HEY UM, I WILL CALL TO ORDER THE
SENATE SELECT COMMITTEE ON
MENTAL HEALTH AND ADDICTION.
WANNA JOIN? AT THE MOMENT BY
SENATOR PAN SARAH NIELSEN AND
SENATOR NEWMAN WILL BE JOINED BY
OTHER MEMBERS AS THE HEARING
PROCEEDS. AH UM. WE CONTINUE TO
TAKE CERTAIN PRECAUTIONS AROUND
COVID 19. BUT WE CAN AND WE
CONTINUE TO WELCOME PUBLIC
COMMENT AND PARTICIPATION BY THE
UM, BY THE PUBLIC WILL BE HAVING
BOTH IN PERSON. PUBLIC TESTIMONY
TODAY, UM, AS WELL AS BY
TELECONFERENCE, OUR PANELISTS
WILL ALL BE REMOTE. UM, BUT
MEMBERS OF THE PUBLIC WERE ABLE
TO PROVIDE IN PERSON PUBLIC
TESTIMONY FOR PEOPLE WHO WISH TO
PROVIDE PUBLIC COMMENT BY
TELECONFERENCE, AND WE WILL HAVE
OUR PUBLIC COMMENT AT THE END
AFTER OUR THREE PANELS ARE
COMPLETE. UM THE TOLL FREE
PARTICIPANT NUMBER IS 8772 TO 6.
8163 AND THE ACCESS CODE IS
997954 TO THAT INFORMATION IS
ALSO ON THE COMMITTEE WEBSITE,
UM, WILL MAINTAIN DECORUM DURING
THIS HEARING AND ANY INDIVIDUAL
WHO IS DISRUPTIVE MAY BE REMOVED
FROM THE REMOTE MEETING SERVICE.
OR HAVE THEIR CONNECTION MUTED.
UM WE HAVE VERY VARIOUS
PANELISTS TODAY FROM THE
DEPARTMENT OF MANAGED HEALTHCARE
. UM MENTAL HEALTH WORKERS AND,
UH, PATIENTS. UM AND, UH, WE
ASKED THAT FOR EVERYONE
PARTICIPATING, UM, WHETHER IT'S
A PANELIST OR PUBLIC COMMENT,
PLEASE MUTE YOUR LINE. UM EXCEPT
WHEN YOU ARE SPEAKING AND FOR
PANELISTS WHO WISH TO BE
RECOGNIZED AT A TIME WHEN I HAVE
NOT CALLED ON YOU. YOU CAN USE
YOUR RAISE YOUR HAND FUNCTION.
UM OKAY? UM SO TODAY'S HEARING,
WHICH IS ACTUALLY THE FIRST
HEARING OF THE SELECT COMMITTEE
ON MENTAL HEALTH AND ADDICTION,
WE FORMED THE COMMITTEE LAST
YEAR BUT DUE TO THE PANDEMIC
SELECT COMMITTEES WERE NOT
MEETING SO I WANT TO THANK MY
STAFF AND RULES COMMITTEE STAFF
AS WELL AS MY COLLEAGUES AND THE
SUBJECT OF TODAY'S HEARING IS
TIMELY ACCESS TO MENTAL HEALTH
CARE AND COMPLIANCE BY HEALTH
PLANS. WITH SENATE BILL 2 21 AND
FOR ANYONE WHO DOESN'T KNOW OR
DOESN'T REMEMBER SP 2 21 WAS A
LAW THAT I AUTHORED LAST YEAR
AND THAT WAS PASSED WITH
OVERWHELMING, ALMOST UNANIMOUS
BIPARTISAN SUPPORT IN THE
LEGISLATURE. UM THAT REALLY, UH,
IS DESIGNED TO REQUIRE THAT
HEALTH PLANS PROVIDE TIMELY
ACCESS TO MENTAL HEALTH
TREATMENT, UM, FOR PEOPLE
SEEKING MENTAL HEALTH CARE, UM,
WE HAVE IN RECENT YEARS
DRAMATICALLY STRENGTHENED OUR
MENTAL HEALTH PARITY LAWS IN
CALIFORNIA. REPRESENTING THE
FUNDAMENTAL NOTION THAT MENTAL
HEALTH CARE IS NO DIFFERENT THAN
PHYSICAL HEALTH CARE, AND THEN
WE NEED TO MOVE AWAY FROM THE
ERA OF TREATING MENTAL HEALTH
CARE OR MENTAL HEALTH ISSUES AS
SOME SORT OF PERSONAL FAILINGS
WHERE PEOPLE JUST NEED TO SNAP
OUT OF IT, UM, AND NEED TO
RECOGNIZE THAT MENTAL HEALTH
DISORDERS. OR IT'S A IT'S A
DISEASE OF THE BRAIN, AND WE
SHOULD BE TREATING IT JUST THE
WAY WE WOULD IF SOMEONE HAD
EMPHYSEMA OR CANCER OR A BROKEN
ARM OR ANY OTHER PHYSICAL
AILMENT, UH AND SP 2 21 REQUIRED
THAT HEALTH PLANS PROVIDE TIMELY
ACCESS TO MENTAL HEALTHCARE
SPECIFICALLY FOR FOLLOW UP
APPOINTMENTS. WHAT WE WERE
SEEING IS THAT PEOPLE WOULD GET
A FIRST APPOINTMENT FOR MENTAL
HEALTH NEED AND THEN WOULD HAVE
TO WAIT SIX OR EIGHT OR 12 WEEKS
FOR THEIR SECOND AND SUBSEQUENT
FOLLOW UP APPOINTMENTS, EVEN IF
THE TREATING PROVIDER DETERMINED
THAT MORE REGULAR VISITS WERE
NEEDED, AND SO SPE 2 21 REQUIRES
THAT THESE FOLLOW UP
APPOINTMENTS HAPPEN. NO LATER
THAN TWO WEEKS. 10 BUSINESS DAYS
AFTER THE FIRST APPOINTMENT,
UNLESS THE TREATER DETERMINES
THAT LESS FREQUENT CARE IS
NEEDED, THE SP 2 21 WNT INTO
EFFECT ABOUT A MONTH AGO ON JULY
1ST. UM AND I AND MANY OTHERS
HAVE SERIOUS CONCERNS THAT IT IS
NOT, UM BEING FULLY IMPLEMENTED.
AND THAT PEOPLE CONTINUE TO
STRUGGLE. EVEN THOUGH THEY HAVE
HEALTH INSURANCE. I CONTINUE TO
STRUGGLE TO GET ACCESS TO CARE.
UM WE ARE LOOKING IN LESS THAN A
WEEK AT A MAJOR STRIKE KAISER
PERMANENTE BY THE NATIONAL UNION
OF HEALTHCARE WORKERS, WHICH
REPRESENTS KAISER MENTAL HEALTH
PROFESSIONALS, UM BECAUSE OF
LACK OF COMPLIANCE WITH SP 2 TO
1, AND SO WHEN WE PASS LAWS, UH
WE MEAN IT, AND WE EXPECT
COMPLIANCE AND THERE WILL BE
ENFORCEMENT IF THERE'S NOT
COMPLIANCE. AND TODAY WE WANNA
AS A LEGISLATURE CONDUCT
OVERSIGHT OF THE DEPARTMENT OF
MANAGED HEALTH CARE AND OF THE
ENTIRE SITUATION TO ENSURE THAT
WE ARE SEEING, UH, COMPLIANCE
AND IF NOT, WHICH IT APPEARS TO
ME THAT WE'RE NOT SEEING
COMPLIANCE. THAT THERE IS GOING
TO BE ACTION TO ENSURE
COMPLIANCE, SO WE HAVE A GOOD
LINEUP TODAY. WE'LL START BY
HEARING FROM MARY WATANABE, THE
DIRECTOR OF THE DEPARTMENT OF
MANAGED HEALTH CARE TO TALK
ABOUT IMPLEMENT IMPLEMENTATION
AND ENFORCEMENT WILL THEN HEAR
FROM A PANEL OF MENTAL HEALTH
CARE PROVIDERS. UM AND THEN WE
WILL HEAR FROM SEVERAL PATIENTS
THEIR PERSPECTIVE. UM AND THEN
WE'LL TAKE PUBLIC COMMENT. SO
BEFORE WE START, I WANT TO GIVE
MY COLLEAGUES AND OPPORTUNITY TO
MAKE ANY OPENING COMMENTS IF YOU
WOULD LIKE TO. SENATOR NIELSEN.
MR CHAIRMAN, I WANT TO THANK YOU
. YOU KNOW, WE HAD KIND OF AN AD
HOC MENTAL HEALTH COMMITTEE. I
GUESS IF YOU CALL IT THAT, BUT
NOW THIS HAS BEEN FORMALIZED.
BUT WHAT I THINK IS NOTABLE. IS
YOUR FOLLOW UP MOST LEGISLATION
THAT MEMBERS PASS. IT PASSES. WE
GOT A PRESS RELEASE. THAT'S THE
END OF IT. MANY CASES, THE
AGENCY'S IGNORE IT. DON'T
RESPOND TO IT. AND STONEWALL IT.
AND YOU WITH YOUR PASSION FOR
THIS. PARTICULARLY VERY
NECESSARY REA WITH THE FOLLOW
UP AND THE COMMITTEE. WE'RE
GOING TO BE ABLE TO SEE THE
IMPLEMENTATION THROUGH AND HOLD
ACCOUNTABLE THOSE WHO ARE
ENTRUSTED TO BE HELPING OUR
FELLOW CALIFORNIANS. SO I THANK
YOU, MR CHAIRMAN. I'M HAPPY TO
BE A PART OF YOUR TEAM. THANK
YOU SO MUCH. AND BEFORE I GET
THE SENATOR NEWMAN, I DO ONE
THING I FORGOT TO MENTION, UM ON
THE AGENDA. YOU MAY NOTICE THAT
THERE IS ONE PARTICULAR GROUP OF
STAKEHOLDERS WHO ARE NOT ON THE
AGENDA. SPECIFICALLY THE HEALTH
PLANS. UM I JUST WANT TO BE
CLEAR THAT WE DID INVITE THE
HEALTH PLANS TO ATTEND,
INCLUDING KAISER. NONE OF THEM
ARE PARTICIPATING. THAT WAS
THEIR DECISION. WE INVITED THEM
, AND WE'RE EAGER TO HAVE THEM
HERE, BUT THEY'RE ENTITLED TO
MAKE THAT DECISION. UM SENATOR
NEWMAN. THANK YOU, MR CHAIRMAN.
LET ME FIRST ALIGN MY COMMENTS
WITH SENATOR NIELSEN. HE'S
ABSOLUTELY RIGHT. AND SO, UM, I
HAD THE PRIVILEGE OF HEARING THE
SENATE SPECIAL COMMITTEE ON
PANDEMIC EMERGENCY RESPONSE. SO
I AM GLAD WE'RE HAVING THIS
HEARING TODAY. THIS IS NOT ONLY
A TIMELY ISSUE. IT'S A VERY
IMPORTANT ISSUE AS WE COME OUT.
OF THE PANDEMIC, WHICH HAS SHINE
A VERY BRIGHT LIGHT ON THE NEED
FOR, YOU KNOW, AGGRESSIVE,
RESPONSIVE, COMPREHENSIVE MENTAL
HEALTH CARE SERVICE IN A WAY
THAT CALIFORNIA HAS NEVER SEEN
BEFORE. WE HAVE A VERY LARGE
TASK BEFORE US IN DEALING WITH
SOME OF THE LATENT IMPACT OF
THIS PUBLIC HEALTH EMERGENCY. SO
TODAY IS A GOOD START, AND I'M
GRATEFUL TO BE A PART OF THIS
HEARING. THANK YOU, SENATOR. PAN
CARE OF OUR HEALTH COMMITTEE.
THANK YOU. THANK YOU, SARAH
WIENER. THANK YOU. SO MUCH FOR
YOUR LEADERSHIP AND FOR
CONVENING THIS, UH, HEARING OF
THE SELECT COMMITTEE. AS YOU
MENTIONED, I CHAIR THE COMMITTEE
ON HEALTH AND ALSO BEEN ABLE TO
WITNESS YOUR LEGISLATION AND
MENTAL HEALTH COMING THROUGH THE
COMMITTEE AND YOUR LEADERSHIP
AND I ALSO WANT TO JOIN SENATOR
NIELSEN AND HIS PRAISE FOR YOU
FOLLOWING UP BECAUSE I'VE ALWAYS
SAID THAT JUST PASSING A BILL
ISN'T ENOUGH, BUT ITS
IMPLEMENTATION. I GUESS I WOULD
JUST ALSO MAKE NOTE THAT IT'S
UNFORTUNATE THAT THE HEALTH
PLANS CHOSE NOT TO APPEAR FOR
THIS HEARING. IS THAT, UM, AND
ONE OF THE THINGS THAT WE'VE
ALSO TRIED TO ADDRESS IN THE
COMMITTEE ON HEALTH AND TALK
ABOUT IS THAT HOW DO WE BETTER
INCENTIVIZE PEOPLE PLANS AND SO
FORTH TO TAKE CARE OF PEOPLE
WITH CHRONIC CONDITIONS AND
PRETTY MUCH THAT YOU KNOW, MOST
OF MENTAL HEALTH FITS IN THAT
CATEGORY. AH AND BECAUSE, UM.
FRANK AND FIRST OF ALL, OF
COURSE, THEY COST MORE. THE
THING IS, IS THEN WHAT IS THE
INCENTIVE FOR THEM TO PROVIDE
HIGH QUALITY CARE? TO BE SURE
PEOPLE HAVE ACCESS RIGHT?
BECAUSE SOMETIMES THAT'S JUST
ACKNOWLEDGED. THERE'S ALSO
REVERSE INCENTIVE WHERE IF YOU
MAKE THINGS HARD ON PEOPLE,
MAYBE SOMEONE WILL CRACK DISEASE
, WHICH IS GOING TO COST YOU
MORE. WELL, THEN GO OFF TO
ANOTHER PLAN. AND SO YOU KNOW,
SOMETIMES IT'S A LITTLE BIT OF
PEOPLE GETTING PASSED BACK AND
FORTH AND SO FORTH. AND I'M NOT
, AND SO I THINK IT'S IMPORTANT
. WE ALSO LOOK AT, UM WHAT ARE
WE DOING TO ENSURE THAT PEOPLE
WHO HAVE CHRONIC CONDITIONS LIKE
MENTAL HEALTH CONDITIONS
ACTUALLY HAVE ACCESS THAT WE DO
HAVE THE WORKFORCE AVAILABLE
THAT THE PROVIDER NETWORKS
AVAILABLE AS WELL? YEAH AND
THINK ABOUT THESE PARTICULAR
SOLUTIONS AND, UH AND INSTEAD OF
TRYING TO YOU KNOW, FIGURE OUT
HOW CAN WE WELL, THIS WAS LIKE,
LET'S LET'S NOT HAVE PEOPLE JUST
FRUSTRATED EVERY TIME THEY EVERY
PLACE THEY TURN AROUND, AND I
KNOW THAT YEN CERTAIN WIENER.
YOU'VE AUTHORED LEGISLATION TO
TRY TO ADDRESS THAT, AND I
APPRECIATE THAT, AND WE NEED TO
BE SURE HE FOLLOWED THROUGH
ENSURE PEOPLE WHO HAVE MENTAL
HEALTH NEEDS ACTUALLY HAVE
ACCESS TO THOSE MENTAL HEALTH.
NEEDS AND ALSO THAT WE ENSURE
THAT THE COVERAGE PLANS THAT WE
HAVE ALSO, UM HAVE THE
APPROPRIATE INCENTIVES. TO BE
SURE PEOPLE HAVE ACCESS TO THE
APPROPRIATE PROFESSIONALS AND
APPROPRIATE SERVICES. THEY NEED
TO ADDRESS THE MENTAL HEALTH
ISSUES. THANK YOU. THANK YOU
VERY MUCH, SENATOR PAN AND THANK
YOU AGAIN FOR YOUR LEADERSHIP AS
CHAIR OF THIS AND HEALTH
COMMITTEE. OKAY WELL, NOW GO TO
OUR FIRST WE'LL CALL THE PANEL
AND PANEL OF ONE AND THAT IS AH
, DIRECTOR WATANABE FROM THE
DEPARTMENT OF MANAGED HEALTH
CARE WHO I SEE RIGHT THERE ON
THE SCREEN. SO UH, DIRECTOR
THANK YOU FOR, UM, FOR
PARTICIPATING TODAY. AND UM, IF
YOU COULD JUST GIVE AN OVERVIEW
OF THE IMPLEMENTATION OF SP 2 21
UM, AND ENFORCEMENT AND HOW YOU
SEE THIS PLAYING OUT? UM AND, UH
AND SPECIFICALLY, I KNOW WE HAVE
THIS IMPENDING STRIKE. KAISER IF
YOU DON'T COMMENT, I'LL BE
ASKING SOME QUESTIONS ABOUT THAT
. UM, AND I APPRECIATE YOU BEING
HERE TODAY. GREAT THANK YOU.
GOOD AFTERNOON. YOU ALREADY
INTRODUCED ME. SO I'LL SKIP THAT
PART. SO THE DEPARTMENT OF
MINISTER HEALTH CARE'S MISSION
IS TO PROTECT CONSUMERS
HEALTHCARE RIGHTS AND ENSURE A
STAPLE HEALTHCARE DELIVERY
SYSTEM. WE LICENSE AND REGULATE
100 AND 40 HEALTH PLANS THAT
PROVIDE HEALTH CARE COVERAGE TO
OVER 28 MILLION CALIFORNIANS. WE
REGULATE MORE THAN 96% OF STATE
REGULATED COMMERCIAL AND
GOVERNMENT HEALTH PLAN
ENROLLMENT IN THE STATE. ONE OF
MY HIGHEST PRIORITIES IS THE
DIRECTOR OF THE DEPARTMENT IS TO
MAKE SURE HELP PLAN ENROLLEES
CAN ACCESS APPROPRIATE BEHAVIOR
HEALTHCARE SERVICES WHEN THEY
MEET THEM. SP 2 TO 1
INCORPORATED. SOME OF THE DMH
SEES TIMELY ACCESS STANDARDS
ADOPTED AND REGULATION INTO THE
HEALTH AND SAFETY CODE. IT'S
SPECIFIED A TIMELY TIMELINESS
STANDARDS FOR FOLLOW UP
APPOINTMENTS FOR CERTAIN. UH
MENTAL HEALTH CONDITIONS,
BEHAVIORAL SERVICES. EXCUSE ME
HERE JUST A MINUTE. UM AND ADDED
REFERENCES TO MENTAL HEALTH AND
SUBSTANCE USE TO SORT OF
PROVIDERS TO A TIMELY ACCESS.
PROFICIENT. BEGINNING IN JULY.
1ST OF THIS YEAR S P 2 TO 1
REQUIRES HEALTH PLANS TO ENSURE
THAT THEIR CONTRACTED PROVIDER
NETWORKS CAN OFFER NON URGENT
FOLLOW UP APPOINTMENTS WITH THE
NON POSITION, MENTAL HEALTH CARE
OR SUBSTANCE USED TO SORT OF
PROVIDE HER WITHIN 10 BUSINESS
DAYS OF THE PRIOR APPOINTMENT OR
LONGER. THE TREATING PROVIDER
DETERMINES A LONGER WAIT. TIME
WILL NOT HAVE A DETRIMENTAL
IMPACT ON THE HEALTH OF BEING
BOTH SB 8 55 FROM 2020 AND SP 2
TO 1 REQUIRE HEALTH PLANS TO
ARRANGE COVERAGE OUTSIDE OF THE
PLANTS CONTRACTED NETWORK IF
MEDICALLY NECESSARY CARE IS NOT
TIMELY AVAILABLE WITHIN THE
HEALTH PLAN'S NETWORK. WHEN
RECEIVING OUT OF NETWORK
SERVICES ENROLLEES ARE ONLY
RESPONSIBLE FOR PAYING THE COST
SHARE AND THEY WOULD HAVE PAID
IF SERVICES WERE PROVIDED IN
NETWORKS. HEALTH PLANS ARE
REQUIRED TO SURVEY THEIR
PROVIDERS ANNUALLY AND SUBMIT
COMPLIANCE REPORTS TO THE GMHC
TO DEMONSTRATE COMPLIANCE AND
PERFORMANCE WITH THE TIMELY
ACCESS STANDARDS. THESE NEW
FOLLOW UP APPOINTMENT TIME
FRAMES UNDER 2 TO 1 WILL BE
INCORPORATED INTO THE ANNUAL
COMPLIANCE FILING. GMHC HAS
TAKEN A NUMBER OF STEPS TO
IMPLEMENT SB 2 TO 1, INCLUDING
ISSUING TO ALL PLANNED LETTER
LETTERS NOTIFYING HEALTH PLANS
OF THEIR OBLIGATION TO COMPLY
WITH THE NEW REQUIREMENTS AND TO
PROVIDE ADDITIONAL
CLARIFICATION. THE FIRST ALL
PLANNED LETTER WAS ISSUED ON
DECEMBER 20TH OF 2021 INCLUDED
GUIDANCE ON COMPLIANCE WITH NEW
LEGISLATIVE REQUIREMENTS,
INCLUDING 22. HEALTH PLANS WERE
REQUIRED TO RSPOND BY FEBRUARY
22ND 2022 AFFIRMING THEIR
COMPLIANCE WITH THE NEW
REQUIREMENTS OF SP 2 TO 1. THE
SECOND ÁP L WAS ISSUED ON MARCH
4TH 2022 INCLUDED ADDITIONAL
COMPLIANCE REQUIREMENTS RELATED
TO THE MONITORING AND SUBMISSION
REQUIREMENTS FOR THE TIMELY
ACCESS COMPLIANCE REPORT ANNUAL
NETWORK REPORT. THE D N H C WILL
BE MONITORING COMPLIANCE WITH SP
2 TO 1 IN SEVERAL IMPORTANT
WAYS. THE FIRST IS THROUGH THE
MONITORING OF HEALTH CENTER
COMPLAINTS. STARTING LAST MONTH
IF WE RECEIVED COMPLAINTS FROM
CONSUMERS THAT HELPS THE NORMAL
WORK WITH THE HEALTH PLAN TO
SECURE A TIMELY APPOINTMENT AND
NETWORK OR HE'LL HAVE THE HEALTH
PLAN ARRANGE FOR OUT OF NETWORK
HERE. WE WILL MONITORTRENDS AND
COMPLAINTS AND TAKE ENFORCEMENT
ACTION AS APPROPRIATE. SINCE THE
FOLLOW UP APPOINTMENT TIMELY
ACCESS STANDARDS REQUIRED BY SP
2 TO 1 TOOK EFFECT LAST MONTH.
THE GMHC HELP CENTER HAS
RECEIVED TWO CONSUMER
COMPLAINTS, BOTH FROM KAISER
ENROLLEES. AND NO COMPLAINTS TO
DATE FROM OTHER OTHER HEALTH
PLANS THAT STUFF EARLIER THIS
WEEK, BUT WE'RE CONTINUING TO
MONITOR THAT. WE WILL ALSO
MONITOR COMPLIANCE. THERE ARE
ANNUAL TIMELY ACCESS REPORTING
HEALTH PLANS ARE REQUIRED TO
EVALUATE THEIR PROVIDER NETWORK
FOR COMPLIANCE WITH THE TIMELY
ACCESS STANDARDS ON AN ANNUAL
BASIS AND MUST SUBMIT A REPORT
TO THE D M HC, DESCRIBING THE
PLAN'S PROVIDER NETWORKS
COMPLIANCE WITH THE TIMELY
ACCESS STANDARDS FOR THE PAST
CALENDAR YEAR. WE ARE ADDING THE
FOLLOW UP APPOINTMENT TIME
FRIENDS TO THE ANNUAL REPORTING
PROCESS STARTING AND MEASUREMENT
YEAR. 23 THAT'S FOR CALENDAR
YEAR 23. WHICH WILL BE REPORTED
TO THE D M X C IN MAY OF 2024
WILL BE INCLUDED IN OUR TIMELY
ACCESS REPORT THAT WE WILL
RELEASE BY THE END OF 2024.
