THE SENATE BUDGET SUB COMMITTEE
NUMBER THREE ON HEALTH AND HUMAN
SERVICES WILL COME TO AN ORDER
GOOD MORNING EVERYONE- YOU KNOW
THE SENATE CONTINUES TO WELCOME
THE PUBLIC IN PERSON AND VIA
TELECONFERENCE ARVEST- FOR
PUBLIC COMMENT FOR INDIVIDUALS
WISHING TO PROVIDE A PUBLIC
COMMENT TODAY'S PARTICIPANT
NUMBER IS. 1-877-226-8160 THREE
AND THE ACCESS CODE FOR THAT'S
GOING TO BE SEVEN THREE SIX
TWENTY EIGHT THIRTY FOUR. AS
ALWAYS WE ARE HOLDING OUR
COMMITTEE HEARINGS HERE IN THE
TEN TWENTY ONE ALL THREE
BUILDINGS SO I ASKED THE REST OF
THE MEMBERS OF THE SUBCOMMITTEE
TO BE PRESENT HERE IN ROOM FIVE
HUNDRED SO WE CAN ESTABLISH OUR
QUORUM AND BEGIN OUR HEARING.
TODAY WE'LL BE HEARING BUDGET
PROPOSALS FROM THREE DEPARTMENTS
DURING TODAY DURING THE- DURING
TODAY AND THOSE APARTMENTS
INCLUDE THE DEPARTMENT OF HEALTH
CARE SERVICES EMERGENCY MEDICAL
SERVICES AUTHORITY AND THE
DEPARTMENT OF PUBLIC HEALTH BUT
BEFORE WE GOT INTO THOSE BUDGET
PROPOSALS WE'RE GONNA BE HEARING
A PRESENTATION WITH TWO
PRESENTATIONS TODAY BUT THE
FIRST ONE IS GOING TO BE- UP. ON
OVERSIGHT ITEM. THE OVERSIGHT
ITEM IN PANEL DISCUSSION OF
IMPLEMENTATION OF RECENT
EXPANSIONS OF MEDICAID
ELIGIBILITY. WILL FIRST HEAR A
STATUS UPDATE ON THESE RECENT
EXPANSIONS FROM THE DEPARTMENT
OF HEALTH CARE SERVICES FOLLOWED
BY A PANEL DISCUSSION WITH
STAKEHOLDERS. JOINING US TODAY
ON THE PALACE IS GOING TO BE
KATHY SUNDERLAND MCDONALD. WHO
IS THE EXECUTIVE DIRECTOR OF
COUNTY WELFARE DIRECTORS
ASSOCIATION OF CALIFORNIA.
SERONT JOINING US FROM ZOOM THE
DIRECTOR OF HEALTH AND PUBLIC
BENEFITS POLICY CALIFORNIA
IMMIGRANT POLICY CENTER KIM.
SELF ON WHO'S ALSO ASSUME ON
ZOOM JOINING US FROM MEDICARE
AND H. I. HSS POLICY SPECIALISTS
FROM BET SIX. LEGAL SERVICES.
LINDA WAY IS A SENIOR POLICY
ADVOCATE IN WESTERN CENTER
ONLINE PARVATI AND CHRISTIAN
GOLDEN TESSA IS THE HEALTH
POLICY DIRECTOR FROM THE
CHILDREN'S PARTNERSHIP AND I
WELCOME THOSE PANELISTS WERE
HERE IN PERSON TO JOIN US.
