WELL COME TO ORDER I WOULD MAKE
NOTE FOR ALL OF THE STAFF
WATCHING FOR MEMBERS OF THE
COMMITTEE. PLEASE ASK YOUR
MEMBERS IF THEY'RE AVAILABLE TO
PLEASE COME DOWN HEREWE ARE IN
A DIFFERENT ROOM OR IN ROOM 2100
JUST SO THAT THEY DON'T HIT THE
WRONG DIRECTION. AH SO ANYWAY,
GOOD AFTERNOON AS WE CONTINUE TO
TAKE SOME PRECAUTIONS TO MANAGE
THE ONGOING COVID 19 RISKS, THE
SENATE CONTINUES TO WELCOME THE
PUBLIC AND HAS PROVIDED ACCESS.
TO BOTH IN PERSON TELECONFERENCE
PARTICIPATION FOR PUBLIC
COMMENT. FOR INDIVIDUALS WISHING
TO PROVIDE PUBLIC COMMENT VIA
TELECONFERENCE SERVICE, THE
PARTICIPANT, TOLL FREE NUMBER
AND ACCESS CODE IS POSTED OUR
COMMITTEE WEBSITE. AND I WILL
ANNOUNCE IT NOW AND IT WILL BE
DISPLAYED ON THE SCREEN. TODAY'S
PARTICIPANT NUMBER IS 877.
226816. AND THE ACCESS CODE IS
648. 862. I WILL MAINTAIN
DECORUM DURING THE HEARING. IS
THIS CUSTOMARY IN ANY INDIVIDUAL
WHO IS DISRUPTIVE, MAYBE REMOVED
THE REMOTE MEETING SERVICE OR
HAVE THEIR CONNECTIONS MUTED. WE
ARE HOLDING OUR COMMITTEE
HEARINGS HERE IN THE O STREET
BUILDING, AND I ASK ALL MEMBERS
THE COMMITTEE TO BE PRESENT AND
HERE IN ROOM 2100 NOT OUR USUAL
OTHER ROOM, BUT HERE IN ROME,
2100 SO WE CAN ESTABLISH A
QUORUM. TO BEGIN OUR HEARING.
THERE ARE 18 ITEMS IN TODAY'S
AGENDA. PLEASE NOTE THAT
SENATORS ROTH AND RUBIO WILL NOT
BE PRESIDENT. TODAY'S HEARING.
WE HAVE SIX ITEMS IN OUR
PROPOSED CONSENT CALENDAR. ITEM
NUMBER ONE A. B 15 50 SORRY.
ITEM NUMBER ONE, MAYBE 5 52. BUY
SOME ERIC QUIRK-SILVA AS AMENDED
ITEM NUMBER 4 21 44 BY SOME
MEMBER RAMOS AS AMENDED ITEM
NUMBER 10, MAYBE 1999 DECEMBER
ARAMBULA. ITEM NUMBER 11 A B 23
60 BY SOME MEMBER ARAMBULA. I AM
NUMBER 12. MAYBE 21 30. BY
SUMMER, CUNNINGHAM IS AMENDED
AND ITEM NUMBER 18 80 27 68 BY
SUMMER, WALDRON. I WOULD ALSO
MAKE NOTE THAT, UM THAT. DUE TO
CONSTRAINTS REGARDING THE LENGTH
OF HEARINGS AND TECHNOLOGY
CONSIDERATIONS. THE COMMITTEE
CHAIR MYSELF WILL INSTITUTE TIME
LIMITS ON TESTIMONY. EACH SIDE
WILL BE PERMITTED AN EQUAL
AMOUNT OF TIME. TO BE DETERMINED
BY THE CHAIR, WHICH WILL BE FOUR
MINUTES ON EACH SIDE. MAXIMUM
WAS ALL OUT. TWO WITNESSES. H
WITNESS WILL HAVE TWO MINUTES IF
THE FIRST WITNESS GOES OVER THAT
COMES OUT THE SECOND PERSONS. SO
WE'LL HAVE FOUR MINUTES ON BOTH
SIDES FOR FORMAL TESTIMONY, AND
THEN ALL OTHERS WHO WISH TO
TESTIFY MUST LIMIT THE COMMENTS,
YOUR NAME, AFFILIATION AND
POSITION ON THE MEASURES. ALSO
MAKE NOTE THAT, UM, IF YOU WISH
TO PROVIDE EITHER MORE LENGTHY
TESTIMONY, OR YOU ARE WANTING TO
GIVE TESTIMONY AND, UH, DIDN'T
HAVE OPPORTUNITY CAN ALWAYS OF
COURSE, SUBMIT A LETTER ARE
OTHER TESTIMONY IN WRITING TO
THE COMMITTEE THROUGH OUR
WEBSITE. AND WITH THAT NOTE THAT
WE DO NOT HAVE A QUORUM. SO WE
WILL BEGIN AS A SUBCOMMITTEE,
AND I SEE A SEVEN MEMBER
ARAMBULA AND IRWIN HERE SO
SIMILAR ARAMBULA, YOU ARE THE
FIRST IN THE FILE ORDER FOR THE
ONES PRESENT. SO WE'LL BEGIN
WITH ITEM NUMBER SIX A. B 18 80
BY SOME MEMBER RAMBLA WELCOME.
THANK YOU, MR CHAIR AND IN THE
FUTURE SENATORS WANT TO FIRST
THANK THE COMMITTEE STAFF FOR
THEIR HARD WORK ON A B 18 80. I
AM PLEASED TO ACCEPT THE
COMMITTEE'S AMENDMENT. 18 80
ENSURES THAT PATIENTS WHO ARE
DENIED COVERAGE OF CRITICAL
MEDICATION CAN HAVE THEIR
APPEALS REVIEWED BYA PHYSICIAN
WHO UNDERSTANDS THIS CONDITION.
ADDITIONALLY A B 18 80 AT DATA
COLLECTION MEASURES TO
UNDERSTAND THE EXTENT OF THE USE
OF STEP THERAPY IN HEALTHCARE.
IN JANUARY, A B 3 47 ESTABLISHED
A PROCESS WHERE PHYSICIANS COULD
REQUEST INSURANCE COMPANIES
COVER THE MOST EFFECTIVE
MEDICINE FOR THEIR PATIENTS.
THESE REQUESTS ARE TYPICALLY
TYPICALLY REVIEWED BY A HEALTH
HEALTH PROFESSIONAL WITHOUT THE
SAME QUALIFICATIONS AS THE
PATIENT'S PHYSICIAN. AND
CURRENTLY IF THE INITIAL REQUEST
IS DENIED, A PHYSICIAN'S APPEAL
OF THE DENIAL CAN SIMILARLY BE
REVIEWED BY AN INDIVIDUAL
WITHOUT SUFFICIENT KNOWLEDGE OF
THE MEDICAL CONDITION. THIS
MEANS THAT THOSE MAKING THE
DETERMINATION MAY NOT FULLY
GRASP THE PHYSICIANS MEDICAL
ARGUMENTS. FOR REFERENCE
ONCOLOGISTS ARE REQUIRED TO HAVE
MULTIPLE YEARS OF ADDITIONAL
TRAINING AND SPECIALIZATION TO
DIAGNOSE AND PRESCRIBE DRUGS TO
TREAT CANCER. A B 18 80 GIVES
THESE PATIENTS AND SO MANY
OTHERS WITH COMPLICATED
ILLNESSES. A FAIR REVIEW OF
THEIR APPEALS. THIS BILL
REQUIRES A PHYSICIAN OF THE SAME
OR SIMILAR SPECIALTY TO REVIEW
THEIR CASE AND MEDICAL ARGUMENTS
BEING MADE. I AM JOINED TODAY BY
RYAN SPENCER, REPRESENTING THE
CROWNS AND COLITIS FOUNDATION.
AND TIM MADDEN, REPRESENTING THE
CALIFORNIA RHEUMATOLOGY
ALLIANCE. THANK YOU SO MUCH
DECEMBER RAMBLIN UNDERSTAND.
BOTH WITNESSES ARE HERE IN
PERSON. EXCELLENT AND ASSUME
THAT'S LIKE MR MEN'S COMMANDS UP
FIRST. IF THAT'S ALRIGHT, SO GO,
PLEASE BEGIN. THANK YOU. CHAIR
AND MEMBERS, TIM MADDEN,
REPRESENTING THE CALIFORNIA
RHEUMATOLOGY ALLIANCE WERE CO
SPONSOR OF HB 18. 81ST OF ALL
WE'D LIKE TO THANK THE SEVEN
MEMBER FOR HIS CONTINUED
SUPPORT. COMMITMENT TO ENSURING
PATIENTS TO HAVE ACCESS TO
MEDICALLY NECESSARY MEDICATIONS
IN A TIMELY MANNER. AS HE
ASSEMBLYMEMBER'S DESCRIBED 18 80
DOES TWO THINGS FIRST BY
REQUIRING PAIRS TO HAVE CLINICAL
HAVE A CLINICAL PEER REVIEW
APPEALS BY THE TREATING
PHYSICIAN. THIS HELPS AVOID
SITUATIONS RHEUMATOLOGISTS FACE
MANY TIMES. WHERE THEY MAY HAVE
A CARDIOLOGIST OR GENERAL
SURGEON REVIEWING APPEALS ON
CARE BEING PROVIDED BY
RHEUMATOLOGISTS. NOT ONLY DO THE
CARDIOLOGIST LACK OF TRAINING IN
RHEUMATOID CONDITIONS BUT THERE
ARE ALSO SITUATIONS WHERE THE
APPEALS ARE DENIED DUE TO WHAT
OUR PHYSICIANS BELIEVES A LACK
OF UNDERSTANDING OF THE
PATIENT'S CONDITION. 18 80
INSURERS MEDICAL REVIEW CAN
OCCUR ON THESE APPEALS. THE
OTHER PART OF THE BILL RELATED
TO THE PAYERS MAKING DATA
AVAILABLE IS IMPORTANT FOR
POLICYMAKERS. THIS INORMATION
WILL ALLOW FOR BETTER
UNDERSTANDING ON THE PERFORMANCE
OF UTILIZATION CONTROLS, SUCH AS
PRIOR AUTHORIZATION STEP
THERAPY. THE PLAYERS ARE USING
AND ITS POSSIBLE IMPACT ON
PATIENTS. WE APPRECIATE THE
ANALYSIS, ALSO POINTING OUT THE
IMPORTANCE OF THIS DATA AND THE
SUGGESTION TO HAVE THE DATA
AVAILABLE BY MEDICAL NECESSITY.
FOR THESE REASONS, WE
RESPECTFULLY ASK FOR ABBOTT.
THANK YOU. THANKS VERY MUCH. I
WILL NOW MOVE ON TO RYAN
SPENCER. WELCOME THANK YOU, MR
CHAIR. UM SPENCER, BEHALF THE
CROHN'S AND COLITIS FOUNDATION,
ANOTHER CO SPONSOR OF THE
MEASURE. I REALLY DON'T HAVE
MUCH ELSE MORE TO ADD TO DR
RAMBLAS AND TIM MADDEN'S
PRESENTATION. I WILL SAY THAT
THE CORONA NIKOLAIDIS FOUNDATION
REPRESENTS PATIENTS THAT HAVE
INFLAMMATORY BOWEL DISEASE AND
ONE OF OUR MAIN GOALS, ENSURE
THAT THEY HAVE ACCESS TO DRUGS.
THEY COULD OBTAIN THE DRUGS AND
THAT THEY STAY STABLE ON THAT
DRUG. THIS BILL, AND THE TWO
PROVISIONS DESCRIBED PREVIOUSLY
WILL DO JUST THAT. THAT'S WHY WE
PROBABLY SPONSOR THE BILL AND
ASK FOR YOUR VOTE. THANK YOU,
SIR. THANKS VERY MUCH. WE'LL NOW
MOVE ON TO ADDITIONAL WITNESSES
AND SUPPORT OF A B 18 80. IS
THERE ANYONE HERE IN ROOM 2100?
SEEING NO ONE APPROACHING THE
MICROPHONE WILL NOW GO TO THE
TELECONFERENCE LINE. MODERATOR
PLEASE OPEN THE LINES FOR
WITNESSES WHO WILL TESTIFY IN
SUPPORT OF A B 18 80. THANK YOU
. AND IF YOU DO WISH TO SUPPORT
, PLEASE PRESS 10 AT THIS TIME
AGAIN, IT'S 10 OR GO FIRST TO
LINE 1 38. IS THAT SHORT BECAUSE
THE ASSOCIATION OF NORTHERN
CALIFORNIA ONCOLOGISTS THANK
SUPPORTERS. THANK YOU. NEXT
WITNESS. 1 46. THANK YOU, MR
CHAIR AND MEMBERS ALEX CON ON
BEHALF OF THE CALIFORNIA CHRONIC
CARE COALITION AND STRONG
SUPPORT. THANK YOU NEXT WITNESS.
1 50. STEPHEN SCHULTZ WITH THE
ARTHRITIS FOUNDATION PROUD CO
SPONSOR THE BILL IN SUPPORT.
THANK YOU NEXT WITNESS. 1 51.
JENNIFER SNYDER ON BEHALF OF THE
CALIFORNIA LIFE SCIENTISTS AND
SUPPORT. 1 58. THANK YOU NEXT
WITH US. MICHELLE REVIS WITH THE
CALIFORNIA PHARMACISTS
ASSOCIATION AND SUPPORT. 1 54.
EARTH IS ADRIEN HARDY WITH
SANDBERG INSTITUTE SUPPORT.
THANK YOU. NEXT WITNESS. ONE
MORE HERE. GIVE ME JUST A MOMENT
AS WE GET BACK, OKAY? WE GOT 1
61. YES THIS IS STEVE HORN,
DIRECTOR OF GOVERNMENTAL
RELATIONS FOR ICANN
INTERNATIONAL CANCER ADVOCACY
NETWORK. WE'RE IN STRONG SUPPORT
OF A B 1880. THANK YOU. THANK
YOU. NEXT WITNESS. AND THEN
FURTHER IN Q AT THIS TIME, ALL
RIGHT. THANK YOU. WE'LL NOW MOVE
TO WITNESSES AND OPPOSITION TO
18 80 18 80. WE DO NOT HAVE A
FORMAL OPPOSITION. REGISTERED
FOR TESTIMONY SO WELL, THEN GO
ON TO ADDITIONAL WITNESSES AND
OPPOSITION TO 18 80 WILL BEGIN
HERE IN ROOM 2100. SCENE NINE
APPROACHING THE MICROPHONE,
PLEASE. GOOD AFTERNOON, MR CHAIR
MEMBERS. JET HAMPTONS,
CALIFORNIA ASSOCIATION OF HEALTH
PLANS HERE REGRETTABLY, IN
OPPOSITION TO THE 18 80, WHICH
REQUIRE HEALTH PLANS TO REDESIGN
OUR UTILIZATION MANAGEMENT
PROCESSES TO REQUIRE THAT
DENIALS OF A STEP THERAPY
EXCEPTION REQUESTS FOR CERTAIN
PRESCRIPTION DRUGS. ARE REVIEWED
BY A CLINICAL PIER WITHIN THE
SAME SPECIALTY, DESPITE THE
PRESENCE OF EXISTING LAWS AND
REGULATIONS ADDRESSING THE ISSUE
MEDICAL MANAGEMENT PRACTICES
SUCH AS PRIOR AUTHORIZATION,
STEP THERAPY OR CRITICALLY
IMPORTANT TOOLS USED BY HEALTH
PLANS TO ENSURE THAT PATIENTS
RECEIVE THE HIGHEST QUALITY CARE
WILL ALSO ENSURING PATIENT
SAFETY AND CONTROLLING HEALTH
CARE COSTS. SPECIFICALLY
EXISTING STEP THERAPY PROTOCOLS
ENSURE PATIENT SAFETY. BY
ENCOURAGING PROVIDERS AND
PATIENTS TO UNDERTAKE A MORE
EVIDENCE BASED MEASURE APPROACH
TO THE TREATMENT THAT IS
TAILORED TO THE INDIVIDUAL. BY
ENGAGING A PATIENT'S RESPONSE TO
LESS HARMFUL MEDICATIONS BEFORE
GRADUATING TO THE MORE POTENT
AND IRISH DRUGS. STEP THERAPY
ALSO ENSURES THAT HEALTH PLANS
ARE GOOD STEWARDS OF PREMIUM
DOLLARS PAID BY EMPLOYERS
ENROLLEES BY REQUIRING DRUG
THERAPY FOR A MEDICAL CONDITION
TO BEGIN WITH THE SAFEST AND
MOST COST EFFECTIVE DRUG BEFORE
PROGRESSING TO THE MORE COSTLY
OR RISKY THERAPIES. EXISTING LAW
CURRENTLY ALLOWS ENROLLEES IN
THEIR PROVIDERS TO REQUEST AN
EXCEPTION TO HEALTH HAND STEP
THERAPY PROTOCOLS FOR
PRESCRIPTION DRUGS. HEALTH PLANS
MUST RESPOND TO THESE REQUESTS
WITHIN 72, OR WITHIN 24 TO 72
HOURS, DEPENDING ON THE
CIRCUMSTANCE. UNFORTUNATELY A B
18 80 WOULD UNDERMINE THIS
EXISTING PROCESS. BY CREATING A
NEW CLINICAL PEER REVIEW PROCESS
WHEN AN EXCEPTION REQUEST IS
DENIED. CURRENT LAW ALREADY
ENSURES STRONG CONSUMER
PROTECTIONS BY REQUIRING AN
APPROPRIATELY LICENSED
HEALTHCARE PROVIDER WHO IS
COMPETENT TO EVALUATE SPECIFIC
CLINICAL ISSUES TO REVIEW AND
APPEAL. IF IF AN APPROPRIATELY
LICENSED HEALTHCARE PROVIDER IS
NOT COMMON TO COMPETENT TO
EVALUATE THAT SPECIFIC CLINICAL
ISSUE, THE PROVIDER IS REQUIRED
TO CONSULT WITH THE PROVIDER WHO
IS COMPETENT BEFORE MAKING A
DETERMINATION ON THE APPEALED
CLAIM. THEREFORE WE BELIEVE THAT
THE CLINICAL PEER PROVISIONS IN
THIS BILL ARE UNNECESSARY AND
DUPLICATIVE OF THE EXISTING LAW.
ADDITIONALLY WE'RE CONCERNED
THAT BILL CREATED
ADMINISTRATIVELY CUMBERSOME AND
POTENTIALLY COSTLY DATA
COLLECTION REQUIREMENT THAT
WOULD REQUIRE HEALTH PLANS TO
COLLECT AND MAINTAIN VARIOUS
DATA POINTS TO BE MADE AVAILABLE
TO THE DEPARTMENT OF MANAGED
HEALTH CARE OR THE CALIFORNIA
DEPARTMENT OF INSURANCE. WITHOUT
ANY CLARIFICATION ON HOW LONG
HEALTH PLANS MUST MAINTAIN THIS
INFORMATION. IN WHAT IS NOT
VALUE THIS WOULD BRING TO THE
PROCESS. THIS IS ESPECIALLY
RELEVANT CONSIDERING THE
VOLUMINOUS AMOUNTS OF DATA THAT
PLANS ALREADY COLLECT AND THE
EXISTING CHALLENGES WITH
RECEIVING ACCURATE AND COMPLETE
DATA. FOR THESE REASONS. WE ARE
REGRETTABLY OPPOSED TO SIMPLY
BILL 18 80. THANK YOU. THANK YOU
. NEXT WITNESS FOR WELCOME MR.
CHAIR MEMBER, STEPHANIE WATKINS
ON BEHALF OF THE ASSOCIATION OF
CALIFORNIA LIFE AND HEALTH
INSURANCE COMPANIES AGAIN. WE'D
LIKE TO THANK THE AUTHOR AND THE
SPONSORS. WE HAVE HAD MULTIPLE
DISCUSSIONS OVER THE LAST COUPLE
OF YEARS REGARDING THIS ISSUE.
UNFORTUNATELY, WE ARE OPPOSED TO
THE BILL TODAY. I THINK WE ARE
CONCERNED. GENERALLY AS WE HAVE
SEEN A LOT OF BILLS DEALING WITH
UTILIZATION MANAGEMENT OF THE
CONTINUOUS NARRATIVE THAT IT'S
INTENDED TO BE PUNITIVE TO
ENROLLEES AND INSURANCE, AND
REALLY, FROM OUR PERSPECTIVE.
THE GOAL IS TO ENSURE THE
APPROPRIATE CARE IS PROVIDED AT
THE APPROPRIATE TIME IN THE BEST
INTERESTS OF THE PATIENT. SO TO
THAT DEGREE, WE REMAIN OPPOSED.
BUT DO LOOK FORWARD TO THE BILL
DOES MOVE FORWARD TODAY.
ADDITIONAL CONVERSATIONS THANK
YOU. THANK YOU. ARE THERE
ADDITIONAL WITNESSES AND
OPPOSITION TO A B 18 80 HERE IN
ROOM 2100. STAYING ON
APPROACHING THE MICROPHONE.
MODERATOR PLEASE OPEN THE LINES
. TWO WITNESSES WHO WISH TO
TESTIFY IN OPPOSITION TO A B 18
80. THANK YOU TO OPPOSE, PLEASE
PRESS 10. WE'LL GO TO LINE 1 62.
THE CHAIR MEMBERS JOHN WINGER ON
BEHALF OF AMERICA'S HEALTH
INSURANCE PLANS AND OPERATIONS.
THANK YOU NEXT WITNESS.
CURRENTLY AND FOR THEIR IN CUBE.
THANK YOU. WE'LL BRING IT BACK
TO THE COMMITTEE OR THEIR
QUESTIONS OR COMMENTS FROM
COMMITTEE MEMBERS. UNFORTUNATELY
HAVE NOT ESTABLISHED A QUORUM
YET, BUT I APPRECIATE THAT. WELL
SIMILAR ARAMBULA APPRECIATE YOU
BRINGING THIS BILL FORWARD. I
THINK IT'S IMPORTANT WE DO HAVE
REVIEWERS WHO UNDERSTAND THE
CIRCUMSTANCE. I CERTAINLY HEAR
FROM THE OPPOSITION. SOME OF THE
CHALLENGES EXACTLY HOW YOU KNOW
WHEN YOU SAY EXPERTISE. HOW
BROAD OR NARROW THAT MIGHT BE.
ESPECIALLY IF YOU'RE TALKING
ABOUT, YOU KNOW, HIGHLY
SPECIALIZED CARE. I'M SURE
YOU'LL CONTINUE WORKING WITH THE
OPPOSITION THAT REGARD BUT
CERTAINLY, UH, SUPPORTING YOUR
BILL AND THANK YOU SO MUCH FOR
WORKING MY STEP TO TAKE THE
AMENDMENTS. BUT THAT WOULD YOU
LIKE TO CLOSE? THANK YOU FOR THE
OPPORTUNITY TO PRESENT AGAIN.
WANTS TO STATE DEFINITIVELY. WE
ARE ACCEPTING THE COMMITTEE'S
AMENDMENTS. AND WHEN THE TIME IS
APPROPRIATE, I RESPECTFULLY ASK
FOR ALL RIGHT. THANK YOU. SO
AGAIN WHEN WE ESTABLISH A QUORUM
, BE HAPPY TO TAKE UP YOUR BILL
FOR A VOTE. ALL RIGHT, AND I
BELIEVE YOU ALSO SEE HERE. NEXT
ITEM IS. ITEM NUMBER EIGHT A B
1930 MEDICAL. COMPREHENSIVE
PRENATAL SERVICES IS ALSO YOURS
AS WELL. SO WE WANT TO DO YOU
WANT TO TAKE THAT ONE? NEXT?
THANK YOU, MR CHAIR AND
SENATORS. A B 1930 IS A
BIPARTISAN MEASURE THAT ENSURES
EVERY CALIFORNIAN HAS A HEALTHY
START IN LIFE BY EXTENDING
COVERAGE OF SERVICES PROVIDED BY
THE COMPREHENSIVE PERINATAL
SERVICES PROGRAM. SEE PSP 21
YEAR POSTPARTUM. HARRY NEEDLE
CARE IS THE HEALTH CARE FOR
PREGNANT PERSONS FROM PERRY
NATAL TO POSTPARTUM? IT ALLOWS
PRACTITIONERS AND OPPORTUNITY TO
DETECT MONITOR AND ADDRESS
HEALTH CONDITIONS AND BEHAVIORS
THAT CAN IMPACT PREGNANCY,
MATERNAL HEALTH AND NEWBORN
INFANT HEALTH OUTCOMES.
CALIFORNIA'S COMPREHENSIVE
PERINATAL SERVICES PROGRAM, OR C
PSP, IS A BENEFIT FOR MEDICAL
BENEFICIARIES WHO BECOME
PREGNANT. SEE PSP PARTICIPANTS
ARE PROVIDED WRPAROUND PERRY
NEEDLE SERVICES, AND THESE
SERVICES ARE AVAILABLE FROM THE
DATE OF CONCEPTION THROUGH 60
DAYS FOLLOWING THE END OF
PREGNANCY. A B 1930 WOULD EXTEND
COVERAGE FOR C PSP SERVICES FROM
60 DAYS TO ONE YEAR POSTPARTUM
TESTIFYING IN SUPPORT, OR LUCY
NIELE, REPRESENTING MATERNAL AND
CHILD HEALTH ACCESS, AND SHANNON
SHAW PIECE EXECUTIVE DIRECTOR OF
HER HEALTH FIRST ALL RIGHT.
THANK YOU. SUMMER ARAMBULA AND
MODERATOR BELIEVE BOTH ARE
TESTIFYING FROM THE PHONE.
PLEASE BRING ON LUCY KWAN'S ELLA
WITH THE MATERNAL CHILD HEALTH
ACCESS. IN YOUR LINE SHOULD BE
THANK YOU, EVERYONE. LUCY QAHTAN
ELLA HERE ON BEHALF OF MATERNAL
, MATERNAL AND CHILD HEALTH ACTS
AS A SPONSOR OF A B 1938 B 1930
IS KEY TO MAKING GOOD ON MEDICAL
PROMISE OF 12 MONTHS, POSTPARTUM
ELIGIBILITY AND HEALTH INSURANCE
COVERAGE. A PERSON'S NEED FOR CP
. SPS HEALTH EDUCATION,
BREASTFEEDING COUNSELING SUPPORT
GROUPS AND OTHER PSYCHOSOCIAL
SERVICES MAY NOT RESULT IN THE
1ST 60 DAYS, POSTPARTUM OVER ONE
HALF OF MATERNAL DEATHS OCCURRED
DURING THE 365 DAY PERIOD.
FOLLOWING THE END OF THE
PREGNANCY. THIS IS DUE TO A
VARIETY OF CAUSES MANY
PREVENTABLE OR TREATABLE, SUCH
AS HYPERTENSION AND HEART
DISEASE. THE MAJORITY OF
MATERNAL SUICIDES IN CALIFORNIA
OCCURRED LATE IN THE YEAR AFTER
GIVING BIRTH AND 85% HAD ONE OR
MORE PSYCHOSOCIAL STRESSORS
DOCUMENTED NEAR THE TIME OF
DEATH. SEE, PSP IS A MEDICAL
TOOL FOR HELPING TO ADDRESS
IDENTIFIED NEEDS FOR BOTH THE
FOR SERVICE AND HEALTH PLAN
MEMBERS IN ORDER TO PREVENT
TRAGIC OUTCOMES AND PROMOTES
HEALTH AND WELL BEING INSTEAD.
THE CPSC CARE TEAM INCLUDES
COMPREHENSIVE PERINATAL HEALTH
WORKERS. THIS ALLOWS DOCTORS,
NURSES, PSYCHIATRISTS AND OTHERS
TO WORK AT THE TOP OF THEIR
LICENSES, WHILE PATIENTS GET
WARM HANDOFFS TO SPECIALTY CARE
AND OTHER KINDS OF SUPPORT, THEY
MAY NEED MAYBE 1930 WOULD
MAXIMIZE THS COST SAVING
APPROACH BY EXPANDING THE
LOCATIONS WHERE SEEPAGE W
SERVICES COULD BE PROVIDED TO
THE PERSON'S HOME AND OTHER
COMMUNITY SETTINGS. INFANTS
WOULD ALSO BENEFIT SIGNIFICANTLY
FROM C PSP THROUGHOUT THE
EXTENDED POSTPARTUM PERIOD. 50
OFFERS INFORMATION ABOUT AND
HELP ACCESSING PEDIATRIC CARE,
FOR EXAMPLE AMONG FAMILIES AND
SEE PSD THROUGH ORANGE COUNTY
MEDICAL PLAN, 93% OF INFANTS
WERE ON TRACK WITH IMMUNIZATIONS
AND 98% WE'RE ON TRACK WITH
DEVELOPMENTAL MILESTONES.
STATEWIDE ONLY 26% OF MEDICAL
INVENTS RECEIVE ALL THEIR
RECOMMENDED WELL CHILD DEATHS IN
THE 1ST 15 MONTHS OF LIFE,
MEDICAL PLANS AND MANY OTHER
CALIFORNIA COUNT OF CALIFORNIA
COUNTIES ARE ADOPTING SIMILAR
DEATH PRACTICES USING C PSP, AND
I'VE NOW LIKE TO TURN IT OVER TO
MY COLLEAGUE, SHANNON SHAW PACE
A COMMUNITY BASED ORGANIZATION
THAT WOULD BENEFIT FROM A P A B
19 THIRTIES CHANGES TO THE C P.
H W PROVISIONS. THANK YOU.
MODERATOR PLEASE BRING ON
SHANNON P. OKAY, YOU'RE ON.
OKAY? YOU HAVE YOU HAVE A MINUTE
AND 40 SECONDS. THANK YOU. OKAY
MY ORGANIZATION. HER HEALTH
FIRST IS FOCUSED ON DECREASING
THE DISPROPORTIONATE AFRICAN
AMERICAN MATERNAL AND INFANT
MORTALITY RATES ARE PROGRAM.
BLACK MOTHERS UNITED, FUNDED FOR
OVER EIGHT YEARS. BY FIRST FIVE.
SACRAMENTO IS MODELED ON C PSP
AND RELIES ON THE SERVICES OF
PREGNANCY COACHES. CLIENTS
DURING PREGNANCY THROUGH FOUR
MONTHS, POSTPARTUM IN THEIR
HOMES AND COMMUNITY. OUR ABILITY
TO MEET CLIENTS WHERE THEY ARE
OUTSIDE OF THE CLINIC ALLOWS OUR
TEAM TO BUILD RELATIONSHIPS
BASED ON TRUST AND EMPOWERMENT,
LEVERAGING CPSC TOOLS LIKE THE
INITIAL ASSESSMENT, WE HAVE
DEVELOPED A ROBUST DATABASE AND
THROUGH INDEPENDENT EVALUATION.
THE FOLLOWING ARE JUST A COUPLE
OF STATISTICALLY SIGNIFICANT
OUTCOMES. WE ARE SEEING.
