THE SENATE COMMITTEE ON
HEALTH WILL COME TO ORDER GOOD
AFTERNOON IN RESPONSE TO THE
COVE IN NINETEEN EMERGENCY AND
TO PROTECT THE PUBLIC
LEGISLATORS EMPLOYEES WE MUST
LIMIT NONESSENTIAL GATHERINGS
AND IT HERE TO SOCIAL DISTANCING
AND FACE COVERING GUIDELINES. IN
COMPLIANCE WITH THIS ORDER THE
SENATE HAS MADE NECESSARY
ADJUSTMENTS TO NORMAL PRACTICES
TO ENSURE THAT THE PUBLIC
CONTINUES TO HAVE ACCESS TO THE
LEGISLATIVE PROCESS WE ARE
HOLDING OUR COMMITTEE HEARINGS
HERE AT TEN TWENTY ONE- STREET
IN HEARING ROOM TWELVE HUNDRED
WELCOME. THEIR FIRST MEETING IN
HERE- FOR THE HEALTH COMMITTEE
AT LEAST. I DON'T KNOW IF ANY
OTHER COMMITTEE MET HERE YEAH.
IS THIS THE FIRST. HEARING IN
THIS ROOM- WE'RE NINE IT'S NOT
TO ME OKAY WELL ANYWAY WE'LL SEE
HOW WE DO THIS TIME OKAY. SO I
ASK THAT ALL MEMBERS OF THE
COMMITTEE BE PRESENT IN HEARING
ROOM TWELVE HUNDRED SO WE MISSED
OUT THIS RECORD IN THE BEGINNER
HEARING SO I KNOW THAT WE'RE NOT
IN THE CAPITAL ANYMORE. TO ALLOW
THE PUBLIC ACCESS
MEMBERS OF THE PUBLIC IN THE
HEARING ROOM TO THE EXTENT THAT
SOCIAL DISTANCING REQUIREMENTS
ALLOWING BE USING A
TELECONFERENCE REVIEWS FOR THOSE
INDIVIDUALS WISHING TO TESTIFY
TODAY. FOR ALL INDIVIDUALS
WISHING TO PROVIDE PUBLIC
COMMENT THE PARTICIPANT TOLL
FREE NUMBER AND ACCESS CODE IS
POSTED ON OUR COMMITTEE WEBSITE.
IT WILL BE D. B. DISPLAYED ON
THE SREEN AND I'LL ANNOUNCE IT
NOW. THE DAY'S PARTICIPANT
NUMBER IS EIGHT FOUR FOUR. TWO
NINE ONE SIX THREE SIX FOUR AND
THE ACCESS CODE IS. ONE FOUR
ONE. ONE ONE FOUR ZERO. FOR
DETAILED INSTRUCTIONS ON HOW THE
TELECONFERENCES TO WORKS PLEASE
REFER TO THE SENATE AND OUR
COMMITTEE WEBSITE. WHEN WE MOVED
TO PUBLIC COMMENT YOU'LL BE
PROMPTED BY A MODERATOR TO DIAL
ONE THEN ZERO FOR SUPPORT
OPPOSITION PRESS THIS ONLY ONE
TIME AND WAIT PATIENTLY FOR AN
OPERATOR TO ASSIGN YOU A LINE
NUMBER. THIS CAN BE A SHORT
WAIT. WHAT YOU RECEIVED A LIGHT
NUMBER YOU'LL WAIT IN THE QUEUE
FOR THE MODERATOR TO CALL YOUR
LINE NUMBER. AT THAT TIME YOU'LL
BE A MUTED AND YOU ARE NOW READY
TO ADDRESS THE COMMITTEE. THESE
NOTE THAT IN ORDER FOR US TO
HEAR YOU CLEARLY AND TO AVOID
ACOUSTIC FEEDBACK YOU MUST MUTE
THE DEVICE YOU'RE WATCHING THE
HEARING ON PRIOR TO GIVING
TESTIMONY OVER THE PHONE. IT IS
IMPORTANT WE HEAR FROM YOU WE
THANK YOU FOR YOUR PATIENCE.
THIS CHAIR I WILL MAINTAIN
DECORUM DURING THIS HEARING IS
THIS CUSTOMARY IN ANY INDIVIDUAL
WHOSE DESTRUCTIVE MAY BE REMOVED
FROM THE REMOTE MEETING SERVICE
OR HAVE THE CONNECTIONS MUTED.
TODAY WE HAVE ELEVEN BILLS ON
TODAY'S AGENDA PLEASE NOTE THAT
WE ARE NOT HEARING FILE ITEM
NUMBER SEVEN SP TEN TWENTY THREE
BY SENATOR TADO. WE DO HAVE TWO
ITEMS ON THE CONSENT CALENDAR
TODAY THEIR FILE ITEMS NUMBER
FIVE. SP NINE SIXTY SIX BY
SEVERAL OF MY OWN AND- I DON'T
NUMBER NINE SB ELEVEN SIXTY FIVE
BY SENATOR BATES. BEFORE WE
BEGIN PRESENTATION ON IT'S THE
ONLY ONE OKAY WE'RE NOT THERE
YET SO WE'LL SEE. WE WILL BEGIN
AS A SUBCOMMITTEE- O WE'LL TAKE
TAKE TESTIMONY THAT THE
SUBCOMMITTEE. I WOULD MAKE NOTE
THAT DUE TO CONSTRAINTS
REGARDING LENGTH OF HEARINGS
TOOK KNOWLEDGE CONSIDERATIONS IN
CLEANING PROTOCOLS I JUST HERE
AND- WILL BE INSTITUTING TIME
LIMITS ON TESTIMONY. EACH SIDE
WILL PERMIT THE PERMIT IN EQUAL
AMOUNT OF TIME- WHICH- IS GOING
TO BE- TWO WELL TOTAL FOUR
MINUTES OF FORMAL PRESENTATION
ON EACH SIDE- UP TO TWO
PRESENTERS SELF. AT TWO MINUTES
APIECE FOR EACH WITNESSES- WE
WILL GIVE SOME FLEXIBILITY- BUT
AGAIN A TOTAL FOUR MINUTES ON
EACH SIDE. AND THEN ADDITIONAL
WITNESSES WHO WISH TO TESTIFY
MUST LIMIT THE COMMENTATOR NAME
AFFILIATION AND OUR POSITION ON
THE MEASURE. SO WITH THAT- WE'RE
GONNA GO AHEAD AND BEGIN WITH
THEIR FIRST ITEM WHICH IS- ITEM
NUMBER ONE SP EIGHT FIVE FIVE-
BEING PRESENTED BY SENATOR
NEWMAN ONLY SEES HERE WELCOME TO
GIVE A CALL AND- YOU DO NOT YOU
DO NOT. YEAH WE'RE NOT THERE YET
NOT CHARLIE BUT- SO WHAT WHAT
SO- CENTER NEWMAN WELCOME AND UP
PLEASE- BEGIN YOUR- AND PRETTY
SOON GOOD AFTERNOON MISTER CHAIR
MY FIRST TIME IN THE HEARING
ROOM LOVE WHAT YOU'VE DONE WITH
THE PLACE. MR MEMBERS I AM HERE
TO PRESENT SENATE BILL EIGHT
FIFTY FIVE- BEFORE I BEGIN LET
ME FIRST THANK COMMITTEE STAFF
FOR THEIR THOUGHTFUL ANALYSIS.
AND NOTE THAT WE ARE CURRENTLY
IN THE PROCESS OF AMENDING THE
BILL TO ADDRESS THE CHANGES
SUGGESTED. SPECIFICALLY
CLARIFYING THAT C. PH IS EFFORTS
AND COLLABORATE WITH OTHER
ENTITIES WILL INCLUDE COLLECTING
DATA FROM EXISTING REPORTING
SYSTEMS. AND SPECIFYING THAT THE
STANDARDIZED FORM THAT CD PH
WILL BE REQUIRED TO DEVELOP ON
ITS BILL FOR COUNTIES USE CAN BE
IN ELECTRONIC FORM- NOW TO THE
BILL. SB EIGHT FIFTY FIVE WILL
CREATE A STATEWIDE CHILDHOOD
DROWNING DATA SYSTEM AS PART OF
A THREE YEAR. PILOT PROGRAM TO
BE ADMINISTERED THROUGH THE
CALIFORNIA DEPARTMENT OF PUBLIC
HEALTH WITH THE ULTIMATE GOAL OF
IDENTIFYING SAFETY IMPROVEMENTS
IN REDUCING CHILDHOOD DROWNINGS
AND NEAR DROWNINGS. IN OUR STATE
RECENT DATA FROM THE CDC SHOWS
THAT IN CALIFORNIA DROWNING
CONTINUES TO BE THE LEADING
CAUSE OF ACCIDENTAL DEATH AMONG
ONE TO FOUR YEAR OLDS AS WELL AS
THE SECOND LEADING CAUSE OF
DEATH. AMONG FIVE TO NINE YEAR
OLDS IN TWENTY SEVENTEEN THE
LEGISLATURE PASSED THE GOVERNOR
SIGNED. SB FOUR FORTY TWO THE
CALIFORNIA SWIMMING POOL SAFETY
ACT WHICH MANDATED REDUNDANT
COMMONSENSE BARRIERS TO REDUCE
THE LIKELIHOOD. OF CHILDHOOD
RESIDENTIAL DROWNINGS DESPITE
THE PASSAGE OF SB FOUR FOUR TO
DEVELOPING AND IMPLEMENTING
HOLISTIC AND STATEWIDE POLICIES
POLICY SOLUTIONS REMAINS
CHALLENGING. DUE TO AN OVERALL
LACK OF QUANTITATIVE DATA ON
DROWNINGS POLICYMAKERS PUBLIC
HEALTH EXPERTS AND ADVOCATES
CONTEND WE BUMP UP AGAINST THIS
LACK OF CRUCIAL INFORMATION.
WHEN ADDRESSING CHILDHOOD
DROWNINGS BECAUSE CALIFORNIA
STILL DOES NOT MAINTAIN A
COMPREHENSIVE STATEWIDE
CHILDHOOD DEATH REPORTING
SYSTEM. AS A RESULT WHATEVER
DATA IS AVAILABLE IS OFTEN
INCONSISTENT OR INCOMPLETE.
UNDERMINED EFFECTIVE MONITORING
AND ANALYSIS OF RISK FACTORS AND
TRENDS THEREBY LIMITING OUR
ABILITY TO COMPREHENSIVELY
EVALUATE PROPOSED DROWNING
PREVENTION STRATEGIES. SB EIGHT
FIFTY FIVE WILL CREATE A
COMPREHENSIVE DATA COLLECTION
SYSTEM TO AID IN THE DEVELOPMENT
OF BEST PRACTICES. COMMUNITY
INTERVENTIONS INVOLVING PUBLIC
POLICY SO THAT WE CAN BETTER
PROTECT CALIFORNIA'S CHILDREN
FROM DROWNING. UNDER THE
PROVISIONS OF THE BILL OVER THE
FIRST TWO YEARS THE PILOT
PROGRAM CDPH WILL COLLABORATE
WITH. FIVE TO TEN COUNTY
ENTITIES WHICH COLLECT DATA ON
SHOW DROWNINGS NEAR DRY. TO
STANDARDIZE THAT DATA AND THEN
YOU IT AS THE BASE FOR TWO
REPORTS ON PROGRESS. AND
FINDINGSTO BE SUBMITTED TO THE
APPROPRIATE LET'S SAY POLICY
COMMITTEES ONE BY APRIL FIRST OF
TWENTY TWENTY FOUR AND THE
SECOND BY APRIL FIRST OF TWENTY
TWENTY FIVE. IN THE FINAL YEAR
OF THE THREE YEAR PROGRAM BY
JUNE THIRTIETH OF TWENTY TWENTY
SIX. THE DEPARTMENT WILL CONSULT
WITH A PANEL OF EXPERTS ON
CHILDHOOD DROWNING PREVENTION AS
THE BASIS FOR SUBMITTING A
COMPREHENSIVE REPORT TO THE
LEGISLATURE. THAT WILL BETTER
INFORM EFFORTS TOWARD THE
DEVELOPMENT OF EVIDENCE BASED
DROWNING PREVENTION POLICIES AND
PROGRAMS. MOVING FORWARD THE
PROGRAMS PROVIDED FOR UNDER THIS
BILL WILL BE FUNDED THROUGH
FEDERAL BLOCK GRANT MONIES.
CURRENTLY ALLOCATED TO THE FATAL
CHILD ABUSE AND NEGLECT
SURVEILLANCE PROGRAM COMMONLY
KNOWN AS FIVE CANS WHICH TRACKS
REPORTING OF ALL CHILDHOOD
FATALITIES WITH ME TODAY TO
TESTIFY VIRTUALLY- DOCTOR
PHYLLIS A GRIN. WITH THE
AMERICAN ACADEMY OF PEDIATRICS
CALIFORNIA AND CHRIS LEFT ONE
POLICE WHO IS THE CEO. OF THE
CALIFORNIA STATE ALLIANCE FOR
YMCAS I RESPECTFULLY ASK FOR
YOUR VOTE THIS AFTERNOON THANK
YOU SIR NEWMAN BEFORE MOVE ON TO
THE WITNESSES SUPPORT I BELIEVE
WE CAN IT'S TIME TO ESTABLISH A
QUORUM. I CONSULTANTS- PLEASE
CALL THE ROLL FIRST OPTION FOR.
CAN HERE MELINDA'S EGGMAN.
GONZALEZ GROVE FURTADO LLEVA THE
MON ROF. RUBIO WINNER. OKAY WITH
THE CORN HAS BEEN ESTABLISHED
THANK YOU LET'S NOW MOVE ON TO
THE WITNESSES TESTIFYING IN
SUPPORT OF SB EIGHT FIVE FIVE-
ACTUALLY WHICH ORDERED A COMING
AND GOING IN I THINK IT'S DOCTOR
EGAN FOCUSED ALL RIGHT SO WE
HAVE- DOCTOR PHIL IS A GRAND-
FROM THE AMERICAN CAB YES EXCEL
FORMULA AND THEN FOLLOWED BY A
CHRIS LOVE TOM LEE- WITH THE
COWBOYS THE ALLIANCE OF YMCAS
MODERATOR CAN PLEASE BRING DR
EIGHT RUNS ONTO THE LINE I'LL
MAKE NOTE THAT YOU HAVE A TOTAL
OF FOUR MINUTES SO DOCTOR EVEN
IF YOU GO I'LL GIVE IT TWO
MINUTE WARNING WHEN YOU HIT THAT
BUT IF YOU GO OVER TWO MINUTES
IT TAKES TIME AWAY FROM THE NEXT
WITNESS. SO WITH THAT OF DOCTOR
EGGMAN. HI THANK YOU FOR THE
INTRODUCTION. I'M A PEDIATRICIAN
AND CHILDHOOD INJURY PREVENTION
RESEARCH HERE AT UCI. MORE THAN
FORTY YEARS. ASKING FOR YOUR
SUPPORT FOR S. EIGHT EIGHT FIFTY
FIVE. THE CHILD'S DROWNING IS
HORRIFIC. YOUR PRESIDENT I CARED
FOR MY FIRST PATIENT WHO FELL
INTO A RESIDENTIAL POOL. MY
MENTOR FACTOR RECORD LET ME KNOW
IN DEL UNCERTAIN TERMS THE
PATIENT CARE IS ONLY PART OF MY
RESPONSIBILITY. ADVOCATING TO
PREVENT THE TRAGIC LOSS OF A
CHILD FROM A PREVENTABLE BECAUSE
WITHOUT MY RESPONSIBILITY THAT'S
WHY WE ARE HERE TODAY. DROWNING
IS THE LEADING CAUSE OF
UNINTENTIONAL INJURY DEATHS
AMONG CHILDREN ONE TO FOUR YEARS
OF AGE CALIFORNIA. FOR EACH
CHILD. IN THAT AGE. FOURTEEN
OTHERS SUFFERING NONFATAL
DROWNING DEATH TRANSLATES TO
NEARLY FIFTY DEATHS PER YEAR IN
SIX HUNDRED FIFTY NONFATAL
INJURIES REQUIRING MEDICAL
ATTENTION. WITH THE PASSAGE OF
THE POOL SAFETY LINE TWO
THOUSAND SEVENTEEN WE EXPECTED
TO SEE A DECREASE IN CHILD
DROWNINGS. SOMETHING HAS GONE
WRONG. WE ARE SEEING THE
PROGRESS INCREASE IN THE DEATH
RATE AMONG THE HIGH RISK
POPULATION. AGAIN WE REQUEST
YOUR SUPPORT FOR SENATE BILL
EIGHT FIFTY FIVE THAT WILL
CREATE A STATEWIDE CHILD
DROWNING DATA COLLECTION SYSTEM
TO IDENTIFY FACTORS SUCH AS THE
ENVIRONMENT RACE ETHNICITY
EDUCATION MEDICAL CONDITIONS
SUCH AS AUTISM. AND ECONOMIC
BARRIERS THAT PUT CHILDREN AT
RISK FOR DROWNING THIS WILL
INFORM AN EVIDENCE BASED BEST
PRACTICES CAN INCREMENTALLY
IMPROVE OUR POOL SAFETY LOCK.
ONE MORE GROUNDING IS JUST ONE
TOO MANY THANK YOU SO MUCH.
THANK YOU CARE DR PAM. THANK YOU
DR DRE NOW LET'S BRING ON- CHRIS
LIVE PALM LEAF WITH THE STATE OF
CALIFORNIA THE ALLIANCE OF YMCAS
YOU ACTUALLY HAVE- TWO MINUTES
AND NINE SECONDS. AFTERNOON
AUDIBLE CHAIR AND MEMBERS CHRIS
LOOKED WOBBLY PRESIDENT CEO FROM
CALIFORNIA STATE ALLIANCE FORMED
CA THANKS FOR THE OPPORTUNITY TO
SPEAK TODAY IS FOR THIS MEASURE.
WILL PLEASE CO SPONSOR AND WE
BELIEVE IT WILL SAVE LIVES. THE
YMCAS HAVE A LONG STANDING
COMMITMENT TO WATER SAFETY AND
DROWNING PREVENTION. OR SAFETY
AROUND WATER PROGRAM IN
PARTICULAR TAKES AN AGE AND
DEVELOPMENTALLY APPROPRIATE
APPROACH TO TEACH OUR YOUNGEST
CHILDREN WATER SAFETY AWARENESS
AND BASIC WATER IMMERSION
SURVIVAL SKILLS BOTH FOR NON
SWIMMERS AND EMERGING SWIMMERS.
PROGRAM ALSO QUICK CARE
PROVIDERS WITH SKILLS TO HELP
AUGMENT YOUR CHILD'S SAFETY WE
WILL SECURE A WATERSHED
PARTNERSHIPS AROUND THE STATE
WHERE WE ARE ABLE USUALLY THE
SCHOOL DISTRICT'S LOCAL AGENCIES
AND WITH SOME. WORK FROM FOUR TO
PREACH WHICH- IS THAT THERE ARE
CHILDREN AND FAMILIES ACROSS THE
STATE WHO AREN'T RECEIVING
DROWNING PREVENTION PROGRAMS
SIMPLY BECAUSE THE PROPER
PARTNERSHIP ELEMENTS AREN'T
THERE WHETHER IT'S- FUNDING LACK
OF CAPACITY EXPERTISE- NO ANCHOR
ORGANIZATION OR SIMPLY A LACK OF
AWARENESS OF THE PROBLEM. SO
RATHER THAN TAKING A TARGETED
AND STATEWIDE APPROACH
PREVENTING CHILDHOOD DROWNING
COMMUNITIES ARE. ACTUALLY DOING
WHAT THEY CAN WEAR THEIR ABLE
FROM OUR PERSPECTIVE THIS
CONTRIBUTES TO THE COUNTY TRAGIC
INCIDENTS EACH YEAR. QUALITY
DATA COLLECTION IS CRITICAL FOR
US TO BETTER UNDERSTAND WHY HOW
WHERE AND WHICH CHILDREN ARE
DROWNING. SO WE CAN BUILD A
COMPREHENSIVE STATEWIDE WALK
TAKE YOU PLANNED BUT INTEGRATES
ALL AVAILABLE PARTNERS AND
RESOURCES SO WE CAN PREVENT
THESE TRAGEDIES. AS DOCTOR
EGGMAN SOB ONE DROWNING STREET
MANY TIMES OF THE ESSENCE. WE
NEED DATA AND WE NEED A PLAN.
THANK YOU SENATOR NEWMAN FOR
THIS MEASURE FORWARD HERE ARE.
GONNA CATCH PEDIATRICS THANK YOU
TO THE COMMITTEE. AND CHAIR FOR
YOUR CONSIDERATION. THANK VERY
MUCH- WHAT I'LL TAKE IT THE
WITNESS AND SOME. OF A EIGHT
FIFTY. FOR A THAT'S NO OR VISIT
ONLY WILL BEGIN WITH ANY
WITNESSES ROOM TWELVE. WHO WISH
TO TESTIFY SUPPORT. SAYING ON
COMEY THE MICROPHONE MODERATOR
PLEASE OPEN THE LINES FOR.
WITNESSES WHO WISH TO TESTIFY IN
SUPPORT. OF SB EIGHT FIFTY FIVE
. THANK YOU IF YOU WISH TO SPEAK
IN SUPPORT OF SB EIGHT FIVE FIVE
PLEASE PRESS ONE THEN ZERO AT
THIS TIME. I HAVE ABOUT THREE IN
Q. GO TWICE FIFTY EIGHT PEOPLE
HAVE. FIVE FIVE EIGHT PLEASE GO
AHEAD. BY TWO THIRTY SEVEN
PLEASE GO AHEAD. KELLY HARDY
WITH CHILDREN NOW IN SUPPORT OF
THE BILL THANK YOU THANK YOU
NEXT LINE. THANK YOU I'M TWENTY
SEVEN PLEASE GO AHEAD. ON BEHALF
OF THE CALIFORNIA BUILDING
OFFICIALS IN STRONG SUPPORT
THANK YOU THANK YOU NEXT TIME.
THANK YOU I'M THIRTY EIGHT
PLEASE GO AHEAD. NINE THREE
EIGHT. OVER ONE TWENTY FIVE
PLEASE GO AHEAD. BY TWO FIVE
PLEASE GO AHEAD. I HAVE NO
FURTHER COMMENT THANK YOU OKAY
THANK YOU WILL NOW MOVE ON TO
WITNESSES IN OPPOSITION TO SB
EIGHT FIFTY FIVE WE DO NOT HAVE
ANY FORMAL TESTIMONY REGISTERED
IN OPPOSITION TO SB FIFTY FIVE
SO MOVE TO- FROM TWELVE HUNDRED
OR IS THERE ANYONE HERE IN ROOM
TWELVE HUNDRED WISHES THAT US
FIGHTING OPPOSITION TO SB EIGHT
FIFTY FIVE. C. NINE A MODERATOR
PLEASE OPEN THE LINES FOR
WITNESSES WHO WISH TO TESTIFY
AGAINST SP EIGHT FIFTY FIVE NAME
ORGANIZATION POSITION ONLY.
THANK YOU IF YOU WISH TO SPEAK
IN OPPOSITION TO SB EIGHT FIVE
FIVE PLEASE PRESS ONE THEN ZERO
AT THIS TIME. I HAVE NO COMMENT
THANK YOU OKAY THANK YOU LET'S
BRING IT BACK TO COMMITTEE
MEMBERS ARE THERE QUESTIONS FROM
COMMITTEE MEMBERS ON THE SPELL.
OKAY A THIRD TITLE THANK YOU
MISTER CHAIR I JUST WANT TO
THANK THE AUTHOR FOR BRINGING
THIS MEASURE FORWARD I KNOW THAT
IN THE CENTRAL VALLEY NEXT
ACTUALLY WE HAVE- A HUNDRED AND-
TEN DEGREES UNDER A DEGREE.
WEATHER AND THERE AREN'T ANY
PULLS AROUND F. CHILDREN TO GO
TO OUR LOCAL RIVERS. AND YOU
KNOW THEY END UP DROWNING IN. I
THINK THIS IS SOMETHING THAT WE
DEFINITELY NEED TO BE. ON TOP OF
WITH ESPECIALLY WITH CLIMATE
CHANGE SO THANK YOU AT AND I'D
LOVE TO- WITH YOUR SUPPORT- THE
EIGHT EIGHT CO AUTHOR OF THIS
MEASURE. BUT TO. THANK YOU SIR
RUBIO. THANK YOU MISTER CHAIR-
WELL FIRST OF ALL I JUST WANNA
SAY TO ALL THE PARENTS OUT THERE
MY HEART GOES OUT TO YOU- IT'S
SO TRAGIC WHEN WE SEE ANY. OF
OUR CHILDREN- YOU KNOW HOUSE AND
AS A TEACHER FOR SEVENTEEN YEARS
I CAN TELL YOU DON'T TEACH FOR
SEVENTEEN YEARS AND NOT. GET
STORIES LIKE THESE ON OCCASION-
YOU KNOW WHETHER IT WAS AT A
BIRTHDAY PARTY AT THE COMMUNITY
POOL AND- AND A LOT OF THE TIMES
I JUST WANTTO EXPRESS HOW
SOMETIMES PARENTS FEEL. SOMEWHAT
ASHAMED AND THERE'S A STIGMA
THAT THEY DON'T TAKE CARE OF
THEIR CHILDREN AND WE KNOW THAT
THIS IS JUST SOMETHING THAT YOU
KNOW THAT HAPPENS NO MATTER HOW
THEY DOING YOU ARE HOW CAREFUL
YOU ARE. IT JUST HAPPENED SO I
THINK IT'S SUCH AN IMPORTANT
THING TO DO AND- I ALSO HAVE
ASKED THE AUTHOR IF I CAN. ADD
ON AS A QUARTER SO ONCE AGAIN I
STRONGLY SUPPORT THIS AND IT'S
THE RIGHT THING TO DO THANK YOU.
THANK YOU. I THANK YOU SEVEN
DOLLARS. THANK YOU- MISTER
CHAIRMAN AS SENATOR NEWMAN I
ALSO WANT TO COMMEND YOU FOR
THIS BILL AS A MOM OF THREE BOYS
AND A LITTLE ONE. A SIMILAR. IN
AGE TO YOUR YOUR DAUGHTER- THIS
IS AN INCREDIBLY IMPACTFUL BILL
AND I WOULD HOPE THAT AFTER THE
THREE YEARS THAT WE CAN ACTUALLY
CREATE POLICIES. THAT WILL-
CONTINUE TO BUILD OFF OF THE
DATA THAT'S COLLECTED SO THAT WE
CAN MAKE- SIGNIFICANT POLICIES
ACROSS THE STATE FOR ALL
CHILDREN. SO THANK YOU.
APPRECIATE THAT. OKAY SIR EDMUND
. THANK YOU VERY MUCH THE CENTER
NEW INJURY THIS FORWARD I THINK
OF ALL JOIN IN THE CHORUS AS- MY
COLLEAGUE FROM THE CENTRAL
VALLEY SAID. OFTEN TIMES WHEN
THE- WEATHER STARTS GETTING HOT
PEOPLE GO OUT AND THAT WHEN THAT
WATER STILL COMING DOWN IN OUR
RIVERS. FROM THE MOUNTAINS AND
IT'S ICE COLD AND PEOPLE GOING
IN AND- OFTEN TIMES- TRAGIC.
TRAGEDIES HAPPEN- I WOULD LOOK
AT THE ACTUAL SCREENING TOOL BUT
I THINK ONE OF THE THINGS THAT I
KNOW ABOUT IN MY OWN DISTRICT IS
A LOT OF THE TIMES THE KIDS WHO
DROWN ARE KIDS OF COLOR SO WHEN
WE TALK ABOUT. EQUITY ISSUES. I
THINK THIS IS INCREDIBLY
IMPORTANT- WE HAVE OVER THE
YEARS D. FUNDED A LOT OF OUR
POOLS AND- RECREATIONAL
ACTIVITIES. I THINK THOSE ARE
THE KINDS OF THINGS THAT WE
REALLY WHEN WE'RE THINKING ABOUT
SOME LIKE THIS REALLY BEEF UP.
THE AMOUNT OF COMMUNITY POOLS WE
HAVE SWIM LESSONS FOR KIDS. I
KNOW IN MY DISTRICT RIGHT WE
LIVE ON THE DELTA ON THE WATER.
AND THERE ARE SO MANY KIDS WHO
DON'T KNOW HOW TO SWIM BECAUSE
THEY DON'T HAVE ACCESS IN THEIR
NEIGHBORHOOD. THEY DON'T HAVE IN
THEIR BACKYARD. AND SO PEOPLE GO
OUT TO LAKES AND RIVERS AND
RESERVOIRS AND RIVERS WHEN IT
GETS REALLY COLD. REALLY HOT-
AND THEN OFTEN TRAGEDIES. IN
HSINCHU PENSIVE SO. THANK YOU
FOR THIS I'D LIKE TO ALSO BE
ADDED AS A CO AUTHOR. AND I
THINK IT'S A I THINK. I THINK
WE'LL FIND THE- THE DATA. IS
FASCINATING ABOUT WHO'S.
DROWNING IN CALIFORNIA THANK
YOU. THE OKAY. THE OTHER
QUESTIONS IN THE NUMBERS. YOU
KNOW WHAT US A SENTIMENT I TO-
WANT TO JOIN MY COLLEAGUES AND
THANK YOU FOR BRINGING THIS BILL
FORWARD- CERTAINLY IS A
PEDIATRICIAN I MYSELF HAVE SEEN
TOO MANY CASES- AS I THINK BACK
A GRIN MENTIONED ONE IS READY TO
MANY BUT- CASES- WHERE.
TRAGEDIES HAPPEN BUT ALSO MAKE
NOTE OF THAT- THESE DROWNINGS-
THEY ARE PREVENTABLE IF WE
UNDERSTAND HOW THEY HAPPENED.
DOES IT'S NOT ABOUT BLAME. ALL
RIGHT I THINK IT'S VERY
IMPORTANT- PARENTS ARE DOING THE
BEST THEY CAN. BUT IT'S AOUT
BEING SURE WE TAKE THE STEPS WE
UNDERSTAND HOW THEY HAPPENED AND
TAKE THE STEPS NECESSARY TO
PREVENT A FACTORY PRESET YOUR-
PREVIOUS WORK IN THE LEGISLATURE
TO- TO REQUIRED THAT- WE PUT IN-
THE SYSTEMS IN PLACE WE PUT IN
THAT WHETHER IT'S THE- VERY
YOUNG THE FENCES OR WHATEVER
ELSE THEY NEED TO DO TO SO THAT
PEOPLE ARE AWARE OF THE CASE
CHILD FALLS INTO A POOL OR
OTHER. BODY OF WATER AND THAT
THAT THEY MIGHT BE AT RISK OF
DROWNING. SO THIS IS ESSENTIAL
STEP- TO SURE WE UNDERSTAND HOW
DROWNINGS HAPPENED AND THEN WE
CAN TAKE THE STEPS TO HELP
PREVENT THEM. SO THESE ARE NOT
JUST ACCIDENTS- THESE ARE THINGS
THAT WE CAN ACTUALLY TAKE STEPS
TO PREVENT AND- I PREVENT TESE
TERRIBLE TRAGEDIES SO. CERTAINLY
IN STRONG SUPPORT OF THE BILL-
WOULD YOU LIKE TO CLOSE. AND
THANK YOU MR SURE DID AS YOU
MENTIONED I AM THE AUTHOR OF
THIS BEFORE FOR TWO FOR TWENTY
SEVENTEEN. ANYBODY ON THIS
COMMITTEE WHO WAS HERE THEN YOU
WILL PROBABLY RECALL VERY
VIVIDLY THE TESTIMONY. OF SOME
OF THE ADVOCATES WHO WERE
THEMSELVES PARENTS. WHO LOST
CHILDREN TO THE DROWNINGS OR
NEAR DROWNINGS. AND YOU WILL
NEVER HEAR A MORE HEART
WRENCHING STORY. HARDLY TO YOUR
POINT BECAUSE THES ARE
PREVENTABLE ACTIONS- AND IT IS
INCUMBENT UPON US AS POLICY
MAKERS DO EVERYTHING WE CAN. TO
PREVENT THOSE ACTIONS TO SMART
POLICIES AND THREW THEM THROUGH
SMART APPROACHES. THAT SO BAD
THANK YOU TO BOTH OF MY
WITNESSES FOR THEIR
PARTICIPATION THANK YOU TO BOTH
OF THEIR ORGANIZATIONS- FOR
THEIR ACTIVE ADVOCACY IN THIS
ROOM- AND WITH THAT I GUESS YOU
ARE GOING. THANK YOU- ACTUALLY.
SPELLS FOR THEY DON'T THINK I'VE
HEARD A MOTION IN FAVOUR OKAY HI
I SAW CENTER GONZALEZ- YOU YOU
KNOW IT'S BEEN MOVED BY SENATOR
GONZALES THE MOTIONS TO PASS AN
AMENDED THE FIRST AMENDED
REFERRED TO THE COMMITTEE ON
APPROPRIATIONS. THAT CONSULTANT
PLEASE CALL THE ROLL HAN HI CAN
I MELINDA'S MELINDA'S I EGGMAN.
EGGMAN CONSOLES SIDE GROVE GROVE
I HER DAUGHTER HI THE TOTAL I.
LEIVA. LEVER I LI MON. ROTH ROTH
IRA RUBIO. RUBIO I WINNER. OKAY
THAT BILL HAS NINE VOTES- WELL
THE ROLE OPEN FOR THE ABSENCE
THANK YOU MEMBERS THANK YOU ALL
RIGHT NOW LET'S MOVE ON TO ITEM
NUMBER TWO SP EIGHT SIXTY FOUR
BY SEVEN MELINDA'S- A LOT. RIGHT
SO THERE. OKAY I THINK-
TESTIMONIES TAKING PLACE OVER
HERE YEAH I KNOW BECAUSE SORRY
AND BECAUSE UNFORTUNATELY WE
ALSO NEED A TABLE FOR NUMBER SIX
WILL HAVE ENOUGH ROOM UP HERE
SO. WHEN. I GUESS THEY'RE OVER
THERE YES- MY APOLOGIES I
THOUGHT THAT'S THE ROOM FOR A
ROLL NOW OKAY- REVEAL ITSELF
THAT'S OKAY THANK YOU- MR
CHAIRMAN AND MEMBERS OF THE
COMMITTEE I AM PLEASED TO
PRESENT SENATE BILL EIGHT SIXTY
FOUR THIS AFTERNOON ALSO NOTICE
TYLER'S LAW- I FIRST WANT TO
ACCEPT THE COMMITTEE'S
AMENDMENTS IN THE THANK THE
CHAIR NEXT AFTER WORKING FOR.
