JOINT LEGISLATIVE. OVERSIGHT
HEARING OF THE JOINT
LEGISLATIVE AUDIT COMMITTEE THE
ASSEMBLY ENVIRONMENTAL SAFETY
AND TOXIC MATERIALS COMMITTEE
ASSEMBLY HEALTH COMMITTEE
SENATE ENVIRONMENTAL QUALITY
COMMITTEE AND THE SENATE HEALTH
COMMITTEE BECAUSE YOU'RE IN
ORDER SO THEY WILL DISCUSS THE
FINDINGS AND RECOMMENDATIONS
IDENTIFIED BY THE STATE
AUDITOR. AND THE AUDIT REPORT
RELEASED IN JANUARY OF TWENTY
TWENTY TITLE CHILDHOOD LEAD
LEVELS MILLIONS OF CHILDREN AND
MEDI CAL HAVE NOT RECEIVED
REQUIRE TESTING FOR LEAD
POISONING. THANK SIMPLY MEMORY
FOR. THIS AUDIT OF THE
COMMITTEE LAST YEAR AND
ALLOWING ME TO BE A CO AUTHOR
ON THAT REQUEST. AS MANY OF YOU
KNOW EXPOSURE TO LEAD
NEGATIVELY AFFECTS THE HEALTH
OF INDIVIDUALS. AND CHILDREN
UNDER THE AGE OF SIX OR
ESPECIALLY VULNERABLE TO LEAD
POISONING AND ITS HARMFUL
EFFECTS. ONE OF THE MAIN
REASONS THAT I SIGNED ON TO
THIS I REQUEST IS BECAUSE I
STRONGLY BELIEVE THAT THE
CHILDREN LIVING IN OUR STATE.
ESPECIALLY IN DISADVANTAGED
COMMUNITIESDESERVE TO HAVE
ADEQUATE LEAD LEVEL TESTING TO
ENSURE THAT THEY ARE NOT
EXPOSED TO LESS HARMFUL HEALTH
EFFECTS. AS THE AUDIT REPORT
POINTS OUT THE STATE REQUIRES
TESTING. REQUIRES TESTING.
CHILDREN WHO HAVE THE GREATEST
RISK OF LEAD POISONING
INCLUDING THOSE ENROLLED IN
MEDICARE OUR OTHER PROGRAMS FOR
LOW INCOME CHILDREN. URBAN OF
HEALTH CARE SERVICES IN THE
CALIFORNIA DEPARTMENT OF PUBLIC
HEALTH HAVE RULES IN PREVENTING
DETECTING AND RESPONDING TO
INCIDENTS OF LEAD POISONING DH
CS OVERSEAS A PROVISIONS OF
LEAD TEST TO CHILDREN AND MEDI
CAL AND CD PH OVERSEAS A
STATEWIDE LET PREVENTION
PROGRAM. AND ITS IMPLEMENTATION
TO REDUCE THE INCIDENCE OF LEAD
EXPOSURE THE STATE AUDITOR
REPORTS THAT BOTH DEPARTMENTS
HAVE FAILED TO FULLY MEET THEIR
RESPECTIVE RESPONSIBILITIES.
FOR EXAMPLE THE AUDITOR FOUND
THAT NEARLY HALF OF THE TWO
POINT NINE MILLION ONE TWO YEAR
OLD CHILDREN ENROLLED IN
MEDICARE NOW WE'RE NOT TESTED
AT ALL AND ANOTHER SEVEN
HUNDRED AND FORTY THOUSAND
CHILDREN MISSED ONE OF THE TWO
TESTS THEY SHOULD HAVE RECEIVED.
SO ONLY ABOUT A QUARTER OF THE
CHILDREN WERE ENROLLED IN
MEDICARE AL A RECEIVING ALL THE
RECOMMENDED LEAD TESTS. FURTHER
THE OTTER FOUND THAT MANY
CHILDREN WHO DO NOT RECEIVE ALL
THE TESTS WERE FROM AREAS WITH
LARGE NUMBERS OF CHILDREN WITH
ELEVATED LEAD LEVELS. THE US
AVERAGE LEAD TESTING RATE OF
CHILDREN AGES ONE AND TWO.
YEARS IN MEDIC MEDICAID IS
ALMOST 45% CALIFORNIA'S RATE IS
APPROX 36% THE CONCERN THAT WE
ARE THAT WE ARE BELOW THE
NATIONAL AVERAGE FOR LEAD
TESTING RATES FOR CHILDREN
CALIFORNIA SHOULD BE LEADING
THE WAY IN ADDRESSING THIS
ISSUE WE SHOULD BE TESTING AT
THE RATE OF 80% LIKE OTHER
STATES LIKE PENNSYLVANIA. TODAY
WE WILL DISCUSS THE ADDITIONAL
FIND IS IN THE STATE AUDITOR'S
REPORT. AND THE RULES. OF THE
CALIFORNIA DEPARTMENT PUBLIC
HEALTH. DEPARTMENT OF HEALTH
CARE SERVICES WILL ALSO DISCUSS
THE DEPARTMENT'S PLANS FOR
CHANGES AND CORRECTIVE ACTIONS
AUDITOR'S RECOMMENDATIONS. TO
HELP INSURE THAT ALL ELIGIBLE.
CHILDREN ARE TESTED. AREAS AT
HIGH RISK FOR LEAD POISONING
ARE PROPERLY IDENTIFIED THE
DEPARTMENT OF HEALTH CARE
SERVICES OVERSEAS. MANAGED CARE
PLANS A PROVIDE LEAD TEST AND
ADOPT A PERFORMANCE STANDARD
FOR LEAD TEST DESIGNED TO
MONITOR. SUCCESS LED TESTING
THE DEPARTMENTS HAVE ADEQUATE
FUNDING TO EFFECTIVELY OPERATE
THEIR PROGRAM- THAT THE
DEPARTMENT OF PUBLIC HEALTH IS
EFFECTIVELY MANAGING AND
OVERSEEING THE PREVENTION
PROGRAMS. AND THAT THE
DEPARTMENTS MEET ALL LEADS TO
MATT. ADDITIONALLY WE WILL HEAR
PERSPECTIVES ABOUT THE REPORT
FROM LOCAL AGENCIES. INVOLVED
WITH THE LEAD POISONING
PREVENTION. MY GOAL FOR THIS
OVERSIGHT HEARING IS TO SHED
LIGHT ON BEST PRACTICES TO MAKE
SURE THAT WE IMPROVE OUR
TESTING RATES ROUTE CALIFORNIAN
TO ENSURE THAT OUR CHILDREN ARE-SAFE- WITH THAT I DO I'D LIKE
TO THANK OUR COMMITTEE CHAIRS-
FROM THE VARIOUS COMMITTEES FOR
BEING HERE TODAY AND I INVITE
THEM TO GIVE AN OPENING
STATEMENT AT THIS TIME. WE DO
HAVE ASSEMBLY MEMBER WOULD WHO
CHAIR OF THE ASSEMBLY HEALTH
COMMITTEE SENATOR ALLEN WHOSE
CHAIR OF THIS ENVIRONMENTAL
QUALITY COMMITTEE- SENATOR PAN
WHO'S THE CHAIR OF THE SENATE
HEALTH COMMITTEE. AND WITH THAT
LET ME ASK IF ANY OF THEM WOULD
LIKE TO MAKE AN OPENING
STATEMENT AT THIS TIME. PLEASE
DOCTOR WOULD THANK YOU MISTER
CHAIR- I'M JUST ANXIOUSLY
LOOKING FORWARD TO- HOW THIS
MIGHT BE ADDRESSED IN THE
COMMENTS FROM THE DEPARTMENT.
THIS IS NOT THE FIRST OUR ARE.
AUDIT IS BEING CRITICAL. OF
DEPARTMENT HEALTH CARE
SERVICES- MY CONCERN LAST YEAR
OVER- PREVENTIVE SERVICES THE
CHILDREN NOT GETTING- PRETTY
SHOCKING- THE HAVE THE
PERCENTAGE IS THERE. THIS ONE
IN MY OWN DISTRICT AS THE
NUMBERS IN FRONT OF ME. OF ONLY
ABOUT A THIRD OF THE CHILDREN-
BETWEEN ONE AND TWO HAVE WE'RE
WE'RE DID RECEIVE HER BLOOD
TESTING THAT'S THAT'S- THAT'S
BELOW THE NATIONAL AVERAGE I
BELIEVE. WHICH IS PRETTY
SHOCKING- AS WELL SO. I'D LIKE
TO KNOW HOW WE'RE GOING TO
ADDRESS IS GOING FORWARD AND
THEN FROM WE HAVE A DUTY TO
PROVIDE SERVICES TO. TWO OF THE
CHILDREN WE HAVE ON MEDI CAL
AND WE'RE- NOT MEETING THAT
MANDATE AND I WOULD LIKE TO HOW
WE'RE GOING TO DO THAT IN THE
FUTURE. THE DOCTOR WOULD.
PLEASE THANK YOU SO MUCH OF
CHAIR SALAS AND I ALSO
APPRECIATE TO OUR COMMITTEES
COMING TOGETHER TO DRESS REPORT
I THINK IS CHIU WOULD MENTION
WE WERE ACTUALLY CHIU WHAT I
WOULD. TO HE'S RIGHT WORD WELL
WE YEAH WE WOULD CARE TO JOINT.
THIS AND- SENATE HEALTH
COMMITTEE HEARING AT THE DATE
IS THAT AS CHAIR WOULD BE THE
LOOK AT OUR TO LOOKED AT HOW
SUPERVISION PREVENTED A VISITS
I WOULD MAKE NOTE THAT THE
PERCENTAGE OF CHILDREN WHO ARE
CAL WHO GOT TO PREVENT VISITS
JUST THE VISIT WHICH TO REMOTE
ALSO WOULD BE THE- WHICH WE-
TALK. ABOUT AND THEN PERFORMING
THE WILL THE LED TO AS WELL
WE'RE BELOW THAT WE SAW OTHER
STATES ACTUALLY THE AVERAGE LOW
HALF BUT IT'S ACTUALLY THAT
SOME OF THE INDIVIDUAL. EVEN AT
A VERY YOUNG AGE THE WERE YOU
WOULD VERY LOW EVEN LOWERED
THAT SO AND FORTUNE ME NICE BE
SURPRISE TO ME THAT ARE LET'S.
RATES ARE SO LOW BECAUSE OUR
WELL CHILD VISIT RAY ARE SO LOW
AS A PDF. SO VERY. OF THE
DANGER OF LAW AND IT'S TALK
EFFECT OF TO TICKLE OF THE
BRAIN. AND THE NERVES SYSTEM
AND DOES SO I WOULD MAKE THAT.
THAT AND CAL. WELL WE HAVE THE
LOW A OF. HOUSING POTENTIAL
LEAD PAINT LET PRODUCTS IN
THEIR AS AN THAT'S A STATE.
THAT ARE UP IN THE NO. OR OTHER
PLACES WITH OLDER WE SAW DO. A
HOUSING HERE TO THAT THE HAVE
LET. AND I'D AND THE REASON I
MENTIONED IS THA EVEN AS WE'RE
TALKING A- THIS AUDIT. WE ALSO
TO THINK WHAT THE FOLLOWS IS
FOR. WE HAVE A HOUSE CRISIS WE
HAVE HE CAN'T. HOW AND SO WE DO
WE DO WITH THE- WHEN THEY HAVE
POSITIVE LED. AND ENTER. AND DO
THEY DO WE HAVE TO FIND THEM
HOUSING BECAUSE THAT'S MOST
LIKELY SOURCE I MEAN STILL TO
DO INVESTIGATE. THAT'S A SO OF
THE LEAD. AND WHERE DO THEY GO.
AND WHAT KIND OF HOUSING TO
HAVE THE- SO THE FAMILY CAN
TAKE THEIR TO. OUT THAT
POTENTIALLY TALK ENVIRONMENT.
AND SO CERTAINLY HERE I KNOW
WILL BE FOCUSING MORE ON THE
FINDINGS OF THIS PARTICULAR
ARTICLE WE ALSO NEED TO THINK
THROUGH. WHAT AND AGAIN I'M NOT
SAYING IT I ANY MEANS WELL WE
SHOULD TELL. ON THE WHAT TO
KNOW BUT THEN WE ARE. TO THAT
WORK ON THE SOLUTIONS. TO HELP
THE FOR AS AS OF COURSE. TRY TO
IMPROVE OUR- SCREEN PROCESS
IT'S BEEN A PROCESS THAT WE
ALSO AND- TO NIGHT THE SCREEN
IN FIND OUT OF. WE NEED TO HAVE
THE REPORT TO ACT ON THOSE RISK.
AND HELP THOSE FAMILY. FIGURE
WE'RE GOING TO ANY GATES ARE.
THE LEAD EXPOSURE IN THESE
CHILDREN SO TO ME THIS IS A
HERE THAT'S BE VERY AND- AS A
FIRST BUT WE- HAVE. STEPS WE
NEED TO THROUGH ON. TO PROTECT
OUR CHILDREN. TO CLEAR YOUR
MOST OFTEN. THANK CIRCUMSTANCES
THANK THANK YOU DOCTOR SO ALAN
PLEASE. WELL I WANT TO THINK
THAT'S EMBRACE AND. AND OF
COURSE OUR CHAIR OF JAIL FOR
PROCEEDING WITH THIS CERTAINLY
SO REALLY SHOCKED FINDINGS FROM
MY- ARE READ OF THE DOCK AND I
LOOK FOR TO THE- AND I HAVE A
BABY BOY MYSELF AND ON CERTAIN
THE- YOU KNOW. MISS PUT
EVERYTHING INTO HOLD LAYER
FIRST FROM WHICH KNOW THAT
THERE IS A TERM OF POISONING
AND LASSEN TO ADOPT THAT
ADULTHOOD AND HAVE US SERIES OF
HOW IMPACT THAT. THAT THE WE
AND UP THAT THE BABCOCK BOTH IN
TERMS OF QUALITY OF LIFE AND AN
AND CALL FOR EVERY ELSE AND SO
IT'S A ONE OF MANY IT'S
SOMETHING WE HAVE TO GET REMEDY
AND SO LOOKING FOR OUR
DISCUSSIONS AND OF COURSE AS
PANTS IT AND WE GO FROM HERE
AND- HOW DO WE MAKE SURE THAT
THAT THEY- ARE THE PHONE. OF
THIS RESPONSIBILITY THE TWO. I
DON'T KNOW MY THE STAFF. YOU
HAVE OF GETTING MORE PEOPLE
COVERED IS OBVIOUSLY LESS AND
SO. ON SCHOOL IN PORT
DISCUSSION TODAY AND LOOK FOR
TO WE LEARN. THANK CENTER WE
ALSO WITH US ASSEMBLY MEMBER
QUIRK WHO'S THE CHAIR OF THE
ENVIRONMENTAL SAFETY AND TOXIC
MATERIALS COME. COMMITTEE WAS
UNABLE TO BE HERE TODAY BUT I
BELIEVE. ASSEMBLY WOMAN
CRISTINA GARCIA WHO SITS ON THE
COMMITTEE IS. PREPARED TO MAKE
AN OPENING REMARK FOR THE
CHAIRMAN I GUESS THINGS FOR THE
CHAIR AND FOR. MYSELF TURN HER
AND I HAVE BEEN WORKING IN THE
SPACE FOR A NUMBER A YEARS NOW
AND- WE HAVE SEEN HOW AGENCIES
CONTINUE TO FAIL OUR
COMMUNITIES AND OUR- LOCAL
COMMUNITIES ARE COMMUNITIES OF
COLOR. AND OUR YOUNG CHILDREN
AND BILLS HAVE BEEN PASSED IN
THOSE BILLS HAVE NOT BEEN
IMPLEMENTED PROPERLY ON AND SO
I THINK WHEN WE LOOK AT THIS
AUDIT THAT OUR COLLEAGUES HAVE
REQUESTED. NOTCHES POINTING TO
THE FACT THAT. WE'RE NOT. UP
THAT WAY NOT. YOU TAKE THE IN
OUR COMMUNITY BOAT REALLY
AGENCIES ARE FOR US IN LET'S
DIVIDE WE PASSED AND ARE
PREPARED TO HEAR AND ABOUT HOW
WE GET IT RIGHT AND HOW DO WE
MOVE. BUT WE NEED COME IN FROM
THESE TO MAKE SURE THAT THEY'RE
DOING THEIRIN DOING WHAT WAS
INTENDED BY THE LEGISLATURE WE
KNOW FROM THE AUDIT WE KNOW
FROM EXPERIENCE THAT IT'S OFTEN
TIMES IN COMMUNITIES OF COLOR
LOW INCOME COMMUNITIES THAT WE
SEE THESE CLUSTERS I AND
DISUSS LET'S IS LOWER TO BABY.
TALK THIS NOT JUST TESTING BUT
TO ADDRESS UP ON IN A LOW TELL
YOU THAT THE QUESTION OF WHAT
HAPPENS WHEN THESE HOMES HAVE
LED AN THEM KNOW WHAT IT DO
WITH THOSE WE DON'T MOVE THEM.
SAN THOUSAND HOMES AND I CAN.
AT BECAUSE OF SIDE AND WE'VE
BEEN TOLD. TO DO MY SHOES
BEFORE GO IN THE HOUSE WITHIN.
NOT TO PLAY OUTSIDE. WE'VE BEEN
TOLD TO THE SOFT AS PART ON AND-
WITH TOLD TO BASICALLY LIVE
WITH THE- ON SO WE ALREADY HAVE.
THAT PUSH NOW I. THAT CAN. TO
THE CASE OUT THERE. THERE A
LETTER. WHETHER IT IS LIKE
EXCITED ARE WE A LOT OF OTHER
SOURCES IT'S EXPOSE TO SOME OF
COUNTY OF WERE EATING FROM
OTHER COUNTRIES THAT ARE COMING
AND I THINK LIKE MINE THERE'S A
LOT OF THEIR THINGS OUT THERE
THAT ARE MAY A SAY AND EVERY IS.
THAT THE AUDIT TOLD A LOT OF
WHAT WE ALREADY HI IN YOU AND
GAVE US SOME WORST FEARS THERE.
SO LOOKING FOR. TO HEAR. HOW
WE'RE GOING TO. MOVE FORWARD
AND SO TO KEEP COMMUNITY
HEALTHY AND MAKE SURE THAT I
SHOW. ARE NOT BEING SIR. UP A
LIFETIME OF FILM BECAUSE THE
SIM. THEY WERE BORN IN A THERE
THE NEW. UP ALONG THE WAY. I
ANY CHILD AT SIX TO THIS IS A
CHAT TO MANY. AT THE- CRIMINAL
WHEN IT'S CHILDREN OF COLOR.
HIS CONSTANT. IN RETALIATES AND
COMMUNITY CENTER TO. THANK YOU.
THANK YOU SOMEONE OVER HER. I
WOULD TO NOTES THERE IS ENOUGH
OF BILLS LEDGE THAT PENDING
REGARD TIS. FROM SOME OF THE
MEMBERS UP THE DIET WE HAVE
SOME BILL TO TWO SEVEN SIX BY
SOME MEMBER. AND NUMBER OF
OTHER SIMPLY TWENTY SEVENTY SO
BY MISS AND- SO I BUILT TWO
SÝ EIGHT BY WOMEN QUIRK AND-
ASSEMBLY BILL TWENTY TWO. NINE
BY THIS GARCIA AND OTHERS A
PLEA WE WALL JOIN AUTHOR EACH
OTHER'S LED. AND THEN WE HAVE
ASSN BILL ONE. AND TO PLACE
LEYVA SO THE IS PENDING LET.
BRADY WANT TO AND AS WOMAN
ELOISE RAY IS TO MAKE IT UP.
REMARK AS REQUESTED THIS AUDIT
LAST YEAR PLEASE MISTRESS.
THANK YOU AND NUMBER. I TO
FIRST THING THE JOINT PLEASE OF
WATER COMING. AND THE AUDITOR.
FOR THEIR APPROVAL AND PART ON
STE. ON A REPORT. MORE ON THIS
ISSUE A FEW YEARS NOW AND TO
AND TIME AGAIN AT THE BY
STATING. THAT THEY WERE IN FOR
DOING THEIR JOBS. THAT'S WHAT
THEY SAID IN A HEARING AND BILL
HEARING IN UP LETTERS. AND ON.
IT'S HARD TO ACCEPT THESE AGE
IN FACT ONE FAR THEIR FEDERAL
STATE MANDATES. AND WE KNEW THE
WERE RECEIVING THE APPROACH
TEST AND WE HAVE FOUND THAT
THESE KIDS. LATER FOUND THAT
WITH THESE KIDS UFFERED FROM
THE BLOOD LEAD POISONING. I
DON'T KNOW HOW LONG THE
DEPARTMENTS INTENDED TO
CONTINUE TO PROVIDE INACCURATE
AND DARE I SAY FALSE
INFORMATION ABOUT THEIR WORK OR
LACK THERE OF. WITH
CALIFORNIA'S MOST VULNERABLE
POPULATION BEING POISONED WITH
CALIPH. BY BY LAND IN THEIR
WATER AND THEIR HOMES. I DO
KNOW THAT AS OF NOVEMBER TWO
THOUSAND NINETEEN THE
DEPARTMENT OF HEALTH CARE
SERVICES CONTINUED TO REPORT
NUMBERS TO THE ASSEMBLY THAT
WERE WILDLY INCONSISTENT WITH
THE FINDINGS OF THE STATE
AUDITOR. IT WAS JUST TWO MONTHS
BEFORE THE AUDIT CAME OUT. T.
OF THE DEPARTMENT OF HEALTH
CARE SERVICES TO SUCCESSFULLY
COMPLETE THEIR JOBS. JOB SWITCH
WHEN DONE ACCURATELY COULD SAVE
THE LIVES OF CALIFORNIA'S
CHILDREN. I'M CONCERNED WITH A
LACK OF ACCURACY AND TRUTH IN
DISCUSSING THE STATUS OF THE
WORK THEY WERE DOING. AND
LASTLY I'M CONCERNED WITH THE
LEVEL OF APATHY WITHIN THE
DEPARTMENT THAT HAS ALLOWED
THIS TO BE A CONSISTENT PROBLEM
YEAR AFTER YEAR AFTER YEAR. DO
THEY HAVE TO THE DEPARTMENTS
WHO ARE HERE TODAY. I NEED YOU
TO THINK ABOUT THIS QUESTION
CRITICALLY. DO YOU UNDERSTAND
THAT WHEN YOU ARE NOT
COMPLETING THE STATE AND
FEDERAL MANDATES AS IT RELATES
TO BLOOD LET TESTS AND
ASSOCIATED SERVICES. THAT YOU
ARE ACTIVELY PERPETUATING
CYCLES OF POVERTY FOR POOR
CALIFORNIANS. IT'S EMBARRASSING
AND SHAMEFUL TO HOLD OUR HEADS
HIGH S THE WORLD'S FIFTH
LARGEST ECONOMY WELL WE HAVE
CHILDREN ACROSS THE STATE WERE
BEING POISONED BECAUSE OF THE
WATER THEIR DRINKING OF THE
STATE IS NOT DOING ITS PART. TO
SUPPORT THEM AND THEIR FAMILIES
AT DIAGNOSING AND PREVENTING
THIS FROM HAPPENING. I HOPE
THAT WE CAN LEARN DIRECTLY FROM
THE DEPARTMENTS. THE HOW AND
WHY WE GOT HERE. BUT MAYBE EVEN
MORE IMPORTANTLY WHAT THE
DEPARTMENT'S INTENT TO DO TO
FIX THIS PROBLEM AND WHEN BILL
MAILED MAKE GOOD ON THESE
PROMISES. I AM VERY GLAD TO BE
WORKING ON A PACKAGE OF BILLS
WITH SOME BRILLIANT PASSIONATE
AND HARDWORKING COLLEAGUES. AND
I KNOW THAT THEY FEEL THE SAME
WAY ABOUT THIS AUDIT. WITH OUR
PARTNERSHIP THIS MAY FINALLY BE
THE YEAR WE CAN START TO
PROTECTION CALIFORNIA'S KIDS
FROM THIS PREVENT PREVENTABLE
CRISIS. IT IS IMPERATIVE THAT
WE DO SO. I WANT TO THANK THE
CHAIRS IN THE MEMBERS AND I
LOOK FORWARD TO SOLVING THIS
PROBLEM WITH YOU. THANK YOU
ASSEMBLY WOMAN- WITH THAT I
KNOW THAT. LIKE A MOMENT OF
PERSONAL PRIVILEGE- SENATOR- MY
ELENA'S ON ALSO ALSO SUBMITTED
A STATEMENT TO THE COMMITTEE
WHICH WILL BE AVAILABLE FOR
FOLKS AS WELL SHE DID WANT ME
TO JUST READ SOMETHING ON THE
RECORD FOR HER- I WILL JUST
PARAPHRASE IF ANYBODY WANTS
THE- THE LETTER WERE BORN HAVE
TO MAKE THAT AVAILABLE. BUT
CENTER DORADO INTERSTATE BUT
SAID LEAD POISONING IS A HEALTH
AND HEALTH ENVIRONMENTAL AND
ECONOMIC JUSTICE ISSUE THAT
DISPROPORTIONATELY IMPACTS
CALIFORNIA WORKING CLASS
COMMUNITIES IN COMMUNITIES OF
COLOR AND SENATE DISTRICT
TWENTY FOUR ALONE OUT OF
850-003-0020 NINE ELIGIBLE
MEDICAL MEDI CAL AND ROLLED
OVER A JUST WANTED TO A TOTAL
OF FIFTY THOUSAND TWO AND
FIFTY. TWO OF THE ARE NOT GOOD
FOR CLINICS. THESE RESULTS ARE
ACCEPTABLE. AND NOT JUST FOR MY
COMMUNITY BUT FOR SO MANY
COMMUNITY IN CALIFORNIA MORE
FOR THIS IS ALSO THE REALITY
THAT SO MANY CHILDREN I DO NOT
GET TESTED WITH THAT LET'S GO
AHEAD. COUPLE OF HOUSEKEEPING
ITEMS A PANEL. MISS LABOR FOR
OUR COUNTY ALSO I ON THAT LEAVE
ALSO IN THAT PANEL DR DAVID
APOLLO RIVERS FRESNO CAN'T
DOCTOR. THE LIVE YEAH. BECAUSE.
A SERIES. I REPRESENTS COUNTY
OR DEAL WITH THE CORONAVIRUS
RESPONSES BEHALF OF THE
COUNTIES THEY WILL ALL NOT BE
IN A TEN TODAY WITH LET'S GO TO
CALL UP OUR AUDITOR. MEMBERS
THIS IS A CHEN ITEM TWO. AGENDA
ITEM TWO OVERVIEW MODIFY
WRECKED. WE HAVE STATE OUT OF
LANE HOW WITH HER IS JOHN FROM
WATER JOSH WILL HOP SENIOR
OUTER BUT WATER WHEN YOU'RE
READY TO PLEASE. THANK YOU
MISTER CHAIR OTHER TO CHAIRS OF
OTHER COMMITTEE COMMITTEE
MEMBERS FOR THE RECORD MY NAME
ELAINE HOW AND CALIFORNIA STATE
AUTO WITH ME AS AS THE CHAIR
INDICATED JOHN KLINE IS TO MY
RIGHT HE WAS THE OUT OF
PRINCIPLE ON THIS PARTICULAR
PROJECT. JOSHUA HOOPER'S ON MY
LEFT HE WAS THE AUDIT
SUPERVISOR ON THIS PARTICULAR
PROJECT AND THEY WILL BE
STEPPING YOU THROUGH- THE
MATERIALS THAT THE SERGEANT
HANDED OUT NOW WE HAVE A
VARIETY OF GRAPHICS- THAT WE
INCLUDED IN THE AUDIT REPORT
AND SOME ADDITIONAL GRAPHICS
THAT WILL. ILLUSTRATE ISSUES
THAT IDENTIFIED IN THE REPORT
AND WILL ALSO T TOO MANY OF
THE RECOMMENDATIONS THAT WE
HAVE. I'M GOING TO GO OVER THE
REPORT IN THREE VERY VERY HIGH
LEVEL AND THEN HANDED OFF TO
MISTER KLEIN SO HE CAN START
STEPPING YOU THROUGH- THE
DOCUMENT THAT THE SERGEANTS.
AGAIN HANDED OUT. WE IDENTIFIED
ISSUES IN THREE KEY AREAS-
AGAIN WITH RESPECT TO
DEPARTMENT HEALTH CARE SERVICES
DEPARTMENT OF PUBLIC HEALTH.
THE FIRST FEW AREAS WERE
RELATED TO THE DEPARTMENT OF
HEALTH CARE SERVICES. AND
WHETHER OR NOT THEY WERE
TESTING ALL ELIGIBLE CHILDREN
CHILDREN IN MEDI CAL AS YOU
SAID MISTER CHAIR CHILDREN.
AGES ONE AND TWO NEED TO BE
TESTED AND THAT'S REQUIRED THAT
THESE CHILDREN BE TESTED FOR
LEAD. AGAIN AS PART OF
PREVENTIVE SERVICES AND AS
MISTER KLEIN WILL STEP YOU
THROUGH SOME GRAPHICS AND MANY
MANY CHILDREN IN CALIFORNIA
WE'RE NOT BEING TESTED. OVER
THE NINE YEAR WINDOW THAT WE
LOOK AT. ONE OF THE REASONS- WE
IDENTIFIED THAT AS A PROBLEM
THE DEPARTMENT HEALTH CARE
SERVICES IS NOT MAKING. THEY
ARE MONITORING. CARE PLANS TO
ENSURE THAT THOSE PLANS THAT
GET INFORMATION FROM THE
PROVIDER. UNDERSTAND THEY KNEW
TO MAKE SURE THOSE PROVIDERS
ARE ACTUALLY CONDUCTING THESE
TESTS AND REPORTING THAT
INFORMATION UP TO THE
DEPARTMENT HEALTHCARE SERVICES
SO THE STATE HAS IDEA. STATE
WHY HOME KIDS TO. AND THREE OF
THOSE TESTS ARE THERE WAS.
ISSUE WE I IN A FIVE. OF THE
NEEDS THAT WOULD. WE IDENTIFIED
IN THE RE BE ISSUED LAST YEAR
AND MARK LOOKED AT AX TO CARE
FOR TO. ACT TO PER SIR. ONE OF
THE KEY. WE HAD IN THAT. WAS
THE STAND THAT HEALTH SERVICE
HAS FOR AGES THROUGH SIX SO
THERE ARE STANDARDS THAT
PROVIDERS AND MANAGED CARE
PLANS HAVE TO. ABIDE BY WE SAW
THE HIGHEST UTILIZATION RATES
FOR CHILDREN IN THOSE AGE
GROUPS BECAUSE THEY WERE BEING
MEASURED AGAINST A PARTICULAR
STANDARD. AND ONE OF THE THINGS
WE IDENTIFIED IN THIS REPORT
THAT WE ISSUED JUST BACK IN
JANUARY IS THERE IS NO UP
SPECIFIC PERFORMANCE STANDARD
FOR. TESTING FOR LEAD- MAKING
SURE THAT CHILDREN AGES ONE AND
TWO ARE GETTING TESTED AND IF
THEY DON'T GET TESTED. THEY
HAVE TO BE TESTED BY AGE SIX-
SO WE WERE LOOKING TO SEE IF
THE DEPARTMENT HEALTHCARE
SERVICES HAD A STAB TO PERFORM
STAND THEY HAD NOT. THEY TO OUR
CA. IS IT. ANOTHER YEAR BE THE
X. COMPLETE THAT PARTICULAR. SO
THAT'S AN ISSUE WE HAD WITH
RESPECT TO HEALTH SERVICE. THE
FINAL ISSUE WHEN IT THIS
GROUPING IS RELATED TO OUT AND
EDUCATION NOT JUST EDUCATING
PROVIDERS ABOUT THE NEED TO
PROVIDE THIS TESTER. MAKE SURE
THAT THIS TEST IS GIVEN TO
CHILDREN BUT EDUCATING FAMILIES
ABOUT PREVENTIVE SERVICES FIRST
OF ALL. BUT SO BILL A TO F.
TILED IS TEST. BACK TO CATIA.
STE OUR SERVICES THEY HAVE
ACCESS THROUGH LOCAL PREVENTION
PROGRAMS TO GET THE PROPER CARE
THAT THAT CHILD NEEDS TO GET
THAT LED. ELIMINATED FROM THEIR
BODY ESSENTIALLY REDUCE THOSE
THOSE SERVICES SO THEY WEREN'T
AGAIN HEALTH CARE SERVICES NOT
DOING ENOUGH TO INFORM FAMILIES
MAKE SURE THAT FAMILIES ARE
AWARE. OF SERVICES THAT ARE
AVAILABLE TO THEM. SO THAT'S IT
THE DEPARTMENT HEALTH CARE
SERVICES ISSUES WHICH MISTER
CLINAL STEP THROUGH IN A
MOMENT. THE SECOND KEY AREAS
THE DEPARTMENT OF PUBLIC HEALTH
DEPARTMENT OF PUBLIC HEALTH HAS
A MAJOR RESPONSIBILITY FOR
IDENTIFYING RISK AREA IN THE
STATE OF CALIFORNIA. THERE ARE
SOME ON THE DAY YES YOU HAVE SO
GRAPHICS WE LOOK INTO YOUR
SPECIFIC DISTRICT WE DID IF
SHARES OF EACH OF THE COMMITTEE.