REPORTED NUTRITIONAL
DEFICIENCIES DECREASED FROM 20%
AT INTAKE TO 6% PROGRAM. FOLLOW
UP MATERNAL DEPRESSION IS
INDICATED BY THE HQ NINE
BEHAVIORAL HEALTH ASSESSMENT WAS
RATED MODERATE OR HIGH IN 30% OF
OUR CLIENTS BEFORE ENTERING THE
PROGRAM AND AFTER PROGRAM
COMPLETION 120 DAYS. POSTPARTUM
VERSUS 60 DAYS, POSTPARTUM BSC
PSP PERCENTAGE HAS DECREASED TO
11. 60 DAYS. POSTPARTUM IS
SIMPLY NOT ENOUGH. WE KNOW THAT
POSTPARTUM MOOD AND ANXIETY
DISORDERS DO NOT OFTEN DISPLAY
IMMEDIATELY AFTER BIRTH AND CAN
ADVERSELY AFFECT INDIVIDUALS
THROUGH ONE YEAR POSTPARTUM WITH
NO OPPORTUNITY FOR SCREENING
THEIR SUPPORT. ADDITIONALLY THIS
EXPANSION WOULD ALLOW PROVIDERS
REIMBURSEMENT FOR ONGOING
LACTATION SUPPORT AS PARENTS AND
BREASTFEEDING LONGER IMPROVING
PHYSICAL AND MENTAL HEALTH
OUTCOMES FOR PARENTS AND
DEVELOPMENT, MENTAL OUTCOMES FOR
BABY ADDITIONALLY, IT WOULD
PROVIDE THE NECESSARY SUPPORT TO
ENSURE THE INFANT IS CONNECTED
TO THEIR PEDIATRICIAN RECEIVING
REGULAR WELL CHILD CHECK
VACCINATIONS AND DEVELOPMENTAL
SCREENING, IF NOT FOR GRANT
RELIANT PROGRAMS LIKE BLACK
MOTHERS UNITED AND HER HEALTH
FIRST. WHERE ELSE WOULD OUR
FAMILIES RECEIVED? THESE
SUPPORTS? GIVEN THE OUTCOMES WE
ARE SEEING IT IS IMPERATIVE WITH
THE CPSC BENEFIT. WE EXPANDED AT
A MINIMUM TO FOLKS FOUR MONTHS
POST UP, HOWEVER, CONSIDERED THE
POTENTIAL IMPACT WE WOULD SEE IF
THE BENEFIT WAS EXPANDED TO
SUPPORT FAMILIES AND THEIR
BABIES THROUGHOUT THE FIRST
YEAR, IT WOULD BE INCREDIBLE.
THANK YOU. THANK YOU. THANKS
VERY MUCH. WILL NOW MOVE ON TO
ADDITIONAL WITNESSES IN SUPPORT
OF, BUT ANYWAY, WE'LL MOVE OUT
TWO ADDITIONAL WITNESSES AND
SUPPORT OF A B 1930 PLEASED THAT
NAME ORGANIZATION POSITION
WELCOME. THANK YOU, MR CHAIR AND
MEMBERS OF UNESCO HINA ON BEHALF
OF THE NURSE. FAMILY PARTNERSHIP
IN SUPPORT. THANK YOU. WELCOME
CINDY HILLARY ON BEHALF OF THE
CALIFORNIA MEDICAL ASSOCIATION
AND SUPPORT THANK YOU WELCOME.
T MADDEN REPRESENT THE
CALIFORNIA CHAPTER OF THE
AMERICAN COLLEGE OF EMERGENCY
PHYSICIANS IN THE SPORT. THANK
YOU. WELCOME. BRIAN SPENCER ON
BEHALF OF THE AMERICAN COLLEGE
OF O B. G Y INSTITUTE. NINE IN
SUPPORT. THANK YOU. THINK NO ONE
ELSE APPROACHING THE MICROPHONE.
MODERATOR PLEASE OPEN THE LINES
FOR WITNESSES SWITCH TO TESTIFY
AND SUPPORT OF A B 1930. THANK
YOU. AND AGAIN, IT'S 10. WELL,
FIRST LINE 1 57. GOOD AFTERNOON
, LINDA WAY WITH WESTERN CENTER
ON LAW AND POVERTY AND SUPPORT.
THANK YOU NEXT WITNESS. 1 24.
GOOD AFTERNOON, MR CHAIRMAN
MEMBERS NICOLE TURTLEMAN ON
BEHALF OF THE CHILDREN'S
PARTNERSHIP SPONSOR AND
SUPPORTER OF A B 1930. THANK YOU
NEXT WITNESS. 1 39. GOOD
AFTERNOON. THIS IS ELIZABETH
ESPINOSA, CALLING IN SUPPORT ON
BEHALF OF THE COUNTY HEALTH
EXECUTIVES ASSOCIATION OF
CALIFORNIA. THANK YOU. THANK YOU
NEXT WITNESS. 1 34. ISABELLA
ORQUERA AND THE HOUSE OF THE
CALIFORNIA NURSES MIDWIVES
ASSOCIATION AND THE DAY AREA
REGIONAL HEALTH INEQUITIES
INITIATIVE. ALSO KNOWN AS FAR
HIGH AND SUPPORT. THANK YOU.
THANK YOU NEXT WITNESS. FIND 1
30. REBECA GONZALEZ NATIONAL
ASSOCIATION OF SOCIAL WORKERS.
CALIFORNIA CHAPTER IN SUPPORT.
THANK YOU NEXT WITNESS. FIND 1
48. HI MY NAME IS SARA DIAZ WITH
THE CALIFORNIA WICK ASSOCIATION
AND SUPPORT THANK YOU. NEXT
WITNESS. 1 55. HI. GOOD
AFTERNOON. MR CHAIRMAN AND
MEMBERS ROXANNE GOLD
REPRESENTING THE AMERICAN NURSES
ASSOCIATION, CALIFORNIA AND
SUPPORT. THANK YOU. THANK YOU.
NEXT WITNESS. 1 53. HELLO GOOD
AFTERNOON. YEAH, REALLY MARIANO
ON BEHALF OF ALAMEDA COUNTY AND
MARCH OF DIMES IN SUPPORT. THANK
YOU. THANK YOU. NEXT WITNESS. 1
45. GOOD AFTERNOON CHAIR MEMBERS
CRYSTAL GET OFF CALLING ON
BEHALF OF THE CITY AND COUNTY OF
SAN FRANCISCO AND SUPPORT. THANK
YOU. THANK YOU. NEXT WITNESS. 1
64. HI THIS IS ROBBIE GONZALEZ,
DOUSE THE EXECUTIVE DIRECTOR FOR
THE CALIFORNIA BREASTFEEDING
COALITION. AND WE'RE IN STRONG
SUPPORT. THANK YOU. NEXT
WITNESS. 1 27. GOOD AFTERNOON,
MOLLY ROBSON WITH PLANNED
PARENTHOOD AFFILIATES OF
CALIFORNIA WEREN'T SUPPORT.
THANK YOU NEXT WITNESS. 1 73.
GOOD AFTERNOON. THIS IS MOLLY
SHEEHAN WITH THE CALIFORNIA
CATHOLIC CONFERENCE AND SUPPORT
THANK YOU. NEXT WITNESS. 1 37.
MICHAEL DAVID. CHILDREN OUT AND
SUPPORT. THANK YOU NEXT WITNESS.
MEMBERS ON YOUR MOTORCYCLE WITH
BLACK WOMAN FULL ON THIS ACTION
PROJECT AND SUPPORT. THANK YOU.
THANK YOU. NEXT WITNESS. 1 60.
LYDIA BORN REPRESENTING THE
AMERICAN ACADEMY OF PEDIATRICS,
CALIFORNIA DIVISION IN SUPPORT,
THANK YOU NEXT WITNESS. IN THE
LAST ONE IN Q AT THIS TIME IS 1
36. HI MY NAME IS GABRIELLE
GONZALEZ. I'M A PUBLIC HEALTH
MASTER STUDENTS SPECIALIZING IN
MATERNAL CHILD AND ADOLESCENT
HEALTH AT UC BERKELEY AND I'M IN
SUPPORT. THANK YOU NEXT WITNESS.
AND THEN FURTHER IN Q AT THIS
TIME, ALL RIGHT, WE'LL NOW MOVE
ON TO WITNESSES AND OPPOSITION
TO A B 1930 WE OH, YES. DID YOU
PROBE PART OF ME, TIFFANY
WAITING WITH THIS YEAR.
CALIFORNIA AND SUPPORT THANK
YOU. AND EVERYONE'S BOUNCING
BETWEEN LOTS OF COMMITTEES COULD
SEE YOU ALRIGHT, WE'LL NOW MOVE
TO WITNESSES AND OPPOSITION TO A
B 1930. WE DO NOT HAVE A FORMAL
OPPOSITION REGISTERED ON THIS
BILL. SORRY, MADE AN ERROR IN
THE PREVIOUS ONE, SO WE'LL NOW
MOVE ON TO ANY WITNESSES WISH TO
TESTIFY. ADDITIONAL WICKEDNESS
IS WE SHOULD TESTIFY IN
OPPOSITION TO A B 1930. SEEING
ONE COMING TO THE MICROPHONE.
MODERATOR PLEASE OPEN THE LINES
FOR WITNESSES WISH TO TESTIFY IN
OPPOSITION TO A B 1930 NAME
ORGANIZATION POSITION. THANK
YOU. IT HAS 10. AND CURRENTLY,
NONE IN QUÊ. THANK YOU. WE'LL
BRING IT BACK TO COMMITTEE
QUESTIONS OR COMMENTS FROM
COMMITTEE MEMBERS. OKAY SENATOR
ARAMBULA. THANK YOU FOR BRINGING
THIS BILL FORWARD AS A
PEDIATRICIAN, KNOW HOW IMPORTANT
IT IS. TO BE SURE, WE CONTINUE
TO PROVIDE CARE AFTER BIRTH FOR
THIS MORE EXTENDED PERIOD TIME
AND INCLUDING OUR PRENATAL
SERVICES, SO CERTAINLY
SUPPORTING THIS BILL, WOULD YOU
LIKE TO CLOSE? THANK YOU FOR THE
OPPORTUNITY TO PRESENT WHEN THE
TIME IS APPROPRIATE WITH
RESPECTFULLY ASK FOR MY VOTE.
OKAY THANK YOU. AND WE'RE STILL
WAITING TO ESTABLISH A QUORUM.
SO ANY COMMITTEE MEMBERS WHO CAN
MAKE THEIR WAY OVER HERE?
APPRECIATE IT. I KNOW EVERYONE
IS IN DIFFERENT PLACES. IT WILL
NOW MOVE ON TO YOUR NEXT BILL. A
B 1995. THANK YOU, DOCTOR PAN,
MR CHAIR AND SENATORS. MAYBE
1995 WILL ENSURE LOW INCOME
CALIFORNIANS. CAN ACCESS THE
HEALTH CARE SERVICES THAT THEY
NEED TO STAY HEALTHY AND THRIVE
BY ELIMINATING THEIR MONTHLY
MEDICAL PREMIUMS AND CO
PAYMENTS. DURING MY YEARS AS AN
EMERGENCY ROOM POSITION. I SAW
WHAT HAPPENED TO PEOPLE AND
THEIR FAMILIES WHEN THEY HAD
DELAYED MEDICAL CARE BECAUSE
THEY HAD NO ACCESS TO HEALTH
INSURANCE OR HAVE LOST THEIR
INSURANCE. THE CONSEQUENCES WERE
SEVERE. THEY WERE DEVASTATING OR
WORSE. WE NEED TO CHANGE THE
SYSTEM SO THAT PREGNANT WOMEN,
CHILDREN AND PEOPLE WITH
DISABILITIES CAN BE ASSURED THAT
THEIR MEDICAL COVERAGE
CONTINUES. AND THAT THEY WON'T
HAVE TO CHOOSE BETWEEN PAYING
FOR THEIR HEALTH CARE OR PAYING
FOR THEIR HOUSEHOLD BILLS.
MEDICAL PREMIUMS AND CO PAYMENTS
OR A RELIC OF THE PAST. IT IS
NOT CONSISTENT WITH WHERE
HEALTHCARE COVERAGE IS GOING,
WHICH IS TO BE MORE INCLUSIVE.
IT ALSO FLIES CONTRARY TO
CALIFORNIA'S GOALS IN TERMS OF
PUBLIC HEALTH AND THREATENS THE
ECONOMIC SECURITY OF INDIVIDUALS
AND FAMILIES FROM ACROSS OUR
STATE. A B 1995 WILL SOLVE THIS
ISSUE BY ELIMINATING MEDICAL
COPAYMENTS AND PREMIUMS FOR
PREGNANT INDIVIDUALS, CHILDREN
AND PEOPLE WITH DISABILITIES.
TESTIFYING IN SUPPORT OF THE
1900 ARCADY ANDREW, ASSOCIATE
DIRECTOR OF HEALTH AT CHILDREN
NOW AND LINDA WAY, SENIOR POLICY
ADVOCATE. AT WESTERN CENTER ON
LAW AND POVERTY. THANKS FOR
WATCHING SUMMER RAIN. BOLA. I
BELIEVE BOTH ARE TESTIFYING BY
PHONE. SO MODERATOR, PLEASE
BRING ONTO LINE MIKE O'DAY FROM
CHILDREN NOW AND LINDA WAY FROM
THE WESTERN CENTER ON LAW AND
POVERTY AND I THINK WE BEGIN
WITH MICHAEL DAY. GOOD AFTERNOON
CHAIR MEMBERS. MICHAEL DAY WITH
CHILDREN NOW WHERE A STATEWIDE
POLICY RESEARCH AND ADVOCACY
ORGANIZATION WORKING ON BEHALF
OF KIDS IN OUR STATE THANK YOU
FOR THE OPPORTUNITY TO FIND
SUPPORT OF 18 1995 AND THE
IMPORTANT IMPACT THAT IT WOULD
HAVE ON THE LIVES OF OVER
530,000 CHILDREN, PREGNANT
PEOPLE AND INDIVIDUALS WITH
DISABILITIES BY ELIMINATING
MEDICAL PREMIUM IN COPAYMENT
REQUIREMENT. RESEARCH HAS SHOWN
THAT MEDICAL COVERAGE HELPS TO
IMPROVE HEALTH, REDUCE
DISABILITY AND INCREASED
EDUCATIONAL ATTAINMENT AND
ECONOMIC STABILITY. HOWEVER
HUNDREDS OF THOUSANDS OF
CALIFORNIANS ARE UNHOOKED FROM
MONTHLY PREMIUMS. THAT CREATE
BARRIERS TO ACCESSING CARE AND
STAYING COVERED. MEDICAL ISN'T
FAMILIES DESERVE RELIEF AND
PROTECTION FROM HEALTHCARE
PREMIUMS THAT CREATE ADDITIONAL
ECONOMIC BURDEN, OFTEN LEADING
FAMILIES TO CHOOSE BETWEEN
PAYING THEIR PREMIUMS OR PAYING
FOR OTHER BASIC NECESSITIES LIKE
FOOD RANKED SECTORS AND GAS. THE
GOVERNOR PROPOSES TO REDUCE
MEDICAL PREMIUMS TO ZERO WITHOUT
ELIMINATING THEM ENTIRELY. WE
BELIEVE THAT THIS DOES NOT GO
FAR ENOUGH AND LEAVE THE DOOR
OPEN FOR FUTURE ADMINISTRATION
TO REINSPECT MEDICAL
REQUIREMENTS. THIS IS AN
EXTREMELY PROBLEMATIC GIVEN THAT
THE FAMILIES AND INDIVIDUALS
THAT ARE REQUIRED TO PAY MEDICAL
PREMIUMS AND CO PAYMENTS ARE
LIKELY TO BE HIT THE HARDEST BY
ANY FUTURE ECONOMIC DOWNTURN.
CALIFORNIA SHOULD ELIMINATE
MEDICAL PREMIUM AND COPAYMENT
REQUIREMENTS ALTOGETHER IN ORDER
TO BRING US ONE STEP CLOSER TO A
MORE JUST HEALTHCARE SYSTEM, AND
THAT'S PRECISELY WHAT 18 1995 TO
DO. AND FOR THESE REASONS,
RESPECTFULLY REQUEST YOUR I
VOTE. THANK YOU. THANK YOU.
WE'LL NOW MOVE ON TO LINDA WAY
WITH THE WESTERN STANDARD LAW
AND POVERTY. GOOD AFTERNOON.
LINDA WAY WITH WESTERN
PHENOMENON POVERTY, PROUD CO
SPONSOR ÁP 1995, WHICH WOULD
ELIMINATE MEDICAL PREMIUMS AND
CO PAYMENTS TO ENSURE VOTE
INCOME CALIFORNIANS. CAN ACCESS
NEEDED HEALTH CARE FOR PEOPLE
WITH DISABILITIES MEDICAL ALLOWS
THEM TO LIVE INDEPENDENTLY IN
THE COMMUNITY AND AVOID COSTLY
INSTITUTIONALIZATION, EVEN WITH
INCOMES BELOW 28 50 A MONTH
PEOPLE WORKING PART TIME ARE
STILL EXPECTED TO PAY UP TO $250
IN MONTHS PREMIUM THIS BILL WILL
ALLOW PEOPLE WHO ARE DISABLED TO
KEEP MORE OF THEIR INCOMES ON
BASIC NECESSITIES. IN ADDITION,
THE BILL WOULD ELIMINATE MEDICAL
COPAYMENTS AS THERE IS NO
FINANCIAL POLICY REASON TO KEEP
IN STATUS. COPE HIM ACT AS A
BARRIER TO CARE AND ARE
CURRENTLY NOT ENFORCEABLE AND
RARELY, IF EVER COLLECTED AND
KEPT BY PROVIDERS. THE BILL HAS
BIPARTISAN SUPPORT AND NO KNOWN
OPPOSITION AND URGED HER I VOTE.
AT THE APPROPRIATE TIME. THANK
YOU. THANK YOU VERY MUCH. WE'LL
NOW MOVE ON TO ADDITIONAL
WITNESSES AND SUPPORT OF A B
1995 BEGIN AND HERE IN ROOM 2100
WELCOME. THANK YOU, CHAIR AND
MEMBERS TO MADDEN, REPRESENTING
THE CALIFORNIA CHAPTER OF
AMERICAN COLLEGE OF EMERGENCY
EFFICIENCY IN SPORT. THANK YOU.
WELCOME. CINDY HILLARY ON BEHALF
OF THE CALIFORNIA MEDICAL
ASSOCIATION AND SUPPORT THANK
YOU. WELCOME. VANESSA AND ON
BEHALF OF THE NURSE, FAMILY
PARTNERSHIP AND SUPPORT. THANK
YOU. WELCOME. BRIAN SPENCER ON
BEHALF OF THE AMERICAN COLLEGE
OF OBGYN INSTITUTE. NINE AND
SUPPORT. THANK YOU THINK NO ONE
ELSE AT THE MICROPHONE.
MODERATOR PLEASE OPEN THE LINES
FOR WITNESSES WHO WISH TO
TESTIFY IN SUPPORT OF A B 1995
NAME ORGANIZATION POSITION. SIR,
IF YOU ARE IN SUPPORT OF MAYBE
1995 IS 10 ON YOUR PHONE. AND WE
WILL START WITH LINE NUMBER 1
24, PLEASE GO AHEAD. GOOD
AFTERNOON, MR CHAIRMAN MEMBERS
NICOLE WARD ULLMAN ON BEHALF OF
THE CHILDREN'S PARTNERSHIP IN
SUPPORT. THANK YOU. NEXT
WITNESS. HE HAS A LINE NUMBER 1
48. HI THERE. DIAZ WITH THE
CALIFORNIA WITNESSES, THE ASIAN
AND SUPPORT THANK YOU. NEXT
WITNESS. MY NUMBER 1 39. GOOD
AFTERNOON. THIS IS ELIZABETH
ESPINOSA ON BEHALF OF THE COUNTY
WELFARE DIRECTORS ASSOCIATION,
THE COUNTY ASSOCIATION OF PUBLIC
HOSPITALS AND HEALTH SYSTEMS.
THE COUNTY HEALTH EXECUTIVES OF
CALIFORNIA AS WELL AS THE COUNTY
OF SANTA CLARA. ALL IN SUPPORT.
THANK YOU. THANK YOU NEXT
WITNESS. WE HAVE LINE NUMBER 1
44. HELLO KATIE LEIGHTON ON
BEHALF OF THE CHILDREN'S
SPECIALTY CARE, COALITION AND
SUPPORT THANK YOU NEXT WITNESS.
OF LYING NUMBER 1 32. GOOD
AFTERNOON, CHRIS MYERS WITH THE
CALIFORNIA SCHOOL EMPLOYEES
ASSOCIATION AND SUPPORT THANK
YOU NEXT WITNESS. HAVE LINE
NUMBER 1 53. GOOD AFTERNOON
NATALIE MEDALLION ON BEHALF OF
ALAMEDA COUNTY AND SUPPORT.
THANK YOU. THANK YOU. NEXT
WITNESS. WE HAVE LINE NUMBER 1
81. GOOD AFTERNOON IS JOSE
TORRES WITH HEALTH ACCESS
CALIFORNIA IN STRONG SUPPORT.
THANK YOU. NEXT WITNESS. MY
NUMBER 1 82. GOOD AFTERNOON.
LYNN CURSEEN, MATERNAL AND CHILD
HEALTH ACCESS IN SUPPORT. 1 91
1995. THANK YOU. THANK YOU. NEXT
WITNESS. MY NUMBER 1 83. GOOD
AFTERNOON. YASMIN PELLET ON
BEHALF OF JUSTICE NEEDING IN
SUPPORT. THANK YOU. NEXT
WITNESS. LINE NUMBER 1 84. GOOD
AFTERNOON CHAIR AND MEMBERS
EMERY SHEET WITH THE COUNTY
BEHAVIOR HEALTH DIRECTORS
ASSOCIATION OF CALIFORNIA AND
SUPPORT. THANK YOU. THANK YOU
NEXT WITNESS. LINE NUMBER 1 85.
GOOD AFTERNOON TURNED MEMBERS.
JUSTIN RAN WITH THE CALIFORNIA
DENTAL ASSOCIATION AND SUPPORT
THANK YOU NEXT WITNESS. IT'S UP
. WE HAVE HERE THEY TAKE
THEMSELVES OUT. WE HAVE LINE
NUMBER 1 30. GOOD AFTERNOON,
REBECA GONZALEZ FOR THE NATIONAL
ASSOCIATION OF SOCIAL WORKERS.
CALIFORNIA CHAPTER AND SUPPORT.
THANK YOU NEXT WITNESS. WE HAVE
LINE NUMBER 1 86. GOOD AFTERNOON
, MR CHAIR MEMBERS, TERESA
ANDERSON ON BEHALF OF THE ART
AND UNITED CEREBRAL PALSY,
CALIFORNIA COLLABORATION AND
SUPPORT. THANK YOU. NEXT
WITNESS. WE HAVE LINE NUMBER 1
26 SO AHEAD. IN THE AFTERNOON
SHARE MEMBERS OF TROY RODRIGUEZ
ON BEHALF OF THE COUNTY OF SAN
DIEGO IN SUPPORT THANK YOU NEXT
WITNESS. LINE NUMBER 1 73. GO
AHEAD WITH THE CALIFORNIA
CATHOLIC CONFERENCE AND SUPPORT.
THANK YOU. THANK YOU NEXT
WITNESS. THERE AND WE HAVE ONE
MORE LEFT IN QUEUE HERE FOR
SUPPORTERS LINE NUMBER 1 60.
VIDEO BORN REPRESENTING AMERICAN
ACADEMY OF PEDIATRICS,
CALIFORNIA DIVISION IN SUPPORT,
THANK YOU. ANYONE ELSE? THERE.
WE DO NOT HAVE ANY MORE INTO MR
KERRY. YOU MAY CONTINUE. ALL
RIGHT. THANK YOU. WE'LL NOW MOVE
ON TO WITNESSES AND OPPOSITION
TO 18 1995. THERE'S NO ONE
FORMALLY REGISTERED FOR
TESTIMONY WILL THEN BRING IT
BACK TO HERE TO ROOM 2100, AND
HE WITNESSES IN OPPOSITION TO A
B 1995. SAYING NO ONE
APPROACHING THE MICROPHONE.
MODERATOR PLEASE OPEN THE LINES
FOR WITNESSES WHO WISH TO
TESTIFY IN OPPOSITION TO THE
1995. DEFINITELY IF YOU'RE AN
OPPOSITION OF A B 1995 IT IS 10
ON YOUR PHONE. ONCE AGAIN, IT'S
ONE AND ZERO FOR OPPOSITION. WE
DO NOT HAVE ANYBODY QUEUING UP,
MR. CHAIR. THANK YOU. I'M GOING
TO TAKE A QUICK PASS HERE
BECAUSE IT LOOKS LIKE WE WILL
HAVE A QUORUM. SO SECRETARY,
PLEASE CALL THE ROLL TO
ESTABLISH THE QUORUM. 10 HERE IS
HERE. MELINDA'S LINDA'S HERE
EGGMAN EGGMAN HERE. GONZALES
GROVE. HER TATO TATO HERE, AVA.
LABOR HERE. LIMÓN WRATH, RUBIO.
WIENER PRESENT. THAT IS A PORN
QUORUM IS ESTABLISHED. THANK YOU
. ALL RIGHT, WE'LL NOW BRING
THIS BACK TO THE COMMITTEE, A B
1995 OF THE QUESTIONS OR
COMMENTS FROM COMMITTEE MEMBERS.
OKAY, SEEING NONE. SOME ARAMBULA
. THANK YOU SO MUCH FOR BRINGING
THIS BILL FORWARD. OF COURSE, WE
KNOW THAT COST SHARING LIKE CO
PAYS AND DEDUCTIBLES CAN BE
BARRIERS TO CARE, AND ESPECIALLY
WITH MEDICAL PATIENTS WHO ARE
LOW INCOME. ELIMINATE THOSE
BEARS WILL BE IMPORTANT TO
ACCESS. WOULD YOU LIKE TO CLOSE?
THANK YOU FOR THE OPPORTUNITY TO
PRESENT AND I RESPECTFULLY ASK
FOR ANOTHER. THANK YOU. IS THERE
A MOTION? OKAY? WELL I HEARD
THAT'S LIKE A CHORUS. ALRIGHT
HEARD SENATOR LEVIN. SHE'S
CLOSEST TO MY EAR HERE. SO YES.
OKAY SO IT'S MOVING BY SENATOR
LEYVA. THE MOTIONS DO PASS AND
REFERRED TO THE COMMITTEE ON
APPROPRIATIONS SECRETARY. PLEASE
CALL THE ROLL PAN AND I.
MELINDA'S EGGMAN. EGGMAN I
GONZALES GROVE, HER TATO TATO
PYLEVA. AYE LIMÓN ROTH RUBIO
WIENER WIENER? AYE. NO. YOU'RE
EITHER. OKAY THE CURRENT BILLS.
CURRENTLY 50 WILL HOLD THE ROLL
OPEN FOR ABSENT MEMBERS. THE
REST OF YOUR BILLS ARE IN
CONSENT. WE WILL EVENTUALLY COME
BACK TO YOUR OTHER BILLS FOR
VOTES. SO THANK YOU VERY MUCH.
OKAY. THANK YOU. NOW SEE SUMMER.
GARCIA'S HERE AND SO WE'LL MOVE
BACK TO ITEM NUMBER TWO A. B 13
41 BY SOME MEMBERS, CRISTINA
GARCIA, WELCOME. THANK YOU. A B
13 41 WOULD HAVE BANNED THE SALE
OF DIET PILLS TO MINORS UNLESS
PRESCRIBED BY A DOCTOR. IN
DISORDERS ARE SERIOUS PUBLIC
HEALTH PROBLEM AFFECTING PEOPLE
OF ALL RACES, AGES AND GENDERS,
BUT ESPECIALLY TROUBLING FOR OUR
YOUNG PEOPLE. WELL. CALIFORNIA
IS AT THE FOREFRONT OF
REGULATIONS FROM TURNING WEIGHT
LOSS DIETARY SUPPLEMENTS IN THAT
APPEALS WITHIN OUR PROHIBIT THE
SALE OF THESE PRODUCTS TO MINORS
DESPITE WILD DOCUMENTED DANGERS.
RECENT STUDIES FROM THE
UNIVERSITY OF MINNESOTA SCHOOL
OF PUBLIC HEALTH AND STANFORD
UNIVERSITY, AND THAT INDIVIDUALS
USING DIET PILLS AND LAXATIVES
FOR MORE LIKELY TO BE DIAGNOSED
WITH IT AND DEVELOP A SERIOUS
EATING DISORDER. HE ALSO FOUND
THAT HOSPITAL STATIONS FOR
EATING DISORDERS AMONG
ADOLESCENTS DOUBLED DURING THE
COVID 19 PANDEMIC. TEENS ARE
ESPECIALLY TARGETED BY THESE
DAYS. PILLS AS SELF IMAGE ISSUES
WANT TO THANK THE OPPOSITION FOR
WORKING COLLABORATIVE WITH MY
OFFICE TO FIND COMPROMISE THAT
BOTH PROTECTS MINORS WHILE
AVOIDING WORKFLOW DISRUPTIONS.
AND SO WHAT YOU HAVE TODAY IS A
COMPROMISE BY MOST PARTIES. I
DON'T KNOW THAT I HAVE REMOVED
ALL OPPOSITION, BUT WE CONTINUE
TO WORK. I ALSO WANT TO THANK
THE COMMITTEE FOR WORKING WITH
US ON THIS AMENDMENTS WITH ME
TODAY TO TESTIFY. HAVE DR JASON
AGATA ÁP, PEDIATRIC DOCTOR WITH
UC SAN FRANCISCO. AND KELSEY
WOO, A STUDENT ADVOCATE WITH
STRIPED, TESTIFYING AND
SUPPORTED THE BILL, AND I
RESPECTFULLY ASK FOR AND I VOTE.
THANKS VERY MUCH SUMMER, GARCIA
WILL NOW MOVE ON TO OUR
WITNESSES AND SUPPORT WHO ARE
BELIEVED BOTH ON THE PHONE. SO,
MODERATOR, PLEASE BRING ONTO THE
LINE. DR JASON NGATA FROM UCSF
AND KELSEY WOO FROM STRIPED.
WE'LL BEGIN WITH DR NGATA. YOU
EACH HAVE TWO MINUTES TOTAL FOUR
MINUTES BETWEEN THE BOTH OF YOU.
