABOUT THIS MOBILE. IN IN THE CAN
OF BASED CARE AND I KNOW I READ
THE WAY FORCE HERE BUT I'M
WONDERING IF YOU COULD TELL A
LITTLE BIT ABOUT KNOW WE'VE
INVESTED A LOT IN THE TWO YEARS
IN HOWEVER THE COUNTY'S
INTEGRATING. THE MOBILE CRISIS
INFRASTRUCTURE INTO THIS
CONTINUUM OF CARE. THAT'S A
WONDER QUESTION SENATOR SO- AS I
MENTIONED IN MY TESTIMONY WE
HAVE IN SOME COMMUNITIES DECADES
WORTH OF EXPERIENCE WITH MOBILE
CRISIS SERVICES IN THAT COUNTY
SAFETY. AND OFTEN TIMES BECAUSE
THESE SERVICES HAVE NOT BEEN
FULLY REIMBURSED WE- REALLY-
DEDICATED THOSE MOBILE CRISIS
SERVICES TO PEAK DEMAND HOURS
SO- THEY'RE OFTEN NOT AVAILABLE
TWENTY FOUR SEVEN IT WAS REALLY
THE FEDERAL GOVERNMENT THAT
OFFERED MOBILE CRISIS SERVICES.
THROUGH MEDICAID- BUT THE
ATTACHED QUITE A FEW STRINGS TO
THE BENEFIT ONE OF THEM IS THAT
SERVICES NEED TO BE PROVIDED
TWENTY FOUR SEVEN. SO THE-
STATE- WITH A LOT OF FORESIGHT
PROPOSED- THE FIRST INITIAL
ROUNDS OF THE- INFRASTRUCTURE
FUNDING UNDER THE V. CHIP. UP
FOR MOBILE CRISIS INFRASTRUCTURE
AND ALL JUST SAY- WE ARE TRYING
TO PIGGYBACK AND LEVERAGE AS
MUCH OF OUR EXISTING COUNTY
BEHAVIORAL HEALTH CRISIS
INFRASTRUCTURE TO SUPPORT THIS
BUT IN SOME PLACES IT'S GONNA
TAKE A LOT MORE TIME TO BUILD
OUT. THAT CAPACITY FOR EXAMPLE I
THINK THAT THE FEDERAL STRUCTURE
AND AS WELL AS THE BENEFIT YEAR
DOESN'T ACKNOWLEDGE ENOUGH THE
ROLE OF DISPATCH IN- STANDING UP
MOBILE CRISIS SERVICES SO OFTEN
TIMES THE GOAL WITH- MOBILE
CRISIS DISPATCH IS NOT JUST TO.
YOU KNOW HIT PRESS A BUTTON AND
SENT A TEAM OUT BUT TO REALLY
EVALUATE WHAT'S GOING ON OVER
THE PHONE AND SEE IF YOU CAN
STABILIZE SOMEONE IN TRIAGE
THOSE SERVICES IN REAL TIME
RIGHT RIGHT FROM THE PHONE. WHEN
THE MOBILE CRISIS SERVICES ARE
NECESSARY THEN YOU NEED A TEAM
THAT'S GOING TO MEET THE
REQUIREMENTS LAID OUT IN FEDERAL
AND STATE LAW AND THERE ARE A
LOT OF STRINGS ATTACHED THERE
YOU KNOW WE FLAG THAT THERE ARE
SIGNIFICANT NEWARK. TO THE STATE
BY BENEFIT SO THAT IS GOING TO
BRING US TO STOP TO SIR LEVEL.
AND TO DOCUMENT QUITE A BIT
THROUGH OUR SERVICES BUT THE KEY
THE KEY PIECES OF SORT OF HOW
WE'RE LEVERAGING WHAT WE HAVE WE
GOT THAT INITIAL INVESTMENT FROM
THE STATE WE NOW HAVE THE NEW
CRITERIA REQUIRED FOR MEDIC CAL
AND AS I MENTIONED. THE MEDIC
HOW FUNDING IS ONLY GOING TO
COVER A THIRD OF THE STATE'S
POPULATION 70% OF THE STATE WILL
STILL BE WANTING THOSE MOBILE
CRISIS SERVICES AND WE FRANKLY
HAVE NOT HAD GOOD SUCCESS WITH
TRYING TO GET PRIVATE INSURERS
TO REIMBURSE US FOR THOSE
SERVICES. SENATOR IF I MAY I'M
SO MY ADDRESS. AS WELL AND
MICHELLE IS RIGHT- THERE ARE
LIMITED RESOURCES AND SO
CONSIDERING NOT I WOULD LOOK
EVEN WITHIN YOUR OWN DISTRICT WE
HAVE SYCAMORE SO I KNOW YOU'VE
MET WITH. RECENTLY WHO RECEIVED
FUNDING FOR MOBILE CRISIS WE'RE
DOING REALLY AMAZING JOB. WE
ALSO HAVE THE NINETY DAY CALL
CENTERS THAT PROVIDE TWENTY FOUR
SEVEN COVERAGE- AND INTERVAL IS
REALLY TO TRY TO LINK THOSE IF
POSSIBLE BECAUSE OFFICIALS THAT
WE WANT TO SEE WHAT SYSTEM. IT
DOES TAKE TIME IT TAKES
PARTNERSHIP WITH COUNTIES AND
PROVIDERS AND- THERE ARE MODELS
OUT THERE THAT ARE. ALREADY
WORKING SO I WOULD SUGGEST I'M
REALLY. LOOKING AT HOW WE CAN
BUILD OFF OF THIS. SENATE THIS
YEAR LISTEN THE NEW. FLOOD
PROGRAM I'M TO ADD CONSCIOUS
ABOUT. OR I MEAN I THINK IT'S-
IMPORTANT TIME. THAT CRISIS.
INCLUDING CRIED SERVICE I WAS
ALWAYS OUR- UNDER EACH G. WHICH
IS THE ANTI. FOR CHILDREN AGE
ONE AND IN MANY STATES FROM.
PRICE SERVICE INCLUDING OKAY
SERVICES MATTER ****. TO CORRECT
- MIGLIOR ENERGY MENTAL HEALTH.
WHICH HAS. AGAIN BEEN CLEAR ON
THE FACT GOVERNMENT EVERY AS A
REQUIRE IS NOT NEW IT'S NOT.
IMPACTED BY THE MOST FEDERAL LAW
THE HAS X. QUALIFY WILL CRISIS
THAT BUT AND YOU CAN'T. MATCH
AND I THINK. AS BEEN ALWAYS A
SHORTCUT I THINK OUR STATE IS
THE IBM. OF PRICES HOME PRICES
ARE. PARTICULARLY PERSONAL. AND
THAT IS REALLY TO BE A THAT'S IN
THE BACK OF THE MANHOLE. THIS
YOU KNOW THAT WHEN CHILDREN AT
ADULTS REALLY WHEN WE BEEN FOR
ALSO WELL- ARE GETTING THESE.
NEEDS NOW ALSO THERE IN THE CAN
THEY NEED TO DO ABOUT PRICE PLAN
PRICE SERVICES PART OF THE
CONTINUED THIS PART OF THE- AS
CRISES ARE PLAN FOR IN THE- WHEN
YOU NEED EXPECT IT. YOU NEED TO
HAVE A PLAN IN PLACE AND MANY
PROVIDERS TO. NOT START A
WRAPAROUND APPROACH TO ENSURE
THAT THERE IS ON PAPER IN.
