TO ORDER A GOOD MORNING IN
RESPONSE TO THE COVERT NINETEEN
EMERGENCY HAD TO PROTECT THE
PUBLIC LEGISLATORS AND
EMPLOYEES MUST LIMIT
NONESSENTIAL GATHERINGS AND IT
HERE TO SOCIAL DISTANCING AND
FACE COVERING GUIDELINES IN
COMPLIANCE WITH THOSE ORDERS
THE SENATE HAS MADE NECESSARY
ADJUSTMENTS TO NORMAL PRACTICES
IN ORDER TO ENSURE THAT THE
PUBLIC CONTINUES TO HAVE.
ACCESS TO THE LEGISLATIVE
PROCESS. WE ARE HOLDING OUR
COMMITTEES HEARING IN THE
CAPITOL WITH SOME MEMBERS ABLE
TO PARTICIPATE REMOTELY. TO
ABSENT EVELYN IS JOINING US
TODAY OKAY WE DO TODAY I'M HERE
IN THE HEARING ROOM AS ONE
OTHER MEMBER OF THE
SUBCOMMITTEE DR PAN. CENTER
MELENDEZ WILL BE PARTICIPATING
REMOTELY. THOSE PROVIDING
TESTIMONY BEFORE THE COMMITTEE
TODAY ARE ALSO PERMITTED
PARTICIPATING REMOTELY FOR OUR
REMOTE PARTICIPANTS PLEASE MUTE
YOUR PHONE YOUR COMPUTERS THIS
WILL GREATLY AID IN ELIMINATING
ANY ACOUSTIC FEEDBACK. I S. IT
EVERY TIME YOU WISH TO BE
RECOGNIZE IT USE THE RAISE YOUR
HAND FEATURE IN THE PROGRAM.
EACH TIME YOU ARE RECOGNIZED TO
SPEAK A POP UP WINDOW WILL
APPEAR ASKING IF YOU'D LIKE TO
ADMIT. PLEASE SELECT I MEAN
BEFORE YOU BEGIN SPEAKING OUR
I. T. PERSONNEL WILL PUT YOU
BACK ON MUTE WHEN YOU ARE DONE.
WHAT'S ONCE RECOGNIZED TO SPEAK
PLEASE MAKE SURE YOU CAN BE
SEEN ON THE SCREEN STATE YOUR
NAME AND THEN YOU ARE READY TO
ADDRESS THIS COMMITTEE. TO
ALLOW THE PUBLIC ACCESS WE HAVE
ADMITTED MEMBERS OF THE PUBLIC
TO TWO HEARING ROOMS THE EXTENT
THAT SOCIAL DISTANCING
REQUIREMENTS ALLOW AND WILL BE
USING A TELECONFERENCE SERVICE
FOR THOSE INDIVIDUALS WHO WISH
TO TESTIFY REMOTELY TODAY. FOR
ALL INDIVIDUALS WISHING TO
PROVIDE PUBLIC KHAQAN COMMENT
REMOTELY. THE PARTICIPANT TOLL
POSTED ON OUR COMMITTEE
WEBSITE. IT WILLBE DISPLAYED
ON THE SCREEN AND I WILL
ANNOUNCE IT NOW. TODAY'S
PARTICIPANT NUMBER IS. EIGHT
FOUR FOUR TWO NINE ONE SIX
THREE SIX FOUR. THE ACCESS CODE
IS ONE FOUR ONE. SEVEN SIX ZERO
NINE. FOR DETAILED INSTRUCTIONS
ON HOW THE TELECONFERENCES TO
MARKS PLEASE REFER TO THE
SENATE ANDORRA COMMITTEE
WEBSITE. PLEASE NOTE THAT IN
ORDER FOR US TO HEAR YOU
CLEARLY AND TO AVOID ACOUSTIC
FEEDBACK YOU MUST MEET YOUR
DEVICE YOU'RE WATCHING THE
HEARING ON PRIOR TO GIVING YOUR
TESTIMONY. I WILL MAINTAIN
DECORUM DURING THE HEARING AS
IS CUSTOMARY. AND ANY
INDIVIDUAL WHO IS DISRUPTIVE
MAY BE REMOVED FROM THE REMOTE
MEETING ROOM SERVICE OR HAVE
THEIR CONNECTIONS MUTED. WHILE
EVERY EFFORT HAS BEEN MADE TO
STREAMLINE THE HEARING PROCESS
AND CONDUCT OUR HEARINGS. IN AS
CLOSE THE SAME MANNER AS IS
CUSTOMARY THERE MAY BE SOME
LIKE TIMES FOR PARTICIPANTS WHO
ARE ADJUSTING TO THE NEW USE OF
ONLINE TOOLS OR TECHNOLOGIES.
PLEASE BE PATIENT. AND
RESPECTFUL SO ALL INTERESTED
PARTIES KIM HERE. IN TODAY'S
HEARING WILL REVIEW THE
GOVERNOR'S BUDGET PROPOSALS FOR
THE DEPARTMENT OF HEALTH CARE
SERVICES NOW. LET'S BEGIN WITH
THE FIRST PRESENTATION FROM THE
GOVERNOR'S DEPARTMENT OF HEALTH
CARE SERVICES. AND I. RIGHT
WING DR PANTS SANDRA MELINDA'S-
FONG WHEN WILL LIKE FOR THE
DIRECTOR OF THE DEPARTMENT OF
HEALTH CARE SERVICES AND I'M
JOINED THIS MORNING'S
PRESENTATION BY J. C. COOPER
WAS DEPUTY DIRECTOR. AND STATE
MEDICAID DIRECTOR- THE
DEPARTMENT HEALTHCARE SERVICES
OPERATES THE STATE'S MEDICAID
PROGRAMS BEHAVIORAL HEALTH
PROGRAMS SUPPLEMENTAL SUPPORT
SPECIALTYPROGRAMS FOR CHILDREN
LONG TERM CARE FAMILY HEALTH
PROGRAMS THE PROGRAM SUPPORTS
FOR QUALITY CONTROL BENEFICIARY
AND PROVIDER ENROLLMENT FEE FOR
SERVICE PAYMENTS MANAGED CARE
CONTRACTS AND RATES AND PROGRAM
INTEGRITY ANALYSTS WE SERVE
FOURTEEN MILLION CALIFORNIA
RESIDENTS ONE IN THREE OF OUR
STATE'S RESIDENTS. AND MORE
THAN HALF OF THE SHOW. IN ORDER
OF ABOUT FOUR THOUSAND
EMPLOYEES COMMITTED TO
PRESERVING AND IMPROVING THE
OVERALL HEALTH AND WELL BEING
OF ALL CALIFORNIANS. THE SCHOOL
YOU'RE TWENTY TWENTY ONE TWENTY
TWO THE PROBLEMS BUDGET
PROPOSES A TOTAL OF ONE HUNDRED
AND TWENTY SIX POINT THREE
BILLION DOLLARS FOR THE SUPPORT
OF DH CS IS PROGRAMS AND
SERVICE. ONE POINT ONE BILLION
IN STATE OPERATIONS FUNDING.
AND ONE HUNDRED AND TWENTY FIVE
POINT THREE BILLION IN LOCAL
ASSISTANCE ONE. YES IS BUDGET
INCLUDES SEVERAL NEW ISSUES
EMBARRASSED PROPOSALS WILL ALSO
BE DISCUSSED DURING THIS YEAR
SUCH AS THE IMPACT OF CALLED
THE NINETEEN SEVERAL BEHAVIORAL
HEALTH PROPOSALS WHICH INCLUDED
FUNDING. FOR THE BEHAVIORAL
HEALTH CONTINUE ON
INFRASTRUCTURE AND INCREASED
ACCESS. TO STUDENT BEHAVIORAL
HEALTH SERVICES. IT ALSO
INCLUDES A NUMBER OF
INITIATIVES TO ADDRESS THE
NEEDS FOR HEALTH EQUITY IN OUR
STATE INCLUDING MEDICAL
COVERAGE FOR CONTINUOUS GLUCOSE
MONITORING EXPANDING CERTAIN
TELEHEALTH FLEXIBILITIES
INCLUDING REMOTE PATIENT
MONITORING. THE MOST
SIGNIFICANTLY THE BUDGET
PROPOSES A SIGNIFICANT
INVESTMENT IN THE CALAIS
MINISTERED TO THE REFORM THE
MEDICAL DELIVERY PROGRAM AND
PAYMENT SYSTEM TO IMPLEMENT
STATEWIDE. STRATEGIES TO
ADDRESS. THE NEEDS TO GET A
GREAT PHYSICAL BEHAVIORAL AND
ORAL HEALTH CARE ALONG WITH
SOCIAL CARE STRATEGIES TO
ADDRESS SOCIAL DRIVERS OF
HEALTH OUTCOMES. THIS
INVESTMENT IS. ONE POINT OH
NINE BILLION TOTAL FARMS IN
FISCAL YEAR TWENTY ONE TWENTY
TWO OF WHICH ONE HUNDRED THIRTY
ONE POINT NINE MILLION IT IS
GENERAL FUND. IT IS ALSO
REQUESTING AN INCREASE OF TWO
HUNDRED AND FIFTY FIVE POINT
FIVE POSITIONS. ALL OF THESE A
HUNDRED AND FORTY FIVE POINT
FIVE A PERMANENT POSITIONS AND
A HUNDRED AND TEN LIMITED TERM
EQUIVALENT POSITIONS THIS IS A
NET INCREASE OF A HUNDRED AND
FIFTY TWO NEW POSITIONS AND A
CONTINUATION OF A HUNDRED ONE
THREE POINT FIVE CURRENT
POSITIONS. RBC PLEASE INCLUDE
REQUESTS FOR RESOURCES
PROPRIETY OF WORKLOAD EFFORTS
INCLUDING BUT NOT LIMITED TO.
CALLUNA SHOULD HAVE MEDI CAL
ENTERPRISE MODERNIZATION AND
INCREASED ACCESS TO STUDENT
BEHAVIORAL HEALTH SERVICES. BUT
NOW LIKE TO TURN IT OVER TO HIS
DEPUTY COOPER- PRESS THREE
COVERT AND DEDICATIONS. ONE
SECOND I THINK DOCTOR PAN HAS A
QUESTION OR COMMENT YOU'D LIKE
TO MAKE YES- I UNDERSTAND- SO
WE'RE STILL AN ISSUE I SOUNDS
LIKE THIS. WE'RE MOVING IT
ISSUE TO READY SO I DO HAVE
SOME QUESTIONS AROUND JUST THE
OVERVIEW. WE WERE MOVING ON TO
ISSUE NUMBER TWO. DIRECTOR WE
WERE GOING TO BUT I I'M SORRY
I. OKAY OF COURSE TO SEE IF
THERE ARE QUESTIONS OKAY THERE
MUST ADDRESS. THANK YOU SO VERY
MUCH- DIRECTOR LIKE PORN AND-
AND YOU KNOW REALLY APPRECIATE
THE- THE WORK BEING DONE BY THE
DEPARTMENT. I DID HAVE SOME
QUESTIONS ABOUT THE OVER YOU
AND I APPRECIATE THAT- YOU
MENTIONED- THAT WE'RE TALKING
YEAH WHEN WE TALK ABOUT THE
EIGHT CS WE'RE TALKING ABOUT. A
HUNDRED AND TWENTY. SIX WITH A
B. DOLLAR BUDGET SO- OFTENTIMES
SWINGS AND DH CS OF SOMEONE'S
CHAIRED THE SUBCOMMITTEE. WE'RE
SITTING HERE DEBATING LIKE A
HUNDRED THOUSAND OR EVEN A
HUNDRED MILLION BUT YOU CAN
HAVE A SWING AT DH CS OF. THE
EARLY FRACTIONS OF PERCENT
WE'RE TALKING YOU KNOW SOMEBODY
WOULD TALK ABOUT BILLION
DOLLARS SO. I DID HAVE A FEW
QUESTIONS REGARDING- SOME OF
THE- FUN DETAILS- UNDER
REIMBURSEMENTS- AGAIN TALKING
ABOUT SWEET FOR BILLIONS- A
BILLION SO WE HAVE- IN THIS
FISCAL YEAR TO. TWO POINT THREE
BILLION AND THEN IT GOES DOWN
TO BASELINE OF ONE POINT THREE
BILLION PROJECTED BUDGET- CAN
YOU SPEAK TO WHAT. WHAT THE-
BASICALLY ONE FROM ONE POINT
FOUR BILLION TO TWO POINT THREE
BACK TO ONE POINT THREE BILLION
IS PROJECTED FOR THE NEXT YEAR-
IS THAT CAN JUST A BRIEF
EXPLANATION AS TO THE BILLION
DOLLAR BUMP. UP ON THE
REIMBURSEMENT LINE- UNDER THE
OTHER FINE DETAIL. J. C. DO YOU
WANT TO CHECK OUT- OF WE WERE
GOING TO COVER SOME OF THE
SWINGS AND THE- LOCAL ASKED
MEANT BUT I THINK THE MAIN
PIECE I WOULD SAY IS A DRIVING
FACTOR TO SIGNIFICANT CHANGES
FOR TWENTY TWENTY ONE IS GOING
TO BE A LOWER PROJECTION OF
CASELOAD INCREASE- YOU'RE ALSO
GOING TO SEE AN INCREASE
PROJECTION FOR. F. MAP
SERVICES- AS WELL AS- REDUCE
ESTIMATES FOR OUR SPEAK ONLY
CLAIMING THAT WAS- ANNOUNCED-
IN THE GOVERNOR'S BUDGET- AND
THEN YOU'LL ALSO SEE SOME ITEMS
REGARDING THE MAN'S CARE
EXTENDED BILE- CORRECTION- AND
THERE'S ALSO LATER I WILL KIND
OF WALK THROUGH THE VARIOUS
WINGS- AND WHAT WE'RE SEEING IN
THE BUDGET I'M TO CALL HELP
HIGHLIGHT. THANK YOU SAID. I
BILLION DOLLARS IN OUR BUDGET
CAN BE YOU KNOW A 1% SWING BUT
THERE ARE USUALLY- BIG FACTORS
THAT DRIVE THOSE GAINS. BETTER
YEAH SOME SORT OF- BUT JUST IN
TERMS OF ON THE OVERVIEW SIDE
THERE'S A LINE CALLED
REIMBURSEMENTS- NINE NINE FIVE
AND THERE'S A BILLION DOLLAR.
SWINGING ROUGHLY- NINE HUNDRED
MILLION- THE EFFORT THIS YEAR
UPWARD AND THEN THIS PROJECTED
TO BACK DOWN. DO WE KNOW WHAT
THAT BILLION DOLLARS IS ABOUT.
R. NINE HUNDRED MILLION TO BE
MORE ACCURATE. I WOULD HAVE TO
I DON'T HAVE THAT EXACT BREAK.
I WOULD ASSUME IT'S PROBABLY
HAS TO DO WITH THE STATE ONLY
CLEANING ADJUSTMENTS WHICH YOU
HAVE OVER AND UNDER CLAIMING
WEBER DRYING DOWN ADDITIONAL
REIMBURSEMENTS FROM THE FEDERAL
GOVERNMENT BUT I WOULD ASSUME
THE MAJORITY OF THAT'S FALLING
OKAY NOW. AND THEN THE COSCO
QUALITY ASSURANCE REVENUE FUND
YEAH AND IT WENT FROM TWO POINT
NINE BILLION TO FIVE POINT FOUR
BILLION AND IS PROJECTED TO GO
DOWN TO THREE POINT. NINE
BILLION- SO IS- THERE'S A
REASON FOR THE EXTRA BUMP FOR.
THIS YEAR AND IT'S AGAIN IS
THAT GOING FROM TWO POINT NINE
UP TO FIVE POINT FOUR DOWN TO
THREE POINT. NINE SO- THIS DOES
THE HOSPITAL QUALITY ASSURANCE
REVENUE FUND DO IT IS THERE
THAT THERE SEEMS TO BE BETTER
SWINGS THERE. YEAH THAT THAT
WOULD NINETEEN PUBLIC HEALTH
EMERGENCY HAS HAD- SOME IMPACTS
ON THE HOSPITAL QUALITY
ASSURANCE FEE BUT LET ME SEE IF
ON WENDY HARRINGTON- ONCE
PROVIDE ADDITIONAL DETAIL
AROUND- THAT EXACT SWING THAT
YOU'RE SEEING- BECAUSE OF THE
PUBLIC HEALTH EMERGENCY. OKAY
I'M ON A HOSPITAL QUALITY
ASSURANCE FEE I'M A LOT OF IT
ACTUALLY ALSO COMES DOWN TO
JUST A CASH BASIC AS MEDIKAL
ESTIMATE OKAY AND SO- FROM A
TINY PERSPECTIVE OF WHEN WE'RE
ACTUALLY MAKING THEIR DEMANDS
I'M OUT YOU CAN CARP WEEK FROM
YEAR TO YEAR- BECAUSE WE'RE
MAKING MORE PAYMENTS IN ONE
YEAR THAN YOU WILL IN THE NEXT
YEAR. EVEN THOUGH IT IS. IF HI
OF WHEN PAYMENTS ACTUAL OCCUR
OKAY YEAH I WELL I JUST MAKING
WHEN WE WHEN YOU LOOK AT EVEN
IF THE OVERALL BUDGET SOMETHING
THAT. GOES A BILLION DOLLARS
YOU KNOW CATCHES NOTICED SO- SO
A DEAL IS MADE OKAY NEED A
CATCH TINY ISSUE BUT- WE HAVE
DISCUSSIONS ABOUT OTHER TYPES
OF THINGS WE WANT TO FUND AND-
THE L. MEDI CAL SWINGS A
BILLION HERE AND THERE. SO I
TRY TO UNDERSTAND AND THEN- ON
THEM I KNOW THE MEDICO DRUG
REBATE. FUND IS ALWAYS
SOMETHING THAT YOU KNOW. TURNS
AROUND AND IT'S TO. UP NO THAT
CENTER- SO. HOW WE HAVE HERE
IT'S A SO WE'RE- FOR THIS PAST
YEARS ABOUT ONE AND A HALF
BILLION. NEXT YEAR IS ABOUT THE
SAME BUT- WE I KNOW WE TOOK
SOME STEPS TO TRY TO MAKE SURE
WE DON'T HAVE SUCH LARGE SWINGS
IN THE MEDICAID DRUG REBATE
FUNDS SO WHAT'S THE LEVEL OF
CONFIDENCE THAT NEXT YEAR IT
WOULD ACTUALLY. BE AROUND THAT
RANGE VERSUS NOW IT HAS A
PRICES UNFORTUNATELY USUALLY
WHEN WE'RE LOOKING BACK. AND
HAVING A HAVING A SIGNIFICANT
IMPACT ON ON OUR BUDGET. YEAH I
THINK YOU KNOW- AS HISTORICALLY
IT IF YOU CAN BE A CHALLENGE TO
ESTIMATE REBATES BECAUSE- OF
THE RETROSPECTIVE NATURE. OF
THEM AND- VARIOUS POLICIES THAT
DRIVE WHAT WE DO AND DON'T GET
REBATES ON- SO I SAY WE DO OUR
BEST TO ESTIMATE THE REBATES-
ESPECIALLY BECAUSE THERE ARE
DIFFERENT TIMINGS FOR DIFFERENT
TYPES OF REBATES. ON THAT COME
IN AND INSTANCE WE ARE ON A
CASH BASIS. WE DO HAVE TO TREAT
THOSE UP ONCE WE HAVE A BETTER
UNDERSTANDING. OF THAT YES IT
CONTINUES TO BE A CHALLENGE
FROM THAT PERSPECTIVE BUT AGREE
THERE HAVE BEEN EFFORTS MADE
WITHIN THE BUDGET TO DO WHAT WE
CAN TO- TO NOT HAVE THOSE
SWINGS- ON THE REBATES I. OKAY
WELL JUST MAKE NOTE THAT YOU
KNOW WE WENT FROM. IN THE PRIOR
YEAR TWENTY NINETEEN TWENTY FOR
A NEGATIVE A HUNDRED SEVENTY
FIVE MILLION TO ONE POINT FOUR
NINE. ONE TWO ONE FIVE BILLION
SO YOU CAN SEE YOU KNOW THAT'S-
AGAIN THAT'S A ONE HALF BILLION
DOLLAR SWING AND COURSE NEXT
YEAR WE'RE PROJECTING. ON A
REVENUE PLUS YOU KNOW- I GUESS
RESIDENTS PLUS ONE POINT FOUR
OR ONE POINT FIVE BILLION
ROUGHLY I'M JUST ROUNDING- SO
GOING FROM THE SENSUALLY WE
HAVE TO PAY MONEY INTO WHAT
EXPECTING. AND THEN FINALLY-
THE HEALTH CARE SERVICES
SPECIAL FUNDS WHICH GOES FROM
ZERO TO TWO POINT SEVEN BILLION
AND THEN IS PROJECTED BUDGETED
FOR TWO AND A HALF BILLION I
CAN YOU RAINY WHAT THAT FUND
IS. AGAIN HEALTHCARE SERVICES
SPECIAL FUNDS THREE THREE THREE
FOUR. I DO NOT HAVE THAT IN
FRONT OF ME I DON'T KNOW IF ANY
OF THE DOCK COLLEAGUES CAN
SPEAK TO THAT YEAH WE CAN GET
BACK TO DOES. THIS FINANCING
WILL TO. TODAY UP JUST. CENTER
YEAH AND THIS IS RYAN MILLER
FROM THE DEPARTMENT OF FINANCE
ACTUALLY AND I WANTED TO GO
BACK TO THE DRUG REBATE I'M
JUST REALLY CORRECTLY I THINK
THAT I THINK THAT THE REASON
YOU'RE SEEING SUCH A KIND OF AN
ODD PATTERN WITH THAT PHONE. I
HAS TO DO WITH- AS YOU PROBABLY
RECALL WE CREATED THE FUND- IN
NINETEEN TWENTY AS A TOOL TO
TRY TO MANAGE THE VOLATILITY
THAT YOU'RE TALKING ABOUT- IN
THE MALAKAL ESTIMATE AND SO TE
FIRST YEAR THERE WE HAD
INITIALLY DEPOSITED- OR OR
MAINTAINED A SMALL RESERVES
THAT WE'VE BEEN LEADERS USE TO
OFFSET WHAT WOULD HAVE BEEN-
OTHERWISE A LARGER GENERAL
FUND. SWING SO I SUSPECT THAT
THAT. HAS TO DO WITH THAT- AND-
I'M LOOKING UP THE FUND RIGHT
NOW DOES ANYBODY ON MY TEAM
HAVE THAT INFORMATION- TO THE
HEALTH CARE SERVICES SPECIAL
FUND THREE THREE THREE FOUR.
YEAH I THINK IT'S THE I THINK
IT'S THE NEW MCO TAXES AND
SALES TAX OKAY YEAH AND SO THE
REASON THAT YOU KNOW THE GOING
FROM ZERO TO SUCH A LARGE-
EXPENDITURE FIGURE WOULD BE
BECAUSE IT LOOKS THE TAX
STARTED COMING IN IN THE
CURRENT- SORRY. OKAY WHEN I
JUST WANT TO KNOW OKAY ALEX
TELL ME TO MCOT THAT. NOW I
KNOW WHAT IT IS. OKAY THANK
YOU- I APPRECIATE THOSE
EXPLANATIONS- I JUST I JUST
MAKE NOTE THAT AS WE DO OUR
BUDGETING HERE- AND I REALIZED
AGAIN I WANTED IN CONTEXT WITH
A BUDGET A HUNDRED TWENTY
BILLION. YOU KNOW OF BILLION
DOLLARS IS STILL LESS THAN 1%
BUT- YOU KNOW I OFTENTIMES WERE
CONSIDERING ISSUES WHERE PEOPLE
ARE REALLY ASKING DOUBT LIKE
HUNDREDS OF THOUSANDS EVEN A
MILLION AND SUDDENLY. YEAH I
BILLION DOLLARS SWING. HAS CAN
HAVE A BIG IMPACT ON DECISIONS
WERE MAKING ABOUT SERVICES OR
OTHER TYPES OF THINGS THAT- WE-
YOU KNOW DEBATING INVENTORS OF
HELPING PEOPLE. WHEN THEY'RE
TALKING SKILLS OF MILLIONS OR
EVEN TENS OF MILLIONS YOU KNOW
THAT BILLION SO ME BEING. FROM
ONE YEAR TO ANOTHER. CAN HAVE A
HUGE IMPACT AND I THINK IT'S
IMPORTANT JUST TO RECOGNIZE
THOSE RECOGNIZE THAT AND THE
BILL UNDERSTAND. HOW THESE
SWINGS HAPPENED AND ALSO
RECOGNIZE IN TERMS OF THE
CONTEXT OF THE OVERALL MEDICAL
BUDGET. IT'S A VERY SMALL
PORTION. BUT IT DOES HAVE
SOMETIMES AN OUTSIZED IMPACT ON
OUR ABILITY TO DELIVER CERTAIN
SERVICES IN THE RIGHT. PLACES
IN THE BUDGET THANKS VERY MUCH.
THANK YOU VERY MUCH JIM LOOK
FORWARD TO GETTING IN THAT MORE
AS THE PRESENTATIONS GO ON. A
CENTER MELINDA'S. NOW I'M GET
MY QUESTIONS ANSWERED THANK
YOU. OKAY THANK YOU VERY MUCH
OKAY I THINK WE CAN MOVE ON TO
ISSUE TO. SO AT DH CS IT
RESPONDED VERY QUICKLY DURING
THE PUBLIC HEALTH EMERGENCY. AT
THIS POINT WE HAVE REQUESTED
CLOSE TO SIXTY OR SEVENTY OF
FLEXIBILITIES TO THE FEDERAL
GOVERNMENT TO ENSURE THAT WE
CAN PROVIDE. THE SERVICES THAT
WE NEED TO OUR MEDICARE
BENEFICIARIES DURING THE PUBLIC
HEALTH EMERGENCY- AND LEVERAGE
VARIOUS FEDERAL- WAIVERS AND
DISASTER- ABILITIES TO MAKE
THOSE FLEXIBILITIES HAPPENED. A
BIT CLUED A NUMBER OF THINGS
THAT ALLOWED FOR US TO QUICKLY
MOVE- DURING THE PUBLIC HEALTH
EMERGENCY. INCLUDING
FLEXIBILITIES AROUND STATE FAIR
HEARINGS BENEFITS- EXPANSION OF
TELEHEALTH. RATES ARE AND
VARIETY OF OTHER KIND OF
ADMINISTRATIVE FLEXIBILITIES
DURING THAT TIME PERIOD- WE
ISSUED NOTICES TO ALL MEDICARE
BENEFICIARIES- TO MAKE SURE
THAT THEY WERE AWARE OF THEIR
RIGHTS DURING THE PUBLIC HEALTH
EMERGENCY THERE FLEXIBILITY IS
THAT THEY- HAD BEEN IMPLEMENTED
SO THEY UNDERSTOOD. HOW THEY
COULD BE RECEIVING HEALTH CARE
DURING THE PUBLIC HEALTH
EMERGENCY WE ALSO LAUNCHED A
TWENTY SEVEN A NURSE LINE
SOMETHING THAT WE HAVE NEVER
DONE AT MEDIC CAL A FOR ALL
MEDICARE BENEFICIARIES AND THAT
INCLUDED THE UNINSURED. FOR
THAT TWENTY FOUR SEVEN NURSE
LINE MAKING SURE PEOPLE
UNDERSTOOD WHERE THEY COULD GO
FOR TESTING AS WELL IF THEY
HAVE QUESTIONS REGARDING KOBE
NINETEEN- AND DIRECTING THEM TO
THEIR MANAGED CARE PLAN IF THEY
HAPPEN TO BE A MANAGED CARE
PLAN- INDIVIDUAL AND ARE WE
TRACKING HOW DO WE KNOW OF WAS
IT WILL USED. IT HAS BEEN USED-
I DON'T HAVE THE EXACT STATS IN
FRONT OF ME BUT WE HAVE SEEN A
NUMBER OF CALLS WE ARE ABLE TO-
CONNECT THEM WITH THEIR LOCAL
PUBLIC HEALTH DEPARTMENTS.
WE'VE ALSO BEEN ABLE TO
IDENTIFY PEOPLE WHO WERE
UNINSURED GET THEM ENROLLED
INTO MEDIC CAL- AND WE WOULD BE
HAPPY TO HAVE A DECK THAT WE
CAN SEND YOU IF YOU'RE
INTERESTED IN REGARDS TO THE
NUMBER OF CALLS THE TYPES OF
CALLS- AND HOW WE HAVE UTILIZED
AT TWENTY FOUR SEVEN NURSE LINE
AND HOW HOW WELL WE- HAVE-
ADVERTISER PUT THE WORD OUT TO
THE PUBLIC. THAT THAT THAT LINE
IS THERE AND AVAILABLE. SO IN
THAT NOTICE THAT I WAS
REFERENCE. WE PUT THE
INFORMATION IN THAT BENEFITS
YOUR NOSE THAT WENT UP TO
THIRTEEN MILLION PEOPLE IN
THEIR HOMES- SO THAT THEY HAD
THE TWENTY FOUR HOUR NURSE LINE
WE HAVE IT. ON OUR WEBSITE WE
DO A SOCIAL MEDIA CAMPAIGN AND
WE HAVE PROVIDED IT TO ALL OF
OUR ADVOCACY GROUPS OF THE
PEOPLE KNOW- HOW TO REACH US
AND GET INFORMATION IF THEY
NEED IT. ALL RIGHT SO THAT'S
EIGHT SO THAT ADVOCACY GROUPS
THEN WILL BE CONTACTING THOSE
WHO ARE NOT. OTHERWISE COVERED
BY MEDICARE THAT THEY THEY WERE
ELIGIBLE. CORRECT AND EVEN
THOSE WITH MEDICARE CAN USE IF
YOU FOR SERVICE OR MANAGED CARE
WE WILL. PROVIDE SERVICES TO
ANYONE WHO CALLS THAT IS
CORRECT THANK YOU. FOR I'M-
ALSO DURING THE PUBLIC HEALTH
EMERGENCY WE STARTED TRACKING
UTILIZATION TRENDS VERY EARLY-
AND NOTICED THAT THERE WAS A
SIGNIFICANT. REDUCTION IN
UTILIZATION OF EMERGENCY ROOM
VISITS OUTPATIENT VISITS. AS
WELL AS CHILDREN IMMUNIZATION
RATES AND WE HAVE BEEN-
CONSISTENTLY SINCE MAY OF THIS
YEAR. A PARTNERING WITH THE
NUMBER OF PEOPLE TO GET THE
WORD OUT THAT PEOPLE SHOULD. A
RE ENGAGE AND HEALTHCARE- THEY
SHOULD BE GETTING IN FOR
IMMUNIZATION RATES AND WE HAVE
RECENTLY BEEN POSTING
DASHBOARDS. THE PEOPLE THAT
HAVE AN UNDERSTANDING OF THE
UTILIZATION TRENDS IN MEDIC
HOW- AND REALLY GETTING.
ESPECIALLY CHILDREN. A BACKEND
FOR IMMUNIZATIONS AND WELL
CHILD VISITS WHERE WE HAD
CERTAIN PARTS DURING THE PUBLIC
HEALTH EMERGENCY. FOR
UTILIZATION WAS SIGNIFICANTLY
DECREASED AND WE- ARE CONTINUE
TO PARTNER WITH A LARGE NUMBER
OF PEOPLE ACROSS THE STATE TO
GET THAT WORD OUT- WHEN IT
COMES TO ELIGIBILITY- I JUST
WANNA MAKE SURE EVERYONE'S
TRACKING IN IN MEDIC HOW- WE
HAVE A CONTINUOUS COVERAGE
REQUIREMENT DURING THE PUBLIC
HEALTH EMERGENCY- SO. FOR THE
MAJORITY OF THAT NO ONE CAN BE
DISTANT ROLLED FROM THE MEDIC
CAL PROGRAM DURING THE PUBLIC
HEALTH EMERGENCY IN ORDER FOR
US TO CONTINUE RECEIVING THE
ENHANCED FEDERAL MATCH- FROM
CMS- THERE ARE A FEW
EXCEPTIONS. TO THAT BUT THE
MAJORITY IS A CONTINUOUS
ENROLLMENT REQUIREMENTS- WE
ALSO IMPLEMENTED FOR OUR A CHIP
INDIVIDUALS WE WAIVE THE
PREMIUMS AND COST SHARING-
DURING THE PUBLIC HEALTH
EMERGENCY THAT WENT IN
IMMEDIATELY UPON DECLARATION OF
THE PUBLIC HEALTH EMERGENCY.
I'M IN SOMETHING WE COMMONLY
DO- WHEN WE HAD EVEN JUST STATE
DECLARED EMERGENCIES- WE
IMPLEMENTED THE OPTIONAL
UNINSURED COVERAGE ELIGIBILITY
GROUPS OF SOMEONE WHO WAS
UNINSURED HAS THE ABILITY TO
ENROLL. UP WITH DH CS TO HAVE
COVERAGE FOR TESTING TESTING
RELATED SERVICES IN KOBE
TREATMENTS- DURING THE PUBLIC
HEALTH EMERGENCY AND WE HAVE
HAD OVER NINETY FIVE THOUSAND
INDIVIDUALS AND ROLL AND THAT
UNINSURED COVERAGE GROUP TO
DATE- AND THEY WILL CONTINUE TO
RECEIVE COVERAGE THROUGH. THE
END OF THE PUBLIC HEALTH
EMERGENCY- WE ALSO TO IN THAT
THAT WERE UTILIZING CARE
THROUGH HOSPITALS- HAD EXPANDED
ACCESS TO PRESUMPTIVE
ELIGIBILITY. SO WE EXPANDED OUR
HOSPITAL PRESUMPTIVE
ELIGIBILITY DID TO INCLUDE
INDIVIDUALS SIXTY FIVE AND
OLDER- BECAUSE OF THE- IMPACT
THEY WERE HAVING DURING THE
PUBLIC HEALTH EMERGENCY WE FELT
THAT WAS. CRITICAL WE ALSO
IMPLEMENTED IN A LOT FOR
SOMEONE TO HAVE. YOU
PRESUMPTIVE ELIGIBILITY PERIODS
WITHIN A TWELVE MONTH TIME
FRAME FIRST IS THE PREVIOUS ONE
PERIOD- THAT WAS THE PREVIOUS
ROLE- WE ALSO ALLOWED FOR A
NUMBER OF FLEXIBILITIES TO
INCREASE ENROLLMENT TO ENSURE
PEOPLE HAVE ACCESS TO HEALTH
CARE SERVICES. INCLUDING
APPLICATION OF FLEXIBILITIES
FOR SIGNATURES AND TELEPHONIC
ENROLLMENT IN PROGRAMS LIKE OUR
AFFECT PROGRAM AND EVERY WOMAN
COUNTS. A FEW OTHER THINGS JUST
NOTE REGARDS TO CRITICAL
CHANGES- WE DID- INCREASE THE-
RATES FOR LONG TERM CARE AND
SKILLED NURSING FACILITIES BY
10% TO ENSURE THAT THEY HAD
ADDITIONAL FUNDS- TO PAY FOR P.
P. ADDITIONAL STAFFING ETCETERA
REALLY CRITICAL DURING THE
PUBLIC HEALTH EMERGENCY. WE
HAVE THE PENDING- STATE PLAN
REQUEST WITH CMS TO INCREASE-
OXYGEN 2100% OF MEDICARE GIVEN
THIS CURRENT- SHORTAGES IN IN
ISSUES GOING ON AROUND THE
STATE THAT WAS AN IMPORTANT
MOVE. A WE DID THE SAME WITH
COVER NINETEEN TESTING ENSURING
THAT COULD NINETEEN TESTING WAS
PAID AT A 100% OF MEDICARE
PERSONS ARE TYPICAL 80% OF
MEDICARE. WE ALSO QUICKLY I
WORKED WITH OUR COUNTY
PARTNERS- TO IMPLEMENT
INTEROPERATES FOR BEHAVIORAL
HEALTH BOTH MENTAL HEALTH AND
SUBSTANCE USE DISORDER. TO
ALLOW- A STEADY FLOW OF CASH TO
THE COUNTIES DURING THE PUBLIC
HEALTH EMERGENCY- WITH THE
RECONCILIATION. AFTER THE
PUBLIC HEALTH EMERGENCY AND WE
DIDN'T MAKE ADJUSTMENTS TO
THEIR ALLOWABLE- COUNTY ADMIN
COSTS DURING THIS TIME AS WELL.
WE DID- PUT NOTICE OUT TO ALL
PROVIDERS DURING THE PUBLIC
HEALTH EMERGENCY IF THEY HAD
HARDSHIPS HOW THEY COULD WORK
WITH THE DEPARTMENT TO ENSURE.
THAT WE ARE WORKING WITH THEM
ON OVER PAYMENT SCHEDULES- AND
WE ALSO. IMPLEMENTED A NUMBER
OF FLEXIBILITIES ON THE
BEHAVIORAL HEALTH SIDE WITH
SAM'S- AND ENERGY YOU WHY
PROGRAM. A FEW OTHER KIND OF
PIECES JUST TO NOTE- WE
IMPLEMENTED CAL HOPE- WHICH IS
A CRISIS COUNSELING PROGRAM IN
PARTNERSHIP WITH FEMA- THAT
ALLOWS FOR TWENTY SEVEN ACCESS
TWENTY FOUR SEVEN ACCESS TO
COUNSELING SERVICES- WE ARE
CURRENTLY WORKING WITH CMS ON
OUR VACCINE REQUESTED HOW WE
WILL PAY FOR- VACCINES. IN THE
MEDICAID PROGRAM MIMI HERE WHAT
I WOULD SAY IS THAT WE
REQUESTED TO COVER ALL MEDICARE
POPULATIONS INCLUDING THE
UNINSURED AND THE RESTRICTED
SCOPE INDIVIDUALS YOU'RE HOPING
CMS WILL COME BACK WITH AN
APPROVAL ON THAT. WE ARE
WORKING WITH THEM ON THE
TESTING IN SCHOOLS PORTION OF
THAT IF IMPACTS MEDI CAL
CHILDREN- AND WE ARE WORKING
WITH THEM ON FLEXIBILITIES IN
CRISIS STABILIZATION FOR
BEHAVIORAL HEALTH. AT THIS
TIME- I WOULD ALSO JUST NOTE.
THAT THE FEDERAL GOVERNMENT HAS
ANNOUNCED THAT THEY WILL AND
INTEND TO EXTEND THE PUBLIC
HEALTH EMERGENCYTHROUGH THE
END. OF THIS YEAR I WHICH
ALIGNS WITH OUR BUDGET
PROPOSAL- AND THAT THEY DO PLAN
ON GIVIG STATES A SIXTY DAY
NOTICE PRIOR TO THE END OF THE
PUBLIC HEALTH EMERGENCY TO
ALLOW FOR PLANNING.
COMMUNICATION WITH PROVIDERS
MANAGED CARE PLANS
BENEFICIARIES- WHICH WE ARE
GRATEFUL FOR- AND WE ARE
CURRENTLY AT DH CS BUILDING OUR
COMPREHENSIVE UNWINDING PLANNED
FOR WHEN THE PUBLIC HEALTH
EMERGENCY AND- POWERFUL ROLE
THAT INFORMATION OUT. TO OUR
PROVIDERS PLANS BENEFICIARIES
BECAUSE THERE HAVE BEEN
SIGNIFICANT FLEXIBILITY TO PUT
IN PLACE DURING THE PUBLIC
HEALTH EMERGENCY AND PEOPLE
NEED TO KNOW WHAT IS
CONTINUING. AND WEBER AND- SO I
WILL THERE AND SEE IF THERE.
REGARDING HOW DO YOU CS HAS
RESPONDED DURING THE PUBLIC
HEALTH EMERGENCY. I THINK I
THINK I JUST BURST LIKE TO SAY
THAT THAT. THAT I WANT TO THANK
EVERYBODY FOR THEIR WORK A
MASSIVE UNDERTAKING. AND NOBODY
PLANNED ON A PANDEMIC BUT THEN
HERE CAME IN SO I JUST I HAVE A
QUICK REACTION TIME I THINK TO
THE BIGGEST POPULATION. IN THE
NATION TO BE ABLE TO RESPOND.
AS QUICKLY AS WE DID SO THANK
YOU FOR OUR FOR ALL OF YOUR
WORK. A DIFFERENT. THANK YOU SO
VERY MUCH FOR THAT-
PRESENTATION AND- SO-
IMPRISONED THE IN THE BUDGET
THE F. MAP ENHANCEMENTS-
BASICALLY IS LINED UP WITH THE
PUBLIC HEALTH EMERGENCY FEDERAL
PUBLIC HEALTH EMERGENCY CORRECT
BECAUSE I BELIEVE YOU HAVE IT
THIS ASSUMPTION IS THAT IT BE
EXTENDED UNTIL DECEMBER THIRTY
FIRST TWENTY TWENTY ONE CORRECT
THAT IS CORRECT IT CURRENTLY
ALIGNS WITH WHAT THE FEDERAL
GOVERNMENT HAS PROPOSED FOR THE
PUBLIC HEALTH EMERGENCY OKAY
AND THEN I SOON MASTERS
DIVERGENCE HE ADDS THAT THE
ENHANCE F. NAPOL. MOLD THEN
REVERT BACK TO OUR CLUB USUAL
F. MAP AND THAT ALL RIGHT AND
THEN DO AND I KNOW YOU
MENTIONED- AND I KNOW YOU CAN'T
ALWAYS PREDICT WHAT CMS IS
GOING TO DO- BUT- APPRECIATE
THE- THE- PENDING APPROVAL
EMAIL THE SPOTS THAT YOU PUT IN
FRONT- DID YOU. DO YOU WANT BE
ABLE TO. GIVE US A WHEN YOU
THINK OF. WE'RE GOING TO GET
FOR EXAMPLE THE VACCINATION
COVERAGE REIMBURSEMENT OF
TESTING IN SCHOOLS IS THAT IS
THAT SOMETHING THAT'S FAR ALONG
THE PROCESS SIR- I AGAIN I'M
NOT GONNA HOLD YOU TO EXPLAIN
NOTE CMS ASIAN NOT YOURS BUT-
WHAT WHAT'S YOUR HOPE FOR
TIMELINE FOR. IF FOR HOPEFULLY-
DECISION OR APPROVAL OR- FOR
OUR LACK OF APPROVAL FOR THE
SAID REQUEST. SO WE HAVE BEEN
VERY ACTIVELY WORKING WITH CMS
REGARDING BOTH VACCINES AND
TESTING IN SCHOOLS. OF ALL
BREAK THEM- SEPARATELY SO FOR
THE VACCINE COVERAGE- BUT WE-
WE FEEL VERY CONFIDENT THAT
THEY WILL APPROVE THAT CARVE
OUT VACCINES FROM MANAGED CARE
TO P. FOR SERVICE WE PROPOSE
THAT. I'VE GIVEN THE COSTS
ASSOCIATED WITH REIMBURSING THE
ADMIN PORTION OF THE VACCINE-
WE HAD NOT BUILT INTO THE
MANAGED CARE PLAN RATES AND SO
FELT IT WAS APPROPRIATE WE ALSO
WANTED TO ENSURE THAT PEOPLE
WOULD HAVE- ACCESS REGARDLESS
OF WHO IS PROVIDING THE VACCINE
AND SO. AS LONG AS THEY WERE IN
ROLLED MEDIC CAL PROVIDER- IT
THEY WOULD BE ABLE TO BILL FEE
FOR SERVICE AND SO WE FEEL
PRETTY COMFORTABLE CMS WILL
IMPROVE THAT. WE HAVE BEEN
DOING SOME BACK AND FORTH WITH
CMS IN REGARDS TO- WHETHER OR
NOT THEY WOULD ALLOW US TO
COVER THE VACCINE
ADMINISTRATION FOR THE
UNINSURED- AND THE RESTRICTED
SCOPE AND WE CONTINUE TO
ADVOCATE FOR THAT- WITH THEM
HOWEVER THEY HAVE. THEY DO HAVE
SOME OPTIONS FOR REIMBURSEMENT
ON THAT FRONT OUTSIDE AND SO
WE'LL CONTINUE TO EXPLORE THAT-
WITH CMS TO DRAW DOWN THOSE
FEDERAL FUNDS. ON THE TESTING
IN SCHOOLS- WE TALKED TO CMS
VERY REGULARLY. HER GUIDING
THIS I THINK. THIS WEEKEND LAST
WEEK WE HAD- COME. AND EMAILS-
I THINK WE ARE GETTING CLOSE-
IN REGARDS TO THIS ONE I THINK
THAT THEY ARE- WANTING TO VERY
MUCH PARTNER WITH CALIFORNIA
REGARDING THIS APPROACH- IN SO
WE ARE WHO. WE ARE CONTINUE TO
WORK AND HOPEFULLY WE WILL BE
ABLE TO- HAVE EIGHT RESULT OR
APPROVAL OR INFORMATION FROM
CMS- IN THE COMING WEEKS- IF
NOT NEXT WEEK HOPEFULLY.
REGARDING THAT OUTCOME. OKAY NO
APPRECIATE THAT ALSO FEATURED
ON THE VACCINE COVERAGE WE'RE
LOOKING TO ESTABLISH MEDICARE
REIMBURSEMENT RATES FOR VACCINE
MINISTRATION I KNOWTHAN THE
MEDICAID SIDE HIS PEDIATRICIAN
TAKES CARE OF MEDICAL PATIENTS.
SOMETIMES THE REIMBURSEMENT FOR
A DEMONSTRATION STILL BELOW
COSTS SO THAT'S AND SOMETIMES A
CHALLENGE FOR SOME. PROVIDERS
ACTUALLY DELIVER VACCINES SO-
WILL BE SURE THAT THE DAY
EXPENSES ARE COVERED- OF- I
THINK BOTH BECAUSE WILL DIVE
INTO SOME OF THE OTHER THINGS
MORE AND MORE DETAILED
SUBSEQUENT. ISSUES SO THANK YOU.
BOTH OF ALL UP QUESTION TO THAT
JUST ON ON THE OF. VACCINES IN
AND- IN SCHOOL. HAVE YOU HAVE
YOU IS THAT ONE OF THE BIGGEST
THINGS YOU'VE HEARD FROM YOUR
PROVIDERS IS IT THE LACK OF
STAFF FOR THE LACK OF TESTING
IN ORDER OR THE LACK OF STAFF
I'M SORRY FOR THE LACK OF
VACCINATIONS IN ORDER TO FULLY
DISTRIBUTE THE VACCINATIONS- TO
THE CONSTITUENCIES. I THINK
THAT- YOU KNOW WE HAVE BEEN
WORKING CLOSELY WITH A PUBLIC
HEALTH AND OTHERS IN REGARDS
TO- THE VACCINE ADMINISTRATION-
AND WORKING VERY CLOSELY WITH
OUR MANAGED CARE PLANS FOR
EXAMPLE- AS INDIVIDUALS ARE
BEING VACCINATED WE ARE WORKING
ON DATA FEEDS IMMEDIATELY BACK
TO OUR MANAGED CARE PLANSSO
THAT THEY CAN BE PARTNERS IN
IDENTIFYING INDIVIDUALS WHO-
HAVE NOT HAD. A VACCINE- YET
AND TO GET THAT INFORMATION OUT
ONCE IT IS IN THE PHASE IN
WHICH THAT PERSON WOULD BE-
AVAILABLE. I THINK THAT THERE
HAVE BEEN A NUMBER OF GREAT
BUT- YOU KNOW- MOVEMENT TO
RECENTLY IN REGARDS TO HAVING
MORE ACCESS TO VACCINE I KNOW
THAT THERE ARE. A NUMBER OF
PLANS THAT ARE STILL ROLLING
OUT IN REGARDS TO IT. I THINK
YOU KNOW THE MAJORITY HAS TO DO
PROBABLY WITH THE- THE NUMBER
OF VACCINES COMING TO THIS TO
THE STATE. OF AND SO I THINK
GETTING THOSE TWO INDIVIDUALS
WHO HAVE THE ABILITY TO GET THE
VACCINES IN. A WE'VE BEEN
PARTNERING WITH KEY PARTNERS
LIKE PUBLIC HOSPITAL SYSTEMS
FOR EXAMPLE WHO ARE- HUGE
PLAYERS IN THE MEDICAID SPACE
TO ENSURE THAT THEY ARE DOING.
WHAT THEY CAN IN THEIR LOCAL
ENVIRONMENTS YOU NOT ONLY GET
THE VACCINE OUT TO MEDICAID
INDIVIDUALS BUT FOCUSING ON IT
FROM AN EQUITY LENS TO ENSURE
THAT THEY ARE INVESTING
THEMSELVES N COMMUNITIES
WHERE. THERE MAY NOT BE AS MUCH
ACCESS AND SO I THINK THERE
WILL CONTINUE TO OUR PARTNER
WITH OUR- R. T. PROVIDERS ON
THE ON THE GROUND OF DOING THIS
VACCINE WORK TO HOPEFULLY GET-
IS MANY. MEDICAID INDIVIDUALS-
WITH THE VACCINE AS SOON AS WE
CAN WITHIN THE DISTRIBUTION OF
FROM THE FEDERAL GOVERNMENT TO
ADD TO CALIFORNIA AS WELL AS-
YOU KNOW WITHIN THE PHASING IN.
THE TEARS THAT ARE ANNOUNCED BY
PUBLIC HEALTH. I AND I WOULD
AND I WOULD JUST I GUESS JUST
JUST TO SAY I THINK THAT'S ONE
OF THE ISSUES AROUND OF ANXIETY
FOR PUBLIC HOSPITALS AND OTHER
PROVIDERS IS THAT THE NEW THIRD
PARTY. ADMINISTRATOR COMING
INTO MAKING SURE THE NETWORKS
THAT WE PROTECT THAT THAT EVERY
MUNICIPALITY HAS. STOOD UP OVER
THIS LAST YEAR IS STILL GOING
TO BE UTILIZED AND ALL THOSE
CONTACTS ARE GOING TO BE JUST.
JUST FOR NOT CAN YOU TELL ME
HAVE THERE BEEN ANY OTHER
STATES THAT ARE FURTHER ALONG
WITH US IN GETTING THIS
APPROVAL FROM CMS- IN REGARDS
TO BACK SCENES OR TESTING. OR
AS I KNOW- I DO NOT KNOW WHERE
OTHER STATES ARE IN REGARDS TO
THEIR VACCINE APPROACH I KNOW
THAT- WE'VE BEEN PARTNERING
WITH A NUMBER OF STATES IN
REGARDS TO IT. I DON'T KNOW IF
THEY RECEIVED AN APPROVAL- I
WOULD I WOULD NEED TO GO BACK
AND CHECK WITH MY OTHER.
MEDICAID DIRECTORS- IN ON
TESTING IN SCHOOLS I BELIEVE
CALIFORNIA IS THE FIRST WITH
THE PROPOSAL TO CMS I'M IN THE
NATURE OF WHICH WE ARE
REQUESTING. ED GENERAL INDUSTRY
YOU HAVE ANY QUESTIONS. FOR
GOOD THANK YOU MANAGER
DEPARTMENT FINANCE. MISTER
JESSE RYAN MILLER DEPARTMENT OF
CRINOID APARTMENT FINANCES
NOTHING HAD THANK YOU OKAY
FILIAL. YEAH HI BEN JOHNSON
FROM THE LA A ONE SORT OF BE
THE CONTEXT WANTED TO ADD IS
THAT FEDERAL LEGISLATION SORT
OF ESTABLISHED THE YOU KNOW
OPPORTUNITY FOR STATES TO COVER
AT A 100% FEDERAL FUNDS THAT
TESTING COST FOR- FOR KOBE. THE
STATE ELECTED TO PROVIDE
TREATMENT AS WELL WITHIN THIS
INSURANCE POPULATION AT A AND
IT'S CURRENTLY REFLECTED AS A
100% GENERAL FUND AND SO ONE
SORT OF A- ONE OPPORTUNITY THAT
MAY EXIST FOR THE STATE IS EVEN
IF THE FEDERAL GOVERNMENT
ELECTS NOT TO SORT OF. FIND
THEIR VACCINE ADMINISTRATION
COSTS FOR THIS POPULATION. TO
USE STATE FUNDS TO DO SO. OKAY
THANK YOU. OKAY SO WE'LL MOVE
ON TO ISSUE THEN NUMBER THREE
THAT MEDICAL LOCAL ASSISTANT
ESTIMATE. GREAT ALL THAT SO
WITHIN THE MEDICAL LOCAL
SYSTEMS ESTIMATE FOR FISCAL
YEAR TWENTY TWENTY ONE THE
ESTIMATE PROJECT A HUNDRED AND
EIGHTEEN BILLION DOLLARS IN
TOTAL- FUND SPENDING IN META
CAL I'M TWENTY TWO POINT FIVE
BILLION IN GENERAL FUND- THIS
DOES REPRESENT A TWO POINT FOUR
BILLION TOTAL FUND INCREASE 42%
INCREASE OF FOR FISCAL YEAR
TWENTY TWENTY ONE COMPARED TO
THE BUDGET ACT- HOWEVER GENERAL
FUND SPENDING IN FISCAL YEAR
TWENTY TWENTY ONE IS DOWN BY
ONE POINT TWO BILLION COMPARED
TO THE BUDGET ACT. SOME OF THE
MOST SIGNIFICANT DRIVERS OF
THIS CHANGE- IS ESTIMATED
SPENDING IN TWENTY TWENTY ONE
INCLUDES A LOWER PROJECTION OF
CASELOAD INCREASE OF AN
INCREASE PROJECTION OF FOR THE
AMOUNT OF INCREASED F. MAP AS
WE WERE MENTIONING EARLIER-
REDUCED ESTIMATES OF PAYMENTS
RELATED TO THE STATE ONLY
CLAIMING THAT WE'RE WORKING
CLOSELY WITH THE FEDERAL
GOVERNMENT ON AS WELL AS A
MANAGED CARE EXTENDED FILE
CORRECTION ON THAT RESULT IN A
ONE TIME COST OF THREE HUNDRED
MILLION DOLLARS. FOR FISCAL
YEAR TWENTY ONE TWENTY TWO OF
THE ESTIMATE PROJECTS EIGHT
HUNDRED AND TWENTY TWO POINT
TWO BILLION IN TOTAL FUNDS
SPENT FOR MEDIC CAL OF WHICH
TWENTY EIGHT POINT FOUR BILLION
WOULD COME FROM THE GENERAL
FUND THIS REFLECTS A THREE
POINT 7% INCREASE OF TOTAL
SPENDING- AND A TWENTY SIX
POINT FOUR INCREASE AND GENERAL
FUND SPENDING ARE THE MOST
SIGNIFICANT DRIVERS FOR THESE
CHANGES INCLUDE SIGNIFICANT
GROWTH IN COSTS RELATED TO THE
CUP IN NINETEEN CASELOAD- BASED
ON THE ASSUMPTION THAT THE
FEDERAL PUBLIC HEALTH EMERGENCY
WILL. CONTINUE THROUGH THE END
OF DECEMBER OF TWENTY TWENTY
ONE- IT ALSO ASSUMES AN
INCREASED F. MAP AND THAT WOULD
BE ENDING AT THE END OF THE
PUBLIC HEALTH EMERGENCY WHICH
IS CURRENTLY ESTIMATED FOR THAT
ARE TWENTY ONE TIME PERIOD
WHICH RESULTS. IN GENERAL FUND
COSTS- IT DOES INCLUDE A ONE
ONE BILLION- TOTAL FUND AND
FIVE HUNDRED TWENTY ONE MILLION
GENRAL FUND TO IMPLEMENT
VARIOUS ASPECTS OF THE CALLIN
PROPOSAL. A SEVEN HUNDRED FIFTY
MILLION DOLLAR GENERAL FUND
PROPOSAL FOR THE BEHAVIOR
HEALTH CONTINUE ON
INFRASTRUCTURE. FOUR HUNDRED
MILLION TOTAL FUN TWO HUNDRED
MILLION GENERAL FUND PROPOSAL
ON TO INCREASE ACCESS TO
BEHAVIORAL HEALTH SERVICES IN
SCHOOLS. AS WELL AS FUNDS A
VARIETY OF OTHER PROPOSALS
INCLUDING REMOTE PATIENT
MONITORING AS WELL AS OTHER-
ITEMS WITHIN ON THE BUDGET
INCLUDING THINGS LIKE
CONTINUOUS GLUCOSE MONITORING-
SO I WILL STOP THERE AND SEE IF
YOU HAVE ANY QUESTIONS. THE
WASHINGTON. THANK YOU ACTUALLY
BOB. WE JUST HAVE A NICE ASK
KELLY- TO COMMENT ON IT AND I
DON'T QUESTION REGARDING THE
CASE LIST I LIKE TO HEAR FROM
LA WHAT THEIR THOUGHTS ARE.
FIRST HELLO AT HI. GOOD MORNING
THIS IS- NETWORKS THE CALL FROM
THE LEGISLATIVE ANALYST'S
OFFICE FIRST OFF JUST LET YOU
KNOW THAT. WE'VE RELEASED OUR
ANALYSIS OF THE OVERALL MEDICAL
BUDGET IS THAT THEY'LL GO ON
OUR WEBSITE. A KEY FOCUS OF THE
IN HOUSE THIS IS ON IS ON
CASELOAD WE HAVE WE HAVE A
SLIGHT DIFFERENCE WITH THE
ADMINISTRATION OVER- CASELOAD
GROWTH WHICH IS. IMPORTANT
BECAUSE IT ACCOUNTS FOR A- VERY
SIGNIFICANT HE'S OF THE- YEAR
OVER YEAR FUNDING INCREASE MMHM
I THINK YOU TAKE AWAY OF OUR
ANALYSIS IS THAT WE BELIEVE
THAT CASELOAD GROWTH WILL BE
LOWER THAN THE ADMINISTRATION
PROJECTS- AND WE'RE EXPECTING
AS A RESULT. ABOUT ONE BILLION
DOLLARS LAST IN CASE OF RELATED
COSTS OVER BOTH MEDIA PER YEAR
AND THE BUDGET YEAR. HAVING
SAID THAT WE ARE NOT
RECOMMENDING ANY ADJUSTMENTS TO
THE BUDGET RIGHT NOW. VK SO%
PROJECTIONS ARE SUBJECT TO
SIGNIFICANT UNCERTAINTY EVEN.
MORE MORE SUBTLY AND NOT AT
THIS YEAR BECAUSE OF THE
UNPRECEDENTED. A PANDEMIC. AND
SO WE FEEL WOULD BE APPROPRIATE
TO WE UNTIL MAY WHEN WE HAVE-
DATA ON- CASES INCREASES OVER
THE COURSE OF THE PANDEMIC TO
WORK OFF OF- BUT JUST BRIEFLY
GO OVER. SOME OF THE SOURCES OF
OUR OUR DIFFERENCES- SO IF YOU
LOOK AT HISTORIC GROWTH OVER
THE COURSE OF THE PANDEMIC
THAT'S FAR FROM. MARCH TWENTY
TWENTY UP UNTIL DECEMBER TWENTY
TWENTY WHICH IS THAT WHEN THE
MOST RECENT- DATA ON KESSLER
WAS AVAILABLE- WHEN WE WERE
CONDUCTING OUR ANALYSIS- OVER
OVER THAT. THE AVERAGE MONTHLY
MEDICAL CASE OF GROWTH WAS A
LITTLE BIT LESS THAN A HUNDRED
FORTY THOUSAND NEW ENROLLEES- I
NOW ORDER TO REACH THE AT
NUMBER IS THAT THE
ADMINISTRATION IS PROJECTING.
THAT WOULD NEED TO INCREASE IN
CALENDAR YEAR TWENTY TWENTY ONE
BY NEARLY 50% FROM FROM LESS
THAN A HUNDRED FORTY THOUSAND
NEW ENROLLEES- MONTHS YOU.
NEARLY TWO HUNDRED THOUSAND-
ENROLLEES PER MONTH. NOW THAT
THAT IS WITHIN THE REALM OF
POSSIBILITY BUT WE THINK IT
REPRESENTS A- WORST CASE
SCENARIO RATHER THAN WHAT WE
WOULD CONSIDER TO BE THE- THE
LIKELY SCENARIO. THE OTHER
IMPORTANT THING TO KNOW IS THAT.
