SO BEFORE WE BEGIN I JUST WANT
TO.
GO OVER.
CHIEF QUICKLY GO OVER THE AGENDA
SO WHAT WE'LL DO IS.
WE HAVE SIR.
SEVERAL ITEMS.
TODAY WE ARE GONNA BE
DISCUSSING THE STATE HOSPITALS
FIRST AND THAT WILL BE GAINES
PROGRAM UPDATES AND SEVERAL.
PROPOSALS FROM THE AGENCY.
SO IT WILL DO IS.
WILL DO THOSE AND THEN TAKE
PUBLIC COMMENTS.
ON ALL THE SAME TOGETHER.
AT THE END OF SECTION CITY
HOSPITALS. WE THEN ALSO HAVE
THAT'S PART OF HEALTH CARE
SERVICES.
WHAT I'M GOING TO DO AND THIS
ITEM?
WE ARE GOING TO SWITCH THE
HEARING ORDER ON TWO ITEMS.
SO.
.
WE'RE GOING TO HEAR ISSUE ONE
AND TWO AND THEN WE'RE GOING TO
HEAR ISSUE FOR WHICH IS THE
PROVIDER REIMBURSEMENT RATE
ACCESS CARE PROPERTY SIX.
BECAUSE A COLLEAGUE MINDS CAN BE
PRESENTING A ABBASI PROPOSAL AND
THEN WE WILL HEAR.
FOLLOWING ISSUE FOR WILL BE
ISSUE THREE SERVER SING THAT TO
THE ORDER OF THOSE TWO.
AND THEN WILL BE GOING AND THEN
DIRECT REMAINING ISSUES AN ORDER.
.
SWELLED THE FILE WE CAN BE
CONCLUDING WITH A PART OF PUBLIC
HEALTH.
TO SIX
FIVE
AS WELL SO I JUST SO EVERYONE'S
CLEAR ON THAT.
DID THE EGGS Y. MENTION IS IS
THAT AS WE PRESENT WILL OF
COURSE BE HEARING FROM THE
AGENCY LA OWNS PART OF FINANCE.
ON THE CITY'S ISSUES FOR YOU.
HAVE AG SEE PROPOSALS I ASK THAT
THE ADVOCATES THAT TRY TO KEEP
YOUR PROPOSAL TO WITHIN THREE
MINUTES A WEEK. I KNOW YOU'VE
SUBMITTED RESTS THAT WRITTEN
VERSIONS TO.
MY STAFF AND OTHERS SO I KNOW
THAT.
THERE'S A.
AND VALUABLE OPERATE MORE IN
AND THOSE AND.
WILL OF COURSE IN ON ARTS YOU
IN A PERIOD TRY ABOUT T. FOR
MORE. A CLARIFICATION IF
NECESSARY.
AND THEN FOR PUBLIC COMMENT I
ASK THAT PEOPLE TRY TO KEEP THE
PUBLIC COMMENT TO A MINUTE. OR
LESS AND IF SOMEONE HAS A READY
MADE STATEMENT SAYING YOU KNOW I.
BE TO DITTO ALL THOSE THAT THAT
WORKS TO. SO WITH THAT.
WE'RE GONNA FIRST BEGAN.
ITEM FOUR FOR FOR A VOTE STATE
HOSPITAL SO WE CAN ASK THE STATE
HOSPITAL. STAFF ELLIE # AND
FINANCE FOLKS TO.
ON THIS ITEM PLEASE COME UP.
WELL WELCOME EVERYONE HERE AT
SEA LEVEL.
GOOD SIZE AUDIENCE HERE TODAY.
SO FOR THE RECORD AND CAN JUST
ASK EVERYONE TO INTRODUCE
THEMSELVES AGENCY FIRST THE NATO
AND AND FINANCE.
SO.
WELCOME.
GOOD MORNING STEPHANIE CLINTON
AND CHIEF DEPUTY DIRECTOR FOR
MAKING MAD COVER DEBATE DIRECTOR
FORENSIC SERVICES.
OKAY.
OKAY. PROPELLANTS OF THE S.
DEPUTY DIRECTOR OF
ADMINISTRATION HEAPED ON A
COMPUTER SENATE LEO.
DRUSILLA BOARD ALEJO.
BUT CHRIS COOK FOREMAN FINANCE A
THANK YOU THANKS VERY MUCH
ALRIGHT SO WE'RE GONNA START
WITH THE TWENTY EIGHTEEN
NINETEEN PROGRAM UPDATES THAT WE
DO HAVE A.
REALLY THOROUGH RIGHT UP AND OUR
AGENDA SETTING TO SIT THE
HIGHLIGHTS
THAT BE GREAT WELCOME.
THANK YOU MISTER SCHER A STEP
MCCLINTON NITTY DEDUCTIBLE
DEPARTMENT OF STATE HOSPITALS.
AND AND IT BUT THE AGENDA
REQUEST ABOUT WE PROVIDE AN
OVERVIEW OF THE FIVE ITEMS ON
THE AGENDA PROVIDE A REAL BRIEF
AND. OVERVIEW OF THOSE ITEMS THE
FIRST ONE IS THE ENHANCE
TREATMENT PROGRAM AND WE'RE
REQUESTING TWO POINT EIGHT
MILLION AND TWENTY THREE POINT
TWO POSITIONS IN THE BUDGET YEAR
AND EIGHT POINT THREE MILLION
AND SIXTY FIVE POINT SEVEN
POSITIONS IN NINETEEN TWENTY AN
ON GOING.
PRESS TO ACTIVATE THE REMAINING
TWO UNITS OF OUR NEW ENHANCE
TREATMENT PROGRAM WE WERE
AUTHORIZED BY AB THIRTEEN FORTY
TO ESTABLISH AN ENHANCED
TREATMENT PROGRAM. I AM AS A
PILOT PROJECT TO.
TREAT PATIENTS WHO ARE AT THE
HIGHEST PRESS OF THE MOST
DANGEROUS BEHAVIOR IN OUR
HOSPITALS. AND UNDER DETERMINE
WHETHER MORE INTENSIVE TREATMENT
PROGRAM IN A HIGHER SECURITY
SETTING ADAM IS A IS A.
BUT THE FISH AFFECT OF WAY TO
IMPROVE THE PATIENT'S I'M
CONDITION AND RETURN THEM TO THE
GENERAL OF A PATIENT POPULATION.
AYE WOMEN BEFORE THE BUDGET
COMMITTEES IN THE PAST COUPLE
YEARS I AM REQUESTING THE
FUNDING FOR THE.
CAPITAL OUTLAY FUNDING AND LAST
YEAR WE REQUESTED THE FUNDING
FOR THAT I'M ACTIVATION OF THE
FIRST TWO UNITS.
WE AS THEME FUNDING LAST YEAR
OF FOR EXCUSE ME THE FUNDING FOR
THE PROJECT OF TWENTY SEVENTEEN
PROVIDED THE FUNDING. AND
STAFFING FIRST ACTIVATE THE
FIRST TWO UNITS AND AND THOSE
TWO UNITS TIME WE HAVE HAD
CONSTRUCTION DELAYS I AM. DO TO.
ATTAINING THEM AND FIRE MARSHAL
APPROVAL AS A FIRE MARSHAL STAFF
WERE I'M REDIRECTED TO THE
OFTEN FIRES THIS YEAR.
SO AND WE ARE ANTICIPATING A
FIVE MILLION DOLLAR SAVINGS IN
THE CURRENT YEAR FROM THE THAT
BUDGET ACT.
PROCREATION AND AND I WILL TALK
ABOUT WHAT WE ARE HOPING TO USE
SOME OF THAT MONEY FOR ANOTHER
PROJECT I'M IT'S ALL GET TO THAT
IN JUST A MOMENT. AND THAT THE
CURRENT YEAR AND PLANS EXCUSE ME
THE BUDGET YOUR REQUEST IS TO
ACTIVATE I'M THE THIRD UNIT
WHICH IS A THIRTEEN BUT IT UNIT
OUT ATASCADERO IN A TEN BED UNIT
AT PATTON STATE HOSPITAL. THIS
INCLUDES ALL THE STOPPING IN OWE
YOU NEED FOR THE ACTIVATION OF
THOSE UNITS.
AND.
I MEAN WE ANTICIPATE TIME
LINCOLN AND THE GOVERNOR'S
BUDGET THE CONSTRUCTION TO BE
COMPLETED FOR THOSE AND. OF TWO
THOUSAND AND EIGHTEEN.
THIS SOCKET M. UPDATE IS
RELATED TO I'M.
CONSTRUCTION PROJECT FOR THE AND
TWO THOUSAND AND FOURTEEN I'M
SOUTH
BY EARTHQUAKE REPAIRS I'M A
DEPARTMENT OF STATE
AS FOR THOSE NAPA.
I KNOW THAT WE ARE PROPOSING TO
USE TWO POINT THREE MILLION
DOLLARS OF THAT FIVE MILLION
DOLLARS IN SAVINGS FROM THE
ENHANCE TREATMENT PROGRAM TO
COVER THAT I'M THAT COSTS
ASSOCIATED WITH THAT. I'M
CONSTRUCTION FURTHER THREE
PROJECTS THAT ARE THAT WE HAD
IDENTIFIED I'M RELATED TO THE
REPAIRS NEEDED.
STOP FOLLOWING THE EARTHQUAKE
AND THE CUT CONSTRUCTION COSTS
INCREASES ARE REALLY DO FROM
MOVING FROM SCHEMATIC DRAWINGS
INTO DE TIGHT IT TIME DETAILED
DESIGN DRAWINGS. AND ONCE WE GET
THE DETAIL DESIGN TRYING TO HAVE
IT BETTER WE CAN DO A BETTER
ESTIMATE OF THE CONSTRUCTION
COSTS SO THE TWO POINT THREE
REALLY IS TO COVER THOSE. I'M
ADDITIONAL AND COSTS RELATED TO
THE WITH THE. DETAILS.
THE THIRD PROJECT OF OUR THIRD
UPDATE IS RELATED TO OUR AND.
ASSEMBLY COMMITTED PATIENTS
LINESMAN PETRA SHORT PAGE.
PATIENTS WE HAVE TIME REQUESTED
TWENTY POINT ONE MILLION DOLLAR
INCREASE IN REIMBURSEMENT
AUTHORITY I'M FOR IN CURRENT
YEAR AND ON GOING AND THIS IS
DUE TO WE'VE HAD AN INCREASE.
POPULATION.
AND WE NEED TO AND THE COUNTIES
PAY FOR THOSE SERVICES THEY
REIMBURSE THE DEPARTMENT FOR THE
SERVICES THAT WE PROVIDE. AND WE
NEED ADDITIONAL REIMBURSEMENT
THIRTY TO COLLECT THE ADDITIONAL
TIME MONEY THAT WE FOR THE
SERVICES.
AS THE THIRD ONE IS. FOR OUR
CONDITIONAL RELEASE PROGRAM.
IT I THINK THAT'S APARTMENT AS
FOR THE CONDITIONAL RELEASE
PROGRAM OF THIS WAS A REQUEST
TIME TO CONTINUE NINE HUNDRED
AND SEVENTY SIX THOUSAND DOLLARS
THAT WE WERE APPROPRIATED AND
SEVENTEEN EIGHTEEN. AND EIGHTEEN
NINETEEN AN ON GOING ON THIS IS
FOR OUR STATE Y. TRANSITIONAL
RELEASE PROGRAM BEDS
FOR THE CONDITIONAL RELEASE
PATIENTS ON THESE OUR BEDS THAT
ARE HAVE HIGHER LEVEL OF
TREATMENT AND I'M SERVICES
AROUND THEM TO HAVE.
PATIENT STEP DOWN FROM A STATE
HOSPITAL INTO THE COMMUNITY THEM
PASS UP SOME NEED SOME
ADDITIONAL SUPPORT AS THEY MAKE
THAT TRANSITION.
I'M WE RECEIVE THE FUNDING INSET
INTO THOUSAND AND SEVENTEEN TO
ACTIVATE A SEVENTEEN EXCUSE ME A
SIXTEEN BIT PROGRAM AND FRESNO
COUNTY.
AND WE DID ACTIVATE THAT PROGRAM
BUT SUBSEQUENTLY HAD TO CANCEL
THE CONTRACT TIME AND ARE
CURRENTLY WORKING WITH A NEW
PROVIDER TO ESTABLISH IN THE
PROGRAM SO REQUESTING THAT
FUNDING IN THE NEW YEAR TO
OPERATE THE NEW PROGRAM.
IN THESE FINAL UPDATE IS
RELATED TO OUR CONDITIONAL
RELEASE PROGRAM FOR SEXUALLY
VIOLENT PREDATORS THIS IS JUST.
AND WE'RE ANTICIPATING IN
NINETY SIX THOUSAND DOLLARS
SAVINGS IN THE KERN.
TWO UPDATED AND COST ASSUMPTIONS
RELATED TO PATIENTS THAT ARE
RELEASED ON TRANSIENT STATUS
OUR. CONTRACTORS DONE AN
EXCELLENT JOB IN KEEPING THE
COST DOWN BY LOCATING STAFF LAND
THAT ARE IN CLOSER PROXIMITY AND
THEN WE ADD ADDITIONAL
ANTICIPATED TIME. FOR PATIENTS
ARE RELEASED ON TRANSIT STATUS.
POPULAR TECHNIQUES.
THANK YOU ANY COMES FROM ILLEGAL.
WE DIDN'T RAISE ANY CONCERNS
WITH THIS GROUP OF PROPOSALS A
THANK YOU FINANCE.
OKAY THANK YOU FOR THE OVERHEAT
AYE DISC.
QUESTION ABOUT THE.
THE STR P..
OVER AND THIS IS A SAFE WAY
TRANSITION RESEARCH.
FRESNO.
BECAUSE HE MADE MENTION THAT.
.
THAT WAS CLOSE SO THERE'S AN
EXISTING PROGRAM THOSE CLOSED AS
WE ACTIVATED IN EXISTING WE
ACTIVATED A PROGRAM IN TWO
THOUSAND AND SEVENTEEN OUT AND
ENDED UP HAVING TO CANCEL THE
CONTRACT.
I'M WITHOUT PROVIDER BECAUSE
THEY WORK MEETING.
IS THE NEW ANTICIPATE BEING
FRESNO COUNTY OR SOMEWHERE ELSE
OR WHAT'S THE.
IT WHERE IT WERE INDISCUSSIONS
WITH A PROVIDER NORTHERN
CALIFORNIA OKAY ALL RIGHT SO
WEARING SO WHAT IT'S.
AND WHEN DO YOU ANTICIPATE YOU
MIGHT.
THE.
.
GETTING ANOTHER ONE UP BILL
WORKING ON THOSE.
DISCUSSIONS WITH THAT PROVIDER
AND WILL BE PROVIDING AN UPDATE
IN MAY REVISION BAD WE.
REQUEST IN THE FUNDING FOR THE
BUDGET YEAR AS WE ANTICIPATE
EITHER ACTIVITY IN THE BUDGET
OKAY ALRIGHT. OKAY SMALL NO BUT
THAT.
OKAY.
ANY QUESTIONS ANY QUESTIONS OF
COMMITTEE MEMBERS.
THAT'S NOW OKAY SO THAT'S THE
OVERVIEW RIGHT SO LET'S MOVE ON
TO ISSUE NUMBER TWO KALINGA AND
YOU ACTIVITY. COURTYARD
REAPPROPRIATION.
THANK YOU CHAIR DR PAN MEMBERS
LOOK BALANCE OF THE S. ADMIN
DEPUTY DIRECTOR THE AGENDA ASPER
BRIEF OVERVIEW OF THE NEXT FIVE
CAPITAL OUTLAY PROJECTS ISSUES
TWO THROUGH SIX SO I WILL DO MY
BEST TO PROVIDE. A BRIEF
OVERVIEW AS IS NOTED IN THE
AGENDA ISSUES TWO THROUGH SIX
OUR CAPITAL OUTLAY PROJECTS THEY
ARE EXISTING PROJECTS THAT HAVE
BEEN PREVIOUSLY AUTHORIZED VIA
PRIOR. ACTIONS THEY ARE ALL FIRE
LIFE SAFETY AND OR PATIENT
RELATED.
WITH RESPECT TO ISSUE NUMBER TWO
THAT CALLING THEN YOU ACTIVELY
COURT YARD THIS IS A REQUEST FOR
EVERY APPROPRIATION AND WE ARE
REQUESTING FIVE POINT SEVEN
MILLION IN GENERAL FUND TO
CONSTRUCT. A SECURE TREATMENT
COURTYARD AT COALINGA IN THIS
FUNDING WHICH SUPPORT
CONSTRUCTION ONES THAT WORKING
DRAWINGS ARE APPROVED BY THE
STATE FIRE MARSHAL THAN WE CAN
EXPECT CONSTRUCTION TO START
THEIR AFTER.
ANY QUESTIONS ON THAT ONE.
ATTRIBUTES. ACTION VIEW IS THAT
IF YOU GOT TACKLE ALL OF THEM
THEN PART SO LET'S JUST GO
THROUGHYES ONCE YOU JUST GO
THROUGH ALL OF YA ISSUE TO
THROUGH.
AND THEN WE'LL SEE
SEC QUESTIONS
THANK YOU I APPRECIATE THAT.
ISSUE NUMBER THREE IS A REQUST
FOR ONE POINT FIVE MILLION
GENERAL FUND AND THIS WOULD
SUPPORT THE CONSOLIDATION AND
HOUSING OF OUR THREE POLICE
SERVICES ATTY A SAGE METRO IT
WOULD DO TWO THINGS IT WOULD
BOTH CONSOLIDATE AND HOUSE THOSE
THREE. ESSENTIAL SERVICES AND IT
WOULD ALSO DEMOLISHED FIVE
SEISMICALLY DEFICIENT IN
BUILDINGS AND THIS WOULD SUPPORT
FUNDING FOR WORKING DRAWINGS AND
THIS IS THE ONLY REQUEST FOR
WORKING DRAWINGS THE OTHER FIVE
PROJECTS ARE IN CONSTRUCTION.
FOR ISSUE NUMBER FOR THIS IS TO
THIS IS ALSO REQUEST FOR
REAPPROPRIATION OF THREE POINT
FOUR MILLION THIS WOULD SUPPORT
THE CT . WHICH IS ONE OF
OUR PATIENT OCCUPIED CHRONIC
TREATMENT EAST BUILDINGS AT THE
A SAGE METRO AGAIN REQUESTING
THREE POINT FOUR MILLION THIS
FUNDING IS FOR CONSTRUCTION. WE
CURRENTLY BOTH FOR YOU'LL NOTE
THAT FOR ISSUES FOUR AND FIVE WE
ARE OF PROPOSING TO UPGRADE OUR
EXISTING FIRE ALARM SYSTEMS IN
ORDER TO ENSURE THAT THEY ARE
ADDRESSABLE INCLUDE COMPLIANT.
SO THAT IS ISSUE NUMBER FOR
ISSUE NUMBER FIVE IS A REQUEST
FOR NINE POINT FOUR MILLION AND
GENERAL FUND VERY SIMILAR IT IS
TO REMOVE AND REPLACE EXISTING
DEFICIENT FIRE ALARM. CONTROL
PANELS AND AGAIN THIS FUNDING
REQUEST IS FOR CONSTRUCTION.
AND LASTLY THE LAST REQUEST IS
FOR PATTON AND IT IS A REQUEST
FOR A REAPPROPRIATION OF THIRTY
THREE POINT ONE MILLION THIS
TO FINALIZE THE CONSTRUCTION OF
OUR NEW KITCHEN WERE REQUESTING
THIS FUNDING IN ORDER TO SEE.
IT COMES.
COULDN'T COME THAT QUESTIONS
BELLY UP COMMENTS.
THANK YOU CHAIRMAN MEMBERS
JONATHAN PETERS SOME OF THE LA
CHO THE ONLY PROPOSAL WE DID
RAISE ISSUES WITH AMONG
CAPITAL OUTLAY WAS THE.
NEW KITCHEN PROJECT IDEAS EACH
PATTON WE DON'T RAISE CONCERNS
WITH THE AMOUNT OF MONEY THAT
THE ADMINISTRATION IS PROPOSING
TO FINISH THE PROJECT WE JUST
HAVE RAISE THE MINOR TECHNICAL
ISSUE AS FAR AS HOW IT'S
BUDGETED. SINCE THE TWO POINT
NINE MILLION NEEDED AS NOT
ENCUMBERED BEFORE THE
ENCUMBRANCE PERIOD EXPIRED WE
DON'T BELIEVE THAT IT CAN BE RE
APPROPRIATED INSTEAD WE BELIEVE
THAT A MORE APPROPRIATE ACTION
WOULD BE TO. OF REQUESTS IN NEW
APPROPRIATION TO FINISH THE
PROJECT.
OKAY.
FINANCE ANY COMMONSENSE
UNITARIA OKAY HERE OVER THERE IF
YOU'LL EXCUSE INTRODUCED
YOURSELF FOR THE RECORD
OCCURRING ON ROBIN PARKS
DEPARTMENT OF FINANCE SO TO
RESPOND TO THE LA US CONCERNS.
THE AT ANY SUBSEQUENT BUDGET
ACT.
WOULD OVERRIDE A PREVIOUS
BUDGET ACCELERATE PREPARATION IS
DEFINITELY A VIABLE OPTION FOR
THIS AND IN FACT WE HAVE AN
EXAMPLE OF ONE FOR THE
DEPARTMENT OF STATE HOSPITALS.
IN TWO THOUSAND SEVEN THERE WAS
AN APPROPRIATION FOR THE
METROPOLITAN YOU MAIN KITCHEN.
AND THERE WAS THREE YEARS TO
ENCUMBER IT BY JUNE THIRTIETH
TWO THOUSAND TEN AND I KNOW
RIGHT NOW WE'RE IN THE INCOME ON
STREETS OF THAT'S WHAT THE
ELLIOTT WAS. AND COMPARING THIS
TO AND THEN IT ALSO HAD TWO MORE
YEARS TO LIQUIDATE THE FUNDS
UNTIL JUNE THIRTIETH TWO
THOUSAND TWELVE. BUT IT WAS NOT
RE APPROPRIATE UNTIL TWO
THOUSAND TWELVE THIRTEEN AFTER
BOTH THE INCUMBENTS TRADE AND
THE LIQUIDATION TRADE HAD
EXPIRED. AND.
THIS WAS AND ADD TWO THOUSAND
TWELVE THIRTEEN IT WAS.
BUT ACT ITEM FORTY FOUR FORTY
FOUR NINETY SO THERE ARE SOME
EXAMPLES WHILE IT'S NOT THE VAST
MAJORITY OF REAPPROPRIATION YOU
CAN REPURPOSE IT ONCE THE
INCUMBENTS AND LIQUIDATION
PERIOD HAD EXPIRED.
OKAY SO.
.
I THINK SOUNDS LIKE THIS IS A
TECHNICAL ISSUE I'LL LET MY
STAFF HELP SORT IT OUT.
HIS WELL.
OKAY ANY OTHER OF A QUESTIONS
YOU COMMITTEE MEMBERS.
NO.
SO ACTUALLY JUST IN TERMS OF. I
HAD HAD DIFFICULT ABOUT PATENT
THAT WAS NOT RELATED TO PUT
THEIR SAID APPROPRIATIONS.
SO.
BASICALLY I UNDERSTAND THAT.
DIVERSE.
US.
DELAYS BECAUSE OF THIS.
FROM AND WHERE THEY'RE
CERTAINLY AND DESIGN ERRORS AND
OMISSIONS.
I MEAN CAN YOU ELABORATE ON I
MEAN THOSE ARE ALL SOLVED BUT
THE. WHAT WHAT HAPPENED THERE?
IS THAT THOSE ISSUES HAVE BEEN
RESOLVED IN AS YOU NOTED AND WAS
ALSO NOTED ON THE AGENDA SOME OF
THE DELAYS WERE ATTRIBUTED TO
ADVERSE WEATHER. AND WHEN YOU
HAVE A RAINY SEASON OFTENTIMES
YOU HAVE TO STOP CONSTRUCTION
CONCERNED I GOT THAT I WAS MORE
THE ERRORS IN THE.
WITH RESPECT TO THE DESIGN
ERRORS AND OMISSIONS THAT THERE.
WAS THE NEED FOR CONCRETE LINED
DRAINAGE CHANNEL SO OF ENSURING
THAT IT HOUSE PROPER DRAINAGE IN
THAT IN THE EVENT OF. A FIRE AND
THE FIRE LINES MCCHRYSTAL OFTEN
ENSURING THAT WE HAD ADEQUATE
ACTIONS THERE AND THEN THERE WAS
AN ISSUE WITH.
WITH THE STEAM PIPE NOT BEING
DETAILED ADEQUATELY SIMPLY FOR
SOLVE BOTH OF THOSE ISSUES OKAY
SO WE'RE SURE ALL THE DESIGNS
GOOD NO OTHER PROBLEMS.
FERDINAND THERE OKAY.
JUST.
AND ACTUALLY JUST IT MORE
GENERALLY AND AGAIN I THINK ALL
THESE THINGS NEED TO GET DONE. I
I KNOW THAT SOME OF THE
FACILITIES ARE AGING AND YOU
KNOW WE'RE PUTTING OF SYMPHONY
AND AND.
TO FIRE ALARM SYSTEM
AND SO FORTH
THIS IS THAT REYES YEAH.
SOLOISTS STRIKING WHAT THE
BALANCE OF UNITS NEWER BUILDINGS
OLDER BUILDINGS HAVING TO NOW
RETRO HARDLY KALRA TO FEDERAL
EVER NEW EQUIPMENT OLDER
BUILDINGS SAFETY EQUIPMENT SO
FORTH.
ARE RESTRAINING GET TO ZAP I
DON'T KNOW IF WE HAVE THE FIRE
ALARMS IS THE REASON FOR THE
EXPENSES THAT THE TYPICAL
EXPENSE FOR THAT SIZE IS IT MORE
EXPENSIVE BECAUSE WE'RE HAVING
TO PUT IT IN AN OLDER BUILDING.
SO I JUST THAT THE CAN YOU JUST
MAKE A GENERAL COMMENT ABOUT THE
EX THE THE EXPECT AND WHAT
SPENDING MILLIONS OF DOLLARS
THAT WE HAVE TO I THINK WE NEED
TO. AND MAYBE THAT'S HOW MUCH IT
COSTS TO PUT IN THE ALARM SYSTEM
IN A FACILITY THAT SIZE BUT I'M
JUST THEIR HOW MUCH OF OUR COST
IS.
MAY BE ATTRIBUTABLE TO THE FACT
THAT WE'RE TRYING TO PUT THINGS
IN OLDER FACILITIES ARE NOT
HOURS THAT NIGHT ISSUE AT ALL.
IF I'M IF I ME AND IF I CAN
SPEAK TO IT GENERALLY THERE ARE
A NUMBER OF DIFFERENT COST
CONTRIBUTING FACTORS THAT GO
INTO ANY CONSTRUCTION BUILDING
THERE'S BOTH OF THE. INCREASE
CONSTRUCTION COSTS IN GENERAL
AND AND CONSTRUCTION
S. TEND TO BE EXPENSIVE THERE'S
ALSO THE THIS SIZE CITY THE
ENORMITY OF OUR BUILDINGS WE
HAVE BOTH OPEN CAMPUSES AS WELL
AS CLOSE CAMPUSES SO. THAT ALSO
CAN PLAY A PART AND I CAN
CERTAINLY WHEN YOU'RE DEALING
WITH CONSTRUCTION PROJECTS IN
WHICH YOU'D THEIR PATIENT
OCCUPIED THEIR PEOPLE OCCUPIED.
AND PARTICULARLY WHEN WE HAVE
PATIENTS IN BUILDINGS WE HAVE TO
ENSURE THAT WE HAVE THE ADEQUATE
SPACE THE TIMING THE FLOW OF
PATIENTS TO ENSURE. THAT WERE
ABLE TO DO THAT SO FOR EXAMPLE
EVEN PAINTING A WALL ISN'T AS
EASY AS IT SOUNDS BECAUSE IF
PAINTING THAT WALL. IS IN A
PEACH OCCUPIED AREA THAN YOU DO
HAVE TO THINK ABOUT THE THE
MILIEU IN THE ENVIRONMENT OF
THAT INDIVIDUAL OTHER THAT
INDIVIDUAL SETTING SO THERE ARE
A NUMBER OF. DIFFERENT REASONS.
BY THOSE CONSTRUCTION COSTS MAY
LOOK THE WAY THEY DO AND
CERTAINLY TO YOUR POINT WITH
RESPECT TO WHERE DO WE FIND THE
BALANCE IN TERMS OF OF.
REQUESTING RESOURCES TO DO FIRE
ALARM UPGRADES AWARENESS I
REQUEST YOU CONSIDER THE LONGER
TERM PERSPECTIVE WE ARE ENGAGING
IN AN INFRASTRUCTURE MASTER PLAN
TO TO HELP THINK ABOUT THOSE
LONG TERM SOLUTIONS.
AT IN A ANY CHAT THAT CHALLENGE
WITH ANY INFRASTRUCTURE MASTER
PLAN IS THAT IT'S IT'S
COMPLICATED IT'S TECHNICAL AND
HAVE TO BOTH EVALUATE THE HOUSES
WHAT IS THE STATE OF THE
BUILDINGS WITH THAT TO BE. WHAT
YOU WANT IT WHAT IS THE VISION
NOT SURE STRUCTURE LIAM
SEISMICALLY BUT WHAT DO YOU WANT
YOUR PATIENT POPULATION TO LOOK
LIKE? AND I THINK YOU KNOW SOME
OF THAT COMPLICATED SOME OF THE.
FACTORS ASSOCIATED WITH OUR
INFRASTRUCTURE MASTER PLAN IS WE
HAVE FIVE HOSPITALS ARMY WAS
HOSPITAL AS YOU KNOW WAS IS
CALLING IT WAS BUILT IN TWO
THOUSAND FIVE. OUR OLDEST
HOSPITAL IT IS I'VE BEEN NOW
THAN IT WAS BUILT.
IT WAS OPENED IN EIGHTEEN
SEVENTY FIVE.
WE HAVE MORE THAN FOUR HUNDRED
AND SEVENTY FOUR BUILDINGS THEY
OCCUPY MORE THAN SIX POINT FIVE
SQUARE FOOTAGE AND WE HAVE OVER
TWO THOUSAND SIX HUNDRED E.
CREATE SHE. SAID UPS ABOUT WHEN
WERE AT WHERE WE'RE CONSISTENTLY
THINKING ABOUT WHAT AND HOW DO
WE MAXIMIZE GENERAL FUND TO
ENSURE THAT WE ARE.
SEEING THAT PIECE.
AND NEEDS NO
AS WELL AS THINKING ABOUT THE
ULTIMATELY THE GENERAL FUND WELL.
I APPRECIATE THAT YOU'RE DOING
AND INFRASTRUCTURE MASSIVE FLAGS
WHAT THINK ABOUT HOW AND.
HIM HOW WE BALANCE THESE THINGS
AS WE TRY TO THINK ABOUT HOW WE
MOST MAKE IT MOST EFFECTIVE USE
OF RESOURCES IN BE SURE
FACILITIES AND INFRASTRUCTURE
SUPPORTING THE THINGS THAT WE
NEED TO HAVE DONE.
OKAY.
NEARLY QUESTIONS ALRIGHT PUBLIC
COMMENT PUBLIC COMMENT ON ALL
THE ITEMS ANDERSON.
THE HOSPITAL SCENE KNOWING
COMING UP.
THAT SO WHAT WE'RE GONNA DO IS
WE ARE GOING TO HOLD. EACH OF
THESE ITEMS OPEN AND OF COURSE
WILL BE WAITING TO I MAY REVISE
SO SORRY FINANCE YOU DE SITS
THEIR SITE AND REALIZED.
SO THAT I THINK YOU SO MUCH FOR
COMING UP AND PRESENTING AND
LOOKING FORWARD TO.
MAYBE VISOR AND TERMS OF ACTION
MOVIE ON THESE PROPOSALS BUT
CERTAINLY THAT I THINK PORTENT
THINGS TO MOVE FORWARD ON. THANK
YOU I THINK SO MUCH. OKAY.
ALRIGHT.
PART OF HEALTH CARE SERVICES.
ALRIGHT.
SO I'M.
SO ACTUALLY I AM.
FOR THE FIRST START WITH ISSUE
ONE PROPOSITION FIFTY FIVE.
AND.
.
FIRST LET'S HAVE EVELYN COME UP
HERE AND WE'LL DO THE ROUND
ROBIN AGAIN.
BUT.
ALRIGHT EXCESSES.
OKAY SO I THINK ACTUALLY BECAUSE
THIS THIS IS ALL PURE MONEY
CALCULATIONS WHICH IS AT FINANCE
AND LA DOES SO ALEJO INTRODUCE
YOURSELVES.
AND HAULING SO LEGISLATIVE
ANALYST'S OFFICE.
RAMBLE THE LEGISLATIVE ANALYST'S
OFFICE OKAY FINANCE EARLY DISNEY
OTHER DEPARTMENT OF FINANCE.
ADAM TO RECEIVE BUT IT'S OKAY
PROP FIFTY FIVE HOW WE CALCULATE
THE NUMBERS ALRIGHT.
THANK YOU YOU.
YEAH HAS YOUR GENDER DOES A NICE
JOB OF SUMMARIZING THE ISSUE SO.
AS HIGHLIGHTED IN FIGURE TWO ON
PAGE SIXTEEN THE DETERMINATION
ARE GOVERNOR'S BUT BUDGET BASED
ON THE GOVERNOR'S BUDGET
PROPOSAL. HAS AVAILABLE REVENUES
INCLUDING THE PROP FIFTY FIVE
INCREASE AT ONE TWENTY NINE
POINT EIGHT.
WHICH IS EXCEEDING THE WORKLOAD
BUDGET BY ABOUT I MEAN WHICH IS
INSUFFICIENT FOR THE RECOVERY
AND BY ABOUT ONE POINT NINE
BILLION.
IF YOU'VE LIKELY TO JUST GO
RIGHT TO THE QUESTIONS AND
ADDRESS THOSE.
THIS PLACE.
SO I'M KIND OF GOING OVER HOW
THE METHODOLOGY WAS IDENTIFIED
FOR DETERMINING THE AVAILABLE
RESOURCES AND. THE DISCRETIONARY
TRANSFER OF PREVIOUS BUDGETS
HAVE DISPLAYED THIS INFORMATION
SIMILARLY.
WHEN WE'RE IDENTIFYING THE
AVAILABLE REVENUE.
BE AVAILABLE REVENUES OF COURSE
ARE THEN AVAILABLE FOR
APPROPRIATION.
IN TWENTY SIXTEEN WHEN THERE WAS
A SUPPLEMENTAL APPROPRIATION
THAT WAS TREATED THE SAME WAY.
SO THE AVAILABLE RESOURCES.
DO NOT INCLUDE.
OF DOLLARS.
OF.
THE NEXT QUESTION ABOUT THE
WORKLOAD BUDGET AND HOW WE
IDENTIFY DOT. OF AS YOU KNOW
MANY OF THE AUGMENTATION SINCE
THE TRUCK SINCE TWENTY SIXTEEN
HAVE LARGELY FOCUSED ON WORKLOAD
AND AND NOT SO MUCH PROGRAM
EXPANSIONS.
LARGE ONE TIME AUGMENTATIONS
HAVE BEEN TARGETED TOWARD ONE
TIME EXPENDITURES. SO AS WE WERE
LOOKING AT THE WORK LOW BUDGET
FOR EIGHTEEN NINETEEN.
FOCUS ON THE WORKLOAD BUDGET
NOT A LOT OF.
INCREASES THAT WERE NOT
ASSOCIATED WITH CASELOAD AND AND
OTHER OF STATUTES.
SO WE DO LOOK AT A CASE BY CASE
BASIS.
AND ABOUT THIRTY SEVEN MILLION
WAS NOT INCLUDED OF THE PROPOSED
BUDGET IN THIS WORKLOAD
DETERMINATION.
THE DETERMINATION WILL BE
UPDATED AGAIN AND I MAYOR VISION
REFLECTING OF COURSE THE MAYOR
VISION PROPOSAL. THE FINAL
DETERMINATION FOR EACH NINETEEN
THOUGH WILL REFLECT THE BUDGET
THAT IS ADOPTED AND THAT WILL BE
DONE BEFORE JUNE THIRTIETH.
AND I THINK THE LAST QUESTION IS
REGARDING.
HOLIDAYS DOLLARS CAN BE USED
AND WE READ BELIEVE THAT THESE
OTHER DOLLARS ARE IF THERE WERE
ANY AVAILABLE DOLLARS FROM THE
EPA COUNT. BUT THAT WOULD BE
AVAILABLE TO FIND OUT TO NOT
SUPPLANT BUT TO FUND GROWTH.
SIMILAR TO PROP FIFTY SIX
ALTHOUGH THERE IS A SLIGHT
DIFFERENCE IN HOW WE ESTIMATE
THE COMPARISONS.
WITHIN GOING TOWARD TELL IF YOU
HAVE QUESTIONS ON THE.
OKAY THANK YOU ALEJO BEGIN A
SLIGHTLY DIFFERENT OPINION.
I THINK YOU CHAIR MEMBERS AND
HOLLINGS OF LEGISLATIVE
ANALYST'S OFFICE.
LIMIT IS START BY PUTTING A
LITTLE BIT OF.
AROUND JUST VERY BRIEFLY AROUND
THE SORT OF DETAILS THAT YOU
JUST GOT FROM THE DEPARTMENT OF
FINANCE.
SO I'LL BE SPEAKING FROM A
REPORT THAT YOU SHOULD HAVE IN
FRONT OF YOU THAT ARE OFFICE
RELEASED ON A COUPLE MONTHS AGO.
AND IS GOING TO TURN TO THE
FIRST FIGURE ON THE FIRST PAGE.
US THIS FIGURE JUST GIVES REALLY
SIMPLY.
AND A SUMMARY OF HOW THE
PROPOSITION FIFTY FIVE FORMULA
WORKS.
SO THAT MEASURE DIRECTS THE
ADMINISTRATION TO START WITH
AVAILABLE REVENUES AND I'LL COME
BACK TO THIS TERM IN A MINUTE.
BUT ESSENTIALLY THIS IS THE
AMOUNT OF GENERAL FUND REVENUES
THAT ARE AVAILABLE IN THE BUDGET
FOR APPROPRIATION.
THE ADMINISTRATION HAS DONE TO
SUBTRACT FROM THIS AMOUNT TO THE
MINIMUM FUNDING GUARANTEES TO
THE PROPOSITION NINETY EIGHT
CONSTITUTIONAL MINIMUM FUNDING
FOR SCHOOLS AND COMMUNITY
COLLEGES. AND THEN JUST SUBTRACT
AN ESTIMATE OF THE WORKLOAD
BUDGET A COME BACK TO THIS TERM
AS WELL BUT PUT SIMPLY THE
WORKLOAD BUDGET IS THE COST
TODAY. OF PROVIDING SERVICES
THAT WERE IN PLACE ON JANUARY
FIRST TWENTY SIXTEEN.
IF A SURPLUS RESULTS FROM
MISCALCULATION THAT HALF OF THAT
SURPLUS UP TO TWO BILLION
DOLLARS IS DEDICATED SOMATIC HOW.
AS THE DEPARTMENT OF FINANCE
JUST NOTED THEY IDENTIFY A
DEFICIT IN THEIR WORKLOAD BUT
THE CALCULATION IN THIS
PROPOSITION FIFTY FIVE
POPULATION EIGHTEEN NINETEEN OF
ONE POINT NINE BILLION. A
SUMMARY ABOUT AS SHOWN ON FIGURE
TO ON THE NEXT PITCH.
ALSO THERE'S ACTUALLY TWO MAJOR
REASONS THAT THE DEPARTMENT OF
FINANCE IDENTIFIES A DEFICIT. IN
THE PROPOSITION THIRTY FIVE
POPULATIONALTHOUGH AS YOU ALL
KNOW THE BUDGET IS IN SURPLUS
THIS YEAR.
THE FIRST IS THAT THE
ADMINISTRATION MAKE SOME
DECISIONS THAT TIME TO MAKE
AVAILABLE RIGHT MAYOR SOMEWHAT
SMALLER. AND THE SECOND IS THAT
THE ADMINISTRATION THAT MAKE
SOME DECISIONS THAT MAKE THE
WORKLOAD BUDGET A BIT BIGGER AND
SO BOTH OF THOSE FACTORS WOULD
OF COURSE MAKE THE SURPLUS
AVAILABLE FOR MEDICARE.
I SMALLER SLIMMER JUST GIVE A
LITTLE BIT EASIER ON BOTH OF
THESE IN TURN.
SO ON THE REVENUE SIDE.
AS THE DEPARTMENT OF FINANCE
NOTES ARE REVENUES FOR MOST
BUDGET DOCUMENTS.
ARE INCLUSIVE INCLUSIVE OF
TRANSFERS SO TRANSFERS IN AND
OUT OF THE JOB.
THIS INCLUDES THE ANNUAL
TRANSFER THAT THE STATE MAKES
THE RAINY DAY FUND.
AND WE HAVE TO PROPOSED
DEPOSITS THIS HEARINGS THAT
RAINY DAY FUND ONE IS THE
CONSTITUTIONALLY REQUIRED
DEPOSIT. AND THE SECOND IS THE
OPTIONAL THREE POINT FIVE
BILLION DOLLARS THE DEPTH OF THE
GOVERNOR PROPOSES PUTTING INTO
THE RAINY DAY FUND.
DEPARTMENT FINANCE COUNTS BOTH
OF THOSE AS NEGATIVES AGAINST
AVAILABLE REVENUES EVEN THOUGH
THERE'S AN ARGUMENT THAT YOU
COULD PROBABLY COUNT THE
OPTIONAL DEPOSIT AS PART OF
AVAILABLE REVENUES. GIVEN THAT
IT IS AVAILABLE FOR
APPROPRIATION.
SECOND ON THE WORKLOAD BUDGET I
NOTED.
THE DEPARTMENT OF FINANCE TAKES
AN INTERPRETATION THAT TENDS TO
MAKE THAT WORK COULD BUDGET
PARTITION A BIT BIGGER. THE
REASON FOR THIS IS THE
DEPARTMENT OF FINANCE TAKES A
VERY BROAD INTERPRETATION OF THE
FIRM THE TERM CURRENTLY
AUTHORIZED SERVICES.
SO TO BERMAN FINANCES BUT I
MEANS ANYPROGRAM OR A SERVICE
THAT WAS IN PLACE ON JANUARY
FIRST TWENTY SIXTEEN IS
CURRENTLY AUTHORIZED. EVEN IF A
SPECIFIC PROGRAM OR BENEFIT OR
SERVICE WAS NOT AVAILABLE AT
THAT TIME SO LET ME GIVE AN
EXAMPLE. I'M IN TWENTY SEVENTEEN
EIGHTEEN THE STATE CREATED THE
EMERGENCY CHILDCARE BRIDGE
PROGRAM AND THIS PROVIDED
IMMEDIATE ACCESS TO CHILDCARE
FOR FOSTER FAMILIES. BEER
EARNEST WISHING COUNTS THIS IS
PART OF THE WORKLOAD BUDGET EVEN
THOUGH THAT SPECIFIC BENEFIT
IMMEDIATEACCESS TO CHILDCARE
WAS NOT AVAILABLE ON JANUARY
FIRST TWENTY SIXTEEN.
AND SO. OF COURSE BOTH OF THESE
APPROACHES TEND TO REDUCE
FUNDING FOR MEDI CAL BOTH THIS
YEAR AND IN THE LONG TERM. UNDER
ALTERNATIVE INTERPRETATIONS
THERE COULD BE HUNDREDS OF
MILLIONS OR EVEN BILLIONS OF
DOLLARS AVAILABLE FOR MEDI CAL
THE FUTURE AND POSSIBLY THIS
YEAR. I'M BUT FINALLY WE WOULD
NOTE THAT THE MEASURE DOES GIVE
THE ADMINISTRATION SIGNIFICANT
DISCUSSION IN MAKING POPULATIONS
UNDER THE MEASURE.
AND THAT THE LEGISLATURE WOULD
NOT BE ABLE TO TAKE ACTION TO
INDEPENDENTLY CHANGE THE
CALCULATION BE HAPPY TO TAKE ANY
QUESTIONS.
THANK YOU.
QUESTIONS FOR COMMITTEE MEMBERS.
JEFF WAS A CERTAIN.
THANK YOU MISTER CHAIRMAN THANK
YOU FOR YOUR PRESENTATIONS AND.
APPRECIATE THE ALEJO'S
EXPLANATION.
THAT.
ILLUSTRATES A WORD OF ONE POINT
NINE BILLION.
UNDER PROFITABILITY YOU.
AND I KNOW OUR GOVERNOR IS.
.
IT IS VERY HAVE HE MAKES A HIGH
PRIORITY THAT WE HAVE.
YOU NO A A CERTAIN PERCENTAGE OF
A YEAR'S BUDGET I THINK TEN
PERCENT AND IN RESERVE AND
THAT'S A RESPONSIBLE THING TO DO
AND. I DON'T DISAGREE WITH THAT.
BUT I ALSO KNOW THAT IF WE
DIDN'T PUT A THREE BILLION INTO
RESERVE AND WE DID COUNT THAT IS
AVAILABLE REVENUES SO WE WOULD
HAVE A BILLION DOLLAR SURPLUS
THAT COULD BE TRANSFERRED OVER
INTO THE MEDICAL PROGRAM.
AND THE REASON I MENTION THAT AS
WE HAVE ROUGHLY THIRTY FIVE
THIRTY EIGHT PERCENT OF THE
STATE OF CALIFORNIA IT'S
ENROLLED IN THE MEDICARE PROGRAM.
TODAY.
YET IT IS VERY DIFFICULT FOR
MANY PATIENTS TO BE ABLE TO.
ACCESS A DOCTOR IN THE MEDICAL
PROGRAM AND WE ALL KNOW WHY IT'S
BECAUSE WE HAVE AN INCREASED.
DR RATES IN FACT WE DECREASE
SOME TO EXTREMELY LOW LEVELS
WHEN WE HAD TO IN TWO THOUSAND
AND NINE WE HAD OUR ECONOMIC
CRISIS.
.
BUT I'M CONCERNED THAT.
YEAR AFTER YEAR WE KEEP.
IGNORING THIS.
THE FACT THAT PHYSICIANS WON'T
PARTICIPATE IN THE PROGRAM.
WHEN THEY CAME TO KEEP THE
LIGHTS ON FOR THE REVENUE
THEY'RE GETTING FROM MEDICAL
PAYMENTS WHICH IS ABOUT I THINK
SEVENTEEN BOX OF AS A. GUN I CAN
BE CORRECTED SERVICE.
AS OPPOSED TO FORTY ONE DOLLARS
FOR A MEDIC.
SO.
THIS IS A A QUALITY OF CARE
ISSUE THIS IS AN ACCESS ISSUE.
.
HOW CAN WE BALANCE WHAT NEEDS TO
GO INTO HOW DO YOU FEEL WE CAN
BALANCE WHAT GOES INTO RESERVES
AND AT THE SAME TIME? WHEN DO WE
BEGIN TO TO MAKE THE EFFORT TO
INCREASE THESE POSITION
REIMBURSEMENT RATES SO THAT
THESE
PEOPLE THAT ARE IN DIRE NEED OF
MEDICAL SERVICES CAN IN FACT GET
THEM.
SO OPPOSE AT BOTH THE ILIO ADMIN
DEPARTMENT FINDING IT SO I MEAN
THAT'S EIGHT HUNDRED POUND
GORILLA IN THE ROOM IS THAT. WE
HAVE ALL THESE PEOPLE THAT ARE
INJURED FOR MEDI CAL BETTER HAVE.
THE CULT THE IN HAVING ACCESS TO
GET THEIR HEALTHCARE CONCERNS.
ADDRESSED SO. THAT'S A BIG
CONCERN FOR ME.
IT'S A ONE ANSWER AT FIRST AND
THEN HELLO.
I'D ADAM DIRTY FINANCE SO I MEAN.
I THINK THAT'S A THAT'S A BIG AT
THE BIG QUESTIONS A BROAD
QUESTION IT'S I'M I THINK THAT
WE HAVE SYSTEMS IN PLACE TO TRY
TO HOLD.
PLANS ACCOUNTABLE HOLD THE
DEPARTMENT OF A COUNTABLE THAT
TO TO MAKE SURE THAT WE'RE
DELIVERING AT THE ENTITLEMENT
BENEFIT TO THE BENEFICIARIES THE
WAY IT'S LAID OUT IN STATE LAW
THE PEOPLE THAT ARE ELIGIBLE FOR
THE PROGRAM OF THE BENEFITS
THEY'RE ELIGIBLE TO RECEIVE.
AND SO THEY'RE THEY'RE SYSTEMS
IN PLACE AND WHEN THEY'RE
SPECIFIC INSTANCES IN WHICH
PEOPLE ARE.
I'M ABLE TO TAXES THE BENEFITS
THEY'RE ENTITLED TO.
THEN YOU KNOW THAT WE'VE WE USE
THOSE REMEDIES TO TO TRY TO
RESOLVE THOSE ON A ONE BY ONE
BASIS.
AS A GOVERNOR SUPPORTED IN THE
PAST A SEVEN AND A HALF YEARS IN
INCREASES IN FEES THAT.
PHYSICIANS CAN CHARGE TO
PARTICIPATE IN THE MEDICAL
PROGRAM.
YES ABSOLUTELY SIR WELL I WITH
THE I THINK THE BEST EXAMPLE OF
THAT RECENTLY HAS BEEN
PROPOSITION FIFTY SIX I'M AND SO
WE COMMITTED. FIVE HUNDRED FORTY
SIX MILLION DOLLARS IN THE
CURRENT YEAR TO.
INCREASE PROVIDER RATE.
THAT PAYMENTS AND AND THE
GOVERNOR'S BUDGET INCLUDED EIGHT
HUNDRED MILLION DOLLARS NEXT
YEAR IN AND NON FEDERAL FUNDS
AND SO. I AM IN ADDITION TO THE
FEDERAL MATCH ON TOP OF THAT SO
I THINK THAT THERE'S BEEN
SIGNIFICANT COMMITMENTS IN THIS
AREA AND S A RESULT OF THOSE
INVESTMENTS HAVE WE SEEN THE.
.
THE.
EXPANSION OF OF OF PHYSICIAN UP
PARTICIPATION THE BACKUP PROGRAM
OR TO SUCH AS HELP EXISTING
BECAUSE
CONSIDERING THE PROGRAM
PRESENTLY.
THAT'S A VERY GOOD QUESTION THIS
IS SOMETHING THAT WE'VE.
YOU KNOW PASSED OVER TIME.
YOU KNOW WHENEVER WE'VE HAD.
YOU KNOW VARIOUS.
PROPOSALS IN FRONT OF US TO TRY
TO EVALUATE HOW THESE INCREASE
WILL BE EFFECTIVE IT'S A
DIFFICULT THING TO DO AND
SOMETHING THAT WILL BE LOOKING
AT AS THE.
PAYMENTS ROLL OUT THIS THIS
FISCAL YEAR BUT APPRECIATE THAT
MY HOPE THAT YOU CAN LOOK AT IT
BECAUSE A COMPLAINT THAT I HEAR.
THROUGHOUT MY DISTRICT
ESPECIALLY EASTERN COACHELLA
VALLEY IS YOU KNOW IS A VERY.
UNDERSERVED POOR.
AREA THAT IT'S A VERY COMMON
COMPLAINT THAT THEY JUST CAN'T
GET IN TO SEE A PHYSICIAN AND.
IT MAKES A VERY VERY
CHALLENGING.
KAREN.
AND WHEN THEY CAN'T GET THE
HEALTH CARE THROUGH A MEDICAL
DOCTOR WHERE THEY GO.
THEY'RE GOING TO GO TO THE
EMERGENCY ROOM WHICH THEN CAUSES
SO MUCH MORE. SO I'M HOPING THAT
CARP ARE BUDGET SUB THREE.
FURTHER RECOGNIZES THAT THAT IS
A PROBLEM IT NEEDS TO BE SOLVED.
AND I HOPE THAT WE CAN MAKE SOME.
SOME GESTURES AND SOME GET SOME
COOPERATION FROM THE GOVERNOR'S
OFFICE TO.
MODESTLY PICK UP THE RATE JUST
SO WE CAN HOPEFULLY GET SOME
MORE. ADMITTED IF PHYSICIANS CAN
AT LEAST TAKE TAKE THE PLAN M.
AT LEAST BREAK EVEN THE NOT LOSE
MONEY I DON'T THINK THERE ARE
CITY ARGUMENT THAT THEY.
WOULD LIKE TO PARTICIPATE IN A
PHILANTHROPIC WAY BUT WHEN IT
COSTS THEM MONEY TO TAKE A
MEDICAL PATIENTS.
IT'S A DETRIMENT TO THE PROGRAM
AND I DON'T AND I WANT TO SEE
THIS PROGRAM.
.
WORK WELL PRETTY FOR THESE
PEOPLE THAT REALLY NEED THOSE
SERVICES SO I I APPRECIATE.
ALL THE HELP THAT YOU CAN GIVE
US AN AND AND GETTING THOSE
RATES MODESTLY INCREASE THAT WE
CAN HELP THESE PEOPLE OUT.
THEN THE FOR LA THOUGH I DESIGN
MENTION THAT.
WE WILL BE TACKLING THE
PROPERTY SIX ITEM.
ACTUALLY I THINK IT'S. ISSUE
NUMBER FOUR BUT WORKSHEET
SWITCHING THAT WITH ISSUE NUMBER
THREE SO THAT WE CAN UP SHORTLY.
I ALSO MAKING NOTES.
AND I'M SURE PHAM DTS WILL
UPDATE US THAT WE'RE STILL
WORKING THROUGH SOME CMS
APPROVALS BEFORE THAT PROPERTY
SIX MONEY ACTUALLY
IT'S FROM THE POT ACTUALLY INTO
THE HANDS OF THE PROVIDERS SO. I
DON'T THINK WE CAN ANSWER THAT
QUESTION YET BECAUSE IT HASN'T
HAPPENED YET.
END OF IN A LARGE WAY I MEAN
LOOKING HERE AT THE CAL NEXT AND
I THINK WE GOT SOME MONEY OUT OF
THAT ACCOUNT PROVIDERS ONLY SEEN
US.
MOBILE ENOUGH TAKEN AGAIN WILL
DELVE INTO MUCH MORE DEEPLY IN
THE NEXT ITEM SO WE'RE CERTAINLY
CAN BE DIGGING INTO THIS.
BUT CLEARLY THERE IS A
CHALLENGE WITHOUT GETTING. A
PROVIDERS TEETERED TAKE OR OF
THE TAKES TO TAKE ADDITIONAL
PATIENTS UNDER.
CALVET BECAUSE OF AND THAT'S
BEEN SHOWN IN NUMEROUS STUDIES.
AND SO.
AND AND FORTUNE WERE SO FAR
BEHIND.
YOU KNOW I THINK WHAT
CHALLENGES THAT WE SAIL WILL
GIVE A LITTLE INCREASE.
AND THEN YOU SAY WELL DIDN'T
HAVE A WHOLE LOT I DO DOCTORS
TAKING IT OUT BUT THAT'S BECAUSE
YOU'RE STILL SO FAR BEHIND IT
YOU WE HAVE TO AT LEAST GET THE
BREAK EVEN POINTS.
WHERE YOU MIGHT ACTUALLY
SARGSYAN TIPPING AND ALSO AN
ASSURANCE THAT THAT WILL STAY
THAT WAY SO FOR EXAMPLE IN THE A
CA? DID THE MEDICARE BOMB.
THOSE ONLY THREE YEARS I WAS IN
THE ACA CALIFORNIA'S ACCIDENT
IMPLEMENTED WHERE THIS IS
ACTUALLY SOLVE THE MONEY INTO
ALMOST TWO YEARS IN. SO YOU DID
NOT SEE AN INCREASE AND
PHYSICIANS STEPPING UP AND THE
OTHER THING IS OUT POINT OUT AS
A POSITION TAKES CARE MEDI CAL
IS THAT.
I EAT WHAT YOU SEE IS
PHYSICIANS DON'T ABANDON TO
PATIENTS SO THE PROBLEM IS IS
THAT THEY KNOW THEY SAY OKAY
I'LL TAKE THIS PATIENT THEN.
IF THE RATE DROPS AGAIN OR
DOESN'T NOTED THAT IT WAS A
TEMPORARY.
THEN WHAT HAPPENS IS THAT
THEY'RE NOT GOING TO DISCHARGED
PATIENT BECAUSE NOW THEY CAN'T
THEY'RE LOSING MONEY ON THEM
THEY'RE GOING TO TRY TO FIGURE
OUT HOW TO MAKE IT WORK. BUT
THEY ALSO DON'T THAT THEY DON'T
HAVE ASSURANCE THEY DON'T WANT
TAKE SOMEONE ON THE FIRST PLACE
WHERE THEY KNOW THEY'RE GONNA BE
IT.
LOSING MONEY TWO OR THREE YEARS
OR FOUR YEARS OUT BECAUSE THEY
CAN'T COUNT ON THE STATE TO.
KEEP UP ITS PROMISES SO AREA
THAT DOES A REALLY FUNDAMENTAL
ISSUES WHICH WILL HOPEFULLY
BUILD INTO BED ON THEM
REIMBURSEMENT SIDE.
.
CUMMINS ELIANE CENTER STONE'S
QUESTION.
NOTHING TO ADD SPECIFICALLY AT
THIS POINT IN THE AGENDA BUT
TIME TO ECHO THAT PROPOSITION
FIFTY SIX AND THE SUPPLEMENTAL
PAYMENTS THEIR ARE VERY CUTE
IT'S ISSUE AND AS YOU MENTION
WILL BE DISCUSSED LATER IN THE
AGENDA.
OTHER QUESTIONS ON SO I DID HAVE
A QUESTION ON PROP FIFTY FIVE SO
FIRST OF ALL.
REMAIN ME HOW MUCH A REVENUE
THIS IS PROPERTY FIVE BRINGING
IN FOR NEXT YEAR.
FOR EIGHTEEN NINETEEN THAT'S
ABOUT FOUR POINT NINE BILLION
THAT'S THE SECOND HALF OF THE
YEARS ACTUALLY. BEFORE POINT
NINE BILLION SO. I GUESS WHAT
THE QUESTIONS I HAVE IS IS THAT
IF.
SO UNDER PROPHECY FIVE AS WE
VERY DISCUSSED.
IT SAID THAT YOU KNOW YOU DO
THAT USES CALCULATION AND NOW IS
DONE BY FINANCE AND THEN WE
FIGURE OUT HOW MUCH GOES TO MEDI
CAL.
AND AND AND SO.
WHEN WE WENT OUT TO THE VOTERS.
FOR PROPERTY FIVE OF IS THE MAIN
THRUST WAS ABOUT BEING SURE WE
WERE ABLE TO GET MORE FUNDING
FOR KIDS SCHOOLS. BUT THERE WAS
THIS MEDI CAL COMPONENT.
AND IF IT HADN'T PASSED.
RIGHT I MEAN PUTTING WE'RE
PUTTING THREE POINT ONE BILLION
YOU KNOW THAT'S AT LEAST THAT'S
WHAT THE GOVERNOR'S PROPOSING
PUTTING THREE POINT ONE ON TOP A
IN ADDITION TO NOT. YOU KNOW
IT'S THAT'S NOT IN ADDITION TO
WHAT WE ARE REQUIRED TO BY.
PROPOSITION TWO WHICH OF COURSE
I SUPPORTED.
.
POLICE I MEAN I GUESS THE
QUESTION IS WILL WE STILL BE
DOING THAT.
YOU KNOW AND AND AND THE REASON
I ASK THAT IS IS THAT.
I ESTIMATE I FIND IT A BIT
DISINGENUOUS THAT WE'RE COUNTING
THE THREE POINT ONE BILLION
WHICH IS A DISCRETIONARY HEALTH
TO CERTAINLY THAT'S NOT THE CITY
A BAD IDEA TO PUT SOME MONEY.
IT'S GOOD THAT HE'S BETTER
ECONOMIC TIMES.
BUT I ALSO FIND IT WILL
DISINGENUOUS TO GO BACK UNTIL MY
CONSTITUENTS THAT YOU VOTED FOR
PROPOSITION.
FIFTY FIVE.
AND YET WE'RE GONNA COUNT THAT
IN THE FORMULA WHAT WE KNOW WE
HAVE A MEDI CAL PROGRAM THAT
STILL UNDER FUNDED.
AND THE VOTERS.
SAID.
WE WANT SOME OF THAT MY EGO
THEY'RE UP TO TWO BILLION IF
THERE'S AN OPPORTUNITY GIVEN THE
FACT THAT WE'RE PASSING THIS.
TAX
YOU KNOW THERE'S ADDITIONAL TAX
ON ON ON TAXPAYERS.
SO CAN YOU I MEAN THAT'S WHAT I
SUPPOSED TO TELL MY CONSTITUENTS
WHEN I SAY WELL ACTUALLY WHAT
HAPPENED IS.
WE'RE NOT THAT WERE BECAUSE THAT
MONEY WOULD HAVE BEEN THERE IF
THEY CAN PASS THIS.
WELL HOW HOW DO I EXPLAIN TO MY
CONSTITUENTS THAT WE'RE COUNTING
THAT IN THE CALCULATION. FOR
TRYING TO FIGURE OUT HOW MUCH
GOES THE NECK TOWN NOW SAYING
THAT WILL THERE'S NO MONEY.
AND I'M NOT SAYING THAT WE WERE
OBVIOUSLY WILL BE TALKING LATER
WE SWITCH SPENDING MONEY ON THAT
ACCOUNT BUT I MEAN IT CONTINUES
CAN YOU CAN YOU. TELL ME WHAT
WHAT ARE WE GOT IT. HEERDEN ON
THE RECORD BUT WE TELL WHAT WE
TELL CONSTITUENTS WHO VOTED FOR
PROPOSITION. FIFTY FIVE. WHY
WERE PLAYING GAMES WITH THE
NUMBERS ON LIKE THIS?
IN TERMS OF BECAUSE THAT'S
DISCRETIONARY I MEAN IT'S NOT.
AND.
LET MY NOT JUST FOLLOW WHAT THE
VOTERS REALLY WANTED A REALIZE
THEY GAVE IN THE PROPOSITION
LEGALISTIC LEAD THEY GAVE
PART FINANCES DISCRETION. THAT'S
LEGALISTIC GLEE OKAY BUT IN
SPIRIT AND THE SPIRIT OF THE
PROPOSITION THAT THE VOTERS
VOTED FOR. HOW DO WE EXPLAIN HOW
DO I EXPLAIN DO I SIMPLY THROW
IT IN THE FACE OF FINANCE AND
SAY WELL GUESS WELL YOU KNOW IT
BUT I MEAN HOW DO I EXPLAIN TO
THE? TO THE CONSTITUENTS
THAT THIS MONEY IS NOT YOU KNOW
THE GOING TO THE.
WHEN WE HAD AND AND DECIDE THE
SURPLUS.
SURE I THINK THAT IF THE.
NOT SATISFACTORY ANSWER IS IT
DOES DEPEND SO WHILE PROP FIFTY
FIVE PROVIDES ABOUT FOUR POINT
NINE BILLION FOR THE SECOND HALF
OF EIGHTEEN NINETEEN. OF THE
BEGINNING BALANCE THAT IS NOT
COUNTED AS PART OF THIS
CALCULATION BECAUSE WE'RE JUST
AT THE RESOURCE.
FOR THAT YEAR
WAS ABOUT FOUR POINT FIVE
BILLION SO WHEN YOU'RE LOOKING
AT THE BUDGET IT IT CAN BE VERY
CONFUSING THAT. DEPENDING ON ON
HOW YOU DESCRIBE IT WE MIGHT
HAVE A SIX POINT ONE BILLION
SURPLUS OR WE INCREASED.
APPROPRIATIONS BY SIX POINT SIX
BILLION AND THE NUMBERS ARE THE
SAME BUT IT DEPENDS ON WHAT
WE'RE TALKING ABOUT SO. IT'S
UNFORTUNATELY NOT AS CLEAR BUT.
HOW MUCH WAS IT OF HOW MUCH
ADDITIONAL REVENUE IS AT LEAST A
MORE?
CONCRETE.
PIECE OF INFORMATION THAT CAN BE
SHARED.
OKAY.
.
CAN I ENACTED TAKE THAT SEGMENT
AND PLAYED OUT MY CONSTITUENTS
SAFECO I SOLD UNDERSTAND.
YEAH I I I THINK THAT THE ONE
THAT FOLLOWED THE SPIRIT OF THE
LAW I MEAN. THERE REALLY IS A
TECHNICAL CALCULATION WE HAD DEL
BUT I MEAN THE IDEA THAT WE'RE
GONNA TAKE A THREE POINT ONE
BILLION OFF THE TOP AND THE IN
IN FRANKLY ACTUALLY YOU KNOW WE
CAN HAVE CONVERSATIONS ABOUT HOW
WE CAN APPLY TO MEDICAL STILL.
SO THAT THAT SILVIO MEETS OUR
MUTUAL AND NEEDS BUT. I'M.
I DIDN'T THAT DIDN'T SEEM LIKE
AN ANSWER.
OF SO ASIDE FROM THAT THAT THE
CLEAR PART WHICH IS HOW MUCH
ADDITIONAL REVENUES FOR RAISED.
THAT THE MEASURE SAYS TO LOOK
AT THE REVENUES THAT ARE
AVAILABLE MY EAR IS DIFFERENT
RESOURCES WHICH INCLUDES THE
FOUR POINT FIVE BILLION. BALANCE
THAT WE BRING IN.
.
I NUMBER OF CALCULATIONS ARE
INVOLVED IN THE BUDGET AND I
THINK THIS WAS DISCUSSED IN THE
OVERVIEW HEARING. OF.
THAT THERE ARE NUMBER OF
CONSTRAINTS IN THE ORDER THAT
THEY OCCURRED OF DETERMINES
HOLLOW.
WHAT MAY SEEM LIKE A COUNTER
INTUITIVE OUTCOME OF A OF A
CALCULATION? OF AN OF THERE'S A.
IT'S NOT A CLEAR WAY TO SAID I
ACCEPT THAT THERE ARE A NUMBER
AND AND WHEN WE LOOKED AT THE
STATE WAS THE REVENUES FOR THE
FISCAL YEAR NOT THE WHOLE ENTIRE
RESOURCES FOR THE FISCAL YEAR.
AND WHILE IT THAT CENTER MONEY
FOLLOW UP AND THEN A FOLLOW UP
AGAIN YET IN ANYTHING. I THINK
COMING AT IT THE SAME QUESTION
THAT MAY BE A LITTLE BIT
DIFFERENTLY.
IF I UNDERSTAND IT CORRECTLY
CRACKED ME IF I'M WRONG. WE'RE
LOOKING AT ABOUT.
THREE BILLION IN IT.
ON TOP OF WHAT WERE REQUIRED TO
PUT INTO RESERVE BY THE RAINY
DAY FUND AND THAT'S WHAT EFFECTS
THIS CALCULATION.
I DON'T IF YOU HAVE IT AT YOUR
FINGERTIPS BUT I THINK WOULD BE
HELPFUL TO US.
YEAH WHERE'S THE TIPPING POINT
IN THAT THREE BILLION IF
IF IT WERE TWO BILLION A FOR ONE
POINT FIVE BILLION A QUICK POINT.
WOULD THERE BE SOME SURPLUS
BIG COULD GO TO THE MEDI CAL.
AND IF IF IF YOU HAVE THAT
ANSWER NOW THAT'S GREAT IF NOT
MAYBE THAT'S SOMETHING W CAN
GET TO SUPER JUST INFORMING. AS
WE DISCUSSED AT THE BIGGER LEVEL.
WHAT'S AN APPROPRIATE AMOUNT.
FROM THE GOVERNOR'S ASK TO GO
INTO RESERVES IN IT MAY BE
EFFECTIVE AS WE GET NEW REVENUE.
PROJECTIONS.
WITH THE MAY REVISE. I THINK
TO KNOW.
WHERE? WHERE WOULD YOU PUT SOME
INTO RESERVE BUT STILL? GET.
I TEN MILLION FIFTY MILLION A
HUNDRED MILLION INTO THE SURPLUS
ACCOUNT.
KNOWN FOR THE MEDI CAL SUPPORT
SO THAT I THINK WOULD BE HELPFUL
TO ALL OF US SO THANK YOU MISTER
CHAIR.
THANK THANK ANSWER MY I GUESS
AND MANY BE JUST SEAT IS THERE A
SHORT.
BOB IS THAT INFORMATION YEAH
GIVE YOU A TWO PART ANSWER THE
FIRST IS THAT.
ONE POINT SIX BILLION IS THE
TIPPING POINT SO THAT'S THE
POINT AT WHICH I THERE WOULD BE
A DOLLAR AVAILABLE FROM AN
ACCOUNT OF THE UNDER THE MEASURE.
BUT THAT SAID I.
OUR OUR PERSPECTIVE ON THIS IS
NOT THAT YOU NECESSARILY WOULD.
THE AMOUNT.
THAT THAT WOULD GO INTO THE
STATE'S RAINY DAY FUND
BUT RATHER JUST COUNTED
DIFFERENTLY FOR THE PURPOSES OF
THE PROP FIFTY FIVE CALCULATION.
THANK YOU BENEFITTED ANYTHING
THAT THAT'S REALLY THE CORE THE
POINT IS TO TO ME IS IS THAT THE
WAY YOU'RE COUNTING IT IN THE
FORMULA. BECAUSE I THINK THAT
THE WAY IT'S BEING DONE.
THE IT'S HARD TO EXPLAIN THE
PEOPLE SAY WAY THAT I VOTED FOR
THIS AND I DON'T THINK YOU KNOW
WE'RE NOT SITTING HERE SAYING
THAT HAVE PUTTING MORE MONEY
INTO GRAY DAY FUND IS AS A BAD
THING.
THAT'S NOT THE ISSUE.
I THINK THE ISSUE BECOMES IS
THAT THE VOTERS VOTED FOR
PROPOSITION FIFTY FIVE AND AGAIN
LEGALISTIC KLAY.
IN YOUR HEAD.
BUT I THINK IT'S SOMEWHAT
VIOLATES THE SPIRIT. OF WHAT THE
PROPOSITION IS IN MY MIND
BECAUSE WHAT HAPPENS IS THAT.
YOU KNOW PEOPLE LOOK AT IT AND
THEN THEY LOOK LIKE WHAT LIKE
WHAT YOU DID IS YOU KIND OF.
YOU KNOW GAME THE NUMBERS AND A
WAY TO SAY THAT THERE'S NO MONEY
BUT YET THE SAME TIME.
BUT LITTLE DID WORK HAD ONE ELSE
EVERYONE'S TELLING US LOOK THIS
IS WHAT THE REVENUES ARE AND SO
FORTH AND AND WHAT THE
PROPOSITION SAID IS THAT.
BECAUSE OF THIS ADDITIONAL MONEY
WE GOT ANOTHER FOUR POINT NINE
BILLION* SELLING ME THIS
NEXT YEAR BECAUSE EOPLE PASSED
HIM BECAUSE THE VOTERS PASSED
THIS.
YOU KNOW WE HAVE SU I FIRST GO
TO SCHOOL THAT'S PROP NINETY
EIGHT GUARANTEED AND THAT'S WHY
THE FORMALISM THERE AND THEN
WHAT'S THE BASELINE AND THAT
THEIR SOME EXTRA REVENUES
CERTAIN PORTION OF THAT SHOULD
GO TO MEDI CAL.
AS A RESULT OF THE FACT THAT WE
PASS THIS.
PROPOSITION. AND WHAT I'M
HEARING IS THAT WE'RE GOING TO.
MANIPULATE THE NUMBERS IN A WAY
SO THAT EVEN WHEN WE HAVE A
SURPLUS AND THAT'S WHY WE'RE
ABLE TO PUT THE THREE POINT ONE
BILL HE AND AND YOU KNOW AND.
THAT WE'RE GONNA SAY THERE'S NO
ADDITIONAL MONEY FOR.
MEDI CAL AND AND THE OTHER THING
I JUST WANT YOU LET'S THIS IS
KNOWLEDGE.
WE ARE PUTTING SOME ADDITIONAL
MONEY IN MEDI CAL BECAUSE WE
HAVE SO THE ONLY THE IN TERMS OF
TRYING TO DO SOME EXPANSION AND
SO FORTH. SO IT'S NOT THAT WE
COULDN'T FIND A WAY TO ACCOUNT
FOR IT BUT I DO.
DOING THIS FORMULA TO CLAIM THAT
WELL BUT PROP FIFTY FIVE DID
PROVIDE ANY MONEY FOR MEDI CAL
THIS YEAR AND A YEAR LIKE THIS
NOW AGAIN WILL SUIT ME REVISED
EVEN AND PUT THE NUMBERS THE
EFFORT. JANUARY JUST.
THAT SEEMS A LITTLE DISINGENUOUS
I MEAN UST IT'S IT'S T'S HARD
HOW IT'S HARD TO EXPLAIN TO
PEOPLE WHAT WHAT HOW DID THAT
TURN OUT. IT INTO WHAT IT IN A
YEAR LIKE THIS HOW CAN WE MEET
THE HOW CAN YOU SAY THERE
THERE'S NOTHING WE CAN ATTRIBUTE
TO COMING FROM UP.
I'VE BEEN THERE THAT THAT'S I
SAID WHAT.
TO ANSWER ASKING.
IF I COULD PRY.
HELP HOPEFULLY HOPEFULLY
ANALOGY.
THE WAY THAT THIS CALCULATION
AND THE WAY THAT THE THE BSA
TRANSFERS OCCUR. IS SORT OF AS
HOW AN INDIVIDUAL WOULD SET
ASIDE FUNDS IN THEIR SAVINGS
ACCOUNTS ARE RETIREMENT ACCOUNTS
SO YESTER RESTRICTIONS ON
WHEREVER YOU'RE SAVING THAT
MONEY. BUT THEN IT'S NO LONGER
AVAILABLE FOR SPENDING SO.
THESE DEPOSITS ARE ARE
TRADITIONALLY AN AND IN PREVIOUS
BUDGET THEY HAVE BEEN.
REDUCED FROM THE REVENUES SO
THAT THEN WHAT'S LEFT FOR
APPROPRIATIONS DOES NOT OCCUR.
STUNT EDGES AT A TO FOLLOW BUT I
DON'T MEAN TO BEAT A DEAD HORSE
TO DEATH BUT TO THE AUDIO.
YOU KNOW WHEN WE REPORT UNDER
PROFITABLE.
IN SOME WAYS STATUTORILY
REQUIRED THAT WE ACCOUNT FOR ALL
REVENUE I MEAN IT REALLY SHOULD
SAY YOU KNOW A HUNDRED AND
THIRTY THREE BILLION AND OUT OF
THE.
BILLION.
THERE IS A.
TRANSFERRED TO THE RAINY DAY
FUND IT IS VOLUNTARY BUT IT
LEASES TRANSPARENT.
TO THE VOTERS AND EXPECTED TO
SEE SOME. ADDITIONAL MONEY GOING
INTO HER CALL PROGRAM THAT
PROBABLY ONE OF THOSE ROBUST
REVENUE YEARS OF THE STATE OF
CALIFORNIA MAY HAVE AND HISTORY
WILL LEARN MORE BY THE MAY
REVISE BUT. I THINK.
SENATOR PAN MAKES A VERY GOOD
POINT THAT. YOU KNOW THAT WE
SHOULDN'T BE.
.
USING VOODOO ECONOMICS IF YOU
WILL TO KIND OF SHOW WHAT THE
NUMBERS.
LOOK LIKE.
BUT BUT RATHER WHAT THEY SHOULD
BE AND AND AND BEING TRANSPARENT
WITH THE WITH THE CITIZENS THAT.
GO TO THE POLLS REGULARLY AND
RE.
SHE DOESN'T HAVE THE ABILITY TO
TRUST THAT IF A
CHAU PASSES THAT IT'S GOING TO
DO WHAT.
THE BELIEVE IT'S GOING TO DO.
AND SO. WHAT IT WHAT IS THE BILL
BUT THE LEGAL?
RESPONSIBILITY IF YOU WILL OF
THE STATE TO ACCOUNT.
AVAILABLE REVENUE.
SOUNDS LIKE TO ME WE SHOULD BE
SAYING A HUNDRED THIRTY THREE
BILLION NOT TO MENTION THAT
THERE WERE COULD BE TRANSPARENT
LINE ITEM HERE THE SAYS A THREE
BILLION. BASED ON THE
RECOMMENDATION OF THE GOVERNOR
IS GOING TO GO TO THE RAINY DAY
FUND SHOULD BE DUMPING MORE
TRANSPARENT.
I'M SURE SO.
IT'S CERTAINLY OUR PERSPECTIVE
THAT.
OF VERY REASONABLE
INTERPRETATION OF THE MEASURE
WOULD BE THAT HUNDRED AND THIRTY
THREE BILLION AS OPPOSED TO A
HUNDRED AND TWENTY NINE
APPROXIMATELY BILLION THE
DEPARTMENT FINANCES WAS. AND IN
ADDITION I AM PERHAPS IT WOULD
BE REASONABLE FOR THE DEPARTMENT
OF FINANCE
SPLIT THE PROPOSITION FIFTY FIVE
CALCULATION IN THE WAY THAT USE.
APPRECIATE THAT.
THANK YOU.
OKAY.
.
PUBLIC CUMMINS ON THIS ITEM.
THE POLICY SOMEONE COMING UP THE
MICROPHONE.
ALRIGHT WELCOME.
AND MEMBERS MARY VALDEZ OF
HEALTHAXIS CALIFORNIA WE
APPRECIATE THE DISCUSSION ON
PROP FIFTY FIVE AND WALKING A
WALKING THE PUBLIC THROUGH HOW
THOSE CALCULATIONS WERE MADE.
AND WE UNDERSTAND.
THAT YOU KNOW.
IF THERE ARE MORE REVENUES
HEALTH ASSN HEALTHAXIS ASKS THAT.
YOU CONSIDER THOSE REVENUES OF
FOUR INVESTMENTS AND MEDI CAL IN
PROPOSALS LIKE HEALTH FOR ALL
AND RESTORING THE REMAINING
OPTIONAL BENEFITS AND MEDI CAL.
THAT WERE CUT DURING THE TWO
THOUSAND NINE RECESSION BUT HAD
NOT BEEN RESTORED FOR ALMOST TEN
YEARS AGAIN.
THANK YOU.
KAREN MEMBERS BARBARA GLAZER
WITH THE CALIFORNIA HOSPITAL
ASSOCIATION WE'RE VERY PLEASED
THAT THAT SUBCOMMITTEE IS TAKING
A HARD LOOK AT THIS ISSUE. AS
SENATORS STONE SAID IN A YEAR
LIKE THIS SINCE SENATOR PAN.
WE DIDN'T SEE MONEY FROM.
SEE IT
SO WE DO HOPE THAT THE
DEPARTMENT OF FINANCE GOING
FORWARD WILL RECONSIDER HOW THEY
WHAT METHODOLOGY THEY DO USE.
SO THAT IN THE FUTURE WE MAY SEE
SOME MEDI CAL DOLLARS I
CERTAINLY THINK THAT WAS THE
INTENT OF THE VOTERS. THANK YOU
THANK YOU.
WHERE MARTIN HERE ON BEHALF OF
THE CALIFORNIA CHILDREN'S
HOSPITAL ASSOCIATION I WOULD
ECHO THE COMMENTS OF MY
COLLEAGUE AT THE CALIFORNIA
HOSPITAL ASSOCIATION?
THANK YOU.
ALRIGHT THANK YOU.
BIGGEST.
IT'S MY. FINAL COMMENT ARE FILE
COME FOR NOW. ON THIS IS THAT.
YOU KNOW THAT.
WHY IS?
THE PROPOSITION IS A AND AND
WHAT YOU SAID IS LIKE AS A AYE
APPRECIABLY SAYS LIKE OKAY WELL
WE'RE MAKING DECISIONS ON HOW WE
SAVE OUR MONEY RIGHT IF WE HAD
THEM WE SAID WE WANT TO SAVE X.
ABOUT A DOLLARS AND OUR PERSONAL
ACCOUNT. AND I GUESS WHAT I
WOULD SAY IS IS THAT.
.
THE VOTERS OF CALIFORNIA. PASSED
PROPOSITION FIFTY FIVE WHICH
SAID WE'RE GOING TO INCREASE
REVENUE TO THE STATE.
BY INCREASING ATTACKS.
AND HOW SHOULD WE USE IT RIGHT
AND THEY SAID.
NOW WE WANT SCHOOLS.
PROP NINETY EIGHT BREAK ME APART
NINETY EIGHT AND THEN THEY SAID
THAT OF IF THERE'S ADDITIONAL
MONEY THAT'S WHAT THE OF THIS
FORMALLY IF THERE'S SOME
ADDITIONAL MONEY SO AFTER WE DO
PROP NINETY EIGHT.
YOUNG WE SAID FOR THIS YEAR.
AFTER WE PUT THAT MONEY FIRST IF
THERE SOME ADDITIONAL MONEY.
