California.
Well that's created a stir
able to address.
Sure this.
Here's.
I am honored
today to have.
Holly.
Number of other C. I. here up.
Why apply?
Norma Scott.
The valley here to the border
region.
Working.
Or working together.
The border region.
And.
His
effort.
To.
.
Created dialogue.
With
all the stakeholders in the
border region so.
Here.
You know I I don't I don't wanna
I. I want to really focus on.
On the issue but I I think.
It would be appropriate just
some my Anderson a very
important message because this
is a.
A bi national event and we have
a important people here
representing.
Mexico in the Mexican
communities and we have people
from Mexico and I just I just
feel that it's appropriate.
To to make a statement here
today.
And this is about the military
Mitchell militarization about
the border. And and what the per
our our recent presidents to sit
in to bring troops to the
border.
I think it's a very very sad day
for country.
And it's a very sad day for for
diplomacy with Mexico I just I
need to say that.
Here as a representative of the
of the border region we're not
proud.
This action nor do nor do we
supported no do we think it's
appropriate.
Nor do we think that or result.
Improving anything at all.
In particular others.
Causing problems with a a great
relationship
that we need to further with
Mexico.
S. it's important they particle
form out Mendoza maggid chemical
this so lightly so so so loudly
that I've.
So anybody that Bedlam.
Interest the facility allowed up
an awesome amount board. Allowed
only put on the enquanto.
I look at a most interconnect
quick in California.
Tenemos esta establecer.
When I'm a quarter less income
make you cool can most second
asparagus irreparably musket
them sickle moon.
He knows the import but M.
decide.
Are.
I Mike left when data will live
on doctoral plus.
Portantino in no I that'll Seki.
E. E. it then M. ostali puts him
at the thought of Congress but
the.
You know money at it to
illegally that kick in medicine.
Anton says.
I just wanna.
Simply.
Get that out of.
It's clear they are little
button welcome.
Our our colleagues.
From Mexico welcome the
representatives from Mexico
here.
They're very welcome.
California and neither are
governor legislature or anyone
here
community.
Support the actions of our
present I just want to make that
very clear.
But in that I wanna move onto
our hearing today and asked. If.
Far assembly member.
Would like to say Andy anything
particular.
Thank you senator and I would
echo of the comp to Jamaica and
both support of our.
Friends and neighbors and family
south of the border and also.
The fact that they're we have
much more pressing matters
before us.
Here in the border.
No but two weeks ago there was
a visit by.
The call number forty five.
And.
He was here.
.
Looking at the water
infrastructure well walls.
That they're being proposed in
the comments.
That I would like to reiterate
here is that we have Bob again.
Infrastructure needs here and
imperial county and along the
border.
That required billions of
dollars to improving.
The goods movement at the
economic opportunities.
For both the California and
Mexico
we have high.
Issues.
Of.
Axis.
I have related to the medical
field we have shortages when it
comes to. Doctors nurses.
Specialty.
Take care that we should be
paying attention to and focusing
on and I think today will have
that conversation we have.
Seven out of ten kids that
suffer from respiratory disease
problems as it relates to.
The air quality in this region.
We have a body of water.
Known as the Salton sea that
required billions of dollars of
attention.
In order to address that
problems are many many other
issues related to the border
region.
That we would hope.
Number forty five in that entire
administration what.
He focused on today were here to
talk about public health is in
the border region in.
Something that is extremely
important as I've highlighted
some of the disparities that
already exist.
I'm hoping that.
In today's dialogue we can
address some of those.
Issues related to the
challenges that we have what.
I see a lot of.
Professionals from the medical
arena here today and what things
I think that is extremely
important is D. collaboration.
And coordination of those
services along with our friends
a south of the border and so I'm
happy to be here.
Senator thank you for the
opportunity to say a few words
subtle opt out of the seat is
the most a key.
As stone monument bodies could
be looked over they must exist
immaculately killed enough from
data.
Yanqi I. moon shot into your.
Either stacks young
and they'll put us for months
and okay aquatic unistar from
bed and also post.
A noble stadium for battles and
Los programas E..
And pasada met while it's on
less.
What do we do that and they
Soros you're not?
I Estes a lot that I must exceed
them mattered less you're not
accessible.
Anderson Richard medicals but an
opportunity
good morning right media. E.
must also. By León this I sold
enough Robert soul discover is
always been just
amazing advocate.
Not only for immigrants but
really the M. Perot. Of
community he's been.
.
I an enormous resource here
locally.
And a great person to work with
on just so many issues his
presence here has only Matt.
The quality of life for our
region is approved of work were.
Very honored to have him here J.
when asked if you had anything.
Did you want to share in terms
of opening comments.
I see a lot of
friends a lot of friendly faces.
Thank you for I. inviting me
over.
I think that this is a very
important meeting.
That you have la.
Fostered the idea that. It'll be
through cooperation
collaboration.
That.
We can solve that we will be
able to solve. All our
differences and problems
all on the border I think it's
very important what has been
said about. On a C. D. arm.
Our statements that were made
yesterday. But we are persuaded
that it'll be through a.
Constructive relationship a
friendly relationship.
That.
The border up between the US and
Mexico will come together
I think that diplomacy will play
a role. But it's a bubble are
common interest in our common.
Commitment to solve whatever are
comes
all in our way.
I think that the president of
Mexico they made a very are
hopper to and very.
Let's say a clear statement or
Mexico stands.
We are looking. At the long run
of our relationship not at this
moment
stuff.
A brick photograph lovely say
how the world of politics
see what the senator senator
hueso has mentioned.
The humanity. And the dimension
that Mexico and the U. S..
Share I think that the potential
is great.
And I will share with senator
hueso.
That. Intracellular common
interests at the border and D.
out D. Quanah river basin.
Mexico has announced.
Just a few days ago that through
the consumers you know the law
well let's see the water
national.
Foundation in Mexico.
Works will start on this week
are.
In order to next week in order
to do some approve meant
improvements and better moments
in the yeah. Sanitation of the
real D. Quanah.
.
I.
Basin which is very important
that is one of our key batter's
saw in respect to the border of
California E. Baja California.
And that that is the way that we
symbolize this approach.
Whatever the differences are we
will work it out together lives
while most satisfied man you
know on it up.
Said M. knocked on de la.
Stumbles out Randall they will
not relax young penalize.
I. this up by the sea air
innocent Dunya mean the.
We're here for the long run.
Are.
It is very difficult that may be
home to guns will make a break
for all the way over to
California to meet idea Tijuana.
In order not to la step into
Mexico soil. But that's another
story I think that we have
common interests common goals
and we have D. out will to work.
Larry less young
intimate Glazer SUNY lost almost
Holly moves is movie.
Yeah we in good Gaza.
Is repressing Duckie saw in him
demise Gandhi captain eagle is
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Or Bob Davie who fit wound up by
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non. Even more ethical.
Most or all of the new Middle
East Abernathy in that would
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does come with us and we'll.
People hueso goes on a lot Toni
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Angelus.
Which addresses and thank you
very much and I also want to
welcome our friends I came all
the way from San Diego.
And city or county for this
event as well welcome.
.
The focus of today's hearing
will be to discuss a health
challenges facing.
Our border region.
Border.
The different are.
We have to make.
All the resource
is available.
And work together and.
Prove that health.
Are we doing what we need to
be doing.
Are we using our research.
Today's hearing will consist of
three panels we will have.
An opportunity to.
.
Scott us at the end of.
Of that third panel comment and
question cards have been
provided to all of you and if
you haven't received one they're
available in case you have any
questions please shut down your
questions and.
And.
Your land.
Raise your hand you learn the
right over there she.
She will.
Come by to get them if you're
if if you are interested in
presenting one of your questions
the panel would be glad. To part
happy participate that way.
Our first panel talk about
status of public health.
In this border region. Yeah the.
Changes and public health in
the last twenty years there's a
report comes out.
Every up every. On on a periodic
basis.
And we're gonna be talking about
those as well.
And it's mainly what is the
state's role in addressing the
public health.
And some of the challenges that
exist in addressing.
Public health on both sides of
the border.
Our speaker will Hella
highlights from the.
Examples of specific projects
and programs that are available
they're trying to do just that
so without further ado will get
started. And I'd like to
introduce our first speaker miss
a profit none this.
A Missy professional this is
over thirty years of experience
in public health management.
She serves as the chief for the
California department of public
health.
In the office of by national
border health.
Coordinating public health
program efforts along the
California.
Bassac California border.
Prior to her position Sherwood
CT PhD server service C.
operations manager for the San
Diego county.
Health and Human Services and
Senate director for Planned
Parenthood. Of inter county show
she comes with a wealth of
experience in and.
These areas
she has a bachelor's degree in
social work from Senate France
Scott State University and
masters degree in a vast studies
and health administration from
the university of California.
Send you assure.
Sajjad will explain the role of.
The.
Shooto explain the the roll of
the.
Office Spanish border health
and addressed in the public
health.
And those existing programs that
we have to adjust to that so
welcome.
Anta whenever you're ready.
Good morning everyone.
Thank you senator hueso and
assemblyman Eduardo Sierra.
Which just press yes.
Took Dodd accordingly holy
doctor Hernandez doctor Frankel
Baja California.
Consul general for scatter.
But any Iraqi.
I've been asked fish.
To know what the role of our
offices in working in public
health.
And.
The California department of
public health works to protect
the public's health. In our
Golden State can help shape
positive health outcomes for
individuals families and
communities.
The department's programs and
services are implemented in
collaboration with local and
state federal health departments
and private partners.
The California department of
public health also Toni CDP H.
had an office a bi national
border health located in San
Diego.
And I service the chief for this
office and.
Are population that we serve is
abominable populations
throughout the state of
California including here in the
border region.
There's a law passed agreement
established in nineteen eighty
three that delineates the border
area and sixty two miles or a
hundred kilometers on either
side of the U. S. Mexico border.
With California's border region
spanning a hundred and forty
miles that includes San Diego
and imperial counties.
This area is remarkable because
it's assorted geography highly
mobile culturally and
linguistically diverse
population.
Recognizing the distinctiveness
of the border region in nineteen
ninety nine assembly bill sixty
three sponsored by
assemblywoman.