WE THINK THAT OF THE NEW
ENROLLEES SET THAT WILL BE
ADDED OVER THE COURSE OF A
CALENDAR YEAR TWENTY TWENTY
ONE. WE EXPECT A RELATIVELY FEW
WORST IN YEARS AND PEOPLE WITH
DISABILITIES AND THAT
POPULATION AND ILLUSTRATION IS
PREDICTING AND- MORE FAMILIES
AND CHILDLESS ADULTS WHO ARE
RELATIVELY SPEAKING TEND TO BE.
LESS COSTLY TO PROVIDE COVERAGE
TO- SO THAT'S WHERE WE GET THE-
PROJECTED A ONE BILLION DOLLARS
LOWER THAN THE- ADMINISTRATION
IS PROJECTING. BUT BUT AGAIN I
JUST- JUST TO REITERATE- THIS
IS ALL SUBJECT TO- SIGNIFICANT
UNCERTAINTY AND SO AS A RESULT
WE ARE NOT RECOMMENDING ANY
ADJUSTMENTS TO THE BUDGET
BEFORE NAY- HAPPY TO TAKE ANY
QUESTIONS ARE YOU- ARE YOU IN
ARE YOU PROJECTING. FEWER
SENIORS JUST BECAUSE YOU THINK
THEY'RE ALREADY ALL IN THE POOL.
ALL RIGHT YEAH WELL BEYOND A
LOT OF THE- WHAT'S DRIVING
CASELOAD IS- GOING TO BE-
EMPLOYMENT LOSSES. AND SO WE
THINK THAT AS A RESULT. IN MANY
OF THE GAMES ARE GOING TO BE
FROM THE WORKING AGE
POPULATION. THANK YOU .COM YEAH
THANK YOU VERY MUCH AND-
VITIATE COMING FROM BOTH THE
ADMINISTRATION AND A LOW- ON
THIS SO IN THIS PROJECTION-
WE'RE ASSUMING THE PUBLIC
HEALTH EMERGENCY WILL GO UNTIL.
DECEMBER THIRTY FIRST TWENTY
TWENTY ONE I UNDERSTAND THAT-
AS PART OF THE- THAT WE BOTH
GET INCREASE F. MAP BUT ALSO
WE'RE WE- ALSO HAVE TO COMMIT
TO PROVIDING. CONTINUED
COVERAGE AND THAT SEEMS AT
LEAST FROM THE EXPLANATION IS
PART OF ONE OF THE STRONGEST
WRITING SOME OF THE
ADMINISTRATION'S INCREASED
CASELOAD- WAS THERE ALSO IN
YOUR PROJECTION WHAT WHAT WAS
YOUR PROJECTION WHAT HAPPENED
THE CASELOAD AFTER DECEMBER
THIRTY FIRST OF TWENTY TWENTY
ONE WHEN AND IF. TO ME THAT THE
PUBLIC HEALTH EMERGENCY OVER
AND WE. LOSE THE F. MAP BUT WE
ALSO THEN WOULD. THEN ALSO
ALAMEDA REQUIRED TO RETAIN
PEOPLE MEDIC. AND ESSENTIALLY
GO BACK TO OUR USUAL MEDICARE
ELIGIBILITY NOW I'M SOMEONE WHO
USUALLY LIKE TO GET MORE PEOPLE
ENROLLED NOT LESS PEOPLE SO I'M
NOT LOOKING FOR HER. YOU KNOW
HAVING A WHOLE BUNCH OF PEOPLE
FALL OFF BUT- I DO WANT TO
UNDERSTAND WHAT THE
ADMINISTRATION'S ASSUMPTIONS
ARE ABOUT WHAT HAPPENS AFTER
DECEMBER THIRTY FIRST TWENTY
TWENTY ONE- AFTER TO. PUT
PUBLIC HEALTH EMERGENCIES
OVERLY SPACE AND THAT
REQUIREMENT NO LONGER APPLIES
AS WELL AS THE YOU KNOW LOSS OF
THESE ENHANCE F. MAP SO IN
TERMS OF CASELOAD WHAT WHAT
HAPPENS AFTER. DECEMBER THIRTY
FIRST TWENTY TWENTY ONE WAS
ADMINISTRATION PROJECTING FOR
THIS BUDGET. OR SO- WE DO- WE
HAVE LOOKED AT THE GUIDANCE
THAT CMS'S PROVIDED IN REGARDS
TO THE STEPS THAT STATES WILL
HAVE TO TAKE TO. LOOK AT
REDETERMINATION AT THE END OF
THE PUBLIC HEALTH EMERGENCY-
YOUR MASTER'S CURRENT
RECOMMENDATION IS THAT THAT
TAKE PLACE WITHIN SIX MONTHS
HOWEVER. GIVEN THE LARGE- SIZE
AND SCOPE OF THE MEDIC HOW-
PROGRAMMING CALIFORNIA- WE ARE
CURRENTLY ESTIMATED IN THE
BUDGET THAT IT WOULD TAKE A
FULL TWELVE MONTHS TO. EVALUATE
I'M INTO THE RE DETERMINATIONS
FOR THAT TIME PERIOD- IN WHICH
CASE WE WOULD HAVE TO MAKE-
THERE ARE SOME OPTIONS IN
REGARDS TO THE NUMBER OF PEOPLE
THAT WOULD STAY ON. A MEDIC CAL
BASED ON THAT REDETERMINATION
OF AND OPPOSE- THAT WOULD AND-
NO LONGER BE ELIGIBLE OF
SUPPORT FOR THE PROGRAM OR
COULD HAVE A CHANGE ENSURE
COSTS FOR EXAMPLE ALL OF THOSE
SCENARIOS ARE. ARE POSSIBLE-
AFTER THAT TIME PERIOD AND SO
THAT IS WHAT THE BUDGET IS
CURRENTLY ASSUMING OKAY SO
THEREFORE YOU WOULD EXPECT-
THAT NOBODY WOULD BE THIS
DROPPED WHAT HAPPENED OVER A
PERIOD OF A YEAR IN TERMS OF
RETURNING ELIGIBILITY. AND AND
IF THE CMS GUIDANCE IS SIX
MONTHS IS THAT. DOES THAT PUT
THE STATE AT RISK. FOR
BASICALLY COURSE THE FEDERAL
BATCHES THEY THEY MAY COME BACK
AND SAY WELL GEE WHAT YOU KNOW
WE WANT YOU TO DO THIS IN SIX
MONTHS AND- WHY SHOULD WE BE
PAYING A MATCH FOR SOMETHING
OVER YEARS AND ISSUES THAT.
YOU'D EXPECT MIGHT COME UP- IN
TERMS OF. AGAIN I'M SOMEONE WHO
ACTUALLY DOESN'T WANT TO TRY TO
TELL PEOPLE OFF THAT BUT I JUST
WANT TO UNDERSTAND BECAUSE THIS
BEING A FEDERAL STATE PROGRAM.
AND CMS GIVES GUIDELINES- IF WE
DON'T FOLLOW THEIR GUIDELINES
STATE SOMETIMES SAY OKAY WE
WANT TO CLAW BACK OUR SHARE THE
MONEY AND YOU CAN PAY FOR IT.
SO DO WE- CAN DO WHAT CAN YOU
JUST CLARIFY THAT'S AN ISSUE.
SO ARE WE ARE CURRENTLY
ADVOCATING WITH CMS. TO ALLOW
FOR THE TWELVE MONTH TIME
PERIOD- AND ARTICULATING TO
THEM WHY THAT'S GOING TO BE SO
IMPORTANT I THINK- WHEN THEY
ORIGINALLY. ISSUED THAT
GUIDANCE I DON'T THINK MANY
ANTICIPATED THAT THE PUBLIC
HEALTH EMERGENCY WOULD BE. I'M
STILL IN PLACE ALL THE WAY
THROUGH DECEMBER OF TWENTY
TWENTY ONE THAT GUIDANCE WAS
RELEASED. I'M QUITE SOME TIME
AGO I DURING. THAT TWENTY
TWENTY AND SO- WITH THE NEW
ADMINISTRATION COMING IN- WE
HAVE FULL INTENTIONS OF. I'M
CONTINUING TO EDUCATE OUR CMS
COLLEAGUES IN REGARDS TO THE
HEAVY LIFT THAT THIS WILL TAKE
ESPECIALLY IN STATES AS LARGE
AS CALIFORNIA. WITH THE NUMBER
OF LIVES THAT WE WILL HAVE TO
RE DETERMINE- IN OF COURSE THE
CMS STILL OPINES WE DO HAVE
ESTIMATES ARE THAT ALLOW FOR US
TO MAKE THOSE ADJUSTMENTS TO
COMPLY WITH FEDERAL LAW- AND WE
WOULD. BE LOOKING TO WORK WITH
OUR COUNTY PARTNERS ON WHAT
THAT WOULD TAKE THEM. IN ORDER
TO MEET WITHIN SIX MONTHS
VERSUS TWELVE MONTHS SO WE DO
HAVE- ANALYTICS ON BOTH SIDES
BUT ARE CURRENTLY STILL I'M
ADVOCATING TO CMS THAT. WE NEED
TO BE REASONABLE- WITHIN THIS-
EXTENSION ESPECIALLY SINCE THE
PUBLIC HEALTH EMERGENCY AT THIS
POINT HAS GONE AS LONG AS IT
HAS. OKAY THANK YOU AN ALLEY-
ARE USING THE SAME ASSUMPTIONS
AND YOUR DETERMINATION IF-
CASELOAD FOR. NEXT YEAR
RECOGNIZING THAT AFTER
DECEMBER. AND USING THE SAME
ASSUMPTION THAT AFTER DECEMBER
THIRTY FIRST OF TWENTY TWENTY
ONE- AT LEAST- THAT- COMMITTEE
SOME CHANGES BECAUSE AT THE END.
WELL THE END OF THE PROJECTED
AND OF THE PUBLIC EMERGENCY WE
DON'T KNOW WHAT REALLY. BUT
BECAUSE- SINCE WE'RE GUESSING
INTO THE FUTURE. YES SENATOR-
WE- WE THINK THE
ADMINISTRATION'S ESTIMATE OF
WHEN THE PUBLIC HEALTH
EMERGENCY IS LIKELY TO AND- IS
REASONABLE- WE HAVE THE RE
DETERMINATIONS. AT THE-
BEGINNING OF THE- RESUMPTION OF
REDETERMINATION IS STARTING OUT
A LITTLE BIT LATER THAN THE
ADMINISTRATION JUST BECAUSE WE-
WE THINK IT WILL. TAKE A LITTLE
BIT MORE TIME FOR US TO SEE THE
EFFECT OF THAT. IN THE CASE OF
NUMBERS. AND I BELIEVE THERE'S
A SMALL DIFFERENCE ALSO IN THE
RATE AT WHICH WE THINK THE
REDETERMINATION WILL AFFECT
CASELOAD OVER THE- COMING YEAR
BUT- OVERALL EIGHT EIGHT. IT'S
FAIR TO SAY THAT- THE
ADMINISTRATION AND L. A. O. R.
R. FAIRLY ALIGNMENT ON ON THE
A. SIX OPTIONS OKAY SO SOUNDS
LIKE THE MAIN DIFFERENCE
BETWEEN YOUR- YOUR ASSUMPTIONS
AND- AND MINISTRATION HAS TO DO
MORE WITH THE ENROLLMENT RATE
TODAY AND THE PEOPLE BEING
DISTANT ROLL LATER. SO OKAY. I
THANK YOU I THINK THIS GROUP
DEPARTMENT FINANCING THEN THAT
CENTER MELINDA'S. MORNING AND
NIGHT BECAUSE THE WITH THE
DEPARTMENT OF FINANCE- JUST
WANT TO CIRCLE BACK ON A FEW
ISSUES THAT. LA- REYES IN
REGARDS TO CASE LOAD SO- ONE IN
TERMS OF THE ENROLLMENT RATE-
OUR ESTIMATE DOES PROJECT THAT
THE ENROLLMENT RATE IN TWENTY
TWENTY ONE. WILL BE HIGHER THAN
THE ACTUAL THAT WE'VE SEEN IN
TWENTY TWENTY AND WE BELIEVE
THAT TO BE RECENT ONE THAT'S-
PRIMARILY DUE TO THE FACT THAT-
ACTUALS IN TWENTY TWENTY YOU
DON'T REALLY REVEAL ANY ON
LABOR MARKET UPTAKE AS WE HAD
EXPECTED AT THE BUDGET ACT. BUT
IN CONSULTING RESEARCHERS WE DO
BELIEVE THAT THE LABOR MARKET
IMPACTS AND ECONOMIC I'LL
FOLLOW OF THE RECESSION WILL
RESULT IN SOME OF THAT TAKE IN
TWENTY TWENTY ONE- AND SO AGAIN
THAT'S WHY WE HAVE KIND OF. A
HIGHER RATE OF ENROLLMENT IN
TWENTY TWENTY ONE TO TWENTY
TWENTY AND THEN IN REGARDS TO
THE SECOND ISSUE THE CASELOAD
MIX OR THE DISTRIBUTION- THE
PERCENT OF SENIORS AND PERSONS
WITH DISABILITIES THAT WE HAVE
IN OUR FISCAL IS REALLY BEING
DRIVEN BY THE AXLES THAT WE'VE
SEEN WITH THE CONTINUOUS
COVERAGE. POPULATION TO DATE SO
WILL BE CIRCLING BACK WITH-
BELIAU AFTER THIS TO SEE WHAT
MIGHT BE THE DISCREPANCY IN
TERMS OF THE ACTUAL AS WE'RE
LOOKING AT BUT AGAIN WE BELIEVE
OUR CASELOAD MIX. IS REASONABLE
GIVEN THE ACTUAL. CELL WE'RE
LOOKING AT. THANK YOU. WHEN YOU
LOOK AT PEOPLE STAYING ON
BECAUSE THEY WON'T BE DISCHARGE
IN THE NEXT YEAR. EXACTLY THANK
U. S. CENTER MELENDEZ. I THINK
CHAIR- SO BE THE DOWNTURN IN
THE LABOR MARKET IN CALIFORNIA
HAS CERTAINLY INCREASED IN
SEVERITY. DUE TO THE LOCKDOWN
DECISIONS BY THE GOVERNOR I'M
JUST WONDERING IF THE
DEPARTMENT HAS AN ESTIMATE OF
HOW MANY WITH THE INCREASES OF
PEOPLE ON MEDICARE DUE TO JOB
LOSS. SURE SO I THINK- YOU KNOW
IT IT'S BEEN INTERESTING FOR US
TO EVALUATE THE MEDIC CAL
ENROLLMENT AND THE CURRENT
ECONOMY I THINK HISTORICAL-
TRENDS ARE NOT THE SAME THAT
WHAT WE'VE SEEN DURING THE
PUBLIC HEALTH EMERGENCY
CLEARLY. ONE THING I WOULD NOTE
THAT YOU KNOW MEDI CAL HAD BEEN
SEEN INCREASES IN ENROLLMENT UP
UNTIL ABOUT EARLY TWO THOUSAND
AND SIXTEEN- AND THEN AS THE
ECONOMY GOT BETTER- WE HAVE
SEEN A STEADY DECREASE IN MEDIC
HOW BETWEEN AT THE BEGINNING OF
TWO THOUSAND SIXTEEN RIGHT UP
UNTIL THE PUBLIC HEALTH
EMERGENCY HAD STEADILY. BEEN
DECLINING FOR ABOUT FOUR YEARS
OUR CURRENT NUMBER SHOWS BACK
UP AT THE TWO THOUSAND AND
SIXTEEN PEAK IN REGARDS TO WHEN
THE ECONOMY WAS AT ITS WORST
RIGHT SO IT DOES SHOW THAT-
THAT THAT FACTOR HAS DEFINITELY
INCREASED AND SHOWN A MATIC CAL
ENROLLMENT- THE TWO BIGGEST
FACTORS THAT CONTRIBUTE ALSO IS
WITH THE CONTINUOUS ENROLLMENT
WE SEE PEOPLE WHO. WILL FOLLOW
UP OUR PROGRAM BUT THEN MAYBE
COME BACK ON A YEAR OR TWO
LATER AND YOU DON'T HAVE THAT
TURN RIGHT NOW BECAUSE PEOPLE
ARE STAYING ON THE PROGRAM- AND
SO YOU HAVEN'T SEEN AS MUCH
IMPACT FROM THE- THE ECONOMY
HIT SB ASSUMES WE ACTUALLY
THOUGHT IT WOULD BE HIGHER
WHICH IS WHY YOU SAW THE
ADJUSTMENT BETWEEN BUDGET ACTED
IN NOW- WE'RE TRYING TO TRUE
THOSE THINGS UP- BUT WE DO
STILL THINK THERE WILL BE
CONTINUED GROWTH- WE'VE SEEN
THE LARGEST GROWTH WITHIN THE
ACA OPTIONAL- ELIGIBILITY
GROUP- AND WE ARE STARTING TO
SEE THE FAMILY AND CHILD
CATEGORY INCREASE IT HASN'T
REACHED QUITE THE TWO THOUSAND
SIXTEEN LEVELS- THAT WE HAD
SEEN. WHERE THE ECONOMY WAS
PREVIOUSLY BAD- OR NOT AT THAT
THE PEAK OF MEDICARE ENROLLMENT
BUT IT IS IT IS GETTING CLOSE
WE CONTINUE TO MONITOR VERY
CLOSELY WE CONTINUE TO WORK
WITH ADVOCATES VERY CLOSELY
BECAUSE WE ACTUALLY DID ASSUME
IT WOULD WOULD BE HIGHER I'M UP
THERE ARE STILL MANY
COMPLICATING FACTORS ESTIMATE
MAYBE WHY IT ISN'T BUT. I WILL
CONTINUE TO WORK WITH PEOPLE
CLOSELY. ISN'T THAT- YOU'RE NOT.
SEEING THE- BEING TRICKY TO
JOHNMYERS FOR IS THAT YOU'RE
JUST NOT ABLE TO ADEQUATELY
TRACK. ARE WE DON'T HAVE WE
DON'T HAVE I CAN'T ASSUME ALL
OF ITS BASED ON JOB LOSS BUT I
WOULD SAY THAT SINCE WE'VE SEEN
PRIOR TO YOU- THE PUBLIC HEALTH
EMERGENCY THE ACA OPTIONS
MEASURE ACTUALLY BEEN PRETTY
STEADY IF YOU LOOK AT OUR A
CODE- CHART IT SHOWS AN
INCREASE THAT GROUP WHICH
WOULD. YOU WOULD ASSUME THAT IS
BASED ON JOB LOSS BUT OTHERWISE
WOULD NOT HAVE BEEN A MEDIC CAL
I'M COMING INTO A MEDICAL
THAT'S SOMEWHAT OF THE
CHILDLESS ADULTS THAT WAS
MENTIONED EARLIER BY THE L. A.
L. AND SO THAT WAS IN ITS SOON
TO INCREASE THAT WE EXPECTED TO
SEE DURING THE PUBLIC HEALTH
EMERGENCY I JUST NOT AT THE
LEVELS AND NUMBERS AND WHICH WE
ASSUME GIVEN THE- UNEMPLOYMENT
RATES CURRENTLY AND IN
CALIFORNIA- HISTORICALLY WE'VE
HAD BETTER TIES TO MEDIC CAL IN
ROME AND UNEMPLOYMENT BUT- IT
HAS. IT'S BEEN HARDER TO TRACK
DURING THE PUBLIC HEALTH
EMERGENCY FIFTEEN THANK YOU.
OKAY THING ELSE RIGHT THEN I
THINK WE'LL MOVE ON TO. ISSUE
NUMBER FIVE CALLING. HELLO
WE'RE LOOKING FOR THREE FOUR.
OKAY I'M SORRY WHICH- OKAY IS A
SMALL ONE YES IT WILL BE SHORT-
SO FOR FISCAL YEAR TWENTY
TWENTY ONE THE FAMILY HEALTH
SPENDING IS ESTIMATED TO BE
THREE HUNDRED AND THIRTY TWO
MILLION DOLLARS A HUNDRED AND
EIGHTY TWO MILLION GENERAL FUND
AND THIS IS A SIXTY FOUR
MILLION INCREASE IN TOTAL
SPENDING AND A FORTY FIVE
MILLION A DECREASE IN GENERAL
FUND SPENDING- COMPARED TO THE
MAY TWENTY TWENTY ESTIMATES-
CHANGES IN THE TIMING AROUND
DRUG REBATES AS WAS MENTIONED
EARLIER. ON IS THE LARGEST
FACTOR DRIVING THE CHANGE OF
THE ESTIMATE AND SPENDING IN
THE LOCAL ASSISTANCE OF FAMILY
HEALTH LOCAL ASSISTANCE
ESTIMATES IF IT'S CLEAR TWENTY-
ONE TWENTY TWO THE FAMILY
HEALTH ESTIMATES ARE PROJECTS
TWO HUNDRED AND SIXTY NINE
MILLION- GENERAL FUND- AND THIS
CHANGE ESSENTIALLY REFLECTS THE
END OF THE ONE TIME DRUG REBATE
CHANGES THAT ARE REFLECTED IN
THE BUDGET AND TWENTY ARE
TWENTY ONE. AND HAPPY TO ANSWER
ANY QUESTIONS. ANYTHING FROM
THE FINANCE. LMAO. OKAY OKAY.
SO JUST TO CLARIFY YOU
MENTIONED THAT- BECAUSE WHAT I
SEE HERE IS FOR C. C. S. WE SEE
ESSENTIALLY 44% REDUCTION- EVEN
THOUGH THE CASELOADS REPORTED
TO ACTUALLY GO UP SLIGHTLY. SO
SO YOUNG GENERAL FUND RESERVE
VICE NINETY SIX- MILLION DOWN
TO SEVENTY EIGHT FEDERAL FUNDS
GO DOWN TO ZERO SO THAT ALL
DRUG EXPENSES ARE HE EXPLAINED
WHY THE 44% DECREASE IN CCS
EXPENDITURE. IT REALLY IS.
MOSTLY ATTRIBUTED TO- THE
REBATES WE'VE ALSO SEEN A LARGE
NUMBER OF. CHILDREN WHO WERE ON
CCS STATE ONLY- WHICH IS WHAT
WE SUPPORT IN THE FAMILY HAS TO
GO TO THE CCS MEDICAL BECAUSE
OF THE REDUCTION IN INCOME.
FAMILIES HAVE TRANSITIONED OVER
TO MEDIC CAL AND OUT OF THE C.
C. ESTATE ONLY SO IT'S GONNA BE
A COMBINATION OF BOTH OF THOSE
THINGS OKAY SO. ALL RIGHT YES
EXEMPTION MEASURE IN THE
FORTIES AS CONDITIONS WE DON'T
HAVE CURES FOR SO I WOULD
EXPECT THE NUMBERS OF. KIDS WHO
NEED TO PROGRAM WHEN A CHANGE
THAT DRAMATICALLY SO BASICALLY
TO SHIFTING TO FROM STATE ONLY
TO MEDIC HEALTH FORTY FIVE
BECAUSE OUR FAMILIES ARE
SUFFERING ECONOMIC. DISTRESS AS
WELL AS THE BUDGET OKAY THANK
YOU FOR THAT. EXPLANATION
COURSE. OKAY NOW I THINK WE'LL
MOVE ON TO- THE MOMENT WE'VE
ALL BEEN WAITING FOR KELLY. ALL
RIGHT- SO YOU KNOW HOW YOU SEE
IT STARTED THE CALLIN JOURNEY-
BACK IN IN TWO THOUSAND AND
NINETEEN I ACTUALLY HAD THE
PRIVILEGE MYSELF TO- GO ACROSS
THE STATE OF CALIFORNIA- AND
HAVE CONVERSATIONS WITH
PROVIDERS I COUNTIES MANAGED
CARE PLANS- AND SAY YOU KNOW
WHAT'S WORKING AND MEDICARE OUT
AND WHAT'S NOT WORKING AND
MEDICARE- AND THE DEPARTMENT
ROLL THAT OUT. AND IN THE FALL
OF TWO THOUSAND NINETEEN AND IT
WAS- CALLED YOU KNOW CALIFORNIA
ADVANCING AND INNOVATING
MEDICARE- AND IT IS A VERY
COMPREHENSIVE. A STRATEGY- THAT
THEN IN IN QUICKLY THE PUBLIC
HEALTH EMERGENCY HIDDEN AND WE
PUT IT ON A DELAYED AND THEN
PUT IT BACK INTO THE IN THE
BUDGET THAT'S BEFORE YOU TODAY
FOR CONSIDERATION- SO YOU KNOW.
WHAT REALLY IS KELLY AND I
THINK YOU KNOW FOR US- WE
REALLY SEE IT AS- USING A
POPULATION HEALTH MANAGEMENT
FOUNDATION- GROUPS OF
INDIVIDUALS- THROUGH IMPROVED
CARE COORDINATION. OF PATIENT
AND COMMUNITY ENGAGEMENT I'M IN
THE CORPORATE FINANCING AND
CARE MODELS- YOU KNOW
HEALTHCARE HAS THREE MAIN
LEVERS BENEFITS ELIGIBILITY AND
FINANCING AND TELLING REALLY
INFLUENCES. ALL THREE OF THOSE
TO CHANGE MEDICARE OUT IN A WAY
THAT WE THINK IS GOING TO. HELP
PROVIDE BETTER QUALITY OUTCOMES
FOR BENEFICIARIES AS WELL AS
THE BENCHLEY BAND BACK COST
CURVE- WE- WE THINK THAT KALYAN
HELPS INFLUENCE- ON A BILL TO
CONTINUE ON FROM. BIRTH ALL THE
WAY TO END OF LIFE- BASED ON
THE COMPONENTS IN THERE AND I
WILL G THROUGH SOME OF THOSE-
TO KIND OF HIGHLIGHT. ON HOW
THAT THAT REALLY HELPS
STANDARDIZE THAT. WE ALSO SEE
YOU'LL SEE AND CAL LAME THAT WE
ARE REALLY FOCUSED ON ON
STANDARDIZING ACROSS THE STATE
OF CALIFORNIA. IS ONE OF THE
GUIDING PRINCIPLES OF BEHIND
WHAT WE'RE WE'RE DOING IN
THERE- BECAUSE WE REALLY DO
THINK THAT- WHERE YOU LIVE
SHOULD NOT DICTATE THE CARE
THAT YOU GET AND SO. ONE OF THE
FUNDAMENTAL PIECES IS
STANDARDIZING MANAGED CARE
ENROLLMENTS ACROSS THE STATE OF
CALIFORNIA AS WELL AS BUT
BENEFITS ARE CARVED INTO
MANAGED CARE VERSUS OUT- AS
WELL AS JUST HAVING A
CONSISTENT SYSTEM- YOU ALSO SEE
A FOCUS ON. INTEGRATING ACROSS
THE DELIVERY SYSTEMS AND
ELEVATING SYSTEMS LIKE
BEHAVIORAL HEALTH- THERE'S A
COMPREHENSIVE A CENTURY
FUNDAMENTAL SHIFT IN REGARDS TO
WHAT WE ARE- EXPECTING FROM A
BEHAVIORAL HEALTH SYSTEM. WERE%
AND- PROPOSING THINGS LIKE
PAYMENT REFORM I CHANGES TO
ACCESS WITH MEDICAL NECESSITY
UP CLEAR FOR CATIONS.
INTEGRATION AND REALLY
EXPANDING ACCESS SO WE REALLY
FEEL LIKE THE PROPOSALS- ARE
THE BUILDING BLOCKS FOR
ELEVATING ON BOTH MENTAL HEALTH
AND SUBSTANCE USE IN CALIFORNIA
IN A WAY THAT- WE HAVEN'T
HISTORICALLY. DONE IN MOVING
FORWARD- YOU ALSO SEE. IN CAL
AIM OF PUSHING OVER IDEA VALUE
BASED PAY AN ISSUE DID. A IT
FOCUSES ON HEALTHCARE AFFORDED.
AS WELL AS MAKING THE RIGHT
INVESTMENTS TO BEND THAT COST
CURVE SO YOU'LL SEE THINGS IN
CALENDAR INCLUDE THE BEHAVIOR
ALL PAYMENT REFORM I MENTIONED
BEFORE. I WE'RE WE'RE CURRENTLY
PAYING OUR COUNTIES ON A COST
BASED REIMBURSEMENT MOVING THEM
TO A- A FEE SCHEDULE THAT
ALLOWS THEM TO KEEP FUNDS- IN
ADDITION TO OVER ACROSS THAT
THEY CAN REINVEST INTO THE
DELIVERY SYSTEM IS REALLY
IMPORTANT- WE TALK ABOUT SHARED
SAVINGS WHETHER MANAGED CARE
PLANS INCENTIVES IN REGIONAL
RATES. REALLY DRIVING ADDS
ACCOUNTABILITY AND COST
EFFECTIVENESS WITH IN OUR
DELIVERY SYSTEM IS REALLY.
IMPORTANT HOWEVER I THINK THE
PROBABLY THE LARGEST THING THAT
YOU SEE OUT WITH IN. THE CALLIN
PROPOSAL FOR THE- AT LEAST FOR
THE UPCOMING FUTURE IS REALLY
LEARNING AND LESSONS FROM OUR
HELP HOMES INITIATIVE ON A
PILOT THAT'S BEEN GOING ON AND
VARIOUS COUNTIES. ACROSS
CALIFORNIA AS WELL AS A WHOLE
PERSON CARE I'M ONE OF THE
BACKBONES OF TELLING IS MAKING
SURE THAT WE ARE PROVIDING A
WHOLE PERSON CARE APPROACHES
ADDRESSING SOCIAL DETERMINANTS
OF HEALTH AND REDUCING HEALTH-
DISPARITIES THAT WE CLEARLY SEE
ACROSS. THE STATE OF
CALIFORNIA- I THINK THOUGH WE
HAVE HAD PILOTS IN CALIFORNIA
FOR QUITE SOME TIME WE WANT TO
TAKE THE SUCCESSES OF THOSE
PILOTS. AND MOVE THEM TO A
STATE WIDE PROGRAM- WE THINK
THAT IT IS. REALLY IMPORTANT
THOSE THOSE PILOTS HAVE BEEN
FUNDED HEALTH HOMES FOR EXAMPLE
THROUGH FOUNDATION FUNDING ON
HISTORICALLY- AND IN IN THE
BUDGET HAD TO MOVE TO USE-
SOME. PROPOSED A GENERAL FUND
THERE AND THAT WHOLE PERSON
CARE OF FUNDED BY LOCAL
COUNTIES IN PUBLIC HOSPITAL
SYSTEMS- IN SO IN ORDER TO HAVE
A SUSTAINABLE INFRASTRUCTURE
ARE MOVING FORWARD. THE BUDGET
DOES PROPOSE TO TAKE- THE
LESSONS OF THOSE IN WHAT WE
CALL AN HEY CARE MANAGE. AND IN
LIEU OF SERVICES. YOU TAKE THAT
STATE WIDE- WE WOULD SAY THAT-
IT IS IMPORTANT THAT WE
TRANSITION THESE THINGS WE'VE
HAD GREAT LESSONS LEARNED FROM
HELP HUNDRED WHOLE PERSON CARE.
BUT THEY'RE CURRENTLY FUNDED IN
OUR ELEVEN FIFTEEN WAIVER OF
WHICH THE STATE WILL BE
TRANSITIONING OUT OF- AND THERE
IS A JEOPARDY IF THAT THOSE
PROGRAMS WERE TO END AND WE
DIDN'T TRANSITION TO ENHANCE
YOUR MANAGEMENT AND- FOR
EXAMPLE- THAT THERE WOULD BE A
FUNDING CLIFF. FOR ARCHIE
COUNTY AND PUBLIC HOSPITAL
PARTNERS- WHICH IS CRITICAL FOR
US TO SUSTAIN YEAH AND WE
REALLY HAVE SEEN THE VALUE OF
WHAT THOSE BRING A MAKING SURE
WE'RE PROVIDING ROBUST CARE
COORDINATION FOR SOME OF THE
MOST VULNERABLE BENEFICIARIES-
ACROSS THE STATE OF CALIFORNIA.
AND SO BY LEVERAGING IT THROUGH
CATALANES WE REALLY THINK THAT
WE CAN DO THAT SO NOW I'M GOING
TO I'M GOING TO PROVIDE SOME
ADDITIONAL INFORMATION AROUND
ENHANCE YOUR MANAGEMENT IN LIEU
OF SERVICES. TO PROVIDE CONTEXT
I'LL GIVE A FEW EXAMPLES OF HOW
CALAMP WILL HELP CERTAIN
VULNERABLE POPULATIONS. SO I
ONE OF THE BIGGEST THINGS THAT
WE LEARNED IN IN SOMETHING I-
YOU KNOW PRIOR TO COMING TO THE
STATE WORKING ON IN A PUBLIC
HOSPITAL SYSTEM AND RUNNING.
CARE MANAGEMENT PROGRAMS
THEY'RE SO CRITICAL TO BEING
ABLE TO WORK WITH VERY COMPLEX-
INDIVIDUALS- WHO ARE OFTEN
TIMES FACING MULTIPLE A CHRONIC
DISEASES BEHAVIORAL HEALTH-
CONCERNS AS WELL AS MANY SOCIAL
DRIVERS IMPACTING THEIR ABILITY
TO. ENGAGE IN THE HEALTHCARE
DELIVERY SYSTEM- SO WE ARE
PROPOSING- ENHANCE CARE
MANAGEMENT WHICH WOULD BE A
COMMUNITY BASED INTENSIVE CARE
MANAGEMENT PROGRAM- THAT
MANAGED CARE PLANS WOULD
CONTRACT WITH. A PROVIDERS TO
PROVIDE- IT WOULD INCLUDE A
SERVICES FOR- VARIOUS TARGET
POPULATIONS INCLUDING CHILDREN
WITH COMPLEX MEDICAL AND
BEHAVIORAL HEALTH CONDITIONS-
INDIVIDUALS EXPERIENCING
HOMELESSNESS S. R. AT RISK OF
BEING. HOME HI. THERE'S A
MERGING. ZERO- HOSPITAL
ADMISSIONS SKILLED NURSING
FACILITIES JUST HIGH UTILIZES
WITH THAT OUR SYSTEM. OF THOSE
AT RISK OF INSTITUTIONALIZATION-
AS WELL AS INDIVIDUALS WHO ARE
TRANSITIONING OUT FROM
INCARCERATION AND THE IDEA IS
TO WRAP IN INTENSIVE SERVICE
AROUND THEM THAT IS ON THE
GROUND GO TO WEAR THAT
INDIVIDUAL IS- AND PROVIDE
THOSE INTENSIVE SERVICES. WERE
ALSO PROPOSING- A LIST OF
FOURTEEN WHAT WE CALL IN LIEU
OF SERVICES AND WE KNOW IT'S
NOT A GOOD NAME- BUT
ESSENTIALLYIT'S SUPPLEMENTAL
WRAP SERVICES THAT- ALLOW US
YOU TAKE SOME OF THOSE SOCIAL
DRIVERS- IMPEDING SOMEONE'S
ABILITY TO- AS- YOU KNOW HAVE A
HEALTHY A LIFE. OR IMPROVE
THEIR HEALTH- AND IMPORTANTLY
REDUCE THE COST OF CARE- IN
WHAT WE PROVIDE AND THERE'S A
LONG LIST THAT INCLUDES THINGS
LIKE HOUSING NAVIGATION
DEPOSITS INTENDANCY SUPPORT
SERVICES. RECUPERATIVE CARE
RESPITE CARE FOR INDIVIDUALS AS
WELL AS PAYING FOR TRANSITIONS
FROM SKILLED NURSING FACILITIES
TO HOMES OR ASSISTED LIVING.
ENVIRONMENTS MEDICALLY TAILORED
MEALS SO BRING CENTERS AS A
REMEDIATION THERE'S A VARIETY
OF THOSE SERVICES. ANY IDEA
THAT IS TO WRAP BOTH THE
ENHANCE CARE MANAGEMENT AND
HE'S ADDITIONAL- SUPPLEMENTAL
SERVICES AROUND A BENEFICIARY-
TO ALLOW THEM TO ENGAGE IN THE
HEALTH ENVIRONMENT AND LEAD
HEALTHIER HAPPIER LIVES. SO I'M
GONNA GO THROUGH THREE
DIFFERENT GROUPS JUST TO GIVE
SOME CONTEXT IN REGARDS TO
WHAT'S IN KALANK IS IT'S BIG
AND COMPLEX AND YOU KNOW THAT-
BUT THE VALUE THAT IT COULD
HAVE- ON BENEFICIARIES- SO.
LET'S START WITH JUSTICE
INVOLVED. MASKING JUST DID REAL
BRIEF LIKE. SO IT'S ALSO ON THE
GROUND RIGHT SO WOULD TO TRY TO
DO THIS WHY BUT HOW ABOUT THE
PROVIDER NETWORK IN IN THESE
AREAS AND THEN WHEN WE COME TO
THE ENHANCED CASE MANAGEMENT
AND CARE SIR WELL EVERYBODY GET
THAT ARE JUST AS TARGETED
POPULATIONS THAT WE'RE THAT
WE'RE TALKING ABOUT AND THEN
WILL THEY BE RESPONSIBLE FOR
PROVIDING THE HEALTH CARE AS
WELL OR JUST THE IN LIEU OF
SERVICES OR THE ENHANCE
SERVICES IF YOU WILL. GREAT
QUESTION SO A FOR ENHANCED-
CARE MANAGEMENT PROVIDERS
REALLY- YOU'RE GOOD IT'S GOING
TO DEPEND ON WHO THE PROVIDER
IS BASED ON THE TARGET
POPULATION SO ENHANCE CARE
MANAGEMENT IS NOT AVAILABLE TO
EVERYONE WE HAVE THREE TIERS OF
THE OF CARE MANAGEMENT WITHIN
MEDIC HOUSE WE HAVE- CASE
MANAGEMENT WHICH IS AVAILABLE
TO ALL INDIVIDUALS IN THE IN
THE PROGRAM ARE BASED ON THEIR
NEEDS AND IS- VERY REGULAR
PROVIDED. WE HAVE WHAT'S CALLED
COMPLEX CASE MANAGEMENT
CURRENTLY WITHIN OUR CONTRACTS
AND THAT'S FOR INDIVIDUALS WHO
HAVE MORE COMPLEX CASES- NEED-
ADDITIONAL- CARE COORDINATION
SERVICES AND THEN WHAT WE'RE
ADDING ON TOP OF THAT IS THE
TOP LEVEL OF SERVICE WHICH IS
ENHANCED YOUR MANAGEMENT AND
THAT IS YOUR TOP HIGHEST- MOST
COMPLEX INDIVIDUALS- WHERE YOU
WOULD NEED A- CONTRACT WITH
PEOPLE WHO REALLY HAVE THE
ABILITY TO MOVE THE NEEDLE FOR
EXAMPLE- IF YOU'RE TALKING
ABOUT THE HOMELESS INDIVIDUALS
OF THE HOMELESS TARGET
POPULATION WITH ENHANCE YOUR
MANAGEMENT. THAT WOULD IT BE
JUST A NORMAL PRIMARY CARE
PROVIDER WHO WOULD MOST LIKELY
BE THE ENHANCED CARE MANAGEMENT
THAT WOULD BE- MOST LIKELY A
COMMUNITY BASED ORGANIZATION OR
STREET BASED TEAM WHERE THEY'RE
GOING OUT ON ON THE STREET
ENGAGING WITH THE HOMELESS
POPULATION BUILDING THAT
TRUSTING RELATIONSHIP IN
ENSURING THAT ALL OF THEIR
MEDICAL BEHAVIORAL HEALTH
ETCETERA- SOCIAL SERVICES ARE
ARE BEING COORDINATED OF ONE OF
THE FUNDAMENTAL PRINCIPLES AND
HALF YOUR MANAGEMENT IS THAT.
THERE'S ONE PRIMARY CARE
MANAGER RESPONSIBLE FOR
COORDINATING ACROSS OUR
DELIVERY SYSTEM AT MEDICARE'S
REALLY COMPLEX- WE. HAVE
ESSENTIALLY SIX TO SEVEN STEP
RIGHT DELIVERY SO. IT SEEMS YOU
GET IN CAL. YOU'RE GETTING
MEDICAL BENEFITS FROM MANAGED
CARE PLAN YOU'RE GETTING- IF
YOU NEED SPECIALTY MENTAL
HEALTH S. U. D. FROM THE
COUNTIES. IF YOU NEED I JUST
THAT'S SERVICES WE'RE GETTING
THAT SEPARATE- AND SO IT CAN BE
VERY CHALLENGING TO NAVIGATE
THAT. THE IDEA BEHIND THIS IS
FOR SOMEONE WHO HAS- HI COMPLEX
NEEDS ACROSS MULTIPLE DELIVERY
SYSTEMS MAKING SURE THAT
THERE'S ONE PERSON COORDINATING
ACROSS THOSE DELIVERY SYSTEMS
WHICH IN THIS CASE COULD
INCLUDE COORDINATING THESE IN
LIEU OF SERVICES. I'M NT
REALLY TRYING TO TACKLE THAT
MOST COMPLEX SO YOU SEE THE
PROVIDERS IT COULD BE COUNTIES
YOU CAN BE PUBLIC HOSPITAL
SYSTEMS WHO ARE DOING THIS
TODAY ON WHOLE PERSON CARE.
COMMUNITY BASED ORGANIZATIONS
HOUSING ENTITIES DEPENDING ON
THE ROLE THAT THEY PLAY- BUT
ANYONE WHO. CONTRACTS WITH THE
MANAGED CARE PLAN TO PROVIDE
ENHANCED YOUR MANAGEMENT HAS TO
BE COMMITTED TO PROVIDING IT IN
THE COMMUNITY A MEETING THE
PERSON WHERE THEY ARE- WHICH
COULD YOU CAN INCLUDE IN A IN A
CLINICAL OFFICE. BUT IT'S
REALLY A HIGHER LEVEL TOUCH.
COORDINATION A SERVICE IF THAT
HELPS KIND OF. ANSWER YOUR
QUESTION. IT DOES THANK YOU. OF
COURSE- SO. YOU KNOW SOMETIMES
I THINK IT'S EASY TO KIND OF
USE POPULATIONS TO KINDA T. UP-
HOW THIS WOULD WORK- IN
MEDICARE ALSO WILL TAKE THE
JUST AS INVOLVED AS AN EXAMPLE-
IN R. KELLY PROPOSAL WE ALLOW
FOR. IT I REQUEST TO THE
FEDERAL GOVERNMENT FOR A THIRTY
DAY IN REACH BUT WHILE SOMEBODY
IS CURRENTLY INCARCERATED.
UNDER THE SUPPORT ACT IS WHAT
WE WILL BE USING IN OUR
REQUEST. I'M TO ALLOW THAT
ENHANCE CARE MANAGEMENT- INTO
T. TO GO IN AND ASSESS THE
INDIVIDUAL- IN ENSURE THAT THE
TRANSITION UPON REENTRY INTO
THE COMMUNITY IS AS SUCCESSFUL
AS POSSIBLE. THERE'S A LOT OF
DATA THAT DEMONSTRATES THAT
SOMEBODY UPON BEING RELEASED
ESPECIALLY IF INCARCERATED FOR
SIGNIFICANT PERIOD OF TIME AND
HAVING ANY- COMPLEX MEDICAL OR
BEHAVIORAL HEALTH CONDITIONS.
WILL MOST LIKELY RESULT IN A
NUMBER IN THE ROOM VISITS OR IN.
STAY SHORTLY BEING. FROM FROM.
THIS ALLOW THAT RE. WORK TO
START- WE ALSO HAVE IN OUR
PROPOSAL- ON A MANDATORY
REQUIREMENT THAT ALL- JAILS AND
IN PRISONS WILL- I SCREEN
SOMEONE FOR MEDIC CAL
ENROLLMENT UPON RELEASE. I
WHICH WOULD ALLOW THEM TO LEAVE
FOR EXAMPLE WITH PRESCRIPTIONS-
UPON RELEASE FROM FROM JAIL-
AND THEN THEY WOULD HAVE A
VARIETY OF IN LIEU OF SERVICES.
ABOUT THEIR DISPOSAL TO USE IF
NECESSARY- AND IF. THE
INDIVIDUAL NEEDS OF SERVICES-
SO A VERY COMPREHENSIVE WAY
WHERE WE HAVE- S. ESSENTIALLY
SAID THAT THERE ARE DIFFERENT
TOUCH POINTS AND WITHIN CAL AB
PROPOSING HOW TO DO THAT. RE
ENTRY IT ALSO INCLUDES
DIVERSION WHERE WE CAN WORK ON
DIVERSION- ACTIVITIES WITHIN
OUR BEHAVIOR HOLD STAYS. AS
WELL AS WITH THE ENHANCED CARE
MANAGEMENT. THE NEXTPOPULATION
WOULD BE ARE HOMELESS
POPULATION THE VARIOUS
COMPONENTS BETWEEN HAVING THE
STREET BASED ENHANCE CARE
MANAGEMENT TEAM ON THE GROUND
WORKING WITH INDIVIDUALS. THERE
ARE. A HANDFUL OF IN LIEU OF
SERVICES THAT HELP- WITH OUR-
HOMELESS INDIVIDUALS INCLUDING
HAVING- HUBS WITHIN LARGE URBAN
AREAS ON THE GROUND THAT CAN
HELP I TARGET INDIVIDUALS FOR
SERVICES- PROVIDE SERVICES FOR
THEM WHILE THEY'RE STILL
HOMELESS- BUT THEN HOPEFULLY
CONNECTING THEM. INTO YOU
HOUSING NAVIGATION IT PAYS FOR-
DEPOSITS AND THEN ONCE THEY ARE
HOUSE TENNESSEE SUPPORTIVE
SERVICES TO ENSURE THAT THEY
STATE HOUSE- AND THOSE ARE
REALLY CRITICAL AND- COMPONENTS
THAT WE'VE LEARNED FROM BOTH
HELP HOMES INTO A WHOLE PERSON
CARE PILOTS. AND THEN THE LAST
ONE THAT'LL GIVE YOU IS-
POPULATION- AND THESE ARE JUST
A FEW THERE ARE MANY THAT SERVE
BY CALLIE IS OUR AGING
POPULATION- CALLIN PROVIDES
FOR- ONE OF OUR TARGET
POPULATIONS AS INDIVIDUALS AT
RISK OF BEING INSTITUTIONALIZED
OR PUT INTO. A LONG TERM CARE
ENVIRONMENTS. IT ALLOWS US TO
PROVIDE BOTH THE ENHANCED CARE
MANAGEMENT BUT AS WELL AS THESE
RAP SERVICES NEEDED ON TO KEEP
SOMEONE EITHER OUT OF AN
INSTITUTION OR SOMEONE WHO IS
IN AN INSTITUTION. IF THEY SO
CHOOSE ALLOW THEM TO TRANSITION
TO THEIR HOME OR AN ASSISTED
LIVING ENVIRONMENT WE WOULD PAY
THE RAP SERVICES WITHIN IN OUR
SEE IF BEARD ARE. YOU A PAPER
HOME MODIFICATIONS AT THAT WHAT
WAS NEEDED FOR THEM TO BE HOME
SAFELY AS WELL AS MEDICALLY
TAILORED MEALS SO REALLY ALLOWS
PEOPLE TO SAFELY RESIDE IN
THEIR HOME. BOB AND IT HAS
PROVEN A COST SAVINGS AND
IMPROVED HEALTH OUTCOMES. I
BRING IT IN THOSE POPULATIONS
BECAUSE I THINK SOMETIMES A
CALLIN IS BAKING COMPLEX AND
IT'S HARD TO KIND OF SEE. THE
DIRECT IMPACT ON A VERY IS BORN
ABOUT POPULATIONS. I THINK THAT
WE HAVE LEARNED A LOT FROM
COBIT IN REGARDS TO HOW
CRITICAL I'M HAVING SOME OF
THESE PIECES IN PLACE OF COULD
HELP- TO BE ABLE TO REALLY.
MOVE THE NEEDLE AND IN SUCH A
REAL WAY- I THE STATE OF. IF
ANYTHING IT ALONE HIS. HELPED
UNDERSCORE THE VALUE OF THE- IN
CALAIS- I THINK WHAT WE WOULD
ALSO SAY IS- WE ARE NOT A SHY
TO THINK THIS IS NOT A LARGE
LIFT IT IS A HEAVY LIFT- AND
IN. ORDER TO ENSURE SUCCESS WE
HAVE PUT IN THE PROPOSAL-
INCENTIVE PAYMENTS- AND- REALLY
THE INCENTIVE PAYMENTS ARE
BECAUSE- WE TAKE UP HIGHLIGHTS
IF YOU TAKE IT STATEWIDE YOU
NEED TO MAKE SURE THAT PEOPLE.
HAVE THE TECHNICAL ASSISTANCE
THAT THEY NEED- AND WE HAVE
PARTS OF THE STATE WHERE WE
DON'T HAVE SOME OF THESE PILOTS
TODAY AND WE NEED TO BUILD THAT
INFRASTRUCTURE CAPACITY IN
ACCESS. IN PARTS OF THE STATES
WHERE WE CLEARLY JUST DON'T
HAVE IT TODAY. ALSO THE
INCENTIVE PAYMENTS ARE THERE TO
DO THAT REALLY TO INCENTIVIZE-
WHERE WE I. DON'T HAVE ANY
ACCESS TO THESE TYPES OF IN
LIEU OF SOURCES OR WE HAVE LOW
ACCESS INCREASING OR EVEN IN
URBAN AREAS WHERE WE HAD GREAT
ACCESS DURING THE PILOT BUT NOT
ENOUGH. OF FOR THE DEMAND IN
THAT AREA BUILDING THAT
INFRASTRUCTURE STATEWIDE- AND-
ALTERNATELY THE GOAL WOULD BE
THAT IF WE CAN BUILD STATEWIDE
INFRASTRUCTURE WE CAN PROVE
COST EFFECTIVENESS- IN REGARDS
TO WHAT WE'RE DOING. ULTIMATELY
EVEN TRANSITIONING SOME OF
THOSE AND GO UP SERVICES INTO A
BENEFIT- WHICH CURRENTLY THE
WAY IT'S PROPOSED IT IS- IT IS
NOT A BENEFIT IT IS- SOMETHING
THAT PLAN WOULD HAVE TO OPT
INTO A PROVIDING A AND THAT'S
HOW WE GET THE FEDERAL
AUTHORITY. AND THAT'S REALLY TO
BUILD THAT INFRASTRUCTURE
ACROSS THE STATE OF CALIFORNIA
WE CAN'T GET TO A POINT WHERE
YOU CAN DEMONSTRATE TO THE
FEDERAL GOVERNMENT THAT YOU
HAVE. STATEWIDE MESSED. UP IN
THE OTHER THING I WOULD MENTION
A QUICKLY IS WITH THE BUILDING
OF THE IN LIEU OF SERVICES
ENHANCE CARE MANAGEMENT THAT
ALLOWS US TO GET YOU MANAGED
LONG TERM SERVICES AND SUPPORTS
FOR OUR- POPULATIONS. BY TWENTY
TWENTY SEVEN BECAUSE MANY OF
THE THINGS OFFERED IN CALLING
IN THE A LITTLE SERVICES
ENHANCE YOUR MANAGEMENT. REALLY
AIMED. AT HAVING SOMEONE BE
ABLE TO SEE DEFINITELY LIVE IN
THEIR HOME AND PROVIDE. THE
LONG TERM SERVICES SINCE THE
THAT THEY- FOR US TO BE ABLE TO
ACHIEVE THAT- IN FUTURE
WAIVERS- AND IMPROVING THOSE
HAVE HEALTH OUTCOMES- IN ORDER
TO DO THIS WORK THE DEPARTMENT
IS REQUESTING. A SIXTY NINE
PERMANENT POSITIONS AND FORTY
SIX LIMITED TERM. EQUIVALENT
POSITIONS OF THE COST OF TWENTY
FOUR MILLION TOTAL FUNDS ARE
ELEVEN MILLION GENERAL FUND-
AND- I THINK YOU KNOW I. WE
KNOW THIS WORK IS COMPLEX- AND
THERE ARE SO MANY FACTORS THAT
ARE INTER DEPENDENT BUT- I
THINK WE REALLY FEEL LIKE THE
PACKAGE AS A WHOLE. HELPS
REALLY ODD WILL BETTER SERVE
PEOPLE IN OUR PROGRAM TO LIVE
KIND LONGER HEALTHIER HAPPIER
LIVES AND- I'M HAPPY TO ANSWER
ANY QUESTIONS THAT. YOU MAY
HAVE IN REGARDS TO CAL. I THINK
WE HAVE QUITE A FEW QUESTIONS
BUT JUST JUST THAT. UP THE-
WHEN YOU WHEN YOU TALK ABOUT
SENIORS AND PACE IS NOT IT'S
NOT PART OF. GOING TO BE THE
PART OF THE CAL AIM OR WILL THE
PACE PROGRAM STILL BE A PART OF
THAT BECAUSE AT WHAT POINT
WOULD PEOPLE TRANSITION BETWEEN
THOSE TWO SYSTEMS. WE WOULD OF
PACES. IT IS A DIFFERENT IT'S
UNDER DIFFERENT RIGHT
REGULATIONS SO ARE THERE.
DIFFERENT THAN OUR MANAGED CARE
PLANS HOWEVER WE WOULD. ENSURE
THAT BENEFICIARIES UNDERSTAND
THE RIGHT TO ENROLL IN A PACE
ORGANIZATION. A VERY EFFECTIVE
MODEL OF FOR INDIVIDUALS- AND
WE WOULD JUST MAKE SURE THAT
INDIVIDUALS DON'T KNOW THEY
HAVE A RIGHT TO THE- TO THE
PEACE PLANS. OKAY MAYBE WE
SHOULD HEAR FROM THE DEPARTMENT
FINANCE AND- L. A- BEFORE WE
GET. MORE TO QUESTIONS
DEPARTMENT FINANCE. I NOTHING
TO ADD AT THIS TIME THANK YOU
LMAO. HEY THANK YOU MADAM CHAIR
OF BEN JOHNSON AGAIN- WITH THE
LEGISLATIVE ANALYST'S OFFICE-
AS IS REALLY WELL SUMMARIZED IN
THE HEARING A GENDER CAL AIM IS
A SPRAWLING SET OF REFORMS TO
EXPAND TRANSFORM AND
STREAMLINED MEDICAL SERVICE
DELIVERY AND- FINANCING- IT
CONTAINS AT LEAST EIGHTEEN
MAJOR REFORMS THAT TOUCH ON
NEARLY EVERY ASPECT OF THE
MEDICAID PROGRAM. AND SO FAR
OUR OFFICE HAS RELEASED YOU AND
ALLERGIES THAT ARE PART OF A
SERIES OF PUBLICATIONS THAT
THAT WILL ANALYZE CALLING THESE
TO EXISTING PUBLICATIONS FOCUS
ON OVERARCHING ISSUES AS WELL
AS FINANCING ISSUES RELATED
CAROLINE AND TWO UPCOMING
PUBLICATIONS WILL EXPLORE
CALENDAR ISSUES RELATED TO
HEALTH EQUITY. AND AGING- ONE
FACET SORT OF LIKE TO RE
EMPHASIZE A REITERATE BUT I
THINK- DIRECTOR COOPER DID A
GREAT JOB OF TOUCHING ON IS
THAT WHILE MUCH OF TELLING HIS
NEW MUCH OF CALLING WOULD ALSO
BUILD UPON OR REPLACE EXISTING
AND EXPIRING PROGRAMS.
INCLUDING ENHANCED CARE
MANAGEMENT IN THEIR SERVICES
AND THE RELATED INCENTIVE
PAYMENTS THAT WOULD GO TO
MANAGED CARE PLANS- BUT TELLING
DOES NOT REFLECT A MERE
CONTINUATION OF THESE PROGRAMS
IT IT REPRESENTS A SIGNIFICANT
CHANGE IN THE STATE'S APPROACH
TO DELIVERING AND FINANCING-
THE SERVICES THAT CALTRAIN WILL
AIM TO REPLACE. FIRST UNDER
KALYAN SIGNIFICAN AND FUNDING
RESEARCH FUNDING AND
RESPONSIBILITIES WOULD BE
CONCENTRATING SHIFTED OVER TO
MEDICARE MANAGED CARE PLANS.
SECOND THE STATE GENERAL FUND
WOULD SUPPORT MAJOR NEW TALENT
SERVICES TO A MUCH GREATER
DEGREE THAN UNDER EXISTING
PROGRAMS FOR EXAMPLE WHERE THE
LOCAL FUNDS- PROVIDE A GOOD
DEAL OF SUPPORT. WE GENERALLY
FIND THE SHIFT TOWARDS THE
GENERAL FUND OUT REASONABLE
GIVEN CALLUM'S PROPOSED DESIGN
OF GOING STATEWIDE AND SHIFTING
CONTROL REALLY IN SOME WAYS
AWAY FROM THE LOCALS AND
TOWARDS MANAGED CARE PLANS. AND
THEN THIRD THOUGH CALTRAIN
WOULD CHANGE- WOULD
SIGNIFICANTLY CHANGE SORT OF
WHICH FEDERAL FUNDING SOURCES
OR AFFORD THESE THE STATE WOULD
USE TO FUND EXPANDED BENEFITS
AND THIS WITH A LOCK ON LOCK
ADDITIONAL FEDERAL FUNDING FOR
NON MEDICAL BENEFITS THAT
HAVEN'T SORT OF BEEN FUNDED
SORT OF. THROUGH THE MEDICAID
SORT OF ENTITLEMENT FUNDING
STRUCTURE PREVIOUSLY AND IT
WOULD AT THE SAME TIME MAKE%
FEDERAL FUNDING MORE
SUSTAINABLE GIVEN CHANGES TO
HOW THE FEDERAL GOVERNMENT IS
OVERSEEING ELEVEN FIFTEEN
WAIVERS. WE FIND THAT CALTRAIN
HAS POTENTIAL TO BRING MAJOR
POLICY BENEFITS FOR EXAMPLE
REDUCING HEALTH DISPARITIES BY
FOCUSING RESOURCES AND
ATTENTION ON MEDICARE'S HIGHEST
HIGHEST RISK IN HIGH SPEED
BENEFICIARIES. BUT WE DO HAVE
MANY OUTSTANDING QUESTIONS.
FIRST SIGNIFICANT DETAIL ON
MAJOR CALLIN COMPONENTS IS
LACKING LIMITING THE
LEGISLATURE'S ABILITY TO FULLY
SCRUTINIZE. ALL THE CHANGES
THAT ARE PROPOSED. SECOND WHILE
WE FIND THE GOVERNOR'S SOUTH
FIVE HUNDRED AND THIRTY TWO
MILLION DOLLAR GENERAL FUND
FUNDING PLAN TO GENERALLY BE
REASONABLE IN TWENTY TWENTY ONE
TWENTY TWO WE FIND THAT
CALTRAIN GIVEN IT SCOPE AND
COMPLEXITY. COMES A SIGNIFICANT
FISCAL RISKS OVER THE LONG TERM
UNFORESEEN IMPLEMENTATION COSTS
COULD MATERIALIZE OVER THE NEXT
SEVERAL YEARS AND ANTICIPATED
SAVINGS MAY NOT MATERIALIZE
QUICKLY ENOUGH FOR IT
SUFFICIENT LEVELS FOR MULTI
YEAR FUNDING PLAN TO PROVE
REASONABLE. THESE LONG TERM
FISCAL RISKS MERIT ESPECIALLY
CLOSE ATTENTION GIVEN THE STATE
BUDGET PROBLEM ANTICIPATED TO
ARISE AFTER. TWENTY TWENTY ONE
TWENTY TWO. NOT THIRDS AND
DESPITE THESE FISCAL RISKS WE
DO BELIEVE CALLIE MERITS
CONSIDERATION GIVEN ITS
POTENTIAL POLICY BENEFITS IN
THE FACT THAT NEW BUT EXISTING
SERVICES SUCH AS- THOSE
PROVIDED UNDER WHOLE PERSON
CARE AND HEALTH HOMES WOULD
EXPIRE ABSENT. THEIR
CONTINUATION IN SOME FORM SUCH
AS IS PROPOSED UNDER CALLIN.