ANYWAY TO GET WHEN I CRY ARISE
FROM THE- WHAT'S GOING TO. WITH
THE PLANNING IT'S NOT YOU KNOW
NECESSARY A CALL ON EXTRA. SHE
COME OUT I DON'T KNOW IDEA WHAT
IN THE AND THAT. FAMILY ARE SO I
THINK REALLY IN. THAT WE IN THE
MODEL NINE GOING A FACTOR FOR
THIS AND MINE- I'LL THAT THAT
THIS IS BENEFIT THAT IS PART OF
THE MEDICAID TO. THANKS. ALL
RIGHT I- THREE SENATORS ON LIST
SENATOR DOLE SENATOR DRAW
INSTEAD MEN. AND I WILL NEED TO
GO TO. PUBLIC FOR PRETTY QUICKLY
THERE AFTER- BECAUSE WE DO HAVE
TO. STOP BY NOON SO LET ME GO TO
SAY DOLE THANK YOU MADAM CHAIR
THANK YOU FOR THE PRE. I WILL
VERY. PRECISE IN MY QUESTION
FIRST I WANTED PREFACE THAT WITH
A WHY I'M HERE FROM. YEAH
COUNTIES- WE HAD THE HEARING THE
WE HEARD ABOUT THE COST OF
HOUSING WE DON'T TALK ABOUT-
OTHER THAN GIVING A RENT THOSE
THING. WE HAD THE IN WERE BLUE
HOSP IN CALIFORNIA DUE TO
REIMBURSEMENT RATES THAT'S BEEN
AN ISSUE- AND ALSO- WE TALKED
ABOUT THE CONDITION THAT
ADDICTION ISSUES WHICH A- US
SENATOR NEEDLE BROUGHT UP SO
WITH THAT. THIS IS THE MOST
BROAD PLAN I'VE EVER SEEN I MEAN
THIS IS VERY COMPLICATED WE'VE
WE'VE HEARD THAT TODAY SO MY
QUESTION IS- I HAVE THE SLIDE UP
THE SECOND SLIDE- WHICH WAS
PROVIDED BY THE SECOND
PRESENTER. FOR MAYBE THE FIRST-
WITH WHO DOES WHAT AND SO. MY
QUESTION IS WHERE AS SENATORS
ARE WE ABLE TO GO ON THIS
DASHBOARD I HEARD DOOR DASH
BOARD WHO'S MONITORING THE
DASHBOARD AND WHO WILL BE
PUTTING UP. A PLACES WHERE WE
CAN GO TO. FASTRAK LIKE. WHAT
ARE THE RATES FOR THE PROVIDERS
WHAT IS THE COUNTY GOING TO DO
WHAT IS THE- NONPROFIT GONNA DO
WHERE WHO'S GOING TO MANAGE THAT
DASHBOARD DOUBTS THAT I THINK
QUESTION FOR ME. I WANT TO BE
ABLE TO GO IN AND ACTUALLY. DIED
IN A LITTLE DEEPER ON WHO'S
DOING WHAT AND WHO'S- GOING TO
BE HELD ACCOUNTABLE FOR THE
RESULTS. HI THIS IS DIXIE COOPER
FROM RETIREMENT HEALTHCARE
SERVICES WILL BE MORE THAN HAPPY
TO PROVIDE YOU A CHEAT SHEET FOR
ADMITTED. OF THE VERY- POSTED
INFORMATION A DATA PIECES SO YOU
CAN GET THAT INFORMATION AND
THEN MONITOR IT. AND THEN ONCE
THE A LARGER DASHBOARD IS
RELEASED WILL ALSO MAKE SURE
THAT YOU ARE AWARE OF THAT
DASHBOARD. ONCE WE GET THROUGH
THE DATA LAGGED WE ARE HOPING WE
CAN GET THAT INFORMATION FLOWING
SO THAT YOU CAN BE LOOKING FOR
THOSE IMPROVEMENTS IN OUTCOMES
AND SO. WE'RE MORE THAN HAPPY TO
OFFLINE AND GET YOU THAT CHEAT
SHEET JUST SO YOU HAVE THE
INFORMATION. WILL WILL THE
PROVIDERS HAVE THE ABILITY TO
SAY. A BE ABLE TO COMMENT ON
THAT DASHBOARD LIKE. WE HAVEN'T
BEEN REIMBURSED FOR SIX MONTHS
OR EIGHT MONTHS SO THAT WE AS AS
LEGISLATORS CAN FIGURE OUT. HOW
WE CAN THROUGH THE BUDGET
PROCESS. ADDRESS SOME OF THOSE
ISSUES. YOU PROBABLY WOULD SEE
SOMETHING LIKE THAT AND THE
DASHBOARD BECAUSE IT'S REALLY
USUALLY FOCUSED ON AN OUTCOME
GOAL AND THEN HOW THAT'S BEING
MEASURED IN THE OUTCOME I'M
RESULTS OF THAT- WE CAN A TICKET
BACK IN REGARDS TO HOW WE- ARE
CLEARLY ARTICULATE VARIOUS
CHALLENGES THAT WE'RE HEARING
AND HOW. WE OR THE MANAGED CARE
PLANS ARE COUNTY ENTITIES OF
COURSE. WHO OVERSEE THESE
INITIATIVES- ARE ADDRESSING
THOSE ITEMS. WE DO HAVE VERY
EXTENSIVE- AB YOU KNOW- ADVISORY
COMMITTEES ON TALENTS THAT WE
HAVE BEHAVIORAL HEALTH SPECIFIC
ADVISORY COMMITTEES. THAT
INCLUDES YOU KNOW HOSPITALS
PROVIDERS ON THE GROUND
PROVIDING FEEDBACK LOOPS TO US
SO WE ARE ME THAT EVERYTHING ON
KELLY THROUGH THESE VARIOUS-
ADVISORY COMMITTEES- BUT I DON'T
KNOW IF IT WILL BE ON OUR
WEBSITE WHICH YOU'RE EXACTLY
ASKING FOR SO LET ME WRAP BACK
AND FIGURE OUT WHAT WE CAN GET
YOU AND THEN WE CAN THINK ABOUT
HOW WE- MAKE THAT AVAILABLE IN
THE FUTURE. THAT WOULD BE VERY
HELPFUL THAT BECAUSE WHAT WE'RE
GETTING IS A SILO TO APPROACH
EACH INDIVIDUAL SILO- AND WE
NEED THE ABILITY BILL TO LOOK AT
IT HOLISTICALLY BECAUSE THIS
PROGRAM. IS SO BROAD AND SO
DETAILED SO I WOULD REALLY
APPRECIATE THAT IT WILL BE
HELPFUL. FOR US TO MAKE THOSE
DECISIONS IN EACH OF THOSE
AREAS. UNDERSTANDING THE
PROBLEMS HOW. THEY'RE RELATED SO
I APPRECIATE THAT THANK YOU.
GREAT THANK YOU SENATOR. DAHLE
CENTER TO THROW. THANK YOU MADAM
CHAIR- I'VE LEARNED FROM MY WORK
AS CHERUBS SUB COMMITTEE FIVE-
ABOUT THE ISSUES THAT PEOPLE
INVOLVED IN OUR JUSTICE SYSTEM-
HAVE TO FACE. THERE ARE A HIGHER
RISK FOR ILLNESSES AND DEATH.
THEY HAVE A- HIGHER RISK OF
VIOLENCE OVERDOSES AND SUICIDE-
THE NEED FOR MENTAL HEALTH CARE
IN OUR JAILS ROSE BY SIXTY THREE
PERCENT- AND THAT OVERDOSE IS
THE LEADING CAUSE OF DEATH FOR
PEOPLE RECENTLY RELEASED FROM
INCARCERATION SO. MY QUESTION. I
DON'T KNOW WHO BUT PROBABLY FROM
PANEL TO. IS SINCE PRISON
INMATES WILL BE ELIGIBLE TO
RECEIVE MEDICAL SERVICES. NINETY
DAYS PRIOR TO RELEASE HOW WILL
THE STATE ASSURE THAT THESE
INDIVIDUALS ARE RECEIVING. OF
THE MENTAL HEALTH AND OR
ADDICTION. TREATMENT SERVICES-
WITH YOU KNOW TREATMENT PROGRAMS
ARE COMMUNITY BASED TREATMENT
PROGRAMS WHEN THEY ARE RELEASED
FROM PRISON. SO THIS IS JC TO BE
MORE THAN HAPPY TO START AND
THEN WELCOME COMMENTS FROM OTHER
PANELISTS- YOU KNOW DCS WAS
REALLY EXCITED FOR THE
ANNOUNCEMENT OF OUR JUSTICE
INVOLVED INITIATIVE- THERE WILL
BE A SUBSET OF REQUIRED SERVICES
WHICH INCLUDES INCLUDES BOTH
KIND OF PHYSICAL AND BEHAVIORAL
HEALTH ASSESSMENT AND TREATMENT
WHILE THEY'RE INCARCERATED. AND
THEN IN EIGHTY ONE THIRTY THREE
WE PARTNERED WITH THE
LEGISLATURE IN REGARDS TO BUDGET
BILLS MANDATED WARM HANDOFFS
LOOK LIKE IN ONE OF THE REQUIRED
WARM HANDOFFS FROM INCARCERATION
INTO THE COMMUNITY. TO ARE
COUNTY BEHAVIOR HEALTH PARTNERS
SO SOMEONE WITH SERIOUS MENTAL
ILLNESS OR SUBSTANCE USE MAKING
SURE THAT THERE IS A COORDINATED
HANDOFF FROM THE PRISON THE JAIL
OR THE JUVENILE FACILITY YOU ARE
COUNTY BEHAVIORAL HEALTH
PARTNERS TO ENSURE THERE IS A- A
COORDINATED REENTRY ESPECIALLY
SINCE ONE OF THE PIECES FOR
EXAMPLE THAT WE'RE REQUIRING IS
AN A. T. SERVICES WITHIN THE
JAILS. WE WANT TO MAKE SURE
WE'RE COORDINATING THE OTHER
THING IS INDIVIDUALS WILL
RECEIVE A PRESCRIPTION UPON
RELEASE IT'S ONE OF THE REQUIRED
PIECES THAT WAY THAT THEY HAVE A
PRESCRIPTION WHEN THEY ARE
LEAVING FROM INCARCERATION- AND
THEN THEY WILL HAVE IT IN ORDER
TO. COORDINATE IN I WOULD ALSO
NOTE THAT ALL OF INDIVIDUALS
BEING RELEASED TO GO THROUGH
THOSE PRE RELEASED EARLY
SERVICES. WILL ALSO BE CONNECTED
TO EITHER A COMMUNITY HEALTH
WORKER FOR ENHANCE CARE
MANAGEMENT DEPENDING ON THE
COMPLEXITY OF THEIR SITUATION.
AND THE IDEA IS THAT WE'RE GOING
TO BUILD A STATE WHAT KIND OF
JUSTICE INVOLVED NETWORK ALSO WE
HAVE PEOPLE WHO ARE. EXPERIENCED
IN PROVIDING THESE SERVICES FEB
HERE TO PEOPLE WITH LIVED
EXPERIENCE OR LET YOU KNOW THAT
HAVE WORKING WITH THE JUSTICE
INVOLVED POPULATIONS. IT'S A
WELCOME THE COMMENTS OF OTHER
PANELISTS BUT THOSE ARE SOME OF
THE MAIN COMPONENTS THAT WE HAVE
WITHIN OUR JUSTICE INITIATIVE.
TO ENSURE WE'RE DOING A
COORDINATED REENTRY ARE THE ONLY
OTHER PIECE I WOULD FLAG. IS
WITH THE OPPORTUNITY EVER COULD
PREDICT CARE ONE OF THE OTHER
PIECES THAT WERE HOPING IS IF WE
HAVE SOMEONE WITH A SERIOUS
MENTAL HEALTH. CONDITION OR
SUBSTANCE USE THAT THEY CAN EVEN
BE OUR PHYSICAL HEALTH CONDITION
CHRONIC DISEASE. THAT THEY CAN
BE DISCHARGED INTERPRETIVE CARE
INTO INSTEAD OF BEING RELEASED
ONTO THE STREETS HOMELESSNESS
THAT WILL TAKE TIME TO BUILD
THOSE CONNECTIONS AND CONTINUE
ONE. OLD THREE THOSE ARE SOME OF
THE GOALS OF WHAT WE'RE TRYING
TO ACHIEVE WITH THAT NEW JUSTICE
INITIATIVE THAT WAS JUST
APPROVED BY THE FEDERAL
GOVERNMENT. GREAT THANK YOU
COULD YOU. GET AND I JUST HAVE
ANOTHER QUESTION I THINK THERE'S
A COUPLE MORE PANELS WHO WANT TO
ANSWER THAT WAS THAT IS THAT
ACCURATE. TO HAPPEN. YES YEAH
PLEASE GO AHEAD. THINGS BOB
DISCOVER SORRY SO. THIS KEN
LEWIS NASH GUARD AND THINK.