HALF OF THE REMAINDER SHOULD GO
TO MEDI CAL LORDS THEY SAID IF
THERE ARE SAVINGS F. BECAUSE NOT
CERTAIN WHAT THEY CANNOT AYE IF
THE NINETY EIGHT FORMALLY TOOK
IT ALL BECAUSE THE NINETY EIGHT
THAT'S FIRST PRIORITY BUT THE
SECOND PRIORITY.
FOR. WHAT'S LEFT.
SHE GOT A MEDI CAL.
AND SO WHAT ESSENTIALLY WHAT
WE'RE DOING BY SAYING WHAT THE
SAVINGS FIRST BEFORE WE START
DOING THE CALCULATIONS WERE
ACTUALLY GOING AROUND WHAT THE
VOTERS WANTED.
BECAUSE OF WHAT THE VOTERS SAID
IS THAT IF THERE SOME MONEY LEFT.
TAKE THE HALF OF IT AND THE
OTHER HALF FIGURE OUT WHAT YOU
DO SAY THAT WHATEVER ELSE BUT
THAT'S.
THAT'S WHAT THEY SAID.
AND THAT'S WHAT I'M CONCERNED
ABOUT IS THAT HOW DO I GO BACK
UNTIL PEOPLE YOU VOTED FOR THIS
PROPOSITION AND THEN WHAT
HAPPENS IS THAT WE.
YOU KNOW ONE NAME THERE'S OF
COULD BE BUT THE VOTERS FOR THE
MAJORITY PASSED IT SO SAID THAT
IF THERE'S SOME SAVINGS MONEY.
WE DON'T WANT ALL OF IT JUST TO
BE SQUIRRELED AWAY WE WANT HALF
OF THAT TO GO TO MEDI CAL.
THAT'S ALL WE'RE SAYING SO WE'RE
GONNA DO THE CALCULATION HUESO
THE WE CAN SQUIRREL IT ALL AWAY.
AND THAT'S TO ME LO PROBLEMATIC
NOW I MAY HAVE MY OWN OPINIONS
ABOUT OKAY WELL MAYBE WE SHOULD
SCROLL AT ALL THE WAY BUT I
DON'T THINK WE SHOULD.
OVERRIDE THE VOTERS.
BECAUSE THAT'S WHAT THE VOTERS.
INTENDED I MEAN I DON'T I DON'T
SEE HOW YOU THINK THE VOTERS
THOUGHT SOMETHING ELSE THEY
VOTED FOR THIS.
I MEAN THEY DID SAY THAT THE
MORE THEY SAID WE'RE GONNA LET
FINANCE
I PLAYED EVERYTHING.
SAY SOMETHING OUT THERE BUT.
.
IT IT IT THERE'S A LEVEL OF
TRUST TO GIVING TO YOU.
THAT YOU DO IT IN THE U. FOLLOW
THROUGH WITH THE AND.
SO I I REALLY DO HOPE THAT WE
CAN FIGURE OUT A WAY TO DO THIS.
AND STILL BE ABLE TO GO BACK TO
ONLY CELEBI AGO THE MAN MY
CONSTITUENTS I REALIZE YOU'RE
NOT LIKED IT. GOVERNOR IS
ELECTED.
AND THEN BE ABLE TO SAY THAT WE
ACTUALLY FOLLOWED THROUGH WHAT
YOU INTENDED BECAUSE IT YOU KNOW
THEY'RE NOT CON YOU EVEN I DON'T
KNOW MAYBE YOU DO READ EVERY
SINGLE LEAGUE.
MOST PEOPLE WHAT HAPPENED.
NOW THAT TERE THERE'S CLEARLY
CERTAIN INTENSE THAT THAT THAT
DATE THAT PEOPLE AND AND.
AND I DIDN'T
TO ME.
THEY WERE SAYING THAT THERE
SOME MONEY LEFT OVER AND THAT
PROP NINETY COMES FIRST THAT
HALF OF THAT SHE GOT A MEDI CAL
AND I THINK THAT'S AND THEN SO
LET'S NINE. LOOKS.
AND I'VE KIND OF PUT YOUR HANDS
BECAUSE THAT'S THE VOTERS IT
SAVED FINANCE BUT I THINK THE
EXPECTED THAT THAT WOULD. THAT
THEIR INTENT WOULD BE FOLLOWED
AND I JUST DON'T SEE HOW THIS
WINDS UP WITH THAT.
SO LOOKS HOPEFULLY NAY REVISING
CAN COME UP WITH A DIFFERENT WAY
OF.
RIGHT OF OF GUY AND THEY SAID I
DO APPRECIATE THE GOVERNOR'S
INVESTMENTS IN MEDI CAL SUMMITS
DON'T BELIEVE ME THERE'S MY
EUREKA PUTTING IN THE BUDGET
THAT KIND OF GOES THAT WAY
ANYWAY WE CAN SAY THAT SHOW THAT
WE DID BUT LET'S NOT SAY THAT.
THERE IS NO MONEY.
OKAY.
SO PUBLIC SHOULD.
STEWART THAT BETWEEN NOW AND MAY
REVISE. RIGHT.
BUT IT. IS A.
OKAY.
OKAY THANK YOU ALL RIGHT.
.
SO WE DO. SO I NOW ANNOUNCE IN
THE BEGINNING I KNOW THAT.
WE HAVE A.
STAKEHOLDER PROPOSAL THAT.
.
THAT WE KNOW WE HAVE SOME
PARENTS HERE IN CENTER GAINES IS
HERE SO I MAY I'M GONNA ASK THE
INDULGENCE TO TAKE SOME TAKE IT
OUT OF ORDER.
.
NMAP.
NTFC SO IT'S NORMALLY PART OF
ISSUE FOR ITS IN PAGE. THIRTY
THREE.
SO.
.
PEDIATRIC. IT'S THE PEDIATRIC DE
HEALTH CENTER.
RATE INCREASE.
SO THAT IT WILL GET TAKE A
LITTLE BIT OUT OF CONTEXT OF A
LOT OF OTHER THINGS HERE SO WE
WHILE WE MAY NOT WE DELVE INTO
FULLER DISCUSSION AFTER WE HEAR
ALL THE REST THAT'S UP BUT WHAT
WHILE WE GO AHEAD.
GIVE YOU AN OPPORTUNITY TO
PRESENT.
MAX SOME PLEASE THREE MINUTES
FOR THE PROPOSAL WE DO HAVE A
WRITTEN VERSION AS WELL AND IT
AND TRY TO BE BRIEF OKAY ALRIGHT
THANK YOU AND AND.
ACTUALLY I KNOW LA OWN FINANCE
AND SAY IT'S WILL GO HAVE THEM
COMMENT AS WELL POWDER OKAY. THE
US ARE GAINES THANK YOU FOR YOUR
CONSIDERATION AND ADJUSTING.
THE AGENDA WE HAVE SOME
CHILDREN HERE SO I JUST WANT TO
MAKE SURE IF WE COULD DO IT
SOONER THAN LATER THAT DUH IS
VERY HELPFUL.
ANSWER ONE THE THANK YOU CHAIR
MEMBERS.
BY AM REQUESTING FOUR MILLION
DOLLARS TO INCREASE
REIMBURSEMENT RATES FOR
PEDIATRIC DAYCARE DAILY
HEALTHCARE FACILITIES.
WHICH WITH A FEDERAL MATCH WILL
BE A TOTAL OF EIGHTY MILLION
DOLLARS IT APPEARS TO ME THAT
THEY HAVE BEEN LEFT OUT PERHAPS
UNINTENTIONALLY. AND WE ARE
ASKING FOR PARITY AND INCLUSION
OF THE CENTER FOR BY CRITICAL
SERVICES TO CHILDREN WITH SEVERE
MEDICAL CONDITIONS. BY ALLOW
CHILDREN TO INTERACT WITH EACH
OTHER DEVELOP FRIENDSHIPS
THE KIDS AND BE PART OF A
COMMUNITY WHILE RECEIVING THE
CARE THAT THEY NEED.
PD H. SEES REIMBURSEMENT RATES
HAVE BEEN STAGNANT FOR FOURTEEN
YEARS MAKING IT INCREASINGLY
DIFFICULT TO RETAIN THE BEST
QUALITY NURSES AND PROVIDERS. OF
CARE FOR CHILDREN TOUGH
DECISIONS HAVE BEEN MADE TO
CLOSE OUR LIMIT HOURS OR NOT
EXPAND OR NOT OPEN NEW
FACILITIES BECAUSE OF LOW
REIMBURSEMENT RATES.
THIS FOUR MILLION DOLLAR BUDGET
REQUEST WILL BRING PURITY.
FOUR PDH CITIES WITH THE
GOVERNOR'S BUDGET REQUEST
INCREASE READ REIMBURSEMENT
RATES SERVICE.
CHILDREN IN THEIR HOME.
HOME HEALTH AGENCIES IN
PEDIATRIC DAYCARE DAY HEALTH
CARE'S.
CENTERS HAVE HISTORICALLY
RECEIVE THE SAME REIMBURSEMENT
RATES.
I HERE TODAY.
IT IS TERRY ARE SHADO CHAIR OF
THE PEDIATRIC DAY. HEALTH CARE
COALITION ARE ALONG WITH MICHAEL
LINEMEN ADMINISTRATOR OF RICH
LINE PEDIATRIC DAY HEALTH AND
RESPITE SERVICES. TO ALSO
PROVIDE.
TESTIMONY OTHER ALSO A NUMBER OF
FAMILIES AND CHILDREN IN THE
AUDIENCE WHO ARE HERE TODAY
BECAUSE OF HOW IMPORTANT IT IS.
FOR THEM THAT THESE CENTERS KEEP
THEIR DOORS OPEN.
THANK YOU.
BRIEFLY. HIGH.
I'VE IN THE INTEREST OF BEING
I'M GOING TO TALK REALLY FAST.
THAT'LL WORK FOR YOU. ON MISTER
CHAIR MEMBERS OF THE COMMITTEE
WE APPRECIATE THE OPPORTUNITY TO
COME BEFORE YOU TODAY. TO
FURTHER EXPLAIN I REQUEST.
MY NAME IS TERRY ROCHAT # I'M
A REGISTERED NURSE I'VE BEEN
DOING PEDIATRIC HEALTHCARE
CENTER SINCE NINETEEN NINETY TWO.
I WOULD LIKE TO ASK THE CHEERS
PERMISSION TECHNOLOGIES THE
PARENTS AND CHILDREN WHO TRAVEL
TO BE HERE TODAY TO BE PART OF
THIS HEARING WHICH YOU WILL HEAR
FROM.
THERE ARE EIGHTEEN PEDIATRIC DE
HEALTH CARE CENTERS IN
CALIFORNIA TO PROVIDE SKILLED
NURSING CARE FOR APPROXIMATELY.
FIVE HUNDRED AND FORTY FOUR
CHILDREN OF THE ONE PERCENT OF
THE MOST MEDICALLY FRAGILE IN
CALIFORNIA.
WE CAN CARE FOR CHILDREN UP TO
THE AGE OF TWENTY ONE. RECENTLY
WITH AB ELEVEN FORTY SEVEN
CHILDREN WHO ARE DEVELOPMENTALLY
UNDER THE AGE OF EIGHTEEN BUT
ARE OVER THE AGE OF TWENTY ONE
CAN STAY. THEY ALSO RECEIVED
OVER DEVELOPMENTALLY APPROPRIATE
PROGRAMS
THE CHILDREN HAVE A CHANCE TO
MAKE FRIENDS AND BE A CHILD NOT
SOMEONE WHO IS DEFINED BY THEIR
HER HEALTH CONDITION. OR THEIR
WAY OF COMMUNICATING.
PAGE SAYS MAKE IT POSSIBLE FOR
PARENTS TO CONTINUE WORKING.
MANY OF OUR PARENTS ARE SINGLE
PARENTS MANY OF OUR CHILDREN
REQUIRE ROUND THE CLOCK HERE.
MANY OF OUR CHILDREN A TENER
CENTER FOR TWO HOURS AFTER
SCHOOL. INSTEAD OF AN EIGHT HOUR
SHIFT THAT WOULD BE DIFFICULT TO
FILL SO THAT THEIR PARENTS AND
THEIR OWN NEEDS CAN BE MAX.
EACH CHILD IS UNIQUE IMPORTANT
AND WELL LOVED AT OUR CENTERS.
WE TALKED ABOUT THE FACT THAT
THE RATES HAVE BEEN STAGNANT.
ONE OF THE THINGS WE DID NOT
DISCUSS HIS THAT PEDIATRIC DAY
HEALTH CARE CENTERS OR THIS SITE
WHERE IN A LOT OF ILL BE IN
NURSING SCHOOLS. HAVE TO HAVE
THEIR PEDIATRIC ROTATION WITHOUT
THAT IS A SITE THE NUMBER OF ALL
BEINGS THAT ARE AVAILABLE IN THE
STATE OF CALIFORNIA WILL BE
GREATLY REDUCED.
.
I'M GOING TO SKIP THROUGH A LOT
OF THIS
IN THE INTEREST OF TIME. WHAT
WE'RE BASICALLY ASKING FOR IS
PARITY BECAUSE IF WE DON'T HAVE
THAT PARITY WE'RE GOING TO HAVE
EVEN LESS STAFF THAN WE HAVE
RIGHT NOW?
YOU TALKED EARLIER ABOUT HOW
PEDIATRICIANS DON'T ABANDON
PATIENTS
WE HAVE NOT ABANDON OUR PATIENTS
WE'VE DONE EVERYTHING WE COULD
DO TO MAKE SURE THAT HAPPENS.
BUT WE REALLY NEED TO HAVE THAT
INCREASE IN ORDER TO BE ABLE TO
FUNCTION WE'RE LOSING STAFF
REDUCING HOURS. WE NEED THE HELP.
AND THAT'S WHAT WE'RE ASKING FOR
HERE TODAY.
AND I'M GONNA STOP OKAY SO
ACTUALLY YOU'RE READY AT THAT
FOUR MINUTES THIRTY TWENTY FOUR
TWENTY FIVE SECONDS SO IF YOU
CAN.
KEEP IT VERY BRIEF AND THEN.
.
MIKE LEMON FROM RICH ON
PEDIATRIC YA OUGHT TO SET TO THE
CONVERSATION. OF THE COMMITTEE.
WE WERE WE WORK IN RURAL KEEP
COMMUNITIES.
YUBA COUNTY SUTTER COUNTY
NEVADA COUNTY WITH OUR CENTERS
VERY SMALL POPULATIONS AXIS
SECURES A HUGE.
SIGNIFICANT PROBLEMS FOR
FAMILIES FINING NURSING CARE
WE'VE WE'VE STRUGGLED IN THE
LAST YEAR WE'VE LOST THE
DIRECTOR OF NURSING TO
REGISTERED NURSES LV ENDS.
IT CONTINUES TO BE A PROBLEM AND
IN FINDING QUALIFIED
PROFESSIONALS TO PROVIDE
SERVICES FOR FAMILIES.
THANK YOU ALL RIGHT THANK YOU. I
KNOW YOU'RE OUT IN THE AUDIENCE
BUT ACTUALLY.
DE EIGHT C. A. S. M..
YOU COME UP BUT FINANCE.
BELIAU COMMENTS ON THIS PROPOSAL.
I DON'T TAKING THIS ONE OUT OF
ORDER.
ALICIA TO MOVE AND STRETCH AND
SECULAR.
OKAY GOD. ANY COMMENTS.
PINK NO COMMENTS OTHER THAN
WE'VE ACKNOWLEDGED THAT THE
REQUEST HAS BEEN MADE IN WAS NOT
PART OF THE GOVERNOR'S JANUARY
BUDGET.
ELLIOTT BECOME INFAMOUS
PROPOSAL.
NO PARTICULAR COMMENTS ON THIS
PROPOSAL WERE GOING TO ADDRESS
THE HOME HEALTH RATE INCREASE
LATER IN THE PROFIT.
ACTION.
OKAY NOW FINANCE A SILENCE OKAY.
QUESTIONS COMMITTEE MEMBERS.
SEARCH THEM. AND I JUST WANNA
ASK.
DISCOUNTED. SO THIS WAS THIS
WAS A DELIBERATE A DECREASE
BECAUSE FROM UNDERSTAND IT WAS A
LACK OF.
ACCESS THE DOCUMENTATION.
SO THERE WHEN WE'VE PROPOSED THE
GOVERNOR'S BUDGET IN JANUARY THE
FIFTY PERCENT RATE INCREASE FOR
HOME HEALTH SERVICES WAS AN
INTENTIONAL RATE INCREASE
SPECIFIC TO HOME HEALTH AGENCIES.
TO ADDRESS
UPS T..
NURSING SERVICES IN BOTH OUR
WAIVER PROGRAMS IN OUR FEE FOR
SERVICE PROGRAM SO WHAT WAS
PROPOSED IN JANUARY WAS THE
PROPOSAL AS THIS COMMITTEE HAS
DONE. PUT ON ITS AGENDA AND
WE'LL BE HEARING.
OKAY BUT THAT THE.
THE MONEY THAT US SENATOR GAINES
AND ALL THESE PEOPLE ARE LINED
UP FOR. THE WAS A CONSCIOUS
DECISION ON BEHALF OF THE
ADMINISTRATION TO MAKE THESE.
CUTS A FEW WELL AS IT WAS A TRUE
AS OVER EXERTED AS A RESULT OF
SOME REPORTING ISSUE.
SO.
IF I UNDERSTAND RIGHT WORTH
TALKING ABOUT OF BUDGET
AUGMENTATION. FOR THE PEDIATRIC
DAY HEALTH CARE FACILITIES AND
MAYBE WE HAVE NOT PROPOSED A
REDUCTION TO THE PEDIATRIC DAISY
HEALTH FACILITY SEVEN MAYBE YOU
ARE TALKING ABOUT THE PEDIATRIC
SUB ACUTE
SALINAS.
OKAY SO I'M NOT IN THE HOME
HEALTH SIDE TO GIVE AN INCREASE.
BUT AT THE SAME INCREASE WAS
AND PASSED ON THE PEDIATRIC SIDE
BECAUSE IT WAS SOME.
ACCESS A DEMONSTRATE OUR DAX'S
DATA DEMONSTRATION THAT WAS NOT
PROVIDED OR.
OR ELIMINATED TO YOU.
CORRECT SO.
WHEN WE PROPOSE THE FIFTY
PERCENT RATE INCREASE FOR THE
HOME HEALTH AGENCIES.
WE HAD.
BOTH RECEIVED.
PROVIDER COMPLAINTS ABOUT.
INABILITY TO SO FILL STAFFING
HOURS WE HAD TALKED HOSPITALS WE
HAD TALKED TO OUR HOME HEALTH
AGENCIES IN TERMS OF THEIR COULD.
AND SO THERE WAS.
THERE WAS A SIGNIFICANT AMOUNT
OF DATA THAT WE HAD TO SHOW THAT
WE HAD CONCERNS ABOUT THE
ABILITY FOR THOSE AGENCIES TO
CONTINUE OPERATING WITHOUT A
RATE INCREASE THE US.
WE PROPOSE TO THE PROPOSAL IN
JANUARY.
THERE WAS NOT THE SAME LEVEL OF
EITHER DATA OR.
ISSUES RAISED WITH THIS
PARTICULAR FACILITY THAT IS
ASKING FOR THE AUGMENTATION
TODAY.
SO IF THERE'S IF THERE'S DATA
THAT UP.
BUT AND WE'RE ALWAYS WILLING TO
ACCEPT A FREE PROVIDER TYPIST
FOLKS BELIEVE THAT THERE IS DATA
THAT WE SHOULD BE AWARE OF THAT
WE CAN LOOK AT SUGGESTS THAT
THERE ARE YOU THERE. IMMINENT
CLOSURES LACK OF CAPACITY THE
LOSS OF KEY STAFF BECAUSE OF.
ATTRITION OR YOU KNOW GOING TO
OTHER HIGHER.
REIMBURSED FACILITIES WERE
ALWAYS HAPPY TO LOOK AT THAT.
BUT AT THIS TIME THE PROPOSAL
AS WE HAD PUT FORTH IN JANUARY
WAS LIMITED TO HOME HEALTH
AGENCIES. SOFA GIVE YOU A CHANCE
TO RESPOND ABOUT THE
DOCUMENTATION THAT.
YOU SEEM TO BE.
DISCUSSING HERE TODAY I I DON'T
KNOW IF.
THE LACK OF ACCESS HAS TO DO
WITH THE
NO IN INCREASING AMOUNTS BUT
FUNDING IS CAUSING YOU TO.
CUT BACK AS OF LIKE YOU BEEN
DOING SOME PHILANTHROPIC WORK.
FOR FOR QUITE SOMETIME HAVE BEEN
THERE'S ONLY SO MUCH THAT YOU
CAN DO OVER A PERIOD OF TIME
UNTIL YOU HAVE A SIGNIFICANT
INCREASE SO.
COULD TALK ABOUT THAT
DEFICIENCY DOCUMENTATION IS A
SOMETHING THAT YOU THINK YOU CAN
UPDATE AND AND GIVE TO.
.
WE'D BE HAPPY TO DO THAT WE ARE
ONLY FILLING FIFTY EIGHT PERCENT.
OF THE HOURS THAT WE'VE BEEN
ALLOWED WE'VE HAD TO REDUCE OUR
SERVICES IN ONE OF MY FACILITIES
I LOST THIRTY FIVE PERCENT OF MY
STAFF IN ONE WEEK. BASED ON THE
FACT THAT WE COULD NOT COMPARE
OR BE ABLE TO DO AND MEET.
THE WAGES THAT THEY CAN REACH
ELSEWHERE.
.
I THINK IT AGAIN GOES BACK TO
THE POINT OF WE DON'T ABANDON
OUR PATIENTS.
BECAUSE WE'VE STOCK IN THERE TO
DO THE BEST WE CAN IN MANY OF
OUR INSTANCES WERE SMALL
BUSINESSES WE PUT UP OUR OWN
PERSONAL ASSETS. IN ORDER TO BE
ABLE TO ABSORB THE LOSSES THAT
WE'VE HAD BUT THERE COMES A
POINT WHEN YOU CAN NO LONGER DO
THAT.
AND THAT'S WHERE WE ARE EIGHTEEN
YEARS IS A LONG TIME.
TO OF NOT HAD AN INCREASE AND
THE FACT THAT WE CONTINUE TO SEE
THE PATIENTS SHOULD NOT BE TO
OUR DETRIMENT. IT'S BECAUSE WE
WERE COMMITTED TO THOSE PATIENTS
LIKE APPRECIATE. YOU BEING HERE
TODAY AND APPRECIATE SENATOR
GAINES.
BRINGING THIS TORRENT TENSION.
.
YOU'RE VERY GENEROUS AND AND
EMPATHETIC AND SYMPATHETIC AND I
APPRECIATE THE SERVICES
ATTRIBUTING.
GIVING DOING MORE WITH LESS BUT
YOU'RE RIGHT IS A COME CERTAIN
POINT TIME WHEN.
YOU KNOW YOU GOTTA PAY YOUR RENT
AND USED TO BETTER TAILOR
WORKMAN'S COMP AND EVERYTHING
ELSE THAT GOES ALONG WITH IT.
AND I JUST HOPE THAT MAYBE
THROUGH SOME BETTER
DOCUMENTATION HOPEFULLY WE CAN
IMPRESS UPON THE. THE GOVERNOR
TO TO MAKE THIS.
THIS IS THIS ALLOCATION SO THAT
WE CAN MAKE YOU SOME A HOLE AND
SO YOU CAN CONTINUE THE. THE
WORK THAT YOU DO IT DOESN'T
SOUND LIKE YOU'RE IN IT FOR THE
MONEY IT SOUNDS LIKE YOU'RE IN A
FOR. TAKING CARE OF SOME SOME
KIDS REALLY NEED THE IN THE IN
THE MEDICAL TENT.
CAN'T GET OTHERWISE ANYWHERE
ELSE THANK THANK YOU.
OKAY.
BOTH THEY GET SO AGAIN I THINK
WHAT YOU HEARD FROM.
PART HAS TO SERVICES GET SOME
DATA TOGETHER AND SHOW WHAT THE
SITUATION IS.
SO WITH THAT LET'S GO AHEAD
TAKE PUBLIC COMMENT
I ASK YOU.
BUT I KEEP YOUR COMMENTS TO
WITHIN A MINUTE ENTERED
ITSELF A FEW REPRESENT
ORGANIZATION
THE ORGANIZATION AND THEN.
COMMENT AND IF SOMEONE THREE
SAID THAT COMMENT YOU CAN ALSO
SAY ME TOO ARE I AGREE.
SO.
WELCOME THANK YOU. AMENDMENTS
BUT CAN BLEND IN THIS MY SON
BEAR AND WE.
HIS CLIENT A BRIDGE LINE PDC.
OUT WITH OUTFITS RPDS THE.
I WOULD BE UNABLE TO WORK OUR
FAMILY WOULD BE THRUST BACK INTO.
.
ISOLATION AND BE ON DEPEND ON
THE STATE AS WE WERE BEFORE WE
FOUND RICH LINE.
THAT IS FOR.
CAL WORKS OF FOOD STAMPS AND
MEDICAL COSTS FOR NOT JUST MY
SON BUT FOR OUR ENTIRE FAMILY
AND I THINK THAT ME AND OTHER
FIVE HUNDRED PLUS FAMILIES IF WE
ALL GET BACK IN BECOME DEPENDENT
ON THE STATE FOR THOSE NEEDS.
BECAUSE WE LOST THIS SERVICE I
THINK THAT THAT WILL HAVE A
LARGER IMPACT ON YOUR BUDGET AS
A WHOLE.
AND I THINK THE REASON WHY I
TRUST THAT MY SON IS SAFE AT
RICH LINE IS BECAUSE.
I KNOW THAT OUR STAFF IS WELL
TRAINED COMPASSIONATE AND AND A
MEDICAL STAFF TO SERVE HIM.
I THINK
THANK YOU THANK YOU.
HELLO MY NAME IS FOR CERTAIN AND
THE FATHER OF A NINE YEAR WITH
LIMITS GUEST OF SYNDROME
CONDITION THAT CAUSES ABOUT ON
AVERAGE. AT ITS PEAK TWENTY FIVE
HUNDRED SEIZURES A MONTH ALONG
WITH DEVELOPMENTAL PROBLEMS THAT
COME ALONG WITH THAT. I WANTED
TO SPEAK TODAY TO JUST SAY A
COUPLE THINGS BASED ON THE
COMMENTS THAT THE IMPACTS OF THE
LACK OF RATES IN INCREASES IN
THESE PROGRAMS CAN BE SEEN IN
THE CAN NO FURTHER THAN THE FACT
THAT THERE'S ONLY EIGHTEEN OF
THEM IN THE ENTIRE STATE OF
CALIFORNIA.
THE INABILITY FOR PEOPLE WHO
WANT TO START THESE PROGRAMS IS
CITIES.
EVIDENCE IN THEIR INABILITY TO
SEE IT WORK OUT ON PAPER AND
TODAY HAS OF SOMEONE WHO HELPS
LOTS OF DIFFERENT FAMILIES WE
HEAR CONSTANTLY THAT. THEY WISH
THEY HAD THE TYPE OF SERVICES
THAT WE HAVE WITH RICH SIGN
PEDIATRIC A I'D LIKE TO ALSO
POINT OUT THAT.
NGUYEN CONSIDERING IF WERE GONNA
HAVE RATING CREASES THE IMPACTS
ON THE FAMILIES IN THEIR
COMMUNITY AROUND THEM IS
SIGNIFICANT AS WITH
CATASTROPHICALLY ILL TERMINALLY
ILL CHILDREN WE SEE IN SOME
STUDIES IS MUCH IN THE EIGHTY
PERCENTILE OF DIVORCE RATE. THE
ABILITY TO RECEIVE SERVICES THAT
WE OFFER. IS YOU HAVE TO LOSE
EVERYTHING BEFORE THAT HAPPENS
ALLOWING THESE PROGRAMS WHO
EXISTS ALLOWS FAMILIES TO KEEP
THEIR JOBS MAINTAIN THE FAMILY
CUT COSTS IN OTHER PROGRAMS LIKE
RESIDENTIAL CARE NIGHTS SS.
THANK YOU THANK YOU.
WELCOME.
MY NAME IS HERBERT OR AND THIS
IS MY DAUGHTER AND ALL IN.
IF YOU'D SERVICES ARE SO
IMPORTANT TO US I WOULDN'T BE
ABLE TO WORK I WOULDN'T.
NOT HOUSE
IF I WASN'T ABLE TO HAVE THE
SERVICES FOR MY DAUGHTER.
I SPEND EVERY DAY BUT I'M ALL
FOR TAKING MY DAUGHTER TO
THERAPIES I TOOK HER TO
APPOINTMENTS SHE HAS OVER ELEVEN
THERE'S.
I TOO EAGER TO PLEASE
APPOINTMENTS AND DIDN'T.
I JUST THINK HURT JUST TO WORK I
DECREE BAKER SO I CAN PROVIDE
FOR HER HAVE A BETTER LIFE FOR
OUR FAMILY.
AND THEN THEY GIVE HER THE
OPPORTUNITY TO DO OTHER SERVICES
OR TAKE HER PLACES AND DO THINGS
WITH HER THAT I CAN'T DO BECAUSE
I'M TOO BUSY TAKING HER TO
APPOINTMENTS.
I DON'T HAVE TO WORRY AYE SHE
USED TO HAVE A NANNY AND THEN A
TWO THOUSAND AND FIFTEEN SHE
SPENT TWENTY DAYS AT UC DAVIS
WERE THEY SAVED HER LIFE. SHE
HAS EXTENSIVE WIND DAMAGE AND
LUNG DISEASE AND SHE GOT A GTO
AND I'M THINKING WELL. WHAT AM I
GONNA DO HOW MEGHAN EVEN GET
SOMEBODY TO CARE FOR HER? AND
THEN SOMEBODY TOLD ME ABOUT
THESE PEDIATRIC CENTERS.
THEY HAVE BEEN A LIFESAVER FOR
ME AND MY FAMILY. I CAN GO AND
AT THE LAST MINUTE SOMETIMES MAY
KNOW THAT SHE'S TAKING CARE OF
WE'VE SEEN NURSES LEAVE FOR
MONEY.
BUT.
I DON'T UNDERSTAND.
EVERYONE SHOULD BE ABLE TO LIVE
pIN AN ENVIRONMENT WHERE THE.
ARE ABLE TO.
CONTRIBUTE AND THAT'S ALL I'M
TRYING TO DO WITH MY DAUGHTER
AND THIS.
I JUST THESE SERVICES JUST CAN'T
LEAVE.
BUT THANK YOU.
AND I.
OKAY.
YEAH.
SORRY AND NO NO DEMON.
IN THE ROOM THAT YOU CAN DO THIS.
OKAY GOOD. WELCOME HELLO MY NAME
IS BRINGING HER SIERRA.
MY CHILD IS SEVERE US REAL
PALSY SHE'S THE ONE PERCENT THAT
IS NAM NAM VOTE NON VERBAL AND
NON.
NO MOBILITY NO ABILITY TO
COMMUNICATE OTHER THAN. THAT
FUNCTION OF A SIX MONTH INFANT.
AS A PARENT OF A CHILD WITH
SEVERE SPECIAL NEEDS.
OKAY ALMOST SIXTEEN BUT
FUNCTIONS AS SUCH.
ACCESS HOME SHE HAS ACCESS AND
RETAINING PRO.
THE PROVIDERS DUE TO HER PALLET
OF CARE REQUIREMENTS IS AN
ONGOING STRUGGLE DAILY.
.
WITH NO PHYSICAL IMPROVEMENT IN
SIGHT SERVICES HAVE BEEN DE SEED
BY PPL O. T. STATING THAT DO TO
HER. NOT PROGRESSING TO THEIR
EXPECTATIONS BUT. YOU CAN NO
HURT PROGRESS.
IN HER OWN WAY IS NOT ENOUGH NOT
NOTABLE PROGRESS TO THEM ENOUGH
TO CONTINUE WITH HER THERAPIES.
AND TO THEM IT IS UNETHICAL TO
CONTINUE SERVING HER.
AND TO THAT I SAY WHEN YOU
CHOOSE TO TAKE.
THE THE PATH OF LEAST RESISTANCE
FOR THESE CHILDREN YEAR CAN PUT
COMPOUNDING THEIR DISABILITY
YOU'RE CONTRIBUTING TO THEIR.
THERE.
DAILY LACK OF CARE REQUIREMENTS
IN THIS CASE THEIR BEING THERE
THEIR DISABILITIES ARE BEING
EXPANDED.
TO THEIR FAMILY MEMBERS AND. IT
ADDS SIDE EFFECTS WHAT HAPPENS
TO PEOPLE WHO CAN'T BE A PART OF
THEIR COMMUNITY AND THE RESIDING
GET OUT OF THEIR HOMES AND TEN
APPOINTMENTS TO MEET THE NEEDS
OF.
THE BECOME SHUT INS AND YOUR AND
SOME OF US ARE.
NOT BEING ABLE TO PROVIDE
ADEQUATE CARE IS CONTRIBUTING TO
THAT AN EXTENDING IT TO THE
FAMILY MEMBERS.
I HAVE TWO BOYS I WISH I COULD
HAVE SUPPORTED IN SPORT MET MORE
OF THEIR NEEDS FOR THE MORE
BEING A BORDERLINE SHUTTING AS A
PARENT YOU LOSE A SENSE OF
YOURSELF. YOU GET DEPRESSION
ANXIETY AND HEART PROBLEMS YOU
LOSE THE ABILITY TO HELP THE
MOST VULNERABLE FOUNDER MEMBERS.
IF MY DAUGHTER DIDN'T HAVE THE
SERVICES SHE HAS WITH PHD SHE
WOULDN'T GO TO SCHOOL I COULDN'T
FIND READ ARTIST AMERICA'S YOU
TO WRAP UP. ITS THOMAS TWO
MINUTES NOW.
TIME RESTRAINTS.
I LOVE THEM.
WELL THEY YOU NEED THESE
SERVICES.
AND DON'T OF THE FAMILIES TO BE
FUNCTIONAL IN SOCIETY.
I DON'T THINK YOU MAY KEEP THIS
MONTH.
WELCOME.
OF THANK YOU TO THE COMMITTEE
FOR HEARING THIS MY NAME IS
DENNIS KEEP MY THIS MY WIFE
ANITA KEEP WERE ON. WE'RE
ACTUALLY SPEAK ON BEHALF OF OUR
SON BRANDON WHO'S TWENTY YEARS
OLD WHO'S BEEN AT THE.
CARE FACILITY OF FOR THE LAST
THIRTEEN YEARS.
AND IT'S BEEN A GODSEND TO US AS
A DUAL INCOME FAMILY WERE WERE
ALLOWED TO CONTINUE OUR
EMPLOYMENT.
PROVIDE FOR A FAMILY HE'S THE
OLDEST OUT OF THREE KIDS.
WITHOUT THESE TYPE OF SERVICES
THAT I WANT TO REITERATE JUST
WHAT'S BEEN SAID HERE TODAY.
IT'S.
GIVE US A SENSE OF NORMALIZATION.
IT ALLOWS BRANDON TO BE CARED
FOR.
AS WELL AS THE REST THE KIDS
THAT ARE THERE.
THIS IS MY FRIENDS OUT OF ELK
GROVE AND THE THING ABOUT IT IS
THAT THESE TYPE OF FACILITIES.
FOR LACK OF A BETTER WORD.
ARE JUST BABY SITTING THERE
DURING THEIR HANDLING THESE TYPE
OF SPECIAL NEEDS ON A DAY IN DAY
OUT. AND WE WOULD REALLY BE
REMISS STIFF.
IF THE FUNDING WAS CUT TO THEM.
THANK YOU VERY MUCH.
THANK YOU.
WELCOME. THANK YOU I THINK YOU
SO MUCH FOR TAKING THE TIME TO
HEAR US WITH COOLIO SMITH HE'S
EIGHTEEN YEARS OLD HE GOES TO
THE MY FRIENDS I'M FACILITY IN
ORANGE WELL. AND WHEN HE STARTED
ATTENDING SIX YEARS AGO OUR LIFE
CHANGED COMPLETELY. MEANT SO
HOPING THAT YOU GET THE
INFORMATION YOU NEED TO CONSIDER
AN INCREASE IN.
WE WERE ABLE TO BOTH BE
GAINFULLY EMPLOYED WITHOUT OUR
SIX.
I WE WERE ABLE TO CONSIDER.
PERHAPS THE GREATEST GIFT IS
HAVING MORE CHILDREN BECAUSE WE
COULD AFFORD IT AND WE COULD
SUPPLY A LIFE THE CLIO DESERVED
AND A FACILITY THAT TAKES CARE
OF HIS. NON VERBAL UP TO THEM
AND ADDITION TO HIS.
AND THE PEOPLE BEHIND ME IN THE
PEOPLE BEFORE ME ARE GOING TO
SPEAK TO. HOW THIS CHANGES LIVES
IT CHANGES THEIR LIVES FOR OUR
CHILDREN TO BE IN A SOCIAL
ENVIRONMENT TO HIT THE GOALS
THAT THEY'RE WORKING? SO HARD TO
BE THE BEST PEOPLE THEY COMPETE.
CLEO IS.
QUITE. POSSIBLY THE BIGGEST
STORY IN OUR FAMILY AND TAP IN A
PROTECTED ENVIRONMENT. WITH
QUALIFIED PEOPLE.
AND THE HE SAFE AND CARED FOR
AND ALSO.
YOU KNOW HAPPY I THINK THAT'S
ALL BUT ONLY ASK. FOR MEDICALLY
FRAGILE CHILDREN TO BE SAFE AND
HAPPY. THANK YOU FOR YOUR TIME
AND WE LOOK FORWARD TO YOU
CONSIDERING THE THING.
HE THOUGHT ABOUT NNOVA THANK YOU.
KRAMER'S RANDY AND THIS IS MY
SON MICA HE'S MEDICALLY FRAGILE.
END SO HE CAN JUST GO.
IF HE'S GOING TO HAVE A CHILD
CARE RESPITE OR SUPPORT INTO THE
ONLY PLACE
WE GO IS TO LORETTA MIRACLES
WHICH IS A PIECE.
.
AND SO THAT'S GIVEN US RESPITE.
BEFORE WE HEARD LEARNED ABOUT
THE AND WE WERE VERY ISOLATED
AND.
NOT ABLE TO DO ANYTHING EVEN GO
AWAY FOR A WEEKEND VERY
ANNIVERSARY WHICH IS A VERY
TYPICAL THING TO DO. FAMILIES
WITH SPECIAL NEEDS TO GET TO DO
THAT THEY DON'T USUALLY HAVE
SUPPORT WE HAVE LIMITED FAMILY
SUPPORT.
TO MOST PEOPLE HE WOULD BE
CONSIDERED KIND OF SCARY TO TAKE
CARE OF AND SO LUCKILY I'M
LORETTA'S IS VERY QUICK TO DO
THAT.
SO TO THE PANEL AND OTHER PEOPLE.
I WOULD SAY THIS WHY OR WHY WAIT
UNTIL. YOU HAVE WON SAID A
PEDIATRIC NURSES AND HAVE FIFTY
PERCENT AND. SOME THAT DON'T
IT'S OBVIOUS WHAT'S GOING TO
HAPPEN IF I WAS OFFERED A FIFTY
PERCENT PAY INCREASE TO GO DO MY
JOB SOMEWHERE ELSE I WOULD DO IT
AND THAT'S EXACTLY WHAT'S GOING
TO HAPPEN. WHY WAITED UNTIL THE
DOORS ARE SHATTERING BECAUSE
THERE'S NOT A PROBLEM NOW THE
PROBLEM IS NOW WE NEED TO FIX
THE BUDGET?
THANK YOU THANK YOU.
WELCOME HELLO OF MY NAME IS
ANDREA CLASS SO I'M THE PROGRAM
DIRECTOR FOR KINSHIP PRESCHOOL
ON PEDIATRIC DAY HEALTHCARE.
KINSHIP IS LOW ONLY PEDIATRIC
DE HEALTH FACILITY AND I'M THE
INLAND EMPIRE MEANING WE COVER
BOTH SAN BERNADINE ON RIVERSIDE.
I'M AT THIS TIME THE MAXIMUM OUT
OF MEDICALLY FRAGILE CHILDREN
WHERE SERVE.
ABLE TO SERVICE TWENTY FOUR I'M
WITH THIS RATE INCREASE WE WILL
BE ABLE TO EXPAND OUR PROGRAM
I MEAN YOU'VE HEARD FROM THE
FAMILIES WHO'VE SPOKEN BEFORE ME
HOW MUCH THEY NEED BE SERVICES
AND THEY'RE ABLE TO LIVE NORMAL
LIVES THEY'RE ABLE TO LEAVE
THEIR CHILDREN WITH US KNOWING
THAT THEY'RE IN A SAFE
ENVIRONMENT. THEIR.
CHILDREN'S MEDICAL NEEDS ARE
BEING MET BUT ALSO ON THEIR ABLE
TO INTERACT WITH TYPICALLY
DEVELOPING CHILDREN THAT ARE
THERE AGENTS SO WE'RE.
ADVANCEMENTS IN THEIR
DEVELOPMENTS ARE PROGRAMS DO
MAKE A DIFFERENCE SO I DO HOPE
THAT YOU WILL CONSIDER THIS RATE
INCREASE BANKIA. BETTING.
WHAT?
HI I'M OLYMPIA JOHNSON THE NEST
MANAGER FOR KITCHEN PEDIATRIC
THEY HEALTH CANADA MELINDA WHICH
SAYS LIKE I AND USE IT INLAND
EMPIRE. AND THAT WHOLE REGION OF
SAN EDINA COUNTY. SO IN ORDER
FOR US TO.
CAREFUL AND SERVE ALL MEDICALLY
FOR.
WITH VERY HIGH ACUITY SUCH AS
SEIZURES REAP.
SPINA BIFIDA BRAIN TO MINISTRY
TO DEPENDENT DIABETES TYPE ONE.
AND NUMEROUS.
YOU KNOW SYNDROME SEPARATE DEAL
WITH.
WE NEED TO HIGH XPERIENCE
PEDIATRIC DAY HEALTH CANISTERS
OF TO SERVE THESE TICKETS TO
PROVIDE THE TOP QUALITY KIT WE
REQUIRE.
FOR EXAMPLE WE HAVE A SPINE BUT
FOR THE KID WAS NON VERBAL WHERE
SIXTY EIGHT SIEGES DALY WHO HAS
A VP SHUNT WAS CHEATED DEPENDENT
WOULD NEED SEIZURE MEDICATIONS.
SHE NEEDS ARE TO BE KEPT EVERY
FOR. AND JUST HIRING JUST A
REGULAR ALVIN IF YOU ARE AND WHO
DOES NOT HAVE ANY EXPERIENCE.
JUST PUTS EVERYTHING AT JEOPARDY
WHICH IF FIXED KEY AND WE WANT
TO PROVIDE TOP QUALITY PATIENT
CARE FOR THESE KIDS.
AND IN ORDER TO DO THAT WE
REALLY NEED TO INCREASE FOOD
RATES BECAUSE WE LOSE STUFF THEY
GO ON TO BETTER. JOBS AND BETTER
POSITIONS AFTER THE TRAINED AND.
THIS IS JUST SOMETHING WE HOPE
YOU WOULD CONSIDER GREATLY
BECAUSE THIS IS A OF ONE OF THE
BEST.
THINGS CALIFORNIA CAN PROVIDE
FOR SPECIAL NEEDS KIDS SO THANK
YOU VERY MUCH PICKING.
THANK YOU.
BUT.
I MONNING STAND THE COME I AM
ABOUT HOW LONG WITH MY PARTNER
CAN MCGUIRE WE OWN AND OPERATE A.
CONTINUUM OF.
PEDIATRIC HEALTHCARE FACILITIES
IN.
CAMPBELL SARATOGA IN SOUTH SAN
JOSE SO SOME OF THE MOST
EXPENSIVE REAL ESTATE IN THE
WORLD. AND US THIS
AB THIS BILL OR THIS THIS
REQUEST IS ABOUT BEING ABLE TO
PAY OUR CLINICIANS. LIVING WAGES
OF THE LITTLE THREE BEDROOM HOME
RIGHT NEXT DOOR FACILITY FACING
THE FREEWAY WALL JUST SOLD FOR
TWO POINT FOUR MILLION DOLLARS.
AND WE ARE AT PAIN SEE AN AIDS
WHO DEDICATE THEIR LIVES TO
THESE CHILDREN. THIRTEEN FIFTY
FOURTEEN DOLLARS AN HOUR.
.
THEY LIVE IN THEIR CARS THEY
LIVE IT THE COMMUTE FROM LONG
DISTANCES THEY LIVE SIX TO AN
APARTMENT THIS IS REALLY ABOUT.
IT PROVIDING THE PEOPLE WHO CARE
FOR THESE CHILDREN WITH THE.
FUNDING TILT TO LIVE A BETTER
LIFE FOR THEMSELVES.
SO THANK YOU FOR YOUR TIME
MINUTE HOBBY BACKUP FROM YOU
THAT SUB ACUTE ALRIGHT THANK YOU.
I MERE MORTON ON BEHALF OF THE
CALIFORNIA CHILDREN'S HOSPITAL
ASSOCIATION ALSO PLEASE.
PROPOSAL WE REALLY VIEW IT.
AND TO AVOID AND.
THE INCREASING HUMBOLDT CARE
RATES WHICH WE ARE STRONGLY
SUPPORTIVE OTHER. UNDER PLEASE
IT THAT'S HAPPENING BUT IT'S THE
SAME NURSES BUT WITH THE SAME
TRAINING THAT ARE PROVIDING THAT
CARE TO THE.
OFTEN A DEVICE DEPENDENT
CHILDREN REALLY MEDICALLY
COMPLEX CASES WHETHER IT'S IN
THE HOME SETTING WERE IN ONE OF
THESE PEDIATRIC DAIS HONORS AND
IF YOU PUT YOUR RATE INCREASE
OVER HERE. YOU'LL LOSE ALL THE
PROVIDERS OVER HERE SO IF WE
DON'T HAVE AN ACCESS PROBLEM
TODAY TO SOUNDS LIKE WE MIGHT. A
WE CERTAINLY WILL TOMORROW SO
FOR THOSE REASONS WE SUPPORT
THIS PROPOSAL THANK YOU. THANK
YOU.
HELLO MY NAME IS ALEX SALDANA
I'M FROM SOUTHERN CALIFORNIA LA
COUNTY AND I'M THE CEO OF OXFORD
HEALTH CARE AND SUPPORT THIS
PROPOSAL.
THANK YOU.
WELCOME.
TWENTY.
THANK YOU THIS IS ALL ACTON FROM
FREED CENTER FOR INDEPENDENT
LIVING SERVING ABOUT THIS YEAR
YUBA SUTTER INCLUSIVE COUNTIES.
WE WORK COLLABORATIVELY WITH
RICH ONLINE.
TO SUPPORT CHILDREN AND YOUTH
WITH SIGNIFICANT DISABILITIES
AND THEIR FAMILIES.
TO LIVE IN THE COMMUNITY WITH A
SPORTS THEY NEED AND WE.
SUPPORT.
THANK YOU.
GOOD MORNING BREAK NEBRASKA A
MAP OF THE CALIFORNIA
ASSOCIATION FELL SERVICES AT
HOME I AND SUPPORT FOR THE
REASONS PRICKLY STATE THINK.
THANK YOU.
RIGHT I WAS THIS THING CALLED
THE WITNESSES WHO CAME AND SPENT
TIME HERE TODAY.
TO TO TO GIVE TESTIMONY.
NO WILL.
FIRST OF ALL I JUST THAT
CERTAINLY IS A PEDIATRIC.
STATE CARE MANY CHILDREN SPENT.
IT'S NOT IMPORTANT
CENTERS ARE
AND CERTAINLY WHEN I DON'T HAVE
AN UNINTENDED CONSEQUENCE OF
BILLS BUT THINK WE NEED TO BE
CLEAR WITH THE CHALLENGE HERE IS
IS THE OR NOT CUTTING RATES BUT
THE RATES ARE LOW AND. WE ARE
RAISING RATES ON NOW FOR VARIOUS
VERY GOOD REASONS.
HOME SERVICES WE NEED TO THINK
WHAT IMPACT THIS IS HAVING AND
ALSO JUST THE ARE WE BUILDING
THE CAPACITY WE NEED ALSO FOR
THESE CHILDREN AS WELL I MEAN I
THINK I. HEARD FROM PEOPLE ABOUT.
NOW THERE'S NOT A GREAT MANY
JUST BECAUSE SOMETIMES A
PAYMENTS TO LOW. I WOULD ALSO
MAKING DOUGH.
THAT THE REASON WE'RE ABLE TO
HAVE THIS DISCUSSION AND THAT
WERE ABLE TO EVEN RAISE THE HOME
HOME VISITING RATES AS WELL AS
BECAUSE.
THE VOTERS AND THAT PEOPLE
CHAMPION AND.
INCREASED REVENUES AS WELL WE
JUST TALKED ABOUT PROP FIFTEEN
MURDER TALK ABOUT PROP FIFTY SIX
A LITTLE LATER ON.
AND THE WILLINGNESS TO AND
WHILE CERTAINLY HAD EXCELLENT
ECONOMIC TIMES.
KNOW SOME OF THESE REVENUES ARE
ALSO AVAILABLE TO US SENATE
BECAUSE PEOPLE.
BEEN WILLING TO STEP UP AND SAY
YOU KNOW WILL BE WILLING TO.
TO RAISE TAXES TO SO THE STATE
HAS OF THE FUNDS NECESSARY TO
PROVIDE OF.
WIDE VARIETY OF SERVICES YOU
KNOW FROM EDUCATION TO COURSE
WE'RE HERE FOR HEALTH HUMAN
SERVICES AS WELL. SO HOPING THAT.
NO WE'RE NOT GONNA HOLD THIS
ITEM OPEN WE USUALLY TELL MAY
REVISE WE GET INFORMATION MORE
AT THE INFORMATION ON.
ALSO WHAT WE'VE OF COURSE HEARD
MANY OTHER PROPOSALS BUT THAT IT
BUT CERTAINLY I THINK A. AS
CERTAINLY.
WE HEAR YOU AND.
THIS IS AN ISSUE THAT WE WE
NEED TO ADDRESS SO.
JERRY FINAL COMMENT SAYS ARE
GAINES SAID PRETTY BEING HERE
ONE TO DO. THAT YOU CHAIR PAN
FOR YOUR ACCOMMODATION IN TERMS
OF THE.
OUR AGENDA AND ALSO FOR THE
OPPORTUNITY TO HEAR THIS MESSAGE
WHICH IS SO CRITICAL OF TO.
OF THE LEAST AMONGST US THAT
MAKE SURE THAT THERE. ARE TAKING
CARE OF HIM WE CAN DO THAT ON A
BIPARTISAN BASIS THAT MAKE YOU
DEFINITELY AND AGAIN I THINK ALL
THE FAMILIES.
OKAY.
SO WE'RE GONNA TRY TO GO BACK
TO THE ORDER I SHOULD MAKE
MENTION THAT I DON'T KNOW THAT.
JUST YOUR FOR THIS ITEM FAT BUT
THIS ROOMS RATHER FULL WE DO
HAVE THE GALLERY AVAILABLE AS
WELL FOR ANYONE.
TO.
WATCH FROM THE GALLERY IN.
AS OF THIS THEIR PEOPLE OUTSIDE
WHO CAN'T FIND A SEAT WE DO HAVE
GALLERY SEATS AVAILABLE LET'S
OPEN NOW.
OKAY SO WE ARE GOING BACK TO.
ISSUE NUMBER TWO. WHICH IS.
DENTAL THAT THE CALVET OVERVIEW
SO WE HAVE.
.
AND I KNOW WE HAVE HEADS OF WHAT
WE JUST.
AND SIXTY HAVE THINK PRETTY MUCH
SAME PEOPLE ON THE TABLE EXCEPT
NOW WE HAVE. OUR DIRECTOR
JOINING US OF FEATURES Y.
INTRODUCE YOURSELF FOR THE
RECORD AND THEN WILL LAUNCH INTO
THAT ACCOUNT.
SURE GOOD MORNING I'M I'M
JENNIFER CAN I'M THE DIRECTOR
FOR THE DEPARTMENT.
THANK YOU.
I'M HERE MUCH.
BRIAN METZLER LEGISLATIVE
ANALYST'S OFFICE THANK YOU PANTS.
ADAM DORSEY BUT IT'S
OKAY THANK YOU. PRODUCT CAN'T.
IF YOU.
SURE AND NONE.
S. CLARIFIED NOW THEY WERE BACK
ON THE GENERAL TALKING TO
INCLUDE YES WE ARE ISSUE TO
DEATH TO TELL A REVIEW WE HAVE A
DETAILED WRITE UP SO IT.
THE HIGHLIGHTS TELL TELL ME HOW
MANY MORE KIDS
ADULTS CAN GET TO DEVELOP BETTER
TO TAKE CARE.
SO.
AS THE AGENDA.
SO.
NOTED THERE HAVE BEEN
SIGNIFICANT.
INCREASES AND CHANGES IN THE
DENTAL PROGRAM SINCE I.
CAME INTO THIS POSITION BACK IN
TWENTY FIFTEEN I'M THE FIRST WAS
THE RESTORATION OF THE TEN
PERCENT
I TO REDUCTION THAT WAS DONE AS
A. AS A RESULT OF THE RECESSION.
SUBSEQUENT WAIVER RENEWALS.
HAD US NEGOTIATING I'M WHAT'S
KNOWN AS THE DIGITAL
TRANSFORMATION INITIATIVE WHICH
IS SEVEN HUNDRED FIFTY MILLION
DOLLARS OVER THE FIVE YEAR LIFE
OF OUR ELEVEN FIFTEEN MEDICAID
WAIVER. FOR OF FOCUS EXCLUSIVELY
ON NON PEDIATRIC DENTAL
UTILIZATION RATES.
THE LEGISLATURE ALSO.
FULLY RESTORED THE ADULT
BENEFIT LAST YEAR AND THEN.
LASTLY THE AS AS WE WOULD BOTH
TALK ABOUT NOW AND TALK ABOUT
AND SPAM FUTURE AGENDA ITEMS IS
THE REVENUE ASSOCIATED WITH
PROPOSITION FIFTY SIX.
SO.
ON THE.
GOOD NEWS AND DUE TO A LOT OF
REALLY DILIGENT WORK ON THE ON
BEHALF OF. THE ASSOCIATIONS THE
PROVIDERS THEMSELVES THE
STAKEHOLDERS.
THE DENTAL UTILIZATION FOR
CHILDREN HAS INCREASED
APPROXIMATELY SEVEN PERCENT
SINCE
STARTED MY
IN THE BASELINE.
BACK IN TWENTY FIFTEEN AND SO
WE ARE STILL.
FINALIZING THE RUN OUT FROM THE
NUMBERS AROUND THE UTILIZATION
FOR CHILDREN
BUT OUR GOAL WAS TO GET TO FORTY
SEVEN.
.
PERCENT ON BY THE END OF THE
FIVE YEARS OF THE WAIVER WHICH
EXPIRES IN TWENTY TWENTY. AND
I'M AS WE RECENTLY.
PROVIDED AN UPDATE TO THE MEDI
CAL CHILDREN'S HEALTH ADVISORY
PANEL LAST WEEK I'M MORE SENATE
ROUGHLY FORTY FIVE PERCENT SO WE
ARE REALLY PLEASED I WHICH IS A
OVER SEVEN PERCENT INCREASE IN
UTILIZATION FOR CHILDREN.
.
VERY OBVIOUSLY.
IT'S HARD TO SAY WHICH
COMPONENT IS LEADING TO THIS
RIGHT BECAUSE AS I MENTIONED
THERE'S BEEN A LOT OF.
WORK ON BEHALF OF BOTH THE
ADMINISTRATION AND THE
LEGISLATURE TO PROVIDE FUNDS AND
SUPPORT TO THIS PROGRAM.
ADULTS IS.
SLIGHTLY.
MORE CHALLENGING.
I UTILIZATION NUMBERS STANDS AT
APPROXIMATELY TWENTY PERCENT.
AND SO WE ARE CONTINUING TO.
DO SEVERAL THINGS TO BOTH
INCREASE PROVIDER PARTICIPATION
SO WE HAVE CHANGED THE
APPLICATION ITSELF AND
DRAMATICALLY REDUCE THE SIZE
FROM APPROXIMATELY FORTY PAGES
DOWN TO ABOUT FIFTEEN.
WE ARE GOING TO BE IN ROLLING
PROVIDERS THROUGH.
OUR PROVIDER ONLINE PORTAL AND
IN FUTURE AYE RELEASES AS WE
HAVE BEEN ALSO ENROLLING OTHER
DIFFERENT TYPES OF PROVIDERS. WE
RECENTLY CHANGED OUR FISCAL
INTERMEDIARY CONTRACT AND SO WE
SPLIT IT INTO BOTH THE CLAIMS.
PAYMENT CONTRACT AS WELL AS AN
ADMINISTRATIVE SERVICE
ORGANIZATION CONTRACT AND SO THE
ON SEPARATION OF THOSE CONTRACTS
ALLOWS.
THE VENDOR FOR THE A ESTO TO BE
MORE ON EXCLUSIVELY FOCUSED ON.
MEMBER CALL CENTER OUT REACH
SUPPORT SERVICES LIKE THAT AND
SO THERE'S GOING TO BE.
SOME ADDITIONAL KIND OF CASE
MANAGEMENT AND CARE COORDINATION
ACTIVITIES THAT ARE A ESOS WILL
BE PERFORMING. ON OUR BEHALF
WHEN INDIVIDUALS COLLINS AND
HAVING DIFFICULTY FINDING AND
DENTIST.
SO JUST TO ALSO.
.
MAKE SURE THAT THE COMMITTEE
KNOWS IS THAT WE HAVE FIFTY SIX
COUNTIES IN WHICH ON DENTAL
SERVICES ARE PROVIDED ON A FEE
FOR SERVICE BASIS.
WE HAVE TO COUNTY SACRAMENTO IN
LOS ANGELES THAT.
DEL MANAGED CARE OUR PROVIDERS
EYES SACRAMENTO'S A MANDATORY
ENROLLMENT INCIDENTAL MANAGED
CARE LA AS A VOLUNTARY I THINK A
LOT OF TIMES.
WHEN PEOPLE TALK ABOUT YOU KNOW
OF DIFFICULTY FINDING A DENTIST
IN THE FEE FOR SERVICE
ENVIRONMENT WE DON'T HAVE THE
SAME MECHANISMS TO.
COMPEL PROVIDERS TO PARTICIPATE
RIGHT THEY CAN BE ENROLLED IN
OUR PROGRAM BUT THERE'S NO.
.
THERE'S NO WAY THAT WE CAN.
REQUIRE THEM TO SEE A CERTAIN
NUMBER OF PATIENTS AND SO WE ARE
CONTINUING TO TRY TO THINK OF
DIFFERENT STRATEGIES FOR HOW WE.
WORK WIH THE DENTAL COMMUNITY
TED BOTH INCREASE THE NUMBER OF
PATIENTS SEEM BUT ALSO IMPROVE.
CUT NEW YOU'VE CARE IN AND
ACCESS STERN INTERRUPT.
JUST TO CLARIFY SACRAMENTO WHO
ACTUALLY OF YOU CAN YOUR. NEED
IT'S ENOUGH YOU CAN OPT OUT
TOWARD FEE FOR SERVICE WE CAN'T
FIND SOMEONE. THAT WOULD CHANGE
THAT THERE'S A MEDICAL EXEMPTION
REQUEST SO SIMILAR TO HOW WE
HAVE IT ON.
.
THE MEDICAL MANAGED CARE IS THAT
IF YOU ARE HAVING DIFFICULTY BUT
BY AND LARGE THE DEFAULT FROM A
STATE I DEFAULT IS HERE AND
RIGHT.
THE FACT I'D AND THEN LA IS
VOLUNTARY ASPECT OKAY SIDES WHEN
YOU SET MANDATORY ONE THE CLEAR
FACTS AND WE WORKED ON.
AND CTUALLY I SUPPORTED THE
IDEA THAT THE DEFAULT AND NOT
OUT AND BUT YOU CAN'T OUT IF YOU
CAN'T FIND.
OKAY SORRY TO INTERRUPT BUT I.
AM SURE WE WERE SENDING THE
RIGHT MESSAGE AND SO I MEAN
WITHOUT I WOULD JUST SAY THAT.
WE HAVE A LOT OF WORK TO DO IN
THIS PROGRAM WE'RE VERY PROUD OF
THE PROGRESS THAT WE'VE MADE IN
WHAT I'M SHOULD BE CONSIDERED A
FAIRLY SHORT AMOUNT OF TIME AND
CERTAINLY APPRECIATE THE SUPPORT.
OF THE LEGISLATURE.
IN WORKING WITH THE
ADMINISTRATION TO PROVIDE SOME
OF THESE RESOURCES BUT ALSO JUST
KNOW THAT WERE. COMMITTED TO
CONTINUING TO AND IMPROVE THE
PROGRAM AND THEN.
.
I WILL SPEAK A LITTLE BIT MORE
SPECIFICALLY ON THE PROP FIFTY
SIX LATER IN THE GENDER I'M
HAPPY TO DO IT NOW IT'S YOUR.
BUT YOU'RE.
I THINK ON THE DENTAL.
PART BOOKS DO THAT NOW TO THINK
THESE PEOPLE WOULD TALK A FIFTY
SIX LATER ON COMEY ON THE
MEDICAL OR THE LETTER.
SO.
WHEN WE RECEIVE THE FUNDING FOR
PROPOSITION FIFTY SIX LAST YEAR
IT WAS A HUNDRED AND FORTY
MILLION DOLLARS.
AND SO WE.
IDENTIFIED MAIN CATEGORIES OF
SERVICES IN THE DENTAL PROGRAM
AND ESSENTIALLY.
PROVIDED A FORTY PERCENT.
INCREASE ACROSS THOSE MAIN
CATEGORIES SO MUM HUNDREDS OF
DENTAL CODES RECEIVES AN
INCREASE WHICH WAS DIFFERENT
THEN THE WAY WE TARGET FOR
PHYSICIANS WHICH WE CAN TALK
BUT LATER. ON WITH THE
GOVERNOR'S JANUARY BUDGET
THERE'S AN ADDITIONAL AMOUNT OF
PROPOSITION FIFTY SIX MONEY THAT
IS AVAILABLE WE HAVE BEEN.
.
MEETING WITH AND HEARING FROM
VARIOUS STAKEHOLDERS AND
ORGANIZATIONS AROUND THOUGHTS
ABOUT IMPROVING OR CHANGING OR
ADDING CERTAIN SERVICES OR CODES
ARE KEPT.
SERVICE ON TO THE DENTAL PROGRAM.
THAT WE'RE AND WORKING TO.
EITHER BETTER UNDERSTAND OR
THINK OF OPTIONS WOULD BE AROUND
SPECIAL POPULATIONS ON DENTAL
ANESTHESIA CONTINUE SUCH AND BE
A CONCERN IN TERMS OF.
HOSPITAL BASED DENTAL
ANESTHESIA PROCEDURES WE THINK
WE.
MAY HAVE SOME.
BETTER WAYS TO THINK ABOUT
DOING CARE IN THAT WAY AND I
KNOW THAT.
THE DEVIL TRANSFORMATION
INITIATIVE.
WHICH IS THE FUNDING ASSOCIATED
WITH OUR MEDICAID WAIVER IS
FOCUSED EXCLUSIVELY ON PEDIATRIC
POPULATIONS AND SO WHEN WE HAD.
PROPOSED THE PROPOSITION FIFTY
SIX PAYMENTS WE.
DID NOT INCLUDE PREVENTIVE
SERVICES BECAUSE WE WERE
CONCERNED ABOUT THE DUPLICATION
AND OVERLAP
I MEAN THE DTI. AND FIFTY SIX
AND SO I KNOW THAT THERE'S BEEN
SOME INTEREST IN TRYING TO. MAKE
SURE THAT WE COULD MAYBE TARGET
OR AND THINK OF WAYS WE COULD
TARGET ADULT PREVENTIVE SERVICES
SO THAT WE DIDN'T HAVE THAT
DUPLICATION AND SO I THINK
THAT'S CERTAINLY SOMETHING THAT
WERE OPEN TO. EITHER CONSIDERING
A BETTER UNDERSTANDING FROM
STAKEHOLDERS ON.
OKAY THANK YOU COMES FROM TOLEDO.
FINANCE.
QUESTIONS BETWEENMEMBERS. OF.
THE END THANK YOU FOR THE
PRESENTATION.
APPRECIATE THE WORK OF THE
PARCHMENTS DOING.
WE'RE GETTING OUR.
UTILIZATION RATE UP NOW I WILL
CITE.
THAT WHAT WE'RE GOING UP AND
THAT THE GOALS FORTIES THAT HE'S
A FORTY SEVEN PERCENT WAVER
AGAIN.
YET FOR THE WAIVER.
I THINK WHEN THE LITTLE HOOVER
COMMISSION CAME OUT THEY SET A
GOAL OF. OF A MUCH HIGHER GOAL
OF THE CONCERT YES YES SO THERE
WAS LEGISLATION.
BY SENATOR CANNELLA AND ADDRESS
AND SAID THAT THAT THEY THERE
WAS A GOAL.
YOU SEE GIVEN IN THAT BILL WAS
SIXTY PERCENT SIX WHERE WE HAVE.
BOTH MET RECENTLY I THINK BUILT
ONE OF THE LAST TIMES I WAS I
HERE I WAS COMING FROM A LITTLE
HOOVER COMMISSION'S.
AND WE SAID SIXTY IS ABSOLUTELY.
A GOAL WE WERE CERTAINLY FOCUS
ON THE NEAR TERM OF THE. OF THE
TERMS AND CONDITIONS OF THE
WAIVER OF FORTY SEVEN FOR
BECAUSE WE HAVE AND SENATE
FUNDING TIED TO THAT.
SEVEN HUNDRED FIFTY MILLION BUT
I'M WE CERTAINLY GIVEN THE
STRONG PROGRESS THAT WE'VE
ALREADY MADE IS I THINK THAT WE
EXCEED THE GOALS SET AND THE
WAIVER AND OBVIOUSLY WOULD BE
MOVING TOWARDS SIXTY PERCENT.
AND AND AS WE LIKE TO SAY AND
BEYOND SAGA SO SO AGAIN I THINK
I APPRECIATE THAT WE'RE MAKING
PROGRESS AND.
A GOAL THAT WE SET OUT BUT
RECOGNIZE THAT THE EVEN FORTY
SEVEN PERCENT IS STILL LESS THAN
HALF.
AND ALTHOUGH AGAIN I KNOW WE'VE
DISCUSSED IT'S NOT SO MUCH ABOUT
EXACTLY WHAT PERCENTAGE OF.
BE SURE THAT EVERY CHILD. WHO
NEEDS IT GETS IT WHEN THEY NEED
IT AND THEY DON'T NEED IT DON'T
HAVE TO GET SO SO I MEAN I KNOW
WE ARE LOOKING AT PROCESS IT'S A
VERY? BROAD. ROUGHLY OF LOOKING
AT IT.
BUT I CERTAINLY THINK.
TO THAT THE OUT THE TRIPLE A
IMPARTED PROBABLY STILL END UP
WITH THE PERCENTAGE AT HIGHER UP
SO I APPRECIATE WILLIAM CONTINUE
MOVING THAT. THE ONE THING THAT
ALSO I MADE THAT WAS IS THAT.
APPRECIATE THAT THE DEPARTMENT
HAD.
THAT A FIVE IS.
BENEFICIARIES ZERO THREE YEARS
OF AGE THAT HAD THAT ALL OF US
IN THE PRISON TWELVE MONTHS THE
SENATE NOTICED THEY GOT TWENTY
NINE PERCENT THIS CHILDREN'S UPS
COOLEY SETTLES. IS THAT
SOMETHING THAT THE DEPARTMENT'S
GOING TO DO ON A MORE ON GOING
BASIS I MEAN.
TO IT TO SOUND LIKE A HEAD OF
WRITTEN WELL BUT GOOD RESULT I
MEAN THAT TWENTY NINE PERCENT.
FOR MAILING IS A NOT BAD I MEAN
BE GREAT OF GOT EVEN MORE BUT.
WE WANT FIRST TO FIRST BIRTHDAY
WE NEEDED PEOPLE NEEDED TO CHECK
UPS.
ATKINS EAGER CHECK UPS IS THAT
SOMETHING THAT THAT THE POLICY
ABOUT DOING. AN ON GOING BASIS
GIVEN THE SUCCESS OF THE
PREVIOUS EFFORT THERE SO I THINK
WE HAVE.
KIND OF FIRMLY ESTABLISHED
PLANS TO CONTINUE OUTREACH AND
NOT SIMILAR TYPE OF STRATEGY I
THINK I'M YOU'LL HEAR US SAY
THAT.
WERE NOT CONVINCED THAT MAIL IS
THE BEST WAY TO TRY TO
COMMUNICATE WITH.
.
BENEFICIARIES ARE MEMBERS OF THE
PUBLIC JUST GIVEN.
KIND OF THE IMMEDIACY AND.
MORE.
RELEVANT.
YOU KNOW COMMUNICATIONS.
THAT WE HAVE SO I THINK WE'RE
ALSO CONSIDERING OTHER
STRATEGIES FOR HOW WE REACH.
IT POPULATIONS ARE HOW WE WORK
ACROSS.
DIFFERENT PROVIDER TYPES TO
MAKE SURE THAT FAMILIES
NO THAT SERVICES ARE AVAILABLE
IN THE FIRST STEP IS MAKING SURE
THE INDIVIDUALS KNOW THAT THERE
IS A DENTAL SERVICE AVAILABLE.
IN THE MEDICAL PROGRAM AND THEN
SECONDLY MAKING SURE THAT
COULDN'T PEOPLE ARE USING THAT
SERVICE AS IT SITS ON MADE
AVAILABLE TO THEM AND SO I THINK
YOU KNOW BOTH MAILINGS AND OTHER
TYPES OF OUTREACH IS CERTAINLY
CONTEMPLATED AND IN OUR PROGRAM.
ALRIGHT WELL I'M GLAD WE'RE
MAKING PROGRESS IN THE DENTAL
AREA.
AND CERTAINLY KNOW THAT DENTAL
CONDITIONS CAN ALSO LEAD TO
PHYSICAL HEALTH CONDITIONS AS
WELL.
AND INFORMATION MOUTH IN LEAD
TO CARDIAC DISEASE OTHERS
SO I MEAN
SENATE CAL IS NOT
SEPARATE FROM MEDI CAL THERE IS
A. THERE IS A LINK VIA EVEN
FINANCIALLY. SO WE DO HAVE IN
THIS SECTION WE HAVE TWO THREE
FOUR.
ADVOCATE PROPOSALS SO WHAT
WE'LL DO IS WE'LL HEAR THOSE AND
THEN WE'LL TAKE PUBLIC COMMENT
ON THAT OF THE CAL SECTIONS SO
WE'LL HAVE YOU. ACTUALLY DON'T
LEAD TO TABLE WAS HAVE YOU MOVE
AROUND.
WOULD LIKE TO HAVE YOUR COMMENTS
ON THE PROPOSALS. SO THE FIRST
ONE IS FROM C. TEN.
OKAY SO WE HAVE TO OF KIMBERLY
CHEN FROM PENN CAO FOUR CAN HAVE
THAT HAN ETHNIC HEALTH NETWORK
AND IT'S THE PROPOSAL FOR
COLLECTION OF DEMOCRATS. THEM.
JUST DEMOGRAPHICALLY STRATIFIED
UTILIZATION DATA O RESTORED
DENTAL BENEFITS AGAIN TRY TO
KEEP YOUR REMARKS TO THREE
MINUTES SEND.
THANKS SO MUCH FOR MISTER
CHAIRMAN FIRST KIMBERLY TEN FROM
THE CALIFORNIA PAN ETHNIC HEALTH
NETWORK MY COMMENTS WILL BE
RECENT ALL BE SPEAKING ON MANY
OF THE SUBJECTS IN THE NEXT
PANEL ON PROPOSITION FIFTY SIX.
US DEPEND AND.
IN ARE STAKEHOLDERS ARE ARE
VERY PLEASED TO SEE THE STATE
INVEST
ADDITIONAL FUNDS.
IN THE DEAD CAO PROGRAM FROM
THE RESTORATION OF ADULT
BENEFITS TO INCLUSION OF A OF A
SUPPLEMENTAL PAYMENTS THROUGH
PROPOSITION FIFTY SIX. AS
REMOVING FOR THESE PROGRAMS UMPS
EVEN STAKEHOLDERS ARE VERY MUCH
INTERESTED IN HOW THE THE
RESTORATION OF BENEFITS AND
ADDITIONAL SUPPLEMENTAL PAYMENTS
IMPACT UTILIZATION RATES
PARTICULARLY FOR THE ADULT
POPULATION THAT HASN'T HAD
ACCESS TO. MANY OF THESE
SERVICES WAR HAS ONLY PARTIAL
ACCESS TO SERVICES FOR A NUMBER
OF YEARS. AS SOON AS YOU IN OUR
MEMBERS KNOW IT'S VERY IMPORTANT
TO UNDERSTAND THE.
DEMOGRAPHIC MAKEUP OF THOSE WHO
ARE RECEIVING SERVICES THERE IF
THERE ARE ADDITIONAL CHALLENGES
THAT MAKE UP RESULT FROM
LANGUAGE SHAH REGION OTHER
BARRIERS THAT MAY EXIST AND SO
WE DO URGE. THE DEPARTMENT TO.
INSTILL.
REPORTING ON THESE MEASURES AS
WELL AS I'M TRANSPARENCY ITS
TRANSPARENCY AND ACCOUNTABILITY
MOVING FOR TO UNDERSTAND HOW
THESE PAYMENTS WILL.
AFFORD IN THE FUTURE THANK YOU.
OKAY THANK YOU.
ALRIGHT AS SOMEONE ELSE TO
SPEAK ON THIS ISSUE.
ANY COMMENTS FROM DEPARTMENT
THERE'S
MRS BELIAU.
FINANCE NOW ALRIGHT. OF SELF
THANKS SO MUCH FOR THE PROPOSAL
AND I'M SEE GETTING TO BE ABLE
TO UNDERSTAND THE PEOPLE
RECEIVING.
AND OLIVE'S THAT DEMOGRAPHIC
BACKGROUNDS GIVE YOU BRING
FORTRESSAND OVER THE ROOF
SUCCESSFUL OWNER OUT REACHED
DOWN AND AND AND TAXES THANK YOU.
OKAY SO NEXT ONE IS WE HAVE
TRANSMIT THINNED ON GILBERT FROM
THE HEALTH PLAN OF SAN MATEO TO.
PROPOSE FOR DENTAL SERVICES
MANAGE CANONIZATION PILOT IN SAN
MATEO.
SO WELCOME AGAIN AND BETWEEN ALL
THE WITNESSES WE CAN KEEP IT
WITHIN THREE MINUTES APPRECIATED.
ABSOLUTELY THANK YOU MISTER
CHAIRMAN SENATOR STONED ON
GILBERT ON BEHALF OF THE HEALTH
PLAN THE SAN MATEO.
OF PROPOSING IN COLLABORATION
WITH.
TENNIS DOWN IN THE DISTRICT
DOWN IN THAT SERVICE TERRITORY A
DENTAL PILOT PROGRAM. WHICH HAVE
RIGHT NOW HEALTH PLAN THE
CEMETERY WAS YOU KNOW IS A
COUNTY ORGANIZED HEALTH SYSTEM.
VERY EXPERIENCE IN DELIVERING
INTEGRATED COORDINATED CARE.
AND AS YOU HAVE JUST REFERENCE
MISTER CHAIR. DENTAL SERVICES
ARE ARE VERY IMPACTFUL ON HEALTH
CARE OUTCOMES WHETHER THEY BE.
NOT HAVING ENOUGH SERVICES AND
HAVING BAD OUTCOMES ARE HAVING
SUFFICIENT SERVICES AND HAVING
GOOD OUTCOMES.
SO THIS THIS PROPOSAL WOULD
INTEGRATE DENTAL SERVICES
AND TO EXISTING THE EXISTING
MANAGED CARE PROGRAM. AND WE
BELIEVE WOULD RESULT AND BETTER
ORAL HEALTH BETTER OVERALL
HEALTH AND REDUCE COSTS TO THE
HEALTHCARE SYSTEM WE UNDERSTAND
THAT IT'S VERY IMPORTANT ALSO.
OUGHT TO HAVE GOOD DATA ARISING
OUT OF THIS PROGRAM AS IT MOVES
FORWARD AND ACCOUNTABILITY AND
WE WOULD OF COURSE WORK WITH THE
DEPARTMENT ANYONE ELSE ON ON
THAT I.
YOU. ANY OTHER WITH IT.
THE OTHER TESTIMONY ON THIS
ISSUE.
A UMBRELLA COMMENDS SPENCER WITH
THE CALIFORNIA DAHLE ASSOCIATION
I'M IN SUPPORT OF THIS PROPOSAL
I'M ALONG WITH OUR LOCAL DENTAL
SOCIETIES.
ALRIGHT DOT COMMENTS FROM. THE
EXCESS ON THOSE.
AND I WOULD I WOULD JUST POINT
OUT.
SOSA HEALTH PLAN THE CEMETERY
# HAS A LONG HISTORY OF
WORKING REALLY CLOSELY AND ITS
LOCAL COMMUNITY TO INTEGRATE
SERVICES THEY WERE THE FIRST
PLANNED TO DO THE CCS.
MODEL IN TERMS OF PROVIDING
INTEGRATED SERVICES IN THE AREA
IN WHICH HAS BEEN TRADITIONALLY
CARVED OUT AND SO. TO THE EXTENT
THAT THE LEGISLATURE WANTS TO
CONSIDER.
OR GIVE MORE CONSIDERATION TO
THIS PROPOSAL WE WOULD BE HAPPY
TO TO WORK WITH THE.
.
LEGISLATURE IN TERMS OF THAT
KIND OF TECHNICAL ASPECTS OF
SUCH A THING OKAY. BELIAU ONCE
FINANCE.
SO I DID HAVE A COUPLE QUESTIONS
AND APPRECIATE THAT THAT THE
DENTAL SO THAT THE DATA SERVER
IN SUPPORT OF OF THIS AND IT WAS
COMING FISCAL.
YOU KNOW IF WE HAVE TWO AREAS
OF MANAGED CARE LA AND
SACRAMENTO.
I THINK WE'VE HAD SOME MIX
EXPERIENCES WITH THAT BUT OF
COURSE THOSE ARE STAND ALONE
THEY'RE NOT IN INTENT AND
COOPERATION WITH THE THE
EXISTING HEALTH PLAN ITS OWN
CEMETERY HEALTH PLAN HAS A YOU
KNOW GOOD.
AS A STRONG HISTORY OF OF
WORKING WITH THAT BEING TOO SURE
THEY WORK. WITH THEIR PROVIDERS
AND WITH THAT THE PATIENTS ABOUT
THE DC THIS AS BEING A I GUESS
IS THAT CORRECT NEGOTIATING A.
CAPITATION RATE WITH THE CS FOR
THE DENTAL PIECES AT ONE
CAPITATION RATE FOR ALL THE
SERVICES I AND I REALIZE THIS
MAY BE DETAILS ARE STILL BE
WORKED OUT BY MISTAKE THE OUT.
SO THIS LOOKS TO BE THE THIRD
MANAGED DENTAL MANAGED CARE
PRODUCTS OUT HOW HOW DO YOU SEE
THAT INTERFACE BETWEEN SAN MATEO
HEALTH PLAN FOR THE SEVERAL
BENEFITS INDEED CS.
MY UNDERSTANDING IS IT'S AN
ENHANCED.
.
NO RATE AT OUR RISK AT THE PLANS
RISK BUT OBVIOUSLY WE WOULD BE
QUITE DEFERENTIAL TO THE
DEPARTMENT NINE OKAY SO IT IS SO
SAFE. SO THE ENHANCED FEE FOR
SERVICE RATE ARE NO ENHANCED OF
MANAGED CARE GAS STATION GREAT
APPETITE AGAIN YES.
YES CD.
YEAH I MEAN OBVIOUSLY WE'VE
BEEN YOU KNOW DIDN'T DISCUSSING
A LOOKING AT THE EXISTING I'M
GENTLE MANAGED CARE PALM PILOT
PROJECTS IS WHEN WE THINK IS IS
DIFFERENT BECAUSE IT IS
INTEGRATED AND SO FROM OUR
PERSPECTIVE. THIS IS SOMETHING
NEW.
AND WE WERE ABLE TO.
AND I REALLY LOOKING AT.
IT'S CONTAINED IT'S TIME LIMITED
AND THEY'RE SOME OF THE.
WHICH WE THINK I'M SORT OF SHORE
UP WHY THIS WOULD BE A GOOD
START TESTING GROUND FOR THIS
IDEA.
BUT I THINK THAT THREE CYRANO WE
HAD ONE OVERSIGHT HEARING WE
HAVE SOME MORE ON HOW DO YOU SET
THESE MANAGED CARE RATES SO THAT
YOUR CAPITATION RATE IS
SUFFICIENT TO SURE THAT YOU HAVE
ACCESS AND. THEY CAN. PROBABLY
NOT AS MUCH OF AN ISSUE IN SAN
MATEO YOU KNOW ACCESS PROBLEMS
ON AN ONGOING.
SO.