JUST CLOSE WITH A FEW ISSUES
FOR CONSIDERATION OF FIRST WE
RECOMMEND THE LEGISLATURE USE
THE BUDGET AND POLICY PROCESS
TO RESOLVE THE OUTSTANDING
QUESTIONS- LEARN MORE ABOUT THE
DETAILS OF THE PROGRAM. OR THE
PROPOSAL AND PROVIDE
LEGISLATIVE INPUT INTO ANY
CALLING COMPONENTS THAT ARE
ULTIMATELY ADOPTED. SECOND
GIVEN THE SCOPE OF CALLANAN THE
IMPLEMENTATION CHALLENGES THE
STATE IS LIKELY TO FACE AS WE
HOPEFULLY EXIT A PANDEMIC OVER
THE COMING MONTHS AND YEARS WE
RECOMMEND THE LEGISLATURE
EXPLORE WHERE DELAYS IN
STATUTORY AUTHORIZATION AND
IMPLEMENTATION ARE ADVISABLE.
AND THEN THIRD TO ENSURE
TELLING HIS ACHIEVING THE
STATE'S GOALS WE RECOMMEND
ESTABLISHING ROBUST MECHANISMS
FOR IMPLEMENTATION OVERSIGHT AS
WELL AS PROGRAM EVALUATION.
THAT CONCLUDES MY PREPARED
REMARKS BUT HAPPY TO TAKE ANY
QUESTIONS ON ASSESSMENTS. OKAY.
DIRECTOR WHO WOULD YOU WANT TO
RESPOND TO ANY OF THOSE BEFORE
WE GET INTO QUESTIONS. NO NOT
NECESSARILY I MEAN I THINK WHAT
I WOULD SAY IS THAT KHALIMOV
THE BENEFITS PUT FORWARD ARE
REALLY MEANT TO BEND THE COST
CURVE- AND TO BE- IN THE OUT
YEARS REDUCING OVERALL HEALTH
CARE SPENDING ESPECIALLY ROUND
INDIVIDUALS WHERE WE SPENT. A
LOT OF MONEY- THAT WITH LONG
TERM CARE FOR EXAMPLE- I'M
INTRANSIGENT HOME SAFELY- WE
HAVE PROVEN THROUGH MULTIPLE
HOME A COMMUNITY BASED WAIVERS
THE EFFECTIVE COST
EFFECTIVENESS OF THOSE TYPES OF
TRANSITIONS AS WELL AS IMPROVED
OUT OF OUTCOMES. I'M AND THEN
FOCUSING ON HOW UTILIZED
THERE'S AN INDIVIDUALS WITH-
HIGH BEHAVIORAL HEALTH NEEDS
HAS. REALLY DEMONSTRATED THAT
THOSE THINGS ARE ARE COST
EFFECTIVE SO I UNDERSTAND THAT
THIS IS NEW GENERAL FUND COSTS
BUT OVERALL REALLY- CAL AND
HELPS. YOU KNOW REALLY BEND THE
COST CURVE IN THE OUT YEARS-
YOU KNOW THAT IS THE INTENT
BEHIND MANY OF THE PROPOSALS
BUT HAPPY TO ANSWER ANY
QUESTIONS THAT YOU ARE. CAN YOU
TALK A LITTLE BIT MORE ABOUT
THE CALLING FOR MORGAN COUNTY'S
WITH THE MANAGED CARE
DEPARTMENT DON'T AND DON'T AND-
AREN'T INCLUDED AND HOW THEN DO
WE GROUP IN THE FEE FOR
SERVICES OR- IS THE PLAN
EVENTUALLY. TO GET THEM ALL
INTO MANAGED CARE PLANS. THE OF
THE- PROPOSED OF CHALLENGES TO
ACTUALLY- TRANSITION A HANDFUL
OF INDIVIDUALS WHO ARE
CURRENTLY IN OUR FUTURE SERVICE
ENVIRONMENT INTO YOU- MANDATORY
MANAGED CARE. I'M SO FOR ALL
NON TOOL- POPULATIONS WE
PROPOSE JANUARY ONE TWENTY
TWENTY- TWO I TO MOVE INTO
MANAGED CARE AND THAT INCLUDES
CERTAIN ZIP CODES FOR EXAMPLE
ACROSS CALIFORNIA THAT ARE
STILL ON NOT IN MANAGED CARE-
AND THEN WE PROPOSE THE JEWEL
POPULATION. I MOVED IN
MANDATORY MANAGED CARE BY
TWENTY TWENTY THREE I'M SO THE
KELLY PROPOSAL DOES ACCOUNT FOR
MAJORITY OF INDIVIDUALS MOVING
TO. OUR TO MANAGED CARE THE
EXCEPTIONS OF LIVES THAT WOULD
STAY WITHIN THE FEE FOR SERVICE
ENVIRONMENT IS RESTRICTED
SCOPE. AS WELL AS A SHARE OF
COST INDIVIDUALS WITH THE
EXCEPTION OF LONG TERM CARE
SHARE OF COST AS THEY OFTEN
NEED THEIR SHARE OF COSTS ON ON
DAY ONE AND WOULD BE IN MANAGED
CARE. SO I'M TELLING DOES
ANTICIPATE- THAT BOTH ENHANCE
YOUR MANAGEMENT AND LOOK
SERVICES- ARE CURRENTLY
BENEFITS ONLY PROPOSED WITHIN
MANAGED CARE- BUT SINCE WE ARE
PROPOSING TO MOVE THE MAJORITY
OF A MEDIC CAL LIVES. IN TWENTY
TWO AND TWENTY THREE INTO
MANAGED CARE. WE DO THINK THAT
THAT IS APPROPRIATE. DO YOU SEE
ANY OF THE SERVICES AS DISCREET
IF THE AS THE L. AS MR JOHNSON
SAID IF THINGS DROPPER FOR NOT
MEETING THE NUMBERS. IF WE HAVE
TO PARE BACK AT SOME POINT.
WILL DO WE SEE SERVICES AS
DISCREET OR- OR DO WE SEE
GEOGRAPHIC AREAS AS AS WHAT
WOULD FALL OFF. BUT WHAT DO YOU
THINK WOULD FALL OFF. IF WE HAD
IF WE HAD A PAIR BACK. I THINK
THAT- YOU KNOW I WOULD I WOULD
JUST SAY THAT WE ARE MAKE
ENHANCE MANAGEMENT A BENEFITTED
IS- THERE ARE. FEDERAL
REGULATIONS IN REGARDS TO
REMOVING A BENEFITS FOR
INDIVIDUALS- ENSURING THAT IT
WOULDN'T- YOU KNOW. BUT REDUCE
OUR HURT OUTCOMES AS WELL AS-
MAKING SURE THAT THEY STILL
HAVE APPROPRIATE ACCESS TO
SERVICES- HOWEVER I WOULD I
WOULD SAY THAT YOU KNOW WITH
OUR CURRENT- PUBLIC HOSPITAL
SYSTEMS AND COUNTIES THAT ARE
PROVIDING THIS UNDER. EXISTING
ELEVEN FIFTEEN WAIVER- I REALLY
WOULD STRONGLY ENCOURAGE YOU TO
CONTINUE THE ENHANCE YOUR
MANAGEMENT IN LIEU OF SERVICES-
AS THERE WOULD BE A DRAMATIC-
FUNDING CLIFF FOR THOSE
COUNTIES I'M A PUBLIC HOSPITAL
SYSTEMS IF THERE WAS NOT- AN
AVENUE TO MOVE FORWARD WITH
ENHANCE YOUR MANAGEMENT IN LIEU
OF SERVICES- WHICH WOULD STILL
IMPACT THE STATE BUDGET
INCLUDING GENERAL FUND IN
REGARDS TO WAYS THAT WE WOULD
HAVE TO. ADDRESS THAT HOLDEN
SO- WE STRONGLY THINK THAT-
THOSE ADDED SHOULD MOVE FORWARD
AND WE SHOULD TAKE THEM
STATEWIDE- THE EDGE INSURE THAT
THERE IS A SUSTAINABLE WAY OF
PROVIDING THOSE SERVICES ACROSS
THE STATE OF CALIFORNIA. AND
THE NICE THING ABOUT IN LIEU OF
SERVICES BEING OPTIONAL IS IT
ALLOWS US TO PHASES IN OVER
TIME ALLOWS US TO LEARN WHAT IS
WHERE WE'RE FINDING SUCCESSES
AND THEN WHERE WE ARE AND WHERE
WE SEE THAT THEY ARE- CLEARLY
DEMONSTRATING IMPROVED OUTCOMES
FOR BENEFICIARIES CAN MAKE
DECISIONS OF COURSE WITH THE
LEGISLATURE- IN REGARDS TO
MAKING THOSE. THOSE BENEFITS-
SO I THINK WE TRIED TO OF PHASE
IN WE'VE TRIED TO ACCOUNT FOR
THOSE TYPES TRANSITIONS WILL
NOT CREATING. UNNECESSARY
CLIFFS WERE KEY PARTNERS- IN
OUR MEDIC CAL DELIVERY SYSTEM
AND HE DID DO THIS AS AS
APPROPRIATELY AS WE CAN- WELL
WE TAKE IT STATEWIDE. AND PETER
GUBER BOUT THE INCENTIVE PAY.
FOR MEDICARE BECAUSE BECAUSE
THAT IS THEN THE INCENTIVIZE IS
TICKETS TO GO TO THE ENHANCED
CASE MANAGEMENT CORRECT. YES OF
THE INCENTIVE DOLLARS ARE
REALLY TO BUILD INFRASTRUCTURE-
IN THE STATE FOR BOTH THE
ENHANCED CARE MANAGEMENT WHERE
DOESN'T EXIST TODAY AS WELL AS
THE IN LIEU OF SERVICES. FOR
EXAMPLE- ONE OF THE PIECES THAT
WE ARE LOOKING TO DO WITH THE
INCENTIVES IS SAYING YOU KNOW.
IF YOU CAN INCREASE THE NUMBER
OF RECUPERATIVE CARE BEDS
AVAILABLE IN YOUR COUNTY WOULD
BE ABLE TO RECEIVE AN INCENTIVE
PAYMENT. RECUPERATIVE CARE BEDS
FOR EXAMPLE ARE REALLY CRITICAL
BECAUSE INDIVIDUALS WHO ARE
HOMELESS YOU I'M GOING TO IN
PATIENT CARE OFTEN CAN LINGER
IN AN INPATIENT BED FOR. WEEKS
AND SOMETIMES MONTHS BECAUSE
THEY CANNOT APPROPRIATELY
TRANSITION SOMEBODY TO THE
STREET GIVEN THEIR CURRENT
HEALTH CONDITION. THAT ALLOWS
SOMEONE TO TRANSITION FROM THAT
IMPATIENCE DAY- INTO A
RECUPERATIVE CARE BEDS SO THE
INCENTIVES WOULD BE AROUND
BUILDING THAT INFRASTRUCTURE
AND CAPACITY ACROSS THE STATE
OF CALIFORNIA- WHICH IS REALLY
CRITICAL. OF THE ALSO WOULD
FOCUS ON CERTAIN OUTCOMES SO
INCREASING ACCESS TO THE
SERVICES- TO ENSURE THAT WERE
GETTING- THE PENETRATION THAT
WE WANT IT WOULD IT COULD
INCLUDE THINGS LIKE TRAINING
INITIATIVES FOR ENHANCED CARE
MANAGEMENT. IN ORDER TO DO
ENHANCE YOUR MANAGEMENT IS A
COMBINATION OF BOTH CLINICAL
AND NONCLINICAL WHERE WE WORK
WITH COMMUNITY HEALTH WORKERS
AND PEERS. BOB AND IT'S REALLY
CRITICAL THAT THEY HAVE
TRAINING MECHANISM SO WE CAN
INCENTIVIZE- THESE TRAINING.
INITIATIVES ACROSS THE STATE OF
CALIFORNIA TO MOVE THE NEEDLE
IN REGARDS TO THAT WORKFORCE-
EFFORTS- THAT WOULD BE. NEEDED
AS WELL AS ACTUAL QUALITY
OUTCOMES WILL HAVE MEASURES FOR
EXAMPLE ON AND WE HAVE TALKED
ABOUT. THINGS WHERE WE WANT TO
CLOSE GAPS FOR EXAMPLE WE KNOW
THAT THE THERE'S A HIGHER
PROPORTION OF A BLACK AN
AFRICAN AMERICAN HOMELESS
INDIVIDUALS- COMPARED TO. THE
NUMBER IN THE IN THE STATE- AND
SO. YOU KNOW WE'RE- THE NUMBER
OF IN ARE. THE NUMBER OF- BLACK
AND AFRICAN AMERICAN
INDIVIDUALS WHO ARE RECEIVING
ENHANCE CARE MANAGEMENT IN LIEU
OF SERVICES. TO MAKE SURE THAT
WE ARE CLOSING EQUITY GAPS
THOSE ARE THE TYPES OF THINGS
THAT WE ARE EXPLORING WITH THE
INCENTIVE DOLLARS PROPOSED IN
CALAIS. OKAY CAN YOU I MEAN
JUST SO TELL ME TELL ME A STORY
OKAY SO LET'S SAY WE HAVE A
HIGH NEEDS INDIVIDUAL RIGHT NOW
ON OUR TRADITIONAL MANAGED CARE
MEDICAL. OKAY AND THEN AND THEN
DESCRIBE TO ME WHAT IT'S GONNA
LOOK LIKE UNDER THE NEW SYSTEM
I GREW UP WITH THAT ONE
INDIVIDUAL RIGHT THEY COME IN
WHAT OTHER ISSUES ARE FACING
AND THEN WHERE DO THEY FALL OFF
OR WERE THEY NOT GET SERVED.
AND HOW WAS THAT PAYMENT
DELIVERED. AND THEN CONVERSELY.
THE BEAUTIFUL FUTURE THAT WE'RE
HEADING TOWARDS. HER SO- TAKEN
INDIVISIBLE AS YOU THE HIGH
UTILIZED- OKAY- SO YOU'RE A
HIGH UTILIZE OR- YOU KNOW I
HAD. THE INDIVIDUAL WHO'S
COMING INTO THE EMERGENCY ROOM
ON A VERY REGULAR BASIS- AND WE
DO HAVE INDIVIDUALS WHO CAN
HAVE MULTIPLE OR EMERGENCY ROOM
VISITS- AND IN A MONTH. MAYBE
THEY'VE HAD AN INPATIENT STAY
OR TO- BUT THEY KEEP CYCLING
THROUGH THROUGH THE SYSTEM
CLEARLY. THEY ARE NOT BEING
CONNECTED. TO THE ACTUAL
DELIVERY SYSTEM TO HAVE
WHATEVER MEDICAL CONDITIONS
USUALLY BEING DRIVEN BY. A
NUMBER OF MEDICAL CONDITIONS OR
BEHAVIORAL HEALTH CONDITIONS-
FOR THEM- AND THAT IS VERY
COSTLY- BOTH TO THE STATE OF
CALIFORNIA AS WELL AS A MANAGED
CARE PLAN. ON IN IF NOT
IDENTIFIED EARLY YOU KNOW.
REALLY CAN- HAVE AN ISSUE. IN
CALAIS. WHAT WE PROPOSE IS THAT
WE HAVE A CLEAR STRATIFICATION
PROCESS IN PLACE WHERE HIGH
UTILIZES FOR EXAMPLE WOULD BE
IDENTIFIED I THROUGH THE
MANAGED CARE PLAN- AND THAT
THERE WOULD BE A HAND OFF- THE
REFERRAL CAN COME FROM A
PROVIDER FROM THE MANAGED CARE
PLAN FOR THE BENEFITS YOU'RE
THEMSELVES- OR FAMILY MEMBER.
WHO SAYS THIS INDIVIDUAL- NEEDS
CARE TO ENHANCE YOUR MANAGER.
OFTENTIMES HOSPITAL SYSTEMS ARE
GOING TO BE REALLY KEY PLAYERS
IN REGARDS TO THE HIGH
UTILIZED- I'M ENHANCE CARE
MANAGEMENT PROVIDER IN THIS
CASE THEY WOULD. ENGAGE WITH
THAT NDIVIDUAL FOR EXAMPLE
SOME OF OUR PUBLIC HOSPITAL
SYSTEMS HAVE SOMEONE IN BED IN
THE EMERGENCY ROOM SO THAT IF
YOU HAVE A HIGH UTILIZE- YOU
CAN CONNECT WITH THEM. YOU CAN
BUILD TRUST AND THEN YOU CAN
START ENSURING THAT THEY'RE
GETTING THE SERVICES THEY NEED
ON THE OUT PATIENT PERSPECTIVE
AND NOT IN THE EMERGENCY ROOM
IF IT'S NOT AN ACTUAL
EMERGENCY. SO THEY WOULD HELP
COORDINATE AND ENSURE- YOU KNOW
THEY HAVE THIS MAYBE THEY'RE
DIABETIC CAN HAVE ON PEOPLE
UNCONTROLLED DIABETES- THEY'D
BE WORKING WITH THEM ON A
REGULAR BASIS TO GET IN TO SEE
THEIR PRIMARY CARE PROVIDER GET
THEM ANY- SPECIALTY- ANCILLARY
SERVICES THAT THEY NEED- AND
MAYBE THAT THEY'RE ALSO
STRUGGLING WITH. ANXIETY
DEPRESSION OR SOMETHING ON THE
BEHAVIORAL HEALTH SPACE
INSURING THAT THEY'RE GETTING
COORDINATED WITH THOSE
SERVICES. AND IF THE INDIVIDUAL
HAPPENS TO ALSO BE HOMELESS AND
EMERGENCY ROOM INDIVIDUAL THAT
ENHANCE YOUR MANAGER WOULD BE
RESPONSIBLE FOR ENGAGING THEM
TO SEE IF THEY WANT TO EXPLORE
BEING HOUSE THAT. PROCESS TAKES
TIME IT TAKES RUST- AND SO
HAVING IN A DEDICATED
INDIVIDUAL- THAT CAN HELP WITH
THAT HOUSING NAVIGATION
SERVICES I'M CONNECTING THEM TO
THE END GOAL OF SERVICE
PROVIDER. I'M WORKING TO GET
THAT DEPOSIT AND GET THEM IN
THEIR HOUSE AND ONCE THEIR
HOUSE I WORKING WITH THEM TO
STAY HOUSE BY A LEAKING ON WITH
THAT TENDENCY SUPPORTIVE
SERVICES. THAT'S OFFERED IN
CALLING THAT'S KIND OF THE
DIFFERENCE WORK TO DATE IN
CERTAIN PARTS OF THE STATE YOU
JUST HAVE TO TURN IN MANAGED
CARE PLANS. BIG CALL THE
INDIVIDUAL AND SAY EIGHT WE
KNOW THAT. USING THE EMERGENCY
WERE A LOT OF WE WANT TO MAKE
SURE YOUR SERVICES BEING
PROVIDED THAT'S ALWAYS NOT
ALWAYS EFFECTIVE AS WELL AS- ON
THE GROUND. IN THE IN THE
EITHER THE EMERGENCY ROOM IN
THE PROVIDER OFFICE ARE
HOMELESS ON THE STREET AND
GAUGING WITH SOMEONE. AT TO
BUILD A TRUSTING RELATIONSHIP
THAT ALLOWS YOU TO KIND OF MOVE
THE NEEDLE- I'VE HAD THE
PLEASURE OF. RUNNING ENHANCE
YOUR MANAGEMENT OF PROGRAMS IN
MY CAREER- IT'S HARD TO ENGAGE
A CERTAIN POPULATIONS- SO
THERE'S ALWAYS GONNA BE THOSE
WHO JUST DON'T ENGAGE- BUT IF
YOU CAN. SEE THAT THAT
ENGAGEMENT IF YOU CAN INVOLVE
SOMEBODY IN THEIR CARE. CONNECT
THEM TO THE OUTPATIENT SERVICES
GET THEM INTO THE BEHAVIORAL
HEALTH SERVICES THEY NEED FOR
CONNECTED WITH- HOUSING OR
OTHER SERVICES- WE HAVE SHOWN
ACROSS THE STATE- THROUGH BOTH
PILOTS AND OTHER INITIATIVES.
YOU REALLY CAN'T REDUCE THE
HIGH COST EMERGENCY ROOM
INPATIENT STAYS YOU CAN REALLY
IMPROVE HEALTH OUTCOMES. I
TAUGHT PRACTICED FOR YEARS I
TAUGHT PRACTICE I TAUGHT THERE
IN I WOULD TELL STUDENTS ALL
THE TIME YOU CAN DO ANY KIND OF
FANCY THING YOU WANT BUT IF YOU
CAN'T BUILD A RELATIONSHIP.
NOTHING ELSE REALLY MATTERS.
CAN YOU TELL ME THOUGH THE
FUNDING STREAMS FOR THAT THAT
FIRST RIGHT SO HOW IS A MANAGED
CARE. BEING FUNDED AND THEN AND
THEN. AND THEN PAYING A
PROVIDER'S. IN THE TRADITIONAL
FORM THAT WE'RE USING NOW AND
HOW IS THAT GOING TO LOOK
DIFFERENT IN THE NEW FORM FOR
FUNDING PURPOSES. FOR THE TODAY
THE WAY WE PAY FOR CASE
MANAGEMENT WE PAY A MANAGED
CARE PLANS- WITHIN THEIR
CAPITATION RATES. OF FOUR BOWS
HE'S MEASURING COMPLEX CASE
MANAGEMENT AND THEN THEY
CONTRACT WITH- A VARIETY OF
PROVIDERS. I'M TO PROVIDE
SERVICES SOME OF WHICH MAY BE-
PROVIDING THE CARE COORDINATION
ON THEIR BEHALF- AND THAT'S
BUILT IN. WHAT WE'RE PROPOSING
TO DO IN CALAIS FOR ENHANCED
YOUR MANAGEMENT THEY WOULD
RECEIVE ADDITIONAL FUNDS- FOR
ENHANCE CARE MANAGEMENT THAT
WOULD GO TO THE MANAGED CARE
PLAN. BUT WE ARE GOING TO HAVE
CLEAR CONTRACTUAL REQUIREMENTS
THAT THEY CONTRACT. OUT SO SOME
MANAGED CARE- PLANS TODAY DO
THE CASE MANAGE. COM CASE.
THEMSELVES WHERE THEY- A NURSES
OR CLINICAL STAFF WHO ARE
CALLING IN DOING OUTREACH TO
INDIVIDUALS. UNDER ENHANCE CARE
MANAGEMENT- WE MAY ALLOW FOR
SOME PORTIONS TO STAY WITHIN
MANAGED CARE PLAN BUT REALLY
THIS IS ABOUT COMMUNITY BASED.
INDIVIDUALS ARE PROVIDERS
COUNTIES PUBLIC HEALTH THE-
DEPARTMENT OR PUBLIC HEALTH
HOSPITALS- ENGAGING IN THAT
CARE SO THEY WOULD CONTRACT
WITH THAT ENTITY- THEY WOULD
MOST LIKELY PAY THEM A PM PM
THAT'S TYPICALLY WHAT WE'VE
SEEN IN MOST OF OUR WHOLE
PERSON CARE PILOTS- AND THAT
WOULD BE TO ENGAGE WITH THAT
INDIVIDUAL ON A VERY REGULAR
BASIS. UP AND PAY THEM TO DO
SO- SO IT'S SEPARATE APART FROM
THE SERVICES THAT WOULD BE
BUILT ON IT WOULD BE A DIRECT
PAYMENTS TO THAT ENHANCE CARE
MANAGEMENT PROVIDER. I'M AND
THAT'S BUILT INTO THE SO THE
AMOUNT OF MONEY THAT WE PUT IN
THE BUDGET FOR ENHANCE YOUR
MANAGEMENT. FOR IN LIEU OF
SERVICES SINCE WE ALREADY HAVE
A PRETTY BIG INFRASTRUCTURE OF
THE NEW OF SERVICES BUILT UP
THROUGH WHOLE PERSON CARE. WE
HAVE PUT FUNDS INTO THE BUDGET-
TO ENSURE THERE'S NO CLIFF. WE
DON'T WANT THAT TO FALL OFF WE
WANTED TO BE ABLE TO CONTINUE
TO FUND THOSE- BUT THEN OVER
TIME AS MANAGED CARE PLANS
PROVIDE. MORE IN IN LIEU OF
SERVICES THAT IS THE HOPE-
ESPECIALLY WHERE THERE'S NOT
SOME TODAY- AFTER THAT GETS
BUILT INTO THEIR RATE PROCESS
SO THEY WILL WE WILL RECEIVING
COUNTER DATA IT WILL R. C.
GREAT DATA FROM THE MASTER PLAN
OF WHAT THAT'S COSTING- AND
THAT GETS BUILT INTO THEIR
FUTURE RATE- ALSO WHICH- GETS
BUILT INTO THEIR RATE. IS YOU
KNOW IF THEY'RE SEEING THAT
THE- IT'S REDUCING THE
INPATIENT AND ER UTILIZATION WE
HAVE WITHIN OUR CALIBER POSTAL
SHARED SAVINGS PROPOSAL. THAT
AS WE START SEEING THOSE
INPATIENT AND ER UTILIZATION
DECREASES- THAT IN THE OUT
YEARS WE WOULD SHARE IN THOSE
SAVINGS WITH THE MANAGED CARE
PLANS- SO. THEY THEY HAD A
REDUCTION- WHERE YOU'RE PAYING
I'M. JUST GONNA USE EASY
NUMBERS A HUNDRED DOLLAR
THERE'S- YOU KNOW FOR SOME. AND
THEY ABLE TO. THE COST EIGHTY-
WE WOULD SHARE IN THAT- THAT
20% INSTEAD OF REAPING ALL OF
THAT SO THAT THEY COULD
REINVEST IN EXPANSION OF
APPROPRIATE. DELIVERY SYSTEM
TRANSFORMATION AS WELL AS
ADDITIONAL IN LIEU OF SERVICES-
AND SO WE HAVE KIND OF.
PROPOSED BOTH A REQUIREMENT
THAT THE MANAGED CARE PLAN
CONTRACTOR ACTUALLY WITH
PROVIDERS ARE KEEPING SOME
INFRASTRUCTURE AT THE PLAN
LEVEL BUT MOST OF IT BEING
COMMUNITY BASED. ON IN PERSON-
TO BUILD THOSE RELATIONSHIPS-
AND THEN WE WILL BUILD IN THE A
LITTLE SERVICES COST OVER TIME
INTO THE RATE AND SHARE IN THE
SAVINGS OF THE REDUCE
UTILIZATION. NO THEY'RE NOT THE
WHOLE PERSON PLANS HAVE BEEN IN
PLACE THE PILOTS FOR ABOUT.
FIVE YEARS APPROXIMATELY BRENT
YEAH RIGHT. YEAH WE'RE IN THE
SIX YOU'RE TECHNICALLY BUT IT
TOOK TIME TO GET THEM UP AND
RUNNING SO- I THINK WEARING
YOUR FOR OF OPERATIONALLY
PAYING FOR THE SERVICES YEAH.
OKAY SO I KNOW MY COUNTY AND
SACRAMENTO COUNTY ARE BOTH ARE
BOTH PART OF IT. AND NOW IT.
YOU KNOW WHEN I AND I WOULD
JUST OFFER THE LAST FIVE YEARS
I THINK PEOPLE WOULD SAY THAT
THAT THE PROBLEMS HAVE
INCREASED. AS FAR AS THE VISUAL
PROBLEMS THAT PEOPLE ARE SAYING
THAT THAT WE CONTINUE TO HEAR
ABOUT HOMELESS ON THE STREET. A
LACK OF HOUSING ALL OF THOSE
THINGS. SO IF IN THE TWO
COUNTIES THAT I'M BY DRIVE IN
EVERY DAY. I'M NOT SEEING
ANYTHING. TELL ME HOW THIS TELL
ME HOW CONTINUING ON THIS IS
GOING TO HELP YOU THE MORE FOR
WHAT WE'VE BEEN MISSING. IN THE
WHOLE PERSON PLANS BEFORE. SO I
THINK ONE OF THE DIFFERENCES IS
WHAT WHOLE PERSON CARE TO PILOT
SO EACH COUNTY WAS ABLE TO PICK
DIFFERENT TARGET POPULATIONS-
AND PICK DIFFERENT INITIATIVES-
AND WHAT WE TRY TO DO WITH
CALLIE. IS LOOK ACROSS THE
PROGRAMS OF WHAT WE'RE THE BEST
PRACTICES WHAT WE'RE THE BEST-
A PACKAGE OF SERVICES- BUNDLED
TOGETHER- THAT. REALLY ALLOWED
US TO MOVE THE NEEDLE AND
THAT'S WHAT WE ENDED UP PUTTING
INTO CALLING- I THINK IT'S ONE
OF THE- THE THINGS WITH PILOTS
IS. EVERYBODY'S TESTING
SLIGHTLY DIFFERENT APPROACHES
AND A COMBINATION OF THINGS.
AND SO BY HAVING THE FULL
PACKAGE OF IN LIEU OF SERVICES
THE NAVIGATION THE DEPOSITS.
THE TNDENCY AS WELL AS
RECUPERATIVE CARE. I'M IN OTHER
PIECES YOU HAVE TO HAVE THE
FULL CONTINUUM. I'M AND SO WHAT
WE'RE REALLY HOPING IS THAT.
PEOPLE WILL EMBRACE THAT
CONTINUUM OF SERVICES THAT
ALLOWS YOU HAVE THE STEP DOWN
AND REALLY MAXIMIZE THE SCENES-
AND I ALSO THINK THAT. A LOT OF
THE STUFF AND WHOLE PERSON CARE
IT'S ONE OF THE THINGS THAT
MAKES IT VULNERABLE. IS IT IS
DEPENDENT ON LOCAL FUNDING-
AND- IN BEAUTY I TO DRIVE TO-
SUSTAINABILITY TO DRIVE TO
STATEWIDE IS. GOING THROUGH THE
MANAGED CARE PLANS WHERE THERE
ARE CLEAR CONTRACTUAL
OBLIGATIONS NO LONGER A PILOT.
SUBJECT TO LOCAL FUNDING- WE
ARE THERE WOULD BE EXPECTATIONS
THAT WOULD NEED TO BE THAT
THERE WOULD BE MONITORING AND
ACCOUNTABILITY- AND TRACKING OF
THOSE PIECES AND SO I THINK.
THAT'S WHY WE PROPOSED THE
STRUCTURE AND THE CHANGE FROM A
LOCAL- KIND OF FUNDED
INITIATIVE- THAT'S PILOTED AND
BERRIES AND ONLY MAYBE HAS
CERTAIN COMPONENTS IN CERTAIN
COUNTIES- TO. A MORE STATE WIDE
SUSTAINABLE STRUCTURE THAT
ALLOWS FOR- YES INVESTMENT IN
GENERAL FUND BUT ULTIMATELY A
MORE KIND OF. IMPROVE OUTCOME-
WHAT WE PULLED THE BEST
PRACTICES WE CAN'T FROM. WHERE
WE HAVE SEEN GREAT SUCCESS IN
THE STATE. OKAYAND THEN JUST
ONE. FINAL QUESTION FOR I TURN
TO DOCTOR PANEL- CENTER
MELENDEZ- SO I. MEAN I WAS IN
THE NINETIES IN I WAS PART OF A
OF VALUE. LOOKING AT THIS. THIS
CALL. IN IN- IN OREGON- BUT
CHAO WELFARE SYSTEM. SO WE
WE'VE BEEN DOING THESE PILOTS
FOREVER RIGHT WILL WE REALIZE
THAT WE CAN'T JUST TREAT ONCE
WHEN PART OF A PERSON WE HAVE
TO TREAT THE WHOLE PERSON IN
THE WHOLE SYSTEM. THAT THEY
LIVE IN- SO WHY ARE WE READY
NOW RIGHT WE'VE BEEN TRYING
THIS FOR EVER AND THEN STARTS
AND FITS AND PILOTS AND- PILOTS
AND- AND NOW WE'RE READY. THANK
WELL I WHAT I WOULD SAY IS THAT.
WELL WE'VE BEEN DOING THE
PILOTS FOR A LONG TIME WE'VE
SEEN A LOT OF SUCCESSFUL PILOTS
AS WELL- AND TAKING THAT ON A
STATEWIDE BASIS- IN ENSURING
THAT WE ARE. MAKING THESE
SERVICES BUT I THINK THAT THE
COMBINATION OF BRINGING THE
MEDICAL AND THE SOCIAL SIDE- IN
LOOKING AT THE WHOLE PERSON THE
VALUE OF THAT IS SIGNIFICANT
AND I THINK- NOW WILL THE
MOMENT IT'S CLEAR I THINK. I
CAN'T EVEN STRESS THE LESSONS
LEARNED THAT WE'VE HAD THROUGH
CODED IN REGARDS TO THERE'S
BEEN MOMENTS WHERE WE'RE SAYING
IF WE REALLY JUST HAD CALAIS
MAINE PLACE. THINK ABOUT THE
RESPONSE TO THE HOMELESS THAT
WE COULD HAVE HAD ACROSS THE
STATE OF CALIFORNIA TO MOVE
QUICKLY ON THE HOUSING
COMPONENTS IN HERE- WE HAVE TO
START BUILDING- BE
INFRASTRUCTURE ACROSS THE STATE
NOW WE HAVE TO FIND WHERE THERE
ARE GAPS- TO START MOVING THE
NEEDLE BECAUSE IF WE JUST KEEP
PUTTING IT OFF I THINK THAT.
WE'RE GOING TO CONTINUE TO SEE-
THE NUMBER OF HOMELESS INCREASE
WE'RE GOING TO CONTINUE TO SEE.
AN INCREASE OF- YOU KNOW
WHETHER IT'S SUICIDE RATES OR
INCREASE MENTAL HEALTH- ISSUES
THAT ARE NOT BEING ADDRESSED I
THINK WE HAVE TO KIND TO INVEST
THE FUNDS NOW TO START SEEING
CHANGES OUT THE DELIVERY SYSTEM
AND IT WILL TAKE TIME IT'S NOT
GOING TO HAPPEN OVERNIGHT- BUT
I THINK THAT NOW. IS REALLY
CRITICAL ESPECIALLY- WHAT WE
LEARNED DURING THE PUBLIC
HEALTH EMERGENCY AND HAVING
THESE PIECES. THE CONNECTION OF
HEALTH AND SOCIAL- REALLY I
HIGHLIGHTED- INVALIDATING THAT
IS CRITICAL. AT THIS TIME AND
THE PLANTS ARE READY. YOU KNOW
I THINK THAT- THE PLANS ARE
VERY EXCITED ABOUT FOR EXAMPLE
INCLUDE SERVICES PLANS HAVE
BEEN PUSHING FOR US TO
IMPLEMENT FOR HER YEARS. OF
BECAUSE OF THE LEARNING THEIR
RIGHT ESPECIALLY AROUND THE
AGING POPULATION AND HOW-
SUCCESSFUL CAN BE AT REDUCING
COSTS. I THINK THAT THAT'S WHY
WE ARE PUTTING INCENTIVE
DOLLARS IN TO MAKE SURE WE
PROVIDE. REALLY TIGHT TECHNICAL
ASSISTANCE AND ACCOUNTABILITY
WITH THE MANAGED CARE PLANS-
AND WE WILL WE WILL WORK
CLOSELY WITH THEM TO MOVE THE
NEEDLE BUT- I'VE YET TO HEAR
PLAN SAY THAT DAY- PART EXCITED
ABOUT TELLING. IT'S MORE OF WHY
WE PUT PHASING IN PLACE JUST TO
MAKE SURE THAT THEY CAN BE AS
SUCCESSFUL AS POSSIBLE. IN
DOING THIS OVER A PERIOD OF
TIME INSTEAD OF EVERYTHING
GOING ON AT ONCE. THANK YOU.
DOCTOR THANK YOU SO VERY MUCH
AND APPRECIATE THE PRESENTATION
I DO HAVE- SEVERAL QUESTIONS.
SO SHE GIVEN THE SCOPE OF- THE
PROPOSAL- I OWE IT ALL TO MAKE
NOTE THAT- I DO REMEMBER DE UM.
THE FIRM THE NATIONAL
IMPLEMENTATION OF SOME OF THE
WHOLE PERSON CARE PILOTS AND-
WELL THERE MAY BE AN OUT THERE
ARE SUCCESSES ARE ALSO A
SIGNIFICANT CHALLENGES- AND- WE
DID HAVE PEOPLE HAVING
PROBLEMS- BUT I DO I SAY THAT
IS. OVERALL AND A JUST EXPRESS
YOU KNOW GENERAL SUPPORT FOR
WHAT YOU'RE TRYING TO
ACCOMPLISH THAT- ONE OF THINGS
THAT I. THINK OVERALL- THERE'S
A LOT THAT'S BEING EXPECTED OF
THE MANAGED CARE PLANS AND ARE
AND SO I GUESS MY FIRST
STATEMENT IS THAT- ONE THING
THAT'S GONNA BE ESSENTIAL TO
MAKING THE SUCCESSFUL IS-
OVERSIGHT- AND CUT AND
ACCOUNTABILITY FOR THIS AND
THIS IS- BEFORE YOUR TIME ON
THIS COOPER BUT- THAT YOU DON'T
WANT TO SHARE THE SIMPLY
COMMITTEE AND THEN LATER HERE
IN THE SENATE HEALTH COMMITTEE-
YOU KNOW- BUT I'VE ALWAYS SAID
THAT WE CAN'T CONTRACT OUT
RESPONSIBILITY. SO THAT THE
AGENCY NEEDS TO BE ACCOUNTABLE
TO US AND- I NEVER WANT TO HEAR
THAT WELL THE PLAN DID THAT. IT
WASN'T US BECAUSE WE'RE THE
ONES WHO MADE THE CONTRACT
WOULD WANT TO SIGN THE CONTRACT
INCLUDING ANY CONSEQUENCES THAT
ARE EMBEDDED IN THE CONTRACT
FOR FAILURE STEP WITH. THAT MAY
HAPPEN AND- SO I JUST WANTED.
FIRST OF ALL MAKE THAT CLEAR
THAT JUST BECAUSE WE HAVE A
MANAGED CARE PLAN DO IT- WE
STILL ARE RESPONSIBLE FOR THE
OUTCOMES- DIRECTLY. CAN'T BLAME
THE PLAN NOW THE PLAN MAY HAVE
HAD SOME FAULT BUT AGAIN WE'RE
THE ONES WITH CON WE'RE THE
ONES WHO MADE CONTRACT- SO
FIRST OF ALL- RIGHT. ONE
QUESTION IS- PART OF WHAT WE'RE
PROPOSING IS TO INCLUDE
ESSENTIALLY LONG TERM CARE AND
LTSS SERVICES INTO THE MANSION
CARE- ESSENTIALLY CARVE THE MEN
AND THE MANAGED CARE BENEFIT.
WE ESTABLISH OUR CAPITATION
RATES- FOR THE DIFFERENT PLANS
LONG TERM CARE IS SOMETHING
THAT'S MUCH MORE EXPENSIVE-
AND- SO. IS THERE SEPARATE
CAPITATION RATE FOR THE PEOPLE
AND WHO REQUIRE LONG TERM CARE
SERVICES FROM THE REST OF THE
POPULATION- IN THAT PLAN ARE
THERE SOME WAYS SO THAT WE CAN
TEAR THAT OUT SO THAT WE DON'T
HAVE A SENSE OF THE TAIL
WAGGING THE DOG- WE MEAN BY
THAT IS THAT. THE AMOUNT OF
EXPENDITURES FOR SOMEONE
REQUIRES LONG TERM CARE
SERVICES IS MUCH HIGHER THAN
LET'S SAY A CHILD OR A WORKING
ADULT AND SO FORTH AND- IF WE
ONLY GIVE ONE. OVERALL
CAPITATION RATE- YOU COULD WE
COULD HAVE A SITUATION WHERE WE
SEE BASICALLY THE PLANS DRIVEN
BY- THAT ONE POPULATION AND-
THE OTHER POPULATIONS PERHAPS
BEING EVEN SHORTAGE BECAUSE IF
IT IF IN ORDER TO MAKE ALL THE
BOOKS WORK OUT. SO I JUST WANNA
BE CAREFUL THAT WE DON'T CREATE
A TRANSPORTATION SYSTEM THAT
BASICALLY- CREATES-
DYSFUNCTIONAL IT SAID WELL I
GUESS INCENTIVE TO CREATE. THAT
DRIVES DECISION MAKING THAT-
THAT THAT MAY- NOT NECESSARILY-
BE BENEFICIAL FOR THE ENTIRE
POPULATION AND- SO NOT UNITING
THAT YOU HAVE YOU KNOW A SUB
SEGMENT THAT HAS IS MUCH MORE
EXPENSIVE STAND OTHER. GROUPS
THAT WE DON'T HAVE A SITUATION
WHERE- WHAT'S WRITTEN ONE WAY
SO CAN YOU JUST SPEAK TO HOW
HOW HOW HOW WE'RE GONNA HANDLE
THE PAYMENTS. FOR CARVING IN
LONG TERM CARE- INTO IT HI HOW
ARE YOU PLANNING TO ESTABLISH
OUR- CAPITA PAYMENTS TO THE
PLANS. BURKE SO- I WOULD THINK
WOULD SAY IS DO HAVE PLANS TO
HAVE LONG TERM CARE CARVED INTO
DAY- IN THEIR RESPONSIBILITY SO
WE DO HAVE EXPERIENCE FROM FROM
THAT PERSPECTIVE- WE ARE
PROPOSING A BLENDED RATE WITH
LONG TERM CARE AND S. B. THE
SPD POPULATION. IF THERE'S
QUESTIONS WEARING THAT I KNOW
IN THE HERINGTON IS ON AND SHE
CAN SPEAK TO THOSE THE ONE
THING I WOULD SAY THOUGH RIGHT
NOW OF WHERE WE DON'T HAVE THE
INCENTIVE FROM THE HOT-
HEALTHCARE PERSPECTIVE. WHEN
LONG TERM CARE IS CARVED IN AND
WE PROVIDE THEM DELUDE SERVICES
THAT ALLOW THEM TO TRANSITION
SOMEONE FROM A LONG TERM CARE
ENVIRONMENT INTO A HOME OR
ASSISTED LIVING- WITH WHETHER
IT'S YOU KNOW HOW MODIFICATIONS
OR- MEDICALLY TAILORED MEALS-
IT'S A LOT. A LOT LESS BECAUSE-
I WOULD BE COVERED OUR AND CUT
SOMEONE OUT OF ME IS. NOT YEAH
I'M NOT TALKING ABOUT CARVING
THEM OUT I'M TALK ABOUT THE
POPULATION SO WHAT HAPPENS IS
THAT YOUR- YOU HAVE A
POPULATION OF PEOPLE WHO WHO
EITHER NEED LONG TERM CARE
SERVICES ARE. THAT THEY WOULD
HAVE A SEPARATE CAPITATION RATE
THAN LETTING A CHILD WHO'S ON.
SOME POSSIBILITY BUT MUCH LESS
LIKELY TO NEED THOSE SERVICES
RIGHT SO WHAT HAPPENS IS WE
NEED TO RECOGNIZE WE HAVE
DIFFERENT RISK STRATIFICATION
WITHIN THE POPULAR MEDICARE
POPULATION. RIGHT SO WHAT SO
YOU HAVE A POPULATION OF PEOPLE
WHO ARE AT HIGHER RISK FOR THE
LONG TERM CARE SERVICES AND YOU
DO WANT HIM TO SAY HEY LOOK YOU
KNOW WHAT INSTEAD OF. PUTTING
HER IN A NURSING HOME WE CAN DO
MEDICAL MEALS OR DO ALL
MODIFICATION AND THAT MAKES
SENSE. THE PROBLEM IS THAT IF
YOU TAKE IF WE GROUP OF PEOPLE
WHO ARE AT HIGH MUCH HIGHER
RISK FOR FAIRLY EXPENSIVE
SERVICES AND WE MIX THEM IN
WITH OTHER PEOPLE WHO DON'T.
THEN SOMETIMES YOU CAN GET SOME
SOME NOTES ESSENTIALLY SOME
SORT OF RISK BASED PAYMENT.
RELATED TO THAN THAT OF
POTENTIAL RISK OF NEED FOR LONG
TERM CARE SO WE DON'T.
BASICALLY HAVE A PLAN THAT GOES
AND SITS BACK AND SAYS WELL YOU
KNOW THIS IS WHAT'S DRIVING OUR
EXPENSES AND SO WE'RE GOING TO
FOCUS ON THAT AND THEN WE- WILL
SUBSIDIZE IT WITH BECAUSE-
WITH. THE PEOPLE WHO ARE TOUGH
LESSON ITSELF I JUST WANNA BE
SURE IT AND TALK ABOUT
POPULATION STRATIFICATION. OF
TALK ABOUT CARVING OUT. YEAH NO
I AM. WHAT YOU'RE SAYING AND WE
DO HAVE A SEPARATE- CATEGORY OF
AID FOR THE LONG TERM CARE. I'M
GOING TO ASK LINDA IF YOU WOULD
LIKE TO PROVIDE SOME
INFORMATION TO SENATOR PAN IN
REGARDS TO YOU- HOW WE'RE
PROPOSING TO BUILD THE- RATE
FOR THE LONG TERM CARE THAT.
THAT MAY GIVE HIM SOME
UNDERSTANDING OF WHAT WE'RE
DOING THERE. SURE WINNER PAN
JUST SAID IT JUST TO CONFIRM
FREE WE DO HAVE SEPARATE RATES
THAT WE PROVIDED THE MANAGED
CARE PLANS. BASED ON THE
POPULATION FROM FOR EXAMPLE
THERE'S A SEPARATE TRIALS IN
ORDER SEPARATE ADULT RATE THAT
IS DIFFERENT THAN A RATE THAT
WE PROVIDE FOR SENIORS AND
PERSONS WITH DISABILITIES ARE.
FOR INDIVIDUALS. WITH LONG TERM
CARE NEEDS WE ARE PROPOSING
COULD YOU A BLENDED. RATE ARE
THERE ANY WITH YOUR- BUT THE-
IN ORDER TO GROW SOME THEIR
SHARED SAVINGS- WHERE WE CAN
SOME INCENTIVE TO ENSURE THAT
ARE GET. THAT THE RIGHT ARE
HERE OKAY. SURE THAT THEY ARE
PROPERLY. OKAY WELL IF IT
PERHAPS YOU CAN YOU SOME DE- ON
THAT WE DON'T NEED TO GO TO ALL
DETAILS RIGHT HERE IN THE- THE-
I WOULD. THE OTHER QUESTION-
HERE THE UNDER PART OF THE
PROPOSED IS. THAT YOU WILL
RECALL ALL MEDICAL MANAGED CARE
PLANS BE CREATED BY NCQA BY
TWENTY TWENTY SIX- NOW MAYBE
YOU CAN COMMENT ON HWY. TWENTY
TWENTY SIX WENT OUT EARLIER BUT
THEN ALSO IT STATE THAT DTS AND
OVER LONGER CONDUCT INDEPENDENT
OVERSIGHT OF THOSE
REQUIREMENTS- SO I GUESS WHAT
IT WOULD LIKE TO UNDERSTAND IS
THAT- SO WHAT KIND OF STANDARDS
ARE IS OF YOU GOING TO DEFER TO
NCQA. FOR THOSE AND THEN YOU'RE
GOING TO DO- THE OVERSIGHT OVER
OTHER REQUIREMENTS CAN YOU TALK
ABOUT THE OVERSIGHT PROCESS FOR
THE PLANS- ESPECIALLY AS WE'RE
GIVING THEM MORE
RESPONSIBILITIES. AND SO IF
YOU'RE GONNA SAY OKAY WELL.
GOOD DEAL YOU GET THE MODEL
CREATED BY NCQA WHAT HAPPENS.
THE PLAN FALLS SHORT DO WE
LEAVE THE PENALTY TO NCQA ARE-
LIKE SO. I MEAN I GUESS OF THE
LOST ACCREDITATION I GUESS YOU
COULD JUST NOT USE THAT PLAN
ALTHOUGH. I'M NOT SURE HOW THAT
WORKS IF IT'S A CLOSE OR IT'S
A- YOU KNOW. IT'S ONE OF THE
TWO PLANS DO YOU JUST SIMPLY ON
THEY'LL FIND A SECOND PLANTS-
CAN YOU JUST TALK ABOUT. HOW
THIS IN C. Q. A ACCREDITATION
IS GOING TO WORK PARTICULARLY
WHEN IT COMES TO IT'S EITHER A
FILTRATION OR- THE DON'T MEET
AND THEY MAY NOT NECESSARILY
LOS REFRIGERATION BUT THEY
HAVE. THEY HAVE SOME FAILURES
IN MEETING THAT DO WE JUST
LEAVE IT AND SEE Q. A. R. DO WE
ACTUALLY HAVE SOME CONSEQUENCES
FOR PLANS THAT DO NOT MEET THE
NCQA. REQUIREMENTS BUT NOT TO
THE GREEK OR NCQA. ITSELF MAY
REMOVE THEIR ACCREDITATION. SO
WE ARE WE ARE PROPOSED TO HAVE
THE ACCREDITATION BY TWENTY
TWENTY SIX THE REASON WHY. I WE
NEEDED THAT LONG AS WE DID WORK
WITH THE NCQA AND PLANS HAVE
ALREADY BECOME ACCREDITED IN
REGARD TO THE TIMELINE THAT IT
TAKES A FROM REQUIRE ME TAKES
ABOUT THREE YEARS TO GET FULL
ACCREDITATION AND SO. THAT'S
THE TIME PRETTY MUCH EVERYONE
HAS TO BE FULLY ACCREDITED BY
JUST A CLEAR BY THAT POINT- AND
SO THAT'S WHY IT'S THE LATER
YEARS THERE. FOR THE POINT
AROUND AT WHAT WE CALL DEEMING-
IN REGARDS TO USING NCQA
ACCREDITATION- ONCE. ABOUT
SIXTEEN I BELIEVE OF OUR
MANAGED CARE PLANS ARE
CURRENTLY NCQA ACCREDITED SO IT
JUST BE THE GAP THERE- BUT WE
CURRENTLY DON'T DO ANY DEEMING.
TODAY OTHER THAN CREDENTIALING
WHERE WE DO WOULD DEEM TO- NCQA
FOR CREDENTIALING IN CALIFORNIA
TODAY- WE WOULD LIKE TO
EXPLORE- SOME NCQA DEEMING AND
BY THAT I MEAN IT WHERE WE
WOULD HAVE AND C. Q. A. B. THE
MAIN SOURCE. OF THE REVIEW FOR
THOSE VARIOUS ADMINISTRATIVE.
FUNCTIONS AND REQUIREMENTS
HOWEVER WE DO PROPOSED TO HAVE
FULL TRANSPARENCY AND
STAKEHOLDER ENGAGEMENT AROUND
WHAT THE DEPARTMENT WOULD DEEM.
TO NCQA VERSUS WHAT WE WOULD
CONTINUE TO DO TO OUR ON GOING
ON OVERSIGHT MONITORING- SO WE
DO WANT TO HAVE THE LEGISLATURE
BE ABLE TO WEIGH IN ON THAT FOR
EXAMPLE IN THE FUTURE. I
DEPENDING ON WHAT WE RECOMMEND
THERE HOWEVER IT WOULD NOT TAKE
AWAY ANY OF THE STATE'S ABILITY
TO STILL HOLD MANAGED CARE
PLANS ACCOUNTABLE. IF FOR SOME
REASON A MANAGED CARE PLAN-
LOST ACCREDITATION FIRST BEFORE
YOU JUST LOSE IT YOU GO INTO
THEIR STAGES OF THAT. THE
DEPARTMENT WOULD INTERVENE
QUICKLY AND EARLY IN REGARDS TO
ANY. OPPONENTS THAT ARE WITHIN
THE DINNING AREA BUT WE ALSO
WOULD PUT OUR MANAGED CARE
PLANS IMMEDIATELY ON CORRECTIVE
ACTION PLAN. A AND- UTILIZE THE
SANCTIONS IF NECESSARY- IF
SOMEONE WERE TO BE AND JEOPARDY
OF SUCH A LOSS OF ACCREDITATION
SO. A LOT WE DO WANT TO
INCREASE THE STANDARDIZATION
ACROSS ALL OF OUR MANAGED CARE
PLANS WITH NCQA ACCREDITATION
SIMILAR TO YOU KNOW COVER
CALIFORNIA AND OTHERS WHO HAVE
NCQA ACCREDITATION
REQUIREMENTS- IT WOULD NOT. IT
WOULD NOT PROHIBIT THE
DEPARTMENT FROM ALL. OVERSIGHT
AND REQUIREMENTS- AS WELL AS
FULLTRANSPARENCY IN REGARDS TO
ANY AREAS THAT WE DO GOING TO
NCQA. VERSES PUTTING OUR
RESOURCES THAT WERE OTHERWISE
LOOKING AT CERTAIN
ADMINISTRATIVE FUNCTIONS TO-
YOU KNOW REALLY FOCUSING ON FOR
EXAMPLE INCREASING-
IMPROVEMENTS IN QUALITY. I
DELIVERY SYSTEM TRANSFORMATION
EQUITY OKAY. SO HOPEFULLY THAT
ANSWERS YOUR QUESTION OKAY
CERTAINLY AND- IT'S NOT THE
ISSUE WHEN YOU SAID- THAT- IT
DOESN'T PROHIBIT THE- AGENCY
FROM ACTING I JUST WANNA BE
SURE THAT- THAT THE AGENCY AND
DEEMING AND DIMMING IS FINALLY
HAVE A- YOU KNOW AN
ORGANIZATION LIKE AND SECURE
WAY- THE- BUT- THAT- THAT. THE
POLICY DOESN'T BECOME A- WELL
SINCE WE'VE DECIDED TO DEEM
THAT WE'RE WE'RE NOT GOING TO
DO ANYTHING ABOUT IT RIGHT SO
THAT YES THERE'S NOTHING THAT'S
IN THE PROPOSAL THAT WOULD
PROHIBIT. THE SYSTEM ACTING AS
WANNA DCS WHACKED. OUT AND NOT
JUST SIMPLY SAY WELL WE'VE WE
IS NOW THE SITE THE DMZ AND
SECURITY SO WE'RE NOT
RESPONSIBLE ANYMORE- SO I JUST
WANNA MAKE SURE THAT THAT THAT
THAT DOESN'T BECOME PART OF THE
CULTURE- THAT- IN TERMS OF THE-
THE- THE MESSAGE WE'RE SENDING-
AND I APPRECIATE THAT THEIR
VIEWS- YOU. KNOW PUBLIC TO
TRANSPARENCY. AROUND THE TEAM
PROCESS. READ MANAGED RATES- US
UNDERSTAND- PART OF FOR YOU'RE
TRYING TO THAT HE DESCRIBED- WE
I MEAN I UNDERSTAND WE DO KNOW
WHAT TO BE. ARE ARE YOU GOING
TO USE TO COVER CALIFORNIA
REGIONS WHAT KIND OF REGION'S
ARE YOU USING. TO SELL US
REGIONAL MANAGED CARE RATE
SETTING- I'M GONNA LET ALLEN
THE HEARING AN ANSWER THAT
QUESTION. GIVE. YES WE ARE WE
ARE STILL WORKING THROUGH WHAT
THOSE REGIONS WILL LOOK LIKE-
AND WHAT WE WILL MATCH THAT UP
WITH WE'VE BEEN DOING SOME
RESEARCH TO TRY TO DETERMINE
BASED ON THAT THE MACRO
INFORMATION THAT WE HAVE TODAY
I'M SURE THAT. THERE'S REGION
POPULAR COST PROFILE SIMILAR
EXPERIENCE I'M INTO WORKING IN
YOUR WORK AND WE WILL ALSO
CONTINUE TO WORK WITH OUR
MANAGED CARE PLAN PARTNERS
ACTUALLY ESTABLISH THOSE YOU
ENSURE THAT THAT THERE ARE- YOU
KNOW MY NAY AND ARE
APPROPRIATIONS YEAH SO
CERTAINLY THAT'S GONNA BE
REALLY IMPORTANT FOR EXAMPLE IN
THE MEDICARE PROGRAM- THERE'RE.
SAMPLE SACRAMENTO SINCE OUR
REGIONAL AREA. AS A AS A RULE
AREA. WE'RE OBVIOUSLY NOT RAY
ROLE AND SO ARE STRUCTURE IN
PAIN AT MEDICARE ARE. BECAUSE
OF AND SO. AND PART OF IT
BECAUSE YOU GUYS. BACK KNOW
DECADES AGO SO AND SO WE COME
TO READ MANAGER CARE RATES I
THINK PART OF IT CERTAINLY WANT
TO KNOW WHAT THOSE REGIONS ARE
GOING TO BE- SO WHY KNOW HOW
THOSE REASONS MIGHT OF ALL OVER
TIME- REFLECTING POTENTIALLY
POPULATION SHIFTS AND OTHER
THINGS THAT. WILL COURSE CAPITA
PER TIME DEMOGRAPHIC SHIFTS AND
SO FORTH. SO THINK WE NEED A
MUCH MORE DETAIL ON THAT- AND
THEN- NOW WE TALKED ABOUT THE
ENHANCED CARE MANAGEMENT- SO
AND YOU TALK ABOUT THE PERCENT
THE YOU HAVE A DESCRIPTION OF
THE- TARGET POPULATIONS COULD
SO HE JUST SPEAK TO WHAT
PERCENTAGE OF OUR THIRTEEN.
MILLION POINT WHATEVER MILLION
PEOPLE WHO ARE ON MEDICARE
MANAGED CARE PLANS WOULD
ACTUALLY. QUALIFY FOR ENHANCED
YOUR MANAGEMENT. HOW MANY OF
THEM. SO WE DON'T HAVE AN EXACT
PERCENT OF WHAT WE DO KNOW IS
THAT. ABOUT A ROUGH PERCENT I
GOT NO EXIT OKAY SO WHAT. WE'RE
TALKING TEN TWENTY THIRTY IT'S
CLOSE 210% NO IT SHOULD BE THE
ENHANCED CARE MANAGEMENT IS FOR
YOUR TOP HIGHEST- WHETHER IT'S
UTILIZED THERE'S OR MOST
COMPLEX INDIVIDUALS THAT ARE
FACING KIND OF ON BOTH THE
MEDICAL AND SOCIAL- DRIVERS A
OF HEALTH SO IT'S NOT
NECESSARILY- IT'S EASY TO PUT.
UP PERCENT ON WHICH IS WHY WE
TYPICALLY DON'T GIVE UP PERCENT
OKAY THAT IT'S GOING TO VERY
BASED ON THE DIFFERENT TARGET
POPULATIONS- AND ONE THING I
WOULD JUST MENTION IS. JUST THE
THOSE THAT MAY BE ELIGIBLE THE
NUMBER THAT ENGAGE IS A VERY
DIFFERENT NUMBERS BECAUSE OF
THE COMPLEXITIES AND SO THAT'S
WHY. IT'S HARD FOR THE
DEPARTMENT BUT- WELL IT OKAY I
YOU CAN GIVE THESE. NUMBER BUT
I THINK SCALE IS IMPORTANT
RIGHT SO AND FOR EXAMPLE YOU
KNOW WHEN THE TARGET
POPULATIONS ARE PEOPLE WHO ARE
AT RISK OF BEING HOMELESS OR
HOMELESS. RIGHT AND BY THE WAY
THEY'RE HARD TO REACH SO. WHEN
WE'RE DOING CONTRACTS MANAGED
CARE PLANS- WHAT WE DON'T WANT
TO DO IS HAVE THEM CONTRACT
RIGHT FOR THE POPULATION AND
THEN NOT DO SUFFICIENT OUTREACH
AND THEN BASICALLY OKAY SO YOU
KNOW WE GOT A SO I THINK HAVING
A NUMBER OF HAVING AT LEAST AND
RANGE IS IMPORTANT SO AND SO
I'M JUST THINKING SKILLS SO WE
TALK ABOUT THE TOP ONE PERCENT.
