OKAY.
ALRIGHT.
OKAY SO YOU CAN KEEP YOUR
REMARKS TO. THREE MINUTES TOTAL
THAT APPRECIATED WE OFF ABSENT
WE ASK QUESTIONS YOU HAVE MORE
TIME TO TALK.
OKAY MICKEY.
GOOD AFTERNOON MISTER CHAIRMAN
MEMBERS MERELY THOUGHT THAT'S
WHAT HEALTHAXIS CALIFORNIA AND
WE ARE PROUD CO SPONSORS OF
HEALTH FOR ALL WHICH WILL BE IN
CALIFORNIA ONE STEP CLOSER. TO
UNIVERSAL COVERAGE OUTSIDE
STUDIES SHOW THAT THE UNINSURED
ARE LESS LIKELY TO GET
PREVENTIVE CARE FOR.
AND CHRONIC DISEASES PROVIDING
COMPREHENSIVE COVERAGE TO
CALIFORNIANS REGARDLESS OF
IMMIGRATION
THAT IS
MEANS THAT PRIMARY AND
PREVENTIVE CARE. AS WELL AS THE
MANAGEMENT OF CHRONIC CONDITIONS
LIKE ASTHMA DIABETES HEART
DISEASE HIGH BLOOD PRESSURE
MANAGEMENT WILL NOW BE COVERED
FOR A POPULATION THAT HAS
HISTORICALLY BEEN SHUT OUT. OF
COMPREHENSIVE COMPREHENSIVE
HEALTH COVERAGE IMMIGRANTS ARE A
CRUCIAL PART OF CALIFORNIA
SOCIAL AND ECONOMIC FABRIC
ENSURING THAT ALL CALIFORNIANS
CAN COUNT ON HAVING
COMPREHENSIVE CARE. IS VIABLE IS
VITAL TO THE SUSTAINABILITY OF
OUR HEALTH SYSTEM AND THE WELL
BEING OF OUR STATE AS A WHOLE
THANK YOU.
GOOD AFTERNOON CHAIR MEMBERS SAT
SENATE BUDGET SUB COMMITTEE. I
THANK YOU FOR THE OPPORTUNITY TO
PRESENT ON THE HEALTH FOR A
PROPOSAL. AYE MY NAME IS CHRIS
GAGLIANO FROM THE CALIFORNIA
IMMIGRANT POLICY CENTER. BY AND
I'M HERE JOINED BY MARIA AND
IMMIGRANT MOTHER WHOSE LIFE. IS
GREATLY IMPACTED BY THE CURRENT
EXCLUSIONS TO HIGH MEDICAID TO
HEALTH CARE.
I THOUGHT CALIFORNIA SHOWN GREAT
I'LL CRITICAL LEADERSHIP IN
ADVANCING BOLD PRO IMMIGRANT I
POLICIES INCLUDING HEALTH FOR
ALL KIDS.
AND THAT REMOVE EXCLUSIONS THE
FULL SCOPE MEDI CAL FOR ALL
UNDOCUMENTED CHILDREN.
HOWEVER TODAY UNDOCUMENTED
PARENTS AND ADULTS.
CONTINUE TO FACE CREW EXCLUSIONS
TO HEALTH CARE BECAUSE OF THEIR
IMMIGRATION STATUS THIS IMPACTS
THE WELL BEING OF ENTIRE
FAMILIES AND COMMUNITIES.
IT'S OUR STATE.
ONE IN SIX CHILDREN ARE IN
CALIFORNIA HAS AN UNDOCUMENTED
PARENTS. AND UNDOCUMENTED ADULTS
MAKE UP FIFTY EIGHT PERCENT OF
THE THREE MILLION REMAINING
UNINSURED CALIFORNIANS.
EFFORTS TO ACHIEVE UNIVERSAL
COVERAGE IN CALIFORNIA MUST
INCLUDE IMMIGRANT COMMUNITIES TO
TAKE CARE OF THEIR FAMILIES
CONTRIBUTE TO THEIR COMMUNITIES.
AND WHO CALL CALIFORNIA HOME.
THIS IS WHY WE NEED HELP FROM
NOW.
I PROPOSAL WHICH WOULD WHICH
WOULD PROVIDE FULL SCOPE
MEDICARE TO LOW INCOME
UNDOCUMENTED ADULTS BY REMOVING
IMMIGRATION STATUS AS AN
ELIGIBILITY EXCLUSION.
WHAT HEALTH FOR ALL WILL HELP
FAMILIES LIKE MARIA'S?
AND CALIFORNIA COMMUNITIES
THRIVE THIS POWERFUL STEP CAN BE
ACCOMPLISHED THIS YEAR AND WILL
MOVE CALIFORNIA FORWARD AND SET
A MODEL FOR THE REST OF THE
NATION.
NOW I'D LIKE TO INTRODUCE MARIA
A SINGLE MOTHER OF THREE WHO
WOULD BENEFIT FROM HEALTH FOR
ALL.
THE NUMBERS MEDINA MENDOZA NAOKO
DEPORTING THEM.
SO ONE ON THIRTY OTHER A LO FI
SEEN THEM GROW RICE CENTER SO
MOTHER SO THEY DON'T THINK OTHER
SEQUELS YOU IMPLY THAT IT DOES
SAY THAT GIVES THEM FAIR MOST SO
YANKEE PARA COMPARTIR.
MISSPELLINGS HERE COMMON METHOD
THAT'LL AYE ME EMMY FOR MEDIA
AND NOTHING THAT ALSO WOULD A
MEDICAL.
MY NAME IS MARIA COME FROM SAN
DIEGO I'M A VOLUNTEER WITH THE
EMPLOYEE RIGHTS CENTER I'M A
SINGLE MOTHER.
THREE CHILDREN AND I TAKE CARE THEN YOU KNOW THAT.
THEN THE M. WE ARE THEM SO
PUTTING IMMEDIATE AYE YES GANDHI
NAM INTERRUPTUS YES I MEANT THAT
ONLY DANIEL GONZALEZ A CHRONICLE.
NOBODY ANY THERE ARE HARD BOILED
US BUT GIMMICK WHAT PANETTA
SPOLIA ID AS A RESULT OF A LOT
STRESS TO
THE WORRY OF NOT HAVING HEALTH
AND.
NOBODY COULD GET ANY ACT GAITA
ETERNAL SPEAK THEM DIMINISH
HYMNS YES THE NECKLACE BUT I'D
ASK FEDERAL DE MOMENT W. SO IT
IS ABOUT STAND THEY THEY MUST
FUNDING. GIVE MISUMI PROMISES IN
THE POLICY ON OUR VIA THE
ESCAMILLA BY SILENCE AND LET ME
GAS WATER CUP BUZZING WITH ENEMY
HAVE PICKING BECAUSE THAT ALSO DOES.
I HAD WAS TO GO TO THE EMERGENCY
HOSPITAL I HAD TO WAIT UNTIL
LAST MOMENT AND THAT WAS
EXHAUSTING AND DEVASTATING THAT
I SANK FOR MONTHS IN DEPRESSION.
THERE WERE DAYS WHERE I SPENT.
LOCKED IN MY HOUSE I WAS NOT
ABLE TO TAKE CARE MY LITTLE
DAUGHTER.
AND BECAUSE I WAS NOT IN GOOD
HEALTH IT'S BECAUSE OF THIS
EXPERIENCE THAT I'VE OP FOUND
THE IN PLAY RIGHT CENTER OF
OFFICE INSERTED VOLUNTEERING.
WITH MUCH EFFORT A DESIRE TO GET
AHEAD I SUPPORT THE HEALTH FRAUD
CAMPAIGN SO THAT UNDOCUMENTED
PEOPLE HAVE HEALTH INSURANCE. IN
MANY CASES WE ARE HEADS OF
HOUSEHOLDS AND OUR CHILDREN
FAMILIES DEPEND ON US.
AND SO WERE RIPPED QUITE A BIT
OVER TIME SO BEGIN SORRY BUT.
AT C. HOOKERS ANOTHER SCORCHER
HE'S ANNOUNCED AMENDING CUENTA
ALSO CLOSE ALMOST LATEST WOMAN
MUST PROMOTE QUITE GIVE US YOUR
ANALYST ALSO NEEDLES.
EVEN THE MOST LITIGIOUS BUT HE
WON INTO THAT USCIS.
I ASK THAT WE BE HEARD AND TAKEN
INTO ACCOUNT WE ARE HUMAN BEINGS
LIKE ANY OTHER US CITIZENS AND
WE DESERVE EQUAL RIGHTS THANK
YOU.
THANK YOU AND THANKS SO MUCH FOR
YOUR TESTIMONY.
ALRIGHT.
OKAY US OUR MONEY.
I JUST WANT TO THANK THE
WITNESSES FOR THEIR TESTIMONY.
CARESSES PURSUE PERCENT SIERRA
NO SATAN WITH JOE COLUMN
SUPPRESSANTS CEILING.
SALUDOS A SUPER MIHNEA.
THE BIG CHALLENGE FOR US
IS. GOING TO BE OUT WE PAY FOR.
BUT THE HUMAN RIGHT OF ACCESS TO
HEALTHCARE FOR ALL.
DO ANY OF YOU OR LA NO. OUR
FINANCE DEPARTMENT.
HAVE AN ESTIMATE OF.
THE DIFFERENCE BETWEEN INVESTING
IN HEALTH CARE THAT INCLUDES
PREVENTION.
PURSES.
THE COST THAT WE PAIN NOW FOR
EMERGENCY ROOM TREATMENT OF
CHRONIC.
DISEASES THAT COULD BE PREVENTED.
.
IF THERE WERE AN INVESTMENT.
OF PREVENTION.
YEAH OF ALL THAT HEALTH ACCESS I
MEAN YOU KNOW I AS YOU ALL KNOW
WHEN AN UNDOCUMENTED PERSON IS
RELEGATED TO EMERGENCY CARE.
IT'S AYE MORE EXPENSIVE TO THE
STATE AND.
WHEN YOU INCLUDE IMMIGRANTS AND
HEALTH COVERAGE THAT ACCESS TO
PREVENTIVE. AYE CARE AND THE
ONGOING MANAGEMENT OF CHRONIC
CONDITIONS LIKE OUR WITNESS WHO
I AM AS YOU HEARD FROM HER
TESTIMONY.
IT SHE VERY QUICKLY DETERIORATE
DETERIORATED WITHOUT THE ACCESS
ON TO YOU KNOW. COMPREHENSIVE
FULL SCOPE MEDICAID JUST LIKE I
AM OTHERS WHO WOULD BE ELIGIBLE
AYE BUT FOR THEIR IMMIGRATION
STATUS.
AND YOU KNOW WE AGREE WITH THE
STAFF ESTIMATE ON THE COST OF OF
THIS PROPOSAL AND THINK IT'S
REASONABLE AND.
YOU KNOW WE CONTINUE TO LOOK
FORWARD TO WORKING WITH THE
COMMITTEE.
AT ON COST AND WHAT WILL WE DO
KNOW IS THAT IT'S TIME WE CAN'T
CONTINUE TO RELEGATE ARE
UNDOCUMENTED TO EMERGENCY ROOM
CARE WHICH IS THE MOST EXPENSIVE
TYPE OF CARE.
YES I THINK.
IN FOLLOW UP AS WE MOVE FORWARD.
THERE'S THE METRIC OF INCREASED
HEALTH CARE COSTS WHEN WE DON'T
TREAT OR PROVIDE ACCESS AT THE
FRONT END.
THERE'S ALSO AN ECONOMIC IMPACT
TO THE WORKFORCE.
INTO THE ECONOMY THE STATE A.
LOST DAYS OF WORK THE DEPENDENCE
OF THIS UNCOVERED POPULATION IT
BE HELPFUL TO US I THINK TO HAVE
SOME ESTIMATES OF THEIR
CONTRIBUTIONS TO THE OVERALL
ECONOMY. OF THE STATE.
COURSE WE WE HAVE THAT DATA AND
WITH THE BE MORE THAN HAPPY TO
SHARE THAT WITH YOU AND WHAT WE
KNOW IS THAT UNDOCUMENTED UP
CALIFORNIANS CONTRIBUTED HOME.
LAST ESTIMATES OVER A HUNDRED
AND EIGHTY BILLION DOLLARS ON TO
THE ECONOMY. ARMS SO AS UNIONS
VERY ROBUST AND VERY. MUCH INTO
THE SOCIO.
FABRIC OF THE STATE AND
S. DO THAT WE CAN TO PAY.
ON THAT GIVEN THE FEDERAL ATTACK
THAT WHERE I'M SEEING OUR
COMMUNITIES TODAY.
SO THERE'S THE CONTRIBUTION TO
THE ECONOMY HE COULD ALSO
PROVIDE ANY ESTIMATES IN FOLLOW
UP.
UNDOCUMENTED WORKFORCE AND
DIRECT TAXATION THROUGH.
PAYROLL TAXES.
PROPERTY TAXES YEAH. THERE'S
THERE'S A LEVEL OF TAX REVENUE
COMING TO THE STATE.
THAT IS NOT BEEN RETURNED TO THE
COMMUNITY THAT SPINNING.
AND AND SO WE DO KNOW THAT
THERE'S AN ANALYSIS.
THAT I'D MORE THAN HAPPY TO
SHARE WITH YOU ALL THAT TIME
SHOWS THAT THE STATE AND LOCAL
TAX CONTRIBUTIONS OF
UNDOCUMENTED CALIFORNIANS ARM
AND I. DON'T WANT TO QUOTE A
WRONG NUMBER SO I WILL GIVE IT
TO BUT IT'S WERE TALKING IN THE
BILLIONS IT AND I THINK AS WE
MOVE FORWARD.
HAVING SOME OF THAT JUST ANA.
SOME BULLET POINTS ON A INGLE
SHEET THAT COULD INFORM ALL
MEMBERS THE LEGISLATURE
SO THAT WE'RE NOT LOOKING THIS
IS KIND OF A ZERO SUM. GAME JUST.%
A COST TO THE STATE LET'S ALSO
LOOK AT WHAT'S.
WHAT'S BEING PAID IN TAXES.
WHERE THOSE PAYING THE TAXES
AREN'T ELIGIBLE? FOR THE
SERVICES THAT OTHER TAXPAYERS
ARE RECEIVING.
I THINK THAT DEFINITELY WILL
WORK ON HAVING THAT PREPARED
AMINA ONE TENTH OF THE WORKFORCE
IS UNDOCUMENTED.
ONE AB ONE OUT OF EVERY SIX
CHILD IN THE STATE HAS AN
UNDOCUMENTED PARENTS SO HOME
WILL DEFINITELY HAVE THAT DATA
READILY AVAILABLE FEEL IS THE
WITNESS TESTIFIED MANY ARE ALSO
CARE PROVIDERS.
WITHIN THEIR HOMES OR WITHIN
THEIR COMMUNITIES.
AND SO AGAIN THERE PROVIDING
CARE TO SOMETIMES PEOPLE THAT.
DO YOU HAVE SOME MEDICAL
COVERAGE.
BUT THEY AS CARE PROVIDERS DON'T
FOR THEMSELVES OR THEIR FAMILY
CYPRESS SHE. YOUR CONTINUED HELP
GETTING THAT TO US THANK YOU
MISTER CHAIR.
HE. THE OTHER ALRIGHT BOISE
WEAVER. MANY PEOPLE.
PROCUMBENT SO AGAIN.
TRY TO KEEP IT UNDER MEDI IF
SOMEONE'S ALREADY SAID SOMETHING
OF ME TOO WORKS AS WELL.
.
ARE ADDED TO.
SO AGAIN WELCOME.
LINDA WAY WITH WESTERN CENTER ON
LAW AND POVERTY WERE IN STRONG
SUPPORT OF THIS MEASURE AS WE
BELIEVE IT'S THE RIGHT THING TO
DO.
THANK YOU.
THANK YOU WELCOME THANK YOU
MISTER RESEARCHER MEMBERS MAY
CONSUMERS ON BEHALF OF
CALIFORNIA HEALTH PLUS ADVOCATES
IN THE THIRTEEN HUNDRED
COMMUNITY HEALTH CENTERS AND
CLINICS IN CALIFORNIA. DITTO.
THANK YOU WELCOME. THANK YOU
MISTER CHAIRMAN MEMBERS MARK
WINDOWS WITH THAT'S HERE YOU
CALIFORNIANS SUPPORT.
THANK YOU WELCOME.
THANK YOU KAREN SAVAGE I
CALIFORNIA PAN ETHNIC HEALTH
NETWORK WERE IN STRONG SUPPORT
OF THIS PROPOSAL AND REALLY WHAT
I THINK MARIA FOR HER TESTIMONY.
THANK YOU WELCOME.
ANY THIRDS ASIA CALIFORNIA AND
SUPPORT.
THANK YOU WELCOME.
NATASHA PHILLIPS CALIFORNIA
COVERAGE AND HEALTH INITIATIVES
IN STRONG SUPPORT OF THE
PROPOSAL.
THANK YOU WELCOME. I'LL HANDLED
AND REPRESENTING NEXT IN
CALIFORNIA I'M VERY MUCH SUPPORT.
THANK YOU WELCOME.
MY NAME IS ALICE. MY NAME IS
ALLISON CAMINO AND I'M AND A
CONSTITUENT AND FROM DISTRICT
SIX IN AN IMMIGRANT RIGHTS
ADVOCATES ON MY BOYS WITH MIKEY
IN SUPPORT OF THIS OUR HEALTH
FOR ALL MEDI CAL ACCESSIBILITY
FOR AN ARC MIDDLE. NONPROFIT
ORGANIZATIONS WITHIN THE
DISTRICTS SUCH AS SACRAMENTO
COVERED IN LA FAMILIA HAVE BEEN
ABLE TO ASSIST HUNDREDS OF
UNDOCUMENTED ADULTS WITHIN OUR
DISTRICT IN FAMILIES WITH
LIMITED MEANS THROUGH SMALL
CONTRACTS AND THE HEALTHY
PARTNERS PROGRAM. THROUGH THIS
SEGMENT COUNTY HOWEVER THE
NEATEST DOG GREATER THAN THE
AXIS A PIE AND I WAS MADE AWARE
BY REPRESENTATIVE THAT ONE OF
THE CUT THE CONTRACTS IS NOT
BEING RENEWED AND SO WHAT
HAPPENS WHEN. OF THE RESOURCES
ARE LOW AND THE TEMPORARY
SOLUTIONS AND EXPANDING MEDI CAL
WOULD HELP ADULTS ESPECIALLY
DURING THIS FEARFUL TIME ONE
CLIMB FROM THE LEFT AMELIA HAD.
MENTIONED TO ME THAT MADE AWARE
TO ME THAT.
HE HAD A CONDITION WITH A LUMP
ON HIS NECK WHICH COULD NOT BE
DIAGNOSED BECAUSE OF THE LACK OF
INSURANCE AND NOW HE'S BEEN LET
GO OF ITS JOB SINCE THEN AND CAN
PROVIDE FOR HIS FAMILY BECAUSE
OF THE CONDITION IN THE
VIABILITY OF. ON THE JOB.
SEEING IS SECURING ACCESS PER A
COMMUNITY MEMBERS LIKE HIM AND
THEIR FAMILIES WOULD NOT ONLY
SUPPORT THEM BUT INCREASE THE
LIKELIHOOD OF FOR CHIU
CHILDREN'S BEAM INSURED. FOR
THESE REASONS I URGE OTHER
CONCERNED ALLY OF THIS COMMUNITY
THAT THE SENATE BUDGET
SUBCOMMITTEE REPORT THIS
PROPOSAL THING SO MUCH THANK YOU.
THANK YOU.
WELCOME.
I'VE A WEST SAM'S WITH UNITED
WAYS OF CALIFORNIA IN STRONG
SUPPORT.
THANK YOU WELCOME.
LL THIS MATERNAL AND CHILD
HEALTH ACCESS WE TO.
BOB DOESN'T USE TORRANCE
DEFENSEMAN CALIFORNIA JUST
WANTED TO PROVIDE THE
PERSPECTIVE THAT THIS.
HEALTH FOR ALL IT WAS A GOING
TO BE A HUGE BENEFIT FOR
CHILDREN BECAUSE. A PARENTS OR
PARENTS AND CAREGIVERS ARE MUCH
BETTER TO CARE FOR AND PROVIDE
FOR THEIR FAMILIES WHEN THEY
HAVE.
HEALTH COVERAGE AND AL ALSO
CHILDREN OF PARENTS WHO ARE
COVERED OR MORE LIKELY TO GET
TIMELY CARE AND BECOME A
THEMSELVES THANK YOU.
THANK YOU WELCOME.
AND FOX LOS ANGELES LGBT CENTER
IN SUPPORT THANK YOU.
WELCOME I PULSE FOR FROM A
KILLER HEALTH AND LOS ANGELES
HERE IN STRONG SUPPORT THANK YOU.
WELCOME.
PITCH MEDINA WITH ASIAN
AMERICANS ADVANCING JUSTICE
CALIFORNIANS SUPPORT. THANK YOU.
WELCOME.
I WHEN THERE'S MARIA AND I'M AN
ORGANIZER FORCED BY THE FOR A
FIRST NATION INTO COMMITTEE
GROUP IN THE NATION NOW TO SHARE
A LITTLE.
QUICK STORY ABOUT. WHY IT'S
IMPORTANT THAT WE HAVE TO CARE
ABOUT HEALTHCARE ANTS BECAUSE
NOT ONLY BECAUSE?
IT OUR IMMIGRATION STATUS LIKE
STOPPIN US. AND IT'S ALSO
ONGOING THREAT OF ANTI IMMIGRANT
ATTACKS AND RATES THAT'S
HAPPENING OUR COMMUNITIES STATES
MAY BEGIN THE SPHERE. THEY'RE
GOING TO A DOCTOR EVEN THOUGH WE
HAVE BEEN WORKING SIX SEVEN DAYS
A WEEK LIKE UNDER THE TABLE AND
RELATED THINGS CONDITIONS NOT
AND NO ONLY THING UP ON MY PHONE.
THINK ABOUT THAT
UNITY
THAT'S BENEFITING THAT COULD
BENEFIT FROM THIS AND I WANT YOU
I'M ASKING YOU TO PLEASE LOOK AT
US THAT ON TOP OF THE COMMUNITY.
NOT NOT ONLY US NUMBERS BUT AS
HUMAN BEINGS OF THE SORT THE
BASIC NEED OF HEALTHCARE THANK
YOU. THANK YOU.
WELCOME
I MIGHT MY NAME IS BRINA HELLO
WHAT IS AND WHAT THE LATINO
COALITION FOR HEALTHY CALIFORNIA.
AND HERE IN SOLITARY FOR ALL
THOSE WHO STILL REMAIN AND A
SHIRT AND ARE WAITING TO HAVE A
DIRE CONDUCT OUR CONDITION UNTIL
THEY CAN FINALLY ACCESS. CARE.
BOB SO THANK YOU FOR YOUR TIME.
THANK YOU STRONG SUPPORT FOR
HEALTH FOR ALL THANK YOU.
WELCOME.
HI MY NAME IS KATHY CONCHITA
THEM I'M HERE ON BEHALF OF THE
HAVING OUR SAY COALITION.
COMPRISED OF THIRTY
ORGANIZATIONS ACROSS THE STATE
AND WHERE IN STRONG SUPPORT OF
THIS. THING THANK YOU.
WELCOME.
GOOD AFTERNOON MISTER CHAIR
COMMITTEE MEMBERS KNOW AT BOTTOM
OAK CALIFORNIA RURAL LEGAL
ASSISTANT FOUNDATION. IN STRONG
SUPPORT OF THE PROPOSAL TO
INCLUDE ALL REMAINING
UNDOCUMENTED ADULTS TO BE
INCLUDED IN MEDI CAL ESPECIALLY
ARE HARD WORKING FARMER CREEK
COMMUNITIES THROUGHOUT THE STATE
THANK YOU.
WELCOME.
AND DATA OF WITH.
ON BEHALF OF THE MEXICAN
AMERICAN LEGAL DEFENSE AND
EDUCATIONAL FUND OR MALL DEAF IN
STRONG SUPPORT.
THANK YOU.
BUT I'M I'M AN ISRAELI I'M WITH
US BY THE FOR SPANISH AND NOT
MAKE GROUPS ALSO MATURED AS
OTHER ASIAN BUT ASIAN START
RIGHT HERE NOW THAT'S MARIA.
AND THIS ONE SAY SHARE MY STORY
OF MY BROTHER ALEX WHO SUFFER
BRAIN CANCER TWO THOUSAND TEN
AND HE WAS ABLE T GET HIS CARE
THEY CAN YOU KNOW THROUGH IMAGE
MEDI CAL. AND AS A DOC RECIPIENT
WAS ABLE TO GET THE FOLLOW UP
CARE THAT HE NEEDED SO THAT'S
LIKE THE IMPACT THAT WILL HAVE
FOR ALL THE PEOPLE WHO ARE.
REMAIN UNSURE LIKE MY PARENTS
AND THE OTHER COMMITTEE MEMBERS
HERE SIX MONTHS APART HEALTH FOR
ALL THAT YOU. MAKE YOU.
WELCOME AYE MY NAME ASSOCIATED
GONZALEZ AND WHAT THE HELL.
MIX THAT GOING THE CAN I
COMMITTEE ORGANIZING PROJECT I'M
HEALTH POLICY AND BEGAN WERE
STRONG SUPPORT HEALTH FROM. I
WILL BE HELPING MY COLLEAGUE I
INTERPRET INTO ENGLISH WHICH SHE
HAS TO SAY HERE TODAY. THANK YOU
WELCOME WHEN ESTABLISH NUMBERS
WHEN I SAID I WAS SAVING MORE
THAN PREDICT THE MYSTICAL AND ON
THE OTHER END DIRECTLY A KEEPER
GAY ON.
ESTAMOS LEVELED ON THE BUT A
CAPE WITH AND THAT.
MEDICAL AT THE LITTLE SUBTLE
DOES AND A SPECIFIC IT OPEN BUT
THEY LISTEN POPULOUS THAT IN A
MOMENT AT THE END EQUIPMENT THAT
THE SI NOS AND ALSO THE
MOST ISSUE CHINA'S UP TO HOW THE
NEXT COUPLE.
I'M SO I'M HERE IN SUPPORT OF
HEALTH FOR I WANT TO TELL YOU
THE STORY OF MY MOM. AND SHE IS
FORTY THREE YEARS OLD AND SHE
HAS BEEN WORKING AT THE FARM
WORKER FOR EIGHTEEN YEARS.
IS AGAIN UP EARLIER THAN IT
ACCESO SALUTE BUT GETS IN THE
CUENTA IT BUT AS LOOK AT BY THE
MOST GAY.
THREE. ELLIS THAT THOSE METHODS
BUT UP WITH IT THE NET AMINIKA.
BUT SHE HAS BEEN LOCKED OUT OF
HEALTH CARE ALL OF THESE YEARS
AND FO THAT WE WANNA ASK. ON
THE U. P. ZERO THE ELIGIBILITY
EXCLUSION.
OF A DOCUMENT COMMITTEE MEMBERS
THANK YOU.
BUT I DON'T THINK YOU.
WELCOME.
OKAY.
AB ONE ESPECIALLY IF ME NOBODY'S
GOTTEN SIGNED KIDS EAT THEM
BEING SO UNITED US BUT WHAT DOES
THAT PREDICT MYSTICAL.
HELLO MY NAME IS CARMEN SONGES
I'M ALSO COMMITTEE HEALTH WORKER
WITH MY CUP.
I KNOW A COMBAT OR NICE THIRTY
OF THEIR OWN I MEAN I CANCEL BE
THE POOR OUT GOES ON AND NOT THE
ONE THAT CLONING WILL NOT GO
THROUGH THE IF IT WOULDN'T HAVE
MADE THE CALL.
I ENDED.
SUBITO THEIR OWN I AM FAT MADE
THEM AM TECHNIQUE ON THE
NET BUT I THINK WHAT I KNOW THAT
I'M DEMISE THEY'VE BEEN DANIEL'S
AT ABOUT HOW GOING LAS VEGANS.
MOTHER IS ON DATA AS TO OF
ALIENS HAVE THOUGH MYSTICA.
I AM AT BECAUSE HIS
CEREBELLUM WOODY AND GO.
I THOUGHT CAPABLE IN COMBAT AND
NO NOT BE THOUGHT ABOUT A CAN
LET THEM GET ON. MIDDLE AND
THOSE THEY THOUGHT DEAL
COTTONSEED CRANDALL.
E. NOT UP WILL NOT THEN THERE'D
BE MEADOW LIBYA DON'T THAT IS
NEEDED OR NOT IS BUT A POOR THAT
I THINK THAT I IN NO SIMPLE THAT
THEN.
ADDRESS ON THE CAN.
I'M THE ONE ACT AS IF IT
WOULDN'T.
SO MY FRIEND ROSA SHE IS ALSO
UNDOCUMENTED HAS BEEN WORKING AT
THE FARM WORKER FOR TWENTY I'M HERE TODAY THANK YOU.
EXPRESSES.
BUT.
THEY WANT OTHERS TO ME NUMBER IS
SEEN AS GONZALEZ SO YOU KNOW THE
LESS PROMOTED AS THEY MIGHT GO
UP.
HI MY NAME IS A ENOUGH I'M ALSO
COMMIT HEALTH WORKER WITH
MICHAEL.
ISMS PEOPLE IS THAT CAN A MOST
HUMBLE GOTTA ADMIT THE
COMPATIBLE SO DO THOSE. THINGS
BOY BEATNIK ON THAT WHEN I
STARTED THEY WILL NOT MEANWHILE
MUCUS IN WHAT DO THEY CONCEPT
BORDER FILE THAT THE SIGNAL.
PEOPLE FUND BY THAT MEDICAL CAN
ELIGIBLE WOMAN LOOKED AT THE
COVER SET UP BUT A KEY CCS OF
CHECK HILLS.
I'M HERE TO TELL YOU TODAY A
STORY OF MY FRIEND.
WHO DIED AT THE AGE OF TWENTY
SEVEN FROM?
STOMACH CANCER NOMINEE WAS
BECAUSE HE WAS UNABLE TO ACCESS
THE CARE HE NEEDED WHEN HE
NEEDED.
THANK YOU MASSES.
WELCOME.
BUT THE REVEREND JERRY FLOWERS
ARE ASSOCIATE DIRECTOR ALSO FROM
MY CUP AS YOU HEARD FROM MY
COLLEAGUES.
WE NEED THIS FOR OUR COMMUNITY
HERE IN CALIFORNIA WE NEED NOW
SO MY CUP IS THE STRONG SUPPORT
OF THIS MEASURE THANK YOU. THANK
YOU.
WELCOME.
THIRTY HEX REPRESENTING EQUALITY
CALIFORNIA AND STRONG SUPPORT
DAY.
THANK YOU.
WELCOME.
IT'S RESPONSIBLE TRAILER THE
COALITION FOR HUMANE IMMIGRANT
RIGHTS RECORD REPRESENTING
IMMIGRANT FAMILIES DIRECTLY
IMPACTED THROUGH UPSTATE
CALIFORNIA INCLUDING FORMER CAN
FAMILIES IN RURAL CALIFORNIA
STRONG SUPPORT FOR AHA THROW.
THANK YOU.
WELCOME.
I AM A CHRISTIAN GOLDEN TESTED
WITH THE CHILDREN'S PARTNERSHIP
IN STRONG SUPPORT OF THIS
PROPOSAL AND HEALTHCARE FOR ALL
IS BUILDING ON THE STRONG
SUCCESS OF THE HEALTH FOR ALL
KIDS. THAT WE'VE HAD IN THE
STATE HAS BEEN VERY PROUD OF AND.
THIS I THE NEXT OBVIOUS
PROGRESSION WHEN YOU COVER WHEN
YOU COVER PARENTS THE KIDS ARE
ALSO GOING TO BE MORE HEALTHY.
OKAY THANK YOU.
AND THERE.
SO I WANT THINKS THAT PRESENTERS
THANK YOU SO MUCH FOR SHARING
YOUR STORY AS WELL. CAN.
TRANSLATE IF YOU'RE SPEAKING OF
STAIRS TO TRANSLATE THAT.
THE CRISIS.
AYE IT'S WHY MAKE NOTE OF THAT
NUMBER FOUR.
BUT I'M THE ACA IN HERE
CALIFORNIA WE WERE ACTUALLY
TRYING TO DO HEALTH REFORM BILLS
NOTED THAT.
.
THAT EVERYBODY YOU ACTUALLY WAS
INSURED ESSENTIALLY WAS PAYING
AND THOUSAND DOLLARS EXTRA.
TO.
BASICALLY FOR THE COST OF
PEOPLE UNINSURED TO BASICALLY
DIDN'T CARE INTEL'S
WAIT. I MEAN ACTUALLY.
PEOPLE DON'T HAVE INSURANCE
DON'T IN THE SHOP EMERGENCY ROOM
MORE OFTEN BUT WHEN THEY FINALLY
SHOW UP THERE MUCH SICKER AND
MORE LIKELY NEED HOSPITALIZATION
AND THAT.
AND SO ACTUALLY ALL OF US ARE
IN SOME WAYS REYES SUBSIDIZING.
THAT FINANCIALLY BUT.
THE HOUSE BURDEN WAS ON THE
PERSONS UNINSURED WHO.
DOESN'T USING THE ARE MORE OFTEN
BUT WHAT HAPPENS IS PAYING OFF
CAREFULLY OF CARE UNTIL IT IS
VERY LATE AND OFTEN TOO LATE.
AND THE US SO THAT'S HUMAN COST.
BUT WE ALSO TO FIGHT IT'S BOTH
HUMAN AND FINANCIAL COSTS AND.
THAT WE WE WORK TO. EXPAND MEDI
CAL AND DO THEY CA AND THEN
WE'VE HERE IN CALIFORNIA WE
STEPPED UP AND AT LEAST TRY TO
GET THE CHILDREN.
HEALTH CARE.
SO.
AND SO THAT.
NEED TO QUOTE CROSS SUBSIDIZE
HOPEFULLY HAS DECREASED BECAUSE
OF THAT BUT WE STILL HAVE TOO
MANY PEOPLE IN OUR COMMUNITIES
ARE UNSURE UNFORTUNATELY WITH
THE FEDERAL GOVERNMENT REPEALING
THE ATTACK.
FOR.
FOR BEING ASSURED WE DO
EXPECTED MORE PEOPLE TO BE
UNCERTAIN EVEN PEOPLE ARE FAIRLY
WELL OFF.
THIS BUT STILL THE MOST WE CAN
CAUSE GOING OF BANKRUPTCY THEY
CAN AFFORD DATA PAYING OUT OF
POCKET SO.
YOU KNOW THIS THIS REALLY IS OF
TRYING TO GET TO.
HEALTH FOR ALL THIS PROPOSAL
CERTAINLY IS A WAY. THAT BOTH TO
ADDRESS NOT ONLY THE HUMAN COSTS
WHICH I THINK SHOULD BE FOR
THOSE FOUR FRONT. AND THE
DECISION BUT ALSO EVEN.
FINANCIALLY SO WE LOOK AT IT I
THINK IS CENTER MONEY SAID.
ABOUT YOU KNOW ONE LEVEL YOU CAN
LOOK AT SAY THIS IS THE COST OF
DOING IT RIGHT WE'RE GOING TO
HAVE HOW MANY MORE PEOPLE ON THE
PROGRAM ETCETERA BUT WHAT WE
OFTEN NOT.
HE IS IS THAT WELL.
WHAT'S THE COST OF NOT DOING IT.
RIGHT AS WELL SO WE HAVE THE
HUMAN COSTS WHICH WE ARE TALKING
ABOUT BUT ALSO EVEN FINANCIALLY
WE ARE BUDGET SUBCOMMITTEE.
BECAUSE MAY NOT BE AS MUCH AS
WE THINK THAT BECAUSE WE TAKE.
WHAT WE KNOW PENCIL OUT IS THE
COST FOR COVERAGE BUT THEN WE?
THEN TAKE WAIT SAID WATER WE
PAINT FOR RIGHT NOW FOR NOT
DOING ANYTHING I THINK THAT
DIFFERENCE MAY NOT BE AS LARGE
AS WE THINK SO. BUT WE DO NEED
TO WORK THAT OUT. AND HOPEFULLY
WE CAN.
THAT WE CAN WE CAN MAKE
PROGRESS ON THIS
SO WITH THAT.
I THINK YOU SO MUCH FOR COMING
TO TESTIFY.
AND OF WE WILL HOLD WILL HOLD
THIS ITEM OPEN FOR IT NOW.
OKAY THANK YOU.
.
THE NEXT ITEM IS THE.
AGE BLIND DISABLED PROGRAM
ELIGIBILITY AND.
WE HAVE.
LISTA SERLO POVERTY AT THE
WAYS YOU BACK HERE AND THE BROTH
FROM DISBELIEVE IT SAYS
CALIFORNIA.
SEC OF OPEN UP. BUT IT DOESN'T.
OKAY SO ACTUALLY KNOW WHAT DID I
KNOW HE DID DEVICE CAO IT PUTS
QUICKLY DO THE INTRODUCTIONS
HERE AND THEN YOU GOT. INTO IT
TO YOU CAN DO IN THREE MINUTES
THAT BE GREAT SELL BUT OF BEACH
DO INTRODUCTIONS THAT DOESN'T
COUNT AGAINST A TIME.
LYNDA WITH WESTERN CENTER ON LAW
AND POVERTY.
GEN FLORA PRESENTING THE HEALTH
CONSUMER ALLIANCE TODAY THE
STATEWIDE CONSORTIUM OF LEGAL
AID ASSOCIATIONS THAT REPRESENT
ALL OF OUR LOW INCOME
CALIFORNIANS AND HEALTH ISSUES.
THANK YOU.
PRESENT. THANK YOU WE APPRECIATE
THE OPPORTUNITY I TO TH
PRESENTED A SUBCOMMITTEE OF THE
PROPOSAL TO RAISE THE MEDI CAL
AGING DISABLED INCOME LIMIT
TO HUNDRED THIRTY EIGHT PERCENT
OF THE FEDERAL POVERTY LINE.
UNDER THE AFFORDABLE CARE ACT
ALMOST ALL ADULTS.
WITH INCOMES OF TWO HUNDRED
THIRTY EIGHT PERCENT OF THE
FEDERAL POVERTY LINE ARE
ELIGIBLE FOR FREE MEDI CAL
EXCEPT FOR SENIORS THOSE SIXTY
FIVE AND OLDER. BY VIRTUE OF
THEIR AGE PEOPLE SIXTY FIVE AND
OLDER HAVE A LOWER INCOME
ELIGIBILITY THRESHOLD OF ABOUT A
HUNDRED AND TWENTY THREE PERCENT
OF THE FEDERAL POVERTY LINE.