HOWEVER BEGINNING LAST MONTH
AWAY 1ST 2022 PLANS ARE REQUIRED
TO INCORPORATE INCORPORATE THESE
NEW REQUIREMENTS INTO THEIR
TIMELY ACCESS WHILE YOU
ASSURANCE AND MONITORING
PROCESSES. ANOTHER WAY. WE WILL
MONITOR COMPLIANCE WITH SP 2 TO
1 IS THROWNOUR ROUTINE MEDICAL
SURVEYS. THE D. M. H C CONDUCT
CONDUCTS ROUTINE MEDICAL SURVEYS
OR AUDITS OF HELP AND OPERATIONS
. EVERY THREE YEARS. WE WILL
ASSESS COMPLIANCE WITH SP 2 TO 1
AND ARE ROUTINE MEDICAL SURVEYS
STARTING IN 2023. THIS WILL
ALLOW THE DMX TO ASSESS
COMPLIANCE WITH THE NEW FOLLOW
UP STANDARDS FOR A PERIOD OF AT
LEAST SIX MONTHS BECAUSE WE'RE
WORKING PAST UTILIZATION PLANS.
THE DAMAGE. SEE MAY ALSO CONDUCT
A NON ROUTINE SURVEY WHEN I
SPECIFIC ISSUE OR PROBLEM
REQUIRES A FOCUSED REVIEW OF THE
HELPLINES OPERATIONS. AND THE
FINAL METHOD THAT WE WILL USE TO
MONITOR COMPLIANCE IS THROUGH
OUR BEHAVIORAL HEALTH
INVESTIGATIONS. IN FISCAL YEAR
2022 21 GMHC RECEIVED AUTHORITY
AD FUNDING TO CONDUCT
INVESTIGATIONS TO ASSESS
COMMERCIAL HEALTH PLANS,
DELIVERY OF MENTAL HEALTH AND
SUBSTANCE USE DISORDER SERVICES.
INVESTIGATIONS FOCUS ON
IDENTIFYING AND EVALUATING
BARRIERS EXPENSIVE EXPERIENCED
BY ENROLLEES IN OBTAINING
BEHAVIORAL SERVICES, UNVEILING
PROVIDER CHALLENGES AND ENSURING
HEALTH PLAN COMPLIANCE FOR STATE
PARITY REQUIREMENTS. THE D M X C
IS CONDUCTING INVESTIGATIONS OF
FIVE COMMERCIAL HEALTH PLANS
EACH YEAR FOR A PERIOD OF FIVE
YEARS, BEGINNING IN 2021. WE
HAVE COMPLETED THE FIRST YEAR OF
INVESTIGATIONS AND ARE WORKING
ON FINALIZING THE REPORTS AND
CONDUCTING THE SECOND YEAR OF
INVESTIGATIONS. THERE IS AN
OPPORTUNITY THROUGH THESE
INVESTIGATIONS TO ALSO LOOK AT
SP 2 TO 1 COMPLIANT. IN
CONCLUSION. I REALLY WOULD LIKE
TO JUST ENCOURAGE CONSUMERS
HAVING PROBLEMS ACCESSING
BEHAVIORAL SERVICES TO CONTACT
THE GMHC HELP CENTER. YOU CAN
REACH US AT 18884662 THE EASIEST
WAYS THROUGH OUR OUR WEBSITE AND
HELP HELP DOT CA.GOV. UM THIS
REALLY ALLOWS US TO HELP
INDIVIDUAL CONSUMERS GET THE
CARE THEY NEED AND HELPS HELPS
US TO PROVIDE INFORMATION TO THE
DEPARTMENT ABOUT WHERE PLANS MAY
NOT BE CONFIRMED. LAW INFORMS
THE OTHER WORK. WE DO, UM, SUCH
AS OUR ROUTINE AND NON ROUTINE
SURVEYS AND BEHAVIORAL HEALTH
INVESTIGATIONS. UM I WILL JUST
RESPOND TO YOUR QUESTION ABOUT
THE KAISER STRIKES, SO WE WERE
NOTIFIED ON JULY 31ST OF THE
POTENTIAL FOREST STRIKE. UM WE,
YOU KNOW, GOT THE LAWS ARE
TIMELY ACCESS STANDARDS AND OUR
OTHER STRONG CONSUMER
PROTECTIONS IN THE LAW. THERE'S
NO ALLOWANCES THAT SETS THOSE
ASIDE DURING A STRIKE, SO WE ARE
FULLY EXPECTING KAISER TO COMPLY
WITH THE TIMELY ACCESS
STANDARDS, INCLUDING THOSE IN
SPT 21 DURING THE STRIKE AGAIN,
THE CRITICAL PIECE THERE IS IF
THE PLAN CANNOT PROVIDE AN
APPOINTMENT IN NETWORK IN
COMPLIANCE WITH THE FAMILY
ACCESS STANDARDS THEY NEED TO
ARRANGE FOR OUT OF NETWORK CARE
AT THE END NETWORK RATE, AND
THIS IS REALLY IMPORTANT FROM A
CONSUMER PERSPECTIVE. IT'S NOT
THE CONSUMER'S RESPONSIBILITY TO
GO THROUGH THE PROVIDER
DIRECTORY AND MAKE CALLS. IT'S
THE PLANS RESPONSIBILITY TO HELP
A RACE. FOR CARE. UM AND THAT'S
PART OF WHAT OUR HELP CENTER
WILL DO. IF WE GET CALLS TO OUR
HELP CENTER FROM SOMEONE WHO IS
NOT ABLE TO EITHER GET A FIRST
APPOINTMENT OR FOLLOW THE
APPOINTMENT, UM, IN MANY CASES
WERE ABLE TO RESOLVE THESE
ISSUES THROUGH WHAT WE CALL OUR
QUICK RESOLUTION WHERE WE DO A
THREE WAY CALL WITH THE PLAN. UM
AND IT'S REALLY THE
RESPONSIBILITY PLAN TO COME BACK
AND TO ARRANGE FOR THAT
APPOINTMENT. UM SO ALL PLUS
THERE AD SEE IF YOU HAVE ANY
QUESTIONS. THANK YOU, DIRECTOR.
I WANTED TO KNOW THAT I WANT TO
THANK SENATOR CORTESI AND
SENATOR EGGMAN FOR ALSO JOINING
US. UM I DO HAVE SOME QUESTIONS,
BUT I'LL, UM, ASK MY COLLEAGUES
TO ASK. THERE'S FIRST. SO
SENATOR PAM THANK YOU, DIRECTOR
AND APPRECIATE YOUR PRESENTATION
. UM AND I DID WANT TO ASK YOU
SOME QUESTIONS ABOUT IN TERMS OF
AND RESPONSE TO THE POSSIBILITY
OF A STRIKE AS YOU MENTIONED
TOWARDS THE END. MANY OF THE
PROCESSES USED DESCRIBED FOR US
MONITORING ENFORCEMENT OR MORE
LONG TERM. SO UM, I IMAGINE THAT
THERE MIGHT BE MORE ACUTE ISSUES
RELATED TO IF THERE WAS A STRIKE
THAT HAPPENED. AND, UM CERTAINLY
YOU REFER TO THE HELPLINE, BUT I
MEAN, I CHAIRED THE API
LEGISLATIVE CAUCUS. WE KNOW OUR
COMMUNITY IS PERHAPS LESS LIKELY
FOR LANGUAGE BARRIERS, STIGMA,
OTHER REASONS TO USE THE
HELPLINE. WHAT PROACTIVE STEPS.
SO NOT WAITING FOR PEOPLE TO
COMPLAIN. WHAT PROACTIVE STEPS.
WELL, GMHC TAKE TO ENSURE THAT
THE STANDARDS ARE MET. AND THE
ACUTE SITUATION. NOT JUST WELL,
I'M YOU KNOW, A YEAR LATER, AND
WE FIND OUT YEAH. DURING THE
STRIKE, PEOPLE COULDN'T GET TO
CARE, ETCETERA. SO WHAT ARE WE
DOING? TO BE SURE, PROACTIVELY
TO ENSURE THAT THE SERVICES ARE
IN COMPLIANCE WITH WITH THE ACT.
THAT PEOPLE ARE THAT THEIR
MENTAL HEALTH SERVICES ARE NOT
OVERLY DISRUPTED. RIGHT? SO I'M
SURE THEY'VE HAD APPOINTMENTS
AND OTHER TYPES OF THINGS. THAT
THOSE ARE SMOOTHLY TRANSFERRED
OVER. UM AH THAT THE PLAN IS
RESPONSIBLE FOR ENSURING THAT
TRULY AT THAT THEY ARE SMOOTHLY
TRANSCENDENT THAT INSTEAD OF
WAITING FOR PEOPLE TO COMPLAIN
THAT THERE IS A PROBLEM. UM SO
WHAT IS GOING WHERE ARE WE GOING
TO BE DOING PROACTIVELY TO AVOID
DISRUPTION? AND ALSO ENSURE THAT
THE TIMELY ACCESS STANDARDS ARE
MET. SURE I'LL ANSWER MAY BE
THAT IN TWO PIECES FIRST IN
RESPONSE TO THE STREET. UM WE
SENT A VERY LONG LETTER WITH
QUESTIONS TO KAISER ON FRIDAY,
ASKING THEM TO RESPOND WITH
THEIR CONTINGENCY PLANS AND HOW
THEY WILL RESPOND TO ENSURE THAT
THERE IS NOT A DISRUPTION IN
HERE AND THAT CONSUMERS ARE
ACCESSING CARE, INCLUDING HOW
THEY ARE, THEY WILL ARRANGE FOR
CARE OUT OF NETWORK IS NEEDED.
UM THE OTHER PIECE THAT WE ARE
DOING REALLY MORE IN RESPONSE TO
COMPLAINTS AND INFORMATION WE'VE
RECEIVED FROM STAKEHOLDERS OVER
THE LAST REALLY 2.5 YEARS. MANY
OF THE ORGANIZATIONS THAT ARE
REPRESENTED HERE TODAY. UM WE
HAVE ENOUGH INFORMATION TO
INDICATE THAT THERE IS A PROBLEM
WITH ACCESS TO CARE OF
BEHAVIORAL SERVICES THAT KAISER
UM AND 20 FROM 2020 TO 21. WE
ALSO SAW A 20% INCREASE IN
COMPLAINTS TO OUR HELP CENTER
FROM KAISER ENROLLEES AND SO ON
IN ON MAY 16TH OF THIS YEAR WE
NOTIFIED KAISER THAT WERE
CONDUCTING A NON ROUTINE SURVEYS
SPECIFIC TO ACCESS TO CARE FOR
BEHAVIORAL SERVICES. SO WE'RE
ALREADY IN THE PROCESS OF
REQUESTING INFORMATION. UM AND
CONDUCTING AN ON ROUTINE SURVEY
TO REALLY DIG INTO JUST KIND OF
WHAT IS GOING ON FROM THE VERY
INITIAL PHONE CALL AND INTAKE TO
HOW ARE THEY PROVIDING HERE? UM
IN COMPLIANCE WITH THE STORM,
STRONG, TIMELY ACCESS
REQUIREMENTS, BOTH IN NETWORK
AND OUT OF NETWORK. SO WE'VE
ALREADY STARTED THAT PROCESS TO
WORK ON THAT. UM WE WILL
CONTINUE THROUGH OUR NON ROUTINE
SURVEY TO LOOK AT ACCESS TO CARE
. SO UM IN IN ADDITION, JUST TO
THE INFORMATION AND QUESTIONS
WE'RE ASKING KAISER. A LOT OF
THIS WILL BE REVIEWED THROUGHOUT
ON ROUTINE. OKAY THANK YOU. SO I
GUESS THE OTHER QUESTION IS, IS
THAT UM YOU HAVE A SYSTEM, WHICH
IS, YOU NOTED. IT WAS ACTUALLY
NOT PERFORMING TO THE STANDARD.
AND NOW THEY HAVE A NOW THEY
MIGHT HAVE FURTHER DESTRUCTION
BECAUSE OF A STRIKE THAT'S
ACTUALLY BEING CAUSED BY THE
FACT THAT YOU HAVE THEIR
PROFESSIONALS FEEL LIKE THEY'RE
NOT BEING ABLE TO PRACTICE THE
STANDARD. UM SO WHAT STANDARD WE
HOLD THEM TO DRAIN THE STRIKE
THE STANDARD THAT ISN'T THE REAL
STANDARD, BECAUSE THAT'S WHAT
THEY WERE DOING BEFORE. ARE WE
GOING TO TELL THEM THAT THEY
NEED TO ACTUALLY UPPED THEIR
GAME? THEY ACTUALLY STILL HAVE
TO ACTUALLY MEET THE STANDARD.
JUST BECAUSE THERE'S A STRIKE
GOING ON DOESN'T MEAN THAT THEY
GET TO, YOU KNOW. HMM. JUST DO
WHAT THEY DID BEFORE. THAT
THEY'D HAVE TO THAT THEY STILL
NEED TO MEET THE STANDARDS EVEN
IN THOSE CIRCUMSTANCES. YOU
KNOW, I STRIKE OR NO STRIKE IS
THE REGULATOR. WE'RE GOING TO
HOLD THEM ACCOUNTABLE FOR
FOLLOWING THE LAW AND THE TIMELY
ACCESS STANDARDS THAT WE HAVE IN
PLACE. AND SO, UM, YOU KNOW,
THERE'S NO ALLOWANCE IN THE LAW
DURING A STRIKE THAT YOU GET TO
EXTEND THOSE TIME PERIODS, SO
WE'LL BE HOLDING THEM
ACCOUNTABLE TO THAT. UM AND
AGAIN, I THINK THIS IS WHERE
HAVING CONSUMERS CALL INTO OUR
HELP CENTER WHEN THEY'RE NOT
GETTING CARE WITHIN THOSE
TIMEFRAMES IS REALLY IMPORTANT
THAT HELPS TO SHOW AND PROVIDE
EVIDENCE. UM IN CASE WE END UP
IN HEARING OR SUPERIOR COURT TO
DEMONSTRATE THAT THERE IS A
PROBLEM. IT ALSO LETS US LOOK
WITH HIM SYSTEMS ABOUT WHAT
HAPPENED WITH SPECIFIC ENROLLEES
. UM SO AGAIN, THERE'S THERE IS
ONLY ONE STANDARD AND THE LAW IS
PRETTY CLEAR ON WHAT THAT IS.
OKAY I APPRECIATE THAT, UM AGAIN
AND REALIZE THERE ARE SOME
CHALLENGES, ESPECIALLY WITH
PRIVACY AND SO FORTH IN TERMS OF
GETTING INFORMATION, BUT I ALSO
URGE THAT, UM YOU KNOW THE THINK
ABOUT PRO WAYS OF GETTING
INFORMATION BECAUSE I'M
CONCERNED THAT JUST RELYING ON
THE COMPLAINT, UH, ROUTE ALONE
WILL WILL UNDERESTIMATE AND
PARTICULARLY THE MORE VULNERABLE
POPULATIONS, POPULATIONS THAT
POOR ACCESS. LEAST LIKELY TO
ALSO USE COMPLAINT LINES. BUT
THANK YOU SO MUCH FOR YOUR
TESTIMONY. THANK YOU. THANK YOU
. SO I HAVE A COUPLE QUESTIONS.
FIRST OF ALL, UM, I WAS THANK
YOU FOR RAISING THE NON ROUTINE
REVIEW OF KAISER AND THAT WASN'T
INITIATED OR ANNOUNCED BY GM IT
SHOULD BEFORE THE STRIKE WAS
ANNOUNCED. UM, CAN YOU JUST, UM
, UH, SORT OF DESCRIBE WHAT IT
IS THAT TRIGGERS A NON ROUTINE
REVIEW? BECAUSE I THINK WHAT YOU
SAID. IN MY UNDERSTANDING THE
PROCESSES THERE ARE REGULAR
REVIEWS THAT HAPPENED THAT
HAPPENED AROUND COMPLIANCE, BUT
THE NON ROUTINE REVIEWS ARE
BECAUSE OF SPECIFIC PROBLEMS
THAT POP UP. SO WHAT? WHAT
TRIGGERED THE NON ROUTINE REVIEW
OF KAISER'S DELIVERY OF
BEHAVIORAL HEALTH SERVICES. HMM
NO. SO EVERY THREE YEARS WE
CONDUCT ROUTINE EXAMINATIONS OF
ALL OF OUR HEALTH PLANS. UM
REALLY, TO LOOK AT THEIR
OPERATIONS. THEY FIND A LOT OF
POLICIES AND PROCEDURES WITH US
, BUT IT'S REALLY TO LOOK AT OUR
THEY ACTUALLY COMPLYING WITH
WHAT THEY PUT IN THEIR POLICIES
AND PROCEDURES. BUT HOW ARE THEY
OPERATIONS OPERATIONAL IZING
THAT TO COMPLY WITH THE LAW? IF
WE FIND ENOUGH INFORMATION TO
DEMONSTRATE THAT THERE IS A
COMPLIANCE ISSUE, UM OR A
VIOLATION OF THE LAW OR SOME
OTHER ISSUE OUTSIDE OF THAT
THREE YEAR CYCLE, WE CAN DO
WHAT'S CALLED A NON ROUTINE. UM
AND THIS CAN YOU KNOW REALLY
GIVES US THE OPPORTUNITY TO GET
IN AND FOCUS ON A SPECIFIC ISSUE
IN THE CASE OF THE NON ROUTINE
WITH KAISER, WE HAVE BEEN HAVING
CONVERSATIONS WITH NUH W AND
THEIR MEMBERS FOR PROBABLY OVER
TWO YEARS, IF NOT LONGER. UM
WE'VE MET WITH A NUMBER OF
PROVIDER ASSOCIATIONS WITH
CONSUMER ORGANIZATIONS, IN
ADDITION TO JUST THE INCREASE IN
VOLUME OF OUR HEALTH CENTER, UM
ONE OF THE THINGS WE DO MONITOR
IS TRENDS AND PATTERNS AND OUR
HELP CENTER EVEN THOUGH YOU KNOW
THERE MAY BE A SMALLER NUMBER OF
CONSUMERS THAT CONTACT OR HELP
CENTER. IT'S REALLY AN EARLY
INDICATION WHEN WE HAVE A
PROBLEM AND SO WHEN WE SEE THAT
UPTICK KIND OF PAIRED WITH ALL
OF THE OTHER INFORMATION THAT
WE'RE GATHERING, UM, THAT REALLY
LED TO OUR DECISION THAT IT WAS
TIME TO DO IT ON A ROUTINE
SURVEY. OKAY AND HAVE YOU HAVE
YOU DONE ANY OTHER NON ROUTINE
SURVEYS OF HEALTH PLANS SPECIFIC
TO BEHAVIORAL HEALTH. I HAVE TO
GO BACK AND LOOK IN THE RECESSES
OF OUR HISTORY. BUT I DON'T
BELIEVE THERE IS ANY OF THAT. UM
I AM AWARE OF SOMEONE MAY TEXT
ME AND SAY WE DID, BUT I CAN'T
THINK OF ANYTHING OFFHAND. OKAY,
SO AS FAR AS YOU CAN RECALL THE
KAISER. ONE OF IS THE ONLY ONE.
