THE COMMITTEE HEALTH COMMITTEE
WILL COME TO ORDER THE COMMITTEE
HEALTH COMMITTEE THE SENATE
HEALTH COMMITTEE WILL COME TO
ORDER- GOOD AFTERNOON AS WE
CONTINUE TO- WELCOME THE PUBLIC
IN PERSON B. R. TELECONFERENCE
SERVICE- WE'RE GONNA ALLOW SIX
MINUTES OF IN PERSON TESTIMONY
PER SIDE DON'T FEEL OBLIGATED TO
USE THAT BUT INDIVIDUALS WISHING
TO CALL ANIMAL WE GET TO THE
CALL IN PORTION. THE NUMBER IS.
877-226-8163 WITH THE ACCESS
CODE. SEVEN THREE SIX TWO EIGHT
THREE FOUR AND WE WILL CAP-
PUBLIC TESTIMONY ON THE PHONES
AT FIFTEEN MINUTES TOTAL TODAY
WE HAVE A FOURTEEN BILLS ON
TODAY'S AGENDA TWO OF WHICH ARE
ON A PROPOSED CONSENT CALENDAR
SB. SEVEN EIGHTY THREE WITH
AMENDMENTS AND SB SIX FORTY ONE
WITH AMENDMENTS. OKAY CENTER
ASHLEY IF YOU DON'T MIND JUST
TALKING TO ME. ALL RIGHT WELL
THEN LET'S GET THIS BALL ROLLING
THANK YOU SO MUCH. AND WELCOME.
YOU ARE HERE TODAY PRESENTING SB
FOUR OH EIGHT. I AM THANK YOU SO
MUCH FOR HAVING ME HERE IN YOUR
OFFICE. WELCOME A MEETING JUST
S. THEY'LL HELP HIM COME DOWN
YOU'LL SEE. ALL RIGHT. CAN WE
ARE HERE TO THE PRESENT FOUR OH
EIGHT AND I LIKE TO START BY
THINKING YOUR INCREDIBLE STAFF
AND I KNOW EVERY SENATOR STARTS
BY SAYING THAT BUT YOURSELF IS
ACTUALLY WORKED REALLY HARD ON
THIS BILL WITH US AND I'M VERY
GRATEFUL AND SO IS MY TEAM THIS
IS A COMPLICATED BILL BUT ALSO.
LIKE A LOT OF THINGS THAT
HAPPENED THIS BUILDING REALLY
IMPORTANT AND MEANINGFUL WORK SO
WE'RE SUPER GRATEFUL TO YOUR
TEAM THANK YOU SO MUCH FOR ALL
OF YOUR- YOUR HELP AND WE WILL
ABSOLUTELY BE ACCEPTING THE
COMMITTEES AMENDMENTS WITH
APPRECIATION. SB FOUR OH EIGHT
AS AMENDED WILL DEVELOP AN
ENHANCED FUNDING MODEL WITHIN
THE CURRENT S. T. R. T. P.
PROGRAM FOR INTENSIVE CARE AND
TREATMENT PROGRAMS. FOR YOUTH
WITH A CUTE TRAUMA BASED NEEDS.
AS OF JANUARY THIS YEAR THERE
WERE APPROXIMATELY FIFTY TWO
THOUSAND CHILDREN IN
CALIFORNIA'S FOSTER CARE SYSTEM.
OVER SEVENTEEN THOUSAND OF THOSE
OUR YOUTH BETWEEN THE AGES OF
ELEVEN AND SEVENTEEN YEARS OLD.
SINCE TWO THOUSAND FOURTEEN
CALIFORNIA HAS BEEN IMPLEMENTING
THE CONTINUUM OF CARE. TO REDUCE
THE USE OF CONGREGATE CARE AND
FOCUS ON KEEPING CHILDREN AND
YOUTH WITH FAMILIES OR FAMILY
LIKE RELATIONS. THROUGH THE CCR
CALIFORNIA REQUIRED FORMER GROUP
HOMES TO CONVERT INTO HIGHER
LEVEL CENTERS WITH MORE
TREATMENT OPTIONS KNOWN AS SHORT
TERM RESIDENTIAL THERAPY
PLACEMENTS WHICH WE
AFFECTIONATELY CALL. S. T. RT
PIECE BECAUSE IT JUST ROLLS
RIGHT OFF YOUR TONGUE. COMPLEX
NEEDS YOU HAVE NEEDS ACROSS
SYSTEMS OF CARE WE KNOW THIS
EDUCATIONAL OCCUPATIONAL MENTAL
HEALTH SUBSTANCE ABUSE JUST TO
NAME A FEW. AND SO THESE
FACILITIES ALLOW THEM TO ADDRESS
THOSE COMPLEX UNDERLYING NEEDS
WHILE DEALING WITH THEM IN A
TRAUMA INFORMED WAY. THE CURRENT
STRUCTURE OF THE S. T. R. T.
P.'S ARE EFFECTIVE PROGRAMS FOR
SOME YOUTH. BUT NOT ALL IN
SPECIFICALLY. S. FAILED OUR MOST
HIGHLY TRAUMATIZED YOU SO THIS
IS AN ATTEMPT TO FIX THAT.
UNFORTUNATELY MANY OF THE STR
TEEPEES ARE UNDER EQUIPPED TO
PROVIDE THE NECESSARY SERVICES
AND STATE WIDE GAPS THAT EXIST
IN SERVING THE NEEDS OF CHILDREN
YOUTH AND FAMILIES. WITH
MULTIPLE CO MORBIDITIES OR CROSS
SYSTEM NEEDS WHICH I'M SPEAKING
TO THE TWO SOCIAL WORKERS IN THE
LEGISLATURE HERE SO I KNOW YOU
KNOW EXACTLY WHAT I MEAN. THE S.
T. R. T. PIECE CAN ALSO DENY A
PLACEMENT THIS IS A PRETTY BIG
DEAL. IF THE CHILD'S NEEDS ARE
TOO GREAT AND WE REALLY NEED TO
CLOSE THAT LOOPHOLE WE CAN'T
JUST SAY IT'S TOO HARD. AS A
RESULT FOSTER YOUTH WITH THE
HIGHEST AND MOST COMPLEX NEEDS
ARE SOMETIMES REJECTED FROM STR
TEEPEES. AND THEN WHAT HAPPENS
IS WHAT WE HAVE ALL DEEMED
UNACCEPTABLE THEY EXPERIENCE
WHAT WE CALL OVER STAYS IN
SHELTERS OR OVERNIGHT STAYS IN
INAPPROPRIATE PLACES LIKE
MOTELS. COUNTY OFFICE WAITING
ROOMS OR EVEN JAIL CELLS WHICH
WE SAW RECENTLY IN SACRAMENTO.
LET ME BE CLEAR NONE OF THESE
ARE APPROPRIATE PLACES FOR
CHILDREN TO BE STAYING NO MATTER
WHAT TRAUMAS THEY'RE FACING OR
WHAT'S HAPPENING IN THEIR LIFE.
TO ADDRESS THESE PROBLEMS SB
FOUR OH EIGHT WILL ESTABLISH AN
ENHANCED VERSION OF THE S. T. R.
T. P. THIS IS THE NEW PIECE THAT
YOU'RE A TEAM HELPED US PUT
TOGETHER HERE. WE'VE COINED THAT
AS AN S. T. R. T. P. OF FOUR.
USED TO BE OF ONE BUT IF WE
ALLOW IT TO GO UP TO FOR. HOW WE
THINK IT WILL WORK BETTER FROM A
FINANCIAL STANDPOINT THIS WILL
PROVIDE. INTENSIVE STABILIZATION
ASSESSMENT THERAPY AND OTHER
DIRECT SERVICES FOR HIGHLY
TRAUMATIZED FOSTER YOUTH. BEFORE
THEY HAVE TO TRANSITION TO A
MORE PERMANENT PLACEMENT SO THAT
THEY GET THE HELP. THEY NEED ON
THE FRONT END. TO BE SUCCESSFUL.
S. T. R. T. PIECE OF FOUR WILL
BE SMALL. NO MORE THAN FOUR BED
FACILITIES THAT WILL TAKE IN.
ALL YOUTH WHO NEED PLACEMENT YOU
DON'T GET TO SAY NOW. AND BUILD
UPON EXISTING STANDARDS TO
INCLUDE ADDITIONAL ON SITE
TWENTY FOUR SEVEN STAFFING. S.
T. R. T. P.'S OF FOUR WILL
INCLUDE DEDICATED CARE TEAMS.
WHERE YOU CAN RECEIVE DIRECT
CARE FROM MULTI DISCIPLINARY
TEAMS. GET ASSESSED ACROSS
MULTIPLE SYSTEMS OF CARE. AND
START TREATMENT AND
STABILIZATION SERVICES FOR UP TO
SIX MONTHS BEFORE BEING
DISCHARGED. S. T. RT PIECE OF
FOR WILL ALSO PROVIDE FAMILY
SERVICES INCLUDING CAREGIVER
RESPITE DURING THE SIX MONTHS
AFTER CARE PERIOD TO HELP
SUPPORT THE FAMILY. STABILIZE
THE CHILD. I WANT TO BE CLEAR
THAT S. T. R. T. PIECE OF FOR IT
WILL BE WITH IN THE CURRENT
LICENSING STRUCTURE OF S. T. R.
T. PIECE. THIS IS AN ENHANCED
SERVICE MODEL WILL NO LONGER BE
A SEPARATE FACILITY OR SEPARATE
LICENSING. SB FOUR OH EIGHT WILL
ALSO CREATE TEN. REGIONAL HEALTH
TEAMS ACROSS THE STATE WILL GO
DIRECTLY TO YOUTH IN CRISIS AND
THEIR FAMILIES. TO PROVIDE
DIAGNOSTIC ASSESSMENT DIRECT
CARE AND SUPPORT. THESE REGIONAL
HEALTH TEAMS ARE MULTI
DISCIPLINARY TRAUMA INFORMED AND
THEY PRIORITIZE REFERRALS FROM
CHILD WELFARE PROBATION. AND
TRIBES. THE REGIONAL HEALTH
TEAMS CAN ALSO HELP YOU AT RISK
OF ENTERING FOSTER CARE SO
THERE'S A PREVENTATIVE COMPONENT
TO THIS. WHICH IS CRITICAL FOR
YOUTH OR NOT ALREADY IN THE
SYSTEM. WHEN CHILDREN ARE
REMOVED FROM THEIR HOMES IN
PLACE OF THE PROTECTION OF CHILD
WELFARE AGENCIES. WE OWE THEM
THE VERY BEST CARE AND TREATMENT
THAT WE CAN POSSIBLY PROVIDE IN
THE STATE OF CALIFORNIA. FOR
THOSE YOUTH WITH COMPLEX NEEDS
TO OFTEN WE'RE RE TRAUMATIZING
THEM. THEY'RE VERY FIRST PLACE
IN THE SOMETIMES BEFORE THEY
EVEN REACH THEIR FIRST
PLACEMENT. SB FOUR AWAY TEMPS TO
ADDRESS THESE GAPS IN PLACEMENT
AND SERVICES SO THAT OUR HIGHEST
NEEDS YOU CAN RECEIVE THE
TREATMENT THEY DESERVE. TO DO
NOTHING. IS TO ACCEPT AN
UNACCEPTABLE ALTERNATIVE
CURRENTLY IN PLAY ONE THAT USES
JAIL CELLS IN PLACE TO TREATMENT
FACILITIES. I'D ALSO LIKE TO
QUICKLY NOTE THAT MY SPONSORS
AND I HAVE MET WITH AND HEARD
THE CONCERNS OF OPPONENTS AND
ALSO OF MY COLLEAGUES HERE ON
THE DYESS AND- IN OTHER
COMMITTEES. WE BELIEVE THIS BILL
AS AMENDED NOW ADDRESSES MOST OF
THOSE CONCERNS. I WANT TO THANK
YOU CHAIR EGGMAN YOU'VE BEEN
EXTREMELY HELPFUL PERSONALLY TO
ME AND TO MY TEAM. AND TO MY
COLLEAGUES SENTIMENTS OF OUR TO
WHO'S BEEN VERY HELPFUL IN
TAKING TIME OUT OF HER DAY TO
MEET WITH ME AS WELL MULTIPLE
TIMES ON THIS BILL. SPILLS
BETTER BECAUSE OF YOU. I HAVE TO
SUPPORT WITH THIS WHAT WITNESSES
WITH ME I'M CHAIRMAN IF THAT WAS
OKAY THIS BILL IS SPONSORED BY
THE CALIFORNIA WELFARE DIRECTORS
ASSOCIATION. AND SO AMANDA
KIRCHER WAS C. W. D. A. IS HERE
AND ROSY MCCOOL WAS CBO SEES
HERE AS WELL. THANK YOU VERY
MUCH. AMANDA. GOOD AFTERNOON
MADAM CHAIR AND MEMBERS THANK
YOU SO MUCH FOR. YOUR WORK ON
THIS BILL ESPECIALLY WANT TO
CALL IT YOUR COMMITTEE STAFF IN
THE AUTHOR STUFF AS WELL- WE DO
AGREE WE THINK WE ARE MOVING IN
THE RIGHT DIRECTION THIS IS A
BETTER FELT- I. I WANNA SAY
SINCE CALIFORNIA IMPLEMENTED THE
CONTINUE OF CARE REFORM. CHILD
WELFARE AND PROBATION AGENCIES
HAVE REALLY STRUGGLE TO MEET THE
GROWING. COMPLEX NEEDS OF OUR
YOUTH AND UNFORTUNATELY IN THE
LAST YEAR AND A HALF WE'VE
REALLY SEEN THIS. AS A CRISIS AT
THIS POINT- AS SENATOR
MENTIONED- NO CHILD SHOULD HAVE
TO SPEND A NIGHT. IN A
CONFERENCE ROOM OR AN AIRBNB OR
A JAIL CELL BECAUSE WE SIMPLY
CAN'T FIND SOMEPLACE ELSE THAT
TO PUT THEM. I'M AND SO SB FOUR
AWAIT. IS GOING TO ADDRESS THAT
UP BY AS WE SAID CREATING
ENHANCE US YOUR T. P. FACILITY
NO MORE THAN FOUR BEDS WITH
CROSS SYSTEMS CARE I'M REALLY
PULLING IN. THE MULTI
DISCIPLINARY TEAMS THAT CAN HELP
US ADDRESS THEIR EDUCATIONAL
NEEDS- INTELLECTUAL THIS
DISABILITIES OR DEVELOPMENTAL
DISABILITIES AND PARTICULARLY
SUBSTANCE ABUSE- WE FIND OF A
PARTICULARLY LARGE NEED AND NOT
ENOUGH- PROVIDERS AND SERVICES.
FOR OUR CHILDREN WHO ARE ARE
STRUGGLING WITH THIS. CRISIS-
IT'S AN- TO NOTE THAT IN A
RECENT SURVEY OF OUR COUNTIES WE
FOUND THAT OVER ONE THOUSAND
INSTANCES. OF CHILDREN STAYING
IN AN APPROPRIATE PLACEMENTS OF
WHETHER THAT WAS BETWEEN CHILD
WELFARE OR PROBATION SO. TO THE
EXTENT THAT WE CAN HAVE AN
ALTERNATIVE WHERE WE CAN GET
THEM STABILIZED WE CAN GET THEM
TREATMENT AND ASSESSMENT AND
THEN HOPEFULLY TRANSITION THEM
INTO A STABLE FAMILY LIKE BASED
PLACEMENT. THAT IS REALLY WHAT
OUR GOAL IS I AM I ALSO WANT TO
PULL PARTICULAR NOTE TO THE- TEN
REGIONAL HEALTH TEAMS THAT WE
WANT TO CREATE. THIS IS
IMPORTANT BECAUSE- ABOUT HOW FOR
KIDS ARE ACTUALLY ONLY IN FEE
FOR SERVICE THEY'RE NOT IN
MANAGED CARE MEDICAL. AND SO THE
ECM THAT IS BEING ROLLED OUT
THREE G. H. THE S. DOES NOT
APPLY TO THEM AND THESE KIDS
REALLY NEED THAT MANAGED CARE
ASPECT. ON THAT WE CAN OFFER
BECAUSE OF THE CROSS SYSTEM-
COMPLICATIONS- AND THEN FINALLY
WHAT THE BILL DOES IS IT HELPS
US FOR. OUR FUNDING MODEL A
LITTLE BIT I'M RIGHT NOW IF YOU
HAVE A COMPLEX NEEDS CHILD YOU
HAVE TO SORT OF. GET THE
SERVICES FIRST AND THEN BE
REIMBURSED FOR THOSE SERVICES TO
THE STATE THIS WOULD FLIP THAT
MODEL GET THE MONEY UP FRONT SO
THAT WE CAN QUICKLY GET THOSE
SERVICES. GET THE KIDS
STABILIZED- AND THEN FOR THEIR-
WE'D BE ABLE TO SPEND THAT MONEY
INSTEAD OF HAVING TO WAIT THAT
THE CURRENT- SYSTEM IS VERY
BURDENSOME AND TIME CONSUMING- I
WANT TO SAY THAT WE ARE
ABSOLUTELY COMMITTED TO WORKING
WITH THE OTHER STAKEHOLDERS.
MOVING FORWARD AND WE APPRECIATE
THEIR COMMENTS AND FEEDBACK AND-
WE APPRECIATE YOUR SUPPORT THANK
YOU. THANK YOU VERY MUCH NEXT
PERSON PLEASE. GOOD AFTERNOON
CHAIRED MEMBERS DANIEL SANCHEZ
ON BEHALF OF THE CHIEF PROBATION
OFFICERS OF CALIFORNIA A PLEASED
TO BE A CO SPONSOR WANT TO THANK
THE SENATOR FOR- LEADERSHIP ON
THIS AND CERTAINLY TO THE
COMMITTEE. TO YOU CHAIR IN AND
YOUR- CONSULTANTS FOR WORKING ON
THIS- PROBATION CHIEFS ALONG
WITH OUR TROUBLE FOR PARTNERS IN
THIS LEGISLATURE. HAVE WORKED
DILIGENTLY TO REALLY DEVELOP THE
RIGHT TYPES OF SUPPORT STABILITY
AND SAFETY FOR YOUTH TO THRIVE.
FOR THE PROBATION CHIEFS WE
REALLY VIEW THESE EFFORTS BOTH
AS BEING ABLE TO BEST SERVE THE
YOUTH WHO ARE IN- PROBATION
FOSTER YOUTH BUT ALSO HOW DO WE
LOOK AT MAKING SURE WE ARE
PREVENTING AND MITIGATING YOU
FROM COMING. INTO THE JUVENILE
JUSTICE SYSTEM AND SO WE THINK
THIS- HAS. A MULTITUDE OF REALLY
IMPORTANT KEY FACTORS TO IT-
ECHO IN OTHER COMMENTS I MADE
CHILD WELFARE COLLEAGUE WHEN WE
LOOKED AT. THE NEEDS OF
PROBATION SUPERVISED FOSTER
YOUTH WE KNOW THE LEVEL OF
ACUITY HAS RISEN AROUND
SUBSTANCE. USE NEEDS MENTAL
HEALTH AND THE COMPLEX MEDICAL
AND MENTAL HEALTH NEEDS ALL OF
WHICH WE SEE THIS BILL AS BEING
AN IMPORTANT FACTOR IN- WORKING
ON IN ADDRESSING- WE ALSO
BELIEVE THAT THIS MEASURE. ON AS
PRE STATED IS REALLY KEY IN
LOOKING AT. THE MEDIA KIND OF
STABILIZATION WHILE WE LOOK AT
HOW BEST THAN TO TRANSITION TO
A- MORE SUITABLE AND SUSTAINABLE
HOME BASED CARE- I WOULD JUST
KIND OF ALSO- ARTICULATE THAT I
THINK THE TIMELY ACCESS TO
FUNDING AND RESPONSES TO YOU CAN
CRISIS IN TERMS OF HOW ABOUT.
FUNDING MODEL WORKS AND MAKING
SURE THAT WE CAN ADDRESS THE
NEEDS AND VERY QUICK IMMEDIATE
WAYS IS IMPORTANT- FOR THE YOUTH
AND STABILIZATION SO. WE SEE
THIS AS A REALLY IMPORTANT PART
OF A WHOLE CONTINUUM. OF
RESPONSES FOR YOUTH IN FOSTER
CARE- BUT PARTICULARLY FOCUS ON
HOW DO WE HELP THOSE YOUTH WHO
ARE IN CRISIS. IN BETTER
ALTERNATIVES THAT REALLY MEET
THEIR NEEDS SELL OUT FOR THOSE
REASONS WERE A PLEASED TO WORK
ON THIS- AND ASK FOR YOUR AYE
VOTE TODAY. THANK YOU VERY MUCH.
NOW IT'S TIME FOR ANYBODY ELSE
WISHING TO EXPRESS SUPPORT TO
COME FORWARD AND JUST YOUR NAME
AND ORGANIZATION AND POSITION
PLEASE. GOOD AFTERNOON CHAIR AND
MEMBERS- SUMMER STEPHAN SAN
DIEGO COUNTY'S DISTRICT ATTORNEY
IN SUPPORT THANK YOU THANK YOU.
KELLY PARKS ON BEHALF OF THE
BOARD OF SUPERVISORS FOR LOS
ANGELES AND SANTA CLARA COUNTIES
HERE IN SUPPORT. THANK YOU.
TIFFANY WHITE WITH THE CSU
CALIFORNIA AND SUPPORT THANK YOU
THANK YOU. JEFF NEAL
REPRESENTING THE BOARD OF
SUPERVISORS IN SAN DIEGO COUNTY
AND CONTRA COSTA COUNTY IN
SUPPORT. THANK YOU VERY MUCH.
DOES EVERYBODY SPEAK IN
OPPOSITION TO THIS BILL TO COME
FORWARD. HE'S GOOD AFTERNOON
MADAM CHAIR MEMBERS GREGORY
KRAMER ON BEHALF OF DISABILITY
RIGHTS CALIFORNIA. WERE IN
OPPOSITION TO THE BILL AS IN
PRINT- WE DID RECEIVE THE
AMENDMENTS THIS MORNING AND
AGREED THAT- THE BILL'S NOW
MOVING IN A MORE POSITIVE
DIRECTION OUR FOLKS HAVE NOT HAD
A CHANCE TO PERUSE THE LANGUAGE
IN DETAIL BUT WE GENERALLY AGREE
THAT IT IS MOVING IN THE RIGHT
DIRECTION- SIMPLY PUT DRC
OPPOSES. ANY TYPE OF LEGISLATION
THAT WOULD EXPAND UPON
INSTITUTIONALIZATION OF YOUTH-
VERSUS COMMUNITY- PLACEMENTS AND
SO- AGAIN JUST REALLY COMMEND
THE COMMITTEE AND THE AUTHOR FOR
WORKING ON THESE AMENDMENTS AND
WE LOOK FORWARD TO CONTINUING
DISCUSSIONS THANK YOU. THANK YOU
. X. PERSON PLEASE. GOOD
AFTERNOON MADAM CHAIR AND
MEMBERS ADRIN SULTAN WITH THE
CALIFORNIA ALLIANCE OF CHILD AND
FAMILY SERVICES A WE ARE NOT
OPPOSED TO THE BILL WE HAVE
EXPRESSED CONCERN ABOUT THE BILL
IN PRINCE BUT WE'RE DEEPLY
APPRECIATIVE OF THE AUTHOR. AND
THE SPONSORS AND THE COMMITTEE
FOR YOUR WORK WE BELIEVE THAT
THIS MOVES THE BILL IN A
POSITIVE DIRECTION SO WE LOOK
FORWARD TO CONTINUING TO ENGAGE
AND I THINK WE'RE ALL LINED ON
THE GOALS. THANK YOU VERY MUCH.
GOOD AFTERNOON CHAIR AND
COMMITTEE MEMBERS MY NAME IS
JORDAN SO SAY HERE ON BEHALF OF
CALIFORNIA YOUTH CONNECTION
WHERE YOU FLAT ADVOCACY
ORGANIZATION WITH A MEMBERSHIP
OF CURRENT AND FORMER FOSTER
YOUTH. THE FIRST ONE I
APPRECIATE C. TO B. D. A. R. AND
HEARING OUR CONCERNS OF THE
POTENTIAL HARM THIS BILL COULD
HAVE TO USE AND FOSTER CARE- WE
DID RECEIVE THE AMENDMENTS THIS
MORNING- HOWEVER WE DO HAVE
CONCERNS. ON AVAILABLE STATE
DATA AND HOW CONGREGATE CARE
SETTINGS HAVE BENEFIT THE SAFETY
AND WELL BEING OF VIEWS IMPACTED
BY THE CHILD WELFARE SYSTEM.
ALSO HERE AT THE CONCERNS OF CDS
AS A ROLLING OUT THE CONTINUED
CARE REFORM DASHBOARD- WITH THAT
WE ARE IN A CAN TO ANY
CONTINUING OUR POSITION. IN
OPPOSITION SB FOUR AWAIT. I
MYSELF AM A FORMER FOX WITH
MYSELF AND I WAS ALSO PLACE IN
EMERGENCY. SHELTERS I COULD TELL
YOU FIRST HAND THAT I WOULDN'T
BE HERE BUT IF YOU IF I DIDN'T
HAVE THE OPPORTUNITY. TO BE
PLACED IN A LOVING HOME- MY
SIBLINGS AND ALL AND I ALL GOT
PLACE IN DIFFERENT PLACEMENTS.
AND I COULD TELL YOU FIRST HAND
WE CANNOT FIND SAFETY AND
LOVING. HOMES AND STABILITY AND
INSTITUTIONS THANK YOU THANK YOU
VERY MUCH NOW JUST NAME A
POSITION PLEASE. AND CARTOONS
LAWCENTER OF CALIFORNIA
REPRESENTING OUR CHILDREN IN THE
DEPENDENCY SYSTEM IN LOS ANGELES
SACRAMENTO AND PLACER COUNTIES
WE DID SUBMIT A LETTER OF
CONCERN AND I JUST REALLY WANT
TO. I THANK THE COMMITTEE FOR
ALL THE WORK- ON THIS AS WELL AS
SENATOR ASHBY AND THE CO
SPONSORS FOR. WILLING TO WORK
WITH US AND LISTEN TO US WE DID
JUST GET THE MINUTES THIS
MORNING THEY SEEM TO ADDRESS.
MOST OF OUR CONCERNS AND I
REALLY APPRECIATE THAT AND LOOK
FORWARD TO CONTINUING TO WORK
WITH YOU ON IT. THANK YOU VERY
MUCH. OKAY A NICE TIME TO GO TO
THE PHONES TO SEE IF ANYBODY
WANTS YES OR NO AND NOW IS THIS
JUST YOUR NAME AFFILIATION AND
POSITION ON THE BILL. MODERATOR
YOU THERE. I AM LATE IN GENPACT
WHICH MAKE A COMMENT IN SUPPORT
OR OPPOSITION. THE AT ONE. ZERO
WILL BE ON THE LINE ONE
THIRTEEN. THE AT. NICOLE KIDMAN
IN BEHALF OF SAN BERNARDINO
COUNTY AND THE CHILDREN
PARTNERSHIP IN SUPPORT. THANK
YOU VERY MUCH TAX COLOR PLEASE.
ACTUALLY ON THE LINE ONE
SEVENTEEN. PLEASE GO AHEAD MA'AM
. MADAM CHAIR MEMBERS BOILER
BEHALF OF THE BOARD SU RESIDENT
HUBBELL FRESNO KERN COUNTIES AS
WELL AS SITTING COUNTY SAN
FRANCISCO. IN SUPPORT. THANK YOU
NEXT CALLER PLEASE. AND ACTUALLY
GOING TO LINE ONE FIFTEEN PLEASE
GO AHEAD. THE TECHNICIAN CARE
AND MEMBERS MY NAME IS CLOSE THE
IDEA WITH ELSE FOR YOU NEXT
VERY. FRANK END UP WITH OF A FEW
. THANK YOU VERY NEXT COLOR
PLEASE. YEAH IT'S GOING TO ONE
TWENTY THREE PLEASE GO AHEAD. HI
THIS IS JENNIFER FOR THE YOUTH
LAW CENTER YOU POSSIBILITIES
CURRENTLY WRITTEN BUT WE WILL
FORWARD TO CAN THE IN. AND
DEPRESSED THE EFFORTS OF SPONSOR
AND THANK THANK. FOR CALLING
PLEASE. WE'RE GOING TO LINE ONE
OH FOUR PLEASE GO AHEAD.
AFTERNOON HEARING MY IS MARK
PARKER I'M COMMUNITY COORDINATOR
CALIBER YOU CAN I. REPRESENTING
THE SACRAMENTO CHAPTER AND I'M
CALLING IN OFFICE OF THAT WORLD
. THANK YOU. I CALLER. ACTUALLY
ON THE LINE EIGHT PLEASE GO
AHEAD. I THINK YOU SHOULD RUN A
GOOD SOLID ARE ON BEHALF OF THE
COMMUNITY ARE THE COMPASS BUT
EIGHT. COURT OF A THE AMOUNT
DIRECTION OF THE THANK YOU THANK
YOU NEXT PLEASE. BACKGROUND
NUMBER THANK MADAM CHAIR THANK
YOU VERY NUMBER THE TIME WOULD
BRING ABOUT TO THE CA. ANY
QUESTIONS CALL. CENTER MENJIVAR
. I'M SURE IF IT'S OKAY WITH YOU
I TWENTY MIKE TO THE WITNESS YES
FROM COUNTY. THANK YOU SO MUCH
OF COURSE. I'M NOT BEEN ABLE TO
DIVE INTO THIS ROAM THROUGH
MYSELF THREE LANES GIVE ME A LOT
OF EXPOSURE TO THESE ENTITIES
I'M IN I JUST A COUPLE QUESTIONS
I HAVE AND I APPRECIATE THE
AMENDMENTS THE AUTHOR MADE WITH
THE WITH THE CHAIR HERE. IT IS
IN THE RIGHT PATH I STILL HAVE
JUST SOME HAS A TENSE SCENE I'M
I'M WONDERING IF YOU COULD SHARE
WITH ME YOU KNOW HOW CALORIES
ARE APPROACHING JUST SOME OF THE
- FUNDS THAT'S BEEN AVAILABLE TO
ADDRESSING CREATE FOR EXAMPLE
THE CHILDREN'S PRICES CONTINUE
ON. THAT ADDRESSES THEM WHAT I
THOUGHT ADDRESS SOME OF THE
CONCERNS AND ISSUES THAT IT'S
BEEN BROUGHT UP TODAY THERE'S A
LOT OF FUNDING THAT HAS BEEN PUT
DOWN BY THE COUNTY YOU JUST DIVE
INTO A LITTLE BIT MORE ON THAT
AND THEN ALSO. I'M EXCLUDING
MORE Y. S. U. R. T. P. PLUS
ONES. AREN'T THE IDEAL APPROACH
A WIDE THAT PROGRAM IS IN BEING
IMPLEMENTED. SURE HAPPY TO TAKE
YOUR FIRST QUESTION. SO IT IS MY
UNDERSTANDING THAT IT'S BEEN
VERY DIFFICULT TO PULL DOWN
THOSE FUNDS AT THE COUNTY LEVEL.
EVEN THOUGH THE FUNDING IS
AVAILABLE- WE HAVEN'T GOTTEN
THINGS US EARLY APPROVED THROUGH
THE STATE. AND SO CARE NEEDS
HAVE BEEN HESITANT TO SORT OF
ASK FOR THINGS WHEN THEY'VE
ALREADY BEEN TONIGHT- AND SO FOR
THE COMPLEX NEEDS YOUTH. THAT'S
PART OF THE REASON WE'RE TRYING
TO FLIP THE FUNDING MODEL SO
THAT IT'S NOT REIMBURSEMENT
BASED IT'S MORE UP FRONT GRANT
BASED. BECAUSE WE HAVE HAD SUCH
PROBLEMS PULLING DOWN THE- THE
CHILD SPECIFIC FUNDING AND SOME
THE OTHER TYPES OF FUNDING. OKAY
AND THEN IN. I'M SORRY THE
SECOND HALF SHE WANTED TO TALK
ABOUT THE PLANO FROM I JUST
WANNA MAKE SURE EVERYTHING WAS
TERMS OF. THE FUNDING COMING UP
FRONT YOU KNOW MANAGER MAYBE YOU
CAN ALSO HAVE THAT WOULD HELP ME
OUT HERE IS YOUR CONCERN IN THE
OVERSIGHT. WERE FOR. PROVIDING
THAT BEFORE THE SERVICE. YOU
KNOW IT'S HARD TO CLAW BACK THE
MONEY. AT ONCE IT'S OUT THE DOOR
THAT'S ALSO A PART WHERE. YOU
KNOW. NO I APPRECIATE BUDGET HAD
. ABSOLUTELY NO AND WE WOULD BE
HAPPY TO PUT IN REPORTING
REQUIREMENTS WE ALSO THAT WE
ALSO HAVE AUDITING REQUIREMENTS-
THROUGH BOTH OUR MANY HEALTH
SERVICES BUT ALSO THE REPORTS
THAT WE HAVE TO DO WONDER CHILD
WELFARE BACK TO DS US- WE'RE
ALSO HOPING THAT WE CAN BUILD IN
SOME REPORTING REQUIREMENTS. FOR
OUR S. T. R. T. P.'S SO THAT WE
CAN ACTUALLY SEE HOW WELL THEY
ARE FUNCTIONING. AND THE RATES
AT WHICH KIDS MAYBE AREN'T BEING
TAKEN INTO CARE- OR ARE
UNFORTUNATELY BEING EJECTED FOR
ANY NUMBER OF REASONS I KNOW
THAT YOU WERE CONCERNED
CONCERNED. ABOUT SOME OF THE
DATA ASPECTS IN HIM THE DATA YET
I DON'T WANT TO MONOPOLIZE THE
BUDGET THIS IS A POLICY
COMMITTEE LIKE YOU KNOW LET'S
FOCUS ON THE POLICY- BUT IT
KINDA LIKE TIES IN TOGETHER AND-
I HAVE OTHER QUESTIONS SO WE CAN
DIVE INTO. THE SECTION RIGHT NOW
YEAH NO PROBLEM- AND THAT WAS ON
THE S. YOUR TWO PIECE OF ONE
CORRECT. SO ONE OF THE THINGS
ABOUT WELL THAT'S WHEN YOU SAID
THAT WAS HARD. TO APPLY FOR
BECAUSE THE MONEY YOU GET DENIED
NO I'M SORRY I WANT TO MAKE SURE
I'M CLEAR- THE CHILD SPECIFIC
FUNDING THAT YOU'RE ASKING WHY
WE- DON'T SEE THE DRAW THAT DOWN
IN THE KILLINGS AREN'T ABLE TO
SPEND IT. THAT'S WHY IT'S IT
THAT'S PART OF WHY IT'S
DIFFICULT TO CRISIS CONTINUE
YAPPING SILVER STR TEEPEES OF
ONE. THEY AREN'T SOMETHING THAT
WE CAN JUST ROLL OUT VERY
QUICKLY THEY CAN TAKE MONTHS TO
ACTUALLY GET SET UP. AND SO AND
ADDITIONALLY THEY ARE VERY
EXPENSIVE- I ACTUALLY RECENTLY
JUST HEARD OF ONE THAT WAS BEING
SET UP. AT A HUNDRED TWENTY
THOUSAND DOLLARS A MONTH. AND
THAT IS NOT ANYWHERE NEAR WHERE
OUR NORMAL LAST YEAR T. P. RATES
ARE RIGHT NOW WE'RE IN THOSE
CONVERSATIONS- TO HAVE THAT. BE
ADDRESSED BUT THESE CAN BE VERY
EXPENSIVE- IT TAKES MONTHS TO
GET THEM SET UP. AND THEIR CHILD
SPECIFIC. AND SO THAT'S GREAT
FOR ONE CHILD BUT IT DOESN'T
SOLVE THE OVERALL NEED FOR ALL
OF OUR COMPLEX NEEDS YOUTH. SO
THAT'S WHERE WE ARE HOPING TO
HAVE SOMETHING A LITTLE BIT
BIGGER UP TO FOUR BEDS SO THAT
WE CAN SORT OF HAVE AN ECONOMY
OF SCALE AND BUILD IT UP. CAN
YOU EXPLAIN TO ME MORE PERFECT I
MEAN THE MATH FOR ME IF ONE IS
EXPENSIVE THEM FOR IS GOING TO
BE REALLY EXPENSIVE. SO PART OF
THE REGION'S THAT IT'S EXPENSE
WAS READY NOT ONE OFF HI. IF WE
HAVE A FOUR BED FACILITY WORK
ALL OF THE STAFF IN THE
TREATMENT OPTIONS ARE ALREADY
BUILT IN. IT BECOMES AN ECONOMY
OF SCALE BECAUSE THEY'RE ALREADY
GOING TO BE THEY'RE OFFERING ALL
OF THOSE THINGS WHETHER IT'S FOR
ONE CHILD OR UP TO FOUR CHILD.
INSTEAD OF TRYING TO CREATE A
KIND OF ON THE FLY. JUST FOR ONE
KID. AS THEY COME UP AND NEEDED
THROUGHOUT THE TOP FOR ME
WORRIES ME BECAUSE WE'RE MOVING
TOWARDS A CHILD SPECIFIC PLAN.
YOU JUST SAID. THE CHILD
SPECIFIC APPROACH IS NOT WORKING
AND WE NEED TO BRING IN FOR SO
WE'RE NOT GONNA BE CHILD
SPECIFIC. INTO YOU KNOW SOME OF
THE CONCERNS OF THE OPPOSITION
IS THAT WE NEED THAT WE NEED
CHILD SPECIFIC WE CAN HAVE AN
UMBRELLA. FOR CHILDREN AND HAVE
A PLAN FOR CHILDREN- I DON'T
THINK THAT WE DISAGREE WITH THAT
AT ALL. AND I THINK THAT'S PART
OF OUR CONCERNS WITH ESTHER
TEEPEES OVERALL. IS THAT WHEN
WE- WHEN WE- MOVED OUT OF THE
GROUP HOME MODEL. WE REALLY
CONDENSED ABOUT TWELVE TO
FOURTEEN LEVELS. OF GROUP HOMES-
AND THEIR NEEDS. INTO ONE
OVERALL LAST YEAR T. P. MODEL.
BUT WHAT WE FOUND OVER THE LAST
FEW YEARS. IS THAT ONE SIZE DOES
NOT FIT ALL. AND WE ARE HAVING A
REALLY HARD TIME FOR THESE.
SMALL POPULATIONS OF YOUTH. TO
MAKE SURE THAT THEY ARE GETTING
ALL OF THE TREATMENT AND SUPPORT
SERVICES THEY NEED. WHEN THEY
CROSS THE MULTIPLE SYSTEMS- WE
HAVE A HARD TIME. PULLING IN
REGIONAL CENTERS WE HAVE A HARD
TIME PULLING IN EDUCATION
SOMETIMES. SUBSTANCE USE THAT IS
A BIG PROBLEM. SO TO THE EXTENT
THAT WE CAN HAVE IT BE. A VERY
SMALL CHILD SPECIFIC FUNDING. IN
A MODEL THAT LETS US. NOT HAVE
TO DO THIS AS A ONE OFF EVERY
TIME. CALLING THE STATE FOR
TECHNICAL ASSISTANCE. TRYING TO
PULL TOGETHER EXPERTS. YOU KNOW
WE'RE ON THESE CALL SOMETIMES
ONCE A WEEK IF NOT MORE. BECAUSE
WE'RE COORDINATING WITH MULTIPLE
PEOPLE ALL OVER THE PLACE.
THAT'S WHY WE'RE TRYING TO BUILD
IN THE REGIONAL HEALTH CENTERS.
HEALTH TEAMS ON TOP OF THAT. SO
THAT THEY CAN BE AN EXPERTISE
LEVEL THAT'S ALWAYS THERE TO
HELP DIRECT THAT CHILD SPECIFIC
CARE. OKAY THANK YOU FOR THAT
AND THEN WHEN ONE OF THE LAST
ONES ARE. YOU KNOW IN IN THE
ALLOWANCES AND WEEK I BROUGHT
THIS UP IN THE FIRST COMMITTEE
HEARING ANALYSIS. YOU KNOW I'M
NOT GONNA DISAGREE THAT THIS IS
A CRISIS LIKE IT IS RIGHT WERE
SEEN CHILDREN IN PLACES THAT
THEY SHOULDN'T BE THAT IS THE
ISSUE- AND IT'S BEEN THE ISSUE
FOR YEARS BUT YOU KNOW. MY
PREDECESSORS LEGISLATORS BEFORE
LOOK AT THAT AND SAID THIS IS A
ISSUE SO LET'S IMPLEMENT SOME
PROGRAMS. AND THIS WAS LIKE BACK
IN TWENTY TWENTY ONE AND JUST
LAST WEEK WE- AYE I GOT A-
FUNDING REQUEST TO EVEN START
THAT PROGRAM WHICH WAS PASSED IN
TWENTY TWENTY ONE. AND I'M
WONDERING IF THE ISSUES WERE
LOOKING TO ADDRESS NOW. THE
PROGRAM WAS PASSED TWO YEARS AGO
THROUGH OTHER LEGISLATION WE
JUST HAVING GIVEN IT TIME. TO
ADDRESS IT IN ONCE IT STARTS IT
WILL ADDRESS IT. NO CONCERN IS
YOU KNOW DEPARTMENTS HAVE. BEEN
GIVEN DIRECTION ON THESE
PROGRAMS. THEY'RE SAID TO BE
WORKING WITH. THE TENT IS FOR
THEM TO WORK. AND HERE COMES I
KNOW WITHIN THE SAME VEHICLE
OFFICE YOUR T. PIECE BUT IT IS
SOMETHING ELSE. THAT'S A
CONTINUING CONCERN I HAVE. EVEN
WITH AMENDMENTS SO IF I COULD
JUST SAY IN TWENTY EIGHTEEN THE
LEGISLATURE PASSED. AB TWENTY
EIGHT EIGHTY THREE FROM
ASSEMBLYMEMBER COOLEY. THAT
DIRECTED THE STATE AND LOCAL
COUNTIES AND OTHER GOVERNMENT-
ENTITIES. TO COME TOGETHER AND
REALLY FIGURE OUT. THE GAPS IN
THE COMPLEX NEEDS OF CARE. AND
SO THAT WAS PASSED IN TWENTY
EIGHTEEN- GUIDELINES WERE SET UP
THERE WAS A REPORT DUE TO THE
LEGISLATURE BUT UNFORTUNATELY
GOT TO LEAD MICHAEL READ. BUT
THAT WAS RECENTLY- PUBLISHED IN
JANUARY OF THIS YEAR. AND ONE OF
THE THINGS THAT IT SAYS. IS THAT
EVEN WITH THE PROGRAMS THAT WE
HAVE CREATED WE STILL HAVE THE
SITE LOAD. PROGRAMS AND FUNDING
MECHANISMS THAT DO NOT FILL ALL
THE GAPS BUT HOW DO WE KNOW THAT
THE PROGRAM IS EVEN STARTED. WAS
IT IT'S BASED ON ABSOLUTE DO YOU
. BE ON THE BILL DATA THEY HAVE
RIGHT OR OUT. AND WHAT THEY KNOW
IS IN THE PIPE. R. AND I WANT TO
MAKE SURE I'M SURE ON WHICH ONE
YOU'RE REFERRING TO ISSUE WHEN
IT YOU KNOW FROM LIKE THE
PSYCHIATRIC RESIDENTIAL
TREATMENT FOR SURE. SO THAT SO
THE PURITY OFFS DON'T ACTUALLY
MEET ALL OF THE NEEDS THAT WE'RE
TALKING ABOUT FOR THESE KIDS.
THAT'S A VERY- SPECIFIC FORM FOR
KIDS HAVING AN ACUTE MENTAL
HEALTH CRISIS WHERE THEY CAN
STEP DOWN OUT OF HOSPITALIZATION
OR AS AN ALTERNATIVE
HOSPITALIZATION. BUT IT DOESN'T
NECESSARILY MEAN ALL OF THE
OTHER NEEDS THAT THEY MIGHT HAVE
AROUND LIKE ELIGIBLE- EDUCATION
OR REGIONAL CENTER NEEDS. I KNOW
OTHER MEMBERS UP. HERE SO I
DON'T I CAN'T NO LONGER
MONOPOLIZE CONVERSATIONS.
MICHAEL THANK YOU VERY MUCH.
ANYBODY ELSE HAVING A QUESTIONS
ON THIS TOPIC SEN SENATE
MAJORITY BEEN. TO AN YES PLEASE.
THANK YOU MADAM CHAIR AND I
APOLOGIZE I'M BOUNCING BETWEEN
COMMITTEES ALL RIGHT ALL OF US
ARE IS WANT TO THANK YOU FOR
INTRODUCING THIS PIECE OF
LEGISLATION YOU KNOW THESE
FOSTER KIDS IT'S NOT THEIR FAULT
THAT THEY'RE WHERE THEY'RE AT.
AND SO THEY SHOULD BE PUNITIVELY
PUNISHED FOR IT ESPECIALLY THOSE
WITH. SEVERE ISSUES THAT NEED TO
BE ADDRESSED- A LITTLE LOVE GOES
A LONG WAY HAND SO I JUST WANNA
THANK YOU FOR BRINGING THIS WORD
I LOOK FOR SUPPORT THE BILL AND
I'LL MOVE IT. WHEN APPROPRIATE
THANK YOU VERY MUCH. THANK YOU
THAT'S NOT NOTED- YEAH IT'S-
THING YOU VERY MUCH FOR TAKING
THE AMENDMENTS AND SENTIMENT OF
OUR TO YOUR POINTS WE- WE WORKED
A LOT ON THIS BILL- IT IS A-
VERY BIG BILL A VERY AMBITIOUS
AND WE DON'T. WE NOBODY DENIES
THE PROBLEM THAT WE'RE ALL
TRYING TO FIX. I THINK I THINK
SOME OF THE HESITATION IS. THE
WORK THIS LEGISLATURE HAS DONE
TO PUT PROGRAMS IN PLACE THAT
ARE STILL ROLLING OUT AND IF WE
CONTINUE JUST PILE MORE THINGS
ON TOP. THE NOTHING HAS A
CHANCE. TO ROLL ALL THE WAY OUT-
SO THAT BEING SAID IT IS BEEN
PARED DOWN NOT TO CREATE A WHOLE
NEW LICENSING SCHEME. BUT JUST
BE ABLE TO PROVIDE THAT SERVICES
THROUGH THE FINANCING MECHANISM.
TO BUILD A MORE NIMBLE WITH THAT
. RIGHT NOW AS YOU UNDERSTAND IT
THAT IS HOW I UNDERSTAND IT AND
I REALLY APPRECIATE THAT AND I.
WOULD JUST ALSO ASK THAT. YOU
KNOW FOLKS REMEMBER THAT THIS
GUIDANCE IS NOT COMING FROM YOUR
NEW FRESHMAN COLLEAGUE THIS IS
COMING FROM ALL OF YOUR CHILD
WELFARE DIRECTORS ACROSS. ALL OF
YOUR COUNTIES. THEY'RE
INCOMPLETE. YOU KNOW UNANIMOUS.