WHICH IS ABOUT A HUNDRED FIFTY
DOLLAR DIFFERENCE WHEN COMPARED
TO AB ONE THIRTY EIGHT.
IF THE SENIORS INCOME IS MORE
THAN TWELVE FORTY TWO A MONTH.
HERE SHE CAN ONLY GET FREE
MEDICARE HOW WITH THE SHERIFF
COST
A SHARE OF BECAUSE OF THE AMOUNT
AN INDIVIDUAL MUST KICK AND THE
FOR FREE MEDI CAL KICKED OUT
KICKS IN. A PERSON'S SHARE COST
IS THEIR MONTHLY INCOME MINUS
SIX HUNDRED DOLLARS AND THIS IS
BASED ON THE ANTIQUATED IDEA
THAT PEOPLE CAN LIVE OFF OF SIX
HUNDRED DOLLARS THAT SIX HUNDRED
DOLLARS IS ENOUGH. FOR FOOD RANT
ON AND OTHER BASIC LIVING
EXPENSES.
FORCE BETWEEN PAYING FOR RENT
AND FOOD OR THEIR MEDI CAL SHARE
COST MANY SENIORS FOREGO NEEDED
MEDICAL EXPENSE PROMPTING THEM
TO MOVE INTO SKILLED NURSING
FACILITIES AT A HIGH COST TO THE
STATE. AND EVEN HIGHER PERSONAL
COST.
TO THEIR OWN UP INDEPENDENCE AND
WELL BEING WE STRONGLY URGE THE
COMMITTEE TO AYE RAISE THE MEDI
CAL AGING DISABLED LIMIT ON SO
THAT IT IS A HUNDRED AND THIRTY
EIGHT PERCENT CREATING PARITY.
FOR ALL ADULTS THINKING.
I'M HERE JUST TO GIVE A STORY TO
ILLUSTRATE WHAT THIS MEANS THAT
TO REAL REAL SENIORS IN REAL
DOLLARS HOW RECENTLY WE HAD A.
COUPLE COME INTO ONE OF OUR
LOCAL PROGRAMS AND TULARE COUNTY.
AND THEY HAD BEEN ON.
MEDI CAL AND THEY'VE ACTUALLY
BEEN WAITING ABOUT A YEAR TO GET
AND HOME SUPPORTIVE SERVICES AND
HAD JUST GOT.
LAST MONTH
BUT WHEN THEY GOT A NOTICE THIS
MONTH IT WAS BECAUSE IN THEIR
SOCIAL SECURITY INCOME HAD JUST
GONE UP.
PUTTING THEM SIX DOLLARS OVER
THE LIMIT. AND SO THEN WHAT
RESULTED IS FOR A COUPLE AND THE
MAINTENANCE NEED INCOME LEVEL IS
SEVEN HUNDRED FIFTY DOLLARS SO
THAT MEANT THAT THEY HAD TO
SPEND SEVEN HUNDRED FIFTY FIVE
DOLLARS. OVER HALF OF THEIR
INCOME BEFORE THEY COULD ACCESS
ANY SERVICES SO THIS COUPLE WILL
NOT BE ABLE TO AFFORD TO ACCESS
IN HOME SUPPORTIVE SERVICES AND
THEY WON'T BE ABLE TO. AFFORD TO
ACCESS THE OTHER HEALTH CARE
SERVICES THEY NEED UNLESS YOU
KNOW THEY'RE ABLE TO PAY OUT OF
POCKET UP INTO PAIN SEVEN. SEVEN
HUNDRED FIFTY FIVE DOLLARS A
MONTH HAD THIS COUPLE BEEN UNDER
AGE SIXTY FIVE THEY WOULD HAVE
BEEN COVERED FOR A LOT OF OUR
SENIORS IN CALIFORNIA TURNING
AGE SIXTY FIVE BECOMES A REALLY
BAD BIRTHDAY.
SO WE JUST WANT TO MAKE SURE
THAT OUR SENIORS ARE CUT.
EVERYONE.
OKAY THANK YOU. INCOMES FROM DTS
ALRIGHT BELIAU WOMEN'S PROPOSAL
FINANCE
NO ALRIGHT.
QUESTIONS FROM COMMITTEE MEMBERS.
OKAY SO I GUESS THIS IS A.
I WAS A HISTORICAL ANOMALY BUT
IT'S.
THE TAP AND IS OVER TIME EROSION
AND THAT SUPPORT THAT ALRIGHT.
OKAY WELL LET'S GO HEAD TAKE
PUBLIC COMMENT.
WELCOME.
NATASHA PHILLIPS OF CALIFORNIA
COVERAGE AND HEALTH INITIATIVES
IN STRONG SUPPORT I THINK THIS
IS A SIMPLE SOLUTION TO A
NONSENSICAL PROBLEM.
THANK YOU.
WELCOME.
IT AFTER. ARMY GOOD AFTERNOON
I'M NINA Y. THE HER WELL WITH A
R. P. WE STAND SUPPORT OF THIS
PROPOSAL.
TOM.
ERIC P. POLICY ARE POLICY BOOK
ACTUALLY EXPLICITLY SUPPORTS
RAISING THE POVERTY LEVEL FOR
ALL MEDICAID RECIPIENTS TO ONE
THIRTY PERCENT OF POVERTY. WE
STRONGLY URGE THIS COMMITTEE TO
EVENTUALLY VOTE IN FAVOR THANK
YOU.
THANK YOU.
WELCOME.
THANK YOU MISTER CHAIRMAN
MEMBERS MARK WINDOWS WITH AS
HERE YOU CALIFORNIANS SUPPORT.
THANK YOU WELCOME.
THANK YOU KAREN SAVAGE
CALIFORNIA PAN ETHNIC HEALTH
NETWORK ALSO IN STRONG SUPPORT
THANK YOU WELCOME.
NO I BOTTOM OR CALIFORNIA RURAL
LEGAL ASSISTANCE FOUNDATION IN
STRONG SUPPORT. THANK YOU.
WELCOME.
PRO SUPPORT A BLUE SHIELD OF
CALIFORNIA ALSO IN SUPPORT THANK
YOU.
WELCOME.
KELLY BROKE SOME BEHALF OF THE
COUNTY WELFARE DIRECTORS
ASSOCIATION HERE IN SUPPORT
THANK YOU WELCOME.
BUT PULSE FOR FROM A KILLER
HEALTH AND SUPPORT THANK YOU.
WELCOME AARON FOX LOS ANGELES
LGBT CENTER IN SUPPORT THANK YOU.
ALTHOUGH I ACCURATELY CONTAIN
ITEM ON BEHALF OF THE HAVING OUR
SAY COALITION WERE IN STRONG
SUPPORT. THANK YOU.
WELCOME IN ASOLO THE CALIFORNIA
EMIGRATE POLICY SENATE'S PORT
THANK YOU.
OKAY VERY VALDEZ HEALTH ACCESS
AND SUPPORT MAKING.
WELCOME LEVEL THIS MATERNAL
CHILD HEALTH ACCESS AND SUPPORT
THANK YOU.
WELCOME RENDON BARNABY HAVE OF
THE AIDS HEALTHCARE FOUNDATION
SUPPORT.
THANK YOU.
ALRIGHT.
A YES ANDERSON THE FIGURES
JEROEN THANK YOU FOR THE
EDUCATION OF.
YEAH I DON'T UNDER KNOW HOW ANY
GOVERNMENTAL AGENCY CAN ASSUME
THAT A SENIOR CITIZEN
COMMITMENTS SIX SEVEN DOLLARS A
MONTH THAT WE WE GOTTA WE GOTTA
GET THAT FIXED THAT'S JUST NOT
RIGHT APPRECIATED YOU PRESS.
FOR THE INEQUITIES.
IT WITH OUR SENIOR CITIZENS
THAT ARE STRUGGLING.
AND.
I WANT TO JUST OFFER MY SUPPORT
TO. THE CORPORATE IF YOU WILL
MAKE SURE THAT OUR SENIOR
CITIZENS GETTING MEDIA. THEY
PURPOSES THAT'S THEY NEED AND I
LOOK FORWARD TO WORK WITH MY
COLLEAGUES ON THIS AS WELL.
IF YOU THINK ABOUT WHAT WENT ONE
QUESTION.
HAVE YOU GUYS PUT A PRICE TAG ON
THIS.
RIGHT NOW IT'S ESTIMATED ABOUT
THIRTY MILLION GENERAL FUND AND
THAT'S BASED ON A PREVIOUS BILL.
IT'S PRETTY MODEST FIGURE MUCH
OF.
OKAY.
SINCE OKAY YEAH AND I THINK IT'S
WE TALKED ABOUT SOMETIMES A
LARGER NUMBERS
ALRIGHT. TRIED HOPEFULLY WE CAN
YACHT SO WE'RE GONNA HOLD THAT
OPEN AND HOPEFULLY WE CAN SEE
WHAT I CAN DO BY MAY REVISE AND.
FLEE THE GOVERNOR'S OFFICE MIGHT
CONSIDER.
THE.
CONSISTENCY HAVE DOING THAT OF
THAT. ALRIGHT.
NEXT ITEM WE HAVE HERE IS A
DISKLESS EXPRESS LANE
ELIGIBILITY FOR WHAT PROGRAM.
AND WE HAVE.
PERSON TEST OF TOOLS
PARTNERSHIP.
AND WE HAVE ANOTHER OKAY THOUGHT
SHE CAN JUST INTRODUCE YOURSELF
AND SILLY VALDEZ RIGHT. ALRIGHT
SERVE ACTIONS WANT TO GO AHEAD
FORMALLY INTRODUCE YOURSELVES
FOR THE RECORD AND THEN WE'LL GO
AHEAD AND THAT
BETWEEN TWO YOU CAN DO IN THREE
MINUTES THAT BE GREAT SO.
THE SHIP ON BEHALF OF THE GUN
CALIFORNIA CHILDREN'S COVERAGE
CAN COALITION.
IRV EARLY WITH THE CALIFORNIA
WITH ASSOCIATION FOR THE EIGHTY
THREE AGENCIES.
THANK YOU RIGHT BUT HAVE BEEN ON
MY MIND TO THINK OF THIS
COMMITTEE AND.
NUYS CHAIRMAN FOR.
HEARING US AND HEARING THIS
PROPOSAL AND WE ARE VERY PROUD
OF CALIFORNIA SHOULD BE VERY
PROUD OF THIS
S. WE'VE MADE IN COVER
CHILDREN.
FORNEY AND.
BUT THERE ARE TWO HUNDRED
THOUSAND CHILDREN STILL
UNINSURED IN CALIFORNIA.
AND HALF OF THEM ARE ELIGIBLE
FOR MEDICAID ALSO CLEARLY THE
WORK TO BE DONE IS TRYING TO
FIND THOSE THAT ON OUR ELIGIBLE
IN ROLL THEM. SO AND THIS IS A
PROPOSALS AND SO SMART SORT OF
US SMART EFFICIENT STRATEGY OF
GOING TO WEAR THAT LARGE NUMBER
OF CHILDREN ARE. AND ACCORDING
TO THE WICK DATA THERE'S ABOUT
NINETY THOUSAND.
WHERE CHILDREN THAT ARE
ELIGIBLE AND FOR MEDI CAL BUT
NOT IN RULED? AND SO THIS IS A
CLEAR AUTUMN OPPORTUNITY TO
ENROLL THEM BASED ON THE
INFORMATION THEY ALREADY HAVE
PROVIDED FROM THERE WICK
APPLICATION.
AND SO BECAUSE THE SYSTEM'S
ALREADY TALK TO EACH OTHER AT
THE END THERE IS A WAY IN WHICH
WE COULD VERY EASILY MAKE THAT.
FROM SOMETHING THAT A AND
EXPEDITES ENROLLMENT THERE'S
FEDERAL AUTHORITY AND TO IT TO
DO THIS THAT ALLOWS THEM TO USE
THE WICK AND FINDINGS AND WE
EVEN HAVE A STATE STATUTE ON
THAT SO. ON IT ALL THE PLACE
PIECES ARE IN PLACE AND I THINK
EASY FIX TO TRY AND GET THOSE
KIDS.
AND SHE'S HERE FOR OF ANY
QUESTIONS.
IF YOU HAVE ANY UNLIKE.
OKAY.
ELLIOTT AND ACTUALLY DTS
INCUMBENTS.
BIO.
FINANCE.
THE.
COMMITTEE MEMBERS.
UP SO.
ALRIGHT SO I AM IN TERMS OF.
I MEANS WELL BECAUSE THERE IS A
WELL KNOWN PROGRAM.
THEORY COLLECTING DATA
ELIGIBILITY TO CERTAIN EXTENT.
SPLURGED PREGNANT WOMEN AND
KIDS SO YOU THINK.
.
WHAT DO YOU SEE ANY CHALLENGES
TO DECIDE FROM MONEY TO DOING
THIS?
PARENTS.
WELL A DIPLOMATIC AS DEPARTMENT
OF FINANCE.
WILL HAVE TO GO BACK AND
EVALUATE.
.
THAT PIECE I AM I DON'T KNOW IF
WE'VE TAKEN A LOOK AT.
ELIGIBILITY AND WAKE.
BUT WILK WILL GO BACK AND TAKE
A LOOK A CLOSER LOOK. BUT NO
THERE'S ANYTHING THAT.
YOUR CAN SHARE THAT WOULD BE
VERY HELPFUL. OKAY YEAH BECAUSE
AT LEAST IN OUR NOTES HERE AND
OF COURSE.
WE'RE LOOKING AT ABOUT EIGHT
MILLION FOR THE HEALTH CARE
ITSELF AND ABOUT A MILLION TO.
BUT ALL THE PIECES TOGETHER. BUT
SEVEN MILLION FOR THEN ROMAN AND
AND JUST OF MINUS LIKE FOUR
HUNDRED THOUSAND AND JEN OKAY
EVEN LET SARAH CHANGES ONE TIME
SYSTEM CHANGES OKAY SO I LET'S
SILICON.
SIMPLY BECAUSE IT'S ME.
ALRIGHT WELL WE HAVE PUBLIC
COMMENT MAYBE THEY WILL SEE WITH
THEIR DEGREE OR NOT.
LINDA AWAY WITH WESTERN CENTER
ON LAW AND POVERTY WE SUPPORT
EFFORTS TO GET ELIGIBLE AYE
WOMEN AND CHILDREN ON TED MEDI
CAL THANK YOU.
THANK YOU WELCOME.
I WAS ABUSED CHILDREN'S DEFENSE
FUND CALIFORNIA LIKE TO COMMENT
ON BEHALF A CDF CALIFORNIA AND
ALSO THE CHILDREN'S PARTNERSHIP
THAT WE STRONGLY SUPPORT THIS
COMMONSENSE MEASURE TO GET. A
ELIGIBLE CHILDREN AND ROLL THIS
IS BEEN A GOAL FOR CALIFORNIAN
CALIFORNIA'S DOING REALLY WELL
AS A GREAT WAY TO REACH SOME OF
THE LAST.
KIDS OUT THERE
OKAY THANK YOU.
WELCOME.
WEST SAM'S AGAIN THAT WAS A
CALIFORNIA US TWO. OKAY THANK
YOU.
WELCOME.
MARRIED OUT OF HEALTH ACCESS AND
SUPPORT THANK YOU WELCOME.
NO I PART OF MOST CRLA
FOUNDATION WE AGREE TO HANK YOU
THANK YOU. WELCOME ENABLE THIS
NCH ACCESS STRONG SUPPORT THANK
YOU.
ALTHOUGH.
A TOUCH OF OF CALIFORNIA
COVERAGE IN HEALTH INITIATIVES
IN STRONG SUPPORT. OKAY THANK
YOU.
WELL IT SOUNDS LIKE ANONYMOUS
ALRIGHT SOUNDS GOOD.
ANY OTHER QUESTIONS.
ALRIGHT WELL.
.
STRIVE FIGURE THIS OUT THAT THE
NUMBERS BUT TAXABLE US SEE WHAT
MAY REVISE HOLDS AND.
WILL HOLD THIS ITEM OPEN TO
THINK SYMMETRY ADJUSTMENT.
ALRIGHT.
OKAY AND.
THE THINGS.
OTHERS THAT'S RIGHT OKAY LAST
AGAIN NEXT ITEM IS THAT YES MEDI
CAL AND ROMAN ASSISTANT ARE
REACHED TALK ABOUT TRYING TO GET
MORE PEOPLE FINDING THE PEOPLE
WHO ARE QUALIFIED IN THE ROLE.
SO WE HAVE SILLY ABOUT THIS
MATERNAL AND CHILD HEALTH ACCESS
RIGHT THINGS WELCOME THANK YOU
SO MUCH FOR THIS OPPORTUNITY TO
SPEAK. AGAIN MY NAME IS SAID
EVER THIS I AM THE AVERAGE AN
AROMA DIRECTOR OF MATERNAL AND
CHILD HEALTH ACCESS.
A NONPROFIT COMMUNITY BASED
ORGANIZATION LOS ANGELES
DEDICATED TO ENSURING MEANINGFUL
ACCESS TO HEALTHCARE.
AND CHICHI PARTNERS WITH A TINY
MOMENT COLLABORATIVE A FIFTEEN
ALLEY KHAN UNITY ORGANIZATIONS
AND A STATEWIDE NETWORK OF OVER
FORTY ORGANIZATIONS AND RULE AS
WELL AS URBAN COUNTIES. ON THE
COAST AND INLAND AND THE NORTH
AND THE SOUTH OUR PARTNER
ORGANIZATIONS ARE IN SACRAMENTO
RIVERSIDE FRESNO SAN BERNARDINO
SAN JOAQUIN.
MONTEREY ORANGE CINEMA PLUS
TWENTY OTHER COUNTIES MAKING IT
TWENTY EIGHT TOTAL.
HERE TODAY TO ASK FOR YOUR
SUPPORT FOR THE CONTINUATION OF
AB EIGHTY TWO FUNDING HAND THE
AMOUNT OF TWENTY SIX POINT FIVE
MILLION.
OVER A TWO YEAR PERIOD.
GRAININESS SEE OPPORTUNITY TO
CONTINUE PROVIDING HEALTH
OUTREACH ENROLLMENT AND ADVOCACY
TWIN SURE UTILIZATION OR ACCESS
AND THE RETENTION OF HEALTHCARE
BENEFITS.
AS YOU KNOW CURRENT FUNDING IS
SCHEDULED TO END ON JUNE
THIRTIETH OF THIS YEAR.
WE ARE A NETWORK OF HIGHLY
SKILLED AND EXPERIENCED HEALTH
CARE ADVOCATES WHO HAVE BEEN
COMMITTED TO SERVING THE MOST
VULNERABLE IN OUR COMMUNITIES.
WE SERVE THE UNINSURED AND THE
UNDERINSURED THE MEDICALLY
FRAGILE HIGH EMERGENCY ROOM
USERS THE HOMELESS POOR AND
WORKING POOR.
CHILDREN AND MAKES ON
IMMIGRATION STATUS FAMILIES
VIRUS PREGNANT WOMEN FORMER AND
FOSTER YOUTH.
AND SENIORS.
AND ALSO THE FORMERLY
INCARCERATED AS WELL.
WE NEED THEM WHERE THEY ARE
BRINGING OUR SERVICES TO THEM WE
SPEAK THEIR LANGUAGE WE GOTTA
WORK SITES CHURCHES SCHOOLS
SHELTERS FOOD PANTRIES
LAUNDROMATS EXEDRA. WE ENROLLED
THEM INTO HEALTH COVERAGE AND
MAKE SURE THEY GET THE CARE THEY
NEED WE ALSO CONNECTING TO ALL
TYPES OF OTHER HEALTH SERVICES
INCLUDING MENTAL HEALTH.
AND SUBSTANCE ABUSE TREATMENT
PROGRAMS AND ALSO CONNECTING TWO
FOOD AND HOUSING SUPPORT
SERVICES.
AN ALLEY COUNTY ALONE WITH APD
TO ARE REACHING A MOMENT FUNDS
WE HAVE REACHED NEARLY TWO
MILLION PEOPLE AND ASSISTED OVER
TWO HUNDRED THOUSAND. WHEN
ENROLLMENT JUST AS THE AS OF
LAST OCTOBER RETENTION RATES AND
THESE PROGRAMS ARE IN THE HIGH
EIGHTY TO NINETY PERCENT.
ARE AMONG THE POPULATIONS WE
HAVE SERVE AND HUNDREDS OF
THOUSANDS MORE HAVE BEEN
ASSISTED THROUGHOUT THE STATE
WITH THESE FUNDS OUR WORK IS
CRITICAL AND ESPECIALLY. IN THIS
FEDERAL CLIMATE WE SPEND A LOT
OF TIME EDUCATING FAMILIES WITH
IMMIGRANT MEMBERS AND USING
THEIR FEARS WE ARE LOOKED UPON
FOR ANSWERS CLARIFICATION AND
HAVE BUILT TRUST WITHIN OUR
COMMUNITIES. FOR THIS REASON WE
SEEK YOUR SUPPORT LOSING THESE
SERVICES DUE TO EXPIRED FUNDING
WILL BE A DETRIMENT NOT ONLY TO
THESE COMMUNITIES BUT TO THE
ENTIRE STATE OF CALIFORNIA.
THANK YOU SO MUCH.
THANK YOU. A COMMENT SITE
INCOMES FROM THE C. S..
OKAY LA JOH.
FINANCE.
MISTER CHAIR MEMBERS AS YOU KNOW
THESE PURPLES ARE THESE
PROPOSALS ARE OUTSIDE OF THE
GOVERNOR'S SPENDING PLAN WILL
CONTINUE TO HAVE DISCUSSIONS.
AND WE DO NOT HAVE A POSITION.
ON THESE PROPOSALS AT THIS TIME
OKAY BUT I DO APPRECIATE THEIR
OUTSIDE THE. GOVERNOR'S CURRENT
PROPOSAL BUT WE'RE HOPING THAT
THAT.
.
WE CAN ALL COME TOGETHER.
INCLUDES ELEMENT THERE ITSELF.
.
ACTUALLY IF WE'RE.
SO WHERE IS THE FUNDING COMING
FROM BEFORE.
SELF KERN SO THAT I UNDERSTAND
FUND SOME FUNNIES CAN BE
EXPIRING AT THE END OF THIS BUT
YELL AND JUNE THIRTIETH SO WHAT
WHAT WHAT WHAT WHO IS CURRENTLY
FUNDING.
SO SO WE WE HAVE SOME AB TWO
DOLLARS.
.
MODELERS SO IT'S FEDERAL
MEDICARE OWN ADMINISTRATIVE
ACTIVITIES.
BINDING MONIES FOR THAT'S
WHAT'S KIND OF KEPT US GOING I'M
NOT SURE ANOTHER COUNTIES THAT.
IS BEING WORKED OUT.
OKAY AND SHE TOOK CAN LOOK LIKE
YOU'RE ABOUT TO SAY SOMETHING
ABOUT THE. THE FUNDING WAS
ORIGINALLY I'M PROVIDED TO US
THROUGH A FOUNDATION SO THEIR
NON.
BUT NOT STATE DOLLARS OKAY
AFFECT TO DRAW DOWN THE FEDERAL
MATCHING DOLLARS OKAY SO OF WAS
ENTIRE AT HOW MUCH OF THE NON
FEDERAL WAS. ALL THAT WAS A
FOUNDATION. FOUNDATION OKAY SO
NOW THE FOUNDATIONS.
STOP DOING BUT IT'S BEEN
FRAGMENTED SO WE'VE BEEN KIND OF
SPLIT WITHIN LA SOME
ORGANIZATIONS HAVE BEEN AB TWO
AND OTHERS HAVE. HAVE BEEN
MODELER OKAY FUNDED ALRIGHT
OKAY.
OKAY WELL WON'T GO AHEAD TAKE
PUBLIC COMMENT THEN.
LINDA WAY WITH WESTERN SINCE
FEDERAL LAW AND POVERTY IN
STRONG SUPPORT.
WELCOME.
THOUSAND VIEWS TO THE CHILDREN'S
DEFENSE FUND A CALIFORNIA
SPEAKING ON BEHALF OF CDF AND
ALSO THE CHILDREN'S PARTNERSHIP
IN STRONG SUPPORT JUST WANT TO
POINT OUT THAT CALIFORNIA HAS
ALREADY DONE SUCH A GREAT JOB TO
EXPAND COVERAGE TO KIDS BUT.
WITHOUT SERVICES LIKE THIS OUT
WE WILL NEVER BE ABLE TO REALIZE
THE FULL. POTENTIAL OF THAT AND
ALSO JUST TO NOTE THAT ON IN THE
CURRENT POLITICAL CLIMATE.
UNDOCUMENTED CHILDREN ARE
ELIGIBLE IN CALIFORNIA AND THOSE
CHILDREN A LOT OF THEM WE MIGHT
BE ABLE TO REACH WITHOUT ON
SERVICES LIKE THIS THANK YOU.
THANK YOU.
WELCOME.
WHAT SENDS UNITED WAYS
CALIFORNIANS STRONG SUPPORT?
THANK YOU.
WELCOME.
VERY VALID HEALTH ACCESS AND
SUPPORT THAT YOU. WELCOME.
PERRANCE AVERAGE SEE PAN IN
SUPPORT THANK YOU BOTH.
KELLY BROOKS ON BEHALF OF THE
COUNTY WELFARE DIRECTORS
ASSOCIATION PLEASED APPEARANCE
PART THANK YOU. WELCOME.
A TOUCH OF US A CALIFORNIA
COVERAGE AND HEALTH INITIATIVE A
STATEWIDE NETWORK OF OUT REACH
MOMENT AND NAVIGATION
ORGANIZATIONS HELPING FAMILIES
GET INTO COVERAGE AND NAVIGATE
THE HEALTHCARE DELIVERY SYSTEMS.
AND OBVIOUSLY WERE IN VERY
STRONG SUPPORT THANK YOU.
WELCOME. NOBODY MOST CRLA
FOUNDATION IN STRONG SUPPORT.
THIS IS FUNDING THE NEEDS TO GO
TO OUR COMMUNITIES THIS IS
ACTUAL FUNDS THAT ARE ON THE
GROUND SERVING OUR FARM WORKER
UNDERSERVED RURAL COMMUNITIES IN
PARTICULAR THANK YOU VERY MUCH.
THANK YOU.
ANY OTHER SO SHE'S. AN OF IN HIS
ANSWERS QUESTIONS SO.
I UNDERSTAND THAT.
.
LOOKS LIKE HERE ABOUT. WAS IT.
A SEVEN THOUSAND APPROVED
MEDICAL APPLICATIONS RESULTING
FROM THIS.
.
THREE THIRTY THOUSAND
BENEFICIARIES I MEAN OF.
LUIS WAS LIKE IF PHAM.
IF THEY DON'T GET ENROLLED A
CERTAIN PERCENTAGE WILL BE SICK
AND THOSE SHOPPERS UNINSURED.
AND THEN WE'RE SUBSIDIZING BAD
SOMEWAY PRIDE BECAUSE THAT
MEASURE APPRECIATED BY CAN
AFFORD TO ACTUALLY PAY. AND IN
SOME SENSES.
IF WE DON'T DO THIS HOW MUCH IS
THIS GOING TO COST US.
AND AND I'D LIKE TO ADD THAT I
MEAN I KNOW THAT YOU DID BEFORE
MY COMMENTS RIGHT SO MUCH OF OUR
TIME IS SPENT ON.
TROUBLESHOOTING.
SO MAKING SURE THAT PEOPLE HAVE
ACCESS TO ACTUAL SERVICES.
SO COURT MAKE HELPING THEM
COORDINATE THEIR THEIR SERVICES
IN WORKING WITH THE HEALTH PLANS
TO MAKE SURE THEIR. SERVICES GET
AUTHORIZED I MEAN THERE'S A LOT
OF WORK THAT'S TIED INTO TO THIS.
THAT'S BEEN DONE AND WE DO WE
WORRY ABOUT WHERE WE'RE KIND OF
THE ONLY GROUPS THAT ARE REALLY
GOING OUT INTO THE COMMUNITIES
THAT WE EXPECT PEOPLE TO GOING
TO A GOVERNMENT OFFICE WHAT ARE
THE CHANCES. OF THAT HAPPENING
OKAY GETS UNDONE JUST ALSO
TRYING TO FIGURE OUT HOW DO YOU
QUANTIFY FOR EXAMPLE.
IF YOU DON'T DO THIS YOU'RE NOT
GONNA GET FOLKS.
GOLD THIS PRINCESS AGE OF THESE
MUNDANE DELFT PERCENTAGE OF THE.
PEOPLE THEY NEED HEALTH CARE.
THEY DON'T GET IT OR THEY SHOW
UP AND THEY CAN'T AFFORD PAY FOR
IT. AT THE BEGINNING OF FEDERAL
MATCH DOLLAR THIS MONEY BUT IF
THERE STEUBENVILLE MEDICARE ALSO.
WHATEVER COSTS THERE IS A FIFTY
CAL WAS A FIFTY FIFTY AND BACK
HOUSE NOT THE YOU KNOW.
AND NOT THE HIGHEST FIGURE IN
THE WORLD SO THAT BUT.
DAYS I MEAN THAT'S THEIR LIVES
MY FEDERAL MONEY WE BELIEVE ON
THE TABLE BY NOT DOING THIS IN
TERMS OF.
IN TERMS OF ACTUAL YOU KNOW THE
ACTUAL EXPENSE OF OF BY NOT
DOING THIS RIGHT BECAUSE OF WHAT
THAT MEANS IS THAT WHILE THEY
SHOP IN A. HOSPITAL EMERGENCY
ROOM.
ETCETERA NOW OF WELL. HOW HOW
DOES THAT COST GET COVERED
ESPECIALLY SINCE AN UPRIGHT ABLE
TO FOOT THE BILL THEMSELVES SO?
AND IF THERE'S A WAY TO.
COME UP WITH THAT ELISE STEVEN A
BACKING A NAPKIN CALCULATION OF
WHAT THE ACTUAL COSTS WOULD BE.
AND THAT THEM THE FEDERAL THEM
THE MODERATES ARE VERY MINIMAL
THEY JUST HOPE A LOT MORE GROUPS
TO THE SOUR. OKAY ALRIGHT. OKAY
WELL.
AND THOUGH THE COURTS THEN OF OF
COURSE WILL HOLD THIS OPEN BUT
MAYBE WE CAN LOOK AT SOME OF
THAT AND SEE. ME HAD AT THAT.
THINK THERE ARE I THINK THERE'S
SOME ARGUMENT THAT MAY STILL BE
COST EFFECTIVE TO.
TO DO THIS.
SO. OUR FAQ.
MUCH.
OKAY.
ALRIGHT.
OKAY.
RIGHT.
OKAY WELL I THINK WE'RE COMING
UP TO THE ITEM THAT EVERYONE'S
BEEN WAITING FOR THREE FORTY BE.
ISSUE NUMBER SIX.
I'M FRIGHTENED SO WILL I SEE
SOME NEW PEOPLE AROUND THE TABLE
SO MAY VOTE DO IT YES.
FAQ I'M I'M SO.
I HAD TO DO THIS BUT I HAVE A
FLIGHT ALSO AND THIS IS REALLY
IMPORTANT TO AND.
.
I WAS JUST WANTING IF IT WAS
POSSIBLE IF I COULD. ASK A FEW
QUESTIONS BEFORE I HAVE TO LEAVE
BECAUSE I CAN'T MAKE KIND OF
WAITING FOR THIS.
.
EVENT AND THAT I WOULD LOVE TO
HEAR THE PRESENTATION BUT I
THINK I UNDERSTAND THE SUBJECT
MATTER. AND.
THE LET ME JUST FOR THE RECORD
OR DO IT BECAUSE IF YOU NEED
BASIS QUICKEN TRADUCTION THIS
AND DO NOT WE DO HAVE THE
BACKGROUND ON TAPE FOR HERE SO
I'LL.
WELL LET'S PUT CENTER SOUND AND
I GO AHEAD AND ASK HIS QUESTIONS.
IF YOU BY CHANCE READ
BACKGROUND.
OKAY SO WE CAN JUST QUICK
INTRODUCTIONS AROUND THE TABLE.
AND FOR CANDIDATES YES THEY CAN.
RACES PICKFORD PLANNED
PARENTHOOD.
SUSAN ERLICH I'M THE CHIEF
EXECUTIVE OFFICER IT'S LIKE UBER
SEVERANCE ESCUCHA.
IT SEEMED.
PRETTY GUERRERO CEO SACRAMENTO
NATIVE AMERICAN HEALTH CENTER
OKAY ALEJO.
BEN JOHNSON WITH DEALIO. FINANCE
WELL ABOVE MONDAY BECAUSE
FINANCE AND SERGIO EIGLER
DEPARTMENT OF FINANCE OKAY THANK
YU.
SO NORMALLY WOULD HAVE DIRECTOR
CANPRESENT BUT I'M GONNA ASSUME
WE ARE. SOME OF US KNOW WHAT'S
GOING ON AND I'M GONNA GO AHEAD
LET'S HEAR STONE ASKS QUESTIONS
BEFORE YES LEAVE FAKE YOU MISTER
CHAIRMAN.
TO ALL OF YOU THANK YOU FOR YOUR
INDULGENCE LE. UNFORTUNATE
SOUTHERN CALIFORNIA PEOPLE WE
ONLY GET SO MANY OPTIONS TO GET
ON A PLANE TO GET HOME SO.
I APPRECIATE YOUR AND MEDIA KIND
OF.
COULD ADVANCE US SOME QUESTIONS
TO YOU.
IF THERE'S BEEN ANY ISSUE SO
FAR THIS YEAR THAT I'VE GOTTEN
SIGNIFICANT PHONE CALLS ON IT'S
CERTAINLY BEEN THE THREE FORTY
BE PROGRAM. AND I UNDERSTAND
THIS CAMP THAT THE THE THE THE
GOVERNOR HAS A DIRECTION HE
WANTS TO GO ON THIS.
BUT I AM VERY CONCERNED THAT
THIS IS GOING TO INCREASE THE
COSTS OF PHARMACEUTICALS FOR. A
LOT OF HOSPITALS AND.
ESPECIALLY ARE HURTING THE THE
MORE RULING ONCE AND I DO HAVE A
NUMBER RURAL HOSPITALS IN MY
DISTRICT.
AND.
AYE I'M WORRIED THAT THAT'S
GONNA.
CREATE AN ACCESS PROBLEM TO
THESE NEGATIVELY NEGATIVELY
AFFECTED HOSPITALS.
DO YOU SEE THAT POSSIBLE LACK
OF ACCESS BECAUSE. WE TALK ABOUT
A SIGNIFICANT AMOUNT OF MONEY TO
SOME OF THESE ENTITIES.
BUT CAN'T.
I'M. SO I THINK THERE'S PROBABLY
A DIFFERENCE OF OPINION.
AS TO THE THE COST FOR THE LOSS
OR THE SAVINGS IN THE PROGRAM.
IT'S A PROGRAM THAT WAS NOT
EVER INTENDED TO SERVE FOR THE
MEDICAID POPULATION RIGHT.
THE THREE FORTY BE PROGRAM WAS
CREATED AND IS OPERATED BY
HERSELF IT IS MEANT TO PROVIDE
DISCOUNTED PHARMACEUTICAL
COMPANIES ARE DISCOUNTED
PHARMACEUTICALS.
TWO INDIVIDUALS THAT ARE SERVED
BY SAFETY NET CLINICS.
THAT ARE SERVING UNINSURED AND
LOW INCOME.
THERE HAS BEEN.
CONTINUED INTEREST AT THE
FEDERAL LEVEL ABOUT MAKING SURE
THAT THE DISCOUNTS THAT ARE
OFFERED UNDER THOSE.
PROGRAMS ON THOSE DRUGS
ARE.
.
NOT OTHERWISE.
HAVING.
COSTS PASSED ON TO OTHER PAIRS
AND I THINK THAT'S REALLY KIND
OF THE HEART OF THE PROPOSAL.
I'M FROM THE ADMINISTRATION
WHICH IS WE ARE A PARTY TO THE
THREE FORTY BE.
DISCOUNTS AND AGREEMENTS
BETWEEN THE PROVIDER AND THE
MANUFACTURE AND YET WE ARE.
REQUIRED TO ENSURE THAT THERE
ARE NO DUPLICATE DISCOUNTS
BEING.
RETAINS.
WE HAVE BECOME AWARE.
DIET OBVIOUSLY AS YOU HAVE
HEARD FROM MULTIPLE PROVIDERS
THAT THEY'RE CONCERNED ABOUT
THIS ON. IF YOU ARE A THREE
FORTY BE. PROVIDER.
AND YOU'RE WRITING A SCRIPT IS
SOMEONE WHO GOES TO A PHARMACY
THAT PHARMACY MAY NOT KNOW. THAT
YOU ARE THREE FORTY BE PROVIDER
YOU SHOULD PROBABLY TELL THEM
BUT. THESE THINGS DON'T ALWAYS
WORK OUT.
AND THERE'S NO PROHIBITION THAT
THREE FORTY BE PROVIDERS
SUBMIT AND GET REIMBURSED FROM
MANAGED CARE. AFTER ACQUISITION
COSTS AND SO WE THE STATE ARE UP
SO I'M SAYING THIS IS WHY WE
WOULD RESPECTFULLY CAN JUST HAVE
A DIFFERENCE OF OPINION IS THE
PLAN SUBMIT THEIR RATES. US AND
THEIR COSTS
IF THEY ARE PAYING A COST BACK
TO A THREE FORTY BE PROVIDER
THAT IS NOT AT A THREE.
POSITION
BUT IT IS A HIGHER COST
THE COST GETS PASSED US THE
STATE. AS MEDICAID PROVIDER AND
SO I THINK.
THERE CERTAINLY.
AB ITS A FAR MORE COMPLEX BAD
DISCUSSION BUT I THINK THERE'S A
DIFFERENCE OF PERSPECTIVE AS TO
WHO PAYS AND HOW AND. AND WHO
GETS SAVINGS AND WHO DOESN'T AND
SO THAT'S KIND OF WHY THIS
PROPOSAL IS IN FRONT OF HIM TH
AND THANK YOU FOR THOSE ANSWERS.
AND I CERTAINLY UNDERSTAND THE.
THE GOVERNOR'S CONCERNED ABOUT
A WE CALLED DOUBLE DIPPING AND
GETTING TOOL DISCOUNTS.
BUT IT IT'S OUTLINED IN THE TWO
THOUSAND SIXTEEN OIG REPORT THAT
STATES ACROSS THE COUNTRY HAVE
FOUND WAYS TO ENSURE THAT
THEY'RE NOT CLAIMING REVIEWED ON
DRUGS PURCHASED TWO THREE FORTY
BE PROGRAM.
SO WHY DOES.
DCS THINK THAT THE WHOLE SO
ELIMINATION OF THE WHOLE PROGRAM
IS THAT IS THE BEST SOLUTION FOR.