BUT PLEASE, IF SOMEONE DOES TEXT
YOU OR YOU LEARN ABOUT IT JUST
LIKE TO KNOW. THANK YOU. AND SO
UM, I WANT TO FOLLOW UP ON
SENATOR PANS. QUESTION ABOUT,
YOU KNOW, UM, GMHC TAKING
PROACTIVE STEPS. UM IN THE EVENT
, UH, IN GENERAL, BUT
PARTICULARLY DURING THE WORK
STOPPAGE TO MAKE SURE THAT
PEOPLE ARE CONTINUING TO HAVE
SEAMLESS CARE. AND I BELIEVE NUH
W MADE SEVERAL SPECIFIC, UM,
SUGGESTIONS TO GMHC AND I'M
GOING TO SORT OF NOTE THEM AND
I'M JUST CURIOUS. WHAT YOU THINK
ABOUT THEM IF THE DEPARTMENT
INTENDS TO ADOPT ANY OF THESE
ONE IS COMMUNICATING DIRECTLY
WITH KAISER PATIENTS TO INFORM
THEM OF THEIR RIGHTS UNDER THE
LAW, AND THAT THOSE RIGHTS
CONTINUE EVEN DURING A STRIKE,
UM, SETTING UP A RAPID RESPONSE
SYSTEM FOR PATIENTS WHO REPORT
UNLAWFUL DELAYS, EVEN IF IT IS
DURING A STRIKE. UM AND ACTIVELY
MONITORING PATIENTS, SCHEDULES
AND CHARTS FOR COMPLIANCE. SO
I'M JUST CURIOUS TO HEAR YOUR
YOUR THE DEPARTMENT'S REACTION
TO THOSE RECOMMENDATIONS. SURE
YEAH, I KNOW. AND I WILL SAY
JUST OVER TWO RESPONSES. WE ARE
. WE WILL BE REVIEWING THE
RESPONSE THAT KAISER SUBMITS TO
US TO SEE IF ANY OF IF THEY'RE
ALREADY ADDRESSING SOME OF THOSE
ISSUES, TOO, DEPENDING ON WHAT
SUBMITTED TO THE DEPARTMENT, UM,
THAT MAY DICTATE SOME OF OUR
RESPONSES IN TERMS OF US
NOTIFYING ENROLLEES. WE DON'T
HAVE UNLIKE A PURCHASER. WE
DON'T HAVE A LIST OF KAISER AND
RELEASE SO WE DON'T HAVE THAT
INFORMATION. NOR DO WE HAVE THE
CAPACITY TO JUST SEND A MASS
MAILING. UM PREVIOUSLY WE HAVE
DONE THINGS LIKE ISSUE A PRESS
RELEASE POST INFORMATION ON OUR
WEBSITE. UM SHARE INFORMATION
THROUGH SOCIAL SOCIAL MEDIA TO
MAKE SURE THAT CONSUMERS ARE
AWARE OF THEIR RIGHTS. WE ALSO
HAVE A FACT SHEET ON OUR THE
TIMELY ACCESS REQUIREMENTS AS
WELL AS THE CONSUMER PROTECTIONS
AROUND MENTAL HEALTH, SO WE WILL
SHARE THAT INFORMATION. I'M
HAPPY TO WORK WITH ANY OTHER
CONSUMER ORGANIZATIONS TO GET
THAT INFORMATION OUT. UM SO
DOING A DIRECT MAILING FROM THE
CMHC IS NOT SOMETHING THAT WE
WOULD BE ABLE TO DO, UM, IN
TERMS OF LIKE SETTING UP A RAPID
RESPONSE SYSTEM OR A PHONE
NUMBER. WE HAVE THAT WE HAVE OUR
GMHC HELP CENTER SO IT IS
ALREADY SET UP. WE ARE READY AND
WILLING AND ABLE TO HELP ANY
CONSUMER THAT'S EITHER A KAISER
MEMBER OR A MEMBER OF ANY OTHER
HEALTH PLAN. UM AND THEN THE
FINAL REQUEST WAS ME. IT WAS
ACTIVELY MONITORING PATIENTS,
SCHEDULES AND SHORTS FOR
NONCOMPLIANCE. YEAH SO ABSENT A
COURT ORDER. WE ACTUALLY DON'T
HAVE THE AUTHORITY TO GO SIT IN
A PROVIDER, OFFICES AND MONITOR
. UM THROUGH OUR NON ROUTINE
SURVEY. WE WILL BE ABLE TO LOOK
AT SYSTEMS AND SOME OF THAT, UM
, BUT THE ABILITY AND JUST THE
RESOURCES TO BE ABLE TO SIT IN
IN KAISER'S, YOU KNOW PROVIDER
OFFICES. IT'S NOT SOMETHING THAT
WE HAVE THE CAPACITY TO DO. WE
WILL BE LOOKING FOR INFORMATION
FROM KAISER ON WHAT IS HAPPENING
AND AGAIN MONITORING BOOK BOOK
THROUGH OUR HELP CENTER
COMPLAINTS AND WHAT WE'RE DOING
WITH THE NON ROUTINE, SO I
APPRECIATE THAT IN TERMS OF THE
FIRST ON THE COMMUNICATING WITH
WITH WITH KAISER MEMBERS OR IF
THERE WERE A DIFFERENT HEALTH
PLAN THAT WAS SUBJECT TO A WORK
STOPPAGE. UM SO I UNDERSTAND
THAT YOU DON'T HAVE THOSE LISTS,
BUT THE QUESTION IS THERE ANY
WAY DOES THE DEPARTMENT OF ANY
ABILITY TO ENSURE THAT THOSE AH
PATIENTS OF THOSE MEMBERS ARE
RECEIVING INFORMATION OF HERE
ARE YOUR RIGHT. YOU HAVE A RIGHT
TO X Y AND Z. HERE'S THE NUMBER
YOU CALL IF YOU THINK YOU KNOW
YOUR RIGHTS ARE BEING VIOLATED,
AND SO FORTH. UM CAN YOU, UH,
GET THAT LIST FROM KAISER? UM
EVEN IF YOU NEVER SEE THE LIST
IN TERMS OF PRIVACY ISSUES, OR
CAN YOU GIVE A WAY OF FORCING
KAISER TO SEND A PARTICULAR
MESSAGE TO MEMBERS? UM I'M JUST
WONDERING, UH, BECAUSE I KNOW
WHAT WILL HAPPEN. THE STRIKE
WILL HAPPEN, AND I'M SURE KAISER
MICHAEL, LOT OF EMPLOYERS WILL
SEND YOU AND EMAIL, UH TO ITS
MEMBERS PROBABLY TRASHING THE
UNION. I'M JUST GONNA I'VE SEEN
SOME OF THE COMMUNICATIONS
ALREADY. SO THAT WOULD NOT
SURPRISE ME, JUST BLAMING THE
UNION BLAMING THE WORKERS AND
IT, YOU KNOW, USING THEIR OWN PR
I'M WONDERING IF THERE'S A WAY
TO ENSURE SOME SORT OF NEUTRAL
PROVISION OF INFORMATION ABOUT
HERE, YOUR RIGHTS, AND HERE'S
HOW YOU MAKE COMPLAINTS. IF YOU
THINK THERE'S A PROBLEM. YOU
KNOW, I WILL SAY WE DISTILLER AT
THIS STAGE WHERE WE NEED TO
EVALUATE COACH'S RESPONSE AND
WHAT THEY ARE DOING, AND THEN
YOU KNOW, OBVIOUSLY WE'LL
PROBABLY HAVE FOLLOW UP
QUESTIONS AND WE'LL JUST HAVE TO
SEE WHERE WE GO FROM THERE IN
TERMS OF WHAT ELSE WE WOULD
REQUIRE TO DO. THANK YOU,
DIRECTOR COLLEAGUES. ANY OTHER
QUESTIONS OF THE DIRECTOR? OKAY,
SENATOR, SENATOR CORTEZ. THANK
YOU VERY MUCH. AND THANKS FOR
THE PRAYER QUESTIONS. I CAME IN
A COUPLE MINUTES LATE, AND, UM,
I APOLOGIZE IF I IF I ASK
SOMETHING THAT WAS ALREADY
COVERED, ALTHOUGH I DID THE
FIRST QUESTION I HAVE IS UM, I
DID HEAR THE STATEMENT THAT YOU
KNOW, LABOR DISPUTE OR WORK
STOPPAGE OR NOT, UM PATIENT
ACCESS WAS PARAPHRASING, UM YOU
KNOW, WOULD STILL BE ENFORCED OR
MUST BE COMPLIED WITH. UM IS
THERE ANY EXCUSE TO THOSE LAWS
OTHER, YOU KNOW, WORK STOPPAGES
SIDE. OBVIOUSLY THAT'S FOREMOST
DONE PROBABLY ALL OF OUR MINDS
HERE BECAUSE IT'S LOOMING. BUT
IS THERE ANY UM, OPPORTUNITY FOR
KAISER IN THAT PARTICULAR
CIRCUMSTANCE, T. TO RESPOND TO
SAY THIS ISN'T ABOUT UM, WORK
STOPPAGE JUST ABOUT OTHER
CRITERIA THAT DO GIVE US YOU
KNOW, FORGIVENESS. IF YOU WILL,
UNDER THE PATIENT ACCESS LAWS. I
JUST I GUESS I'M NOT A STUDENT
OF THOSE OF THOSE LAWS, AND I'M
JUST WONDERING IF THERE'S A
SHORT ANSWER TO THAT. YEAH I
WILL JUST SAY THE SHORT ANSWER
IS THE LAWS DON'T ALLOW FOR
FLEXIBILITY DURING STRIKES THE
TIME WHEN YOU ACCESS STANDARDS
AND THE STRONGEST CONSUMER
PROTECTIONS IN THE LAW ARE WHAT
THEY ARE, UM, WE EXPECT PLANS TO
HAVE CONTINGENCY PLANS IN PLACE
AND BE ABLE TO PROVIDE THAT CARE
. UM I WILL JUST NOTE IN CASE
YOU MISSED. THAT PART IS IF
KAISER IS NOT ABLE TO PROVIDE
CARE ACCESS TO CARE WITHIN THE
TIMELY ACCESS STANDARDS WITHIN
THEIR EXISTING NETWORK THEY NEED
TO BE ABLE TO ARRANGE FOR OUT OF
NETWORK HERE, SO THIS MEANS
ALLOWING INDIVIDUALS AND HELPING
TO ARRANGE FOR CARE OUTSIDE OF
THE KAISER SYSTEM AND ENROLLING
SHOULD NOT PAY ANY MORE THAN
THEY WOULD AS IF THEY WERE IN
NETWORK. UM AND YOU KNOW TO
SENATOR WIENERS POINT ABOUT
THIS, THE STRONG CONSUMER
PROTECTIONS THAT HAVE BEEN ADDED
OVER THE LAST FEW YEARS THAT ARE
RANGING IS REALLY IMPORTANT. IT
IS NOT OUR EXPECTATION THAT A
CONSUMER WHOSE HAVING A MENTAL
HEALTH CRISIS IS GOING TO CALL
50 PROVIDERS, WHETHER THAT'S IN
IN OR OUT OF KAISER TO FIND AN
APPOINTMENT. THAT'S THE HEALTH
PLANS RESPONSIBILITY. AND I
GUESS I GUESS WHAT. MAYBE THAT
THE PHRASES THAT BEGS THE
QUESTION IT SEEMS TO BE IN TERMS
OF THE LABOR DISPUTES THAT THAT
BOTH SIDES ARE ACKNOWLEDGING
THAT THERE'S PROBLEMS WITH
PATIENT ACCESS. NOW UM THERE'S
NO STRIKE YET THAT THERE'S
DELAYS. UM I HAVE A LETTER HERE
FROM KAISER THAT TALKS ABOUT HEY
, LOOK, WE'RE IF I'M READING IT
PROPERLY. THE WAY I READ IT AND
SAY, LOOK, YOU KNOW WE'VE WE
NEED TO ADD POSITIONS. WE'VE GOT
POSITION ISSUES WE'VE HAD ADDED
170 OVER A PERIOD OF TIME, BUT
WE HAVE A PROMISE THAT SEEMS TO
BE ACKNOWLEDGEMENT THAT PATIENT
ACCESS IS BEING COMPROMISED NOW.
CERTAINLY. I YOU KNOW, THE LABOR
UNIONS HAVE ASSERTED THAT UM,
AND SO I'M NOT ASKING TO GET IN
THE MIDDLE OF THAT DISPUTE. I
GUESS WHAT I'M REALLY ASKING IS
HOW DO YOU GET AWAY WITH
ACKNOWLEDGED. COMPROMISE PATIENT
ACCESS AGAIN KIND OF REPEATING
THE FIRST QUESTION. ABSENT THE
LABOR DISPUTE. I DID BY THE WAY
HERE, WHAT YOU SAID ABOUT THE
LABOR DISPUTE. IN THE
OBLIGATION. UM T YOU KNOW FOR
KAISER, IN THIS CASE TO TAKE
AFFIRMATIVE STEPS TO, UH UH, TO
CONNECT PEOPLE WITH OUT OF
NETWORK. AND AGAIN, I WOULD THEN
ASSUME THAT THAT OBLIGATION
EXISTS RIGHT NOW. TODAY YOU
KNOW, ABSENT A STRIKE. I'M NOT
SURE. THAT'S HAPPENING IN. DO
YOU KNOW? IS THAT HAPPENING NOW?
YEAH I MEAN, I WILL SAY THAT I
HAVE ENOUGH CONCERNS ABOUT WHAT
WAS HAPPENING. UM OVER THE LAST
FEW YEARS THAT WE WERE
CONDUCTING AN HONORABLE TEEN
SURVEYS, SO WE ANNOUNCED THAT
BACK IN MAY REALLY IN RESPONSE
TO THE INFORMATION THAT WE HAD
GATHERED FROM STAKEHOLDERS,
INCLUDING NUH W AND OTHERS,
OTHER ASSOCIATIONS. BUT ALSO WE
SAW 20% INCREASE IN COMPLAINTS
TO OUR CONSUMER HELP CENTER FROM
2020 TO 21. SO ARE NON ROUTINE
SURVEY WAS REALLY OUR RESPONSE
TO THE FACT THAT WE WERE
CONCERNED ABOUT THIS PRIOR TO
THE STRIKE. I UNDERSTAND. THANKS
FOR CONNECTING THAT DOT WITH ME.
I WASN'T CONNECTING THOSE TWO
THOSE TWO THINGS, SO I
APPRECIATE THAT. AND THEN IN
THAT REGARD, I WOULD ASSUME THAT
THEY HAVE A CONTINUITY OF CARE
PLAN AND AGAIN, YOU MAY HAVE
MENTIONED THAT EARLIER. BUT IT
IS PART OF THIS ADDITIONAL
SURVEY IF YOU WILL. UM AND
ASSESSMENT THAT THAT CONTINUITY
OF CARE PLAN MAY NOT BE ADEQUATE
FOR WHAT KAISER IS FACING RIGHT
NOW. DO YOU HAVE AN OPINION
ABOUT THAT? YOU KNOW, I DON'T
MAYBE A LITTLE BIT EARLY FOR ME
TO RESPOND TO THAT. I THINK WE
CERTAINLY WANT TO SEE WHAT
KAISER'S RESPONSE IS IN TERMS OF
HOW THEY'RE RESPONDING TO THIS
UPCOMING STRIKE. UM AS PART OF
OUR GONE ROUTINE SURVEY, WE CAN
ALSO LOOK AT KIND OF WHAT, WHAT
THOSE CONTINGENCY PLANS ARE AS
WELL AS WHAT KAISER'S CAPACITY
IS TO ARRANGE FOR CARE OUTSIDE
OF THE KAISER SYSTEM, IF NEEDED.
SO THAT WILL BE PART. I THINK
PART OF WHAT WE NEED TO GET TO
THE BOTTOM OF ALONG WITH A
NUMBER OF OTHER ISSUES OF JUST
HOW CONCERNED MERGED OR
ACCESSING CARE FROM THIS POINT
OF CALLING AND SAYING, I NEED
HELP, UM TO THE FIRST
APPOINTMENT AND FOLLOW THE
APPOINTMENTS. YES AND LET ME
JUST SAY I APPRECIATE YOU'RE
CLEAR AND CANDID RESPONSES IN A
APPRECIATE YOUR RESPONSE. TO THE
PER QUESTIONS AND TO OUR CHAIRS.
QUESTIONS ABOUT WHAT
AFFIRMATIVELY MIGHT BE DONE, OR
MORE THAN ONE MEMBER IS ALREADY
ASKED US QUESTIONS AND IT SOUNDS
LIKE YOU'RE PREPARED TO NOT WAIT
UNTIL UM TOO MUCH ASSESSMENT
TAKES PLACE. UM. YOU KNOW, NOW
GOING TO THE EVENT OF A STRIKE
BEFORE WE MAKE A DETERMINATION
WHETHER CONTINENT CARE PLAN WAS
WAS ADEQUATE OR NOT, AND I DON'T
KNOW WHAT THE HISTORY OF THAT IS
, I THINK THE LAST QUESTION I
HAVE AND I'LL STOP. THERE IS UM. IN ORDINARY CIRCUMSTANCES IN
AGAIN FOR THIS QUESTION, I JUST
WANT TO SET ASIDE FOR A MOMENT.
THE IDEA OF A LABOR DISPUTE.
UNDER ORDINARY CIRCUMSTANCES.
WHAT ARE THE COMPLIANCE
MECHANISMS? UM YOU KNOW, IN YOUR
OFFICE OR JUST IN THE STATE OF
CALIFORNIA. FOR ENSURING THAT
CONTINUITY OF CARE PLANS. OR
ACTUALLY UM WHAT THEY NEED TO BE
THAT THAT THEY'RE THAT THEY'RE
NOT JUST DOCUMENTS THAT ARE
SITTING ON A SHELF SOMEWHERE
THAT DON'T HAVE A REAL NEXUS T.
UM. YOU KNOW TO THE DISRUPTION
OF THE OUTSIDE DISRUPTION OF
CONTINUITY OF CARE. IS THERE
SOME ORDINARY COMPLIANCE
MECHANISM OR IS THAT WHAT YOU
ALREADY DESCRIBED WHAT WE DO A
REVIEW AND IF WE FEEL WE NEED TO
GO IN AND DO AN ADDITIONAL
SURVEY, WE DO IT. YEAH I MEAN, I
THINK THAT'S A BIG PART OF IT IS
JUST MONITORING OVERALL
COMPLIANCE AND YOU KNOW EVERY
THREE YEARS WE DO THESE ROUTINES
SURVEYS OR WE CAN DO THE NON
ROUTINE SERVICE IF WE NEED TO.
UM THERE'S A NUMBER OF OTHER
THINGS THAT WE DO AT THE
DEPARTMENT, INCLUDING WHAT WE
CALL OUR ANNUAL NETWORK REVIEWS
SO EVERY YEAR THE PLANS HAVE TO
BASICALLY FILE THEIR ENTIRE
NETWORK WITH US. AND PART OF
WHAT WE LOOK AT IS TO MAKE SURE
THEY HAVE A ROBUST ENOUGH
NETWORK OF PROVIDERS, UM, TO
PROVIDE A LITTLE SERVICES THAT
THEY'RE RESPONSIBLE FOR
COVERING, SO THERE'S A LOT THAT
WE DO JUST THROUGH OUR NETWORK
REVIEW TO MAKE SURE THEY CAN.
THEY CAN MEET, UM, RATIOS AND
GEOGRAPHIC ACCESS STANDARDS AS
WELL AS OUR TIMELY ACCESS
STANDARDS. UM AND I WILL JUST,
YOU KNOW, REITERATE OUR HELP
CENTER AS KIND OF THE EARLY
INDICATION OF WHERE THERE MAY BE
A PROBLEM, AND THAT REALLY HELPS
INFORM ALL OF THE OTHER WORK BUT
FIRST AND FOREMOST, YOU KNOW,
THERE IS AN INDIVIDUAL PERSON IN
OUR C THAT IS PROBABLY IN CRISIS
THAT NEEDS HELP. SO OUR PRIMARY
GOAL IS TO HELP THAT INDIVIDUAL
, BUT THAT INFORMATION GETS
FILTERED INTO ALL OF THE OTHER
AREAS OF OUR WORK THAT I KNOW
SOUNDS VERY, VERY TECHNICAL. BUT
IT IS REALLY IMPORTANT BUT FIRST
AND FOREMOST, IS HELPING THAT
INDIVIDUAL CONSUMER YEAH, I VERY
MUCH APPRECIATE THAT. LAST
COMMENT. THANK YOU. THANK YOU,
MR CHAIR. THANK YOU, SENATOR.
SENATOR NEWMAN. THANK YOU, MR
CHURCHILL. DIRECTOR WHAT? I WANT
TO FOLLOW UP AND BUILD ON
SENATOR CRITICIZES QUESTIONS
ABOUT MY QUESTION FOR YOU IS IN
THE IN THE ABSENCE OF COMPLIANCE
, WHAT PENALTIES OR OTHER
SANCTIONS DO YOU HAVE AT YOUR
DISPOSAL? MORE GENERALLY, DOES
THE STATE HAVE TO ENSURE UM UH,
A SUFFICIENT RESPONSE IN THE
SHORT TERM RIGHT IN THE EVENT OF
A WORK STOPPAGE. TO ENSURE THAT
THERE'S NOT THEN THERE ARE REAL
PENALTIES AND A REAL INCENTIVE
FOR RESTORING COMPLIANCE TO
ENSURE CARE FOR PATIENTS. YEAH
NO, I MEAN OFFICE THINK ARE
FINES OR PENALTIES ARE PROBABLY
THE THING THAT GETS THE MOST
ATTENTION. UM YOU KNOW, WE WILL
NEED TO BE ABLE TO DEMONSTRATE
AND HAVE EVIDENCE TO SUPPORT A
VIOLATION OF THE LAW. BUT THAT
IS PROBABLY THE MORE WELL KNOWN
AVENUE THAT WE HAVE TO, UM, YOU
KNOW, ADDRESS VIOLATIONS OF THE
LAWS ARE PENALTIES. WE OFTEN
HAVE PROACTIVE ACTION PLANS
ASSOCIATED WITH THOSE UM, YOU
KNOW, THIS IS NOT JUST ABOUT A
LARGE PENALTY. THIS IS ABOUT
CORRECTING BEHAVIOR. CORRECTING
SYSTEMIC AND OPERATIONAL ISSUES
. AND SO THAT'S PART OF THE
CORRECTIVE ACTION PLAN. UM WE DO
HAVE A NUMBER OF OTHER JUST
MECHANISMS IF WE NEED THEM AND
PUTTING THINGS LIKE, UM, HOUSTON
DESIST ORDERS ORDERS TO
IMMEDIATELY STOP BEHAVIOR. UM
YOU KNOW ALL THE WAY UP TO
INSTALLING A MONITOR OR
CONSERVATORSHIP. I MEAN, THERE'S
A LOT OF TOOLS THAT WE HAVE, BUT
YOU KNOW, OUR GOAL IS REALLY TO
TRY AS QUICKLY AS POSSIBLE TO
CORRECT THE BEHAVIOR SO THAT
CONSUMERS AREN'T HARMS. I
APPRECIATE THAT. SO CAN YOU GIVE
US A SENSE AS TO TIMELINES IN
THE EVENT THAT YOU KNOW ONE OR
MORE OF THOSE SANCTIONS ARE
APPLIED. YEAH. I MEAN, IT'S
REALLY CASE SPECIFIC AND WILL
DEPEND ON THE EVIDENCE THAT WE
HAVE, UM, YOU KNOW, WE SAY-EVIDENCE A LOT BECAUSE IN MANY
CASES WE END UP IN HEARING OR IN
SUPERIOR COURT ON THESE. SO
HAVING THOSE CONSUMER CASES
WHERE THERE'S VERY SPECIFIC
VIOLATIONS, UM YOU KNOW, NOT
JUST ANECDOTAL STORIES. WE
REALLY MEAN YOU DOCUMENTATION IF
THERE'SWITNESSES THAT ARE
WILLING TO COME FORWARD, SO SOME
OF THIS WILL DEPEND ON THE
EVIDENCE THAT WE HAVE. THAT WILL
DICTATE KIND OF THE PATH AND HOW
QUICKLY WE MAY BE ABLE TO TAKE
THOSE PATHS. AND SO IS IT FAIR
TO SAY THIS IS A MATTER OF
WEEKS, NOT DAYS AND IN A SORT OF
A NORMAL NO, I WOULD SAY IN MOST
CASES, BUT AGAIN, THAT REALLY
DEPENDS ON HOW EGREGIOUS THE
VIOLATION IS AND WHAT
DOCUMENTATION EVIDENCE WE HAVE.
I APPRECIATE THAT. THANK YOU, MR
CHAIR. OKAY THANK YOU.
COLLEAGUES I SEE NO OTHER
QUESTIONS. SO, DIRECTOR, THANK
YOU. SO MUCH FOR YOUR TESTIMONY
TODAY AND FOR ANSWERING OUR
QUESTIONS. THANK YOU. UM SO WE
ARE NOW I'M GONNA ACTUALLY MY
APOLOGIES. FLIP THE ORDER OF OUR
NEXT TWO PANELS. WE'RE GOING TO
PROVIDERS AND THEN PAY OUR TWO
PATIENTS. ONE OF THE PATIENTS
HAS A TIME CONSTRAINT. UM, AND I
THINK THAT'S PROBABLY QUICKER
PANEL. UM ANYWAY, SO WE'RE GOING
TO GO TO OUR PATIENT PANEL. NEXT
WE'LL HEAR FROM JASMINE HICKS.
AND HEIDI STRUNK. UM. SO UH, PUT
THEM UP AND WE'LL START WITH
JASMINE HICKS. THANK YOU. AND
THANK YOU FOR BEING FLEXIBLE
WITH ME. UM I'M THE MOTHER OF
TWO DAUGHTERS, UM, IN 2013. MY
ELDEST WAS DIAGNOSED WITH
MULTIPLE SERIOUS MENTAL ILLNESS
CHALLENGES, AND KAISER OFFERED
US IF YOU PAMPHLETS AND SENT US
HOME, UM IN 2019, SHE. AH VERY
ILL AND HER SUICIDAL IDEATIONS,
UM, WERE ALARMING ENOUGH TO FOR
US ARE PLEADING WITH KAISER
SERIOUSLY FOR HELP AND THERAPY
THROUGH EMAILS AND PHONE CALLS.
AND WE WERE TOLD, REPEATED THERE
WERE NO REGULAR THERAPISTS
AVAILABLE. AND UM AND ONE IN ONE
INSTANCE WE TOOK HER IN FOR AN
EMERGENCY VISIT WITH HER ARMS
AND LEGS COVERED IN DEEP, SELF
INFLICTED WOUNDS. AND AT THAT
VISIT, SHE WAS GIVEN A PAMPHLET.