GOOD MORNING THANK YOU SO MUCH
FOR THOSE WHO JOINED US HERE IN
PERSON AND PER OR THOSE ON ZOOM
. LET'S BEGIN THIS OVERSIGHT
PANEL FROM PRESENTATION FIRST
FROM D. H. A CS AND THEN WE'LL
HEAR FROM THE REST OF THE
PANELISTS- GREAT GOOD MORNING JC
COOPER CALIFORNIA STATE MEDICAID
DIRECTOR AND CHIEF DEPUTY
DIRECTOR OF THE DEPARTMENT OF
HEALTH CARE SERVICES ANNALES AS
OUTLINED IN THE COMMITTEE'S
AGENDA CALIFORNIA HAS GREATLY
EXPANDED ACCESS TO MEDICAL
COVERAGE IN THE LAST THREE YEARS
NOW PROVIDE AN UPDATE ON THOSE-
IMPLEMENTATIONS. I'M REGARDING
EXPANDING FULL SCOPE MEDI CAL
COVERAGE REGARDLESS OF
IMMIGRATION STATUS THE YOUNG
ADULT EXPANSION IMPLEMENTED IN
JANUARY TWENTY TWO HASN'T ROLLED
OVER A HUNDRED AND TWENTY TWO
THOUSAND INDIVIDUALS WHICH WAS
ORIGINALLY ESTIMATED AT NINETY
THOUSAND SOMEWHERE FAR EXCEEDING
WHAT WE WERE ORIGINALLY
ESTIMATING WHICH IS GREAT
BECAUSE THAT MEANS WE'RE GETTING
TO PEOPLE THAT NEED ACCESS TO
SERVICES. SIMILAR EXPANSION IN
THE ADULT OR OLDER ADULT
EXPANSION IMPLEMENTED IN MAY OF
TWENTY TWENTY TWO HASN'T ROLLED
OVER THREE HUNDRED TWENTY FIVE
THOUSAND INDIVIDUALS ORIGINALLY
ESTIMATED AT TWO HUNDRED FORTY
THOUSAND INDIVIDUALS MEDICARE
WILL ALSO BE EXPANDING COVERAGE
ON AS PROPOSED IN THE BUDGET FOR
INDIVIDUALS TWENTY SIX TO FORTY
NINE I'M IMPLEMENTED NO EARLIER
THAN JANUARY FIRST OF TWENTY
TWENTY FOUR AND WE ARE
ESTIMATING APPROXIMATELY SEVEN
HUNDRED THOUSAND INDIVIDUALS. WE
WOULD THEN AT THAT POINT HAVE
FULL COVERAGE FOR ALL
INDIVIDUALS. REGARDLESS OF
IMMIGRATION STATUS IN MEDIC HOW
AMAZON'S ANY CRITERIA THIS IS
THE LARGEST EXPANSION THAT WE
HAVE HAD IN THE MEDICARE
PROGRAM. ADDITIONALLY FOR THE
ELIMINATION OF SENIOR PENALTY
FOR AGED AND DISABLED PROGRAM
THE AGE BLIND AND DISABLED
FEDERAL POVERTY LEVEL PROGRAM
INCOME LIMITS WERE INCREASED
FROM A 10210038% OF THE FEDERAL
POVERTY LEVEL. ON DECEMBER FIRST
TWENTY TWENTY SAYS THIS
IMPLEMENTATION OF THE EXPANSION
APPROX ME FORTY THREE THOUSAND
INDIVIDUALS THAT PREVIOUSLY
ELIGIBLE WITH THE MONTHLY
PREMIUM OR SHARE OF COST. NOW
ARE ELIGIBLE WITH NO COST
MEDICAL COVERAGE. ADDITIONALLY
REGARDING THE PHASE OUT OF THE
ASSET TEST FOR THE NON MATCH I
MEDICAL ELIGIBILITY GROUP. THE
DEPARTMENT IS IMPLEMENTING THIS
IN TWO PHASES PHASE ONE.
STARTING JANUARY FIRST TWENTY
TWENTY TWO WHICH HAS ALREADY
GONE LIVE WE INCREASE THE ASSET
LIMIT TWO HUNDRED AND THIRTY
THOUSAND- AND- FOR INDIVIDUALS.
AND SIXTY FIVE THOUSAND FOR EACH
INDIVIDUAL PERSON. THE
DEPARTMENT ESTIMATES.
APPROXIMATELY EIGHTEEN THOUSAND
NEW MEDICAID ENROLLEES- HAVE
BEEN IMPLEMENTED SINCE THAT TIME
AND THIS IS ONLY WITHIN THE
FIRST THREE MONTHS- WE'RE
ESTIMATING APPROXIMATELY
EIGHTEEN THOUSAND YOU HAD FIVE
THOUSAND TWO HUNDRED EIGHTY
THREE NEW ENROLLEES. AND THAT'S
ONLY WITH THE A THREE MONTH SO
STILL TRENDING VERY WELL IN
REGARDS TO OUR REGION GAUGE MINT
WHICH IS CRITICAL. PHASE TWO
WILL BE IMPLEMENTED IN JANUARY
OF TWENTY FOUR. THE DEPARTMENT
IS ESTIMATED APPROXIMATELY
THIRTY THOUSAND NEW ENROLLEES
WILL BE ELIGIBLE FOR MEDICARE
DUE TO THE ELIMINATION OF THE
ASSET TESTS. A WE HAVE ALREADY
ISSUED GUIDANCE IN NOVEMBER OF
TWENTY TWENTY TWO ON PHASE TWO
AND IS CURRENTLY WORKING ON A
STATE PLAN AMENDMENT THAT WE
WOULD SUBMIT TO CMS FOR THAT
APPROVAL FOR JANUARY FIRST GO
LIVE. ADDITIONALLY WE SENT OUT
DIRECT OUTREACH LETTERS TO
INDIVIDUALS PREVIOUSLY DENIED
FOR BEING OVER THE ASSET L'IMAGE
ENCOURAGING THEM TO RE APPLY TO
MEDICAL SO THEY ARE INFORMED IN
REGARDS TO THE CHANGES OF THE
EXPANSIONS THAT WE ARE
IMPLEMENTING. WE WILL ALSO BE
WORKING WITH OUR COMMUNICATIONS
VENDOR ON THAT WE HAVE BROUGHT
ON FOR THE PUBLIC HEALTH
EMERGENCY TO GET THE WORD OUT TO
EVERYONE IN REGARDS TO THESE
TRANSITIONS. AND EXPANSIONS.