TO OFFER. INTERACTIVE MAP OF
CALIFORNIA ON OUR WEBSITE SO
FOLKS COULD GO IN AND SEE OUR
THEIR- CHILDREN WHO ARE BEING
TESTED IN WET HIGH LEVELS OF
LEAD IN MY COMMUNITY- ARE THEIR
HOT SPOTS IN MY COMMUNITY. THIS
IS SOMETHING THAT THE
DEPARTMENT OF PUBLIC HEALTH IS
RESPONSIBLE FOR DOING
IDENTIFYING RISK IN THE STATE.
IDENTIFYING GEOGRAPHIC AREAS
THAT MAY HAVE HIGH LEVELS OF
LEAD OR HAVE CHILDREN WHO HAVE
TAPPED BEEN TESTED AND- I'VE
BEEN IDENTIFIED THAT THEY HAVE
HIGH LEVELS OF LEAD THAT MEANS
OTHER CHILDREN IN THAT REGION-
ARE POTENTIALLY BEING EXPOSED
TO LEAD POISONING AND THOSE.
ARE NEED TO BE TESTED SO THAT'S
ANOTHER ISSUE. SO PUBLIC HEALTH
NEEDS TO ASSIST IN ABATEMENT.
MAKING SURE THAT. LEAD
ABATEMENT IS OCCURRING IN THE
COMMUNITIES AND WHAT WE FOUND
WHEN WE CONDUCTED THE AUDIT IS
THERE PRIMARILY JUST MONITORING
ABATEMENT. FOR THOSE HOMES FOR
WHICH CHILDREN HAVE BEEN TESTED
AND ENDED UP WITH A POSITIVE
RESULT SO NOT BEING MORE
PROACTIVE WE WOULD HAVE WOULD
HAVE EXPECTED PUBLIC HEALTH TO
BE MORE PROACTIVE- WITH RESPECT
TO IDENTIFYING RISK AREAS AND
THEN DOING WHAT IT CAN WORKING
WITH THE LOCALS. TO ABATE THOSE
THOSE- AREAS THAT HAVE LED
POISE. AND THEN THE LAST ISSUE
IN THIS AREA AGAIN IS MORE
ABOUT EDUCATION AND BEING
PROACTIVE- AND CREATING ONLINE
REGISTRIES ESSENTIALLY
INFORMATION THAT SOME OTHER
STATES PROVIDE ON THEIR
WEBSITES. OF AREAS IN
CALIFORNIA OR COMMUNITIES IN
CALIFORNIA THAT HAVE HIGH
LEVELS OF LEAD THAT HAVE HAD
MULTIPLE CHILDREN TESTED WHERE
THEY THEY WERE IDENTIFIED TO
HAVE LEAD POISONING. AND THIS
REALLY WOULD PROVIDE VALUABLE
INFORMATION TO PEOPLE IN THE
STATE OF CALIFORNIA ABOUT THE
REGIONS IN THE STATE. THE LAST
AREA WAS REALLY LOOKING AT
PROGRAM MANAGEMENT AND THERE
ARE A VARIETY OF STATUTORY
RESPONSIBILITIES THAT THE
DEPARTMENT PUBLIC HEALTH HAS.
THEY'RE RESPONSIBLE FOR MAKING
SURE THEY HAVE CERTAIN
INFORMATION ON THE WEBSITE
THAT'S AVAILABLE TO THE PUBLIC
A RESPONSIBLE FOR CRUDE
COMPLETING A BIENNIAL REPORT A
LOOKING AT THE EFFECTIVENESS OF
PROGRAMS AND THEN FINALLY
DEVELOPING REGULATIONS THAT
WOULD LAY OUT WHAT ARE THE RISK-FACTORS THAT NEED TO BE
ASSESSED. IN A COMMUNITY I'M
NOT JUST PERHAPS THE USE OF
LEAD PAINT AND HOUSING BUT
THERE ARE OTHER RISK FACTORS
THAT SHOULD HAVE BEEN INCLUDED
IN REGULATIONS AND WE WERE
SEEING AND YOU'LL SEE IN A
GRAPHIC. OTHER STATES HAVE A
LOT MUCH BROADER LIST OF
FACTORS THAT THE STATE SHOULD
BE CONSIDERING AND PROVIDER
SHOULD BE CONSIDERING WHEN
THEY'RE ASSESSING THE RISK OF A
CHILD BEING EXPOSED TO LEAD
POISONING. THE LAST TWO AREAS
RELATED TO PUBLIC HEALTH WORK.
WE WOULD HAVE EXPECTED PUBLIC
HEALTH ADVOCATE MORE FOR
CHANGES TO STATE LAW WITH
RESPECT TO REPORTING WHAT LABS
ACTUALLY REPORT TO THE STATE OF
CALIFORNIA. AND YOU'LL SEE WHEN
MISTER HOOPER STEPS YOU THROUGH
SOME OF THE GRAPHICS A LARGE
NUMBER OF TESTS THAT HAVE NOT
BEEN PROCESS BECAUSE THERE
ISN'T ENOUGH IDENTIFIABLE
INFORMATION. OUGHT TO BE ABLE
TO TIE THAT TASK TO A SPECIFIC
MEDI CAL BENEFICIARIES IDEA
CHILD- SO THAT'S AN ISSUE THAT
WE FELT NEEDS TO BE ADDRESSED I
KNOW THAT SOME OF THIS IS BEING
ADDRESSED IN IN LEGISLATION.
AND THEN THE LAST YEAR WITH
RESPECT TO PUBLIC HEALTH IS
THEY ALLOCATE MONIES TO LOCAL-
PROGRAMS. THESE LOCAL
PREVENTION PROGRAMS BUT WHEN WE
LOOK AT THEIR ALLOCATION
METHODOLOGIES AND THE FUNDING
THAT'S GOING TO DIFFERENT
COMMUNITY TO GET WHERE A GRAPH.
PACKET IT REALLY SHOWS.VERITY
AND- THEY PROVIDE PLANS TO LOW
LOW ENTITIES. OUT THERE USING
INFORMATION THAT IS DATE BACK
TO TWO THOUSAND AND SO THEY
HAVE AN UP IN THAT. FORM
REFLECT WHAT. IS BEING DONE OF
FIGHTING FOR HIS FOR AS THE
NUMBER OF KIDS BEING TEST. AND
WHICH COMMUNITY REALLY NEED THE
FUNDING SO THERE'S REALLY A
DISPARITY IN AB PROBLEM AND HOW
THEY'RE ALLOCATING THE FUNDS.
TO THE DIFFERENT COMMUNITIES TO
DEAL WITH- THIS THIS SITUATION-
IN THEIR RESPECTIVE
COMMUNITIES. SO AT A HIGH LEVEL
APARTMENT HEALTH CARE SERVICES
TESTING EDUCATION PUBLIC HEALTH
RISK MITIGATION ABATEMENT. AND
THEN PROGRAM MANAGEMENT SO WITH
THAT MEMBERS I'M GONNA HAND
OVER MISTER KLEIN AND HILL
START STEPPING YOU THROUGH
OTHER MATERIALS THAT YOU ALL
RECEIVED FROM. PLEASE A GOOD
AFTERNOON FOR THE RECORD MY
NAME IS JONATHAN KLEIN AND I'M
THE PRINCIPAL AUDITOR WITH THE
CALIFORNIA STATE AUDITOR'S
OFFICE AFTER PERSONS COMMITTEE
MEMBERS THANK YOU FOR ALLOWING
US TO PROVIDE YOU WITH
INFORMATION ON CHILDHOOD LEAD
LEVELS- AS WE KNOW SOCIETY HIS
USE LEAD FOR A VARIETY OF
PURPOSES- THIS INCLUDES
PLUMBING PAINT AUTOMOTIVE FUEL
AND ALTHOUGH THESE USES HAVE
BEEN BANNED IT'S STILL USED IN
CAR BATTERIES. ELECTRONICS THE
CONSEQUENCE OF THESE USE IT IS
LEAD CONTAMINATION THROUGHOUT
OUR STATE. THE EFFECTS OF LEAD
EXPOSURE WELL KNOWN ON PAGE TWO
OF THE DOCUMENT WE PROVIDED
YOU. HAVE WE SUMMARIZE HOW
ELEVATED LEAD LEVELS CAN LEAD
TO REDUCE I Q. HEARING DAMAGE
BEHAVIORAL DISORDERS. AND IN
EXTREME CASES SEIZURES AND
DEATH. AS A STATE AUDITOR
DESCRIBED DH CS IS RESPONSIBLE
FOR MAKING SURE THAT CHILDREN
IN MEDI CAL ARE TESTED FOR LEAD
AGES ONE AND TWO. BUT HASN'T
DONE ENOUGH TO ENSURE THAT
THESE TEST HER. THIS IS AN
ONGOING CONCERN- IN MAY OF TWO
THOUSAND ONE OUR OFFICE
REPORTED THAT THEY WERE
CONCERNED HOW DID LEAD TESTING.
IN THE CHILDHOOD HEALTH AND
DISABILITY PREVENTION PROGRAM
TESTING RATES HAVE NOT EXCEEDED
25% IN THE PRIOR YEARS. AND
TESTING RATES IN MEDI CAL WERE
ONLY 17% BY THE STATE AUDITOR'S
OFFICE RECOMMENDED THAT THE
DEPARTMENT TAKE IMMEDIATE
ACTION TO IDENTIFY AND EDUCATE
THOSE PROVIDERS PARTICIPATING
IN MEDI CAL WHO WERE NOT
ORDERING BUT LET LET BLOOD
TESTS AS REQUIRED. BUT TODAY
TWENTY YEARS AFTER THOSE AUDITS
THAT AUDIT SOME THINGS HAVE
CHANGED. THE DEPARTMENT OF
HEALTH SERVICES HAS BEEN SPLIT
INTO THE DEPARTMENT OF HEALTH
CARE SERVICE HEALTH CARE
SERVICES AND PUBLIC HEALTH. BUT
UNFORTUNATELY IMPROVEMENTS IN
MY TESTING RATES HAVE BEEN
SLOWER. AS SHOWN ON PAGE THREE
OF THE DOCUMENT THAT WE
PROVIDED TO YOU. AND AS
CHAIRPERSON SALAS DESCRIBED.
DURING THE LAST NINE YEARS ONE
POINT FOUR MILLION CHILDREN IN
MEDI CAL DID NOT RECEIVE THE
REQUIRED LIKE TESS. ONLY TWENTY
FIRST 27% OF ELIGIBLE CHILDREN
ARE RECEIVING ALL OF THE
REQUIRED TESTS. AND THE STATE
STILL IS NOT CREATED A PROCESS
TO IDENTIFY AND EDUCATE THE
SPECIFIC PROVIDERS WHO ARE
FAILING TO PROVIDE THE STATUS.
IN OUR AUDIT PUBLISHED IN
JANUARY OF THIS YEAR WEMADE A
NUMBER OF RECOMMENDATIONS TO
ADDRESS THIS ISSUE. AT FIRST WE
RECOMMENDED THE DH CS COMPLETE
ITS CURRENT EFFORTS TO MEASURE
MANAGED CARE PLANS PERFORMANCE
AND IMPOSE SANCTIONS OR PROVIDE
INCENTIVES AS APPROPRIATE.
ALTHOUGH DHC ESTATES THAT IT
HAS IMPLEMENTED AN INCENTIVE
PROGRAM TO DATE IT IS NOT
PROVIDED ANY EVIDENCE THAT IT
IS MADE ANY LEAD TESTING
INCENTIVE PAYMENTS. SECOND WE
ALSO COMMENDED AGAIN THAT
HEALTH CARE PROVIDERS WHO ARE
NOT PROVIDING REQUIRED TESTS BE
IDENTIFIED AND REMINDED OF THE
REQUIREMENT TO PROVIDE THE
STATUS. THIS STRATEGY HAS
WORKED IN OTHER STATES AND
WOULD LIKELY HAVE AN IMMEDIATE
EFFECT EFFECT HERE IN
CALIFORNIA. IN ADDITION TO OUR
REVIEW OF DHT S. WILL ALSO
ASSESS THE EFFORT EFFORTS OF
THE CHILDHOOD LEAD POISONING
PREVENTION PROGRAM OVERSEEN BY
C. PH. WHICH IS RESPONSIBLE FOR
REDUCING THE NUMBER OF CHILDREN
EXPOSED TO LEAD. AND PROVIDING
CASE MANAGEMENT SERVICES TO
THOSE WHO HAVE LEAD POISONING.
OUT MY COLLEAGUE MISTER HOOPER
HAS ADDITIONAL INFORMATION ON
WHAT WE FOUND C. PH. THANK YOU
OF FOR THE RECORD MY NAME IS
JOSH COOPER I WAS THE LEAD ON
THIS AUDIT. BUT WHEN WE LOOK AT
CITY PH IS DATA ON LEAD TEST
RESULTS- AS YOU CAN SEE ON PAGE
FOUR OF OUR HAND OUT WE FOUND
THAT CERTAIN AREAS OF THE STATE
HAVE HIGH CONCENTRATIONS OF
CHILDREN WITH ELEVATED LEAD
LEVELS. WE'VE MADE THIS
AVAILABLE AS THE STATE AUDITOR
SAID ON AN INTERACTIVE
DASHBOARD AWARE WE'VE NARROWED
IT DOWN BY CENSUS TRACT. AND BY
LEGISLATIVE DISTRICT. OUT IN
SOME NEIGHBORHOODS AS YOU CAN
SEE IN THE PLOTS OF SACRAMENTO
COUNTY LOS ANGELES COUNTY THEIR
SIGNIFICANT CONCENTRATIONS OF
CHILDREN WITH ELEVATED LEAD
LEVELS. AND WE HAVE A
RECOMMENDATION TO ADDRESS THAT
MEDICINE CITY PH IMMEDIATELY
COMPLETE AND PUBLICIZED AN
ANALYSIS OF THE HIGH RISK AREAS
THROUGHOUT THE STATE. WE ALSO
FOUND THAT CITY PH COLLECTS
DATA ON LED INSPECTIONS AN
ABATEMENT ACTIVITIES FOR
RESIDENCES IN THE STATE. OF
THIS INFORMATION WOULD BE
USEFUL TO POTENTIAL HOME BUYERS
AND RENTERS. AND WE HAVE A
RECOMMENDATION TO THE
LEGISLATURE THAT- TO REQUIRE
CITY PH TO MAKE THIS
INFORMATION PUBLICLY AVAILABLE
IN AN ONLINE REGISTRY. THE
REASON IT IS IMPORTANT TO MAKE
THIS INFORMATION AVAILABLE
ABOUT WHERE THE RISKS TO
CHILDREN OR THE HIGHEST. IS
THAT A SO THAT SOMETHING CAN BE
DONE TO ADDRESS THOSE RISKS. ON
PAGE FIVE. WE HAVE WE LOOKED
SPECIFICALLY AT SOME OF THE
AREAS IN SACRAMENTO COUNTY AND
FOUND THAT OVER THE LAST FIVE
YEARS. WE FOUND THREE HUNDRED
AND THIRTY EIGHT CHILDREN WITH
ELEVATED LEAD LEVELS LOCATED IN
JUST TEN APARTMENT COMPLEXES IN
THE COUNTY. SOME OF THESE
COMPLEXES HAD DOZENS OF
CHILDREN WITH ELEVATED LEAD
LEVELS AS THE GRAPHIC SHOWS.
THIS SUGGESTED CITY PH IS NOT
ADEQUATELY REDUCING RISKS IN
THOSE HIGH RISK AREAS- THAT IT
IS REQUIRED TO IDENTIFY. OR ITS
CURRENT APPROACH IS TO IT-
CONTRACT WITH LOCAL AGENCIES TO
CONDUCT OUTREACH AND EDUCATION.
BUT WE'RE NOT SEEING THAT THOSE
ARE THOSE IT IS NOT ABLE IT IS
CITY PH HAS NOT BEEN ABLE TO
DEMONSTRATE THAT THAT- APPROACH
HAS BEEN EFFECTIVE. SO OUR
RECOMMENDATION IS THE CITY PH
TO DETERMINE THE EFFECTIVENESS
OF THAT APPROACH AND IF IT
DETERMINES THAT IT IS NOT
SUFFICIENTLY. EFFECTIVE THAT IT
SHOULD- REPLACE AUGMENT THAT
APPROACH WITH PROACTIVE
ABATEMENT OF LEAD RISKS IN THE
IN THE STATE. WE ALSO FOUND
THAT CITY PA TO SPEND- SHOWN
POOR MANAGEMENT OF THE CHILD
HAD LED PREVENTION PROGRAM.
PRIMARILY WE FOUND AS WE SHOW
ON PAGE SIX OF THE HAND OUT THE
CITY PAGES FAILED TO MEET A
NUMBER OF STATUTORY
REQUIREMENTS THAT WERE DO LAST
YEAR. THESE INCLUDE POSTING
INFORMATION ON THIS WEBSITE
ABOUT EFFORTS THAT IS TAKEN TO
REDUCE LEAD RISKS IN THE STATE.
AND COMPLETING OF. COMPLETING
AND PUBLICIZING A BI ANNUAL
REPORT WITH INFORMATION ON THE
NUMBER OF CHILDREN WITH
ELEVATED LEAD LEVELS THAT IS
RESPONSIBLE FOR. IN ADDITION
CITY PH IS NOT MET A STATUTORY
REQUIREMENT TO DEVELOP THE
REGULATIONS HEALTH CARE
PROVIDERS ARE TO USE. IN
DETERMINING WHETHER OR NOT TO
TEST A CHILD FOR ELEVATED LEAD
LEVELS WHEN THAT CHILD IS NOT
ON MEDICARE. WE GOING TO THIS
ON THE NEXT PAGE ON PAGE SEVEN.
CURRENTLY CALIFORNIA'S
REGULATION REQUIRED HEALTHCARE
PROVIDERS TO USE JUSTA SINGLE
APPROACH TO DETERMINING WHETHER
OR NOT A CHILD SHOULD BE TESTED
FOR LEAD POISONING. THAT IS
WHETHER OR NOT THAT CHILD LIVES
IN OLDER HOUSING- THAT IS
CURRENTLY UNDERGOING REPAIRS OF
RENOVATIONS. WE LOOKED DURING
THE COURSE OF OUR AUDIT AT
INDIVIDUAL CASES OF ELEVATE
CHILDREN WITH ELEVATED LEAD
LEVELS AND FOUND A NUMBER OF
CASES THAT WERE COSTS BY MORE
THAN JUST THIS SINGLE APPROACH.
OF FOR EXAMPLE WE FOUND CASES
WHERE A CHILD'S PARENTS WORKED
WITH LEAD AND THE PARENT WAS
BRINGING THAT- EXPOSURE HOME TO
THE CHILD. OR CASES- WHICH IS
BEEN MENTIONED- HERE ON THE
DESK THAT. WHERE CHILDREN WERE
EXPOSED TO LEAD THROUGH- THE
CANDIES THAT THEY EAT FROM
OTHER COUNTRIES. OR THROUGH-
TOYS OR OR HOME REMEDIES. OTHER
STATES INCORPORATE THOSE OTHER
RISK FACTORS IN THE REGULATIONS
USED TO DETERMINE RISK WHICH WE
SHOWING THE GRAPHIC ON PAGE
SEVEN. OUR RECOMMENDATION IS
THAT CALIFORNIA'S FINISHED THE
REQUESTED THE RECOMMEND THE
REGULATIONS THAT IT IS REQUIRED
TO DEVELOP AND INCORPORATE
THESE OTHERS SOME OTHER RISK
FACTORS. LIKE OTHER STATES DO
YOU. ON PAGE EIGHT WE GO ON TO
DISCUSS ANOTHER AREA WHERE CITY
PAGES DEMONSTRATED POOR
MANAGEMENT CITY PH HAS- NOT
ADDRESS THE LACK OF INFORMATION
THAT'S PROVIDED BY LABS WITH
TEST RESULTS AS WE SHOW IN THE
GRAPHIC. LABS SUBMIT TEST
RESULTS TO SEE PH IS CASE
MANAGEMENT SYSTEM BUT WHEN
THOSE TEST RESULTS DON'T HAVE
ADEQUATE IDENTIFYING
INFORMATION. THOSE TEST RESULTS
FALL INTO A BACKLOG THAT AT ITS
CURRENT RATE C. PH WOULD TAKE A
HUNDRED AND THIRTY TWO YEARS TO
PROCESS. OUR RECOMMENDATION
HERE IS TO THE LEGISLATURE TO
REQUIRE LABS TO REPORT
SUFFICIENT IDENTIFYING
INFORMATION INCLUDING A UNIQUE
IDENTIFIER OR MEDI CAL
IDENTIFICATION NUMBER WITH
THOSE LAB TEST RESULTS. FINALLY
ON PAGE NINE WE ADDRESS ANOTHER
AREA OF MISMATCH OF POOR
MANAGEMENT BY C. PH. C. B. H.
CURRENTLY- USES AN OUTDATED
FORMULA TO DISTRIBUTE- FUNDING
TO THE LOCAL PREVENTION
PROGRAMS. THIS OUTDATED FORMULA
HAS RESULTED IN AN EQUITABLE
FUNDING- BEFORE- THE LOCAL
PROGRAMS INCLUDING IN OUR
GRAPHIC WE SHOW RIVERSIDE
COUNTY HAD LESS THAN HALF OF
THE CHILDREN WITH ELEVATED LEAD
LEVELS AS SACRAMENTO COUNTY BUT
RECEIVED FAR MORE IN FINDING.
OUR RECOMMENDATION HERE IS THAT
CITY PH SHOULD UPDATE IT'S
FUNDING METHODOLOGY INCLUDING
USING DATE ON THE MOST READ ITS
MOST RECENT DATA ON THE COUNT
OF CHILDREN WITH ELEVATED LEAD
LEVELS. AND THAT IT SHOULD
REVISE THESE ALLOCATIONS BEFORE
EACH THREE YEAR CONTRACT CYCLE.
THANK YOU AND AT THIS TIME
WE'RE OPEN TO TAKE ANY
QUESTIONS. THANK YOU THANKS FOR
THE PRESENTATION OF THAT OVER
HERE AT THIS TIME WE GO IN AND-
TURN IT BACK TO MEMBERS ON THE
DIET SEE IF THERE'S ADDITIONAL
QUESTIONS FOR MANY MEMBERS ON
THE DíAS WILL START WITH
DOCTOR WHERE THE MOVE TO DOCTOR
PAN. THANK YOU THANK YOU MISTER
CHAIR- AND THANK YOU TO THE ON.
TO YOU FOLKS FOR THE FOR YOUR
WORK ON THIS AND- I'M CURIOUS.
YOU YOU TALKED ABOUT ON PAGE
SIX YEARS THE STATUTORY
REQUIREMENTS NOT MATT- HOW DID
SEAT HOW DID THEY RESPOND WHEN
YOU WHEN YOU ASK THEM ABOUT
THAT I MEAN. POSTING
INFORMATION A WEBSITES PRETTY
SIMPLE TO DO. UNLESS YOU
HAVEN'T DONE ANYTHING IN WHICH
CASE YOU WOULDN'T HAVE ANYTHING
TO POST. SO CAN YOU CAN YOU
WALK ME THROUGH WHAT THE- WHERE
THE RESISTANCE IS A WHITE WHITE
WHERE WE NOT DOING THIS. SIR
THANK YOU- CVH GAVE US VARIOUS
REASONS FOR THE DELAYS- MOST OF
THEM. BUREAUCRATIC IN NATURE-
SAYING THAT- WELL PRIMARILY
THAT THEY HAD OF BACON POSITION
IN THE- IN THE CHIEF POSITION
FOR THEIR LEAD PREVENTION
PROGRAM- AND THEN THAT THEY HAD
APPROVED- CERTAIN ACTIONS THAT
THEY WERE TAKING BUT THEY WERE
WAITING FOR HIGHER UP APPROVAL
BEFORE THEY WERE ABLE TO MAKE
IT PUBLIC. OKAY ALL THE WAY UP
IN THE NEXT PANEL MISTER WOULD
HAVE DONE WHAT IF I COULD ADD
MISLI HERE- WHAT MISTER HOOPER
SAID ABSOLUTELY AND THEN THE
OTHER ISSUE IS WE HANDED OUT AN
EXAMPLE OF CENSUS TRACK
INFORMATION AND THAT'S
INFORMATION THAT THE DEPARTMENT
OF. PUBLIC HEALTH IS REQUIRED
TO PROVIDE ON THEIR WEBSITE
IT'S CENTRIST IT'S IN IT IT
SHOULD BE REQUIRED SO WE
DECIDED TO USE OUR I. T. FOLKS
WE GOT SOME INFORMATION FROM
DEPARTMENT HEALTH CARE SERVICE
AS WE GOT IN FOR INFORMATION
FROM THE DEPARTMENT OF PUBLIC
HEALTH. MY I. T. FOLKS WERE
ABLE TO- USING G. I. S. AND
WORKING THEIR MAGIC- WE WERE
ABLE TO USE TABLEAU OTHER
INFORMATION TO BE ABLE TO
CREATE THOSE SENSORS TAX THIS
IS INFORMATION IS REQUIRED
POSTED ON WED. ONE OF THE THAT
THE DEPARTMENTS- GAVE TO US OR
SHARED WITH US IS THEY DIDN'T
WANT TO- DISCLOSE CONFIDENTIAL
INFORMATION SO THEY FELT THAT
THEY NEEDED TO BE CAREFUL ABOUT
WHAT THEY DISCLOSED ON THE
WEBSITE BUT OUR- POSITION IS
THAT'S FINE DO NEED TO BE
CAUGHT TEN OF THAT BUT THE AREA
THERE ARE WAYS FOR YOU TO BE
ABLE TO. ADDRESS THE FOR ME AND
AS WE DID WITH THE EXAMPLES
WE'VE SHARED WITH THE CHAIR
THEY'RE VERY SCARCE IN A
COMMITTED TO SHOW THOSE SPOTS
AND THAT WOULD PROVIDE
INFORMATION TO. THE PUBLIC S.
AS MISTER HOOPER INDICATED
WHERE THERE ARE AREAS IN THE
STATE THAT ARE PROBLEMATIC THAT
WOULD ALSO INFO STRANDED THAT
THE STATE WOULD WANT TO EMBARK
TO. PROVIDE THE FUNDING TO THE
GEN HAVE HI AS OF. IN THE
ENVIRONMENT TO HOPEFULLY DO
MORE PROACTIVE ABATEMENT AS
OPPOSED THIS THAT'S BEING WHERE
THE EIGHT ONLY HALF IN HOME
WHERE HAVE OUR- TESTED OUR
CONCERNS DEPARTMENT IS WAS WITH
THREE. TO. PROTECT THE
CONFIDENTIALITY OF A PARTICULAR
CHILD WHO HAS BEEN TESTED
POSITIVE FOR EXPOSURE LET JUST
WANTED TO ADD THAT. THANK YOU
MADAM WATER AND THANK YOU YOU
AND YOUR TEAM FOR ACTUALLY
PROVIDING THIS INFORMATION
STILL MAINTAINING THAT
CONFIDENTIALITY- BE INTERESTING
TO HEAR THE DEPARTMENT'S
RESPONSE IN THE NEXT PANEL ON
THAT. WITH THAT WE'RE GOING TO
MOVE TO SENATOR PAN. THESE
THANK YOU- SO WE MAY NOTE IN
OUR INTRODUCTIONS AND I THINK
YOU IN YOUR PRESENTATION THAT
TO US SOME OF THE LOW RATE OF
TESTING IS SOMEWHAT CORRELATED
WITH THE LACK OF ACTUALLY
VISITS FOR RIGHT FOR THE CHECK
UPS. CAN YOU PERHAPS SPEAKS FOR
THE- CHILDREN WHO ACTUALLY DID
GET THEIR CHECK UPS IN OTHER
WORDS YOU KNOW WHAT PERCENTAGE
OF PEOPLE ACTUALLY GOT TO LEAD
TESTING SO IN OTHER WORDS IS
OUR ISSUE THAT WE GOT ALL THE
KIDS WE SOMEHOW GOT AND WE WERE
WORKING WITH DTS ON THIS. GOT
ALL THE KIDS WE BUMPED UP THE
WELL CHILD GREAT TWO EIGHTY
PLUS 8590% IS THE LEAD TESTING
RATE GOING TO GO UP TO THE
PARALLEL YOU KNOW WITH THAT A
PRICE WILL GO UP SOMEWHAT OR DO
YOU HAVE A PROBLEM OF TWELVE
ACTUALLY BECAUSE YOU'RE BEING
SEEN BUT THEY'RE STILL NOT
GETTING THEIR LEFT TEST SO IT'S
ONE. WAIT FINDINGS WERE
REPORTING FOR THE KIDS WHO
ACTUALLY WERE SEEN IN TERMS OF
THE RATE OF LIKE TESTING SO. WE
WEREN'T WE WEREN'T PASSED WITH
COORDINATING BETWEEN THE TO SEE
WHAT IT SAID HOW- WE DO HAVE.
BY AND- A PERFORM MEASURE THC
WILL RAISE THE- THE- TESTING
RATE FOR LEAD LEAD OKAY. SO AND
THIS IS. VERY SIMILAR TO THE
SAME- TO THE RIVER THE
RECOMMENDATION THAT WE HAD IN
THAT THE PREVIOUS OFFICE. AUDIT
THAT YOU'RE REFERENCING. SO
SYSTEMS SO BASICALLY YOU DON'T
HAVE THAT INFORMATION BECAUSE
THEY'RE TWO SEPARATE AUDITS AND
THEY WERE LOOKING. PERHAPS YOU
SEPARATE DATABASES BUT WHAT I
CLEARLY ON SOLUTIONS I MEAN WE
CAN LOOK AT WRITING DIFFERENT
THINGS. WELL THEN THE SECOND
THING IS ACTUALLY YOU TALKED
ABOUT THE RISK FACTORS SO I
KNOW AS A PEDIATRICIAN AND I.
TAKE YOUR MEDI CAL PATIENTS
THAT- SOMEWHAT FAMILIAR WITH
THAT- NOW WE DO RIGHT NOW I
HAVE A REQUIREMENT THAT YOU
ACTUALLY DO TEST EVERY CHILD
THAT ONE AND- TWO YEARS OF AGE-
USE OF. THIS A RISK FACTOR. IS
THAT TO DECIDE WHERE TO DO
SUBSEQUENT TESTING IS THAT WHAT
YOU'RE SUGGESTING ARE. HOUSE
YOU MENTIONED THE OTHER STATES
ARE USING IT SO SOME PEOPLE OF
USES AND- WAITED SIDE WHETHER
YOU NEED. TO FIRST BASE NOT
RAISE YOUR HIGH RISK WE TESTING
YOU'RE NOT. BECAUSE THERE IS A
YOU KNOW THAT. SAYS LIKE. IS
NOW IN. CAUGHT YOUR YOUR- A
IT'S THOSE AS- AND HERE'S
ANOTHER STICK WITH DO ASK THAT
YOU FOR BLOOD SOMETIMES THERE
MAY BE A RELUCTANCE RIG. A
CHILD WAS TESTED FOR LEAD GOT
TO HEMOGLOBIN AT TWELVE MONTHS
OF AGE IN THEIR BACK FOR TO
YOUR VISIT THE PARENT LOOKS AT
YOU SAID. I REALLY NEED TO DO
THIS AGAIN WE'RE LIVE IN THE
SAME HOUSE WAS NEGATIVE LAST
TIME. AND IT AND SO I I'M JUST
ALSO THINKING FROM A PRACTICAL
POINT OF VIEW YOU KNOW. IF
YOU'RE A- THAT TERMS OF IF
YOU'RE LOW RISK DO WE STILL
TEST YOU ARE NOT I REALIZE THE
GUIDELINES ARE RIGHT NOW YES
YOU. STILL TEST TO DO ONE YEAR
TWO YEARS. BUT MAYBE YOU CAN
SPEAK TO HAVE OTHER STATES HAVE
USED THEIR RISK FACTOR- VERSUS-
WHAT WE'RE DOING HERE IN
CALIFORNIA. SHORT THAT'S AN
EXCELLENT QUESTION AND SO- AS
YOU MENTIONED THE REQUIREMENT
RIGHT NOW IS FOR TESTING ALL
CHILDREN AGES ONE AND TWO. IF
THEY'RE IN A CAL OR RECEIVING-
ANOTHER OF BENEFIT FOR LOW
INCOME CHILDREN. THE
REQUIREMENTS PAGE SEVEN IS A
REQUIREMENTS THAT APPLY TO
CHILDREN WHO ARE NOT IN THOSE
PROGRAMS. SO IF IN ORDER TO. IN
ORDER TO DETERMINE WHETHER OR
NOT A CHILD IS AT RISK THE
FIRST- FACTOR THE U. CONSIDERS
IS A CHILD IN THAT THAT THAT
PROGRAMS THAT BENEFIT THE
SECOND WOULD BE THE RISK
FACTORS THAT ARE CURRENTLY IN
REGULATION AND RIGHT NOW IT'S
JUST THAT SINGLE RISK FACTOR.
ABOUT DOES A CHILD LIVE IN OR
SPEND TIME. IN OLDER HOUSING.