WHICH IS RIGHT AND THAT THIS IS
A- THIS IS NEW. THAT ARE. WAY
TO. THE SENATE BEACH SIR.
SENTENCE VERY. TO SEE HOW ARE
THE FOREFRONT OF THIS BANK. AND
AND ENSURING PEOPLE GETTING THE
KIND OF SIR. WHILE AND- SETTINGS
BUT- IT VERY AND WHEN THEY GO A
COMMUNITY BUT FOR CREDIT I THINK
. FOR US TO ENSURE. IT SERVICE
CONTINUE HIS OF. WHEN THEY GET
OUT SO THAT AT LEAST SERVICES
CONDITION. YEAH YOU KNOW. THAT
MASS. MANY AND SENTRY FOR
INDIVIDUALS. THERE WAS SUCH USED
AS- PARTICULARLY INCOMING AT
HOME OR IN SO THAT THEY'RE NOT
JUST GETTING THAT AND PARTIAL
SENDING OUR- FOR EXAMPLE AND
NEED TO PARTNER CAN IN YOUR MIND
. AND ALSO SOME OF THE ADMITTED
BASED OF YOU TALK ABOUT EARLIER
AS YOU TEAM. ARE SUPPORTED
BERMAN. A LOT OF MODEL ARE
REALLY DESIGNED TO KEEP YOUR
BODY INTERNATIONAL CITING IN OUT
OF THE- BEING. MEMBERS SO WE TO
THANK YOU RUNNING WELL THE
BACKING OF POWER KEEP PEOPLE OUT
OF THAT SYSTEM. IN THE FIRST
PLACE SO THAT WE'RE NOT YOU
KNOW. AND TO GO IN AND SEARCH
LEAVING FIRST. CALIBER SIR THAT
ARE AND BORN.
IT EVEN UNDER THIS KELLY
MINISTRY TO THE SHERIFF'S IT IS
THE SHERIFF'S DOMAIN RIGHT IN IN
COUNTY THEY SHOW OR THE STATE
CORRECTIONS DEPARTMENT AT THE
STATE LEVEL AND SO. THE WILL BE
WORKING TO DETERMINE WHICH
PROVIDERS ARE- HOUSED WITHIN
THOSE CARCERAL CITING SENTENCE.
J. C. MENTIONED. THERE WILL BE
CERTAIN NEW REQUIREMENTS AROUND
CONNECTIONS TO SERVICES ONCE
FOLKS ARE RELEASED IT IS. HIGHLY
COMPLEX ARE FOLKS WHO ARE
PROVIDING- SERVICES IN CARCERAL
STUDIES TO DATE THROUGH COUNTY
BEHAVIORAL HEALTH- TALK ABOUT
YOU KNOW ISSUES LIKE YOU KNOW
COURTS WILL REQUIRE THAT
SOMEBODY GETS DISCHARGED IN THE
MIDDLE OF THE NIGHT. RIGHT WITH
VERY LITTLE NOTICE THOSE SORTS
OF THINGS AND JAIL STAYS ARE
OFTEN REALLY SHORT AND SO THERE
ARE SO MANY DIFFERENT LAYERS OF
ISSUES HERE RELATED TO YOU KNOW.
MAKING SURE THAT FOLKS HAVE THE
RIGHT EXPERTISE TO DO FORENSIC
BEHAVIORAL HEALTH SERVICES IN
THE SETTINGS. HI AND OUTSIDE OF
THE SETTINGS AND THEN ALSO
MAKING SURE THAT THERE'S
ADEQUATE COORDINATION
COMMUNICATION BETWEEN OUR
JUSTICE ARE YOU KNOW- JAIL
PARTNERS. ARE HEALTH PLANS AND
THEN COUNTY BEHAVIORAL HEALTH
ULTIMATELY SOMETHING LIKE YOU
KNOW- TREATMENT FOR SUBSTANCE
USE DISORDER IS VOLUNTARY AND SO
THE KEY IS BEING THERE TO CATCH
THAT PERSON WHEN THEY'RE READY.
TO ENGAGE IN TREATMENT AND YOU
KNOW WE'VE GOT LOTS OF VERY
INNOVATIVE PRACTICES ALREADY
SUCH AS PUTTING- FREE YOU KNOW
ACCESS TO FREE NOR CAN AND OTHER
OVERDOSE REVERSAL- YOU KNOW
PRODUCTS IN JAILS. SO THAT WHEN
PEOPLE ARE LEAVING IF THERE'S
NOT A HUMAN THERE TO SORT OF
WALK THEM TO A TREATMENT
FACILITY IF THAT'S WHAT THEY
WANT BUT THEY HAVE OTHER WAYS TO
PREVENT. THOSE NEGATIVE OUTCOMES
. THANK YOU A MANAGER ONE YES.
WHEN YOU'RE CLEAR ABOUT ITS
ACTUALLY NOT A QUESTION I JUST.
SAY CENTER RAW- REQUEST.
RECOMMENDATION ON THE PLAN FOR
THE WORK FORCE ISSUE ALMOST
EVERY SINGLE PERSON WHO SPOKE
TODAY- MENTIONED THE WORK FORCE
SHORTAGE MENTIONED THE WORK
FORCE SHORTAGE CRISIS. SO AND I
WOULD INCLUDE IN THAT REQUEST-
WHERE WE STAND ON WAGES- FOR
THOSE MEN AND WOMEN WHO WORK IN
THOSE CRITICAL JOB THANK YOU.
ALL RIGHT NOW BEFORE WE GO TO-
PUBLIC COMMENT I DO A FOLLOW UP
QUESTION SO IF THERE'S ANY OTHER
MEMBERS THAT HAVE ONE FOLLOW UP
QUESTION YOU CAN GO TO THAT- MY
FIRST COMMENT- APPRECIATE-
DISCOVER YOUR COMMENTS VETS FROM
THE PERSPECTIVE OF THE COUNTIES
BUT I ALSO. WANTED TO I ALWAYS
HAVE TO REMIND OUR COUNTIES THAT
YES THE JAILS ARE IN THE DEMAND
OF THE SHERIFF'S HOWEVER ARE
COUNTIES DO YOU. APPROVE THE
SHERIFF'S BUDGETS AND ALLOCATE
THE FUNDING TO OUR SHARE OF
STATE ALSO HAVE THE OVERSIGHT
FOR THE GEO INSPECTIONS THEY
HAVE A VARIETY OF ROLES. THAT
INVOLVE THEM IN THIS AND IS NOT
IT IS- AND I KNOW YOU KNOW THIS
BUT I ALWAYS THINK IT'S
IMPORTANT TO POINT OUT IT IS NOT
1100% TO MAIN OF THE SHERIFF'S.
AND THE- IT AT LEAST IN THE
HEALTH COMPONENT OF IT WHICH WE
UNFORTUNATELY SEE. THE NUMBER OF
DEALS HAPPEN ON THE STATE
INCLUDING MY OWN COUNTY ALAMEDA-
SOME VERY- JUST REALLY
DEPLORABLE PRACTICES SO- HAVING
THE COUNTY STEP UP TO THEIR
RESPONSIBILITY IN THIS REGARD IT
WOULD BE- ALWAYS WELCOMED AND
HELPFUL. BUT THE FOLLOW UP
QUESTION I HAVE IS THAT- WELL
FIRST I WANT TO SAY THAT I'M
VERY HAPPY THAT WE FINALLY HAVE
THIS WAIVER THAT ALLOWS US TO DO
THESE SERVICES- OR B. SIGN UP
OUR- INCARCERATED. FOLKS BEFORE
RELEASE AND TO PROVIDE I SOME
LEVEL OF SIR THIS IS SOMETHING
THAT- MANY OF US HAVE WORKING
ALL RIGHT. BEEN WORKING SINCE
TWO FOUR. SO AND- GREAT THAT
IT'S FINALLY. BEEN APPROVED
SUGGEST GIVING IT SOME OF MY
COLLEAGUES THE SENSE THAT
SOMETIMES THESE THINGS TAKE. YOU
CAN INITIATE SOMETHING YOU KNOW
TEN YEARS- PREVIOUS AND IT'S TEN
YEARS BEFORE YOU SEE IT COME TO
FRUITION SO THOSE OF YOU WHO
WILL BE HERE FOR A WHILE- HANG
IN THERE AND- KEEP MONITORING
THOSE THINGS YOU INITIATE-
ANYWAY SO MY QUESTION IS- THE-
THINGS LIKE. THE SIX MONTHS OF
HOUSING WHICH WOULD RECEIVE A
50% FEDERAL MATCHING THE NUMBER
OF THE OTHER. BENEFITS THAT
CALTRAIN COULD PROVIDE ARE NOW.
STILL BYE BYE FROM WHAT YOU
DESCRIBED MANY THE PROVIDER
STILL VIEW- IS OPTIONAL SO IN
OTHER WORDS IF I AM A MEDICARE
RECIPIENT. THOSE ARE NOT IT IS
NOT MY RATE YET FOR THOSE
SERVICES IF I IF I UNDERSTAND
THIS AT WHAT POINT ARE WE GOING
TO GET TO THE PLACE WHERE. IT IS
YOUR RIGHT BECAUSE MY OTHER CARE
UNDER MEDICARE WAS MY RIGHT.