SO LIKE PUT FORWARD TO THE
PROPOSAL AND THAT. AND OTHERS
TRY TECHNICAL STUFF TO WORK OUT.
AND.
AND CERTAINLY WISH WISH YOU
SUCCESS IN THAT. THANK YOU
MISTER CHAIR OKAY THANK YOU OKAY
NEXT THE PROPOSAL IS.
FROM WEST HEALTH.
TO INCREASE TENNECO
REIMBURSEMENT
SERVICES CHILDREN'S SPECIAL
NEEDS.
BECAUSE THEY CUBA PATTERN PAN IN
THE COMMITTEE FOR THE
OPPORTUNITY HERE I'M PUBLIC LAST
AND PROFESSOR. AT UNIVERSITY
PACIFIC SCHOOL OF DENTISTRY OF
HAD A FORTY YEAR CAREER MOSTLY
FOCUSED ON PROVIDING DENTAL CARE
TO PEOPLE WITH. WHAT'S TERM IN
THIS PROPOSAL SPECIAL DON'T HAVE
GURNEYS CLEAN PEOPLE'S CHRONIC
MEDICAL MENTAL BEHAVIORAL AND
OTHER KINDS OF PHYSICAL
CONDITIONS THAT MAKE IT
DIFFICULT TO GET.
DENTAL CARE. NINE THAT LONG
CAREER I START OUT OF WITH A
VERY CLINICAL FOCUS ON WORKING
IN A HOSPITAL DONE APARTMENTS
I'VE SEEN PEOPLE. DIE IN THE
HOSPITAL BECAUSE OF DENTAL
DISEASE THE DEATH CERTIFICATE
TYPICALLY SAYS SOMETHING ELSE
LIKE SEPSIS OR HEART ATTACK.
BUT I KNOW THAT MEN THESE PEOPLE
DIED BECAUSE THEY HAD DONE WHEN
FACTIONS THAT WERE.
CHRONICLE LED THE SERIOUS
DETERIORATION.
BY NOW DIRECTOR OF POLICY AND
RESEARCH CENTER AT THE DENTAL
SCHOOL WERE WORKING ON VARIOUS
STRATEGIES TO TRY TO IMPROVE
ACCESS TO DENTAL CARE FOR. OF
ALL KINDS OF PEOPLE HAVE TROUBLE
GETTING IN THE TRADITIONAL GET
OFF CARE SYSTEM I'M SENATOR
PANYU WERE VERY HELPFUL IF YOU
YEARS AGO ENOUGH. PIECE OF
LEGISLATION THAT HELPED US A AN
ACT THE TELEHEALTH CONNECTED
TEAMS
AND WE'VE SEEN USING GRANT
FUNDING PEOPLE IN RESIDENTIAL
FACILITIES WITH DISABILITIES BE
ABLE TO HAVE.
DENTAL CARE DONE IN A SYSTEM
WHERE THEY WERE COMFORTABLE AND
ALL KINDS OF THINGS CAN BE DONE
FOR SOME PEOPLE WHO HAD ALL THE
PREVIOUS TO OCCUR DONE IN THE
HOSPITAL OPERATING ROOM.
CURRENTLY IN CALIFORNIA WE HAVE
LONG WAITING LISTS FOR PEOPLE TO
GET INTO A HOSPITAL HAVE COURT
HOSPITAL DENTISTRY. MANY OF
THOSE PEOPLE HAD THEY BEEN ABLE
TO BE IN A SITUATION WHERE.
DENNIS COULD TAKE MORE TIME AND
DO THINGS MORE SLOWLY
INCREMENTALLY COULD HAVE NOT HAD
THAT NEED FOR THE HOSPITAL. SO
THIS PROPOSAL IT BY THE WAY IN
THE SUMMARY IS REFERRING TO
CHILDREN PROPOSES.
ADULTS
THIS PROPOSAL WOULD AMANDA HAD
BUT PAYMENT SYSTEM THAT
RECOGNIZES THE ADDITIONAL TIME
AND EFFORT THAT IT TAKES FOR A
DENTAL PROVIDER TO BE ABLE TO.
BOTH AT THE CHAIR AND TO BE ABLE
TO ARRANGE FOR ALL THE
COMPLICATED THINGS THAT GO INTO
GETTING POSITION BECAUSE
PETITIONS.
GOT CONSENT FIELD ARRANGE FOR
SOME COMPENSATION FOR THEIR TO
MAKE IT SO THAT DENTAL. OF
PROVIDERS WHO ARE CURRENTLY JUST
BARELY GETTING BY WORKING WITH
PEOPLE WHO DON'T HAVE ALWAYS
COMPLICATED NEEDS.
COULD REMOVE THE DISINCENTIVE TO
TAKE ON SOMEONE THAT'S GONNA
TAKE A LOT MORE TIME LET MORE
TEND TO TREAT. IT'S HARD TO
QUANTIFY THE COSTS OF THESE
THINGS BECAUSE THE A LOT OF THE
OF THE HOLOCAUST OF NEGLECT COME
UP IN OTHER ACCOUNTING BUCKETS.
AND I KNOW THE EXPENSES ARE IN
THE DEVON BUCKET BUT I KNOW THAT.
THAT. IF WE HAD A SYSTEM WHERE
WE COULD PROVIDE INCENTIVES AND
HELP THE PROVIDERS WHO WANT TO
BE ABLE TO TAKE THIS EXTRA TIME
TO BE ABLE TO DO IT. THAT
THERE'D BE TREMENDOUS COST
SAVINGS IN BOTH MEDICAL CARE AND
ALSO SOME OF THE OTHER SOCIETAL
COULD MEAN WE GET A JOB AND AND
WE.
SO MY FEELING IS THAT ALL OF THE
STUFF PLEASE.
AND THE VERY COST EFFECTIVE WAY
TO IMPROVE THE. HEALTH OF OUR
POPULATION THANK YOU.
OKAY THANK YOU.
BRANDED HIM FORTY SECONDS AND.
BUT ALSO ALSO IN SUPPORT.
WE'VE BEEN WORKING WITH THAT
PROPONENTS OF THIS MEASURE AND
I'M THE CORRESPONDING
LEGISLATION ON SOME TECHNICAL
ISSUES BUT DEATH.
INTENT
OKAY.
BROWN'S MONSTER AND HAVE A WEST
HEALTH INSTITUTE JUST IN SUPPORT
OKAY ALRIGHT NOW WE WERE
CREATING PUBLIC COMMENT I GUESS
THAT'S PART OF THAT OKAY.
COMMENTS FROM THE C. S.
NO ORINDA AND LEO FINANCE.
IT ISN'T THIS AND SO I KNOW YOUR
SORT OF IT THAT WHAT KIND OF
REIMBURSEMENT INCREASE ARE WE
TALKING ABOUT.
I'M I THINK THERE'S A
CONVERSATIONS ARE STILL ONGOING
INTO THIS CONVERSATION WITH AN
APARTMENT ABOUT A NUMBER OF
ISSUES SAYS. OF CD JUST SAID OF
BOTH TECHNICAL ABOUT IT
DESIGNATED THE POPULATION THAT
WOULD BE ELIGIBLE FOR THIS AND
AND HOW THE PAYMENTS TO BE
STRUCTURED IN WHAT THE FIVE.
YET ALL.
THINGS ARE
BEING CONSIDER BECAUSE IT'S
CRITICAL THOSE GET WORKED OUT
FOR THIS TO BE IMPLEMENTED. OKAY
SO IT'S LEFT IN IT IT IS SAM
LATE APRIL WE'RE GONNA GET A
PROPOSAL IN MAY I'M SURE.
ADMINISTRATIONS WORKING ON IT
BUT.
PRIVACY WILL NEED THOSE DETAILS.
THERE'S ALSO ALRIGHT.
OKAY.
.
FINAL ITEM IS SILVER DYNAMITE
FLUORIDE COVERAGE IN DEBT TO
TELL.
SOMETIME BRENTON SPENCER WITH
THE CALIFORNIA DENTAL
ASSOCIATION I'M HERE WITH THE
PROPOSAL I'M TO ALLOW DENNIS AND
WHO PROVIDE CARE AND AN ACCOUNT
PROGRAM TO BE REIMBURSED WHEN.
THEY ARE USING SILVER DIAMINE
FLUORIDE AS A CARRIES ARRESTING
AGENT AND THIS REIMBURSEMENT
WOULD BE ALLOWED WHEN YOU.
IT WOULD ITS USE WITH AN
IMPROVED INFORMED CONSENT AND
THAT'S PART OF A COMPREHENSIVE
TREATMENT PLAN. STF IS A TOPICAL
LIQUID MEDICATION THAT CAN
ACTUALLY SLOW OR STOP THE
DEVELOPMENT OF KERRY'S SORT OF
SILVER AND HAS FLUORIDE.
SO IT'S IN A BACTERIAL AND AND
STRENGTHENS TOOTH ENAMEL INSERTS
ESPECIALLY USEFUL FOR YOUNG
CHILDREN.
VULNERABLE POPULATIONS AND CAN
REALLY AND JUST STABILIZE A
TOOTH AND STOP THE PROGRESSION
WHICH IS SERVE NEW AND VERY
EXCITING I'M IT WAS APPROVED BY
THE FDA AND TWENTY FOURTEEN AND
IS GROWING SERVE IN ITS USAGE.
SO WE JUST WANT TO MAKE SURE.
THAT.
THAT IT'S AVAILABLE FOR DENNIS
WERE PRACTICING IN THAT ACCOUNT
BECAUSE IT IS I AM SUCH A NEW
INSERTED EXCITING TO ALL.
OKAY THANK YOU.
ALRIGHT.
COMES FROM THE EXCESS.
I WOULD JUST NOTE THAT THIS.
.
PRODUCT IN APPLICATION IS BEING
I'M PILOTED IN THE DIM
TRANSFORMATION INITIATIVE SO WE
HAVE SOME LIMITED.
BOTH USE AN EXPOSURE I'M SO I
THINK WE ARE I AM INTERESTED IN
KIND OF THE RESULTS OF OF THAT
THE DTI REQUIRES AN EVALUATION
WE WOULD WANT TO.
KIND OF LOOK AT AND OBVIOUSLY
WE'RE WILLING TO WORK WITH THAT
PROVIDERS AND AND OTHERS AND I
KNOW THAT.
DR KUMAR WHO'S THE STATE ORAL
HEALTH DIRECTORS ALSO BEEN IN
CONVERSATIONS IS TO KIND OF
BETTER UNDERSTAND OUTREACH
APPROPRIATE POPULATIONS FOR USE
AND THINGS LIKE THAT.
ALRIGHT O. ELLIOTT VINCE FINANCE.
pTHREE SO. IT IN THE DTI IS
YOU'RE USING AT.
WHAT DO YOU SAY CENTERS
EVALUATION ARE OF LITTLE TINY TV
ALL THE TIME?
SO.
TI HOW WEIRD WHEN THEY EXPECT TO
HAVE SOME EVALUATION RESULTS AND
SO FORTH BACK SO THAT WE FOR
ITSELF EXPIRES DECEMBER THIRTY
FIRST OF TWENTY TWENTY. AND THE
EVALUATION BACK TO THE FEDERAL
GOVERNMENT I BELIEVE IS A YEAR
AFTER THAT SO.
WE WOULD BE LOOKING AT THE
WHOLE ENTIRE FIVE YEARS.
THESE.
SERVICES ARE BEING PROVIDED
THROUGH THE LOCAL DENTAL PILOT
PROJECTS AND SO WE WOULD BE
WORKING WITH THEM THEIR REQUIRED
AS PART OF THE CONTRACTS TO BE
PROVIDING SOME OF THE DATA. SO I
THINK ON THE EVALUATION WOULD BE
LOOKING AT.
WHAT IT'D DO?
IN WHICH POPULATIONS AND HOW
DID IT HELP OR IF THEY'RE IN THE
ANY ISSUES OF CONCERNS RAISED SO
I THINK WE WOULD BE PROBABLY
MAKING THAT EVALUATION. BOTH.
.
SHE SHARED WITH OUR INTERNAL
STATE.
STAKEHOLDERS AND BEFORE WE SEND
IT OFF TO THE FEDERAL GOVERNMENT
I THINK IT'S USUALLY ABOUT A
YEAR AFTER THE WAIVER CLOSES.
SO I GUESS.
WHAT I?
SO OBVIOUSLY FOR THE WHOLE THE
TI YEAH I GET THAT TIMELINE AYE
IT TAKES WITH THIS SPECIFIC ONE
FIRST OF ALL OBVIOUSLY WE'RE NOT
THE ONLY ONE DOING RESEARCH.
AS FAR AS I UNDERSTAND AND SO
I'VE BEEN I KNOW LITTLE BIT
ABOUT THE ISSUE BECAUSE I'M
GOING TO.
THE PIECE OF LEGISLATION ABOUT
IT.
.
AND I HOPE THAT.
CERTAINLY UNDERSTAND ABOUT
GETTING EVALUATION THAT MAYBE WE
CAN AT LEAST ON THE SPECIFIC
ISSUE OF THEIR SOME MORE
PRELIMINARY DATA. AFFECT ONE
THINGS I BLADES GO AHEAD NASCO
CDA I MEAN. THAT MAKES US LOOK
AT SOME OF IT. DC THERE'S
ACTUALLY OPPORTUNITIES FOR COST
SAVINGS FOR
SERVE US OVERTIME I
AS PART OF REGULAR DENTAL
PRACTICE.
YEAH I INTENDED TO CAL.
I THINK THERE IS SOME I MEAN
THE.
STIFF IS NOT ALWAYS A FINAL
TREATMENT SOMETIMES IT'S REALLY
JUST TO STABILIZE A TWO.
TO AND WHERE YOU WOULD SEE
THOSE COST SAVINGS AS IF YOU
HAVE LIKE A VERY YOUNG CHILD TO.
WOULD NEED ANESTHESIA.
TO RECEIVE A FAILING BECAUSE A
THREE YEAR OLDS JUST TALKING
HOPING TO SIT THERE AND HOLD
THEIR MOUTH OPEN AND SO IF YOU
CAN USE AM STF AS AN ALTERNATIVE.
UNTIL THEY ARE OLD ENOUGH TO
RECEIVE THE TREATMENT THAT THEY
WOULD NEED OR INTEL SAY THE TWO
FALLS OUT I'M YOU MIGHT SEE AT.
ACOSTA EVENINGS BECAUSE YOU
WOULDN'T WAY THIS FURTHER
TREATMENT.
AND YOU KNOW I THINK THE SAME
HOLDS TRUE FOR THE DD POPULATION
AND THOSE WHO NEED ANASTASIA I'M
TO RECEIVE TREATMENT. IT WOULD
NOT ALWAYS BE.
ACROSS SAVINGS BECAUSE YOU
MIGHT HAVE INSTANCES WHERE YOU
WOULD TO THE FILLING OR WHATEVER THE
FURTHER TREATMENT WAS BUT IT'S
REALLY AND. FRANKLY IT'S
OFTENTIMES A MORE HUMANE WAY OF
TREATING.
POPULATIONS WHO CAN'T RECEIVE
REGULAR TREATMENT.
BUT I THINK YOU ITEM INTO IT YOU
KNOW ANECDOTALLY I WOULD SAY IS
IS THAT.
TAKING CARE OF CHILDREN WHO
HAVE SPECIAL NEEDS MANY OF WHO
ACTUALLY.
FACULTY GETTING DENTAL CARE
EXCEPT UNDER SEDATION.
THAT THE CHALLENGES THAT I
THINK ONE OF THINGS I AM NOT
THINKING THE OPTIMIZER COST
SAVINGS IS BEING ABLE TO
ACTUALLY JUST HALT THE
PROGRESSION.
THE DENTAL CARIES.
BECAUSE USUALLY WHAT HAPPENS IS
THAT WE SEE THEM WE KNOW THEY
HAVE DENTAL CARIES
WE CAN GET THEM EN.
AND TODAY'S FOR YEARS AND IT'S
GETTING WORSE AND SO BY THE TIME
YOU ACTUALLY FINALLY GET THE MEN
THAT LEVEL OF WORK THAT NEEDS TO
BE DONE.
THE AND THE PRICE OF THAT IS
MUCH MORE IF WE COULD WAVE OF
HALTED AT THE TIME WE GOT TO
FIGHT IT.
EVEN AND I I MEAN WE STILL NEED
TO SIXTY ACCESS FROM SO SHOULD
TAKE YEARS FROM THE GET EN BUT
WERE ABLE TO HOLD.
AND.
SO BY THE TIME THE SURGICAL
WORK IS DONE THE LEVEL SURGICAL
WORK THAT NEEDS TO BE DONE AS
MUCH LASSEN THAT'S GOING TO BE A
COST SAVINGS VERSUS WHAT WOULD
HAPPEN IF WE WEREN'T ABLE I MEAN
WE KNOW THE PROBLEMS THERE WE
SEE IT WE SEE IT IN THE. OFFICE
AND TO HAVE BE ABLE TO GET
ACCESS TO A TREATMENT TO HALT
THE PROGRESSION.
I THINK IS PERSON WOULD
CERTAINLY SOMETHING WE SHOULD
LOOK AT THE.
ESSENTIAL COST SAVINGS OF THAT
BECAUSE I MEAN THESE ARE NOT
CHEAP PROCEDURES BY TIME YOU
HAVE TO BRING HIM INTO THE O. R.
R. SEDATION AND AND AND DO THAT-KIND OF WORK THAT THAT'S THE.
BEST EXPENSIVE AND THE DENTAL
CARE.
SO IF WE CAN AVOID THAT I THINK.
THAT WOULD BE SOMETHING THAT WE
SHOULD BE DEFINITELY. BOOK IT IS
OBVIOUSLY FROM A HUMANITY POINT
OF VIEW AS WELL I MEAN THAT.
THIS BUDGET COMMITTEE WE TALK A
LOT OF MONEY BUT OBVIOUSLY THE
SUFFERING THAT WERE AVOIDING BUT
ALSO I THINK THE COST REPORTING
AS WELL SO I HOPE WE CAN. LOOK
AT LOOK AT THIS AND NOT WAIT
UNTIL THE END OF THE DTI.
TO DO THIS FOR.
ANY OTHER QUESTIONS RIGHT SO
LET'S GO AHEAD AND TAKE. PUBLIC
COMMENTS ON
THE CAL OVERALL IN.
OR.
GUY PROPOSALS ARE NOT WELCOME.
IT AFTERNOON MEMBER CHAIR LINDA
WAY WITH WESTERN CENTER ON LAW
AND POVERTY WHILE WE APPRECIATE
THE DEPARTMENT'S EFFORT TO
RESTORE FULLY RESTORED ALL
DENTAL AS WELL AS THE DENTAL
TRANSFORMATION INITIATIVE.
ACCESS REMAINS TO BE A CONCERN
AS SEEN FROM THE RECENT ARE
PROVIDED DATA THAT SHOW THAT THE
NUMBER OF DENNY CALPERS FIGHTERS
ACTUALLY DECLINE FROM TWO
THOUSAND TWELVE TO TWO THOUSAND
SIXTEEN. A TIME WHEN YOU'D
EXPECTED TO ACTUALLY GO OUT IN
ADDITION WE'D LIKE TO SEE A
FOCUS ON PREVENTIVE CARE NOT
JUST UP FORWARD. BOARD ALL IT'S
NOT JUST FOR CHILDREN DO THAT
DENTAL TRANSFORMATION INITIATIVE.
AS I'VE TWO OF THE TOP TEN
SERVICES UTILIZE. UP FOR ADULTS
WERE.
EXTRACTIONS AND THAT'S JUST
APPALLING BUT IN ADDITION WE
SUPPORT SEE PANS DATA REQUEST AS
WELL AS WHAT'S HEALTH.
REQUEST ON AYE SOCIAL NEEDS IS
AS WE'VE HEARD ACCESS ISSUES
THERE IN REGARDS TO THE DENTAL
SERVICES MAN MANAGED CARE
IMMIGRATION PROP. PILOT WE DON'T
HAVE AN OFFICIAL POSITION IS
THIS IS THE FIRST WE'VE HEARD OF
IT I'M RECOGNIZING THAT IT'S
DIFFERENT FROM SACRAMENTO AND
LOS ANGELES WE WOULD NOT WANT TO
SEE SOME OF THE SAME PROBLEMS
THAT. HAVE HAPPENED THERE ON AS
WELL AS I LOOK AT UTILIZATION AS
WE'VE CERTAINLY SEEN THE
UTILIZATION RATES IN MANAGED
CARE. IS MUCH LOWER THAN IN FEE
FOR SERVICE
THANK YOU.
WELCOME.
MARY VALDEZ OF HEALTH ACTS OF
CALIFORNIA AND WE WANT TO
SUPPORT.
OF THE ADVOCATE PROPOSALS WE
WANT TO MAKE SURE WE SUPPORT THE
DEMOCRATIC DEMOGRAPHICALLY
STRATIFIED UTILIZATION DATA ON
THE RESTORED BENEFIT.
HEALTHAXIS SUPPORTED BOTH THE
RESTORATION OF THE ADULT DENTAL
BENEFIT AND WE THINK THE
ADMINISTRATION FOR MAKING THE
BENEFIT AVAILABLE ON JANUARY
FIRST TWENTY EIGHTEEN WHILE THE
FEDERAL APPROVAL PROCESS WAS
COMPLETED. AND WE ALSO ASK THAT
THE ADDITIONAL TWENTY FOUR
MILLION AND SUPPLEMENTAL
REIMBURSEMENTS OF DENTAL
PROVIDERS.
A TWENTY EIGHTEEN NINETEEN
INCLUDE PREVENTIVE AND
PERIODONTAL TREATMENTS TO
IMPROVE DENTAL CARE FOR MEDICARE
BENEFICIARIES.
WE ALSO ENCOURAGE THE
DEPARTMENT.
TO WORK WITH CONSUMER ADVOCATES
ON THE ALLOCATION OF THESE FUNDS.
BUT WE DO REMAIN CONCERNED THAT
UTILIZATION AMONG CHILDREN
CONTINUES TO BE LOW WITH LESS
THAN HALF OF KIDS GETTING
PREVENTIVE CARE AND VERY LITTLE
CHANGE IN THE NUMBER OF DENTAL
PROVIDERS AS OUR COLLEAGUES AS
WESTERN CENTER MENTIONED. THE
LEGISLATURE SHOULD CONTINUE TO
MONITOR PROVIDER PARTICIPATION
AND DONALD UTILIZATION IN THE
DATA CAL PROGRAM AND SPECIALLY
IN LIGHT OF THE RESTORATION OF
THE FULL BENEFIT. AND.
SUPPLEMENTAL AT OUR INVESTMENTS
IN THE PROGRAM THANK YOU.
THANK YOU.
OKAY CALIFORNIA DISABILITY
RIGHTS THAT'S NICE THAT THERE
ARE YOU SAYING ALL THIS NOW WHEN
YOU GO OUT INTO THE REAL WORLD.
I HAVE SOMEBODY WHO LOST THEIR
PLATE.
DEPT DEPT TO TWO MISSING TEETH
UP HERE. AND BECAUSE OF THAT
THEY LOST THEIR PLATE DAY THAT'S
GONNA SKINNER HELD FOR THEM TO
GET THE NEXT ONE. I'VE A FRIEND
OF MINE WHO'S TAKING PAINKILLER
AFTER PAINKILLER AFTER PAIN
KILLER.
BECAUSE HE'S AFRAID IF YOU GO TO
THE DENTIST TO GET ONE TOOTH
FIXED THERE WANT TO FIX THEM ALL
AND HE CAN'T AFFORD THAT. WE ARE
FRIENDS OF OURS WHO HAVE BOB WHO
ARE HOMELESS THAT CAN GET DENTAL
KILL SERVICES AT ALL BECAUSE
THEY DON'T KNOW WHERE THE RIGHT
PLACES TO WHERE TO GO. YOU GUYS
ARE TALKING ABOUT MONEY HERE
WE'RE TALKING ABOUT PEOPLE HERE
AND ANYTHING THAT YOU GUYS CAN
DO TO IMPROVE ADULT DENTAL AND
I'M SORRY TO HEAR THAT GIVE ME
LASSEN DENTAL POKES.
TO DO THIS SERVICE THAT'S THAT'S
NOT GOOD NEWS EITHER SO IT SEEMS
LIKE AN EXASPERATED THE PROBLEM
AND JUST ONE MORE STORY MY.
MOM'S LIFE MY PARTNER'S MOTHER
IN LAW HAD TO GO TO THE.
HOSPITAL BECAUSE HE HAD A HEART
ATTACK BUT IT COULD OPERATE
HONOR BECAUSE THEY HAD TO GET
HER TEETH FIXED.
AND WITHOUT GETTING SO SHE
WOULDN'T DIE IN THE SURGERY.
THAT.
IT'S THE REAL WORLD AGAIN A CAL.
THANK YOU.
BRENT SPENCE RA BEHALF FOR THE
WEALTHY WEST HEALTH INSTITUTE IT
INTO OUR RIPPLES OBSCENE SUPPORT
WE SUPPORT CITIES PROPOSAL TO
THAT INCREASE COVERAGE OR SO BUT
I MEAN FLORA AND. THANK YOU
THANK YOU.
WELCOME.
HI LONG TIME NO SEE. UM JUST
WANTED TO. TAKE THIS OPPORTUNITY
TO PROVIDE SOME GENERAL COMMENTS
ON THE DAILY CAL PROGRAM.
SHE SHOULDN'T STILL INTRODUCE
YOURSELF FOR THE RECORD.
SPENCER WITH THE CALIFORNIA
DENTAL ASSOCIATION.
JUST ONE I.
ECHO AND APPRECIATES IN THE
COMMENTS OF DIRECTOR KEN TO THAT
THERE'S BEEN A LOT OF WORK IN
THE PROGRAM AND A LOT OF
IMPROVEMENT ALTHOUGH WE DO KNOW
THAT THERE ARE STILL CHALLENGES.
AS YOUJUST HEARD SOME OF
THERE'S A LOT OF WORK THAT STILL
NEEDS TO BE DONE I'M CDA REALLY
APPRECIATES THE COLLABORATIVE
RELATIONSHIP THAT WE HAD WITH
THE DEPARTMENT OVER THE LAST
COUPLE OF YEARS.
AND WE REALLY APPRECIATE THE
WORK THAT THEY'VE DONE ON THE
PROVIDER ENROLLMENT FORM THAT
HAS REALLY STREAMLINE THINGS AND
WE LOOK FORWARD TO THAT GOING
ONLINE AND ONE OF THE.
NEXT ROLLOUTS OF THE PAVE
SYSTEM AND I GUESS THE LAST
PIECE I JUST LEAVE YOU WITH IS
WHILE WE'VE MADE SOME
IMPROVEMENTS DONE A CAL HAS BEEN
A. FROM CHALLENGING AND VERY
UNDERFUNDED PROGRAM FOR I WOULD
SAY A DECADE OR MORE AND WHILE
WE HAVE YOU KNOW SERVE WE'RE
SEEING SOME IMPROVEMENT AND
WE'RE SEEING THE LIGHT I'M AT
THE END OF THE TUNNEL. THEIR IAN
WE NEED THAT MAINTAIN THE
STABILITY IN THE CONSISTENCY OF
THIS COMMITMENT.
BEFORE WE'RE REALLY GONNA SEE
OVERT REVERSAL OF THAT BECAUSE
THERE ARE A LOT OF PATIENTS WHO
HAVE. A BACKLOG OF NEED BECAUSE
OF THE CUTS TO THE ADULT DENTAL
BENEFITS THERE ARE I WOULD SAY
PUBLIC GENERATIONS OF DENNIS WHO
COMING OUT OF DENTAL SCHOOL DID
NOT SEE DONE TO CAL IS A VIABLE.
BUSINESS OPTION AND WE ARE CITY
AIR DOING EVERYTHING WE CAN TO
EDUCATE.
OUR MEMBERS AND TO GET THEM TO
TAKE ANOTHER LOOK AT THIS
PROGRAM BECAUSE OF THESE
INVESTMENTS I'M BUT THAT MAY
TAKE TIME SO JUST WOULD LEAVE
YOU WITH THAT THOUGHT THANK YOU.
THANK YOU I APPRECIATE THAT ANY
OTHER QUESTIONS.
SO I DID HAVE I JUST TO FOLLOW
UP ON SOME OF THE COMMENTS THAT
WERE MADE SO WHEN THIS ISSUE
ABOUT.
TREES
PARTICIPATION OF THE NUMBER OF
DESK TO SPAIN DATA CAL DID DID
ANY COMMENTS ABOUT LIKE GO WILL.
LIE NO THAT WE HAVE SPENT.
A LOT OF TIME.
ADMINISTRATIVELY WORKING ON OUR
PROVIDER MASTER FILE IN TERMS OF
BUILDING A RENDERING PROVIDERS
AND SO THERE WAS A SIGNIFICANT
DROP. I'M ON WE KIND OF FINISH
THAT CLOSE OUT AND CLEAN UP OF
PROVIDERS THAT HAD NOT BUILD THE
PROGRAM FOR A HISTORICALLY LONG
PERIOD TIME AND SO.
AGAIN I'M AND I'M HAPPY TO
PROVIDE IT TO THE COMMITTEE AND
OUR.
PRESENTATION TO THE MEDICAL
CHILDREN'S HEALTH ADVISORY PANEL
LAST WEEK.
WE REPORTED THAT THERE WAS AN
INCREASE A SLIGHT INCREASE OF
PROVIDERS AND ROLLED ON FORTY TO
FORTY FIVE OVER A PERIOD OF TIME
A CAMERA WITH THE MEASUREMENT
YEAR WAS BUT. I THINK WE ARE
SEEN SLOW PROGRESS BUT I WOULD
ACKNOWLEDGE THE COMMENTS OF THE
CDA IS THAT SOMETIMES ON SOME OF
THESE. I'M INTERVENTIONS JUST
TAKE LONGER TO BE AFFECTION
WADED OUT INTO THE.
PROVIDER OFFICE AND SO THAT'S
KIND OF WHAT WE'RE CONTINUE TO
DOING IS A LOT OF IMPROVEMENTS
STILL NEED TIME TO BOTH
DEVELOPMENT AND BE INGRAINED
INTO THE OVERALL CULTURE OF THAT
PRACTICE OKAY SO. IT SOUNDS LIKE
THERE IS A CLEAN UP OF THE FILE
TO THAT MIGHT HAVE FLIPPED OVER
AND.
DID COME OUT OF THE.
WHO LOW WHO REPORT TO IS THAT
NOW THE CULTURE EVER ATTEND TO
CAL AT LEAST WHEN THEY CAME OF
THE REPORT BEFORE WHICH?
AS SOMEWHAT HOSTILE DAY I SHOULD
TALK TO HOSTILITY IN TERMS OF
LOOKING AT PROVIDERS AS PEOPLE
WERE JUST TRYING TO.
TO ACTUALLY TAKE ADVANTAGE OF
THE DATA CAL PROGRAM AND MILK AS
MUCH MONEY OUT OF IT AND THEN ME
NOT YET THE SOURCE STAND OFF
BACK AND FORTH. ACTUALLY NAM
APPRECIATE YEARS HERE I SEE OR
HEAR ALSO SO.
MADE ON THIS ISSUE.
SO BUT WHO'S WHO'S CURRENTLY
THE LEADER OF SIDE TEND TO CAO
AND HE'D JUST MAYBE SPEAK A
LITTLE BIT ABOUT WHAT EFFORTS
ARE BEING MADE AND THAT MONTH
AND THE DEATH CAO THE VISION TO
TRY TO CHANGE THAT CULTURE THAT
WAS SPOKEN OF THAT THAT. IN IN
THE LIVE HOOVER REPORT. SURE SO
WE.
SOBRE NAME ALTHOUGH IS THE
DEPUTY DIRECTOR OVER BENEFITS
ELIGIBILITY IN THE DENTAL
PROGRAM.
THAT DENTAL DIVISION CHIEF AS A
WOMAN BY THE NAME OF THE LANI
JACKSON.
SO SHE'S BEEN WITH THE
DEPARTMENT FOR A FIVE BEEN THERE
ABOUT THREE AND HALF YEARS SHE'S
PART IN THERE FOR ABOUT TWO AND
A HALF ALMOST THREE YEARS.
WE IN ADDITION TO MAKING A LOT
OF THE OTHER ADMINISTRATIVE
CHANGES AND MAKING THE
MANAGEMENT CHANGE AND WEAR IT
WHEN WE CHOSE MISS JACKSON.
WE HAVE RELOCATED THAT OFFICES
AND THEY USED TO BE LOCATED OUT
IN RANCHO CORDOVA AND WE
RELOCATED. TO OUR OFFICE HERE IN
THE EAST AND COMPLEX I'M ON THE
SAME FLOOR AS MY OFFICE I'M SO
WE HAVE.
TRIED TO.
REALLY.
BOTH BRUCE THE PROGRAM UP IN
TERMS OF THE RESOURCES THAT
WE'VE TALKED ABOUT TODAY BUT
ALSO FROM A. MANAGEMENT AND
INTERNAL CAPACITY BUILDING AND
STRENGTHENING THAT HAS BEEN.
A LOT OF WORK THAT WE'VE DONE
INSIDE THE DEPARTMENT SAYS
STRENGTH IN THE PROGRAM BOTH
FROM A.
PERSPECTIVE AS WELL AS.
IMPROVING RELATIONSHIPS WITH
I'M PROVIDER COMMUNITIES OKAY I
THINK THAT'S AN IMPORTANT
ELEMENT APPRECIATE YOU. BRING
AND THE LEADERSHIP. TO DO THAT
AND.
BECAUSE KEEPING THE MEDICAL
SIDE AND I GUESS LOSING FOUR.
VERY WARM AND COZY AND ARE.
OKAY ALRIGHT EXCELLENT. OKAY
WELL THANK YOU SO MUCH FOR YOUR
PRESENTATION AND THEN TO KYLE.
.
ACTUALLY I'M GOOD AT IT SO I'M
GOING TO TAKE A FIVE MINUTE
STRETCH BREAK IS IT'S WHAT
THIRTY SEVEN AND THEN WE WILL.
THEN MOVE ON TO ACTUALLY ISSUE
NUMBER FOUR.
IN PERSON.
AND
THE SIX
THROUGH RESEARCH TOUCHING ON
THAT AND THEN WE'LL GO BACK TO
DO ISSUE NUMBER THREE
STOPS ALL BENEFITS. THANK YOU
FOR WHAT I GOT TO ISSUE NUMBER
FOUR AND WE WILL BE DOING ISSUE
NUMBER THREE AFTER THAT SO
THOUGH FORGET.
YOU SHOULD
THREE SO THIS IS.
MEDIC CAO PROVIDER
REIMBURSEMENT RATES ACCESS CARE
FROM.
SIX.
SO WE CAN HAVE.
FOLKS
FOR THAT.
PANELS.
TURNING.
THIS.
SO I SHOULDN'T BE DIMINISH
PATIENTS.
AND.
THE PRESENT.
BUT WE DIDN.
OKAY.
ALRIGHT I WANNA BE SURE FINANCES
AND CHOKE ON. IT.
BUT ALL THAT'S OKAY.
WE BOTH ACT BUDDY AS A PHYSICIAN
I HAVE TO YOU KNOW I'VE TO THE
SHERMAN.
I WOULD LOOK REALLY BAD IF
ANYONE GOT SICKER.
YOU LOVE IT OR HATE YEAH WE DO
HAVE A LOT OF FEE I LOVE HELPERS
HERE TO.
THAT MAY NOT BE A GOOD THING IN
YOUR OPINION.
THURMOND CROWDING AROUND.
OKAY.
SO ISSUE NUMBER FOUR I AM.
SO WELL THAT'S.
PHYSICALLY I'M BETTER PROVIDER
REIMBURSEMENT RATE ACCESS TO
CARE PROP FIFTY SIX SO. ITEMS
THAT WILL HAVE THE INITIAL.
PRESENTATION THAT WE DO HAVE A
PENALTY TO ALSO ADDRESS SOME OF
THE ISSUES.
SO WITH THAT ACTUALLY LETS GOOD
ROUND ROBIN AGAIN OF
INTRODUCTIONS IN THE WALL.
DIRECTOR UP SO I CAN IMAGINE FOR
KENT DIRECTOR FOR THE DEPARTMENT
OF HEALTH CARE SERVICES.
BRENDA HENSON WITH THE LA TWO.
BRIAN METZLER WITH YELLOW.
OUTDOORSY BUT IT'S OKAY
EXCELLENT.
YES BETO.
THE I WILL SAY THAT.
THERE'S.
ALWAYS GOOD NEWS AND THEN.
CHALLENGING NEWS WHEN IT COMES
TO THE IMPLEMENTATION OF CERTAIN
SUPPLEMENTAL PAYMENTS AND SO
FROM A GOOD NEWS.
STANDPOINT
THE LEGISLATURE ADMINISTRATION
AND I DEDICATED TO WHAT WE WOULD
CONSIDER TO BE A SIGNIFICANT.
AMOUNT OF RESOURCES.
INTO THE MEDICAL PROGRAM LAST
YEAR.
IN A FEW KEY BUCKETS I'M SO
THREE HUNDRED AND TWENTY FIVE
MILLION FOR PHYSICIANS SERVICES
HUNDRED AND FORTY MILLION FOR
DENTAL.
AND DIDN'T GET MY NUMBERS WRONG
ON THE H. I. V..
WEAVER AGENCIES ICF DD'S.
AND THEN FIFTY MILLION DOLLARS
FOR A WOMEN'S HEALTH SERVICES.
FROM I WOULD SAY THAT THOSE ARE
ALWAYS THOSE WHO THE GOOD NEWS
ITEMS ON THE MORE COMPLICATING
OR CHALLENGING OPPORTUNITIES ARE
THAT THESE ARE ONE YEAR
SUPPLEMENTAL PAYMENTS THAT W
HAVE TO SEEK. AND OBTAIN FEDERAL
APPROVAL FOR SO THERE'S ALWAYS
KIND OF AN ADMINISTRATIVE AND.
LENGTH OF TIME IN WHICH WE ARE
PREPARING A STATE PLAN
AMENDMENTS OR IN THE CASES OF
THE FUNDS THAT HAVE TO FLOW
THROUGH THE MANAGED CARE PLANS
WE HAD TO GET APPROVAL FROM THE
FEDERAL GOVERNMENT.
FOR THE DIRECTED PAYMENTS SO
THERE WAS A.
DELAY IN THAT AND THEN.
IN ORDER TO GET THE MONEY OUT
THE DOOR WE HAVE TECHNICAL
PROGRAMMING AND CHANGES THAT WE
HAVE TO MAKE INTO OUR CLINIC
CLAIMS SYSTEM.
SO I WILL JUST SAY THAT DOES
HAVE ALL PRESENTED.
VARIOUS BUMPS IN THE WAY FOR
DIFFERENT AND PIECES OF THIS BUT
I THINK THAT ON THE GOOD NEWS IS
IS THAT WE ARE.
BOTH WORKING REALLY CLOSELY
WITH A DIFFERENT PROVIDER GROUPS
THAT ARE RECEIVING THE FUNDING
AND THAT WERE ALSO I'M TALKING
I'M WITH THE BOTH THE PROVIDER
ASSOCIATIONS AS WELL AS OUTSIDE
STAKEHOLDERS AND OTHERS AROUND
THE NEW MONEY THAT HAS BEEN
IDENTIFIED IN THE GOVERNOR'S.
AND BUDGET
SO I'M FOR THE PHYSICIAN
SERVICES.
AS WAS NOTED IN THE GOVERNOR'S
BUDGET WE DID NOT ANTICIPATE
USING THE FULL THREE HUNDRED
TWENTY FIVE MILLION.
AND THAT'S PROBABLY IN SOME
PART DUE TO THE LAGAN PAYMENTS
THE FACT THAT WE'RE ON A CASH
BASIS AND NOT AN ACCRUAL BASIS.
BUT I THINK ALSO ON THE TEN OR
SO CODES THAT WE IDENTIFIED ON
AN ATTACHED SPECIFIC DOLLAR
AMOUNTS TO SO WE CHOSE
PHYSICIANS CPT CODES. THAT ARE.
BROUGHT IN NATURE IN TERMS OF
THEY REPRESENT STANDARD EXAM
CODES AND YOU'RE. SHAKING YOUR
HEAD BECAUSE THOSE ARE PROBABLY
SOME OF YOUR FAVORITE BILLING
CODES JUST STANDARD
COMPREHENSIVE EXAM NEW PATIENTS
ESTABLISHED PATIENT.
AND WE ATTACHED I'M
SUPPLEMENTAL PAYMENTS ON TO
THOSE TEN YOU KNOW FIFTEEN
TWENTY DOLLARS WE ALSO
SPECIFICALLY CHOSE ON CODES
RELATED TO PSYCHIATRY AND THAT
WE FELT THAT THIS WAS REALLY A
CRITICAL AREA OF OUR PROGRAM
THAT COULD USE. ADDITIONAL.
BUT THE TENSION AND ENHANCE
RESOURCES IN AN EFFORT TO TRY TO
INCREASE THE.
BOTH AVAILABILITY AND
PARTICIPATION OF PSYCHIATRISTS
IN THE PROGRAM.
THE DIRECTED PAYMENTS FOR THOSE
PHYSICIANS SUPPLEMENTAL ON
PAYMENTS* AND GOING OUT TO
THE HEALTH PLANS THIS MONTH SOME
PLANS HAVE CHOSEN TO.
FRONT THE MONEY AND PAY THE
SUPPLEMENTAL PAYMENTS ON EARLIER
THAN WHEN WE FLOOD THE MONEY TO
THEM BUT ALL PAYMENTS UNDER THE
SPECIFIC CODES ARE RETROACTIVE
BACK TO JULY ONE OF LAST YEAR'S
SO. IF YOU WERE.
SERVING PATIENTS USING THESE
CODES BUT OF SUPPLEMENTAL
PAYMENTS WILL FLOW BACK.
FOR DENTISTS AND AS A
ACKNOWLEDGED EARLIER WE PUT WE
USE A DIFFERENT STRATEGY FOR HOW-WE WERE GOING TO PROVIDE
SUPPLEMENTAL PAYMENTS AND THAT.
I'M PARTICULAR AREA AND THAT WE
DID A FORTY PERCENT RATE
INCREASE ACROSS VARIOUS
CATEGORIES AS SERVICE.
AND SO THOSE FUNDS HAVE.
BEGAN FLOWING BACK IN JANUARY I
BELIEVE AND THEN THE DENTAL
MANAGED CARE PLANS.
EITHER HAVE OR WILL BE
RECEIVING SHORTLY THIS AMOUNT OF
MONEY I'M SPECIFIC TO THE
DIRECTED PAYMENTS.
.
FOR THE WOMEN'S HEALTH SERVICES.
THAT IS ONE OF THOSE CHALLENGES
THAT I JUST SPOKE TO IN TERMS OF
THE PROGRAMMING OF THE. OF THE
SYSTEM AND SO WE HAVE HAD SOME
GLITCHES IN OUR CLAIM SYSTEM
THAT WE ARE WORKING QUITE
CLOSELY WITH THE PROVIDER
COMMUNITY ON.
BECAUSE WE ARE AWARE THAT THE
FUNDING THAT HAS BEEN PROVIDED
TO THEM IS NOT ON WHAT WE
INTENDED IT'S SHOWING AT A LOWER
IT'S STILL A SUPPLEMENTAL RATE
BUT IT'S A SUPPLEMENTAL RATE
THAT IS NOT.
IS NOT WHAT WE INTENDED AND SO
WE'RE HAVING TO WORK THROUGH THE
TECHNICAL ISSUES ON THE AND THAT
THE
THIS WILL BE
PAID TO THOSE.
PROVIDERS
ON THE ICY FDD I RATE INCREASE
WAS.
DONE AND HAS BEEN IMPLEMENTED
AND HIV WAIVER AGENCY I'M
FUNDING WAS THE QUICKEST.
AND THE FASTEST APPROVAL FROM
THE FEDERAL GOVERNMENT SO THAT
HAS BEEN IN PLACE THE LONGEST.
AND THEN.
OBVIOUSLY WITH THE JANUARY
BUDGET AND WE TALKED ABOUT IN
THE PREVIOUS AGENDA ITEM IS THAT
THE ADMINISTRATION IS PROPOSING
TO USE ADDITIONAL PROP
YOU SIX MONEY. TO PROVIDE A
FIFTY PERCENT.
RATE INCREASE TO HOME HEALTH
I'M OBVIOUSLY NOTING SOME OF THE
CONCERNS AND.
ISSUES THAT WE BELIEVE WERE OUT
IN THE PROVIDER COMMUNITY ABOUT.
CONTINUING ACCESS AND
WILLINGNESS OF NURSES TO
CONTINUE PROVIDING SERVICES AND
SO THAT IS SOMETHING THAT AND WE
WILL BE SEEKING THE
LEGISLATURE'S APPROVAL ON.
GOING STARTING JANUARY JULY
FIRST.
SO.
I'M HAPPY TO TAKE QUESTIONS.
RIGHT THANK YOU AYE COMMENTS
MILLION.
I'M BEN JOHNSON WITH THE LA ARE
WE DID CONDUCT AN ANALYSIS OF
THE GOVERNOR'S SAT TWENTY AUG
TWENTY EIGHTEEN NINETEEN BUDGET
PROPOSAL RELATING TO PROP FIFTY
SIX IN ESSENTIALLY FOUND.
IS CONSISTENT WITH THE AGREEMENT
THAT WAS STRUCK IN
A SEVENTEEN
GOVERNOR'S PROPOSING TO SPEND
THE MAXIMUM AMOUNT OVER THE TWO
YEARS SOME COULD BLEED INTO THE
FOR INTO A THIRD YEAR. BUT IN
FULL ONE POINT THREE FOUR.
SIX BILLION DOLLARS ON PROVIDER
PAYMENT INCREASES REALLY WITHIN
THE CATEGORIES AND SERVICE GET
THE PROVIDER AND SERVICE
CATEGORIES SAT IN THE TWENTY
SEVENTEEN AGREEMENT. WE DO
ESTIMATE THAT THERE IS FIVE
HUNDRED AND TWENTY THREE MILLION
DOLLARS.
IN PROPOSITION FUNDING THAT IS
BROADLY ALLOCATED TO PROVIDER
PAYMENT INCREASES BUT FOR WHICH
THERE'S NO DETAILED PLAN FOR HOW
TO ACTUALLY TARGET THAT FUNDING.
AND ULTIMATELY FIND THAT THE
THAT THE GOVERNOR LEFT THOSE
DETAILS TO BE WORKED OUT WITH
THE LEGISLATURE TO VOTE OVER
THEM OVER THE.
CYCLE.
SO THAT THE LEGISLATURE COULD
TAKE TO TAKE ACTIONS THAT ARE
CAN I THINK CONSISTENT WITH THE
GOVERNOR'S APPROACH IN TARGETING.
YOU KNOW NEW PROCEDURE CODES
AND SO FORTH WITHIN DENTAL
WITHIN PHYSICIAN.
SERVICES FOR A ADDITIONAL
SUPPLEMENTAL PAYMENTS AMOUNTING
TO THAT FIVE HUNDRED AND TWENTY
THREE MILLION.
OR THE LEGISLATURE COULD
ALTERNATIVELY PROVIDE.
THE TARGET THAT FUNDING TOWARDS
OTHER PROVIDERS SERVICE
CATEGORIES OR USE IT FOR
POTENTIALLY OTHER USES WITHIN
MEDIC CAO WHETHER THAT WAS TO.
ALLEVIATE SOME OF THE GENERAL
FUND PRESSURES OR.
AT TAKE A NUMBER OF DIFFERENT
ACTIONS. SO WE DID ALSO REVIEW
THE HOME HEALTH SERVICES
INCREASE.
AS WELL AND.
WE FOUND THAT THE
ADMINISTRATION DID PROVIDE SOME
EVIDENCE THAT ACCESS CHALLENGES
ARE PRESENT IN THIS AREA.
BUT WE DO RECOMMEND THAT THE
LEGISLATURE CONSIDER.
WHETHER THE RATE INCREASE
SHOULD BE ONGOING YOUR LIMITED
TURN SENSE THE BOAT BECAUSE.
WAS NOT IDENTIFIED NECESSARILY
AS BEING A RACE ISSUE AS AS WELL
AS OPPOSED TO SOMETHING ELSE.
WE ALSO.
BELIEVE THE LEGISLATURE SHOULD
CONSIDER.
IF IT DOES WISH TO INCREASE THE
PAYMENTS FOR HOME HEALTH
SERVICES.
THAT.
IT ASKED THE DEPARTMENT TO
REPORT BACK ON THE FINDINGS HAVE
AND TO SEE IF THOSE SERVICES ARE
BEING UTILIZED TO A GREATER
EXTENT ONCE THE LAWS ARE IN
PLACE SO. HAPPY TO TAKE ANY
QUESTIONS.
OKAY THINKING FINANCE.
I JUST FOLLOWING UP THAT THE
AGENT IS A REALLY NICE JOB I'M
GONNA COME OUTLINING THE
GOVERNOR'S BUT BUDGET PROPOSAL
AND SO IN EIGHTEEN NINETEEN
WE'RE PROPOSING THIRTEEN POINT
SIX MILLION TOTAL FUNDS FOR ICF
DD'S SINCE.
POINT EIGHT MILLION AND IT WEBER.
THANK YOU.
RIGHT QUESTIONS FOR COMMITTEE
MEMBERS.
AND WE'RE GONNA HAVE A PANEL
COME UP TALK ABOUT FEDERATES.
VERY SHORTLY.
TERMS OF A.
YOU MENTIONED THE MANY DIFFERENT
THINGS HAVE TO BE DONE AND THE
BOMBS SO CAN YOU JUST SAY WHERE
ARE E RIGHT NOW ON THE TH
POSITION PARTY MENTIONED THAT WE
ARE ABLE TO GET THE HIV.
STURDY OF
THAT'S ARE SO
SO WHERE ARE WE.
IN TERMS OF THE BOMBS
AND HOW MUCH MONEY HAVE WE
GOTTEN OUT ALREADY.
ON ON THIS PROP ON THE PROPERTY
SIX FUNDS.
AND I WILL HAVE TO FOLLOW UP
WITH YOU AND HOW MUCH MONEY HAS
ACTUALLY GONE OUT THE DOOR AND
WE DON'T HAVE ANY.
PENDING FEDERAL APPROVALS THAT
ARE SO NECESSARY SO WE'VE
RECEIVED AT ALL OF THEM SO NOW
IT'S. A MATTER OF BOTH FLOWING
THE MONEY TO THE PLAN SO THAT
THE CAPITATION PORTION THE
DIRECTED PAYMENTS FOR THROUGH
THE PLANS TO THEIR PROVIDERS
THAT ARE UNDER THE MANAGED CARE
SYSTEM. AND AS I OTED ON WE
HAVE HAD SOME TECHNICAL.
CHALLENGES IN THE CLAIMS
ADMINISTRATION OF.
OF THE SUPPLEMENTAL PAYMENTS AS
THEY PERTAIN TO THE WOMEN'S
HEALTH AND. PROVIDER PORTION AND
SO WE ARE WORKING TO BOTH. I'M.
QUICKLY KIND OF FIGURE OUT HOW
TO PROGRAM THE SYSTEM AND THEN
WE WOULD HAVE TO RERUN THOSE
CLAIMS TO PAY OUT AT THE RIGHT
AMOUNT BUT I THINK THOSE ARE
SOME OF THE. KIND OF STATE
ALLIES INTERNAL ADMINISTRATION
CHALLENGE THIS POINT BUT THE
FEDERAL PROPOSAL APPROVALS HAVE
ALL BEEN BEEN AND DONE I WOULD
LIKE TO JUST POINT OUT ON THE
HOME HEALTH JUST TO MAKE SURE
THAT THE COMMITTEES CLEAR. WHILE
THE GOVERNOR'S BUDGET IS
PROPOSING TO USE PROP FIFTY SIX
PAYMENTS FOR THE FIFTY PERCENT
RATE INCREASE FOR THE HOME
HEALTH.
IT IS.
OUR PROPOSAL TO MAKE THAT A
PERMANENT ONGOING RATE INCREASE
AND NOT A ONE YEAR SUPPLEMENTAL
SIMILAR TO SOME OF THE OTHER
PROP FIFTY SIX AND PROPOSALS
OKAY.
AND IT IS SO AIDS. AGAIN.
SAFETY UPON THE POSITION
AND IS.
THAT WAS THAT YOU MENTIONED THAT.
ON THE UP WOMEN'S HEALTH WERE
STILL WORKOUTS PROGRAMMING I
KNOW YOU SAID ON THIS IS
AND THEN
WE'RE GONNA DO YOU KNOW WILL
RETROSPECTIVELY PAID BACK TO
CERTAIN DATE BUT IS THEM.
SO FEDERAL APPROVALS ARE DONE.
IT IS A RESTORING HAPPENED YET
ARE NOT OKAY FUNDS HAVE BEEN
FLOWING ON THE FEE FOR SERVICE
SIDE SINCE JANUARY FEBRUARY OKAY
SO IT JUST TAKES TIME FOR US TO
KIND OF RE RUN. CLAIMS ARE YOU
AND YOU PAY THAT FORWARD AND
THEN ON THE MANAGED CARE SIDE I
BELIEVE THAT THE DIRECT PAYMENTS
FOR THESE PHYSICIAN.
INCREASES ARE IN THE MANY.
PAYMENT TO THE PLAN SO THEY
SHOULD BE RECEIVING NOT IN THE
NEXT.
COUPLE OF WEEKS AND SPENT SOME
PLANS HAVE.
BEEN UMPTEEN KNOWS IN ADVANCE
OF RECEIVING THE FUNDS FROM US
JUST BECAUSE. THEY CHOSE TO IT
WASN'T REQUIRED OF THEM BUT SO
THOSE FUNDS WILL ALSO CATCH UP
BACK TO. JULY FIRST
BUT ON THE GROUND UNTIL THE
MONEY ACTUALLY SHOWS UP WE CAN
SAY WE'RE GOING TO DO SOMETHING
SO I JUST GET TO KNOW WHEN IT'S
HAPPENING ALRIGHT. OKAY THANK
YOU SO WHAT WE GO AHEAD AND
BRING UP OUR PANEL SO IF YOU CAN
DISCERN AND WE HAVE FIVE.
FIVE PEOPLE HAVE FUN DOCTOR SO
BOO EXECUTIVE VICE PRESIDENT YOU
SEE HEALTH.
COASTAL STREETS HE OH.
FAT PLANNED PARENTHOOD
CALIFORNIA.
YOUR.
LUTHER CHIEF DENTAL OFFICER
WESTERN DENTAL ORTHODONTICS THEM
SHOW. INCOME FOR MEDICAL
ASSOCIATION INCOMPLETE CHEN FROM
CATHOLIC PAN ETHNIC HEALTH
NETWORK.
AND.
BASICALLY APPRECIATE YOU
DRESSING THE ISSUES OF OUR
PROVIDER REIMBURSEMENT
ACCESS TO MEDICAL CARE FOR MEDI
CAL BENEFICIARIES.
NO I APPRECIATE YOU BEING HERE
AND.
AND THE US SO WE ASK YOU TO.
THREE MINUTES PIECE A MAXIMUM.
AND APPRECIATE YOU BEING HERE
AND.
AND SPEAKING ABOUT THAT AXIS
REIMBURSEMENT YEARS IS SO WHAT'S
GO HEAD START WITH ADOPT HOBO
THANK YOU VERY MUCH THANK YOU
VERY MUCH CHAMPION IN A MEMBERS
OF THE COMMITTEE MY NAME IS TALK
TO JOHN D. STILL LOW AND I'M
EXECUTIVE VICE PRESIDENT YOU SEE
HEALTH.
I APPRECIATE THE OPPORTUNITY TO
SHARE A FEW THOUGHTS WITH YOU
TODAY. YOU SEE HEALTH.
IS MADE UP OF FIVE WILL CLASS
ACADEMIC. HEALTHCENTERS ELEVEN
HOSPITALS IN EIGHTEEN HEALTH
PROFESSIONAL SCHOOLS.
BUT TODAY HAVE BEEN ASKED TO
PROVIDE AN UPDATE TO LASHES
TESTIMONY REGARDING OUR
EXPERIENCE WITH MEDI CAL.
MEDICARE AS CRITICALLY IMPORTANT
TO THE STATE'S GROWING
POPULATION.
HAVE IN KEEPING THIS IS THE
STATE'S GOING POPULATION HAS.
YOU SEE HEALTH CONTINUES TO MAKE
EXTRAORDINARY COMMITMENT TO THE
MEDICARE POPULATION AND WE ARE
PLEASED TO DO SO.
YOU SEE IS THE THIRD LARGEST
PROVIDER OF HOSPITAL INPATIENT
SERVICES TO MEDI CAL
BENEFICIARIES.
IT HOSPITAL'S REPRESENT LESS
THAN SIX PERCENT.
OF ACUTE CARE HOSPITALS IN
CALIFORNIA.
WE HAVE ALSO BECOME THE FOURTH
LARGEST PROVIDER OF OUTPATIENT
SERVICES. TO MEDICARE
BENEFICIARIES IN THE STATE.
LAST YEAR I TESTIFIED THAT YOU
SEE HELP ABSORB MORE THAN SEVEN
HUNDRED MILLION DOLLARS AND I'M
PRETTY IMPRESSED MEDI CAL
BECAUSE.
IN TWENTY SEVENTEEN THAT FIGURE
GREW TO NEARLY NINE HUNDRED
MILLION DOLLARS.
THIS FINANCIAL COMMITMENT I
FEEL IS UNPRECEDENTED.
TO ADDRESS THE SHORTFALL THE
LEGISLATURE IN THE STATE
DEPARTMENT OF HEALTH CARE
SERVICES.
PARTED WITH THE UNIVERSITY
CALIFORNIA AND I THE PUBLIC
HEALTH HOSPITALS TO PURSUE
FEDERAL MATCHING FUNDS. WHICH
ARE CRITICAL SUPPLEMENTAL
PAYMENTS.
REMEMBER I'M MEDICAL CENTERS RE
FEES NO STATE GENERAL FUNDS.
SO ARE REIMBURSED COST MUST BE
OFFSET BY OTHER REVENUES.
WE A POLICE REPORT PROGRESS IN
FOUR AREAS.
COMPARED TO OUR REPORT LAST
YEAR FIRST.
NOW WE HAVE BEEN ABLE TO ACHIEVE
IT MASTER SERVICES AGREEMENT
WITH THE THREE LARGEST MEDI CAL
MANAGE PLANS AND SOUTHERN
CALIFORNIA LA CARE INLAND EMPIRE
AND CAL OPTIMUM.
THIS SHOULD RESULT IN A MORE
ROBUST. AYE INTERACTIONS BETWEEN
THREE MEDICAL CENTERS IN THE
SOUTH.
UCLA UC IRVINE AND UC SAN DIEGO
WITH THESE MANAGE MEDICAL PLANS
TO MAKE A MOVE IN OF MEDI CAL
PATIENTS FROM MY FACILITIES TO
PLANTS MISSION SMOOTHER.
SECOND O. WE INTO REPORTED THAT
UC DAVIS ENTERED INTO AN
AGREEMENT WITH UNITED HEALTHCARE
LAST YOU TO PROVIDE MEDICAL
PATIENTS WHO PRIMARY SPECIALTY
CARE.
THIS CONTRACT WAS RECENTLY
EXPANDED.
TO INCLUDE MORE MEDI CAL
BENEFICIARIES.
THIRD THROUGHOUT LEVERAGING
SKILLFUL VALUE INITIATIVE WHICH
IS A SYSTEM WIDE COST REDUCTION
INITIATIVE.
WE'VE ACHIEVED UP TO EIGHT
HUNDRED MILLIONS IN SAVINGS.
UP FROM JUSTOVER FIVE HUNDRED
MILLION LAST YEAR AND I TARGET
IS TO HAVE FIVE HUNDRED MILLION
DOLLARS A SAVINGS FACT EACH YEAR.
LASTLY ALTHOUGH PATIENTS COME TO
YOU SEE TYPICALLY FOR MORE
HIGHLY SPECIALIZED AND ADVANCED
SERVICES WE UNDERSTAND AND THE
IMPORTANCE OF THE NEED TO
INCREASE PRIMARY CARE.
WE TRY TO DO SO MANY TWO
PARTNERSHIPS WITH COMMUNITY
BASED PROVIDERS COMMUNITY BASED
PRIMARY CARE PROVIDERS AND
FACILITIES SUCH AS THE
PARTNERSHIP WE HAVE WITH EL
CENTRO IN SOUTHERN CALIFORNIA.
AS WE MENTIONED UC DAVIS.
HOME IT IS A PARTICULAR AREA OF
INTEREST TO US.
WE DO THE UC DAVIS HAS BEEN
ABLE TO ENTER INTO AGREEMENTS
WITH H. FEDERALLY QUALIFIED
HEALTH CENTERS.
BUT IN THE SACRAMENTO AREA.
UNDER THE ALICIA NAME.
A AM UC DAVIS CHILDREN'S
HOSPITAL HIS CHEST MARKED THE
ONE YEAR ANNIVERSARY. # WITH A
RELATIONSHIP WITH SACRAMENTO
PRIMARY CARE CENTER.
SO WHILE WE MAY HAVE WE HAVE
MADE SOME PROGRESS IT UC DAVIS
WE FEEL THAT WE STILL HAVE A WAY
TO GO.
IN CLOSING THOUGH I MISSIONOF
TRAINING FUTURE POSITIONS WE'VE
EXPANDED I TOUCH POINTS WELL
BEYOND THE WALLS OF YOU SEE
HOSPITALS.
OUR DOCTORS ROTATE TOO MANY
SITES OF CARE WAY FROM MY
CAMPUSES.
AT ANY MOMENT ABOUT TWENTY
PERCENT OF OUR RESIDENTS MARIN
COUNTY HOSPITALS TWENTY PERCENT
EARNED COMMUNITY HOSPITALS
ANOTHER TWENTY PERCENT ARE IN VA
FACILITIES.
THE STRAIN PROGRAMS OF THE HALF
OF OUR POWER OF THE HIGHEST
CALIBER.
ACCORDING TO THE TWENTY EIGHTEEN
US NEWS AND WORLD REPORT THREE
OF OUR MEDICAL SCHOOLS FRANK IN
THE TOP TEN NATIONALLY.
A IN FOR PRIMARY CARE EDUCATION.
OVER THIRTY PERCENT OF OUR
RESIDENTS ARE TRAINING IN
PRIMARY CARE SPECIALTIES.
WE APPRECIATE THE OPPORTUNITY TO
BE WITH YOU TODAY. AND I'M HAPPY
TO ANSWER ANY QUESTIONS THAT YOU.
THANK YOU I THINK WE'RE GOING TO
DO THE WHOLE PANEL THAT WILL
HAVE TO QUESTIONS FROM THE.
COMMITTEE MEMBERS UP THE STREET.
GOOD AFTERNOON TO MISTER
CHAIRMAN THANK YOU FOR HAVING US
I THINK YOU'RE YOU ME I'M A
LITTLE TIRED I JUST GOT OFF A
RED EYE FROM DC AND. IT IS A
QUITE DIFFERENT BEING OBVIOUSLY
IN THIS CAPITAL THEN. THE OTHER
ONE AND I THINK THAT'S THE POINT
I REALLY WANT TO EMPHASIZE TIED
TO FOLKS THAT.
.
YOU KNOW PLANNED PARENTHOOD WE
REALLY WE DREAM OF THAT TIME
WHEN WE CAN FOCUS AND BE
INNOVATIVE AND LEAD IN WOMEN'S
HEALTH CARE IN IT AND A GREATER
MORE PROGRESSIVE WAY. AND
UNFORTUNATELY GIVEN THE CONSTANT
ATTACK IN THE WAR ON WOMEN THAT
WE FACED.
SOMETIMES HERE BUT MOSTLY NOT
HERE IT IT'S BEEN A REAL
STRUGGLE AND SO I WANT TO
EMPHASIZE THAT BETWEEN THAT AND
ECONOMIC CHALLENGES AND JUST
HEALTH CARE CHALLENGES AND.
HOW IMPORTANT THE PROP FIFTY SIX
MONEY HAS BEEN THAT IS REALLY
CREATING I THINK THE FIRST
OPPORTUNITY IN QUITE A LONG TIME
FOR US TO LOOK UP?
TO BE ABLE TO LOOK UP AND ASK I
THINK SOME OF THE IMPORTANT
QUESTIONS THAT ALL OF YOU WANT
US TO ASK OURSELVES HOW DO WE
MOVE TO A VALUE BASED CARE. HOW
DO WE FOCUS ON HEALTH EQUITY
ISSUES IN THE PLACES THAT ARE
REALLY?
IN GREAT NEED AND THAT IS WHAT
WE'RE FOCUSED ON SO I'M HAPPY TO
REPORT THAT I'M OUT OF THE SEVEN
AFFILIATES TO. OPERATE ABOUT
HUNDRED AND FIFTEEN HEALTH
CENTERS.
SERVE NEARLY A HUNDRED THOUSAND
PATIENTS THAT EACH ONE OF THE
AFFILIATES AS EITHER LOOKING AT
EXPANDING AN ACTUAL HEALTH
CENTERS SOMETIMES CONSOLIDATING
RIGHT WHICH YOU ACTUALLY NEED
RESOURCES TO BE ABLE TO RE
FIGURE. ON HOW TO PROVIDE AS
MUCH CARE AS POSSIBLE LOOKING AT
HOW WE EXPAND STI ANOMALY
TESTING BUT TREATMENT CRAP I'M
PAT. RELIEVED BRANCHING OUT NOT
JUST WOMEN'S HEALTH OF MEN'S
HEALTH LGBTQ.
AND OTHER FAMILIES LOOKING AT
PRENATAL CARE WE ALL KNOW HOW
IMPORTANT IT IS TO REACH.
WOMEN EARLY AND THEIR
PREGNANCIES AND THOSE ARE ALL
THE UPPER
IS THAT THIS
THESE RESOURCES PROVIDE US AND
WE'RE HOPING AND WE KNOW WE WILL
BE ABLE TO COME TO YOU AND SOON.
WITH REPORTS ON HOW THE PROGRESS
AN ACTUAL SPECIFIC DATA AND YOU
CAN CONTINUE TO MAKE I THINK
GREAT DECISIONS.
.
WANTING TO REMIND EVERYONE THAT
EIGHTY PERCENT OF OUR PATIENTS
ARE MEANS TESTED AND SO THAT THE
POINT I CONTINUE TO MAKE ABOUT
THE INVESTMENT. IS THAT WE ARE
TWO THOUSAND THIS IS YOUR DATA
TWO THOUSAND SEVEN DATA SHOWS
THAT I'VE FOR EVERY DOLLAR
YOU'RE INVESTING IN OUR WORK
HERE RECEIVING NINE AND A
QUARTER BACK SO THE REALLY
STRONG INVESTMENT AND WE THINK
THAT'S AN IMPORTANT STORY. I'M
FURTHER TO MAKE SURE TAXPAYERS
KNOW NOT JUST IN CALIFORNIA BUT
AROUND THE COUNTRY AGAIN AS WE
ARE IN A CLIMATE WHERE. THERE'S
A LOT OF QUESTIONS ABOUT.
WHAT INVESTMENT SHOULD BE MADE
PARTICULAR I WOMEN'S HEALTH
CARE THINK IT'S IMPORTANT TO
MAKE SURE PEOPLE KNOW IT'S
ECONOMICALLY SOUND?
SO I WANT TO MAKE SURE I'M
EMPHASIZING TWO POINTS AND THAT
WE NEED YOUR HELP BECAUSE WE
WANT TO CONTINUE TO DO THIS WORK
AND FIRST AND IT'S.
VERY MUCH RELATED TO WHAT
DOCTOR KENT BROUGHT UP IS THAT
WE NEED THE FUNDS ADMINISTRATED.
I'M QUICKLY I THINK YOU DOCTOR
PAN FOR REMINDING EVERYONE THAT
PROVIDERS I'M REALLY CAN ONLY
USE THE MONEY IF THEY HAVE THE
MONEY AND I JUST WANNA THINK.
DIRECTOR CAN'T FOR HER
LEADERSHIP I JUST AND FIRST
SHEPHERDING THROUGH THE FEDERAL
GOVERNMENT A LOT OF DIFFERENT
MEN MINSON AND WAIVERS THAT
NEEDED TO HAPPEN OR BEAVER
AMENDMENTS ARE NEEDED TO HAPPEN.
BUT REMINDING EVERYONE THAT AT
ANY GIVEN POINT ABOUT THREE
PERCENT OF OUR OPERATING MONEY
IS HELD UP SOMEWHERE IN THE
BILLING SYSTEM AND AS. A
PROVIDERS YOURSELF AS BUSINESS
OWNERS OF PEOPLE WORK FOR
NONPROFITS YOU UNDERSTAND THAT
THAT THREE PERCENT.
REALLY IS THE DECISION ON
WHETHER OR NOT HOW WE CAN
PROGRESS HOW WE CAN INNOVATE HOW
CAN WE OPEN A NEW HEALTH CENTER
AND ALSO NOT KNOWING. THAT
UNCERTAINTY IS THAT THREE
PERCENT GOING TO CALM AND AGAIN
I WOULD REALLY WANT TO
COMPLEMENT THE LEADERSHIP ADULT
PERMANENT ALTAR SERVICES. BUT
SOME OF THIS IN THIS WILL NOT BE
ADDRESSED THIS YEAR IS DEEP
INFRASTRUCTURE CHALLENGES THAT
WILL NEED TO BE ADDRESSED ADAM
AND I WOULD ENCOURAGE YOU TO.
START.
DODD AGAIN MCCARTY NOT THIS
BUDGET CYCLE BUT REALLY THINKING
ABOUT THAT. AND.
AND THEN THE OTHER PART OF
COURSE IS JUST HELPING US REALLY
TELL THE STORY AND LIKE I
MENTIONED.
THE DATA THAT YOU HAVE THUS FAR
IS TWO THOUSAND SEVEN DATA WOULD
REALLY ENCOURAGE YOU TO CONSIDER
THIS YEAR ASKING THE DEPARTMENT
ASKING ON THIS BE EXPEDIA UPDATE
THAT STUDY I THINK THAT WE WOULD
FIND THAT. TEN YEARS AGO IF WE
WERE RICH DAD SAVING AS
SIGNIFICANT NINE TO ONE SAVINGS
THAT WE WOULD SEE MUCH WHERE A
BIGGER RETURNS I THINK. THE
TAXPAYERS WOULD LIKE TED
KACZYNSKI THE BENEFIT OF THAT.
THANK YOU.
ALRIGHT DOT LUTHER.
ON DOCTOR LUTHER ON THE CHIEF
CLINICAL OFFICER FOR WESTERN
DENTAL. WE ARE THE LARGEST AND
CAL PROVIDER IN CALIFORNIA.
I WANT TO THANK YOU FOR THE
OPPORTUNITY TO RETURN AND
ADDRESS A GROUP IT'S BEEN NEARLY
A YEAR SINCE.
.
A SINCE PROP FIFTY SIX OUT
ALLOCATION WENT INTO PLACE AND
CERTAINLY WE HAVE SEEN SOME
IMPROVEMENT.
AS WAS MENTIONED EARLIER WE
WE'VE SEEN MORE PROVIDERS WE'VE
SEEN MORE PROVIDERS THAT ARE
TREATING.
TEN OR MORE CHILDREN FOR
PREVENTIVE SERVICES.
ADDITIONALLY AS WAS POINTED OUT.
AS OF THE FIRST OF THE YEAR WE
SEE. THE RESTITUTION OF ADULT
BENEFITS WHICH IS WHICH IS ALSO
IMPORTANT BECAUSE OF THAT FLOW
OF PATIENTS COMING INTO. AN
ACCOUNT PRACTICES.
SO FOR WESTERN DENTAL IN THE
LAST TWO YEARS WE'VE ADDED ABOUT
TWENTY PRACTICES. THROUGH
ACQUISITION OR OR BUILDING.
GIVING US A TOTAL OF ABOUT TWO
HUNDRED DENTAL PRACTICES IN
CALIFORNIA.
WE ALSO HAVE NOW TWENTY FOUR
PEDIATRIC PRACTICES SO WHERE
WHERE.
REALLY REALLY AYE OF MAKING
PROGRESS ON THAT FRONT.
SO THAT BEING SAID IT STILL VERY
VERY DIFFICULT FOR MANY DENTAL
PROVIDERS.
TO TO TREAT.
DATA CAL PATIENTS WHY IS THAT
BECAUSE EVEN WITH THE RATE
INCREASE FROM PROP FIFTY SIX. IT
TOOK RATES FROM ABOUT TWENTY
SEVEN TO THIRTY SIX THIRTY SEVEN
PERCENT OF COMMERCIAL RATES.
SO BECAUSE OF THAT IT'S STILL
NEXT TO IMPOSSIBLE FOR MOST BILL
PROVIDERS TO TREAT ONLY DATA CAL
PATIENTS THEY HAVE TO HAVE A
SUPPLEMENT.
OF.
OTHER PATIENTS EITHER FEE FOR
SERVICE OR MORE CASH PAYING.
SO JUST SPEAKING BROADLY ABOUT
THE PROGRAM.
I THINK IT TO BEND THE COST
CURVE IMPROVE ORAL HEALTH WE
HAVE TO FOCUS ON PREVENTION AND
EARLY INTERVENTION AND MOVE AWAY
FROM. EXPENSIVE RESTORED OF CARE
FOR ADULTS.
PERIODONTAL CARE IS IS VERY
VERY IMPORTANT IT'S THE COURT
CORNERSTONE REALLY HAVE GOOD
DENT.
AND ALSO WE ARE SEEING MORE AND
MORE THE CORRELATION BETWEEN
PARAGON OF THE SEASON OVERALL
HEALTH AS YOU POINTED OUT
EARLIER.
THAT BEING SAID WE WOULD LIKE
TO SEE THE.
THE TAR REMOVED TO THEIR
REQUIREMENT FOR PRE
AUTHORIZATION FOR CERTAIN
PROCEDURES.
BECAUSE THAT SLOWS DOWN
TREATMENT IN THE DATA CAL
POPULATION THIRTY PERCENT OF THE
PATIENTS DO NOT RETURN FOR FOR
APPOINTMENT NUMBER TWO.
SO OF THE THREE THINGS THAT WE
CONSIDER MOST IMPORTANT.
GOING FORWARD ARE REALLY
ADEQUATE RATES FOR FOR
PROCEDURES GENERALLY AND THE
INCLUSION OF.
OF BOB.
STRATEGIES ALSO PERIODONTAL CARE
AS AS WAS POINTED OUT SECOND
WE'D LIKE RELIABLE RATES SO WE
WOULD LIKE MULTI YEAR.
.
OUR RATES IT IN PLACE IS VERY
DIFFICULT FOR PROVIDERS TO HIRE
STAFF.
OR TWO TO MAKE IMPROVEMENTS TO
THEIR OFFICES IF THEY'RE NOT
INSURED THAT THOSE RATES REMAIN
IN PLACE.
OVER TIME AND THEN LASTLY WE
WOULD WE WOULD LIKE TO SEE
TIMELY PAY UP PAYMENTS FOR
SERVICES RENDERED.
SO IF YOU LOOK AT WHAT HAPPENED
IN YOUR ONE.
THERE WAS A BUILT IN DELAY ABBY
BECAUSE.
IT TOOK NINETY DAYS FOR FEDERAL
APPROVAL OF THE STATE PLAN
AMENDMENT.
AND THEN WITH OTHER
ADMINISTRATIVE DIFFICULTIES
THAT VIGIL Y. PAYMENTS WERE NOT
REALLY RECEIVED UNTIL THE END OF
THE YEAR.
SO SO THAT MAKES IT VERY VERY
DIFFICULT FOR PROVIDERS TO TO
REALLY BUILD MOMENTUM.
WITH THE PROP FIFTY SIX DOLLARS
SO WE'RE HOPING MOVING FORWARD
THAT THE STATE AND I REQUEST.
.
IN WRITING. RATES TO CONTINUE
UNTIL FURTHER NOTICE IF THAT IF
THAT WERE PUT INTO PLACE WE WE
WOULD CERTAINLY SEE A PROGRAM
THAT.
THAT REALLY I THINK REALLY
TAKES OFF.
THANK YOU VERY MUCH. THANK YOU.
I ESTA MISAKA.
GOOD AFTERNOON MISTER CHAIRMAN
MEMBERS MITCHELL BUCKO WITH THE
CALIFORNIA MEDICAL ASSOCIATION.
THAT'S THE COMMITTEE IS WELL
AWARE PROVIDER REIMBURSEMENT
RATES IN THE CALLER SOME OF THE
LOWEST IN THE NATION.
ADDITIONALLY RACE WHERE FURTHER
REDUCED TO ADDRESS BUDGET
SHORTFALLS IN TWENTY ELEVEN OF
STATE MADE REDUCTIONS TO NUMBER
OF SAFETY NET PROGRAMS.
INCLUDING A TEN PERCENT CUT TO
MEDI CAL PROVIDER RATES WHICH
FURTHER EXACERBATED THE PROBLEM.
THIS FUNDING HAS BEEN RESTORED
FOR THE VAST MAJORITY OF THE
SAFETY NET PROGRAMS HOWEVER THE
AB NINETY SEVEN RATE CUT HAS NOT
BEEN RIVERS FOR PHYSICIANS
SERVICES.
CMA HAS HAD LONG STANDING
CONCERNS WITH LOW PROVIDER
REIMBURSEMENT RATES PAID TO
MEDICAL PROVIDERS AND THE EFFECT
THIS HAS ON THE ABILITY OF
BENEFICIARIES TO FIND ACCESS TO
COVERED MEDICAL SERVICES.
WHILE THE STATE HAS GRANTED
COVERAGE TO ONE THIRD OF ITS
POPULATION THROUGH THE MEDICAID
EXPANSION. ACCESS TO MEDICAL
SERVICES HAS LAGGED DRAMATICALLY
WITH A LARGE PERCENTAGE OF
BENEFICIARIES REPORTING ACCESS
DIFFICULTIES PROTECT
PARTICULARLY WHEN IT COMES TO
FINDING A SPECIALIST.
PROPOSITION FIFTY SIX PROVIDES A
DEDICATED FUNDING STREAM TO MAKE
STRATEGIC INVESTMENTS.
IN THE MEDICAL PROGRAM PROVIDING
THE OPPORTUNITY TO INCREASE
REIMBURSEMENT RATES AND HELP
ADDRESS THE ACCESS PROBLEM.
WE'RE PLEASED THAT THE
GOVERNOR'S BUDGET ALLOCATES
ADDITIONAL FUNDING FOR
SUPPLEMENTAL PAYMENTS ABOVE WHAT
WAS PROVIDED IN THE TWENTY
SEVENTEEN BUDGET ACT.
HOWEVER THERE IS CURRENTLY A
HIGH LEVEL OF FRUSTRATION AMONG
OUR MEMBERS SURROUNDING
IMPLEMENTATION OF THE
SUPPLEMENTAL PAYMENT PROGRAM.
PARTICULARLY ON THE MANAGED CARE
SIDE.
BUT WE UNDERSTAND THE CHALLENGES
THAT CAN SOMETIMES COME WITH
SEEKING FEDERAL APPROVAL FOR NEW
PROGRAMS.
WE'RE ALMOST TEN MONTHS INTO THE
CURRENT FISCAL YEAR AND THE
DIRECTED PAYMENTS HAVE NOT BEGUN
TO FLOW TO PROVIDERS AND
MEDICARE MANAGED CARE WHICH
ACCOUNTS FOR THE VAST MAJORITY
OF THE POT FIFTY SIX FUNDING.
WITH FEDERAL APPROVAL FOR THE
MANAGED CARE SUPPLEMENTAL
PAYMENT PROGRAM RECEIVED IN LATE
FEBRUARY AND THE STAKEHOLDER
COMMENT PERIOD FOR THE ALL PLAN
LAST MONTH IT IS UNCLEAR WHAT IS
BECAUSE SUCH A LINK LENGTHY
DELAY. IN GETTING THE LETTER
RELEASE OF THIS PAYMENTS COME
AGAIN.
AT THIS POINT THE STATE NEEDS TO
SEND A POSITIVE SIGNAL TO
POSITIONS OF CALIFORNIA BUT IT
IS SERIOUS ABOUT MAKING THIS
INVESTMENT AND IMPROVING THE
MEDICAL PROGRAM.
WE WOULD REALLY LIKE TO BE A
PARTNER TO DE IT'S YES AND IF WE
CAN FIGURE OUT WHERE THE
OBSTACLES ARE GETTING THESE
PAYMENTS OUT.
BUT UNTIL THE FUNDS ACTUALLY
START TO FLOW. AS HAS BEEN
MENTIONED ON THE PANEL ALREADY
EFFECTIVE THE SUPPLEMENTAL
PAYMENTS ON PARAGLIDER POSITION
PARTICIPATION AND ACCESS TO CARE
CANNOT BE DETERMINED.
MOREOVER COMPLICATING IT. AND
EVALUATION OF WHETHER THE
SUPPLEMENTAL PAYMENTS ARE
IMPACTING.
ACCESS IS THE FACT THAT NO DATA
HAS BEEN PUBLICLY RELEASED ON
THE PAYMENTS I HAVE GONE OUT
TODAY.