OKAY SO JUST TO CLARIFY.
BECAUSE HE'S IS YOU MENTIONED
YOU'RE READY AND MEDI CAL AND I
THINK YOU'RE LOOKING AT SO ARE
YOU LOOKING JUST AT MEDI CAL
WHEN YOU'RE LOOKING AT THIS ARE
YOU LOOKING A PRIVATE INSURANCE
AS WELL. SO THE RISK FACTORS ON
PAGE SEVEN APPLIED ONLY TO
CHILDREN WHO ARE NOT IN MEDI
CAL. OKAY BUT IT IS IMPORTANT
TO NOTE THAT PARENTS CAN REFUSE
THESE TESTS YES RIGHT. OKAY SO
IF I COULD ADD DOCTOR PAN SO
THE STATISTICS THAT WE HAVE AS
FAR AS WE WERE SPECIFICALLY
ASKED TO LOOK AT CHILDREN IN
MEDI CAL SO OF THAT NOT THE
NINE YEAR WINDOW. THERE WERE
TWO PONT NINE MILLION KIDS WHO
WERE ELIGIBLE AT AGED AGES ONE
AND TWO TO BE TESTED WHAT SOUND
AND YOU SAW IN THE PACKET IS.
THERE'S YOU KNOW CLOSE TO TWO
MILLION OF THOSE CHILDREN THAT
DID NOT RECEIVE BOTH OR OR ONE
OF THE TESTS THE REASON WE
THINK THIS- ADDING THESE
ADDITIONAL FACTORS IN THE
REGULATIONS IS YOU'RE STILL
GOING TO INFORM THIS WILL
INFORM PROVIDERS. TO NOT JUST
ASK ABOUT THE ONE RISK FACTOR
FOR A METAL CAL CHAU CHILD WHO
IS A MEDICARE BENEFICIARY THERE
ARE OTHER FACTORS YOU SHOULD
CONSIDER FOR THAT CHILD BUT
THEN FOR THOSE PROVIDERS WHO
SEE CHILDREN WHO ARE NOT IN
MEDI CAL. THIS WOULD BE
INFORMATIVE TO THEM IT IS A
CHILD THAT PERHAPS IS EXPOSED
TO ONE THESE ONE OF THESE OTHER
RISK FACTORS THAT MAKE MAKE.
PROVIDER DECIDE WE NEED TO TEST
THE CHILD EVEN THOUGH THE
CHILD'S NOT A MEDIC WELL IT'S
NOT BANNED THAT THAT CHILD
TESTED THIS. THIS WOULD BE USED
FOR BOTH AND IT WOULD BURKE AND
SHIP IN WHO ARE NOT PART OF CAL
SO WE WOULD. FACTORS YOU'RE
GOING TO PENSION TEST CHILL WHO
ARE NOT IN MAY CAL MAY BE AT
RISK OF EXPOSURE LEAD POISONING
I HOPE THAT HELP TO ALL RIGHT I
KNOW THAT THAT'S HELPFUL- YEAH
AND I DON'T CALL TOUGH TALK MY
HEAD I THINK WE WANT TO LOOK
BACK AT SO IF YOU SHEET THESE
ITEMS I DON'T OF ALL THESE
ITEMS HAVE BEEN ALSO BEEN
RECOMMENDED BY A PUBLIC HEALTH
YOU KNOW- SCIENTIFIC BODIES OF
LOOK AT ACTUAL RISK FACTORS-
CERTAINLY LET IS EXTREMELY
SERIOUS SO WE WANT TO DO WHAT
WE CAN TO SCREEN LEAD. I ALSO
JUST WANT TO MAKE NOTE OF THAT
AND- THERE'S A LOT OF THINGS
PEOPLE WANT US TO SCREEN FOR
AND SO IN THE END FOR A YOU
KNOW SHE ACTUALLY VISIT YOU
KNOW WHAT GETTING A PENNY TO
THE PARENT COMPANY THINGS
LISTED TO CHECK OFF ANY
QUESTIONS THEY HAVE THE ANSWER
IT'S AT AROUND- WE HAVE TO I
JUST WANNA BE CONSCIOUS OF THAT
OTHER SIDE THAT BURDEN.
OBVIOUSLY THAT IS. IT'S SO
SERIOUS SO I APPRECIATE THIS SO
THE ONE TO BE SURE TO SEE.
LATER WITH WHAT THE EVIDENCE
SHOWS INTO OF WHAT ARE THE
HIGHEST. YEAH THE QUESTIONS
THAT HAVE THAT ACTUALLY MAKE A
DIFFERENCE IN TERMS OF. SCREEN
FOR LEAD TOXICITY. AS SOMEONE
WHO ACTUALLY USED TO PRACTICE
IN THE AREA OF WHEN I WAS A
TRAINING AT WHICH HAD A LOT OF
LET HOUSING. SO THANKS RIGHT
AND TO. VERY WE DID INCLUDE IN
THE REPORT IN THE INTRODUCTION
WE LOOKED AT WHAT CDC RAT OUT
THERE. AS FAR AS GUIDANCE AND
ALSO OUR DEPARTMENT OF PUBLIC
HEALTH AND WE USE THAT GUIDANCE
TO DETERMINE WHAT. SHOULD
POTENTIALLY BE OTHER RISK
FACTORS TO US ASSESS AND THAT'S
WHEN WE LOOK AT WHAT OTHER
STATES WERE DOING SO WE DID
RELIANCE ON RESEARCH THAT'S OUT
THERE. THANK YOU SO MUCH RIGHT
THANK SENATOR YEAH WITH YOU I
THINK BY SOME FORM HAVE THAT
DATA AND THOSE HOT SPOT. RIGHT
AND I BELIEVE ASSEMBLYMAN
GARCIA- THIS WAS ASSEMBLY BILL
TWENTY TO SEVENTY NINE.
IDENTIFIES AS THINGS DIVIDE.
THAT SUPPLIED WITH THAT WE'RE
GONNA MOVE TO SENATOR DOLLIES
AND MORE LOCKED IN CENTER. CHAU
LEVEL. ASSEMBLYMEMBER THAT
SENATOR DOLLINGER YOU CHAIRMAN.
SO ON ON PAG SEVEN I HAVE
ACTUALLY TWO QUESTIONS. IN NEW
YORK DAVE CHAPPELLE WALK THIS.
AND WE CHECK ONE BOX. SO WHAT
IT WILL ARE THEY FIND WE DO DO
WE ARE ANY OF. FOR ME AND WHAT
WHAT THE PROCESS LOOKS LIKE AND
WHO WHO THEY'RE ALL HITTING. IN
THEIR TEST AND I DIDN'T GET A
CHANCE TO. GO THROUGH THE
PAMPHLET THAT UNIT OUT SO IF
IT'S IN THERE I BY ME AND MR
BUT I WOULD ASK THAT QUESTION.
SO WE LOOK AT- WE LOOK AT WHAT
OTHER STATES WERE USING IN
THEIR- LEAD QUESTIONNAIRE- WE
LOOKED AT THEIR TESTING RATES.
OTHER THAN THAT WE DIDN'T GO
IN- VERY DEEPLY INTO- THE DATA
THAT OTHER STATES MAYOR OR MAY
NOT HAVE OUR OUR- OUR AUTO.
FOCUSED ON CALIFORNIA BUT WE DO
KNOW THAT BECAUSE OF OUR
TESTING RATE THAN CALIFORNIA-
WE ALSO KNOW THAT. ALTHOUGH NEW
YORK HAS TESTED HAS CHECKED ALL
OF THE BOXES. THERE MAY BE.
OTHER AREAS. THAT WE DIDN'T
INCLUDE IT THIS LOOKS THAT THAT
THEY COULD ALSO HAVE BEEN AND
FOR YOU KNOW WHIPS. DEMOGRAPHIC
THEY WERE. WITH IT REALLY
FOCUSED ON WANTED TO YOUR WITH
A FOCUSED ON. THE UNDERSERVED.
COMMUNITIES I MEAN I KNOW THAT
IT FROM NEARLY POSITIVE BUT
IT'S ALSO WANTED TWO YEAR OLDS
IN NEW YORK. OKAY MY SECOND
QUESTION IS ON THE NEXT PAGE
YOU HAVE. THIS VERY. STARTLING
TO ME THAT IT WOULD TAKE A
HUNDRED THIRTY TWO YEARS TO GET
THE BACKLOG OF TESTS THAT ARE.
OUT THERE SO CAN YOU ELABORATE
MAYBE ON WHY THAT IS AND IS IT
A LACK OF FUNDING IS IT. I MEAN
I THINK THIS IS SOMETHING THAT
DOESN'T DO ANY GOOD TO HAVE A
TEST IF YOU CAN'T CONNECT
ANALYZE IT AND DO SOMETHING
WITH IT. RIGHT AND THIS THE
YOU'LL NOTICE THAT THIS IS WHAT
ONE OF OUR RECOMMENDATIONS THE
LEGISLATURE'S CITY PH HAD. THE
PROBLEM HERE IS A LACK OF
INFORMATION WITH THESE LEAD
TEST RESULTS. AND THE- WHEN THE
LABS ART REQUIRE AREN'T
REPORTING FULL. CLEAR
IDENTIFICATION ARE ENDED
IDENTIFYING INFORMATION WITH
THOSE LAB TEST RESULTS CITY
PAGES DATA SYSTEM. CAN'T
AUTOMATICALLY PROCESS THAT
WHICH MEANS THE LOCAL AGENCIES
AREN'T ABLE TO IDENTIFY OKAY
HERE'S THAT THE LEAD TEST
RESULT. WAS LOOKING FOR- THIS
WHAT I NEEDED TO HELP OUT THIS
SPECIFIC CHILD. SO THERE ARE A
NUMBER OF PIECES TO THAT
PUZZLE- AND SO OUR
RECOMMENDATION ADDRESSES THE
VERY FIRST PIECE- AND I CAN'T
GIVE YOU MORE INFORMATION ABOUT
WHETHER OR NOT. THERE'S THE IF
THERE'S ANYTHING THAT I WOULD
SPECIFICALLY TARGET TO C. PH ON
THIS ISSUE. WELL AS YOU KNOW
OUR- JOB IS TO FIGURE OUT WHERE
THE SHORTCOMINGSARE AND THEN
TRY TO ADDRESS THOSE ISSUES AND
TYPICALLY I WOULD SAY 99% OF
THE PEOPLE AT LEAST VISIT MY
OFFICE ALWAYS NEED MORE
RESOURCES TO GET WHATEVER IT IS
THEY'RE TRYING TO GET DONE DONE.
AND I ALWAYS COME BACK WITH
SOMETIMES IT'S NOT. ALWAYS THE
RESOURCES AVAILABLE IT'S
SOMETIMES OUR POLICIES IN THIS
BUT IN THIS CASE I'M CONCERNED
THAT MAYBE OUR POLICIES IN
RESOURCES ARE A LINE BECAUSE- I
KNOW THAT. WE HAVE IN AREAS
THAT WE KNOW WE HAD HOT SPOTS
AND ASSEMBLY MEMBER GARCIA AND
I WORKED I WAS INNOCENTLY ON A
BILL TO. ADDRESS WHAT WE HAD IT
EXCITED BECAUSE WE KNEW THERE
WAS A THE- PROBLEM THERE BUT
FOR US WE'RE GONNA NEED THAT
INFORMATION TO MAKE GOOD
DECISIONS SO IT WOULD BE
HELPFUL. I THINK IF I COULD
JUST FOLLOW UP ON THAT
QUESTION. CENTER DOLLY ASKED WE
WERE LOOKING AT THE OTHER
STATES I LOOKED AT THE AUDIT ON
PAGE TWENTY THREE YOU HAVE A
LIST OF ALL THE STATE TO WORK
CALIFORNIA RANKS. OBVIOUSLY NEW
YORK- PENNSYLVANIA WAS RANKED
REALLY AYE BUT WERE THERE ARE
FACTORS YOU WERE ABLE TO
IDENTIFY THE BEST PRACTICES A
WHY. THOSE STATES WERE ABLE TO
TEST AT SUCH A HIGHER LEVEL TO
THE STATE OF CALIFORNIA. AGAIN
OUR OUR AUDIT FOCUSED ON
CALIFORNIAN WHAT WE'RE DOING
HERE. OKAY WHAT DOES RESERVE
MORLOCK THANK YOU MISTER CHAIR
JUST A FEW QUESTIONS THAT MAYBE
OBSERVATION FROM. WE HAD A
PROCESS CALLED RESULTS ORIENTED
GOVERNMENT- WE HAD OUR
DEPARTMENTS PUT TOGETHER
BUSINESS PLANS AND SAID THIS IS
WHAT WE DO AND THIS IS HOW MANY
WE DO AND THIS IS HOW WE'RE
DOING IT AND THIS IS WHY WE
JUSTIFY. OUR BUDGET AND SO WE
KNOW WHAT'S GOING ON AND IF
THERE STAFF PROPERLY OR DOING
MOSTLY DOING. AND SO THIS IS
JUST AN OPPORTUNITY TO. IT'S AS-
SENATE DOLLY SAID CHECK BOXES
AND MAKE SURE YOU'VE DONE
CERTAIN THINGS ARE. JUST SORT
OF CURIOUS YOU KNOW IT WITH
WITH MEASURING THINGS THEN YOU
MANAGE IT. SO ON BLOOD TESTS
YOU CAN REQUEST THAT CERTAIN
THINGS WE LOOK FOR- THE
TECHNOLOGIES. QUITE AMAZING-
AND I'M JUST WONDERING. I GUESS
FIRST QUESTION IS THIS JUST A
CHECK WITH SUGGEST LET'S MAKE
SURE WE GET THE BLOOD TEST SO
WHERE WHERE'S THE FAILURE. I
WAS AT DIFFICULT. THAT SOUNDS
LIKE A GOOD QUESTION FOR THE
OTHER AGENCIES I THINK THAT WE
COULD DEFER TO THE DEPARTMENT'S
BUT THAT'S ONE OF THE CONCERNS
THAT WE HAD WHERE THESE ARE
MANAGED CARE PLANS THEY'RE
GETTING PAID. YOU KNOW I'M
MOUNT IT'S NOT FOR SERVICE THEY-
RIGHT A PREVENTATIVE SERVICES-
AND PART OF PREVENTIVE CARE IS-
PROVIDING THESE TESTS FOR
CHILDREN MAKING SURE THAT
CHILDREN AGES ONE AND TWO.
WHERE WE SAW THE PROBLEM IS TO.
SERVICES IS NOT MONITORING
THOSE MANAGED CARE PLANS TO
MAKE SURE THOSE PLANS ARE
ENSURING THAT THOSE PROVIDERS
ARE FIGHTING ALL OF THE
SERVICES THAT. CHILDREN MEDI
CAL ARE ELIGIBLE TO RECEIVE IN
PARTICULAR- TESTING OF CHILLED
YOU JUST WANT TO. FOR CLOSURE
TO LEAD SO THE HEALTHCARE IS
NEEDS TO DO A BETTER JOB MAKING
MANAGED CARE PLANS THAT HAVE
THIS INFORMATION. BECAUSE THE
LACK. PORT ST OUT FOR THAT THE
MANAGED PLANS ARE ON TOP OF THE
PROVIDE TO MAKE SURE THAT THEY
ARE REMINDED YOU ARE WIRED TO
PROVIDE THIS SERVICE TO
CHILDREN AND MEDI CAL- AND IF
YOU'RE NOT PROVIDING SERVICES
WE NEED TO HAVE AN AT ITS OF
OUR RECOMMENDATIONS TO THE
DEPARTMENT OF COURSE IS WAS
MODEL BY CONTRACT WHICH- FOR
THE MET. FOR THE HANDS TO MAKE
SURE THAT THEY ARE REQUIRED IN
THIS IS PART OF WHAT WE
RECOMMENDED IN OUR PREVIOUS
AUDIT. THAT THERE ARE VERY
SPECIFIC SERVICES THAT MEDI CAL
CHILDREN ARE ELIGIBLE FOR AND
THEY SHOULD BE RECEIVING NO SO
YOU'VE GOT TO MAKE SURE YOU
HAVE. THAT THE STATE OF FOR TO
HOLD THE MANAGED CARE PLANS
ACCOUNTABLE WHICH WILL
INCENTIVIZE THEM TO HOLD THEIR
PROVIDERS ACCOUNTABLE. IN THE
MATERIAL THAT WE WERE GIVEN BY
THE COMMITTEE- ON PAGE FOUR IT
SAYS- THAT D. EIGHT C. S. HAS
ONLY RECENTLY BEGUN DEVELOPING.
IF PROGRAM EIGHT. WHAT'S AN
INCENTIVE PROGRAM WHAT IS IT
ANY IN THIS CASE AN INCENTIVE
PROGRAM IS EXTRA MONEY FOR
TESTING. SO AS A AS A PROVIDER-
REPORTS THAT THEY'VE PROVIDED-
THESE LEAD TESTS- DHS IS GOING
TO PAY MORE MONEY- IN IT'S- A
REIMBURSEMENT TO THAT THAT TO
THAT PLAN WHICH WOULD THEN GO
TO THE- YOU'LL BE. REWARDED
MONETARILY FOR DOING WHAT YOU
SHOULD HAVE DONE THAT'S EXACTLY
RIGHT SO WHAT ARE YOU PENALIZED
IF YOU DIDN'T. CAN YOU PAY. A
BONUS BACK CERTAIN DTS ALSO
HAS- IN ITS DEVELOPMENT AS A
PERFORMANCE- METRIC AND UP IT
HAS THE MEANS TO- ISSUE
SANCTIONS- IF PLANS ARE MEETING
THE- THE TARGETS THAT THEY
SHOULD BE REACHING FOR THEM
JUST MY LAST COUPLE QUESTIONS-
GOOD WE HOLD ACCOUNTABLE.
ULTIMATELY IT IS THE EXCESSES
RESPONSIBILITY TO MAKE SURE
THAT CHILDREN AND MEDICAL AYE
GETTING THESE TESTS SO WE DON'T
HAVE A CHIEF OPERATING OFFICER
AT. WE HAVE SECRETARIES WE HAVE
A GOVERNOR BUT I YOU KNOW I WAS
TOLD THIS BE A COMMITTEE THAT.
WE MEET THREE TIMES A YEAR. AND
WE'RE MEETING THREE TIMES A
WEEK. AND THE REPORT SIR REALLY
DISCOURAGING. AND IF THIS IS A
SAMPLING OF WHAT'S GOING ON IN
THE REST OF THE DEPARTMENTS IN
CALIFORNIA I'M GETTING PRETTY
NERVOUS PRETTY UPSET IN FACT
I'M I'M TRYING TO FIGURE OUT AS
ALLEGE THAT ARE NO LONGER AN
EXACT. AS I WAS SAYS COUNTY
SUPERMARKET HAD- SO FORGIVE ME
FOR BEING A LITTLE FRUSTRATED
BUT- I'M LOOKING AT THE THIRTY
THOUSAND FOOT LEVEL I I'M
SAYING HOW DO I IMPROVE.
BUREAUCRACY HOW DO WE- BUT
THEY'RE SUPPOSED TO BE DOING
AND DO IT WITH EXCELLENCE SO I
GUESS MY QUESTION IS DO WE
REORGANIZE DO WE LOOK AT THE
ORG CHART DO WE OUT SOURCE.
THESE ARE LIKE THIRTY THOUSAND
FOOT QUESTIONS BUT HOW DO WE
GET GOVERNMENT TO DO WHAT IT'S
SUPPOSED TO BE DOING AND DOING
IT. SO THAT. NO WE DON'T ALWAYS
DMV JOKES. WELL I SAID SENATOR
I THINK THERE ARE A VARIETY OF
THINGS OVERSIGHT HEARINGS LIKE
THIS HELPS CERTAINLY I KNOW THE
DEPARTMENT OF HEALTH CARE
SERVICES- AND PUBLIC HEALTH
WILL BE PRESENTING IN THE NEXT
THE NEXT PANEL THE OTHER ASPECT
IS THAT I THINK WORKS- QUITE
WELL THE FOLLOW UP PROCESS THAT
MIGHT. BE WE'VE ISSUE THE POOR
IN JANUARY- EARLY JUST READ THE
SIXTY RESPONSE TO ALL OF THE
RECOMMEND. THAT WERE MADE
RESPECTIVE APARTMENT WHERE LOOK
THAT IN. WILL BE POSTING THAT
ON OUR WEBSITE THEN WE FOLLOW
UP IN SIX MONTHS WE FOLLOW UP
IN A YEAR IF INPUT IF
RECOMMENDATIONS HAVE NOT BEEN
IMPLEMENTED AFTER YEAR WE
CONTINUE TO FOLLOW UP AND WE
ACTUALLY. HIGHLIGHT THOSE
AGENCIES A SPEC REPORT THAT
JUST IDENTIFIES HERE ALL THE
DEPARTMENTS AND THE ISSUES WE
IDENTIFIED RECOMMENDATIONS WE
MADE HAVE NOT IMPLEMENTED ITS
PLACED IT HERE WE FOLLOW UP.
YEARS COME UP FOR YEARS CUENTA.
EXACT SOMETHING THAT WOULD HOLD
COUNTY. I THINK SOME OF THE RE.
THAT ARE AND OF THE LEDGE.
THAT'S BEEN INTRODUCED HELP AS
FAR AS REQUIRING LABS THEY
REPORT INFORMATION TO BE ABLE
TO GET PAID THEY REPORT.
IDENTIFIABLE INFORMATION ARE
THE MEDI CAL- IDENTIFIER. IF
THE LABS WERE REQUIRED TO
REPORT THAT AND AN ADDITIONAL
INFORMATION THAT MAY BE
NECESSARY TO I'D BE ABLE TO
IDENTIFY THAT CHILD- YOUR GOING
TO BE ABLE TO- PROCESS MORE SO
SHE WON'T HAVE SEVEN HUNDRED
THOUSAND TESTS. WAITING TO BE
PROP. MANUALLY BY FOLKS AT
PARTMINER OF PUBLIC HEALTH- SO
I THINK THERE'S A VARIETY OF
DIFFERENT THINGS OVERSIGHT BY
THE LEGISLATURE- THE SOME OF
THE LEGISLATION THAT'S BEEN-
INTRODUCED DOES ADDRESS MANY OF
THE RECOMMENDATIONS WE MADE TO
THE LEAD. TO BECAUSE WE THINK
IT'S TO BE PATCHED TORY
CHANGES. OUGHT THAT WILL
STRENGTHEN THE PROGRAM AND
ALSO- ALLOW FOR MORE
ACCOUNTABILITY MORE
TRANSPARENCY BECAUSE SOME THIS
INFORMATION NEEDS TO BE ON THE
WEBSITE THAT'S WHAT ONE. DOCTOR
WHICH QUESTION. IT DEPARTMENT
IS RECALL. IN THE NATION WITH
RESPECT BACK ON THE WEBSITE AND
THEY CAN'T ARGUE WITH ANY OF
YOU TODAY AND SAY WE DON'T HAVE
THAT INFORMATION. WE USED THEIR
DATA WE USE DIFFERENT HEALTH
CARE SERVICES AND PUBLIC HEALTH
TOGETHER AGGREGATED DATA BY
CENSUS TRACT DID IT BY ASSEMBLY
AND SENATE DISTRICT SO IT IS
POSSIBLE TO DO THAT WE DID THAT
DURING THE COURSE OF THE AUDIT.
I THINK THE- OVERSIGHT HERE.
THIS MEMBERS ASKED OFFICE
QUESTIONS ASKED THE DEPARTMENT
QUESTIONS I THINK WE'LL
HOPEFULLY HOLD THE STATE OF
CALIFORNIA ACCOUNTABLE SO THAT
WE CAN IMPROVE- IN THIS
PARTICULAR AREA AND OTHER AREAS
THAT THAT THE MEMBERS OF THIS
LEGISLATURE ASK MY ALL. TO LOOK
AT. SO THAT'S HOW I WANT TO.
WORK MISTER HOOPER AND MISTER
KLEIN THANK YOU AYE AYE REPORTS
STRODE CANDID IS. TELLING WHAT
IS AN ALL IN THAT. IT TAKES
BRAVERY. BUT YOU'RE NOT THE CEO
YOU'RE NOT THE YOU NOT THIS SO
I DON'T KNOW HOW WE COULD PUT
THE OVERSIGHT ACCOUNTABILITY
BURDEN ON YOU AS WELL BUT I
APPRECIATE YOUR BEING WILLING
TO STEP UP TO IT BUT IT SEEMS
TO ME TO MAYBE SIT DOWN AND SEE
A BETTER WAY TO RUN A SEARCH
BUT I AM IMPRESSED. THANK YOU
VERY MUCH. THANK YOU MISTER.
THANK YOU CENTER THANK YOU FOR
THAT RESPONSE THE ONLY THING I
BUDGET SUB COMMITTEES WE CAN
ALSO. HOLD THEIR FEET TO THE
FIRE IS WELL FOR THE DEPARTMENT
STRUCTURE THEY'RE DOING WHAT
THEY'RE SUPPOSED TO BE DOING.
ESPECIALLY IF IT'S MANDATED
THROUGH LEGISLATION- WITH THAT
I WILL REMIND MEMBERS THAT WE
ARE NOW AT AN HOUR OF JUST THE
FIRST PANEL WE STILL OF THE
DEPARTMENTS COMING UP. WHICH
BASED ON QUESTION SO FAR HAVE A
LOT OF- INTEREST TO PROVIDE. SO
WE WILL MOVE TO SENATOR
MITCHELL INTO SENATOR LEYVA.
THANK YOU MISTER CHAIRMAN AND
WITH THAT I WILL HOLD THE-
LOCAL MY QUOTE. TO DEPARTMENT.
ONE IS THAT PRO. YOU WILL.
FIRST OF ALL I APPRECIATE. ON
THE TOWARDS TRANSPARENCY I WHAT
MORE IMPORTANT ME IS TO. AN
ULTIMATE WE MAY BE. AND SO FAR
WE'RE GONNA FOCUS RESOURCES
THAT'S RIGHT PUT THE
PARTICULARLY SINCE I REPRESENT.
THE CENSUS. THAT'S REFLECTED
HERE. AND WHEN I LOOK AT YOUR
AND PARK I KNOW THAT COMMUNITY
I KNOW BUT THERE'S ALLN COLDER.
AFTER L. DRILL NEAR THAT'S OF
ACTIVITY GOING ON THERE WERE
PEOPLE. OR PEOPLE UNTIL
PROBABLY SHOULDN'T HAVE. BUT
WHAT STRIKES ME. REFLECT THE-
DOESN'T IT WESTERN CENTER FIVE
ON THE THIRTY YEARS WHEN I A
LOT OF LET POLICY. I AM STRUCK
BY THIS LIST ON PAGE SEVEN- AND
SO MY QUESTION TO YOU IS WAS
THERE A POINT IN TIME WHEN WE
DID CONSIDER PROXIMITY I'M TO
LET PRODUCING FACILITIES AND
RESIDENCY HI RECIPE CALLED AS A
RISK FACTOR. THIS LIST STRIKES
ME. IN AND IT DOESN'T COINCIDE
WITH MY OWN RECOLLECTION SO
WHAT'S YOUR POINT TIME WE DID
THAT- SO MY RECOLLECTION OF THE
LAW IS THAT IT HAS NOT CHANGED
SINCE IT. OR TH REGULATION I
SHOULD SAY IS THAT IT HAS NOT
CHANGED SINCE IT WAS PASSED
INTERESTING THANK YOU. OKAY
THANK YOU SENATOR- WITH THAT
CENTER LEYVA WILL HOLD A
QUESTION FOR THE NEXT PANEL.
CENTER FOR TITLE FOR THE NEXT
PANEL AS WELL WITH THAT LET ME
ASK IF YOU HAVE ANY CONCLUDING
REMARKS IF NOT WE'LL MOVE ON TO
THE NEXT PANEL NO NO. SHAKE
SHAKE QUESTIONS MEMBERS THANK
YOU THANK YOU. LOOK AT THIS
TIME WE WILL MOVE TO AGENDA
ITEM NUMBER THREE COMMENTS AND
RESPONSES TO THE AUDIT. WE HAVE
DOCTOR BRADLEY GILBERT DIRECTOR
OF FORTY MILLION HEALTH
SERVICES AND CHASING COOPER
CHIEF DEPUTY DIRECTOR FOR
HEALTH CARE PROGRAM THE STATE
MEDICAID DIRECTOR DEPARTMENT OF
HEALTH CARE SIR. AND WE ARE
MONICA MARIAH BUT I LIVE DE
DIRECTOR CENTER FOR HEALTHY
COMMUNITIES CALIFORNIA FROM THE
PUBLIC HEALTH- IF YOU COULD
PLEASE APPROACH THE DIOCESAN.
PERHAPS WE PERCEIVE THAT ORDER
PLEASE. MISTER CHAIRMAN OF THE
CHAMBERS MEMBERS OF THE
COMMITTEE FIRST I'D LIKE TO
INTRODUCE MYSELF I'M DOCTOR
BRAD GO OVER YOUR NEW DIRECTOR
OF THE DEPARTMENT HEALTHCARE
SERVICES FOR THOSE WHO DON'T
KNOW ME I'M A PHYSICIAN WHO WAS
TREATED MEDI CAL INDIVIDUALS.
I'VE BEEN A PUBLIC HEALTH
OFFICER IN TWO COUNTIES. AND
THE CEO OF INLAND EMPIRE HEALTH
PLAN WHICH IS ONE OF THE MEDI
CAL MANAGED CARE PLANS IN THE
INLAND EMPIRE. RESIDENTS. WE
TAKE THIS REALLY SERIOUSLY. I'M
A PHYSICIAN I UNDERSTAND THE
IMPLICATIONS OF ELEVATED LEAD
LEVELS IN CHILDREN IN TERMS OF
ALL THE THINGS I'VE BEEN
BROUGHT OUT TODAY. IMPACTS ON
THEIR INTELLECTUAL DEVELOPMENT.
THERE'S ACTUALLY NEW
CORRELATIONS WITH INDIVIDUALS
THAT ARE EXPOSED TO LEAD-
BECOMING A MORE COMMONLY PART
OF THE JUSTICE SYSTEM AS
ADOLESCENCE DUE TO BEHAVIOR DID
OF EVER ISSUES. SO WE TAKE THIS
VERY SERIOUSLY WE KNOW THAT THE
AUDIT RESULTS IN THE AMOUNT OF
TESTING THAT'S OCCURRING IS
UNACCEPTABLE. THERE'S SOME GOOD
NEWS AT THE LEVEL OF POSITIVE
TESTING IS GOING DOWN. BUT IF
WE'RE NOT STING CHILDREN WE
DON'T KNOW IF THERE'S A CHILD
OUT THERE THAT HAS AN ELEVATED
BLOOD LEVEL THAT WE HAVEN'T
TESTED. SO AS HOUSING STOCK
TURNS OVER IT'S ABSOLUTELY TRUE
THAT THERE ARE MORE RISKS THAN
JUST HOUSING STOCK- BUT- YOU
KNOW. HOUSING IS A BIG PIECE OF
IT WITH THE LEAD PAINT. AND
THAT'S GETTING A LITTLE BIT
ABOUT OUR- BUT AGAIN. SUPPOSE
THAT HASN'T BLOOD LEVEL THEN WE
DON'T KNOW ABOUT THAT. WE DID
SIMILAR SIXTY DAYS STATUS
UPDATE TO THE AUDIT- WE BELIEVE
RUN SCHEDULE WILL TALK ABOUT
ONE ITEM THAT- BECAUSE OF
WHAT'S GOING WITH COVERT
NINETEEN WE WANT TO DO
SOMETHING A LITTLE. FRONT WE
NEED TO WORK CALL WITH CD PH.
ONE OF THE REAL KEYS HEROES
ALIGNMENT THAT WERE ALIGNED
WITH CD PH THAT WE'RE GETTING
THE TEST RESULTS THAT WE'RE
LOOKING AT A HIGH RISK AREA.
FEDERAL THERE'S A- DOWN TO THE
HEALTH PLANS AS THE AUDITOR
SIDE. AND EVENTUALLY TO THE
PHYSICIANS AND OTHER PROVIDERS
THAT ARE SEEING THE CHILDREN OR
NOT SEEING THE CHILDREN. IN
TERMS OF DOING LEAD TESTING SO
REALLY THE ALIGNMENT IS REALLY
REALLY KEY IN THIS WHOLE
PROCESS. HI CHOOSE A DOG
PANNIER ABOUT IF THE CHILD DOES
NOT COME IN FOR A WELL CHILD
VISIT THEN IT'S UNLIKELY
THEY'RE GONNA GET ALL THEY'RE
GOING TO GET THAT LEAD TEST I
MEAN IF THEY CONVINCE YOU KNOW
IF THEY'RE NOT TO STICK OF.