SURE HAPPY RESPOND TO THIS WE
ARE WE ACTUALLY LOVE THIS
AMBIENCE FIFTY SO I'M WHEN
YOU'RE BUILDING BRAND NEW
BENEFITS THAT HAVEN'T EXISTED
BEFORE YOU HAVE TO BUILD A
PROVIDER BASE WHICH IS WHAT
WE'RE DOING RIGHT NOW WE ARE
WORKING ON. A BUILDING THE
POLICIES IMPLEMENTING THE PEACE
IT IS BUILDING NOT GROSS. THIS
IS A BRAND NEW NEVER BEEN DONE
IN MEDICAID AT THE LEVEL
CALIFORNIA'S DOING IT WE OFTEN
READ THE CHARGE AND SO THAT'S A
BIG WE'RE IN RIGHT NOW FINE
TUNING POLICY AND BUILDING
PROVIDER CAPACITY ACROSS THE
STATE OF CALIFORNIA. THE
ULTIMATE GOAL. IS TO MOVE THESE
FOURTEEN CHINESE PARTS AND
FIFTEEN IF WE GET THE PRINTS
THROUGH THE BUDGET PROCESS WHICH
WE ARE VERY HOPEFUL OF FOR THE
TRANSITIONAL RENT- DID MOVIES
EVENTUALLY TO BENEFITS ACROSS
THE STATE OF CALIFORNIA WE DO
HAVE TO SEE A PENETRATION OF
PROVIDERS. TO MAKE SURE THAT WE
CAN PROVIDE ACCESS TO
BENEFICIARIES WHICH IS WHY WE
ARE IN THIS KIND OF GROWTH
PERIOD BUT THAT'S WHAT WE'LL BE
MONITORING I WOULD JUST FLAG WE
HAVE. BUT YOU KNOW WITHIN THE
FIRST YEAR WE HAVE HOUSING
NAVIGATION HOUSING TO POTS AND
HOUSING. LIAISON SERVICES IN ALL
FIFTY EIGHT COUNTIES THAT WERE
SEEN GOOD GROWTH BUT WE STILL
NEED TO GET THERE WERE VERY
HELPFUL. AND WE ARE WORKING VERY
HARD TO WORK WITH OUR MANAGED
CARE PLANS IN THE PROVIDERS TO
GET THAT CAPACITY BUT THAT IS
THE END GOAL. IS TO MOVE ALL OF
THESE TO ACTUAL BENEFITS ON SAID
THAT IT IS NOT. A VOLUNTARY FOR
MANAGED CARE PLAN BUT IT IS
REQUIRED- ENDED THAT PEOPLE THAT
NEED SERVICES ACCESS WILL BE
ABLE TO HAVE IT AVAILABLE IN ALL
FIFTY EIGHT COUNTIES SO THAT IS
THE GOAL THAT WE ARE WORKING
TOWARDS. I'M AND THAT'S WHAT THE
DOLLARS GETTING OUCH THAT JUST
STARTED IN THIS YEAR WILL BE SO
CRITICAL TO BUILD THAT
INFRASTRUCTURE ACROSS THE STATE
IN IT LOOKS LIKE THE MOTHER I'M
HANNAH MEMBERS WOULD LIKE TO
SPEAK AS WELL. OKAY BY ME JUST
TO CLARIFY THAT THE RANGING SIX
MONTHS OF RENT IN TRANSITIONAL
HOUSING IS NOT LIVE TODAY THAT
IS A NEW COMMUNITY SUPPORT THAT
WE'RE PROPOSING AS PART OF THAT
THE GOVERNOR'S BUDGET THAT IS
BEFORE YOU SO. I JUST WANTED TO
BE VERY CLEAR ABOUT THAT THAT
IT. THAT PARTICULAR. COMMUNITY
SUPPORT IS NOT LIVE TODAY. SO
IT'S A 50% MAY CORRECT. BUT IT'S
NOT LIVE TODAY. MMHM OKAY. I
JUST BRAVE IT AT THE- CENTER. IN
THIS BUT GIVEN THE- NUMBER OF
HOME- ON HOUSE PEOPLE. HAS AND
GIVEN THAT THE SUCH THINGS AS
OUR EMERGENCY RENTAL ASSISTANCE
PROGRAM IS NOW. IN FACT. DONE IN
VARIOUS OTHER THAT IT'S THAT
SUCH A TOOL MAYBE ONE OF. ONE OF
OUR KEY WAYS TO HELP- A GOOD
PERCENT OF OUR IN HOUSE PEOPLE.
TRANSITION TO PERMANENT HOUSING
SO. TO ERASE IT BUT IF- ANY
PANELISTS- COULDN'T GIVE ANY-
OTHER THOUGHTS QUICKLY AND THEN
I CAN GO TO. A PUBLIC COMMENT.
IN A WAY WITH. THEIR ON. LAW AND
POVERTY IT. AS GREAT TO HEAR THE
DEPARTMENT REAFFIRM THEIR
COMMITMENT TECHNICAL IS TO MAKE.
THIS EIGHT. COMMUNITY THAT
HOUSING. SUPPORT SERVICES A-
MEDIC CAL BENEFIT AND TO MOVE US
IN THAT DIRECTION THERE IS- A
LEGISLATIVE VEHICLE OUT THERE AB
TEN EIGHTY FIVE TO REQUIRE THE
DEPARTMENT TO REQUEST FEDERAL
APPROVAL FOR CAN YOU MAKE THIS A
BENEFIT AND WE KNOW THAT. OTHER
STATES HAVE ALREADY DONE THIS A
LOOKING FORWARD TO MOVING TOWARD
THAT GOAL- STATUTORILY. THANK
YOU HER CASE AND LINDA AND GO
AHEAD LINDA GROUP RUNS. YEAH
THANK LEN ACKERMAN BUT OTHER TO
BE. I'M SO IT YET YOU I THINK
ONE OTHERS. IN ADDITION TO THE
CONCERT ABOUT BILL AND FOR WITH
IS. SOMETHING VERY YOU HEARD A
LOT ABOUT OVER THE LAST COUPLE
OF OUR IN THE LATTER TIME IN
RESOURCES INTO LOCALLY. BUT JUST
POINTING OUT THAT THAT THE CAR
MACHEN AND THE STATE HAD YOU.
YOU ARE. PLANS TO TEST THE LACK
OFFERED THE CARD IS THROUGH US
RULE. AND CALLED IN WE WOULD
START SO BEFORE- THESE WILL FOR
READ IT PARKS THE FEDERAL
MACINNES AND IN SERVICE AND WHY
NOTHING. IS BECAUSE- IT REQUIRE
THAT THESE IS BEING DELIVERED
WHETHER IT OUT AND RECUPERATE OR
- BE ESSENTIALLY- IN OF AB COST
. MEDIC HOUSE BENEFITS I'M SO IT
EIGHT I REYES BECAUSE IT. THAT
RIGHT NOW THE CRATE FOR OF THESE
. IT PAR. BECAUSE NOT ONLY DOES
THE MAN NEED YOU KNOW. HOW NEED
. WILL NEED FOR THE SERVICE.
THEY HAVE TO BECAUSE THE FACT
FROM- MEDICAL THIRTY THE PERSON
SO MANY OF THE FOR. THAT WERE
OFFER. BOTH OVER THAT YOU HAVE
YOU KNOW A CHRONIC DISEASE I'M
HAVE AND COULD AT AND HIGHER.
BECAUSE THAT IS A FACT REQUIRE
IF THE THIRD ARE ARE OPTIONAL
WHEN TRAINED IT'S A WHEN THEY'RE
TRANSIT CABANA OF COURSE THAT'S
A- CAN- AND HELP. THANK YOU.
AND I THINK THIS IS A REALLY
CRITICAL POINT NOMINEE THE ONE
MINUTE. THERE WAS A LITTLE. WHAT
WE WOULD CALL A MAJOR CHALLENGE
I WOULD SAY BETWEEN THE
CONVERSION FROM WHOLE PERSON
CARE HELP HOMES OVER TO EASING
OUT WITH REGARD TO ELIGIBILITY
CRITERIA. AND THAT'S THE FACT
THAT THE ELIGIBILITY CRITERION
CAN MUCH MORE CONSTRAINED AND
REALLY LIMITED THE ELIGIBLE
POPULATION FOR. THE ENHANCED
CARE MANAGEMENT. IT REDUCED OUR
ELIGIBLE POPULATION HERE IN OUR
HELP CENTER BY NEARLY 40% SO IT
WAS REALLY SIGNIFICANT THAT WE
WERE DELIVERING REALLY
INTENSIVE. CARE COORDINATION TOO
MANY MEMBERS WHO THEN BECAME
INELIGIBLE. I WANT TO THANK
ALAMEDA HEALTH CONSORTIUM CDC
AND- THE DEPARTMENT OF HEALTH
CARE SERVICES THERE WAS A AN
INITIATIVE LAUNCHED BY OUR LOCAL
HEALTH PLAN TO ASK FOR AN
EXPANSION OF ELIGIBILITY
CRITERIA THAT WAS SUCCESSFUL.
OUR PROVIDERS ARE ABLE TO MEMBER
FOR MEMBERS CHIU THE HEALTH PLAN
AND HAVE THE REVIEW AND MANY NOW
ARE BECOMING ELIGIBLE WHO WERE
NOT ORIGINALLY ON ELIGIBILITY
LISTS AND THIS IS REALLY
IMPORTANT BECAUSE I HEARD OTHER
PRESENTERS TALKING ABOUT
INDIVIDUALS HAVING ISSUES OR
CONSTRAINTS AND BECOMING
ELIGIBLE FOR THE PROGRAM OR
ENROLLING. SO IF IT IF NOTHING
ELSE AND SPEAKING WITH SCOTT
OVER AT THE ALLIANZ AND I KNOW
WHAT WHAT COULD BE SET IN THIS
IN THIS PRESENTATION IT'S JUST
TORN CURRENT COUNTIES. TO
EXPLORE SOME MORE OPPORTUNITIES
TO EXPAND ELIGIBILITY CRITERIA
SIMILAR TO HOW THE LINE STATE
THANK YOU TO DCS FOR BEING
RECEPTIVE TO THESE REQUESTS AND
IN IT IT REALLY EXPANDED THE
ELIGIBLE PATIENT POPULATION SO
THAT WE CAN DELIVER SERVICES TO
OUR MEMBERS SO JUST WANTED TO
PROTECT LITTLE. THE WORD OF IT-
RECOMMENDATION THANK YOU CORRECT
FREE SHE ADDED AND KIM AND THEN
I'M GONNA GO TO THE. PUB OUR
PUBLIC. BUT WE THINKING SENATOR
I THINK I MEAN YOU COULD YOU SEE
. DIDN'T QUICKLY TO THE- YOU
KNOW IN SIR. BOEING ACTS JUST
THE WAY THAT FEDERAL. FEDERAL
TALK ABOUT OUT OF THESE CAN BE
ARE THAT WE HIM. AND THERE ARE.