AS WE MOVE FORWARD WITH
IMPLEMENTATION GIVEN THAT THERE
ARE ADDITIONAL RESOURCES
AVAILABLE FOR SUPPLEMENTAL
PAYMENTS. IT IS IMPERATIVE THAT
THESE FUNDS ARE DISTRIBUTED
WITHOUT SUCH SIGNIFICANT DELAY
AND IN A WAY THAT IS MOST
IMPACTFUL TO BENEFICIARIES AND
GEOGRAPHIC AREAS WHERE PATIENTS
NEED THE MOST QUE.
AND IF IF THAT REQUIRES. A
ADDITIONAL.
BUT. YEARS OF BLAME FOR ME
AREAS AND.
AND GETTING FEDERAL APPROVAL SO
THAT WE DON'T HAVE THAT
TIME AND I THINK. THAT WOULD BE
SOMETHING THAT WE WOULD LIKE TO
SEE.
GIVEN THE SIGNIFICANT DELAYS
THAT WE'VE SEEN.
IN GETTING THAT PROGRAM STARTED
UP SO. WITHOUT THANK YOU FOR THE
OPPORTUNITY TO PRESENT TODAY AND.
ANSWER ANY QUESTIONS.
THANK YOU SEND.
MISTER CHAIRMAN RISK CAN REALLY
TELL THE CALIFORNIA PAN ETHNIC
HEALTH NETWORK THANK YOU FOR
HAVING HERE TODAY I'D LIKE TO
SHARE WITH YOU THE BENEFICIARY
EXPERIENCE IN LIGHT OF THE
PROPERTY SIX INVESTMENT.
A LARGELY FOCUS MY COMMENTS ON
DECK HOUSE AND
THE PEN IS A CONVENER OF THE
STATE ORAL HEALTH NETWORK AND I
HAVE SOME COMMENTS TO SHARE
ABOUT MEDICAID MANAGED CARE AS
WELL.
AS THE COMMUTER THE SEAT ORAL
HEALTH NETWORK.
WE EMBARKED ON A TOUR THROUGH
CALIFORNIA LEARNING ABOUT THE
STATE OF ORAL HEALTH BUT THE
PARTICULAR AYE TOWARDS ACCESS
SINCE THE RESTORATION OF ADULT
BENEFIT. ADULT DENTAL BENEFITS
ALONGSIDE THE PROP FIFTY SIX.
THAT INVESTMENTS
FOR MORE MEETINGS ONE OF THE TOP
ISSUES THAT CONSUMERS FOR
CONSUMERS ACCESSING CARE WILL
STILL NAVIGATING WHAT THEY
CONSIDER THE PATCH PATCHWORK OF
SERVICES. WE KNOW THAT THE STATE
HAS DONE A TREMENDOUS AMOUNT IN
IN IN.
EX RESTORING ADULT SERVICES BUT
THERE STILL REMAINS CONFUSION
OFTENTIMES FOR PROVIDERS OF OF
WHAT'S COVERED. UNDER THE FOLD
AND CAL PROGRAM WHAT'S ELIGIBLE
FOR SUPPLEMENTAL PAYMENTS AND
WHAT'S NOT.
AND THAT TRICKLES DOWN TO THE
CONSUMER EXPERIENCES BECAUSE
SOMETIMES THE RECOMMENDED
SERVICES.
THAT.
A PROVIDERS.
RECOMMEND TO PATIENTS MAY NOT
NECESSARILY BE COVERED UNDER
DANTE CAL'S ADULT SERVICES FOR
INSTANCE CERTAIN TYPES OF OF OF
RESIN FILLING CENTER UP PERHAPS
DIFFERENT THAN WHAT DATA CAL
COVERS.
DEBATE MAY NOT BE COVERED AND
SO.
I THINK THAT THE STE THE THE
MORAL OF OF THAT A EXPERIENCE IS
THAT.
BECAUSE THAT FOLKS ARE STILL
NAVIGATING THROUGH THIS
PATCHWORK IT CAN ERODE THE TRUST
BENEFICIARIES.
HEY YOU TOLD ME THAT I'M COVERED
I'M HERE AND AND CERTAINLY
PERHAPS THIS WAS NOT COVERED OR.
BUZZ IF THINGS OF THAT NATURE.
AND I REALLY ALSO WANT TO
HIGHLIGHT THE FOCUSED THE NEED
FOR PREVENTIVE SERVICES IS
DOCTOR THE THIRD SPOKE TO
EARLIER.
AS ONE PARTICIPANT NOTED WE NEED
A FROM THE STATE A BUSINESS
MODEL FOR PREVENTIVE SERVICES
FOR PATIENTS ACCESS FOR TO
PREVENTION IS HOW WE WILL
IMPROVE HEALTH OUTCOMES AND
REDUCE HEALTH DISPARITIES.
IN THE STEEP THE STATE EAST
MAKE THAT A PRIORITY FOR UP PROP
FIFTY
IT'S PAYMENTS MOVING FORWARD.
LASTLY WE KNOW THAT THE
ELIMINATION OF BENEFITS PRIOR.
DEVASTATED THE CAPACITY THE
PROGRAM TO SERVE PATIENTS IN OUR
CONVERSATIONS IN FRESNO WE
LEARNED THAT THERE WAS IN FACT
AN UPTICK IN UTILIZATION AND
ACCESS FROM EARLY SO WE ASK WHY.
WE ACTUALLY LEARNED THAT THE
COUNTY HIRED.
AB OUT REACH FOLKS WERE SALES
PEOPLE. A TO WORK ONE ON ONE
WITH PROVIDERS SAYING ABOUT
WORKING WITH THEM ON THE
BUSINESS CASE FOR TAKING
PATIENTS AND HOW.
PROP FIFTY SIX PIC PAYMENTS IN
THE RESTORATION BENEFITS WOULD
HELP FIT INTO THEIR PRACTICE AND
WE THINK WE NEED MORE OF THIS
BECAUSE IN MANY PLACES IT
REMAINS THE CASE THAT DENTAL
OFFICES SAY THEY MAY TAKE.
THAT'LL HELP PATIENTS BUT MAY
SCHEDULED MAYBE ONE OR TWO
PATIENTS A WEEK.
AGAIN WE CAN MAKE THE CASE OTHER
POLICIES HERE ENSURING THAT HE
SERVICES LIKE PREVENTION INCOME
TREATMENT ARE COVERED.
LASTLY I WANT TO FOCUS ON SOME
MORE GENERAL COMMENTS ON PROPER
SIX UP PAYMENTS.
I SPOKE TO EARLIER.
ABOUT THE GREATER NEED FOR
ACCOUNTABILITY FOR DCS.
.
WE WOULD ECHO THAT FOR MEDI CAL
MANAGED CARE AS WELL TODAY
DOESN'T APPEAR THAT THEY HAVE A
GOOD WE EVALUATING WHETHER THE
RATE INCREASES ACTUALLY IMPACT
ACCESS TO SERVICES OVERALL.
WE CANLOOK AT THINGS LIKE THE
TIMELY ACCESS REQUIREMENTS THAT
WOULD BE A GOOD INDICATOR WE
BELIEVE WHETHER PLANS ARE
CONTRACTING WITH SUFFICIENT
PROVIDERS TO MEET NETWORK
ADEQUACY REQUIREMENTS.
WE WANT TO MAKE SURE THAT MOVING
FOUR THESE PAYMENTS ARE
ADDRESSING THE GREATEST NEEDS
PART PERHAPS AND SPECIALTIES IN
OTHER AREAS.
WE HAVE A TREMENDOUS OPPORTUNITY
TO IMPROVE THE HEALTH OF OVER A
THIRD OF CALIFORNIANS AND WE
URGE THE LEGISLATURE TO LOOK
CLOSELY. I HAD HOW WE IMPLEMENT
THESE PAYMENTS MOVING FORWARD
THANK YOU.
THANK YOU. QUESTIONS FROM
COMMITTEE MEMBERS FEATHERSTONE.
WE'LL OF THINK YOU OFFER YOUR
ILLUMINATING A TESTIMONY.
I'D REALLY APPRECIATE IT
CERTAINLY A LEARNING EXPERIENCE
FOR ME AND.
.
APPRECIATE ALL OF THE WORK THAT
ALL THE PROVIDERS TO IN. THERE
WITH ALL THESE CHALLENGES SO.
JUST A COUPLE COMMENTS SUCH TO
UC HEALTHY MENTION THAT.
YEAR.
UNCOMPENSATED LIABILITY FOR I
THINK FOR LAST YEAR THE SEVENTH
SUM FROM SEVEN HUNDRED MILLION
TO NINE HUNDRED MILLION DOLLARS.
IT THAT'S CORRECT CORRECT YET SO
THAT'S IT SYSTEM WIDE SYSTEM
WIDE SO. I UDERSTAND THAT YOU
KNOW YOU TAKE COMMERCIAL
ACCOUNTS AND. OBVIOUSLY. YOU
HAVE TO.
BACK FILL THAT THAT MONIES FROM
SOMEPLACE SO COMMERCIAL RATES
ARE UNFORTUNATELY A REYES TO
COMPENSATE FOR YEAR A LACK OF.
LEGITIMATE REIMBURSEMENT.
IS IT IS HER BREAKING POINT FOR
YOU SEE HEALTH.
WELL I THINK IT IS SURELY
ANSWERS YES I THINK IN THE PAST
TO COMMIT OF COMMERCIAL PAYERS
HAVE BEEN WILLING TO SUBSIDIZE.
THE LOSSES THAT OCCUR WITH THE
PUBLIC BUT POPULATION MEDICARE
MEDICAID.
I THINK WITH THE RISING COST OF
HELLO I KNOW WITH THE RISING
COST OF HEALTHCARE. AND THEY'RE
LESS AND LESS INCLINED.
AND IF THEY DO OF PAID MORE
THAN THE COST WHICH THEY DO.
OTHERWISE HE VALUE FOR THAT.
SO THE BREAKING POINT IS GONNA
COME FROM THE PAY IS HIT WITH A
BE INSURERS OR. ARE MORE LIKELY
LARGE SELF INSURED EMPLOYERS.
WHO ARE GOING TO NOT WANT TO PAY
MORE BUT WANT TO PAY LESS?
WELL II ALSO MADE A VERY
IMPORTANT POINT THAT YOU THAT
YOU SEE A DISPROPORTIONATE HIGH
LOW HIGH HIGH PERCENTAGE OF OF A
BETTER CAL BENEFICIARIES.
PROBABLY BECAUSE THEY HAVE
NOWHERE ELSE TO GO SO YOU'RE
LIKELY TO THE HOSPITAL OR THE
CLINIC OF LAST RESORT.
WHICH FURTHERS MY ARGUMENT THAT
WE NEED TO INCREASE HIS MEDICAL
RATES TO. OFFSET THE LIABILITIES
THAT YOU'RE YOU'RE LOOKING AT A
FOR WENT UP TWO HUNDRED. MILLION
IN ONE YEAR WE'RE LOOKING AT ONE
POINT ONE BILLION NEXT YEAR AND
I I DON'T TO GET SOMETHING THAT
YOUR. YOUR BOARD WOULD LIKE TO
WOULD LIKE TO.
TO SEE SO I I'VE YOU HAVE MY SO
MY SUPPORT TO CONTINUE TO WORK
WITH MY COLLEAGUES AND
AND DO WE CAN WITH THE
ADMINISTRATION TO. REALISTICALLY.
EXAMINE. WHERE WE ARE WITH THE
MEDI CAL FEE AND AND TO
APPROPRIATELY BEGIN THE PROCESS
OBVIOUSLY WE'RE NOT GOING TO BE
ABLE TAKEN UP TO WHERE IT SHOULD
BE?
BUT WE WE NEED TO MAKE SOME
INCREMENTAL INCREASES TO SHOW IT
GOOD FAITH THAT WERE.
APPRECIATING THE SERVICES AT
YOUR.
YOU'RE PROVIDING.
AND THEN TO MY FRIENDS AT CMA.
.
THANK YOU FOR YOUR ADVOCACY HERE
AS WELL HERE TODAY IN. THE COULD
YOU JUST ELABORATE A LITTLE BIT
MORE I WAS REALLY CONCERNED
BECAUSE IT THIS IS KIND OF NEW
TO ME ABOUT THIS.
DELAY IN THIS FEDERAL MATCH I
MEAN WHERE. I HEAR SOMETIMES IT
TAKES UP TO TEN MONTHS BEFORE
YOU CAN GET THE APPROPRIATE
MATCHING FUNDS FROM THE FEDERAL
GOVERNMENT TO PAY THE BILLS.
SO CONSECUTIVE. ELIMINATE WHY
THEY'RE SUCH A DELAY AND I GOT
THE FEDERAL GOVERNMENT BUT. AND
IT IS THERE ANYTHING WE CAN DO
AS A STATE.
AND OTHER PENALTIES ASSOCIATED
WITH THEM PAYING LATE OR IS IT
JUST WHICH BECAUSE OF THEIR
WEIGHT AND THAT AND THAT AND WE
FOR THEIR TIME TO TO TO PAY THE
APPROPRIATE BILLS.
I'M I I MAY HAVE TO DEFER TO MY.
ADMINISTRATION I COLLEAGUES FOR
THE.
FEDERAL GOVERNMENT ELSE ABOUT I
I I DON'T. KNOW.
SPECIFICALLY WHAT MIGHT CAUSE.
SUCH INSIGNIFICANT.
DELAY IN APPROVAL I OR I MEAN I
KNOW THAT THEY'VE BEEN WORKING.
DILIGENTLY FROM WHAT I
UNDERSTAND.
AND AND I'M TRYING TO GET THAT.
GET THAT PUSHED THROUGH.
DIET TO DO WITH THE MAGNITUDE
OF THAT.
BACKLOG AS AN INFANT FUNDS.
HOPE PROXIMALLY WERE TALKING
ABOUT HUNDREDS OF MILLIONS OF
TALK ABOUT BILLIONS.
MISS CAN'T OF FREEDOM.
SO THE.
.
THERE'S A COUPLE THINGS.
.
THE STATE PLAN AMENDMENTS.
AND THE MANAGED CARE DIRECTED
PAYMENT STRUCTURE PAYMENTS ARE
FAIRLY NEW.
AND SO WHEN WE.
REQUESTED THOSE TO BE APPROVED
LAST YEAR ON WE WERE ESSENTIALLY.
TRYING SOMETHING NEW OUT IT WAS
PART OF THE FEDERAL MANAGED CARE
RULES THEY HAD CHANGED A LOT OF
THE WAYS THAT STATES AND ARE
ABLE TO SET MANAGED CARE RATES
AND.
MEDICAID.
SETTINGS.
SO I THINK THAT.
SOMETIMES WHEN YOU TRY
SOMETHING NEW AND IT TAKES A
LITTLE BIT LONGER I WOULD ALSO
JUST SAY THESE ARE SUPPLEMENTAL
PAYMENTS THAT WE ARE FLOWING
THROUGH.
MANAGED CARE SORE ACTUARIES
HAVE TO BOTH DEVELOP THE RATES
RACIER PAULINE I'M UTILIZATION
ENCOUNTER DATA FROM THE PLANS
BECAUSE WE USE THE PLANTS OWNED.
DATA TO HELP US INFORMED HOW
MUCH WE SHOULD BE GIVING THE
PLANS FOR THE DIRECT PAYMENTS
THEMSELVES. AND IF YOU DON'T
WANT TO GIVE TOO MUCH AND YOU
DON'T WANNA GIVE TOO LITTLE AND
SO THAT'S A PROCESS IN AND OF
ITSELF AND THEN WHAT YOU DO IS
YOU HAVE TO PUT A RATE PACKAGE
TOGETHER WE HAVE.
OVER A HUNDRED.
DIFFERENT RATES AND PACKAGES
THAT WE HAVE ACROSS OUR.
TWENTY FOUR PLANS DIFFERENT
SERVICE AREAS AND WE PROBABLY
SET FOURTEEN HUNDRED.
CATEGORIES OF RATES ACROSS ALL
OF OUR DIFFERENT MANAGE CARRIES
I CAN.
I CAN TALK ABOUT ALL THE
DIFFERENT COMPLEXITIES AROUND
HOW WE SET RATES BUT THEN WHEN
YOU GET THEM TO THE FEDERAL
GOVERNMENT. IT GOES TO THE
FEDERAL CMS PROCESS IT ALSO GOES
TO THE FEDERAL OFFICE OF THE
ACTUARY.
AND THEY ALSO TAKE RATE
PACKAGES.
ANY.
.
IN A PIPELINE.
MENTALITY SO IF YOU HAVE A RATE
PACKAGE HAT HAS BEEN SUBMITTED
AND YOU HAVE OTHER RATES THAT
HAVE BEEN PUT IN BEHIND IT.
THEY WON'T CLEAR ANYTHING OUT
UNTIL THAT FIRST SUBMITTED
PACKAGE THAT'S HOLDING UP THE
REST.
IT'S PROOF SO I WOULD JUST SAY
GIVEN ALL OF THAT IT'S ACTUALLY.
.
IT'S BEEN GOOD THAT WE GOT AS
FAST AS WE HAD WE HAVE SOME RATE
PACKAGES THAT HAVE BEEN THERE.
FOR A LONG LONG TIME.
SO AND THEN ONCE WE GET THEM
APPROVAL WE LOADED INTO OUR
CAPITATION SYSTEM WHICH
ESSENTIALLY SAYS TO THE PLANS
HERE'S THE MONEY THAT YOU'RE
GOING TO BE GETTING.
AND THEN THE FUNDS FLOW AND WE
DRAW THE FEDERAL FUNDING DOWN
BUT I THINK THE OTHER THING THAT
YOU JUST WANT TO BE AWARE OF AND
THIS IS WHAT MAKES FINANCE.
WANT TO GET INTO THE
CONVERSATION IS THE STATE DOES
NOT WANT TO BE PUTTING OUT FUNDS
THAT WE HAVEN'T RECEIVED FEDERAL
APPROVAL FOR JUST BECAUSE
THERE'S A RISK TO THE STATE THAT
WE WOULD OTHERWISE.
IF SOMETHING WERE TO HAPPEN WE
WOULD BE AT RISK FOR THOSE AND
SO THAT SOMETIMES ALSO THE DELAY
IS THAT WE WON'T.
FOR THE FUNDS UNTIL WE HAVE
RECEIVED FEDERAL APPROVALS IN A
LOT OF THE LEGISLATION IS
INCUMBENT. ON US NOT PROVIDING
PAYMENT UNTIL FEDERAL APPROVALS
HAVE BEEN SOUGHT RECEIVED
ACCUSES THE DINNER IS NOT EVEN A
GUARANTEE THAT WE'RE GOING TO
GET THE MONEY NUMBER ONE. AND
DOES AND SOUNDS LIKE IT'S NOT A
STATUTORY FEDERAL DEADLINE TIME
TO FULFILL THOSE BLIGATIONS TO
STATES ALL WE KNOW FOR A FACT ON
THESE PROP FIFTY SIX
SUPPLEMENTAL PAYMENTS AT THAT
HAS BEEN APPROVED AND SO THE
PLANTS HAVE. AND WE HAVE LOADED
THOSE DIRECTED PAYMENTS AND AND
SO WHEN I SAID THEY WOULD BE
FLOWING PROBABLY I'M NOT SURE
WHAT THE EXACT SCHEDULE IS FOR
THE MAY CAPITATION PAYMENTS BUT
THOSE ARE COMING. TO THE PLANS
PROBABLY WITHIN THE NEXT WEEK OR
SO. ON THOSE WILL BE.
FOLLOWING RETROACTIVELY BACK TO
JULY I'M SO THOSE FUNDS ARE
ASSURED BUT.
THERE'S NO REAL TIME FRAME.
FOR MANAGED CARE IN TERMS OF
YOU KNOW I THINK WE HAVE GENERAL.
TIME FRAMES THAT WE LIKE TO SEE
RATE PACKAGES.
APPROVED WITH THE FEDERAL
GOVERNMENT BUT THERE'S NO
GUARANTEE IT'S NOT A YOU KNOW IF
YOU DON'T APPROVE IT IS DEEMED
APPROVED THAT'S NOT THE PROCESS
THAT WE HAVE WITH THE FEDERAL
GOVERNMENT AND THEN FOR STATE
PLAN AMENDMENTS.
BRETT
ON THERE'S USUALLY A NINETY DAY
PROCESS SO WE SUBMIT A STATE
PLAN AMENDMENT THEY HAVE NINETY
DAYS TO EITHER ACCEPT OR RESPOND
AND THEN. I'M STATE PLAN
AMENDMENTS.
TYPICALLY IF THEY'RE FAIRLY
SIMPLE DON'T TAKE LONGER THAN
NINETY DAYS BUT WE ALSO HAVE
STATE PLANE AMENDMENTS GIVEN IF
THERE'S.
ADDITIONAL COMPLEXITY ARE
CONCERNED CAN TAKE MONTHS IF NOT
YEARS DEPENDING ON THE STATE
PLAN AMENDMENT.
AND SO IT IS ALSO A IS ALSO A
FUNCTION OF THE OF THE FEDERAL
GOVERNMENT'S.
FISCAL A CALENDAR WHICH IS A
LITTLE BIT DIFFERENT THAN THE
STATE'S FISCAL CALENDARS. MADE
NO I JUST THINK.
CALIFORNIA HAS A VERY.
WE HAVE A VERY COMPLICATED.
CAPITATION STRUCTURE WE FLOW A
LOT OF SUPPLEMENTAL PAYMENTS
THROUGH OUR MANAGED CARE PLANS
SO THE PROP FIFTY SIX.
PAYMENTS ARE ONE OF SEVERAL
SUPPLEMENTAL FUNDS THAT WE FLOW
AND SO ONCE YOU START TO ADD A
LOT OF. THOSE ADDITIONAL ITEMS
IN IT JUST THERE'RE.
WANTING TO BE CAUTIOUS ON THEIR
SIDE JUST AS MUCH AS WE WOULD
WANT TO BE CAUTIOUS ON OURS
GIVEN THEN NUMBERS AND SO.
QUESTION SOMETIMES
MEAN THAT THEY'RE JUST TRYING TO
MAKE SURE THAT THEY ARE
APPROVING SOMETHING THAT IS NOT.
EITHER INAPPROPRIATE OR POINTS
YOU KNOW FEDERAL FUNDS AT RISK
TOO SO IT IT IT'S YOU KNOW IT'S
BILLIONS AND BILLIONS AND
BILLIONS OF DOLLARS AND SO I I
CAN APPRECIATE WHY THEY
SOMETIMES TAKE A LITTLE BIT
LONGER ALSO APPROVED THOSE.
OKAY THANKS FOR EDUCATION.
I THINK IT'S UNDERMINING.
THANK YOU MISTER CHAIR I DON'T
THINK ALL THE WITNESSES FOR YOUR
TESTIMONY. NAM I DID OF QUESTION
OF FROM A STREET WITH A RELATED
SOME OF THE PLANNED PARENTHOOD
SERVICES.
I BELIEVE YOU REFERENCED A
REIMBURSEMENT RATE IS TEN NINE
TWOONE. ON NINETY ONE IN TERMS
OF DAY THAT ESTIMATED IN TWO
THOUSAND SEVEN YOU TO A YOU
ISSUED A STUDY THAT SHOWED THAT
FOR EVERY DOLLAR WE INVEST
IN FAMILY PLANNING. THE STATE
SAVES THE PARKS WINNING NINE
NINE DOLLARS AND TWENTY FIVE.
CENTS BASED ON THE SAVINGS
PROJECTED SAVINGS FROM THE
INVESTMENT.
AND QUITE STICK CURRENT STATUS
OF.
FEDERAL REIMBURSEMENT FOR
PLANNED PARENTHOOD SERVICES
EXCLUDING ABORTION SERVICING IT
SO AS YOU REMEMBER TED TEN TEN
OF THE FIFTY MILLION SET ASIDE
WENT TO ABORTION SERVICES WHICH.
I'M WE.
BUT PARENT HAD I'M PARTICIPATES
IN THE END OBVIOUSLY THAT
PROGRAM THE OTHER FORTY MILLION
IS.
WE'VE BEEN ACCESSING THROUGH
FAMILY PACK.
I WILL SAVE MUCH LIKE.
THE OTHER WITNESSES WE STILL
WHERE WE ARE IN THE TEN MONTH
DELAY BUT I DIDN'T WANT I REALLY
COMPLIMENT.
DAD JENNIFER CAN SET LEADERSHIP
AND MAKING SURE THAT WE'RE ABLE
TO ADDRESS THAT I THINK.
PART OF THE ISSUE IS AGAIN THE
HOWL AND SHE BY WELCOME HER
CORRECTION IF IF IF I AM I MATT
MISTS CHARACTERIZING IT BUT IT
REALLY AT THIS POINT IT'S NOT
THE FEDERAL GOVERNMENT AND IT'S
NOT ANYTHING THAT THE DEPARTMENT
IS DOING ITS LITERALLY.
PAYMENT SYSTEM THAT HAS BEEN
BUILT SYSTEM AFTER SYSTEM IN.
THOUSANDS OF LITTLE SYSTEMS
COBBLED TOGETHER AND IT'S IT
DOESN'T.
ALWAYS WORK THE WAY WE WANT IT
TO. SO WHAT'S REALLY REQUIRED SO
THAT THE THE POINT I'D MAKE
THOUGH IS THAT. I I WILL SAY I
THINK WE FEEL MORE CONFIDENT
THAN WE HAVE BEFORE IN THE
DEPARTMENT WHEN THEY'RE LETTING
WHEN WE'RE SEEING SOME OF THE
PAYMENTS START COMICS WE HAVE
HAD SOME OF THE PAYMENT START
BUT IT'S. BUT THEY'RE STILL
ABOUT TWENTY MILLION DOLLARS OUT
OF THE EIGHTEEN POINT SIX
MILLION KUN IS A REMINDER. WHAT
PERCENTAGE OF PLANNED PARENTHOOD?
OUR HEALTH SERVICES NOT RELATED
TO ABORTION.
I'D NINETY NINETY EIGHT PERCENT.
AND ROUGHLY HOW MANY. PEOPLE ARE
YOU SERVING IN THE STATE OF
KELLY WE SERVE NEARLY EIGHT
HUNDRED THOUSAND AND I THINK
WHAT'S ALSO SIGNIFICANT. IS THAT.
NATIONALLY PLANNED PARENTHOOD
SERVES TO POINT FOR MILLIONS OF
THE TO SAY IT REALLY SHOWS YOU
HOW IMPORTANT CALIFORNIA AYE IS.
IN ANY.
A. UPDATES ON.
RISK OF FEDERAL SUPPORT FOR
PLANNED PARENTHOOD AND I DON'T
HAVE A CRYSTAL BALL BUT.
WHAT'S THE CURRENT STATUS OF
WE'VE HAD SOME.
I'D.
YESTERDAY THERE IS A GREAT JOB.
COURT CASE OR AN INJUNCTION THAT
I ISSUED BY JUDGES IN SPOKANE
FOR TEEN PREGNANCY PREVENTION
AGAIN THAT'S A GREAT EXAMPLE
CALIFORNIA ONLY RECEIVES THREE
HUNDRED THOUSAND DOLLARS OUT OF
THE THREE HUNDRED MILLION.
ONLY GIVEN.
BUT WITHOUT MONEY WE SERVE.
TWENTY FIVE THOUSAND IT FOR
EXAMPLE IN LOS ANGELES TWENTY
FIVE THOUSAND LATINO FAMILIES
ARE ABLE TO RECEIVE HEALTH
EDUCATION SO THESE ARE REALLY
SIGNIFICANT FINDS AN UNFORTUNATE
WHAT WE'RE SEEING IS THESE AND
SAID YOU. INSIDIOUS ATTACKS I
THINK DAM WILL BE TALKING ABOUT
TITLE TEN QUITE A BIT WITH YOUR
OFFICES.
WERE ABLE TO NOT ONLY ACCESS.
I'VE I'VE EDUCATION FUNDING
THROUGH THAT ALSO THREE FORTY BE
WHICH IS ANOTHER TOPIC I KNOW
WE'VE DISCUSSED SO THE POINT
BEING A ADAM THAT'S IMPORTANT
FOR ALL OF US TO REMEMBER AS A
KID AND IT'S ALL THE SMALL
ATTACKS ARE NOT SEEING AS MUCH
OF THE. HUGE DEFINED ATTACKS AS
WE SAW LAST UMMER.
AND LATE LAST FALL BUT THERE
STILL IS A MANY ATTEMPTS FROM
THE FEDERAL GOVERNMENT TO
PREVENT.
PONDERED IF RECEIVING ANY
SERVICES IN ANY AND PARTICULARLY
IN THE FAMILY PLANNING
INVESTMENTS.
THAT SPRING ONE OF THE KEY
INVESTMENTS THAT SAVES.
OUT HERE DOLLARS DOWN FOR MONDAY
AND AND AND AND AND.
MAKING SURE THAT EVERY PREGNANCY
IS INTENDED I'M AS SUCH AS
SAVINGS AND I AND I WANT TO
EMPHASIZE AGAIN FOR THIS BUDGET
COMMITTEE I KNOW WE NEED TO TALK
ABOUT. THE FINANCIAL SAVINGS BUT
IT'S ALSO THE SOCIAL COSTS IN
THE ECONOMIC AND THE SOCIAL
COSTS ON PEOPLE AND AS WE. THINK
ABOUT AND I KNOW ALL OF YOU ARE
THINKING IN THIS BUILDING ABOUT
CULTURE AND WOMEN AND. EQUITY
AND YOU PUT THOSE ISSUES
TOGETHER AYE WE CANNOT EMPHASIZE
ENOUGH THAT IT REALLY DOES START
WITH HEALTHY RELATIONSHIPS AND.
THANK YOU THANK YOU MISTER
CHAIRMAN AGAIN I THANK ALL THE
WITNESSES AND. THANK THE
DEPARTMENT AS WELL FOR HELPING.
DEAL WITH THESE BUREAUCRACIES
AND KEEP THE MONEY FLOWING THANK
YOU.
OKAY THANK YOU.
SO FEW QUESTIONS AS WELL AND I
THINK PANEL FOR BEING HERE.
SO FIRST OF ALL JUST TO CLARIFY
ON THE ME FOR DIRECTOR ON ON THE
VARIOUS ON THE WAIVERS AS WE'VE
GOTTEN THROUGH FOR THE FEDERAL
GOVERNMENT. A.
ARE THE DO WE HAVE TO RENEW THEM
NEXT YEAR WHAT'S THE STORY I AND
SO I MEAN WE.
IF YOU'RE TELLING ME WE'RE JUST
GONNA GET THE PASSAGE OF THE THE
MANAGED CARE FOR THE MANAGED
CARE PLANS AND THEN THE NEXT DAY
YES MONTH THERE SO. THAT IS THE
W. HAVE ANOTHER HOLE AND THEN
START UP AGAIN OUTHOUSES GOING
TO WORK ENTERED OUR OURS THAT
MONEY.
BE ABLE TO KEEP FLOWING AMONG
THEM TIMING WISE FEEL THEY KEEP
DOING THAT ARE GOING TO BE
LURCHING HERE FROM HERE ON IN
TERMS F PAYMENTS COMING DOWN TO
PROVIDERS.
SO THE SO THE STRUCTURE
ACCORDING TO THE GOVERNOR'S
JANUARY BUDGET WAS THAT.
WE NOT ONLY.
SAYS
PROPOSED I'M ADDING ADDITIONAL
PROPOSITION FIFTY SIX FUNDING
BUTTON FOR THAT WE WOULD BE
CONTINUING THE FUNDING AS WAS
NEGOTIATED BETWEEN THE
ADMINISTRATION LEGISLATURE LAST
YEAR. THEY ARE CONSTRUCTED AS
ONE YEAR SUPPLEMENTAL PAYMENTS
AND SO WE WOULD HAVE TO GO BACK
IN TO RECEIVE.
APPROVAL FOR FEDERAL FUNDING
STARTING ON JULY FIRST OF TWENTY
EIGHTEEN THROUGH JUNE THIRTIETH
OF TWENTY EIGHT NINETEEN SO.
AGAINST MY KIND OF POINT
EARLIER WAS THE ONCE THE FEDERAL
GOVERNMENT GETS YOU SEEN THESE
AND WERE ESSENTIALLY JUST RE
SUBMITTING A PROPOSAL TO SAY WE
WANT TO DO AN ADDITIONAL. ONE
YEAR OF THIS PROPOSAL AND AS AS
LONG AS IT'S EITHER GENERALLY
SIMILAR OR ALMOST IDENTICAL. WE
THINK ABOUT KIND OF ALLOWS FOR A
LOT MORE AND.
EASE IN TERMS OF THE
ADMINISTRATION OF THE FUNDING.
AND AGAIN.
I THINK THAT WHAT YOU WILL AND.
SEE IN THIS WOULD OBVIOUSLY BE
IN FURTHER DETAIL IN THE
GOVERNOR'S MAY REVISION IS.
.
IF THERE ARE ADDITIONAL FUNDS
THAT NEED TO BE SPENT I THINK WE
WOULD BE WANTING TO WORK WITH
THE LEGISLATURE AND OTHERS TO
KIND OF EITHER.
TARGETER OTHERWISE IDENTIFY.
YOU KNOW SELECTED MECHANISMS
WITH THE YOU KNOW KEY CAVIAR IS
AS IT ALWAYS REQUIRES FEDERAL
APPROVAL IF YOU WANT FEDERAL
FUNDING. AND THAT THE MORE
COMPLICATED IS I'M SOMETIMES THE
HARDER IT IS FOR US TO
ADMINISTER SO WE REALLY WANT TO
STRESS.
BUT WHATEVER WE CAN DO IN TERMS
OF ADDITIONAL FIFTY SIX DOLLARS
THAT WEWOULD LIKE IT DONE IN A
WAY THAT.
IS AS EASY AS POSSIBLE SO THAT
WE DON'T HAVE UNNECESSARY DELAYS
OKAY APPRECIATE NO THERE'S SOME
CONCERN BECAUSE THIS IS A IT
WOULD DO IS A YEAR BY YEAR THAT
YOU END UP OF THE SITUATION
WHERE.
IT STOPS THE GOES IT STOPS AND
EVEN IF YOU DO A RETROSPECTIVE.
AGAIN THAT. WHEN.
IN THIS ROOM WE KINDA UNDERSTAND
THAT AND WE CAN TALK ABOUT IT
BUT OUT THERE WITH YOUR TO
PROVIDER GETTING PAYMENT AND
YOU'RE GOING TO GO UP AND DOWN
AND UP AND DOWN DEAL PEOPLE TO
SAY.
AND THEY ARE PLENTY OF OTHER
PATIENTS THERE LIKE OKAY.
LEADS TO THE QUESTION FOR CM A.
SO YOU MENTIONED A TEN PERCENT
CUT I WAS AROUND THE LEGISLATURE
WE HAD TO DO THAT.
.
I KNOW THAT FOR PROP FIFTY SIX
WE ARE DOING TARGETED SO WE'RE
NOT DOING ACROSS THE BOARD. IN
ARE TARGETING ARE WE BRINGING
PEOPLE HAS UP PASSED THE TEN
PERCENT CUT AND WOOD I KNOW SOME
SOME SERVICE SO THAT WE TEN
PERCENT CUT ARE WE I MEAN IT'S
HOW MUCH OF AN UP OR.
GETTING. UP FROM YOUR
PERSPECTIVE OR YOU GET A.
YES I THINK THAT THERE FROM MY
UNDERSTANDING.
IT IT IS BRINGING THOSE RATES
UP.
.
TO THAT A TO THE.
I DON'T OF ITS TO THE PREVIOUS
LEVELS BUT IT IS BRINGING IT UP.
AND MAKING UP IS WHAT I'M OF
THAT SOMEBODY ABOUT IT WHETHER
WE WERE GETTING TO. ACTUALLY
EVEN.
TO THE PREVIOUS ARE EVEN PASSED
THAT ARE WE STILL GOING TO NOW
BE LOW WELL THE CUTS ARE STILL
BEING IMPLEMENTED SO THERE I
MEAN THEY.
MEANWHILE THE PATRICK THE SIXTH
HOW RIGHT IT STILL LOWERS AREAS
AT THE RATE PARTICIPATING AS
COMEY COMING THROUGH FOR THE
TARGET ONES ARE WE GETTING AXED
BECAUSE EVEN BEFORE EVEN BEFORE.
NOW WE HAVE ACCESS IS
SO WHERE WILL.
BUT IF THE LAR COMMENTS.
WE WE DID REVIEW THE THE RATE
LEVELS AND IT LOOKS LIKE THEY
WERE AROUND TWENTY TO FORTY FIVE
PERCENT DEPENDING ON THE ACTUAL
BILLING CODE AND. AB NINETY
SEVEN MY UNDERSTANDING WAS A TEN
PERCENT CUT SO.
IT IS OPENED OF WHATEVER THE
RATE WAS BUT.
YET TWENTY FORTY FIVE TO FORTY
FIVE PERCENT ON EACH OKAY SO WE
ACTUALLY ARE AT LEAST FOR THE
TARGET ONCE AFTER.
PASSED THE PREVIOUS CUTS ARE NOW.
THAT THAT WOULD BE MY
UNDERSTANDING FROM ABOUT WHAT I
KNOW ABOUT THE RATE INCREASES
ARE THE REALLY SUPPLEMENTAL
PAYMENT INCREASES FOR THE
INDIVIDUAL CODES. OKAY AND THAT
POINT OUT EVEN BEFORE THE TEN
PERCENT CUT DOOR NUMEROUS.
BODIES RESEARCH SHOWING ACCESS
PROBLEMS LOW PARTICIPATION RATES
BELLS PRETENSE PERCENT CUTS OF.
AND THEN I GUESS THE. OTHER
QUESTION I HAVE SIDE THAT
ACTUALLY BUT I APPRECIATE YOU
BEING HERE.
ATTY JUST REMIND ME OF WHAT
PERCENTAGE OF THE TOTAL YOU SEE
BUDGET IS YOU SEE HEALTH.
WITH THE MEDICAL CENTERS
THEMSELVES WHICH OF THE
HOSPITALS ARE ONE THIRD IF YOU
INCLUDE THE OR THE RESEARCH
REVIEW THE CONTENT OF THE HEALTH
PROFESSIONAL SCHOOLS IT'S
PROBABLY CLOSER TO FIFTY PERCENT
OKAY SO I JUST. I KNOW WE'RE NOT
BUDGETS OF ONE.
BUT I WOULD POINT OUT YOU'RE
TALKING THAT'S WHY I WANT YOU
HERE BECAUSE NORMALLY YOU SEE.
PRECEDE DIDN'T BUT RECOGNIZE.
AND I THINK IN YOUR TESTIMONY
YOUR MAJOR PROVIDER AND
FINANCIALLY.
THIS I MEAN ANDRETTI HOW MUCH IS
YOU SEE GET FROM OUR STATE
BUDGET.
UP FROM THE STATE OVERALL
GENERAL AT THE TOTAL WAS.
TOM I HAD.
BUT.
RIGHT NOW YOU'RE TELLING ME
THERE IS A NINE HUNDRED MILLION
DOLLAR.
ON THE SAND WATER TAKING BETS
ARE GIVING WITH ONE HAND THEY
WERE TAKING AWAY HERE THIS
COMMITTEE.
THE NINE HUNDRED MILLION BECAUSE
OF OUR RACE ISSUES.
WRECKED CORRECT OKAY SO ALMOST A
BILLION OKAY DISTANCE JUST
KEEPING THAT MIGHT.
.
SO YOU KNOW WHERE I GUESS I
WOULD COMMITTEE IT'S TAKING AWAY.
EARLY.
THAT LOOKED AT THE LAST
QUESTION. TWO HUNDRED MILLION
CHANGE IN ONE YEAR WHAT WHAT
HAPPENED IS IT MORE MEDI CAL
PATIENTS SO WHAT WHAT WHAT WHAT.
IT'S ONE YEAR
MANY VOLUME BOTTOM OKAY AND AND
I BUILDING A HOUSE HAVE TO ASK
WHATEVER COMES THE HEALTH CARE.
THIS IS THIS IS.
COST NOT BILL AB NOT CHARGES
BECAUSE PEOPLE SAY THERE'S NO
YOU CAN CHARGE THIS BUT THIS IS
ACTUAL LOSS IN TERMS OF ACTUAL
COSTING IT OUT. BECKY CORRECT
TOOK COSTS RIGHT IT'S NOT
BECAUSE YOU SEE BILLS THIS MUCH
WE DIDN'T COLLECT. OUR TOTAL
CHARGE THIS IS ACTUAL COST TO
USE THAT TO.
OKAY BOTH TOOK THE VOLUME IS A
LARGE BUT THE OTHER PART IS YOU
SEEN CIRCUIT MEDICAL PATIENTS
OAK PURER OKAY. NAM AND THEN THE
OTHER THING AND I APPRECIATE THE
FOCUS. UC DAVIS OBVIOUSLY.
REMEMBER THERE IT'S IN MY
DISTRICT.
AND WHEN THE THINGS THAT WE'RE
REALLY TRYING TO WORK ON IS AND.
IS IS AND I KNOW THAT AND FIRST
WHILE I THINK THE FACT THAT. FOR
EXAMPLE UCSF AND SEVERAL THE
OTHER YOU SEE THAT ACTUALLY DO
TAKE.
FULL SCOPE MEDI CAL PRIMARY CARE
CENTER. UC DAVIS TOM HAD AND I
KNOW WORK TRYING TO MOVE IN THAT
DIRECTION WITH THE. ONE CONTRACT.
DIDN'T DO YOU KNOW HOW MAY.
COVERED LIVES UC'S TAKING ON
TERMS IF THERE GMC MEDI CAL
CONTRACTS IN TERMS OF THOUGHT.
THAT FROM PRIMARY FOR BASICALLY
DOING FOR PRIMARY CARE AND
SPECIALTY DEAN HAD.
WELL TO COUNTRY WORLD IN THE
CONTRACT THAT COVERS MEDI CAL
PATIENTS THAT DAVIS HAS IS ONE
ANTHEM WHICH IT HAD FOR SOME
TIME AND THEN THE RECENTLY
SIGNED UNITED CONTRACT.
I DON'T RECALL THE EXACT NUMBER
OF MEDI CAL PATIENTS THAT ARE
COVERED UNITED COUNTRY GOODS TO
THE UNITED PATRICK I CAN GET
THAT IF.
OKAY YEAH THAT THAT'S IN IT THAT TOOK A STEP TOWARDS THE FAIRLY
SMALL NUMBER SO I HOPE THAT I
THINK I THINK THAT IS CORRECT TO
USE BUT IT'S JUST YOU HAVE TO
START. OKAY WE DO SEE MEDI CAL
PATIENTS AGES THE FQHCS EN AND
OTHER CLINICS.
YES AND I AND I APPRECIATE THAT
COLLABORATION AS WELL.
AND THEN I GUESS IN TERMS OF.
ACTUALLY.
FROM A STRAIGHTENED PARA DON'T
ONE WE WERE TALKING ABOUT THIS
LAST YEAR.
UNFORTUNATELY I THINK AS YOU
CAME ON A CEO.
TO PLAN PAIRED CLINICS WERE
ACTUALLY CLOSING.
WE HAD A NOW WAS A PLAN PAIRED
CLEARLY REPRODUCTIVE HEALTH
CLINIC HERE SACRAMENTO CLOSE MY
VERY OWN DISTRICT.
SO JUST TO REMIND EVERYONE THAT.
WE WERE IN A SITUATION WAS IT
JUST THAT PEOPLE WERE LOSING
MONEY PEOPLE ARE CLOSING. YEAH
JESUS SPEAK TO NOW THAT WITH THE
AND I REALIZE THAT WE'RE STILL
TRYING TO GET SOME THE MONEY
TRICKLED THROUGH I MEAN ARE
THERE ARE WE ABLE TO.
STABILIZE AT.
AND I WANT TO SAY I THINK BY
BENEFIT FOR PLAN
IT IS BECAUSE WHERE I SEVEN
AFFILIATES IN CALIFORNIA AND.
WHO BUILDS I THINK INTO QUITE A
BIT OF STRONG RELATIONSHIPS WITH
MANY OF YOU AT YOUR CONFIDENCE
AND THAT THE MONEY WILL COME AYE
I CAN'T STRESS ENOUGH?
ON MY A ECHO WAIT ON THE CHARITY
SAID ABOUT PROVIDERS AND BEING
WORRIED AT THE END OF THE LINE
AND I THINK THE OTHER
SUBSTATIONS FACE THAT A LITTLE
MORE THAN WE DO BECAUSE OF THE
TRUST THEY HAVE BEEN YOU ALL OF
YOU. AND I DO WANT TO THANK YOU
FOR THAT.
WHAT
SO KNOWING THAT THIS MONEY
BELIEVING THAT THIS MONEY?
IS IS FLOWING WHAT WHAT I
REALLY HOPE YOU ARE AT WERE
EMPHASIZING IS THAT STOPPING THE
BLEEDING.
THERE'S BEEN QUITE A FEW.
.
WAIT WHEN THEY ATTEMPTED
EFFICIENCIES AND BUILDING AROUND
EFFICIENCIES AND TO THE AS AGAIN
EVERY PROVIDERS BEEN THROUGH
THAT AND AS WE KNOW. I THINK
WHAT WE'RE NOW BE ABLE TO DO AS
I AS I'VE EMPHASIZES THAT ALSO
THINK ABOUT WAS A FOR EXAMPLE WE
HAVE A.
.
I.
THE I A HEALTH CENTER THAT WAS
ABLE TO ADD TO CLOSE DOWN SO
THAT WE CAN OPEN AND VALLEJO
WHICH HAS A MORE OF A POPULATION
IN IN CAN BE CENTERED SO WHAT
WE'RE NOW ABLE TO DO. IS.
FRANKLY MAKES A LEMONADE MAKE
TAKE SOME OPPORTUNITIES TO LATIN
SHUFFLE THINGS AROUND BUT REALLY
I WE HOPE TARGET POPULATIONS BUT
THAT WOULD ONLY HAPPEN WITH
THESE.
OUT WITH THIS ADDITIONAL
FUNDING AND REMINDING EVERYONE
WE WE ARE DOING OUR BEST NOT TO
BE DRAMATIC AND NOT TO.
.
I SIMPLY.
.
HIGHLIGHT WHAT'S HAPPENING ON
THE AT THE FEDERAL LEVEL BUT IT
IS IT IS IT IS VERY TOUGH I MEAN
IT IS THAT WE ARE EIGHTY PERCENT
OF THE PATIENTS WE SERVE. OUR
MEANS TESTED IN SOME WAYS YOU
KNOW AND I'M THEY WE REALLY ARE
TEETER ON THE MARGINS SO. THAT'S
WHY I EMPHASIZE THE THREE
PERCENT THAT IT.
GETS KIND OF CAUGHT UP IN THE
PROVERBIAL RED TAPE AGAIN I
DON'T EXPECT.
A BILLING SYSTEM TO BE
CORRECTED IN A YEAR OR SOMETHING
THERE SOMETHING TO BE FIXED BY
REALLY HOPE THAT WE CAN START
HAVING THOSE CONVERSATIONS.
I. AND THEN.
FOR DOCTOR LUTHER.
AND WE WE ARE SPEAKING I WOULD
RETURN OR TALKING ABOUT
REIMBURSEMENT BICU DID MAKE
REFERENCE
TO.
US ALSO SERVE THE OVERHEAD PART
RIGHT SO WHAT HAPPENS IS THAT
THE GAME PROVE WILL AFFECT ONLY
A CERTAIN PERCENTAGE OF PATIENTS
ACTUALLY.
PROCEDURE DONE I KNOW THIS IS
BEEN BROUGHT UP BEFORE.
I ADDED THAT THE DIRECTOR
TESTIFIED FLIPS OF CHANGING THE
WAY WE ADMINISTER IT WE HAVE TWO
DIFFERENT THAT HAVE AND WE GOT
TO BE ABLE TO FIX THAT SITUATION.
AND SOME WAY WHERE INSTEAD OF
TELLING DANA CAO UNLIKE. AT
OTHER PATIENTS FOR YOU COME AND
YOU HAVE A CAVITY WE FIX IT WE
FELT. SAID SAYING A WELL NOW
WILL HAVE TO COME AND WE HAVE TO
SEND ALL THE PAPERWORK AND.
SEND YOU HOME AND THEN. SEE WE
APPROVAL AND THEN BRING YOU BACK
AGAIN TO TRIPS ETCETERA ONE
EVERY EVERY GONNA BILL FIX THAT
SITUATION.
I'M SO I WOULD SAY NOT ENTIRELY.
SO WE HAVE TREATMENT
AUTHORIZATION REQUESTS IN PLACE.
AND COMMERCIAL DENTISTRY HAS
CERTAIN.
TREATMENT AUTHORIZATION
REQUESTS FOR SNOW AND SO WHEN I
SAY NOT ENTIRELY AS IT WERE NOT.
EVER GOING TO REMOVE CERTAIN
UTILIZATION CONTROLS IN THE
PROGRAM I THINK THAT THERE ARE
IN THE EXTENT TO REMOVE YOU
DECISION CONTROLS TO MAKE THEM
MORE WORKABLE SPECIALLY FOR THE
PATIENT PERSPECTIVE SO.
WE'VE RECENTLY GAVE A DIRECTIVE
TO OUR ADMINISTRATIVE SERVICES.
ENTITY TO DECREASE THE AMOUNT
OF TIME THAT THEY HAD
TO DO I'M TREATMENT
AUTHORIZATION REQUESTS.
I WILL I CAN LOOK AND.
SEAT WHAT THE DATE OF THE DROP
OR WHAT THE TIMEFRAME WAS AND
THEN TO OUR DENTAL MANAGED CARE
PLANS WE ALSO INSTRUCTED THEM.
TO TURN OUT TREATMENT
AUTHORIZATIONS IT I REQUEST
AROUND WITH AND I THINK IT WAS
THREE BUSINESS DAYS AND SO
THEY'RE WELL UNDER THOSE.
REQUIREMENTS
SO WE REQUIRE.
CERTAIN STANDARDS TO BE MET
WHEN WE GET A TREATMENT
AUTHORIZATION REQUESTS IT WON'T
NECESSARILY CORRECT THE YOU KNOW
ISSUE OF A PATIENT GOES AND
THEY'D REQUIRE PROCEDURE THAT
REQUIRES A TREATMENT
AUTHORIZATION REQUESTS.
THE DENTIST WILL HAVE TO ASK FOR
PERMISSION WE HAVE COMMITTED TO
INCREASING THAT TURN AROUND FOR
APPROVAL WITHIN A CERTAIN NUMBER
OF DAYS AND IT'S NOT. VERY MANY
I'M BUT THE PATIENT DOES HAVE TO
COME BACK FOR A SECOND PROCEDURE
OKAY NXT THAT THOSE SO THE
DIFFICULTY IS SAY IT DOESN'T
MATTER SO MUCH WHETHER IT'S
THREE DAYS OR FIVE DAYS ONCE
THAT. ONCE THE DAN ECHO PATIENT
LEAVES A IT'S DIFFICULT.
TO GET THEM TO RETURN.
OUR OUR PREFERENCE.
CERTAINLY THESE ARE DONE FOR
PROGRAM INTEGRITY. OUR
PREFERENCE WOULD BE UP BACK AND
REVIEW IF POSSIBLE JUST TO.
TO EXPEDITE.
BUT I PATIENT TREATMENT YEAH I
MEAN I THINK THERE'S A WAY.
THAT YOU CAN DO IN THE BACK AND
FRANKLY IF SOMEONE IS IF YOU
HAVE AN OFFICE THAT. IS HAVING
LARGE NUMBERS OF PEOPLE AS
YOU'RE DOING BACK AND REVIEW.
THEN HE THERE'D THEN THEY GET
PUT INTO A DIFFERENT FRONT END
REVIEW ARE YOU HOW THE SYSTEM
KIND OF THING. AND AGAIN IF YOU
HAVE A REALLY EXPENSIVE
PROCEDURE I COULD SEE WHERE IT'S
GONNA BE ANYWAY GETS ME MULTIPLE
VISITS OR WHATEVER MULTI STAGED.
BUT SOME OF THEM IF YOU DON'T.
DO IT AT THE POINT A SERVICE I
GIVE THERE'S A WAY THERE'S
INCIDENT YOU KNOW ELF THAT IN
ITS REVIEW OR BACK AND REVIEW.
THE SOONEST WRITES THIS IT'S CUT
WHILE ESOS I KNOW THE CAR DEALER
TIRES UNTIL THE CAR YOU KNOW
WHAT THE CUSTOMER LEAVE RIGHT
BECAUSE AS SOON AS THEY LEAVE
THE LIKELY OF COMING BACK.
EVEN AND SAME SITUATION ANY OF
ANY TIME I HAVE TO SEND THE
PATIENT POUTS AND EXPECT THEM TO
BACK FOR FOLLOW UP.
DON'T YOU HAVE A BIG DROP IN
TERMS OF FOUGHT EVEN FOR
SOMETHING THAT THEY WANT TO SEE
LIFE CATCHES UP BUT SEPARATE
TYPES OF THINGS SO. IT'S A POINT
OF SERVICES THAT IT ISN'T IS
REALLY IMPORTANT IN TERMS OF
ACTION BE SURE YOU CAN CARRY
THROUGH. AND SO. THAT THE LA
AGAIN WE'RE NOT SAYING ELIMINATE
ALL YOU LADIES REVIEW BUT IT'S
IS ABOUT.
.
CUSTOMER SERVICE AND ALSO TRYING
TO TO MEET THEIR NEEDS AS WELL.
SOME HOPING WE CAN MAKE SOME
PROGRESS THERE IN A WAY THAT
ALSO CAN ENSURE THAT.
WE MAINTAIN PROGRAM ATTACKED
HIM TIGHTLY TO BUT I THINK GALA
TO SOME OF THE BAD ACTOR IN A
GOOD ACTORS SHOULD HAVE TO PAY
THE PRICE VISIT PATIENTS OF THE
GOOD ACTORS I SEE THE GOOD
ACCIDENTS A PIECE OF THE GOOD
ACTORS.
THE BAD ACTORS.
MY MIND.
HER UP JUST TO MAKE THE POINT
THAT WE REQUIRE AND THE
TREATMENT TURNAROUNDS TO DROPPED
FROM FIFTEEN TO FIVE BUSINESS
DAYS.
AND THE PLANS THE AVERAGE
PROCESSING TIME.
IS BETWEEN ONE DAY AND ONE AND
A HALF DAYS AND THEN OUR
ADMINISTRATIVE SERVICE
ORGANIZATION IS DOING. TIRES ON
AVERAGE THREE AND A HALF DAYS
TURN AROUND TIME.
OKAY WELL. BUT MAYBE MAYBE SO
THE TRIBE PILOTS DO YOU ACTUALLY
I'D GET BETTER SERVICE NOW HOW
MUCH OF A LOSS YOU REALLY GET
FROM DOING A BACK AND PERHAPS SO.
AND THEN FINALLY I KNOW CAN
ONLY KIDDING EVERYBODY HAVE THE
MOST IMPORTANTLY.
.
STRAND I THINK YOU TALKED ABOUT
TIMELY ACCESS SO I MEAN I KNOW
THAT DE KISSES TESTIFIED AND WE
FASHION PREVIOUS HEARINGS ABOUT.
APPLYING ABOUT THE NEXT EIGHTEEN
STANDARDS.
BUT WHAT HE SEE. AND TERMS AND
SPECIALLY ON SPECIALTY CARE
BECAUSE I THINK OUR MAY HAVE A
COMMITTEE CLINICS WHO PROVIDE
PRIMARY CARE OFTEN.
BECAUSE THEY GET.
KILL THE THREE THIRTY MONEY.
CONSERVE MAKE THINGS WORK LOW
BETTER BUT AND SPECIALTY CARE.
WHAT WHAT WHAT DO YOU THINK ARE
FURTHER STEPS TO BE SURE THAT IS
PROP FIFTY SIX MEETING ITS GOALS
OF TRYING TO IMPROVE ACCESS WE
SEE FROM THE CONSUMER
PERSPECTIVE?
THAT I THINK MISTER I THINK AS
WE STATED EARLIER I THINK ONE OF
THE KEY PIECES WE'D LIKE TO SEE
IS IS GREATER TRANSPARENCY AND
ACCOUNTABILITY AROUND THAT.
UNDERSTANDING WHETHER THESE.
ADDITIONAL MONIES HAVE ACTUALLY
RESULTED IN.
SHORTER WAIT TIMES FOR PATIENTS
MORE.
OF PROVIDERS ACCEPTING INTO NEW
PATIENTS AND I THINK SOME OF THE
TOOLS WE HAVE IN PLACE ARE
THINGS LIKE THE TIMELY ACCESS
STANDARDS. AND SO I THINK THAT'S
WHAT WE'RE SUGGESTING IS THAT
THAT THERE IS SOME LEVEL OF DATA
RIGHT NOW ON.
A LONG WAIT TIMES SHORES OF
SHORTAGES OF PROVIDERS AND SO
CAN WE TAKE THAT AND AND MARRY
THAT WITH ON THIS ADDITIONAL
PAYMENTS AND FIND OUT. IF THERE
ARE.
IF IT'S IF IT'S WORKING AS
INTENDED.
OF.
OKAY ANY OTHER QUESTIONS.
ALRIGHT. OKAY WELL I WANT TO
THANK OUR PANEL HERE SO MUCH FOR
YOUR PRESENTATION.
.
AND THAT REALLY APPRECIATE IT
AND.
APPRECIATED WHEN TAKING TIME I
KNOW YOU CAME IN FROM A RED EYE
IN
FISHERIES. SENIOR.
CERTAINLY YOU'RE TESTS A MAYES
CAN BE VERY IMPORTANT AS WE LOOK
AT BOTH THIS YEAR'S
BUDGET
FORD AS WELL SO.
WHAT WE'LL DO NOW ON THIS ISSUE
IS WE HAVE SEVERAL STAKEHOLDER
PROPOSALS?
THAT WE WERE HERE AND THEN
WE'LL TAKE PUBLIC COMMENTS ON
THIS ISSUE.
SO THE.
WITH C. WE FIRST HAVE.
.
THE CHILDREN NOW TO PRESENT THE
PROPOSAL ON INCREASING PEDIATRIC
PREVENTIVE HEALTH FRED DONALD
SPECIAL BE REIMBURSEMENT WITH
PROPERTIES
IT'S FUNDS.
PETER.
CAMPUS.
WELCOME AND THAT IF YOU CAN KEEP
YOUR PROPOSED. TOGETHER YOUR
PROPOSAL TO THREE MINUTES OR
LESS THAT P. GREAT MOVIE OF
QUESTIONS THERE BE MORE TIED TO
ARTICULATE. WELCOME.
GREAT GOOD MORNING BOB OR GOOD
AFTERNOON I'M MY NAME'S MICHAEL
DAY I'M WITH.
CHILDREN NOW COM AND ON BEHALF
OF THE CALIFORNIA COVERAGE IN
HOPES.
I'M I'M SORRY ON BEHALF OF THE
CHILDREN'S HEALTH COVERAGE
COALITION AND SELLER AB THE
PARTNERS AND TEASED HER. PRESENT
ON A PROPOSAL.
HE'S PROPERTY SIX DOLLARS TO
INVEST IN CHILDREN'S ACCESS TO
CARE. ARM WAS STILL VERY EARLY
IN THE PROP FIFTY SIX EXPERIENCE
FOR THE STATE THERE ARE MILLIONS
OF DOLLARS. IN ADDITIONAL
DOLLARS INVESTED PROP FIFTY SIX
AND WE THINK THIS IS AN
OPPORTUNITY TO TO FOCUS ON
CHILDREN'S ACCESS.
SO THE PROPOSAL I'M HAS THREE
SORT OF PLANKS ONE WOULD BE I.
IT'S TARGETED SUPPLEMENTAL
PAYMENT RATES TURN FOR. COMMON
PEDIATRIC PREVENTIVE SERVICES ON
VIS ACTUALLY MAYBE YOUR FAVORITE
CODES.
DOCTOR PAN.
THESE ARE BRIGHT FUTURE
SERVICES THAT INCLUDE THINGS
LIKE WELL CHILD VISITS
DEVELOPMENTAL SCREENINGS. A
VISION HEARING.
AUTISM SCREENINGS.
IN BIG COMPRISE MOST OF THE
SERVICES THAT MOST KIDS NEED I'M
IN THE SERVICES ARE. REIMBURSING
THAT CALIBRATE SUB MOSTLY RATES
BELOW THE COMPARABLE MEDICARE
RATES. ON THE SECOND PIECE WOULD
FOCUS ON SUPPLEMENTAL RATES FOR
DENTAL SERVICES SPECIFICALLY
FLUORIDE VARNISH APPLICATION IN
PHYSICIAN OFFICES.
BOB AND OTHER PREVENTIVE DENTAL
SERVICES INCLUDING REMOVAL OF
ORTHODOX REFER FORMER FOSTER
YOU'VE.
TARGET INVESTMENTS TOWARDS UNDER
UTILIZED DENTAL SERVICES WE
THINK COULD GO A LONG WAY IN
ADDRESSING THE DATA ACCESS
ISSUES THAT WERE DISCUSSED
EARLIER.
AND THEN FINALLY RECOMMENDED
INCREASE IN THE CALIFORNIA
CHILDREN'S SERVICES RATE FOR CCS
OUTPATIENT SERVICES. I'M IN MY
COLLEAGUES AND I CAN SAY MORE
ABOUT THAT AND THANK YOU FOR THE
OPPORTUNITY.
THE GOOD AFTERNOON MISTER
CHAIRMAN AND MEMBERS OF THE
COMMITTEE KAREN KELLY EXECUTIVE
DIRECTOR.
OF THE CHILDREN SPECIALTY CARE
COALITION I WANT TO THANK YOU
FOR YOUR CONSIDERATION OF THE
STAKEHOLDER PROPOSAL. CSEC
REPRESENTS NEARLY TWENTY FIVE
HUNDRED PEDIATRIC SUBSPECIALTY
PHYSICIANS STATEWIDE
OUR MSSION IS TO ENSURE ACCESS
TO QUALITY AND TIMELY CARE FOR
CHILDREN WITH COMPLEX HEALTH
CARE NEEDS.
IT IS WELL DOCUMENTED IN MANY
SURVEYS AND REPORTS INCLUDING C.
SEC'S MEMBER ACCESS SURVEY THAT
FAMILIES CONTINUE TO FACE
CHALLENGES ACCESSING SPECIALTY
CARE IN CALIFORNIA.
TIMELY ACCESS TO PASS A
PEDIATRIC SPECIALTY IN SUB
SPECIALTY PROVIDERS IS ESSENTIAL.
DELAYS IN CARE COULD NOT ONLY
RESORT RESULT IN POOR OUTCOMES
BUT ALSO GREATER COSTS TO THE
HEALTHCARE SYSTEM.
THE DEMAND FOR PEDIATRIC
SPECIALTY CARE SERVICES IS ALSO
ON THE RISE WITH CHILDREN WITH
MEDICAL COMPLEXITY LIVING LONGER
AND AN INCREASING NUMBER OF
CHILDREN DIAGNOSED WITH
CONDITIONS LIKE DIABETES.
DEPENDING ON THE REGION ANYWHERE
FROM FIFTY PERCENT UP TO EIGHTY
PERCENT A PEDIATRIC SPECIALTY
CARE MEDICAL GROUP PATIENTS ARE
ON MEDI CAL.
WITH MANY ENROLLED IN THE
CALIFORNIA CHILDREN'S SERVICES
PROGRAM WHICH IS STILL LARGELY A
FEE FOR SERVICE DELIVERY SYSTEM
IN THE STATE.
THERE ARE A HUNDRED AND EIGHTY
NINE THOUSAND CHILDREN CURRENTLY
ENROLLED IN CCS AND THESE
CHILDREN HAVE LIFE THREATENING
COMPLEX AND CHRONIC DISEASES
WHERE ACCESS TO SPECIALTY CARE
IS PARTICULARLY VITAL.
WE PROPOSE USING PROP FIFTY SIX
FUNDING TO PROVIDE A TARGETED
INCREASE OF TEN PERCENT TO THE
CCS AUGMENTED RATE FOR
OUTPATIENT CCS PHYSICIAN
SERVICES.
THERE'S NOT BEEN AN INCREASE AND
THE CCS RATE FOR NEARLY TWENTY
YEARS AND THIS WOULD BRING RATES
CLOSER TO MEDICARE AND MOST
NOTABLY. HELPED PEDIATRIC
SPECIALTY MEDICAL GROUPS RECRUIT
RECRUIT QUALIFIED PHYSICIANS
THAT ARE IN SHORT SUPPLY.
AS WELL AS RETAIN TOP TALENT TO
STAY IN PRACTICE HERE IN
CALIFORNIA.
THIS FUNDING WILL NOT ONLY
BENEFIT CHILDREN IN CC US BUT
ALL CHILDREN THAT NEED SPECIALTY
CARE SAID THANK YOU OKAY THANK
YOU. THINK ISRAEL MUCHAS ANY
COMMENTS FROM THE T. S. BELIAU
FINANCE.
QUESTIONS COMMITTEE MEMBERS.
SO THANK YOU FOR YOUR
PRESENTATION ACTUALLY I DID HAVE
A QUESTION.
.
RELATED SO.
ACTUALLY I MEAN I KNOW YOU'RE
THIS ABOUT YOU ASKED ABOUT PROP
FIFTY SIX FUNDS BUT I ALSO POINT
OUT THAT WHEN THE FEDERAL
GOVERNMENT.
.
EXTENDED THAT CHIP.
WE HAD BUDGETED FOR A ABOUT THE
OLD RATE.
SEAT BEING MORE CAUTIOUS BUT
THEY ACTUALLY APPROVED NOT
FOREVER BUT FOR SEVERAL YEARS
HIGHER.
BATCH GREAT ON ON.
CHIPPED
AND.
YOU SPOKE TO THE.
DEFICIT AND.
AND PAYMENT FOR OUR CHALLENGES
OF RECRUITING FOR PEDIATRIC
SUBSPECIALTY. NOW OF COURSE YOU
KNOW WE CAN TALK ABOUT IT IT WAS
SO FORTH I MEAN.
IN TERMS OF.
ADDRESSING THAT PARTICULAR
ISSUE THE TEN PERCENT OF MAYBE
GETTING MEDICARE RATES.
FOR IT TO BE ACHIEVED THAT
THAT IT'S.
WATCHES QUESTION FOR FINANCES
THERE SOME THOUGHT THAT BUT
THAT'S HELP BETS CHILDREN'S
HEALTH CARE MONEY.
SO YOU KNOW THAT'S THE FEDERAL
GOVERNMENT HAS SAID WE WANT TO
DO A BETTER MATCH AND TRY TO
IMPROVE ACCESS AND STATES FOR
PEDIATRIC CARE PEDIATRICS
SERVICES.
THERE'S SOME THOUGHT ABOUT.
YOU KNOW.
AT LEAST GOING FORWARD AT
ANOTHER SOME MONEY FOR DEL COME
FROM LAST YEAR AND SO FORTH
GOING FORWARD. THINKING ABOUT
DIRECTING SOME OF THAT THOSE
FUNDS THAT RELATES OFF YOU CAN
SAIL FUNDS ARE FUNGIBLE IN SOME
WAYS BUT. A INTO A TOWARD DIED
DRESSING THIS. DEFICIT IN.
IT AND TRIED AND ACCESS FOR
PEDIATRIC SUBSPECIALTY OF
PEDIATRIC SERVICES.
.
SO I I THINK THAT YOU'RE RIGHT I
MEAN THE.
WE THINK ABOUT WHAT OUR
PRIORITIES ARE AS A STATE OF THE
LEGISLATURE IN THE
ADMINISTRATION AND AND WERE IN
THE MIDDLE OF BUILDING THE MAYOR
VISION RIGHT NOW SO. I'M YOU
KNOW I DON'T KNOW HOW ALL OF THE
CHANGES ARE GONNA NET OUT IN
TERMS OF EXPENDITURE AND REVENUE
CHANGES INCLUDING THAT THE
CHANGE IN CHIP FUNDING AND SO.
I'M GLAD TO SEE WHAT HAPPENS AND
THEN WE CAN COME TO CONTINUE
THAT DISCUSSION FROM THERE. OKAY
SO I MEAN I WOULD THINK GIVEN I
MEAN THIS WE'VE TALKED ABOUT
TWENTY YEAR LACK OF INCREASE IN
CCS.
OF FUNDING.
REIMBURSEMENT CHANGES CLEARLY.
I MEAN THERE'S BEEN INFLATION
MEDICAL INFLATION RATES ETCETERA.
AND.
THIS IS PM DISRUPTED YET TRICKS
SERVICES I THINK MANY OF THEM DO
QUALIFY FOR CHIPPED.
AS WELL WE GET HANDS.
THAT MAYBE THAT'S SOMETHING TO
LOOK AT IT WILL CALL PROPERTY
SIX OR CHIP BUT ANYWAY BUT I
THINK THAT'S SOMETHING WE
HOPEFULLY CAN LOOK AT SOME.
OKAY.
ALRIGHT IT OF ANY COMES FROM
ALIONA.
NOW ARE EIGHT OKAY.
ALRIGHT THANKS VERY MUCH.
.
BLEARY HEARD ARE ABOUT THE
DENTAL HEALTH SO I NEXT TO
CALIFORNIA WITH ASSOCIATION
BREAST PUMP READING.
WELCOME I MY NAME IS KAREN
FARLEY REPRESENTING EIGHTY THREE
WEEK AGENCIES.
AS THOUGH I CALIFORNIA WITH
DISSOCIATION OR THE SPONSORS OF
THE PROPOSAL. YOU HAVE EXCELLENT
SUMMARY IN YOUR BACKGROUND
INFORMATION I JUST WANT TO
UNDERSCORE A FEW THINGS.
THE REIMBURSEMENT RATES HAVING
NOT BEEN INCREASED IN THIRTY
YEARS.
ARE CAUSING ACCESS ISSUES DME
PROVIDERS OF SAID THEY WON'T
CARRY THEM THEY CAN'T AFFORD TO
CARRY THEM.
IF THEY DO CARILLO THEIR
OFTENTIMES OF A QUALITY THAT IS
CLOSER TO THE RATE THAT THEY'RE
GONNA GET WHICH MEANS OFTENTIMES
THE PUMPS ARE DEFECTIVE.
WE HAVE WOMEN WE HAVE GREAT
SUCCESS IN CALIFORNIA WITH MORE
WOMEN BREASTFEEDING NINETY FOUR
PERCENT OF WOMEN INITIATE BREAST
FEEDING IN THE HOSPITAL.
DURATION RATES ARE INCREASING
WOMEN WANT TO GO BACK TO WORK IN
THE HAVE TO EQUIPMENT THE WORKS.
SO THAT REDUCES OUR
BREASTFEEDING OUTCOMES SO WE ASK
FOR YOUR CONSIDERATION THE
REIMBURSEMENT RATE WE'VE
PROVIDED IN THE RESOURCES.
AN ACTUARIAL ANALYSIS PROVIDED
BY MILLIMAN DENOTES THE VERY LOW.
ANNUAL COST AND COST SAVINGS.
OKAY THANK YOU.
OF COMES FROM THE T. S..
BUT LEO.
FINANCE KNOW ALRIGHT THEN AND
JUST REMIND ME IN TERMS OF.
COMMITTEE MEMBERS OKAY ARE WHO
UP. WHERE'S THE FOR SO WE'RE
ASKING FOR IT WAS THE FUNNY.
WHERE IT WAS FUNDING COMING FROM
BUT WHAT IS THE CURRENT FUNDING
COMING FROM FOR FOR THE BEST
PART IS IT PART IS IT ALSO STAYS
SOME STATE FUNDS OR IS IT
FEDERAL OR JUST?
MEDICARE FUNDS IF IT IS MEDI CAL
SO IT'S COMBINATIONS THAT WERE
ASKING FOR MORE TRIED DRAWN THE
MORE OPEN MAJORITY OF WOMEN OR
IT'S A LITTLE INCOME WOMEN
RECEIVE THEIR SUPPORT THROUGH
MEDI CAL WHICH THROUGH WICK.
WHICH IS SUPPOSED TO BE THE
SECOND PROVIDER SUPPORT AND
THEY'LL CONTINUE TO PROVIDE THE
EXCELLENT SERVICES BUT THEIR
SUPPORT THROUGH THEIR HEALTH.
LACKING OKAY ALRIGHT OKAY THANK
YOU EXTRA MUCH.
OKAY.
NEXT PROPOSAL IS.
AND STUFF FROM SO WE HAVE
REPRESENT FOR SALLY SUN VALLEY
SPECIALTY HEALTH CARE AND HOLY
KIDS SON VALLEY ANTS THE RATE
INCREASE
STANDALONE PS EXIT.
FACILITIES.
WELCOME.
SO FIGURE HAS SPLIT THE TIME
BETWEEN THE TWO OF YOU I THINK.
.
THREE MINUTES TOTAL IF SIR HIGH
MONEY WAS BOB KNIGHT I'M I'M THE
PRESIDENT OF SOME BELLY SPECIAL
BE HEALTH CARE. IT IS A FORTY
FIVE BED PEDIATRIC SUB ACUTE TO
HUNDRED TWENTY EMPLOYEES AND WE
SERVE MEDICALLY FRAGILE CHILDREN
WHO ARE TECHNOLOGICALLY
DEPENDENT. SO MOST OF THEM ARE
COMING FROM ICE USE IN NATAL ICY
USE ON A VENTILATOR. ARE MEDICAL
DOCTORS ARE INTENSE VISTA UCLA.
AYE BOOK MANY OF OUR KIDS RIGHT
NOW OUR BABIES COMING AND.
FOR EXAMPLE THE YOUNGER OF A
TWIN.
WE HAVE NINETY NINE PERCENT
SINCE THIS ANNUALLY AND WE HAVE
A CONSTANT WAITING LIST.
THE DAILY RATE FOR THE
PEDIATRIC SUB ACCUSED NOT
INCREASED IN TEN YEARS.
AS ARE ALL A RESULT OF THIS WORK
FACING ONGOING A GROWING
SHORTFALLS THAT THREATEN THE
ABILITY TO CONTINUE PROVIDING
SERVICES IN THE FREE STANDING
PEDIATRIC.
.
THE SUB ACUTE OR FIVE TIMES LESS
EXPENSIVE THAN THE ALTERNATIVE
WHICH IS AN ACUTE FACILITY WHICH
IS THE INTENT WHEN THIS OUT WHEN
THIS PURPOSE MODEL STARTED IN
NINETY SEVEN. WHICH DO NOT LET
CHILDREN BE TRAPPED IN ACUTE
FACILITIES.
SO WHERE ARE RATE IS ABOUT SEVEN
HUNDRED FIFTY DOLLARS A DAY THE
ICU WAS THREE THOUSAND FIVE
THOUSAND.
THIS PAST YEAR IN TWO THOUSAND
SEVENTEEN WE ALSO WOULD SUBMIT
AUTHORIZATION ENTIRE AND BILL
FOR SUPPLEMENTAL THERAPY AND
FRIEND WE.
THAT WAS A HUNDRED PERCENT.
APPROVED IN BILLABLE UP UNTIL
TWO THOUSAND SEVENTEEN. AND
THERE HAS BEEN SOME ISSUES
WITHOUT WHERE NOW IT'S BEING
HUNG PERCENT DENIED.
THIS WAS A SOLID SOURCE OF
REVENUE FOR US AND PROVIDED
THERAPY TO OUR CHILDREN AND
PROVIDED FUNDING FOR VENT WE
NEED. ALL THOSE THINGS WERE
STILL DOING BUT WE'RE NOT
GETTING FUNDED FOR AND HE JUST
PULLED THE VEIL OFF OUR RATE AND
SHOW THAT IS COMPLETELY
INSUFFICIENT FOR WHAT WE'RE
DOING. GONNA GIVE YOU A QUICK
STORY.
I HAD A FIGHT WE HAD A FIRE NEED
MILE AWAY FROM OUR FACILITY. IN
THIS IN SEPTEMBER THEN WE HAD A
FLOOD.
IT NOT TIME THE FIREMAN CAME IN
SUPPORT PRIDE AMAZING CARE AND
WHERE OF OUR DISASTER PRETTY
PREPAREDNESS WAS OUTSTANDING.
BUT ARE FAR OUR PARKING LOT IS
DESTROYED WE CAN AFFORD TO PAY
FOR IT TO BE FIX.
I CAN CARE FOR MY KIDS.
BUT I CAN'T KEEP GOOD STAFF
IT'S IT'S A CHALLENGE.
ARE THE LAST THING I WOULD SAY
IS THIS IS THAT IF WE CAN'T GET
MORE INCREASE IN THE RATE.
YOU'RE TAKING YOUR YOUR AND THIS
ISN'T CORRECTED IT'S NOT A
SUSTAINABLE MODEL THE
FREESTANDING SUBACUTE IT WILL GO
AWAY.
THANK YOU AN ELECTION THIRTY
SECONDS SORRY.
WHEN EXTEND THAT WITH INNOVATION.
THAT.
THAT MIGHT ON.
SHOULD LIGHTEN UP THERE YOU KNOW
RUNNING STANDARD WITH
INNOVATIONS HEALTH AND UP WE
HAVE. A CHILDREN'S HOSPITAL
NORTHERN CALIFORNIA AND CAMPBELL.
AND SARATOGA SUBACUTE.
CHILDREN'S HOSPITAL HAS A
FREESTANDING SUBACUTE AND IT
ACTUALLY.
IT IS PAINTED A DIFFERENT
BOTTLE A LEVEL.
SARATOGA JUST SO YOU KNOW WE HAD
A VISIT FROM.
THE HEAD OF PEDIATRICS FOR THE
DQ ATSTEP PAD LUCILLE PACKARD
AND HER COMMENT WAS THAT THE
LEVEL OF THE QT.
THAT WE COVER IS AT AT THE SAME
LEVEL OR HIGHER THAN IN THE NICK
YOU ATTACH OF LUCILLE PACKARD AT
HIS FRACTION OF THE COST AND. AS
BOB INTIMATED IF THESE
FACILITIES ARE NOT PROFITABLE IN
THIS IN THEIR CURRENT FORM AND
WE AND YET THEY NEED A LOT OF
INVESTMENT AND THIS IT'S
CRITICAL TO ADDRESS THIS FUNDING
SHORTAGE THANK YOU. THANK YOU.
OKAY.
INCUMBENTS FROM DHS BELIAU.
FINANCE OKAY QUESTION COMMITTEE
MEMBERS.
ALL RIGHT WELL THANK YOU FOR
YOUR PRESENTATION AND.
FREE SHE DIDN'T.
WELL. TAKE A LOOK AT IT IF YOU.
ALRIGHT.
NEXT ITEM AYE CATS GOT FROM THE
CALIFORNIA ASSOCIATION AIR
MEDICAL SERVICES
PROPOSAL FOR AIR EMBOLUS
PROVIDER READING FOR.
THREE PLACE EXISTS EXPIRING
SUPPLEMENTAL PAYMENTS.
WELL OKAY I SEE THAT DOES NOT
LOOK LIKE CAT THAT LOOKS LIKE
JODY HICKS. OKAY A FATHER ALSO
MAKES YOU INTRODUCE YOURSELF OR
DIRECTOR.
THANK YOU.
I APOLOGIZE CAPTAIN AUSTIN
SCOTT COULD NOT BE HERE SO ASKED
ME TO FILL IN. AND I REPRESENT
AIR METHODS WHICH IS ONE OF THE.
AIR AMBULANCE COMPANIES SO.
I WILL BE BRIEF SINCE
AND I HAVE REPRESENTING THE
ASSOCIATION AND THE SUMMARY. IN
THE.
AGENDA DOES A DOES A GREAT JOB
OF LAYING OUT THE ISSUE BUT
ESSENTIALLY.
FOR US AND THE.
AIR AMBULANCE SYSTEM OBVIOUSLY
WE.
OPERATE ON EMERGENCY SERVICES
AND DON'T AND PICK AND CHOOSE ON
ON THE PATIENTS THAT WE HAVE.
DE.
ARE OUR BASE RATE HAS NOT BEEN
INCREASED FOR OVER THIRTY YEARS.
WE WERE ABLE TO GAIN A
SUPPLEMENTAL PAYMENT OF A FOUR
DOLLAR FEE ON TOP
VIOLATIONS
SET TO EXPIRE IN TWO THOUSAND
NINETEEN.
WHICH WILL DEVASTATE THE THE
COMPANY SO WE ARE ASKING FOR A
RATE INCREASE UP TO MEDICARE
RATES WHICH WILL AT LEAST.
GET US CLOSER TO BASE BECAUSE IT
STILL WON'T COVER EVERYTHING BUT
IT WILL CERTAINLY GET CLOSER.
I'M RIGHT NOW IF WE LOSE THAT
THAT FOUR DOLLAR FEE WE WE WON'T
EVEN COVER HALF THE COST OF THE
SERVICES THAT WE HAVE WE HAVE TO
PROVIDE AND OBVIOUSLY WITH ALL
OF THE.
WILD FIRES AND THINGS THAT
HAPPENED IS A REALLY IMPORTANT
THAT WE HAVE AIR AMBULANCE OPEN
AND AVAILABLE SO.
WE ASK FOR THE INCREASE THIS
YEAR THANK YOU.
I THINK YOU INCOME IF DH YES.
I AM I WOULD JUST SAY THAT. WE
HAD WORKS ON AND THE
IDENTIFICATION OF THE NON
FEDERAL SHARE WAS THROUGH THIS
FOUR DOLLAR. ASSESSMENT AND SO
AM. I BELIEVE THAT WE CAN
PROVIDE TECHNICAL ASSISTANCE ON
THE GENERAL FUND IMPACT OF THE
LOSS OF THOSE.