FOR FOR MEDI CAL.
.
WHEN IT SUCH A VITAL COMPONENT I
UNDERSTAND ITS ORIGINAL INTENT
BUT WHEN YOU. YOU'RE LOOKING
HOSPITALS TODAY AND YOU LOOK AT
THE UNINSURED POPULATIONS ARE
GOING TO THE EMERGENCY ROOMS AND
ESPECIALLY THOSE RURAL AREAS.
I THINK IT'S GOING TO HAVE A
SIGNIFICANT.
IMPACT ON THE ACCESS TO CARE
WHICH IS SOMETHING THAT BROKEN.
AND AYE I WOULD DEFER TO THE
PROVIDERS TO HAVE TALK ABOUT.
YOU KNOW IF YOU'RE ACQUIRING A
DRUG.
YOU KNOW AT A HUNDRED DOLLARS.
I'M AND YOU'RE BEING REIMBURSED
FOR THAT HUNDRED DOLLAR
ACQUISITION COSTS.
I OULD I WOULD DEFER TO THEM AS
TO HOW THAT CHANGES THEIR COST.
BUT FROM OUR STANDPOINT IS YOU
KNOW WE AS A STATE AND OBVIOUSLY
AS A.
AS A PURCHASER INNER AB ENTITY
THAT'S RESPONSIBLE FOR BOTH
FEDERAL AND STATE FUNDS I'M WE
ARE SEEKING TO NOT.
.
PAY FOR SOMETHING THAT WE
OTHERWISE SHOULD BE REIMBURSING
AT A DIFFERENT LEVEL YOU KNOW WE
HAVE.
FEDERAL RULES THAT SAY YOU KNOW.
OUT PATIENT DRUGS SHOULD BE PAID
FOR OUT AN ACQUISITION COST PLUS
THE DISPENSING FEE. ON THE
COMPLEXITY OF HOW THREE FORTY BE
IS EITHER CONTRACTED ARE
PROVIDED CERTAINLY MAKES IT MORE
DIFFICULT SO A THREE A THREE
FORTY BE DRUG.
OR AT THREE FORTY BE A REBATE
SHOULD NEVER HIT OUR REBATE
SYSTEM AND YET THEY DO BECAUSE
WHAT HAPPENS IS A PHARMACY FILLS
A CLAIM.
LATER ON THAT THREE FORTY BE
PROVIDER GIVES A LIST TO THAT
PHARMACY IN SAYS THESE ARE THE
DRUGS THAT WERE THREE FORTY BE.
DRUGS AND THEN THE PROBLEM IS AT
THE PHARMACY WE PAY IN REAL TIME
AS A PHARMACIST YOU WOULD KNOW.
WE PAY IN REAL TIME SO THE
PHARMACY LATER ON HOUSE TO AMEND
THE CLAIM AND SAY OH BY THE WAY
HERE ARE THE DRUGS THAT WERE
THREE FORTY BE.
THEY'VE ALREADY BEEN CLAIMS THEY
WERE TO BEEN REIMBURSED AND SO
THERE'S NO MECHANISM FOR WHICH
WE ARE CAPABLE OF KIND OF UNWIND
IN THAT AND THEN THE
MANUFACTURES DISPUTE.
THE INVOICES BECAUSE THEIR
REBATES DON'T MATCH WITH WHAT WE
HAVE SUBMITTED SO IT JUST.
.
IT IS A REALLY DIFFICULT.
SYSTEM FOR US TO OPERATE AND
AGAIN GOING BACK TWO THIS WAS
NOT THE INTENTION OF THE PROGRAM
RIGHT IT'S NOT A MEDICAID.
RELATED ITEMS SO THIS WEEK D. H.
CS RELEASE THE DRAFT LETTER TO
ALL PLANS OUTLINING.
STEPS AND MEDICARE MANAGED CARE
PLANS MUST TAKE TO PREVENT THE
DUPLICATIVE DISCOUNTS RECURRING.
WHY NOT GIVE THAT A CHANCE FOR
YEAR TO SEE IF THAT MIGHT SOLVE
THE PROBLEM?
BECAUSE MY AGAIN MIGHT MIGHT MY
ULTIMATE CONCERN IS I DON'T TAKE
ANY. MONEY ESPECIALLY FEDERAL
MONEY OUT OF OUR HEALTH SYSTEM
IN THE STATE OF CALIFORNIA.
AND SO WHEN THE STATE CLAIMS A
REBATE FROM A DRUG MANUFACTURE
THESE HALF THAT REPEATS GOT A
RETURN TO THE FEDERAL GOVERNMENT
AND HE TALKED FOR ABOUT EIGHTY
EIGHT TWELVE WE TALK ABOUT
NINETY FIVE FIVE. YOU TALK ABOUT
FIFTY FIFTY. AND SO. IT CENTERS
ARE GOING TO BE TAKING A
SIGNIFICANT AMOUNT OF MONEY OUT
OF OUR HEALTHCARE SYSTEM AND.
SENDING IT BACK TO WASHINGTON DC.
SO IT'S IT'S NOT THE REBATES
THAT ARE IN QUESTION RIGHT SO WE
GET BOTH MANDATED FEDERAL AND
STATE REBATES AS A MEDICAID
ENTITY WE HAVE A STATE
SUPPLEMENTAL REBATE PROGRAM THAT
WE NEGOTIATED WITH MANUFACTURERS
DIRECTLY. I THINK THE ISSUE IN
THIS IS A FAIR DISCUSSION IS THE
BENEFIT OF THOSE DISCOUNTS AND
THE.
.
THE.
THE MONEY THAT IS BEING PAID BY
THE HEALTH PLANS TO A THREE
FORTY BE ENTITY THAT MAY NOT BE
A THREE FORTY BE PRICE. THOSE
BENEFITS ACCRUE OUTSIDE OF THE
PURVIEW OF THIS DEPARTMENT AND
OUTSIDE THE PURVIEW. OF.
POLICY MAKERS ARE TAXPAYERS AND
I THINK THAT THAT'S YOU
CERTAINLY PART OF THE NAIONAL
CONVERSATION THAT'S ALSO BEEN
TAKING.
PLACES THERE WERE. HEARINGS THE
OTHER DAY IN THE SENATE.
BETWEEN HOSPITALS AND THE
FEDERAL SENATORS ABOUT YOU KNOW
WHO GETS THE BENEFIT YOU KNOW IF
THE BENEFIT IS ACCRUING TO THE
HOSPITAL. BUT IT'S
SUPPORTING THE SAFETY NET HOW DO
WE KNOW THAT THOSE DOLLARS ARE
GOING IN THE RIGHT PLACE I THINK
THE PROBLEM IS IS THAT NGUYEN
THE NEGOTIATION AND THE BENEFIT
DON'T ACCRUE TO THE. TO THE
STATE ALMOND SO IF THERE'S A
CONVERSATION TO BE HAD THAT'S
THIS IS THE TIME TO HAVE THAT.
SO I WOULD LOVE TO FURTHER OUR
CONVERSATION I REALLY DO
APPRECIATE YOUR ANSWERS AND I'M
JUST WONDERING. I'M I HAVE HAD
SOME VISITS FROM VARIOUS
ENTITIES OF THROUGHOUT THE STATE
BUT IN PARTICULAR THE RIVERSIDE
COUNTY.
REGIONAL MEDICAL CENTER WHICH
IS UNIVERSITY HEALTH SYSTEMS
IMPACTS ON THEM AND CERTAINLY
SOME ARE RURAL HOSPITALS.
WOULD YOU MIND IF MY OFFICE
WHICH COULD DROP A FOLLOW UP
APPOINTMENT WITH SOME OF THESE
ENTITIES TO SHARE THEIR CONCERNS.
BECAUSE I THINK WE ALL WANT IS
IT WHEN IT OCCURS MANY
CALIFORNIANS AS WE POSSIBLY CAN
AND. AND AND KEEP THOSE FEDERAL
DOLLARS HERE IF WE POSSIBLY CAN
BUT I KNOW WE HAVE SOME ISSUES
OF IT WILL AGREE ON SOME THINGS
WILL DISAGREE ON. BUT I'LL I'LL-EVERYONE TO GO TO THE MAT FOR
THESE HOSPITALS ARE DOING
YEOMAN'S JOB OF TRYING TO KEEP
PEOPLE.
HEALTHY ABSOLUTELY THANK YOU SO
MUCH WHICH SHERMAN APPRECIATED I
THINK YOU CENTER STONE APOLOGIZE
THAT. YOU HAVE THE.
THAT WE BUMPED UP AGAINST HER
FLIGHT HERE.
THE DELAYS ARE RIGHT WELL I KNOW
THIS MAY SOUND WILL BACKWARDS
BUT.
FOR THE FOR ALL THE PEOPLE HAVE
AND IT'S ABLE TO FOLLOW EIGHTY
CAN PRESENT WHAT THE PROPOSAL IS.
WE WILL HAVE A SIMILAR DALY
OAKLAND FINANCE COMMENTS AND.
THEN WILL HAVE THE PANEL WHICH
I'M SURE. THAT YOU'RE HERE
EXHIBIT OPINION ABOUT THAT SELF
OKAY.
SURE AND SO JUST VERY QUICKLY
BASED ON THE QUESTIONS I THINK.
IT IT SHOULD BE CLEAR THAT THE
GOVERNOR'S PROPOSAL IS TO
ELIMINATE THE USE OF THREE FORTY
BE. DRUGS IN THE MEDICAID
PROGRAM.
FOR A LOT OF.
OF THE ADMINISTRATIVE REASONS
THAT I JUST WENT INTO IN TERMS
OF THEY ARE.
DISCOUNTED DRUGS
THE STATE RECEIVES DISCOUNTS.
FROM PHARMACEUTICAL COMPANIES
AS A.
AS THE BENEFIT OF BEING A
MEDICAID AGENCY AND SO THAT THE.
ADMINISTRATIVE COMPLEXITY OF
HOW WE BOTH REIMBURSED FOR
PHARMACY AS WELL AS THE
CONTINUED.
AND FAR REACHING ON MANAGED
CARE.
EXPANSION IN CALIFORNIA HAS
CERTAINLY CHANGED THE WAY IN
WHICH WE REIMBURSE FOR. THESE
PRODUCTS AND SO THE NATURE OF
THE.
WORKLOAD AROUND MAKING SURE
THAT THESE ARE NOT A DUPLICATE
DISCOUNTS ISN'T THAT ONE OF THE
REASONS AND OBVIOUSLY THEY'VE
BEEN FEDERAL CONCERNS REYES SAID.
BURYING.
FORUMS THAT HAS LED US TO
PROVIDE YOU KNOW PROPOSE WHAT WE
ARE PROPOSING TODAY.
WE WOULD BE PROBABLY COMING
FORTH IN THE MAY REVISION.
WITH SON.
ABILITY ARE SOME AND.
ROUGH SAVINGS I THAT WOULD BE
REALIZE BASED ON THIS PROPOSAL
TIME SHOULD BE ADOPTED IN TERMS
OF WHAT THE SAVINGS ORINDA COST
AVOIDANCE WOULD BE OTHERWISE.
OKAY THAT COMES FROM A LEO.
.
YESTERDAY EVENING WE ACTUALLY
RELEASED A REPORT DATA THAT
INCLUDES OUR ANALYSIS OF THE
GOVERNOR'S PROPOSAL.
ON THE THREE FORTY P. PROGRAM
AND.
IN THE REPORT WE REALLY NEED
THAT WE TEND TO REALLY CLEARLY
AND SIMPLY LAYOUTS OF HOW THE
PROGRAM INTERACTS WITH MEDI CAL
AND SOME OF THE MAJOR ISSUES
THAT ARE HERE.
WE PROVIDE AN ASSESSMENT AND IN
OUR ASSESSMENT WE RECOGNIZE
AS THE ADMINISTRATIVE
AND JUST BECAUSE BY THE PROGRAM
FOR THE DEPARTMENT OF HEALTH
CARE SERVICES.
AND AGREE WITH THE
ADMINISTRATION'S ASSESSMENT THAT
THE ELIMINATION OF THREE FORTY
P. IN MEDI CAL WOULD LIKELY
RESULT IN AN OVERALL STATE
SAVINGS.
THE SAVINGS HOWEVER WE KNOW
WOULD WOULD COME AT THE.
EXPENSE OF SAVINGS THAT ARE
CURRENTLY RETAINED BY COVERED
ENTITIES AS WELL AS BY THEIR
PARTNERS AND OTHER PARTICIPANTS
IN THE HEALTHCARE SYSTEM.
OVERALL WE FIND THAT THE
PROPOSAL OF THE GOVERNOR.
A MERIT SERIOUS CONSIDERATION.
FLETCHER SENSE IT WOULD LIKELY
RESULT IN SAVINGS AND ELIMINATE
THOSE ADMINISTRATIVE CHALLENGES
AND IT WOULD PREVENT THE
DUPLICATE DISCOUNTS THAT ARE
RECEIVING FEDERAL SCRUTINY. OF
THE POTENTIAL SAVINGS THAT WOULD
BE PROPONENT WOULD BE GENERATED
UNDER THE PROPOSAL OUT WOULD BE
GENERAL FUND RESOURCES
ALTERNATELY AVAILABLE FOR
APPROPRIATION BY THE LEGISLATURE.
AND GIVE THE LEGISLATURE
FLEXIBILITY PURSUE ITS
PRIORITIES AND SO FORTH AND
MAXIMIZE THE LEGISLATIVE
OVERSIGHT OVER HOUSE SAVINGS
FROM DRUG DISCOUNT IN AND IN THE
MEDICARE UNDER THE MEDICAID
PROGRAM. ARE ULTIMATELY TARGETED.
WOULD PROVIDE CERTAIN EXAMPLES
AND I KNOW THAT.
WITH THE SAVINGS THE
LEGISLATURE COULD OPT TO EITHER
TEND TO HOLD COVERED ENTITIES TO
SOME DEGREE HARMLESS FOR.
FOR THE SAVINGS THAT THEY LOSE
OR TO TARGET THE FUNDING FOR
EXAMPLE TO.
SPECIFIC COVERED ENTITIES WHO.
WHERE THERE MIGHT BE ACCESS
CHALLENGES AND SO FORTH SO WE DO?
WE DO ACTUALLY THOUGH.
TO RECOMMEND THAT BEFORE
REACHING A DECISION ON THE
GOVERNOR'S PROPOSAL.
THAT THE LEGISLATURE SHOULD ASK
FOR ADDITIONAL KEY INFORMATION
INCLUDING WHATWHAT THE MEDICAL
SAVINGS BE LIKELY MOSTLY IN THE
OUT YEARS.
AND THEN WHAT WOULD THE FISCAL
AND OTHER IMPACTS ON ON COVERED
ENTITIES BE.
FINALLY JUST NOTE THAT WE DO
PROVIDE SOME PRELIMINARY
ANALYSIS OF ALTERNATIVE
APPROACHES TO SOLVING THIS ISSUE
ON HAPPY TO TAKE ANY QUESTIONS
ON THOSE.
I DO. SO WHEN YOU'RE LOOKING AT
THIS ISSUE USE YOU NOTE THE
STATE SAVINGS.
BUT IN TERMS OF OVERALL SO.
IF WE ELIMINATE THREE FORTY BE.
WHAT'S THE.
.
IS IS THIS THE AMOUNT OF MONEY
THAT COVERED ENTITIES WHO OF
COURSE WE ALSO PAY FOR ALL THE
THINGS THAT WE KINDA NEED THEM.
THERE SHE DELIVERED SERVICES.
ARE AT ODDS IS THE AMOUNT OF
STATE SAVINGS EQUIVALENT TO WHAT.
WE ARE WE GOING TO
IN THAT
LHASA FEDERAL DOLLARS BECAUSE
THEY ACTUALLY GOT.
YOU NO TWICE AS MUCH AND NOW
WHAT HAPPENS IS WILL SAVE HALF
OF THAT BUT THEY LOSE ALL OF IT
AND SO WE WERE SO THAT.
OUR HOUSE DARBAR MEDICARE.
HEALTH SYSTEM ACTUALLY IS AND
DOING WHAT THE OVERALL IMPACT ON.
AYE OCCULT ARE MEDI CAL HEALTH
SYSTEM RIGHT SO IT THAT'S
OBVIOUSLY STATE IS A PAYER BUT
WE ALSO HAVE ALL THE ENTITIES
ARE DELIVERING THE CARE.
IS THAT IS THE END POINT THAT WE
ACTUALLY SO YOU KNOW THE STATE
HAS SAVINGS BUT OVERALL THERE'S
THAT MUCH LESS MONEY IN THE
OVERALL MEDI CAL. SYSTEM YEAH WE
WE ABSOLUTELY RECOGNIZE THAT
CONCERN SINCE THE SAVINGS WOULD
BE I HAVE TO BE SHARED WITH THE
FEDERAL GOVERNMENT HOWEVER WE
NOTE THAT INSOFAR AS WE USE
THOSE SAVINGS TO AUGMENT THE
MEDI CAL PROGRAM IN OTHER WAYS
SUCH AS THE IDEA OF YOU KNOW
TARGETING FUNDS TOWARDS. COVERED
ENTITIES WHERE THERE ARE ACCESS
CHALLENGES.
YOU KNOW PROVIDED IT'S IS
WITHIN FEDERAL RULES WE COULD
READ IT WE COULD ALSO DRAW DOWN
THAT FUNDING AND SO STILL BE
ABLE TO MAINTAIN THE USE OF
FEDERAL DOLLARS SIMILARLY IF WE.
USE THE SAVINGS ON OTHER SORT
OF FEDERAL MATCHING PROGRAMS WE
COULD YOU KNOW OVERALL.
BENEFIT TO A LARGER DEGREE THAN
JUST WHAT THE SAVINGS OF THE
STATE WOULD RETAIN A UNDER THE
GOVERNOR'S PROPOSAL.
SO WITH SO I UNDERSTAND WHAT
YOU'RE SAYING IS THAT.
SAVINGS MIGHT NET OUT AS LONG AS
THE THAT THAT THAT WHATEVER
GENERAL FUND SAVINGS WE GENERATE
FROM DOING THIS HAVE TO GO BACK
INTO MEDI CAL.
YEAH RIGHT I CAN IMAGINE HOW ARE
YOU KNOW BECAUSE.
NOW IN TERMS OF THE GIVEN THE
LEVEL THE MATCH RIGHT EXACTLY
TOP TEN TENDS TO BE HIGH
NATURALLY NOT NOT NOT BE
DIVERTED SOMEWHERE ELSE AND SOME
OTHER PORTION THE BUDGET.
I'M AYE YAY AND TO THE DEGREE%
THAT IT'S PUT TOWARDS MATCHING
DOLLARS WE COULD YOU KNOW
INCREASE THE TOTAL FUNDS.
BUT YES MEDI CAL HAS HIGH
MATCHES AND IN CERTAIN AREAS
EXPECT BESTSELLER TO BREAK EVEN.
OUT IN THE I BELIEVE WE COULD IF
IF IF THE MATCHING RATE TURNED
AT THAT TURNED OUT TO THE SORT
OF BE EXACTLY COMPARABLE THEN
YEAH WE COULD WE COULD
POTENTIALLY BREAK EVEN. ARE
EXCELLENT CLARIFY OKAY FINANCE.
IT'S A DRAG OVER DEPARTMENT OF
FINANCE AS THOUGH FINANCE THAT
SUPPORT THIS PROPOSAL TO
ELIMINATE THE USE OF THREE FORTY
PEOPLE IN THE MEDICAL PROGRAM.
OUTRO THOUGH DOES ALLOW THE
STATE TO COMPLY WITH FEDERAL
REQUIREMENTS AYE HELPS PROTECT
PROGRAM INTEGRITY AND REDUCE
UNNECESSARY OVERPAYMENTS I'D
ALSO ALLOW THE TWO CLICK
MISSIONAL.
STAY AT.
DE FEDERAL DRUG REBATES AND
THEN ALSO MITIGATES THE AMOUNT
TIME AND RESOURCES SPENT ON
TRYING TO ADDRESS.
DRUG REBATE DISPUTES UP FOR
THREE FORTY BE RELAYS CLAIMS AS
A DIRECTOR CAN MENTIONED EARLIER
WE ARE CURRENTLY IN THE PROCESS
OF DEVELOPING A. FISCAL ESTIMATE
FOR THE COST TO THE STATE AND WE
DO AIMS AT SOMETHING FOR ME
REVISE.
HOWEVER WE DO KNOW SOME
SIGNIFICANT CHALLENGES WITH
DEVELOPING UP FISCAL ESTIMATE IN
TERMS OF THE IMPACT OF COVERED
ENTITIES PARTICULARLY GIVEN THAT
THE LACK OF DATA. AND WE ARE
OPEN HAVING CONTINUE
CONVERSATIONS WITH THE LA JOH ON
A POTENTIAL PROCHE TO TO LOOK AT
THE IMPACT THE COVERED ENTITY
THAN ALSO OPEN A CONVERSATION
THE COVERED ENTITIES. ON THE
AVAILABILITY OF DATA THAT COULD
HELP US ACTUALLY DETERMINE A
FISCAL IMPACT.
AS FINANCING AGREE THAT.
IF WE DO THIS BECAUSE OF THE
NET LOSS TO COVERED ENTITIES
THAT ANY SAVINGS WOULD BE RE
SPENT AS NOT TO FILL. AS
ADDITIONAL MEDICAL DOLLARS.
I THINK WE'RE ALWAYS OPEN THE
CONVERSATION DISCUSSION THEN AND
I'D SAY OPEN THE CONVERSATIONS
YOU GOOD THE CONCEPT SINCE WE'RE
GONNA BASICALLY TAKE THE MONEY
OUT OF THE COVERED ENTITIES THAT
THAT MONEY NEEDS TO STAND MEDI
CAL.
SO WE CAN TO AT LEAST BREAK EVEN.
AT THAT THE CONVERSATION THAT WE
CAN HAVE BUT WE GET THE C. AS
TWO SEPARATE THINGS OF UNKNOWN
THEY'RE NOT SEPARATE.
YOU'RE CUTTING.
BUT IT'S AN EGG CARTON.
OKAY ALRIGHT I GOT AYE I HEARD
WHAT YOU SAID. OKAY ALRIGHT WELL
IT THAT.
.
OKAY NO THE QUESTION THEN I
THINK WE'LL GO AHEAD THAT SIR
HAVE A PANEL HERE.
.
AND WHAT ORDER YOU GUYS WANNA GO
IN.
BUT ART THEM I THINK I'M FIRST
ON THE AGENDA AT MY NAME IS
DENISE FOREMAN I'M THAT I'M A
PHARMACIST AND I'M ALSO THE
DIRECTOR OF PHARMACY SERVICES AT
WHAT THE MEMORIAL HOSPITAL.
WITH A MEMORIAL PARTICIPATES IN
THE THREE FORTY BE PROGRAM I'M
HERE TODAY IN OPPOSITION OF THIS
BUDGET PROPOSAL TO PRECLUDE
THREE FORTY BE PROVIDERS FROM
DISPENSING DRUGS. PURCHASED
THROUGH THE THREE FORTY BE
DISCOUNT PROGRAM TO MEDI CAL
PATIENTS.
SERVING THE CITY OF WETLANDS IN
THE SURROUNDING COMMUNITY FOR
OVER A CENTURY WOODLAND PROVIDES
NUMEROUS SERVICES SUCH AS ACUTE
AND EMERGENCY CARE WERE
RECOGNIZED THAT SINCE HER
CENTERS OF EXCELLENCE FOR
NUMEROUS SERVICES SUCH AS CRITIC
WELLNESS PROGRAM CHEST PAIN
CENTER. FAMILY BURST CENTER
PRIMERS STROKE CENTER AND WE'RE
ALSO A CERTIFIED BY THE
COMMISSION ON CANCER WE ALSO
INVEST IN SPECIAL COMMUNITY
SERVICES SUCH AS THE YOLO ADULT
DAY HEALTH CENTER.
WE ARE ALSO ONE OF THE FEW
PROVIDERS IN CALIFORNIA WITH AN
INPATIENT PSYCHIATRIC ACUTE CARE
PROGRAM AND RECENTLY EXPANDED
OUR UNIT TO THIRTY ONE THAT'S.
PATIENTS WITH PSYCHIATRIC NEEDS
THAT NEED ACUTE CARE COME TO
WOODLAND MEMORIAL FROM ALL OVER
CALIFORNIA TO GET TREATMENT. FOR
NEARLY TWENTY YEARS ARE INFUSION
CENTER HAS PROVIDED ACCESS TO
LIFESAVING TREATMENTS TO OUR
NEIGHBORS SO THEY DON'T HAVE TO
DRIVE TO SACRAMENTO OR TO THE
BAY AREA TO GET TREATMENT.
THE CENTER ALSO PLAYS AN
IMPORTANT ROLE IN PROVIDING
ACCESS TO TREATMENT PROVIDING
CARE TO TWENTY FIVE PATIENTS
TRIPS PER DAY WHICH IS ROUGHLY
SIX THOUSAND FIVE HUNDRED
PATIENTS PER YEAR. INDIAN FUSION
CENTER.
CANCER PATIENTS HAVE ACCESS TO
CHEMOTHERAPY MS PATIENTS HAVE
ACCESS TO DRUGS THAT HELP THEM
STAY HEALTHY AND MOBILE.
I THINK PATIENTS BATTLING OTHER
DID PELLETS DEBILITATING
ILLNESSES HAVE ACCESS TO OTHER
LIFESAVING THERAPIES.
OUR APPEARED MAKES IS
CHALLENGING THE COMMUNITY WE
SERVE IS DIVERSE.
THE AVERAGE PATIENT AGES SIXTY
PLUS YEARS BUT WE ALSO CARE FOR
INDIVIDUALS RATE.
SENIOR CENTER.
TO THE HOMELESS TEENAGE CHILDREN%
COMING IN FOR CARE AFTER SCHOOL
AND EVERYWHERE EVERYONE IN
BETWEEN. BECAUSE WE ARE LOCATED
IN THE COMMUNITY CHILDREN DO NOT
HAVE TO MISS SCHOOL THE HOMELESS
DO NOT HAVE TO TAKE A BUS ALL
DAY TO RECEIVE CARE.
SENIOR CITIZENS DO NOT UP TO
CROSS THE CAUSEWAY INJURE
CAPITAL CITY TRAFFIC TO
IS THAT CARE. NEARLY FORTY
PERCENT OF OUR PATIENTS ARE ON
MEDICARE.
AND MORE THAN THIRTY TWO PERCENT
ARE MEDI CAL BENEFICIARIES LAST
YEAR ALONE OUR HOSPITAL ONLY A
HUNDRED AND THREE BEDS. PROVIDED
MORE THAN THIRTY FOUR MILLION
AND COMMUNITY BENEFIT. NEARLY
FORTY PERCENT OF THE BENEFIT
ALMOST THIRTEEN MILLION WAS A
SHORT FALL FROM THE COST
NOT CHARGES FOR CARING FOR MEDI
CAL PATIENTS.
ONE OF THE WAYS WE'RE ABLE TO
SUSTAIN THIS LEVEL COMMITMENT TO
OUR COMMUNITY IS BY
PARTICIPATING IN THE THREE FORTY
BE DISCOUNT DRUG PROGRAM. IN
ADDITION TO HELPING A STRETCH
SCARES REIMBURSEMENT BUT THREE
FORTY BE PROGRAM ALLOWS US TO
PURCHASE LIFESAVING DRUGS
INCLUDING EXPENSIVE.
CANCER TREATMENTS AN MS DRUGS AT
A DISCOUNT TO TREAT THE PATIENTS
IN OUR COMMUNITY. THE VALUE IN
TWENTY SEVENTEEN TO THE THREE
FORTY BE PROGRAM TO OUR HOSPITAL
AMOUNTED TO ROUGHLY TWO POINT
SIX MILLION DOLLARS JUST A
FRACTION OF THE SHORTFALL WE
EXPERIENCE FROM THAT ACCOUNT
ALONE.
NAPA.
I'M HERE. TO ENCOURAGE THE
COMMITTEE TO RECOMMEND THE
DEPARTMENT TO WORK WITH
PROVIDERS TO PROPERLY ADDRESS
THE ISSUE OF DUPLICATE DISCOUNTS
AND LEVER EXISTING COMPLAINTS
METHODOLOGIES.
WE OURSELVES DO CONDUCT INTERNAL
AUDITS AND WE IDENTIFY ADDRESS.
DISCREPANCIES FOR THE PROGRAM.
I RESPECTFULLY ENCOURAGE YOU TO
MAINTAIN PATIENT ACCESS TO CARE
AND NOT TO APPROVE THIS HARMFUL
PROPOSAL.
THANK YOU THANK YOU ACRYLIC.
I AM DOCTOR SUSAN EHRLICH ON THE
CEO AT SOCCER PERSIMMONS IT'S
GOOD GENERAL AND A PRIMARY CARE
INTERNIST BECAUSE IF SHE IS ONE
OF TWENTY ONE PUBLIC HIGH
HEALTHCARE SYSTEMS IN CALIFORNIA
THAT WOULD BE IMPACTED VERY
SEVERELY BY THIS PROPOSAL. AND
SO I'M HERE TODAY TO EXPRESS MY
CONCERNS NOT JUST ABOUT MY
FACILITY BUT ABOUT ALL OF THESE.
TWENTY ONE.
AND MOST IMPORTANTLY THE
PATIENTS THAT WE SERVE.
SOME BACKGROUND JUSTABOUT OUR
FACILITY WE'RE THREE OR NINETY
SEVEN.
BED ACUTE CARE HOSPITAL OBSERVE
MORE THAN A HUNDRED AND SIX
THOUSAND PATIENTS PER YEAR.
WERE PART OF THE SAN FRANCISCO
DEPARTMENT OF PUBLIC HEALTH IN A
CRITICAL RESOURCE FOR THE
COMMUNITY. WHERE THE CITY'S ONLY?
THE CITY AND NORTHERN CEMETERY
COUNTIES ONLY LEVEL ONE TRAUMA
PROGRAM WHERE THE CITY'S ONLY
TWENTY FOUR SEVEN PSYCHIATRIC
EMERGENCY SERVICE.
WE PROVIDE ALMOST SIX HUNDRED
THOUSAND OUT PATIENT VISITS HERE
THESE ARE PRIMARY CARE VISITS
AND MEDICAL AND SURGICAL
SPECIALTY VISITS WERE THOSE
SPECIALTY HUB. FOR NOT JUST THE
SAN FRANCISCO DEPARTMENT OF
PUBLIC HEALTH BUT MOST OF THE A
FEDERALLY QUALIFIED HEALTH
CENTERS IN THE CITY.
SO ALL THERE WERE NO CITYWIDE
RESOURCE WE REALLY FOCUS ON THE
MOST VULNERABLE IN OUR COMMUNITY
ABOUT FIFTY PERCENT OF OUR
PATIENTS ARE COVERED BY MEDICARE
ALL. IN ABOUT TEN PERCENT ARE
UNINSURED.
THE DISCOUNTS WE GET A THREE
FROM THE PHARMACEUTICAL INDUSTRY
THROUGH THREE FORTY BE SUPPORT
OUR EFFORTS TO IMPROVE CARE FOR
ALL PATIENTS INCLUDING OFFERING
SPECIAL SERVICES OFFER SPECIFIC
POPULATIONS.
THE PROGRAM ALSO PROTECTS
SYSTEMS LIKE OURS FROM VERY HIGH
DRUG PRICES.
I WANT TO PROVIDE A FEW EXAMPLES
OF THE SPECIAL SERVICES WERE
ABLE TO PROVIDE TO OUR PATIENTS
BECAUSE OF THE THREE FORTY BEEP
BEEP PROGRAM.
ONE EXAMPLE IS THAT OUR
OPPOSITION FORMS THE OPERATION
PROVIDES A FULL COMPLEMENT OF
DISCHARGE PHARMACY SERVICES THAT
ARE DESIGNED TO REDUCE HOSPITAL
READMISSIONS FOR OUR MOST
COMPLEX CLIENTS. WE IDENTIFY A
PATIENTS AT HIGHEST THE HIGHEST
RISK FOR RE ADMISSION. OF BASED
ON THEIR HIGH RISK MEDICAL
CONDITIONS LIKE HEART FAILURE OR
HIGH RISK MEDICATIONS LIKE
ANTICOAGULANTS OR INSULIN OR
PATIENTS WITH A HISTORY OF
MEDICATION NONCOMPLIANCE.
AND THE SERVICE IS BASICALLY
MEETING THE PATIENT BEFORE THEIR
DISCHARGED PROVIDING THEM IN
HAND WITH MEDICATIONS SO THEY'RE
MORE LIKELY TO HAVE THEM AND
TAKE THEM.
SECONDLY PROVIDED ONE POINT SIX
MILLION DOLLARS IN FREE
MEDICATIONS FOR PATIENTS WHO ARE
UNINSURED OR UNDER INSURED FOR.
THEIR MEDICATIONS AND THEN
FINALLY.
THE LAST EXAMPLE PROVIDED
SPECIALIZED SUPPORT FOR PATIENTS
WITH HIV AND HEPATITIS C.
REQUIRE COUNSELLING FOR THEIR
MEDICATIONS WE DO THIS IN OUR
SPECIALTY CLINICS. WE ALSO HAVE
PHARMACISTS BASED IN OUR OUT
PATIENT PRIMARY CARE CLINICS YOU
CAN PROVIDE EXTRA COUNSELLING
FOR PATIENTS WHO HAVE COMPLEX
MEDICAL REGIMENS.
OR EXTENSIVE NUMBERS OF
MEDICATIONS I'VE USED THIS
SERVICE RIGHT PATIENTS MYSELF.
AND IT'S ESSENTIAL.
TO PROVIDE A GOOD CARE TO THEM.
.
SUIT THE STATE'S PROPOSAL TO
ELIMINATE THREE FORTY BE IN MEDI
CAL WILL DRAMATICALLY INCREASE
OUR PHARMACY COSTS BY MILLIONS
OF DOLLARS IDEAS HAVE G. R. DRUG
COSTS WOULD MORE THAN DOUBLE.
FURTHERMORE UNDER FEDERAL LAW
SOME THREE FORTY BE PROVIDERS
LIKE US ARE PROHIBITED FROM
PURCHASING DRUGS TO OTHER GROUP
DISCOUNT OF PURCHASING PROGRAMS.
AND SO WE WOULD BE FORCED TO
PERVERTED BY OUR DRUGS AT THE
WHOLESALE ACQUISITION COST.
SORRY YES ALTERNATELY RAPIDLY
JUST A COUPLE EXAMPLES OF WHAT
THAT MEANS RETURN SEMANTICALLY
PATIENTS FOR WHICH REMIT
ARTHRITIS.
IT GOES FROM ELEVEN THOUSAND
TWO HUNDRED PER YEAR PER PATIENT
TO TWENTY FIVE THOUSAND DOLLARS
PER YEAR PER PATIENT.
HIV MEDICATION.
TO.
TWENTY SIX HUNDRED DOLLARS PER
MONTH A.
TO.
.
SORRY DOT FIFTEEN HUNDRED
DOLLARS PER MONTH AYE IN TWELVE
FORTY BEE.
TO TWENTY SIX HUNDRED DOLLARS
SO EVEN BASIC DRUGS LIKE LANCE'S
INSULIN COST TRIPLES FOR ROSS.
A AND THEN AND SO WAS THE RESULT
OF THIS WE WOULD HAVE TO.
POTENTIALLY CLOSE THE ARE OUT
PATIENT PHARMACY PRODUCER
LIMITED ACCESS TO MEDICATIONS
FOR THE AND UNINSURED OR
UNDERINSURED. AND MAKE MAJOR
FORMULARY RESTRICTIONS SO WHERE
IN SUPPORT OF.
TRYING TO FIX THE PROBLEM OF THE
DUPLICATE DISCOUNTS AND NOT
THROWING THE BABY OUT WITH THE
BATHWATER.
BECAUSE IT WOULD HAVE EXTENSIVE
HARM ON A PROVIDERS LIKE THE SSG
AND OUR COLLEAGUES IN THE OTHER
UP ESSENTIAL PUBLIC HOSPITALS
THANK YOU VERY MUCH THANK YOU SO.
I THINK FOR THEM THREE MINUTES.
BUT TRY TO GO STRAIGHT TO THE
POINT ABOUT WHAT THE FORTY BEES
GONNA DO TO YOUR ORGANIZATION SO
DON'T TELL ME.
TYPE.
MISTER CHAIR THANK YOU FOR THE
OPPORTUNITY TO SHARE THE HEALTH
CENTER PERSPECTIVE ON THREE
FORTY P. AND THE IMPORTANT ROLE
IT PLAYS IN SUPPORTING ACCESS TO
CARE.
MY NAME IS PRETTY GUERRERO I'M
THE CEO OF THE SACRAMENTO NATIVE
AMERICAN HEALTH CENTER.
A NONPROFIT FEDERALLY QUITE
HEALTH CENTER AN URBAN INDIAN
PROGRAM. PROVIDING HEALTHCARE TO
OVER EIGHTEEN THOUSAND PATIENTS
DROUGHT SACRAMENTO. I'M A PROUD
MEMBER OF CPC A CENTRAL. VALLEY
HEALTH NETWORK AND THE
CALIFORNIA CONSORTIUM PERMANENT
AND HEALTH.
I'M GONNA JUMP RIGHT INTO THE
IMPACTS.
NOT BEEN PROVIDING OR
PARTICIPATING IN THE THREE FORTY
BE PROGRAM SENSE AT TWENTY
TWELVE.
THE BEST SERVER CLIENTS WE HAVE
AN IN HOUSE PHARMACY AND
SEVENTEEN CONTRACT PHARMACIES.
THIS MODEL ALLOWS OUR PATIENTS
TIMELY ACCESS TO PHARMACEUTICALS
INCLUDING SPECIALTY MEDIC
MEDICATIONS PATIENTS CAN PICK UP
MEDICATIONS RIGHT AFTER THEY SEE
THEIR PROVIDER AND OR SUBMIT
REFILLS AT PHARMACIES CLOSE TO
THEIR HOMES.
TODAY IRKS ME.
BUT THE VAST MAJORITY OF SNACKS
THREE FORTY BE PROGRAM IS AN
MEDI CAL.
OVER SIXTY PERCENT OF OUR THREE
FORTY PER PROGRAM IS IN. MANAGED
CARE MEDI CAL WELL TWENTY
PERCENT HIS MP FOR SERVICE.
WE DEPEND ON THREE FORTY BE
SAVINGS TO IMPLY MEMBERS OF OUR
CARE TEAM SUCH AS CARE TEAM
NURSES CASE MANAGERS.
REFERRAL COORDINATORS AND OTHER
POSSESS AB POSITIONS NOT
ELIGIBLE FOR THE PPS
REIMBURSEMENT.