OPINION ON THERE SO I KNOW THERE
ARE SOME OUTSIDE INTEREST I HAVE
SOME CONCERNS ABOUT WHAT WE'RE
DOING WHERE WE'RE GOING. BUT
YOUR WELFARE DIRECTORS YOU'RE
YOU'RE COUNTY CAST SAYS. YOUR
COUNTY PROBATION OFFICERS YOUR
COUNTY DA'S THERE ARE 1100%
ONLINE. BECAUSE OF EXACTLY WHAT
CENTER GROVE SAID. THEY DON'T
WANT TO SEE YOUNG PEOPLE IN
INAPPROPRIATE PLACEMENTS AND- I
DON'T HAVE TO TELL ANYONE ON
THIS DÍAS HOW HARD IT IS TO.
MOVE EVEN JUST A COUPLE FEET TO
THE LEFT IN THE LEGISLATURE OR
AND IN STATE GOVERNMENTS IT'S
CHALLENGING. BUT I THINK THIS IS
NECESSARY THE BILL IS MUCH
BETTER TODAY THAN IT WAS EVEN A
FEW WEEKS AGO BECAUSE OF THE
INPUT OF. FOLKS ALONG THE WAY
I'M SURE WILL BE EVEN BETTER BY
THE TIME WE SIT ON THE FLOOR.
AYE ARJUN AYE VOTE I THANK YOU
VERY MUCH FOR YOUR TIME. SENATE
IF YOU WERE THE ONLY ONE BRING
THIS IT WOULD STILL BE BEAUTIFUL
YOU. THREE THAT YOU. NOW DO THE
SAME. DAY DAY EVERY DAY SO I
WANT TO GIVE THEM THE SUPPORT
AND HELP THEY NEED. THANK YOU
VERY MUCH AND WE'LL TAKE THAT AS
YOUR CLOTHES. OKAY SENATOR GROW
. AND JUST A QUICK QUESTION CAN
I ASK ANOTHER OKAY LET'S. GO I
KNOW I KNOW. I WAS ALMOST ALL-
YOUR GROWTH- WITH THE. SHE
WANTED TO MONOPOLIZE MORE TIME.
LIKES ME. T. LIKE TEARS. IN YOU
KNOW I JUST WANTED TO COMMENT ON
WHAT YOU JUST SAID IT HOW IT
TAKES A LOT. TO MAKE THE
LEGISLATURE MOVE. YEAH ARE THERE
TO GET THIS DONE. BUT IF THEY
ALL TURN TO PAGE SEVEN ON THE
ANALYSIS- AT EIGHTY THREE IN
TWENTY TWENTY TWO. JEST LAST
YEAR TWENTY TWENTY TO THE
STATE'S CHILD WHERE FOR AGENCIES
RECEIVED. FOUR HUNDRED AND FORTY
THOUSAND TWO HUNDRED AND TWELVE
REPORTS OF ABUSE OR NEGLECT. OF
THESE. FIFTY ONE THOUSAND EIGHT
HUNDRED AND SIX REPORTS IN ONE
YEAR. YEP ONE TWELVE MONTH
PERIOD CONTAINED ALLEGATIONS
THAT WERE SUBSTANTIATED IN
NINETEEN THOUSAND NINE HUNDRED
FIFTY THREE CHILDREN REMOVED
FROM THEIR HOMES. IN PLACE AND
CUT BY SECURE VIA CBS SYSTEM SO
WITH ALL OF OUR CHILDREN HURTING
IN THIS SPACE AND THERE'S DATA
FROM LAST YEAR. THEN WE HAVE TO
DO SOMETHING AND I AM NOT
ADVOCATING REMOVING CHILDREN
FROM THEIR HOME OR ANYTHING LIKE
THAT THAT'S NOT MY INTENT. BUT
IF CHILDREN ARE BEING ABUSED AND
HURT AND PUNISHED- SOMETHING
NEEDS TO BE DONE. AND SO THANK
YOU THANK YOU. THURMOND EVER.
UNITED YOU KNOW THAT. TRUE A
100% TRUE. YOU KNOW I JUST. I
FEEL LIKE WE'VE DONE SOMETHING
WE HAVE UNLIMITED GROWN BUT I'LL
LEAVE THAT I THINK OF. THE HORSE
A GROUND ON THAT. MY LAST
QUESTION IS AND MAYBE THIS IS
FOR YOU TO SENATOR IS. DO YOU
FEEL THAT IT'S A 100% NEEDED
THAT YOU NEED THE FUNDING UP
FRONT TO CREATE THIS YEAR T. P.
PLUS FORCE LET ME ANSWER THAT I
HAVE NO DOUBT. AND ALSO LET ME
JUST TELL YOU YOU KNOW IN THE
CHILD WELFARE SYSTEM. AND THIS
IS SOMETHING THAT YOUR STAFF HAS
DOUBLED DOWN ON HERE THEY HAVE
TO GET A LICENSE FIRST. THAT
MEANS THEY'VE BEEN PRE APPROVED
TO DO THIS WORK THEY'VE ALREADY
THEY ALREADY HAVE ACQUIRED A
LICENSE TO WORK WITH THIS
POPULATION. WHICH YOU'RE ASKING
THEM TO DO IS NOW MOVES FORWARD
AND WE'VE TRIED FOR A COUPLE
HERE YEARS HERE TO ASK THEM TO
JUST SEEK A REIMBURSEMENT. AND
WHAT THAT HAS GOT MASS IS KIDS
IN JAIL CELLS AND KIDS SLEEPING
IN CONFERENCE ROOMS AND THAT'S
NOT WORKING SO MAYBE IT WOULD
HELP YOU TO THINK OF IT THIS
WAY. THIS IS A TWEAK. TO
SOMETHING THIS LEGISLATURE
WORKED REALLY HARD ON AND THAT
IS GOOD WORK BUT IT THERE'S A
PIECE OF IT THAT'S NOT WORKING
AND YOU'RE WELFARE DIRECTORS ARE
COMING TO YOU SAYING THAT PEACE
ISN'T WORKING. PLEASE ALLOW US
TO MAKE THIS CHANGE SO THAT WE
CAN ADDRESS THESE. THOUSANDS OF
KIDS THAT CENTER GROVE IS
TALKING ABOUT THAT'S THAT'S WHAT
THIS LEGISLATION DOES. THANK YOU
. THANK YOU AND AGAIN NOBODY IS
ARGUING THAT. THE BEST CARE OF
OUR KIDS IS MOST IMPORTANT. I
THINK- WITH CINNAMON YOU ARE
SAYING AND WHAT SOME OF US FEEL.
IS THAT WITH. SOME OF THE THINGS
ARE STILL ROLLING OUT AND IF-
OUT. I AM I DO NOT WANT TO
REALIZE IS THAT ALL BUT- IT'S
LIKE ME START TO MAKE DINNER MY
DAUGHTER COMING HOME AND SAYING
I'M HUNGRY I WANT TO MAKE
SOMETHING NOW. AND STARTING ON
TOP OF IT SO WE NEVER GET. TO
THE MEAL BECAUSE WE'RE ALWAYS
STARTING. SOMETHING ELSE AND
NEVER GET TO THE FOR THE
FINISHED. PRODUCT OF WHAT WE'RE
TRYING TO DO IS REFORM THE
SYSTEM. SO WITH THAT SAID. WOULD
YOU LIKE TO CLOSE AGAIN. AND
FROM THE FUTURE AFTER SIMPLY
CLOSES WE DON'T GO BACK. BUT WE
DON'T HAVE A QUORUM YET SO I'M
BE AT. I GUESS I WOULD JUST YOU
KNOW IT STARTED IT CHAIRWOMAN I
JUST WOULD SAY I AGREE WITH YOU
ONE HUNDRED PERCENT. AND I HAVE
WORKED IN THIS SPACE IN THE PAST
IN MY- IN MY LIFE AND THAT. I
THINK WHAT'S GREAT ABOUT THIS IS
THAT WE'RE TRYING TO BE
PROACTIVE I'M ACTUALLY REALLY
PROUD OF THIS LEGISLATORS WORK
PRIOR TO ME. GETTING HERE THAT'S
VERY OBVIOUS. AND THAT AND I
THINK THIS PROGRAM WORKED REALLY
WELL AND THE IDEA OF TAKING THIS
AND EMBEDDING IT IN THE EXISTING
PROGRAM I THINK ANSWERS THAT
QUESTION SO AYE ARJUN AYE VOTE.
AGAIN THANKS AND WE- WE HAVE A
MOTION MY SENTIMENTS OF OUR AND
WHEN WE HAVE A QUORUM YEAH THE
MOTION FOR CENTER GROVE I THINK.
CENTER GROVE THANK YOU VERY
MUCH. AND WE HAVE A QUORUM. WILL
TAKE THE- ALL RIGHT THANK YOU
VERY MUCH FOR YOUR TIME. THANK
YOU VERY MUCH. OKAY CENTER.
PORTANTINO. TO GO BACK. ARE YOU
. S. B. FOR. TWENTY SO. TODAY
YEAH. WE ARE. VERY SHORT ISSUE
FOLDER. THANK YOU I DO HAVE A
FULL I'M- CLIP. THANK YOU AB
MADAM CHAIRMAN. SB FOUR TWENTY
SEVEN WILL ELIMINATE COST
SHARING AND REDUCE ACCESS
BARRIERS. TO PREP. AND PAP IN
HEALTH INSURANCE COVERAGE THE
HIV EPIDEMIC CONTINUES TO
DISPROPORTIONATELY IMPACT.
HISTORICALLY DISADVANTAGED
COMMUNITIES IN CALIFORNIA.
AFRICAN AMERICANS ARE THE MOST
DISPROPORTIONATELY AFFECTED BY
HIV MAKING UP 17% OF
CALIFORNIA'S HIV POSITIVE
POPULATION BUT ONLY AROUND 6% OF
CALIFORNIA'S TOTAL POPULATION
LIGHT NEXT PEOPLE MAKE UP THE
LARGEST RACIAL ETHNIC GROUP
AMONG NEW HIV DIAGNOSIS
ACCOUNTING FOR. 50% OF ALL NEW
HIV DIAGNOSIS BUT AGAIN ONLY 40%
OF CALIFORNIA'S POPULATION- SB
FOUR TWENTY SEVEN WOULD
ELIMINATE COST SHARING FOR
PREPPING GRANDFATHERED HEALTH
PLANS ELIMINATE COST SHARING FOR
PAP. IN BOTH GRANDFATHERED AND
NON GRANDFATHERED HEALTH PLANS
AND REQUIRE HEALTH PLANS AND
INSURERS TO SUPPLY INJECTABLE
PREP AND PEP DIRECTLY TO
PROVIDERS WHO ADMINISTER THE
DRUG TO PATIENTS. THE BILL ALSO
ADDRESS UNNECESSARY BURDENSOME
UTILIZATION MANAGEMENT METHODS
USED BY INSURERS TO ALLOW PEOPLE
TO ACCESS NON FORMAL FORM YOU
LARRY OR NON GENERIC DRUGS ONE
PROVIDER DETERMINES THAT AN
ALTERNATIVE DRUG WOULD BE SAFER
OR MORE EFFECTIVE. FIVE PER
PATIENT- THIS AFTERNOON I HAVE
TO TESTIFY. KATIE FISHER FROM
THE CALIFORNIA DEPARTMENT OF
INSURANCE- THE XIN CHURCH
COMMISSIONERS THE SPONSOR THE
BILL AND WHEN APPROPRIATE AND
WHEN THERE'S ACQUIREMENT
RESPECTFULLY ASK FOR AN AYE VOTE
THANK YOU VERY MUCH CENTER
PLEASE GO AHEAD FOR SUPPORTER.
GOOD AFTERNOON MADAM CHAIR
MEMBERS AND KATIE FISHER AN
ATTORNEY AT THE HEALTH EQUITY
AND ACCESS OFFICE OF THE POLICY
AND LEGISLATION BRANCH AT THE
DEPARTMENT OF INSURANCE. I'M
HERE TODAY ON BEHALF OF
INSURANCE COMMISSIONER RICARDO
LARA. FIRST I'D LIKE TO THANK
SENATOR PORTANTINO FOR AUTHORING
SB FOUR TWENTY SEVEN
COMMISSIONER LARA IS A PROUD
SPONSOR OF THE SPELL. AS THEIR
CENTER- IT PARTY SAID SB FOUR
TWENTY SEVEN WOULD ELIMINATE
BARRIERS TO HIV PRE EXPOSURE
PROPHYLAXIS OR PREP AN HIV POST
EXPOSURE PROPHYLAXIS OR PEP IN
HEALTH INSURANCE COVERAGE. PREP
IS A DRUG THAT AN HIV NEGATIVE
PERSON TAKES TO REMAIN HIV
NEGATIVE AND PATH IS A DRUG THAT
IF TAKEN WITHIN SEVENTY TWO
HOURS AFTER POTENTIAL HIV
EXPOSURE WILL PROVIDE A PREVENT
HIV INFECTION. AS THE SENATOR
MADE REFERENCE TO IN CALIFORNIA
THERE ARE CLOSE TO A MILLION
PEOPLE STILL IN GRANDFATHERED
HEALTH INSURANCE COVERAGE. BUT
THEIR HEALTH INSURANCE DOES NOT
HAVE TO COVER PREP WITHOUT COST
SHARING. SB FOUR TWENTY SEVEN
WOULD ELIMINATE COST SHARING FOR
PREPPING GRANDFATHER POLICIES. I
CURRENTLY HAVE DOES NOT HAVE TO
BE COVERED WITHOUT COST SHARING
COST SHOULD NOT BE A BARRIER IN
URGENT SITUATIONS WHERE PENN IS
URGENTLY NECESSARY. THIS MEASURE
WOULD ELIMINATE COST SHARING FOR
PAP AND BOTH THE GRANDFATHERED
AND NON GRANDFATHER MARKETS. AT
TO ENSURE THAT PREP AND PACK
PEPCK ACCESS CONTINUES TO BE
AVAILABLE AT SMALLER CLINICS
WITH LIMITED. INSURERS FROM
REQUIRING CLINICS TO PAY FOR
THESE DRUGS HAVE FRONT. INSTEAD
IT WOULD BE COVERED THROUGH THE
OUTPATIENT PRESCRIPTION DRUG
BENEFITS- THIS MEASURE ALSO
HENCE THE SLIGHTLY TECHNICAL
WILL ALLOW WILL STILL ALLOW
INSURERS TO USE FORMULARIES BUT
WOULD REQUIRE INSURERS TO CREATE
A PATHWAY FOR PEOPLE TO GET
COVERAGE FOR DRUGS. THAT IS NOT
ALREADY OTHERWISE LISTED ON
THERE- INSURERS FOR MARY. SB
FOUR TWENTY SEVEN WOULD EXPAND
ACCESS TO ZERO DOLLAR PREP IN
CALIFORNIA WELL SIMILAR COVERAGE
IS IN PERIL THROUGHOUT THE
NATION. G. IN THIS- IN THIS
COUNTRY DUE TO THE BRAIDWOOD
DECISION WHICH I'M SURE YOU'RE
FAMILIAR WITH. ITS INHERENT THAT
IT'S VERY IMPORTANT THAT WE LEAD
THE WAY AND EXPAND ACCESS FOR
COVERAGE FOR ALL. ON BEHALF OF
INSURANCE COMMISSIONER RICARDO
LARA ASK. THANK YOU VERY MUCH.
BILLS BECAUSE SUPPORT OF THIS
TODAY. AS A TIME TO COME FORWARD
. NAME AND AFFILIATION PLEASE.
THANK YOU MADAM CHAIR CHER
GONZALEZ ON BEHALF OF THE HUMAN
FAILURE COUNCIL OF CALIFORNIA
OTHERWISE KNOWN AS H. CC IN
SUPPORT THANK YOU. AND CRIPPLES
FROM BEHALF OF QUALITY
CALIFORNIA IN SUPPORT. THANK YOU
. GOOD MORNING WHIMSICAL ART I'M
SORRY GOOD AFTERNOON WHIMSICAL
HARD ON BEHALF OF THE CALIFORNIA
COMMUNITY PHARMACY COALITION
SUPPORT. THANK YOU. GRAFTING
CHARMERS JOSE TORRES WITH HEALTH
ACCESS CALIFORNIA INSTRUCTS PART
AS WELL THANK YOU VERY MUCH
INTEREST IN OPPOSITION TO THIS
BILL TODAY NOW'S THE TIME TO
COME FORWARD. WELCOME. GOOD
AFTERNOON MADAM CHAIR MEMBERS OF
THE COMMITTEE BUDGET HIMSELF
CALIFORNIA ASSOCIATION OF HEALTH
PLANS REPRESENTING FORTY THREE
KNOCKS KEEN LICENSE PLANS
COVERING APPROXIMATELY TWENTY
EIGHT MILLION CALIFORNIANS. ARE
READY WE ARE OPPOSED TO- SB FOUR
TWENTY SEVEN I WOULD LIKE TO
THINK THE AUTHOR'S OFFICE AYE
AND THE SPONSORS- PRETTY OPEN
DIALOGUE WE'VE HAD ON THIS BILL
TO DATE- BUT ULTIMATELY WE ARE
CONCERNED THAT THIS BILL
REQUIRES HEALTH PLANS TO COVER
ALL THE- PREP AND PEP DRUGS
DEVICES AND PRODUCTS- WITHOUT
MEETING. A CRITICAL MEDICAL
NECESSITY CRITERIA. I WE ARE
ALSO CONCERNED THAT THIS BILL
REMOVES COST. CARSHARING FOR
PREP AND PEP SHUTS THE LIGHTS OF
THE PRODUCTS- YOU KNOW THE TRIP
NOW SAYS THE CALIFORNIA HEALTH
BENEFIT REVIEW NOW SAYS HAS PAID
THE PREMIUM IMPACT ON THIS BILL
TO BE. APPROXIMATELY A HUNDRED
FIFTY SEVEN MILLION DOLLARS
INCREASE PREMIUMS- YOU KNOW AS
AN INDUSTRY WE ARE LOOKING AT
ALL OF THE MANDATE BILLS I'LL
TWENTY THREE MANDATE THOSE ARE
INTRODUCED THIS YEAR. I AM
LOOKING AT THEM HOLISTICALLY-
AND IN FACT TO BURKE- THIS. THIS
MORNING RELEASED A LETTER
INDICATING- THE PREMIUM IMPACTS
FOR THE EIGHTEEN BILLS THAT THEY
ANALYZE THIS YEAR AND THEY TAKE
THE PREMIUM INCREASES TO BE.
APPROXIMATELY ONE POINT TWO
EIGHT BILLION DOLLARS IN PREMIUM
INCREASES THIS YEAR SOUTH
AFRICA'S REASONS. WE ARE CLOSE.
TO THE BILL THANK YOU. STEPHANIE
SEVENTY ONE CAN SOMEBODY OF THE
ASSOCIATION OF CAL. LIFE AND
HEALTH COME AND ECHO MY CALL
COME AT THE OUR CONCERN. ALSO
RIVER AROUND THE TWO OF MY THIS
WOULD LIKE CONTINUE CONVERSE.
THE SECOND BILL WE'VE SEEN IN
THE LAST COUPLE DAYS AND GIVEN
THE FACT THAT THAT'S UBIQUITOUS
THERE ARE CODES IT'S WHAT WE
ALWAYS USED TO DETERMINE THE
STANDARD FOR WHICH CAROUSEL
LIVERED I THINK WE'D LIKE TO
HAVE SOME CONVERSATIONS A BETTER
UNDERSTAND THAT. THANK YOU.
THANK YOU VERY MUCH. IT WILL
SPEAK IN OPPOSITION TO THIS BILL
HAS TIME TO COME FORWARD JUST
YOUR NAME AND AFFILIATION PLEASE
. THANK YOU OF PRESTON YOUNG FOR
THE CALIFORNIA CHAMBER OF
COMMERCE HERE IN OPPOSITION
BECAUSE THE PREMIUM IMPACT THANK
YOU. THANK YOU VERY MUCH. NOW
WILL GO TO THE PHONE LINES
MODERATOR IF THERE'S ANY CALLS
ONLINE. FOR OR AGAINST HIS NAME
AND AFFILIATION IN YOUR POSITION
ON THE BILL. GEMMATA WHICH MAKE
COMMENTS SUPPORT OR OPPOSITION
THIS PRESS ONE. THE EURO. WILL
BE GOING TO LINES ONE TWENTY
FIVE PLEASE GO AHEAD. ONE TWENTY
FIVE YOUR LINE IS OPEN. X. ARE
WE GOING TO LINE NINETEEN.
PLEASE GO AHEAD. YOUR HONOR-
EQUITIES AND COMMUNICATIONS TALK
ABOUT THANK YOU THANK YOU VERY
MUCH THAT'S COLOR PLEASE.
ACTUALLY GOING TO LINE NINETY
EIGHT PLEASE GO AHEAD. BONTA
BROUGH WESTERN CENTER ON LAW AND
POVERTY IN SUPPORT. THANK YOU
NEXT CALLER PLEASE. THERE IS
CURRENTLY NO ONE ELSE IN THE
QUEUE MANAGER THANK YOU VERY
MUCH NOW THE TIME WE BRING THIS
BACK TO THE- COMMITTEE THE
QUESTIONS ON THE DYESS. OKAY I
WE DON'T HAVE A QUORUM HERE FOR
A MOTION BUT I'LL JUST SAY THANK
YOU FOR WORKING WITH THE
COMMITTEE ON THIS- AND I YOU
KNOW I CERTAINLY HEAR THE PLANS
AND I CERTAINLY SHARE THE
CONCERN ABOUT- TO CONTINUE
MANDATES AND THE COST SHARING
AND ANNA SYSTEM WE LIVE IN RIGHT
NOW- AND WILL HAVE TO CONTINUE
TO HAVE THESE CONVERSATIONS AND
I'M HOPING YOU'LL CONTINUE TO
HAVE A- CONVERSATION WITH THE
OPPOSITION. VERY MUCH WOULD YOU
LIKE TO CLOSE UNDER I WOULD I
WOULD LIKE TO JUST MAKE ONE
COMMENT UPON THE MEDICALLY
NECESSARY NECESSITY PIECE
PREVENTIVE MEDICINE IS NEVER
SUBJECT TO THE- MEDICALLY
NECESSARY STANDARD BECAUSE BY
DEFINITION IT'S PREVENTIVE IT'S
- REACTING BEFORE. THE EMERGENCY
AND SO IT'S JUST NOT SUBJECT TO
THAT AS A GENERAL POLICY SO.
OBVIOUSLY WE WILL CONTINUE TO
HAVE CONVERSATIONS IT'S
IMPORTANT- THING TO DO AND- I
RESPECTFULLY ASK WHEN I BUT WHEN
APPROPRIATE. THANK YOU VERY
MUCH. AND YOU HAVE ANOTHER BILL
BEFORE US TODAY SB FIVE FIFTY
ONE. I DO. AND I WOULD BEGIN I
WOULD LIKE TO BEGIN BY ACCEPTING
THE COMMITTEE AMENDMENTS
OUTLINED IN THE MOCK UP AND
THANK YOUR COMMITTEE STAFFER
WORKING WITH MY STAFF. TO GET SB
FIVE FIVE ONE TWO WHERE IT IS
RIGHT NOW- IT WOULD ENHANCE
COLLABORATION BETWEEN COUNTIES
AND LOCAL EDUCATION AGENCIES
ENSURING THAT MENTAL HEALTH
BOARDS INCLUDING REPRESENTATION
OF YOUTH AND EDUCATION LEADERS.
ALL WORK TOGETHER- WITH THE
AMENDMENTS IN THE MOCK UP SB
FIVE FIVE ONE WOULD REQUIRE THAT
AT LEAST 20% OF MEMBERS ON A
MENTAL HEALTH BOARD BE EMPLOYED
BY LOCAL EDUCATION AGENCY. AT
LEAST 20% WE TWENTY FIVE YEARS
OF AGE OR YOUNGER. THIS WILL BE
IN COUNTIES WITH A POPULATION OF
FIVE HUNDRED THOUSAND OR MORE.
IN COUNTIES WITH POPULATION
FEWER THAN FIVE HUNDRED THOUSAND
BUT MORE THAN A HUNDRED THOUSAND
SB FIVE FIVE ONE WOULD REQUIRE
AT LEAST ONE MEMBER EACH OF
THESE CATEGORIES. AND IN
COUNTIES WITH POPULATIONS BELOW
A HUNDRED THOUSAND. THE COUNTY
WOULD BE REQUIRED. TO KEEP
STRONG PREFERENCE TO AT LEAST
ONE IN EACH OF THE CATEGORIES.
LAST LEAD FIVE FIVE ONE
REQUIRES. THAT NO MORE THAN 49%
OF MEMBERS ON THESE BOARDS OWNER
OPERATOR ORGANIZATIONAL BUSINESS
WITH A FINANCIAL INTEREST. AND
THE BILL WILL HELP ADDRESS THE
DIRE STATE THE OF OUR CHILDREN
AND YOUTH MENTAL HEALTH CRISIS
KNOW THAT SOME. THAT THE- SHARES
DEEPLY ABOUT THERE'S LOTS OF
EFFORTS IN THIS CONTINUED SPACE
SO. OBVIOUSLY OUR GOAL TODAY IS
TO KEEP THE BILL MOVING TO BE
RELEVANT TO THE CONVERSATION AND
WE HAVE WITH US. DR MERION DAY
ONE THE SUPERINTENDENT OF SANTA
CLARA COUNTY SCHOOLS. AND DR-
MICHAEL ROMERO THE CHIEF OF
TRANSITIONAL PROGRAMS FOR LA
UNIFIED TO TESTIFY IN SUPPORT.
THANK YOU VERY MUCH WELCOME.
PLEASE BECAUSE- THANK YOU IT'S A
PLEASURE TO BE HERE I'M DR
MERION TO ONE SANTA CLARA COUNTY
SUPERINTENDENT OF SCHOOLS. WE'RE
PLEASED TO SPONSOR SENATE BILL
FIVE FIVE ONE IN PARTNERSHIP
WITH C. T. A. L. A. U. S. T. THE
CALIFORNIA SCHOOL BOARDS
ASSOCIATION AND THE CALIFORNIA
ASSOCIATION OF SCHOOL
PSYCHOLOGISTS. MY APPRECIATION
TO SENATOR PORTANTINO FOR
BRINGING FORWARD THIS REALLY
ESSENTIAL BILL. THAT PRIORITIZES
YOUTH MENTAL. HEALTH AND
WELLNESS- AS WE ALL CAN AGREE
YOU ARE FACING A HEALTH AND
MENTAL HEALTH CRISIS.
INTENTIONAL SELF HARM AMONG
THIRTEEN TO EIGHTEEN YEAR OLDS
HAS INCREASED BY NINETY ONE
PERCENT. AND OVERDOSES HAVE
INCREASED BY NINETY FIVE
PERCENT. DIAGNOSIS OF MAJOR
DEPRESSIVE DISORDER HAVE
INCREASED BY EIGHTY FOUR
PERCENT. YET ACCESS TO MENTAL
HEALTH SERVICES TO YOUTH HAS
DECLINED. THE MENTAL HEALTH
SERVICES ACT REQUIRES COUNTIES
TO SPEND 51% OF PREVENTION AND
INTERVENTION OR P. I. FUNDS ON
CHILDREN AND YOUTH. BUT NEARLY
ALL COUNTIES STRUGGLE TO MEET
THIS THRESHOLD. ACCORDING TO THE
MENTAL HEALTH SERVICES OVERSIGHT
AND ACCOUNTABILITY COMMISSION
CURRENTLY MOST MHSAA FUNDED
PROGRAMS DO NOT FOCUS ON
CHILDREN. AND MAY ONLY REACH A
SMALL NUMBER OF INDIVIDUAL GIFT
. IN ADDITION THE VAST MAJORITY
OF COUNTIES CURRENTLY HAVE NO
USE FOR PUBLIC EDUCATION
REPRESENTATIVE ON THEIR MENTAL
HEALTH BOARD. AND DESPITE
CHILDREN AND YOUTH BEING AND
IDENTIFIED PRIORITY AND
PROPOSITION SIXTY THREE. THIS
LACK OF REPRESENTATION AS ONE OF
THE ROOT CAUSES OF CONCERN THAT
LEADS TO UNDER INVESTMENT AND
CHILDREN IN SCHOOL BASED
SERVICES. WHICH HAS COMPOUNDING
EFFECTS AS CHILDREN EXPERIENCING
TRAUMA GROW INTO ADULTS THAT HAD
NO ACCESS TO PREVENTION AND
EARLY INTERVENTION SERVICES.
SCHOOL BASED SERVICES INCLUDING
WELLNESS CENTERS WILL BE KEY TO
MEETING OUR STUDENTS NEEDS. AND
THIS BILL WOULD HELP ADDRESS
UNDER REPRESENTATION OF YOUTH.
INTEREST BY ENSURING THAT COUNTY
MENTAL HEALTH BOARDS WHICH ARE
RESPONSIBLE FOR REVIEWING AND
HELPING TO CREATE THE COUNTIES
THREE OR MENTAL HEALTH SPENDING
PLAN. INCLUDE YOUTH AND PUBLIC
EDUCATION REPRESENTATIVES. I
URGE YOU TO JOIN MY OFFICE AND
SUPPORTING SENATE BILL IF THAT
FIVE FIVE WHEN AND RESPECTFULLY
REQUEST YOUR IPHONE. THANK YOU
VERY MUCH NEXT WITNESS PLEASE.
GOOD AFTERNOON CHAIR A TELEPHONE
DAY TAKE MEN AND MEMBERS OF THE
COMMITTEE. I AM DR MICHEAL
ROMERO CHIEF OF TRANSITIONAL
PROGRAMS WITH THE LOS ANGELES
UNIFIED SCHOOL DISTRICT AND HERE
TO TESTIFY AS A CO SPONSOR IN
SUPPORT OF SENATE BILL FIVE FIVE
ONE. BY SENATOR PORTANTINO. IN
TWO THOUSAND FOUR VOTERS PASSED
PROPOSITION SIXTY THREE THE
MENTAL HEALTH SERVICES ACT OR-
IN MHSAA. AND PROPOSITION SIXTY
THREE ALLOCATES 20% OF ITS
FUNDING IN EACH COUNTY FOR
PREVENTION AND EARLY
INTERVENTION. AND STATES THAT
51% OF THOSE FUNDS SHALL BE USED
TO PROVIDE SERVICES TO CHILDREN
AND YOUTH. SB FIVE FIVE ONE SIX
TO RE VISIT THE MH ESSAY'S
INTENT OF PROVIDING ESSENTIAL
MENTAL HEALTH FUNDING. FOR YOUTH
BASED SERVICES AND INTERVENTIONS
IT STRENGTHENS THE CRITICAL
COLLABORATION BETWEEN COUNTIES
AND LOCAL EDUCATIONAL AGENCIES
ARE L. E. AS- IN THE NEARLY TWO
DECADES SINCE THE MH ESSAYS
INCEPTION. COUNTY MENTAL HEALTH
BOARDS DEVELOPED ENTRENCHED
MEMBERSHIPS THAT DOES NOT
REFLECT ALL OF THE NEEDS OF
THOSE THE PROPOSITION ORIGINALLY
INTENDED TO SERVE. INCLUDING
YOUTH TWENTY FIVE AND YOUNGER.
IT IS FOR THIS REASON THAT SB
FIVE FIVE ONE REQUIRES YOUTH
MEMBERSHIP AND MEMBERSHIP OF
SCHOOL EMPLOYEES ON MENTAL
HEALTH BOARDS IN LARGE COUNTIES
. IN OUR CASE L. A. UNIFIED MAY
ONLY BE ONE OF EIGHTY SCHOOLS
DISTRICTS IN L. A. COUNTY YET WE
REPRESENT 40% OF COUNTY STUDENTS
AND ARE THE SECOND LARGEST
SCHOOL DISTRICT IN THE NATION.
LA UNIFIED SERVICE AS A NATIONAL
LEADER IN THE INVESTMENTS AND
DELIVERY OF SCHOOL BASED MENTAL
HEALTH SERVICES. IN TWO THOUSAND
NINETEEN WE LAUNCHED A ONE OF
ITS KIND EARLY CHILDHOOD MENTAL
HEALTH PROGRAM THE TRAUMA AND
RESILIENCY INFORMED EARLY
EDUCATION PROGRAM. THIS PROGRAM
UTILIZES A PREVENTION MODEL TO
INCREASE PROTECTIVE FACTORS AND
REDUCE RISK FACTORS FOR CHILDREN
AND FAMILIES IN HER EARLY
EDUCATION CENTERS ACROSS OUR
DISTRICT. THIS PROGRAM IS ONE OF
MANY THAT LA UNIFIED PROVIDES US
AN OPPORTUNITY TO SUPPORT THE
PARENTS AND CAREGIVERS OF OUR
YOUNGEST LEARNERS. BUT IT IS
BASED ON ONE TIME FUNDING IT IS
NOT SUSTAINABLE WITHOUT THE AN
ONGOING INVESTMENTS OF
CALIFORNIA. LEVERAGING PROP
SIXTY THREE FUNDS TO BETTER MEET
THE MENTAL HEALTH NEEDS OF
YOU'VE TWENTY FIVE AND UNDER. IS
CRITICAL WHILE THE STATE
CONTINUES ITS IMPLEMENTATION OF
THE FOUR BILLION DOLLAR CHILD
YOUTH HEALTH BEHAVIORAL AND
NISHA TO. OUR EXPERTISE AND THE
EXPERTISE OF ELEAZAR IN
CALIFORNIA IS VITAL TO THE
ETHICAL OVERSIGHT OF THESE
MENTAL HEALTH DOLLARS THAT CAN
BETTER SUPPORT. THE NEEDS OF OUR
YOUTH. LOS ANGELES UNIFIED IS
PLEASED TO CO SPONSOR SB FIVE
FIVE ONE AND WE THANK YOU FOR
YOUR COMMITMENT TO STUDENT
WELLNESS THANK YOU. THANK YOU
VERY MUCH NOW WOULD BE THE TIME
FOR NO ONE ELSE WANTED TO SPEAK
IN SUPPORT JUST TO COME FORWARD
TO GIVE YOUR NAME AND
AFFILIATION. GOOD AFTERNOON
MADAM CHAIR MEMBERS ASSEMBLED BY
THEM ON BEHALF OF PUBLIC HEALTH
ADVOCATES IN SUPPORT THANK THANK
YOU. GOOD AFTERNOON CHAIR
MEMBERS LIKE JOHNSON BATH
STATEMENT IN A PUBLIC ATTRACTION
TONY THURMOND PROPOSED BONTA
HERE SUPPORT THANK YOU. MADAM
CHAIR TONY TO CARE ON BEHALF OF
THE CALIFORNIA TEACHERS
ASSOCIATION ONE OF THE CO
SPONSORS OF THANK YOU FOR YOUR
SUPPORT THANK YOU VERY MUCH.
OKAY NO MOVED ANY OPPOSITION FOR
THE BILL. COMPORT.
HI TO SUCCUMB STARK WITH THE
CALIFORNIA ASSOCIATION OF LOCAL
BEHAVIORAL HEALTH BOARDS AND
COMMISSIONS- WE HAVE REQUESTED
CHANGES AND I UNDERSTAND THERE
HAVE BEEN SOME BUT IT DOESN'T
SOUND LIKE IT'S STILL- DOABLE
FOR OUR BOARDS AND COMMISSIONS-
THEY HAVE A LOT OF REQUIREMENTS
ALREADY- TO BE UNDERSTOOD- WE
HAVE REQUESTED- THAT A PORTION
BE DELETED. THAT INCLUDES AT
LEAST 20% OF TOTAL MEMBERSHIP.
BE EMPLOYED BY A LOCAL
EDUCATIONAL AGENCY AND AT LEAST
20% SHALL BE AN INDIVIDUAL WHO
IS TWENTY FIVE YEARS OF AGE OR
YOUNGER. BECAUSE- THAT ACTUALLY
EQUALS 40% AND THAT DOES NOT
REPRESENT THE- THE DEMOGRAPHICS
OF THE COMMUNITY- SO. WE HAVE
ASKED FOR THESE AMENDMENTS AND I
GUESS YOU KNOW AT THIS POINT WE
HAD TAKEN THE SUPPORT OF AMENDED
POSITION- WE ASKED THE INSTEAD
OF THAT REQUIREMENT THAT IT BE
REPLACED. SO THAT COUNTIES WITH
A POPULATION OF A HUNDRED
THOUSAND OR MORE AT LEAST ONE
MEMBER OF THE BOARD BE EMPLOYED
BY A LOCAL EDUCATION AGENCY. AND
AT LEAST ONE INDIVIDUAL B. AGE
TWENTY FIVE YEARS YOUNGER THANKS
THANK YOU VERY MUCH. THANKS
PERSONS IN OPPOSITION. GOOD
AFTERNOON LISA GARDNER WITH THE
COUNTY BEHAVIORAL HEALTH
DIRECTORS ASSOCIATION WE HAVE IN
OPPOSE POSITION ALONG WITH- A
COALITION OF PROVIDERS AND
OTHERS ON THE BILL IT IN PRINT-
WE ARE VERY APPRECIATIVE OF THE
WORK OF THE COMMITTEE. AND THE
AMENDMENTS WE ARE CONTINUE TO
REVIEW THEM AND- THANK THE
AUTHOR AND LOOK FORWARD TO
FURTHER ENGAGEMENT THANK THANK
YOU VERY MUCH. GOOD AFTERNOON
SIR TO CAD ON BEHALF OF THE
RURAL COUNTY REPRESENTATIVES OF
CALIFORNIA OPPOSE UNLESS AMENDED
I WANT TO THINK ABOUT THE FOR
THE AMENDMENTS WERE STILL
CONCERNED ABOUT THE THRESHOLD
FOR- IT WILL JURISDICTIONS IN
WHAT'S CONSIDERED SMALL LOOKING
FORWARD TO WORKING WITH THE
AUTHOR. THANK YOU SIR. KELLY
BROOKS. KELLY BROOK I'M HERE ON
BEHALF OF THE URBAN COUNTIES OF
CALIFORNIA AND THE CALIFORNIA
STATE ASSOCIATION OF COUNTIES
THAT WE SUBMITTED OPPOSE LETTER-
WHEN I THINK THAT COMMITTEE
STAFF ON THE AUTHOR FOR TAKING
THE AMENDMENTS TODAY WE'RE STILL
REVIEWING THEM- AND LOOK FORWARD
TO CONTINUING TO WORK ON THE
BILL THANK YOU. THANK YOU VERY
MUCH NO GO TO THE PHONE LINES
THIS AND BE THE TIME FOR PEOPLE
SPEAKING FOR AND OR AGAINST JUST
NAME AND AFFILIATION IMPOSITION
PLEASE. EGGMAN WHAT IN IT WHICH
TO MAKE A COMMENT THE PARK OR
OPPOSITION THE PRESS ONE AND
PROBLEM. BUT I DO HAVE A COUPLE
THAT HAVE QUEUED UP A NUMBER OF
OTHER GIVEN THE LINE. FOR
WE WERE GOING TO LIVE ONE TWENTY
EIGHT PLEASE GO AHEAD. PAGE
MEDICARE MEMBERS MORE WHAT THE
WITH THE CALIFORNIA ASSOCIATION
OF. SCHOOL PSYCHOLOGISTS ARE
BECAUSE I'M FROM THE MEASURE AN
ORANGE COUNTY DEPARTMENT OF
EDUCATION TO BRING TENANTS ELMER
HARI IN SUPPORT OF THE S. P.
FIVE FIVE ONE. THANK YOU. THANK
YOU VERY MUCH TAX COLOR PLEASE.
WILL BE ON THE LINE ONE TWENTY
NINE PLEASE GO AHEAD. HI
LITHOSPHERIC YOUNG PERHAPS THE
RIVERSIDE COUNTY SUPERINTENDENT
OF SCHOOLS IN SUPPORT THANK YOU
NEXT CALLER PLEASE. IT'S
CURRENTLY NO OTHERS IN THE QUEUE
CARE. OKAY THANK YOU VERY MUCH
OF THE TIME WOULD BRING IT BACK
TO THE COMMITTEE FOR ANY
COMMENTS OR QUESTIONS. SENATE
ROTH A MEASURE I JUST WANT TO
THANK THE AUTHOR FOR BRINGING
THIS MEASURE FORWARD OBVIOUSLY
WE'RE ALL INTERESTED IN MAKING
SURE THAT THE- YOUNG PEOPLE HAVE
THE CARE AND THE SERVICES THAT
THEY NEED THOSE WITH A- WITH
MENTAL HEALTH ISSUES I THINK. I
THINK THE COMMENTS THAT WE'VE
LISTENED TO- THIS AFTERNOON
HIGHLIGHT THE PROBLEM WHICH IS
WE HAVE A BUCKET OF. FUNDING AND
IT'S OF. A PROP SIXTY THREE AND
THAT BUCKET OF FUNDING HAS A TOP
AND A BOTTOM AND WE CONTINUE TO
ADD TO REQUIREMENTS- ON THAT
BUCKET FOR THE BEHAVIORAL HEALTH
FOLKS IN OUR COUNTIES AND
OTHERWISE- AND IT POINTS TO THE
NEED FOR MORE MONEY- WE'LL
FIGURE THAT OUT AND WILL
CONTINUE TO WORK THAT I KNOW. I
KNOW OUR CHAIR IS- IS LASER
FOCUSED ON THAT SO. WITH THAT I
AM PLEASED TO SUPPORT THE BILL.
THE SENATE ROTH. ALL RIGHT
CENTER PORTANTINO THANK YOU VERY
MUCH THANK YOU FOR TAKING THE
AMENDMENTS THANK YOU FOR YOUR-
ATTENTION AND INTEREST IN THIS
REALLY IMPORTANT TOPIC- AND I'M
SURE HE'LL CONTINUE TO WORK WITH
THE OPPOSITION ON THE- THE
NUMBERS OF THE DETAILS. BUT I
CERTAINLY UNDERSTAND YOUR
INTENT. WOULD YOU LIKE TO CLOSE.
THANK YOU AND RESPECTFULLY ASK
FOR AN IPHONE THANK YOU VERY
MUCH HOPEFULLY WHEN WE GET MORE
MEMBERS HERE WILL GET A MOTION
AND WILL TAKE A VOTE ON THAT WE
THANK YOU. CENTER CABALLERO. I
THINK YOU'RE GONNA BE HERE WITH
US FOR AWHILE. ALL RIGHT YOU GET
YOUR LUNCH SNACKS IN PARTICULAR
TO. HAVE I KNOW HOW WAS YOUR TO
MIDNIGHT LAST SO I- WE DO NOT TO
DO THAT ON THE WHOLE COMMITTEE.
VERY GOOD I AM. OKAY I'LL TALK
ABOUT. SO THANK YOU MADAM AND
I'M PLEASED TO PRESENT- IT'S
FILE NUMBER FOUR. SB FIVE TWENTY
FOUR WHICH WILL ALLOW
PHARMACISTS TO PROVIDE DIRECT
TREATMENT TO PATIENTS FOLLOWING
A POSITIVE TEST FOR A SELECT
NUMBER OF COMMON. EASILY
TREATABLE DISEASES. I WOULD LIKE
TO THANK THE COMMITTEES
ASSISTANCE WITH DRAFTING THE
AMENDMENTS BEFORE YOU TODAY. AND
I'LL BE ACCEPTING- THE AMENDMENT
THAT REMOVED STI'S FROM THE LIST
OF DISEASES THAT CAN BE TREATED
PURSUANT TO. A CLEAR WAIVED TEST
THANK YOU HEALTH CARE AS YOU
KNOW IS INACCESSIBLE FOR MANY
MANY CALIFORNIANS ESPECIALLY IN
RURAL CALIFORNIA. RURAL
RESIDENTS ARE CONFRONTED BY MANY
OBSTACLES INCLUDING A SHORTAGE
OF PHYSICIANS AND PRIMARY CARE
PROVIDERS LACK OF TRANSPORTATION
HOSPITAL CLOSURES AND LIMITED
ACCESS TO TREATMENT FOR VARIOUS
VIRAL ILLNESSES. MANY RURAL
CALIFORNIANS FACE EXPENSIVE
EMERGENCY ROOM VISITS. AS THEIR
PRIMARY CARE FACILITY ARE LONG
WAITS IN ORDER TO BE TREATED FOR
DISEASES LIKE COPD NINETEEN OR
STREP THROAT. THE LIMITED NUMBER
OF HEALTH CARE FACILITY SERVING
RURAL AREAS ARE OFTEN BURDENED
WITH MORE PATIENTS AND THEY HAVE
THE CAPACITY TO SERVE. THIS WAS
PARTICULARLY THE CASE DURING THE
RECENT TRIPLE THEM ACT OF
COVERAGE INFLUENZA AND RSV.
NEARLY NINE IN TEN CALIFORNIANS
LIVE WITHIN FIVE MILES OF A
COMMUNITY PHARMACY AND THE ROLE
OF THE PHARMACIST IS IN
ORCHESTRATING PATIENT CARE IS
UNDER UTILIZED. FOR MANY
PATIENTS COMMUNITY PHARMACY
PHARMACIES CAN PROVIDE A QUICK
PRIMARY ACCESS POINT TO HEALTH
CARE AND QUITE FRANKLY PEOPLE
USE THEIR PHARMACIST. AS A WAY
TO GO BY AND GET INFORMATION
ABOUT WAYS TO TREAT REALLY
COMMON- TYPES OF ILLNESSES AND
INJURIES. TWO YEARS AGO I
AUTHORED A BILL THAT ALLOWS
PHARMACISTS TO PERFORM. TO
PERFORM SEVERAL FDA APPROVED OR
AUTHORIZED CAST ALLOWING
PHARMACISTS TO SCREEN FOR KOBE
NINETEEN AND SEVERAL CAUGHT
COMMON ILLNESSES. HOWEVER
PHARMACISTS CANNOT CURRENTLY
PRESCRIBED TREATMENT. FORK
COMMON HEALTH CARE CONDITIONS
FOR TESTS. BOB THEY CURRENTLY
PERFORM LIMITING ACCESS TO
TREATMENT FOR CALIFORNIANS FOR
EXAMPLE A PERSON WHO GOES TO A
PHARMACY AND TEST POSITIVE FOR
STREP STREP THROAT WOULD NOT BE
ABLE TO RECEIVE. TREATMENT BY A
PHARMACIST THEY WOULD HAVE TO GO
TO A DOCTOR OR A HEALTH CARE
FACILITY. RECOGNIZING THE
ESSENTIAL ROLE OF PHARMACISTS.