OTHERWISE NON GENERAL FUND
DOLLARS BECAUSE THEY DO HAVE A
SIGNIFICANT IMPACT THERE WILL BE
ON THE GENERAL FUND EXPENDITURE
THAT OTHERWISE WOULD NOT NEED TO
BE MADE IF THE FUNDS WERE
OTHERWISE AUTHORIZED BUT THEY
HAVEN'T BEEN AT THIS TIME.
OKAY THANK YOU BELIAU.
FINANCE.
OKAY THANKS VERY MUCH YOUR
PRESENTATION.
ALRIGHT.
OKAY USHERS GONZALEZ RIPS THE
ADVOCATING FOR ACCESS AND BLOOD
FACTOR REIMBURSEMENT HOLE SO I.
OKAY AND OF COURSE IF MULTIPLE
TESTS OF FIRES KEEP IN MIND
THREE MINUTES TOTAL. I WAS KNOWS
HOW THE FIRST PERSON SEEM TO EAT
UP ALL THE TIME.
THAT AFTERNOON MISTER CHAIR AND
MEMBERS OF THE COMMITTEE I'M
SHARE GONZALEZ I'M HERE ON
BEHALF A FAA I'M HERE AT THE
DESK MERELY FOR TECHNICAL
SUPPORT I HAVE WITH ME OUR
PHARMACY EXPERTS. AND SHE WILL
BE GIVING THE TEST
THANK YOU.
ISSUE WITH TWO MORE NERVOUS
THIRTY SECONDS.
AFTERNOON MISTER CHAIR AND
MEMBERS OF THE COMMITTEE MY NAME
IS AMY ELLERS AND I'VE BEEN A
PHARMACIST FOR TWENTY YEARS.
HOLD A BACHELOR'S IN DOCTOR AND
PHARMACY ITEM OF THE PS BOARD
CERTIFIED PHARMACOTHERAPY
SPECIALIST.
I AM THE DIRECTOR OF PHARMACY TO
SPECIALTY PHARMACY IN SOUTHERN
CALIFORNIA RIGHT CARED WITH
PATIENTS FOR HEMOPHILIA FOR THE
PAST ELEVEN YEARS.
THANK YOU FOR THE OPPORTUNITY TO
EXPLAIN THE ROLE THAT SPECIALTY
PHARMACIES PLAY IN TEAM BASED
CARE FOR PATIENTS OF BLEEDING
DISORDERS.
AND A POTENTIALLY DEVASTATING
IMPACT THAT THE DEPARTMENT OF
HEALTH CARE SERVICES PROPOSED
REDUCTION TO MEDI CAL BLOOD
FACTOR REIMBURSEMENT COULD HAVE
ON THEIR LIVES.
AS A PHARMACIST I MEAN INTEGRAL
PART OF THE PATIENT CARE TEAM
AND I'M RESPONSIBLE FOR MANAGING
MEDICATIONS AND PREVENTING
THERAPY RELATED PROBLEMS.
AND HAEMOPHILIA THIS INCLUDES
ENSURING PATIENTS ARE FOLLOWING
THEIR TREATMENT PLAN AND HAVE
THE APPROPRIATE AMOUNT OF BLOOD
FACTOR PRODUCT ON HAND AT ALL
TIMES.
BY MINIMIZING BELIEVE RELATED
COMPLICATIONS UNPLANNED E. R.
VISITS AND HOSPITAL ADMISSIONS
PATIENTS HAVE A HIGHER QUALITY
OF LIFE AND THE STATE SAVES
HEALTH CARE DOLLARS.
SPECIALTY PHARMACISTS TRAINING
BLEAKNESS ORDERS UNDERSTAND THIS
IS NOT A ONE SIZE FITS ALL
APPROACH.
WE TAILOR OUR CARE TO EACH
PATIENT BASED ON THEIR
INDIVIDUAL NEEDS GOALS AND
CHALLENGES.
I HAVE A PEDIATRIC PATIENT ARE
SIGNIFICANT ISSUES WITH HIS
HEMOPHILIA AND WE KIND TAXES
CAREGIVER ON A WEEKLY BASIS TO
ASSESS HIS HEALTH AND BLOOD
FACTOR NEEDS.
PATIENTS SEEM TO BE ONE HUNDRED
PERCENT CONFIDENT THAT I IS OUR
PHARMACIST UNDERSTAND THEIR
EXACT NEEDS AND KNOW THAT AN
ACTIVE LEAD REQUIRES SWIFT
ACTION WITH NO ROOM FOR ERROR.
THEIR LIFE TRULY DEPENDS ON IT.
I HAVE SEEN THE CONSEQUENCES
pTO AN EXPERT SPECIALTY PHARMACY
TEAM. BUT PATIENT IN HIS EARLY
FORTIES UNDERWENT A TOTAL HIP
REPLACEMENT DUE TO REPEATED
UNTREATED BLEEDING EPISODES IN
HIS TEENS AND TWENTY.
DO TO COMPLICATIONS OF THE
INITIAL PROCEDURE HE HAD A TOTAL
OF THREE HIP SURGERIES AND SIX
MONTHS.
HE WENT FROM INFUSING AS BLOOD
FACTOR WEEKLY TO ALMOST DAILY.
THIS LACK OF A CONSISTENT
QUALIFIED SPECIALTY PHARMACY
TEAM CONTRIBUTED TO A NEGATIVE
AFFECT ON HIS PHYSICAL HEALTH.
PERSONAL LIFE FAMILY JOB AND
FINANCES.
THE D. H. CS PROPOSED CHANGE THE
MEDI CAL BLOOD FACTOR
REIMBURSEMENT WITH THREATEN
BILLION THIS ORDER PATIENT
HEALTH. BY MAKING IT EXTREMELY
DIFFICULT FOR SPECIALTY
PHARMACIES TO CONTINUE TO
PROVIDE CARE FOR THESE PATIENTS.
A SEVENTY FIVE PERCENT REDUCTION
IN MEDI CAL FOR REIMBURSEMENT
FOR BUT FACTOR PRODUCTS
WOULD NOT ALLOW ME TO CONTINUE
TO PROVIDE MANY CAO PATIENTS
WITH THE OUTREACH EDUCATION AND
PATIENT CARE SERVICES THAT ARE
CURRENTLY DO.
PATIENTS SHOULD BE FORCED
UTILIZED EMERGENCY DEPARTMENTS
WHICH ARE NOT EQUIPPED WITH A
VARIETY OF BLOOD CLOTTING
FACTORS AND THEIR INVENTORY
NECESSARY TO TREAT THESE
PATIENTS.
THANK YOU FOR THE OPPORTUNITY TO
SPEAK ABOUT THIS IMPORTANT ISSUE.
I RESPECTFULLY URGE YOU TO
PREVENT DHT ES ROOM POSING AND
NINETY FIVE.
SEVENTY FIVE TO NINETY PERCENT
CUT IN BUT FACTOR REIMBURSEMENT
TO SPECIALTY PHARMACIES WHO
SERVICE HEMOPHILIA PATIENTS
UNHAPPY ANSWER QUESTIONS.
PERFECT TIMING.
ALRIGHT DOT COMMENTS FROM THE
BOTTOM HEALTHCARE SERVICES. YEAH
SO ON THE CHANGES IN THE WAY
THAT WE REIMBURSE FOR BLOOD
FACTOR ARE A RESULT OF A FEDERAL.
RULE FOR LP
DRUGS AND SO WE HAVE BEEN
WORKING WITH THE INDUSTRY.
BECAUSE WE WERE FORCED TO
ESSENTIALLY UNBUNDLE THE WAY
THAT WE REIMBURSED FOR IT AND SO
I'M THERE HAVE BEEN A LOT OF
STAKEHOLDER.
GROUPS AND DISCUSSIONS AND WE
RECOGNIZE THAT THERE ARE CERTAIN
ON FINANCING AND REIMBURSEMENT
ON CONCERNS ABOUT HOW WE HAVE TO
THEN RESTRUCTURE THE PAYMENT AND
THE COSTS FOR HOW WE. PAY FOR
EACH OF THESE THINGS BUT I DON'T
KNOW THAT WE HAVE REACHED.
I'M AN INTERNAL UP CONSENSUS YET
FOR WHAT THAT LOOKS LIKE WE'VE
BEEN I'M WORKING WITH A LOT OF
DIFFERENT SPECIALTY PHARMACY TO
UNDERSTAND WHAT THEIR COSTS ARE.
WHAT IS SUPPORTED AND WHAT IS
NOT BY THE NEW OUTPATIENT RULE
AND SO I THINK IT'S NOT?
STATION
OKAY AND AND DISCOVERED THAT
THAT OUTPATIENT RULES OF WHAT
MORE GENERAL RULE THAT'S HEAVY
AND MORE SPECIFIC IMPACT ON THIS
WAS A VERY GOOD EFFECTIVE WHAT
FACTOR UPDATED SPECIFIC PUBLIC
AND THERE WAS A LOT OF OTHER
CHANGES IN THE OUTPATIENT
PROGRAM BUT THERE WAS A VERY
SPECIFIC.
REQUIREMENT THAT WE HAD TO
CHANGE AND BLOOD FACTOR BECAUSE
IT WAS A BUNDLED RATE AND SO
THEN WE HAD TO BREAK IT OUT SO
THERE'S A LOT OF SERVICESTHAT
HAVE BEEN TRADITIONALLY PROVIDED.
BASED ON HOW IT WAS CONSTRUCTED
IN THE FEDERAL GOVERNMENT IS
ASKING TO SEE EACH OF THOSE
COMPONENTS EITHER BROKEN OUT ARE
JUSTIFIED.
OKAY ALRIGHT COMES FROM MILLIE
O..
FINANCE
OKAY THURSTONE BUT THANK YOU
SODA TO THE SPECIALTY PHARMACY
ARE YOU.
SLICE IN THE BY THE STATE BOARD
OF PHARMACY OR YOU DO YOU DO YOU
ARE YOU LICENSED BY THE
DEPARTMENT ALSO.
WHERE LICENSE BY THE STATE BOARD
OF PHARMACY OKAY AND OTHER ANY
SPECIAL REQUIREMENTS ON U. AS
FAR AS BEING A SPECIALTY
PHARMACY AND?
SELLING IF YOU WILL.
CLOTTING FACTORS.
NOT RESPECT TO THE BOARD OF
PHARMACY BUT DH HE ASKED AS HAVE
GUIDELINES THAT WE ARE REQUIRED
TO ME IN POLISH AND CLEANERS SO
IT'S MY UNDERSTANDING THAT YOU
HAVE TO CARRY. AN ADEQUATE
INVENTORY OF ALL THOSE CLOTTING
FACTORS AND THAT.
.
YOUR RISK IF YOU HAVE THOSE
CLOTTING FACTORS AND YOUR STOCK
AND THEY HAVE EXPIRATION DATES
IF THEY EXPIRE.
THAT COULD BE A SIGNIFICANT
LOSS TO YOU. AND OBVIOUSLY.
BE ABLE TO HAVE THE APPROPRIATE
REIMBURSEMENT WILL DOUBLE BY
ALLOW YOU TO REMAIN IN BUSINESS
BECAUSE OF BUT THE EXPENSE OF
THESE CLOTTING FACTORS IF YOU
HAVE TO DISPOSE OF.
TWENTY FIVE PERCENT OF THEM
BECAUSE
A CHANCE TO DISPENSE THEM IS
GOING TO BE SOME WAY TO
REIMBURSE YOU FOR THAT.
SO.
AND AND I KIND OF HEARD IT IS A
A FEDERAL.
INTERVENTION HERE WHICH IS.
GETTING IN THE WY OF
CONTINUALLY REIMBURSING THEM IN
SUCH A WAY THAT THEY CAN.
CONTINUE TO US TO STOCK THESE.
LIFE ESSENTIAL BORROWED FACTORS
IN. A IT'S MY UNDERSTANDING THAT
THE EVEN EMERGENCY ROOMS ON ANY
CARRY OF THESE FACTORS ARE MOST
OF THEM AND.
THE SHE WOULD LET YOU TELL ME
OTHERWISE BUT IT'S MY
UNDERSTANDING THAT THEY DON'T.
RIGHT SAID THESE ARE SOME OF THE
MOST EXPENSIVE PRODUCTS THAT IN
THE.
PROGRAM.
REIMBURSES FOR AND YOU ARE
CORRECT IT WAS A FEDERAL RULE
BUT ESSENTIALLY.
I THINK THERE WAS CONCERN AT
THE FEDERAL LEVEL.
BUT THE WAY THAT THE
REIMBURSEMENT WAS AND BEING DONE
WAS THAT THERE WERE THEY THEY
WERE TRYING TO TRY TO DECREASE
THE MARGIN SO WE ARE ESSENTIALLY
PAIN FOR THE ACQUISITION COSTS
SO IF IT COSTS A PHARMACY.
FIFTY THOUSAND DOLLARS TO
ACQUIRE AT A BLOOD FACTOR
PRODUCT I'M WE PAY THE
ACQUISITION COSTS A FIFTY
THOUSAND DOLLARS AND THEN
THERE'S A DISPENSING FEE AND I
THINK. WHAT HAD BEEN
TRADITIONALLY PAID WAS A
DIFFERENTIAL RATE AND SO A LOT
OF THE INSULAR SUPPORTER AND A
LOT OF THE OTHER KINDS OF
CONDITIONS AROUND HOW THESE
PHARMACIES?
PROVIDED CARE MANAGEMENT AND
COORDINATION SERVICES AND THE
WHOLE THING WAS. I'M
ENCAPSULATED IN THAT PREVIOUS
RAY AND SO WERE HAVING TO BREAK
APART ALL OF THOSE DIFFERENT
COMPONENTS AND THEN THE FEDERAL
GOVERNMENT WANTS TO UNDERSTAND
HOW WE WOULD PROPOSE TO PAY FOR
THOSE.
SEPARATELY SO THEY CAN HAVE A
BETTER VISIBILITY INTO THE
OVERALL COST OF THOSE SERVICES.
THAT'S THE PROCESS THAT WERE IN
IN DEVELOPMENT WITH RIGHT NOW.
WELL I CAN UNDERSTAND IF THIS
WAS IF THESE WERE TRADITIONAL A
PHARMACY PRODUCTS LIKE. YOU KNOW
SOMEBODY VERY EXPENSIVE THE BY
CAPSULES YOU.
YOU KNOW WITH COMPUTER
TECHNOLOGY INSURANCE COMPANIES
GOVERNMENTS KNOW PRETTY MUCH
WHERE PHARMACIES PAY FOR THINGS
ON THEM TO GIVE UP IN A PRETTY
PRETTY LOW DISPENSE FEE THAT IS
THE CASE WHERE. THEY HAVE TO%
CARRY A VARIETY OF MULTIPLE
FACTORS AUGUST TWENTY.
I'M GOING BACK. TO SCHOOL
LEADERS TWENTY CLOTTING FACTORS
OUT THERE ABOUT HOW MANY.
NEED TO BE KEPT IN STOCK.
RATHER READILY BUT IT'S MY
UNDERSTANDING THAT THESE
PHARMACIES DE TO BE AVAILABLE
TWENTY FOUR HOURS A DAY SEVEN
DAYS A WEEK WHICH IS A AND
NORTON EXPENSE. AND JUST TONSIL
SYMBOLISES FIGURE OUT YOUR
ACQUISITION COST IS ADDING A
MODEST FEE.
BECAUSE I THINK MANY THE
SPECIALTY PHARMACIES SO WILL NOT
BE IN BUSINESS FOR THIS VERY
NARROW.
PATHOLOGY OF.
HEMOPHILIACS THAT WE WE NEED TO
ENSURE THAT THEY HAVE.
APPROPRIATE ACCESS TO THE
CLOTTING FACTORS THAT THEY NEED
SO IT'S MY HOPE.
THAT WE WE CONTINUE DISCUSSIONS
THAT YOU COULD TO DISCUSSIONS
AND I DRIVE IF YOU BUT MANY WHAT
THE SPECIALTY PHARMACIES YEAH
THOUGHT IT RIGHT THERE BEEN LOTS
OF WORK GROUPS AND WE'VE MET
WITH BOTH. THE BRIDE COMMUNITY
OF PHARMACIES AND STAKE HOLDERS
AS WELL AS WE HAD INDIVIDUAL
MEETINGS WITH PARTICULAR
SPECIALTY PHARMACIES I'VE MET
WITH SOME. MY PHARMACY DIVISION
CHIEF IS NOT WITH A LOT OTHER OF
OTHERS AND THEN WE'VE BEEN
ASKING FOR THEM TO PROVIDE US
DATA IN TERMS OF SOCIAL COSTS
CHAU ISSUE REIMBURSEMENT ISSUES
SHOW US YOUR ANCILLARY SUPPORT.
SHOWS ALL THESE THINGS THAT WE
CAN BETTER UNDERSTAND WHAT THE
TRUE NATURE OF THE COSTS ARE
BECAUSE.
WE ARE JUST AS INTERESTED IN
MAINTAINING ACCESS FOR THESE I'M
SERVICES UNDERSTANDING THAT THEY
ARE VERY. RARE VERY IMPORTANT
VERY CRITICAL SERVICES.
WELL I APPRECIATE I I'M I'M
HAPPY TO HEAR THOSE.
MEETINGS WILL CONTINUE.
I WOULD EVEN LIKE TO BE INVITED
IF I COULD GO IF YOU GET TO A
POINT WHERE WE'RE. REACHING A
CONCLUSION I WANT TO MAKE SURE
THAT WE'RE NOT GOING TO BE
PUTTING SOME OF THE SPECIALTY
PHARMACEUTICAL BUSINESS.
MOSTLY DUE TO THE DATA
DISASTROUS EFFECT IS GOING TO
HAVE ON THESE PATIENTS THAT ARE
GONNA FIND A WAY TO EMERGENCY
ROOMS AND.
AND NOT GET THE RELIEF THAT THEY
NEED AND.
IF YOU LOOK AT THE NUMBER
BELIEVES THAT IT HAPPENED.
WITH THE PRESIDENT DUH
AVAILABILITY THE SPECIALTY
PHARMACIES VERSUS.
IN THE PAST.
WE WOULDN'T HAVE THE SPECIALTY
PHARMACIES A NUMBER BLEEDS WAS.
QUITE A QUITE EXTRAVAGANT WE
DON'T WANT TO RETURN BACK WITH
WE DON'T GO BACKWARD TO WANT TO
MOVE FORWARD BUT WE NEED TO MAKE
SURE THAT THE SPECIALTY
PHARMACIES ARE GIVEN THE
APPROPRIATE TOOLS TO STAY IN
BUSINESS AND. REIMBURSEMENT IS
PROBABLY TOP ON THAT LIST SO I'D
LIKE TO BE A PART OF THAT
DISCUSSION MAY BE HAPPY AND IF
WE NEED HELP WITH THE FEDERAL
GOVERNMENT.
LIKED I LIKED HEALTH NET
ENDEAVOR TO BECAUSE.
I THINK YOU'RE TAKING A VERY
SHORTSIGHTED.
REVIEW OF OF WHAT'S IN PALED IN
AND INDISPENSABLE ENSURING THAT
THESE CLOTTING FACTORS ARE IN
FACT.
READILY AVAILABLE AND
EXPEDITIOUSLY DELIVERED WHEN THE
PATIENTS DEVELOPED PROCEDURAL
BUT THAT.
OKAY WELL AGAIN I APPRECIATE #
I HOPE THAT WE CAN COME TO SOME
RESOLUTION BY ME BY TIME WE COME
BACK TO THIS AND MAY REVISE SO.
ALRIGHT THINK IT'S VERY MUCH
OKAY AND FINALLY WE HAVE.
THE SHABAKA FROM THE CAN FOR
MEDICAL ASSOCIATION.
PROPOSAL LIMIT ERRONEOUS
PAYMENT CORRECTION AND THEN
AFTER THAT WE WILL TAKE PUBLIC
COMMENT ON THIS. ISSUE NUMBER
FOUR WHICH IS ALL OF PROPERTIES.
AND ALSO THE PROPOSAL'S WE'VE
HEARD. WELCOME.
THANK YOU VERY MUCH MISTER CHAIR.
THEM SHABAKA WITH THE COMPANY
MEDICAL ASSOCIATION ON THIS IS
AN ISSUE THAT SUBCOMMITTEE HEARD
LAST SPRING.
SO I THINK YOU VERY MUCH FOR
ALLOWING ME TO PRESENT IT TO YOU
AGAIN.
WE HAVE SIGNIFICANT CONCERNS
WITH THE PROCESS OF THE STATE
CURRENTLY HAVE IN PLACE TO
RECOUP PROVIDER OF OVERPAYMENTS
TO HAPPEN AS A RESULT OF AN AREA
THAT THE STATE MADE.
I HOLDS KEEP MY COMMENTS BRIEF
BECAUSE IT'S A NICE SUMMARY IN
THE.
AGENDA BUT.
WE ARE.
REQUESTING TRAILER BILL
LANGUAGE THAT WOULD.
PUT SOME REASONABLE LIMITS ON
THE TIME FRAME THAT THE
DEPARTMENT CAN GO BACK AND
RECOUP.
THESE PROVIDER OVERPAYMENTS.
OF ONE YEAR AND A.
TWENTY PERCENT.
WITHHOLD FROM.
CURRENT PAYMENT FOR SERVICES.
AND SO.
I'M WITH THAT I'M HAPPY TO
ANSWER ANY QUESTIONS.
THANK YOU VERY MUCH ANY COMMENT
FROM THE LA NO.
FROM. FINANCES ARE THE
DEPARTMENT.
KAY THANK YOU VERY MUCH I THINK
WILL HERE FOR SOME RESPONSE IN.
IN THE PUBLIC COMMENT BUT THANK
YOU FOR YOUR TESTIMONY.
.
WE ARE GONNA MOVE INTO PUBLIC
COMMENT NOW.
PLEASE TO LINE UP.
IN THE QUEUE FOR THE FLOOR
MICROPHONE.
WE ASK THAT YOU.
GIVE YOUR NAME AND AFFILIATION.
AND A ONE MINUTE TIME LIMIT AND.
A FEW COULD.
TRY TO BE QUIET AS YOU MOVE
INTO LINE. LET ME JUST ALSO
POINT OUT THAT BY EIGHT HEARING
TO OUR ONE MINUTE RULE. YOU
RESPECT OTHER PEOPLE IN LINE
BEHIND YOU TO MAKE SURE THEY GET
A CHANCE.
SHARE THEIR TESTIMONY AND IF
YOU'RE. SAYING THE SAME THING
THAT'S BEEN SAID YOU CAN USE
LESS THAN A MINUTE.
NOT TURN THE CHAIR BACK TO
MISTER CARE DOCTOR CHAIR OKAY
WELCOME. WELCOME.
THE DOCTOR PAN AND MEMBERS TERRY
CALLIER HILLA ME HALF OF CALGARY
ASSOCIATES I'M HERE TODAY ON
BEHALF OF TO CLIENTS ALL START
WITH CHILDREN'S HOSPITAL OAKLAND
WE ARE HERE TO SUPPORT THE
ADMINISTRATION'S PROPOSAL FOR
THE FIFTY PERCENT RATE INCREASE
FOR HOME NURSING SERVICES. AT
CHILDREN'S HOSPITAL OAKLAND
WE'VE HAD A CHALLENGE OVER MANY
MANY YEARS WHERE WE HAVE BONE
MARROW TRANSPLANT PATIENTS. THAT
ARE IN THE HOSPITAL FOR THIS
COMPLEX PROCEDURE THERE OFTEN IN
THE HOSPITAL FOR A THIRTY THIRTY
PLUS PATIENT INPATIENT DAYS. AND
THERE'RE STABILIZER READY TO GO
HOME BUT WE HAVEN'T HAD THE
OPPORTUNITY TO FIGHT NURSES WHO
WOULD BE ABLE TO CARE FOR THEIR
COMPLEX NEEDS IN THE HOME
SETTING. THIS RATE INCREASE GOES
SUCH A LONG WAY IN ENSURING THAT
THE NURSES WILL BE THERE FOR
THESE PATIENTS WHEN THEY'RE
STABILIZED READY TO GO HOME.
SEWERS IN STRONG SUPPORT OF THAT
PROPOSAL AND FOR CHILDREN'S
HOSPITAL OAKLAND WERE ALSO
SUPPORTING THE ON AIR AMBULANCE
RATE INCREASE WE HAVE A LEVEL
ONE PEDIATRIC TRAUMA CENTER. THE
IS THE ONLY ONE IN NORTHERN
CALIFORNIA BECAUSE UC DAVIS IS
FOR ADULTS AND WE SEE ABOUT
THREE HUNDRED SEVENTY FIVE
CHILDREN THAT ARE AIR
TRANSPORTED TO THE HELIPAD ON
THE TOP OF THE HOSPITAL. AND
THIS RATE INCREASE WILL GO A
LONG WAY IN SUPPORTING THAT FOR
THE IMMENSELY COUNCIL CALIFORNIA.
THE COMMENTS THAT WERE JUST MADE
I'M FOR OUTLET FACTOR WE KNOW
THAT DIRECTOR KEN'S BEEN IMPOSED
BY A FEDERAL RULE AND WE JUST
ASK FOR LEGISLATIVE INPUT AND
OVERSIGHT IN WHATEVER FACTOR
RATE GETS DETERMINED. THEY'RE
NOT ONLY THE SPECIALTY
PHARMACIES BUT THERE ARE THE
THREE FORTY BE PHARMACIES THAT
ARE AFFILIATED WITH ME MONTHLY A
TREATMENT CENTERS AND THOSE
CENTERS ARE THE BACKBONE OF CARE
FOR OUR PATIENTS. SO WE NEED TO
HAVE AND THE RATE BE FAIR ENOUGH
SO THAT IT DOESN'T COMPROMISE
ACCESS TO CARE AND WE APPRECIATE
WORKING WITH.
DIRECTOR CAN'T AND WITH ALL OF
YOU ON THIS ISSUE. THANK YOU
ALRIGHT THANK YOU.
GOOD JOB TRYNA.
GET ALL YOUR ISSUES AND. WELCOME
GOOD AFTERNOON UP PATRICK DUNLAP
HEMOPHILIA FOUNDATION NORTHERN
CALIFORNIA ALSO REPRESENTING OUR
CENTRAL CALIFORNIA CHAPTER
SUDDEN CALIFORNIANS SAN DIEGO.
THAT REPRESENTS THE STATE OF
CALIFORNIA AND ALL BLEEDING
DISORDERS WERE IN SUPPORT OF THE
HEMOPHILIA COUNCIL CALIFORNIA'S
EFFORTS THANK YOU.
THANK YOU.
WELCOME.
I'M STEPHANIE DANCE KURRAM
PARENT OF AN ADULT SON WAS
SEVERE HEMOPHILIA AND JUST MY
COMMENTS IS WITHOUT SUFFICIENT
REIMBURSEMENT RATE FOR CLOTTING
FACTOR ACCESS TO LIFESAVING
MEDICATION. AND THE CENTERS OF
EXCELLENCE TO PROVIDE MEDICAL
CARE TO PEOPLE WITH BLEEDING
DISORDERS WILL BE CUT
DRASTICALLY. THIS WILL LEAD TO
EVEN GREATER COST TO THE STATE
AND EVEN MORE SERIOUSLY IT WILL
INCREASE PATIENT SUFFERING
DISABILITY AND EVEN LEAD TO
DEATH.
THANK YOU.
WELCOME.
HIGH MAINTENANCE CAN SCHAEFER
I'M A NURSE PRACTITIONER AT THE
UC DAVIS HEMOPHILIA TREATMENT
CENTER.
AS THE NURSE PRACTITIONER AT THE
HEMOPHILIA TREATMENT CENTER MY
WILL IS TO PROVIDE COMPREHENSIVE
CARE TO THESE PATIENTS. WE
CLOSELY MONITOR THEM PROVIDING
AND MANAGING AND COORDINATING
THEIR MEDICAL CARE THEY CARE
THAT'S REQUIRED TO EFFECTIVELY
TREAT THESE PATIENTS IS COMPLEX
AND GOES WELL BEYOND TREATMENT
WITH CLOTTING FACTOR.
SPECIALTY PHARMACY CARE ALONE IS
NOT.
AS IS NOT THE ONLY MEANS FOR
PRODUCING GOOD OUTCOMES.
ANY NEW MEDICAL OUR ROLES AND
ANY I WOULD ASK THAT ANY NEW
MEDICAL MEDI CAL RATES FOR
CLOTTING FACTOR. NEEDS TO BE
SUFFICIENT TO COVER THE TRUE
COST OF HEMOPHILIA TREATMENT
CARE SERVICES TO ENSURE THESE
HTC'S. CAN ONTINUE THIS
SPECIALIZED COMPREHENSIVE MULTI
DISCIPLINARY CARE WHICH
DECREASES MORBIDITY AND
MORTALITY FOR THESE PATIENTS AND
ALLOWS THEM TO LIVE LONGER AND
PRODUCTIVE LIVES THANK YOU.
THANK YOU.
OKAY.
THANK YOU CHAIR AND COMMITTEE
AND ALSO DIRECTOR KENT I MY NAME
IS DOCTOR JUDITH BAKER AND I'M
THE PUBLIC HEALTH DIRECTOR FOR
THE CENTER FOR INHERITED BLOOD
DISORDERS. I'M HERE REPRESENTING
ALL CALIFORNIA ELEVEN FEDERALLY
SUPPORTED HEMOPHILIA TREATMENT
CENTERS IT IS THE HEMOPHILIA
TREATMENT CENTERS THAT REDUCE
MORBIDITY AND MORTALITY BY SIXTY
PERCENT REDUCING. INPATIENT
HOSPITALIZATION KEEPING PEOPLE
ALIVE HEALTHY. REDUCING WORK IN
SCHOOL LOSS AND IT IS THROUGH
THE BLOOD FACT REIMBURSEMENT
RATE. THAT HAS BEEN
TRADITIONALLY FOR THE PAST TEN
PLUS YEARS HELP SUPPORT THE
ANCILLARY SERVICES THAT ARE NOT
OTHERWISE COVERED BY THE STATE.
SO WE RESPECTFULLY ASK THAT ANY
CHANGE IN THE BACK TO
REIMBURSEMENT RATE.
BE CAREFULLY CONSIDERED SO THAT
THE ANSWER SERVICES TO KEEP OUR
PATIENTS ALIVE.
THE COVERED TRULY COVER THE COST
OF CHILDCARE THANK YOU. THANK
YOU.
WELCOME.
HELLO MY NAME IS WENDY CHAD I
HAVE AN ADULT BROTHER IN A
TWENTY ONE YEAR OLD SON WITH
MODERATE TO SEVERE HEMOPHILIA I
AM OPPOSED TO THE MEDICAL CUTS
THAT WOULD THREATEN HIM WITH A
PATIENT ACCESS. TO CARE AND
SPECIALLY PHARMACIES I'VE GROWN
UP IN THE MIDDLE YOU COMMITTEE
THROUGH SOME VERY CHALLENGING
TIMES I UNDERSTAND FIRST HAND
THE VITAL ROLE THAT SPECIALLY
PHARMACIES PLAY. IN THE RULES
ABOUT FAMILIES IN OUR COMMUNITY.
DUE TO COST HOSPITAL EMERGENCY
ROOMS DO NOT CARRY BUT FACTORS
OF ANY KIND AND AS A YOUNG
MOTHER I'VE HELD MY TODDLER SON
AS HE BLOOD FROM THE BACK OF HIS
HEAD.
AS HE HAD A SIMPLE FALL AT THE
PARK AM I IN A PANIC DROVE
STRAIGHT TO THE EMERGENCY ROOM.
EMERGENCY ROOM NURSE TOLD ME
THAT THERE WAS NOTHING THEY
COULD DO FOR ME AND I HAD TO
DRIVE FIFTY FIVE PLUS MYERS
MILES IN CALIFORNIA TO MY
UNIFIED TREATMENT CENTER TO
RECEIVE FACTOR.
I HAD EXPLAINED THAT I COULDN'T
WAIT THAT LONG DUE TO MY SON'S
HEMOPHILIA HE NEEDED FACTOR
IMMEDIATELY IT TO AVOID THE
BLEED TO HELP STOP HIS BLEEDING
AND AVOID A LIFE THREATENING.
BRAIN BLADE.
FROM THE EMERGENCY ROOM WE
CALLED OUR SPECIALLY PHARMACY
ARE PHARMACISTS NOT ONLY
DISPENSED ARE FACTORED
IMMEDIATELY BUT BROUGHT IT TO US
PERSONALLY AND THEN STAYED WITH
US IN THE EVENT THAT THE
EMERGENCY ROOM STAFF HAD ANY
QUESTIONS AS WE ADMINISTERED HIS
FACTOR.
OUR SPECIALLY PHARMACY PLAYED A
VITAL ROLE THAT DAY IN TREATING
A HAD PLAYED THAT COULD HAVE
MEANT DETRIMENTAL BRAIN DAMAGE
CHANGE OUR LIVES FOREVER. AND
TRULY DRASTICALLY INCREASE OUR
SON'S LIFE TERM CARE NEEDS AND
COSTS.
THIS IS SIMPLY ONE EXAMPLE OF
ESPECIALLY PHARMACIES ROLE IN
OUR LIVES AND AS A MOTHER I ASK
YOU TO REJECT THE MEDICAL
PHARMACY REIMBURSEMENT CUTS
PROPOSED BY THE DEPARTMENT OF
HEALTH. FOR BLOOD CLOTTING
FACTORS THANK YOU SO MUCH
THANK YOU.
WELCOME ALONE NAME IS TERRY
RICIN A FIFTY SIX YEAR OLD
SEVERE PERSON WITH HEMOPHILIA
BUT AS RARE AS A UNICORN.
WHY I BROUGHT Y. ARISE TODAY IN
OPPOSITION TO D. H. CSS CURRENT
PROPOSED ALGORITHM FOR
REIMBURSEMENT IS THAT IT WILL
CAUSE ACCESS TO CARE PROBLEMS DO
THESE CRITICAL? BLOOD UP PRODUCT.
INFUSION THERAPY IS THAT WE NEED
ESSENTIALLY TO SAVE OUR LIVES
AND REDUCE MORBIDITY MORTALITY.
JUST AS A QUICK STORY BECAUSE I
AM FIFTY SIX I'VE GONE FROM
ABSOLUTELY NO THERAPY AVAILABLE
WHEN
IS BORN. THE MOST HIGHLY
ADVANCED THERAPIES THAT HAVE
REVOLUTIONIZED OUR LIVES TO BE
NEARLY NORMAL WHENI WAS FOUR
YEARS OLD I WENT IN FOR A CUT
WITH THAT HAND INTO A MAJOR
MEDICAL INSTITUTION. THERE WAS
SOMETHING CALLED CRIER
PRECIPITATE WHICH WAS A
PRECURSOR TO THE CONCENTRATE. BY
THE TIME THEY HAD DRAWN SOME
BLOOD OUT OF THIS ARM HERE
INFILTRATED THE BANES IN THIS
ARM I A LEFT THAT HOSPITAL FORTY
EIGHT HOURS LATER WITH THE
BOATMAN'S CONTRACTURE
COMPARTMENT SYNDROME. AND LEFT
THIS ARMED VIRTUALLY EIGHTY
PERCENT USELESS IT'S BUT A CLAW
ON THE SIDE OF MY ARM ON THE
SIDE OF MY BODY SINCE THE AGE OF
FOUR I AM NOW FIFTY SIX. LET ME
TELL YOU THIS REIMBURSEMENT
METHODOLOGY WILL COMPROMISE
ACCESS TO THESE THERAPIES THE
QUESTION IS HOW MUCH AND WHAT
DEMOGRAPHIC WILL BE EMPTY IT
WILL BE. HARMED BY THESE.
REIMBURSEMENT THE CUTS TO THIS
THERAPY I'M HERE TODAY TO SIMPLY
SAY PLEASE LET'S NOT TURN THE
CLOCK BACK PEOPLE DON'T HAVE TO
GO THROUGH WHAT I WENT THROUGH
TODAY.
I THINK YOU.
EXHIBIT THEM SO I THINK THEY
JUST WANT TO MAKE NOTE BECAUSE I
HAVE LEAVE HERE TO HEAR THE
TESTIMONY.
FIRST OF ALL OF COURSE I
APPRECIATE THE DIRECTOR SAYING
WE'RE WORKING WITH THE
PHARMACIST DRIVE JUST ISSUE THIS
IS ALSO UNFORTUNATELY SOMETHING
CAME DOWN FROM THE FEDERAL.
I AM A WOMAN DO WHAT WE CAN.
THIS
PRESS THIS ISSUE.
AT HERE IN THE STATE OF
CALIFORNIA I WOULD ALSO URGE
THOSE OF YOU ARE TESTIFYING HERE
AND AS YOU COMMUNICATE OTHER
PEOPLE. ACTUALLY ALSO ENCOURAGE
YOU TO TALK TO YOUR
CONGRESSIONAL REPRESENTATIVES
AND SAYING CAN YOU HELP WHAT CMS
BECAUSE WE MAY END UP HAVING TO
GO YOU KNOW WHAT TO DO WHAT WE
CAN AT THIS AND TRY TO MITIGATE
THIS.
BUT THIS ALSO CAME DOWN ON THE
FROM THE FEDERAL GOVERNMENT THEY
PROVIDE HALF THE MONEY THAT'S
WHY THEY GET TO DICTATE STUFF TO
US. AND SO.
SO I APPRECIATE YOUR
PASSIONATELY TO CONTINUE TO
SHARE WITH US YOUR STORIES AND
TESTIFY AND AND TELL US THAT WE
NEED TO FIX THIS BECAUSE WE DO.
BUT I ALSO WANT TO TELL YOU
WHEN YOU LEAVE HERE PLEASE CALL
YOUR KIND
PERSON AND TELL THEM THAT THEY
NEED TO HELP OUR YOUNG TOLD THEY
NEED CALLS HIM AS INTEL THAT
SEEM S. NEEDS TO WORK WITH US TO
SOLVE THIS PROBLEM AS WELL
BECAUSE UNFORTUNATE WITHOUT
SEEING. MESSES COOPERATION
AND WE GONNA DO WHAT WE CAN BUT
SOME OF THIS IS BECAUSE THE
FEDERAL GOVERNMENT TOLD US WE
HAD TO CHANGE THE WAY WE DID
THIS IT'S NOT OUR IT WASN'T OUR
IDEA TO START WITH SO I. JUST
WANTED TO MENTION THAT.
AND AGAIN I DON'T WANT TO LIMIT
AND SO PLEASE FEEL FREE TO TELL
US WE NEED TO FIX IT. I'M HERE
THAT WE'RE GOING TO TRY WORK ON
THAT AND PLEASE TELL US THAT BUT
THEY ALSO DON'T FORGET TO TELL.
FEDERAL GOVERNMENT THE SAME
THING SO BIG YOU WELCOME.
I'M MARTINEZ SOME A FATHER WITH
TWO SONS WITH SEVERE I'M
APPEALING ABOUT ONE MILE THEM UP
YOU KNOW AND TO SAY THAT IT'S
BEEN SPECIALLY PHARMACIES IN THE
ACCESS TO SPECIALTY PHARMACIES.
BUT TOOK MY SONS FROM BEING IN A
WHEELCHAIR MONTHLY TO PLAYING
SPORTS BEING BLACK BELT IN
KARATE OVER THEIR LIFETIME. SO
I'D LIKE URGE THE COMMITTEE TO
HAVE A FAIR AND AND THE ADEQUATE
REPORT REIMBURSEMENT POLICY THAT
WILL CONTINUE THAT ACCESS TO
CARE FOR EVERYBODY IN THE STATE.
THANK YOU NO THANK YOU.
WELCOME.
CRAIG MARES NAM REPRESENTING THE
ADVOCATING FOR ACCESS SPECIALLY
PHARMACY. AND I JUST WANT TO
CLARIFY THAT I THINK THE FINAL
RULE.
I CAME DOWN FROM THE FEDERAL
GOVERNMENT REQUIRED STATES TO
LOOK AT THE REIMBURSEMENT
METHODOLOGY GAVE ADVICE ON THAT.
WE ARE WORKING AND HAVE WORKED
WITH THE DEPARTMENT ON THAT. BUT
I DON'T THINK IT WASN'T ACTUALLY
IN THE FINAL RULE BUT SAID HE
HAD TO DO IT A CERTAIN WAY.
THERE'S OTHER STATES THAT HAVE.
LOOK AT.
MORE A BASIC REIMBURSEMENT.
METHODOLOGIES AND WORK TO SEE A
MASS THAT WASN'T A TOTAL MANDATE
TO DO IT A CERTAIN WAY THEY
WANTED IT TO LOOK AT IT. GO
THROUGH IT WORK WITH THEIR
PROVIDERS AND SO FORTH.
I JUST WANT TO MAKE THAT COMMENT
THANK YOU NO THANK YOU. AND I
APPRECIATE THAT THANK YOU MANY
LOCAL HAVING HELTON I LIED
CENTER CALIFORNIA'S MY
COLLABORATIVE I'M A RESPIRATORY
THERAPIST IN AS A CLINICAL
SPECIALIST.
I TAR SOON THAT'S OUR ACRONYM
FOR THAT THERE'S A REASON FOR
THAT THEY STICK UP THE SYSTEM.
THEY MAKE IT VERY DIFFICULT TO
WORK.
AND FOR MANY PATIENTS THAT
RESULT IN EMERGENCY ROOM VISITS
WHICH IS SOMETHING THAT IS NOT
OFTEN TRACKED. OUR
RECOMMENDATIONS TO PATIENTS WHEN
WE FIND OUT WE'VE GOT TO DO A
TAR FROM SOMETHING. THAT I
APPRECIATE THE HA*
AGGRESSIVE PUSH ON THIS TO GET
IT DOWN TO THREE DAYS.
I WILL SAY WE'RE NOT DONE YET
UNTIL IT'S NO DAIS SHOULD BE AN
AUTOMATED SYSTEM THESE PATIENTS.
NEED SOMETHING NOW AS A GENERAL
WHETHER IT'S DENTAL OR MEDICAL
BY THE WAYS FOR PRESCRIPTIONS AS
WELL. SO WE SHOULD MAKE NO
MISTAKE WHEN WE SAY THAT IT
COVERS THE WHOLE CARE SPECTER
MINUTE DELAYS. THE ONSET OF CARE
WHICH INCREASES SECURITY QUITE
OFTEN IN THE PROBLEM.
BY THE TIME THE PATIENT COMES
BACK TO US THERE NOW SICKER THAN
THEY WERE BEFORE. AND SO WE HAVE
TO DO HONOR TO OUR. OR SEND THEM
TO THE HOSPITAL AND WEBER
WAITING FOR THE TAR YOU CAN
ASSUME OUR ADVICE TO THEM IS. GO
TO THE ER IF YOU HAVE A PROBLEM.
SO THERE ARE HIDDEN COSTS HERE
THAT NEED TO BE UNCOVERED AND
DISCUSSED.
THERE'S MODELS OF QUALITY THAT
YOU CAN USE TO ADDRESS THIS SUCH
AS THE GOOD ACTOR BAD ACTOR. NO
EXAMINING THE SYSTEM WHO'S DOING
A GOOD JOB CREATE A PROBATIONARY
PERIOD THEY FINISH IT THEY'RE
DOING A GOOD JOB GIVEN HERE AT
IT WITHOUT HIM. SEE HOW THEY DO.
YOU CAN RUN A PROGRAM LIKE THAT
AND YOU THE DATA THANK YOU.
THANK YOU I AM A MEDICAL
PROVIDER I SHOULD MAKE NO
BECAUSE OF CUT MAKANA COUPLE
TIMES I AM I AM A MEDICAL
PROVIDER HOWEVER I VOLUNTEER MY
SERVICES SO I HAVE NO FINANCIAL.
BENEFIT FROM ANY OF THE THINGS
ARE DISCUSSED HERE WILL BE
CLEARED UP.
THEY DO WELCOME THANK YOU FOR
THAT.
.
SENATE CHAIR DR PAN AYE CHEN FOR
CAN'T COMMITTEE MEMBERS OF THE
SENATE MY NAME IS JEFF GRIP OF A
BEEN A MEMBER OF THE HEMOPHILIA
COMMUNITY.
FOR NEARLY TWENTY YEARS NOW I'VE
BEEN ON THE DRUG MANUFACTURER
SIDE OF BEEN ON THE SPECIALLY
PHARMACY SIDE.
WHEN I CAME INTO THIS ARENA I
WAS ATTENDING ABOUT.
TEN TO FIFTEEN FUNERALS HERE.
NOW IN TODAY'S DAY AND AGE THESE
CHILDREN LEAVE AND ADULTS.
LIVE A BLEED FREE LIFE THIS IS
REALLY ABOUT THE QUALITY OF CARE.
THE QUALITY OF LIFE.
AND OBVIOUSLY HAVING ACCESS TO
CERTAIN THERAPIES.
I STRONGLY OPPOSE.
BOOT THE NEW PROPOSAL AS FAR AS
WITH THAT I KNOW THAT.
US SENATE COMMITTEE MEMBER
STONE WHO WAS AS LEFT HE BROUGHT
UP EARLIER AS FAR AS BASED ON
THE AMOUNT COST.
THIS FIRE IS E. R. VISITS THOSE
WILL GO UP DRASTICALLY.
OUR GOAL IS TO KEEP CHILDREN OUT
OF THE HOSPITAL IN LIVE THAT
BLEED FREE LIFE.
AND WITH YOUR HELP SO I THANK
YOU VERY MUCH.
DOCTOR PAN.
A DIRECTOR CAN'T AND THE REST OF
YOU FOR.
GOING ON RECORD SAYING THAT YOU
WANT TO HELP US FIGHT THIS FIGHT.
WE DON'T WANT TO GO BACKWARDS WE
WE CAME FROM HELL AND WE'VE BEEN
A SUCCESS SO. THANK YOU ALL VERY
MUCH FOR ALLOWING US ALL THE
TALK.
AND.
HAVE A GOOD DAY THANK YOU.
THANK YOU WELCOME.
MY NAME'S JENNY THEM THE MY EN
FOR FAIRFIELD CALIFORNIA AND I'M
A HEMOPHILIA MOM.
I'D A STRONGLY OPPOSED THE
MEDICAL CUTS OF TWO SPECIALTY
PHARMACY FOR BLOOD CLOTTING
FACTOR.
IT'S ALWAYS BEEN A NIGHTMARE
FOR ME AND MY FAMILY DEALING
WITH REGULAR PHARMACIES BECAUSE
THEY DON'T UNDERSTAND WHAT OUR
NEEDS ARE FOR HEMOPHILIA I ENDED
UP YOU KNOW SOMETIMES DAYS OR. A
MONTH WITHOUT FACTOR BECAUSE
THEY DON'T KNOW WHAT TO DO OR
HOW THEY CAN REVEAL MY SON'S
MEDICINE. AND IT'S SO HARD TO BE
BOUNCE BACK FROM ONE DEPARTMENT
TO ANOTHER BECAUSE THEY DON'T
KNOW WHAT I.
WHICH SPECIALTY PHARMACY DE
ENSURE THAT MY SON RECEIVES
MEDICINE EVERY MONTH. AND THAT
WE ARE TAKING CARE THE LOVE SOLD
THINK YOU SO MUCH PLEASE PROTECT
OUR PATIENTS CARE.
THANK YOU.
WELCOME.
YEAH CARRIER SO THEY HAVE TO
MARCH DONS HERE SUPPORT AND THE
PROPOSAL SUPPORTED BY CHILDREN
NOW ON THE FIFTY SIX AT THE
PROPERTY SIX RELATED PROPOSALS
AS WELL AS DE BACK CALIFORNIA
WITH ASSOCIATION PROPOSAL FOR
BREAST PUMP RATE INCREASE.
THANK YOU THANK YOU.
WELCOME.
JENNIFER CENTER BEHALF OF THE
CALIFORNIA ASSOCIATION HOPE
FACILITIES JUST WANTED TO
EXPRESS OUR SUPPORT FOR THE
PROPOSAL THAT WAS BEFORE YOU
TODAY WITH RESPECT TO PEDIATRIC
FREE STANDING PEDIATRIC SUB
ACUTE FACILITIES.
WE HAVE.
A FEW OF THOSE FACILITIES THAT
ARE PART OF OUR MEMBERSHIP
THERE'S A VERY SMALL AMOUNT THE
STATE PROBABLY LESS THAN TEN. OF
THOSE PROBLEMATIC FIVE OR SIX
THAT ARE FREE STANDING SO THEIR
LICENSE TO SKILLED NURSING
FACILITIES BUT RECEIVE A
CERTIFICATION TO THE MEDICARE
PROGRAM FOR PEDIATRIC SUB ACUTE
SERVICES.
AND THEY'RE KIND OF LOST IN THE
MIDDLE A BIT BECAUSE THEY AND
ARE ABLE TO TAKE ADVANTAGE OF
THE A. B. SIXTEEN TWENTY NINE
PROGRAM THAT. MOST LICENSE
SKILLED NURSING FACILITIES PAY A
QUALITY ASSURANCE CITY AND THEY
CAN'T DO THAT BECAUSE THEIR
RATES ARE FROZEN IN THE OAO NINE.
RATE SETTING YEAR AND SO ANY OF
THEIR COST OF LIVING INCREASES
HAVE NOT BEEN RECOGNIZED
CONTINUE TO NOT BE RECOGNIZED SO
WOULD ENCOURAGE THE COMMITTEE TO
CONSIDER. AND SOME TYPE OF.
SUPPORT FOR THEM FOR THOSE ON
COST OF LIVING NEEDS. THANK YOU
THANK YOU.
WELCOME.
GOOD AFTERNOON MR CHERUB CENTER
MONEY.
PUB OUR TODAY ON BEHALF OF THE
PREMIER HEALTHCARE SERVICES IN
SUPPORT OF THE ADMINISTRATION'S
PROPOSAL TO INCREASE THE RATES
FOR THE IN HOME. A PEDIATRIC
NURSING PROGRAM. HAD. THESE
FUNDS ARE. VITAL TO THE SUCCESS
OF THE CONTINUED SUCCESS OF THE
PROGRAM THANK YOU.
THANK YOU.
WELCOME TO.
GOOD AFTERNOON I'M I'M HERE TO
SUPPORT THE FIFTY PERCENT RATE
INCREASE IN THE HOME HEALTH
SETTING BUT I WANT TO POINT OUT
AND I WANT TO THANK YOU ALL FOR
ACTUALLY WORKING ON THIS AFTER
SEVERAL YEARS.
BUT WE HAVE BEEN FIGHTING FOR
THIS FIGHT.
IS THAT THIS JUST GETS A SLIGHT
BREAK EVEN POINT.
THIS DOESN'T SOLVE THE PROBLEM
FOR THE FUTURE AND AS YOU CAN
SEE THERE ARE OTHER INDUSTRIES
THAT ARE PAYING A LOT MORE. WE
MIGHT LOSE AND FUTURE GENERATION
THAT MIGHT NOT BE ABLE.
TO JUMP IN AND TO HELP IN THE
HEALTH CARE INDUSTRY AS A WHOLE.
SO HE CAN PLEASE KEEP THAT IN
MIND AND ADEPTLY THANK YOU FOR
SUPPORTING THE FIFTY PERCENT
RATE INCREASE.
I THINK AS A SHELVE THE KEY
INTRODUCE YOURSELF I'M SORRY MY
NAME IS ALEX HOLD ON A FROM
OXFORD HEALTH CARE IN THE LA
COUNTY OKAY THANK YOU I REPRESENT A COMPANY ALWAYS
HOME OR SEEN WE SPECIALIZE IN
PROVIDING PEDIATRIC.
PATIENT NURSING CARE FOR
CHILDREN WITH COMPLEX MEDICAL
NEEDS AND WE HAD ONLY SUPPORT
THE INCREASE TO HOME HEALTH
REIMBURSEMENT THEM. I CAN ATTEST
CERTAINLY THE ACCESS ISSUE I
PERSONALLY KNOW BUT THE
RECRUITMENT DEPARTMENT IN THE
PAST YEAR WE'VE. HAD ELEVEN
HUNDRED NURSES WHO APPLIED FOR
OUR JOB POSTINGS AND WE HIRED
EIGHT OF THOSE.
AGAIN THOSE ARE NURSES THAT
APPLY TO OUR POSTINGS NOT ONES
THAT WE SOLICITED FOR EMPLOYMENT.
ECONOMY REASON OBVIOUSLY WAYSWAS WAGES.
COMMERCIALLY ON OUR INTAKE SIDE
WE HAVE A WAITING LIST OF OVER A
HUNDRED PATIENTS. WHO WERE
BASICALLY PLEADING FOR SERVICE
ISN'T I PERSONALLY SPOKEN TO?
ALL THE FAMILIES PARENTS WHO
WERE ESSENTIALLY PLEADING FOR
HELP THEY'RE VERY SIMILAR TO THE
ONES YOU SAW TODAY.
AND YOU KNOW JUST THIS WEEK WE
HAD A NURSE THAT.
WE WERE ABLE TO HIRE WHOMEVER
COMPETENCY STANDARDS IN TRACY.
WE WERE REALLY EXCITED ABOUT
THIS IS RARE I MEAN THIS IS.
THE NEEDLE IN THE HAYSTACK I WAS
REAL EXCITED CALL FAMILY LET
THEM KNOW THAT WE WOULD HAVE
SOME SUPPORT FOR THEM AND. FOUND
OUT THAT THAT PATIENT PASSED
AWAY.
.
WHICH WAS CRASHING FOR ME TO
HAVE THAT. PHONE CALL IN THE
CONVERSATION IS FOR SOMETHING
THEY NEVER SHOULD HAPPEN THAT WE
WE SHOULD NEVER LET IT GET TO
THIS POINT AND.
TO SPEAK TO LIKE ALEX SAID IT'S
NOT ONLY CATCHING UP FOR
SEVENTEEN YEARS OF NEGLECT BUT
ALSO LOOKING AHEAD FOR. YOU KNOW
WHAT IT MIGHT LOOK LIKE FIVE
YEARS FROM NOW APPRECIATE YOUR
TIME. THANK THANK THANK YOU.
WELCOME.
THAT MEMBER YOU KNOW PRESS HIM
WE HAVE THE CALIFORNIA
ASSOCIATION OF HEALTH SERVICES
AT HOME ON IN SUPPORT OF THE
HEALTH HOME HEALTH. WAS A RATE
INCREASE I'M JUST REAL QUICK
JUST WANT TO SAY THAT WE BELIEVE
THERE'S A REAL SIGNIFICANT GAP
AND THE NUMBER OF HOURS
AUTHORIZED TO THE NUMBER OF
HOURS RENDERED IN THIS OF A LONG
WAY TO FIX THAT THINK.
THANK YOU.
WELCOME GIVEN THE GRAVITY
REPRESENTING OUR MAXIMUM A
HEALTH CARE SERVICES.
WE ARE HERE IN SUPPORT OF THE
ADMINISTRATIVE POSTAL FOR THE
HOME HEALTH.
A RATE INCREASE
I WE APPRECIATE THAT AND I THINK
THE COMMITTEE THANK YOU.
THANK YOU WELCOME. I AM CAN
REALLY ADMINS THE DIRECTOR OF
HEALTH SERVICES FOR WOMEN'S
HEALTH
AND SPECIALIST AND I AM HERE.
TO SPEAK IN FAVOR OF UC DAVIS
EXPANDING PRIMARY CARE SERVICES
FOR MEDI CAL PATIENTS AND TALK
AROUND A COUNTY. WE FIRSTHAND
KNOW THE BURDEN OF TAKING ON AND
YOU KNOW EIGHTY PERCENT OF OUR
CLIENTS HAVE MEDI CAL BUT IT IS
NOT ENOUGH TIME. TO JUST OFFER
E. R. VISITS BE OUT TO PROVIDE A
WAY FOR OUR AND OUR.
CONSTITUENTS TO HOW OF PRIMARY
HEALTH CARE THANK YOU THANK YOU.
WELCOME.
I HAVE MY NAME IS DOCTOR
CRISTINA BORN AND I AM A SECOND
YEAR RESIDENT IN FAMILY MEDICINE
AND PSYCHIATRY I UC DAVIS.
AND I'M ADVOCATING FOR THE
INCLUSION OF MEDI CAL PATIENTS
TO BE SEEN OUR PRIMARY CARE
CLINICS.
AS AN OUTPATIENT FAMILY
MEDICINE DOCTOR I SHOULD BE THE
MAIN PHYSICIAN IN WHICH MEDI CAL
PATIENTS EXCLUSIVELY SEE.
INSTEAD I SEE MEDI CAL PATIENTS
IN THE EMERGENCY ROOM OR AN IN
PATIENT HOSPITAL SETTINGS.
THIS AFFECTS MY TRAINING AS A
RESIDENT AND MORE IMPORTANTLY
DISPROPORTIONATELY AFFECTS OF
FOUR HUNDRED AND THIRTY THOUSAND
SACRAMENTO INTO A RELIGION MEDI
CAL.
LASTLY IT WAS MENTIONED BY DR
STOBO THAT ARE YOU SEE.
UC DAVIS MEDICAL PATIENTS ARE
MORE EXPENSIVE BECAUSE THEY ARE
SICKER.
BUT WAY OF PROMOTING HEALTH
WELLNESS AND DECREASE HEALTH
EXPENDITURES AS INCLUDING THEM
DIRECTLY INTO OUR PRIMARY
HEALTHCARE SYSTEM.
AND IF YOU WOULDN'T MIND I'M
SPEAKING N BEHALF ALSO OF MY
COLLEAGUE WHO HAD TO GO ON FOR
THOUGHT HER CLINICAL DUTIES AM
DR RACHEL MITCHELL.
MY NAME IS DOCTOR RACHEL
MITCHELL AND I AM A RESIDENT
PHYSICIAN AT UC DAVIS. WHEN I
WAS A MED STUDENT HERE I WAS ON
MEDI CAL ALONG WITH MY CHILDREN.
MY DAUGHTER BENDY QUEST SPECIAL
NEEDS WAS DROPPED FROM HER
PEDIATRICIAN AND NINE SPECIALIST.
WHEN UC DAVIS DROPPED THE HEALTH
NET CONTRACT
AND IT TOOK US SIX MONTHS TO GET
BACK TO THE SERVICES THAT SHE
NEEDED ON A DAILY BASIS.
NOW I SEE MY PRIMARY CARE
PATIENTS STRUGGLING WITH THE
SAME ISSUES THAT CAN ONLY BE
SEEN IN THE HOSPITAL AND
EMERGING CONDITIONS. BECAUSE UC
DAVIS SEE SO FEW MEDI CAL
PATIENTS IN THE OUTPATIENT
SETTING.
I KNOW IT IS EXPENSIVE TO SEE
MEDI CAL PATIENTS IN OUR CINICS
BUT IS FAR MORE EXPENSIVE FOR US
TO SEE THEM IN OUR HOSPITAL. AND
EMERGENCY ROOMS AND LISA MUCH
WORSE HEALTH OUTCOMES FOR THEM.
WE SHOULD BE MORE CONCERNED WITH
LONG TERM OUTCOMES AND.
LESS CONCERNED WITH SHORT TERM
PROFITS THANK YOU. THANK YOU.
WELCOME.
AFTERNOON SENATORS AND BOARD
MEMBERS MY NAME IS ALAN AND AS
LYNN AND I'M A FIRST YEAR
MEDICAL STUDENT AS UC DAVIS
MEDICAL CENTER.
THIS PAST WEEKEND THERE WAS A
YOUNG MAN WHO CAME INTO ONE OF
OUR FREE STUDENT RUN CLINICS
WHAT A VIRAL ILLNESS LAST WEEK
AND MISSED TWO DAYS OF WORK. HE
WORKS IN CONSTRUCTION IS
EMPLOYER REQUIRED A DOCTOR'S
OVER PAID SICK LEAVE ALTHOUGH HE
WAS A MEDIC KYLE AND HE HAD
COULD MEDICAL COVERAGE AND
GENERALLY RECEIVE CARE AT THE
COUNTY CLINIC. DO SO THAT THEY
WERE INTENDED WITH PATIENTS IN
COULD NOT SCHEDULE HIM IMPLEMENT
TILL JUNE DISQUALIFYING HIM FOR
THE PAY FOR THOSE TWO DAYS.
IN HIS FAMILY LIVE PAYCHECK TO
PAYCHECK SO THAT DOCTORS DON'T
WOULD BE UNABLE TO MAKE RENT.
UNFORTUNATELY IT IS A VERY
COMMON STORY AT THE UC DAVIS
STUDENT CLINICS WE ARE AT
MAXIMUM CAPACITY AND MUST TURN
AWAY PATIENTS WITH SIMILAR
PROBLEMS EVERY SINGLE WEEKEND.
ARE WE CAN CLINICS CANNOT
SUBSTITUTE FOR THE CONTINUAL
PRIMARY CARE SERVICES AT UC
DAVIS MEDICAL CENTER COULD
PROVIDE FOR MEDI CAL PATIENTS.
WE ARE LEARNING EARLY ON THAT WE
MUST ADVOCATE FOR OUR PATIENTS
OURSELVES WHICH IS WHY WE ARE
HERE ON A SCHOOL DAY A WEEK AND
HALF BEFORE FINALS.
WE NEED YOUR HELP TO PUT
POLITICAL PRESSURE ON IN BOYNTON
AND RICE AND THE REST THE UC
DAVIS HEALTH ADMINISTRATION TO
EXPAND MEDI CAL CONTRACT BEYOND
CURRENT COVERAGE FOR JUST THREE
THOUSAND PATIENTS. WHICH WOULD
ALLOW US AS MEDICAL STUDENTS
PROVIDE. PRIMARY CARE SERVICES
FOR THOSE PATIENTS AT OUR
TEACHING HOSPITAL.
THANK YOU THANK YOU.
WELCOME.
HI MY NAME IS AMANDA UPON AND I
AM A FIRST YEAR MEDICAL STUDENT
AT UC DAVIS.
SO THIS YEAR I'LL BE TURNING
TWENTY SIX MEANING I WILL NOT BE
ON MY PARENTS INSURANCE ANY
LONGER MEANING I WILL BE
APPLYING FOR MEDI CAL.
AND THE SAD PART IS THAT UC
DAVIS HEALTH SYSTEM DOESN'T TAKE
MEDICAL PATIENTS THE SAME
INSTITUTION WHICH I'M A PART OF.
AND THERE ARE MANY OTHER
STUDENTS IN OUR SCHOOL THAT ARE
ALSO YOU KNOW WITHIN THE MEDICAL
SYSTEM BUT YET WE CAN GET
HEALTHCARE FROM OUR OWN
INSTITUTION.
AND I WOULD JUST LIKE TO SAY
THAT THIS ISN'T JUST A PROBLEM
WITH JUST MEDICAL STUDENT THE
PROBLEM FOR NURSING STUDENTS PA
STUDENTS WERE ALL DEALING WITH
THIS TOGETHER. AND I FEEL LIKE.
OUR MISSION AT UC DAVIS IS TO
HELP THE UNDERSERVED BUT HOW CAN
WE HELP YOU UNDERSERVED IF WE
CAN'T EVEN PROVIDE CARE AND
SERVICE.
TO THOSE THAT ARE MOST
VULNERABLE. AND.
I FEEL LIKE AS A TEACHING
HOSPITAL WE NEED TO BE THE ROLE
MODEL WHICH PROVIDE SERVICE AND
IT'S INCLUSIVE OF ALL PATIENTS.
BUT YET WE WE DON'T DO THAT. AND
I WOULD LIKE TO ECHO THAT YES
YOU KNOW MEDI CAL REIMBURSEMENTS
THEY ARE VERY LOW. BUT THAT
DOESN'T MEAN THAT WE SHOULDN'T
BE FIGHTING HIT CARE TO OUR.
.
MEDICAL PATIENTS AND I WOULD
ALSO LIKE TO ECHO YOUR COMMENTS
SENATOR UPON THAT YES YOU SEE A
SUB DOES TAKE THE FULL SCOPE OF
MEDI CAL PATIENTS SO WHY
SHOULDN'T WE.
THANK YOU AGAIN.
WELCOME.
HELLO MY NAME IS ONLY ON THE
LOBBY LA I'M A FIRST YEAR
MEDICAL STUDENT AT UC DAVIS.
I CHOSE TO GO TO MEDICAL SCHOOL
UC DAVIS BECAUSE I BELIEVE IN
THEIR MISSION.
TO SERVE THE UNDERSERVED AND TO
SPEAK OUT AGAINST THE INJUSTICES.
BUT THE PEOPLE OF CALIFORNIA
FACES PATIENTS.
I CANNOT STAND BY WHILE YOU SEE
DAVIS MEDICAL GROUP REFUSES TO
PROVIDE PRIMARY CARE SERVICES TO
CALIFORNIA'S MOST VULNERABLE
PATIENT POPULATION.
MEDI CAL RECIPIENTS.
THERE ARE TOO MANY SACRAMENTO
RESIDENTS THAT ARE NOT GETTING
THE OPTIMAL HEALTH CARE THAT
THEY NEED.
AND IT ONLY HURTS US IN THE LONG
RUN.
MANY SACRAMENTO RESIDENTS ARE
LIVING WITH POORLY CONTROLLED
CHRONIC HEALTH DISEASES THAT CAN
BE MANAGED WITH ADEQUATE HEALTH
CARE. BUT ARE NOT BECAUSE UC
DAVIS MEDICAL GROUP REFUSES TO
TREAT THEM.
IRONICALLY IT'S THE SAME
RESIDENTS THEY REFUSE TO TREAT
THE END UP AS PATIENTS IN THEIR
EMERGENCY DEPARTMENT.
THE PEOPLE SACRAMENTO ARE
SUFFERING AND I ASK THAT THE
POWERS THAT BE.
HOLD EASY DAVIS MEDICAL GROUP
ACCOUNTABLE. TO ACCEPTED TREAT
THE PATIENTS THAT THEY CLAIM TO
SERVE.
AND IF REIMBURSEMENTS ARE THE
ISSUE.
THEN PLEASE BY
TO GET THEM THE FUNDING THAT
THEY NEED TO PROVIDE PRIMARY
CARE SERVICES TO MEDICAL
PATIENTS.
THANK YOU.
WELCOME.
I AM MY NAME IS DANA ISAACS I AM
ALSO A FIRST YEAR MEDICAL
STUDENT AT UC DAVIS.
I AM NATIVE FROM SACRAMENTO.
AND I STAND HERE WITH MY CLASS
FELLOW FIRST YEAR MEDICAL
STUDENT AT UC DAVIS IN
SOLIDARITY FOR EXPANDING PRIMARY
CARE SERVICES FOR MEDI CAL
PATIENTS AT DAVIS.
AS A FUTURE POSITION WITH A
MASTER'S DEGREE IN PUBLIC HEALTH
I BELIEVE THAT UC DAVIS SHOULD
FOCUS ON PREVENTIVE SERVICES
ESPECIALLY SINCE DAVIS A SCENE
MEDICAID PATIENTS IN THE ER. HOW
CAN DAVIS AT THOUGH ITS MISSION
OF PROVIDING CULTURALLY
COMPETENT COMPASSIONATE CARE IF
WE'RE TURNING AWAY OVER FOUR
HUNDRED THOUSAND PATIENTS THIS
IS NOT WHY I CHOSE THE SCHOOL TO
STUDY MEDICINE? THANK YOU THANK
YOU.
I MY NAME IS KILEY BUT THEN. I'M
ALSO FIRST YEAR MEDICAL STUDENT
AT DAVIS I'M INTO ANSWER YOUR
PREVIOUS QUESTION DOCTOR PAN
THEIR FOUR HUNDRED THIRTY
THOUSAND MEDI CAL MANAGED CARE
LIVES IN SACRAMENTO COUNTY. AND
YEAH AS OUR PUBLICLY FUNDED
HOSPITAL LESS THAN ONE PERCENT
ONLY THREE THOUSAND OF THESE
PATIENTS ARE COVERED BY UC DAVIS.
UNDER THE NEW UNITED CONTRACTS.
AS FUTURE PHYSICIANS IN AS PART
OF THE UC DAVIS MEDICAL SYSTEM
WE WANT TO KNOW WHEN UC DAVIS
WILL BE A PART OF THE SOLUTION.
THANK YOU THANK YOU.
WELCOME GOOD AFTERNOON MY NAME
IS ANGELA CHANG I'M A FIRST YEAR
MEDICAL STUDENT I'M CURRENTLY ON
MEDI CAL AND I AM ONE OF SIX OF
MY CLASSMATES WHO ARE PART OF
THE THREE YEAR OF PRIMARY CARE
TRACK EASY DAVIS. AND EVEN
BEFORE STARTING MEDICAL SCHOOL
WE COMMITTED TO BECOMING AN
ANSWERING TO FOR PRIMARY CARE
BECAUSE WE WANT TO SERVE THE
UNDERSERVED COMMUNITIES THAT WE
GREW UP IN.
AND SO BY UC DAVIS AND CHOOSING
NOT TO COVER THESE FOR INJURED
THIRD THIRTY THOUSAND A MEDICAL
PATIENTS AND SECOND COUNTY IT'S
NOT ONLY DOING A DISSERVICE TO
THE OVAL COMMUNITY THAT IT'S
COMMITTED TO SERVING. BUT IT'S
ALSO OF FAILING TO FAILING TO
FULFILL ITS MISSION TO TRAIN AND
ADEQUATELY PREPARE FUTURE
PHYSICIANS TO CARE FOR THIS UP
BUT OLD LOW INCOME AND DIVERSE
COMMUNITIES THREE URGE YOU TO.
UNDER PRESSURE ON UC DAVIS OF
THAT WE CAN CONTINUE SERVING THE
MOST VULNERABLE IN OUR
COMMUNITIES
THANK YOU THANK YOU.
WELCOME.
MY NAME IS BELOW WILL REMOVE
THEM OFFICIAL MEDICAL CERVANTES
IS.
MY NAME IS FAR SOME FRIES.
MY NAME IS ESTHER GONG.
BUT IN SYNDICATE WAS MONDAY AND
I CAN.
MY NAME IS KINDER VIRGA AND WE
ARE PART OF THE UC DAVIS MEDICAL
STUDENTS WHO ARE PURCHASE PENS
AND THE TRANSFORMING EDUCATION
AND COMMUNITY HEALTH TRACK
PROGRAM. OR PROGRAM IS COMMITTED
TO SERVING URBAN UNDERSERVED
COMMUNITIES SUCH AS THE OAK PARK
NEIGHBORHOOD HERE IN SACRAMENTO.
AS SUCH WE SUPPORT EXPANDING
PRIMARY CARE A UC DAVIS HEALTH
FOR MEDI CAL PATIENTS AND
INCREASING REIMBURSEMENT RATES
TO MAKE THAT FEASIBLE THANK YOU.
THANK YOU.
WELCOME.
I AM A SIGNIFICANT TINA I'M ALSO
FIRST YEAR MEDICAL STUDENT I
JUST WANTED TO ECHO WHAT MY
COUSIN.
FED.
THANK YOU.
MY NAME IS MONA BATIK I'M ALSO
FIRST YEAR MDICAL STUDENT AT UC
DAVIS SCHOOL OF MEDICINE. AND I
ALSO AM AGREE WITH MY FELLOW
PEERS AND EXPANDING PRIMARY CARE
SERVICES I'M I UC DAVIS HEALTH
CENTERS ON FOR MEDI CAL PATIENTS.
THANK YOU.
HELLO MY NAME IS MARY WELTER OF
ALSO A FIRST YEAR MEDICAL
STUDENT AT UC DAVIS SCHOOL OF
MEDICINE I WANT TO SUPPORT.
THOMAS AND SOLIDARITY WITH MY
PEERS HARDY SAID.
THANK YOU.
I MEAN IT WAS COHEN WILL.
I'M A FIX HE MEDICAL STUDENT
HERE YOU SEE DAVIS ALSO AND ALSO
MEDI CAL PATIENTS I'M HERE TO
SUPPORT THE EXPENSIVE MEDICAL
SERVICE AT UC DAVIS HOW. THANK
YOU THANK YOU I MY NAME IS HELEN
CAME AND ALSO A FIRST YEAR
MEDICAL STUDENT AT UC DAVIS AND.
EYES.
I AGREE WITH THE REST.
CLASSMATES BECKY.
WELL I MY NAME IS DAN I'M ALSO
FIRST YEAR MEDICAL STUDENT AND
I'M HERE TO TACKLE AND SUPPORT
WHAT A COST BASIS.
THANK YOU ON MY NAME IS HAVE
FRIENDS HIS OWN HEAD I'M A FIRST
YEAR MEDICAL STUDENT I'M ALSO
PART OF THE. WORLD TRACK AND
RURAL PRIME TRACK PROGRAM.
AS A FUTURE OF PRIMARY CARE
PHYSICIAN I WANNA ADVOCATE FOR
THE EXPANSION OF MEDICARE AT THE
UC SYSTEM IT WAS VOICE THAT
WHERE ONE OF THE TOP HEALTH
SYSTEMS.
SO WHY NOT LEAD AND BE ONE OF
THE FIRST ONES WHO PUT IT OUT
FIRST UP PREVENTIVE CARE
SERVICES.
AND THIS IS THE REASON WHY A
STAND WITH ALL MY COLLEAGUES
HERE ADVOCATING FOR THE
EXPANSION THANK YOU. THANK YOU.
WELCOME.
I MEAN IS ILEANA AMONG NEW AND
I'M A FIRST YEAR MEDICAL STUDENT
AT DAVIS.
AND MY NAME IS RUNNING DEEP
DILLON THEM ALSO FIRST YEAR
MEDICAL STUDENT WHERE
REPRESENTING FOR THE SAN JOAQUIN
VALLEY PRIME PROGRAM AS WELL
THAT SERVES THE UNDERSERVED
WITHIN THE CENTRAL VALLEY.
AND WE'RE HERE IN SOLIDARITY
WITH OUR CLASSMATES ON SUPPORT
EXPANDING PRIMARY HEALTH CARE UC
DAVIS FOR MEDICAL PATIENTS THANK
YOU. THANK YOU.
HELLO MY NAME IS KIMBERLY NO I'M
ALSO FIRST YEAR MEDICAL STUDENT
I'M ALSO HERE TO ST SOLIDARITY
AND SUPPORT WHAT LIFE FELLOW
COLLEAGUES HAVE SAID IN TERMS OF
EXPANDING MEDICARE COVERAGE.
MEDI CAL COVERAGE SHOULD
PATIENTS HERE AT UC DAVIS
MEDICAL CENTER THANK YOU THANK
YOU.
HIGHER MULLIN TILL AM ALSO FIRST
YEAR MEDICAL STUDENT AND I WOULD
ALSO LIKE TO ECHO WHAT MY
CLASSMATES HAVE SIDE.
THANK YOU.
HI MY NAME IS ROXANA AND NOW I
AM A FIRST YEAR MEDICAL STUDENT
AT UC DAVIS AND ALSO PART OF THE
RULE PRIME PROGRAM. WHICH
PROVIDE HELPS PREPARE THE NEXT
GENERATION OF PHYSICIANS AND
RURAL UNDERSERVED AREAS IN
CALIFORNIA. AND I WOULD JUST
LIKE TO STAND IN SOLIDARITY WITH
THE REST OF MY CLASSMATES TODAY.
THANK YOU.
HELLO I'M CHRISTIAN GRAYSON THE
PERSON THAT POSTED A C. DAVIS
AND I'M HERE TO STAND IN
SOLIDARITY WITH MY FELLOW
CLASSMATES ABOUT EXPANDING AND
MEDI CAL. A COVERAGE TO A PEAK
OUR TO OUR PATIENTS IN THIS AREA.
BY POOR.
UC DAVIS MEDICAL CENTER.
EDU.
HELLO MY NAME IS EMILY MOODY I'M
ANOTHER FIRST YEAR MEDICAL
STUDENT AT UC DAVIS SOMEONE TO
ECHO MY CLASSMATES COMMENTS AND
ALSO SHARE AN ANECDOTE THAT
RECENTLY AS ONE OF THE CO
DIRECTORS OF OUR.
WE CAN STUDENT RUN CLINICS
WE HAD.
GENERAL SURGERY RESIDENT COME
TO US AND INQUIRE ABOUT THE
POSSIBILITY OF US SEEING
DISCHARGED TRAUMA SURGERY
PATIENTS FOR PRIMARY CARE
SERVICES AND BECAUSE THEY ARE
UNABLE TO BE FOLLOWED UP WITH.
AT AND THE UC DAVIS SYSTEM OUT
AFTER RECEIVING THESE EMERGENCY
SERVICES ADAM WHICH I THINK
REALLY EMPHASIZED THE ISSUE OF
US PROVIDING PREVENTIVE CARE
SERVICES FOR MEDI CAL PATIENTS
I'M NOT ONLY ASSISTING THEM IN
EMERGENCIES.
THANK YOU THANK YOU.
WELCOME AYE MANY OF MY SELECT AG
AND ALSO A FIRST YEAR MEDICAL
STUDENT AT UC DAVIS.
I JUST WANT TO SUPPORT MY FELLOW
CLASSMATES AND EXPANDING MEDI
CAL FOR OUR PATIENTS.
THANK YOU.
HELLO MY NAME IS JACQUELINE TO
SARS I'M ALSO A FIRST YEAR
MEDICAL STUDENT AT UC DAVIS
THANK YOU SO MUCH FOR LISTENING
TO OUR CONCERNS TODAY I'M I JUST
LIKE TO AGREE WITH MY CLASSMATES
ABOUT EXPANDING PRIMARY CARE OUT
FOR MEDICAL PATIENTS AT UC DAVIS.
THANK YOU THANK YOU.
HELLO MY NAME IS RYAN PASQUA I
AM ALSO A MEDICAL STUDENT AT UC
DAVIS I'M ALSO A CO DIRECTOR ACT
THE NICK AT THE BUT THE WHICH IS
A CLINIC THAT SERVES THE
UNDERSERVED HISPANIC POPULATION
HERE IN SACRAMENTO. AND ONE OF
THE OTHER KIND OF COMPLICATIONS
AND CONSEQUENCES OF OUR LACK OF
SUPPORTING MEDI CAL PATIENTS IS
THAT WHEN WE DISCOVER THINGS IN
OUR CLINIC FOR EXAMPLE A SCARY
LUMP IN A WOMAN'S BREAST OR. ON
A.
SOME PUT A PATIENT THAT MIGHT
REQUIRE MORE I GUESS INTENSIVE
SURGERY OR PROCEDURE WE CAN NO
LONGER EVEN RIP RUN I GUESS RELY
ON OUR OWN INSTITUTION. AND
SERVICE IS SOMETHING THAT'S A
CONCERN FOR US THERE AND THANK
YOU FOR YOUR TIME NO THANK YOU.
HELLO MY NAME IS SARAH PLATFORM
ALSO FIRST YEAR MEDICAL STUDENT
WITH UC DAVIS AND I'M JUST ALSO
HERE TO ENCOURAGE EXPANDING. I'M
PRIMARY HEALTHCARE SERVICES FOR
MEDI CAL PATIENTS AT UC DAVIS A
GREAT THANK YOU.
RACHEL CAME BACK FIRST YEAR
MEDICAL STUDENT AND I'D LIKE TO
AGREE WITH.
WHAT MY COLLEAGUES HAVE
PREVIOUSLY STATED THANK YOU
THANK YOU?
OTHER THANK YOU ALL ON MY NAME
IS HOLY CRANIUM A FIRST YEAR
MEDICAL STUDENT I STAND IN
SOLIDARITY WITH MY CLASSMATES AS
WELL JUST TO. AND BE A PROPONENT
FOR MEDI CAL EXPANSION AND
REIMBURSEMENT.
AS WELL AS BRINGING THAT
ACCOUNT FOR PRIMARY CARE HOTTER
HOUSE
THANK YOU THANK YOU.
I AM MY NAME IS BRITTANY RADISH
I'M ALSO FISH YOU MEDICAL SU NAY
EASY DAVIS AND I WOULD LIKE THIS.
I EXPRESS MY SUPPORT FOR
EXPANDING IRAQ CARE.
COVERAGE FOR MEDI CAL PATIENTS
AYE EASY. I THINK YOU.
I MY NAME IS ADAM BACON I JUST
LIKE TO ECHO MY COLLEAGUES
COMMITS.
THANK YOU.
SENATE MEMBERS MY NAME IS SIMS
AND ANA FOR SHOULDN'T. FIRST
YEAR MEDICAL STUDENT AT UC DAVIS.
SOMETHING I WOULD LIKE TO ADD
TO WHAT MY CLASSMATES HAVE SAID
IS THAT. JUST WITHIN THIS PAST
WEEK IN THE MERCHANTS WHO
DEPARTMENT I SEEN PATIENTS WHO
HAVE MEDICO WHO CANNOT SEE IT
PRIME MAKERS SERVICE PROVIDER.
AND HAS BEEN STRUGGLING WITH
THAT DONORS FOR LIKE THE PAST
NINE MONTHS.
AND WHILE STRUGGLING WITH THE
DISEASE IS HARD ENOUGH AS IT IS
SEEING THEM WITH IN THE
EMERGENCY DEPARTMENT AFTER
LOSING THIRTY FIVE POUNDS WITHIN
THE PAST. NINE MONTHS
STRUGGLING WITH TRYING TO SEE
SOMEONE AND TO GET THAT COVERAGE
HAS BEEN A VERY.