THESE CARE COORDINATION SERVICES
ARE CRITICAL TO ENSURE THE
COMPLEX NEEDS OF OUR PATIENT
POPULATION ARE BEING MET. BY
CONNECTING PATIENTS WITH
COVERAGE TO ENROLL WITH COVERAGE
ENROLLMENT.
TRANSPORTATION TRANSLATION
SERVICES SPECIALISTS AND OTHER
SUPPORT OF SERVICES THAT THEY
NEED.
LOS A THREE FORTY BASED SAVINGS
WOULD CREATE BARRIERS TO PROVIDE
THE STANDARD OF CARE REQUIRED
PARA CREDITING BODIES.
WELL ALSO IMPACTING OUR
WORKFORCE.
THESE NON BILLABLE PROVIDERS AND
THE SERVICE IS TIED TO THEM WILL
BE AT RISK REDUCED ARE
POTENTIALLY ELIMINATED.
WITHOUT THREE FORTY BE SAVINGS
WE RELY SO MUCH ON TO SUPPORT A
WRAPAROUND PROGRAMS AND SERVICES.
IF WERE UNABLE TO CONTINUE
PARTICIPATION OF A THREE FORTY
BE PROGRAM UNDER FEE FOR SERVICE.
AND MANAGE CARE MEDI CAL WE ALSO
NEED TO CLOSE OUR IN HOUSE
PHARMACY.
DISRUPTING PHARMACEUTICAL ACCESS
FOR ALL OF OUR PATIENTS AND FOR
MANY RAISING COSTS AS WE PROVIDE
LOW COST AND FREE MEDICATIONS TO
CASH PAYING PATIENTS. IN AND THE
UNINSURED.
AS RESPONSIBLE THREE FORTY BE
PARTICIPANTS
WE HAVE CONTRACTED A THIRD PARTY
ADMINISTRATOR ELIMINATE DUPLICATE DISCOUNTS
UNDER THE THREE FORTY THE
PROGRAM.
WE ABSOLUTELY WANT TO
COLLABORATE WITH THE STATE
PHARMACIES PLANTS. MANUFACTURERS
AND OTHER COVERED ENTITIES ON
WAYS THAT WE CAN ASSURE THE
APPROPRIATE DRUG DISCOUNT
INFORMATION IS BEING REPORTED AN
AUDIT AT.
IF ENACTED THIS PROPOSAL WILL
HAVE A DIRECT ND IMMEDIATE
IMPACT ON HEALTH CENTERS AND
WILL ULTIMATELY HARM ACCESS FOR
LOW INCOME AND VULNERABLE
COMMUNITIES.
LIKE SNACK HEALTH CENTERS ACROSS
THE STATE AND AMONG FEDERALLY
DEFINED THREE FORTY BE COVERED
ENTITY.
AS SUCH THEY RELY ON THREE FORTY
BE SAVINGS TO ENHANCE PATIENT
SERVICES EXPAND HOURS OF
OPERATION.
AND. AT ADDITIONAL PROVIDERS AND
SUPPORT STAFF.
WE LIKE OUR THREE FORTY BE
COVERED ENTITY COLLEAGUES ON
THIS PANEL.
ARE CONCERNED ABOUT A HASTY
PROPOSAL.
WITH A FEDERAL POLICY
ENVIRONMENT THE CONTINUES TO
THREATEN AND DESTABILIZE
CALIFORNIA'S HEALTH SYSTEM.
CALIFORNIAN NEEDS TO BE
INVESTING IN SUPPORTING BOTH
COVERAGE AND ACCESS AND NOT
TAKING FROM ONE TO SUPPORT THE
OTHER. WE RESPECTFULLY URGE YOU
TO REJECT THE ADMINISTRATION'S
PROPOSED CHANGES TO THREE FORTY
BE PROGRAM.
AND AS YOU CONTINUE YOUR
DELIBERATIONS ON THE THREE FORTY
BE PROGRAM.
HEALTH CENTER COMMUNITY LOOKS
FORWARD TO BEING A RESOURCE TO
YOU IN YOUR TEAM. THANK YOU
THANK YOU.
I REMEMBER THE MARKET PRETTY
BRIEF.
MY NAME IS FRANCIS PICKFORD AND
AND I'M THE VICE PRESIDENT OF
FINANCE FOR PLANNED PARENTHOOD
OF THE PACIFIC SOUTHWEST.
PLANNED PARENTHOOD HEALTH
CENTERS THROUGHOUT CALIFORNIA
SERVE OVER A HUNDRED THOUSAND
PATIENTS ANNUALLY.
APPROXIMATELY EIGHTY SEVEN
PERCENT OF OUR PATIENTS ARE
ELIGIBLE FOR MEDICAL.
LAST YEAR WE SERVE CLOSE TO TWO
HUNDRED SIXTY THOUSAND PATIENTS.
THROUGH OUT SEVENTEEN HEALTH
CENTERS IN SAN DIEGO RIVERSIDE
AND IMPERIAL COUNTIES.
THE LAST YEAR OF FEDERAL THREATS
ASIDE YOU COULD IMAGINE THE
FINANCIAL BALANCING ACT WE FACE
WITH PROVIDING QUALITY SERVICES
TO OUR PATIENTS.
WELL MAYBETING OVERHEAD COSTS
AS A SAFETY NET PROVIDER.
BUT TODAY THE CONTACTS ARE
HEALTH CENTERS LIVE IN IS THAT
OF THE FEDERAL ADMINISTRATION
SEEKING INSIDIOUS WAYS TO COME
AFTER BASIC HEALTH CARE. WE
PROVIDE AND ALSO OUR PIECES.
OUR DOORS OPEN TO ALL
CALIFORNIANS FOR A WIDE RANGE OF
HEALTH SERVICES AND THE THREE
FORTY BE PROGRAM IS A VITAL PART.
OF THE CONTRACEPTION.
VACCINATION AN STI TREATMENTS
THAT WE PROVIDE.
AT OUR LOCAL AFFILIATE OF
POSSIBLY THIRTY FIVE PERCENT OF
OUR PATIENTS. LEVER HEALTH
CENTERS WITH THE PRESCRIPTION
PURCHASE UNDER THE THREE FORTY
BE PROGRAM.
EVEN WITH A THREE FORTY BE
PROGRAM WE CONTINUE THE STRUGGLE
THAT BY THEIR HEALTH CENTERS.
AS A MATTER OF FACT SEVERAL
PLANNED PARENTHOOD AND OTHER
LIKE HEALTH CENTERS HAVE CLOSER
RECENT YEARS DUE TO FISCAL
CHALLENGES.
IF WE LOS ACCESS TO THREE FORTY
BE PROGRAM WE WOULD FACE
SIGNIFICANT COSTS INCREASE.
INCREASES THAT WOULD IMPACT
THEIR OPERATING MARGIN AND THEIR
ABILITY TO KEEP OUR DOORS OPEN.
FOR EXAMPLE THE COST OF ONE OF
OUR MOST EFFECTIVE BIRTH CONTROL
METHODS AYE YOU DE WHICH TRIPLE
IN PRICE.
OVER THE YEARS WE PARTNER WITH
THE DEPARTMENT ON PROPER
BUILDING USING YOU THE MODIFIERS.
THEM HAPPY TO REPORT THAT THE
PAST TWO YEARS WE HAVE NOT BEEN
A RECIPIENT OF INCREASE FROM.
THE DEPARTMENT ABOUT DUPLICATE
DISCOUNTS.
WE HOPE TO CONTAIN THE USER
THREE FORTY BE PROGRAM IN ORDER
TO PROVIDE ACCESS TO CARE TO THE
ALMOST EIGHT HUNDRED THOUSAND
CALIFORNIANS THAT WE SERVE
ACROSS THE STATE.
AGAIN THANK YOU FOR THIS
OPPORTUNITY AND FOR YOUR
CONSIDERATION OF OUR PROSPECTIVE.
THANK YOU.
SO.
IN TERMS OF.
A.
IT'S ABOUT WHY I'M HEARING A LOT
FROM FOLKS IS THAT WHAT WE NEED
BEST SAVINGS THE BILL TO FUND A
LOT OF OTHER STUFF.
RIGHT.
.
THE HOW.
BILL I MEAN.
YES IN TERMS OF FARM.
WELL ACTUALLY WE WATCH EXPLAINED
HOW WELL.
START WITH MARIKA OUT HOW THIS
THREE FORTY BE HELP I MEAN IT'S
SIR YET YOU HAVE. GATHERED
CHEAPER MEDICATION IS THAT
BECAUSE YOU PAY YOUR PAIN GAME
PAID MORE I MEAN HOW THE HELL
OUT WAREHOUSED SAVINGS. GENERATE
THE HOUSES IN A SAVINGS FOR ALL
THE OTHER STUFF TO TALK ABOUT.
WELL WE GET THE DISCOUNTS RIGHT
WERE ABLE TO DELIVER.
.
LOW COST AND NO COST
PRESCRIPTION ELECTIONS RIGHT
PLANTATION HOUSE THEM RIGHT WE
GET THE DISCOUNTS AND PHARMACY
BEN GETS THE REBATE.
SO WE HAVE A THIRD PARTY
ADMINISTRATOR HELPS DID THE
BILLING AND THEN THE SAVINGS IS
PASSED ON TO US.
OKAY AND THEN THERE PREVENT THE
COOK
THE COLLISION WITH THE STATE'S
WOULD YOU DO.
AND WE HAVE A MONTHLY
RECONCILIATION PROCESS AND WE
ALSO HAVE A THIRD PARTY
ADMINISTRATOR MONITORING.
.
ALL THE.
PHARMACEUTICALS THAT WE PURCHASE
AND HOW THE ALLOCATED TO EACH
PATIENT.
AND HOW THAT GOING PROCESS TAKES
PLACE.
SO THERE'S A TRACKING.
MECHANISM THOR NPI NUMBER SO
ALL OF THE MEDICATIONS THAT WE
PURCHASE ON ALL OF THE
MEDICATIONS THAT ARE DISTRIBUTED
ATTRACT DIRECTLY BACK TO US.
OKAY AND HOW THAT INTERFACE WITH.
WITH
THAT THE CS WOULD HAVE TO.
AND ON HER RESPONSE.
SO I THINK THERE'S A.
THERE'S A LOT.
BILL ELLIOTT DOES
REPORT ACTION DOES A NICE JOB OF
FLAYED OUT IN A KIND OF A CLEAR.
CIRCULAR PATH
SO IF THEY ARE PUTTING THE RATE
MODIFIERS ON.
WHAT IT TELLS THE PLAN IF THEIR
MANAGED CARE ENTITIES THAT
THAT'S A?
A PHARMACY CLAIM THAT SHOULD NOT
BE.
PAID OUT.
ORG INCLUDED IN THE UTILIZATION
DATA THAT WE OTHERWISE WOULD
SUBMIT FOR FEDERAL OR STATE
REBATES I THINK WHERE THE
SAVINGS ACCRUE. ON THE CLINICS
AND OTHER COVERED ENTITIES SIDE
IS THE AMOUNT THAT THEY ARE
REIMBURSED BY THE PLAN IS HIGHER
THAN THE THREE FORTY BE
ACQUISITION COSTS AND SO IT'S
THAT DIFFERENCE.
THAT WERE NOT PARTY TO BECAUSE
THAT'S NOT SOMETHING THAT WE SO
BASICALLY THE FINANCES WILL PAY
ACTS BUT YOU'RE ACTUALLY PLAYING
WHY YOU GET THE DIFFERENCE.
IT'S AMERICA ALRIGHT OKAY AND IN
TERMS OF BEING ABLE TO.
TO ZEALOT TERMS OF BEING ABLE TO
BE SURE THAT WE'RE NOT DOUBLE
DIP I NEED ANY WITH THE BIG
ISSUES.
DOUBLE DIPPING.
AS CERTAIN XML DEBTS THAT THE
OPERATIONAL ISSUE.
.
I MEAN. IT AND STANDARDS THAT
THE TALENT I GUESS IS THAT.
IS THERE A WAY TO UNIVERSALLY BE
SURE WE DON'T HAVE THIS HAPPEN
NAY AND MAYBE INDIVIDUAL PEOPLE
AND THAT PART IN SAYING NO.
WELL IT'S IT'S A COVER SOURCES
GOOD GENERAL WE PUT A MODIFIER
HONOR MEDICA.
WE OUGHT WITH THAT'S ALREADY OUR
PRACTICE AND SO TAT ALLOWS THE
DEPARTMENT TO SEE. WHERE WE'VE
ALREADY GOTTEN A DISCOUNT AND SO
THERE SHOULDN'T BE THEIR THERE
SHOULDN'T BE A DUPLICATE? NAM
IT'S ABOUT IT'S ABOUT GETTING
PUTTING THE MODIFIER ON AND THEN
MANAGING THE CLAIMS IN A TIMELY
WAY SO YOU'RE NOT GETTING IT
DUPLICATE DISCOUNT.
SO THERE'S DEFINITELY AWAY TO
AVOID THE TYPICAL CUT CLAIMS.
THE THE THING ABOUT THE
RESOURCES IS A TRICKY ONE
BECAUSE IF YOU LOOK AT A ZOO FOR
US.
FOR THOUGH COSTS OF PROVIDING
CARE MEDI CAL PATIENTS WE HAVE A
HUNDRED MILLION DOLLARS IN
UNREIMBURSED COSTS. AND THAT'S
BASED ON SHORT FALLS EVEN THOUGH
WE GET.
A RATE WE GET A WE GET.
SUPPLEMENTAL PAYMENTS AND WE
STILL PROVIDE SERVICES THAT GO
BEYOND THAT THAT OUR REVENUES.
WHEN YOU LOOK AT THAT THE THE
MONEY THAT WE SAVE ON ACQUIRING
DRUGS.
ALLOWS US TO CONTINUE TO PROVIDE
SERVICE EVEN THOUGH WE HAVE THAT
GIANT GAP BETWEEN WHAT WE
PROVIDING WHAT WE GET PAID.
.
SO WE REALLY REQUIRE THOSE THOSE
DISCOUNTS IN ORDER TO KEEP DOING
WHAT WE'RE DOING AND AVOID BIG
CUTS TO SERVICES LIKE THE ONES
THAT YOU YOU DESCRIBED.
OKAY SO WE BELIEVE YOU CAN AVOID
THE DUPLICATE DISCOUNTS AND
CONTINUE TO PROVIDE COVERED
ENTITIES.
WITH FEES
VERY GOOD RATES AT OF ACQUIRING
PHARMACEUTICALS.
WE ALSO GO ABOVE AND BEYOND AND
HAVE THAT YOU DO MODIFY HONOR
CLAIMS AS WELL AND THEN WE ALSO
DO AUDITS MONTHLY TO LOOK IT
WHICH DRUGS WERE PURCHASED WHICH
PATIENTS AND THEN ALSO LOOK AT
THE BILLING FOR THAT AS WELL.
IT'S NEVER THE COMPLIANCE WORK
PLAN.
SO I SEEDS.
THESE ARE SAYING AYE WEEKEND
TOWN PEOPLE USED A MODIFIER WE
CAN'T HAVE A PENALTY IF YOU
DON'T USE A MODIFIER
INAPPROPRIATELY GET BANNED FROM
DOING IT I MEAN THERE'S A
THERE'S A WAY TO TWO HUNDRED
COVERED ENTITIES APPROXIMATELY
IN CALIFORNIA SO. THERE'S.
OR IF IT WERE OF THEM HERE.
I DON'T EVEN FEE FOR SERVICE.
IT'S MAYBE A LITTLE BIT CLEANER
WHEN YOU'RE SUBMITTING INTO OUR
PHARMACY CLAIMS ON A FEE FOR
SERVICE BASIS I THINK THE USE OF
CONTRACTS PHARMACIES WHICH AGAIN
THAT LEO DID A NICE JOB.
IF A PATIENT WALKS OUT WITH A
SCRIPT AND GOES TO. CVS OR
WALGREENS OR RITE AID FROM A
COVERED ENTITY IT MAY NOT BE
CLEAR TO THE PHARMACY AT THE
TIME HEN THEY FILL THE
PRESCRIPTION THAT IT'S A THREE
FORTY BE HOT CLAIMED THEY SUBMIT
THEY GET REIMBURSED ON A REAL
TIME BASIS.
AND THEN IT'S A BACKEND PROCESS
WHERE IT'S GREAT THAT THEY DO
RECONCILIATION BUT THE PROBLEM
IS WE VERY PAID THE CLAIM. IT'S
ARTY HIT THE REBATE SYSTEM.
AND SO WHERE DO IN THE BACKEND
WORK TO UNDO THE DUPLICATE
DISCOUNT THAT SHOULD NEVER HAVE
BEEN DONE IN THE FIRST PLACE
RIGHT FROM AN ADMINISTRATIVE
STANDPOINT THAT'S THE KIND OF
COMPLEXITY THAT WERE TALKING
ABOUT.
SO ASIDE FROM ESSENTIALLY TRAIN
ELIMINATE THE WHOLE PROGRAM IS
THERE A WAY TO WORK IT SAID THAT.
BASICALLY.
PHARMACIES THAT.
IF YOU CAN SHOW THAT THEY'RE
ABLE TO DO THE RIGHT THING AND
HAVE THE INFORMATION SO I MEAN
VERSES.
BUT THE PHARMACY.
.
ARE ABLE TO.
TAKE ADVANTAGE OF THIS AND THEN
TRY TO BASICALLY OTHER ONES THAT
ARE GONNA DO IT THE RIGHT WAY OR
JUST DON'T KNOW HOW IS NOT
TELLING THE FAMILY WERE DONE.
MAYES THIS ASIDE FROM DESTROYING
ELIMINATE THE WHOLE PROGRAM.
THAT THAT WE LOOK AT SOME
ALTERNATIVES.
SEEMS LIKE A LITTLE DRASTIC STEP
TO JUST SIMPLY SAY WILLIAM.
WELL THE WHOLE THING UP BUT I
MEAN I THINK AND WE WE HAD A
BRIEF PROPOSAL IN THE GOVERNOR'S
BUDGET LAST YEAR WHICH ALSO WAS
NOT RECEIVED WELL. AND THIS IS
THE CURRENT ADMINISTRATION
PROPOSAL TO THE EXTENT THAT THE.
STAKEHOLDERS THINK THAT THERE'S
A BETTER WAY TO DO IT THAT STILL
GETS THAT THE CONCERNS THAT
WE'VE EXPRESSED IN TERMS OF OUR
ADMINISTRATION OF THE PROGRAM
AND THE DUPLICATION OF THE.
DISCOUNTS ON THE KIND OF
ADMINISTRATIVE BACK AND WORK.
WERE WELL TO HEAR THOSE
PROPOSALS BUT THIS IS THE
ADMINISTRATION'S PROPOSAL OF THE
NO I KNOW.
BUT MY GUESS IS THAT WE'RE NOT
LOOKING TO KINDLY AT AT THE
MOMENT. OKAY. SO HOPING THAT WE
CAN COME TO SOMETHING ELSE
SO.
.
TRAVESTY MY HOPE COMMITTEE IS IN
HERE BUT YOU HEARD FROM ONE
OTHER MEMBER YOU'RE HEARING FROM
ME.
ALRIGHT.
BUT WHAT WE GO AHEAD AND HEAR
PUBLIC COMMENT WAS EVEN WITH
WILL SEE WHAT THE PUBLIC COMMENT
GOES. RIGHT WELCOME DOCTOR PAN
TERRY CALLIER HILL ON BEHALF OF
THE HEMOPHILIA COUNCIL OF
CALIFORNIA. I REPRESENT THE FOUR
THOUSAND PATIENTS THAT HAVE
HEMOPHILIA WHICH IS A RARE
BLEEDING DISORDER AS WELL AS THE
THREE HUNDRED FORTY THOUSAND
PATIENTS IN CALIFORNIA. WHO HAVE
ON WILLEBRAND DISEASE WHICH IS A
SIMILAR BLEEDING DISORDER WE ARE
I RESPECTFULLY OPPOSE TO THIS
PROPOSAL BECAUSE OF ITS IMPACT
ON PATIENTS AND ACCESS TO CARE?
OUR PATIENTS RECEIVE EXCELLENT
CARE AT HEMOPHILIA TREATMENT
CENTERS IN CALIFORNIA THEY ARE
PRIMARILY LOCATED IN CHILDREN'S
HOSPITALS AND UC MEDICAL CENTER
SUCH AS UC DAVIS MEDICAL CENTER
HERE IN SACRAMENTO. AND OUR
PATIENTS CAN GO IN AND SEE THEIR
HEMATOLOGIST THEIR SOCIAL WORKER.
AND THEIR PHYSICAL THERAPIST AND
THOSE.
THREE FORTY BE DOLLARS ARE USE
TO PROVIDE THAT THE SERVICES
THAT THOSE PATIENTS PROVIDE ARE
ARE PROVIDED AND INCLUDING NEW
ULTRASOUND MACHINES WHICH CAN
LOOK AT THE JOINTS AND COULD.
SHOW A COST EFFECTIVE WAY IN
WHICH THAT THE DOCTORS CAN TREAT
THOSE PATIENTS THAT WITH WE
DON'T HAVE ACCESS
TO THE HEMOPHILIA TREATMENT
CENTERS BECAUSE THEY'RE FUNDING
GOES AWAY. THAT'S PROBLEMATIC
FROM A PATIENT CARE PERSPECTIVE
I MIGHT ALSO ADD THAT BLOOD
FACTOR IS CARVED OUT OF MEDI CAL
MANAGED CARE'S THOUGH IT COULD
BE EASILY TREATED SEPARATELY AS
YOU'VE MENTIONED DOCTOR PAN SO
WE RESPECTFULLY OPPOSE THIS
PROPOSAL.
THANK YOU.
WELCOME.
I AM MY NAME IS STEPHANIE DOWN
SKIRT AND I'M HERE TO GIVE A A
FACE A VOICE.
IN A NAME TO THE TO THE ISSUE AT
HAND I HAVE A THIRTY ONE YEAR
OLD SON WAS SEVERE HEMOPHILIA.
IT CAME AS A SURPRISE AS A
SURPRISE TO US. BUT AFTER THE
DIAGNOSIS HE ENDED UP AT ONE OF
THESE FEDERALLY FUNDED
HEMOPHILIA TREATMENT CENTERS AND
IT SAVED HIS LIFE I'M NOT SAYING
THAT TO BE OR MELODRAMATIC OR TO
EXAGGERATE BUT BECAUSE. OF THE
CLINICAL TRIAL THAT WAS
AVAILABLE THAT HEMOPHILIA
TREATMENT CENTER MY SON WAS NOT
EXPOSED HIV OR HEPATITIS C..
HE DID NOT SUFFER ANY INTER
CRANIAL LEADS WHICH COULD HAVE
LED TO BRAIN DAMAGE OR EVEN
WORSE WORSE DEATH.
TODAY IS INDEPENDENT FULLY
EMPLOYED AND A CONTRIBUTING
MEMBER TO THE CALIFORNIA ECONOMY.
HTC CARE ALSO SAVED MY SON'S
JOINT REPEATED BLEEDING INTO
MUSCLES AND JOINTS DID NOT CAUSE
ANY DMAGE HE WAS ABLE TO BE
PHYSICALLY ACTIVE ATTEND SCHOOL.
I WAS ABLE TO GO TO WORK MY
HUSBAND WAS ABLE TO GO TO WORK
OUR DAUGHTER WAS ABLE TO GO TO
SCHOOL THE IMPACT ON THE FAMILY
WAS REDUCED GREATLY.
WHERE IT ALSO PROVIDED CARE FOR
OUR ENTIRE FAMILY CYLES OF
SOCIAL SUPPORT FOR ALL OF US?
ALLOWED US TO MANAGE THIS.
CONDITION SO THAT FOR ALL
INTENTS AND PURPOSES MY SON HAS
HAD A NORMAL LIFE OUR FAMILY HAS
MOVED ON.
I'M GAINFULLY EMPLOYED MY
HUSBAND'S GAINFULLY EMPLOYED.
PLEASE
FIND SOME OTHER WAY TO RESOLVE
THIS PROBLEM BUT DO NOT.
THROUGHOUT THE BABY WITH THE
BATH WATER.
BUT YOU CAN TRY KEEP TO A MINUTE
AND APPRECIATE IT THANK YOU
WELCOME. THOUGH I'M DOCTOR DIE
IN NEW CHEN I REPRESENT THE
ELEVEN CALIFORNIA HTC'S
HEMOPHILIA TREATMENT CENTERS AS
WELL AS THE FOUR WESTERN STATES
ARE HER SIR WESTERN STATES.
OUR OUR THREE FORTY BE PROGRAM
IS AN H. M. DESIGNATION IT'S
DIFFERENT FROM THE DISH
HOSPITALS. AND BECAUSE OF THAT
WE'VE BEEN UNDER SCRUTINY BY THE
GOVERNMENT FEDERAL GOVERNMENT
AND OFFICE OF PHARMACY AFFAIRS
FOR TWENTY YEARS WITH OUR
PROGRAM.
WE HAVE DEVELOPED A REALLY GREAT
SYSTEM IN COLLABORATION WITH
CALIFORNIA STATE PHARMACY
SERVICES TO IDENTIFY ADD
MODIFIERS THAT REALLY CLEARLY
SEPARATES FACTOR ARM SO THAT
THERE ARE NO DOUBLE DISCOUNTS WE
DO REGULAR MONITORING AND
AUDITING WE ARE HERE TO HELP.
THE OTHER ENTITIES THE DISH
HOSPITALS AND SO ON TO DEVELOP
AND PUT THE SYSTEM IN PLACE.
I IT'S IMPORTANT TO REALIZE THAT
SINCE THE.
A CA THE REBATES THAT THE
STATES ARE GETTING IS LESS THAN
THE UP FRONT DISCOUNT THAT WE'RE
GETTING FOR THE FACTORED SO
ALTHOUGH YOU WILL GET A REBATE
IT IS LESSEN YOUR COST SAVINGS
UP FRONT AND WE'VE BEEN ABLE TO
DEMONSTRATE THAT THROUGH TWENTY
YEARS OF.
FEDERAL REPORTING ON HOW THE NET
INCOME IS USED IN OUR STATE SO
BUT DON'T MAKE US GO BACK TO THE
BAD DAYS THANK YOU VERY MUCH
THANK YOU. WELCOME.
THANK YOU MISTER CHAIRMAN
CONSUMERS ON BEHALF OF THE
CALIFORNIA HEALTH PLUS ADVOCATES
THE COMMUTER HEALTH CENTERS AND
CLINICS GONNA APPRECIATE THE
DIALOGUE.
FROM ALL PARTIES TODAY THIS IS
REALLY AN IMPORTANT ISSUE FOR
OUR HEALTH CENTERS I JUST WANTED
TO MENTION A COUPLE OF THINGS I
THINK YOU KNOW IT'S IMPORTANT
THAT IF WE REFER TO THESE
DOLLARS ITS POTENTIAL STATE
SAVINGS. THAT REALLY THESE ARE
DOLLARS THAT ARE GOING TO
HOSPITALS CLINICS SAFETY NET
PROVIDERS TODAY AND IF WE TURN
AROUND AND SAY THAT THE STATE
CAN USE THOSE DOLLARS.
MAYBE NOT MAYBE IN MEDI CAL
MAYBE NOT THERE WOULD HAVE TO
SEND AT LEAST HAVE TO THE FEDS
MAYBE NINETY FIVE PERCENT.
THOSE ARE DOLLARS LIKE I SAID
THERE'S CURRENTLY BEING USED BY
A PROVIDERS TO FOR SERVICES THAT
THEY OTHERWISE CANNOT PAY FOR I
THINK THAT'S A REALLY IMPORTANT
POINT THAT DESERVES MORE
DISCUSSION. I ALSO THINK THAT
YOU KNOW WELL IT MIGHT BE LESS.
OF ADMINISTRATIVELY BURENSOME
TO ELIMINATE THE PROGRAM I DO
THINK IT DESERVES IT MORE FULLER
CONVERSATION ABOUT HOW WE CAN
MAKE SURE THESE DISCOUNTS ARE
BEING TRACKED.
OUR HEALTH CENTERS WANT TO BE IN
COMPLIANCE IF FOR NOT CURRENTLY
IN COMPLIANCE WITH THE STATE AND
WITH FEDERAL GUIDELINES WE WANNA
MAKE SURE WERE AT THE TABLE
PRESENTING OURSELVES AS.
AS STAKEHOLDERS WE WANT TO WORK
WITH THAT THE LEGISLATURE AND
THE DEPARTMENT TO FIND A
SOLUTION BUT AT THIS TIME WE.
CANNOT SUPPORT THIS PROPOSAL I
WOULD ASK THAT IS REJECTED AT
THE APPROPRIATE TIME THANK YOU.
THANK YOU WELCOME.
HI MY NAME IS KIM SURFER AND A
NURSE PRACTITIONER AT THE UC
DAVIS HEMOPHILIA TREATMENT
CENTER. WE PROVIDE COMPREHENSIVE
CARE TO PATIENTS WITH INHERITED
BLOOD DISORDERS.
AND OUR STAFF INCLUDES SOCIAL
WORKERS HAD PHYSICAL THERAPIST
DENTAL HYGIENIST A COLLABORATIVE
APPROACH WITH OBGYN TO ADDRESS
ALL THE NEEDS OF OUR PATIENTS.
IF THE THREE FORTY BE INCOME
GOES WAY. OUR HTC WILL BE IN
DIRE STRAITS AND WE WILL
DISAPPEAR AND ALONG WITH THAT IT
WILL PLACE THE PATIENTS IN DIRE
NEED. A NEED THESE VITALLY AND
SPECIAL CARE THAT WE PROVIDE TO
THE PATIENTS WITHOUT THAT THEY
WILL HAVE A NEGATIVE IMPACT SO I
URGE YOU TO. OPPOSE THE
ELIMINATION OF THREE FOUR AB
THANK YOU. BANKING.
WELCOME.
HI ELAINE BECAUSE TRAINED
REGISTERED NURSE PROGRAM MANAGER
AT STANFORD ON IN SOLIDARITY
WITH OUR COLLEAGUES AT THE
WESTERN SEATS AT THE REGIONAL
HEMOPHILIA CENTER. AND W ARE
STRONGLY OPPOSED TO THIS BILL AS
OUR COLLEAGUES HAVE SAID BEFORE
OUR PATIENTS GREATLY BENEFIT
FROM THIS ARE PROGRAM INCOME
SUPPORTS A MULTI DISCIPLINARY
TEAM. THAT SUPPORTS PATIENTS AND
PROVIDES CARE FOR.
FOR THOSE THAT DIAGNOSIS AND
THROUGHOUT THE CONTINUUM OF LIFE
ADDITIONALLY WE ALSO SUPPORT
OUTREACH AND EDUCATIONAL
SERVICES TO OUR COMMUNITY
PARTNERS AND. AND JUST
INCREASING OUR CAPACITY TO GIVE
CORRECT ACCESS AND COMPREHENSIVE
CARE TO PATIENTS WITHIN OUR
COMMUNITY.
THANK YOU.
WELCOME.
ANYWHERE TO UNITS OF THE
CALIFORNIA PHARMACISTS
ASSOCIATION WE REPRESENT
PHARMACISTS IN EVERY PRACTICE
SETTING RESPECTFULLY OPPOSE TO
THIS PROPOSAL.
THANK YOU.
WELCOME.
THANK YOU MISTER CHAIRMAN
AMBER'S MARK WINDOWS ON BEHALF
OF AS HERE YOU CALIFORNIA.
WE BELIEVE THAT THIS PROPOSAL
WOULD MAKE A DEVASTATING IMPACT
ON CRIME CALIFORNIA SEEKING A
PROVIDERS.
HARMING LOW INCOME AND
VULNERABLE COMMUNITIES.
AND POPULATIONS.
IN CONTRAST TO WHAT THE
ADMINISTRATION HAS PROPOSED WE
WOULD URGE THE COMMITTEE TO
REQUEST THAT DH CS ENGAGE
STAKEHOLDERS TO DEVELOP SYSTEMS
FOR THE STATE TO ENSURE
INTEGRITY AND FULL COMPLIANCE
WITH FEDERAL REQUIREMENTS THINK
YOU.
THANK YOU WELCOME AFTERNOON
CRACKPOTS FOR FROM A KILLER
HEALTH AND CO CHAIR OF THE
CALIFORNIA HIV ALLIANCE WHERE A
COALITION OF OVER A DOZEN HIV
SERVICE PROVIDERS IN THE STATE.
AYE WE ARE STRONGLY OPPOSED TO
THE PROPOSAL I THINK YOU'D AGREE
WITH THE CHAIR THAT IT'S GOING
TO RESULT IN A NET LOSS.
I'LL LET SERVICES ESPECIALLY
SERVICES TO ADDRESS THE HIV AND
STD EPIDEMICS.
OBVIOUSLY LESS SERVICE HAS
EQUALS LESS OUT POOR HEALTH
OUTCOMES
SO STRONGLY URGE YOU TO REJECT
THE PROPOSAL THANK YOU.
THANK YOU WELCOME.
I AARON FUNCTIONAL LOS ANGELES
LGBT CENTER WE ARE COVERED AND
IN THE EYES AND FQHC RYAN WHITE
PROVIDER AND STD CLINIC WE THINK
THIS IS AN ILL ADVISED.
AN UNWISE PROPOSAL PUT FORTH BY
THE ADMINISTRATION.
THAT AGAIN IS GOING TO RESULT
IN A NET. NEGATIVE FOR
CALIFORNIA BILLS AND HEALTH
OUTCOMES.
AND IN BUDGET AND WHILE WE
WOULD OBVIOUSLY URGE OF THE
COMMITTEE.
TO REJECT THIS PROPOSAL.
WE WOULD FIRST URGE THE
ADMINISTRATION TO PULL THIS
PROPOSAL FROM EVEN CONSIDERATION
AND TO SIT DOWN WITH
STAKEHOLDERS MONTHS COME TO A
CONSENSUS RATHER THAN DOING THIS.
THE WAY THAT THE ADMINISTRATION
IS THE SIDE TO IT.
OKAY THANK YOU WELCOME. THANK
YOU MISTER CHAIR IT'S FAIRLY
PAID TING WITH THE CALIFORNIA
STATE ASSOCIATION OF COUNTIES
REPRESENTING ALL FIFTY EIGHT
COUNTIES IN CALIFORNIA WE
RESPECTFULLY OPPOSED TO THIS
PROPOSAL BY THE GOVERNOR WE LOOK
FORWARD TO WORKING WITH DH YES
AND OTHERS. AS WELL AS PROVIDERS
COUNTY HOSPITALS AND COUNTY
CLINICS TO FINDING A SOLUTION
THANK YOU.
THANK YOU WELCOME. MICHELLE
GIVEN THAT THE COUNTY HEALTH
EXECUTIVES ASSOCIATION OF
CALIFORNIA REPRESENT THE LOCAL
HEALTH DEPARTMENTS THROUGHOUT
OUR STAY IN WE ALSO MUST
RESPECTFULLY OPPOSE THE PROPOSAL
BEFORE YOU. WE WOULD ASK THAT
THE SUBCOMMITTEE REJECTED AND WE
HAVE CONCERNS ABOUT WHAT IT WILL
DO TO ACCESS AND OTHER SERVICES
THAT WE PROVIDE WITHIN OUR LOCAL
HEALTH DEPARTMENTS AND AND
PARTICULARLY AT FAMILY PACKS ARE.
THANK YOU WELCOME.
BUT KELLY BROOK SOME BEHALF OF
THE BOARD OF SUPERVISORS OF
SANTA CLARA VENTURA AND
RIVERSIDE COUNTIES AS WELL AS
THE ASSOCIATION OF CALIFORNIA
HEALTH CARE DISTRICTS.
I'M HERE AND RESPECTFUL
OPPOSITION I JUST WANTED TO ADD
TO THE CONVERSATION THAT.
.
PUBLIC HOSPITALS ARE REALLY
USING THEIR SCARCE RESOURCES TO
DO INNOVATIVE THINGS I'M FOR
EXAMPLE IN RIVERSIDE THEY'RE
ACTUALLY FUNDING.
A CLINICAL PHARMACY PROGRAM
THAT IS.
TRAINING PHARMACISTS TO DO SOME
OF THE OUT REACH INTO THE
COMMUNITY BECAUSE OF THE
SHORTAGE OF POSITIONS IN THE
INLAND EMPIRE AND SO I THINK
YOU'RE GONNA SEE INNOVATION AND
CREATIVITY LIKE THAT STIFLED BY
THOSE LOSS OF I'M DOLLARS
THINKING.
THANK YOU.
WELL. MISTER CHAIR GERMAN
DIVORCE ON BEHALF URBAN COUNTIES
OF CALIFORNIA RE REPRESENT THE
FORTUNE WAS POPULOUS COUNTIES IN
THE STATE. MANY OF WHICH HAVE
COUNTY PUBLIC HOSPITALS WHICH
ARE THE SAFETY NET WE ARE
THEREFORE. I RESPECTFULLY APART
ON OPPOSITION TO THE GOVERNOR'S
PROPOSAL OBVIOUSLY WILLING TO
WORK ON DOUBLE DIPPING ISSUES
ARE DUPLICATE.
ISSUES BUT NOT WILLING TO
COMPLETELY ELIMINATE THIS
PROGRAM WHICH PROVIDES IMPORTANT
SAVINGS FOR THE SAFETY NET THANK
YOU.
THANK YOU.
MISTER CHAIRMAN BARBOUR GLAZER
ON BEHALF OF THE CALIFORNIA
HOSPITAL ASSOCIATION IN
CALIFORNIA WE HAVE ONE HUNDRED
AND SEVENTY FIVE HOSPITALS THAT
PARTICIPATE IN THIS PROGRAM. AND
THEY DO SAVE SIGNIFICANT AMOUNTS
OF DOLLARS THROUGH THE THREE
FORTY BE PROGRAM.
WE BELIEVE THAT THE ORIGINAL
INTENT OF THE PROGRAM WAS TO
STRETCH SCARCE HEALTHCARE
DOLLARS ACROSS ALL PAYER TYPES
NOT NOT JUST FOR ANY ONE GROUP
OR ANOTHER.
ON HOSPITALS AND CLINICS PROVIDE
A NUMBER OF VERY IMPORTANT
PROGRAMS YOU'VE HEARD ABOUT THEM
TODAY. IF THE DEPARTMENT'S
PROPOSAL MOVES FORWARD MANY OF
THOSE PROGRAMS WILL HAVE TO BE
SIGNIFICANTLY REDUCED IF NOT
DONE AWAY WITH ALTOGETHER.
WE WOULD LIKE TO WORK WITH THE
DEPARTMENT TO WORK THROUGH SOME
OF THE DOUBLE DISCOUNT PROBLEMS
IN ANY PROBLEMS THERE MAY BE BUT
WE REALLY DON'T WANT TO SEE THIS
PROGRAM ELIMINATED IT'S SIMPLY
TOO IMPORTANT IN OUR. FOR OUR
COMMUNITIES AND OUR HOSPITALS
THANK YOU.