Denise to Cheney established a
permanent office the bi national
border health within the
California department of public
health foreman formally known as
California department of health
care services. And began
operating in January of two
thousand.
One of the mandates from this
bill is to convene a twelve
member of voluntary community
advisory committee
representatives of various
entities to develop. The
strategic plan in our office.
Advisory committee members are
appointed by the state director
of public health and comprised
of individuals representing
public private community based
and academic entities
specializing in border and buy
national health issues.
Public Kreiner is here as.
She's the epidemiology.
Manager for imperial county
public health department and
she's the designated.
Staff person from the
department to represent within
this advisory group.
The mission of our offices
dificil facilitate communication
coordination and collaboration
among California and Mexico
health officials.
Health professionals and
communities in order to optimize
Bryant by National and border
health.
We serve as the link between
health officials in California
and in Baja California on public
health issues of mutual
interest.
We work in close communication
with local state and federal
public health programs
such as JB TB to ensure the bi
national infectious disease
cases are addressed. And public
health action is taken when
needed on both sides of the
border.
Our office has for over arching
goals.
The first is to assess monitor
and report on border M. by
national public health issues.
We do this in several ways.
First we annually develop a
legislator. Mandated report to
the legislature on the health
status of the border area that
evaluates epidemiology data from
border communities. And
identifies priority health
needs.
This annual assessment sets the
foundation of prioritizing
public health issues for policy
makers and public health
professionals here in the border
region.
We determine our priority issues
of this report by conducting a
needs assessment among our
stakeholders including art Siri
group members. And obtain data
from a variety of public health
programs and through UCLA's
California health interview
survey known as chess.
We also monitor health in the
border region through our
surveillance programs and
routinely monitor infectious
diseases at our Sentinel sites
and enhance situational
awareness. Via ongoing
communication with public health
professionals.
Throughout the state of
California and Baja California.
The second goal of our offices
to facilitate and optimize
communication coordination and
collaboration on border and buy
national health issues and
policies.
This is done in many ways
for example is.
For example it is in in
partnership with several local
partners.
On both sides of the border we
have formed a consortium known
as border health consortium of
the California's.
The consortium consists of
public private and academic
entities.
Coordinate and collaborate on
border health issues.
Third goal of our office is to
build capacity to effectively
address Forder M. by national
public health issues.
An example of this goal is
through our border infectious
disease surveillance program or
we have conducted a survey for
health care providers to assess
third knowledge of seca. A
vector borne disease that has
affected thousands of people all
over the world particularly in
pregnant women.
Additionally we have conducted
several by national trainings
for providers to assist with a
better understanding of
diagnosis an impact of this
ticket vipers.
Our fourth goal is to increase
awareness about border M. by
national public health issues
and the role of our office
addressing them.
Through this goal we work with
with subject matter experts on
both sides of the border to
address specific public health
issues. Such as rocky mountain
spotted fever or T. B. chronic
diseases like obesity and
diabetes and service
clearinghouse to work together
through collective impact
approach. In addressing these
issues.
We also recognize the need to
address threats posed by
infectious disease to our border
M. by national populations.
Stop in our office focuses on
enhancing the detection and
response to infectious disease
incidents and threats in the
border region.
This is a critical role in
fostering by national
partnerships and strengthening
surveillance and communication
capabilities in the border
region.
Our staff works collaboratively
with state local and federal
partners focusing on
surveillance and monitoring of
infectious diseases. Developing
routine and emergency by
national communication
protocols.
Silla taping cross border
exchange of information
investigating by national
infectious disease cases and
outbreaks and facilitating
communications between public
health officials in California
and Baja California. On
infectious disease matters of by
national interest.
We strive to enhance
collaboration because
communication with our
colleagues in Baja California as
we have worked jointly.
And we have faced several public
health threats such as pandemic
influenza and most recently
vector borne diseases as I
mentioned earlier.
As one of the ten border states
located along the two thousand
mile U. S. Mexico border.
Our office overseas the US
Mexico border health commission
California outreach office
a federal program under the U.
S. HHS health Human Services.
Agency office the global
affairs.
And this commission's mission is
to provide international
leadership and optimize its
health and quality of life along
the US Mexico border.
There are three commission
members representing each border
state. And here in California
doctor Karen Smith the director
of California department of
public health and state public
health officer is the designated
member representing the state of
California.
And the other two members are
appointed by the president of
the United States and they are
doctor Larry Klein. A physician
in San Diego county and doctor
Osseo Rudy Lewis who is here.
Today and reside hearing and.
Imperial county if you could
stand up to reading lists.
I think many of you know him.
I have.
So in regards to.
Public health and how it's
changed in the last twenty
years.
Increasing population mobility
throughout the world has created
different threats for public
health.
We have seen an increase in the
number and type of emergency
infectious diseases such as
sika.
Climate change among other
things
may have had a potential impact
on the on the habitat in this
part of the world for certain
vectors.
In regards to vaccines although
we have the availability to
vaccines.
They prevent many infectious
diseases we have unfortunately
seen a growth of a culture that
does not trust this amazing
public health prevention tool.
As public health professionals
it is our duty to ensure that
our public is empowered and has
been had has the most accurate
and to date information to
protect themselves and their
families.
Taken from our board health
status reports
the population in California
border region which includes San
Diego and imperial county's has
increased by approximately eight
percent since two thousand ten.
The demographics here in
imperial county have shown in an
increase in Hispanics with over
eighty four percent eighty four
percent Latino.
In regards to the poverty level
in two thousand one thirty six
point three percent of San Diego
county and sixty three point six
percent of imperial county were
living below the two hundred
percent.
Up federal poverty level.
By twenty sixteen this
percentage decrease in San Diego
by four point six eight percent.
But increased in imperial by
five point one nine percent.
The health areas of interest in
the border area are obesity
diabetes tuberculosis sexually
transmitted infections and HIV
aids.
In regards to obesity there has
been an overall increase in the
percentage of those imperial in
San Diego county who were
considered overweight or obese.
To the World Health Organization
categories for the body mass
index.
From two thousand one to two
thousand sixteen there has there
was a twelve point one in a
nineteen point three. Percent
increase in the percentage of
those who were considered
overweight or obese in imperial
county and San Diego counties.
For diabetes for
two thousand three the two.
Those who.
San.
All of this.
The rate of D..
Q. Los's.
Thousand.
It has D..
However in imperial county from
thirteen.
Jean there has been a de.
Trend
M. thirty seven point five case
forty forty case.
Spite the one year decrease.
During twenty sixteen twenty
seventeen it's important to note
that imperial county
consistently reports the highest
rates of TB statewide four times
higher than California overall.
A lot I mean is the percent
increase in the rates of
sexually transmitted infections
in the border region. From two
thousand five to twenty fifteen
the rates for chlamydia
gonorrhea and primary and
secondary syphilis cases have
increased significantly.
In San Diego county.
There was a forty five percent
increase in rates for chlamydia
and thirty.
Point six percent increase in
gonorrhea and a hundred and
thirty nine point six increase
in primary and secondary
syphilis.
In imperial county there was a
sixty two percent increase in
rates for chlamydia. A one point
five three increased for
gonorrhea. And nine hundred and
eighty three percent increase in
syphilis so. That's
a big difference.
The rate of syphilis in imperial
county has increased from point
six per hundred thousand in two
thousand five to six point five
hundred thousand.
Cases in twenty fifteen.
For the rate of new diagnoses
with HIV from twenty eleven to
twenty fifteen.
San Diego county has decreased
by six
point eight percent in imperial
county seem there has been no
change within the timeframe.
Rates of death and had that have
had. A diagnosis of HIV has
decreased over all in San Diego
Hannah decrease of twenty two
percent an imperial with a
decrease of eighty five percent.
So what are some of the
challenges that exists in
addressing public health. On the
US side.
The border experiences.
Public health challenges and
issues that are distinctive to
the region due to the
complexities of the relationship
between the US and Mexico.
Often there are challenges
providing healthcare services
especially as it relates to
disease prevention surveillance
and control.
Maintaining communication and
fostering relationships with our
Mexican colleagues is essential.
To address public health
challenges in the border region.
It's estimated that one million
or so American citizens live in
Mexico many of them retirees.
Our head who heads south of the
border due to the lower cost of
living.
According to the last Mexican
census in twenty ten some sixty
thousand of US citizens are
living in Mexico indefinitely.
Mostly in Baja California.
In the northwest of the country
or in Mexico City.
Americans commonly seek health
care and dental services located
across the US border in cities
like Tijuana and maybe Callie.
The challenge is that health
records are not typically shared
between countries make it
difficult to monitor reportable
diseases such as TB and HIV.
However as mentioned
communication through our bids
programmable order infectious
disease surveillance program.
Has helped monitor immediate by
national cases of mutual
concern.
The border region many times has
a disproportionate burden in
infectious and chronic diseases
as opposed to other parts of our
state.
Social and economic inequalities
are among the cause of this
disproportionate burden.
Our department in our office has
made great efforts to reduce
help inequities
which is a topic that we
consider of utmost importance.
If we are not if we are to
protect the health of our
citizens.
Answer department is on a
mission to work together and
develop strategies to address
health inequities thank you very
much.
Thank you and.
.
Now we have our next speaker.
Doctor about Courtney Flynn
media.
She is the director of public
health services for the state of
our California. She has a
medical degree from the when
yourself taught him on the. Bus
California as well as a. Number
of different certificates
specializing. In public health.
Epidemiology healthcare
administration another public
health hot topics.
Prior to her position as
director she served as.
Making gullies health
commissioner and manage programs
targeting epidemics another
transmittable diseases.
Sugar over the status a boat
border health from the Baja
California perspective.
Including some of the
opportunities for additional
improvements by national
corporations.
She is joined by doctor
distorted at non this beyond he
said epidemiologist.
And doctor today Suffolk whiskey
that she's a coordinator of.
The PDA mail optical
epidemiological surveillance.
Try to set up fast.
I epidemiological surveillance
of communicable diseases both
from state of baka.
California so welcome thank you
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come in until it by easy's over
at all anybody else I mean.
As he entered.
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muscles
that might think that they could
possibly? A sort of a book but
an upper limit because we get
Andy poses heat that at the next
company that a phenomenal me get
the audio in the most sinister
bites so I only speak
can I.
.
Our our programs.
Having a positive effect.