ON THE MOTION MOMENT FOR ME SOME
REALLY HOPING THAT THIS GROUP
HERE CAN PRESSURE. YOU SEE DAVIS
TO EXPAND PRIMARY CARE SERVICES
THANK YOU THANK YOU.
HELLO MY NAME IS CRYSTAL
FOREST'S PURSUE MEDICAL SENSE
AND I LIKED ST SOLIDARITY WITH
MY CLASSMATES COMMENTS.
I THINK YOU.
HI MY NAME IS NICOLE YOUNG I'M
ALSO A FIRST YEAR MEDICAL
STUDENT AND I STAND IN
SOLIDARITY WITH MY CLASSMATES.
THANK YOU.
I AM ELI NATIONAL SO FIRST YEAR
MEDICAL STUDENT I'M HERE IN
SOLIDARITY WITH MY CLASSMATES
THANK YOU THANK YOU.
HI MY NAME'S GRADUATE FOR NEW.
I AM SINGLE OUT THERE BUT WE.
AND WHERE ALSO FIRST YEAR
MEDICAL STUDENTS AND WE JUST
WANTED TO STAND IN SOLIDARITY
WITH THEIR EASING CLASSMATES AND
FUTURE PHYSICIANS.
THIS ONE HOW IT AND THE REASON
WE HAVE SO MANY OF US OUT HERE
IT IS BECAUSE THIS IS A VERY
IMPORTANT ISSUE AND WE REALLY DO
HOPE THAT YOU GUYS.
SPENT A LOT OF TIME LOOKING AT
MADISON GIVETH GIVE EVERYBODY
THE PRESSURE THAT IS NEEDED TO
MOVE US FORWARD.
THANK YOU SO MUCH AGAIN. THANK
YOU.
AFTERNOON LIES ATTENTION ON A
MANAGING ATTORNEY AT LEGAL
SERVICES OF NORTHERN CALIFORNIA
WHERE THE LEGALLY PROVIDER FOR
LOW INCOME PEOPLE IN SACRAMENTO
COUNTY FOR THE MOST COMMON
ISSUES THAT WE HEAR FROM OUR
CLIENTS IS AN INABILITY TO
ACCESS PRIMARY CARE DUE TO. HOW
IMPACTED SO MANY OF THE FQHCS IN
SACRAMENTO ARE AND IT'S
UNACCEPTABLE THAT UC DAVIS IS
PROVIDING PRIMARY CARE TO THAT
LESSON THREE THOUSAND PEOPLE OUT
OF FOUR HUNDRED THIRTY THOUSAND
MEDICAL LIVES? SEEING MEDICARE
PATIENTS IN THE ER IS NOT ENOUGH
AND YOU SEE IT SHOULD BE A
LEADER IN ALLEVIATING THE SSUE
IF YOU OKAY THANK YOU.
GOOD AFTERNOON LINDA WAY WITH
WESTERN CENTER ON LAW AND
POVERTY LIKE TO ALIGN OUR
COMMENTS WITH THE UC DAVIS
RESIDENTS AND LIVE NICK. ON IT
AS WELL AS ADD THAT THIS IS NOT
JUST AN ISSUE AT UC DAVIS BUT
WITH THE UC'S THROUGHOUT THE
STATE WE'VE HEARD FROM OUR LEGAL
SERVICE ADVOCATES THAT ON THIS
IS AN ISSUE THROUGHOUT THE STATE
AS WELL AS NOT JUST FOR PRIMARY
CARE BUT. ALSO FOR SPECIAL.
A IN ADDITION WE'D LIKE TO ALIGN
OUR COMMENTS WITH THE PEN
REGULATED TO DIE UNTIL I
REIMBURSEMENTS BUMPING FOCUS ON
PREVENTIVE INCOME TREATMENT. A
WE ALSO LOOK AT LIKE TO ADD ON
THAT GEOGRAPHIC REGIONS COULD BE
CONSIDERED PARTICULARLY NOTING
THAT THERE ARE. FIVE COUNTIES
THAT HAVE O DENTAL CAL
PROVIDERS ON IN REGARDS TO YOU
ON PHYSICIAN SERVICES I WOULD
ALSO LIKE TO NOTE THAT THE FOCUS
ON SPECIALIST WITH.
PARTICULARLY GAS STERN COLLEGES
NEUROLOGY ORTHOPEDICS QUAN OLOGY
RHEUMATOLOGY AND UROLOGY WERE
LISTED AS ODD AREAS OF SHORTAGES
I'M AS WELL AS A GEOGRAPHIC
REGIONS. ARMS PARTICULARLY WE'VE
WE'VE THERE'S THERE WAS THE CASE
OF A WOMAN AND CENTRAL VALLEY
WHO HAD TO WAIT THREE YEARS FOR
TO ATTACK HAVE SURGERY ON HER
RUPTURED. ON.
BREAST IMPLANT AS WELL AS I HAVE
A WOMAN ON TRIAL OR A PERSON
TRAVELING FROM NEVADA COUNTY
OVER THREE HUNDRED MILES TO SEE
A RHEUMATOLOGY.
I'M IN ADDITION WE'D LIKE TO.
BOYS ARE SUPPORT FOR.
THE OTHER.
HEALTH HOME A RATE INCREASES.
.
THANK YOU.
BANKAMERICARD HERE ON BEHALF OF
THE CALIFORNIA CHILDREN'S
HOSPITAL ASSOCIATION PLEASED TO
SUPPORT THE HOME HEALTH RATE
INCREASES AND JUST WANNA THINK
YOU'D THINK THE DEPARTMENT FOR
ALL OF ITS WORK ON THIS ISSUE.
AM MAKE SURE THAT OUR KIDS GET
TO BE DISCHARGED WHEN THEY'RE
READY AND HOPEFULLY DO NOT GET
READMITTED.
I HAVE ALSO WE WOULD LIKE
SUPPORT PEDIATRIC PREVENTATIVE
HEALTH DENTAL AND SPECIALTY
REIMBURSEMENTS I'M REALLY HAVE A
SHORTAGE OF SPECIALTY CARE FOR
KIDS AND AND SO WHAT ARE PLEASED
TO SUPPORT THAT. AND THEN
FINALLY I WOULD LIKE TO SUPPORT
THE RATE INCREASE FOR AIR
AMBULANCE PROVIDERS MOST OF OUR
HOSPITALS TO PROVIDE AIR
AMBULANCE SERVICES AND SERVE A
DISPROPORTIONATELY MEDICAL
PATIENTS. BUT ALSO EVEN THOSE
THAT DON'T OFFER IT I DO BENEFIT
FROM HAVE GETS TRANSFERRED TO
THEM USING THE SERVICES OF THEIR
CRITICAL. THINKING THANK YOU.
CALIFORNIA DISABILITY RIGHTS
STAYING HOME IS VERY GOOD IDEA
ON AND HAVE AN INDEPENDENT
SUFFERING IDEAL SO WE'RE VERY
MUCH IN FAVOR TO HOME HEALTH
RATE INCREASE FUNDED BY
PROPOSITION FIFTY SIX THANK YOU
ALL FOR THAT. ANDA AND
REIMBURSEMENT RATES YOU KNOW WE
A TEN PERCENT CUT BROWN
REIMBURSEMENT RATES FOR MEDI CAL
FOR.
IT'S BEEN A REAL HARD TIME FOR
THAT TO GET DOCTORS TO STAY IN
AREAS.
CLINICS LIKE IN YOUR AREA INTO
CANNELLA COUNTY IT'S BEEN VERY
DIFFICULT SO ANYTHING THAT WE
CAN DO TO INCREASE. RATES FOR
DOCTORS TO GET HIM TO STAY AND
THE SERVICE CENTER.
FAVORITE PATIENTS IS A VERY GOOD
IDEA THANK YOU THANK YOU.
GOOD AFTERNOON JANICE ACCOUNT
FROM CHILDREN'S DEFENSE FUND
CALIFORNIA ON BEHALF OF THE
CHILDREN'S HEALTH COVERAGE
COALITION INCLUDING UNITED WAYS
CALIFORNIA. CHILDREN NOW THE
CHILDREN'S PARTNERSHIP IN
CALIFORNIA COVERAGE AND HEALTH
INITIATIVES
I'D LIKE TO ALIGN OUR COMMENTS
WITH THE EARLIER ONES BY MY
COLLEAGUES FROM CHILDREN NOW IN
FROM THE CHILDREN ESPECIALLY
CARE COALITION.
ON THE AYE IN SUPPORT OF THE
PEDIATRIC PREVENTIVE HEALTH.
PREVENTIVE DENTAL ESPECIALLY
CARE REIMBURSEMENTS THANK YOU
THANK YOU.
WELL.
HELLO MY NAME IS DAVID ROMERO
SOME REPRESENTING THE HEALTH
ACCESS ACTION TEAM.
AND SACRAMENTO WHICH HAS BEEN
MEETING WITH ADMINISTRATORS.
UC DAVIS MET CENTER WITH.
WHAT IF A NOT A LOT TO SHOW FOR
IT?
WHEN.
UC DAVIS MEDICAL SCHOOL WAS
ESTABLISHED WAS ESTABLISHED ON
THE PRINCIPLES.
OF PROVIDING FIRST RATE DUH.
EDUCATION FOR PRIMARY CARE
DOCTORS.
AND PROVISIONS SERVICES TO. A
HALT LOW INCOME COMMUNITIES SUCH
AS THE COMMUNITIES THAT SURROUND
UC DAVIS MED CENTER.
AND.
.
UC DAVIS MIGHT CENTERS FAILING
IN THIS MISSION UNTIL SUCH TIME
AS IT.
FEES ITS FAIR SHARE OF THE FOUR
HUNDRED THIRTY THOUSAND.
MEDICAL PATIENTS SON IN THE
SACRAMENTO AREA.
OKAY THANK YOU.
HI MY NAME IS SHARON ROGOFF I'M
REPRESENTING SACRAMENTO AREA
COMMENDATIONS TOGETHER AND I AM
ECHOING I'M DAVID TO MARISSA'S
COMMENTS THANK YOU THANK YOU.
MARY VALDEZ OF HEALTHAXIS
CALIFORNIA ONE ALIGN OUR
COMMENTS WITH THE STUDENTS FROM
THE C. DAVIS AND OUT WITH THOSE
OF MY COLLEAGUES AT WESTERN
CENTER ON LAW AND POVERTY. ADAM
AND AGREE THAT ARE YOU SEE
SYSTEM NEEDS TO DO MORE TO SERVE
MEDI CAL PATIENTS IN ADDITION
ONE ALIGN OUR COMMENTS WITH.
SEE PAN ON DENTAL AND PROVIDER
UP PROPERTY SIX PROVIDER RATES
AND ALSO.
YOU KNOW WANNA HELP ANSWER
DOCTOR PANTS QUESTION ON ANOTHER
WAY TO MEASURE IF THESE PAYMENTS
ARE ACTUALLY INCREASING ACCESS
TO CARE IS REQUIRING DATA ON
WHETHER PROVIDERS ARE ACTUALLY
SEEING. NEW MEDI CAL PATIENTS SO.
WANTED TO YOU KNOW HELP ANSWER
THAT QUESTION FROM EARLIER AND
ON PROP FIFTY SIX HEALTH ACCESS
WAS ONE OF THE ORGANIZATIONS
ORGANIZATIONAL SUPPORTERS OF
PROPERTIES EXCEPT THAT THE
INITIATIVE. AND ACTIVELY
CAMPAIGNED FOR THE MEASURE AND
WE.
YOU JUST REQUEST THAT THE
LEGISLATURE REQUIRE THE
ADMINISTRATION TO EVALUATE AND
WAYS MEANT AS WAYS TO MENTION
BEFORE WHETHER THE RATE
INCREASES ARE ACTUALLY THE BEST
WAY. TO IMPROVE ACCESS TO CARE
MOVING FORWARD AND WE ASK THAT
YOU INCLUDE CONSUMER ADVOCATES
AS PART OF THE PROCESS THAT
DOCTOR CAN'T MENTION SO. I'M
AGAIN THANK YOU AND THAT WE LOOK
FORWARD TO WORKING WITH YOU OKAY
THANK YOU.
WELCOME.
A GOOD AFTERNOON I'M BRANDED HIM
AND SPENCER WITH THE CALIFORNIA
DENTAL ASSOCIATION TO ALIGN
MYSELF WITH THE COMMENTS OF THE
FOLKS ON THE PROVIDER PANEL.
EARLIER ESPECIALLY I'M FROM
WESTERN I'VE DONE ALL.
PAN WE DO HAVE.
WE ALSO GREAT CONCERNS ABOUT
THE DISCREPANCY IN THE
DISCONTINUITY THAT'S CREATED BY
THE ONE YEAR I'M SPA THAT'S BEEN
PUT FORWARD THE START STOP IS
REALLY JUST GONNA WRECK HAVOC ON
WHAT I THINK I'M IS THE INTENT
THAT ALL OF US HOW.
PROP FIFTY SIX
BUT WE ENCOURAGE MORE PROVIDERS
TO GET INTO THE SYSTEM AND TO
EXPAND ACCESS BY TAKING MORE
PATIENTS.
AND WE'RE ALSO A LITTLE
CONCERNED THAT WHILE LAST YEAR'S
BUDGET ALLOCATION LOOKED AT A
HUNDRED AND FORTY ARE UP TWO
HUNDRED FORTY MILLION.
IN STATE FUNDING FOR DANTICAT
ALL THE STATE IS LOOKING AT
REALLY ONLY SPENDING ABOUT
SEVENTY EIGHT SEVENTY NINE
MILLION. THERE'S A BIG
DIFFERENCE AND WHEN THAT WHEN
YOU LOOK ESTIMATES FOR TWENTY
EIGHTEEN NINETEEN I'M OUT HERE
IT'S AYE UNDERSTANDING EVEN FROM
IF YOU LOOK AT THE ONE FORTY
FROM THIS YEAR SEVENTY MILLION
FROM LAST OR FROM. THIS COMING
YEAR SO JUST WANNA.
BECAUSE ASK WHAT THE DEPARTMENT
IS GOING TO BE DOING TO ENSURING
THAT WERE FULLY SPENDING AND
TAKING ADVANTAGE OF THIS
OPPORTUNITY I HAD TO TO GET THE
MONEY OUT THE DOOR. AND THEN AS
FAR AS WHERE THE MONEY AND THE
NEW MONEY THE SEVENTY MILLION IS
GOING WE WOULD ENCOURAGE I'M
ALONG WITH THINK OUR COLLEAGUES
AND THAT THIS MONEY GO TOWARDS
THE SERVICES THAT WERE NOT
COVERED IN LAST YEAR'S.
SUPPLEMENTAL PAYMENTS
SPECIFICALLY PREVENTION AND
PERIODONTAL SERVICES WHICH IS
TREATMENT OF GUM DISEASE BUT ARE
TOO BIG REALLY IMPORTANT PIECES
ESPECIALLY THE GUM DISEASE FOR
ADULTS WHO AND DIDN'T HAVE THAT
COVERAGE UP UNTIL THIS LAST YEAR.
WE THINK THAT THOSE ARE ON THE
SHOULD BE THE PRIORITIES AND
WOULD ENCOURAGE THE LEGISLATURE
TO.
DIRECT THE DEPARTMENT OF BUT
THE FUNDING THERE THANK YOU
THANK YOU.
RIGHT NOW I THINK EVERYONE KNEW
MADE PUBLIC COMMENT.
CENTER MY.
THANK YOU MISTER CHAIR I TO JUST
WANT TO ADD MY THANKS TO ALL
THOSE.
WHO WERE PATIENT PROVIDED THEIR
PUBLIC TESTIMONY PARTICULARLY
THE?
MEDICAL STUDENTS AND RESIDENTS
FROM UC DAVIS.
I KNOW OUR FOCUS SUCH
PARTICULARLY ON. PROP FIFTY SIX
REIMBURSEMENT CALCULATIONS
ACCESS.
MEDICAL PROVIDERS DO WE PROVIDE
ENOUGH FOR PEOPLE TO TAKE IT ON.
I WAS RATHER SURPRISED THAT OF
ALL THE FIRST YEAR MEDICAL
STUDENTS NOBODY QUESTIONED OUR
BASIC.
ORGANIZATION OF DELIVERY OF
MEDICAL SERVICES.
IN THIS STATE AND THIS COUNTRY
AND WHILE I KNOW THIS HEARING IS
NOT DEVOTED TO THAT.
WHEN YOU HEAR THE SHORTFALLS.
IN OUR SYSTEM OF ACCESS TO
MEDICINE I THINK WE DO NEED TO
TAKE A STEP BACK.
AND LOOK AT OTHER WAYS THAT WE
MIGHT ORGANIZE WHETHER IT'S A
MEDICARE FOR ALL. MODEL
SOMETIMES CALLED SINGLE PAYER ON
FRIENDS.
TOO MANY PEOPLE ARE FALLING
THROUGH THE CRACKS IN WHAT WE'RE
LOOKING AT HERE. IS
BANDAID. SHIFTING ARE NOT THAT
IS NOT IMPORTANT I'M GONNA WORK.
WITH THE ADMINISTRATION WITH MY
COLLEAGUES IN THE SENATE IN THE
CHAIR OF THIS COMMITTEE. HOW WE
CAN BETTER NOT MAXIMIZE
REIMBURSEMENT RATES LEADING TEN
BETTER ACCESS BUT?
?
WERE PART OF A BIGGER CHALLENGE
RIGHT NOW WITH HEALTH CARE
DELIVERY IN THIS STATE IN THIS
NATION SO. THANK YOU MISTER
CHAIRMAN I AM GONNA HAVE TO
EXCUSE MYSELF I JUST WANNA LET.
PEOPLE KNOW THAT WE WILL
CONTINUE TO MONITOR THESE
PROCEEDINGS IN MY OFFICE I HAVE
SOME. PRE ENGAGED MEETINGS.
AND SOME MEETINGS IN MY
DISTRICT BUT OUR STAFF WILL
CONTINUE TO MONITOR THROUGH THE
AFTERNOON.
AND REMAIN AVAILABLE FOR ANY
INPUTS.
FOLLOWING TESTIMONY THIS
AFTERNOON SO THANK YOU MISTER
CHAIR.
THANK THEY DESERVE IT CHESTER
MINING IN.
APPRECIATE YOUR REMARKS OF I
WANTED TO GET ALSO THINK THIS
STUDENTS AT UC DAVIS AND.
OTHER PEOPLE IN THE COMMUNITY.
.
SEE THAT'S IN MY DISTRICT WAS A
FORMER FACULTY MEMBER AT UC
DAVIS AS A FACULTY MEMBER AND
ALSO NOW AS A LEGISLATOR I
FASTER ONLY ADVOCATE UC DAVIS
PROVIDE.
.
EXCEPT MEDI CAL IN ITS FULL
SCOPE OF TECHNOLOGY.
TAKE IT FOR SPECIALTY AND HE OUR
CARE.
BUT ALSO I THINK WE HEARD FROM.
.
FROM A DUCK THOUGH.
THE FACT THAT YOU SEE.
AND CALCULATES THAT THEY SPEND
ABOUT NINE HUNDRED MILLION NOW
SEVENTY MILLION LAST YEAR. A
SUBSIDISING MEDICARE HOW AND.
I UNDERSTAND THAT THE HOST TOLD
THAT ACTUALLY AT THE.
ON THE EDGE CASES AYE WE GIVE
YOU SEE THREE AND A HALF BILLION
SO I GUESS WE'RE TAKING BACK
ALMOST A BILLION. AND I THINK
THAT CREATES THAT CHALLENGE.
THE FOR THAT AS WELL.
I WOULD MAKE NOTE THAT.
MEDI CAL A COVERS A THIRD OF
ALL CALIFORNIANS OF HER HAVE
OF ALL CHILDREN HAVE ALL
DELIVERIES SO IT IS OUR
CALIFORNIA STATE SINGLE PAYER
SYSTEM FOR FOR THAT MUCH OF A
POPULATION.
AND.
WE HAVE TO MAKE IT WORK BETTER.
AND I THINK WE ARE SEEING SOME
GOOD POSITIVE MOVEMENT.
THAT WE TALKED ABOUT EARLIER
BUT ALSO WE STILL CONTAMINATED
KNOWLEDGES IN FACT ACTUALLY WON
A QUESTIONS I'M GOING TO ASK
DIRECTOR US SINCE WE HAD BUDGET
FEWER UC DAVIS.
AND YOU KNOW WE HAVE SACRAMENTO
GMC.
SO UNLIKE MANY OTHER COUNTIES.
MAYBE PERHAPS FROM THE REASON
THAT WE HAD SO MANY PEOPLE COME
HERE.
ABOUT UC DAVIS MORE
SPECIFICALLY IS IS THERE SOMEONE
IN. WHO OVERSEES THE SACRAMENTO
GMC PROGRAM AND?
AS IT. I MEAN YOU'RE HERE TO
OVERSEE THE HOMERIC HOUSES
VIEWERS ARE SOMEBODY THAT WE
SHOULD BE TALKING TO THAT TO
HELP TRY TO RESOLVE.
SEE WHAT WE CAN DO WITH ONE OF
THE LARGEST PROVIDERS AND AND
THE MEDI CAL AND IN SACRAMENTO
COUNTY WE HAVE A PROBLEM HERE.
INSTEAD TO PROVIDERS AND WILL
PROB HERE WHO DO WE TALK TO ON
THE STATE SIDE.
BECAUSE THERE'S NO IT'S NOT
COUNTY OVERSEAS IT UNLESS YOU
WANT TO TELL ME DIFFERENTLY I
MEAN THE COUNTY TOLD ME TO HAVE
ABSOLUTE CONTROL OVER MEDI CAL
AND SACRAMENTO COUNTY DOES IT
WOULD AVOCADOS. OR NOT TO PLAN
MODELED COUNTY DOESN'T MONEY
PLANS.
THEY CUT SUGAR SHOULDERS AND
SAID DUMB IAGO TALK TO DCS SO
WHAT WHAT WHICH WHICH SHOULD ALL
THESE FOLKS DO WHAT SHOULD I DO
IS THERE REPRESENTATIVES TO TRY
TO. BRING SACRAMENTO GMC.
AND IS SENT INTO BEING PART A
SOLUTION.
SURE SO.
WE HAVE TWO GMC COUNTIES IN THE
STATE SECOND ON SAN DIEGO WE
OVERSEE.
.
PLANS THAT CONTRACT IN THE GMC
REGIONS SO.
AND SAN DIEGO I BELIEVE IT'S
SIX CERTAIN.
SACRAMENTO SEVEN OR THE NUMBERS
COULD BE REVERSED SYNDICATE
COULD BE SEVEN SEGMENT BE SEX
BUT I CAN I CONFIRM THAT UP. I'M
SO WE.
REQUIRE ALL THE PLANS
CONTRACTING IN THE GMC AREA TO
PROVIDE THE FULL SCOPE OF
BENEFITS THAT ALL OF THE REST OF
OUR PLANS ARE HELD TO.
THE.
THE ISSUE BETWEEN UC DAVIS AND
THE PLANS IS A CONTRACTUAL ISSUE
THAT.
THAT WE DON'T NECESSARILY GET
DIRECTLY INVOLVED IN UNLESS IT
IMPACTS.
THE PLAN'S NETWORK ADEQUACY AND
TIME AND DISTANCE REQUIREMENTS
WHICH ALSO INVOLVES THE
DEPARTMENT OF MANAGED HEALTHCARE.
SO TO THE EXTENT THAT PLANS ARE
NOT ABLE TO PROVIDE THE
CONTRACTUALLY AND STATUTORILY
REQUIRED SERVICES UNDER THE KNOX
CAN ACT. WHEAT AND TYPICALLY DO
NOT GET INVOLVED IN WHAT ARE
CONTRACTING SLASH BUSINESS
DECISIONS SO TO THE EXTENT THAT.
UC DAVIS SERVE ANY UC OR ANY
PRIVATE HOSPITAL DECIDES THAT
THEY DO NOT WANT A CONTRACT WITH
A MEDICAL MANAGED CARE PLAN FOR
SERVICES. I'M WE TYPICALLY DON'T
TELL THEM THAT THEY HAVE TO ON
THE ONLY TIME THAT WE WOULD GET
INVOLVED.
BOB WOULD BE IF THERE WAS A
CRITICAL.
.
ACCESS JUNCTURE IN WHICH THE
LOSS OR THE REFUSAL TO CONTRACT
WOULD REQUIRE US TO OTHERWISE
STEP AND THAT OTHER. USUALLY WE
DO NOT.
AND I CERTAINLY UNDERSTAND THAT
AND MAYBE WE CAN TOSS OFF
FLANNEL THAT I THINK WHEN THE
CHALLENGES SECULAR COUNTY HAS
BEEN.
IS THAT.
IN TERMS OF OUR LOCAL
PRIORITIES AND AGAIN I
UNDERSTAND THIS YELLOW. AND SOME
WAYS THE DISCUSSION ABOUT USE UC
DAVIS AND WHETHER TO TAKE MEDI
CAL I MEAN GREAT I MEAN THAT'S A.
CONTRACTED SOME OF THAT YOU KNOW
SUMMERS CONTRACTUAL BUT THERE'S
ALSO I THINK AN OVERALL AYE
OVERLAYING.
ISSUE ABOUT HOW.
I COUNTIES LIKE SECOND ACCOUNT
WHICH OF GMC.
.
ARE ENABLED TO INCORPORATE
THEIR PRIORITIES INTO
CONTRACTING AND OTHER TYPES OF
THINGS SO THAT WE CAN DALY A
PUBLIC HEALTH GOALS WITH OTHER
TYPES OF.
S. WERE CLEARLY.
YOU KNOW.
MEDI CAL AS A MAJOR IS A FUNDER
FLORIDA HEALTH CARE SERVICES
PARTICULARLY FOR OUR MOST
DISADVANTAGED. COMMUNITIES AND
AND PATIENTS ARE WE.
AND.
THAT WE CANNOT ELISE RIGHT NOW
AS I A AS AN ACTIVE PARTNER IN
HELPING US ADDRESS THOSE TYPES
OF ISSUES IN OUR COMMUNITY.
AND AGAIN I THINK THAT'S ALSO
YOU KNOW SO IT'S NOT SO MUCH
THAT CAN WE MAKE UC DAVIS
CONTRACTOR MAKE IT PLAIN
CONTRACT AT THE
SEE DAVIS BUT I THINK THERE'S
THIS. OTHER LARGER PICTURE. THAT
IS BEEN.
DIFFICULT SO I HOPE WE CAN TRY
TO WORK TOGETHER TO TRY TO RE
YOU KNOW AS AT THIS. AS A THIS
IS A JOB DECADES LONG PILOT
PROJECT THAT NEEDS TO AND DOES A
PILOT PROJECT AND.
MOVE INTO
YOU KNOW EVEN SAN DIEGO'S NAM BY
GMC THAT.
PROGRAM. NOW HAS MUCH MORE
COMEDIAN PUT SO TO HAVE THAT
CONVERSATION.
AND THEN I GUESS THE OTHER
PIECE AND I KNOW THOSE TESTIFIED
TO AND.
WHILE WE HAD FOLKS ME SEE DAVIS
HERE AND I THINK THERE'S A MIX
AT YOU SEE.
LIKE BUT BROUGHT A CONVERSATION
WITH YOU SEE ABOUT EVERY UC
MEDICAL CENTER.
HOW DO WE GET THEM TO AND SOME
OF THEM ALREADY DO?
BE ACTED PARTISAN MEDI CAL
SUMMITS ON THE U. SEASIDE SO
CERTAINLY IT'S NOT NESTLE ON THE
MEDICAL SIDE BUT I THINK TRYING
TO FIGURE OUT WE GET PRTNERSHIP
WORKING KNOWLEDGE IN THE FACT
THAT WHEN YOU.
HE COMES AND SAYS THEY LOSE.
THIS YEAR AND SEVEN HUNDRED
MILLION LAST YEAR IN AND MEDI
CAL.
THAT SPEAKS TO THAT THAT SPEAKS
A PROBLEM SO WITH THAT.
THAT.
WE NEED TO LOOK AT THOSE AS A
STATE MORE BROADLY SO NOW
BETWEEN THOSE THINGS I HOPE WE
CAN WE CAN.
WE CAN LOOK AT THAT AND SO THAT
WE THINK WE NEED TO HAVE YOU SEE
STEP UP ON. THERE MAY BE CERTAIN
THINGS WE NEED STEP UP ON HERE
ON DOWN ON THE.
VERY CALLOUS I'D AS WELL.
OKAY O AGAIN I APPRECIATE ALL
THE TESTIMONY OF WE ARE.
NOW GOING TO GO BACK TO BECAUSE
WE HAD ACTION TAKEN THINGS OUT
WE'RE BACK TO MEDI CAL OPTIONAL
BENEFITS.
I BELIEVE FOR THIS SECTION.
WE JUST.
WE HOPE WE HAVE STAKEHOLDER
PROPOSALS THAT I DON'T OF THEIRS.
AND.
FOR.
MEDICAL OPTIONAL BENEFITS SO
FIRST WILL HAVE AS KIM THIS.
AND.
REFUSING TO OKAY THEIR SUB
FALCATE I THINK REPRESSIVE
TATIAN FROM ANY GUY FROM THAT
THE T. S.. ABOUT THAT OPTIONAL
BENEFITS AND THEN I WILL GO AND
IT TAKES A LITTLE PROPOSALS.
SURE I MEAN I THINK.
IN SHORT THE AGENDA LAYS OUT
WHAT WE HAVE UNDONE IN THE LAST
YEAR SINCE A NUMBER OF OPTIONAL
BENEFITS WERE ELIMINATED IN THE
TWO THOUSAND TO. TWO THOUSAND
EIGHT TWO THOUSAND NINE. ARM
RECESSION BOND TO THE EXTENT
THAT THE LEGISLATURE.
WOULD LIKE TO EITHER RESTORE OR
PARTIALLY RESTORE IN SOME CASES
I'M SOME OF THESE OPTIONAL
BENEFITS WE HAVE DONE A COUPLE.
ON THAT WERE NOTED IN THE AGENDA
OVER THE LAST FEW YEARS AND
INCLUDING DENTAL WAS THE FIRST.
SIGNIFICANT RESTORATION OF
OPTIONAL BENEFITS BACK IN I
BELIEVE TWENTY THIRTEEN AND THEN.
.
OPTICAL.
ACUPUNCTURE AND.
MEDIA AND A COUPLE OF OTHER SO
I THINK IT'S JUST A MATTER OF
THE.
BUDGET NEGOTIATION TERMS OF
WHAT THE FISCAL IN THE COST OF
THE RESTORATION OF THOSE ITEMS
ARE.
OKAY OF ANY COMES FROM MILLION
O. FINANCED. FROM I GUESS BEFORE
WE BRING THE SAY COLOR PROPOSALS
AND.
AND I KNOW THAT.
MAYBE THE DEED IS AND THAT'S.
NOT NECESSARILY ALWAYS AVAILABLE.
FOR I GUESS FOR LA OAKWOOD.
AND SOME OF THESE WHEN YOU LOOK
AT THEM.
.
FOR EXAMPLE SPEECH THERAPY.
RIGHT IS.
AT LEAST AS A PEDIATRICIAN IF
YOU HAVE A CHILD WHO IS A
DEVELOPMENT OF THE WAY DON'T GET
SPEECH THERAPY.
AND AND.
NOW MAYBE THEY'LL PICK IT UP IN
SCHOOL OR YOU HAVE AN ADULT TO
NEEDS OF NEW ORAL MOTOR.
SOMETIMES WHAT HAPPENS IS THAT
THAT THE COST TO THAT. CRUISE
THROUGH THE NOT NECESSARILY TO
THE. MEDICARE PROGRAM FOR NOT
DOING IT FOR THE CREWS OTHER
PORTIONS OF OUR STATE BUDGET AS
WELL.
SO A PERSON WITH THE DIET SHE
WOULD TALK ABOUT PEOPLE DIABETES
AND NOT ABLE TO GET TO ADEQUATE
FOOT CARE THAN IF THEY CAN GET A
GOOD FOOT CARE THEN THEY GET
HOSPITAL.
THAT IS DO YOU DO YOU SEE ANY
AYE AYE OPPORTUNITIES ERRORS LA
O. PERHAPS LOOKING AT SOME OF
THESE AND LOOKING AT WHAT MIGHT
BE THE. YOU KNOW THE POTENTIAL
COST IMPACT OF US NOT PROVIDING
THOSE TYPES OF BENEFITS FOR MEDI
CAL PATIENTS.
WE HAVEN'T DONE THAT ANALYSIS
OURSELVES NO.
ALRIGHT SO I HOPE WE CAN PERHAPS
MAYBE CENTER ADVOCATES CAN HELP.
DO SOME OF THE RESEARCH AND.
SHARE IF THERE STATE OUT THERE
OUGHT TO LOOK AT THAT AND AS WE
ALSO ENCOURAGE FINANCES AS WELL.
BECAUSE IT DOCTRINE AND I
DISAPPOINTED CLARIFICATION SO IN
YOUR EXAMPLE FOR SPEECH THERAPY
FOR KIDS IT'S COVERED UNDER EP
STT. SO SPEECH THERAPY WOULD
ONLY GET ON THE ADULT OUTSIDE SO
YEAH I'M JUST TO BE REALLY CLEAR
MOST OF THE SERVICES THAT ARE
OPTIONAL BENEFITS ARE NOT
OPTIONAL UNDER EPS UT SO THEY'RE
PROVIDED FOR POPULATIONS UNDER
THE AGE OF TWENTY ONE.
I APPRECIATE THE CLARIFICATION
AND I USE THOSE SAYING AND I
THINK THAT'S WHY SHIFTED TO DOGS
THEY REALIZE THAT NO THEY WERE
RECOVERED IN THE TSTT CORRECT
AND THANK YOU FOR THAT
CORRECTION.
OKAY.
BUT DOES SAY LIKE PODIATRY FOR
THE ARTS OKAY.
OR EVEN SPEECH THERAPY FOR
ADULTS.
ALRIGHT SO WITH THAT AT WHAT WE
CALL COLLECT HIGHER STAKEHOLDERS
SO. THIS CHEN WHO APPEAR HAY SEE
BACK THERE I THINK.
CAN'T CALIFORNIA FAN F. ACCOUNT
THAT WORK AS MY HOME THIS.
AND.
AGAIN.
THREE MINUTES
S. R. OR LESS AND IF YOU HAVE.
MORE THAN ONE SPEAKER JUST TRY
TO PORTION THE TIME
APPROPRIATELY.
YOU KNOW IF YOU DON'T WANT
MISTER SPEAKER MY COLLEAGUE WHAT
WILL GO FIRST OKINAWAN. BUDGET
PRIORITY OUGHT TO GO AND CHECK.
BUT WHAT YOU'RE MEMBERS OF THE
COMMITTEE MY NAME IS TO ALL OF
US WITH RAMP REGIONAL ASTHMA
MANAGEMENT AND PREVENTION WE'RE
HERE TODAY TO ASK THE WORK WITH
THE DEPARTMENT HEALTHCARE
SERVICES TO ENSURE ACCESS TO
ASTHMA EDUCATION.
HOME AND
TRIGGER ASSESSMENTS FOR MEDI CAL
BENEFICIARIES WITH POORLY
CONTROLLED ASTHMA.
SPECIFICALLY REQUESTED THE
DEPARTMENT ENSURE MEDICAL
COVERAGE FOR QUALIFIED NON
LICENSED PROFESSIONALS
TO PROVIDE THE SERVICES UNDER
THE SUPERVISION OF A LICENSED
PRACTITIONER. IMAGINE A FAMILY
WHERE FOUR YEAR OLD HAS RECENTLY
RETURNED HOME FROM A THIRTY DAY
VISIT FOR ASTHMA. AT THE
DIRECTION OF THE DOCTOR AND THE
VISIT BY SYLVIA A WELL TRAINED
COMMUNITY HEALTH WORKERS SPEAK
THE LANGUAGE.
TWO VIEWS THE DOCTORS AS AN
ACTION PLAN PICTURE THE FAMILY
KNOWS HOW TO RECOGNIZE SYMPTOMS
OF FORCING ASTHMA. AND LOOKS
AROUND THE FAMILY'S HOME THAT'S
WHEN SHE QUICKLY IDENTIFIES
SEVERAL ASTHMA TRIGGERS IMAGE
IT'S THE FAMILY ABOUT HOW TO
ELIMINATE OR REDUCE THEM.
WE KNOW THAT SOVIET SUPPORT FOR
THE FAMILY WORKS SUCH
INTERVENTIONS INCLUDING THOSE
PROVIDED BY QUALIFIED NON
LICENSED PROFESSIONALS HAVE BEEN
PROVEN IN A VARIETY OF STUDIES
TO REDUCE HAS MEDIA VISITS AND
HOSPITALIZATIONS. AND IMPROVE
HEALTH OUTCOMES
MANY CITIES ALSO NOT THE
FINANCIAL RETURN ON INVESTMENT
FROM THESE INTERVENTIONS BY
REDUCING MORE COSTLY ET VISITS
AND HOSPITALIZATIONS.
UNFORTUNATELY ACCESS TO THE
SERVICES IN CALIFORNIA IS VERY
LIMITED INCREASING THE USE OF
QUALIFY NON LICENSED
PROFESSIONALS IS AN EFFECTIVE
WAY TO PROVIDE MEDI CAL
BENEFICIARIES WITH POORLY
CONTROLLED ASTHMA THE SUPPORT
THEY NEED. THANK YOU FOR YOUR
TIME.
THANK YOU.
MISTER CHAIRMAN MEMBERS I CAN
REALLY TELL THE CALIFORNIA PAN
ETHNIC HEALTH NUMBER OFF ALSO
HERE IN SUPPORT OF THIS PROPOSAL.
YOU KNOW ASTHMA SIGNIFICANT
PUBLIC HEALTH PROBLEM IN DRIVER
COST AS MY COLLEAGUE JUST NOTED
THIS TREMENDOUS COST WHEN
INDIVIDUALS HAVE.
THROUGH THE UPPER EMERGENCY ROOM
PART.
EFFECTIVE ASTHMA MANAGEMENT
REQUIRES SORT OF COMBINATION OF
FOR VITAL FACT
CLINICAL ASSESSMENT MEDICATION
PATIENT US EDUCATION AND CONTROL
OF ENVIRONMENTAL TRIGGERS AND
THIS IS THOSE LAST TWO
COMPONENTS OF THE AREAS IN WHICH.
WE TEND TO HAVE A GAP BUT ALSO
THEN A CRITICAL OPPORTUNITY TO
MAKE IMPROVEMENTS.
ORGANIZATIONS DEPEND RAMP AND
CHILDREN NOW HAVE BEEN.
WORKING ON THIS ISSUE FOR A
NUMBER OF YEARS WORKING WITH THE
DEPARTMENT OF HEALTH CARE
SERVICES ON HOW TO ENSURE THESE
US SERVICES ARE DELIVERED
PATIENTS.
WE DON'T NECESSARILY BELIEVE
THEIR OPTIONAL NEW BENEFITS
BENEFITS THAT THERE ARE OF A
WAYS IN WHICH.
THIS COULD BE DELIVERED UP
THROUGH INDIVIDUALS FOR NON
LICENSE ALONG AS ARE SUPERVISED
BY LICENSED PROVIDERS.
WORKED WITH ASSEMBLY MEMBER CHU
ON A OF A PIECE OF LEGISLATION
LAST YEAR TO.
CLARIFY THIS BUT ALTHOUGH THAT
PIECE OF LEGISLATION WAS VETOED
WE CONTINUE TO WORK WITH THE
DEPARTMENT TO CLARIFY THIS AND
DO APPRECIATE THEIR TECHNICAL
ASSISTANCE ON THIS BUT THE. FACT
REMAINS IT UP WE DON'T HAVE YET
CLEAR A A CLEAR SOLUTION ON THIS.
AND WE WOULD ASK THAT OF THE
LEGISLATURE TO DIRECT THE
DEPARTMENT TO ENSURE MEDI CAL
BUT AFFAIRS BENEFICIARIES HAVE
ACCESS TO THE SERVICES INCLUDING
WHEN THEY'RE PROVIDED BY. NON
LICENSE INDIVIDUALS LIKE SEATS
W'S AS LONG AS ARE SUPERVISED BY
LICENSED PROVIDERS.
AND WE ASK THE DEPARTMENT MAKE
CLEAR IF.
THEY NEED ANY ADDITIONAL
LEGISLATIVE AUTHORITY OR SEAT
RESOURCES DO SO THANK YOU MERGER
SUPPORT.
THANK YOU. COMMENTS FROM DHS.
AND I THINK AYE THE DEPARTMENT
HAS WORKS ON CLOSELY WITH
ADVOCATES ON THIS PARTICULAR
PROPOSAL AND WHILE IT'S NOT A
PART OF THE.
GOVERNOR'S BUDGET I THINK WE
WOULD OBVIOUSLY BE YOU I'M HAPPY
TO PROVIDE ADDITIONAL ONGOING
TECHNICAL ASSISTANCE AND COST
ASSESSMENT CIVIC CENTER THE
LEGISLATURE WANTS TO.
EITHER UNDERSTAND ACOSTA THAT
PART OF THE PROPOSAL IN IN IN
GREATER DEPTH.
OKAY THANK YOU EARLIER COMMENTS
FINANCE ACTUALLY OTHER GIVE
INTRODUCE YOURSELF FOR THE
RECORD YET SWITCH OUT WITH.
MISTER DOHERTY. WELL A BERMAN
TICKETS DEPARTMENT OF FINANCE
DAY THANK YOU.
OF THE SO I GUESS WHO WAS AMONG
THE COURTS HAVE APPRECIATE THE
CONVERSATION'S BEEN HAPPENING.
.
WE HAVE.
MEDI CAL MANAGED CARE FOR MOST
PEOPLE.
.
COULD THIS HOW THIS WOW THIS
INTERFACE WITH THEIR MEDI CAL
MANAGED CARE PLANS.
IZZARD OPPORTUNITY FOR SHARED
SAVING.
BECAUSE IF THEY WOULD INVEST IN
THIS AND THEY COULD SAVE MONEY.
AT ITS THERE SOME POSSIBILITY
OF FOURTEEN WITH CMS TO DO LIKE
IT AS MY CARRY CA SO.
WHERE YOU CAN DO SHARED SAVINGS
I MEAN THAT IS A LOT BIGGER THAN
THAT THIS PROPOSAL BUT I ACCEPT
THE THROW THAT OUT THERE YOU
KNOW WE WE WERE DOING?
WITH THREE PEOPLE MANAGED CARE
SAY MANAGED CARE WERE SUPPOSED
TO ALSO GIVE PLANS THE
FLEXIBILITY TO THINK ABOUT SOME
SOME DIFFERENT APPROACHES TO TRY
TO. ADDRESS SOME OF THE SOCIAL
TERMS HEALTH THAT IMPACT.
DISEASE LIKE ASTHMA. SO. OF
PERHAPS YEARS. A CITIES THOUGHTS
ON THAT.
YEAH SO I'M OUR MEDICAL MANAGED
CARE PLANS TODAY I'M COULD
VOLUNTARILY CHOOSE TO USE AND
ADMINISTRATIVE PORTION OF THEIR
CAPITATION PAYMENTS TO SUPPORT
THE SERVICES THEY'RE NOT
REQUIRED TO THEY'RE NOT REQUIRED
UNDER THE CONTRACT. ON TO THE
EXTENT THAT.
THE LEGISLATURE TOOK ACTION TO
EITHER FUND OR STRUCTURE THIS
BENEFIT WOULD BE SIMILAR TO WHAT
THE LEGISLATURE DID LAST YEAR
AROUND MEDICALLY TAILORED MEALS
FOR EXAMPLE OR THE DIABETES.
PREVENTION PROGRAM SO WE WOULD
HAVE TO WORK ON TO CONSTRUCT A
BENEFIT IN BOTH THE FEE FOR
SERVICE IN MANAGED CARE.
DELIVERY SYSTEM I'M TYPICALLY
WHAT WE WOULD DO IS THE CONTRACT
FOR THE PLANTS WOULD BE AMENDED
TO LAY OUT. WHAT THEY WOULD BE
REQUIRED TO DO AND THEN FROM A
RATES IN CAPITATION?
DEVELOPMENT STANDPOINT WE WOULD
HAVE TO ACCOUNT FOR WHAT THAT
COST WOULD LOOK LIKE AND THEN
FUNDS THE PLANTS ON TO DO THAT
WORK THROUGH THEIR RATES.
ANY THOUGHTS ROM YOUR
PERSPECTIVE IN THEIR DISCUSSIONS.
THAT'S THAT'S HELPFUL TO HEAR I
THINK.
WHAT WE WOULD ASK IS THAT I
THINK WE'VE GONE BACK AND FORTH
A LITTLE BIT OF?
FROM THE LEGISLATION LAST YEAR
TO THIS THAT.
BUDGET REQUEST THIS YEAR AND I
THINK THAT'S CERTAINLY REALLY
REALLY HELPFUL.
WOULD BE HELPFUL FOR US IS.
IF
TWO THE IN OUR FOR THE
CONVERSATIONS CLARIFY OF YOU
KNOW IF THAT'S ADDITIONAL
STATUTORY LANGUAGE IS THAT
INCLUDED IN TRAILER BILL
LANGUAGE WHAT IS THAT. LOOK LIKE
WE'VE HAD.
VERY PRODUCTIVE CONVERSATIONS
WITH YOUR STAFF ON THIS AND
THERE SEEMS TO BE SOME
UNDERSTANDING THAT YOU KNOW THIS
IS BENEFICIAL AND SO I THINK
WE'RE REALLY TRYING TO GET DOWN
TO WHAT WHAT DO YOU NEED. US TO
DO AND HOW CAN WE WORK THE
LEGISLATURE TO DELIVER THAT IF
WE ALL AGRE THIS IS THE
THE RIGHT THING TO DO.
AND IF I COULD I THINK THERE'S
IN OUR COME BACK AND FORTH
CONVERSATIONS WITH WITH STAFF
WHICH HAVE BEEN VERY PRODUCTIVE
THERE'S A QUESTION AS TO. HOW
MUCH?
THE HOW MUCH THE BERMAN HAS
AUTHORITY TO MOVE FORWARD NOW
VERSES DE SOME ADDITIONAL
AUTHORITIES OR. AND FUNDING THAT
MAY BE NEEDED AND I THINK WHAT
WE'RE HOPING TO CLARIFY THAT.
BUT CONTRA THE WELL AND SO THAT
WE CAN MOVE FORWARD OKAY WELL I
APPRECIATE THEM AND I THINK
CERTAINLY.
TRYING ADDRESS THESE SOCIAL
DETERMINANTS IS. IS.
PEOPLE RECOGNIZING THIS IS THE
WAY WE NEED TO GO FOR GOING TO
TRY REDUCE HEALTHCARE COSTS.
PEOPLE TO BE WILLING TO MAKE
INVESTMENTS IN AND IN DOING THAT.
AND LATIMES HOW DO WE TRY TO.
WORK OUR PAYMENT SYSTEMS.
IN A WAY THAT ALLOWS PEOPLE TO
DO THAT AND ACTUALLY GIVE PEOPLE
INCENTIVES TO DO THAT BECAUSE
THAT DON'T TECHNICALLY I GUESS
THE PLANTS COULD DO IT
THEMSELVES BUT.
THAT THERE'S NO INCENTIVE TO DO
AND HE ALWAYS TAKES WORK TO
STICK DID IT WELL. APARTMENT AS
THE SCOURGE HIM AS BE SOMETHING
NEW TO ALL KINDS OF THINGS TO DO
RIGHT THAT BUT.
BUT HOW DO YOU TREAT IT SAID
THE SHOW THAT WE CAN ACTUALLY
HAVE A.
THAT IT NEEDS TO DO SOME SORT
OF.
IMPROVEMENT OR SAVINGS SO YES.
A FINAL POINT ON THAT I THINK
IT'S IT'S HELPFUL TO HEAR THAT
THE PLANTS HAVE AUTHORITY TO DO
THAT NOW BUT THEY'RE DOING THAT
WITH ADMINISTRATOR.
AND THE ASK AROUND HERE IS
REALLY TO CLARIFY CAN THEY DO
THIS WITH CLINICAL BULLISH
BECAUSE THEY'RE MANY PLANTS THAT
ARE DOING THIS NOW ARE OFTEN
RELYING ON GRANT FUNDING OR
LIMITED RESOURCES ELSEWHERE
WHERE. IS REALLY A CLINICAL
FUNCTION YEAH AT IT WHY IT AND I
KNOW WEEKS THAT I'VE HAD TO
DISCUSS WITH THE DIRECTOR AND
THE ROLE CMS ALSO PLAYS IS THAT.
IF YOU HAD IF YOU'RE ABLE TO THE
SHARED SAVINGS.
RIGHT THEN WHAT HAPPENS IS IT
STARTS THE QUESTION BECOMES A
BIT DIFFERENT BECAUSE WHAT
HAPPENED IS IS THAT OKAY BY
INVEST IN THIS.
AND I GET AND I SAVE MONEY A
GIANT DISSIPATE YOU WELL.
AND THEN I GET TO KEEP.
THAT MONEY ARE FOR A SIGNIFICANT
PORTION OF THAT THE NETWORKS
INVADE. BUT THE INVESTMENT AND
TAKE MY MINISTRY DOLLARS
WHATEVER PUT IT AND.
THAT I SHOULD SAVE THE MONEY AND
THEN SEEM AS AS WE GET OLDER
LOSE LOWER YOUR RATES.
AND THAT MONEY DISAPPEARS
THAT I JUST.
BUT IN MONEY AND PUTTING TIME
AND DIDN'T GET ANYTHING OUT OF
IT SO I'M NOTS AND THAT PEOPLE
STILL SOMETIMES DO THAT BECAUSE
YOU KNOW THEY'RE DO WANT TO HELP
PEOPLE BETTER OUTCOMES IT'S NOT
JUST ABOUT THE MONEY BUT.
CERTAINLY FINANCIALLY THAT THOSE
ADS ALLOWED SO.
SO BEGAN TOM
WE CERTAINLY HOPE WE CAN TRY TO
FIGURE OUT HOW TO. HOW TO DO
THIS?
I GUESS IN SOME SENSES I'M
SAYING IS THAT. WE CAN DO THIS
BUT ALSO USES A PLATFORM TO TRY
TO MOVE THIS GUY CONCEPT TO CMS
WHERE WE CAN DO MORE SHARED
SAVINGS WE CAN STEP AS IT IS A
SHARED SAVINGS MODEL EVEN IF WE
CAN'T QUITE KEEP THE SAVINGS
RELEASE.
GIVE ENOUGH OF AN INCENTIVE TO
THE PEOPLE TRY AT THAT LOOK WHAT
MORE STUFF LIKE THIS.
WE KNOW IT AT BIG.
AND I APPRECIATE DEL ESTIMATES
DIRECTORS TALKS ABOUT
FLEXIBILITY TO ME FLEXIBILITY
ISN'T ABOUT IMPOSING. NEEDLESS
AND AND ACTUALLY
COUNTERPRODUCTIVE FOR PLEASE YOU
KNOW OUT WORK WITH.
TRADING SHOPS COPIES FOR SHARED
SAVINGS AND.
AND I MEAN THAT'S WHERE IF
THEY'RE SERIOUS ABOUT TRYING TO.
BETTER MAKE MEDICAID WORK
BETTER MEDI CAL IN OUR STATE AND
AND ALSO A LOWERING COSTS OF
CARE THAT'S WHAT THEY SHOULD BE
DOING NOT NOT NOT THIS POLITICAL
STUFF ABOUT WORK PROGRAMS.
SO LETS LOOK AT THE EVIDENCE AND
MAKE THIS THING WORK SO.
.
I REALIZE IT'S WILL BE BEYOND
THE SCOPE ASSEMBLY DHS IS ALSO
DEALING WITH THE.
WITH SEEM S. BUT HOPEFULLY WE
CAN TRY TO FIGURE THAT OUT AT
LEAST FIGURE OUT WHAT TO DO HERE
IN CALIFORNIA AROUND THAT.
OKAY THANK YOU.
ALRIGHT.
OKAY NEXT ITEM IS.
.
IS ARE HYPERTENSION AWARENESS
PILOT PROJECT.
FEATURE SO.
ALRIGHT.
AMERICAN HEART ASSOCIATION WHO
UP HULA.
UP TO VIEW.
OKAY.
ALRIGHT AGAIN. ABROGATE MY
ADMONITION ABOUT EXCLUDING TIME.
WE THINK YOU ON COOLER KOENIG
WITH THE AMERICAN HEART
ASSOCIATION AYE CONSTRUCTS
OPPOSITION GERMAN PAN THANK YOU
SO MUCH.
FOR GIVING US THE OPPORTUNITY
TO PRESENT TODAY I'M ON THE
HYPERTENSION AWARENESS ON PILOT
PROJECT.
I'M SO OUR GOAL WITH FACE
ISRAELI TO REDUCE RATES OF
HYPERTENSION WHICH AFFECT
ONE IN THREE ADULTS IN
CALIFORNIA AND COSTS ARE STATE
ABOUT FORTY SORRY BECAUSE OUR
NATION ABOUT FORTY EIGHT BILLION
DOLLARS.
.
AS YOU KNOW THE DOCTOR PHAM
HYPERTENSION IS ONE OF THE MOST
MODIFIABLE UNTREATABLE CHRONIC
CONDITIONS. AND IT HAS HUGE
BENEFITS IF WE CAN ACTUALLY I'M
CONTROL IT AND WE KNOW THAT IT'S
A FACTOR AND.
AND HEART DISEASE.
AS YOU KNOW AS WELL AS THE
DOCTOR.
BUT WE WANT TO REALLY GET THAT
POPULATIONS ARE MOST IMPACTED
AND LOOKING AT THE COUNTIES
THE HAVE THE HIGHER IS PREVALENT
OF HYPERTENSION SPECIFICALLY
ALSO DRILLING DOWN TO THOSE ON
POPULATIONS AS YOU KNOW. ON
NATIVE AMERICANS AND AFRICAN
AMERICANS HAVE HIGHER I'M
PREVALENT.
OF HYPERTENSION BUT NAY ARE
AFRICAN AMERICANS HAVING THE
HIGHEST ACTUALLY I'M IN THE
NATION.
THE SO SO WHAT IT IS TO
ACTUALLY WHAT WE'RE PROPOSING IS
FOR.
DOCTORS TO PRESCRIBE PRESCRIBED
BLOOD PRESSURE CUFFS TO PATIENTS
WERE HYPERTENS TENTED THIRTY
COVERED IN MEDI CAL BUT IT'S
ACTUALLY THE UTILIZATION RATE AS
WE KNOW IN THE AGENDA IS IS
FISCALLY LOW.
AND THEN ONCE.
PATIENTS ARE ARE PRESCRIBED IS
BUT PATRICOF'S ON WHEN THEY'RE
AT HOME THEY ACTUALLY WILL THEN
BE LINKED THE COMMUNITY HEALTH
WORKER WHO HELPED THEM TRACK AND
THEN REPORT BACK THAT HELPS WITH
ADHERENTS WERE GIVING THEM THE
TOOLS TO ACTUALLY. ON BE ABLE TO
CONTROL THEIR BLOOD PRESSURE.
AND THE COMMUNITY HEALTH
WORKERS ARE ALSO COULD BE IN THE
COMMUNITY AND.
DOING SCREENINGS AND AND MAKING
SURE THAT PEOPLE WHO HAVE HIGH
BLOOD PRESSURE NO THAT AND CAN
GET TREATED FOR A.
AND I'M BY SEEING THAT YOU KNOW
THAT WE KNOW THIS IS EFFECTIVE
THERE'S A RECENT STUDY AND AND
GEMMA I'M TALKING ABOUT HOW ON
COMMITTEE HEALTH WORKERS
ACTUALLY HAVE BEEN VERY
EFFECTIVE. EVEN MORE SO.
THEN SOME TRADITIONAL METHODS
AND I'LL SEE THE REST OF MY TIME
TO MY COLLEAGUE.
TO EXPAND DEMAND REPEAT IN THE
CALIFORNIA CHAPTER OF THE
AMERICAN COLLEGE OF CARDIOLOGY
IN FOR CARDIOLOGISTS MAY TIMES
WHEN WE SEE PATIENTS THAT HAVE
HYPERTENSION IT'S AT A POINT
WHERE IT'S PROGRESSED AND WOOD
HEART DISEASE IS REALLY IN PLACE.
SO WE LOOK AT THIS PROPOSAL IT
EXCITES OUR FOLKS.
I AM VERY MUCH TO THE EXTENT
THAT ANYTHING WE CAN DO TO
EMPOWER A PATIENT TO STAY CLOSER
TO THEIR DISEASE TO UNDERSTAND
WHAT'S GOING ON. IN THE NOTION
OF UTILIZING THE COMMUNITY
HEALTH WORKERS I THINK IS IS AN
IMPORTANT POINT THE MISCONDUCT
HAD HIGHLIGHTED SO THE MORE WE
CAN GET PEOPLE TAKING
RESPONSIBILITY. FOR THEIR
CONDITION THE BETTER ONE OF OUR
BIG FRUSTRATIONS IS THAT WEEKS
WE SEE PATIENTS BOMB OUR FOLKS
GIVE THEM ADVICE AND THE
ADHERENCE IS THE CHALLENGE THE
MORE WE CAN HELP PEOPLE
UNDERSTAND. THE CONDITION THEY
HAVE WHAT THEY NEED TO DO TO
CHANGE IT I THINK IT'S BETTER
FOR THEIR OVERALL HEALTH. THANK
YOU.
OKAY THANK YOU COMES FROM CS
HELLO PLANTS NOW ALRIGHT. BUT IN
THE THANK YOU SO MUCH FOR OUR
FOR BRINGING THIS.
BOZELL FORWARD.
YOU KNOW I'VE HAD MY OWN
PERSONAL EXPERIENCES. AS A
PHYSICIAN WORKING WITH.
THE HEALTH WORK.
ARE SIMILAR IF.
BOOKS IN TERMS OF REALLY
LOOKING AT BRIDGING Y. CALL THE
CULTURAL DIVIDE BETWEEN THE
COMMUNITY AND THE HEALTH CARE SO.
RIGHT BECAUSE WE HAVE OUR OWN
CULTURE IN OUR CLINICS AND
SCHOOLS AND SO FORTH AND OFTEN
THERE'S A DISCONNECT BETWEEN THE
TWO.
AND FIGURE HOW DO WE HOW DO WE
BRIDGE THAT AND HAVING.
PEOPLE LIKE COMMITTEE HEALTH
WORKERS.
WHO CAN?
?
THEY SUCH A BRIDGE THAT CULTURAL
DIVIDE COMMUNICATION DIVIDE THAT
HAPPENS AS WELL AS HELP DO SOME
KIND OF COORDINATION OF CARE NOT
LEVEL A NURSE WOULD BE ABLE TO
DO BUT.
COORDINATING MP SUGAR DADDY GO
GAINED A PRESCRIPTION
STILL ARE ACTUALLY TAKING IT.
COMMUNICATE PEOPLE HOW IMPORTANT
IT IS.
AND I KNOW ANTI OF PROTESTS
OBSERVED IT A CHALLENGE BECAUSE
YOU TAKE A PILL EAT YOU TAKE THE
PILL. BUT NOTHING'S DIFFERENT
RIGHT AND SO YOU DON'T FEEL
ANYTHING BETTER IN MY GO IF THE
RIVER TAKE IT EVERY DAY BUT I'LL
FEEL A DIFFRACTION SOMETIMES
PEOPLE SAY THEY FEEL A LITTLE
WORSE AFTER HE TAKES FILLED HIS
HIGH BLOOD PRESSURE COMES DOWN
HERE. SONY'S MAKE PHILIPPEVILLE
WILL MORE TIRED OR SOMETHING.
SO IT'S A IT'S A CHALLENGE TO
GET AND MEANTIME YOU'VE GOT A
PHARMACIST IN AFRICA PAYER
COPAYS AND ALL THAT FUN STUFF.
SO ARE ARE ARE NOT ARE YOUR TAR.
HOA. THAT'S THAT IS SO
APPRECIATED AGAINST THAT AND
WON'T REITERATE PREVIOUS
DISCUSSION WE HAVE SOME OF IT'S
ABOUT WELL WHAT KIND OF SAID IS
CAN WE CREATE. A FOR THE
SUSTAINABILITY POINT OF VIEW I
MEAN YOU CAN DO A PILOT AND THEN
WHAT HAPPENS IS THAT EVENTUALLY
HOW DO WE MAKE SURE THAT IF YOU
CAN GET GOOD RESULTS.
WHICH.
THAT THE.
MEDI CAL MANAGED CARE PLANS WILL
CONTINUE TO DO THIS AFTERWARDS
RIGHT THAT WE'RE NOT LOOKING AT
A SEPARATE PROCREATION AND EVERY
YEAR FOR THIS OR EVERY HOW MANY
YEARS BUT. IF IT WORKS THAT
SHOULD BE INCORPORATED INTO THE
NORMAL WAY WE PAY THINGS AND
THAT'S WHAT THEY SHOULD BE
PAYING FOR HOW WE DO THAT SHOULD
CERTAINLY BE SOMETHING I THINK.
TO THINK ABOUT INCORPORATING
INTO ANY SUCH PROPOSAL AND SO
THAT'S OUR GOES BACK BLOOM IN
OUR PREVIOUS CONVERSATION ABOUT
YOU KNOW WHERE'D INCENTIVES FOR
OUR MAC HOW.
MANAGED CARE PLANS TO PAY FOR
THIS ON AN ONGOING BASIS IN
THEIR OWN AND. AND THEN WE WON'T
GET INTO HOW WE STRUCTURE THE
MANAGED CARE RATE AND SO FORTH.
AND THE CAPITATION RATES IN A
WAY THAT.
CAN BELT PAID FOR THAT AND ALSO
CAPTURED A SAVINGS THAT RESULTS
FROM THE. FROM FROM FROM THE A
GOOD OUTCOMES. APPENZELL.
I HAVE A SAID MORE ENOUGH
ANYTHING ANY ANY FOR ANY COMMENT
ON THAT THAT'S THAT'S THAT'S OUR
HOPE THAT YOU KNOW THIS THIS WE.
THINGS HAPPENED LET'S LET'S
ACTUALLY HAVE THIS BE
SUSTAINABLE AND CONTINUE THIS
THROUGH AND FIND WAYS WHERE WE
CAN ACTUALLY HAVE IT AS A AS A
SYSTEM AND SOMETHING THAT IS.
STANDARDS OF JUST SOMETHING THAT
THE PILOT SO THAT'S WHICH WILL
COME BACK.
OKAY SO EXCUSES ONE OTHER FINAL
COMMENT ACTUALLY LEADER THAT I
APPRECIATE YOU BRINGING THIS FOR
WEEKS EVER HAD SOME
CONVERSATIONS SOME FOLKS IN
SACRAMENTO THAT WE SHOULD DO
SOMETHING LIKE THIS.
EXCEPT I'M GONNA LOOK IN THAT
MATCH TNC MANAGED CARE PLAN
PRODUCT IS THAT WE HAVE SO MANY
MEDI CAL PLANS AND HOW DO WE GET
ALL THE PLANS TO COOPERATE
BECAUSE WE HAVE SO MANY HAVE TO
DEAL WITH AND ALL SEPARATE INTO
THEIR ACCOUNTABLE FOR AND SO
FORTH.
BUT AGAIN I DON'T I WILL SEE
WHERE THIS PROPOSAL GOES AND I
HOPE WE CAN DO SOMETHING LIKE
THIS I HOPE WHEN HIS COUNTIES OF
BE SACRAMENTO AND WILL HAVE A
POINT PERSON WHO CAN HELP US BE
SURE THAT ALL THE SACRAMENTO
PLAN.
IT'S ALL SIX OR SEVEN OF THEM
WOULD PARTICIPATE IN SOMETHING
LIKE THIS AND YOU KNOW THE THAT
YOU HER.
PRESIDENT SACRAMENTO MISSED NAM
VET WHO'S BEEN VERY ACTIVE IN
THE COMMUNITY AND WITH LOVE THAT
WORK WITH THAT YOU IN THE HEART
ASSOCIATION MAKING DOING
SOMETHING SACRAMENTO IS LINE'S
SHOWED WHAT WE CAN MAKE. MAKE
SOMETHING LIKE THIS WORK FULLY
THANK YOU OKAY THANK YOU REYES
RAJ.
IT CAN ONLY GET ALL SEVEN
PLAYERS AGREED ON ONE THING.
ALRIGHT BUT YOU TO HELP ME
DIRECTOR CAN'T WRITE OR GET ALL
SEVEN PLANS THAT.
IT'S ONLY ONE COUNTY THOUGH.
IT'S ONLY WHAT COUNTY WE CAN'T.
YEAH.
OKAY NEXT ONE.
DO PAY HAS OUT THERE YOU ARE
OKAY VISION TO LEARN.
PROPOSAL FOR MEDI CAL FUNDING
FOR MOBILE VISION SERVICES.
OKAY AND I THINK PUTS LIKE USE
TWO PRESENTERS HERE.
ALRIGHT.
SIDE WHO STARTS.
THANK YOU MISTER CHAIRMAN MANY
WAS SAM HOLLISTER AND THE
EXECUTIVE DIRECTOR VISION TO
LEARN. REASON TO LEARN IS A
NONPROFIT MOBILE VISION PROVIDER
WE CURRENTLY HAVE ELEVEN MOBILE
CLINICS IN CALIFORNIA AT THAT
PROVIDE FREE EYE EXAMS AND
GLASSES TO.
IT'S IN LOW INCOME.
MASON TO LEARN WAS FOUNDED SIX
YEARS AGO. AND SINCE THAT TIME
AS A PUBLIC PRIVATE PARTNERSHIP
WE'VE PROVIDED OVER NINETY FIVE
THOUSAND EYE EXAMS AND SEVENTY
FIVE THOUSAND PAIRS OF GLASSES.
THE CALIFORNIA STUDENTS IN K.
THROUGH TWELFTH GRADES AT OVER
THREE THOUSAND SCHOOLS.
SEVENTY FIVE THOUSAND OF THOSE
EXAMS AND FIFTY EIGHT THOUSAND
OF THOSE PAIRS OF GLASSES HAVE
BEEN THE KIDS IN LA COUNTY.
VISION TO LEARN DOCTORS AND
CLINICS.
GOOD WHERE KIDS ARE ALL DAY
EVERYDAY AT SCHOOL. WE HELP
EVERY CHILD REGARDLESS OF
CITIZENSHIP OR INSURANCE STATUS.
ACCORDING TO A JOURNAL PUBLIC
HEALTH STUDY NINETY FIVE PERCENT
OF FIRST GRADERS IN CALIFORNIA
IN LOW INCOME COMMUNITIES DON'T
HAVE THE CLASSES THEY NEED TO
SEE THE BOARD.
OUR OWN SAMPLE OF NINETY FIVE
THOUSAND KIDS FOUND THAT TWO
THIRDS OF THE CHILDREN WHO GOT
CLASSES WHO VISION LAUREN HAD
NEVER HIGH GLASSES BEFORE. AND
ANOTHER TWENTY FIRST THREE
PERCENT OF THE KIDS WHO GOT
CLASSES.
FROM US HAD GLASSES WITH
INCORRECT PRESCRIPTIONS PRIOR TO
OUR CLINIC COMING TO THE SCHOOL.
IN OTHER WORDS EIGHTY NINE
PERCENT OF STUDENTS PROVIDED
GLASSES WITH VISION DILLER AND
DID NOT HAVE A WORKING PARENT
CLASS
CSUS.
A UCLA MATTEL CHILDREN'S
HOSPITAL STUDY OF LA UNIFIED
KIDS AT
TO LEARN HAS STUDIED.
SHOULD THE GRADES IMPROVED IN
JUST A YEAR IN FACT THIRD GRADE
MATH SCORES WENT UP TEN PERCENT
FOR BOYS.
THE SAME STUDIES SHOW THAT
NINETY PER TO PERCENT OF
TEACHERS FELT MOST CHILDREN
SCHOOLS WOULD NOT HAVE HAD
ACCESS TO
* WITHOUT THE SERVICES OF
MISSION TO LEARN.
VISION TO LEARN CURRENTLY SERVES
AN ALLEY CATS CURRENTLY SERVES
LA COUNTY THE BAY EIGHT BAY AREA
COUNTIES IN SACRAMENTO. THIS
APPROPRIATION REQUEST WILL ALLOW
US TO EXPAND OUR SERVICES
STATEWIDE WHILE THE DEPARTMENT
CONTINUES TO WORK WITH US TO
IDENTIFY A LONG TERM OPTION FOR
MEDI CAL REIMBURSEMENT.
WE KNOWS WE'VE TALKED
EXTENSIVELY TO THAT DEPARTMENT
THE HAVE ARE CURRENTLY LEANING
TOWARDS THE ALLEY A FUNDING
MECHANISM AS A POSSIBLE
PERMANENT SOLUTION. AND WE ARE
HOPE TOTALLY OPENED UP TO
UNDERSTANDING THAT OPTION.
WE KNOW CALIFORNIA MEDI CAL AND
COFFEE IS VERY COMPLEX I AND
OTHER STATES WHERE REMEMBER WE
GET MEDICAID REIMBURSEMENT
DIRECTLY BUT WE ARE ARE GRATEFUL
TO THE DEPARTMENT'S EFFORTS TO
FIND A SOLUTION. THANK YOU.
I THINK IT COMES FROM ITS S..
AND ALEJO FINANCE NOW ALRIGHT.
AND AND SO AND I KNOW THE AUDI
AB SO THAT'S SOMETHING ARE.
SCHOOL MEDICAL FOLKS CAN.
WORK ON.
SO YES WE HAVE BEEN IN
CONVERSATIONS WITH THE.
VISION TO LEARN AND AND IT IS A.
IT'S ALONGER TERM TRIP
DISCUSSION ABOUT PERMANENT
FUNDING AND MECHANISMS FOR THAT
AND SO IT'S IT'S NOT QUITE.
READY FOR PRIMETIME BUT WE HAVE
BEEN IN DISCUSSION OKAY WAS
CERTAINLY OUT YEAH I THINK A
SINCE YOUR SCHOOL BASIN I'M THAT
PLEASURE OF BE OVER THE VISIT
OUR OFFICE AND THAT I SEE YOU IN
ACTION AND.
SCHOOL IN SACRAMENTO.
HIM THINKING THERE'S A SCHOOL
BASED SERVICE HOPEFULLY THAT'S A
VEHICLE FOR WHICH WE CAN TRY TO.
TIADA DRAWDOWNS A MEDI CAL FUNDS
FOR FOR THE SERVICES YOU PROVIDE
TO THOSE KIDS AT SCHOOL SO BE
SHAPE THAT.
SACRAMENTO. ALRIGHT THANK YOU
EXTRA MUCH.
OKAY AND.
.
LAST BUT NOT LEAST IN THE
SECTION WE HAVE THE AMERICAN
DIABETES ASSOCIATION PROPOSAL
FOR COVERAGE OF CONTINUOUS
GLUCOSE MONITORING AND MEDI CAL.
WELCOME.
THANK YOU MISTER CHAIR SHARE
GONZALEZ ON BEHALF OF THE
AMERICAN DIABETES ASSOCIATION I
HAVE WITH ME OUR MEDICAL EXPERT
I'M AT THE DESK MERELY FOR
TECHNICAL ASSISTANCE.
GOOD AFTERNOON THANK YOU VERY
MUCH MR CHAIRMAN MEMBERS OF THE
COMMITTEE. MY NAME IS FRANCISCO
PRE AT THE WHIM DE I'M NOT
PRACTICING FAMILY PHYSICIAN FOR
THE LAST THIRTY FIVE YEARS MOST
OF THAT TIME HERE IN THE
SACRAMENTO AREA. UP I'M ALSO
VICE CHAIRMAN OF THE NATIONAL
ADVOCACY COMMITTEE FOR THE.
SERVE AS A.
MEMBER
THE BOARD OF.
CALIFORNIA'S TO
REGION OF MEDICINE
CALIFORNIA STEM CELL RESEARCH
AGENTS.
I'M HERE TODAY ON BEHALF OF A
COALITION OF POSITIONS AND
NURSES DIABETES EDUCATORS
PATIENTS AND THEIR CAREGIVERS TO
ASK THIS SUBCOMMITTEE. TO
SUPPORT OUR PROPOSAL TO.
YOU DON'T SEE.
A COVERED BENEFIT FOR MEDICARE
BENEFICIARIES
WHO HAVE DIABETES.
THAT'S PARKS WE FOR MILLION
CALIFORNIANS WHO HAVE DIABETES
NOW OF. APPROXIMATELY ONE IN
SEVEN ADULTS.
CALIFORNIA HAS THE HIGHEST
LEVEL OF NEW CASES OF DIABETES
IN
THE U. S.. PARDON THAT NUMBER
HAS INCREASED THIRTY TWO PERCENT
IN TEN YEARS.
AND ACCORDING TO THE DEPARTMENT
OF HEALTH CARE SERVICES
REPORTING TWENTY FIFTH
TEEN MEDICAL SPENDING JUST ON
ADULTS TOTALED THREE POINT SIX
BILLION DOLLARS.
PERHAPS MORE IMPORTANTLY THE
MOST COSTLY FIVE PERCENT OF THAT
TOTAL IT'S RESPONSIBLE FOR OVER
A THIRD OF ALL OF THAT SPENDING.
AN AVERAGE COST OF TWELVE
THOUSAND FOUR HUNDRED NINETY
THREE DOLLARS PER MEMBER PER
MONTH.
DIABETES THE SEVEN LEADING CAUSE
OF DEATH IN CALIFORNIA THE
LEADING CAUSE OF CARDIOVASCULAR
DISEASE ADULT POLITENESS KIDNEY
DISEASE NON TRAUMATIC
AMPUTATIONS.
CROWD.
MOST OF WHICH OCCUR IN PEOPLE
WITH DIABETES SEE JIM'S
CONTINUOUSLY MONITOR BLOOD
GLUCOSE THROUGH A VERY SMALL
CATHETER INSERTED UNDER THE SKIN
CHANGED EVERY FEW DAYS. AND THE
USE ALARMS OR ALERTS TO INFORM
PATIENTS WHEN THEIR BLOOD
GLUCOSE IS HE THE RISING UP.
OR FALL
BELOW
IF LEVELS.
MULTIPLE STUDIES HAVE SHOWN IN
ALL OF OUR ORGANIZATIONS AGREE
THAT EXPANDING COVERAGE OF CGM
LEADS TO IMPROVED OUTCOMES FOR
PEOPLE WITH DIABETES.
I CAN CITE NUMEROUS STUDIES
SHOWING YOU THESE IMPROVED
OUTCOMES AND THAT CGM IS COST
EFFECTIVE.
BUT MISTER CHAIRMAN I THINK YOU
KNOW FROM EXPERIENCE THAT THE
GREATEST FEAR OF OF FAMILY WITH
A YOUNG CHILD WITH TYPE ONE
DIABETES OR. THE FAMILY OF A
PERSON WHO HAS DIABETES AND
HYPOGLYCEMIC UNAWARENESS. IS THE
POSSIBILITY OF SUDDEN DEATH DUE
TO HYPOGLYCEMIA.
FORTUNATELY MOST PATIENTS WITH
DIABETES WILL NOT NEED CGM MOST
PEOPLE WITH DIABETES WILL
DEVELOP SYMPTOMS WHEN THEIR
BLOOD SUGAR DROPS RAPIDLY. I'M
IN MOST CASES THOSE SYMPTOMS ARE
SEVERE ENOUGH TO WAKE SOMEONE
FROM SLEEP.
BUT FOR SMALL CHILDREN HAD FOR
PEOPLE WITH HYPOGLYCEMIC
UNAWARENESS THIS TECHNOLOGY CAN
LITERALLY MEAN THE DIFFERENCE
BETWEEN LIFE AND DEATH.
OTHER PUBLIC PAYER SUCH AS
MEDICARE VIRTUALLY ALL PRIVATE
HEALTH PLANS IN THE U. S.
CURRENTLY COVER CGM BECAUSE THEY
RECOGNIZE ITS VALUE IMPROVING
OUTCOMES.
WE ASK YOU TO PASS THIS
IMPORTANT BUDGET PROPOSAL WE
EACH WE BELIEVE WILL SAVE LIVES
AND.
GIVE US THE OPPORTUNITY FOR
FUTURE SAVINGS IN THE MEDICAL
PROGRAM.
THANK YOU AND I'D WELCOME ANY
QUESTIONS YOU MIGHT HAVE AND
THANK YOU AND COMMENTS FROM THE
DEPARTMENT OF HEALTH SERVICES.
OHIO. FINANCE.
OKAY SO.
.
IN TERMS OF WHETHER IT'S COVERED
OR NOT.
.
IT'S.
THIS SOUNDS LIKE SOMETHING THAT
SHOULD BE COVERED.
AS THREE ACTUALLY I MEAN IS IT
NOT COVERED UNDER WHAT'S
THE CURRENT DEFINITION WHAT
THINGS SHOULD BE COVERED BY A
MEDI CAL MEDICALLY NECESSARY
IT'S A. SIN IT'S A NOT SO IT'S A
NON COVERED BENEFIT BUT IT'S
PROVIDED.
TO THE EXTENT THAT A PROVIDER
SEEKS.
.
I REQUEST AUTHORIZATION FOR US
TO PROVIDE AND SO UNDER CERTAIN
CIRCUMSTANCES WE WOULD PROVIDE
IT BECAUSE IT'S MEDICALLY
NECESSARY. SO THERE WAS A BILL
THAT WAS.
PASSED BY THE LEGISLATURE LAST
YEAR VETOED BY THE GOVERNOR I
THINK SINCE THAT POINT TIME WE
HAVE BEEN IN DISCUSSIONS WITH.
I'M STAKEHOLDERS INTERESTED
PARTIES AND THEN WE HAVE BEEN
WORKING INTERNALLY TO DEVELOP.
BETTER.
GUIDANCE TO ARE PROVIDERS
THROUGH A PROVIDER BULLETIN IN
ESSENCE SAYING UNDER THE
CIRCUMSTANCES THIS IS NOT
COVERED BENEFIT BUT IT'S
ALLOWABLE IN THE CERTAIN
CIRCUMSTANCES SO.
AND IT'S AVAILABLE BUT NOT.
WITHOUT.
SOME EITHER RESTRICTIONS ARE
OTHER OVERSIGHT.
OKAY DELUDE RESPOND YES IF I
COULD RESPOND SO.
.
MY OF ON COLLECTOR USED TO MAKE
A CRACK THAT.
IN MEXICO MILK WAS PASTEURIZED
BY LAW NOT BY HEAT.
A.
SIMILARLY CGM IS AVAILABLE THE
RADICALLY BUT NOT IN REALITY.
WE HAVE IS A DENIAL LETTER THAT
WE SHARE.
BY PATIENT WITHIN THE PAST YEAR.
.
FOUR CGM.
PATIENT WITH SEVERE I ABSENCE
OF HYPOGLYCEMIA. OF MINE OF
BLOOD GLUCOSE REQUIRING
EMERGENCY.
DEPARTMENT TREATMENT WITH THE
BLOOD SUGAR OF TO.
FOR.
SEVERAL LOW BLOOD SUGAR
READINGS.
WHOSE PHYSICIAN FELT HIS CGM
WAS A FAULTY HIM WASN'T
MEDICALLY NECESSARY.
APPEALED HIS THE DENIAL OF CGM.
A DECISION WAS MADE IN FAVOR OF
THIS PATIENTS OR A RECEIVING CGM.
BY ADMINISTRATIVE LAW JUDGE BUT
THE DEPARTMENT NEVERTHELESS
OVERRULED THAT DECISION.
.
ON THE BASIS NOT OF MEDICAL
NECESSITY OR LACK THEREOF BUT
BECAUSE THIS WAS NOT A COVERED
BENEFIT.
SO I BELIEVE THAT IN ORDER FOR
THIS TO BE TRULY AVAILABLE FOR
PEOPLE WITH DIABETES.
TO BE EXPLICIT THAT YES THIS IS
A COVERED BENEFIT IF IT IS
MEDICALLY NECESSARY.
THANK YOU WELL. WON'T WORK ON
THIS BUT I ALSO HOPE THERE'S.
DIALOGUE ABOUT THIS I MEAN THAT
THE CHALLENGES DIABETES AND KNOW
THAT YOU KNOW IS IS THAT.
IT'S HERE.
SO SAVE YOUR HYPOGLYCEMIC.
EITHER IF YOU DON'T HAVE EITHER
PASS OUT OR YOU TO AWARENESS AND
YOU HAVE THAT PROBLEM AND SO THE.
PROBLEM.
AND NOW VIEW HAPPENED THAT HAVE
HIGH BLOOD SUGAR YOU ARE NOT
IMMEDIATELY SYMPTOMATIC BUT.
OVER YEARS AND EVENTUALLY YOU
LOSE SENSATION IN YOUR EYE SIGHT
AND DINNER ENDED SENSATION AND
YOU GET THE. CORD BLOOD FLOW AND
ALL THE OTHER SYMPTOMS. DIABETES
AND SO THE CHALLENGES IS THAT OF
COURSE
CLINICIANS WE TRY TO. KEEP
PEOPLE A VERY NARROW RANGE BUT.
IT'S A REAL CHALLENGE BECAUSE IF
YOU DROP IF THEY OBSERVE LOBATO
THEY DROPPED.