THAT WOULD INCLUDE THE ASSET
LIMIT EXPANSION AS WELL AS THE
FULL- COVERAGE FOR ALL
INDIVIDUALS WELL TO BE WORKING
VERY CLOSELY WITH OUR NAVIGATOR
HEALTH ENROLLMENT NAVIGATOR
PROGRAMS. ACROSS THE ENTIRE
STATE OF CALIFORNIA. WE WERE. TO
FLAG SOME OF THE- OPERATIONAL
CHALLENGES AT THE END OF THE
PUBLIC HEALTH EMERGENCY AND THE
REAR. A DETERMINATION PROCESS
MAY BRING A TO THIS VARIOUS
COVERAGE REQUIREMENT EXPANSION
AND HOW WE ARE PLANNING TO
MITIGATE THOSE CHANT AT
CHALLENGES. IN ORDER TO ENSURE
THAT INDIVIDUALS THAT WERE
BROUGHT ON YOUNG ADULTS THAT
WOULD BE OTHERWISE AGING OUT WE
DID DEEP PRIORITIZE THE ANNUAL
RE DETERMINATIONS FOR
INDIVIDUALS THAT WOULD HAVE
OTHERWISE H. DOUBTS TO JANUARY.
SO THEY COULD HAVE SEAMLESS
COVERAGE ONCE WE EXPAND TO
UNDOCUMENTED. I'M INDIVIDUALS. I
AM TWENTY SIX TO FORTY NINE SO
THEY WOULD HAVE SEAMLESS
COVERAGE. ADDITIONALLY
SUBMISSION- WAS JUST SUBMITTED
TO CMS- FOR A ESSENTIALLY A
WAIVER- THAT WOULD ALLOW US TO
CONTINUE INDIVIDUALS WHO
OTHERWISE WOULD HAVE LOST
COVERAGE BECAUSE OF THE ASSET
BEING OVER A HUNDRED THIRTY
THOUSAND- SINCE WE ARE LIMITING
IT IN JANUARY TWENTY FOUR TO
MAINTAIN COVERAGE. ON THROUGH
THAT TIME PERIOD- AND WE WOULD
THEN HAVE FULL ELIMINATION OF
THE ASSETS JANUARY FIRST SO WE
ARE TRYING TO MAKE SURE THAT
PEOPLE WOULD NOT LOSE COVERAGE
THAT THEY WILL MAINTAIN COVERAGE
IF THEY WOULD HAVE ELIGIBILITY
ON JANUARY FIRST OF TWENTY
TWENTY FOUR. WE ARE CONFIDENT
WITH MANY CONVERSATIONS WE'VE
HAD WITH CMS THAT THEY WILL MOST
LIKELY APPROVE THAT BUT THAT IS
STILL PENDING CMS APPROVAL AND
WE ARE VERY EXCITED THAT WE WERE
ABLE TO FIND A SOLUTION FOR THAT
MOVING FORWARD SO WE CAN
CONTINUE COVERAGE WITH PEOPLE.
ON THAT NEED THAT SERVICE ALSO
DUE TO THE SHEER VOLUME OF
POLICY CHANGES ARE COUPLED WITH
THE ON YOU KNOW THE HUGE WORK
THAT WILL COME UNDER THE PUBLIC
HEALTH EMERGENCY. DH CS HAS
TAKEN MANY STEPS TO ENSURE THAT
WE ARE AS READY AS WE CAN BE IN
CALIFORNIA. A WE HAVE REQUESTED
MULTIPLE FEDERAL WAIVERS TO
SIMPLIFY THE REDETERMINATION
PROCESS TO SIMPLIFY THE NUMBER
OF TOUCHES ARE COUNTY PARTNERS.
WILL HAVE TO TAKE AND WE'RE TO
STREAMLINE WHETHER IT'S EX PARTE
WHICH IS ESSENTIALLY A FAST.