COURSE YOU CAN CHáVEZ CAN DO
THAT. THE WORK THAT NEEDS TO BE
DONE THERE BUT IF YOU'RE NOT
COMING IN. YOU'RE NOT GOING TO
GET TESTED AND SO I DON'T. KNOW
THAT I CAN SAY FOR THE RECORD
NUMBER MAKES ABSOLUTE SENSE
THAT THOSE TWO WOULD GO
TOGETHER. SO ME AND FOR THE
DEPARTMENT IT'S REALLY ABOUT
SEEING HOW WE CAN GET THE
ALIGNMENT ALL THE WAY DOWN- AND
CAN I WANT TO BE CLEAR THAT YOU
KNOW JC BURGERS ARE NEW
MEDICAID DIRECTOR WE UNDERSTAND
THE SERVICE OF THE SERIOUSNESS
OF THIS GOING TO WORK HARD. I
WILL ALSO MENTION THAT ENJOY-
WOULD HAVE CERTAINLY LIKE TO BE
HERE AND MONOCLE TALK ABOUT
THAT BUT SHE'S INVOLVED IN A
COURSE TO COVER NINETEEN
RESPONSE AND VERY HEAVILY
INVOLVED IN THAT'S AVAILABLE.
I'M GONNA HANDED OVER TO THE-
SUPER SOME OF THE DETAILS BE
AVAILABLE FOR QUESTIONS- AND
CONCERNS MANY OF WHICH HAVE
BEEN RAISED BY MANY OF YOU
ALREADY. THANK YOU PLEASE
PROCEED YES THANK YOU JC COOPER
STATE MEDICAID DIRECTOR AT THE
DEPARTMENT OF HEALTH CARE
SERVICES- JUST TO REITERATE
DOCTOR GILBERT'S. ON WE TAKE
THIS VERY SERIOUSLY WILL BE
ACTING IMMEDIATELY UPON. ON THE
AUDITS RECKON. I WILL WALK
THROUGH THE DEPARTMENT OF BONTA
HOW WE ARE. ON TO THE NATION'S.
ON A- LISTING ALL TYPE ON A-
THIS IN. ONCE WE WILL BE
EDUCATE BENEFITS. OF THEIR
RIGHT TO THESE SIR INCLUDING
SIR BUT ALSO AND LET THINGS. IN
THE NOTICES OF WHICH IS A MEDI
CAL COVERED SERVICE WE ALSO
WOULD BE HOLDING OUR MANAGED
CARE PLANS ACCOUNTABLE I'M-
VERY MEMBERS. ON THE PREVENTIVE
SERVICES LIKE LEAD TESTING WE
WILL BE ARMING MEDI CAL
PROVIDERS OF INFORMATION WHICH
IS WHICH OTHER MEMBERS HAVE
SEAT BEST. HAVE NOW. TO THE
THEY ACT ON THAT VI LEE
CLOSING THE- AND THEN WE WILL
BE IN M. IMPLEMENTING NEW
CHANGES TO OUR MONITOR POLITY
OVERSIGHT. AND I'LL GO INTO
MORE DETAIL ALL OF THOSE THINGS.
SO THE EMENDATION BY THE
AUDITOR. PORT WHERE THAT THE
DEPARTMENT SHOULD REMAIN CENTER
ROOM TO GET TO LEAD TESTING TO
CHILDREN WHO HAVE MISSED THEIR
REQUIRED TEST- IN EARLY MARCH
OF TWENTY TWENTY SO THEN THIS
MONTH THE DEPARTMENT HAS
STARTED MAILING TO ALL OF OUR
MEDI CAL MANAGED CARE CHILDREN
ABOUT FIVE MILLION IT WILL ROLL
OUT OVER AN EIGHT WEEK PERIOD.
ON PATIENT ABOUT RIGHT TO
PROVIDE SERVICES PUTTING A TEST
THE VAGUELY LIST KNOWS NO.
ARMING FAMILIES AND AS WITH THE
OF THE BILL THEY ARE THEY HAVE
THE RIGHT TO VERY COOL FOR THE
TO HAPPEN I'M WE ARE AT WORK
NOT WE WILL BE WHAT'S CALLED A
CALL HIM. SOMETHINGTHAT WE TO
DO WE WERE LARGE CHANGES AND
THEN PROGRAM MANAGED AND REACH.
TO ON HOLD BECAUSE OF KOBE
NINETEEN IN THE KRONA VIRUS WE
DIDN'T WANT TO GIVE CONFLICTING
INFORMATION WHICH IS
TENTATIVELY COMING OUT FROM OUR
PUBLIC HEALTH COLLEAGUES. IN
REGARD TO ACCESS TO SERVICES AT
THIS TIME SO WHAT WE WILL
CONTINUE TO SEE ALL OF THE
MAILERS BECAUSE WE DO THINK
IT'S AND- TO ARM. AND FISHERIES
WITH THAT IN. WE WILL NOT
CONVENE ACTUAL. PAIN FROM CARE
PLANS BENEFIT YOUR AND- WE GET
A LITTLE BIT MORE INFORMATION
FROM PUBLIC KALI IN THE AND
STATEWIDE. TO THE- SO WE- JUST
MAKE SURE I'VE WAS CLEAR AWARE
OF THE TODAY. BUT WE GET WEIRD
WE WOULD. THE PAINS FOR OUR
MEDI CAL. THE NEXT RECOMMEND.
HAS TO DO WITH PLAN AND
PROVIDER- OVERSIGHTS SO BY JUNE
OF TWENTY TWENTY THE DEPARTMENT
WILL BE SUBMITTING TO CMS
FEDERAL GOVERNMENT IT CONTRACT
AMEND. THOSE MANAGED CARE PLAN
CONTRACTS IN THOSE CONTRACTS WE
WILL MAKE CLEAR. BUILDING
PUBLIC. BUT CHILDREN HAVE
ACCESS TO LED LIGHTS AND THAT
THEY ARE DOING THE PROPER
OVERSIGHT ENSURE THAT THEY GET
THOSE SCREENINGS WE WILL ALSO
RELEASE WAS CALLED IN ALL PLAN
LETTERED AS THEY- ALLEGE USED
TO GIVE I DO TO MEASURE. BOB
BERRIES CONTRA ARE. S. PIECES
SO THEY ON IN THE DETAILS OF
THOSE WERE ALL MANAGED CARE
PLANS WILL RECEIVE THAT IT WILL
BE WORST. TO THEN EACH QUARTER
I REACH OUT TO ANY CHILDREN
YOUNGER THAN SIX YEARS OF AGE-
WHO HAVE NO RECORD. CAN CLOSELY
WITH PUBLIC HEALTH TO IT GET
THEIR DATA- AND MAKE SURE THAT
OUR MANAGED CARE PLANS HAVE
THAT BECAUSE IF THEY RECEIVE A
CONTACT. THAT SIT NEXT MAKES IT
REQUIRED IN IT'S IN IN ALL PLAN
LETTER IT'S ALSO VERY CRITICAL
THAT THEY HAVE A WAY OF
REACHING OUT TO PROVIDERS TO.
THE VISUALS THAT YOU WERE
RESPONSIBLE FOR HAVE NOT
RECEIVED A BLOOD SCREENING. I'M
IN WE WILL BE CLOSELY TO GET
INFORMATION TO OUR MANAGED CARE
PLANS REGARDING THAT. WE WOULD
NOT THOUGH- IN THE AUDITOR'S
REPORT THEY REQUESTED OR-
RECOMMENDED THAT WE REACH OUT
TO PROVIDERS ON A MONTHLY
BASIS. DEPARTMENT HAVE MODIFIED
THAT QUARTERLY BASED ON WHAT I
JUST SAID MAINLY BECAUSE WE
NEED TO GIVE PROVIDERS TIME
NOTICE TO DO OUTREACH TO GET
INDIVIDUALS IN AND ACTUALLY BE.
TO RUN TESTS ON THOSE CAN. WITH
THE- CONDITION SO WE HAVE
MODIFIED THAT TO. IS WE WANT TO
BE CLEAR AND TRANSPARENT DO YOU
REGARD NOT RECOMMENDING. WE
ALSO WILL REQUIRE MANAGED CARE
PLANS TO MEET WITH DEPARTMENT
THEIR POLICIES AND PROCEDURES
FOR HOW THEY WILL BE IN
COMPLIANCE WITH ORDERLY PORTING
PROCESS OUT REACH YOU THERE
RIGHT AND TO THEIR PROVIDERS.
WELL AS IN ADDITION OUTRAGE
EFFORT IN THIS CASE. THEN THE
NEXT THE NEXT OF PIECES THAT WE
WOULD BE MAKING SURE THAT WE
MOVE FORWARD IS THAT THIS WOULD
BE IMPLEMENTED IN OUR ANNUAL
AUDIT TOOL SO THE DEPARTMENT
IMPLEMENTED TO PULL ON WHEN WE
ARE GOING AND DOING LIKE. THE
MEASURE OR PROVIDER ON HIS
BERKELEY IT'S JUST BEEN AN
OVERSIGHT OF PREVENTIVE
SERVICES- WE WILL BE EXPLICITLY
ADDING IN THE BLOOD THAT SCREEN
PORTION INTO TO. BUT IT'S ARE
DONE. BY THE TIME WE JUST MAKE
SURE IT IS THAT THIS WOULD NOT
BEING ADDED IN THAT SPECIFIC
ITEM AND TOLD TO OF TWO TWENTY.
TO ALLOW CARE PLANS PROVIDERS
TO MAKE SURE THAT THIS IS
IMPLEMENTED AND THE WAY THAT
THEY OPERATE AND IN THEIR
SEASON PROCEDURES. THE LAST
RECORD ASIAN THAT CAME FROM THE
AUDIT REPORT HAS TO DO WITH
PERFORMANCE AND MONITORING DH
CS WILL RELEASE ITS FIRST
VERSION OF THE PREVENTATIVE
SERVICES UTILIZATION REPORT BY
DECEMBER OF TWENTY TWENTY WE
INTEND TO INCLUDE THE BLOOD
THAT SCREENING- IN THIS REPORT.
THE DEPARTMENT IS LOOKING AT AS
YOURS THAT YOU WILL START
REPORTING ON A REGULAR BASIS
THE FIRST ONE IS THE EXISTING
HE DOES MEASURE- THAT IS USED
NATION WIDE- ACROSS THE NATION.
HOWEVER THAT PARTICULAR-
MEASURE DOESN'T ALIGN THE STATE
LAW IN CALIFORNIA STATE LAW
REQUIRES TESTING AT ONE INTO
THE NATIONAL JR IS ANY UNDER
THE AGE OF TWO SO DOESN'T HAVE
A DIRECT CONNECTION WITH THE
CALIFORNIA'S. WHEN IT INTO THE
NO MATTER. WHICH I THAT IS
IMPORTANT ONE TO AT BECAUSE THE
DOES A LOT US TO LOOK ACROSS
THE OTHER SIDE TO SEE
CONSISTENCY WHAT HOW THEY ARE
DOING IT ALLOWS US TO HAVE A
BENCHMARK. TO SEE WHAT HOW WE
ARE MEASURE UP WITH OTHER
STATES SO IT'S TO MEASURE BUT
IN ORDER. SURE THAT WE ARE ALSO
COMPLY WITH STATE AND- THE-
WILL BE. WITH PUBLIC HEALTH AND
IN THE DEPARTMENT TO HELP IT
THE CALIFORNIA MEASURE WHERE WE
ALSO REPORT AT AGE ONE ENDED
AGE TO IN ORDER TO PROVIDE
ADEQUATE INFORMATION TO YOU IN
REGARDS TO WHERE ARE IN EATING
THIS RESPONSE. LASTLY I WOULD
MENTION- THERE WAS A
RECOMMENDATION THAT WE LOOK AT
pPURCHASED- OR PAYMENT
ARRANGEMENTS THE DEPARTMENT HAS
IMPLEMENTED BLOOD SCREENING IS
A PART OF OUR PROP FIFTY SIX
VALUE BASED PAYMENT. PROPOSAL I
WOULD LIKE FOR YOU. WE ARE
STILL WAITING FOR CMS IS
APPROVAL OR THE FEDERAL.
GOVERNMENT'S APPROVAL ON THAT
BASEMENT PROPOSAL BUT THE
DEPARTMENT HAS FULL INTENT IN
INCLUDING THAT THAT SCREENING
ON THOSE THAT THAT PAYMENT I
I'M PROCEDURES. THAT CONCLUDES
MY COMMENTS. THANK YOU PLEASE.
REVENUE FOR THE RECORD MY NAME
IS MONICA MORALIS I'M HERE WITH
THE DEPARTMENT OF PUBLIC HEALTH
I AM THE DEPUTY DIRECTOR OF THE
CENTER FOR HEALTHY COMMUNITIES
UNFORTUNATELY AS YOU HEARD
DOCTOR ANGEL COULDN'T BE HERE
WITH YOU TODAY SO I'LL BE HERE
REPRESENTING THE DEPARTMENT. HE
PUSHED BUTTON TO PRESENT TO THE
COMMITTEE TODAY AND I DO WANT
TO EMPHASIZE AS WELL THAT WE DO
TAKE THIS VERY VERY SERIOUSLY-
OVER THE PAST COUPLE OF YEARS
WE'VE BEEN WORKING WITH. A CLIP
PROGRAM TO REALLY ELEVATE THE
WHAT THAT WILL DO IN THEIR-
AND- YOU KNOW LET ME HOPEFULLY
PROVIDE YOU A LITTLE BIT OF
BACKGROUND AS WELL TO HELP SET
THE CAR. STE IN OUR RESPONSE TO
THE ORDER. THE RIGHT NOW AND
JUST SEE IF I GET A SENSE OF.
PROCESSES OVER SIX HUNDRED
THOUSAND A LEAD TESTS- ANNUALLY
THAT REPRESENT ABOUT FIVE
HUNDRED THOUSAND CHILDREN
INDIVIDUAL CHILDREN- IN- 
REPORTS FROM OVER FOUR HUNDRED
LABORATORIES PERTAINING TO
THESE TESTS. OTHER TOTALLY
POISONING PREVENTION PROGRAM
CONTRACTS WITH FIFTY LOCAL
HEALTH JURISDICTIONS TO PROVIDE
THE CASE MANAGEMENT. AND THEN
THE STATE CLIP PROGRAM- DOES
THE CASE MANAGEMENT FOR THE
REST STATE LEVIN- REMAINING
JURISDICTIONS. AND TWO THOUSAND
EIGHT WE HAD OVER EIGHT
THOUSAND. OF WITH LAB TESTS
THAT DEMONSTRATED ELEVATED BUT
LET BLOOD THAT LEVELS- IN AGAIN
AS A REMINDER WE WORK WITH THE
LOCAL HEALTH JURISDICTIONS-
SOME OF THE CLIP PROGRAM
SUPERVISED THE CASE MANAGEMENT-
PERTAINING TO THIS TO ALSO DO.
SOME OTHER ENVIRONMENTAL
INVESTIGATIONS AND TO DO YOU OF
OUR REGION FAMILY- EDUCATION
AND TRAINING. WELL WE RECOGNIZE
THAT THE AUDIT FINDINGS SO-
REALLY HIGHLIGHTED SOME OF THE
AREAS THAT NEED TO CAN TO WORK
ON WE ALSO RECOGNIZE THAT THERE
IS SOME WORK THAT WE HAVE BEEN
DOING. REALLY TRANSFORM THE WAY
THAT WE'RE DOING BUSINESS AND
I'LL GIVE YOU A QUICK UPDATE ON
WHERE WE ARE AT IN TERMS OF
MEETING. THE AUDITOR'S
INUNDATIONS SO AS EACH YES
MENTIONED WE WILL CONTINUE TO
PARTNER AND ART STAFF MEET I
DON'T KNOW PROBABL MONTHLY TO
START REALLY LOOKING AT THE
DATA PROBABLY. DEPEND CONTINUE
TO ANNA YOU KNOW OF DATA AND
TRYING TO DO THE MATCHING WE
WILL BE USING THAT DATA TO THEN
DO TARGETED OUTREACH IF WE GET
IT FOR EXAMPLE ZIP CODE OR BY-
A PLAN WILL BE ABLE TO THEN
WORK WITH DH CS TO TARGET OR
ARE BOTH FOR THE INTEREST BUT
ALSO THE- CAN. I'M SHOULDN'T
ONE OF THE BIGGEST SETBACKS
THAT WE HAVE WORKED OR- YOU
KNOW ISSUES THAT WE'RE DEALING
WITH IS OUR ANTIQUATED DATA
SYSTEM WE COLUMN RASCAL RASCALS
MORE THAN TEN YEARS OLD AND IT
REALLY WAS MORE OF A REPOSITORY
SYSTEM THAN A REPORTING SYSTEM
SO WE ARE TRYING TO RIGHT NOW
WE'RE ACTUALLY GOING THROUGH
WHAT WE CALL THE HELP PROCESSES
TO CREATE A NEWS. OR ARE LEAD
PROGRAM AND WORK THAT SHIELD.
WELL WE'RE ALSO WORKING ON
RIGHT NOW IS WE HAVE CREATED A
MAP OUTLINING THE AREAS- WITH
HIGHEST CONCENTRATION OF
CHILDREN UNDER SIX YEARS OLD
WITH ELEVATED- BUT LEVEL CENTS
POSTED ON OUR WEBSITE ALREADY
AND WE'RE FINALIZING THE BINDER
REPORTS WHICH WILL INCLUDE SOME
OF THE INFORMATION THAT YOU
HEARD FROM THE AUDITOR'S
INCLUDING YOU KNOW ALLEN ZIP
AND ALSO THE RISK FACTORS-
RESPECT IS. CODE EXCUSE ME.
MOREOVER CITY PAGES TAKING
MULTIPLE STEPS REALLY WORK WITH
THEIR LOCAL HEALTH- CLIP
PROGRAMS WE ARE I JUST UPDATED
THEIR SCOPES OF WORK SO WE'LL
BE ABLE TO INCLUDE KEY VALUE
ASIAN EXPECTATIONS AND-
INDICATORS SO THAT ARE DEALING
WITH ABATEMENT THAT ARE DEALING
WITH CASE MANAGEMENT- WERE
ALSO. LOOKING AT WAYS THAT WE
CAN- BASED ON THE BURDEN OR
BASED ON THE NUMBER OF CHILDREN
WITH ELEVATED LEVELS THINK
ABOUT OUR FUNDING FORMULA AND
HOW WE CAN BETTER. S. WITH THE
FUNDING ALLOCATIONS THAT WE-
ARE ABLE TO MANAGE OR OR HAVE
ACCESS TO. AND THEN WE WILL-
STARTING IN JANUARY WE STARTED
TO DO THREE AT A MINIMUM THREE
VISITS A MONTH TO OUR LOCAL
CLIPS JUST TO WORK WITH THEM
LOOK AT THE PERFORMANCE AND BE
ABLE TO PROVIDE FEEDBACK. I'M
ONE OF THE RECOMMENDATIONS ALSO
HIGHLIGHTS THE- LIST OF FUNDING
FOR ABATEMENT ACTIVITIES THAT
SOMETHING THE AS- MANY OF YOU
MIGHT KNOW IT IT'S VERY
EXPENSIVE TO DO ABATEMENT A
HOME ONE HOME BY ITSELF
AVERAGES ABOUT. TWENTY TO
THIRTY FIVE THOUSAND DOLLARS SO
WE WERE TRYING TO CREATE A LIST
WHERE WE WOULD BE ABLE TO TAP
INTO FEDERAL. RESOURCES AND
ALSO LOCAL RESOURCES TO DO SOME
OF THAT. YOU KNOW KERN GOING
THROUGH THE TO PROCESS TO DO
FOR PERTAINING TO RESPECT TO
THE RESPECTIVE CRITERIA AND A
LITTLE BIT TO ANSWER SOME OF
THE QUESTIONS CURRENTLY AS WE
HEARD OF FROM THE AUDITOR
THEY'RE REALLY JUST ASKING DO
YOU LIVE IN A HOME THAT'S OLDER
THAN NINETEEN SEVENTY EIGHT AND
THEN UP QUITE LOOK AT THINGS
THE NECK TO FREE ARE YOU NEXT
TO AIRPORT OF SO IT HE'S AT AND
NAY. YET LET AND THOSE ARE SOME
OF THE OF RISK FACTORS THAT
WE'RE TALKING ABOUT THAT WEEK
WITH EXPLORING MORE HOPING TO
ACT BE DOING A FORMAL OF ONLY
PROCESS THE FALL OF MANY MANY
OF US HAVE BEEN IN THE WITH
REGULAR STILL THEY USUALLY
TAKES TWO THREE YEARS DEPENDING
ON THEN THE REGULATION. KIND OF
TRY IN ADDITION WE ARE. IN THE-
WE DID IT UP IN THE OF TWO
NINETY THE STAND OF CARE
GUIDELINES FOR PROVIDER. WE
ACTUALLY POSTED ON A WEB AND
AUGUST. THAT ALSO WAS PUBLIC ON.
ON THE MEDICAL OR NEWS THAT THE
MOM. AND ONE DO OUR ACTIVITIES
OF WITH PROVIDERS WE HAD ALSO
HE'S GIVE THEM THE AIM FOR.
JUST SO THEY CAN STAY ON TO IN
UNDER. WHAT THEY NEED TO AS A
PERTAINS TEST. I'M JUST TO HELP
IN OF LOW POISONING IN AND HE
REMINDED AND ABOUT THEM TO.
RETEST THESE KIDS. THANKS FOR
THE TESTIMONY- LET ME JUST.
FIRST TASK JUST VERY POINTEDLY-
SHOULD WE ACTUALLY QUESTIONS
ARISE FROM THE LAST PANEL BUT
YOU KNOW A LOT OF US WERE
DISAPPOINTED AND DISMAYED WHEN
WE LEARNED THAT ONE POINT FOUR
MILLION CHILDREN. I HAVE NOT
BEEN TESTED SO IF I CAN ASK
JUST VERY DIRECTLY WHY DIDN'T
THIS OCCUR- FROM YOUR
PERSPECTIVE AND THEN SECONDLY
FOR DEPARTMENT OF PUBLIC HEALTH
YOU KNOW THE STATE AUDITOR
PROVIDED US ALL INFORMATION
WITH. THE DATABASE TO FIND ALL
THE HOT SPOT WHY WAS THIS NOT
PROVIDED WHY WAS THIS NOT DONE
BY CITY PH THESE ARE QUESTIONS
KERRY FROM PREVIOUS PANEL.
PLEASE I THINK IT'S A DIFFICULT
ANSWER BUT I THINK THERE'S
REALLY THREE DIFFERENT PARTS TO
IT. AND IT'S ABOUT ALIGNING
BETWEEN ALL THE PARTS OF THE
SYSTEM. SO ONE IS YOU'VE GOT TO
GET INDIVIDUALS AND WE'VE GOT
TO GET CHILDREN IN FORTHEIR
FOR THEIR WELL JOHN PREVENTIVE
VISITS AND THEN. MY CONCERN IS.
IN ONE SEE EVEN IF THEY COME IN
FOR THOSE PREVENTIVE VISITS DO
THEY DO THE LEAD. SO YOU TO PUT.
THEY DON'T COME IN WHEN THEY
COME IN IF YOU DON'T DO THE
TEST SO THEY'LL BE ONE PIECE.
AND I THINK THERE'S A COUPLE
THINGS RELATED TO THAT. IS NO
MORE A VERY GOOD AT THE CLOSE
WE PAY FOR. THINGS THAT YOU
KNOW. IN THEORY SHOULD BE DONE.
I ALSO THINK THAT MONEY MAKES A
DIFFERENCE AND SO I THINK WHEN
WE THINK ABOUT INCENTIVES. FOR
PROVIDERS HAVING FOCUSED
INCENTIVES THAT MAKE THEM THINK
ABOUT A PARTICULAR THING LIKE
SOMETHING AS IMPORTANT AS LEAD
TESTING FOR CHILDREN. I THINK
THAT'S HELPFUL BECAUSE IT
FOCUSES ATTENTION. AND WE'VE
SEEN HALTH PLANS DO THAT. IN
DIFFERENT CIRCUMSTANCES THAT IS
BAD AND HELPFUL SO THAT'S ONE.
THING I'M HEALTH PLAN WELL. I
THINK IT'S BEEN MOSTLY A DATA
PROBLEM IT IS COMPLICATED
BECAUSE YOU'VE GOT CLOUT IT'S
GOING UP TO SEE PHD. YOU'VE GOT
SOME INFORMATION COMING BACK
THE PLANS BUT NOT THIS IS THE
TEST RESULTS THEMSELVES THAT'S
ABSOLUTELY CRITICAL BECAUSE
THEN YOU KNOW IN YOUR PRACTICE
pYOU KNOW YOU'VE GOT AWAY FOR
THE PLAN TO HELP YOU SAY.
HERE'S WHERE THE KIDS ARE
COMING FROM WHERE YOU'RE REALLY
CONCERNED ABOUT RISK AND TO YOU
KNOW HOW YOU DOING OVERALL IN
TERMS YOUR TEST. SO THERE'S
REALLY A DEBT PROBLEM AND I
THINK OF THE DEPARTMENT LOCAL-
NO SPEAKING NOT FOR THE
APARTMENT TIME BECAUSE OF THE
JOB FOR TWO WEEKS AND ONE DAY.
YOU KNOW THAT THAT FOCUS THAT.
ALL THE WAY DOWN FROM THE
DEPARTMENT TO THE PLANTS INTO
THE PROVIDERS HAS NOT BEEN AS
STRONG AS IT SHOULD BE BOTH
FROM A DATA PERSPECTIVE. THE
INFORMATION. AND I'M A BELIEVER
IN INCENTIVES AND PENALTIES I'M
A BELIEVER IN THEM. SO I THINK
THAT OPPORTUNITY NOW AS WE
PRESENT TO. GET THE DATA GET IT
BY MANAGED CARE AND HOLD THEM
ACCOUNTABLE FROM A FROM A
PENALTY OF YOU AT THAT LEVEL.
PROVIDE THE INCENTIVES THE
PHYSICIANS. TO MAKE SURE
THEY'RE THINKING ABOUT THIS AND
DOING THIS EVERY THEY HAVE THE
OPPORTUNITY IT UP WHEN YOU
CLOSE TO ONE YEAR CLOSE. YOUR
VOTE. TO ME THOSE ARE THE IS
THAT WEREN'T THERE. AND SO. YOU
KNOW. CAN I SAY WHY NOT- BUT I
CAN SAY THAT I THINK THE THINGS
THAT WE'RE GOING TO TRY TO DO
NOT TRY TO DO THE THINGS WE'RE
GOING TO DO WILL MAKE A
DIFFERENCE OKAY BUT IT WILL
TAKE TIME AND I APPRECIATE THAT
VERY DIRECT RESPONSE BUT- I
WOULD ASK. YOU HAVE. WHEN YOU
TALK ABOUT INCENTIVES YOU'RE
TALKING ABOUT PENALTIES. WHEN
YOU CONTRACT OUT WITH MANAGE
HEALTHCARE PLANS DON'T YOU HAVE
THEY ARE MAKING SURE THAT THESE
TESTS ARE DONE. YES THERE'S TWO
PIECES IN ONE IS WE'VE NOT DONE
THE MEASUREMENTS YOU KNOW
THERE'S NOT BEEN. THAT
PARTICULAR MEASURE THE HE JUST
MEASURE AND THEN THE SPECIAL
MEASURE WE'RE GONNA DO TO HAVE
ONE YEAR OLDS. HAVE NOT HAVE
NOT BEEN THAT'S NOT BEEN
SOMETHING THAT'S BEEN
COLLECTED- THERE'S BEEN MANY
OTHER MEASURES AS YOU KNOW
THERE'S BEEN AN ACCOUNTABILITY
AT. ABOUT A CERTAIN SET A
MEASURE. UP APARTMENT IS NOW
GROSSLY SIGNIFICANTLY INCREASE
THE NUMBER OF THOSE THOSE- TO
THOSE STUDY. BE DONE- AND THEY
RAISE THE PERFORMANCE LEVEL TO
A- WAS. THAT IT. YOU YOU KNOW
MAKE SURE WE'RE GETTING THAT
DATA FROM THE HEALTH PLANS SO
WE CAN HOLD THEM ACCOUNTABLE
AND I DON'T KNOW J. C. THANK
YOU AND I THINK THAT'S WHY YOU
SEE A NUMBER OF LEGISLATIVE
PROPOSALS AIMED AT HOW DO WE
INCREASE THE AMOUNT OF.
CHILDREN BEING TESTED SO THAT
WE CAN FIGURE OUT HOW TO
EXACTLY HELP THESE FOLKS.
ESPECIALLY IN THE- THE HOT SPOT
AREAS AND WE ASKED BERMAN
PUBLIC HEALTH ON. THE DATA
BECAUSE YOU KNOW THIS IS
BROUGHT UP TO AS A- AS AN
ISSUE. PLEASE YEAH AS I
MENTIONED EARLIER ARE. YOU KNOW
OUR KEY STRUGGLE RIGHT NOW IS.
OUR OUR DATE. CONTINUOUS MAN SO
I THINK THE AUDITOR'S MENTIONED
THAT ABOUT 10% OF OUR- DATA
STILL HAS TO BE MANUALLY
PROCESSED IN ADDITION. WHICH
MEANS WE HAVE TO DO A LOT OF
CLEANING WE HAVE TO THEN GO
BACK. TO MATCHING IN. PART OF.
THE INITIAL STEP FOR US WE READ
WANT TO. MAKE SURE WE HELLO THE
DATA THE- WE HAVE TO. WE HAVE
TO CLEAN. THEN READY TO REPORT.
WE ASK. HAD A FIRST DRAFT OF
THE REPORT- IN THE SUMMER AND
WE REALIZE LATER THAT. WE
DIDN'T HAVE THE MOST RECENT
WHAT WE DO WE DO. WE DIDN'T
HAVE THE MOST RECENT NUMBERS
AND SO PEOPLE WHEN WE SHOWED
THIS AND IF WE GET THE DATA
THAT WAS FOUR YEARS OLD YOU
WERE GOING TO SAY WE- HAPPENED.
THE MOST RECENT DATA WHAT WE
DID RIGHT NOW IS. THE PAST
COUPLE OF MONTHS. UPDATING THE
RIVER TO INCLUDE DATE FROM
TWENTY EIGHTEEN. AND SO WE'VE-
IT'S ALL IT'S TAKING TIME. AND
THEN OBVIOUSLY INC WILL WE HAVE
RIGHT NOW WITH CO NINETY IT'S
JUST ELAINE A LOT OF VERY AS
THOUSANDS OF REPORTS IN THE
DEPARTMENT TO KILL. AND I THINK
FROM. IT PERSPECTIVE YOU KNOW
THE WE'VE MANDATED SOME OF
THESE THINGS OF THE STATE OR TO
BE COLLECTED SO JUST WONDERING
WHY I'M ABLE TO GO ON LIKE A
WEBSITE AND SEE PER DISTRICT OR
PER COUNTY YOUR CODE HOW TO
JUST I'M OF THE STATUS OF
HARDWOOD. IS IT. LOOKING
PROVIDING THIS INFORMATION TO
THE PUBLIC. ARE YOU ON THAT
PATH WHERE YOU DON'T YEAH.
ABSOLUTELY WE ARE OUR OUR GOAL
IS TO HAVE THIS PUBLISHED BY
THE SPRING OF TWENTY TWENTY
WILL YOU'LL YOU WILL HAVE. THE
ZIP CODE DATA LOOKING AT. YOU
KNOW ZIP CODES WITH HIGH RISKS
YOU WILL ALSO SEE. MY COUNTY
THE NUMBER OF CASES THAT ARE
HAVE- ELEVATED BLOOD LEVELS SO
YOU'LL BE ABLE TO SEE ALL THAT
YOU CAN. TO OUR WEBSITE NOW IN
CHECK. THAT HAVE INTO YOU KNOW
IT'S FOR I. WE'RE JUST REALLY
FINAL SOME OF THE LAST MINUTE
DETAILS TO THE REPORT GOT IT.
RIGHT AND HAVING THAT DATA IS
GOING TO BE VERY IMPORTANT FOR
US TO. FIGURE OUT WHERE WE NEED.
IT IS HOT SPOT FOR THE ACTUAL
TESTING WHICH- WAS CENTER WE
ARE WITHOUT A- NUMBER OF
MEMBERS THAT HAVE QUESTIONS
WE'LL START WITH SENATOR
MITCHELL PLEASE. THANK YOU VERY
MUCH APPRECIATE THAT I'LL STICK
TO JUST ONE I KNOW YOU'VE GOT
MULTIPLE COMMITTEES HERE SO I
WILL. ASK ONE. I'M IT TODAY AND
I. SHE IN PERSPECTIVE THAT AS
WE ADD TO THE YOU KNOW YOUR
WILL CHILD VISITS YOU KNOW WE
ONLY PAY FOR. TWENTY THIRTY
MINUTES A SELF DID MANAGE CARE
THEY'RE GONNA HAVE TO EXTEND IF
WE CAN GET THROUGH THIS. I
HOWEVER I MUST SAY WE KNOW THAT
THE LONG TERM IMPACT- OF
EXPOSURE TO LET IS YOU KNOW
HUGELY DETRIMENTAL AND WHEN WE
CONSIDER THE CHILDREN WHO ARE
MOST LIKELY EXPOSE WERE POOR
KIDS WE HAVE TO ACKNOWLEDGE
THAT THESE ARE CHILDREN. WHO
ARE- READY COMPROMISED SECONDS.