SOME ELEMENTS THESE REQUIRE
FEDERAL APPROVAL TO BE IN BY
LIKE THROUGH MY LANGUAGE EMAIL
WORK ON THE HOUSING- CHEESES GET
. WITH THE FEDERAL. FUNDS ARE
NOT. COMPARABLE CAFE FOUNDED SO
I THINK THAT'S- ALWAYS JUST THE
BUDGET YOU KNOW BUDGET IS AT ALL
. I A FEDERAL PROCESS TO GET
YOUR LAWN SUMMER JEFF FISHER IS
THAT THANK YOU AND MAY BE J. C.
I IF I GAVE ANY. YOU CAN TELL ME
IF THIS IS SO- SAY WE HAVE THIS
A NEW COMMUNITY BETTER FOR THE-
SIX MONTH OF HOW SAY PER. HIM
THE PERSON WITH- PRACTITIONER
SAY WELL THIS PERSON- YOU KNOW
NEEDS THREE HAVE. SO WOULD IT
MAKE IT BE THE MIGHT QUALIFY
THEM FOR THE HOUSING AND A DAY.
PROGRAM THAT IS LESS EXPENSIVE A
RESIDENTIAL REHAB WOULD THAT BE
THE KIND OF THING LIKE IN LIEU
OF OR NOT J. C. YEAH ATTENTION
LEE I THINK THOSE ARE THE I MEAN
THE IDEA OF IN LIEU OF SERVICES
IS THAT IT'S MEDICALLY
APPROPRIATE IT'S COST EFFECTIVE
AND THAT. YOU ARE BY PROVIDING
THE SERVICE AVOID READING A
HIGHER COST SERVICE ABOUT
HELPFUL SO- WHY THERE'S THE
INTERSECTION WITH THE VARIOUS
PIECES BUT I WILL BLOOD TWO
KITTENS POINT BECAUSE I THINK
IT'S AN IMPORTANT ONE FOR PEOPLE
TO UNDERSTAND. IS THAT WHILE WE
HAVE THE AUTHORITY FOR THE
MUSEUM FOR ITS THROUGH ITS A
SIMPLE NINETEEN FIFTEEN BE IN A
CONTRACT FOR THE A LITTLE
SERVICES THERE ARE TWO IN ELEVEN
FIFTEEN BUT WE HAD A HUGE WIN AT
THE- BEGINNING OF THIS YEAR
WORST MS APPROVED THOSE
COMMUNITY SUPPORTS AS WHAT'S
CALLED BUDGET NEUTRAL. WHICH
MEANS WE DON'T HAVE TO HAVE
SAVINGS TO PAY FOR THEM INTO THE
FUTURE WHICH MEANS. THEY CAN BE
A BENEFIT- IN THE FEW WHICH IS.
AND WE WANT PEOPLE TO KNOW THAT
THERE'S A SIXTEEN. FUND PATHWAY.
FOR THESE THINGS AND LETTING.
WHERE TRANSIT RENT IS GOING TO
GO I JUST WANT TO TOUCH THOSE.
IN FOR PEOPLE THAT WE DO WANT
PROVIDE THINK THAT THIS IS GOING
TO BE. IN I'VE BEEN FLOW. ON
THERE IS A PATHWAY FOR. LAW TERM
BOND TIED TO THESE THINGS NOW WE
NEED TO MAKE SURE WE'RE- THE- IN
THE OUTCOMES COURSE- BUT JUST
WANTED TO MAKE SURE THAT THAT-
WAS CLEAR. IN WOULD DO THIS FOR
OF THE- SO. YOU KNOW I WANTED TO
POINT TO IT HELLO I NAY OF
COMICS WERE ABLE TO DEMONSTRATE
YOU SEE A MASTER EXTENSIVE
LITERATURE REVIEW. THAT THESE
COMMUNITIES SUPPORTS BOBBY
INTERSECTION IS ON THEIR FACE
MEDICALLY APPROPRIATE AND COST
EFFECTIVE WHICH MEANS YOU CAN DO
THEM FROM A PREVENTATIVE-
NATURE'S WELL SO DOESN'T HAVE TO
BE AT THE- INDIVIDUAL BASIS. WE
HAD A BROAD BASED CONVINCED- THE
FEDERAL GOVERNMENT THAT THEY ARE
MEDICALLY APPROPRIATE NAY ARE
COST EFFECTIVE. IT'S THAT IS WHY
YOU CAN'T JUST ADD ANYTHING TO
THE COMMUNITY SUPPORTS LIST-
BECAUSE WE NEED TO BE SURE THAT
WE'RE NOT SUPPLANTING OTHER
SYSTEMS THAT ARE MAYBE SOCIAL
SERVICES OR OTHER AREAS TO.
RESPONSIBILITY ABOUT MAKING SURE
THAT'S INTERSECTION SO HOPEFULLY
THAT'S HELPFUL CONTACT IN
REGARDS TO HOW WE'RE THINKING OF
MOVING TO THE BENEFIT IN. THE
LONG TERM SUSTAINABILITY OF
THESE BENEFITS AS WELL. ALL
RIGHT GREAT. OKAY WE ARE NOW
GOING TO MOVE ON TO PUBLIC
COMMENT. AND I WANT TO GIVE THE
PARTICIPANT NUMBER FOR THOSE OF
YOU WHO ARE CALLING IN THAT
NUMBER IS EIGHT SEVEN SEVEN. TWO
TWO SIX EIGHT ONE SIX THREE. THE
ACCESS CODE IS FOUR FOUR ZERO
ZERO FIVE NINE FIVE. BUT WE WILL
START WITH PUBLIC COMMENT. FROM
THOSE WHO ARE PHYSICALLY HERE IN
THE HEARING ROOM. AND IT IS SO
THOSE WHO WANT TO PLEASE LINE UP
AND I WOULD ASK IF YOU COULD
KEEP IT TO A MINUTE. GO AHEAD.
ABSOLUTELY THANK YOU MADAM CHAIR
MEMBERS OF THE SENATE BUDGET
COMMITTEE JET HAMPTON WITH THE
CALIFORNIA ASSOCIATION HEALTH
PLANS. WHICH REPRESENTS FORTY
FOUR- HEALTH CARE SERVICE PLANS
THAT COLLECTIVELY PROVIDE
COVERAGE TO NEARLY TWENTY EIGHT
MILLION PEOPLE. ACROSS THE
STATE. I WOULD LIKE TO THANK
THE- COMMITTEE FOR THE UP TO
DELIVER. COMMA ON TODAY THAT.
HERE I CAN CAP IN OUR AND MANAGE
CARE PLAN MEMBERS ARE FROM THE
CA. TO THE SUCCESSFUL
IMPLEMENTATION OF KALYAN. NOT
WORKING TIRELESSLY WITH THE
ADMINISTRATION ON THIS
INNOVATIVE PROGRAM. IN IN IN THE
INTEREST OF KEEPING IT BRIEF I
WILL GO DIRECTLY TO OUR COMMENTS
SPECIFICALLY AROUND THE IN
CANCER MANAGEMENT PROGRAM. FIRST
IT'S IMPORTANT NOTE AS MANY
OTHERS HAVE HERE TODAY- THAT
THIS PROGRAM IS RELATIVELY NEW
IT'S ONLY BEEN. IN EFFECT FOR
OVER A YEAR. AND ALL NEW
PROGRAMS ESPECIALLY ONE AS
TRANSFORMATIONAL AS THIS ONE.
TAKE SOME TIME TO RAMP UP AND
FULLY IMPLEMENT. I CERTAINLY
THIS PROGRAM IS NO. IS NO
EXCEPTION AS EVIDENCED BY THE
FACT THAT SEVERAL COMPONENTS OF
THE IN HIS COMMISSION PROGRAM
HAVE NOT GONE COMPLETELY LIVE AS
OF YET- SPECIFICALLY THE
CHILDREN YOUTH POPULATION TO
FOCUS NOT GO LIVE UNTIL JANUARY
TWENTY TWO OR EXCUSE ME JULY OF
TWENTY TWENTY THREE. AND THIS IS
IMPORTANT HIGHLIGHTS BECAUSE-
CHILDREN AND YOUTH MAKE UP SUS
UP A SUBSTANTIAL PORTION OF THE
ELIGIBLE POPULATION. A SECOND
LIEN MANY PROVIDER TYPES
OPERATING WITHIN THE SAME
FRAMEWORK ARE RELATIVELY NEW TO
MANAGE CARE AND IS IT BECAUSE
YOU FOR TODAY MANAGED CARE CAN
BE A RELATIVELY COMPLICATED
SYSTEM. WE'RE CONTINUING TO WORK
WITH WITH. EDUCATING IN
CONTRACTING WITH THESE NEW
PROVIDERS- AND ARE ENCOURAGED TO
SEE THAT PROVIDERS ARE OUR
GETTING INVOLVED AT VARIOUS
LEVELS- AS WE CONTINUE SEE MORE
MORE PROVIDERS ON BOARDING AND
LASTLY. I WANT TO ENSURE THAT
ALL STAKEHOLDERS HAVE REALISTIC
EXPECTATIONS FOR THE PROGRAM
MOVING FORWARD. WE BELIEVE THAT
LEE LISTEN PROVIDER FOR
REFERRALS CONTINUE TO IMPROVE
OVER TIME AND IS THIS PROGRAM
MATURES. WE EXPECT TO SEE MORE
ENROLLMENT INTO THE PROGRAM
MOVING FORWARD SO WE CONTINUE TO
LOOK- THE REPLICATING ORATORY
ALL STAKEHOLDERS. INVOLVED THANK
YOU- NEXT. GOOD MORNING MICHELLE
AT THE COUNTY HOW X. ASSIST.