THEN EITHER THEY'RE SYMPTOMATIC
CORPORATE OUTSIDE THE MAX THEY
CAN DIE.
BUT IF YOU'RE HIGH YOU DON'T
ALWAYS NO ITS ARTISTS IT NOTES
PEOPLE TEND THIS.
PATIENTS TEND THE.
SIR LEANING TOWARD HIGH BECAUSE
THEY SEE THE IMMEDIATE EFFECT OF
BEING LOW ON THEIR BLOOD SUGAR
BUT THEN. OF COURSE
EVENTUALLY I CATCHES UP TO YOU
AS WELL ALSO.
I MEAN THIS TECHNOLOGY IS REALLY
IMPORTANT IN TERMS OF GETTING
PEOPLE AND WE WILL EVENTUALLY
PAY FOR IT I MEAN THAT'S IT WE
HAVE TO END UP PAYINGFOR YOU
KNOW PEOPLE BEING GOING BLIND
WE'RE PAYING FOR PEOPLE
BASICALLY NGHE APPLICATION.
OTHER AT THE AND CHECK
AND SO FORTH.
THAT WILL EVENTUALLY SHOW UP SO
I JUST HOPE WE CAN TRY TO FIGURE
THIS OUT TOM. DALY FTA PREVENT
NAILED THE.
THE HYPOGLYCEMIC SU MAYBES.
THAT I GUESS NON SYMPTOMATIC WHO
COULD SUDDENLY DIE BUT ALSO FOR
ALL THE REST OF THE DIABETICS.
WHO WILL EVENTUALLY CAN DEVELOP
DIABETIC NEPHROPATHY AND RAN UP
THE AND ALL THAT OTHER STUFF?
LATER ON AND. AND AND THE.
PROBABLE STILL YOUNG BUT
ACTUALLY PROBABLY WILL STILL BE
ON MEDI CAL.
.
PAYING FOR IT THAT WAY TO SELL
OF THE WE CAN WORK THIS OUT.
ALRIGHT THANK YOU. OKAY SO THOSE
SO.
THAT'S THE LAST OF THE.
SEE PROPOSALS UNDER THIS.
SO WILL TAKE PUBLIC COMMENT ON
THIS IS DONE ON THIS. ISSUE.
LINDA WAY WAY WHAT WAS IN CENTER
ON LAW AND POVERTY.
YOU CAN HEAR ME.
.
YES. I HAVE AND WE APPRECIATE
THE LEGISLATURE TAKING CLOSER
LOOK AT RAW RESTORING THE
OPTIONAL SO CALLED OPTIONAL
BENEFIT THAT WERE CUT IN TWO
THOUSAND NINE. CALLED OPTION NO
I'M NOT BECAUSE OTHER OPTIONAL
TO THAT THE BENEFICIARIES BUT
RATHER BECAUSE.
BOB THE STATE CAN ELECT TO TO
PROVIDE THEM THESE ARE CRITICAL
SERVICES IN TIME OF RECOVERY
APPRECIATE THAT LEGISLATURE
CONSIDERING THAT AS WELL AS
SUPPORT. THE ASTHMA HOME
VISITING BENEFIT AS WELL AS A
CONTINUOUS GLUCOSE MONITORING
THINKING OKAY THANK YOU.
BRENT SPENCER WITH THE
CALIFORNIA PUT YAK MEDICAL
ASSOCIATION IN SUPPORT THE
REINSTATEMENT UP WHAT IT SERVICE
AS A MEDICAL BENEFITS
SPECIFICALLY.
IN TWO THOUSAND NINE BECAUSE
POINT POINT TWO THOUSAND NINE
WHEN THEY MADE THAT CUT IT WE
CUT THAT CARE PER SE THEY CUT
WHO COULD PROVIDE THE CARE
BASICALLY NARROWING THE ACCESS
TO. PROVIDE ESSENTIAL SERVICES
TO PATIENTS WHO NEED THEM A FROM
TWENTY TEN TO TWENTY SIXTEEN WE
SAW ARISES THAT. IT'S THE CHEN
APPOINTED OUT IN AMPUTATIONS AND
SO WE PUT A STOP TO THAT YES YOU
READ STATE PODIATRIST ALLOW THE
ACTION TO THE SERVICES ARE
TRYING TO DO SO THANK YOU THANK
YOU.
VERY VALID WITH HEALTHAXIS
CALIFORNIA WE WANNA LINER
COMMENTS WITH WESTERN CENTER ON
THE RESTORATION OF THE REMAINING
SO CALLED OPTIONAL BENEFITS AND
ALSO.
URGE THAT THE OPTICAL BENEFIT
WHICH WAS RESTORED LAST YEAR
PENDING INACTION BY THE
LEGISLATURE IS INDEED. I
INCLUDED IN THE LEGISLATURE IN
THIS YEAR'S BUDGET TO ENSURE
THAT THE BENEFITS AVAILABLE. OUR
TO MEDICARE BENEFICIARIES BY
JANUARY ONE TWENTY TWENTY THANK
YOU THANK YOU.
WELCOME.
HELLO MY NAME IS COULD SANTORUM
I'M WITH.
HERE WITH A CENTRAL CALIFORNIA
EYES BUT COLLABORATIVE.
I'M HERE IN SUPPORT OF THE
ASTHMA PREVENTIVE SERVICES.
PROPOSAL.
AND ARE YOU TO DIE TO THE SAME
THANK YOU OKAY THANK YOU.
WELCOME.
IT IN HAMILTON DIRECTOR OF
CENTRAL CALIFORNIA ASTHMA
COLLABORATIVE. ONE RECOMMENDED
TO AND THANK.
DIRECTOR CAN'T FOR HER.
I LANGUAGE TO PROVIDE DIRECTLY
TO THE COMMITTEE TO USE TO.
INSURE THAT THIS AS A HOME
VISITOR PROGRAM GETS FUNDED VERY
SELDOM DO YOU HAVE A PROGRAM
THAT ACTUALLY PAYS ITSELF BACK.
THIS ONE WILL.
BY THE WAY A DOCTOR CAN I
APPRECIATE YOUR SUPPORT FOR
HEALTH IMPACT ON STRATEGIES I
REALLY LOVED HEARING THAT.
SHARED COST PIECES
A SIGNIFICANT PIECE OF THIS AND
WE RAN THE PROJECT TESTING THAT.
BUT UNFORTUNATELY.
THE STATE OF CALIFORNIA WAS NOT
AS FUN WITH IT AS YOU ARE. SO
THANK
I THINK YOU.
HELLO I'M LUCINDA BAZELL WITH
LIFELONG MEDICAL CARE A
FEDERALLY QUALIFIED HEALTH
CENTER IN ALAMEDA COUNTY CONTRA
COSTA IN MARIN COUNTY.
AND I'M HERE IN SUPPORT OF THE
ASTHMA PREVENTION SERVICES
PROPOSAL.
I'M AS A EDUCATION INCLUDING
HOME VISITS ARE EXTREMELY
CRITICAL AND DECREASING COSTLY
EMERGENCY ROOM VISITS.
AND IMPROVING HEALTH OUTCOMES AS
YOU ALL KNOW. OUT WE HAVE
CONDUCTED A SMALL PILOT PROGRAM
WITH THE USE OF HEALTH PROMOTERS
AND COMMUNITY HEALTH WORKERS. TO
REACH OUT OF PATIENTS WHO HAD
URGENT CARE AND EMERGENCY ROOM
VISITS. TO ADDRESS THEIR
UNCONTROLLED ASTHMA.
AND THESE VISITS HAVE HOPE ARE
ON PATIENTS.
DO HOME ASSESSMENT HOME
ASSESSMENTS TO ASSIST THEM TO
UNDERSTAND THE TRIGGERS IN THEIR
HOME. PROVIDE TOOL KIT SO THAT
THEY CAN GET RID OF THE TRIGGERS
AS WELL AS GIVE THEM HEALTH
EDUCATION IS ABOUT UNDERSTANDING
THE MEDICATIONS THAT ARE IN
THERE AS AN ACTION PLAN. WHICH
MANY OF THEM. MANY OF THEM DON'T
REALIZE THAT THEY HAVE.
SO.
THIS PLAN HAS THIS PROGRAM HAS
BEEN WELL RECEIVED BY OUR
PATIENTS AND HELPING THEM BETTER
MANAGE. THEIR CONDITION AND IS
VERY CRITICAL. AND UNDERSERVED
COMMUNITY SUCH AS PLACES LIKE
RICHMOND OAKLAND. WHERE WE
PROVIDE SERVICES IN THEIR
VARIOUS SCHEMES ENVIRONMENTAL
ISSUES THAT ARE NOT BEING AND?
ADDRESS SO THIS WILL BE VERY
HELPFUL THANK YOU THANK YOU.
WELCOME.
HI KATIE HI KATIE HEIGHT ON OUR
BEHALF OF HEALTH NET ON HERE IN
STRONG SUPPORT OF VISION TO
LEARN PROGRAM AND ALL IT DOES
FOR CALIFORNIA CHILDREN THANK
YOU.
WELCOME. EARLY HEAD SOME HAVE
THE CALIFORNIA ACADEMY OF FAMILY
PHYSICIANS IN SUPPORT OF THE
ADVOCATES PROPOSAL OR ANA.
COVERING CONTINUOUS GLUCOSE
MONITORING AND MEDI CAL THANK
YOU OKAY THANK YOU.
GOOD AFTERNOON ALL OF IRAQ GRAY
CALIFORNIA LICENSES CESSATION IN
STRONG SUPPORT OF TWO PROPOSALS.
THE HYPERTENSION AWARENESS
PROGRAM AYE THAT EMPOWERS
PATIENTS TO REALLY BE PROACTIVE
ABOUT THEIR NEEDS AND.
IN IN THE DEBATES ARE ON COST
CONTAINMENT.
PROVIDING PATIENTS WITH BETTER
TOOLS A BETTER UNDERSTANDING OF
THEIR DISEASE MANAGING THAT
DISEASE IS A GOOD THING AND
SECONDLY COVERAGE OF CONTINUOUS
GLUCOSE MONITORS AGAIN IT
EMPOWERS PATIENTS AND THEIR
PROVIDERS. OUGHT TO PROVIDE. THE
MOST ACCURATE TOOLS AND.
STRONG SUPPORT THANK YOU THANK
YOU.
WELCOME. DOCTOR PAN PUTTING
MADDEN REPRESENT CALIFORNIA
CHAPTER OF AMERICAN CULTURE
CARDIOLOGY IN SUPPORT OF THE
CONTINUOUS GLUCOSE MONITORING
PROVISION FOR THE REASONS
ALREADY DISCUSSED THANK YOU.
THANK YOU.
AFTER NEWMAN DEFEATED BUT THE
AMERICAN LUNG ASSOCIATION AND
CALIFORNIANS STRONG SUPPORT OF
THE AS MASS HOME CARE BY
PROVISION. AYE WE BELIEVE IT'S
GOING ASSOCIATION THAT THIS IS A
KEY COMPONENT ANY ASTHMA
MANAGEMENT PLAN IS CRUCIAL TO
MAKING SURE THAT PATIENTS ARE
ABLE TO ADEQUATELY MANAGE ERIC
AZMAT SO. THAT PLEASE.
THANK YOU.
MITCHELL BUCKET WITH THE
CALIFORNIA MEDICAL ASSOCIATION
HERE IN STRONG SUPPORT OF MAKING
CONTINUOUS GLUCOSE MONITORS A
COVERED BENEFIT MEDICAL THANK
YOU. THANK YOU.
MAKE MAKE A HARD DECISION MAKING
JUXTAPOSITION.
SUPPORT OF OUR ON HYPERTENSION
AWARENESS PILOT PROJECT LOOK FOR
TO WORK WITH YOU I'M ON THAT
THANK YOU.
GOVERNOR MARTIN HERE ON BEHALF
OF THE CALIFORNIA CHILDREN'S
HOSPITAL ASSOCIATION IN SUPPORT
OF THE ASTHMA HOME PREVENTATIVE
PROGRAMS GIVE GREAT THANK YOU.
POLITICAL EXIT CALIFORNIA'S
DISABILITY RIGHTS I'M REYES
SPORTING OF THE OPTIONAL BETTER
RETURN ESPECIALLY SPEECH THERAPY
WE HAVE A LOT OF FOLKS IN THE
DISABILITY COMMUNITY EXPRESSING
THE DDS COMMUNITY. WE HOP TURN
BEING DUE BLOOM VERBAL
COMMUNICATION THIS IS AN AMAZING
PROGRAM THAT THEY HAD THERE TO
HELP.
MAKES HIM FEEL CONFIDENT THEY
CAN SAY WHAT THEY WANT TO SAY
AND IN OUR NAY ANDERSON WHICH
ARE BEING SET TO AND THAT'S A
VERY IMPORTANT THING AS FOR
PODIATRY. AGAIN WITHIN THE
DISABILITY COMMUNITY A LOT OF.
FOOT FUNGUS AND THINGS LIKE THIS
HAPPENS AND YOU KNOW IF YOU
DON'T USE YOUR FEET YOU LOSE
THEM AND WE WANTED FELT SAVE
THEM THOUGHT WE THANK YOU FOR
THAT AND THANK YOU FROM EXACTLY
OTHER OPTIONAL BENEFITS.
THANK YOU.
HI MY COULD A WITH CHILDREN NOW
UP PROUD COSPONSORED THE ASTHMA
PREVENTIVE SERVICES BUDGET ASK A
REALLY GLAD TO HEAR THAT THERE'S
SOME MODELS LIKE THE DPP THAT WE
CAN GO FROM AN ENTHUSIASTICALLY.
LOOKING FOR TO THE TECHNICAL
ASSISTANCE FROM THE DEPARTMENT I
CHILDREN I WAS ALSO IN SUPPORT
OF THE MOBILE VISION SCREENING.
BUT PROPOSAL FOR ITS THANK YOU
OKAY THANK YOU.
PARTICULARLY JUMP HAVE TO
CALIFORNIA PAN ETHNIC HEALTH
NETWORK WANTED TO EXPRESS OUR
SUPPORT FOR THE HYPERTENSION
PILOT PROJECT PRO PILOT PROJECT
PROPOSAL THANK YOU VERY THANK
YOU.
NUMBERLESS HOMES COMFORT CHRONIC
CARE COALITION IN SUPPORT OF
BOTH HYPERTENSION AND THE
GLUCOSE MUTTERING SYSTEMS THANK
YOU. THANK YOU.
HER CHILD DISABILITY RIGHTS
CALIFORNIA WHERE TALK SUPPORT OF
US. RESTORING THE.
OPTIONAL BENEFITS
OKAY THANK YOU.
ALRIGHT WELL THANK EVERYONE WE
WILL TAKE THEM SAID WHICH WILL
HOLD OPEN EACH OF THESE APPS THE
PROPOSALS ARE SO WE'RE HOLDING
OPEN.
PROPOSALS AND ITEMS FOR.
ON PROP FIFTY SIX IN THE
REIMBURSEMENT AS WELL.
SO WE.
TURN NOW ONTO.
ISSUE NUMBER FIVE SO THAT'S OUR.
CALIFORNIA ELEVEN FIFTEEN WAIVER
MEDICAL TWENTY
TWENTY.
ALRIGHT.
CORRECT CAN'T.
YOU WERE YOU HAD AND WAS SURE SO
I KNOW THAT WE.
HAVE THE RIGHT UP IN FRONT OF
US I'M WE ARE SEEKING BOTH.
THE CONTINUATION OF SAN.
STAFFING RESOURCES THAT ARE
CURRENTLY WORKING AYE WITHIN THE
WAIVER PROGRAMS BUT ALSO.
.
FUNDING FOR THE EVALUATIONS THAT
ARE REQUIRED AS PART OF THE
TERMS AND CONDITIONS FOR THE
WAIVER. I'M I'M NOT GONNA COULD
WALK THROUGH EACH OF THE
COMPONENTS TO DEEPLY BUT I WOULD
I WANT TO KNOW.
THAT BOTH PRIME WHOLE PERSON
CARE AND.
.
WE TALKED ABOUT IT IN A PREVIOUS
AGENDA BUT THE ELEVEN FIFTEEN
WAIVER ALSO INCLUDES A SUBSTANCE
USE DISORDER ORGANIZED DELIVERY
SYSTEM. AS A COMPLIMENT THESE
ARE ALL.
ITEMS THAT CALIFORNIA HAS BOTH
pTHE COUNTRY TO DO THROUGH AN
ELEVEN FIFTEEN WAIVER AND SO
WE'RE VERY PROUD OF THE WORK
THAT WE DO.
WE BELIEVE THAT PRIME HAS OUT
NOT ONLY HELPS.
SHORE UP THE BOND DOES AGAIN
PUBLIC HOSPITALS IN THE STATE OF
CALIFORNIA IN TERMS OF THE
CRITICAL INFRASTRUCTURE NEEDS
THAT THEY HAVE.
BUT PRIME HAS ALSO BEEN ON
EXTENDED TO A NON DESIGNATED
PUBLIC HOSPITALS THE DISTRICT
HOSPITALS WHO HAVE BEEN
RECEIVING FUNDING AND DOING A
LOT OF QUALITY IMPROVEMENT WORK.
THE GLOBAL PAYMENT PROGRAM.
IS ALSO A NEW PAYMENT
METHODOLOGY THAT WE HAVE WITH
THE PUBLIC HOSPITALS TO CONTINUE
PROVIDING CARE TO THE UNINSURED
ARE THE REMAINING UNINSURED IN
CALIFORNIA. ITEM BY TRYING TO
ENCOURAGE INCENTIVIZE THE USE OF
PREVENTIVE OUTPATIENT SERVICES
RATHER THAN INPATIENT.
SERVICES AND THEN.
LASTLY WHOLE PERSON CARE.
WE ARE CONTINUING TO BE BOTH
IMPRESSED AND I'M HEARTENED BY
THE FACT THAT THE COUNTIES AND
THE.
OTHER ORGANIZATIONS THAT ARE
PARTICIPATING AS PART OF HOPE
PERSON CARE HAVE REALLY DONE
SOME EXTRAORDINARY WORK.
IN REACHING OUT TO CERTAIN
POPULATIONS NOTABLY.
HOMELESS PEOPLE THAT ARE AYE
RECENTLY RELEASED FROM JAILS
PAST THEY'VE BEEN DOING SO BRING
CENTERS IN A LOT OF MOBILE
CRISIS OUT REGION SO WE REALLY
BELIEVE THAT THOSE ARE THE KINDS
OF BOTH INNOVATIONS IN
ACTIVITIES THAT WAIVERS ARE
DESIGNED.
TO BOTH DEMONSTRATE AS WELL AS
IMPROVE THE QUALITY OF OUR LIVES
IN THE MEDICAID POPULATION SO.
WITHOUT I'MHAPPY TO ANSWER ANY
QUESTIONS BUT REALLY WOULD
APPRECIATE THE.
LEGISLATURE SUPPORT OF THE SITE
REQUESTED FUNDING FOR THE
CONTINUATION OF THE WAIVER
ACTIVITIES.
THANK YOU.
ALEJO COMES.
WE HAVE IDENTIFIED NO CONFLICT
NO CONCERNS WITH THIS PROPOSAL
OKAY FINANCE.
ALRIGHT.
SO.
.
NO PUBLIC COMMENT YES.
SENATOR TERRY THOMAS AYE ME
HAVE THE CALIFORNIA ASSOCIATION
OF PUBLIC HOSPITALS AND HEALTH
SYSTEMS AND WE'RE HERE IN
SUPPORT OF THE CONTINUED
POSITIONS AND THE FUNDING FOR
THE EVALUATIONS WERE REALLY
PROUD OF THE WORK THAT WE'VE
BEEN ABLE TO DO THROUGH THE
WAIVER. ON IMPROVING QUALITY IN
OUR HOSPITALS AND OUR PAY FOR
PERFORMANCE WORK AND WE'VE
WORKED IN YOU KNOW WE FEEL LIKE
OUR COLLABORATIVE RELATIONSHIP
WITH THE DEPARTMENT ON THE
WAIVER. HAS YIELDED GREAT
RESULTS FOR THE PEOPLE WHO USE
OUR HEALTH SYSTEM SO WE'RE IN
SUPPORT OF THE SITE.
OKAY.
THANK YOU OTHER PUBLIC AT PUBLIC
COMMENT CRITICS CALIFORNIA'S
DISABILITY RIGHTS WE REALLY LIKE
TO HOPE PERSON CARE PILOT
PROGRAM ITS TEETH IT'S BEEN
AMAZING TO BE UGLY DOT MENTAL
HEALTH. AND PHYSICAL HEALTH AND
SO THEY CAN STAY AT HOME AND
LIVE INDEPENDENTLY IT'S JUST BUT
SKINNER JUST AMAZING PROGRAM SO
ANYTHING THAT YOU CAN DO.
CONTINUE THAT BRING THAT FORWARD.
WE APPRECIATE THAT.
THANK YOU.
THIS NO PUBLIC COMMENT ON THIS
ITEM WAIVER.
NOT PAN GARY PASSED MORE PRESENT
IN THE CONGRESS OF CALIFORNIA
SENIORS. IS A MEMBER OF THE
STAKEHOLDER ADVISORY COMMITTEE
THAT OVERSEES THE WAIVER PROGRAM
I'M STRONGLY IN SUPPORT. AND THE
CCS IS STRONGLY IN SUPPORT OF
THESE INITIATIVES.
THANK YOU AND OTHER PUBLIC
COMMENT ON THIS ITEM.
SO JUST A. COUPLE THINGS SO SO
FIRST OF ALL CERTAINLY YOU KNOW
WE WANNA BE SURE WE HAVE THE
RESOURCES OF THE VALUATION SO
APPRECIATE THE REQUEST ON THAT.
I THINK IS THIS IS ROLLING OUT I
WANTED THINGS.
ALSO BE HELPFUL WE DON'T
YOU TO GO THROUGH IT HERE RATE
IN THE HEARING BUT. AS EACH OF
THE DIFFERENT TACK ENTITIES THAT
WE HAVE I THINK COUNT HOW MANY
HERE.
ARE A RULING THESE OUT I
PRESUME WHAT HAPPENS IS EVELYN
YEAH I'VE ONCE THEY ARE COMING
UP WITH SUMMER COMING OF STE
DIFFERENT INNOVATIONS AND SO
FORTH IT BE GOOD TO. I DON'T OF
THERE'S GOING TO BE REPORTERS
WAS PLAYING GUITAR FOR LIKE
WIERD THINGS THAT PEOPLE ARE
ACTUALLY DOING SO I'M SURE THAT
WHEN BEGIN THE WAIVER PEOPLE
LIKE THINKING ABOUT DIFFERENT
THINGS AND THEN THEY START
IMPLEMENTING TO SERVICE. GET A
LOT MORE OF A. CATALOG OF OKAY
THESE ARE THE DIFFERENT PROJECTS
ARE APPROACHES.
PEOPLE ARE TAKING THROUGH THE
WAIVER IN TERMS OF WHAT THEY'RE
ACTUALLY.
YEAH I'M DOING SO A USE AND WE
HAVE HAD.
LEARNING COLLABORATIVE'S WITH
EACH OF THE WHOLE PERSON CARE
PILOTS WHERE WE BRING THEM ALL
TOGETHER AND WALK THROUGH EITHER
BEST PRACTICES OR. IF ONE IS
STRUGGLING WHEAT SO WE'VE
THERE'S A CONTINUOUS KIND OF
QUALITY FEEDBACK AND I'M
WE'VE CONSTRUCTED WHICH I THING
HAS ALSO BEEN VERY HELPFUL OKAY
NOW THAT'S GREAT AND I'M. GLAD
TO HEAR THAT THEY'RE ALSO
LEARNING FROM EACH OTHER SO I
THINK JUST IN TERMS OF.
I KNOW WEEK YOU TALKED ABOUT ICE
IN THE TIMELINE ON ON THE WAIVER
FOR EVALUATION.
SIMILAR TO THE ONE YOU TOLD ME
FOR DTI WHICH IS PART OF THE
SLAVERS WELL SO WE'RE.
BUT IT.
THE. SO BUT I THINK IT'S HELPFUL
BECAUSE THAT WILL STILL BE YOU
KNOW TWENTY TWENTY TWENTY TWENTY
ONE.
ALSO DESERVE LIKE OKAY WELL
THIS IS WHAT PEOPLE ARE DOING SO
WE CAN GIVE THAT FEEDBACK TO.
PUBLIC ABOUT SO THIS IS WHAT'S
COMING OUT A WAIVER WE WON'T
HAVE THE VALUATION FOR SEVERAL
YEARS BUT THIS IS THESE ARE TWO
DIFFERENT THINGS PEOPLE TRYING
TO DO SO. AND HOPE POLL PERSON
CARE WHAT EXACTLY ARE THEY DOING
IN. THESE DIFFERENT AREAS ON THE
WHOLE PERSIAN CAT WHAT EXACTLY
DID THEY COME UP WITH.
SO THAT WOULD BE HELPFUL.
OKAY.
ALRIGHT WELL WE WILL HOLD THAT
ITEM OPEN. SINCE WE'VE WE FOR
EVERYTHING UNTIL WE SEE WHAT
HAPPENS IN MAY.
OKAY SO I NEXT IS THE ISSUES SIX
IS THE HOSPITAL ASSURANCE THE
FEE PROGRAM.
SURE SO THE DEPARTMENT IS
SEEKING TO.
MAKE PERMANENT ELEVEN AND A
HALF OPPOSITIONS TO ADMINISTER
THE HOSPITAL QUALITY ASSURANCE.
THE AND VARIOUS ADMINISTRATIVE
ACTIVITIES ASSOCIATED THERE WITH
I THINK THIS IS ANOTHER EXAMPLE
WHERE WE HAVE WORKED CLOSELY
WITH THE HOSPITAL. COMMUNITY TO
BOTH.
CREATE EMPLOYMENT AND GET THE
FEDERAL NECESSARY FEDERAL
APPROVALS TO.
.
PROVIDE THE SUPPLEMENTAL
PAYMENTS TO THE HOSPITAL'S I
WOULD KNOW IN YOUR ANALYSIS.
THAT
WE'RE ASSUMING THREE POINT EIGHT
BILLION DOLLARS.
AND COIFFED REVENUE AND
SEVENTEEN EIGHTEEN APPROXIMATELY
NINETEEN SAID THESE ARE NOT
INSIGNIFICANT.
FUNDS THAT HELP SUPPORT
CALIFORNIA HOSPITALS ON THE
SERVICES THEY PROVIDE TO THE
MEDICAID BENEFICIARIES AND SO.
WE BELIEVE.
THAT THE.
RESOURCES IN THE PERMANENT
ONGOING POSITIONS GIVEN THAT
THIS IS A PERMANENT ONGOING
REVENUE STREAM.
ARE APPROPRIATE AT THIS TIME.
ALRIGHT COME ITS MALAYO.
FINANCE.
OKAY ANY PUBLIC COMMENT ON THIS
ISSUE.
SEEING NONE. ALL RIGHT SO.
OKAY WELL CERTAINLY VERY
IMPORTANT A SOURCE RESOURCES AND
THERE WILL HOLD THIS ITEM OPEN.
OKAY MOVING ON TO ISSUE NUMBER
SEVEN GRADUATE MEDICAL EDUCATION
PROGRAM OVERSIGHT MODERATE.
YES SO THIS IS.
SOMETHING THAT THE.
PUBLIC HOSPITALS TO COME TO US
LAST YEAR AND I KNOW THAT WE HAD
WORKED WITH THEM TO CONSTRUCT.
A PROPOSAL TO THE FEDERAL
GOVERNMENT IN ORDER TO DRIVE
DOWN ADDITIONAL FUNDING FOR GME
COSTS.
SO WE HAVE SUBMITTED A PROPOSAL
pBELIEVE THAT WE FEEL THAT THE
CONVERSATIONS HAVE BEEN BOTH
PRODUCTIVE AND THAT WE DON'T
ANTICIPATE. SIGNIFICANT DELAYS
IN THE APPROVAL SO WE DON'T HAVE
APPROVAL YET BUT WE'RE NOT
ANTICIPATING THAT THIS SHOULD BE
A.
PROLONGS KIND OF EITHER
CONVERSATION ARE SIGNIFICANT
DELAYS IN THE APPROVAL AND SO
THESE ARE.
SEEKING TO POSITIONS AND SOME
EXPENDITURE AUTHORITY TO OPERATE
THIS PROGRAM ON AN ANNUAL BASIS.
OKAY COMES FROM OIL.
BRIAN METZGER EARLIER WE'VE
REVIEWED THE BCP IT HAVE NO
SCRIPT NO CONCERNS OKAY FINANCE.
OKAY PUBLIC COMMENT. YES TERRY
THOMAS AGAIN ON BEHALF THE
CALVARY CESSATION PUBLIC
HOSPITALS AND HEALTH SYSTEMS ARE
WERE IN STRONG SUPPORT OF THIS.
REQUEST BY THE DEPARTMENT.
THIS A FUNDING FROM THE FEDERAL
GOVERNMENT WILL HELP OUR
FACILITIES.
IN THERE REALLY IMPORTANT
MISSION OF CHANGED OF TRAINING
THE NEXT GENERATION OF
PHYSICIANS AND.
ALSO BY WORKING IN OUR
FACILITIES.
HELPING TO EXPOSE THEM TO
EVERYTHING FROM ROUTINE MEDICAL
PROBLEMS TO SOME OF THE MOST
COMPLICATED.
MEDICAL ISSUES THAT ARE HAVE AN
OVERLAY OF SOME SERIOUS SOCIAL
ISSUES AS WELL AND SO WE REALLY
WANT TO SEE THIS PROGRAM GO
FORWARD IN BEACH FOR* YOUR
SUPPORT THANK YOU. THANK YOU SO.
PRINT WITH SO YOU SAID THAT
IT'S AN PROCESS.
AND YOU DON'T ANTICIPATE TO
MEDIA SO WHEN WE TALK ABOUT
IMPROV.
WHAT WOULD IT WHAT WHAT IS THE
ANTICIPATED TIME YOU THINK CMS
WOULD ACTUALLY MAKE A DECISION?
?
I WOULD SAY I'M PROBABLY WITHIN
THE QUARTER OKAY THOUGH I I IT'S
NOT.
LONG BUT I THINK ON THE
CONVERSATIONS HAVE BEEN DOWN.
BETWEEN OUR DEPUTY DIRECTOR FOR
FINANCING. A WHO WORKS.
EXTENSIVELY WITH THE FIVE
FINANCING FOLKS AT CMS AND SO I
THINK WE'RE FEELING THAT THAT'S
KIND OF A QUARTER ISSUE AS
OPPOSED TO A. LONGER TIME OKAY
ALRIGHT AND THEN.
IN.
AND REMIND US HOW MUCH MONEY
ARE WE TALKING ABOUT AYE KNOWS
IN THE.
LAST YEAR'S BUDGET.
BUT IF THIS IS APPROVED HOW
MUCH WE BILL THE DRAWDOWN.
IT HAS A TOTAL PHONE WITH THE.
ONE POINT TWO BILLION DOLLARS
OKAY OCCURRING HERE AND.
.
AND NINE HUNDRED NINETY NINE
MILLION DOLLARS IN THE BUDGET
YEAR.
YEAH SO SENSITIVE YOU KNOW OVER
BUT FRANKLY BILLION PLUS SO.
THE OTHER THING I WOULD MAKE
NOTE AS SOMEONE WHO KNOWS A
LITTLE BIT ABOUT JIMMY FUNDING.
SINCE
IS ALSO GOOD.
THE FLIES KIND LIKE THE MEDICARE
FORMULA KIND OF THING.
SO I APPRECIATE THE TESTIMONY
FROM PUBLIC HOSPITALS ABOUT OF
COURSE WITH CANDLELIGHT FREMONT
TRAINEES BUT TWO THIRDS OF THAT
IS FOR AND DIRECT MEDICAL COSTS
WHICH
INCLUDE ENHANCED PAYMENTS. OF
FOR.
THAT SERVES AS A MEDI CAL
WAIVER FOR MEDI CAL PATIENTS.
FOR THOSE HOSPITALS AS WELL SO
WE SHOULD JUST. KEEP THAT KEEP
THEM MY IN TERMS OF OUR ABILITY
TO TRY TO. GET ACCESS AS WELL
SELF.
ALRIGHT.
WITH THAT WILL HOLD THAT ITEM
OPEN AS WELL AND I WISH
CERTAINLY WISH.
DEPARTMENT AND ALL OF US THE
BEST OF MY SUCCESS IN ACTUALLY
GETTING THE APPROVAL ON THAT.
BILLION DOLLARS WHEN HEARD. OKAY.
ISSUE NUMBER EIGHT.
HIS HOME COMMUNITY BASED
SERVICES WAIVER PROGRAM.
SURE SO I'M AS YOUR.
AGENDA NOTES WE HAVE SIX WE
HAVE A SIGNIFICANT NUMBER OF
WAIVERS AND THE HUMMING
COMMUNITY BASED AREA WITHIN THE
DEPARTMENT. ON S THEY HAVE BEEN
COMING UP FOR RENEWAL WITH THE
FEDERAL GOVERNMENT WE HAVE TAKEN
SOME.
TIME TO TRY TO LOOK AND SEE IF
THERE WERE WAYS THAT WE COULD
EITHER.
CONSOLIDATE OR OTHERWISE
IMPROVE UPON WAIVERS THAT HAD
PREVIOUSLY NOT BEEN.
.
GIVEN A WHOLE LOT OF ATTENTION
AND I THINK THE ASSISTED LIVING
WAIVER IS A REALLY GOOD EXAMPLE
WHERE.
WE HAVE NOT ONLY INCREASE THE
NUMBER OF COUNTIES THAT HAVE
BEEN PARTICIPATING AND THEY'LL
W. BUT WE ARE.
SEEKING TO INCLUDE FUNDING TO
ADD AN ADDITIONAL TWO THOUSAND
SLOTS ON THE NUMBER OF
INDIVIDUALS CURRENTLY ABLE TO
USE THE WAIVER IS THREE THOUSAND
SEVEN HUNDRED AND FORTY FOUR. SO
THIS WOULD OBVIOUSLY
SIGNIFICANTLY INCREASE THE
CAPACITY.
BUT THERE'S ALSO.
A LOT OF ADMINISTRATIVE
ACTIVITIES THAT WE'RE SEEKING TO
DO IN TERMS OF MAKING SURE THAT.
THERE ARE THE RIGHT AGENCIES
THAT ARE OVERSEEING THE
ADMINISTRATION THE WAIVER
WORKING WITH THE FAMILIES AND
THE PROVIDERS TO MAKE SURE THAT.
ALL THE DIFFERENT TYPES OF
SERVICES ARE COORDINATED AND SO
ON THAT'S REALLY KIND OF THE
ACTIVITY THAT WE FIND OURSELVES
IN RIGHT NOW AND THEN. TO THE
EXTENT THAT WERE GOING TO BE
SEEKING TO RENEW THE WAIVER
WE'VE BEEN ALSO VERY MINDFUL
ABOUT THE NEEDS TO I'M DEEPLY
INVOLVED.
ADVOCATES DISABILITY.
PROVIDERS.
.
POPULATION ITSELF THAT IS
BENEFITING FROM THE WAIVER TO
KIND OF UNDERSTAND SOME OF THE
EITHER AREAS OF IMPROVEMENT OR
AREAS OF CONCERN THAT WE CAN TRY
AND ADDRESS AS WE SECRETLY WILL
WITH THE FEDERAL.
OKAY THANK YOU AYE COMMENTS FROM
ALEJO ABOUT WAIVERS FINANCE.
ALRIGHT SO WE DO HAVE US COUPLE
STAKEHOLDER PROPOSALS TO HERE'S
WHAT ON THEN WILL TAKE PUBLIC
COMMENT SO FIRST IS.
TRIPS CHARLTON DISBELIEVE AIDS.
PROPOSAL FOR CONTINUED
CONTINUATION OF CALIFORNIA'S
COMMITTEE TRANSITIONS PROGRAM.
WELCOME.
ALRIGHT SO WE HAVE TWO
PRESENTERS HERE. BUT JUST ONE
ALRIGHT OKAY ALRIGHT SO YOU
DON'T HAVE TO WORRY ABOUT
SPLITTING UP YOUR TIME. I THANK
YOU SO MUCH TO GET AFTERNOON
MISTER CHAIR AND MEMBERS.
HIS NAME ANIMALS ON A ACTON AND
I'M THE EXECUTIVE DIRECTOR FREED
CENTER FOR INDEPENDENT LIVING
SERVING ABOUT A SEARING YUBA.
SUTTER INCLUSIVE COUNTIES
INHERITANCE.
TO TESTIFY IN SUPPORT OF THE
BUDGET REQUEST FOR THE
CALIFORNIA COMMUNITY TRANSITIONS.
OR CCT WHICH HELPS INDIVIDUALS
TRANSITION.
BUT LONG TERM INSTITUTIONAL
SETTINGS BACK TO THE COMMUNITY.
UNFORTUNATELY THE FUNDING FOR
THIS CRITICAL PROGRAM IS PHASING
OUT AT THE FEDERAL LEVEL.
AND THE STATE HAS NOT PROPOSED
ITS CONTINUATION BEYOND THIS
CALENDAR YEAR.
WE ARE ASKING FOR THE STATE TO
CONTINUE FUNDING CCT. AT
NINETEEN POINT ONE MILLION AND
I'M GOING GENERAL FUND DOLLARS
TO REFLECT BOTH THE STATE
CONTRIBUTION AND THE
DISCONTINUED.
FEDERAL FUNDS.
THIS UP FRONT INVESTMENT OF
NINETEEN POINT ONE MILLION IS
ESTIMATED TO RESULT. IN A TOTAL
SAVINGS OF APPROXIMATELY TWENTY
EIGHT MILLION DOLLARS.
ACROSS CALIFORNIA CCT HOPES
INDIVIDUALS WHO DESIRE TO LIVE
IN THE COMMUNITY.
AND WHO ARE CONFINED TO NURSING
HOMES OR OTHER INSTITUTIONAL
SETTINGS AND WHO OTHERWISE WOULD
HAVE NO OPPORTUNITY TO RETURN TO
THE COMMUNITY.
TAKE FOR EXAMPLE JOAN. JOAN AS A
BRIGHT AND ENERGETIC YOUNG WOMAN.
WHO LOST EVERYTHING AFTER AN
ACCIDENT JOHN IS QUADRIPLEGIC IN
NEEDS ASSISTANCE THAT?
IMPLICIT.
BEFORE SHE FOUND CCT SHED NO
HOPE OF FINDING OUT.
THAT LIVING OUTSIDE OF THE
INSTITUTION.
CC TEAM MADE IT POSSIBLE FOR HER
TO APPLY FOR AND SECURE AN
APARTMENT PURCHASE BASIC
HOUSEHOLD ITEMS MAKE
MODIFICATIONS.
TO ALLOW FOR BATHING AN
INDEPENDENT ACCESS INCREASE
INDEPENDENCE WITH ASSISTIVE
TECHNOLOGY AND SUPPLY THE
CONSIDERABLE SUPPORT TO HELP HER
PUT TOGETHER. A CARE TEAM
NAVIGATE THE EACH CBS WORLD AND
SECURE THE ON GOING SUPPORT SHE
NEEDS TO. BE SAFE IN THE
COMMUNITY SETTING THAT SHE LOVES
SHE NOW LIVES INDEPENDENTLY AND
CONTRIBUTES THE COMMUNITY. SHE
SAYS SOME STATE LOCAL OH YES AND
EMERGENCY PREPAREDNESS
FACILITATES A TRAUMATIC BRAIN
INJURY GROUP.
AND MENTORS YOUTH AND IS ACTIVE
IN OUR CHURCH.
AS YOU CAN SEE FROM JONES STORY
CCT TRANSITION TEAMS WORK WITH
INDIVIDUALS TO DEVELOP A SAFE
TRANSITION.
BUT IDENTIFIES AND CONNECTS THEM
WITH THE HOUSING AND COMMUNITY
SUPPORT THE NECESSARY FOR SIX
S. WILL TRANSITION.
INCLUDING HELP WITH ACTIVITIES
OF DAILY LIVING AND OTHER
SUPPORTS.
IN ADDITION SEE CITY IS ABLE TO
PAY FOR HOME MODIFICATIONS AND
PER ITEMS TO SET UP THE HOME
INCLUDING BASIC FURNITURE. THERE
IS NO OTHER SIMILAR PROGRAM
AVAILABLE FOR THIS PROGRAM IS
BOTH COST EFFECTIVE AND IN LINE
WITH THE STATE'S EFFORT TO
UPHOLD THE US SUPREME COURT'S
OLMSTEAD DECISION. WHICH FOUND
THAT UNDER THE ADA. INDIVIDUALS
HAVE THE RIGHT TO LIVE IN THE
LEAST RESTRICTIVE SETTING
ACCORDING TO THAT ON HOW THE
RIGHT TO THE LEFT IN THE LEAST
RESTRICTIVE IT SETTINGS.
SINCE TWO THOUSAND AND EIGHT THE
CITY PROGRAM HAS HELPED OVER
THIRTY FIVE HUNDRED INDIVIDUALS
LIKE JOAN MOVE FROM
INSTITUTIONAL SETTINGS FOR THE
COMMUNITY.
THESE TRANSITIONS RESULT IN
SIGNIFICANT SAVINGS TO THE STATE
AVERAGING SIXTY THOUSAND DOLLARS
PER INDIVIDUAL. AND FORTUNATELY
THE DEPARTMENT OF HEALTH CARE
SERVICES IS PLANNING ON PHASING
OUT THIS VALUABLE PROGRAM.
THE STATE INDICATES THE
TRANSITION SERVICES CAN CONTINUE
THE AGE CBS.
THE H. AND THE HUMMING COMMUNITY
BASED ALTERNATIVES WAIVER.
YET THIS DOESN'T COMPORT AS THE
ELIGIBILITY REQUIREMENTS AND THE
SERVICES OFFERED UNDER THE
WAIVER PROGRAM ARE DIFFERENT IN
THE TRANSITION COSTS ARE NOT
REIMBURSED.
SIMPLY PUT WITHOUT FUNDING
DESIGNATED TO SPECIFICALLY FOR
C. C. T. WE WILL NOT BE ABLE TO
HELP INDIVIDUALS LIKE JOAN
WITHOUT AN INSTITUTIONAL
SETTINGS FOR THE COMMUNITY. THIS
IS NOT ONLY BAD FISCAL POLICY
BUT IT'S BAD PUBLIC POLICY AS
WELL.
OKAY SIR THANK YOU SO MUCH WE.
ENCOURAGE YOUR SUPPORT.
OKAY THANK YOU.
EXTRA MUCH.
COMMENTS FROM THE PARK HAS
HYSTERESIS LA JOH.
FINANCE.
SO SO BASICALLY JUST CLARIFY THE
FLOW THE FEDERAL GOVERNMENT'S
PHASING OUT.
THERE FUNDING AND WE HAD WHAT WE
A STATE MATCH BEFORE OR AND.
AND BASICALLY.
BECAUSE THE FEDERAL GOVERNMENT'S
PHASING OUT WERE THAT. YET
THOUGH THAT THE PROGRAM IS
ENDING IN TWENTY TWENTY AND
BECAUSE THERE'S SIDE TRANSITION
SERVICES THAT ARE OFFERED
THROUGH THIS PROGRAM THAT BIG
BASICALLY GO OVER THE COURSE OF
THE YEAR. THE PHASE OUT TO SORT
OF THE GLIDE PATH OUT.
OF THE PROGRAM'S STARTING AT
THE END OF.
.
SHARE THE CALENDAR YEAR
AND SO THESE WOULD BE DOLLARS
TOTAL STATE FUND DOLLARS THAT
WOULD CONTINUE THE PROGRAM.
BEYOND DUH THAT TO PHASE OUT
PERIOD AND INTO THE FUTURE
PROVIDED THAT.
THE PROGRAM'S NOT RESTORED
FEDERALLY.
NOW JUST OUR ACT IS BEING HAS
BEEN IN BEING CONSIDERED BY
CONGRESS AND SO THERE'S ACTUALLY
TRANSFERS SO WHEN THE FEDERAL
GOVERNMENT
FACE OUT THERE FUNDING WERE DAY
AT THE I WASN'T SURE FROM YOUR
TESTIMONY WHETHER THEY WERE. AT
ASSUMING THAT DOES ANOTHER
PROGRAM THAT'S GONNA PICK IT UP
WHERE THEY JUST DECIDED YOU KNOW
WE'RE JUST DONE WITH THIS
SOMEWHERE OUT.
IT EXPIRED AND WAS NOT RENEWED
LOOK AT ROUGHLY THE BETTER WE
ARE RIGHT EXPIRED AND NOT
RENEWED OKAY THAT'S SO ALRIGHT
SOLICIT THEIR TRANSITION PEOPLE
FROM ONE PROGRAM TO ANOTHER.
OKAY IN THIS SIGNIFICANT PIECE
ABOUT THIS.
PROGRAM CHAIR IT IS THE FACT
THAT THERE HAVE BEEN SIGNIFICANT
SAVINGS SO EVEN IF THE STATE
PICKS UP THE TOTAL FUNDS THAT IS
OTHER STATES HERE IN THAT FFP
SHARE AND WE WOULD STILL REALIZE
THE. SAVINGS BASED ON.
THE DEPARTMENT'S NUMBERS THAT
THEY. ESTIMATED ON THE PHASE OUT
FOR THE PROGRAM SO WE WOULD
ESSENTIALLY IN A CERTAIN SO WE
WE GET FUNDS OKAY SO THE SAVINGS
WOULD COME FROM WHERE AGAIN SO
THE SO THESE ARE TRANSITIONING
FRIGHT LONG TERM CARE. INTO
INDEPENDENT WRITING SO THE
SAVINGS ARE FROM THE ON THE LINE
AS THE ELECTRIC CAR OKAY ALRIGHT
THAT'S WHY IT'S BEEN SUCH A.
VERY SUCCESSFUL PROGRAM A VERY
DISAPPOINTING HAT THE US
CONGRESS WAS LETTING. IT EXPIRE.
ALRIGHT.
OKAY WELL CERTAINLY DAHLE
PASSIVE ENOUGH TO SAVE MONEY.
.
SO IT IS EARLIER LOOKED AT THAT.
AND ALL OUR. THIS IS NOT
SOMETHING WE'VE LOOKED AT OKAY.
BUT WE'RE HAPPY TO. TALK TO.
THAT THE STATE BECAUSE HERE AND
LEARN MORE ABOUT
WHERE OKAY AND FINANCE IF YOU
LOOKED AT THIS SO THEY'RE SAYING
IT'S GOING TO SAVE US MONEY
ANYWAY EVEN THOUGH. SO MAYBE WE
pLOOKED AT IT BEYOND THE FACT
THAT IT'S EXPIRING SO OKAY.
ALRIGHT WELL MAYBE WE CAN LOOK
AT IT SPEND IF YOU CAN SHARE
DATA WITH BUT FOLKS.
I MEAN AGAIN I REALIZE THAT I'M
MONEY AND THE FEDS ARE PAPER
BEFORE BUT IF IT HELPS US
DECREASE OVER SPENDING ON.
CARE.
I THINK WE SHOULD BE THINKING
ABOUT IT RIGHT.
BUT. YES I OUR NUMBERS MISTER
CHAIR ARE THE DEPARTMENTS
NUMBERS THAT WE'VE PULLED FROM
THE ESTIMATES OKAY.
I AND I.
SO THE PROGRAM I APPRECIATE THAT
STATES A BIG PLACE THAT'S WHY
WHEN ASKED SO THAT WE WOULD LOOK
AT IT SO WE CAN SHARE THE
NUMBERS HOPEFULLY IF. YOU AGREE
WITH THOSE NUMBERS THEN.
SOUNDS LIKE SOMETHING WE SHOULD
DO RIGHT.
GO BACK AND TAKE A LOOK AT
ADDICT DOESN'T EXPIRE UNTIL
SEPTEMBER THIRTIETH OF TWENTY
TWENTY SO IT'S BEYOND THE FISCAL.
BUT BUDGET YEARS.
.
THAT'S WHY WERE HERE NOW THE THE
PHASE OUT START OKAY YEAH ALL
RIGHT OKAY WELL YOU KNOW LET'S
ARE CHURNING THE NUMBERS ON THE
SAVINGS FAR BECAUSE WELL OF THAT
SITE HOPEFULLY THE FED STILL
FUNDED SOMEDAY WILL. PASS A LAW
CHANGE THAT.
YOU KNOW I MEAN WE SHOULD ALSO
START THINKING LIKE WHAT WILL WE
DO IF THAT.
AGAIN IF IT SAVES US MONEY.
SOUNDS LIKE A GOOD OUTCOME TO
MOVE THE BOTTOM CARE I ALRIGHT.
THANK YOU. SO MUCH OKAY AT
SECOND THE PROPOSAL.
WE HAVE AND MISSISSIPPI STATE
ASSOCIATION.
AND WITH THE PUBLIC COMMENT
AFTER THAT ON THIS WHOLE
SECTIONS SO JUST.
THAT FORGET HANG OUT FOR A
MOMENT.
SO WHEN THE STATE JUST RATES
FOR MS SP PROVIDERS AND WE WILL
TAKE PUBLIC COMMENT ON THIS
WHOLE SECTION.
OKAY.
WELCOME.
I'M HERE ON BEHALF OF THE AND
MISSISSIPPI CITED THIRTY SHOULD.
BE ASSOCIATION REPRESENTS THE
EIGHTY THAT THIRTY EIGHT M. S.
B. SITE TO PROVIDE SERVICES
ACROSS THE STATE OF CALIFORNIA
I'M ALSO EXECUTIVE DIRECTOR OF
HEALTH PROJECTS CENTER. AND RUN
THE SANTA CRUZ AND MONTEREY AND
I SUSPECT.
I'M MONEY BRIEFLY REMIND YOU
ABOUT WHAT WHEN THIS HAS P. DOES
AND SAYS P. SERVICE.
TWELVE THOUSAND FIVE VERY FRAIL
LOW INCOME SENIORS AND WE WERE
SUPPORTIVE SERVICES EITHER
PEOPLE HAVE A HIGH LEVEL OF CARE
MAKING THEM ELIGIBLE FOR
PLACEMENT SKILLED NURSING
FACILITY. PAPER ONE HUNDRED
PERCENT BY MEDI CAL.
BUT THESE PROVOKES THE STATE
PREFERRED TO STAY AT HOME AND IT
IS OUR JOB KEEPING THEIR.
THE MAJORITY OF AND MISSISSIPPI
CLIENTS LIVE ALONE AND HAVE
COMPLEX MEDICAL PSYCHOSOCIAL
NEEDS RECURRING SPECIALIZED
MEDICAL AND SOCIAL SUPPORT
SERVICES. IN RECENT YEARS THE
COMPLEXITY CUTIE IF THE AVERAGE
PATIENT HAS INCREASED DUE TO
CHANGES IN THE PROGRAM.
BRIEFLY CONSIDER THESE
STATISTICS FROM THE SENATE
RESUMES HIS PIECE TYPE WHEN I
RUN. UNDER PERCENT OF THESE
POINTS I'D BE LOW THE POVERTY
LINE THEIR AVERAGE AGE EIGHTY
ONE.
FORTY SEVEN PERCENT NEED HELP
USING THE TOILET SEVENTY SEVEN
PERCENT NEED HELP EATING.
THE AVERAGE PERSON PERSON TAKE
SEVEN PRESCRIPTION MEDICATIONS
FORTY PERCENT HAVE DIABETES
ANOTHER FORTY PERCENT HAVE
MENTAL HEALTH ISSUES YOU GET THE
POINT.
OUR ARE TEAMS OF SOCIAL WORKERS
AND NURSES ASSIST PATIENTS WITH
DAILY LIVING NEEDS SO THAT THEY
CAN BE LIT UP LIFE AT HOME WITH
DIGNITY.
PROVIDE PERSONAL ASSESSMENT CARE
PLANNING PATIENT MONITORING
SERVICE COORDINATION ACCESS TO
RESOURCES THE UNEXPECTED NEEDS.
WE WRK WITH OTHER SERVICE
PROVIDERS CLOSELY SUCH AS IN
HOME SUPPORTIVE SERVICES.
ADULT PROTECTIVE SERVICES TO
ENSURE THAT SOME OUR NEEDIEST
CITIZENS ARE TAKEN CARE.
UNFORTUNATELY ALL THE GOOD WORK
IS AT RISK OF BEING ERODED DUE
TO ARE NEGLECTING TO FUND AND
ASSIST BE APPROPRIATELY.
AND THIS IS KEY PROVIDERS ARE
STILL RECEIVING THE SAME RATES I
RECEIVED A TWO THOUSAND AND SIX
YET THE DEMANDS OF THE PROGRAM
THAT HAVE INCREASED.
COST OF DOING BUSINESS HAVE
INCREASED IN ORGANIZATIONS LIKE
MINE ARE FINANCIALLY STRESSED IS
WE REALLY SCRAMBLE TO TRY TO
KEEP THIS GREAT PROGRAM RUNNING.
BECAUSE THIS IS A FEDERAL CMS
PROGRAM SPECIFIC STANDARDS WE
CAN'T DECREASE THE QUANTITY YOUR
TYPER SERVICES WE PROVIDE. OR
PROVIDE THE SERVICE IS USING
LESS QUALIFIED STAFF TWELVE
YEARS WITHOUT A RATING CREASES
AFFECTING THE CURRENT BY ABILITY
EQUALITY THE PROGRAM.
THIS FAILURE TO FUND MC'S BE
APPROPRIATE UP BECAUSE THEY
ALREADY HAD A NEGATIVE IMPACT ON
SERVICE ORGANIZATIONS AND THE
MISSISSIPPI CLIENTS IN THE LAST
TEN YEARS. ELEVEN SERVICE
ORGANIZATIONS HAVE TERMINATE A
MISSISSIPPI CONTRACTS DUDE IN
SUFFICIENT PAYMENT.
OTHERS ON THE BRINK OF CLOSING
NOW AND THAT THAT'S HAPPENING.
IT I NOW THE TIME WE OUGHT TO
CAN I MEAN STEP RETAIN STAFF.
BECAUSE WE CAN'T PAY COMPETITIVE
SALARIES GIVE RAISES REGARD OR
PROVIDE IMPROVED BENEFITS.
FREQUENT STAFF TURNOVER IN TURN
NEGATIVELY AFFECTS THE CARE WE
PROVIDE.
IT IS NOT FAIR TO TREAT THE WORK
FORCE OR SERVING THIS FULLER OR
POPULATION SO PARTLY.
IN FACT WITH A RATING CHRIS MY
STAFF.
WON'T GET A RAISE THIS YEAR
THAT WE'LL GET A CUT TO THEIR
HEALTH BENEFITS.
.
I CHALLENGE YOU TO DO SOMETHING
ABOUT THIS THAT THIS IS THE
OPPORTUNITY. BRIEFLY I REQUEST
AS HE PROVIDED ANNUAL FUNDING
INCREASE OF FOUR POINT SEVEN
MILLION DOLLARS PER YEAR.
I REPRESS I REQUEST PROVIDES FOR
CONTINUED OPERATIONS OF IMMENSE
P. AT AN ANNUAL COST.
BUT ONLY FIVE THOUSAND THREE
HUNDRED FIFTY SIX DOLLARS PER
PATIENT ALLOWING US TO MAINTAIN
ALL FEDERAL WAIVER REQUIREMENTS
YOU CONTINUE SERVICES AT THE
SAME TIME THANK YOU.
THANK YOU. AYE COMMENTS FROM THE
DATES. KNOW. OF.
FINANCE
ALRIGHT.
THANK YOU BASED DRAMATIC
PRESENTATION ALRIGHT SO LET'S
TAKE PUBLIC COMMENT.
ON.
THE SECTION THAT INCLUDES
VARIOUS WAIVER PROGRAMS AND THE
TO AFFECTS THE PROBLEMS.
WELCOME.
THANK YOU MY NAME IS.
JIMMY SOTO I'M THE EXECUTIVE
DIRECTOR FOR THE INDEPENDENT
LIVING CENTER OF KERN COUNTY.
I GOT ON A TRAIN IN BAKERSFIELD
TOOK ME FIVE AND A HALF HOURS TO
COME OVER HERE JUST TO SEE THESE
FEW WORDS AND THAT IS THAT.
THE CCT PROGRAM THAT WAS BEING
TALKED ABOUT EARLIER. IS A VERY
POWERFUL PROGRAM WAS SOMEHOW
CONTENT IT THINK EVERYBODY WOULD
UNDERSTAND WHETHER YOU'RE IN THE
FIELD ARE NOT. AND THAT HAS TO
DO WITH GETTING PEOPLE WITH
DISABILITIES AND SENIORS OUT OF
A NURSING HOME THAT DO NOT WANT
TO BE THERE NOT SHE DON'T NEED
TO BE THERE. I'VE BEEN DOING
THIS PROGRAM SINCE ITS INCEPTION
IN TWO THOUSAND EIGHT.
AND I CAN TELL YOU. I'VE HAD
MANY PEOPLE WALK INTO THEIR
APARTMENT IN THEIR HOME WITH
TEARS IN THEIR EYES IN TELLING
ME.
THANK YOU.
THANK YOU FOR GETTING ME OUT OF
THAT NURSING HOME. BECAUSE I
DON'T WANT TO DIE THERE.
AND.
I WANT TO DYE MY OWN HOME.
AND IT'S VERY VERY HEARTENING
WHEN SOMEONE TELLS YOU THAT
THAT'S WHAT I MEAN BUT IT'S SO
POWERFUL. AND IT'S A NO BRAINER
TO THAT THIS IS JUST A WIN WIN
IT'S GOING TO SAVE THE STATE'S
GOING TO SAVE TAXPAYER DOLLARS
IS GETTING PEOPLE WITH
DISABILITIES AND SENIORS HAD OF
NURSING HOMES.
IMAGES SEEMS LIKE A NO BRAINER
THIS IS A SMALL INVESTMENT AND.
THE STATE WILL GET THEIR MONEY
BACK.
EVERY SINGLE PERSON IS ON MEDI
CAL.
AND SO.
WHEN THEY GET OUT IT'S AN
ONGOING SAVING YEAR AFTER YEAR
AFTER YEAR SO AS LONG IS THERE
OUT THAT SAVINGS HIS KEEPS
HAPPENING. SO THANK YOU FOR YOUR
TIME THANK YOU FOR LISTENING TO
ME.
THANK YOU AND THANK. TRIP UP
HERE. CRAFTSMAN DUNCAN PAN FROM
THANK YOU FOR YOUR HOME.
ATTENTION TO THE CCT PROGRAM I
AM CHERYL KASAI WITH THE STATE
INDEPENDENT LIVING COUNCIL.
FAMILY PROVIDE GUIDANCE TO THE
TWENTY EIGHT INDEPENDENT LIVING
CENTERS ACROSS CALIFORNIA.
WHO ARE REQUIRED BY FEDERAL LAW
TO PROVIDE TRANSITION SERVICES?
TO BOTH YOU AND.
ADULTS AND OLDER ADULTS WITH
DISABILITIES.
PHOTO VINYL PROGRAM THE O. WE
SUPPORT AND.
WHILE WE DO PROVIDE THE SERVICES
ALREADY IN THE STATE OWNED
THROUGH COMMUNITY NONPROFIT
ORGANIZATIONS.
AND IT IS A CONCRETE COST
SAVINGS TO THE STATE AS WELL
THANK YOU. THANK YOU.
WELCOME.
MY NAME'S RICHARD STRANGE ON THE
SITE DIRECTOR FOR THE MULTI
PURPOSE SENIOR SERVICES PROGRAM
FOR NAPA AND SOLANO COUNTIES.
AND.
ONE ECHO THE TIME. COMMENTS A
JOBLESS WHO JUST SPOKE ABOUT THE
PROGRAM. AND I BECOME A FOR
TWELVE YEARS SOMETIMES TO SAY
PLEASE DON'T CUT OUT MONEY AND
SOMETIMES TO SAY PLEASE GIVE US
THAT YOU KNOW THE FUNDING THAT
WE NEED.
TO.
TO CONTINUE THE GOOD WORK AND
WE REALLY AT A VERY CRITICAL
POINT.
AT THIS POINT IN TIME.
IT'S EXTREMELY DIFFICULT TO.
FUND IT TO TO RECRUIT AND RETAIN
STAFF IN PARTICULAR.
MY LAST TWO HIRES A THEY WERE
THE ONLY APPLICANTS
LUCKILY THEY WERE GREAT FOLKS
BUT IT'S EXTREMELY DIFFICULT TO
FIND A BILINGUAL STAFF NURSES.
TRAINED SOCIAL WORKERS OF
EXPERIENCE IN THIS FIELD.
AND TO RETAIN THEM BECAUSE YOU
KNOW THE UNEMPLOYMENT SITUATION
IS CHANGING QUITE A BIT AND
THERE ARE OTHER OPPORTUNITIES
OUT THERE AND AND IT'S VERY
DIFFICULT.
WE PROVIDE A BROAD RANGE OF
SERVICES THAT ARE CRITICALLY
IMPORTANT FOR HELPING FOLKS LIVE
INDEPENDENTLY AT HOME.
THEY LOVE IT THERE REALLY GLAD
TO BE ABLE TO FEEL AND THAT THEY
HAVE BETTER CONTROL. OVER THEIR
HEALTH OUTCOMES FROM THE
EDUCATION SUPPORT WE PROVIDE.
AND I FEEL SAFER FOR THE
EQUIPMENT THAT WE PROVIDE FOR
THEM SO THAT THEY'RE NOT AFRAID
OF. FALLING IN NOT BEING ABLE TO
GET SOME ASSISTANCE WHEN THEY
LIVE ALONE THANK YOU WE REALLY
APPRECIATE YOUR SUPPORT ON THIS
I THINK YOU.
GARY PASSED MORE CONGRESS OF
CALIFORNIA SENIORS EXPRESSING
THE CCT PROGRAM. AND FOR THE
RATE INCREASE FOR MISSISSIPPI.
THANK YOU.
GOOD EVENING IT'S BEEN A LONG
DAY ARM AND I'M DOCTOR BY
REPORTER I'M DIRECTOR OF THE
MISSISSIPPI PROGRAMMING CONTRA
COSTA COUNTY. I WANNA THANK YOU
FOR LISTENING IN HEARINGOUR
PLEA I'M AYE SERVICE SMALL
DISTRICT IN NEMESIS P. OF A
HUNDRED AND SIXTY CLIENTS. IN IF
YOU COULD REMEMBER THE LAST TIME
YOU WATCHED A CIRCUS HE SAW THE
TIGHT ROPE WALKER.
THAT'S WHAT OUR MISSISSIPPI
CLIENTS ARE LIKE THEY'RE WALKING
ON THE EDGE IN ANY DAY THEY CAN
SLIP AND FALL. BY THE WAY EVERY
ELEVEN SECONDS THE PERSON OVER
THE AGE OF SIXTY FIVE FALL FROM
ENDS UP IN THE ER BUT ON ONE THE
THINGS THAT WE DO IS WE PROVIDE
THE UP BUTTON THAT SAYS. HELP BY
PHONE AND I CAN'T GET UP WHAT
HAPPENED JUST ABOUT A WEEK AND A
HALF AGO ONE OF OUR PERSONS WAS
WEARING ONE OF THOSE BUTTONS BUT
IT WASN'T A GPS BUTTON. SHIVER
CAREGIVER DIDN'T SHOW UP IN TIME
SHE LEFT HER APARTMENT CAME OUT
THE PATIO DOORS AND ENDED UP IN
UP THE SHOPPING AREA BEHIND ONE
OF THE RESTAURANTS. CRAWLED
INSIDE THE DUMPSTER IT WAS ONE
OF THOSE DAYS WHEN IT WAS
RAINING ND WE COULDN'T FIND HER.
FOR ABOUT SEVEN OR EIGHT HOURS
HE WAS VERY SCARY FOR EERYONE.
ONE THE THINGS THAT THE
MISSISSIPPI WITH THIS INCREASE
FUNDING WILL DO WE CAN BY GPS
ONE THAT'S ABOUT THREE TIMES
WHAT WE NORMALLY ARE PAYING.
HALF OF MY CLIENTS COULD BE ABLE
TO HAVE ONE OF THE.
I WANT TO LEAVE YOU WITH ONE
LAST THOUGHT WERE PASSIONATE
ABOUT CARING FOR
PEOPLE THE MEAN MORE TO US
SOMETIMES AND EVEN OUR OWN
FAMILY MEMBERS BUT DON'T LET
THEM KNOW THAT. I'M ONE OF
THINGS I WANT TO LEAVE YOU WITH
IS THIS ONE THOUGHT.
TO CARE FOR THOSE WHO HAVE SPENT
THEIR ENTIRE LIFE.
CARING FOR OTHERS IN CARING FOR
US IS PROBABLY THOUGH HOPE MOST
NOBLE IN HIGHEST HONORS. I
INVITE YOU TO REALLY CONSIDER
IT'S NOT A WHOLE LOT OF MONEY
BUT IT'S GOING TO CHANGE THE
LIVES OF SO MANY OF OUR PEOPLE
THANK YOU SO MUCH I THINK YOU.
MANY ELEMENTS DISABILITY RIGHTS
I ALSO VOLUNTEER AT A
MISSISSIPPI.
ONE HEALTH THE HEART CENTER
WHICH IS DOWN THE ROAD HERE IN
TWENTY EIGHT IN YOUR DISTRICT
HAS A LOT OF THINGS GOING ON DAY
HAVE EXERCISE CLASSES THEY HAVE
COMPUTER CLASSES TO HELP PEOPLE
GET OUT OF THE HOUSE. WE TALK TO
CLIENTS WHO GO TO MSPS AT ALL TO
HEART A NAY SAID IF IT WASN'T
FOR THIS PLACE TO GO TO THEY
WOULD END UP SITTING AT HOME.
THEY ALSO LEARN TO JOIN OTHER
ORGANIZATIONS SO THEY CAN SEE
HOW THIS ALL WORKS.
SO.
I DON'T SEE HOW KEEP IT NO
MATTER HOME AND HAVING THEM
GIVEN THEM NOTHING TO DO.
AND NOT BE ABLE TO BE AN ANTENNA
MEMBERS OF SOCIETY IS REALLY
GOING TO SAVE THE STATE MONEY. I
DON'T SEE HOW THAT'S GOING TO
HAPPEN SO IN THAT PROPOSAL I
BELIEVE THAT.
CHEMISTRY AND AT HOME COMMUNITY
BASED SERVICES ARE KIND OF THE
SAME THING YOU MUST FIND A WAY.
TO GET THEM BE OUT IN SOCIETY
BECAUSE IF THEY HAVE TO STAY AT
HOME UNDER INSTITUTIONALIZED
THAT COSTS THE STATE MONEY AT
AGAIN.
THAT EMPHASIZES AGAINST CENTER
MEDICARE SERVICES SAYS IT COSTS
MORE FOR THEM TO STAY HOME THAN
TO BE OUT IN SOCIETY.
INDEPENDENT LIVING IS WHERE IT'S
AT.
THANK YOU.
PRODUCTIVE AND MANY MISS
CRISTINA VASE HAMILTON WITH UW
APPS ME WE REPRESENT A HUNDRED
THOUSAND I JUST US WORKERS.
UPM'S WANTED SUPPORT THE REQUEST
ON THE CCT AND ALSO AM SSB THESE
ARE REALLY IMPORTANT PROGRAMS.
AND ITS REALLY A SHAME THAT
WE'RE.
HAVING TO REQUEST THESE REALLY
SMALL AMOUNTS OF MONEY THAT
SHOULD BE PRIORITIZE REGARDLESS
THANK YOU THANK YOU.
OKAY. LINDA AWAY WITH WESTERN
CENTER ON LAW AND POVERTY IN
SUPPORT OF THE CCT PROPOSAL.
BACK YOU.
THE COMMON WITH A CALIFORNIA
LONG TERM CARE OMBUDSMAN
ASSOCIATION IN SUPPORT OF THE
CCT AND MSP.
THANK YOU.
GIRLS SCHOOL FROM THE CALIFORNIA
COMMISSION ON AGING IN SUPPORT
OF BOTH PROGRAMS THE
CONTINUATION THANK YOU THANK YOU AGAIN I WANT TO. EXPRESS MY
SUPPORT FOR THE CCT AND REALLY
BRIEFLY I RECENTLY TALKED TO A
CLIENT WE TRANSITIONED ARE YOU
THANK ME FOR GETTING OUT OF JAIL.
HE'D BEEN IN A LONG TERM CARE
ACILITY FOR TEN YEARS AND SAID
HE WOULD HAVE BEEN ABLE TO
OTHERWISE YOU COULD DO THE MATH
OF MANY HUNDREDS OF THOUSANDS OF
DOLLARS. THE STATE IS PAID TO
KEEP HIM THERE FOR A FEW
THOUSAND DOLLARS WE GOT ABOUT SO
I THINK IT'S A GOOD DEAL ALRIGHT
THANK YOU.
OKAY MAKES A MUCH.
SO WILL HOLD THOSE ITEMS OPEN
AND.
APPRECIATE.
THE TESTIMONY.
ALRIGHT SO WERE MOVING.
OKAY SO NEXT IS.
ISSUE NUMBER NINE PHILLY
QUALIFIED HEALTH CENTER AUDITS
A. B. EIGHTEEN SIXTY THREE.
AFTER SO WE'RE SEEKING.
.
SOME EXPENDITURE AUTHORITY AND.
POSITIONS IN BOTH EIGHTEEN
NINETEEN AS WELL AS IN NINETEEN
TWENTY TO IMPLEMENT THE
PROVISIONS OF.
EIGHTEEN SIXTY THREE AB
EIGHTEEN SIXTY THREE WHICH WILL
ALLOW FOR MARRIAGE FAMILY
THERAPIST TO BE.
BILLABLE PROVIDERS AND FQHCS.
BY WHAT MEANS OF AN UPDATE WE
FILED THE STATE PLAN AMENDMENT
TO AUTHORIZE THE SERVICES WITH
THE FEDERAL GOVERNMENT ON MARCH
THIRTIETH.
SO.
WE WILL OBVIOUSLY BE WORKING
WITH THEM AS WE WORK THROUGH THE
APPROVAL PROCESS BUT FOR THE
BUDGET REQUESTS TODAY ON ITS.
APPROXIMATELY A HUNDRED AND
FORTY ONE THOUSAND DOLLARS IN
GENERAL FUND WITH MATCHING
FEDERAL FUNDS AS WELL AS.
.
TOTAL FUNDS OF ONE POINT THREE
MILLION IN THE. NINETEEN TWENTY
BUDGET YEAR.
YOU PARA ALLELES COMMENTS.
BRENT METZ GIRLY # WE
RECOMMEND APPROVING THE
REQUESTED TWO THOUSAND EIGHTEEN
NINETEEN RESOURCES AN
EXPENDITURE AUTHORITY BY
REJECTING THE TWO THOUSAND
NINETEEN TWENTY. RESOURCES AN
EXPENDITURE AUTHORITY.
BY WAITING UNTIL THE TWO
THOUSAND AND NINETEEN TWENTY
BUDGET CYCLE TO CONSIDER THOSE
RESOURCES AND AND AUTHORITY.
THE LEGISLATURE HAVE MORE
INFORMATION ABOUT WHETHER THEY.
RECENTLY SUBMITTED SPOT WAS
APPROVED.
Y. HOW MANY FQHCS ARE READ OUR
RURAL HEALTH CENTERS.
SUBMITTED THE CHANGE IN SCOPE
OF SERVICE REQUESTS IN EIGHTEEN
NINETEEN.
AND THAT WOULD GIVE A BETTER
SENSE OF WHAT THE WORK LOOKED
LOOK LIKE IN NINETEEN.
FINANCE.
SO I'M.
WITH THIS WORKLOAD WE'RE
EXPECTING IT TO REALLY
MATERIALIZE BY MID YEAR NEXT
YEAR. AND SO.
.
THERE'S GONNA BE LIMITED DATA
AVAILABLE BY THE TIME YOU START
CONSIDERING REQUESTS FOR NEXT
YEAR AND SO. THIS IS THE
ESTIMATE THAT WE'VE GOT.
ON THE TIME FRAME THAT WERE
ONTO IT IMPLEMENT THIS WORKLOAD.
OKAY ALRIGHT.
OKAY SO ACTUALLY DID. CIRCULAR
CA SO I DIDN'T KNOW I GET THE OR
LET'S CAN YOU TELL I JUST. GIVEN
WHAT FINANCES SAID SIR.
WE WOULD JUST NOTE THAT THE
IMPLEMENTATION PLAN FOR THE
PROPOSALS SUGGESTED THAT THE
ACTUAL S. NINA RECRUITMENT OF
THESE AUDITOR POSITIONS AND
HIRING OF THEM WAS GOING TO
OCCUR IN NINETEEN TWENTY. SO
EVEN THOUGH THE WORKLOAD WOULD
IN MATERIALIZE.
INTO LATER IT'S AND IT'S STILL
AN ESTIMATE WE WOULD RECOMMEND
CONTINUING TO HOLD OFF ON THESE
RESOURCES.
ALRIGHT.
OKAY IF YOU BOTH OF YOU BAG SELF.
OKAY AND SO I THINK WE DO HAVE
THE.
STAKEHOLDER PROPOSAL AND
RELATED TO.
ABOUT SEPARATE DAY FCC VISITS
FROM MENTAL HEALTH SERVICES.
DOCTOR PATEL. OF NEIGHBORHOOD
HEALTH CARE SO I GUESS IT'S NOT
REALLY SPECIFIC TO THE I DID BUT
AS DO WITH FQHCS AND MEMBERS.
SO.
AND HOW MANY PEOPLE SPEAKING
HERE TO OKAY NOW MEMBERS THREE
MINUTES TOTAL SO WHOEVER GOES
FOR STUDIES OF ALL THE OTHER
PERSON'S TIME.
GOOD AFTERNOON MR CHAIRED. BUT
HIS DOCTORATE BECAUSE BOTTOM THE
CEO OF NAY BUT HEALTH CARE A
NONPROFIT W. QUALIFIED HEALTH
CENTER. F SERVING SIXTY SEVEN
THOUSAND PATIENTS IN SAN DIEGO
IN RIVERSIDE COUNTY.
PART TWO SOME THE ROLE OF CEO IN
TWENTY SEVENTEEN ALSO PORTS
CERTIFIED FAMILY PHYSICIAN I'M
HAVING SERVED OUR SAME PATIENTS.
AS CLINICIANS WE KNOW THAT THE
MENTAL HEALTH ISSUES MAKE IT
HARD FOR PATIENTS TO TAKE CARE
OF THEIR OWN NEEDS.
OUR CLINICAL TEAMS HAVE BEEN
SCREENED FOR DEPRESSION ANXIETY.
AND YOU KNOW RESEARCH SHOWS THAT
AT LEAST TWENTY PERCENT PRIMARY
CARE VISITS.
WILL HAVE A MENTAL HEALTH AND
ISSUE RELATED.
EVEN THOUGH WE KNOW WARM HAND OF
SO THE BEST THING TO DO
CLINICALLY THE CURRENT SYSTEM OF
PAYMENT DISCOURAGES US FROM
DOING THAT. WE CAN GET
REIMBURSED FROM MEDICAL VISIT
AND A MENTAL HEALTH VISIT THE
HAPPEN ON THE SAME DAY.
AS A CLINICIAN AND ASSOCIATE ON
INCOME BY HIM UNCOMFORTABLE WITH
SIMPLY HOPING THEY WILL COME
BACK.
THAT IS WHY I AM HERE TODAY TO
RESPECTFULLY URGE THE
SUBCOMMITTEE AND THE LEGISLATURE
TO ADOPT THE NECESSARY POLICY
CHANGES AND FUNDING THROUGH THE
BUDGET PROCESS TWO OUT OF THREE
SEASON ARE EIGHT CITIES. TEMPLE
TO BILL MEDICARE FOR TWO VISITS
THE PATIENTS PROVIDE MENTAL
HEALTH SERVICES ON THE SAME DAY
THEY RECEIVE OTHER MEDICAL
SERVICES. OUR PATIENTS AND
HEALTH CENTER PATIENTS ACROSS
THE STATE DEMAND THAT WE BUILT
ASSISTANT ACTUALLY PROVIDES THE
CARE THAT THEY NEED WHEN THEY
NEED IT.
LONG HELD SENATE'S ACCESSING THE
BILLING STATURE ALREADY IN PLACE
AND OTHER PUBLIC PROGRAMS WILL
ENSURE MORE EARLIER. IN MENTAL
ILLNESS AND GUARANTEE THAT WE'RE
USING OUR INTEGRATED HEALTH
MODEL.
TO ITS FULL POTENTIAL.
AS WE KEEP COMMUNE MEMBERS OUT
OF COSTS EMERGENCY ROOMS AS WELL
AS REDUCE THE FALL OUT OF A TREE
MENTAL ILLNESS.
I'M ARE YOU KNOW ARE STILL
BETTER UTILIZE RESOURCES AND
OVER TIME REDUCE COSTS BURDENS.
IT'S FOR THESE REASONS THAT WE
RESPECTFULLY URGE THE
SUBCOMMITTEE TIPTOP TRAILER BUT
LANGUAGE FOR FULL IMPLEMENTATION
OF THIS PROPOSAL.
THANK YOU.
GOOD AFTERNOON I'M A JANITOR US
WITH THE STEINBERG INSTITUTE.
PUBLIC AWARENESS OF MENTAL
HEALTH AND SUBSTANCE USE
DISORDERS IS GROWING WITH MUCH
OF IT DRIVEN BY HOMELESSNESS AN
OPEN AT THE OPIOID EPIDEMICS.
WE ALL SEE THE OUTCOME OF
UNTREATED MENTAL ILLNESS ON OUR
STREETS
OUR JAILS IN OUR COMMUNITIES
COMMUNITY BASED PRIMARY CARE
LIKE THAT PROVIDED. BY EASTERLY
QUALIFIED HEALTH CLINICS AND
RURAL HEALTH CLINICS IS OFTEN
THE FIRST LINE OF DEFENSE FOR
DETECTION AND TREATMENT OF
MENTAL HEALTH AND SUBSTANCE USE
DISORDERS.
THESE HEALTH CENTERS FOCUS ON
WHOLE PERSON CARE BY INTEGRATING
CARE FOR THEIR BENEFICIARIES AS
MUCH AS POSSIBLE. UNFORTUNATELY
THE REIMBURSABLE AS HE DESCRIBED
BY DOCTOR PATEL A CREATES AN
UNNECESSARY FINANCIAL BARRIER
FOR THESE CLINICS AND THEIR
ABILITY TO PROVIDE INTEGRATED
CARE.
IN A TIMELY MANNER. BY ALLOWING
SAME DAY BILLING AND COMMUNITY
CLINICS FOR BOTH A MEDICAL
PROVIDER AND A MENTAL HEALTH
SPECIALIST WE WILL ENSURE THAT
WE ARE USING THE INTEGRATED
HEALTH SERVICES AVAILABLE TO OUR
COMMUNITIES.
AT THEIR FULL POTENTIAL PQ.
THANK YOU.
OTHER COMMENTS FROM BERTHA
SERVICES OHIO. FINANCE.
OKAY WELL PRECARIOUS YOUR
QUESTION THEN.
.
I KNOW YOU.
SO WHY DON'T WE ALLOW PEOPLE TO
DO THIS I MEAN FOR.
BUT AS OF THE AYE PRACTICE IN
THE CLICK TO SEXY SOURCE OF
FRUSTRATION TO ME TO KNOW I HAVE
A PATIENT WHO HAS BEEN A HEALTH
ISSUE.
AND.
THE ENOUGH FOR THEM TO GET TO
CLINIC Y. YELLED THEY MAY NOT
THAT'S HAVE A CARD AT THE PUBLIC
TRANSPORTATION.
.
AND.
SO. I HAVE TO SEND THEM OUT AND
MAKE A FOLLOW UP APPOINTMENT
WHEREAS NOW THE SOCIAL WORKER
THEM THERAPIST TASK IN TIME TO
SEE THEM RIGHT THEN AND THERE
THEIR E. PRESENT.
IS.
ARE AT A FOR WE COULD SCHEDULE
IT THAT WAY SO THEY DON'T HAVE
TO MAKE TWO TRIPS.
AND SO I'M JUST THAT IT'S THERE
EXIST BUT BRING OUT OF THE OUT
OF YOU KNOW WHY.
I'M I THINK IT'S A COUPLE THINGS
THAT I THE UNIQUE STRUCTURE OF
THE PS RATE IN AND OF ITSELF.
SO I AM NOT THE. I'M NOT THE
PERSON THAT DOES THE ACTUAL RATE
SETTING BUT THERE'S AN. THERE'S
AN ACCOUNTING FOR THE COSTS THAT
ARE ASSOCIATED WITH THE PPS RATE
BETTER INCLUSIVE OF BEHAVIORAL
HEALTH SERVICES I THINK THAT
THIS.
AB EIGHTEEN SIXTY THREE IS
CERTAINLY INDICATIVE OF.
WHAT WE HAVE BEEN WILLING TO DO-TO MAKE?
MENTAL HEALTH SERVICES MORE
BROADLY AVAILABLE AS A BILLABLE
SERVICE.
I THINK THERE WAS AS.