THANK YOU WELCOME NOON THERE HAS
GIVE ALSO WRITTEN FROM THE
CALIFORNIA ASSOCIATION OF PUBLIC
HOSPITALS ALSO RESPECTFULLY AN
OPPOSITION TO THE GOVERNOR'S
PROPOSAL WE WOULD MAKE ONE OTHER
NOTE MISTER CHAIR YOU ASKED
ABOUT ALTERNATIVE PROPOSED OR
ALTERNATIVE APPROACHES TO THOSE.
ON THE STATE ACTUALLY RELEASED
ALL PLANNED LETTER EARLIER THIS
WEEK THAT DEMONSTRATES THERE'S
MORE THAN ONE WAY WE MAY BE ABLE
TO APPROACH THE ISSUE AROUND
DOUBLE DISCOUNT SO THAT.
PROVIDERS IN THE STATE CAN WORK
VERY CLOSELY TOGETHER TO ENSURE
ROLLING COMPLIANCE THANK.
THANK YOU WELCOME. AND GOOD
AFTERNOON CHAIR.
MY NAME'S ANGELA GILLIARD I
REPRESENT THE UNIVERSITY
CALIFORNIA.
MEDICAL CENTERS I'M WE'RE HERE
IN OPPOSITION AND WE HAVE.
SUBMITTED A LETTER IN
OPPOSITION WITH DETAILS ABOUT
SOME OF THE PROGRAMS WERE ABLE
TO PROVIDE WITH THE DISCOUNT AND
AND AND THE POTENTIAL IMPACT TO
US WE ASSOCIATE OUR COMMENT.
WITH I'M MOST OF THE COMMENTS
YOU'VE HEARD HERE AYE TODAY THAT
WE DON'T THINK IT'S A AT A GOOD
IDEA TO DO THIS AND AT THE SAME
TIME WE'RE WILLING TO WORK. WITH
THE STATE ON A SOLUTION ARM ON
THE STATE A PROBLEM OF DUPLICATE
AT A DISCOUNT.
THANK YOU.
WELCOME MISTER CHAIR MEGHAN LOW
BROWN BEHALF OF THE DISTRICT
HOSPITAL LEADERSHIP FORUM AND
OUR THIRTY EIGHT DISTRICT A
MUNICIPAL HOSPITALS HERE IN
CALIFORNIA. I WOULD ECHO THE
COMMENTS WE RESPECTFULLY ASK THE
REJECT THIS PROPOSAL MAY LOOK
FOURTEEN OPPORTUNITY TO WORK ON
AN ALTERNATIVE SOLUTION.
THANK YOU.
WELCOME.
SOME I KNOW HARD ON BEHALF OF
THE CHILDREN SPECIAL TO CARE
COALITION IN OPPOSITION TO THIS
PROPOSAL BEING CAREFUL.
YOU WELCOME. JENNIFER TENER HELL
ON BEHALF OF THE CALIFORNIA
CHILDREN'S HOSPITALS ASSOCIATION
ALSO IN OPPOSITION FOR THE
REASONS STATED HERE TODAY THANK
YOU.
I THANK YOU WELCOME.
REMEMBER NO MEMBERS MISTER CHAIR
HER GRAND BAR NOT BE HEALTHY
IT'S HEALTHCARE FOUNDATION I'M
SURELY THE ELIMINATION OF
PROGRAM WOULD BE IMPACT OUR
ABILITY TO PROVIDE THE RANGE OF
SERVICES THAT WE DO NOW. BUT I
WANT TO POINT OUT THERE'S AN
ADDITIONAL.
OUTCOME UP ELIMINATING THIS
PROGRAM AND THAT'S THE IMPACT ON
THE PUBLIC HEALTH. I'M IN LOS
ANGELES EIGHT CHEF HAS A RATE OF
EIGHTY FIVE PERCENT OF OUR
PATIENTS WHOSE VIRAL LOAD IS
UNDETECTABLE. THAT MEANS ONCE
IT'S UNDETECTABLE BUT THEY ARE
NO LONGER INFECTIOUS. I'M IF WE
DO NOT HAVE THE RANGE OF
SERVICES THAT WE HAVE CURRENTLY
I'M WE FEAR THAT THAT RATE WOULD
GO DOWN AND MORE PEOPLE WOULD BE
IN.
INFECTIOUS AND WE'D SEE A RISE
IN THE HIV EPIDEMIC AGAIN SO WE
ENCOURAGE YOU TO REJECT THIS
PROPOSAL.
THANK YOU WELCOME.
MR MCGREGOR ON BEHALF OF ALAMEDA
HEALTH SYSTEM. I'M AS YOU HEARD
WE REINVEST THOSE SAVINGS INTO
PROGRAMS.
THAT HELP MEDICATION ADHERENCE
AND PREVENT READMISSIONS SO AS
YOU POINTED OUT. ELIMINATION
THESE EVAN.
OF THE THREE FORTY BE PROGRAM.
AND ELIMINATION OF THOSE
PROGRAMS THAT WERE USING TO FIND
WOULDN'T.
INCREASE READMISSIONS AND NOT
ELIMINATE THE OVERALL COST OF
THE PROS STATE PROGRAMS.
THANK YOU.
WELCOME.
ANDREAS MEL BEHALF OF PLANNED
PARENTHOOD AFFILIATES OF
CALIFORNIA. AND WE JUST WANT TO
THANK THE COMMITTEE FOR CREATING
A PUBLIC FORUM ON THIS IMPORTANT
ISSUE. AND I'D LIKE TO ECHO THE
COMMENTS AND CONCERNS OF MY OUR
COLLEAGUE FROM THE PACIFIC
SOUTHWEST.
THANK YOU.
RIGHT WELL.
HOPING WE COULD FIGURE OUT HOW
TO LAND THIS AMIN.
YEAH CERTAINLY THE DEPARTMENT
HAS I THINK OF YOU KNOW VERY
ILLEGITIMATE AND.
SERIOUS ISSUE THAT THEY HAVE TO
DEAL WITH.
WHICH IS
TO DUPLICATE NAM THAT'S NOT
SOMETHING WE NEED AND ALSO
TRYING TO. BE ABLE TO SIGNAL AND
AT THE FRONT END AND NOT THE
BACK END SO THAT WE'RE NOT
CONSTANTLY TRY TO CHASE OUR
TAILS SO. I THINK THAT'S
EXTREMELY IMPORTANT POINT MADE
BY THE DEPARTMENT
NEED A SOLUTION THAT ADDRESS
IS THAT SO AT THE FRONT END.
I'D I DO THINK THAT.
YOU KNOW JUST TRYING TO LIMIT
THE PROGRAM SEEMS TO BE A BIT OF
A AND.
YOU KNOW.
.
AND IMPACTS WOULD NEGATIVE PET
THAT WIDESPREAD NEGATIVE IMPACTS
I THINK I THINK THAT WE CAN TRY
TO SOLVE THE PROBLEM WITHOUT.
TRYING TO GO THAT FAR RIGHT I
THINK THERE'S THERE ARE
DIFFERENT WAYS WE CAN GO ABOUT
BEING SURE THAT AT THE FRONT END
ELVES IF A PROVIDER IS GOING TO
USE THIS PROGRAM THEY NEED TO
USE APPROPRIATE MODIFIER RIGHT
UP FRONT IF.
DO THAT OR.
THEY DON'T HAVE THE EXPERIENCE
TO DO THAT YOU KNOW WE SHOULD
NARROW THE NUMBER THEN THE
NUMBER PEOPLE PARTICIPATE DE CAN
DO THAT. A BUT I I THINK THAT.
I JUST SIMPLY SINGLE ELIMINATE
THE PROGRAM ALTOGETHER.
.
AND I AM NOT SURE THAT WORKS AND
AND AND FRANKLY.
AND I YOU KNOW I I HAVE TO HAVE
BEEN I HAVEN'T HAD A CHANCE TO
FULLY READ THE REPORT BUT. AT
LEAST BASED ON THE TESTIMONY
HERE THE BEST WE CAN DO IS QUOTE.
BREAK EVEN HAPPENED QUOTES.
AND FOR THE SYSTEM OVERALL.
AND.
I'M NINETEEN ASSURANCES THAT
THE MONEY WILL STAY SO AS FAR AS
I'M CONCERNED THAT THAT'S JUST
MONEY BEING TAKEN OUT OF THE
MEDICARE PROGRAM THAT'S READY
UNDER FUNDED SO.
I THINK THAT.
LET'S SEE WHETHER WE CAN COME
TO A BETTER SOLUTION AND NUMBER
NOT THE ONLY STATE THAT. HAS
THIS PROGRAM AND OTHER STATES
MAKE IT WORK TO SELL.
.
SO LET'S MAKE SURE WE CAN FIGURE
THIS OUT AND BUT THE ASSEMBLY I
THINK ELIMINATED PROGRAM I DON'T
THINK IT'S SOMETHING THAT. I
WOULD FIND THE OF APPROPRIATE
ARE ARE ARE.
IS GONNA WORK OUT FOR FOR FOR
SYSTEM SO WE STILL HAVE TIME.
FIGURES OUT SO I HOPE IT WILL
COME TOGETHER. BUT I DO ALSO SAY-THE ON WE HAVE TO SOLVE THE
FETUSES PROBLEM TO WRITE IT SAID
WE CAN'T JUST HAVE THE WILD WEST
AND HAVING THEM HAVING TO.
CHASE DOWN STUFF ALL THE TIME SO
LET'S SEE WHAT WE CAN LAND LAND
THIS THING ALRIGHT.
OKAY.
ANY OTHER COMMENTS.
BUT DIRECTORY CAN'T ENJOY
SAVINGS.
I THINK WE'RE DONE FOR THE DAY
SANTA I LOOK FORWARD TO SEEING
YOU AGAIN SOON. OKAY WELL THANK
HISTORY MUCH ALRIGHT WELL I
THINK EVERYONE FOR BEING HERE
FOR THE PARTY HEALTH CARE
SERVICES.
AND WHAT WE'LL DO IS I KNOW.
YEAH AND WE WILL HOLD THIS ITEM
OPEN.
SINCE I DON'T HAVE ENOUGH
MEMBERS VOTED DOWN ANSWER.
YET.
OKAY.
ALRIGHT SO WHAT PART PUBLIC
HEALTH.
EXCEED WHAT WE TAKE AYE I KNOW
THAT YOU GUYS AND WE HAVE TO
TAKE A TWO MINUTE BREAK. STRETCH
BREAK. I THINK OF THE PUBLIC
HEALTH UNDERSTAND STRETCHING.
AND THEN WE'LL GO AHEAD GET
STARTED WITH THAT I KNOW IT'S
GETTING LATE TO ANYONE.
SO ALRIGHT THINKS
YEAH.
OKAY.
ALRIGHT WERNER HOMESTRETCH.
SO ALL OF THIS IS IN ANY
COMPENSATION FOR COMING LASTS
TODAY BUT I WILL JUST BEFORE HE
STARTED TO SAY THAT THE PART
PUBLIC HEALTH I LOVE ALL THE
DEPARTMENTS OVERSEE BUT I DO
HAVE SOME FAVORITES.
ONE OF THEM. SO SORRY TO START
OFF WITH THAT AND AGAIN WELCOME
AND SO WILL DO IS JUST THAT DID
A QUICK ROUND ROBIN
INTRODUCTIONS FOR THE RECORD AND
THEN. THE.
TRAKTOR BEGINS OF YOU CAN JUST
THAT QUICK INTRODUCTION.
KAREN SMITH DIRECTOR SORT
CALTRAIN DEPARTMENT PUBLIC
HEALTH.
RENDON NEWNESS CHIEF DEPUTY
DIRECTOR FOR OPERATIONS OF THE
DEPARTMENT OF PUBLIC HEALTH
HELLO. SONYA PEDICLE AO.
MANY GREAT LENA GRANT FINANCE.
BELOW PLANTS A THANK YOU.
ALRIGHT SO ITEM NUMBER ONE IS.
THE OVERVIEW AND I THINK
THEY'LL JUST NEED TO HIT THE
HIGHLIGHTS AND THAT THANK YOU
FOR BEING HERE.
THANK YOU.
CHAIR FOR THIS OPPORTUNITY I
THINK I KNOW YOU'RE VERY
FAMILIAR WITH THE DEPARTMENT I
MEAN HIT SOME.
.
THINGS THAT HAVE HAPPENED A SOME
ACTIVITIES FROM THE PAST YEAR
THAT WERE ABOVE THE USUAL ON
SUSPECTS IF YOU WILL OF THE WORK
THAT WE DO AS A DEPARTMENT. I'M
REALLY IT'S BEEN A BANNER YEAR
FOR INFECTIOUS DISEASE OUTBREAKS
AS I SURE.
I'M INFLUENCE OF BEING THE MOST
REAL RECENT IN ADDITION TO OUR
USUAL I'M SUPPORT FOR THE HEALTH
SYSTEM I THE LOCAL HEALTH
DEPARTMENTS WE ALSO.
DISTRIBUTED OVER TWO MILLION
DOSES OF INFLUENZA VACCINE
INCLUDING ONE POINT FIVE MILLION
DOSES OF PEDIATRIC VACCINE. ON
THE HEPATITIS A OUTBREAK WE HAVE
THE UNFORTUNATE DISTINCTION OF
THE LARGEST HEPATITIS A OUTBREAK
PERSON A PERSON IN THE UNITED
STATES. OVER THE PAST YEAR.
AND THERE AGAIN PROVIDING
SUPPORT BUT ALSO TO.
DISTRIBUTING OVER HUNDRED
TWENTY THREE THOUSAND VACCINES
INCLUDING THIRTY EIGHT THOUSAND
DOSES THAT WERE STATE FUNDED I'M
DUE TO THE EMERGENCY ORDER THAT.
THAT THE GOVERNOR AND PUT OUT
BUT WE ARE ALSO STILL MONITORING
FOR ZECA AND WE CONTINUE TO HAVE
SECRET KISSES AND.
WE'VE HAD TWELVE CONGENITAL
CASES UNFORTUNATELY AS WELL.
AND WE'RE CONTINUING TO WORK
WITH VECTOR CONTROL AGENCIES ON
AND HAVE A STATEWIDE PLAN THAT
TO YOU.
CONTROLS ECA AS WELL AS REALLY
AGGRESSIVE OUTREACH AT THE
BORDER.
AND THEN I JUST WANNA IN
ADDITION TO THE COMMUNICABLE
DISEASE OUTBREAKS.
HEPATITIS BUT ALSO TO.
FETAL AM BACTERIAL MENINGITIS.
OUR.
EMERGENCY OPERATIONS CENTER
THAT THE MEDICAL HEALTH
COORDINATION CENTER HAS BEEN
ACTIVATED EVERY SINGLE DAY THIS
YEAR PRETTY MUCH.
FOR A VARIETY OF OTHER
ACTIVITIES.
INCLUDING THE.
IT TO THE EVACUATION OF ELEVEN
FACILITIES IN FOUR HUNDRED
SEVENTY PATIENTS FOR THE OR BILL
DAM A RESPONSE.
OVER TWENTY EIGHT FACILITIES
AND A THOUSAND PATIENTS
EVACUATED DURING THE NORTHERN
CALIFORNIA FIRES
THE.
FIFTY FOUR FACILITIES SOME FIVE
HUNDRED NINETY FIVE PATIENTS
EVACUATED DURING THE SOUTHERN
CALIFORNIA FIRES. AND THEN IN
JANUARY THE MUD SLIDES WHICH
WE'RE AT NOW HAVE SEVERAL
FACILITIES THAT ARE ACTUALLY ON
THEIR FOURTH EVACUATION.
DOWN IN SANTA BARBARA COUNTY SO
WE REMAIN VERY ACTIVE IN ARMOR
RESPONSE TO EMERGENCIES
THROUGHOUT THE STATE OF
CALIFORNIA. THANK YOU ALSO
FAMILIAR WITH OUR WORK ON THE
OPIATE EPIDEMIC WE CONTINUE TO
HAVE A SEVERE PUBLIC HEALTH
PROBLEM WE ALSO HAVE ONE OF THE
MOST INNOVATIVE AND BROADS BROAD
APPROACHES TO.
THE OPIATE EPIDEMIC IN THE
UNITED STATES AND WE'RE
BEGINNING TO SEE. SOME I'M
ENCOURAGING.
THAT CHANGES IN PRESCRIBING
PATTERNS IN PARTICULAR AND WE'RE
CONTINUING TO WORK ON THAT.
ACTIVELY ALSO MANAGED TO VERY
SUCCESSFULLY I THINK.
LAUNCH BOTH A REGULATORY
STRUCTURE BUT ALSO LICENSING FOR
THE MANUFACTURE OF CANNABIS AND
TO DO SO THAT'S JUST A KIND OF.
HIGH LEVEL OVERVIEW OF SOME OF
THE THINGS BEYOND OUR NORMAL
WORK THAT WE'VE BEEN DOING THIS
PAST YEAR. FAQ AND.
BRAND IT'S GONNA GIVE YOU THE
F. FINANCIAL REVIEW JUST A QUICK
OVERVIEW ON OUR BUDGET OF COURSE
WE HAVE A BUDGET THREE POINT TWO
BILLION FOR SEVENTEEN EIGHTEEN.
GOING INTO EIGHTEEN NINETEEN
IT'S RELATIVELY FLAT.
CHANGES
ABOUT A ONE PERSON
A KLEIN FROM THE SEVENTEEN
EIGHTEEN BUDGET.
COURSE WE HAVE A BUDGET THAT HAS
A.
MIX OF GENERAL FUND VERY SMALL
PERCENTAGE AND OFTEN A FOUR
PERCENT.
LARGE PROPORTION OF OUR FUNDING
COMES FROM FEDERAL FUNDS OF
ABOUT HALF AND THEN WE HAVE A
LARGE NUMBER OF SPECIAL FUNDS IN
ABOUT FORTY SIX PERCENT OR ONE
AND A HALF BILLION COMES FROM
OUR SPECIAL FUNDS SOURCES.
YOU'LL BE HEARING TODAY FROM A
NUMBER OF OUR CENTERS.
THAT.
DID THE CHANGES RELATED TO OUR
BUDGET OBVIOUSLY DRIVEN BY NINE%
BCP'S THAT WE HAVE WE HAVE FOR
ESTIMATES WILL BE PRESENTING TO
YOU THIS YEAR FROM OUR WOMEN
INFANTS AND CHILDREN ARE GENETIC
DISEASE SCREENING. OUR LICENSING
AND CERTIFICATION AND ARE HIV
ASSISTANCE PROGRAM.
YOU'LL BE HEARING MOST OF THOSE
ADJUSTMENTS THIS YEAR AND HEARD
TODAY ACTUALLY AND THEN WE HAVE
ON THE SMALL GENERAL FUND
INCREASE THAT HIGHLIGHT THIS
YEAR.
WE HAVE THREE AND A HALF
MILLION THAT'S GOING TO BOTH OUR
AL'S HYMERS PROGRAM AND OUR MEAT
SAFETY MONITORING PROGRAM YOU'LL
HEAR ABOUT BOTH THOSE AS WELL
TODAY.
THANK YOU.
THANK YOU COMES FROM ALEJO.
FINANCE.
ALRIGHT.
.
JUST YOU KNOW I THINK EVERY
SHAPE THE OVERVIEW I THINK.
WENT QUESTIONS I HAVE IS IS
THAT GIVEN THE FACT THAT.
REALLY I MEAN THE THREE POINT
TWO BILLION DOLLAR BUDGET BUT
THE GENERAL FUND PORTION IS SUCH
A SMART PORTION MOST OF THIS IS
FEDERAL MONEY DO YOU SEE THREATS
IN THE FEDERAL BUDGET TO.
TO TO OUR DEPARTMENT AND.
ARE POTENTIAL PREPAREDNESS ARE
TO BE OUT THERE ARE CARRY OUT
THERE.
DEPARTMENT
AIMS OF.
IT'S SORT OF THE TALKS ABOUT.
THE LARGE CUTS TO A TO
PREVENTION FUND PROGRAM FUNDING
AND AT THE FEDERAL LEVEL. BUT AT
THE FROM WE HAVE SEEN SOME
DECREASES IN.
SOME OF OUR PROGRAMS THAT DUST
OR WE'VE BEEN ABLE TO ABSORB
PRETTY WELL AND GOOD NEWS FROM
THIS MORNING ASSUMING THAT THE
APPROPRIATIONS BILL PASSES THAT
WENT THROUGH THE SENATE. I'M IT
LOOKS LIKE WE'RE ACTUALLY NOT
GOING TO SEE MANY OF THE LARGEST
CUTS
SO.
ALRIGHT SO BE VERY SENSITIVE THE
FACT THAT ARE. PART OF A CULT
BUDGET IS.
AND NOW THE GENERAL FUND SIDE
NAY EVEN SMALLER PORTION WHAT.
KEYS MAYBE SPIEGEL WITHOUT SO
WE HAVE THIS THREE BILLION TO
WHAT WE SPEND THE GENERAL FUND.
SLEEP.
IN TERMS OF THE.
SO AND THIS PAST YEAR OVER THE
PAST COUPLE YEARS THERE'S BEEN
SOME AUGMENTATIONS THAT HAVE
COME FROM OUR GENERAL FUND.
WE HAD TO NAPA AND SIXTEEN
SEVENTEEN ALONE WE HAD SOMEONE
SIGN UP AUGMENTATIONS OF ABOUT
TWO.
DISEASE PROGRAM.
WE HAD.
THREE MILLION THAT CAME FROM.
DRUG OVERDOSE A DRUG OVERDOSE
PREVENTION PROGRAM.
THIS PAST YEAR WE RECEIVED AND
I WENT ASIAN OF ABOUT ONE POINT
SEVEN MILLION I'M FROM PARKER
FROM OUR PARKINSON'S REGISTRY A
LARGE PROPORTION ALSO GOES TO WE
HAVE THE RICHMOND
I HAVE BEEN SO. PART OF THE THAT
THE PROCESS OF REPAINTING BONDS
GOES TO THAT.
I WOULD SAY THAT. THAT'S A AND
THEN ANOTHER STAFF PERSONNEL
COSTS ON LARGE PORTION OF IT
ACTUALLY IS WITH OUR CENTER FOR
INFECTIOUS DISEASES BECAUSE A
LOT OF OUR LAB INFRASTRUCTURE IS
GENERAL FUND.
SO THAT'S WHERE MOST OF IT.
I APPRECIATE THAT AYE AYE AYE IT
BELIEVE THAT WE'RE ACTUALLY
GOING TO HAVE A. PANEL ON ARE
THE TEXAS DISEASE ARE CONTAGION
PREVENTION THAT A FUTURE HEARING
SO I APPRECIATE YOU CITING THOSE
THINGS BECAUSE BOB EVEN AS WE'RE
DEALING WITH WILD FIRES AND MUD
SLIDES AND WORRY ABOUT
EARTHQUAKES AND FLOODS.
IT DIED THE NEW NORMALS ALSO.
SEEMS LIKE EVERY YEAR THERE'S
ANOTHER. ACTIONS DISEASE
OUTBREAK CRICHTON DUH AND HOW WE
MITIGATE THAT RIGHT SO THAT THEY
SEEK A.
YELL STDS RIGHT HERE FOR YOU TO
CITIES AROUND AYE AND WE STILL
HAVE VALLEY
EVER PLUS NINE.
AROUND.
PURPOSELY NOT ANOTHER MEASLES A
THINK AWFULLY WE HAVE POLICIES
IN PLACE THAT MITIGATE THAT BUT.
SO.
BUT IT SEEMED LIKE EVERY YEAR
THERE'S ANOTHER ONE TO TALK
ABOUT SO. ALRIGHT. RATE OF ANY
PUBLIC COMMENT ON THE OVERVIEW.
ALRIGHT SEEING NONE I WILL START
GETTING INTO SOME OF THE
SPECIFIC.
CHIU SO THAT WAS JUST
INFORMATIONAL SO I ISSUE NUMBER
TUESDAY ALZHEIMER'S DISEASE
PROGRAM GRANT AWARDS.
WELCOME AND IF YOU CAN AND JUST.
INTRODUCE YOURSELF FIRST FOR
THE RECORD AND THEN. THEN AFTER
THAT WE CAN BEGIN THE
PRESENTATION GOOD AFTERNOON THIS
IS MONIQUE UMBRELLAS AND THE
DEPUTY DIRECTOR FOR THE CENTER
FOR CHRONIC DISEASE PREVENTION
AND HEALTH PROMOTION.
AFTERNOON MARK STAR W. DIRECTOR
FOR RONALD HEALTH.
OKAY EXCELLENT HERE TO ASSIST
WITH SOME QUESTIONS IF THEY MAY
PAPA. ALRIGHT EXCELLENT OKAY
WHICH GO THEN BEGIN.
SO ISSUE NUMBER TO THE
LZHEIMER'S DISEASE UP PROGRAM
FUNDED SO ON CP IT IS REQUESTING
A ONE TIME INCREASE IN BUDGET
AUTHORITY FOR FROM THE
ALZHEIMER'S SPECIAL FIND. UP TO
SPEND AN ADDITIONAL TWO HUNDRED
FORTY TWO THOUSAND DOLLARS IN
LOCAL.
IN EIGHTEEN AND NINE.
AND THIS IS TO HONOR THE TOTAL
RESEARCH GRANT AMOUNTS THAT THE
PROGRAM I'VE PUT IN PLACE.
AND THIS PAST YEAR UNFORTUNATELY
THE PROGRAM MISTAKENLY AWARDED A.
IN EXCESS IN OUR RESEARCH.
GRANTS AND SO THIS IS WHAT WE'RE
MAKING TO AND THE FIRST TASK FOR
THIS BCP.
ON THE SECOND ASK IS IN OF.
ONGOING DECREASE IN OPERATION
EXPENDITURE AUTHORITY. FROM THE
ALZHEIMER'S RESEARCH ACCOUNT
CONSISTING OF A HUNDRED AND
THIRTY THOUSAND DOLLARS AND THIS
IS JUST FOR US TO BALANCE OUR
EXPENDITURE WITH A LOT
PROJECTIONS FOR READING.
FULLER.
FINALLY. OF WE REQUESTED AN
EXPENDITURE AUTHORITY INCREASE
OF THREE POINT ONE MILLION
DOLLARS FROM THE GENERAL FUND.
SO THESE CHANGES FOR ITS REALLY
ARE JUST TO CONTINUE THE WORK
THAT WE'RE DOING AROUND
SOMERS SUSIE'S IN.
THAT YOU SEE OUTLINED IN THE
AGENDA TODAY PROGRAM.
OKAY THANK YOU.
AND ANY COMING FROM ELIOT. NO
FINANCE.
LEANING GRANT DEPARTMENT OF
FINANCE AND.
ALONG WITH JUST THE.
FINANCE SUPPORTS A PROPOSAL TO
FUND ADDITIONAL AND. FROM THE
START WEST ALRIGHT AND A HOME
THE AIRED IT LED TO THE OVER THE
GRANTING OR EXPENDITURE TRAN IS
THAT WE IDENTIFIED THE ROOT
CAUSE OF THAT.
THE VALUE OF HAVING THE FUTURE
YES WE DID AND WE ACTUALLY HAVE
PUT ON STRONG SYSTEMS IN PLACE
OF ADDED DID DOUBLE.
IN A REVIEW BASICALLY OF WHAT
WE HAVE AN AUTHORITY VERSUS WHAT
WE ACTUALLY HAVE IN THE FINE.
OKAY TO.
APPRECIATE YOU COMING FORWARD
NOTING THAT THAT HAPPENED IN
WHICH I'M SURE IT.
TRY TO AVOID THOSE AND FUTURE
ABSOLUTELY OKAY ALRIGHT ANY
PUBLIC COMMENT.
WELCOME.
BLAMES JOSS WHEDON AND REPS IN
THE ALZHEIMER'S ASSOCIATION.
AND WE STRONGLY SUPPORT THIS
PROPOSAL INCREASED ARM AT THIS
TIME THERE'S NO WAY TO CURE
TREAT OR PREVENT ALZHEIMER'S
DISEASE AND ALZHEIMER'S DISEASE.
IT IS A FATAL DISEASE.
CURRENTLY AT THIS MOMENT EVERY
DOLLAR WE SPEND ON RESEARCH.
SPEND A HUNDRED DOLLARS ON CARE
AND SUPPORT RESULTING AND THE
AVERAGE LIFETIME COST OF
ALZHEIMER'S DISEASE TREATMENT
FOR BEING THREE HUNDRED FORTY
THOUSAND DOLLARS FOR EACH FAMILY
MEMBER.
SO IF WE'RE GOING TO HEAD OFF
THIS COSTS WERE SOCIETY.
AND PROVIDE CARE AND SUPPORT AND
CURE THIS DISEASE ME TO SPEND
ONE RESEARCH
THANK YOU.
I THINK YOU.
SINGLE OIL SUPPLY MICROPHONE.
BEHOLD THE SAME OPEN DATA
THANKS SO MUCH FOR YOUR
PRESENTATION.
OKAY.
NEXT ITEM.
IS ITEM NUMBER THREE IS EXPANDED
LET TESTING FOR CALIFORNIA'S
CHILDREN AB THIRTEEN SO.
AGAIN FOR THE RECORD MONIQUE
UMBRELLAS AND DEPUTY DIRECTOR
FOR THE CENTER FOR CHRONIC
DISEASE.
I'M SO THIS PC PETER CRESCENT
EXPENDITURE OF FORTY OF TO.
THOUSAND TWO HUNDRED AND
SEVENTY SIX THOUSAND IN STATE
OPERATIONS FROM THE LEAD.
THE TYPE OF LEAD POISONING.
TO CARRY AT THE NEW REGULATIONS
PERSON BILLY DALE THIRTEEN
SIXTEEN.
PACIFIC EARLY THIS FUNDS UP TO
STATE POSITIONS FOR US TO BUILD
OF THE CUT
CITY TO. FOLLOW UP ON THE NEW
REGULATIONS THE DATA ANALYSIS
THAT REPORTING THAT WILL TAKE
PLACE AND BECAUSE OF AB THIRTEEN
SIXTEEN.
CURRENT BELIAU.
FINANCE WENT. OF IT SAID ONE
QUESTION REGARDING THIS ISSUE.
AND OUR ANALYSIS IT.
THE TERMS OF REGULATORY PROCESS
IT SAID IT WAS.
GONNA TAKE A MINIMUM OF TWO
YEARS AND. LEAD THIS PRE WILL
RESEARCH SO MISS WONDERING AS TO
WHY WOULD TAKE SO LONG TO THE
ABOUT THE REGULATIONS.
THERE IS A PROTOCOL THAT WE HAVE
TO FOLLOW INCLUDING FOR EXAMPLE
OF FORTY FIVE DAY OF.
COMMENTS THE STANDARDS ALSO
WORKING WITH STAKEHOLDERS
BRINGING THEM TOGETHER. BAD AND
WE BELIEVE WILL TAKE AS AND THAT
PERIOD OF TIME THEY WERE
ACTUALLY CURRENTLY RIGHT NOW.
ACTIVE THE ALREADY A YOU KNOW IN
DESIGNING AND IMPLEMENTING AND.
WORKING WITH OUR TEAM TO KIND OF
MAKE SURE THAT WE TRY TO MEET
THAT DEADLINE.
WELL I MEAN CERTAINLY IT'S
IMPORTANT BRING TOGETHER
STAKEHOLDERS AND SO FORTH BUT
YOU KNOW FORTY FIVE DAYS SOME.
MONTH AND A HALF SO THAT. I DO I
HOPE THAT WE CAN LOOK AT AND SEE
WHAT CAN BE DONE TO SPEED THE
PROCESS.
NOW ALONG ITS.
ABSOLUTELY IT'S SPILLWAYS
CONCERNING THAT GIVEN ISSUE
OBVIOUSLY LEADS TO SERIOUS ISSUE
AND. TO HEAR THAT YOU TAKE TWO
YEARS DEVELOP REGULATIONS THEM
I'M NOT SURE THERE'S A BUNCH OF
PEOPLE WHO WANT IT'S THE
POISONED BY LEAD HIS LOBBY ON
THE OTHER SIDE BUT. YOU KNOW I
THINK THAT.
WERE HOPEFULLY THIS IS MORE
STRAIGHT FORWARD AND WE CAN WE
CAN GET WE CAN GET THERE FASTER
AND PERHAPS A.
AND IF YOU BECOME IT MAYBE YOU
NEED BABY OF A COMMENT THAT I
NEED TO CHANGE SOME LAWS OR
SOMETHING TO SPEED THE PROCESS
BUT I JUST SEEMS LIKE A LONG
TIME FOR FOR THIS SO. AND.
YEAH I COULD CHIME IN LITTLE BUT
MY CENTER FROM RUN HEALTH DOES.
A LOT OF REGULATIONS.
IN OTHER AREAS OF THE RHETORIC
PROCESS IS PRETTY WELL DEFINED
CALIFORNIAN AND THE SUPPLIED BY
ONLY ALLEN AND.
MINISTER RIGHT EXACT SO WE'RE.
WHAT OUR EXPENSES IT TYPICALLY
TAKES ABOUT THREE YEARS FOR
REGULATION PACKAGE TO BE
COMPLETED SO TOM WE CAN DO SOME
FASTER?
BUT AS A LOT OF IT'S PRESCRIBED
IN THOSE TIME LINES THAT ARE
NECESSARY NOT JUST THE FORTY
FIVE DAY COMMENT PERIOD THAT'S
ONE OF THEM.
NEITHER COME I MIGHT ADD IS THAT
WE ARE PROGRAM ALREADY DOES
ANTICIPATORY GUIDANCE FOR
PHYSICIANS HEALTH CARE PROVIDERS
ABOUT CHILDHOOD LEAD EXPOSURES
AND. ON MANY OF THE ITEMS THAT
ARE PART OF THE RISK ASSESSMENT.
WE ENCOURAGE PROVIDERS ARE TO
DO THAT AND ANY GUIDANCE.
THIS WILL REQUIRE REGULATIONS TO
HAVE SOME OF THE SAME
INFORMATION BUT. NOW WE'RE NOT
STANDING STILL RIGHT NOW LOWER
WHILE WE'RE WORKING ON THE RACE
AS WELL.
I APPRECIATE THAT AND I
PERSONALLY EXPERIENCE THAT AS
WELL AS SONOZAKI PRACTICING.
ANY PUBLIC COMMENT.
WELCOME GOOD AFTERNOON THANK YOU.
MY NAME SUSAN LITTLE I'M WITH
THE ENVIRONMENTAL WORKING GROUP
AND I'M HERE ON BEHALF OF EWG AS
WELL AS THE CALIFORNIA COALITION
OF WELFARE RIGHTS ORGANIZATIONS.
EWG WAS A SPONSOR OF AB
THIRTEEN SIXTEEN LAST YEAR AND
I'M.
JUST INITIALLY IN IN RESPONSE TO
THE QUESTIONS ABOUT TIMING. NO
WE WOULD DEVON WELCOME ANDI PAHS.
BRICK NAM.
INTEREST AND GETTING SOME EARLY
COMMENTS FROM OUR ORGANIZATION
OUR COALITION OF FOLKS.
BEFORE THINGS EVEN GET GOING IF
WE NEED TO. TALK ABOUT SPEEDING
UP THE PROCESS THAT WE BE HAPPY
TO DO THAT. ARM JUST WANT TO SAY
THAT WORST DEATHLY WERE VERY
MUCH IN SUPPORT OF THE
DEPARTMENT'S RECOMMENDATION THAT
THEY RECEIVE THIS FUNDING. A
MEMBER DEFTLY ASKED THE THE CAN
MEDI TO FULLY FUND THE
RECOMMENDATIONS SINCE THERE ARE
TEARS OF FUNDING OPTIONS.
YOU KNOW MOST WE HAVE WORKED
WITH ASSEMBLY MEMBER QUIRK AND
DATA.
THE STM COMMITTEE TO TAKE A LOOK
AT D. H. CS IS BILLING DATA FOR
MEDI CAL KIDS AND. AS PART OF
THAT WE FOUND OR D. H. CS IS
NUMBER ON THEIR HAND COUNT OF
THOSE NUMBERS.
FOUND THAT MOST LOW INCOME
CHILDREN WHO ARE SUPPOSED TO BE
GETTING LED TESTS ARE NOT
GETTING THOSE TESTS AND SO IN
THAT BACKS UP DATA FROM.
THE PUBLIC HEALTH INSTITUTE
WHICH INDICATES THAT WERE. AS
MANY AS SIXTY THREE PERCENT OF
KIDS
IN CALIFORNIA THERE LEAD
POISONED ARE NOT IDENTIFIED IN
SO. WE DO BELIEVE THIS IS A.
TOM AN ISSUE THAT NEEDS TO BE
ADDRESSED IN A TIMELY WAY IT'S
WERE TALKING ABOUT.
AND THAT THE LEAD TESTING
REGULATIONS NEED TO BE REVISED
AS QUICKLY AS POSSIBLE SO THANK
YOU.
THANK YOU.
ALRIGHT WELL.
.
GO TO HOLD THIS ITEM OPEN BUT
CERTAINLY WHAT THE SUPPORT
DEPARTMENT AND BE ABLE TO TO
ADDRESS THIS VERY IMPORTANT
ISSUE AND.
IMPLEMENT THAT THIS IMPORTANT
BILL THANK YOU.
ALRIGHT CIVILIAN MOVE ONTO ISSUE
NUMBER FOUR WHICH IS A PROGRAM
UPDATE THE RURAL HEALTH PROGRAM.
THAT'S WHERE.
YOU CAN INTRODUCE YOURSELF FOR
THE RECORD.
AND ACTUALLY GONNA HAVE US
STAKEHOLDER HOLES MOVES WELL SO
WE GOT ROOM THERE OKAY.
SO I SEE FEDERAL AND CAN
INTRODUCE THEMSELVES FOR THE
RECORD AND THEN.
WILL START WITH THE
PRESENTATION FROM THE PARK
PUBLIC OFFICE OF.
LARA. EXITED.
VERY GOOD DEL DIRECTOR.
WITH THE CALIFORNIA DEPARTMENT
PUBLIC HEALTH WELCOME.
MICHELLE GIBBONS AT THE COUNTY
HEALTH EXECUTIVES ASSOCIATION OF
CALIFORNIA.
BOB BREANNA PITTMAN SPENCER WITH
THE CALIFORNIA DENTAL
ASSOCIATION THANK YOU.
ALRIGHT SO THE DOCTOR YOU CAN
THEN BEGIN.
THANK YOU THANK YOU FOR THE
OPPORTUNITY.
THERE ARE THREE QUESTIONS THE
FIRST ONE IS ABOUT THE OR BRIEF
OVERVIEW OF THE ORAL HEALTH
PROGRAM SAID.