HEALTH YOUR- LOOK HEALTH THE
ACROSS STATE. THE DISCUSSION
HERE TODAY AND FOR THE- FLEET.
IN IN. CALLING WE KNOW THAT THIS
IS A HUGE INITIATIVE AND THERE'S
MANY MOVING PIECES. THAT IN
SEVERAL. JURISDICTIONS LOCAL
HEALTH DEPARTMENTS WHERE THE
LEAD ENTITIES AND WHOLE PERSON
CARE. AND SO WE ARE JUST LOOKING
TO CONTINUE TO SUPPORT THE
VISION OF CALENDAR- CONTINUING
TO. HAVE PARTNERSHIPS WITH THE
HEALTH PLANS BUT TO ALSO
COURTNEY AND OR BE THE SERVICE
PROVIDERS AS WELL. WE APPRECIATE
THE DEPARTMENT APPROACH ON THE
POPULATIONS THAT POPULATION
HEALTH APPROACH. WE HOPE THAT
THE DEPARTMENT AND HEALTH PLANS
WILL LEVERAGE THE WITH THE
KNOWLEDGE AND THE WORK THAT
PUBLIC HEALTH DEPARTMENTS DO IN
THIS SPACE. TO REALLY ENSURE
THAT IT CAN BE MEANINGFUL. WE
ARE ALSO INTERESTED IN
SUPPORTING PUBLIC HEALTH
DEPARTMENTS TO BE POSITIONED AS
CRITICAL ECM PROVIDERS FOR KEY
POPULATIONS. MANY OF THE
POPULATIONS THAT ARE UPCOMING
THAT WE ALREADY TOUCH LIKE THE
CCS POPULATION. OR AT THE BIRTH
EQUITY POPULATIONS. AND WE JUST-
WOULD PASS THAT BAD WE WILL
CONSIDER AND THAT THE DEPARTMENT
PLANS CONSIDER INVESTMENTS THAT
ARE NEEDED IN HEALTH DEPARTMENTS
TO COME UP TO SPEED ON THINGS
LIKE MEDICAL BILLING PRACTICES.
AND THAT NAVIGATING CONTRACT
NEGOTIATIONS WITH HEALTH PLANS
THESE ARE NEW SPACES FOR LOCAL
HEALTH DEPARTMENTS DESPITE THE
FACT THAT WE HAVE EXPERTISE IN
THE WORK. AND LASTLY I WOULD
JUST SAY THAT WE APPRECIATE THE
CONTINUED ENGAGEMENT WE HOPE
THAT HEALTH DEPARTMENTS WILL BE
LOOKED AT AS MEANINGFUL CRITICAL
PARTNERS IN THESE EFFORTS. THANK
YOU THANK YOU. KELLY BROOK'S
COMMENTING ON BEHALF OF THE
CALIFORNIA ASSOCIATION OF PUBLIC
HOSPITALS AND HEALTH SYSTEMS.
FOR MORE THAN A DECADE
CALIFORNIA'S TWENTY ONE PUBLIC
HEALTH CARE SYSTEMS WHICH
INCLUDE COUNTY OWNED OPERATED
AND OR AFFILIATED. FACILITIES IN
THE UNIVERSITY OF CALIFORNIA
MEDICAL CENTERS HAVE BEEN
LEADERS AND MEDICAL
TRANSFORMATION. MOST RECENTLY
PUBLIC HEALTH CARE SYSTEMS WERE
THE LEAD ENTITIES AND
CALIFORNIA'S WHOLE PERSON CARE
PROGRAM. A STATEWIDE EFFORT TO
ADDRESS SOCIAL NEEDS ALONGSIDE
PHYSICAL HEALTH. FOR SOME OF OUR
MOST AT RISK POPULATIONS
INCLUDING INDIVIDUALS
EXPERIENCING HOMELESSNESS. OUR
WORK IN WHOLE PERSON CARE LAID
THE FOUNDATION FOR CALLING HIM
AND WE ARE EAGER TO BUILD ON
THAT SUCCESS AS CORE PROVIDERS
OF ENHANCE CARE MANAGEMENT AND
COMMUNITY SUPPORTS. UNDER KELLY
AND WE LOOK FORWARD TO CLOSELY
WORKING WITH OUR HEALTH PARTNERS
COMMUNITY BASED ORGANIZATIONS
AND OTHER STAKEHOLDERS TO
CONTINUE CARING FOR PEOPLE WITH
COMPLEX HEALTH AND SOCIAL NEEDS.
THANK YOU THANK YOU. THANK YOU
MADAM CHAIR AND MEMBERS GILLIAN
A DERA WITH THE CALIFORNIA STATE
ASSOCIATION OF COUNTIES-
REPRESENTING THE FIFTY COUNTIES.
LIKE TO PASS THESE APPRECIATE
THE LEGISLATURE AND THE
GOVERNOR'S. COMMITMENT TO THE
CRITICAL INVESTMENTS MADE TO
SUPPORT THE KELLEY MISSION OF.
IT ALSO CONCUR WITH THE
TESTIMONY TODAY. FROM THE
PANELISTS HIGHLIGHTING BOTH THE
CHALLENGES AS WELL AS THE
OPPORTUNITIES. FOR THIS A MULTI
YEAR AND MULTI PRONGED
INITIATIVE. I'D LIKE TO SUPPORT
EXPRESS COUNTY SUPPORT FOR THE
THREE HUNDRED SEVENTY FIVE
MILLION DOLLARS- FOR THE
BEHAVIOR HEALTH PAYMENT REFORM
THEY'LL BE SO CRITICAL TO COUNTY
SAYS HE TRANSITION TO THIS NEW.
SYSTEM JULY ONE OF THIS YEAR.
ADDITIONALLY WOULD ALSO
EXPRESSED SUPPORT FOR FUNDING
FOR WORKFORCE DEVELOPMENT
PROGRAMS THAT ARE SO CRITICAL.
LASTLY I JUST WANTED TO NOTE.
THAT COUNTIES DO RECOGNIZE THE-
OPPORTUNITIES OF FORTY ZERO
HEALTHCARE. CONTINUUM COMMUNITY
BASED CONTINUUM. WAIVER
DEMONSTRATE AND FOR TO THE
CONTINUED PARTNERSHIP WITH BOTH
THE ADMINISTRATION AS WELL AS
THE LEGISLATURE ON THOSE ISSUES
THANK YOU THANK YOU. MADAM CHAIR
MEMBERS AMY BLOOMBERG BUT THE
CALIFORNIA CHILDREN'S HOSPITAL
ASSOCIATION I'D LIKE TO PROVIDE
COMMENTS TODAY REGARDING
CONCERNS WITH CAL AM
IMPLEMENTATION WITH RESPECT TO
THE CALIFORNIA CHILDREN'S
SERVICES PROGRAM. CCHA OPPOSES
THE DEPARTMENT'S PROPOSED HOLD
HELD MILE MODEL EXPANSION
TRAILER BILL FOR THREE REASONS
FIRST THE DEPARTMENT AGREED AS
PART OF SB FIVE EIGHTY SIX
HERNANDEZ OF TWENTY SIXTEEN THAT
WHOLE CHILD MODEL WOULD NOT BE
EXTENDED UNTIL THE DEPARTMENT
HAS CONDUCTED A THOROUGH
EVALUATION. AND THAT EVALUATION
HAS NOT BEEN RELEASED ALTHOUGH
IT WAS COMPLETED LAST JUNE.
SECOND THE CCS PROGRAM PROVIDES
MANY IMPORTANT SERVICES FOR
CRITICALLY ILL CHILDREN AND
THEIR FAMILIES INCLUDING
KNOWLEDGEABLE COUNTY CCS CASE
MANAGERS WHO UNDERSTAND THE
UNIQUE NEEDS OF THESE CHILDREN
EXPANSION OF THE WHOLE CHILD
MODEL DEPRIVED CHILDREN AND
FAMILIES OF THESE EXPERTISE.
THIRD WHOLE CHILD MODEL RESULTS
AND MEDICARE SUPPLEMENTAL
PAYMENT CUTS TO CHILDREN'S
HOSPITALS BECAUSE PROVIDER FEE
PAYMENTS TO HOSPITALS ARE
ADJUSTED FOR QT WHEN SERVICES
ARE PROVIDED IN FEE FOR SERVICE
BUT ARE NOT ADJUSTED FOR QT WHEN
CCS SERVICES ARE IN MANAGED
CARE. AND FOR EXAMPLE THIS WILL
RESULT IN A CUT OF ABOUT TWENTY
FIVE MILLION DOLLARS IN MEDICAL
PROVIDER FEE ANNUAL ANNUALLY TO
A CHILDREN'S HOSPITAL IN
SOUTHERN CALIFORNIA AND- WITH
THE EXPANSION OF WHOLE CHILD
MODEL TO ALAMEDA COUNTY WILL
RESULT IN A PROVIDER FEE LOSS OF
TWENTY EIGHT MILLION SAID
NOTHING HAPPENED NORTHERN
CALIFORNIA CHILDREN'S HOSPITAL.
SO WE HAVE A NUMBER OF CONCERNS
AND WILL FOLLOW UP WITH THE
LETTER THANK YOU. GOOD MORNING
MADAM CHAIR MEMBERS KAREN LAYING
ON BEHALF OF THE SOLANO COUNTY
BOARD OF SUPERVISORS HERE IN A
VERY SPECIFIC ISSUE THAT AFFECTS
SOLANO AND SACRAMENTO COUNTIES
YOUR STAFF IS VERY FAMILIAR WITH
THE PROBLEM. AS PART OF CAL
AIMED THE ADMINISTRATION IS
TRYING TO GIVE BACK TO SOLANO
AND SACRAMENTO COUNTIES THE
SEVERELY MENTALLY ILL. PEOPLE
THAT THE STATE HAS BEEN
PROCURING SERVICES FOR DECADES.