FOR MEDITATION, AND WE WERE TOLD
THAT THEY WOULD GET BACK TO US
WITH, UM, SOME OTHER HELP. BENCH
TRIED TO KILL HERSELF TWICE. AND
SHE'S BEEN ON LIFE SUPPORT IN
THE ICU TWICE IN THE LAST TWO
YEARS. SHE'S BEEN HOSPITALIZED
SIX TIMES, AND EVERY TIME SHE'S
BEEN FOLLOWED. SHE'S BEEN
DISCHARGED WITH NO FOLLOW UP
SERVICES OR AFTER CARE. FOR THE
FIRST TIME SHE WENT ON LIFE
SUPPORT. I HAD A CONVERSATION
WITH THE HOSPITAL'S HEAD OF
PSYCHIATRIC CARE TO DISCUSS WHAT
WOULD HAPPEN WHEN AND IF SHE
WOKE UP. I TOLD HIM THAT IF I
THAT I HAVE BEEN TRYING TO GET
HER HELP FOR YEARS AND THAT
SHE'D BEEN LIVING IN HER CAR IS
SLEEPING AT TRUCK STOPS WHEN HER
MENTAL ILLNESS LEFT HER UNABLE
TO TRUST IN MY CARE. UM I TOLD
HIM THAT I COULDN'T KEEP HER
SAFE AND THAT DANGER TO HERSELF
AND NEEDED TO BE PUT IN A PLACE
WHERE SHE COULD LIVE FOR A TIME
TO HEAL AND GET TREATMENT DOCTOR
SHOOK HIS HEAD AND SAID, KAISER
DOESN'T HAVE ANYTHING LIKE THAT.
AND IT WOULD BE UNREALISTIC TO
EVEN HOPE FOR SOMETHING LIKE
THAT. IN SPITE OF THIS SEVERITY
OF MENTAL HEALTH CHALLENGES AND
REPEATED APPEALS FOR SERVICES,
AND IN SPITE OF THE LAWS GOING
INTO EFFECT, KAISER HAS
CONTINUED TO INFORM US THAT
THERE ARE NO AVAILABLE MENTAL
HEALTH PROFESSIONALS ON STAFF
AND THEIR CONTRACTED THERAPISTS
ARE BOOKED SOLID. THEIR
TREATMENT PROGRAMS HAVE STAGNANT
WAITLIST, FOR INSTANCE, THE
FIRST TIME AND THE SECOND TIME
SHE WAS IN THE ICU. WE HAD TO
WAIT. ONCE SHE WAS STABILIZED TO
SEE IF THEY HAD A BED AVAILABLE
IN ANY KIND OF SET YOUR
PSYCHIATRIC WARD AND IN BOTH
INSTANCES, WE WERE TOLD THEY
WERE FULL. THEY HAD NO
ALTERNATIVE. HURTS KAISER
PSYCHIATRIC PSYCHIATRIST ONLY
COMES IN ON MONDAYS SO IT TAKES
MONTHS FOR HER TO GET AN
APPOINTMENT. AND BUT EVEN AFTER
ALL THIS, UM CONSIDER OURSELVES
LUCKY SHE'S ALIVE. UM BUT HMM.
THE THING THAT BOTHERS ME THE
MOST IS THAT MY CAREER STARTED
IN CALIFORNIA POLITICS I'VE HAD
YEARS OF EXPERIENCE IS A
CAMPAIGN FUNDRAISER AND
NONPROFIT DEVELOPMENT DIRECTOR
RAISING AWARENESS AND
FUNDRAISING FOR DISADVANTAGED
AND AT RISK COMMUNITIES. I WROTE
AN OP ED FOR THE L A TIMES ABOUT
OUR SITUATION THAT GOT PICKED UP
BY NEWS CHANNELS ACROSS THE
COUNTRY. AND WE RECEIVED AN
OUTPOURING OF SUPPORT AND
RECOMMENDATION BECAUSE OF THIS,
SO IN MANY WAYS, MY DAUGHTER AND
I ARE IN A VERY PRIVILEGED
POSITION. I KNOW HOW TO NAVIGATE
BUREAUCRATIC LABYRINTH AND MY
PROFESSION HAS ALLOWED ME THE
TIME AND ABILITY TO DEDICATE
MUCH OF THE LAST YEAR AND A HALF
ADVOCATING ON HER BEHALF. BUT
EVEN WITH ALL OF THOSE
ADVANTAGES AND RESOURCES, SHE
STILL DOESN'T HAVE THE CARE SHE
NEEDS. WE FILED GRIEVANCES WITH
KAISER AND WE'VE WORKED WITH, UM
, THE DEPARTMENT OF MANAGED
HEALTH CARE, TRY TO APPEAL FOR A
CONTINUUM OF CARE, AND WE WERE
TOLD BY EVERYONE THAT WE CAN
ONLY FILE GRIEVANCES FOR
SOMETHING THAT'S ALREADY
HAPPENED. NOT FOR SOMETHING THAT
NEEDS TO HAPPEN IN THE FUTURE.
UM SO WE CONTINUE TO FIGHT AND I
JUST REFUSED TO BELIEVE THAT
THIS IS THE BEST KAISER CAN DO.
BUT FOR ALL THAT I HAVE RAISED
AS FAR AS A FUSS AND NOISE ABOUT
IT TO KAISER AND OTHERS. UM I'VE
COME TO BELIEVE THAT THEY JUST
DON'T HAVE THE SERVICES. THEY
DON'T HAVE THE ABILITY TO HELP
MY DAUGHTER OR OR SOMEONE LIKE
HER. UM OH, THANKS FOR YOUR
TIME. THANK YOU VERY MUCH. AND
IF YOU COULD JUST START HANG ON
. I KNOW YOU HAVE TO LEAVE BY
THREE WILL HAVE PLAYED SOME
QUESTIONS AFTER THE NEXT WITNESS
THE NEXT WITNESSES, HEIDI STRUNK
, THE PRESIDENT AND CEO OF
MENTAL HEALTH AMERICA OF
CALIFORNIA. S. CALIFORNIA'S A
STATEWIDE PEER RUN ORGANIZATION
THAT'S BEEN ADVOCATING ON BEHALF
OF CALIFORNIANS SINCE 1957.
IMPLEMENTATION OF SB 2 TO 1 IS
IMPORTANT TO THOSE OF US WHO
WORKED TO REFORM TO FAILURE
FIRST SYSTEM OF CARE INTO A
PROACTIVE SYSTEM, A SYSTEM THAT
ALLOWS FOR TIMELY ACCESS PRIOR
TO REACHING CRISIS. I HAVE
UNIQUE TESTIMONY COME BEFORE YOU
WITH AN UNFORTUNATE THREE
PRONGED APPROACH. FIRST IM HERE
AS A LEADER OF AN ADVOCACY
ORGANIZATION. SECOND I'M HERE AS
AN EMPLOYER WHO PLAYS PREMIUMS
TO KAISER THAT HAS FAILED TO
PROVIDE TIMELY ACCESS TO MY
EMPLOYEES. AND THIRD. I'M HERE
AS A FAMILY MEMBER WHOSE FAMILY
HAS BEEN DONE NIGHT TIMELY
ACCESS BY PFIZER. AS A LEADER OF
ADVOCACY ORGANIZATION. I AM
FREQUENTLY CONTACTED BY PEOPLE
ACROSS THE STATE TO ASSIST THEM
WITH NAVIGATING THE SYSTEMS
THAT'S FAILING THEM. EACH STORY
IS SIMILAR, AND IT FALLS ALWAYS
INTO ONE OF TWO CATEGORIES,
EITHER ONE THEY CAN'T GET IN AN
INITIAL APPOINTMENT WITH A
THERAPIST OR TWO. THEY HAVE A
THERAPIST AND CAN'T GET A FOLLOW
UP APPOINTMENT WITH THEM BECAUSE
THE COMPANY SYSTEM WON'T ALLOW
THEIR THERAPISTS TO BOOK AN
APPOINTMENT. APPROXIMATELY 95%
OF THE PEOPLE WHO CONTACT US OUR
KAISER INSURERS. UM IN
ENROLLEES. MY RESPONSE IS ALWAYS
THE SAME. I EXPLAINED TO THEM
HOW TO FILE INTERNAL COMPLAINTS
AND APPEALS AND EXPLAIN THEIR
RIGHTS. HOW TO CONTACT THE
DEPARTMENT OF MANAGED HEALTH
CARE TO RECEIVE ASSISTANCE AND
FILED GRIEVANCES. UNFORTUNATELY,
FOR MOST. OF ALL THESE PEOPLE,
THE PROCESS IS INTIMIDATING AND
OR THEY DON'T HAVE TIME OR
ENERGY TO FIGHT FOR THEIR
ENTITLED SERVICES. THEY JUST
WANT HELP. WITHOUT FAILURE. BY
THE TIME THESE FOLKS CONTACT ME
, IT'S ALREADY BEEN DEFEATED BY
COMPANIES GHOST LYS. THESE ARE
COMMON. THIS IS A COMMON TERM
FOR A PANEL OF MEDICAL PROVIDERS
WHO FOR VARIOUS REASONS AREN'T
PROVIDING SERVICES. THIS IS A
LIST OF THERAPISTS THAT
COMPANIES GIVEN ROLLEY'S ONCE
IT'S BEEN DETERMINED THAT AN
ENROLLEE QUALIFIES FOR SERVICES.
ENROLLEES ARE TROUBLE TO GO PICK
UP PROVIDER OFF THE LIST. MAKE
AN APPOINTMENT AND START YOUR
THERAPY SESSION. THEY MAKE IT
SOUND SIMPLE AND EASY. THIS LIST
IS TYPICALLY HAS 30 THERAPIST ON
IT. BUT THE PROBLEM VERY OFTEN
IS. NONE OF THESE PROVIDERS ARE
AVAILABLE OR PHONE NUMBER IS NO
LONGER IN SERVICE FOR THE
PROVIDERS AND ACCEPTING THE
COMPANY'S ENROLLEES. OR THE
PROVIDERS AREN'T TAKING NEW
PATIENTS AND VERY OFTEN TIMES
ENROLLEES NEVER RECEIVED RETURN
CALLS. HENCE GHOST LIST. FOR
SOME INDIVIDUALS WHO ARE BARELY
HOLDING ON THE CALL ONE CALL,
IT'S ALL THE ENERGY THAT THEY
HAVE TO MAKE. BY MAKING
ENROLLEES NAVIGATED GHOST LIST.
WE LOSE THE OPPORTUNITY TO HELP
THEM. THEIR CONDITION IS
EXACERBATED AND IT'S WITHOUT
EXAGGERATION TO SAY WE HAVE LOST
PEOPLE'S LIVES AS A RESULT OF
MAKING THEM JUMP THROUGH
UNNECESSARY HOOPS. LISTS ARE
PART OF THE FAILURE FIRST SYSTEM
AND A BARRIER TO OBTAINING
TIMELY CARE. SECOND I'M ALSO
HERE AS AN EMPLOYER WHO PRAYS
PREMIUMS FOR MY TEAMS HEALTHCARE
COVERAGE, INCLUDING MENTAL
HEALTH. I DO HAVE THE PERMISSION
OF MY EMPLOYEE TO SHARE THIS
OUTSIDE OUT THERAPIST THROUGH
KAISER. AND THEN MY EMPLOYEES.
INITIAL EXPERIENCE WAS EXACTLY
LIKE THE PRIOR EXAMPLE WITH THE
GHOST NOUS. AFTER EXHAUSTING THE
GHOST LIST, THEY MADE NUMEROUS
CALLS TO THE INSURANCE COMPANY
TO ASK FOR HELP AND WAS PASSED
AROUND AND AROUND WITHOUT
RESOLUTION, THEY EVEN ELICITED
THE SYSTEMS OF THEIR PRIMARY
CARE PROVIDER WHO ALSO ATTEMPTED
TO TRY TO MAKE CALLS ON THEIR
BEHALF. AFTER SIX MONTHS OF NOT
RECEIVING ANY HELP FROM KAISER.
MY EMPLOYEE CAME TO ME FOR HELP
. THEY WERE EMBARRASSED, THEY
WONDERED AS A PROFESSIONAL AND
AN ADVOCATE. WHY COULDN'T BE
NAVIGATE THE SYSTEM? THERE ARE
SELF ADVOCACY FELL ON DEAF EARS
AND BROKEN PROMISES BY KAISER.
UPON ME GETTING INVOLVED DESPITE
MY NUMEROUS MEETINGS WITH KAISER
, BEHAVIORAL HEALTH
ADMINISTRATORS AND VARIOUS
MEMBERS OF THEIR TEAM, IT WAS
ONLY THROUGH OTHER METHODS BY
WHICH MY EMPLOYEE FINALLY
RECEIVED SERVICES. AFTER EIGHT
MONTHS OF SEEKING THEM OUT. I'M
ALSO HERE AS A FAMILY MEMBER
WHOSE FAMILY HAS BEEN FAILED
AGAIN BY KAISER AND FORTUNATELY
AND ALSO HAS KAISER HAS TRIED TO
MANIPULATE AND INTIMIDATE MY
FAMILY FROM PURSUING SERVICES OF
WHICH MY FAMILY IS ENTITLED MY
FAMILY MEMBERS QUEST TO FIND
HELP FOR THEIR MINOR CHILD
STARTED EXACTLY AGAIN. THE GHOST
LIST. SAME PROCESS, SAYING
FAILURE. MY FAMILY STARTED
FIGHTING WHEN THEIR CHILD WAS A
MINOR IN CONTINUED THEN INTO
YOUNG ADULTHOOD. HMM. EXCUSE ME.
MY MINOR FAMILY MEMBER WANTED
HELP. WE KNOW BARRIERS ARE
INTENTIONALLY PLACED IN HOPES
THAT ENROLLEES WILL GIVE UP
FIGHTING, BUT THEY'LL GO AWAY
AND KAISER WILL NO LONGER HAVE
AN OBLIGATION TO PROVIDE THEIR
SERVICES. WE THOUGHT KNOWING
THIS WOULD PREPARE US FOR THE
FIGHT. MY FAMILY FOLLOWED. THE
STEPS FOLLOWED INTERNAL
GRIEVANCES WITH KAISER
EVENTUALLY FILED AGREEMENTS WITH
DEPARTMENT MANAGED HEALTH CARE,
WHICH RESULTED IN AN INDEPENDENT
MEDAL FOR EXAM. THE DECISION WAS
MADE, KAISER WAS FORCED TO PAY
FOR OUTSIDE FACILITY. UM, AS
IDENTIFIED BY MY FAMILY. BUT
WHILE THE GMHC RESULTS, UM WERE
EXACTLY WHAT MY FAMILY HOPES FOR
AND FOUGHT FOR. IT TOOK A YEAR
AND THIS IS GOING THROUGH ALL
THE PROCESSES AND THIS IS FAR
FROM TIMELY ACCESS. THE DESIRED
OUTCOME, UM, BECAME AT A PRICE.
THROUGH THEIR PILLS AND
GRIEVANCES. KAISER. MAINTAIN
PATRONIZING, CONDESCENDING
LANGUAGE AND MANIPULATIVE
TECHNIQUES AND ATTEMPTED
BARRIERS. JUST A QUICK COUPLE
EXAMPLES. MY PROFESSIONAL ADULT
FAMILY MEMBER WAS BERATED BY
KAISER QUOTE IF YOU WERE THERE,
A BETTER PARENT, YOUR CHILD
WOULD NEED THESE SERVICES. IT'S
HARMFUL, AS THE COMMENT WAS, WE
KNEW IT WAS AN ATTEMPT TO
MANIPULATE MY FAMILY INTO
BACKING DOWN AND TO STOP
PURSUING FOR APPROPRIATE TIMELY
SERVICES MANIPULATION ATTEMPTED
BARRIER. MY FAMILY PUSHED FOR
PROPER TIMELY SERVICES. THEY
WERE TOLD BY CRIES, ER, THERE'S
NO SERVICES THAT THAT EXISTS
LIKE THAT. AND BESIDES,
TEENAGERS DON'T WANT HELP AGAIN
. MY TEENAGER FAMILY MEMBER
WANTED HELP. AFTER MANY, MANY
HOURS OF RESEARCH TO IDENTIFY
AND APPROPRIATE FACILITY AND
AFTER CONFIRMING WITH THAT
FACILITY, THEY ACCEPT KAISER
INSURANCE. MY FAMILY ASKED
PFIZER TO COVER THE COST. KAISER
WAS FURIOUS, AND THEY CALLED THE
FACILITY AND DEMANDED THAT THE
FACILITY STOP TELLING THE PUBLIC
THAT KAISER WILL PAY FOR
ENROLLEES AT THEIR FACILITY. I
JUST WANTED TO KEEP IT SECRET
AGAIN MORE MANIPULATION AND THEN
ATTEMPTED BARRIER. THE LAST
EXAMPLE DURING THAT SAME MONTH,
MY MINOR FAMILY MEMBER 2018
DURING THAT TIME, HEUSER TOLD MY
FAMILY THAT THEY IT WOULD BE
BETTER FOR THEM TO GET MY THE
NOW ADULT YOUNG ADULT ONTO THE
PUBLIC SYSTEM MENTAL HEALTH
SYSTEM, THEY WOULD RECEIVE
BETTER CARE AGAIN. MANIPULATION
AND ATTEMPTED BARRIER. MY FAMILY
MEMBERS STILL STRUGGLES SHE'S
ALIVE. UM, CONTINUES TO FIGHT
WHILE ON HER PARENTS' INSURANCE
. AND UNFORTUNATELY ALL THESE
EXAMPLES THAT I GAVE ARE VERY
REPRESENTATIVE OF MANY, MANY
SIMILAR EXPERIENCES ACROSS OUR-STATE AND SPECIFICALLY IN
NORTHERN CALIFORNIA. IN CLOSING
, WE NEED TO HOLD COMPANIES
ACCOUNTABLE AND ELIMINATE THE
EGREGIOUS, COMPLACENT SYSTEM
THAT ROUTINELY PLACES PEOPLE IN
HOLDING PATTERNS OF 68, PLUS
MONTHS, PREVENTING MENTAL HEALTH
CARE. PLEASE DON'T ALLOW THESE
COMPANIES TO HIDE BEHIND THE
STAFFING SHORTAGES. SMOKESCREEN
LET'S FIX WHAT IS IN FRONT OF US
INSTEAD OF SOLELY FIXATING ON
THE NEED TO ADD WORKERS TO AN
ALREADY BROKEN SYSTEM WILL WORK
FOR SHORTAGE IS NOT AN EXCUSE AS
TO WHY WE SHOULDN'T AND CAN'T
ADDRESS THE TIMELY ACCESS ISSUE.
LASTLY ALIGNED WITH THE
COMMITTEE'S CONCERNS, UM, TO BE
PROACTIVE DURING THE STRIKE. WE
ASKED THAT HEUSER IN GOOD FAITH,
PROACTIVELY ENSURE. THAT THEY
DON'T JUST CANCEL APPOINTMENTS
DURING THE STRIKE, BUT THEY ALSO
INFORM ENROLLEES OF THEIR RIGHTS
TO OBTAIN OUT OF NETWORK CARE
HOVERED BY KAISER WITHOUT
ADDITIONAL COSTS TO THESE
ENROLLING WE REMAIN AVAILABLE TO
COLLABORATE TO ASSIST IN
RESOLVING THESE ISSUES. AND WE
THANK YOU FOR THIS VERY
IMPORTANT HEARING TODAY. THANK
YOU VERY MUCH. JUST ASK, UM,
BECAUSE EACH OF YOUR COMMENT ON
OKAY. KAISER WAS ON A YOU STATED
THAT THEY DIDN'T HAVE THE
RESOURCES. UM HOW DID AND I
THINK YOU TOUCHED ON THIS TO AN
EXTENT, BUT BECAUSE JUST SORT OF
CRISPLY. IN TERMS OF OUT OF
NETWORK CARE. WHAT DID THEY WHAT
DID THEY SAY ABOUT THAT?
SPECIFICALLY? THEY SAID THEY
DON'T HAVE THOSE TYPES OF
SERVICES AVAILABLE AND THEY
DON'T COVER THOSE TYPES OF
SERVICES. AS IT TURNED OUT, THE
FACILITY DID HAVE KAISER
PATIENTS IN IN THEIR FACILITY,
AND THEY DID COVER IT. WHAT
ULTIMATELY ENDED UP HAPPING IN
IS THROUGH THE APPEALS AND THE
GRIEVANCE PROCESSED FOOD
DEPARTMENT OF MANAGED HEALTH
CARE. THAT WAS THE FACILITY THAT
KAISER DID ULTIMATELY WAS
ORDERED TO HAVE TO PAY AND THAT
WAS OUT OF NETWORK. CORRECT.
OKAY AND MISS HICKS. YEAH WE
ULTIMATELY FOUND AT FUNDRAISING
AND FOUND A PRIVATE FACILITY FOR
MY DAUGHTER AND ACTUALLY, THE
SAME THING HAPPENED. KAISER WHEN
THEY FOUND OUT THAT SHE WAS IN
THAT FACILITY CALLED THAT
FACILITY AND TOLD THEM TO STOP
PROVIDING HER CARE AND THAT THEY
WERE NOT GOING TO PAY FOR IT.
AND THEY CHASTISED US FOR
PUTTING HER IN THERE. UM, AND WE
ULTIMATELY UH, JUST HAD TO END
UP PAYING OUT OFPOCKET FOR IT.
AND WHEN YOU SAY WHAT THEY
CHASTISED THEM, DID THEY? WERE
THEY CALLING THEM? YEAH THEY
THEY THEY JUST THEY JUST STARTED
TO HOW DID YOU YOU KNOW? WHY DID
YOU ADMIT HER? WE'RE NOT GOING
TO PAY FOR THIS. YOU SHOULD HAVE
CONTACTED US FIRST AND THEY JUST
TRIED TO INTIMIDATE THEM, AND IT
WAS JUST VERY KIND OF BAFFLING,
UM, THAT THEY THAT THEY WERE
DOING THAT TO MYSELF AND THE
ACTUAL FACILITY. OKAY? UM
COLLEAGUES. ANY QUESTIONS,
SENATOR CORTESI? YES. THANK YOU,
MR LET ME JUST SAY I'M VERY
SYMPATHETIC AND I'LL EVEN GO
FURTHER AND SAY, EMPATHETIC TO
THE TESTIMONY THAT WE JUST HEARD
FROM BOTH WITNESSES. I'M SURE
I'M NOT THE ONLY ONE. IN THE
STATE SENATE THAT HAS LIVED
EXPERIENCE THAT, UM THAT WOULD
CAUSE ME TO BE EMPATHETIC, BUT I
DO AND I'M NOT GONNA GO INTO
THAT. BUT MY QUESTION IS IN A
NO. WE'RE VERY FOCUSED ON KAISER
TODAY. BUT I'D LIKE TO ASK EACH
OF THE WITNESSES GIVEN HOW MUCH
WORK THEY HAVE DONE IN THIS
SPACE. UM AND HIS HIS AGAIN, UM
, ACKNOWLEDGING WHAT I FEEL IS
UM, THE VERACITY OF YOUR
TESTIMONY. HOW DO YOU HOW DO YOU
RESPOND TO THE LARGER ISSUE OF.
LACK OF BIDS. LACK OF PSYCH
BEDS. UM YOU KNOW IF YOU'RE.
LOVED ONE ENDS UP, YOU KNOW,
CHECKED IN AT STANFORD OR.
COUNTY HOSPITAL OR UCSF, FOR YOU
KNOW, NORTHERN CALIFORNIA
HOSPITALS, YOU KNOW, I COULD GO
ON AND ON, I THINK TYPICALLY,
THE RESPONSE IS EVEN WHEN, UM, A
PSYCH BED IS RECOMMENDED. WHEN
THAT IS RECOMMENDED. AH, THAT.