WITH MY OFFICE ON THIS BILL I
APPRECIATE THE CONSTRUCTIVE-
COMMENTS THAT WERE PROVIDED. ON
OCTOBER TWENTY FIRST TWO
THOUSAND EIGHTEEN TYLER SHAMUS
DIED IN THE BATHROOM OF A SOBER
LIVING HOME AFTER HAVING
INGESTED FENTANYL. THE NIGHT
BEFORE HIS DEATH HE WAS TREATED
AT A LOCAL EMERGENCY ROOM FOR
SUSPECTED OVERDOSE AFTER
COMPLAINING ABOUT AN UPSET
STOMACH. AT THE EMERGENCY ROOM
TYLER WAS ADMINISTERED TEST FOR
OPIOIDS WHICH WERE THOUGHT TO
PICK UP ANY SIGN OF SENTINEL
UNFORTUNATELY THAT WAS NOT THE
CASE. IT WASN'T UNTIL AFTER
TYLER PASSED AWAY THAT THE
DOCTOR IN TYLER'S FAMILY WERE
INFORMED THE TANDARD TOXICOLOGY
SCREEN DOES NOT PICK UP
SYNTHETIC FORMS OF FENTANYL.
FENTANYL IS A SYNTHETIC OPIOID
ONE HUNDRED TIMES MORE POTENT
THAN MORPHINE WERE TWO
MILLIGRAMS WHICH IS ABOUT THE
SIZE OF TWO GRAINS OF SALT CAN
BE FATAL. BUT NO WAS THE NUMBER
ONE CAUSE OF DEATH LAST YEAR FOR
PEOPLE AGES EIGHTEEN FORTY FIVE
OUTPACING SUICIDES AND EVEN COPE
WITH DEATHS. I KNOW CAN BE FOUND
IN METHAMPHETAMINE COCAINE
HEROIN FAKE. FAKE PILLS OF XANAX
OXYCODONE AND MOST RECENTLY A
STORY I READ LAST NIGHT PUT OUT
BY CNN WAS. THERE NOW MAKING
PILLS. FENTANYL PILLS THAT LOOK
LIKE TYLENOL. IRAQ IS ACTUALLY
LIKE TYLENOL- SO. WE HAVE A LOT
OF WORK TO DO. SB SIXTY FOUR IS
ABOUT MAKING SURE EMERGENCY ROOM
DOCTORS CAN PLAY A KEY ROLE IN
IDENTIFYING OVERDOSES AND
ULTIMATELY SAVING SOMEONE'S
LIFE. RAPID TESTING PROFESSIONAL
CURRENTLY EXIST AND IS BEING
USED IN HOSPITALS IN SAN DIEGO
WITH MUCH SUCCESS. IN FACT IT
HAS BEEN SO SUCCESSFUL THAT THE
MAJORITY OF HOSPITALS IN SAN
DIEGO INCLUDE FENNEL TESTING
ANYTIME A DRUG SCREEN IS
ORDERED. THE FINAL EPIDEMIC
THREATENING OUR COMMUNITIES AND
HARMING OUR CHILDREN HAS
EXPLODED AND WE MUST PASS
MEANINGFUL LEGISLATION IN THE
HOPES OF SAVING MORE LIVES. WITH
ME HERE TODAY IS JULIE SHAMUS
TYLER'S MOM AND CHARLES IS HERE
OSCAR HIS DAD- AND DOCTOR LAB
WHO'S THE CURRENT. DIRECTOR OF
OPERATIONS AT SCRIPPS MERCY
EMERGENCY DEPARTMENT IN SAN
DIEGO AND I WOULD LIKE TO INVITE
YOU TO COME. TYLER'S PARENTS UP. FOR TESTIMONY PLEASE THANKS SO
YOU GOT. THE DELTA SURVIVORS YES
CAN START. OKAY WHAT WELCOME
AND- SO- AGAIN WILL IT TOTAL
FOUR MINUTES TESTIMONY TWO
MINUTES FOR YOU TWO MINUTES FOR
DOCTOR LEFT IF YOU GO OVER.
THAT'S FINE BUT THEN THAT'S LESS
TIME FOR DOCTOR LET BUT YOU
SHOULD DEFINITELY WANNA HEAR
FROM YOU SO HELPFUL TRY TO
SPEAK. NOT TOO FIRM THAT'S OKAY
TAKE YOUR TIME. MANY IS JULIE
SAMUS AT SP EIGHT SIX FOUR
TYLER'S LAW HIS NAME FOR MY SON.
ON OCTOBER TWENTY FIRST TWO
THOUSAND EIGHTEEN MY CLIENT AND
BRILLIANT SON DIED FROM
INGESTING FENTANYL IN THE
BATHROOM OF HIS SOBER LIVING.
TYLER AND OUR WHOLE FAMILY SAGA
STRUGGLED WITH HIS ADDICTION FOR
THREE YEARS. THE NIGHT BEFORE HE
DIED HE WAS TAKEN BY AMBULANCE
TO AN EMERGENCY ROOM FOR A
SUSPECTED OVERDOSE HE CLAIMED TO
HAVE ACCIDENTALLY TAKEN TOO MUCH
IMODIUM FOR AN UPSET STOMACH.
SINCE I WAS WELL AWARE THAT DRUG
USERS DON'T OFTEN TELL THE TRUTH
I ASK THE TREATING DOCTOR THREE
TIMES IF HE HAD BEEN TESTED FOR
EVERYTHING INCLUDING FENTANYL.
THREE TIMES HE ASSURED ME THAT
THEIR TALK SCREEN. TEST FOR
OPIOIDS AND IT WOULD PICK UP THE
PHONE TO TALK. AFTER TYLER DIED
WE FOUND OUT THAT THE DOCTOR WAS
MISINFORMED. THE STANDARD TALK
SCREEN DOES NOT TEST FOR
FENTANYL BECAUSE IT IS A
SYNTHETIC OPIOID. HAD WE KNOWN
THAT TYLER HAD FENCE ON THEIR
SYSTEM WE WOULD HAVE SENT HIM TO
DETOX OR RESIDENTIAL TREATMENT
BOTH. OF WHICH OFFER A HIGHER%
LEVEL OF CARE INSTEAD OF BACK TO
A SOBER LIVING. TYLER STORY IS
JUST ONE EXAMPLE OF A DOCTOR I
KNOW WHERE THAT IS SEPARATE
FENTANYL SCREENING TEST IS
NECESSARY. LAST WEEK I WAS
SPEAKING WITH A FRIEND WHO'S AN
OB AND HE HAS TO ORDER TALK
SCREENS FOR MOTHERS WHO ARE
PREGNANT THAT HE SUSPECTS OF
USING DRUGS. LIKE THE ER DOCTOR
WHO TREATED TYLER HE HAD NO IDEA
THAT THE STANDARD FIVE PANEL-TALK SCREEN DOES NOT TEST FOR
FUNCTIONAL AND THAT HE WOULD
HAVE TO ORDER A SEPARATE
FUNCTIONAL SCREEN. SP EIGHT SIX
FOUR WILL SAVE LIVES IN
SITUATIONS LIKE TYLER'S. AS WELL
AS IN THOSE CASES WHERE SOMEONE
IS TAKEN TO AN ER BECAUSE OF AN
OVERDOSE FROM ONE SUBSTANCE. BUT
WHO HAS UNKNOWINGLY CONSUMED
FENTON ALL FROM A PLEASANT
PRODUCT. SENTINEL IS A
BIPARTISAN ISSUE THAT AFFECTS
EVERYONE. IF WE KNEW HIS DRUG
SCREEN WAS POSITIVE FOR FENTANYL
TYLER MAY BE ALIVE TODAY. HOW
MANY OTHER LIVES COULD BE SAVED.
THANK YOU AND PLEASE SUPPORT SB
EIGHT SIX FOUR. THANK U. SURAJ
MISAMIS. WELL BRING ONTO. ONTO
THE LINE- DOCTOR A NEAT LIVE-
MODERATOR SHE THERE. I'M ON THE
PHONE OKAY ALL RIGHT PLEASE
BEGIN YOU HAVE- ALMOST TWO
MINUTES. MEMBER CENTER HELP I
URGE YOU TO ACT TODAY TO
STABILIZE AND MAKE HISTORY. AND
SET A NATIONAL STANDARD ON THE
TRAGIC BATTLE CRISIS EVERY DAY I
TREAT PATIENTS WHO ARE EXPOSED
TO FENTANYL MY RELATIONSHIP AND
THEY WERE DIFFERENT WHEN I
CREATE A YOUNG MAN WHO THOUGHT
HE TOOK AS ALEX. WITHOUT
CONSCIOUS AND BARELY BREATHING
IN A CAR HE WAS THANKFULLY
REVIVED WITH NALOXONE AND HE
READILY GAVE A URINE SAMPLE I
WAS SHOCKED TO FIND OUT THAT HE
HAD KNOWN THAT I CAN ASSIST THEM
BUT DIDN'T. GOTTEN A POSITIVE
FINAL TEST LET ME SEE GIVEN A
PRESCRIPTION FOR NALOXONE AND
THE FOR HIM TO APPROPRIATE
TREATMENT THE POSITIVE TEST LET
ME JUST. THROW AWAY HIS FACE
VANISHED SO THEN ONE IS FRIENDS
WHO MAY HAVE BOUGHT THE SAME
TALE. BUT NOW IS THE NUMBER ONE
CAUSE OF DEATH IN THE UNITED
STATES. IN AGES EIGHTEEN TO
FORTY FIVE MORE THAN KOBE THE
NUMBER OF TEENS WHO OVERDOSED
AND FELL NOW HAS GONE UP
THREEFOLD THE NUMBER OF THE
BLACK JEANS OF OVERDOSE AND SIGN
BY FULL. CALIFORNIA FEDERAL
DEATHS HAVE GONE UP FIVE FOLD IN
THE PAST TWO YEARS AND DIEGO OUR
MEDICAL EXAMINER'S DEALING WITH
TWO AND A HALF DEATH DATE FROM
FAST AND ALL. INCREASINGLY
HOBBLED AROUND CALIFORNIA
INCLUDING FAT NO A PART OF THEIR
STANDARD RAPID URINE DRUG FREE
THIS BILL WILL PUSH THE REST OF
CALIFORNIA HOSPITALS TO DO THE
SAME A RAPID URINE DRUG TEST FOR
COCAINE AMPHETAMINES OPIATES
DERIVED FROM POPPY PLANTS. SUCH
AS HEROIN AND MORPHINE THE
TRADITIONAL PATH DOES NOT
INCLUDE FENTANYL A SYNTHETIC
DRUGS AND CAME CLOSE TO AN OLD
HOSPITAL NEED TO FIRE PURCHASED
A SEVENTY FIVE PERCENT. AND A
LITTLE BIT NORWEGIAN HOSPITAL
QUICKLY ADAPTED TO INCLUDE COAL
THE TESTING WITH A PANDEMIC AND
THEY CAN AND SHOULD DO THE SAME
WITH THAT NOW BUT NOBODY WILL
SOLVE THE CRISIS BUT IT WILL
ENGAGE THE MEDICAL COMMUNITY AND
SOLUTIONS THAT COULD SAVE SOME
LIVES AND I URGE YOU ALL TO
UNITE. AND LEADING KIND OF
CALIFORNIA AND OUR NATION'S AND
SOLUTIONS THE FACT ALSO PLEASE
SUPPORT F. B. EIGHT FOUR.
CREATED HERE. AT FOREVER
SEVENTEEN KILLED BY A
COUNTERFEIT PILL MADE OF FENNEL
I ALSO SERVE AND WITH SONG FOR
CHARLIE A NONPROFIT AIMED AT
WARNING CHILDREN ABOUT THESE BIG
BILLS. THANK YOU THANK YOU AND I
SEE YOUR SITE URGE YOU TO VOTE
YES THANK YOU THANK YOU. X.
WITNESS. GERMANTOWN MEMBERS TO
MADDEN REPRESENT THE CALIFORNIA
CHAPTER OF THE AMERICAN COLLEGE
OF EMERGENCY PHYSICIANS AND
STRONG SUPPORT OKAY THANK YOU A
SINGLE OTHER WITNESSES IN THE
ROOM- MODERATOR PLEASE BRING ON
TO THE LINE- WITNESSES WHICH TO
TESTIFY IN SUPPORT OF SB EIGHT
SIXTY FOUR AGAIN NAME
ORGANIZATION POSITION. THANK YOU
IF YOU WISH TO SPEAK IN SUPPORT
OF SB EIGHT SIX FOUR PLEASE
PRESS ONE THEN ZERO AT THIS TIME. FIVE TWENTY FIVE PLEASE GO
AHEAD. GOOD AFTERNOON MR
CHAIRMAN MEMBERS CLIENTELE
BOTTOM HALF OF THE CALIFORNIA
EMERGENCY NURSES ASSOCIATION
PART OF THE BILL. EXCELLENT NEXT
WITNESS. THANK YOU. THANK YOU
LUCKY ONE MOMENT FOR THE NEXT
FIVE.
BY TWENTY THREE PLEASE GO AHEAD
. MY NAME IS HEIDI FINE I'M WITH
HER MOST OF BEACH COALITION FOR
DRUG FREE KIDS AND I AM IN
STRONG SUPPORT OF TYLER'S LOG
LET'S SAVE LIVES. THANK YOU
EXLINE. WHAT HELLO WELL YES.
YOUR SELF THE MODERN YES MY NAME
IS ANSEL MY NAME IS ANNA
KOENIGSBERG NOT AFFILIATED I'M
INUNDATED. AND I VERY MUCH. THIS
BILL TYLER'S LAW SB EIGHT SIX
FOUR BECAUSE PEOPLE FAVOR. THANK
YOU SO MUCH THANK YOU NEXT NEXT
WITNESS. THANK YOU BYE FIVE
PLEASE GO AHEAD. THE HIGHLIGHT
NAME IS SKIP KOENIG AND I'M
CALLING IN SUPPORT OF SB EIGHT
FOUR I THANK YOU FOR YOUR-
POSSIBLE THANK NEXT WITNESS.
THANK YOU RIGHT TWO PLEASE GO
AHEAD. IN PLACE I'M SORRY AND I
FOUND THE OF SAFETY THANK YOU
NEXT WITNESS. THANK YOU I'M
THIRTY EIGHT PLEASE HAVE. WHY
THREE EIGHT PLEASE GO AHEAD. BY
FORTY PLEASE GO AHEAD. MY NAME
IS JANE ROGERS I AM IN STRONG
SUPPORT OF TYLER'S BELL THERE
BEEN TOO MANY YOUNG LIVES LOST
PLEASE VOTE IN SUPPORT OF THIS
BILL THANK YOU NEXT WITNESS.
THANK YOU BYE FORTY SIX PLEASE
GO AHEAD. HI MY NAME IS MELANIE
NEWMAN ON THE CALIFORNIA THANKS
I STRONGLY URGE YOU TO CALL BILL
. F. B. EIGHTY FOUR THANK YOU
THANK YOU NEXT WITNESS. THANK
YOU I'M THIRTY FIVE PLEASE GO
AHEAD. HI HELLO I'M NOT SURE IF
THIS IS MY LINER THIS IS YOUR ON
THE FLOOR HAD HE'S ONLY JUST MY
NAME IS JEFF. MIGHT SORRY MY
NAME IS JEFF FISHMAN AND- I'M A
FRIEND OF THE FAMILY AND I
REALLY STRONGLY SUPPORT SP EIGHT
SIXTY FOUR IT'S GOING TO SAVE A
LOT OF LIVES ESPECIALLY YOUNG
PEOPLE I THANK YOU VERY MUCH
THANK YOU NEXT WITNESS. THANK
YOU I. FIFTY EIGHT PLEASE GO
AHEAD. HELLO MY NAME IS TASHA
WILLIAMS I. RESIDENTS FROM
PLASTIC AND I NEED STRONG
SUPPORT OF SB. EIGHT SIX FOUR
THANK YOU THANK YOU NEXT WITNESS
TH. THANK YOU BYE TWENTY NINE
PLEASE GO AHEAD. HI MY NAME IS
JENNY IT IS GONE I'M A FRIEND OF
THE FAMILY AND I STRONGLY URGE
YOU TO PLEASE SUPPORT TYLER'S
LAW THANK YOU THANK YOU NEXT
WITNESS. THANK YOU I'M THIRTEEN
PLEASE GO AHEAD. YES HI MY NAME
IS MIKE MY NAME IS JANET GILMORE
FINE- CALIFORNIA RESIDENT AND
VOTER AND FRIEND OF THE FAMILY
AND- I STRONGLY URGE YOU TO
SUPPORT SB EIGHT SIXTY FOUR
TYLER SLOT BECAUSE HE WILL. SAVE
LIVES IT COMES LAST TAKE BACK
THE SUPPORT THANK YOU NEXT
WITNESS. THANK YOU I TWENTY
EIGHT PLEASE GO AHEAD. HELLO MY
NAME IS CHRISTY HERE AND I AM
BACK THE TEARS BOTHER NAME AMY-
CURRENT RESIDENT BOXER CALORIE
CONCERNED PARENTS. AND AN
ADVOCATE TO BRING AWARENESS OF
DEFENSE ON DANGERS OCCURRING
DANGERS IN OUR COMMUNITY AND I
AM STRONGLY STRONGLY IN SUPPORT
OF THAT'S THE EIGHT SIXTY FOUR
FATHERS LAW PLEASE. YES. THANK
YOU NEXT WITNESS. THANK YOU I'VE
NINE PLEASE AT. MY NAME. ADRIAN
HE I LOST MY SON THANK YOU KNOW
LATE HI THERE- YEAH. I SHOULD
PROBABLY WORK HIGHLIGHTS LAW
OKAY THANK YOU A MODERATOR HOW
MANY HOW MANY ADDITIONAL
WITNESSES ARE ON THE LINE. WE
HAVE ABOUT FIVE LAPS OKAY THANK
YOU. NEXT WITNESS. THANK YOU I'M
SIXTY ONE PLEASE GO AHEAD. FIVE
SIX ONE. HELLO YES PLEASE
INTRODUCE YOURSELF. HELLO MY
NAME IS ANTON ZERO- I'M A FRIEND
OF THE FAMILY AND- STRONGLY URGE
YOUR SUPPORT TO THE YEAH ON- AT
BEEF EXPORT HOUSE BAR I BELIEVE
THE WAY THEY WANT LIFE. THANK
YOU NEXT WITNESS. THANK YOU ALL
RIGHT WHEN SIX PLEASE GO AHEAD.
LOOK YES YES PLEASE GO AHEAD. HI
MY NAME IS RYAN GROSS- MY LITTLE
BROTHER KEVIN GROSS CATHOLIC
WITH AN OVERDOSE AT THE AGE OF
TWENTY FOUR- I BELIEVE THIS WILL
SAVE A LOT OF LIVES AND PREVENT
IT. OTHER YOUNG PEOPLE AND
EVERYBODY IN GENERAL FROM
PATHWAY FROM NORTH ISLAND STRONG
- THE BOARD- BUT TELL YOU WHAT
THANK YOU THANK YOU NEXT WITNESS
. THANK YOU RYAN FOURTEEN PLEASE
GO AHEAD. HELLO MY NAME BELIEVE
EMAILS- AT EIGHT AM AND STRONG
SUPPORT AT AT THE AGE OF FOUR IN
HONOR OF TYLER AND BRIGHT
LIGHTS. THANK YOU NEXT WITNESS.
THANK YOU I. TWENTY ONE PLEASE
GO AHEAD HI MY NAME IS BONNIE
REFUNDED THE FAMILY I STRONGLY
SUPPORT TYLER'S LOT LOTS OF
FOUNTAINS. AND PAT. WELL. THANK
YOU RIGHT THANK YOU THANK YOU
THANK YOU THANK WITNESS. THANK
YOU RIGHT FORTY EIGHT PLEASE GO
AHEAD. HELLO CAN YOU HEAR ME YES
PLEASE INTRODUCE YOURSELF. MY
NAME IS DANA ON TEN I LOST MY
SON THE SENTINEL POISONING AT
THE AGE OF TWENTY SEVEN YEARS
OLD JUST NINE MONTHS AGO. I
WOULD JUST ENCOURAGE YOU TO
SUPPORT THIS BILL I STRONGLY
ENCOURAGE IT AND I JUST WANNA.
CONCLUDE AND REMIND OTHERS NOT
TO JUDGE THE WEST POINT VOICES
CAN HAPPEN TO ANYONE AND IT IS
IMPERATIVE THAT WE GET THE
FLOPHOUSE. THANK YOU. THANK YOU
- RENDERED NAME ORGANIZATION
POSITION- NEXT WITNESS. THANK
YOU I HAVE NO FURTHER COMMENT
THANK YOU OKAY THANK YOU AND IT
BEGAN THANK YOU TO ALL THE
WITNESSES WHO TESTIFIED THAT
WILL NOW MOVE ON TO THE
OPPOSITION- THERE'S NO FORMAL
REGISTERED OPPOSITION- FOR
TESTIMONY SO WILL NOW MOVE TO
ANY OF THE WITNESSES WISH TO
TESTIFY IN OPPOSITION TO SB
EIGHT SIXTY FOUR BEGIN WITH ROOM
TWELVE HUNDRED. SEE NO ONE
APPROACHING THE MICROPHONE ROOM
TWELVE HUNDRED MODERATOR. PLEASE
OPEN THE LINES FOR ANY WITNESSES
WHO TESTIFIED AGAINST. SB EIGHT
SIXTY FOUR. NAME OR THANK YOU IF
YOU WISH TO. THANK YOU IF YOU
WISH TO SPEAK IN OPPOSITION TO
SB EIGHT SIX FOUR PLEASE PRESS.
ONE THEN ZERO AT THIS TIME. I
HAVE NO COMMENT YOU OKAY THANK
YOU ALL RIGHT WE'LL NOW MOVE ON
TO COMMITTEE MEMBERS OR
COMMITTEE MEMBERS WHO WISH TO
SPEAK- CENTER ADMIN. SIX THANK
YOU VERY MUCH THANK YOU SENATOR
FOR BRINGING THIS FORWARD- HI I
HAVE A NIECES AND NEPHEWS OF. OF
A CERTAIN AGE TOO AND IT'S
EVERYTHING YOU READ ABOUT THIS
BECOMES MORE AND MORE.
FRIGHTENING I KNOW OUR OUR HEAD
PUBLIC DEFENDER LOST A CHILD
THIS LAST YEAR- AND AGAIN IT
JUST TAKES IT TAKES ONE TIME AND
IN IT BEING- THE SPENT ALL THAT
GETS IN DRUGS AND KIDS HAVE NO
IDEA THAT IT'S THERE- AND IT
SEEMS LIKE AS SOON AS WE TRY TO
GET A HANDLE ON. ISSUES AROUND
ADDICTION WHICH IS DIFFICULT
ENOUGH SOME NEW SYNTHETIC
SOMETHING COMES ALONG THAT
SNEAKS INTO THE SYSTEM SO- THANK
YOU FOR BRINGING THIS FORWARD
THANKS FOR POINTING OUT THIS. IS
A GLITCH THAT EXISTED- WITH NEW
TECHNOLOGY SCIENCE AND OUR OUR-
OUR TOOLS NEED TO KEEP PACE WITH
WHAT THEY'RE DOING- ILLEGALLY-
SO AND AGAIN TO THE- TO THE
PARENTS TO THE FAMILIES THOSE
WHO HAVE LOST AND I AM DEEPLY
SORRY FOR YOUR LOSS. AND I KNOW
THAT YOUR WORKER ADVOCACY YOU'RE
SHOWING UP HERE. AND PEOPLE WHO
ARE CALLING IN OR HELPING OTHER
PARENTS AND FAMILY MEMBERS OF
LLOYD. THE PAIN THAT YOU'VE
EXPERIENCED. THANK YOU. IF YOU
ARE. A NEXT STEP- CENTER TARA.
IT'S I'D LIKE TO THINK AUTHOR
FOR- FOR BRINGING THIS MATTER
FORWARD IT. YOU KNOW MY HEART IS
WITH THE LOVED ONES THAT HAVE
LOST A LOVED ONE I KNOW IT'S
VERY DIFFICULT B. HERE YOU
SHOULDN'T HAVE TO BE HERE YOU
SHOULD HAVE TO BE IN THE
SITUATION- AND I'M- THANKFUL
THAT. WE'RE PUTTING THIS MEASURE
AND MOVE TO HOPEFULLY MOVE IT
FORWARD- TO PREVENT TO PREVENT
DEATHS. I ALSO. I THINK WE NEED
TO DO MORE. I JUST BOUGHT A WEEK
AGO THERE WAS. A BIG BUST AND
THE LOS ANGELES AREA OF. A
FENTANYL I THINK THAT'S WE GOT
TO GET IT OFF THE STREET IN THE
FIRST PLACE- AND AWAY FROM.
PEOPLE FROM CHILDREN COMMUTE
FROM EVERY ANYBODY AND
EVERYBODY. SO THANK YOU ONCE
AGAIN AND- MY HOW. BY- THOUGHTS
AND PRAYERS ARE WITH WITH ALL OF
YOU THAT ARE HERE TODAY. THANK
YOU I JUST LET YOU KNOW SO I
HAVE THE NEXT SENATOR GROW
FOLLOWED BY CENTER RUBIO FATHER
LISTEN TO ROCK. AND ROLL. THANK
YOU MR CHAIR THANK YOU-
MISCELLANEOUS FOR BRINGING THIS
BILL FORWARD. I'VE BEEN READING
ARTICLE AFTER ARTICLE THAT SAYS
THAT FENTANYL COMING ACROSS OUR
BORDERS GONNA QUICKLY BECOME THE
NUMBER ONE KILLER OF OUR
CHILDREN. AND SO FOR YOU TO AT
LEAST- BRING THIS MEASURE
FORWARD IT'S A START. IF YOU ARE
TAKING CO AUTHORS I'D BE HONORED
TO BE A CO AUTHOR ON THIS BILL.
AND I LOOK FORWARD TO ITS
PASSAGE OF COURSE THANK YOU
WOULD BE HAPPY TO ADD YOU ON.
THANK YOU SIR RUBIO. THANK YOU
MR CHAIR AND I ALSO WANT TO JUST
COMMEND THE PARENTS FOR HAVING
THE COURAGE TO COMMENT AND SHARE
YOUR STORY WITH US I KNOW IT'S
PAINFUL IT'S NOT EASY- YOU KNOW
I COME FROM A FAMILY THAT HAD A
DRUG ADDICTION AS WELL AND A
LIFELONG ADDICTION AND SOMEONE
WHO- YEAH IT WAS HARD TO
UNDERSTAND AND I KNOW IT'S
REALLY IMPACTFUL TO THE FAMILIES
THAT ARE DEALING WITH THAT SO
BELIEVE ME I UNDERSTAND HER
PERSONAL LEVEL HOW HARD IT IS
AND- AND ON TOP OF THAT JUST
DRUGS BUT NOW WE HAVE TO DO WITH
THE SYNTHETIC DRUGS THAT ARE
CREATED ON THE STREETS ARE
POTENTIALLY MORE DANGEROUS MORE
POISONOUS BUT- ALL DRUGS ARE BAD
BUT I CAN SEE SOME OF OUR
CHILDREN ARE GOING ON. ON THE
STREET TRYING TO PURCHASE THINGS
THAT ARE JUST OUT THERE SO AS
SANDERS WRITABLE STATED WE JUST
HAVE TO DO BETTER TRYING TOGET
DRUGS OFF THE STREET BUT JUST IN
GENERAL I ALSO LIKE TO SPEAK OF
THE STIGMA ONCE AGAIN YOU KNOW
THE IDEA THAT ONLY KIDS ON THE
STREETS WITHOUT PARENTS WITHOUT
THE FINANCIAL MEANS ARE THE ONES
WHO GET CAUGHT UP WITH DRUGS YOU
KNOW IT'S JUST NOT NOT SURE- YOU
KNOW A LOT OF. GREAT PARENTS A
LOT OF GRIEF FAMILIES WHO ARE
CAUGHT IN THE SYSTEM BECAUSE
AGAIN OUR KIDS ARE BUYING THEM
OFF THE STREETS SO THANK YOU FOR
YOUR STORY INSURING YOUR YOUR
PERSONAL TRAGEDY SO WE CAN
ADVANCE SOMETHING LIKE THIS AND
THANK YOU TO THE AUTHOR AND I
ALSO WOULD ENCOURAGE SUPPORT
THANK YOU. THIRD THANK YOU MR
CHAIR FOR. MIKE TO THOSE.
FAMILIES TRAGICALLY IMPACTED BY
THIS TERRIBLE TERRIBLE- DRUG.
ALSO ONE. THANK THE AUTHOR FOR
HER- TIRELESS EFFORTS TO MAKE A
DIFFERENCE. IN THIS ARENA IT'S A
IT'S A- HORRIBLE PROBLEM. IN OUR
REGION. AS WELL AS UP AND DOWN
THE STATE AND SHE'S TO BE
COMMENDED FOR. CONTINUING TO
TACKLE THIS HUGE HUGE PROBLEM.
THE BILL HASN'T BEEN MOVED TO
MISTER CHAIR I MOVE THE BILL.
RIGHT DOES THE MOVE I SERRATA
DURING ANY OTHER OR COMMENTS
FROM COMMITTEE MEMBERS. SEEING
US AGAIN SIR MELINDA'S ONE FIRST
OFF THANK YOU SO MUCH PREVIOUS
BILL FORD AND WORKING WITH MY
STAFF AS WELL TO TAKE CARE OF
THINGS SOME TECHNICAL ISSUES-
I'D TOO WANT TO THANK- SHAMUS IS
THANK YOU SO MUCH FOR BEING HERE
SHARING YOUR SON'S STORY. AND
ALSO THE OTHER WITNESSES AS
WELL- YOU KNOW I THINK OF. THE
WHO'S ACTUALLY WORKING EMERGENCY
ROOM NOT ER DOC- SOMETIMES- WE
MAKE CERTAIN ASSUMPTIONS ABOUT
THE TESTS THAT WE DO AND- AND I
REALLY APPRECIATE THAT- YOU
IDENTIFIED WITH- THE SHINS AND-
COMMUNITY- A GAP. THAT
UNFORTUNATELY LED TO THE TRAGEDY
THAT WE HEARD ABOUT. THAT WE
ALSO NEED TO TRY TO DO BETTER TO
BE SURE THAT WE CAN IDENTIFY.
PEOPLE WHO'VE BEEN EXPOSED TO
SYNTHETIC OPIOIDS LIKE FENTANYL
UNFORTUNATELY IT'S MAKING ITS
WAY INTO ALL SORTS OF. THINGS
RIGHT. SO MANY OF THE VICTIMS OF
THAT NOW DON'T KNOW THAT THEY
WERE EXPOSED TO FAT NOW. AND SO
WE NEED TO BE SURE WE HAVE THE
TOOLS TO PICK THAT UP. CERTAINLY
I KNOW WE'VE WORKED ALSO HERE IN
THE LEGISLATURE TO TRY TO.
IMPROVE TREATMENT FOR- SUBSTANCE
USE- EXPAND- ACCESS TO
BEHAVIORAL HEALTH SERVICES I
KNOW MY GOOD FRIEND CENTER
ADMINS BEEN WORKING VERY HARD ON
THAT AND THE BUDGET SUBCOMMITTEE
AND THAT. ACTUALLY SENT IN ON
THIS AND I BOTH SAID ON- BUT
ALSO IT'S IMPORTANT WE ADDRESS-
THE FACT THAT- MANY PEOPLE
EXPOSED TO SYNTHETIC OPIOIDS
DON'T EVEN KNOW IT THEY'RE NOT-
AND- SO UNFORTUNATELY WHAT. IS
THAT WE'RE NOT. ABLE TO IDENTIFY
IT THEN WE CANNOT GET THEM.
APPROPRIATE TREATMENT AND- TO
SAVE OUR LIVES. SO- AGAIN I
WANNA THANK YOU SO MUCH FOR
BRINGING THIS BILL FORWARD- IT'S
BEEN MOVED BY SERA ASSUR
MELINDA'S WHICH LIKE THE CLOTHES
. I WOULD THANK YOU SO MUCH FOR
CHAIR AND CO. THINK YOU SO MUCH
FOR THOUGHTFUL COMMENTS AND I.
WANT TO- EXTEND A PERSONAL THANK
YOU TO- CHARLES IN JOLIE AND OF
COURSE LAURA- FOR BEING HERE IN
PERSON AND EVERYONE WHO CALLED A
NIGHT IT'S- IT'S HARD TO TALK
ABOUT. IT'S HARD TO RELIVE IT
IT'S JUST VERY DIFFICULT FOR
THESE FAMILIES AND I AM
GRATEFUL. THAT YOU YOU KNOW HAD
THE STRENGTH TO COME IN AND
SHARE YOUR STORY READ WE DO
APPRECIATE IT- AND I WISH THAT
YOUR SIDE AND- WERE HERE. WITH
US BUT- YOU KNOW PERHAPS
SOMETHING. SOMETHING GOOD CAN
COME OUT OF ALL OF THIS AND THAT
IS BY PASSING LEGISLATION IT
HOPEFULLY KEEPS OTHER PARENTS
FROM LOSING THEIR CHILD IN THE
WAY THAT YOU LOST YOURS SO I
WOULD LIKE TO CLOSE BY SAYING
THAT WE DO HAVE A CHANCE TODAY
TO CHANGE THE STANDARD OF CARE
IN OUR COMMUNITIES TO INSURE
MORE PEOPLE DO NOT DIE FROM THIS
PLACE AND- IT IS CROSSING OUR
BORDERS IN. MASSIVE QUANTITIES-
WE KNOW THAT LAW ENFORCEMENT IS
HAVING A VERY HARD TIME KEEPING
UP WITH THIS- AND IT CENTERED
HER TADO YOU MENTIONED THAT
THERE WAS IT WAS FIVE. DIFFERENT
DAY FIVE I DON'T KNOW WHAT THE
EXACT NUMBER IS A HUGE SHIPMENT
OF FENNEL THAT THEY SEIZED-
WHICH WAS ENOUGH TO KILL OVER A
MILLION PEOPLE JUST THAT AMOUNT
OF TIME AND ALSO IT IS. A
PROBLEM- THE EPIDEMIC IS OUT OF
CONTROL IN OUR STATE CERTAINLY
ACROSS THIS COUNTRY AND WE HAVE
TO DO EVERYTHING WE CAN TO- TRY
TO CONTAIN IT SAID THIS BILL IS
B. SIXTY FOUR. IS SIMPLY ABOUT
ENSURING DOCTORS HAVE ALL THE
TOOLS NECESSARY EVERYTHING
THAT'S AVAILABLE TO THEM TO
TREAT THEIR PATIENTS. WELL I'VE
DONE IT FOR SENSE ABUSE PROBLEMS
- WHERE THEY HELP TO PAY. BEFORE
BEFORE THEY DIE SO I HOPE THAT-
YOU WOULD JOIN ME TODAY. IN
SUPPORTING SP EIGHT SIXTY FOUR
IT IS CERTAINLY NOT GOING TO
SOLVE THE PROBLEM IN ITS
ENTIRETY. BUT IT IS A IT'S A
PIECE OF THE PUZZLE SO THANK YOU
MR CHAIRMAN I WOULD RESPECTFULLY
ASK FOR YOUR I. BOATS. OKAY
THANK YOU SIR MELINDA'S- THE
BILLS A MOVE I CENTER ROCKED THE
MOTIONS TO PASS AS AMENDED BUT
FIRST THE MAN REFERRED TO THE
COMMITTEE ON APPROPRIATIONS
CONSULTANTS- PLEASE CALL THE
ROLL. HAND BY HAND HI MELINDA'S
EIFFEL AND AS I AIKMAN. AIKMAN I
CAN SOLACE. CONSOLES I GROW.