THE DEPARTMENT OF CONSUMER
AFFAIRS DURING THE CORONAVIRUS
GAVE PHARMACIST THE AT THE AT
THIRTY TO PRESCRIBE A CO A
COVERT NINETEEN TREAT TREATMENT
PACKS LOADED DIRECTLY TO
PATIENTS. THIS WAIVER IS SET TO
EXPIRE SOON MEANING THAT THEY
WON'T BE ABLE TO DO THIS
ANYMORE. BUILDING ON THIS
GROUNDWORK SB FIVE TWENTY FOUR
WOULD ALLOW PHARMACISTS TO
PRESCRIBE TREATMENT FOR COMMON
CONDITIONS. WELL S. T. EYES WERE
INCLUDED IN AN EARLIER VERSION
OF THE BILL IT'S BEEN BEEN
REMOVED. I'M MORE FOCUSING ON
FOR- THAT ARE VERY SIMPLE TO
TREAT THEY ARE COVERED NINETEEN.
INFLUENCER THERE THE FLU STREP
THROAT AND CONJUNCTIVITIS OR
PINKEYE AND IF YOU HAVE EVER HAD
PINK EYE YOU KNOW WHEN YOU HAVE
PINK EYE AGAIN- BUT YOU CAN'T
GET. TREATMENT FOR IT UNLESS YOU
GO IN TO SEE A DOCTOR. THESE
CONDITIONS WERE SELECTED BECAUSE
THEY ARE COMMON. THE DISEASES
THAT PLAGUE COMMUNITIES AND
HEALTH CARE FACILITIES AND
THEY'RE EASILY TREATABLE- I WANT
MAKE IT VERY CLEAR THAT BY THE
BILL AUTHORIZES BUT DOES NOT
MANDATE THAT PHARMACIST
PARTICIPATE IN THE TESTING TREAT
PROGRAM. ON THERE MAY SEEM TO BE
SOME CIRCUMSTANCES WHERE
STAFFING DOES NOT- WARRANT IT.
AND AND SO WE'VE WE'VE LEFT IT-
OPTIONAL AND ON THE OTHER THING
IS THAT WHAT WE'VE DONE IS
WE'VE- INCLUDED A TREATMENT-
EIGHT. EIGHT AN OPPORTUNITY FOR
THE- STATE BOARD OF PHARMACY AND
THE CALIFORNIA MEDICAL BOARD TO
CREATE PROCEDURES AND PROTOCOLS
TO BE ABLE TO GIVE DIRECTION TO
PHARMACISTS ON HOW THEY SHOULD
TREAT THESE DISEASES AND WITH
THAT- I WOULD RESPECTFULLY ASK
FOR YOUR AYE VOTE. WITH ME HERE
TODAY AS LINDSAY VIZCARRA WITH
THE INTERNATIONAL FOUNDATION FOR
AUTO IMMUNE AND AUTO
INFLAMMATORY ARTHRITIS AND MARK
JOHNSTON WITH CVS. THANK YOU
VERY MUCH THE FIRST PERSON
PLEASE. GOOD AFTERNOON MADAM
CHAIR MEMBERS THANK YOU MY NAME
IS LINDSAY THE SCAR ON THE
PUBLIC POLICY MANAGER FOR THE
INTERNATIONAL FOUNDATION FOR
AUTO IMMUNE AND AUTO
INFLAMMATORY ARTHRITIS OR A AYE
ARTHRITIS BECAUSE THAT'S AN
AWFUL- I'M ALSO A PERSON LIVING
WITH PSORIATIC ARTHRITIS AND THE
CARE GIVER OF TWO CHILDREN WITH
AUTOIMMUNE DISEASES. AND I SAY
THAT BECAUSE WE ARE- OUR
FOUNDATION IS ENTIRELY PATIENT
LED. ALL OF OUR STAFF OR
PATIENTS- LIKE MANY PATIENTS ON
WITH CHRONIC AUTOIMMUNE DISEASES
WE ARE ALL ON IMMUNO SUPPRESSIVE
MEDICATIONS SO ANYTIME ANYONE IN
MY HOUSE GETS A SORE THROAT. I
PANIC IMMEDIATELY- AND I KNOW
THAT A LOT OF OUR PATIENTS DO AS
WELL SO EVERY TIME SOMEONE GETS
SICK I WEIGH THE CONSEQUENCES OF
URGENT CARE AGAINST THE
CONSEQUENCES OF WAITING AND
SEEING WHAT HAPPENS. AND EITHER
WAY THE CONSEQUENCES ARE
TERRIBLE- IF I COULD RUN TO THE
SAFE WAY A MILE FROM MY HOUSE
INSTEAD OF URGENT CARE BECAUSE
THAT ALWAYS HAPPENS ON THE
WEEKENDS THAT SOMEONE GETS SICK-
IT WOULD. CUT DOWN ON THE TIME
THAT MY KIDS HAVE TO SIT IN A
WAITING ROOM WHERE PEOPLE ARE
COUGHING THEIR HEADS OFF IT
WOULD CUT DOWN ON THE TIME THAT
WE WAIT. AND I CAN BUY TYLENOL
IN THERE SO EVERYBODY WINS. IN
ADDITION TO THE CONVENIENCE
EFFICIENCY AND SAFETY OF GOING
TO THE PHARMACY FOR TREATMENT
MANY CALIFORNIANS LIVE MORE THAN
FIFTEEN MILES FROM THE NEAREST
HEALTH CARE FACILITY. I LIVE UP
IN CHICO WHICH IS SORT OF SEMI
RURAL AND WE'RE DOWN TO ONE
URGENT CARE THAT'S ALL WE HAVE
LEFT THERE'S A SHORTAGE OF
PEDIATRICIANS I CAN'T ALWAYS GET
INTO THE PEDIATRICIAN THERE'S A
SHORTAGE OF PRIMARY CARE
PHYSICIANS- OUR CHOICES ARE
PRETTY LIMITED. BUT THE OTHER
HAND 90% OF CALIFORNIANS LIVE
WITHIN FIVE MILES OF THE
PHARMACY. EIGHT MILLION
CALIFORNIANS LIVE IN AREAS OF
THE STATE WITH HER WHAT HEALTH
CARE PROGRAMS SHORTAGES LIKE
OURS. AND MANY HEALTH CARE
PROVIDERS DON'T TAKE ALL FORMS
OF INSURANCE AND MANY DON'T TAKE
MEDIC HEALTH SO IT LEAVES ALL OF
HIS MEDICAL PATIENTS. OUT OF
LUCK AS WELL. WE SHOULD ALLOW
ALL HEALTH CARE PROVIDERS TO
PITCH IN. AND HELP STOP THE
SPREAD OF ILLNESS IN COMMUNITIES
LIKE MINE. I URGE YOU TO VOTE I
ON SB FIVE TWENTY FOUR WHICH
WILL HELP ENSURE CALIFORNIANS
HAVE EFFECTIVE SAFE AND
CONVENIENT TREATMENT. FOR COMMON
CONDITIONS LIKE COPD WITH THE
FLU. AND STREP THANK YOU FOR
YOUR TIME THANK YOU VERY MUCH.
NEXT PERSON PLEASE. MADAM CHAIR
MY NAME IS MARK JOHN. AND I'VE
BEEN A CALIFORNIA LICENSE
PHARMACIST FOR OVER THIRTY
YEARS. STARTING MY CAREER TO
COMMUNITY PHARMACY IN TRUCKEE.
HI SIR FOR PHARMACY ASSOCIATIONS
AND A BOARD OF PHARMACY. WHERE I
DEVELOPED MY PASSION FOR
PROTECTING PUBLIC SAFETY. AND I
BELIEVE THAT ACCESS TO CARE IS A
CORNERSTONE FOR WHICH PUBLIC
SAFETY LAW SHOULD BE BUILT. THAT
IS WHY I AM A STRONG SUPPORTER
OF SB FIVE TWENTY FOUR. EIGHT
MILLION CALIFORNIANS LIVE IN
AREAS WITH HEALTH CARE
PROFESSIONAL SHORTAGES. AND A
LACK OF. AVAILABLE PRIMARY CARE
PROVIDERS THIS IS PARTICULARLY
TRUE IN RURAL. CAN BE DIFFICULT
TO OBTAIN CARE DUE TO HOURS AND
AVAILABILITY. 48% SAY THEY DON'T
SEEK TREATMENT IF IT IS
INCONVENIENT ALLOWING THEIR
SYMPTOMS TO WORSEN AND SPREAD TO
OTHERS. IT TAKES AN AVERAGE OF
TWENTY SIX DAYS TO VISIT A
PRIMARY CARE PHYSICIAN. FOR WHOM
MANY. GET 90% OF US LIVE WITHIN
FIVE MILES OF A COMMUNITY
PHARMACY WITH EXPANDED HOURS.
AND 60% OF US ALREADY VISIT THE
PHARMACY MONTHLY. WHERE YOU HAVE
AUTHORIZED PHARMACISTS TO
FURNISH NUMEROUS PRESCRIPTION
MEDICATIONS. WITHOUT A
PHYSICIAN'S ORDER FOR YEARS
INCLUDING. MORE MOST RECENTLY
CALIFORNIA PHARMACIST HAVE
SUCCESSFULLY BEEN FURNISHING
PRESCRIPTION TREATMENT FOR
COATED. SB FIVE TWENTY FOUR
WOULD CONTINUE THIS FEDERAL OUT
ONCE AND CONTINUE CALIFORNIA'S
COMMITMENT TO PROVIDING SAFE AND
EFFECTIVE ACCESS TO TESTING AND
TREATMENT BY PHARMACISTS BY
ADDING MODEST CATEGORIES THAT
OTHER STATES HAVE ALREADY
ENACTED SUCH AS FLU AND STREP.
PHARMACISTS HAVE THE EDUCATION
AND ACCESSIBILITY TO PERFORM
THESE TASKS WHILE PHYSICIAN
DRIVEN PROTOCOLS ALREADY GUIDE
PHARMACIST THROUGH A MYRIAD OF
INCLUSION AND EXCLUSION CRITERIA
THAT HAS RESULTED IN A 22%
REFERRAL RATE TO PHYSICIANS FOR
KOBE TREATMENT. SB FIVE TWENTY
FOUR CREATE STANDARDIZED
PROCEDURES AND PROTOCOLS
DESIGNED INTO APPROVED BY THE
MEDICAL BOARD. AT CVS PHARMACIST
ENCOUNTERS ARE DOCUMENTED IN THE
PATIENTS ELECTRONIC MEDICAL
RECORD VIEW THE MOST POPULAR
INTERFACING SOFTWARE APNIC
NOTIFYING THE PATIENT'S PRIMARY
CARE PHYSICIAN. STILL IT IS
VOLUNTARY NOT MANDATORY FOR
PHARMACISTS TO PARTICIPATE IN
ACTIVITIES ALLOWED BY SB FIVE
TWENTY FOUR. IN CONCLUSION SB
FIVE TWENTY FOUR INCREASES
PUBLIC SAFETY BY INCREASING THE
CHANNELS THROUGH WHICH INFECTED
PATIENTS CAN SEEK TIMELY AND
ACCESSIBLE HEALTH CARE
ESPECIALLY FOR THOSE WHO NEED IT
MOST SUCH AS MEDICARE PATIENTS
AND I HEARD TONIGHT. THANK YOU
VERY MUCH ANYBODY ELSE WANT TO
SPEAK IN SUPPORT OF THIS NOW
JUST NAME AND AFFILIATION PLEASE
. THANK YOU MADAM CHAIR MEMBERS
DAVID GONZALEZ ON BEHALF OF
CALIFORNIA LIFE SCIENCES IN
SUPPORT THANK YOU. GOOD
AFTERNOON MADAM CHAIR MEMBERS
MISTY JOHNSON ON BEHALF OF THE
CALIFORNIA PHARMACISTS
ASSOCIATION IN SUPPORT THANK YOU
. GOOD AFTERNOON WHIMSICAL HARD
ON BEHALF OF THE CALIFORNIA
COMMUNITY PHARMACY COALITION IN
SUPPORT THANK YOU. GOOD
AFTERNOON CHARLIE DALTON ON
BEHALF BEHALF OF SOVIET IN
SUPPORT. MARIA LOPEZ COMMITTEE
PHARMACIST IN SUPPORT THANK YOU
THANK YOU VERY MUCH ALL RIGHT
NOW- FOR THE OPPOSITION ON A
COME FORWARD IN. OPPOSE THIS
BILL. GOOD AFTERNOON MADAM CHAIR
AND MEMBERS OF THE COMMITTEE.
SENATE CALERO- ONE OF HIS FIRST
APPROACH WE'RE GOING TO HAVE THE
OUTPUT IN COMMERCIAL WORKERS
WESTERN STATES COUNCIL. I WANT
TO THANK THE AUTHOR FOR AND OUR
STAFF. FOR THEIR WORK WITH US ON
AMENDMENTS SO FAR NO THE BILL I
THINK WE'RE STILL WORKING ON AN
AMENDMENT TO CLEAR FURTHER
CLARIFIED THE ISSUE OF PRIVACY
FOR THE PHARMACIST. LET ME
ADDRESS ARE ARE ARE LESS
CONCERNED WITH THE BILL AS AS IN
PRINT TODAY- WE SYMPATHIZE VERY
MUCH IN A KNOWLEDGE THE ISSUE
OF. ACCESS TO HEALTH CARE
PARTICULARLY RURAL AREAS WHICH
CENTER COMING YEAR ON OTHERS ON
THE COMMITTEE REPRESENT. HOWEVER
OUR CONCERN IS THAT WHILE WE
SHIP SOME OF THESE. DUTIES THAT
ARE ELIMINATED THAT ARE NUMBERED
IN THE BILL THE PHARMACIST MIGHT
BE CREATING ANOTHER PROBLEM- ARE
CONSERVE LESS GHRELIN EFFECTIVE
PHARMACY PHARMACY IS CURRENTLY
DO NOT HAVE ADEQUATE STAFFING TO
COMPLETE. THEIR WORKLOAD AND
PHARMACISTS DO NOT HAVE A TANAMI
OVER WORK FOR DECISIONS.
PHARMACIST IN THE RETAIL SETTING
UP A SOUNDING ALARM BELLS FOR
YEARS ABOUT THEIR CURRENT
WORKING CONDITIONS. THE
CALIFORNIA STATE BOARD OF
PHARMACY CONDUCTED A SURVEY AND
THE RESULTS WERE VERY ALARMING.
91% OF CHAIN PHARMACIST SAID
THAT STAFFING IS THERE IN THEIR
PRIMARY WORK SITE IS NOT
APPROPRIATE OR ADEQUATE TO
ENSURE ADEQUATE. PATIENT CARE
35% OF PHARMACISTS IN THE CHAIN
SETTING INDICATE THAT I HAVE
THAT THEY HAVE ON AVERAGE. THREE
TO FIVE MEDICATION ERRORS IN A
MONTH. ANOTHER 45% SAID THEY
HAVE WANTED TO MEDICATION ERRORS
A MONTH THAT'S 80% OF CHAIN
PHARMACISTS. SCHERING THE LEAST
ONE MEDICATION ERROR IS
HAPPENING A MONTH. 83% OF
PHARMACISTS SAID THEY DO NOT
HAVE TIME TO PROVIDE.
APPROPRIATE PATIENT
CONSULTATIONS- AND FORMER TO
SAYING THAT THEY DON'T HAVE TIME
TO BEFORE THE PROPER REVIEW. IF
IT MEANS THEY- CURLING THERE'S
OF. I GUESS I'LL I THINK A- ALL
OF OUR VISITS TO OUR PRIMARY
PHYSICIAN OR EVEN URGENT CARE.
WHEN YOU CHECK IN TO THE TO THE
FACILITY YOU SEE ONE PERSON THE
CHECK YOU IN THE CHECK YOUR
INSURANCE. THEY HAD YOU OFF TO
SOMEONE ELSE. NOT THE POSITION.
THEY TAKE YOUR VITALS THEN YOU
GO TO THE PHYSICIAN. YOU FINISH
THAT THE POSITION MAKES GIVE
YOUR PRESCRIPTION THE
PRESCRIPTION GOES BACK TO THE
FRONT DESK UP THE FRONT TESTED
SENSE. TO THE PHARMACY. ALL OF
THESE DUTIES THAT I ENUMERATED
UNDER THAT ARE HAPPENING. RIGHT
NOW IN THE PHARMACIES BY ONE
PERSON. THAT YOU KNOW WHEN YOU
GO IN THE PHARMACY THE
PHARMACIST IS THERE THEY TAKE
YOUR PRESCRIPTION. THEY FILL
YOUR PRESCRIPTION. THEY CAN ALSO
YOU ON THE ON THE USE. AND THEN
THEY RING UP. WHAT WE'RE SAYING
UNDER THE BILL IS IF YOU WANT TO
IF YOU WANT TO SOME POINT
IMPLEMENTATION OF SUCCESSFUL.
THE MAMMOTH ARRESTING FOURS THAT
THERE BE AN EXTRA PHARMACIST
ASSIGNED EACH PHARMACY THAT SOLD
ME BE ASSIGNED THE DUTIES IN THE
BILL. THEN WILL HAVE A WORKABLE
SOLUTION AND WE'LL MAKE SURE
THAT. ONE THE FARMERS SOME WORK
AND MORE IMPORTANTLY. ORGANISED
WE'RE GOING TO MAKE SURE THE
PATIENTS. ARE PRESCRIBED AROUND
HIS MEDICATION THAT CAN OFTEN.
OFTEN LEAD TO DEADLY RESULTS SO
RESPECTFULLY REQUEST FOR WE'RE
WE HAVE AN OPPOSE. UNLESS
AMENDED POSITION THANK YOU.
THANK YOU. SMEAL'S WHEN TO SPEAK
OPPOSITION. GOOD AFTERNOON CHAIR
MEMBERS GEORGE SOURIS OF THE
CALIFORNIA MEDICAL ASSOCIATION
SO WE DO APPRECIATE WORKING WITH
THE AUTHORED US FAR IN THE-
CONVERSATION WITH THE COMMITTEE
AS WELL- CMA'S CONCERNS ARE
FOCUSED ON TREATMENTS THE
PHARMACIST WILL BE ALLOWED TO
PRESCRIBE TO INDIVIDUALS AT
RETAIL PHARMACIES UNDER THIS
BELT- THE TREATMENTS ARE TOO
EXPENSIVE. AND A ONE SIZE FITS
ALL APPROACH TO TREATING
ILLNESSES CAN BE DANGEROUS FOR
COMMUNITIES. WE ARE AWARE THAT
THIS BILL HAS BEEN AMENDED
RECENTLY TO INCLUDE TEST TO
TREAT FOR. COVERT FLU STREP
THROAT IN PINK EYE HOWEVER-
TREATMENT PLANS THOSE ILLNESSES
ARE NOT ALWAYS THE SAME THAT-
THE BILL DOES NOT CONSIDER
INDIVIDUALS WITH PRE EXISTING
CONDITIONS. AND INDIVIDUALS
PRIMARY CARE PHYSICIAN SHOULD
NOT BE REMOVED FROM THAT
TREATMENT PROCESS. ADDITIONALLY
IT IS UNCLEAR HOW COMPLICATED
MEDICAL CASES WOULD BE HANDLED
AND REFERRED. TO APPROPRIATE
MEDICAL PROVIDERS IN THIS BILL.
THE BILL ALSO ALLOWS PHARMACISTS
TO PRESCRIBE ANTIBIOTICS FOR A
COUPLE OF THE ILLNESSES IN HERE.
WHICH COULD HAVE FAR REACHING
UNINTENDED CONSEQUENCES- TO THE
HEALTHCARE DELIVERY SYSTEM WE
SHOULD NOT SUPPORT POLICY THAT
WOULD FURTHER EXACERBATE ANY
TYPE OF. ANTIBIOTIC RESISTANCE.
WE UNDERSTAND AND APPRECIATE THE
AUTHOR'S INTENT AROUND ACCESS TO
CARE FOR THIS MEASURE DOES NOT
ACHIEVE ACCESS. AND FURTHERMORE
WE DON'T BELIEVE THAT THIS
APPROACH BUT SHE'S HEALTH EQUITY
IN OUR MOST UNDERSERVED AREAS.
UNDERSERVED COMMUNITIES DESERVE
HAVE ACCESS TO A PRIMARY CARE
PHYSICIAN AND SHOULD NOT HAVE TO
RELY ON GETTING THEIR HEALTHCARE
AT WALGREENS OR CVS WHICH
RESPECTFULLY ARE NOT COMMUNITY
PHARMACIES. WE LOOK FORWARD TO
CONTINUE TO BE PART OF THE
SOLUTION ACCESS TO CARE FOR THIS
MEASURE DOES NOT STRIKE THAT
BALANCE. CM I RESPECTFULLY URGE
YOU TO VOTE NO ON SB FIVE TWENTY
FOUR TODAY. AT THE PROGRAM HAD
HAPPENED ANSWER ANY QUESTIONS
THANK YOU THANK YOU VERY MUCH
JIM REAL SPEAKING IN OPPOSITION
TODAY JUST NOW NAME AND
AFFILIATION PLEASE. RIGHT
SPENCER PAP THE AMERICAN COLLEGE
OF OBGYN WE DO APPRECIATE THE
MINISTER STI'S BUT REMAIN
OPPOSED. THANK YOU. MADAM CHAIR
MEMBERS TO MADDEN REPRESENT THE
CALIFORNIA CHAPTER OF THE
AMERICAN COLLEGE OF CARDIOLOGY
IN OPPOSITION. THANK YOU VERY
MUCH. NUMBER THE TIME BECAUSE
THE PHONE LINES. ANYBODY IN
SUPPORT AND OR OPPOSITION JUST
NAME AND AFFILIATION AND
POSITION. MODERATOR YOU THERE. I
AM LATE AND THEN ONCE AGAIN IF
YOU WISH TO MAKE COMMON IN
SUPPORT OR OPPOSITION PLEASE
PRESS ONE AND ZERO.
I CURRENTLY HAVE KNOWING QUEUING
UP MADAM CHAIR. THANK YOU VERY
MUCH. OF THE TIME TO BRING IT
BACK TO THE COMMITTEE AT THE
SENATE CAREER YOU HAD ONE
OPPOSITION SAY THEY WEREN'T
QUALIFIED ANOTHER ONE SAID THERE
WASN'T ENOUGH. TO HUNT OF YOU
WANNA WEAR A DRESS THAT AT ALL.
WELL I THINK THAT THAT THE THAT
THE CHALLENGES IS THERE THEY'RE
GOING TO BE SOME. THE ON THE
QUALIFICATIONS AND WE JUST SAY
THAT- PHARMACISTS ARE HIGHLY
TRAINED INDIVIDUALS- THEY GO
THROUGH VERY SIMILAR TRAINING AS
MEDICAL DOCTORS THEY JUST DON'T
DO THE CLINICAL- AND SO- AS PART
OF WHAT WE PUT IN THE BILL AS A
CONSEQUENCE IS A TRAINING
PROGRAM THAT THEY WOULD HAVE TO
COMPLETE IN ORDER TO BE ABLE TO.
BE UP TO DATE AND READY TO ROLL
ON WHAT THAT- THE CURRENT
TREATMENTS MIGHT BE- AND WHAT
ARE THE ISSUES AND QUESTIONS YOU
MIGHT WANT TO ASK IN REGARDS TO
THAT KIND OF TREATMENT- THE
ISSUE OF WORKLOAD IS A REAL
ISSUE- AND SO IN THAT REGARD-
YOU WERE HAVING CONVERSATIONS
ABOUT WHAT DOES THAT LOOK LIKE-
IN PARTICULAR IN THE SMALL
COMMUNITY- PHARMACIES- THE
PHARMACIST DO A WHOLE BUNCH OF
THINGS AND- IT'S A- IT'S A DIRT.
FACILITY RIGHT IT'S THEIR STORE
IF YOU WELL AND- AND WE WANT TO
BE ABLE TO MAKE SURE THAT THERE
IS A PRIVATE PLACE THAT THEY CAN
DO THE TESTING- AND THEN CAN
ALSO DO THE TREATMENT- AND DO
THAT KIND CONCEPTS OF THAT IT'S
NOT OUT IN THE MIDDLE OF BUT OF
AN NOW SOMEWHERE. AND SO- WE'RE
WE'RE WORKING ON THOSE KINDS OF
ASSURANCES- BUT BUT IN REGARDS
TO THE WHOLE THE WHOLE ISSUE.
VIA OF STAFFING AYE AYE I HAVE I
HESITATED MAIN MANDATE- WHAT THE
STAFFING HAS TO BE THERE MAY BE
TIMES I KNOW WHEN I'VE GONE IN
FOR MY VACCINES AT THE PHARMACY-
YOU HAVE TO MAKE AN APPOINTMENT.
AND YOU AND YOU MAKE AN
APPOINTMENT WHEN THEY ARE LEAST
BUSY RIGHT AND WHETHER SOMEONE
THAT'S AVAILABLE THAT CAN THAT
CAN HANDLE THAT. THAT THE
PROCEDURE AND SO ON MY GUESS IS
I MEAN WE CAN MAKE THAT PART OF
THAT THE BILL BUT- BUT- IN TERMS
OF MANDATING. THAT THE WHOLE
ISSUE OF THE ERRORS THAT
SOMETHING THE PHARMACY BOARD HAS
TO DEAL WITH THAT. THAT IS THAT
IS QUALITY CONTROL AND- AND- AND
I'M I'M SENSITIVE TO WE WANT
REALLY WANT TO MAKE SURE THAT
THE PRESCRIPTIONS ARE GOING OUT
APPROPRIATELY- BUT I DON'T THINK
IT IT. IT SHOULD IMPACT WHETHER
OR NOT AND I JUST GOT TO SAY
IT'S HAVING DONE THAT THAT. THAT
CODE WOULD TEST EVERY SINGLE
WEEK FOR ALMOST THREE YEARS NOW
I CAN DO IT IN MY SLEEP. AND IF
YOU GIVE ME THE PINK EYE TEST I
PROBABLY CAN DO THE BIT THERE
CLEA- CERTIFIED WHICH MEANS
THEY'VE BEEN THE FDA. HAS COME
IN AND CERTIFIED THEM AND IT'S A
LIGHT THAT BIT IT EITHER IT'S
POSITIVE RICH AIR IT'S NEGATIVE
AND SO- I JUST THINK THAT- THESE
ARE ARE FAIRLY SIMPLE TESTS-
AND- AND I. TO ME THE WHOLE IDEA
THAT IT'S GOING TO BE TOO
DIFFICULT TO BE ABLE TO DO THAT
JUST DOESN'T MAKE ANY SENSE TO
ME. THANK YOU. AND I TRULY
APPRECIATE YOUR- DEDICATION RULE
CALIFORNIA TRY TO EXPAND ACCESS
IT IS A IT IS A CONUNDRUM AND I
APPRECIATE WHAT YOU'RE TRYING TO
DO. THANK YOU AND THE OTHER
THING IS THAT IT IS THERE ISN'T
AN ARGUMENT THAT. IT IT WORK
PROVIDING LESS- LESS QUALIFIED
TREATMENT TO DISADVANTAGE FOLKS
AND THAT THEY SHOULD HAVE
DOCTORS IT'S LIKE. HELLO YEAH
AND THAT'S EXACTLY WHAT I'D LIKE
YOU KNOW IF WE COULD OPEN ABOUT
TEN MORE MEDICAL SCHOOLS AND IT
WILL OPEN IN RURAL CALIFORNIA.
AND THEN PROVIDE INCENTIVES FOR
DOCTORS TO STAY IN ROW
CALIFORNIA THEN MAYBE WE CAN
WAIT TEN YEARS TO BE ABLE TO.
SAY NOW WE'VE PROVIDED EQUITY
BUT- IN THE MEANTIME WE'RE NOT
HAVING EQUITY IN TO SAY NOTHING
IS BETTER THAN- THAT THE STATUS
QUO IS BETTER THAN TRYING TO LET
PHARMACISTS ARE HAVING THEM DO
THIS AS WELL. GO THROUGH THE
TRAINING LEARN EVERYTHING YOU
NEEDED TO DO IN ORDER TO BE ABLE
TO DO THIS JUST DOESN'T MAKE ANY
SENSE TO ME. SAID NOTHING IS
BETTER THAN. THEM I AGREE IT'S
LIKE YOU HAVE THIS OR THE
ALTERNATIVE IS NOTHING NOTHING.
CORRECT SENTIMENT FOR. IT AND I
APPRECIATE THAT TOO I THINK THIS
IS A CREATIVE APPROACH TO
ADDRESS YOU KNOW YOU HAVE
HOSPICE CLOSING IN YOUR DISTRICT
IN FRONT OF OTHER MEMBERS HER.
FACING THAT IMMINENT DOOM THERE
SO HOW ELSE CAN WE- PROVIDE
ACCESS WHAT WE'RE DOING WITH
THAT FOR A PERMIT SOLUTION. ONE
OF THE QUESTIONS WAS ADDRESSED
READY MY OTHER QUESTION WAS-
REGARDING PRIVACY- I THINK I
IT'S HARD TO. HIDE THAT I MEAN
IF A PRETTY VISIBLE- BUT YOU
KNOW IT'S JUST LIKE A STRIP
THROUGH OR- PEOPLE WHO HAVE. THE
FLU AND COUGH IN HOW
CONVERSATIONS GOING THERE ON HOW
TO. ADDRESS THE PRIVACY THE
PRIVACY IT REALLY HAS TO DO WITH
THE SPACE IN THE PHARMACY TO BE
ABLE TO SEE. GET PEOPLE UP A- IF
NOT A SEPARATE ROOM THEN AT
LEAST- A SCREEN. SO THAT THEY
CAN GO BEHIND AND I THINK THEY
I'M NOT MY EXPERIENCE WITH THE
COALBED. A PANDEMIC IS THAT THEY
WERE ABLE TO HANDLE THAT VERY
WELL BECAUSE YOU HAD AN
APPOINTMENT. AND IF YOU CAME IN
FOR THE VACCINES- YOU HAD TO
WAIT- IN AN AREA THAT WAS
DESIGNATED AND THEN THEY TAKE
YOU BEHIND THE SCREEN AND THEN
THEY YOU HAD TO FILL OUT THE
PAPERWORK AHEAD OF TIME- AND SO
THE IDEA IS THAT. IS THAT YOUR
SCREEN FROM THE PUBLIC AND IT'S
NOT SOMETHING THAT PEOPLE CAN-
HERE OR OR SEE IN IN THE IN THE
PHARMACIES THAT I WAS AND THEY
WERE PRETTY BUSY IT'S- THE EVE.
PEOPLE AREN'T REALLY BEING NOSY
ABOUT YOU KNOW WHO'S HERE AND
LET ME TAKE A LOOK AND WE GOT
RID OF THE S. T. TT SO THAT THAT
I THINK MAKES IT EVEN- EASIER IN
IN ORDER TO MEET THE NEEDS. OF
THE FLU. STREP THROAT AND
PINKEYE. AND ONE MORE I'M
FORGETTING. I THINK. COBEN WILL
COVER OF IT YEAH WELL HOW DID I
FORGET. HOW EASY WE FORGET SO I
IS THAT THE ISSUE AROUND PRIVACY
HAS BEEN. THE ISSUE WITH WITH
THE SPACE AND THE ABILITY TO PUT
UP. BARRIERS QUITE FRANKLY THAT
THE PHARMACIES HAVE A- REALLY
GOOD SYSTEM. OF ELECTRONICALLY
KEEPING INFORMATION THAT YOUR
DOCTOR CAN ACCESS AND THAT YOU
CAN ASK. THAT THEY IN THE THAT
TRANSMITS THE INFORMATION TO
DOCTORS RICE ON ONE OF THE
PROVISIONS MAYBE PERHAPS I FELT
ADDRESS SOME OF IT- IS THAT THE
PHARMACIST WILL NOTIFY. THE
PATIENTS PRIMARY CARE PHYSICIAN
RIGHT. OKAY THANK YOU. THANK YOU
VERY MUCH SENATE ROTH. THANK YOU
MADAM CHAIR YOU KNOW OF. IT
OCCURS TO ME I THINK WE LICENSE
PHARMACIES. MUSICIAN TO
PHARMACISTS IN THE STATE AND
GOING BACK TO WHAT THE MYSTERY
CO SAID IN HIS- OPPOSITION WE
ALL WANT. HEALTH CARE DOUBLE TO
BE DELIVERED IN A SAFE MANNER.
AND IF THERE ARE- STAFFING
ISSUES OR ANY OTHER ISSUES THE
RESULT IN. UNSAFE PRACTICES
INSIDE A LICENSED PHARMACY IT
SEEMS TO ME THAT ARE TO BE
WITHIN THE PURVIEW OF THE BOARD
OF PHARMACY. MR TO READ DISA ON
SURE. STEP UP AND SAY SO AND IF
THE BOARD OF PHARMACY NEEDS
ADDITIONAL TOOLS IN ORDER TO.
ENSURE THAT LICENSE PHARMACIES
ARE ENGAGING IN THE ACTIVITIES
WE AUTHORIZE. IN A SAFE MANNER
THAN THE OTHER COMMITTEE THAT
SOME OF US SIT ON CAN CERTAINLY
TAKE CARE OF THAT SO. OF THE
SPORTING A MEASURE DAY CENTER.
THANK YOU VERY MUCH. FURNITURE
BUSINESS AND PROFESSIONS
ABSOLUTELY. SEEING NO OTHER
QUESTIONS WOULD YOU LIKE TO
CLOSER. THIS IS REALLY AN ACCESS
ISSUE IN A RESPECTFULLY ASK FOR
YOUR I. BOATS TODAY THANK YOU
VERY MUCH. STILL HAVE A QUORUM
BUT WE'RE GETTING CLOSER VERY
GOOD- ANY MEMBERS OUT THERE CAN
HEAR THE SOUND OF MY VOICE WE
NEED A QUORUM. I'M GONNA MOVE ON
WITH SB SIX TWENTY ONE. THANK
YOU MADAM CHAIR I AM PLEASED TO
PRESENT SB SIX TWENTY ONE WHICH
WILL INCREASE PATIENT ACCESS TO
LOWER COST BIOSIMILAR
MEDICATIONS IN ORDER TO REDUCE
HEALTHCARE COSTS TO PROVIDE SAFE
AND EFFECTIVE TREATMENT OPTIONS.
I WILL BE ACCEPTING THE
AMENDMENTS THAT ADDRESSED
CONCERNS RAISED BY THE
OPPOSITION. EIGHT THE CUT
COMMITTEES ASSISTANCE TO MAKE IT
MORE EXPLICIT THAT IMPORTANT
PAID PATIENT PROTECTIONS
INCLUDING THE ABILITY OF A
POSITION TO REQUEST A STEP
THERAPY EXCEPTION WOULD BE
APPLIED TO BIOSIMILARS.
CALIFORNIANS ESPECIALLY AS I'VE
SAID RURAL RESIDENTS ARE
CONFRONTED BY SAID SUCH
CHALLENGES AS HOSPITAL CLOSURES
LIMITED TREATMENT UP ACCESS AND
HIGH HEALTH CARE PREMIUMS. I'VE
BEEN LONG CONCERNED WITH THE-
HEALTH CARE ACCESSIBILITY AND SB
SIX TWENTY ONE WILL TARGET A
CRUCIAL AREA LOWER LOWERING THE
PRICE OF PRESCRIPTION DRUGS. TO
LOWER HEALTH PLAN PREMIUMS. PER
CAPITA SPENDING ON PRESCRIPTION
DRUGS INCREASED 7100% BETWEEN
NINETEEN EIGHTY AND- TWENTY
EIGHTEEN WHICH IS OVER THIRTY
THIRTY YEAR PERIOD MANY PATIENTS
PAY TENS OF THOUSANDS OF DOLLARS
ANNUALLY. IN OUT OF POCKET COSTS
FOR LIFE SAVING MEDICATIONS MANY
OTHERS ARE FORCED TO PAY HIGH.
HEALTH CARE PREMIUMS HIGH
PRESCRIPTION DRUG PRICES ALSO
IMPACT THE BOTTOM LINE OF
FINANCIALLY STRAINED HOSPITALS
PARTICULARLY WITH RECENT
INFLATION IT WAS ONE OF THE
FACTORS THAT THEY CITED AS- AS
IN INCREASED COSTS THAT. BEAT
MAKES IT VERY DIFFICULT. TO TO
MEET THAT DAY THEN THAN THE
NEEDS THE HIGH COST OF
PRESCRIPTION DRUGS IS IN PART
DUE TO THE LACK OF COMPETITION
THE BRANDED DRUG COMPANIES
RECEIVED FROM LOWER PRICE BUT
EQUALLY EFFECTIVE TREATMENT
OPTIONS. THERE IS A GROUP OF
DRUGS CALLED BIOSIMILARS THAT
ARE VERY SIMILAR TO GENERICS BUT
ARE DESIGNED FOR COMPLEX
BIOLOGIC. BETTER BUT FOR COMMON
BILE DRUGS THESE DRUGS ARE
RIGOROUSLY APPROVED BY THE FDA
AS HAVING QUOTE NO CLINICALLY
SIGNIFICANT DIFFERENCE FROM THE
BRAND NAME DRUG IN TERMS OF
SAFETY PURITY AND POTENCY. THIS
MEANS THAT BIOSIMILARS ARE JUST
AS SAFE AND EFFECTIVE AS A BRAND
NAME DRUG WHILE ALSO BEING LESS
EXPENSIVE. THE INTRODUCTION OF
BIOSIMILARS FREQUENT FREQUENTLY
LEADS TO INCREASED ACCESS FOR
PATIENTS DRIVEN BY THE LOWER
COST OF BIOSIMILARS AND PRICE
REDUCTIONS WHETHER TREATMENTS.
SINCE BIOSIMILARS WERE
INTRODUCED IN THE INTO THE U. S.
THEY HAVE SAVED OVER THIRTEEN
BILLION DOLLARS AND THERE ARE
EXPECTED TO GENERATE OVER A
HUNDRED AND EIGHTY BILLION. IN
SAVINGS OVER THE NEXT FIVE
YEARS. DESPITE BIOSIMILARS
WIDESPREAD ADOPTION IN EUROPE
BARRIERS TO THEIR ADOPTION
REMAIN IN THE UNITED STATES THIS
IS DUE TO THE POWER OF THE-
PRESCRIPTION DRUG COMPANIES
WHICH HAVE EXPLOITED THE LEGAL
SYSTEM TO BLOCK THE WIDESPREAD
ADOPTION OF BIOSIMILARS. THIS IS
RESULTED IN TENS OF THOUSANDS OF
DOLLARS IN OUT OF POCKET COSTS
FOR MANY PATIENTS. FACING
CONDITIONS SUCH AS AIDS AND
ARTHRITIS. CURRENTLY HEALTH
PLANS MAY ACCESS A LIST OF
SEVERAL LOWER COST DRUGS FOR
ENRON AND IN IN ROWLEY BEFORE
TRYING TO BACK BRAND DRUGS.
HOWEVER MOST BIOSIMILARS ARE
EXCLUDED FROM THIS LIST THIS
MEANS THAT MANY BIOSIMILARS
CANNOT BE USED TO LOWER HEALTH
CARE PREMIUMS FOR PATIENTS. THIS
BILL WOULD ALLOW HEALTH PLANS TO
HAVE THE TOOLS TO DIRECTLY
ACCESS A LOWER COST BIOSIMILAR
BEFORE THE EQUIVALENT BRAND
DRUGS. THE BILL ALSO EXTENDS
RELEVANT PATIENT PROTECTIONS TO
THE USES USAGE OF BIOSIMILARS
SUCH AS THE ABILITY OF OUR
PROVIDER TO REQUEST THAT THE
ORIGINAL BRAND TREATMENT BE USED
. A PRESCRIPTIVE A PRESCRIBER IN
CALIFORNIA WILL HAVE TO APPROVE
THE USE OF THE BIOSIMILAR PRIOR
TO IT BEING BEING ADMINISTERED
TO A PATIENT SO AS NOT TO IT SO
AS NOT TO INTERFERE WITH THE
PHYSICIAN. TREATMENT DECISIONS
ULTIMATELY SB SIX TWENTY ONE
WILL GIVE PATIENTS GREATER
ACCESS TO TREATMENT. FOR THESE
DISEASES BY HELPING PATIENTS
ACCESS LOWER COST AND EQUALLY
EFFECTIVE ALTERNATIVES. IT WILL
WORK TO LOWER THE PRICE OF THE
PRESCRIPTION DRUGS AND REDUCE
HEALTHCARE PREMIUMS WITHOUT
DELAY. TO HELP OUR FINANCIALLY
STRAINED HEALTH CARE SYSTEM AND
ENSURE PAY PATIENTS WITH CHRONIC
CONDITIONS AGAIN THESE ARE
CHRONIC CONDITIONS YOU DON'T
JUST TAKE THE MEDICATION AND
YOU'RE CURED. THESE ARE CHRONIC
CONDITIONS AND THEY'LL BE ABLE
TO GET THAT THE SYSTEMS THEY
NEED. WITH ME TODAY TO TESTIFY
IS BRED MISSED MISSION MICHELIN
WITH THE ASSOCIATION FOR
ACCESSIBLE MEDICINES AND ITS
BIOSIMILARS COUNCIL. THANK YOU
VERY MUCH FOR WELCOME. GOOD
AFTERNOON MADAM CHAIR MEMBERS
PREDNISOLONE WITH THE
ASSOCIATION FOR ACCESSIBLE
MEDICINES A AM REPRESENTS THE
GENERIC AND BIOSIMILAR
MANUFACTURERS. AND THE
BIOSIMILARS COUNCIL IS A
SUBSIDIARY WHICH OBVIOUSLY IS
FOCUSES ON BIOSIMILARS. FIRST
LIKE TO THANK THE SENATOR FOR
CARRYING THIS BILL WE ARE
PLEASED TO SPONSOR AND FOR THE
WORK OF YOUR STAFF AND HER STAFF
ON ITS- ON HIS BEHALF SO FAR. I
WILL TRY AND SEE A LITTLE TIME
TODAY- PRIMARILY ANSWER
QUESTIONS IF YOU HAVE ANY IT'S A
KIND OF COMPLICATED AREA OF LAW-
WITH THE DIFFERENCES IN THE
DRUGS- SO ALL OVER JUST WAIT AND
SEE IF THERE'S QUESTIONS ON THAT
BUT I DO WANT TO MAKE A COUPLE
OF POINTS IF I CAN. THE INTENT
OF THIS BILL IS TRULY TO
INCREASE ACCESS TO BIOSIMILARS
WHICH ARE LOWER COST DRUGS. AND
WE DO THAT BY REMOVING
ARTIFICIAL BARRIERS TO THEIR
COVERAGE. IT'S APPROPRIATE WHAT
THIS BILL IS DOING BY ADDING
BIOSIMILARS TO PROVISIONS OF LAW
THAT ALREADY INCLUDE GENERIC AND
INTERCHANGEABLE BIOLOGICS. WHAT
THIS BILL DOES NOT DO BUT
THERE'S BEEN QUESTIONS ON IT
DOES NOT CREATE AN ADDITIONAL
STEP FOR PATIENTS TO GAIN ACCESS
TO DRUGS THAT THEIR- PRESCRIBERS
PREFER. IT ALSO DOES NOT FORCED
SUBSTITUTION. BIOLOGICS ARE
BIOSIMILARS ARE NOT
SUBSTITUTABLE AT THE PHARMACY
COUNTER. SO AS THE SENATOR
MENTIONED IT THE PROVIDER
ACTUALLY HAS TO WRITE THE
PRESCRIPTION FOR THE BIO
SIMILAR. IT'S NOT GOING TO BE
SUBSTITUTED WITHOUT THE
PROVIDERS ENGAGEMENT. WHILE
SOMEONE'S DO SAVE MONEY AND I DO
SO WANT TO GIVE A COUPLE OF- OF
SPECIFIC EXAMPLES TO THAT-
RELATIVELY NEW BIOSIMILARS TO.
COME TO MARKET INSULIN OBVIOUSLY
A DRUG. THAT IS RAISED A LOT OF
QUESTIONS AND A LOT OF CONCERNS
ABOUT ITS COSTS. THE NEW WHILE
SIMILAR THE FIRST BIOSIMILAR TO
COME TO MARKET WAS OFFERED AT A
65% DISCOUNT FROM. LANTUS WHICH
WAS VIEWED THE ORIGINAL OR
ORIGINATOR DRUG 65% DISCOUNT. IT
WAS ALSO OFFERED AT A 5%
DISCOUNT WITH A GREATER BACK END
REBATE. AND THAT WAS THAT'S
BECAUSE OF THE WAY THAT THE
MARKET IN FOR BIOSIMILARS IS
STARTING TO DEVELOP. ANOTHER
EXAMPLE HUGH MERA ONE OF THE
MOST EXPENSIVE. HIGHEST GROSSING
DRUGS EVER PRODUCED AROUND THE
WORLD. THE FIRST BIOSIMILAR JUST
CAME TO MARKET EARLIER THIS YEAR
IT WAS INTRODUCED MARK AT THE
55% REBATE. WE HAVE EXAMPLES OF
THAT THROUGHOUT- THE LIFESPAN OF
BIOSIMILAR DRUGS. IN ONCOLOGY IS
IT IS A PERFECT EXAMPLE ONE OF
THE EARLIEST- AREAS WHERE
BIOSIMILARS BECAME AVAILABLE.
COST INCREASE FOR THE TREATMENT
OF ONCOLOGY WERE ABOUT 18% A
YEAR. EACH YEAR GOING UP 18%
WHEN FILE SUMMERS CAN MARKET.
THAT INCREASE WAS CUT IN HALF
IT'S AT 9% SO COSTS ARE STILL
GOING UP FOR THE TREATMENT OF
CANCER. BUT BY HALF OF WHAT IT
WAS PRIOR TO BIOSIMILARS COME
MARKET. WITHOUT I'M I'M- AGAIN
HAPPY TO HAVE THE ANSWER
QUESTIONS IF YOU HAVE IT BUT WE
DO HAVE SOME MORE EXAMPLES IN
THE- OF THIS TOO THANK YOU VERY
MUCH IN REAL SPEAK IN SUPPORT OF
THIS BILL TODAY. I'M SURE
MEMBERS RAND MARTIN HERE ON
BEHALF OF THE AIDS HEALTHCARE
FOUNDATION WHICH IS THE LARGEST
NONPROFIT SERVING PEOPLE WITH
HIV AND AIDS IN THE STATE OF
CALIFORNIA. AND THIS IS A VERY
IMPORTANT BILL TO US IN TERMS
OF- INCREASING ACCESS- TO- TO
TREATMENT REGIMENS FOR PEOPLE
WITH HIV AND AIDS THANK YOU.