DEPARTMENT OF. PUBLIC HEALTH.
OAK OR TO HELP PROGRAM'S
MISSION IS TO PROMOTE OR HOW THE
NEWS ORDER TO SEE THIS THROUGH
PREVENTION EDUCATION AND
ORGANIZED COMMUNITY EFFORTS.
OUR PROGRAM IS FOCUSED ON
SITTING AT YOU BOTH POPULATION
HEALTH GOALS AND OUTCOME
MEASURES DEVELOPING SURVEILLANCE
SYSTEM TO TRACK PROGRESS.
ADVANCING POLICY SYSTEMS AND
ORGANIZATIONAL CHANGES TO
ACHIEVE IMPROVEMENTS.
ALIGNING OUR PROGRAMS WITH
ESTABLISHED EVIDENCE BASED
PRACTICES AND FINALLY LIVE
LEVERAGING STRATEGIC VALUE
PARTNERSHIPS AND COLLABORATION.
SO IN TWO THOUSAND SEVENTEEN BE.
PUBLISHED A BOOK STATUS OF ORAL
COUNTY IN CALIFORNIA.
NOW WATER DISEASE BURDEN AND
PREVENTION.
AND IN JANUARY THIS YEAR
REPUBLISHED BE.
CALIFORNIA OR OF HEALTH PLAN.
THIS IS A ROADMAP FOR OF WATER
HAD PRIORITIES FOR THE NEXT TEN
YEARS FOR THE STATE TO ADDRESS.
A WITH RESPECT TO OUR REGULATORY
RESPONSIBILITIES AND HEALTH AND
SAFETY CORD ESTABLISHES THE
OFFICE OF PUBLIC OFFICE OF OR
HOW. THERE ARE CERTAIN SECTIONS
IN THE CORD. THAT ESTABLISH OUR
AUTHORITY FOR SEPIA EDGE TO IT
MAINTAIN THE DENTAL PROGRAM THAT
INCLUDES. SEVERAL.
THE AREAS.
THE PROGRAM USFSA DEPARTMENTS
GENTLE A PARTY. OUT TO ISSUE
GUIDELINES AS FAR
ORGANIZATIONALLY BR INTO CENTER
FOR CHRONIC DISEASE PREVENTION
AND HEALTH PROMOTION BIAFRA
THREE DOING THAT.
ADMINISTRATION PROGRAM
INTERVENTIONS AND THEN FINALLY
SURVEILLANCE AND EVALUATION.
A OUR INITIATIVES INCLUDE AND
THE MANAGEMENT OF THE.
TOBACCO TAX OF TWO THOUSAND
SIXTEEN OR HOW OFTEN THEY SHOULD
DO.
THROUGH WHICH THE FUNDING IN
THE MIND THIRTY MILLION IS
AVAILABLE ANNUALLY TO IMPLEMENT
THE STATE OR ABOUT PLAN.
I THOUGHT I HAD THE PROGRAM IS
COMMUNITY WATER FLUORIDATION.
WE HAVE A FEDERAL HER SON GRANT.
HOW TO THE IT WITH RESPECT ORAL
HEALTH WORKFORCE EXPANSION IT'S
FOCUSED ON PILOT TESTING? TELLY
DENTISTRY PROJECT.
VIRTUAL DENTAL HOME.
WE ALSO HAVE ANOTHER GRAND FROM
HER SCENT AND IT IS SO FOCUSED
ON PREGNANT WOMEN AND YOUNG
CHILDREN SET QUALITY IMPROVEMENT
PROJECT IT'S A PILOT PROJECT IN
NASA NUMBER COUNTY.
THE SECOND QUESTION IS ABOUT THE
OR HOW THE OR HAD PROGRAM IS
MEETING DEFINED GOALS IDENTIFIED
IN THE CALIFORNIA OR OF HEALTH
PLAN.
IBM ESTABLISH TO GRANT THE GRANT
PROGRAM TO PROVIDE FUNDS TO ALL
SIXTY ONE LOCAL HIGH
JURISDICTIONS BUT PLANNING AND
IMPLEMENTING EVIDENCE BASED
PROGRAMS AND POLICIES.
SO IN PHASE ONE LOCAL HOW
JURISDICTIONS UP CONDUCTING
NEEDS ASSESSMENT AND DEVELOPING
A COMMUNITY HEALTH IMPROVEMENT
PLAN.
AND IN PHASE TWO FUNDS MAY BE
USED FOR SUCH ACTIVITIES AS
COORDINATION OF SCHOOL BASED
PROGRAMS.
PROMOTING KINDERGARTEN OR A
HOUSE ASSESSMENT REQUIREMENT AND
THEN USING THAT DATA FOR
PLANNING INTERVENTIONS.
ESTABLISHING A COORDINATE AND
BUT THIS COORDINATED SYSTEM FOR
SCREENING AND REFERRAL OF
CHILDREN AND PREGNANT WOMEN.
PROMOTING RETHINK YOUR DRINK
CAMPAIGN AND TOBACCO CESSATION
IN DENTAL SETTINGS.
AND ALSO LAUNCHING EDUCATION AND
HELP THE TO SEE CAMPAIGNS.
OTHER GRANTS AND CONTRACTS WILL
HELP COMMUNITIES TO PROMOTE.
EVIDENCE BASED INTERVENTIONS
LIKE COMMUNITY WATER
FLUORIDATION AND SCHOOL BASED
PROGRAMS.
WE HAVE ESTABLISHED THAT
CONTRACT WITH THE UC A STEP DOWN
SCHOOL TO PROVIDE TRAINING AND
TECHNICAL ASSISTANCE TO LOCAL
HOW JURISDICTIONS.
YEAH WE ARE.
WELL TO EXPLORING SEVERAL
CAMPAIGNS THAT WILL IMPROVE ORAL
HEALTH BUT TO SEE.
THE FIRST ONE IS TO ENHANCE
COMMUNICATION AND DENTAL
SETTINGS WE ARE UP PROPOSING TO
CREATE A TOOLKIT FOR DENTAL
OFFICES.
I IT'S BASED ON THE. AGENCY FOR
HEALTHCARE RESEARCH AND QUALITY
UNIVERSAL PRECAUTIONS KID. THIS
WAS HOW DENTAL OFFICES TO
CREATED A SPOT. RESPECTFUL
ENVIRONMENT.
COMMUNICATE USING PLAIN LANGUAGE
AND.
SIMPLE VISUALS AND ALSO USED TO
TEACH BACK METHOD.
A THE AMERICAN DENTAL
ASSOCIATION FOUNDATION HOUSE A
CAMPAIGN COURT TINY SMILES IT'S
DESIGNED TO ENGAGE THREE
INFLUENTIAL GROUPS EDUCATORS.
DENTAL PROFESSIONALS AND MEDICAL
PROFESSIONALS.
AND WE ARE. PLANNING TO LAUNCH
THIS CAMPAIGN AND SOME CAMINO
COUNTIES.
THERE IS NO THE CAMPAIGN YOU MAY
BE BUT A FAMILY OF Y. THE
AMERICAN ACADEMY OF PEDIATRICS.
CAMPAIGN CALLER BRAASCH BOOK IN
BED BEEN ALSO. INTERESTED IN
PROMOTING THAT CAMPAIGN IN SOME
COMMUNITIES.
WELL WE ARE ESTABLISHING A
SURVEILLANCE SYSTEM TED WILL BE
CONSISTENT WITH THE NATIONAL OR
A HOT SURVEILLANCE SYSTEM AND IT
INCLUDING QUESTIONS IN MANY OF
OUR STATE BASED SERVICE LACTIS
BEYOND A PROCESS SEND ME HA.
IN WHERE THERE ARE GAPS WILL BE
A AND WE ARE DESIGNING SPECIAL
SURVEYS TO GATHER DATA
ESPECIALLY ON THE.
OR A HOUSE OUTCOMES IN CHILDREN.
THE FINAL QUESTION IS ABOUT THE
STATUS OF CLIENTS.
WE HAVE PROCESS TO FIFTY SEVEN
APPLICATION SO FAR.
AND EXECUTED FORTY NINE
AGREEMENTS.
BE HAVE GRANTED EXTENSION BUT
THREE LOCAL HAS JURISDICTION.
A.
THE A LOCAL HOUSE JURISDICTIONS
ON IN THE PROCESS OF HIDING
STAFF AND CONSULTANTS AND ALSO
FINALIZING CONTRACTS AND
APPROACHES SAUNDERS.
MOST OF THESE CONTRACTS BECAME.
EFFECTIVE IN MARCH.
SO THIS IS A GRANT PROGRAM THAT
GIVES FLEXIBILITY TO LOCAL
HEALTH JURISDICTIONS TO DESIGN
THEIR OWN PROGRAMS BASED ON THAT
NEEDS.
IN GENERAL WE ARE ASKING THE
GRANT IS TO FOCUS ON REDUCING TO
DECAY PREVALENCE IN UNTREATED
DISEASE IN CHILDREN.
INCREASING DENTAL VISIT TRAITS
AND CHILDREN AND ADULTS
ESPECIALLY PREGNANT WOMEN PEOPLE
WITH DIABETES AND BORDER ON
THOSE.
I ALSO ADDRESSING COMMON RISK
FACTORS SUCH. BUDGET DIETARY
CHOICES AND PROMOTING TOBACCO
CESSATION IN DENTAL SETTINGS.
INTEGRATION OF ORAL HEALTH AND
PRIMARY CARE IS A HIGH PRIORITY
AT THE NATIONAL LEVEL.
THE ARE ENCOURAGING A LOCAL HOW
JURISDICTIONS TO FOCUS ON UNITED
STATES PREVENTIVE SERVICES STUFF.
TAX FORCE RECOMMENDATIONS.
HOW FOR A?
AB AND OF WHICH RECOMMENDS THE
APPLICATION OF FLUORIDE VARNISH
AND PRIME TICKET OFFICES.
THERE'S A NATIONAL CONSENSUS
STATEMENT OVERLOOKED BY HER SON
THAT RECOMMENDS.
THAT ALL HEALTH PROFESSIONALS
PROVIDE PREGNANT WOMEN WITH
APPROPRIATE AND TIMELY ORAL
HEALTH CARE.
OF THEIR. ASKING ALL LOCAL HOW
JURISDICTIONS TO PROMOTE THIS
AND THEY'RE OUT COMMUNITIES
THANK YOU.
THANK YOU I REMEMBER SERVING ON
A CD A FOUNDATION TASK FORCE ON
ON THAT VERY ISSUE ABOUT GETTING.
A TRAIN WOMEN ARE OF.
THE SERVICES. SURE THEY GOT
THERE WILL HEALTH CARE GREAT.
SO AND COMES FROM A LEO DEL
FINANCE.
RIGHT. AND I BELIEVE WE HAVE OUR
PANEL HAS A PROPOSAL REGARDING
FUNDING FLEXIBILITY SO.
WE CAN DO IT IN THREE MINUTES OR
LESS LESS WHEN. OKAY GREAT.
SO I HAVE ROPOSITION FIFTY SIX
INCLUDES THIRTY MILLION A YEAR
FOR THE OR.
OBSERVERS UP.
S. WE ARE VERY EXCITED THAT THE
OUT PIECES IN THERE AND WANT TO
MAKE SURE THAT THERE IS MAXIMUM
FLEXIBILITY TO GET THE MONEY OUT
THE DOOR WE REALLY SEE THIS THIS
IS A TOTAL GAME CHANGER FOR ORAL
HEALTH.
WE HAVE HAD SOME CONCERNS ABOUT
HOW WITH IMPLEMENTATION WAS
GONNA LOOK LIKE WE RAISE THOSE
WITH ON THE DEPARTMENT OF
FINANCE AND DPH AND WHERE
ESSENTIALLY STAR FILLED IN THE
STATUTE IS WHAT IT IS. MONIES
COMING EVERY YEAR.
WE HAVE THE SENSE THAT HEARD
SOME CONCERNS FROM THE LOCAL
AGENCIES WHICH I THINK MY
COLLEAGUE CAN SPEAK TO A LITTLE
BIT MORE CLEARLY. AND SO
COALITION CAME TOGETHER.
MODELED SOME LANGUAGE AFTER
OTHER PROGRAMS AND DPH THAT HAVE
A LITTLE BIT MORE FLEXIBILITY
SPECIFICALLY. THREE YEAR
SPENDING AUTHORITY IN THOSE
GRANTS JUST TO GIVE ENOUGH TIME
TO THE COUNTIES ACTUALLY GET OUT
THE DOOR SO WE KNOW IF IT'S A
IT'S A SYSTEM THAT'S BEEN USED
BEFORE AMENDED WE JUST WANNA
MAKE SURE THAT THERE ARE ANY.
ANY BARRY BARRIERS.
FOR FOLKS SPENDING THIS MONEY
BECAUSE WE ARE VERY EXCITED
ABOUT IT.
THANK YOU KNOW AND AND WE DO
APPRECIATE THE COLLABORATION
THAT'S BEEN HAPPENING WITH THE
CALIFORNIA DEPARTMENT PUBLIC
HEALTH AND PARTICULARLY WITH DR
KUMAR IN HIS TEAM. I THINK AND
JUST TO FURTHER ELABORATE ON
WHAT BEYOND A HIS SAID LOOK ALL
DEPARTMENTS ARE FACING
CHALLENGES AROUND EXPENDING THE
FUNDING PARTICULARLY IN THE
FIRST YEAR BUT WE COULD FOR SEE.
THIS BEING A NEED ON THE ONGOING
BASIS AND SO WHAT WE'RE ASKING
FOR IS THE ABILITY FOR THE
DEPARTMENT TO ROLL OVER THAT THE
FUNDING FROM ONE YEAR TO THE
NEXT.
TO MAKE SURE THAT A JURISDICTION
CAN CONTINUE TO SPEND THE FUNDS
IN THE FUTURE YEARS JUST TO GIVE
YOU HAVE IT A BIT OF AN EXAMPLE
AS DR KUMAR SAID THERE'S A
NUMBER OF CONTRACTS THAT HAVE
NOT BEEN IMPLEMENTED OR WERE NOT
AND THE.
UNTIL ON MARCH OF THIS YEAR
WHICH MEANS THAT THEY HAVE THREE
MONTHS TO ESSENTIALLY SPENT
COUPLE YEARS ALLOCATION OF
FUNDING. AND FUNDING WITHIN THE
GRANTS ARE PROVIDED TO LOCAL
HEALTH DEPARTMENTS AND THEY HAVE
AT THE SAME AMOUNT OF FUNDING
PER YEAR. AND SO WE HAVE A FULL
YEAR'S ALLOCATION SPEND IN THREE
MONTHS OR AT THE MAX IT WAS SIX
MONTHS AND SO THAT'S PRETTY
CHALLENGING AND DIFFICULT NAY
DON'T WANNA MAKE RASH DECISIONS
ON HOW THEY SPEND THE FUNDS THEY
WANT TO MAKE SURE THAT THEY ARE
DOING IT TO BUILD. AND A FIRST
IN THE EARLY PHASES TO BUILD
THAT CAPACITY AT THE LOOK AT THE
LOCAL LEVEL TO MAKE SURE THAT
THEY'RE DOIG THE NEEDS
ASSESSMENT AND DOING IT IN A WAY
THAT WILL PROVIDE MEANINGFUL
INFORMATION ABOUT HOW WE CAN
BEST MAKE THE INVESTMENTS INTO
OUR COMMUNITIES.
AND SEND AND THEN GOING FORWARD
AND ANY MONEY THAT'S ROLLED OVER
INTO FUTURE YEARS THAT ARE NOT
NEEDED FOR PLANNING WILL THEN GO
TOWARDS ADDITIONAL INVESTMENTS
THAT CAN HAPPEN. TO REALLY
FURTHER THE WORK OF THE THE ORAL
HEALTH GRANTS IN THE INTENDED
PURPOSE FOR IT SO YOU WE ARE
REALLY ASKING FOR WHAT WE
BELIEVE TO JUST BE A SIMPLE FIX
TO ALLOW FUNDING TO BE ALLOCATED
FROM YEAR TO YEAR.
ALRIGHT THANK YOU ANITA COMMENTS
FROM THE. APARTMENT ABOUT THE.
THIS REQUEST IT WE UNDERSTAND
THE CONCERNS AND WE HAVE BEEN
WORKING.
TO DISSOLVE THIS WHEN WE HAVE A
MECHANISM THROUGH THE STATE
ADMINISTRATIVE MANUAL TO ALLOW
THE FLEXIBILITY FOR LOCAL
JURISDICTIONS.
YEAH WE'LL BE PROVIDING
ADDITIONAL GUIDANCE I'M IN THE
COMING WEEKS
OKAY ILIO THE CUMMINS NOT
FINANCE.
NO ISSUES WITH THIS IDEA.
GOOD.
WELL.
AS DR KUMAR NOTED.
YOU KNOW THIS IS A NEW FUNDING
STREAM AND WE DO ACKNOWLEDGE
THAT THERE WILL BE BUMPS IN THE
ROAD AND WE'VE BEEN HAVING A LOT
OF CONVERSATIONS WITH THE.
STAND WHAT THE CONCERNS ARE AND
WE'VE BEEN WORKING WITH THEM AND
WE DO BELIEVE IT THERE'S AN
ADMINISTRATIVE MECHANISM TO DO
THIS. SO WE'RE STILL IRONING OUT
ALL DETAILS FOR THAT BUT HOPE TO
HAVE MORE INFORMATION FOR.
PROVOKES.
I LIKE THE IDEA ADMINISTRATIVE
OKAY HE HAS AND THAT'S REALLY
GOOD NEWS TO HEAR AND WE LOOK
FORWARD TO HAVING FORTHE
CONVERSATIONS WITH THE
ADMINISTRATION THE ONLY THING
THAT I WOULD NOTICE TO MAKING
SURE THAT WE'RE ABLE TO ROLL IT
OVER FOR A NUMBER OF YEARS AND
THAT. WE HAVE
THE ADVANCE NOTICE TO DO THAT SO
THE STATUTE THAT WE WERE LOOKING
A CHANGE WOULD ALLOW ROLL OVER
FOR A THREE YEAR PERIOD AFTER
AND THAT YOUR CLOSES AND WE
WANNA MAKE SURE THAT. LOCAL
JURISDICTIONS KNOW IN ADVANCE AT
THAT THEY WOULD BE ABLE TO DO
THAT ON AN ANNUAL BASIS VERSUS
HAVING IT BE SUBJECT ELEGANT
PROCREATION OR ANYTHING LIKE
THAT SO WE JUST.
I'M ASKED FOR THAT FLEXIBILITY
AS WELL.
OKAY WELL SKIES WORK IT OUT IF
TURNS OUT THERE'S SOME
LEGISLATIVE PEACEFUL FIGURE OUT
OUT TOO. ALRIGHT OF PUBLIC
COMMENT.
TIM GIVES THE AMERICAN CANCER
SOCIETY CANCER ACTION NETWORK
AND ALSO SPONSOR PROPOSITION
FIFTY SIX I WANTED TO ECHO THE.
QUESTION FLEXIBILITY ON HOW
THESE FUNDING THAT ABBAS THESE
FUNDS ARE SPENT SOME EXAMPLE
PROPOSITION NINETY NINE FUNDS
THAT CALIFORNIA TOBACCO
EDUCATION AND.
RESEARCH PROGRAMS THEY'VE THE
TWENTY FIVE YEAR HISTORY OF
MULTI YEAR SPENDING AUTHORITY
AND WITH THE PASSAGE OF
PROPOSITION FOR
THE SIX IT SEEMS AN EFFORT TO
CURTAIL THAT EFFORT WITHOUT.
ADEQUATE EXPLANATION WHY SO WE
JUST ENCOURAGE.
BOB CONTINUED.
.
CONVERSATION AND ENDS MAXIMUM
FLEXIBILITY SO WE CAN SPEND
THESE TOBACCO TAX FUNDS AS THEY
WERE INTENDED.
THANK YOU.
WELCOME.
RATHER THAN THE FATE IS A THE
AMERICAN LUNG ASSOCIATION IN
CALIFORNIA AND SUPPORTING THE
PROPOSAL ON AT GOING WHAT MY.
FRIEND FROM THE CANCER SOCIETY
SAID. I IT'S REALLY IMPORTANT
THAT THESE FUNDS HAVE THIS
FLEXIBILITY AT SOMETHING THAT
HAS BEEN BUILT INTO IT AND IN
FACT PROPOSITION FIFTY SIX
OUTLINED TO CONTINUE ITS
APPROPRIATION FOR THESE FUNDS
AND SO. I WE NEED TO MAKE SURE
THAT WE YOU KNOW BY BY THE WILL
OF THE VOTERS AND DO WHAT NEEDS
TO BE DONE SOMETHING CAL. THANK
YOU.
WELCOME. GOOD AFTERNOON COOL
CUTTING WITH THE AMERICAN HEART
ASSOCIATION AMERICAN STROKE
ASSOCIATION I'M ALSO WERE CO
SPONSORS OF PROPOSITION FIFTY
SIX A ECHO THE SENTIMENTS OF MY
COLLEAGUE FROM. CANCER CITING
AMONG WE SUPPORT THE STAKEHOLDER
PROPOSAL TO ALLOW FOR MAXIMUM
FLEXIBILITY IN HOW THESE FUNDS
ARE SPENT THANK YOU. THANK YOU.
WELCOME.
AFTERNOON KATIE ANDREW CHILDREN
NOW.
EYES ONE ECHO AS IS SENTIMENTS
OF THOSE WHO CAME BEFORE ME.
WE ARE ALSO IN STRONG SUPPORT
OF THIS PROPOSAL TO PROVIDE
LOCAL HEALTH JURISDICTIONS THE
FLEXIBILITY.
THANK YOU.
WELCOME.
AFTERNOON DOUG VICTOR CHRISTY
WITH CALIFORNIA HELPLESS
ADVOCATES REPRESENTING COMMUNITY
HEALTH CENTERS US SOMETIMES A
COMMITTEE HEALTH CENTERS ARE THE
ONLY PROVIDER IN TOWN. ALSO
HAVING THIS OF FLEXIBILITY WOULD
REALLY ALLOW US TO WORK WITH OUR
PROVIDERS TO I'M.
REALLY MEET THE NEEDS. OF THE
EVOLVING OUR.
MEET THE NEEDS OF PATIENTS IN
THE COMMUNITY SO THE GUITAR IN
SUPPORT.
OKAY THANK YOU.
RIGHT.
APPRECIATE THE PRESENTATION I DO
JUST BEFORE WE. MOVE ONTO THE
NEXT ITEM.
FROM YOUR WORLD DISEASE BURDEN
REPORT.
ONE THIRD OF CHILDREN HAVE
UNTREATED TOOTH DECAY.
FORTY FOUR PERCENT OF
BENEFICIARIES.
AND.
MEDIC CAO.
CABIN ROLE FOR LEASE NINETY
CONTINUOUS DAYS
ONLY FORTY FOUR PERCENT RECEIVED.
AT LEAST ONE.
THAT SERVICE.
SO WE HAVE SOME WORK TO DO HERE.
THANK YOU. SO. WILL HOLD THIS
ITEM OPEN AND HOPEFULLY WE CAN
WORK SOMETHING OUT FOR.
ME REVISE.
SO THANKS SO MUCH PRESENTATION
OKAY.
I NEXT ISSUES ISSUE NUMBER FIVE.
PUBLIC BEACHES PUBLIC BEACH
INSPECTIONS FOR TEN MINUTES
INFLATION SP THIRTEEN NINETY
FIVE.
WELCOME BACK.
SO HAVE YOU INTRODUCE YOURSELF
FOR THE RECORD AGAIN IS FOR THE
SIDE.
THANK YOU VERY MUCH MR SHARE HIT
AFTERNOON MARK STAR W. DIRECTOR
FOR RONALD HEALTH IN THE FORM OF
PUBLIC HEALTH.
BUT THIS REQUEST IS TO ENABLE
THE DEPARTMENT OF PUBLIC HEALTH
A FINALIZED IMPLEMENTATION OF
MANDATED PER. PROVISIONS OF
SENATE BILL THIRTEEN NINETY FIVE
WHICH WAS CHAPTER IN TWENTY
FOURTEEN.
AND IT'S ABOUT THE APPROVAL OF
THE USE OF NEW RAPID TEST
METHODS FOR BEACH WATER TESTING.
YOUR AGENDA PACKET HAS NIXON
RIGHT OPPOSE PROPOSAL SOLVES
PROVIDE A VERY QUICK OVERVIEW.
THE CONTEXT HERE IS THAT LOCAL
DEPARTMENTS ARE RESPONSIBLE FOR
BEACH WATER SAFETY TESTING FOR
CONTAMINATION.
BACTERIAL CONTAMINATION FROM
OVER USE OR FROM NEARBY US
SOURCES.
AND THEY'RE ALSO RESPONSE FOR
POSTING OR CLOSING BEACHES AS
NECESSARY.
OUR ROLE THE STATE IS TO
DETERMINE THE TESTING METHODS
AND STANDARDS FOR THAT TESTING
AND THAT SPECIFIED IN
REGULATIONS.
THE CURRENT GOLD STANDARD IS
BACK TO LOGIC CULTURE.
REQUIRES ABOUT TWO DAYS OF TURN
AROUND TIME. AND THERE'S
POTENTIAL HEALTH OF IMPACTS OF
THAT BECAUSE YOU MAY HAVE A
BEACH IS CONTAMINATED BICU
DON'T ACTUALLY IDENTIFIED FOR
TWO DAYS.
THERE'S ALSO ECONOMIC IMPACTS IN
REOPENING BEACHES AND DELAYING
THAT ON THAT ARE IMPORTANT FOR
TOURISM.
SO THE NEW RAPID PCR TEST BECAME
AVAILABLE EARLIER THIS DECADE
AND.
THEY HAVE ABOUT A FOUR HOUR
TURNAROUND TIME.
YEAH SO S. B. THIRTEEN NINETY
FIVE CAME INTO PLAY AFTER THAT
WHICH REQUIRES US TO DEVELOP
INVALIDATE THE NEW TEST METHODS
AND THE COMPLEX PROCESS THEIR
SITE SPECIFIC.
TESTING THERE'S INTERFERING
SUBSTANCE IS A DIFFERENT
LOCATIONS THAT'S MUCH MORE
DIFFICULT EMPLOYMENT AND CULTURE.
BUT TO DO SIDE BY SIDE
COMPARISON WITH THE CULTURE
TESTING. AND ULTIMATELY PREPARE
TESTING STANDARDS GUIDELINES DO
TRAININGS AND AND SO ON.
SO THE FIRST BUDGET PROPOSAL.
IN TWENTY FIFTEEN AND SIXTEEN
PROVIDED THREE YEARS RESOURCES
FOR ONLY THE INITIAL LAB WORK.
WHICH HAS OF BEEN US VERY
SUCCESSFUL AND THE PROGRESS IS
DESCRIBED IN YOUR AGENDA PACKET
INCLUDING OUR CLOSE
COLLABORATION WITH STAKEHOLDERS.
THIS PROPOSAL REQUEST THE
RESOURCES NEEDED TO COMPLETE THE
JOB BASICALLY THERE'S TWO TASKS
COMPLETE THE LAB WORK. AND IN
THE SECOND ONE IS TO THEN WRITE
THE REGULATIONS.
WE VERY TALK ABOUT REGULATIONS
ARE. A IN ORDER TO.
ALLOW LOCAL JURISDICTIONS TO BE
ABLE TO UTILIZE THIS TEST THIS
IS ALL NECESSARY BEFORE LOCAL
HEALTH DEPARTMENTS CAN USE THE
RAPID TESTS. FOR THEIR BEACH
MANAGEMENT DECISIONS.
THANK YOU SO WENDY ANTICIPATE
REGULATIONS BEING AVAILABLE FOR
OUR OUR BEACH COUNTIES TO BE
ABLE TO USE THIS.
THE ARE SCHEDULED FOR COMPLETION
IS FIVE YEARS.
FIVE MORE YEARS WE HAVE THROUGH
THROUGH THREE YEARS OF LAB OF
FINISHING LABOR AND THEN THERE'S
AN OVERLAP YEAR. THE THIRD YEAR
AND THEN AFTER THAT THERE'S TWO
MORE YEARS.
TO COMPLETE THE RATE VERY
PROCESS BUT ALSO THERE'S
GUIDELINES TECHNICAL ASSISTANCE
EDUCATIONAL WORKING TRAIN TO BE
PART OF THAT I'M KINDA JUST.
ARE TRYING TO SUMMARIZE THIS
QUICKLY FOR IT I APPRECIATE THAT
AND I DON'T I KNOW THIS CASE YOU
HAVE TO GATHER SOME DATA. YEAH
YOU'RE DOES FROM THE LAB WORK
AND SO FORTH.
JUST THINKING LIKE WE GOTTA FIND
A WAY TO MAKE WITH THESE THINGS
FASTER BUT ANYWAY. OKAY WELL
HOPEFULLY IN FIVE YEARS WE CAN
OPEN OUR BEACHES MORE QUICKLY
THAN ALRIGHT.
COMES FROM ELIO. NO FINANCE
BELT.
ANY BEACH COMMENTERS OUT THERE.
NO SO FOR THE NEXT FIVE YEARS
THESE CLOTHES FOR TWO DAYS YOU
KNOW WHY. IT'S WERE WAITING.
OKAY.
BOHO THIS ITEM OPEN THANKS MUCH
FOR YOUR PRESENTATION NOW IS THE
BY THIS. VERY PORTANT TRIES
DELUDE FOR ITSELF THANK YOU.
ALRIGHT ISSUE NUMBER SIX
OVERSIGHT. CALIFORNIA SAFE
COSMETICS FOR.
WE.
HAVE FUN A SOME STAKEHOLDERS TO
HAVE A PROPOSAL SO OKAY FEAR WE
CAN JUST MAKE LITTLE ROOM FOR
THEM ON THE SIDE THERE.
AT SEA.
SO WE HAVE.
TWO PRESENTERS I FLICK WITH TWO
CHAIRS OR GOOD THERE OKAY SO.
ALRIGHT. AND THE.
WE'LL DO IS WE'LL HAVE THAT PART
OF PRESENT AND AND IF THE UPDATE
AND THEN YOU CAN INTRODUCE
YOURSELVES AFTER WE.
IS THAT ALRIGHT SO.
I TRIED AGAIN.
GOOD AFTERNOON FOR THE RECORD
THIS IS MONEY COME AROUND THIS
DEPUTY DIRECTOR FOR THE CENTER
FOR CHRONIC DISEASE PREVENTION
AND HEALTH PROMOTION. THERE
SPECIFICALLY TO QUESTIONS FOR
ISSUE NUMBER SIX OF THE
DEPARTMENT WILL BE ANSWERING.
WILL START WITH THE FIRST ONE
WHICH IS REGARDING THE DATA
COLLECTION REPORTING ACTIVITIES
OF THE SIX COSMETICS PROGRAM.
ON.
OUR PROGRAM CURRENTLY MANAGES AN
ONLINE SYSTEMIC OR COMPANY
FREEPORT PRODUCTS CONTAINING
INGREDIENTS IDENTIFIED OR
SUSPECTED. OF HAVE COURT AND TO
BECOME A CARCINOGENS FOR FIVE
REPRODUCTIVE TOXINS.
IN ADDITION WE MANAGE A PUBLIC
DATABASE WHERE CUSTOMERS CAN
ACTUALLY LOOK UP THESE PRODUCTS
THAT THESE COMPANIES ARE
REPORTING. PART OF THE DATA
COLLECTION THAT WE DO AND TELLS.
YOU KNOW COLLECTING PRODUCT
NAME TYPE OF PRODUCT BRAND OR
COMPANY NAME.
AND REPORTABLE INGREDIENTS.
IN TERMS OF QUESTION NUMBER TO A
HOW WE VERIFY THAT THE COSMETIC
PRODUCTS OF THAT ARE BEING
REPORTED. CURRENTLY THE PROGRAM.
IT HAS A VERY DIFFICULT TIME
DETERMINE AT ANY POINT ATONE
NUMBER OF COMPANIES WHO HAVE TO
REPORT THE PRODUCTS.
IN WHO MEET THE CRITERIA PER.
SAFE COSMETICS ACT.
AND IT'S VERY DIFFICULT FOR US
BECAUSE IT IS ANY BALL BEING A
BUSINESS FORMULATIONS ARE
CONSTANT BEING DEVELOPED.
SO IT'S IT MAKES IT DIFFICULT
FOR US TO ACTUALLY KNOW AND
COMPANIES ARE WE DON'T HAVE ANY
EXISTING LIST OF ALL THE
COMPANY'S HAN. SINCE IT'S A
MOVING TARGET.
IN TERMS OF QUESTION NUMBER
THREE OF PRODUCTS THAT ARE NOT
BEING REPORTED TO THE PROGRAM
AND HOW WE GO ABOUT IT. I'M A
DIDN'T YOU KNOW THAT
CALIFORNIA'S OF COSMETICS ACT OF
TWO THOUSAND FIVE DID NOT
PROVIDE ANY SPECIFIC GUIDANCE ON
HOW THE.
WOULD IN FORCE REPORTING AND SO
THEREFORE WE HAVE YOU KNOWN
KNOWN FORSMAN CAPABILITIES.
HOWEVER I WHEN WE DO FIND OUT
THAT OF PRODUCT NEEDS TO BE
REPORTED WE DO FOLLOW UP WITH
THE COMPANY. AND WE SEND ALSO
LETTERS A ANNUALLY WE SING
MOUSE SOME.
OKAY THANK YOU UP COMES LA YOU.
KNOW FINANCE.
ALRIGHT.
OKAY SO ONE SANDERS A PROPOSAL
HERE SO HE CAN KEEP FOR TOGETHER
WITHIN THREE MINUTES.
APPRECIATED.
AND ACTUALLY POINT YOU'VE UP
BEFORE WE START THE CLOCK WANT
TO JUST INTRODUCE YOURSELVES
EACH FOR THE RECORD.
MY NAME IS DOCTOR JEAN CONNIE
AND I'M AN OBSTETRICIAN
GYNECOLOGIST FROM ROSA
CALIFORNIA HAS PRESIDENT OF THE
AMERICAN COLLEGE OF
OBSTETRICIANS. AND GYNECOLOGISTS.
GOOD AFTERNOON MY NAME IS JANET
MIDDLEMAN I'M WITH A BREAST
CANCER PREVENTION PARTNERS AND
WE ARE ONE OF THE STAKEHOLDER. A
PROPOSAL PROPOSERS ALONG WITH
BLACK WOMAN FROM WELLNESS OKAY
NICE EVEN GO IN BEGIN THANK YOU
I SERVE ON THE EXECUTIVE BOARD
OF THE INTERNATIONAL FEDERATION
OF OBSTETRICIANS.
AND GYNECOLOGISTS AND LEAD A
GLOBAL TASK FORCE AND HOW THE
ENVIRONMENT IMPACTS ARE HOOKED.
SORRY. AND A CUT IS THE LEADING
I AM PROVIDER FOR WOMEN'S HEALTH
CARE AROUND THE UNITED STATES
WERE MEMBERSHIP ORGANIZATION
FIFTY EIGHT THOUSAND WOMEN A
FIFTY THOUSAND POSITIONS. AND
THE WOMEN WE SERVE ACROSS UNITED
STATES FIVE THOUSAND POSITIONS
HERE IN CALIFORNIA.
I'M GRATEFUL FOR THIS
OPPORTUNITY TO SPEAK TO THE
SUBCOMMITTEE. AND TO
CONGRATULATE OUR LEGISLATIVE
BODY AND A VERY SUCCESSFUL
EXISTING CALIFORNIA'S SAFE
COSMETICS PROGRAM.
WE ARE PROPOSING A FEE BASED.
FUNDING INCREASE TO SUPPORT THAT
EXISTING PROGRAM SO WE'RE NOT
QUESTIONING THE EXISTENCE WE DO
APPRECIATE HOW DIFFICULT IT IS.
ADAM WITH WHAT YOU'VE OUTLINED
TODAY.
FIVE YEARS AGO A COG AND
PRESENTED A MAJOR COMMITTEE
OPINION.
AND REAFFIRMED IT THIS YEAR THAT
THE ENVIRONMENTAL IMPACTS OF
TOXIC CHEMICALS CAN IMPACT OUR
HEALTH WHETHER WE'RE TALKING
ABOUT THE HEALTH OF WOMEN OR THE
FETUS.
AND THE GO IN THREE YEARS AGO
ISSUED A SIMILAR OPINION TO
SUMMARIZE SOME OF THE IMPORTANT
POINTS THEIR. NUMBER ONE. WE
RECOGNIZE THAT THE IMPORTANCE OF
REDUCING AND PREVENTING
EXPOSURES
TO TOXIC CHEMICALS IS A CRITICAL
AREA FOR PRACTICING CLINICIANS.
AND ALL THE PATIENTS THAT WE
SERVE.
NUMBER TWO PREGNANCIES A
PARTICULARLY VULNERABLE TIME.
FOR WOMEN BECAUSE THE CHEMICALS
THAT THEY ARE EXPOSED TO CAN BE
CUMULATIVE CAN BE ADDITIVE. AND
THE TIMING OF THE EXPOSURE CAN
IMPACT THE EFFECT ON THE FETUS.
THE PREGNANCY IS A PARTICULARLY
VULNERABLE PERIOD. AND THIRD
UNDERSERVED WOMEN ARE ESPECIALLY
VULNERABLE BECAUSE THEY HAVE AN
EXPOSURE TO HIGHER POTENTIAL
TOXICS SO THOSE ARE THREE
UNDERLYING AREAS OF CONCERN.
AS A PHYSICIAN I APPRECIATE THE
FORESIGHT OF OUR LEGISLATIVE
BODY THAT LED TO THE CALIFORNIA
SAFE COSMETICS
PROGRAM IT IS AN IMPORTANT TOOL
FOR PHYSICIANS.
CONSUMERS AND WORKERS.
WITH THE INFORMATION THAT THEY
NEED TO AVOID EXPOSURE TO
POTENTIAL CARCINOGENS
REPRODUCTIVE TOXIC.
WE ALSO REALIZE THE CONSUMERS
WORKERS HAVE A RIGHT TO KNOW.
POSITIONS HAVE A NEED TO KNOW.
IF WE'RE GOING TO PROVIDE THE
RIGHT GUIDANCE FOR OUR PATIENTS.
THIRTY SEVEN YEARS AGO I HAD MY
FIRST CHILD AND I REMEMBER
ASKING MY POSITION ABOUT A CREAM
THAT I USED AND HE SAID FOR
GOD'S SAKE YOU'RE NOT EATING UP
WHY ARE YOU WORRIED.
THAT'S NOT HOW WE SHOULD RESPOND
TODAY.
THIS IS A VERY SIMPLE PROPOSAL
THAT CREATES A FEE BASED
STRUCTURE TO PROVIDE ONGOING.