GROUP I HER TADO I. THE TOTAL I.
LLEVA. LABOR I LI MON.LEE MON
HI ROTH. ROTH IRA RUBIO. RUBIO I
WINNER. OKAY THAT BILL HAS TEN
VOTES WILL HOLD REAL OPEN FOR
THE US NUMBER. THANK YOU. RIGHT
FLEUR NOW MOVING ON TO ITEM
NUMBER. THREE- SIR ROCK. S. B.
EIGHT EIGHTY THREE YOU CAN
TESTIFY THAT FROM YOUR MISSED.
CHAIR ATTACKS SENT PORTENT. BILL
I'M JUST THE BRIEFCASE CARRIER
ON THIS ONE. CENTER FOR DETAIL
WELCOME. JANUARY OR SO MUCH MORE
THAN A BRIEFCASE FOR RECORD- BUT
IT DOES THANK YOU MR CHAIR AND-
TO MY JOINT OFFICER A- GENERAL
RAFI THAN MANY MEMBERS I'M
PLEASED TO PRESENT TO SP EIGHT
EIGHT THREE- WHICH SEEKS TO
EXTEND THE SUNSET OF THE
CALIFORNIA BIBLICAL CORD BLOOD
COLLECTION PROGRAM. I ACCEPT THE
COMMITTEE AMENDMENTS REFERENCE
IN THE ANALYSIS TO ASCEND EXTEND
THE SUNSET DATE FOR THIS TWO
DOLLAR FEE SURCHARGE. BELIEVE IT
OR NOT THIS WAS THE VERY FIRST
BILL I INTRODUCED WHEN I GOT
ELECTED TO THE STATE ASSEMBLY IN
TWO THOUSAND SIX I MIGHT JOIN
AUTHOR AT THE TIME WAS JOEL
ANDERSON. WHO YOU ALL REMEMBER-
AND NOW WE GOT TO A UNANIMOUS BI
PARTISAN SUPPORT ON THE STATE
ASSEMBLY THE TIME AND- THE
PROGRAM HAS COLLECTED. NEARLY
SIX THOUSAND UNITS OF LIFESAVING
CORD BLOOD- EVERY YEAR AND THIS
BILL EXTENDS THE PROGRAM FOR
ANOTHER FOUR YEARS TO TWO
THOUSAND TWENTY SEVEN AS YOU
KNOW CORD BLOOD CURES LEUKEMIA.
CALIFORNIA'S MOST DIVERSE BLOOD
SUPPLY IN THE COUNTRY- BECAUSE
WE HAVE THE MOST DIVERSE
POPULATION IN THE COUNTRY. WE
HAVE FIVE HUNDRED FIFTY THOUSAND
BIRTHS- AND CORD BLOOD IS A
HUNDRED TIMES EASIER TO MATCH
THAN BONE MARROW LET ME SAY THAT
AGAIN. CORPORATE IS A HUNDRED
TIMES EASIER TO MATCH THAN BONE
MARROW TO CURE LEUKEMIA AND SO
AGAIN WE ARE THE PERFECT PLACE
TO COLLECT STORE AND MAKE
AVAILABLE THIS LIFESAVING CORD
BLOOD CELL WITH THAT I KNOW I
HAVE. FROM THE UNIVERSITY
CALIFORNIA- DAVIS WHO'S HERE TO
PRESENT AND I THINK SUZANNE DR
SUZANNE IS HERE AS WELL FROM THE
UMBILICAL CORD BLOOD COLLECTION
PROGRAM SO AN APPROPRIATE I
RESPECTFULLY ASK WHEN I WROTE.
THANK YOU SIR PARTY NOW LET'S-
BRING FORTH OUR WITNESSES- IN
SUPPORT OF SB EIGHT EIGHTY
THREE- YOU HAVE BETWEEN THE TWO
OF YOU FOR MINUTES WELL OKAY THE
THANK YOU SENATOR. A FORTY
INTRODUCTION AND FOR. THIS
OFFERING THIS IMPORTANT OF
LETTUCE. I'M SUSAN AND DIRECTOR
OF THE HELLO UMBILICAL BLOOD
PROGRAM THAT WE MANAGE UC DAVIS
. THE UMBILICAL CORD BLOOD
COLLECTION PROGRAM WAS AT.
CREATED IN TWENTY TEN IN
RESPONSE TO MANY CALIFORNIANS
BEING UNABLE TO FIND A MATCH FOR
A BLOOD STEM CELL TRANSPLANT.
UMBILICAL CORD BLOOD. HAS IT IT
IS A SOURCE OF BLOOD STEM CELLS
AS HIS BONE MARROW. AND IS USED
WHEN I MATCHED BONE MARROW DONOR
CAN'T BE FOUND. AND CALIFORNIA
RANKS SECOND IN RACIAL AND
ETHNIC DIVERSITY WHICH MEANS
THERE ARE A LOT OF RESIDENTS
THAT ARE HARD TO MATCH FOR A
TRANSPLANT. UMBILICAL CORD BLOOD
IS USED TO TREAT HEART TO MATCH
PATIENTS. ESPECIALLY THOSE WHO
ARE OF NON EUROPEAN OR MULTI
RACIAL ETHNICITY- ANCESTRY.
PRIOR TO THIS PROGRAM. THE
NATIONAL INVENTORY OF CORD BLOOD
. DID NOT REFLECT THE DIVERSITY
OF CALIFORNIANS. NOW WE HAVE A
GROWING CALIFORNIA INVENTORY AND
TWENTY FOUR SINCE TWENTY TWELVE
WE'VE ADDED ALMOST THIRTY FIVE
HUNDRED UNITS TO THE NATIONAL
REGISTRY. SEVENTY SEVEN UNITS
HAVE BEEN MATCHED TO PATIENTS
AND TRANSPLANTED. AND WE'VE
DISTRIBUTED OVER A THOUSAND
UNITS FOR RESEARCH. THIS
FANTASTIC PROGRAM IS FUNDED BY A
TWO DOLLAR FEE ON CERTIFIED
BIRTH CERTIFICATE COPIES AND
IT'S FREE TO THE FAMILIES THAT
DONATE. AND BECAUSE CORD BLOOD
CAN BE- STORED INDEFINITELY.
THIS INVESTMENT NOW WILL HAVE
IMPACT FAR INTO THE FUTURE. SO I
URGE YOU TO PLEASE VOTE YES TO
EXTEND THIS IMPORTANT LIFE
SAVING PROGRAM. THANK YOU SO
MUCH. THANK YOU DOCTOR PATEL NOW
BRING UP FIRST SERRA- SORRY
THAT'S- PROBLEM AT SIERRA ECHO
THE NUMBER STEVE CALIFORNIA
OFFICE OF THE PRESIDENT I THANK
YOU AGAIN SENATOR FOR OFFERING
THIS IMPORTANT PIECE OF
LEGISLATION AND WERE AVAILABLE
FOR ANY QUESTIONS YOU MAY HAVE.
YOUR SUPPORT. THANK YOU THANK
YOU SIR HAVE ALL. RIGHT ALL
RIGHT- WE'RE GOING OUT LATE AT
HERE FROM ANY ADDITIONAL
WITNESSES IN SUPPORT OF SB EIGHT
EIGHT THREE- WE'LL GO FIRST TO
ROOM- THIS ROOM SCENE ON COMING
TO A MICROPHONE MODERATOR PLEASE
OPEN THE LINES FOR WITNESSES WHO
WOULD TESTIFY. IN SUPPORT OF SB
EIGHT EIGHTY THREE NAME
ORGANIZATION POSITION ONLY.
THANK YOU IF YOU SPEAK IN
SUPPORT OF SB EIGHT EIGHT THREE
PLEASE PRESS ONE THEN ZERO AT
THIS TIME. OVER ONE FIFTY FIVE
PLEASE GO AHEAD. THIS IS MOLLY
SHEEHAN AT THE CALIFORNIA
CATHOLIC CONFERENCE IN SUPPORT
OF SB EIGHT EIGHTY THREE THANK
YOU ALL THANK YOU NEXT WITNESS.
THANK YOU I PLEASE GO AHEAD. NO
WORRY ON BEHALF OF THE
CALIFORNIA MEDICAL ASSOCIATION
IN SUPPORT THANK YOU NEXT
WITNESS. THANK YOU I HAVE NO
FURTHER COMMENT THANK YOU ALL
RIGHT THANKS FOR MUCH WILL NOW
MOVE TO WITNESSES IN OPPOSITION
WE DO NOT HAVE A FORMAL
REGISTER- OPPOSITION TO TESTIFY
SOUL MOVED THEN MOVED TO
ADDITIONAL WITNESSES IN
OPPOSITION BEGAN FROM TWELVE
HUNDRED SCENE ON HERE- OPEN
ALLIANCE. SAID WITNESSES WHICH
ARE TESTIFY IN OPPOSITION TO SB
EIGHT EIGHT THREE. THANK YOU IF
YOU WISH TO SPEAK IN OPPOSITION
TO SB EIGHT EIGHT THREE. PLEASE
PRESS ONE THEN ZERO AT THIS TIME. I HAVE NO COMMENT THANK YOU
OKAY SEEN NONE- THAT'S BRING IT
BACK TO COMMITTEE OF THE
QUESTIONS OR COMMENTS FROM
COMMITTEE MEMBERS. ETCETERA
THANK YOU MR TRUE THIS MAY SEEM
A LITTLE ODD BUT THIS IS IN FACT
SENATOR PORTMAN TINA'S BILL. AND
HE'S BEEN CHAMPIONING THIS CAUSE
FOR. FOR YEARS SOME OF YOU MAY
NOT KNOW SOME OF YOU MAY KNOW
BUT- I LOST MY- MY YOUNGER
SISTER IN FEBRUARY OF TWO
THOUSAND NINETEEN TO MULTIPLE
MYELOMA. BEFORE SHE WAS ABLE TO
BENEFIT FROM. THIS TYPE OF
PROGRAM I CAN'T ASSURE YOU
DURING THAT. THAT RATHER
HORRIBLE PROCESS SAYS HER BODY
WAS RAVAGED BY THE DISEASE. I
LEARNED A LOT ABOUT BLOOD
CANCERS IN ABOUT THE IMPORTANCE
OF. STEM CELL TRANSPLANTS IN THE
UMBILICAL CORD BLOOD PROGRAM IN
THE- SIGNIFICANT ADVANTAGES AND
ACTUALLY FUTURE. THE PROGRAMS
SUCH AS THIS. FOUR PEOPLE FOR
INDIVIDUALS WHO ARE. SUBJECTED
TO THAT HORRIBLE DISEASE AND
DISEASES LIKE THAT SO I JUST
WANT TO THANK THE SENATOR FOR
CONTINUING HIS FIGHT. TO EXTEND
THIS PROGRAM AND FOR ALL THE
BENEFITS IT PROVIDES TO. NOT
ONLY THE RESIDENTS OF THE STATE
BUT- THE RESIDENTS OF. OF THE
REST OF THE STATES IN THE UNITED
STATES OF THANK YOU SIR. CENTER
MONTHS. THANK YOU TO BOTH THE US
SENATOR PRINTING ON ROCK I
ACTUALLY ONLY RECENTLY LEARNED
ABOUT THIS PROGRAM IN THE LAST
IF MONTH OR SO BECAUSE I LOOKED
INTO IT AND ONE OF THE THINGS
THAT STRUCK ME AS ONE- HOW MUCH
PEOPLE DN'T KNOW ABOUT IT BUT
TO ALSO THAT IT COULD BE COST
PROHIBITIVE- FOR SOME WHO WHO
WANT TO DO THIS- SO IT'S-
IMPORTANT THAT WE DO MORE TO
MAKE IT ACCESSIBLE BECAUSE IT
HAS BEEN STATED- THE BENEFITS-
IN THE LONG RUN ARE REALLY
INVALUABLE SO- I'M GLAD YOU'RE
MOVING THIS FORWARD AND THINK.
AT THEY WERE DOING MORE TO MAKE
ONE THIS INFORMATION MORE
ACCESSIBLE BUT ALSO THE COST
BECAUSE THEY KNOW THAT THAT IS
SOMETHING THAT- PROHIBIT SOME
INDIVIDUALS FROM EVEN BEING ABLE
AT. ANY OTHER QUESTIONS OR
COMMENTS. MANY MEMBERS. OKAY
SAYING NINE US ARE FOURTEEN L. I
TOO WANT TO THANK YOU FOR YOUR
WORK IN THIS AREA FOM THE RIGHT
TIME CAME THE LEGISLATURE AND OF
COURSE- NOW EXTENDING THE SUNSET
DATE ALSO THANK YOU- CIROC THIS
WELL- WOULD YOU LIKE TO CLOSE
YES THANK YOU DOCTOR PEN- AND
WHAT TO BUY CALLING FROM SANTA
BARBARA I BELIEVE WAS ALLUDING
TO IS THERE'S A PRIVATE BANKING.
INDUSTRY WHICH AGAIN YOU HAVE TO
PAY SOMEBODY TO COME INTO YOUR-
DELIVERY ROOM AND HARVEST THE
CORD BLOOD AND THEN YOU PAY A
YEARLY FEE TO START WITH THIS
PROGRAM IS THIS IS A PUBLIC CORD
BLOOD PROGRAM SO YOU WOULDN'T
HAVE TO GO THROUGH THAT SO WOULD
BE AVAILABLE FOR THE GENERAL
PUBLIC- AND FRANKLY THAT'S HOW I
GOT INVOLVED IN THIS- OKAY
CONSTITUENT WHO WAS THE FIRST
CALIFORNIA. CORD BLOOD
TRANSPLANT RECIPIENT IN
CALIFORNIA A UCLA FLEW THE
TODDLER BACK TO JOHNS HOPKINS TO
HAVE THE TRANSPLANT AND IT CURED
HIS LEUKEMIA AND THE MOM SHARED
THAT STORY WITH ME- WHEN I WAS
ON THE CITY COUNCIL AND I SAID
GEE. IF I EVER HAVE ANOTHER
CHILD THAT YOU KNOW WILL
CONSIDER DONATING HER CORD BLOOD
AND SO WHEN. YOU GO. TO DONATE-
CORD BLOOD AND THERE WAS NO
INFRASTRUCTURE TO DO THAT AND SO
I CALLED ONE OF THE PRIVATE
COMPANIES AND I SAID I'LL JUST
DONATE HER BLOOD AND I ACTUALLY
MADE THE ARRANGEMENTS IN THE
HOSPITAL AND TALK TO THE DOCTOR
AND GOT IT HARVESTED IN WAS
THERE AND THEN I HAD A PACKET ON
ICE AND SHIP IT AND I SAID MOST
PEOPLE ARE GOING TO DO THAT JUST
TO GIVE IT AWAY AND SO- THAT'S
WAS THE GENESIS OF WHY I DID
THIS AND I'VE OFTEN SAID IF. YOU
SAVE ONE LIFE THAT'S ENOUGH FOR
A LIFETIME BUT THIS PROGRAM IS
GONNA SAVE MANY MORE THAN ONE
LIFE AND SO WITH THAT I L. AND
ONE OTHER THING I DON'T KNOW IF
YOU SAW TOO MUCH AGO NEW YORK
TIMES REPORTED CORD BLOOD BEING
USED TO CURE HIV AND BACK IN TWO
THOUSAND SIX CITY OF HOPE TOLD
ME ABOUT THE POTENTIAL SCIENCE
BEHIND CURING HIV THAT THERE'S A
PARTICULAR CORD BLOOD- VARIANT
THAT HAS NO. GENETIC MARKER FOR
THE HIV VACCINE TO PENETRATE
THAT SELL AND SO IF YOU CAN
HARVEST MORE OF THOSE HIV
RESISTANT STEM CELLS YOU CAN
CURE HIV IN IT IN TWO THOUSAND
SIX IT WAS A THEORY TWO MONTHS
AGO IT IT HAPPENED AND SO THERE
ARE MANY MORE APPLICATIONS THAN
JUST LEUKEMIA WHICH UNITS OF
ITSELF IS LAUDABLE SO WITHOUT I
RESPECTFULLY ASK FOR ALAN SCOTT
CENTER WILK IS A. CO AUTHOR ON
THIS AS WELL. RIGHT THANK YOU
CENTER FOURTEEN. IT'S A MOTION.
THE MOVE MY CENTER OF. ZATERDAG
MEANT SORRY I WAS THANKS SO THE
MOST IS- DEEP A MAN BUT FIRST
THE MAN REFERRED TO THE
COMMITTEE ON APPROPRIATIONS ITS
OWN PLEASE CALL THE ROLL. CAN I
HAND HI MELINDA'S MELINDA'S I
EGGMAN EGGMAN I CAN SOLACE.
THEMSELVES I GROW GROVE BY HER
TADO I TITLE II LLEVA. LABOR I
LEE MOON THE MOON I. ROSS ROSS I
RUBIO. RUBIO I WINNER. OKAY YOU
HAVE TEN VOTES SEVERAL THE ROLE
OF AND FOR THE NUMBER OKAY THANK
YOU ALL RIGHT- THE NEXT BILL
OTHERS ACTUALLY ITEM NUMBER FOUR
SP NINE TWENTY NINE BUT CENTER
EGLIN. THANK YOU VERY MUCH. OKAY
I'LL PRESENT RIGHT HERE. I THANK
YOU ALL RIGHT SO THANK YOU. TO
THE CHAIR AND COMMITTEE MEMBERS
AND ALSO. I WANT TO THANK THE
COMMITTEE STAFF FOR WORKING WITH
US. AND ACCEPT THE RECOMMENDED
AMENDMENT TO INCLUDE
INFORMATION. FROM ALL ENTITIES
THAT CAN DETAIN FOR INVOLUNTARY
HOLDS NOT JUST THOSE THAT WERE
ADMITTED- SO PEOPLE MAY HAVE
HEARD ME TALK ABOUT MY- BILL
PACKAGE TO REALLY TRY TO ADDRESS
THE ENTIRE CONTINUUM OF CARE
FOR. OUR BEHAVIORAL HEALTH
SYSTEM AND THIS IS ONE OF THOSE
STEPS. S. B. NINE TWENTY NINE
WOULD EXPAND ON THE INFORMATION
THAT WE CURRENTLY REQUIRE. TO BE
REPORTED TO THE STATE REGARDING
OUR INVOLUNTARY. TREATMENT
SYSTEM UNDER THE LPS ACT. AS
PEOPLE KEEP SAYING YOU KNOW WHAT
WHAT'S GOING ON THE STREETS WHAT
WHAT WHY CAN'T WE HELP PEOPLE.
AND ONE OF THE THINGS THAT I
THINK WE'RE REALLY GONNA TRY TO
FOCUS ON THIS YEAR IS GETTING
BETTER DATA. HEY WE KNOW THAT WE
HAVE- THAT THAT WE KNOW WE SPEND
MILLIONS AND BILLIONS OF
DOLLARS. BUT WE HAVE NOT BEEN
ABLE TO TIE THAT TO OUTCOMES ON
PEOPLE ACTUALLY GETTING TREATED
AND BETTER. AND SOMETIMES WE
NEED TO KNOW WHERE PEOPLE FALL
OUT. OF THE SYSTEM. AND WHAT IS
THE DISPOSITION AFTER THEY THEY
LEAVE AN INTERACTION SO THAT WE
CAN ACTUALLY REPLICATE WHAT
WORKS GET RID OF WHAT DOESN'T.
AND ACTUALLY TRACK PEOPLE
THROUGH A SYSTEM IN A MORE
EFFICIENT WAY- SO THIS WOULD
INCLUDE ADDITIONAL INFORMATION
ABOUT THE TYPES OF SERVICES AND
OUTCOMES FOR INDIVIDUALS ON
VARIOUS TYPES OF HOLD. WAITING
PERIODS RECEIVING CARE AND OUR
DATA ON CURRENT AND FUTURE BED
CAPACITY WE DON'T SO OFTEN
PEOPLE ARE TAKEN IN. A IN A
CRISIS AND OFTENTIMES SPEND WAY
TOO MUCH TIME IN EMERGENCY ROOM.
NEVER ACTUALLY ARE TREATED FOR
THEIR- FOR THEIR CRISIS AND SENT
BACK ON TO THE STREETS ONLY TO
RETURN. TO ANOTHER EMERGENCY
ROOM OR JAIL OR SOMEWHERE ELSE-
INTO TWENTY THE STATE AUDITOR
DID RELEASE. REPORT ON LPS AND
LAST DECEMBER OUR COLLEAGUES IN
THE ASSEMBLY. HELD AN
INFORMATIONAL HEARING ON THE
TOPIC WHICH I WAS ABLE TO
ATTEND. AND ONE OF THE MOST
COMMON POINTS OF AGREEMENT. WAS
THAT WE NEED TO KNOW MORE ABOUT
HOW OUR CURRENT SYSTEM IS
WORKING. SO THAT WE CAN DO
EVERYTHING WE CAN TO MAKE IT
WORK BETTER. ESPECIALLY AS IT
RELATES TO INVOLUNTARY CARE- AND
WHAT ACTUALLY WORKS AND MOVES
PEOPLE TO A LOWER LEVEL OF CARE
AS SOON AS POSSIBLE. AFTER
THEY'RE STABILIZED- I DO THINK
THERE ARE OTHER SYSTEMS ARE
MENTION OF THEIRS AND BUY MORE
BILLS BUT THIS IS THAT ONE
THAT'S REALLY GOING TO I THINK
FOCUS ON. GATHERING THE DATA
THAT WE NEED FROM EVERYBODY WHO
WAS DETAINED- AND THE
DISPOSITION. A LINK TO STAY IN
THE E. R. STANDARDIZING DATA
REPORTING- THERE IS THERE ARE SO
MANY ISSUES THAT WERE HAVING A
LOT OF CONVERSATIONS WITH VERY
STAKEHOLDERS INCLUDING THE
BEHAVIORAL HEALTH DIRECTORS.
HOSPITAL'S EMERGENCY ROOMS. C.
FAN. TO EXPLORE OTHER
INFORMATION THAT COULD BE
HELPFUL- WHICH THIS COMMITTEE-
PROVIDED FOR US TO EAT OTHER
INFORMATION THAT COULD BE
HELPFUL SO WE CAN REALLY GET.
THAT COMPREHENSIVE PICTURE THAT
WE NEED- SO THE DEPARTMENT
CURRENTLY REQUIRED TO COLLECT
DATA ON BROAD NUMBERS BUT WE
KNOW RUN NUMBERS ARE JUST
THEY'RE JUST NUMBERS THEY DON'T
HAVE ANY. ANY CONTEXT TO THEM
THAT HELPS US UNDERSTAND- SO
THERE'S HOPE THAT THIS BILL WILL
CONTINUE TO PROVIDE GUIDANCE ON
HOW WE IMPROVE SERVICES.
OUTCOMES AND CONTINUE TO FOCUS.
ON WHERE OUR SYSTEM LACKS
CAPACITY AS WE CONTINUE. TO PLAN
FOR THE FUTURE. OVER THE LAST
FEW MINUTES AGAIN WE'VE BEEN
MEETING WITH A LOT OF FOLKS I'VE
MET WITH MOST OF- THE MAYORS
AROUND THE STATE TO BIG CITY
MAYORS THAT ARE PART OF THE
COALITION OF CO SPONSORS ON THIS
BILL. AND THE REST. OF OUR
BEHAVIORAL HEALTH PACKAGE- THIS
IS A TRULY BIPARTISAN ISSUE
EVERYBODY AGREES WHAT OUR SYSTEM
IS BROKEN IT IS NOT WORKING. AS
IT SHOULD- AND WE HAVE TO DO
SOMETHING ABOUT IT CREATES FOR
ALL OF US EVERY SINGLE DAY. OUR
OWN PERSONAL CRISIS AS WE SEE
THINGS AS WE HAVE TO EXPLAIN TO
OUR CHILDREN WHY WE CAN'T DO
BETTER. AND FEEL LIKE WE'RE
TURNING OUR HEADS AWAY FROM WHO
IS ACUTELY IN NEED CARE- THIS
BILL HAS NO OPPOSITION I
RESPECTFULLY ASK FOR YOUR I
VOTED THE PROBE. APPROPRIATE
TIME. AND WITH ME TODAY I HAVE
RENTAL HAGAR. WITH THE
PSYCHIATRIC PHYSICIANS ALLIANCE
OF CALIFORNIA ON THE PHONE. AND
CALL DELUCA REPRESENTING THE BIG
CITY MAYORS. OF CALIFORNIA HERE
IN PERSON. OKAY THANKS VERY MUCH
SIR I AM AN EX YOU WHICH WOULD
BE WITNESSES BEGINNING FIRST.
OKAY ARTICLE SO OKAY WELCOME-
LOOK AT THE CODE TO LOOK- AND
AGAIN- BETWEEN THE TWO IF YOU
FOUR MINUTES TWO MINUTES APIECE.
THANK YOU ABSOLUTELY THANK YOU
MR CHAIRMAN MEMBERS OF THE
COMMITTEE. MY NAME IS NICHOLA-
AND I'M HERE THIS AFTERNOON ON
BEHALF OF THE BIG CITY MAYORS
COALITION WHICH IS LED- THIS
YEAR BY OAKLAND MAYOR LIBBY
SCHAAF AND STRONG SUPPORT AND
THANK THE SENATOR. FOR ALL HER
LEADERSHIP. SO AS YOU ALL KNOW
THE BIG CITY MAYORS IT'S MADE UP
OF THE THIRTEEN LARGEST CITIES-
ROUGHLY ELEVEN MILLION
RESIDENTS. SO THOSE CITIES
INCLUDE LA SAN DIEGO SAN JOSE.
SAN FRANCISCO FRESNO SACRAMENTO
LONG BEACH OAKLAND BAKERSFIELD
ANAHEIM SANTA ANA RIVERSIDE IN
STOCKTON. THIS COALITION DOES
NOT TYPICALLY SPONSORED
LEGISLATION NORMALLY WE'RE
FOCUSED ON- THE BUDGET WE'RE
VERY APPRECIATIVE FOR PAST YEARS
OF BUDGET FUNDING. HOWEVER THE
BEHAVIORAL HEALTH CRISIS THAT
WE'RE SEEING IN OUR CITIES HAS
BROUGHT A NEW LEVEL IN SENSE OF
URGENCY TO OUR MAYORS. THEY'RE
SEEN FIRSTHAND JUST LIKE YOU ALL
ARE ARE OUR COMMUNITIES HAVE
STRUGGLED TO PROVIDE THE
APPROPRIATE- IN TIMELY CARE TO
THOSE EXPERIENCING SEVERE MENTAL
HEALTH. AND ALSO HOST CITY
PUBLIC SAFETY EMPLOYEES AND
FIRST RESPONDERS. ARE OFTEN
THOSE THAT MISS INTERVENE IN A
TIME OF CRISIS. ARISES CENTER
SAID SP NINETY NINE IS JUST ONE
OF THE BILLS IN THE PACKAGE THAT
WERE CO SPONSORING- WE REALLY
APPRECIATE HER LEADERSHIP AND
RESPECTFULLY ASK YOUR IPHONE.
THANK YOU VERY MUCH. HI THANK
YOU VERY MUCH- BUT- PLEASE BRING
ON TO THE LINE RANDALL HAGAR
FROM THE PSYCHIATRIC PHYSICIANS
ALLIANCE OF CALIFORNIA. TO
TESTIFY. GOOD AFTERNOON- MR
CHAIRMAN MEMBERS OF THE
COMMITTEE- THIS IS RANDALL HAGER
FROM PSYCHIATRIC PHYSICIANS
ALLIANCE OF CALIFORNIA- ONE OF
THANK YOU FOR THE OPPORTUNITY TO
TESTIFY ON THIS REALLY IMPORTANT
THEY ALL WANT TO THANK THE
AUTHOR FOR HER LEADERSHIP-
COMPLIMENT THE STAFF ON YOUR
ANALYSIS- PSYCHIATRIC-
PHYSICIANS. WHO WORK IN A SYSTEM
THAT'S REALLY FRAGMENTED ILO
THE WE LOOK AT DATA TO TRY TO
HELP US FIGURE OUT WHAT WE NEED
TO DO TO IMPROVE WHAT WE COLLECT
NOW DOESN'T WORK- THIS BILL
WOULD. REQUIRE THE COLLECTION OF
A MORE MUCH MORE COMPREHENSIVE
SET. OF DATA- ALSO IF WE WANT
SERVICES THAT LEAD TO BETTER
OUTCOMES AND QUALITY. THIS BILL
DOES THAT IF WE WANT MORE.
TRANSPARENCY AND OVERSIGHT
FRANKLY THIS BILL HELPS US GET
THERE IF WE WANT TO KNOW WHAT
BARRIERS ARE TO ACCESS INTO THE
QUALITY OF CARE THIS BILL HELPS
IDENTIFY THOSE. WE WANT. YOU
KNOW WHAT'S WORKING- AND WE NOT
THIS BILL WILL HELP US IN
RESPECT. THANK YOU FOR YOUR TIME
TODAY AT WE COMMEND THAT STUFF
BUILT TO YOUR SUPPORT THANK YOU
. HI THANK YOU. AND NOW WE'LL
MOVE ON TO ADDITIONAL WITNESSES
IN SUPPORT OF SB NINE TWENTY
NINE PM ROOM TWELVE HUNDRED.
OKAY CHAIRMAN MEMBERS PAUL YOU
HAVE THE CALIFORNIA STATE
ASSOCIATION OF PSYCHIATRISTS
ALSO ANOTHER PROUD CO SPONSOR OF
ALL THE BILLS AND CENTER
EGGMAN'S PACKAGE- HOPE THE
SENATE CAN. MAKE SURE THAT ALL
EIGHT GET OVER TO THE ASSEMBLY
OR DRIVE OUT THANK YOU. THANK
YOU- SINGLE THE WITNESS COMING
INTO MY FRONT ROOM TWELVE
HUNDRED MODERATOR. THE LINES FOR
WILL SWITCH TO TESTIFY IN
SUPPORT OF SB NINE TWO NINE AND
AGAIN NAME WORKSTATION POSITION
ONLY. THANK YOU IF YOU WISH TO
SPEAK IN SUPPORT OF SB NINE TWO
NINE PLEASE PRESS ONE THEN ZERO
AT THIS TIME. I HAVE ONE COMMENT
THANK YOU IT'LL JUST BE ONE
MOMENT FOR THAT COMMENT RIGHT.
THANK YOU.
BY FIFTY TWO PLEASE GO AHEAD.
YES GETTY ON BEHALF OF THE
COUNTY BEHAVIORAL HEALTH
DIRECTORS ASSOCIATION IN SUPPORT
IF THE MANDATE. OKAY THANK YOU.
X. WITNESS. THANK YOU I HAVE NO
FURTHER COMMENTS THANK YOU THANK
- WELL MOVE ONTO AN OPPOSITION
TO SB NINE TWENTY NINE WE DO NOT
HAVE SOMEONE REGISTERED TO
PROVIDE FORMAL TESTIMONY ON SB
NINE TWENTY NINE WILL THEN MOVE
TO ROOM TWELVE HUNDRED SAYING NO
ONE COMING TO THE MICROPHONE
ROOMS- TWELVE HUNDRED MODERATOR
PLEASE OPEN THE LINE FOR
WITNESSES WHICH IS DEFINED IN
OPPOSITION TO SB NINE TINA MAY
RESIST POSITION. THANK YOU IF
YOU WISH TO SPEAK IN OPPOSITION
TO SB NINE TO NINE PLEASE PRESS
ONE THEN ZERO AT THIS TIME. I
HAVE NO COMMENT THANK YOU OKAY
THANK YOU MODERATOR WILL BRING
IT BACK TO THE COMMITTEE OF THE
QUESTIONS OR COMMENTS FROM
COMMITTEE MEMBERS. SENATOR RUBIO
. THANK YOU MISTER CHAIR AND I'M
PROBABLY JUST DUB THING FOR
THAT THAT THE AUTHOR HAS NOT
ONLY BROUGHT THIS FAR UT I KNOW
SHE HAS A PACKAGE OF BILLS THAT
I ROLE EAGERLY WAITING TEST TO
EXPLORE BUT ON A PARTICULAR I
PERSONALLY BELIEVE THAT DATA IS
KEY AS IT PERTAINS TO RELIEF I
DEAN IN JANUARY. SO WE CAN DO
BETTER ALL RIGHT I DO UNDERSTAND
THE FRUSTRATION FROM LOCAL
GOVERNMENTS MUNICIPALITY-
CONSTANTLY COMING TO US AND WHAT
WHY WE'RE NOT DOING SOMETHING.
ON THE STREETS AND OF COURSE ARE
UNDER.THE DATA TO SEE HOW WE
CAN EXACTLY TELL AS YOU STATED
TIED TO BETTER OUTCOMES AND SEE
WHERE WE CAN. HELP THESE
INDIVIDUALS THAT CANNOT HELP
THEMSELVES AND ALSO- YOU KNOW
WOULD LIKE TO BE ADDED AS A-
FATHER WHEN APPROPRIATE BUT I'D
LIKE TO MOVE. THANK YOU OKAY
IT'S BEEN MOVED BY SENATOR RUBIO
AND OTHER QUESTIONS OR COMMENTS
FROM MEMBERS YES OUR CENTER
GROVE. I GUESS I JUST WANNA TAKE
A MINUTE TO THINK CONSENT FROM
STOCKTON. YOU KNOW THE LAST MEET
THAT I HAD TO IN THE DISTRICT
ESPECIALLY MY RURAL COMMUNITIES
ON RIDGECREST- NEEDLES IN THOSE
AREAS THEY HAVE TO TRAVEL TO LOS
ANGELES TO PICKET MENTAL HEALTH
TREATMENT. AND IT'S FIRST COME
FIRST SERVE. SO THEY MIGHT DRIVE
FOR FIVE HOURS TO TRY TO GET
TREATMENT IN THE NEVER GET THAT
TREATMENT AND ALREADY UNDERGOING
THOSE ISSUES WITH MENTAL.