In targeting and reducing
disease.
In the border region.
And M. missed
Fernandes is you'll take a.
Teach it is.
.
We generally is.
What can you say about that?
I think.
With partnerships with our own
colleagues in Baja California
because of the. Populations that
crossed the border.
There has been improvements.
And.
It's it's one of the things
that we we monitor on a regular
basis.
So to answer your question and
it depends on the particular
disease.
And Tom you know we also have
representatives from local
health departments Tom that are
gonna be here today specify on
those particular issues and I
know in the last few years we've
worked very hard to expand
access to health.
And federal governments on their
job I know the state we've been
very aggressive in implementing.
A formal correct but also
expanding it here within our
state.
Has that been helpful. It that
at making sure people have
treatment to problems.
I believe so yes do we have to
have focal data to back it up.
Yes in our health says report
we cover access to healthcare.
Okay.
And I'll be the odd one make go.
.
In particular.
.
Senate canticle more.
Look at most of those Iraqi
California spend their. Alexis.
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The service yips medical said
making quote under the
denominator.
Kate what once personas that a
I wouldn't plan medical.
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Sign a petition at the.
Steven in Mexico City be villa
publicity that's important but
up on the
fifth. Did that many Iraqis seem
most gay is Mitchell quiz
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if exploited suitable panache.
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do that they C. impetus hint.
Russ has his first delivery of
services here is.
Is there a strategy that's
developed at this
state level was at that zero
county level strategies and.
Under the office by national
health we develop a strategy for
how to deliver.
How to improve healthcare
services when the population I
need services and ensuring
that?
The health care in our health
status report does cover that.
But as far as a strategy you
know where focused on the
population as a whole.
Not really looking at the
biggest areas of concern.
Definitely yeah I mean I think
that you're sorry Wesley I know
we study M. we put together a
report but is there an actual.
Of approach in terms of out are
we at all up. Do we have a
requirement to do something
about for example. If we if we
see that we have a high
population of.
Suffering from diabetes or heart
disease or anything in
particular.
What at what point is this
somebody decide this is how
we're going to? Tackle this
Rizzi that even done right well
the health status report does
provide those trends in the
information and and we pass that
information to the subject
matter experts up in Sacramento.
Which then raises it to the
higher level and so that's where
that comes from and and we we
data is the most important
thing.
That our office produces is is
that the data that is produced
from in the border region do you
will have of the directive do
you feel you have to direct it
to make some policy
recommendations.
That's at the higher level we
provide the data and then it's
taken up to the higher and
higher level probably be at the
department department said the
right to the head of. Public
health and.
Whether they decide that they
want to make a recommendation at
all exactly yes.
Okay so they can decide we want
to do something about it or not.
And but as far as the.
Policy recommendations those are
made internally are those ever
put into a report.
How does a M. are made public
it's up in the administration?
Is there any conservative
public.
Now is there something we could
do.
That would be something that
you should raise to the
administration.
Very well
do you wanna.
Yeah thank you.
To to correlations that I by
pick up on.
In both presentation by.
.
Yourself a
Fernandez and doctor represents
Ted about California's.
The increase in HIV aids.
Infections and.
You know there's been a
tremendous amount of effort.
In education campaigns I think
on both sides of the border.
I can speak to.
At efforts are underway here in
imperial county.
M. more but visible happen with
the presence of.
Medical clinics organizations
such as Planned Parenthood.
Who?
Go out and do the education
intervention given that.
A standing there still this.
Compensation happening this
part a state that.
.
People are still hesitant.
To engage into this conversation
but these numbers.
Tell us that.
.
Not having the conversations and
considering the amount of
investment and effort that is
being made.
Where not making a huge
difference and so can can you
can't touch John?
That is there. Something.
In addition.
That the. Us here to stay in
partnership with our.
Colleagues about conform you can
do to increase.
This awareness.
Denny's to take place of.
.
A problem that is clearly. A big
one bed the numbers that you
share.
You know yeah I think you here
in the audience a.
A couple Mike got kind of a. Of
feeling when you hear those
numbers right but but we are
failing to have.
D. direct conversation about
this problem right the
prevention.
Intervention and so can can you
touch a little bit on that.
But for C. seem Anthony look but
I would think it seven okay
claramente I will not learn a
Steven and don't okay or
quarterback year. Telephone
directly one back on the phone
at this but dawn.
They act.
He uses infamy us.
Beneath the aesthetics while.
But most.
Then around would never have
seat. Media.
Not a lot even think of myself
if I'd been a specific coming
Debbie if you see that is one of
Hannah keeping the stigma.
Sat a Beth Sentinel kickass
hypocrites them phantom.
Let him take a kilo antiquity
grocers what I hope they took it
out later that he just a minute.
Elastic Mike they labeled as
Toni locally stigma.
Eleven indeed that but really
León could a mental.
SMBs that export gap but do the
daily dose me ghostly.
In a restaurant by these.
Let Bob last
Casey sat baby I suppose he
people inmediatamente via.
Anderson before the federal act
I mean does it giving it a
miracle he sees that the
speaker.
Noise Skinner left them by yes
it but it is John again beef
Wiener eagle what is he that was
hit not
then go out on the court.
Delano's laws may be coming to
C. publicity and despite Perama
that you have it if I let me
hot.
Fatal notify when and the little
bit I. palace Beth into the B.
act he set his whenever that.
Gallery hopefully how
doubleclick on India going
imperial count.
And from that the state has
developed a campaign it's a
getting to zero campaign. That
is is available you know through
the.
Because HIV branch om for you
to to look at.
That's accessible to the public
arm and also the local health
department on in San Diego and
I'm not sure about imperial
county but it's Andy Eiko
they've also implemented the
getting to zero.
Campaign to really focus on
lowering.
The incidence of HIV I. it bill
in the border region.
Aqaba D..
Actually transmitted infections
the pieces the analysis that
that. Is from what I'm seeing
it.
Isn't that the same yeah that
that was done up and and there
are clusters of of a different
work that's being done either
through STD branch. But I really
can't answer that question to
tell you the strategy that would
be something that would have to
come from the branch itself.
Or the local health department
KQ.
Up can I help but the herbicide
of mental health issues and I
think it's a huge topic of
conversation this country today.
That.
.
Intersects with the gun
conversation a intersects with
the homelessness discussion. I'm
can we.
Spend a little time looking at
MPO county specifically.
As it relates to.
Have we seen some.
At.
Prop sixty three investments
that come from the state in the
mental health programs.
Move the needle a bit on mental
health cases in.
I guess one thing that I know
right now would be redundant for
me to ask is that there is a.
Significant access problem.
In MPO Connie to mental health
services and.
At that probably exists up and
down the state of California but
it seems to be one that is far
more.
.
Prevalent here and so can can
you just talk a little bit on
some of the. Efforts that have
been made in have we been
moving.
The needle just a bit in terms
of identifying and treating
mental health issues as I
mentioned it intersects with. A
wide array of issues the
homelessness the.
The violence in our communities
and things of that sort.
Yeah again for me.
In our office we convene the
meetings with different.
Subject matter experts and so
we work with a different look
local health department so I
think. You know hearing from the
local health departments on what
their strategies are.
That we're trying to work to
ensure that there's a dialogue
between. Our.
Health officials and
California's health officials
so I think and so I think that
would be the best thing to do is
to to ask that question to the
local bit in the world but I
guess for my perspective.
Relates to the data that you
collect right on out.
Regular basis.
Are you seen.
The programs the strategies that
are being made here on the
ground.
Improving based on the data that
you're providing I think you
know with the stigma with mental
health.
It is becoming more apparent
that that is the key to solving
the lot of the. Public health
problems.
And so we have been working on
that in implementing mental
health along with other
different trainings that are
conducted. Here in the border
region and like for prom
retorted groups. Dealers mental
health America we work in
partnership with a lot of
different organizations to
ensure that the mental health.
Issue is being addressed in the
the the population that we
serve.
Okay thank you.
Thank you very much much much
earlier the purse but but this
bus young that's supposed to
consult those rooms. Cannella
bun work gonna change the panel.
To.
.
Now environmental threats to
public health.
.
This is.
.
Speaking to.
.
The environment itself and how
it but protects our health.
Or next speaker is David
florist florists is a community
development director for casa
familiar.
It's a nonprofit look look
innocently C. there among the
Mike California next
the border.
As an architect he understands.
The environmental impacts
because I community planning and
infrastructure investment.
In his presentation he'll be
going over the impacts and air
quality. Resultant
from living next to the signage
that a border crossing.
Thank you miss Flores thanks for
being here.
You very much.
Center hueso Anderson member
Garcia for for up for this the
time to present on some of the
issue around Sonny CEO.
.
Sonny Seattle as this many
people know isn't right adjacent
to the border crossing.
And two of the border fence and
between Sunday went to Quanah.
In two thousand and four.
The. US general services
administration began amassed
plan and design of a new.
Says he drove land. Border
station a completely new
reconstruction up costing seven
hundred fifty million dollars on
this one federal project.
During the environmental impact
statement period that's a
familiar out brought up issues
of air quality. And the fact
that.
The port expansion was moving
forward with having twenty two
northbound lanes
to an expansion of having now
thirty northbound lanes and
double stack booth so sixty
inspection booths.
Moving forward with.
Southbound inspection facility
for the first time ever.
That the border patrol would
have southbound inspection
facilities in this design. Arm
increasing the existing six
lanes of vehicle Efik moving
from our Sunday were to take
wanna.
Tune out eighteen are I'm sorry
sixteen lanes.
With inspection booths that is
currently under construction.
As we know this so Lamport of
entry is open twenty four hours
a day seven days a week.
With an average of about fifty
thousand vehicles across from
south to north.
And anywhere between twenty five
thirty thousand pedestrians at
cross from south to north. On a
daily basis.
Across through the committee
Senate zero and in the evening.
When folks are returning home.
The same phenomenon happens.
Sun zero is at community of
thirty thousand people
so it's getting.
All of the impacts of this huge.
Infrastructure.
And and border facility.
Wait times as we know have been
anywhere between two to four
hours.
And and continue to up persist.
The federal government has
stated that at the conclusion of
the construction. A expects that
cross border wait times right at
maximum efficiency will reach
thirty minute wait times.
We are very.
.