THANK YOU FOR THE OPPORTUNITY TO
SPEAK WITH YOU TODAY ABOUT
ASSEMBLY BILL 13 41. MY NAME IS
DR JASON GOTTA AND I'M, A
PEDIATRICIAN FACULTY MEMBER AT
UNIVERSITY OF CALIFORNIA
SAMPSON, CISCO. I'M HERE TO
SHARE SCIENTIFIC RESEARCH
SUPPORTING ASSEMBLY BILL 13 41
AND URGE YOU TO VOTE IN FAVOR OF
THIS IMPORTANT BILL. THE U. S
WEIGHT LOSS SUPPLEMENT INDUSTRY
GENERATES OVER $2.5 BILLION IN
ANNUAL REVENUE. THESE PRODUCTS
ARE LOCAL PHARMACIES, GROCERY
STORES AND HEALTH FOOD STORES.
BUT WHAT MANY PEOPLE DON'T KNOW
IS THAT WEIGHT LOSS SUPPLEMENTS
ARE NOT REVIEWED BY THE FDA FOR
SAFETY OR EFFECTIVENESS BEFORE
THEY ENTER THE MARKET. RESEARCH
DEMONSTRATES THAT MANY
BANNED SUBSTANCES. PRESCRIPTION
DRUGS. SIMULANT STEROIDS AND
OTHER TOXIC INGREDIENTS. ONE
RECENT SCIENTIFIC STUDY FOUND
THAT YOUTH USING WEIGHT LOSS
SUPPLEMENTS FOR THREE TIMES MORE
LIKELY THAN THOSE USING ORDINARY
VITAMINS TO EXPERIENCE SEVERE
MEDICAL HARM, INCLUDING
HOSPITALIZATION, DISABILITY AND
EVEN DEATH. THE CDC ESTIMATES
THAT SUPPLEMENT SUPPLEMENT USE
LEAD 23,000 EMERGENCY ROOM
VISITS EVERY YEAR WITH A QUARTER
DUE TO LOSS WEIGHT LOSS
SUPPLEMENTS ALONE. THE AMERICAN
ACADEMY OF PEDIATRICS ECENTLY
ISSUED A REPORT STRONGLY
CAUTIONING AGAINST TEAMS USING
THIS PRODUCT FOR ANY REASON.
YOUTH COULD USE THESE OVER THE
COUNTER DIET HOLDERS SIX TIMES
MORE LIKELY TO BE DIAGNOSED WITH
AN EATING DISORDER THAN NON
USERS. ASSEMBLY BILL 13 41,
CALIFORNIA LAWMAKERS THE
OPPORTUNITY TO TAKE ACTION NOW
TO PROTECT OUR CHILDREN. THIS
BILL WOULD PREVENT THE SALE OF
WEIGHT LOSS SUPPLEMENTS AND OVER
THE COUNTER DIET TO MINORS. I
URGE YOU TO VOTE IN SUPPORT OF A
B 13 41. WE MUST ACT NOW TO
PROTECT THE CHILDREN OF
CALIFORNIA. THANK YOU. THANK YOU
. NOW, LET'S MOVE ON TO KELSEY
WOO STRAIGHT. THAT AFTERNOON,
CHAIRPERSON CAN ACTUALLY
ACTUALLY SPOKE. CAN YOU PLEASE
TRY TO SPEAK INTO THE
MICROPHONE? WE'RE HAVING A
LITTLE TROUBLE HEARING YOU. OH
COLOR. CAN YOU HEAR ME NOW? UM
YES. YOU HAVE A LOT OF
BACKGROUND NOISE. NOT SURE WHERE
YOU'RE AT. OKAY. UM OKAY. ISN'T
IT BETTER THAT THAT'S BETTER?
YEAH. PLEASE, PLEASE, PLEASE,
PLEASE, PLEASE GO ON. OKAY GOOD
AFTER NEW CHAIRPERSON CAN
CHAIRPERSON RANDA'S AND
HONORABLE MEMBERS OF THE SENATE
COMMITTEE HEALTH THANK YOU FOR
THE OPPORTUNITY TO SPEAK ABOUT
MY NAME IS KELSEY LU AND I MADE
17 YEAR OLD VIEWS FROM DIAMOND
BAR CALIFORNIA WHERE I ATTEND
MEMBER HIGH SCHOOL. I'M HERE
TODAY TO SHARE MY STORY AND
SPEAK ON BEHALF OF THE MANY
ACROSS THE STATION LIKE STRONGLY
SUPPORT FOR FUN. AS A TENURED
YOU'RE GOING UP TODAY. I'M NO
STRANGER TO WAIT CONCERNS AND
NEGATIVE BODY IMAGE. I DEVELOPED
AN EATING DISORDER AT THE AGE OF
14 AND LIVING IN A COMMUNITY
WHERE THE MAJORITY OF
ADOLESCENTS HERE MY SAME
EXPERIENCES. I KNOW THE EXTENT
WHICH KIDS DEBATE WILL GO FOR AN
IDOLIZED BODY. FOR ME NOW IT IS
TERRIFYING FACT,14, AND WITH SO
MANY OF MY TEARS ARE A B C D NOW
BECAUSE WITH THE EVER GROWING
PRESSURE TO THIS PLACE AT ANY
COST AND I FEEL BADLY ABOUT MY
APPEARANCE AND LOOKING FOR A
QUICK FIX TO MY PROBLEM. I HAVE
24 7 ACCESS TO HUNDREDS OF
PRODUCTS SUPPLEMENTS THAT I CAN
EASILY BUY WITH NOODY
RESTRICTIONS WHATSOEVER OF A
BUTTON ON MY PHONE. EVEN MORE
CONVENIENT. WALKED BY LOCAL CBS
, I CAN EASILY PURCHASED OVER
THE COUNTER DIET PILLS AND
SUPPLEMENTS TO USE AND MY OWN
DISCRETION. NO SOURCE OF
ADVANCES WOULD HAVE THE RIGHT TO
STOP ME AND MY PARENTS NEVER
KNOW UNLESS THEY TOLD THEM.
WEIGHT LOSS SUPPLEMENT AND DIET
COKE COMPANIES KNOW THAT
TEENAGERS ARE THEIR BEST
CUSTOMERS, AND THEY THINK IT IS
ON THEIR PRODUCTS. THEY WILL
HAVE A GUARANTEED MARKET FOR
YEARS TO COME. STATE
DELIBERATELY EXPLOIT OUR LOW
SELF CONFIDENCE AND BODY AND
STRUGGLE. IMPOSSIBLE PROMISES
THAT VULNERABLE PIECE CAMPUS
HELP PROBABLY STILL NUMBER 1341
IS PASSED, IT WILL LIMIT THE
WIDESPREAD AVAILABILITY OF
HARMFUL WEIGHT LOSS SUPPLEMENT
OVER THE COUNTER DIAGNOSES AND
MY FRIENDS. I ALONG WITH
HUNDREDS OF THOUSANDS, MAYBE
NOTIONS OF YOUNG PEOPLE LIKE
BEING IN CALIFORNIA BEING MUCH
SAFER BUT STRONGER PROTECTION
AGAINST DANGEROUS AND I'VE HEARD
I URGE YOU ALL PARENTS,
GRANDPARENTS, RELATIVES EXPECTED
LEADERS FOR OUR STATE. HE'S
COACHED SUPPORT ASSEMBLY BILL
NUMBER ONE BEFORE ONE. THE
CHILDREN OF CALIFORNIA ARE
DEPENDING ON YOU. THANK YOU FOR
YOUR TIME AND LEADERSHIP ON THIS
LAST YEAR. THANK YOU THAT THANK
YOU. SO MUCH FOR WITNESSES NOW
WILL GO MOVE ON TO ADDITIONAL
WITNESSES AND SUPPORT. OF A B 13
41 WILL BEGIN HERE IN ROOM 21
2100 SAYING ON APPROACHING THE
MICROPHONE MODERATOR, PLEASE
OPEN THE LINES FOR WITNESSES
WHICH TESTIFY AND SUPPORT OF A B
13 41. WORRIED IF YOU WEREN'T
SUPPORTIVE, 18 WHICH I'M SORRY,
18 31 13. 13 MY BAD MY FAULT.
SORRY ABOUT THAT. IF YOU AREN'T
SUPPORT, IT'S ONE THEN ZERO. AND
WE DO HAVE A COUPLE THAT ARE
QUEUING UP HERE. SO IT'LL BE
JUST ONE MOMENT. THANK YOU,
MODERATOR. STAND THEN THAT THE
LOOKS LIKE WE ARE GOING TO START
WITH FINE NUMBER 1 68 AHEAD. HI
MY NAME IS DR BRENNAN AUSTIN
FROM THE STRATEGIC TRAINING
INITIATIVE FOR PREVENTION OF
EATING DISORDERS AND I SUPPORT A
B 1341. THANK YOU. THANK YOU.
NEXT WITNESS. NEXT WEEK. WE'LL
GO TO LINE NUMBER 1 47, PLEASE
GO AHEAD. HI. MY NAME IS AMANDA
OF FOOLED. I'M FROM STRATEGIC
TRAINING INITIATIVE FOR THE
PREVENTION OF EATING DISORDERS.
AND I'M IN SUPPORT OF THIS BILL.
THANK YOU. NEXT WITNESS, PLEASE.
LINE NUMBER 1 74. SIDE MY NAME
IS TAMBIÉN. UNDER MURRAY. I WORK
WITH THE STRATEGIC TRAINING
INITIATIVE FOR THE PREVENTION OF
EATING DISORDERS AND I SUPPORT A
B 1341. THANK YOU NEXT WITNESS.
NEXT TO GOOGLE TO LINE NUMBER 1
89. HI. MY NAME IS REALLY I WORK
WITH THE STRATEGIC TRAINING
INITIATIVE FOR THE PREVENTION OF
EATING DISORDERS AND I SUPPORT A
B 13 41. THANK YOU NEXT DOOR.
NEXT. WHAT? THIS OKAY, WE WILL
GO. NOTHING TO THE LINE. 1 90.
THINK THIS ONE SECOND HERE.
THEY'RE QUEUING UP. OKAY SO WE
WILL GO TO LINE NUMBER 1 90.
YOUR LINE IS OPEN. HI MY NAME IS
NAOMI CENTER. SO AND I WORKED
FOR THE STRATEGIC TRAINING
INITIATIVE FOR THE PREVENTION OF
EATING DISORDERS. AND I SUPPORT
BABY 30 BEFORE YOU ARE. THANK
YOU NEXT WITNESS. OKAY AND WE DO
HAVE ONE MORE THAN JUST CUED UP.
IT'LL BE JUST ONE SECOND HERE.
ALL RIGHT. WE WILL GO TO LINE
NUMBER 1 19 GO AHEAD. HI. MY
NAME IS JILL CAVANAUGH ON BEHALF
OF STRATEGIC TRAINING INITIATIVE
FOR THE PREVENTION OF EATING
DISORDERS AND SUPPORT OF A B
1341. THANK YOU NEXT WITNESS.
THERE. WE DO NOT HAVE ANY MORE
INTO MR CARE. ALL RIGHT? THANKS
VERY MUCH. WE'LL NOW MOVE TO
WITNESSES AND OPPOSITION TO THE
13 41. WE DO HAVE FOR TESTIMONY
AND OPPOSITION KYLE TURK FROM
THE NATURAL PRODUCTS
ASSOCIATION. SINCE EVEN THAT
YOU'RE THE SOLE WITNESS IN THE
OPPOSITION. SO YOU HAVE UP TO
FOUR MINUTES FOR ANY TESTIMONY,
ALTHOUGH, IF YOU DON'T NEED THAT
LONG, YOU DON'T NEED TO TAKE ALL
THE TIME. WELCOME. AWESOME THANK
YOU. CAN YOU HEAR ME? YES.
PLEASE BEGIN. ALRIGHT PERFECT.
THANK YOU. MP REPRESENTS OVER
700 DIVERSE NUMBER OF
ORGANIZATIONS UNITED AND
PROVIDING CONSUMERS WITH ACCESS
TO SAFE PRODUCTS MASON AND
APPROVE THEIR HEALTH. WE WERE
THE FIRST ORGANIZATION OFFER
THIRD PARTY GMP CERTIFICATION
PROGRAMS THAT DIETARY
SUPPLEMENTS AND INGREDIENT MAYBE
IF ACTUATORS WITH RESPECT TO A B
13 41. THE ONE THING WE NEED TO
KEEP IN MIND HERE IS THAT
SUPPLEMENTS ARE NATURAL PRODUCTS
FOUND IN FOOD AND NATURE. AND
WHILE EATING DISORDERS ARE A
SEVERE MENTAL AND PHYSICAL
CONDITION, AND THESE PEOPLE
CERTAINLY NEED HELP, AND WE
SHARE THE CONCERN 14 EENAGERS
WITH EATING DISORDERS M P A
BELIEVES THAT BANNING
INGREDIENTS FOUND IN FRUITS,
FRUITS AND VEGETABLES IS NOT THE
NOT THE ANSWER HERE. 80% OF
AMERICANS TAKE AT LEAST ONE
DIETARY SUPPLEMENT AS A SAFE,
EFFECTIVE AND AFFORDABLE WAY TO
MAINTAIN GOOD HEALTH. AND
ADDITIONALLY, MPA IN THE LAST
FEW YEARS HAS AVOIDED THE FDA,
UM, TO LOOK FOR A LINK BETWEEN
THE USE OF DIETARY SUPPLEMENTS
AND EATING DISORDERS. AND
THANKFULLY, THERE HAS NOT BEEN A
CONNECTION OR DATA POINTS
SUGGEST. THAT THERE IS A
CONNECTION, ACCORDING TO THE FDA
. I KNOW SOME HAVE ARGUED THAT A
TRS ARNIE VALUABLE, VALUABLE AND
DETERMINING A TEMPORAL
RELATIONSHIP BETWEEN A PRODUCT
AND AN EATING DISORDER ON THIS
COULDN'T BE FURTHER FROM THE
TRUTH SINCE THE FDA USES THE MED
WATCH SYSTEM TO ADD WARNINGS TO
PRODUCT THAT REGULATES. THAT
LEAD TO OR EXACERBATE EATING
DISORDERS. SO THE HYPOTHESIS
THAT SUPPLEMENTS DIRECTLY LEAD
TO EATING DISORDERS WOULD THEN
BE PICKED UP BY BED. WATCH IF
THIS WOULD WORK TO EXIST.
ADDITIONALLY ALL THE REFERENCES
THAT HAVE BEEN SUPPORTED IN
PREVIOUS TESTIMONY MENTIONED
LACK THE CHALLENGE THE CHALLENGE
RE CHALLENGE THEORY, COMMONLY
KNOWN AS CD R. IT'S A MEDICAL
TESTING PROTOCOL IN WHICH A
PRODUCT IS ADMINISTERED,
WITHDRAWN. AND THEN READ,
ADMINISTERED WHILE BEING
MONITORED FOR ADVERSE EVENTS
THAT NEEDS STAGE. NOT CDR IS
USED WHEN STATISTICAL TESTING IS
INAPPROPRIATE, UM, FOR A NUMBER
OF GIVEN REASONS, UM, INCLUDING
A LACK OF SUFFICIENT TEST
SUBJECT AND A UNIT OF ANALYSIS.
BEING THE INDIVIDUAL. THE BOTTOM
LINE IS NUTRITIONAL SUPPLEMENTS
SUPPORT A BALANCED LIFESTYLE,
AND WE SHOULD BE DOING
EVERYTHING WE CAN TO CONTINUE TO
PROMOTE HEALTHY LIVES. I'VE BEEN
IN DIETARY SUPPLEMENTS AND THE
INGREDIENTS FOUND IN FOOD AND
NATURE IS THE WRONG DIRECTION TO
GO. MP WOULD BE SUPPORTIVE OF
AMOUNT OF AN AMENDMENT TO STRIKE
THE DIETARY SUPPLEMENT
PROVISIONS FROM MAYBE 13 41
WHILE MAINTAINING THE OVER THE
COUNTER DIET PILL PROVISION.
CONSIDERING THOSE ARE OVER THE
COUNTER DRUG. UM AND WE WILL BE
MORE THAN HAPPY TO WORK WITH THE
SPONSOR ON THAT AND BE HAPPY TO
ANSWER ANY QUESTIONS. ANYONE HAS
THANK YOU. THANK YOU VERY MUCH
WILL NOW MOVE ON TO ADDITIONAL
WITNESSES AND OPPOSITION TO HB
13 41 WILL BEGIN HERE IN ROOM
2100 SEEN ONE APPROACHING THE
MICROPHONE. MODERATOR, PLEASE
OPEN THE LINES FOR WITNESSES WHO
WE SHOULD TESTIFY IN OPPOSITION
TO THE 13 41. NAME ORGANIZATION
POSITION. IF YOU ARE AN
OPPOSITION, IT IS ONE THEN ZERO.
OPPOSITION 10 ON YOUR PHONE. WE
DO HAVE ONE LETTER QUEUING UP
THERE GETTING THEIR LINE NUMBER.
ALL RIGHT. THEY'RE BEING PUT
BACK IN. Q. HERE ALL RIGHT. WE
WILL GO TO LINE NUMBER 1 63 GO
AHEAD, PLEASE. MY NUMBER 1 63,
YOUR LINE IS OPEN. IS THAT ME?
YEP. THANK YOU YOURSELF. OH, HE
SAID, MY NAME IS 1 69. I'M SORRY
. RELEASED A DIFFERENT NUMBER.
MY NAME IS VERONICA FROM US
COUNTY AND I AM CONFIDENT. JUST
UH, OPPOSED ABC. 1341. THANK
YOU. THANK YOU. NEXT WITNESS.
MHM AND WE DO NOT HAVE ANY MORE
IN QUÊ. THANKS VERY MUCH. WE'LL
BRING IT BACK TO COMMITTEE UNDER
THE QUESTIONS OR COMMENTS FROM
COMMITTEE MEMBERS. SARAH
MELENDEZ. THANK YOU, MR
CHAIRMAN. UM OKAY, SO I HAVE
SEVERAL QUESTIONS. BEEN LOOKING
AT. THE AUTHORS, STATEMENTS FOR
THE BILL AND THE ANALYSIS. SO.
THERE WAS A STUDY. UM THE USC
ANNENBERG STUDY BECAUSE IN YOUR
ANALYSIS IT TALKS ABOUT I THINK
IT SAYS 30 TO 40. OF LATINO
KIDS. ARE USING THESE
SUPPLEMENTS MORE SO THAN OR AT A
HIGHER PERCENTAGE. IF I CAN FIND
THE EXACT WORDS HERE. OKAY, SO
THIS SAYS. LATINO KIDS ARE 40%
MORE LIKELY TO USE OVER THE
COUNTER DIET PILLS THAN WHITE
TEENS. UM AND SO I FOUND THIS
INFORMATION ON THE. HARVARD
WEBSITE. THEIR INITIATIVE CALLED
OUT OF KIDS HANDS. IT WAS KIND
OF VERBATIM. SO I ASSUME THAT'S
WHERE YOU GOT IT FROM, UM AND
THEY LIST AND I JUST I WAS VERY
CURIOUS NOW. I WANTED TO SEE
WHERE THIS DATA IS COMING FROM,
BECAUSE I THINK WE'RE VERY
FORTUNATE. AS LEGISLATORS ON
HEALTH COMMUNITY. WE HAVE ACCESS
TO ALL OF THIS DATA AND THESE
STUDIES AND SO UM, I WAS VERY
PLEASED TO SEE THAT YOU HAD
REFERENCE SOME IN HERE SO FROM
THAT STUDY. UM, WHEN I LOOKED AT
IT, IT ACTUALLY SAYS THAT LATINO
STUDENTS HAD A 30 TO 40. HIGHER
ODDS OF USING DIET PILLS BEYOND
30 DAYS. NOT THAT THEY HAD A 30
TO 40% HIGHER USAGE OF THEM, BUT
THAT IT'S BEYOND 30 DAYS, AND
I'M LOOKING AT THIS STUDY RIGHT
NOW, BECAUSE THIS WAS THE
ARTICLE WRITTEN BY JULIA
VITAGLIANO. WHICH IS REFERENCED
IN THIS ANNENBERG STUDY FROM
USC. SO THAT'S A LITTLE
DIFFERENT THAN SAYING THAT THESE
YOU KNOW LATINO YOUTH ARE USING
THIS AT A HIGHER RATE. THEY ARE
USING IT AT A HIGHER RATE BEYOND
30 DAYS. THE CDC WEBSITE SAYS
THAT, UM LATINO KIDS. GENERALLY
SPEAKING, UM DO YOU TRY TO LOSE
WEIGHT PERCENTAGE WISE, MORE
THAN WHITE KIDS ABOUT 50% FOR
LATINO KIDS ABOUT 33% FOR WHITE
KIDS. UM BUT WHAT'S INTERESTING
IS THEIR DATA ALSO SAYS THAT THE
WAY IN WHICH THEY TRY TO LOSE
WEIGHT IS VERY DIFFERENT THAN
WHAT IS BEING PRESENTED IN YOUR
BILL. 83% OF THESE KIDS ARE
USING EXERCISE. TO LOSE WEIGHT,
NOT USING ANY TYPE OF SUPPLEMENT
OR PILL. AND THEN. THE NIH
WEBSITE SAYS THAT LIKELY USERS
OF THESE DIETARY SUPPLEMENTS OR
WEIGHT LOSS PILLS, THINGS OF
THAT NATURE ARE WHITE KIDS. AND
THAT THE PERCENTAGES WERE 37%
WEIGHT. KIDS 20% HISPANIC AND
THE DEMOGRAPHICS WERE THAT YOU
KNOW, THEY MOST OFTEN HAD
PRIVATE HEALTH INSURANCE AND
INCOME LEVELS ARE VASTLY
DIFFERENT, SO I'M JUST I'M
QUESTIONING WHAT I'M READING IN.
IN YOUR STATEMENT AND IN THE
ANALYSIS BECAUSE IT'S SETTING IT
UP AS AS SOME SORT OF RACIAL
DISPARITY OR SOME SORT OF RACIAL
TARGETING, AND THE NIH AND THE
CDC ARE SAYING OTHERWISE IN
THEIR STATES, AND IN FACT THE
STUDY THAT YOU REFERENCED IN IN
THE ANALYSIS. SAYS SOMETHING
OTHER THAN. THAN WHAT YOU HAVE
STATED. NOW, ALL OF THAT ASIDE.
HONEY, I DON'T DISAGREE THAT
THERE IS SOME PRODUCTS OUT THERE
THAT I DON'T WANT MY KIDS
TAKING, YOU KNOW, I MEAN, I
WOULDN'T TAKE IT MYSELF. THERE'S
PLENTY OF DIETARY SUPPLEMENTS
OUT THERE. THERE ARE NATURAL AND
HEALTHY AND HAVE YOU KNOW
VITAMINS AND MINERALS AND AMINO
ACIDS AND CAN CERTAINLY HELP
SOMEONE. BUT THEN, OF COURSE,
THERE ARE SOME OTHERS THAT HAVE
SOME THINGS THAT CAN INCREASE
YOUR HEART RATE, YOU KNOW,
METABOLIC TYPE OF ENHANCERS.
THINGS LIKE THAT. SO I GET WHERE
YOU'RE COMING FROM. BUT MY
QUESTION TO YOU, THOUGH, IS IF
YOU. IF WE SAY YOU HAVE TO HAVE
A PRESCRIPTION FROM A DOCTOR TO
BUY ANY TYPE OF DIETARY
SUPPLEMENT, WHICH, UM, COVERS A
LOT OF THINGS, NOT JUST YOU
KNOW, THE METABOLIC ENHANCERS
THAT I WAS TALKING ABOUT. THEN
DO YOU HAVE A CONCERN THAT, UM,
FOR THOSE MORE VULNERABLE
STUDENTS, LIKE THE YOUNG LADY
WHO TESTIFIED AND WOULD TURN TO
ALTERNATIVE MEANS LIKE ANOREXIA
OR BULIMIA OR ABUSE OF LAXATIVES
OR THINGS LIKE THAT, IN ORDER TO
ACHIEVE THE WEIGHT LOSS GOALS
THAT THEY'RE TRYING TO ATTAIN. I
THINK THAT, UM THE MORE OPTIONS
THAT THEY HAVE OUT THERE TO
ABUSE, THE EASIER IT IS FOR THEM
TO ABUSE AND GO DOWN THIS, I
THINK, IF INDIVIDUALISTIC,
DETERMINED TO TRY DIFFERENT
THINGS. YOU HAVE THAT
POSSIBILITY, BUT I THINK
REMOVING MOVING ANY ANY OF THESE
OPTIONS, I THINK REDUCES THE
SITUATION. UM IT DOESN'T MATTER
EVERYTHING. I THINK WE TRY TO
WORK WITH THE OPPOSITION TO SAY,
WELL, YOU KNOW WHAT'S WHAT ARE
WE TRYING TO BEND? WHAT SHOULD
BE UNDER SUPERVISION OF A
PHYSICIAN, WHICH SHOULD BE UNDER
SUPERVISION OF THE PARROT.
THINGS LIKE SLIM FAST, FOR
EXAMPLE, I THINK IS WHAT WE
THINK ABOUT. THAT'S NOT BAD OUT
THERE. UM A LOT OF NATURAL
VITAMINS ND NATURAL SUPPLEMENTS
WOULD NOT BE BAD EITHER. WE'RE
NOT TRYING TO TOUCH THAT EITHER
I KNOW THAT THE OPPOSITION
THAT'S BOTH TALKED ABOUT WHAT
THE NATURE AND TOBACCOS NATURE
TOO, AND SO WE HAVE RESTRICTIONS
THERE FOR MINORS. AND SO WE HAVE
BEEN WORKING WITH A LOT OF THE
OPPOSITION'S AND TRY TO NARROW
LIST AND SAY, REALLY, WHAT ARE
THE THINGS THAT OUR KIDS SHOULD
NOT HAVE ACCESS TO IT? THAT'S
PROVISION OF A PARENT. AND A
DOCTOR. AND IF THE DOCTOR SO
THEY NEED THAT THAT PRESCRIPTION
WOULD BE THERE. AND SO IT MIGHT
NOT STOP ALL KIDS, BUT I DO
THINK AS WE REMOVE SOME OF
ACCESS TO SOME OF THESE THINGS,
IT WILL BECOME A DETERRENT TO
SOME OF OUR CHILDREN OUT THERE.
SO YOU DON'T HAVE ANY CONCERNS
THAT IF YOU REMOVE THOSE TYPES
OF PRODUCTS THAT THEY WOULD JUST
TURN TO ALTERNATIVE MEANS. I
MEAN, I THINK THE REALITY IS
DIRECT. THINK SOME YOUTH MIGHT
DO THAT? YEAH, BUT I THINK LESS
YOUTH WILL DO THAT. I THINK
IT'LL IT'LL JUST MAY I ASK WHY
YOU WHY YOU THINK THAT JUST
CURIOSITY OF TIMES? YOU KNOW,
THE FIRST THING WE THINK ABOUT
IS A PILL IS WASTE HERE. AND I
THINK EVEN SINCE MY DADDY A
CARETAKER FROM MY PARENTS AND
THERE'S LIKE THINGS WE HAVE TO
DO TO KEEP THEM HEALTHY IN THERE
LIKE YOU JUST GIVE ME A PILL
BECAUSE I DON'T WANT TO DO THIS
EXTRA WORK. AND SO YOU KNOW, I
DO THINK THAT IT'S EASIER AND IT
DOESN'T MEAN THAT IT'S GONNA
STOP EVERYBODY, BUT I THINK A
LOT OF TIMES WE WANT THE EASIER
THING, OKAY? AND SO, UM I'M
LOOKING AT THE DEFINITION HERE
IN THE BILL FOR DIETARY
SUPPLEMENTS FOR WEIGHT LOSS
MEANS A CLASS OF DIETARY
SUPPLEMENTS THAT ARE LABELED
MARKETED OR OTHERWISE
REPRESENTED FOR THE PURPOSE OF
ACHIEVING WEIGHT LOSS. SO YOU'RE
SAYING THAT SOMETHING LIKE SLIM
FAST WOULD NOT BE COVERED UNDER
THAT, UM I'M JUST. IS THERE IS
THERE SOMEWHERE ONE COULD LOOK
TO SEE WHAT IS COVERED AND WHAT
IS NOT COVERED UNDER THAT A LOT
OF PRODUCTS, YOU KNOW, CLAIM
WEIGHT LOSS, OR, YOU KNOW
ENHANCED OR, YOU KNOW, INCREASED
. SPEED IT UP. THAT SORT OF
THING DOES THAT FALL UNDER THIS
HAS TO FALL NTO THE FEDERAL
FOOD, DRUG AND COSMETIC ACT
RIGHT TO BE TO BE INCLUDED IN
THIS BILL. OKAY I UNDERSTAND. SO
IS THERE A LIST THAT SOMEONE
COULD LOOK AT TO KNOW WHETHER
THE PRODUCT THEY WANT IT WOULD
STILL BE AVAILABLE. WOULD BE
AVAILABLE TO YOU AS AN ADULT. I
WOULDN'T BE. SOME OF THESE
THINGS WOULDN'T BE AVAILABLE AS
A MINOR THERE WERE IN TALKING TO
THE OPPOSITION AND TALKING TO
THE RETAILERS AND HOW WE MAKE
SURE THAT POPS UP THAT THERE
NEEDS TO BE AN ID CHECK. THEY
HAVE A SYSTEM THAT THEY FEEL
CONFIDENT THAT THEY COULD HAVE A
CLEAR LIST FOR THEMSELVES TO
CHECK AND I D. OKAY SO THERE'S
NO WHAT I'M ASKING IS IF I'M 17
, AND THERE'S SOMETHING THAT
I'VE BEEN PURCHASING UM. THERE
WOULD BE NO WAY FOR ME TO JUST
SAY GOOGLE IT BEFORE. YOU KNOW
WHEN I HEAR ABOUT THIS BILL, AND
THEY SAY, OH, GOSH, I HOPE THIS
PRODUCT IS STILL AVAILABLE TO ME
AS A MINOR. IS THERE A WAY I CAN
LOOK THAT UP, OR IS IT JUST YOU
GOTTA GO TO THE STORE AND AT
HOME MOMENT. I MEAN, YOU HAVE TO
DO A LITTLE BIT OF RESEARCH, BUT
IT THE CD PH COULD CREATE THIS
LIST AS WELL. THAT'S AN OPTION
AND THEY'RE JUST AS WELL. BUT
THERE'S NOT A LIST NOW. NO OKAY,
I'M JUST I'M JUST TRYING TO.
IT'S NOT A GOTCHA. I'M JUST
TRYING TO UNDERSTAND, YOU KNOW.
OKAY? OKAY WELL, UM, THANK YOU
FOR THE CLARIFICATION. AYE. I'M
WITH YOU ON TRYING TO KEEP YOU
KNOW SOME OF THESE PRODUCTS OUT
OF THE HANDS OF MINORS, THOUGH I
HONESTLY I JUST QUESTION WHETHER
OR NOT THAT WILL CHANGE THE
BEHAVIOR AND THAT THEY WON'T
TURN TO SOME OTHER METHOD TO
ACHIEVE THE GOALS THAT THEY WANT
MUCH LIKE. I MEAN, WE HEAR THE
SAME ARGUMENT. WE TALK ABOUT
OTHER ISSUES IN THE LEGISLATURE.