THE TOP 3% THE TOP 5% TOP 10%
THERE'S A DIFFERENCE BETWEEN
SAYING WE'RE ONLY GOING TO DO
THE TOP 2% HARD TO TOP 10% OF
THE TOP 20% RIGHT SO- FOR YOU
KNOW THAT AT LEAST IN TRYING TO
FIGURE OUT HOW YOU KNOW WHAT
WHAT EXACTLY WE'RE TRYING TO
BUDGET FOR. I MEAN WE HAVE
SEVEN DIFFERENT NOT A CATEGORY
MANDATE MANDATORY TARGET
POPULATIONS WE SHOULD AT LEAST
HAVE SOME EXPECTATION ABOUT
ROUGHLY HOWMANY PEOPLE ARE
THESE ALL ADD UP AND HOW MANY
PEOPLE IN EACH CATEGORY SO
INDIVIDUALS EXPERIENCING
CHRONIC HOMELESSNESS SERVICE
COULD BE HOMELESS. HOW MANY
PEOPLE ARE WE TALKING ABOUT
THAT WE EXPECT MANAGED CARE
PLANS REACH IS GONNA BE THE
HUNDRED THIRTY THOUSAND WE'RE
EXPECTING A WHOLE STYLE THAT I
AM TRYING TO READ WHAT THE L.
A. O. HAS THEIR HAND UP IS YEAH
MAYBE L. CAN HELP OUT WITH THAT
TOO BUT. YES SIR AT LEAST FOR
BUDGET IS SOME. THAT FOR I.
THIS WITH MY EYES THIS BE THE-
SENATE OF MEDIC HELD MINISTER
BENEFIT SHOWS THAT WOULD SIR.
THREE CM MINE. ARE INNER IS
THAT THE ASSUMPTION IS 1% YEAH
I WAS JUST GONNA SAY FROM A
PURE RATE PERSPECTIVE WE HAVE
HISTORICALLY BEEN USING 1% THAT
WAS DRIVEN BY OUR EXPERIENCE IN
BOTH HEALTH HOMES AND WHOLE
PERSON CARE- AND WE WILL FINE
TUNE THAT BUT THAT DOESN'T
NECESSARILY MEAN THAT'S THE
NUMBER THAT WOULD BE ELIGIBLE-
THAT'S BASED OFF OF- THOSE THAT
ENGAGE. OF OR HAVE HISTORICALLY
BASED ON OUR EXPERIENCE SO
THAT'S WHY YOU KNOW IF IT'S
WHAT'S BEING BUILT INTO THE
RATED IT IS CURRENTLY.
PROJECTING AROUND ABOUT A 1% OF
MEDICARE BENEFICIARIES OF FOR
THE ENHANCE YOUR MANSER OKAY SO
THAT THAT'S VERY HELPFUL TO
KNOW- I THINK IT'S IMPORTANT.
TO NOTE BECAUSE YOU TALK ABOUT
ENGAGEMENT BUT ENGAGEMENT IT
ALSO. SOMETIMES ENGAGEMENTS
ATTEND OUTREACH. EIGHT SO YOU
KNOW WHEN TO WAY STREET. AND
IT'S AND IS WHERE BUILDING THE
THINGS OUT AND AGAIN I
APPRECIATE YOU KNOW THE PICTURE
YOU PAINTED AND THAT'S I THINK
WE'D ALL LOVE TO SEE THE THING
BUT- YOU KNOW THE PERSON WHO
FREQUENT GOES TO THE ER. IF
SOMEONE IF WE'RE NOT IF THE
PLAN IS AN ENGAGING. RIGHT
BECAUSE THEY'RE LIKE OH WELL WE
HAVE 1% THAT'S WHAT WE GOT PAID
FOR- THEN WE'RE NOT REALLY
NEEDING THE PROMISE- THAT WERE
THESE PAINTINGS SO I THINK WE
NEED TO SET. APPROPRIATE
EXPECTATIONS FOR HOW MANY. AND
THE 1% AS OF NOW AND AGAIN I
KNOW THAT WE'RE TALKING ABOUT
FOCUSING ON THE MOST HIGHEST
RISK PEOPLE BUT- YOU KNOW
THERE'S A LOT OF THINGS HERE
WE'RE TALKING ABOUT THAT WE'RE
GONNA TRY TO PROVIDE THAT YOU
REALLY QUE YEAH THAT'D BE GREAT
AND BUT IT'S ONLY 41% AND
PEOPLE NEED TO KNOW THAT. OKAY
HERE 22% WHICH WILL STILL HAVE
A LOT OF NEEDS DOES MATCH THE
1% BUT STILL PRETTY HIGH.
YOU'RE NOT GONNA BE ELIGIBLE
OUT YOU MAY NOT BE OR IF WHAT'S
THE PERCENTAGE OF DAR ELIGIBLE
AND THE PERCENT OR SPRAYS-
FUNDING FOR SO WE GOT NO THAT
IS THAT. IS THAT 1% YOU KNOW
HALF OF ALL THE PEOPLE WHO
MIGHT BE ELIGIBLE IS THAT A
THIRD IS THAT. NO EIGHTY
PERCENT- SO THAT WE KNOW WHERE
WE'RE HEADING TOWARDS- AND
WHETHER AND. HOW WELL
RESOURCING- IN LIEU SERVICE-
YOU KNOW AGAIN. AT THE- THE OF
DIFFERENT THINGS HERE BUT ALSO
SAYS ALLOW PLANTS INVOLUNTARY
INCLUDE ONE OR MORE IN THESE
SERVICES. SO- SO DOES THAT MEAN
THE PLAN GETS TO DECIDE WHETHER
THEY WANT TO DO. WELL THE CITY
HOW MANY DO WE HAVE HERE HELLO
WE HAVE SEVERAL POTENTIAL ONCE
BUT- SO WHAT KIND OF OVER IS SO
IS IT SIMPLY THE PLAN THE SIDES
OR IS THAT SOMETHING THEIR DTS
NEGOTIATES WITH THE PLAN OR DO
WE- WHAT KIND OF OVERSIGHT IS
THERE ABOUT WHICH INCLUDES
SERVICES THEY PROVIDE- IS THERE
ANY EXPECTATION FOR EXAMPLE OF
THE PLAN SERVES A- POPULATION
WITH- THAT THAT HAS A HIGH NEED
FOR. SEVERAL OF THESE LIKE FULL
TIME LISTENERS HOUSING DEPOSITS
HOUSING TELLS YOU THAT THEY
WILL INCLUDE THAT OUR VISIT IS
IT UP TO THEM TO DECIDE WHICH
ONES THEY WANT INCLUDING WHICH
ONES THEY DON'T- AND THE THAT
AFFECTS- PEOPLE'S ACCESS. TO
THESE SERVICES. BUT FEDERAL
REGULATIONS THAT WE ARE USING
TO IMPLEMENT THE IN LIEU OF
SERVICES DOES REQUIRE THAT IT
IS VOLUNTARY FOR THAT MANAGED
CARE PLAN- TO PROVIDE THEM OR-NOT. WE HAVE A MODEL OF CARE
AND TRANSITION TEMPLATE THAT'S
CURRENTLY OUT FOR PUBLIC
COMMENT RIGHT NOW. GUARDS TO
THE FILING TIMELINES THAT
MANAGED CARE PLANS WOULD MAKE
WITH THE DEPARTMENT FOR WHICH
IN LIEU OF SERVICES THAT THEY
ARE CONTINUING- WE HAVE HAD FOR
EXAMPLE THAT A CROSSWALK ALL OF
THE EXISTING IN LIEU OF
SERVICES. ARE BEING PROVIDED
WITHIN BOTH HEALTH HOMES AND
WHOLE PERSON CARE FOR MANAGED
CARE PLANS- SO THAT THEY CAN
CONTINUE TO PROVIDE. THOSE
SERVICES- ONE OF THE MOST
CHALLENGING THINGS ARE GETTING
A LITTLE SERVICES OP IS
IDENTIFYING THE CORRECT
PROVIDERS BECAUSE THERE ARE-
CLEAT THE CLEAR SUBJECT MATTER
EXPERTS WHO SHOULD BE
PROVIDING- THOSE CERTAIN TYPES
OF SERVICES AND SO- WE WILL BE
ENCOURAGING ALL OF OUR MANAGED
CARE PLANS. TO CONTINUE THE
SERVICES ARE PROVIDED IN WHOLE
PERSON CARE AND THEN EXPAND- TO
THE OTHER A LITTLE SERVICES
THERE ARE FOURTEEN OF THEM SO
WE DON'T IMAGINE ALL MANAGED
CARE PLANS WILL- YOUR TAKE UP
ALL FOURTEEN AT THE SAME TIME-
BUT WE DO HOPE THAT THEY WOULD
BE. FACING THOSE IN OVERTIME WE
DO LOT FOR THEM TO ADD A
LITTLE SERVICES EVERY SIX
MONTHS- AND SO WE WILL WE'LL
KNOW BY THIS SUMMER- WHICH- IN
LIEU OF SERVICES MANAGED CARE
PLANS ANTICIPATE AT LEAST
PROVIDING IN THE NEXT YEAR OR
TWO- ARE PROPOSING TO BE ABLE
TO ASSESS OUR GAPS- AND
ENCOURAGE THEM- AND CONNECT
THEM WITH PROVIDERS TO BE ABLE
TO PROVIDE THOSE SERVICES IN
THEIR COMMUNITY. THE ONLY OTHER
THING I WOULD ADD IS THAT WITH
THE UPCOMING PROCUREMENT- FOR
MEDICARE MANAGED CARE PLANS IT
WILL BE VERY CLEAR THAT ANY
MANAGED CARE PLAN I WANTED TO
ENTER INTO THE CALIFORNIA
MARKET. WOULD BE EXPECTED TO
COME IN WITH A FULL COMPOSED
ALL IN REGARDS TO HOW THEY ARE
GOING TO PROVIDE IN THE
SERVICES IN CALIFORNIA. IT
DEMONSTRATE THAT TO US SO
SOMEONE USE THAN AND- SO WHEN
YOU SAY THAT IN PROCUREMENT IS
THERE PLAN SUPPOSED TO TALK
ABOUT ALL THIS IS A TELL ME
WHAT THE FOURTEENTH AND HELP
THEM ALL. THE FOURTEENTH OKAY
SO IS THERE ARE THEY SUPPOSED
TO COME OF PLAN. TO TALK ABOUT
HOW THEY MIGHT INCORPORATE. WHY
OF THEM. FOR ALL FOR. SOMETHING
IN- WHAT I THINK WE WOULD SAY
OTHER- NEARING LOOK INITIATIVE
FOR EXAMPLE IF THERE ARE
COMMERCIAL PLAN AND THEY HAVE A
LOCAL INITIATIVE THEY SHOULD AT
A MINIMUM BE ABLE TO PROVIDE
WHAT THAT LOCAL INITIATIVE IS
PROVIDING EVAN LOW OF SERVICES
TO HAVE- COVERAGE ACROSS THE
ENTIRE COUNTY. AND TELL US HOW
AND WHAT IN LIEU OF SERVICES
THEY WOULD BE OFFERING OF THE
FOURTEEN ON THAT TO ENSURE THAT
ANYONE COMING INTO OUR MARKET
IS VERY COMMITTED TO- YOU KNOW
BRINGING UP EVEN IF IT'S
OVERTIME A PHASE IN OF THESE IN
LIEU OF SERVICES ON THAT WILL
BE A VERY STRONG REQUIREMENT
FOR US. AND THEN. RIGHT SO JUST
TO CLEAR SO HAVE YOU KNOW WE
HAVE STE SOME COUNTIES ARE
BECAUSE THEY'RE ONE PLANNED SO
THAT. THE BILL HAS WHATEVER IN
LIEU SERVICES STATE CHOOSE.
THEN YOU HAVE TO PLANT COUNTY
ZERO GMC COUNTIES- THE RURAL
COUNTIES I THINK THE LEVEL THAT
IT USUALLY WATER TO LEAST
COUPLE PLANNED SO AND COUNTIES
IN MULTIPLE PLANS. ARE WE-
EXPECTING THE PLANS WITHIN THE
SAME COUNTY TO AT LEAST OFFERED
THE SAME SAID IN LIEU SERVICES
ARE TOGETHER DIFFERENT SETS OF
IN HOME SERVICES. SO WE ARE-
WITHIN LIKE TO PLAN FOR EXAMPLE
YOU'RE GOING TO ENCOURAGE-
PLANTS HOWEVER UNDER FEDERAL
REGULATIONS WE CANNOT MANDATE
IT JUST TO BE CLEAR- AND SO
YOU'LL BE ENCOURAGING PLANS TO
WORK TOGETHER TO PROVIDE THE
SAME LIEU OF SERVICES- I'VE FOR
INDIVIDUALS- THROUGH THE
PROCUREMENT PROCESS WE WILL
ALSO BE ARE. REDUCING THE
NUMBER OF PLANTS IN GMC
COUNTIES- THE END THAT WILL BE
ROLLED OUT THROUGH THE
PROCUREMENT PROCESS- AND SO.
WE'RE GONNA DO EVERYTHING WE
CAN TO WORK WITH THE PLANS.
HERSCHEL AND LOCAL INITIATIVES-
TO ALIGN AND PROVIDE THE SAME
IN LIEU OF SERVICES AND COUNTY
TYPICALLY- THE BIG THING AND
LEFT FOR GETTING IN LIEU OF
SERVICES UP AND RUNNING IS
IDENTIFYING. PROVIDERS WHO ARE
I HAVE THE AILITY TO PROVIDE
THOSE IN LIEU OF SERVICES- AND
SO BROKERING THOSE
CONVERSATIONS OF PROVIDERS
ACROSS BOTH OF THE PLANS ARE TO
INVEST IN THOSE SERVICES WILL
BE WORKED AT THE DEPARTMENT
WILL HAVE TO ENGAGE IN. OKAY HI
I APPRECIATE THAT THE BIGGEST
BARRIER IS THE IS THE PROVIDERS
BUT I I'M I'M ALSO JUST
CONCERNED THAT COUNTIES WITH
MULTIPLE PLANS. IF THERE IF
PEOPLE OF DIFFERENT SETS OF THE
NEW SERVICES- THEN YOU'RE GOING
TO HAVE ITSO I DON'T KNOW IF
THAT'S GOING TO FACTOR
CAPITATION RATES OR SOMETHING
BECAUSE UPS BUT YOU MAY TRACK
DIFFERENT TYPES OF POPULATIONS-
AND THEN THE OTHER ISSUE IS
THAT YOU KNOW THE MEDICARE
POPULATION. SOMETIMES PEOPLE
DON'T ALWAYS. THE SIDE WHICH
PLAN LETTER TECHNIQUE THE
SENATE PLAN BUT OFTEN. THEY MAY
NOT MAKE A DECISION TO GET
PLACE PLACE IN THE PLAN AND
THEN THAT THAT YOU MAY FIND
PEOPLE. AND WELL YOU HAVE A
COMBINATION OF EITHER PEOPLE
OR- FIND THEMSELVES. THEY'LL
AUTOMATICALLY PLACED IN THE
WRONG PLAN OR YOU COULD ALSO
HAVE- DISTORTIONS IN TERMS OF
WHAT POPULATIONS AND WHAT WE
DON'T WANT TO DO SAID MANAGED
CARE PLANS. ACTUAR LEGAL WELL
I'D WANT PROVIDE DENIMS
SERVICE. BECAUSE I DON'T EVEN
WANT TO ATTRACT ALL THE
HOMELESS PEOPLE RIGHT SO WILL
VOID THOSE SERVICES. AND
HOPEFULLY THE OTHER PLAN WILL
DO IT AND NO NO PLAN WILL DO
THOSE BECAUSE THEY NEED A ONE
WHAT'S THAT POPULATION IS IT'S
MUCH HARDER. AND SO I DON'T
KNOW IT BUT FOR EXAMPLE. I
KNOW. AGAIN I UNDERSTAND YOU
SAID FEDERAL REGULATION
REQUIRES THAT IN LIEU SERVICES
THAT THEY DO ARE VOLUNTARY- DO
YOU SEE ANY ADJUSTMENTS TO
THEIR PAYMENT RATES FOR PLANS
TO CHOOSE THE DECIDE
DIFFERENTLY SERVICES WE GATHER
MORE DATA ON HOW POPULATIONS.
WILL BENEFIT. FROM RECEIVING
CERTAIN AND LOSE SERVICES THAT
MIGHT ACTUALLY. CAUSE
DIFFERENCES IN CASE MIX. YES WE
WOULD- THEY- PROVIDE THE IN
LIEU OF SERVICES THAT WOULD BE
BUILT INTO THEIR RATE SO IF
THEY- ARE PROVIDING THEM AT A
HIGHER RATE OR- I'M MORE IN
LIEU OF SERVICES THAT IS. THAT
EVENTUALLY GETS BUILT INTO THE
RATE IN OUTSCORED IN THE BUDGET
RIGHT NOW. BECAUSE OF THE IN
LIEU OF SERVICES PROVIDED
THROUGH WHOLE PERSON CARE. AND
HELP HOMES AS THOSE TRANSITION
IN THOSE COUNTIES WE ACCOUNT
FOR THOSE PLANS THAT. ELECT TO
GET THOSE IN THOSE SERVICES TO
RECEIVE THOSE FUNDS THROUGH
THROUGH THE BUDGET AS WELL SO
THEY WOULD BE FUNDED. WHICH
WOULD BE THERE. YOU KNOW WHICH
IS IMPORTANT FOR THEM TO HAVE
THAT FUNDING ALL RIGHT NOW SO
THAT WE DON'T HAVE THE DROP OFF
OF THOSE IN THE WEB SERVICES IN
THE COULD MAINTAIN THOSE
SERVICES WITHIN THE COUNTY- SO
THAT KELLY PROPOSAL COUNTER
ABOUT. OKAY AND- JUST. DO I
POINT OUT THAT THE- IN TERMS OF
THE EXPENDITURE AUTHORITY- THE
AMOUNT FOR IN LIEU SERVICES
UNDER LOCAL ASSISTANCE RESOURCE
REQUEST. WAS HERE SAID FORTY
ESSENTIALLY FORTY EIGHT MILLION-
IS THAT REFLECT WHAT WAS THAT
REFLECT- SO THAT IS- SIX MONTHS
WORTH OF IN LIEU OF SERVICES
BECAUSE WE'RE ONLY SCORING SIX
MONTHS- AND THERE'S A CASH
FLAG- BUT- I BELIEVE IT GETS
CLOSE TO THE COURSE I DON'T
HAVE MY ANNUAL NUMBERS AND
BERNIE BUT LIKE ABOUT A HUNDRED
AND FIFTEEN OR SO- IF I'M GOING
OFF OF MEMORY MILLION DOLLARS
FOR. SERVICES AND THAT'S BASED
OFF OF OUR EXPERIENCE WITH THE
SERVICES BEING PROVIDED THROUGH
HEALTH COMES IN HOT PERSON CARE
TODAY BASED ON UTILIZATION
TODAY OKAY AND THEN FINALLY-
AND- I JUST WANT TO TOUCH ON I
KNOW THAT UNDER STAFFING
RESOURCES REQUEST- I SHOULD
NOTE THAT THE MEDICAID MANAGED
INFORMATION SYSTEM DIVISION
ONLY. HAD ONE ADDITIONAL
INFORMATION TECHNOLOGY
SPECIALIST- I GUESS AND I KNOW
WE'RE GONNA DELVE A LITTLE MORE
INTO THE I. T. STUFF AND
THERE'S OTHER VCTS FOR I. T.
BUT I DON'T IT IN TERMS OF
CALAMP WHAT HE JUST MUST BE
GENERALLY IN TERMS OF I. T. L.
I THINK OVERSIGHT AND DATA
COLLECTION CAN BE REALLY
IMPORTANT RIGHT WE'RE DOING
THIS HUGE TRANSFORMATION WE
DIDN'T KNOW WHERE WE'RE GOING
HOW'S IT GOING AND SO FORTH-
WHAT DO YOU SEE AS THE I. T.
DEMANDS- FOR- FOR. GOING TO
MOVING ON TO CALAIS AND IN
TERMS OF BEING ABLE TO DO THE
KIND OF THIS ASSESSMENTS IN
OVERSIGHT AND ACCOUNTABILITY
AND THEN TH OTHER PART IS
THAT- I KNOW YOU'RE ADDING SOME
ADDITIONAL PERSONNEL MANAGER
QUALITY MONITORING DIVISION-
BUT AGAIN I'D SAY WITH THIS
BROADER ROLE FOR MANAGED CARE
AND I THINK THAT REALLY GOING
TO DO ANOTHER QUESTION AT THE
THAT THE NOW THE ISSUE IS THAT
I DON'T THINK WE- THE CONCERN
IS THAT THE GOALS I THINK THE
QUESTION IS THAT. WE CAN'T WE
WHAT WE DON'T WANT HIS CONTRACT
OUT THE RESPONSIBILITY
ACCOUNTABILITY SO THEREFORE IS
THAT ENOUGH STAFF TO BE SURE
THERE SUFFICIENT ACCOUNTABILITY
FOR THE MANAGED CARE PLANS AND
WHAT HAPPENS WHEN A MANAGED.
CARE PLAN DOESN'T- WELL DOESN'T
DELIVER ON UNDER THINGS THAT WE
COUNT ON SO- AND WHAT THE
CONSEQUENCES FOR THIS HOW HOW
LONG ARE THEY ON A CORRECTIVE
ACTION PLAN BEFORE SOMETHING
HAPPENS WHAT OPTIONS DOES. THE
CS ACTUALLY HAVE GIVEN THE FACT
THAT MANY COUNTIES THERE ARE
MANY PLANS SO THAT MEANS NOT
JUST SIMPLE AS SIMPLY TURNING
OFF THE PLAN- SO CAN CAN YOU
SPEAK TO- THE- THE STE. THE
STAFFING- SO I GUESS THE FACT
I'M ACTUALLY BRING UP THE ISSUE
DO YOU HAVE ENOUGH STAFF. TO BE
SURE YOU DO ENOUGH OVERSIGHT
THE SENATE SORRY I KNOW YOU'RE
ASKING FOR A LOT MORE STAFF.
BUT I'M JUST WONDERING DO YOU
HAVE ENOUGH TO BE ABLE TO DO
THE LEVEL OVERSIGHT THAT WE'RE
GOING TO EXPECT. FOR SUCH A
LARGE TRANSFORMATION AND- YEAH.
SO- ON THE- ON THE E. R. T. S.
OR THE- ENTERPRISE TECHNOLOGY
SERVICES WE DO HAVE A REQUEST
FOR- SOME STAFF THERE WE DID
SEPARATE OUT OUR SYSTEMS. ASK
WHICH- AS YOU MENTIONED- WILL
BE- COMING LATER WITH THE
MODERNIZATION OF OUR SYSTEMS
AND SO. ON THAT'S WHY YOU'RE
SEEING IT MAYBE NOT AS-REFLECTIVE AS STRONGLY IN THE
ACTUAL CALLIE IN THE IBC PK WE
WENT BACK AND FORTH WHETHER WE
SHOULD- PT HIM IN. IN THEIR
RESPECTIVE PIECES AND LANDED
WHERE WE SEPARATED THE TO ASK
BUT YOU DO SEE SOME. IN THE
CALIBER I'M NOT AS MUCH AS-
WHAT YOU'RE SEEING IN THE
REQUEST ON THE ON. THE
ENTERPRISE SIDE- ON THE M. C.
Q. AND THE WHAT I WOULD SAY IS
YOU KNOW WE DON'T CURRENTLY
OTHER THAN THAT. THIS THE MINOR
CREDENTIALING PIECE WE DON'T.
WE DON'T DENY. ANY OF THOSE
OVERSIGHT FUNCTIONS TODAY SO WE
HAVE. AN EXISTING STAFF DOING
THAT THE REQUEST HERE IS THE
ADDITIONAL STAFF FOR THE
ADDITIONAL OVERSIGHT OF ENHANCE
YOUR MANAGEMENT IN LIEU OF
SERVICES. ON THE ADDITIONAL-
WIVES COMING INTO MANAGED CARE.
AND TO TIGHTEN UP AND SHORE UP-
SOME OF OUR SERVICES IN REGARDS
TO. OF THAT OVERSIGHT
MONITORING AND THAT SPANS OVER
BOTH THE MANAGED CARE QUALITY
IMAGING DIVISION AS WELL AS THE
MANAGED CARE OPERATIONS
DIVISION- SO JUST POINTING OUT
THAT. THEY BOTH ARE ASKING FOR-
YOU KNOW. PRETTY SIGNIFICANT
RESOURCES. TO ADD TO THE
ADDITIONAL OVERSIGHT PIECES-
AND THEN WE JUST SAY WE HAVE.
THE OTHER STAFF FROM OUR
EXISTING KIND OF- WITHIN B.
LIMITED TERM AND THE ONGOING
PERMANENT REQUEST. SOME OF
THOSE PERMANENT. POSITIONS IN
THE OTHER BCPS ARE FORMER
OVERSIGHT AND INCREASED
MONITORING- WITHIN THE- FINAL
RULE THE MEASURE FINAL RULE
THAT CAME DOWN. IN CONVERTING
THOSE TO PERMANENT REQUEST.
THAT ALSO HELPS FROM AN
OVERSIGHT MONITORING AND THAT
IS JUST. IN A SEPARATE B. C. P.
WHERE WE ARE ASKING FOR THOSE
POSITIONS OKAY IF THAT HELPS OF
VETERANS INSTILLED. YOU DON'T
HAVE THE ANSWERS RIGHT NOW BE
IT I'D- BE INTERESTED IN.
HAVING SOME MORE INFORMATION
ABOUT. HOW OVERSIGHT IS GO
GOING TO BE. HANDLED FOR CAL
AIM AND HOW WE GET SOMETHING
THAT WERE PLANTED DIFFERENTLY-
ORDER SAME INTO OF OVER. AND ON
THE I SIDE- THE- NOW I WON JUST
BE FAIR WE'VE ACTUALLY HAD WITH
SUCCESSFUL IT PROJECTS DON'T
MAKE THE NEWS AND SO WE DO HAVE
SUCCESSFUL IT PROJECTS IN THE
STATE SOMETIMES IT SEEMS LIKE
THE ONLY. BECAUSE THE ONES THAT
WE HAVE PROBLEMS WITH MAKE THE
NEWS SO I DON'T WANT ANYONE TO
THINK THAT WE DON'T HAVE
SUCCESSFUL IT PROJECTS. BUT NOW
WE ALSO HAVE HAD I. T. PROBLEMS
WITH THAT LEGACY SYSTEMS ISSUES
ETCETERA. SO ALSO WOULD LIKE
TO- PERHAPS YOU CAN REPORT BACK
ON FOR CALAMP. ARE WE LOOKING
AT NEW IT SYSTEMS ARE HAVING TO
UP SIGNIFICANTLY UPGRADE
EXISTING IT SYSTEMS IN ORDER
TO- TO BE SURE WE CAN COLLECT
THE KIND OF DATA WE NEED
BECAUSE I COLLECT A MUCH
BROADER SET A DATE I ASSUME
IT'S WORKING DOING THAT AND
LOSE SERVICES AND THE WHOLE
PERSON ETCETERA. AND THAT- WE
THAT WE'RE GONNA HAVE A SYSTEM
THAT'S ROBUST ENOUGH THAT WE
CAN GET THE ANSWERS TO THE
QUESTIONS WILL HAVE. LATER IN
TERMS OF IMPLEMENTATION HOW
SUCCESSFUL IMPLEMENTATION ISN'T
AND OUTCOMES. SO IF WE CAN GET
A REPORT BACK FROM- FROMDH CS
AND OR- THE PROPIEDADES EN
SEIZE. ON THAT PRIOR TO- IN THE
NEXT FEW MONTHS THAT WOULD BE
VERY HELPFUL. PRIOR TO A
REVISED. WE'D BE HAPPY. I THANK
YOU. THANK VERY MUCH TALK TO
PAY AM CAN YOU JUST M. AND I
THINK WE'RE WHAT YOU'RE FROM
FROM ALL OF US IS THAT IS THE
NEED A YOU KNOW THE OPTIMISM
ABOUT ABOUT THE PROGRAMS. BUT
ALSO THE CONCERNED ABOUT
OVERSIGHT AND ACCOUNTABILITY AS
SOMEBODY NEW TO THE BUDGET
COMMITTEE BUT WITH A STRONG
pMENTAL HEALTH WE ACTUALLY LOOK
AT ALL THE MONEY WE'RE SPENDING
YOU THINK WELL IT'S NOT MAYBE
WE DON'T NEED MORE MAYBE WE
JUST NEED TO USE IT. IN A MORE
EFFECTIVE MANNER CAN YOU TELL
ME OF JUST. BRIEFLY SO IF WE'RE
GONNA BE DOING ALL THIS OUT TO
THE PLANS WHAT'S GOING TO BE
THE INTERFACE WITH THE ALL THE
PROP SIXTY THREE PROGRAMS OR
WILL THEY BE PART OF THE
CONTRACTOR. CONTRACTING
SERVICES. SO ARE WE ARE HOPING
THAT OUR MANAGED CARE PLANS
WILL CONTRACT WITH. OUR COUNTY
PARTNERS- IN REGARDS ESPECIALLY
WHERE THERE'S CROSSOVER WITH
THE ENHANCED CARE MANAGEMENT
AND- SOME ACCOUNT PARTNERS IN
THE A LITTLE SERVICES THAT HAVE
EXPERIENCE THERE- IT IS ONE OF
OUR EXPECTATIONS OF- THE
ROLLOUT AND THE HOPE THAT THE
PARTNERSHIPS WILL TAKE PLACE. I
THINK THAT- INTEGRATING OUR OUR
SYSTEMS IS REALLY CRITICAL AND
IT'S ONE OF THE KEY COMPONENTS
THAT WE ARE HOPING THAT WE WILL
ACHIEVE- WITH SOME OF THE
CALAIS BY HAVING DIRECT
CONTRACTS BETWEEN MANAGED CARE
PLANS AND COUNTY BEHAVIOR
HEALTH DEPARTMENTS OKAY. AND WE
DON'T ANTICIPATE LOSING ANY OF
THE ANY OF THIS THE THERE ARE
THE WAY THE PLANS ARE CURRENTLY
STRUCTURED DO WE SEE ANY
CHANGES TO ANY OF THAT. IT'S
REGIONAL OR OR- TO COUNTY YOUR-
PUBLIC. SO THOSE CHANGES ARE
PROPOSED IN AND CAL AIM-
HOWEVER WITH HER UPCOMING
PROCUREMENT- WE DO CURRENTLY
HAVE A REQUEST FOR INTENT FOR
COUNTIES THAT ARE REQUESTED TO
CHANGE. THEIR MODEL- WHETHER
THAT BE A TO A TO PLAN OUR
CLOTHES OR- I SMALL COUNTIES
THAT ARE WANTING TO JOIN
EXISTING CODES FOR EXAMPLE-
THOSE LETTERS OF INTENT OR DO
YOU TO LAST. UP SO THAT WE CAN
EVALUATE THAT FOR THE PURPOSES
OF THE PROCUREMENT TO WORK ONLY
PROCURING COMMERCIAL PLANS- IN
COUNTIES WHERE WE NEED TO AND
SO. WE WOULD NEED TO GET BACK
TO YOU ONCE WE HAVE INFORMATION
IN REGARDS TO WHICH COUNTIES
ARE CONTEMPLATING CHANGING
THEIR- THEIR MODEL- DURING THE
PROCUREMENT PROCESS. VISIT
WHERE WE WOULD JUST WANT TO BE
ESPECIALLY MINDFUL OF THOSE WHO
ARE. IT'S VERY HARD TO SERVE IN
THE RURAL AREAS THAT WE DON'T
LOSE ANY. OKAY ASSEMBLY THIS.
THANK YOU RECOGNIZE ME NOW
CHAIR- I HAVE A FEW QUESTIONS
GIVEN THE SIZEABLE UP FRONT
INVESTMENTS IN CALTRAIN- WHEN
HIS APARTMENT WINDOWS IN
DEPARTMENT EXPECT THAT WE WILL
BREAK EVEN- BRUCE CAL COST
REDUCTIONS. I DO NOT HAVE A
PRODUCTION OF THAT AT THIS TIME.
OKAY LEARN MY NEXT QUESTION
WOULD BE THEN THAT- THE STATE
AUDITOR'S PRETTY SEVERAL
RECORDS DOCUMENTING THE
STRUGGLES- IN THAT ACCOUNT
MANAGED PLANS IN BEING ABLE TO
PROVIDE BASIC PREVENTATIVE
CARE. SO HOW CONFIDENT AND IS
THE DEPARTMENTS- EIGHT IN MEDIC
CAL- MANAGED CARE PLANS BEING
ABLE TO TAKE ON THESE ADDED
RESPONSIBILITIES GET AND
THERE'S BEEN SOME DIFFICULTY.
IN JUST PROVIDING- YOU KNOW
BASIC HEALTHCARE DELIVERY. SO I
THINK THAT- THE DEPARTMENT
INTENDS ON- HAVE BEING VERY
TIGHT ACCOUNTABILITY AND
OVERSIGHT- FOR EXAMPLE WE DO
PLAN ON IMPLEMENTING VERY YOU
KNOW POST GO LIVE REPORTING
REQUIREMENTS BOTH FROM OUR
REGION GAUGE MEN AS WELL AS
ACTUAL UTILIZATION OF THE
SERVICES- WE ARE ALSO THINKING
THROUGH WHAT METRICS YOU WILL
WANT TO EVALUATE TO CLOSELY
MONITOR- THIS WORK- AND REALLY
THINK ABOUT IT FROM A DELIVERY
SYSTEM OF POINT OF VIEW. WE
CONTINUE TO PARTNER WITH OUR
MANAGED CARE PLANS IN REGARDS
TO YOU- ENSURING THAT CHILDREN
HAVE ACCESS TO PREVENTATIVE
SERVICES- AND THINKING A LITTLE
DIFFERENTLY IN REGARDS TO HOW
WE DO THAT WITH AND THERE'S
BEEN A NUMBER OF INITIATIVES
THAT WE HAVE ROLLED OUT- IN
TWENTY TWENTY EVEN WITH THE
PUBLIC HEALTH EMERGENCY AND WE
WILL CONTINUE TO. WORK CLOSELY
WITH ALL OF OUR MANAGED CARE
PLANS I THINK IT'S ALSO ON THE
PROCUREMENT I WAS MENTIONING IS
AN OPPORTUNITY FOR THE
DEPARTMENT TO ENSURE THAT WE
ARE USING- EVALUATION OF WHO
COMES INTO THE MARKETING
CALIFORNIA TO ENSURE THAT THEY
ARE PROVIDINGHIGH QUALITY OF
SERVICES AND QUALITY AND THINGS
pSERVICES TO CHILDREN. IT'S
GOING TO BE A KEY FACTOR IN
REGARDS TO OUR VALUATION OF
THOSE PLANS I'M. JUST TO STAY
IN CALIFORNIA IN THE FUTURE-
OKAY SO THEN MY FINAL QUESTION
WOULD BE GIVEN THE FACT THAT
THE HEALTH CARE- SYSTEM HAS
BEEN EXPERIENCING SO MANY
CHANGES- WHITE IS DH CS YEAR
OLD THAT- SO MANY THESE
DRAMATIC CHANGES ARE NECESSARY
THIS YEAR. ALSO THE DRIVING
FACTOR BEHIND- THE CHANGES THIS
YEAR IS THE END OF OUR ELEVEN
FIFTEEN WAIVER SO- WE ACTUALLY
WERE SUPPOSED TO HAVE OUR
ELEVEN FIFTEEN WAIVER WHICH IS
CURRENTLY WHERE MANY OF THESE
PILOTS ARE- FUNDED OF WHETHER
THROUGH LOCAL FUNDS OR MATCHING
FEDERAL FUNDS- IT WAS SUPPOSED
TO END ON DECEMBER. THIRTY
FIRST TWENTY TWENTY BECAUSE OF
THE PUBLIC HEALTH EMERGENCY- WE
QUICKLY SUBMITTED AN EXTENSION
TO THE FEDERAL GOVERNMENT FOR A
TWELVE MONTH EXTENSION WHICH IS
UNPRECEDENTED JUST TO BE CLEAR
IN REGARDS TO THAT REQUEST- IT
WAS GRANTED- TO CALIFORNIA TO
GET ONE MORE YEAR. ON WITH OUR
LIVES FIFTEEN ENDING. A IT DOES
HAPPEN TO TRANSITION TO OTHER
FEDERAL AUTHORITIES WOULD NO
LONGER HAVE THE ABILITY TO
CONTINUE- THE DELIVERIES ARE
THE UP THE WHOLE PERSON CARE
PILOTS- AND OTHER. YOU KNOW
PILOTS LIKE THE DENTAL
TRANSFORMATION INITIATIVE
WITHIN THE ELEVEN FIFTEEN- AND
SO THAT IS THE ISSUE BEFORE US
IN REGARDS TO SOME OF THE
CALLIN PROPONENTS. OF THAT THAT
ARE CURRENTLY SCORED IN THE
BUDGET BOTH SIDES BELIEVE THE
ENHANCED CARE MANAGEMENT LOVE
SERVICES AN INCENTIVE DOLLARS
AS WELL AS THE DTI TRANSITION-
WE DO THINK THAT- WE ARE WHAT
YOU WANT TO ENSURE THAT THE
COUNTIES IN THE PUBLIC HOSPITAL
SYSTEMS THAT ARE PROVIDING.
MANY OF THOSE SERVICES HAVE A
SMOOTH TRANSITION FROM A
FUNDING PERSPECTIVE. INTO
SERVICE DELIVERY PERSPECTIVE
FOR BENEFICIARIES BECAUSE-
MINUS THE ELEVEN FIFTEEN WOULD
HAVE TO END THOSE PROGRAMS
PILOTS AND FUNDING TO THOSE
ENTITIES WHICH COULD BE VERY
DETRIMENTAL TO THE. COSMETIC
HEALTHCARE SYSTEM. OKAY THANK
YOU MUCH THE YOU MENTION. THANK
YOU SO- BY IT I AS AS EVERYONE
IS YOUR MY ME AGAIN I'M TO THEM.
NEW TO THIS WE WERE STARTING
THIS WE THOUGHT THIS IS ALL
WE'RE GONNA BE TALKING ABOUT IN
TWENTY TWENTY WAS KILLING HIM.
BUT INSTEAD WE ALL STOPPED
STOPPED AND TALKED ABOUT THE
PANDEMIC. AND NOW GOING TO
TWENTY TWENTY ONE WE NEED TO
REVISIT THE CONVERSATION TO
BEGIN OUR TRANSITION. OKAY
THANK YOU VERY MUCH ARTIFICE
NOTHING ELSE WILL MOVE ON TO
ISSUE NUMBER SIX. ALL RIGHT- SO
I WILL TRY TO. KEEP THIS BRIEF
AND THEN OPEN FOR QUESTIONS-
CURRENT LAW PROVIDES FOR THE
SUSPENSION OF A NUMBER OF PROP
FIFTY SIX- SUPPLEMENTAL
PAYMENTS- JULY OF TWENTY TWENTY
ONE. AND A NUMBER OF OPTIONAL
BENEFITS AT THE END OF DECEMBER
TWENTY TWENTY ONE. THE
GOVERNOR'S BUDGET GENERALLY
PROPOSES TO DELAY THE
SUSPENSION DATES BY ONE YEAR-
BUT I WILL KIND OF BREAK DOWN
THE VARIOUS CATEGORIES. I'M SO
THE BUDGET PROPOSES TO AND THE-
PROPERTY SIX SUPPLEMENTAL
PAYMENTS THE LIE OF TWENTY TWO.
OR PHYSICIANS DENTAL
NONEMERGENCY MEDICAL
TRANSPORTATION- TRAUMA
SCREENINGS- DEVELOPMENTAL
SCREENINGS AND THE VALUE BASED
PAYMENT- PIECE AS- IT PROPOSES
TO AND THE PROPERTY SIX
PAYMENTS DECEMBER TWENTY TWENTY
TWO. OR AYE CFT D. FREESTANDING
PEDIATRIC SUB ACUTE AND THE SEA
BASS PROGRAM. THERE ARE NO
PROPOSED SUSPENSIONS FOR
WOMEN'S HEALTH FAMILY PLANNING.
THE LOAN REPAYMENT PROGRAM OR
THE BEHAVIORAL HEALTH
INTEGRATION INITIATIVES. THE
AIDS AND HIV WAIVER AS WELL AS
THE HOME HELP IN PEDIATRIC. DAY
HEALTH CARE SERVICES. THE DOES
PROPOSE. OF AN EXTENSION OF THE
POSTPARTUM ELIGIBILITY
EXPANSION TO DECEMBER OF TWENTY
TWENTY TWO. AND ALL OPTIONAL
BENEFITS TO DECEMBER OF TWENTY
TWENTY TWO I WOULD JUST NOTED
THAT WE PREVIOUSLY HAD INCLUDED
IN SUSPENSIONS OTHER SCREENING
FOR ADDITIONAL SUBSTANCES ALSO
KNOWN AS S. BURKE- FOR THIS
PARTICULAR ONE- SENSE THE
FEDERAL GOVERNMENT HAS DEEMED
IT A PART OF- OUR REGULAR
SCREENING REQUIREMENTS WITHIN
MEDICAID- AND THEREFORE CANNOT
BE SUBJECT TO SUSPENSION IN THE
FUTURE IS NOW A FEDERAL
REQUIREMENT TO PROVIDE. IN
MEDICAID. I'M HAPPY TO ANSWER
ANY QUESTIONS. FIRST WITH NO
DEPARTMENT FINANCED. NO
COMMENTS OR QUESTIONS AT THIS
TIME HELLO PLEASE. THANK YOU
SENATOR EGGMAN A CORE ISSUE
THAT WITH THE L. A. L. JUST
WANT TO BRING TO YOUR ATTENTION
AND MAKE A BRIEF COMMENT THAT
OUR OFFICE ACTUALLY PUBLISHED
AN ANALYSIS ON OUR WEBSITE- NOT
TOO LONG AGO DISCUSSING THE
SUSPENSION LANGUAGE ACROSS THE
BUDGET MORE GENERALLY SO NOT
ONLY IN MEDIC CALORIE IN DH CS-
AND IN THAT ANALYSIS WE
RECOMMENDED THAT THE
LEGISLATURE REJECT THE
GOVERNOR'S PROPOSED BUDGET BILL
SUSPENSION LANGUAGE- WE FIND
THAT MOST OF THE SUSPENSION
ITEMS. FIND CORE STATE SERVICES
THAT SHOULD BE TREATED AS
ONGOING COSTS- AND NOT AS
TEMPORARY COSTS AS AS THE
SUSPENSION MECHANISM MAKES
THEM- WE ALSO FIND THAT THE
SUSPENSION LANGUAGE CREATES
UNCERTAINTY FOR PROVIDERS AND
RECIPIENTS OF SERVICES FOR THE
PROGRAMS- POTENTIALLY AFFECTED
BY THE SUSPENSIONS- WHICH COULD
HAVE NEGATIVE IMPACTS ON THEM
SERVICE DELIVERY- JUST SORT OF
WANT TO EMPHASIZE THAT- OUR
RECOMMENDATION DOESN'T
NECESSARILY PRECLUDE. I'M AN
ASSESSMENT BEING DONE OF ON THE
ON GOING SORT OF- ITEMS
SUBJECTS THIS FUNCTION IN THE
SPENDING IS ASSOCIATED WITH
THEM- BUT WE VIEW THAT DECISION
AS SORT OF A SEPARATE- PROCESS
FROM YOU KNOW THE ACT OF MAKING
PROGRAM SUBJECT TO SUSPENSION
WHICH- SORT OF CONVEYS
UNCERTAINTY IN NON COULD GIVE
THE IMPRESSION OF TEMPORARY
COSTS THAT. ARE ESSENTIALLY ON-
DIDN'T DESERVE FAR MORE
INTEREST FOR DOC. S. YOU
QUESTIONED. AB NO THE
DEPARTMENT HAVE RESPONSE THANK
YOU DOCTOR. THANK AND I JUST
WANT TO THE WIND. MY WITH WHAT
THE L. A. S. R. DO IS. IN THIS.
WE HAVE THIS VERY UNFORTUNATE
SITUATION. WHERE WE HAVE
ESSENTIALLY THE ADMINISTRATION-
PAYING A SOARED OVER HEALTH AND
HUMAN SERVICES BY BUILDING IN
CUTS AND THEN SAYING WELL WE'LL
SUSPEND- ARE WE WILL MAKE THEM
THIS YEAR BUT WILL LEAVE THEM
AND SO WE HAVE THESE CUTS
THEY'RE BASICALLY. HANGING OUT
THERE SO I APPRECIATE THAT THE
GOVERNOR HAS CHOSEN TO THE LADY
THE SUSPENSIONS BUT WE SHOULD
HAVE THE SUSPENSIONS IN THE
FIRST PLACE WHEN WE HAVE THAT
BUDGET YEAR OF IT TURNS OUT WE
NEED TO MAKE CUTS WE SHOULD
DELIBERATE ON. WHAT WE NEED TO
DO HOW BIG IT CETERA INSTEAD OF
PUTTING AUTOMATIC CUTS
ESSENTIALLY BUILDING IT IN TO
THE HEALTH ESPECIALLY THE
HEALTH AND HUMAN SERVICES
BUDGET I MEAN IT SEEMS TO BE
PRIMARILY THAT'S WHERE THEY ALL
ARE SO HERE WE'RE TALKING ABOUT
THE PROPERTY SIX A MEDIC CAL
WILL BE TALKING ABOUT THAT
DEVELOPMENTAL SERVICES LATER WE
TALK ABOUT THAT SOCIAL
SERVICES. AND IT DOES CREATE
YOU KNOW IT THAT DOES CREATE
THIS UNCERTAINTY- YOU KNOW WE
HAVE LOW PARTICIPATION RATES OF
PROVIDERS AND MEDIKAL PROPERTY
SIX WAS ACTUALLY FUNDING TO TRY
TO GET MORE FIGHTERS TO ACCEPT
MEDICARE NOW ITHINK WE'VE BEEN
SUCCESSFUL AT THAT BUT THIS
WHOLE IDEA THAT FOR IF YOU'RE A
PROVIDER OF HEALTH AND HUMAN
SERVICES. THAT WE'RE GOING TO
KEEP THIS LOOMING CUTS OVER YOU
AND THEN I GUESS GRANT ISSUE
THAT WE WERE NOT GONNA MAKE THE
CUT THIS YEAR IS NOT REALLY THE
WAY WE SHOULD BE DOING BUSINESS
SO I JUST WANT TO HAVE TO SAY
THAT AND I APPRECIATE THE L. A.
L. ALSO CHANGE SEEM CONCERNED
SO I DO SUPPORT CERTAINLY
WHAT'S BEFORE US WE DON'T WANT
TO SAY THAT YOU KNOW WE WANT
TO. TO HAVE THE DELAYED THE
SUSPENSIONS BUT WE SHOULD HAVE
THEM IN THE FIRST PLACE IN MY
OPINION THANK YOU. THINK YOU'RE
MEANT CENTER MELINDA'S- I THINK
UNANIMOUS. ONLINE SPEAKING
BEHALF OF MY CAN- MARICAO. ALL
CAL. WHO ARE. I DON'T WANT
CRAZINESS. FOR ME TO COMMITTEE
COLLEAGUES BUT I SUSPECT. THEY
MAY SHARE MY SENTIMENTS THAT-
THESE ARE VERY COOL TAX. HIKES
FLATLY. REJECTED THEM AND I
DON'T THINK WE SHOULD WAIT
UNTIL JUNE FIFTEENTH OR EVEN
AFTER THE MAIN RESIGNS TO
REJECT THESE CALL THESE KINDS I
THINK THEY SHOULD BE REJECTED
NOW SO. I WOULD LIKE TO MAKE A
MOTION TO REJECT- THESE CUTS IN
THE PROPOSED BUDGET AND
INSTEAD- I DOCTOR ARE
PLACEHOLDER TRAILER BILL
LANGUAGE THAT WE DON'T HAVE
THESE CUTS AND FUTURE. BYE
APPRECIATE YOUR MOTION- I THINK
JUST TECHNICALLY WE'RE NOT
PREPARED TO BE ABLE TO DO THAT
RIGHT NOW- BUT WE CAN'T HAVE
DISCUSSION ON IT. I A TO
BELIEVE AND I CAN GET A SECOND
LOS ALAMOS THEIR GENDER YEAH WE
HAVE AN AGENDA IS THE VOTING
ITEM SO I DON'T THINK WE CAN
TAKE UP VOTING ITEMS AT THIS
HEARING. THAT'S THAT THAT IS MY
UNDERSTANDING AS WELL PERCENT
AGENDAS WE CANNOT VOTE ON THE
MOMENT. WE GET. IS THAT CORRECT.
YEAH AND WHEN THE **** WE DON'T.
GREAT IT IS AN INFORMATIONAL
HEARING SO IT'S NOT A FOR
VOTING ON RIGHT NOW BUT I THINK
WE CAN DO WE KNOW YOUR- IT'LL
BE IT'LL BE REFLECTED- YOUR
MOTION AND YOUR DESIRE AND WILL
CERTAINLY REVISIT THIS AS WE
CONTINUE TO GO FORWARD.
INFORMATIONAL HERE YEAH. THANK
YOU. OKAY FOR A FINANCES YOU
HAVE YOUR HAND UP FOR THIS
ISSUE. ACTUALLY I'M TRIED OF.
SO JUST TO CLARIFY BECAUSE
RIGHT I WILL I BELIEVE THAT'S
WHAT I SAID THIS IS AN
INFORMATIONAL HEARING SO WE
WILL NOT BE VOTING ON ANYTHING
AT THIS TIME BUT WE DULY NOTED.
YOUR CONCERNS. PART OF FINANCED.
THANK YOU MANAGER RYAN MILLER
FROM THE DEPARTMENT OF FINANCE-
I THINK I JUST START BY UNITED
KNOWLEDGE IN THE COMMENTS
OFFERED BY SENATORS AND
MELENDEZ- YEAH I DON'T I DON'T
KNOW THAT WE WOULD NECESSARILY
DISAGREE WITH SOME OF THE
CRITIQUES THE MAIN THING I
WOULD JUST POINT OUT AS YOU
KNOW OUR OUR OFFICE IS
PROJECTING MULTI BILLION DOLLAR
FUTURE DEFICITS YOU KNOW FROM A
STRUCTURAL PERSPECTIVE- BY IN
LARGE THE GOVERNOR'S BUDGET IS.
IS PROPOSING LARGELY ONE TIME
SPENDING THAT IS NOW- YOU KNOW-
I THINK REFLECTING THE NATURE
OF THE BUDGET CONDITION- AND TO
THE EXTENT THAT WE WOULD WALK
AWAY FROM THE SUSPENSIONS
PACKAGE BUT ONLY MAKE WHAT WE
EXPECT TO BE A SIGNIFICANT
FUTURE PROBLEM EVEN WORSE- SO
IT'S NOT YOU KNOW I RECOGNIZE
IT'S AN INFORMATIONAL HEARING I
WOULD JUST WANT TO PUT ON THE
RECORD THAT WOULD NOT BE AN
ACTION THAT WE WOULD BE
SUPPORTIVE. OF THAT THIS TIME
SO THANK YOU. THANK YOU VERY
MUCH. I THINK FURTHER. OKAY BUT
THEN I THINK WE CAN GO ON TO
ISSUE NUMBER SEVEN GROUND
EMERGENCY MEDICAL
TRANSPORTATION PUBLIC PROVIDER.
PROGRAM RIGHT SO AB SEVENTEEN
OH FIVE REQUIRES DH CS TO
CREATE A NEW ROUND EMERGENCY
MEDICAL TRANSPORTATION PUBLIC
PROVIDER- INTERGOVERNMENTAL
TRANSFER PROGRAM NO SOONER THAN
JULY ONE OF TWENTY TWENTY ONE
YES CURRENTLY ADMINISTERS AGM
AT- G. E. N. T. R. O. QUALITY
ASSURANCE FEAR ACROSS A PROGRAM
FOR BOTH PUBLIC AND PRIVATE
PROVIDERS- THIS CURRENT PROGRAM
PROVIDES INCREASED
REIMBURSEMENT TO NON CONTRACTED
A G. E. N. T. PROVIDERS DH CS
COLLECTS A PER TRANSPORTATION
VITA FUND THE NON FEDERAL SHARE
OF THE INCREASED EXPENDITURES.
AB SEVEN OH SEVENTEEN OH FIVE
WILL SUSPENDED CURRENT PROGRAM
IN TRANSITION TO THE NEW I. G.
M. T. PUBLIC PROVIDER ID T.
PROGRAM. THE ACS WILL DEVELOP A
STATEWIDE OUT ON INCREASE FOR
ABOUT THE FOR SERVICE AND
MANAGED CARE THE I. D. T.'S
WILL BE INCLUSIVE OF A 10%
ADMINISTRATIVE FEE TO REIMBURSE
THE ACS FOR THE COST OF
ADMINISTERING THE NEW PROGRAM.
AB SEVENTEEN OH FIVE IT'S A
VOLUNTARY PROGRAM- HOWEVER THE
PROGRAM WILL TERMINATE IF DH CS
TO DETERMINES IT NO LONGER TO
BE COST EFFECTIVE AND
FINANCIALLY AND PROGRAMMATIC WE
SUPPORTED. IN THE MEDICARE
PROGRAM THE G. AND T. PUBLIC
PROVIDER ID T. PROGRAM IS
ANTICIPATED TO LAUNCH CHEN ONE
OF TWENTY TWO YOU AND DH CS
CONTINUES TO WORK WITH
STAKEHOLDERS ON THE PROGRAM. WE
ARE CURRENTLY IT REQUESTING
FIVE PERMANENT POSITIONS
EFFECTIVE JULY ONE OF TWENTY
ONE I TO IMPLEMENT THIS PROGRAM
AND HAPPY TO ANSWER ANY
QUESTIONS YOU MAY HAVE. THANK
YOU VERY MUCH DEPARTMENT
FINANCE. NOTHING THAT AT THIS
TIME THANK YOU. THE OIL. IF I
CAN DESERVES THAT A CURIOSITY
IS COMING FROM LOCAL GOVERNMENT
HOW MANY HOW MANY PUBLIC AT
WHAT'S WHAT'S THE PERCENTAGE OF
PUBLIC- SERVICES EACH MERGING
SEA SERVICES VERSUS A PRIVATE
YOU KNOW. I AM GOING TO SEE IF
WENDY HARRINGTON HAS THAT
ANSWER. I DO NOT HAVE A READILY
AVAILABLE BUT WE CAN'T WE CAN'T
PROVIDE THAT. AND I FOLLOW UP
ALL RIGHT AND IF THEN IF THIS
IS GOING TO PROVIDE FOR PERHAPS
A HIGHER LEVEL OF REIMBURSEMENT
DO WE SEE THE END OF A
TRANSITION FROM. THE MODELS
THAT WE'VE DEVELOPED WITH WITH
CONTRACTING WITH PRIVATE DID TO
MOVING BACK MORE TOWARDS A
PUBLIC MODEL WOULD BE MY
QUESTION AROUND THAT. DR GRANT.
THE TERM LENDERS. I YES MANAGER
THANK YOU I'M NOT REALLY INTO
THIS ISSUE I DIDN'T GET MY HAND
RAISE ANTITRUST SORRY WHEN I GO
BACK TO THE MOTION THAT I NEED-
BECAUSE I BELIEVE IF WE
ESTABLISH A QUORUM THEN WE CAN
TAKE ABOUT. I DO I DO NOT
BELIEVE WE CAN TAKE A VOTE IN A
INFORMATIONAL HEARING- JUST
BECAUSE IT WOULD HAVE TO BE
NOTICED. MMHM I WONDER IF
THERE'S A- AN OPPORTUNITY TO
JUST. DOUBLE CHECK ON THAT JUST
TO MAKE SURE BECAUSE IF IT'S
POSSIBLE CERTAINLY I THINK SHE
MIGHT NOT WOULD LIKE TO DO THAT
IF WE CAN'T OKAY AND I THINK WE
HAVE OUR EXPERT HERE. A
PARLIAMENTARIAN I GUESS WE
SHOULD INSTEAD OF EXPERTS. THE
QUESTION IS CAN WE TAKE A VOTE
ON AN INFORMATIONAL HEARING AND
I GUESS ALSO WE DON'T HAVE A
QUORUM ESTABLISHED JUST A
PERCEPTION PURPOSES- SO THE
QUESTION IS A SYMBOL AND HAS
MADE THE MOTION FOR TO TAKE A
VOTE NOW WE SAID WE CANNOT
BECAUSE AN INFORMATIONAL AND
SHE ASKED IF WE COULD PLEASE
VERIFY THAT. WE'RE IN A FACT
FINDING. HEARING AT THIS TIME.
THERE'S NO BILL ACTUALLY HAD A
LOT OF RECORDS- WITH THE
ANSWER. MEDICOS THANK YOU.
DIGITAL DID YOU WANT TO GO TO
THE- YEAH YEAH OKAY. EXHIBITOR
MANAGER MEMBERS WERE IN A FACT
FINDING HEARING RIGHT NOW THERE
IS NO BILL BEFORE US THERE'S
NOTHING TO VOTE ON RIGHT NOW
THERE'S NO QUORUM OF THE SENATE.
AND IN THIS COMMITTEE HEARING
THE ESTABLISHMENT OF A QUORUM
IS NOT NECESSARY BECAUSE IT'S
INFORMATIONAL AND AT THIS TIME.
IT IS PRACTICE AND CUSTOM FOR
THE CHAIR AND THE COMMITTEE NOT
TO. ENTERTAIN MOTIONS AN
INFORMATIONAL HEARING. THANK
YOU CENTER MODEST- HUESO I
THINK IT'S THE KIND OF SOUNDS
LIKE IT'S NOT PRACTICING IN BUT
THAT WE DO HAVE THE OPPORTUNITY
TO MOVE FORWARD AND I
UNDERSTAND THAT CORRECTLY
BECAUSE IF WE ESTABLISH A
QUORUM WHICH I REALIZE WE
HAVEN'T DONE YET THIS COMMUNE
OR WE COULD DO THAT AND A LOT
OF. POTENTIAL POTENTIALLY WE
COULD I THINK IF THE SENATE
WERE IN SESSION BUT WE ARE BUT
WE ARE NOT BUT NOT IN YOUR
COMMITTEE RIGHT AND IN THIS
COMMITTEE WERE NOT ACTUALLY IN
SESSION BECAUSE IT'S AN
INFORMATIONAL HEARING VERSUS A.
A REGULAR BILL HEARING. IT YOU
WERE IN A BILL HERE IT WOULD BE
DIFFERENT. BUT WELL BUDGET
HEARING IT'S I MEAN WE DON'T
HAVE ANYTHING ENGENDERS TO VOTE
ON BUT I. WASN'T MY IMPRESSION
THAT THIS WAS SIMPLY LOOK
PROFESSIONAL HERE. YES MA'AM IT
IS IT INFORMATIONAL HEARING.
OKAY THANK YOU AND WELCOME.