THANK YOU. THANKS PERSONS NAME
AND AFFILIATION. THANK YOU
PRESTON YOUNG FOR THE CALIFORNIA
CHAMBER OF COMMERCE HERE TODAY
IN SUPPORT. THANK YOU. LYNSEY
THE SCAR INTERNATIONAL
FOUNDATION FOR AUTOIMMUNE AND
OTHER INFLAMMATORY ARTHRITIS IN
SUPPORT THANK YOU. OKAY ANYBODY
SPEAKING IN OPPOSITION TO THIS
BILL TODAY. PLEASE THANK YOU AN
INTERMARRIAGE TIBETAN I'M
SPEAKING ON BEHALF OF THE
CALIFORNIA RHEUMATOLOGY ALLIANCE
IN THE COALITION OF STATE
PRIMATOLOGY ORGANIZATIONS WE ARE
REMOVING OPPOSITION WITH THE
AMENDMENTS THAT THE CENTER JUST
ACCEPTED. THEY JUST WANT TO TAKE
A QUICK MINUTE TO THINK THE
SENATOR IN OUR STAFF AND THE
SPONSORS AND ESPECIALLY- YOUR
CONSULTANT ON WORKING ON THESE
AMENDMENTS TO HELP CLARIFY TO
MAKE SURE THAT WE'RE ALL- IN
AGREEMENT WITH WHAT THE LAWS
DOING GOING FORWARD. AND THAT
WITH THAT WERE MOVING OPPOSITION
THANK YOU THANK YOU VERY MUCH
APRIL TWENTY SPEAK. OPPOSITION
TO THIS TOWN JUST COME FORWARD
NAME AND AFFILIATION. SEEING
NONE WILL GO TO THE PHONE LINES
MODERATOR IS THERE ANYBODY IN
THE QUEUE. IN GENERAL IT'S GONNA
WISH TO MAKE A COMMENT OR
OPPOSITION PLEASE PRESS ONE AND
ZERO. THE BILL THE LINE ONE OF
THE PLEASE GO AHEAD. WHICH ARE
THE CAN DO CLEANINGS ARE AFTER.
YOU OF ACTION REPORT. THANK YOU
VERY MUCH TO TAX CODE PLEASE.
THERE'S CURRENTLY BILL WENT OUT
THANK YOU PAT. THANK YOU VERY
MUCH BRING IT BACK TO THE
COMMITTEE NOW PRETTY QUESTIONS
COMMENTS. I THINK IT'S A GOOD
BILL AND AGAIN IT REALLY INITIAL
RUN ACCESS AND TRY TO SEE PEOPLE
SOME MONEY. WOULD YOU LIKE TO
CLOSE RESPECTFULLY ASK FOR YOUR
I. BOATS THANK YOU VERY MUCH AND
AGAIN WHEN WE DO GET A QUORUM
WE'LL MAKE SURE THOSE VOTE START
HAPPENING. AND YOU HAVE ONE
FINAL BILL BEFORE'S- TODAY WE
LIKE TO TALK THROUGH THE LAST
THING WE AND UNDERSTANDING THE
COMMITTEE IS A FINAL TALK WHICH
EVERYONE'S FINE WITH THIS MOVING
THROUGH. WE UNDERSTAND IT'S A- A
SHELL OF A BILL YES POINT- AND
WE'VE ALL BEEN WORKING WITH THE
ADMINISTRATION TO TRY TO REALLY
GET THEM FOCUSED ON AND MCO TAX
WE ALL KNOW WE NEED. AND SO IN
ORDER TO PUT A LITTLE BIT OF
PRESSURE WITH THEM WE JUST HAVE
YEARS GOING ALONG SIDE- SO WE
CAN BE READY TO BE NIMBLE WOULD
YOU LIKE TO PROCEED YES AND
THANK YOU FOR THAT. MADAM CHAIR
THAT'S EXACTLY RIGHT- AS YOU
KNOW- HOW HOSPITAL FAILED. ARE
ARE NOT OPTION IN OUR
COMMUNITIES WE JUST CAN'T AFFORD
IT AND IT- IN. THAT THE END OF
LAST YEAR IT CAME TO MY
ATTENTION THAT MADERA HOSPITAL
WAS IN DISTRESS- AND I FOUND OUT
ALSO THAT. HOSPITAL IN SAN
BENITO COUNTY HE'S A HAWKINS WAS
ALSO IN DISTRESS- AS
CIRCUMSTANCES. PUSH MADERA
HOSPITAL- TO A POINT WHERE WENTZ
THEY SENT OUT THE LETTERS
INDICATING THEY THEY MAY BE
CLOSING IN SIXTY DAYS- PEOPLE
LEFT ANNA AND THE HUSBAND WAS
FORCED TO CLOSE. RIGHT AFTER
CHRISTMAS BEFORE THE NEW YEARS
AND- THEY HAVE SINCE FILED FOR
BANKRUPTCY IN THE IN THE
CHALLENGES IS THAT- IT WAS A
PERFECT STORM. BETWEEN THE
CORONA VIRUS THAT. CLEARED THE
HOSPITAL OF ALL OF THE- THE
SURGERIES THAT WERE NOT URGENT-
AND- FILLED IT WITH. PEOPLE THAT
WERE VERY VERY SICK AND A HIGH
PROPORTION OF SENIORS WHICH MEAN
THEY WERE ON MEDICAL OR
MEDICARE- WHICH WHICH DOESN'T
PAY IT REIMBURSEMENT RATE-
SUFFICIENT TO KEEP THE HOSPITAL
OPEN IF THAT'S THE ONLY PATIENT
THAT YOU'RE SEEING- INCLUDING
THE HIGH COST OF SUPPLIES
BECAUSE OF THE CORONA VIRUS AND
THE- HIGH COST OF PRESCRIPTION
MEDICATIONS- IT WAS A PERFECT
STORM THEY'D- ALL THESE
HOSPITALS- BASICALLY UTILIZED.
THEIR RESERVES SUCH THAT THEY
WERE TO KEEP THEMSELVES OPEN AND
WE DISCOVERED AT THE BEGINNING
OF THE YEAR THAT THERE WERE
ABOUT NINE OR EIGHT HOSPITALS IN
THE STATE THAT WERE- AT. A
TEETERING ON THE EDGE OF CLOSING
IN BANKRUPTCY AND SO WE PUT
TOGETHER A COMMITTEE OF SENATORS
THAT COULD SIT DOWN AND START
TALKING ABOUT WHAT ARE SOME OF
THE OPTIONS. THAT WE NEED TO
EMPLOYEE TO BE ABLE TO- TRY TO
SURE UP THESE HOSPITALS AND IT
WAS NOT JUST THOSE SEVEN OR
EIGHT HOSPITALS THIS WAS SEVEN
OR EIGHT HOSPITALS THIS YEAR IN
ANOTHER SEVEN OR EIGHT HOSPITALS
NEXT YEAR SO. A MAJORITY OF THE
SENATORS WOULD EXPERIENCE A
HOSPITAL CLOSING WITHIN THE NEXT
TWO YEARS. I'M WHICH BE A
TREMENDOUS DRAIN OF MEDICAL-
SERVICES. YOU'D SEE DOCTOR LEAVE
THE STATE NURSES LEAVE THE
STATE- THEY'D BE LOOKING FOR A
PLACE TO LAND WHERE THEY COULD
HAVE PRIVILEGES AND SO- WE
STARTED WORKING ON SOME IDEAS
THERE'S- A BUNCH IN IN- IN THE
PLANNING STAGES BUT- BUT THE MCO
TAX WHICH EXPIRED AT THE
BEGINNING OF THIS YEAR BECAME
ONE OF THE FOCAL POINT. BECAUSE
THE GOVERNOR HAD IT IN HIS
BUDGET IN JANUARY BUT CONSISTENT
WITH WHAT WE'VE DONE IN THE
PAST- THE M. AT THE MCO TAX- IS
UTILIZED IT'S A IT'S A TAX IT'S
A TAX ON ON MANAGED HEALTH CARE
SYSTEMS- WHICH IS THE INSURANCE
WE ALL PAY AND- BECAUSE OF THAT
TAX WE PULL DOWN. ADDITIONAL
FEDERAL RESOURCES- SO IT HAS TO
BE CRAFTED VERY VERY CAREFULLY.
AND AND IT IT. THE WAY THAT IT'S
WORTH IT WORKS PRACTICALLY IN A
REALLY SIMPLISTIC WAY IS IT IS
IT GOES STRAIGHT INTO THE
GENERAL FUND AND IT BACK FEELS
GENERAL FUND PAYMENTS FOR HEALTH
CARE. SO IT IT IT IT THERE WAS
SOME EXTRA BUT NOT MUCH AND WHEN
WE STARTED TALKING ABOUT HOW
THIS TAX SHOULD BE STRUCTURED.
MEETING WITH ALL OF THE
DIFFERENT- ORGANIZATIONS WITH
THE UNIONS WITH THAT- THAT- THE-
HEALTH CARE PROVIDERS THE
DOCTORS THE HOSPITALS- IT
EVERYBODY FELT VERY STRONGLY
THAT THE MONEY SHOULD COME BACK
IN THE HEALTH CARE- BECAUSE WHAT
WE DID IS WE EXPANDED THE NUMBER
OF PEOPLE THAT WERE COVERED BY
MEDICARE. BUT WE DID NOTHING TO
BOLSTER THE SYSTEM TO CHANGE IT
AND TO MAKE SURE THAT PEOPLE HAD
PRIMARY KERR- OPTIONS RATHER
THAN USING THE HOT THAT
EMERGENCY CARE AT THE HOSPITAL
FOR THEIR- FIRST LINE OF-
PRIMARY CARE. WAY TOO EXPENSIVE
INEFFICIENT AND IT DOESN'T WORK
MADERA HOSPITAL HAD THREE
CLINICS- BUT WHEN THEY CLOSER
HOSPITAL A CLOSED EVERYTHING
BECAUSE I COULDN'T AFFORD TO
KEEP ANY OF IT OPEN AND SO THEY
THE THAT THAT IMPACTS ARE NOT
JUST THE HOSPITAL PATIENTS AT
THE CLINIC PATIENTS. AND THEN
WHAT CAME TO LIGHT IS IT
INCLUDED THE NURSING STUDENTS
THAT WE'RE GOING TO THE
COMMUNITY COLLEGES AND NEEDED. A
PLACE TO GET THEIR- THEIR OUR
INTO. WE HAVE THE- WHILE WE'RE
TRYING TO- EXPAND THE MEDICAL.
SCHOOL AT UC MERCED AND IT
FRESNO STATE WHICH HAS BEEN A
GREAT PARTNERSHIP WITH UC SAN
FRANCISCO- THEIR MEDICAL SCHOOL.
WHILE WE'RE DOING THAT WERE
LEADING THAT MEDICAL SYSTEM
COLLAPSE UNDERNEATH OUR
OURSELVES AND SO- THIS IS A WORK
IN PROGRESS- THE- THERE'S A
GROUP THAT IS WORKING ON PUTTING
THIS. IS SOMETHING ON THE BALLOT
THE CHALLENGE IS PUTTING
SOMETHING ON THE BALLOT YOU
CAN'T CHANGE IT AND THE FEDERAL
GOVERNMENT HAS RULES AND
REGULATIONS WE HAVE TO FOLLOW.
IN ORDER TO PULL DOWN EXTRA
FUNDS SO WE NEED TO BE NIMBLE ON
THIS- SO THIS IS THIS IS THE
PLACE HOLDER AND THERE'S A LOT
ABOUT THE WORK I'LL COME BACK
SOME OTHER TIME WE'LL TALK ABOUT
THE OTHER THINGS WE'RE WORKING
ON BUT- THIS IS CRITICALLY
IMPORTANT- TO. REALLY LOOK AT-
THE KINDS OF THINGS THAT WE
COULD DO WITH THIS SO FOR
EXAMPLE TO TAKING SETTING UP A
DIFFERENT SYSTEM FOR MENTAL
HEALTH. FIFTY ONE FIFTIES RATHER
THAN THEM GOING TO THE HOSPITAL
TO GO TO ANOTHER HEALTHCARE
FACILITY GET TRIAGE AND GO
SOMEWHERE ELSE- IT TUITION
REIMBURSEMENT FOR. I'D AREAS
THAT ARE HAVE A LACK OF WITH
PEOPLE THEY GO TO AREAS THAT
HAVE A LACK OF HEALTH CARE
OPTIONS. IF PEOPLE GO TO WORK
THEIR NURSES AND DOCTORS SO
THERE'S THAT THERE'S A WAY THAT
WE CAN USE THIS TO REALLY
BOLSTER AND CHANGE OUR HEALTH
CARE SYSTEM AND I'M HOPING WE
GET THERE SO. WITH THAT- I WOULD
ASK FOR YOUR AYE BUT TODAY. AND
I AM AGAIN APOLOGIZE TO SOCCER
THE ROAD OF SOME REALLY NICE
NOTES AND THEN I JUST DIDN'T USE
THEM AT ALL. WHICH YOU KNOW
MAKES OUR STUFF TO GET USED TO
THAT YEAH. THE WHOLE I KNOW AND
SO WITH. WITH ME ALWAYS ALWAYS
HELPFUL WE LOVE THEY'RE
WONDERFUL AND RATE NAY MAKE BASS
HELP ME ORGANIZE- WITH ME TODAY
IS KATHERINE SCOTT WITH
CALIFORNIA HOSPITAL ASSOCIATION
AND PHYLLIS BALTZ. WHO'S
PRESIDENT OF THE METHODIST
HOSPITAL. OF SACRAMENTO. MISKA I
CALIFORNIA HOUSE SAYS HE WANT TO
BE BECAUSE DO YOU FOLLOW THAT.
WHEN YOU HAVE A ATTIC AS STRONG
FOR OUR HOSPITALS AND THERE'S
TRUST THERE AND- I'LL JUST GO
OVER A FEW STATEWIDE NUMBERS AND
THEN HONESTLY DEFERRED OR
WITNESS TO. OUR REPRESENTS ONE
OF THE LARGEST MEDICAL PROVIDERS
IN THE STATE- FEW NUMBERS FOR
HOSPITALS. ARE FROM TWENTY
NINETEEN WE'VE LOST ABOUT TWENTY
BILLION DOLLARS EXCLUDING THE
MONEY- THAT CAME FROM THE FEDS
FOR. FOR COVERT RELIEF SO- THAT
THAT THAT THAT'S OUR NET LOSS
OVER THE LAST THREE YEARS. I TWO
HUNDRED OF OUR ROUGHLY FOUR
HUNDRED HOSPITALS ARE OPERATING
IN THE RED CURRENTLY TWENTY I
TWENTY TWO WAS ONE OF OUR WORST
YEARS IN THE LAST THREE YEARS-
RESULTING ABOUT ONE FOOT ONE IN
FIVE OF OUR HOSPITALS AT RISK OF
CLOSURE. I'M NOT ONLY ARE THOSE
NUMBERS COMING. ADD UP THE
NUMBERS IN THE NEGATIVE- BUT
BECAUSE OF THE 19% INCREASE IN
FARM ACROSS THE 18% INCREASE IN
MEDICAL SUPPLY COSTS. AND THE
2222% INCREASE IN LABOR COSTS WE
DON'T SEE THOSE NUMBERS THOSE
NEGATIVES- OPERATING MARGINS
COMING DOWN. SO FOR US THE MCO
TAX REPRESENTS AN OPPORTUNITY-
TO SUSTAIN THE FIELD IN THE LONG
TERM AND SOME OF THE
CONVERSATIONS WE'VE HAD WITH
SENATORS. THERE ARE NOT ONLY
WORRIED ABOUT THE SHORT BUT
THEY'RE REALLY WORRIED ABOUT THE
LONG TERM NOT ONLY AGAIN FOR
HOSPITALS BUT FOR PRIMARY CARE
PROVIDERS ARE E. OURS ARE
OVERLOADED RIGHT NOW BECAUSE WE
DO NOT HAVE PRIMARY CARE
PROVIDERS AND SPECIALISTS. SO
THIS IS AGAIN REPRESENTS A GREAT
OPPORTUNITY TO ASSIST IN THE
HEALTHCARE FIELD AND INVESTED A
TIME WHEN WE NEED IT. BUT I DO
WANT TO MAKE SURE THERE'S TIME
FOR AN ACTUAL PROVIDER. THANK
YOU VERY MUCH. NEXT PERSON. GOOD
AFTERNOON CHAIRING COMMITTEE
MEMBERS I'M PHYLLIS BALTZ CEO OF
METHODIST HOSPITAL AT SOUTH
SACRAMENTO. I AM PLEASED TO BE
HERE TODAY REPRESENTING MY
HOSPITAL AND THIRTY ONE OTHER
DIGNITY HEALTH HOSPITALS IN
CALIFORNIA THIS IS IMPORTANT
BILL FOR HEALTH SYSTEM. OUR
SYSTEM PROVIDES THE FULL ARRAY
OF HEALTH SERVICES INCLUDING
PRIMARY CARE SPECIALTY CARE
AMBULATORY SERVICES AND ACUTE
CARE SERVICES. WE ARE A CRITICAL
COMMUNITY PROVIDER IN MANY
COMMUNITIES THROUGHOUT THIS
STATE SERVING URBAN RURAL AND
SUBURBAN AREAS. AS THE LARGEST
PRIVATE PROVIDER OF MEDICAL
SERVICES IN THE STATE. DIGNITY
HEALTH CONSIDERS ITSELF A
LONGTIME PARTNER IN PROVIDING
ACCESS TO MEDICARE
BENEFICIARIES. WE PROVIDE NEARLY
10% OF THE PROGRAM SERVICES
ANNUALLY WE HAVE PROVIDED MORE
THAN SIX HUNDRED THOUSAND
INPATIENT DAYS AND ONE POINT TWO
MILLION OUTPATIENT VISITS. FOR
DECADES STAGNANT DIGNITY HEALTH
HAS WORKED TO STRENGTHEN THE
MEDICARE PROGRAM FOR THE
PATIENTS THAT WE SERVE. EACH
YEAR AFTER ALL SUPPLEMENTAL
PAYMENTS INCLUDING THE HOSPITAL
QUALITY ASSURANCE FEE DIGNITY
HEALTH LOSES MORE THAN HALF A
BILLION DOLLARS BASED ON OUR
COSTS OF PROVIDING CARE TO
MEDICARE BENEFICIARIES. LIKE
OTHER HEALTH CARE PROVIDERS
THOSE LOSSES ARE NOT
SUSTAINABLE. AND WILL ULTIMATELY
RESULT IN DECLINING SERVICES FOR
MEDIC CAL PATIENTS OR
LIMITATIONS IN PROGRAMS AND
SERVICES THAT ARE CRITICAL TO
OUR PATIENTS. OUR HOSPITALS AND
CLINICS ARE THE LIFELINE FOR
MANY COMMUNITIES. WE ALSO
PARTNER WITH OTHER HOSPITALS
THROUGHOUT THE STATE TO ENSURE
SERVICES ARE PROVIDED TO
MEDICARE RECIPIENTS. AS COSTS
HAVE RISEN CONSIDERABLY
ESPECIALLY AS A RESULT OF CODED
. WE MUST SEEK A SOLUTION THAT
WILL IMPROVE AND SUSTAIN MEDICAL
SERVICES BY SUPPORTING THE
PROVIDERS FOR THE CARE OF THESE
PATIENTS DAILY. THE MCO FUNDS
BEING DISCUSSED IN SENATE BILL
EIGHT SEVENTY NEED TO STAY IN
THE SYSTEM SUPPORTING OUR
PATIENTS AND THOSE THAT WE CARE
FOR. I RESPECTFULLY ASK FOR YOUR
SUPPORT OF SB EIGHT SEVENTY.
THANK YOU VERY MUCH HEBRAEUS
WISHING TO SPEAK IN SUPPORT OF
THIS BILL. SEEING NONE
OPPOSITION OR TWEENER. THE
TWEENER. THANK YOU MADAM CHAIR
AND MEMBERS I NICK LOUISE US ON
BEHALF OF THE CALIFORNIA
ASSOCIATION OF HEALTH PLANS AND-
THANK YOU- AND THANK YOU MADAM
CHAIR AND TO THE AUTHOR FOR
BEING GRACIOUS IN ALLOWING ME TO
MAKE COMMENT TODAY ON. SB EIGHT
SEVENTY WE DON'T HAVE A SUPPORT
OR OPPOSE POSITION ON THE BILL
BUT SINCE- OUR ASSOCIATION
MEMBERS ARE THE ONES THAT ARE
PAYING THE TAX WE THOUGHT WE'D-
A PROVIDER VIEW ON YOU KNOW
WHERE WE'RE AT THE CURRENT
MOMENT SO THANK YOU VERY MUCH-
SO AS MANY OF YOU KNOW IN THE
PAST. CAP IN CALIFORNIA'S HEALTH
PLANS HAVE SUPPORTED- EVER
CHANGING ITERATIONS OF THE MCO
TAX. BECAUSE OF THE SUBSTANTIAL
OF FEDERAL MATCHING FUNDS AND
OTHER ISSUES- AS WE'VE DONE IN
YEARS PAST WE'RE CURRENTLY
WORKING WITH THE STATE- IN THE
TASK AHEAD OF US IS MADE THAT
MUCH HARDER BY- EVERY EVOLVING
FEDERAL GUIDANCE AND AN
INTERPRETATION OF THAT GUIDANCE
ON THIS ISSUE- OUR POSITION ON
THE TAX- IN THE PAST AND
ULTIMATELY MOVING FORWARD-
CONTINUES TO BE BASED ON SOME
FUNDAMENTAL PRINCIPLES SO. WE
BELIEVE THAT THE MCO TAX MUST
DIRECTLY BENEFIT AND ENHANCE
SERVICES IN A MEDICAL PROGRAM-
IN OTHER WORDS THE REVENUE
SHOULD BE USED TO SUPPLEMENT AND
NOT SUPPLANT FUNDING IN THE
MEDICARE PROGRAM- THE TAX MUST
BE AFFORDABLE FOR THE EMPLOYERS
AND INDIVIDUALS THAT ARE
PURCHASING COVERAGE. IN A MUST
BE PREDICTABLE STABLE AND AS
EQUITABLE AS POSSIBLE. YOU KNOW
OTHER HELP BELIEVE THAT- THE
REVENUE SHOULD BE INVESTED IN
AREAS THAT ARE OF DIRECT BENEFIT
TO BENEFICIARIES IN MEDICARE
ALL. ON INCLUDING PRIMARY CARE
SPECIALTY CARE- DATA SHARING
CAPABILITIES AND GRADUATE
MEDICAL EDUCATION ASSISTANCE-
ARE MEMBER PLANS IN THEIR
CUSTOMERS PERCHING SEEM COVERAGE
IN THE COMMERCIAL MARKETS ALSO
NEED CONFIDENCE THAT THE TAX
WILL BE STABLE AND PREDICTABLE-
WE BELIEVE THAT. THAT THERE MUST
BE FEDERAL APPROVAL OF THE TAX
IN THAT THERE MUST BE FEDERAL
MATCHING FUNDS ASSOCIATED WITH
IT- THE STATE SHOULD HAVE TO GO
BACK TO THE LEGISLATURE IF THERE
ARE CHANGES TO THE TAX AS A
RESULT OF NEGOTIATIONS BETWEEN
THE STATE AND FEDERAL
GOVERNMENTS- IN THE STATE SHOULD
BE REQUIRED TO PROVIDE SOME SORT
OF RECONCILIATION OF THE REVENUE
AND HOW IT'S BEING. SPENT IN THE
MEDICARE PROGRAM. SO IF YOU KNOW
ALL STOP THERE AND I JUST WANT
TO GET AND THINK THAT YOU'RE IN
THE OFFICE FOR LETTING ME SPEAK
ON THIS BILL EVEN THOUGH WE
DON'T HAVE A CLEAR CUT POSITION
ON IT. BUT I THINK IT'S
IMPORTANT FOR US TO BEGIN THE
DISCUSSION HERE TODAY SO THANK
YOU FOR YOUR TIME. THANK YOU FOR
CREATIVELY GETTING AWARDS OUT
THERE. OKAY ANYONE WISHING TO
SPEAK IN OPPOSITION COME FORWARD
NEWMAN FILIATION. BLOW UP
MATTRESS A ABOUT ESSAY YOU WE
DON'T HAVE A POSITION SIMILAR TO
CAP IT JUST WANNA REALLY
STRESSED THE NEED WITH THE MC ON
THE NEED TO INVEST IN THE WORK
FORCE. THANK YOU THANK YOU VERY
MUCH. ELSE I GIVE YOUR INPUT ON
MCO. OKAY SEEING NONE ON BRING
IT BACK THE COMMITTEE FROM THE-
SENATE ROTH. THANK YOU MA'AM
SURE YOU KNOW I'M- HEALTH CARE
IN RURAL AREAS IS A VERY
DIFFICULT ISSUE. PARTICULARLY
WHERE WE ARE IN A STATE WHERE-
IF YOU HAVE A HOSPITAL IT AS I
RECALL IT NEEDS TO BE A FULL
SERVICE HOSPITAL WITH FULL
SERVICE LINES. A VERY DIFFICULT
TO STAFF VERY DIFFICULT TO PAY
FOR BUT- WE HAVE THE SYSTEM THAT
WE HAVE SO I THINK I'M OBVIOUSLY
FULLY SUPPORTIVE OF THIS MCO TAX
A MEASURE AND- LOOK FORWARD TO
SEEING WHAT. THE ADMINISTRATION
PROPOSES A FURTHER PROPOSES IN
THE BUDGET. BUT I THINK WE
CERTAINLY NEED TO ANALYZE THE
IMPACT OF THE A MEDIC CAL.
REIMBURSEMENT RATE INCREASES AND
PERHAPS TARGETED RATE INCREASES
IN RURAL AREAS. AND TO SEE WHAT
ACTUALLY WE NEED TO HAVE IN
TERMS OF AN INCREASE. TO MAKE
HEALTH CARE AND HOSPITAL
OPERATIONS SUSTAINABLE IN THESE
RURAL A RULER IS IN PERHAPS IN
NON RURAL AREAS AS WELL. I THINK
WE NEED TO. TO KNOW WHAT WE NEED
TO DO IN ORDER TO STABILIZE THE
HEALTHCARE DELIVERY SYSTEM. IN
AREAS LIKE MADERA AND OTHER
AREAS IN THE CENTRAL VALLEY AND
SOME IN. INLAND SOUTHERN
CALIFORNIA AND I'M SURE SOME IN.
NORTHERN CALIFORNIA AS WELL.
IT'S IMPORTANT TO BE ABLE TO.
THEY WERE ABLE TO DELIVER.
HEALTH CARE AND FULFILL THE
PROMISE THAT WE'VE MADE WITH THE
MEDIC CAL EXPANSION. AND THAT'S
GOING TO REQUIRE INVESTMENT
RESOURCES IN THIS MCO TAX SHOULD
PROVIDE THAT. BUT WE NEED TO I
THINK WE NEED TO KNOW WHAT WE
NEED TO HAVE. AT THE HOSPITAL
CERTAINLY IN ORDER TO MAKE THOSE
HOSPITALS STABLE. SO THANK YOU
FOR BRINGING THIS AND THANK YOU
MADAM CHAIR FOR LET ME- MAKE A
COUPLE COMMENTS OF COURSE THANK
YOU VERY MUCH. AND ANYBODY WHO
IS SET DOWN. I THINK AND TALK
ABOUT M. C. OVERALL SAID ABOUT
THE NEED FOR THE- INCREASE IN
MEDICARE REIMBURSEMENT TO MAKE
IT SUSTAINABLE. WE CAN ACTUALLY
PROVIDE THE CARE THAT WERE
PROMISING TO PEOPLE- SCENERY
ELSE WOULD YOU LIKE TO CLOSE.
THANK YOU VERY MUCH I APPRECIATE
THEM I JUST. I DO YOU NEED TO GO
TO THE THINK I NEED TO GO THE
PHONES PHONES NOT RAIDERS IS
THERE ANYBODY ON THE PHONE IN
THE QUEUE. EIGHT SEVEN ONE IF
YOU WISH ASKING IF YOU WISH TO
MAKE A COMMON. AND SUPPORT OR UP
THIS PLEASE PRESS ONE THEN ZERO
. THERE'S CURRENTLY NO ONE
QUEUING UP AT CHECK. THANK YOU
VERY MUCH SEE WE KNEW IT. OKAY
WOULD YOU LIKE TO CLOSE. THE LET
ME JUST SAY THAT I REALLY
APPRECIATE THE COMMENTS THAT
WERE MADE. IN BOTH IN FAVOR AND
IN IN BETWEEN- FOR ALL WORKING
REALLY HARD TOGETHER AND I
WANTED KNOWLEDGE THAT. CALF HE
CAME- AND BASICALLY SAID WE WANT
TO BE A PARTNER AND- AND I WANT
TO THANK THEM FOR THAT BECAUSE-
THEY ARE THE ONES THAT GET GET.
GET TAXED AND THEY COME TO THE
TABLE BEFORE AND IT DID IT'S
WHAT IT'S GOING TO TAKE YOUR FOR
GOING TO BE ABLE TO FIGURE THE
FIGURE THIS THING OUT. IT'LL BE
A TWO THIRDS VOTE- WHETHER IT'S
DONE IN THE BUDGET OR IT'S DONE
IN A SEPARATE BILL- IT'S GOT TO
PROVIDE THE REAL RELIEF THAT WE
NEED AND IT'S GOT THERE ARE A
MYRIAD OF ISSUES THAT I THINK.
CAN BE TACKLED AT THE SAME TIME
THAT'LL MAKE IT THE SYSTEM WORK
MUCH BETTER AND SO- IT'S MY HOPE
THAT WE CAN GET THERE. IT'S
TOUGH TO BE DOING THIS PROBABLY
SHOULD HAVE BEEN A TWO YEAR BILL
THAT WE WORK ON REALLY HARD TO
MAKE SURE EVERYBODY'S AT THE
TABLE WE GOT TO GET IT DONE NOW
AND SO- WITH THIS EXPEDITED
PROCESS- I NEED EVERYBODY TO
KIND OF COME TOGETHER AND GET
THINGS DONE BECAUSE- THE- I'D-
APPRECIATE AT CENTER ROTH YOUR
YOUR COMMENTS THE BOTTOM LINE IS
THAT. THERE ARE A NUMBER IN THE
URBAN AREAS AS WELL THAT ARE
THAT ARE AT RISK AS MATTER FACT
ONE IT'S- AND NOW. HERE
MONTEBELLO IT'S IN THAT THAT
REGION IN A SENATOR TO LET US
DISTRICTS SO- IT THAT IT'S
HITTING US ALL- VERY HARD AND
WITH THAT I. RESPECTFULLY ASK
YOUR AYE VOTE TODAY THANK YOU
VERY MUCH. THANK YOU SPENDING
TIME WITH THE COMMITTEE. TODAY
THANK YOU I APPRECIATE IT. OKAY
WAS LOADS OF FUN YEAH. WE ALL
ENJOYED IT. OKAY. OUR SIR
BACKERS UP. HE'S NOT HE- HE'S IS
THERE THERE IS A IS OKAY.
FRANCIUM ALRIGHT. BACK. GOOD
AFTER. THAT AND MEMBERS.
CALIFORNIA PUBLIC DISTRICT
HOSPITALS SURE SOME CALIFORNIA'S
MOST DIVERSE. AND UNDERSERVED
POPULATIONS. ARE THE MOST LOCAL
FORM OF PUBLIC HOSPITAL. BUT
DESPITE BEING THE SOLE OR CLOSE
A SOURCE OF HEALTH CARE. FOR
MANY FAMILIES AND SENIORS. THIS
ACOSTA WAS ARE ARE THE ONLY
PUBLIC HOSPITALS THAT ARE NOT
ALLOWED TO DIRECTLY EMPLOY
PHYSICIANS. THIS HURTS ABILITY
PRIDE SERVICES TO THE LARGELY
UNDERSERVED PATIENTS AT DISTRICT
HOSPITALS ARE ARE GENERALLY ARE
THE RURAL. AND STRUGGLE TO
RECRUIT PHYSICIANS WAR IN URBAN
AREAS WERE HIGH COST OF LIVING
MAKE IT DIFFICULT TO RECRUIT AND
RETAIN PHYSICIANS. DREXEL
EMPLOYMENT RIGHTS WAY TO
COMPETE. WITH LARGER LEE AND TO
GIVE IN OR WITH LARGE LABOR
MARKETS OPPOSITION'S BENEFITS
THAT MAKE WORKING A PUBLIC
HOSPITAL MORE ATTRACTIVE. LIFE
IS TO CHOOSE DIRECT EMPLOYMENT
THIS BE CHOICE IN THIS CASE. I
STRICTLY TRACTORS DOCTORS COMING
OUT OF RESIDENCY WERE RELOCATED
TO OTHER STATES WERE DIRECT
PLYMOUTH SESSIONS WERE COMMON.
AND WOULD PREFER TO RECEIVE A
SET SALARY BENEFITS AND HOURS
WELL SO HAVING THEIR CLINICAL
TIME TO ME AS PHYSICIANS
RESPECTED. ABSENCE CHANGES ROSS
WAS MUSKIE TO RELY SOLELY ON
CONTRACTING POSITION GROUPS OR
INDIVIDUAL DOCTORS MAYBE
CHRISLEY DIFFICULT INSURE THEY
CAN TRY TO CENTRAL CARE TO THOSE
WHO NEED IT MOST AND AS
MENTIONED I SENT HER DAUGHTER
BROUGHT UP THE ISSUE WITH OUR-
THE- TO OUR OFFICE WERE. MEETING
WITH HER IN. JUST BECAUSE AGAIN
THIS BILL IS NOT MEANT TO
ENCOURAGE CORPORATE INFLUENCE.
AT ALL IN ANY WAY- AND- WE
CERTAINLY AGREE THAT MAKING SURE
THE CENTER ON THE NEEDS OF THE
PATIENTS. RATHER THAN FINANCIAL
INTERESTS- REPORT MEMBERS OR
OTHER NEEDS THE COMMUNITY- IS
PREEMINENT I'M WITH THAT WE HAVE
TO DO IT WITNESSES TO ENHANCE
AND FROM THIS YEAR PALOMAR
HEALTH. AND THEN AND DR CARMEN
ARE CLEARLY FROM WASHING
HOSPITAL ICU MEDICAL. CENTER
THANK YOU. FOR SUPPORT PLEASE.
SENATOR THANK YOU. MADAM CHAIR
AND COMMITTEE MEMBERS GOOD
AFTERNOON AND I APPRECIATE THE
OPPORTUNITY TO BE HERE TODAY.
TODAY PALOMAR IS THE LARGEST
HEALTH CARE DISTRICT IN THE
STATE ENTRUSTED TO CARE FOR MORE
THAN HALF A MILLION RESIDENTS.
OUR ROOTS ARE TRACED TO HUMBLE
BEGINNINGS IN NINETEEN THIRTY
THREE WHEN TO COMPASSIONATE
WOMEN LEFT THEIR JOBS TO
ESTABLISH A THIRTEEN BED
HOSPITAL. TO SERVE THE SMALL
FARMING COMMUNITY OF ESCONDIDO.
ALOMAR'S EXISTENCE IS CLOSELY
TIED TO COMMUNITY AS MOST
DISTRICT HOSPITALS ARE. DISTRICT
HOSPITALS ARE THE SAFETY NET WE
ARE PROVIDERS FOR PEOPLE WHO
FACE SOCIAL FINANCIAL AND ACCESS
BARRIERS TO CARE. NEARLY 60% OF
PATIENTS IN OUR BEHAVIORAL
HEALTH PROGRAMS OR THOSE
RECEIVING OB SERVICES ARE ON
MEDICARE. WE ARE ALSO OPERATING
IN ONE OF THE LEAST AFFORDABLE
AREAS IN THE COUNTRY WE'RE
HOUSING GAS AND UTILITIES MAKE
OUR COST OF LIVING. 44% HIGHER
THAN THE NATIONAL AVERAGE. WELL
DISTRICT HOSPITALS ARE TYPICALLY
LOCATED IN EITHER UNDERSERVED
HIGH COST OF LIVING SUBURBAN
AREAS. PALOMAR IS POSITIONED IN
BOTH. DESPITE SERVING AS THE
SAFETY NET DISTRICT HOSPITALS
ARE THE ONLY PUBLIC HOSPITALS
PROHIBITED FROM DIRECTLY
EMPLOYING PHYSICIANS. AS A
RESULT WE ARE AT A SEVERE
DISADVANTAGE FOR RECRUITMENT AND
RETENTION. DIRECT EMPLOYMENT
PROVIDE STABILITY FOR RELOCATING
PHYSICIANS SINCE IT TAKES TIME
TO BUILD A PATIENT BASE. RIGHT
NOW THEIR INCOME IS DEPENDENT ON
BILLINGS WHICH IS TOO RISKY WHEN
RELOCATING TO UNDERSERVED AND
HIGH COST OF LIVING AREAS. THERE
IS NO WAY FOR US TO AFFECT THE
CLINICAL JUDGMENT OF OUR
PROVIDERS. NOR WOULD WE WANT TO.
AS A DISTRICT HOSPITAL OUR ONLY
GOAL IS TO PROVIDE CARE TO OUR
COMMUNITY AS DEMONSTRATED BY OUR
CONTINUED EXPANSION OF SERVICES.
TO MEET THE NEEDS OF OUR
DISTRICT REGARDLESS OF
PROFITABILITY OF THESE SERVICES.
SB SEVEN EIGHTY FOUR IS ABOUT
EQUITY ACROSS PUBLIC HOSPITALS
AND IS A MODEST APPROACH TO
ALLOW A SMALL NUMBER OF
HOSPITALS A TOOL THAT HAS PROVEN
TO BE EFFECTIVE. FOR THESE
REASONS WE RESPECTFULLY ASK FOR
YOUR AYE VOTE. THANK YOU THANK
YOU VERY MUCH. NEXT UP DR
WELCOME. GOOD AFTERNOON MADAM
CHAIR. MEMBERS OF THE COMMITTEE
AND TO ALL OF. OUR AGENTS. THANK
YOU FOR THE OPPORTUNITY TO SPEAK
TODAY IN SUPPORT OF SB SEVEN
EIGHTY FOUR I'M DR CARMINA
REALLY I'M THE MEDICAL DIRECTOR
OF THE CRITICAL CARE UNIT. AT
WASHINGTON HOSPITAL HEALTHCARE
SYSTEM. A PUBLIC DISTRICT
HOSPITAL IN FREMONT CALIFORNIA.
I'M A PULLMAN KNOWLEDGES AND
INTENSITIES BY PROFESSION AND
WITH MY TEAM I SPECIALIZE IN
CARING FOR THE MOST CRITICALLY
ILL PATIENTS. AT THE DISTRICT
HOSPITAL WHERE. WE FOLLOW THE
PATIENT FIRST AT THE WE FOCUS ON
WHAT IS BEST FOR THE PATIENT BY
PROVIDING HIGH QUALITY CLINICAL
CARE. I'VE BEEN UP WASHINGTON
FOR THE LAST THIRTY THREE YEARS.
SEVENTEEN IN PRIVATE PRACTICE
AND SIXTEEN IN THE LARGE MEDICAL
GROUP. LOCALLY GOVERNED AND
PUBLICLY ACCOUNTABLE MY DISTRICT
HOSPITAL IS RESPONSIVE TO OUR
COMMUNITY HEALTH NEEDS. DURING
THE PUBLIC HEALTH EMERGENCY
WASHINGTON HOSPITAL WORK WITH
THE C. TO FREMONT TO OFFER FREE
CALL THE NINETEEN TESTING AND
LAUNCH. A MOBILE TESTING UNIT
FOR SENIOR LIVING FACILITIES. TO
DATE NURSES HAVE GIVEN ALMOST
HUNDRED THOUSAND COLBY. NINETEEN
VACCINATIONS TO THE RESIDENTS OF
SOUTHERN ALAMEDA COUNTY. I'M
HERE TODAY. DO RESPECTFULLY ASK
YOUR SUPPORT. FOR SENATOR
BACKERS BILL SB SEVEN EIGHTY
FOUR THIS BILL WILL PROMOTE A
SHOW READY HEARD HEALTH EQUITY
AND ACCESS FOR ALLOWING DISTRICT
HOSPITAL TO DIRECTLY EMPLOYED
PHYSICIAN. I THINK STANDS TODAY
MR COSTNER'S US YOU'VE HEARD I
THE ONLY PUBLIC HOSPITAL BARRED
FROM EMPLOYING PHYSICIANS UNLIKE
COUNTY HOSPITALS CHILDREN'S
HOSPITALS AND ACADEMIC MEDICAL
CENTERS. SB SEVEN EIGHTY FOUR
WOULD PROVIDE AN IMPORTANT TOOL
TO DISTRICT HOSPITAL TO RECRUIT
AND RETAIN HIGHLY SOUGHT AFTER
SPECIALTY. PHYSICIANS TO SHARE
COVERAGE. AND ALSO PREVENT
PHYSICIAN BURNOUT. WHEN I TALK
WITH MY PHYSICIAN COLLEAGUES WE
ALL AGREE THAT WHAT KEEPS US UP
AT NIGHT IS WHETHER OUR DISTRICT
HOSPITAL WE'LL HAVE ENOUGH
SPECIALTY PHYSICIANS TO TREAT
EVERYONE WHO COMES TO THE
HOSPITAL. CLINICAL PRACTICE
GUIDELINES ARE SET UP BY SELF
GOVERNING INDEPENDENT MEDICAL
STOCK ORGANIZATION. THAT'S
REALLY TO PROTECT THE PATIENT'S
THE STRUCTURE OF THE STATE
HOSPITAL THIS NOT ALLOW
ADMINISTRATORS TO INFLUENCE
THOSE GUIDELINES. I JUST WANT TO
REASSURE YOU. THAT THE HOSPITAL
ADMINISTRATION WOULD NOT HAVE
THE ABILITY TO DIRECTLY TO GO
GET IT PHYSICIANS WERE DIRECTLY
EMPLOYED BY THE HOSPITAL
PHYSICIAN PRACTICE MEDICINE
BASED ON EVIDENCE AND GUIDELINES
SET BY THE RESPECTIVE MEDICAL
SOCIETIES. SB SEVEN EIGHTY FOUR
WOULD SIMPLY GIVE PUBLIC
DISTRICT HOSPITAL LIKE OURS AN
OPTION. THAT OTHER PUBLIC
HOSPITALS CURRENTLY ENJOYS
STRENGTHENING OUR ABILITY TO
PROVIDE ESSENTIAL LOCAL CLINICAL
SERVICES AND TO INCREASE
HEALTHCARE ACCESS. THANK YOU FOR
YOUR TIME TODAY. THANK YOU VERY
MUCH HE WILL SPEAK IN SUPPORT
NOW JUST NAME AND AFFILIATION
PLEASE. THANK YOU ARE MADAM
CHAIR AND MEMBERS THEIR BRIDGE
ON BEHALF OF THE ASSOCIATION OF
CALIFORNIA HEALTHCARE DISTRICTS
HERE AS PROUD SPONSORS OF THE
BILL THANK YOU THANK YOU VERY
MUCH. GOOD AFTERNOON THAT IN
TURN MEMBERS CONNIE DELGADO ON
BEHALF THE DISTRICT HOSPITAL
LEADERSHIP FORUM IN SUPPORT
THANK YOU VERY MUCH NEXT PERSON
PLEASE. GOOD AFTERNOON CHAIR
MEMBERS OF THE COMMITTEE RUBBER
TO GO HERE WITH THE CALIFORNIA
HOSPITAL ASSOCIATION ALSO IN
SUPPORT THANK YOU THANK YOU. I
GOOD AFTERNOON JOHN CALLIN FROM
EL CAMINO HEALTH PROUD TO BE
HERE AND SUPPORT THANK YOU THANK
YOU VERY MUCH. OKAY SEE NOBODY
ELSE APPROACHING THE MIKE NOBLE
GOOD OPPOSITION PLEASE COME
FORWARD LIKE THE- SUPPORTERS YOU
HAVE SIX MINUTES. I THANK YOU
MADAM CHAIR MEMBERS OF THE
COMMITTEE BRANDON MARCHING WITH
THE CALIFORNIA MEDICAL
ASSOCIATION I HEAR AND
RESPECTFUL OPPOSITION TO THE
BILL. A TREMENDOUS AMOUNT OF
RESPECT FOR THE AUTHOR SENATOR
BACKER UNFORTUNATELY- WE DO
THINK THAT THIS BILL I JUST
DOESN'T SOLVE THE STATED PROBLEM
OF GETTING PHYSICIANS INTO THE
COMMUNITIES THAT NEED CARE. I
INSTEAD SEVEN EIGHT SB SEVEN
EIGHTY FOUR WOULD WIPE AWAY LONG
STANDING PROTECTIONS. FOR
PATIENTS. SKINNING ARE FOR
PATIENTS AND PROVIDERS FROM ALL
TERRY MOTIVES SUCH AS PROFITS
SHIFTING CULTURE AND POLITICAL
PRESSURES AND FAITH BASED
BELIEFS WITH CURRENT ATTACKS
ACROSS THE NATION TO CUT
ABORTION AND OTHER REPRODUCTIVE
CHEN. CARE GENDER AFFIRMING
SERVICES AND CORPORATE.
INVOLVEMENT IN HEALTH CARE IS
MORE IMPORTANT THAN EVER TO
DEFEND PATIENTS ABILITY TO GET
THE QUALITY CARE THEY NEED AND
DESERVE. IT IS OUR UNDERSTANDING
THAT THE SENATOR INTRODUCED A
BILL TO ALLOW EL CAMINO HOSPITAL
DISTRICT TO EMPLOY PHYSICIANS.
HOWEVER THE EXEMPTION IS NOT
JUST LIMITED TO EL CAMINO IN
FACT IT APPLIES TO ANY HOSPITAL
DISTRICT WHETHER THEY HAVE OTHER
MEANS TO EMPLOY PHYSICIANS WERE
NOT. A HOSPITAL DISTRICTS
INABILITY TO COME TO NEGOTIATE A
CONTRACT WITH PHYSICIANS THAT
RESIDE IN AND PROVIDE CARE TO
THOSE COMMUNITIES IS NOT A
REASON TO COME TO THE
LEGISLATURE. TO UNDERMINE LONG
STANDING LAW. THAT PROVIDES
PATIENTS WITH THE PEACE OF MIND
THAT WHEN THEY ENTER THEIR
DOCTORS OFFICES THAT DOCTOR HAS
THEIR BEST INTERESTS. AT HEART
NOT THEIR EMPLOYER. RECENTLY AND
OVER THE LAST SEVERAL YEARS
STUDIES AND DATA HAVE SHOWN THAT
HEALTHCARE COSTS RISE
SIGNIFICANTLY WHEN CARE DELIVERY
MOVES FROM INDEPENDENT PROVIDERS
CONTRACTED WITH HOSPITALS AND
OTHER ENTITIES. TO HOSPITAL
EMPLOYED OR EMPLOYED DELIVERY
SYSTEMS. AT A TIME WHERE THE
LEGISLATURE HAS WORKED
TIRELESSLY TO ADDRESS COST AND
RISING PREMIUMS WE THINK IN
ADDITION TO THE CONCERNS THAT I
RAISED BEFORE THIS BILL TAKES A
STEP IN THE WRONG DIRECTION.