EVERYTHING FROM. THEFT TO YOU
KNOW ABORTION THAT PEOPLE IF YOU
TAKE THIS OPTION AWAY, THEY WILL
FIND ANOTHER WAY TO DO SO. SO
UM, BUT THANK YOU FOR THE
CLARITY. MM. ANY OTHER QUESTIONS
OR COMMENTS. ANY MEMBERS.
ALRIGHT YES, SARAH EGGMAN. THANK
YOU. I WAS JUST LOOKING ALSO
JUST AT THE SUPPORT FOR THIS. SO
THE ACADEMY FOR EATING DISORDERS
CENTER FOR ANY DISORDER
STRATEGIC TRAINING INITIATIVE
FOR THE PREVENTION OF EATING
DISORDER. SO I GUESS JUST TO
MAKE THE POINT THAT, UM, A LOT
OF PROFESSIONALS IN THE FIELD
SEEMED TO THINK THAT YOU'RE ONTO
SOMETHING. UM SO IF IT HASN'T
BEEN DONE YET, I'LL MOVE THE
BILL. TO MOVE THE CENTER EGGMAN
ANY OTHER QUESTIONS OR COMMENTS
, SAYING NONE. UH SUMMARY,
GARCIA, I WANT TO THANK YOU FOR
BRINGING THIS BILL FORWARD. I
THINK CHALLENGES IS THAT FIRST
OF ALL, THERE'S A LOT OF
DECEPTIVE MARKETING OUT THERE,
AND SOMETIMES THESE PRODUCTS UM. MAY NOT NECESSARILY, UM,
BECAUSE OFTEN AND REGULATED
THERE ARE SOME CONCERNS AND YOU
HEARD NEW TESTIMONY ABOUT
CONTAMINATION SO FORTH HAVE SEEN
STUDIES LIKE THAT AS WELL. THE
OTHER POINT IS THAT, FOR EXAMPLE
, YOU KNOW, I KNOW THE
OPPOSITION TALKED ABOUT WELL. UM
THESE MEDICATIONS, WHICH AGAIN
MANY OF THE UNREGULATED SO THEY
MIGHT TRACKED AND PROBABLY
TRACKING THEM THE SAME WAY, YOU
KNOW, DON'T LEAD TO EATING
DISORDERS. IT'S NOT THAT THEY
CAUSE EATING DISORDERS THAT WENT
TO SOMEONE HAS EATING DISORDER.
THEY'RE LOOKING FOR DIFFERENT
WAYS NOW. I APPRECIATE MY LIKE
MY COLLEAGUE BRINGING UP WELL,
WELL, SOMEONE WILL TRY ANYTHING
. TRY SOMETHING ELSE. BUT FIRST
OF ALL THAT SOMETHING ELSE COULD
BE SOMETHING ACTUALLY WORKS IN
THIS POSITIVE, RIGHT LIKE
EXERCISE. OR OR SOMETHING, SO IT
DOESN'T NECESSARILY MEAN THAT SO
WHAT WE DON'T WANT TO DO IS HAVE
PEOPLE DECEIVED BY INAPPROPRIATE
MARKETING OR SOMETHING THAT IS
NOT SAFE. AND SO THAT'S REALLY
IMPORTANT. I GUESS THE OTHER
KIND OF JUST MAKE US I KNOW THE
WORD NATURAL MAKES. EVERYONE
THINKS IT'S SAFE. I WOULD POINT
OUT THAT WHILE CERTAINLY FOR
EXAMPLE, FOOD HAS GREAT THINGS
LIKE VITAMINS AND MINERALS, BY
THE WAY, SOME BITE AND AGAIN,
THE DOES MATTERS BECAUSE WE HAVE
TOO MUCH OF CERTAIN VITAMINS IS
NOT GOOD FOR YOU EITHER. WHETHER
YOU'RE NOT LIKELY TO GET THAT
FROM EATING, BUT FOR EXAMPLE,
I'LL TELL YOU FORMALDEHYDE IS A
NATURAL SUBSTANCE IN FOOD. NOW
WHEN YOU HAVE A LOT OF IT, IT'S
NOT SO GOOD LITTLE BIT OF IT.
THAT'S ACTUALLY NORMAL. AND
THAT'S NATURAL. BUT MOST PEOPLE
HERE FORMALDEHYDE. OH, MY GOD,
RIGHT, UM SO AND THERE'S A
DIFFERENCE BETWEEN CONSUMING IT
INTO FOOD NECESSARILY, AND
CONSUMING AS A PROCESS ITEM,
LIKE A PILL OR SOME OTHER, YOU
KNOW, MANUFACTURED MECHANISM AND
SO I ALWAYS BLOW CAUTIOUS WHEN
EVERYONE SAYS NATURAL, AND THEN
EVERYONE ASSUMES THAT MEANS IT'S
OKAY AND IT'S SAFE. SO THAT'S
NOT NECESSARILY THE CASE AS
WELL. BUT ANYWAY, UM, PERHAPS
GOING A LITTLE TOO LONG, BUT
CERTAINLY IN SUPPORT OF YOUR
BILL, WOULD YOU LIKE TO CLOSE?
AH, YES, THANK YOU. SO I DIDN'T
KNOW THAT MINERS COULD BUY DIET
PILLS, I THINK, AND THAT WAS NOT
AN IDEA THAT CAME TO ME. IT WAS
BROUGHT TO ME BY THE YOUNG WOMAN
YOU HEARD. SPEAK WHO GOT
ADDICTED TO DIET PILLS? UH AND
BECAME HER GATEWAY INTO AN
EATING DISORDER. AND I,
OBVIOUSLY BEHIND THE MEDIAN
SERVICE A LOT MORE THAN JUST THE
ACCESS TO THESE DIET PILLS, AND
THERE'S A LOT MORE THAT GOES
INTO ENSURING OUR KIDS HAVE THE
SUPPORT THEY NEED OUT THERE. AND
IT WAS IN MY DISCUSSIONS WITH
EXPERTS OF PART OF THE SOLUTION
, SO THIS IS SOMETHING THAT
THEY'VE BEEN WORKING ON AND
WANTING TO WORK ON THE STATE
LEVEL AND THE FEDERAL LEVEL FOR
A WHILE. I TRY TO BE
COLLABORATIVE AND HAVE BEEN
WORKING WITH US MANY
STAKEHOLDERS IN THE OPPOSITION
TO GET TO BILL. THAT MOVES US
FORWARD IN A BETTER DIRECTION.
BUT IT'S A COMPROMISE WHICH IS
WHAT YOU SEE TODAY. AND WHILE I
COULDN'T CAPTURE EVERYBODY,
WE'VE CAPTURED ALMOST EVERYBODY
IN THIS WORK OUT THERE. I WILL
SAY WHEN THIS IDEA OF HIS CAN BE
FOR ME, I COULDN'T HELP BUT, YOU
KNOW, I FEEL LIKE I WAS I WAS IN
AN AFTER SCHOOL SPECIAL AND OR
SEEING SAVED BY THE BALANCE. YOU
KNOW THAT JESSIE'S FINAL HAVING
TOO MANY PILLS AND SHAKING AND
HAVING ISSUES FOCUSING AND
ANECDOTALLY. I THINK A LOT OF US
HAVE SEEN THE EFFECTS OF THIS OR
HAVE EXPERIENCED IT OURSELVES
OUT THERE AS MINORS OR AS ADULTS
OUT THERE, AND SO IT JUST MADE.
IT JUST MAKES COMMON SENSE. OF
HOW WE PROTECT OUR YOUTH OUT
THERE AND HOW WE ENSURE THAT
THAT'S A DISCUSSION THEY'RE
HAVING WITH THEIR PARENTS AND
WITH THEIR PHYSICIANS ABOUT HOW
TO MAKE BEST MAKE HEALTHY
CHOICES, AS WE ARE TRYING TO
LOSE WEIGHT AND HAVE A HEALTHY
WEIGHT LEVEL THAT I RESPECTFULLY
AS WHEN I VOTE. ALL RIGHT. THANK
YOU. SO THE MOTIONS DO PASS
REFERRED TO THE COMEDIAN
JUDICIARY. IT'S BEEN MOVED BY
SENATOR EDMUND SECRETARY. PLEASE
CALL THE ROLL PAN AND I.
MELINDA'S EGGMAN. SIGMUND I.
GONZALES GROVE, HER TATO TATO I
LABOR LABOR. I LIMÓN BROTH RUBIO
WIENER. PAY THAT BILL CURRENTLY
HAS FOUR VOTES WILL HOLD THE
ROLL OPEN FOR ABSENT MEMBERS,
AND YOU ALSO HAVE ITEM NUMBER 3
23 20 CORRECT. YES THANK YOU.
MAYBE 23. I WANT TO START OFF BY
ACCEPTING ALL THE COMMITTEE
AMENDMENTS AND THINK STUFF FOR
WORKING WITH MY OFFICE ON THIS
BILL, MAYBE 23 20 WILL ESTABLISH
A PILOT PROGRAM FOR FIVE
COUNTIES IN CALIFORNIA TO
SUPPORT CAPACITY BUILDING FOR
PRIMARY CARE CLINICS PROVIDING
REPRODUCTIVE HEALTH CARE
SERVICES. THIS BILL UNLIKE ANY,
IT'S UNLIKE ANY OTHER BECAUSE IT
PUTS EXPERTS, CLINICIANS AND
CLIENT FACING STAFF IN THE
DRIVER'S SEAT OF CHANGE,
DEVELOPED PRACTICES THAT ARE
RESPONSIVE TO SPECIFIC NEEDS OF
OUR CLIENT OF THEIR CLIENT
POPULATIONS. ACCORDING TO THE
AMERICAN MEDICAL ASSOCIATION,
WOMEN OF COLOR LGBTQ PLUS LOW
INCOME ROLE IMMIGRANT AND PEOPLE
WITH LIMITED ENGLISH PROFICIENCY
BASED SOME OF THE HIGHEST RISK.
IN EARLYEVERY ASPECT OF
REPRODUCTIVE HEALTHCARE.
PATIENTS FROM HISTORICALLY
MARGINALIZED COMMUNITIES
EXPERIENCE HIGHER RATES OF
MATERNAL MORTALITY, CERVICAL
CANCER, MORTALITY, ESTÁ
INFECTIONS AND ACCESS TO
SERVICES AND EDUCATION. CLINIC
STAFF UNDERSTANDS THAT THEIR
PATIENTS INTERSECTING IDENTITIES
IMPACT HER BUT DON'T HAVE THE
FUNDING OR SUPPORT TO ADEQUATELY
RESPOND. CALIFORNIA HAS
COMMITTED ITSELF. TO ENSURING%
THAT WE HONOR PROMISES TO ALL
AND NOT JUST TO SOME, AND THIS
BILL LOOKS TO CLOSE PERSISTENT
GAPS IN SERVICES, UH AND CHRONIC
UNDER RESOURCING FOR PRIMARY
CARE CLINICS TO CONTINUE THAT
CONTINUE TO BURDEN PATIENTS AND
PROVIDERS. WHEN MEETING TESTIFY
TODAY I HAVE LINEAR WATKINS.
OAKLAND L G B T Q COMMUNITY FROM
THE OAKLAND LGBTQ COMMUNITY
CENTER. AND ESTHER PRISCILLA.
OBEY HE, UH, WITH THE SHERIFF'S
FEATURES FOR BLACK MOMS AND
BABIES. I RESPECTFULLY ASK WHEN
I WROTE WHEN APPROPRIATE.
ALRIGHT. WELCOME TWO MINUTES
EACH. WELCOME. PLEASE BEGIN.
HELLO MY NAME IS LINEAR. WATKINS
I'M THE PROGRAM DIRECTOR AT THE
OAKLAND LGBTQ COMMUNITY CENTER,
WHERE OUR MISSION IS TO PROVIDE
ACCESS TO SERVICES THAT ENHANCE
SUSTAINED THE WELL BEING OF
LESBIAN, GAY, BISEXUAL.
TRANSGENDER IN QUEER
INDIVIDUALS, THEIR FAMILIES. AND
ALLIES BY PROVIDING EDUCATIONAL
, SOCIAL AND HEALTH RELATED
ACTIVITIES, PROGRAMS AND
SERVICES. IN MY 15 YEARS OF
EXPERIENCE WITH WORKING IN NON
TRADITIONAL SETTINGS THAT SERVE
COMMUNITIES OF COLOR. LGBTQ PLUS
COMMUNITY AND NON ENGLISH
SPEAKERS ARE CLINICAL TEAMS
OFTEN NOTICE THAT COMMUNITY
MEMBERS RARELY FOLLOW UP WITH
HEALTHCARE PROVIDERS BECAUSE OF
LANGUAGE BARRIERS, CULTURAL
BARRIERS. AND LIKE LACK OF
PROPERLY TRAINED STAFF. TO
ADDRESS THESE ISSUES. WE HAVE
ADOPTED A WHOLE PERSON HEALTH
CARE MODEL THAT ENCOMPASSES
INTERDEPENDENT DIMENSIONS OF
HOLISTIC WELLNESS. IN MY ROLE AS
PROGRAM DIRECTOR I DEVELOPED
GRANT FUNDED PROGRAMMING TO MEET
THE NEEDS OF COMMUNITY MEMBERS.
OUR SENIOR RECENTLY HAD TO
ADDRESS AN INFLUX OF NON ENGLISH
SPEAKING PATIENTS THAT WERE IN
NEED OF TRANSLATION DURING ABOVE
CLINICAL IN CASE MANAGEMENT
APPOINTMENTS, WE SAW FUNDING
FROM ADDITIONAL SPANISH FOR
ADDITIONAL SPANISH SPEAKING CASE
MANAGERS AND INVESTED IN SEVERAL
TRANSLATION DEVICES THAT STAFF
TO USE INCOME WHILE IN CLINIC.
THIS ADDITIONAL FUNDING HELPED
US TO LEVERAGE SERVICES TO
PROVIDE PATIENT CENTERED CARE.
pTO IMPROVE CLINICAL SERVICES AND
COVER COSTS OF MEDICAL DOES NOT
COVER WE URGE YOU TO PASS A B 23
20 TO STRENGTHEN THE CLINICAL
TEAM THAT ARE OFTEN OVERBURDEN.
IF ROE VERSUS WADE IS OVERTURNED
THIS MONTH, WE WILL SURELY SEE
OUR PRIMARY CARE CLINICS STAFF
IN NEED OF ADDITIONAL SUPPORT AS
THEY SUPPORT THEIR PATIENTS.
PRIMARY CARE CLINICS HAVE THE
RESOURCES TO IMPROVE COMMUNITY
HEALTH, BUT WE CAN'T DO ANYTHING
WITHOUT THE SUPPORT AND FUNDING
FROM THE STATE. I SUPPORT A B 23
20 AND ASK FOR THE COMMITTEE
SUPPORT BY PASSING THIS BILL.
THANK YOU. THANK YOU. WELCOME.
THIS WEEKEND, GOOD AFTERNOON TO
THE CHAIR AND COMMITTEE MEMBERS
. MY NAME IS ESTHER PRISCILLA OF
WHAT HE AND I SERVE AS A STATE
POLICY FELLOW WITH THE WOMEN'S
FOUNDATION, CALIFORNIA POLICE
POLICY INSTITUTE, THE SPONSOR OF
HB 23 20. I WILL BE PROVIDING
THIS TESTIMONY ON BEHALF OF DR
JOSEPHINE OR VINA AND O B. G. Y
N PHYSICIAN AND FELLOW AT UC SAN
FRANCISCO. I AM THE DAUGHTER OF
MEXICAN IMMIGRANTS WHO CAME TO
THIS COUNTRY TO SEEK A BETTER
LIFE FOR THEMSELVES AND THEIR
CHILDREN. MY EXPERIENCE AS A
TEENAGER TRYING TO NAVIGATE A
HEALTHCARE SYSTEM THAT WASN'T
MADE FOR ME REVEALED TO ME THAT
INEQUALITIES THAT PEOPLE LIKE
MYSELF EXPERIENCE PEOPLE WHO
COME FROM SPANISH SPEAKING
SINGLE PARENT HOMES AND LOW
INCOME COMMUNITIES, WHERE A
BLIND EYE HAS TURNED TO TOPICS
REGARDING SEXUAL AND
REPRODUCTIVE HEALTH. IN MY LOCAL
PRIMARY CARE CLINICS. I FOUND
THAT NONE OF THE MEDICAL STAFF
REFLECTED THE PATIENT POPULATION
THEY SERVE. THE PART, THE
PROVIDERS WERE CONDESCENDING IN
THEIR INTERACTIONS WITH US
ALMOST SCOLDING US FOR NOT
KNOWING ENOUGH ABOUT THE VARIOUS
BIRTH CONTROL METHODS. ONE
INTERACTION I OVERHEARD IN THE
CLINIC WAS A WHITE, MIDDLE AGED
NURSE PRACTITIONER, GIVING A
SPANISH SPEAKING PATIENT
INSTRUCTIONS IN ENGLISH AND THE
PATIENT SAYING IN SPANISH, NONE.
THE ENDO MASCULINE TÂM. THERE
WAS NO DESIRE FOR THE STAFF TO
CALL AN INTERPRETER TO DISCUSS
THE CONTRACEPTIVE INJECTION SHE
HAD JUST RECEIVED. THIS RESULTED
IN WHAT I NOW REALIZE WAS
CONTRACEPTIVE COERCION AND ONE
OF THE MAIN REASONS I DECIDED TO
BECOME AN O B G Y N I RECENTLY
HAD A PATIENT THAT WAS REFERRED
TO ME FOR HER THIRD ATTEMPT AT
ECOLE POSCA P AND CERVICAL
BIOPSY IDENTIFIED AS A CIS,
GENDER LATIN, A QUEER WOMAN AND
MENTIONED THAT SHE HAD VIOLET.
SHE HAD AVOIDED GETTING A PAP
SMEAR FOR YEARS BECAUSE SHE
FOUND THE EXPERIENCE UNPLEASANT.
FROM MY EXPERIENCE AND PROVIDING
TRAUMA, INFORMED CARE AND
DEVELOPING PARTNERSHIPS WITH OUR
PATIENTS. WE CAME UP WITH A PLAN
TO MAKE SURE SHE FELT
COMFORTABLE BEFORE DURING AND
AFTER HER APPOINTMENT. I MADE
SURE TO TELL HER OUR HIGHEST
PRIORITY WAS HER COMFORT. DURING
THE PROCEDURE SHE TOOK LEAD IN
PLACING THE SPECULUM HERSELF,
JUST DEMONSTRATING THAT SHE FELT
EMPOWERED. I WALKED HER THROUGH
EACH STEP OF THE PROCEDURE AND
WAS ABLE TO OBTAIN CERVICAL
BIOPSIES WITH MINIMAL
DISCOMFORT. WHEN I TOLD HER THAT
PROCEDURE WAS DONE, SHE ASKED
WHY THIS WASN'T THE STANDARD OF
CARE AT OTHER CLINICS. I BELIEVE
CULTURAL AND LANGUAGE CONCORDANT
CARE ENHANCES TRUST BETWEEN
PATIENTS AND PROVIDERS,
OPTIMIZES HEALTH OUTCOMES AND
ADVANCES. HEALTH EQUITY, PLEASE
WRAP UP POPULATIONS, MEDICAL
PROVIDERS AND CLINICAL STAFF
SHOULD BE SUPPORTIVE OF THE
PATIENTS. THEY SERVE TO PASS. HB
23 20. THIS BILL WOULD BE THE
FIRST STEP IN THE RIGHT
DIRECTION FOR OUR COMMUNITIES.
THANK YOU. THANK YOU SO VERY
MUCH, OKAY? WILL TAKE ADDITIONAL
WITNESSES AND SUPPORT THIS BILL
HERE IN ROOM 2100. WELCOME.
THANKS BRIAN SPENCER ON BEHALF
OF THE AMERICAN COLLEGE OF
OBEDIENCE DISTRICT. NINE IN
SUPPORT. THANK YOU. WELCOME
HELLO, SEAN SMITH FOR GREENBERG
HARD ON BEHALF OF THE CALIFORNIA
PARTNERSHIP TO END DOMESTIC
VIOLENCE AND SUPPORT. THANK YOU
. WELCOME CINDY HILLARY ON
BEHALF OF THE CALIFORNIA MEDICAL
ASSOCIATION AND SUPPORT THANK
YOU. NO ONE ELSE AT THE
MICROPHONE. MODERATOR PLEASE
OPEN THE LINES FOR WITNESSES WHO
WISH TO TESTIFY IN SUPPORT OF A
B 23 20 NAME ORGANIZATION
POSITION. IF YOU ARE IN SUPPORT
OF A B 23 20, IT IS ONE DÂN ZERO
ON YOUR PHONE. WE DO HAVE ABOUT
52 UP HERE. WE WILL START WITH
LINE NUMBER 1 39. GOOD AFTERNOON
. THIS IS ELIZABETH ESPINOSA TO
ME. ELIZABETH ESPINOSA,
TESTIFYING IN SUPPORT FOR THE
COUNTY HEALTH EXECUTIVES
ASSOCIATION OF CALIFORNIA. THANK
YOU. THANK YOU NEXT WITNESS. WE
HAVE NEXT IN LINE NUMBER 1 34,
PLEASE GO AHEAD. ISABELLA
ORQUERA ON BEHALF OF THE
CALIFORNIA NURSE MIDWIFE
ASSOCIATION IN THE PRO CHOICE
CALIFORNIA AND SUPPORT THANK
YOU. THANK YOU. X WITNESS.
ACTUALLY HAS MY NUMBER 1 93. HI
GOOD AFTERNOON, MR CHAIR AND
MEMBERS ON YOUR MOBILE BLACK
MENTAL, HONEST ACTION PROJECTS
AND SUPPORT. THANK YOU. THANK
YOU. NEXT WITNESS. WE HAVE NEXT
LINE NUMBER 1 35. GOOD AFTERNOON
. JANINE EREKAT, WITH
PARTNERSHIP FOR ADVANCEMENT OF
NEW AMERICANS CALLING IN
SUPPORT. THANK YOU NEXT WITNESS.
EARNER. LAST ONE IN Q HERE, LINE
NUMBER 1 27. MY NUMBER 1.7. I'LL
GO AHEAD. YES HI, SORRY.
ANDREASEN MIGUEL FROM PLANNED
PARENTHOOD AFFILIATES IN
CALIFORNIA AND SPORTS. THANK
YOU. NEXT WITNESS. THERE. WE DO
NOT HAVE ANY MORE IN QUÊ, MR
KERRY. THANK YOU. WE'LL NOW MOVE
TO WITNESSES IN OPPOSITION TO A
B 23 20. WE DO NOT HAVE ANYONE
FORMALLY REGISTERED FOR
TESTIMONY, SO WE'LL GO. HERE TO
ROOM 2100 SEEN ON APPROACHING
THE MICROPHONE. MODERATOR PLEASE
OPEN THE LINES FOR WINDOWS
SYSTEM WHICH SHOULD TESTIFY IN
OPPOSITION TO A V 23 20. SIR, IF
YOU'RE AN OPPOSITION OF A B 23
21 0 AND WE HAVE ONE IN HERE
NUMBER 1 76. WHY IS THAT? ME AND
MY IN THE SENATOR PAN HEARING
ABOUT THE PANEL? MODERATOR
PLEASE TURN OFF. THANK YOU. ARE
THERE OTHER WITNESSES AND
OPPOSITION TO HB 23 20? AND WE
HAVE TO IN. Q. HERE, ONE LINE
NUMBER 1 69 IS SEX. THANK YOU.
HI THIS IS OKAY. YOU HEAR ME?
YES PLEASE BEGIN. MY NAME IS
VERONICA UP REPRESENTING YOU,
COOK COUNTY AND I AM OPPOSITION
OF MAYBE 23 20. THANK YOU. THANK
YOU. NEXT WITNESS. OKAY, AND WE
DO HAVE ONE THAT JUST CUED UP
HERE, SO IT'LL BE JUST A MOMENT
WHERE WE GET THEIR LINE NUMBERS.
OKAY SO THEY RELEASED THEMSELVES
AND WE HAVE ONE THAT JUST CUED
UP HERE ALSO AGAIN. SO ONCE
AGAIN, IT'S IN OPPOSITION OF A B
23 20. THEN WE HAVE LONG LINE 1
76. YOU'RE NOT FOLLOWING YOUR
PRODUCT, SO THANK YOU. ALL RIGHT
. NUMBER 1 76. YEAH ALRIGHT, SO
WE DO NOT HAVE ANYBODY ELSE.
THANK YOU. MODERATOR WILL BRING
IT BACK TO COMMITTEE QUESTIONS
OR COMMENTS FROM COMMITTEE
MEMBERS. YES, SENATOR MELINDA'S
OKAY? UM THANK YOU, MR CHAIRMAN
. SO, UM. THIS BILL I'M ASSUMING
BASED ON READING HERE THAT, UH,
REFERENCES. PLACING OR I'M SORRY
. CHOOSING THE. THE CENTERS THAT
WOULD RECEIVE THIS FUNDING. UM.
BASED PARTLY ON THE LIKELIHOOD
THAT NON RESIDENTS WILL BE
TRAVELING TO THAT COUNTY FOR
REPRODUCTIVE HEALTH CARE
SERVICES. SO I AM MAKING THE
ASSUMPTION THAT THIS IS DESIGNED
TO SERVICE WOMEN WHO ARE COMING
FROM OUT OF STATE. NOT
NECESSARILY THOSE THEY WOULD
STILL BE SERVED CALIFORNIA
RESIDENT BUT MORE LIKELY
DESIGNED TO SERVICE WOMEN WHO
ARE COMING FROM ADAM STATE. IS
THAT A FAIR ASSUMPTION? I WOULD
SAY NOT MORE LIKELY, BUT BOTH
COMMUNITIES LIKE MINE. THE
CLINIC IS KIND OF ALL WE HAVE. I
THINK I WOULD SAY BOTH, OKAY,
BECAUSE I MEAN, IT DOES TALK
ABOUT SPECIFICALLY WHAT AREAS OF
THE STATE THAT THEY WOULD HAVE
TO BE LOCATED IN BUT IT GOES ON
TO SAY AND THE LIKELIHOOD THAT
THEY WOULD BE YOU KNOW THAT NON
RESIDENTS WOULD BE TRAVELING TO
THAT PARTICULAR LOCATION FOR
THESE SERVICES. SO UM. I KNOW
YOU SAID YOU WANTED ABOUT $12
MILLION OVER A PERIOD OF FOUR
YEARS FOR THIS, THOUGH, I DON'T
KNOW IF THAT'S BEEN WORKED OUT
YET, BUT I KNOW THAT'S
ORIGINALLY WHAT YOU SAID YOU
WANTED. THAT'S ABOUT ROUGHLY 2.5
MILLION PER LOCATION. EACH OF
THESE FIVE THAT YOU WANT THIS
FUNDING TO GO TO AND SO WHAT I'M
TRYING TO UNDERSTAND IS WHAT IS
THAT MONEY TO BE USED FOR IF
THESE CENTERS ALREADY EXIST? UM
THEN WAT IS THE MONEY FOR THE
2.5 MILLION. SOME OF IT IS WELL,
THEY EXISTED MIGHT NOT HAVE
TRANSLATION SERVICES, FOR
EXAMPLE. THEY MIGHT NEED
ADDITIONAL TRAINING FOR THEIR
STAFF TO MAKE SURE THAT THEY'RE
BEING CULTURALLY SENSITIVE,
COMMON FORMED. AS WELL. THEY
MIGHT NEED ADDITIONAL EQUIPMENT
YOU HEARD FROM OUR WITNESS OF
HOW THEY HAD TO BUY SOME
TRANSLATION EQUIPMENT AS WELL.
AND SO IT'S A COMBINATION OF HOW
THEY BEST SEE. AT THE NEED TO
ADJUST TO FIT A POPULATION
THAT'S COMING THROUGH THERE AND
CULTURALLY SENSITIVE WAY FOR
MOST. VULNERABLE COMMUNITY
MEMBERS OFTENTIMES DON'T FEEL
LIKE THE SYSTEM AND CATERS TO
THEM. OKAY THAT'S WHAT SOME OF
THE MONEY COULD BE USED FOR.
WHAT I'M ASKING IS, IS THERE
ANYTHING SPECIFIC? IS THERE ANY
LIMITATION TO WHAT THE FUND
COULD BE USED FOR? IS IT UM THAT
COULD BE USED AROUND THE
REPRODUCTIVE JUSTICE PRINCIPLES
, WHICH IS, YOU KNOW THE RIGHT
TO HAVE A CHILD, THEIR RIGHT NOT
TO HAVE A CHILD THE RIGHT TO
NURTURE THAT THE CHILD IN A SAFE
AND HEALTHY ENVIRONMENT. HUESO
MUST HAVE THAT NEXUS AS WELL.
OKAY BUT THAT DOESN'T COST MONEY
. WHEN I'M ASKING IS WHAT WILL
THE MONEY BE SPENT ON? BECAUSE
IF YOU'RE LOOKING TO EXPAND
ACCESS WHEN I'M TRYING TO
UNDERSTAND HERE IS THAT WE'RE
TALKING ABOUT ALREADY EXISTING
CENTERS. WHAT WOULD THEY NEED
THE MONEY FOR SHORT OF? I GUESS
IF YOU'RE EXPECTING AN INCREASE
IN CLIENTELE THAN THEY WOULD
HAVE TO INCREASE THE NUMBER OF
EMPLOYEES WHO WORK THERE. IS
THAT WHAT YOU'RE GETTING AT?
THAT'S WHAT THEY FEEL THEY
NEEDED FOR TO PROVIDE THE
SERVICE. THAT'S FINE. BUT I
MEAN, I JUST GIVE YOU EXAMPLES
ABOUT TRANSLATION SERVICES THAT
MIGHT BE NEEDED ADDITIONAL
TRAINING THAT MIGHT BE NEEDED.
AND SO I DON'T THINK IT'S
LIMITED TO THAT. IT COULD ALSO
INCLUDE IF WE NEED ADDITIONAL
SAYING IT'S LIMITED TO THAT. I'M
ASKING YOU WHAT IS IT FOR?
BECAUSE IT'S NEEDED GOING TO
NEED $2.5 MILLION FOR
TRANSLATION SERVICES. THAT'S
ABSURD. THAT'S AND BECAUSE THE
CENTER EXISTS AS IT MEAN THAT IT
HAS THE CAPACITY TO EVEN SERVICE
, THE COMMUNITY THAT IT'S AROUND
THAT IT'S AND IT'S SURROUNDINGS
OFTEN TIMES THESE CLINICS. OUR
UNDERFUNDED, UNDERSTAFFED EVEN
MEET THE NEEDS THAT ARE
CURRENTLY THERE IN THOSE
COMMUNITIES, SO YES, I DO EXPECT
THAT SOME OF THESE FUNDS CAN BE
USED FOR ADDITIONAL STUFF. I DO
EXPECT THAT WE WILL BE HAVING
BOTH COMMUNITY MEMBERS AND MAYBE
COMMUNITY MEMBERS WHO ARE NOT IN
THE COUNTY TRAVELING IN IT'S NOT
JUST OUT OF STATE. SOMETIMES YOU
HAVE TO LEAVE YOUR COUNTY IN
CALIFORNIA TO GET ACCESS AND
POLICE OFFICERS NOT NEAR YOU.