THANK YOU. ANY FURTHER COMMENTS
THE SENTIMENT IS HONEST. NOW
MANAGER THANK YOU SO MUCH THANK
YOU VERY MUCH ALL RIGHT MOVING
ON THEN TO ISSUE NUMBER. EIGHT
TELEHEALTH. SORRY. ALL RIGHT
TELEHEALTH SO I'D THE
DEPARTMENT HEALTHCARE SERVICES
IN TWO THOUSAND NINETEEN
GREATLY EXPANDED OUR TELEHEALTH
POLICY I'M AND- IN LIGHT OF THE
PUBLIC HEALTH EMERGENCY THAT
WAS BEFORE US IN IN TWENTY
TWENTY- WE EXPANDED SIGNIFICANT
FLEXIBILITIES AROUND THE
TELEHEALTH- IN ADDITION TO THE
FLEXIBILITY THAT WE HAD PUT
PLACE IN TWO THOUSAND NINETEEN
AND SAW AND EXTENSIVE UPTAKE
AND UTILIZATION OF THAT
TELEHEALTH DURING THE PUBLIC
HEALTH EMERGENCY ON SOME OF THE
TEMPORARY POLICIES THAT THE
DEPARTMENT OF BLACK STUDIES PUT
IN PLACE DURING THE PUBLIC
HEALTH EMERGENCY INCLUDE THINGS
LIKE EXPANDING THE ABILITY FOR
PROVIDERS TO RENDER ALL
APPLICABLE MEDICAL SERVICES-
VIA TELEHEALTH WHEN
APPROPRIATE- INCLUDING- THE
HISTORICAL ADD PIECES BEING
PROVIDED AND IN OUR HOME AND
COMMUNITY BASED SERVICES- OUR
LOCAL EDUCATION AGENCIES ARE
ELEAZAR. AS WELL AS TARGETED
CASE MANAGEMENT HAD PREVIOUSLY
NOT BEEN ABLE TO USE TELEHEALTH
WE EXPANDED THE CENTURY A
PRETTY COMPREHENSIVE EXPANSION
OF TELEHEALTH ACROSS OUR ENTIRE
DELIVERY SYSTEM WE ALSO ALLOWED
FOR TELEHEALTH MODALITIES TO BE
PROVIDED- FOR NEW AND
ESTABLISHED PATIENTS ACROSS THE
DELIVERY SYSTEMS ARE WE ALLOWED
FOR COVERED SERVICES TO BE
PROVIDED VIA TELEHEALTH AND
AUDIO ONLY SERVICES FOR THE
FIRST TIME NOT SOMETHING THAT
WE HAD HISTORICALLY IN MOST
DELIVERY SYSTEMS UP ALLOWED FOR
A PRIOR TO THE PUBLIC HEALTH
EMERGENCY. WE ALSO IMPLEMENTED
PAYMENT PARITY BETWEEN SERVICES
THAT ARE PROVIDED FACE TO FACE
A SYNCHRONOUS AND TELEPHONIC
AUDIO- ONLY DURING THE PUBLIC
HEALTH EMERGENCY AND THAT
INCLUDED FOR A FEDERALLY
QUALIFIED HEALTH CENTERS AND
RURAL HEALTH CENTERS. IN BOTH
FEE FOR SERVICE AND MANAGED
CARE WE ALSO WAY TO SITE
LIMITATIONS FOR BOTH PROVIDERS
AND PATIENTS- FOR FQHCS. WHICH
ALLOWS THE PER BY INDOOR THE
BENEFITS YOU TO BE AN LOCATION
OUTSIDE OF CLINIC RENDER AN OR
RECEIVE SERVICE. I'M IN LOVE
EMPLOYMENT. ALL FEDERAL
FLEXIBILITIES INCLUDING OF
FLEXIBILITIES FOR GOOD FAITH
EXEMPTION GRANTED BY THE OFFICE
OF CIVIL RIGHTS ALLOWING FOR
VARIOUS- HIT BUT REQUIREMENTS
COLLECTIBILITY. YOU KNOW MUCH
ABOUT LED TO YOU- AT A GREAT
EXPANSION DH YES HAS BEEN
WORKING FOR QUITE SOME TIME TO
PUT FOR THE TELEHEALTH PROPOSAL
THAT WE- MADE PUBLIC AT THE
BEGINNING OF FEBRUARY. OR WHAT
WE PROPOSED TO CONTINUE AFTER
THE END OF THE PUBLIC HEALTH
EMERGENCY- WHAT I WOULD- NO
TAKE HERE IS THAT WHILE. THE
PUBLIC HEALTH EMERGENCY IS
CURRENTLY EXPECTED TO ADD ENDED
NOW IT DECEMBER OF TWENTY
TWENTY ONE OUR TELEHEALTH
PROPOSAL WE ARE PROPOSING IT
START IN JULY- PROVIDERS AND
MANAGED CARE PLANS WOULD STILL
HAVE ALL A PUBLIC HEALTH
EMERGENCY FLEXIBILITIES. THE
END OF THE PUBLIC HEALTH
EMERGENCY. WHAT IT ALLOWS US TO
DO IS GET ALL FEDERAL APPROVALS
BEFORE THE END OF THAT TIME
PERIOD SO THAT PROVIDERS AND
PLANTS ARE VERY AWARE. OF WHAT
THE DEPARTMENT IS PROPOSING
THAT WE CONTINUE AT THE END OF
THE PUBLIC HEALTH EMERGENCY I
IMPORTANT PIECE THAT WE THINK
IT'S CRITICAL TO HAVE IN PLACE
AND SO THAT'S AT THE TINY.
THERE BUT WE ALSO BELIEVE THAT
THE RECOMMENDATION THAT WE PUT
FORWARD IS VERY REASONABLE AND
BALANCED IN TERMS OF PROMOTING-
APPROPRIATE STANDARDS OF CARE-
WHILE PROVIDING ACCESS TO
QUALITY HEALTHCARE SERVICES AND
HELPING TO ADVANCE EQUITY-
ACROSS THE VARIOUS MODALITIES
IN OUR DELIVERY SYSTEM- BUT WE
ALSO IT. I THINK THAT IT'S
IMPORTANT TO MAINTAIN A
BENEFICIARY CHOICE- AND
PRESERVE OUR PROVIDER
FLEXIBILITY WHILE STILL
PROTECTING AS YOU KNOW FROM
APPROPRIATE PROGRAM INTEGRITY
POINT OF VIEW OF. A BOTH FROM.
A QUALITY AND A FISCAL
PERSPECTIVE. I SO- WE TO A
NUMBER OF GUYS PRINCIPLE AS WE
CAN- UP WITH OUR AYE PROPOSAL
NEW FORD. INCLUDING EQUITY
ACCESS STANDARD OF CARE PATIENT
CHOICE. CONFIDENTIALITY
STEWARDSHIP AND PAYMENT
APPROPRIATENESS- AND I WALK
THROUGH WHAT WE ARE
RECOMMENDING- THE MOVE FORWARD-
IN OUR TELEHEALTH PROPOSAL-
AFFECTED YOUR JULY ONE OF
TWENTY ONE- AS REFERENCED
PREVIOUSLY. ALSO WE ARE
PROPOSING TO ALLOW SPECIFIC
FQHC AND RURAL HEALTH
PROVIDERS- TO BE ABLE TO
ESTABLISH A NEW PATIENTS.
LOCATED WITHIN ITS FEDERALLY
DESIGNATED SERVICE AREA THROUGH
SYNCHRONOUS TELEHEALTH.
SOMETHING THEY PREVIOUSLY WERE
NOT ABLE TO DO- MAKE PERMANENT
THE REMOVAL OF THE SITE
LIMITATIONS CURRENTLY FOR FQHCS
AND RURAL HEALTH CLINICS. OF
FOR EXAMPLE IS MENTIONED. ALONG
THE BENEFITS YOU'RE A PROVIDER
TO BE. OUTSIDE OF THE OFFICE OR
WITHIN THEIR. HOME TO RECEIVE
SUCH SERVICES. POSED TO X.
THANK AND EAST AS TELEHEALTH.
IN OUR NINETEEN FIFTEEN SEE
WAIVERS ARE WHAT SOME PEOPLE
KNOW IS HOME COMMUNITY BASED
SERVICES IN OUR TARGET CASE
MANAGEMENT PROGRAM AND WITHIN
THE L. E. A. BACH OR BILLING
OPTION PROGRAM. WE ARE
PROPOSING TO ADD SYNCHRONOUS
TELEHEALTH AND TELEPHONIC AUDIO
ONLY SERVICES TO THE STATE PLAN
DRUG MEDI CAL PROGRAM. WE ARE
ALSO PROPOSING TO REQUIRE
PAYMENT PARITY FOR IN PERSON
FACE TO FACE VISITS AND
SYNCHRONOUS TELEHEALTH
MODALITIES ONLY- THIS WOULD
ALSO INCLUDE FOR ACCURACY AND
RURAL HEALTH CLINICS IN REGARDS
TO THAT PAYMENT PARITY- HOWEVER
WE ARE PROPOSING THAT THERE
WOULD BE. SUBJECT TO A SEPARATE
FEE SCHEDULE FOR- ASYNCHRONOUS
VIRTUAL COMMUNICATION AND
TELEPHONIC AUDIO ONLY- SERVICES
WITHIN THE PROPOSAL- I WOULD
JUST HIGHLIGHT HERE- THAT THAT
THAT WOULD MEAN THAT WE WOULD
NOT ALLOW AT UACS OVERALL
HEALTH CLINICS THE BILL FOR
TELEPHONIC AUDIO ONLY SERVICES
IN OUR PROPOSAL. WE ARE ALSO-
RECOMMENDING THAT THE- TCM AND
ELIA BOB WOULD CONTINUE TO BE
REIMBURSED AT A- CERTIFIED
PUBLIC EXPENDITURE OR COST
BASED REIMBURSEMENT SO THERE'S
BE SCHEDULE WOULD BE DIFFERENT
AND SEPARATE FROM WHAT WAS JUST
RECOMMENDED- SO AGAIN TO JUST-
INDICATE THE DEPARTMENT IS NOT
RECOMMENDING THE CONTINUATION
OF CERTAIN FLEXIBILITIES
INCLUDING- TELEPHONIC AUDIO
ONLY MODALITIES AS A BILLABLE
VISIT FOR FQHCS VERALL HEALTH
CLINICS AT THE PPS RATE. WHEN
WE CONSULTED WITH- THE FEDERAL
GOVERNMENT I SENSE IT IF A
PHYSICIAN OR A BILLABLE
PROVIDER UNDER AN ACT YOU EACH
THE- BILLS FOR SERVICES WE ARE
REQUIRED TO PAY THE PPS RATE
AND SINCE WE ARE PROPOSING TO
NOT PAY TELEPHONIC AUDIO ONLY
SERVICES- AT. THE SAME RATE ARE
AT PARITY WITH A FACE TO FACE
BUT BASED ON A DEATH A
DIFFERENT FEE SCHEDULE IS WHY
WE ARE NOT MOVING FORWARD THAT
RECOMMENDATION HOWEVER I WOULD
SAY THAT WE WOULD I'M HAPPY TO
ENTERTAIN- THE FQHCS AND RURAL
HEALTH CLINICS THAT ARE GOING
TO BE PARTICIPATING IN THE
ALTERNATIVE PAYMENT
METHODOLOGY. THAT WE ARE
CURRENTLY WORKING WITH THEM ON
THAT WE WOULD ALLOW IN THE APM
MODEL- FQHCS TO DO TELEPHONIC
AUDIO ONLY ALLOWABLE A VIRTUAL
COMMUNICATION- WITHIN THAT
EIGHT PM. WE ALSO- ARE NOT
RIGHT. THAT THE TELE AUDIO ONLY
MODALITIES CAN BE USED TO
ESTABLISH A NEW PATIENT- WE
FEEL LIKE IT'S ONLY SOMETHING
THAT SHOULD BE USED ONCE- THAT
RELATIONSHIP PROVIDER
RELATIONSHIP HAS BEEN
ESTABLISHED AND THAT'S ACROSS.
ALL DELIVERY SYSTEMS FOR THAT
PROPOSAL- AND THEN AS MENTIONED
PREVIOUSLY NOT RECOMMENDING
PAYMENT PARITY FOR AUDIO ONLY
VIRTUAL COMMUNICATIONS- WITHIN
THIS A PROPOSAL. I WOULD ALSO
NOTE THAT THE FEDERAL
GOVERNMENT IS THE ONE
RESPONSIBLE FOR. MAKING ANY
CHANGES FOR TRIBAL SIX THIRTY
EIGHT CLINICS IN REGARDS TO
TELEHEALTH PROVISIONS. AND I
WOULD DEFER TO THEM HOWEVER IF
A TRIBAL- AREA MOVES TO THE
TRIBAL FQHCS THEY WOULD THEN
ADOPT ANY OF OUR PROPOSED
RECOMMENDATIONS. FOR FQHC RURAL
HEALTH CLINICS. I'M THERE IS A
TABLE IN THE DEPARTMENT OF
TELEHEALTH PROPOSAL THAT HELPS
BREAK THIS DOWN IN REGARDS TO
PRE- THE CODED A NINETEEN AND
THEN PROPOSED CODE NINETEEN OF
PROPOSALS ARE BECAUSE OUR-
DELIVERY SYSTEM IS COMPLEX. IF
WE DO BREAK IT DOWN BY THE
DIFFERENT DELIVERY SYSTEMS OF
WHAT WE ARE PROPOSING AS A
CHEAT SHEET FOR INDIVIDUALS- WE
ALSO WOULD HAVE TO IMPLEMENT A
NUMBER OF OTHER ACTIONS TO MAKE
THIS HAPPEN INCLUDING- AT
TRAILER BILL- BEFORE AT PEOPLE
FOR REVIEW. ON STATE PLAN
AMENDMENTS. WEBER CHANGES-
REGULATION CHANGES AS WELL AS
WORKING VERY CLOSELY TO DEVELOP
KIND OF BERRIES POLICY GUIDANCE
IN REGARD TO HOW THIS WOULD
WORK IN MEDIC HOW- SO I WILL.
ALSO HIGHLIGHT THAT WE ARE
RECOMMENDING- TO ADAM REMOTE
PATIENT MONITORING- WITHIN THE-
THE BUDGET PROPOSAL. WE DID NOT
PROVIDE FOR A REMOTE PATIENT
MONITORING DURING THE PUBLIC
HEALTH EMERGENCY BOB AFTER
REVIEWING- COMPREHENSIVELY
ACROSS OUR ADOBE SYSTEMS WE
FELT LIKE IT WAS ON THE
CRITICAL OF BENEFIT TO PUT
FORWARD FOR CONSIDERATION- WE
ARE REQUESTING NINETY FIVE
MILLION TOTAL FUNDER THIRTY
FOUR MILLION GENERAL FUND- OUT
AS A PART OF THE PROPOSAL. WITH
AN EFFECTIVE DATE OF JULY ONE
TWENTY TWENTY ONE TO COVER
REMOTE PATIENT MONITORING- SO I
WILL PAUSE THERE AND SEE IF YOU
HAVE ANY QUESTIONS FOR THE
DEPARTMENT. THANK YOU
DEPARTMENT OF FINANCE. NOTHING
AT THIS TIME THANK YOU LMAO.
THANK YOU VERY MUCH I
APPRECIATE THE WORK THAT THE TS
IS DOING TO TRY TO INCREASE
ACCESS TO TELEHEALTH AND ALSO
INCLUDING- REMOTE PATIENT
MONITORING I THINK THAT-
PARTICULARLY FOR COMMUNITIES
WHERE- THEY HAVE MORE FOR
ACCESS TO SPECIALTY CARE AND
OTHER THINGS IS. THAT I THINK
THIS WILL BE HELPFUL I GUESS
THE- MARTIN AND I HEAR WHAT
YOU'RE SAYING ABOUT AUDIO I
GUESS MY CONCERN. ABOUT SOME OF
THE- NOT SENDING SOME OF THE
FLEXIBILITIES AROUND AUDIO ONLY
A TELEPHONIC AUDIO ONLY IS
THAT- WE'RE GONNA CAL'S A LOWER
INCOME LOWER RESOURCE
POPULATION- SO USUALLY LESS
ACCESS TO HIGH SPEED LIKE WIFI
AND OTHER THINGS- THAT'S WHAT
WIFI THEY MAY HAVE OR ACCESS IS
OFTEN LESS STABLE- DALY HAVE
DATA CAPS AND OTHER THINGS. SO-
SO I THINK THERE'S A BIT OF THE
OF THE- I MEAN THEY'LL TELL
GOES BOTH WAYS RIGHT SO KNOW WE
CAN HAVE THE- SET UP IN THE
CLINIC BUT IF THE PERSON AT THE
OTHER END- DOESN'T HAVE STABLE
BROADBAND THEY MAY NOT WHY ARE
DAY AND DATE WITH DATA CAPS WE
MAY NOT BE ABLE TO STAB WISHES
CONSISTENT VIDEO CONNECTION
WIRELESS WE MAY BE ABLE TO
ESTABLISH A- AUDIO CONNECTION
RIGHT WE MAY NOT BE ABLE TO
SEE. THEY MAY NOT WANT TO USE
VIDEO AND THEN I THINK FOR
CERTAIN SENT SENSITIVE
SERVICES- THAT- YES- SOMEONE
MAY NOT ACTUALLY WHAT THE VIDEO
ONLINE- THE NAY WITH THEY MAY
BE TRYING TO HAVE A
CONVERSATION IN A CROWDED
HOUSEHOLD ORDER TRYING TO GET
TO FIND SOME PRIVATE SPACE. ARE
STEPPING OUTSIDE OR SOMEWHERE
WHERE AGAIN BROADBAND THAT IS
GOOD BECAUSE THEY'RE NOT IN
YEAH THIS IS BAD ENOUGH TO
START. WITH SO- SO I GUESS I
URGE THAT- WE'D LOOK VERY CARE.
AT WHAT WE DOING AND HEALTH.
ARE TERM OF PAIN- YOU KNOW- AND
BECAUSE I THINK DOES IT
DIFFICULTY BECOMING ACCESS
ISSUE- WE ALSO THE ONE SCOURGE
PROVIDERS FROM SINCE BASICALLY
WINDING GAUGE BECAUSE THEY'RE
LIKE WELL I'M GONNA GET PAID A
LOT LESS BUT THIS WAS WAY WHEN
I CALL A LAWYER IS A LAWYER
TAKES. STILL GIVING THE SAME
HOURLY RATE- YOUR A SKILL
PERSON SKILLS THE HEALTH. AT
THE OTHER THAT IS THE IT IS OUR
PAIN SO- SO I CERTAINLY
UNDERSTAND SOME OF THE REST
BEING PUT FOR THIS PROPOSAL-
BUT- I THINK WE ALSO NEED TO
THINK VERY CAREFULLY ABOUT. THE
POPULATION THAT WERE TRYING TO
SERVE AND THEIR ACCESS AND
THEIR ABILITY TO MAINTAIN THEIR
AND OF THE TLE HEALTH-
CONNECTION AND THAT AND BY
LIMITING TELEPHONIC AUDIO. IN
TERMS OF PAYMENT WHAT KIND OF
THE- HOW WE MIGHT ACTUALLY
DECREASE ACCESS TO THIS TYPE OF
SERVICE FOR THE MEDICARE
POPULATION. AND JUST TO ECHO I
MEAN. WE KNOW THAT THE- THAT
pACCESS TO SOME TYPES OF CARE
SPECIALTY CARE ARE OFTEN THOSE
SAME REGIONS WHO HAVE THE LEAST
TALK ACCESS TO BROADBAND IN
SUPPORT AND THAT KIND OF HUESO.
I THINK THIS WILL BE SOMETHING
THAT WILL CONTINUE TO HAVE
CONVERSATIONS ABOUT GOING
FORWARD. OKAY ISSUE NUMBER
NINE. ALL RIGHT- SO THE BUDGET
DOES PROPOSE EFFECTIVE JANUARY
ONE TWENTY TWENTY TO THE
DEPARTMENT REQUEST ELEVEN
MILLION DOLLARS TOTAL FUND FOUR
MILLION GENERAL FUND TO ADD
CONTINUOUS GLUCOSE MONITORING-
AS A COVERED BENEFIT- FOR
BENEFICIARIES AGE TWENTY ONE OR
OLDER- CGM'S ARE CURRENTLY
COVERED FOR INDIVIDUALS UNDER
THE AGE OF TWENTY ONE. IN MEDIC
HOW- TODAY- THE DEPARTMENT IS
ALSO ENTERING INTO REBATE
AGREEMENTS WITH VARIOUS
MANUFACTURERS REGARDING THE-
CONTINUOUS GLUCOSE MONITORING
SYSTEMS AND SUPPLIES- IN THE
REBATES WILL OFFSET A GENERAL
FUND COSTS FOR THAT EDITION.
ADDITIONALLY THE DEPARTMENT
PROPOSES TO REINSTATE THE OVER
THE COUNTER ADULT COUGH AND
COLD PRODUCTS EFFECTIVE JULY
ONE OF TWENTY TWENTY ONE I THIS
DOES RESULT IN SAVINGS- THAT.
DID EXPAND- THIS OVER THE
COUNTER DRUG DURING THE PUBLIC
HEALTH EMERGENCY WHICH IS
CURRENTLY REFLECTED IN OUR
BUDGET WE ARE PROPOSING TO MAKE
THAT A PERMANENT CHANGE. FOR
MANY YEARS MEDICARE PROGRAM CUT
BIRD OVER THE COUNTER DRUGS- AS
AN INEXPENSIVE ALTERNATIVE TO
PRESCRIPTION DRUGS- THOSE
CHANGES WERE MADE THAT QUITE A
FEW YEARS AGO IN REGARDS TO
THAT NOT BEING A BENEFIT IN
MEDIC CAL. HOWEVER MANY OF OUR
MANAGED CARE PLANS HAVE STILL
CHOSEN TO COVER THAT AND WE ARE
ESSENTIALLY PROPOSING TO ALSO
WITHIN THE FULL MEDICAL PROGRAM
OFFICIALLY GO BACK TO
REINSTATING OVER THE COUNTER-
ADULT A COUGH AND COLD
PRODUCTS- SO I WILL STOP. THERE
AND SEE IF THERE ARE ANY
QUESTIONS. DEPARTMENT FOR ANY.
HELLO OKAY BUT THE THANK YOU I
APPRECIATE THAT GOING BECAUSE
COVER THAT GLUCOSE MONITOR- IS
A PEDIATRICIAN COURSE A LOT OF
AND TO TAKE YOUR MEDICARE
ALLOWED THE COVERAGE FOR A
RETURN AND SEE MEDICINE COSCO
PRODUCTS THESE HELPFUL I GUESS
THE QUESTION IS THAT COUGH AND
COLD PRODUCTS IS PRETTY BROAD
CATEGORY ARE WE TALKING ABOUT
EVIDENCE BASED COUGH AND COLD
PRODUCTS. I WOULD ASSUME SO BUT
I DO NOT KNOW THE DEPTH AND
BREADTH OF WHAT. WE'VE BEEN
COVERING DURING THE PUBLIC
HEALTH EMERGENCIES I MAY HAVE
TO GET BACK TO YOU OKAY SO YEAH
MAYBE SOMEONE CAN GET GET BACK
ON THE C. C. TO MEDICINES
EVIDENCE BASED. SEVEN DAYS NOW-
CERTAIN. BUT THERE'S ALSO OTHER
CONSTANT MEDICATIONS WHICH- MAY
NOT BE. MADE CONTAIN EVAN BASED-
AND SO I SAW WHAT THE PRESS OF
THE- THANK FOR MAKING GET
SOMEONE TO GET BACK ME THANK.
HOPING NOT TO ABOUT THE- OKAY.
IF NOTHING FURTHER WILL MOVE ON
TO A NUMBER TWO. ALL RIGHT. SO
TWO FOUR- THAT HAS CURRENT NOT
BEEN IMPLEMENTED YET BY THE AS
A OF AN TO THE FOR MONEY FALLS
THE PERSON DEMONSTRATE. ON THE
RECENT A MODIFY THEIR L.
CRITERIA THROUGH THE U. S.
SHE'S UP. ACT OF TWENTY ONE THE
AMENDMENT RE THE NUMBER OF DAYS
IN INDIVIDUALS REQUIRED TO
RESIDE IN AN INSTITUTION TO BE
ELIGIBLE FOR THE MONEY FOLLOWS
THE PERSON DOLLARS WHICH IS
ALSO KNOWN AS THE CALIFORNIA
COMUNITY TRANSITIONS OR C. C.
T. IN CALIFORNIA FROM NINETY
DAYS TO SIXTY DAYS- SO THIS
WILL BE INCREASING THE FUNDS TO
CALIFORNIA- AND THE STATE
PROGRAM IS A PAIR OF LAST
RESORT- SO AS THERE ARE FEDERAL
FUNDS AVAILABLE WE WILL BE. A
MAXIMIZING THOSE FEDERAL FUNDS
FOR THOSE TRANSITIONS THE STATE
ONLY CCT PROGRAM IS CURRENTLY
AUTHORIZED GENERAL
BENEFICIARIES THROUGH JANUARY
ONE OF TWENTY TWENTY THREE- IN
WITHIN TEAM TO PROVIDE
TRANSITION PAYMENTS- THROUGH
JANUARY ONE OF TWENTY TWENTY
FOUR- AND WE ARE. I IN A
REQUEST TO THE STATE ONLY PRO
THAT'S PER. THROUGH SB TWO
FOURTEEN REQUESTING THREE-
THREE YEAR LIMITED TERM
RESOURCES EQUIVALENT TO THREE
POSITIONS EFFECTIVE JULY ONE OF
TWENTY TWENTY ONE. I'M HAPPY TO
ANSWER ANY QUESTIONS. AND WE
EXPECT COST SAVINGS FROM THE SO
DO WE PLAN TO. TO MAKE THIS GO
OUT EVEN FURTHER. SO THE THAT
WAS SCORED IN THE PREVIOUS THIS
SPECIFIC REQUEST HAS TO DO WITH
THE POSITIONS- AND WE DO SCORE
THE VARIOUS SAVINGS I WOULD
ALSO- HIGHLIGHT THAT- SOME OF
THE C. C. T. SERVICES ARE
PROPOSED AS IN LIEU OF
SERVICES- IN THE CALLIN
PROPOSAL WHICH WOULD ALLOW US
TO CONTINUE THOSE. ON EVEN
BEYOND THE CURRENT A PROPOSED
DATE IN. SB TWO FOURTEEN OF
ENDING JANUARY ONE OF TWENTY
TWENTY THREE AND IF FOR IN THE
FUTURE I'M MONEY FALLS PERSON
IS NOT FUNDED THAT WOULD ALSO
BE AN OPPORTUNITY TO CONTINUE
AND YES WE SEE ARE. PRETTY
SIGNIFICANT COST SAVINGS WITH
THESE TYPES OF TRANSITIONS.
THANK YOU A DEPARTMENT FINANCE
ANYTHING. I HEAR NOTHING OKAY
LMAO. I SEE NO NOT UNKNOWN
NODDING OKAY A DOCTRINE WE
THINK WE'RE GONNA CENTER
MELINDA'S. OKAY THEN LET'S MOVE
ON TO ISSUE NUMBER ELEVEN LONG
TERM HEALTH CARE FACILITY
PENALTIES FOR IMPROPER
DISCHARGE. LET'S GIVE IT A
BREAK FOR A MOMENT FIX WATER G.
C. BOB. SO VERY BRIEFLY OF THAT
THE KREMLIN PROPOSED TRAILER
BILL OR AUTHORIZES THE PARTS TO
IMPOSE PENALTIES ON- OF. ROSEN
DOLLARS A DAY GAINES LONG TERM
HEALTH CARE FOR NON COME WITH
HEARING TO SEARCH. SHOULD BY
THE AGE OR RIO OF AGGRESSIVE.
OF IF WE FIND THAT THE
PRESIDENT WAS ON OUR IMPROPERLY
TO JUST CHAU FOR REFUSED OR
READ MISSION FOR COST. FROM
FEDERAL AND LAW WELL. REQUIRE
THAT SO THE RESIDENTS ARE TIED
TO A HEARING WHENEVER THEY ARE
TRANSFERRED DESTROY REFUSED
READMISSION. CONTRA OF THEIR
QUESTIONS- WE ADEQUATE RECEIPTS
COME ABOUT ON- DECISIONS WERE
RENDERED. OR NOT I. SACRAMENTO
BARGHOUTI- SO IS A VERY .COM
WITH A VERY DECISION.
COMPLIANCE SITUATIONS THERE
ARE- ADVOCACY GROUPS ON THE
VISUAL CASES STORE TENSION WITH
REGULARITY- SO BECAUSE WE DON'T
HAVE THE NUMBER ASSOCIATED WITH
THAT WE'RE NOT SCORING ANY.
SIMON'S FOR THE REQUIREMENT WE
PROVIDE DAVID HEARING RIGHTS TO
ALL ALL RESIDENTS WHETHER OR
NOT THE MEDIC CAL BUT HOME. CMS
CAL RULES REQUIRE THAT THE
STATE MEDICAID AGENCY OFFERING
THESE LEADS THESE HEARING
PROCESS. LET ME STOP THERE AND
SEE IF THERE ARE ANY QUESTIONS.
ANYTHING FROM THE DEPARTMENT
FINANCIAL NEWS. HELLO. OKAY BUT
YEP THAT'S IT IT'S HARD TO KNOW
HOW OFTEN IT HAPPENS I THINK
BUT IF YOU DON'T HEAR BUT WE
CERTAINLY DO IN OUR DISTRICTS
LIKE FLAG WE'VE SPECIALLY
THROUGH THIS HAVE HAD SOME
CALLS FROM CONSTITUENTS ABOUT
THESE KIND OF ISSUES THAT WE'VE
WE'VE INTERVENED WITH. THE PLAN
THIS. OKAY HOW YOU THINK IT JC
VERY LONG BREAK A DIRECTOR.
OKAY THAT NUMBER TWELVE. LOGO
DURING THIS WINTER. NO ALL UP
THIS IS OUR MEDICAL ENTERPRISE.
SYSTEM MODERNIZATION. WELL
IT'S- IT'S A PROPOSAL FOR
TWENTY TWO MILLION DOLLARS FOUR
MILLION GENERAL FUND. ALL
IMPORTANT ONE TWENTY TWO AND
ONE POINT THREE TWENTY TWO
TWENTY THREE WELL TO CONTINUE
ARE OF CRITICAL INFORMATION
TECHNOLOGY MODERNIZATION.
EFFORTS LOAN SPECIFICALLY WERE
REQUESTING FUNDING TO CONTINUE
CURRENTLY APPROVED PROJECTS OF
THE FEDERAL COURT REPORTING
CALIFORNIA OR MAGIC RECOVERY
MANAGEMENT AND THE
COMPREHENSIVE BEHAVIORAL HEALTH
DATA SYSTEM MODERNIZATION. AS
WELL AS NEW CONTRACT FUNDING TO
DEVELOP A HOLISTIC STRATEGY.
FOR ON THE WHAT WE. CALL OUR
SYSTEM SYSTEMS- HELLO TWENTY
PLUS TO MEDICAL PROGRAM WELL
MANY OF OUR EXISTING SYSTEMS
ARE UPDATED- CMS HOUSE SORT OF
VERY STRONGLY- RESISTED
MEDICAID AGENCIES NEED GROW UP
SYSTEM WIDE SOLUTIONS RATHER.
THERE IS QUALIFY ONE OF. FROM
THE WOULD HAVE ACROSS TWO
HUNDRED OF THE SYSTEM'S
CURRENTLY THAT SUPPORT OUR
VARIOUS ACTIVITIES MANY OF
WHICH ARE FORTY OR FIFTY YEARS
OLD AND SO THE- I'M HERE WITH
THIS PROPOSAL IS TO BUILD THE
CAPACITY. WELCOME TWO GRADES
THEM INTO A- BASICALLY
ENTERPRISE SYSTEM THAT'S THE
HAS BEEN TO AND BASS. LET ME
STOP AND IF WEST. ANYTHING FROM
THE PART OF ON THIS. LMAO.
RIGHT MR L. A. L. WE RECOMMEND
THE LEGISLATURE APPROVED THE
PROPOSAL BUT ALSO DIRECT THE
ADMINISTRATION YOU WORK WITH
THE LEGISLATURE ON ANY
POTENTIAL CHANGES TO I. T.
PROJECT PROCESS SEES THAT THE
ADMINISTRATION IS CONSIDERING
FOR THIS EFFORT- THE NEW MES
MODERNIZATION PROJECT PORTFOLIO
WILL BE UNLIKE ALMOST ANY OTHER
I. T. PROJECT IN THE STATE
BECAUSE OF ITS BREATH
COMPLEXITY- ANY ADMINISTRATION
LIKELY WILL NEED TO MODIFY ITS
TRADITIONAL APPROACH TO
PLANNING DEVELOPMENT AND
IMPLEMENTATION FOR BOTH
PROJECTS WITHIN THE EFFORT AS
WELL AS OVERSIGHT OF THE WHOLE
PORTFOLIO. AND WHILE THE
ADMINISTRATION EXPECTS TO
PROVIDE INDIVIDUAL PROJECT
INFORMATION FOR THE LEGISLATURE
TO ASSESSBUDGET REQUESTS IT IS
UNCLEAR AT THIS TIME WHETHER
THAT INFORMATION WILL ALSO BE
AVAILABLE FOR THE ENTIRE EFFORT
AND LIMITED INFORMATION ABOUT
THE WHOLE EFFORT WILL MAKE IT
DIFFICULT FOR THE LEGISLATURE
TO AS AN EXAMPLE IDENTIFY WHEN
COMPLEX AND COSTLY PROJECTS
WITHIN THE PORTFOLIOARE
EXPECTED TO BEGIN AND WHAT
IMPACT THEIR FAILURE COULD HAVE
ON THE EFFORT AS A WHOLE. AND
SO TO IMPROVE LEGISLATIVE
OVERSIGHT OF THE EFFORT WE
RECOMMEND THE LEGISLATURE
DIRECT THE ADMINISTRATION TO
KEEP THE LEGISLATURE REGULARLY
INFORMED OF KEY CHANGES TO
EXISTING I. T. PROJECT PROCESS
SEES THAT HE ADMINISTRATION IS
CONSIDERING AS WELL AS A TOP
SUPPLEMENTAL REPORT LANGUAGE
THAT WOULD DIRECT THE
ADMINISTRATION TO REPORT BACK
ON CHANGES MADE TO EXISTING I.
T. PROJECT PROCESS SEES FOR
THIS EFFORT SENSUALLY LOOKING A
NEW OPTIONS FOR LEGISLATIVE
OVERSIGHT AND CONSIDERING
POTENTIAL OTHER IMPROVEMENTS TO
CURRENT OVERSIGHT PROCESSES FOR
IN PARTICULAR THOSE COMPLEX AND.
COSTLY IT PROJECTS THANK YOU.
THE YOU VERY MUCH- YES AND I
THAN AND THAT WELL I'M NEW TO
THE HEALTH THAT. POLICY AREA I
AM CERTAINLY NOT NEW TO THE
PROBLEMS WITH A LOT OF OUR IT
PROJECTS THAT WE'VE UNDERTAKEN.
I'M AND SO WELL THE WELL THE
FRENCH DEFENSE WANT TO LOOK AT
THE WHOLE MODEL I THINK THE
LEGISLATURE WILL WANT TO LOOK
AT THAT THOSE COMPONENTS SO
THAT WE CAN MORE CAREFULLY
EVALUATE. AS MR METZGER SAID-
AND WE KNOW WE'RE BIG COMPLEX
STATE WE'RE NOT YOU KNOW WE ARE
NOT WYOMING WE ARE CALIFORNIA
AND SO IT'S IT IS A- RICH WITH
COMPLEXITIES- BUT AS WE'VE SEEN
WITH SOME OF OUR OTHER. SYSTEMS
THAT WE'RE TRYING TO DO
OVERSIGHT ON IF WE DON'T KNOW
EXACTLY YOU KNOW I CAN I CAN TO
SEE US BACK HERE NEXT YEAR AND
ASKING. WHICH ONE WENT BAD YOU
I WILL NOT SURE BECAUSE IT'S
ALL COMBINED BECAUSE THE FED
REQUIRE US TO DO IT ALL
TOGETHER. SO WELL THE FEDS WILL
ORGAN REQUIRED THAT WAY. I
THINK WE'LL BE ABLE TO WANT TO
SEE THE DISCRETE ISSUES TO WHEN
SOMETHING GOES WRONG WE CAN
MORE CAREFULLY FINE TUNE IT.
THEN TRYING TO BLOW UP THE
WHOLE SYSTEM OR JUST SAYING
IT'S TOO BIG AND WE CAN'T WE
CAN'T MANAGE IT. DR THANK THANK
YOU MADAM CHAIR- AND ANOTHER
WITH CODE WE HAVE TO CHANGE
THINGS BUT- ONE OF THE THINGS
THAT WE'VE DONE THE PASSES FOR
EXAMPLE- BIGGEST QUESTION. IS
WE'VE ACTUALLY HAD. THE
CALIFORNIA PHARMACOLOGY
ACTUALLY ALSO BE PRESENT AT THE
HEARING WE TALK ABOUT IT
PROJECTS SO THAT WE CAN GUESS.
ASK THEM QUESTIONS AS WELL. SO%
I GUESS MY FIRST QUESTION FOR
DTS IS THAT- TO WHAT DEGREE IS-
DEPARTMENT TECHNOLOGY BEING
INVOLVED IN YOUR PROCUREMENTS
AND YOUR VALUATION OF THE- THIS
I. T. EFFORT TO TIE INTO GREAT.
CELL SIZE IMAGE KIND OF ALL
SOFTWARE- THAT CONTRACTS FIRST.
UPGRADE ARE. ARE NEW SOFTWARE
AND ALSO- ALSO- YOU'RE GONNA
HAVE TO ENGAGE I MEAN ONE OF
THE MOST FREQUENTFAILURES OF
IT SYSTEMS IS NOT ENGAGING THE
PEOPLE ACTUALLY USE THE SYSTEM
NOT JUST THE IT EXPERTS BUT THE
PEOPLE ACTUALLY HAVE TO USE THE
SYSTEM- THAT THEY'RE THAT
THEY'RE INVOLVED AS WELL SO TO
DEAL WITH INTERFACES USE AND SO
FORTH SO CAN YOU SPEAK TO. AND
IS ACTUALLY AND KALECKI
ACTUALLY DOES HAVE A SEQUENCE
OF SERIES OF THINGS THEY THEY
DO TO EVALUATE SO CAN YOU JUST
SPEAK TO HOW HOW HE'S BEEN
INVOLVED AND- AT WHAT- WHAT
STAGE ARE YOU AT AND- IN TERMS
OF THEIR- AND IN TERMS OF- THIS
THIS PROCESS. YEAH I MEAN WE
ARE. COMPLETELY COMMITTED TO
TRANSPARENCY ROBUST OVERSIGHT
AND ACCOUNTABILITY. WELL WE
HAVE ONGOING COLLABORATION WITH
THE DEPARTMENT TECHNOLOGY. AND
WE DO NOT QUARTERLY PROJECT
STATUS UPDATES TO LEGISLATIVE
STOPPED. THE L. A. O. THEY GREW
STATE AUDITOR. OKAY I
UNDERSTAND IS THE PART OF
TECHNOLOGY ACTUALLY AVAILABLE.
I AND OTHERS IN YES HELLO OKAY
CAN- SO- THE DENTURES ALRIGHT
CAN WE HAVE OUR TECHNOLOGY
SPEAK TO THEIR INVOLVEMENT WITH
THIS SYSTEM AND THEIR
RECOMMENDATIONS IN REGARDS TO
THIS INTEGRATION. YEAH SENATORS
ELECTION LAST MONTH I AM THE
BEST YOU FOR THE HELP AND HUMAN
SERVICES PORTFOLIO AND ACTUALLY
IT WAS AT ONE TIME WAS THE
PROJECT OVERSIGHT MANAGER
LOOKING MODERNIZATION BECAUSE
BALLOT THE AND YES MONITORS. HE
CAME ON THE WITH THE M. S. MY-
IS. ON TO LET. ONE IS ON THE OR
WHAT ON- THEY'VE GOT A AND YES.
IS STILL NONSENSE WHICH FROM TO
ME AS- RIGHT NOW IT'S A TO ANY
STRATEGY DON'T LOOK THAT WOULD
BE S. YES IT'S- ONE I DON'T
WANT USE BUT- I THAT I THINK
WILL BE SITE. I SHOULD ONE OF
PROJECT COME ON. OF THE STRAT
AND BENDING BE A BIG FOR THAT.
THE SECOND IS THAT THE PROJECT
NO ONE BETWEEN YOU PROJECT
ADDED BY UNDER MORE THAN A-
STRATEGY. WILL GO TO THE WILL.
AND THIS IS BADLY TO THE FORTY
STATE ON BUDGET THAT AND SEE.
BUSINESS ON THANKS ALIGNED ON
DEFINED- GOALS AND THEN I'LL
THAT BUT THE PROJECT HAS BEEN
EXPLAINED ADDED TO. THANK GOES
TO THAT PARTICULAR MAY AND BENT
ON AND THE D. I. WHEN THE
FUNDING INTO THE THEY MADE.
PART OF THEIR DAY IF YOU
PROVIDE THAT WILL. THE LOOKING
AT THE PROD HELLO BUT THAT WILL
GIVEN. BUT THERE DESK BY AND
THE SCHOOL IT G. THE BATTLE
FOR. THE ISSUE. OVER THIS AND
IS MORNING. OKAY SO HELPFUL YOU
YOU CAN- BOTH THE AND THE PARKS-
TECHNOLOGY FOR US THAT. OF
WE'RE NOT TECHNICAL BUT MY ME
JUST ASK A COUPLE. OTHER
QUESTIONS RELATED THIS TO TRY
SO FIRST OF ALL IN TERMS OF
MODERN. I KNOW THAT PART OF ITS
BY ITS OF FEDERAL BUT ARE WE
DEALING WITH LEGACY SO. I MEAN
WE HEARD ABOUT THE ALL THINGS
AND STILL COLD AND CERTAIN PLAY
AND THE STATE AND SO FAR- TO
WHAT ARE WE DEALING WITH THE
LEGACIES THAT NEED TO BE SENT.
UP TO IS THAT AN ISSUE OR NOT
WE'RE HAVING TO DEAL WITH-
HAVING TO RE WRITE SOFTWARE AND
SOMETHING THAT ACTUALLY SOMEONE
WHO GRADUATES FROM COLLEGE NOW
COULD ACTUALLY PROGRAM OR- ARE
WE. HAVING SO CAN YOU SPEAK TO
THAT. IT'S A SERVICE. NICK NICK
REIMBURSEMENTS KAPLAN SYSTEM
WHICH DOLLARS THAN. RAYMOND
STORE FORMATS KAPLAN BUT THERE
YEAH. AS I SAID BEFORE
PROXIMITY TO HOME SUB YOU KNOW
SYSTEMS FRAZIER WEARABLE LINE
OKAY WELL MANY OF THEM ARE OLD
LIKE A SIX. AND SILOED IS TO
ALL HAVE THEM. ACTUALLY
REPLACED WITH THAT INTEGRATED
SYSTEM THAT WHY- START
DESCRIBING IT AS ONE SYSTEM IS
IN FACT. SORT OF A FEDERAL
DEVELOPMENT. USER CENTRIC WELL
OKAY WHAT TOGETHER SO THAT
WOULD BE HELPFUL AS IS BECAUSE
I MEAN I MEAN I REALIZE YOU
DESCRIBED AS A SHORT
DESCRIPTION SERVE WHAT THE
ROADMAP IS FOR YOUR I. T. SO
THAT WE CAN IN TERMS OF OUR
OVERSIGHT THAT WE KNOW GET THE
BIGGER PICTURE ND THEN I GUESS
THE OTHER QUESTION. THE OTHER
THING IS THAT- AND- WE CAN
SPEAK TO OUR CALVET IS THAT I
THINK WE'RE TRYING TO DO IS
MOVE AWAY LIKE ALL THE BIG BANG
PROJECT RIGHT I MEAN WHAT WE
DON'T WANT IS ACTUALLY YOU KNOW
SOME HUGE SYSTEM THAT'S MADE
FOR ONE POINT IN TIME THAT
THERE'S ONLY LIKE THREE
CONTRACTORS OUT THERE I THINK
IT'S US. TO LLOYD AND SOMEONE
IN THAT WE ACTUALLY BUILD
MODULAR SYSTEMS BECAUSE IT'S
NOT ABOUT BUILDING A SYSTEM FOR
ONE POINT TIME IS BUILDING
pTIME RIGHT BECAUSE YOU HAVE
DIFFERENT COMPONENTS THAT WILL
EVOLVE IT SAID- AND THAT YOU
CAN ACTUALLY HAVE SMALLER
CONTRACTORS TO BE ABLE TO DO
MODULES OR COMPONENTS. AND
IMPROVE AND UPGRADE IMPROVES
THOSE IS YOU KNOW CHANGED OUT
REQUIRED THINK DIFFERENT
DEMANDS CHANGE AND SO FORTH BUT
HAVING TO REDO THE WHOLE.
INFRASTRUCTURE ITSELF SO IS SO
PERHAPS COUNTY CAN SPEAK TO
THAT IS THAT IS THAT THE
APPROACH A PLANE TO TAKE WITH.
THIS MEDICAMENTS ATION SYSTEM.
AND I'M GETTING MANY SECOND
LIGHT I DO THREE DECADES OUR
CITIES ARE S. CD RIGHT. FOR
TECHNOLOGY. YEAH SO ON. IN THIS
CASE WHEN WE HAD THIS
MODERNIZATION THESE ARE VERY OR
LEGACY SYSTEM OKAY FIFTY AND
NINETY HIM IT WAS ACTUALLY-
FROM COMBINATION ABOUT NINETY
PLUS THIS. SO WHEN HE STARTED
BACK IN THIS MORNING QUALITY
SEVERAL WAS MAINLY FOCUSED ON
THAT HIT LIST SOMETHING
COMPANIES OF. NINETY AND MARK
THIS NOT SHE TO MORE A MEDIC
AND PRICES. WHICH IS BIGGER
THAN GET AT IT ALL HE THE
SYSTEM WAS ON THE MANAGED CARE
AT THIS POINT WE DO NOT THE
FOURTEENTH FOUR OFF WHAT IS
MORE. IS TO LOOK LIKE BUT JUST
IT IS THE THAT. PLAN IS TO HAVE
A IN WOULD MY OF THE PROJECT-
BASICALLY LOOK AT THE IF THAT
WITH- SYSTEMS HE- WHAT HE SAYS
YEAH THE MARTIN BUST FROM MAKE
SOME SYSTEMS CAN MY- AND DO IN
A MODEL AT. BASED ON LIKE I
BASEMENT OF MAY MODEL OKAY. BUT
THAT SO THAT THE FOR OUR
OVERSIGHT PURPOSES THAT WE CAN
SERVE SEE WHAT'S THE ROADMAP.
THAT WERE- EMBARKING ON IN
TERMS OF OUR I. T. NEEDS FOR
MEDICARE AND I JUST SPOKE
EARLIER WE TALKED ABOUT HOW
LAME THE FACT THAT WE NEED
UPGRADED SYSTEM STUDENT DATA
COLLECTION. AS WELL. I THINK
THAT- AND MANY. SURE THAT.
MISTER SO THAT IDEA HERE
BECAUSE OKAY LET ME BY NOW YEAR
WE CAN HAVE A ROAD MAP. WILL BE
CLOSER TO HAVING A ROAD MAP. I
WANT TO PROMISE THE ROADMAP
THEN- THIS THIS REALLY GO LOTS
SMOOTH IN TOOK. OF OKAY OF REAL.
SHORTING WHERE NEEDS TO OKAY SO
I GUESS I WOULD SAY BOTH YOU.
THAT AND- T. AND L. A. L.
PERHAPS HELPING US OVER NEXT
YEAR AND CERTAINLY YOU ALSO OF
WHAT TRYING TO DO HERE START.
AN OVERSIGHTSTRUCTURE FOR US
SO THAT WE CAN- PROBABLY
MONITOR- THAT PROGRESS IN
DEVELOPMENT WHAT SOUNDS LIKE
IT'S GOING TO BE A FAIRLY
SIZEABLE- AND- I. T. PROJECT
AND TO BE SURE THAT- THIS AT.
HOPEFULLY WE DON'T EVER HEAR
ABOUT IN THE NEWS SO. THE DOOR
SURELY WITH NOT A BIG BASS.
ROGER OKAY WELL THAT'S GOOD
KNOW SO I JUST ASKING FOR A
COMMITMENT THAT- WEEK WE GET A
BETTER ROAD MAP AND OF COURSE
WORK WITH L. A. O. ON THAT TOO.
GOOD THANK YOU THANK YOU VERY
MUCH OKAY. I'M IF ALL RIGHT TO
ISSUE NUMBER THIRTEEN
COORDINATION OF BENEFITS AND
POST PAYMENT RECOVERY. THIS IS
ALMOST CARRILLO BILLING WHICH
THAT SIMPLY ARE WILL GIVE US A
STANDARDIZED DATA AS WELL AS A
HOME. FOR A PROCESSES TO
OBTAIN- ALL THE INFORMATION FOR
ALL OTHER HEALTH CARE ALL.
COURAGE GROUPS WE ARE THE PAYER
OF LAST RESORT. AND WHAT IS THE
MOST INCONVENIENT STORE ALL.
FIND THAT WE THAT WE DIDN'T GET
THE HEALTH CAN. INVOLVED
BEGINNING AND THEN WE SORT OF
DOING PAY ON ON. SO THIS ALL
STANDARDIZE ZEROS ARE DAY
COLLECTION AND WELCOME. THE
LIST OF OTHER HEALTH PROVIDERS-
THE HEALTH CARE COVERAGE GROUP-
THAT. SUPPLY US WITH THE SO
QUICKLY WE DO THIS ROUND AND
ONE OF THE DOCTOR. THANK YOU
FINANCE. HELLO FELLOW. OKAY I
HAVE MAKE A DIFFERENCE OKAY.
ALL RIGHT LET'S MOVE ON THEN TO
ISSUE NEW FOUR LIMITED TIME
EXTENSION OR CONVERSION TO
PERMANENT. FIRST THIRTY ACS AS
AMENDED TO SEPARATE BCPS- TO
ADDRESS STAFFING RESOURCES
NEEDED IN THAT DEPARTMENT THE
LIMITED TERM EXTENSION B. C. P.
REQUEST TO CONTINUE LIMIT TERM
RESOURCES EQUIVALENT TO THIRTY
EIGHT POSITIONS- WITH AN
EXPENDITURE THIRTY OF SEVEN
POINT EIGHT MILLION DOLLARS. ON
THIS WORK- IT WOULD ADDRESS A
NUMBER OF THE OF PROGRAM SOME
EVEN TALK ABOUT TODAY INCLUDING
THE CALIFORNIA COMMUNITY
TRANSITION OF FEDERAL MANAGED
CARE REGULATIONS ELEVEN FIFTEEN
WAIVER EXTENSION OF THE DRUG
MEDI CAL ORGANIZED DELIVERY
SYSTEM RENEWAL AND POLICY
IMPROVEMENTS- AS WELL AS THE
HEALTH NAVIGATORS- ITEMS. WE
ALSO HAVE THE I REQUEST TO
CONVERT OF LIMITED TERM
POSITION IS TO PERMIT REQUESTS-
AT A TOTAL OF SIXTY TWO POINT
FIVE LIMITED TERM POSITIONS. TO
PERMANENT POSITIONS WITH THE
EXPENDITURE AUTHORITY OF NINE
POINT FOUR MILLION TOTAL FUNDS
THE CONVERSION- DEPARTMENT-
POSITIONS OF WOULD INCLUDE
THINGS FOR THE MANAGED CARE-
THAT REGULATIONS LEGAL SUPPORT
FOR ONGOING WAIVER ACTIVITIES.
HEALTH CARE REFORM FINANCED BY
REPORTING AS WELL AS PRIVATE
HOSPITAL DIRECTED PAYMENT
PROGRAM AND HAPPY TO ANSWER ANY
QUESTIONS YOU MAY HAVE.
DEPARTMENT FINANCE. BELIAU. DR
GRANT GIVING HONEST OKAY THANK
YOU AB MOVING ON TO ISSUE
NUMBER FIFTEEN COMMUNITY MENTAL
HEALTH. OR SO I'M GONNA GIVE A
AN OVERVIEW AND THEN. GOING
QUESTIONS SO- MEDICAL BREAKING
INTO A VARIETY OF THE DELIVERY
SYSTEMS FOR BEHAVIORAL HEALTH-
IN COMMUNITY MENTAL HEALTH
PIECES SO WE HAVE SPECIALTY
MENTAL HEALTH CARE- WHICH IS
SERVICES PROVIDED. TO PEOPLE
WITH SERIOUS MENTAL ILLNESS OR
SERIOUS EMOTIONAL DISTURBANCE
THIS IS CARVED OUT OF OUR
MEDICARE MANAGED CARE PLANS-
THE RESPONSIBILITY FOR
FINANCING AND MANAGING THE BET
BENEFIT WAS RELYING TO COUNTIES
IN NINETEEN NINETY ONE TWO
THOUSAND ELEVEN. I COUNTY
MENTAL HEALTH PLANS ARE
RESPONSIBLE FOR THE FULL
DELIVERY OF THESE SERVICES THAT
ARE CARVED OUT THE SPECIALTY
MENTAL HEALTH SERVICES. THE END
OF THEIR REQUIRED UNDER FEDERAL
LAW TO FOLLOW ALL MANAGED CARE
RESPONSIBILITIES INCLUDING
THINGS LIKE TIMELY ACCESS
STANDARDS NETWORK ADEQUACY
GRIEVANCES ETCETERA. FOR THE
NON SPECIALTY MENTAL HEALTH
CARE SERVICES- OF FOR SERVICES-
THAT ARE ADULTS AS OUR MEDICARE
MANAGED CARE PLANS RESPONSIBLE
FOR MILD TO MODERATE SERVICES-
IT FOR CHILDREN UNDER THE AGE
OF TWENTY ONE THEY ARE
RESPONSIBLE FOR NON. SPECIALTY
MENTAL HEALTH SERVICES. WHEN
COMES TO USE USE DISORDERS.
WITHIN OUR PROGRAM- SUBSTANCE
USE DISORDER TREATMENT IS
DONNELLY CARVED OUT OF THE
MEDICAID MANAGED CARE PLAN IS
THE RESPONSIBILITY OF THE
COUNTIES. THROUGH REALIGNMENT
OF COURSE WE HAVE SERVICES ARE
AVAILABLE IN ALL COUNTIES ARE
THIS IS CALLED DRUG MEDI CAL.
WHICH INCLUDES OUTPATIENT
TREATMENT NARCOTIC TREATMENT
PROGRAMS AND RESIDENTIAL
TREATMENT FOR PREGNANT AND
POSTPARTUM WOMEN WOMEN. I WE
HAVE AN EXPANDED SUITE OF
SERVICES AVAILABLE IN COUNTIES
THAT HAVE OPTED IN TO THE DRUG
MEDI CAL ORGANIZED DELIVERY
SYSTEM. INCLUDING RESIDENTIAL
CARE OF FOR ALL BENEFICIARIES
MEETING MEDICAL NECESSITY
CRITERIA- AND THEN WE JUST KNOW
THERE ARE A FEW SPECIFIC
RESPONSIBILITIES IN MANAGED
CARE PLANS. MOST NOTABLY THE
SCREENING BRIEF INTERVENTION
AND REFERRAL TO TREATMENT FOR
ALCOHOL AND OTHER DRUGS AS WELL
AS PRESCRIBING IN MANAGING-
MEDICATIONS FOR OPIOID USED
DISORDER- IS WELL IN THE
PRIMARY CARE SETTING.
ADDITIONALLY WE HAVE THE MENTAL
HEALTH SERVICES AFTER WHAT'S
KNOWN AS AND I JUST SAY I
PASSED BY CALIFORNIA CALIFORNIA
VOTERS IN TWO THOUSAND AND
FOUR. I FUNDED BY 1% INCOME TAX
ON PERSONAL INCOME IN EXCESS OF
ONE MILLION- PER YEAR. IT IS
DESIGNED TO EXPAND IN TRANSFORM
CALIFORNIA'S BEHAVIORAL HEALTH
SYSTEM TO BETTER SERVE
INDIVIDUALS WITH AND AT RISK OF
SERIOUS MENTAL HEALTH ISSUES
AND THEIR FAMILIES. ADDRESSES A
BROAD CONTINUUM OF BOTH
PREVENTION AND EARLY
INTERVENTION AND SERVICES
NEEDED AS WELL AS- THE NEEDED
INFRASTRUCTURE TECHNOLOGY AND
TRAINING ELEMENTS TO EXPAND THE
PUBLIC BEHAVIORAL HEALTH
SYSTEM. SENSE PASSED IN TWO
THOUSAND AND FOUR EIGHT
GENERATES APPROXIMATELY FIFTEEN
BILLION DOLLARS- FURTHER ON OUR
SUBSTANCE USE DISORDER SIDE THE
DEPARTMENT RECEIVES FEDERAL
GRANTS ARE. GRANTS FROM SAM SAT
ON THE SUBSTANCE ABUSE AND
MENTAL HEALTH SERVICES
ADMINISTRATION- WE HAVE
RECEIVED AS- A BLOCK GRANT FOR
TWO HUNDRED FIFTY FIVE MILLION
DOLLARS THE FUNDS ARE ALLOCATED
TO COUNTIES TO PROVIDE
PREVENTION TREATMENT AND
RECOVERY SERVICES TO
INDIVIDUALS WITH SUBSTANCE USE
DISORDERS. WE ALSO HAVE
RECEIVED A COMMUNITY MENTAL
HEALTH BLOCK GRANTS ARE FOR THE
FISCAL YEARS OF TWENTY TWENTY-
INCLUDING NINETY TWO MILLION
DOLLARS IN THOSE FUNDS. AND
LAST BUT NOT LEAST A WE ALSO
HAVE THE STATE'S OPIOID
RESPONSES SO SANTA PROVIDES
GRANT FUNDS TO THE DEPARTMENT
OF FOR THE STATEWIDE OPIOID
RESPONSE A CURRENT PROJECT
PERIOD- RUNS THROUGH SEPTEMBER
OF TWENTY TWENTY TWO. BUT THE
TOTAL PROJECT AMOUNT OF A
HUNDRED AND TWELVE MILLION
DOLLARS. THESE FUNDS ARE USED
TO SUPPORT EXPANSION OF
MEDICAID AS MEDICATION ASSISTED
TREATMENT IN MULTIPLE SETTINGS
ACROSS STATE OF CALIFORNIA- WE
HAVE SEEN GREAT- INCREASES IN
THE USE OF THESE FUNDS SO I
WILL PAUSE THERE AND SEE IF
THERE ARE ANY QUESTIONS.
DEPARTMENT FINANCE. HELLO. IT
THIRTY COOPER. WHAT WILL HAPPEN
WITH THIS THROUGH THE CALENDAR
PROGRAM HOW WILL THIS CHANGE.
WE ACTUALLY HAVE A QUITE
EXTENSIVE PROPOSALS IN THE
BEHAVIORAL HEALTH SPACE WITHIN
CAL AIMS- THE FIRST ONE HAS TO
DO WITH CHANGES TO THE MEDICAL
NECESSITY CRITERIA THAT WE USE
FOR- THE SPECIALTY MENTAL
HEALTH PROGRAMS WHERE WE ARE
PROPOSING- TO MAKE
MODIFICATIONS FOR EXAMPLE BEING
ABLE TO PROVIDE ASSESSMENT AND
TREATMENT OF SERVICES PRIOR TO
DIAGNOSIS- TO ALLOW THE
RELATIONSHIP AND TREATMENT TO
BEGIN WITH THE- PROVIDER AND
BENEFICIARY. ALTHOUGH THEY ARE
DETERMINING THAT DIAGNOSIS WE
ALSO MADE MODIFICATION IN
REGARDS TO SERVICES FOR
CHILDREN IN ENSURING THAT THEY
HAVE MAXIMUM ACCESS TO ALL AND
A NEEDED MENTAL HEALTH
SERVICES- AND SO THAT'S ONE
PIECE- ADDITIONALLY WE ARE
PROPOSING OF BEHAVIORAL HEALTH
PAYMENT REFORM- CURRENTLY WE
PAY OUR COUNTIES ON A COST
BASED REIMBURSEMENT- WE ARE
PROPOSING IN CALAIS TO MOVE TO
A FEE SCHEDULE. WHICH WOULD
ALLOW US SERVICES TO BE
PROVIDED BASED ON THAT FEE
SCHEDULE AND THEN IT WOULD
ALLOW FOR EXAMPLE COUNTY IF
THEY WERE TO CONTRACT WITH THE
MEDICARE MANAGED CARE PLAN TO
PROVIDE MAYBE ENHANCE YOUR
MANAGEMENT OR LIEU OF SERVICES
THEY WOULD BE ABLE TO KEEP THE
REVENUE UP FROM THOSE SERVICES.