A. Cautious of that.
In in believing that that will
actually happen.
But the last phase of
construction of the Senate C.
torment port is currently under
way.
It is expanded by a hundred
percent of the footprint.
Taking over there ten out an
additional acres
if commercially zoned property.
In the committee associated.
Included in this new part design
is a new south been inspection
facility that. Arm the border
patrol.
That department of homeland
security.
It's going to be inspecting
every vehicle.
Before it leaves the United
States.
And enters into Mexico.
That practice is currently
happening right now as we speak
the bear patrol kannst traffic
on I. five going need to
decline.
Start to spectacles
the queuing lines for these
vehicles are now beyond the
communities here.
So we C. backups on the hifi.
Extending it will anywhere
between four and six miles.
Right.
So what what.
Our. Colleagues in familiar
Essen and Pete and and residents
of the city of Tijuana have been
suffering for a long time.
Socio is now.
Starting to recognize that huge
impact on air quality in
traffic.
Since the two thousand and eight
because a familiar at has
started working with.
Senate with state university
doctor can you can Donna on.
Strani to. Do air monitoring.
We and initial study back then
and are currently completing. A
two year study funded by the
state for that by the state of
California department or office
of environmental health hazard
assessment. It following.
You know that the wonderful
work that our friends here echo
me to see people and we saw
Melanie and his team have been
doing. In imperial valley.
We.
Ran a thirteen monitors
four period of of all months and
have been fighting. Intact the
or. Are kind of notion that
Sonny C. role is being higher
higher impacted by this.
By this phenomena is in fact
true.
So we placed one monitor at the
decline of river estuary in
imperial beach that was are
clean site. Ten monitors within
the community Stevo we formed a
a community committee of
residents that helped us to
identify all those monitor
locations.
Tom and reasons why they were
concerned about those.
Different locations in
neighborhoods.
And we.
Have.
A.
Made a change already. Between.
State school Connie buyer screen
two point no.
Where Sonny Seto was not
identified as impacted right and
it was showing green? And
Calvaire screen three point no
where sincero now is at the top.
Ninety five percentile of
impact so.
With respect to two of the.
Two of the indicators
Sonny C. rose at a ninety five
percent.
Percentile impact.
And is at I. one hundred
percent percentile impact when
it comes to traffic.
It's this a huge stress on the
cleaners on cedar on its
residents to even get an where.
Within two miles of that border.
Particularly over the weekend
says it's is very heavy.
Leaves we have identified that
there.
The particulate matter in
imperial beach is ten times
cleaner.
Then five or six miles to the
committee of some pseudo the
closer you get to the border
crossing.
I'm so there's ten times worse
right Allen levels of
particulate matter at that
border crossing.
And we have also identified
that.
During.
Phenomenon of important
holidays right or important
cross.
Border a happenings.
The pollution does in fact.
Elevate and all of our monitors
that have been calibrated with
the with the county here on
they're pushing told district.
All are also showing the same.
So.
We arm are comforting. Aren't
that.
So the studio is overly
impacted.
.
Just by being
close to the border.
And we are working with carp.
Our air pollution control
district.
Other agencies and other aroma
to justice groups
to make sure that the border
areas including now in the city
of Tijuana.
Are right and find the data
that the federal government. Did
not want us
did not pan did not and is not
collecting.
So.
.
We are trying to connect.
Public health
to this issue as much as we can.
In our next steps are to connect
with a. Their pollution control
district our county health
department of of course the
state at different levels to
make sure that. A public health
up both from both sides of the
border is started to be
correlated. With air quality
data and cross border traffic
wait times.
.
We no there's a higher incidence
of asthma rate in. In school
children and in sunny Seto and
we're gonna start to work with
the local agencies as well as
the local health centers just to
get more of that data.
So it's early on in our
correlation of this work with
the. With the air quality data
but home where we now have. A a
good measure of where to begin
the what to focus on.
One final thing.
We also did a.
Snapshot campaign over several
weeks and months
a at some of the sites and we
identified that black carbon.
Spikes in the middle of the
night.
For both a sunny pseudo decline
that and imperial beach
so we know this this.
This issue is not just the sun
if you wish not just or across
initialisms English.
We're gonna be doing more data
analysis in the next months
to see what else we can find and
share with everybody.
One final note we have received
a USEPA border twenty twenty.
And we will we will pick
spending six
monitors in the city of decline.
Not to our network.
Thank you.
Our next speaker is Hassan
please you secular director lead
engineer for the call Colorado
River basin water quality
control board.
He is responsible for the
development and implementation
of water quality control for
the.
Water board and serves on the.
By national technical committee
for the New River.
Holly sanitation program.
He ripped represents the state
of California in the good
neighbor.
Environmental board.
And he is.
An independent federal
committee.
The I'm sorry the.
.
Good neighbor at environmental
board is an independent federal
committee the devices the
president Congress
on the good neighbor in Bob Dole
practices along the US.
Border with Mexico
he has a bachelors degree in
civil engineering from
California State.
Fresno a university is also a
California Richard civil
engineer Anna hazardous.
Cereals specialist
he's here productive I'd us an
impact on the up I'm sorry he's
here provide us an update.
Regarding the impacts to water
quality along the border.
Thank you struck and welcome.
Think it scares me a thank you
chairman hueso assemblyman
Garcia.
Thank you very much for the
opportunity to represent a or
board at this very important
hearing.
Distinguished guests supervisor
Catley.
IT director solace. And non
console Flores peace Kara.
And distinguished guests and
colleagues thank you.
Are. Twitter like to do today it
it the chairman allows me. To.
Put context to the New River
water quality problems at the
border.
A I have previously provided
testimony assembly committee on
environmental safety and
hazardous materials.
On the New River problem from
the border all the way to the
Salton sea my remarks today are
going to focus.
On de Niro forever a pollution
problem not border. Up more
specifically I would like to
share with the committee and
members of the audience.
The things that we're doing it
and the strategies that we're
implementing they're actually
working. And if nothing else I
want to leave you with this
thought.
A binational cooperation works
for us has worked historically
for us and we have results to
show for it. And they have
benefited the state.
Before I describe the problem
what I like to do is put it and
regulatory context.
And by that I mean. A as most of
you know.
My board. Is charged with
controlling water quality of
activities on this side of the
border.
That could impact water quality.
Our review or federal government
namely the United States.
International boundary and water
commission.
And the United States
environmental protection agency
as the to primary federal
agencies.
We're responsibility for
addressing pollution at the
border with Mexico.
That said it doesn't mean that
the state of I should does not
get involved in dealing with the
problem in fact.
On god to argue that the state
has a very keen important role
to play. To make sure that we
protect not just environment but
by inference public health.
X. like please.
First let me start by they
complain to you that.
The New River waterfall problem
on the international border.
Is a significantly different
problem from the problem of the
new very very worried this gets
into the Salton sea.
Apples and oranges.
The new record the main problem
not the border is. And we call
it on zero.
Is the threat.
That water quality of the river
closest
like health.
A the New River water quality
problem Alton C. it's much much
different relates to some of the
Salton sea problems.
Next please.
For are her visitors such as one
at the water visitors to get an
idea.
Of the footprint.
Of the many county metropolitan
area as compared to the.
Calexico.
And the. The best dressed jury
entered are make Ghali has to
making wastewater treatment
facilities.
One that is. In operation since
the early sixties the star was a
waste water treatment facility
can on you were one of the thing
you're solved which is called a
sorry neatness.
Thus any does which water to
facility doesn't this Josh.
Into the number that we don't
get that which water go south.
Typically to Luxor set retirees
to the delta.
And next please.
Historically a then your river
has been.
Infamous are reckoned nice.
.
So significant water quality
problem Mike border primarily
because of the order. In Amman
of our untreated waste.
That is to carry.
.
It it and the the problem is
closely aligned.
With population boat can make
the county.
A population Mexicali a.
On the demand for switching for
structured D. not keep up Bob
with the population growth.
So are to make a long story
short the next light please on.
But by the. Mid nineties seventy
two thousand next please of we
were dealing.
Basically.
A would ever revert carry
significance amounts of raw
sewage a anywhere from. One to
twenty million gallons per day.
Please keep in mind that he
doesn't take a lot of raw sewage
to basically turn revert the
sizing to a septic river.
Hence the order. And water
quality impacts but what I
wanted to point out would you
with this slide is.
The level so pathogen indicator
bacteria that we were mashed.
Throughout the nineties and
early two thousand.
Are there were. Is a density
measure. The millions we used to
stop counting after he hit sixty
million because.
Is meaningless.
Our our standard is in the low
one hundreds
and that's just give you a sense
the proportionality of that
magnitude.
Of the water quality problem we
are facing.
Understanding that this that we
were dealing by national waters
and they. Limited jurisdiction
that we need the state have.
A to control that the problem.
That clearly we needed to
develop a a different strategy
than the typical regulatory
strategy and strategy is based
on cooperation basically.
Next slide please.
Are.
The international boundary and
water commission on develop a
series of.
.
Treaty stuff what they are. Up
interpretive amendments to the
nineteen forty four water.
So I river outfield band treaty
with Mexico.
One of the most fundamental
things that worked.
That the items I tell you C.
that'll work is that number one
developed by. As strategy in
writing to basically revealed a
solution for structure Mexicali.
So that making alley would end
up with a.
The infrastructure that would
keep up with the demand.
More importantly from my
perspective because engineering
problem was fairly straight
forward to me more importantly
from a policy perspective what
he did next like please. Is not
establish
they by national technical
committee.
To oversee.
The implementation of the plan.
To bring up the infrastructure.
The necessary level of the
treatment and incapacity.
But also to improve and enhance
by national cooperation and
communication.
There are national technical
committee has representatives of
ma.
Both regulatory state agencies
sympathize with the border. It
also has a local representation
a county in our case imperial
county.
A.
He imperial irrigation district.
And the USEPA the when national
technical committee is called
share.
By D..
I W. C. WWC is open National
Commission of most of you know.
That we have a U. S.
commissioner and a Mexican
commissioner. Of the local head
of the office here in. Maybe
county and not the wanting Duma.
Co chaired the committee. On
behalf of the.
Well over the commissioners.
I.
This model.
.
Proven the very effective info
Philip dating Munich Asian
providing adequate notification.
An aunt and so forth Doug to get
projects done.