AND SO THE REALITY IS THAT,
YEAH. YOU CAN YOU CAN EXPECT
FOLKS FROM OUT OF STATE, BUT I
THINK A LOT OF PEOPLE WHO ARE
GONNA END UP WITH THESE CLINICS
ARE ACTUALLY FROM THE COMMUNITY
OR FROM NEIGHBORING COMMUNITIES
THAT DON'T HAVE ACCESS TO
ANYTHING. OKAY, UM THAT WAS A
LOT TO UNPACK BECAUSE YOU DID
REFERENCE THAT A LOT OF THESE
CENTERS MAYBE THEY DON'T. QUÊ
THEY'RE NOT AS SOPHISTICATED AS
SOME OTHERS OUT THERE, SO I'M
NOT SURE HOW I CENTER THAT IS IN
AS UP TO DATE IN MODERN AS SOME
OTHERS WOULD THEN BE ATTRACTING.
PEOPLE TO THEIR CENTER WERE IT
NOT FOR ADDITIONAL FUNDING WHERE
THEY COULD PERHAPS MODERNIZE AND
ADD MORE STAFF, AND I JUST
WANTED TO GET SOME CLARITY ON
WHAT SPECIFICALLY THE MONEY. IS
ALLOWED TO BE SPENT ON IF THIS
IS A BILL ABOUT EXPANDING CARER,
UM AND I'M. LOOKING AT THE
REQUIREMENTS FOR GETTING THE
MONEY AND YOU HAVE TO DO ONE OF
FOUR THINGS. IN ONE OF THEM IS
TO IMPROVE SPOKEN AND WRITTEN
LANGUAGE TRANSLATION SERVICES
FOR NON ENGLISH SPEAKERS. UM. SO
THAT'S ALL YOU HAVE TO DO IS FOR
$2.5 MILLION. YOU JUST TURNING A
REPORT THAT SAYS WE'VE IMPROVED
TRANSLATION SERVICES, AND THAT'S
IT. WELL THEY'RE ALSO WE'RE
ASKING THEM TO TRACK DATA AND
SUBMIT INFORMATION TO US AS WELL
TO SEE. YOU KNOW HOW IT'S
WORKING. UM AND I THINK THAT.
BUT DO YOU AGREE THAT IF IT'S
YOUR, IT'S YOUR CLINIC. AND IT'S
IN YOUR BEST INTEREST TO MAKE
SURE YOU HAVE A GOOD REPORT
GOING FORWARD THAT YOU CONTINUE
TO GET YOUR MONEY. THEN YOU'RE
GOING TO WRITE THAT REPORT. IN A
WAY THAT'S MOST BENEFICIAL TO
YOUR CENTER, RIGHT? THAT'S HUMAN
NATURE. I MEAN, LET ME SAY THIS.
I WANT TO GO BACK EARLIER TO
BEING SOPHISTICATED OR NOT, I
THINK SOMETIMES OUR CLINICS ARE
MORE SOPHISTICATED BECAUSE THEY
HAVE THAT DIRECT CONTACT WITH
THE COMMUNITY AND ARE GOING TO
BE MORE CULTURALLY SENSITIVE.
ARE GOING TO BE FORCED TO BE
NIMBLE, SOMETIMES BECAUSE OF
LACK OF RESOURCES OUT THERE.
$2.5 MILLION TO AN INDIVIDUAL IS
A LOT OF MONEY, BUT TO A CLINIC
IS NOT A LOT OF MONEY, SOMETIMES
EVEN BUYING EQUIPMENT THAT IS
NEEDED. CAN TAKE UP THE WHOLE
$2.5 MILLION OUT THERE. I FEEL
THIS IS A DROP IN THE BUCKET OF
WHAT? WE PROBABLY NEED TO BE
INVESTING IN THIS CLINIC FOR
WHAT THEY PROVIDE OUT THERE. AND
SO IT'S NOT JUST TRANSLATION
ISSUES. BUT EVEN ONE OF OUR
WITNESSES IS WITH THE L G B T Q
AND BEING CULTURALLY SENSITIVE
THERE TO COMMUNITY MEMBERS AND
WHAT THEY NEED AS WELL AND THE
TRAINING THAT THEY NEED OR WHAT
THEY FEEL. THEY NEED TO PROVIDE
THAT. PROPER EXPERIENCE THAT
THIS COST MORE TRAUMA TO OUR
PATIENTS AND JUST GIVING THEM A
LITTLE BIT OF FLEXIBILITY AND
USING THE KNOWLEDGE THAT THEY'VE
BEEN ABLE TO DEVELOP IN THOSE
COMMUNITIES. OKAY. THANK YOU,
ASSEMBLYWOMAN. THINK. HEARD A
MOTION FROM SENATOR TATO.
CORRECT. OKAY. ANY OTHER
QUESTIONS OR COMMENTS? OKAY,
SEEING NONE. SENATOR GARCIA. I
REALLY APPRECIATE YOU BRINGING
THIS BEFORE WORD. ACTUALLY I'D
MAKE NOTES AS CHAIR OF THE AAPI
CAUCUS FOR WE'RE ALWAYS TRYING
TO GET MORE TRANSLATION SERVICES
BECAUSE OF THE NUMEROUS
LANGUAGES SPOKEN IN OUR
COMMUNITY, ACTUALLY, UM THE
RESPONSIBILITY GET IS TOO
EXPENSIVE. SO UM, I THINK THAT
UH AH, ESPECIALLY THE COVER
SEVERAL DIFFERENT LANGUAGES. IT
COULD ADD UP PRETTY QUICKLY. THE
OTHER THING IS, FOR EXAMPLE,
TALKING ABOUT JUST
INTERPRETATION. I KNOW YOUR
BILLS BROADER THAN THAT,
ACTUALLY, RIGHT? FOR EXAMPLE, WE
TO ENHANCE QUALITY OUR CLINIC.
ACTUALLY, WE WENT FOR
TELEPHONIC. WE PILOTED
TELEHEALTH VERSUS TELEPHONIC AND
TO CHECK THE QUALITY DIFFERENCE,
AND IT WAS A SIGNIFICANT
DIFFERENCE TO DO. TELEHEALTH
BECAUSE THEY CAN SEE BODY
LANGUAGE AND OTHER TYPES OF
THINGS. WELL THAT'S A WHOLE
UPGRADE OF YOUR IT IS AS WELL AS
OF COURSE, HAVING THE PEOPLE
AVAILABLE THROUGH TELEHEALTH SO
I COULD SEE POTENTIALLY JUST IN
THAT ONE SPACE INVESTMENTS THERE
. AND THEN, OF COURSE, YOU
TALKED ABOUT THE TRAININGS,
RIGHT? AND THAT SEEMS TO BE A
PRETTY BIG PART OF THE BILL WHEN
I WAS READING IT. THE EDUCATION
AND TRAINING THAT WOULD BE DONE
AND THE CAPACITY BUILDING AND
SO, UM TO ME. I AGREE WITH YOU.
IT'S A DROP IN THE BUCKET. IN
FACT, I CAN EASILY SEE THAT THE
ACTUAL DEMANDS BEING MUCH
GREATER THAN THE MONEY THEY
WOULD GET. BUT I KNOW OUR
CLINICS WORK HARD TO DO TO DO
THE BEST THEY CAN WITH WHAT THEY
HAVE. AND HAVING THIS ADDITIONAL
MONEY WILL ALLOW THEM TO BUILD
THAT CAPACITY TO SERVE THE CAT
POPULATIONS. YOU TALK ABOUT
BEING TARGETED, INCLUDING PEOPLE
WHO NEEDS TO SPEAK DIFFERENT
LANGUAGES, AND I WOULD POINT OUT
THERE'S A LOT OF PEOPLE DON'T
SPEAK THRESHOLD LANGUAGES. SO UM
, SO IT'S YOU KNOW, JUST SO
DEVELOPING WHOLE INTERPRETATION
SYSTEM COULD EASILY CONSUME ALL
THIS MONEY IN ITSELF, ACTUALLY,
IN MY OPINION, SO WITH THAT,
CERTAINLY SUPPORTING YOUR BILL.
WOULD YOU LIKE TO CLOSE? THANK
YOU. RESPECTFULLY ASK FOR AND I
VOTE. OKAY SO IT'S BEEN THE
MOTIONS DO PASS AS AMENDED. WE
REFERRED TO THE COMMITTEE ON
APPROPRIATIONS THE MOTIONS BY
SENATOR TATO SECRETARY. PLEASE
CALL THE ROLL HAN AND I.
MELINDA'S BELINDA'S NO EGGMAN.
SIGMUND I. GONZALES GROVE.
POTATO POTATO. I LABOR LABOR.
AYE. LIMÓN BROTH. RUBIO WIENER
WIENER? AYE. OKAY SO THE BILL IS
CURRENTLY 51, AND WE'LL HOLD THE
ROLL OPEN FOR ABSENT MEMBERS. I
SEE ASSEMBLYMEMBER'S CHEN HERE
AND YOU'RE NEXT UP. SO WE HAVE
THIS. OH SO WE ARE AN ITEM
NUMBER FIVE B 17 OH, FOUR BY
SEPTEMBER 10 WELCOME. THANK YOU,
MR CHAIRMAN. REALLY PRETTY SURE
TIME AND FOR ALLOW ME TO PRESENT
A B 17 04. I WANT TO BEGIN BY
THANKING THE COMMITTEE FOR
WORKING SO DILIGENT WITH ME AND
MY STAFF ON THESE AMENDMENTS,
WHICH WE ARE MORE THAN HAPPY TO
ACCEPT. CURRENT LAW STATES IN
ORDER FOR INDIVIDUALS TO FORM X
RAYS OF THE FOOT AND THE ANKLE
THEY WOULD NEED AT LEAST A
CALIFORNIA X RAY TECHNICIAN A
LIMITED PERMIT WITH EITHER OF
THE EXTREMITIES CATEGORY OR
ALLEGED PODIATRIC CATEGORY.
HOWEVER, THERE ARE NO SCHOOLS IN
CALIFORNIA WHO OFFER THIS
PERMIT. THIS HAS LEFT A DIRE
SHORTAGE OF INDIVIDUALS
AVAILABLE TO ASSIST IN
PERFORMING X RAYS AND PODIATRIC
OFFICES, WHICH CREATES A
SITUATION OF HARMS INDIVIDUALS
AND SMALL GROUP PRACTICES,
ABILITY TO PROVIDE PROPER CARE.
RESULTING IN X RAYS EITHER NOT
BEING PERFORMED. REFERRED TO
OUTSIDE CENTERS OR EITHER FROM
INFERIOR MODALITIES BEING
EMPLOYED THIS UNFORTUNATELY,
DANGERS OR PUBLIC SIMPLY PUT,
DOCTORS OF PODIATRIC MEDICINE
CANNOT FIND X RAY TECHNICIANS
WERE WILLING TO WORK. A
PEDIATRIC OFFICE AND BE LIMITED
TO ONLY PERFORMING PODIATRIC
RADIOGRAPHY. MAYBE 17 04 WILL
CREATE AN ALTERNATE PATHWAY FOR
X RAY TECHNICIANS TO TAKE
COMPREHENSIVE FORCES OR EXAMS.
REFORM THESE X RAYS ON A
SPECIALIZED PODIATRIC X RAY
EQUIPMENT BUILT IN SAFETY
FEATURES SPECIFIC TO THE FOOT
AND ANKLE. CURED BY PREVENTING
THE OVER CERTIFICATION FOR
TECHNICIANS ENCOURAGED THE FIELD TO QUALIFY
APPLICANTS. WE HAVE ONE WITNESS
TESTIMONY HERE TO TESTIFY, DR
KAREN RUBLE AND DR DEREK PAUL.
THANK YOU SO MUCH. SO MEMBER
CHEN MODERATOR. I BELIEVE THE
REST TESTIFIED BY PHONE TO
MODERATE. PLEASE BRING ONTO LINE
DOCTORS, KAREN WARBLE AND DR
DEREK BALL. YOU EACH HAVE TWO
MINUTES. I WILL START WITH DR
WARBLE. HI. THIS IS DR GARRETT.
PAUL OH, DR DEREK PAUL. THANK
YOU. ALRIGHT WE'LL BEGIN WITH DR
DEREK BALL THEN I GUESS IF DR
HERBAL IS NOT OKAY, I WANT TO
GO. ALRIGHT, DOCTOR BALL ONCE
YOU GO AHEAD AND BEGIN HELLO.
YES. HI CAN I BE HEARD? YES
PLEASE. PLEASE. AGAIN SIR. UH
THANK YOU, SOMEBODY MEMBER CHEN.
THANK YOU, MR CHAIR AND MEMBERS
OF THE COMMITTEE. WE IN
PODIATRIC MEDICINE HAVE A
PROBLEM AND WE NEED YOUR HELP.
THANKS FOR ALLOWING US TO SPEAK
TODAY TO ADDRESS THIS PROBLEM,
AND WE'VE BEEN EXPERIENCING THIS
IN PODIATRIC MEDICINE ACROSS THE
STATE, AND THAT IS THE INABILITY
TO FIND AN EMPLOYED QUALIFIED
INDIVIDUALS TO PERFORM LIMITED X
RAYS OF THE FOOT AND ANKLE AND
ANY GIVEN DAY IN PODIATRIC
MEDICINE. ONLY ABOUT 20% OF OUR
PATIENTS REQUIRE AN X RAY. THIS
PROCESS INVOLVES USE OF PLAIN X
RAYS USING A TYPE OF DIGITAL
EQUIPMENT, WHICH IS SPECIFIC TO
THE FOOT AND ANKLE. AND WHICH
HAS STOPPED IN SAFETY FEATURES
MANY OF THE COMMON PATHOLOGIES
WE TREAT, INCLUDING TRAUMA
INFECTION, PRE IMPOSED SURGICAL
CARE ALL REQUIRE AN IMMEDIATE X
RAY READING TO DETERMINE PROPER
TREATMENT. FAILURE TO OBTAIN AN
IMMEDIATE READ CAN DIRECTLY
AFFECT THE TRAJECTORY OF MANY OF
THESE PATHOLOGIES. SHOULD HAVE
QUALIFIED STAFF AVAILABLE TO
ASSIST US THE REALITY OF TIME
MANAGEMENT. MOST OFFICES MAKES
IT DIFFICULT OR IMPOSSIBLE FOR
PODIATRIST TO TAKE OUR OWN X
RAYS, EVEN THOUGH WE'RE
CERTIFIED BY THE RHB AS
RADIOLOGY, SUPERVISORS AND
OPERATORS. THE REALITY IS THAT
ACTUALLY, STUDIES ARE EITHER
AVOIDED ENTIRELY OR SENT TO
TERTIARY FACILITIES, WITH THE
RESULT IN DELAY IN CARE, SO TO
ENSURE PATIENTS RECEIVE
IMMEDIATE CARE THEY NEED BUT I
JUST SEEK ASSISTANCE. C
TECHNICIANS ARE MEDICAL
ASSISTANCE TO PERFORM IN OFFICE
X RAY. THESE INDIVIDUALS ARE
PODIATRIC MEDICAL ASSISTANCE ARE
DIFFERENT FROM OTHER TECHNICIANS
WHO PERFORM X RAYS IN THAT THEIR
PRIMARY DUTY WOULD BE TO CHAIR
SIDE ASSISTANT WHILE THEIR FOOT
AND ANKLE X RAYS ARE SECONDARY
DUTY. IT MIGHT BE MISUNDERSTOOD
THAT CERTIFIED EXTREMITY XT,
SUCH AS ONE WHO MIGHT WORK FOR
NORTH OF GROUPS SAY COULD BE
EMPLOYED HERE, HOWEVER, EVEN
IGNORING THE FINANCIAL REALITIES
THEIR COMMAND HIGHER SALARIES.
THIS WOULD BE AN ERROR. THOSE
EXTREMELY, EXT ES,
UNDERSTANDABLY ELECTED PRACTICE
IN THEIR FULL SCOPE ALMOST
SOLELY AS TAX NOT AS PRIMARY
MEDICAL ASSISTANCE. WE NEED A B
1704 TO BE ABLE TO TRAIN OUR M A
STREET LIMITED X RAY TAX FOR THE
FOOT AND ANKLE. THANK YOU. THANK
YOU NOW MOVE ON TO DR RUBLE.
REVISED. DR RUBLE ONLINE.
SPILLER AHEAD. ARE YOU NOW? YES,
PLEASE BEGIN. AND DR RUBLE, AND
I'M IN PRACTICING PODIATRIST IN
SOUTHERN CALIFORNIA, AND I'M
SPEAKING TO THE ON BEHALF OF THE
CALIFORNIA PODIATRIC MEDICAL
ASSOCIATION. AND I LOOKED AT A
BIT OF HISTORY TO THIS ISSUE FOR
DECADES PRIOR TO 2013 ARE
EMPLOYED PODIATRIC MEDICAL
ASSISTANCE WHO WISH TO INCREASE
THEIR SKILLS WOULD TAKE IT
AVAILABLE COURSE. APPROVED BY
THE RHP IN RADIATION TECHNIQUE
AND SAFETY, WHICH WAS OFFERED
OVER THE PERIOD OF SEVERAL
WEEKENDS. AFTER PASSING A
REQUIRED TESTS DETERMINED BY THE
RHB. THEY WERE AWARDED
CERTIFICATION BY THE SAME ARE
EXPECTED. MANY AMAZED THIS
COURSE INCREASE THEIR VALUE TO
OUR PRACTICES BY THEIR SALARIES.
IT WAS A GOOD SYSTEM. BUT IN
2013, THE REGULATION THAT
ALLOWED THIS WAS REMOVED IN
ACCORDANCE WITH THE ART AND THE
RHP, DON'T SAVE OUR MÁS TO
BECOME EDUCATED, PODIATRIC EXT
NO LONGER EXISTS. BECAUSE THERE
ARE CURRENTLY NO SCHOOLS IN
CALIFORNIA THAT OFFER OR ARE
WILLING TO OFFER COURSES IN THIS
SPECIFIC LEG FOR THE ACTRESS
CATEGORY HAS BECOME A DEFECT OF
PROHIBITION. ALSO NOW THOSE LEGS
PODIATRIC SIXTIES WHO TOOK BACK
FOR AS LONG AGO HAD BEEN LOST TO
ATTRITION. IN FACT, ONLY A
HANDFUL REMAINING CALIFORNIA
THIS HAS CREATED A CRISIS
SITUATION IS WHY WE COME TO YOU
TODAY FOR THE SOLUTION. AND WE
NEED A SOLUTION SOON. SIMPLY PUT
NITROUS CANNOT FIND EXCUSE WHO
ARE WILLING TO WORK IN PODIATRIC
OFFICE AND PERFORM ONLY FOOT AND
ANKLE RADIOGRAPHY. THEY JUST DID
NOT EXIST. I JUST NEED A NEW
PATHWAY SIMILAR TO OTHER STATES
THAT HAVE HER MÁS TRAINED TO
SAFELY AND COMPETENTLY TAKE X
RAYS SPECIFIC PODIATRIC MEDICAL
OFFICE PRACTICE. WITH A B 17. OH
FOUR. THIS PODIATRIC EQUITIES
WOULD STILL BE REQUIRED TO TAKE
A TEST APPROVED BY THE RHB AND
TECHNIQUE. BEEN TURNING THE HIGH
STANDARDS WE CURRENTLY HAVE IN
PLACE. AND I WANT TO BE CLEAR
THIS BILL DOES NOT INCREASE THE
SCOPE OF DOCTORS OF PODIATRIC
MEDICINE IN ANY WAY. A B 17. OH,
FOUR CREATES THE OPPORTUNITY FOR
THE SOLUTION TO THIS CRISIS AND
WE WERE SPECULATING AFTER YOUR
SUPPORT. THANK YOU VERY MUCH. I
WILL NOW MOVE ON TO ADDITIONAL
WITNESSES IN SUPPORT OF A B 17.
OH, FOUR WILL BEGIN HEARING ROOM
2100 WELCOME. RYAN SPENCER ON
BEHALF OF THE SPONSORS OF THE
BILL. THE CALIFORNIA PODIATRIC
MEDICAL ASSOCIATION OFFICIALLY
REGISTERED OUR SUPPORT. THANK
YOU. THANK YOU. ATHENA IS
APPROACHING THE MICROPHONE.
MODERATOR PLEASE OPEN THE LINES
FOR WITNESSES WHO WISH TO
TESTIFY AND SUPPORT A B 17. OH,
FOUR. IF YOU ARE IN SUPPORT OF A
B 17410 ON YOUR PHONE. OKAY. AND
WE DO HAVE SOMEBODY QUEUED UP.
HERE IT IS. LINE NUMBER 1 96.
ALRIGHT, 1 96 YOUR LINE IS OPEN.
HI. CAN YOU HEAR ME? YES. PLEASE
INTRODUCE YOURSELF. OH, GREAT.
HI. MY NAME IS RENO LATTE AND
I'M CALLING FROM PLASTER COUNTY.
YES, I AM IN SUPPORT OF THIS
SPELL AND SHAME ON DOCTOR. THANK
YOU VERY MUCH. THANK YOU. NEXT
TO WITNESS. ALRIGHT WE DO NOT
HAVE ANY MORE AND QUÊ MR CHAIR.
THANKS VERY MUCH WILL NOW MOVE
ON TO WITNESSES AND OPPOSITION.
WE DO NOT HAVE A LEAD.
OPPOSITION WITNESS REGISTERED
FOR TESTIMONY WILL RETURN HERE
TO ROOM 2100 ANY THIS IS AN
OPPOSITION SAYING, YOU KNOW.
OKAY SO YOU KNOW ONE APPROACHING
THE MICROPHONE MODERATOR, PLEASE
OPEN THE LINES FOR WITNESSES,
WHICH TESTIFY IN OPPOSITION TO A
B 17. OH, FOUR. IF YOU'RE AN
OPPOSITION OF A B 17 OH, 410 ON
YOUR PHONE. AND WE DO NOT HAVE
ANYBODY QUEUED UP FOR, UM IN
OPPOSITION. THANKS VERY MUCH.
WE'LL NOW MOVE RETURNED BACK TO
THE COMMITTEE QUESTIONS OR
COMMENTS FROM COMMITTEE MEMBERS.
THERE'S A MOTION BY SENATOR
LEYVA SAYING NO OTHER QUESTIONS
OR COMMENTS. THANK YOU SO MUCH
DECEMBER 10 FOR WORKING WITH MY
, UH, COMMITTEE STAFF AND TAKING
THE AMENDMENTS AND REALLY
APPRECIATE YOU'RE TRYING TO
ADDRESS A NEED IN THE COMMUNITY
. WOULD YOU LIKE TO CLOSE? THANK
YOU, MR CHAIR. RESPECTFULLY ASK
FOR MY VOTE. ALL RIGHT, SO THE
MOTIONS DO PASS AS AMENDED AND
REFERRED TO THE COMMITTEE ON
BUSINESS PROFESSIONS AND
ECONOMIC DEVELOPMENT. IT'S BEEN
MOVED BY SENATOR LEVA. SECRETARY
PLEASE CALL THE ROLL HAND AND
I'M MELINDA'S MELINDA'S AYE,
EGGMAN. SIGMUND I. GONZALES
GROVE, HER TATO TATO. AYE. LABOR
LABOR, I LEMON WRATH. RUBIO,
WIENER WIENER? AYE. SIX THAT
BILL CURRENTLY IS 60 WILL HOLD
THE ROLL OPEN FOR ABSENT
MEMBERS. OKAY AND I DO NOT SEE
ANY MEMBERS HERE. SO WE ARE
WAITING FOR AUTHORS. OH, THERE
YOU SORRY YOU'RE IN THE SHADOW.
OKAY I AM NOT WELCOME. I KNOW
IT'S LIKE. OKAY, SO WE HAVE ITEM
NUMBER 14 22 81 CORRECT. THANK
YOU, MR CHAIR. PROLONGED ME TO
PRESENT THIS IMPORTANT BILL THAT
PRIORITIZES INVESTMENTS IN YOUNG
CHILDREN'S MENTAL HEALTH. THE
EARLY CHILDHOOD MENTAL HEALTH
SERVICES ACT CREATES A GRANT
PROGRAM ESTABLISHING A CONTINUUM
OF CARE TO DELIVER. BEHAVIORAL
HEALTH SERVICES TO THE 0 TO 5
POPULATION, THEIR PARENTS,
FAMILIES AND ADULT CAREGIVERS.
EARLY INTERVENTION ADDRESSING
THE MILD TO MODERATE NEEDS OF
THESE YOUTH IS ESSENTIAL FOR
ADJUSTMENT, UNENCUMBERED BY
ANXIETY AND TOXIC STRESS CAUSED
BY WHAT IS CALLED ADVERSE
CHILDHOOD EXPERIENCES OR ACES.
HAVE LEFT UNTREATED. THESE ACES
MANIFEST LATER IN LIFE HAS
BEHAVIORAL HEALTH ISSUES AND
SUBSTANCE ABUSE DISORDERS. THIS
BILL WOULD ALLEVIATE
EXACERBATION OF OUR SHARED
SYSTEM BY DECREASING THE
LIKELIHOOD THAT THESE FACTORS
LEAD TO THE DEVELOPMENTAL,
SERIOUS DISEASES WE UNDER INVEST
IN THE 05 POPULATION. PARENTS
OFTEN WAIT TO THEIR CHILDREN ARE
IN SCHOOL TO RECEIVE SERVICES
WHILE CRUCIAL DEVELOPMENT PERIOD
PERIOD PASSES BY THEM. WE NEED
TO DO BETTER FOR THE YOUNGEST
AMONG US AS WE MOVE INTO AN
INCLUSIVE AND COMPREHENSIVE
APPROACH TO ARE BEHAVIORAL
HEALTH. CALIFORNIA'S EMBARKED ON
A SIGNIFICANT JOURNEY TO
STRENGTHEN OUR SUPPORT OF
CHILDREN, FAMILIES AND ADULT
CAREGIVERS AND APPRECIATION FOR
THEIR MENTAL HEALTH NEED IS
VITAL AS WE COME OUT OF THIS
PANDEMIC. WE NEED TO REMEMBER
THAT THERE WAS AN EXISTING
MENTAL HEALTH CRISIS WHICH THE
LOCKDOWNS ASSOCIATED WITH COVID
INFLAMED. WE ALL NEED HELP IN
DEALING WITH THE TRAUMA AND
ADJUSTING TO SUCH RAPIDLY
CHANGING CIRCUMSTANCES. THESE
GRANTS WILL PRODUCE AN
UNDERSTANDING OF WHICH EVIDENCE
BASED PRACTICES ARE BEST FOR
TREATING THE NEEDS OF YOUNG
CHILDREN AND WILL SPUR
INNOVATION FOR HOW WE CAN
SUPPORT THESE CHILDREN AND THEIR
FAMILIES. I BELIEVE THIS
INVESTMENT IS ESSENTIAL FOR THE
SUPPORTING VULNERABLE
COMMUNITIES AND ADDRESSING
LONGSTANDING HEALTH DISPARITIES
WITH EARLY INTERVENTION. I AM DR
TOBY EWING, THE EXECUTIVE
DIRECTOR OF MENTAL HEALTH
SERVICES, OVERSIGHT AND
ACCOUNTABILITY COMMISSION WITH
ME TODAY. ADDITIONALLY ALSO HAVE
ANGELO VAZQUEZ, THE POLICY
DIRECTOR, FROM THE CHILDREN'S
PARTNERSHIP ON THE LINE TO ALSO
PROVIDE TESTIMONY. THANKS VERY
MUCH. SENATOR LACKEY WILL BEGIN
WITH A DOCTOR TOBY EWING, YOU
HAVE TWO MINUTES THANK YOU, MR
CHAIR AND MEMBERS APPRECIATE THE
CHANCE TO JOIN YOU TODAY AND
THANK THE AUTHOR FOR THIS BILL.
AS THE AUTHOR MENTIONS, UH, YOU
KNOW, OUR COMMUNITIES ARE FACING
SOME PROFOUND CHALLENGES, AND IT
CAN BE PARTICULARLY DIFFICULT
FOR FAMILIES TO UNDERSTAND
WHAT'S HAPPENING IN THE LIFE OF
A VERY YOUNG CHILD. PARTICULARS,
CHILDREN HAVE DIFFICULTY
EXPRESSING THEIR NEEDS. THIS
STAGE IN LIFE IS OFTEN THE MOST
CHALLENGING IN TERMS OF YOU KNOW
WHAT'S HAPPENING IN IN
DEVELOPMENT FOR THEIR MENTAL
HEALTH. BECAUSE OF THE
VULNERABILITIES THAT CHILDREN
FACE, WE SEE SOME OF THE LARGEST
PERCENTAGES OF CHILDREN INVOLVED
IN CHILD WELFARE SYSTEM AMONG
THE CERTIFIED POPULATION. THIS
IS ALSO THE MOST OPPORTUNE TIME
FOR PREVENTION AND EARLY
INTERVENTION BECAUSE IT PRESENTS
A CHANCE FOR US TO INTERVENE
EARLIER TO ADDRESS RISKS AND
JUST SUPPORT RESILIENCY AND
WHILE THE STATE HAS MADE
SUBSTANTIAL ADDITIONAL
INVESTMENTS, PARTICULARLY THANK
THE LEGISLATURE FOR THE WORK
YOU'VE DONE IN THIS SPACE 0 TO 5
AGE GROUP OFTEN HAS LEFT OUT OF
SOME OF THOSE CONVERSATIONS. WE
OFTEN RELY ON SCHOOLS. TO PICK
UP THAT PIECE, AND SCHOOLS CAN
ENGAGE TYPICALLY, AT AGE THREE
AND ABOVE, OR WE RELY ON OUR
PHYSICIANS ARE MEDICAL
OPPORTUNITIES. BUT AS THE
ASSEMBLYMEMBER'S POINTS OUT, WE
HAVE MANY MORE OPPORTUNITIES TO
ENGAGE, PARTICULARLY EDUCATION.
CHILD DEVELOPMENT. CHILDCARE
PROVIDERS BETTER UNDERSTAND
THESE NEEDS AND PUT IN PLACE
EFFECTIVE STRATEGIES TO RESPONSE
FOR THAT REASON, THE COMMISSION
IS VERY SUPPORTIVE OF THIS. WE
SEE TREMENDOUS POTENTIAL TO DO A
BETTER JOB IN THE EARLY STAGES
OF LIFE FOR OUR CHILDREN AND
FAMILIES. WITH THAT WE ASK YOU
FOR YOUR I VOTE AND HAPPY TO
ANSWER ANY QUESTIONS YOU MIGHT
HAVE. THANK YOU. THANKS VERY
MUCH. WE'LL NOW MOVE ON TO OUR
NEXT WITNESS WHO IS ON THE PHONE
LINE, SO PLEASE BRING ON ANGELA
VALDES QUIZ WITH THE CHILDREN'S
PARTNERSHIP. HELLO EVERYONE.