AND FOR WHAT IT'S IT IT IT IT
HEIGHTENS OUR- TO MAKE SURE THE
DO THIS. THE WE DO WELL. I AM
LOOKING AT THE AUDITOR'S FULL
REPORT ON PAGE THIRTY SIX OUT
FOR THE DEPARTMENT OF PUBLIC
HEALTH. THEY LIST A NUMBER OF
MISSED DEADLINES ON A RELATION
TO. CURRENT LAW CURRENT CODE
SECTION. I WANT TO AS AS A
FOLLOW UP TO MY- QUESTION TO
THE FIRST PANEL. LOOK AT THE-
FOR LEGAL. WHICH IS THE FOR YOU
TO PROMULGATE RAGS TO INCLUDE-
A NEW DETERMINATION OF RISK
FACTORS FOR WHETHER CHILD IS AT
RISK AND I GO BACK TO THE CHART
THAT'S ALSO INCLUDED IN THIS
REPORT- AND WILD. PROMULGATING
RIGS YOU KNOW. CAN BE. AN
ARDUOUS TASK I GET THERE. IT'S
NOT IS ROCKET SCIENCE LET'S
JUST BE HONEST AND SO CAN YOU
GIVE US A NEW DATE BY WHICH WE
CAN REALISTICALLY EXPECT THAT
YOU WILL HAVE COMPLETED THESE
RAGS SO WE KNOW THAT IT WHETHER
IT'S THIS LIST WHETHER BASED ON
YOUR STAKEHOLDER PROCESS WILL
BE DIFFERENT. ME TELL YOU WHY
THAT'S IMPORTANT WHY I'M ASKING
WE ARE AS A LEGISLATURE IN THE
PROCESS OF TRYING TO EXPAND
ACCESS TO HOUSING- AND WE ARE
HAVING MULTIPLE CONVERSATIONS
ABOUT WHERE AND HOW QUICKLY WE
CAN BUILD AFFORDABLE IN LOCUM.
LOW INCOME HOUSING AND I DON'T
WANT US TO POSITION WHERE WE
ARE NOT YOU KNOW. SAYS SITTING.
LOCATIONS THAT ARE APPROPRIATE
FOR CHILDREN TO LIVE AND SO
WHEN I LOOK AT THAT LITTLE
DIAGRAM THAT I FOR THIS MY
DISTRICT IN JEFFERSON PARK
WHERE UP. BUILDINGS ARE SHEER
PROPERTY LINE WITH WITH WITH
WITH- OIL COMPANIES- WE NEED TO
MAKE SURE THAT WE ARE ACCURATE
PERMITTING WHERE. YEAH AND CAN
IN A POSITION WHERE WE'VE DEALT
WITH LEAD PAINT BACK TO
NINETEEN SEVENTY EIGHT AND ARE
NOT TECHNOLOGY ALL THESE NEW
RELEVANT MORE TIMELY RISK
FACTORS THAT ARE EXPOSING
CHILDREN TO LET WITHOUT
QUESTION. SO WHEN CAN WE EXPECT
THOSE REGULATIONS TO BE DONE.
SO WE ACTUALLY HAVE BEEN
WORKING VERY FEVERISHLY TO GET
THESE DONE LAST YEAR WE SPENT
PRACTICALLY ALL OF YOUR
CONVENIENCE STAKEHOLDERS IN AND
LET ME JUST KIND OF REMIND
FOLKS. THIS ALTHOUGH IT- A
PROCESSES THE PRICE IS NOT IN
ITSELF IS NOW WHAT THE ISSUE IS
THAT WE HAVE TO CONVENE THE
STAKEHOLDERS WE HAVE TO LOOK
INTO THE SCIENCE BEHIND THIS WE
CALL OTHER STATES WANTED TO DO
WHAT DID YOU LEARN WHAT CAN WE
DO DIFFERENT OR BETTER HERE IN
CALIFORNIA. ALL THAT IN ITSELF
HAS TAKEN ALL OF THESE MINES-
HE WE- WENT THROUGH THAT
PROCESS AND TWENTY NINETEEN WE
HAVE DRAFT IT SOME OF THE
REGULATIONS BASED ON. THEIR
FEEDBACK AND I NOW WE'RE HOPING
TO ACTUALLY HAVE IT IN THE FALL
OF TWENTY TO TWENTY. UP FOR
OPEN COMMENT TO WITH A
FINALIZED STRIKES FIGHT SPRING
OF TWENTY TWENTY ONE AND THAT'S
THE WAY FOR US ON. WORST CASE
SCENARIO IN THAT IT HAPPENED
WHAT'S- THE SPRING OF TWENTY
TWENTY. OKAY AND I GET THE-
PROCESS IN THE END AND IT AND
IT TAKES STUFF FOR REASONS WE
WANT TO HAVE STAY COLD ENGAGE.
KNOW WHAT DATE THE COLD WIND SO
LONG THIS ALSO A REALLY ABOUT
PLANNING ON YOUR PART IN TERMS
OF FACTORING IN ALL OF THOSE
STEPS THAT'S THAT'S A- CUSTOMER
PROCESS THAT YOU HAVE TO GO
THROUGH. WHEN YOU PROBABLY GET
ROEG'S ALL THE TIME SO SPRING
OF TWENTY TWENTY ONE. THANK YOU
MISTER CHAIR SHE THANKS. A MOVE
TO ASSEMBLY WOMAN THE GIRL. I
THANK YOU TO PAY BACK ON I. THE
BILL WAS PASSED IN IS AB
THIRTEEN SIXTEEN DOCTOR QUIRK
AND MYSELF IT SAYING THAT THESE
REGULATIONS HAD TO BE DONE BY
MARCH TWENTY NINETEEN AND WE'VE
MISSED THAT THAT LINE WE
HAVEN'T HAD A STAKEHOLDER
MEETING SINCE MARCH OF TWENTY
NINETEEN THAT'S BEEN AT LEAST
POSTED. AND SO YOU KNOW WHERE
WE'RE GOING TO DO THIS WE'RE
GONNA DO THIS AND I JUST HEARD
CONFLICTING DAY TO JUST TOLD
MISS MITCHELL THE WHOLE BY
TWENTY TWENTY. HOW A LIST YOU
JUST GONNA LEADING PROCESS IN
THE FALL TWENTY TWENTY AND THAT
SIX TWO THREE YEARS AND SO DOES
NUMBER SOMETHING TO MATCH UP TO
ME SO THAT I MISSED SOMETHING
THERE ON THAT CAN IN AND FOR ME.
SO I HOLDERS IN TWENTY NINETEEN
WE ARE WE DRAFTED- SOME OF
EXAMPLE REGULATIONS WORKING
WITH OUR LEGAL TEAM ILL GO
THROUGH THE APPROVAL PROCESS
FREIGHT IT GOES THROUGH OUR
DEPARTMENT HEAD AGENCY-
GOVERNOR'S OFFICE AND THROUGH
THE WHOLE PROCESS WERE HOPING
TO BE IN UP THEY CALL LATE THE
FORTY FIVE DAY WERE FOLKS CAN
COMMENT ON WILL WE ACTUALLY
CAME UP WITH SO WE'RE DOING TWO
SETS OF. IT IN FROM STAKEHOLDER
DOESN'T HELP. I DON'T KNOW THAT
HOW CLOSELY BUT I WILL SAY THIS
MY FIRST QUESTION IS WE HEARD A
LOT ABOUT WHAT WE'RE GONNA DO
SO THAT- PROVIDERS WERE WORKING
BETTER WITH A LOT OF WHAT WE'RE
GONNA DO SAID THERE'S
INFORMATION TO. THE INDIVIDUAL
THAT THEIR KIDS ARE GOING TO
THE DOCTOR ABOUT GETTING TESTED
I HAVEN'T HEARD ANYTHING ABOUT
HOW WE'RE GOING TO HOLD IN THIS
DEPARTMENT. IS A CULTURAL ISSUE
OF TREATIES COMMITTEES ARE
VULNERABLE IS COMMUNITIES ARE
LOW INCOME. I DON'T HAVE A LOT
OF FATE THAT EVEN THESE KIDS
ARE GOING TO BE AT WHAT WE IN
LAW THAT YOU ASKED TO THIS IS
AN ARTIST. IN ALL THOSE THAT
LIE. ON AN AND FOR ME IT'S WHAT
ARE WE DOING JUST WE HAVE IS
THAT. TIME BECAUSE IN THE
MEANTIME I HAVE THIRTY SECONDS
TO BE PUT I HAVE SEVEN THAT
CONTINUE. HELLO I KEEP AN EYE
ON. PRETTY REYES WHEN I. PEOPLE
COME COMMUNITIES THAT LOOK LIKE
MINE AND SO WHAT ARE WE DOING
TO CHANGE THE CULTURE AT THIS
DEPARTMENTS THAT WE PRIOR
PURCHASES WANT TO LOOK
COMMUNITIES I HAVEN'T HEARD
THAT YET. QUESTION I KNOW THAT
THIS IS- VERY IMPORTANT FOR
DIRECTOR AND OUR AGENCY AND I
ALSO KNOW THAT IT'S VERY
IMPORTANT TO OUR PROGRAM- YOU
KNOW LIKE THAT I'M A MOTHER- I
LET THE NOW AND I COMPLETELY
UNDERSTAND- THEY NEED TO MAKE
SURE THAT WERE ADDRESS SEEING
AT THE MOST HONORABLE ZIP CODS
THE COMMUNITIES AND WE ARE AT
IT WE'VE DONE A LOT OF YOU KNOW.
FOR A LOT. EACH MANAGEMENT IN
OUR- BRANCH AND IN OUR CENTER
TO GET AHEAD OF THE GAME AND
REALLY TRANSFORM AND BE MORE
INNOVATIVE ON THE WAY THAT
WE'RE APPROACHING THE WORK THAT
WE'RE DOING. I APOLOGIZE FOR
THE DELAY I ALSO KNOW THAT WE
NEED TO GO THROUGH THE
STAKEHOLDER PROCESS NOT JUST
SHOW THEM WHEN WE DRAFTED
SOMETHING BASED ON SCIENTIFIC
RESEARCH BUT- GET THE
STAKEHOLDERS PERSPECTIVE WE
HEARD A LOT FROM PROVIDERS ON.
HEALTH FOR EXAMPLE THIS WAS
REALLY CAN IT TAKE MORE TIME
THAN THE FIFTEEN MINUTES THAT
THEY HAVE AND THAT THEY NEEDED.
US TO BE CONSCIOUS OF ENSURING
THAT IT WAS IT A SMOOTH PROCESS
THAT THEY CAN JUST KIND OF GO
THROUGH AND CHECK UP SO. WE
NEED IN ORDER FOR THESE TO WORK
IN IT DOESN'T ACTUALLY TAKE
LONGER. TO GET OUT FOR OPEN
COMMENT REDUCE THE BACK FOR-
INITIALLY. BACK TO PLAIN I MEAN
I STILL UNDERSTAND WHY WE
DIDN'T DO THIS WHEN THE BILL.
WAS MOVING WHEN THE BILL WAS
SIGNED- THERE WAS AN AUDIT AND
YOU SURPLUS COMING INTO THIS.
LACK OF PLANNING- IN THERE YOU
HAVE PROVIDED SOME. DATA I
UNDERSTAND YOU DATA IS YOUR
SYSTEM AS OLDER YOU'RE TRYING
TO. UPDATE IT AND SO IT'S HARD
TO SPLIT UP WITH THE AUDITOR
WAS STILL ABLE TO USE YOUR
ANTIQUATED SYSTEM AND THE WAY
YOUR DATA IS COLLECTED TO COME
UP WITH THE PORTS FOR US. BASED
ON DISTRICTS BASED ON. THIS
TRACK YOU HAVE NOW YOURSELF
PROVIDED SOME INFORMATION. ON
YOUR WEBSITE AND WE HAVE TO
THAT HERE. IT DOESN'T BREAK IT
DOWN BY SIP CODE YET. ONE IS
GOING TO BE AVAILABLE FOR. YOU
IDENTIFY COMMUTE MY LOOK AT THE
ALLEY. FOR EXAMPLE I MIGHT MISS
OUT LIKE THAT THERE'S THE
CENSUS TRACK WHERE IT'S- IN
PLACE AND SINCE LOOKING AT
HOLISTICALLY WHEN ARE WE GONNA
SEE THAT TYPE OF MORE GREATER
DATA. AVAILABLE SO THE REPORT
WILL HIGHLIGHT- SIT CODE SO WE
CONSIDERED- AT RISK FOR. FOR
EXAMPLE AS WE MENTIONED THE
NEXT TO FREEWAYS BE NEXT TO
ROADS. THAT READ. WILL BE. IN
THE SPRING ON INDUSTRY OF
TWENTY. TO BE. COOL SO I GUESS
THE COULD CREATE AN A FOR THAT
VERSUS THE BY PHONE SEE AHA. OR
THEY CHILL TO. MAKE IT DOESN'T
FIT INTO ONE MY CHECK MY I
STILL GO CHECK IT OUT. ON IN
THAT AVAILABLE THEN FROM
AVAILABLE NOT. MISSION WAS
AVAILABLE THAT WHY THAT NOT A
BILL AT THAT LEVEL ON THE
WEBSITE FIRST YOU. TO LOOK AT
AND HOW OFTEN WITH THE STATE BE
UPDATED. WE'RE GONNA HAVE TO
WAIT AND WE'RE GOING TO SEE AN
UPDATE. THIS YEAR AND NOT ONE
FOR FOUR YEARS ARE GONNA BE
SEEING QUARTERLY UPDATES- AND
SO I GUESS. MY QUESTION IS THIS
DATA TO A PIECE US OR OR DO WE
REALLY HAVE A PROCESS THAT
WOULD THINKING ABOUT HOW THIS
IS DATA GOING TO BE USEFUL FOR
COMMUNITIES. FOR PROVIDERS FOR
LEGISLATORS AND HOUSING TO
UPDATE IT REGULARLY. SO OUR
GOAL IS TO ACTUALLY AND WHAT IT
TAKES THAT LONG. OUR GOAL IS TO
ACTUALLY UPDATE THIS REPORT.
ANNUALLY THE AND IT'S PART OF
ONE OF THE REQUIREMENTS AND ONE
OF THE STATUTES- BID IN
ADDITION TO THAT. WORRY WE HOPE
THAT AS A SYSTEMS. AND THE NEW
SYSTEM SHIELD IS IN PLACE THAT
WE COULD ACTUALLY DO THIS A LOT
FASTER- BUT AGAIN. THAT'S KIND
OF WHERE WE'RE AT RIGHT NOW.
WELL YOU'LL BE ABLE TO SEE IN
THE REPORT TO IS. YOU'LL SEE
THAT ARE NOW IS SLIGHTLY
DIFFERENT SO WE'LL HAVE THE
DATE OF. OUR OWN. TWENTY SIX
SEVENTEEN AND- EIGHTEEN YOU'LL
HAVE. FOR EXAMPLE BY THE NO. OF
CASES. LET BY. T. C. BAD YOU'LL
SEE SAID. WE CONSIER HI RISK
SO THAT REPORT WILL BE
PUBLISHED IN THE SPRING OF
TWENTY TWENTY. MY LAST QUESTION
ON THIS THIS NEW SHIELD A
PROGRAM THAT YOU ARE. WORKING
TO IMPLEMENT WE GAVE YOU MONEY
AND THE BUDGET LAST YEAR WORRY
OUT WITH THAT AND HOW QUICKLY
SECOND AB DONE. OKAY SO- WE'RE
GOING THROUGH THE HELP PROCESS
AND SORRY I'M NOT AN 80% BUT
WHAT I UNDERSTAND I KNOW THAT
WERE ON STAGE FOUR THERE'S FOUR
STAGES WERE ENTERING THE AST
STAGE WITH THAT- IN TERMS OF
THE PRESS. SINCE IT'S GONNA
TAKE ABOUT FOUR YEARS TO
FINISH- SHIELDS TO ACTUALLY
COMPLETE THE NEW DATA SYSTEM.
AND SAYS WE ARE. WE HAVE
COMMUNITIES THAT ARE BEING
PLACED AND NOW WE HAVE A NEED
NOW- I HOPE. I'M NOT GONNA ASK
THE QUESTION TODAY FIVE AM I
KNOW I'M NOT GONNA GET THE
ANSWER BY HOPE QUICKLY FIGURE
OUT HOW WE'RE GONNA CONSOLIDATE
THE FACT THAT YOU HAVE AN OLDER
SYSTEM AB WORKING WITH FREDDY'S
FOUR MORE YEARS AN EXPECTATION
THAT WE HAVE THAT WE GET. NEED
A RAID EARLY IN ITS UPDATED. ON
AND IT'S ACCURATE AS YOU DOING
THIS OTHER WORK AT THE SAME
TIME YOUR MULTI TASKING. AND
WHILE ON A MISSION WE HAVE
PROCESS THAT'S SMART BASED ON
SCIENCE TALKING TO STAY HOME.
THIS PRIORITIZE SO WE DON'T
HAVE TO CONTINUE WAITING FOR
ANOTHERFOUR YEARS FOR THAT TO
HAPPEN. THERE IS A LOT LET'S BE
NONE OTHER. THIS IS. FINDING
SOME OF THE SAME. OR DO. I KNOW
WE CAN ADOPT. TEMPORARY EXPENSE.
OF YOU KNOW WHAT WHAT WE SHOULD
BE TESTING FOR- UP AND THAT
THAT COULD BE AUGMENTED LATER I
JUST DELETED BUT WE KNOW ENOUGH
NOW THAT. I WOULD GET AT THEM
TO THIS LIST NINE WITH EVEN IF
IT'S NOT A COMPLETE LIST. THANK
YOU YEAH I THINK YOU'RE JUST
LIKE HEARING THE FRUSTRATION
ESPECIALLY BECAUSE WE ALL
REPRESENT A LOT OF COMMUNITIES
THAT ARE SUFFERING NOW AND- YOU
KNOW. WE'VE BEEN WAITING FOR A
LONG TIME AND WHEN WE SEE DATA
THAT'S AVAILABLE WE WANT TO SEE
THAT DATE ALSO AVAILABLE. LIKE
WEBSITE AS WELL SO THAT WE
START PRIORITIZING ESPECIALLY
AS WE'VE BEEN ALLOCATING MONEY
THROUGH THE BUDGET PROCESS. TO
START SEEING THOSE RESULTS AND
HELPING THOSE COMMUNITIES THAT
ARE SUFFERING THE MOST- SO I
THINK THAT'S WHAT YOU'RE
EXPERIENCING. TODAY FROM-
MEMBERS OF THE LEGISLATURE NOW
WITH THAT WILL MOVE TO SENATOR
LIFE PLEASE. THANK YOU MISTER
CHAIR. AND I DATA IS GOOD
RESULTS ARE BETTER LET ME
CHECK. WITH THAT. SO I WOULD
LIKE TO THINK MADAM AUDITOR AND
HER TEAM UP FOR ANOTHER
THOROUGH AUDIT. VERY EYE
OPENING VERY ENLIGHTENING. SO
WE KNOW IT IS A FACT THAT SINCE
NINETEEN EIGHTY SEVEN LET HAS
BEEN KNOWN TO CAUSE
REPRODUCTIVE DAMAGE AND- BIRTH
DEFECTS. SINCE NINETEEN NINETY
TWO WE KNOW THAT LED CAUSES
CANCER. AND IN THE LITTLE
EXAMPLE HERE OF BLOOD LEVELS
WHICH IS VERY EASY FOR SOMEONE
LIKE ME WHO'S NOT A DOCTOR TO
READ. THE VERY LOWEST LEAD IN
EXPOSURE TO CHILDREN IN THEIR
BLOOD CAUSES DAMAGE HEARING.
BEHAVIORAL DISORDERS AND JUST
DECREASED IQ LEVEL SO IT IS
ABSOLUTELY UNCONSCIONABLE TO ME
THAT WE ARE SITTING HERE TODAY
IN TWENTY TWENTY. AND WE ARE
TRYING TO FIGURE OUT HOW WE CAN
TEST CHILL AND- YEAH WE- BEEN
ARM VULNERABLE COMMUTE. I
APPRECIATE ALLOF YOU HAVE SAID
THAT YOU TO THIS VERY SERIOUSLY
BUCKLEY SOMEONE WAS TAKING A
VERY SERIOUSLY FOR ALMOSTA
DECADE- WHEN WE LOOK AT THE
AUDITOR'S KEY FINDINGS. DH DS
DID NOT INSURE OVER A NINE YEAR
PERIOD MILLIONS OF CHILDREN
ENROLLED IN MEDICARE SEE ALL
THE LEAD TEST THAT THEY SHOULD.
TO DETERMINE WHETHER THEY HAD-
HAD LEAD POISONING AND REQUIRE
TREATMENT WHY HOW DOES THAT
HAPPEN OVER ALMOST A DECADE. I
UNDERSTAND THAT YOUR NEW DOCTOR
HOW DOES THAT HAPPEN. THERE WAS
A FAILURE ON MANY LEVELS AND I
THINK THE FAILURE WAS A
COMBINATION LIKE I MENTIONED
BEFORE OF. NOT HAVING WORDING
THAT ALLOWS YOU TO SAY THIS
PLANS DOING OKAY ABOUT PLANS
NOT DOING OKAY THIS DOCTORS NOT
DOING AS WELL AS THEY SHOULD
PURSES THIS DOCTOR BECAUSE
THAT'S THAT'S THE WAY YOU
FIGURE OUT HOW TO HOLD PEOPLE
ACCOUNTABLE AS YOU KNOW WHERE
THE PROBLEM IS BECAUSE NOT
UNIVERSE I MEAN THERE ARE
POSITIONS THAT ARE VERY
ORGANIZED TEARS UP TO DO THE
WELL CHILD THEY REALLY HARD
IT'S ABOUT THE DO THE TESTING.
AND THERE'S OTHER PHYSICIANS
NOT AS MUCH BUT IF YOU HAVE THE
DATA WE DON'T HAVE THE ABILITY
TO MAKE THOSE COMPARISONS IT
MAKES IT HARD CHECKS IN TEXAN
MAKE SURE THAT THE DATE THERE
FIND IT AT. WAIT ANOTHER DESK.
I'M NOT IT'S I THINK IT'S TO
ONE IS THE DATE IS FRAGMENT SO
THE TEST RESULTS GO TO CITY PH
THE ACTUAL LEVELS THE PLAN GET
SOME RESULTS THE TEST HAS BEEN
DONE BUT REALLY YOU NEED THE
LEVELS SO I THINK WHAT YOU'RE
HEARING TODAY IS WE'VE GOT TO
FIGURE OUT HOW THAT ALL COMES
TOGETHER NOT ONLY COULD GATHER
BUT HAS A FIRE THE FACT THAT
THERE SEVEN THOUSAND. AS THE
DOOR OF DEAD OF THEM SEE AN
ATTACHED THAT TO A CHILD MAKES
IT REALLY DIFFICULT TO THEN SAY
ALL RIGHT WHAT'S THE STATUS OF
THAT CHART WHERE WAS THE CHILD
WHO IS THE POSITION AND WHAT
HEALTH CLUB WITH A- IF YOU. ARE
I DON'T UNDERSTAND. LAB
REPORTING WITHOUT A IDENTIFY.
WE ARE US. SO I THINK IT'S THAT.
OF GETTING THE DATA IT'S ALSO.
YOU KNOW HAVING THE REPORTING
UP TO THE STATE TO THE STAKE IN
ALL THE PLANS ACCOUNTABLE. SO
THE FAILURE ON MANY LEVELS. SO
IF THE AUDIT HAD NOT BEEN DONE
DO YOU THINK YOU WOULD HAVE
DISCOVERED THAT THIS WAS A
PROBLEM. BECAUSE I THINK THAT'S
THE BIGGER QUESTION FIGURE
CLOCK ARE WE MONITORING
OURSELVES AND ARE WE MAKING
SURE WE'RE DOING OUR JOBS. SO
AT THIS CHEESY COOPER- I THINK
THAT- THERE'S BEEN A LOT OF
RECENT CONVERSATIONS IN LIGHT
OF BOTH THE PREVENTIVE SERVICES
AUDIT AS WELL AS THE BLOOD THAT
SCREENING IN REGARDS TO THE
DEPARTMENT TAKING A STEP BACK
AND THINKING ABOUT HOW ARE WE
MONITORING OUR MANAGED CARE
PLANS. ON WHO THEN WE HOLD
RESPONSIBLE FOR MONITOR OUR
PROVIDERS TO DO WHATEVER IS IN
OUR CONTRACT AS DOCTOR GILBERT
WAS MENTORING THERE'S MANY
LAYERS OF HOW WE APPROACH THIS
AS WELL AS ARMING
BENEFICIARIES- AND FAMILIES
WITH THEIR RIGHTS. THEY HAVE
ACCESS TO AND SO I THINK PARTY
WILL BE I'M STEPPING BACK AND
THINKING STRONGLY ABOUT DOES
THAT LOOK LIKE HOW DO WE HAVE
BETTER SUCCESS HOW DO WE NOT
MIX- SOMETHING. WE COULD HAVE
INFORMATION- OR DATA OR AND SO
I THINK WE WILL CONTINUE TO DO
VERY STRONG THINKING IN THIS
AREA- PARTNER WITH OUR CARE
PLANS A PROVIDER OUT WHAT IS
THE BEST APPROACH HOW ENSURE
THAT PEOPLE ARE GET ACCESS TO
SERVICES THAT. I AM. AN THE IS
NOT A GREAT. BUT I THINK PART
OF IT IS WE DID NOT KNOW HOW
BAD THIS WAS THE DO NOT HAVE AN
ELEVEN THINK WE KNEW ABOUT THIS
WAS BECAUSE I THINK. YOU KNOW
GIVEN THEM THE LEAD EXPOSURE
AND WHAT IT DOES TO CHILDREN.
AND BY WE I'M I'M TALKING BOTH
YOU KNOW IT EVERY LEVEL- AND
THAT'S THAT'S NOT OKAY. IT'S
NOT A GOOD ANSWER BUT IT'S AN
HONEST ANSWER AND I CAN
APPRECIATE THAT. SO I GUESS
WHAT I WOULD SAY IS BECAUSE WE
KNOW THE DETRIMENTAL EFFECTS TO
CHILDREN THAT IT SHOULD BE ONE
OF THE TOP PRIORITIES FOR BOTH
DEPARTMENTS TO MAKE SURE THESE
TESTS ARE BEING DONE. BUT I
WOULD ALSO SAY THAT WE- YOU
KNOW WE WANT TO. WE WANT TO
TREAT THESE CHILDREN BUT SHOULD
WE DO A BETTER JOB OF
PREVENTION. I THINK IT GOES A
LITTLE BIT TO MS MITCHELL'S
POINT ABOUT US INDIVIDUALS
POINT ABOUT WHERE WE BUILD
HOUSES AND WHATNOT SO THAT IS
ALL OF US. BUT I WOULD LOVE TO
SEE THIS MOVIE TO IN A TIME IN
AN AREA WHERE WE ARE AND WE ARE
PREVENTING IT SO WE DON'T HAVE
TO WORRY ABOUT CHILDREN BEING
EXPOSED TO LEAD. AND DOCTOR PAN
I APPRECIATE YOUR- COMMENTS
ABOUT HOW LONG DO WE MAKE THE
FORM- I AM A NEW GRANDMA AND
I'VE BEEN TO THE PEDIATRICIANS
OFFICE WITH MY DOG- FILLS. ARM
AND I GET TO LOOK AT HER AND
WHAT SHE DOINGTHAT. BUT IT'S A
TWO PAGE FOR AND I MEAN IF WE-
ASK YOUR TO WATCH. I WE CAN PUT
ON THAT FORM YOU KNOW THESE
QUESTIONS ABOUT WHETHER OR NOT
YOUR CHILD IS EXPOSED TO LEAD.
SO YOU THINK COULD MAKE TAKE
ALONG. I THINK YOU TAKE OUT MY
LONGER I ALSO WONDERFUL. ABOUT
THOUGHT ABOUT DOORS. JUST IN
FOR. TO OUR SCHOOL. THAT THAT'S
HOW WE USED TO GET. PERMISSION
I WAS A CHILD TELL ME. GOT
PERMISSION. IN MAKE SURE
PARENTS KNOW THAT THEY SHOULD
BE ASKING THESE QUESTIONS WHEN
THEY TAKE THEIR CHILD MAKE SURE
YOU WERE TALKING ABOUT MAKING
SURE PEOPLE KNOW WHAT THEIR
RIGHTS ARE THIS IS A GREAT
PLACE O KNOW WHERE THEIR
RIGHTS ARE SO I AM FRUSTRATED
BECAUSE SINCE I'VE BEEN HERE I
HAVE HAD THREE BILL SIGNED INTO
LAW THE DEAL WITH LEAD.
POISONING IN OUR COMMUNITIES IN
OUR SCHOOLS WHY I AM PART OF
THE GROUP THAT HAS ANOTHER BILL
THIS YEAR- YOU KNOW WE IT'S TOO
BAD THAT WE HAVE TO KEEP DOING
THIS SO I THINK WE'LL KEEP
DOING IT FOR AS LONG AS WE NEED
TO BUT I ASK YOU TO PLEASE TAKE
THIS AS SERIOUSLY IT SHOULD BE
TAKEN THERE'S NO SAFE EXPOSURE
TO LET WE ARE HARMING OUR
CHILDREN AND DOWN DOWNSTREAM
IT'S GOING TO COST US EVEN MORE
TO DO THE REMEDIATION SO I
APPRECIATE YOUR HONEST ANSWERS
NOW WE JUST REALLY NEED TO DO
YOUR JOB THANK YOU. THANK YOU
THANK YOU CENTER LEVEL WITHOUT
LIVE TO ASSEMBLY MEMBER WOULD
THEN TO ASSEMBLY WOMAN RIGHT.
THANK YOU THANK YOU VERY MUCH
COUPLE. HAVE BEEN IN. BUT OF
ONE FUNDAMENTAL IS- THE AUDITOR
WAS ABLE TO TAKE DATA. AND PUT
IT TOGETHER FOR US TO SHOW THE
HOT SPOTS- IN. ARE YOU WHY
CAN'T YOU DO THE SAME KIND OF
THING IN THE INTERIM BEFORE
WAITING FOR THIS SHIELD COME ON
LINE WHICH YOU SAID MIGHT TAKE
FOUR YEARS. ARE WE NOT GONNA
HAVE DATA ON OUR WEBSITE FOR
FOUR YEARS. AND WHY WHY IS IT
SO DIFFERENT WHY WHY WHY COULD
THEY DO IT. AND YOU GUYS
COULDN'T DO IT. SO YOU WILL
HAVE A DATA OF THE BY IN A
REPORT AS I MENTIONED WILL.
HIGHLIGHT THE- COUNTY. WITH A
NUMBER FOR THE WEBSITE. THE
WEBSITE BUT THEN THERE'S A FULL
REPORT. DUE IN MARCH OF LAST
YEAR CORRECT AND THAT'S GONNA
BE WHEN WE'RE GONNA GET THAT
THIS SPRING OF THIS YEAR SO A
FULL WITH THIS WE'RE IN THIS
WORLD WHERE INSPIRON MOST IN
SPRING. SO IT'S A FOUR YEAR
LATE AND THEN THE NEXT BI
ANNUAL REPORT WILL BE TWO NEXT
YEAR OR WILL IT BE PUSHED OFF A
COUPLE OF A COUPLE OF YEARS
BECAUSE OF THAT. NO HOPEFULLY
BE DONE BY NEXT YEAR YEAH SO
EVEN THOUGH WE ARE CURRENT
RASCAL SYSTEM IS ANTIQUATED WE
ARE STILL CLEANING DATA MINING
DATA. TO GET THE REPORTS
PRODUCED. OKAY WE HEARD FROM
THE AUDITOR THAT ONE OF THE
ISSUES THAT WAS GOING ON- AND
WHY SOME OF THE DATA WASN'T
BEING COLLECTED WAS BECAUSE
THE- THERE WASN'T A DEPARTMENT
HEAD OR SOMETHING DO YOU HAVE
THE STAFF IN PLACE NOW. TO DO
TO SUPERVISE ALL OF THIS YES SO
AS OF APRIL OF LAST YEAR WE
HIRED A NEW BRANCH CHIEF- IN AS
I MENTIONED TO YOU BEFORE-
PRIOR TO HER EATING COMING ON
BOARD WE STARTED THE WHOLE
PROCESS OF LOOKING AT THE DATA
TRYING TO CLEAN THE DATA TRYING
TO MAKE IT. UP TO DATE AND THE
TIME WE WERE ABLE TO WORK WITH
THE AUDITOR THEY WERE ABLE TO
GET SENIOR DATA THAT YOU KNOW
WE WERE ABLE TO. GO THROUGH AND
ARE NOT ONLY IS A NEW DAY EVEN
PLACE BUT WERE ALSO IS- GOING
THROUGH A LOT OF THE- YOU KNOW
MANAGEMENT CHANGES IN A- BRANCH.
OR STAKEHOLDERS WERE CLOSER
WITH A LOCAL HEALTH- CLICK
PROGRAMS TRYING TO IT YOU KNOW
PROVE ON EVALUATION.
EXPECTATION IS THAT WE HAVE.