ADDITIONALLY THE SAFEGUARDS IN
SB SEVEN EIGHTY FOUR NOT STRONG
ENOUGH TO PROTECT THE PATIENT
PHYSICIAN DECISION MAKING BODY
AN ENTITY. AS THOSE. AS THOSE
ARM UNDUE INFLUENCES ARE
EXTREMELY DIFFICULT TO PROVE THE
CORPORATE PRACTICE OF MEDICINE
BARS AND FORCE VIA A LAWSUIT
OFTENTIMES PROVIDERS ARE SMALLER
ENTITIES AND DO NOT HAVE THE
RESOURCES TO. WITHSTAND THAT
TYPE OF OR SUSTAIN THAT TYPE OF
LAWSUIT AGAINST. A HOSPITAL
SYSTEM OR OTHER CORPORATE
INTEREST. AT A MINIMUM THE BILL
SHOULD REQUIRE A REPORT FROM THE
DEPARTMENT OF HEALTH CARE ACCESS
AND INFORMATION TO SEE HOW OFTEN
THE EXEMPTION IS USED. THERE ARE
QUITE THE RECRUITMENT AND
RETENTION RATE OF PHYSICIANS AT
THE HOSPITAL FROM OUTSIDE THE
COMMUNITY SINCE THERE IS A-
SENSE THERE IS A CHARGE THAT
THERE ARE NOT ENOUGH PHYSICIANS
WITH IN THE COMMUNITY. AND TO
ASSESS THE IMPACT ON PATIENT
PHYSICIAN DECISION MAKING. TO
REALLY ADDRESS THE ISSUE AND I
KNOW THAT THE MEMBERS OF THIS
COMMITTEE WHICH SCOTT DONE WITH
AN MCO TAX DISCUSSION BUT TO
REALLY ADDRESS THE ISSUE OF
PHYSICIAN RECRUITMENT AND
RETENTION IN RURAL AND
UNDERSERVED COMMUNITIES
CALIFORNIA MUST ADDRESS PUBLIC
PAYER REIMBURSEMENT RATES. THE
ABILITY OF A HOSPITAL AND
PHYSICIAN BE PAYER AGNOSTIC AND
NOT LOSE MONEY ON A MEDIC CAL
VISIT IS CRUCIAL. TO FINALLY
DECISIONS ABOUT PATIENT CARE.
REGARDLESS OF THE SERVICE SHOULD
BE INSULATED FROM PROFITEERING
OR POLITICAL MOTIVES SB SEVEN
EIGHTY FOUR WOMEN WOULD
ELIMINATE THE CURRENT BULL WORK
THAT ENSURES THAT CARE DECISIONS
ARE MADE IN THE BEST INTERESTS
OF PATIENTS. AND ARE NOT
ENCUMBERED BY ULTERIOR MOTIVES
WE RESPECTFULLY REQUEST YOUR
NOVEL. THANK YOU VERY MUCH MR
MARSHY AREAS WEEKS BEGIN A IN
OPPOSITION TO THIS BILL. COME
FORWARD. SEEING NONE. OF THE
MODERATOR ANYBODY IN THE QUEUE
FOR ON THIS BILL. AND IF YOU
WISH TO MAKE A COMMENT IN
SUPPORT OR OPPOSITION PLEASE
PRESS ONE AND. ZERO
IS CURRENTLY KNOWN QUEUING UP AT
THIS TIME MANAGER THANK YOU VERY
MUCH IT WOULD BE THE TIME WOULD
BRING IT BACK TO THE COMMITTEE
FOR ANY QUESTIONS COMMENTS AND
OR LONG. THANK YOU AND I KNOW
WE'VE HAD A LITTLE BIT OF BACK
AND FORTH ON THIS AND SO. I WAS
JUST A LITTLE CONFUSED- ONE OF
YOUR WITNESSES WHO IS A
PHYSICIAN AND ON THE OTHER HAND-
PHYSICIANS OPPOSING US AND I'M
TRYING TO UNDERSTAND. UNDER WHAT
CIRCUMSTANCES AND CONDITIONS
THIS HELPS SOME DOCTORS AND THIS
IS A CONCERN TO DOCTORS. AND
I'VE READ BOTH THE BMP ANALYSIS.
AND THIS ONE AND THAT THE HEALTH
CARE HOUSES TO TRY TO FIGURE OUT
AND ARGUMENTS. THE SAME GROUP OF
PEOPLE ARE MAKING ARGUMENTS IN
SUPPORT OF THE BILL BUT ALSO
OPPOSED TO THE BILL AND I'M
TRYING TO FIGURE OUT WHICH ONE.
IT IS AND UNDER WHAT CONDITIONS
THE SAME GROUP OF PEOPLE WOULD
FEEL DIFFERENTLY LIKE WHAT ARE
THE CONDITIONS AND I'M HAPPY TO
. YOU KNOW WITH ONE EYE IF YOU
OR ONE OF YOUR SPONSORS OR
ANYBODY- IT'S JUST ONE OF THE
PIECES THAT I'VE NOT BEEN. AS
CERTAIN ABOUT- YOU KNOW IS I'VE
TRIED TO KIND OF GRAPPLE WITH
THIS- AND ALSO RECOGNIZING THAT
I HAVE A DISTRICT WITH CRITICAL
ACCESS HOSPITALS THAT HAVE. RATE
THIS EXEMPTION OR THIS THIS
ABILITY TO DO SOME OF WHAT
YOU'VE ASKED- IN THIS BILL SO
JUST. FIGURE OUT WHAT I THINK IS
A COUPLE THINGS I THINK YOU
KNOW- THERE'S SEVERAL POINTS
THAT WERE RAISED INITIALLY WITH
THE LAST ONE ABOUT MEDICARE
REIMBURSEMENT RATES IN MAKING
SURE THAT AND THAT'S- SOMETHING
WE'RE ALL WORKING TOWARDS- I
THINK YOU KNOW THE GENERAL
CONCERNS AROUND. THE CORPORATE
BAR RIGHT AND THE CORPORATE
PRACTICE OF MEDICINE AND- AND I
UNDERSTAND THOSE CONCERNS AND-
AND THIS BILL THAT'S WHY THIS
BILL IS NOT A BROADER BILL ABOUT
REMOVING THE CORPORATE- THE
CORPORATE PART OF THE MANY
STATES HAVE. TAKEN THAT STEP IT
WOULD SURELY NOT ADVOCATING FOR
I'M NOT ADVOCATING. FOR THAT. SO
I THINK THAT'S WHERE AT LEAST
YOU KNOW SOME THE CONCERNS COME
IN AROUND. FROM DOCTORS ABOUT
THE COVER PRACTICE MEDICINE AND
WHETHER- THERE'S GOING TO BE
UNDUE INFLUENCE FROM- FROM THE
OWNERS OF THE HOSPITAL SAY FOR
EXAMPLE. AND N. WHERE IS THAT
THE PUBLIC DISTRICT HOSPITAL
THEMSELVES OF YOU HEARD TODAY
WERE THE ONLY PUBLIC OFFICE WHO
DON'T HAVE THIS. THAT OUR PUBLIC
HOSPITALS HAVE THIS AND WE HAVE
PROTECTIONS IN PLACE. AND ARE
BUILT CONTINUES TO MERE THOSE AT
PROTECTIONS YOU KNOW IN SHORT
THE CLINICAL JUDGMENT RESTS
SOLELY WITH THE POSITIONS AND
NOT- WITH AND SURPLUS OF BREAD
WITH ISSUE AROUND THIS RUN THE
CERTAIN. CONSTRUCTION VERTICAL
INTEGRATION RIGHT SHOULD MAKE
BEEN AND SO WE'RE VERY
DETERMINED TO MAKE SURE THAT WE
PRESERVE THE CLINICAL JUDGMENT
OF THE PHYSICIAN. AND THAT
THAT'S NOT A ROAD IN IN IN ANY
SENSE SO. I DON'T KNOW I CAN'T
SPEAK IT THE OFFICE FULLY ANSWER
YOUR QUESTION BUT I THINK THE
DIFFERENCES BETWEEN. THE SERVE A
GENERAL. CONCERN ABOUT THE
CORPORATE BAR VERSUS PEOPLE WHO
ARE IN THESE VERY SPECIFIC OR
RUNNING THE SPECIFIC DISTRICT
HOSPITALS- THAT SEE THIS NEED IN
IN ABLE FOR THEM AS PUBLIC
DISTRICT HOSPITALS TO BE ABLE
TO. COMPETE AND RETAIN
PHYSICIANS SONG WOULD YOU LIKE
TO SPEAK WITH A PHYSICIAN WHO
TESTIFIED. SURE. HELPFUL DR. THE
QUESTION IS. CMA THE
ORGANIZATION IS OPPOSED YOUR
PHYSICIAN. AND YOUR IN SUPPORT
HOW DO THOSE TWO THINGS LINE UP.
OKAY AS I SAID MY PRACTICES IN
CRITICAL CARE. AND I HAVE A HARD
TIME. GETTING SPECIALIZED CARE
IN THE HOSPITAL. SO THE I THINK
IT'S PROBABLY NOT FOR ALL
PHYSICIANS BUT FOR SOME
PHYSICIANS WHO JUST GRADUATED.
FROM FELLOWSHIP AND THINGS LIKE
THAT TRYING TO GET A PLACE- TO
PROPERTIES YOU KNOW THIS IS.
SOMETHING THAT WE CAN OFFER WE
GET WE CAN OFFER. THE SPECIALTY
THINGS LIKE TRAUMA SURGEONS AND
SPECIALTY SOMETHING GI DOCTORS
WERE HAVING A TOUGH TIME.
GETTING THEM ALREADY IN OUR
COMMUNITY. SO IF YOU'RE GONNA
TAKE CARE OF THE PATIENT. YOU
BETTER WHAT EVER MEANS TO TAKE A
DECISION IS WHAT I'M I'M OPEN
TO. BECAUSE REALLY MADE MY
EXPERIENCE WITH MY DISTRICT
HOSPITAL IS THAT. IT'S TWO
DIFFERENT BODIES YOU KNOW THIS
IS THE MEDICAL STAFF. AND THIS
IS THE ADMINISTRATION THEY'RE
EQUALLY IMPORTANT. AND THEY
DON'T DICTATE RIGHT NOW THEY
DON'T DICTATE WHAT WE NEED TO DO
SO ARE WE ARE DICTATED BY A
CLINICAL GUIDELINES BY MEDICAL
SPECIALTY. AND THE ONE THE PEER
REVIEW WITH US ARE THE DOCTORS.
SO DID I ANSWER YOUR QUESTION.
WHY IS IT THAT SOME DOCTORS
DON'T DO NOT LIKE IT AND WHY IS
IT THAT SOME BOOKS JUST LIKE IN
YOUR OTHER PROFESSIONS TO. SOME
WILL TAKE UP. EMPLOYEE KIND OF
OPPOSITION AND SOME WILL NOT
LIKE KAISER PERMANENTE REYES SO
I GUESS THAT I WAS TRYING TO
FIGURE UNDER WHAT CONDITIONS SO
IS THE CONDITION THAT IF YOU ARE
IMPACTED AND YOU ARE AT A PUBLIC
HOSPITAL THEN. ALL OF THE
DOCTORS THERE THINK THAT THIS IS
THE RIGHT APPROACH AND IF YOU
ARE NOT THEN THEY THINK THAT IS
NOT I JUST TRYING TO FIGURE OUT
THE CONDITIONS UNDER WHICH THE
OTHER ONE. THE SAME GROUP THE
SAME BODY WOULD BOTH AGREE AND
DISAGREE. YEAH I THINK OVERALL.
EVEN PHYSICIANS AND HOSPITALS
THEIR MAIN. THEIR MAIN OBJECTIVE
IS PATIENT CARE WHAT IS BEST FOR
THE PATIENT WHAT'S THE QUALITY
FOR THE PATIENT RIGHT. BUT TO
GET PHYSICIANS TO GET
ADMINISTRATION ARE ALL TWO
DIFFERENT KINDS OF THINGS IN OUR
DISTRICT I CAN OWN I CAN SPEAK
FOR MY DISTRICT WERE WERE HAVING
A TOUGH TIME. GETTING
SPECIALIST. YOU KNOW AND- THE
CRITICAL CARE INTENSITIES
SOMETHING LIKE THAT. AND SOME GI
DOCTORS. SO THE DIFFERENCES IS.
NUMBER ONE THE NEED OFF A
CERTAIN HOSPITAL. AND ALSO THE
NEED OF A CERTAIN PHYSICIAN. THE
ANSWER IT IF I IF I. ONE THING I
THINK YOU SAID WAS THAT SOME
DOCTORS PREFER IT RIGHT YEAH
IT'S A CHOICE BUT SOME COME
ESPECIALLY COMING RIGHT OUT OF
RESIDENCY OTHER THINGS MIGHT
PREFER THIS IF IT WAS AVAILABLE
. YEAH THAT'S THAT'S ONE OF THEM
SOME SOME OF THEM PREFER IT. AND
SOME OF THEM WITH A TWENTIETH
AND A SOUL. MAYBE WHAT. WHAT
THEY'RE SAYING IN IN THE L. FOR
CMA. STUDIES YEAH A LITTLE A
LITTLE BIT DIFFERENT FROM WHERE
WE STAND AND- IS IT APPROPRIATE
CHAIR- TO ALSO ASKED OPPOSITION
TO. EITHER CERTAINLY BUT SIR YET
THANK YOU TO AND THEN I JUST
WANNA READ BECAUSE I DID THEY'RE
WORRIED ABOUT. THE CORPORATE
WORLD INFLUENCING IT LIKE KAISER
PERMANENTE IS A CORPORATE EIGHT
INFLUENCING THE MEDICAL JUDGMENT
OF THE PHYSICIAN. AND SO FAR THE
DISTRICT HOSPITAL WHERE I'M IN.
AS I SAID THESE ARE TWO
DIFFERENT BODIES INDEPENDENT
BODIES. THAT WORK TOGETHER FOR
THE PATIENT CARE. SO THANK YOU
MISTER MARCH. THANK YOU CEREMONY
I'M I. FOLLOWING THE GOOD DOCTOR
OF COURSE THERE ARE OF COURSE
DIFFERENCES OF HOW PHYSICIANS
LIKE TO PRACTICE IN THE STATE OF
CALIFORNIA RIGHT ENTITIES LARGER
ENTITIES LARGE MEDICAL GROUPS.
AND HEALTH SYSTEMS CAN PROVIDE
ECONOMIES OF SCALE TO INCREASE
EFFICIENCIES AND BILLING AND SO
ON AND SO FORTH. HOWEVER WHEN IT
COMES DOWN TO AND WHAT WE HEARD.
FROM THE SUPPORTERS RIGHT IS
THAT THERE IS A MEDICAL STAFF IN
EACH HOSPITAL AND THERE IS A
BOARD OF DIRECTORS OF EACH
HOSPITAL THERE IS A CONCERN THAT
OTHER MEMBERS WITHIN OUR
ORGANIZATION AND A MAJORITY OF
OUR MEMBERS WITHIN THE
ORGANIZATION HAVE. IN WHICH THAT
HOSPITAL BOARD OF DIRECTORS HAS
. THE ULTIMATE AND FINAL SAY
OVER WHAT HAPPENS IN THE
HOSPITAL. IF YOU WERE CALLED
SEVERAL YEARS AGO OUR GOOD
FRIEND NOW CONGRESSWOMAN AS ANY
CALM WATER DOES. HOW TO BILL ON
THIS EXACT ISSUE AND THERE WAS A
CONCERN AND CURRENT LAW IS SORT
OF. A LITTLE VAGUE ON THE
SUBJECT THAT THERE IS THE
ABILITY OF THE HOSPITAL TO MAKE
CARE DECISIONS AND OUR
PHYSICIANS IN THOSE AREAS
REGARDLESS OF PUBLIC ENTITY OR
PRIVATE. ARE CONCERNED THAT THAT
ENTITY I IS. TOO FAR REMOVED AND
HAS DIFFERENT MOTIVES- IN AND IT
AS IT RELATES TO DELIVERY OF
CARE. AND THEIR ABILITY TO
INFLUENCE THAT DELIVERY CANNOT
SYSTEM. THANK YOU AN END THIS IS
HELPFUL I THINK IT WAS PART OF
MY OWN JUST KIND OF CONFUSION OF
TRYING TO UNDERSTANDING GOING
THROUGH. THE ANALYSIS AND TRYING
TO MAKE SURE I UNDERSTOOD I'M
I'M SUPPORTING YOUR BILL TODAY-
AND- I LOOK FORWARD TO A BETTER
UNDERSTANDING AND I WOULD
PROBABLY ECHO. THE SENTIMENT
THAT IF THERE IS THE ABILITY
EITHER NOW OR IN THE FUTURE AM
AT TO. GET MORE INFORMATION ON
WHAT THE PRACTICES AGAIN
RECOGNIZING THAT I HAVE A
DISTRICT WHERE THIS PRACTICE HAS
BEEN IN EFFECT- SO WHETHER
THAT'S THROUGH A POOR OR YOU
KNOW- I THINK WOULD BE GENERALLY
HELPFUL TO UNDERSTAND- IF THIS
RAISES OTHER BIGGER QUESTIONS
OR- OR OR NOT SO I WOULD BE
SUPPORTIVE OF THAT- I HAVE TO
STEP. OUT AND I DON'T KNOW IF
YOU WANT TO CONCORD I WOULD I
WOULD LIKE TO DO THAT. YES VERY
MUCH OF THAT. I'D LIKE TO
CLARIFY. YES BUT CAN WE GET A
QUORUM FIRST BEFORE SOLVE FOR-
YEAH YEAH. I WASN'T I WAS
LEAVING GENERAL- AND I WILL SAY.
THAT I'VE HAD TALKS WITH CMA AND
THEY FULLY INTEND TO COME BACK
NEXT YEAR THERE'S BEEN KIND OF A
DORMANT ISSUE. AND NOW WE HAVE A
LOT OF NEW MEMBERS A LOT OF NEW
QUESTIONS AND SO I THINK THEY'RE
REALLY GONNA SPEND SOME TIME-
GOING FORWARD AND REALLY
PROVIDING SOME MORE EDUCATION
FOR ALL OF US. ARE ON THE
IMPORTANT INDOOR THE RELEVANCE
OF THAT MAINTAIN THE CORPORATE
FOR. US SIGNATURE COULD YOU
PLEASE CALL THE ROLL. SENATORS
EGGMAN YOUR EGGMAN HERE WHEN.
GLAZER GONZALEZ HERE GONZALEZ
HERE. GROWTH GROWTH HERE HER
TADO. FURTADO HERE THE MOMENT.
HERE LIMON HERE MENJIVAR.
MENJIVAR HERE ROTH HERE. ROTH
HERE. RUBIO WAHABI. WIENER.
SEVEN AND THAT MAKES SEVEN WE
HAVE A QUORUM SENATOR ROTH.
THANK YOU VENTURE I WAS ACTUALLY
GOING TO MAKE THIS SORT OF
COMMENT FOR. CENTER OF THE MOANS
OF. PURPOSES BUT. YOU KNOW
HOSPITALS THESE DISTRICTS CAN BE
LOCATED IN A VARIETY OF SECTIONS
OF THE STATE AND THOSE ARE
LOCATED IN RURAL AREAS. WHERE
IT'S TOUGH TO PROVIDE HEALTH
CARE AND IT'S YOU'RE GOOD IF YOU
CAN MAINTAIN A HOSPITALS TO
PROVIDE FULL SERVICE CARE.
HOSPITALS TRY TO RECRUIT
DOCTORS- AND WHEN THE DOCTOR
COMES THE DOCTOR WANTS TO SET UP
A PRACTICE BECAUSE MOST OF THEM
ARE HOSPITAL BASED PHYSICIANS
AND THEY HAVE TO HAVE PATIENCE
AND THEY HAVE TO HAVE A HOSPITAL
TO ADMIT PATIENTS TOO OFTEN. AND
SO WHEN THE DOCTORS LOOKING
TOWARD WHETHER TO MOVE TO AN
AREA TO SET UP A PRACTICE THEY
LOOK AT THE AVAILABILITY OF
PATIENTS THE PATIENT MIX. THE
CONTRACTS HOUSE CARE GONNA BE
PAID FOR A CAN THE DOCTOR MAKE A
LIVING AND IN SOME OF THESE
RURAL AREAS PERHAPS WERE
DISTRICT HOSPITALS EXIST AND I'M
LOOKING TO SEE A MAKING CORRECT
ME IF I'M WRONG. IT'S DIFFICULT
TO MAKE A LIVING AND IN THOSE
CIRCUMSTANCES OF PHYSICIAN WHO'S
WILLING TO ACCEPT EMPLOYMENT AT
A DISTRICT HOSPITAL AS AN
EMPLOYEE MAY CHOOSE AN ELECT TO
GO TO THAT DISTRICT TO PROVIDE
THAT AREA THAT RURAL AREA TO
PROVIDE CARE WHEN. OTHERWISE
THEY MIGHT NOT BE ABLE TO DO SO
BECAUSE GIVEN THE NUMBER OF
PHYSICIANS THE PATIENT MIX HOW
THEY GET PAID OR WHETHER THEY
GET PAID AT ALL THEY SIMPLY
CAN'T DO SO CANNOT DO SO. AND SO
THAT HASN'T BEEN MENTIONED I
THINK THAT PERHAPS WOULD HAVE A
DRESS CINNAMON'S. CONCERNS IN AS
TO THE PROFIT. MOTIVE AFFECTING-
MEDICAL DECISIONS YOU KNOW WE
SEEM TO HAVE THIS EMPLOYMENT
MODEL IN COUNTY HOSPITALS. AND
SOME OTHER SIMILAR HOSPITALS IN
THE STATE AND- THOSE HOSPITALS
HAVE CEOS THE COUNTIES HAVE.
CEOS. AND AS THEY USED TO TELL.
THE BOARD OF A NONPROFIT THAT
ICE POSSIBLE THAT I SAID ON
NONPROFIT IS A TAX STATUS EVERY
HOSPITAL HAS TO MAKE MONEY.
MADEIRAN OTHERS IN ORDER TO KEEP
THE DOORS OPEN SO. THOSE ARE
JUST MY COMMON EXPENDITURE THANK
YOU IF IT HELPS ANYONE THANK YOU
VERY MUCH AND I JUST HAD ENOUGH
AND MY DISTRICT ONE OF MY
HOSPITALS. I MEAN TO GET THIS IS
GOING TO STOP THEIR OBGYN
DELIVERY SYSTEM BECAUSE THEY
DON'T HAVE. THAT WOULD HAVE BEEN
DID YOU ANSWER THAT MEANS. PEACE
IS GONNA HAVE TO DRIVE FROM
TREATMENT TAKE AREA TO MODESTO
OR TURLOCK WHICH CAN BE A LONG
TIME IF YOU'RE IN LABOR. CENTER
GROVE. THANK YOU MADAM CHAIR.
IT'S A NOT VERY OFTEN THAT AS
THE SENATOR AND I HAVE.
SOMETHING IN COMMON- I DO REALLY
BELIEVE THAT THIS BILL DOES HELP
RULE COMMUNITY SEVERAL HOSPITALS
AND RURAL PROVIDERS- I
UNDERSTAND CMA'S CONCERNS I
REALLY DO- IN RESPONSE TO
SEVERAL MONTHS QUESTIONS IN THE
COMMENTS THAT SENATOR ROTH MADE.
IBM I THINK IT'S ALSO IT IS THE
POSITION WHICH THESE THESE
MEDICAL WRITERS OR PHYSICIANS
ARE IN THEIR PROCESS. I THINK
THE YOUNGER GENERATION JUST
COMING OUT OF- YOU KNOW MID
SCHOOLER INTERNSHIPS- I DON'T
THINK THEY HAVE I THINK THEY
MIGHT EMBRACE THE FACT THAT THEY
WILL HAVE AN EMPLOYER NOT HAVE
TO DEAL WITH A NON YOU KNOW ALL
THE STAFF. I THINK THE I DON'T
SEE OLDER BUT THEM YOU KNOW THE
LONGER TERMED AND MEDICAL
PROVIDERS. PHYSICIANS I THINK
THEY'RE LIKE THIS IS MY PRACTICE
THESE ARE MY PEOPLE I'M SETTING
MY I'M DOING MY OWN THING IN
YOUR PAIN NEED TO BE A
CONTRACTOR WHATEVER POSSIBLE AT
RATES. FREEZE SO I DO THINK THAT
THERE'S- THERE'S THAT AVENUE
THAT ISSUE AS WELL AND LIKE I
SAID THE YOUNGER ONES MIGHT JUST
WANT TO COME OUT WORKS DIRECTLY
FOR A HOSPITAL. I APPRECIATE
THAT YOU'RE GIVING US THE
OPTION- I KNOW THAT I DO
UNDERSTAND SEEN THESE CONCERNS I
KNOW IT CAME UP LAST YEAR. AND
BUT I REALLY DO. I REALLY DO
THINK THAT THIS ITEM VOTE FOR MY
DISTRICT AND I THINK THIS HELPS.
THE RULER A COMMUNITY HOSPITALS
I'M LIKE MY COLLEAGUE- FROM
STOCKTON WE'RE DEALING WITH- AS
SEVERE AS- YOU KNOW DISTRESS
FINANCIALLY DISTRESSED HOSPITALS
SITUATIONS AND- HER HOSPITAL
STOPPING LABOR DELIVERY WE LOST
TO. A COMPLETE YOU KNOW HUNDRED
SEVENTY BED UNIT HOSPITAL IN IN
. THE MADERA COUNTY AND YOU KNOW
WITHIN THIRTY THE DAYS WERE
GONNA LOSE THIS CENTER FIFTY BED
JUST. AND TO LAY COUNTY WITH
KOREA SOMETHING ISN'T DONE. SO
THAT WILL HAVE A SEVERE IMPACT
ON FRESNO KINGS AND OTHER AREAS.
AND THAT'S ALL PUBLIC SO I'M NOT
YOU KNOW DURING ANYTHING OUT
THERE THAT'S NOT PUBLIC. AND THE
BET AT AND THEN WE ALSO HAD ONE
AND SENATE ARCHER LET IS
DISTRICT. THAT FILE BANKRUPTCY
MA'AM JUST A FEW DAYS AGO SO WE
DO HAVE A PROBLEM. WE AND
PROVIDERS CAN'T PRACTICE WHERE
THERE'S I MEAN CAN'T PRACTICE IN
THE BACKYARD. SO WE HAVE TO HAVE
A FACILITY FOR THEM TO PRACTICE
IN. IN THEM AND I KNOW SO. WE
HAVE A LOT OF MEDICAL ISSUES-
AND PROVIDER ISSUES AND- HEALTH
CARE ACCESS ISSUES THAT HAVE TO
BE ADDRESSED THIS YEAR. AND I
APPRECIATE YOU BRINGING THIS ONE
FORWARD. AND I AM GOING TO GO
BACK TO RULES BECAUSE THE SENATE
PRO TEM IS. AND TEXTING ME AND
SHARING SO ALL OF THE OF. THANK
YOU. THUS TYLER. THANK MANAGE. I
WANT TO EXPRESS. MY SUPPORT FOR
THE BILL- TO BUT I. WANT TO EXT
. CONCERN AND WANT TO HOLD MY-
RIGHT TO YOU KNOW- BOOKING SOME
BILLS DOWN THE ROAD IF NECESSARY
BUT- YOU KNOW. DEALING OF WHICH
YOU LIVE IN A RURAL CALIFORNIA
WE FACE UNIQUE CHALLENGES AND
OBVIOUSLY. YEAH STRUGGLES WITH
THE CRITICAL INFRASTRUCTURE
INCLUDING HEALTHCARE INCLUDING
AGRICULTURE. AND I'VE I'VE I
FEEL LIKE I'VE- BEEN SEEING LIKE
THIS THIS TREND OF- THE NEED TO
COME IN AND INVEST IN RURAL
COMMUNITIES IN IN IN I THINK YOU
KNOW AND- SECTORS THAT ARE
STRUGGLING LIKE AGRICULTURE LIKE
HOT LIKE RURAL HOSPITALS. AND
I'M VERY CONCERNED ABOUT OF. THE
ISSUE OF VERTICAL INTEGRATION
AND HEALTH CARE LIKE I AM IN IN
IN IN AGRICULTURE. AND IT IT'S
IMPORTANT TO ADDRESS THE MATTER
TO ENSURE THAT YOU KNOW WE GET.
WE ARE PROTECT PATIENTS AND
IMPROVE THE QUALITY OF CARE
PROVIDED TO PATIENTS AND I KNOW
THAT IT'S A DIFFICULT SITUATION
BECAUSE- WE ALL DON'T WANT TO
LOSE OUR HOSPITALS WE DON'T WANT
TO LOSE OUR- DOCTORS WE WANT TO
MAKE SURE THAT EVERYBODY GETS
THE CARE THAT THEY NEED BUT AT
THE SAME TIME. R. E. LOOK WE
DON'T WANT HISTORY TO REPEAT
ITSELF I MEAN IF YOU LOOK AT
SOME OF THE- A SCENARIO THAT
THAT OCCURRED IN TWO THOUSAND
NINETEEN AND I BELIEVE IT WAS IN
NEW YORK. WITH PRIVATE YOU KNOW
EQUITY FIRMS GOING IN BAHRAIN
YOU KNOW- IT. HOSPITALS THAT ARE
IN DISADVANTAGED COMMUNITIES AND
- YOU. PROVIDING ALMOST FALLS
OPENED IT ALMOST IMMEDIATELY TO
GO IN FILED FOR BANKRUPTCY AND
THEN WHAT GO BACK IN AND- MAKE A
HUGE PROFIT OFF OF IT AND THEN.
OF COURSE A VERTICALLY
INTEGRATE- HEALTH CARE THERE AND
HUGE PROFITS COMING OUT AND SO
IT PUTS ALL THE- THE PATIENT AT
RISK AND SO I THINK THAT. BUT
THE BIG THANK YOU ME VERY WELL
AND I WANT TO SUPPORT YOU. BUT I
ALSO WANT TO MAKE SURE THAT WE
ALL HAVE THIS IN MIND THAT
THERE'S JUST SCHEMES THAT ARE
OUT THERE AND ACTUALLY THE
PRIVATE EQUITY FROM THE DID ALL
OF THIS WAS BASED OUT OF
CALIFORNIA. SO I EAT I WANT US
TO BE CAUTIOUS AND IN. IN IN IN
MAKING SURE THAT WE- WE DON'T
ALLOW THIS TO HAPPEN HERE. SO
WITH THAT I. WILL BE SUPPORTING
YOUR BILL TODAY AND I'M HAPPY
WITH IT AT THE PROTECT. Q. THANK
YOU. SEEN NOBODY ELSE WISHING TO
SPEAK. TELL TO GIVE STARTED VERY
GOOD CONVERSATIONS AND- WOULD
YOU LIKE TO CLOSE THANK YOU I DO
APPRECIATE APPRECIATE THE
MARKSMAN JUST LIKE SCHOOLS ARE
ALSO ALL ABOUT THE TEACHERS IN A
TRACKING TEACHERS YOU KNOW HAAS
WAS ALL ABOUT. DOCTORS AND WE
WANT TO MAKE SURE THAT WHATEVER
WE DO WE'RE SETTING UP THE
CONDITIONS THAT THE NEXT. KID
GRADUATED THINKING ABOUT MEDICAL
SCHOOL DOES GO THERE AND ISN'T
DETERRED BY THE DYNAMICS OF THE
INDUSTRY WE WANT TO MAKE SURE
THAT. THAT THEY'RE TRACKED INTO.
AN TO THE PRACTICE HERE IN
CALIFORNIA WE DO THAT I THINK
THIS WILL HELP. FOR CERTAIN YOU
KNOW FOR THIS CERTAIN SLICE OF
HOSPITALS AND I APPRECIATE THE
COMMENTS ASPEN I VOTE. THANK YOU
VERY MUCH- SECRETARY OF A MOTION
FROM CENTER HER TADO- WHICH IS.
TO PASS AND REFERRED TO THE
COMMITTEE ON APPROPRIATIONS-
WITH THE MOTION FOR CENTER TOTAL
SECRETARY PLEASE CALL THE ROLL.
SENATORS EGGMAN. EGGMAN AYE.
GLAZER GONZALEZ. GONZALEZ I HER
TADO HI FOR TODD- I GROWTH.
LIMON MENJIVAR. BINGE OF OUR
EYEING ROSS. ROTH AYE RUBIO. BOB
WIENER. OKAY THAT IS. FIVE ZERO-
AND WE WILL TAKE NEXT SENATOR
MENTOR BURKE. NO NO. SAID IT WAS
OKAY. SHE'S. SENTIMENTS OF OUR
THIS IS- ITEM NUMBER NINE S. B.
ELEVEN CALIFORNIA STATE
UNIVERSITY MENTAL HEALTH
COUNSELING. YES PLEASE PROCEED
IN READING THANK YOU SO MUCH
SENATOR GOOD AFTERNOON FELLOW
COMMITTEE MEMBERS AND- INTERIM
CHAIR- I'M AGAIN FIRST ONE I
THINK THE COMMITTEE STOP WORKING
ON FOR THEIR SUPPORT AND WORKING
WITH MY TEAM ON THIS- ANALYSIS
AND THIS VERY IMPORTANT BILL.
DURING THE TWENTY TWENTY AND
TWENTY TWENTY ONE SCHOOL YEAR
MORE THAN 60% OF COLLEGE
STUDENTS MET THE CRITERIA FOR AT
LEAST ONE MENTAL HEALTH PROBLEM
A STAGGERING NUMBER THAT WE
CONTINUE TO SEE AN INCREASE EVEN
MORE SO IN THE PANDEMIC.
UNFORTUNATELY WERE SEVERELY
LACKING IN OUR MENTAL HEALTH
PROFESSIONAL WORKFORCE AVAILABLE
TO MEET THE NEEDS EVER CSU
STUDENTS. THE INTERNATIONAL
ASSOCIATION OF COUNSELING
SERVICES BUT I ACS WHICH IS HOW
WILL BE REFERRING TO IT MOVING
FORWARD RECOMMENDS A COLLEAGUE
THE UNIVERSITIES MAINTAIN A
RATIO OF ONE FULL TIME
EQUIVALENT MENTAL HEALTH
PROFESSIONAL TO EVERY THOUSAND
TO FIFTEEN HUNDRED STUDENTS
WHICH THIS BILL IS LOOKING TO
CODIFY. SB ELEVEN WILL ALSO
CREATE A FIRST OF ITS KIND B. S.
THE CSU MENTAL HEALTH
PROFESSIONALS ACT. THIS ADDS TO
INCENTIVIZE CSU STUDENTS TO
BECOME MENTAL HEALTH
PROFESSIONALS IN THE STATE BY
CREATING A NON COMPETITIVE GRANT
PROGRAM TO FUND TRAINING FOR
LICENSURE IN CALIFORNIA. ODYSSEY
ISSUE OR AN UNDERSERVED
COMMUNITY. IT IS DIFFICULT TO
PURSUE A DEGREE AND A MENTAL
HEALTH PROFESSION A SOCIAL
WORKER WHEN YOU'RE ASKED TO DO
TWO YEARS OF UNPAID WORK ON
SOMETHING I HAD TO EXPERIENCE
MYSELF. WE ALL HEARD ABOUT THE
WORKER SHORTAGES IT'S BEEN
BROUGHT UP HERE- AND WE'VE KNOW
THAT UNIVERSITIES ARE NO
STRANGER TO THE SHORTAGE AS WELL
ACROSS THE STATE WERE
EXPERIENCING SHORTAGES IN
CERTAIN FIELDS. AS WELL AS IN
THOSE LOOKING TO ADDRESS THE
STUDENT MENTAL HEALTH CRISIS OR
THE YOUTH MENTAL HEALTH CRISIS
THAT WE SEEN. THE SHORTSTOP
INTIMATES WHAT SERVICE PROVIDERS
AT THE TO USE YOU HAS LED TO
WAIT TIMES. WHERE STUDENTS ARE
WAITING AROUND FORTY EIGHT WEEKS
TO SEE A COUNSELOR AND JUST
YESTERDAY I MET WITH SEVERAL CSU
STUDENTS WHO TOLD ME THAT SOME
OF THEM ARE WAITING. CLOSE TO
THREE MONTHS FOR AN APPOINTMENT
. THE DEMAND FOR ACCESSIBLE
THROUGH THE MENTAL HEALTH
RESOURCES HAS ONLY INCREASED IN
RECENT YEARS OUR STUDENTS
STRUGGLE WITH ECONOMIC SOCIAL
AND PSYCHOLOGICAL IMPACT OF THE
PANDEMIC AN ENTRANCE INTO
ADULTHOOD. THIS ISSUE SYSTEM
EDUCATES CLOSE TO HALF A MILLION
STUDENTS EACH YEAR IN TRAINS THE
MAJORITY OF CALIFORNIA'S IS SUCH
A WORKFORCE WITH THAT IN MIND WE
SHOULD BE INCENTIVIZING- CSU
STUDENTS TO BECOME MENTAL
PROFESSIONALS IN CREATING A
STRONG STUDENT TO WORK FIRST
PIPELINE- AT THE CSU. SO IF WE
ARE CALLING FOR SOCIAL WORKERS
AND MENTAL PROFESSIONALS TO BE
IN ALL THESE DIFFERENT SPACES
THEY WE NEED TO RAMP UP OUR
WORKFORCE EFFORTS. WITH THAT I'D
LIKE TO NOW TURN IT OVER WITH
THEM. THE CHURCH PERMISSION TO
MIGHT WITNESSES WHO WOULD SPEAK
IN SUPPORT OF THIS BILL. FIRST
WITNESS PLEASE FIRST ONE IS.
ENGINE ANGEL MARIE TAYLOR
STUDENT AT CSU CHANNEL ISLANDS
AND THEN FOLLOWED BY G. SIN.
CONWELL WAS THE STUFF ON THE CFA
COUNSELORS COMMITTEE. GOOD
AFTERNOON AND WELCOME. SIX SIX
MINUTES BETWEEN THE TWO OF YOU.
GOOD AFTERNOON COMMITTEE MY NAME
IS ANGEL MARIE TAYLOR AND I'M A
FOURTH YEAR BUSINESS STUDENT AT
CSU CHANNEL ISLANDS. WE ARE ONE
OF THE VERY FEW CSCS THAT MEETS
THE EYE C. S. RECOMMENDATION FOR
STUDENTS TO COUNSELOR RATIO.
HAVING BEEN A STUDENT HERE FOR
FOUR YEARS. I VERY CLEARLY
REMEMBER WHAT IT WAS LIKE WHEN
WE DID NOT MEET THE RATIO. WAIT
TIMES WERE ANYWHERE BETWEEN FOUR
TO SIX WEEKS. AS A STUDENT WHO
COMES FROM A FAMILY OF LOW
INCOME AND THAT'S TO WORK
MULTIPLE JOBS YEAR ROUND TO KEEP
MYSELF AFLOAT WHILE PUTTING
MYSELF THROUGH COLLEGE. MENTAL
HEALTH SHOULD BE THE LAST THING
THAT I SHOULD HAVE TO WORRY
ABOUT. IN ADDITION TO THAT I
HAVE EXPERIENCED. HIS NAME. I
HAVE EXPERIENCE DIFFICULTY WITH
HOUSING INSECURITY OF FOOD FOOD
INSECURITY ALONG THE WAY. THESE
REAL TRIALS THROUGHOUT MY PURSUE
SUIT PURSUIT TOWARDS EDUCATION
HAVE BEEN. ABSOLUTELY ENORMOUS
AND HAS TAKEN A TOLL ON MY
MENTAL WELL BEING AS WELL AS MY
ACADEMIC PERFORMANCE. NOW THAT
WE DO READ THE RATIO INSTEAD OF
WAITING ONE MONTH WHICH WAS NOT
QUALITY AND ENOUGH ACTIVE. FORM
OF MENTAL HEALTH SERVICES FOR
ME. MEAN THE RATIO I CAN GO AND
SEE A COUNSELOR TODAY. TOMORROW
ANYTIME THIS WEEK ANY TIME NEXT
WEEK THAT WORKS FOR ME. THIS
DIFFERENCE HAS BEEN MONUMENTAL
AND I'VE NEVER FELT SO SUPPORTED
BOTH IN MY PERSONAL LIFE AND
ACADEMICALLY AND MY CURRENT
GREAT STAND TO PROVE THAT. HAVE
BEEN EXPERIENCE BOTH SIDES OF
THE RATIO. I STRONGLY SUPPORT SB
ELEVEN AND FIND THE IN THIS
RATIO NEEDS TO BE MANDATED NOT
RECOMMENDED ACROSS ALSO UC'S
ACROSS THE STATE. FOR OTHER
STUDENTS WHO HAVE EXPERIENCED.
ADVERSITIES LIKE ME THANK YOU.
THANK YOU VERY MUCH. NEXT PERSON
PLEASE. GOOD AFTERNOON. MY NAME
IS JASON CONWELL AND SPEAKING
HERE ON BEHALF OF THE CALIFORNIA
FACULTY ASSOCIATION IN SUPPORT
OF S. B. ELEVEN AND IS WORTH THE
TWO HUNDRED AND SEVENTY MENTAL
HEALTH COUNSELORS WE REPRESENTED
THE CALIFORNIA STATE UNIVERSITY
. IN ONE OF MY ROLES I SERVICE
THAT CFA STAFF TO THE COUNSELORS
COMMITTEE. IN THAT ROLE I MEET
REGULARLY WITH CANCER FROM
ACROSS THE CALIFORNIA STATE
UNIVERSITY AND I'VE DONE SO FOR
MOST OF THE PAST SIXTEEN YEARS.
I'VE MET HUNDREDS OF MENTAL
HEALTH COUNSELORS IN THE CSU. I
WANNA SAY THESE ARE SOME OF THE
MOST IMPRESSIVE PEOPLE I'VE EVER
MET. THEY'RE EMPATHETIC
HARDWORKING AND DEDICATED
PROFESSIONALS WHO HELP OUR
STUDENT COLLEGE STUDENTS WHEN
THE STUDENTS THAT THERE ARE AT
THE LOWEST POINT OF THEIR LIVES.
THESE ARE HONORABLE PEOPLE WHO
ENGAGE IN CRITICAL AND OFTEN
LIFESAVING WORK. BUT THEY NEED
HELP. DURING MY SIXTEEN YEARS
THE CFA I'VE WATCHES COUNTERS
HAVE BEEN PRESSURED TO HOLD MORE
AND MORE ONE ON ONE SESSIONS
WITH STUDENTS. AND EXCEEDING ANY
REALISTIC EXPECTATIONS OF THE
CAPIT CAPACITY OF OUR
COUNSELORS. I WATCHES COUNSELING
CENTERS ACROSS THE STATE HAVE
UNLIMITED PERMANENT COUNSELOR
POSITIONS AND REPLACE THEM WITH
COUNSELORS WORKING ON TEMPORARY
APPOINTMENTS. I'VE WATCHES THE
MENTAL HEALTH NEEDS OF THE CSU
STUDENTS. HAVE INCREASED
EXPLANATION EXPONENTIALLY BOTH
BEFORE AND DURING. AND DURING-
THE PANDEMIC. I WATCHED AS MORE
AND MORE OF OUR COUNSELORS HAVE
BECOME TIRED AND BURNED OUT.
TRYING TO HELP EVERY STUDENT
THAT NEEDS MENTAL HEALTH SUPPORT
. TOO FREQUENTLY SEE I SEE ARE
GOOD COUNSELORS LEAVE THE CSU.
FOR MORE REASONABLE WORKLOAD
BETTER PAY. AND MORE JOB
SECURITY ELSEWHERE. WELL WHAT
SOLVE EVERY THING SB ELEVEN WILL
HELP ADDRESS THESE PROBLEMS OVER
HALF THIS CAMPUS IS IN THE CSU
DO NOT MEET THE FIFTEEN HUNDRED
TO ONE RATIO REQUIRED IN THIS
BILL. SEVEN OF OUR CAMPUSES HAVE
A RATIO THAT IS AT LEAST 50%
WORSE THAN THE FIFTEEN HUNDRED
TO ONE RATIO. THIS BILL WILL
HELP INCREASE ACCESS TO MENTAL
HEALTH COUNSELOR FOR THE SEE IT.
IN THE CSU FOR OUR STUDENTS. AT
BECAUSE OUR STUDENTS TO SIMPLY
ARE NOT PROVIDED THE ACCESS THEY
NEED. SB ELEVEN WILL ALSO CREATE
NEW INCENTIVES AND FUNDING FOR
STUDENTS WHO WANT TO DEVELOP A
CAREER IN MENTAL HEALTH. AND
THAT IS SIMPLY NEEDED CALIFORNIA
NEEDS GREATER ACCESS TO MENTAL
HEALTH PROFESSIONALS.
RESPECTFULLY AYE ARJUN AYE VOTE
ON SB ELEVEN AND THANK YOU FOR
YOUR TIME. THANK YOU VERY MUCH
HE REAL SWEET WILLING TO
SWITCHING TO SPEAK IN SUPPORT
NOW JUST COME FORWARD JUST YOUR
NAME AND AFFILIATION. GOOD
AFTERNOON CHAIR MEMBERS PERSONAL
KILLS HERE WE HAVE THE
CALIFORNIA STATE ASSOCIATION OF
PSYCHIATRIST IN STRONG SUPPORT
THANK YOU. DID ANYONE WITH THE
CA CALIFORNIA CO SPONSORS OF THE
BILL IN A STRONG SUPPORT THANK
YOU THANK YOU. JOHN CARVE CHAIR
OF THE- COMMITTEE ENOUGH'S OF
THE PLO CHAIR OF THE SOUNDS THE
SAME AS A STATE. CHAPTER IN
STRONG SUPPORT THANK YOU. HELLO
MY NAME IS ISAAC SHARON I'M A
FOURTH YEAR STUDENT AT.
CALIFORNIA STATE UNIVERSITY
DOMINGUEZ HILLS AND EYES
STRONGLY SUPPORT THIS BILL.
THANK YOU. HELLO MY NAME IS
RACHEL FLORES I'M A GRADUATE
STUDENT AT SAN JOSE STATE
UNIVERSITY AND THE DEPARTMENT OF
CHICANA CHICANO STUDIES AND I
STRONGLY SUPPORT THIS BILL THANK
YOU. HELLO MY NAME IS HALEY
POWELL I'M A MASTER OF PUBLIC
POLICY STUDENT AT CAL POLY SLOW
AND I STRONGLY SUPPORT SB ELEVEN
THANK YOU. HELLO MY NAME IS LISA
COUPLE MARA I AM A TWENTY FIVE
YEAR TEMPORARY EMPLOYEE AT. CAL
POLY SAN LUIS OBISPO- IN AND THE
CHAPTER PRESIDENT FOR CFA AT CAL
POLY SAN LUIS OBISPO AND I STAND
STRONGLY IN FAVOR OF THIS BILL
THANK YOU. HI MY NAME'S CHRIS
NINETY KIANA TWENTY EIGHT YOUR
FACULTY MEMBER CAL STATE SAMBAR
DINO VICE PRESIDENT OF THE
CHAPTER AND ON BEHALF OF CFA
SPEAKING IN SUPPORT. THANK YOU.
HELLO ALL MY NAME IS JENNIFER
TRAVIS AND I'M A SECOND YEAR
SOCIOLOGY MAJOR- AT CAL STATE
LONG BEACH AND I STRONGLY
SUPPORT THIS BILL THANK YOU.