STREAM ENROLLMENT A
REDETERMINATION PROCESS- TO DO
THINGS WE'VE BEEN WORKING ON
TRAININGS WITH OUR COUNTY
PARTNERS. READINESS PLANS WITH
OUR COUNTY PARTNERS AN EXTENSIVE
TECHNICAL ASSISTANCE TO BE READY
FOR THE RE DETERMINATIONS COMING
BUT FOR US. IN APRIL OF. YEAR
AND SO WE LOOK FORWARD TO
CONTINUING CONTINUING TO WORKING
WITH OUR COUNTY I DIRECTORS AND
A C. W. D. A. ON THIS. VERY
LARGE MOVEMENT. I'M THERE ARE
ALSO TWO COVERAGE EXPANSION
INITIATIVES THAT WERE APPROVED
IN SB ONE EIGHTY NINE LAST YEAR
THAT ARE SUBJECT TO A SPRING
TWENTY TWENTY FOUR
DETERMINATION. THE GENERAL FUND
OVER THE MULTI YOUR FORECAST IS
AVAILABLE TO SUPPORT ON GOING
AUGMENTATIONS. AND ACTIONS. THEY
ARE THE SHARE OF COST REFORM
INCREASING THE MAINTENANCE
LEVELS AND THE CONTINUOUS
COVERAGE OF CHILDREN ZERO TO
FIVE YEARS OF AGE. REGARDING THE
CHANGES ARE FOR THE CALCULATIONS
OF SHARE OF COST FOR MEDICALLY
NEEDY OLDER ADULTS AND PERSONS
WITH DISABILITIES. THIS CHANGE
WILL LOWER OR ELIMINATE THE
SHERIFF COSTS FOR INDIVIDUALS IN
CERTAIN MEDICARE PROGRAMS. AND
WILL POTENTIALLY ALLOW A GREATER
NUMBER OF INDIVIDUALS IN THESE
PROGRAMS THE ABILITY TO MEET
THEIR SHARE OF COST EACH MONTH.
THIS PROPOSAL WILL ALSO ALLOW
THESE INDIVIDUALS TO KEEP MORE
OF THEIR INCOME TO PAY A
NECESSITIES WHILE ALLOWING THEM
TO ACCESS MEDICAL SERVICES. THE
DEPARTMENT ESTIMATES THAT
APPROXIMATELY TWENTY EIGHT
THOUSAND MEDICARE MEMBERS WHICH
TRANSITION FROM HAVING A SHARE
OF COST YOU NO LONGER HAVING A
SHARE OF COST. AND APPROXIMATELY
NINETY ONE THOUSAND MEDICAID
MEMBERS WOULD HAVE A SHARE OF
COST REDUCTION. THE STATE IS
WORKING ON A STATE PLAN
AMENDMENT OBVIOUSLY THAT IS
CONTINGENT UPON APPROPRIATION IN
NEXT YEAR'S BUDGET. THE
CONTINUOUS COVERAGE- FOR
CHILDREN ZERO TO FIVE PROVIDES
CONTINUOUS COVERAGE BY.
DISREGARDING ALL INCOME CHANGES
TO THE CHILD. AND WITHOUT ANY RE
DETERMINATIONS AND TELL THEY
REACH THE AGE OF FIVE. DH CS IS
LOOKING TO THE POLICY DESIGNED
OF ORGAN WHICH RECENTLY HAD THIS
APPROVED BY THE FEDERAL
GOVERNMENT AS A BASELINE IN
REGARDS TO HOW THEY'RE
DESIGNING. WE'VE BEEN HAVING
CONVERSATIONS WITH THEM AND SEE
A MASTER PREPARE FOR THIS
DESIGN. DH CS ASSUMES THAT SIXTY
FOUR THOUSAND A LITTLE OVER
SIXTY FOUR THOUSAND CHILDREN
WOULD REMAIN COVERED IN MEDIC
CAL THAT WOULD OTHERWISE BE THE
CASE IF ABSENCE OF THIS POLICY.