PROBLEM AND THEN BE. DID NOT NOT
DENY THE TREATMENT BUT NOT
THERE'S NOT ENOUGH CAPACITY OUT
THERE. SO TO PROVIDE THE AND SO
I APPRECIATE YOUR BILLING AND
I'D BE HONORED TO CO AUTHOR IF
THAT'S POSSIBLE. THANK YOU. ANY
OTHER YES. I THINK THANK YOU MR
CHAIRMAN- SO CENTER AND MAN I
KNOW YOU HAVE BEEN WORKING VERY
HARD ON ISSUES LIKE THIS AND YOU
KNOW YOU- BROUGHT UP A VERY GOOD
POINT IN THAT WAY WE'RE SEEING
THE EFFECTS OF NOT BEING ABLE TO
DO A THING WITH THE DAGGER
ANIMAL AT THE PASSION ALL FIRST
. EVERYWHERE NO SEE IT IN MY
HAND AND I AND EVERY WE HAVE
PEOPLE OUT THERE WHO NEED HELP
MAYBE GO IN AND- TRY TO GET THE
HELP AND THEN THAT JUST
DISAPPEARS. INTO THE ETHER AND
THERE'S NOTHING WE CAN DO AND
THAT'S REALLY NOT HELPING THEM
SO- I. RESPECT GREATLY THAT WHAT
YOU'RE TRYING TO DO HERE I THINK
IT'S A GOOD STEP I'M IN A PRETTY
SHADE YOU. BEING SO TENACIOUS
AND TRYING TO MOVE POLICIES LIKE
THIS FOR IT THANK YOU. ANY OTHER
QUESTIONS OR COMMENTS- SAYING
NONE OF. SIR EDMUND I TOO WANT
TO THANK YOU FOR BRINGING THIS
BILL FORWARD- APPRECIATE YOU
WHILE WORKING WITH MY STAFF ON
THE AMENDMENT WHICH ONE B.
SURELY. GETTING EVERYBODY WHO- I
THINK THAT- WHO'S AN FIFTY ONE
FIFTY ONE BE SURE THAT THAT DATA
WAS AVAILABLE TO MAKE IT MORE
EFFECTIVE. AND AGAIN REALLY
APPRECIATE- YOUR YOUR LEADERSHIP
AND A DRESSING- THESE PARTICULAR
ISSUES- CERTAINLY- I THINK THIS
DATA IS GOING TO BE ESSENTIAL
WHEN WE TALK ABOUT THE QUESTION
BEFORE THE PREVIOUS BILL IN
DIFFERENT AREA BUT- THAT'S THE
FUN OF. THE UNDERSTAND OF WHAT'S
GOING ON AND WHAT WE NEED TO DO
ABOUT IT THE FIRST STEP IS
GETTING GOOD DATA SO. AGAIN
REALLY APPRECIATE- IT THIS BILL-
WOULD YOU LIKE TO CLOSE. BUT I
WOULD JUST THINK EVERYBODY- OR
FOR THEIR COMMENTS AND
RESPECTFULLY ASK FOR YOUR I.
THANK YOU FOR THEIR ACHIEVEMENT-
BELIEVE THIS BILL'S BEEN MOVED
BY SENATOR RUBIO THERE CORRECT-
AND THE MOTION IS TO PASS
AMENDED THE FIRST AMENDED
REFERRED TO THE COMMITTEE ON
APPROPRIATIONS CONSULTANT PLEASE
CALL THE ROLL PAN HI CAN I
MELINDA'S. MELINDA'S I AIKMAN
EGGMAN AIKEN SOLACE AND SELES I
GROVE GROVE I HER TADO I TOTAL I
LIVE AT. ABOUT EILEEN MOON THE
MOON I ROTH RIGHT. ROTH I RUBIO
. WE OKAY YOU HAVE TEN VOTES-
WILL LEAD ROLE OPEN FOR THE
OPTION NUMBER. ALL RIGHT WE'RE
NOW GOING TO MOVE ON TO ITEM
NUMBER SEVEN SP TEN TWENTY NINE
BY SENATOR TIDO. HE WAS TO
TESTIFY AT YOUR SEAT OR AT THE
PODIUM WHICHEVER ONE YOU CHOOSE
. WITH YOUR PERMISSION MISTER
CHAIR. PRESENT FROM MY SEAT
PLEASE. SO A GOOD AFTERNOON MR
CHAIRMAN MEMBERS- I'M HERE TO
PRESENT S. B. TEN TWENTY NINE
WHICH FURTHERS CALIFORNIA'S
COMMITMENT TO THE GOALS AND
PRINCIPLES SET FORTH BY THE ONE
HEALTH APPROACH. THE ONE HEALTH
APPROACH IS A COLLABORATIVE
EFFORT BETWEEN MULTIPLE HEALTH
SCIENCE PROFESSIONS COMING
TOGETHER TO ACHIEVE OPTIMAL
HEALTH FOR HUMANS. DOMESTIC
ANIMALS WILDLIFE PLANTS IN OUR
ENVIRONMENT S. B. TEN TWENTY
NINE. REQUIRES THE CALIFORNIA
DEPARTMENT OF PUBLIC HEALTH AND
THE CALIFORNIA DEPARTMENT OF
FOOD AND AGRICULTURE TO DEVELOP
AND ADMINISTER A FRAMEWORK TO
CARRY OUT A ONE HEALTH PROGRAM
GOALS AND PRINCIPLES. CURRENTLY
THERE ARE AN ESTIMATED ONE POINT
SIX MILLION UNDISCOVERED VIRUSES
CIRCULATE IN THE ANIMAL
POPULATION AT LEAST HALF OF
WHICH HAVE THE POTENTIAL TO
SPREAD TO HUMANS THE CENTER FOR
DISEASE CONTROL AND PREVENTION
PREVENTION ESTIMATES THAT THREE
OUT OF FOUR EMERGING INFECTIOUS
DISEASES AND PEOPLE COME FROM
ANIMALS. MOST RECENTLY OF HORSES
AND- IN SEVERAL CALIFORNIA.
COUNTIES WERE PLAGUED WITH A
VIRUS THAT CAUSES RESPIRATORY
DISEASE. ABORTION NEONATAL DEATH
AND THAT NEUROLOGICAL DISEASE
KNOWN AS- A AND JUST TALKING TO
TRY TO HUNT IT IT'S A VERY
DIFFICULT WORD BUT- NONE THE
LESS THERE IS A NEUROLOGICAL
DISEASE THAT. WAS SPREADING
AMONG- THE HORSES AND DUE TO
THIS VIRUS MOST EVENTS AND ALL
NONESSENTIAL HORSE MOVEMENT WERE
POSTPONED AT THE RECOMMENDATION
OF THE CALIFORNIA STATE
VETERINARIAN IN AN ATTEMPT TO
LIMIT THE SPREAD OF THIS VIRUS-
THE REALITY IS THAT THIS EVER
CHANGING INTERACTION AND
PROXIMITY BETWEEN HUMANS AND
ANIMALS HAVE LED. TO THE
CONTINUED SPREAD OF EXISTING OR
EMERGING ZOONOTIC DISEASES. AS
WELL AS OTHER ENVIRONMENTAL
ISSUES NEITHER CALIFORNIA NOR
THE UNITED STATES HAS INVESTED
ENOUGH INTO THE RESEARCH OF THE
NOTICES AND- EMERGING INFECTIOUS
DISEASES. THAT'S WHY WE HAVE S.
B. TEN TWENTY NINE WHICH WILL
ENSURE THAT CALIFORNIA CONTINUES
TO RAISE AWARENESS OF ONE HEALTH
AS IT CONTINUES TO PREVENT
OUTBREAKS OF ZOONOTIC DISEASES
IN ANIMALS AND HUMANS. IMPROVE
FOOD SAFETY AND SECURITY AND
PROTECT GLOBAL HEALTH SECURITY
OVER ALL AND HERE TO TESTIFY IN
SUPPORT OF SB TEN TWENTY NINE
IST ANGST EVEN HIGGS AND
ASSOCIATE VICE PRESIDENT FOR
RESEARCH. AND DIRECTOR OF THE
BIOSECURITY RESEARCH INSTITUTE
AT KANSAS STATE YOU KNOW. RIGHT
THANK YOU SO MUCH CENTER TIDO-
MODERATE PLEASE BRING UP THE
LINE DR HIGGS- FROM THE- FROM
THE BASS SECURITY RESEARCH
INSTITUTE. AND YOU HAVE UP TO.
WELL YOU HAVE TWO MINUTES TO
TESTIFY OF THE WEEK IF YOU GO TO
LOWELL BUT YOU SINCE YOU'RE THE
ONLY CUSTOMER. THANK YOU CAN YOU
HEAR ME OK YES. PLEASE LOG IN
I'M STEVE HAYES DIRECTOR OF
KANSAS STATE UNIVERSITY'S BUSTER
HE RESEARCH INSTITUTE WE ARE ALL
RIGHT I'M ALSO EDITOR IN CHIEF
OF THE INTERNATIONAL JOURNAL
BORNE AND ZOONOTIC DISEASES ON
IT IN ORDER TO GIVE TESTIMONY TO
SOME OF THE TALKERS. SENATE BILL
AND TWENTY NINE. OVER 70% OF NEW
AND EMERGING DISEASES ALSO DO
ALL BODY SUPPLY IN FACT BOTH
HUMANS AND OTHER ANIMALS. THE
COVERT NINETEEN PANDEMIC KICKING
GRUNION G. CAPITA MIX ON THE
INTRODUCTION OF WEST NILE VIRUS
INTO THE U. S. OF SHOWING US
THAT HUMAN HEALTH IF YOU CAN
EXPECT RELATED DISEASES BOTTOM.
HENCE THE NEED. FOR A ONE HEALTH
APPROACH. ONE HEALTH RESEARCH
DIRTY FOR OF THE B. ARE ALL IN.
PEOPLE IN GROUP WITH DOG SUCH.
INCLUDING THE PAGE PARTS INVEST.
AND NINETEEN. GROUPS SUCH AS THE
NATIONAL. BIOSECURITY STANDARDS
BUT FUNDED BY THE DEPARTMENT OF
MANAGED SECURITY. GENERAL
EMERGENCY WHEN ALL THE KINGS BUT
HIS. FUNDED BY THE NIH AND THEN
THE KANSAS DEPARTMENT OF
AGRICULTURE AND THE U. S.
DEPARTMENT OF AGRICULTURE.
INDUSTRIAL OFFICE. THE
RELATIONSHIP AND ALSO I'VE
SECURING PROVIDE UNDERSTOOD OF
BIOLOGICAL RIGHT BUT THEN I
WOULD JUST TRY TO WORK WITH
THESE DANGEROUS PATHOGENS.
DEVELOP AND TEST DIAGNOSTICS
VACCINES AND THERAPEUTICS UNDER
DEVELOPED RESEARCH AND RESPONSE
PLANS. TO DEVELOP AN EFFECTIVE
PLAN TO COMBAT THREATS TO THE U.
S. PUBLIC HEALTH AND I HOPE YOU
NEED A MULTI DISCIPLINARY
APPROACH. BILL AND TWENTY NINE
FORMALIZES A RELATIONSHIP
BETWEEN DEPARTMENTS WITH
ACCOUNTABILITY THE KING DELIGHT
DATA DRIVEN DECISIONS ON
POLICIES. TO BENEFIT
CALIFORNIA'S POPULATION OF
ALMOST FORTY MILLION US FIFTY
BILLION DOLLAR AGRICULTURAL
INDUSTRY. A TEN TWENTY NINE
STATES COMMUNICATION
COORDINATION AND COLLABORATION
PARTNERS WORKING ON POSSIBLE
HUMAN AND ENVIRONMENTAL HEALTH
AND OTHERS ARE ESSENTIAL PART.
OF THE ONE HEALTH APPROACH.
GETTING DIFFERENT GROUPS
TOGETHER AND WORKING TOGETHER
NOT A WAY EASY SOMETIMES YOU
HAVE TO ADDRESS VARIOUS OF PURE
ROCK SHE TERRITORIALITY EVEN
PERSONALITIES DEVELOPER COLOR.
CULTURE OF COLLABORATION STOP
MUST UNDERSTAND THE POWER OF
WORKING TOGETHER AND REALIZED
YEAH THEY CAN ACCOMPLISH MUCH
MORE TO HELP CALIFORNIA PUBLIC
HEALTH TOO MANY CULTURE THE
NETWORKING ALONE. THANK YOU VERY
MUCH. CORRECT THANK YOU FOR MUCH
SIX- NOW WE'LL MOVE ON TO
ADDITIONAL WITNESSES IN SUPPORT
OF SB TEN TWENTY NINE WILL BEGIN
WITH WITH TWELVE HUNDRED SAYING
NO ONE COMING TO MY CURRENT
TWELVE HUNDRED MODERATOR PLEASE
OPEN THE LINES FOR WITNESSES
WHICH TO TESTIFY IN SUPPORT OF
SB. TEN TWENTY NINE NAME OR
POSITION POSITION ONLY. THANK
YOU WHAT'S THE FIGURE FOR PORT
OF S. B. TEN TWENTY NINE PLEASE
PRESS ONE AND ZERO AT THIS TIME. I HAVE NO COMMENT THANK YOU.
OKAY THANK YOU- WILL NOW MOVE ON
TO WITNESSES IN OPPOSITION TO
THE SP TEN TWENTY NINE- WE DO
NOT HAVE ANYONE- FORMAL
REGISTERED. OPPOSITION TO
TESTIFY. THRIVE FORMAL TESTIMONY
SO JUST NOW TAKE ON ADDITIONAL
WITNESSES IN OPPOSITION TO SB
TEN TWENTY NINE AGAIN THROUGH
TWELVE HUNDRED. SEE NO ONE HERE
IN THE ROOM- MODERATOR PLEASE
OPEN THE LINES FOR ANY WITNESSES
WHICH TO TESTIFY IN OPPOSITION
TO SB TEN TWENTY NINE. THANK YOU
IF YOU WISH TO SPEAK IN
OPPOSITION TO SB TEN TWENTY NINE
PLEASE PRESS ONE AND ZERO AT
THIS TIME. I HAVE NO COMMENT
THANK YOU OKAY THANK YOU
MODERATOR ALICE MOVED QUESTIONS
OR COMMENTS FROM COMMITTEE
MEMBERS. QUESTION COMES FROM
THREE MEMBERS. SAYING NONE- SIR
TIDO I'VE I THANK YOU SO MUCH
FOR BRINGING THIS BILL FORWARD
WE KNOW THAT- WE'VE SEEN MANY
EXAMPLES ARE READY EVEN END UP
WITHIN OUR LIFETIME OF
ESSENTIALLY DO NOT EXPRESS SO A
DISEASE THAT IS PRESENT ANIMALS-
THEN CROSSING OVER AFTER
MUTATIONS IN THE HUMAN SCORES
REMAIN IN ONE RIGHT NOW
UNFORTUNATELY THE PANDEMIC. WITH
KILL THE BILL WE'VE SEEN OTHERS
AS WELL- AND- SO IT'S VERY
IMPORTANT FOR A PANDEMIC
SURVEILLANCE FOR PREVENTION OF
SPREAD OF DISEASE THAT WE
ACTUALLY- AND THEN IF I DO NOT
EAT DISEASES SO THIS IS A VERY
IMPORTANT- BUILT FOR THAT
PREPARATION AND SO WILL
CERTAINLY UP AGAIN THANK YOU FOR
BRINGING THIS BILL FORWARD. I
WOULD LIKE TO CLOSE. THANK YOU I
RESPECT LAST SPRING I VOTE. OKAY
ALL RIGHT AS I'VE HEARD THAT
IT'S BEEN MOVED BY SENATOR ROTH-
THE MOTION IS TO PASS THE FIRST-
BE REFERRED TO THE COMMITTEE ON
AGRICULTURE- CONSULTANT- PLEASE
CALL THE ROLL. HAND BY HAND HI
MELINDA'S MELINDA'S I EGGMAN.
EGGMAN I CAN SOLACE. SOLACE I
GROW. GROVE I HER TADO HYFR TARA
I LAY BACK. LEAVE EILEEN MOON
THE MOON I ROTH. ROTH IRA RUBIO
. RUBIO I WINNER. OKAY THAT BILL
HAS TEN VOTES TO HOLD THE ROLE
OPEN FOR ABSENT MEMBERS OKAY-
THE NEXT TO THE BILLS ARE MINE
SO GETTING HIM THE GAVEL OVER.
THIS THE- RECENT. CAPITALA AND.
AT ALL THE DIFFERENT ANGLES HERE
SOMEONE PRESENT FROM THE PODIUM
HERE ALL RIGHT- SO. MOST. AND.
OKAY HEY- SENATOR PAIN YOU HAVE
THREE BILLS YOU'RE PRESENTING
TODAY THE FIRST OF WHICH WOULD
BE ITEM NUMBER NINE SP NINE
THIRTY NINE PLEASE PROCEED WHEN
YOU'RE READY ALL RIGHT THANK YOU
MADAM VICE CHAIR- I'M PLEASED TO
PRESENT SP NINE THIRTY NINE-
WHICH IS- BUILT- TO ADDRESS
ACTUALLY THE THREE FORTY B.
FEDERAL DRUG DISCOUNT PROGRAM SO
THE THREE FORTY B. FEDERAL DRUG
DISCOUNT PROGRAM WAS CREATED BY
CONGRESS BACK IN NINETEEN NINETY
TWO IT'S DESIGNED TO SET OF ICE
SAFETY NET PROVIDERS LIKE
COMMUNITY HEALTH CENTERS AND-
STATE HOSPITALS TO PARTICIPATE
IN THE FULL SPECTRUM OF KERR.
FROM ISSUING PRESCRIPTIONS
DISPENSING OF DRUGS THIS PROGRAM
SUPPORTS THE SAFETY NET BY
PROVIDING DRUG DISCOUNTS ENSURE
LOWER DRUG COSTS TO PATIENTS.
AND PROGRAM FACTORS INTO AN
AGREEMENT WITH THE FEDERAL
GOVERNMENT IN EXCHANGE FOR
HAVING DRUGS COVERED BY MEDICAID
AND MEDICARE. MAY FACTIONS
AGREED TO PROVIDE UP FRONT
DISCOUNTS THAT ARE COVERED- AND
COVERED OUTPATIENT DRUGS TO
COVERED ENTITIES LIKE HEALTH
CENTERS THAT SERVE UNDERSERVED
COMMUNITIES. CONGRESS'S INTENT
WAS TO FOR THE COVERED ENTITIES
TO STRETCH SCARCE FEDERAL
RESOURCES AS FAR AS POSSIBLE
REACHING MORE ELIGIBLE PATIENTS
PROVIDING MORE COMPREHENSIVE
SERVICES. ANY SAVINGS FROM THE
PROGRAM THAT GENERATES FOR
HEALTH CENTERS IS DERIVED
DIRECTLY FROM THE STATUTORILY
MANDATED DISCOUNT PRICING WHICH
COST TAXPAYERS NOTHING. HEALTH
CENTERS ARE REQUIRED TO REINVEST
ANY SAVINGS FROM THE DISCOUNT
DRUGS INTO EXPANDING ACCESS TO
NECESSARY AND CRUCIAL MEDICAL
ENABLING SERVICES SUCH AS
PATIENT NAVIGATION
TRANSPORTATION EXPANDING CLINICS
OUR OPERATIONS HIRING CASE
WORKERS FOR INDIVIDUALS
EXPERIENCING HOMELESSNESS
PROVIDING PATIENTS WITH
TRANSPORTATION THE SPECIALTY
CARE AND OTHER VITAL PROGRAMS.
THEY'RE OFTEN NOT EXPLICITLY
REIMBURSED BY THE MEDICAID.
PROGRAM THIS MEASURE BUILT ON A
NATIONAL TREND WERE OVER FIFTEEN
STATES HAVE ALREADY ENACTED
SUBSTANTIALLY SIMILAR
PROTECTIONS ABOUT A DOZEN
OTHERS. HAVE ACTIVE LEGISLATION
MOVING ON THE ISSUE RIGHT NOW. I
WILL POINT OUT THAT- THE IS A
PRO AGAIN BEEN AROUND FOR A LONG
TIME. AND PROVIDES A CRUCIAL
FUNDING FOR OUR SAFETY NET
PROVIDERS- WE DO HAVE FORMAL
OPPOSITION- THAT IS GOING TO
TESTIFY IN TERMS OF- IN REGARDS
TO THE- NATURE OF THESE- YOU
KNOW- THESE ARE DISCOUNTS IN
TRACKING AND SO FORTH. BUT I
WANTED THIS TO KEEP IN MIND
AGAIN THIS IS A PROGRAM THAT'S
BEEN LONG STANDING THAT IS
ACTUALLY AN STANDARDS
ESTABLISHED BY THE FEDERAL
MEANT- THAT. ASIANS CAN CONTINUE
TO GET THE SERVICES. THAT THEY
NEED THAT OFTEN AGAIN OFTEN ARE
NOT EXPLICITLY FUNDED. THROUGH
OTHER MEANS AND SO- THIS BILLS
IN AN EFFORT TO ENSURE THAT
THOSE SERVICES DON'T GET CAUGHT-
IN- THE UPPER BEING PROVIDED BY
SAFETY NET PROVIDERS. SO I HAVE
WITNESSES. APOLLO HEALTH WHO'S
HERE IN PERSON AND THE COAL
SIDE- THAT- DIRECTOR OF PHARMACY
SERVICES AT THE L. G. B. T.
ALEXANDER L. G. P. CENTER WHO'S
GONNA BE TESTIFYING BY PHONE
ABOUT THE IMPORTANCE OF THIS
PROGRAM. THANK YOU. THANK YOU
SENATOR PAN ON YOUR FRUIT
PERSISTENCE CRAIG HE'S ALREADY
AT THE MICROPHONE OKAY THIS POST
FOR PLEASE. THANK YOU GOOD
AFTERNOON CRAIG PULLS FOR
ASSOCIATE DIRECTOR OF GOVERNMENT
AFFAIRS A. P. LA HEALTH WE'RE A
COMMUNITY HEALTH CENTER IN LOS
ANGELES THE PROVIDES PRIMARY
CARE FOR LOW INCOME PATIENTS
WITH A SPECIFIC FOCUS ON THE
LGBT COMMUNITY. WE'RE ALSO ONE
OF THE LARGEST HIV SERVICE
PROVIDERS IN THE COUNTY AND A
PROUD CO SPONSOR OF THIS BILL.
FREE KELLY HEALTH AT THREE FORTY
B. PROGRAM IS ESSENTIAL TO THE
pKAREN SERVICES THAT WE PROVIDE.
IT'S BECAUSE OF THIS PROGRAM
THAT WE CAN PROVIDE FREE OR LOW
COST MEDICATIONS TO ALL OF OUR
LOW INCOME PATIENTS THE PROGRAM
ALL WHEN I WAS ASKED TO EXPAND
ACCESS TO L. G. B. T.
HEALTHCARE. ACROSS LA COUNTY AND
IN ADDITION UNCOMPENSATED
SERVICES LIKE AIR COORDINATION
ENTRANCE. I THE PROP IS THAT THE
TAX FROM ALSO. IT'S CONCERNING
A. P. LA HEALTH SINCE LAST YEAR
OVER A DOZEN. HAVE TAKEN ACTIONS
TO LIMIT THE USE OF CONTRACT
PHARMACIES. BECAUSE A. P. L. A.
CURRENTLY DOES NOT HAVE AN IN
HOUSE PHARMACY WE RELY ON A
NETWORK OF TRUSTED COMMUTING
RETAIL PHARMACIES. TO PROVIDE
OUR PATIENTS WITH CONVENIENT
ACCESS TO AFFORDABLE DRUGS.
WITHOUT CONTRACT PHARMACIES A.
PL A WOULD NOT BE ABLE TO
PARTICIPATE IN THE THREE FORTY
B. PROGRAM. AND OUR PATIENTS
WOULD LOSE ACCESS TO AFFORDABLE
MEDICATION. AS JUST ONE EXAMPLE
LAST WEEK GILEAD SCIENCES A
CALIFORNIA BASED MANUFACTURER
WITH TWENTY SEVEN BILLION
DOLLARS IN REVENUE. ANNOUNCED
THEY WOULD STOP OFFERING THREE
FORTY B. DISCOUNTS FOR HEPATITIS
C. DRUGS. THROUGH CONTRACT
PHARMACIES AND LAST COVERED
ENTITIES AGREED TO SUBMIT
ADDITIONAL CLAIMS DATA. TO BE
CLEAR NOTHING IN THE THREE FORTY
B. STATUTE GIVES MANUFACTURERS
THE RIGHT TO PLACE THESE TYPES
OF RESTRICTIONS ON THREE FORTY
B. DISCOUNTS. AND WE ARE NOT
ALONE IN THIS ASSESSMENT.
PRESIDENT BY THEN HHS AND OVER
TWO HUNDRED REPUBLICAN AND
DEMOCRATIC MEMBERS OF CONGRESS
HAVE STATED THAT THESE ACTIONS
ARE UNLAWFUL. YOU WILL HEAR FROM
THE OPPOSITION THAT THEY HAVE
CONCERNS ABOUT OVERSIGHT THE
PROGRAM. AND THEY'RE ONLY TAKING
THESE ACTIONS TO ENSURE PROGRAM
INTEGRITY. THIS COULD NOT BE
FURTHER FROM THE TRUTH MR PULSE
FROM ONE AND JUST LET YOU KNOW
YOU HAVE THIRTY SECONDS LEFT
HIM. COVERED ENTITIES ARE ONLY
REQUIRED ARE ALREADY REQUIRED TO
MAINTAIN ROBUST RECORDS TO
DEMONSTRATE COMPLIANCE WITH THE
THREE FORTY B. PROGRAM. IF A
MANUFACTURER HAS CONCERNS THEY
CAN REQUEST A FORMAL AUDIT. THE
REASON THEIR DRUG MAKERS ARE
TAKING THESE ACTIONS IS TO SCALE
BACK THE PROGRAM AND IMPROVE
THEIR BOTTOM LINE. CALIFORNIA
MUST SEND A CLEAR SIGNAL THAT
THESE ACTIONS WILL NOT BE
TOLERATED. IF LEFT UNCHECKED
MANUFACTURERS WILL CONTINUE
THESE ATTACKS ON THE THREE FORTY
B. PROGRAM. IN CALIFORNIA SAFETY
NET PROVIDERS AND THEIR PATIENTS. WILL BE SIGNIFICANTLY HARMED
THANK YOU. THANK YOU VERY MUCH
MR POLLS FOR NEXT WE WILL MOVE
ON TO- NICOLE WHO I BELIEVE IS
ON THE LINE MISTER MODERATOR
MADAME MODERATOR. AND COULD YOU
PLEASE BRING THE CALL UP. HELLO
I HAVE OPEN. GREAT THANK YOU GO
HEAD MISS I DON'T KNOW HOW TO
PRONOUNCE YOUR LAST NAME THE.
THANK YOU PLEASE GO AHEAD. GOOD
AFTERNOON MY NAME IS DR NICOLE
P. WELL AND I AM THE DIRECTOR OF
PHARMACY SERVICES AT THE LOS
ANGELES LGBT CENTER THE LARGEST
LGBTQ PLUS THE ORGANIZATION IN
THE WORLD AND COMMUNITY HEALTH
CENTER WITH FIVE LOCATIONS
PROVIDING HEALTHCARE AROUND LOS
ANGELES. I AM ALSO A MEMBER OF
THE CALIFORNIA STATE BOARD OF
PHARMACY SELLING SPEAKING TODAY
SOLD IN MY INDIVIDUAL
PROFESSIONAL CAPACITY AND NOT AS
A MEMBER OF. OR ON BEHALF OF THE
BOARD OF PHARMACY. PARTICIPATING
IN THE THREE FOUR B. PRO ALLOWS
US TO STRUCTURE. AND SERVE THE
MOST VULNERABLE IN OUR
COMMUNITIES THIS INCLUDES THE
STI TESTING AND TREATMENT FOR
UNINSURED PATIENTS AND CLINICAL
PHARMACY SERVICES JUST COULD
HELP OUTCOMES IN DIABETIC
PATIENTS. THE BIGGEST CHALLENGE
OUR PHARMACY FEE DAY IS NOT A
GLOBAL PANDEMIC BUT RATHER A
BARRAGE OF ATTACKS BY PHARMACY
BENEFITS MANAGER PM AND DRUG
MANUFACTURERS. MULTIPLE PBMS AND
MANUFACTURERS HAVE FOR SAFETY B.
FORTY B. SPECIFIC CONTRACTS WITH
A LOWER RATE. OF REIMBURSEMENT.
UNDERMINES THE INTENT OF THE
THREE FORTY B. PROGRAM AND
REMOVE MONEY FROM THE SAFETY NET
TO LINE THE POCKETS OF HIGHLY
PROFITABLE COMPANIES. PBMS HAVE
ALSO PLACE REQUIREMENTS FOR OUR
PATIENTS USE MAIL ORDER PHARMACY
HAVING MEDICATION FOR HIV OR
HORMONES FOR TRANSGENDER
PATIENTS DELIVERED RISK THEIR
SAFETY IF THEY ARE NOT OUT OR
OTHERS ARE NOT AWARE OF THEIR
STATUS MR BUT I WANNA LET YOU
KNOW. YOU HAVE THIRTY SECONDS
LEFT IN YOUR TESTIMONY. IN YEAH
OUR PBM THE DRIVE IN. HAVE THE
RIGHT AUDIT OR FIRM IF YOU SO
VERY. WE HAVE AN AVERAGE OF ONE
AUDIT PER WEEK FROM PMR
MANUFACTURER WE EMPLOYED TWO
FULL TIME STAFF MEMBERS JAPANESE
ALL THE REQUIREMENTS OF PPM AND
MANUFACTURERS TO GET MEDICATION
COVERED FOR A PATIENT. WE
CURRENTLY HAVE NO PATH FOR
RECOURSE WHEN A PBM OR FACTOR
TAKE THE ACTIONS THAT HARM OUR
ABILITY TO PROVIDE CARE TO OUR
PATIENTS MR THOUGH IF YOU COULD
WRAP UP PLEASE YOU ARE NOT YOUR
TIME LIMIT. IF YOU COULD WRAP UP. THANK YOU SO MUCH. YEAH READ
THAT THE- TO BE CONTINUE TO
PROVIDE QUALITY TO CATCH. KNOCKS
ON OUR EIGHT PM THANK YOU VERY
MUCH. OKAY THOSE ARE THE TWO
LEAD WITNESSES IN SUPPORT WE
WILL NOW MOVE HERE TO ROOM
TWELVE HUNDRED ARE THEY ANY
WITNESSES WHO WISH TO TESTIFY IN
SUPPORT PLEASE COME FOR STATE
YOUR NAME YOUR ORGANIZATION.
THANK YOU MADAM VICE CHAIR MEGAN
SUPERS ON BEHALF OF CALIFORNIA
HEALTH PLUS ADVOCATES A CO
SPONSOR OF THIS MEASURE IN
SUPPORT THANK YOU. MANAGER
MEMBERS RANDY MARTIN ON BEHALF
OF THE AIDS HEALTHCARE
FOUNDATION WHICH IS THE LARGEST
NONPROFIT PROVIDER OF CARE AND
TREATMENT HERE IN THE STATE OF
CALIFORNIA. WE ARETHREE FORTY
B. COVERED ENERGY- AND WE URGE
YOUR SUPPORT FOR THIS BILL THANK
YOU. THANK YOU VERY MUCH ANYONE
ELSE WISHING TO COME FORWARD
HERE IN ROOM TWELVE ENTERED IN
SUPPORT OF THE BILL NO. OKAY WE
WILL MOVE TO ANYONE ON THE LINE
THEN- META MODERATORS ANYONE ON
THE LINE WHO WISHES TO TESTIFY
IN SUPPORT OF THIS BILL. HE
COULD PLEASE OPEN UP THEIR-
MINDS. THANK YOU IF YOU WISH TO
SPEAK IN SUPPORT OF SB NINE
THREE NINE PLEASE PRESS ONE
BUTTON ZERO AT THIS TIME. THEY
HAVE ABOUT FIXING HE WOKE UP TO
ONE EIGHTY FIVE PLEASE GO AHEAD
. EIGHTY FIVE. BUT WHAT TURNED
THEM HERE AND YOU SAID HERE YES
WE CAN HEAR YOU GO HEAD OR HAVE
. APOLOGIES FOR THAT HI AND THEY
CAN ANSWER MEMBERS OF THE
COMMITTEE I'M DAVID LEVINE AT ON
TODAY ON BEHALF OF THE HELP ONE
OF NORTHERN CALIFORNIA AND THE
NORTHWEST CLINIC NETWORK.
REGIONAL TEMPTATIONS THAT
ACTUALLY OUT THERE SERVING TWO
HUNDRED THOUSAND PATIENTS ACROSS
INTERSTATE I MEAN WE'RE STRONG
SUPPORT. EXACTLY NINETY NINE
THANK YOU THANK YOU. NEXT CALLER
THANK YOU WRITE NINE PLEASE GO
AHEAD. THANK YOU CHAIR AND
MEMBERS OF THE COMMITTEE MY NAME
IS ANGEL OF THE LORD I'M CALLING
ON BEHALF OF COMMUNITY HEALTH
SYSTEMS INCORPORATED AND A
TWENTY THREE THOUSAND PATIENTS
LOCATED TWELVE SENATOR DINO
RIVERSIDE AND SAN DIEGO
COUNTIES. IN SUPPORT OF A NINETY
NINE THANK YOU THANK YOU. NEXT
CALLER ON THE LINE THANK YOU
RIGHT EIGHTY THREE PEOPLE HAVE.
THANK YOU VENTURE AND THE
MEMBERS OF THE COMMITTEE MY NAME
IS DON THE CHIEF DEPUTY
EDUCATION HEALTH SERVICES THE
COMMITTEE HEALTH CENTER IN
OAKLAND. ON BEHALF OF OUR FIFTY
THOUSAND ACTIVATIONS I SUPPORT
FIFTY NINETY NINE THANK YOU.