THERE'S A LACK OF FACILITIES
THAT THERE'S JUST, UH YOU KNOW,
I'M I'M CONNECTING THAT A LITTLE
BIT IN MY OWN HEAD WITH THE
COMMENTS. UM PARAPHRASING YOUR
OWN TESTIMONY THAT YOU KNOW,
THERE'S JUST A LACK OF SERVICES
OR LACK OF FACILITIES. I DON'T
ASK THAT QUESTION TO GET KAISER
OR ANYONE ELSE OFF THE HOOK. I'M
JUST WONDERING WHAT YOUR
PERSPECTIVE IS ON THE LARGER THE
BIGGER PICTURE IN TERMS OF LACK
OF FACILITIES BECAUSE I THINK
IT'S ALSO SOMETHING THAT'S YOU
KNOW, CRITICAL FOR THE STATE
SENATE TO KEEP DEALING WITH I
APPRECIATE THAT THAT QUESTION.
AND IT IS DIRECTLY IN LINE WITH
TIMELY SERVICE BECAUSE HERE AT
MENTAL HEALTH AMERICA OF
CALIFORNIA WE ADVOCATE FOR
VOLUNTARY ACCESS TO TREATMENT IF
WE HAD FOR THE MAJORITY OF
SITUATIONS IF WE HAD TIMELY
ACCESS TO CARE, WE WOULD NOT
NEED THOSE CRISIS BETS. WE WOULD
NOT NEED TO BE IN A POINT OF
CRISIS AND THAT IS GOES HAND IN
HAND WITH THE TIMELY RESPONSE.
UM FOR MY FAMILY MEMBER. BY THE
TIME WE GOT TO CRISIS WE HAD
ALREADY BEEN FIGHTING FOR A
YEAR. WE DO NOT ADVOCATE FOR
MORE INPATIENT HOSPITAL CRISIS
BEDS. WHAT WE ADVOCATE ON BEHALF
OF IS WAR SERVICES UPFRONT,
TIMELY SERVICES UPFRONT
COMMUNITY BASED SERVICES THAT
ARE ACCESSIBLE. UM OR IF
NECESSARY RESPITE BEDS IF ABED
IS NECESSARY TO WEAR AN
INDIVIDUALLY INDIVIDUAL
VOLUNTARILY, AND IT'S THEMSELVES
INTO A RESPITE CENTER OR
ASSISTANCE AND AGAIN WAY EARLIER
ON THE CONTINUUM OF CARE BEFORE
THEY REACHED THE POINT OF
CRISIS. IF I COULD JUST FOLLOW
UP ON THAT BEFORE GOING TO THE
OTHER WITNESS IN SO I GUESS
WHAT? I'M ASKING HIM. IT'S
SUGGESTING THERE'S AN EASY
ANSWER TO THIS. IN THIS
SCENARIO, WHERE THAT EARLY CARE.
UM. I KIND OF TAKE THAT AS A
PREVENTATIVE CARE. YOU KNOW,
EARLY INTERVENTION. UM, AND AN
APPROPRIATE CARE. STILL. UM, FOR
WHATEVER REASON, WITH THAT
PARTICULAR PATIENT. ENDS UP
CLIENT OR PATIENT ENDS UP. UM
RESULTING IN THE OUTCOME. WE
DIDN'T WANT A 51 50, FOR
EXAMPLE, UM YOU KNOW, HOSPITAL
STAY THAT, UM, NEEDS TO BE
EXTENDED, UH, YOU KNOW, BY 50 TO
50 OR BY JUST BY VOLUNTARY UM,
YOU KNOW, WILLINGNESS TO SEEK
TREATMENT. UH YOU KNOW, I GUESS
I GUESS MY VIEW FROM AGAIN FROM
IT'S NOT ENTIRELY ANECDOTAL.
IT'S FROM SERVING IN ONE OF THE
LARGEST COUNTIES. IN THE SECOND
LARGEST HEALTH AND HOSPITAL
SYSTEM IN THE STATE AS A COUNTY
SUPERVISOR AND AGAIN WITH A
LARGE EXTENDED FAMILIES HAVE
LIVED EXPERIENCE ABOUT DIFFICULT
IT IS WHEN ALL OF THAT FAILS.
GIVEN THE SEEMING EPIDEMIC OF
MENTAL HEALTH ISSUES, PSYCHOSIS.
YEAH. YOU KNOW, SCHIZOPHRENIA IS
SUCH THAT WE HAVE THAT WHEN YOU
WHEN YOU JUST NEED A
STABILIZATION PERIOD HE CAN'T
FIND ABED AND AGAIN, THAT'S NOT
TO GET KAISER OFF THE HOOK. UM,
BUT I GUESS I GUESS MY PREMISES.
AS MUCH AS WE NEED EARLY
INTERVENTION AS YOU JUST SPOKE
TO EARLY TREATMENT. UM WE ALL
KNOW THAT THE NATURE OF THE
DISEASE IS OFTEN THAT, UM IT
RESURFACES AND RESURFACES AND IN
SUCH A WAY THAT PEOPLE NEED TO
BE STABILIZED. BECAUSE I GUESS
WHAT I'M SAYING, AND I'LL GET MY
OPINION OUT THERE IS, I THINK,
WHETHER IT'S KAISER OR ANYBODY
ELSE. WE NEED THOSE FACILITIES
AVAILABLE. THERE SHOULD BE NO
EXCUSE TO NOT PROVIDING THEM.
THAT'S THAT'S MY OPINION. BUT
I'M ASKING FOR YOUR OPINION.
THANK YOU. IT'S NOT WHAT WE SEE
TIME AND TIME AGAIN, AND WHEN
YOU LOOK AT THE STUDIES, IT'S
NOT THE VIOLENT. IT'S NOT THE
INVOLUNTARY PROCESS IN WHICH
ALLOWS AN INDIVIDUAL TO GET
BETTER. IT IS THE ACCESS TO
THOSE SUPPORTS AND SERVICES THAT
THEY RECEIVE ONCE IN ADMITTED TO
A HOSPITAL, SO IT'S OUR WHAT WE
ADVOCATE FOR, AND IT DOES. IT
GOES HAND IN HAND WITH EARLY
ACCESS, BUT IT'S ACCESS AT ALL
OR TIMELY ACCESS. IT'S ACCESS TO
SUPPORTS AND SERVICES. IT IS
EVEN WHEN INDIVIDUALS WHEN YOU
LOOK AT A O T AND R, STAY OUT
PATIENT, AND, UM TREATMENTS.
IT'S NOT THE MANDATORY VARIABLE
OF THOSE TREATMENTS THAT ALLOW
AN INDIVIDUAL TO GET BETTER.
IT'S HAVING ACCESS TO THOSE
SUPPORTS AND SERVICES AND MANY
INDIVIDUALS HUGHES TO TAKE
ADVANTAGE OF THOSE SUPPORTS AND
SERVICES WHEN THEY HAVE ACCESS
TO THEM. IT IS IT ISN'T THAT A
COMPREHENSIVE ISSUE THAN ACROSS
ACROSS. HEALTHCARE ENTITIES.
MAYBE THAT'S WHAT I'M ASKING.
LET'S SUPPOSE I AGREE WITH
EVERYTHING YOU JUST SAID. DON'T
WE HAVE A COMPREHENSIVE ACCESS
ISSUE? THAT ABSOLUTELY. IT'S A
CONTINUUM OF CARE. ALL RIGHT.
THANK YOU. ABSOLUTELY SURE. I
DIDN'T KNOW IF THE OTHER
WITNESSES WANTED TO SAME THING
ON THAT. ARE UM UH, SHE'S AH,
WELCOME IF SHE WOULD LIKE WELL,
I'LL JUST ADD TO THAT. THAT, UM
HE HAD MY DAUGHTER HAD SIX YEARS
BETWEEN WHEN SHE WAS DIAGNOSED
INITIALLY AND WHEN SHE REALLY
NEEDED HOSPITALIZATION, AND THAT
SIX YEARS IF PLEAD FOR, UM, JUST
THERAPY AND CARE FOR TO HELP
STABILIZE AND I DO REMAIN
CONVINCED THAT IF SHE HAD HAD
THAT CARE, IT WOULD NOT HAVE LED
TO THIS, BUT WE'VE EXPERIENCED
BOTH THE LACK OF PREVENTATIVE
CARE AND THE LACK OF, UM,
EMERGENCY CARE. THANK YOU. THANK
YOU AGAIN, MR. CHAIR THANK YOU.
COLLEAGUES ANY ADDITIONAL
QUESTIONS? YES, SENATOR NELSON.
BUT THANK YOU. MR CHAIRMAN. I
MUST CONFESS THAT WHAT I
LISTENED TO IS AGONIZING AND
FRUSTRATING. BASED ON MANY, MANY
YEARS OF DEALING WITH THESE
HEALTH ISSUES, NOT JUST MENTAL
HEALTH, BUT DD AND OTHERS. AND
THE PLAINTIFF CRIES OF FAMILIES.
AND THE RESISTANCE OF SOME
PROVIDER ORGANIZATIONS. THE
DILATORY ASUS TECHNIQUES THAT
THEY EMPLOY TO DISCOURAGE.
PARTICIPATION. OR PLACEMENT. OR
TREATMENT. OR EVALUATION. OR THE
RUDENESS, WHICH I'VE HEARD HEARD
EXPRESSED AND THE INTIMIDATION
SADLY, IT IS MY OPINION THAT IS
MORE TYPICAL THAN NOT. AND IT IS
A CHALLENGE I THINK TO
PROVIDERS. TO BE MORE
RESPONSIVE. AND THAT'S WHY I'M
GLAD THAT THE COMMITTEE HERE IS
ADDRESSING THIS PORTION OF A
MUCH LARGER ISSUE. I'LL NEVER
FORGET AS A BRAND NEW SENATOR
MANY YEARS AGO. I'VE NEVER BEEN
EXPOSED TO THE D D ISSUE
DEVELOPMENT, DISABILITY OR
MENTAL HEALTH. BUT I END UP THE
SENATOR FOR NAPA STATE HOSPITAL
AND SONOMA STATE HOSPITAL. WELL
TO SAY IT WAS A SHOCK. WOULD BE
TO PUT IT MILDLY. AND THAT'S
JUST THE TOURING OF THE FACILITY
IN THE VIEWING OF THE
CIRCUMSTANCES OF THE RESIDENTS
THERE IN AND THE SYSTEM. THAT
THEY WERE A PART OF. BUT THE
NEXT LEVEL WAS DEALING WITH THE
FAMILIES. AND THE AGONY. OF THE
FAMILIES AS EXPRESSED HERE
TODAY. FAMILIES WHO HAVE
ENCOUNTERED THE SYSTEM.
DESPERATELY TRYING TO SEEK HELP
AND ASSISTANCE AND COMFORT AND
DIRECTION. FOR THE LOVED ONE.
AND MEETING RESISTANCE. OR
RUDENESS. NOW THERE ARE MANY
PROVIDER NAMES THAT I COULD
THROW OUT HERE. I'M NOT GOING TO
DO THAT. WE'VE GOT ONE BEFORE US
TODAY, BUT THERE ARE MANY. AND
THEY TAKE MANY FORMS. AND MR
CHAIRMAN. I'M GLAD THAT WE'RE
FORMALIZING THE COMMITTEE AND
THAT WE WILL BUILD ON THIS FOR
FUTURE DIALOGUE AND HOPEFUL
RESOLUTION. AND SIMPLY THROWING
MONEY AT IT IS NOT THE ANSWER.
IT'S HOW THE SYSTEM EVOLVES OR
DEVOLVES. AND I ENCOURAGE
PROVIDERS. WE HAVEN'T HEARD TOO
MUCH FROM THE PROVIDER TYPE
TODAY, BUT I EXPECT THEY'LL WANT
TO SPEAK UP. THEY'LL TALK ABOUT
STRIKES. I'VE TALKED ABOUT
LIABILITIES. WELL MAYBE WE ARE
DRIVEN BY THOSE ISSUES. BY
ATTORNEYS. BUT WE OUGHT TO BE
BALANCING THAT WITH THE ADVICE
OF PROVIDER. PROVIDERS. MEDICAL
PROFESSIONALS. WHO REALLY FACED
A LOT OF CHALLENGES ON THEIR
OWN. THIS IS KIND OF AN OVERVIEW
OF AN EXPRESSION OF THE HEART.
BUT WHAT OVER THE DECADES FOR ME
HAS GONE FROM THE HEART TO
OVERALL PASSION. TO ADVOCATE FOR
INDIVIDUALS. AND SOME OF THE
POSITIONS THAT I HAVE NOW COME
TO ARE NOT TRADITIONALLY WHAT I
WOULD HAVE BEEN. IN TERMS OF
BEING SYMPATHETIC TO PROVIDERS.
INCLUDING MAJOR MEDICAL
ASSOCIATIONS. I THINK THEY DO.
DO I SAY THIS SERVICE? THAT'S AN
OBSERVATION. MR CHAIRMAN. I LOOK
FORWARD TO CONTINUING THE
DIALOGUE HERE TODAY. AND I
APPRECIATE THE OPPORTUNITY OF
THESE INDIVIDUALS TO SPEAK TO
US. THANK YOU, SENATOR NELSON,
SENATOR PAN. THANK YOU AND
AGAIN, I WANT TO THANK THE
WITNESSES FOR THEIR TESTIMONY
AND CERTAINLY, UH FEEL THEIR
FRUSTRATION AS A PHYSICIAN WHO
TAKES CARE OF CHILDREN WHO HAVE
DEVELOPMENTAL DELAYS OR
BEHAVIORAL ISSUES. I WOULD ALSO
MAKE NOTE, AND I APPRECIATE THE
COMMENTS FROM, UH MY GOOD FRIEND
, SENATOR NIELSEN. WE ALSO NEED
TO RECOGNIZE THAT, UM AH! PEOPLE
PROVIDING CARE. ACTUALLY. ARE
THE ONES WHO HAVE TO LOOK AT THE
PATIENTS IN THE EYES. AND TOO
OFTEN, THEY ALSO WORK IN
CIRCUMSTANCES AND SYSTEMS WHERE
THERE ARE PEOPLE WHO DON'T HAVE
TO FACE THE PATIENTS AND TALK TO
PATIENTS AND LOOK AT PATIENTS IN
THE EYE. WHO THEN SET THE RULES.
ENGAGEMENT THEY DECIDE THE
PAYMENTS. THEY DECIDE WHAT
RESOURCES ARE AVAILABLE OR NOT.
AND HENCE, ACTUALLY SOME OF MY
REMARKS AND THE INTRODUCTION,
WHICH IS THAT UM IF WE DON'T
HAVE INCENTIVES FOR WITHIN THE
SYSTEMS. TO ACTUALLY TAKE CARE
OF THE PATIENTS. BECAUSE THE
INCENTIVE MIGHT BE TOO. LET'S
NOT PROVIDE REALLY GREAT CARE,
BECAUSE MAYBE THEN THOSE
PATIENTS WILL GO SOMEWHERE ELSE.
AFTER ALL, IT COSTS US MONEY.
MORE MONEY THAN A DIFFICULT
FAMILY. OR YOU HAVE A
CIRCUMSTANCE WHERE YOU'RE TOLD
THAT AND CERTAINLY HAD THAT
EXPERIENCE BY THE WAY. THEY ALSO
STATE WORKERS WHERE THEY'RE TOLD
BY THEIR BOSS, THEIR MANAGERS TO
THE ROUTE IS NOT CORRECT TERM
BUT ESSENTIALLY SET RULES FOR
HOW YOU YOU'RE SUPPOSED TO
INTERACT WITH THE PUBLIC IN WAYS
THAT MAKES IT DIFFICULT. UM. TO
UH, FOR PATIENTS TO GET A
POSITIVE RESPONSE SAID YOU'RE
TOLD. YOU HAVE TO SAY NO, NO, NO
OVER OVER AGAIN. BECAUSE THAT'S
WHAT YOUR IF YOU WANT TO KEEP
YOUR JOB. AND IN FACT, I THINK
THE REASON WE'RE ABOUT TO HAVE A
STRIKE IS BECAUSE. THE VERY
PEOPLE WHO HAVE TO LOOK THE
PATIENTS IN THE EYE. ARE ALSO
YOU KNOW, BASICALLY ARE
FRUSTRATED THAT THEY CAN'T
ACTUALLY TAKE CARE OF THE
PATIENTS THE WAY THEY'VE BEEN
TRAINED TO. THE WAY THEY THINK
THEY SHOULD BE TAKEN CARE OF.
AND THEY'RE NOT BEING GIVEN THE
SUPPORT AND THE RESOURCES TO DO
THAT, AND SO UM, YOU KNOW, AS
WE'RE HAVING OUR DISCUSSIONS
WITH HEARING FROM PATIENTS AND
ALSO THE MHC AND SO FORTH. UM WE
REALLY HAVE TO THINK ABOUT WHERE
THE POLICIES THAT ENSURE THAT WE
HAVE A SYSTEM THAT FACILITATES
THE CARE. PROVISION OF CARE OF
MENTAL HEALTH WHEN WE THINK
ABOUT OUR WORKFORCE WHY WOULD
SOMEONE WANT TO GO INTO A
PROFESSION WHERE THEY ONLY
EXPERIENCE FRUSTRATION? WILL BE
TRAINED AND TOLD THAT YOU SHOULD
DO X AND THEN WHEN YOU GO TO
WORK, YOU'RE TOLD YOU CAN'T DO
X. YOU GOT TO DO WHY? BECAUSE
IT'S TOO EXPENSIVE. IT'S
WHATEVER FOR OTHER REASONS, AND
I WOULD SAY CERTAINLY, MENTAL
HEALTH IS NOT THE ONLY AREA
WHERE WE FACE THIS CHALLENGE. I
THINK WE'VE SEEN THIS IN
EDUCATION. YOU KNOW, WE TALKED
ABOUT THE TEACHERS SHORTAGE. WE
DO SEE THIS IN MENTAL HEALTH OR
MENTAL HEALTH SHORTAGE. UM AND
SO HOPEFULLY UM, IN ADDITION TO
ENSURING THAT PATIENTS CONTINUE
TO GET CARE AND NOT DISRUPTION
DURING STRIKE, WE SHOULD BE
LOOKING AT THESE LARGER SYSTEMS
ISSUES AS WELL AND HOLDING.
HOLDING THE PEOPLE ACTUALLY
CONTROL THE RESOURCES MAKING
DECISIONS ACCOUNTABLE. AND AND
THAT'S GOING TO BE VERY
IMPORTANT BECAUSE AGAIN IT'S THE
PROVIDERS WHO ARE ACTUALLY THE
PEOPLE ON THE FRONT LINES. THE
PROFESSIONALS WE'RE WORKING WITH
THE PATIENTS. CERTAINLY I THINK
YOU KNOW THE PATIENTS AND THE
FAMILIES. THEY'RE THEY'RE
FEELING THE MOST. AND THEN THE
ONES WHO ACTUALLY HAVE TO
INTERACT WITH THEM WHO SHOULD
WANT TO INTERACT WITH THEM WHO
ARE LOOKING THEM IN THE EYE WHO
WANT TO HELP THEM? NEED TO BE
ABLE TO HELP THEM. THANK YOU.
THANK YOU, SENATOR. PAN OKAY, SO
I WANT TO THANK MS TRUNK AND
THIS HIGGS FOR YOUR FOR YOUR
TIME AND TODAY AND FOR SHARING
PERSONAL DIFFICULT STORIES.
THANK YOU. WE'RE NOT GOING TO GO
TO OUR FINAL PANEL, WHICH IS
HEARING FROM THREE UH PROVIDERS
. UM, WE'LL BE HEARING FROM
SARAH SAROKIN, WHO'S A KAISER
CLINICIAN? UH EXCUSE ME, DR.
SARAH. SARAH OGAN. DOCTOR BRANDY
PLUMLEE, UM, KAISER CRISIS
RESPONSE THERAPIST. AND DR EMILY
WOULD WHO IS THE CHAIR OF THE
GOVERNMENT AFFAIRS COMMITTEE FOR
THE CALIFORNIA STATE
ASSOCIATION. OF PSYCHIATRISTS.
SO THANK YOU TO THE THREE OF YOU
FOR BEING HERE TODAY WE'LL START
WITH DR SAROKIN. HI SO MY NAME
IS SARAH SARAH OCON, AND I'M A
LICENSED MARRIAGE AND FAMILY
THERAPIST AT KAISER IN THE NAPA
SOLANO SERVICE AREA. PRESENTLY
KAISER IS NOT IN COMPLIANCE WITH
CALIFORNIA'S LEGAL REQUIREMENTS
FOR TIMELY ACCESS TO BEHAVIORAL
HEALTHCARE. AS UPDATED BY SP 2
21. MOST PATIENTS CONTINUE TO
WAIT 4 TO 12 WEEKS BETWEEN
INDIVIDUAL PSYCHOTHERAPY
APPOINTMENTS IF THEY'RE ABLE TO
GET CONNECTED TO A THERAPIST FOR
TREATMENT AT ALL. IN MY SERVICE
AREA, THE VAST MAJORITY OF
PATIENTS WITH MODERATE TO SEVERE
SYMPTOMS MUST WAIT MORE THAN
THREE MONTHS FOR EVEN THEIR
FIRST INDIVIDUAL THERAPY
APPOINTMENT. PATIENTS WITH MILD
TO MODERATE SYMPTOMS REFERRED TO
KAISER'S INADEQUATE EXTERNAL
PROVIDER NETWORK CALLBACK WEEKS
AND MONTHS LATER AFTER NOT
GETTING CONNECTED TO NEEDED
CARE, BEGGING FOR AN
APPOINTMENT. THERE IS NOTHING IN
THE RESEARCH LITERATURE OR
GENERALLY ACCEPTED STANDARDS OF
CARE THAT SUPPORTS WEIGHTS OF
THESE LENGTHS WHEN PATIENTS ARE
EXPERIENCING ACTIVE SYMPTOMS OF
DEPRESSION, ANXIETY, BIPOLAR
DISORDER, SCHIZOPHRENIA OR ANY
MENTAL HEALTH OR SUBSTANCE USE
DISORDER. AS A TRIAGE THERAPIST
. I SPEAK WITH PATIENTS IN
CRISIS WHO NEED MORE INTENSIVE
AND COSTLY TREATMENT BECAUSE
THEIR CONDITIONS WORSENED DURING
LONG WAITS BETWEEN APPOINTMENTS.
PATIENT'S PROGNOSIS DETERIORATE
AND MANY SUFFER INABILITY TO
FUNCTION AT WORK OR HOME, SEVERE
EMOTIONAL PAIN AND EVEN SUICIDE
ATTEMPTS AND HOMELESSNESS. OUR
PATIENTS INCLUDE ADULTS AND
CHILDREN, THOSE ON MEDICAL AND
MEDICARE, THOSE FROM
HISTORICALLY MARGINALIZED AND
UNDERSERVED GROUP. AND OUR
FAMILY MEMBERS, FRIENDS AND
NEIGHBORS. AS A CLINICIAN. IT IS
HEARTBREAKING NOT TO BE ABLE TO
PROVIDE PATIENTS WITH THE CARE
THEY NEED AND DESERVE. I'D LIKE
TO SHARE WITH THE COMMITTEE
IMAGES OF KAISER'S APPOINTMENT
SCHEDULING SYSTEM PROVIDED BY A
WHISTLEBLOWER THAT DOCUMENT
EXCESSIVE WAITS FOR SECONDARY
INTAKE APPOINTMENT FOR ADULT
PATIENTS AT 10 SEPARATE CLINICS
ACROSS NORTHERN CALIFORNIA.
SO AS YOU CAN SEE FOR THE FIRST
CLINIC. BOTH UM, THE NEXT
AVAILABLE APPOINTMENT IS
SEPTEMBER 20TH 6.5 WEEKS AWAY.
FOR THE NEXT FIVE CLINICS,
MODESTO. ROOSEVELT SACRAMENTO.