THERE'S MORE THINGS THAT WERE
DOING. OR ELLERY ACTIVITIES
HAVE STOPPED WE CONTINUE TO FOR
EXAMPLE REACH OVER ONE POINT
TWO MILLION FAMILIES ANNUALLY
WORK. ARE WORTH- BIT WE ARE
WORKING VERY HARD TO MAKING
SURE THAT WE DO BETTER WITH THE
REPORT IN OUR DATA IN ANOTHER
AND I HAVE TWO QUESTIONS ON AND
OFF ON THE DOT ON. ANOTHER ONE-
WAS IT IN AND SOME THE
DOCUMENTS WE GOT TODAY ONE OF
THE THINGS THAT WAS POINTED OUT
THAT- FUNDING FOR- DATA
COLLECTION ACTIVITIES OR OR
THINGS IN COUNTIES. ISN'T
ISN'T- ISN'T DISTRIBUTED IN A
WAY THAT MAKES SENSE FOR
EXAMPLE YOU HAVE IN ONE COUNTY
YOU'VE GOT FORTY KIDS AND NEVER
CAN YOU GOT EIGHTY KIDS WITH
THE COUNTY DISCOVER FORTIES
GETTING MORE MONEY. SO WHEN CAN
WE EXPECT SOME REFORM IN IN HOW
YOU'RE ALLOCATING RESOURCES I
HAVE A COUNTY IT'S IT IS
HIGHLIGHTED IN THE REPORT THAT-
HUMBOLDT COUNTY THAT- IS ONE OF
THOSE COUNTIES THAT. WE GOT
PARENTS WHO WHO WHO WHO DON'T
ALWAYS WANT TO COOPERATE AND I
UNDERSTAND THAT SO THAT MEANS
THERE'S ADDITIONAL FOLLOW UP
AD EDUCATION AND SO ON TO TRY
TO HELP. BUT ONE OF THE THINGS
THE REASONS THAT THAT THAT SOME
OF THAT ACTIVITIES AND
HAPPENINGS THEY DON'T HAVE THE
RESOURCES LOCALLY TO BE ABLE TO
DO THAT. SO HOW DO WE GET THE
FUNDING REFORM GOING AND HOW
LONG COULD THAT TAPE BECAUSE
IT'S CLEARLY NOT EQUITABLE- AND
THAT THAT'S JUST CONTINUE TO
ADD TO THE PROBLEMS. SO WE
SPEND SOME TIME IN THE FALL OF
TWENTY NINETEEN SO JUST A FEW
MONTHS AGO LOOKING AT OUR
FUNDING FORMULA. WE UPDATED
BASED ON THE LATEST DATA THAT
WE HAVE IN TERMS OF- A LITTLE
ELEVATED HE LEVELS BY COUNTY.
RIGHT NOW WE'RE IN THE PROCESS
OF LOOKING AT- A FUNDING
MECHANISM TO BE ABLE TO ELEVATE
THE FUNDING- FOR LOCAL HEALTH
DEPARTMENTS IN AS YOU ARE AWARE
OF. WE HAVE TO GO THROUGH THE
BUDGET PROCESS THE REPORT
EXPLORE THE BUDGET PROCESS TO
SEE WHAT KIND OF OPTIONS WE
WOULD HAVE TO DO THAT. WE HAVE
A GOOD SENSE OF NOW. BASED ON
THE NEW NUMBERS THAT WE HAVE
HOW WE WULD APPROACH IT IN TE
TYPE OF ALLOCATIONS THAT WE
WOULD MAKE. IT'S JUST NOW
FINDING WHAT MECHANISM DO WE
HAVE TO ACTUALLY OF MAN OR
AUTHORITY FROM THE BUDGET TO DO
SO. AND IT'S KIND OF A FINAL
FINAL FINAL POINT HERE YOU KNOW
THIS IS THE THIS IS NOW THE
THIRD RECENT AUDIT THAT- HAS
BEEN CRITICAL OF DCS AND THE
DOCTOR GO OVER. WELCOME ABOARD
AND I. AND THIS COOPER YOU KNOW
I APPRECIATE YOU APPRECIATE
THIS- WE'VE HAD ISSUES AND WITH
RURAL EXPANSION SO YOU KNOW.
THAT THAT'S CRITICAL WIN WIN
WIN BENEFICIARIES YOU'RE HAVING
TO TRAVEL HUNDREDS OF MILES
SOMETIMES TO GET CARE- NOW WE
HAVE THE WE HAD THE PREVENTIVE
CARE- ISSUE- AND NOW THIS ONE
AND I HEARD WHAT HURTS AS-
WELL. YOU KNOW WE NEED TO IN OF
THE PLANS ARE PARTIALLY
RESPONSIBLE. BUT BUT IN
EVERYONE OF THOSE AUDITS DH CS
HAS BEEN HIGHLIGHTED FOR NOT.
DOING THEIR THEIR JOB IN THAT.
AND I JUST WONDER HOW MANY MORE
OF THESE THESE KINDS OF ISSUES
ARE OUT THERE. AND THE
FRUSTRATION THAT I HAVE IS THAT
WE DON'T KNOW WHERE TO TURN
BECAUSE- WE'RE DOING WE'RE
PASSING LAWS WE'RE WE'RE WE'RE
WE'RE TRYING TO MAKE PROGRESS.
AND YET OUR OWN DEPARTMENTS
CAN'T SEEM TO MOVE ON ON THAT-
IT'S SAID THAT'S WHERE THAT'S
WHERE SOME OF THE FRUSTRATIONS
COMING FROM- IN. IT HOW DO HOW
HOW MUCH HOW MUCH MORE IS OUT
THERE I HAVE TO WONDER QUITE
FRANKLY- YOU KNOW PRIOR TO THE
TERM LIMITS BEING THE WAY THEY
WERE. SOME OF US WERE ONLY HERE
FOR ABOUT FOUR YEARS AND SO.
WAS PRETTY EASY TO IGNORE SOME
OF THIS A LITTLE BIT- BUT GUESS
WHAT WERE AROUND FOR LONGER.
AND WE AND WE- AND PART OF OUR-
ROLE AS LEGISLATORS IS
OVERSIGHT. AND WHEN WE FIND
THESE THINGS AND WE BRING THEM
TO YOUR ATTENTION TO ATTENTION.
WE FEEL LIKE WE'VE KIND OF HIT
A WALL BECAUSE WE GET WILL WILL
IMPROVE WILL IMPROVE. BUT AT.
THE PACE SEEM SOMEWHAT GLACIAL.
QUITE FRANKLY- AND- I YOU KNOW.
CAN SOMEONE GIVE US HOPE THAT
THINGS SPINACH. BUT HONESTLY
BECAUSE- AND THEN I CAN I CAN
GO BACK COME YEARS OVERSIGHT
WITH- LONG TERM CARE
FACILITIES- AND SOME AND
DUPLICATION AND WASTE AND
THINGS LIKE THAT- ONCE AGAIN
YOU KNOW SOMETHING THAT HADN'T
BEEN LOOKED OUT FOR A LONG TIME
SO I. I'M LOOKING FOR SOMETHING
OVER A RAINBOW OR SOMETHING BUT
I CAN. DO YOU SEE YOUR DO YOU
SEE OUR WHY WERE FRUSTRATED.
THE START WELL. YES I MEAN I
THINK THAT WE UNDERSTAND WHY
ARE FRUSTRATED JUST TO BE CLEAR
AND I THINK ON THE DEPARTMENT
IS GOING TO HAVE TO DO AN
EXTENSIVE DEEP DIVE IN REGARDS
TO HOW WE OVERSEE OUR MANAGED
CARE PLANS- ALL THE WAY FROM
THE GUIDANCE THAT WE GIVE THE
LANGUAGE IN OUR CONTRACT TO BE
CLEAR THE LANGUAGE IN THE
CONTRACT SOMETIMES IS SO BIG
ORDERS TO BEG THAT IT IS HARDER
FOR US TO HOLD PLANS
ACCOUNTABLE TO AN EXPECTATION
AND SO THE DEPARTMENT IS
CURRENTLY DOING A- FULL
REWRITE. OF OUR MANAGED CARE
PLAN CONTRACT TO MAKE IT MORE
SPECIFIC SO THAT YOU'RE NOT
HAVING A HUGE VARIATION ACROSS
THE STATE OF CALIFORNIA AND HOW
SOMEONE INTERPRETED THE
CONTRACTUAL YOU KNOW LANGUAGE
IN OUR CONTRACT BECAUSE OF THE
ELLIPTICAL IF THE CONTRACT
LANGUAGE IS TIGHTER IT ALLOWS
US TO THEN HOLD THEM
ACCOUNTABLE TO PUT THAT INTO
CORRECTIVE ACTION PLAN IT TO
SANCTION THEM SO WE ARE
STEPPING BACK AND LOOKING AT
OUR CONTRACT BECAUSE THAT IS
THE CONTRACTUAL OBLIGATION
BETWEEN THE STATE OF CALIFORNIA
AND DOES WE HAVE DELEGATED OUR
RESPONSIBILITY TO THE MANSION.
PLANNED PERCY THAT INCENSED
POINT FIVE MILLION LIVES AND
THEN IF YOU FOR SERVICE OUTSIDE
OF THAT AND SO ON THAT IS ONE
PLACE THAT WE ARE LOOKING AT IN
REGARDS TO TIGHTENING UP OUR IT
IS WITHIN THAT CONTRACT WITH
OUR MANAGED CARE PLANS WE ARE-
ALSO LOOKING AT HOW WE CAN DO
IMMEDIATE SUSPICIONS WITH AND-%
CALIFORNIAAS A- PLANT COUNTY
OF WE'RE ALSO STEPPING BACK AND
THINK ABOUT THE WAY WE DO CALL.
DIFFERENTLY IN SOMETHING'S
WRONG IN THE LAST YEAR OR SO%
I'M IN LIGHT AUDITS- BUT I
THINK OVERALL THINKING HOW CAN
WE THINK OF QUALITY IN A
DIFFERENT WAY I'M LOOKING AT
BOTH PROCESS QUALITY OUTCOMES
AND HOLD PLANS ACCOUNTABLE AND
THEN LASTLY I'M WE NEED TO
pMANAGED CARE PLANS BECAUSE
CLEARLY WE'VE BEEN AUDITING
CALIFORNIA IS THE ONLY STATE
WHO AUDITS MANAGED CARE PLANS
EVERY SINGLE YEAR IN THIS
NATION NO OTHER MEDICAID
PROGRAM DOES THAT THEY DO EVERY
THREE YEARS OR SO OFTEN BUT WE
NEED TO LOOK AT OUR AUDITING
PROCESS TO SEE WHAT ARE WE
MISSING OR HOW ARE WE-
CAPTURING THINGS THAT ARE
SHOWING. IN THIS AUDIT ON THE
PROCESS HE'S AS WELL IT SURE
THAT WE. ARE OUR TAKING A FRESH
LOOK THOSE ITEMS ON A- BASIS SO
I THINK THERE'S A MULTI PRONGED.
INTO IN REGARDS TO THAT THEN
THE DOWNSTREAM TO WERE HOLDING
MANAGED CARE PLANS RESPONSIBLE
AND THEN THEY MANAGED VERY
LARGE NETWORKS OF PROVIDERS-
AND HOW ARE THEY- ON WHETHER
IT'S- A PROVIDING INCENTIVES OR
INFORMATION OR GUIDANCE TO
THEIR PROVIDERS TO MAKE SURE
THAT THEY UNDERSTAND. ON THEIR
REQUIREMENTS AS A MEDICAID
PROVIDER WHICH IS. SOMETIMES
VERY DIFFERENT- THAN OTHER
PLAYERS ON AS WE MENTIONED IN
THIS HEARING TODAY. IT IS A
MEDICAID REQUIREMENTS TO SCREEN
FOR BLOOD THAT SCREENING AT AT
TWO AND AT ONE. BUT IS NOT AND
IT IS NOT A REQUIREMENT FOR ALL
OTHER PLAYERS IN THE STATE OF
CALIFORNIA. SO THEY NEED TO
UNDERSTAND BY COMING A MEDICAID
PROVIDER MEDI CAL PROVIDER IN
CALIFORNIA. THERE ARE OTHER
REQUIREMENTS THAT THEY HAVE TO
MEET IN ORDER TO DO THAT AND
SO. IF YOU'RE SEEING ONLY A
SMALL PORTION OF MEDICAID OR
MEDICARE BENEFICIARIES
SOMETIMES WE NEED TO MAKE SURE
PROVIDERS UNDERSTAND- THOSE
THOSE DIFFERENCES. AND THE
EXPECTATION WE HAVE IN OUR MEDI
CAL PROGRAM. THEY'RE SEEING A
VERY LARGE PORTION OF MEDI CAL
BENEFICIARIES- SOMETIMES THEY
HAVE AS DOCTOR GILBERT
MENTIONED EARLIER. VERY TIGHT
PROCESS SEES IN REGARDS TO THE
EXPECTATIONS OF THE MEDICAID OR
MEDICARE PROGRAM. SO A LOT OF.
THESE THE LAST PORTION AND
DEFINITELY THE LEASES HOW DO WE
MAY SURE BENEFITS. ARE AWARE OF
THEIR RIGHTS AND PERFECT-
PROTECTIONS IN THIS PROGRAM IN
PARTICULAR TODAY THERE EPS YOU
T. BENEFIT PROGRAMS AND I THINK
WE ARE THINKING THROUGH A
NUMBER OF WAYS IN WHICH WE CAN
DO THAT. ARE BOTH OUR FAMILIES
BENEFICIARIES WITH- INFORMATION
AS WELL. WE DOCTOR WOULD I SAY
TO MY I SAY TO THE HEALTH PLANS
THE GOOD NEWS IS. I KNOW WHAT
HEALTH PLANS CAN DO AND HOW
THEY OPERATE. THE BAD NEWS FOR
YOU IS A HEALTH PLAN IS I KNOW
HOW HEALTH PLANS OPERATE. AND
WHAT THEY'RE CAPABLE OF AND SO.
I BRING A LOT OF EXPERIENCE IN
TERMS OF THINKING ABOUT HOW TO
AUDIT. IN TERMS OF THINKING
ABOUT HOW TO HOLD ACCOUNTABLE.
BUT I HAVE TO SAY. THE
DEPARTMENT IS REALLY RAISE THE
BAR AROUND QUALITY AND THEY DID
IT LAST YEAR AND IT WAS. YOU
KNOW THERE'S THE- RESULTS DRIVE
CHANGE THEY DO- BY RAISING THE
MPL THE FIFTIETH PERCENTILE
THAT IS A BIG DEAL IN TERMS OF
CREATING THAT STANDARD BECAUSE
THAT'S A NATIONWIDE STANDARD.
AND FIFTY OF APPEAL MEANS HAVE
PLANS ARE BELOW IT. AND HELP
PLANS ARE ABOVE IT AND THEN
REALLY LOOKING AT. AND THEY
INCREASE THE NUMBER MEASURES
THAT ARE OUT THERE SO. I FEEL
LIKE SOME POSITIVE CHANGES HAVE
BEEN STARTED TO BE MADE FOR
SURE. AND I THINK- JC IS A BIG
PART OF THAT- BUT I DO BRING
SOME SPECIALIZED KNOWLEDGE THAT
I THINK WILL HELP IN THIS AREA.
THANK YOU. THANK YOU FOR THE
SAME MOVED ASSEMBLY WOMAN RAY
AS AND SENATOR WHITE HOUSE
CONSIDER. PLEASE DISTRICTS.
I'VE ONLY BEEN HERE THREE YEARS.
AND IN THESE THREE YEARS I'VE
HAD THE INTERACTION WITH THE
DEPARTMENT. AND IT'S ALMOST THE
FLIP IN ITS KIND OF ATTITUDE
THAT IT ISN'T UNTIL. SOMETHING
IS DEMANDED DIDN'T EVEN I
LISTEN TO MY COLLEAGUES WERE
ALMOST PLEADING WON'T YOU
PLEASE DO YOUR JOB. YOU MAY BE-NEW DOCTOR GILBERT BUT THE REST
OF THE TEAM IS NOT. AND YOU'RE
COMING INTO A DEPARTMENT THAT
HAS ABSOLUTELY FAILED OUR
CHILDREN. OUR CHILDREN. WITH
ONLY 27% GETTING ALL OF THE
TESTING THEY'RE SUPPOSED TO GET.
THE THIS IS CRIMINAL WHAT WE'RE
DOING TO THE CHILDREN AND THEY
ARE THE MOST VULNERABLE OF THE
CHILDREN. AND THAT IS WHAT
CONCERNS ME THE MOST WHEN WE-HAD OUR MEETING WITH THE
AUDITOR AND WITH THOSE WOULD
WORK ON THIS. QUESTION WE ASKED
IS HOW LONG DID IT TAKE YOU TO
GO THROUGH THE INFORMATION TO
BE ABLE TO PUT IT UP ON THE
WEBSITE. SEVENTY TWO HOURS
WASN'T THAT IT SEVENTY TWO
HOURS THEY WENT THROUGH ALL OF
THE INFORMATION THAT WAS
AVAILABLE AND WERE ABLE TO PUT
IT UP ON BY BY CENSUS. THE FACT
THAT YOU HAVE SO MANY PEOPLE ON
YOUR STAFF AND THEY'RE NOT ABLE
TO TAKE CARE OF THE BUSINESS
THAT THEY ARE HIRED TO DO IS OF
GREAT GREAT CONCERN TO ME.
GREAT CONCERN TO ME BECAUSE IN
THE END WE ARE TALKING ABOUT
THE CHILDREN FORGIVE ME FOR
BEING SO ANGRY BUT I AM JUST.
BEYOND FRUSTRATED. BECAUSE IT'S
BEEN THREE YEARS ONLY FOR ME
BUT I REMEMBER WHEN MY DEAR
SENATOR HAD INTRODUCED BILLS
BILLS I REMEMBER. WHEN I WOULD
INTRODUCED I WOULD TALK ABOUT
THESE BILLS ACHIEVING PRODUCED
THEY WERE SIGNED BY THE
GOVERNOR. AND THEN I'D COME IN
AND I'M STILL DOING THE SAME
TING. AND TO BE. DURING ONE OF
THE HEARINGS TO HAVE THE
DEPARTMENT. TELL US. I'M SORRY
LIED TO US ABOUT THE THESE
STUDIES HAVE BEEN DONE THE
REPORTING THAT HAVE BEEN DONE
AND THEY WERE ABSOLUTE FALSE
FALSEHOODS. AND IT IS A MARK MY
COLLEAGUE ASSEMBLY MEMBER
GARCIA ASKED THE QUESTION THAT
DESERVES AN ANSWER AND IT
DESERVES A LOTS OF THOUGHT.
WHAT WILL BE DONE TO CHANGE THE
CULTURE OF THE DEPARTMENTS HOW
SOMETHING HAS TO BE DONE TO
CHANGE THE CULTURE EITHER WE
CARE OR WE DON'T CARE YOU WE
ALL OF YOU WILL CONTINUE TO
RECEIVE YOUR PAYCHECKS. YOU'RE
WELCOME DID YOU RECEIVE YOUR
PAYCHECKS AND THOSE CHILDREN
WILL CONTINUE TO NOT BE TESTED
AND THOSE CHILDREN WHO TEST
WILL WHAT WOULD HAVE TESTED
POSITIVE WILL RECEIVE NO
SERVICES. AND THOSE PARENTS
WILL THINK ALL MY GOODNESS IS
THAT SOMETHING THAT I DID I
DIDN'T DO SOMETHING FOR MY
CHILD BUT IT'S ALSO IT'S A
STATE OF CALIFORNIA THAT
FAILED. AND IT IS THE
DEPARTMENTS THAT ARE
RESPONSIBLE FOR THIS THERE ARE
NOT DOING WHAT THEY'RE SUPPOSED
TO DO. AND IT YEAH I GET IT.
YOUR BRAND NEW. PLEASE
UNDERSTAND. YOU'RE THE ONLY ONE
THAT'S BRAND NEW. WE HAVE LOTS
OF PEOPLE THAT ARE A BIT BUT
WORKING ON THIS WHO BEEN
RESPONSIBLE FOR THIS WEREQUEST
AN AUDIT AND THE AUDITOR AND
HER TEAM. ARE ABLE TO PUT THESE
THINGS TOGETHER IN A WAY THAT
WE CAN ALL UNDERSTAND AND WE
ALL KNEW IT WAS IT. WILL KNOW
THERE WAS SOMETHING WRONG. BUT
WE HAVE TO HAVE PROOF. WE
SHOULD BE ABLE TO RELY ON YOU.
WE SHOULD BE ABLE TO ASK THE
DEPARTMENT. TELL US WHAT THE
NUMBERS ARE- WHICH ONLY 27%
WHAT DO YOU NEED FROM US. WHAT
DIDN'T WORK TEAM WE ALL WANT
WHAT'S BEST FOR THE CHILDREN.
INSTEAD OF HIDING WELL YOU KNOW
IT'S OUR ANTIQUATED SYSTEMS AND
WE CAN'T DO THIS AND WE CAN'T
DO THAT AND THE PLANS ARE DOING
WHAT THEY'RE SUPPOSED TO AND
THE DOCTORS ARE DOING THIS AND
IT'S- TOO LONG FORM. THOSE ARE
EXCUSES AND WE WOULD NOT USE
THOSE WITH OUR OWN CHILDREN. WE
WOULD NEVER ALLOW THIS TO
HAPPEN TO OUR OWN CHILDREN.
NEVER AND YET WE'RE ALLOWING IT
TO HAPPEN. AND GO UNCHCKED
UNTIL WE REQUEST AN AUDIT AND
WE HAVE A SUCH A DYNAMIC
AUDITOR AND TEAM THAT THEY ARE
ABLE TO PUT THIS TOGETHER. WE
WERE FAILING OUR CHILDREN IN IN
IN A CRIMINAL MANNER. IN A
CRIMINAL MANNER AND WE CAN'T
CONTINUE WE HAVE TO BE ABLE TO
TRUST WHEN WE AS LEGISLATORS
ASK A QUESTION WE HAVE TO BE
ABLE TO TRUST THAT THE ANSWER
IS AN HONEST ANSWER. WE
SHOULDN'T HAVE TO REQUEST ON
IT'S- OUR DEPARTMENTS. WE
SHOULDN'T HAVE TO DO THAT WE
SHOULD BE ABLE TO ASK YOU
QUESTIONS AND YOU GIVE US AN
ANSWER WE GO TO THE BANK WITH
THAT. THAT'S NOT HAPPENED FOR
MANY YEARS AS I CAN TELL IT'S
STILL NOT HAPPENING. WE CAN'T
CONTINUE THIS WAY. WE CAN'T
CONTINUE THIS WAY WE CAN'T JUST
SAY WELL WHAT ARE YOU GOING TO
DO AND- WHAT CAN WE COUNT ON
THIS. WE'RE SO FAR BEHIND. AND
IF THE- ONE OF THE OTHER HINGS
THAT THAT I WANTED TO ASK-
THERE WAS A COMMENT MADE ABOUT
SANCTIONS AGAINST THE PLANTS
THE HEALTH PLANS FOR THE
SANCTIONS AGAINST OUR OWN
DEPARTMENTS THAT ARE TAKING
CARE BUSINESS. OKAY TO DO
SOMETHING. AND IF IT'S
SOMETHING THAT YOU WORK. I SEE
YOU WHOEVER YOU ARE IF YOU
CANNOT DO IT DON'T ACCEPT THE
JOB. AND MAKE US BELIEVE THEIR
CHILDREN ARE BEING TAKEN CARE
OF BECAUSE THEY'RE NOT BEING
TAKEN CARE OF. WE'RE TALKING
ABOUT OUR CHILDREN ARE LITTLE
CHILDREN. SIX MONTHS OLD ONE
YEAR OLD UP TO TWO YEARS OLD
THAT COULD HAVE HAD THAT
TESTING AND DIDN'T HAVE IT.
ONLY 27% IT. THERE'S SOMETHING
ABSOLUTELY WRONG HERE AND I
LOOK FINE ONE. QUESTION PLACE
WAS REYES. WHEN YOU CAME IN YOU
CLEARLY KNEW THAT THERE WERE
SERIOUS PROBLEMS DID YOU DO OR
HAVE YOU DONE OR DO YOU WANT
HIM TO DO AN EVALUATION OF THE
PRIOR LEADERSHIP. NOT JUST AT
THE VERY TOP LEADERSHIP AT
EVERY LEVEL TO SEE WHAT THEY
DID WRONG AND TO PUT PLANTS
TOGETHER ON WHAT THEY NEED TO
DO TO IMPROVE OTHERWISE YOU
NEED TO GET SOMEBODY ELSE IN
EACH OF THOSE AREAS THIS IS TOO
SERIOUS TO ALLOW IT TO GO ON
FOR ANOTHER YEAR ANOTHER TWO
YEARS THREE YEARS FOUR YEARS.
OUR CHILDREN'S LOOK HEALTH IS
AT STAKE AND WE CANNOT IT
CANNOT BE BUSINESS AS USUAL
EITHER TINGS CHANGE OR PEOPLE
WILL CHANGE OUT YOU'VE GOT TO
DO SOMETHING TO CHANGE TO TAKE
CARE OF THIS. I THINK YOU HAVE
TO LEADERS SITTING UP HERE THAT
ARE ABSOLUTELY COMMITTED TO
THAT THANK YOU FOR YOUR
PASSION. AND I HAVE TWO
GRANDCHILDREN TWO AND A HALF
YEAR OLD AND A FIVE YEAR OLD SO
I COMPLETELY UNDERSTAND. THAT
WE'RE NOT DOING WHAT WE NEED TO
DO FOR OUR CHILDREN LIKE I
COMPLETELY GET IT I REALLY
APPRECIATE YOUR PASSION. YOU
HAVE TO LEADERS THAT CARE. I
CAN TELL YOU THAT FROM. TWO
WEEKS OF WORKING WITH WITH JC.
SO WE'VE GOT TO FIGURE OUTHOW
WE MAKE. THE DEPARTMENT CARE I
MEAN THAT'S THAT'S OUR JOB AS
LEADERS. SO I'M SORRY TO
INTERRUPT HOW LONG IS THAT
GOING TO TAKE. HONESTLY HOW
IMPORTANT IS THIS IT'S VERY
IMPORTANT IT IS IMPORTANT AS IT
GETS. THANK YOU. SIR WHY CASKEY
PLEASE. FEATHER WELL- I
CELEBRATED COURT CASE IN THE
STATE BUT THE LEAD PAINT
COMPANIES THERE'S AN INTERPLAY
HERE AND THIS IS WE'LL GET TO
THE AUDIT AND ALL THAT DISMAY
BUT CAN YOU EXPLAIN TO US THE
MOVIE REMEDIATION THAT'S GOING
ON IN THE PUBLIC HEALTH AND THE
HEALTH CARE SERVICES AND THERE
IN THE IMPROVEMENT IN THE
OUTCOMES WITH THE CHILDREN THAT
WE'RE FOCUSING ON BECAUSE THIS
WORK HAS BEEN GOING ON THE
LAWSUIT HAS BEEN SETTLED THE
APPEALS HAVE BEEN EXHAUSTED.
AND WE KNOW THAT THE WE KNOW
THE ACTUAL ENVIRONMENTAL WORK
IS GOING ON IN THE DIFFERENT
CITIES IN THE COUNTY SO COULD
YOU JUST GIVE US AN UPDATE
BECAUSE WHETHER THEY WERE
TESTED OR NOT TESTED IF THE
ENVIRONMENT IS IMPROVED. I'M A
BETTING MAN WOULD SAY THE
OUTCOME WILL BE BETTER SO CAN
YOU GIVE ME A FLAVOR OF HOW
THAT WORKS BEEN GOING FROM LAST
YEAR. UNFORTUNATELY OF A
REPRESENTATIVE FROM ALAMEDA
WHO'S LEADING SOME OF THE
EFFORT TO MAKE IT I CAN SHARE
WITH YOU A LITTLE BIT HOW WE'RE
WORKING WITH THEM. SO ARE.
LATER RELATED CONSTRUCTION
PROGRAM IS PART OF THE
DEPARTMENT OF PUBLIC HEALTH IN
WE- CERTIFIED LEAD ABATEMENT
WORKERS AND WE ALSO. OVERSEE
THE TRAINING THAT TAKES PLACE-
WE KNOW THAT THERE'S TEN
COUNTIES RIGHT NOW THAT HAVE
BEEN EMPOWERED WITH A COUPLE
MILLION DOLLARS TO DO
ABATEMENT. SO FOR US REALLY ARE
TRYING TO CAPITALIZE ON THAT WE
UNDERSTAND THAT YOU KNEW- IS
LONG AS THERE IS LETTING THEM
FIREMEN TO A LOT OF THE WORK
FOR US. STILL IS NOT IT'S MORE
YOU KNOW TREASURY AND SECONDARY
PREVENTION AND SO WE'RE WORKING
CLOSELY WITH THEM TO REALLY TRY
TO. GET THE NUMBER OF TRAINEES
AT THE NEED WE INCREASED OUR
TRAININGS- TWO SEVEN I BELIEVE
USUALLY. THERE IS- TRAINEES
ACROSS THE STATE WE WERE ONLY
pABOUT SEVEN TO EIGHT THEY'RE
TAKING PLACE WE'RE TRAINING
OVER- EACH. CLASS HOLDS ABOUT
EITHER ABOUT A HUNDRED AND
FIFTY TO TWO HUNDRED STUDENTS
DEPENDING ON THE LOCATION. SO
WE'RE WORKING WTH THEM ON
THAT- HOPEFULLY YOU KNOW. AT
THE NEXT- OR SOMEHOW WE CAN GET
AN UPDATED- INFORMATION FROM
LARRY ASKED TO WEAR THEIR I'D
IN TERMS OF ACTUAL SITES THAT
THEY'RE BEING BECAUSE I DON'T
HAVE THAT INFORMATION CURRENTLY
RIGHT NOW. I KNOW THAT THEY'RE
IN THE PROCESS OF STARTING SOME
OF THAT BUT I'M NOT SURE
DEPENDING ON EACH. COUNTY KINDA
WHERE THEY'RE AT WITH IT.
BECAUSE IT WAS COULD. OF THE
THERE WAS A OF THE BALLOT
INITIATIVE IT WAS GOING IN
DISCUSSIONS THAT WE HAVE ABOUT.
STICKING WITH THE SUIT WITH
THEIR COURT CASE BECAUSE THEY
HAD LIMITED TIME. THAT THERE
WAS A DEADLINE AND IT WAS A
LIMóN AMOUNT OF MONEY THAT
WOULD GO IN AND THEY WOULDN'T
BE ABLE TO DO ALL THESE
TRAINING TO DO THE REMEDIATION.
SO THAT'S NOT ON YOU GUYS
THAT'S ON THE DISTRICT
ATTORNEYS WHO WERE LEADING THE
CASE. I'M A BIT CONFUSED.
PUBLIC HEALTH AND HEALTH CARE
SERVICES YOU DON'T TREAT
CHILDREN RIGHT YOU DON'T
ACTUALLY SEATED TO THE
PEDIATRICIAN THAT ACTUALLY SEES
THE CHILD SEKARANG. CORRECT WE
CONTRACT WITH A NUMBER OF
PROVIDERS TO SEE THE R.
MEDICARE BENEFICIARIES. BECAUSE
I'M I'M LOOKING AT YOU KNOW WE
ARE I READ THROUGH THE REPORT
AND ONE OF THE CRITICISMS ON
PAGE THRTY EIGHT AND THIRTY
NINE IS THAT THE REGULATIONS TO
NOT REQUIRED THE HEALTH CARE
PROVIDERS TO ASK FAMILIES
QUESTIONS THEY GOT NEW YORK IN
TEXAS IN THERE YOU KNOW ASKING
ALL THESE THESE OBVIOUS
QUESTIONS. THE PRO THE
PEDIATRICIANS IN THE HEALTH
CARE PROVIDERS ARE NOT
PROHIBITED IN CALIFORNIA FROM
ASKING THESE OBVIOUS QUESTIONS
ABOUT PEOPLE THAT BEEN EXPOSED
TO LEAD. CORRECT YOU ARE
CORRECT I MEAN YEAH I KNOW THAT
THAT WE'RE HERE ON THIS AUDIT
AND YOU DIDN'T ASK THIS
QUESTION BUT- THE- PHYSICIAN.
AND I WILL CERTAINLY AGREE WITH
MY COLLEAGUES THAT WAS IN HERE
BEGINNING THAT WE'RE NOT PAYING
THAT THE MANAGED CARE PROVIDERS
ENOUGH MONEY TO DO THE WORK
THAT WE WON. WE DO A GREAT JOB
OF SAYING YOU NEED TO DO ALL
THESE THINGS WE DON'T PUT ANY
MONEY ON THE TABLE. THERE'S I
GUESS THE QUESTION IS. SAVE THE
REGULATIONS WHAT'S THE- MEDICAL
COMMUNITY FEEDING BACK DOOR
TELLING TO YOU ABOUT THE-
ABOUT. THE PROVIDING THIS
THEIR- BASIC HEALTH CARE
SERVICE TO. SEE THESE CHILDREN
AND DOING THESE AND DOING SEIZE
TEST ON THEIR OWN IF WE DON'T
HAVE THE DATA THAT THEY'RE-
THEY'RE SUPPOSED TO BE
PROVIDING TESTS OF THAT'S- IF
THAT'S CLEAR YOU KNOW YOU GOT A
SICK KITTY COMES IN. SO THEY
ACTUALLY DO GET ADDITIONAL
INCOME THROUGH PROP FIFTY SIX
IN TERMS OF DOING WELL CHILD
VISITS OR EVEN SICK VISITS AND
THEN AS YOU AS YOU MAY HAVE
HEARD WE'RE GOING TO ADD
THROUGH PROP FIFTY SIX WHEN CMS
APPROVED. A SPECIFIC ADDITIONAL
PAYMENT TO DO THE LEAD TEST SO
THE ANSWER IS CORRECT I MEAN
THE PEDIATRICIAN OR THE FELLOW
PRACTITIONER OF JEWEL
PRACTITIONERS SEIZE THE CHILD
AND THEN THEY DO THE TESTING
THAT'S APPROPRIATE FOR THE AGE
OR THE DEVELOPMENTAL SCREENING
OR THE DEVELOPMENTAL INCH
EDUCATION. WHATEVER'S NECESSARY
FOR THAT CHILD AT THAT AGE
THAT'S REALLY THAT'S REALLY
WHERE THOSE ACTIVITIES OCCUR.