THANK YOU. GOOD AFTERNOON
MEMBERS. THANK YOU. CHAIR PAN
FOR YOUR COMMITMENT TO PROVIDING
TESTIMONY ACCESS TO DISABLED
HIGH RISK ADVOCATES SUCH AS
MYSELF. I AM ANGELA VASQUEZ, THE
POLICY DIRECTOR OVER MENTAL
HEALTH THAT CHILDREN'S
PARTNERSHIP. THIS PAST FALL, THE
CHILDREN'S PARTNERSHIP AND THE
FIRST SIDE ASSOCIATION TOGETHER
WITH THE FIRST KIND OF
CHILDREN'S POLICY, RELEASED A
REPORT ADDRESSING INCIDENT AND
EARLY CHILDHOOD MENTAL HEALTH
NEEDS OPPORTUNITIES FOR
COMMUNITY SOLUTIONS. THAT
HIGHLIGHTED THE HISTORICAL AND
STILL ESCALATING MENTAL HEALTH
NEEDS OF VERY YOUNG CHILDREN.
OUR RESEARCH SHOWS THAT
COMMUNITY LEVEL PROGRAMS SUCH AS
THOSE THAT WOULD BE FUNDED BY A
B 22 81 ARE UNIQUELY POSITIONED
TO CREATE LONG LASTING CHANGE AT
THE LOCAL LEVEL. MANY OF THESE
PROGRAMS THAT SUPPORT SENT AN
EARLY CHILDHOOD MENTAL HEALTH IN
THE COMMUNITY. ARE SHOVEL READY
FOR ONGOING PUBLIC INVESTMENT
WITH MANY AT IMMINENT RISK OF
STOPPING SERVICES DUE TO LIMITED
AND SHRINKING PUBLIC FUNDING.
UNLIKE OLDER CHILDREN AND YOUTH,
INFANTS AND TODDLERS ARE
UNIQUELY DEPENDENT ON THEIR
CAREGIVERS HAVE THEIR SOCIAL
EMOTIONAL NEEDS MET. PROGRAMS
SUCH AS INFINITE EARLY CHILDHOOD
MENTAL HEALTH CONSULTATIONS,
POSITIVE PARENTING PROGRAM, OR
TRIPLE P AND THE INCREDIBLE
YEARS AMONG OTHERS, HAVE THE
ABILITY TO HAVE THE ABILITY TO
MEET THE SOCIAL, EMOTIONAL AND
DEVELOPMENTAL NEEDS. OF YOUNG
CHILDREN IN COMMUNITY SETTINGS
OUTSIDE OF A CLINIC OR DOCTOR'S
OFFICE AND ARE THEREFORE LESS
STIGMATIZED AND ACCESSIBLE TO
FAMILIES OF WEST AND BROWN
CHILDREN, IMMIGRANT FAMILIES AND
LOW INCOME AND RURAL RURAL
FAMILIES WHO HISTORICALLY ELECT
ACCESS TO ADEQUATE AND
CULTURALLY APPROPRIATE MENTAL
HEALTH CARE. DESPITE THE GROWING
EVIDENCE BASE FOR THESE AND
OTHER PROGRAMS AND PROMOTING
POSITIVE CHILD DEVELOPMENT AND
PREVENTING FUTURE POOR MENTAL
HEALTH, HEALTH OUTCOMES, THESE
TYPES OF TRUE UPSTREAM
PREVENTION AND EARLY
INTERVENTION SERVICES. AND LACK%
OF APPROPRIATE CLINICAL AND NON
CLINICAL WORKFORCE. UH SEVERELY
LIMIT OUR ABILITY TO MEET THE
NEEDS OF VERY YOUNG CHILDREN.
FOR THESE REASONS, THE
CHILDREN'S PARTNERSHIP
RESPECTFULLY REQUEST YOUR I VOTE
FOR A B 2 TO 81. THANK YOU VERY
MUCH. WE'LL NOW MOVE ON TO
ADDITIONAL WITNESSES IN SUPPORT
OF A B 2 TO 81 HERE IN ROOM
2100. WELCOME. TALK, A RESEARCH
CENTER. WE ARE THE LARGEST
CHILDCARE AND FAMILY SERVICES
PROVIDER AND CALIFORNIA
REPRESENTING SAN BERNARDO UK AND
LOS ANGELES COUNTY. WE ARE IN
SUPPORT. THANK YOU. SAY YOU? NO
ONE ELSE APPROACHING THE
MICROPHONE. MODERATOR, PLEASE
OPEN THE LINES FOR WITNESSES IN
SUPPORT OF A B 2 TO 81. IF YOU
ARE IN SUPPORT OF ABC 281. IT IS
ONE AND ZERO ON YOUR PHONE. AND
WE WILL START WITH LINE NUMBER 1
40. THE CALIFORNIA COUNCIL OF
COMMUNITY BEHAVIOR, HEALTH EACH
INFUSION SUPPORT. THANK YOU NEXT
WITNESS. NEXT WE'LL GO TO LINE
NUMBER 202, PLEASE GO AHEAD.
GOOD AFTERNOON, ADRIAN SHELTON
WITH THE CALIFORNIA ALLIANCE OF
CHILD AND FAMILY SERVICES AND
SUPPORT OF A B 2 TO 81. THANKS.
THANK YOU NEXT WITNESS. OKAY AND
THEY ARE GETTING THEIR LINE
NUMBERS. SORRY NEXT SUPER BOWL
TO LINE NUMBER TWO. OH, ONE
BASEBALL AHEAD. HI, ADRIAN
HEARTBEAT, WITH STEINBERG STILL
AND SUPPORT THANK YOU NEXT WEEK
LOUD, RIGHT? OKAY AND NEXT, WE
WILL GO TO LINE NUMBER 205. YOU
OFTEN CALL ME THAT. MY GOSH.
NEXT WITNESS, PLEASE. OKAY WE
WERE ABOUT TO LINE NUMBER 203,
PLEASE GO AHEAD. HELLO CHAIR
MEMBERS TELLING STUDENTS PEONY
ON BEHALF OF THE LEAGUE OF
CALIFORNIA CITIES IN SUPPORT OF
A B 22 81. THANK YOU. THANK YOU.
NEXT WITNESS. WE DO NOT HAVE ANY
MORE IN QUÊ MR CARE. THANKS VERY
MUCH. WE'LL NOW MOVE TO
WITNESSES AND OPPOSITION TO 22
81. THERE'S NO LEAD. OPPOSITION
WITNESS FOR TESTIMONY WILL
RETURN HERE TO ROOM 2100. SEEN
ON APPROACHING THE MICROPHONE.
MODERATOR PLEASE OPEN THE LINES
FOR WITNESSES WHO WISH TO
TESTIFY IN OPPOSITION TO A B 22
81 NAME ORGANIZATION POSITION.
IF YOU ARE AN OPPOSITION OF A B
22 81, THERE'S 10 ON YOUR PHONE.
AND WE DO NOT HAVE ANYONE DOING
UP AS OF NOW, MR QUÊ. WE'LL
BRING YOU BACK COMMITTEE OR YOUR
QUESTIONS OR COMMENTS FROM
COMMITTEE MEMBERS. SENATOR
MELENDEZ THANK YOU SO MUCH. MR
CHAIRMAN, I WILL MAKE THIS BRIEF
BUT SIMILAR MAN LIKE I JUST WANT
TO THANK YOU FOR BRINGING THIS
FORWARD. AND I THINK THERE IS A
GAP THERE WITH RESPECT TO THE
MENTAL HEALTH OF KIDS. THIS AGE,
I WAS WATCHING ONE OF THE
COMMITTEE'S EARLIER I THINK IT
WAS EDUCATION IN WHICH IS
SUDDENLY WOMAN. RUBIO HAD A BILL
RELATING TO FUNDING AND YOU KNOW
THE EARLY CHILDHOOD DEVELOPMENT
AND HAD TO DO WITH SOME OTHER
THINGS, TOO. BUT WHAT I NOTICED
DURING THE TESTIMONY WAS THE
DISCUSSION ABOUT THE
DIFFICULTIES THAT A LOT OF THESE
YOUNG CHILDREN ARE HAVING. UM
AFTER, YOU KNOW, POST COVID
LOCKDOWN AND. BEHAVIORAL ISSUES
TRYING TO UNDERSTAND HOW TO DEAL
WITH, YOU KNOW THEIR PEERS AND
EXPRESS THEMSELVES AND ALL OF
THE THINGS THAT WE HAVE SEEN
MANIFEST AFTER KIDS NOT BEING IN
SCHOOL FOR SUCH A LONG TIME, AND
I THINK IT'S WORTH UM YOU KNOW,
INVESTING IN THIS AREA SO THAT
WE'RE UNDERSTANDING WHY THEY'RE
DOING THAT AND HELP THEM WITH
THAT, RATHER THAN TWO.
ESSENTIALLY LABEL THEM AT SUCH A
VERY YOUNG AGE THAT YOU KNOW
YOUR BAD, DISRUPTIVE KID, WHICH
IS MOST OFTEN TIMES, NOT THE
CASE. I JUST WANT TO THANK YOU
FOR THE WORK YOU'VE DONE AND
WORKING. WITH ALL THE
STAKEHOLDERS AND ANY OPPOSITION,
IT MAY HAVE COME YOUR WAY. THIS
IS THIS IS GOOD BILL AND I WILL
MOVE THIS BILL. THANK YOU,
SENATOR. SENATOR MELENDEZ. YES,
SENATOR EDMUND. I ALSO WANT TO
THANK YOU, MR LUCKY FOR THIS
BILL, AND FOR YOUR CONTINUED
DEDICATION IN THIS SPACE, YOU
ARE A GOOD EXAMPLE. I THINK OF A
VERY EFFECTIVE LEGISLATOR WHO
FOCUSES IN AND DOES GOOD,
IMPORTANT WORK, AND I APPRECIATE
THAT. UM I HAD A RECENT RECENT
EXPERIENCE, BUT MY, UM I HAD I
HAD THE OCCASION REVISITING
SOMEBODY WHO WAS ILL, AND THEY
HAD A LESS THAN A YEAR OLD CHILD
AND UM AND IT YOU KNOW, FROM A
MENTAL HEALTH PROVIDERS EYES I
COULD SEE SOMETHING'S WRONG WITH
THE BABY. AND THEY WERE LIKE,
OH, NO, NOTHING. NO AND SURE
ENOUGH THAT THEY DID THEN GET
SOME INTERVENTION AND THE CHILD
HAS YOU KNOW SOME SIGNIFICANT
ISSUES, BUT YOU'RE RIGHT. IF
THERE'S NO EYES ON IT,
ESPECIALLY THIS WAS AN IMMIGRANT
FAMILY. WHO WOULD HAVE THAT?
REACH OUT? AND THAT CHILD IS NOW
HAD ONGOING FOR A LONG TIME AND
IS MAKING GOOD PROGRESS. SO
REALLY IMPORTANT, AND I THANK
YOU FOR THIS BILL. THANK YOU FOR
THAT. SEEING NO OTHER QUESTIONS
OR COMMENTS. I DO HAVE A
QUESTION. BUT FIRST OF ALL, I
JUST WANT TO SAY SIMILAR, LIKE
THANKS SO MUCH FOR BRINGING THIS
BILL FORWARD IS A VERY IMPORTANT
ISSUE IS A PEDIATRICIAN WILL
CERTAINLY SEE MENTAL HEALTH
ISSUES AND VERY YOUNG KIDS.
SOMETIMES YOU DON'T BELIEVE THAT
ACTUALLY HAPPENS, BUT IT DOES. I
GUESS THE QUESTION I HAVE, WHICH
WHICH YOU COULD DIRECT TO.
PERHAPS MR EWING, YOUR FIRST
WITNESSES IS THAT, UM, IN THAT
SORT OF EARLY AGE SPACE. UM WE
ALSO HAVE DEVELOPMENTAL SERVICES
AND SOMETIMES TRYING TO
SOMEONE'S DEVELOPMENT NUTRITION
, BESIDES DISTINGUISH BETWEEN
MENTAL HEALTH AND DEVELOPMENTAL
ISSUES CAN SOMETIMES BE A LITTLE
CHALLENGING OR BLURRY. SO MAYBE
, UM, AND WHETHER SOME, I GUESS
MY QUESTION IS THAT IN TERMS OF
WHAT YOU'RE PROPOSING HERE,
WHICH I'M FULLY IN SUPPORT OF.
HOW DO YOU SEE THAT INTERFACING
WITH DEVELOPMENTAL SERVICES AND
D D IN TERMS OF COORDINATING
SERVICES FOR THESE CHILDREN?
GREAT QUESTION. I WILL DEFER TO
THEM BECAUSE IT'S THE
PROFESSIONAL IN THAT SPACE. I
APOLOGIZE FOR WALKING UP TO THE
MIKE. MR. CHAIR FOR THAT
QUESTION. I FIGURED YOU'D BE THE
PRIDE THE RIGHT PERSON ANSWER,
ALTHOUGH WE HAVE A VERY, VERY
CAPABLE AND, UH, KNOWLEDGEABLE
ARTHUR, TOO. SO I MEAN, YOU'VE
HIGHLIGHTED THE SORT OF THE
MISMATCH BETWEEN THE WAY WE
DEFINE THINGS IN LAW AND IN THE
BUDGET AND THE REALITIES THAT
ARE FACING THE HUMAN BEINGS THAT
OUR IN OUR HOMES AND OUR
FAMILIES AND OUR COMMUNITIES
BECAUSE THEY'RE PARTICULARLY IN
THIS AGE. THOSE LINES ARE NOT
CLEAR. THEY'RE VERY GRAY RIGHT
WHERE THE COMMISSION HAS SORT OF
OUR BIAS HAS BEEN BECAUSE OF THE
LANGUAGE OF THE MENTAL HEALTH
SERVICES ACT IS TO SPEAK VERY
INCLUSIVELY PREVENTION AND EARLY
INTERVENTION. LANGUAGE OF THE
IMAGES SAY DOESN'T DOESN'T
ENGAGE AROUND CLINICAL
DIAGNOSTIC ISSUES IT ACTUALLY
ENGAGES AROUND. GO FAILURE AND
HOMELESSNESS AND PROLONGED
SUFFERING. SO IT FOCUSES MORE ON
WHAT WE'RE ACTUALLY TRYING TO
ACCOMPLISH WITH THE PEOPLE WE
SERVE RATHER THAN THESE
DIAGNOSTIC DIAGNOSTIC CRITERIA,
HOWEVER, HAVING SAID THAT
THERE'S OTHER LANGUAGE IN THE
ACT THAT TALKS ABOUT THESE
DOLLARS AS BEING SORT OF THE
LAST AVAILABLE IF THERE ARE
OTHER SERVICES, BUT THE
COMMISSION HAS DONE IN THESE
INSTANCES AND I THINK THAT WE
WOULD PURSUE IN THIS INSTANCE AS
WELL IS TO SIT DOWN WITH OUR
COUNTERPARTS. IN IN THE
DEVELOPMENTAL COMMUNITY TO
FIGURE OUT HOW DO WE STRUCTURE
THIS SO THAT WE CAN ACTUALLY
BRING IN THE BEST OF THE MENTAL
HEALTH SPACE WITH THE BEST OF
THE DEVELOPMENTAL SPACE AND MAKE
IT EASIER FOR FAMILIES TO
NAVIGATE THOSE JURISDICTIONS SO
THAT WE'RE ACTUALLY REDUCING
BARRIERS TO CARE AND
INCENTIVIZING THE INTEGRATION
AND COLLABORATION BECAUSE THE
GOAL IS TO BE RESPONSIVE TO THE
NEEDS OF THE FAMILY HAS AND NOT
TO LET THESE SORT OF
JURISDICTIONAL DEFINITIONAL
CHALLENGES THAT ARE THAT ARE
BEING THAT ARE EVOLVING DAILY.
GET IN THE WAY OF THE OUTCOME
THAT YOU AS LEGISLATORS ARE
TRYING TO ACHIEVE. THANK YOU
VERY MUCH. SO AGAIN. APPRECIATE
YOU YOUR LEADERSHIP AND BRINGING
THIS BILL FORWARD. WOULD YOU
LIKE TO CLOSE JUST REAL QUICKLY
THAT THE DISTINCTION THAT
SENATOR EDMUND MAIN IS THE MOST
ASTONISHING ASPECT, AND THAT IS
THE FACT THAT MANY FAMILIES
DISMISSED THESE SIGNS AND UNLESS
THERE'S SOME KIND OF
PROFESSIONAL ATTENTION AND SOME
PRIORITY GIVEN TO THIS CHALLENGE
, IT'S GOING TO CONTINUE TO BE
TRAGIC, AND I THINK THAT THIS
PREVENTIVE MEASURE WAS CALLED
FOR AND WE HAVE THE OPPORTUNITY
TO DO IT. AND I'M PROUD TO BRING
THIS TO THE ATTENTION OF THE
LEGISLATURE. THANKS SO MUCH AS
EVER. LACKEY MOTIONS DO PASS
REFERRED TO THE COMMITTEE.
APPROPRIATION SINCE MOVED BY
SENATOR MELENDEZ SECRETARY.
PLEASE CALL THE ROLL PAN AND I.
MELINDA'S MELINDA'S AYE, EGGMAN.
GONZALEZ GROVE, HER TATO. FLAVOR
LIMÓN ROTH RUBIO WIENER WINNER.
I ONLY HAS FOUR VOTES WILL HOLD
THE ROLL OPEN FOR ABSENT
MEMBERS. I SEE A SIMILAR MYRNA
ZURI IN. I KNOW THAT SERMON.
WE'RE TRYING. SORRY WE'RE GOING
TO FOLLOW ORDER. UM ALL RIGHT,
SO WE'LL MOVE ON TO ITEM NUMBER
15 23 52 BY SIMILAR NAZARIAN
WELCOME. THANK YOU, MR CHAIR AND
SENATORS. FIRST AND FOREMOST, I
WANT TO SAY THANK YOU TO MR
CHAIR AND COMMITTEE STAFF, HAPPY
TO TAKE THE AMENDMENTS AND WORK
WITH YOU. UM AS FOR THIS BILL, A
B 23 52 IS A COMMON SENSE BILL
WILL ALLOW PATIENTS AND THEIR
HEALTH CARE PRESCRIBERS THE
ABILITY TO MAKE INFORMED
DECISIONS THAT TAKE INTO ACCOUNT
RELEVANT COVERAGE COST AND
UTILIZATION MANAGEMENT
INFORMATION AT THE POINT OF
CARE. INSTEAD OF GOING INTO THE
VIRTUES OF THE BILL AGAIN, THE
BILL A STRAIGHTFORWARD WHAT I'D
LIKE TO DO IS TURN OVER. AH TO
LIST HELMS AS WELL AS TIM MADDEN
FOR THEIR COMMENTS. THANK YOU.
THANKS VERY MUCH. REMEMBER THIS
, ARIAN? UH LIZ HELMS. YOU HAVE
TWO MINUTES AND THEN SAME WITH
TIMID AND WELCOME. THANK YOU SO
MUCH CHAIRMAN, PARENT AND
HONORABLE MEMBERS UNLESS HELMS,
PRESIDENT AND CEO OF THE
CALIFORNIA CHRONIC CARE
COALITION, OR FORESEES, WE'RE
PLEASED TO BE THE SPONSOR OF A B
23 52. THE FOUR SEASONS, A
COALITION OF MORE THAN 30,
LEADING CONSUMER HEALTH
ORGANIZATIONS AND PROVIDER
GROUPS THAT PROVOKED THE
COLLABORATIVE WORK OF
POLICYMAKERS. INDUSTRY LEADERS
HEALTHCARE PROVIDERS. AND
PATIENTS TO IMPROVE THE HEALTH
OF CALIFORNIA'S WITH CHRONIC
CONDITIONS. 23 52 ENABLES
DECISION MAKING TO OCCUR WHERE
IT SHOULD, IN THE DOCTOR'S
OFFICE BETWEEN THE PATIENT AND
THEIR PHYSICIAN. WITH THE
ENACTMENT OF THIS BILL PATIENTS
WITH THE CENTRAL ACTIVE
STAKEHOLDERS IN THEIR OWN HEALTH
AND WANT TO BE MORE LIKELY TO
STICK WITH THEIR TREATMENT PLAN.
THIS BILL WOULD ALLEVIATE TIME
CONSUMING AND FRUSTRATING
PROCESS IS THAT WAY ON PATIENTS
AND PROVIDERS AND IMPROVED
ACCESS TO QUALITY CARE. PATIENTS
MAKE DECISIONS ABOUT THEIR
HEALTH CARE BASED IN LARGE PART
OF WHAT THEY CAN AFFORD. YET TOO
OFTEN, THIS INFORMATION IS NOT
AVAILABLE UNTIL THEY REACH THE
PHARMACY COUNTER WHERE THEN THEY
MAY REALIZE THE TREATMENT IS
UNAFFORDABLE AND MAY ABANDON THE
MEDICATION ALTOGETHER. DELAYS IN
CARE NOT ONLY WORSEN THE
PATIENT'S STATE OF HEALTH, BUT
ALSO LEAD TO INCREASED
UTILIZATION OF MORE COSTLY
HEALTHCARE SERVICES. THE SYSTEM
DOES NOT WORK FOR PATIENTS OR
HEALTH CARE PROVIDERS, WHO WERE
THEN BURDENED WITH ADDED
ADMINISTRATIVE RESPONSIBILITIES.
AS FAMILIES CONTINUE TO STRUGGLE
FINANCIALLY FROM COVID 19
PANDEMIC, AND NOW INFLATION IS
CRITICAL TO ADOPT PRACTICAL
CHANGES THAT IMPROVE
AFFORDABILITY BY FREEING UP
EXISTING DRUG COST DATA FOR
PATIENTS AT THE PUBLIC CARE AT
THE POINT OF CARE IN REAL TIME,
WHILE I KNOW WE ALL AGREE WITH
THE TRANSPARENCY OF THIS MEASURE
CREATES OPPOSITION IS RAISED
VAGUE CONCERNS ABOUT
IMPLEMENTATION. IN REALITY, IT'S
QUITE SIMPLE. THE PHYSICIAN
SELECTS THE TECHNOLOGY THEY WANT
TO USE THAT WILL ALLOW THEM TO
REVIEW THE PATIENT'S SPECIFIC
PHARMACY BENEFIT INFORMATION IN
WORKFLOW. AND THEN TECHNOLOGY
GOES THROUGH THE HR OUT TO THE
PLAN TO ACCESS THE INFORMATION
FROM A STANDARD ÁP I. THIS IS
THE SAME INFORMATION THAT THE
PATIENT WOULD OTHERWISE HAVE TO
WAIT TO RECEIVE AT THE PHARMACY.
AVERY 23 30 TO OFFER SOLUTIONS
THAT WILL LEVERAGE EXISTING
TECHNOLOGY AND STRENGTHEN
PATIENT DOCTOR RELATIONSHIPS.
FOR THESE MANY REASONS WE
STRONGLY URGE AND IVA THANK YOU.
THANK YOU. NOW BRING ON TIM
MADDEN FROM THE RHEUMATOLOGY
ALLIANCE. SHE LEFT YOU A MINUTE
AND 45 SECONDS. THANK YOU. CHAIR
MEMBERS, TIM MADDEN,
REPRESENTING THE CALIFORNIA
RHEUMATOLOGY ALLIANCE, SPEAKING
THROUGH IT OLOGISTS ON 23 52.
THEY PROVIDE ME WITH SOME INPUT
AND EXAMPLES OUTLINING THE NEED
FOR THE BILL. IT IS NOT UNCOMMON
FOR RHEUMATOLOGY PRACTICE TO BE
WORKING WITH NUMEROUS INSURANCE
COMPANIES, WHICH MAY HAVE IN
TOTAL 20 TO 30 DIFFERENT
INSURANCE PRODUCTS, ALL WITH
DIFFERENT BENEFITS STRUCTURES
COVERING DIFFERENT MEDICATIONS.
WITH UNIQUE COST REQUIREMENTS
FOR THE PATIENT. ONE SOLO
RHEUMATOLOGY PRACTICE, HAS FIVE
STAFF JUST DEDICATED TO WORKING
WITH THE INSURANCE COMPANIES. A
PATIENT EXAMPLE. SHARED WITH ME
IS A RHEUMATOLOGIST TREATING AN
ADULT OR CHILD WITH SEVERE
ARTHRITIS DUE TO THE SHORTAGE OF
RHEUMATOLOGISTS. GETTING INITIAL
APPOINTMENT FOR NEW PATIENTS CAN
BE ANYWHERE FROM FOUR WEEKS UP
TO AS MUCH AS THREE MONTHS. ONCE
THE RHEUMATOLOGIST SEES THE
PATIENT, THEY WILL ORDER SOME
TESTS TO UNDERSTAND THEIR
CONDITIONS BEFORE MEDICATIONS
ARE PRESCRIBED. ONCE THE TEST
RESULTS ARE BACK. A SECOND
APPOINTMENT IS NEEDED, WHICH MAY
TAKE AS MANY AS 30 DAYS, AT
WHICH TIME MEDICATIONS
PRESCRIBED FOR THE ARTHRITIC
CONDITION NEAR THE
RHEUMATOLOGIST OR THE PATIENT
MAY KNOW IF THE MEDICATION BEING
PRESCRIBED IS COVERED, EVEN IF
IT IS COVERED, HOW MUCH COST THE
PATIENT WILL BE. WILL INCUR THE
PATIENT ONLY FINDS OUT WHAT
THEIR COST IS. WHEN THEY GO TO
THE PHARMACY. IT IS NOT UNCOMMON
FOR PATIENTS ONCE THEY LEARN THE
COST TO NOT OBTAIN THE
MEDICATION. THIS THEN REQUIRES
THE PATIENT TO SET ANOTHER
APPOINTMENT WITH THE
RHEUMATOLOGIST FOR A NEW
PRESCRIPTION, WHICH CAN TAKE
ANOTHER MONTH. THIS WHOLE
PROCESS OF TRYING TO GET
PATIENTS ON TWO MEDICATIONS THAT
ARE EFFECTIVE AND AFFORDABLE,
CAN TAKE MORE THAN THREE MONTHS
. ALL THE WHILE THE PATIENT IS
SUFFERING FROM THEIR ARTHRITIC
PAIN. IF THE PAIN BECOMES SO
BAD, SOME PATIENTS WILL END UP
IN THE EMERGENCY DEPARTMENT
SEEKING TREATMENT, A REAL TIME
TOOL TO KNOW WHAT DRUGS ARE
COVERED AND WHAT TIER LEVEL
WOULD BE A TREMENDOUS BENEFIT
FOR PATIENTS, PHYSICIANS AND
PHARMACIES. ONE RHEUMATOLOGIST I
SPOKE WITH, SAID 90% OF
PRESCRIPTIONS, HE WRITES, CAN BE
REPLACED WITH ANOTHER. PLEASE
WRAP UP WITH THE MEDICATION. IF
HE KNOWS WHAT THE OCCASION COSTS
FOR THESE REASONS, WE
RESPECTFULLY ASK FOR PRIVATE.
THANK YOU VERY MUCH, WILL NOW
MOVE ON TO ADDITIONAL WITNESSES
AND SUPPORT OF A B 23 52 HERE IN
ROOM 2100. WELCOME GOOD
AFTERNOON, MICHAEL DAFT WITH THE
PRAYER AND MCNALLY ON BEHALF OF
MCKESSON IN SUPPORT. THANK YOU.
WELCOME. BRIAN SPENCER ON BEHALF
OF THE CROHN'S AND COLITIS
FOUNDATION IN SUPPORT. THANK
YOU. SEE NO ONE ELSE APPROACHING
THE MICROPHONE. MODERATOR,
PLEASE OPEN THE LINES FOR
WITNESSES WHO WISH TO TESTIFY
AND SUPPORT OF A V 23 52. IF YOU
ARE PART OF A B 23 52 10 ON YOUR
PHONE. AND WE WILL START WITH
LYING 204. GOOD AFTERNOON, MR
CHAIR SHARE GONZALEZ ON BEHALF
OF CALIFORNIA LIFE SCIENCES.
FEEL US IN SUPPORT. THANK YOU.
NEXT WITNESS. NEXT TO THE BOAT.
THE LINE NUMBER 1 42. THANK YOU
, MELISSA CORTEZ ON BEHALF OF
COVER MY MEDS AND SUPPORT. THANK
YOU. NEXT WITNESS. NEXT WE WILL
GO TO LINE NUMBER 08 AHEAD.
MICHELE DAVIS, CALIFORNIA
PHARMACISTS ASSOCIATION AND PART
THANK YOU NEXT WITNESS. OKAY. WE
DO NOT HAVE ANY MORE INHUMAN
CHAIR. THANK YOU. WE'LL NOW MOVE
ON TO WITNESSES AND OPPOSITION
TO A V 23 50 TO UNDERSTAND THE
LEAD WITNESS IN OPPOSITION IS
THE CALIFORNIA ASSOCIATED FROM
HEALTH PLANS. THANK YOU, LOUISE
SAYS CHAIR AND MEMBERS NICK
LOUISA'S CALIFORNIA ASSOCIATION
HEALTH PLANS. I'LL BE BRIEF. WE
HAVE AN OPPOSING LESS AMENDED
POSITION ON THIS BILL. WE
CERTAINLY DON'T OBJECT TO THE
PREMISE OF THIS BILL. CONSUMERS
SHOULD HAVE MORE INFORMATION
ABOUT THEIR DRUG COVERAGE. AND
INDEED OUR PLANS. DO YOU HAVE
MANY SYSTEMS AND OOLS IN PLACE
TO PROVIDE? YOU KNOW SOME OF THE
ELEMENTS THAT ARE REQUIRED UNDER
THIS BILL? WE HAVE IDENTIFIED
SOME WORKABILITY ISSUES. WE
SUPPLIED SOME CONCEPTS, IDEAS
AND AMENDMENTS TO THE SPONSORS
OF THE BILL. UM YOU KNOW, WE'VE
RECEIVED INDICATION THAT SOME OF
THOSE ARE UNDER REVIEW. UM AT
THIS TIME THAT SOME OF THEM ARE
LIKELY TO BE TAKEN. OTHERS HAVE
QUESTIONS ABOUT SO WE LOOK
FORWARD TO CONTINUED ENGAGEMENT
. IF THIS BILL MAKES IT OUT OF
COMMITTEE AND HOPEFULLY WE'RE
ABLE TO RESOLVE SOME OF OUR
TECHNICAL CONCERNS BEFORE THIS
BILL IS SENT TO THE GOVERNOR, IF
IT IF IT'S INTO THE GOVERNOR, SO
THANK YOU FOR YOUR TIME AND, YOU
KNOW, LOOK FORWARD TO WORKING
WITH THE AUTHOR AND THE SPONSORS
MOVING FORWARD. THANK YOU.