Our next slide please.
It was charged with basically
implementing close to one
hundred million dollars port to
buy national projects in making
Allen.
Now a lot of people question why
the money was being spent in me
Connie as opposed to on this
side of the border and and and
quite frankly. It was bang for
the Buck number one. A we have
always the state has always been
the position that the problem
should be addressed at the
source that's the most
economical way to do it. But
also you know my boy was looking
at a at the problem politically
that anything the benefit there.
Mickey Colleen turns to water
quality.
Would also benefit the state in
terms of water quality in by
implication.
It would improve the quality of
life of our citizens on both
sides with the.
Needless to say that he took us
up quite talk what amount of
time because it was quite a lot
of work to be done.
To get a project done
approximately ten years. From
inception to completion.
And right after those projects
were completed.
Number one a we managed to get
all Deborah suicidal the New
River that in itself is quite an
accomplishment by any standard
including our stand there's.
But the river water quality
improve significantly overnight
as soon as the new wastewater
treatment plant went into
operation.
W. S. June two thousand seven
there about we. That the
reasonable and others.
.
To sampling.
A determined that the.
The projects work where is she
in intended objective.
Okay my war had had a monitoring
program for the new forever I at
the international border since
the early nineteen seventies.
Are we use that program number
one to two
to keep track.
Of a cleanup progress.
But also to assess emerging
threats
and and our primary concern we
focused on tracking. A the level
of the up after Justin pathogen
indicator organisms.
Thought to alert the local
health officer in and get
purpose stakeholders about the
conditions of the New River but
also to make representations by
Frank. To our federal government
to what else needs to get done.
So that's whole well then intend
that Andy has proven very very
good results next likely.
Here's an overview of the new
wastewater treatment facility I
I. again the problem from an
engineering perspective is
fairly staple or sanitation
problem I mean.
A at that that the main toward
by national policy C. issues.
And what the help us. It.
Hello in people can argue back
and forth just whether nafta is
good or bad. Depending who you
ask.
Now after then a fetid bought
countries in particular the
border area. Because nafta. A
allsorts doubtless in north
American Development Bank and
the Dan by a border environment
cooperation commission.
Who I. locator resources to make
the problems and Mickey Callie
it top priority?
There's no lock will there's no
lock up operation in Mexico a
list de Mexico as you as you
noted the needs are great Dan.
Like any other country has
priority stuff for his limited
resources Linda but once we got
the resources and the bi
national cooperation so we've
been there.
And we got the job done I. S. he
relates to the on national
projects
next please.
This the slide here compares the
problem before and after.
And and and and you concede but
but but just looking at the
first a relative to how.
Basically there Sir.
Four five logger. Reduction and
your metric reduction in the
level of pathogen indicator
organised.
We use that pathogen indicators
would on sample for specific
diseases because number one it's
a number one.
.
Less expensive but also we get
ourselves more readily.
And Bob stands to reason that
if.
If
certain levels of Beth we detect
certain levels Beth again.
That anyone who comes in contact
directly or indirectly with the
river water runs a risk.
Public health risk.
So are that's why dis numbers
are important the other thing
that a witch's suggest a
corollary is that. There was
also significant reduction of
the amount of nutrients from
Mexico that went to the Salton
sea.
So the projects work we're not
nine year and that there are a
emerging challenges.
.
Next like please.
Just turn on the VOC yes.
Or said some detected an
undetected. We're talking about
you're measuring the actual air
so that the emissions of the
liquid no we were at not not
not.
Directly what we're maturing as
balked organic constituents in
the water within the watercolor
okay and endorsed kick back this
you you valley alluding to
senator hueso to industry.
A.
In this case.
Mexican both Mexican on and and
McHale Orison.
Sally and
because that there were.
Not given the level of services
for because mentality and have
enough sewage.
Capacity.
Some of them are were
discharging indirectly to they
never ever untreated wastewater.
And W. once so we revealed
infrastructure making County to
the bi national technical
committee.
You know on one okay any makes
sense.
Well up at.
The cylinder seal you may recall
that I appear before idea.
Assembly committee on
environmental safety and.
And I hazard materials about
three years ago.
And I conveyed to the committee
that back then.
That we had a problem and and
and now we have an emergency it
turn into an emergency and and
at that time I believe I
reported to the committee.
That we had a thirty meet thirty
five thirty million dollar
problem again with the things
that needed to get done with
this issue for structuring
making galley.
Well I am not pleased to report
that thirty five million dollars
is now a seventy five million
dollar problem.
We're facing a yet the.
Asian infrastructure making down
the line used to be rebuilt.
.
We.
We have that elevated the
problem. To our federal
government.
Holly PA secretary has been
instrumental in the.
Securing additional resources to
our federal government to make
sure. Mexico a does not this
Josh rose tuition to the never.
A into Mexico's credit there
also is spending some of their
limited resources.
To make sure that that on the
shelf rustlers but again we have
a patient out there that is and
tremendous need of a. Service
and care.
And that maybe county rely so
pursue their services are not
serious the pumping stations.
Take sewage pipes and
collectors.
They're quite frankly have
either.
Up past their useful life.
Or I need that would prepare for
excellent recent.
That is the main threat right
now.
Any of that threat does not
address with a sense of urgency
by our federal government.
Things are just going to get
worse and we stand to lose. If
the hard fought water quality
Gaines.
All that means is that if we
could if we if we don.
Says in continue to cooperate
with Mexico.
To address the problem.
Are the New River water quality
is going to go back to the
nineteen I. X..
And that poses again a serious
threat. To anyone that the
constant contact directly and
indirectly. Without water.
A I I I have provided my
testimony to your staff M.
riding with us you're so
recommendations.
But we don't want to reinvent
the wheel to me just gotta do to
the chase.
By national cooperation works.
The one national technical
committee has this year she saw
obligations outnumber León my
opinion not because where
members but we because. It has a
good track record.
And we have the data to prove
death.
So we we recommend that the dom
model.
It's a model for communication
by national corporation
continued to be used to address
the problems
or monitoring program has
worked.
And my board Wilk convicted to
prioritize its limited resources
to continue to maintain the
program.
That is important also for
local ski at stake holders.
A but but the other thing that I
wanted respectfully bring to
your attention and request that
the policymakers.
Speak with one voice and
continued to haul the federal
government responsible.
Put this problem.
That's what we need to put the
resources.
Because when we improve things
to make he county it does
benefit the state.
And when we work quite
predictably we can get things
done sooner than.
I really appreciate the
opportunity. To provide
testimony on behalf of my not be
happy to answer any questions
Mike thank you and I just want
to congratulate you on all your
work.
I hear in the border region I I
can attest to the fact that.
You've been doing amazing
things.
And we're grateful to you so
thank you for being here and
also. A Mister Flores.
Also M. I'm familiar with the
workings Andy said of course
we've worked together for many
years.
And in particular we've been
working hard on the on the
cleaner monetary in.
The live viral the Calaveras
screen that we've been working
at state level to fully capture.
The the emissions related to
industry along the border it we
we.
We have a problem in terms of
how the state.
Defined a.
.
Contamination along the border
and and.
Environmental justice.
And and we we.
With working with the governors
office to correct a problem that
we have that would probably
bring more. Resources to the
border area so. I gave it has
been a huge advocate in that.
And we bill working hard to make
sure that the. Border regions
are treated.
Equally when in regards to
environmental justice and T..
.
Attraction of important
dollars to two to fund this
program so thank you for which
had been there to Germany
questions.
Senator thank you for.
The opportunity we have.
A couple questions that to David
that you mentioned. Callebaut
screen.
And.
Efforts at Senate just
mentioned to try to expand its
reach.
To address.
In disadvantaged communities
very much justice issues.
Beyond what the Calamaro screen
was set up to do in.
You know we're hopeful to begin
to see those benefits.
I know that.
As a result of assembly bill
fifteen people the that de. Now
congressman Jimmy Gomez
worked on we we were able to
include.
A further.
Reach in the lower income
communities that were not part
of.
The Calaveras screen and and we
believe that there will be.
Great opportunities for border
communities as well as other
inland.
I. areas in the state rural
parts of state Central Valley
areas that suffer.
With issues related to air
quality as we do here and broke
down but want to just highlight
that you know there are efforts
underway.
That will benefit our border
region to.
.
Quantify.
And consider D. daytime
populations.
In California that are coming
from south of the border. For
the same purpose of aleve
eighteen.
The.
Scott shin about the need.
And making those.
Dollars from the greenhouse gas
reduction funds.
Available to addressing whether
it be the air quality.
Monitoring systems that we have
made reference to several times
today or developing the actual
strategic plans to mitigate. And
minimize.
The impacts.
Mission.
To the public health look
and that's assembly bill
nineteen forty five.
And de it's something that
senator night working on very
closely.
To make sure that. I think that
could become a model moving
forward. To addressing a a wide
array of issues on the border
that are relevant to formulas
used.
When we distribute resources
based on.
The per capita populations and
our religion may we know for a
fact. That living here force
inside the C. little.
You mentioned Sonny C. there was
a population of thirty thousand
registered residents but.
Uniting given moment there's
probably three times the amount
of people. That are there.
Doing business right. And at
the same time you know I think
we can make that same.
Comparison to the border here in
Calexico and other communities
north.
Of here so one just to raise
that as a plates to.
The.
You've ever.
I know that.
There been tremendous strides
to improve what's happening on
the north side of of the border.
And. It it's very difficult.
When we can get the problem
solved.
And it at its root venue you
just highlighted it to seventy
five million dollar.
Price tag now.
To what was already in eighty
million dollar investment that
was made at one time.
The building that treatment
facility that you highlight it
one of the two that you.
They you highlighted earlier
presentation.
Can you talk about some of the
efforts that are under way. On
the north side of.
The border that I think could
bring about.
Some.
More positive.
.
Reflection.
Because there's there are
efforts and we know that die in
the water bond that is in the
Jim ballot there's.
.
Ten or fifteen million dollars
of what's been estimated cost of
twenty. To do something on this
side of the border to addressing
the impacts of thinking you
elaborate a bit on what's
happening yes. Thinking some
León Garcia.
We the state they're not letting
obviously until our federal
government decides what to do
about the seventy five million
Lara Priscilla dress public
health the in the Calexico area.