THIS TYPE OF CHANGE THOUGH DOES
REQUIRE A SECTION ELEVEN FIFTEEN
WAIVER FROM THE FEDERAL
GOVERNMENT WHICH HAS A PRETTY
DETAILED PROCESS. AT THE
DEPARTMENT IS COMMITTED TO
STAKEHOLDER ENGAGEMENT AND
WORKING ON AN ENGAGEMENT PLAN TO
REVIEW AND THAT POLICY DESIGN
LATER THIS FALL IN TWENTY TWENTY
THREE. HOWEVER WHILE THE
DEPARTMENT WILL KICK OFF
STAKEHOLDER ENGAGEMENT LATER
THIS YEAR OFFICIAL SUBMISSIONS
OF ANY WAIVERS OR STATE PLAN
AMENDMENTS TO CMS WILL BE
SUBJECT TO A SPRING TWENTY
TWENTY FOUR DETERMINATION. THAT
GENERAL FUND OVER THE MULTI YOUR
FORECAST IS AVAILABLE TO SUPPORT
ON GOING AUGMENTATIONS IN
ACTIONS. HOWEVER WHAT I WOULD
SAY THE DEPARTMENT IS VERY
COMMITTED TO THAT STAKEHOLDER
ENGAGEMENT AND WE DO IT FOR ALL
EXPANSIONS INCLUDING THE ONES
MENTIONED PREVIOUSLY WHERE WE
WORK VERY CLOSELY ON PROGRAM
POLICY DESIGN OUTREACH
MATERIALS. WE WORK ON SYSTEM
CHANGES BE PROVIDE TECHNICAL
ASSISTANCE TO OUR COUNTY
PARTNERS ALL THINGS THAT ARE
NEEDED TO MAKE SURE THAT WE HAVE
SUCCESSFUL IMPLEMENTATIONS. AND
AS YOU CAN SEE BY OUR TRACK
RECORD WHERE WE HAVE EXPANDED
MEDICAID COVERAGE WE ARE FAR
EXCEEDING OUR VARIOUS EXPANSION
NUMBERS IN EVERY EXPANSION THAT
WE'VE DONE IN THE LAST FEW
YEARS. WHICH MEANS THE PROCESS
WE'VE BEEN WORKING ON ENGAGEMENT
WITH OUR LOCALS WITH THEIR
COUNTY PARTNERS IN WITH OUR
ADVOCATES IS WORKING. AND WE ARE
EXCITED TO. POTENTIALLY ENGAGE
IN THOSE OTHER TWO EXPANSIONS
THAT ARE COMING BEFORE US. NEXT
YEAR- ADDITIONALLY THERE WERE
SOME QUESTIONS AROUND THE
SYSTEM'S. DO YOU SEE S. AS IN
MANY OF OUR PARTNERS HAVE BEEN
GOING THROUGH A MASSIVE
MIGRATION OF SYSTEMS IN THE LAST
FEW YOU YEARS WE ARE. THAT THIS
WILL BE A EVENTUALLY COMING TO
AN END I'M IN REALLY WE THINK
ONCE IT IS IT WILL OBVIOUSLY BE
VERY A LOT EASIER FOR US TO
IMPLEMENT SYSTEMS IN ONE SYSTEM
ACROSS HOWEVER WE DO JUST WANT
TO FLAG FOR PEOPLE. ANY CHANGES
AROUND EXPANSION- IN VARIOUS
PIECES WILL ALWAYS REQUIRE
SYSTEM CHANGES WHICH TAKES
DESIGN TESTING CONFIGURATION
TECHNICAL ASSISTANCE TO OUR
COUNTY PARTNERS- AND SO WE WILL
ALWAYS NEED. A NINE TO TWELVE
MONTH RUN WAY FOR ANY MEDICAID
EXPANSION JUST TO MAKE SURE WE
HAVE TIME TO ENGAGE WITH OUR
ADVOCATES TO ENGAGE WITH OUR
PARTNERS AND TO IMPLEMENT
SUCCESSFULLY. I'M SO HAPPY TO
ANSWER ANY QUESTIONS WHEN THE
TIME IS RIGHT. THANK YOU SO MUCH
WILL MOVE ON TO COPY. GREAT
THANK YOU MADAM CHAIR SENATOR
DOT KATHY SANDERLING MCDONALD I
NEED SENATOR RAFIU. THAT
WATCHING CENTER DOT EARLIER. IN
THE SAN. SO YEAH. THANK YOU SIR
- SO I COUNTIES REALLY NEED. FOR
CW- I WAS ASSET ANSWER IF YOU.
AS WELL. SO THE FIRST QUESTION
WAS RELATED TO FROM THE SPEC
PERSPECTIVE OF COUNTY
ELIGIBILITY. HOW THE EXPANSIONS
IMPACTED OUR VOLUME AND THE
COMPLEXITY OF OUR ELIGIBILITY
WORKLOAD- FIRST I WANT TO SAY
THAT COUNTIES HAVE WELCOMED AND
SUPPORTED THAT ELIGIBILITY
EXPANSIONS. WE'RE GLAD TO SEE
THE INCREASE IN UPTAKE TO
MEDICAL PROGRAM. AND THE
ELIGIBILITY CHANGES FOR
UNDOCUMENTED INDIVIDUALS AS WELL
AS SENIORS PERSONS WITH
DISABILITIES AND YOUNG CHILDREN.
THE EXPANSIONS HAVE- DEFINITELY
COME WITH WORKLOAD AS THEY HAVE
BOTH INCREASE OUR CASELOAD AND
MADE SOME CHANGES TO THE PROGRAM
ROLES. SO COUNTIES HAVE UPDATED
AT TRAINING MATERIALS SO THAT
OUR ELIGIBILITY WORKERS KNOW
ABOUT THE COMING CHANGES AND HOW
TO IMPLEMENT THEM WE NEED TO
MAKE OPERATIONAL CHANGES WHEN
THINGS LIKE THIS HAPPEN. SO WE
CAN ADDRESS INCREASING
APPLICATIONS MAKING SURE THAT
WE'VE GOT SYSTEMS IN PLACE TO
MONITOR THAT- AND ALSO THE
INCREASE AN ONGOING CASE
MANAGEMENT WORK THAT REQUIRES.