APPRECIATE IT. THANK YOU VERY
MUCH. UH, WE'LL NOW MOVE ON TO
ANY ADDITIONAL WITNESSES IN
OPPOSITION TO A B 23 52 HERE
ROOM 2100. SEE NO END
APPROACHING THE MICROPHONE.
MODERATOR. PLEASE OPEN THE LINES
FOR WITNESSES. WE SHOULD TESTIFY
IN OPPOSITION TO A B 23 52. FOR
IF YOU ARE AN OPPOSITION OF A B
23 52, IT IS ONE THAN ZERO. AND
WE WILL START WITH MY NUMBER 2
11. THIS IS AARON RIVERS ON
BEHALF OF THE ASSOCIATION OF
CALIFORNIA LIGHTS AND HEALTH
INSURANCE COMPANIES AND WITHIN
OPPOSING RECOMMENDED POSITION.
THANK YOU. THANK YOU NEXT
WITNESS. WE DO NOT HAVE ANY
MAREQUE YOU MR CHAIR. THANK YOU.
LET'S BRING IT BACK TO THE
COMMITTEE. ANY QUESTIONS OR
COMMENTS, SAYING, OKAY, IT'S
BEEN MOVED BY SENATOR WIENER,
SENATOR NAZARIAN. THANK YOU SO
MUCH FOR BRINGING THIS BILL
FORWARD. APPRECIATE YOU WORKING
WITH OUR COMMITTEE STAFF TO ALSO
TO ADDRESS THE AMENDMENTS AND I
THINK IT'S YOU KNOW, IT HELPS
PATIENT AND IT'S IMPORTANT THAT
PHYSICIANS AND OTHER HEALTHCARE
PROVIDERS ARE ABLE TO, UH, TO
HAVE ACCESS TO THAT KIND OF
INFORMATION THAT THERE'S A P I S
AND SO FORTH THAT CAN BE BUILT
INTO THEIR WORKFLOW SO THAT THEY
CAN APPROPRIATELY PRESCRIBED
ACTUALLY, IN MANY WAYS TO MEET
THE NEEDS OF THE HEALTH PLANS
WHO SAY THAT YOU HAVE TO FOLLOW
CERTAIN FORMULA AREA OR WHATEVER
ELSE THEY CAN BE AWARE OF THAT
AND SAID, MAKING THE PATIENT
INTERMEDIARY AND THEY SHOW UP IN
THE PHARMACY. OH, THAT WAS
COVERED AND THEY HAVE TO CALL
THE DOCTOR. THAT NEW FORM,
ETCETERA, SO I THINK THIS
ACTUALLY IS, YOU KNOW, RESOLVING
THE TECHNICAL ISSUES THAT MAY BE
STILL OUTSTANDING, BUT BUT IT'S
GOING TO MAKE QUALITY OF CARE
BETTER FOR EVERYONE. BUT MOST
IMPORTANTLY FOR PATIENTS, SO
WITH THAT, WOULD YOU LIKE TO
CLOSE? THANK YOU, MR CHAIR. I
ACTUALLY, THAT'S A GREAT CLOTHES
AND I LOOK FORWARD TO WORKING,
CONTINUING TO WORK WITH THE
OPPOSITION AND RESPECTFULLY ASK
FOR I VOTE. THANK YOU. THANK YOU
. SO THE MOTIONS DO PASS THIS
AMENDED. WE REFERRED TO THE
COMMITTEE APPROPRIATIONS. IT'S
BEEN MOVED BY CENTER WIENER
SECRETARY PLEASE CALL THE ROLL
AND I MELINDA'S EGGMAN. GONZALEZ
GROVE GROVE, I HEARD TATO LEYVA
. AYE LIMÓN. ROTH RUBIO WIENER
WIENER. I OKAY? THAT BUILDS
CURRENTLY FOR ZERO. THANK YOU.
THANK YOU AND I SEE A SIMILAR
IRWIN. I DON'T SEE ANYONE ELSE
HERE. HURRY UP, OKAY, YOU'RE
NEXT, SO WE'RE NOW GOING TO MOVE
ON TO ITEM NUMBER 17 26 73 BY
SENATOR ERWIN WELCOME. THANK
YOU, DOCTOR PAN AND SENATORS.
CALIFORNIA STATE AUDITOR
RELEASED A REPORT THIS PAST
MARCH THAT DEMONSTRATED LARGE
SCALE FRAUD WITHIN THE HOSPICE
INDUSTRY. A B 2673 WILL
IMPLEMENT RECOMMENDATIONS MADE
BY THE AUDITOR TO ADDRESS THIS
EGREGIOUS BEHAVIOR. IT FOLLOWS A
B 12 80 FROM LAST YEAR, WHICH
ALREADY STARTED SOME OF THE
REFORMS. I WANT TO THANK THE
COMMITTEE FOR THEIR WORK ON THIS
BILL. AND I WILL BE AMENDING THE
BILL TO ADDRESS THE COMMENTS IN
THE ANALYSIS AND WE WERE VERY
HEARTENED TO SEE ALREADY A
MILLION DOLLARS IN THE BUDGET
FOR THE HOSPICE FRAUD TASK
FORCE. WITH ME TO TESTIFY AND
SUPPORT IS PETER KELSON,
REPRESENTING THE CALIFORNIA
HOSPICE AND PALLIATIVE CARE
ASSOCIATION. THANK YOU, SENATOR
. ERWIN WELCOME. THANK YOU.
DOCTOR CHAIRMAN MEMBERS, PETER
KELSON ON BEHALF OF THE
CALIFORNIA HOSPICE AND
PALLIATIVE CARE ASSOCIATION. THE
ASSOCIATION HAS BEEN SUPPORTIVE
OF PAST EFFORTS BY THE AUTHOR
HAS BEEN SUPPORTIVE OF THE
RECOMMENDATIONS BY THE STATE
AUDITOR GENERAL AND WANT TO
EXTEND THEIR APPRECIATION TO MR
NGUYEN. FOR THE BALANCED EFFORT
AND APPROACH HE HAS TAKEN O
ENSURING THAT THOSE WHO WOULD
SEEK TO TAKE ADVANTAGE OF THE
TERMINALLY ILL OR THEIR FAMILIES
AND TO ENSURE THAT THEY HAVE NO
PLACE IN THE SYSTEM HAS BEEN
BALANCED WITH APPROPRIATE EFFORT
TO ENSURE THAT ACCESS IS
RETAINED. TO THOSE NEEDING
HOSPICE CARE. THE BILL ITSELF
PROVIDES SEVERAL ELEMENTS TO
REDUCE FRAUD AND NEGLIGENT ACT
ACTIVITIES THAT PROVIDE SOME
RELIEF. ON HOSPICE ENTITIES TO
ENSURE THEY CAN PROVIDE ONGOING
pACCESS AND AVAILABLE TO ANSWER
ANY QUESTIONS. I WANT TO THANK
THE AUTHOR. ALL RIGHT. THANKS
VERY MUCH WILL NOW HEAR FROM ANY
ADDITIONAL WITNESSES AND SUPPORT
OF A B 26 73 HERE IN ROOM 2100.
SEE NO ONE APPROACHING THE
MICROPHONE. MODERATOR PLEASE
OPEN THE LIONS FOR WITNESSES WHO
COULD TESTIFY IN SUPPORT OF A B
26 73. YOU ARE IN SUPPORT OF A B
26 73. IT IS ONE, THEN ZERO.
OKAY, AND WE WILL START HERE
WITH LINE NUMBER. 2 12. D12
YEAR LINE IS OPEN. OKAY? WE DO
NOT HAVE ANY MORE AND QUÊ. MR
CHAIR. THANK YOU. MODERATOR WILL
NOW MOVE ON TO WITNESSES AND
OPPOSITION TO A V 26 73. WE DO
NOT HAVE FORMAL OPPOSITION
REGISTERED FOR TESTIMONY. SO
WE'LL SEE ANY ADDITIONAL
WITNESSES AND OPPOSITION HERE
FROM 2100 SAY NONE. MODERATOR
PLEASE OPEN THE LINES FOR
WITNESSES WHO WISH TO TESTIFY IN
OPPOSITION TO A B 26 73. YOU'RE
AN OPPOSITION OF A B 26 73 10.
WE DO NOT HAVE ANYBODY QUEUING
UP. OKAY, THANK YOU. BRING IT
BACK TO THE COMMITTEE. ARE THERE
QUESTIONS OR COMMENTS FROM
COMMITTEE MEMBERS, AND IT'S BEEN
MOVED BY SENATOR LEVA. SENATOR
BERMAN. THANK YOU SO MUCH FOR
WORKING WITH MY COMMITTEE STAFF
ON ON THE AMENDMENTS AND AGAIN
REALLY APPRECIATE YOU ADDRESSING
THIS ISSUE OF HOSPICES.
IMPORTANT PEOPLE HAVE ACCESS TO
HOSPICE. BUT WE DON'T NEED TO
ALSO BE SURE THAT THEY'RE
GETTING ACCESS QUALITY CARE.
WE'RE NOT GETTING FRAUD OR OTHER
TYPES OF PROBLEMS IS NOTED BY
THE AUDITOR. WOULD YOU LIKE TO
CLOSE? JUST RESPECTFULLY ASK FOR
YOUR VOTE. OKAY THANKS VERY
MUCH, SO THE MOTION IS DUE
PASSES AMENDED, REFERRED TO THE
COMMITTEE ON JUDICIARY HAS BEEN
MOVED BY CENTRAL EVA. SECRETARY
PLEASE CALL THE ROLL AND I'M
MELINDA'S EGGMAN. EGGMAN I,
GONZALEZ GONZALEZ, I GROVE GROVE
I POTATO. LIVER LIVER? AYE.
LIMÓN WRATH. RUBIO WIENER
WIENER. AYE. STICKS. OKAY, THAT
BILL CURRENTLY 60 AND WE'LL PUT
THE BILL ON CALL FOR ABSENT
MEMBERS. THANK YOU. OKAY WE HAVE
ANY OTHER. I DON'T SEE OTHER
AUTHORS HERE. SO YES, I THINK
YOU ARE SO AS YOU'RE SO WE'RE
GOING TO NOW MOVE ON TO ITEM
NUMBER 13 21 99 DECEMBER WEEKS
IS TO BE PRESENTED BY SENIOR
WIENERS AS HE COMES UP. I DO
WANT TO QUICKLY MAKE AN
ANNOUNCEMENT WAS ALWAYS CALLING
OFF CONSENT CALENDAR ITEMS. I
WOULD MAKE NOTE THAT I DIDN'T
MENTION IS ALSO ITEM NUMBER 7
1900 BY ASSEMBLY. ARAMBULA IS
ALSO ON THE CONSENT CALENDAR AS
WELL FOR RIGHT NOW, SO, UM,
THOSE. SO WE DO THE CONSENT
CALENDAR. IT ITEMS ON THE
CONSENT CALENDAR AND WILL NOW GO
TO ITEM NUMBER 13 21 99 BY SOME
MEMBER WICKS. WELCOME CENTER
WIENER. THANK YOU VERY MUCH, MR
CHAIRMAN. I'M HONORED TO PRESENT
A B 21 99 ON BEHALF OF SOME
REMEMBER WICKS, ALTHOUGH
CALIFORNIA HAS REDUCED MATERNAL
MORTALITY RATES BLACK AND
INDIGENOUS BURNING PEOPLE
CONTINUE TO EXPERIENCE
DISPROPORTIONATELY HIGHER RATES
OF MATERNAL MORTALITY AND
MORBIDITY TO ADDRESS
DISPROPORTIONATELY HIGH NEGATIVE
PREGNANCY AND BIRTH OUTCOMES.
THIRTIES HAVE SHOWN THAT DOULAS
ARE ASSOCIATED WITH IMPROVED
HEALTH OUTCOMES. AS THEY PROVIDE
PHYSICAL, EMOTIONAL AND
INFORMATIONAL SUPPORT TO WOMEN
BIRTHING PEOPLE DURING LABOR,
BIRTH AND IN THE IMMEDIATE
POSTPARTUM PERIOD. IN ADDITION
TO THIS CAN HELP FAMILIES AVOID
COSTS ASSOCIATED WITH PREGNANCY
RELATED AND BIRTH RELATED
COMPLICATIONS. CALIFORNIA HAS
TAKEN STEPS TO INCREASE ACCESS
TO DOULA CARE BELOW INCOME
PEOPLE. HOWEVER THERE IS STILL A
SIGNIFICANT NUMBER OF PEOPLE WHO
EXPERIENCE PREGNANCY RELATED AND
BIRTH RELATED COMPLICATIONS. AND
CAN'T ACCESS TO THE CARE BETWEN
T. 1 99 WAS ESTABLISHED THE
BIRTHING JUSTICE FOR CALIFORNIA
FAMILIES PILOT PROJECT, IT WILL
CREATE A THREE YEAR PILOT
PROGRAMS TO PROVIDE GRANTS TO
FUND COMMUNITY BASED DOULA
GROUPS AND OTHER ORGANIZATIONS.
TO PROVIDE FULL SPECTRUM DOULA
CARE TO WOMEN AND BURNING PEOPLE
WHOSE COMMUNITIES SUFFER FROM
HIGH RATES OF NEGATIVE BIRTH
OUTCOMES AND ARE NOT ELIGIBLE
FOR MEDICAL COVERAGE AND ALSO TO
INCARCERATED PEOPLE. THE DOORS
SPONSORED BY BLACK WOMEN FOR
WELLNESS ACTION PROJECT AND
SUPPORTED BY A NUMBER OF HEALTH
AND REPRODUCTIVE RIGHTS
ORGANIZATIONS. TODAY I HAVE TWO
WITNESSES. SHANTY DAVIES BULGE
FROM BLACK WELLNESS AND
PROSPERITY CENTER. AND NO ONE TO
TELL FROM PLANNED PARENTHOOD,
PASADENA AND SAN GABRIEL VALLEY.
I RESPECTFULLY ASK FOR YOUR I
VOTE. THANK YOU, SENATOR WIENER.
MODERATE PLEASE BRING OUT TO THE
LINES ARE WITNESSES FOR
TESTIMONY SUPPORT SHANTY DAVIS,
BAULCH WITH BLACK ONENESS AND
PROSPERITY CENTER AND KNOWING TO
TELL FROM PLAYING PAINTER TO
PASADENA SAINT GABRIEL VALLEY.
WE'RE GOING TO BE IN WITH SHANTI
DAVIES BOTCH. TWO MINUTES. HELLO
AND THANK YOU. COMMITTEE MEMBER
. MY NAME IS SHANTIA DAVIES BALL
, AND I'M THE PRESIDENT AND CEO
OF BLACK WELLNESS AND PROSPERITY
CENTER. WE ARE A RESEARCH DRIVEN
SOCIAL ENTERPRISE FOUNDED TO
MAKE POLICIES AND PROGRAMS MORE
EQUITABLE, ACCESSIBLE AND
EFFECTIVE FOR BLACK WOMEN ARE
LASER FOCUSES ON REDUCING
PRETERM BIRTH. REDUCING MATERNAL
MORTALITY AND BUILDING
INFRASTRUCTURE CAPACITY. I AM
ALSO A CERTIFIED NEWBORN CARE
SPECIALISTS CERTIFIED LACTATION
EDUCATOR, DOULA AND A MOTHER OF
THREE. I AM HERE TO EXPRESS
STRONG SUPPORT FOR A B 2199. THE
BIRTHING JUSTICE FOR CALIFORNIA
FAMILIES PILOT PROJECT. THIS
BILL WILL REALLY BUILD UPON OUR
STATE EFFORTS TO IMPROVE BIRTH
OUTCOMES FOR ALL CALIFORNIANS
AND DECREASE RACIAL DISPARITY BY
EXPANDING ACCESS TO DO WITH
CARE. BLACK WOMEN EXPERIENCED
SOME OF THE HIGHEST RATES OF
ADVERSE OUTCOMES, BUT ARE THE
LEAST LIKELY TO HAVE ACCESS TO
DO WITH SUPPORT. IN THE PAST TWO
YEARS. I'VE EXPERIENCED BY
MISCARRIAGES. I HAVE BEEN LUCKY
ENOUGH TO HAVE ACCESS TO THE
DUAL SUPPORT I NEEDED DURING
THOSE TRAUMATIZING EXPERIENCES.
CREDIT AND DO A SUPPORT I
RECEIVED TO RESTORING MY MENTAL
HEALTH AND WELL BEING. DURING
TIMES OF EXTREME STRESS, SUCH AS
EXPERIENCE A LAW OR WHILE BEING
INCARCERATED. HAVING THE TYPE OF
EMOTIONAL, NONJUDGMENTAL SUPPORT
OF SPECIALLY TRAINED, DO A AND
PROVIDE AND WILL IMPROVE. THE
HEALING PROCESS NEEDED WHILE
BERTHING INCARCERATED. I WOULD
ALSO LIKE TO SHARE THAT IN 2003
. I SUPPORTED MY OWN SISTER
DURING HER BIRTH WHILE SHE WAS
INCARCERATED. I WAS ONLY ABLE TO
GAIN ACCESS BECAUSE OF THE
EXISTING TRUSTED RELATIONSHIP
WITH THE HOSPITAL THAT I HAD.
BUT MY DUELIST SUPPORT. TWO
MINUTES REALLY HELPED TO ENSURE
THAT SHE EXPERIENCED BIRTH WITH
DIGNITY, SUCH AS MAKING SURE HER
HANDCUFFS WERE REMOVED DURING
HER LABOR AND DELIVERY. A B 2199
WILL ADVANCE EQUITY BY ENSURING
THAT MORE BIRTHING PEOPLE HAVE
ACCESS TO RESPECTFUL AND
EMOTIONAL SUPPORT DURING THEIR
INCARCERATION AND BIRTHING
EXPERIENCE. EVERYONE DESERVES
DIGNITY AND BIRTH AND PERRY
NEEDLE SUPPORT. RESPECTFULLY
URGE YOU TO VOTE? YES ON A B
2199. THANK YOU. THANK YOU VERY
MUCH. WE'LL NOW MOVE ON TO DR
NOAH, TELL YOU HAVE A MINUTE AND
A HALF. HI THERE. MY NAME IS
DOCTOR. NO ONE TO TELL. I'M A
BOARD CERTIFIED IN AND I AM THE
DIRECTOR OF WOMEN'S HEALTH FOR
L. A COUNTY CORRECTIONAL HEALTH
SERVICES PROVIDE PRENATAL CARE
IN THE NATION'S LARGEST WOMEN'S
JAIL RIGHT HERE IN LOS ANGELES,
AND I'M CALLING TO SUPPORT
BRINGING DOULAS AND JUST SERVE
THIS SHOCKINGLY HIGH NUMBER OF
PREGNANT AND POSTPARTUM
INCARCERATED PEOPLE IN
CALIFORNIA. HAVE BEEN WORKING IN
THE JAIL FOR SIX YEARS, AND I'VE
SEEN WHAT IT'S LIKE TO DELIVER.
BABIES HAVE MISCARRIAGES, UM AND
BE SEPARATED FROM FAMILIES WHILE
IN JAIL. THIS IS NOT HOW THOSE
WITH THE GREATEST NEEDS TO BE
TREATED, NOR SHOULD THIS BE THE
WAY VULNERABLE INSTANCE ABOUT IT
TO THE WORLD. THE FACTORS THAT
LEAD IT TO INCARCERATION, THE
FACTORS THAT LEAD TO
MARGINALIZATION WITHIN THIS
AGREEMENT, CRIMINAL LEGAL SYSTEM
OR THE SAME FACTORS. THAT LEAD
TO MARGINALIZATION IN THE
MEDICAL SYSTEMS, RACISM,
ECONOMIC, HOUSING AND
EDUCATIONAL INJUSTICE. THESE
INEQUITIES HAVE BEEN PERPETUATED
BY BOTH THE MEDICAL AND THE CAR,
SURREAL SYSTEM. AND HAVE
RESULTED IN GENERATIONS OF
TRAUMA AND EXACERBATED HELPS
SEVERITY. AND I CAN THINK OF NO
BETTER WAY TO INTERRUPT A
MULTIGENERATIONAL PATTERN OF
HEALTH AND EQUITY AND BY
PROMOTING DOULAS, ESPECIALLY OF
THE COMMUNITY IN WHICH THEY
SERVE TO ATTEND THE PRENATAL
BIRTH AND POSTPARTUM NEEDS OF
OUR MOST DISENFRANCHISED. I HAVE
THE PRIVILEGE OF WORKING WITH
DUALISM HALLE COUNTY JAIL AND A
PARTNERSHIP WITH DEPARTMENT OF
PUBLIC HEALTH. AND EVEN IN THE
FLEDGLING PROGRAM, I'VE SEEN
THAT FACT THROUGH THE
EMPOWERMENT OF MY PATIENTS TO
DETERMINE THEIR OWN HEALTH
OUTCOMES. THIS WORK IS NOT EASY
AND SHOULD BE WELL COMPENSATED,
AND WE SHOULD ALL STRIVE TO
PROVIDE THE BEST REPRODUCTIVE
HEALTH CARE FOR THESE
MARGINALIZED GROUPS IN OUR
SOCIETY AND SUPPORT FIRST WORK
HERE. PLEASE WRAP UP WORKERS FOR
INCARCERATED INDIVIDUALS. THANK
YOU. THANK YOU. ALRIGHT WELL,
NOW MOVE ON TO ADDITIONAL
WITNESSES AND SUPPORT OF A B 21
99 WILL BEGIN TO YOUR ROOM, 2100
SAYING NO ONE APPROACHING THE
MICROPHONE. MODERATOR PLEASE
OPEN THE LINES FOR WITNESSES,
WHICH TESTIFY IN SUPPORT OF A B
21 99 NAME ORGANIZATION
POSITION. IF YOU ARE IN SUPPORT
OF A B 21 99. IT IS ONE THEN
ZERO ON YOUR PHONE. SUPPORT ONE,
THEN ZERO. AND WE WILL START
WITH MY NUMBER. 1 34. HELLO
ISABELLA GROUND BEHALF OF THE
CALIFORNIA NURSES ASSOCIATION IN
NARROW CALIFORNIA. THANK YOU.
THANK YOU. NEXT WITNESS. NEXT WE
WILL GO TO LINE NUMBER TWO. OH,
SEVEN. YES HELLO. GOOD AFTERNOON
. CHAIR MEMBERS. THIS IS EDWIN
BARBONE ON BEHALF OF THE
CHILDREN'S PARTNERSHIP AND
SUPPORT. THANK YOU SO MUCH.
THANK YOU. NEXT WITNESS. NEXT TO
THE WATER LINE NUMBER 1 48. HI
THIS IS SARAH DÍAS WITH THE
CALIFORNIA WICK ASSOCIATION AND
SUPPORT THANK YOU NEXT WITNESS.
NEXT YEAR. WE'LL GO TO LINE
NUMBER 1 53 1 53 LINE IS OPEN.
GOOD AFTERNOON, NARROWLY
MARATHON ON BEHALF OF ALAMEDA
COUNTY AND SUPPORT OF A B 21 99.
THANK YOU. THANK YOU. NEXT
WITNESS. 2 14. GOOD AFTERNOON
JOANN PARKS ON BEHALF OF HULU,
CALIFORNIA OPTION IN SUPPORT.
THANK YOU. THANK YOU. NEXT
WITNESS. I NEVER WON 93. 1 93.
YOUR LINE IS OPEN. IS THAT IS
THAT ME? PLEASE INTRODUCE
YOURSELF. OH, HI THERE. GOOD
AFTERNOON, MR SHARON MEMBERS ON
YOUR MOBILE WITH BLACK WOMEN FOR
HONEST ACTION PROJECTS, PROUD
SPONSOR OF THIS BILL AND URGING
YOUR SUPPORT. THANK YOU VERY
MUCH. THANK YOU. NEXT WITNESS.
AND WE HAVE LINE NUMBER 1 64. 1
64. YOUR LINE IS OPEN. THIS IS
ROBBIE GONZALEZ WITH THE
CALIFORNIA BREASTFEEDING
COALITION AND STRONG SUPPORT.
THANK YOU NEXT WITNESS. WE DO
NOT HAVE ANY MORE IN QUÊ, MR.
CHAIR ALL RIGHT. THANKS VERY
MUCH. WE'LL NOW MOVE TO
WITNESSES AND OPPOSITION TO A B
21 99. WE DO NOT HAVE ANYONE
FORMALLY REGISTERED IN
OPPOSITION, SO WE'LL TAKE
ADDITIONAL WITNESSES IN THE ROOM
SO AGAIN. PLEASE BEGIN NAME
ORGANIZATION POSITION. I AM NOT
HERE TO ARGUE. I'M ONLY HERE TO
COME INTO AGREEMENT. SHOW MY
HONOR AND RESPECT FOR THE
QUANTUM COMMUNITY. I HAVE
DISTRIBUTED DOCUMENTS TO YOU
SHOWING THAT THE SENATE
COMMITTED A FEDERAL FELONY.
SORRY SIR. NAME ORGANIZATION IN
POSITION. OKAY? LET THE RECORD
REFLECT THAT. I JUST GOT YOUR
AGREEMENT THAT YOU AGREE THAT
YOU COMMITTED FEDERAL FILM.
ALRIGHT. THAT'S AH. APPROPRIATE
BUT OKAY, ANY OTHER WITNESSES
SAYING THE OTHER WITNESSES AT
THE MICROPHONE, WE WILL NOW MOVE
ON TO WITNESSES ON THE
TELECONFERENCE LINE. SO,
MODERATOR, PLEASE. AND WE ARE AN
OPPOSITION OF A V 21 99
MODERATORS. CAN YOU PULL THE
MOMENT HERE? SURE THERE A
WITNESS. OKAY WE DO HAVE ONE
ADDITIONAL WITNESS WHO, UH,
WISHES TESTIFYING. OPPOSITION.
TO A V 21 99. YES. NAME
ORGANIZATION POSITION. HOLD ON.
WE CAN'T HEAR YOU HERE. OKAY? I
JUST NEED TO OPPOSE TO THIS BILL
BECAUSE I DON'T APPRECIATE IT.
NAME YOUR NAME, PLEASE BIRTHING
PEOPLE. MY NAME IS SASHA
WILLIAMS AND I OPPOSED TO THE
LANGUAGE USED IN THE VIEW. OKAY,
THANK YOU. ALL RIGHT. I SEE NO
OTHER WITNESSES IN THE
MICROPHONE. MODERATOR PLEASE
OPEN THE LIONS FOR WITNESSES AND
OPPOSITION TO A V 21 99. SAYING
WE HAVE LINE NUMBER 1 69. PIKE
NEAR ME. PLEASE INTRODUCE
YOURSELF. MY NAME IS VERONICA. I
RESIDE AND YOU HAVE A COUNTY AND
I RESPECTFULLY OPPOSED. I'M
SORRY, 21 9199. THANK YOU. ALL
RIGHT. THANK YOU. NEXT WITNESS.
YOU HAVE MY NUMBER 2 13. YOU
NEED TO TAKE WHAT YOU NEXT
WITNESS, PLEASE. WE HAVE A LINE
NUMBER 2 12. YES I CAN HEAR ME.
PLEASE INTRODUCE YOURSELF. SHE
JUST CONNECTED OUT WITH THE CUTE
NEXT WITNESS. THERE IS NO OTHER
WITNESSES IN THE QUEUE. THANKS
VERY MUCH. WE'LL BRING IT BACK
TO COMMITTEE QUESTIONS OR
COMMENTS FROM COMMITTEE MEMBERS.
SARAH GROVE. THANK YOU, MR CHAIR
, AND I MISS SENATOR. MY
COLLEAGUE FROM SAN FRANCISCO. I
DO BELIEVE THAT YOU'RE JUST THE
PRESENTER, SO I'LL TRY NOT TO
CATCH YOU UP. I JUST DO HAVE
SOME QUESTIONS THAT I'D LIKE TO
ASK. SO UM, ALL THE COMMENTS ON
THE INTRODUCTION OF THE BILL AND
WHAT I CAN SEE SO FAR IN THE
ANALYSIS TALKS ABOUT BIRTHING
PEOPLE AND I GET THAT, UM, THE
PERSON I BELIEVE THAT ONLY A
WOMAN CAN HAVE A BABY, BUT
THAT'S IRRELEVANT IN THIS
PARTICULAR CONVERSATION. I DO
AGREE WITH THE BILL, AND I THINK
WE SHOULD PROVIDE DUELIST TO
INDIVIDUALS WHO ARE LOW INCOME.
AND SPECIFICALLY IN PRISON. YOU
KNOW THEY'RE ALREADY
INCARCERATED. THEY'VE GOT
STRUGGLES GOING ON. BUT THE
QUESTION THAT I HAVE IS THE
QUESTION THAT I HAVE IS THAT
LIKE I SAID, THE COMMENTS AND
EVERYTHING SAYS THAT YOU KNOW
THEIR HAND HOLDING THEIR THERE
TO BE THERE AND YOU KNOW,
DIGNITY AND BIRTH AND THINGS
LIKE THAT. BUT THERE'S ALSO DUAL
IS OUT THERE THAT PROVIDE
ABORTION COUNSELING AND SERVICES
ABORTION OF FULL SPECTRUM. LIKE
INFORMATIONAL INFORMATION
SUPPORT VALIDATE THEIR CLIENT,
REGARDLESS OF WHAT DECISION
THEY'RE MAKING. WILL THIS
FUNDING ALSO GO TO THAT? OR WILL
THIS ALSO GO TO THAT? THE
FUNDING GOES TO DOULA SERVICES.
AND SO WHATEVER SERVICES DO
ALLOW THOSE PROVIDE IS WHAT IS
WHAT TELL PROVIDE, SO THE
FUNDING GOES TO DO THE SERVICES
TO GO INTO THE PRISON SYSTEM TO
HELP WOMEN. WHO ARE PREGNANT
THAT WOULD HAVE AN ABORTION.