You may recall that that the Dan
assemblyman Victor Morrell
paralysis sponsored legislation
that became law.
That required the state to
develop a strategic plan to
address New River water quality
problems none is Saudi not just
at the border of all the way to
the Salton steam.
One of the provisions.
That the D. strategic plan that
was required by that
legislation.
Provides for.
So here's a project and
recommendations for the New
River in Calexico area. A and
the.
About the thanks to your efforts
and the efforts of your
colleagues India legislature.
A one point four million dollars
where allocated through our
perinatal in C. this they water
resource control board.
To basically the ballot but the
plans and specifications.
And the environmental
documentation to address
primarily to help problem of the
New River and the Calexico area.
The plan a basically recommend
that that that brief thanks for
the New River in the Calexico
area.
Wong wants to.
In case the river.
Meaning convey it outside the
metropolitan area in Calexico is
to minimize the public health
threat.
A put a trash screen at the
border also to deal with some of
the tracks to León in the new
river. And and also build up Tom
back system to put a clean water
back into the river where for
that section that the river
would be underground.
I'm pleased to report to you and
your colleagues and everyone
here.
That that we have a contract on
board.
We'd.
Two basically develop those
plans specifications and
environmental documentation we
have a very aggressive schedule.
Aggressive Ben very realistic
still.
To get Douglas plans and
specifications and environmental
documentation dot by October of
this year. Are we have had
issues to meetings.
With our consultant.
We're in charge of managing the
contract.
Where colleagues from Hahnemann
security border patrol county I.
eighty and us here Calexico not
picky stakeholders?
To operational D. a promise
that we made M. basically a
layout also expectations some of
the components that I described
in particular that trash can the
company and systems. Of will
require consultation and
coordination with Hans security
we understand that we want to
get the show on the road.
The feedback that we got him
from a college set up by friends
at the. Border patrol enough
common security has been very
positive and supportive of the
efforts to shore end of it thus
M. León she eyes that Dodd.
We are taking steps a are level
at the state level.
To make sure that we address
the immediate public health
threat. And the. But as you
pointed out that the if the
proposed water bong gets
approved by give voters.
Not only a look at resources
also to continue to manage not
read the Salton sea problems but
more importantly.
We believe there's ten million
dollars just to see if I could
allocated to this project in
Calexico. So would quite hopeful
that the the water bomb will
pass because we can hit the
floor running one C. if he gets
past.
To make the right to the people
of Calexico in imperial valley
so I appreciate you highlight in
that and I think the job of the
senator and I moving forward
will be to.
Up close that gap mate that that
twenty million dollar ten
million dollar that remaining.
Gap and that's you know a budget
Oscar will make.
From now till when we get.
.
Given what you've highlighted
our efforts and progress being
made in California it still
doesn't take away from the fact
that.
We still have a seventy five
million dollar estimate cost to
the root. Of the problem and
certainly.
That collaborative.
You know partnership is going
to be critical. Whether federal
you know in Minnesota ministry
hers. And representatives to be
able to.
Address that problem because for
some people it makes absolutely
no sense.
I would imagine that we are
making these strides to improve
the situation on this side of
the border when in fact we're
still.
At risk
somewhere another two being
impacted by what's
coming from.
South to north but let me know
if if I may just the two of.
Lara litter that additional time
assemblyman Garcia and center
hueso just leave you with this
thought okay.
We could have not achieved.
Would one billion dollars.
On this side of the border would
what we achieved with a million
dollars on the Mexican side.
That is not just to be good
neighbors and humor pakcik okay
again you know I'm of the belief
and so is my board.
That what benefits Mickey county
from a water quality and
environmental perspective.
Benefits the state in the border
region.
The the Dodd said I don't want
you up I don't want to leave you
with the impression the magical
is is is just awful waiting for
my national assistance.
They are spending their limited
resources and so far they spent
close to a million dollars. Just
to make sure they don't send
those are a sewage.
Now.
I think that that.
X. well Mexico is is the common
sense to do.
A but but but are my board will
continue to use by national
cooperation with Mexico because
it worked before. And will
continue to yell our federal
government because he has work
also before.
Thank you struck Killin thank
you which flourished and and I
just wanted to also just a.
Say.
.
Thank you for that for that
leadership at the state level
for on all the work that has
been going on with air quality
monitoring.
With a beat seventeen I know
it's early and that program but.
On both recent I really looking
to help develop that.
Stronger more robust program
and and also appreciate the
identification of the equitable
distribution of of greenhouse
gas reduction funds that come
through these programs.
We're looking at a whole array
of different.
Ways to solve this for out or
to mitigate for Sonny Seto right
from collaborating with their
school districts for inter elf
air filtration to looking at.
How new constructions are going
to be moving forward in in the
sunny state also of bay area
onto connecting with?
Our university Skinner
researchers on what else can we
be doing.
And of course all of us put a
lot of pressure on the federal
government when when we. When we
can present the data that before
we didn't have thank León we
really really appreciate thank
you and and really that is the
point of this hearing. I mean
we're trying to get to a better
place where China.
Move an agenda forward and we
want we want to hear mainly what
what is the most.
I should expect to do that and
when it comes to public health.
We we could use a good
suggestions here in the
legislature in terms of how to
do that we've been working very
hard to find that pathway but we
we know we need to involve.
The best and the brightest and
in developing what that is so
thank you thank you for being
here helping to that.
Are on the next panel we have.
.
We can ask a doctor would be a
definite from.
Good it does a.
Subtle the partner come up and
also. Uppala isn't Criner.
Criner public Criner.
A a. Epidemiology program
manager with the imperial county
public health department so.
We're gonna have Dr Geffen.
Present first D..
Is of.
From the university of here
holds a medical degree from the
university of Miami and has.
Numerous certifications
in forensic medicine emergency
medicine he has collaborated
with Stanford University school
of medicine.
The Berkeley.
.
Medical program. And also
university of San Diego so on.
Welcome were very happy to he
hear from you.
.
He is gonna speak on.
.
He's gonna explain what health
professionals and clinics are
doing to keep up with the.
Growing demand
keep up.
With these emerging threats to
public health in our community
thank you doctor Jeff thanks
for.
Thank you senator hueso innocent
assemblyman.
So.
.
We can look next life.
Hopefully I can read it from
here.
.
Basically having been practicing
medicine in this area since
eighty two.
And that's important thing about
this life.
So a some people here know me
and some people. Do not know me
so.
Hello.
Okay
so. Clearly because a solid
point.
I I think that in the nineteen
seventies and that was the
first.
Migrant health centers
knowledge.
In the you opposed by the for of
all them and that's the
important thing about the clinic
as they've been in the
community.
Four thirty.
Forty plus years.
Season that expand that.
Currently they have twelve
clinics.
Out of our medical clinics
some of their are combined with
the women's health and with
dental.
Health.
Well US infant and children.
Okay are they're about to open
later on this year estate of the
at our facility how central and
it's going to be right on the
eight freeway.
I think the.
The infrastructure's going up
now.
And that's gonna offer.
A lot of services.
It's gonna of for.
Xray in house laboratory
ultrasound.
And multi specialty.
Another thing that they're
working on he's a residency
program for nurse practitioners.
Us will know there's a lot of
fun.
.
But features in this community
so that should.
Help retain.
Features put clinics.
Clinic us have also received.
Grant's fora diabetes asthma and
heart disease.
And out have benefit to a basis
to the committee.
The next one.
Sorry sort the measure they have
of the twelve clinics are in the
pale county Andy riverside
county.
Are the proximity of the border.
The weather.
And.
Continuing education.
And one of the important thing
is that the clinic because
provides.
School loan repayment so that's
a nice way to retain people.
.
Basically we. All the physicians
in this committee manage
a lot of things.
But the environment does affect
asked mom.
Respiratory illnesses.
Chronic and long term care.
And they thought they'd affects
and it baby so the way to.
Elderly population.
.
Pollution is very important us
as you'll for.
On affects the health.
And the.
The clinic us are also involved
in research
some projects and they use a
promo Toras.
Demographics.
.
Based on the bill graphics on
the left.
Melee Latino I I. Athena her
this IV eighty five percent in
the bell county.
And another factor affects the
health these.
Port.
So well.
What do we may delete tree that
the clinics?
The main diagnoses will be
diabetes hypertension asthma and
obesity that's increasing and it
affects.
All of the above.
And now one problem that we've.
Noticed.
That it's growing.
It's patient that calm.
From Mexico and also from the U.
S..
Requesting benzodiazepines.
The band's us.
The vessels in the U. S. have
increased that in sixty seven
percent in the last couple
years.
There Senate be then become
benzodiazepines as well as
opiates.
And that's a problem because.
Overdoses addiction.
And.
Bugfix the called the cognitive
factors well.
The next one.
Ankle coalition a Buckley
because they look at the provide
excellent care.
And.
.
They have growing.
And we expect high level of
services.
And.
Of here to the highest higher
standards of care.
Unethical conduct.
And any bumped information those
other corporate offices.
That's the end of.
That they should
thank you you're welcome thank
you Dr Geffen our final speaker
is miss Paula Criner.
Is the program. Program manager
for the appeal Connie public
health department.
Responsible for. Epidemiology
and surveillance of communicable
diseases including tuberculosis
sexually transmitted diseases
and HIV aids.
As well as immunizations
epidemic influence of
preparedness.
She has been actively involved
in border health issues
for the past seventeen years and
represents a public health
department.
On the California office a bi
national border health advisory
group.
And she has a master's degree in
public health.
Talk about the public health
concerns involved over the years
recommendations on how to
support.
Efforts
trade dress
those particular issues.
Region earn much.
Thank you for the opportunity
to.
Participate in this hearing
and to address ways to improve.
Public health in the border
region.
At the local level.
And as were all aware imperial
counties a geographic location
adjacent to the US Mexico border
provides many opportunities as
well as challenges.
For public health the border is
fluid
people cross everyday from one
side of the border to the other
to work.
To visit friends and families.
Shop
and we have many health issues
and concerns in common.
One of the greatest challenges
as has been brought up
previously is communicable
diseases.
Specially tuberculosis.
HIV aids and other sexually
transmitted diseases.
Communicable diseases.
And is diseases in particular it
is important for in public
health to identify test
intrigued individuals who may
have been exposed to the
disease.