AND THEN- AT TIMES WE'VE HAD TO
PERFORM MANUAL WORKLOAD AS WE'RE
WAITING FOR EVERYTHING TO GET
FULLY IMPLEMENTED TO ENSURE THE
INDIVIDUALS IN THE EXPANSIONS
ARE GOING TO CONTINUE TO HAVE
MEDICAL COVERAGE. IS ACTUALLY AS
RELATED TO THE LAST THREE YEARS
THE PANDEMIC IN THE CONTINUOUS
COVERAGE REQUIREMENT WE WORK
VERY CLOSELY TO ALL OF THE STEPS
TO MAKE SURE THAT AS WE'VE
EXPANDED WE'VE NOT DROPPED OFF
PEOPLE- ARONIE ASLI- AS THAT
CONTINUOUS COVERAGE REQUIREMENT
HAS BEEN IN PLACE. SO IT IS ALSO
IMPORTANT NOTE- ELIGIBILITY WORK
ISN'T DONE IN A VACUUM WE ALSO
OF COURSE A MINISTER CAL WORKS
AND CALFRESH ON BEHALF OF THE
STATE. AND FEDERAL GOVERNMENT
AND SO OUR WORKERS ARE OFTEN
TRAINED TO PERFORM ELIGIBILITY
FUNCTIONS ACROSS ONE OR MORE OF
THOSE PROGRAM AREAS. AND SO
EXPANSION JUST IN ONE AREA CAN
ALSO AFFECT THE WORK THAT THEY
DO ELSEWHERE BECAUSE WE HAVE TO
THINK ABOUT HOW THE PROGRAMS
WORK TOGETHER. AND MAKE SURE
THAT THE WORKER WHOSE CROSS
TRAINED UNDERSTANDS AS
INTERACTIONS AND CAN WATCH OUT.
FOR THOSE IS ARE IMPLEMENTING SO
THEY DON'T- I. A THE ON A
CALFRESH CASE FOR EXAMPLE WHEN
THEY'RE MAKING A CHANGE A MEDIC
CAL- OVERALL THOUGH- WE FEEL
LIKE THEY'VE GONE WELL AND AS
YOU HEARD FROM. MS COOPER- THAT
THE NUMBERS SEEM TO INDICATE
THAT WERE IN THE RIGHT DIRECTION
WITH THE EXPANSION. WE'RE ALSO
HAS TO TALK ABOUT THE RESOURCES
THAT WE RECEIVE FOR THE
EXPANSIONS ARE WE WILL RESOURCE.
AND HOW DOES THAT ALSO INTERACT
WITH THE UNWINDING OF THE
CONTINUOUS COVERAGE REQUIREMENT
THAT WE'RE GOING TO START AS
YOU. HEARD I KNOW I'M DOING IN
APRIL. I'LL SAY IN GENERAL
COUNTIES HAVE BEEN MORE
ADEQUATELY FUNDED FROM MEDICAID
ELIGIBILITY. THAN WE HAVE IN
RECENT YEARS FOR THE OTHER TWO
PROGRAMS AND WE'LL TALK TO THE
BUDGET PROCESS ABOUT ISSUES THAT
WE'VE GOT. IN THE CALFRESH SPACE
AS WELL AS IN THE CAL WORK
SINGLE ALLOCATION- HOWEVER I
WILL SAY THAT WE'VE IDENTIFIED A
COUPLE OF RECENT ISSUES-
ESPECIALLY WITH THE WAY IN WHICH
THE ADMINISTRATION IS
CALCULATING. OUR ANNUAL COST OF
LIVING ADJUSTMENT. THAT WE ARE
GROWING MORE CONCERNED ABOUT SO
I DID JUST WANT TO PUT. THIS ON
YOUR RADAR TODAY. IT'S A
TECHNICAL ISSUE BUT THE BOTTOM
LINE IS THAT THE ADMINISTRATION.
HASN'T BEEN USING THE MOST
UPDATED CPI NUMBERS ARE THE COST
OF LIVING INDEX NUMBERS TO
ADJUST THAT- AMOUNT THAT WE
RECEIVED- WITH THAT WE RECEIVE
EACH YEAR. ON THIS OCCURRED IN
THE CURRENT BUDGET YEAR-
REMEMBER HOW INFLATION REALLY
SPIKED VERY HIGH IT AT THE
BEGINNING OF TWENTY TWENTY TWO.