WHATEVER DOULAS DO
PROFESSIONALLY, AND THERE'S A
WIDE SPECTRUM OF INFORMATION AND
SERVICES AND SUPPORT THAT THEY
PROVIDE. THEY WOULD BE SORT OF
APPLY TO THAT. JUST LIKE IF WE
SUPPORT DOCTOR IF WE SUPPORT UM
MORE RESIDENCIES FOR RBG Y N
THEY CAN DO A VARIETY OF THINGS
SO THEY CAN PRACTICE TO THE POST
SCOPE OF THEIR TRAINING AND
TOOLS PROVIDED A NUMBER OF
DIFFERENT SERVICES AND ADVICE
AND SUPPORT AND IS ONE OF THOSE
THINGS. ABORTION SUPPORT AND
ADVICE. I THINK REPRODUCTIVE
HEALTH SERVICES CAN BE PART OF
WHAT A DUAL ADVISORS I'M NOT A
DUEL, AND MAYBE ONE OF OUR
ACTUALLY, PERHAPS MAYBE WE CAN
BRING OUR LEAD WITNESS WHO WAS
IT WAS A DOULA. UM SHANTY DAVIS
SPOKE. ARE YOU STILL AVAILABLE
ON THE LINE? YES I AM HERE, OKAY
? AND I KNOW YOU HAVE A CHANCE
TO HEAR SOME QUESTIONS. OKAY? I
DIDN'T KNOW IF YOU HEARD SANDRA
GROVES QUESTION IF YOU WANT TO
ANSWER THAT. I DID HEAR THE
QUESTION AND, UM THEIR RESPONSE
TO THAT IS WE HAVE FOUR SPECTRUM
DUELISTS WHO ARE TRAINED TO
PROVIDE FOUR SPECTRUM RANGE OF
SERVICES. UM AND THAT SCOPE OF
PRACTICE CAN RANGE FROM
SUPPORTING BIRTHING PERSONS. AH
AGAIN DURING THEIR PREGNANCY
DURING THEIR LABOR. AND AFTER
DELIVERY, IT CAN ALSO SUPPORT UM
, PERSONS DURING LOSS, SUCH AS
THE TESTIMONY THAT I SHARED
DURING FIVE PREGNANCY LOSSES.
AND SO I'M REALLY APPRECIATIVE
OF THE FACT THAT WE DO HAVE
DOULAS WHO ARE TRAINED, CAN BE
ABLE TO PROVIDE THIS SPECIALIZED
SUPPORT. UM, TO REALLY SUPPORT
THE HEALTH. AND WELL BEING OF
WOMEN IN THE STATE OF
CALIFORNIA. IT'S A PRETTY SIMPLE
QUESTION. I'M JUST ASKING IF
THESE DOULAS WILL BE COMPENSATED
BY STATE TAXPAYER DOLLARS TO
PERFORM DOULA SERVICES
ASSOCIATED WITH ABORTION FOR
PRISON INMATE PREGNANT WITH
INDIVIDUALS OR WOMEN IN IN
PRISON. I'M JUST ASKING IF
THAT'S PART OF IT. I THINK HE
WAS IN THE STATE OF CALIFORNIA
WILL BE COMPENSATED TO PROVIDE
SERVICES WITHIN THEIR SCOPE OF
PRACTICE. DOES THAT INCLUDE
ABORTION? SO DEPENDING ON WHAT
TYPE OF TRAINING THE DOABLE HAS
JUST AS WHAT TYPE OF TRAINING A
PHYSICIAN MAY HAVE, UM, IT IS
BASED ON THEIR SCOPE OF PRACTICE
AND WHAT THEY ARE. QUALIFIED TO
PROVIDE WHICH IN SOME CASES, BUT
WE ARE ABORTION THURMOND THAT DO
US. WHO ARE TRAINED AND WELL
QUALIFIED TO SUPPORT BIRTHING
PERSON IN THE STATE OF
CALIFORNIA WILL BE COMPENSATED
TO PROVIDE SUPPORT AND SERVICES.
AGAIN BASED ON THEIR TRAINING MR
CHEN BE ON NOT TRYING TO BE
HOSTILE, MR. CHAIR. YEAH YEAH,
THIS IS MY QUESTION. I THANK YOU
CONSULTANTS BEFOREHAND AND I
THOUGHT, YOU KNOW THIS IS
PROBABLY A REALLY GOOD BILL FOR
US TO SUPPORT BECAUSE WE NEED TO
OFFER SERVICES. FOR WOMEN
SPECIFICALLY IMPRISONED OR
UNDERSERVED COMMUNITIES TO ALLOW
THEM TO HAVE, UM THE SUPPORT
THEY NEED FOR BIRTHING FOR
HAVING A BABY, RIGHT? ESPECIALLY
IF YOU'RE IN PRISON, YOU KNOW,
AND YOU KNOW, AND I KNOW THAT'S
WHAT THIS FOCUSED ON AND THEN I
STARTED READING THROUGH SOME OF
THE INFORMATION AND IT LOOKS
LIKE TO ME, TOO, SUPPORTS
ABORTION SERVICES. SO OBVIOUSLY
I'M NOT GOING TO SUPPORT A BILL
LIKE THAT. AND I KNOW YOU DON'T
NEED MY VOTE. BUT I WOULD LIKE
TO VOTE FOR THE BILL IF IT DOES
NOT. SO I'M JUST TRYING TO ASK A
SIMPLE QUESTION. WHAT DOES IT
NOT? HOLD ON? WAIT WAIT, WAIT,
WAIT, WAIT. NO ACTUALLY, MA'AM,
HOLD ON. I MEAN, THAT'S THAT'S
ONE OUT OF TIME HERE, OKAY? SO
ACTUALLY, THERE WAS A VERY
SPECIFIC QUESTION SENATOR GROVE
HAD I WOULD APPRECIATE IF YOU
COULD JUST FOCUS YOUR ANSWER
BRIEFLY ON ANSWERING THAT
QUESTION. LET ME JUST PAINT A
SCENARIO, THOUGH PERHAPS THAT
MIGHT HELP CLARIFY RIGHT. SO YOU
MAY HAVE SOMEONE WHO'S PREGNANT
, RIGHT? THEY HAVE A DUEL OF
SUPPORTING THEM. AH TEST COMES
BACK IN YOUR STATUS OR SOMETHING
SHOWING THAT PERHAPS MAYBE THAT
FETUS HAS A GENETIC DEFECT AND
THEY DECIDED TO MAKE PREGNANCY.
IT'S POSSIBLE TO DO THAT MAY
HELP THEM THROUGH THAT. WE ALSO
HEARD ABOUT PREGNANCY LOSS. SO
IN THIS CARRIAGE OF SOME SORT,
SO PERHAPS, AND NOW I'M NOT THE
DUAL, A. SO SO THIS IS THE
ANSWER IS YES. OKAY THANK YOU.
YES, I DO WONDER WHO WAS
QUALIFIED. WELL PROVIDE SERVICES
FOR PREGNANCY LOST AND VARIOUS
PREGNANCY OUTCOMES BASED ON THE
SCOPE. THANK YOU. THANK YOU.
OKAY, HOPEFULLY THAT ANSWER YOUR
QUESTION. I WASN'T CONCERNED
ABOUT PREGNANCY LOSS. I MEAN,
YOU KNOW, I WASN'T I JUST I WAS
TRYING TO FIND A WAY TO STILL
SUPPORT THE BILL. MY SENATOR
COLLEAGUE BECAUSE I THINK IF
PEOPLE CHOOSE TO HAVE A BABY,
AND EVEN IF THEY'RE IN PRISON,
AND THEY WANT TO KEEP THAT BABY
AND THEY NEED SOMEBODY TO HOLD
THEIR HAND AND WALK THEM THROUGH
THAT PROCESS IN FOR THAT. BUT
I'M NOT GOING TO SORT OF BORDER
BILL THAT ALLOWS THEM TO GO IN
AND CONSULT AND DO THAT STUFF
FOR ABORTION SERVICES BECAUSE I
SUPPORT LIFE. SO IT WAS JUST A
SIMPLE QUESTION. IT WAS HOSTILE.
IT WASN'T IT WASN'T ANYTHING
OTHER THAN I WAS JUST LOOKING
FOR A SIMPLE ANSWER TO SEE IF I
COULD STILL SUPPORT THE BILL.
PERIOD YEAH, I WOULD. YOU'RE
GONNA OBVIOUSLY RESPECT YOUR
WELL BOTH THE WAY WE WANT TO
BUILD WHAT I WAS SAYING. WAS
THAT QUESTION OR A COMMENT? SURE
WHATEVER. OKAY, ALRIGHT. SO I'M
GONNA SAY IS THERE ARE VARIOUS
pY N WHERE I'M I'M GOING TO GUESS
THAT YOU SUPPORT HAVING YOU
KNOW, SLOTS FOR TRAINING
RESIDENCIES TO TRAIN O B G Y N
SOME WILL BE GÂY ENGINES PROVIDE
ABORTION SERVICES. UM AND I'M
I'M GOING TO GUESS IT. YOU'RE
STILL IMAGINE A STRONG SUPPORTER
OF HAVING AN APO B G Y N FOR
PEOPLE, SO I THINK THIS IS ONE
ASPECT OF MANY THINGS THAT IT
DOES, BUT I JUST WANTED TO SORT
OF PUT THAT OUT THERE. BUT I
APPRECIATE YOUR QUESTION, OKAY?
QUESTIONS OR COMMENTS SARAH
MELINDA'S THANK YOU. SO I WANT
TO THANK MY COLLEAGUE FROM
BAKERSFIELD FOR POSING THAT
QUESTION. AND I WILL JUST SAY
THAT I'M IN THE SAME POSITION
WHERE AS A MOTHER, WHO HAS GIVEN
BIRTH TO FIVE CHILDREN, THOUGH
NONE WITH THE DUELIST, BUT YOU
KNOW, I RESPECT THE DIFFERENT
CHOICES THAT WOMEN MAKE WITH HOW
THEY'RE DELIVERING THEIR
CHILDREN. MY MAIN CONCERN,
THOUGH, IS THERE IS A WHOLE
SLATE OF ABORTION RELATED BILLS
THAT ARE RUNNING THROUGH THE
LEGISLATURE IN ANTICIPATION OF
THE ROE V. WADE DECISION, AND I
AM CONCERNED THAT THE FUNDING
THAT THAT IS RECOGNIZED IN THIS
BILL IS NOT GOING TO GO TO WHAT
SENATOR GROVE AND I WOULD LIKE
IT TO GO FOR. IT'S GOING TO BE
REDIRECTED TO OTHER SERVICES
LIKE DUALIST SERVICES SUPPORTING
WOMEN WHO ARE CHOOSING TO HAVE
AN ABORTION AND THAT'S THE
OPPOSITE OF WHAT I WOULD LIKE
AND I HAVE NO WAY OF KNOWING
THAT YOU KNOW, AHEAD OF TIME,
BUT THAT'S MY SENSE IS THAT I
DON'T LIKE KEEP HEARING A
MICROPHONE. BUT THAT'S MY SENSE
IS THAT THERE IS A BIT OF A BAIT
AND SWITCH GOING ON HERE. I HOPE
THAT'S NOT THE CASE. BUT
NONETHELESS, I JUST WANTED TO
VOICE MY CONCERNS. THANK YOU.
THANK YOU. SARAH MELINDA SENATOR
EGGMAN. SORRY JUST SORRY. WE'RE
SORRY. WE'RE NOW HAVING
COMMITTED DISCUSSIONS. SO UM,
UH, SO IF IT'S A MEMBER HAS A
QUESTION THAT WE WILL CALL ON
YOU. WE WILL. WE WILL ASK YOU TO
RESPOND TO THAT. SO SENATOR
EDMUND. THANK YOU. AND JUST ON
THAT TOPIC OF IT IS MY
INTERESTING TO DO. IT DID NOT
PROVIDE ACTUAL ABORTIONS THEY
PROVIDE. CAN THEY PROVIDE HAND
HOLDING AROUND DECISION MAKING
IN LOS MIKE. I JUST WANT TO MAKE
THE POINT. THAT I THINK THIS IS
A FINE BILL. I'M GOING TO, OF
COURSE SUPPORTED BUT WE'RE
ALWAYS TALKING ABOUT BIRTH
DUELISTS. THERE'S DEATH DUEL IS
TOO AND WOMEN IN PRISON DIE ALSO
, SO MAYBE I'LL DO THAT BILL
NEXT YEAR. THANK YOU, AND THEY
WON'T BE DOING ABORTIONS. OKAY.
ANY OTHER QUESTIONS OR COMMENTS
FROM MEMBERS? OKAY SEEING NONE.
SARAH WIENER. THANK YOU SO MUCH
FOR PRESENTING THE BILL FOR A
SUMMER OF WEEKS. I THINK YOU
MAKE AN EXCELLENT POINT. YOU
MADE AN EXCELLENT POINT THAT THE
DOOR IS THERE TO SUPPORT UM, YOU
KNOW, THE BURNING WOMAN, THE
PREGNANT WOMAN AND THE PREGNANCY
AND THEN SO THE AND, UH THAT
PERSON MAY MAKE DIFFERENT
DECISIONS DEPENDING ON WHAT'S
GOING DOWN THE PATH AND THAT
THEY'RE THERE TO PROVIDE SUPPORT
. AND CERTAINLY WE WANT TO HELP
PROVIDE ACCESS TO THAT SUPPORT
FOR PEOPLE ARE INCARCERATED.
OTHER OTHER PEOPLE IN NEED FOR
THAT, SO CERTAINLY I WILL BE
SUPPORTING THE BILL. WOULD YOU
LIKE TO CLOSE? RESPECTFULLY ASK
FOR MY VOTE. OKAY THANK YOU
ACTUALLY WAS THEIR EMOTION ON
THE BILL. OKAY IT'S BEEN MOVED
BY SENATOR LEAVE A OKAY, SO IT'S
THE MERCHANT IS DO PASS AND
REFERRED TO THE COMMITTEE.
APPROPRIATIONS MOVED BY SENATOR
LEYVA. SECRETARY PLEASE CALL THE
ROLL PAN AND I'M MELINDA'S
EGGMAN. EGGMAN I, GONZALEZ
GONZALEZ, I GROVE GROVE KNOW HER
TATO. LEYVA A. I LIMÓN ROTH
RUBIO. WIENER. WIENER. AYE. OKAY
THAT BILL IS CURRENTLY 61. WE
WILL HOLD THE ROLL OPEN FOR
ABSENT MEMBERS. DON'T SEE THAT
SIMILAR SANTIAGO. THERE YOU ARE.
SORRY. IT'S THAT SHADOW THERE
CAN START TO SEE OKAY. I KNOW
SOMEONE'S THERE. I CAN'T ALWAYS
RECOGNIZE THEM, OKAY? ALL RIGHT
. WELCOME SO WE'RE NOW MOVING ON
TO ITEM NUMBER16, MAYBE 25 21.
WELCOME THANK YOU, MR CHAIR.
FIRST. I WANT TO ACCEPT THE
COMMITTEE AMENDMENTS AND THANK
YOU VERY MUCH FOR YOUR WORK ON
THIS. MAYBE 2025 21 WOULD SIMPLY
RENAME THE TRANSGENDER WELLNESS
EQUITY FUND. TO THE T G WELLNESS
AND EQUITY FUND TO ACCURATELY
REPRESENT THE COMMUNITY. THE
PROGRAM IS MEANT TO SERVICE WE
HAVE ONE WITNESS, MR CHAIR, AND
THAT IS ALEJANDRA MAYA GONE. I
HOPE I PRONOUNCED THAT RIGHT
FROM THE TRANS LATINA COALITION
. THANK YOU. THANKS VERY MUCH.
ASSEMBLYMEMBER'S SANTIAGO. UH
AND MODERATOR, PLEASE BRING ONTO
THE LINE. ALEXANDRA MEGA LEON
FROM THE, UH, TRANSLATING
COALITION. HELLO. THANK YOU FOR
HAVING MANY MISS ALEXANDRA
MAGADAN. I AM AN INTERSEX PERSON
THAT IS A COORDINATOR OF POLICY
AND COMMUNITY ORGANIZER AT THAT
. I'M PUTTING OUT COALITION
SPEAKING ON BEHALF OF THE
CALIFORNIA TRANSGENDER GENDER
NONCONFORMING INTERSECT. POLICY
ALLIANCE. MAYBE 25 21 WOULD
CHANGE THE TITLE OF T. W S TWO
TRANSGENDER, GENDER
NONCONFORMING INTERSEX ONENESS
AND EQUITY FUND TO MAKE IT
EXPLICITLY INCLUSIVE OF ALL
MEMBERS. OF THE COMMUNITY THAT
THE COURT WE HOPE THAT THIS
WORLD ONE NICKY EASIER FOR
GENDER, NONCONFORMING AND
INTERSEX IS SERVING
ORGANIZATIONS TO UNDERSTAND THAT
THIS FUND MOVEMENT TO SUPPORT TO
COMMUNITIES AND TO EXPLICITLY
AND VISIBLY INCLUDED GENDER
NONCONFORMING AND INTERSECTS
COMMUNITIES IN THE T G. I
UMBRELLA MAYBE 25 21 WOULD ALSO
ADD. THE DEFINITION SECTION
LANGUAGES OF REVOLVING IN REGARD
TO HOW WE DESCRIBE THE TEACHING.
I COMMUNITY WE WANT TO ENSURE
THAT PEOPLE KNOW THAT T G S W E
F WAS CREATED TO PROVIDE
CULTURALLY COMPETENT, HOLISTIC
MEDICAL SERVICES TO THE
COMMUNITY. IT IS ESPECIALLY
IMPORTANT AS ONE A NATIONAL
STUDY OF INTERSEX ADULTS IN THE
U. S 43% OF PARTICIPANTS RATED
THEIR PHYSICAL HEALTH AS THEIR
REPORT AND 53% RECORDED AIRPORT
MENTAL HEALTH. PREVALENT HEALTH
DIAGNOSIS INCLUDED DEPRESSION
AND ANXIETY, ARTHRITIS
HYPERTENSION, A NOTABLE
DIFFERENCES BY AGE AND SERIOUS
DIFFICULTIES PATH. AS YOU ANY
2015 SURVEY 32% OF TRANSGENDER
PEOPLE REPORTED HAVING A
NEGATIVE EXPERIENCE RELATED TO
BEING TENSE CENTER AND
HEALTHCARE SERVICES. THANK YOU
VERY MUCH FOR LISTENING FOR YOUR
TIME AND FOR YOUR SUPPORT NOW
COMMUNITY THANK YOU VERY MUCH,
WILL NOW MOVE ON TO ADDITIONAL
WITNESSES AND SUPPORT OF 25. 21
GO TO ROOM 2100 C NOT
APPROACHING THEMICROPHONE.
MODERATOR PLEASE OPEN THE LINES
FOR WITNESSES, WHICH HAD
TESTIFIED IN SUPPORT OF A B 25
21. OR COMMENTS IN SUPPORT.
PLEASE PRESS ONE THAN ZERO THAT
COMMAND AGAIN ONE THAN ZERO. AND
WE HAVE NO COMMENTS AT THIS
TIME. ALL RIGHT. THANK YOU.
WE'LL NOW MOVE ON TO WITNESSES
AND OPPOSITION TO A V 25 21. WE
DO NOT HAVE A LEAD UP POSITION.
WITNESS FOR TESTIMONY WILL GO TO
ROOM 2100. SEE NO ONE
APPROACHING THE MICROPHONE.
MODERATOR PLEASE OPEN THE LINES
FOR WITNESSES WHO TESTIFY IN
OPPOSITION TO A V 25 21. FOR
COMMENTS AND OPPOSITION, PLEASE
PRESS 10 THAT COMMAND AGAIN, 10.
AND WE HAVE NO COMMENT AT THIS
TIME, RIGHT? WE'LL BRING YOU
BACK TO THE COMMITTEE QUESTIONS
OR COMMENTS FROM COMMITTEE. OH
YES, IT'S A LONG WAY AND IT'S
NOT ENOUGH TIME. SO MY NAME IS
CRUCIAL. WILLIAMS I'M A PLAZA
COUNTY RESIDENT AND I'M SPEAKING
IN OPPOSITION TO THIS BILL,
MAYBE 25 TO 1. THANK YOU. THANK
YOU. ALL RIGHT, THANKS VERY
MUCH. ARE THERE ANY OTHER
WITNESSES HERE ROOM 2100
OPPOSITION. SORRY. OKAY UM, NOW
BRING IT BACK TO THE COMMITTEE
OR QUESTIONS OR COMMENTS FROM
COMMITTEE MEMBERS. OKAY JUST
MOVED BY SENATOR WIENER SEEING
NO. THE QUESTIONS OR COMMENTS
SUMMER SANTIAGO. THANKS SO MUCH
FOR BRINGING THIS FORWARD TO
MAKING, RENAMING THE FUNDING,
THE MORE INCLUSIVE MANNER
CERTAINLY IN SUPPORT. WOULD YOU
LIKE TO CLOSE? I RESPECTFULLY
ASK FOR NAVAL. AND THANK YOU, MR
CHAIR MEMBERS. THANK YOU. THE
MOTIONS DO PASS AS AMENDED AND
RE REFERRED TO THE COMMITTEE AND
JUDICIARY IS MOVED BY SENATOR
WIENER. SECRETARY PLEASE CALL
THE ROLL. MELINDA'S MELINDA'S NO
EGGMAN. EGGMAN I GONZALES
GONZALES, HIGHGROVE. GROVE KNOW
HER. TATO LAVER LAVER. AYE,
LIMÓN. AYE ROTH RUBIO WIENER.
AYE BILLS. CURRENTLY 62 WILL
HOLD THE ROLL OPEN FOR ABSENT
MEMBERS. THANK YOU. OKAY SO
WE'VE NOW HEARD ALL THE BILLS
WOULD MAKE TOWN OF SENATOR TITLE
COMING BACK. OKAY ALL RIGHT, SO
WE CAN FINDOUT OF SENATOR
HOUSE. BUT IN THE MEANTIME,
WHILE WE'RE HERE, LET'S GO
AHEAD. WE HAVE HAD HER TWO
BILLS, WHEN WHICH WE HAVE NOT
ACTUALLY AS A SUBCOMMITTEE, SO
LET'S MOVED TO THOSE. SO THAT IS
FIRST OF ALL THAT'S UM. ITEM
NUMBER SIX A B 18 80 BY SOME
MEMBER ARAMBULA PRIOR THAT'S
BEEN MOVED BY SARAH LEVA. OKAY
IN THE MOTIONS DO PASS AND
AMENDED REFERRED TO THE
COMMITTEE. APPROPRIATIONS MOVED
BY SENATOR LEYVA. ITEM NUMBER
EIGHT. SECRETARY PLEASE CALL
SORRY. I HAVE NUMBER SIX. I HAVE
ALWAYS ITEM NUMBER SIX A B 18 80
BY SUMMER ARAMBULA. OKAY
SECRETARY, PLEASE CALL THE ROLL
AND I AND I, MELINDA'S MELINDA'S
NO EGGMAN. SIGMUND I. GONZALES
GONZALES GROVE GROVE KNOW HER
TATO LEYVA, LIMÓN TÔI ROTH RUBIO
WIENER 18 80. YES. RIGHT OKAY.
SO THAT BUILDS CURRENTLY, 62
WILL HOLD THE ROLL OPEN FOR
ABSENT MEMBERS. THE NEXT ITEM IS. IS ITEM NUMBER EIGHT A B 1930
BY SOME MEMBER ARAMBULA. IT'S
BEEN MOVED BY CENTRAL EVA. THE
MOTIONS DO PASS AND REFERRED TO
THE COMMITTEE ON APPROPRIATIONS
AGAIN. MOVED BY SENATOR LEYVA
SECTOR PLEASE CALL THE ROLL.
PEN. AND I, MELINDA MELINDA'S
AYE, EGGMAN. SIGMUND I.
GONZALES, GONZALES GROVE. DROVE
HER TATO LEYVA LEHMAN! RAMONA, I
RATH RUBIO WIENER WIENER. AYE
BILLS CURRENTLY 80. NOW LET'S
MOVE ON TO THE CONSENT CALENDAR.
AND BECAUSE I HAD LET ME JUST
READ THE ENTIRE CONSENT CALENDAR
APOLOGIZE, BUT IT WASN'T A
COMPLETE LIST LAST TIME. SO THE
EXTENT CALENDARS ITEM NUMBER
1552 BY SUMMER QUIRK-SILVA AS
AMENDED. ITEM NUMBER FOUR A B 21
44 BY SUMMER RAMOS AS AMENDED. I
AM NUMBER 7 1900 BY A SIMILAR
ARAMBULA AS AMENDED ITEM NUMBER
10 A B 1999 DECEMBER ARAMBULA. I
AM NUMBER 11 23 60 BY SOME
MEMBER ARAMBULA ITEM NUMBER 12
21 30 BY SUMMER WE'RE CUNNINGHAM
IS AMENDED. ITEM NUMBER 18 27 68
BY SUMMER, WALDRON THAT'S A
CONSENT CALENDARS. EMOTION ON
THE CONSENT CALENDAR. SENATOR
LEYVA CONSULTANT. PLEASE CALL
THE ROLL IN THE CONSENT CALENDAR
PEN I MELINDA'S MELINDA'S
EGGMAN. SIGMUND I. GONZALES
GONZALES GROWTH. GROVE. I HER
TATO. HÓ I
ROCK RUBIO WIENER WIENER, I
CONSENT CALENDARS OUT 90. ALL
RIGHT NOW WE'RE GOING TO JUST
START FROM THE TOP, AND WE'LL
ROLL THROUGH NOW WE HAVE
EVERYONE HERE. OKAY SO WE'RE
GOING TO FIRST BEGIN WITH ITEM
NUMBER TWO A B 13 41 BY SUMMER
BIRD CRISTINA GARCIA, CONSULT
THE SECRETARY. PLEASE CALL THE
ROLL OF THE ABSENT MEMBERS.
MELINDA'S GONZALEZ GONZALEZ, I
GROVE GROVE. AYE. LEMON LIMÓN I,
RATH RUBIO WIENER WIENER. I ATE. OKAY THAT BILL IS OUT 80. NEXT
IS ITEM NUMBER THREE A B 23 20
BY DECEMBER CRISTINA GARCIA
SULTAN, PLEASE CALL THE ROLL OF
ABSENT MEMBERS. GONZALEZ
GONZALEZ, I GROVE GROVE. NO.
LIMÓN LIMÓN AYE, BROTH RUBIO. 72
72. THAT BILL IS SEVEN TO THAT
BUILDS OUT SEVEN TO NEXT ITEM IS
ITEM NUMBER FIVE BY A B 17 OH,
FOUR BY SOME MEMBER CHEN.
CONSULTANT. PLEASE CALL THE ROLL
OF ABSENT MEMBERS. GONZALEZ
GONZALEZ I, GROVE GROVE. AYE.
LIMÓN TIRATH RUBIO. OKAY THAT
BUILDS OUT 90. NEXT ITEM IS ITEM
IS OKAY, NEXT TIME, BUT I'M
NUMBER SIX A B 18 80 BY SUMMER
ARAMBULA BECAUSE SECRETARY
PLEASE CALL THE ROLL OF ABSENT
MEMBERS. POTATO HER TOTAL I
BROTH RUBIO. OKAY, THAT BILL IS
OUT SEVEN TO NEXT ITEM IS, UM
THANKS. LET'S EAT. OKAY NEXT
ITEM IS ITEM NUMBER 8 1930 BY
SUMMER, ARAMBULA, PLEASE CALL
THE ROLL OF ABSENT MEMBERS. TOÀN
TOTO, I ROTH RUBIO. OKAY THAT
BILL IS OUT 90. OKAY. NEXT ITEM
IS ITEM NUMBER 9 1995 BY SOME
MEMBER ARAMBULA CALLED THE ROLE
OF ABSENT MEMBERS. MELINDA'S
GONZALEZ GONZALEZ, I GROW.
LEHMAN LIMÓN. AYE, ROTH. RUBIO
OKAY, THAT BILL IS OUT 70. NEXT
ITEM IS ITEM NUMBER. 13 80 21 99
DECEMBER WICKS SECRETARY. PLEASE
CALL THE ROLL OF ABSENT MEMBERS.
MELINDA'S HER TAITO HURTADO, I
RATH RUBIO. OKAY THAT BILL IS
OUT 71. THE NEXT ITEM IS ITEM
NUMBER 14 22 81 BY SOME MEMBER
LACKEY SECRETARY. PLEASE CALL
THE ROLL OF ABSENT MEMBERS
EGGMAN. EGGMAN I, GONZALEZ
GONZALEZ, I GROVE DROVE. I HEARD
TATO TATO, I LIMÓN ROTH RUBIO.
YES, YES. THAT BILL IS OUT. 90
NEXT ITEM IS ITEM NUMBER 15 23
50 TO BUY SOME URBAN NAZARIAN
SECRETARY. PLEASE CALL THE ROLL
OF ABSENT MEMBERS. MELINDA'S
MELINDA'S AYE, EGGMAN. SIGMUND
I. GONZALEZ GONZALEZ. I HEARD
TATO TATO, I LIMÓN LIMÓN TIRATH
RUBIO. THAT BILL IS OUT. 90 NEXT
ITEM IS ITEM NUMBER 16 18 25 21
DECEMBER. SANTIAGO SECRETARY,
PLEASE CALL THE ROLL OF ABSENT
MEMBERS. HER TATO V ROTH RUBIO
. THAT BILL IS OUT. SEVEN TO
NEXT ITEM IS ITEM NUMBER 17 26
73 BY SEPTEMBER. URWIN SECRETARY
CALLED THE ROLE OF ABSENT
MEMBERS. MELINDA'S MELINDA'S
AYE. POTATO POTATO. AYE. THE
MONTH. RAMONA ROTH RUBIO. THAT
BILL IS OUT 90 OKAY, THAT
CONCLUDES THE ITEMS. YES,
SENATOR GROWTH. D. I THINK
TECHNICALLY WHICH ITEM YOU SAID
ITEM NUMBER NINE. I OFFICIALLY
CALLED IT FLOWS. THAT'S THE
PROBLEM. WHAT? WHAT CAN I DO
HERE? IT'S ON THE FLOOR. OKAY
ALRIGHT. OKAY ALRIGHT. I
APOLOGIZE. ALL RIGHT. SORRY.
ONCE I ANNOUNCED IT'S CLOSED I
GET IT TRYING TO OKAY. ALL RIGHT
WITH THAT, UM, THANK YOU SO
MUCH, EVERYONE. AND I WANT TO
THANK THE COMMITTEE STAFF FOR
THE WORK ON THE BILLS. I WANT TO
THANK OUR SURGEONS FOR KEEPING
THINGS GOING OUR TECHNICAL STAFF
FOR ALLOWING TELECONFERENCE
SYSTEM SO AGAIN REALLY
APPRECIATE EVERYONE THAT THIS
AND ALL THE INDIVIDUALS WHO
PARTICIPATE IN PUBLIC TESTIMONY
TODAY. IF YOU ARE NOT ABLE TO
TESTIFY TODAY, PLEASE SUBMIT
YOUR COMMENTS AND SUGGESTIONS IN
WRITING TO THE SENATE COMMITTEE
ON HEALTH ARE VISIT OUR WEBSITE
. YOUR COMMENTS AND SUGGESTIONS
ARE IMPORTANT TO US, AND WE WANT
TO INCLUDE YOUR TESTIMONY IN THE
OFFICIAL HEARING RECORDS. WE
THANK YOU AND APPRECIATE YOUR
PARTICIPATION. WE HAVE NOW
CONCLUDED THIS AGENDA OF THE
SENATE COMMITTEE ON HEALTH. THIS
HEARING IS NOW ADJOURNED. THANK
YOU.