HOW AVENUE. SACRAMENTO DOWNTOWN
AND STOCK THEN THE NEXT
AVAILABLE APPOINTMENTS ARE
ADMITTED TO LATE OCTOBER. PUT,
UM BUT. AND SO THESE CLINICS IN
QUESTION ARE IDENTIFIED. I
FORGOT IF I MENTIONED THIS PART
BUT IDENTIFIED BY THREE LETTER
ABBREVIATIONS, AND FOR EACH
RECORD THE ELAPSED APPOINTMENT
WAIT. TIME IS CALCULATED FROM
AUGUST 3RD ONE MONTH AFTER SB 2
21. AND FOR, UM, THE LAST FOUR
CLINICS RANCHO CORDOVA, REDWOOD
CITY, SAN MATEO AND GALILEO.
THERE ARE NO NEW APPOINTMENTS
WHATSOEVER AVAILABLE. THESE LONG
WAITS ARE IN CLEAR VIOLATION OF
THE LAW AND HAVE REAL AND
FREQUENTLY SEVERE CONSEQUENCES
FOR PATIENTS. I HAVE A VALUE
WAITED A PATIENT IN THE
EMERGENCY DEPARTMENT WHO
ATTEMPTED SUICIDE AFTER
RECEIVING AN EXTERNAL REFERRAL
FOR INDIVIDUAL THERAPY, THEN
CALLING THROUGH THE LIST OF
THERAPIST TO FIND NONE WERE
AVAILABLE. I HAVE SPOKEN WITH A
PARENT WHOSE CHILD WAS FORCED TO
WAIT A MONTH AND A HALF BURN
INDIVIDUAL PSYCHOTHERAPY
APPOINTMENT DESPITE HAVING MADE
A RECENT SUICIDE ATTEMPT. I HAVE
TALKED WITH PATIENTS WITH
SERIOUS MENTAL ILLNESSES WHO
HAVE BECOME INCREASINGLY
SYMPTOMATIC AND HOMELESS DURING
LONG APPOINTMENT, WAIT. HAVE
ASSESSED COUNTLESS PATIENTS
CALLING IN CRISIS ON FRIDAY
AFTERNOONS WHO HAVE BEEN FORCED
TO WAIT FOR URGENT CARE UNTIL
MONDAY BECAUSE KAISER DOES NOT
OFFER URGENT APPOINTMENTS ON
WEEKENDS. I WAS CLINICIAN. WE
HAVE MADE PROPOSAL AFTER
PROPOSAL TO KAISER FOR GREATER
INVESTMENT IN TIMELY CARE, AND
KAISER HAS REJECTED ALL OF THEM
. WE HAVE WORKED HARD TO HELP
PASS LEGISLATION TO IMPROVE
PATIENT ACCESS. BUT KAISER DOES
NOT COMPLY WITH THE LAW. NOW
CLINICIANS FEEL WE HAVE NO OTHER
OPTION BUT TO STRIKE WE DON'T
MAKE WE DON'T MAKE THAT CHOICE
LIGHTLY, BUT AS A LAST RESORT WE
URGE YOU TO DO EVERYTHING IN
YOUR POWER TO ENFORCE PATIENTS
RIGHTS TO CARE. RIGHTS WHICH
THEY HAVE, EVEN DURING A WORK
STOPPAGE AND TO HOLD KAISER
ACCOUNTABLE TO MEET THE
REQUIREMENTS OF THE LAW. THANK
YOU. THANK YOU VERY MUCH NEXT TO
HEAR FROM BRANDY PLUMLEE, UH,
KAISER CRISIS RESPONSE
THERAPIST. THANK YOU. MY NAME IS
BRANDY PLUMLEE AND I'M A
LICENSED MARRIAGE AND FAMILY
THERAPIST AT KAISER IN RICHMOND.
AS A FRONTLINE THERAPIST. IT IS
EXTREMELY FRUSTRATING TO SEE
KAISER, WHICH MADE THE SURPLUS
OF 8.1 BILLION LAST YEAR,
CONTINUED TO DENY PATIENTS
TIMELY ACCESS TO BEHAVIORAL
HEALTHCARE, TO WHICH THEY ARE
ENTITLED UNDER THE LAW. I HAVE
BEEN AT KAISER FOR 10 YEARS. AND
I HAVE SPOKEN WITH COUNTLESS
PATIENTS WHO CANNOT GET THE CARE
THEY NEED. IT IS TRULY
HEARTBREAKING TO ME THAT
PATIENTS WHO ARE EXPERIENCING
PTSD DEPRESSION, ANXIETY SO
DEBILITATING THAT IT IMPACTS
THEIR DAILY FUNCTIONING ARE
SUBJECTED TO LENGTHY APPOINTMENT
RATES AND WEIGHTLESS. EVEN
PATIENTS SEEM TO HAVE MILD TO
MODERATE SIMPSON SYMPTOMS AND
REFERRED TO KAISER'S EXTERNAL
NETWORK PROVIDER OR OFTEN HAVING
TROUBLE FINDING AN AVAILABLE
THERAPIST. HI SERVICE,
BEHAVIORAL HEALTH CLINICS. ARE
SEVERELY UNDERSTAFFED, AND
KAISER IS UNWILLING TO INVEST
WHAT IS NECESSARY TO BECOME
COMPLIANT WITH SP 2 TO 1,
IMPROVING WORKING CONDITIONS TO
ATTRACT AND RETAIN THE STAFF
NECESSARY TO TREAT OUR PATIENTS
. KAISER SIMPLY BLAMES WORKFORCE
SHORTAGES. THE TRUTH IS, IS THAT
KAISER IS UNDERSTAFFING HAS BEEN
PERSISTENT, STRETCHING BACK LONG
BEFORE COVID. ACCORDING TO L. A
OH, THERE ARE HIGH NUMBERS OF
LICENSED THERAPIST IN MAJOR
METROPOLITAN AREAS OF
CALIFORNIA, WHERE KAISER HAS
MOST OF ITS CLINICS. THE TRUTH
IS THAT KAISER HAS DONE LITTLE
TO ATTRACT. AND RETAIN THERAPIST
. MEMBERS OF THE BROADER
COMMUNITY OF CLINICIANS KNOW
ABOUT THE POOR QUALITY OF CARE
AND WORKING CONDITIONS AT KAISER
AND DO NOT WANT TO WORK THERE.
WHILE KAISER'S INCUMBENT
CLINICIANS ARE LEAVING IN RECORD
NUMBERS. KAISER'S CHRONIC
UNDERSTAFFING, UNDERSTAFFING AND
WORKING CONDITIONS. IN THE PAST
YEAR 668 MINUTES OF HEALTH
CLINICIANS HAVE LEFT KAISER
THAT'S ALMOST TWICE AS MANY AS
THE PREVIOUS YEAR. OUR MEMBERS
SURVEY SHOWED 85% OF THESE
CLINICIANS LEAVING BECAUSE OF
UNSUSTAINABLE WORKLOADS. AND 76%
FEELING THEY WERE NOT ABLE TO
TREAT PATIENTS IN LINE WITH
MEDICAL NECESSITY AND GENERALLY
ACCEPTED STANDARDS OF CARE.
THERAPIST OF COLOR AND THOSE
PROFICIENT IN LANGUAGES OTHER
THAN ENGLISH ARE TASKED WITH
PROVIDING THE BULK OF KAISER'S
CULTURALLY AND LINGUISTICALLY
COMPETENT BEHAVIORAL CARE. TOO
MANY OF OUR PATIENTS OF COLOR
AND SPEAKERS OF PRIMARY
LANGUAGES OTHER THAN ENGLISH,
YET MAKEUP DISPROPORTIONATELY
SMALL NUMBERS OF OUR STAFF.
KAISER HAS NO PLAN TO ADDRESS
THE SHORTFALL. WICH WILL ONLY
WORSEN IN THE FUTURE. WE ALSO
MUST STRUGGLE TO EXPOSE AND
BREAK FREE FROM KAISER'S TACTICS
TO EVADE ENFORCEMENT OF TIMELY
ACCESS LAWS, TACTICS THAT
VIOLATE MEDICAL ETHICS. MOST
RECENTLY, KAISER RECONFIGURED AS
ELECTRONIC MEDICAL RECORDS TO
MAKE REINFORCED TO MAKE
ENFORCEMENT OF SP 2 TO 1 AND
POSSIBLE STARTING ON JULY 1ST.
WHEN SP 2 TO 1 BECAME LAW,
KAISER UPDATED THE ELECTRONIC
RECORDS AND MANY OF ITS SERVICE
AREAS WITH A SET OF DROP DOWN.
MENUS AND OTHER FEATURES THAT
STOPPED THERAPISTS FROM
ACCURATELY DOCUMENTING WHEN A
LONGER THAN 10 BUSINESS DAY WAIT
FOR AN INDIVIDUAL PSYCHOTHERAPY
APPOINTMENT WILL BE DETRIMENTAL
FOR PATIENTS. THERAPISTS WERE
BEING FORCED TO AFFIRM ARE ASKED
TO AFFIRM THAT THE DELAY WILL
NOT HARM THE PATIENT'S HEALTH.
UNTIL KAISER STOPS THESE ILLEGAL
AND UNETHICAL TACTICS AND STEPS
UP OR IS HELD ACCOUNTABLE TO
PROVIDE THE CARE OUR PATIENTS
NEED. THERAPISTS WILL CONTINUE
TO LEAVE KAISER AND RECORD
NUMBERS AND CONDITIONS WILL
FURTHER DETERIORATE. ALTHOUGH
KAISER HAS WONDERFUL AND
TALENTED CLINICIAN WHO WORK HARD
EACH DAY TO PROVIDE MENTAL
HEALTH AND SUBSTANCE USE
TREATMENT TO THOUSANDS OF
PATIENTS THE MORAL INJURY AND
BURNOUT CAUSED BY KAISER SYSTEM
OF AUSTERITY IS CRUSHING.
CONTINUE TO FAIL TO COMPLY WITH
SP 2 TO 1. IT IS UNCONSCIONABLE
THAT SUCH A WEALTHY COMPANY WITH
ENORMOUS SURPLUSES THAT TOUTS
ITS LEADERSHIP AND THE MENTAL
HEALTH FIELD IS FIELD FAILING
ITS PATIENTS AND CLINICIANS. WE
HAVE NEGOTIATED, PLEADED HELD
PRECEDENCE, FILED GRIEVANCES
WORK TO HELP PASS LEGISLATION
YET THE PROBLEM CONTINUES. WE
ARE LEFT WITH NO OTHER OPTIONS.
WE ASKED THE COMMITTEE TO URGE
GMHC TO HOLD KAISER ACCOUNTABLE
TO ALL LAWS AND REGULATIONS
REGARDING THEIR MEMBERS RIGHTS
TO TIMELY CARE BOTH NOW AND IN
THE EVENT OF A WORK STOPPAGE.
CLINICIANS SEE NO OTHER OPTION
TO IMPROVE CONDITIONS. THANK YOU
VERY MUCH. AND THEN FINALLY,
WE'LL HEAR FROM DR EMILY WOULD
THE CHAIR OF THE CALIFORNIA
STATE ASSOCIATION OF
PSYCHIATRISTS GOVERNMENT AFFAIRS
COMMITTEE. THANK YOU SO MUCH FOR
ALLOWING ME TO SPEAK TO YOU
TODAY ON BEHALF OF THE
CALIFORNIA STATE ASSOCIATION OF
PSYCHIATRISTS. AND IT'S FIVE
AFFILIATED AMERICANS, I GUESS
ASSOCIATION DISTRICT BRANCHES.
WE REPRESENT APPROXIMATELY 3000
PSYCHIATRISTS AND CALIFORNIA.
STOP SUPPORTED SENATOR WIENERS
AS THE 2 TO 1 AND ALSO SUPPORTS
THE UPCOMING AS B 25. WE ARE CO
SPONSORING, SUPPORTING MANY
BILLS AUTHORED BY OTHER MEMBERS
OF THIS MEETING. THANK YOU ALL
FOR EVERYTHING YOU DO
INDIVIDUALLY AND COLLECTIVELY TO
HELP IMPROVE BEHAVIORAL HEALTH
SERVICES IN CALIFORNIA. THANK
YOU FOR WORKING TO REFORM LPS
AND CONSERVATORSHIP LAW FOR
INVESTING SO MUCH OF THE LAST
SEVERAL YEARS AND ADDING BEDS IN
AND SIGNIFICANTLY GROWING THE
WORKFORCE IN THIS STATE AND MORE
WE STAND READY TO WORK WITH ALL
OF YOU NEXT SESSION. I'M A
GENERAL CHILD AND ADOLESCENT
PSYCHIATRIST WITH THE L. A
COUNTY DEPARTMENT OF MENTAL
HEALTH IN THE DIVISION OF
JUVENILE JUSTICE. ASIDE FROM L.
A COUNTY I'M NOT AFFILIATED WITH
ANY HEALTHCARE SERVICE PLANS FOR
INSURERS. PSYCHIATRISTS DO NOT
WORK IN A VACUUM AND ARE HIGHLY
DEPENDENT ON THEIR NON POSITION
COLLEAGUES TO PROVIDE ADEQUATE
EVIDENCE BASED MENTAL HEALTH
CARE. IT'S WIDELY KNOWN THAT
THEY'RE INADEQUATE NUMBERS OF
PSYCHIATRISTS, PROSTHESIS, EVEN
COUNTRY, ESPECIALLY CHILD AND
ADOLESCENT PSYCHIATRIST. SO
OFTEN WE TREAT THE INDIVIDUALS
IN NEED OF SERVICES. PREVIOUS
ESTIMATES HAVE SUGGESTED THAT 15
TO 26 PSYCHIATRISTS FOR 100,000
POPULATION REQUIRED IN
CALIFORNIA IS COMING IN UNDER
12. WHILE PSYCHIATRISTS ARE
TRAINED TO PERFORM ALL TYPES OF
MENTAL HEALTH TREATMENT,
INCLUDING PHARMACOLOGICAL
INTERVENTION AND PSYCHOTHERAPY,
AND YOU'RE THE ONLY PROVIDERS
WITH ADEQUATE TRAINING AND
PSYCHOPHARMACOLOGY AND MERRILL
INTERVENTIONAL TECHNIQUES.
FORTUNATELY, THE DATA SHOW THAT
FOR MANY OF THE MOST COMMON
MENTAL HEALTH DISORDERS QUALITY
PSYCHOTHERAPY IS AN EQUALLY
EFFICACIOUS OR PREFERRED FIRST
LINE TREATMENT COMPARED TO
MEDICATION AND MORE INVASIVE
TREATMENTS. WE WORK WITH AND
RELY ON OUR WELL TRAINED AND
HIGHLY SKILLED, NON POSITION.
MENTAL HEALTH CLINICIANS.
COLLEAGUES WHO CAN PROVIDE THESE
PSYCHOTHERAPEUTIC TREATMENTS.
THE BLINK OF EFFICACY STUDIES
UNDERLYING OUR PSYCHOTHERAPY
TREATMENTS HAVE BEEN BASED ON
METHODS AND MINISTERED AT LEAST
ONCE A WEEK. CLINICAL TRIALS AND
DURING VARIOUS PSYCHOTHERAPEUTIC
MODALITIES, INCLUDING COGNITIVE
BEHAVIORAL TREATMENT AT
DIFFERENT FREQUENCIES, FOR
INSTANCE, WEEKLY VERSUS EVERY
OTHER WEEK HAVE FOUND THAT MORE
FREQUENT THERAPY IS ASSOCIATED
WITH FASTER RECOVERY, MORE
REMISSION OF SYMPTOMS AND LONGER
DURATION OF POSITIVE OUTCOMES
WHEN A PAIR ACROSS SIMILAR
NUMBERS OF THERAPY SESSIONS
INTERESTING, SOME RECENT DATA
SUGGEST THAT RECOVERY REQUIRES
FEWER OVERALL SESSIONS WHEN THE
FREQUENCY IS ONCE OR TWICE PER
WEEK, COMPARED TO LONGER
DURATIONS BETEEN SECTIONS. THIS
SUGGESTS THAT SERVICE PROVIDERS
COULD ACTUALLY SAVE RESOURCES IN
LAURENT, LONG RUN AND FOLLOW UP
FREQUENCY IS GUIDED BY EVIDENCE
BASED APPROACHES. EASY TO ARE
ALSO SUPPORTED BY THE
UNDERPINNING NEUROBIOLOGY. MUCH
OF THE THERAPY IS THE PROCESS OF
LEARNING AND PRACTICING MORE
ADAPTIVE BEHAVIOR AND COPING
SKILLS. AND FROM A NEUROSCIENCE
PERSPECTIVE, WE KNOW THAT THOSE
PROCESSES AH, BUT UNDERLYING
LEARNING AND MEMORY FACILITATES
PSYCHOTHERAPY. THERE'S LOTS OF
REASONS TO BELIEVE THAT BETTER.
SESSION FREQUENCY THAT ARE
CLINICIANS ARE RECOMMENDING IS
ACTUALLY THE RIGHT THING TO DO.
FURTHERMORE AS OTHERS AND STATED
CLINICIAN BURNOUT ISN'T REALLY
IMPORTANT ISSUES RELATED TO
TIMELY ACCESS AND WORKLOAD. HAS
RESEARCH CLEARLY IDENTIFIES HIGH
WORKLOAD, INCLUDING, INCLUDING
HIGH CASELOAD. NUMBER OF HOURS
WORKED AS PREDICTORS OF
CLINICIAN, BRUNO AND EFFORTS
MADE BY HEALTHCARE SERVICE PLANS
TO MAXIMIZE CASELOADS AND
EXPENSIVE TIMELY ACCESS ARE NOT
ONLY DECREASING TREATMENT
ADVOCACY BUT ARE LIKELY TO
WORSEN CLINICIAN. FOR NOW, WE
CANNOT AFFORD TO LOSE ANY MORE
COMMISSIONS. COMMUNICATING WITH
PSYCHIATRIST ACROSS CALIFORNIA
ON THE TOPIC OF TIMELY ACCESS TO
CARE AND MENTAL HEALTH PARITY.
WE HAVE RECEIVED A LOT OF
FEEDBACK IN EXAMPLES OF WHAT
PSYCHIATRIST CURRENTLY STRUGGLE
WITH AND WORKING WITH VARIOUS
SERVICE PLANS. IN GENERAL ACCESS
TO NON POSITION. CLINICIANS
FREQUENT ISSUE REPORTED BY
DOCTORS ACROSS THE STATE AND ALL
HELL THINGS WHEN WE REFER
PATIENTS TO RECEIVE
PSYCHOTHERAPEUTIC SERVICES FROM
A NON POSITION PROVIDER,
REGULARLY DIRECTED PATIENTS TO
CONTACT THEIR INSURANCE PROVIDER
THE GIRL LIST OF PROVIDERS WHO
ARE COVERED BY THEIR PLANS. WHEN
PATIENTS GOING TO CONTACT THE
LIST OF PROVIDERS, THEIR REGULAR
REGULARLY FIND AS MANY AS 75% OR
NOT TAKING THE SCIENCE AND THE
REMAINING THERAPISTS ARE
SCHEDULING INTAKES WEEKS, TWO
MONTHS IN THE FUTURE. I NOW KNOW
THIS IS CALLED THE GHOST LIST. I
CAN TELL YOU THAT THIS PRACTICE
IS DEFINITELY NOT LIMITED TO
TIZER. WE ALSO HAVE HEARD FROM
DOCTORS WHO HAVE PATIENTS MAKING
SERIOUS SUICIDE COMES BUT HAVE
HAD THEIR PARENTS ADOPTED
WITHOUT THEIR KNOWLEDGE PLANS.-CHANGING WHO IS IN OR OUT OF
NETWORK. THEN THEY HAVE TO WAIT
WEEKS, IF NOT MONTHS TO SEE
OTHER PROVIDERS. OKAY TRESS
REPORT THAT FMLA AND OTHER FOUR
TERM DISABILITY PAPERWORK
SIGNIFICANTLY INCREASES ACCESS
TO MAN AND THEN FIND OUT THAT
PEOPLE WHO ARE TEMPORARILY
UNABLE TO PERFORM THEIR REGULAR
CUSTOMARY WORK DUE TO MENTAL
HEALTH SYMPTOMS FROM A FEW
GREEKS. HARASSMENT WORKS IF
YOU'RE BURNT OUT, AND OTHER
CONDITIONS SHOULD NOT BE FORCED
TO SEE A DOCTOR FOR ALL SHORT
TERM DISABILITY CLEAN
PSYCHIATRISTS WOULD HAVE MORE
TIME FOR PATIENTS WITH SERIOUS
MENTAL ILLNESS OF NON POSITION
CLINICIANS TO BE RESPONSIBLE FOR
THESE CLAIMS AND THERAPIES IN A
TIMELY WAY. MANY PLANS ARE NOT
SEEMINGLY TRYING LISTEN OUT,
COVERED BY PSYCHIATRISTS IN
CERTAIN PARTS OF THE STATE, AND
WE'RE HEARING FROM DOCTORS WHO
USUALLY ONE OF SEVERAL PAPERS
WITHIN 10 OR 15 MILE RADIUS ARE
NOW THE ONLY ONE THAT'S IN A 30
MILE RADIUS. WE HAVE DOCTORS WHO
ARE PAYING OUT OF POCKET FOR
DRUGS THAT PATIENTS CRITICALLY
NEED, BUT HEALTH PLANS EITHER
DELAY OR DENY. ONE PSYCHIATRIST
IS IN CALIFORNIA'S CURRENTLY OUT
THOUSANDS OF DOLLARS TRYING TO
TREAT PATIENTS WITH BRAVADO.
THEY HAVE CHOSEN NOT TO PRESENT
PAYMENT FROM THEIR PATIENTS AS A
FUNDAMENTAL GOAL WAS TO HELP
THEM NOT GIVE THEM MORE PROBLEMS
THAN THEY ALREADY FACE. PRODUCTS
FOR BETO. HOW DO YOU NEED TO
ADHERE TO THE TITLE ITERATION?
AS PREVIOUSLY STATED THE
WORKFORCE INVESTMENT IN THIS
YEAR'S STATE BUDGET ARE
SIGNIFICANT. HOWEVER WE NEED TO
DO MORE AT THE STATE LEVEL TO
DEVELOP THE ENTIRE CONTINUUM OF
BEHAVIORAL HEALTH SERVICES IF
OUR SHARED GOAL IS THAT MENTAL
HEALTH CARE AND SUBSTANCE ABUSE
TREATMENT ARE TRULY EQUAL TO
THAT OF PHYSICAL HEALTH CARE AND
EVERY CORNER OF CALIFORNIA.