However when partners are
contacts
two and kiss diseases are
located across the border.
Health departments on either
side of the border have to find
ways to collaborate to
accomplish that.
Without those measures these
diseases will continue to
spread.
Tuberculosis is a case in point.
Well rates of active TB disease
have been declining in
California and in the U. S.
overall.
TB rates are increasing in
imperial county.
Our county reports the highest
rate of tuberculosis disease
statewide.
Four times higher than
California overall.
And we have one of the highest
rates of tuberculosis.
In the country.
One of the factors affecting
imperial counties high rate.
Is the higher rate of TB disease
in Mexico.
Baja California has one of the
highest rates of tuberculosis in
Mexico.
A significant proportion of
imperial counties caters of
active TB disease.
Our bi national because they
work.
And or live in the U. S. and
Mexico.
Or they have contacts who reside
on the opposite side of the
border.
Managing tuberculosis.
Has become more difficult.
In recent years.
An increasing number of
individuals diagnosed with TB
disease.
Other health issues.
Such as diabetes.
Substance abuse
and mental illness.
This place is an inordinate
burden not only on public health
staff.
Also on our hospitals.
The provide care for these
individuals.
When they become severely ill.
As well as our local jails when
persons with undiagnosed has
undiagnosed tuberculosis.
Are incarcerated.
It is C. sensual to ensure that
individuals with TB infection on
both sides of the border are
evaluated to determine if they
are at high risk for. Active TB
disease if TB disease.
It typically take six months or
more of appropriate medications
to cure.
If not treated properly
tuberculosis disease can be
fatal.
Another important public health
concern are chronic diseases
such as asthma and diabetes.
These impact a adversely impact
residents in throughout the
border region.
For individuals who suffer from
asthma poor air quality can
exacerbate this condition.
As has been stated previously
asthma is a critical health
issue in this region.
Imperial Connie reports the
highest rates of hospitalization
due to asthma as well as the
highest rates of emergency
department visits dude at the.
The prohibitory condition.
These rates are highest
among children under age five.
And they are the most vulnerable
cohort of our population.
Improving access to care. Ink
increases the likelihood that
asthma will be better managed
and controlled leading to fewer
exacerbations and
hospitalizations.
Public health must be vigilant
for emerging infectious
diseases.
Such as severe acute respiratory
infections M. Skeeter borne
diseases.
We must.
Constantly monitor for
respiratory illnesses including
new strains of influenza and
other viruses for early
detection and identification.
In two thousand and nine
imperial county identified the
first case of pandemic influenza
a eight one eight one.
Through our enhanced
surveillance system for
influenza like illness.
Other early cases have influence
a eight and in one were later
confirmed in Mexico.
This sin example of the new flu
strain.
Detected locally.
That spread worldwide.
Skinner borne diseases.
Or another emerging threat to
the public's health.
As has been stated previously.
These persecuted borne diseases
currently circulating Mexico.
Imperial work County residents
could be bitten by mosquitoes
when they travel to M. make
Hugo.
Or up by mosquitoes that are
expanding their range across the
US Mexico border.
This county.
So.
I was asked to talk about what
areas stakeholders should focus
on to improve public health and
maximize benefits.
On public health.
So Harriet locally your your
residence key stakeholders and
local advocates in imperial
county formed.
The community health improvement
partnership
and embarked on an extensive
collaborative process to examine
the health of our community.
To identify priorities and to
develop a plan to focus on key
areas for improvement.
A partnership conducted an
indepth community assessment.
The result of this effort was
the twenty seventeen twenty
twenty one. Community health
improvement plan which
identifies three priority areas
along with the impact targets
for each area.
Healthy eating active living is
the focus of one of those
priority areas.
D. impact. Our consumption of
affordable accessible and
nutritious foods.
Engagement an affordable and
safe opportunities for physical
activity.
And achieving them maintaining a
healthy weight.
Community prevention linked with
high quality healthcare targets
asthma detection management and
education.
Early an adequate prenatal care.
And diabetes detection
management and education.
Finally the healthy safe healthy
and safe communities and living
environment. Focus on focuses on
engagement in improving air
quality.
Prescription drug abuse and
prevention.
And linking family members
caregivers and persons living
with dementia.
Across systems of care and
support.
The community health improvement
plan outlines how the community
and local organizations can come
together to improve these
priority health issues. By
working together through
partnerships and systems change
to make a lasting effect in our
community.
So how was public health
concerns a evolved over the
years.
There is definitely an increased
recognition of global health
threats
and preparedness to identify and
respond to those threats.
In imperial county that has led
to the development of cross
border surveillance.
An increase communication
between local and state health
jurisdictions on both sides of
the California. Baja California
board.
Health departments in imperial
county and make Holly recognize
the value of sharing knowledge
and resources to detect cases
and follow up on contacts of
communicable diseases
such as tuberculosis. And
sexually transmitted diseases.
Another key area of change is a
focus on phase we can work
together in our own community.
Ways that we can join forces to
have a collective impact on
priority health issues.
Not just in terms of an
innovative project but evidence
based programs that bring
together disparate partners and
tackle health concerns from
different angles.
It also means developing and
supporting new leaders.
Our health
in our community.
Finally I was asked to address
how we can.
How?
You Senate quite a cell and
assemblyman Garcia. Can.
A help a support local efforts
to address the concerns.
And as you are aware.
Local health departments faced
mounting health issues.
With dwindling we use resources.
We urge you don't recognize the
importance of supporting public
health
and rural infrastructure in the
frontline border region.
Not just the more populated
urban centers.
We urge support for collective
efforts to improve public health
both in our community and with
our partners across the border.
Thank you for allowing me to.
Thank you and.
Sometimes I miss the problems.
Are not financial I'm in San
Diego we had an outbreak of
hepatitis.
And found that the county had a
surplus.
Or or really a hundred forty two
million dollars up for not
really related to they also had
a different surplus fund.
Of of the of nearly a hundred
million dollars a hundred forty
two million.
That they just were
ideologically opposed to
spending on public health.
We found that they had a hundred
forty two million dollars it was
just certain there unused.
And they really didn't have that
then put forth much of an effort
until they got. Public criticism
of course. Lara leaders came out
and and I am particular
identified funds and ice and we
gave them money from the state.
To fight this problem and yet.
They're sitting there idle.
Doing groove.
Little to nothing about it that
from from our standpoint and.
This hepatitis a outbreak
because because many lives.
But not only that I mean.
It gave our county a black eye
in terms of having fighting a
third world problem.
In Anna Anna in a state in a
community that is.
.
Has plenty of resources to
combat that.
And in addition to that our
business community was hurt
because people did not want to
go near restaurants.
Or communities where they
thought that there health would
be.
Impacted.
And thereby did not go to
downtown region and we saw.
A big drop in in in the
consumer's going to restaurants
and businesses.
That.
Were in that region simply
because of that issue.
I herd of of complaints that
statewide so this this goes.
This goes to the heart of.
Do we have the resources.
To provide.
Up up.
A programmer a plan of action.
Begin to combat this.
And whose responsibility is that
is at this level is at a local
level
if the locals don't put together
plan.
And don't come to us you can't
come this and say we need more
funding if we don't have.
And what we're trying to come
to.
A better place to terms of
encourage I mean the solutions
always began at the local level
because every region has to
challenge.
And while you may have an as
months ridiculous challenge
here.
The challenges in in.
Sample discourse and you or.
Fresno might be different.
And then we are.
I I I'm very concerned about the
the the air quality issues here
that's why both.
They León I we work on air
quality measures we work on some
C. measures those are things
that we're working on. Hopefully
with the sport of communicative
week we think those are the
things that.
Will make a difference in
improving the quality of life
but we need to hear.
That the locals also are
initiated.
A plan of action.
And there is a strategy.
And and that there there needs
to be sits
support from the state.
And at and would love to a I'd
like to get some feedback in
terms of what.
What you think we can do to
better support you?
Do you have a plan of action
that you're implementing.
And Andy is think your plan of
action in the area of reducing
tuberculosis reducing HIV.
Reducing.
.
Obesity and.
It is something in the works in
the county that we can support.
So.
Thank you very much.
For.
Allowing me to address this in
as I mentioned in our community
health improvement plan.
Which we we've been working to
put together M. M. we recognize
there are multiple issues in the
community and these are the ones
that. We chose to target we as a
community top chose to target M.
were we we also understand that
there are a lot there is a lot
going on.
Dr Griffin mention that in.
Clean because has research M.
projects going on and we
collaborate with clean because
in different areas. So there are
things going on M. were working
now to see to make sure that
we're all working together.
Instead of working separately
because it's working together
and coming together improve and
and seen where the gaps are.
That we can move forward
so.
Were in the process of doing
that to identify where the gaps
are and.
.
We will.
Beep.
Definitely.
Share those with you as we
continue to move in this
process.
But it with regard to
tuberculosis a we are working
with our colleagues our
counterparts in make Holly of we
had a meeting this week to
discuss ways to strategize and
come up with ways that we could.
We can tackle this problem how
can we better communicate when
we have these by national cases
what are the issues are in in
Mexico with regard to there'd.
Deficits in the with our isn't
how how can we work together
took to to improve this issue
that affects both of us.
Make a comment one to doctor
with the cleaning because thank
you for the work that you do.
You know the.
Very qualified healthcare
centers provide a significant
amount of care.
In rural counties drop
California.
And there's a constant battle
with our state.
As it relates to imposing new
regulations
and wanting to kind of play a
bigger role in how you deliver
cared. I know that.
It currently there are some
possible rule.
Changing efforts up by the
department of health and.
I were working very closely with
coalition of of organizations
but I just want to.
To say that that we acknowledge
the work that you've done.
.
A stronger point I want to make
is.
You no we worked really hard
over the course of.
The last several years with you
a pair of formal care act.
To enroll more people to be
covered out for healthcare.
But what we have not been able
to accomplish.
Is increasing the amount of.
Practitioners doctors specialty
type care.
Providers
and so really putting a
significant burden on the
medical infrastructure. That we
currently have by I wanted to
can I get your take.
And may beat the comments that
you. Mention what are some of
the things that any causes doing
to recruit retain.
Providers.
For this area.
Th.
Thank you.
They're trying to.
.
They're trying to break they
providers.