THAT POPULATION IS NEVER A
FACTOR IN THE TWO THOUSAND LOVE
AND REALIGNMENT. IN JANUARY OF
TWENTY TWENTY THREE THE STATE-
ADMINISTRATION DECIDED TO TAKE A
CHUNK OF THE GROWTH MONEY IN THE
REALIGNMENT FORMULA AND GIVE IT
TO THE TWO COUNTIES. WHICH MEANT
THAT THE OTHER FIFTY SIX GOT
LAST SO THAT THE TWO COUNTIES
CAN GET A FRACTION OF WHAT THEY
NEED. TO TAKE CARE OF THIS
POPULATION WE ARE ON. A SPEEDING
COURSE TOWARDS JULY ONE WHEN THE
STATE WANTS THE COUNTIES TO TAKE
IT OVER. THEY HAVEN'T HAD ANY
MONEY. MADE AVAILABLE TO THEM
UNTIL JANUARY AND IT'S ONLY LESS
THAN A THIRD OF WHAT THEY NEED.
AND IT'S GONNA LEAVE SEVERAL
THOUSAND OF THIS MOST SEVERELY
MENTALLY ILL PEOPLE INSULIN AND
SACRAMENTO COUNTIES- IN THE
HANDS OF THOSE TWO COUNTIES
WITHOUT AN ABILITY TO PROVIDE.
CARE FOR THEM AND AS YOU'VE
HEARD REPEATEDLY THIS MORNING
THERE'S A WORKFORCE SHORTAGE. IN
THE COUNTIES ARE GOING TO HAVE
TO GO OUT AND FIND DOCTORS OR
PROCURE. CONTRACTS TO SERVE THIS
POPULATION THAT'S GOING TO TAKE
MONTHS AND MONTHS AND MONTHS.
AND THEY HAVEN'T BEEN ABLE TO
GET THAT FAR BECAUSE THEY DON'T
HAVE THE MONEY. AND SO WE'RE
ASKING THAT IS PART OF THE- THE
SUB COMMITTEE PROCESS WE GET TO
DO A DEEP DIG. ON THIS ISSUE AND
GET TO WHERE WE CAN FIND SOME
MONEY. FOR THESE TWO COUNTIES
BECAUSE AT THE END OF THE DATE
COULD ROUNDUP VULNERABLE PEOPLE
AND WE DON'T WANT TO DO ANY HARM
THANK YOU VERY MUCH THANK YOU.
I'M HERE NUMBER SIX YOU STEVE
HORN PRESIDENT THE CALIFORNIA
MEDICAL TRANSPORTATION SOCIAIS
ASIAN. AND WHILE WATER PROJECT
CAL AIM IS BUT I CAN TELL YOU
RIGHT NOW THAT IT IS STARTED OFF
WITH A HUGE FAILURE AS IT COMES
TO THE DUAL ELIGIBLES IN THE
TRANSPORTATION PRIMARILY THE
CHRONICALLY ILL- GOING TO AND
FROM DIALYSIS AND- CURRENTLY.
IT'S FEBRUARY TWENTY SECOND THE
MAJORITY OF THESE DUAL ELIGIBLES
WERE TRANSFERRED AS OF FEBRUARY
FIRST. MANY OF THEM STILL DO NOT
HAVE RIDES TO AND FROM DIALYSIS.
AND THAT DEPARTMENT- YOU KNOW
THE PLAN WAS THAT IT WOULD TAKE
THE ELIGIBILITY IS WOULD
TRANSFER OVER TO THE YEAR OF
TWENTY TWENTY THREE BUT SOMEBODY
DECIDED HEY LET'S DO IT ALL IN
THE MONTH AND BECOME EFFECTIVE
FEBRUARY FIRST. IN THE MAJORITY
OF THESE MEMBERS WERE NOT ABLE
TO ARRANGE TRANSPORTATION-
TRANSPORTATION PROVIDERS
THROUGHOUT THE STATE WERE
HELPING DIALYSIS CLINICS AND
SOCIAL WORKERS IN THE
INDIVIDUALS TO TRY TO CONTACT
THEIR NEW INSURANCE COMPANY AND
THEY SAID HEY WE HAVEN'T EVEN
BEEN NOTIFIED THAT YOUR OUR
MEMBER. WE CAN'T DO ANYTHING
UNTIL THE FIRST. SO AGAIN
THOUSANDS OF PEOPLE HAVE BEEN
LEFT WITHOUT TRANSPORTATION. AND
I DON'T KNOW IF YOU'VE GOT THE
DATA ON. MR ALICE'S APPOINTMENTS
BUT IT HAS SERIOUS HEALTH
IMPACTS ON THEM AND I BELIEVE
SOMEBODY NEEDS TO LOOK INTO THAT
RIGHT AWAY. AND GET A RESOLUTION
ON THAT THANK YOU. MANAGER
MEMBERS JOHN LINGER ON BEHALF OF
THE NATIONAL COALITION FOR
ASSISTIVE AND REHAB TECHNOLOGY
WERE THE TRADE ASSOCIATION FOR.
THE PROVIDERS AND MANUFACTURERS
OF COMPLEX REHAB TECHNOLOGY
WHICH IS. A HIGHLY CUSTOMIZED
EQUIPMENT FOR ADULTS AND
CHILDREN WITH SEVERE PHYSICAL
DISABILITIES LIKE ALE US
MULTIPLE SCLEROSIS- SPINA
BIFIDA. WERE- VERY EXCITED ABOUT
KELLY MAN THE PROSPECTS OF IT
FOR OUR PATIENTS- IT'S A VERY
DIFFICULT DELIVERY MODEL. THAT
WE THAT WE FACE- WE DO HAVE
CONCERNS CONTINUING CONCERNS ON
REIMBURSEMENT- WERE UNDER
DURABLE MEDICAL EQUIPMENT WHICH
IS PURELY. A QUICK MINUTE- AND
SO THE REIMBURSEMENT MODEL
DOESN'T GIVE US- ANY
REIMBURSEMENT FOR TRANSPORTATION
COSTS OUT TO THE HOME. FOR ALL
OF THE LABOR COSTS- RELATED TO
THE TEAM OF PROVIDERS THAT IT
TAKES TO ACTUALLY DELIVER. AND
THAT FIT THE CUSTOMER- AND SO WE
DO HAVE SOME REIMBURSEMENT
CONCERNS I KNOW THE MEDICARE FEE
SCHEDULE I HAD OF ABOUT A 15%
BUMP FOR. INFLATIONARY REASONS
THAT'S NOT BEING ADOPTED BY THE
DEPARTMENT SO THERE'S SOME
CONCERNS THERE- WE ALSO. HAVE A
FEW- CONCERNS AROUND OUTCOMES
MEASUREMENT- WE'D LIKE TO SEE A
STATEWIDE. KIND OF ACROSS THE
BOARD THE OUTCOMES MEASUREMENT-
SYSTEM FOR C. R. T. PATIENTS WE
THINK THAT COULD BE DONE THROUGH
LIKE A FUNCTIONAL MOBILITY
ASSESSMENT ACROSS ALL PLANTS IN
CIVIL FALL OVER THE DEPARTMENT
AND- THE HEALTH PLANS ON THAT.
DEGREE THANK YOU SO WILL GO TO
THE PHONE LINES NOW AN APOLOGIES
WE DO HAVE. WE HAVE VERY LITTLE
TIME LEFT BUT THE- OPERATOR IF
YOU COULD QUEUE UP. ANYONE YOU
HAVE IN THE PHONE LINE. THANK
YOU MADAM CHAIR WE- WE HAVE- WE
HAVE PEOPLE WHO'VE ALREADY
QUEUED UP TO ASK QUESTIONS THEN
PLEASE OUR SLEEP YOU IF NOT
PRESSED ONE DIDN'T ZERO PRESS
ONE AND ZERO AT THIS TIME I'M
GOING TO GO TO LINE TWENTY SIX.
GOOD MORNING MADAM CHAIR MEMBERS
MY NAME IS SHERIN REPORT I'M THE
CORPORATION FOR SUPPORTIVE
HOUSING. HOUSING SUPPORT
SERVICES WHICH ARE OFFERED TO
CALLIN COMMUNITY SUPPORTS HAVE
BEEN PROVEN TO IMPROVE THE
HEALTH CONDITIONS OF MANY CALLIN
ROLLING CIARAN GILES. BOB KELLY
WAS A POSITIVE STEP IN OFFERING
HOUSING SUPPORT SERVICES THE
MEDICATED THIRTY THE STATE USES
TO FUND SERVICES. TAX POSES
BARRIERS ACCESSING SERVICES
SOMETIMES. WITH INEQUITABLE.
YOUR PLAN RESTRICT ELIGIBLE TO.
SUFFICIENT ON. TO PAY FOR THE-
COST. WE WITH NEW WAY THE NEXT
FOR THE- SHOULD BE TO CREATE A
HOUSE SUPPORT SERVICE TENANTS.
THE BENEFIT THAT OFFERS. BASED
ON RATHER THAN REACH ON AND- THE
BENEFIT WOULD BRING SIGNIFICANT
FEDERAL RESOURCES TO
CALIFORNIANS SCALE LEFT SERVICES
FUNDING. EIGHT ZERO. RIGHT AND
IN FULL OF READING SO SIR WILL
SPEND. SO WE- URGE THE STATE TO
MOVE IN THIS. AND FUND CAR.
THINKING APPROVAL THANK YOU VERY
MUCH THANK. HE HELLO WHY. TWENTY
NINE. THE ONLY PROBLEM FOR.
THANK YOU FOR THE ANSWER ANOTHER
DIFFERENT. THE QUESTION A CALM
ON THE WITHIN THINGS WITHIN
ABOUT OUR- AND HAVE A JOBS. FOR
THE IMPORTANCE THE STATE
INSURANCE FUNDING PACKAGE
INCREASE FUNDING FOR THE PROGRAM
HEALTH.