AND THEY ARE NOT PROHIBITED
FROM ASKING ADDITIONAL
QUESTIONS AROUND IF THEY'RE
GIVING SO YOU KNOW IF THEY'RE
PROVIDING CARE IN AN AREA THAT
HAS RISKS. OTHER THAN LEAD
BASED PAINT. AND I THINK ONE OF
THE THINGS THAT WE PLAN ON
DOING AND WE'VE BEEN HAVING
CONVERSATIONS ON IS HOW TO BE
BETTER PARTNER WITH PUBLIC
HEALTH IN REGARDS TO THEIR HOT
SPOTTING REPORTS. ON THAT THEY
WILL BE DOING SO THAT IN
ADDITION TO JUST THE THINGS
THAT WE WALK THROUGH AND ARE
REPORTED THAT WE WILL BE DOING
WITH OUR MANAGED CARE PLANS.
HOW DO WE USE THAT TO DRIVE A
VERY LASER FOCUS IN VERY CLEAR
AREAS OF THE STATE ZIP CODES
ARE COUNTIES WHERE WE SEE A
HIGHER ELEVATED LEVEL OF THESE
BUT THAT. IN ADDITION TO ENSURE
THAT ALL CHILDREN GET TESTED
DON'T TAKE MY COMMENTS THE
WRONG WAY- BUT HOW DO WE ALSO
DO ADDITIONAL HEIGHTENED
SCRUTINY IN THOSE HOT SPOT
AREAS THAT. HAVE BEEN
IDENTIFIED WORKING WITH THEIR
PLANS VERY CLOSELY IN THOSE
AREAS A TO MAKE SURE PROVIDERS
UNDERSTAND ON THAT THERE IS A
AN INCREASED RISKON IN THESE
PARTICULAR AREAS AND THEY
SHOULD BE TAKING HEIGHTENED
FOCUS IN EDUCATING FAMILIES
ABOUT THAT RISK IN CASE. YOU'RE
FAMILIES DO HAVE THE RIGHT TO
DECLINE AS WE MENTIONED EARLIER
REGARDING THE TEST BUT MAKING
SURE PROVIDERS ARE HAVING A
CONVERSATION WITH-
BENEFICIARIES AND FAMILIES WHEN
THEY COME IN THAT THIS IS A
HIGH IN THE AREA. OF RISK IN
THAT THEY SHOULD BE AWARE OF
THAT RISK ON IF DECLINE IN THE
TEST AS WELL. AND I GUESS MY
FINAL QUESTION MR JURORS
MEDICALLY I MEAN IT'S I THINK I
HEARD DIRECTED TO WE GET THE
MEDI CAL AND THE MEDICARE-
TESTING. ONE IN AND AT. BUT BY.
OF MY TWO AND A HALF. TO AND A
HALF TO ONE OR- TWO. ONE AND
TWO AND THEN. THE FEDERAL ONLY
REQUIRES ONE TEST AT AT ONE-
WHERE TO ENTER. TWO AND A HALF
HOURS SO THERE'S SO THERE'S
DIFFERENT. STANDARDS OUT THERE-
THAT THAT THAT ARE THERE. THE.
I GUESS THE QUESTION IS THAT IF
YOU GET TESTED AT. AT TWO AND
YOU'VE MISSED IN YOU MISS THE
TESTS WE MIGHT INSTINCTS IS
THAT IF THE IF THE CHILD IS
EXPOSED TO HIGH LEVELS OF LEAD
IT WITHOUT SOME REMEDIATION AND
SOME CHANGES AS HE COULD BE.
LIFETIME CONSEQUENCES RIGHT. ON
THE ON THE NATURAL WHAT WITH
THE DOCTOR BE DEALING WITH THAT.
SIX SHALL THEY CAME IN EVERY
LET'S SAY THEY MISS THE ONE THE
ONE YOUR TEST BECAUSE WE LEASE
WE SPEND A LOT OF TIME ABOUT ON
THE AUDIT YOU GOT TO HAVE THAT
SECOND TESTING YOU RELATE ON
THE SECOND TEST SO WHAT WAS I
GUESS WHAT'S THE- I THINK I
UNDERSTAND WHAT THE ANSWER TO
BE WHAT'S THE MEDICAL. IMPACT
ON THIS POPULATION OF ALL THE
FOR THE MEDICAL IMPACT TO A
DOCTOR YOU OVER HERE- BUT SO
THERE'S A FEW THINGS SO THE
RECOMMENDATION IS- TEST AT ONE
AND TWO AND THEN- IF- YOU HAVE
NOT HAD A TEST BY. YOU KNOW SIX
THAT YOU ARE ALSO GETTING ANY
TEST IF YOU MISSED YOUR FIRST
AND SECOND BIRTHDAY- THE OTHER
THING I WOULD SAY IS RIGHT NOW
THE TECHNICAL SPECIFICATIONS
THAT CMS HAS IN PLACE- OR SOME
OTHER ONES. LOOK AT ACTOR
SECOND BIRTHDAY WE KNOW THAT
OFTEN TIMES PEOPLE ON DON'T GET
THEIR KIDS IN RIGHT AFTER BIRTH
DATE- IN IN REGARDS TO. A WELL
CHILD VISITS A GOOD HAPPENED A
FEW MONTHS LATER ON AND SO THE
DEPARTMENT HAS BEEN WORKING
WITH PUBLIC HEALTH OVER THE-
THE TIME SINCE THIS IS BEEN
BROUGHT UP OF. HOW O WE LOOK
AT THE BROADER CONSTRUCTION
OUTSIDE OF JUST THE CLEAR
TECHNICAL SPECIFICATIONS- TO
LOOK AT THE IMPACT AND TO MAKE
SURE LOOKING AT THE FULL
PICTURE NOT JUST THE KIND OF.
VARIOUS NARROW IN THERE ARE
DIFFERENT NATIONAL STANDARDS
VERSES STATE OF CALIFORNIA
STANDARDS- TO MAKE SURE WE'RE
CAPTURING EVERYONE IF THEYGOT
IT SLIGHTLY AFTER THEIR SECOND
BIRTHDAY OR TO ENSURE CHILDREN
UP TO THE AGE OF SIX ARE
GETTING- TESTED AT SOME POINT.
ON AND THEN A LOT DOCTOR
GUILDERS SPEAK TO THE OTHER
QUESTION. SO THE REAL KEY IS
YOU DON'T WANT A CHILD
CONTINUOUSLY EXPOSED UPDATES TO
THAT'S WHY YOU HAVE THE ONE
YOU'RE TESTING IN THE TO YOUR
TESTING. SO IF YOU'VE GOT A
CHILD THAT'S CRAWLING AND YOU
KNOW AS EXPOSED TO EITHER. THE
EXAMPLE OF- THE FAN THE HUSBAND
OR WIFE BRINGING HOME. LED FROM
THEIR WORKPLACE AND IT BEING ON
THE FLOOR OR LEAD BASED PAINT
PEELING OFF THE WALLS. SO
THAT'S WHAT YOU REALLY WANT THE
WITH THE TEST AT ONE AND TWO
BECAUSE YOU DON'T WANT TO WAIT.
YOU KNOW OF AN EXPOSURE IS
ONGOING AND THEN. ACTUALLY
PUBLIC HEALTH IS INVOLVED IN
THE MAN BUT THE REMEDIATION.
AND REALLY THE KEY IS STOP THE
EXPOSURE I MEAN THAT'S THE REAL
KEY AND THEN A FEW VERY AYE
LEVELS ALLOWED. VERY HIGH
LEVELS THERE'S OF THE TWO.
HELLO LOOKS TO STOP THE
EXPOSURE. AND GET THE KIDS YOU
KNOW SO THE SO THE TOUCH TO
SAVE YEAH I WOULD JUST SEND THE-
I MEAN THE BEAR. EVER. HUGE
INTO. CAN POPULATION HE- HAS.
RELATIONS IN SOME OF THEM ARE
NOT THE ZIP CODE SAID HAVE LEAD
AND ALAMEDA COUNTY BUT HAVE THE
LEAD PAINT IN THE IN THE MAKE
UP THAT YEAH AT THE IN THE
CELEBRATION THAT THEY PUT ON
THERE FOR IN THESE LITTLE ARE
EXPOSED TO AND THEN THE CERAMIC
IN THE JEWELRY THAT COMES IN
FROM ACROSS THE BORDER THAT
THAT THEY'RE NOT EATING YOU
KNOW WE'RE WE'RE SAYING OKAY
WANT TO TEST THIS AND WE WANT
YOU TO. WE WE'RE THE EXPOSURES
THAT WERE NOT NATURAL AT EIGHT
ONE C. TRADITIONAL BUT IT'S NOT
WHAT YOU'RE THE NORMAL CULPRIT
THAT YOU WOULD EXPECT SO THAT
SAY- A SHIFTING TERRITORY- I'LL
BE LOOKING FOR TODAY. UPDATE ON
THE AND ENVIRONMENTAL QUALITY
AND THE REMEDIATION PORTION OF
BECAUSE THEY THINK THAT THERE'S-
A NEED FOR COMMUNICATION. AT AT
THAT LEVEL WHERE THE WORK IS
BEING DONE AND WHERE THE WORKS
NOT BEING DEAD FROM A PUBLIC
HEALTH. THANK YOU SIR PAN. WELL
THANK YOU THANK YOU VERY MUCH
AND- APPRECIATE- THE- QUESTIONS
THAT- MY COLLEAGUES HAVE BEEN
ASKING- IRST OF ALL I GUESS-
ACTUALLY TO FORCE A DRESS- MY
GOOD FRIEND- SERRA CASKEY- I
WOULD MAKE NOTE THAT THE
QUESTIONS TWENTY DESCRIBE WHICH
QUESTIONS ARE REQUIRED. THAT
DOESN'T MEAN THAT THOSE
QUESTIONS ARE BEING ASKED-
PHYSICIANS ASK QUESTIONS BASED
ON THE LEVEL OF RISK AND- THE
POPULATION THERE ARE WORKING
WITH SO THERE IS YES ONE MATED
QUESTION- I WILL PRESUME DODD
YOU CAN CORRECT ME IF I'M WRONG
YOU DIDN'T REVIEW ALL THE
MEDICAL RECORDS FOR ALL THE
KIDS YOU DON'T KNOW WHAT
QUESTIONS ARE ACTUALLY ASKED
WHAT YOU DID IS YOU WENT SAID
WHAT'S REQUIRED IN THAT ONE
QUESTIONS REQUIRED. YEAH QUITE
REQUIRED THE CALIFORNIA DOESN'T
MEAN THEY WEREN'T PASSED THE
PILOT ASKED OF EVERY PATIENT
AND SO I DO APPRECIATE SO MY
COLLEAGUES OF TWENTY ALL NIGHT
DID SAY MY OWN REMARKS THAT IT
IS EXTREMELY IMPORTANT IT'S A
SERIOUS NEUROTOXIN WE NEED
SCREEN- WE NEED TO TEST- BUT I
ALSO DATE NOTE THAT. YOU KNOW
YOU HAVE- NOT ONLY IT'S NOT
ABOUT THE DOCTOR OR IN THE MAIL
TIME WE HAVE THE OUT THIS
SPURRED ON THE PATIENT SO.
ANYONE WHO YOUR CHILD AND I
HAVE CHILDREN YOU BRING HOW
MANY QUESTIONS YOU GET ASKED
AND WHAT WE DO IS TRY TO ARGUE
THE QUESTIONS IS APPROPRIATE
FOR THE POPULATION AS A WHOLE
I'D WRITE IF WE HAVE TO THAT WE
BE ADDRESSING A LOT CERTAINLY
BE A BRAND WHAT BUT THERE'S
ALSO WHOLE BUNCH OF OTHER
THINGS ARE VERY SERIOUS AS WELL
IN FACT. BUT ALSO POINT OUT
THAT ENTITY TO TEST THAT THOSE.
AT THE LEADS. WE SHOULD ALL BE
SURE CHECKING PURNIMA. OKAY BUT
CHAO IS ANEMIC ALL HAS A IQ
JUST LIKE LET AND EFFECTIVE
YOUR NAME TO MARVOLO TO LET.
WE'RE NOT TALKING ABOUT THAT'S
THAT'S SOMEWHAT AUDIT IS BUT IF
WE'RE GONNA START TALKING ABOUT
THE LAW SO I SHE HOPE WERE
NIGHT WE'RE JUST SAYING OH WELL
I WAS ON LEAD THERE FOR WE'RE
GOING ON DO A- FOR LEAD. WE
WERE DOING FOR ANEMIA TO RIGHT
THAT WAS THE SUBJECT THIS AUDIT
REPORT BUT- IS A PEDIATRICIAN I
KNOW THAT'S JUST AS THAT THAT'S
ALSO IMPORTANT TO WRITE IS A
WHOLE BUNCH OF REALLY IMPORTANT
THINGS WE DO- LET IS ONE OF
MORE IMPORTANT BECAUSE IT'S A
VERY SERIOUS TOXIN BUT THERE'S
A LOT OF OTHER. THINGS THAT
ALSO HAVE AN IMPACT AND IT
AGAIN- POOR NUTRITION LACK OF
ACCESS TO GOOD FOOD SO FORTH
ARE THINGS THAT ALSO
DISPROPORTIONATELY AFFECT.
COMMITTEES OF COLOR. RIGHT SO-
AND LOW INCOME COMMUNITIES SO
AGAIN I CERTAINLY HOPE THAT AS
WE ARE LOOKING AT THIS FROM A
SYSTEMATIC POINT OF VIEW. THAT
WE'RE JUST NOT LOOKING AT. ONE
PARTICULAR AUDIT BUT WE'RE
TAKING A LOOK AT THE BODY OF
EVIDENCE AND SAYING WHAT ARE
THE THINGS WE NEED TO DO. TO
IMPROVE HEALTH- BUT I WOULD
ALSO- WANT TO SAY IS THAT
CERTAINLY I HEAR MY COLLEAGUES
FRUSTRATIONS- WITH- DEPARTMENT
HEALTH CARE SERVICES AND- SOME
OF THE AGENCIES- YOU KNOW I'VE-
BEEN IN THE LEGISLATURE SINCE
TWENTY TENSE A LITTLE LONGER-
IF WAS PREVIOUSLY CHAIR OF THE
ASSEMBLY HEALTH COMMITTEE- NOW
CHAIR OF. THE SENATE HEALTH
COMMITTEE- WE HAVE DONE. YEAH
ACTUALLY- QUITE A BIT OF
OVERSIGHT- LOOKING AT. THINGS I
HI YOU KNOW I'VE I'VE HAD SOME
PREVIOUS RESTORATION
PARTICULARLY DURING THE- GREAT
ART RIGHT AFTER THE GREAT
RECESSION OF WHERE. THERE IS A
MOVEMENT TO MOVE EVEN MORE.
THINGS TO MANAGE CARE- WHERE I
IS EXPLICITLY TOLD THE
DEPARTMENT UNDER ACTUALLY NOT
YOUR PREDECESSOR PROFESSOR
BEFORE THEN IS THAT- WE MAY
MOVE MORE OF OUR PATIENTS AND
MEDI CAL TO MANAGE CARE BUT I
WILL ALWAYS HOLD THE-
DEPARTMENT HEALTHCARE SERVICES
RESPONSIBLE. NOT THE HEALTH
PLAN. OKAY YOU CAN'T CONTRACT
AWAY YOUR RESPONSIBILITY.
BECAUSE AFTER ALL YOU WROTE THE
CONTRACT YOU DRAFTED THE
CONTRACT YOU BUT- CONTINGENCIES
ON THE CONTRACT YOU STICK THE
STANDARDS THE CONTRACT BY THE
WAY WE CAN'T EVEN WE DON'T
WE'LL SEE A MODEL CONTRACT BUT
THE EXACT CONTRACT ITSELF WE
DON'T GET TO SEE. RIGHT WE JUST
SEE THE MODEL CONTRACT AND- YOU
KNOW AND CERTAINLY IF AND I'M
I'M NOT GONNA GO THROUGH THE
WHOLE LITANY OF DIFFERENT OVER
SITES AND ALL ITS BY- IT DENTAL
BUNCH OF OTHER THINGS AND WE
HAD. WE FOUND ON THE DENTAL
AUDIT THAT THE DEPARTMENT FOR
TEN YEARS DIDN'T DO WHAT THE
LAW ASK THEM TO DO TO MONITOR
ACCESS. SO THESE THINGS COME UP
NOW. I JUST ALSO WANT TO SAY IS
YOU KNOW WE DID A HEARING AN
INFORMATIONAL HEARING ABOUT
WHAT WE'RE DOING ABOUT THE
MANAGED CARE ACTUALLY. FOR AT
ON THE SENATE SIDE WE TALKED
ABOUT OUR MANAGED CARE ACTUALLY
TOOK LOOK LOOK BETTER MANAGED
CARE CONTRACTING WE DID IT
WE'RE LOOKING AT CALLING. I
THINK THAT RISE AS A IS THAT
YEAH WE HAVE SOME NEW
LEADERSHIP HERE I DO THINK
THAT- THAT AT LEAST IN THE TIME
I'VE BEEN THE LEGISLATURE I'VE
SEEN SOME VERY POSITIVE SHIFTS
IN THE DEPARTMENT- I THINK THAT
YOU KNOW WHEN I CAME IN I MEAN
DEPARTMENT WAS ALSO SUFFERING
FROM- WE WERE IN THE RECESSION
YOU KNOW WE'RE LOOKING AT EVERY
PLACE WE COULD CUT. OKAY ALL
RIGHT. I MEAN THAT'S JUST
REALITY BOB I DO THINK THAT IS
IMPORTANT THAT WE HAVE A-
CULTURE SHIFT IN IN THE
DEPARTMENT I THINK WHAT HAS
BEEN HAPPENING AS WELL BUT WE
NEED TO BE SURE THAT CONTINUES-
SOMETHING A LITTLE MORE
PROACTIVE WAS THINGS I CRITIQUE
THE DEPARTMENT BEFORE WAS IS
THAT THEY WOULD TELL ME. WELL
WE'RE MONITORING THINGS. AND I
LOOK AT THEM AND SAID WELL IT'S
NOT JUST ENOUGH TO MONITOR TO
HAS TO BE MINIMUM PERFORMANCE
STANDARDS WHAT ARE DAY. BECAUSE
THERE'S SOME POINT THAT YOU CAN
MONITOR SOMETHING'S IT WILL THE
RESULT IS THIS AT WHAT POINT
YOU SEE THAT RESULT IS
UNACCEPTABLE. IT'S TOO BAD IT'S
REALLY BAD YOU KNOW HE'S A- AND
DELUDE SO AND I APPRECIATE THAT
THE DEPARTMENT NOW IS SITTING
SOME HIGHER STANDARDS RIGHT AND
ACTUALLY SAYING THAT THERE ARE
THINGS. SO THAT'S A GOOD
POSITIVE DIRECTION WE'RE MOVING
IN. SO I GUESS WHAT I WANNA SAY
IS THAT CERTAINLY I THINK YOU
HAVE YOU HEARD FROM. MANY OF US
ABOUT THIS PARTICULAR ISSUE.I
ALSO LOOK FORWARD TO WORKING
WITH YOU IN MY VARIOUS ROLES
AND THAT THE SENATE HEALTH
COMMITTEE AND BUDGET
SUBCOMMITTEE- ON HELP- ON
HEALTH HUMAN SERVICES ABOUT HOW
WE'RE GONNA MOVE FORWARD I
APPRECIATE ACTUALLY THE
INVESTMENT THAT. THE STAFF MADE
AND CAL AIMS TO TRY TO TAKE A
MORE PROACTIVE APPROACH- I ALSO
RECOGNIZED BY THE WAY THAT- WE
PROBABLY ACTUALLY NEED TO STAFF
UP THE DEPARTMENT. MORE
BANDWIDTH WISE OKAY I MEAN TO
THINK ABOUT ALL THE THINGS
DEPARTMENTS HAD TO ACCOMPLISH.
IN THE TIME SINCE LA IT'S I'VE
BEEN THE LEGISLATURE- BUT AT
SAME TIME EVEN AS WE- STEPPED
UP. WE NEED TO ALSO INFUSE A
DIFFERENT PHILOSOPHY ABOUT THE
ROLESDEPARTMENTS IN TERMS OF
BEING MORE PROACTIVE. ABOUT
THESE THINGS YOU KNOW I THINK
IT'S ALWAYS FRUSTRATING TO
HAPPEN AUDIT AND THEN SAY. OH
WELL SORRY WE'RE GONNA TRY TO
DO BETTER NOW. LIKE WHY DIDN'T
YOU KNOW FOR THE AUDIT OKAY SO
WHAT WE CAN TALK ABOUT THIS
WHEN WE CAN TALK ABOUT THE
DENTAL AND WE CAN SO FOR. ALL
RIGHT SO I THINK THAT AND BY
THE TIME BY THE TIME WE ASK FOR
NOT THERE'S A REASONWE ASK FOR
THE AUDIT THERE WERE A LOT OF
SIGNS OUT THERE RIGHT SO. I'M
HOPING WE CAN BE MORE PROACTIVE
THAT WERE AND I KNOW YOU'RE A
STATE YOU UNDER YOU'VE HEARD
ME. NOT JUST MONITORING YOU
KNOW MINIMUM PERFORMANCE
STANDARDS HOW GREAT YOU KNOW
TWO HOW DO YOU PROMOTE
EXCELLENCE WE TALK ABOUT HOURS.
THERE'S A LOT OF SO I SO I WHY
DO YOU WANT TO GIVE SOME PROPS
THAT THINGS I THINK ARE MOVING
IN A MORE POSITIVE ACTION I
KNOW. I CERTAINLY- WHY EXPRESS
MY HOPE AND MY CONFIDENCE THAT
THE CURRENT LEADERSHIP IS GONNA
CONTINUE TAKING IT IN THAT
DIRECTION. AND THAT HOPEFULLY
WE WILL. THAT WE'LL SEE SOME
EVEN BETTER RESULTS. KLAY THIS
IS AN FOR. ANOTHER CAN A BLACK
GUY- THE PREVIOUS AUDITS THAT
WE JUST HAD RECENTLY WITH THE
AND SORT OF LINKS THE
CHILDREN'S SCREENING YOU KNOW
THAT THAT PREVENTIVE SERVICES
WAS ANOTHER BLACK GUY THAT. SO
YOU CAN UNDERSTAND ICING
CERTAINLY I THINK- WE HAVE SOME
FRUSTRATION BUT- I AM HOPEFUL-
THAT- BUT WE WILL BOTH HOPEFUL
BUT WE WILL EXPECT AND WE WILL
HOLD ACCOUNTABLE THE DEPARTMENT
TO BE SURE THAT WE- ADDRESS
THOSE ISSUES. AND ACTUALLY I
APPRECIATE THAT THE- HONESTY OF
THEIR CURRENT LEADERSHIP AND
SAY HEY WE FIND OUT MORE- WILL
TELL YOU AND ASK YOU TO HELP US
OUT. NOW I GUESS THE OTHER
QUESTION I HAVE- BECAUSE I KNOW
WE ALSO HAVE CD PEACH HERE- SO
ONE OF THE THINGS THAT THE
AUDIT REPORT ALSO POINTED OUT
WAS THAT THE LEAD PREVENTION
PROGRAM SO WE TALKED ABOUT YOU
KNOW WHAT WE DO WHEN WE HAVE A
POSITIVE. IS OPERATING AT
DEFICIT. AND SO I DON'T KNOW IS
AM I EXPECTING MY BUDGET
SUBCOMMITTEE TO SEE A REQUEST
FOR A AUGMENTATION THE BUDGET
RIGHT RIGHT A RISE IN THE FEE
TO COVER THIS SO THAT WE
ACTUALLY HAVE ADEQUATE
RESOURCES TO ADDRESS THIS
BECAUSE AGAIN THIS IS THE PRO
ACTIVITY ALL RIGHT I MEAN WE
YOU CAN YOU CAN SAY WELL THE
LEGISLATURE'S JOB TO OF COURSE
IN THE END WE FORMULATED BUDGET
THAT THEN THE GOVERNOR SIGNS WE
COME TO AGREEMENT BUT I ALSO
THINK THE ADMINISTRATION. NEEDS
TO STEP UP AND PROPOSE THINGS
AND THEY HAVE FOR CERTAIN AREAS
I WANT TO GIVE SOME CREDIT YOU
KNOW- THIS GOVERNOR IS NOT BEEN
SHY ABOUT SAYING WE NEED SOME
MORE MONEY FOR SOMETHING BUT
AGAIN THIS IS A DEFICIT HERE
WE'RE RUNNING A NEGATIVE ARE WE
WHAT ARE WE DOING TO BE SURE WE
HAVE THE ADEQUATE FUNDS TO DO
THE- CASE MANAGEMENT AND OTHER
THINGS WE NEED DO WE HAVE A
POSITIVE IT'S GREAT TO SCREEN
PEOPLE WE'RE NOT DOING A GOOD
JOB AT IT WELL HOPEFULLY WE
WILL DO BETTER AND THEN WE
STILL NEED TO. DO SOMETHING
ABOUT IT. YEAH WE'RE CLOSELY
MONITORING ARE ARE YOU KNOW I
DON'T LIKE TO WORK MONITORING I
WANNA SOLUTIONS NOT JUST
MONITORING. BUT SO IS THERE
PROPOSAL THIS YEAR FOR AN
INCREASE NEPHI. SO WITH. SO
WE'RE ACTUALLY THE AGAIN I CAN
I CAN I CAN USE ANOTHER WORD
WERE CLOSELY LOOKING AT OUR
BUDGET RIGHT NOW IN BASED ON
OVER AT OR IS IT IN THE IT OF
GOVERNOR SUBMITTED A DRAFT
BUDGET JANUARY'S IT IN THERE.
IT'S NOT IN THERE OKAY WHY.
BECAUSE BASICALLY WHAT WERE SSE
RIGHT NOW IS THAT WE'RE STILL
NOT IN A PHASE IT WARMER
NEEDING TO MAKE THE REQUEST
THIS YEAR OKAY SO I HOPE THAT
AND REALIZE THAT THERE'S A
CONVERSATION BETWEEN YOU AND
FINANCE AND I KNOW YOU DO YOUR
YOUR YOUR BOSS ISN'T HERE AND
SHE'S BUSY DOING. SOME OTHERS
NOW SOME OTHER THINGS THAT ARE
VERY IMPORTANT TO. AND I ALSO
UNDERSTAND THAT YOU IS AN
AGENCY- WELL THE DIRECTOR OF
REPRESENT AGENCY DIRECTOR
CANNOT OPPOSE FINANCE ARE TO
GOVERNOR'S BUDGET AND DISAGREE
WITH IT SO I WANT TO ASK YOU
TO- BUT I CERTAINLY HOPE THAT
WHEN WE FINALLY HERE. THAT PART
OF THE BUDGET- YOU CAN RELATE
TO. WHOEVER NEEDS TO HEAR- I
EXPECT TO HAVE AN ANSWER TO
THAT QUESTION. AND PROPOSAL
YEAH RIGHT SO AT AND NOT JUST
WELL WE'RE LOOKING AT IT. WE
ARE TOO ACTUALLY WE'RE NOT ONLY
IT'S NOT JUST OUR DEPARTMENT
LIKE WE MENTIONED IT'S THE
FIFTY LOCAL HEALTH CLIPS THAT
DEPEND ON THIS AND IT'S ALSO
YOU KNOW OF FOR US MAKING SURE
THAT WE CONTINUE. THE VARIOUS
ACTIVITIES THAT ALMOST ABOUT
SIX DIFFERENT BILLS THAT HAVE
PASSED AND THEN. THE LAST THREE
YEARS SO WE COMPLETELY
UNDERSTAND AND I KNOW YOU WERE
MONITORING THAT WE ARE CLOSELY
WATCHING OUR EXPENDITURES AND
WE WILL BE READY TO PROPOSE
SOMETHING ONCE WE KNOW THAT
WE'RE HEADING THAT AT IS IT I.
MINE TRAIN IS. FINE BUT IT'S
NOT ENOUGH THAT'S WHAT I'M
SAYING. RIGHT AND SO I KNOW
YOU'RE THE ONE IN THE HOT SEAT
RIGHT NOW SO THE OTHER QUICK
QUESTION IS THAT. I DO HAVE TO
POSE THIS QUESTION BECAUSE
AGAIN I UNDERSTAND WHY- DOCTOR
ANGEL CAN'T BE HERE AND WHAT
SHE'S UP TO- AND MAYBE A CELL
THE LOW PERIPHERAL BUT I THINK
IS CENTRAL TO THIS SO- OUR
STAFF FROM C. PH BEING HAVING
TO BE DIRECTED FROM OTHER
TASKS. INCLUDING POTENTIALLY
LEAD ISSUES ARE PEOPLE
PERSONNEL BEING PULLED TO
ADDRESS THE CORONA VIRUS OR CUP
IN NINETEEN CRISIS RIGHT NOW.
AND THE DEPARTMENT OF PEOPLE
BEING TAKEN OFF IN THE REGULAR
JOB SO THAT THEY CAN FOCUS ON
THAT. NOT OUR CLIP PRO. OKAY NO
WE THEIR THEY HAVE THEIR OWN.
OKAY AND ALSO AT THE LOCAL
HEALTH DEPARTMENTS WE KNOW THAT
THAT'S NOT HAPPENING. I'M NOT
SURE ABOUT LOCAL HEALTH
DEPARTMENTS TO BE HONEST WITH
YOU BUT I CAN TELL YOU FROM THE
CLIP PROGRAM- NO WE HAVE OTHER.
FOLKS SUPPORTING FROM OTHER
PROGRAMS CENTERS OKAY SO I
MIGHT BE SURE WE HAVE THE
CAPACITY TO MAINTAIN ITS OF
PROGRAMS LIKE THIS SOMETIMES
ARE THE ONES THAT GET. PULLED
FROM- BECAUSE EVEN IF YOU
CRISIS YOU HAVE TO DEAL WITH
THE Q. CRISIS. THIS IN ITSELF
IS A CRISIS SO WE SHOULD BE
SURE WE HAVE A CONVERSATION
ABOUT CAPACITY AS WELL YEAH I
WAS SURE THAT WITH YOU IN AT
YOU KNOW WE ARE PULLING ACROSS.
EVERYWHERE BID FROM I. CAN
CONFIRM THAT FORMER CLIP
PROGRAM THERE WAS PRETTY BUSY
WITH A LOT OF THE WORK THAT WE
JUST DISCUSSED. OKAY THANK YOU
BUT EVERYONE'S BUSY WITH A LOT
OF WORK. THANK YOU MOVING AS
JUST ADDED TO THE FRUSTRATION
FROM FROM THE MEMBERS
ESPECIALLY IF WE'RE GOING TO
HEAR. AN ARMY REVISED
ADDITIONAL REQUEST FOR
ADDITIONAL FUNDING FOR THE
DEPARTMENTS AND YEAH WE EXPECT
TO SEE RESULTS FROM THE US.
SPECIALLY FROM WHAT'S BEEN
EXPECTED OVER THE LAST YEAR TWO
YEARS- WITH THAT WE ASK IF YOU
HAVE ANY CONCLUDING REMARKS. IF
PLEASE OKAY VERY MUCH FOR YOUR
PASSION AND YOUR INPUT REALLY
APPRECIATED. I ECHO THE SAME WE
REALLY ARE COMMITTED AND WE
WILL YOU KNOW STRIVE TO
PERFORMING MEET- YOU KNOW WHAT
WE HAVE IN THE AUDITOR'S REPORT
THANK YOU. OKAY WITH THAT WE
WILL MOVE TO AGENDA ITEM NUMBER
FOUR COMMENTS IN RESPONSE FROM
LOCAL AGENCIES. A BOY WEHAVE
DOCTOR ROBERT- BIRD VOCAL
DIRECTOR PEDIATRIC AMBULATORY
CLINICS ACTING SECTION CHIEF
GENERAL. PEDIATRICS WITH UC.
DAVIS HEALTH WHEN I WE DID HAVE.
MAURICE FROM THE HIGH BRANCH
DIRECTOR WITH THE VITAMIN A
WHOLE DIVISION LOS ANGELES
COUNTY FROM A PUBLIC HEALTH BUT
HE HAD TO GO AND CATCH A FLIGHT.