And they're trying to bring new
providers because they're
growing.
And I would meet the needs for
the patients.
But it it's been extremely
challenging.
What are some of the unique
things that Janet guys doing to?
From here right de.
Anything in particular any type
of an you mentioned earlier.
And the. But they need an
elaborate too much
I just
what we're trying to do as.
Is make sure that regions like
ours.
Have a ordinated effort so for
example. Right now we're working
on.
Sharing that.
The governor's budget is
reflective of monies.
That are being collected from a
tobacco tax.
That was. To be invested in
graduate medical education
programs
and we're wanting to make sure
that.
Were.
Investing directly into these
ma'am medically underserved
areas of the state.
To be able to recruit.
And how.
Folks to do the residency here
because it's
a proven fact that at the do the
residency someplace.
Is it really good chance that
they stay there were asking for
forty million dollars from that
budget.
That's coming from the tobacco
tax mean certain what are some
of the things again that.
Maybe you have some ideas that
we need to occur in order to
help. Address the doctor and
medical practitioner shortages.
Go. It's difficult to attractive
facetiously area.
That's about stone it's been
going on for many years.
But. What the clinic because
they did their approach is
trying to get more? Mid levels
nurse practitioners and trying
to program.
So they can be survived a nest
practitioners and that way they
can retain that's one.
Number two is.
Loan repayments student loans
there helping with that.
I know for example.
Borrego health.
The other a family a primary
care from the residency program
in riverside.
On Dodd retains decisions for
them.
Ask for us I know the clinic
because he's not looking at that
you.
So following format of our
committee we we.
Give the up to people ask
questions but they mostly wanted
to make comments.
And some we had one person
wanted to make a question to a
panel member that stepped down.
.
Now what's the room. I just want
to ask a London Memphis.
About what is a requirement on
public comment his era. Public
comment.
We can't okay I just one Richard
would following all the rules
here.
Of notice of I wanted a.
If anybody still wants to make a
comment will give you. A minute
to.
Make your comment because it
seems like.
.
You wanna make comments we wanna
hear from you so we're going to
begin.
In order that we receive dumb.
The first being Felix
for I think it's Felix Danny.
But then you forget the other
Felix that Daniel Lopez.
Come come forward and maybe just
a.
The we have a Mike for you. So
why don't why don't you wear
them.
We have a we have a lot of.
Right over there if if people
couldn't up following him will
have C. via that non. And then
we'll have really sort of metal.
You guys are still here.
And.
Following that nuclear non this.
Once you speak into the Mike
and.
You can face us here in the
committee.
Faces here of.
Thank you very dressed up to him
yeah her right. Up first of all
I'm gonna say that restoring
though the quality at the new
reverse bearing portent it's
very important but are. You guys
we forgot to dress the big
problem with the Salton sea and
if not you though water quality
but the dust beneath the Salton
sea which is receiving a record
rate.
I don't think that the us via
does mitigation projects if no
really a restoration plan it's
just mitigation plan.
This.
Help.
Comet senior meeting and I'm
really surprised M. non of you
mentioned that talk to particles
of the Salton sea.
I mean no one of you up with say
I'm hit did mention the
pollutants and the water. But
those pollutants did the water
evaporates and your looks are
natural cycle of pollutants
state. And the dirt and Dennis
blown by the wind like it is
right now it's a little windy.
So. That is one of the biggest.
Awfully close in our own.
Community I. health improvement
that we should. Tackle
definitely.
Obesity.
You're. Gonna see here in the
valley I'm if you guys notice
the right now it's like I'm a
summer. Are people going to
don't do exercise outside from
the pallet.
The only way you're gonna M..
I called the. Fight obesity BR
exercise if by building a bunch
of facilities that have a C..
And I will cost that much money.
He's going to mention that.
.
Okay thank you thank you thank
you very much.
Sylvia but not needs to want to
comment.
Did you have a.
Yes.
Good morning I'm other Heffernan
memorial healthcare district.
I I wanna make my comments
bottles this Anya.
.
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needle.
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put I'm said Diana seventh I
mean we've León this little
thing of land though.
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on them than that.
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employment I. it I suspect
Sonozaki.
But ekeus Demian.
I you wouldn't those numbers
psychic animal may hold. But I'm
just a little we've gotten with
Anthony he guided your time's up
at what I'd like you to
encourage you to do Sir direct
your question her personally at
right.
Right at maybe after ours
obsession and I'm sure. C. C.
put it on a lot and threatened.
Which tell us he'd let lesser
level who will tell you that
that particular that. Are
specifically infamous and.
And and and process think that
come up at all.
But it also affects save all of
its US fairly carrier in thank
you thank you and we.
You did make some comments will.
What will that will appreciate
those very much thank you?
The Wilk receive those.
We also have loosened metal
here.
Katz I just jotted a few notes
many little metal and executive
director Connie because he
because I.
I think you Senate hueso for
competing at this committee.
Hearing Anderson ever larger C.
F. arousal being part of this
hearing.
.
So I just signed my notes here
wanted to go very briefly a
concerning the time that. I ever
is a very important issue that
affects both my he got León in
pure valley. And both have
equal.
.
Responsibility however as you
know there are different sources
that affect us.
Of some predominantly because it
is a metropolitan area with
upwards of a million M.
copulation.
Versus a couple hundred thousand
here but altogether we need to
see this air district as one
from he Kylie all the way to the
Coachella Valley. And I in that
you know we're we're looking
quite quite a significant amount
of population. I. profit is a
big problems of public
transportation is is important
issue that needs to be addressed
if we are to continue this
collaboration with medical we
need to be able to provide. This
by national interconnectedness
through not only altitude jobs
through through collaboration
and how.
In health data I. sharing but
as well as transportation.
Going was that I think it'll be
a benefit.
To the imperial valley's economy
as well as M. he Connie.
The differences in regulations
are very important so more
collaboration
I've been.
Front.
A Kelly.
I heard over the years I have
studied.
There there.
I've heard that they are good
regulations
I'm getting.
If we as the
doing
the US.
California
imperial and we use face Lara
personable charm.
Because of the different
interests.
The industry wants
Meyer space community wants.
Cleaner air you know for for
health purposes thank your
time's up okay thank thank you
meticulous.
Meegeren Andi's.
Hi.
I'm going and this
I'm going to seek a light.
Thank yous an or Wessel thank
you some remember that I was
here.
I just want to share with you
guys I. yesterday we had a
meeting without a PC D.. Assure
that all Senate imitation plant.
And they mentioned.
.
That OPL on on on the air
cleaner. Tom clean air act.
Second one so you can be. And it
stays and I'm gone quoting them
on the presentation that they
give yesterday.
I says that this section sets we
do this planning brick funding
requirements in the border areas
impacted by admissions from
outside the U. S..
So I mean.
We live in a border region and
obviously.
Sums.
By national efforts to be
consider.
We should work together with
Mexico into cut out regardless
of what the section states.
Odd because it's it's affecting
everybody not just not just
Mexico not just us ICBM.
Mutual effort between Mexico
And down.
It regards of air quality ha we
should we should all take into
consideration what they're gonna
clean air act instead it states.
.
But it's not it's not possible
and just to. Have found.
.
Had like laws on on that states
but Mexico like Richard get
something will get involved with
the government somehow I don't
back talk about work.
To get down to the point of
having a better M. cloudy on
both areas of the adult border.
Solon on next thank you for
everything.
Thank you very much.
Well I want to thank everybody
fear for participating also my
colleague who are lower C. on I
didn't mention that we do did
have today supervisor.
Kelly here on a few so here but
he was here for the duration.
Of that committee also.
I. a D. of board member of
fighting a solace there's also
here thank you for being here.
And.
Looted I miss here tomorrow
thank.
Are all of you for for.
And.
.
I think I think.
It's important to assess where
we are.
Now Allen and I am at appreciate
all the help of of the people
from panel.
All the panels that we have
today and and.
It paid in that the picture for
we are today and.
How we can get to a better place
but I'm I'm looking forward to
it parents recommendations?
Are there I think there will be
lots of bills coming this year.
Quite a bit actually on on many
of the subjects of the looking
at those in terms of how we.
Achieve up better chief summer
goals in our state I think
healthcare is a big priority. In
our state and no other status to
demonstrate but more clearly.
In California and how we have
implemented the affordable Care
Act and how we've expanded on it
now with a different Jim.
Initiatives for universal
healthcare and.
And.
How we're trying to to properly
fund?
All our services in the state
working very hard on it.
But were.
Part particularly interesting to
see what we can do.
At in the border area.
Has any particular with Mexico
we we have so many problems to
solve.
But with Mexico and and.
I appreciate the represents
from Mexico being here today to
speak to those and
to extend.
That a hand in not only
friendship and cooperation as
well.
Thank you for being here today
and for doing that and.
Do know why I I'm gonna be
working on a bill particular
that's gonna.
Deal with the the the office by
national health.
I'm hoping that we could not.
Work with.
The different various local
agencies in the
and the government man of Mexico
to develop strategies.
I'd like to see is for
strategies at work on
implementation plans.
And bring results to the people
of our communities and this is
where we're making Gaines
this is where we need your help.
But we we need that we need a
plan of action these problems
are serious.
They're affecting our community
we need to let people know.
Hello to what.
Up to what level they are
afectan.
The quality of life of the
people in our community we need
to make this wonderful place
repeat
want to live.
And and healthcare is a big part
of that.
So PA a particular I want to
thank.
.
The.
.
Again assembly member Garcia I
wanna thank a particular the.
The FARC farm credit services
southwest the Mexican consulate.
Clinic because a salute locus of
homeopathic the Connie reburial
state water boards in the state
of. California.
And the a for of course do can't
we can't miss out are mentioned
in the office by national border
health.
And in my office I like to thank
Alexis Katherine everybody M.
no.
And our imperial valley stuff on
the Pentagon.
And.
John Garcia annually you're on
the politic he's here.
A yearly guy now ion the politic
is here representing my office
in San Diego.
Up thank you very much everybody
and I was one encourage
everybody just keep in touch
with us.
We represent you in Sacramento
where your voice is there. But
you're were also your servants
we work for you.
And let us know we can do better
do better job representing you
and Sacramento thank you very
much.
You are making
.
Ntfc the California.
This is the California State
Senate