THEIR SUB ISSUES OF PARTY THAT
NEEDS FURTHER WORK. THE
AVAILABILITY OF BEHAVIORAL
HEALTH PROVIDERS IN THE MORE
RURAL PARTS OF CALIFORNIA IS NOT
COMPARABLE TO THAT IN MORE URBAN
AREAS. FURTHERMORE CALIFORNIA'S
PROVIDER COMMUNITIES TO BECOME
MORE DIVERSE TO BETTER AND
EQUITABLY SER ALL INDIVIDUALS
SEEKING CARE. YOU NEED TO WORK
TOGETHER IN THE COMING
LEGISLATIVE SESSION TO ENSURE
THAT THE AGENCY TAKE CARE CAN
IMPACT BEST IDENTIFY WITH THEIR
PROVIDERS. THEY WOULD ALSO LIKE
TO POINT OUT THAT THE ISSUE
PROVIDED EARLIER OF, UH, LACK OF
BEDS IN THE STATE DOES
ABSOLUTELY RELATE TO THESE
ISSUES OF PENNY ACCESS, AS I
THINK, VERIFY THAT MANY PATIENTS
WITH EITHER NOT NEED A AN ACUTE
PSYCHIATRIC BED, A BIG GOTTEN
TIMELY ACCESS TO SERVICES THAT
THEY NEEDED. AND THAT MANY
PEOPLE WHO ARE IN THE
PSYCHIATRIC HOSPITAL COULD BE
LEAVING SOONER IF WE KNEW THAT
THEY WOULD BE GETTING TIMELY
ACCESS TO THE, UM FOLLOW UP
SERVICES THAT THEY NEED. THANK
YOU AGAIN FOR ALLOWING ME TO
TESTIFY TODAY AND SEASIDE LOOKS
FORWARD TO MEETING WITH EACH
MEMBER OF THIS COMMITTEE IN THE
FALL TO IDENTIFY THE AREAS OF
OUR COLLECTIVE FOCUS. NEXT NEXT
QUESTION. THANK YOU. THANK YOU
VERY MUCH, UM, EVER THOUGHT
QUESTION FOR, UM, FOR DR
PLUMLEY. YOU MENTIONED BEFORE
ABOUT HOW ABOUT, UM KAISER'S
DROP DOWN MENUS AND THE WAY THE
SYSTEM HAS BEEN REDESIGNED AS
BEING A BARRIER. UM FOR, UM,
EVEN KNOWING ABOUT ACCESS IS
TIMELY. AH AND THEN ALSO
SOMETHING ABOUT, UM, PUSHING OR
ENCOURAGING PROVIDERS TO SAY
THAT TIMELY ACCESS OR THE
SHORTER ACCESS IS NOT NEEDED.
CAN YOU JUST TALK ABOUT THAT? A
LITTLE MORE DEPTH? ABOUT WHAT?
THE EXACT WHAT THE EXACT DESIGN
FEATURE IS HOW IT IMPEDES.
ENFORCEMENT AND WHEN IT WAS
IMPLEMENTED SURE. AND I'M I'M
ALSO THINKING MY COLLEAGUE SARA
CAN SPEAK ON THIS AS WELL. BUT
FROM WHAT I UNDERSTAND THERE ARE
CERTAIN SERVICE AREAS THAT
IMPLEMENTED ATTEMPT BLOOD AND
THAT AT THE CLINICIANS HAD NO
OTHER CHOICE THAN TO SAY THAT A
10 DAY LONGER THAN 10 DAY. WAIT,
TIME WOULD NOT BE DETRIMENTAL,
SO THEY WEREN'T GIVING THE
CLINICIAN A CHOICE TO SAY THAT,
IN FACT, IT WOULD BE
DETRIMENTAL. UM HMM. I DON'T SO. I DON'T GET THAT DOESN'T
REALLY MAKE ANY SENSE TO ME. UM
NOT NOT THE WHAT YOU'RE SAYING.
BUT LIKE HOW SO. I SO LITERALLY
THE ONLY CHOICE TO THE PROVIDER
THE CLINICIAN HAS IS TO SAY.
THAT THE 10 DAYS AS A NEEDED IT
CAN BE A LONGER PERIOD OF TIME.
THAT IS MY UNDERSTANDING. THIS
HAPPENED IN SEVERAL SERVICE
AREAS. UM AGAIN, I THINK MAYBE
SARAH COULD SPEAK A LITTLE BIT
MORE ON THIS SUBJECT. IS THAT
WHEN YOU SAY THAT THE IS THAT
THE DROPDOWN ASPECT THAT MAKES
IT IMPOSSIBLE TO UM, TO TRACK
COMPLIANCE 2 TO 1 OVER THERE
SOMETHING ELSE AS WELL. NO. THIS
IS REGARDING SB 2 TO 1. RIGHT
BUT NOT YOU SAID THAT THERE WAS
NO OPTION OTHER THAN TO SAY IT
DOESN'T NEED TO HAPPEN RIGHT
AWAY. UM IS THAT IS THAT WHAT
PRECLUDES COMPLIANCE MONITORING
WITH SP 2 TO 1? OR WAS THERE
SOMETHING ELSE ABOUT THE
DROPDOWN MENUS? THAT WAS GOING
TO PRECLUDE MONITORING
COMPLIANCE. I GUESS I DON'T
QUITE UNDERSTAND YOUR QUESTION
AT THE BEGINNING OF YOUR
TESTIMONY, YOU SAID THE REDESIGN
OF THE DROPDOWN MENUS IMPOSSIBLE
WOULD MAKE IT IMPOSSIBLE TO
TRACK COMPLIANCE, DETERMINE
COMPLIANCE WITH TIMELY ACCESS
STANDARDS. CORRECT THAT WHEN YOU
WHEN YOU MADE THAT STATEMENT,
WHERE YOU REFERRING TO ONLY
GIVING CLINICIANS THE OPTION. TO
SAY THAT THE TWO WEEKS THE 10
BUSINESS DAYS WASN'T NECESSARY,
OR WAS THERE SOME SOMETHING ELSE
ABOUT THE DROPDOWN MENUS? THAT.
THAT MADE TRACKING COMPLIANCE
IMPOSSIBLE. NO IT WAS JUST THAT
IT WOULD ONLY GAVE THE
CLINICIANS THAT CHOICE AND
THAT'S UNETHICAL TO GIVE THE
CLINICIANS ONLY ONE CHOICE.
OKAY, I UNDERSTAND. THANK YOU.
THANK YOU. AND I DON'T KNOW IF
THIS IS A, UM DR SAROKIN. YES UM
, SO THERE WAS ONE OTHER FEATURE
. UM WHICH WAS, UM, A CASE
REVIEW OF EACH PATIENT CASE THAT
A THERAPIST WANTED TO HAVE SEEN
WITHIN 10 BUSINESS DAYS WHEN
THEY DIDN'T HAVE AN APPOINTMENT
WITHIN 10 BUSINESS DAYS TO
OFFER. HMM SO A FORM THAT
THERAPISTS WOULD HAVE TO FILL
OUT EXPLAINING THEIR REASONING
BEHIND WHY THEY THINK THE
PATIENT NEEDS TO BE SEEN, UM,
WITHIN 10 BUSINESS DAYS. UM SO
THAT WAS THE OTHER. OKAY? THANK
YOU. UM, SENATOR NEWMAN. FOLLOW
UP THAT I THINK TO DR SOROKIN.
YOU MENTIONED THAT THERE WERE NO
PROVISIONS. AS AS I UNDERSTOOD
YOUR TESTIMONY FOR URGENT
APPOINTMENTS ON WEEKENDS. IS
THAT CORRECT? YES THAT IS
CORRECT. AND YOU KNOW THAT IS
KIND OF DISCONCERTING AND IN
SOME WAYS STUDY, SO I MEAN,
THAT'S SORT OF AND WHAT IF THE
FIRE DEPARTMENT SAID YOU DON'T
CALL US ON THE WEEKEND? UM IF
YOUR HOUSE IS ON FIRE, SO IT
MENTAL HEALTH, ESPECIALLY FOR
SOMEONE IN CRISIS. IS YOU KNOW,
TIME IS OF THE ESSENCE,
OBVIOUSLY SO AS A PRACTITIONER
ARE THERE. ALTERNATIVES TO THAT?
WHAT? WHAT DO YOU DO? WHEN
CONFRONTED WITH A SCENARIO LIKE
THAT, AND HOW DOES THAT COMPARE
TO OTHER PLACES YOU MAY HAVE
PRACTICED? YEAH SO, UM, THE
OPTIONS? UM FOR CARE ON WEEKENDS
IS TO CALL OUR CRISIS LINE FOR A
TRIAGE OR CRISIS THERAPIST TO
CONDUCT A RISK OF VALUATION AND
DETERMINE IF YOU NEED TO GO TO
THE EMERGENCY DEPARTMENT. UM FOR
EMERGENCY CARE, SO THAT'S OUR
CURRENT, UM CRISIS OR URGENT
CARE SYSTEM FOR THE IS THAT
VISIT TO THE EMERGENCY ROOM
TREATED AS AN OUT OF NETWORK
VISIT, FOR WHICH KAISER TAKES
RESPONSIBILITY OR WHAT IS THE
PATIENT DOING THAT INSTANCE? I'M
NOT SURE ABOUT THE COVERAGE.
QUESTION ABOUT IT. NETWORK YEAH
, JUST, UM, BUT THE OFTEN IS
THAT WE HAVE AVAILABLE TO THEM.
SHALL WE? IF YOU WOULD MIND. I
MEAN, YOU KNOW, AS A
PRACTITIONER, UM, YOU'VE CLEARLY
SEEN FIRSTHAND EXAMPLES OF
SOMEBODY IN NEED OF CARE. AND IN
THAT CONTEXT, WHO HAS NOT BEEN
ABLE TO RECEIVE CARE? COULD YOU
ELABORATE A LITTLE BIT. YEAH SO
, UM AS A TRIAGE AND CRISIS
THERAPIST, WHAT I WILL TRY TO DO
IS DO MY BEST TO HELP CREATE A
SAFETY PLAN WITH THE PATIENT AND
EVEN PROVIDE INTERVENTION, UM,
TO HELP THEM, UH, FIGURE OUT HOW
THEY'RE GOING TO COPE WHILE THEY
AWAIT THE NEXT AVAILABLE
APPOINTMENT. UM AND TO, UM
INFORM THEM OF EMERGING CARE
SERVICES IF THAT NEED DOES ARISE
OVER THE WEEKEND, SO IF YOU IF
YOU MAP IT KIND OF YOUR
TESTIMONY TO THAT OF ONE OF THE
EARLY PATIENT WITNESSES THAT YOU
KNOW THAT IS REALLY UM, SCARY
FOR ONE OF A BETTER WORD. AND SO
WHAT? YOU KNOW WHAT WOULD YOU
SAY? CACHES OBLIGATION IS, UM
AND MORE GENERALLY AS IT COMES
TO FREQUENCY OF CARE. I ASSUME
YOU'VE PRACTICED ELSEWHERE LIKE
YOU KNOW WHAT'S A BETTER
STANDARD OR APPROACH THAT YOU'D
LIKE TO SEE. WELL IN TERMS OF
URGENT CARE, IN PARTICULAR, THE
LAW STATES THAT URGENT
APPOINTMENTS NEED TO BE PROVIDED
WITHIN 48 HOURS. SO THAT IS THE
LAW AND UM, IN TERMS OF PAST UM
, UH, PLACES THAT I'VE PRACTICED
, UM I MYSELF HAVE NOT
EXPERIENCED AN ISSUE BEING ABLE
TO, UM, PROVIDE MY PATIENTS WITH
APPOINTMENTS WHEN I DETERMINE
THEY ARE CLINICALLY NEEDED. I
APPRECIATE THAT. THANK YOU, MR
CHAIR. THANK YOU. AND THANK YOU
FOR TO ALL OF THE PANEL STREET
TESTIMONY. SENATOR COURTESY. I'M
JUST WONDERING IF EITHER OF THE
OF THE KAISER PERSONNEL UM HAS
HAD ANY OBSERVATIONS ABOUT JUST
BASICALLY WHAT'S GOING ON. IN
TERMS OF RECRUITMENT AND
RETENTION. I REALIZED IT'S MORE
OF A AN HR QUESTION OF
MANAGEMENT QUESTION, PROBABLY
PER SE, BUT ACCEPTED ON THE
RECRUITMENT SIDE. IT WOULD SEEM
TO ME THAT IF YOU'RE EXISTING
PERSONNEL. THAT YOU'D BE
FAMILIAR WITH, UM WHAT'S WHAT,
WHAT? WHAT'S GOING ON IN THAT
REGARD, OR IF ANYTHING IS GOING
ON IN THAT REGARD, AND PERHAPS
IF THERE'S UH, YOU KNOW,
INCENTIVES GOING ON ON THE
HIRING SIDE. YOU'D BE FAMILIAR
WITH THAT AS WELL. IF YOU'RE NOT
, THAT'S FINE, BUT I'M JUST
WONDERING WHAT YOUR OBSERVATIONS
ARE, IN A REALIZE THAT'S UH A
LITTLE EXTRA CURRICULAR TO YOUR
EXPERTISE. YEAH. SO I'M NOT
EXACTLY SURE FOR THAT QUESTION,
BUT WHAT I OBSERVE IS THAT MORE
THERAPISTS ARE LEAVING, THEN ARE
BEING HIRED. BECAUSE THE UM UH
THE WORKING CONDITIONS ARE SUCH
THAT, UM, THERAPIST BURNOUT.
THEY'RE NOT ABLE TO CONTINUE
WORKING IN THIS SORT OF
ENVIRONMENT. UM AND SO THE
RETENTION IS WORSENING. SO UM,
THAT'S WHAT I'M OBSERVING. AND
IN ANY HAVE YOU SEEN ANY EFFORTS
TO MITIGATE THAT? I MEAN, IS
THERE AGAIN. YOU DON'T HAVE TO
ANSWER THIS. I DON'T WANT TO PUT
YOU INTO ANY KIND OF YOU KNOW,
VULNERABLE POSITION, BUT I'M
REALLY ASKING ON THE POSITIVE
SIDE. I MEAN, DOES IT APPEAR TO
BE THAT THERE'S AH! A BETTER
WORD, YOU KNOW, ADVERTISED
EFFORTS CIRCULATED EFFORTS TO
IMPROVE RECRUITMENT AND OR, YOU
KNOW, RECRUIT FOLKS FROM THE
OUTSIDE AS IMPROVE RETENTION.
I'M SORRY, BUT TO ATTRACT PEOPLE
SOME I'VE BEEN IN ORGANIZATIONS,
YOU KNOW, OFTEN, INCLUDING LARGE
PUBLIC SECTOR ORGANIZATIONS
WHERE THE EMPLOYEES THEMSELVES
ARE OFTEN ASKED TO. YOU KNOW,
REWARDED SOMEHOW, SO TO SPEAK TO
HELP BRING PEOPLE IN WHEN
THEY'RE IN CIRCUMSTANCES LIKE
THIS HIRING DEFICITS. SO I AM
NOT AWARE, BUT I'M SURE THAT'S
SOMETHING THAT I CAN ASK AND
PROVIDE AT A LATER TIME FOR YOU
AFTER THIS HEARING, UM, BUT I
JUST AM NOT AWARE. UM, NO,
THAT'S FINE. NO, IT'S DON'T
DON'T PLEASE DON'T FEEL
OBLIGATED TO DO THAT. IT WAS
JUST, UH I THINK I THINK IN AND
OF ITSELF, THERE'S AN ANSWER
THERE. YOU KNOW, IT'S NOT
SOMETHING THAT YOU'RE FAMILIAR
WITH, UM THAT THAT TELLS THAT'S
TELLING, I THINK FOR ME AT SOME
LEVEL I DON'T KNOW IF THE OTHER
WITNESS WANTED TO TRY TO RESPOND
TO THAT OR NOT. UM I THINK IT'S
JUST IMPORTANT FOR THE PANEL TO
KNOW IS THAT THE REASON KAISER
CLINICIANS ARE LEAVING? THIS IS
WE'RE JUST WE'RE EXHAUSTED. I
MEAN, WE'RE UNDERSTAFFED,
OVERWORKED AND THE MORAL INJURY
AGAIN OF HAVING TO LOOK YOUR
PATIENT IN THE EYE AND SAY I'M
SORRY I CAN'T SEE YOU FOR EIGHT
OR 12 MORE WEEKS. THAT IS BEYOND
HEARTBREAKING. THAT IS NOT WHY
WE WENT TO SCHOOL. THAT'S NOT
WHAT WE WERE TAUGHT. UM IN TERMS
OF THE, UH, YOU KNOW, RETURN
VISITS. WE ARE WE ARE TAUGHT TO
SEE PATIENTS WHEN THEY HAVE
THESE SORTS OF EXTREME. AND EVEN
MORE MODERATE SYMPTOMS TO SEE
PATIENTS WEEKLY. SO THAT IS WHY
SO MANY KAISER CLINICIANS ARE
LEAVING AND, QUITE FRANKLY,
THEY'RE GOING O DO IN THEIR OWN
PRIVATE PRACTICE WHERE THEY CAN
SEE THEIR PATIENTS WEEKLY HAVE
LESS STRESS AND STILL MAKE, YOU
KNOW A DECENT LIVING. YEAH THEY
DON'T WANT TO PUT WORDS IN YOUR
MOUTH. I GOT IT FROM, YOU KNOW
THE EARLIER COMMENTS THAT THAT'S
YOU KNOW, THAT'S YOUR
OBSERVATION ON ON SORT OF THAT
SIDE OF THINGS. UM YEAH, I GUESS
PART OF MY QUESTION WAS IS ARE
YOU AWARE OF ANYTHING THAT'S
BEEN DONE TO MITIGATE THAT, UM.
YOU KNOW, ASIDE FROM COLLECTIVE
BARGAINING ISSUES, JUST YOU KNOW
EFFORTS WITHIN TO TRY TO BOLSTER
THE RANKS, BUT I DO HAVE SOME
INFORMATION HERE THAT KAISER HAS
PRESENTED FROM GOVERNMENT
RELATIONS, INDICATING THAT
THERE'S YOU KNOW BEEN SOME
THRUST SOME EFFORT TO TRY TO
BRING PEOPLE ON. UM AND AGAIN. I
WAS JUST WONDERING IF YOU IF
YOU'VE SEEN EVIDENCE OF THAT.
DOESN'T SOUND LIKE IT BECAUSE
DEFICIT YOU'RE BOTH SPEAKING OF,
BUT I LET YOU ANSWER. I BELIEVE
THAT THERE HAS PROBABLY LIKELY
BEEN EFFORT, BUT CLEARLY NOT
ENOUGH EFFORT. THANK YOU
APPRECIATE THAT. THANKS, MR
CREW. OKAY SEEING NO ADDITIONAL
QUESTIONS I APPRECIATE AH, THE
PANELISTS. SO THANK YOU VERY
HELPFUL. UM AND AGAIN AH, I WAS
PLANNING TO HAVE 1/4 PANEL, UM,
WITH THE HEALTH PLANS. UM
INCLUDING BUT NOT LIMITED TO
KAISER. BUT AS NOTED AT THE
BEGINNING, WE DID INVITE THE
PLANS, INCLUDING KAISER, AND
THEY DECLINED TO ATTEND. THAT'S
OBVIOUSLY BIRDS POINTING THEIR
IMPORTANT, UH, PART OF THE
CONVERSATION, BUT THEY DID
DECLINE OUR INVITATION TO
ATTEND. UM SO WITH THAT SAID
THAT CONCLUDES THE WITNESS
PORTION OF THIS HEARING WILL NOW
GO TO PUBLIC COMMENT, SO FIRST
OF THERE IS ANYONE MAKING PUBLIC
COMMENT WHO IS HERE IN THE
HEARING ROOM? YOU MAY COME
FORWARD. OKAY, SEEING? YEAH.
PLEASE COME FORWARD. YEAH. GOOD
AFTERNOON, MR CHAIR MEMBERS,
MATTHEW GALLAGHER, AND YOU HAVE
A COW VOICES. UM FIRST AND
FOREMOST, WANT TO THANK THE
COMMITTEE IN THE CHAIR FOR YOUR
LEADERSHIP ON THIS ISSUE. AND I
WOULD JUST NOTE THAT BACK IN
JUNE ON THE I BELIEVE JUNE 22ND
WHEN THIS ONE S ARAMBULA WAS
PRESENTING TO 7 TO 4 ON THE SOLE
SOURCE, KAISER CONTRACT THE
CHAIR ASKED A KAISER
REPRESENTATIVE, WOULD YOU BE
PREPARED TO COMPLY WITH SP 2 TO
1 WHEN IT WENT INTO EFFECT, AND
THEIR ASTOUNDING ANSWER WAS YES.
WE HAVE HEARD HERE TODAY THAT
APPEARS KAISER, MAYBE TKING
STEPS TO CIRCUMVENT TWO TO ONE'S
PROTECTIONS, AND THAT IS
ALARMING CONCERNING AND REALLY
CANNOT STAND. UM. THE BILL WE'RE
TALKING ABOUT HERE TODAY CANNOT
PURELY BE ASPIRATIONAL. IT HAS
TO BE FOUNDATIONAL, AND IT HAS
TO REALLY YOUNG, FERMENTED BY
ALL THE HELP, AND I KNOW TODAY,
KAISER APPEARS TO BE ON TRIAL,
BUT I WOULD ENCOURAGE US TO WORK
, NOT JUST THEIR KAISER. BUT ALL
THE HEALTH PLANS IS THEY'RE ALL
SUPPOSED TO BE COMPLIANT WITH
THIS, AND IF KAISER IS DOING IT,
ODDS ARE THEY'RE NOT ALONE. AND
FIVE DAYS. WE HAVE FIVE DAYS
UNTIL THE STRIKES OCCURS, AND
PEOPLE ARE GOING TO SUFFER. IF
THESE INDIVIDUALS GO ON STRIKE,
AND SO I WOULD IMPORT THIS
COMMITTEE IMPORT THIS BODY TO DO
EVERYTHING THEY CAN TO AVOID A
STRIKE IS WE'RE LOOKING AT
PEOPLE'S LIVES HERE. AND WE
REALLY WANT TO AVOID AS MANY
MENTAL HEALTH CRISIS IS CONCERNS
AS WE CAN. AND I REALLY ASKED
FOR CONTINUED LEADERSHIP ON THIS
ISSUE. THANK YOU. THANK YOU VERY
MUCH ANY ADDITIONAL PUBLIC
COMMENT HERE IN THE HEARING ROOM
, SEEING NONE WILL GO TO THE
PHONE LINES. WILL THE MODERATOR
PLEASE QUEUE UP ANY REMOTE
PUBLIC TESTIMONY? AND PROPOSED
TESTIMONY. IT'S NOT NOT LIKE A
TYPICAL BILL HEARING WHERE WE
ASK YOU TO ONLY STATE YOUR NAME
AND POSITION. UM FOLKS WILL BE
ABLE TO MAKE BRIEF COMMENTS. WE
JUST ASK THAT YOU KEEP IT
CONCISE, BUT DEPENDING ON HOW
MANY MEMBERS SPEAKERS WE HAVE.
THANK YOU, MR MODERATOR. THANK
YOU IF YOU'D LIKE TO PROVIDE
PUBLIC COMMENT OVER THE
TELEPHONE AT THIS TIME WE
IMPRESS ONE FOLLOWED BY ZERO
USING YOUR TELEPHONE KEYPAD.
ONCE AGAIN, THAT'S ONE AND THEN
ZERO, PLEASE.
WE HAVE A FEW PARTICIPANTS WITH
OPERATORS WOULD BE JUST A
MOMENT.
OUR FIRST COMMENT COMES FROM
LINE 37 37, PLEASE GO AHEAD.
THANK YOU. UM MY NAME IS
SOLUTION DAILY AND A
PSYCHOLOGIST. IN A TYPE OF THE
CENTRAL VALLEY AREA. I WORK IN,
UH, WOMEN'S HEALTH DEPARTMENT IN
MODESTO. AND JUST JUST TWO QUICK
POINTS THAT I WANT TO MAKE. YOU
ASKED EVERY TENSION. I'M A
BILINGUAL AND BI POSTREL
CLINICIAN SPANISH AND I'M ABLE
TO PROVIDE SERVICES IN SPANISH.