SO DOCTOR BIRD WOULD YOU ARE
READY POLICE. THANK YOU FOR
HAVING. THIS. CORRECT HI. I'LL
START BY. VARMINT WHERE KIDS
ARE WE CAN PREVENT THEM FROM
BEING EXPOSED WE'RE TESTING
WE'RE JUST FINDING OUT IF THEY
WERE EXPOSED SO I'M ROBERT BYRD
I AM A PROFESSOR OF CLINICAL
PEDIATRICS AT UC DAVIS WHERE
I'VE BEEN FOR TWENTY TWO YEARS
PRIOR THAT IT WAS A FELLOW IN
JUNIOR FACULTY MEMBER AT
UNIVERSITY OF ROCHESTER AND IN
NEW YORK AND PRIOR TO THAT. I
WAS AT THE CENTERS FOR DISEASE
CONTROL IN THERE ARE EPIDEMIC
INTELLIGENCE SERVICE- WHERE I
LEARNED EPIDEMIOLOGY SO MY TIME
IN ROCHESTER NEW YORK NINETEEN
NINETY ONE TO NINETEEN NINETY
SEVEN SHAPE MY THINKING ON THAT
AT THAT TIME 25% OF CHILDREN
LESS THAN SIX YEARS OLD HAD A
BLOOD LEAD LEVEL ABOVE TEN
MICROGRAMS PER DECILITER. 10%
HAD ABOVE 25% ARE TWENTY FIVE
MICROGRAMS PER DECILITER AND AT
THAT TIME THE MEDIAN YEAR OF
HOME BUILD WAS- IN THE CITY OF
ROCHESTER NINETEEN TEN. AND SO
IT'S THERE WHERE I DID A STUDY
WITH BRUCE LAMP HERE. COMMUNITY
CHARACTERISTICS ASSOCIATED WITH
LEVATED BLOOD LEAD LEVELS IN
CHILDREN IS PUBLISHED IN THE
JOURNAL PEDIATRICS IN. NINETEEN
NINETY EIGHT IN THERE WE ARGUED
FOR SCREENING STRATEGIES THAT I
DIE IDENTIFIED HOUSING THAT
CONTAIN LEAD HAZARDS RATHER
THAN SIMPLY IDENTIFYING.
IDENTIFYING ELEVATED BLOOD LEAD
LEVELS IN CHILDREN AFTER THEY
WERE EXPOSED BRUCE LAND FEAR
WENT ON TO DEMONSTRATE THAT
THERE IS NO SAFE LEVEL AND-
THAT'S A PART OF THE DATA THAT
HE- PRESENTED AND MULTIPLE
PAPERS IS A WHAT HIS LOWERED
THE ACTION LEVEL FOR BLOOD LEAD
LEVEL TO FIVE FROM ITS PREVIOUS
LEVEL OF TANNED. FROM ITS
PREVIOUS LEVEL OF TWENTY FIVE
ONE ROCHESTER I WAS PART OF AN
AYE AND THE PUBLISHED ANYWHERE
WE'RE LOOKING AT BLOOD LEAD
SCREENING INFORMATION AND WE
WERE TRYING TO FIND OUT WHERE
THE CASES WERE AND- LOOKING AT
MULTIPLE CHILDREN FROM POSSIBLE
FROM DIFFERENT. WHERE THERE ARE
ELEVATED BLOOD LEAD LEVEL SEEM
TO COME FROM THE SAME ADDRESS
AND WHAT WE FOUND WHERE THERE
ARE A NUMBER OF KIDS WHERE LEAD
ABATEMENT EFFORTS ERE EITHER
LIMITED TO THAT INDIVIDUAL UNIT
IN A MULTI FAMILY DWELLING
WARS. THAT FAMILY AND THAT
CHILD MOVED OUT OF THAT UNIT
AND NO ABATEMENT WAS DONE AND
ANOTHER CHILD MOVED IN.
ESSENTIALLY CAUSING EACH CHILD
TO SERVICE THEIR OWN CANARY IN
THE LEAD MINE SHAFT THAT'S
ALREADY BEEN IDENTIFIED AS A
LEAD HAZARD AND- I REALLY
APPRECIATED ONE OF THE COMMENTS
EARLIER THAT IN SACRAMENTO.
THERE ARE TEN APARTMENT
COMPLEXES THAT HAVE BEEN
IDENTIFIED AS THE SOURCE OF.
ELEVATED LAD IN THE COUNTY
WHERE I'M AT AND IF WE WERE
DOING OUR JOBS IF WE WEREN'T
SHE- ONLY TESTING BUT WE WERE
DOING THE ABATEMENT THAT WAS
NECESSARY. AND A WIDER
ABATEMENT- WHERE WE DON'T JUST
LOOK AT INDIVIDUAL CHILDREN IN
INDIVIDUAL UNITS WE MIGHT NOT
HAVE THAT DATA TO LOOK AT RIGHT
NOW. SO I APPRECIATED- ONE OF
THE COMMENTS EARLIER THAT THE
DATA ARE GOOD RESULTS ARE
BETTER. IN SOME WAYS WE ALREADY
HAVE AN- TO ACT IN DO SOMETHING
TO PROTECT KIDS EVEN AS WE'RE
WAITING FOR MORE TESTING TO BE
DONE AND BETTER DATED TO BE.
MADE AVAILABLE. AFTER I CAME TO
CALIFORNIA NINETEEN NINETY
EIGHT I WAS ON THE CALIFORNIA
LED SCREENING ADVISORY TASK
FORCE FROM NINETEEN- NINETEEN
ONE. THERE I ARGUED FOR SOME
FOCUS ON HOUSING
CHARACTERISTICS- IN LIMITING
LET IT- EXPOSURE AND TARGET IS
STRAINING EFFORTS WHERE WE SAW
HOT SPOTS. BUT THE DIRECTION IT
CAN COMMITTEE WAS TO ADVOCATE
FOR UNIVERSAL SCREENING OF ALL
CHILDREN RECEIVING PUBLIC
ASSISTANCE. FAST FORWARD IN TWO
THOUSAND SEVEN I DID A STUDY OF
MY OWN CLINICS LET'S GREETING
EFFORT LOOKED AT TWO HUNDRED
AND FORTY ONE CHILDREN WHAT I
HAV THE ABILITY TO GET DOWN TO
A MORE GRANULAR LEVEL THAN THE
HUGE VERY IMPRESSIVE STUDY THAT
WERE IS THE FOCUS OF THIS
COMMITTEE MEETING- AND THERE
ARE. AT THAT TIME THE-
GUIDELINE FOR- ACTION LEVEL OF
CONCERN WAS TEN AND- WE DID BY
THOSE LEVELS ADD. AT TWELVE
MONTHS AND THEN A YEAR LATER WE
ONLY FOUND ONE CHILDREN ONE
CHILD THAT SCREEN POSITIVE.
ABOUT TEN MICROGRAMS PER
DECILITER IN THE REMAINDER TWO
HUNDRED. FORTY CHILDREN NONE OF
THEM HAD A BLOOD LEAD LEVEL
OVER TEN- IN THEIR SECOND
SCREENING SO WE DID. TWO
HUNDRED AND FORTY TEST TWICE
SHOWING NO BLOOD THAT LEVEL BUT
PART OF THAT IS- THE COMMUNITY
THAT WE'RE SERVING AND THE
LEVEL OF CONCERN. OF ATTENDED
THE TIME FAST FORWARDED NOW THE
LEVEL CONCERN IS NOW ABOVE- A
FIVE MICROGRAM AND STIRRED- PER
DECILITER FOR THE LAD. AND I
LOOKED AT MY CLINICS DATA- IN
PREPARATION FOR TODAY LAST YEAR
I'M JUST TAKING ONE YEAR SWIPE
SO I CAN SEE WHERE WE ARE MY
CLINIC TESTED THE BLOOD OF
SIXTY FOUR CHILDREN. AGES TWO
TO FIVE- THIS IS BOTH PUBLICLY
AND PRIVATELY INSURED AND ONLY
ONE IT WAS ABOVE FOUR POINT
NINE MICROGRAMS PER DECILITER
AND THAT ONE. IS NINE POINT SIX
ON THE FIRST TEST OF THE YEAR
AND SIX POINT SEVEN IS
SUBSEQUENT TESTING DOWN FROM
THE PRIOR YEARS OF ELEVEN POINT
FOUR SO AMONG THE- I SIXTY FOUR
CHILDREN. ONLY WILL ONE KID WAS
IDENTIFIED ME WAS ALREADY
IDENTIFIED THERE WAS NO NEW
CASES OF BLOOD LEAD- IT- THERE
WAS IDENTIFIED AS IT WAS GOING
THROUGH THIS GRANULAR DATA I
SAW ONE CHILD WHOSE LAST YEAR
HAD A TASK THAT WAS TWENTY TWO
POINT THREE. AND THEN TEN DAYS
LATER. WAS ONE POINT FIVE. AND
SO WHEN WE HAVE TESTS LIKE THAT
WHERE YOU CAN HAVE A
CONTAMINATED FIRST SAMPLE AND
THEN WE GET A VENUS SAMPLE
AFTERWARDS. I DON'T BELIEVE
THAT CHILD HAD A TWENTY TWO
POINT THREE. AND THAT THE VENUS
SAMPLE WAS TRUE AND MY QUESTION
WHEN WE'RE LOOKING AT THE LARGE
STATUS AT THAT. DOESN'T HAVE
THE SAME GRANULAR LEVEL HOW
MANY OF THOSE TWENTY TWO POINT
THREE CENT TEST LIKE THAT STAY
IN THE DATA. THAT DON'T GIVE US
GOOD DATA AS TO WHERE OUR KIDS
ARE TRULY AT RISK. SO I HAVE
QUESTIONS TO- DO WE HAVE THE
BEST DATA WE I'VE ALREADY
BROUGHT UP THE ISSUE OF- HIGH
LEVELS FOLLOWED BY NORMAL LEVEL
IF THE- AUDITOR'S TOOK THAT
INTO ACCOUNT. I AND I ALSO
DON'T KNOW WHETHER OR NOT THAT
THEY WERE ABLE TO LOOK AND SEE
WHERE PRIOR TESTS WERE DONE FOR
THE KIDS TO GO ON AN OFF MEDI
CAL THE GO ON AND OFF PRIVATE
INSURANCE AND THEY MAY GET A
TEST IN THERE ARE- THERE ARE-
HEALTH CARE'S ACILITY WITH
THEIR OTHER INSURANCE AND IT
MAY OR MAY NOT MATCH UP I
RECOGNIZE THERE'S ENOUGH OF A
PROBLEM IF WE TOOK OUT THAT
NOISE THERE'S A PROBLEM. AND
I'VE LOOKING AT MY OWN CLINIC
DATA. I SAW THAT- WE TESTED A.
A 70% EITHER THEY WERE TESTED
OR THEY WERE- PRIOR SCREEN NOT
TO THE 80% THATYOU ARE LOOKING
FOR THE STATE NOT TO THE 100%
THAT I'M LOOKING FOR BUT AS A
RESULT OF THAT TESTING AS A
RESULT OF THIS- AUDIT REPORT IN
MY LOOKING AT MY OWN DATA- I
TOOK STEPS TO CONTACT EVERYONE
OF THE PROVIDERS GIVING THEM
INDIVIDUAL INFORMATION SO THAT
ARE TESTING RESULTS OF GET
HIGHER BUT I ALSO FEEL LIKE
THAT BY ITSELF. WILL TAKE CARE
OF THE PROBLEM AND I EXPECT
THAT THIS HEARING ACTUALLY WILL
IMPROVE TESTING THAT-NUMBER OF
PEOPLE CARE ABOUT IT BUT I ALSO
AM HOPING THAT COUPLED WITH
INCREASED TESTING. WE LOOK AT
ABATEMENT AND WE LOOK AT
ABATEMENT WIDER THAN INDIVIDUAL
UNITS FORCING EVERY CHILD TO BE
THEIR OWN CANARY. IN THAT LED
MINE SHAFT. IF WE IDENTIFY A
UNIT. WHERE THERE'S ONE CHILD
WE OBEYED THE ENTIRE UNIT. THEN
WE HAVE PREVENT SAID EXPOSURE
TOOL A NUMBER OF KIDS AND SO
THAT. PART OF MY PERSPECTIVE IS
I COULD GET TO A GRANULAR LEVEL
I CARE ABOUT. PREVENTING LEAD
EXPOSURE IN KIDS- THERE IS NO
SAFE BLOOD LEAD LEVEL. AND IT'S
MY HOPE THAT AS WE IMPROVE
TESTING WE ALSO TAKE THE DATA
THAT WE CURRENTLY HAVE THE
WONDERFUL DATA THAT SHOWS THAT
THE AUDITOR SHOW WHERE THESE
HOTSPOTS ARE. AND WE DO THE
HARDER WORK- OF ABATING.
GETTING THE LEAD OUT OF THE
LIVES OF KIDS WHERE THE A- LIVE
WHERE THEY PLAY- WHERE- THEY'RE
FORCED TO BE AT TIMES. NOT
HAVING AS MANY CHOICES IN THEIR
OWN LIVES AS SOME OF THE REST
OF US HAVE SO I WILL TAKE
QUESTIONS THAT'S- MY PASSION IS
TAKING CARE OF KIDS AND I'M
HOPING THAT WE DON'T STOP WITH
JUST TESTING. THANK YOU THANK
YOU FOR YOUR TESTIMONY. LET ME
ASK IF YOU HAVE QUESTIONS. I
JUST HAD A QUICK QUESTION COULD
YOU TALK A LITTLE BIT ABOUT THE
ABATEMENT AND YOU KNOW EARLIER
IN THE PREVIOUS PANELS WE HAD
ASKED ABOUT. THE I GUESS WILL
RECALL THE ENACT WHAT ABILITY
AND THE METHODOLOGY FOR
ALLOCATING FUNDS. RIGHT TO THE
LOCAL AGENCIES IT WAS THE SLIDE
IF YOU YEAH I CAN'T REALLY
SPEAK ON THAT BECAUSE AS A
PEDIATRICIAN AND RUNNING A
CLINIC- WE HAND OVER THE
ELEVATOR REPORTS TO THE HEALTH
DEPARTMENT. AND WE HEAR WHAT
HAPPENS ON THAT CHILD BUT WE
ACTUALLY DON'T HEAR WHAT'S
HAPPENED FOR. THE REST OF AN
APARTMENT COMPLEX. WE THEY MAY
CHOOSE TO MOVE OUT OF THAT
PLACE AND THEN WE DON'T HEAR
ANYTHING MORE ABOUT THAT PLACE.
OKAY WELL THANK YOU MAY ASK
JUST WHAT THE DOCTOR PAN CENTER
PANEL PLEASE. THANK YOU AND
IT'S GOOD TO SEE YOU AGAIN
DOCTOR BURKE. COLLEAGUES AT UC
DAVIS AND I APPRECIATE YOUR
PERSPECTIVE I THINK THAT-
CERTAINLY WELL THE AUDIT
FOCUSED ON SCREENING AND THE AB
AND THEN THE LACK OF- SCREENING
AND PARTIALLY ASSOCIATE WITH
THE FACT THAT WE ALSO HAVE LOW
PERCENTAGES MEDI CAL PATIENTS
ARE. GETTING THEIR HEALTH TO
PROVISIONS. BUSINESS ALTOGETHER
SO NOT ONLY MISSING LEAD TO
PRIVACY A WHOLE BUNCH OF OTHER
SCREENING THINGS. THAT WE
SHOULD BE DOING- CLEAN
DEVELOPMENTAL SCREENING OR
DOING. ASUS AND- LOTS OF OTHER
THINGS- THAT WE ALSO NEED TO BE
SURE WE HAVE FOR REALLY GOING
TO DO SOMETHING ABOUT IT JUST
THAT THE OTHER DAY AND THEN A
FINAL PROBLEM- THAT WE NEED TO
ACTUALLY- SURE THERE'S ENOUGH
FUNDING FOR MITIGATION WHICH IS
WHY ALSO POSE THE QUESTION I
MEAN WE HAVE A FUN THAT'S- IN
THE DEFICIT. THAT'S THAT THAT
IS DEFICIT SPENDING AND WE- WE-
AND SO WE NEED TO BE SURE THAT
WE HAVE THE FUNDS AND AT AND
CERTAINLY APPRECIATE DR BIRD
SAID THAT. THIS PEDIATRICIANS
WE SEE WE SEE SOMEONE HAS A
HIGH LED BE REFERRED BACK TO
THE PARK PUBLIC HEALTH RIGHT I
MEAN IT'S- IT'S REALLY AYE WE
WILL YOU KNOW WEEK THERE
CERTAIN TREATMENTS TO BRING
FROM REALLY HIGH TO. HIGH ARE
DOWN TO LOW BUT NOT LOW ENOUGH
AND SO ULTIMATELY IT IS ABOUT
REMOVING THE EXPOSURE AND SO
THAT BECOMES A FUNCTION PUBLIC
HEALTH AND WE NEED TO BE SURE
PUBLIC HEALTH. THOSE HAS THE
FUNDING BUT ALSO HAS THE WELL I
THINK WE ARE A LITTLE BIT OF
FRUSTRATON ABOUT. THAT BE SURE
THE PUBLIC THAT'S. AND I'M NOT
SAYING THEY DON'T WANT TO DO IT
I'M SAYING THAT THE THAT IT
DOWN TO REALLY CHASE DOWN AND
GET THIS DONE IT'S NOT EASY. I%
ALWAYS NOT EASY TO GO TO A
LANDLORD AND SAY OH BY THE WAY-
WE HAVE TO GO AND- CLEAN UP
THIS PLACE AND THE PEOPLE WHO
LIVE THERE MIGHT HAVE TO MOVE
OUT AND YOU MIGHT HAVE TO PAY
FOR THEIR HOUSING WHILE THEY'RE
MOVED OUT YOU'RE NOT GETTING
THE REVENUE FROM THIS PLACE
AND- ETCETERA TO GO AND- FIND
IT AND REMOVE. THE SOURCES OF
LEAD THAT MIGHT BE IN THERE AND
THEN OF COURSE. YOU KNOW THERE
MIGHT BE OTHER SOURCES ALLEGE
ASIDE FROM HOUSING ITSELF AND
SO THAT WE MAY RUN TO SOME
CULTURAL ISSUES OR SOME OTHER.
ISSUES AS WELL THAT THE IN THAT
REGARD BUT- WE DO NEED TO BE
SURE PUBLIC HEALTH. HAS THE
CAPACITY TO DO THESE THINGS. SO
LET IS NOT CHEST. PAIN AND
HOUSES ISSUE WHEN IT OUT AND I
THINK THE LEAD SCREENING
PROGRAM IN MICHIGAN AND-
ALLOWED US TO FIND THAT THERE
WAS LED IN THE WATER- AND THAT.
WHEN THERE'S A HOT SPOT TO
FIGURE OUT WHERE IT IS AND
FOCUS EFFORTS TO. TRY TO
PREVENT ON GOING EXPOSURES AND
TO- BEST USE THE DATA THAT WE
HAVE. ALTHOUGH WE CAN ASK FOR
BETTER DATA- AT BEST USE NOW
WHAT WHAT WE CURRENTLY HAVE. TO
PROTECT THE KIDS AS BEST WE CAN
WITH THE CURRENT DATA ASKING
FOR MORE TESTING ASKING- FOR
BETTER DATA OF. THERE'S ALREADY
ENOUGH. DATA THAT WOULD SUCK IF
IT'S IN EVERYBODY'S HANDS HERE
THAT- THERE SHOULD BE ACTION.
AND IT'S NOT JUST WITH MORE
TESTING. THANK YOU THANK YOU
DOCTOR DO YOU HAVE ANY CLOSING
REMARKS I KNOW BUT THANK YOU
FOR. ALLOWING ME THE
OPPORTUNITY TO ADD TO- THIS
IMPORTANT WORK WE APPRECIATE
YOUR TESTIMONY THANK YOU FOR
THATWILL MOVE TO AGENDA ITEM
NUMBER FIVE IF THERE'S ANY
PUBLIC COMMENT IF YOU COULD
PLEASE IDENTIFY YOURSELF AND
YOUR ORGANIZATION IF YOU'RE
WITH AN ORGANIZATION OR- THE
COUNTY IN WHICH YOU RESIDE.
PLACE PROCEED GOOD EVENING
CHAIR MEMBERS LINDA WAY WITH
WESTERN CENTER ON LAW AND
POVERTY FIRSTLY YOU WANTED
THANK THE COMMITTEE FOR HOLDING
THIS IMPORTANT HEARING AS WELL
AS THE LEVEL OF ENGAGEMENT- ON
ON ON THIS ISSUE- WE APPRECIATE
THAT PROGRESS TAKES TIME BUT
THE DEPARTMENT HAS CONSISTENTLY
FAILED TO INSURE MEDI CAL
CHILDREN ARE RECEIVING THE
MANDATE IT BLED LET SCREENING
AND APPROPRIATE FOLLOW UP CARE
THAT THEY ARE ENTITLED TO.
DATING BACK YEARS AND EVEN
DECADES. THE OBLIGATION IS
CLEAR AND WE ASK DH CS TO DO
ITS JOB IN ENFORCING LONG
STANDING REQUIREMENTS TO PLAN
IN FORCE THAT NOW. AS WELL AS
EDUCATING PROVIDERS IN ADDITION
TO FAMILIES ABOUT- THAT THAN
THIS REQUIREMENT. THANK YOU
THANK YOU ADDITIONAL OF A
COMMENT PLEASE CAN LARA'S
REPRESENTING CHILDREN NOW AND
WANTED TO COMMEND THE AUDITOR
FOR HER WORK AS WELL AS- AND
THE COMMITTEES ARE PAYING
ATTENTION TO THIS IMPORTANT
ISSUE THAT IMPACTS CHILDREN'S
HEALTH ENVELOPMENT. I'M I THINK
WE SHARE THE SENTIMENT OF THE
CHAIRS WHEN IT COMES TO THE
DISAPPOINTMENT OF DS DH CS AND
FAILING IN THEIR OVERSIGHT
ROLE. AND NOT JUST IN THE BLOOD
LEVELS LED SCREENINGS BUT ALSO
IN OTHER AREAS AROUND WELL
CHILD CHECK UPS AND I'M AND
GENERAL ACCESS TO PROVIDERS.
THE MEDICAL PROGRAM NEEDS TO
PRIORITIZE KIDS AND RESTRUCTURE
THE PAYMENTS AND CONTRACTS YOU
AND- ENSURE THE KIDS ACTUALLY
RECEIVE SIR THE SERVICES THEY
NEED AND THAT THEY'RE ENTITLED
TO SO THANK YOU. THANK YOU
PLEASE. HI KATHY BURKE WITH THE
HEALTH OFFICER'S ASSOCIATION OF
CALIFORNIA. I AM HERE ON THEIR
BEHALF AND ALSO ON THE BEHALF
OF OUR COLLEAGUES AT THE COUNTY
HEALTH EXECUTIVES ASSOCIATION
OF CALIFORNIA. TO APOLOGIZE
THAT THERE WERE NO LOCAL
REPRESENTATIVES HERE TODAY IT
DOES NOT REPRESENT. ANY SORT OF
UNWILLINGNESS TO COLLABORATE
IT'S JUST THAT WE ARE WORKING
TWENTY FOUR SEVEN FULL TIME ON
COVERT NINETEEN IN MY FIFTEEN
YEARS AND HOW I GOT NEVER SEEN.
AN ALL OUT EFFORT LIKE THIS AND
I LOOK FORWARD TO SHARING SOME
DETAILS ABOUT IT WITH CENTER
PANTS COMMITTEE ON THURSDAY
MORNING THANK YOU THANK YOU.
PLACE HELLO MY NAME IS SUSAN
LITTLE I'M WITH THE
ENVIRONMENTAL WORKING GROUP AND
I JUST WANT TO START FIRST OF
ALL BY JUST THINKING. THE J.
LACK MANY. HEALTH COMMITTEE YES
TâM EQ COMMITTEE IS FOR. FIRST
OFF FOR THEIR INTEREST IN THIS
ISSUE AND CLEARLY THEIR
COMMITMENT AND THEIR DESIRE TO
TRY TO ADDRESS THIS PROBLEM- WE
ATE THE VERBAL WORKING GROUP
KIND OF. CAME UP. WE'VE BEEN
LOOKING AT THIS FOR A LONG TIME
REMIND EVERY I'D LIKE TO REMIND
EVERYBODY THAT TWENTY YEARS
AGO. THE AUDITOR DID SEVERAL
AUDITS ON THE SAME ISSUE AND
CAME UP WITH SIMILAR
CONCLUSIONS- ABOUT THE LEAD
POISON PREVENTION PROGRAM. AND
WHEN WE WERE SO FORTUNATE TO
SPONSOR- A BILL BY ASSEMBLY
MEMBER QUIRK IN A SWIMMER
GARCIA REGARDING. THE BLOOD LET
TESTING REGULATIONS UPDATING
THOSE REQUIRING UP THE AN
UPDATE OF THAT THOSE
REGULATIONS. WE TOOK ANOTHER
LOOK AT THE DATA WORK KIND OF
JUST BASED ON WHAT WE COULD
PIECE TOGETHER STARTED TO
REALIZE THAT THERE WERE IT
APPEARED TO STILL BE ANOTHER
PROP PROBLEM. AND DID SOME
PUBLIC RECORDS ACT REQUEST WITH%
THROUGH THE DEPARTMENT AS A
RESULT OF THAT AND- NOT ONLY
DID WE KIND OF GUESSTIMATE-
ABOUT 28% OF THE KIDS WERE
GETTING TESTED THAT KIND OF
MATCH. THE MORE GRANULAR DATE
THEM IN THE MUCH MORE DETAILED
DATA THAT THE AUDITOR-
PRESENTED. IN HER REPORT BUT WE
ALSO CAME ACROSS IN OUR IN THE
COURSE OF A PUBLIC RECORDS ACT
REQUEST. THE THAT NUMBER 88%
AND THAT BEING 88% OF CHILDREN
ON MEDIC HOW IT'S USED. 88% OF
CHILDREN HER BLOOD LEAD
POISONED CORN THE DEFINITION OR
MEDI CAL. AND THAT JUST SCREAM
TO US THAT HEY YOU KNOW WE'RE
REALLY MISSING OUT THESE WERE
MISSING THEN THESE KIDS- AND-
SO WE'RE VERY PLEASEDTHAT YOU
OF THAT THE LEGISLATURE'S
TAKING THIS TO HEART AND TRYING
TO ADDRESS AND- SO COMMITTED TO
ADDRESSING THE ISSUE AND WE'RE-
WE REALLY APPRECIATE ALL THE
COMMENTS MADE TODAY- BUT IT
WOULD ALSO. LIKE TO. ECHO THE
COMMENTS MADE BY. THE DOCTOR
WHO JUST CALM WHO JUST
TESTIFIED THAT. NO ABATEMENT IS
REALLY OUR CORE CONCERNS AND
I'M WE NEED TO TEST THE KIDS
BUT IT'S A TOOL- APPROACH
REALLY THAT'S NEEDED AND- SO WE
ALSO LOOK FORWARD TO WORKING
WITH THE LEGISLATURE ON TRYING
TO IDENTIFY BUT GOOD WAYS TO-
START TO. GET LED OUT OF
CHILDREN'S HOMES OUT OF THERE
IN AND OUT OF THEIR
ENVIRONMENTS AND TO PROTECT
THEM FROM IT. TO BEGIN WITH SO
WE PUT VERY MUCH APPRECIATE
THIS CAN THIS. HEARING AND
AGAIN AND ALL THE INTEREST IN
IT THANK YOU THANK YOU
ADDITIONAL PUBLIC COMMENT
PLEASE YES. OR THIS. MY NAME IS
STEPHANIE MACKLIN I'M
REPRESENTING THE- COALITION OF
CALIFORNIA WELFARE RIGHT FORM.
SERVICES ATTORNEY. UP MY
INTEREST IN THIS WAS OF COURSE
PICKED BY. THE INTEREST I HAVE
BEEN WORKING WITH COMMUNITIES.
ARE IN POVERTY NOT JUST
COMMUNITIES OF COLOR- I WOULD
LIKE TO MAKE SOME SUGGESTIONS
BECAUSE FIRST OF ALL THINKING.
THE AUDITOR AND HER STAFF FOR A
BEAUTIFUL BEAUTIFUL PLEASE OF
PUBLIC WORK. BUT HERE'S THE
THING. AS DR BRADLEY SAID
THERE'S AN ISSUE ABOUT
ALIGNMENT. THERE IS THE FIRST
FIVE COMMISSIONS WHICH I KNOW
US ASSEMBLYMEMBER SALAS IS
CONCERNED WITH IF YOU GO ON
EACH OF THE WEBSITES FOR THE
COUNTIES THAT WERE NOTED IN THE
AUDITOR'S REPORT THERE WAS NO
INFORMATION EXCEPT FOR ONE
COUNTY IF YOU'VE FIGURED OUT
HOW TO GET THERE ABOUT LEAD
POISONING AND TESTING. THE
STATE. HERE'S AN AGENCY AN
ENTITY THAT SUPPOSED TO SERVE
PARENTS OF CHILDREN. UP TO FIVE
YEARS OLD IT DOESN'T HAVE
INFORMATION AND THERE IT IS.
COUNTY WELFARE DEPARTMENT
SHOULD BE PROVIDED WITH THE
WONDERFUL MATERIALS THAT THE
LEAD PREVENTION BRANCH PRODUCES
IN MULTIPLE LANGUAGES SO THEY
CAN POST THEM IN THEIR OFFICES
WERE FAMILIES ARE COMING TO GET
MEDI CAL OR OTHER SERVICES.
PUBLIC LIBRARIES. PRESCHOOL
PROGRAMS CHILDCARE PROGRAMS
THERE'S AN ENTIRE UNIVERSE OF
PEOPLE WHO COULD BE PROVIDED
INFORMATION SIMPLE ONE THAT CAN
START WITH THE WICK PROGRAMS.
THOSE ARE SPECIFICALLY ORIENTED
TOWARD THE CHILDREN WHO SHOULD
BE RECEIVING THIS TEST I GUESS
THE LAST THING I WOULD SAY IS
THANK YOU FOR PAYING ATTENTION
TO THIS- IN THE LAST TWO YEARS
I'VE BEEN TAKING A LOOK AT
EVERY NEWS ARTICLE THAT COMES
ACROSS IN. SENATOR PAN YOU WERE
ASKING ABOUT CHILDREN'S
EXPOSURE IN THE CITY OF DETROIT
WHAT THE DISCOVERED IS THAT
WELL OLDER CHILDREN IN A FAMILY
MIGHT NOT HAVE HAD LEAD
EXPOSURE THE YOUNGER CHILDREN
WHO WERE BORN WHEN THE CITY WAS
IN ITS MASSIVE TRANSFORMATION
WHEN THERE ARE A LOT OF.
SOCIALIST SAY UNDOCUMENTED OF
CARE DOWNS WAS GETTING AIRBORNE
EXPOSURE TO LET. SO ALL AND
THERE WAS THE REPORT THAT WAS
DONE I THINK BY. REUTERS OR ONE
OF THE NATIONAL NEWSPAPER ART
ETHICAL ALL THAT THEY FOUND
LEAD POISONING OF UPPER MIDDLE
CLASS CHILDREN IN KANSAS CITY
LIVING IN HOUSES THAT WERE
BEING REMODELED. SO THIS IS A
MUCH BROADER PROBLEM IT HAS
AMAZING CONSEQUENCES AND WE ARE
IN A POSITION TO STOP IT THANK
YOU THANK YOU APPRECIATE THAT
AND WE NEED TO MAKE SURE WE GET
AS MANY KIDS DRESSES AS WE CAN.
LET ME ASK AT THIS TIME WITH
THERE'S ADDITIONAL PUBLIC
COMMENT HEARING AND SEEING ON I
WILL TURN IT BACK TO THE DíAS
LET ME ASK THERE'S ANY- CLOSING
REMARKS- HEARING AND SEEING
NINE LET ME JUST SAY THAT I
THINK ABOUT A MONITORED YOUR
TEAM FOR THE WORK THAT YOU'VE
DONE I THINK YOU'VE
HIGHLIGHTED. A LOT OF THE
FRUSTRATIONS OF THE MEMBERS
FELL- WITH THE DEPARTMENT'S BUT
I DO WANT TO THANK THE
DEPARTMENT FOR BEING HERE- DH
CS AND CITY PH AND DOCTOR BIRD
THANK YOU FOR YOUR TESTIMONY AS
WELL- GET OVER THESE-
DISCUSSIONS THAT ARE GOING TO
CONTINUE TO KEEP HAPPENING WE
EXPECT TO SEE PROGRESS BEING
MADE. I THINK YOU'VE HEARD THAT
IN A NUMBER OF QUESTIONS
OUTLINED BY MEMBERS- THIS IS
NOT AN ISSUE THAT'S GOING TO GO
AWAY EXPECT THIS TO BE BROUGHT
UP AGAIN DURING OUR- BUDGET
NEGOTIATIONS OR SUBCOMMITTEES.
AND ESPECIALLY WITH J. LIKE IF
WE DON'T SEE ANY ANY PROGRESS
ON THESE ISSUES AS WELL SO WITH
THAT I'M GOING TO GO AHEAD AND
CONCLUDE THIS. THIS HEARING. AT
SIX OH FIVE YOU.