AND REINVEST THEM INTO THE
DELIVERY SYSTEM I WHERE IS
TODAY WITH THE COST BASE WE
RECONCILE- AT THE AT THE LOCAL
LEVEL AND SO AN OPPORTUNITY
THERE FOR BEHAVIORAL HEALTH TO
INCREASE THEIR ABILITY TO
ACCESS SERVICES. WE ALSO ARE
PROPOSING- IT DO YOU DO YOU
BEHAVIORAL HEALTH INTEGRATION
AND BY THAT WE MEAN- BETWEEN
MENTAL HEALTH AND OUR SUBSTANCE
USE DISORDER WHERE WE HAVE OF
THE MANAGED CARE ENTITIES THEY
ARE SEPARATELY- FOLLOWING
SEPARATE CONTRACTS- WE HAVE
SEPARATE REQUIREMENTS IN
REGARDS TO OVERSIGHT PIECES. IN
BY COMBINING THOSE INTO
BEHAVIORAL HEALTH MANAGED CARE
ENTITIES- THAT WE WOULD BE ABLE
TO REDUCE A LARGE NUMBER OF
ADMINISTRATIVE BURDEN BOTH AT
THE STATE AT THE COUNTY AND THE
PROVIDER LEVEL- IT ALLOWS FOR
MORE STREAMLINED OVERSIGHT
MONITORING OF. THE BEHAVIORAL
HEALTH ENTITIES I WE HAVE A
FIVE YEAR ROAD OF HOW CAN GET
TO YOU A BIT. AND FOR MANY
HEALTH AND SO USE. I WOULD JUST
NOTE THAT WOULDN'T REQUIRE THAT
AT THE PROVIDER LEVEL THEY BE
INTEGRATED BUT IT WOULD ALLOW
FOR IT I WHICH WE THINK IS A
BENEFIT- ON THAT PERSPECTIVE-
WE ALSO HAVE PUT FORWARD. A
NUMBER OF PROPOSALS WITHIN OUR
DRUG- R. D. N. CO DS OR ARE A
DRUG MEDI CAL ORGANIZED
DELIVERY SYSTEM- TO JUST
IMPROVE THAT PILOT THAT WE'VE
BEEN WORKING ON. FOR THE LAST
FIVE YEARS IN MOVES THINGS
FORWARD SO THERE IS A
COMPREHENSIVE- PROPOSAL WITHIN
CALLAHAN TO REALLY MOVE. ON
INCREASE ACCESS AND IMPROVE
QUALITY OF SERVICES ON THE
BEHAVIOR OUTSIDE. BUT TOCONTINUE TO LEAVE SYSTEMS IN
PLACE FOR THE SO FOR THOSE
OUTSIDE OF THE MEDICAL SYSTEMS
TO STILL BE ABLE TO ACCESS.
THESE LARGER PROGRAMS. YEAH WE
WOULD ADD ALL OF THE SERVICES
WILL STILL BE THE
RESPONSIBILITY TO THE SPECIALTY
MENTAL HEALTH SERVICES WILL
STILL BE THERE SPOTS ABILITY OF
THAT COUNTIES FOR EXAMPLE- AND
AS WELL AS A SUBSTANCE USE
DISORDER SERVICES THATWERE
MENTIONED- IT'S JUST REALLY
AROUND- POLICY CHANGES THAT
ALLOW US TO INCREASE ACCESS AND
IN IMPROVE OUTCOMES THANK YOU.
THIRTY THANK YOU SO MUCH FOR
THIS- FOR THE OVERVIEW- EXCEEDS
FIRST WHO- I BELIEVE IT WAS
SEVERAL YEARS AGO FORTUNATELY-
WE WERE PENALIZED BY THE
FEDERAL GOVERNMENT CMS FOR-
NOT. YES COMPLYING WITH THE
OUTCOME REQUIREMENTS AND ARE
COUNTY MENTAL HEALTH WATER AND
AROMATIC OUR METAL HEALTH SIDE
OF THINGS AND- I BELIEVE. THE
SITE IS A STATE TO SPREAD THAT
EXPENSE OF THE FINALS FOR QUITE
SIZEABLE OVER SEVERAL YEARS SO
THAT WE DIDN'T HIT. COUNTIES
WITH IT ALL AT ONCE AND WE PAID
AT ALL OFFERS THAT STILL ON
GOING. I MAY HAVE TO ASK FOR MY
DAHLE COLLEAGUES AND OR LINDY
IF YOU HAVE A- AN UPDATE
REGARDS TO THE- THE PAYOFF OF
THAT AUDIT. YEAH. I WILL HAVE
TO CONFIRM BUT I BELIEVE WE ARE
IN THE YEAR HEW OUT OF THE FOUR
THAT IT WAS RIGHT ACROSS. BUT I
WILL HAVE TO GO BACK AND BERMAN.
OKAY YEAH YOU CAN GET BACK TO
ME ON THAT- SO I GUESS THE PART
THE PART. PART REASON FOR IT UP
TO IS THE- DID RAISE SOME
ISSUES ABOUT- OVERSIGHT. OVER
SOME OF THE MENTAL HEALTH PLAN.
I KNOW THAT WE'RE MAKING SOME
IMPORTANT TRANSFORMATIONS WITH
CALLING HIM AS WELL- BUT- WHAT
WHAT KIND OF OUTCOMES ARE WE
MARCHING ACROSS THE STATE SO I
KNOW WE TEND TO FOR A LOT TO
RAISE COUNTIES WHAT WHAT. HOW
WE- AT TRYING TO. DO STATEWIDE-
OUTCOMES FOR MENTAL HEALTH
GOALS- THROUGH OUR MEDICAL
PROGRAM WHAT KIND OF STANDARDS
ARE WE- SETTING FOR OUR MENTAL
HEALTH. PROGRAMS I KNOW IT'S A
GREAT QUESTION- SENATOR PAN SO
WE- WE DO HAVE SOME DASHBOARDS
THAT WE CURRENTLY HAVE ON DCS
IS WEBSITE TODAY HOWEVER- WE
RECENTLY ANNOUNCED THAT WE ARE
IN THE PROCESS OF HIRING IN
BRINGING ON A CHIEF QUALITY
OFFICER AND ONE OF THE
RESPONSIBILITIES OF THAT CHIEF
QUALITY OFFICER IS GOING TO BE
TO COME TO DEVELOP A
COMPREHENSIVE QUALITY OF AN
OUTCOME MEASUREMENT STRATEGY
FOR OUR BEHAVIORAL HEALTH
AREAS- WOULD BE LOOKED ACROSS
OUR DELIVERY SYSTEM WE ARE
REPORTING EXTENSIVE METRICS ON
THE MANAGED CARE CITED YOU
HEARD VERY AWARE OF. OF THAT
BUT WE HAVE A VERY LITTLE THAT
WE ARE REPORTING PUBLICLY IN
REGARDS TO OUR BEHAVIOR HEALTH
SYSTEM AND SO THE NEW CHIEF
QUALITY OFFICER WILL BE
RESPONSIBLE FOR DEVELOPING A
THAT IT WOULD BE STATEWIDE THAT
WE WOULD REPORT THOSE MEASURES
AND YOU WOULD MAKE THOSE OF
COURSE ARE PUBLIC ANDTRANSPARENT I WOULD JUST NOTE-
ONE OF THE PIECES OF KALANK
WHICH I DIDN'T MENTION EARLIER
AND SHOULD UP WAS THAT THE H.
Q. I. P. AND THAT B. H. Q. I.
P. R. QUALITY IMPROVEMENT
PROGRAM IS TO HELP FUND SOME OF
THE DATA- CHANGES NEEDED AT THE
COUNTY LEVEL AND SYSTEM LEVEL
CHANGES NEEDED. SO THAT WE CAN
GET THE DATA IN A BETTER WAY
FROM THE COUNTIES THAT
CURRENTLY THE WAY THEY CODED
REPORT TO US DOESN'T ALLOW OR
HAVE THE BEST OUTCOME- IN WHEN
WE'RE LOOKING AT THE QUALITY
PERSPECTIVE BECAUSE IT'S NOT
BROKEN DOWN AT THE RIGHT LEVEL
AND SO WE ARE WORKING WITH THEM
TO IMPLEMENT THAT THOSE FUNDS
HELP PAY FOR THOSE SYSTEM
CHANGES SO THAT WE CAN GET IT
IN A PLACE WHERE WE CAN HAVE
MORE QUALITY AND OUTCOME.
METRICS WITHIN OUR BEHAVIOR
HEALTH. I APPRECIATE THOSE
EFFORTS THINK BEEN LOST THE
ISSUE SERVICE I. THEIR MANY
COUNTY STAR DUO OUT. JOB AND
HERO BUT THERE'S A- AN FOR I
THINK WE'VE SEEN INSTANCES. WE
ALSO DON'T HAVE GOOD- IT IS IT
AND I APPRECIATE AND I MEAN
THAT. AND I REALIZE THAT FOR
EXAMPLE CMS ISSUE WAS YOU KNOW
SOME OF THOSE TECHNICAL ISSUES
AT CETERA. BUT I THINK IT
UNDERSCORED. THE ACT THAT.
WELL CERTAINLY WE HAVE MANY
OUTSTANDING- COUNTY PROGRAS.
THAT WE ALSO OUR STATE AND WE
DO NEED TO THAT EVERY PERSON
WHO LIVES IN THE STATE OF
CALIFORNIA NOT JUST ONE
PARTICULAR COUNTIES DESERVE TO
HAVE. GOOD ACCESS TO MENTAL
HEALTH AND- IN SOME WAYS I
WOULD JUST SAY THAT. PROP SIXTY
THREE HAS CERTAINLY BEEN A
TREMENDOUS BOON BUT SOMETIMES I
THINK PEOPLE GET TOO DISTRACTED
JUST LOOKING AT THE PROP SIXTY
THREE FUNDS AND- NOT PAYING
ENOUGH ATTENTION TO HOW ARE
USING A MEDIC CAL FUNDS. WHICH
ACTUALLY IS A VERY SUBSTANTIAL
PART OF THE RESOURCES WE PUT IN
THE MENTAL HEALTH. AND WE NEED
TO HAVE STATEWIDE STANDARDS NOW
I REALIZE YOU KNOW. DIFFERENT
COUNTIES ARE DIFFERENT THEY
HAVE DIFFERENT NEEDS AND WE
NEED TO HAVE THAT FLEXIBILITY
BUT HAS TO BE ACCOUNTABILITY TO
ON A STATEWIDE BASIS. AND SO- I
HOPE THAT YOU CAN CONTINUE TO
KEEP US APPRAISED OF THE
EFFORTS THAT YOU TALKED ABOUT.
IN THE TIMELINES AND RESOURCES
NECESSARY TO BE SURE WE HAVE
THOSE IN PLACE SO THAT WE- SO
THAT THERE CAN BE
ACCOUNTABILITY ACROSS THE
STATE- FOR A BEHAVIORAL HEALTH.
SYSTEM IT. TO TAKE ON THE
MEDICAL SIDE. THANK YOU. THANK
YOU OKAY- I THINK WE'RE ON
SIXTEEN. RIGHT SO THE
DEPARTMENT DID PUT FORWARD A
PROPOSAL IN REGARDS TO
INCREASING ACCESS TO THE
BEHAVIOR HEALTH CONTINUUM OF
CARE INFRASTRUCTURE- TO THE
PANDEMIC OF THE CALIFORNIA AND
NATIONWIDE REALLY SEEING AN
INCREASE IN REGARDS TO YOU-
OVERDOSE DEATHS SUICIDES IN AN
INCREASE OF NEED FOR MENTAL
HEALTH ILLNESS AND SUBSTANCE
USE DISORDER SERVICES- AND THE
PANDEMIC I REALLY JUST
ACCELERATED- THOSE TRENDS- WE
DO NOT. FORGET STOP YOU ONE
SECOND AT THE BECAUSE I'VE BEEN
MOST MOST ANIMAL AND IS DID YOU
HAVE A QUESTION THE LAST ISSUE
I'M SORRY FORGOT TO CALL IN
YOUR INTO YOUR HAND UP. OKAY.
OKAY AND APART IN FINANCE IN
THE LAST ONE. YES IT WE ARE
ALMOST APARTMENT OF FINANCE I
JUST WANT TO LOOK BACK TO
SENATOR POUNDS QUESTION ON THE
OFFICE OF INSPECTOR GENERAL
AUDIT SETTLEMENT THE STATUS A
BIT OF THAT. SO THERE WAS A
REPORT SUBMITTED THAT REQUIRE
THAT- CALIFORNIA DO PREPAY A
HUNDRED EIGHTY MILLION ODD TO
SEE A MASS FOR ALLOWABLE COUNTY
SPECIALTY- MENTAL HEALTH CLAIMS
THE STATE PAY FOR IN DECEMBER
TWO THOUSAND EIGHTEEN AND- WE
HAVE BEEN RECOUPING. COUNTY
FUNDS- TO SUPPORT THAT THE AND
THE INITIAL INTENT WAS TO
RECOUP THAT OVER A FOUR YEAR
PERIOD WE WERE ABLE TO RECOUP
THAT FOR EIGHTEEN NINETEEN IN
NINETEEN TWENTY I WE WERE
UNABLE TO RECOUP THAT DUE TO
THE LIMITED REALIGNMENT FUNDS
BUT WE ANTICIPATE BEING ABLE TO
RECOUP- STARTING IN TWENTY
TWENTY ONE. OKAY THANK YOU VERY
MUCH ALL RIGHT. NOW WE'RE BACK.
TO THE NUMBER- SO THE- IN
CALIFORNIA WE'VE BEEN- WE SEE
THAT WE HAVE INPATIENT
PSYCHIATRIC BED CAPACITY- IS
ABOUT TWENTY ONE BEDS PER ONE
HUNDRED THOUSAND- RESIDING IN A
COUNTY HOWEVER ACT EXPERTS
ESTIMATE THAT REALLY CAPACITY
SHOULD BE AT ABOUT FIFTY PER
ONE HUNDRED THOUSAND- IN
CALIFORNIA- AND SO WE ARE WE
CURRENTLY ONLY HAVE AROUND A
TWO THOUSAND SIX HUNDRED MENTAL
HEALTH TREATMENT BEDS- WITH THE
PROPOSAL BEFORE THE-
LEGISLATURE FOR CONSIDERATION
WE'RE PROPOSING SEVEN HUNDRED
FIFTY MILLION ONE TIME GENERAL
FUND DOLLARS- OVER THREE YEARS
WHERE WE WOULD ALLOW FOR
COMPETITIVE GRANTS TO INCREASE
THAT BEHAVIORAL HEALTH
CONTINUUM. INFRASTRUCTURE IT
WOULD BE AVAILABLE TO BOTH
COUNTIES AND TRIBES- WE WOULD
START THE- THE COMPETITIVE OF
PROCESS IN JANUARY OF TWENTY
TWO OF THE INTENT BEHIND THE
GRANTS WOULD BE TO ACQUIRE- AND
OR REHABILITATE EXISTING REAL
ESTATE ASSETS- ACROSS THE STATE
OF CALIFORNIA GIVEN THE PUBLIC
HEALTH EMERGENCY WE DO KNOW
THAT- IT IS AN OPPORTUNITY-
WHERE CERTAIN BUILDINGS
PROPERTY WILL BECOME AVAILABLE-
AND MAXIMIZING THAT OPPORTUNITY
TO CONVERT THAT INTO BEHAVIORAL
HEALTH INFRASTRUCTURE ACROSS
THE STATE OF CALIFORNIA I WITH
THE SEVEN HUNDRED FIFTY MILLION
WE ARE ASSUMING THAT WE WOULD
INCREASE ABOUT FIVE THOUSAND
BEDS SO IT PRETTY SIZEABLE.
INCREASE IN REGARDS TO THAT BUT
PRINT- WE ARE PROPOSING THAT
THE US SERVICES BE ACROSS THE
FULL CONTINUUM I WHICH WOULD
INCLUDE OF ALL THE WAY FROM
CRISIS STABILIZATION
RESIDENTIAL AS WELL AS
COMMUNITY BASED- AN OUTPATIENT
MENTAL HEALTH SERVICES A REALLY
ALLOWING FOR US YOU ARE IN THE
FUTURE I SPEAK AS AN SMI I. C.
D- I AND D. WAIVER FROM THE
FEDERAL GOVERNMENT SIMILAR TO
WHAT WE HAVE ON THE SUBSTANCE
USE DISORDER SIDE I TO DRAW
DOWN FEDERAL FUNDS FOR I. N. D.
STAYS- BUT WHICH WOULD ALLOW
THOSE FUNDS. TO COME IN AND
FIND ADDITIONAL ACCESS S. TO
BEHAVIOR HOW SERVICESAND CAL.
AND THIS ALLOWS US TO DENNIS TO
THE FEDERAL. THAT CALIFORNIA'S
VERY COMMITTED TO EXPANDING OUR
MENTAL HEALTH FOOTPRINT ACROSS
THE STATE OF CALIFORNIA WHICH
WILL BE REQUIRED TO BE ABLE TO
RECEIVE FEDERAL FUNDS FOR THOSE
DAYS- I WOULD ALSO SHOULD I
JUST NOTICED THAT- WE WOULD
REQUIRE THAT THE COUNTY OR
TRIBES UP. FLYING A FOR THESE
FUNDS PROVIDE A LOCAL MATCH- IT
WE ARE CURRENTLY PROPOSING AS
25% A LOCAL MATCH WITH THIS
PROPOSAL- AND THAT WOULD
INCLUDE- THAN BEING ABLE TO USE
PROPERTY FOR EXAMPLE ON THE
LOCAL MATCH IN ADDITION TO
STATE GENERAL FUND AN HSA OR
OTHER FUNDS AVAILABLE FOR THAT
LOCAL MATCHING WANNA. WORK VERY
CLOSELY WITH OUR COUNTY AND
TRIED COLLEAGUES IN REGARDS TO
THAT BUDGET SURE THAT'S NOT A
BARRIER TO YOU- ACCESSING THESE
FUNDS BUT IN AN IMPORTANT PART
OF THE PROPOSAL. WE ALSO I'D
GIVEN THE FACT THAT WE ARE
TRYING TO INCREASE ACCESS TO
THE CONTINUE ON A WOULD BE
LOOKING FOR A COMMITMENT. FROM
THE COUNTY'S AND ARE CURRENTLY
PROPOSING. I THIRTY YEAR
COMMITMENT OF THOSE FUNDS TO
SECURE ACCESS TO THOSE SERVICES
IN THE LONG TERM. I IN OR TO BE
ENSURE THAT WE ARE CLOSING-
BEHAVIORAL HEALTH CONTINUE IN
GAPS ACROSS THE STATE OF
CALIFORNIA. WE WILL BE
CONDUCTING A GAP ANALYSIS AND
ASSESSMENT- TO BE ABLE TO
INFORM THE AWARD GRANTS ACROSS
THE STATE TO ENSURE THAT WE
ARE. A CLOSING GAPS IN CERTAIN
PARTS OF THE STATE WHERE WE
DON'T HAVE ENOUGH ACCESS TO
OUTPATIENT AND COMMUNITY BASED.
MENTAL HEALTH SERVICES. IN TO
REALLY GROW THAT THAT FOOT
PRINT- ALSO WE HAVE REACHED OUT
TO A TO C. H. R. TO CABINET TO
MEET AND LEARN FROM THEIR
EXPERIENCE- HOWEVER WE DO
BELIEVE IT IS IMPORTANT FOR THE
DEPARTMENT OF HEALTH CARE
SERVICES TO OVERSEE. THE
IMPLEMENTATION OF THESE BONDS
TO ENSURE THAT THE FACILITIES
ARE MEETING- ARE REQUIREMENTS
THAT WE'RE CLOSING CONTINUE IN
GAPS WE ARE THE ONES TO LICENSE
AND CERTIFY- THESE ENTITIES AND
WE DO THINK IT IS THE BEST. A
DEPARTMENTS YOU TO OVERSEAS
FUNDS AND HAPPY TO ANSWER ANY
QUESTIONS YOU MAY HAVE. TO
FINANCE. NO COMMENT TO
QUESTIONS AT THIS TIME THANK
YOU BILYEU. THANK YOU SENATOR
EGGMAN- KOREA SHEET WITH THE L.
A. JUST WANT TO BRING TO YOUR
ATTENTION THAT OUR OFFICE
ACTUALLY PUBLISHED AN ANALYSIS
ON OUR WEBSITE- DISCUSSION
DISCUSSING THIS PROPOSAL AND
I'LL JUST GIVE SOME BRIEF
REMARKS ON TOUCHING ON SOME OF
THE MAIN POINTS THAT WE REYES-
FIRST WE JUST KNOW THAT THERE
ARE SOME SUBSTANTIAL DETAILS
RELATED TO THIS PROPOSAL THAT.
REMAIN UNDER DEVELOPMENT- THESE
WOULD INCLUDE FOR EXAMPLE WHAT
SPECIFIC MILESTONES COUNTIES
WOULD HAVE TO MEET IN ORDER TO
RECEIVE DISBURSEMENT OF FUNDS
OR HOW THE PROGRAM WOULD BE
EVALUATED- IT'S ALSO OUR
UNDERSTANDING THAT FOR THIS
PROPOSAL THE ADMINISTRATION
INTENDS TO RELY ON BUDGET BILL
LANGUAGE RATHER THAN TRAILER
BILL LANGUAGE TO ESTABLISH
PROGRAM. WE HAVE CONCERNS ABOUT
THIS GIVEN THAT BUDGET BILL
LANGUAGE TYPICALLY LACKS
SPECIFICITY AND DETAIL WHEN.
COMPARED TRAILER BILL AND WE
FIND THAT THE LEGISLATURE'S
ROLE IN PROVIDING OVERSIGHT OF
THESE FINES- MAYBE
SIGNIFICANTLY CONSTRAINED UNDER
THE BUDGET BILL APPROACH AND SO
WE'RE SUGGESTING THAT THE
LEGISLATURE DOT TRAILER BILL.
I'M JUST SORT OF ENSURE THAT IT
HAS THAT AS THE FISHING ROLE IN
THE PROCESS- NEXT TIME WE DON'T
WE DON'T RAISE ANY ISSUES WITH
THE CONCEPT OF- EXPANDING
BEHAVIOR HEALTH TREATMENT
CAPACITY STATEWIDE. CERTAINLY
IS A VERY PRESSING NEED ACROSS
THE STATE- WE ALSO FIND THAT
THIS ONE TIME INVESTMENT IS%
LIKELY A GOOD USE OF THE
STREETS- SIGNIFICANT ONE TIME
WINDFALL- WE DO FIND THAT
THERE'S ENOUGH OVERLAP BETWEEN
THIS PROGRAM AND PRIOR STATE-
GRANT PROGRAMS INCLUDING- WANTS
TO CHINA AS THE ADMINISTRATION
JUST- INDICATED. OUR BEHAVIOR
HEALTH FACILITIES TO PROVIDE AN
OPPORTUNITY TO APPLY LESSONS
LEARNED- FOR EXAMPLE- THE
INVESTMENT AND- IN THE MENTAL
HEALTH AND WELLNESS ACTIVE
TWENTY THIRTEEN ESTABLISHED A
GRANT PROGRAM UNDER JAVA. TO
PROVIDE FUNDING FOR FACILITY
FOR CRISIS STABILIZATION UNITS-
WHICH IS ONE OF THE FACILITIES
THAT THIS THIS. PROPOSAL WOULD
ALSO. FIND AND TO AVOID DELAYS
IN DISBURSEMENT OF FUNDS UNDER
THAT PROGRAM- YOU KNOW- THE
STATE SORT OF. MADE THE OPTION
AVAILABLE FOR NON PROFITS OR
CORPORATIONS TO APPLY FOR
FUNDS- DIRECTLY ON COUNTIES
BEHALF AND SORT OF BAD THAT
SORT OF LIKE. XCELERATED THAT
THE PROCESS FOR GETTING- FUNDS
OUT THE DOOR AND HELP DEVOID
AND DELAYS IN. IN IN THE
PROGRAM. WE WOULD ALSO FOR THE
THIS PURPOSE HAS. A SICK INTER.
WITH A COUPLE OF OTHER MAJOR
BUDGET PROPOSALS- IN THE BUDGET
FIRST- AS NOTED BY THE
ADMINISTRATION EARLIER THE CAL
A MEDIC CAL PROPOSAL INCLUDES.
A COMMITMENT TO PURSUE A
FEDERAL WAIVER OPPORTUNITY TO
ACCESS FEDERAL FUNDS FOR
SERVICES IN INSTITUTIONS THAT
NORMALLY MEDICAID WILL NOT PAY
FOR- AND AS THE ADMINISTRATION
NOTED YOU KNOW IN ORDER TO GET
THIS WAIVER APPROVED. THE STATE
WOULD HAVE TO DEMONSTRATE A
COMMITMENT TO BUILDING UP
COMMUNITY TREATMENT OPTIONS TO
SORT OF AVOID A
DISPROPORTIONATE- INSTANT
INCENTIVISING OF INSTITUTIONAL-
PLACEMENT- SOME OF THE
LEGISLATURE MAY WANT TO
CONSIDER IT STANDS ON THAT
KALYAN COMMITMENT AND WEIGH.
THAT AGAINST THE POTENTIAL
BENEFITS OF THIS PROPOSAL- IN
ADDITION THERE'S A PROPOSAL IN
DEPARTMENT OF STATE HOSPITALS
TO. EXPAND COMMUNITY BASED
OPTIONS FOR INDIVIDUALS WHO ARE
INCOMPETENT TO STAND TRIAL- INTHE LEGISLATURE MAY WANT TO ASK
THE ADMINISTRATION HOW IT SORT
OF COORDINATING THESE TWO
EFFORTS. TOGETHER IN ADDITION-
THE ADMINISTRATION IS
PRESENTING THIS PROPOSAL AS
PART OF ITS OVERALL
HOMELESSNESS EFFORTS AND WELL
THERE IS CERTAINLY OVERLAP
BETWEEN INDIVIDUALS
EXPERIENCING HOMELESSNESS AND
THOSE WITH SIGNIFICANT
BEHAVIORAL HEALTH NEEDS- WE
FIND THAT A TARGETING OF FUNDS
TO. SPECIFICALLY TO
INDIVIDUALS- EXPERIENCING
HOMELESSNESS WHO ALSO STRUGGLE
WITH BEHAVIORAL HEALTH ISSUES-
WOULD BE A MORE DIRECT WAY TO
SORT OF GET OUT THE OVERALL
HOMELESSNESS ISSUES THAT THE
STATE. ON THE STATE BASIS- AND
FINALLY AND YOU KNOW AS THE
ADMINISTRATION MENTIONED- THE
COUNTIES UNDER THIS PROPOSAL
WOULD BE- REQUIRED TO SORT OF
PUT UP A LOCAL MATCH AND- ON
THE LEGISLATURE MAY WANT TO
SEEK ADDITIONAL DETAILS TO SORT
OF ON HOW THAT TWENTY FIVE
PERCENT- MATCH LEVEL WAS
DETERMINED AND- IN ORDER TO
SORT OF ASSESS WHAT WHAT
COUNTY'S CAPABILITIES OF. OF
PUTTING UP THAT MATCH WITH THE-
OKAY THANK YOU VERY MUCH. YEAH
I GUESS IT WOULD BE ONE OF MY
FIRST QUESTIONS IS. THE WE HAVE
SO MUCH GOING ON IN THIS SPACE.
DID YOU DID YOU TALK WITH WITH
THE- CATCH ON ON LESSONS
LEARNED FROM THE MENTAL HEALTH
WELLNESS ACT THAT THEY'RE
ALREADY DOING. AND WHY STAND UP
A WHOLE NEW PROGRAM WHEN WE'RE-
IN THE MIDST OF ALL THIS
REFORM. VERSUS JUST GOING WITH
THE WITH THE AGENCY THAT
ALREADY HAS THE EXPERIENCE IN
DOING THIS AND COME MORE
QUICKLY STAND UP AND JUST A
CONTINUE FORWARD. BUT WE HAVE
REACHED OUT TO- TO CAP A TO.
HEAR AND LEARN FROM THEIR
EXPERIENCE HOWEVER- DO YOU FEEL
LIKE A GIVEN THE RESPONSIBILITY
OF THE DEPARTMENT OF HEALTH
CARE SERVICES TO OVERSEE THE-
BEHAVIORAL HEALTH CONTINUE ON.
AS WELL AS IN PARTNERSHIP WITH
OUR OUR COUNTIES IN REGARDS TO
THAT- THAT IT BE OUR
RESPONSIBILITY TO ENSURE THAT
THE FUNDS ARE GOING
SPECIFICALLY TO CLOSING THOSE
CONTINUE I'M GAPS ACROSS THE
STATE OF CALIFORNIA- AND TO
ENSURE THAT THERE IS A
COMMITMENT FOR EXAMPLE TO YOU-
ONGOING. OPERATIONAL MANAGEMENT
OF FUNDS TO ENSURE THAT WE HAVE
THE FROM A SERVICE DELIVERY
POINT OF VIEW THAT MOVING
FORWARD IT'S LARGER THAN JUST-
THE FACILITIES AND THE
ACQUISITION OF A BUILDINGS AND
THE- YOU KNOW REHABILITATION.
IT REALLY IS FOCUSED ON THE
FACT THAT WE WOULD WANT TO
ENSURE THAT THE FUNDS ARE GOING
TO- SERVICES THAT WOULD BE A
LICENSED AND CERTIFIED BY THE
DEPARTMENT THAT THAT IS
COORDINATED- SEAMLESSLY WITH US
IN OR UPON THE- ALLOCATION OF
THOSE FUNDS- AND THAT WE ARE
BEING STRATEGIC IN REGARDS TO.
THOSE CLOSING THOSE GAPS TO
ULTIMATELY REALLY INCREASED I'M
AND HAVE A CLEAR INSIGHT INTO
YOU- MAKING SURE THE DOLLARS
ARE NOT JUST ALLOCATED OUT- OR
THAT WERE REALLY CLOSING ON
CONTINUE ON. GAPS THAT WE SEE
IN CALIFORNIA. I GUESS I WOULD.
A I WOULD AGREE WITH THE SECOND
PART MAYBE NOT NECESSARY THE
FIRST PART AS MUCH BECAUSE I
THINK JUST THAT THAT IS A TON
OF NEW FUNCTIONS THAT YOU WOULD
BE TAKING ON WITH THAT AND THEN
THE QUESTION THE L. A. O. ASKED
ABOUT COUNTIES AND THIS 25% HOW
DO WE COME UP WITH THAT FIGURE
AND DO AND HAVE WE ASSESSED BY
COUNTY THAT WILL BE ABLE. TO
MATCH THAT. SO WE HAVE LOOKED
AT A NUMBER OF PREVIOUS
PROGRAMS IN REGARDS TO WHAT-
HAS. REQUIRED A LOCAL MATCH TO
SEE THE VARIATION OF THE
PERCENT. REALLY GIVEN THE
RESPONSIBILITY THAT THE
COUNTY'S BAIRD REGARDS TO YOU-
BEHAVIORAL HEALTH SERVICES IN
CALIFORNIA SPECIFICALLY WITHIN
THE MEDICAID PROGRAM. WE DID
THINK IT WAS IMPORTANT TO HAVE
A LOCAL MATCH- AND COMMITMENT
TO ATTACH TO THE FUNDS
PROVIDED. I'M SO WE DON'T HAVE
AN EXACT IN REGARDS TO THAT THE
TWENTY FIVE PERCENT- THOUGH WE
DO THINK IT IS IMPORTANT TO
HAVE THE LOCAL MATCH. GIVEN
THAT THOUGH WE ARE TRYING TO BE
AND HAVE. ALREADY HAD
CONVERSATIONS WITH C. B. H. T.
A. N. C.'S ACT. REGARDING
FLEXIBILITY AROUND WHAT THAT
LOCAL MATCHLOOKS LIKE IT COULD
INCLUDE- YOU KNOW COUNTY
GENERAL FUND AN HSA FUNDS. ON
THE OTHER FUNDS THEY CAN ALSO
MATCH IT WITH THE PROPERTY-
COST AS WELL AS YOU KNOW WE
WILL BE. YOU KNOW WILLING TO
WORK WITH COUNTIES ON THE
FLEXIBILITY AT THE LOCAL MATCH
I DO THINK IT'S AN IMPORTANT
PART. REGARDING THE
RESPONSIBILITY COUNTIES
CURRENTLY BEAR. FOR BEHAVIORAL
HEALTH CONTINUUM SERVICES.
THANK YOU. THIRTY PAN. OKAY
THANK YOU VERY MUCH WILL BE
WILL BE FOLLOWING THIS ONE
GREAT INTEREST NUMBER SEVENTEEN
PLEASE. COURSE I'M SO WITHIN
THE GOVERNOR'S PROPOSED BUDGET
WE ARE PROPOSING TO INVEST FOUR
HUNDRED MILLION TOTAL FUND TWO
HUNDRED MILLION GENERAL FUND
OVER THREE YEARS TO INCREASE
THE NUMBER OF A GENDER THREE
TWELVE- STUDENTS ARE RECEIVING
PREVENTIVE EARLY INTERVENTION
BEHAVIOR HEALTH SERVICES
OFFERED BY SCHOOL AFFILIATED
BEHAVIORAL HEALTH PROVIDERS OF
THE FUNDING WOULD BE
DISTRIBUTED VIA INCENTIVE
PAYMENTS- THAT- THROUGH OUR
MEDICARE MANAGED CARE PLANS SO
ESSENTIALLY THE DEPARTMENT IS
PROPOSING A TO HAVE A ROBUST
INCENTIVE PROGRAM THROUGH
MANAGED CARE TO REALLY A LOOK
AT INCREASING ACCESS- TO
SERVICES IT WOULD PAY FOR
INFRASTRUCTURE. PARTNERSHIPS
AND CAPACITY BUILDING- WE DO
ALLOW FOR- VARIATION IN REGARDS
TO THE TYPES OF INCENTIVES IT
COULD INCLUDE FOR EXAMPLE A
THREE WAY CONTRACTS BETWEEN OUR
MEDICAID MANAGED CARE PLAN
TOWNIES IN SCHOOL DISTRICTS- IT
COULD PAY FOR PLANNING SERVICES
FOR HOW DO WE INCREASE ACCESS
TO BEHAVIORAL HEALTH SERVICES
IN SCHOOLS. A FOR TELEHEALTH OR
BILLING PORTAL- IN IN SCHOOLS I
TO BE ABLE TO INCREASE ACCESS
TO- THOSE TYPES OF SERVICES I
WOULD JUST NOTE THE PROPOSAL IS
SPECIFICALLY FOR
INFRASTRUCTURE- CASSIDY
BUILDING EXCEPT A SERVICES CAN
BE BILLED DIRECTLY IN SEPARATE
OUTSIDE OF THIS. THE MAIN
REASON WE ARE PROPOSING IT GOES
THROUGH THE MEDICARE MANAGED
CARE PLANS IS OUR MEDICAL
MANAGED CARE PLANS ARE
RESPONSIBLE FOR THE NON
SPECIALTY MENTAL HEALTH
SERVICES. ABIDED TO OUR
CHILDREN WHICH IS DOMINANTLY
CHILDREN ARE GOING TO BE
NEEDING NON SPECIALTY MENTAL
HEALTH SERVICES- WE KNOW THAT
ARE COUNTY PARTNERS HAVE MADE A
LARGE INROADS IN REGARDS TO
PARTNERING WITH SCHOOL
DISTRICTS TO GET SPECIALTY
MENTAL HEALTH SERVICES IN
PLACE- AND WE ARE REALLY
WANTING TO ENSURE THAT WE ARE.
LOOKING ACROSS THE FULL
CONTINUUM WHERE WE PAY OUR
MEDICARE MANAGED CARE PLANS TO
PROVIDE OF THE NON SPECIALTY
MENTAL HEALTH SERVICES SO THAT
ALL CHILDREN. CAN RECEIVE
BEHAVIORAL HEALTH SERVICES IN
SCHOOLS- AND WE THINK THAT IS
REALLY IMPORTANT TO MAXIMIZE
WELL OUR CURRENT FOCUS IS ALSO
FOCUSED ON INCREASING ACCESS TO
YOU MEDICARE BEHAVIORAL HEALTH
SERVICES IN SCHOOLS. WE DO HOPE
THAT BY PUTTING IN THE
INFRASTRUCTURE- THE LIKE THE
BILLING SYSTEMS THE DATA
SHARING SYSTEMS- THE TECHNICAL
ASSISTANCE THAT'S NEEDED FOR
THE SCHOOL DISTRICTS I TO BE
ABLE TO UNDERSTAND HOW TO
BETTER BILL MEDIC HOUSE
SERVICES AND INTERACT WITH
MANAGED CARE PLANS. THAT WE'D
BE ABLE TO INCREASE ACCESS TO
ALL MEDICAL SERVICES ON SCHOOL
BASED SERVICES. IN THE IN THE
SCHOOLS- WE ALSO THINK THAT BY
INVESTING IN THESE
INFRASTRUCTURE AND CAPACITY
BUILDING WITH SCHOOL DISTRICTS-
THAT IT WOULD IMPACT NON
MEDICAL KIDS AND REALLY ALLOW
FOR YOU KNOW WELL MEDICARE OUT.
IS 5255% OF ALL KIDS ARE ON
MEDICAID ALL ON THERE ARE NON
MEDICAL KIDS THAT COULD GREATLY
BENEFIT FROM SCHOOL DISTRICTS
BEING ABLE TO A BILL AND-
PROVIDE SERVICES TO THOSE OTHER
PAYERS IN THE SCHOOL DISTRICTS
WE THINK THAT IS A- YOU KNOW AN
OUTCOME THAT WOULD. GREATLY
BENEFIT- ALL CHILDREN ACROSS
THE- SCHOOL- WE DO ALSO I KNOW
THAT THIS IS- WE'RE HOPING THIS
WILL BE BRAIDED FUNDING AND
COLLABORATE WITH OTHER KIND OF
FUNDING STREAMS THAT ARE
FLOWING IN THIS WAY BUT- THAT'S
AN HSA- OR OTHER DOLLARS THAT
SCHOOL DISTRICTS. HAVE WE PLAN
ON PROVIDING EXTENSIVE
TECHNICAL ASSISTANCE TO MAKE
SURE THAT IT IS COMPLEMENTARY
ACROSS- THE MEDICARE MANAGED
CARE PLANS THE COUNTY'S L. A.
BACH- AS WELL AS OTHER- AN HSA.
FUNDS BUT WE DO THE IT IS
IMPORTANT. TO MAKE TO WE'RE-
ACCESS TO MEDICAL SERVICES IN
SO. I TO BE ABLE TO DO THIS DO
YOU CS IS REQUESTING A LIMITED
TERM RESOURCES EQUIVALENT TO
TWELVE POSITIONS- WITH THE
FUNDING EXPENDITURE OF ELEVEN
MILLION TOTAL FUN. I TO BE ABLE
TO IMPLEMENT THIS PARTICULAR
PROPOSAL AND HAPPY TO ANSWER-ANY QUESTIONS YOU MAY HAVE.
THANK YOU DEPARTMENT OF FINANCE.
THE COMES AT THIS TIME THANK
YOU BELIAU. THANK YOU SENATOR
EGGMAN ACCORDING ISSUED AGAIN
WITH THE L. A- AGAIN WE
RECENTLY PUBLISHED AN ANALYSIS
OF THIS PROPOSAL ON OUR ON OUR
WEBSITE NOW TO SORT OF GET SOME
BRIEF REMARKS TOUCHING ON SOME
OF THAT THE MAIN POINTS THAT WE
RAISED- FIRST WE JUST KNOW THAT
SIMILAR TO THE LAST PROPOSAL
AND THE CONTINUUM
INFRASTRUCTURE PROPOSAL THERE
THERE ARE SOME SUBSTANTIAL
DETAILS RELATED TO THIS
PROPOSAL THAT- TO OUR
UNDERSTANDING ARE NOT SORT OF
FULLY FLESHED OUT AT THIS
MOMENT TIME. THIS WOULD INCLUDE
FOR EXAMPLE THESE SPECIFIC%
ALLOCATION METHODOLOGY THAT
WOULD DETERMINE HOW THE
INCENTIVE PAYMENTS WILL BE
DISTRIBUTED TO MANAGED CARE
PLANS- AND OUR UNDERSTANDING IS
THAT THE ADMINISTRATION IS ALSO
PROPOSING TO- RELY ON THE
BUDGET BILL PROCESS TO DONE TO
ESTABLISH THIS THIS INCENTIVE
PROGRAM AS WELL AND WESUGGEST
THE SAME SORT OF LIKE TRAILER
BILL- APPROACH THAT. I
DISCUSSED EARLIER IN THE
CONTINUUM THE PROPOSAL. WHEN IT
COMES TO THE INTENT OF THIS
PROPOSAL WE DON'T RAISE ANY
ISSUES WITH THE CONCEPT OF.
INCREASING MANAGED CARE PLANS
FOOTPRINT IN SCHOOLS- WE DO
FIND THAT IT'S NCLEAR WHETHER
THE AMOUNT PROVIDED AN
INCENTIVE PAYMENTS WILL
ACTUALLY INDUCE MANAGED CARE
PLANS TO INVEST IN THESE
PARTNERSHIPS- IN THE
LEGISLATURE MAY WANT TO ASK
ADMINISTRATION HOW IT
DETERMINED THAT THIS FUNDING
AMOUNT WOULD BE- SUFFICIENT TO
SORT OF CHANGE. PLAN BEHAVIOR
IN AN INDUCED THE DESIRED-
PARTNERSHIPS BEING BEING
CREATED- IN ADDITIONWE FIND
THAT THE REAL CHALLENGE WITH
THIS PROPOSAL IS GOING TO BE.
NAVIGATING THE VERY FRAGMENTED
BEHAVIORAL HEALTH DELIVERY
SYSTEM- STUDENTS CAN ACCESS
MEDICAL BEHAVIOR HEALTH
SERVICES THROUGH. SEVERAL INTO
DIFFERENT ENTITIES THAT COULD
BE A COUNTY IT COULD BE A
MANAGED CARE PLAN IT COULD BE A
SCHOOL DIRECTLY- AND THE
ADMINISTRATION TOUCHED ON SORT
OF THE- THE DIVIDING LINE
BETWEEN SPECIALTY MENTAL HEALTH
AND NON SPECIALTY MENTAL HEALTH
BETWEEN- COUNTIES IN MANAGED
CARE PLANS BUT- WHICH ENTITY IS
RESPONSIBLE FOR. FOR WHAT
SERVICE THROUGH MEDIC HOW CAN
CA OFTEN BE DETERMINED
INCONSISTENTLY- AND IN ADDITION
COUNTIES MAY ALSO PROVIDE. SORT
OF THE SAME SERVICES THAT CAN'T
MANAGE CARE PLANS COULD PROVIDE
UNDER THEIR NON SPECIALTY
MENTAL HEALTH RESPONSIBILITIES-
AND JUST USE THEIR LOCAL FINES
INSTEAD OF- PAYING FOR THE
SERVICES THROUGH MEDICARE AL
AND SO. ALL OF THIS IS TO SAY
THAT THIS PROPOSAL REALLY
HIGHLIGHTS THE NEED FOR- THE
ADMINISTRATION TO CLARIFY
EXACTLY WHAT SERVICE GAPS
MANAGED CARE PLANS COULD FILL
UNDER THIS PROPOSAL. AND IT
REALLY ALSO SORT OF HIGHLIGHTS
THE NEED FOR A COMPREHENSIVE
STATE EFFORT EVEN EVEN THINKING
MORE GENERALLY OUTSIDE OF THE
SPECIFIC PROPOSAL. TO
COORDINATE THESE DIFFERENT
ENTITIES TOGETHER. ON TO ENSURE
THAT A ALL THE SERVICES THAT
STUDENTS ARE ENTITLED TO THE
MEDIC CALORIE PROVIDED AND BE
THAT- NO DUPLICATED SERVICES
ARE BEING PROVIDED BY- EITHER
COUNTIES OR OR MANAGED CARE
PLANS- WE WOULD ALSO- REYES
THAT THERE ARE. A. COUPLE OF
OTHER. ALTHOUGH IN THE BUDGET-
RELATED TO STUDENT MEADOW
HEALTH- YOU KNOW THERE'S A-
PROPOSAL TO PROVIDE- IMAGES
FUNDS TO SUPPORT A- STATE GRANT
PROGRAM TO YOU KNOW SORT OF
SUPPORT. YEAH COUNTY SCHOOL
PARTNERSHIPS AND THERE'S ALSO A
PROPOSAL TO PROVIDE- PROP
NINETY EIGHT FUNDS TO SCHOOLS
IN ORDER TO MATCH COUNTY. A MED
STUDENT MENTAL HEALTH
ACTIVITIES AND SO- DISCORDANT
NATION ISSUE IS- IT THAT SORT
OF BRINGS UP THE COORDINATION
ISSUE AGAIN SORT OF- RAISES THE
ISSUE OF THAT- IT'S SORT OF
UNCLEAR HOW. THIS PROPOSAL WILL
SORT OF INTERACT WITH WITH
THOSE OTHER GOALS THAT ARE
THERE IN THE BUDGET. THANK YOU
VERY MUCH. BUT SINCE THE
DIRECTOR COOPER GUEST. I WE ALL
AGREE I THINK AGREE WITH THE
IDEA OF INCREASED BEHAVIORAL
HEALTH SERVICES IN SCHOOLS AND
TO OUR YOUNG PEOPLE. AND I AND
I BELIEVE THIS IS UP AND IT'S
AN ATTEMPT TO TRY TO PROVIDE
ACCESS AND STREAMLINE THINGS.
BUT HOW DO YOU HOW DO YOU. HOW
DO YOU RESPOND TO THE TO THE
ISSUE THAT IN SOME WAYS IT JUST
IT JUST MAKES ONE MORE LEVEL OF
CONFUSION. AND POTENTIALLY
DUPLICATIVE SERVICES AND NOT A
REAL CLEAR PATH ABOUT HOW
SOMEBODY GETS CARE. WHAT I
WOULD SAY THERE IS THAT THE
MEDICARE MANAGED CARE PLANS
HAVE A CLEAR RESPONSIBILITY TO
PROVIDE THE NON SPECIALTY
MENTAL HEALTH SERVICES TO
CHILDREN AND BY CLEARLY
UNDERSTAND THAT SOME COUNTIES
MAY CHOOSE TO. USE A LOCAL
FUNDS TO PROVIDE THOSE SERVICES
YOU'RE ALREADY PAYING THE
MEDICARE MANAGED CARE PLANS TO
DO THIS WE HOLD THEM
ACCOUNTABLE TO IT IN THE
CAPITATION PAID. A RATE THAT WE
PAY THEM- AND SO IT WOULD BE
MORE PRUDENT FOR US SINCE WE
ALREADY PAYING THE MANAGED CARE
PLANS THROUGH THAT- FOR THEM TO
BE ON ENSURING THAT CHILDREN
ARE GETTING ACCESS. TO THOSE
SERVICES I THINK WITH THIS
PROPOSAL OR TRYING TO LOOK A
LITTLE BIT MORE UPSTREAM- IN
REGARDS TO MAKING SURE THAT OUR
KIDS AR GETTING ACCESS EARLY-
AND WE DO THINK THAT THERE IS
AN OPPORTUNITY WITH THIS TO
BETTER STRENGTHEN THE
RELATIONSHIPS BETWEEN THE
MEDICAID MANAGED CARE PLANS. IN
COUNTY BECAUSE THEY DO HAVE A
SHARED RESPONSIBILITY FOR
PROVIDING MENTAL HEALTH
SERVICES AS A WHOLE- BETWEEN
THE TWO OF THEM I TO BOTH
CHILDREN AND ADULTS IN
CALIFORNIA- AND SO WE REALLY WE
DO THINK THAT THERE IS- I'M
STILL A HUGE OPPORTUNITY FOR
EXAMPLE. YOU KNOW TODAY- WITHIN
MANY OF THE BEHAVIOR HEALTH
SERVICES PROVIDED IN SCHOOLS
WHETHER TO L. A. BACH OR
SPECIALTY MENTAL HEALTH- IT
OFTEN TIME IS ONLY AS- REALLY
PROVIDED FOR INDIVIDUALS WITH-
YOU KNOW SPECIAL EDUCATION
SERVICES OR WHEN IT'S IN THE I.
U. P. DEPENDING ON WHICH
PORTION WE'RE TALKING ABOUT-
AND THERE ARE COUNTIES HAD. WHO
HAVE EXPANDED TO THE NON
SPECIALTY SIDE TOO EVEN THOUGH
ULTIMATELY THAT RESPONSIBILITY
IS MANAGED CARE PLANS. HOWEVER
WE WANT TO MAKE SURE THAT
CHILDREN HAVE ACCESS TO THEIR
FULL RIGHTS UNDER U. P. S. U.
D.N. UNDER MEDICAID TO ALL
BEHAVIORAL HEALTH SERVICES AND
ALL MEDICAL SERVICES- AND SO
BY. GIVING THE MANAGED CARE
PLANS INTO THE SCHOOLS WELL WE
DO NEED TO HAVE BETTER UP
COORDINATION WITH OUR COUNTY
PARTNERS IT ALSO ALLOWS ALL OF
THOSE OTHER NON BEHAVIORAL
HEALTH MEDIC HEALTH SERVICES.
TO BE AVAILABLE FOR THOSE
CHILDREN. THE SCHOOLS AS WELL
SO THERE IS THAT ADDITIONAL.
OPPORTUNITY WITH THE LEVERAGE
THE STOCK. IN PUTTING THE AND-
IN PLACE THAT DISTRICTS- CAN
REMOVE THOSE BARRIERS REPORT
FOR A LONG TIME THAT EVERYONE
WANTS TO BE IN THE SPACE. BUT
THEY CAN'T DO IT BECAUSE THEY
DON'T THEY DON'T UNDERSTAND HOW
TO BILL MEDICARE HEALTH THEY
DON'T HAVE THE DATA SYSTEMS TO
DO IT THEY DON'T HAVE THE
BILLING SYSTEMS TO DO IT. AND
SO THESE INCENTIVE DOLLARS ARE
REALLY MEANT TO REMOVE THOSE
HISTORICAL BARRIERS THAT WE'VE
HEARD. I TO BE ABLE TO GET A
SPACE WHERE CHILDREN CAN
MAXIMIZE THEIR FULL MEDICARE
BENEFIT AND NOT JUST A VERY
SMALL PORTION WHICH IS
CURRENTLY BEING PROVIDED TODAY.
THROUGH IF SO THE PLANS ARE
ALREADY WILL BE DOING IT WHY
AREN'T THEY AND WHY DO WE THINK
THIS INCENTIVE IS GOING TO BE
ENOUGH. TO INCENTIVIZE THEM.
IT'S REALLY THE PIECES I WAS
TALKING ABOUT EARLIER YOU KNOW
IT IS COMPLEX JUST TO BE CLEAR
THIS IS. NOT EASY TO DO- BUT
WE'VE HEARD YOU KNOW SCHOOL
DISTRICTS- HISTORICALLY HAVE
HAD CHALLENGES UNDERSTANDING
YOU KNOW WHETHER IT'S
NEGOTIATING WITH THE MANAGED
CARE PLAN- HOW TO BILL HAVING
BUILT SYSTEMS THAT ALLOW FOR
THEM TO BILL- AND THEN BE
REIMBURSED- FOR SERVICES-
XTERRA. AND SO THAT'S WHY DO
THESE BONDS ARE FORCED THE
SERVICES THAT'S ALREADY BUILT
INTO OUR BUDGET TODAY IN
REGARDS TO THE CAPITATION RATES
GOING OUT. THIS IS REALLY TO DO
THE ACTUAL INFRASTRUCTURE
NECESSARY SO IF THEY WANT TO
CONVENE- THE PLAN AS SCHOOL
DISTRICT IN COUNTY TO HAVE A
PLANNING PROCESS TO FIGURE OUT
HOW THEY'RE GOING TO INCREASE.
THE INCENTIVE DOLLARS CAN PAPER
THAT PLANNING AFTER IF YOU PLAY
FOR TECHNICAL ASSISTANCE TO
COME IN I TO HELP. MOVE THE
NEEDLE IN THE SPACE OR TO PUT
IN THE BILLING SYSTEM OR DATA
SHARING SYSTEM. OR A TELEHEALTH
PORTAL THAT COULD BE IN THE
SCHOOLS. THAT ALLOW FOR THE
SERVICES TO BE EASIER ACCESS-
SO IT'S REALLY PAYING FOR THAT
INFRASTRUCTURE OUR PARTNERSHIP
AND CAPACITY BUILDING- WHICH IS
WHAT WE HAVE HISTORICALLY HEARD
ARE THE MAIN BARRIERS FOR BOTH
MANAGED CARE PLANS YOU WANT TO
GET IN THE SPACE. AND SCHOOL
DISTRICTS TO KIND OF GET OVER
THOSE HUMPS INSTEAD OF JUST.
COVERING IT WITH LOCAL FUNDS WE
SHOULD BE MAXIMIZING THE
FEDERAL DOLLARS THAT ALLOW FOR
US TO DRAW DOWN HERE. AS AS
WELL AS THE DOLLARS THAT WE PAY
OUR MEDICARE MANAGED CARE PLANS
IN THIS SPACE AND SO IT'S
REALLY ABOUT BEING PRUDENT WITH
THE FUNDS THAT ARE IN THE
SYSTEM AND THEN. LEVERAGING IT
TO BE ABLE TO DRAW THOSE DOWN
SO THAT'S WHY WE THINK THE
INCENTIVE IS GOOD BECAUSE IT'S-
REMOVING SOME OF THOSE
HISTORICAL BARRIERS FOR WHITE
PEOPLE SAID THEY HAVE. NOT BEEN
ABLE TO MOVE INTO THIS SPACE.
THANK YOU THE CLIP. THANK YOU A
PRE THE THIS PROPOSAL I SHOULD
DRESS FIRST OF ALL FOR MY
REMARKS BY SAYING THAT- I USED
TO BE MEDICAL CONSULTANTS FOR A
SCHOOL DISTRICT AND- BEEN VERY
INVOLVED IN SCHOOL HEALTH
ISSUES THROUGH THE MY PERSONAL
SITE AMERICAN CHAMPIONSHIPS AND
SO I HAVE SOME PRACTICAL.
KNOWLEDGE AND I APPRECIATE THIS
EFFORT SO I GUESS MY FIRST
QUESTION. IS THAT WILL YOU HAVE
A MANDATE. FOR EVERY MANAGE IT
FOR YOU FOR THE MANAGED CARE
PLANS TO PARTICIPATE MEDIC CAL.
TO CONTRACT WITH EVERY SCHOOL
DISTRICT IN OUR REGION. BECAUSE
AFTER ALL THE SCHOOL DISTRICTS
DON'T WANT US AND AT ONE POINT
OUT SCHOOL DISTRICTS ARE
EDUCATIONAL INSTITUTIONS. THEY
DON'T HAVE OR AND THERE'S A
THOUSAND SCHOOL DISTRICTS BY
THE WAY WHO WERE THOUSAND
SCHOOL DISTRICTS IN THE STATE
OF CALIFORNIA. AND MAYBE SOME
OF THE LARGER ONES DO BUT FOR
GENERALLY THEY'RE NOT
INTERESTED IN HIRING A BUNCH OF
STAFF TO NEGOTIATE MANAGED CARE
CONTRACTS. I MEAN IT'S JUST
BLUNT ABOUT IT RIGHT SO THAT'S
WHY I HAVE THAT AND SO IT DID
ACTUALLY BUT WHO'S THE MANAGED
CARE COMPANIES TO- SEVEN IT AND
MAYBE THERE'S A STANDARD
CONTRACT OR SOMETHING THAT YOU
DEVELOPING CONTENT WITH APART
EDUCATION. BUT I WOULD SAY
FIRST OF ALL IS A REQUIREMENT
THAT THE MANAGED CARE COMPANY
HAVE TO HAVE A CONTRACT OF SOME
SORT AND WE CAN. YOU CAN
DEVELOP A BASELINE CONTRACT.
WITH EVERY SCHOOL DISTRICT IN
THE REGION. THAT IN THEIR
SERVICE AREAS SO THAT TODAY ARE
COMPELLED TO ACTUALLY TALK TO
THE SCHOOL DISTRICTS BECAUSE
YOU CAN'T EXPECT SCHOOL
DISTRICTS GO TRY TO FIND A
MANAGED CARE. MANAGED CARE
PLAN- BUSY TRYING TO TEACH KIDS.
SO WITH THIS CURRENT PROPOSAL
WHAT WE HAVE BEEN HERE IS THAT
WE WOULD HIGHER INCENTIVE TO
MANAGED CARE PLANS THAT HAVE. A
HIGHER PERCENTAGE OF SCHOOL
DISTRICTS IN THEIR IN THEIR
SERVICE AREA OKAY SO THAT'S A
TOTAL TO CUT IT MY QUESTION IS
ARE YOU REQUIRE THEM TO. SO
YES. DIALERS THE ANSWER'S NO
WE'RE NOT. HOWEVER I IF I
COULD- WE CONSIDER WITH THE
PARK. IN THE FUTURE TO ENSURE
THAT- PLANS THAT ARE COMING
INTO CALIFORNIA UNDERSTAND THAT
THE FUTURE EXPECTATION WILL BE
THAT MANAGED CARE PLANS IN
CALIFORNIA. DO THAT COMMIT TO
AN ATTEST TO- COMMITTING TO
THOSE CONTRACTS TO PROVIDE.