I'M IN THE CENTRAL VALLEY, AND
THAT'S A GREAT NEED FOR SPEAKING
CLINICIAN. UM THE RECRUITMENT
BONUS. THERE IS TWO IN BONUS,
BUT IT'S NOT. WE'RE NO LONGER
WILLING TO, UM TOOL. UH, GET
SOME OF OUR COLLEGE TO COME AND
WORK FOR CHRIST BECAUSE OF THE
CONDITIONS AND JUST ANY GOOD
CONSCIOUSNESS AND ETHICAL
STANDARDS. I CAN'T ASK SOMEBODY
ELSE BECOMING WORK FOR I KNOW
THAT THEY'RE WORKING CONDITIONS
ARE TO THE POINT THAT ITS
HIGHEST STRESSFUL TO NOT BE ABLE
TO SEE OUR PATIENTS AND THE
TIMELY MATTER THAT WE THINK
THEY'RE NEEDED, ESPECIALLY WHEN
THEY HAVE A SUICIDAL IDEATION.
OR FINDING DEPRESSION AND SOME
OF THE OTHER, MORE SEVERE
CONDITION AND AS FAR AS THE
RETENTION IN WHAT THE EFFORTS
ARE DOING, SO I HAVE BEEN ON A
MEDICAL LEAVE, AND I WAS
RELEASED TO RETURN TO WORK THREE
DAYS A WEEK. UM IN CRISIS WISDOM
, THEY HAVE OPTED TO DENY IT
ACCOMMODATION FROM OUR
DEPARTMENT AND WOMEN'S HEALTH
HAS DONE WITHOUT A PSYCHOLOGIST
FOR SEVEN MONTHS NOW. I COULD
HAVE BEEN THERE THREE DAYS A
WEEK, BUT BECAUSE MY DOCTOR DID
NOT RELEASE ME TO GO BACK
FRIDAY, POLICE I AM BEING ASKED
TO LEAVE. UM AND THAT IS JUST
THAT IS JUST SO CONTRARY TO
WHATEVER KEISTER IS SAYING ABOUT
THEIR EFFORTS FOR RETENTION, UH
, IT YOU HAVE THE WOMEN'S HEALTH
DEPARTMENT GO WITHOUT IT.
PSYCHOLOGISTS. AND IT'S JUST
IT'S JUST YEAH, AND SO I MUST
POINT THAT I FIGHT CHOICE. I'M
LEAVING KAISER BECAUSE OF THE
WORKING CONDITIONS AND, UM AND
IT'S JUST I AM NOT ONE TO WALK
AWAY FOM A FIGHT, BUT I JUST
POINT I'VE GIVEN IT MY ALL AND I
ONCE THOUGHT, AND I WORKED VERY
HARD TO MAKE MY SER THE BEST
PLACE TO PROVIDE SERVICES AND
EVERYTHING SERVICES AND I JUST
SEE AT THIS POINT THAT IT'S NOT
A REALLY WERE ALREADY THAT'S
GOING TO HAPPEN WITHIN MY
LIFETIME. THANK YOU FOR YOUR
EXPERT COMMENT IS FROM LYON, 41
FOR ONE. ARE YOU SAYING I'M ON
NEXT? THAT'S CORRECT. GREAT.
YEAH, I'M ALSO WATCHING IT ON
VIDEO. APOLOGIZE YOU'RE ON NOW.
SIR WALKED AWAY FROM A FIGHT. I
JUST HELLO. MY NAME IS HARRY.
CAMILLE I'M A PSYCHOLOGIST WHO
HAS BEEN WORKING AT RICHMOND
KAISER FOR 41 YEARS AND I JUST
WANT TO THANK SENATOR WEINER AND
ALL THE SENATE REPS HERE FOR
HEARING US. UM IT'S SUCH A
RELIEF TO SEE THAT YOU'RE
ACTUALLY UNDERSTANDING AND
SUPPORTIVE. OF WHAT WE KAISER
CLINICIANS ARE GOING THROUGH AND
I JUST WANT TO UNDERLINE SOME OF
THE THINGS THAT HAVE BEEN SAID
IN MY 41 YEARS IN KAISER, I CAN
TELL YOU I HAVE NEVER SEEN SUCH
A STRESSFUL WORK ENVIRONMENT AND
I SUPPOSE COVID REALLY MADE
THINGS EVEN WORSE, BUT IT'S
ALWAYS BEEN A VERY STRESSFUL,
DEMANDING PLACE TO WORK. BUT NOW
WHEN OUR NO SHOW RATE OF OUR
PATIENTS HAS DROPPED DOWN TO
CLOSE TO ZERO AND OUR COMPUTER
TIME BECAUSE WE'RE DOING ALMOST
TALLER, WORK REMOTELY AND OUR
CASE, MANAGEMENT TIME AND THE
PRESSURE OF PATIENTS IN NEED IS
SO TREMENDOUS THAT IT'S IF I
HADN'T BEEN HERE 41 YEARS AND
HAD GOTTEN A FEEL FOR IT. I
WOULD UNDERSTAND COMPLETELY WHY
WE HAVE A REVOLVING DOOR OF
CLINICIANS, AND I JUST WANT TO
MAKE SURE THAT YOU STATE
SENATORS UNDERSTAND HOW
INCREDIBLY STRESSFUL OUR WORK
SITUATION IS. NOW YOU KNOW,
THERE'S AN ALMOST ORWELLIAN
QUALITY AT KAISER, AS WAS TALKED
ABOUT PREVIOUSLY ABOUT THOSE
DROPDOWN MENUS. KAISER
MANAGEMENT DOES EVERYTHING IT'S
POSSIBLY CAN PRETEND THAT WE'RE. YOU KNOW, CONFORMING TO ETHICS
AND CONFORMING TO STATE LAW WILL
NOT DOING SO THEY'VE GOT SO MANY
WAYS TO COOK THE BOOKS AND
PRESSURE WE CLINICIANS. TO
DOCUMENT AS IF THINGS ARE FIND
WHEN THEY'RE NOT FINE, SO
THERE'S DROP DOWN MENUS THAT ARE
SKEWED TO REPORTING THAT WE'RE
SEEING OUR PATIENTS IN A TIMELY
MANNER AND WERE PRESSURED TO DO
THAT. AND IF WE DON'T DO THAT
WERE SUPPOSED TO SEND A MESSAGE
TO THE MANAGER AND WE HAVE TO
MEET WITH THE MANAGER. THEY JUST
MAKE IT EXTREMELY STRESSFUL. UM
IN ORDER TO JUST CONFORM WITH
STATE LAW AND WITH OUR OWN
ETHICS THAT, YOU KNOW, I JUST
WISH I COULD CONVEY THAT
STRONGLY ENOUGH HOW HARD IT IS
JUST TO MAINTAIN BEING AT KAISER
. I KNOW DOZENS OF PEOPLE WHO
ARE LEAVING KAISER, ESPECIALLY
THE NEWER ONES. WE MAY BE HIRING
ROUGHLY 300 IN THE PAST YEAR OR
SOMETHING I'VE HEARD AND WE'VE
LOST A LITTLE BIT MORE THAN
THAT. BECAUSE I KNOW WE'RE HIRES
CAN KEEP UP WITH THE PRESSURE OF
THIS PATIENT CARE AND THAT'S WHY
WE'RE HERE TODAY. MY VIEW AND
I'M SO GRATEFUL THAT YOU'RE
MEETING WITH US NOW BECAUSE IN
OUR CONTRACT NEGOTIATIONS AND
I'VE SAT IN ON HALF A DOZEN OF
THEM OVER THE PAST MONTH OR SO,
WE KEEP REPORTING THIS TO KAISER
MANAGEMENT, AND THEY'VE EVEN
COMPLAINED TO US, THE LEAD
MANAGER WHY DID YOU GO TO THE
DMH? SEE? WHY DIDN'T YOU GO TO
US? AND IN REAL TIME WE'RE
TALKING TO THEM, AND THEY'RE NOT
GETTING IT, WHICH IS MAKING IT
OBVIOUS WHY WE HAVE TO GO TO
OUTSIDE BODIES LIKE THE
LEGISLATURE AND THE GMHC BECAUSE
MANAGEMENT IS JUST DEAF TO THIS
. MAYBE IT'S BECAUSE THEY'RE NOT
IN THE TRENCHES OF DOING THE
CLINICAL WORK THAT WE ARE DOING
. BUT FRANKLY, WE DESPERATELY
NEED YOUR HELP. AND THE THINGS
THAT WERE DISCUSSED EARLIER IN
THIS MEETING, AND I COULD SEE
WHERE IT WAS GOING. I'M GRATEFUL
TO DR PAN AND ALL THE STATE
SENATORS REALLY FOLLOWING UP ON
THIS IS WE NEED ENFORCEMENT NOW
IN REAL TIME THAT SERIOUS
BECAUSE WE'RE BARELY HANGING ON
HERE, AND IT'S YOU KNOW, IT'S
IMPOSSIBLE TO REALLY RETAIN
CLINICIANS AND SUCH A DIFFICULT
WORK ENVIRONMENT. SO KAISER
MANAGEMENT WILL NOT PLEASE
THEMSELVES AND WE'RE BEGGING
THEM TO INCREASE OUR TIME THAT
WE CAN TAKE BETWEEN WHEN WE SEE
PATIENTS TO CARRY OUT ALL THE
OTHER TASKS AND THEY ARE JUST
REFUSING TO GIVE US THE TIME. WE
NEED TO MAKE THE WORK
SUSTAINABLE AND AGAIN IF I
HADN'T BEEN HERE FOR 41 YEARS,
THERE PROBABLY IS A RELATIVELY
NEW HIGHER I WOULD BE OUT OF
HERE BECAUSE I WOULDN'T HAVE HAD
TO COPE WITH IT. I'M JUST
HANGING ON FOR THE LAST FEW
YEARS. MY CAREER HERE AT KAISER,
BUT I JUST WANT TO THANK YOU SO
MUCH FOR ASKING THE RIGHT
QUESTIONS, AND I JUST WANT TO
REINFORCE HOW INCREDIBLY
STRESSFUL IT IS WORKING AT
KAISER AND FRANKLY, TELL YOU AS
A KAISER VETERAN, WE NEED ALL
YOUR HELP AND YOUR ENFORCEMENT
HELP STATE LEGISLATURE, SENATOR
WIENER ALL THE MEMBERS OF THE
COMMITTEE D M A C BOY WE NEED AS
MUCH INTENSIVE HELP AS YOU CAN
GIVE US NOW. BECAUSE WE'RE
REALLY IN A CRISIS IN ALL THE
OTHER WAYS THAT HAVE BEEN
DESCRIBED BY THE PEOPLE HERE. I
COULD GO ON FOREVER, BUT I'LL
LEAVE IT AT THAT. THANK YOU SO
MUCH, AND I'D BE HAPPY TO ANSWER
ANY QUESTIONS IF THERE WOULD BE
OF HELP. THANK YOU VERY MUCH.
NEXT WITNESS. OUR NEXT COMMENT
COMES FROM LINE 38. BY CAN YOU
HEAR ME? YES, WE CAN HEAR YOU.
OKAY HI. MY NAME IS CHRISTY AND
FROM THE FRONT WOULD CALIFORNIA
AREA UM I'M 24 YEARS OLD AND I'M
CALLING AS A PATIENT. I STARTED
MY MENTAL HEALTH JOURNEY WITH
DESSERT. JANUARY 2021. I DIDN'T
GET A THERAPIST UNTIL ROUGHLY
JUNE 2021. AND BREATH IN 2021.
SO ABOUT. JUNE 2022. I WAS IN A
GRADUAL, DECLINING MENTAL STATE.
UM, I WAS ONLY. ALLOWED TO SEE
MY PROVIDER FOR ABOUT 30 MINUTES
ONCE A MONTH. UM WHICH IT AFTER
THE PAPERWORK, AND AFTER
SCHEDULING THE NEXT APPOINTMENT,
IT WAS ABOUT 30 MINUTES OF TIME.
UM BETWEEN SCHEDULING, IT
ACTUALLY ENDED UP BEING MORE A
MONTH AND A HALF IN BETWEEN
APPOINTMENTS. ON JUNE. JUNE 27TH
2021 I ALMOST KILLED MYSELF. I
HAD CALLED KAISER. MENTAL
HEALTH. UM. AND AT THE TIME I
DIDN'T REALIZE I SHOULD HAVE
HOLD EMERGENCY SERVICES THAT I
CALLED. KAISER ASKED. IF I TALK
TO MY PROVIDER AND THEY TOLD ME,
OKAY, OKAY, WE'LL GO CHECK. THE
PROVIDER WAS IN A MEETING AND I
FEEL LIKE SHE'S IN ANOTHER
MEETING, AND AFTER THAT SHE WAS
DONE FOR THE DAY. I WAS THREE.
SHE, THE LADY ON THE PHONE SAID
THAT MY NEXT APPOINTMENT WITH
HER WOULD BE JULY. THINK AGAIN.
THIS WAS JUNE SUMMIT AND I WAS
IN A CRISIS. MY FIRST CRISIS.
ACTUALLY FIRST AND ONLY CRISIS.
UM I ASKED. YOU KNOW ANOTHER
PROVIDER IS ANYBODY AVAILABLE?
AND SHE JUST SAID NO. UM AGAIN.
YOUR APPOINTMENT IS JULY 18TH.
UM, LUCKILY, I HAD BESIDES THE
TREVOR PROJECT. AND THEY'RE THE
ONES WHO HELPED ME DURING THE
CRISIS. BUT THROUGH THIS YEAR
AND A HALF OF A GRADUAL DECLINE
IN MENTAL HEALTH HAS BEEN A
STRUGGLE. UM I ALSO COME FROM A
UNIQUE EFFECTIVE WHAT I
ATTENDED. UNIQUE IS THAT I WORK.
I WORK WITH HOMELESS OUTREACH
AND CONTRA PROCESS. I AM
FAMILIAR WITH MENTAL HEALTH. I
ASSIST PEOPLE WITH THEIR MENTAL
HEALTH AND BEING CONNECTED TO A
PROVIDER. ANYTIME I COME ACROSS
SOMEBODY WITH KAISER INSURANCE
AND THEY'RE HOMELESS. I HONESTLY
DO MY BEST TO GET THEM OFF THE
KAISER AND ON THE COUNTY BECAUSE
KAISER CAN'T HELP THEM. NOT IN
THIS. JUST COME FROM MY
EXPERIENCE PERSONALLY BUT ALSO
WORK EXPERIENCE WORKING WITH
KAISER WITH MY CLIENT TO GET
THEM HELP HAS BEEN INEFFECTIVE.
BUT THAT'S COOL. THANK YOU VERY
MUCH. NEXT SPEAKER. THANK YOU AT
THIS TIME. THERE ARE NO OTHER
LINES AND QUÊ. OKAY UM, SO WE'LL
BRING IT BACK TO THE COMMITTEE.
UH FIRST OF ALL I WANT TO. I
WANT TO THANK MY STAFF. UH FOR,
UM, UH, FOR PUTTING TOGETHER
THIS HEARING TODAY I'M VERY
APPRECIATIVE. UM AND TO THANK
ALL OF THE WITNESSES, THE
PATIENTS, PROVIDERS AND DIRECTOR
WATANABE FOR PROVIDING VERY,
VERY INFORMATIVE TESTIMONY TODAY
, I AGAIN I WISH I WISH THE
HEALTH PLANS HAVE BEEN HERE AS
WELL TO PROVIDE THEIR
PERSPECTIVE SINCE WE DID OFFER
THAT OPPORTUNITY THAT WOULD HAVE
ALSO BEEN HELPFUL, BUT PERHAPS
ANOTHER TIME. I ALSO WANT TO
THANK MY COLLEAGUES FOR BEING
HERE AND ASKING SOME VERY
THOUGHTFUL QUESTIONS. AND SO
COLLEAGUES UM, I THIS IS JUST AN
INCREDIBLY IMPORTANT ISSUE. UM,
WE ARE FINALLY MOVING AS A
SOCIETY AWAY FROM THE NOTION
THAT MENTAL HEALTH AND ADDICTION
UH, CHALLENGES ARE SOME SORT OF
PERSONAL FAILURE, AND PEOPLE
JUST NEED TO BE STRONGER OR
TOUGHER. SNAP OUT OF IT. UM
BEHAVIORAL HEALTH DISORDERS ARE
DISEASES OF THE BRAIN. AND WE
NEED TO TREAT THEM, UM, LIKE AS
THE MEDICAL CONDITION THAT THEY
ARE. AND WE WOULD NEVER, EVER
EVER TOLERATE. UM WHAT WE HEARD
TODAY AND WHAT WE HEAR ON A
REGULAR BASIS, UM, IN TERMS OF
DENIAL OF CARE, WE WOULD NEVER
TOLERATE THAT IF SOMEONE SHOWED
UP WITH WITH CANCER, UM OR WITH
A BROKEN ARM. UH WE JUST
WOULDN'T TOLERATE THAT FOR
SOMEONE WHO HAS HEALTH INSURANCE
. AND YET WE'VE FOR MANY, MANY
YEARS JUST ACCEPTED THAT HEALTH
PLANS WOULD EFFECTIVELY DENY
ACCESS TO CARE FOR PEOPLE WHO
ARE SUFFERING. FROM ANXIETY OR
PTSD, OR HEROIN ADDICTION OR
WHATEVER THE DISORDER MIGHT BE.
AND THIS LEGISLATURE AND THE
GOVERNOR HAVE BEEN CRYSTAL CLEAR
IN OUR POLICY PRONOUNCEMENTS BY
PASSING LAWS THAT THE GOVERNOR
SIGNED INTO LAW THAT IT HAS TO
END THAT WE'RE GOING TO TREAT AH
BEHAVIORAL HEALTH DISORDERS, THE
SAME AS OTHER HEALTH DISORDERS.
AND THAT PEOPLE ARE GOING TO GET
TIMELY ACCESS TO CARE, AND IT'S
GOING TO BE IN THE LAW AND IT
WILL BE ENFORCEABLE AND WE'RE
NOT JUST GOING TO WRITE IT DOWN
ON PAPER AND THE CODE AND THEN
FORGET ABOUT IT. SO IT IS
DISAPPOINTING THAT WE CONTINUE
TO HEAR ABOUT THESE DELAYS AND
ABOUT THE INTENSE STRUGGLES THAT
PEOPLE WHO HAVE INSURANCE FACE
WHEN THEY TRY TO ACCESS THAT
INSURANCE TO GET CRITICAL AND AT
TIMES, UH, LIFE SAVING, UH,
HEALTH CARE FOR THEIR BEHAVIORAL
HEALTH DISORDERS. I AM VERY,
VERY CONCERNED ABOUT THE LACK OF
COMPLIANCE WITH SP 2 21. I AM
WE'RE APPRECIATIVE THAT GMHC
APPEARS TO BE TAKING THIS
SERIOUSLY AND WE'RE GOING TO
CONTINUE TO WORK CLOSELY WITH
THE DEPARTMENT TO ENSURE THAT
THERE IS COMPLIANCE AND
ENFORCEMENT WHEN THERE'S A LACK
OF COMPLIANCE, WILL CONTINUE TO
WORK WITH PATIENTS AND PROVIDERS
TO MAKE SURE THAT WE, YOU KNOW,
WE THE PATIENTS PROVIDERS ARE
THE BOOTS ON THE GROUND. THESE
ARE FRONT LINE. FOLKS WHO ARE
SEEING WHAT'S HAPPENING ON A DAY
TO DAY BASIS, WHETHER IT'S A
PATIENT EXPERIENCE OR PROVIDER,
TALKING ABOUT A CHANGE IN THE
DROP DOWN MENU THAT WE WOULD
NEVER KNOW ABOUT UNLESS YOU TELL
US AND SO I APPRECIATE IT WHEN
PEOPLE COME TO A HEARING AND
TELL US OR TELL US IN ANOTHER
CONTEXT OR MAKE A REPORT TO D
MHC SO WE HAVE TO DO BETTER. I
ALSO WANT TO SAY THAT I AM
DEEPLY CONCERNED ABOUT WHAT'S
GOING TO HAPPEN WITH PATIENTS
WHEN THE UPCOMING STRIKE STARTS
. I WANT TO JUST THANK THE
NATIONAL UNION OF HEALTHCARE
WORKERS FOR JUST CONTINUALLY
RINGING THE ALARM BELL FOR THE
PROBLEMS THAT KAISER AROUND
BEHAVIORAL HEALTH ACCESS, AND I
KNOW THAT NO WORKER LIKE IS
CHOMPING AT THE BIT TO GO ON
STRIKE. NO UNION IS CHOMPING AT
THE BIT. TO GO ON STRIKE STRIKES
ARE PAINFUL FOR EVERYONE.
ABSOLUTELY EVERYONE AND I KNOW
THAT THE UNION AND ITS MEMBERS
HAVE MADE THIS DECISION AS A
VERY LAST RESORT AFTER TRYING
EVERY OTHER OPTION AND AT TIMES
, HITTING A WALL AND BANGING
THEIR HEADS AGAINST THE WALL,
BUT I'VE LEARNED OVER TIME IS
THAT IF YOU BANG YOUR HEAD
AGAINST THE WALL LONG ENOUGH AND
HARD ENOUGH, UM EVENTUALLY
YOU'RE GOING TO BUST THROUGH THE
WALL, AND I HOPE THAT IF THE
STRIKE DOES HAPPEN, WHICH IT
LOOKS LIKE IT WILL. I HOPE THAT
IT LEADS US TO A BETTER PLACE.
BUT WHILE THIS IS BEING WORKED
OUT, WE NEED TO MAKE SURE THAT
KAISER IS DOING RIGHT BY
PATIENTS. DIRECTOR WATANABE MADE
CRYSTAL CLEAR TODAY. THAT A WORK
STOPPAGE AND A STRIKE. UM DOES
NOT IN ANY WAY EXCUSE A HEALTH
PLAN FROM ENSURING THAT PEOPLE
FROM COMPLYING WITH THE LAW AND
ENSURING THAT PEOPLE HAVE ACCESS
AND TIMELY ACCESS TO BEHAVIORAL
HEALTH CARE, INCLUDING GOING OUT
OF NETWORK AND PAYING FOR THAT,
SO WE'RE ALL GOING TO BE
WATCHING VERY CLOSELY TO MAKE
SURE THAT KAISER COMPLIES WITH
THE LAW. UM WHEN THE STRIKE
HAPPENS SO AGAIN, THANK YOU TO
EVERYONE AND COLLEAGUES IF THERE
ARE ANY ADDITIONAL COMMENTS
SENATOR NEWMAN JUST VERY QUICKLY
. SO THANK YOU TO THE CHAIR FOR
CONVENING THIS CHEERING. THANK
YOU TO THE WITNESSES AS YOU
POINT OUT MENTAL HEALTH, UH AND
EFFICIENT, APPROPRIATE RESPONSE
TO MENTAL HEALTH ARE ONE OF THE
PRIME ORDINARY ISSUES OF OUR
DATA'S OUR OBLIGATIONS BODY TO
MAKE SURE WE MAKE PROGRESS IN
THAT AND I'M GRATEFUL OF THE
WITNESSES, PARTICULARLY MOVED BY
ONE OF THE LAST WITNESSES, THE
LONGTIME PRACTITIONER AT KAISER
, WHO MADE VERY CLEAR HOW URGENT
THIS IS MY HOPE IS THAT WE, YOU
KNOW, WE WON'T SEE A STRIKE, BUT
I'M ACTUALLY GRATEFUL. AS I
SAID, MOVED BY BY THE COMMITMENT
AND THE URGENCY OF THE FOLKS WHO
DO PROVIDE CARE, AND IT'S OUR
JOB TO MAKE SURE THEY GET THE
RESOURCES AND THE SUPPORT TO DO
THAT. SO THANK YOU. GREAT OKAY,
SAYING NO OTHER MIX UP. UM WE
ARE WE HAVE GONE THROUGH OUR
AGENDA AND THIS HEARING IS
ADJOURNED.