THANK YOU. NO MODERATE AREA MUCH
ANYONE ELSE ON THE LINE WISHING
TO TESTIFY YES. OKAY THANK YOU
I'M SEVENTY THREE PLEASE CALL AT
. THE CENTERS ON BEHALF WITHOUT
THE MED AND STRONG SUPPORT OF
THIS IMPORTANT MEASURE. THANK
YOU. THANK YOU I'M SIXTY FIVE
PLEASE GO AHEAD. GOOD AFTERNOON
THE SAND ON THE ON BEHALF OF THE
SAN FRANCISCO AIDS FOUNDATION
ALSO AT THREE FORTY B. COVERED
ENTITY AND THE CALIFORNIA
HEPATITIS ALLIANCE WITH STRONG
SUPPORT FOR US THE- ONE THIRTY
ONE. THANK YOU. THANK YOU I'M
THIRTY PLEASE GO AHEAD. HI GOOD
AFTERNOON THIS IS GOING TO BE
AVAILABLE AT THE LOS ANGELES
LGBT CENTER OFTEN STRONG SUPPORT
AT B. NINE THIRTY NINE. THANK
YOU. THANK YOU VERY MUCH. THANK
YOU I. EIGHTY FOUR PLEASE GO
AHEAD. THANK YOU CARE CAN
REMEMBER THE COMMITTEE MY NAME
IS WELL REGARDED CALLING IN
BEHALF OF THE COMMUNITY CREDIT
INSTITUTIONS LACK ANGELES
COUNTY. MEDICAL I RECOMMEND THAT
NEED TO CONNECT TO HEALTH
RECORDS RALPH LA COUNTY SERVICE
MEDICAL HOME FOR MORE THAN ONE
POINT ONE POINT SEVEN MILLION
PATIENTS EACH YEAR FOR CALLING
IN STRONG SUPPORT OF. PARENTS-
NINE THIRTY NINE THANK YOU. THE
YOU VERY MUCH. THANK YOU I HAVE
NO FURTHER COMMENT THANK YOU ALL
RIGHT THANK YOU MADAM MODERATOR
WE WILL NOW MOVE TO LEAD
WITNESSES IN OPPOSITION WE HAVE
TO LISTED HERE- ASHER I BELIEVE
IT'S LYSYK LEAST SICK- THAT YOU-
HI THERE HOW ARE YOU HOW DO YOU
PRONOUNCE YOUR LAST NAME. IT'S A
SHORT ILICIC NOTHING LIKE IT'S
SPELLED WHAT. OUR EIGHT THAT'S A
DIRTY TRICK OKAY PLEASE GO AHEAD
YES REALLY THAT'S MY- MADAM
CHAIR AND MEMBERS OF THE
COMMITTEE THANK YOU FOR HAVING
ME HERE TODAY TO OFFER
RESPECTFUL TESTIMONY IN
OPPOSITION TO SB NINE THREE
NINE. FORMER GREASE THAT IT IS
IMPORTANT TO ENSURE THE THREE
FORTY B. PROGRAM TRULY BENEFITS
THE SAFETY NET THAT SERVES OUR
UNDER SERVED COMMUNITIES IN
CALIFORNIA. UNFORTUNATELY PHARMA
IS OPPOSED TO THIS LEGISLATION
BECAUSE IT FURTHER DISTORTS THE
SECOND LARGEST FEDERAL
PRESCRIPTION DRUG PROGRAM. BUT
FORCING MANUFACTURERS TO EXTEND
THREE FORTY B. PRICING TO
CONTRACT PHARMACIES WHICH ARE
NOT MENTIONED IN THE THREE FORTY
B. STATUTE IN ADDITION ITS
PROVISIONS DIRECTLY CONFLICT
WITH THE FEDERAL THREE FORTY B.
PROGRAMS RULES AND ENFORCEMENT
REGIME. S. B. NINE THREE NINE
WOULD REQUIRE MANUFACTURERS TO
PROVIDE THREE FORTY BE
DISCOUNTED DRUG SALES TO COVERED
ENTITIES THROUGH. SPECIFIED
CONTRACT PHARMACIES WHILE
RESTRICTING MANUFACTURERS
ABILITY TO IMPOSE REASONABLE
CONDITIONS ON SALES OF COVERED
DRUGS. THAT ARE ALLOWED BY THE
FEDERAL THREE FORTY B. STATUTE.
MANDATING MANUFACTURERS SHIP
THREE FORTY B. DRUGS AT THREE
FORTY BE CAUGHT- PRICES TO
CONTRACT PHARMACIES BENEFITS
CONTRACT PHARMACIES THOUSANDS OF
WHICH ARE LOCATED OUTSIDE THE
STATE OF CALIFORNIA NOT
PATIENCE. IN FACT THE FIVE
LARGEST FOR PROFIT PHARMACY
CHAINS COMPRISE 60% OF THREE
FORTY B. CONTRACT PHARMACIES
NATIONWIDE. THESE THREE FORTY B.
COVERED ENTITIES AND THEIR
CONTRACT PHARMACIES GENERATED
THIRTEEN BILLION DOLLARS IN
GROSS PROFITS ON THREE FORTY B.
PURCHASE MEDICINES AND TWENTY
EIGHTEEN. I WANNA LET YOU KNOW
YOU HAVE THIRTY SECONDS OKAY
THANKS FINALLY WE WANT TO
ACKNOWLEDGE THE FINANCIAL IMPAT
AT Q. EIGHT C. AS IN OTHER
CITIES HAVE EXPERIENCED DUE TO
THE MEDIC HOW ARE EXTRINSIC
SHIN. BURMA SUPPORTS THE
SUPPLEMENTAL PAYMENT TOOL WHICH
WILL ENSURE THESE ENTITIES MAY
CONTINUE TO PROVIDE ESSENTIAL
SERVICES TO MILLIONS OF
CALIFORNIANS. UNFORTUNATELY DUE
TO ONGOING LITIGATION AROUND
THIS ISSUE I WILL NOT BE ABLE TO
PARTICIPATE IN QUESTION AND
ANSWER TODAY I APPRECIATE YOUR
TIME AND RESPECTFULLY ASPIRIN
ABOUT. YOUR THREE SECONDS UNDER
GOOD WORK OKAY- ALL RIGHT WE
WILL MOVE ON TO THE NEXT WITNESS
IN OPPOSITION WHICH IS. SKEWS ME
BILL HE'D BILL HAND I DON'T KNOW
HOW IS HE HERE YEAH. GO AHEAD
OKAY BILL. I BELIEVE- MADAM
CHAIR AND MEMBERS OF THE
COMMITTEE MY NAME IS BILL HAD IT
REPRESENT THE PHARMACEUTICAL
CARE MANAGEMENT ASSOCIATION WITH
THE NATIONAL PBM TRADE
ASSOCIATIONS AND RESPECTFUL
OPPOSITION TO SB NINE THIRTY
NINE- SPECIFICALLY THERE ARE TWO
PROVISIONS WHICH GIVE US A GREAT
CONCERN FOR UNDER SUBSECTION BE
THREE PLANS AND PBMS ARE
PROHIBITED FROM REQUIRING
PHARMACIES TO DISCLOSE WHICH
DRUG BEING DISPENSED OR THREE
FORTY B. DRUGS. WHILE I
UNDERSTAND THE DESIRE TO HAVE A
HIGHER- WE ADVERTISEMENT LOCAL
YOU CAN STILL REQUIRE THAT BUT
NOT REPENT WELL NOT PROHIBITING
US FROM KNOWING WHICH ROADS. ARE
PACKED WITH FORTY B. DRUGS. THE
CANCER THE LAW TO JUST THREE
FOUR FORTY A CHOIR DRIVES. TO
NINE THREE FORTY PACE. THE TECH
AWAY OUR ABILITY TO TRY THAT.
AND CHANGE INVITES FRIED I WOULD
REMIND THE COMMITTEE THAT IN
TWENTY TWENTY THEN ENTER THE
GENERAL PROCESS. SETTLE THE CASE
OF A LARGE HOSPITAL WHICH HAD A
FATHER- MEDI CAL TO THE TUNE OF
TWENTY ONE MILLION DOLLARS UNDER
THREE FORTY B. WE DON'T WANT THE
LEGISLATION TO UNINTENTIONALLY
DO THE SAME BYE AND- AND COURAGE
GENE- LISA ROWING THE POTENTIAL
FOR FIVE- THE OTHER SECTION. IS
SET SOME SEVENTY THREE. THANKS
SIX. WHICH ARE I LOST MAIL OR
AND I WOULD POINT OUT THAT ONE
TEXAS AND- OF THE BILL- WAS
CRITICAL OF MAIL ORDER AND THIS
THE FACT ALLOW IT. AND
COMBINATION OF NOT ALLOWING US
TO KNOW WHICH- COULD BE DRUGS TO
BE DISPENSED PROBABLY AT THE
COUNTER. DISPENSING MAIL- MAKES
IT VIRTUALLY IMPOSSIBLE FOR US
TO KNOW WHICH THREATENED. THE
MAIL ON FACTORY FORTY B. DRUGS
BILL I WANNA LET YOU KNOW ABOUT
TWENTY SECONDS LEFT. I WILL I
JUST GONNA WRAP UP THESE REGIONS
MADAM CHAIRMAN OF THE COMMITTEE
WOULD RESPECTFULLY URGE YOU TO
VOTE NO ON SB NINE THIRTY NINE
THANK YOU. OKAY THANK YOU VERY
MUCH. SURE TO LEAD WITNESSES IN
OPPOSITION WILL MOVE NOW TO
SOMEBODY'S ALREADY LINING UP AT
THE MICROPHONE PLEASE GO AHEAD
THANK YOU MADAM CHAIR MEMBERS
NICK LOUISE US ON BEHALF OF THE
CALIFORNIA ASSOCIATION OF HEALTH
PLANS THAT WERE PRESENT WAS
AMENDED. THANK YOU. MADAM CHAIR
MEMBERS FIELDING GRIEVES ABOUT
COM CALIFORNIA RESPECTFULLY POST
THANK YOU. OKAY ANYONE ELSE HERE
IN THE ROOM WISHING TO TESTIFY
IN OPPOSITION NOPE NO ONE COMING
FORWARD OKAY WE WILL GET TO THE
PHONE LINES MATTER MODERATORS
ANYONE QUEUED UP TO SPEAK IN
OPPOSITION TO THIS BILL. THANK
YOU IF YOU WISH TO SPEAK IN
OPPOSITION TO SB NINE THREE NINE
PLEASE PRESS ONE THEN ZERO AT
THIS TIME. AT ABOUT FIVE IN Q.
I. THIRTY ONE PLEASE GO AHEAD. I
DON'T CARRY MEMBERS JENNIFER ROW
ON BEHALF OF THE BIOTECHNOLOGY
INNOVATION ORGANIZATION IN
OPPOSITION. THANK YOU RIGHT
EIGHTY SEVEN PLEASE GO AHEAD.
CALIFORNIA LIFE SCIENCES WE ARE
OPPOSED. THANK YOU BYE NINETY
THREE PLEASE GO AHEAD. BY.
NINETY THREE. FIVE SEVENTY NINE
PLEASE GO AHEAD. ENTER MEMBERS
JOHN LINGER ON BEHALF OF
AMERICA'S HEALTH INSURANCE PLANS
AN OPPOSE UNLESS AMENDED. THANK
YOU. THANK YOU I'M SEVENTY TWO
PLEASE GO AHEAD. THANK YOU
PRESTON YOUNG FROM THE
CALIFORNIA CHAMBER OF COMMERCE
CURRENTLY OPPOSED UNLESS MESSAGE
THANK YOU. THANK YOU I'M FIFTY
EIGHT PLEASE GO AHEAD. WILLIAM
THE PRESIDENT FROM PLASTER I
WILL POST. ZERO NINE THREE NINE.
THANK YOU I. NINETY SIX PLEASE
GO AHEAD. THANK YOU THIS IS ERIN
REID BOURQUE ON BEHALF OF THE
ASSOCIATION OF CALIFORNIA LIFE
AND HEALTH INSURANCE COMPANIES
BUT OPPOSE UNLESS AMENDED
POSITION THANK YOU. THANK YOU I
HAVE NO FURTHER COMMENT THANK
YOU OKAY THANK YOU MADAM
MODERATOR WILL BRING IT BACK UP
HERE TO THE COMMITTEE FOR ANY
COMMENTS SENATOR EDMUND. THANK
YOU VERY MUCH- THANK YOU DOUG
PAN AND I KNOW THIS IS A- AND
THEN THE ISSUE VERY IMPORTANT TO
YOU AND I KNOW YOU'RE YOU ARE
LOOKING AT THE NOT NOT THE
SUNSET OF YOUR CAREER BUT YEAH.
THE TIME IN IN THE LEGISLATURE
AND I AND I UNDERSTAND PEOPLE
WHO WANT TO GET THINGS DONE-
THAT HAVE BEEN VERY IMPORTANT
AND HAVE BEEN SOMEWHAT DIFFICULT
TO WORK ON AND SO MY
UNDERSTANDING OF THIS IS YOU
WANT TO MAKE SURE THAT THE THREE
FORTY B. PROGRAM ACTUALLY THE
SAVINGS GO TO THE PATIENT AND TO
THE PEOPLE WHO ARE TRYING TO
PROVIDE THE CARE. FOR THOSE
PEOPLE WHO ARE THE RECIPIENTS OF
THOSE- THOSE MEDICATIONS THE
OPPOSITION TALKS A LOT ABOUT THE
DANGER AROUND FRAUD- CAN YOU
ADDRESS THAT A LITTLE BIT FOR US
. THANK YOU SIR EDMUND FOR
ASKING THAT QUESTION- I THINK
THAT I FIND IT INTERESTING-
AGAIN APPRECIATE THE- TESTIMONY-
BOTH FOREIGN OPPOSITION AND THEY
TALK ABOUT- THE NEED FOR THEM TO
TRACK TO BE SURE THAT. THERE'S
AN FRAUDS. OF POINT OUT THAT THE
ENTITY THAT'S ACTUALLY-
RESPONSIBLE AND ACTUALLY WAS
HELD ACCOUNTABLE THERE'S FRAUD
IS ACTUALLY THE COVERED ENTITY.
SO THAT'S THE CLINIC OR THE
HOSPITAL OR SO FORTHRIGHT. AND
THEY'RE THE ONES WE TALK ABOUT
CONTRACT PHARMACIES THEY'RE THE
ONES OF THE CONTRACT THE
PHARMACY. SO IT'S NOT ACTUALLY
THE PBM OR THE- PHARMACEUTICAL
MANUFACTURER WHO'S HELD
ACCOUNTABLE RIGHT I MEAN IT'S
ACTUALLY THE COVERED ENTITY AND
IN FACT THEY ARE RESPONSIBLE
UNDER FEDERAL LAW. AND IN FACT
TO THE FEDERAL GOVERNMENT HAS-
HAS A STRICT DEFINITIONS AS TO
WHAT TO COVER AND IT AND THAT
YOU HAVE TO BE COVERED ENTITY
AND THAT THE FUNDING HAS TO GO
TO THE COVERED ENTITY AND THAT
THE COVER AND YOU CAN ONLY SPEND
THE MONEY ON THINGS TO IMPROVE
PATIENT CARE. RIGHT THE FIRST
THINGS I TALKED ABOUT MY
TESTIMONY. SO IT'S KIND OF
FASCINATING TO ME THAT THE- EDM
AND THE IS SO INTERESTED IN
DOING THE WRK OF THE FEDERAL
GOVERNMENT FOR THEM. TO ENFORCE
THIS- ESPECIALLY SINCE IT'S
ACTUALLY THE COVERED ENTITY THAT
IS ACTUALLY RESPONSIBLE AND IF.
THE FEDERAL GOVERNMENT
INVESTIGATES WHICH THEY DO- THAT
THEY'RE THE ONES WHO ACTUALLY
ARE ONCE AGAIN TROUBLE IT'S NOT
THE PVM- THE CONCERN I THINK
THAT- WE NEED TO NAVIGATE. IS TO
ENSURE THAT. THE PBMS AND THE
PHARMACEUTICAL MANUFACTURERS
DON'T- ESSENTIALLY- DISCRIMINATE
AGAINST THE CLINICS ARE SO FOUR
TWO ARE GOING TO GET THE THREE
FORTY B. DISCOUNT RATE SO IF YOU
HAVE A BUNCH OF CUSTOMERS THAT
SOME WHO I AM YOU KNOW I HAVE A
DEAL AGREEMENTS ARE GOVERNMENT
GONNA GIVE THAT DISCOUNT.
ANOTHER ONES WHO DON'T WRITE
BECAUSE THEY'RE NOT COVERED
ENTITIES ARE NOT SERVING THE
SAFETY AND SO FORTH. I'M GOING
TO GET A HIGHER RATE RIGHT AND
SO AND SO I THINK WHAT WE WANNA
BE SURE IS THAT- WE DON'T HAVE
THIS ADVANTAGE. THE VERY
ENTITIES BY DEFINITION WHO ARE
SERVING THE SAFETY NET. RIGHT SO
I'M CERTAINLY- YOU KNOW WILLING
TO WORK WITH THE OPPOSITION- TO
BE SURE YOU KNOW WE WANT THE
MONEY THE PURPOSE OF THE BILL IS
TO BE SURE THAT DISCOUNT. THAT
MONEY GOES TO PEOPLE WHO NEED IT
RIGHT THAT THOSE PATIENTS ARE
BEING SEEN IN THE STATION HOUSE
ALSO CERTAINLY. HAVE TO CONTINUE
WORKING WITH THE OPPOSITION TO
TRY TO ADDRESS THEIR CONCERNS
BUT ALSO WE WANT TO ENSURE THAT
WE DON'T DISADVANTAGE THE VERY
INSTITUTIONS THE VERY THE- VERY
PEOPLE ARE TAKING CARE OF THEM.
THAT WE DON'T DISADVANTAGE THEM
AND THEN THEN AND ENTER PATIENTS
THAT THEIR PATIENTS ARE GOING TO
BE THIS ADVANTAGE IN TERMS OF
GETTING ACCESS TO DRUGS JUST
BECAUSE THEIR PARTICIPATION
THROUGH FORTY B. PROGRAM. THANK
YOU DOCTOR. AND I WOULD MOVE THE
BILL AT THE APPROPRIATE TIME.
THANK YOU SENATOR EDMUND- ON MY
LIST I HAVE SENATOR GROVE NEXT
FOLLOWED BY SENATOR RUBIO AND
THEN SENATOR LEE MOAN AS ANYONE
ELSE SENATOR ROTH WISHES TO
SPEAK ANYONE ELSE. AND SENATOR
HER TANTO YOUR ANYONE WHO DOES
NOT WISH TO SPEAK WITH YOU. NOW
OKAY. YOU DON'T CONSIDER WHEN
ALL RIGHT SENATOR GROUP PLEASE
THANK YOU FOR THE CHAIR I DO
HAVE A COUPLE QUESTIONS FOR THE
ONE OF THE LEAD WITNESSES IF
THAT'S POSSIBLE MR PULSIPHER
COULD I ASK YOU FEW QUESTIONS
PLEASE. I JUST HAVE A COUPLE
QUESTIONS AS THE AUTHOR JUST
RESPONDED TO A QUESTION
REGARDING SOME CONCERNS THAT
WERE ADDRESSED. ON THE THREE
FORTY B. PROGRAM. AND ONE OF THE
STATEMENTS THAT HE MADE WAS IT'S
THE GOVERNMENT COVERS THE
COVERED. ENTITY AND I'M ASSUMING
AND I GET THIS I GUESS IS THE
QUESTION OF THE AUTHOR. I'M
ASSUMING THAT THE COVERED
ENTITY. IS THE ORGANIZATION LIKE
THE LOS ANGELES L. G. B. T. THE
LADY THAT TESTIFIED THAT OFFERS-
LOWER DISCOUNTED
PHARMACEUTICALS. CERTAIN PARCELS
TO- AN ADVERSE OR RISK AT RISK
COMMUNITY THAT'S THE COVERED
ENTITY. CORRECT OR NOT. BREXIT
IS THOSE PLANS IS THAT THE
MEDICATIONS ARE SUPPLIED. TO
EITHER TO THE COVER ANY ARE THE
PEOPLE WRITING PRESCRIPTIONS.
THAT'S THROUGH THE COVERED
ENTITY RIGHT SO THAT'S RIGHT AND
THAT'S AND WHO THE COVERED
ENTITIES CAN BE IS DEFINED BY. A
FEDERAL. REGULATION WHICH SERVES
AN UNDERSERVED POPULATION. YES
THAT IS BY DEFINITION YES. IS IT
IS MY UNDERSTANDING CORRECT THAT
YOU WERE A CONTRACT. PHARMACY TO
A COVERED ENTITY. AND YES SO IT
HEALTH WERE OUT. HOW CENTERS
WORK THREE FORTY B. COVERED
ENTITY BUT WE CONTRACT WITH
PHARMACIES TO DISPENSE
MEDICATION SO SOME COVERED
ENTITIES HAVE IN HOUSE
PHARMACIES LIKE A LOS ANGELES
LGBT CENTER. WE DO NOT AND SO
THE ONLY WAY FOR PATIENTS TO
ACCESS MEDICATION IS IF WE
PARTNER WITH COMMUNITY IN RETAIL
PHARMACIES. SO THAT'S WHERE MY
QUESTION GOES SO THESE COMMUNITY
AND RETAIL PHARMACIES DO THEY
GET THE- THREE FORTY B. PRICING
TO PROVIDE TO YOU. YES SO THE SO
THREE FORTY B. DRUGS ARE ONLY
DISPENSE TO PATIENTS OF THE
COVERED ENTITY SO THAT CONTRACT
PHARMACY IS NOT AT THREE FORTY
B. COVERED ENTITY THOSE
DISCOUNTED DRUGS CAN ONLY BE
DISPENSED TO OUR PATIENTS. SO
THE SET RETAIL CHAIN STORES OR
OTHER OTHER. OTHER ENTITIES THAT
PROVIDE TO YOU AS A COVERED
ENTITY I GUESS MY QUESTION IS
THAT AND- WHEN THEY PURCHASE
THESE DRAGS DO THEY GET THOSE
DRUGS OR IN THEY GET THEM TO YOU
AND YOU PROVIDE THEM TO YOUR
INDIVIDUALS THAT ARE COVERED
THAT ARE. DISADVANTAGED OR NEED
TO BE HAVE A DISCOUNTED RATE. DO
THEY HAVE THE ABILITY TO
PURCHASE THAT. AT THOSE SAME
DRUGS AT THAT RATE. FOR ANY
OTHER PEOPLE THAT THEY SERVICE
OTHER THAN A COVERED ENTITY NO
THAT DISCOUNT IS ONLY EXTENDED
TO THE THREE FORTY B. COVERED
ENTITY NOT THE PHARMACY. AND YOU
AS THE COVERED ENTITY BASED ON
WHAT I BELIEVE THE AUTHOR SAID
AND I'M JUST TRYING TO
UNDERSTAND IT IT'S A VERY
COMPLICATED BILL AND IT IS FOR
ME IT IS AND OKAY WELL I'M GLAD
IT IS FOR YOU. BECAUSE YOU'RE IN
THE INDUSTRY AND IT'S VERY COMFY
SO THE AUTHOR MENTIONED THAT THE
COVERED ENTITY IS THE
RESPONSIBLE PARTY. AND FOR
MAKING SURE THAT THESE OTHER
PEOPLE DON'T PROVIDE THESE DRUGS
TO OTHER THAN THOSE THAT ARE
COVERED UNDER THE COVERED ENTITY
SO WHAT'S YOUR WHAT'S YOUR SO
PEER WHAT'S YOUR- AUDIT PROGRAM
TO MAKE SURE THAT THOSE OTHER.
THOSE CONTRACT PHARMACIES ARE
NOT PROVIDING THOSE- NOT
OBTAINING THOSE DRUGS AT A
REDUCED COST INTO THE THREE
FORTY B. PROGRAM AND THEN TURN
AROUND AND SELLING THEM. IN OUR
ANALYSIS SHOWS ANY PAY FIFTEEN
CENTS AND SOMETIMES ITS BORDER
DOLLARS UNDER RETAIL. SO WHAT IS
YOUR PROCESS TO MAKE SURE THAT
IS NOT HAPPENING YEAH I'M IN THE
SYSTEM YEAH. YES SO THE DISCOUNT
IS PROVIDED TO US THE COVERED
ENTITY NOT THE CONTRACT PHARMACY
AND THEN WE HAVE CONTRACTS WITH.
THOSE PHARMACIES TO MAKE SURE
THAT THOSE ARE NOT BEING
DISPENSED OUR PATIENCE AND SO WE
CONTRACT WITH A THIRD PARTY
ADMINISTRATOR. WHO ESSENTIALLY
LOOKS AT THESE CLAIMS TO MAKE
SURE THAT NONE OF THOSE
DISCOUNTED DRUGS ARE BEING
DISPENSED TO NON THREE FORTY BE
ELIGIBLE PATIENTS. BUT I
UNDERSTAND THAT PEACE BUT I
GUESS MY QUESTION IS IT ARE THEY
DISPENSING DRUGS TO OTHER
PATIENTS. WHERE THEY PAY A
REGULAR PRICE AND NOT AT THREE
FORTY P. PRICE BUT YET BECAUSE
THEY'RE A CONTRACT PHARMACY. T.
U. THEY OBTAIN THE THREE FORTY
B. PRICE PROGRAM AND THEY
DISPENSE IT. TO AN INDIVIDUAL
WHO IS NOT COVERED UNDER THE
THREE FORTY B. PRICE PROGRAM IS
THAT A POSSIBILITY. YEAH I MEAN
I GUESS IS THE QUESTION IS IT
POSSIBLE FOR THREE FORTY B.
DRUGS TO BE DISPENSED TO NON
THREE FORTY B. PATIENTS. SO FOR
ME TO SEE IF I CAN MAKE IT A
LITTLE SIMPLER SO I UNDERSTAND
AN ANSWER IF YOU UNDERSTAND WHAT
I'M ASKING THAT I'D APPRECIATE A
RESPONSE FROM YOU I'M TRYING TO
ASK IF I AM UP CONTRACT
PHARMACY. AND I'M ELIGIBLE TO
GET THREE FORTY B. PRICING
BECAUSE I'M PROVIDING PRICING TO
YOU ARE IN PROVIDING PRODUCT TO
YOU SO THAT YOU CAN DISTRIBUTE
TO YOUR THREE FORTY B. PATIENTS.
AND INDIVIDUALS THAT YOU SERVE
THAT ARE UNDERSERVED THAT NEED
HELP WITH PHARMACEUTICAL
EXPENSES. BUT YET I CHOOSE TO
TAKE THAT THAT PRODUCT THAT I
GET AT THREE FORTY BE PRICEY AND
I SELL IT TO DOCTOR PANTS
FACILITY AND HE SELLS IT TO THE
DOCTOR OR THE LAWYER THAT HE
SERVES AT A REGULAR PRICE. AND
THERE'S A PROFIT MARGIN THERE
THAT'S NOT BEING AUDITED AND- NO
OFFENSE SIR I'M JUST USING YOU
AS AN EXAMPLE FOR DOCTOR PANTS
FACILITY THAT'S WHAT I WANT TO
KNOW YEAH. AND I THINK YEAH. SO
SERIOUSLY- THERE ARE SEVERAL
WAYS A CONTRACT PHARMACY SO WHAT
HAPPENS YOU'RE SAYING LIKE OKAY
FINE SOMEONE WROTE A
PRESCRIPTION RIGHT. TO GO TO THE
PHARMACY AND HOW DOES THE
PHARMACY NO THAT'S THE FROM THE
THREE FORTY B. ENTITY ALL RIGHT
SOMEONE OR THEY'RE JUST ANOTHER
COMMERCIAL PATIENT RIGHT AND
SELF. INSERT AND GET THE
DISCOUNT RATE SO THERE ARE
DIFFERENT WAYS- THAT A PHARMACY
CAN IDENTIFY SO ONE IS THAT THE
WITH THE ELIGIBLE PATIENTS COULD
HAVE A CARD THAT THE SHOW AT THE
PHARMACY THAT WOULD BE ISSUED BY
THE THREE FORTY. BY THE COVERED
ENTITY- THE PRESCRIPTIONS
WRITTEN BY PROVIDER WHO'S BOTH
THE NAME AND ADDRESS MATCHES THE
COVERED ENTITY- SO THAT SO THEY
AND ACTUALLY THEY THERE SURE THE
ADDRESSES AND I JUST THAT
PROVIDING PEACE PROVIDER
PRACTICE N MULTIPLE SETTINGS
RIGHT SO THEY HAVE THAT ALL HAS
TO MATCH. THEY ALSO DATA
MATCHING SYSTEMS AS WELL
COMPARED TO COVERED ENTITIES
PATIENT THE PRESCRIPTION DATA
WITH- WITH THE CONTRACT
PHARMACY. SO THAT THERE ARE MEN
THERE FROM MANY DIFFERENT WAYS
IN WHICH- TO ENSURE THAT.
MEDICATION THAT IS ONLY THE
DISCOUNT ONLY GOES TO SOMEONE.
WHO IS BEING CARED FOR BY THE
AVERRED ENTITY. I KNOW THE SO-
AND IF THEY'RE NOT TO DO A THAT
THEN- BECAUSE THE COVERED AT A
ALSO HAS TO. OVERSIGHT OF THE
PURCHASING AND DISPENSING
RECORDS ALL RIGHT SO DON'T SO
THEY HAVE A CONTRACT WITH THE
PHARMACY. BUT THEY'RE STILL
RESPONSIBLE FOR IN THE CONTRACT
WITH THE PHARMACY THE CONTRACT
PHARMACY. THEY NEED TO HAVE THE
THEY NEED TO GET THE DATA BACK
TO SAY OKAY WHO DID YOU
DISPENSARY FORTY B. THINGS TO
WRITE BECAUSE THEY'RE THE ONES
WHO ARE HELD ACCOUNTABLE. AND
SO- THE SICKLY USUALLY THEY'RE
SUPPOSED TO GET THE DISPENSING
RECORDS AND THEY CAN GO WELL
LOOK YOU KNOW THESE ARE ALL MY
PATIENTS WAIT A MINUTE HOW COME
YOU'RE DISPENSING SOMEONE. ELSE
THAT THAT THAT THAT THIS WAS AN
**** SO THERE'S A RECONCILIATION
THAT ALSO. NEEDS TO HAPPEN AS
WELL SO THERE ARE THERE ARE
CHECKS AND BALANCES. TO BE SURE
THAT THE- PERSON ACTUALLY
GETTING. YOU KNOW GETTING THE
PRESCRIPTION IS ACTUALLY A
PATIENT OF IT QUALIFIES FOR OUR
PATIENTS OF THE THREE FORTY B.
THE COVERED ENTITY AND THAT
THEY'RE NOT SOME OTHER PATIENT.
AND THEY'RE JUST GETTING THE
DISCOUNT SO YOU CAN CUT A
PHARMACY CAN'T JUST GO AND SAY.
OH BY THE WAY. I COULD. PHARMACY
WE'RE JUST GONNA GO AHEAD AND
GIVE DISCOUNTED DRUGS TO EVERY
THEY HAVE TO ACTUALLY PROVIDE
THE RIGHT THE PROOF IN THE
COVERED ENTITY WANTS THOSE
RECORDS BECAUSE THEY'RE THE ONES
WHO ARE IN TROUBLE IF IT TURNS
OUT THAT- WAIT A MINUTE. WE'RE
DISPENSING THE DRUGS ARE BEING
DISPENSED WITH THE THREE FORTY
B. DISCOUNTS. TO PATIENTS WHO
DON'T. DON'T QUALIFY. SO I GET
THAT PIECE OF IT AND I
UNDERSTOOD THAT FROM THE
BEGINNING I THINK YOU FOR MAKING
IT CLEAR- I GUESS I'M GOING TO
THE MIDDLE SECTION SO. JUST IF
THERE'S A HUNDRED PILLS
DESCRIBED PRESCRIBED BY CONTRACT
PHARMACY. THAT THEY GET THE
THREE FORTY B. T. NINE. AND THEN
THE INDIVIDUAL WHO'S THE COVERED
ENTITY. SAYS I NEED. FORTY PILLS
AND IT'S GOING TO GO ONE TO EACH
OF THESE FORTY PATIENTS. AND
THEN THERE'S SIXTY PILLS LEFT
OVER. IS THERE AT A COVERAGE OR
DISAPPEAR SENDING THAT MAKE
SURE. THAT THAT CONTRACT FARMER
CERTAIN PHARMACY WHO'S NOT. THE
COVERED ENTITY AND RESPONSIBLE.
FOR MAKING SURE EVERYTHING IS
OKAY SOMETIME ABOUT THE MIDDLE
CLASS. I DIDN'T. IS THAT. THAT
PROTECTS M. ASSIST TAXPAYERS OR
ANYBODY ELSE THAT THAT THOSE
OTHER SIXTY PILLS ARE SOLD AT
THE FOUR HUNDRED DOLLAR PRICE
WHEN THEY WERE PURCHASED BY THE
CONTRACT PHARMACY. AT THE LOOP
LOWER PRICE AT THREE FORTY P.
PRICE IS THAT'S WHAT I'M LOOKING
FOR THOSE SO AGAIN THE COVER AND
AGAIN MAYBE YOU CAN ADDRESS IT
BY ITS FINEST IN THE COVERED
ENTITIES RESPONSIBLE SO
THEREFORE AND SO THE CONTRACT
PHARMACY THE REASON CALLED
CONTRACT PHARMACY HAVE A
CONTRACT WITH THE COVERED ENTITY
AND IF THAT AND SO DO THE
CONTRACT THE PHARMACY IS BE SURE
THEY'RE NOT DISPENSING BECAUSE
OTHERWISE THE COVERED ENTITIES.
AGAIN BOTH OF THAT AND IT WAS
GOING AND SAYING HEY YOU KNOW
WHAT I SIXTY REBELS AND- I CAN
GIVE IT TO OTHER PEOPLE. AND THE
CUTTER AND HE DOESN'T HAVE THE
PROVISIONS TO BE SURE THEY KNOW
THAT THAT'S GOING ON. AND
THEY'RE DOING IT UNDER THE NAME
OF THE COVERED ENTITY THAT
COVERED ENTITIES THE ONE THAT
GETS THAT ACTUALLY COULD LOSE
THEIR STATUS AS A COVERED ENTITY
AND THEREFORE LOSE. THE ENTIRE
C. FORTY B. PROGRAM FOR THEIR
OWN ENTITY BUT MAYBE YOU CAN
SPEAK TO WHAT'S WHAT'S- THE NAME
OF THE CONTRACT YET JUST TO SEE
YEAH AND JUST IF YOU COULD. WELL
THIS IS WHAT I'M GETTING AT.