HELLO MY NAME IS LUIS ORTIZ I'M
A SECOND YEAR COMMUNICATIONS
STUDENT- BECAUSE IT LONG BEACH
AND ITS STRONG SUPPORT THIS BILL
THANK YOU. HELLO MY NAME IS
COOLEY LUMINARY SPENCER I'M A
FOURTH YEAR AT CAL STATE
FULLERTON AND I STRONGLY SUPPORT
THIS BILL THANK YOU. GOOD
AFTERNOON MY NAME IS CARE TO SEE
AGAIN I AM A FOURTH YEAR SENIOR
AT CSU MARITIME ACADEMY IN
VALLEJO CALIFORNIA AND I
STRONGLY SUPPORT THIS BILL THANK
YOU. GOOD AFTERNOON I AM EXCITED
TO BE HERE BUT- I'M A STUDENT AT
COUNSELING MY NAMES AND I WILL
GO AHEAD AND ARE YOU STRONGLY
SUPPORT THIS BILL THANK YOU.
GOOD AFTERNOON MADAM CHAIR AN
OLD FRIEND AND COLLEAGUE I'M
KEVIN WARE PROFESSOR OF
SOCIOLOGY AT SACRAMENTO STATE
AND VICE PRESIDENT OF CALIFORNIA
FACULTY ASSOCIATION STRONGLY IN
SUPPORT OF THIS BILL THANK YOU
MY FORMER COLLEAGUES HIM A UNION
CFA. PERSON PLEASE GOOD
AFTERNOON I'M DOCTOR DEMOCRATS
FROM CAL STATE SAMBAR TO DINO
AND I STRONGLY SUPPORT THIS BILL
THANK YOU. GOOD AFTERNOON I'M
AMY ESCALANTE I'M A LECTURER AT
CSUMB MONTEREY BAY. AND I
STRONGLY SUPPORT THIS BILL THANK
YOU. HI I AM JOHNSON I'M A
FACULTY MEMBER AT CALIFORNIA
STATE UNIVERSITY SAN BERNARD
DINO AND A MEMBER OF THE CFA AND
I STRONGLY SUPPORT THIS BILL
THANK YOU VERY MUCH DOES BECAUSE
THE PEOPLE WHO ARE OPPOSING THIS
BILL. COME FORWARD AT THIS TIME
. WE DO HAVE LISTED OPPOSITION
BUT I GUESS AND I CAN COME TODAY
SO ANYWAY JUST WANTED TO SAY
THEY'RE AGAINST IT. OKAY SEEING
NONE OF MODERATOR IS THERE
ANYBODY IN THE QUEUE. THANK YOU
MADAM CHAIR THOSE WHO WISH TO
SPEAK IN SUPPORT OR OPPOSITION
PLEASE PRESS ONE THAT THAN ZERO
AT THIS TIME PRESS ONE THEN ZERO
. WE HAVE SEVERAL PEOPLE OF
SIGNALED THAT THEY WISH STATE A
MOMENT PLACE. AND WE'RE GOING TO
FIRST GO TO LINE ONE OH SEVEN
YOUR LINE IS NOW OPEN. THANK YOU
THIS IS A RUSH DAY. ON BEHALF OF
INDIVIDUAL DEL INDIVISIBLE
CALIFORNIA STAY STRONG A
COALITION OF ECLIPSE STRONG
SUPPORTER THIS BILL THANK YOU.
THE COLOR PLEASE. FIVE ONE
TWENTY SEVEN. I CALIFORNIA STATE
UNIVERSITY YEAH WE ARE NOT
ENOUGH. WHAT ARE THE LAST MINUTE
SESSION ON AT ELEVEN. OUR
CONCERN ACTING RIGHT. RIGHT NOW
AND IF I AND EIGHT. THANK YOU
VERY MUCH NAME AND POSITION
RIGHT NOW NEXT CALLER PLEASE. BY
. ONE THIRTY EIGHT. THE
HERNANDEZ AND I'M CALLING ON
BEHALF OF THE NATIONAL
ASSOCIATION OF COURSE ISN'T
SUPPORT AND I'M AS MUCH OF. IT
THANK YOU VERY MUCH NEXT CALLER
PLEASE. BUT I'M SURE THERE IS I
WENT OUT TO SIGNAL THAT THEY
WISH TO SPEAK ALL RIGHT THANK
YOU VERY MUCH OF THIS TIME WE
BRING IT BACK TO THE COMMITTEE
MANY QUESTIONS COMMENTS. THE END
RESULT I'M ALL MOVED THE BILL IN
A PROPER I MEAN OBVIOUSLY THIS
HAS OF A PRICE TAG BUT MORE
IMPORTANTLY- THIS IS SO VERY
IMPORTANT FOR SO MANY OF OUR
STUDENTS- WHO YOU KNOW WE SEE I
MEAN I TALKED TO MANY OF MY
CONSTANT LONG BEACH YOU KNOW
CONSTITUENTS AND- I KNOW THAT
THE PAIN AND THE HURT AND YOU
WANT. MORE SUPPORT FROM NOT JUST
THE LEGISLATURE FROM YOUR OWN
CSU AND WE HEAR YOU LOUD AND
CLEAR AND I KNOW- WITH SENATOR
MANY OF OUR THAT WILL START
OPENING A DISCUSSION AND
CONVERSATION OF WHAT THIS CAN
LOOK LIKE- AND I LOOK FORWARD TO
WORKING WITH YOU ON THAT SO
THANK YOU FOR BRINGING THIS
FORWARD. AND TURN AROUND YOU
KNOW IT THE PRICE TAG OF IT YOU
KNOW WE ARE IN DISCUSSIONS
TALKING WITH BUDGET POTENTIALLY
LOOKING AT SOME H. CHI FUNDING
THAT COULD BE PUT INTO THIS
MENTAL HEALTH WORK- WORK FOR SO.
VERY MINDFUL OF THAT AS WELL.
THANK AND YOU ARE ACCEPTING THE
AMENDMENTS RIGHT WHICH WE TRY TO
LESSEN THE HURT OF THE- IN.
WHICH IS A TECHNICAL. YES YES
I'M PAID FOR. OKAY THANK YOU ALL
RIGHT THANK YOU VERY MUCH OKAY.
WE DO HAVE A MOTION. WOULD YOU
LIKE TO CLOSE WITHOUT YOUR
CLOTHES. I JUST WANNA SAY THANK
YOU- I THINK STRATEGICALLY BRING
SOME LONG TO BE STUDENTS FOR THE
SENATOR YOUR YOUR EX COLLEAGUE-
YOU KNOW THIS. YOU KNOW I WANT
TO THINK THAT WHEN THIS ISSUE
CAME AND SPOKE ABOUT YOU KNOW
HOW DIFFICULT IT IS FOR THEM TO
SEEK MENTAL HEALTH IN SCHOOLS
AND- YOU KNOW I SHARON THAT WHEN
I WAS A STUDENT AS WELL. YOU
KNOW I WENT TO SEEK FOR MENTAL
HEALTH DURING A VERY DEPRESSED
OF TIME IN MY LIFE AND- I'M
AFTER EXPLAINED TO THEM WHY I
NEEDED MENTAL HEALTH AFTER THE
QUICK THIRTY MINUTE INTAKE THEY
SAID WE'LL SEE YOU IN TWO
MONTHS. AND THEY LEFT ME FLOORED
IN THAT MOMENT AND IT COULD HAVE
EASILY DETERRED ME- BUT I WANT I
WAS ABLE TO THE VA FOR IT. BUT I
HAD TO GO OUTSIDE. TO FIND
MENTAL HEALTH WHERE. I WAS ON
THE SCHOOL CAMPUS ARE GOING TO
BE EASY WOULD HAVE BEEN EASIER
FOR ME SO I'M. THE WORKING
ENSURE THAT IT'S- A PRICE TAG
THAT WE CAN ACHIEVE AN
IMPLEMENTED. THANK YOU THANK YOU
VERY MUCH ALL RIGHT SO THAT-
MOTION BY CENTER GONZALEZ. AND
THAT IS DUE PASSED AS AMENDED
AND RE REFER TO THE COMMITTEE ON
APPROPRIATIONS SECRETARY PLEASE
CALL THE ROLL. SENATORS EGGMAN
I. MEAN I WENT. GLAZER GONZALEZ
HI GONZALEZ I HER TADO. LIMÓN I
. MENJIVAR I'VE- MENJIVAR I.
GROWTH ROTH HI ROTH AYE. RUBIO
WHAT HOP. HOP I WINNER. SIX SIX
ZERO WILL LEAVE THAT OPEN- FOR
MEMBERS- WORK SHOULD WE MOVE
ONTO YOUR NEXT BILL SB SEVEN
TWENTY NINE YES GREAT. HELLO
AGAIN. STILL ME. I WANT TO THINK
AGAIN THE COMMITTEE STOP WORKING
WITH MY TEAM ON THIS VERY VERY
IMPORTANT AND VERY PERSONAL BILL
. SB SEVEN TWENTY NINE- MAYBE.
SOUND SIMILAR TO YOU BECAUSE OUR
OTHER HALF WAS WORKING ON THIS
THE LAST YEAR. SB SEVEN TWENTY
NINE IS LOOKING TO REQUIRE
HEALTH PLANS TO PROVIDE COVERAGE
FOR FERTILITY CARE INCLUDING
TREATMENT FOR INFERTILITY AND IN
VITRO FERTILIZATION- WHICH I'LL
BE. MENTIONING AS IBF MOVING
FORWARD. I WANT TO FIRST ASK THE
COMMITTEE TO ADOPT THE
AMENDMENTS AS STATED ON PAGE
NINE OF THE COMMITTEE ANALYSIS I
WOULD LIKE TO MOVE FORWARD WITH
THIS REMEMBER YOU SHOULD HAVE
THE MOCK. AMENDMENTS IN FRONT OF
YOU THAT IS GOING TO LIMIT THIS
TO THE LARGE GROUP MARKET. BY
REQUIRING HEALTH PLANS AND
INSURERS TO OFFER THIS COVERAGE.
IT SO IT'S GOING TO LIMIT THIS
THE LARGE GROUP MARKET END IT'S
GOING TO REQUIRE HEALTH PLANS
INSURERS TO JUST SIMPLY OFFER
THIS COVERAGE IN THE INDIVIDUAL
AND SMALL GROUP MARKETS. THE
PACIFIC FERTILITY IS CENTRAL
VALLEY ESTIMATES THAT ONE IN A
OPPOSITE SEX COUPLES WILL
STRUGGLE WITH INFERTILITY. AND
THAT RATIO DOESN'T EVEN BEGIN TO
INCLUDE OUR LGBTQ PLUS COUPLES.
DATA FROM THE PEW RESEARCH
CENTER INDICATES THAT A FOR
THIRD OF AMERICANS HAVE USE
FERTILITY HEALTH SERVICES- YOU
KNOW SOMEONE WHO HAS. YET RIGHT
NOW THE SAFEST AND MOST RELIABLE
METHODS OF FERTILITY CARE REMAIN
OUT OF REACH FOR MOST
CALIFORNIANS. CURRENT LAW RIGHT
NOW MANDATES ONLY THAT HEALTH
INSURERS OFFER COVERAGE FOR THE
TREATMENT OF INFERTILITY BUT
DOES NOT REQUIRE THAT ALL PLANS.
PROVIDE COVERAGE. ADDITIONALLY
CURRENT LAW REQUIRES INVASIVE
STANDARDS OF PROOF IN ORDER TO
ACCESS CARE INCLUDING NEEDING AN
OFFICIAL MEDICAL DIAGNOSIS THAT
COULD TAKE YEARS TO ACHIEVE. AND
TO HAVE COMPLETED ONE YEAR-
TRIED FOR ONE YEAR. I'M PROTECT
UNPROTECTED SEX THAT COULD HAVE
RESULTED IN PREGNANCY AND ACT
THAT'S SIMPLY MOST LGBTQ PLUS
INDIVIDUALS CANNOT MEET. WORSE
YET THE LAW EXPLICITLY EXCLUDES
ANY COVERAGE OF IBF THE MOST
RELIABLE TREATMENT THAT HAS IN
UP 277% SUCCESS RATE. FOR
CALIFORNIA STRUGGLING WITH
INFERTILITY THE VERY EXISTENCE
OF THE FAMILY HOPE TO BOTH CAN
DEPEND ON INCOME ALONE. SB SEVEN
TWENTY NINE THAT WOULD EXPAND
ACCESS TO FERTILITY CARE FOR
CALIFORNIANS INCLUDING COVERAGE
FOR IVF. SPECIFICALLY IT REVISES
CURRENT LAW TO REMOVE THE IBF
EXCLUSION AND TO MANDATE
COVERAGE OF FERTILITY CARE FOR
HELP HEALTH PLANS. REGULATED BY
THE DEPARTMENT OF MANAGED
HEALTHCARE IN CALIFORNIA
DEPARTMENT OF INSURANCE. AS A
REPRODUCTIVE FREEDOM- STATE
CALIFORNIA STILL HAS SIGNIFICANT
WORK TO DO I WILL ALWAYS BE AT
THE FRONT LINE TO ENSURE THAT
PEOPLE HAVE A RIGHT TO NOT HAVE
A CHILD. BUT THAT ALSO MEANS
THAT TO REPRODUCTIVE FREEDOM IS
THAT WE'RE SUPPORTING THOSE THAT
DECIDE WHEN IF AND WHEN THEY
WANT TO HAVE A CHILD FOR ME
ANOTHER LGBTQ PLUS SAME SEX
COUPLES ACCESS TO FERTILITY
DONORS. A DOCTOR'S POTENTIAL
DONORS AND OPTIONS TO
INTRAUTERINE INSEMINATION AND
IVF FOR CRITICALLY IMPORTANT.
ABOUT TWO YEARS AGO I SAT DOWN
WITH MY WIFE AND WE DECIDED ARE
WE GOING TO BUY A HOUSE WITH THE
SAVINGS WE HAVE OR WE CAN USE
THAT SAVINGS TO START A FAMILY.
FOR THE PAST FOUR MONTHS I'M
PRETTY SURE YOU HAVEN'T HEARD ME
SPEAK ABOUT A CHILD I HAVE SO
YOU CAN KNOW WHAT DECISION WE
HAD TO MAKE AND I WAS A TOUGH
DECISION TO MAKE. AND THAT'S THE
KIND OF DECISION I'M LOOKING TO
REMOVE FROM SO MANY COUPLES.
COMMITTEE MEMBERS- RIGHT NOW
FOURTEEN OTHER STATES HAVE
ALREADY PASSED IVF INSURANCE
LAWS. IN CALIFORNIA ALWAYS
PRIDES ITSELF IN BEING ONE OF
THE FIRST UNFORTUNATELY WERE NOT
THE FIRST BUT WE SHOULDN'T FALL
SO FAR BEHIND. WE MUST CATCH UP
TO CONTINUE TO EARN OUR
DESIGNATION AS A REPRODUCTIVE
FREEDOM CHAIR WITHOUT WITH YOUR
PERMISSION BROWN SHARED MADAM
TRIED LIKE TO TURN TO ME TO WIN
THIS IS HERE WITH ME. FIRST SUB-
KATIE MCKNIGHT WHO BRINGS
FIRSTHAND EXPERIENCE FOLLOWED BY
DR MOVEMENT A LITTLE PROFESSOR
ABSTRACT OF OBSTETRICS AND
GYNECOLOGY. WELCOME. GOOD
AFTERNOON MADAM CHAIR AND
MEMBERS. MY NAME IS KATIE
MCKNIGHT AND I LIVE IN RICHMOND
CALIFORNIA WITH MY HUSBAND
EIGHT. TWO AND A HALF YEARS AGO
I WAS DIAGNOSED WITH STAGE TWO
BREAST CANCER AT AGE THIRTY. THE
TYPE OF BREAST CANCER I WAS
DIAGNOSED WITH WAS FAST GROWING
AN AGGRESSIVE KNOWN AS TRIPLE
NEGATIVE INVASIVE DUCTAL
CARCINOMA. AT THE TIME MY
DIAGNOSIS MY HUSBAND AND I WERE
NEWLY MARRIED WITH HOPES FOR
TRYING WITH FOR A BABY. BUT WE
PUT OUR HOPES ON HOLD WHEN I
STEP BACK FROM WORKING UNDER
WENT SIXTEEN WERE MONTHS OF KEEP
CANCER TREATMENT. THAT ENTAIL
TWENTY SIX ROUNDS OF
CHEMOTHERAPY FOR SURGERIES SIX
VISITS TO THE EMERGENCY ROOM AND
HUNDREDS OF DOCTORS APPOINTMENTS
IN BETWEEN. I HAVE KNOWN SINCE
AGE TWENTY FOUR THAT I HAVE A
PATHOGENIC BROCK ONE MUTATION A
MARKER HIGHLY LINKED WITH THE
DEVELOPMENT OF HEREDITARY BREAST
AND OVARIAN CANCERS. MY FATHER
WATCHED HIS MOTHER DIE OF BREAST
CANCER WHEN HE WAS YOUNG AND HE
WATCHED HIS AUNT AND GRANDMOTHER
SUFFER THROUGH BREAST CANCER AND
SURVIVE IT. SINCE LEARNING I WAS
RECORD POSITIVE. I'VE DONE
EVERYTHING IN MY POWER TO BE AS
PROACTIVE WITH MY HEALTH IS
POSSIBLE AND DESPITE MY BEST
EFFORTS BREAST CANCER PREVAILED
. SB SIX HUNDRED AT THE BILL
THAT ESTABLISHED COVERAGE FOR
FERTILITY PRESERVATION FOR
PATIENTS LIKE ME. HAS HAD A
PROFOUND IMPACT ON MY AND MY
HUSBAND'S LIFE. IT ALLOWED ME TO
FREEZE EMBRYOS AHEAD OF MY LIFE
SAVING CHEMOTHERAPY TREATMENTS
AND ALLOW ME TO PRESERVE HOPE
THAT ONE DAY I MAY BE ABLE TO
BECOME. A MOTHER WITH A
BIOLOGICAL CHILD OF MY OWN
DESPITE THE COPIOUS AMOUNTS OF
TOXINS THAT MY BODY HAS ENTERED
. HAD IT NOT BEEN FOR SB SIX
HUNDRED I WOULD HAVE HAD TO TRY
TO COME UP WITH UPWARDS OF
TWENTY THOUSAND DOLLARS IN THE
MATTER OF A FEW DAYS TO FREEZE
MY EMBRYOS AHEAD OF POTENTIALLY
STERILIZING CHEMOTHERAPY. SB SIX
HUNDRED MEANT NOT HAVING TO
CHOOSE BETWEEN PRESERVING MY
ABILITY TO BECOME A MOTHER ONE
DAY AND- HAVE TO CHOOSE BETWEEN.
VERY EXPENSIVE CANCER TREATMENT
. WHILE SB SIX HUNDRED HAS MADE
INCREDIBLE PROGRESS IN
CALIFORNIA TO PROTECT YOUNG
CANCER SURVIVORS LIKE ME. IT
DOES NOT SOLVE THE WHOLE
INFERTILITY PROBLEM. NOW THE
ACTIVE TREATMENT IS BEHIND ME
I'M BEGINNING TO THINK ABOUT THE
NEXT STEPS NEEDED TO BUILD MY
FAMILY. FOR ME IT THIS MEANS THE
ABILITY TO IMPLANT MY EMBRYOS
AND CARRY A BABY TO TERM. A
SERVICE THAT IS CURRENTLY NOT
COVERED BY MY HEALTH INSURANCE.
IT ALSO MEANS SCREENING MY
EMBRYOS FOR THE BRACKET MUTATION
TO BREAK THE CHAIN OF
MALIGNANCIES THAT IS PLAGUE MY
FAMILY FOR GENERATIONS. SB SEVEN
TO NINE IS A CRITICAL STEP. IN
HELPING CASE CANCER PATIENTS
LIKE ME. REALIZE THE PROMISE
THAT WAS CRITICALLY STORED AHEAD
OF CANCER TREATMENT. CANCER
SURVIVORS ALREADY FACE
INCREDIBLE CHALLENGES TO
REALIZING THAT DREAM OF A FAMILY
THE RISK OF CANCER RECURRENCE.
THE RISK OF PERMANENT PHYSICAL
AND EMOTIONAL EFFECTS FROM
CANCER TREATMENTS. AND THE RISK
OF JUST DYING TOO YOUNG. BUT THE
RISK OF NOT BEING ABLE TO AFFORD
THE SUBSTANTIAL OUT OF POCKET
COST OF IVF FOR THOSE WHO NEED
IT. TO HAVE THEIR CHILDREN NEED
NOT BE INCLUDED IN THIS LIST. ON
BEHALF OF YOUNG CANCER SURVIVORS
LIKE ME AND ALL CALIFORNIANS WHO
ARE FACING OR MAY ONE DAY FACE
INFERTILITY. I RESPECTFULLY ASK
YOU TO SUPPORT SB SEVEN TO NINE
TO BRING MORE EQUITABLE AND
COMPREHENSIVE INFERTILITY
COVERAGE TO ALL CALIFORNIANS WHO
NEED IT. THANK YOU THANK YOU
VERY MUCH. NEXT PERSON UP. GOOD
AFTERNOON. MY NAME IS- DOCTOR
RUBIN OLIVERO I AM I AM A
PROFESSOR AND DIVISION DIRECTOR
OF REPRODUCTIVE ENDOCRINOLOGY
AND INFERTILITY AT STANFORD
MEDICAL SCHOOL. I'M ALSO THE
PAST PRESIDENT OF THE NATIONAL
SOCIETY FOR REPRODUCTIVE
ENDOCRINOLOGY AND INFERTILITY
WHICH IS THE NATIONAL
ORGANIZATION OF FERTILITY
PROVIDERS. I'M CURRENTLY ON THE
BOARD OF DIRECTORS OF THE
AMERICAN SOCIETY FOR
REPRODUCTIVE MEDICINE AND I'M
ALSO A TWENTY SEVEN YEAR
VETERAN. OF THE U. S. ARMY WHERE
I TOOK CARE OF INFERTILITY
PATIENTS IN THE IN THE MILITARY.
BOB INFERTILITY IS A DISEASE AND
IT'S NOT UNLIKE A DIABETES AND
HEART DISEASE IT PROFOUNDLY
AFFECTS THE QUALITY OF LIFE FOR
THOSE AFFECTED. AND ITS IMPACT
COULD BE PROFOUND IN THE ONE IN
EIGHT CALIFORNIA THE CALIFORNIA
PERSONS WHO ARE AFFECTED. BOTH
THE WORLD HEALTH ORGANIZATION
AND THE AMERICAN MEDICAL
ASSOCIATION ALONG WITH EVERY
MEDICAL OR OR OR TO REPRODUCTIVE
MEDICAL ORGANIZATION THAT I'M
AWARE OF. SUPPORTS THE DIAGNOSIS
OF INFERTILITY AS A DISEASE. OUR
QUALITY CARE UNEQUIVOCALLY HAS
BEEN SHOWN TO BE EFFECTIVE IN
TREATING CONDITIONS AND IN MOST
CASES. UNFORTUNATELY THERE IS
UNEQUAL ACCESS TO OUR QUALITY
FERTILITY CARE SINCE EVEN IN THE
MOST AFFLUENT COUNTRY IN THE
WORLD. ONLY FOURTEEN STATES HAVE
SENT SOME MANDATES FOR INSURANCE
COVERAGE. UNFORTUNATELY
CALIFORNIA IS NOT ONE OF THOSE
STATES. I TO COMING TO
CALIFORNIA I PRACTICE IN RHODE
ISLAND WHICH IS ONE OF THOSE
STATES. AND I HAD THE PRIVILEGE
OF CARING FOR FISHERMEN BUS
DRIVERS COPS TEACHERS FIREMEN.
AND JUST ABOUT EVERY SECTOR OF
THE LOCAL COMMUNITY. AT WALTER
REED WHERE I WAS THE VISION
DIRECTOR AS WELL I CARED FOR ALL
RANKS EQUALLY FROM ENLISTED TO
NONCOMMISSIONED OFFICERS TO.
COMPANY GREAT TO FEEL GREAT EVEN
GENERAL OFFICER SERVICE AN
EQUITABLE POPULATION THAT I
CARED FOR. FERTILITY CARE HAS
BEEN SHOWN TO BE COST EFFECTIVE
IN MULTIPLE JOURNALS AND IN
MULTIPLE MANDATED STATES
ESTIMATES FOR THE COST OF A
SINGLE. BIRTH GENERALLY RANGE
FROM TWENTY FIVE THOUSAND TO
THIRTY THOUSAND WHICH IS
EXCEPTIONALLY GOOD. IN THE COST
EFFECTIVENESS WORLD.
ADDITIONALLY MANDATES HAVE BEEN
SHOWN TO ALLOW FOR EFFECTIVE
CONSERVATIVE MANAGEMENT PRIOR TO
THE USE AGGRESSIVE OF AGGRESSIVE
TREATMENTS. AND ALSO TO FOSTER
THE USE OF SAFER APPROACHES SUCH
AS TRANSFERRING ONLY A SINGLE
EMBRYO. AND THIS IMPROVES
OUTCOMES AND REDUCES COSTS. AS A
NATIVE SPANISH SPEAKER I AM ALSO
USED TO CARING FOR TO SERVING
THE HISPANIC COMMUNITY. AND
USUALLY ABOUT A THIRD OF MY
PATIENTS ARE SPANISH SPEAKING
SADLY GIVEN THE ABSENCE OF
MANDATED KAREN CALIFORNIA. I
SPEAK VERY LITTLE SPANISH IN MY
IN MY CLINICS. DR YOU CAN WRAP
IT UP OKAY THANK YOU. OUT SO
FERTILITY SERVICES CONSIDERED
THE STANDARD OF CARE IN ANY
COMMUNITY IN OUR PART OF THE
CAN. CONTINUUM FROM PRE
PREGNANCY TO NEONATAL CARE LACK
OF WELL RESOURCE FERTILITY CARE
REPRESENTS A GAP IN THE
SPECTRUM. AN ABSENCE OF THE
SUPPORT PUTS CALIFORNIA BEHIND
THE STATE'S AND MEDICAL SYSTEM
SET UP CHAU CHOSEN TO DO THE
RIGHT THING. I ASKED THE SUPPORT
SENATE BILL SEVEN TWENTY NINE
THANK YOU VERY MUCH OTHERS
WISHING TO SPEAK IN SUPPORT JUST
NAME AFFILIATION. MADAM CHAIR
AND MEMBERS I'M ERIN EVANS ON
BEHALF NARAL PRO CHOICE
CALIFORNIA PRODS CO SPONSOR OF
THIS IMPORTANT MEASURE. AS WELL
AS A CALIFORNIA NURSE MIDWIVES
ASSOCIATION IN SUPPORT THANK YOU
. I THANK YOU MADAM CHAIR
MEMBERS DAVE GONZALEZ ON BEHALF
OF THE CALIFORNIA LIFE SCIENCES
AND SUPPORT. THANK YOU. MADAM
CHAIR AND MEMBERS MICHELLE
TRAMMELL FORK WITH THE
CALIFORNIA COMMISSION ON THE
STATUS SO MANY GIRLS IN STRONG
SUPPORT THANK YOU. CRACKPOTS FOR
QUALITY CALIFORNIANS STRONG
SUPPORT THANK YOU. MEET EMMA SO
OUR FAMILY COALITION WERE ONE OF
THE CO SPONSORS IN STRONG
SUPPORT THANK YOU. KATIE FISHER
ON BEHALF OF THE CALIFORNIA
DEPARTMENT OF INSURANCE ADS IN
STRONG SUPPORT ALSO IN MY
PERSONAL CAPACITY IS THE PARENT
OF TWO DONOR CONCEIVED CHILDREN
IN SUPPORT. THANK YOU. HI I'M
I'M JOYCE REINECKE WITH THE
ALLIANCE FOR FERTILITY
PRESERVATION WE ARE ALSO A PROUD
CO SPONSOR OF THIS- BILL. AND
ANA IN STRONG SUPPORT OBVIOUSLY
AND FROM MY PERSONAL EXPERIENCE
AS A CANCER SURVIVOR WHO ALSO
NEEDED TO GO THROUGH IVF. I
PERSONALLY SUPPORT ABOUT THANK
YOU. HI AGAIN- CAVING NIGHT OF
SPEAKING ON BEHALF OF THE BOARD
MEMBER FOR THE BAY AREA YOUNG
SURVIVORS IN SUPPORT THANK YOU.
MADAM CHAIR MEMBERS JOSE TORRES
WILL HELP ACT AS CALIFORNIA
INSTRUCT IN STRONG SUPPORT THANK
YOU VERY MUCH. NOW WE GO TO
THOSE SPEAKING IN OPPOSITION
TODAY.
THE THANK YOU MADAM CHAIR AND
COMMITTEE MEMBERS PRESTON YOUNG
FOR THE CALIFORNIA CHAMBER OF
COMMERCE HERE TODAY IN
OPPOSITION TO SB SEVEN TO NINE.
FROM THE OUTSET I JUST WANNA
MAKE IT ABUNDANTLY CLEAR WE ARE
NOT HERE OPPOSING THIS BASED ON
THE POLICY THAT IS ATTEMPTING TO
BE- FORWARDED AND ACHIEVED WITH
SB SEVEN TO NINE. WE UNDERSTAND
THAT THIS IS A WELL INTENTIONED
BILL WE UNDERSTAND WHAT IT'S
TRYING TO DO AND WE CAN
CERTAINLY EMPATHIZE WITH THAT.
AND SYMPATHIZE WITH THAT THE
REASON FOR OPPOSITION OR THE
UNINTENDED CONSEQUENCES THAT ARE
ASSOCIATED WITH SB SEVEN TO NINE
PRIMARILY THE COSTS THAT ARE
ASSOCIATED WITH IMPLEMENTING
THIS MANDATE. SO THE CALIFORNIA
HEALTH BENEFIT REVIEW PROGRAM
CONDUCTED AN ANALYSIS OF THIS
BILL NAY DID A FEW DIFFERENT
SCENARIOS NOW ONE OF THE
SCENARIOS THE ANALYZED WAS THE
SCENARIO THAT THE AMENDMENTS
WILL ADDRESS WHERE THIS IS ONLY
MANDATED UPON LARGE GROUP-
HEALTHCARE BENEFITS. NOW IN THAT
CASE COLLECTIVELY IT WILL
INCREASE PREMIUMS FOR CALIFORNIA
EMPLOYERS THREE HUNDRED THIRTY
TWO MILLION DOLLARS I REALIZE
WHEN YOU BREAK IT DOWN PER
MEMBER PER MONTH WE GET DOWN TO
DOLLARS AND CENTS AND SOMETIMES.
IT ALMOST INVOKES AND IRAL
RETHINK OKAY THAT'S SUCH A SMALL
AMOUNT WHEN WE COLLECTIVELY LOOK
AT THIS WHAT'S THE BIG DEAL BUT
THIS ONE IN PARTICULAR IS GOING
TO INCREASE PER MEMBER PER MONTH
CLOSE TO THE FOUR DOLLAR RANGE
WHICH IS A LARGE- INCREASE IN TO
PUT THAT IN PERSPECTIVE AND
CONTEXT THIS IS JUST ONE PIECE
OF LEGISLATION THAT'S GOING TO
DO THAT. THAT WILL THEN BE
LAYERED ON TOP OF OTHER HEALTH
CARE COST DRIVERS IN THE SYSTEM
SO THAT INCLUDES INFLATIONARY-
ISSUES THAT ARE GOING ON IN THE
ECONOMY RIGHT NOW THAT INCLUDES
POINT OF CARE COST INCREASE AND
THEN INCLUDES PHARMACEUTICAL
CARE COST CREASING. AND
INCREASING THAT INCLUDES- LABOR
COSTS INCREASING THOSE ARE ALL
HEALTH CARE COST DRIVERS
INDEPENDENT OF LEGISLATION THAT
IS PUSHED THROUGH THIS BODY. SO
MANY LAYERED ON TOP OF THAT. NOW
IT'S ONE MORE EXPENSE THAT
EMPLOYERS IN THE STATE HAVE TO
PAY AND IT'S NOT JUST. ALL
EMPLOYERS NOW IT'S ONLY FOCUSED
ON THE LARGE EMPLOYERS IN OUR
STATE BECAUSE THIS WILL ONLY
APPLY TO LARGE GROUP BENEFITS-
TO DRILL DOWN A LITTLE BIT
FURTHER IN REGARDS TO CONTEXT.
WHEN WE LOOK AT HEALTH CARE
AFFORDABILITY IN CALIFORNIA OVER
THE ASK FIVE YEARS. THE AVERAGE
PREMIUM FOR FAMILY COVERAGE
IMPLORES SPONSOR PLANS HAS
INCREASED TWENTY PERCENT. NOW
WHAT'S THAT MEAN WHEN IT COMES
TO DOLLARS SO IN TWO THOUSAND
AND TWENTY TWO THE AVERAGE
ANNUAL PREMIUM FOR CALIFORNIA
EMPLOYER SPONSORED FAMILY HEALTH
CARE COVERAGE. REACHED
220-004-0060 THREE DOLLARS. SO
THAT HAS TO BE PAID OVER TWELVE
MONTH TIME PERIOD IN A PLEASE ON
AVERAGE CONTRIBUTE SIX THOUSAND
ONE HUNDRED SIX DOLLARS THIS
PREMIUMS. SO ONE PIECE OF
LEGISLATION IS GOING TO INCREASE
THAT AMOUNT THAT IS PAID OVER
TWELVE MONTH TIME PERIOD- AGAIN
I CAN'T REITERATE THIS ENOUGH I
THE POLICY HERE IS NOT THE
ISSUE. WE'RE JUST POINTING OUT
THE CONCERN WE HAVE WHEN IT
COMES TO THIS ACTING AS A HEALTH
CARE COST DRIVER ALL MANDATES DO
BUT THIS ONE IN PARTICULAR IS A
VERY LARGE ONE. SO I REALLY DO
THANK YOU FOR YOUR TIME
CONSIDERATION ON THIS- THANK YOU
VERY MUCH. THANK YOU VERY MUCH.
NEXT PERSON. I THANK YOU MADAM
CHAIR MEMBERS OF THE COMMITTEE
JEFF HAMPTON WITH CALIFORNIA
ASSOCIATION OF HEALTH PLANS
RIDLEY HER OPPOSITION. I DO I
THINK THE AUTHOR- IN THE WIN
SOME SUPPORT- ENOUGH FOR SHARING
THEIR STORIES WE ARE OBVIOUSLY-
SINCE THE TO. AN APPRECIATIVE OF
THE INTENT OF THIS BILL- YOU
KNOW WHAT I CALL MY- MY CALLING
FROM THE CHAMBERS- COMMENTS
AROUND THAT AS WELL- REGRETTABLY
OUR OPPOSITION IS ALSO BASED IN
AND THE OVERALL COSTS ASSOCIATED
WITH THE BILL- YOU KNOW AS I
MENTIONED ON A PREVIOUS. BILL
YOU KNOW WE HAVE TWENTY THREE
MANDATES THAT WERE INTRODUCED
THIS YEAR- WITH THE PREMIUM
IMPACT OF ONE POINT TWO EIGHT
BILLION DOLLARS ON CALIFORNIANS-
THIS UNFORTUNATELY- IS ONE OF
THOSE BILLS- BUT AGAIN.
CERTAINLY APPRECIATE THE INTENT-
HOWEVER- INTO THE COST IMPACT
THAT WE ARE REGRETTABLY POST.
THANK YOU THANK YOU VERY MUCH
OKAY ANYBODY ELSE JUST JUST NAME
AND AFFILIATION AT THIS POINT.
STEPHANIE WHAT CAN THE MAP THIS
ASHISH CALIFORNIA LIFE AND
HEALTH INSURANCE COMPANIES
OPPOSITION THANK YOU. JOHN WHEN
YOU'RE ON THE HAVE MAKE SOUTH
INSURANCE PLANS IN OPPOSITION.
THANK YOU VERY MUCH. SEEN NOBODY
ELSE CAN GO TO THE PHONES
MODERATORS OR ANYBODY IN THE
QUEUE. AS GERMAN IF YOU WISH TO
MAKE A COMMENT SUPPORT OR
OPPOSITION. AT ONE THAT ZERO.
BEYOND THE LINE OF ONE NOTE IT.
THE- AT. HM OF THE SEPTIC USE
WILL BE GOING TO LINE ONE OH
FIVE. PLEASE GO AHEAD. MY NAME
IS DOCTOR CAN COPE- CALIFORNIA
READ. AND MY HUSBAND ROBERT
TRENT AND I HAVE MADE A WRITTEN
. STATEMENT CONSTRUCT PART OF
THE TWENTY NINE. RESPECTFULLY
ASK. YOUR THANK YOU VERY MUCH
NEXT COLOR PLEASE. AND NOW WILL
BE ON THE LINE ONE OF SIX PLEASE
GO AT. GOOD AFTERNOON. MADAM
CHAIR AND MEMBERS NINETY TWENTY
ON BEHALF OF IF YOU COPY ACTION
IN STRONG SUPPORT THANK YOU
THANK YOU NICE COLOR PLEASE.
NEXT ON THE LINE ONE THIRTY
THREE PLEASE GO AHEAD. ANNA
HORNE BARK ONE MISSION VIEJO IN
STRONG SUPPORT. THANK YOU X.
COLOR. AN EXTRA ON THE LINE ONE
THIRTY FOUR PLEASE GO AHEAD. IN
A BRICK OUT OF ORANGE CAL IN
STRONG. THANK YOU THANKS CALLER
. IT CURRENTLY NO ONE ELSE THANK
YOU PAT OBJECT THANK YOU VERY
MUCH THIS TIME WILL BRING IT
BACK TO COMMITTEE SANDRA THANK
YOU MA'AM SURE I'M WONDERING IF-
ONE OF THE- OPPOSITION SPEAKERS
SUGGEST COULD CLARIFY FOR ME THE
- INCREASE IN EMPLOYER. COST I
WANT TO. FIRST THANK YOU FOR
BREAKING IT DOWN PER EMPLOYEE OF
YOURS SO AGO I WAS ASKING
QUESTIONS AND- ON THAT VERY
ISSUE AND I APPRECIATE- YOU ALL
RESPONDING TO MY IF YOU
RESPONDED TO MY QUESTIONS
APPRECIATED IF NOT I STILL
APPRECIATED. BUT I MAY HAVE
MISSED IT I THOUGHT THERE WAS
TWENTY TWO THOUSAND DOLLARS. BUT
I CAN'T RECALL- IS SO THE TWENTY
TWO THOUSAND DOLLARS THAT I
CITED THAT'S THE AVERAGE-
FAMILY. EMPLOYER SPONSORED PLAN
PREMIUM COST IN TWO THOUSAND
TWENTY TWO AND THAT WAS- STUDY
AND A SURVEY DONE BY THE KAISER
FOUNDATION FAMILY FOUNDATION AND
SO THEN THE EMPLOYER PORTION OF
THAT COST WOULD BE. WELL OF THE
EMPLOYEE PORTION EMPLOYER ON
AVERAGE FOR THAT STUDY WAS SIX
THOUSAND ONE HUNDRED SIX DOLLARS
FOR THE REMAINDER OF THE ON THE
EMPLOYER FOURTEEN THOUSAND OR SO
IT YET SIXTEEN AREA OKAY
APPRECIATED THANK YOU. OKAY I'M
MANAGER JUST IF I COULD JUST
MAKE A COMMENT I MEAN I THINK.
OBVIOUSLY EACH OF THESE BILLS OF
THIS ONE IN PARTICULAR THESE ARE
VERY- IMPORTANT ISSUES AND
BENEFITS TO BE PROVIDED IN
SERVICES TO BE COVERED. I THINK
THERE IS VALUE IN THE POINT MADE
THAT YOU KNOW AS WE KEEP
LAYERING. OF BENEFITS ON TOP. IT
NEED TO BE COVERED. OF THOSE
IMPORTANT COVERAGE BENEFITS NEED
TO BE PAID FOR SOMEHOW AND I
THINK AS I'M SUPPORTING THIS
BILL AND I'VE SUPPORTED OTHERS
AND WILL CONTINUE TO SUPPORT
BILLS TO PROVIDE HEALTH CARE. TO
THOSE IN NEED I THINK WE ARE ALL
GOING TO HAVE TO GET TOGETHER
AND FIGURE OUT. HOW THIS IS PAID
FOR BECAUSE- SOMEONE HAS TO PAY
FOR IT. AND NOTHING IS FREE. I
AGREE I THINK THE CHAIR YOU KNOW
IN A COUPLE IN ANOTHER HEARING
SAID THEY WERE PLAIN WELCOME ON
EVENTUALLY WE'RE GONNA HAVE
NUMBER MOST LAPSED. TO WHACK IN
THIS AND I DO AGREE WITH YOU-
THE GENERAL IS THAT. WE NEED TO
COME TO YOU KNOW THE END GAME
HERE OF THIS ENSURING. JUST
EQUITABLE. AND ACCESS TO
INSURANCE HERE. THIS IS NOT A
ONE AND DONE TYPE OF BILL YOU
KNOW THIS ISN'T THE END ALL
SOLUTION BUT IT IS STILL STEP IN
THE RIGHT DIRECTION TO ENSURE.
THAT OR- AND I RECOGNIZE THAT
WHEN WE'RE LOOKING TO REMOVE
DISCRIMINATION IN HEALTH CARE
COVERAGE. THAT THERE IS GOING TO
BE SOME PRICE TO THE FULL POOL-
BUT IT SHOULDN'T BE ON THE BACKS
OF THOSE THAT HAVE BEEN
DISCRIMINATED AGAINST. THANK YOU
SO A VERY ELOQUENT CHAIR. OF
CENTER GROVE. THANK YOU. THANK
YOU MADAM CHAIR AS THIS IS A IS
IT A DIFFICULT BILL- FOR ME
BECAUSE- AND YOU KNOW IN IN IN
THE REAL WORLD I WERE TWO HATS I
HAVE AN EMPLOYER. AND OUR COSTS
FOR BENEFITS THAT WE PROVIDER IN
PLACE WHEN IT SIXTEEN THOUSAND
DOLLARS A YEAR. LAST YEAR IN
LIKE FOURTEEN THOUSAND DOLLARS A
YEAR BEFORE THAT AND I THINK IT
IT IS A- IT IS A DIRECT
REFLECTION OF THE POLICIES BEST
OF THIS BUILDING. AND ON THE
OTHER SIDE OF THAT. AS I HAVE A
AN EMPLOYEE THAT- SCREAMS AND
SAVES EVERY SINGLE DOLLAR SHE
CAN SAVE. TO DO IN VITRO. AND
THEY'VE TRIED IT TWICE AND IT
HASN'T WORKED AND IT'S A VERY
EXPENSIVE PROCEDURE. AND I HAVE
A- THE- OF SOMEBODY IN THE
COMMUNITY. AND THEY'LL KILL ME
IF I USE THEIR REAL NAMES SO I
CAN'T DO THAT BUT- I JUST
RECENTLY SAW HER- I WAS DOING
RETAIL THERAPY HANNAH. MY SENATE
COLLEAGUES FROM STOCKTON'S
DISTRICT AND SHE HAPPENED TO BE
THERE. AND WE RAN INTO EACH
OTHER IN SHE HAD A BABY IN HER
ARMS. AND M. MY FIRST THOUGHT
WAS. IT WAS KIND OF NOT A GOOD
THING TO SAY BUT I SAID I. I
THOUGHT YOU HAD CANCER IN GOT
CHEMO TREATMENTS SHE WAS I DID.
N. I KNEW WHAT SHE DID FOR A
LIVING AND I KNEW SHE DIDN'T
HAVE THE INSURANCE TO COVER IN
VITRO. AND I SAID TO HIM DID YOU
ADOPTING SHE DOES KNOW SHE'S
MINE AND I HAVE FOUR MORE AG
SPEECHES. THIS PERSON WE BOTH
KNOW. AND FOUND OUT WHEN I SERVE
HIM COFFEE EVERY MORNING THAT I
HAD CANCER. AND SAID BUT YOU
JUST GOT MARRIED AND- YOU DON'T
HAVE A BABY AND- YOU KNOW IN HIS
MIND HE'S THINKING THAT'S THE
KID THE WAY THINGS GO. AND HE
WENT OUTSIDE ROTARY CHECK. TO
AND PROVIDE FOR THE SERVICES SO
THAT WHEN SHE GOT THROUGH WITH
CANCER. TREATMENT SHE WOULD BE
ABLE TO DO THIS AND BE TURNED
OUT IT HADN'T BEEN FOR THAT VERY
GENEROUS INDIVIDUAL. AND SHE
WOULD NOT HAVE THAT BABY. AND
SO. THERE'S A LOT OF- THERE'S A
LOT OF REASONS IT IS VERY VERY
VERY GOOD REASONS TO SUPPORT IT
AND I. I UNDERSTAND THAT
COMPLETELY BUT I ALSO AGREE WITH
YOU KNOW THE GENERAL. SOMEHOW
SOME WAY SOMEBODY'S GOT TO PAY
FOR ALL THIS. AND I HATE TO
THINK THAT YOU JUST PUT A PRICE
ON ON. YOU KNOW THE BENEFITS OF
SOME HEALTH CARE PLANS. M. BUT
IT IS A REALITY I MEAN IT'S
EITHER AN EMPLOYER AND
INDIVIDUAL I MEAN IF YOU HAVE A
STATE FUNDED PROGRAM. AND YOU
KNOW OBVIOUSLY TAXPAYERS PAY FOR
THAT- BUT- IT THERE HAS TO BE
SOME TYPE OF BALANCE IN THERE IS
BEEN LAYER AFTER LAYER AFTER
LAYER OF BENEFITS. REQUIRED OF
FOR PLANS. AND PROVIDERS AND THE
DIFFICULT THING IS THAT THE COST
IS CONTINUING TO GO UP AND AGAIN
FROM. PUTTING BACK ON MY
EMPLOYER HAT. WE HAVE YOU AYE
BENEFITS THEY'RE OVERDRAWN THE
U. I FIND. AN ESTIMATED COSTING
MY COMPANY IF WE DON'T BUDGET
PHILIP. NOT JUST FOR ME BUT THE
EMPLOYERS IN GENERAL FOR THE
OVERDRAFT. IT ADDITIONAL FIFTY
FIVE THOUSAND DOLLARS I DON'T
HAVE FIFTY FIVE THOUSAND
DOLLARS. IT MAKES A MANY YOU
GUYS DO. M. SO IT AND THEN THE
ADDITIONAL COSTS FOR INSURANCE
TO DISCUSS HER FUEL THE
ADDITIONAL COSTS FOR. EMPLOYEE
WAGES THE DISCUSS FOR YOU KNOW
TAXES GOING UP. SO EAT THERE HAS
TO BE SOME TYPE OF BALANCE IT
CAN'T BE ALL ONCE. BUT IT IS
VERY DIFFICULT FOR ME BECAUSE-
THESE ARE HEART WRENCHING
STORIES AND I HAVE PERSONAL
CONNECTIONS. TO PEOPLE THAT
STRUGGLE WITH THIS ISSUE AND
THAT YOU KNOW DESPERATELY WANTED
CHILD. IN THEIR HOME IN THIS IS
THE ONLY WAY THAT THEY'D BE ABLE
TO DO THAT. AND SO- I DON'T I
DON'T KNOW WHAT THE ANSWER IS IN
YOU KNOW AND I WANNA MANTRA IF
YOU'LL ALLOW ME I'D LIKE TO TALK
A LITTLE BIT ABOUT THE- BUDGET
BECAUSE- THE PRICE TAG ON THIS.