SERVICES IN SCHOOLS TOTAL SO I
DID AND I JUST WANT TO LOOK AT
ALSO FROM THE PERSPECTIVE OF
THE SCHOOL DISTRICT RIGHT SO
WHAT HAPPENS IS THAT- FOR THE
SCHOOL DISTRICT. YOU KNOW AND
GENERALLY THEY'RE- SOMEWHAT
RELUCTANT. TO SAY THAT THIS SET
A KIDS. GET THE SERVICES AND
THAT'S AT A KIDS DOESN'T NOW
YOU KNOW CERTAINLY THEY DO HAVE
DIFFERENCES LIKE FREE AND
REDUCED LUNCH AT CETERA
ALTHOUGH AGAIN FOR YOU HAVE A
HIGH PERCENTAGE WE DROUGHT SO
YOU CAN IMAGINE THE A SCHOOL
DISTRICT THAT'S BEING SERVICED
BY. YOU KNOW THE TWO PLANNED
COUNTY AGENCY COUNTY OR SOME
OTHER TO THEIR ACTUALLY
MULTIPLE MANA CAL MANAGED CARE
PLANS AND THE PROBLEM IS THAT
ONE PLAN DECIDED TO CONTRACT
THE OTHER ONE DOESN'T AND
THEY'RE SITTING THERE HAVING TO
SORT OUT AND TELL THIS KID
WHO'S ON THAT ACCOUNT NOPE
SORRY WE CAN'T DO THAT BECAUSE
YOUR MANAGED CARE PLAN DIDN'T
STAR USED AND SO GETS THEM INTO
THIS BIND AND THAT AND
GENERALLY IF THEY CAN'T GET ALL
OF THEM. IT'S THIS IS LIKE IT'S
HARD AS A- TO SAY YOU KNOW
WHAT. IF YOU'RE A MEDIC CAL IF
BUT YOU HAVE TO BE ON THIS
PLANNED AND WILL STILL PROVIDE
THE SERVICES TO YOU THROUGH OUR
SCHOOL BUT YOU'RE ON THAT PLAN
WHERE NOTS AND HOW DO YOU
EXPLAIN TO THE PARENTS TO SAY
WILL. GUESS WHAT I'M ON
MEDICARE ALSO HOW COME I'M NOT
GETTING THIS BUT THAT OTHER KID
IS. I MEAN THAT'S A REALLY HARD
PLACE TO BE AND I'M NOT SURE
JUST LAW SCHOOL DISTRICTS ONE
EVEN BE IN THAT PLACE AND
THAT'S WHY ANSWER SAY. INS AND
SOME WAYS THAT IT IN THIS
ACTUALLY. MY PERSPECTIVE SPEAKS
TO. MEDICAL SERVICES SCHOOL AND
GENERAL IS THAT UNLESS YOU FOR
THAT YOU BASICALLY YOU NEED TO
BE SURE ANY CAN IS A MEDIC CAL
AT LEAST WE CAN DRAW A LINE
WHERE IF YOU'RE MEDICARE NOT
MEDI CAL BUT IF YOU'RE ON
MEDICARE AL. THERE NEEDS TO BE
A UNIVERSAL SYSTEM FOR THE
SCHOOL DISTRICT SO THEY'RE NOT
CENTER SORTING OUT WHICH PLAN
YOU'RE IN LIKE EITHER YOU'RE ON
MEDICAID MEDICARE CARD YOU'RE
NOT AND YOU GET THE SERVICE
RIGHT. AND THEN THERE SOME
SYSTEMATIC WAY THAT THEY'RE
GETTING AND BY THE WAY THEY
DON'T HAVE DIFFERENT BILLING
PROCESSES FOR DIFFERENT PLANS
BECAUSE THE AND ARE NOT
INTENDED TO CATION SPACE THEY
DON'T HAVE A BUNCH OF STAFF
SAYING. I HAVE TO FILL THESE
FORMS FOR THIS PLAN THAT FOR
THAT PLANT IS- IN FACT. IF
THERE FRANKLY I WOULD SAY IS
THAT IS THERE FOR SCHOOL BASED
SERVICES. THAT THAT THAT THEY
MIGHT PAY FOR THAT YOU WOULD
ACTUALLY DEVELOP A STANDARDIZED
BOTH BILLING SYSTEM THAT'S VERY
SIMPLIFIED. AND ALSO SOME SORT
OF A BECAUSE YOU GOT TO MAKE IT
REALLY SIMPLE AT SCHOOL
DISTRICT AND BECAUSE THE SCHOOL
DISTRICT IS NOT A HEALTH CARE
FACILITY ALL RIGHT NOW A CLINIC
THEY CAN DEVELOP WHOLE BILLING
SYSTEM SO FOR EXAMPLE IN A HOLE
RIGHT TO SERVICES AT SENTARA
HOSPITAL. EVEN A DOCTOR'S
OFFICE THE SCHOOL DISTRICT YOU
KNOW WE DON'T WANT JUST TO HAVE
THEM HAVE A LARGE AMOUNT OF
OVERHEAD TO FIGURE OUT HOW TO
INTERFACE WITH MEDICARE MANAGED
CARE PLANS. SO I SOLD FOR SO I
GUESS I'D SAY IS THAT. I DON'T
MISTAKE THIS I THINK THIS IS A
GOOD IDEA I APPROVE OF PRESHEAF
PROVIDING INCENTIVES BUT I
THINK IN ORDER FOR IT TO WORK
YOU GOT ALSO LOOK AT FROM THE
SCHOOL DISTRICTS AND- SO
GOVERNOR RIGHT INCENTIVES TO
MANAGED CARE PLANS BUT FOR THEM
SCHOOL DISTRICTS AND THEY DON'T
SIT THERE AND PARSE OUT. WHICH
KID GETS THIS SERVICE WHICH KID
GETS THAT SERVICE AT THE
SCHOOL. AND I THINK WE DO WANT
SCHOOL BASED SERVICES THE
SOMEWHERE AT THE SCHOOL BASED
SERVICE LEVEL THERE'S GOT TO BE
SOME SIMPLIFIED WAY THE SAY
YOU'RE. GONNA GET PAID FOR THIS
THAT AND THAT ON A FIX HE
SCHEDULES ARE NOT. SO WE'RE NOT
GETTING PAID. AMOUNTS FOR. KIDS
FOR THIS SERVICE. AND THEN
PERHAPS THE MANAGED CARE AND
MANAGED PLAN. TO SO DON'T SIT
THERE AND HAVE MULTIPLE. MANAGE
YOU KNOW WHAT. KIDS AT ONE
MANAGED CARE GETTING SERVICES
ANOTHER ONE THAT CAN GET THE
SAME SERVICES WE GOT
STANDARDIZED PACKAGE THERE. AND
THEN OF COURSE THE MANAGED CARE
PLAN CAN ALSO PROVIDE. YOU KNOW
THROUGH THEIR OWN NETWORKS AND
SO FORTH THE NON SCHOOL BASED
YOU KNOW STUFF BECAUSE THEY'RE
GONNA HAVE REFERRALS TO
COUNSELORS AND STUFF. OUTSIDE
THE SCHOOL. THAT DAY AND THEY
CAN DO THEIR OWN NETWORK
WHATEVER THING BUT IN TERMS OF
THEIR INTERFACE WITH THE
SCHOOL. IT HAS TO BE.
STRAIGHTFORWARD AND SIMPLE. AND
WE MAKE IT. TOO COMPLEX WE'RE
TALKING ABOUT HAVING CONTRACTS
AND THINGS LIKE THAT. EARLY L.
DID YOU HAVE TO NEGOTIATE
INDIVIDUAL CONTRACTS THAT MAYBE
IT IS A STANDARD CONTRACT
THAT'S FINE BUT INDIVIDUAL
CONTRACTS OR SO FORTH. YOU'RE
GONNA NOT THAT THE UP TAKE IT
THINGS CAN BE FAIRLY LOW. YOU
HAVE A LOT OF MISSING SCHOOL
DISTRICTS AND WE'RE NOT GONNA
CHIEF THE AIM TO ACHIEVE SO. I
REALLY DO APPRECIATE THAT
YOU'RE MAKING AN EFFORT IN THIS
PROPOSAL BUT JUST FROM MY OWN
EXPERIENCE. AND THEN MY OWN
KNOWLEDGE TALKING TO SCHOOL
DISTRICTS I MEAN AFTER ALL THIS
THIS WAY- WHEN I WAS HERE
ASSEMBLY HEALTH COMMITTEE. I
HATE I COULDN'T GET THE ACS AND
DEPARTMENT I HAD TO FORCE THE
JUSTICE DEPARTMENT STATION TO
TALK TO EACH OTHER. ABOUT ELLIE
A BILL EVEN MEET AND HOW WE GOT
A MEETING GOING. I MEAN THAT'S
THE DISTANCE THAT WE'RE STILL
TRYING TO CROSS AND THINGS ARE
BETTER NOW BUT- I THINK YOU
REALLY DO HAVE TO LOOK AT IT
FROM THE SCHOOL DISTRICT AND
BECAUSE I THINK THAT'S WHAT
YOU'RE UP TAKE PROBLEMS GOING
TO BE. AND IF YOU DON'T MAKE
THE MANAGED CARE COMPANIES DO
SOMETHING YOU KNOW. BE ABLE TO
DO SOMETHING SIMPLE WITH SCHOOL
DISTRICTS AND SOMETHING
CONSISTENT ACROSS. THEN YOU
TODAY THEN FORTUNATELY I THINK
THIS NOT JUST INCENTIVES. IT
HAS TO BE A SET UP A SERVER.
INFRASTRUCTURE THAT'S
DEVELOPED. WITH THE USER IN
MIND WHICH IS THE SCHOOL
DISTRICT. AS WELL OF COURSE THE
STUDENTS IN SCHOOL. I ALL YOU.
COMMENTS ARE ARE WELL TAKEN AND
THINGS THAT WE HAVE BEEN-
THINKING THROUGH ON OUR SIDE
BECAUSE WE DO KNOW THAT- SOME
OF THE LARGEST CHALLENGES WOULD
BE FOR THE SCHOOL DISTRICT
ESPECIALLY. IN PARTS OF THE
STATE- SACRAMENTO AND SAN DIEGO
FOR EXAMPLE WHERE THERE ARE SO
MANY MANAGED CARE PLANS. WE'VE
BEEN TRYING TO THINK THROUGH
CONCEPTS FOR. ON THE HW WE SET
UP THE INCENTIVES FOR IF WE DO
REQUIRE. I'M CERTAIN PLAYERS BE
AT THE TABLE TO RECEIVE THE
INCENTIVES OF FOR YOU KNOW THE
POINTS THAT YOU'VE EXACTLY
MADE. I THINK WE'RE CONTINUING
TO THINK THROUGH THOSE THINGS
AND I THINK. I WOULD BE HAPPY
TO CONTINUE TO BRAINSTORM WITH
THE LEGISLATURE REGARDS TO HOW
TO MAKE THIS A SUCCESSFUL AS
POSSIBLE. I THINK WE ALL AGREE
THE NEED IS THERE- I ACTUALLY
THINK YOUR IDEA IN REGARDS TO A
STANDARD. A CONTRACT INTO
PIECES IS VERY INTERESTING AND
SOMETHING THAT WE CAN TAKE BACK
AND CONTINUE TO THINK THROUGH
AS THIS. PROPOSAL INVOLVES AND
WE FIGURE OUT HOW. HOW WE
REALLY CAN MOVE THE NEEDLE IN
REGARDS TO YOU- GETTING THESE
SERVICES IN SCHOOLS. OKAY WHAT
APPRECIATE THAT- I. THIS IS
SOMEONE WHO'S BEEN IN THIS
SPACE ACTUALLY INTERESTING
AFTER. THE PROJECT I WORKED ON
FOR- WITH SCHOOL DISTRICT THAT
WAS ACTUALLY IMPROVING CARE FOR
CHILDREN ADHD GET A MENTAL
HEALTH ISSUE- SO. WE ACTUALLY
PUBLISH THE RESULTS IN THE
JOURNAL- AND THE VERY
INTERESTED IN WHAT YOU'RE
PLANNING IS AND YOU THOUGHT AND
HOW YOU'RE ALSO ENGAGING THE-
EDUCATION COMMUNITY AND THIS.
TO BE SURE THAT WE HAVE IT'S
NOT YOU KNOW BECAUSE- YOU'RE
USED TO. THAT'S WHAT I. AM I'M
SURE. THE MANAGED CARE
COMPANIES ARE USED WITH YOU
BECAUSE YOU KNOW YOU DO HAVE
THAT. AT THE END OF. TO ALSO
NEEDS TO BE. TO BE SURE TO WORK
FOR THEM BECAUSE BECAUSE YOU
NEED TO HAVE BOTH TO MAKE THIS
WORK AND I'M NOT SAYING THAT
YOU HAVEN'T TALKED TO THEM BUT-
IT. I THINK THAT'S- A VERY
IMPORTANT PIECE AM VERY
INTERESTED IN SEEING. MORE
SPECIFICS ON HOW YOU PLAINTIFF
TO ROLL THIS OUT THAT BECAUSE I
ACTUALLY WANT THIS TO HAPPEN SO
I DON'T MEANT THAT ONLY NEEDS
BECAUSE OF YOU JUST LIKE- I
DON'T THINK WE SHOULD DO THIS-
BUT I'M REALLY GLAD THAT YOU'RE
TRYING TO DO THIS AND I. BUT I
ALSO WANT TO SEE SUCCESSFUL
ANNA YOU TOO AS WELL AND SO
HOPEFULLY WE CAN SHARE. OUR
KNOWLEDGE AND EXPERIENCES- TO
MAKE THAT HAPPEN. YES WE WOULD
APPRECIATE CONVERSATIONS AND WE
HAVE. ALREADY DONE OUTREACH TO
AND THE DEPARTMENT OF EDUCATION
WILL CONTINUE TO PARTNER WITH
THEM AND LOOK FOR DEPARTING
WITH YOU. THANK YOU VERY MUCH
OKAY- NOW I THINK WE WILL BE
MOVING ON ISSUE NUMBER EIGHTEEN.
MENTAL HEALTH SERVICES ACT
FLEXIBILITIES YES- AS A PART OF
THE TWENTY TWENTY BUDGET ACT AB
EIGHTY ONE ALLOWED FOR
TEMPORARY FLEXIBILITIES FOR
COUNTIES DUE TO THE PUBLIC
HEALTH EMERGENCY. IT ALLOWED
COUNTIES TO SPEND DOWN THERE A
LOCAL AND I JUST SAY PRUDENT
RESERVES AS OPPOSED TO
SUBMITTING A REQUEST U. G. H.
YES. ON THAT ALLOWED COUNTY
SUSPENDED CLINICAL SERVICES AND
SUPPORTS PROGRAM FUNDING
REGARDLESS OF SUBCOMPONENTS.
ALLOWED COUNTIES TO USE THEIR
CURRENT APPROVED THREE YEAR
PLAN OR ANNUAL UPDATE- IF THE
BEHAVIOR HEALTH DIRECTOR
CERTIFIES THAT THEY WERE UNABLE
TO SUBMIT A NEW. PLAN DUE TO
THE PUBLIC HEALTH EMERGENCY IT
ALSO EXTENDS THAT- THE
REVERSION A DEADLINE FOR THE
UNSPENT COUNTY FUNDS SUBJECT TO
REVISION AS OF JULY. ONE TWO
THOUSAND NINETEEN TO. THE LIGHT
NOW TO TWENTY ONE- AND ALLOWS
THE CS TWO ACHIEVE THE ABOVE A
THROUGH BALL IT'S AN AUTHORITY
ON SO THIS LITTLE IDEAS YES
EXPAND THE CURRENT
FLEXIBILITIES FOR ANOTHER YEAR
GIVEN THE ON GOING PUBLIC
HEALTH EMERGENCY- AND. HELLO
THANK. I THINK THIS MAKES SENSE
TO ALL OF US- MOVING ON TO
ISSUE NUMBER. NINETEEN SO HERE
DHS IS REQUESTING- PARKS MAY
MILLION DOLLARS FOR TWO YEAR
LIMITED TERM CONTRACTOR
RESOURCES TO PROVIDE A USER
ACCEPTANCE TESTING- AND
TECHNICAL SUPPORT TO COUNTY ON
MENTAL HEALTH PLANS A DRUG MEDI
CAL GMC IDEAS TO IMPLEMENT-
HEALTH PROVIDER DIRECTORY
EXPANSION ON THE HEALTH
PROVIDER DIRECTORY EXPANSION
PROJECT IS A DEPARTMENT WIDE
INITIATIVE TO STANDARDIZE THE
FORMAT CONTENT AND TRANSMISSION
OF MEDICAID MANAGED CARE
PROVIDER NETWORK DATA TO THE
DEPARTMENT WE ARE EXPANDING
THAT TO OUR BEHAVIORAL HEALTH
COUNTERPARTS I'M HAPPY TO
ANSWER ANY QUESTIONS. TURN TO
FINANCE ANYTHING. THE PART LMAO.
pTHE SPECIAL ONES AT THE END
OKAY NUMBER TWENTY. YES HERE-
THE DEPARTMENT IS REQUESTING
EXPENDITURE THIRTY TO IMPLEMENT
THE ASSISTED OUTPATIENT
TREATMENT PROGRAM- EXPANDED
STATEWIDE BEGINNING JANUARY ONE
TWENTY TWENTY ONE UNLESS A.
COUNTY CHOOSES TO OPT OUT
THROUGH THE BOARD OF SUPERVISOR
APPROVAL. OF PARTICIPANTS IN
THE ASSISTED OUTPATIENT
TREATMENT ARE INDIVIDUALS WITH
SERIOUS MENTAL HEALTH ILLNESS-
AND WHO ARE AT RISK OF
INSTITUTIONALIZATION- BUT
OTHERWISE YOU SERVE IN AN
INSTITUTIONAL SETTING- AND
HAPPY TO ANSWER ANY QUESTIONS
REGARDING THIS REQUEST.
DEPARTMENT FINANCE. HELLO
SOUNDS LIKE A FINE IDEA
DOCUPRINT YEAH I JUST WANNA SAY
IT'S VERY IMPORTANT THAT- WE
FUND THE IMPLANTATION OF THE
OUTSTANDING BILLS. THE. TWENTY
ONE. ALL RIGHT SO HERE. THERE
ARE OTHER DEPARTMENT IS
REQUESTING FOR POSITIONS IN
EXPENDITURE AUTHORITY- OF
APPROXIMATELY SIX HUNDRED
THOUSAND DOLLARS TO IMPLEMENT
SB FOUR OH SIX BY TAKING ACTION
ON COMPLAINTS AGAINST RECOVERY
RESIDENTS OF ASSOCIATED WITH
LICENSE FACILITIES THAT PROVIDE
UNLICENSED SUV TREATMENT
SERVICES OF POSITIONS WOULD BE
USED TO DEVELOP AND IMPLEMENT
REGULATIONS- PROTOCOLS
COMPLIANCE REVIEWS AND TO
INVESTIGATE COMPLAINTS AND
HAPPY TO ANSWER ANY QUESTIONS.
DEPARTMENT FINANCE. HELLO THIS
MONTH CAMPUS ONE MAKES SENSE
ALSO DOCTRINE ADJUSTER BEGAN
PRE SHOULD THE PROPOSED WITH OF
PRO SO I DO WANT KNOWLEDGE EVEN
THOUGH THE ANALYSIS IT IS A
COMMITTEE BILL THANK OF OUR
HEALTH AND THAT WOULD INCLUDE A
PROVISION THESE PROVISIONS
RELATE TO CENTER BATES SO I
WANT TO ADD RECOGNIZE AND-
THAT- THIS IS- CENTER BATES-
AND PLANTATION. AND- CERTAINLY
HAPPY TO HAVE. TO SEE THIS
MOVIE. THANK YOU. THANK YOU
VERY MUCH- ALL RIGHT AND I
THINK THAT CONCLUDES THE ITEMS
THAT WE'VE BEEN TALKING TO WE
CERTAINLY- WHEN I GO TO PUBLIC
COMMENTS NOW BUT WE CERTAINLY
THANK YOU FOR. ALL THE TIME
THAT YOU PUT IN BOTH TODAY AS
WELL AS ALL YEAR LONG IN
PREPARATION FOR THIS ALSO
DEPARTMENT FINANCING L. A. O.
WE APPRECIATE YOUR HARD WORK-
IF WE COULD NOW. WE'RE GONNA
AGAIN HOLD EVERYTHING OPEN FOR
NOW BUT WE'RE GOING TO MOVE TO
ANYONE WAITING TO PROVIDE
PUBLIC COMMENT- AND AS A
REMINDER TODAY'S PARTICIPANT
NUMBER IS. EIGHT FOUR FOUR TWO
NINE ONE SIX THREE SIX FOUR.
AND THE ACCESS CODE IS. ONE
FOUR ONE SEVEN SIX ZERO NINE.
DUE TO TIME CONSTRAINTS I'M
GONNA ASK CALLERS TO PLEASE
KEEP YOUR CALL TWO ONE MINUTE.
MEDINA BY YOURSELF AND THEN GO
ON ONE MINUTE AND THEN WILL BE
MOVING ON. ARE THERE ANY
WITNESSES IN THE HEARING ROOM
MIGHT SEE NONE. OKAY. AND THEN
NOW WILL MOVE TO THE
TELECONFERENCE LINE FIRST
CALLER PLEASE. ELLER MINDRE IF
YOU WISH TO MAKE PUBLIC COMMENT
PLEASE PRESS ONE FOLLOWED BY
ZERO. AND YOU WILL ALSO WANT TO
MUTE YOU'RE WELCOME CAST ALL
YOUR PHONE LINES OPEN. I'M SURE
YOU READY FOR THE FIRST COMMENT
I'M READY. THANK YOU OVER THE
LINE TWENTY EIGHT. TWO EIGHT
PLEASE GO AHEAD. THANK YOU ALL
RIGHT VENTURE ON BEHALF- TEN
AND THE CALIFORNIA TELL NETWORK
REGARDING ISSUE NUMBER EIGHT.
ODIN'S NETWORK OF COMMUNITY
CLINICS INCLUDES THIRTY TWO
CALIFORNIA MEMBERS SERVING
NEARLY ONE POINT FIVE MILLION
NETWORK PATIENTS HAVE TO THOSE
RECEIVING CARE UNDER BACK. IN
TWENTY TWENTY ORGANIZATION THEN
THE PASSWORD YOU SEEN OVER TWO
POINT EIGHT MILLION UNIQUE AND
CALIFORNIA AND AS A RESULT
DIRECT RESULT OF THE TELEFLEX
ABILITIES AND EXPANSION
THROUGHOUT TWENTY TWENTY. 37%
OF THOSE ENCOUNTERS WERE
CONDUCTED USING TELEHEALTH THE
MAJORITY IN PRIMARY CARE
SERVICES. HELLO THIS IS AN
ESSENTIAL TO ADVANCING
HEALTHCARE HEALTH CARE WOULD BE
FOR EXAMPLE PROBABLY 47%
MOTIONS CAL POLY NETWORK
PATIENTS ARE HISPANIC. AND 31%
OVER FIFTY YEARS OF AGE OF
THESE PATIENTS THE COUNTERS 45%
WERE DELIVERED IN A LANGUAGE
OTHER THAN ENGLISH WITH THREE
OUT. OF FOUR PATIENTS
CIRCUMSTANCES. OKAY STRONG WITH
A COULD THAT. ABILITY
PARTICULARLY ENSURING PAYMENT
IN ALL SETTINGS INCLUDING
ACTUATE THESE. ESPECIALLY
CRUCIAL ITS PARITY FOR AUDIO
ONLY APPOINTMENT. ABOUT TWENTY
SIX PERCENT- TO DEVELOP IT THAT
WERE AUDIO ONLY MOST OF WHICH
WERE BEHAVIORAL HEALTH
SERVICES. BOTTOM LINE
INDIVIDUALS THE BASE AFTER THE
FIRST IN PERSON CARE HAVE BEEN
ABLE TO RECEIVE CARE. BY
TELEHEALTH DURING COLD IN
NINETEEN. PATIENTS WHO STATED
THEY NEEDED HOUSING
TRANSPORTATION SUPPORT OR 40%
AND 70% MORE LIKELY TO USE
TELEHEALTH RESPECTIVELY.
REGENERATION PARODYING EXPANDED
TELEHEALTH COVERAGE INCLUDING
AUDIO AND SERVICES FROM
ACTUATES THESE IS ESSENTIAL IN
ORDER TO MAINTAIN ACCESS TO
CARE FOR HIGH RISK. AND
LOCATIONS THROUGHOUT THE STATE
HELP MANY OTHERS OVERCOME
COMMON HEALTHCARE PAYERS SUCH
AS WORK EDUCATION CHILD CARE.
BEYOND THE ENDEMIC THANK YOU
FOR YOUR TIME. THANK YOU VERY
MUCH OUR NEXT CALLER PLEASE
PLEASE TO LIMIT YOUR YOUR CALL
YOUR COMMENTS TO MAN. WE'LL GO
TO LINE SIXTEEN ONE SIX YOUR
LINE IS OPEN. THEN CHAIR- AND
MEMBERS OF TRUCKS AND GOLD IN
THE INTEREST OF TIME I'M
CALLING REPRESENTING THE
AMERICAN NURSES ASSOCIATION OF
CALIFORNIA AND CALIFORNIA
ASSOCIATION OF CLINICAL NURSE
SPECIALIST. IN SUPPORT OF ITEM
NUMBER NINE. THANK YOU VERY
MUCH NEXT CALLER PLEASE. NINE
FORTY FOUR ZERO YOUR LINE IS
OPEN. HELLO MADAM CHAIR AND
VENDORS IT IS ENGAGED YET ON
BEHALF OF YEAH YOU CALIFORNIA
HERE TO SHARE A QUICK COMMENT
ON THE ADMINISTRATION'S HAKIM
BEHAVIOR HEALTH AND TELEHEALTH
PROPOSAL FIRST ON CAMPAIGN WE
APPRECIATE SOME OF THE SLIGHT
CHANGES IN THE SECOND PROPOSAL
ENSURING THAT THERE IS A LEVEL
OF CONTINUITY BY REQUIRING
MANAGED CARE PLANS TO CONTACT
THE COUNTY WHOLE PERSON CARE
PROVIDERS. BUT WE WOULD STILL
LIKE TO EMPHASIZE THE ROLE OF
OUR COUNTY WORKERS SPECIALLY
THEIR SKILLS AND KNOWLEDGE OF
LOCALLY AVAILABLE RESOURCES TO
MAKE TIMELY AND DIRECTLY PEARL
CONNECTING PEOPLE TO CRITICAL
SERVICES WE STILL HAVE A LOT OF
QUESTIONS ON THE MANAGED CARE
PLANS ABILITY TO EITHER PROVIDE
THE SERVICES IN HOW OR WHO THEY
END UP CONTRACTING OUT TO. ADD
ECM NEED CARE MANAGERS IN THE
FUTURE SECOND ON THE BEHAVIORAL
HEALTH THAT INVESTMENT WE
GENERALLY SUPPORT THE SEVEN
HUNDRED FIFTY MILLION DOLLAR
INVESTMENT AS WELL AS THE THREE
HUNDRED EIGHTY NINE MILLION
DOLLAR INVESTMENT ON STUDENT
MENTAL HEALTH. ALTHOUGH FOR THE
SEVEN HUNDRED FIFTY MILLION
DOLLARS WE'D LIKE TO ALSO
REQUEST THAT THE FUNDING COULD
BE USED TOWARDS IMPROVING AND
UPGRADING EXISTING IT SYSTEMS
AND I BEHAVIORAL HEALTH
DELIVERY SYSTEM IN ORDER TO
BUILD OUT LINKAGES FOR DATA
THAT WE ACTUALLY KNOW WHAT BEDS
ARE AVAILABLE AND WHAT RELATED
SERVICES ARE PROVIDED OR COULD
BE PROVIDED BY HOSPITALS. AND
PSYCHIATRIC FACILITIES AND
LASTLY ON TELEHEALTH WE ARE
ALSO GENERALLY SUPPORTED OF
EXPANDED ACCESS TO CARE BUT
WANT TO MAKE SURE THAT THIS IS
ADDITIVES AND IT WOULD NOT-
HOPEFULLY IMPACT OR ELIMINATE
EXISTING WORK FORCES THANK YOU.
THANK YOU VERY MUCH NEXT CALLER
PLEASE. MIND NINE FIVE NINE
YEAR LINE IS- OPEN. THIRTY FIVE
THANK YOU MADAM CHAIR AND
MEMBERS OF THE PARLIAMENT
DATING ON BEHALF OF THE
CALIFORNIA STATE ASSOCIATION OF
COUNTIES IN THE RUN THROUGH
OTHER FIVE ISSUES THAT WORK- WE
WERE MONITORING TODAY IN THE-
FINAL DAYS WE APPRECIATE ON
ISSUE TO THE PUBLIC RESPONSE
FOR DHS. WE APPRECIATE THAT YES
YES THE TURNED ON A DIME A
VERITABLE BUYING THROUGHOUT THE
ENTIRE ENDEMIC IT AND JUST THE
PARTNERSHIP HAS BEEN GREAT AT
THE FAR AND THAT'S SOMETHING I
HAVEN'T BEEN ABLE TO STAY FOR A
LONG TIME BUT WANTED TO MAKE
SURE THAT THE COMMITTEE. WAS
AWARE OF THAT ALL ON ISSUE FIVE
CALTRAIN WERE UP BROADLY
SUPPORTIVE OF THE WHOLE
KELLYANE EFFORT OF COURSE THE
DEVIL WILL BE IN THE DETAILS-
INCLUDING HEALTH PLANS PLANNED
OUTREACH TO MEMBERS OR NOT-
PERSPECTIVE MEMBERS. SO AGAIN
WE'RE WORKING CLOSELY WITH THE
ATS AND OUR PARTNERS IN THAT
AREA ON ISSUE SIXTEEN THE
BEHAVIORAL HEALTH THE
GOVERNOR'S PROPOSAL FOR.
INVESTING SEVEN HUNDRED FIFTY
MILLION DOLLARS INTO THE
BEHAVIORAL HEALTH HOUSING
CONTINUE AWARE STRONGLY
SUPPORTIVE OF THAT ISSUE WE
ALSO ARE SUPPORTIVE OF THE TWO
EIGHTEEN WHICH IS THE IMAGE OF
FACEBOOK'S ABILITY AND I WE ARE
PLEASED TO SUPPORT ISSUE TWENTY
MADAM CHAIR THE IMPLEMENTATION
OF AB NINETEEN SEVENTY SIX WITH
THAT SOME ADDITIONAL STAFF FOR
DETAILS HELP WITH THAT
WORKLOAD. AND LASTLY TO ISSUES
THAT CAME UP DURING THE HEARING
BUT WERE ON THE AGENDA THAT
QUALITY IMPROVEMENT FUNDING IS
THAT MS COOPER MENTIONED- FOR
COUNTIES TO- GET BETTER DATA TO
BETTER TRACK OUTCOMES WERE
STRONGLY SUPPORTIVE OF THAT AND
THEN WE'RE SUPPORTIVE OF THE-
WHY DO YOU RECOUP MIX- YOU
HEARD FROM- THERE AT DEPARTMENT
FINANCED- THE THROW MOST I'M
TALKING ABOUT THE RECRUITMENT
WE ASK THAT THE STATE. THE PER
THAT RECRUITMENT FOR THE
CURRENT YEAR AND ARE IN TALKS.
WITH THE ADMINISTRATION AND
OTHERS. I CAN I WANT TO- THE-
ON BEHALF OF ALL FEET
CALIFORNIA COUNTY. THANK YOU
THANK YOU THANK YOU NEXT. ONE
IS. I SIXTY ONE SIX Y. PLEASE
GO AHEAD. GOOD AFTERNOON THIS
KELLY I WILL COMMON ON PROPOSED
ON THE OF FORD CLIENTS FIRST ON
HOW AIM I'M HAS A ON THE OF THE
K. ASSOCIATION OF PUBLIC AND
SYSTEMS. THE COUNTY HEALTH
EXECUTIVE ASSOCIATION OF
CALIFORNIA AND URBAN COUNTY
POCKET HOW IN A CRITICAL FOR
THE PUBLIC HEALTH CARE SYSTEM
AND COUNTIES LEADING WHOLE
PERSON CARE PILOTS UNDER THE
ELEVEN FIFTEEN LABOR THE PILOTS
COME TO AN END ALLEN PROPOSES
TO SUSTAIN AND EXPAND UPON THE
IMPORTANT WHOLE PERSON CARE
MANAGEMENT AND WRAPAROUND
SERVICES BY INCORPORATING
MANAGEMENT MEDICAID MANAGED
CARE. ADEQUATE FINANCING AND
ROBUST COOPERATION BETWEEN
PUBLIC HOSPITALS ASSEMBLY
COUNTY THE MANAGED CARE PLANS
WILL BE ESSENTIAL TO ENSURE A
SMOOTH TRANSITION COMET HAS
UNDERSCORE THE CRITICAL ROLE
THAT COUNTIES IN PUBLIC
HOSPITAL SYSTEM HAPPENED DURING
THE MOST VULNERABLE. AND NOT
VALUE SHOULD BE LEVERAGED UNDER
KELLY LASTLY THE TIMELINE IS
INCREDIBLY AMBITIOUS WE MUST
CLOSELY MONITOR LOCAL
IMPLEMENTATION READY THAT THE
DOCTOR IS NEEDED- SECOND ON THE
ISSUE RELATED TO TELEHEALTH AND
TESTIFYING ON BEHALF OF THE
CALIFORNIA ASSOCIATION PUBLIC
HOSPITALS AND HEALTH SYSTEMS.
TELEHEALTH HAS BEEN ABSOLUTELY
CRITICAL FOR PUBLIC HEALTH CARE
SYSTEM DURING THE PANDEMIC MANY
PATIENTS HAVE COME TO PREFER
CONNECTING WITH OUR PROVIDERS
VIA TELEHEALTH AND THAT WILL
STILL BE TRUE POST PANDEMIC
VIDEO THAT ARE NOT AVAILABLE
VIABLE OPTION FOR MANY OF OUR
PATIENTS OF IDEA ONLY FROM
THOSE THAT HAVE BEEN A CRITICAL
MODALITY AND WE MUST CONTINUE
TO ALLOW IN THE MEDICAL
PROGRAM. TO ENSURE EQUITABLE
ACCESS TO CARE SOME BUSINESS
CAN BE A GOOD SUBSTITUTE FOR
CERTAIN TYPES OF IN PERSON AT
THAT AND WHEN THE SAME
STANDARDS OF CARE ARE MET WE
BELIEVE PAYMENT SHOULD BE THE
SAME AS IF IT HAD BEEN IN
PERSON WE LOOK FORWARD TO
CONTINUING TO WORK WITH THE
DEPARTMENT ON THIS IMPORTANT
ACCESS POINT FOR PATIENTS-
NEXT- CAUGHT IN REGARDS TO THAT
SEVEN HUNDRED FIFTY MILLION
DOLLAR PROPOSAL FOR BEHAVIORAL
HEALTH INFRASTRUCTURE- BOTH
URBAN COUNTIES. OF CALIFORNIA
AND- RIVERSIDE COUNTY SPPORT
THAT PROPOSAL AND FINALLY- ON
BEHALF OF A RESPECT HONEY I
WANTED TO MENTION THEY ARE
LOOKING VERY CLOSELY AT THE
STUDENT BEHAVIORAL HEALTH-
PROPOSAL THAT RECEIVED A LOT OF
CONVERSATION THIS AFTERNOON AND
TRYING TO FIGURE OUT HOW THAT
PROPOSAL COMPLEMENT SOME OF THE
EXISTING WORK BUT IT'S GOING ON
BETWEEN SCHOOL DISTRICTS. AND
COUNTY. BEHAVIORAL HEALTH- AND
WE LOOK FORWARD THE- RECEIVE
MORE INTO. IF YOU THANK YOU.
APPRECIATE THANK THANK YOU VERY
MEXICO PLEASE. WHY AM SIXTY TWO
SIX THREE GO AHEAD. I THANK YOU
MADAM CHAIR MEMBERS KATHY
SOUTHERLY MAKE ALL FOR THE
COUNTY WELFARE DIRECTORS
ASSOCIATION FIRST I'D LIKE TO
ASSOCIATE- PETER BDA WITH THE
COMMENTS REGARDING WHOLE PERSON
CARE THAT WERE MADE BY THE
PRIOR SPEAKER Y BROOKLYN NY.
ADDITIONALLY WE REALLY
APPRECIATE THE CONVERSATION ON
ITEMS TWO AND THREE RELATED TO
MEDICAL CASELOAD AS WELL AS
WHAT HAPPENED TO THE PUBLIC
HEALTH EMERGENCY AFFLICTED WITH
REGARD TO OUR COUNTY
ELIGIBILITY AFTER PROCESSING
CASES THAT HAVE WILL HAVE BEEN
IN SOME CASES I'M NOT LOOKED AT
FOR TWO YEARS OR LONGER. WE ARE
WORKING CLOSELY WITH THE STATE
AND THEY NOTED THAT HAVE
PROVIDED SOME THINKING IT WILL
LOOK FORWARD TO WORKING CLOSELY
WITH THEM AND ALL OF THEM
GAUGING AND ADVOCACY AT THE
FEDERAL LEVEL TO ENSURE THAT
THE FEDERAL- CENTERS FOR
MEDICARE AND MEDICAID SERVICES
PROVIDE SUFFICIENT TIME FOR
STATE TO PROCESS THE CASES THAT
HAVE BEEN PUT ON HOLD DURING
THE PANDEMIC. THANK YOU FOR
YOUR TIME. THANK YOU VERY MUCH
NEXT CALLER PLEASE. NINE SIXTY
FOUR SIX FOUR MINUTE OPEN.
THANK YOU MADAM CHAIR MEMBERS
THAT HE THAT WOULD KEEP YOU
PUBLIC AFFAIRS ON BEHALF THE
CALIFORNIA ACADEMY OF FAMILY
PHYSICIANS. I'M TELLING WE
APPLAUD THE DEPARTMENT
COMMITMENT TO IMPROVING QUALITY
AND OUTCOMES REDUCING
DISPARITIES AND TRANSFORMING
DELIVERY SYSTEM THESE WERE NOT
BEING DISCUSSED EVEN JUST TEN
YEARS AGO ENGAGED YES SHOULD BE
COMMENDED FOR INCORPORATING
THOSE PRINCIPLES AND THE
HEALTHCARE POLICY FOR VERY
VULNERABLE INDIVIDUALS. WE
APPRECIATE THE COMMITTEE'S
QUESTIONS REGARDING OVERSIGHT
OF MANAGED CARE PLANS WE TAKE
ON MORE AND MORE RESPONSIBILITY
PRETTY PATIENT CO COMPLEX
CONDITIONS WE URGE THE
COMMITTEE ENGAGE THE ATTHE
PRIMATOLOGY BASED PAYMENT IN
PRIMARY CARE THE COLORING NEEDS
REFORM. THIS INCLUDES GREATER
OVERSIGHT OF CONTRACTED PLANS
DOWN THROUGH THEIR DELEGATED
ENTITIES RATHER BMX IF YOU FOR
SERVICE PAYMENTS AND CONTRACT.
VALUE BASED PAYMENT SUPPORT
PATIENT CENTERED CONTINUOUS
CARE AND ANY TRANSFORMATION
MEDICAL DELIVERY MUST INTEGRATE
THE OTHER MEANS. BETTER CARE
FOR MEDI CAL BENEFICIARIES. I
ARE THEY MINISTRATIONS PROPOSAL
WE'RE IN A TRANSIT POINT THE
MEDIA RESPONSE NEW. NINE OR-
CLINICIANS NEED TO ALLOW WE
TODAY YOU CAN TREATING HERPES
IN THE EFFECTIVE POSSIBLE. YEP
HE SUPPORTS EFFORTS TO EXPAND
AND MAKE PERMANENT TELEHEALTH
FLEXIBILITY AS AUTHORIZED UNDER
BECAUSE THE. NINETEEN FOR BOTH
PRIVATE AND PUBLIC PAYER.
LIEUTENANT FOR ENCRYPTION FACE
TO FACE WITH ANYTHING FOR US.
HELLO HELLO BOTH MEDICAL HELP
YOU FOR SERVICE MANAGED CARE
AND APPLICATION MONITORING.
CONGRESSMAN INVESTMENT BEEN
MADE BY PROVIDER GOING TO
TELEHEALTH MENTALITY TO BE
REIMBURSED FOR TELEHEALTH
INCLUDING THE TELEPHONIC
MODALITIES REGARDLESS OF
PROVIDER TYPE WILL KEEP THE ON
GOING HEALTH OF OUR COMMUNITIES
AT THE FOREFRONT AS WELL AS
CONTRACTED BY THE LADY THANK
YOU. THANK YOU VERY MUCH NEXT
CALLER PLEASE. NINE SIX FIVE
SIXTY FIVE PLEASE GO AHEAD.
GOOD AFTERNOON CHAIR- THIS IS
LISA COLEMAN THE CALIFORNIA
LONG TERM CARE OMBUDSMAN
ASSOCIATION AND I'M CALLING IN
THE QUARTER INCH FORTIFIED
NUMBER ELEVEN. I WANT TO MAKE
IS JUST REAL FOR YOU A- AT A
STORY A MAGIC YOU ARE AT. A
LONG TERM CARE FACILITY
RESIDENT AND SOMETHING HAPPENS
AND YOU ARE SENT TO THE
HOSPITAL AND YOU WANT TO GO
BACK HOME BECAUSE YOU CONSIDER
THAT SKILLED NURSING FACILITY
OR HOME BUT FOR SOME REASON.
THEY DECIDED THEY DON'T WANT
YOU TO COME BACK. SO YOU'RE IN
THE HIGH. IS NOT WELL. MUSTER
UP THE ENERGY TO GO TO THE
OFFICE OF ADMINISTRATIVE
HEARINGS AND YOU GO THROUGH THE
APPEAL PROCESS. AND YOU WIN YOU
GET A PIECE OF PAPER THAT SAYS
THE FACILITY COULD NOT
DEMONSTRATE WHY YOU AREN'T A
GOOD FIT. BUT THAT PIECE OF
PAPER LEVINE DID NOTHING.
BECAUSE THERE'S NO STICK
ASSOCIATED WITH THAT PIECE OF
PAPER BUT NOW YOU HAVE TO GO TO
THE DEPARTMENT OF PUBLIC HEALTH
AND YOU HAVE TO PLEAD YOUR CASE
AGAIN AND THIS COMMITTEE HEARD
JUST LAST WEEK FROM THE
DEPARTMENT ON HOW LONG
SOMETIMES IT TAKES WITH A
COMPLAINT INVESTIGATIONS TO. BE
RESOLVED. AND YOU HEARD TODAY
FROM DIRECTOR MIKE BORN THAT
MORE OFTEN THAN NOT THE
FACILITIES ARE NOT ABLE. TO WIN
THOSE HEARING THE RESIDENTS DO
IN FACT WIN MOST OF THOSE
HEARINGS. SO WE ARE VERY MUCH
IN SUPPORT OF THIS PROPOSITION
FOR THIS BILL PROPOSAL BUT WE
WOULD ASK THAT YOU PUT A LITTLE
BIT MORE DETAIL AT. WHY ARE WE
WAITING TO FIXED TODAY. ADDED
THE SCRIPT. WHY NOT MAKE THAT
THOUSAND DOLLAR FINE HAPPEN.
WITHIN TWO DAYS. I WANT TO EVEN
FURTHER. IN A RESIDENT HAS BEEN
DENIED ACCESS TO THEIR HOME.
AND THE HEARING HAD PROVEN THAT
THE FACILITY HAS NO LEGAL RIGHT
NOT TO BRING THEM BACK AND
THEY'VE SPENT THEIR HUNDRED
DATE THAT THEY'VE ACCRUED A
HUNDRED THOUSAND DOLLAR FINE IF
THEY'RE STILL NOT WHEN WE CAN
BRING THE RESIDENTS BACK. WHY
DON'T WE GO FURTHER AND GIVE
THE DEPARTMENT THE AUTHORITY TO
PROHIBIT ANY NEW ADMISSION
UNTIL THAT RESIDENT IS PRETTY
IS- WE ADMIT IT STARTING ON
THAT DAY ONE HUNDRED ONE. SO
WE- ARE VERY MUCH IN SUPPORT OF
THIS BILL AND WE THANK YOU FOR
YOUR SUPPORT OFFICE. THANK YOU
VERY MUCH NEXT CALLER PLEASE.
AND AGAIN PLEASE TO KEEP YOUR-
TO ONE MINUTE. SIX SIX WE GO
AHEAD. GOOD AFTERNOON WINDOW
WITH WESTERN CENTER ON LAW AND
POVERTY YOU HAVE A COMMENT ON
SIX DIFFERENT ISSUE AREAS
FIRSTLY WE SHARE THE ALLEY-
QUESTIONS REGARDING THE
ADMINISTRATION MEDICARE
CASELOAD PROJECTION NOTING THAT
LAST YEAR'S PROJECTION TEN NOT
BORNE OUT AN APPLICATION FOR
STILL LOWER TO TWENTY NINETEEN.
REGARDING ISSUE FIVE WE
APPRECIATE THE WORK IN
DEVELOPING THE TALENT PROPOSAL
BUT REMAIN CONCERNED ABOUT
PLANNED CAPACITY FOR CARE
MANAGEMENT AND THEY'RE ABLE TO
SEE CURRENT OBLIGATIONS PRIOR
TO MANDATING CRIME INVOLVEMENT
IN GETTING CONSTITUTIONAL
RESPONSIBILITY WE HAVE CONSUMER
PROTECTION RECOMMENDATIONS
INCLUDING AND READING OR
SHARING WRITING ALSO REQUEST
HOW THE TO PUT THAT THIS WOULD
BE A STATE WIDE BENEFIT THE
MINISTER TO THE COUNTY OR
EASTON ECM BENEFIT REGARDING
ISSUE FIXED WE SUPPORT THE
DELAY OF PROP SIXTY SIX FUNDING
CONTENTION AND THE QUESTION
RELATING TO. AND TO COMPLETELY
REPAIR CRITICAL MEDICARE
BENEFITS BOTH PART ELIGIBILITY
REGARDING ISSUE EIGHT WE
SUPPORT THE EXPANSION OF
TELEHEALTH IN A WAY THAT HONORS
CONSUMER CHOICE BUT HAVE WITH A
GREAT WEEKEND CONSUMER
PROTECTION IF HE BE OUT THAT
EXPAND ALTERNATIVE ACCESS
MANAGEMENT. ANNUAL TWO THREE
YEARS. WE ISSUE MY CONNECTED TO
THE COULD MONITOR. A MEDIC CAL.
AND ISSUE TEND AND WHEN. A
STRATEGIC. AND FINALLY THE GUY
ISSUES WE SUPPORT INCREASED TAX
TO BEHAVIOR HEALTH CARE. IN THE
L. L. RECOMMENDATIONS FOR TDL
OVER AND- THANK YOU THANK YOU
FOR MUCH NEXT CALLER PLEASE.
LINE FOR FIVE FIVE YOUR LINES
OF. KLEIN'S FIVE. AB ONE LINE.
HELLO IS THAT ME AND MY AND
COMMITTEE. YOU HAVE ONE MINUTE
MA'AM TO MAKE YOUR COMMENTS.
WHAT BUT BUT BUT WHAT YOU'RE
GETTING TWO TO THREE MINUTES IS
THE SENATOR EGGMAN. YOU HAVE
ONE MINUTE TO MAKE YOUR
COMMENTS PLEASE PROCEED. THE
FACT PSE AND MADERA NASDAQ GS
MRNA VACCINES ARE BOTH MRNA
TREATMENTS. BUT WHEN SHOT IS
NOT BY DEFINITION A TRUE
VACCINE IT IS AN HONOR AND A
TECHNOLOGY THAT HAS SEEN YOU
AND MERGING THE YOU
AUTHORIZATION ONLY. WELCOME
THESE COMPANIES ARE TRADED ON
WALL STREET WITH HEDGE FUNDS
BEING THE MAIN SHAREHOLDERS
THEY FUNCTION MEANS THAT SHOPS
BY REPROGRAMMING THE RECIPIENT
CELLSAT THE CYTOPLASM LEVEL
NOT ONLY ARE THE COMMON
VACCINES UNPROVEN THE TREATMENT
ITSELF M. I. N. A IS ONLY A FEW
YEARS OLD. THE ENTIRE HUMAN
POPULATION IS BEING ASKED BY
THE WALL STREET MEDIA FEEDBACK
LOOP TO BE GENETICALLY
REPROGRAMMED BY A NEW
EXPERIMENTAL TREATMENT I'M
QUESTIONABLE EFFICACY THAT
BECAUSE OF THE SERIOUS. SIDE
EFFECTS INCLUDING. ALL FOR
DISEASE SEVEN NINETY NINE POINT
9% SURVIVE RATE WHAT COULD GO
WRONG. WHERE IS. WHAT DID HE
LEAVE IT BUT IF THANK VERY MUCH
MA'AM CALLER PLEASE. MEXICO
PLEASE THANK YOU VERY MUCH.
NINE SIXTY EIGHT SIXTY ELEVEN
OPEN. GOOD AFTERNOON CHAIR I
WOULD ON A LITTLE HAND ZERO AND
GET ON THE RAMP. THE CALIFORNIA
HOSPITAL- WANT TO COMMENT ON
TWO ISSUES- REGARDING ISSUE
WADE- THE CHILDREN'S HOSPITAL
ASSOCIATION IS EXCITED TO SEE
THE ADMINISTRATION IS LOOKING
TO MAKE MANY OF THE TELEHEALTH
FLEXIBILITIES ADOPTED DURING
THE PANDEMIC PERMANENT.
RESPONSIBILITIES HAVE BEEN A
LIFELINE FOR MANY OF THE
CHILDREN AND FAMILIES THAT ARE
SUFFERING DURING THESE TIMES
HOWEVER ONE BOROUGH WE WOULD
LIKE TO INSURE THAT PEDIATRIC
PROVIDERS WILL CONTINUE TO ROOT
BE REIMBURSED FOR THE CARE THEY
PROVIDE. FROM OUTSIDE THE FOUR
WALLS OF THE HOSPITAL AND
HOSPITAL BASED CLINICS.
SECONDLY MANAGER WE LOOK
FORWARD- TWO NINE WE ARE
WELCOME BE EXTENDED COVERAGE ON
A CONTINUOUS GLUCOSE MONITORS
FOR ADULTS AS IT ALLOWS FOR
BETTER CONTINUITY OF CARE FOR
CVS YOU AS THEY AGE OUT OF THE
PROGRAM WITH THAT I THANK YOU
AND- THAT'S ON MY TIME. THANK
YOU VERY MUCH NEXT CALLER
PLEASE. LINE THIRTY SIX THREE
SIX YOUR LINE IS OPEN. HI CAN
YOU HEAR ME. HE'S PROCEED. CAN
YOU HEAR ME YES I CAN HEAR YOU
CANNOT HEAR YOU GO AHEAD PLEASE
OKAY MY NAME IS AMY I AM
CALLING AGAIN FROM SAN DIEGO-
YOU KNOW I DON'T KNOW WHY DID
PAN LEFT THE ROOM BUT I COULD
TELL YOU RIGHT NOW THANK YOU
VERY MUCH FOR MOVING ON LIBERTY
HAD THIS CALLER THANK YOU VERY
MUCH. NEXT CALLER PLEASE
ACCESSIBLE ONLINE SEVENTY THREE
SEVEN THREE PLEASE GO AHEAD. BY
YOU MY NAME OF THE SONG FRANCIS
AND I'M WITH WILL GET NOW. I'D
LIKE TO COMMENT ON THE ISSUE
THE FIRST BEING ISSUE NUMBER
FIVE. ON KILEY ONE PORT FEES
ARE HURT WE DON'T BELIEVE THAT
TELLING FOLKS. WHEN I. OUR
MARKET. AND RECREATION WITH
MANY ADDITIONAL THANK YOU
STRONG SUPPORT ELIMINATING
LANGUAGE AROUND THAT HOUSE YOU
KNOW IN ADDITION NUMBER SEVEN.
WE CERTAINLY HAVE A CONCERN
VOICED BY THE L. A. L. AND
DOCTOR CANCER AND WE HAVE
BECOME ON THE ISSUE FOR. A
THANK YOU VERY MUCH NEXT CALLER
PLEASE. WE'LL GO TO LINE
SEVENTY FIVE SEVEN FIVE PLEASE
GO AHEAD. GOOD AFTERNOON MADAM
CHAIR AND MEMBERS ADRIAN'S
ULTIMATE THE CALIFORNIA
ALLIANCE THAT CHILD FAMILY
SERVICES WE ARE SUPPORTING A
NUMBER OF ITEMS DISCUSSED TODAY
ITEM NUMBER SIXTEEN WHICH IS A
SEVEN HUNDRED FIFTY MILLION.
FOR INFRASTRUCTURE TO SUPPORT
THE BEHAVIORAL HEALTH CONTINUE
ON EITHER CRITICALLY NEEDED
FUNDS TO BUILD OUT ARE STICKING
UP FOR KIDS AND ADULTS. I DID
NUMBER EIGHTEEN MENTAL HEALTH
SERVICES ACT FLEXIBILITY WE ARE
PART OF A COALITION OF
ADVOCATES THAT CAME TOGETHER ON
THE ISSUES LAST YEAR THAT
CREATE THE ADMINISTRATION'S
COMMITMENT. AND I'M ITEM NUMBER
SEVENTEEN WHICH IS THE
INCREASED ACCESS TO STUDENT
BEHAVIORAL HEALTH SERVICES AS
DESCRIBED IN OUR LETTER TO THE
COMMITTEE WE HAVE A LOT OF
QUESTIONS ABOUT THIS PROPOSAL
WE SUPPORT THE INTENT BUT A
WIDE OUR COMMENTS WITH THOSE OF
THE ALLEY OUT. BACK HE KEEPS
DETAILS ARE STILL DEVELOPMENTS
AND GIVEN THAT MANAGED CARE
PLANS ARE NOT GENERALLY IN%
SCHOOLS ONE OF OUR
RECOMMENDATIONS THE DOCTOR BE A
STRONGER MANDATE TO PARTNER
WITH THE PUBLIC THE APRIL OF
SYSTEMATIC THANK YOU. THANK YOU.
FIFTY FOUR SECONDS NEXT CALLER
PLEASE. I AM SO TWO SEVEN TWO
YOUR LINE IS OPEN. THANK YOU
MADAM CHAIR MEMBERS LEGACY
BIRDS ON BEHALF OF CALIFORNIA
HEALTH PLUS ADVOCATES AND I
JUST COMBINED MY COMMENTS TODAY
TO NUMBER EIGHT ON TELE HEALTH.
AND COMMUNITY HEALTH CENTERS
FQHCS AND ARE YOU SLEEPING
CALIFORNIA PROVIDE
COMPREHENSIVE PRIMARY CARE
SEVEN POINT FOUR MILLION PEOPLE
CALIFORNIA AND ONE IN THREE
MEDIC HELP PATIENT WE
APPRECIATE THE ADMINISTRATION
COMING FOR THE PROPOSAL AND I
THINK THAT WE DO HAVE SOME
CONCERNS ABOUT THE CURRENT
PROPOSAL. I AM INTERESTED HIGH
MARKET SHARE ONE EXAMPLE HERE
AT THIS PROPOSAL WILL
DISPROPORTIONATELY IMPACT
HEALTH CENTER PATIENTS. BY
TAKING AWAY PATIENT CHOICE
ACCESS TELEPHONIC HERE WOULD
DEPART PARTICULATE NEED TO
ADDRESS EXISTING HEALTH
DISPARITIES AND FOR INDIVIDUALS
WHO DO NOT HAVE ACCESS TO
BROADBAND. I WOULD LIKE TO BE
THE ADMINISTRATION BUILDING ARE
CRITICAL EARLY PANDEMIC
LEADERSHIP AND GUIDANCE TO
ALLOW HEALTH CENTER FULLY
REALIZED ALL THE TELEHEALTH
MODALITIES GOING FORWARD. I
CURRENTLY PROPOSED THAT COULD
PROMOTE A POST PANDEMIC MEDIC
HEALTH SYSTEM WHERE PATIENTS
CAN CHOOSE TO RECEIVE THEIR
CARE AT A HEALTH CENTER ARE
OFFERED A DIFFERENT ARE PERHAPS
LOWER TIER OF ACCESS TO CARE WE
WERE ENCOURAGED TO HEAR THE
DEPARTMENT REFERENCE TO EIGHT
PM AND THEIR CREAKING PATIENTS.
HOWEVER WE DO NOT HAVE A CLEAR
SENSE AND TIGHTENING ON THAT
EFFORT AND WOULD APPRECIATE
EXPLORING WAYS TO BRIDGE THE
GAP UNTIL WE GET THERE SO WE'RE
HOPING. TO CONTINUE THEIR
CONVERSATIONS WITH THE
DEPARTMENT AND FIND ONE ECHO
GLOBAL SOLUTION THAT INCLUDES
THE HEALTH CENTER AND OUR
PATIENTS THANK YOU. THANK YOU
VERY MUCH NEXT CALLER PLEASE.
WELL I AM. SIX SIX GO OUT. GOOD
AFTERNOON MADAM CHAIRMAN DATE
DOUGLAS ON BEHALF HVAC
PROMISING AND ISSUE AN ISSUE
THREE WE THAT ABOUT HEALTHCARE
PROJECT LOOK FOR TO CONTINUE TO
EXAMINE OF DISCREPANCIES WHICH
THE DIFFERENT. AND IF YOU FIVE
KELLY WE ARE. OF THE PROJECT OF
AND CONTINUE TO EMPHASIZE THE
NEED FOR ADEQUATE RESOURCES.
AND METRICS TO KEEP PLAN THE
COUNTABLE AS WE ASK THEM TO
INCREASE THEIR RESPONSIBILITY
IF. WE DO I'VE GOTTEN QUESTIONS
THAT WERE POSED THE COMMITTEE
TODAY ON ENFORCEMENT OF
STANDARDS AND THE NEED TO
ENSURE PLANTS ARE STEPPING UP
TO INCLUDE. SERVICES NEEDED IN
THEIR COMMUNITIES. I KNOW YOU
FIX ALL APPRECIATE WE INVEST.
DELAY AND FROM THE BENEFITS
PREVENTION THE COPPER.
REINSTATEMENT OF THESE BENEFITS
AND PAYMENTS INCLUDING THE PROP
FIFTY SIX PROVIDER PAYMENT
MEDICAL POST PREGNANCY
EXTENSION. AND OTHER SERVICES.
FINALLY AND PUBLIC HEALTH WE
SUPPORT THE ADMINISTRATION'S
PROPOSAL TO EXTEND MANY OF THE
POSSIBILITIES. TO ENSURE
EQUITABLE ACCESS WITHOUT TO
ENSURE THE ADMINISTRATION TO
INCLUDE PARITY FOR AUDIO ONLY
CALL. ALONG WITH WHAT THE
BUILDINGS THERE MUST BE STRONG
EVALUATION ON IMPACTOF
TELEHEALTH ON HEALTH OUTCOMES
AND ASSURANCES THAT CONSUMERS
CAN CHOOSE AND PERSONAL CARE.
THANK YOU FOR YOUR TIME THANK
YOU VERY MUCH. FIFTY NINE
SECONDS NEXT CALLER PLEASE.
NINE TWENTY NINE TWO NINE YOUR
LINE IS OPEN. HI MY NAME IS
THERESA PATRICK RAINY I AM A
LOCAL STATE NATIONAL MENTAL
HEALTH ADVOCATE- I'M ALSO THE
PROUD MOM OF AN ADULT SON WHO
LIVED DIRECTLY WITH MENTAL
ILLNESS. SHE AND I AM CALLING
TODAY AS ONE OF THE CO AUTHORS
OF THE HOUSING THAT HE'LL
PROJECT. AND WE WOULD LIKE TO
PROBABLY SUPPORT ITEM SIXTEEN
GOVERNOR NEWSOM TRIP HAS SEVEN
HUNDRED FIFTY MILLION DOLLAR
INVESTMENT IN B. CALIFORNIA BE
HOPPING CAN YOU ON. THIS IS AN
OPPORTUNITY THAT CALIFORNIA
CAN'T MESS TO EXPAND THE
CAPACITY IN EQUITY OF OUR
BEHAVIOR HEALTH JUSTIN AND I
KNOW IT WILL SAVE LIVES. REDUCE
INSTITUTIONALIZATION
INCARCERATION- FOR DAMAGE LIKE
MINE THANK YOU VERY MUCH THANK
YOU VERY MUCH ALL OF OUR GOALS
NEXT CALLER PLEASE. NINE FORTY
SEVEN FOUR SEVEN PLEASE GO
AHEAD. HELLO BOBBLING ON BEHALF
OF THE VHA REPRESENTING MENTAL
HEALTH AND SUBSTANCE USE
DISORDER PROVIDERS ACROSS THE
STATE SERVING OVER HALF A
MILLION CLIENTS. WEREN'T STRONG
SUPPORT OF ITEM EIGHT SIXTEEN
SEVENTEEN IN CONTACT AND
EIGHTEEN ARE THE HALL BOLSTER
THE CRITICAL BEEKEEPER HOW
INFRASTRUCTURE THAT IS NEEDED
THE FINANCIAL SUPPORT WE ALSO
ALIGNED WITH THE COMMENT THE
DOCTOR HANDED OUT IN THE
BAHAMAS MEASURES IN GENERAL WE
ASK THE COMMITTEE CAN TO
CONSIDERING MOVING THAT
MINISTRY TO COST BARRIERS TO
OUR ABILITY TO ACCESS. FUNDING
FOR OUR LOCAL SERVICE. ARE
MOVING MORE. ADDITIONALLY OF IN
THE- THANK YOU. THANK YOU VERY
MUCH COLOR. NINE ELEVEN ONE ONE
YOUR LINE IS OPEN. THANK YOU
MADAM CHAIR AND MEMBERS K
LATE ON BEHALF OF THE CHILDREN
SPECIALTY CARE COALITION
REPRESENTING OVER TWENTY FIVE
HUNDRED PEDIATRIC SUBSPECIALTY
PROGRESSION THROUGHOUT
CALIFORNIA. WE RAN STRONG
SUPPORT OF THE CONTINUED
INVESTMENT IN PROPOSITION FIFTY
SIX PROGRAM- PROVIDER PAYMENTS
ON THE LOAN REPAYMENT PROGRAM
IN PARTICULAR HAVE HAD A MARKET
IMPACT ON THE ABILITY FOR A
MEMBER MEDICAL GROUP. YOU
RECRUIT AND RETAIN PROVIDERS.
WERE ALSO IN SUPPORT OF BUDGET
ITEMS FIVE EIGHT NINE
PARTICULARLY THE COVERAGE OF
CONTINUOUS GLUCOSE MONITORS A
MEDIC CAL. AS WELL AS ITEM
SIXTEEN AHMED HELLO HOLD
PROPOSAL WERE IN THE PROCESS OF
CAREFULLY ANALYZING IT BUT WE
DO SEE PUBLIC HEALTH AS- AN
ABSOLUTELY VITAL TOOLS FOR
PEDIATRIC SUBSPECIALTY CARE AND
WE ALL CALIFORNIANS SHOULD HAVE.
EQUAL ACCESS TO IT AND THAT.
THANK YOU FOR YOUR TIME THANK
YOU VERY MUCH NEXT CALL PLEASE.