THREE NINE FORTY BILLION DOLLAR
PROFIT MARGIN IN HERE FOR
SOMEONE. I DON'T THINK IT'S THE
LOCAL COVERED ENTITY OR THE
PERSON WHO'S IN THE DEAD CENTER
OF LOS ANGELES SERVICING THEM.
PEOPLE IN OUR SOCIETY. IT'S
SOMEWHERE UP THE CHAIN AND I'M
JUST TRYING TO FIGURE THAT OUT
TRYING TO FIGURE OUT WHAT
MECHANISMS ARE IN PLACE. TO MAKE
SURE THAT THEY CAN EARN FORTY
DOLLARS DOESN'T EXIST- I THINK
IT DOES EXIST. AND SO MY
QUESTION IS THAT- FOR. ARE THEY
COVERED ENTITY. IN SOME OF THIS
MAY SOMEHOW AND THERE. THAT FOR
A SERVER. FOR THE COMMUNITY THAT
THEY SERVE. I'M TRYING TO FIGURE
OUT HOW THAT THREE NINE FORTY
BILLION DOLLAR PROFIT MARGIN IS
IN THERE. WHEN WE'RE GIVING-
DRAGS. ON THREE FORTY B. WE'RE
GIVING THREE FORTY B. DRUGS AT A
DISCOUNTED RATE TO LOCAL
COMMUNITY SERVICE ORGANIZATIONS%
OR HOSPITALS OR CLINICS. THAT
ARE SERVING THE MOST VULNERABLE
MERGERS AND MY SIDE OF OUR
SOCIETY THAT MAKES SENSE. YEAH I
MEAN I THINK JUST TO BE CLEAR SO
THERE IS SOME SAVINGS THERE
THAT'S GENERATED BY THE COVERED
ENTITY WHEN THEY PURCHASE A DRUG
AT A DISCOUNTED PRICE. THE
CONTRACT PHARMACY RECEIVES A
PORTION OF THAT SAVINGS POOREST
DISPENSING THAT MEDICATION THOSE
CONTRACTS VARY DEPENDING ON THE
COVERED ENTITY IN THE PHARMACY
BUT THE MAJORITY OF THAT SAVINGS
STAYS WITH THE COVERED ENTITY.
AND THEN THEY'RE REQUIRED TO USE
THAT THAT SAVINGS TO EXPAND
ACCESS TO SERVICES FOR
UNDERSERVED PATIENTS. OKAY SO
THAT MAKES SENSE TO ME AND THAT
ANSWERS MY QUESTION I THINK SO
FROM A COVERED ENTITY AT LOS
ANGELES LIKE THE MRS T. BENNETT
WAS ON THE PHONE. AND I HAVE A
CONTRACT PHARMACY AND I GET THE
DRUGS FOR A THOUSAND DOLLARS AND
I'M ABLE TO GET. TAKE CARE OF
THE PEOPLE THAT ARE UNDERSERVED
AND THEN I CAN IN TURN. USE
THOSE RESOURCES WITH A CONTRACT
WITH YOU- I MAKE ADDITIONAL
RESOURCES WHICH ADDS TO MY
BOTTOM LINE AND I CAN PROVIDE
MORE SERVICES TO THE COMMUNITY I
SERVE. IS THAT CORRECT EXACTLY.
SO THAT'S YEAH THE COVERED
ENTITY THE SAFE NET PROVIDER
THAT SAVING SO THEY CAN USE
EXPAND SERVICES AND THAT WHAT
THEY WERE TALKING THE THREE
FOURTY BILL DOLLARS. YEAH OKAY
AND THAT'S WHAT THE WAS INTO TO
DO BY KONG. OKAY I WHAT YOU'RE
SAYING- OKAY THANK THAT SENSE TO
ME THAT MAKES ME FEEL LIKE I
DON'T WANT TO SUPPORT THE BILL
BECAUSE I'M CONCERNED ABOUT.
TAXPAYER DOLLARS AND MANY THAT
THE I AND I UNDERSTAND THE
PHARMACEUTICAL SIDE OF IT NOW
AND BELIEVE ME I WASN'T I DON'T
SEE HIM TAKING THEIR SIDE BUT I
UNDERSTAND WHY THEY HAVE A BIG.
ON OVER THIS. I DO HAVE ONE MORE
QUESTION FOR THE OTHER BUT THANK
YOU VERY MUCH FOR YOUR TESTIMONY
APPRECIATED IT. THANK YOU FOR
HELPING ME UNDERSTAND IT MORE.
S. THROUGH THE TERROR- I
UNDERSTAND THERE'S TWO SUITS
FILED AGAINST- THE PROGRAM AS IT
IS IT WILL THIS BILL IF IT'S
PASSED- AFFECT THE- OUTCOME OF
THE LAWSUITS BECAUSE IT IS IN
LITIGATION RIGHT NOW. NOT THAT
I'M NOT THAT I PERSONALLY AWARE
OF THIS IS US THIS IS A STATE
LAW SO THERE'S I THINK BELIEVED
TO. HANDLE ALL THE DETAILS OF
THE LAWSUITS BUT- INTENDED IT'S
BASED AROUND- YOU KNOW WHO. WHO
QUALIFIES AS A COVERED ENTITY AT
CENTER AND THAT'S THAT'S THAT'S
A FEDERAL ISSUE OKAY I THINK. WE
WILL THIS BILL ACTUALLY CALLS
FOR WHATEVER THE FEDERAL
DEFINITION IS WELL IN FORCE
AGAINST. SO WHATEVER DILIP
BALCOMBE THE LAWSUIT IS
REGARDING WHO GETS THE FIND IT
THAT'S WHAT'S BILLED BY TWO.
THANK YOU AND THANK YOU FOR IT
FOR TOLERATING MY QUESTIONS TO
TRY TO UNDERSTAND THE THREE TO
FORTY BILLION DOLLARS AND WE'RE
WAS. ROUGHLY THREE TO FOUR WHERE
IS IT GOING. YEAH AND IF I MAY
JUST MAKE A COMMENT ABOUT THAT-
I MEAN- THE- AND THEY SAY THAT'S
PROFITABLE AGAIN THE MONEY THAT
COMES OUT OF THE FROM THE
DISCOUNT RATE FROM BETWEEN THAT
THAT THAT THAT COVERED ENTITIES
GET. BY LAW. THEY HAVE TO SPEND
IT SO IT'S ME CAUGHT WE CAN CALL
PROFIT BUT FIRST HONESTLY AS A
NOT FOR PROFIT BUT THEY HAVE TO
SPEND IT ON EXPANDING PATIENT
CARE SERVICES AGAIN OFTENTIMES
THEY'RE SPENDING IT ON THINGS
THAT WE DON'T EXPLICITLY
REIMBURSE. SO THAT'S THE
CONSPIRACY THE MAIN REASON FOR
THIS BILL IS TO BE SURE WE DON'T
HAVE THOSE SERVICES CUT YEAH
WE'VE BEEN DOING THIS SINCE
NINETEEN NINETY TWO. SO I THINK
THAT THAT WE DON'T WANT TO SEE
FOR EXAMPLE YOU MAY HAVE
COMMUNITY CENTER I THINK GIVE ME
HEALTH CENTERS IN YOUR YOUR OWN
DISTRICT THEY'RE PROVIDING YOU
KNOW LOTS OF SUPPORTING PEOPLE
HAVE TROUBLE TRANSPORTATION
OTHER TYPES OF THINGS GETTING
IN. WE DON'T WANT THOSE THINGS
GET TIGHT- THE SAID SERVICE
GETTING CUT- AND THAT'S WHAT
THIS BILL IS ABOUT AND I DON'T
WANT THE SERVICES TO GET CUT IN
YOUR DISTRICT MY DISTRICT OR
ANYWHERE IN CALIFORNIA. BUT I
THINK THERE'S A VIABLE A- AND-
IF YOU ARE ON A PRO. THAT ALLOWS
YOU TO OBTAIN. PHARMACEUTICALS
AT A LOWER DISCOUNTED RATE BUT
YOU HAVE THE ABILITY TO SELL
THEM AT A HIGHER RATE. AND EVEN
IF YOU'RE NOT. NOT TO THE
COVERED PEOPLE. BUT OUTSIDE OF
THE COVERED PEOPLE AND OUTSIDE
OF THE STATE OF CALIFORNIA. AND
ARE YOU SAYING THAT THEY'RE NOT
SOLD OUTSIDE OF THE CITY
CALIFORNIA YOU SHOULD WELL THEY
SHOULD BE SOLD IT'S IF YOU'RE
PATIENT THE COVERED ENTITY DON'T
YOU DOES THE ONLY ONES WHO CAN
GET. THE DISCOUNTS SO I DON'T
KNOW HOW WHY OR STAND OUTSIDE OF
THE STATE OF CALIFORNIA THEY MAY
HAVE. CONTACTED UP THE CONTRACT
PHARMACY YEAH WELL THE CONTRACT
PHARMACIES ARE YOU KNOW THAT SO
IF YOU DON'T HAVE AN IN HOUSE
PHARMACY RIGHT AS YOU HEARD FROM
THE WITNESS. YOU MAY HAVE A
CONTRACT WITH THE PHARMACY
BECAUSE AGAIN YOU ACTUALLY
BECAUSE THE OTHER THING IS OF
COURSE PEOPLE GET THEIR
MEDICATIONS AND DIFFERENT PLACES
AND SO DID YOU WANT TO HAVE ONE
THAT'S CONVENIENTLY CLOSE TO
THEM RIGHT SO IMAGINE YOU HAVE.
MEALS IN A ROW HEALTH CENTER
RIGHT TO SERVING VERY LARGE AREA
RIGHT SO THEY MAY ACTUALLY HAVE.
EVEN IF THEY HAD AN IN HOUSE
PHARMACY- PEOPLE MAY SAY WELL
YOU KNOW IF YOU CAN I CAN I GO
TO SOME PLACES CLOSE TO THE MAY
HAVE CONTRACTS WITH PHARMACIES
OTHERS YOU KNOW TO ME PHARMACIES
OUT IN THE COMMUNITY TO MAKE
THOSE MEDICATIONS MORE
ACCESSIBLE. AND THERE IS A AGAIN
THERE'S THAT THERE'S A PROCESS
FOR RE CONCILIATION AND OTHER
THINGS. INSURE THAT THOSE
DISCOUNTED PHARMACY.
PHARMACEUTICALS CAN ONLY GO TO
PATIENTS WHO ARE BEING SEEN
SERVED BY THAT COVERED ENTITY
NOT ANY OTHER PATIENTS. AND I
THINK THAT'S REALLY IMPORTANT.
TO EMPHASIZE. THE END AND WE I
GUESS WE- SEE THAT DIFFERENT
WAYS- AND I THINK THAT'S THE
PROBLEM THAT WE HAVE. IS THAT
IT'S ONLY ADDRESSING THE
INDIVIDUALS UNDER THE COVERED
ENTITY PROGRAM. AND NOT OUTSIDE
OF THAT WHERE THEY HAVE THE
ACCESS TO THE SAME DRUGS. AT THE
REDUCED COST. THAT'S WHERE I
THINK. THERE'S A PROBLEM. THANK
YOU THOUGH FOR LETTING YOU TRY
TO FIGURE THAT OUT. OKAY YEAH WE
- THANK YOU SENATOR GROVE-
SENATOR RUBIO YOU'RE UP. THANK
YOU- CHAIR I WANT TO SAY I AGREE
WITH SHANNON OR DISAGREE BUT I
GOT LOST SOMEWHERE IN THE
DISCUSSION HERE- FOR ANYBODY
LISTENING TO IT SO YOU KNOW
REALLY TECHNICAL AND DOUBT
REALLY DIFFICULT TO UNDERSTAND
SO I'M SEEING THAT SORT OF FAR
FROM WHAT SHE SAID IN SOME OF
THE TESTIMONY I HEARD. ON IT I
KNOW SHE WAS TRYING TO GET TO
THE POINT OF IS THERE POTENTIAL
FOR FRAUD AND- HOW DO WE MAKE
SURE THAT THE SAVINGS I DO HAVE
TO GO DIRECTLY TO THE PATIENTS
WERE TRYING TO HELP OR OR THE
CLIENTS I MEAN IS THERE ANYTHING
THAT YOU SEE THAT WE CAN BE
DOING MORE TO ENSURE THAT THE
DISCOUNT. THAT THREE FORTY B.
DISCOUNT DRUG RATE IS. PASS
ALONG TO THE CONSUMER WHAT I'M
TRYING TO RECONCILE AS THEY DID
HERE- YOU'RE IN SOMEBODY'S
TESTIMONY THAT THERE IS A
PROHIBITION IN TERMS OF
DISCLOSURE FROM THREE FORTY P.
DRUGS TO THE- NON. AT THREE
FORTY B. PATIENTS AND I GUESS
THAT IF THERE'S A LACK OF
INFORMATION THERE SO THAT'S WHY
I'M TRYING TO RECONCILE YEAH.
CAN WE DO MORE. TO DISCLOSE AND
MAKE IT A LITTLE BIT MORE
TRANSPARENT NOT TO SAY IT'S NOT
RIGHT NOW BUT IT IS. VERY TRICKY
BECAUSE YOU'D HAVE TO RELY AS I
THINK SHANNON WAS TRYING TO
EXPLAIN SORRY JUST- SENATOR
GROWTH OKAY- YOU KNOW THAT
POTENTIAL IN BETWEEN FOR. OFF
FOR PEOPLE NOT TO DO THE RIGHT
THING SUCH AS CAN YOU SPEAK TO A
LITTLE BIT MORE ABOUT THE
TRANSPARENCY CAN WE ADD. MAYBE
MORE DISCLOSURES WHAT CAN WE DO
TO MAKE IT BETTER SO I HAVE
THINGS THAT I SAY I THINK- AS I
MENTIONED IS THAT. I FULLY AGREE
WITH YOU AND I THINK SERRA GROVE
IN TERMS OF SAYING THAT WE WANT
TO BE SURE THE SAVINGS SKILLS
HELP PATIENTS. RIGHT I MEAN
THAT'S THE PURPOSE OF THE
DISCOUNT IN FACT THAT'S WHY THE
LAW. ON THREE FORTY V. SAYS.
THAT THE QUAKE JUST CAN'T SPIT
OUT ANYTHING THAT IS THEY NEED
TO. SPEND ON THINGS THAT THAT
THAT SUSPICIONS. AND OF YOU KNOW
POTENTIAL. AND SO FORTH ARE OUT
THIS PROGRAM HAS BEEN IN PLACE
SINCE NINETEEN NINETY TWO RIGHT
SO THERE ARE- SO- YOU CAN TELL
ME HOW MANY STORIES OF FRAUD AND
SO FORTH I'M NOT SAYING THAT
DOESN'T EXIST AT ALL BUT- YOU
KNOW THE- THE AGENCY THE FEDERAL
AGENCY RESPONSIBLE YOU KNOW
THEY'VE BEEN MONITORING THIS
PROGRAM. THEY'VE DONE AUDITS AND
SO FORTH- THEN THE QUESTION IS
THAT- L. WHO SHOULD BE THE ONES
TO MONITOR. THE FRAUD RIGHT- SO
CERTAINLY THE FEDERAL AGENCY
THAT'S RESPONSIBLE THREE FORTY
P. PROGRAM- IS. IS INVOLVED- THE
HEALTH RESOURCE SERVICE
ADMINISTRATION. THEY MONITOR
DATE DO AUDITS IT'S CETERA. THE
QUESTION IS THAT THERE'S A THE
POINTED OUT A LITTLE EARLIER IS
THAT. SO THE PBMS IN THE
PHARMACEUTICAL COMPANIES
CERTAINLY ARE SO THAT YOU KNOW
ARE INTERESTED IN ACTUALLY DOING
THAT ROLE SO THE QUESTION IS
WHY. WHAT YOUR AFTER ALL IT'S
THEIR DID NOT LAW ENFORCEMENT
THEY'RE NOT FEDERAL GOVERNMENT
THE FEDERAL GOVERNMENT IS THE
ONE WHO NEGOTIATES WITH THE
PHARMACEUTICAL COMPANIES FOR
THREE FORTY DISCOUNTS ALREADY SO
INTERESTED. AND NOW SUDDENLY
BEING THE ENFORCERS- IT JUST OUT
OF THEIR OWN YOU KNOW IS IT JUST
OUT OF THE GOODNESS OF THEIR
HEART NOW AND MAYBE- BUT- I
WOULD ALSO POINT OUT THAT WE
WANT TO BE SURE THAT THERE
ISN'T. THAT WE DON'T
DISADVANTAGE THE PATIENTS WHO
ARE IN THE THREE FORTY B.
PROGRAM BECAUSE AFTER ALL THEY
HAVE AN AGREEMENT FEDERAL
GOVERNMENT THAT THEY'RE GETTING
A DISCOUNT RIGHT AND- YOU KNOW
THE PBMS THEY WORK IF THEY HAVE
REBATES AND SO FORTH. AND SO THE
QUESTION IS THAT. YEAH I'M
CERTAINLY OPEN TO AGAIN WORK
WITH THE OPPOSITE. SPOKE TO
SAYING WE WANTED WE STAMP OUT
FRONT RIGHT WE WANT THAT MONEY
TO GO- PROPERLY TO THE PATIENTS
WHO NEED HELP RIGHT AND AGAIN
THIS PROGAM'S BEEN AROUND FOR A
LONG TIME. SO WE WANNA BE SURE
THAT'S WHERE THE MONEY GOES AND
SO THERE'S THINGS WE CAN DO TO
GET. THAT DONE ARE YOU SURE THAT
THAT'S GREAT. WELL I DON'T WANT
TO HAVE HAPPEN THOUGH IS WE TRY
DON'T WANT TO. THEMSELVES WHO
ARE THE PATIENTS OF THE COVERED
ENTITY TO BE DISADVANTAGED
BECAUSE- NOW WHAT'S HAPPENING IS
WE HAVE ENTITIES MAY HAVE OTHER
INTERESTS AS WELL. IN FINDING
OUT THIS INFORMATION THAT MAY BE
USED TO DISADVANTAGE THEM TO
MAKE THE DRUGS LESS AVAILABLE TO
THEM. RIGHT BECAUSE AFTER ALL
THEY'RE NOT GETTING MAKING AS
MUCH MONEY ON THESE BECAUSE THEY
HAVE TO GIVE A DISCOUNT. SO THE
QUESTION IS WHICH AND- ARE THE
BEST ENTITIES. TO ACTUALLY TRACK
THE FRONT. AND SO CERTAINLY
HAPPY TO HAVE THAT DISCUSSION-
TO SAY YOU KNOW WHAT WHAT KIND
OF REPORTING NEEDS TO HAPPEN IF
WE DON'T. YOU KNOW DON'T- IF YOU
THINK THAT COVERED ENTITIES WHO
ACTUALLY ARE LEGALLY
RESPONSIBLE- DEAL THAT DID THAT
THERE'S INSUFFICIENT OVERSIGHT
OVER THEM OR SOMETHING LIKE
THAT. LET'S HAVE THAT
CONVERSATION BUT I DID WANT TO
ALSO BE SURE THAT. THE ENTITIES
ARE DO OVERSEE THIS RIGHT SO YOU
THAT THAT. THAT THIRD
APPROPRIATE ENTITIES THAT ARE
DOING THE OVERSIGHT AND THAT
THEY DON'T HAVE OTHER INTERESTS
THAT MAY CONFLICT WITH. ACCESS
TO THESE MEDICATIONS. SO I DID
THAT SO I THINK THAT'S- THE
THAT'S THE- THAT'S- AND THEN
CERTAINLY AGAIN. NOW THIS IS THE
FIRST COMMITTEE- SELL PRE
SHAPED- YOU KNOW GETTING SOME
OPPORTUNITY TO WORK. WITH THE
WITH ITH FOLKS ON THIS. BUT
AGAIN. WE WANT TO ENSURE THAT IN
THE REASON I DECIDE TO CARRY
THIS BILL WHEN THE WHEN THE
SPONSORS APPROACH ME IS THAT I
WANT TO BE SURE. THAT WE DON'T
HAVE. CUTS IN THESE SERVICES.
RIGHT BECAUSE AS THIS IS IT SAYS
THIS THINGS MOVING ALONG. THE
THREE FORTY B. PROGRAM WHICH
AGAIN HAS BEEN AROUND SINCE
NINETEEN NINETY TWO IS A BIT
UNDER ATTACK BECAUSE WHAT
HAPPENS IS THAT THIS IS. YOU
KNOW- THAT THAT- DOES PROVIDE
DISCOUNTED MEDICATIONS AND-
UNFORTUNATELY THERE YOU KNOW
THAT THAT. THAT THERE'S A LOT OF
PEOPLE WHO WHO DO ARE JUST AS
YOU KNOW WHO WHO ARE NOT. HIGH
INCOME AND SO FORTH TO DEPEND ON
THESE MEDICATIONS. AND AND ALSO
AS THE IRONICALLY EVEN AS- SOME
MEDICATIONS YOU KNOW NEW
MEDICATION COMING OUT WHICH ARE
BECOME VERY YOU KNOW IT'S A VERY
EXPENSIVE. THESE DISCOUNTS
BECOME. EVER MORE. TO THE TO
PATIENTS WHO ARE THREE FORTY B.
TO VOTE FOR THEM TO BE ABLE TO
ACT GET ACCESS TO THEM SO- SO I
CERTAINLY WANT AGAIN WORK WITH-
WITH FOLKS- BUT- I THINK WE ALL
SHARE THE SAME GOAL. AND I
HAVEN'T EVEN DISAGREED THAT.
LET'S GO AHEAD. YEAH AND- THAT.
THE SERVICES THAT THESE PATIENTS
GET. DON'T GET CUT AND THAT WE
TRY TO DETER BRACKETS ALL THE
OTHER DISCOUNTS THIS. THAT TO BE
ABLE TO SUPPORT. THOSE SERVICES
AND THAT- WE CONTINUE TO. TO
MAKE THAT AVAILABLE NOW IT'S YOU
KNOW ONE THING I WOULD ALSO JUST
SORT OF POINT OUT IS THAT. THIS
IS THE BEST WAY TO SUPPORT THESE
OTHER SERVICES. THAT'S ALL
BIGGER DISCUSSION AND I WOULD
STAND ON THAT I THINK THERE'S
SOME DEBATE ABOUT THAT. GOSH WE
MORE EXPLICITLY FUNDED INSTEAD
OF MAKING IT IMPLICITLY FUNDED
IS THAT THESE ARE OFTEN COVERING
SERVICE THAT ARE EXPLICITLY
REIMBURSED I MAYBE WE OUGHT TO
DO IT THE OTHER WAY. THAT'S THE
ONLY. FOR A- DISCUSSION. WELL
THAT. LET'S HAVE THIS CUT
BECAUSE WE THEN OF THIS PROGRAMS
ESSENTIALLY FAIL ARE ARE ARE ARE
YOU GONNA GET NARROWED IT WELL
WE HAVEN'T ADDRESSED THE LARGE
THAT THAT OTHER QUESTIONS AS
WELL SO- SO CERTAINLY HAPPY TO
HAVE THAT'S GOING. THANK YOU- I
HAVE FOLLOW UP QUESTIONS AND-HEAR FROM HIS HARI. AND I AGREE
WITH YOU- A DOCTOR PANNED OUT
YOU KNOW I PERSONALLY THE-
CLINICS HAVE BEEN UNDERFUNDED
AND- WE DEFINITELY WANT TO MAKE
SURE THAT THEY GET THE SAFETY
NET IS THERE FOR OUR MOST
VULNERABLE PATIENTS AND- AND
TAKE THEIR LIKE OR CLEAN. LOCAL
CLINICS HAVE BEEN HURT BY HIT
THE PANDEMIC YELLS IT TO DEAL
WITH THAT YOU KNOW NOW THAT THE
PROBLEM HAS BEEN HERE SINCE
NINETEEN NINETY TWO BUT- IT. MY
QUESTION. OKAY NOW THAT I THIS
CASE THAT I HAD SAID RECENTLY.
BUT THIS HAD DOES NOT TO DO IT
CALIFORNIA HAS TO DO WITH
ARKANSAS RIGHT. AND I BELIEVE IN
YOU NEED TO CORRECT ME IF I'M
WRONG THAT. THEY FOUND THAT
THERE IS- IT THERE'S A
DISRUPTION TO THE FEDERAL THREE
FORTY B. PROGRAM AND SOMEHOW
DIRECTLY CONFLICTS WITH AT THREE
FORTY P. STAT. SHEET SO. IT DOES
THAT HAVE TO DO WITH CALIFORNIA
I'D LIKE THAT THE RECENT RULING
WHICH ISN'T A VIRUS VERSUS HAS
BEEN NO SUCH AS THAT. EIGHT AND
- TRYING TO. THE HI- I'D TO GET
BACK TO YOU DON'T YOU GIVE YOU
AN ACCURATE ANSWER- I DON'T KNOW
IF ANY OF MY WITNESSES ARE
FAMILIAR ENOUGH WITH THAT CASE
TO BE ABLE TO ADDRESS THAT- SO I
DON'T KNOW WHETHER THE CALL- BUT
COULD COULD COULD ADDRESS THAT.
YEAH I MEAN I KNOW THERE IS ON
GOING TO THE GATE CAN AN
ARKANSAS OVER LEGISLATION WAS
PASSED THERAPIST NOT SURE IF
IT'S THIS SPECIFIC CASE OR NOT.
WHAT IS THE RECENT FEDERAL COURT
DECISION SO THERE HAS BEEN A
DECISION BUT IF YOU COULD JUST
GET BACK TO ME ON UP OKAY I'M- A
BETTER. IT DOES. I WAS. IT'S AN
- WITH THE FORTY B. BUT YOU CAN
GET OUT OF. WE WOULD JUST LAUGH
I WILL SAYING. MAYBE BECAUSE I
DIDN'T HEAR YOU CORRECTLY THIS
IS ONE OF THE FIRST OUT TEST-
WITNESSES THAT TESTIFIED. I'D
BETTER MAKE A STATEMENT THAT.
SINCE OUR BEANS. US SENT OUT
OUTSIDE OF CALIFORNIA AND I
HEARD A NUMBER 60% AGAIN MIGHT
BE THAT. EARLY ON IT I HEARD A
IN- AND THEY- S. SHIN DIRECT
MAIL. ORDER TO STAY- YOU KNOW
CAN WE KEEP TRACK. OF WHAT'S
SOLD HERE IN THE STATES OF
ITSELF A LOT THROUGH MAIL I MEAN
JUST HELP ME UNDERSTAND WHAT
THAT STATEMENT WAS I MAY BE
WRONG. CAN YOU MENTION- OUTSIDE
. 60% OUTSIDE. IN A TRUST FUND
YEAH I MEAN I THINK THAT WAS A
STATEMENT FROM THE OPPOSITION.
ANDSO I THINK WE NEED TO HAVE
MORE DISCUSSION WITH THEM ABOUT
THAT CONCERN. OKAY AND ACTUALLY
CAN I ALSO HAVE- BUT I KNOW
SHE'S ON THE LINE I CAN I ALSO
HAVE NICOLE TYPO ALSO PERHAPS
CAN YOU CAN YOU. THAT THAT THE
FROM THE OP. THERE IS. JOHN IS
THAT YOU KNOW CALL. YES YES I'M
HERE WOULD YOU MND. THE
QUESTION PLEASE. YOU KNOW I
CAN'T I CAN'T SPEAK I KNOW AT
THE COVERED ENTITY UNDER BOTH OF
THE FEDERAL PROGRAM WE CANNOT
SEND OUT OF STATE. WE DO NOT
SEND ANY MEDICATION OUT OF STATE
AND I CAN'T- I'M NOT FAMILIAR
WITH THAT CONDITION UNDER WHICH
YOU COULD- SO I WOULD HAVE TO
HAVE A LITTLE MORE INFORMATION
IT DIDN'T WANT TO JUST REALLY
QUICK JUMP IN AND MENTION THAT.
COVERED IT. HAVE RIGHT AUDIT.
AND SELL ALL OF THE TIME WE ARE.
OUT WENT. BY ONE OR THE OTHER SO
THEY ABSOLUTELY HAVE ACCESS TO
ALL OF THAT INFORMATION. AT
FIRST I HAVE THE RIGHT THAT'S SO
WE ARE VERY THEORY HIGHLY
MONITORED ON SO I'M NOT SURE
WHY. THE MANUFACTURERS AND PBMS
WOULD BE BEYOND. ALREADY TOO
WHAT. IT DOES. I THANK YOU AND
IT MAY THE PERHAPS IT HELPFUL AS
ARE REVIEWED THE PERSON WHO MADE
THE STATEMENT THAT 60% WERE SENT
OUT OF STATE IS THAT. MEDITATION
CENTER STATED THAT BECAUSE THE-
SEA WAS HEADQUARTERED OUT OF
STATE. AT THE TRAPS IT'D BE
HELPFUL TO HAVE THAT
CLARIFICATION FROM THE PERSON
MADE STATEMENT. WHAT EXACTLY DID
HE MEAN BY THAT. BUT YOU KNOW
I'LL JUST FOR CLARIFICATION I
HEARD AND SO I JUST WANTED TO
ADDRESS IT SINCE I HEARD IT BUT
I'LL JUST MOVE FORWARD CLEARLY.
THERE'S A LOT OF LINGERING
QUESTIONS FOR ME AGAIN NOT
BECAUSE IT IT'S A BAD BILL OR
ANYTHING IT'S JUST THAT IT IS A
VERY INTENSE CONVERSATION WE'VE
HAD HERE AT THE TOP. I HAVE
EVERY CONFIDENCE AND- SENATOR
PAT THAT HE WILL WORK WITH THE
OPPOSITION THAT HE JUST DATE
ITSELF I'LL JUST LEAVE IT AT
THAT BUT THANK YOU I KNOW IT'S
BEEN NOT. IDENTIFY I LOOK FOR IS
HERE MORE DETAILS IN THE NEAR
FUTURE YOU GUYS UP WITH AN- AND
- YEAH ALL RIGHT. LIVING ON
ANOTHER. THANK YOU. AND IF YOU.
AND LONG TIME I THINK ON THE
POINT OF COLLECTING DATA AT ALL
I WILL SAY IS THAT I THINK DATA
CAN BE COLLECTED TO ASSESS FRONT
BUT I ALSO THINK THAT IT COULD
JUST BE COLLECTED- AND IN THE
ROOM AND IT'S ALSO USEFUL IS TO
UNDERSTAND YOUR YOU KNOW PATIENT
NEEDS AND UNDERSTAND WHERE THE
TRENDS ARE AT YOU KNOW IN TERMS
OF THE MEDICINES- AND SO FORTH
SO I KNOW THAT THAT'S BEEN A BIG
POINT OF CONVERSATION ABOUT- THE
ABILITY TO. TO TRACK- AND
REQUEST DATA THAT'S USED AND SO
I WANT TO TAKE IT NOT JUST FROM
BLENDS IT'S ONLY BECAUSE- ONCE
THE TRACK FRAUD AS WELL AS
BECAUSE IT TAKES. THING THE
MEDICINE THE BEING USED. BUT
MICHAEL. HAS TO DO WITH A THEME
THAT THAT HAS COME UP SO MUCH AT
TODAY WHICH IS THEABILITY TO
HAVE CONTRACTS WITH PHARMACIES
AND I REPRESENT A REGION THAT'S
UNIQUE YOU KNOW MULTI COUNTY
VERY LARGE AND I HAVE A URBAN
HUBS I HAVE RULE HUGS- AND
CERTAINLY GET ACCESS TO
AFFORDABLE MEDICINES FOR THE
NEEDIEST. WHICH IS WHAT THIS IS
TRYING TO DO- HAS ALWAYS BEEN AN
ISSUE THAT'S IMPORTANT TO US BUT
ALSO PRESENTSQUITE A NUMBER OF
COMPLICATIONS SO AS I HEARD THIS
CONVERSATION ABOUT CONTRACTING
WITH PHARMACIES- I THINK ABOUT
THE COMMUNITIES I REPRESENT AND
I REPRESENT ME BE ABOUT EIGHTY
NINE NINETY ZIP CODES AT
SOMETHING LIKE THAT. AND AT
LEAST HALF OF THOSE IF NOT MORE
DON'T HAVE CONTRACTS WITH
PHARMACIES IN MY LOCAL COMMUNITY
AND SO YOU SEE THAT YOU FOR
EXAMPLE HOSPITALS MAY HAVE TO OR
CHOOSE TO. CONTRACT OUT OF STATE
AND NOT WITH MY LOCAL PHARMACY
SO I'M NOT SURE WHO TO ASK UNTIL
AND SO I'M CAN YOU RESPOND AND
HOW DO WE THINK ABOUT SOME OF
THE CONTRACTS WITH FAR ARE ARE
GOING HELLO FOR IN. THEIR
HAPPENING OUT OF STATE AND HOW
DOES ONE THINK ABOUT THAT IN
TERMS OF WHAT IT COULD PROVIDE
WHAT IT MEANS TO THE ALTERNATE
GOAL THAT I SHARE WITH YOU WHICH
IS HOW TO GET AFFORDABLE.
MEDICINE TO THOSE YOU KNOW WHO
MOST NEED IT CAN YOU JUST
COMMENT ON THAT AND HELP ME
THINK THROUGH AN ISSUE LIKE THAT
YEAH AND AN ATTACK- BEAR FOR
VALVE THE NATIONAL ANSWER AND
HAVE A FOLLOW UP HERE BECAUSE
I'D THINK FOR. MANY COVERED
ENTITIES THEY'RE STRUGGLING WITH
THE SAME ISSUE YOU ARE RIGHT IF
YOUR. MANAGER IS VERY LARGE. IF
YOU IN THE HOUSE. THAT MEANS I
DON'T HAVE TO MAKE THEIR WAY
OFF. YOU YOU'RE ONE CLINIC- OR
WHATEVER IT IS TO GET TO THEIR
MEDICATION THINK ABOUT REFILLS
AND SO FORTHRIGHT. SO IT MAY
MAKE MORE SENSE IN ORDER TO
SERVE THE POPULATION THAT THEY
HAVE CONTRACTS WITH MULTIPLE
OTHER YOU KNOW PHARMACY SAID
THAT THAT BECAUSE THEY'RE NOT TO
BE ALL SET UP THEIR OWN PHARMACY
EVERYWHERE RIGHT IN THE HOLE IN
THE WHOLE AREA. SO I CONTRACT
PHARMACY MAY MAKE SENSE NOW
EXACTLY DO THE CONTRACT WITH AND
WHY. THAT'S THE L. THAT'S NOT
REALLY MUCH- I DON'T MAKE THOSE
KIND OF DECISIONS- SO WHY DO
THEY CHOOSE THE CONTRACT WITH
ONE PHARMACY AND NOT ANOTHER.