ONE AB TWENTY TWENTY NINE WAS
INTRODUCED WITH THE SOME MEMBER-
BUFFY WICKS RELATED TO THIS. DID
YOU KNOW THAT YOUR PROGRAM NOW
THIS IS CAME OUT WITH A REALLY
HEFTY PRICE TAG. AND THE
COALITION. THAT IS SUPPOSED
SPONSORING THIS BILL AS WELL.
DID AN INDEPENDENT REVIEW OF
FISCAL REVIEW- THROUGH THE
FERTILITY DYNAMICS AND THERE'RE
ANALYSIS CONCLUDED A MUCH LESS
PRICE TAG. VENTURE PROBE
MENTIONED BEEN THROUGH THEN THE
OPPOSITION MENTIONED. AND IF
THERE'S ROOM WHERE THERE'S AN
ABILITY TO. HAVE THE- EXPERT IN
THIS SPEAK ON THAT. WOULD YOU
LIKE TO HEAR FROM I REMEMBER
THAT YES POVERTY. THIS IS A
DIFFERENT PERSON IT'S A
DIFFERENT PERSON THAT'S A NO
THEN I CAN DO MY BEST. A
DIFFERENT NOTICES ALL RIGHT BUT
WE HAVE TO PREPARE AS WELL SO
LET'S YEAR. HAVE YOUR FAMILY Q.
TO COME FORWARD AND EXPLAIN THIS
TO ME. AND I WILL SAY THAT THE
SENATOR DID TAKE THE AMENDMENTS
WHICH TO DRASTICALLY REDUCE THE
COST- I'M SORRY AND I APOLOGIZE
FOR BOUNCING BACK AND FORTH FROM
ROLES THAT'S A GOOD I DID NOT
KNOW YOU TOOK THE MINUTES I
APOLOGIZE. OKAY THERE'S STILL A
BIG YES ABSOLUTELY BUT IT'S LESS
CURRENT TRUTH. I'M PATRICK CHAN
AND I REPRESENT THE FERTILITY
COALITION BEHIND THE BILL I DID
JUST WANT TO COMMENT A BIT ON
CHIP BIRDS AND ALICE'S. IF YOU
DO HAVE TO APPEAR THEY CAN
COMMENT I'M TRYING NOT I THINK
YOU ASKED FOR CHIPPER. FIRST YOU
WANT AYE PART WHEN YOU WERE
FIRST BUCKET. HI I. MADERA
CITRON YOUR BIRTH. AND WAY
QUESTIONS DO YOU HAVE IS THAT.
IN RELATION TO THE RELATIONSHIP
TO THE COST OF THIS BILL. I
THINK THAT WAS A QUESTION AS
AMENDED THE COST YEAH THE COST
TO THE BILL AS AMENDED. AND
COMPARED TO THAT THE AUTHOR
BROUGHT UP THE BUFFY WICKS BILL
LAST YEAR THAT HAD A- A YEAH I
THINK IT WAS A DEPARTMENT
FINANCER POSSIBLY AND AT SOME
POINT WHO DID THE ANALYSIS I
WITHIN THE DEPARTMENT OF FINANCE
IT WAS. SUCH A GOOD THING TO
SPEAK ON THE COALITION WENT OUT
AND DID THEY DIDN'T INDEPENDENT
FISCAL REVIEW OF THIS ARE NOT
RELATED TO AND THAT'S WHY I WAS
INTERESTED. OKAY PATRICK AND
THEN WE BROUGHT YOU THAT MA'AM
AND I APOLOGIZE FOR THAT
BECAUSE- I DIDN'T HAVE A
QUESTION FOR YOU I HAD A
QUESTION ON THE INDEPENDENT
ANALYSIS. THAT THE FACILITIES-
CEMENTING I'M HAPPY TO ANSWER
QUESTIONS AND COMPARE THE TWO
AFTER PATRICK SPEAKS IF THAT'S
OKAY THAT'S FINE THANK YOU VERY
MUCH YOU SORRY FOR THE CONFUSION
. PATRICK OKAY. GREAT SO THE
SENATORS CORRECT LAST YEAR WITH
A FEW WEEKS BILL WE- RETAINED A
PRIVATE CONSULTANT CALLED
FERTILITY DYNAMICS THERE A
NATIONAL LEADER IN DATA. FOR
FERTILITY CLINICS IN THE USE
ACTUAL DATA FROM THE COST FROM
FERTILITY CLINICS NATIONWIDE.
AND THEY DID AN ESTIMATE OF WHAT
THE COST WOULD BE TO BOTH THE
EMPLOYER AND THE EMPLOYEE FOR A
LARGE GROUP PLAN MANDATE ONLY.
AND THEIR ULTIMATE CONCLUSION
WAS- IT WAS SIXTY EIGHT CENTS
PER MEMBER PER MONTH. WHICH WAS
MUCH LOWER THAN CHIU BURBS
ANALYSIS WHICH AT THAT TIME WAS
IN THE BALLPARK OF THREE DOLLARS
PER MEMBER PER MONTH- THIS
ANALYSIS FOR THIS YEAR. DOES
RANGE SOMEWHERE BETWEEN THREE
AND FOUR. THE PRIMARY DIFFERENCE
BETWEEN THE TWO ANALYSES ARE ONE
METHODOLOGICAL DIFFERENCE GIBBER
INCLUDES IN THE COST OF
FERTILITY ALSO ALL INDIRECT
DOWNSTREAM COSTS FOR MATERNITY
ALL PREGNANCY CARE- PRE
PREGNANCY CARE PREGNANCY CARE.
MATERNITY CARE DELIVERY. AND
THAT REPRESENTS IN THIS CONTEXT
AT LEAST HALF OF THE TOTAL COST.
AS YOU DO APPRECIATE MATERNITY
CARE IS ALREADY A MANDATED
BENEFITS. SO AND THE SECOND
THING I WOULD SAY ABOUT THAT
INFERTILITY DYNAMICS SAID ABOUT
IT CALIFORNIA IS AN OUT LIAR IN
INCLUDING THE MATERNITY COSTS IN
THE COSTS OF FERTILITY. SO IT'S
AN OUT LIAR AND SHOULD NOT BE
CONSIDERED IN OUR VIEW IT WOULD
BE A CANDACE AND SOMEONE WITH
MULTIPLE CONDITIONS WHO GOES AND
SAY FOR DIABETES TREATMENT YOU
THEN HAVE TO FIGURE AND WHAT THE
COST WOULD BE FOR LIFESAVING
PROCEDURES IF THEY LATER HAVE TO
BE TREATED FOR THEIR HEART
CONDITION. SO THAT'S MORE THAN
HALF OF THE COST THAT LOWERS ITS
ME SO THAT'S NUMBER ONE NUMBER
TWO IS WE HAVE SOME DIFFERENCES
ABOUT HOW THE ACTUAL COSTS OF
THE SERVICES FOR FERTILITY-
ACTUALLY DO COST IN THE REAL
WORLD. AND SO WE CAN GO THROUGH
THAT BUT THAT'S WORTH ABOUT
ANOTHER HUNDRED MILLION DOLLARS
IN COST AND SO IN THE FINAL
ANALYSIS WE SAY FERTILITY
DYNAMICS HAS REPORTED THAT THE
TOTAL COST WOULD DEFINITELY BE
UNDER A DOLLAR PER MEMBER. PER
MONTH FOR LARGE GROUP PLANS NOW
THAT WOULD BE ABOUT A HUNDRED
MILLION DOLLARS PER YEAR. AND
THAT WOULD BE FOR NINE MILLION
PEOPLE IN LARGE GROUP PLANS. SO
THAT IS A RELATIVELY LOW COST.
THE LAST THING I WOULD SAY IS
THAT. PEOPLE ARE PAYING FOR
FERTILITY CARE RIGHT NOW. AND
WHAT YOU SHOULD BE FOCUSED ON IS
WHAT THE NEW NET COST IS.
BECAUSE YOU'VE GOT TO TAKE INTO
ACCOUNT THE PEOPLE ARE ALREADY
PAYING. SO WHAT ARE FRIENDS FOR
THE CHAMBER PRESTIN QUOTED WITH
THAT FOUR DOLLAR RATE. THAT DOES
NOT TAKE OUT WITH PEOPLE ALREADY
PAYING WHAT THE DIFFERENCE HERE
IS WHAT IS THE NEW NET COSTS
ASSOCIATED WITH THAT THAT'S
WORTH OVER A HUNDRED MILLION. SO
THAT IS WHY YOU GET TO UNDER ONE
HUNDRED MILLION TOTAL AND UNDER
A DOLLAR. PER YEAR PER MEMBER
PER MONTH THAT'S TWELVE DOLLARS
A YEAR. I CAN I HAVE A FOLLOW
CAN I JUST CLARIFY SOMETHING
JUST TO MAKE SURE I UNDERSTAND
IT. SO YOU CAME UP WITH A DOLLAR
PER MONTH TWELVE DOLLARS PER
YEAR PER MEMBER AND LARGE GROUP
PLANS. ARE WHERE DID YOU GET THE
NUMBER FOR THE TOTAL MEMBERSHIP
OF THE LARGE GROUP PLANS TO AND
ANALYZE THAT DATA I GUESS TO SAY
THERE ARE SO MANY GROUP THERE SO
MANY MEMBERS FOR THESE LARGE
GROUP PLANS AND IF THE TO PAY
TWELVE DOLLARS A YEAR. AND THEN
ALL OF THIS TO BE A COVERED
THAT'S A NUMBER THAT WE SHARE
WITH CHIPPER AND SO IT IT RELY
ENTRY BURKE YEAH. OKAY AND DO
YOU KNOW WHERE THAT IS NOT IN
DISPUTE I THINK- IT'S NOT IN
DISPUTE OKAY THAT'S WHAT I
WANTED TO KNOW THANK YOU SIR
VERY MUCH FOR THAT INFORMATION
THANK YOU SIR AND CAN I ASK YOU
PER VISIT TROOP ON THE
METHODOLOGY ISSUE THAT YOU DO
THE CURRENT INCLUDE ALL THE
COSTS. OF MATERNITY. IT IS TRUE
OUR CHARGE IS TO LOOK AT THE
PICTURE OF COSTS AND WHEN YOU GO
THROUGH INFERTILITY TREATMENT A
BABY DOES RESULT FROM THAT AND
SO WERE ASKED TO LOOK AT. HOW IT
IMPACTS HEALTH CARE SPENDING
OVERALL AND JUST TO CORRECT WHAT
PATRICK SAID AND WE ESTIMATED
THAT. IN THE SECOND YEAR OPPOSED
TO MANDATE. 74% OF THE INCREASE
IN PREMIUMS IT'S ATTRIBUTABLE TO
FERTILITY SERVICES. WELL 26% OF
THE TRIBUTYLTIN MATERNITY CARE.
SO IT'S A LITTLE BIT DIFFERENT
THAN THE HALF THAT HE WAS
QUITTING. OKAY OKAY. ONE ONE
ARSENAL. THANK YOU. I KNOW SHE'S
REGRETTING THAT I CAME BACK FROM
RULES. AND SO I JUST HAVE A
QUICK FOLLOW UP QUESTION SO
OBVIOUSLY IF YOU CAN'T I MEAN
OBVIOUSLY WE CAN'T GET PREGNANT
AND YOU DON'T HAVE MATERNITY
CARE WHICH SAVES A PLANTS MANY.
IN THAT ASPECT IS THAT
CALCULATED INTO YOUR GUISES
CALCULATION IN ANY WAY ON EITHER
OF YOUR- CALCULATIONS FOR
REDUCTION IN COST. WHAT'S NOT A
SAVINGS AND SO WE'RE LOOKING AT
WITH THAT IN WHAT THE NET
INCREASE WOULD BE. SO WE ASSUME
THAT AT BASELINE PEOPLE. YOU
KNOW DON'T. THEY'RE GOING
THROUGH INFERTILITY TREATMENTS
AT. WHATEVER THE RATE IS
HAPPENING RIGHT NOW. SO IF THEY
DON'T EXPERIENCE A PREGNANCY OR
LIVE BIRTH. THAN THOSE COSTS ARE
NOT INCLUDED IN THE BASELINE
EXPENDITURES. BUT THOSE COSTS
ARE ALREADY INCLUDED IN PLAN
COVERAGE NOW CORRECT SO WE'RE
YOU YOU'RE DOUBLING OR YOU'RE
NOT I WAS A DOUBLE IT'S WHAT'S
IN THAT IS SO WHAT THE
DIFFERENCE IS IF PEOPLE KNEW
LEAGUE USE. INFERTILITY
SERVICES. WHAT ARE THE NEW
PREGNANCIES THAT RESULT THAT
WOULDN'T HAVE RESULTED BEFORE.
OKAY I UNDERSTAND WHAT YOU'RE
SAYING OKAY THANK YOU VERY. MUCH
FOR THAT ABOUT THEM. THANK YOU.
THANK YOU. OKAY ANYBODY ELSE
WISHING TO MAKE A COMMENT. OR
QUESTION CENTER RUBIO. THANK YOU
MADAM CHAIR AND TO- MY
COLLEAGUE- AB THANK YOU SO MUCH
AT FOR THIS MEASURE BUT I DO
HAVE A LOT OF THE QUESTIONS I
HAVE TO JUST PREFACE IT BY THE
FACT THAT I WAS ALSO DOING SOME
OTHER WORK AND I WALKED IN. I
THINK AFTER YOUR TESTIMONY AND
THEN I WAS HANDED THIS- HI THANK
GOD AMENDMENTS- SELL. IT FEELS
WEIRD TO TALK ABOUT IT WHEN YOU
PROBABLY ALREADY TALKED ABOUT IT
AND IT'S HARD TO UNDERSTAND THIS
IS A REALLY COMPLICATED ISSUE
IT'S ALMOST LIKE YOU KNOW I'M
HEARING THE NET COSTS AND- THE
NUMBERS IT'S REALLY COMPLICATED.
BUT THE ISSUE YOU KNOW IT'S
REALLY SERIOUS AND THIS IS
COMING FROM SOMEONE THAT JUST
PASSED THE BILL YESTERDAY. OUT
OF COMMITTEE THAT WOULD ALLOW.
YOU KNOW FAMILIES THAT ARE
STRUGGLING WITH INFERTILITY IVF-
REPRODUCTIVE LOSS EITHER
MISCARRIAGES OR ABORTIONS I'M
SORRY ABORTIONS ARE. ADOPTIONS
FALL THROUGH AND SUGGEST YOU
KNOW ALLOWING. FAMILIES TO
GRIEVE FAN AND REALLY TAKE TIME
TO PROCESS IT AND THEN KEEP
TRYING AND SO YOU KNOW CLEARLY
THE CONCEPT FOR ME IS A NON
STARTER IT'S SOMETHING THAT'S SO
IMPORTANT AND SO FAMILIES NEED
AND I GET THAT BUT- THERE'S
STILL A LOT OF CONFUSION IN MY
HEAD AND NOT JUST YOU KNOW AND-
AGAIN I. JUST GOT HANDED THIS
PAPER SO I HAVEN'T HAD A CHANCE
TO REVIEW IT BUT- YOU KNOW I
WANT PEOPLE TO HAVE THIS SERVICE
I WANT PEOPLE TO HAVE ACCESS TO
BE ABLE TO CREATE A FAMILY BUT
I. JUST WANNA. SHARE MY
RESERVATIONS FOR OF NOT FEELING
LIKE I FULLY UNDERSTAND
EVERYTHING THAT WAS JUST. YOU
KNOW PUT ON THE TABLE. BECAUSE
AT THE END OF THE DAY I DO
UNDERSTAND THAT- I THINK THE
GENTLEMAN THAT DID THE
INDEPENDENT REVIEW SAID IT'S
JUST HALF BUT THAT'S- IF IT'S
50% IT'S STILL THREE THOUSAND
FOUR. OR A MEMBERS THAT ARE
PAYING OUT OF POCKET AND SO. I'M
JUST TRYING TO WRAP MY HEAD
AROUND IT SO I'M GONNA SUPPORT
IT BUT I DO HAVE TO. JUST
HIGHLIGHT HOW. IT'S A LOCAL.
CIRCLE I DID IT YEAH I INTEREST
NO JUST THAT DON'T FOR EXAMPLE
ONE OF THINGS THAT I HAVE AND
AGAIN I FEEL LIKE I CAME IN THE
MIDDLE OF A WAR I DON'T KNOW IF
YOU'RE EXPRESS IT LIKE. WHAT IS
THAT MEANS THOSE YOU KNOW
SOMEONE WANTS TO GET YOU KNOW I.
P. F. AND THEY HAVE ONE CHILD.
OR CAN THEY HAVE TEN OR OR LIKE
ARE THERE LIMITS CAN YOU
EXPLAIN. THAT I'M DONE. THE
ROUNDS YES. I MEAN YOU CAN
IMAGINE IN YOUR BILL THAT YOU
JUST SPOKE ABOUT- THE LOSSES OF
BY B. F. IT'S WOW I HAD BEEN UP
277% RATIO I'M SUCCESS RATE. IS
NOT ALWAYS SUCCESSFUL RIGHT SO
YOU DO YOUR YOUR BILL IS LOOKING
TO ADDRESS THE LOSS THAT COMES
AFTER TRYING- IT'S- CORRECT ME
IF I'M WRONG THERE IS NO CAP IN
MY- BILL. THERE IS NO CAP ME
JUST CAN I MY FAILED. THE ROUNDS
IT'S NOT BROWN YEAH I THINK I
THINK SHE'S SAYING I GAP CAN YOU
HAVE TEN KIDS AND THEN GO
THROUGH IVF- THAT IT. MANY LIKE
YOU. ALL OF COURSE. ARE GONNA
FAIL RIGHT SO YOU HAVE TO KEEP
TRYING BUT- YOU KNOW DOES
SOMEONE HAVE FOUR CHILDREN AND
THEN. GO TO ANOTHER ONE FIVE
CHILDREN LIKE IS THERE. A LIMIT
OR OR THAT'S- GREAT GREAT
QUESTION- AS FAR AS I KNOW WE
DON'T BUT I'D BE I AM OPEN TO
HAVING THOSE CONVERSATIONS WITH
MY COALITION AND SPONSORS. TO
SEE IF WE CAN GET SOME LANGUAGE
ON THAT TO SEE IF WE CAN FURTHER
LIMIT- BUT. I AS A CURRENTLY A-
TICKET AS A KERN I THINK. AS IT
STANDS THERE'S- NO I DON'T
REALLY TALK ABOUT THAT WE DID
TALK ABOUT. CAPPING THE AMOUNT
SOMEBODY COULD HAVE- INCOME- BUT
WE DECIDED NOT TO GO WITH THAT.
WHEN WE TALKED ABOUT HOW TO HOW
TO. AS WELL AND IT DOES NOT A
LIMIT THE BILL BECAUSE AT FIRST
IT HAD EVERYBODY. WE PARED IT
DOWN TO JUST LARGE GROUPS WHEN
THE OTHER THINGS WE LOOKED AT
WAS- THE HOW MUCH SOMEBODY COULD
MAKE IN ORDER TO. GET IT. BUT WE
OPTED TO GO WITH TRYING TO LIMIT
THE POOL. SO I GUESS IT YOU KNOW
BECAUSE I THINK EVERYONE HERE IS
TRYING TO EXPRESS HOW IMPORTANT
THIS ISSUE IS AND YOU KNOW AGAIN
I WOULD ENOUGH PASSED IN ON THE
BILL YESTERDAY BECAUSE I BELIEVE
IN IT. I MEAN I CAN SEE MYSELF
YOU DON'T HAVING TAKEN ADVANTAGE
OF IT. BUT IT'S NOT THE ISSUE
YOU KNOW IT'S ABOUT PROVIDING
THIS FOR EVERYONE BUT IT'S YOU
KNOW WHEN I'M THINKING THAT SAY
A MILLIONAIRE JUST HAVING TO PAY
LIKE. KEPT THEIR BE PARAMETERS
WITH SOMEONE THAT COULD YOU
KNOW. OVER MILLION SALARY AFFORD
IT YOU KNOW BECAUSE I THINK THAT
WOULD MINIMIZE WHAT GOES ON THE
BACK OF THOSE. PLAYERS YOU KNOW
BUT YOU KNOW WHAT LET'S JUST
ASSUME IT'S FIFTY PERCENT. OF
THAT WOULD BE THREE THOUSAND.
OUT OF POCKET SO. I'M NOT SAYING
ONE OR THE OTHER IT'S NOT MY
BILL I'M JUST SAYING THINKING OF
HOW DO WE MINIMIZE IT OUT OF
POCKET FOR THOSE THAT COULD
AFFORD IT- AND LIKE I SAID. WE
WANT EVERYONE TO EXPERIENCE YOU
KNOW UP THE JOY OF HAVING A
FAMILY BUT- SOMEONE HAS SIX
CHILDREN SEVEN CHILDREN AND
KEEPS GOING IN AND- IT SAID I
MEAN. CAN THAT BE TWELVE CARE NO
SENATOR AFTER SOME ENSURE WE
DON'T SEE OFTEN KEEPS GOING BUT
I DON'T HAVE IT BUT YOU
UNDERSTAND THIS IS AN UNANSWERED
QUESTION SO IF THIS IS SIX.
THOUSAND PER SHARE BOURBON LET'S
ASSUME 50% FOR THE INDEPENDENT
AND ANALYSIS AT THREE THOUSAND.
BUT DOES THAT MEAN I CAN THINK
ONE. PERCENT CONTINUE TO KEEP
GOING AND GOING. AND SO THAT IS
NO LONGER LIKE ACCESS TO THREE.
MAYBE FOUR KIDS RIGHT NOW THIS
IS SOMETHING THAT COULD JUST
CONVENTION KEY POINTS OUT. I'M I
GOT. OKAY IT IS A- LOT OF
TOPICAL SO TO LIKE LIMIT
SOMEONE'S ABILITY TO. YOU KNOW
YEAH. AND THIS IS. THE FIRST
COMMITTEE. SPURS POLICY
COMMITTEE AND SO I THINK WE'VE-
WE'VE WE- MADE AMENDMENTS. ARE
THAT ARE. THAT NARROW THE BILL
SOME. AND THERE ARE THERE. ARE
WILL STILL BE CONCERNED GOING
FORWARD. YEAH AND IT'S NOT ABOUT
LIMITING BUT I'D LIKE. THERE'S
NOTHING THERE RIGHT SO I JUST
WANTED TO UNDERSTAND A LITTLE
BETTER BUT I'D LIKE IT'S I'M NOT
SUPPORTED I YESTERDAY PASSED A
BILL ON. AN IVF AND JUST HOW
IMPORTANT IT IS BUT- FOR ME IT'S
JUST UNDERSTANDING THE WHOLE
PACKAGE BUT- WE THANK YOU.
THINGS THAT ARE IN OUR OFFICE
CAN DEFINITELY CONTINUE HAVING
THIS CONVERSATION SO BEFORE IT
GETS TO THE FLOOR FOR YOU. DO
YOU HAVE. A REALLY GOOD
UNDERSTANDING OF IT YEAH AND I
DO A REALLY GOOD JOB OF
EXPLAINING. I THINK REALLY
APPRECIATE THANK YOU MADAM
RESEARCH. YOU READY ELSE WISHING
TO SPEAK. ALL RIGHT. I THINK. I
MEAN I THINK WE ALL SHARE THE
SAME. THE SAME FEELINGS
IMPORTANT ISSUE WE WANT PEOPLE
TO BE ABLE TO EXPERIENCE.
CHILDREN AT THAT IS THEIR
DESIRE. AND WE'RE ALL CONCERNED
ABOUT THE COST OF EVERYTHING WE
KEEP DOING. THANK YOU VERY MUCH
WE HAVE A MOTION FROM SENATOR
ROTH WOULD YOU LIKE TO CLOSE. NO
I YOU KNOW THANK YOU AGAIN THIS
IS A BIG TOPIC THIS IS- IT GETS
INTO THE WEEDS OF A LOT OF
THINGS LIKE THE CHAIR MENTIONED
THIS IS DUMB. THE FIRST PLACE-
COMMITTEE WE'RE GOING TO
CONTINUE HAVING THESE
CONVERSATIONS. YOU KNOW I DO
WELL THIS IS THE PUBLIC POLICY
COMMITTEE YOU KNOW AND IN A
PROBE STALK MORE ABOUT THE
BUDGET SIDE OF IT. AND SEE HOW
WE CAN HELP ON THAT SIDE I'M SO
THANKFUL TO BE US THE SUB THREE
CHAIR THAT FOCUSES ON HEALTH AND
HUMAN SERVICES. AT THIS FALLS
UNDER AND HAVE AN EVEN MORE IN
DEPTH CONVERSATION WITH MY
CONSULTANT THERE ON THAT- BUT I
DO THINK YOU KNOW I MENTIONED
EARLIER I. THESE ARE ISSUES
THAT- HOW HEALTH COVERAGE.
UNINTENDED LEAD- DISCRIMINATES
INDIVIDUALS AND I THINK WE
SHOULD. WHILE I MENTIONED WE I
WILL FIGHT FOR SOMEONE'S RIGHT
TO NOT HAVE A CHILD THAT WAS A
FIVE FOR SOMEONE'S RIGHT TO HAVE
A CHILD A THING THAT'S- BOTH
EQUALLY VERY IMPORTANT WITH
THAT. I RESPECTFULLY ASK YOUR
IDOL. THANK YOU VERY MUCH
SECRETARY PLEASE CALL THE ROLL
AND THE MOTION IS TO PASS AS
AMENDED. AND RE REFER TO THE
COMMITTEE ON APPROPRIATIONS.
SENATORS EGGMAN AYE. EGGMAN AYE.
WHEN GLAZER. GLAZER AYE.
GONZALEZ GONZALEZ I GROWTH.
GROVE I. HER TADO. LIMÓN THE MON
ICE MENJIVAR. MENJIVAR AYE ROTH.
ROTH AYE RUBIO AYE RUBIO AYE
MOHAWK. BOB I WIENER. NINE ZERO.
NINE ZERO IS NOT TO GET OUT BUT
WILL HOLD IT OPEN FOR THE ABSENT
MEMBERS SENATOR LAMAR WE
UNDERSTAND YOU ARE PRESENTING.
FOR SENATOR WIENER. YOU'RE VERY
KIND COLLEAGUE. SOMETHING WE GET
OUR QUESTION. HI AM SENATOR
WIENER. I THANK YOU MADAM CHAIR
ON BEHALF OF SENATOR WIENER I
WOULD LIKE TO START BY THANKING
THE COMMITTEE- AND I'M STARTING
WITH FILE AND ELEVEN OKAY THEY
CAM. AS TO START BY THANKING THE
COMMITTEE STAFF FOR THEIR WORK
ON THIS AND ACCEPT THE
AMENDMENTS AS OUTLINED IN THE
ANALYSIS. COLLEAGUES RIGHT NOW
MILLIONS OF CALIFORNIANS LIVE IN
FEAR OF NOT BEING ABLE TO AFFORD
THE INSULIN THEY NEED TO REMAIN
HEALTHY. SENATE BILL NINETY THE
INSULIN AFFORDABILITY ACT WOULD
ELIMINATE THAT FEAR. IN THE
PROCESS IT WOULD STOP FORCING
THOUSANDS. OF INDIVIDUALS
RISKING THEIR LIVES BY RATIONING
INSULIN TO SAVE ON COSTS. SB
NINETY WOULD PROHIBIT HEALTH
INSURERS AND HEALTH MAINTENANCE
ORGANIZATIONS H. M. O.'S FROM
IMPOSING A DEDUCTIBLE
COINSURANCE COPAYMENTS OR ANY
OTHER COST SHARING. FOR AN
INSULIN PRESCRIPTION DRUG THAT
EXCEEDS THIRTY FIVE DOLLARS OR
THIRTY DAYS OR THIRTY DAYS
SUPPLY. FOR A THIRTY DAY SUPPLY
INSULIN PRICES HAVE NEARLY
TRIPLED IN THE PAST DECADE
CREATING FINANCIAL HARDSHIPS FOR
MILLIONS OF CALIFORNIANS RELY ON
IT TO SURVIVE A SURVEY BY THE
AMERICAN DIABETES ASSOCIATION
FOUND THAT ONE IN FOUR PEOPLE
USING INSULIN HAVE REPORTED
INSULIN UNDER USE DUE TO THE
HIGH COST OF INSULIN. WHILE THE
NATIONAL INFLATION REDUCTION ACT
PASSED LAST YEAR CREATED A
THIRTY FIVE DOLLAR MONTHLY CAP
ON INSULIN THE LEGISLATION IS
LIMITED TO SENIORS ON MEDICARE
AND WROTE. AND MEDICAL OR MORE
ENROLLEES LEAVING MILLIONS
WITHOUT FINANCIAL RELIEF SINCE
INSULIN IS CONSIDERED A
PREVENTATIVE CARE UNDER FEDERAL
GUIDANCE HIGH DEDUCTIBLE HEALTH
PLANS. HAVE DISCRETION OVER
WHETHER TO OFFER INSULIN WITHOUT
COST SHARING. IT IS SIMPLY
OUTRAGEOUS THAT ACCESS TO A
LIFESAVING MEDICATION IS AT THE
HANDS OF THE HEALTH PLANS GOOD
WELL. IMPOSING A DEDUCTIBLE ON
INSULIN REQUIRING INDIVIDUALS TO
MEET THAT DEDUCTIBLE CREATES A
FINANCIAL BURDEN THAT PRESENTS A
BARRIER TO ACCESSING INSULIN.
AND AS WE KNOW THIS FINANCIAL
BURDEN IS ENTIRELY UNNECESSARY.
RESEARCH FROM USC'S AT SHOP FOR
SCHOOL OF HEALTH POLICY FOUND
THAT THE PRICE INCREASE IS NOT
BECAUSE OF RISING COSTS IT'S
BECAUSE PHARMACY BENEFIT
MANAGERS AND OTHER MIDDLE.
INDIVIDUALS ARE CHARGING MORE
AND MORE FOR SUPPLIES PHARMACY
FIRST TO SUPPLY PHARMACIES AND
HEALTH PLANS WELL PHARMACY
BENEFIT MANAGERS WILL TELL
SAVINGS THOSE SAVINGS DO NOT GET
PASSED DOWN TO THE CONSUMERS.
RATHER PATIENTS ARE FORCED TO
BUY INSULIN OUTSIDE OF THEIR
HEALTHCARE COVERAGE. THAT DO NOT
COUNT TOWARDS THEIR OUT OF
POCKET MAXIMUMS. COLLEAGUES I
ASK FOR YOUR SUPPORT ON BEHALF
OF FOUR MILLION CALIFORNIANS
DIAGNOSED WITH DIABETES TO
MANAGE THEIR DISEASE AND STAY
HEALTHY. TODAY TO TESTIFY IN
SUPPORT OF THE BILL OUR DOCTOR
FRANCISCO BUT YET THOUGH FAMILY
MEDICINE PHYSICIAN AND PATIENT
ADVOCATE FOR DIABETES LISA
MURDOCK CHIEF ADVOCACY OFFICES
WITH THE AMERICAN DIABETES
ASSOCIATION WITH SHARE GONZALEZ
AVAILABLE FOR TECHNICAL
QUESTIONS. THANK YOU VERY MUCH
DR. GOOD AFTERNOON MADAM CHAIR
AND MEMBERS. I'M DOCTOR
FRANCISCO PREETO AYE MAYES
PHYSICIAN PRACTICING FAMILY
MEDICINE IN THE SACRAMENTO AREA
FOR THE LAST THIRTY FIVE YEARS
AND I CURRENTLY SERVE AS THE
CHAIR OF THE AMERICAN DIABETES
ASSOCIATION'S. NATIONAL ADVOCACY
COMMITTEE AND AM A MEMBER OF THE
EDS NATIONAL BOARD OF DIRECTORS.
I'M HERE TODAY TO SPEAK IN
SUPPORT OF SENATE BILL NINETY
WHICH WOULD CAP COST SHARING FOR
INSULIN AT THIRTY FIVE DOLLARS
IN CALIFORNIA. I BECAME INVOLVED
WITH DIABETES BECAUSE OF THE
TERRIBLE IMPACT THAT I SAW THIS
DISEASE HAVING ON MY COMMUNITY-
AS MOST OF YOU KNOW LOWER INCOME
CALIFORNIANS AND PEOPLE OF
COLOR. HAVE A DISPROPORTIONATE
INCIDENCE OF DIABETES AND
ALREADY PAY A VERY HIGH PRICE.
EVEN BEFORE YOU CONSIDER THE
COST OF INSULIN. PEOPLE WITH
DIABETES IN CALIFORNIA FACE A
SERIOUS THREAT TO THEIR HEALTH
FROM THEIR DISEASE. THAT SHOULD
NOT BE COMPOUNDED BY BEING
UNABLE TO AFFORD THE MEDICATION
THEY NEED TO SURVIVE. A
TREATMENT WHICH WAS DISCOVERED
AND FIRST BECAME AVAILABLE OVER
A CENTURY AGO. MULTIPLE SURVEYS
HAVE ACTUALLY FOUND THAT AS MANY
AS ONE IN FOUR PEOPLE IN THE U.
S. REQUIRE INSULIN TO LIVE
CANNOT AFFORD ITS PRICE WHICH
HAS RISEN ALARMINGLY IN THE PAST
FEW DECADES. AND FACED WITH THIS
HARDSHIP TO MANY OF THEM ARE
FORCED TO RATION OR SKIP DOSES
OF INSULIN PLACING THEM AT
INCREASED RISK. FOR SERIOUS
SHORT TERM AND LONG TERM HEALTH
PROBLEMS. CAPPING OUT OF POCKET
COSTS AT THIRTY FIVE DOLLARS IN
LINE WITH THE PRICE THAT
MEDICARE RECIPIENTS NOW PAY WILL
HELP TO ENSURE THAT PEOPLE WITH
DIABETES ARE ABLE TO AFFORD THE
MEDICATION THEY NEED. TO LIVE
AND THRIVE. AS A POSITION. I'VE
SEEN TOO MANY PATIENTS STRUGGLE
WITH THESE COSTS. WHEN THEY FACE
THE CONSEQUENCES OF SKIPPING A
RATIONING DOSES. WHEN THEIR
HEALTH PLAN PASSES ON THE
INFLATED COSTS OF THE CENTURY
OLD TREATMENT. THEY TRY TO SAVE
A LITTLE MONEY BY CUTTING BACK.
WE SEE THEM AGAIN WHEN THEY
REALIZE THAT THEY'RE LOSING
THEIR VISION OR THEIR KIDNEYS
ARE FAILING OR THEY'RE ON THE
VERGE OF LOSING A TOE OR LOSING
A FOOT. ALL THINGS THAT WE KNOW
HOW TO PREVENT. BUT WHAT WE'RE
THANKFULLY IT A BETTER PLACE IN
THE PANDEMIC WHAT WE EXPERIENCE
OVER THE PAST FEW YEARS
SHOULDN'T BE FORGOTTEN. PEOPLE
WITH DIABETES ARE 40% MORE
LIKELY TO EXPERIENCE SEVERE
COVERT NINETEEN COMPLICATIONS.
INCLUDING HOSPITALIZATION DEATH.
AND THE MOST IMPORTANT RISK
FACTOR FOR ADVERSE OUTCOMES IS
POOR CONTROL OF BLOOD SUGAR.
TWENTY TWO STATES AND THE
DISTRICT OF COLUMBIA HAVE
APPROVED LEGISLATION CAPPING THE
COST OF INSULIN. THEY DONE SO
BECAUSE THEY REALIZED THAT
PEOPLE SHOULDN'T DIE BECAUSE
THEY CAN'T AFFORD THIS
LIFESAVING MEDICATION. AND
AL-SISI'S SHOWN THAT THESE CAPS
DO NOT RESULT IN A SIGNIFICANT
IMPACT ON PREMIUM RATES AND MAY
RESULT IN SAVINGS FROM FEWER
EMERGENCY ROOM IS ROOM VISITS TO
TREAT POORLY MANAGED DIABETES.
EVERY OTHER DEVELOPED NATION ON
EARTH REGULATES THE COST OF
INSULIN. TO ENSURE THAT ITS
PORTABLE AND IT'S ALL OF THOSE
COUNTRIES. INSULIN MANUFACTURERS
REMAIN PARK PROFITABLE AND THEY
REMAIN IN BUSINESS. AS A
PHYSICIAN WHO CARES FOR PEOPLE
WITH DIABETES I RESPECTFULLY ASK
YOUR AYE VOTE AND I'M AVAILABLE
FOR ANY QUESTIONS THANK YOU VERY
MUCH THANK YOU. NEXT SUPPORTER
THANK YOU MADAM CHAIR AND
MEMBERS- I REALLY JUST
APPRECIATE THE OPPORTUNITY TO
TALK WITH THE FAMILY SUMMER
DOCUMENT CHIEF ADVOCACY OFFICER
FOR THE AMERICAN DIABETES
ASSOCIATION. I'M YOU KNOW WE
WERE REALLY PLEASED TO SEE WHAT
HAPPENED LAST YEAR WITH MEDICARE
AND WE WERE EVEN MORE PLEASED TO
SEE THE REINTRODUCTION OF A
BIPARTISAN BILL AT THE FEDERAL
LEVEL LAST WEEK- IN THE U. S.
SENATE. BUT THIS CONVERSATION
DIDN'T START AT THE FEDERAL
LEVEL THIS CONVERSATION WAS
DRIVEN BY STATE LEGISLATURES
ACROSS THE COUNTRY. TWENTY TWO
STATES AND THE DISTRICT OF
COLUMBIA HAVE ALREADY DONE THIS
HAVE ALREADY CAPPED THE PRICE OF
OUR COSTS OUT OF POCKET COSTS
FOR PEOPLE WITH DIABETES AND
THEY'VE DONE IT BECAUSE THEY
KNOW. THAT YOU KNOW THAT THE
DRAMATIC AND DESPERATE SITUATION
THAT THERE ARE CITIZENS THEIR
RESIDENTS HAVE WITH DIABETES TO
MAKE SURE THAT THEY CAN AFFORD
THE LIFESAVING TREATMENT THE
INSULIN PROVIDES SOME SO. I
DOCTOR PRE IT WAS COVERED ALL OF
THIS I'M NOT GONNA TO BELABOR IT
BUT WE JUST ASK FOR YOUR I.
PHONE. THANK YOU. THANK YOU VERY
MUCH ANYBODY ELSE SPEAKING IN
SUPPORT OF THIS BOARD AT THIS
TIME. JUST NAME AND AFFILIATION
. GOOD EVENING ALEX CALLING ON
BEHALF OF THE CALIFORNIA CHRONIC
CARE COALITION IN SUPPORT THANK
YOU. BRENT SPENCER BAPTIST
AMERICAN COLLEGE OF OBGYN
STRYCHNINE AND THE CALIFORNIA
PODIATRIC MEDICAL ASSOCIATION
BOTH IN SUPPORT THANK YOU. HELLO
I'M WILLIAM WELL I'M A SECOND
YEAR MED STUDENT AND I SUPPORT
THIS BILL THANK YOU. HELLO A
SEAN THE SECOND YEAR OF PODIATRY
SOON I SUPPORT THIS BILL THANK
YOU. HI JOCELYN EXECUTOR
PORTEOUS MEDICAL STUDENT I
SUPPORT THANK YOU. MEGAN LOOKED
HAVE SECOND YEAR MEDICAL STUDENT
I SUPPORT THANK YOU. CHAIR
MEMBERS JOSE TORRES WITH HEALTH
ACCESS CALIFORNIA IN STRONG
SUPPORT. AFTER INVESTMENT ASK IT
AS HEAR CALIFORNIANS SUPPORT
THANK YOU VERY MUCH. NO GO TO
THOSE SPEAKING IN OPPOSITION TO
THIS BILL TODAY. A GOOD
AFTERNOON CHAIR MEMBERS OF THE
COMMITTEE ROBERT BOYKIN WITH THE
CALIFORNIA ASSOCIATION OF HEALTH
PLANS REGRETTABLY IN HERE IN
OPPOSITION SB NINETY. FIRST YOU
WANT TO MAKE CLEAR THAT WE ARE
FULLY UNDERSTAND IT SYMPATHIZES
PATIENTS OR BURDEN WITH THE HIGH
AND CONTINUE RISING COST. OF
INSULIN WE HAVE CONTINUALLY
VOCALLY EXPRESSED THAT
ADDRESSING THE HIGH UNDERLYING
PRICE OF PRESCRIPTION DRUGS
WITHIN OUR HEALTH CARE SYSTEM IS
CRITICAL TO MAINTAINING
AFFORDABILITY FOR ENROLLEES. WE
SHARON RELIEF ASSERTIONS THAT
THEIR EXPONENTIAL RISE A
PRESCRIPTION DRUG PRICES
INCLUDING INSULIN- IS CONTINUE
TO DRIVE ACROSS WITHIN OUR
HEALTH CARE SYSTEM THE FACT IS
THE INSULIN PRODUCTS HAVE BEEN
ON THE MARKET FOR ALMOST A
CENTURY. YET THE PRICE OF
INSULIN CONTINUE TO RISE FAR
OUTPACING- INFLATION AND WITHOUT
ANY MAJOR MEDICAL IMPROVEMENT TO
THE DRUG. THE NEWSOME
MINISTRATION IS ATTEMPTING TO
MAKE PROGRESS ON THIS BY WORKING
WITH THE NONPROFIT DRUG MAKER TO
CREATE ITS OWN LOW LOW COST
INSULIN DRUG. THE RECENT
ANNOUNCEMENTS THAT GIVES US HOPE
THAT THE INCREASED COMPETITION
WILL HELP LOWER THE OVERALL COST
OF INSULIN AND HELP EASE THE
FINANCIAL BURDEN ALL
CALIFORNIANS. REGRETTABLY SB
NINETY IN SIMILAR BILLS IN YEARS
PAST TAKE A BANDAID APPROACH AND
DO NOTHING BUT INCREASE COSTS
FOR EVERYONE. THIS IS REFLECTED
IN THE CALIFORNIA HEALTH
BENEFITS REVIEW PROGRAM ANALYSIS
OF THE BILL WHICH INDICATES THAT
PREMIUMS WILL INCREASE FOR ALL
INSURED BY APPROXIMATELY SIXTY
TWO MILLION. HEALTH PLANS REMAIN
COMMITTED TO PROVIDING
COMPREHENSIVE COVERAGE THAT
HELPS OUR RELEASE PREVENT
DIAGNOSE. AND MANAGE BOTH ACUTE
AND CHRONIC CONDITIONS THAT
PROMOTE HEALTH WELLNESS AND
PREVENTION BUT SB NINETY IS THE
WRONG ANSWER. FOR THESE REASONS
RESPECTFULLY OPPOSE SB NINETY
THANK YOU THANK YOU VERY MUCH.
STEPHANIE STEPHANIE WADKINS ON
BEHALF OF THE ASSOCIATION
CALIFORNIA LIFE AND HEALTH
INSURANCE COMPANIES IN THE
INTEREST OF TIME I'LL JUST. READ
REPRESENT MY OPPOSITION THANK
YOU THANK YOU. JOHN WENGER
AMERICA'S HEALTH INSURANCE PLANS
OPPOSITION THANK YOU. PRESTIA IN
CALIFORNIA CHAMBER OF COMMERCE
HERE IN OPPOSITION THINKING Q.
OKAY OVER THE PHONE LINES NO
MODERATOR ANYBODY IN THE QUEUE
TO SPEAK ON. S. B. NINETY. HM IF
YOU WISH TO MAKE A COMMENT
SUPPORT OR OPPOSITION THE- ONE
BUREAU. WILL BE ON THE LINE ONE
FORTY THREE PLEASE GO AHEAD.
HELLO MY NAME IS MARTY WARD AND
I'M WITH UNIVERSITIES ALLIED FOR
ESSENTIAL MEDICINES AT UCLA AND
STRONG WORK THANK YOU. THANKS
CALLER PLEASE. NEXT WE'RE GOING
TO LINE IN NINETY EIGHT YOU ARE
AT. YES WONDERFUL WITH THIS IN A
LONG POVERTY IN SUPPORT. THANK
YOU NEXT CALLER PLEASE. MEXICO
INTO LINE ONE OH SEVEN PLEASE GO
AHEAD. THANK YOU I AM NOT A WITH
INDIVISIBLE CALIFORNIA STATE
STRONG A COALITION OF OVER
EIGHTY DEGREES THROUGHOUT
CALIFORNIA STRONG SUPPORT THANK
YOU THANK YOU. THANKS CALLER
PLEASE. IT ON THE LINE ONE FORTY
ONE PLEASE GO AHEAD. BUT FORTY
ONE YOUR LINE IS OPEN. NEXT IT
WILL BE GOING TO LINE ONE FORTY
NINE. LINES OPEN. FORTY NINE.
YOU SHOULD MOVE ON MODERATE.
NEXT WE'LL GOING TO LINE ONE TEN
PLEASE GO AHEAD. I FINALLY WOULD
COME BEHALF. A. A. R. P.
CALIFORNIA IN SUPPORT THANK YOU
. NEXT WEEK WILL BE GOING TO
LINE ONE FIFTY FOUR PLEASE GO
AHEAD.
I THANK YOU FOR YOUR LINE IS
OPEN. ACTUALLY WE'RE GOING TO
LINE ONE FORTY EIGHT PLEASE GO
AHEAD.
CREATE YOUR LINE IS OPEN. X. IT
WILL BE GOING TO LINE ONE FIFTY
ONE PLEASE GO AHEAD.
JUST LIKE THAT'S IT MODERATOR
AND NEXT UP WE HAVE A FEW MORE
TO APOLOGIZE OF MAKING SURE THAT
WHEN THAT. THAT ON THE OPEN
THERE AND UNLESS WE GO TO LINE.
ONE UNCERTIFIED RELIANCE OPEN.
JACKSON WILL BE GOING TO LINE
ONE FIFTY THREE GO AHEAD. NOT A
BAD BATCH YOUR MODERATOR. HI
RAHUL MODY AND I'M AND I'M GREAT
CHAPTER UNIVERSITIES ALLIED FOR
ESSENTIAL MEDICINES I'M
INSTRUCTED BUT STILL. THANK YOU
. THIS ORDER LINE ONE FIFTY
PLEASE GO AHEAD.
AND FIFTY ALLIANCE OPEN.