AND FUNDING FOR IMPORTANT
PROGRAM THAT HELPS GUIDE OUR
PATIENTS AND PHYSICIANS THANK
YOU.
I'M ACTUALLY HERE TODAY GOD JUST
TO TO RESPOND TO QUESTIONS THAT
YOU MIGHT HAVE I KNOW HOW LONG
THAT THEY HEARINGS GONE ALREADY
SO. I'LL.
SKIP ANY ADDITIONAL COMMENTS AT
THIS TIME. AND EXACTLY THREE
MINUTES MAKING.
PERFECT.
OF.
SO JUST TO CLARIFY THE. TO
YOU'RE. A FEE FOR EACH PRIDE HOW
MUCH
REVENUE EXPECTING TO RAISE WITH
THE CITY.
WELL IN THE LAST ROUND OF
REPORTING THAT WAS CONDUCTED BY
THE THE SAFE COSMETICS PROGRAM
SIXTY FIVE THOUSAND PRODUCTS
WERE REPORTED TO THE PROGRAM.
BETWEEN TWO THOUSAND AND NINE
AND TWO THOUSAND AND FIFTEEN SO
WE USE THAT NUMBER.
TO.
IT TO COME UP WITH A
RECOMMENDED FEE OF THIRTY
DOLLARS PER REPORTABLE PRODUCT
WHICH WOULD GENERATE ABOUT ONE
POINT FIVE MILLION DOLLARS AND
AN ADDITIONAL REVENUE.
AND DOES.
YOUR CONCERN IS THAT THERE ISN'T
SUFFICIENT STAFFING CURRENTLY TO
IMPLEMENT THE CURRENT LAW WILL
ARE OUR BIGGEST CONCERN I HAVE
IS THAT THE PROGRAM HAS BEEN
CHRONICALLY UNDERFUNDED.
AND THAT'S NO ONE'S FAULT THERE
ARE SO MANY COMPETING PRIORITIES
FACING THAT.
BUT SINCE ITS INCEPTION THE
PROGRAM HAS BEEN CUT TWENTY FIVE
PERCENT IN FUNDING IT NOW HAS A
BUDGET OF ABOUT THREE HUNDRED
SEVENTY THOUSAND DOLLARS IT'S
ONLY ABLE TO EMPLOYEE TO STAFF.
SO WITH ADDITIONAL FUNDING
THOUGH PROGRAM WOULD BE ABLE TO
HIRE ADDITIONAL STAFF AS WELL AS
FULLY COMPLY THE LAW BY HIRING
AN ENFORCEMENT OFFICER.
ANY COMMENTS FROM THE PUBLIC
BECAUSE.
NO NOT CURRENTLY THINKING OKAY
LA JOH DOESN'T FINANCE.
YES OTHER STAKEHOLDERS HAVE
REACHED OUT TO US IN AT THIS
TIME ARE STILL ASSESSING THE
PROPOSAL WE DON'T OF A POSITION
OR HAVE IT RIGHT TECHNICAL
SUPPORT.
OKAY.
AND I THINK WE'RE PUBLIC COMMENT.
WELCOME.
GOOD AFTERNOON MISTER CHAIR
CORBULO SOME HALF OF BEST CANCER
PREVENTION PARTNERS.
S. CANCER ACTION IN.
AND KEEP ABREAST IN SUPPORT.
OKAY
THANK YOU WELCOME.
WELCOME.
WHEN SPENCER ON BEHALF OF THE
AMERICAN COLLEGE OBSTETRICIANS
AND GYNECOLOGISTS THE
ASSOCIATION SUPPORT THE STICKERS
PROPOSAL THANK YOU. THANK YOU.
WELCOME.
GOOD AFTERNOON MAYOR DALEY ON
BEHALF OF THAT PERSONAL CARE
PRODUCTS COUNCIL.
.
I WANNA WE OPPOSE THE THE THIS
BUDGET REQUESTS AND I WANNA SAY
AT THE OUTSET THAT.
ON BEHALF OF THE COSMETICS
INDUSTRY WE OBVIOUSLY CARE ABOUT
THE SAFETY OF CONSUMERS.
AND SAFETY IS A PRIORITY FOR
INDUSTRY OTHERWISE OUR BRANDS OF
BE EXTREMELY COMPROMISE.
I'M.
WE ARE OPPOSE WE WERE OPPOSED TO
SB FORTY FOUR THAN THAT CREATED
THIS DATABASE BACK THEN AND WE
ARE OPPOSED TO. THE EXPANSION OF
THE DATABASE TODAY.
BASED ON THIS FEE BASED
APPROACH TO FIND AND EXPAND THIS
PROGRAM.
IT'S RATHER BAFFLING THAT WE
HAVE A STATE FUNDED AND STATE
RUN PROGRAM THAT PROVIDES
INFORMATION THAT'S READILY
AVAILABLE ON THE PRODUCT LABEL.
IT WAS ASKED AT THE ASSEMBLY
HEARING WHETHER THERE WOULD BE
ANY DIFFERENT INFORMATION THAT
WOULD BE FOUND ON THIS DATABASE
THAT COULDN'T BE FOUND ON THE
PRODUCT LABEL AND THE ANSWER IS
NO NOTS THE REALITY.
WE ARE NOT HERE ASKING FOR THE
ELIMINATION OF THE PROGRAM BUT
WE ARE VERY MUCH OPPOSED TO THE
EXPANSION OF THIS PROGRAM ON THE
BACKS OF MANUFACTURES.
THE REALITY IS THAT THE INDUSTRY
IS COME A REALLY LONG WAY WE
HAVE EMBRACED TRANSPARENCY IN
MANY WAYS LIKE I SAID WE LIST
ARE INGREDIENTS HONOR LABELS
THOSE OF THE PRODUCTS THAT ARE
AVAILABLE DIRECTLY TO CONSUMERS.
AND LAST YEAR WE DID SOMETHING
THAT WAS RATHER UNPRECEDENTED
WHERE WE EMBRACED
A TRANSPARENCY MEASURE TO
PROVIDE INGREDIENT DISCLOSURE
FOR. PROFESSIONAL COSMETICS AND
WE UNDERSTAND THAT BACKING TWO
THOUSAND FIVE MINUTES BEFORE HE
FOUR WAS ENACTED. THE THE ONE OF
THE MAJOR COMPONENTS OF THE BILL
WAS TO PROVIDE SAFETY AND
INFORMATION TO SALON WORKERS AND
SO THERE WAS A BILL LAST YEAR A.
B. FIFTEEN SEVENTY FIVE KALRA.
THAT CALLED FOR IN GREETING
DISCLOSURE OF THOSE CATEGORIES
OF PRODUCTS WE CAME WE SUPPORTED
THAT BILL WE REMAIN COMMITTED TO
SUPPORTING AGAIN THIS YEAR.
THE STATE HAS ALSO COME A LONG
WAY WE'VE ENACTED A NUMBER OF
PROGRAMS TO REGULATE THESE
PRODUCTS.
AND I KNOW THIS IS BEEN A
REALLY LONG HEARING MISTER CHAIR.
SO I WOULD JUST KEEP IT BRIEFLY
WE'VE ENACTED GREEN CHEMISTRY
BACK IN TWO THOUSAND EIGHTEEN
EXTENSIVE REGULATORY AUTHORITY
THEY'VE NAMED OUR PRODUCTS AS
PART OF THE TWO THOUSAND
EIGHTEEN TWO THOUSAND TWENTY
WORK PLANS THEY WILL BE LOOKING
AT. OUR PRODUCTS THEY WILL HAVE
REGULATORY AUTHORITY TO MANDATE
SAFER FORMULATIONS THAT AS A
MEANS TO AN END. NOT A DATABASE
THAT REPLICATES WHAT YOU CAN
ALREADY FIND ON PRODUCTS FOR
THOSE REASONS.
WE OPPOSE.
OKAY CAN I GIVE YOU SOME EXTRA
TIME AND FAIRNESS
THROUGH SINCE THE PRISONERS HAD
CHANCE TO GIVE A.
PRESENTATIONS SO BUT IF WE CAN
ASK EVERYONE ELSE TO KEEP TO A
MINUTE.
IF YOU MISTER SIERRA DAWN KEPT
HERE ON THE Q. CAPTAIN
ASSOCIATES ON BEHALF THE
CALIFORNIA MANUFACTURERS AND
TECHNOLOGY ASSOCIATION ALSO
REGRETTABLY OPPOSED
PUZZLE. ADEN WOULD ECHO THE
COMMENTS BY MISLEAD EYES WHILE
IT JUST INDICATES ON THAT
RELATED TO THE CHEMICALS
REQUIRED VIA. NOTIFIED ONTO
DEPARTMENT UNDER THIS PROGRAM
THOSE ARE CHEMICALS THAT ARE
ALSO COVERED UNDER PROP SIXTY
FIVE I MEAN ALTHOUGH PROP SIXTY
FIVE IS NOT UNNECESSARILY ON
SOMETHING YOU OFTEN DISCUSS AS
PART OF THIS SUBCOMMITTEE. I
CERTAINLY IDEAS RELEVANT
RELATIVE TO THE CARCINOGENS AND
REPRODUCTIVE TOXICANTS AT THE
PROGRAM COVERS UNDER THAT
PROGRAM AS YOU WELL KNOW OUR
REQUIREMENTS TO WARREN HI
RELATIVE TO. AYE EXPOSURES AND
WE THINK THAT AS FAR AS ON THAT
PROGRAM GOES THERE IS OVERLAP
AND POSSIBLY DUPLICATION WITH
THIS PARTICULAR PROGRAM FURTHER
THAT PROGRAM UNDER A NEW
APPROACHES THAT THEY'RE TAKING
BASED ON RECENTLY ADOPTED
REGULATIONS. ARE PROVIDING MORE
CONTEXT FOR THOSE CHEMICALS
RATHER THAN JUST A NAME
AND I KNOW FOR THE CONTEXT AS TO
WHAT THERE. ARE PARTICULAR
BENEFIT A REASON FOR A CHEMICAL
BEING INCLUDED SUCH AS A
SUNSCREEN PROTECTION MIGHT HOW
BILL AS A BELLOWS REASONS
ANOTHER SO WE APPRECIATE YOUR
TIME AND MUST OPPOSE. THANK YOU
THANK YOU WELCOME. IDENTICAL
KENYATTA'S ON BEHALF OF THE
HOUSEHOLD AND COMMERCIAL
PRODUCTS ASSOCIATION AND THE
INTERNATIONAL FRAGRANCE
ASSOCIATION OF NORTH AMERICA WE
ARE ALSO OPPOSE I JUST ONE MORE
POINT ONE I'D APPRECIATE THAT
THE PROPONENTS. HAVE.
OFFERED A THIRTY DOLLAR FEE
SORT OF.
AS PART OF PROPOSAL HOWEVER THE
LANGUAGE THAT'S BEEN OFFERED TO
THE COMMITTEE I AM IS MUCH MORE
BROAD AND SIMPLY STATES THAT THE
DEPARTMENT OF FINANCE COULD
ASSESS A FEE ANNUALLY OR WOULD
REQUIRE THEM TO SAYS AVI
ANNUALLY WITH NO CAP SO. I'M
SIMILAR COMMENT THANK YOU.
THANK YOU.
WELCOME.
I CARE BANKING ON THE FOUNDER OF
A JUICE BEAUTY IN ORGANIC BEAUTY.
PRODUCTS COMPANY THANK YOU FOR
THE CALIFORNIA BALLOT PRODUCTS
ACT WOULD LOVE THAT. AND I'M
HERE IN SUPPORT OF.
THAT THE.
SAFE COSMETICS ACT IT IS
POSSIBLE TO.
FORMULATE IN A HEALTHIER WAY
WITHOUT ALL THE CHEMICALS THAT
ARE OUTLINED IN PROP SIXTY FIVE
SO WE USE THE DATABASE
EXTENSIVELY. OF BEAUTY COUNTER
WAS ALSO HERE FROM SOUTHERN
CALIFORNIA BUT THEY HAD TO LEAVE
SO.
THEY ARE ALSO IN SUPPORT OF THE.
ACT THANK YOU THANK YOU THANK
YOU.
WELCOME.
I DO WE SET THAN FLEET ON BEHALF
OF A NUMBER OF ORGANIZATIONS
HAVE ALREADY HAD TO LEAVE.
SO IN BRIEF.
NATURAL RESOURCES DEFENSE
COUNCIL CLEAN WATER ACTION
WOMEN'S VOICES FOR THE EARTH
TEENS TURNING GREEN. THE HEALTH
A NAIL SALON COLLABORATIVE WORK
SAFE POSITIONS FOR SOCIAL
RESPONSIBILITY SAN FRANCISCO BAY
AREA BLACK WOMEN FOR WELLNESS
AND THE CALIFORNIA LEAGUE OF
CONSERVATION VOTERS IN STRONG
SUPPORT OF THIS PROPOSAL.
AND JUST VERY QUICKLY FOR THOSE
PEOPLE SHOPPING ONLINE THE
PROPOSITION SIXTY FIVE WARNINGS
AND THE INGREDIENT LABELS ARE
NOT ALWAYS VISIBLE SO THIS
DATABASE IS EXTREMELY IMPORTANT
FOR THOSE DOING COMPARISON
SHOPPING AND RESEARCH. TO GET
INFORMATION
ABOUT TOXIC CHEMICALS IN THESE
PRODUCTS THANK YOU. THANK YOU.
WELCOME.
GIVE CATHARINE BATES
REPRESENTING INVESTOR
ENVIRONMENTAL HEALTH NETWORK IN
STRONG SUPPORT.
THANK YOU.
THANK YOU WELCOME. THOUGH SUSAN
LITTLE WITH THE ENVIRONMENTAL
WORKING GROUP ALSO HERE ON
BEHALF OF THE CAP ON COALITION.
TO MAKE HELP HEARD THE
CALIFORNIA PRODUCT STEWARDSHIP
COUNCIL. AND THE.
CENTER FOR ENVIRONMENTAL HEALTH
ALSO IN SUPPORT THINK.
THANK YOU.
SO I ACTUALLY JUST HAVE A GOOD
SELF OFTEN I'VE REALIZED
DEPARTMENT. DIDN'T REALLY HAVE A
COMMENT ON THE PROPOSAL BUT IN
TERMS OF THE CAPACITY OF THE
DEPARTMENT TO PERFORM THE
FUNCTION.
DOES REFERENCE SERVICE SAY HEY
BUDGET CUT.
.
YEAH THAT THERE WASN'T THE BCP
FROM THE DEPARTMENT ON THIS SO
WAS THAT CAN CAN PERHAPS COMMENT
ON ON THE CAPACITY OF THE
DEPARTMENT TO PERFORM THE
FUNCTION NOW. TERMS OF THE
STAFFING NECESSARY TO CARRY OUT
THE FUNCTIONS OF.
OF THE ACT OF THE ACT.
YES SIR AND FOR THE RECORD THIS
IS A MONEY COME AROUND AS YOU
KNOW WE HAVE TO STAFF THAT WORK
IN THIS PROGRAM AND AND YOU KNOW
THE WE ARE ACTIVELY JUST TRYING
TO MANAGE THE DATABASE. FOR THE
COMPANIES AND FOR THE CUSTOMERS
ON THAT ONE TO ACTUALLY GO
ONLINE AND SEARCH THE DATABASE
SO. AT THIS POINT WE YOU KNOW.
.
TRIED EXIST IT TROUBLESHOOT SOME
OF THE ISSUES THAT WE'RE FACING
WITH THE WEBSITE.
I'M IN REPORTING AND WORKING
WITH OUR IT TO ALSO TRY TO FIND
SOME OTHER ON SOLUTIONS TO
UPGRADE OUR CURRENT IT OF THE
SYSTEM SO.
I THINK YOU KNOW TOGETHER WITH
THE TO STAFF WE WERE TRYING OUR
HARDEST JUST KIND OF MEET THE
DEMAND.
BUT THAT WASN'T EXACTLY AN
ANSWER TO THE QUESTION.
BUT.
ARE A.
.
SO ONE OF THE COMMENTS WAS MADE
WAS THAT ESSENTIALLY LUIS IS THE
SAME AS YOU CAN FIND ON THE
BOTTLE.
ARE ON THE LABEL OR WHATEVER I
KNOW SOMEONE TESTIFIED TO SAYING
THAT WELL MAYBE HARD TO READ IT
BUT CAN YOU COMMENT ON THAT.
YEAH THAT'S A HOME AT THIS THIS
PROGRAM WAS CREATED SPECIFICALLY
TO PROVIDE CONSUMERS AND WORKERS
AND THE DEPARTMENT OF PUBLIC
HEALTH ANOTHER STATE AGENCIES
AND REGULATORS. WITH INFORMATION
ABOUT.
SIXTY FIVE CHEMICALS IN PRODUCTS
AND WELL THEY MIGHT APPEAR ON A
PRODUCT LABEL MOST OF US EVEN
THOSE OF US UNDER FORTY HAVE A
VERY HARD TIME FINDING. THOSE
INGREDIENTS ON THE PRODUCT LABEL
TO BEGIN WITH I MEAN THEY'RE
THEY'RE VERY SMALL IF YOU LOOK
AT SOME MAKE UP PRODUCTS.
YOU CAN BARELY EVEN SEE THE
PRODUCT LABELS YOU NEED A
MAGNIFYING GLASS TO DO SO.
PROFESSIONAL SALON PRODUCTS
AREN'T EVEN REQUIRED BY LAW TO
BEAR A DECLARATION OF THE
INGREDIENTS ON THEIR PRODUCT
LABELS.
THE PROP SIXTY FIVE CHEMICALS IN
THESE PRODUCTS ARE ALSO REPORTED
TO THE DATABASE WHICH WHICH
PROVIDES A REALLY IMPORTANT
RIGHT TO NO FUNCTION FOR THAT
COMMUNITY AS WELL.
THE OTHER THING I DO HAVE ONE
MORE THING.
ACTUALLY I'M SORRY AND THAT IS
THE A REALLY IMPORTANT FUNCTION
OF THE DATABASES TO AGGREGATE
ALL OF THIS INFORMATION SO WHILE.
YOU AND I MIGHT IF WE HAVE THE
THE THE GOOD EYESIGHT TO DO SO
BE ABLE TO FIND THE INGREDIENT
ON THE PRODUCT LABEL. BUT THAT
THE DATABASE DOES IS IT IS IT
PRESENTS A SNAPSHOT OF THE
OVERALL. A USE OF THESE PROP
SIXTY FIVE CHEMICALS IN PRODUCTS
SOLD IN THE STATE AND THEN THE
NUMBER OF PROP.
USING PROPS SIXTY FIVE CHEMICAL
SOLD IN THE STATE AND THERE'S
TWO NUMBERS THAT JUST REALLY I
FIND MIND BOGGLING. ESPECIALLY
IN RESPONSE TO WHAT THE
OPPOSITION SIDE WHICH IS THAT
THERE IS NO PROBLEM REAL PROBLEM
THAT PROGRAM IS TRYING TO
ADDRESS AND THAT IS THE FACT
THAT. SIXTY FIVE THOUSAND
PRODUCTS WERE REPORTED TO THE
SAFE COSMETICS PROGRAM BETWEEN
TWO THOUSAND AND NINE AND TWO
THOUSAND AND FIFTEEN.
CONTAINING EDTA INDIVIDUAL
UNIQUE PROP SIXTY FIVE CHEMICALS
AND I HAVE THIS FACT SHEET WHICH
I COULD LEAVE WITH YOU.
IT SHOWS.
THERE'S ONE PRODUCT HERE THAT
CONTAINS TEN DIFFERENT PROP
SIXTY FIVE CHEMICALS.
IT THEY'RE END NUMEROUS
CHEMICALS MANY CONSUMERS DON'T
KNOW WHICH OF THE CHEMICALS THE
PROP SIXTY FIVE CHEMICALS THAT
THEY SHOULD BE CONCERNED ABOUT
SO IT SHINES A LIGHT ON THE
PRESENCE OF THESE.
PARTICULARLY TOXIC CHEMICALS.
AND I WOULD ECHO THAT I WOULD
SAY MOST PATIENTS ASSUME
EVERYTHING IS SAFE WE A CUT
BECAME INVOLVED WITH THIS WHEN
THE LEGISLATORS PHONE DOESN'T
SAID. WHAT'S A CUT POSITION
UNLEADED LIPSTICK AND OUR
RESPONSES WE HAD NO IDEA THERE
WAS LETTING LIPSTICK. THAT WAS
JUST THE TIP OF THE ICEBERG
PATIENTS DON'T READ A LABEL ON
LIPSTICK NOR DO THEY READ MOST
OF THE LABELS NOW YES WE CAN SAY
THAT'S THEIR PROBLEM THEY SHOULD
KNOW. THAT THERE ARE ALL THESE
CHEMICALS IN IT.
BUT IF WE HAVE A MEANS OF
LETTING THEM KNOW THAT THERE'S
THEY SHOULD BE AWARE THAT SOBRE
COMPLICATING.
IT IS ONE OF THE COMMON AS IT
MAKES AND I REALIZE IT.
THE OBVIOUS TEXAS EAST BASED ON
DOES RIGHT IT'S NOT JUST NEARLY
EASE THE EXISTENCE OR LACK IN
THEIR THINGS A VIOLENT OF IRON
ANDSO I'VE SIMILAR WE'RE
TALKING ABOUT IS.
THE ABSORPTION RATES ARE YOU
KNOW EXPOSURE AT AT DOSES THAT
THAT WOULD ACTUALLY BE
CONCERNING.
IN THE IN THE IN A CONCISE IS
PROBABLY THE MOST IN DEPTH
ANALYSIS OF THAT M. PUBLISHED
NOW TWICE WHEN THEY TALK ABOUT
AND IT CAN DISRUPTING. CHEMICALS THAT WE SHOULD BE AWARE OF WHAT
THEY WERE TALKING ABOUT THE
LIBRARY DISEASE ADAM INFERTILITY.
CHANGING IN SPERM COUNTS A
NUMBER OF DIFFERENT CONCERNS.
CAN YOU SHOW CAUSE AND EFFECT
THAT ONE PERSON USING THIS HAIR
PRODUCT WILL DEVELOP CANCER NO.
NO THAT'S NOT POSSIBLE BUT CAN
WE LOOKED IN AGGREGATE AND SAY
THAT WE'VE SEEN DISEASE
PROCESSES INCREASE OVER TWENTY
TO THIRTY YEAR TYPE BEARD WITH
THOSE CHEMICALS ARE BEING
PRODUCED WEEKEND.
AND WE ALSO DO KNOW THAT BUT
THERE IS A GROWING BODY OF
EVIDENCE THAT SHOWS THAT
CUMULATIVE EXPOSURES TO THESE
CHEMICALS ARE IN FACT GETTING UP
TO HARM.
AND NONE OF US LIVE IN A BUBBLE
SO AN INDIVIDUAL A BABY IS AND
EXPOSED TO FORMALDEHYDE JUSTIN
HER BUBBLE BATH SHE MIGHT BE
EXPOSED TO THE SAME CHEMICAL. IN
NAM IN A BODY WASH AND IN A
SHAMPOO AND ALSO IN THE CLEANING
PRODUCTS USED IN HER HOME. AND
IN THE THE FLOORING AND THE
BUILDING MATERIALS SO THE LIST
REALLY GOES ON AND ON WE'VE SEEN
NOT ONLY CUMULATIVE EXPOSURES
LINK TO HARM BUT ALSO THE TIMING
OF EXPOSURES.
A RESULTING IN AN INCREASED RISK
OF DISEASE LATER IN LIFE.
BUT OUT OF SOME BIG NOTE THAT
FOR EXAMPLE FORMALDEHYDE IS
ACTUALLY A NATURAL METABOLIC
PRODUCT OF THE BODY AS WELL I
MEAN IT DEPENDS ON THE DOES HOW
MUCH EXPOSURE YOU HAVE THEN IT
YES IT CAN BE CUMULATIVE TO SELL.
SO I THINK WE HAVE TO GO BEYOND
JUST SIMPLY SAYING ó LOOK
THERE'S SOMETHING WITH THE SCARY
NAME IN THE.
THEN AND WE HAVE TO THINK ABOUT
LEVEL EXPOSURE ON YOUR RIGHT TO
LIVE EXPOSURE IS SOMETHING WE
SHOULD THE.
THAT IS SOMETHING THAT. NEEDS
TO BE ADDRESSED AND I WOULD
ARGUE THAT THE THERE ARE I MEAN
WE DON'T HAVE THE RESEARCH
STUDIES THAT WE CAN WE CAN GIVE
THEM TO YOU. BUT THERE CERTAINLY
ARE A NUMBER OF STUDIES THAT
HAVE LOOKED AT NOT JUST
CUMULATIVE BUT THE IMPACTS ON
HEALTH NATIONAL INSTITUTE OF
ENVIRONMENTAL HEALTH SCIENCES.
IS BY THE MOST IMPORTANT
ORGANIZATION FOR PROVIDING SOME
OF THAT RESEARCH FOR US
ON CAREER DR CONNERY WAS
REFERRING TO SOME OF THE NEW
SCIENCE TALKING ABOUT LOW DOSE
EXPOSURES BECAUSE DOCTOR PAN
YOU'RE RIGHT. NOT EVERY EXPOSURE
IS GOING TO RESULT IN A IN A
DISEASE.
TO THAT THE HOUSE OR TRADE
ASSOCIATED WITH THAT CHEMICAL ON
THE OTHER SIDE.
BUT THE DOSE MAKES THE POISON
HAS REALLY BEEN TURNED ON ITS
HEAD WHEN IT COMES TO THESE
ENDOCRINE DISRUPTING COUNT
POUNDS. BETTER TOXIC AT
SOMETIMES AT PARTS PER BILLION
OR PARTS PER TRILLION. BPA FOR
EXAMPLE CAN CROSS.
THE PLACENTA AND IMPACT THE
MAMMARY GLANDS OF THE DEVELOPING
FETUS AT PARTS PER BILLION OR
PARTS PER TRILLION.
PREDISPOSING THAT THAT FETUS
THAT DEVELOPING FETUS TO AN
INCREASED RISK OF BREAST CANCER
OF LATER AND I WAS LIKE A
SENSUAL OILS HAVE JUST BEEN AND
THAT IDENTIFIED AS YOU KNOW
CAUSING KIND OF PANIC.
POTENTIALLY PERHAPS GANIC MASIUS
SELF WILL AND THAT'S A GOOD
POINT BECAUSE THE OTHER THING
THE SAFE BECAUSE.
AUTHORIZES IS FOR THE SAFE
COSMETICS PROGRAM TO INVESTIGATE.
BOTH THE CHEMICALS AND THE
PRODUCTS AND THE EXPOSURE
POPULATIONS AND THEN MAKE
RECOMMENDATIONS TO OTHER STATE
AGENCIES AS TO HOW TO PROVIDE A
HARD.
WORKERS FOR EXAMPLE OR TO TO
YOUNG PEOPLE INFANTS PREGNANT
WOMEN EXCITE AURA.
I THINK WE JUST HAVE TO BE
CAREFUL ABOUT OUR LANGUAGE.
AND I I WOULD SAY THAT A COG IN
THE A CUT IN THE WORLD COLLEGE
CAME OUT WITH THEIR COMMITTEE
OPINION IN THE SAME YEAR. AND
BOTH OF US MET AND SAID. WE HAVE
TO.
INCREASED AWARENESS WITHOUT THE
ALARM AND AS OBSTETRICIANS WE
KNOW ANYTHING WE SAY CAN SCARE
PATIENTS THAT HAVE TO BE
CAUTIOUS AND HOW YOU SAY IT. BUT
I'LL TELL YOU THE QUESTION I GET
ASKED ALL THE TIME IS.
WHAT SHOULD I BE DOING WHILE I'M
PREGNANT?
WHAT CHEMICALS YOU KNOW WHAT
PRODUCTS WITH SAFE?
WELL.
THE PEDIATRICIAN IDEA THAT'S THE
ROCKETS TO SELL. THAT'S GREAT
AND THAT'S A REALLY NICE
CONCLUDING THOUGHT WHICH IS THE
SAFE COSMETICS PROGRAM ISN'T
USED.
FORNEY CONSUMERS AND.
IT'S IT'S SEEN AS A NATIONAL
TREASURE BY BY PEOPLE THROUGHOUT
THE COUNTRY THAT ARE REALLY
CONCERNED.
ABOUT INCREASING EXPOSURES TO
TOXIC CHEMICALS AND THE LINK
BETWEEN INCREASING RATES OF
DISEASE AND WANT TO DO SOMETHING
ABOUT THE PROBLEM.
OKAY WELL WE'RE GONNA HOLD ITEM
OPEN. AND.
.
GO AHEAD AND MOVE ONTO.
THANK YOU FOR YOUR TIME THANK
YOU AND GIVE.
ISSUE NUMBER SEVEN.
WHEN INFANTS CHILDREN LOOK
LISTEN ESTIMATE
.
ONE.
HELLO I'M CONNIE MITCHELL.
OKAY.
I'M THE DEPUTY DIRECTOR OF THE
CENTER FOR FAMILY HEALTHY AND
YOU'RE GOING TO BE HEARING TODAY
FROM NOW ON EACH OF OUR
DIVISIONS WE HAVE THREE
DIVISIONS OF THE CENTER FOR
FAMILY HELPED. BY THE WEAK
DIVISION WILL BE PRESENTING
THEIR ESTIMATE.
WICCAN AT SUB AT THAT SRONG
FOCUS ON PROVIDING ACCESS TO
HEALTHY FOODS HILL HERE FROM OUR
HOME VISITING PROGRAM WHICH IS
EARLY UPSTREAM INTERVENTION FROM
ALL THE ROLE WOMEN. AND FINALLY
OUR GENETIC THE SECURITY PROGRAM
TAX AMERICAN JUST DO
INTRODUCTIONS FIRST.
LESLIE CALLOUSLY CHIEF OF THE
NCA EACH DIVISION.
RICHARD ONLY CHIEF OF THE JOHNS
THE SCREENING PROGRAM.
CHRISTINA OLSEN CHIEF OF THE
WEAK DIVISION OF PUBLIC HEALTH.
THANK YOU AND WE CAN PROCEED
SHOULD NUMBER SEVEN ACCESS ISSUE
NUMBER SEVEN PLEASE ACT THINKING.
SO YOU HAVE ASKED THREE
QUESTIONS ABOUT THE WITH PROGRAM
AND THEY WILL LEAD WHAT
PERFECTLY ONE INT THE OTHER
SELF ON DISK PRIME GIVE YOU A
QUICK UPDATE.
I'M THE WOULD PROGRAM WE OF
COURSE HIS YOU KNOW RECEIVES
FEDERAL DOLLARS FROM THE US
DEPARTMENT OF AGRICULTURE AND WE
HAVE SUFFICIENT FEDERAL FUNDING
TO CONTINUE TO OPERATE THE
PROGRAM WITH NO IN.
GENERAL FUND.
IN ADDITION TO FEDERAL DOLLARS
FROM USDA WE ALSO RECEIVE A
REBATE FUNDS FROM THE CONTRACTED
INFANT FORMULA MANUFACTURER AND
WE MUST SPEND THOSE REBATE
DOLLARS FIRST ON OUR FOOD BEFORE
WE CAN TAP INTO FEDERAL DOLLARS
FOR FOOD.
COST DRIVERS FOR THE PROGRAM FOR
FOOD COSTS ARE PROGRAM
PARTICIPATION AND INFLATION ON
FOOD COSTS.
AB FOR THE BUDGET YEAR SUE ME
FOR THE IN THE BUDGET ACT WE HAD
ESTIMATED THAT WE WOULD SPEND
EIGHT HUNDRED SEVENTY FOUR
MILLION DOLLARS ON FOOD. AND
THIS ESTIMATE REVISE IS THAT THE
CURRENT YEAR FIVE TO EIGHT
HUNDRED AND THIRTY TWO MILLION
FOR FOOD AND EIGHT HUNDRED AND
NINETEEN MILLION IN THE BUDGET
YEAR.
THE BUDGET YEAR THAT ESTIMATE
INCLUDES FIVE HUNDRED EIGHTY
EIGHT MILLION DOLLARS FROM THE
FEDERAL FUND AND TWO HUNDRED AND
THIRTY ONE DOLLARS FROM OUR
REBATE FUNDS.
THERE IS NO CHANGE YOUR ESTIMATE
FOR OUR A LOCAL SERVICES THAT
HAVE THREE HUNDRED ONE MILLION
DOLLARS AND A MINOR ADJUSTMENT
TO OUR STATE OPERATIONS.
CALIFORNIA WHICH SERVES JUST
OVER ONE MILLION PARTICIPATION
PARTICIPANTS EACH MONTH AND THAT
NUMBER HAS BEEN DECLINING SINCE
TWENTY TWELVE.
I'M EACH YEAR THE US DEPARTMENT
OF AGRICULTURE PREPARES A REPORT
ESTIMATING THE WITH ELIGIBLE
POPULATION AND COMPARES THAT
ACTUAL NUMBER OF PRETTY
DEPENDS SERVED.
AND THE RESULTING PERCENTAGES
CALLED THE PROGRAM REACH.
CALIFORNIA CONTINUES TO HAVE THE
HIGHEST PROGRAM REACH OF ALL
DECLINING IN THE PAST YEARS.
THE MOST RECENT REPORT FROM USDA
WAS JUST RELEASED AND OF
FEBRUARY AND IT'S LOOKING AT
TWENTY FIFTEEN DATA.
CALIFORNIA'S PROGRAM REACH WITH
SIXTY FIVE PERCENT OF THE
ELIGIBLE POPULATION WHILE THE
NATIONAL AVERAGE WAS FIFTY TWO
PERCENT.
AT LAST YEAR'S REPORT WE WERE AT
SEVENTY ONE PERCENT ARM PROGRAM
REACH SO NOT ONLY ARE NUMBERS
DECLINING BUT OUR PROGRAM
REACHES DECLINING WHICH. IS A
SIGNIFICANT ISSUE FOR US.
THE USDA REPORT AB PRODUCES THIS
REPORT JUST AT THE STATE LEVEL
AND WE WANTED TO DIG DOWN DEEPER
SO A FEW YEARS AGO WE PARTNER
WITH MATERNAL. CHILD AND
ADOLESCENT HEALTH THEY HAVE A
GREAT EPIDEMIOLOGISTS TEAM. AND
THEY'D PREPARED A METHODOLOGY TO
TAKE THAT USDA PROCESS AT THE
LOCAL LEVEL WITH IN CALIFORNIA
SO WE WERE ABLE TO. ESTIMATE THE
PROGRAM REACH MORE AT THE COUNTY
LEVEL.
THE LAST TIME THAT WE DID THAT
WAS LOOKING AT BELIEVE IT WAS
TWENTY ELEVEN DATA AND SO WERE
UPDATING IT THIS YEAR TO LOOK AT
MORE RECENT DAVIS WILL ALSO HAVE
TWENTY FIFTEEN DATA. TO BE ABLE
TO CONNECT WITH THE USDA REPORT.
AND ONE LAST THE LAST TIME THAT
WE SAW WE SAW QUITE A VARIATION
ACROSS THE COUNTIES. IN
CALIFORNIA SO IT'S REALLY
IMPORTANT FOR US AND HOW WE
TARGET OUR OUR EFFORTS TO
IMPROVE PARTICIPATION.
WE'D LOOK WHEN WE DO OUR WORK
TO INCREASE PROGRAM
PARTICIPATION WE LOOK AT THREE
DIFFERENT CATEGORIES OF
INDIVIDUALS.
THE FIRST IS RETAINING OUR
ACTIVE PART
OFFENSE.
SECOND IS RE ENGAGING FAMILIES
THAT ARE CURRENTLY CERTIFIED IN
WHAT PROGRAM BUT NOT COMING IN
ACTIVELY TO RECEIVE THEIR TAX.
SO WHAT THE USDA COUNTS AS A
PARTICIPANT IS SOMEBODY THAT IS
NOT JUST CERTIFY BUT ACTUALLY
COMING IN ON A BREAK.
IT'S TO THE
TO PICK UP THEIR CHECKS.
AND ALASKA A CATEGORY IS
RECRUITING ELIGIBLE FAMILIES AND
IT'S IMPORTANT TO NOTE THAT
THOSE FAMILIES THAT ARE ELIGIBLE
NOT CERTIFIED. THEY MAY BE
COMPLETELY NEW TO WORK OR THEY
MAY HAVE BEEN PREVIOUS WITH
PARTICIPANTS PERHAPS THE CHILD
IS NOW THREE OR FOUR YEARS OLD
AND THEY'VE DROPPED OUT OF THE
PROGRAM OR THEY'VE.
.
SO THAT'S IT IMPORTANT THING
WHEN WE TALK ABOUT OUR OUTREACH
MESSAGING.
ARE THREE KEY STRATEGIES.
THE FIRST AREA IS DATA AND
RESEARCH.
SECOND AS OUTREACH AND THIRD IS
REVIEWING THE PROGRAM TO IMPROVE
UPON.
HALF OF THE PROGRAM THAT.
SO LOOKING AT DATA THERE'S A
NUMBER OF THINGS THAT WE'VE BEEN
DOING ANALYZING TRENDS
CONDUCTING STUDIES TO UNDERSTAND
THE REASONS WHY PEOPLE DO NOT
COME. TO WAKE OR STAY IN WAKE
AND THERE'S ALSO A NUMBER OF. OF
OUR PARTNERS OF DIFFERENT ABBASI
GROUPS AND FEDERAL PARTNERS THAT
ARE LOOKING AT THE SAME
QUESTIONS.
WE'VE PROVIDED DATA AND GEO
MAPPING TOOLS TO OUR LOCAL
AGENCIES. WE'VE FUNDED LOCAL
AGENCY PROJECTS WHO CONDUCTS AND
EVALUATE INNOVATIVE PROJECTS AS
WELL SO A FEW YEARS AGO YOU STA
OFFERED A GRANT FOR THAT. WAS A
VERY SMALL.
LEVEL OF NUMBER OF OF GRANTS
THEY WOULD GIVE NATIONALLY IN A
VERY SMALL DOLLAR AMOUNT AND
WE'VE KIND OF TOOK THAT.
PROCESS AND REPLICATED IT TO BE
MUCH BROADER WITHIN CALIFORNIA.
WE'RE ALSO DOING A LOT OF WORK
IN OUTREACH TO CONTINUE TO
SUPPORT LOCAL LOCAL OUTREACH
EFFORTS AND EXPANDING OUR STATE
LEVEL OUTREACH EFFORTS.
WE'VE DEVELOPING NEW
PARTNERSHIPS AND MESSAGING
ENSURING THAT WE'RE RESPONSIVE
TO WHAT WE LEARN FROM THE
RESEARCH ABOUT REASONS WHY
PEOPLE DON'T COMMERCE STAY IN
THE WITH PROGRAM. AND WE'RE
CONTINUE TO PARTNER WITH THE COW
FRESH PROGRAM ON OUTREACH
STRATEGIES AS WELL.