BUT MAYBE I'LL GO AND PASS IT TO
MISS TYPE OF TALK ABOUT EXACTLY
HOW. SOLID COVERED ENTITIES SITE
YOU KNOW. MAKE DECISIONS ON. WHO
THE CONTRACT WITH AND- AND WHY
THEY CONTRACT WITH THE PHARMACY.
YEAH I MEAN APPRECIATE THE
CONCERN ABOUT HOW THE STATE
PHARMACIES TO BE HONEST THIS IS.
THE FIRST TIME I'M HEARING ABOUT
THIS CONCERNS WILL BE HAPPY TO
HAVE MORE DISCUSSION ABOUT THIS
FOR I CAN SPEAK FROM A P. LA OUR
GOAL TO
ACCESS TO MEDICATION FOR
PATIENTS SO THAT MEANS HAVING
ACCESS TO A PHARMACY IN THEIR
NEIGHBORHOOD. AND SO WE CONTRACT
WITH. ONE COMMUNITY PHARMACIES
THAT ARE THERE ARE CLINICS SO
PATIENTS CAN ACCESS MEDICATION-
I'M NOT AS FAMILIAR WITH THE OUT
OF STATE ISSUE BUT WOULD HAPPY
TO YOU KNOW TALK ABOUT THIS
MORE. YEAH AND I APPRECIATE THAT
IT'S JUST THAT YOU KNOW ON A LOT
OF HEALTH ISSUES THIS IS MY
SIXTH YEAR HON HEALTH COMMITTEE-
AND I MEAN AND CERTAINLY THE
REGION MATTERS. AND IF YOU ARE
IN A COMMUNITY LIKE- YAMA- AND
YOU DON'T HAVE A CONTRACT THERE
WITH THE PHARMACY I MEAN. THAT'S
A PRETTY. YOU KNOW LOW LOW
INCOME COMMUNITY THAT'S GOING TO
NEED AND CAN BENEFIT IF THAT YOU
KNOW FROM THIS. AND I WANT TO
KNOW WHAT THE TRADES ARE THE
TRADE OFFS ARE- IF WE DON'T HAVE
THE ACCESS TO LOCAL COMMUNITIES
AND LIKE I SAID I'M NOT AS
WORRIED ABOUT COMMUNITIES IN
OCTOBER THERE'S TONS OF
HOSPITALS AND CLINICS. THERE BUT
IT'S SOME OF MY OTHER
COMMUNITIES THAT I REPRESENT
THAT HAVE MUCH MORE. LIMITED AND
YOU SEE THIS TREND OF LIKE. WE
BUT THEY DON'T HAVE ACCESS TO
THIS YOU KNOW HAVE ACCESS TO
THAT- AND SO IT. OF TELLS UP SO
IF WE COULD. YOU KNOW IF YOU CAN
ALL JUST HELP ME BETTER
UNDERSTAND THIS I AM CERTAINLY
VERY SUPPORTIVE AND I APPRECIATE
THIS BECAUSE EVERY YEAR WE HAVE
A THREE FORTY B. CONVERSATION-
SO THANK YOU. IF OKAY THANK YOU
SENATOR LEMON WE'LL MOVE ON TO
SENATOR RON. THANK YOU MA'AM BYE
SURE THIS ISA PRETTY
COMPLICATED ISSUE AND EVERY TIME
WE PICK UP ONE OF THESE THREE
FORTY BILL BE BILLS I HAVE TO.
GO BACK AND TRY TO REFRESH MY
VERY OLD BRAIN WHAT'S LEFT OF IT
AS TO HOW THIS THING WORKS. AND
I'VE BEEN LISTENING TO THIS
CONVERSATION ABOUT MAIL ORDER
PHARMACIES. THREE FORTY B.
PATIENCE I DIDN'T FIND A
DEFINITION OF THAT IN THE
MATERIAL BUT I ASSUME WE'RE
TALKING ABOUT A PATIENT OF A
COVERED ENTITY WHEN WE TALK
ABOUT THE THREE FORTY BE
PATIENT. I THINK IT'S IMPORTANT
NOT TO LOSE SIGHT OF WHAT WE'RE
TALKING ABOUT HERE WERE AS I
UNDERSTAND IT WE'RE REALLY
TALKING ABOUT A PROGRAM THAT WAS
DESIGNED. AND HAS BEEN DESIGNED
FROM ITS OUTSET TO HELP COVERED
ENTITIES USER THESE ARE CLINICS
THESE ARE NONPROFIT HOSPITALS A
VARIETY OF OTHER HEALTH CARE
PROVIDERS THAT ARE LISTED BOTH
IN OUR ANALYSIS AND A BILL. TO
HELP THESE COVERED ENTITIES
CONTINUE TO PROVIDE VARIOUS
SERVICES BY BY REDIRECTING OR
DIRECTING MONEY TO THEM
ESSENTIALLY THE DELTA BETWEEN
THE DISCOUNT AND WHAT THEY
ULTIMATELY BILL. THE PAIR. AND
THAT'S VERY VERY IMPORTANT AND
WE'RE TALKING ABOUT WHERE THE
PHARMACIES ARE LOCATED IN THIS
THAT ANOTHER AND MAIL ORDER
PHARMACIES THIS THAN THE OTHER
AND I DON'T RECALL WHETHER
THEY'RE APPROVED BY PERMITTED BY
FEDERAL OR NOT I'LL LEAVE THAT
TO THE PEOPLE THAT ARE MUCH
SMARTER THAN I AM BUT I THINK
IT'S IMPORTANT BECAUSE THIS
DELTA AND IT WAS IMPORTANT
FRANKLY BEFORE WE. SHOTS BUT
WILSON COUNTY HOSPITALS TO HELP
THEM STAY AFLOAT AND CONTINUE TO
PROVIDE SERVICES. WE SHOULD ALSO
NOTE THAT THIS YOU KNOW THIS
PROGRAM APPLIES WHETHER THE KING
OF THE COVERED ENTITY IS
ULTIMATELY REIMBURSE FOR THE
DISPERSED. UP PRESCRIPTION DRUGS
THE PHARMACEUTICAL BUT BY MEDIC
COW REGARDLESS WHETHER THEY GET
IT FROM MEDICARE- MEDICARE
COMMERCIAL INSURANCE. YOU
SHOULDN'T SERVE THEM PATIENTS
THEMSELVES. THESE CONTRACT
PHARMACIES- THEY CONTRACT WITH
THESE COVERED ENTITIES TO
DISPENSE THREE FORTY B. DRUGS.
ON THE COVERED ENTITY'S BEHALF
AND I THINK THAT WAS MENTIONED
BEFORE BUT I THINK THAT PHRASE
WHICH IS IN OUR ANALYSIS IS KEY
THEY DISPENSE ON THE COVERED
ENTITIES. BUT I HAVE SO THE
DISCOUNT IS THE COVERED ENTITY'S
DISCOUNT NOT THE PHARMACIES
DISCOUNT AND M. AS THE ANALYSIS
PROVIDES THIS HEALTH RESOURCES
AND SERVICES ADMINISTRATION.
CONDUCTS DOES THE ANALYSIS SAYS
A SYSTEMATIC APPROACH TO
AUDITING. THE COVERED ENTITIES
IN THE PHARMACIES TO MAKE SURE
THAT THE DISCOUNTS ARE
APPROPRIATELY PROVIDED AND I
NOTICED ONE OF THE COMMENTATORS
ALSO MADE NOTE OF THE FACT THAT
THE MANUFACTURERS AND THE PBMS
ANOTHER ISSUE THAT WE SEEM TO BE
DEALING WITH A LOT. BUT BOTH OF
THOSE OPERATIONS HAVE THE HAVE
THE OPPORTUNITY AND PRESUMABLY
EXERCISE THE OPPORTUNITY TO
REGULARLY AUDIT. THE COVERED
ENTITIES IN THE CONTRACT
PHARMACIES TO MAKE SURE THAT THE
DISCOUNTS ARE APPROPRIATELY
APPLIED. AND WE'RE TALKING ABOUT
COVERED ENTITY PATIENTS
PRESCRIPTIONS THAT ARE BETTER
THE OTHER BEING FILLED SO. LOOK
AT THERE ARE A LOT OF CONTINUED
QUESTIONS THE UNFORTUNATE
CONSEQUENCE OF OUR CURRENT
FORMAT IS I DON'T HAVE THE
SPEAKERS IN FRONT OF ME AT THE
PANEL. BECAUSE SOME OF YOU WHO
HAVE SEEN THE CHAIR COMMITTEES I
ENJOYED TAKING EACH ONE OF THEM
IN ASKING A SERIES OF DETAILED
QUESTIONS I CANNOT DO THAT
TODAY. BUT I AM GOING TO SUPPORT
THE BILL I URGE MY COLLEAGUES TO
SUPPORT THE BILL WE SHOULD
CONTINUE TO HAVE CONVERSATIONS
WITH WITH ALL OF THE FOLKS WHO
SPOKE TODAY AND THOSE WHO
DIDN'T. I'D LIKE TO FIND OUT
SPECIFICALLY WHAT ADDITIONAL
DATA THE MANUFACTURERS ARE
FOREVER THAT WAS IT SPOKE WANT
TO RECEIVE FROM THE COVERED
ENTITY'S AND THE CONTRACT
PHARMACIES WHAT DATA. IT IS THEY
WANT TO GET THAT I ALSO WANT TO
FIND OUT WHAT DATA THEY GET. THE
MONTHLY- BUT IT'S THE DAY IN THE
PBMS CONDUCT OF THE COVERED
ENTITY'S AND THE CUT CONTRACT
PHARMACIES TO TRY TO FIGURE OUT
WHAT THIS ISSUE REALLY IS. FOLKS
HAVE BEEN TALKING ABOUT BILLIONS
OF DOLLARS OF PROFIT. MAYBE I
MISSED IT IN THE ANALYSIS BUT I
HAVEN'T SEEN ANY DATA ANY
SPECIFIC DATA. ON THAT ON THAT
PROFITABILITY FACTOR THAT
APPARENTLY. SOME ARE ALLEGING
THAT LARGE PHARMACIES OR OR- ARE
REALIZING ON THIS THREE FORTY B.
PROGRAM SO I'M GOING TO STOP
TALKING THANK YOU DUCK PLAN FOR
BRINGING THIS WE'RE GOING TO
HAVE ADDITIONAL CONVERSATIONS
AND I LOOK FORWARD TO MEETING
WITH THE FOLKS HAVE SPOKEN ON
BOTH SIDES OF THIS. IN MY OFFICE
OR OTHERWISE TO ASK A FEW MORE
THANK YOU. PLACE YOUR- THANK YOU
SENATOR ROTH- SENATOR WHO TAUGHT
. THANK YOU MADAM CHAIR. I JUST
WANT TO START OFF WITH A SAME
THAT'LL BE SUPPORTING
LEGISLATION TODAY OBVIOUSLY IT
LIKE. OTHERS ARE OTHER
COLLEAGUES ON THIS IN THIS
COMMITTEE- I HAVE SOME CONCERNS
. AND I'M GONNA TRY TO KIND OF
WALK THROUGH MY THINKING PROCESS
IN TERMS OF THE QUESTIONS THAT I
THAT I'VE HAD OVER THE LAST
COUPLE OF DAYS. AND I START OFF
WITH DOING YOUR RESEARCH ON MY
OWN RIGHT TRYING TO GET A LITTLE
BETTER UNDERSTANDING OF WHAT THE
THREE FORTY B. PROGRAM. DOES WHO
IT UP YOU KNOW- WHAT APPLIES TO
WHAT IT COVERED AND LIKE. WHAT
IS A COVERED ENTITY TO BEGIN
WITH RIGHT AND I THAT WAS THE
FIRST. MY FIRST QUESTION AND-
UNDER THE FAIR AND UNDER MY
RESEARCH I FOUND THAT-
PHARMACIES ARE ALSO INCLUDED AS
PART OF A COVER DEFINED AS A
COVERED ENTITY IS THAT IS THAT
YOUR UNDERSTANDING AS WELL. ONE
OF THE ONE OF THE QUESTIONS I
HAVE WELL I MEAN THEY CUT
COVERED ENTITIES CONTRACT WITH
PHARMACIES BUT PHARMACIES
THEMSELVES ARE NOT COVERED
ENTITIES OKAY BUT THAT COULD BE
BE A COVERED ENTITY WELL ON
THEIR OWN IF YOU'RE A FAR WELL
L. AT A PHARMACY IT STANDS ALONE
I MEAN YOU HAVE COVERED ENTITIES
THAT OPERATE FROM THAT THAT MAY
HAVE PHARMACIES. IT'S NOT ALL OF
THEM BUT SOME MAY OPERATE A FARM
A FARM A PHARMACY ESSENTIALLY
WITHIN THEIR INSTITUTION LIKE A
HOSPITAL LIKE A SAFETY NET
HOSPITAL MAY HAVE A PHARMACY
YEAH THERE'S A THERE'S A FEDERAL
DEFINITION OF A THREE FORTY B.
COVERED ENTITY- SO THAT INCLUDES
COMMUNITY HEALTH CENTERS RYAN
WHITE CLINICS AS THE EYE CLINICS
TITLE TEN PROVIDER CERTAIN
HOSPITALS BUT PHARMACIES ARE NOT
INCLUDED IN THAT DEFINITION. AND
OKAY BECAUSE I. THE WEBSITE I
WAS WAS BETTER WEBSITE EIGHT
THAT'S YEAH UNDER THERE HAS A
HEALTH CARE PROVIDER AND THEN
HAS SEVERAL. HAS DOCTORS CLINICS
PSYCHOLOGIST- PHARMACIES MAYBE
MAYBE I READ IT WRONG MAYBE IT
WAS IT WAS REALLY LATE SO I WILL
SAY THAT- WAT I ALSO FOUND IS
THAT. THAT THERE'S COVERED
ENTITIES AND BUSINESSES. WHICH I
WOULD ASSUME THAT. BUSINESS
ASSOCIATES BEING CONTRACT
PHARMACIES. YEAH YEAH THAT'S A
GREAT QUESTION I'M NOT AS
FAMILIAR WITH THAT TERM NICOLE
MIGHT BE MORE FAMILIAR WITH THAT
TERM. AND I WOULD TAKE THAT TO
BE OUR CONTACT PHARMACY BUT AS-
NOW I'M I'M I'M NOT CERTAIN WHAT
THEY MEANT EITHER. BECAUSE IT
SAYS HERE IT'S BEEN ON THE
WEBSITE HERE IT SAYS THAT THE
HIPPA RULES APPLY TO COVERED
ENTITIES AND BUSINESS
ASSOCIATES- INDIVIDUALS
ORGANIZATIONS AND AGENCIES THAT
MEET THE DEFINITION OF A COVERED
ENTITY UNDER HIPAA MUST COMPLY
WITH THE RULES AND REQUIREMENTS
TO PROTECT THE PRIVACY AND
SECURITY OF HEALTH. IT ALSO GOES
ON TO SAY THAT IF IT ENTITY DOES
NOT MEET THE DEFINITION OF A
COVERED ENTITY OR BUSINESS
ASSOCIATE WHICH I ASSUME IS A
CONTRACT PHARMACY. THAT IT DOES
NOT HAVE TO COMPLY WITH HIPPA
RULES. SO AND- YEAH. THAT THAT'S
THE HIP FLASK. THAT'S A
DIFFERENT THING THAN THREE FORTY
B. WELL THAT'S THE HIPAA PRIVACY
LAW. NO I I'M FAMILIAR WITH WITH
HIP- BUT I'M I'M TALKING IN
TERMS AND CONTEXT OF THIS PIECE
OF LEGISLATION BECAUSE- SEE MY
CONCERN AND THE WAY I MAY BE A
MIS READ IT BUT IT SAYS HERE
THIS BILL PROHIBITS THE PHARMACY
BENEFIT MANAGER FROM IMPOSING
ANY REQUIREMENT CONDITIONS. OR
EXCLUSIONS THAT DISCRIMINATE GET
DISCRIMINATE AGAINST A. C. E. OR
A SPECIFIED PHARMACY IN
CONNECTION WITH DISPENSING COVER
DRUGS SO I'M TRYING TO FIGURE
OUT IF THE SPECIFIED. PHARMACY
IS THE- THE BUSINESS- ASSOCIATE
THAT IS COVERED UNDER COVERED
ENTITIES OR IS IT SOMETHING
COMPLETELY DIFFERENT. I THINK IT
SAID THEY WERE THEY WERE TALKING
ABOUT THE CONTRACT PHARMACY WITH
THE- COVERED ENTITY OKAY.
BECAUSE I KNOW THAT ALSO ON THE
BILL IT GOES ON TO DEFINE A
SPECIFIED PHARMACY AS WELL SO. I
WANTED TO GET MORE MORE CLARITY
ON THAT AND I THINK THAT- ON MY
FROM MY POINT OF VIEW I THINK
THERE'S A- THERE'S A LOT MORE
THAT WE NEED TO DO IN TERMS OF.
LOOK WE JUST HEARD EARLIER TODAY
AND THIS COMMITTEE THAT WE HAVE
EIGHT EIGHT SENTINEL- EPIDEMIC
WE HAVE. AN OPIOID CRISIS IN THE
UNITED STATES AND- WE HAVE TO
ALSO UNDERSTAND THAT THERE'S-
BAD ACTORS OUT THERE NOTHING
THAT ANYONE IN THIS. IS- BUT I
YOU KNOW THERE HAS TO BE SOME
ACCOUNTABILITY WHEN IT COMES TO
DISPENSING OP ED YOU NOTE DRUGS
AND MY CONCERN IS THAT. ALONG
THIS WAY IN THIS PATH THAT WE
ARE POTENTIALLY. EXPOSING MORE
INDIVIDUALS IN IT TO ACCESS.
DRUGS THAT MAYBE THEY SHOULDN'T
BE ACCESSING THAT WILL HAVE BAD
ACTORS- BECAUSE IT I'M ASSUMING
THAT THERE'S ALREADY BAD ACTORS
AND OF COURSE THERE'S ALREADY AN
EFFORT. AN AUDIT THAT. TAKES
INTO ACCOUNT AND REMOVE THOSE
BAD ACTORS FROM THE PROCESS. SO
I I'M CONCERNED THAT IF
EXPANDED- THAT THAT YOU KNOW
WE'LL WE'LL HAVE THAT THERE BE
LESS ACCOUNTABILITY SO I JUST
WANTED TO OPT. EXPRESSED MY
CONCERNS TODAY AND CAN COMMITTEE
I WILL BE SUPPORTING THE BILL
TODAY I WILL BE DOING MORE
HOMEWORK AND RESEARCH ON THIS
BECAUSE I JUST I DUG IN AND I
FOUND IT INTERESTING AND SO- AND
IF I MAY ASK TO THE SPONSORS OF
THE BILL. I KNOW YOU SAID YOU
HAD A CONTRACT FORM A CONTRACT
PHARMACIES THAT YOU WORK WITH.
THAT LIKE HOW MANY AND ARE ANY
OF THOSE OUT OF STATE. YEAH I
KNOW NONE OF THEM ARE OUT OF
STATE I DON'T WANT TO GIVE YOU
AN INCORRECT ANSWER ON HOW MANY
WE HAVE BECAUSE I. AM NOT FIRMLY
AWARE WE HAVE FIVE CLINICS
ACROSS LA COUNTY. AND SO I KNOW
WE CONTRACT WITH AT LEAST FIVE
CONTRACT PHARMACIES WHERE
PATIENTS HAVE ACCESS TO
MEDICATION BUT I COULD GET BACK
TO YOU WITH A SPECIFIC NUMBER
BUT- CERTAINLY NONE OF THEM ARE
OUT OF STATE THEY'RE ALL. CLOSE
TO THE CLINIC WHERE WE PROVIDE
SERVICES OKAY AND HOPEFULLY WE
CAN CLARIFY THE STATEMENT ABOUT
OUT OF STATE EXACTLY WHAT WE
TALKED ABOUT SO FOR EXAMPLE IS
IF YOU'RE KIND OF A CONTRACT
WITH WALGREENS BECAUSE HAPPENS
WALGREENS HAS A LOT OF
PHARMACIES AND YOUR- DATE ARE
SERVING THE AREA TRYING TO
SERVE. THAT COULD BE CONSIDERED
OUT OF STATE BUT THE REASON
YOU'RE DOING IT'S BECAUSE YOU
WANT PHARMACIES THAT ARE IN THE
AREA WHICH YOU'RE SERVING IN THE
NAVY YOU KNOW. I HAVE HERE IS MY
DISTRICT ARE LOW INCOME AND WE
DO HAVE SOME COMMERCIAL THEY'LL
PHARMACIES RITE AIDS WALGREENS
OF WHAT. IT TURNED OUT THEY ARE
THE ONES THAT PEOPLE GO TO
BECAUSE THEY'RE WONDERFUL REST
CONVENIENCE SO. ERIC CLINIC MAY
CHOOSE TO THEREFORE. HAVE A
CONTRACT WITH THEM TO MAKE THE
MEDICATIONS MORE ACCEPTABLE. TO
THOSE PATIENTS THOSE
NEIGHBORHOODS. AND THEN I GUESS
JUST THE LAST QUESTION AND I.
PROMISE THIS IS THE LAST ONE. I
WONDER IF- SO. AS PART OF THE
DEAF THE DEFINITION OF. THE BILL
IT SAYS INTERFERE WITH AN
INDIVIDUAL'S CHOICE RECEIVE A
COVER DRUG FROM C. E. OR
SPECIFIED PHARMACY. WHETHER
PERSON OR VIA DIRECTLY DELIVERY
MAIL OR OTHER FORM OF. SHIPMENT
AND WE CAN YOU JUST. ELABORATE
AS TO. AT THAT THAT COMPONENT OF
THE BILL. YES SIR NICOLE HAD
SPOKEN TO THIS ISSUE SO PBMS CAN
IMPLEMENT MAIL ORDER
REQUIREMENTS SO ESSENTIALLY
INSTEAD OF PATIENTS BEING ABLE
TO PICK UP MEDICATION FROM-
COMMUNITY OR RETAIL PHARMACY
THEY'RE REQUIRED TO RECEIVE
THOSE MEDICATIONS THROUGH MAIL
ORDER SO SOME OF THE EXAMPLES
NICOLE MENTIONED WERE PEOPLE
WITH HIV PEOPLE TAKING HIV
PREVENTION MEDICATIONS.
TRANSPOSED WHO WOULD HAVE
SENSITIVITY ISSUES ABOUT
RECEIVING THEIR MEDICATIONS IN
THE MAIL SO THE BILLS INTENDED
TO PREVENT THOSE MANDATORY MAIL
ORDER REQUIREMENTS AND MAKE SURE
THAT PATIENTS CAN PICK UP THEIR
MEDICATION IN PERSON IF THEY
NEED TO. THANK YOU. ALREADY
THANK YOU SO MUCH AND SENATOR
WIENER HAS HAD A CHANGE OF HEART
AND HAS. THAT'S TO SAY. I DID
I'M A I'M A CO AUTHOR I SHOULD
SAY SOMETHING- NO I JUST I WANT
TO THANK THE AUTHOR FOR LEADING
ON THIS AND I'M HAPPY TO BE A CO
AUTHOR OF THE BILL AND THE
REASON I CALLED IT IT IS-
THROUGH THREE FORTY P. PROGRAM
IS A REALLY REALLY IMPORTANT
PROGRAM AND- IT'S A LIFELINE
FOR- SO MANY- COMMUNITY CLINICS
AND CALIFORNIA AND ELSEWHERE AND
THESE ARE. THE CLINICS THAT
PROVIDE- OFTEN HEALTH CARE TO
PEOPLE WHO DON'T REALLY HAVE-
OTHER OPTIONS- BECAUSE OUR
FRONTLINE COMMUNITY CLINICS OR
IN DIRECTLY IN IMPACTED
COMMUNITIES THAT ARE CULTURALLY
COMPETENT- THAT THAT KNOW HOW TO
REACH INTO THESE COMMUNITIES AND
CONNECT PEOPLE TO CARE- AND
THESE ARE LIKE APL- YOUR- THE
SAN FRANCISCO AIDS FOUNDATION-
PLANNED PARENTHOOD AND- THESE
ARE CLINICS THAT WE SHOULD BE
SUPPORTING AND THREE FORTY B.
AS- ESSENTIAL. FOR THEM TO NOT
TO SURVIVE BUT TO BE STRONG AND
TO SAVE LIVES IN A HEALTHCARE
SYSTEM THAT ISN'T ALWAYS THE
BEST- AT PROVIDING CULTURALLY
COMPETENT CARE- TO SERVICE SOME
OF THE MOST MARGINALIZED
COMMUNITIES SOME A STRONG.
SUPPORTER OF THE THREE FORTY B.
PROGRAM- WELL I WAS WITH AND
PROGRAM A SPECIAL A BIG NATIONAL
PROGRAM. IF THERE BUT IT'S NEVER
GOING TO BE PERFECT AND WILL
THERE BE ABUSES YES- AND SHOULD
WE BE LOOKING FOR WAYS TO. YOU
KNOW MAKE SURE THAT THE PROGRAM
IS BENEFITING THE- THE
ORGANIZATION THE CLINIC SO. IT'S
SUPPOSED TO BE BENEFITING. CHRIS
AND AS I SAID TO THE OPPONENTS
IF THERE ARE YOU KNOW.
RIDICULOUS ABUSES YOU'RE LOOKING
TO GET- I NOTE THE AUTHOR IT
ALWAYS HAS AN OPEN DOOR TO IF
THERE IF THERE WERE WAYS THAT WE
CAN DO THAT OF COURSE WE SHOULD
BE DOING THAT- BUT I ALSO DON'T
WANT TO THROW THE BABY OUT WITH
THE BATHWATER AND I'M CONCERNED
THAT. SOME OF THESE ARE
PRACTICES- HOW ABOUT A FACT THAT
ARE GOING TO BE HARMFUL TO OUR
COMMUNITY CLINICS- THAT'S ONE
QUARTER IN THE BUILD AND I DON'T
KNOW IF ANYONE'S GONNA MOTION
BUT SOMEONE THAT OKAY WELL I
WILL MAKE A MOTION ABOUT NOTHING
. RATE LAST CALL LAST CALL
ANYBODY ON THIS SIDE OF THE-
COMMITTEE HEARING ROOM OR
SOMETHING. NO OKAY. ALL RIGHT
WELL I THINK- WE'VE HEARD QUITE
A BIT OF TESTIMONY TODAY NOT
ONLY FROM WITNESS. FROM
COMMITTEE MEMBERS- SO. DOCTORS
CAN WE HAVE A MOTION WOULD YOU
LIKE TO CLOSE. THANK YOU AND YOU
KNOW WHAT WE'VE HAD EXTENSIVE
DISCUSSION I DID HAVE A WHOLE
STATEMENT FOR CLOSING BUT YOU
KNOW WHAT I'M- GONNA SAY I
APPRECIATE. APPROVAL APPRECIATE
THE OPPORTUNITY CONTINUE TO WORK
ON THIS IMPORTANT PROTECTOR
SAFETY NET ESPECIALLY ASPIRIN I
THOUGHT. OUR RATE THANK YOU VERY
MUCH THE MOTION IS. DO YOU PASS-
THE COMMITTEE CONSULTANT-
SECRETARY PLEASE TAKE THE ROLE.
HAND BY HAND HI MELINDA'S.
EGGMAN EGGMAN I. GONZALES
GONZALES I GROWTH NO. GROWTH NO
HER TADO I THE TOTAL I. LEIVA
LEAVE I LEAVE ON THE MOON I ROTH
ROTH IRA RUBIO. RUBIO I WINNER
WINNER I. OUR RATE THAT BILL-
THAT'S OUT NINE ONE
CONGRATULATIONS ON YOUR FIRST
SUCCESS OF THE DAY SENATOR PAN
WE WILL MOVE ON NOW TO. ITEM
NUMBER TEN. WHICH IS S. B. NINE
FOUR FOUR PROCEED WHEN YOU'RE
READY OKAY THANK YOU MADAM VICE
CHAIR HOPEFULLY THE OTHER TWO
BILLS A LITTLE LESS CONTENTIOUS-
OR CONFUSING I WILL SAY- SO
ANYWAY- I'M PLEASED TO PRESENT
SP NINE FOUR FOUR WHICH IS A
FOLLOW UP TO A BUDGET TRAILER
BILL FROM LAST YEAR THAT TASK
COVERED CALIFORNIA. TO COME UP
WITH OPTIONS TO REDUCE COST
SHARING PLANS AVAILABLE THROUGH
COVERED CALIFORNIA. THE BILL
WOULD HAVE COVERED CALIFORNIA
ELIMINATE DEDUCTIBLES AND
SUBSTANTIALLY REDUCE COST
SHARING WITH THE MOST GENEROUS.
APPLICATION TO LOWER LOWER
INCOME POPULATIONS I AM WORKING
WITH US SIMPLY CHAIR- HEALTH
COMMITTEE CHAIR WOULD WHO HAS A
MERE VISIT VERSION OF THIS BILL-
THIS BILL IS ABOUT- MAKING
COVERED CALIFORNIA MORE
AVAILABLE AFFORDABLE THIS IS
SOMETHING WE'VE WORKED ON VERY
HARD HERE IN THE SENATE OVER
TIME. IN EFFECT THE FACT THAT IS
THAT COVERED CALIFORNIA'S
PREMIUMS IN FACT OVER THE LAST
FEW YEARS HAVE ACTUALLY BEEN.
THE INCREASES SEVEN UNDER
PERCENT FOR TWO COUPLE YEARS I
THINK THIS YEAR TO AND THAT'S
BECAUSE OF THE WORK THAT WE'VE
DONE TOGETHER HERE IN HE SENATE
SO WE I CONTINUE THAT WORK ON
THE LINES- I'M PLEASED TO HAV
SPONSORING. WHO HAD SPONSORED
THE BILL DIANA DOUGLAS WITH
HEALTH ACCESS CALIFORNIA AND
BIANCA BLOOM QUEST WITH THE
SMALL BUSINESS MAJORITY THANK
YOU. ALL RIGHT THANK YOU SENATOR
PAN- WE WILL GO TO LEAD
WITNESSES IN SUPPORT- MADAME
MODERATOR CAN YOU SEE IF DIANA
DOUGLAS IS ON THE LINE PLEASE.
ALL RIGHT OPEN. DIANA PLEASE GO
AHEAD YOU HAVE TWO MINUTES.
THANK YOU GOOD AFTERNOON MADAM
CHAIR AND MEMBERS OF THE
COMMITTEE MY NAME IS DIANA
DOUGLAS ON BEHALF OF HEALTH
ACCESS CALIFORNIA THE STATEWIDE
HEALTHCARE CONSUMER ADVOCACY
COALITION. YOUR PROBLEM SPONSORS
OF SB NINE FORTY FOUR WHICH WILL
DRAMATICALLY REDUCE THE BURDEN
OF COST SHARING FOR COVERED
CALIFORNIA ENROLLEES. A
SIGNIFICANT PREMIUM ASSISTANCE
PROVIDED BY FIRST THE STATE AND
THE FEDERAL GOVERNMENT MORE
CALIFORNIANS THAN EVER HAVE BEEN
ROLLED IN OUR COVERAGE FOR YOUR
MARKET PLACE. HOWEVER EVEN WITH
COVERAGE BRIGHTENS DOUBLED AND
COPAYS KEEP CARE OUT OF REACH
FOR MANY 60% OF CALIFORNIANS
REPORT FEELING WORRIED ABOUT OUT
OF POCKET COSTS USING HEALTH
INSURANCE. A GREATER PERCENTAGE
THAN THOSE WORRIED ABOUT THE
COST OF HOUSING UTILITIES OR
GROCERIES THIS IS UNSURPRISING
GIVEN DEDUCTIBLES OFTEN ABOUT
SEVERAL MONTHS OF WEIGHT. PERSON
IN A STANDARD CLOVER PLAN MAKING
JUST OVER TWO THOUSAND PER MONTH
MIGHT HAVE A DEDUCTIBLE OF
THIRTY SEVEN HUNDRED THE AMOUNT
THAT WILL RISE TO OVER FORTY
SEVEN HUNDRED BY NEXT YEAR.
THEY'LL BE PAYING A FORTY FIVE
DOLLAR COPAY TO SEE A PRIMARY
CARE DOCTOR AND EVEN MORE THAN
THAT FROM LANCASTER. ESPECIALLY
I PRACTICAL. LESS THAN HALF OF
ALL HEALTH. DIPPING OR DELAYING
. PAST YEAR. F. B. NINE FORTY
FOUR WILL ELIMINATE DEDUCTIBLES
FOR COVERED CALIFORNIA ENROLLEES
AND SILVER PLANS. AND IT WILL
OPERATE ALL OVER PANAMA LEAKS
AND MORE AFFORDABLE HERE'S THE
COST SHARING. THE BILL ALSO
EXTEND CRUSHER AND HELP TO THOSE
IN THE MIDDLE INCOME RANGE
EARNING UP TO SEVENTY FIVE
THOUSAND DOLLARS PER YEAR.
THEY'RE OPTIMISTIC THAT FEDERAL
PREMIUM SUBSIDIES WILL BE
EXPANDED LATER THIS YEAR WHICH
GIVES US THE OPPORTUNITY TO
FINALLY TAKE ACTION TO REDUCE
THE DEDUCTIBLES AND CO PAYS.
THANK YOU SOMEBODY FROM TAKING
CARE WHEN THEY NEED IT. THE
OUTLOOK FORTY CONTINUING TO WORK
WITH THE HEALTH PLANS AND
RESOLVE ANY OPERATIONAL ISSUES
THAT MIGHT ARISE. ON SB NINE
FOUR AM RESPECTFUL ASK IPHONE
THANK YOU FOR YOUR CONSIDERATION
. THANK YOU VERY MUCH DIANA
MIGHT MATTER MODERATOR CAN YOU
PLEASE OPEN UP BIANCA BLOM
QUESTLINE PLEASE. YOUR LINE IS
OPEN GO AHEAD BIANCA WELCOME.
NINE YEARS THANKS TO THE
CHAIRMAN OF THE COMMITTEE FOR
GIVING SMALL BUSINESS AFTER ANY
OPPORTUNITY THAT YOU CAN PUT IT
BACK IN NINE FORTY FOUR I'M
PARTICULARLY EXCITED FOR THAT
AND THAT INCLUDES THE
PORTABILITY BUT HONDA THOUSANDS
OF LOW AND MODERATE INCOME ON
NORTH AND SMALL BUSINESS OWNER.