APPARENTLY NO ONE ELSE IN THE
QUEUE AT THIS TIME THANK YOU
VERY MUCH MODERATOR OKAY- NOW
WILL BRING IT BACK TO THE
COMMITTEE FOR ANY QUESTIONS OR
COMMENTS. MOVE THE BILL CENTER
GONZALEZ MOVES A BILL CENTER
GLAZER YOU HAVE A QUESTION OR
COMMENT I DO AND I RESPECT THE
REPRESENT OF THE CENTER WIENER
MAY NOT KNOW THE ANSWER THIS BUT
THE CHAIR CONSULTANTS OR MAYBE
CHEAPER FOOD NOW I'M TRYING TO
UNDERSTAND THE EFFECTIVE- FOR
GOVERNOR NEWSOM'S PROPOSAL TO
PUT A TO MAKE INSULIN HERE IN
THE STATE AND I BELIEVE LIMIT TO
THIRTY DOLLARS. COST THIRTY
DOLLARS IS THAT TAKING INTO
ACCOUNT AND THAT SHOULD BURKE
THE DALLAS IS THAT WE HAVE HERE.
WE HAVEN'T TAKEN SURE- A MEMBER
FROM CHIPPER A JAR IT WHO CAN
ADDRESS THAT YOU'RE BERMAN
ALICE'S SPECIFICALLY AND THEN WE
CAN TALK ABOUT THE GOVERNOR'S
PROPOSAL. HI AGAIN I'M NO
SUBURBAN ALICE SAYS DID NOT
INCORPORATE THE GOVERNOR'S
PROPOSAL- AT THAT TIME WE DIDN'T
HAVE ENOUGH INFORMATION AS TO
WHAT WAS HAPPENING I'M ALSO WITH
THAT DRUG MAKERS AND LIMITING
THE COST OF INSULIN. NOT ALSO
WILL CHANGE THE IMPACT OF THE
ANALYSIS AND SO WE GET A LOT WE
ASSUMED THIS IS BASED ON CLAIMS
DATA. THAT THE AVERAGE COST OF
INSULIN. WHY IS FIVE HUNDRED
TWENTY ONE DOLLARS PER MONTH PER
PRESCRIPTION SO WITH CHANGES
BOTH BY THE DRUGMAKER'S AND ALSO
WHAT'S HAPPENING IN CALIFORNIA
THE COST IMPACTS WILL BE
SUBSTANTIALLY DECREASED. IS IT A
TAX DECREASE. POTENTIALLY AND
YOU KNOW WHEN THE GOVERNOR'S
PROPOSAL SUPPOSED TO. BE IN
EFFECT IT'S GOING TO BE
AVAILABLE. I DON'T HAVE I DON'T
KNOW TWENTY HOW MANY. TWENTY
TWENTY TWENTY FOUR TWENTY FOUR.
THIS BILL WOULD GO INTO EFFECT
UNTIL JANUARY FIRST OF TWENTY
FOUR CORRECT. SO IT APPEARS
THAT- AND MAYBE THE I THINK I'M
CONTENT BUT MAYBE THE PLANS WANT
TO EXPLAIN THEN. GIVEN THAT
CIRCUMSTANCE YOU KNOW WHY IT WHY
IS THERE SUCH CONCERNED STILL
ABOUT THIS PROPOSAL. WHAT AND
THAT'S WHAT WE TRY TO TAKE INTO
ACCOUNT WHEN WE ASK FOR THE
AMENDMENTS WAS JUST TO REALLY
GIVE EVERYTHING TIME TO GET ON
THE RAMP AND ALSO- LIMITING A
LOT BUT IF THE IF YOU LIKE TO
HEAR FROM THE PLANTS WE CAN
CERTAINLY. I JUST UNDERSTAND THE
PLANS POSITION WHEN THEY
ACKNOWLEDGE IN THEIR TESTIMONY
ABOUT THE GOVERNOR'S PROPOSAL
YET. COULD BE A TEN X. OR
GREATER REDUCTION YES BUT THE
I'M SORRY- OPPOSITION KIND OF
RELIED ON THE FACT THAT
DRUGMAKERS SET THE PRICE. OF THE
OF THE DRUG ITSELF AND THE
GOVERNOR'S PROPOSAL IS HELP
BRING COMPETITION WILL HELP
LOWER THE COST OVERALL FOR
EVERYBODY ELSE SO THAT'S
SOMETHING WE'RE BEHIND WHAT IS
THAT MEAN THAT THAT THE
CALIFORNIA. INSULIN WHEN IT'S
AVAILABLE IS NOT AVAILABLE TO.
FOR THE PLANS TO UTILIZE AYE.
AYE HAS WOULD HAVE TO WAIT AND
FIND OUT I DON'T KNOW THE ANSWER
I WAS ARE YOU THERE. I CAN FIND
OUT FOR YOU LATER AND GIVE AN
ANSWER. IT MAKES ME COMFORTABLE
WITH THE BILL SO. THANK YOU.
THANK YOU VERY MUCH OKAY- CENTER
WOULD YOU LIKE TO CLOSE AND HAVE
CENTER WIENER I RESPECTFULLY ASK
YOUR NEIGHBOR THANK YOU VERY
MUCH WE HAVE A MOTION FROM
CENTER GONZALEZ. SATISFACTION
FROM. SENATOR GLAZER AND IT IS
DUE. TO PASS AS AMENDED REFERRED
STICK COMMITTEE ON
APPROPRIATIONS. SECRETARY PLEASE
CALL THE ROLL. SENATORS FIVE
EIGHT I. WENT GALAY. IS YOUR AYE
GONZALEZ. AND SALAS I. GROWTH
HER TADO. LIMÓN AYE LIMÓN AYE
MENJIVAR. MENJIVAR AYE ROTH.
ROTH AYE RUBIO. RUBIO I WILL HOP
. WIENER. SEVEN SEVEN IS ENOUGH
TO GET UP WILL HOLD THAT OPEN
FOR ABSENT MEMBERS NOW MOVING ON
TO SENATOR WIENER'S SB THREE
THREE NINE HAVING TO DO WITH
PREP AND PEP. THANK YOU CHAIR
AND MEMBERS ON BEHALF OF SENATOR
WIENER I AM PRESENTING SENATE
BILL THREE THREE NINE WHICH WILL
RESOLVE SOME IMPLEMENTATION
ISSUES WITH THE PREVIOUS BILL
THAT HE AUTHORED SB ONE FIVE
NINE AND THAT WAS PASSED INTO
LAW IN TWENTY NINETEEN TO
BRIEFLY SUMMARIZE A PREP IS A
ONCE DAILY PILL OR AND EVERY
OTHER MONTH INJECTION. THAT AT
THAT ALL BUT ELIMINATES THE RISK
OF HIV INFECTION. IT LOWERS YOUR
RISK FOR MEDICALLY MORE THAN
CONDOMS TO PEOPLE CAN AND SHOULD
STILL USE CONDOMS ESPECIALLY TO
PREVENT STI'S BUT PREP IS A
TRANSFORMATIONAL PREVENTION TOOL
FOR HIV. THE TWENTY NINETEEN
BILL GRANTED PHARMACISTS THE
ABILITY TO PROVIDE PREP AND PAP
WITHOUT A PRESCRIPTION SIMILAR
TO HOW BIRTH CONTROL IS
DISTRIBUTED THE IDEA WAS THAT
PEOPLE WOULD BE ABLE TO GO INTO
THEIR NEIGHBORHOOD PHARMACY AND
THAT THEY COULD GET THIS
MEDICATION. WE WERE THE FIRST
STATE IN THE COUNTRY TO ENACT
THAT FOUR YEARS AGO WE AGREE TO
SOME RESTRICTIONS ON THE BILL WE
WORKED WITH THE UP THE PONENS TO
PUT CERTAIN LIMITATIONS ON THE
BILL. BUT WE DID IT IN GOOD
FAITH NOW IT IS CLEAR THAT ONE
OF THOSE RESTRICTIONS IS NOT
WORKING AND IS A MAJOR
IMPEDIMENT TO THE IMPLEMENTATION
OF THE BILL. BY AND LARGE
PHARMACIES HAVE NOT IMPLEMENTED
THIS BILL. THEY ARE TELLING US
THAT THE LIMITATION IN THE BILL.
IN THE BILL THAT THE PHARMACIST
CAN ONLY DISPENSE SIXTY DAYS
WORTH. EVERY TWO YEARS DOES NOT
WORK. THE OTHER IMPEDIMENT THAT
HAS BEEN IDENTIFIED IS THAT
INSURANCE IS THAT INSURANCE
COMPANIES ARE NOT REIMBURSING
PHARMACISTS FOR THE TIME AND
EFFORT IN COMPLYING WITH THE
BILL. AFTER SB ONE FIVE NINE WAS
PASSED COLORADO ILLINOIS NEVADA
OREGON VIRGINIA AND UTAH
FOLLOWED OUR LEAD WITH THE SIXTY
DAY LIMITATION. WE ACTUALLY
PREPARED A CHART LOOKING AT ALL
THE OTHER STATES NONE OF THEM
HAVE THE SIXTY DAY LIMITATION IN
THAT IN PLACE. AND THEY ALL
EITHER REQUIRE REIMBURSEMENT OR
ARE WORKING TOWARDS REQUIRING
REIMBURSEMENT AND THEY'RE
SUCCEEDING IN THOSE STATES. SB
THREE THREE NINE BRINGS
CALIFORNIA'S CLOSER TO THE
SUCCESS TO THE SUCCESSFUL
PROGRAM IN OTHER STATES BY
ALLOWING PHARMACISTS TO FURNISH.
PREP AND PAP FROM SIXTY DAYS TO
NINETY DAYS OR ON AN ONGOING
BASIS SO LONG AS THE PATIENT
RECEIVES APPROPRIATE TESTING AND
FOLLOW UP. CARE CONSISTENT WITH
THE CDC GUIDELINES ADDITIONALLY
SB THREE THREE NINE REQUIRES
HEALTH PLANS TO REIMBURSE
PHARMACIES FOR PHARMACISTS
SERVICES IN PROVIDING PREP. AND
INCLUDING COST FOR THE
PHARMACIST SERVICES AND RELATED
TESTING. IF EVERYONE AT RISK OF
HIV ON THIS PLANET WERE TAKING
PREP. IF EVERYONE HAD AXIS WE
WOULD END THE HIV PANDEMIC. I
HAD TO TESTIFY IN SUPPORT OF THE
BILL. R. MARIA LOPEZ PRESIDENT
OF MISSION VALLEY WELLNESS
PHARMACY AND DR HYMAN SCOTT
MEDICAL DIRECTOR OF THE SAN
FRANCISCO AIDS FOUNDATION. FIRST
WITNESS PLEASE. AND HOW MUCH
TIME DO I HAVE. YOU HAVE ****
SIX MINUTES TOTAL FOR HOWEVER
MANY PEOPLE ARE SPEAKING OKAY
BUT THERE IS YOU DON'T HAVE TO
TAKE THAT LONG. THANK YOU-
HONORABLE CHAIR AND COMMITTEE
MEMBERS- MY NAME IS MARIA LOPEZ
I HAVE A DOCTOR OF PHARMACY.
DEGREE I'M A PHARMACIST AND
OWNER OF MISSION WHEN THIS
PHARMACY WHICH IS A COMMUNITY
PHARMACY IN THE HISPANIC LATINO.
DISTRICT OF THE MISSION DISTRICT
IN SAN FRANCISCO WHERE WE HAVE
EXPERIENCE ESTABLISHING TRUST
AND SERVING DIVERSE COMMUNITIES-
I'M ALSO CAPACITY BUILDING
ASSISTANT CONSULTANT. WHICH IS
FUNDED BY THE HIV OUT BY THE
CENTERS FOR DISEASE CONTROL AND
PREVENTION FOUR EIGHT- AND WE
WORK- AT SEA BY WITHOUT
PROVIDING EXPERTISE TO PUBLIC
HEALTH DEPARTMENTS ON HIV
PREVENTION AND TESTING. I ALSO
HOLD ASSISTANT CLINICAL
PROFESSOR TITLES AT TO YOU-
UNIVERSITIES OF PHARMACY- I'M
HERE ON MY OWN SPEAKING.
COMMITTEE PHARMACIES OFFER
CONVENIENT AND LONGER HOURS AND
MEDICAL OFFICES AND OUR STAFF BY
PHARMACIST WHO KNOWS THE
MEDICATIONS MAINTAIN ESTABLISHED
RELATIONSHIPS WITH THE
COMMUNITIES THEY SERVE. AND THUS
HAVE EXISTING RAPPORT WITH
PATIENCE AND THIS IS KEY TO
ADHERENCE. BASED ON PUBLISHED
MODELS WHICH MISSION WELLNESS IS
ONE PHARMACIST CAN SAFELY AND
EFFECTIVELY PROVIDE PREP AND
PAP. AND THIS IS WHY THE CDC AND
FEDERAL PARTNERS SUPPORT
PHARMACIST FURNISHING PROPPANT
PATH. WELL SB ONE FIVE NINE WAS
THE FIRST BILL IN THE NATION
GRANTING PHARMACISTS AUTHORITY.
IT IS AMONG THE MOST RESTRICTIVE
AND S. B. THREE THREE NINE WILL
ADDRESS THESE BARRIERS FOR
CALIFORNIA PHARMACIST. THE SIXTY
DAY SUPPLY IS NOT IN LINE WITH
THE CDC GUIDELINES WHICH
RECOMMEND NINETY DAYS OF
DISPENSING. AND THE ONE TIME
SUPPLY EVERY TWO YEARS DOES
NOTHING TO INCREASE PROP ACCESS
BECAUSE THERE IS A SHORTAGE OF
PROVIDERS AND PATIENTS CANNOT
ACCESS ONGOING PREP. THE LACK OF
REIMBURSEMENT REMAINS A MAJOR
BARRIER FOR CALIFORNIA
PHARMACIST. AND WHILE OUR
PROGRAM IN SAN FRANCISCO HAS
RECEIVED SOME LIMITED SUPPORT
THE MERE FACT WE CANNOT BILL FOR
SERVICES GREATLY HINDERS OUR
ABILITY TO PROVIDE SERVICES FOR
ALL PATIENTS WHO SEEK. PROP AT
OUR SITE AND WE HAVE HAD TO TURN
PATIENTS AWAY DUE TO THIS
BARRIER. TO BE CLEAR WE HAVE
APPROACHED INSURANCE COMPANIES
ABOUT PAYMENT FOR SERVICES AND
HAVE BEEN REPEATEDLY TOLD THEY
DO NOT HAVE A MECHANISM TO PAY
US. PHARMACISTS HAVE AUTHORITY
TO ORDER ALLOWS FOR MEDICATION
MANAGEMENT AND S. B. THREE THREE
NINE OUTLINES LABS IN ACCORDANCE
WITH THE CDC PROP GUIDELINES.
NATIONAL PHARMACY SCHOOL
STANDARDS ARE FOR ALL PHARMACY
STUDENTS REQUIRE PHARMACY
STUDENTS TO INTERPRET LABORATORY
TEST PRIOR TO GRADUATION.
FINALLY THIS BILL TAKES INTO
ACCOUNT THE VARYING LEVELS OF
PHARMACY PRACTICE SETTINGS SOME
SITES CAN PROVIDE THE NINETY DAY
SUPPLY. WHILE OTHERS WILL
PROVIDE ONGOING PRODUCT PROVIDED
THEY HAVE THE LABORATORY SIDE UP
AND FOLLOW UP FOR THE BILL. AND
I RESPECTFULLY REQUEST YOUR
SUPPORT OF THIS IMPORTANT PUBLIC
HEALTH MEASURE TO ENSURE
PATIENTS HAVE ACCESS TO THESE
LIFESAVING MEDICATIONS THANK YOU
THANK YOU VERY MUCH. FOR SOMEONE
ELSE ONE SPEAK IN. SUPPORT EIGHT
THANK YOU CHAIRMAN AND- MEMBERS
OF THE COMMITTEE FOR ALLOWING ME
THE OPPORTUNITY TO SPEAK OUT
SUPPORT OF SB THREE THREE NINE-
I'M DOCTOR HYMAN SCOTT ON THE
MEDICAL DIRECTOR AT THE SAME
JUST GRAZE FOUNDATION. MASA
PREPARATORY TO- WITH INSECTS THE
PART PUBLIC HEALTH INFECTIOUS
DISEASE TRAINED ON AND ALSO-
ASSISTANT CLINICAL PROFESSOR AT
UCSF- PREP IS A HIGHLY EFFECTIVE
HIGHLY SAFE- HIV PREVENTION
INTERVENTION THAT CAN REALLY
CHANGE. THE SCOPE OF WHAT WE'RE
SEEING IN THE HIV EPIDEMIC IN
THE U. S. WE HAVE ENDING THE
EPIDEMIC GOALS BOTH IN
CALIFORNIA AND- ACROSS THE
NATION THAT WE'RE NOT MEETING.
AND THAT ONLY ABOUT 25% OF
PEOPLE WHO WOULD HAVE AN
INDICATION FOR PROP ARE
CURRENTLY RECEIVING IT AND A BIG
PART OF THIS IS A SUPPLY OF
PROVIDERS TO PROVIDE ACCESS TO
PREP. OF PHARMACISTS ARE A KEY
ELEMENT OF OUR HEALTH CARE
SYSTEM IN ONE OF OUR LARGEST
HEALTH CLINICS IN SAN FRANCISCO
IT'S ACTUALLY RUN BY
PHARMACISTS- AND SO WE CAN BE
DONE SAFELY CAN BE DONE WHILE.
WE HAVE OVER THREE THOUSAND
PEOPLE ON PREP WITHIN THE SAME
SCHOOL AID FOUNDATION AND WE
STILL HAVE- MORE NEED MORE-
DEMAND THAT WE HAVE NEED THAT WE
CAN MEET- PHARMACISTS ARE-
PROVIDING OTHER PREVENTIVE CARE
MEASURES AND WE THINK THAT. THE
EXPANSION OF PROP WITHIN THE
PHARMACIST IS A REAL WIN FOR
CALIFORNIANS A WIN FOR HIV
PREVENTION I MAY HELP US TO
ACHIEVE OUR GOALS FOR- ENDING
THE EPIDEMIC- IT IS GOING TO BE
ESSENTIAL IF WE- ARE. GOING TO
TRY TO AND GET TO ZERO HIV WHICH
HAS BEEN- OUR GOALS BOTH LOCALLY
AND THE BAY AREA CALIFORNIA OUT
WIDE AND ACROSS THE UNITED
STATES- AND WE REALLY BELIEVE
THAT SB THREE THREE NINE IS A
KEY- POLICY THAT CAN HELP US TO
ACHIEVE THAT TO WE CAN MEET THIS
DEMAND THAT. IS CURRENTLY
LEADING TO PEOPLE- BEING
DIAGNOSED WITH HIV A WE HAVE
THIS TREMENDOUSLY POWERFUL SAFE
PREVENTIVE TOOL THAT WE CANNOT
GET OUT. TO THOSE WHO NEED IT SO
THANK YOU FOR YOUR SUPPORT.
THANK YOU VERY MUCH. OTHERS
WISHING TO SPEAK IN SUPPORT. NOW
JUST NAME AND AFFILIATION PLEASE
. THOMAS SEVEN CISCO ITS
FOUNDATION PROUD TO BE A CO
SPONSOR OF THIS LEGISLATION IN
SUPPORT THANK YOU. KELLY BROOKS
ON BEHALF OF THE COUNTY HEALTH
EXECUTIVES ASSOCIATION OF
CALIFORNIA AND SUPPORT. KATHY
MUSBURGER BEHALF OF ESSENTIAL
ACCESS HEALTH AND A PILLAR
HEALTH IN SUPPORT. DIVIDENDS
AUSABLE HALF OF CALIFORNIA LIFE
SCIENCES AND SUPPORT. THE CARD
PULSE FOR QUALITY CALIFORNIA
PROUD CO SPONSOR IN STRONG
SUPPORT. CHARLIE DONALDSON ON
BEHALF ACCEPTED IN SUPPORT.
THANK YOU. ANYBODY SPEAK IN
OPPOSITION TO THIS BILL TODAY
PLEASE COME FORWARD AT THIS
POINT. RIGHT SHE'S BEEN. RENT
SPENT ABOUT HALF OF THE
CALIFORNIA MEDICAL ASSOCIATION
AND THE AMERICAN COLLEGE OF
OBGYN WE REGRET WE HAVE AN
OPPOSE UNLESS AMENDED POSITION
WE FULLY EMPATHIZE AND
APPRECIATE THE INTENT GOAL OF
THIS BILL AND ACTUALLY BELIEVE
THERE IS PROBABLY A WAY TO
IMPROVE ACCESS AND INCREASE THE
AMOUNT OF TIME. THAT FARMS IT
HAS THE ABILITY TO FURNISH- PREP
AND PAP HOWEVER AT SOME POINT WE
BELIEVE THAT THAT INDIVIDUAL
RECEIVING THE PROPER PEP SHOULD
SEE A QUALIFY PROVIDER OF WHO IS
AUTHORIZED TO PROVIDE
PRESCRIPTION WE HAD SOME GOOD
DISCUSSIONS WITH THE AUTHOR. I
KNOW HE'S AT THIS POINT HE'S NOT
WILLING TO GO THERE BUT WE HOPE
TO CONTINUE DISCUSSIONS BUT TELL
THAT WAS A MEMBERS ARE DRESSED
ARE CURRENT CONCERNS ARE
ADDRESSED WE REMAIN OPPOSED
THANK YOU THANK YOU MR
PRESIDENT. WISHING TO SPEAK IN
OPPOSITION COMPORTED THIS TIME.
OUR MEDICARE MEMBERS THE
COMMITTEE HEDGE AT HIMSELF
CALIFORNIA ASSOCIATION OF HEALTH
PLANS WE CURRENTLY HAVE AN
OPPOSE UNLESS AMENDED POSITION
ON THE BILL. I'M WE KNOW
ARMAMENTS WERE- ADDRESSING
ANALYSIS- WE ARE SIMPLY SEEKING
TO- CHANGE ONE WORD AND I HIT IT
TO FROM ALTERNATIVE FROM
ACQUITTAL INTO ALTERNATIVE TO
ENSURE THAT WE CAN UTILIZE. A
NEW TO THE MARKET GENERIC
VERSIONS OF A PREP AND PAP- I
WOULD THINK THAT WILL CREATE A
HUGE COST SAVINGS ON THESE DRUGS
AND AGAIN THOSE THOSE- THOSE
SPECIFIC DRUGS ARE JUST THE SAME
DRUG MAKERS THE GENERIC VERSION-
AND ARE ALSO REQUESTING AN
AMENDMENT TO IT TO ENSURE THAT.
WE ARE- UNDER THE OBLIGATION TO
PAY PHARMACISTS OTHER CONTRACTED
RATE OR THE ORDER OUT OF NETWORK
RATES- WENT WHEN APPLICABLE
SELF. WE ARE BOTH NOT AMENDED I
LOOK FORWARD TO WORKING WITH THE
AUTHOR'S OFFICE- AND SPONSORS.
TO ADDRESS OUR CONCERNS THANK
YOU VERY MUCH. AND THERE'S NOW
JUST NAME AN AFFILIATE.
STEPHANIE WATKINS ON BEHALF OF
THE ASSOCIATION OF CALIFORNIA
LIFE AND HEALTH INSURANCE
COMPANIES WE TO HAVE AN OPPOSE
UNLESS AMENDED THANK YOU VERY
MUCH. SEE NOBODY ELSE
APPROACHING THE- THE MIKE
OPERATOR DO WE HAVE ANY CALLS IN
THE QUEUE ON THIS. WE DO AS A
REMINDER IF YOU WISH TO MAKE A
COMMENT SUPPORT OR OPPOSITION
PLEASE PRESS ONE THEN ZERO GOING
TO LINE ONE FIFTY TWO. PLEASE GO
AHEAD. THE THING CARE MEMBERS
PRESS OCULUS CALLING ON BEHALF
OF THE CITY AND COUNTY OF SAN
FRANCISCO AND THE CITY OF WEST
HOLLYWOOD IN SUPPORT. THANK YOU
. THANK YOU NICE COLOR PLEASE.
GOING TO LINE ONE FORTY SEVEN
PLEASE GO AHEAD. HI I WANT TO GO
OVER AND ON BEHALF OF THE
CALIFORNIA COMMUNITY PHARMACY
COALITION IN SUPPORT. THANK YOU
VERY MUCH NEXT COLOR PLEASE.
ACTUALLY GOING TO LINE NINETY
EIGHT PLEASE GO AHEAD. GOOD
EVENING FOUNDER POOL WESTERN
CENTER ON LAW AND POVERTY IN
SUPPORT. THANK YOU NEXT CALLER
PLEASE. IT'S GOING TO LINE ONE
FORTY FIVE PLEASE GO AHEAD. MORE
TOP ON BEHALF OF VIACOM
CALIFORNIA IN SUPPORT. THANK YOU
NEXT CALLER PLEASE. ACTUALLY ON
THE LINE ONE OH SIX PLEASE GO
AHEAD. GOOD EVENING MADAM CHAIR
MEMBERS MY NAME IS TO COONEY ON
BEHALF OF ACLU CALIFORNIA ACTION
IN STRONG SUPPORT THANK YOU I
THINK MEDIAN. NEXT COLOR PLEASE
. NEXT ON THE LINE ONE FIFTY
EIGHT PLEASE GO AHEAD. AFTER
MEMBERS JOHN LINGER ON THE
AMERICAN HEALTH INSURANCE PLANS
ALTHOUGH AN OPPOSE UNLESS
AMENDED POSITION. YOU WENT HOME
JOHN. NEXT CALLER PLEASE. IT'S
CURRENTLY KNOW ENOUGH TO MAKE
YOU MAD. THANK YOU VERY MUCH-
MISTER MODERATOR BRING IT BACK
TO THE DYESS QUESTIONS COMMENTS
MOTIONS. AS A MOM OUR MOTION BY
SENATOR ROTH WOULD YOU LIKE TO
CLOSE A BEHALF CENTER WIENER I
RESPECTFULLY ASK FOR NAY BUT
THANK YOU VERY MUCH SECRETARY
PLEASE CALL THE ROLL. IN THE
MOTION IS TO PASS AND REFERRED
TO COMMITTEE ON APPROPRIATIONS.
SENATORS EGGMAN AYE EGGMAN AYE
WHEN. GLAZER GLAZER AYE
GONZALEZ. GONZALEZ I GROWTH. HER
TADO. LIMÓN I LIMON I MENJAGA.
AND OF AYE ROTH. ROTH AYE RUBIO
- I WILL HOP. WIENER. SEVEN WE-
HAVE CERTAIN. THIS. YEAH NO IT
WAS EXCELLENT. I DON'T WANT TO
KNOW RIGHT. WE CANNOT WE CAN
WITH BILL PRETTY QUICK YEAH.
YEAH. NEXT ITEM IS NUMBER.
SENATE BILL THREE TO SIX SENATOR
EGGMAN MENTAL HEALTH SERVICES
ACT. PLEASE PROCEED WHEN READY
QUICKLY. SIR TIGHT SHIP. SB
THREE SIXTY TWO IS A STANDS
RIGHT NOW IS A SIMPLE
CLARIFICATION AROUND REPORTING
OF- MHSAA FUNDED SERVICES IT
WILL BE CONTINUE TO REQUIRE
COUNTIES TO SUBMIT CLAIMS FOR
SOON TO THE MEDICARE RULES
REGULATIONS OF THE SERVICES A
REIMBURSABLE UNDER MEDICAID AND
CHILDREN'S HEALTH INSURANCE- YOU
KNOW HEALTH SERVICES ACT IS AN
ESSENTIAL GLUE WITHIN OUR
BEHAVIORAL HEALTH FUNDING AND
THIS BILL IS JUST MAKING SURE
WE'RE NOT LEAVING ANY FEDERAL
DOLLARS ON THE TABLE- I A- I A
GAULISH THAT WE STILL HAVE TO
WORK TO DO ON THIS AND- UNTIL
THEN I RESPECTFULLY ASK FOR YOUR
AYE VOTE. THANK YOU. THANK YOU
YOUR FIRST SUPPORT WITNESSES
CENTER I DO NOT SIR OTHER
WITNESSES IN SUPPORT OF THIS
MEASURE PLEASE STEP FORWARD. HI
MADAM CHAIR MEMBERS OF THE
COMMITTEE BRANDON MARSHALL THE
CALIFORNIA MEDICAL ASSOCIATION
AGREE WITH THE POLICY IN THE
BILL STRONG SUPPORT PERFECT ANY
OTHER SUPPORT WITNESSES. ANY
WITNESSES IN OPPOSITION PLEASE
STEP FORWARD. GOOD AFTERNOON MY
NAME IS STACY HER A MODEL I
REPRESENT REMCO THE RACIAL AND
ETHNIC MENTAL HEALTH DISPARITIES
COLLISION WE ARE NOT IN
OPPOSITION. BUT HOURS JUST
HOPING WE ARE BETWEEN EARNERS I
REPRESENT A COALITION OF NOT
ONLY PEOPLE FROM RACIAL AND
ETHNIC COMMUNITIES BUT ALSO THE
L. G. B. T. Q. PLUS. AND
CHILDREN'S COMMUNITIES WHO ARE
ALL UNITED IN OUR CONCERN. THAT
THE BILL MAY EVENTUALLY BE
AMENDED TO LET THE COUNTIES
REDUCE THEIR SPENDING ON
PREVENTION AND EARLY
INTERVENTION FUNDS TWO ZERO- P.
E. I. IS ONE OF THE ONLY SOURCES
OF COMMUNITY DEFINED PRACTICES.
THAT SERVES THE LGBTQ PLUS-
RACIAL ETHNIC COMMUNITIES AND
CHILDREN'S COMMUNITIES IN
PREVENTION. AND THIS THIS ITEM
IS EXTREMELY IMPORTANT TO US AND
WE'RE JUST TRYING TO GET THE
MESSAGE WE DIDN'T WANT TO OPPOSE
BECAUSE THE BILL HASN'T BEEN
AMENDED YET BUT- THE GOVERNOR AT
LEAST IN THE MATERIALS HAS MADE
IT CLEAR THAT THAT IS HIS PLAN.
AND ALTHOUGH WE ARE OF COURSE
DON'T THINK THAT THE- AND IT
JUST SAY IS PERFECT. TO REDUCE
P. E. I. IT WOULD GREATLY
GREATLY DEVASTATE OUR
COMMUNITIES THANK YOU THANK YOU
MA'AM ANY OTHER INDIVIDUALS IN
THE ROOM WHO WISH TO MAKE A
COMMENT SUPPORTER OPPOSE. SEEING
NONE LET'S MOVE TO THE-
TELECONFERENCE SERVICE MODERATOR
PLEASE PROMPT ANY INDIVIDUALS
WAITING THERE WHO IS TO TESTIFY
IN SUPPORT OR OPPOSITION AND WE
WILL TAKE THEM NOW. OF COURSE
ONE SECOND LATER GERMAN IF YOU
WISH TO MAKE A COMMENT SUPPORT
OR OPPOSITION EXPRESSED. ONE
ZERO. THAT'S CURRENTLY OF NO ONE
IN THE QUEUE THANK YOU MODERATOR
LET'S BRING THE MATTER BACK TO
THE DAYS MY COLLEAGUES
COLLEAGUES ANY QUESTIONS OR
COMMENTS. IT'S BEEN MOVED BY
SENATOR GLAZERS ANY QUESTIONS
COMMENTS. SEEING NO HANDS LAST
CALL. PLEASE CALL THE ROLL. IT
CENTER IF I COULD JUST A WANT IT
WAS LIKE A CLOSE I APOLOGIZE
IT'S OUR IT'S OKAY- BUT JUST TO
JUST TO SAY TO THE OPPOSITION-
THAT IN THE GOVERNOR'S BEEN
CLEAR AND I'M CERTAINLY CLEAR IF
THERE IS SOMETHING THAT PEOPLE
DON'T THINK IT WILL BE COVERED
UNDER UNDER. THANK MEDICAL
SOURCES OF THE SOMETHING YOU
REALLY THINK HE'S GOING TO LOSE
OUT ON- THEN PLEASE BE ABLE TO
PROVIDE THAT. FOR CONSIDERATION
. CAN I ASK FOR YOUR VOTE THANK
YOU CENTER NOW WE CAN CALL THE
ROLL. THE MOTION IS TO PASS IN
REFER TO THE COMMITTEE ON
APPROPRIATIONS. SENATORS EGGMAN.
EGGMAN I WENT. GLAZER AYE GLAZER
AYE GONZALEZ. I THINK GONZALEZ I
GROWTH. GROVE I. HER TADO. HER
TADO AYE THE MON. THE MON I
MEANT OF OUR- OF OUR AYE ROTH.
ROTH AYE RUBIO. RUBIO I WILL HOP
. WIENER. NINE ZERO. NINE ZERO.
I WILL LEAVE THAT BILL OPEN FOR
A LITTLE BIT LONGER AND WE WILL
ASK ALL ABSENT MEMBERS TO REPORT
TO THE COMMITTEE WILL BE CLOSING
THE ROLES. IN DUE TIME- WOULD
THERE BE A MOTION ON THE CONSENT
CALENDAR- THE CONSENT CALENDAR
HAS BEEN MOVED BY SENATOR
MENJIVAR AND THAT IS SB SEVEN
EIGHTY THREE AND SB SIX FORTY
ONE SECRETARY PLEASE CALL THE
ROLL. SENATORS EGGMAN HI A MAN I
WHEN. GLAZER GLAZER AYE GONZALEZ
GONZALEZ I GROWTH. GROVE I HER
TADO. RICARDO I LIMÓN. THE MON I
MEANT OF OUR- BINGE OF OUR AYE
ROTH. ROTH AYE RUBIO. RUBIO I
WILL HOP. WIENER BOB HI I.
WIENER. THAT'S. TEN TEN TEN ZERO
WILL HOLD THAT OPEN FOR THE ONE
ABSENT MEMBERS. OF SB FOUR OH
EIGHT BY CENTER ASHBY IS
AWAITING A MOTION. MOVED BY
SENATOR BROTH US SECRETARY
PLEASE CALL THE ROLL. IT IS S.
B. FOUR OH EIGHT BY SENATOR
ASHBY DO PASS AS AMENDED AND
REFERRED TO COMMITTEE ON
APPROPRIATIONS. SENATORS EGGMAN
EGGMAN EYEING WHEN. GLAZER
GLAZER AYE GONZALEZ GONZALEZ I
GROWTH. GROVE I HER TADO FURTADO
I THE MOAN. MOAN I MENJAGA. ROSS
ROSS I RUBIO HI RUBIO I WILL
HOP. BOB I WINNER. NINE NINE
ZERO HOLD THAT OPEN FOR ABSENT
MEMBERS SB FOUR TWENTY SEVEN BY
PORTANTINO. YOUR BROWSER MOTION
SECRETARY NO MOTION WE HAD NO
MOTION ON THAT MOVE BY SENATOR
ROTH THAT IS- SB FOUR TWENTY
SEVEN MOTION TO PASS REFERRED TO
COMMITTEE ON APPROPRIATIONS
SECRETARY CALL THE ROLL.
SENATORS EGGMAN HI EGGMAN AYE
WHEN. GLAZER GLAZER AYE GONZALEZ
GONZALEZ I GROWTH. NOT VOTING.
GROWTH NOT VOTING. KEEP HER TADO
. HER TADO II LIMÓN. LIMON I
MENJAGA AND OF OUR AYE ROTH.
ROTH AYE RUBIO. RUBIO I WILL HOP
. BOB I WINNER. NINE NINE ZERO
HOLD OUT OPEN A MOVIE GONDA SP
FIVE FIFTY ONE WAS- MOTION
NUMBERS NO MOTION. WHO IS
MANAGEMENT OF OUR- OUR TARA
MOVEMENT MOVES SB FIVE FIFTY ONE
DO PASSED AS AMENDED AND
REFERRED TO THE COMMITTEE ON
APPROPRIATIONS. SENATORS EGGMAN
HI EGGMAN AYE WHEN TH GLAZER
GLAZER AYE GONZALEZ GONZALEZ I
GROWTH. GROVE I HER TADO. HER
TADO II LIMÓN THE MON I MENJAGA
. END OF OUR AYE ROTH. ROTH AYE
RUBIO FIVE RUBIO I WILL HUG. BOB
I WIENER. TEND TO INJURE WILL
HOLD THAT OPEN SB FIVE TWENTY
FOUR BY CABALLERO MOTIONS TO
PASS AS AMENDED AND RE REFER TO
THE COMMITTEE ON APPROPRIATIONS
DID WE HAVE A MOTION WE HAD NO
MOTION. SO MOVED BY SENATOR ROTH
SIGNATURE CALL THE ROLL. IT
SENATORS EGGMAN AYE EGGMAN AYE
WHEN. GLAZER GONZALEZ. GROWTH.
RIGHT GROVE I. HER TADO. HER
TADO I. RIGHT TWENTY FOUR BY
FIVE. OKAY LIMÓN YOU LIKE IT IS
RULES THE MON I MENTIONED OUR
MINDS OF OUR AYE ROTH. ROTH AYE
RUBIO. RUBIO I WILL HOP. WE'LL
HAVE AYE WIENER. EIGHT EIGHT
ZERO WILL THAT OPEN UP SB SIX
TWENTY ONE BY CABALLERO NO
MOTION. OUR GROWTH KIND OF GOT
IT OUT FIRST. SB SIX TWENTY ONE
WILL BY SENATOR GROWTH DEPRESSES
AMENDED A REFER TO THE COMMITTEE
ON APPROPRIATIONS ALTHOUGH
SENATORS EGGMAN HI EGGMAN AYE
WHEN. GLAZER GLAZER AYE GONZALEZ
. GONZALEZ I GROWTH. GROWTH I
FURTADO. PORTATO ICE LEMOND. MON
I MENSHEVIK. MENJIVAR AYE ROTH.
ROSS I WHO RUBIO RUBIO I WILL
HAUNT. BOB I WIENER. TEN TEN JR
WILL HOLD THAT OPEN. SB EIGHT
SEVENTY CABALLERO NO MOTION. SO
MOVED BY CENTER GLAZIER A DO
PASS AND REFERRED TO THE
COMMITTEE ON APPROPRIATIONS
SIGNATURE PLEASE CALL THE ROLL.
SENATOR D. EIGHT SEVENTY. EGGMAN
AYE EGGMAN AYE WHEN. GLAZER
GLAZER AYE GONZALEZ GONZALEZ I
GROWTH. GROVE I HER TADO FURTADO
I LIMÓN. LIMÓN AYE MENJIVAR.
MENJIVAR II ROSS ROTH AYE RUBIO
. RUBIO I WILL HOP. HOBB I
WINNER. TEN ZERO TEN ZERO HOLD
IT OPEN SB SEVEN EIGHTY FOUR
BACKER IT WAS MOVED BY HER
DAUGHTER. SIGNATURE PLEASE CALL
THE ROLL MOTION IS TO PASS AND
REFERRED TO THE COMMITTEE ON
APPROPRIATIONS. SENATORS AT WHEN
. GROWTH. RIGHT GROVE I. GLAZER
. THE GROUP. LIMON LEBANON I.
RUBIO RUBIO AYE WHAT HOT WHAT
HAAB I WINNER. AT. NINE YEAH.
ZERO NINE ZERO. YEAH OKAY OKAY
S. B. ELEVEN MEN JOB. AND THAT
ALSO HAD A MOTION I BELIEVE BYE
GONZALEZ AND THE MOTIONS TO PASS
AS AMENDED AND REFERRED TO
COMMITTEE ON APPROPRIATIONS
SECRETARY PLEASE CALL THE ROLL.
SENATOR WENT. GROWTH GLAZER.
GLAZER AYE. HER TADO FOR TODD- I
THINK. RUBIO RUBIO AYE WIENER.
NINE ZERO NINE ZERO HOLD THAT
OPEN SB SEVEN TWENTY NINE
MENJIVAR MOTION BY SENATOR ROTH
THE MODES AND THE MOTION IS TO
PASS AS AMENDED AND REFERRED TO
COMMITTEE INAPPROPRIATE
PREPARATION SECRETARY PLEASE
CALL THE ROLL. SENATORS THAT
WHEN. FOR TADO HER TADO I.
WIENER. TEN TO ONE TEN TEN ZERO
TEN ZERO. OKAY MOVING ON AND
THEN TO. SB NINETY WIENER WHICH
WAS MOVED BY GONZALEZ AND THE
MOTION IS DUE PASSAGE AMENDED
EVERY REFERRED THE COMMITTEE ON
APPROPRIATIONS SECRETARY PLEASE
CALL THE ROLL SENATORS WENT.
GROWTH HER TADO FURTADO I. WHAT
BOB I WIENER. NINE ZERO NINE
ZERO OKAY. SB THREE THIRTY NINE
WIENER MOVE BY SENATOR ROSS
AGAIN DO PASS AND REFERRED TO
THE COMMITTEE ON APPROPRIATIONS
SECRETARY PLEASE CALL THE ROLL.
SENATORS THAT WHEN. WITH GROWTH
. HER TADO. HER TADO I. WAHAD
BOB I WINNER. NINE ZERO. OKAY SB
THREE TWENTY SIX EGGMAN MOVE BY
GLAZER DO PASS AND REFERRED TO
THE COMMITTEE ON APPROPRIATIONS.
SECRETARY PLEASE CALL THE ROLL
SENATOR WHEN. WHAT HAAB. THE
HOBBIT I WIENER WITH. TEN ZERO
TEN ZERO HOLE THAT OPENED. ALL
RIGHT WE'VE BEEN THROUGH IT
THANK YOU ALL VERY MUCH MEMBERS
FOR ALL YOUR WORK TODAY. RIGHT
NOW ALL FIVE. THE NEW. DOES NOT
COME ABOUT SHOE THAT CAN OKAY
THAT IS SO TO LEGISLATORS AND.
BUT TO BE CALLING ON THE- ON.
THE CALL LOOKING AT THE OKAY
DOES YOUR BABY BILL SO YEAH YEAH
I WOULD WANT TO KNOW YEAH THANK
. THIS REYES SAID. PICKLE FIFTY
MONTH.
TO HAVE A QUICK SIX.
OKAY WE'RE OPENING THE FILE ON
S. B. FOR A WAIT S. B. DEPRESSES
AMENDED REFERRED THE COMMITTEE
ON APPROPRIATIONS. SENATOR WHEN
. MENJIVAR WINNER WINNER I. TEN
ZERO TEN JUROR THAT BILLS OUT SB
FOUR TWENTY SEVEN PORTANTINO TO
PASS AND REFERRED TO THE
COMMITTEE ON APPROPRIATIONS
SECRETARY WHEN. GROWTH WINNER
WIENER AYE SB FIVE FIFTY ONE
PORT NINE ZERO THAT BILL IS OUT
ROSE CLOSE TO ENSURE THAT RULES
THE RULES OUT CLOSED WHATEVER IT
IS- SB FIVE FIFTY ONE PORTANTINO
TO PASS AS AMENDED RE REFER TO
THE COMMITTEE ON APPROPRIATIONS.
WHEN WIENER HI WIENER HI ELEVEN
ELEVEN ZERO THAT BILLS OUT THE
ROLES CLOSED SB FIVE TWENTY FOUR
CABALLERO DO PASSED AMENDED AND
RE REFER TO THE COMMITTEE ON
APPROPRIATIONS SECRETARY WHEN.
GLAZER GONZALEZ WINNER WINNER HI
NINE ZERO NINE ZERO THE THAT
BILL PASSES THE ROADS CLOSED. SB
SIX TWENTY ONE CABALLERO HAD TWO
PASSES AMENDED AND REFERRED TO
THE COMMITTEE ON APPROPRIATIONS.
WHEN WIENER. HI WIENER AYE
ELEVEN ZERO ELEVEN ZERO THAT
BILLS OUT THE ROADS CLOSED SB
SEVEN EIGHTY FOUR BAKER TO PASS
AND REFERRED TO COMMITTEE ON
APPROPRIATIONS. SEVEN EIGHTY
FOUR BETTER YES I HAD THE
SEVENTY IT IS- WHAT ABOUT YOU
SEVEN. IF YOU WANT. SB EIGHT
SEVENTY COVER EURO DO PASS AND
REFERRED TO THE COMMITTEE ON
APPROPRIATIONS SECRETARY. WHEN
WIENER AYE WIENER AYE ELEVEN
ZERO ELEVEN ZERO THAT BILL IS
OUT THE ROAD IS CLOSED NOW
MOVING ON TO SB SEVEN EIGHTY
FOUR BAKER TO PASS AND REFERRED
TO THE COMMITTEE ON
APPROPRIATIONS. WHEN GLAZER.
WIENER OUR WINNER I. SB ELEVEN
MENJIVAR. AND HELP ME ANY COUNT
MY VOTE'S REPORT. SEVEN I. WITH
NINE THAT NINE NOTHING TEN I
HAVE I HAVE A TEN I HAVE TEN
CENTS TEN SORRY. THE DELAY. THE
NUMBERS. NO TEN ZERO THAT FILLS
OUT THE ROADS CLOSED SB ELEVEN
CENTER MENJIVAR TO PASS AS
AMENDED AND REFERRED TO
COMMITTEE ON APPROPRIATIONS.
WHEN GROWTH. WIENER HI WIENER I
TEND TO TEN ZERO BILLS OUT TO
ROADS CLOSED SB SEVEN TWENTY
NINE MENJIVAR AND AMEND THE
MOTION IS TO PASS AS AMENDED AND
RE REFER THE COMMITTEE ON
APPROPRIATIONS SECRETARY- WHEN.
WIENER AYE WIENER I LIVE IN ZERO
THAT IS ELEVEN ZERO ROLE IS-
CLOSED MEASURE PASSES SB THREE
THIRTY NINE WIENER DO PASS AND
REFERRED TO THE COMMITTEE ON
APPROPRIATIONS. NINETY STAJAN
NINETY ALSO GOING BACK TO THAT
THE FILM DO THREE THIRTY NINE
THREE THIRTY NINE- WHEN. GROWTH
. WIENER AYE WIENER. TEN ZERO
TEN ZERO BILLS OUT THE ROADS
CLOSED LET'S GO BACK TO SB
NINETY FIRST TO MIX IT UP WIENER
TWO PRESENTS AMENDED AND
REFERRED TO COMMITTEE ON
APPROPRIATIONS. AND WHEN. GROWTH
. WIENER FIVE WINNER I. SINCE
MOVING ON NOW TO- EGGMAN SB
THREE TWENTY SIX TO PASS AND
REFERRED TO THE COMMITTEE ON
APPROPRIATIONS. WHEN. WIENER HI
WIENER AYE. ELEVEN ZERO ELEVEN
ZERO. BILLS OUT THE ROLE IS
CLOSED AND A MOVING TO THE
CONSENT CALENDAR- PLEASE CALL
THE ROLL THAT IS SB SEVEN EIGHTY
THREE AND SB SIX FORTY ONE. WHEN
AND WIENER HI WIENER I HAVEN'T
ZERO. OUT ELEVEN ZERO AND THAT
CONCLUDES THE HEALTH COMMITTEE
FOR TODAY I THANK EVERYBODY WHO
PARTICIPATED.