I'M UNFORTUNATELY WE DIDN'T SEE-
FUNDING FOR THAT BECAUSE OF THE
WAY THAT THEY- HAD CALCULATED
THE BUDGET. THEY WERE STILL
LOOKING AT AN OLDER NUMBER AND
IT WAS NOT UPDATED FOR THAT
HIGHER NUMBER THE DIFFERENCE WAS
FORTY SIX MILLION DOLLARS. THIS
IS A BIG PROGRAM AND WE DO
RECEIVE A SIGNIFICANT AMOUNT OF
FUNDING ACROSS FIFTY EIGHT
COUNTIES AND FIFTEEN MILLION
RECIPIENTS IN ORDER TO
ADMINISTER IT. AND SO A FEW
PERCENTAGE POINTS CAN TRANSLATE
INTO A SIGNIFICANT AMOUNT. AND
THE ISSUE IS THAT COUNTIES DO
ACTUALLY NEED TO ABSORB THOSE
COSTS I MEAN WE WERE
EXPERIENCING. INFLATION JUST
LIKE EVERYONE ELSE HAS BEEN AND
SO- IT WAS A DIFFICULT
CONVERSATION LAST YEAR- TO TRY
TO FIGURE OUT. HOW DO WE ADJUST
MAYBE THE METHODOLOGY GOING
FORWARD. AND I'LL SAY THAT-
COULD THIS YEAR IT DOES SEEM
LIKE TIMING CONTINUES TO BE AN
ISSUE- THAT WORK. AGAIN NOT
SEEING THE SAY C. P. INCREASE
THAT OTHER ASKED. OF THE STATE
BUDGET NOT IN THIS. ARE AND SO
WILL BE ENGAGING WITH THE
ADMINISTRATION BUT ALSO WANTED
TO PUT ON YOUR RADAR THAT WE'RE
SEEING- ANOTHER ISSUE- AGAIN
THIS YEAR. AND THAT WE ARE I'M
CONCERNED ABOUT THAT SO WE'RE
HOPEFUL THAT WE CAN. KIND OF
NAIL DOWN THE PROCESS AND GET IT
TO BE MORE UP TO DATE. ON OUR
MEMBER ARE MY STAFF HAVE
EXPERIENCE WITH- WORKING IN THE
ADMINISTRATION AND NO KIND OF
WHAT THE PROCESSES FOR UPDATING
THAT AND SO- WILL BE- TALKING
WITH THEM BUT WE ARE CONCERNED
THAT. YOU KNOW IT'S NOT A REALLY
GREAT TIME TO BE KIND OF NICKEL
AND DIMING THE OPERATION ONE
WERE ABOUT TO START THEIR
RECOVERY DETERMINATIONS FOR
FIFTEEN MILLION PEOPLE. MANY OF
WHOM WE'VE NOT WORKED WITH FOR A
REALLY LONG TIME SO I DEFINITELY
WANT TO GET THAT ON YOUR ON YOUR
RADAR WE REALLY APPRECIATE THE
AGREEMENT THAT IN OUR PROGRAM WE
GET A COST OF LIVING ADJUSTMENT.
NOT EVERY PROGRAM DOES BUT
MAKING SURE THAT ACTUALLY
REFLECTS THE ACTUAL COST
INCREASE WOULD BE HELPFUL. I'M I
ALSO WANTED TO LET YOU KNOW THAT
WE ARE REQUESTING FROM THE
ADMINISTRATION A ONE TIME
INCREASE OF FORTY FOUR POINT
FIVE MILLION DOLLARS GENERAL
FUND. TO COVER COUNTY STAFF TIME
ASSOCIATED WITH ANTICIPATED
HEARING. A REQUEST THAT WE
ANTICIPATE GETTING WHEN SOMEONE
IS DISCONTINUED OR HAS
ADJUSTMENTS. THAT ARE
DETRIMENTAL TO THEIR COVERAGE
THEY CAN REQUEST A FAIR HEARING
AND WE WANT TO BE ABLE TO BE ON
HAND TO HELP WITH THAT PROCESS.