THERE'S ALSO A BILL BY SENATOR
MITCHELL THAT WAS SIGNED LAST
YEAR THAT WOULD ALLOW FOR EXCUSE
TO PROVIDE. AS YOU DE AND
SPECIALTY MENTAL HEALTH SERVICES
IN AN EFFORT YOU SETTING I THINK
WHEN YOU TALK ABOUT.
THE ABILITY TO.
ESSENTIALLY.
.
HAVE SAME DAY BILLING FOR
MULTIPLE TIMES I THINK ALSO JUST
GETS DOWN TO THE FISCAL CONCERNS.
I'M QUITE HONESTLY AND AS IT AS
IT RELATES TO THAT ESPECIALLY
WHEN THE PPS RATE IS DESIGNED TO
BE A. ALL INCLUSIVE DATE DAY
RATE IF YOU ALSO AND I THINK
WE'RE WILLING TO.
TALK WE WOULD WANT TO REALLY
UNDERSTAND WHAT THE FISCAL
RAMIFICATIONS WOULD BE TO US AS
A STATE GIVEN THE UNIQUENESS OF
THE PPS RATE THERE CERTAINLY.
I'M OTHER RAMIFICATIONS IN THE
MANAGED CARE SETTING AS WELL SO.
.
WERE ALWAYS WILLING TO TALK BUT
THIS ONE IS ALSO. USUALLY BEEN
AND
HIGHLY AND CONCERNING TO US AS A
AS AN ONGOING FISCAL TO THE
DEPARTMENT.
SO.
TO USUALLY AND I AND I
APPRECIATE THE ANSWER. THAT'S
NOT THAN EXPECTED TO ANSWER.
BECAUSE USUALLY WHAT HAPPENS IS
THAT PEOPLE SAID WELL.
WHAT THAT MEANS IS THAT YOU KNW
MAYBE PEOPLE GENERATE EXTRA
VISITS AND SO FORTH AND AND ONE
LEVEL I WOULD SAY YEAH YOU
TERRORISTS GOING TO BE A FEW
EXTRA VSITS NOT BECAUSE THEY'RE
EXTRA BECAUSE THEY WERE NEED?
BECAUSE WHAT HAPPENS IS THAT.
AND I KNOW BECAUSE I WAS HERE
DURING MORE DIFFICULT TIMES ARE
DIFFERENT PROPOSALS TO
DISCOURAGE PEOPLE FROM GETTING
THE CARE THEY NEED.
BUT JUST BE REALLY GLAD ABOUT
THAT WE PUT THROUGH FOR
PROPOSALS IN A WAY TO DRIVE DOWN
UTILIZATION BECAUSE WE WERE IN
BUDGET CRUNCH TIMES TO SAY THAT
WELL MAYBE WE CAN SAVE A LITTLE
MORE MONEY. BUT WHAT THAT MEANT
WAS PEOPLE THEY NEED CARE AND
THAT.
CONDITION DIDN'T GO AWAY.
SO THEN SURELY EVENTUALLY IT
CATCHES UP WITH YOU KNOW THEY
MAKE THEIR WAY BACK IT'S WORSE
THEY SHOW UP IN THE EMERGENCY
ROOM BECAUSE OF THAT THEY GET
ARRESTED WHATEVER ELSE.
AND.
THAT AT IT SENSUALLY COMES BACK
TO US AND OFTEN IN A WAY THAT IS.
BETTER FOR THE PATIENT IS WORSE
IS THATIF YOU GET IF YOU HAVE
MENTAL HEALTH ISSUES THAT TAKEN
CARE OF NOW YOU LOSE YOUR JOB TO
GET ARRESTED. SOMETHING ELSE.
IT EVENTUALLY BY ITS ACT BUT
WHAT YOU CAN SAY IS BUT I CAN
TELL YOU THAT I KEPT SOMEONE
FROM HAVING YOU KNOW GETTING YOU
KNOW A. MENTAL HEALTH CARE THAT
VERY VISITS WE SAVE SOME MONEY
THERE.
AND I KNOW THAT'S WHY WE OFTEN
DO THESE THINGS WERE WE DON'T WE
OFTEN THAT MEANS SINCE I.
SOMETIMES A WE'VE MAKES WHEN WE
SAY SOMEONE CAN'T HAVE SOMETHING
IN THE SAME DAY OURS CAN MORE
CONVENIENTLY IS THAT WE'RE
HOPING THAT THAT INTO THE.
TRIBES.
GETTING YELLED FROM ACTUALLY
PARTAKING OF THAT SERVICE LATER
ON.
AND I I HOPE THAT WE CAN THINK
DIFFERENTLY ABOUT IT IN THE
SENSE THAT.
WHAT WE DON'T OFTEN PRICE OUT IS
WE PRICE OUT THE COST OF THE?
ADDITIONAL VISITS GOOD I THINK
IF YOU DO. DO IT YOU'LL GET
ADDITIONAL VISIT BECAUSE IT'S
MORE CONVENIENT TO GET THEM
RIGHT. THE QUESTION IS WHAT'S
THE LONG TERM CONSEQUENCES THE
LONG TERM COSTS BECAUSE WHAT
YOU'RE NOT OFTEN
IT'S HARDER TO.
TO.
WHEN SOMEONE DOESN'T GET THE
SERVICE RIGHT THEY GET SENT HOME
TOLD TO COME BACK THEY CAN'T AND
THEY DON'T MAKE IT BACK THEY
CAN'T MAKE IT BACK AND THEN THEY
DON'T GET THE SERVICE AND THEN
WHAT IS THE CONSEQUENCE OF THAT
HOUSE AND THAT'S HOW MUCH HARDER
TO PRICE. OUT SO SOMETIMES IT
FEELS EASY TO CAPS THAT THAT'S
EASY TO COUNT AND SIZE WHEN IT'S
HARD BECAUSE
BILLS THAT WELL MAYBE IT WASN'T
ANYTHING.
AND I AND AND I AND I JUST YOU
KNOW I I HAVE BEEN CONCERNED
ABOUT THAT.
SO THEY SAID THINGS ARE HARD TO
MEASURE SOMETIMES PEOPLE TEND
LIKE DIDN'T HAPPEN.
AND SO I HOPE WE CAN THINK
ABOUT THIS AND AND AND IN THAT
REGARD AND AND TRY TO MOVE AWAY
FROM.
THEM IF THERE'S AN ISSUE ABOUT
PEOPLE NOT ACTUALLY NEEDING THE
SERVICE AND FIND WAS PUT IN THE
THINGS IN PLACE OF IT. SO THAT
YOU KNOW THEY DON'T GIVE ME
FAVOR NOT NEEDING SURVEY THEY
NEED TO SERVICE WHY MAKE IT
HARDER FOR PEOPLE TO GET IT.
I GUESS THAT'S WHAT I'M
CONCERNED ABOUT WHEN WE SAY WELL
YOU CAN'T BUILD TWICE RELATED SO.
THAT IF YOU LOOK LIKE YOU WANT
TO SAY SOMETHING ELSE WHEN
NUMBERS ARE INTO INTERNAL DATA
FOR THAT FIRST VISIT WHEN WE
REFER THEM TO OUR INTERNAL BE
AGE.
ONE THIRD DON'T JUST MAKE IT UP
FIRST APPOINTMENT. SO THIS MIGHT
HELP US TO GET THEM THE NEEDED
SERVICES BECAUSE FOR THE REASONS
YOU MENTIONED TRANSPORTATION
DYSFUNCTIONAL LIFE THEY'RE NOT
GETTING THAT FIRST APPOINTMENTS
SO.
OKAY.
THEY SHOULD MISTER DO ABOUT SAY
SOMETHING WITH LIKE YOU'RE
REACHING FOR THE MICROPHONE A
FEW TIMES OKAY.
ALRIGHT SO I I I I YOU KNOW I I
HOPE WE CAN REALLY TRY TO FIGURE
THIS ONE OUT.
AND IF WE NEED TO DO A PILOT
BUT I THINK THE CHALLENGE IS
GOING TO BE CAN.
THE.
THE PEOPLE WHO ACTUALLY JUST.
QUOTE DROP OUT BUT THEY DON'T
THAT IS THAT THE CONDITION
DOESN'T DISAPPEAR JUST BECAUSE
IT AND COME BACK. AND I THINK
THAT THAT'S WHAT OFTEN WE DON'T
COUNT AND IT'S HARD TO COUNT
RIGHT IN THE NATION UP SOMEWHERE
ELSE IN. THE SYSTEM I WOULD CALL
THAT.
AND BABY COULD HAVE BEEN
PREVENTED IF THEY WERE ACTUALLY
GAVE HIM ONE DAY.
WHEN YOU IDENTIFY THE PROBLEM AT
THE PRIVATE CARE VISIT AND YOU
SAID OUR YOU DEFY THE PROBLEM
YOU CAN DO THAT TOGETHER.
YOU MIGHT HAVE BEEN NO POINT
SOMETHING SO.
ALRIGHT.
WITH THAT.
SO WOO TAKE.
PUBLIC COMMENT ON ACTUALLY THE
OVERAUDITS ISSUES WELL AS THE
STAKEHOLDER QUEST.
LINDA AWAY WITH WESTERN CENTER
ON LAW AND POVERTY IN SUPPORT OF
THE STAKEHOLDER REQUEST TO ALLOW
FOR PASSING THE PHILLY.
THANK YOU.
AFTERNOON TERESA COOK ON BEHALF
ABREGO HEALTH IN SUPPORT OF BOTH
PROPOSALS THAT I THINK OF IT
THANK YOU.
X. CALIFORNIA'S DISABILITY
RIGHTS.
IN TH INSUPPORTABLE PROPOSAL
RESPECT TO THE STAKEHOLDER
PROPOSED.
PEOPLE WHO GET ON THE BUS.
YOU KNOW THAT WHEN THEY GET TO
THEIR HOSPITAL APPOINTMENT THAT
WE GET THERE AND THEN OF.
THEY MIGHT NOT HAVE ENOUGH MONEY
TO GET TO THE NEXT APPOINTMENT
ONE. TO IF YOU TAKE PARA TRANSIT.
LIKE I DO COST YOU TEN DOLLARS
SO YOU PAY TEN DOLLARS TO GET
THERE ONE DAY PAY TEN DOLLARS
GET THERE THE NEXT DAY. SO THIS
IS ACTUALLY WOULD SAVE MONEY AND
HELP CONSUMERS THE WERE FOR THIS
PROPOSAL AND FOR THE AUDIT OKAY
THANK YOU.
THAT BROUGHT FROM DISABILITY
RIGHTS CALIFORNIA FOR ALL THE
REASONS THAT YOU STATED ANOTHER
SUPPORTER STATED IN THE
STAKEHOLDER PROPOSAL ONE IT'S
JUST ADD THAT. OF PEOPLE WITH
DISABILITIES PARTICULARLY
MOBILITY DISABILITIES WOULD
OFTEN HAVE A DIFFICULT TIME
MAKING TWO VISITS AND THEN
THERE'S THE WARM HAND OFF ISSUE
FOR SOMEONE WHO IS THERE THE
FIRST TIME. AND THE POSITION
SUCH AS YOURSELF RECOGNIZES THAT
PERHAPS THERE'S A MENTAL HEALTH
ISSUE GOING ON. WITH RESPECT TO
WHAT DIRECTOR KEN SAID ABOUT THE
RATES I RESPECTFULLY DISAGREE
THAT PPS RATE IS AN ALL
INCLUSIVE. OUR DAY RATE IF I
HEARD HER CORRECTLY HOWEVER.
GREAT FEELING IS REALLY
COMPLICATED.
OF FOR FQHCS THE PPS SYSTEM. IS
EXTREMELY DIFFICULT BUT THIS
SHOULD BE FIXED THIS ISSUE
DESERVES ATTENTION THANK YOU.
THANK YOU.
THANK YOU MISTER SPEAKER MISTER
CHAIR MEGAN SUPERS ON BEHALF OF
A CALIFORNIA HEALTH PLUS
ADVOCATES THE COMMUNITY HEALTH
CENTERS IN CALIFORNIA I JUST
WANTED TO FIRST EXPRESS OUR
SUPPORT FOR THE DEPARTMENT'S
PROPOSAL. PROMPTED FOR THE FULL
IMPLEMENTATION OF AB EIGHTEEN
SIXTY THREE AND APPRECIATE THAT
AND THEN ALSO EXPRESS OUR
SUPPORT FOR THE STAKEHOLDER
PROPOSAL TO IMPLEMENT.
SAME DAY VISITS IN CALIFORNIA
WE HVE HAD DE FIRST
CONVERSATION WITH THE DEPARTMENT
AND THOUGHT IT WAS A VERY GOOD
CONVERSATION THANK THEM FOR.
FOR INVITING US TO THE TABLE TO
HAVE THAT CONVERSATION I'M
LOOKING FORWARD TO WORKING WITH
THE DIRECTOR AND THE DEPARTMENT
THANK YOU. THANK YOU.
EMILY CHEN ON BEHALF THE
CALIFORNIA PAN ETHNIC HEALTH
NETWORK IN SUPPORT OF THE
STAKEHOLDER PROPOSAL FOR SAVED
IF IT'S AT.
THANK YOU.
AND THE US OF A GOOD THING AND
THANK EVERYONE FOR TESTIFYING
AND OF COURSE.
CERTAINLY WE WANT TO SUPPORT
THE DEPARTMENT'S CURRENT EFFORTS
TO PROVIDE ACCESS
TO.
.
TO PETITION MMS TEAS AND THAT
TOO. AFTER PRO SO YOU INITIAL
PROPOSALS WELL SO WILL HOLD BOTH
OF THOSE ITEMS OPEN.
.
ISSUE NUMBER TEN.
SO THAT'S A CLINICS COMMITTEE
TREATMENT FACILITY SUPPLEMENTAL
PAYMENTS.
SURE SO THIS IS A PROPOSAL THAT.
IN SPITE OF ITSELF.
WE HAVE BEEN UNABLE TO MAKE
SUCCESSFULLY WORK SO THIS IS
FROM LEGISLATION DATING BACK TO
TWO THOUSAND AND SIX.
THE NATURE OF THE CLINICS THAT
WERE ELIGIBLE TO PARTICIPATE ON
THE DELAY IN THE LINKS IN TIME
IN WHICH WE WERE ABLE TO WORK
WITH THE FEDERAL GOVERNMENT TO
GET APPROVAL. BY THE TIME WE
WENT OUT TO THE CLINICS THAT WE
EVEN ELIGIBLE TO PARTICIPATE IT
WAS A VERY SMALL NUMBER. THAT
WAS VERY LIMITED INTEREST AND.
PARTICIPATION AND SO WERE
ESSENTIALLY SEEKING TO REPEAL.
THIS PARTICULAR.
EITHER PROGRAMMER SUPPLEMENTAL
PAYMENT IF YOU WILL I'M JUST DUE
TO THE LACK OF INTEREST AND
PARTICIPATION.
EARLIER.
FINANCE.
PUBLIC COMMENT.
OKAY.
SOMETIMES A GOOD IDEA DOESN'T.
PAN OUT ITSELF L. ALRIGHT. OKAY
OH ALL THIS ITEM OPENED A MAY
REVISE.
OKAY ISSUE NUMBER ELEVEN
OMBUDSMAN CUSTOMER RELATIONS
MANAGED MANAGEMENT SYSTEM.
SURE SO I'M.
OBVIOUSLY THERE HAS BEEN.
AN INTEREST AND.
COLLECTING ADDITIONAL ON PIECES
OF DATA.
AND OBVIOUSLY PROVIDING BETTER
CUSTOMER SERVICE WHEN PEOPLE
CALL INTO OUR OMBUDSMAN OFFICE
AND SO AS A RESULT OF BOTH THE
NEED AN INTEREST IN COLLECTING
THAT DEMOGRAPHIC DATA AS WELL AS
KIND OF HAVING.
TECHNOLOGICALLY ADVANCED AND
STABLE SYSTEM WE ARE SEEKING ON
EXPENDITURE AUTHORITY TO ON PAY
FOR A NEW.
THE CULT CUSTOMER RELATIONS
MANAGEMENT SOFTWARE.
SO I'D THIS IS A FAIRLY MODEST
BUT WE WOULD.
URGE THE LEGISLATURE'S
CONSIDERATION OF THIS JUST TO
THE EXTENT THAT WE THINK IT
HELPS I'M OBVIOUSLY.
PROVIDE BETTER.
SERVICE IN HANDLING FOR PEOPLE
THAT CALL INTO THE OMBUDSMAN'S
OFFICE.
I THINK YOU ALEJO.
BRENT METZ EARLIER WE'VE
REVIEWED THE OFFSPRING FINANCE
LETTER HAVE NO CONCERNS OKAY
FINANCE.
PUBLIC COMMENT.
THE VALVE THAT HEALTHAXIS
CALIFORNIA AND WE SUPPORT
FUNDING FOR THE CUSTOMER
RELATIONS MANAGEMENT SYSTEM TO
IMPROVE TRACKING OF DATA
RECEIVED I'D DURING BUT. ALSO
THE OMBUDSMAN AND WE ALSO ASK
THAT IMPLEMENTATION OF THIS A
CLOUD FIRST POLICY NOT DELAY THE
QUARTERLY REPORTING REQUIREMENTS
ON DEMOGRAPHIC INFORMATION AS
REQUIRED BY LAST YEAR'S BUDGET
ACT. THANK YOU MAY THINK YOU.
LINDA WAY WITH WESTERN CENTER ON
LAW AND POVERTY WE ALSO SUPPORT
IS WE THINK THAT COLLECTION OF
DEMOGRAPHIC DATA IS IMPORTANT
WE'D ALSO LIKE TO. AYE.
GIVE UP APPRECIATION TO THE
DEPARTMENT WE KNOW THAT THE THE
WAIT TIMES FOR THE OMBUDSMAN
HAVE GONE DOWN FROM TWENTY TO
FORTY FIVE MINUTES TO ABOUT
SIXTY EIGHT. SO THINK ABOUT THAT
IS AN IMPROVEMENT ALTHOUGH THINK
WE CAN STILL GO FARTHER THINKING.
OKAY THANK YOU WELL LOTS A LOVE
THEIR. CELL COULD SEE THAT WE'RE
MOVING FORWARD AND WAS LATER IT
GETS THE MORE LEFT THERE AS
ARIEL.
WELL BOTH RECEIVE PUBLIC HEALTH
FEELS THE SAME WAY.
ALRIGHT. OGRES ALTHOUGH THAT
ITEM OPEN.
OKAY SO NEXT ISSUE IS HIPAA
PRIVACY RULE COMPLIANCE
SURE BUT THAT WE ARE SEEKING
SOME ADDITIONAL AND MUCH NEEDED.
STAFF MEAN.
FOR POSITIONS AND ADDITIONAL
EXPENDITURE AUTHORITY.
TOO.
HANDLE THE VARIOUS BOTH.
BREACHES AND I PRIVACY AND
SECURITY RELATED INCIDENTS THAT
WE ARE.
MANDATING OUR PROVIDERS AND
HEALTH PLANS TO ON PROVIDE TO US
SO WE NEED TODAY IF.
THERE'S A SECURITY INCIDENT OR
A PRIVACY BREACH THINK OF STOLEN
LAPTOPS
THINK OF FILES THAT HAVE BEEN
LEFT SOMEWHERE THINK OF ALL THE
DIFFERENT WAYS IN WHICH THERE
COULD BE A PRIVACY OR SECURITY
INCIDENT.
WE RECEIVE THOSE AND WE ARE
MANDATED TO BOTH I'LL LOOK INTO
THEM TO MAKE SURE THAT THEY ARE
ADDRESSED IF THERE'S AN ACTION
NEEDS TO BE TAKEN BY THE
PROVIDER THE PLAN. OUR STUFF
WORKS WITH THEM THE INCREASE HAS
BEEN ON SIGNIFICANT AND THE
NUMBERS REPORTED TO US AND SO.
WE ARE ASKING FOR A LIMB YOU
KNOW LIMITED BOTH POSITIONS OF
AUTHORITY TO CONTINUE TO HANDLE
THIS WORKLOAD.
OKAY FELLOW.
FINANCE
PUBLIC COMMENT.
NO BY OKAY THE SHIRLEY
WASHINGTON. OKAY UMBEL CERTAINLY
WE WANT TO HEAR COOPER AND
PRIVACY SO AWFUL THAT I AM OPEN.
NEXT ITEM IS I AM PLEASED.
IN CALIFORNIA
THE CLOSEST SINCE A PROGRAM
EXTENT.
YES SO THIS IS A.
THIS IS AN EASY ONE EIGHTY TWO
YEAR NO COSTS.
EXTENSION OF SOME.
CONTRACT DOLLARS THAT WE HAVE
BEEN WORKING THROUGH THAT
CALIFORNIA TECHNICAL ASSISTANCE
PROGRAM SAID THIS IS INTENDED TO
HELP US FIND AND WORK WITH
PHYSICIANS ON THAT ARE ELIGIBLE.
TO.
GET EHR INCENTIVE.
PROGRAM DOLLARS AND TO BECOME
MORE COMPLIANT SO WE ARE JUST
SEEKING TO KIND OF.
CONTINUE THE USE AND RUN OUT OF
THIS FUNDING THAT WAS
APPROPRIATED AND SECURE APPROVAL.
OKAY AYE LOW.
FINANCE PUBLIC COMMENT.
BUT MISTER CHAIRMAN DAVID FOR
EXECUTIVE DIRECTOR OF THE
CALIFORNIA HEALTH INFORMATION
PARTNERSHIP IN SERVICES
ORGANIZATION. WE ARE THE LARGEST
OF THE FOUR CONTRACTORS IN THE
PROGRAM.
GIVEN THE ADVANCING OUR I'LL
JUST SAY THAT WE WE APPRECIATE
THE WORK THAT THE ADMINISTRATION
HAS DONE TO DATE TO.
WORK ON THIS EXTENSION IT'S
SORELY NEEDED THANK YOU THANK
YOU.
GOOD AFTERNOON MR CARAGIALE
BLANCHARD ON BEHALF OF THE
CALIFORNIA DENTAL ASSOCIATION
HERE IN SUPPORT. OKAY THANK YOU.
ALRIGHT O. HOLD THAT ITEM OPEN
AS WELL BUT NO COST EXTENSION I
HOPE I'M SURE THAT WE CAN MAYBE
VICE.
ISSUE FOURTEEN MEDICARE PROGRAM
A TICKET
DATA AND.
SURE SO WE'RE SEEKING
EXPENDITURE AUTHORITY TO.
.
WORK WITH SAID DATA ANALYTICS
VENDOR.
IN OUR AUDITS AND
INVESTIGATIONS.
DIVISION OUTSIDE THE STATE
ANALYTICS.
VENDOR WAS SELECTED.
AND WE HAD BEEN USING THEM ON A
LIMITED BASIS AROUND OUR DRUG
MEDI CAL PROVIDERS BUT.
WE ARE SEEKING TO BOTH EXPAND
THE USE OF THAT AND OBVIOUSLY
NEED THE EXPENDITURE AUTHORITY
SO IT'S TWO POINT THREE MILLION
GENERAL FUND.
SIX POINT EIGHT MILLION IN
FEDERAL FUNDS AND EIGHTEEN
NINETEEN AND UP TO TEN MILLION
DOLLAR TOTAL FUNDS IN NINETEEN
TWENTY.
AND HAPPY TO ANSWER QUESTIONS
BUT IT'S ONE OF THE TOOLS THAT
WE USE TO BETTER IDENTIFY EITHER
FRAUDULENT PROVIDERS FRAUDULENT
PRACTICES ON EARLIER AND MORE
OFTEN I'M RATHER THAN.
MORE THE TRADITIONAL BACK AND
SO IT'S BEEN A INTERESTING TOOL
AND AND WE'RE CERTAINLY
ENCOURAGED BY THE USE OF IT AND
A LARGER. I'VE.
A LARGER PART OF OUR PROGRAM.
ELIOT.
BRENT METZ GIRLY #.
OUR OFFICE IS STILL REVIEWING
THIS PROPOSAL AND HAS REQUESTED
SOME INFORMATION FROM THE
ADMINISTRATION AND ONCE WE HAVE
A WATCHER OF THE LEGISLATURE.
OKAY THANK YOU FINANCE.
OKAY PUBLIC COMMENT ON THIS ITEM.
I'D SEEN NOT.
PARA IT SO.
THE TERMS OF I. SAID YOU SEE
THAT YOUR RACE USING YOU WHAT
EXPAND THE USE OF IT RIGHT THERE
AND THAT TO DATE IN TERMS OF.
POTENTIAL SAVINGS.
YES MA'AM.
BEEN ABLE TO SAVE ON FOR EVEN
ABLE TO YOU SO FAR.
OUR OUR FRAUD THAT YOU'VE BEEN
ABLE TO CATCH I GUESS EXOTICALLY
SAVINGS I GUESS.
YEAH WE WE THE I THINK IT'S
LARGELY COST AVOIDANCE WE I'M IS
SUMMER EARLY ESTIMATES WE THINK
THAT THERE'S POTENTIAL FOR UP TO
FORTY MILLION DOLLARS A YEAR AND
COST AVOIDANCE BUT I'M YOU KNOW.
WE HAVE PROVISIONAL LANGUAGES
INCLUDING THE BUDGET BILLS TO
THE COUNTY GIVES US THE
OPPORTUNITY TO YOU KNOW TAKE A
BREAK EVALUATE NAM HOW IT'S
WORKING THE NORMAL WILL CAN GO
FROM THERE.
OKAY GOOD ALRIGHT AND CERTAINLY
APPRECIATE ME WE DON'T WANT TO
CREATE A PERVERSE INCENTIVE
PROGRAM OR SOLIS AND FIND STUFF
THAT ISN'T THERE.
BUT CERTAINLY WE WANT TO CATCH
ANY FRAUD THAT'S GOING ON.
OKAY SO ISSUE NUMBER FIFTEEN
HEALTH CARE REFORM FINANCIAL
REPORT.
SO WERE SEEKING TO EXTEND
EIGHTEEN.
LIMITED TERM POSITIONS FOR AN
ADDITIONAL THREE YEAR.
LIMITED TERM AUTHORITY FOR.
IN OUR ACCOUNTING.
AREA SAID THIS IS ALL RELATED
TO THE WORKLOAD AND REPORTING
REQUIREMENTS UNDER THE
AFFORDABLE CARE ACT AND SO ON
WOULD SEEK THE LEGISLATURE'S
APPROVAL OF THE EXTENSION OF
THOSE POSITIONS.
OKAY ELLIOTT.
COMMENTS
FINANCE
PUBLIC COMMENT.
ISSUE.
NOPE
OUR NO PUBLIC COMMENT OKAY.
SO WHERE.
.
ALRIGHT.
SO WE WILL HOLD THAT ITEM OPEN
AS WELL AND BUT CERTAINLY SOUND
LIKE YOU'VE BEEN NEED FOLKS FOR.
WE CAN SEE US ALL RIGHT SO NEXT
IS ISSUE SIXTEEN OUR IMAGE
COUNTY OFFICE CONSOLIDATION.
HERE SO THIS IS SEEKING ARMS
MEDICINAL AUTHORITY OF BOTH
GENERAL FUND AND WE WOULD DRIVE
DOWN FEDERAL FUNDS I'M THERE'S A
STE A BUILDING IN SANTA ANA THAT
HAS.
.
IS IS ESSENTIALLY NOT AN
ACCEPTABLE PLACE FOR EMPLOYEES
AND SO WE'VE BEEN WORKING
CLOSELY WITH DDS ON TO LOCATE
ENDS ON CONSOLIDATE SOME OF OUR
OTHER OFFICES DOWN SOUTH AND SO
THE. INCREASE IN RENTS.
IS WHAT WE ARE SEEKING.
SO IT'S ABOUT FIVE HUNDRED AND
SIXTY TWO THOUSAND AND EIGHTEEN
NINETEEN AND FOUR HUNDRED TWENTY
THREE THOUSAND.
ANNUALLY THEREAFTER IN ORDER TO.
.
COULD BOTH CONSOLIDATE OUR STAFF
AND MOVE THEM INTO A MORE
ACCEPTABLE BUILDING OKAY ALEJO.
BRIAN METZGER LA THOUGH OUR
OFFICE A PREVIOUSLY RECOMMENDED
REJECTION OF THE SPECIES P..
BASED ON THE JOINT LEGISLATIVE
BUDGET COMMITTEES.
INITIAL DECISION NOT TO MOVE
FORWARD WITH A PROPOSAL THAT HAS
SINCE CHANGED AND SO.
THE GBC IS MOVING FORWARD WITH
THE PROPOSAL NOW.
SO WERE RETRACTING OUR PREVIOUS
RECOMMENDATION BUT WE WOULD NOTE
THAT THE FINAL LEASE AGREEMENT I
IS STILL NEGOTIATIONS SO WILL
PROVIDE ADDITIONAL INFORMATION.
SIVA OKAY DEFIANCE.
OKAY PUBLIC COMMENT.
ALRIGHT I. I JUST ASIDE
OBSERVATION IT'S ALWAYS
INTERESTING THAT WE BOTH HAVE
ISSUES REGARDING LIKE.
OPTIONAL BENEFITS AND GETTING
CARE TO LOTS OF PEOPLE AND SAY
TO CONSOLIDATE OFFICES.
SO ALRIGHT.
OTHER BIG DEPARTMENT OKAY WELL I
WILL.
WE WILL PUT THAT ON BOTH
POSSIBLE THAT OPEN UNTIL MAY
REVISE AND MAYBE WHEN YOU FLIP
THE LEAST GETS NEGOTIATED.
BECAUSE. MY PERMISSION OKAY
ISSUE NUMBER SEVENTEEN FAMILY
HEALTH ESTIMATES OVERVIEW.
SURE SO AGAIN IN THE INTERESTS
OF TIME THAT AGENDA LAYS OUT
THESE ARE THE SMALLER OR.
.
PROGRAMS WITHIN THE DEPARTMENT
THAT ARE.
YES CALIFORNIA CHILDREN'S
SERVICES SEATS DP.
GENETICALLY HANDICAPPED PERSONS
PROGRAM EVERYWOMAN COUNTS I'M
FAIRLY STABLE AND.
FAIRLY SMALL PROGRAMS IN THE
OVERALL GRAND SCHEME OF. THINGS
BECAUSE WHEN I SAY CCS ASSIST
THE STATE ONLY COMPLEMENT OF CCS
AND NOT THE LARGER CCS PROGRAM.
SO I'M REALLY I THINK.
THERE'S NOT BEEN A SIGNIFICANT
NUMBER OF CHANGES THE THING I
WOULD SAY IS WHERE WE'VE SEEN
THE MOST.
DRAMATIC CHANGE HAS BEEN IN THE
CGP PROGRAM JUST WITH THE.
OVERALL EXPANSION OF COVERAGE
INCLUDING SB SEVENTY FIVE AND
THE.
ENROLLMENT OF ALL CHILDREN
UNDER THE AGE OF NINETEEN AND SO
THE FULL SCOPE MEDI CAL BENEFITS
THAT HAS REALLY BEEN. A PROGRAM
THAT IT HAS SEEN A DRAMATIC
DECREASE IN AND UTILIZATION BUT
HAPPY TO ANSWER.
ANY QUESTIONS THAT YOU MAY HAVE.
OKAY.
ALRIGHT.
.
WELL IT IS LATE.
I CAN GO INTO A LONG TIME ON
CCS.
.
ACTUALLY DOT COMES FROM ILIO.
BRENT METZ GALIA WE'VE REVIEWED
THE ESTIMATE HAVE NO CONCERNS
OKAY FINANCE.
ALRIGHT.
ZERO IN TERMS OF.
THE CCS HOLD CHILD MODEL.
.
SO I KNOW YOU'RE IMPLEMENTING IT
WITH THE FIVE KOS.
.
THE TERMS OF THE REMAINING
COUNTIES TELL US AND THE
LEGISLATION I THINK.
TWENTY NINETEEN I MEAN ARE WE
GOING TO BE GETTING SOME KIND OF
INFORMATION BACK BEFORE WE
ACTUALLY TRY TO DO ANYTHING LIKE
THAT. AND.
YES SO I BELIEVE UNDER S. B.
FIVE EIGHTY SIX.
AND.
I BELIEVE THE STATUTE WAS CLEAR
THAT ADDITIONAL COUNTIES WOULD
NOT BE CHANGED ALTERED OR
OTHERWISE.
MOVED UNLESS THE EVALUATION
BOTH WAS PRODUCED PROVIDED TO
THE LEGISLATURE AND THEN THERE
WOULD BE A SUBSEQUENT. ON
DISCUSSION ON THAT AND SO AT
THIS POINT IN TIME WE ARE
COMMITTED TO.
THAT FIVE CAN YOU ORGANIZE
HEALTH SYSTEMS THAT WE'RE
CURRENTLY WORKING WITH WE ARE ON
TRACK.
I'M FOR JULY ONE IMPLEMENTATION
DATE FOR CENTRAL CALIFORNIA
LINES FOR HEALTH WHICH IS
MONTEREY SANTA CRUZ. AND.
MERCED AND THEN.
SEND CAL WITCHES SAN LUIS
OBISPO AND SANTA BARBARA
COUNTIES ORANGE COUNTY AND THEN
THE FOURTEEN COUNTIES IN THE
PARTNERSHIP.
HEALTH PLAN ARE SLATED FOR
JANUARY ON SOME KEY NOTABLE
ACTIVITIES IS THE NINETY DAY
NOTICE HAS BEEN SENT OUT TO
BENEFICIARIES IN THE PHASE ONE.
I'M SOAKED TO BE FOLLOWED UP
WITH SIXTEEN THIRTY DAY NOTICES
THE PLANTS HAVE ALL SUBMITTED
THEIR PROVIDER NETWORKS TO US
BOTH LARGELY FOR THE. ITEM
OVERALL NETWORK CERTIFICATION
THAT WE'RE DOING BY JULY FIRST
pPARTICIPATING. IN THE HOTEL
MODEL THEY HAVE SUBMITTED
ADDITIONAL NETWORK INFORMATION
AROUND ON CERTAIN KEY PEDIATRIC
SUBSPECIALTY PROVIDERS AND OTHER.
ANCILLARY PROVIDERS THAT WE
WANTED TO SEE FOR PURPOSES OF
THAT SO I THINK.
AT THIS POINT IN TIME AYE WE
ARE FEELING I'M CONFIDENT THAT
WILL MEET THE JULY ONE DAY.
SHOULD ANYTHING.
OBVIOUSLY COME UP THAT IS OF A
CONCERN THE LEGISLATION SAYS NO
SOONER THAN SO WE HAVE THE
ABILITY TO.
CHANGE THAT OR SLOT OR SLIDE IT
IF NECESSARY BUT I THINK RIGHT
NOW WE'RE FEELING THAT WE HAD A
LOT OF TIME. TO DO A LOT OF AND
PREPARATION WE SHARED A LOT OF
THE NOTICES AND LETTERS AND
COMMUNICATIONS WITH STAKEHOLDERS
GOTTEN A LOT OF REALLY GOOD FEET.
AND SO.
RIGHT NOW I THINK EVERYTHING'S
IS GOING AS WELL AS WE WOULD
WANT IT TO BE AN ALRIGHT SO I'VE
HEARD VARIOUS CONCERNS I WON'T
GO INTO ALL OF THEM TODAY IN
TERMS OF LIKE THEY NATURE OF
WHAT'S REQUIRED FOR NETWORKS AND
SO FORTH SO.
I AND HOPEFULLY WE CAN FOLLOW UP
ON THAT.
SO WE WILL TAKE TIME RIGHT NOW.
BUT WE DON'T REALLY HAVE A
SEPARATE SECTION ON CCS OVERALL
HERE THE MOMENT ITSELF.
OKAY AND THEN. OF COURSE I THINK.
EVERYONE'S COUNTS.
WE ALSO.
ACTUALLY I HEARD WELL ACTUALLY
WHAT WE HAVE STAKEHOLDER
PROPOSAL ON THAT ANYWAY SO IT'S
GONNA BRING THAT UP BUT WHEN WE
GO AHEAD AND HAVE THAT SO.
.
SINGULAR PROPOSAL FROM.
KELLY MCMILLAN OF.
COME IN NORTHERN CALIFORNIA.
ELIMINATE THE TREATMENT
LIMITATION FOR STATE ONLY BREAST
AND CERVICAL CANCER TREATMENT.
WELCOME.
SHOWS ABOUT THE BRING THAT UP IN
A REALIZE YOU'RE HERE TO TALK
ABOUT SELF KNOWLEDGE YOU DO IT.
A FOLLOW UP THEN.
NOW HERE TO SPEAK ABOUT IT VERY
BRIEFLY CANCELED LANTERN ON
BEHALF OF THE CALIFORNIA
AFFILIATES IS.
IN FOR THE CURE HERE TODAY TO
RESPECTFULLY REQUEST EIGHT POINT
FOUR MILLION DOLLARS AND TRAILER
BILL LANGUAGE
TO SUPPORT REMOVAL OF THE BREAST
AND CERVICAL CANCER TREATMENT
CAPS UNDER OUR STATE ONLY SIDE.
AS YOU KNOW TREATMENT CATS DO
NOT EXIST IN MEDI CAL NOR DO
THEY EXIST IN ON PRIVATE
INSURANCE IN HERE TODAY WERE
WE'RE LOOKING TO CLOSE THE GAP
AND NOT. THINK YOU.
THANK YOU I JUST WANNA ADAM AS
YOU SAID I'M KELLY MACMILLAN'S
EXECUTOR TO FOR SUSAN G. KOMEN
IN NORTHERN CENTRAL CALIFORNIA.
AND OUR MISSION IS TO FIND THOSE
CRITICAL NEEDS IN THE COMMUNITY
IN THE BREAST AND CERVICAL
TREATMENT PROGRAM.
HAS BEEN A PARTNER FOR US AND
BEEN ABLE TO REACH THE UNINSURED
UNDERINSURED AND WOMEN OF COLOR.
AND.
CURRENTLY AND WE ALSO WANT TO
MAKE SURE THAT WOMEN ARE TREATED
THE CONTINUOUS CARE. AND THAT'S
NOT HAPPENING CALIFORNIA WITH
THESE WITH THE SONG LIMITATIONS
ON TREATMENT AT EIGHTEEN MONTHS
AND. WE WE YEAH I KNOW THAT IT
MAKES A DIFFERENCE IN A SAVES
LIVES AND TO CUT SOMEBODY'S
TREATMENT OFTEN THE MIDDLE OF
THAT JUST DOES NOT MAKE ANY
SENSE.
SO WE COME WE ASK THAT YOU.
RESPECTIVELY.
HELP US AND SUPPORTER BUDGET
PROPOSAL AND.
FUND THE REMOVAL OF THE
TREATMENT CAPS.
THANK YOU.
.
OKAY COMES FROM THE PERMIT TO
SERVICES LA JOH.
FROM A FINANCE OKAY NOW BEFORE
WE TAKE PUBLIC COMMENT DON'T GOT
TO GO ANYWHERE VIRULENT.
.
SO PRE SHEET OF PRESENTATION I
KNOW.
YOU KNOW I THINK THAT.
.
IT'S A CONCERN WHEN YOU HAVE A
PROBE AND OF COURSE THEY ARE
TECHNOLOGY HAS CHANGED SINCE
PROVIDED ESTABLISHED AND.
THE BIGGEST THE GOOD NEWS IS
PEOPLE ARE LIVING LONGER.
BUT PRESS CERVICAL CANCER WE
ALSO HAVE LONGER SHIELD THE
BECAUSE A LIVING LONGER YOU'RE
MORE LIKELY YOU MAY BUT YOU MAY
STILL NEED TO BE A TREATMENT.
SO BY MY GUESS IS I DON'T KNOW
THE TERROR HISTORY THAT PROBABLY
THESE LIMITS MAY HAVE MADE QUOTE
I DON'T SEE MORE SENSE BEFORE
WHERE EASY YOU THEIR SURVIVOR
YOU DIED BY THE TIME BUT NOW
YOU'RE STILL BE TREATMENT. ARE
ROUND TWO AND NOW YOU'RE STUCK
IN THE MIDDLE AND THAT'S. I
THINK.
FLOW ND AND I THINK THAT'S
THAT'S THE CHALLENGE WERE
RUNNING INTO.
.
SO. APPRECIATE THAT PRESENTATION.
AND HOPEFULLY WE CAN TRY TO
FIGURE OUT HOW TO HOW TO ADDRESS
THAT.
SO ON THAT ANY FURTHER COMMENTS
ALRIGHT.
THE OTHER THING ACTUALLY BEFORE
YOU. DO PUBLIC THAT A COMMENT ON
THIS WHOLE ITEM.
ALSO THEY SORT TOUCH LLOBET G.
H. PP HAVE.
SO.
THE AYE AND RECENTLY TOUCH ON
THAT IS I.
SO I THE BILL THAT I AUTHORED IT
WAS VETOED BY THE GOVERNOR THAT
ASKED TO PUT A CONDITION ON TO
TEACH BICU.
AND SERVE ACTUALLY IN SOME WAYS
IT'S NOT THE SAME BUT. AS THIS
WAS JUST PRESENTERS OF BREAST
CANCER PEOPLE GETTING CUT OFF
BUT WE HAVE WE HAD BILL CCS WAS
DESIGNED AT A TIME WHEN WE HAD
CHILDREN TO BASICALLY WOULDN'T
LIVE PAST CHILDHOOD.
THE GOOD NEWS IS THAT PEOPLE NOW
WITH THE ADVANCES MEDICAL
TREATMENT PEOPLE LIVING LONGER
INTO ADULTHOOD.
BUT THERE.
IT'S NEEDS FOR SUPPORT HAVEN'T
CHANGED SO THEY'RE GRADUALLY
HOUSE CCS IN THIS IS SOMETHING
WE HEAR FROM A LOT OF FAMILIES
YES THAT THAT THAT ON THE
BIGGEST WORRIES YOU KNOW FIRST
WORRY IS CAN I GET TO.
PEOPLE I NEED TO TAKE CARE OF ME
SO THAT'S WHY WE HAVE SEIZE FOR
PROGRAMS FIRST PLACE BUT THEN.
WHEN I HIT THE AGE OUT LIMIT.
ALL THE FALLS AWAY AND SO AND
WHEN I DID MY BILL LIKE BE ON
THE GOVERNOR SAID WELL WE SHOULD
TRY TO FIGURE OUT HOW HE FIT
INTO. BUT THE IN WHICH CASE WE
NEED TO START THINKING ABOUT.
THE MEDIC CAO PROGRAM.
FOR ADULTS WHO BASICALLY HAVE
THESE DISABILITIES RESULT OF
THEY'LL.
THERE AGING AND THIS WAS OF
COURSE THE BILL TO HAVE REQUIRED
NEW TO SIT DOWN DISABILITIES IN
ADULTHOOD.
I'M. DOING BETTER SO YOU KNOW
WE'RE TALKING ABOUT MOVING CCS
INTO.
THE SEVENTIES MANAGED CARE
PLANS IN TERMS OF THE WHOLE
CHILD MODEL.
BUT I'M ALSO THINKING LIKE WELL
WE ALSO NEED TO FIGURE OUT.
YOU KNOW IT'S NOT JUST HOLD
CHILD LOVE A WHOLE PERSON IN THE
WHOLE LIAM BECAUSE WHATEVER YOU
HAVE A TWENTY SIX YEAR OLD
THIRTY FIVE YEAR OLD FORTY
SOMETHING OUT BECAUSE.
THEY'RE LIVING LONGER AND THAT'S
A GOOD THING.
BUT THEY STILL NEED LOTS
SUPPORT OF THEY'RE GOING TO BE
ABLE TO BE MORE INDEPENDENT AND
SO.
.
THOSE WERE LOOKING AT YOU KNOW
WE HAVE TO CREATE A SPECIAL
PROGRAM G. HPP TO TRY TO ADDRESS
SOME OF THAT.
AND I THINK.
BUT I THINK WE'RE ALSO LACKING
IN TERMS OF.
HOW WE PULL THAT ALL TOGETHER SO
I HOPE WE CAN TRY TO?
IT'S NOT LIKE THIS BUDGET
NECESSARILY BUT SOMETHING WE
NEED TO FIGURE OUT.
BECAUSE I DON'T THINK WE HAVE A
GOOD ANSWER FOR THOSE FAMILIES
RIGHT NOW.
AND ACTUALLY WORRIED ABOUT WHAT
YOU SEE THAT HAPPENED BOLTS AND
YOU'VE PRIDE HURT THIS. WHAT
WE'RE WORRIED ABOUT CCS
DESTROYED BILL MATCH CARES
BASICALLY YOU GONNA ACTIONS THAT
OF MAKING A SYSTEM WORKS BETTER?
AND TO TOWARD ADULTHOOD WE'RE
TAKING A AT DYSFUNCTIONAL DOT
SYSTEM AND MOVING IT BACK IN THE
CHILDHOOD.
AND UP TO DATE AND AND AND AND
MAKING IT WORSE SO. AND SO I
THINK WE WE GOT THINK ABOUT.
THE GOOD NEWS IS WE HAVE
TECHNOLOGY TREATMENTS ARE A LOT
OF PEOPLE LIVE LONGER.
WHO MAY NEED MARK ONGOING
TREATMENT BUT WE HAVE SYSTEMS
THAT WERE DESIGNED AND YEARS
PAST THAT WHERE PEOPLE JUST
DIDN'T LIVE? AS LONG AND SO WE
CREATE LIMITS AND CUT CUT OFFS
THAT DON'T. MAKE SENSE NOW.
FOR BEST CANCER FOR TALENT Z..
DODD GENETIC CONDITIONS ETCETERA.
NOW ALRIGHT WITH THAT.
PUBLIC COMMENT.
MARY VALDEZ WITH HEALTHAXIS
CALIFORNIA WE SUPPORT
ELIMINATING THE TREATMENT CAPS
ON THE PROGRAM THANK YOU.
LINDA WAY WITH WESTERN CENTER ON
LAW AND POVERTY IT'LL.
OKAY THANK YOU.
OKAY ALRIGHT WHAT WILL HAVE
LEVEL THAT ITEM OPEN.
FOR.
AND AND AND AS WELL AS ON THE.
FAMILY ESTIMATE OVERVIEW.
FINALLY WE HAVE.
ADDITIONAL PROPOSALS FOR
INVESTMENT.
SO WE'VE GOTTEN.
AND SO WE HAVE FOR HERE SO WE'RE
GONNA START WITH THAT KERRY
GRAHAM.
FOR A WITH THE UC BERKELEY
HEALTH RESEARCH FOR ACTION
PROPOSAL ON LONG TERM SERVICES
SUPPORT DATA COLLECTION.
OKAY.
TALKING ABOUT PLANNING FOR THE
FUTURE.
OKAY.
WELL.
YOU DON'T HEAR ME X. ADAM.
SO MY NAME'S CARRIE GRANDMA FROM
UNIVERSITY OF CALIFORNIA AND I'M
A GERONTOLOGIST RESEARCHER AT
UNIVERSITI AT UC BERKELEY AND
UCSF.
AND I'VE SPENT MY CAREER
STUDYING AGING IN THE NEEDS OF
OLDER ADULTS IN CALIFORNIA AND
PEOPLE DISABILITIES MOST
RECENTLY THE COMEDY CONNECT
EVALUATION.
SO I'M HERE SPEAKING ON BEHALF
OF THE ALL TSS EXPLORATORY
COALITION. AND THEY ARE
INTERESTED IN FUNDING.
BUDGET PROPOSAL TOADD S. NEW
SET OF QUESTIONS ON THE
CALIFORNIA HEALTH INTERVIEW
SURVEY. AND THESE ARE SOME
REALLY IMPORTANT QUESTIONS THAT
ARE CURRENTLY MISSING FROM THE
DATA THAT WE HAVE IN OUR.
IN OUR POPULATION DATA ON ASIAN
POPULATIONS THE USE OF LONG TERM
SERVICES AND SUPPORTS.
LONG TERM SERVICES SUPPORTS IS
BASICALLY A TERM MEANING THE
KIND OF HELP PEOPLE NEED WHEN
THEY NEED HELP BATHING DRESSING
GETTING AROUND INSIDE THEIR
HOUSE. AND THIS IS OBVIOUSLY
GONNA BECOME MORE MORE IMPORTANT
CALIFORNIA.
AS A THIS UNPRECEDENTED INCREASE
AN AGING POPULATIONS I THINK WE
HAVE ABOUT EIGHT MILLION SENIORS
AND PEOPLE DISABILITIES
CURRENTLY WE'RE GONNA HAVE ABOUT
FOUR MILLION MORE. SENIORS IN
CALIFORNIA BY TWENTY THIRTY WHO
ARE USING AND SEVENTY PERCENT OF
SENIORS USE LTFS.
THE CALIFORNIA HEALTH INTERVIEW
SURVEY IS.
IT'S REALLY A CALIFORNIA
TREASURE IT'S A POPULATION BASED
SURVEY WE GET DID ON DIAGNOSES
HEALTH BEHAVIORS INSURANCE
STATUS BUT THERE'S NOTHING ON.
SENIORS AND PEOPLE DISABILITIES
AND THEIR USE OF CARE FOR.
ACTIVITIES OF DAILY LIVING AT
HOME.
WE CURRENTLY DON'T HAVE THAT
DATA AND IT'S A PROBLEM BECAUSE
WE CAN'T PLAN FOR THE FOR THE
NEEDS WE HAVE A COUNTY OR CITY
LEVEL PROGRAMS LIKE AND
MISSISSIPPI THAT ALREADY HAVE
WAITING WEIGHT LIMIT.
HE WAS LIVING ARRANGEMENTS
BECAUSE PEOPLE WHO LIVE ALONE
NEED MORE CARE WE DON'T KNOW
ABOUT WHAT TYPE OF HELP AND HOW
MUCH HOW PEOPLE ARE GOING TO BE
NEEDING.
WE DON'T KNOW ABOUT WHAT OUR
HOUSING NEEDS ARE GOING TO BE OR
THE KIND OF WORK FORCE WE NEED
TO PREPARE FOR. IN TERMS OF
PEOPLE'S LTFS USE.
IN THE COMEDY CONNECTED
VALUATION WE WERE LUCKY ENOUGH
TO BE ABLE TO DO A SURVEY OF
TOOLS IN CALIFORNIA. WE DID ASK
THESE QUESTIONS WE FOUND THAT
ABOUT FORTY PERCENT OF TOOLS
NEED. HELP WITH.
BATHING DRESSING GETTING AROUND
INSIDE THEIR HOME.
FORTY PERCENT OF THOSE. HAVE
UNMET NEEDS MEANING THEY DON'T
GET ALL THE HELP THEY NEED.
THEN OF THOSE WE ASKED HIS
QUESTION CAUSE ADVERSE
CONSEQUENCES LIKE DID THIS
HAPPEN TO YOU BECAUSE YOU HAD AN
UNMET NEED. AND WE SAW THAT
ABOUT HALF OF PEOPLE WITH UNMET
NEEDS
HAD THESE ADVERSE CONSEQUENCES
THINGS LIKE NEEDING TO USE THE
BATHROOM IN NOT BEING ABLE TO
GET THERE.
NEEDED TO TAKE A SHOWER NOT BE
ABLE TO TAKE ONE. MISSING HEALTH
CARE APPOINTMENTS AND A THIRD OF
PEOPLE HAD PROBLEMS LIKE AND
MAKING MISTAKES IN THEIR
MEDICATION BECAUSE IT DIDN'T GET
HOW.
AND I'M HAVING TO STAY HOME WHEN
THEY NEED TO GO OUT.
SO ARE THESE ARE KINDS IT THIS
IS THE KIND OF DATA THAT WOULD
BE GREAT IF WE COULD HAVE A
POPULATION LEVEL AND REALLY HELP
WITH WAIVER EVALUATIONS. IN
TERMS OF HAVING POPULATION DATA
TO COMPARE TO IN AUGUST.
OKAY THANK YOU.
ANY COMMENTS FROM THE TS ELIOT.
WE DON'T HAVE ANY SPECIFIC
COMMENTS OF THIS TIME BUT WANT
TO KNOW THAT WE HAVE MET WITH
THE STAKEHOLDERSON THIS
PROPOSAL MORE AVAILABLE TO
ASSIST THE COMMITTEES YOU
CONSIDER THIS.
THANK YOU OF FINANCE.
OKAY WELL I THANK YOU FOR YOUR
PRESENTATION I KNOW THAT.
WE'VE TO AND THE PREVIOUS
PRESENTATION WITH THE PART OF
AGING TALKED ABOUT THE NEED TO
LOOK AT.
IN TERMS OF A DEMOGRAPHIC.
FOR VARIOUS PROGRAMS.
SUCH AS I JUST SAID SO WERE.
ACTUALLY NURSING HOME CARE LONG
TERM CARE IS A SIGNIFICANT
PORTION OF THE MEDI CAL BUDGET.
AND SO FORTH TO BE ON THE
PROJECT WHAT THE DEMAND IS
LIKELY TO BE.
GIVEN.
DEMOGRAPHIC CHANGES SO THAT'S
CERTAINLY SOMETHING THE
SUBCOMMITTEE'S VERY INTERESTED
AND.
AT SOMETHING THAT UP TO SEE IT
WILL IMPACT THE BUDGET YEAR
AFTER YEAR I KNOW THE LA O.
STRAIN TO. SAID THAT ARE YOU
LOOKING INTO THIS ONLY SO YOU.
MEMBERS PREVIOUSLY TESTIFIED
THAT INSTANTLY TO STATE IT WOULD
BE VERY HELPFUL IN THAT REGARD
CELL THANK YOU.
THANK YOU SO WHAT WE ARE TO GO
TO A PUBLIC COME AT THE END OF.
THE ALL THE STATE BECAUSE WE
HAVE FOUR OF THEM CYCLE
PROPOSALS THAT WILL TAKE PUBLIC
COMMENT ON. ALL FOUR SELL I'D SO
JUST JUST YOU KNOW. AND OF A
PERSON IN MIND THERE.
SO DEXTER STAKEHOLDER PROPOSALS
THE CALIFORNIA CHILDREN'S HEALTH
CARE COVERAGE COALITION FOR
CHILDREN CD COLLECTION.
INTRODUCE YOURSELF AND THERE ARE
THREE MINUTES OR LESS LAST DOZEN
WORKS TO.
FUN.
YES I THINK YOU MISTER CHAIR.
TINSELTOWN CHILDREN'S DEFENSE
FUND CALIFORNIA ON BEHALF OF THE
CHILDREN'S HEALTH COVERAGE
COALITION INCLUDING UNITED WAYS
OF CALIFORNIA CHILDREN NOW THE
TO IMPART THE CHILDREN'S
PARTNERSHIP.
AND THE CALIFORNIA COVERAGE AND
HEALTH INITIATIVES.
I'M OR HERE.
TO TALK ABOUT THE CALIFORNIA
HEALTH INTERVIEW INTERVIEW
SURVEY CHURCHES. A MUCH PROVIDES
VALUABLE STATE AND COUNTY DATA
ON CALIFORNIA FAMILIES INCLUDING
HEALTH INSURANCE.
HEALTH CONDITIONS AND ACTIVITIES
AFFECTING HEALTH.
CHOOSE RESEARCHERS REPORT THAT
INTERVIEW RESPONSES FOR CHILDREN
ARE TRENDING DOWN.
IF THIS CAN TREND CONTINUES
CHOSE WILL NO LONGER REPORT ON
CHILD HEALTH DATA OF THE MEN
STATE LEVEL DATA.
WITHOUT TO IS IMPORTANT HEALTH
INSURANCE AND HEALTH DATA FOR
CHILDREN OF FUTURE POLICY
SOLUTIONS TO IMPROVE HEALTH CAN
BE SERIOUSLY HAMPERED.
CHOOSE RESEARCHERS ARE EXPLORING
NEW METHODOLOGIES INCLUDING AN
ONLINE SURVEY TO INCREASE
RESPONSE RATES FOR CHILDREN.
FOUNDATIONS ARE PITCHING AND TO
SUPPORT THE FIRST ROUND OF
TESTING ON THESE CHANGES HOWEVER
ADDITIONAL TESTING INCLUDING
USING A SPANISH ONLINE SURVEY IS
NEEDED. ALONG WITH TESTING
SURVEYS I'M ASKING ABOUT
CHILDREN IN THE HOUSEHOLD AT THE
BEGINNING OF THE INTERVIEW.
WE ARE REQUESTING SEVEN HER
FIFTY THOUSAND AND GENERAL FUNDS
WHICH IS ELIGIBLE FOR A FEDERAL
MATCH.
TO COMPLETE THIS ONE TIME SECOND
ROUND OF SURVEY TESTS
WITH THESE FUNDS TESTING CAN
BEGIN IN THE FALL. AND HOPEFULLY
YEAR OLD IMPROVE CHILD RESPONSES
FOR THE NEXT ROUND OF SURVEYS
THANK YOU.
OKAY THANK YOU.
COMMENTS FROM THE PERMITTED
SERVICES BELIAU FINANCE
OKAY.
ALRIGHT WELL THANK YOU SO MUCH
FOR YOUR PRESENTATION AND
CERTAINLY.
THE FUTURE
SIR NO OBVIOUS WE GET MORE DATA
ON.
OKAY I MEXICO PROPOSAL SARAH CAN
TELL FOR A PAN ETHNIC HEALTH
NETWORK ON COLLECTING A NH P. I
DID AND IT WAS REALLY SYSTEMS.
WELCOME BACK MISTER CHAIR
PROMISE IT'LL BE THE LAST MOMENT
HERE CAN REALLY CHANNEL DON'T
SAY THAT THE DAY TODAY.
OKAY. ALRIGHT COULD REALLY TURN
ON THE OF THE CALIFORNIA PAN
ETHNIC HEALTH NETWORK I'M HERE
ON BEHALF OF.
C. PENDENCY IRAQ TO REQUEST ONE
POINT FOUR MILLION FOR THE
DEPARTMENT HEALTHCARE SERVICES
TO EXPAND. DISTANT DIS
AGGREGATED DEMOGRAPHIC DATA
COLLECTION FOR THE ASIAN AND
PACIFIC ISLANDER COMMUNITIES.
CALIFORNIA'S HOME TO THE LARGEST
ASIAN AMERICAN AND SECOND
LARGEST NATIVE HAWAIIAN AND
PACIFIC ISLANDER POPULATIONS AND
THESE ARE THE FASTEST GROWING
GROUP IN CALIFORNIA. AS MR SURE
YOU MIGHT RECALL WITH PASSAGE OF
SIMPLY BILL SEVENTEEN TWENTY SIX
BY MR BONTA AND TWENTY SIXTEEN
DEPARTMENT OF PUBLIC HEALTH WILL.
AND NOW BE COLLECTING IN
RELEASING DEMOGRAPHIC DATA FOR.
API COMMUNITIES SUBPOPULATIONS
NOTED IN THE BILL BUT I THROUGH
THE PROCESS WE WORKED WITH THE
DEPARTURE THE LEGISLATIVE
PROCESS WE AGREED TO WORK WITH
THE DEPARTMENT.
TO.
INCLUDE DEMOGRAPHIC DATA A A
FOR THEIR PARTICULAR SYSTEMS
THERE ARE ELIGIBILITY SYSTEMS.
AND THAT IS WHAT YOU HAVE BEFORE
YOU TODAY A ONE POINT FOUR
MILLION.
REQUEST TO IMPLEMENT.
DE.
SO THE DISAGGREGATED DATA THAT
WE'VE DISCUSSED WITH THE
DEPARTMENT.
WE URGE THE BUDGET COMMITTEE TO
MAKE THIS CRUCIAL INVEST
TO GILLOOLY TO TIE.
FEDERAL MINISTRATION IS
POLITICIZING THE CENSUS.
WITH CITIZENSHIP QUESTIONS
MAKING IT MUCH MORE IMPORTANT
AFTER THAT CALIFORNIA IS TAKING
INTO ACCOUNT THE DIVERSE
POPULATIONS AND ITS NEEDS THANK
YOU. OKAY THANK YOU A PTS
COMMENTS ARE HELLO. FINANCE.
RIGHT OF YOU SEE VERY IMPORTANT
THAT WE COLLECT THAT THIS DATA
SO.
THERE'S A LOT. THAT WE SAY THAT
ASIA IS THE BIGGEST CONTINENT
SICK POTIONS THE BIGGEST OCEAN
OF ONE AND ONE WEBSITE SOLVE
TOGETHER.
THIS DIDN'T WORK OUT.
OKAY THANK YOU HAVE FINALLY WE
HAVE.
THE KILL FOR MEDICAL
ASSOCIATION PROPOSAL FOR AN
ENHANCED MEDICARE FUNDING FOR
HEALTH INFORMATION EXCHANGES.
ALRIGHT THREE MINUTE SET OF TWO
PURSE PEOPLE OF PRESENTING OKAY
THREE MINUTES TOTAL.
THANK YOU DOCTOR PAN AND
MICHELLE BLOCK WITH THE
CALIFORNIA MEDICAL ASSOCIATION.
AT WHERE REQUESTING FIVE MILLION
GENERAL FUND.
.
FOR IDIOTS HAVE TO PROVIDE A
STATE MATCH TO DRIVE DOWN
ADDITIONAL HEALTH INFORMATION
TECHNOLOGY AND ECONOMIC.
CLINICAL HEALTH OR HIGH TECH
FUNDS. THESE FUNDS FOR WHICH THE
FEDERAL GOVERNMENT PROVIDES A
NINETY PERCENT MATCH
WOULD PROVIDE THE STATE WITH A
TOTAL OF FIFTY MILLION TO IT
ASSIST HEALTH INFORMATION
EXCHANGES WITH ONBOARDING NEW
PROVIDERS.
CONNECTING THEM TO IN EACH TO IT
HIV SO THAT THEY CAN
SUCCESSFULLY USE THAT SERVICE OF.
IN TWENTY SIXTEEN THE FEDERAL
GOVERNMENT EXPANDED ITS PREVIOUS
GUIDANCE ON THE USE OF THESE
FUNDS ALLOWING STATES TO APPLY
FOR THE ENHANCE FEDERAL MATCH
FOR A WIDER ARRAY OF PROVIDERS
AND SERVICES.
INCLUDED IN THE ALLOWABLE
ACTIVITIES THAT STATES CAN CLAIM
FOR IS THE ONBOARDING MEDICAID
PROVIDERS.
TO HEALTH INFORMATION EXCHANGES
AND ASSISTING PROVIDERS WITH
ESTABLISHING A DIRECT CONNECTION
TO A STATE PRESCRIPTION DRUG
MONITORING PROGRAM. WHICH IS
TIMELY GIVEN THAT THE STATE LAW
IN CALIFORNIA NOW AUTHORIZES
HEALTHCARE PROVIDERS.
TO ESTABLISH A DIRECT CONNECTION
BETWEEN AN ELECTRONIC HEALTH
RECORD SYSTEM AND THE CURES
DATABASE.
IN ADDITION TO ADVANCING HEALTH
INFORMATION TECHNOLOGY
CAPABILITIES THE ABILITY TO
CONNECT DIRECTLY TO CARE AS WELL
LEVY EIGHT ONE OF THE MOST
COMMON COMPLAINTS BY PROVIDERS.
USING THE DATABASE AS IT WILL
ELIMINATE THE NEED FOR THEM TO
LOG ON SEPARATELY TO ACCESS
INFORMATION.
WE BELIEVE MAKING A MODEST ONE
TIME INVESTMENT WOULD ALLOW THE
STATE TO TAKE ADVANTAGE OF THE
ENHANCED FEDERAL MATCHING
RECEIVING NINE TWO ONE RETURN ON
THAT INVESTMENT.
ADDITIONALLY THROUGH THE SEE TAP
CALIFORNIA ALREADY HAS THE
INFRASTRUCTURE EMPLOYEES.
TO SUPPORT THE DISSEMINATION OF
AN ADDITIONAL FIFTY MILLION IN
HIGH TECH FUNDS AS THOSE BECAUSE
DATES YES IS ALREADY SUPPORTING
THOUSANDS OF PROVIDERS WITH
HEALTH IT TECHNICAL ASSISTANCE
TO THIS PROGRAM.
THESE FUNDS WERE ALLOW THE STATE
TO BUILD UPON THE SUCCESS OF
SETUP FOR THEN THE ADVANCEMENT
OF CALIFORNIA'S HEALTH IT
CAPABILITIES.
I PICKING THAT AGAIN MISTER
CHAIRMAN DAVID FORD BAGS A
CONDUCTOR OF CAL HIP SO I'VE
ALSO BEEN ASKED TO SPEAK ON
BEHALF OF THE BOARD OF THE
CALIFORNIA ASSOCIATION OF HEALTH
INFORMATION.
CHANGES
TODAY I'M JUST AT A COUPLE
POINTS TO WHAT MY COLLEAGUE FROM
CMA HAS ALREADY SAID. ON THIS
OPPORTUNITY TO RECEIVE A NINE TO
ONE FEDERAL MATCH FOR THESE.
FOR THESE SERVICES DOES NOT GO
ON FOR EVER SORTS OF SOME
THOUGHT WE COULD COME BACK TO
THIS NEXT YEAR THESE FUNDS MUST
BE EXPENDED BY TWENTY TWENTY ONE
BY THE END OF CALENDAR YEAR
TWENTY TWENTY ONE.
AND WITH THE NEED TO GET
FEDERAL APPROVALS AND ACTUALLY
CARRY OUT THE PROGRAM. WHOM WITH
THE TIME IS NOW TO DO THIS.
ONE MORE THOUGHT BECAUSE JUST
BECAUSE IT'S VERY TIMELY.
EARLIER THIS WEEK THE SENATOR
MEDICARE MEDICAID SERVICES
RELEASED A NOTICE OF PROPOSED
RULE MAKING UPDATING WHICH IN
THE.
RULES GOVERNING MEANINGFUL USE
AND THEY HAVE ADDED SOME
SPECIFIC.
QUALITY MEASURES TO MEANINGFUL
USE RELATED TO OPIOID TREATMENT
AND.
ENCOURAGING PROVIDERS TO CHECK
THE STATE PRESCRIPTION DRUG
MONITORING PROGRAMS SO IT MAKES
THIS REQUEST EVEN MORE TIMELY.
ADDS THAT THE FUNDS ARE TO BE
USED TO SUPPORT PROVIDERS
ACHIEVING MEANINGFUL USE THANK.
IF YOU ANNIE COMES FROM IT TO
SEE IRATE THAT LEO FINANCE
ALRIGHT THANK YOU SO MUCH FOR
YOUR PRESENTATIONS.
I THINK YOU ARE AT STAKE WILL
TAKE PUBLIC COMMENT ON THE
STAKEHOLDER PROPOSALS.
VERY PASSED MORE CONGRESS OF
CALIFORNIA SENIORS.
WELL I MERELY TO OUR.
SPREADS ARE STRONG SUPPORT FOR
THE LONG TERM SERVICES AND
SUPPORT STATE COLLECTION
PROPOSAL.
UP THERE ARE FEW THINGS THAT
NEED TO BE NOTED ONE OF THEM IS
THAT.
CALIFORNIA COLLABORATIVE FOR
LONG TERM SERVICES AND SUPPORTS
ISN'T DISTINCT.
ARE.
IT ENTITY A COALITION OF
ORGANIZATIONS THAT.
WE ARE NOT WE ARE NOT THAT THE
COLLABORATIVE THERE'S A LOT OF
OVERLAP AND THIS IS THINGS
CELEBS SERVICES
AND. STATE AGENCIES.
PALM THE OTHER THING IS I
BELIEVE SCOTT THAT THE THAT THE
TEXT SAYS THAT WERE SEEKING
THREE AND A HALF MILLION DOLLARS.
IN GENERAL FUND AUTHORITY AND I
MAY I MAY STAND CORRECTED BUT I
THINK WE'RE ASKING FOR THREE
MILLION.
AND O. ASSUMING THAT THE HEAD OF
THE HALF A MILLION COULD.
IS ALWAYS WILL FEDERAL SUPPORT.
SO FAR JUST TO MAKE THAT SLIGHT
CORRECTION BUT.
ABOUT WE BELIEVE THAT THIS
ACTIVITY THAT UNDERTAKING THIS
IS CENTRAL TO OUR BEING ABLE IS
A STATE.
TO PREPARE FOR WHAT WE'RE FACING
OVER THENEXT. DECADE YOUR
SEVERAL DECADES
AND THAT IS THE CARE.
AND SUPPORT FOR OUR AGING AND
ARE DISABLED POPULATIONS.
AND WE ARE STRONGLY IN SUPPORT
OF THIS
THANK YOU.
OKAY.
HI CRISTINA BUS HIM ATTEND AGAIN
WITH UT W. ASKS ME. REPRESENTING.
THE ALLUSION.
OH SORRY. HUNDRED THOUSAND I
JUST AS WORKERS SAW A MAN TWENTY
ONE COUNTIES AS WE HAVE MANY.
OF OUR MEMBERS HERE TODAY THIS
IS OURS AT ONE OF OUR SINGLE
PRIORITIES THIS YEAR AND EVERY
YEAR WE COME AND WE USUALLY ASK
FOR HUNDREDS OF MILLIONS OF
DOLLARS.
SO I'M HAPPY TO SAY THAT THREE
MILLION IS IT FOR US AND WE
REALLY WANT. THE STATE TO DO
THIS TYPE OF DATA THIS IS VERY
NICE NECESSARY FOR THE LONG TERM
SUSTAINABILITY OF I JUST US
THANK YOU. THANK YOU.
CLEVER ROTH DISABILITY RIGHTS
CALIFORNIA WHERE MEMBERS OF THE
COALITION OF STAKEHOLDERS THAT
WORKED ON PUTTING THIS PROPOSAL
TOGETHER.
IT'S A VERY SMART THING TO DO
RIGHT NOW WE SUPPORT IT. THANK
YOU.
NEXT ON CALIFORNIA'S DISABILITY
RIGHTS WHERE MEMBERS OF THE
COLLABORATIVE HERE AND WE
BELIEVE THAT IT WILL WITH PROPER
DATA WE GET PROPER SERVICES AND
EVERYBODY IS COVERED SO FREMONT.
THE THREE MILLION NOT TOO MUCH
YOU KNOW.
I THINK IT BE WORTH IT.
THANK YOU.
WELCOME.
THREE THE ANDERSON ON BEHALF OF
THE ARCANE UCP CALIFORNIA WE ARE
pALSO MEMBERS OF THE
COLLABORATION AND FOR ALL THE
REASONS THAT YOU'VE HEARD
ALREADY.
SUPPORT THIS EFFORT FOR LTFS.
THANK YOU.
NORTH PART OF THE STAFF SUPPORT
TO THE CALIFORNIA COLLABORATIVE
FOR LONG TERM SERVICES AND
SUPPORTS. AND SO WE ARE IN
STRONG SUPPORT OF THIS OF THE
DATA COLLECTION FOR LTO SAN.
AND I'LL ASSOCIATE MY REMARKS
WITH
YOUR BODY IS JUST SPOKE UP.
THANK YOU.
CAROL SUL FOR THE CALIFORNIA
COMMISSION ON AGING WHERE
ACTUALLY THE ONLY STATE ENTITY
THAT'S BEEN A PART OF THIS LONG
TERM SERVICES AND SUPPORT
EXPLORATORY COALITION.
AND ARE VERY PLEASED TO SEE THE
GROUP THAT HAS COME TOGETHER IN
THIS EFFORT AND WE FEEL THE DATA
IS ESSENTIAL FOR US TO MOVE
FORWARD AND. HELPING PEOPLE IN
THE FUTURE THANK YOU THANK YOU.
WELCOME AYE BY NAME IS JOYCE
DALE. AND I MEAN I JUST SAYS
WORKER. FROM MERCED COUNTY WOULD
YOU DO W. AT A TAKE CARE MY
EIGHTY TWO YEAR OLD MOTHER HAS
PANCREATIC CANCER.
I'M ASKING YOU TO PLEASE SUPPORT
THE ONETIME REQUEST FOR FUNDING
L. T. S. AS
DATA SO WE CAN PREPARE FOR
CALIFORNIA'S A LONG TERM CARE
NEEDS THANK YOU THANK YOU.
WELCOME. DEL UP FOR HOURS
HOMECARE PROVIDER COUNCILS
COUNTY I'M HERE IN SUPPORT.
OF FUNDING FOR LDS AS.
DATA COLLECTING THANK YOU THANK
YOU.
WELCOME HI MY NAME IS ELIZABETH
DE ISN'T IAMA HOMECARE PROVIDER
FROM STANISLAUS COUNTY WITH THE
U. D. W.. I. SUPPORT THE OUT T.
SS DATA PROPOSAL BECAUSE IT WILL
HELP CALIFORNIA PREPARE FOR.
GOING LONG TERM CARE NEEDS.
THANK YOU.
WELCOME.
MY NAME IS MARIA ROSA'S NIEM ARM.
E. H. X. ES PROVIDE AFFIRMATIVE.
PLEASE SUPPORT THAT ONE TIME
REQUIRES FOR FUNDING.
LTFS THE ACCOUNT SO WE CAN
PREPARE FOR CALIFORNIA FLUNKED
AND CARE NEEDS.
THANK YOU.
WELCOME.
THE NUMBER OF MONEY ABOUT THE
STAND SO BLOW IT AROUND THAT
LAST WEEK AND CAST.
THEY PUT THAT LINK GAS SAYING IT
ON THE OTHER THAT MITCH SAY BUT
TROUBLED UP FOR YOU IN THE
CLINICS HE OWNED. BIGFOOT MICE
YOU DON'T BUT I LEFT FOR YOU
THEY SAID WE SHIELDS THAT
LATERAL MY. MY NAME IS MEDI ABOUT THESE
THE AND THEY MAY U. D. W.
PROVIDER FROM MERCED COUNTY
PLEASE APPROVE THE PROPOSAL TO
BUDGET DATA COLLECTION FOR LTFS.
THANK YOU THANK YOU.
THE NUMBER IF YOU GET A
MUNICIPAL WITH ANOTHER NICKEL
NOT ONLY CLASSWORK WITHIN THE
EQUIVALENT TO SAMPLE HOA
POIGNANT MCCARTY FILM THEY WANT
NOTHING. BUT IT UP FOR YOU KNOW
THE THIRD OF THESE ELEVEN
HOPELESS THANK YOU.
CLASSES.
TRANSLATION.
MY NAME IS HERE THERE ARE A FIVE MINUTE TALK
BUT.
I'M JUST GETTING ONE MINUTE SAW.
IT'S VERY PERSONAL.
MY MOTHER IN LAW JUST PASSED
AWAY IN DECEMBER AND FIVE DAYS
AGO WE HAD A FUNERAL FOR MY THAT
THEY WERE LIKE TO BET I'VE BEEN
TAKING CARE OF THEM. SPENDING
THOUSANDS OF DOLLARS OF MY OWN
MONEY HELPING THEM.
THERE WITH THEIR DAILY LIVING
AND I'D SPENT COUNTLESS OF OURS
DRIVING AND THAT ARE
APPOINTMENTS.
SO I AND AND OUT BEING A VETERAN
MYSELF I AM PARTICULARLY
INTERESTED WITH.
THE BETTER ONES WITH DRAMATIC
BRAIN INJURY THAT WILL NEED THIS
OUT THE SS
BUDGET AT. THANK YOU THANK YOU
THANK YOU.
WELCOME.
ANY CONTRARY SO THE CALIFORNIA
FOUNDATION FOR INDEPENDENT
LIVING CENTERS WE ARE ALSO A
MEMBER OF THE EXPLORATORY COLOR
COALITION AND WE ARE IN STRONG
SUPPORT OF THE OLD. TSS DATA
COLLECTION PROPOSAL THANK YOU
THANK YOU.
HI PETER HANSEN WOULD KILL PACE
THAT'S THE ASSOCIATION OF
PROGRAMS OF ALL INCLUSIVE CARE
FOR THE ELDERLY. A WE ALSO
LEARNED VERY STRONG SUPPORT OF
THE PROPOSAL TO INCORPORATE DEL
TSS.
QUESTIONS INTO THE HEALTH
INTERVIEW SURVEY WERE PART OF
THE COALITION THAT'S PUTTING THE
PROPOSAL FORD.
WE THINK IT'S A MODEST ONE TIME
INVESTMENT THAT'LL PRODUCE
ENORMOUS BENEFITS FOR THE STATE
IN TERMS OF BEING ABLE TO BETTER
PLAN FOR THESE NEEDS.
AS PROVIDERS WE SEE PEOPLE
FALLING THROUGH THE CRACKS EVERY
DAY THAT ARE NOT.
GETTING ACCESS TO TIMELY
SERVICES THE STATE WOULD GO A
LONG WAY. TO HELPING US PUT IN
PLACE INTERVENTIONS TO MAKE SURE
THAT DOESN'T HAPPEN
STRONG SUPPORT. THANK YOU.
THURMOND CATHY PROSPER WITH THE
PUBLIC HEALTH INSTITUTE WANNA.
SHARE SUPPORT FOR THE
CALIFORNIA CHILDREN'S HEALTH
COVERAGE COALITION REQUEST TO EN
FEMME.
FOR THE PILOT PROGRAM IN THE
CHEST DATA THIS IS BEEN
pDATA IT GETS DOWN TO THE COUNTY
LEVEL WHICH IS VERY DIFFERENT
THAN WHAT YOU'LL SEE OTHER
STATES BE ABLE TO TO PULL
TOGETHER. THIS IS IMPORTANT FOR
US AS WE PUT FORWARD OUR PUBLIC
HEALTH REQUEST THANK YOU THANK
YOU.
MISTER CHAIR TIFFANY RIGHT IN
WITH THE SERVICE EMPLOYEES
INTERNATIONAL UNION AND SUPPORT
OF THE LTFS DATA COLLECTION FOR
ALL THE REASONS PREVIOUSLY
STATED THANK YOU. THANK YOU.
WELCOME. GOOD AFTERNOON GERMANE
CAMPBELL PART OF LA CARE HERE IN
SUPPORT FOR THE SAME I REQUEST
FOR HEALTH INFORMATION EXCHANGES.
YOU.
OKAY.
HI KATIE HIDE OR IN WITH HEALTH
NET I'M HERE IN SUPPORT FOR
EXPANDING HEALTH INFORMATION
EXCHANGE FUNDING THANK YOU.
THANK YOU.
WELCOME.
FELIX YOU WITH BUSHEL CALIFORNIA
ALSO HERE STRONG SUPPORT OF THE
CMA PROPOSAL TO DRAW DOWN
ENHANCED NINETY TEN FUNDING FOR.
MEDI CAL HEALTH INFORMATION
EXCHANGE THANK YOU THANK YOU.
LOW LISA COLEMAN WITH THE
CALIFORNIA LONG TERM CARE
OMBUDSMAN ASSOCIATION WE'RE VERY
PROUD TO BE A MEMBERS OF THE
COALITION AND.
LOOK FORWARD TO THIS PASSING SO
WE HAVE THAT HARD DATA THE
DEPARTMENT OF FINANCE CAN CAN
USE IT AND YOU CAN MOVE THIS
NEEDLE PATH SENATOR PAN.
THANK YOU.
WELCOME.
BELINDA AWAY WITH WESTERN CENTER
ON LAW AND POVERTY IN SUPPORT OF
THE LTFS DATA COLLECTION IS ALL
OF THAT DISAGGREGATED API PITA
THINKING THANK YOU.
I CARRY THOMAS SOME HAVE THE
CALIFORNIA ASSOCIATION OF PUBLIC
HOSPITALS AND HEALTH SYSTEMS IN
SUPPORT OF THE ITEM ON EXPANDING
PARTICIPATION AND HEALTH
INFORMATION EXCHANGES THANK YOU
THANK YOU.
MARY VALDEZ WITH HEALTHAXIS
CALIFORNIA IN SUPPORT OF
DISAGGREGATED EPA DID THANK YOU
THANK YOU. ALRIGHT SO WE'RE
GOING TO THANK ALL THE PUBLIC
COMMENT I KNOW THAT FOLKS WHO
ARE TESTIFYING HERE BEEN WAITING
ACTUALLY THAT FOLKS ARE GOING TO
TALK A PUBLIC HEALTH WAITING
LONGER.
I APPRECIATE ALL THE TESTIMONY
WE'RE GONNA HOLD EACH OF THOSE
ITEMS OPEN.
THAT PRINT
IT WRAPS UP
SECTION THE PART HEALTHCARE
SERVICES.
I LACKS YOU THINK DIRECTOR TENET
NOT ONLY FOR HER ENDURANCE BUT
ACTUALLY IS A DIRECTOR AND BEING
ESSENTIALLY SO OF THE WHOLE TIME
GIVEN THE SIZE AND BREADTH YOU
DEPARTMENT THAT'S VERY
IMPRESSIVE.
SO.
YEAH WELL ACTUALLY YOUR STAFF
SHOULD THANK YOU A LOT BECAUSE
YOU'RE HERE THEY DON'T HAVE TO
BE HERE AND.
I ASK A LOT OF DETAILED
QUESTIONS CELL AND YOU GOT IT
YOU YOU HAD TO BE ON TOP OF ALL
OF THEM. SO THANK YOU EXTRA MUCH
ALRIGHT SO WE ARE GOING TO TAKE
AT LEAST I NEED TO TAKE A TWO
MINUTE BREAK AND THEN WE WILL
RESUME.
PUT THAT THE PART OF PUBLIC
HEALTH.
AND.
HOPEFULLY WE'LL WELL WE WILL
TAKE THE TIME NECESSARY TO DO
OUR JOB SO WELL IS THAT BY
TWENTY FOUR OKAY THANK YOU SO
WILL BE BACK IN TWO MINUTES