THANK YOU VERY MUCH FIND. FIVE
THIRTY SIX. GOOD MORNING MADAM
CHAIR IN THE KITCHEN WITH
BENEFIT BAD ACTS ONE OF THE
CALIFORNIA NONPROFIT HEALTHCARE
NATIONAL GRADATIONS. SHORT I WAS
VERY GRATEFUL FOR THIS YEAR IN
ADVERTISING YOU NEED TO BUILD
INFRASTRUCTURE TO ENABLE THE-
THE EQUITY IN QUALITY
CONFIRMATION THAT COUNTY
INUNDATIONS. AND ONE OF THE
RECURRING THEMES AND ALL THE
MEDICATIONS THAT BEATING HEART
AT CALTRAIN IS TRULY THE ABILITY
TO SHARE AND TO USE ELECTRONIC
INFORMATION. THAT INCLUDES
TRADITIONAL MEDICAL PROVIDER TO
HELP PLAN THE QUALITY NEW
PARTNERS CBO. SOCIAL SERVICE
PROVIDER CAN CARRY A- NOT WE AND
TOP H. YELLOW HAPPEN TOOLS
EXPERTISE. INFRASTRUCTURE BUT WE
GET NO SUPPORT FROM THE BUDGET
AFTER COOLEY NISHA OF NOT YEAH.
I'M WE KNOW IN A FAILED FUNDING
TO BRING FOR A IDEAS SECOND DRAW
CAN EXTREMELY GENEROUS. MATCHING
FUNDS. I CAN TO YOUR BUDGET-
OVERSIGHT AND WORK AT THE
ESPECIALLY IN THIS. AND BY WE
URGE YOU TO CATCH NAME ARE WITH
THE HIGHLY MATCHED FUNDING IT
THE BILL IT AND PERSONAL THAT
CRITICAL TO FAST EIGHT YOU THANK
YOU.
INTRUSION REFERS TO ITS SPECTRUM
OF FOOD BASED INTERVENTION SUCH
AS PRODUCERS. PHARMACIES AND
MEDICAL TAILORED MEALS IN ACTION
AT THE LOCAL A PREGNANT BUT THE
THEIR DOG BEING WITH JESSE DIED
. INSTEAD OF CALL EACH HEALTHIER
THE DOCTOR CAN ACTUALLY THE-
WITH THE FOOD AND THAT NO AS A
PER FOR. THAT ALLOWS THE
TECHNICAL TO VISIT THE GROCERY
OR FARMERS WERE. THAT IS GOOD
FOR THREE INVEST. AND THAT'S
COMPLETED IN FACT APPROACH THAT
THAT THE POWER TO REDUCE THE
RATE OF BIRTH I 7% THE PROJECT
WANT TO BE OF THE BENEFITS OF
MEDICALLY THE NUTRITION EITHER
RELATES TO A BENEFIT THROUGH
CALAIS. INTERVENTIONS BOTH AND
HEALTH INTRODUCED AB- BUT FOR
READ HAVE A- THAT THE HEALTHY
FOOD PAY FOR BILLION FOUR
HUNDRED BILLION IN HEALTH COSTS
NATIONALLY WE SEE MY SUPPORT THE
NATURE OF THE AND- COMMUNITY OR
OF THE- UNDER CAL IN THANK YOU
SO MUCH THANK YOU. BY. TWELVE
GOOD AFTERNOON MY NAME IS TRACY
. I CAL TRANSFER TO A- SOCIAL TO
TERM OF HEALTH. THAT AND WE
COULD WANT ADVANCE HEALTH TECH
AND CONTAIN HEALTH COSTS WE MUST
IN THE IN. THAT BEYOND IN THE
MEDIC CAL MA'AM. AND CAN AND-
PREVENT PEOPLE FROM GETTING SICK
IN THE FIRST PLACE. THANK IN
VESTMENT. PUT IN CALVET BACK THE
BENCH PUBLIC WORK DAMAGED THAT
PREVENT WORK. AMONG OTHER THINGS
. THAT GO CONTROLLED SMOKE FREE
ENVIRONMENT REDUCED YOU THANK TO
TOBACCO. USE INCORRECT MARK IN
COMMUNITIES COLOR IT WAS. OVER
ONE TELEPHONE LIFE THANK AND OF
AND THIRTY FOUR. AND HEALTH CARE
COSTS ABOARD. MY QUESTION IS
WILL BE AN OFFER. TO EXPAND
COMMUNITY SUPPORT CONCLUDES
PREVENT STRATEGY THAT THE BEYOND
INTO PATIENT SUPPORT CREATING
HELPING. I APPRECIATE THAT WILL
- SUBMITTED TO THE- BUDGET STAFF
AND WE WILL GET BACK TO YOU- MY
FOR NEXT COMMON PLEASE. WHY
THIRTY SEVEN YEAR IS NOW OPEN.
WHY THIRTY YEAR LINE IS WILL.
HELLO MADAM DURING MEMBER THANK
YOU IS CHANDRA IN JERSEY
ADVOCATE WOULD HE BE IN THE
CALIFORNIA CAN BEHAVIORAL HEALTH
AGENCIES THIS PROVIDING IN
SUPPORT OF OUR- THE YOUNGER
CARTES TESTING ON REGARDING
CHALLENGES CBO THEIR- REALLY
ACCOUNT MENTAL. AND ALSO TO
THINK THAT FOR PROVIDE A FORM
DISCUSS THE ON THE CLOUT NEED
WITH COMMUNITY BASED. COUNTY IN
THE UNITED. AND DOCTOR QUICKER
MENTIONED EIGHTY FOUR SEVEN
QUIRKS AND I FOR THE STATE MAKE
IT YOU COOPER TO DELIVER MY
ALSO. I DOCKING IN STATE WIDE.
WE WANT TO THANK YOU FOR YOUR
LEADERS ON THE COULD BE TO
CONTINUE BE AVOID FOR BEHAVIOR
HEALTH KERR ACROSS THE STATE WE
LOOK FOR TO PARTNERING WITH
ALSO. INCLUDING A COMMITTEE YOU
. THANK YOU LINE WILL NOW GO
LINE THIRTY YEAR LINE IS NOW.
GOOD AFTERNOON KOREA'S WITH
STEINBERG INSTITUTE OR ANY NON
PUBLIC INSTITUTE DEDICATED TO
TRANSFER CAL MENTAL HEALTH- CARE
THROUGH AND- AT AND OF IN THE
LEADERSHIP JUST WANT TO COMMENT
KNOW OUR STRONG. FOR THE ADMIN
CAL BE HEALTH BAY CONTENT ON THE
MEN'S FOR. A NEW COMMUNITY BASED
SERVICES INCLUDED IN THIS
PROJECT- CRITICAL ENGINES OF
CARE THAT WILL SAVE LIVES AND
PROPOSAL SIMULTANEOUSLY HEALTH
INSURER THAT INSTITUTIONAL CARE
IS PROVIDED AS A LAST RESORT WE
ALSO APPRECIATE PROPOSALS FOCUS
ON ACCOUNTABILITY PERFORMANCE
IMPROVEMENT AND STANDARDIZATION
OF MEASURES. AND PRACTICES-
THANK YOU. THANK YOU. NOW MOVE
ON THE LINE TWENTY EIGHT YOUR
LINE IS NOW OPEN. GOOD AFTERNOON
MADAM CHAIR FOR A ON. CHILDREN
NOW- CHILDREN NOW APPRECIATE THE
VISION AND GOALS OF THE CAL A
MINUTE. SPECIALIST GIVEN THE
LONGSTANDING DEFICIENCIES IN
CHILDREN'S UTILIZATION OF
PERMANENT AND MEDICAID. THE
AUDITOR HAS REPORTED ON WE HEAR
THE OPERATIONAL CONCERNS AROUND
IMPLEMENTATION THAT HAVE BEEN
POINTED OUT BY TODAY ANALYSTS
AND WE LOOK FORWARD TO WORKING
WITH EACH. OTHER STAKEHOLDERS TO
ENSURE CHILDREN YOU CONSISTENTLY
HAVE EQUITABLE ACCESS TO QUALITY
COORDINATED MEDICAL BEHAVIORAL
HEALTH AND DENTAL CARE. THANK
YOU THANK YOU. MODERATOR I
BELIEVE THERE'S ONE REMAINING.
NINE AND ONCE AGAIN LADIES AND
GENTLEMEN IF YOU DID HAVE A
QUESTION BECAUSE THAT'S THAT
MODERATOR IF THAT WAS THE LAST
TO HADN'T Q. THEN WE'RE GOING TO
STOP. SINCE I TECHNICALLY SHOULD
HAVE STOPPED AT NOON I AM VERY
APPRECIATIVE THAT WE WERE ABLE
TO FIT IN. THOSE PEOPLE WHO HAD
BEEN QUEUED ON APPRECIATIVE OF
THAT AND- I WANT TO THANK THE
PANELISTS VERY MUCH THIS WAS A
LOT OF INFORMATION FOR OF I KNOW
FOR MYSELF I'M SURE FOR MY
COLLEAGUES. AND IT WAS VERY
IMPORTANT HEARING FOR US TO HOLD
- WE DON'T ALWAYS HAVE THE
BENEFIT TO GET INTO THE DETAIL
CERTAINLY THE SUBCOMMITTEE DOES
IN MY- SUBCOMMITTEE CHAIR
SITTING RIGHT HERE AT THE ON THE
DIETS- BUT I THINK IT WILL HELP
THE REST OF US AS WE- LOOK. AT
IS WE- BASICALLY PLAY OUT THE
LEGISLATURES APPROACH TO THESE
THINGS FOR THE TWENTY THREE
TWENTY FOUR BUDGET SO PRECIADO
EVERYONE ALL THE PANELISTS STAFF
THANK YOU SO MUCH FOR THE
ARRANGING IT. AND MEMBERS WHO
ARE STILL IN THE ROOM THANK YOU
FOR HANGING IN THERE AND WITH
THAT I WILL CONCLUDE THE
SENATE'S BUDGET IN FISCAL REVIEW
COMMITTEE HEARING FOR TODAY.