AND YOU PROBABLY KNOW THERE ARE
OVER FOUR MILLION SMALL
BUSINESSES THAT MAKE UP 99% OF
TOTAL BUSINESSES IN CALIFORNIA
MORE THAN HALF OF ALL ENROLLEES
NATIONWIDE ARE SMALL BUSINESS
OWNERS SMALL BUSINESS EMPLOYEES
MORE THOUGHT THEM WAIT
INDIVIDUAL. RECENT FEDERAL
ASKING TO MAKE HEALTH CARE MORE
AFFORDABLE AND HELP FORMULA AND
IN THE DAY THAT THEY CAN TAKE
ACTION TO REDUCE OUT OF POCKET
COSTS ARE HINDERING
ENTREPRENEURSHIP IN OUR STATE
THE NEED FOR AFFORDABILITY AMONG
CALIFORNIA ON THE NORTHEAST
GROUNDS. KEEPING IN MIND SEVEN
POINT FOUR MILLION WORKERS IN
CALIFORNIA DEPEND ON GOD
PROVIDED BY SMALL BUSINESS
OWNERS THE FORTY FOUR RESEARCH
WE FOUND THAT MORE THAN ONE IN
THREE SMALL BUSINESSES REPORT
THAT IT'S BEEN A CHALLENGE
BECAUSE CAN HELP INSURANCE
COVERAGE THEMSELVES AND THEIR-EMPLOYEES DURING THE CAMPAIGN.
FOR BROADBAND REPORTED BASEMENT
BATTERING REDUCING HEALTHCARE
COVERAGE IN ORDER TO KEEP THEIR
BUSINESSES OPEN ENTREPRENEURS OF
COLOR WERE MORE LIKELY TO
INDICATE MAKING THIS CHANGE
STRONG AFFORDABLE MARKETPLACE
THE CENTRAL FOR A FUTURE
CALIFORNIA NINE NORTH. I THINK
I. FORTY FOR THE CENTRAL PARK
NETWORK BECAUSE THE MEDIAN
INCOME FOR A SMALL BUSINESS
OWNER WITH EMPLOYEES AND JUST
OVER THE COPPER HEALTHCARE
SUBSIDIES WHICH IS ABOUT TWO
THOUSAND DOLLARS. BUT I RESET
OUR RESEARCH SHOWS THAT 70% OF
THOSE POLLED BY EXPANDING
OFFERINGS THAT MEET THE
INDIVIDUAL CAN MAKE UP 26100% OF
THE FEDERAL POVERTY LEVEL IN
CALIFORNIA. FOR THE PAST THREE
YEARSBECAUSE OF THE FEDERAL TAX
CREDITS MORE SMALL BUSINESS
OWNERS HAVE BEEN ABLE TO ACCESS
AFFORDABLE HEALTH CARE.
CALIFORNIA MUST BEGIN TO ADDRESS
ESCALATING COSTS DURING THE NINE
FORTY FOUR DOES A PRETTY SMALL
BUSINESSES ARE NOT EQUIPPED YET
AND WE MUST ACT IN A STRONG
RECOVERY FROM THE CAMP AND I.
ORDERED THE PORK AT NINE FORTY
FOUR FOR CALIFORNIA SMALL
BUSINESS. OWNERS AND
ENTREPRENEURS THANK YOU.
THE OBJECTIVES OF THIS BILL IS
VERY IMPORTANT- WE HAVE
IDENTIFIED SOME OPERATIONAL
TIMING CONCERNS AT HE SPONSOR-
MENTIONED IN THEIR TESTIMONY WE
LOOK FOR TO FURTHER
CONVERSATIONS TRY TO IRON THOSE
OUT. THANK YOU ALL RIGHT THANK
YOU VERY MUCH. I HAD. THANK YOU
MADAM VICE CHAIR TIM MADDEN OF
REPRESENT CALIFORNIA CHAPTER OF
THE AMERICAN COLLEGEOF
EMERGENCY PHYSICIANS AND SUPPORT
THANK YOU VERY MUCH ANYONE ELSE
HERE IN THE COMMITTEE HEARING
ROOM WISHING TO TESTIFY IN
SUPPORT. OKAY WE WILL MOVE ON
TO- OPPOSITION I DON'T BELIEVE
WE HAVE WE HAVE NO LEAD
OPPOSITION WHO WHO'S REGISTERED
. I DON'T KNOW DO ANY TESTIMONY
SUPPORT OF PHONES. ONE YEAH I
JUST WANNA MAKE SURE THERE'S
NOTHING LISTED HERE SO- WE WILL
GO. TO YOU DON'T THERE'S NO ONE
THAT ADDED ON RIGHT I DON'T SEE
ANYTHING ON THE LIST OF LEADERS.
REGISTERED OKAY I DON'T KNOW BUT
I DON'T KNOW THREE PEOPLE ON THE
PHONE NUMBER. FOR ME TO ASK.
YEAH I GOT YOU DON'T WORRY- ALL
RIGHT SO WE WILL- MOVE TO ANY
OPPOSITION IN OPPOSITION TO THIS
BILL WHO'S HERE IN THE COMMITTEE
HEARING ROOM. NO ONE GOING ONCE
GOING TWICE OKAY THEN WE WILL GO
TO THE PHONE LINES MADAME
MODERATOR WHICH OPEN THE LINE
FOR WITNESSES WISHING TO TESTIFY
IN OPPOSITION TO A. B. NINE FOUR
FOUR. I'M SORRY SP NINE FOUR
FOUR MY APOLOGIES. THANK YOU IF
YOU WISH TO SPEAK IN OPPOSITION
TO FC NINE FOUR FOUR PLEASE
CORRECT ONE ZERO I THINK TIME.
YEAH SUPPORT. OKAY I'M SORRY DID
I SKIP YOUR SUPPORT I APOLOGIZE
ON THE PHONE BUT A MODERATOR.
SCRATCH THAT WE WANT THOSE ON
THE PHONE WHO WISH TO TESTIFY IN
SUPPORT OF THIS BILL I THINK THE
LENGTH OF THE LAST BILL WENT ON
TO LONG I JUST ASSUME WE'VE
ALREADY DONE THAT. WE HAVE NOT.
MY MODERATOR THE REMOTE. YES TO
REMOVE YOURSELF FROM THE QUEUE
PLEASE PRESS ONE AT THE END OF
THE ROYAL. SAVE YOURSELF IN CUBA
FOR SUPPORT OF SB NINE FOUR FOUR
PLEASE PRESS ONE ZERO ACTUAL
TIME. OVER TO ONE SEVENTY SIX
PLEASE GO AHEAD THANK YOU. THANK
YOU MADAM VICE CHAIR AND MEMBERS
ALEX CALLING ON BEHALF OF THE
CALIFORNIA CHRONIC CARE
COALITION AND STRONG SUPPORT
THANK YOU. THANK YOU I'M AT ONE
PLEASE GO AHEAD. HELLO THIS IS
KEVIN HANDS GO WITH THE FRIENDS
COMMITTEE ON LEGISLATION
CALIFORNIA AND STRONG SUPPORT OF
SB NINE FOUR FOUR THANK YOU.
THANK YOU I. NINETY PLEASE GO
AHEAD. GOOD AFTERNOON MADAM
CHAIR AND MEMBERS STAND OBRERO
ON BEHALF OF THE CALIFORNIA
SCHOOL EMPLOYEES ASSOCIATION IN
SUPPORT. THANK YOU I'M ONE
HUNDRED PLEASE GO AHEAD. GOOD
AFTERNOON LINDA WAY WITH WESTERN
CENTER ON LAW AND POVERTY IN
SUPPORT THANK YOU. THANK YOU I
WANNA ONE PLEASE GO AHEAD. GOOD
AFTERNOON FAITH BOARDED ON
BEHALF OF THE CALIFORNIA AGENTS
AND HEALTH INSURANCE
PROFESSIONAL PROPERTY OF THE DAY
AND THE RELATED WORKING GROUPS
IN STRONG SUPPORT. THANK YOU ALL
RIGHT NINETY FIVE PLEASE GO
AHEAD. HELLO GOOD AFTERNOON HERE
AND NUMBER IF YOU'RE NOT
FAMILIAR WITH THE CALIFORNIA
LABOR FEDERATION AND OF COURSE.
THANK YOU I AM SEVENTY SEVEN
BEFORE I HAVE. GOOD AFTERNOON
REBECCA GONZALEZ OF THE NATIONAL
ASSOCIATION OF SOCIAL WORKERS
CALIFORNIA CHAPTER IN SUPPORT.
THANK YOU I'M TWENTY FOUR PLEASE
GO AHEAD. AFTERNOON JENNY TO DO
WITH COMMUNITY HEALTH INITIATIVE
OF ORANGE COUNTY IN SUPPORT OF
SB NINE FORTY FOUR. THANK YOU
WHY NINETY EIGHT PLEASE GO AHEAD
. HI MY NAME IS STEPHANIE TALK
ABOUT- WITH CALIFORNIA
PHYSICIANS ALLIANCE CALLING IN
SUPPORT OF SB NINE FORTY FOUR
THANK YOU. THANK YOU I HAVE NO
FURTHER COMMENTS THANK YOU.
THANK YOU SO MUCH MAN MODERATOR
OKAY NOW WE WILL GO TO
OPPOSITION MY APOLOGIES DOCTOR
PAN- OKAY SO WE DON'T HAVE ANY
LEAD WITNESSES IN. OPPOSITION
REGISTERED SO WE WILL AGAIN ASK
ONE MORE TIME HERE THE COMMITTEE
HEARING ROOM I DON'T SEE ANYONE
SO WE'LL GO TO THE PHONE LINES
BUT A MODERATOR CAN OPEN UP THE
PHONE LINES FOR THOSE WHO WISH
TO TESTIFY IN OPPOSITION TO SB
NINE FOUR FOUR. THANK YOU IF YOU
WISH TO SPEAK IN OPPOSITION TO
SB NINE FOUR FOUR PLEASE PRESS
ONE SEVEN ZERO AT THIS TIME. I
HAVE NO COMMENT THANK YOU ALL
RIGHT THANK YOU SO MUCH MY
MODERATOR CENTER WILL BRING IN
HERE TO THE COMMITTEE MEMBERS
THERE'S- WE HAVE SENATOR RUBIO
WHO WISHES TO ASK QUESTIONS OR
ANYONE ELSE. YOU KNOW OKAY.
THANK YOU MADAM CHAIR INTO YEP
THIS WILL BE QUICK I JUST THINK
THIS IS A REALLY GOOD BELL AND-
NOT LIKE TO MOVE THE BILL AND
ALSO ASKED TO BE ADDED AS A CO
AUTHOR WHEN APPROPRIATE THANK
YOU MADAM CHAIR. ALRIGHT DULY
NOTED THANK YOU ANYONE ELSE
GOING ONCE GOING TWICE OKAY
CENTER WOULD YOU LIKE TO CLOSE-
PROVIDES FIVE DEAD MENTIONED AT
THAT WE WILL BE WORKING WITH THE
HEALTH PLANS ON THE OPERATIONAL
ISSUES. AND STRICTLY ASPEN
EITHER THANK YOU. ALL RIGHT
THANK YOU SO MUCH THERE IS A
MOTION AND IZZY DO PASS BUT
FIRST BE REFERRED TO THE
COMMITTEE ON APPROPRIATIONS
MADAM SECRETARY WOULD YOU PLEASE
TAKE THE ROLE. HAND HI. CAN I
MELINDA'S NO MELINDA'S NO EGGMAN
EGGMAN I CAN SOLACE GROVE GROVE
NO HER TADO FOR TOTAL I. LEIVA
LEAVE EILEEN MOANS THE NON I.
ROTH ROTH IRA RUBIO RUBIO I
WINNER WINNER I. OKAY OH HERE
SHE COMES. ON S. B. NINE THREE
NINE AND SOLACE THEMSELVES I SHE
NO THAT'S NINE FOUR FOUR. BY
TAKING THESE OKAY SORRY HONESTY
NINE FOUR FOUR GONZALEZ HI.
IRATE THAT BAIL IS OUT NINETY
TWO CONGRADULATIONS CENTER PAN
ON YOURS. NO PROBLEM ON THE
SHELF. FOR YOUR SECOND SUCCESS
OF THE DAY WILL MOVE NOW TO THE
FINAL BILL OF THE DAY ITEM
NUMBER ELEVEN WHICH IS S. B. ONE
TWO THREE FOUR CENTER PANTS
THANK YOU ADAM VICE CHAIR-
SENATORS SP ONE TWO THREE FOUR
TWELVE THIRTY FOUR REQUIRES THE
FAMILY PACK PROGRAM TO COVER
SIXTY TRANSMIT INFECTION
SCREENING AND TREATMENT SERVICES
FOR INCOME ELIGIBLE PATIENTS
REGARDLESS OF THE REASON FOR
VISITING THE PROVIDER. UNTREATED
STIS CAN HAVE SERIOUS LONG TERM
EFFECTS INCLUDING INFERTILITY
BLINDNESS CERVICAL CANCER AND
NEGATIVE MATERNAL AND CHILD
HEALTH OUTCOMES CALIFORNIA DOES
NOT HAVE A STANDALONE PROGRAM
FOR LOW INCOME UNINSURED PEOPLE
TO ACCESS STI CARE AND WHAT
FAMILY PACKAGE COVERS STI
SERVICES IS ONLY WITHIN THE
CONTEXT OF A FAMILY PLANNING
VISIT PEOPLE WHO AREN'T AT RISK
FOR EXPERIENCING CAUSING
UNINTENDED PREGNANCY AREN'T
ELIGIBLE FOR FAMILY PRACTICE
SERVICES. VALUE PACK PROGRAM HAS
A NETWORK OF MORE TWO THOUSAND
COUNTRY CULTURALLY COMPETENT
PROVIDERS BUT WE'LL TRY TRAINED
TO DELIVER STI SERVICES
MAXIMIZING EXISTING PROGRAM LIKE
FAMILY PACK OFFERS A PATHWAY FOR
EQUITABLE STI COVERAGE COMPARED
TO CREATE A BRAND NEW PROGRAM
CHECK THE SCOPE OF THE TI THE
STI EPIDEMIC REQUIRES ACTION NOW
THE CODE NINETEEN PANDEMIC IS
EXASPERATED RATES IN CALIFORNIA
ACROSS THE COUNTRY THE CRISIS
LEVELS. THAT'S THE ONE TWO THREE
FOUR AIMS TO IMPROVE HEALTH
OUTCOMES BY EXPANDING ACCESS TO
STI PREVENTION AND TREATMENT FOR
LOW INCOME UNINSURED PATIENTS
THROUGH FAMILY PACKED I
RESPECTFULLY ASK FOR AN ARTIST
AND WE HAVE THE AND SUPPORT-
TAMMY MARTIN FROM EQUALITY
CALIFORNIA ILLINOIS SHOP IS. A
FORMER- FAMILY PACK PATIENT.
WHEN THANK YOU SO P. WE WILL GO
TO A LEEWAY. A SUPPORT MODERATE
IF YOU CAN PLEASE SEE IF TAMMY
MARTIN IS ON THE LINE. THE WIDE
OPEN. GO AHEAD TELL ME GOOD
AFTERNOON THANK YOU SO MUCH GOOD
AFTERNOON SHARING COMMITTEE
MEMBERS THIS IS TOMMY MARTIN ON
BEHALF OF EQUALITY CALIFORNIA
AND WE ARE ONE OF THE PRAGUE CO
SPONSORS OF THE BILL AND WE
JOINED THIS EFFORT BECAUSE THE
LGBTQ PLUS COMMUNITY-
EXPERIENCES SEVERE NEGATIVE
HEALTH DISPARITIES IN MANY WAYS
INCLUDING WEST ACTUALLY IRATE.
AND B. ANALYSIS LEAVES OUT THE
MANY REASONS FOR THESE
DISPARITIES REASONS THAT OFTEN
IMPEDE ACCESS AND CREATE
CONFIDENTIALITY CONCERNS FOR
LGBTQ PLUS PATIENTS USE AS WELL
AS COMMUNITIES OF COLOR SO THIS
IS PARTICULARLY IMPORTANT FOR
OUR COMMUNITY. SAMPLE THE
CALIFORNIA HE CONTROL BRANCH
REPORTS THAT MEN WHO HAVE SEX
WITH MEN CONSTITUTE MORE THAN
HALF OF REPORTED. MAIL GONORRHEA
CASES IN TWO THOUSAND SEVENTEEN
AND WE ALSO KNOW THAT MORE THAN
HALF OF ALL S. T. I THINK
CALIFORNIA ARE EXPERIENCED BY
YOU BETWEEN THE AGES OF FIFTEEN
AND TWENTY FOUR. SO WE ALL
RECOGNIZE THAT THE PANDEMIC HAS
ONLY EXACERBATED ACTUALLY IRATE
AND LONGSTANDING HEALTH
DISPARITIES. AND OF COURSE
CALIFORNIA HAS MADE GREAT
STRIDES IN EXPANDING HEALTHCARE
ACCESS BUT WE NEED TO CLOSE
REMAINING COVERAGE GAPS THAT ARE
DRIVING SD I READ AND-
DISPARITIES. IN A DOCTOR CAN
MENTION BECAUSE THE FAMILY PACK
PROGRAM CANNOT SERVE PEOPLE WHO
ARE NOT AT RISK OF UNINTENDED
PREGNANCY. THIS LEAVES MANY LOW
INCOME LGBTQ PLUS CALIFORNIANS
WITH NO OTHER PATHWAY TO FREE
STI COVERAGE. I WILL HEAR AN
LGBTQ PLUS PERSON MIGHT BE
GRANTED ACCESS TO THIS COVERAGE
ONE DAY AND BE DENIED ACCESS
JUST BECAUSE OF WHO THEY ARE.
WHICH SHOULD RESULT IN HARMFUL
LAPSES IN CARE SO THIS UNFAIR
STRUCTURAL INEQUITY REQUIRES AN
UPDATE TO ENSURE THAT
CALIFORNIANS HAVE ACCESS TO THE
FINANCIAL HI SENSITIVE SERVICES.
THANK YOU VERY MUCH AND HAPPY
NATIONAL GBTQ. PLUS HEALTH
AWARENESS WEEK. THE YOU VERY
MUCH TO PRIEST THAT ANSWER ABOUT
MY- YOUR NAME AND WE WILL MOVE
NOW TO ELENA SHOP AS MADAME
MODERATOR SHE ON THE LINE. HELLO
HI LINDA YOU HAVE TWO MINUTES
PLEASE GO AHEAD. OKAY GREAT THAT
AFTERNOON MADAM VICE CHAIR AND
COMMITTEE MEMBERS MY NAME IS
OLENA SHOT THAT I AND THE
TRAINING COORDINATOR FOR TEACHER
AND I'M HERE TO SHARE MY
EXPERIENCE AT THE COLLEGE
STUDENTS RECEIVING THEM TAX
SERVICES HELLO FROM YOUR PUBLIC
UNIVERSITY STUDENT CENTER. I
HAVE I LOST ACCESS TO HEALTHCARE
ADMISSIBLE IDENTITY OF ALL MY
FRESHMAN YEAR IDENTIFIED AS
STRAIGHT AS I WAS NOT YET
COMFORTABLE WITH ACCEPTING MY
SEXUALITY I THANK GOD FOR US
BACK IN IT WE HAD ACCESS TO FREE
BIRTH CONTROL AND STI TESTING NO
QUESTIONS ASKED. HOWEVER OVER
THE DURATION OF MY UNDERGRADUATE
CAREER AND NOW GRASS LASTED VERY
THING UNIVERSITY BEGAN HERE AND
IDENTIFY AS A LESBIAN OR
PANSEXUAL. BUT I WANT TO REMIND
ROMAN AND I'VE PASSED THE
PROVIDERS AND THEY NO LONGER
QUALIFY FOR THE PROGRAM AS I WAS
CLOSE NO LONGER INTERESTED IN
FAMILY PLANNING. AND DIDN'T NEED
THEIR SERVICES. MY HEART THANK
YOU FOR OUR THE TIME I WAS AT AN
INTERN MAKING FOR HUNDRED. A DAY
IN THE IN THE EXPENSIVE CITY IN
THE UNITED STATES. I NOT KNOW
HOW I WOULD BE ABLE TO AFFORD MY
MEDICATION AND HEALTHY WITHOUT
ACCESS TO FREE F. F. P. F. B. I
WAS LUCKY THAT I WAS RESOURCEFUL
AND LIVED IN A PROGRESSIVE CITY
WHERE I CAN FIND FREE STI.
SERVICES OFF CAMPUS AS PART OF A
PUBLIC HEALTH PROGRAM. WHILE I
WAS RELIEVED TO FIND IF YOU CARE
I COULDN'T HELP BUT FEEL GUILTY
AS ANY OTHER QUEER FOLKS GO INTO
COLLEGE AND BROUGHT CONSERVATIVE
AREA. MUCH LIKE THE ONE I GREW
UP IN WANT TO HAVE THE SAME
OPTIONS AS ME. SO I'M HERE TODAY
TO SHARE MY EXPERIENCE OF LOSING
ACCESS TO HEALTH CARE AND
CRITICAL S. YES SERVICES OF THE
PANSEXUAL OR LET THE MOMENT. SO
NOT NO OTHER CAREER PATHS AND
HAVE TO GO WITHOUT. THE CARE
THAT THEY WANT AND NEED AND
DESERVE AND DOESN'T HAVE TO. BE
MADE IN ADVANCE BY A STATE
PROGRAM PLEASE VOTE YES ON SB
TWELVE THIRTY FOURTH TO EVERYONE
REGARDLESS OF SEXUAL IDENTITY.
AND ACCESS TO EQUITABLE.
HEALTHCARE THANK YOU FOR YOUR
TIME. THANK YOU. MUCH FOR YOUR
TEST- WE WANT. MOVE ANY ONE. ON
ONE IN THE ROOM THEY'RE WEAK OW
HE WISHES AS FRANCE PARK I HAD.
GERMAN FIRST GOT THE MOSSBERG
GROUP SING A. P. LA HEALTH.
PRODUCTS POINT CIRCLE SPONSOR OF
THE BILL AND URGE YOUR SUPPORT
THANK YOU. THANK YOU SO MUCH
ANYONE ELSE IN THE ROOM NOW.
OKAY SO WE'LL GO TO THE PHONE
LINES MAN MODERATOR RIGID UP
OPEN UP THE LINES FOR THOSE WHO
WISH TO TESTIFY IN SUPPORT. AND
IN THE WESTERN HALF OF. SORRY
JUST ONE REMIND EVERYONE IT'S
FOR SP ONE TWO THREE FOUR. THANK
YOU IF YOU WISH TO SPEAK IN
SUPPORT OF SB ONE TWO THREE FOUR
PLEASE PRESS ONE THEN ZERO AT
THIS TIME. FORTY ONE NINETY
SEVEN PLEASE GO AHEAD. THANK YOU
RIGHT CENTER ON BEHALF OF THE
AMERICAN COLLEGE OF OBGYN
STATION NINE IN SUPPORT. THANK
YOU I'M THIRTY SIX PLEASE GO
AHEAD. JANUARY ON BEHALF OF THE
CALIFORNIA MEDICAL ASSOCIATION
IN SUPPORT. THANK YOU I'M AT
THREE FOUR S. GOOD AFTERNOON
DEAL WITH THE SENSUAL ACCENT
HELP PROUD COUPLES BUNKERS OF
THE BILL TRUMP SUPPORT. THANK
YOU ALL RIGHT NINETY FOUR PLEASE
GO AHEAD. GOOD AFTERNOON JOSH
DUGGAR ON BEHALF OF THE COUNTY
HEALTH EXECUTIVES ASSOCIATION OF
CALIFORNIA IN SUPPORT. THANK YOU
I AM SIXTY FIVE PLEASE GO AHEAD. FIVE SIX FIVE.
FIVE SEVENTY PLEASE GO AHEAD.
HISTRIONIC CANTRELL WITH WOMEN'S
HEALTH SPECIALISTS OF
REPRODUCTIVE HEALTH CARE
PROVIDER IN THE BAR RULED
NORTHERN AREA OF CALIFORNIA IN
ABSOLUTE SUPPORT AND WITH
GRATITUDE FOR F. B. ONE TWO
THREE FOUR. THANK YOU I'M THIRTY
PLEASE GO AHEAD. FIVE THREE
ZERO-
OR SOMETHING THANK YOU I HAVE NO
FURTHER COMMENT THANK YOU. OKAY
THANK YOU MADAM MODERATOR- WE
WILL MOVE NOW TO OPPOSITION
THERE IS NO LEAD OPPOSITION
REGISTERED- SO IS THERE ANYONE
HERE IN THE COMMITTEE HEARING
ROOM WISHES TO TESTIFY IN
OPPOSITION I DON'T SEE ANYONE SO
WE'LL GET TO THE PHONE LINES
MADAME MODERATOR IS THERE ANYONE
ON THE PHONE LINE WISHING TO
TESTIFY IN OPPOSITION TO SB ONE
TWO THREE FOUR. THANK YOU ARE
PEOPLE SHOULD SPEAK IN
OPPOSITION TO ASK THE ONE TWO
THREE FOUR PLEASE PRESS ONE THEN
ZERO AT THIS TIME. I HAVE NO
COMMENT THANK YOU ALL RIGHT
THANK YOU MA'AM MODERATOR SO
BRING IT UP HERE TO THE
COMMITTEE ANY COMMENTS FROM THE
COMMITTEE MEMBER SENATOR WIENER
PLEASE GO AHEAD. AND THINK ABOUT
A MOISTURE I WANT TO THANK THE
AUTHOR FOR BRINGING THIS FORWARD
I SHOULD AUTHORS- HAS BEEN A
REAL CHAMPION FOR STI- TESTING
AND TREATMENT ACCESS INCLUDING A
VERY MAJOR BILL I GUESS LAST
YEAR SOME OF. THEM ON THE BUS-
S. TI- TESTING AND TREATMENT X.
WELL WHICH IS REALLY REALLY
IMPORTANT AND THIS IS A GREAT
BUT I. I HAVE TO SAY- WHEN I
FIRST HEARD ABOUT THIS BILL
ACTUALLY HAD NOT EVEN REALIZED-
THIS DISPARITY AND IT'S-
ABSOLUTELY HORRIFYING AND LIFE
COURSE. COME FROM. IN
REPRESENTING COMMUNITY MANY OF.
MAY WHO BUT LARGELY WOULD NOT
EVEN L. FOR THESE FUNDS. I WAS A
LOT OF LOW INCOME PEOPLE WHO-
ARE DEFINITELY AT RISK- FOR
STI'S INSIST. JUST HORRIFIC THE
CALIFORNIA IN TWENTY TWENTY TO
WHATEVER PROGRAM. THAT WOULD
EXCLUDE THEM FROM THIS PROGRAM
BECAUSE- OF THE YOU KNOW AREN'T
AT RISK OF PREGNANCY- SO DID I-
STRONG SUPPORTS SPOKE TO BE
ADDED AS A CO AUTHOR AND I MOVED
ABOUT. THANK YOU SENATOR ONE OR
ANY OTHER MEMBERS OF THE
COMMITTEE CENTER IN DALLAS. YES
I TOO WANT TO COMMEND YOU DR PAN
YOU'VE DONE INCREDIBLE WORK IN
THE SPACE AND I THINK LIKE MY
COLLEAGUE SENATOR WIENER ALSO.
PRETTY SURPRISED THAT WE WERE
ALREADY DOING THIS SO. ALSO
WOULD LIKE TO BE ADDED AS A CO
AUTHOR AND I JUST THANK YOU FOR
CONTINUING THIS WORK AS WELL.
AND SENATOR LEYVA THANK YOU
MADAM VICE CHAIR SENATOR PAM I
WOULD ALSO LIKE TO BE ADDED AS A
CO AUTHOR PLEASE. ALL RIGHT ANY
OTHER COMMITTEE MEMBERS NO OKAY
SENATOR PAM WOULD YOU LIKE TO
CLOSE. THANK YOU VERY MUCH- I
WOULD PREFER SOMEONE MENTIONED
THAT- WE ACTUALLY HAD THIS IS
PART OF THE REGIONAL ON THIS
BILL LAST YEAR UNFORTUNATELY
BECAUSE OF SOME FISCAL CONCERNS-
IT WAS. REMOVED BUT THAT MEANT
THAT- THE- THIS BILL WHICH WE
WORKED ON AND MY THANKS AND
WINNER FOR HIS STRONG SUPPORT OF
THAT AND THEN YOU KNOW THAT THAT
WE WERE ABLE TO CERTAIN
PROVISIONS THAT HE'S BEEN
WORKING IF YOU HAVE BEEN WORKING
ON FOR A VERY LONG TIME. AND FOR
SELECT THE LGBTQ COMMUNITY
BEHIND. AND SO- I SAID WELL AS
MUCH AS I AM VERY HAPPY THAT WE
GOT A BILL SIGNED BY THE
GOVERNOR LAST YEAR. WE'RE NOT
GOING TO GO AND LEAVE THE LGBTQ.
COMMUNITY BEHIND AND STOP THERE
SO THAT'S WHY I BRING THIS BILL
FORD. WE NEED TO ADDRESS THIS
ISSUE- AND- YOU KNOW I THINK WE
CAN ADDRESS THE FISCAL ISSUES
BUT- IT CERTAINLY WE DO NOT
WANT. TO PERPETUATE THE
DISPARITIES THAT HAVE BEEN
HAPPENING. SO LET'S GO AHEAD AND
GET THIS DONE AGAIN THANK ALL
THIS THANK YOU FOR ALL THE
PEOPLE ARE SUPPORTING AND ALSO
THE COAST NICOLE AUTHORS. AND
ESPECIALLY S. WHEN I VOTE. ALL
RIGHT THANK YOU SO MUCH SO THE
MOTION WAS MADE BY. MADE THE
MOTION NO ONE MADE A MOTION
SOONER CENTER WE IMAGINATION ONE
FALL. IN THE MOTION IS TO PASS
BUT FIRST BE REFERRED TO THE
COMMITTEE ON APPROPRIATIONS
MADAM SECRETARY WOULD YOU PLEASE
TAKE THE ROLE. CAN I CAN I AM
MELINDA'S. EGGMAN EGGMAN
ARKANSAS'S GONZALEZ I GROW FOR.
HER TADO. FOR TOTAL I. LLEVA
LABOR I LEAN ON. THE MOON I ROTH
ROTH IRA RUBIO. RUBIO I WINNER.
WEINER I. THANK YOU VERY MUCH
THE BILLS OUT NINE ZERO AND
CENTER PAN I WILL LEAVE IT TO
YOU TO CLOSE OUT THE SHOW. RIGHT
THANK YOU AND AGAIN I THINK MY-
VICE CHAIR MELINDA'S THANK YOU
SO MUCH FOR CARING AND DOING
EXCELLENT JOB- WE DO HAVE ONE
OTHER ITEM TO VOTE ON BEFORE YOU
LEFT THE CALL AND THAT IS OUR
CONSENT CALENDAR SORRY CONSENT
CALENDAR. INCLUDES ITEM NUMBER
FIVE SP NINE SIXTY SIX BY
SALAMONE AND ITEM NUMBER EIGHT
SP ELEVEN SIXTY FIVE BY CENTER
BATES. IS EMOTIONS CAN TAKE
UNDER OKAY SENEGAL DOLLARS AS
MOVIE CENTEL UNDER. CONSULT
THESE CALL THE ROLE FOR THE
CONSENT CALENDAR. HAND HI CAN I
MELINDA'S MULLINS. I EGGMAN
EGGMAN I. GONZALEZ. GONZALEZ I
GROVE. GROVE BY HER TADO. HER
TITLE I LLEVA. LABOR HI LEE
MOON. THE MOON IRA. ROTH IRA
RUBIO. RUBIO I WIN. WINNER HI
OKAY CONSENT CALENDARS OUT
ELEVEN ZERO. ALL RIGHT SO NOW
WE'RE GONNA GO BACK AND LIVE
CALL ON THE BILLS MS GUNN RAN
DOWN IN ORDER HERE OKAY ITEM
NUMBER ONE SP EIGHT FIFTY FIVE
BY CENTER NEWMAN- FOR. ITS OWN
PLEASE CALL THE ROLL THAT SOME
MEMBERS OF THE MOON THE MOON I
WINNER WINNER HI. OKAY THE LEVEL
OF UNKNOWN THAT FILLS OUT ELEVEN
ZERO ITEM NUMBER TWO SP EIGHT
SIXTY FOUR BY CENTER MELINDA'S-
IT'S CONTROLLED PEOPLE THE ROLE
THAT SOME MEMBERS WINNER. WINNER
I. THAT BILLS ELEVEN ZERO NEXT
ITEM IS ITEM NUMBER THREE SP
EIGHT EIGHT THREE BY CENTERS.
ROCK IMPORTANT TINO. OF THE
CONSULTANTS CALL THE ROBINSON
NUMBERS WINNER WINNER HI THAT
FILLS OUT ELEVEN ZERO I NEXUS I
AM NUMBER FOUR SP NINE TWENTY
NINE BY CENTER ADMIN CONSOLE
PLEASE CALL THE ROLL ABSENT
MEMBERS WINNER. WINNER HI THAT
FILLS OUT ELEVEN ZERO AND THEN-
ITEM NUMBER SEVEN SP TEN TWENTY
NINE I SENT HER TADO. SO PLEASE
CALL THE ROLL OF ABSENT MEMBERS.
WINNER WINNER HI THAT BILL IS
OUT ELEVEN ZERO. EIGHT IS THAT
IT. THAT'S EVERYTHING. YEAH
CONSENT WAS THE ITEM FIVE AN
ITEM. EIGHT NINE SIXTY SIX
ELEVEN SIXTY FIVE. AND THEN I
THINK YOU PUT IT ON. WITH
EVERYTHING OKAY EXCELLENT WELL
AGAIN YES I CAN SO- THAT
CONCLUDES THE AGENDA OF THIS
HEARING OF THE SENATE COMMITTEE
ON HEALTH AGAIN I WANT TO THANK
MY VICE CHAIRS AND MELINDA'S FOR
PROTESTS DURING THE MOST
CONTENTIOUS FILLED HIS HEARING.
I DO WANNA THANK ALL THE STAFF
WHO HELPED. ORGANIZE THE THIS
HEARING AND- AGAIN APPRECIATE
ALL TECHNICAL STAFF AS WELL
THANK YOU TO ALL THE WITNESSES
WHO PARTICIPATED BOTH THANK YOU
IN PERSON AND- AND- ONLINE IS
ALTERED OR TELL TELECONFERENCES
STONE. AND WITH THAT- THIS
HEARING OF THE SENATE COMMITTEE
HEALTH IS ADJOURNED.