NINE FIFTY SIX FIVE SIX PLEASE
GO AHEAD. THANK YOU COMMITTEE
MEMBERS MY NAME IS FOR THE
ACCOUNTS WITH THE CENTRAL
ACCESS HELP AND WE LEAD THE
LARGEST TITLE PAN FEDERAL
FAMILY PLANNING PROGRAM- IN THE
COUNTRY WHICH CONSISTS OF
COMPREHENSIVE FAMILY PLANNING
SERVICE PROVIDERS AN STD
PREVENTION PARTNERS. THAT
COLLECTIVELY SERVE PATIENTS IN
OVER TWENTY IN TWENTY
CALIFORNIA COUNTY AND WE'RE
CONCERNED THAT THE
ADMINISTRATION'S TELEHEALTH
PROPOSAL COULD NOT PROVIDE
PAYMENT PARITY FOR TELEPHONE
CARE WILL PREVENT PEOPLE FROM
ACCESSING ESSENTIAL
REPRODUCTIVE HEALTH CARE BEYOND
THE PANDEMIC PART OF PROVIDING
QUALITY CARE FOR TIME SENSITIVE
SERVICES LIKE BIRTH CONTROL
ACCESS AND HE SERVICES INCLUDE
THE ABILITY TO GIVE PATIENTS.
MULTIPLE OPTIONS FOR CARE
WHETHER IN PERSON AND VIA VIDEO
OR TELEPHONE CALLS WE'VE LONG
ADVOCATED FOR TELEPHONIC CARE
TO BE AVAILABLE FOR MANY COUNTY
AND FAMILY POPULATION TO REDUCE
BARRIERS TO CARE AND INCREASED
ACCESS TO REPRODUCTIVE HEALTH
SERVICES FOR PEOPLE WHO FACED
YOUR GRAPHIC TRANSPORTATION
TIME BARRIERS AS WELL AS
CONFIDENTIALITY CONCERNS. AND
IT'S OFTEN PEOPLE OF COLOR WHO
FACE. MORE OF THE STRUCTURAL
BARRIERS TO CARE. AND PECAN PIE
EXPRESS THAT WE SEE KERRY AT
TALLAGHT. IS AN THE FLAG SUMMER
SERVE OVER FOUR HUNDRED COME
FROM MEDIA. AND SEVENTY PER
SAID THEY WOULD CERTAINLY
ACCESS BIRTH CONTROL AND STD
CARE VIA TELEHEALTH. 47% SAID
THEY'D BE MORE LIKELY TO GET
THE CARE THEY NEED OVER
TELEHEALTH THAN GOING INTO A
CLINIC. AND TO OUR SURPRISE 52%
MORE THAN HALF SAID THEY WOULD
PREFER. TO TAKE PLACE OVER THE
PHONE WENT OVER VIDEO. ISSUE
LIKE PRIVACY EASE OF ACCESS AND
LESS INTIMIDATING OR NOTING IT
HAS RESUMED LIGHT TRAINING FOR
INTERESTED IN VIRTUAL. IS IT WE
ALSO SERVE IN OUR TITLE TEN
PROVIDER NETWORK- SAID. THAT
60% OF THEM SAID THAT REMOTE
CARE WORKING THAT WE MUST BE
PROTECTED HEALTH SERVICES WERE
CONDUCTED VIA TELEPHONE AND A
MAJORITY EXPECT THAT THEIR
PATIENTS. THANK YOU VERY MUCH
MAJORITY VERY MUCH. OKAY. THANK
YOU VERY MUCH THANKS CALLER
PLEASE. CLEMSON EIGHT SEVEN
EIGHT YOUR LINE IS OPEN. ANY
UPPER THE NATIONAL ON MENTAL
ILLNESS ALSO KNOWN AS NAMI
CALIFORNIA- SHOW MY GRATITUDE
TO THE COMMITTEE THESE B. H. T.
F. AND L. A. I'M GONNA KEEP
THAT UNDER THIRTY SECONDS. ON
ITEM SIXTEEN. ON BEHALF OF OUR
ONE HUNDRED TEN THOUSAND
MEMBERS IN CALIFORNIA THIS IS
SEVEN HUNDRED FIFTY MILLION
PEOPLE FOR THE PEOPLE THAT WE
LOVE. AND OR THE PEOPLE THAT WE
ARE. SO OBVIOUSLY WE WANT BE
ENTRENCHED IN A LOT OF THIS BUT
WE STRONGLY SUPPORT IT. THANK
YOU. TWENTY SEVEN SECONDS VERY
NICE OUR NEXT CALLER PLEASE.
WELL. NINE SEVENTY ONE SEVEN
ONE YOUR LINE IS OPEN. GOOD
AFTERNOON MEMBERS OF THE
COMMITTEE CRED MAIN. TESTIFYING
TO ON OF CAL PAGE THE PROBE FOR
ALL INCLUDE CARE THE L. AND THE
DAY HEALTH. COALITION FIRST ON
BEHALF OF CAL. ON ISSUE BY CAL
AIM. WE WANT TO THE DEPARTMENT
BECAUSE INCLUDING CAL PAY SAYS
AND- IN THE TRAILER BILL
LANGUAGE WE WOULD STILL LIKE TO
CONTINUE TO WORK WITH THE
DEPARTMENT TO MAKE SURE THAT.
IT'S A COUPLE AN EQUAL CHOICE
AND THAT THERE ARE
OPPORTUNITIES FOR ASSESSMENT OF-
IN ROWLEY'S FOR PASTE- WHEN
THAT'S APPROPRIATE ON ISSUE
EIGHT ON TELEHEALTH. PAGE WAS
GRANTED FLEXIBILITIES DURING
THE PUBLIC HEALTH EMERGENCY AND
WE WOULD CERTAINLY BILL
INCLUDING TELEHEALTH CAN
CERTAINLY BELIEVE THAT THOSE
HAVE. LEAD TO A GREATER-
OUTCOMES FOR OUR PARTICIPANTS
AND ARE WORKING WITH DHS TO
DETERMINE HOW WE FIT INTO THE
CONTINUED TELEHEALTH
APPROACHABILITY LANGUAGE ON THE
PHCS ARE THEY PROVIDE-
PEDIATRIC DAY HEALTH CARE AND
WERE EXCLUDED. FROM THE PROP
FIFTY SIX SUSPENSIONS AND WE
THANK THE DEPARTMENT FOR THAT
IN SUPPORT OF THE ACTION THANK
YOU VERY MUCH THANK YOU VERY
MUCH NEXT CALLER PLEASE. ONE
SEVENTY SEVEN SEVEN SEVEN YOUR
LINE IS OPEN. SHARE MEMBERS
KATHY MUST'VE REPRESENTING I'D
TO CLIENTS WITH TWO DIFFERENT
ISSUES ALL ON ISSUE NUMBER FIVE
ON BEHALF OF THE LOCAL HEALTH
CALIFORNIA THAT HE NONPROFIT
LOCAL PLANNED AROUND THE STATE
OF CALIFORNIA WE CERTAINLY WANT
TO GO ON RECORD AS SAYING WE
ARE PLEASED TO SEE THAT KELLY
MCCAULEY FUNDING. IN THE
GOVERNOR'S BUDGET NO THERE ARE
A LOT OF DETAIL TO WORK THROUGH
AND WE LOOK FORWARD TO WORKING
WITH THE LEGISLATURE AND THE
ADMINISTRATION AS WE MOVE
FORWARD AND ADVOCATE AS WE LOOK
FORWARD TO WHAT THOSE ITEMS
THROUGH- I KNEW SHE NUMBER SIX-
FINALLY HAVE TO DEVELOP HEALTH
SERVICES NETWORK AS WELL. AND
LONG PEDIATRICS. WE ALSO WERE
PLEASED TO SEE THE
ADMINISTRATION'S EXTENSION TO
JANUARY TWENTY TWENTY THREE OF
THE PROPERTY THE COUPLE MIDDLE
CLIENT BUT DO YOU HAVE
CONCERNS. AS THAT THAT
EXTENSION WOULD BECAUSE YOU'RE
MOVING INTO CALTRAIN AS OF THE
BEGINNING OF TWENTY TWENTY
THREE SO WE HOPE YOU CAN START
CONVERSATIONS WITH THE
DEPARTMENT AS WE WORK INTO THE
INTO THE KILLING PROCESS THOSE
CONVERSATIONS HAVE NOT BEGUN
AND THE OTHER ITEM TO ADD IN
THERE WOULD BE WE CURRENTLY
HAVE. A COMBINED 1910% OF TOTAL
MENTAL WE WOULD LIKE TO TALK TO
THE COMMITTEE AND TO THE
ADMINISTRATION ABOUT TEACHING
ME THAT SUPPLEMENTAL TO THE
PEOPLE BUDGET YEAR IT IS
CURRENTLY SLATED AND MADE
BUDGET CYCLE AND WE THINK THAT
WOULD BE A DETRIMENT TO THE
FACILITY TYPE- THANK YOU FOR
YOUR TIME. THANK YOU VERY MUCH
NEXT CALLER PLEASE. HELLO
PRODUCERS. FIVE SEVEN YEAR LINE
OF THE- HI CAN YOU HEAR ME.
PLEASE PROCEED BELOW PLEASE
PROCEED YOUR OKAY AT ALL RIGHT
SORRY YOU AND I AM CALLING AT
THE- DURABLE WASTE AT MONEY
INTO THE TESTING AND TRACKING.
FILE OUR CHILDREN IN SCHOOL
THAT THE TERRIBLE WASTE OF
TAXPAYERS FIND WE DON'T AT
TERENCE WE DON'T WANT THAT POOL
OR MEDIC CALTRAIN FOR TESTING
OR TRACKING OF OUR CHILDREN NEW
YORK STATE ALREADY TRIED THAT
AND THEY WERE TAKEN TO COURT
AND THAT WAS KNOCKED DOWN
CALIFORNIA DOES NOT HAVE THE
MONEY THAT'S NOT UNDER THE
CONSIDERATION OF THIS COMMITTEE
AT THIS TIME WE THANK YOU VERY
MUCH NEXT CALLER PLEASE. ORDER
ONLINE FOUR NINE FOUR NINE
ALIGN IS OPEN. STREAMLINED
FORTY NINE. ARE YOU ON MUTE ON
YOUR SIDE. S. NEAR ME. YES
PLEASE PROCEED RIGHT THANK YOU
HI MY NAME IS WILLIE TORRENT- I
AM WITH A COMMUNITY CLINIC
ASSOCIATION LAKE COUNTY THANK
YOU CARE ACT MEN AND MEMBERS OF
THE COMMITTEE AND HE REPRESENT
SIXTY FOUR COMMUNITY CLINICS
AND HEALTH CENTERS OPERATE MORE
THAN THREE HUNDRED FIFTY SITE
FROM SERVICE PACK NINE ONE
SEVEN MILLION LOW INCOME
UNINSURED AND UNDERSERVED
INDIVIDUALS ACROSS L. A.
COUNTY. OUT WE STRONGLY SUPPORT
GETTING TELEHEALTH INCLUDING
TELEPHONIC CARE BEYOND COMING
NINETEEN TELEHEALTH TYPICALLY
AUDIO ONLY TELEPHONE VISITS ARE
CENTRAL TO ENSURING ACCESS TO
HEALTH CARE FOR PATIENTS WHO DO
NOT HAVE ADEQUATE INTERNET
TECHNOLOGY DEVICE ACCESS OR
LITERACY MADE KNOWLEDGE THE
ADMINISTRATION PROPOSAL IS A
STEP FORWARD WERE GREATLY
CONCERNED- WITH THE PROPOSAL AS
IT'S CURRENTLY WRITTEN ON. THE
CLEANUP AT U. H. T. TERM
CONTINUING. TO PROVIDE
TELEPHONIC VISIT. BOTH WITH
SOME COMMUNITIES FORWARD
LEAVING THE- MOST IN BY THIS.
FOR ON IT SO THEREFORE WE ARE.
THAT THE GOVERNOR THE LIKE.
EXTENDED CURRENT TELEHEALTH BUT
PEOPLE DEFINITELY INCLUDING
TELEPHONIC AUDIO ONLY
FLEXIBILITY AND PCS. HOW WE
LOOK FORWARD TO WORKING WITH
OUR ELECTED LEADERS TO MAKE
TELEHEALTH FLEXIBILITY
PERMANENT FOR THE HEALTH OF OUR
FAMILIES AND OUR COMMUNITIES IN
OUR STATE THANK. YOU THANK YOU
VERY MUCH THANKS COLOR PLEASE.
WELL I AM EIGHTY EIGHT ZERO
PLEASE GO AHEAD. THANK YOU. FOR
YOUR CALL REPRESENTING THE
COUNTY BEHAVIORAL HEALTH
DIRECTORS ASSOCIATION WHICH
REPRESENTS THE PUBLIC MENTAL
HEALTH AND SUBSTANCE USE
DISORDER PROGRAM A FORTY EIGHT
IN COUNTY THROUGHOUT. YEAH I
WANT TO THANK THE
ADMINISTRATION FOR IDENTIFYING
THE NEEDS IN THE GAPS IN THE
COUNTY BEHAVIORAL HEALTH
DELIVERY SYSTEM AND PUTTING
FORWARD A MEANINGFUL INITIATIVE
TO ADDRESS THIS NEED WE
STRONGLY SUPPORT ISSUE SIXTEEN
THE SEVEN HUNDRED AND FIFTY
MILLION. DOLLAR COMMITMENT
CHORE INFRASTRUCTURE AND HAVE
SUBMITTED A LETTER TO THE
SUBCOMMITTEE DEMONSTRATING THE
BROAD SUPPORT FROM BEHAVIORAL
HEALTH THANK EIGHT HOLDERS. WE
ALSO WANT TO THANK THE ACS FOR
THE STRONG PARTNERSHIP WITH
COUNTY BEHAVIORAL HEALTH IN
DEVELOPING PAYMENT REFORM
TRANSFERRED TRANSFORMATION
UNDER CAL GAME AND THE PROPOSED
CHANGES TO MEDICAL NECESSITY.
ON ISSUE SEVENTEEN THE SCHOOL
MENTAL HEALTH PROPOSAL WITH YOU
WE ALSO HAVE SOME QUESTIONS WE
WANT TO CLARIFY THE BROAD
EXISTING FOOTPRINT OF COUNTY
BEHAVIORAL HEALTH PARTICIPATION
ON FOR FIGHT. IN OVER THIRTY
COUNTY BEHAVIORAL HEALTH
ALREADY PARTNERS WITH 821100%
OF THE SCHOOL DISTRICT AND
PROVIDE HE PSTG SERVICES ALONG
WITH OTHER SPECIALLY MENTAL
HEALTH SERVICES HASN'T ALLOWED
UNDER OUR CURRENT MANDATE.
WE'RE INTERESTED IN HAVING THE
PROPOSALS BUILD ON THESE
EXISTING EXTENSIVE PARTNERSHIPS
WE AGAIN AND WE ALSO WANT TO
EXPRESS OUR SUPPORT FOR ISSUE
EIGHTEEN ON HIM BECAUSE THEY
FLEXIBILITY THANK YOU. THANK
YOU VERY MUCH NEXT CALLER
PLEASE. NINE EIGHT ONE EIGHT OR
YEAR LONG IS OPEN. HI CINDY
FROM THE CALIFORNIA MEDICAL.
AND I'D LIKE TO COMMENT ON HIS
U. X. AND EAT ON ISSUES YOU AT
THE STATE CONTINUES TO ATTRACT
THE COOK AT NINETEEN PUBLIC
HEALTH EMERGENCY THE AND I WANT
TO ENSURE CONDITIONS TO TREAT
MEDICAL PATIENTS CAN AFFORD
THEIR DOORS OPEN. INCREASED
NEED FOR P. P. BUT COSTS
INCREASED BY 15% I HOPE FOR
MOST PRACTICES THIS COPY IMPACT
MEDICAL PRACTICES THE MONTH.
PROVIDING ONE TIME FUNDING IN
THE MEDICAL BUDGET FOR PP FOR
MEDICAL PROVIDER WHAT HELPED
ARE OPEN ON ISSUE SIX I'D LIKE
TO SET AT PM I SUPPORT THE
GOVERNOR'S PROPOSAL THE WAY THE
SUSPENSION SACRAMENTO PROVIDER
PAYMENT. CURRENTLY FUNDED
THROUGH PROPERTY SIX SACRAMENTO
PAYMENTS ARE KEY IN INCREASING
ACCESS TO THE MEDIC HEALTH
SYSTEM AND SHOULD BE CONSIDERED
A PERMANENT COMPONENT. OF THE
MEDICAL FUNDING ST. YEAH EAGER
FIND A TERM FOR. THAT PROTECTS
THE CRITICAL. INCLUDING PEOPLE
ANY QUESTIONS RIGHT. INSURANCE
THAT WILL MENTAL PAIN ARE
FOCUSED ON. ACCESS TO CARE ON
ISSUE EIGHT AT THE BEGINNING OF
THE PANDEMIC YOU MAY WORK HARD
WITH THE STATE'S SECURITY
AFFECT HELP THE TELEHEALTH FOR
PATIENT. BMI URGES YOU TO
COMMENCE AND BUILD ON THE
SUCCESSES AND PREVENT RETURNING
TO PRE PANDEMIC I'LL HELP
TRAVESTY. VMA IS CONCERNED WITH
THE H. THE AFTER TELEHEALTH
PROPOSAL WHICH THE DRAFT PAINT
FOR AUDIO ONLY SAYS THAT. WILL
RECEIVE REIMBURSEMENT AT A
LOWER FEE SCHEDULE IT WOULD BE
A SERIOUS IMPEDIMENT PACKED
WITH THE CARE THE PANDEMIC IT
HIGHLIGHTED CALIFORNIA'S
DIGITAL DIVIDE EVEN IMPACTS
HAPPY CALIFORNIA OLDER PATIENTS
RURAL AREAS AND UNDERSERVED
POPULATION. STRUGGLE WITH
ACCESS TO BROADEN YOUR WHILE
THE STATE CONTINUES TO BRIDGE
THE DIVIDE THE TELEPHONE WILL
CONTINUE TO BE AN ESSENTIAL
COMPONENT ACT THE CARE.
TREATING TELEPHONE VISIT AS
SECOND RATE ONLY. INEQUALITY I
THANK YOU VERY MUCH FOR YOUR
CALL YES. THANK. YOU VERY MUCH
THANKS CALLER PLEASE. WHY NAY
THREE EIGHT YEAR OF THE- KELLY
BEING WITHHELD NET AND HEALTH
AND WELL SURVEY ALMOST TWO
MILLION BETTER CAL AND- YOU
COULD THE- AND COUNTY. SAN
READY TO STRENGTHEN IT CONTINUE
COUNTY PARTNERSHIP IN SUPPORT
OF THE CALLIE MINNICH'S.
BEHAVIOR HEALTH SERVICES FOR
CHILDREN PROPOSAL AND
BEHAVIORAL HEALTH
INFRASTRUCTURE PROPOSAL. WE
LOOK FORWARD TO CONTINUING THE
EXCELLENT WORK OF THE WHOLE
PERSON CARE AND HELP ON PILOT
TO REALIZE MANY MORE IMPROVE
HEALTH OUTCOMES FOR MEDIC CAL
MEMBERS ACROSS CALIFORNIA. MANY
MORE THAN THOSE CURRENTLY
BENEFITING. IN REFERENCE TO
TELEHEALTH HELP NOT WITH ONE OF
THE FIRST HEALTH PLANS TO
REIMBURSE THE PARITY IN ORDER
SUPPORT PATIENT ACCESS AND ALSO
TO SUPPORT PHYSICIAN PRACTICES
WHO ARE UNABLE TO SEE CREATION.
WE LOOK FORWARD TO DISCUSSIONS
OF THE COMING MONTH TO EXTEND
THE USE OF TELEHEALTH BEYOND
THE PUBLIC HEALTH EMERGENCY IN
ORDER TO SUPPORT AND ENHANCE
THE CARE OF. THE ARE OF HARD
TO REACH MEDICARE MEMBERS IN
OUR COMMUNITY THANK YOU SO MUCH
YOU VERY MUCH THANKS COLOR
PLEASE. ONE FIFTY FOUR FIVE
FOUR YOUR LINE IS OPEN. MADAM
CHAIR AND THE SENATORS AND
FEELING GREASY ADVANCED MEDICAL
TECHNOLOGY ASSOCIATION THANK
YOU SO MUCH WE WANT TO. VOICE
OUR SUPPORT FOR ITEM NINE ON
CONTINUES GLUCOSE MONITOR
FUNDING- THIS IS REALLY
IMPORTANT TO DRIVE HEALTHCARE
INEQUITIES FOR ECONOMICALLY
DISADVANTAGED PATIENTS
ESPECIALLY CHILDREN IN
UNDERSERVED COMMUNITIES. WE
WILL REDUCE RISK OF CODE
COMPLICATIONS FROM FROM
DIABETIC CARE- AND REDUCE
GENERAL FUND PRESSURE AND
REDUCE THE STRAIN ON PROVIDERS
SO WE WANT TO THANK ACCENTOR
THANKS TO THE GOVERNOR FOR THE
PROPOSAL AND I WOULD APPRECIATE
YOUR VOTE SUPPORT THE
PREPARATORY. THANKS SO MUCH
THANK YOU VERY MUCH NEXT CALLER
PLEASE. BLIND NINE EIGHT NINE
GO A- SENATOR EGGMAN AND
COMMITTEE MEMBERS AT THIS IS
JULIE SNYDER REPRESENTING
MISTING BURKE INSTITUTE AND I'D
LIKE TO EXPRESS THEIR SUPPORT
FOR FIVE ITEMS ON TODAY'S
AGENDA. ITEM FIVE ON KELLY- WE
APPLIED THE INCREDIBLE WORK
THAT'S ALREADY GONE INTO THIS
BY THE ADMINISTRATION AND
EVERYONE AND LOOK FORWARD TO
SEEING IT MOVE FORWARD. ITEM
EIGHT- MAKING TELEHEALTH
FLEXIBILITIES PERMANENT ITEMS
SIXTEEN THIRTY SEVEN HUNDRED
FIFTY MILLION DOLLARS FOR
BEHAVIORAL HEALTH
INFRASTRUCTURE WE APPRECIATE
THE ADMINISTRATION'S FOCUS ON
IDENTIFYING GAPS IN CHARTING
THE FUNDS WERE THERE BUT YOU
CAN MEET AT. ITEM SEVENTEEN
ENSURING SCHOOL KIDS RECEIVE
THE MENTAL HEALTH SERVICES THAT
THEY'RE ENTITLED TO AND
DESPERATELY NEED AND ITEM
TWENTY CONFINED TO THE
IMPLEMENTATION. OF AEO T.
SERVICES ACROSS THE STATE WE
ALSO APPRECIATE THE KEY KEEP UP
THE HSA WERE ITEM FOR CONTINUE
DISCUSSION THANK YOU VERY MUCH
THANK YOU VERY MUCH NEXT CALLER
PLEASE. I AM A EIGHT EIGHT
PLEASE GO AHEAD. THIS IS
THERESA CALL WITH THE CAL SAYS
HE OF LOS BE HAVE HEALTH AND-
KALBE BC SO THE WAY OF
CALIFORNIA'S NINE LOCAL MENTAL
AND BEHAVIORAL HEALTH BOARDS
AND COMMISSIONS AND WE'RE IN
STRONG SUPPORT OF ITEM SIXTEEN
THIS SEVEN HUNDRED FIFTY
MILLION FOR BEHAVIORAL HEALTH
INFRASTRUCTURE. THANK YOU THANK
YOU VERY MUCH NEXT CALLER
PLEASE. LINE TWENTY FOUR TO
FOUR PLEASE GO AHEAD. THANK YOU
MARTI AMADO FAMILY MEMBER OF
TWO INDIVIDUALS WITH DELL
DEVELOPMENTAL DISABILITIES ALSO
A MEMBER OF THE DEVELOPMENTAL
SERVICES PASSPORTS AND SERVED
ON THE MASTER PLAN FOR AGING
SUBCOMMITTEE- ON ISSUE SIX
SUPPORT MY- THE- GOOD TO HAVE
RAISED THE ISSUE OF MAKING
THOSE BENEFITS AND SUPPLEMENTAL
RATES PERMANENT. SIMILAR ISSUE
IN REGIONAL CENTRES- THAT WILL
BE BROUGHT UP NEXT WEEK AND ON
ITEMS OUT FIVE- SUPPORT I
REALLY APPRECIATE THE
DEPARTMENT IRENE GAUGING ON
KELLYANE TO SUPPORT THAT BUT
APPRECIATE THE SUBCOMMITTEE
CONCERNS WHICH WE SHARE. AND
LASTLY REALLY APPRECIATE- THAT
SUBCOMMITTEE DOING THIS HEARING
THANK YOU SO MUCH. THANK YOU
VERY MUCH NEXT CALLER PLEASE.
NINE TWO NINE NINETY TWO PLEASE
GO AHEAD. THANK YOU MADAM CHAIR
MEMBERS OF THE SENATE
SUBCOMMITTEE THREE MY NAME IS
KAREN MODERN ROCK AND I'M
CALLING ON BEHALF OF AN
ASSEMBLY CLINIC A COMMUNITY
HEALTH CENTER SERVING TWENTY
THOUSAND PEOPLE IN LOS ANGELES
COUNTY I'M COMMENTING ON ISSUE
NUMBER EIGHT WE ARE STRONG
SUPPORTERS OF EXPANDING
TELEHEALTH INCLUDING TELEPHONIC
CARE BEYOND THE COVETED AFTER.
ENDEMIC CURRENTLY OVER 60% OF
OUR VISIT OUR VIRTUAL BUT NO
MORE THAN 15% OF THESE VIRTUAL
VISITS ARE COMPLETED BY VIDEO
WE KNOW THAT TELEHEALTH
ESPECIALLY TELEPHONIC IS THE
SOLUTION TO ADDRESS EXISTING
HEALTH DISPARITIES HOWEVER MANY
OF OUR PATIENTS DON'T GET PAID
SIX HUNDRED EMPLOYEES TAKING
TIME OFF TO THAT WITH THE
CONNECTING FORFEITING INCOME.
ALSO MANY OF OUR PATIENTS RELY
ON TIME CONSUMING PUBLIC
TRANSPORTATION BEING ABLE TO
SPEAK TO THE CLINICIAN OVER THE
HOLIDAYS AND PRECIOUS TIME AND
MONEY. AND INSURERS ARE GETTING
THE MEDICAL CARE THEY NEED. I
NO SHARP OF ONLY FOUR PER FOR
TOLD. VISIT SHOWS HOW WELL THEY
ARE WORKING. GREATLY CONCERNED
THAT TELEPHONIC VISITS ARE
BEING LOCKED OUT OF THE
ADMINISTRATION HELLO HOPE
PROPOSAL. PLEASE DO NOT LEAVE
OUR COMMUNITY BEHIND MAKE SURE
TELEPHONIC CARE IS INCLUDED IN
ANY TELEHEALTH PROPOSAL THANK
YOU. THANK YOU VERY MUCH SEEMS
LIKE TELEPHONIC CARE IS A BIG.
TICKET ITEM TODAY NEXT CALLER
PLEASE. NINE SIXTY SEVEN SIX
SEVEN PLEASE GO AHEAD. MADAM
CHAIR MEMBERS THERE ARE LOCKS
ON BEHALF OF THE CALIFORNIA PAN
ETHNIC HEALTH NETWORK AND ON
EXPANDED TELEHEALTH FLEXIBILITY
THE ISSUE OF THE DAY- YOU CAN
APPLAUD THE GOVERNOR'S PROPOSAL
FANS AND MAKE PERMANENT CERTAIN
TELEHEALTH FLEXIBILITY AND TO
IT ADD THE REMOTE PATIENT
MONITORING AT THE NEWS THAT
COVERED BENEFIT. AND GIVEN THE
RAPID DEPLOYMENT OF THE NEW
TECHNOLOGY IT'S INCREDIBLY
IMPORTANT THAT ATTENTION PAID
THE NEW THAT BLACK INDIGENOUS
AND PEOPLE OF COLOR INCLUDING
LOW INCOME SENIORS LIMITED
ENGLISH PROFICIENT PEOPLE WITH
DISABILITIESAND THOSE LIVING
IN RURAL AREAS TO EXPERIENCE
VISUAL BARRIERS AT HIGHER RATE.
IT'S ALSO IMPORTANT THAT THE
LEGISLATURE ENSURE EQUITABLE
ACCESS TO TELEHEALTH TECHNOLOGY
TO ALL PATIENTS CAN BENEFIT
FROM IMPORTANT FLEXIBILITY THAT
WE SUPPORT THE GOVERNOR'S
PROPOSED INVESTMENT AND REQUEST
THE LEGISLATURE INCREASED ITS
INVESTMENT AND TARGET THE
DOLLARS TO ENSURE EQUITABLE
ACCESS TO TELEHEALTH TO
ADOPTION OF BROADBAND AND FIBRE
OPTIC AND DIGITAL CELLULAR
TECHNOLOGY- AND ALSO EXPANDED
ACCESS TO APPROPRIATE PATIENT
TOOLS AND SUPPORT FOR PATIENTS.
ON CALLAHAN WE ARE SUPPORTIVE
OF MANY ELEMENTS THE CALAMP BUT
WE ALSO SHARE THE CONCERNS
ABOUT THE TRANSFER OF
ADDITIONAL RESPONSIBILITIES
HEALTH PLAN THAT HISTORICALLY
FALLEN SHORT ON DELIVERING
BASIC CARE INCLUDING THE
PROVISION OF LANGUAGE
ASSISTANCE SERVICES ENSURING
TIMELY PRIMARY AND SPECIALTY
CARE ACCESS. AND PROVIDING IT
WITH REASONABLE ACCOMMODATION-
AND SO WE SUPPORT THE ALLEY
OWES RECOMMENDATION THAT THE
LEGISLATURE USE THAT PROCESS TO
RESOLVE THE OUTSTANDING
QUESTION- AND WEIGH THE
BENEFITS AND RISKS OF THE
CURRENT REFORM PACKAGE AND
IDENTIFY COMPONENTS THAT MAY
STILL BE NOTHING THANK YOU SO
MUCH. THANK YOU VERY MUCH NEXT
COLOR PLEASE. NINE EIGHT PLEASE
GO AHEAD. THANK YOU GOTTA MADAM
CHAIRMAN OF THE COMMITTEE THREE
MY NAME IS JULIE BATES AT AMBER
HOUSE ON BEHALF OF THREE POINT
THREE MILLION AARP MEMBERS IN
CALIFORNIA WE STRONGLY SUPPORT
MAKING PERMANENT THE EXPANSION
OF THE TELEHEALTH ALLOWED TO.
DUE TO THE PUBLIC HEALTH
EMERGENCY INCLUDING ISSUE
EIGHT. TELEHEALTH SERVICES HELP
TO EXPAND HEALTHCARE ACCESS AND
THEREFORE IT ADDRESS MANY
EXISTING HEALTH INEQUITIES.
TELEHEALTH IS SAFE EFFECTIVE
PROVEN MODEL OF CARE THAT HAS
THE SUPPORT OF BOTH PATIENTS
AND PROVIDERS. CONTINUATION OF
TELEHEALTH FLEXIBILITY IS A
CRITICAL COMPONENT IN IMPROVING
CALIFORNIA'S HEALTH CARE
INFRASTRUCTURE AND IT WILL HELP
PAVE THE WAY FOR FUTURE HEALTH
CARE INNOVATION AND
ADVANCEMENT. WE STRUCK FINALLY
SUPPORT TELEHEALTH EXPANSION.
AND IT IS A PRIORITYFOR OLDER
ADULTS AND THEIR CAREGIVERS
THANK YOU. THANK YOU VERY MUCH
NEXT CALLER PLEASE. NINE EIGHTY
FIVE EIGHT FIVE PLEASE GO AHEAD.
THANK YOU TERM MEMBERS THERE
BUT ON BEHALF OF THE
ASSOCIATION OF CALIFORNIA
HEALTHCARE DISTRICT COMMENTING
ON ISSUE AND- ALLOW VOTER
DISTRICTS OF ALL TYPES UTILIZED
TELL HOW TO DELIVER PRIMARY AND
SPECIALTY CARE HELLO
PRESERVATION AND EXPANSIONS ARE
ESSENTIAL TO ACCESS TO CARE
THROUGHOUT CALIFORNIA
ESPECIALLY IN RURAL AND
UNDERSERVED AREAS OF THE STATE.
AND THE PORTANTINO THAT NOT ALL
CALIFORNIANS HAVE ACCESS TO
HIGH SPEED INTERNET CAPABLE OF
ALLOWING FOR THINKING TO TELL
HOW WITHOUT RECOGNITION AND
REIMBURSEMENT FOR TELEPHONIC
REMOTE PATIENT MONITORING
ASYNCHRONOUS CARE HOPEFUL NOT
MEANINGFUL STRIDES IN
DELIVERING CARE TO DOUG YET
NOW. FOR THESE REASONS WE HAVE
SIGNIFICANT CONCERNS WITH THE
DTS PROPOSAL TO CREATE A
SEPARATE FEE STRUCTURE I'M ROLL
BACK MANY OF THE CURRENT
TELEHEALTH SERVICES FOR
ANYTHING CORRECT CARE AMONG
OTHER ITEMS LOOK FORWARD TO
CONTINUING THE CONVERSATION
WITH THE LEGISLATURE INTO
COLDER TO EXPAND ACCESS FOR
CALIFORNIANS THANK YOUNG. THANK
YOU VERY MUCH NEXT CALLER
PLEASE. BY EIGHTIES. EIGHT
SEVEN. PLEASE GO AHEAD. GOOD
AFTERNOON MADAM AND MEMBERS
MANY IS LUCY QUESTION AND
SPEAKING HERE TODAY ON BEHALF
OF MATERNAL AND CHILD HEALTH
ACCESS OF THEIR TWO SEPARATE
ISSUES WE'D LIKE TO ADDRESS THE
FIRST ONE CONCERNS ISSUES TWO
AND FIVE COMBINED- WE COMMEND
THE DEPARTMENT FOR WHAT SOUNDS
LIKE A VERY LONG RUN WAY THAT
IT'S BUILDING FOR THE UNWINDING
FROM THE- PANDEMIC MORATORIUM
ON DISCONTINUANCE IS FROM THAT
ACCOUNT. AND WE VERY MUCH LOOK
FORWARD TO. CONTINUING TO WORK
WITH THE DEPARTMENT ABOUT THE
BEST STRATEGIES AND FLEXIBILITY
IS TO SEEK FROM CMS TO ENSURE
THAT THE MOST VULNERABLE
MEDICARE BENEFICIARY SUCH AS
POSTPARTUM INDIVIDUALS AND
THEIR YOUNG CHILDREN. ARE KEPT
ON THAT RUNWAY FOR AS LONG AS
NEEDED AND AS IS POSSIBLE. ON
THE SECOND ITEM I'D LIKE TO
ADDRESS INVOLVES ISSUE NUMBER
FIVE THE CALLIN PROPOSAL NCH
ACCESS- IS INVOLVED WITH FAMILY
MEMBERS FACING THE TYPES OF
CHALLENGES THAT THE CAL AIMED.
PROPOSAL TARGETS JUSTICE
INVOLVED INDIVIDUALS AND
FAMILIES HOMELESS INDIVIDUALS
PEOPLE WITH SUBSTANCE ABUSE
DISORDER THEY'RE ALL PART OF
THE COMMUNITY THAT MATERNAL AND
CHILD HEALTH ACCESS SERVICE.
AND WE COMMEND THE DEPARTMENT
FOR EDUCATION INTEL LANE
HOWEVER WE MUST EXPRESSED
CONCERN ABOUT A PART OF THE
COUNTING PROPOSAL THAT HAS NOT
RECEIVED MUCH ATTENTION AT ALL
AND THAT IS. A VERY BIG PROBLEM
FOR PREGNANT INDIVIDUALS THE
MANDATORY MANAGED CARE PROPOSAL
INVOLVED ACCOUNT. COULD RESULT
IN MUCH LESS ACCESS TO
PREGNANCY RELATED CARE. THIS IS
FOR A VARIETY OF REASONS ONE OF
THEM IS THAT. IF YOU PLANS
CONTRACT WITH A SUFFICIENT
NUMBER OF CERTIFIED NURSE
MIDWIVES OR LICENSED MIDWIVES
TO MEET THE NEEDS THIS IS
ESPECIALLY TRUE IN. RURAL AREAS
BUT NOT LIMITED URBAN AREAS
ALSO FACE PROBLEMS. WITH ACCESS
MAKING. PREGNANCY WILL NAY.
MANDATE TEN CARE WILL ONLY A-
THAT PROBLEM T ALSO HAS REALLY
NO PLACE THE PROPOSAL OF MAKING
HOLDEN POPULATIONS MANDATORY TO
MANAGED CARE REALLY HAS NO
PLACE WITH THE OVERALL DESIGN
OF KILLING. SO WE URGE MEMBERS
TO REJECT THAT PART OF THE
PROPOSAL THANK YOU VERY MUCH
THANK YOU VERY MUCH NEXT CALLER
PLEASE. MY NINETY THREE NINE
THREE YOUR LINE IS OPEN. GOOD
AFTERNOON MADAM CHAIR SHARE
GONZALEZ TESTIFYING ON BEHALF
OF A RIGHT FOR RIGHT EIGHTY UP
CLIENT ON ISSUE EIGHT AN ISSUE
NINE ON THE ISSUE EIGHT THE
CALIFORNIA LIFE SCIENCES
ASSOCIATION SUPPORT THE
DEPARTMENT OF HEALTH CARE
SERVICES. REQUESTED EXPENDITURE
EXPENDITURE AUTHORITY CAN
SUPPORT A NEW REMOTE. PATIENT
MONITORING BENEFIT. OUR AND
THEY'RE TELLING PROPOSAL BREAK
TO PRIMARY THANK YOU. I THANK
YOU CONTACTING. AS A RESULT
BECAUSE THAT NINETEEN REMOTE
PATIENT MONITORING DEVICES ARE
MORE IMPORTANT THAN AFTER FOR
BOTH CRITICALLY AND CHRONICALLY
ILL PATIENTS AS WELL AS
PROVIDERS. FIND ISSUES NINE I'M
TESTIFYING ON BEHALF OF MY
CLIENT AND I FEET THAT THAT THE
INSURANCE THE AMERICAN DIABETES
ASSOCIATION SUPPORT G. THE
ACTOR REQUESTED EXPENDITURE.
ALL MEDICARE BENEFITS FOR
BENEFICIARIES WITH TYPE ONE
DIABETES THE EIGHTY EIGHTH
REPORT TO COVER JACKSON CAN
THAT WILL CUT MONITORS ONE
PRESCRIBED BY A PHYSICIAN AT
MEDICALLY NECESSARY AND WE URGE
THE COMMITTEE TO PLEAD ADOPT
BDA THE ACTOR REQUESTED
EXPENDITURE AT. FORTY TO
ADDRESS AT THE NEW BENEFIT AND
MEDIC COW THANK YOU VERY MUCH
THANK YOU VERY MUCH THANKS
COLOR PLEASE. ONE NINETY FOUR
NINETY PLEASE GO AHEAD. GOOD
AFTERNOON MADAM CHAIR MEMBERS
JUSTIN RANDALL THE CALIFORNIA
DENTAL. HAVE COMMENT ON TWO
ITEMS HERE- ITEM NUMBER FIVE ON
TELLING WE APPRECIATE THE
DEPARTMENT PLANS TO TRANSITION
THE MULTIPLE PIECES OF THE
DENTAL TRANSFORMATION
INITIATIVE INTO THE OVERALL
DENTAL PROGRAMS TO THE CALENDAR
NISHIDA BUT GIVEN THAT THE MSP
DID NOT EXTEND THE DISPUTE
FUNDING ALONG WITH THE REST OF
THE UNDER FIFTEEN LEVER
EXTENSION WE DO HAVE CONCERNS
THAT A JANUARY FIRST TWENTY
TWENTY TWO START DATE. FOR THE
DENTAL SEGMENT OF THE COUNTING
WILL CREATE- AND GAVIN PROVIDER
RATE AND ON ISSUE NUMBER EIGHT
FOR TELEHEALTH ME WOULD LIKE TO
THANK ADMINISTRATION FOR
COMMITTING TO EXTEND THE
TELEHEALTH BUT THE ABILITIES
THAT WERE ALLOWED DURING THE
PANDEMIC IN HIS JANUARY BUDGET
PROPOSAL HOWEVER WE WERE
DISAPPOINTED AT THE OF THE
DEPARTMENT GPL DOES NOT INCLUDE
THE ABILITY TO ESTABLISH A
TEACHING. HELLO HELLO THE RIGHT
TO DENY HOME MODEL IS
SUCCESSFUL EVIDENCE BASED MODEL
FOR TELEHEALTH IN WITH THAT HI
JENNIFER IN THE SYSTEM'S GOING
THE COMMUNITY FIGHT THROUGH
DIAGNOSTIC PREVENTATIVE AND
EARLY INTERVENTION DENTAL CARE
IN PARTNERSHIP WITH THE
COLLABORATING DENTIST YOU WOULD.
USE OUR RECORDS ABOUT. THE
DEPARTMENT LANGUAGE HAS THE- TO
UNDERMINE EXISTING. EXAMPLE OF
COULDN'T PROGRAM. WE ASK THAT
YOU PLEASE EVEN. TO FOR
TELEHEALTH AND WITH LED LOOK
FORWARD TO A ON BLOOD. ON THESE
ISSUES THANK YOU SO MUCH THANK
YOU FOR MUCH TAX COURT PLEASE.
MY NAME SEVEN NINE SO. PLEASE
AHEAD. AFTERNOON I CHAIRMAN AT
THE WITH THEM AFFILIATE BUT
PROVIDING ON NUMBER EIGHT
RELATED TO TELL. INTERCONNECTED
GAS QUINN PARENT HAS SEVEN AND
IMPLEMENT INNOVATIVE HEALTHCARE
DELIVERY TO CONTINUE CARE OVER
FROM HUNDRED THOUSAND PATIENTS
IN THE- OVER EIGHTY FIVE PER OF
ARE MEDICAL YOU. SPENT BY MARCH
TWENTY BY PERCENT OF THE THIRD
IN THE OF THE PROVIDED VIA
WHOLE AND OF THE HAVE BEEN
AUDIO ONLY THAT WELCOME THROUGH
THE ENACTED WITHIN THE SYSTEM
WE CAN. INCREASE ACCESS FROM
COPIES BY ENSURING THAT OUR
STATE HEALTH POLICIES ARE BOTH
ABOUT A COMMERCIAL INSURANCE I
AM THE CONCERNS THAT HAVE BEEN
TODAY THE DH YEAH OF THE LAW
ENFORCEMENT FALSE ABOUT HOW.
NEED AND IS THERE FOR AND
ARGUED COMMITTEE TO COMPATIBLE
THE BY MEDICAL BY CONTINUING
PARITY FOR AUDIO THOSE THAT
REMEMBER IDEAL FOR THE NEW P.
AND CONTINUE REMOTE MOMENT
LIMITED MEDICAL PROGRAM BILL
PARTY CONTINUING CAN VERY MUCH
OUR NEXT CALLER HOLD. YOUR.
NINE ONE HUNDRED ONE ZERO ZERO
GO OUT. ONE HUNDRED DR HANY
COULD SEEN AND WE WERE HE
INSTITUTE A NATIONAL. AT THE
TIME QUALITY RESEARCH BY ACTUAL
ADULT WHO ARE THREE FOR. WE
ISSUED A TWENTY SIX PAGE WERE.
AND IT IS IN THE INBOX OF ALL
THE OF THE COMMITTEE AS WELL AS
THE ASSEMBLYMEMBER'S REPRESENT
WHERE I AM A GOOD FIT. WE ARE.
CONCERNED THE CAL. OF PROVISION
FOR EXPAND CASE WHICH IS NOT
COMES WITH THE A EIGHT. FOR
ACCOMMODATING REASONABLY
AVAILABLE THE COMMUNICATION AND
CARAMEL THE COMMUNICATION
IMPAIRMENT MAKES IT PROHIBITIVE
TO ACCESS TELEHEALTH MAKE THE
PROHIBITIVE FOR LAND TWO MEN
DON'T. KNOW I CASE MANAGER WHO
ARE TO. SERVICE CORPS. ARE IT
MAKES IT IN. FOR ALL MANNER
CARE FOR CASE ACCORDING. LIKE
THE ONE THAT MIGHT HAVE. HI
HERE PROBABLY MANAGE ON THE BAY
OF ALL OF THEM GENETICS
MORBIDITY WE'RE I AM LIMITED TO
ONE TOPIC HOME WARRANTY- ISSUE-
PHONE CALL. INCREASING G. TERRY
FOR THESE PROFESSIONALS.
REPLICATE. FOR DOMINATION BY
SPEECH LANGUAGE FOR IF CONTINUE
TO ASK HIS MANAGER ONE FOR
MEMBERS EMERGENCY BECAUSE DAHLE.
HELLO PROVIDERS YOU CAN AND WE
CONTINUE TO ASK YOU KNOW NON
CREDENTIALED INDIVIDUALS TO
PROVIDE AN ACCOMMODATION FOR
COMMUNICATION IMPAIRMENT WE
FAILED. HOW A FEDERAL RIGHT
REASONABLE ACCOMMODATION FOR
MORE OF A COMMUNICATIONS AND
ALTERNATIVE COMMUNICATION WITH
NATALIE I'M ASKING THAT YOU
PLEASE. CONSIDER THE
COMMUNICATION SUPPORT. TWENTY
FIFTY REPORT A FIVE YEAR OLD
WITH. FOR UNC HEALTH PROGRAM
THAT WAS IN THE STATE THANK YOU
VERY MUCH FOR YOUR CALL YOU
VERY FOR YOUR CALL AND THERE'S
ALWAYS THE OPPORTUNITY EMAIL
THE COMMITTEE FOR FURTHER
FOLLOW UP NEXT COLOR PLEASE AND
MODERATOR THANK YOU FOR DOING
SUCH A GOOD JOB TODAY HELPING
US KEEP ON TRACK. THANK YOU
MANAGER WILL GLOBAL LINE ONE OH
TWO. ONE HUNDRED TWO PLEASE GO
AHEAD. GOOD AFTERNOON CHAIR
MEMBERS ARE SELLING OF OUR WITH
THE CHILDREN'S PARTNERSHIP I AM
INTERESTING A FEW ITEMS
DISCUSSED TODAY. WE URGE- WE
URGENT ECHO THE COMMENTS TO
ADOPT ONGOING CONTINUOUS
COVERAGE FOR AT LEAST YOUNG
CHILDREN AT LEAST DURING THE
POST CONDEMNING REDETERMINATION
PERIOD. POST PANDEMIC
REDETERMINATION FURTHER WE
STATE DISINVESTMENT IN
COMMUNITY BASED PARTNERSHIPS TO
ENGAGE IN COMBAT NINETEEN
RECOVERY AND WE'LL FOLLOW UP
FOLLOW UP WITH WRITTEN
COMMENTS. ON ITEM FIVE WE URGE
THE INVESTMENT TO BE EXPANDED
TO ALSO INCLUDE ONE KIND AND
INFRASTRUCTURE INVESTMENT IN
THE BASIC CARE COORDINATION
SYSTEMS FOR ALL MEDICARE
BENEFICIARIES UNDER. A CALLIN
POPULATION HEALTH MANAGEMENT
REQUIREMENTS AND AGAIN THE
CONTINUED COVERAGE FOR YOUNG
CHILDREN AS WELL AS THE
INCENTIVE IN ORDER TO BOOST THE
LOW PREVENTATIVE CARE RATE FOR
CHILDREN ON ISSUE SIX WE
STRONGLY URGE THE REPEAL OF
THE- MENTION OF PROPERTY SIX
COUPLE MENTAL PAYMENT. ON ISSUE
EIGHT WHICH WE ARE STRONG
SUPPORTERS OF INCREASING ACCESS
TO TELEHEALTH FOR FAMILIES OF
COLOR AND LOW INCOME FAMILIES.
WE ARE TO LEGISLATURE AND THEN
MINISTRATION TO RECONSIDER THE
TELEHEALTH PROPOSAL IN ITS
CURRENT FORM AND ENSURE
COMMUNITY HEALTH CENTERS CANADA
WHICH PATIENTS USING
ASYNCHRONOUS TELEHEALTH AND BE
REIMBURSED FOR AUDIO ONLY TELL
A WHOLE. ON ISSUE FIFTEEN
SEVENTEEN AND EIGHTEEN WE
APPLAUD THE PROPOSED WHOLE
CHILD APPROACH TO MENTAL HEALTH
INVESTMENT. YOU KNOW THERE'S
MORE TO BE DONE PARTICULARLY TO
ENSURE THE INVESTMENT BEGIN IN
EARLY CHILDHOOD AND THAT THE
LOCAL SCHOOLS HAVE RESOURCES
AND TECHNICAL CAPACITY
NECESSARY TO PARTNER LOOK
LOCALLY FOR LONG TERM SCHOOL
BASED MULTI TIERED SYSTEMS OF
SUPPORT. THANK YOU FOR YOUR
CONSIDERATION. THANK YOU VERY
MUCH NEXT CALLER PLEASE. BLIND
ALSO ONE OF HUNDRED SIX PLEASE
GO AHEAD. HI GOOD AFTERNOON
MADAM CHAIRMAN INPUT COMMITTEE
JET HAMPER CAL THOUGHT THEY
HELP REPRESENTING FORTY POP
NONPROFIT WORK ORGANIZATION
THAT COLLECTIVELY DELIVER
HEALTHCARE COVERAGE TO
APPROXIMATELY TWENTY SEVEN
MILLION CALIFORNIANS. I THANK
YOU FOR THE OPPORTUNITY TO
PROVIDE PUBLIC COMMENT ON
TODAY'S HEARING I AM INTERESTED
TIME I JUST WANT TO EXTEND OUR
APPRECIATION FOR ALL WORKING
DOWN THE VERY SILENCE THE SCRAP
TODAY AND WE LOOK FORWARD TO
WORKING WITH LEGISLATURE AND
ADMINISTRATION ON MANY OF THESE
ITEMS. INCLUDING ITEM NUMBER
FIVE ON CALTRAIN AND ITEM
NUMBER EIGHT ON TELEHEALTH
AMONG OTHERS REPORTING
ADDITIONAL DETAIL HIS PROPOSALS
AND BEING A PART OF THE
SESSIONS MOVING FORWARD THANK
YOU. THANK YOU VERY MUCH TAX
COLOR PLEASE. HELLO ONE SEVEN
ONE HUNDRED SEVEN PLEASE GO
AHEAD. ONE OF SEVEN I'M LYING
ONE OH SEVEN AND I'M CALLING TO
SPEAK ABOUT ITEM NUMBER TWO-
THE TESTING AND- BAXEEN- EFFORT
AMONG THE STUDENTS OF
CALIFORNIA AND I'M CALLING TO
EXPRESS MY DEEP CONCERN THAT
PEOPLE ARE GIVEN INFORMED
CONSENT ABOUT THIS VACCINE.
ADDITIONAL VACCINES CONTAIN
CHOPPED UP PIECES OF THE VIRUS.
SO THAT THE RECIPIENT CAN GET
IMMUNITY WITHOUT GETTING THE
DISEASE. BUT THIS IS NOT A TRUE
VACCINE THIS IS MRNA TECHNOLOGY
THAT CAUSES THE RECIPIENT CELLS
TO MANUFACTURE THE ANTIGEN ON
ITS OWN AND THEY DON'T KNOW IF
THIS WILL WORK BECAUSE THIS IS
A NEW TECHNOLOGY. AND PEOPLE
NEED TO BE GIVEN TRUE INFORMED
CONSENT ABOUT THIS BECAUSE
WHERETHERE IS RISK THERE MUST
BE CHOICE. UNLESS PEOPLE ARE
BEING EDUCATED ABOUT WHAT THIS
IS AND IT IS NOT A TRUE VACCINE
IT IS M. R. ANY TECHNOLOGY THEN
OUR LEGISLATORS ARE NOT DOING
THEIR DUE DILIGENCE AND IN
TERMS OF THE TESTING YOU ARE
PROMOTING THIS TESTING AND YOU
VERY MUCH MEMBERS NEXT CALLER
PLEASE. WE'LL GO TO LINE ONE OH
NINE ONE HUNDRED NINE PLEASE GO
AHEAD. HI MY NAME IS CRYSTAL
MARTIAN A PULLEY ON L. AND THE
CHIEF ADVOCACY OFFICER BEYOND
TYPE ONE DIABETES NONPROFIT
ORGANIZATION HEADQUARTERED IN
CALIFORNIA. THEM COMING TO ME
THAT HEY ON ISSUE NUMBER NINE
AND EXPRESSING BEYOND TYPE ONE
STRONG SUPPORT TO THE
GOVERNOR'S PROPOSALS YOU GM FOR
MEDICARE BENEFICIARIES. SEVEN
INDIVIDUAL MYSELF LIVING TYPE
ONE DIABETES FROM A THIRTY
EIGHT YEAR I PERSONALLY KNOW
THE BENEFIT. OF CONTINUOUS
GLUCOSE MONITORING PROFESSOR
DIABETES MANAGEMENT. AND PBMS
ROLE IN PREVENTING COSTLY ER
VISITS AND COSTLY
HOSPITALIZATIONS. DUE TO
DANGEROUSLY. LOW AND HIGH
GLUCOSE LEVEL. DID YOU TO
PROVIDE BROADER ACCESS TO THE
GYM TECH. BEYOND THE CURRENT
COVERAGE IN THE CALIFORNIA
PEDIATRIC POPULATION BECAUSE AS
ADULTS WE DO NOT OUTGROW OUR
TYPE ONE DIABETES WE APPRECIATE
YOUR CONSIDERATION THANK YOU
THANK YOU VERY MUCH NEXT CALLER
PLEASE. LINE NINETY EIGHT NINE
EIGHT GO AHEAD. HE MADAM CHAIR
RED BULL HAGER PUT PSYCHIATRIC
BUSINESS PHYSICIAN'S ALLIANCE
OF CALIFORNIA- WE FIND A LOT
LIKE IN THIS BUDGET- PROPOSALS-
ALL THESE BUDGET PROPOSALS IN
PARTICULAR ITEMS EIGHT SIXTEEN
SEVENTEEN AND TWENTY AND TWENTY
WE THANK THE ADMINISTRATION OR
RECOGNIZING DIDN'T NEED TO STEP
UP TO DO THE DATA GATHERING
REPORTING AND OVERSIGHT. OF
ASSISTED OUTPATIENT TREATMENT
BOND ISSUE SEVEN WE ASSOCIATE
OURSELVES WITH COMMENTS MADE BY
DR HANLEY SHARE THOSE CONCERNS
ISSUE PAGE WE ARE POOR- PARITY
IN- AUDIO ONLY SERVICES TO
MAINTAIN THAT- AMOUNT ISSUE
SEVEN THEY ARE SORRY SIXTEEN-
WE WOULD JUST NOTE THAT THERE
IS SEEMS TO BE- A LITTLE BIT OF
IT OVERSIGHT AND NO DISCUSSION
ABOUT. THE WHOLE ISSUE OF
INSTITUTES FOR MENTAL DISEASE
AND WHAT A PROBLEM THAT THEY
GAVE- SERVER. IN THE SYSTEM AND
YOU KNOW THAT THEY PREVENT
PEOPLE FROM ACTUALLY TIMELY
LEAVING IT PATIENT UNITS WE
LOOK FORWARD TO FURTHER
DISCUSSIONS ON ALL THESE
MATTERS THANK YOU. THANK YOU
VERY MUCH NEXT CALLER PLEASE.
BLIND NINE SEVEN NINE ALAINA
OPEN. A GOOD AFTERNOON MADAM
CHAIR MEMBERS MARKET CARRERA
THE AND COUNTY ISSUE AND WE ARE
IN SUPPORT OF THE AUGMENTATION-
OF SIXTY FIVE POINT FOUR
MILLION FOR ITEM NUMBER THREE
WHICH IS A MEDIC CAL COUNTY
ADMINISTRATION THANK YOU VERY
MUCH FOR ALL YOU DO IS GREATLY
APPRECIATED. THANK YOU VERY
MUCH NEXT CALLER PLEASE. LINE
ONE FIFTEEN ONE ONE FIVE PLEASE
GO AHEAD. HI CAN YOU HEAR ME
PLEASE PROCEED. WHAT YOU KNOW
WHAT MY NAME'S AMY AGAIN YOU
CUT ME OFF BEFORE WE DON'T WANT
YOUR VACCINE. WE DO VERY MUCH
COLOR YOUR BACK. THANK YOU VERY
MUCH NEXT CALLER PARTIES. OUR
FINAL COMMENT IN QUEUE LINE
SEVENTY SEVEN ZERO PLEASE GO
AHEAD. MADAM CHAIR AND MEMBERS
ANY BLOMBERG WITH THE
CALIFORNIA ASSOCIATION OF
HEALTH FACILITIES I'D LIKE TO
ALIGN MY COMMENTS- FOR ISSUE
NUMBER SIX WITH KATHY BONTA
BURKE WITH THE DEVELOPMENTAL
SERVICES NETWORK ON BEHALF OF
ICS ET FUNDING AND FOR
PEDIATRIC SUB ACUTE- AND ALSO
WANT TO COMMENT ON ISSUE NUMBER
ELEVEN. PENALTIES FOR IMPROPER
DISCHARGES THAT SKILLED NURSING
FACILITIES CASTLE STRONGLY
OPPOSE TRANSFERS AND DISCHARGES
ARE COMPLICATED AND CHALLENGING.
THIS ISSUE. HE AND P. M. S. ARE
HAS ABILITY FIND THE BILL FIFTY
DOLLARS A DAY FOR FAILURE TO.
WITH THE TRANSFER DISCHARGED
DECISION FOR GIVEN THE LEVEL
TYPE PATIENT OF THE PENALTY
ABOUT THOUSAND. THE PROPOSAL AS
THE NEW FINDINGS ABILITY THAT
TWENTY TIMES THE CURRENT FINE
ASSESSED BY CPA. THOUSAND
DOLLARS A DAY WITH A MAXIMUM OF
A HUNDRED THOUSAND DOLLARS IT'S
IMPORTANT TO KNOW HOW THE ACS
CAME UP WITH THE FINE AMOUNT
AND ARE THESE. HIGH PENALTIES
APPROPRIATE. THE CURRENT.
CANCER DISCHARGED PROCESS WITH
LAW. OF DENIED DUE PROCESS TO
SKILLED FOR SHOULD REASON. FOR
JUST CHARGING. ARE OFTEN
RELATED TO CONCERNS REGARDING
SAFETY. OF RESIDENTS AND STAFF.
BUT NOW WITH THIS ITEM STATE
THAT THE OFFICE OF
ADMINISTRATIVE HEARING APPEALS
FROM PHD S. CONDUCT THE HEARING
AND GIVES A MISIMPRESSION THAT
THESE ARE FORMAL HEARING.
CONDUCTED BY ADMINISTRATIVE LAW
JUDGES THAT A LOT. IN FACT
EITHER INFORMAL HEARING THAT
ARE CONDUCTED BY HEARING
OFFICERS WHO DO NOT DETERMINE.
WHAT CONSIDER THE CORE
SUBSTANTIVE ISSUES REQUIRED
UNDER THE APPLICABLE FEDERAL
REGULATIONS. THANK YOU VERY
HARD TO CHANGE AND TO BE GIVEN
A PUBLIC POLICY HEARING. THANK
YOU VERY MUCH THANK YOU- THAT'S
ALL THE CALLS WE HAVE TODAY BUT
OF COURSE YOUR CALLS AND YOUR
FEEDBACK AND YOUR INPUT IS VERY
IMPORTANT TO US SO WE ENCOURAGE
YOU TO REACH OUT TO THE
COMMITTEE IF YOU DIDN'T GET TO.
SPEAK TODAY OR IF YOU DIDN'T
GET TO SPEAK QUITE AS LONG AS
YOU WANT TODAY AND YOU HAVE
MORE. SPECIFIC THINGS YOU'D
LIKE TO SED US- I'M GONNA
THINK THE MODERATORFOR DOING A
GREAT JOB IN KEEPING US ON
TRACK. THANK THE DEPARTMENT THE
STAFF AND. AND EVERYBODY WHO
WHO HAVE MADE THIS. COMMITTEE
HEARING. TODAY WITH THAT WE
WILL. THIS BUT SUB THREE
HEARING.