LASTLY WE'VE BEEN MAKING THE OF
REVIEWING OUR PROGRAM AND MAKING
FOR IMPROVEMENTS TO REDUCE
BARRIERS. OR MAKING ENROLLMENT
PROCESS MORE EFFICIENT REVIEWING
STATE POLICIES AND PROCEDURES TO
REDUCE ACCESS TIME WHILE
MAINTAINING MAINTAIN PROGRAM
INTEGRITY. MODERNIZING
COMMUNICATION WITH FAMILIES M.
ACCRETING NEW OR UPDATING
NUTRITION EDUCATION CLASSES A
MATERIAL SO THAT ONE FAMILIES
COMING TO WAKE THEY'RE NOT
SAYING THE SAME COSTS THAT
PERHAPS THEY SAW A YEAR AGO OR
TWO YEARS AGO WITH THE PREVIOUS
TROUT. AND CONTINUE TO FOCUS ON
TRAINING ON THE LOCAL AGENCY
STAFF SO THAT THE CUSTOMER
SERVICE THAT CLIENTS RECEIVED IS.
IS OF UTMOST QUALITY WHILE.
THANK YOU A INCOMES ILIO FINANCE.
SO.
JUST
SO.
GIVEN THE DATA MAYBE I MISSED IT
WHEN HE SAID THAT WHAT IS THE
FORTY THINK IS THE BIGGEST
FACTOR IN THE DECLINE AND
PARTICULARLY THE UP PERCENTAGE.
YOUR REACH FACTOR AND. THERE'S
A NUMBER OF REASONS AND
UNFORTUNATELY IT'S NOT ONE.
REALLY CLEAR ANSWER THERE WASN'T
THERE HAS BEEN SOME STUDIES
ABOUT WHITE PEOPLE THAT WERE
ELIGIBLE FOR WAKE DID NOT IN
ROLL. THAT BATES TO QUESTIONS
THERE IS THE BIGGEST RESPONSE
THE MOST COMMON RESPONSES OR. I
DIDN'T THINK I WAS ELIGIBLE SO
ONE OF THE THINGS THAT WE WANT
TO FOCUS ON IS WORKING FAMILIES
MAKING SURE THAT THEY KNOW THAT
THEY MIGHT THEIR OWN SELF
PERCEPTION OF JAIL OUR OWN SELF.
AND THEN THE SECOND PIECE WHICH
IS REALLY INTERESTING IS THEY
DIDN'T FEEL THAT THEY NEED AT
THE PROGRAM OWE IT AND.
THE ME HA MATERNAL INFANT
HEALTH ASSESSMENT QUESTIONNAIRE
THAT ALSO MC H. CONDUCTS.
THEY ASKED THE QUESTION OF
PREGNANT WOMEN OR WOMEN THAT
HAVE GIVEN BIRTH.
THAT WERE WITH THEIR. DELIVERY
WAS COVERED BY MEDICARE SO WHY
DID YOU ENROLL IN WAKE WHEN YOU
WERE ELIGIBLE FOR WAKE.
AND THEY SOME OF THEM SAID THEY
DIDN'T NEED THE PROGRAM BUT THEY
ALSO MIGHT ANSWER ANOTHER
QUESTION THAT SAYS YES THEY DO
EXPERIENCE FOOD INSECURITY.
SO THAT'S VERY.
PROCESS VERY INTERESTING
RESPONSE THERE SO WE NEED TO
CONTINUE TO MESSAGE TO FAMILIES
THAT WORKING FAMILIES ARE.
ELIGIBLE FOR THE PROGRAM HOW DO
WE AND HOW DO WE CREATE.
.
RESOLVE THOSE MANY PEOPLE HAVE
TIME DATE I MEAN IS THAT AND
BECAUSE HE SAID IT'S DECLINING
SO IT'S THEIR SHIFTING ATTITUDE
THAT'S CHANGING OUR AYE OF ARE
YOU ONLY HAVE ONE POINT TIMES
THAT'S WHEN THAT INTERVIEW THAT
WAS A THAT WAS ONE PARTICULAR.
SURVEY ASKING OKAY PRIVATELY
OWNED Y. THEY DIDN'T ENROLL
ANOTHER PIECE THAT HAS BEEN
CHANGING AS THAT GAP OF.
FAMILIES THAT ARE CERTIFIED BUT
NOT COMING IN FOR THE CHECKS
THAT THAT GROUP IS GROWING AS
WELL.
OKAY.
ALRIGHT I DECIDED EMPATHIZES
WITH REDUCTION IS HAPPENING ALL
ACROSS THE COUNTRY SO ALL OTHER
STATE SAY HOW'RE YOU DOING SO
GOOD.
DON'T THINK THAT WE THINK
THERE'S A LOT OF ROOM FOR
IMPROVEMENT BUT THAT'S THE SAME
PHENOMENA ALL ACROSS THE COUNTRY
THERE'S A SOLELY IN SOME KIND OF
SECULAR TREND THAT'S GOING ON.
THAT'S OKAY THAT MAY BE
HAPPENING ACROSS THE COUNTRY IN.
BIRTH
SO ARE DECLINE SIMILAR TO THAT
OF OTHER STATES INTERNET RATE.
OKAY.
ALRIGHT WELL GET SOME WORK TO DO
THERE.
ALRIGHT.
AT ANY COMMENTS. OKAY PUBLIC
COMMENT.
BUT HEARING FARLEY WITH THE
CALIFORNIA WITH ASSOCIATION
ASSOCIATION FOR THE EIGHTY THREE
AGENCIES.
AND WE APPRECIATE THIS
DISCUSSION ON THE DECLINE IT'S
VERY CONCERNING AND SOMETHING
THAT WE HAVE TO REMEMBER IS WITH
ASSOCIATED WITH A VERY IMPORTANT.
HEALTH OUTCOMES.
AND THESE ARE PROBABLY ALREADY
ERODING IF WE'VE HAD FIVE YEAR
DECLINE.
LOW BIRTH WEIGHTS PRETERM BIRTHS
ANEMIA. CHILDHOOD OBESITY THESE
ARE THINGS THAT WHAT REALLY
CREDITED WITH IT WITH IMPROVING.
VOTE RELEVANT TO YOUR COMMITTEE
WHAT I'D LIKE TO POINT OUT. IS A
LOCAL AGENCIES ARE VERY
CONCERNED ABOUT THE TYPE OF
CONTRACT THEY HAVE WITH THE
STATE DEPARTMENT OF PUBLIC
HEALTH IT'S QUITE RESTRICTIVE.
AND WITH DECLINING PARTICIPATION
WE HAVE TO BE REALLY AWARE THAT
WE'RE PROTECTING THOSE FEDERAL
DOLLARS IN THE LOCAL AGENCIES
CAN FULLY USE THOSE CONTRACTS
AND SPEND THEIR MONEY. WERE
AWARE.
THAT THE STATE USES SOME OTHER
CONTRACTS FOR OTHER PROGRAMS
THAT ARE PERHAPS MORE FLEXIBLE.
YOU WOULD ASK THAT SOME A
INVESTIGATION BE AYE.
HE PUT ON THIS TOPIC SO THAT.
THE LOCAL AGENCIES CAN BE
REASSURED THAT THEY CAN FULL USE
THEIR DOLLARS AND WE WOULD
RESPECTFULLY SUGGEST.
AN URGENCY TO THE US AND THAT
THE TRAILER BILL MIGHT BE A AN
AVENUE FOR ADDRESSING THIS
VEHICLE VERY SOON.
THANK YOU.
THANK YOU ANY COMMENTS FROM THE
DEPARTMENT ABOUT FLEXIBILITY AT
CHALLENGES THERE.
SO WE CERTAINLY HAVE HAD THIS
DISCUSSION FOR AWHILE WITH OUR
LOCAL AGENCIES AND.
ITEM WE FOLLOW AT THE CONTRACT
MODEL THAT IN A PUBLIC CONTRACT
CODE FOR CONTRACTS THAT ARE NOT.
ALLOCATED THROUGH COMPETITIVE
BID PROCESS AND MANY OF OUR
LOCAL AGENCIES ARE NOT COUNTY
HEALTH DEPARTMENTS AS WELL SO
THAT DOES.
CREATE AN ADDITIONAL CHALLENGE
WHERE THERE ARE SOME CONTRACT
MODELS THAT ARE ALLOWABLE IF ALL
THE AGENCIES ARE COUNTY HEALTH
DEPARTMENTS BUT WE ARE NOT ABLE
TO FOLLOW THOSE.
BECAUSE WE HAVE A LOT ABOUT HALF
OF OUR CONTRACTS ARE NOT WITH
COUNTY HEALTH DEPARTMENTS.
IN THIS MODEL OF CONTRACTING IS
THAT SOMETHING THAT'S RECENT
ARTS AND EVEN DOING THE SAME WAY
FOR EVER.
BETWEEN.
WE JEFF WE HAD TO CHANGE THAT
MODEL ABOUT FOUR YEARS AGO.
BEFORE YEARS OUT OF FOUR YEARS
AGO.
OKAY.
EN WELL AS IF THERE'S A SECULAR
TREND FOR DECLINE BUT THE THINK
IT HAS ANYTHING.
THE THINK THERE'S AN IMPACT OF
THAT TO CHECK ON WHAT THE
PREVIOUS MODELS BEFORE IS
CHANGED AND WHETHER IT WAS MORE
FLEXIBILITY HERE.
SO THE NEW I HAVE TO LOOK AT
THE NEW CONTRACT MODEL CAME
AFTER THE DECLINE HAD ALREADY
STARTED AND THE DECLINE AS
CONNIE HAD SAID THEY'D DECLINE
IS HAPPENING IN OTHER STATES AS
WELL.
IT'S
DOES NOT THINK ABOUT WHETHER YOU
KNOW.
MAYBE IT DOESN'T THAT I MEAN I'M
NOT SAYING TO THE CLIENTS
BECAUSE JUST BY THIS BUT YOU
KNOW THIS EXACERBATED DOES IT
CAUSE ANY ISSUES ARE WHATEVER
ELSE.
PAGE GOT TO RECOGNIZE IS ALWAYS
CHALLENGES WHEN YOU PUBLIC
DOLLARS IN.
ACTUALLY HAVE I GUESS IS A SOLE
SOURCE CONTRACT OF SORTS RIGHT.
NOW THAT THERE ALWAYS PRESENTS
SOME CHALLENGES TO IN TERMS OF
ACCOUNTABILITY AND SO FORTH BUT.
.
AND ASSURING THE PUBLIC.
BUT VIA ALSO LOOKS MORE.
MY THINK SINCE THEY. THINK ABOUT
THAT STUFF ALRIGHT.
A DESPITE WANTED OUT OF AT THE
TIME. I THINK THAT WE REALLY
NEEDED TO LEARN WHAT MIGHT BE
CONTRIBUTING TO THE DECLINE AND
SELL THE IDEAS FIRST TO REALLY
UNDERSTAND WHO IS A FIVE MINUTE
POPULATION THAT WE NEED TO
ADDRESS. HOW DO WE BEST REACH
THEM ONE OF THE KEY MESSAGES AND
THEN?
HAVE A COORDINATED APPROACH
THROUGHOUT THE WHOLE STATE THERE
IS SOME CONCERN THAT GET PEOPLE
DOING KIND OF THEIR OWN THING
THAT YOU'RE NOT REALLY
ADDRESSING THE REAL PROBLEM.
THEM IN A COMMENT TO SINCE CAN
PARLAY THE CALIFORNIA
ASSOCIATION VERY STRONG PARTNER.
BY THEY REFERRED TO THE TBL THAT
CAME UP I'M PREVIOUS OF THE THE
OBSTACLE TO PROPOSAL.
WE ARE VERY MUCH IN FAVOR OF
TRYING TO FIND HUESO CROPPING
APPEASING CROSS ELIGIBILITY
BETWEEN MEDI CAL ON LIKE WE JUST
NOT HAVE HAD THE OPPORTUNITY TO
EVALUATE THE FISCAL IMPACT FOR
OUR PROGRAM IN IMPLEMENTING THAT
I WANT TO MAKE SURE THAT. WE
HAVE THAT ON THE RECORD OKAY
THANK YOU.
ALRIGHT OF CIVIL HOLD THAT ITEM
OPEN AND LET'S MOVE ON THE ISSUE
MEMORY EARLY IN AND. INFINITE
EARLY CHILDHOOD HOME VISITATION
PROGRAM.
THANK YOU SO MUCH THE MATERNAL
CHILD AND ADOLESCENT HEALTH
DIVISION REQUEST TO CONVERT
TWENTY SEVEN LAMENTED TERM
POSITIONS INTO PERMANENT
POSITIONS.
HE'S TWENTY SEVEN POSITIONS ARE
FUNDED BY FEDERAL FUNDS.
AND AS OF FEBRUARY NINTH PIECE
THE FEDERAL FUNDS THAT WE KNOW
THE FEDERAL GOVERNMENT PASSED IN
THEIR THEIR RESOLUTION MONEY TO
SUPPORT THESE HOME VISITING
PROGRAMS. FOR ANOTHER FIVE YEARS
SO WE KNOW THAT THAT THE FUNDING
IS SOLID FROM THE FEDS WE GET
ABOUT TWENTY TWO MILLION DOLLARS
FOR THESE TWENTY SEVEN POSITIONS.
AND THAT A ENABLES US TO CARRY
OUT HOME VISITING PROGRAMS IN
TWENTY THREE COUNTIES ACROSS
CALIFORNIA.
WE HAVE TODAY'S MADE OVER ARE
CLOSE TO A HUNDRED AND FIFTY
THOUSAND HOME VISITS WE SERVED
NEARLY EIGHT THOUSAND FAMILIES
AND CURRENTLY WE CARRY CASELOAD
OF AROUND TWO THOUSAND.
THANK YOU ANY COMES FROM ALEJO.
FINANCE.
BUT IT'S JUST KNOWS THAT WE
SUPPORT THE PROPOSAL.
OKAY THANK YOU WELL I APPRECIATE
THE GOVERNORS THAT COMMITMENT TO
HOME VISITATION WE'D THERE'S ALL
THAT DATA AND THEY BILLS MODEL
ALL THAT.
MILLER THAT AND SO.
ANY PUBLIC COMMENT.
CASEY NO PUBLIC COMMENT.
WE WILL. ALSO PUT THAT.
I WASN'T ON HOLD A.
LEAVE IT OPEN.
BUT CERTAINLY WANTED SUPPORT
CONTINUING OUR CHILDHOOD SOME
VISITATION PROGRAMS.
AND I'VE ANY COMMITTEE MEMBERS
HERE OF A RUNNY THINKS THE
MOMENT BUT.
MAY REVISE WOLF OKAY AYE AYE
ISSUE NUMBER SIX GENETIC
SCREENING PROGRAM LOCAL
ASSISTANCE ESTIMATES.
I'M NOT NINE A CITY.
EIGHTEEN NINETEEN THE GDP SP
ESTIMATE IN THE GOVERNMENT'S
BUDGET LISTS A TOTAL OF JUST
UNDER HUNDRED AND THIRTY THREE
MILLION DOLLARS WHICH IS AS YOU
KNOW FEE SUPPORTED THROUGH THE
GENETIC.
STING FUN.
AND THIS REPRESENTS AN INCREASE
OF ABOUT A HALF MILLION OVER THE
SEVENTEEN EIGHTEEN ESTIMATE AND
ABOUT ONE AND A HALF MILLION
OVER THE SEVENTEEN EIGHTEEN
BUDGET ACT.
THEY'VE ONLY BEEN SLIGHTCHANGES
IN OUR SCREENING CASELOAD THIS
INCREASE IN OUR BUDGET FOR
EIGHTEEN NINETEEN IS LARGELY DUE
TO EXPENDITURES REQUIRED TO
COMPLY WITH THE NEWBORN
SCREENING EXPANSION. PREVENTS
ENACTED IN TWENTY SIXTEEN.
THROUGH LEGISLATION AND
INITIATED BY THE CHAIR.
WHICH WILL EFFECTIVELY A TWO
NEW NEW DISORDERS TO THE
CALIFORNIA NEWBORN SCREENING
PANEL IN TWENTY EIGHTEEN.
DUE TO THE RECENT ADDITION
THE FEDERAL BURKE.
SCREENING PAN ON THOSE DISORDERS
ARE POMPEII DISEASE AND IM PS
ONE.
THE INCREASE IN EXPENDITURES
WILL BE REQUIRED FOR EXPANSIONS
AND TESTINGS IN OUR LABORATORY
IN RICHMOND. OF FOR THE NEW
DISORDERS A WHICH IS REQUIRED TO
BEGIN BY AUGUST TWENTY EIGHTEEN.
THESE ADDITIONAL COSTS WILL
REQUIRE A NEWBORN SCREENING FEE
INCREASE OF TWELVE DOLLARS PER
SPECIMEN FOR THE NEW DISORDERS.
OF SO LITTLE GO FROM AROUND
HUNDRED THIRTY DOLLARS TWO
HUNDRED FORTY TWO DOLLARS AND
TWENTY FIVE CENTS EFFECTIVE IN
JULY THIS YEAR.
BY THE FEE INCREASE WILL
PRIMARILY COSTS BECAUSE OF.
COVER THE COSTS OF ROUTINE
TESTING WITH OUR LABORATORY
DEVELOPED TESTS.
AND EVENTUALLY THE COSTS OF
PROCESSES INVOLVED WITH ROLLOUT
OF FDA APPROVED TEST KITS.
THAT COULD BE USED IN OUR
REGIONAL LABORATORIES.
ARE APPROVALS BY THE FDA ARE
PROJECTED TO OCCUR LATER THIS
YEAR OR AND TWENTY NINETEEN THEN
WE WOULD PLAN TO IMPLEMENT
SCREENING OVER TWO OR THREE
YEARS AFTER THAT.
THANK YOU.
ALEJO SUMMITS FINANCE
I PUBLIC COMMENT.
OKAY THANK YOU FOR YOUR HARD
WORK ON THIS.
SAVING LIVES AND ACTUALLY WE'RE
SAVING I THINK WILL BE SAVING
MONEY TO BECAUSE WELL IT'S NOT
THE PUBLIC HEALTH SIDE. AMEND
HER COLLEAGUES IN MEDI CAL WILL
HOPEFULLY BE HAVING TO PAY FOR.
CARE DATA WAS BECAUSE MY CITIES
DISEASES WE CAN PREVENT THEM SO
THANK YOU.
YES OKAY ISSUE NUMBER TEN NEW
GENETIC DISORDERS SP TEN NINETY
FIVE AND SECOND YOUR TESTING.
BUT SO THIS IS ARE OF A NEWBORN
SCREENING BCP AND WE HAVE AROUND
TWO MILLION DOLLARS.
REQUESTED AN ONGOING
EXPENDITURE AUTHORITY FROM THE
GENETIC DISEASE TESTING FUN. OF
THIS IS WHAT WITH FIFTEEN NEW
POSITIONS FOR PERSONNEL WHO WERE
PERFORMED SCREENING FOR THE NEW
DISORDERS AND ARE A RICHMOND
LABORATORY.
WORD MEANING EXPECTED TIMELINE
SO THERE ARE NO CONCERNS ABOUT
THE EXPECTED LAUNCH OF THE NEW
DISORDER SCREENING IN OUR AND
AUGUST.
OTHER NEW PERSONNEL WILL BE
REQUIRED TO CARRY OUT CARRY OUT
THE ONGOING PROCESSES OF
SCREENING.
FOR THE NEW DISORDERS IN OUR
LAB.
AND ALSO IN THE BCP WE'VE LISTED
A FOUR HUNDRED SIXTY THOUSAND
DOLLARS AND A STATE OPERATIONS.
EXPENDITURE AUTHORITY AND THREE
POSITIONS FOR ONGOING SECOND
TIER TESTING.
SECOND YOUR TESTING IS
PERFORMING A SECOND SCREEN ON
THE SAME BLOOD SPOT THAT'S A
COLLECTED. ORIGINALLY TO REDUCE.
FALSE POSITIVE RESULTS.
BUT I'M WE ALREADY DO THIS A
LITTLE BIT OF SECOND TIER
TESTING FOR A CONDITION SUCH AS
ADRENAL CATASTROPHE.
AS DISPLAYED IN THE ESTIMATE
THIS.
FOUR HUNDRED SIXTY THOUSAND
DOLLAR INCREASE WILL BE OFFSET
BY A DECREASE ARE OF THE SAME
AMOUNT IN LOCAL ASSISTANCE
FUNDING.
AND THAT AND HAPPENS BY
DECREASING OUR COSTS FOR FOLLOW
UP OF FALSE POSITIVES SCREENS
AND FOR UNNECESSARY CONFIRMATORY
TESTING.
I THANK YOU COMES ALEJO FINANCE.
AND SUPPORTS A PROPOSAL OF
BECAUSE IT ACCOMMODATES AND THE
EW TESTING THAT IS REQUIRED BY
THE FEDERAL RUST.
THANK YOU BYE PUBLIC COMMENT.
SEEING NONE.
THANK YOU. AGAIN AND IT WILL
HOLD THIS ITEM OPEN.
THAT THE GUYS NEVER SAID THE
PREVIOUS ITEM AS WELL SO. LIVES
NINE INTERNAL HELD OPEN. RIGHT
THANK YOU SO NEXT THAT IS
FINALLY IS ISSUE NUMBER ELEVEN
WE HAVE TO.
PROPOSALS FOR INVESTMENT.
WHAT'S ONE.
DON'T ENOUGH GREAT OKAY SO I
GUESS RESERVE ONE TO HEAR TODAY
WITCHES.
FOR WAS A DIFFERENT OF THE CARE
FOR A LS.
WELCOME.
IT.
ACTUALLY SIR SOMEONE FROM THE
PART PUBLIC HEALTH WHO.
BIRD THIS WOULD FALL UNDER WANTS
TO BE A FABLE LAWLER.
THANK YOU.
WE ALSO GIVE THE DEPARTMENT
OPPORTUNITIES SAY SOMETHING THEY
HAVE A THING TO SAY ABOUT IT AND
IF YOU DON'T MOTHER WAS. LISTENS
WELL ALRIGHT THANK YOU.
OKAY US SO FOR THE RECORD OF YOU
TO PLEASE INTRODUCE YOURSELVES
AND THEN I'LL ASK IF YOU CAN TRY
TO.
I KEEP REMARKS TWO. TOTAL THREE
MINUTES I APPRECIATE ITSELF WAS
FIRST INTRODUCED INTRODUCTIONS
FIRST BUT THANK YOU MISTER
CHAIRMAN AND MEMBERS I'M FRED
NOWHERE IN OUR FROM REPRESENTS
THE ALICE'S.
THANK YOU.
SEC VOLUNTEER I WITH THE ELLIS
ASSOCIATION ALSO ON THE BOARD OF
THE GOLDEN WEST CHAPTER OF THE
ALS ASSOCIATION OF YOUR BUT YOUR
NAME AGAIN FOR THE RECORD LINDA
DELA. RIGHT OF BY FUNDS OFF WITH
A TIME PAMELA JACOBSEN I'M THE
VICE PRESIDENT OF CARE SERVICES
FOR THE ALS ASSOCIATION.
OKAY WELL WELCOME EVERYONE.
YOU WANT OF IT BEGIN.
THANK YOU MISTER CHAIR IT'S A
VERY NICE BEARD WE WOULD VERY
MUCH APPRECIATE THE OPPORTUNITY
PRESENTS PROPOSAL.
AND BEEN BRIEFED THE LS
ASSOCIATION IS REQUESTING THREE
MILLION DOLLARS.
TO SUPPORT THE ONGOING WORK.
OF ITS ACTIVITIES AND DIRECT
CARE FOR PATIENTS WHO HAVE BEEN
DIAGNOSED WITH LOU GEHRIG'S
DISEASE.
AND JUST A BIT OF BACKGROUND IN
TWO THOUSAND A THE ASSOCIATION
SPONSORED SENATE BILL FIFTY NO
THREE SIGNED BY THEN GOVERNOR
SCHWARZENEGGER THAT PUT INTO THE
IS HEALTH AND SAFETY CODE. THE
OPTIMAL MODEL OF CARE FOR ALS
PATIENTS NAMELY AND THE
SUBCOMMITTEE ANALYSIS DID A VERY
NICE JOB DESCRIBING IT. AND
EVIDENCE BASED MULTI
DISCIPLINARY WRAPAROUND SYSTEM
OF CARE THAT COMBINES MEDICAL
COMMUNITY AND HOME BASED
SERVICES.
THEY'LL ASSOCIATION CERTIFIES
THE SITES AROUND THE STATE KNOWN
AS CENTERS OF EXCELLENCE WHERE
ALS PATIENTS RECEIVED THIS CARE.
ALL OF THE MONEY THE ASSOCIATION
RAISES FOR ITS PROGRAMS COMES
FROM PHILANTHROPIC SOURCES AND
WE'RE HERE TODAY BECAUSE. THE
ASSOCIATION CANNOT KEEP PACE
WITH THE GROWING DEMAND FOR CARE
FOR THREE ESSENTIAL REASONS
NUMBER ONE.
MORE AND MORE PATIENTS WITH THE
DISEASE ARE AVAILING THEMSELVES
OF THE CARE IS AT THE CENTERS.
REFERRALS FROM GENERAL
NEUROLOGISTS TO THE CENTERS ARE
GROWING AND THE GOOD NEWS IS
MORE PATIENTS ARE COMING TO THE
CENTERS AT AN EARLIER STAGE IN
THEIR DIAGNOSIS.
NUMBER TWO.
CALIFORNIA HAS MORE PATIENCE
THAN ANY OTHER STATE DIAGNOSED
WITH LOU GEHRIG'S DISEASE. AND
WITH THE GROWING GENERAL
POPULATION IN THE STATE. THE
OVERALL CASELOAD AVAIL AS
PATIENTS IN CALIFORNIA IS ALSO
GROWING.
AND ONE OF OUR WITNESSES WILL
SPEAK TO THIS IN A MINUTE.
AND AND NUMBER THREE BECAUSE OF
THE QUALITY OF CARE RECEIVED AT
THE CENTERS AND AGAIN MORE
PEOPLE ARE AT THE CENTERS.
AND I AS WELL AS IN THE
COMMUNITY IN THE SERVICES THAT
THE ASSOCIATION PROVIDES PEOPLE
WITH THE DISEASE ARE LIVING
LONGER.
I THINK WAS VERY NOTABLE THAT
STEPHEN HAWKING PASSED AWAY BUT
TEN DAYS AGO HE HAD EXEMPLARY
CARE AND THERE'S NO DOUBT THE
EVIDENCE SHOWS. LIFE IS LONGER
WHEN YOU HAVE BETTER CARE.
WE HAD ONE EXPLORATORY MEETING
WITH THE DEPARTMENT OF PUBLIC
HEALTH AND WHAT FINANCE. AND WE
SIMPLY WANT TO THANK YOU AGAIN
FOR YOUR ATTENTION. TOWARD
REQUEST TO KEEP THEM HIS PROGRAM
GOING IN THE IN LIGHT OF THE
GROWTH OF THE NUMBERS.
THE CURRENT FINANCIAL STRUCTURES
UNSUSTAINABLE WE REALLY HAVE
NOWHERE ELSE TO GO SO THANK YOU.
ALRIGHT THANK YOU HOUSTON ALMOST
ALL THE TIME BUT. MEDICAID. AND
LINDA AND AYE LINDA DANO
REPRESENT PATIENTS AND FAMILIES
WITH A LS ON. AND I'M ALSO HERE
IN MEMORY OF MY HUSBAND WHO WAS
THE CHIEF CONSULTANT FOR THE
SENATE ENERGY. ENERGY COMMITTEE
FROM US TWENTY YEARS HE PASSED
AWAY IN TWO THOUSAND EIGHT WITH
A LS.
BUT A LOT OF PEOPLE DON'T KNOW
ABOUT ALS IS THAT IT'S SUCH A
COMPLICATED DISEASE THAT ANYONE
DOCTOR USUALLY DOESN'T KNOW WHAT
TO DO. AND EVEN IN THE MOST
NEUROLOGISTS I KNOW YOUR DOCTOR
MOST UROLOGISTS MAYBE ONLY SEE
ONE LS PATIENT IN THEIR ENTIRE
CAREER.
SO WE ARE VERY DEPENDENT UPON
THE CENTERS THAT ARE DEVELOPED
BY THE LS ASSOCIATION.
TO JUST SUSTAIN LIFE AND
EVERYBODY'S ELLIS IS DIFFERENT
SO THESE ARE LIFE SUSTAINING A.
CENTERS THAT NEED YOUR SUPPORT
AND I WOULD LIKE TO UNDERSCORE
THAT THANK YOU VERY MUCH FOR
YOUR FOR ANY SUPPORT AND YOU.
CORD OF THIS MODEL OF CARE OUR
CLINIC COORDINATORS CASE
CONFERENCING TO DEVELOP CARE
PLANS AND CARE MANAGEMENT TO
IMPLEMENT THESE CARE PLANS NONE
OF WHICH IS CURRENTLY FUNDED.
THEY'RE ALL TAKING CARE OF
THROUGH PHILANTHROPIC DOLLARS
WHICH WERE RAISED FROM THE LS
COMMUNITY. SO ALS THE ATLAS
COMMUNITIES FUNDING THEIR OWN
CARE.
THAT'S WHERE THE ELLIS
ASSOCIATION COMES AND. BAYLISS
ASSOCIATION OFFSETS THE COSTS OF
THESE CLINICS THROUGH
PHILANTHROPIC DOLLARS PROVIDES
CARE MANAGEMENT TO SERVE AS A
BRIDGE BETWEEN THE CLINIC THE
HOME AND THE COMMUNITY SETTINGS
TO IMPLEMENT CARE PLANS.
AND THIS IS A VERY EXPENSIVE
DISEASE THIS IS A DISEASE WHERE
PEOPLE CAN NO LONGER WORKING
OFTENTIMES THEIR SPOUSES NEED TO
QUIT WORK IN ORDER TO CARE FOR
THEIR LOVED ONE. THE FINANCIAL
IMPACT IS DEVASTATING ASKING THE
ANALYST COMMUNITY TO COMPETE
CONTINUE TO FIT THE UP FOR THE
BILL. IS DEVASTATING. MEANWHILE
THIS WRAPAROUND MODEL OF CARE IS
THE ONLY THING CURRENTLY PROVEN
TO HELP PEOPLE LIVE LONGER WITH
A LS
SO WE APPRECIATE YOUR TIME TODAY
IN HER OPEN DIDN'T QUESTIONS YOU
MAY HAVE.
I THINK YOU. ANY COMES FROM THE
TOP OF THE GULF.
NO WE DID.
HAVE AN OPPORTUNITY TO MEET
WITH THEY'LL ASSOCIATION AS WE
MENTIONED TO THEM WE DON'T
CURRENTLY HAVE AN ALICE PROGRAM.
AT THE DEPARTMENT OVER HERE TO
FIGHT TECHNICAL ASSISTANCE AS
NEEDED OKAY A ALEJO.
ONCE FINANCE.
DEPARTMENT BONE WE MET WITH THE
ADVOCATE SUMMER SAYS MR WERE
STILL ASSESSING THE PROPOSAL BUT
WE DON'T HAVE A POSITION AT THIS
TIME.
SO I GUESS FROM I UNDERSTAND THE
PROPOSAL I MEAN THE REQUESTS FOR
FUNDING TO SUPPORT THE CENTERS
ARE PROVIDING WELL CLINICAL WELL.
CLINT CRITICAL SUPPORT
COORDINATION OF CARE EIGHT.
OF SO I GUESS.
CERTAIN IN ADDITION OUTSIDE FROM
THE OUT THE OUT OF THE NEED FOR
FOR THE SERVICES.
I GUESS ONE QUESTION IS THAT IT
IS WORTH HEARING INTO CONTEXT
THE PART OF PUBLIC HEALTH IS THE
PRIME PUBLIC HEALTH OPERATE ANY
SIMILAR TYPES CENTERS ARE
SERVICES FOR OTHER CHRONIC
DISEASE ENTITIES OURS IS.
BETTER ALONG IN A MORE CLINICAL
THE FIRELIGHT WELL AS IT COULD
BE LIKE PCS ACTUALLY FUNDS
CLINICAL CARE. ARE OR SOME OTHER
AGENCY AND FOR THE RECORD THIS
IS MONICA WELL AS UPS.
A SIMILAR PROGRAM OF THE YEAR
ALZHEIMER'S PROGRAM ACTION HONEY
WHERE WE FIND.
AND THE DEBTS AT GUN ALZHEIMER'S
CENTERS ACROSS THE STATE THERE'S
TEN OF THEM AS YOU REMEMBER
RIGHT YEAH YEAH. SAID THAT'S
SOMETHING SIMILAR THAT WE HAVE.
INVESTIGATOR THAT'S SOMETHING WE
LOOKED AT IN DEVELOPING A
PROPOSAL. UP I'M GONNA AND AGAIN
THERE'S THERE'S A CENTER OF
EXCELLENCE ELEMENT BUT THERE'S
ALSO THE COMMUNITY A OF WORK
THAT'S DONE AND HASN'T JUST AS A
QUICK EXAMPLE. PEOPLE WHO HAVE
FAILED US IS YOU KNOW ULTIMATELY
LOSE THEIR ABILITY TO USE THEIR
LAMBS.
RIGHT AND SO MANY PATIENTS HAVE
A HOIST IN THEIR BEDROOM TO TO
PUT THE PATIENT IN BED AT NIGHT.
QUESTION WHERE IS ALWAYS COME
FROM WHO MAINTAINS IT WHO
TEACHES THAT FAMILY MEMBERS HOW
TO USE IT THAT'S WHAT THESE
FOLKS DO.
SO
IT'S A GOOD EXAMPLE.
SO I MEAN I THINK A PART OF FINE
SIR MENTALLY THINKING ABOUT IS
THAT WE THINK ABOUT OUR SYSTEM
OF CARE. AND THEY KNOW YOU'RE
COMING FOR THIS PROPOSAL.
MIKE WHERE WHERE DID THE
DIFFERENT PARTS SAID RIGHT SO.
NO WEAR OUT AND THAT YOU KNOW
WELL.
THE UGLY FUND COORDINATION OF
CARE YOU KNOW WHO DO THAT THAT
THE OUT THE RANGER EDUCATION OR
ARE OUR OUR OUR TRAINING OF. THE
FAMILY MEMBERS OF THE CARE
GIVERS.
THEY'RE NOT SO YEAH.
YEAH GREAT POINT.
FOR THE RECORD I I SHOULD SAY
THAT WE FUND AL SUMMERS RESEARCH
THAT.
YEAH SO WE WERE NOT CURRENTLY
FINDING CARE COORDINATION AND UP.
THROUGH THE ALZHEIMER'S FUNDING.
AND PROGRAM SO IT IS DIFFERENT
IN TERMS OF THE CLINICAL ANGLE
THAT THIS SPECIFIC PROPOSAL HAS.
ALRIGHT
OKAY.
OKAY AND ANY PUBLIC COMMENT.
YOU.
ALRIGHT.
SO A BIG CERTAINLY YEAH I.
THIS IS A A.
.
I MEAN THIS IS A VERY IMPORTANT.
ISSUE OF THOSE FOR.
.
YOUR COMMUNITY THIS.
PEOPLE OF THE DUTIES ALSO I
THINK WE DO HAVE SERVER.
LARGER QUESTION.
ABOUT.
.
THERE ARE NUMEROUS BACK CRANK
DISEASE ENTITIES THE GOOD NEWS
IS THAT THERE ARE MEDICAL CARE
IS GOTTEN BETTER BUT IT HASN'T
DEVELOPED THE CURIA AT.
SO WE HAVE PEOPLE WHO
FORTUNATELY OUR LIVE
UNDER
MORE PER
OF LIVES
BUT WHO NEED THESE VITAL
SERVICES AND. FIGURE OUT WHERE
THEY FIT IN GO EN AND THE
PROBLEM IS IS OUT TO OFTENTIMES
THE VERY SERVICE YOU TALK ABOUT
HALF ALL THE CRACKS IN LIKE
WELLS THAT REIMBURSED HERE IS
THAT COVER THAT PROGRAM SO PLACE
SO. WE DO NEED TO FIGURE OUT THE.
BEST OF THE PLACE THE WHERE
WHERE IT LANDED AND DIVE
APPRECIATE THAT ACTUALLY THE
PART PUBLIC HEALTH IS LOOKING AT.
POTENTIALLY BEING.
AT LEAST THAT A PLACE WHERE WE
CAN NOW PUT THIS JOB BUT I THINK
MOVE WE DO HAVE TO THINK A
LITTLE BIT ABOUT.
HOW WE CAN ALSO MAXIMIZE THE
RESOURCES AS WELL SO EVEN AS
YOU'RE LOOKING AT A GENERAL FUND?
?
I REQUEST YOU KNOW WE SHOULD BE
LOOKING AT IS. WHO HAS THE
EXPERTISE TO SEE WHETHER WE CAN
USE THAT AS A CORE TO LEVERAGE
SOME OTHER FUNDS ARE RESOURCES
AS WELL?
TO TRY TO GET GET MORE SO SINCE.
SIGHTS Y. KEEP DOWN THE BACK OF
MY MIND AS WELL. AND THINKING
ABOUT IT THERE'S NO OF SOME OF
THE SERVICES THAT ARE THAT WOULD
BE DONE BY THE CENTERS ARE COULD
BE.
YOU KNOW COULD WE COULD FIND A
WAY TO LEVERAGE SOME FEDERAL
MONEY OR SOME OTHER TYPES OF
RESOURCES WHILE IN. HOW HOW WE
WOULD DO THAT? AS WELL THOUGH.
OKAY WELL I WANNA THANK YOU SO
MUCH FOR YOUR PRESENTATION NOW
WE'RE GONNA HOLD THAT THIS ITEM
OPENED. AND ON THE.
BUT.
APPRECIATE. THE PRESENTATION
AND ALSO.
TRYING TO HELP US FIGURE
FIGURES OUT THE NEED HERE ITSELF
WE CAN FIGURE SOMETHING OUT. A
REVISED. FIGURE THANK YOU THANK
YOU THANKS VERY MUCH.
OKAY.
WITH THAT I THINK WE'VE
CONCLUDED OUR AGENDA.
SELL.
I WAS PROUD FARM WHERE ONLY
DESPITE THIRTY FIVE.
THAT'S A PHYSICAL OR ANY.
SILENT AGAIN THANK EVERYONE FOR
BEING HERE.
.
AND THE.
SO WE WILL ADJOURN THIS HEARING
AT THE US SENATE BUDGET FISCAL
REVIEW COMMITTEE NUMBER THREE.
ON HEALTH AND HUMAN SERVICES
THANK YOU