COUNTIES TO HAVE STAFF THAT ARE
DEDICATED TO THAT. THEY COVER
ALSO THE CAL WORKS CALFRESH. I
AGES SAYS CHILD WELFARE THE
WHOLE GAMUT OF THE PROGRAMS THAT
WE RUN. AND SO WE KNOW WHAT THE
STATE HEARINGS LEVEL THEY'RE
LOOKING AT WHETHER THEY NEED
ADDITIONAL- ADMINISTRATIVE LAW
JUDGES TO HANDLE THE ANTICIPATED
INFLUX. FROM AN ESTIMATED TWO
POINT EIGHT MILLION PEOPLE
POTENTIALLY BEING DISCONTINUED-
PARTLY BECAUSE THEY MAY NOT
RESPOND. PARTLY BECAUSE PERHAPS
THEIR INCOME HAS GONE UP WE HOPE
THAT IT'S A LOWER NUMBER BUT
CERTAINLY WE WOULD ANTICIPATE
SOME OF THEM. TO ASK FOR A
HEARING SO WE'LL BE TALKING
AGAIN WITH THE ADMINISTRATION
ABOUT THAT BUT ALL. ONE PUT THAT
ON YOUR RADAR AS WELL. ON THE
THIRD QUESTION THAT I WAS AS TO
ADDRESS. WAS RELATED TO THE
OUTREACH THAT WE'VE GOT DONE FOR
THE EXPANSIONS THAT YOU HEARD
ABOUT. I'M I WOULD SAY THAT
COUNTIES REALLY APPRECIATE OUR
OUTREACH WORK THAT THE STATE OUR
COMMUNITY PARTNERS TO YOU. TO
MAKE SURE THAT THE NEWLY
ELIGIBLE POPULATIONS ARE AWARE
OF THE OPPORTUNITY TO APPLY FOR
MEDICAL COVERAGE. AS YOU HEARD
FOR EXAMPLE THE NOTICE TO PEOPLE
WHO'D BEEN PREVIOUSLY. DENIED
BECAUSE OF THEIR ASSETS KNOWING
THAT THAT RULE IS CHANGING WE
WORK VERY CLOSELY TO COORDINATE
TO KNOW WHEN- MESSAGES LIKE THAT
ARE GOING TO BE GOING OUT. SO
THAT WE CAN ALERT OUR WORKERS-
EVEN YOU KNOW ACT COUNTIES FOLKS
AT THE FRONT DESK YOU MIGHT BE
HEARING ABOUT THIS. SO THEY KNOW
THAT THAT'S HAPPENING WE ALSO
USE RESOURCES THAT ARE PRODUCED
BY DHS AS WELL AS- OUR COUNTIES
AND OTHER ORGANIZATIONS. SUCH AS
POSTERS AND FLYERS AND OFTEN.
THOSE I TRANSLATED WHERE THEY
NEED TO BE INTO THE THRESHOLD
LANGUAGES AS WELL SO WE GET.
GOOD OUT REACHING COVERAGE- IN
ADDITION COUNTIES- CAN PUBLICIZE
ELIGIBILITY EXPANSIONS ON OUR
WEBSITES- AND ON OUR SOCIAL
MEDIA PAGES THE NUMBER COUNTIES
ARE VERY ACTIVE. IN SOCIAL MEDIA
AND SO THEY WILL DO THAT KIND OF
OUTREACH AS WELL BECAUSE THEY
KNOW THE PEOPLE CHECK ON GOOGLE
AND KIND OF SEE WHAT'S GOING ON
IN THE PROGRAMS AND THAT THEY
MAY COME IN ACCORDINGLY. WE ALSO
WORK VERY CLOSELY LOCALLY WITH.
OUR LOCAL ORGANIZATION FOR. AND
THEN FINALLY WE WERE ASKED TO
ALSO ADDRESS THE CAL. QUITE
RELATE TO- ELIGIBILITY CHANGES
AND HOW WE DO HAVE THAT LAG AS
OF COOPER WAS NOTING WHEN WE GET
AN ELIGIBILITY CHANGE- AND THAT-
THE HOPE IS. YOU KNOW ONCE WE
GET MIGRATED OVER TO THE
CALZAGHE'S AND HAVE FIFTY EIGHT
COUNTIES IN HEALTH SIZE WHICH-
WE DO ANTICIPATE IN JANUARY
TWENTY TWENTY FOUR. IS IT GOING
TO BE EASIER TO IMPLEMENT- I
WILL SAY IT IS- DEFINITELY THE
CASE OF THE FEDERALLY MANDATED
MOVE TO THE SINGLE- SYSTEM HAS
TAKEN UP. A LOT OF THE BANDWIDTH
FOR SYSTEM CHANGES ELIGIBILITY
EXPANSION PROGRAMMING AND
CHANGES ACROSS ALL OF THE
PROGRAMS THAT ARE WITHIN. THE
SYSTEM AND REALLY LIMITED OUR
ABILITY TO MAKE THESE CHANGES-
AS QUICKLY AS ANY OF US WOULD
WANT. SO THOSE IMPACTS WILL GO
AWAY WHEN THE MIGRATION IS
COMPLETE- WE DO WANT TO KNOW
THAT THE FEDERAL GOVERNMENT.
DIDN'T ALLOW. A LOT OF CHANGES
TO THE UNDERLYING SYSTEM. AND
SO- THERE WILL BE- STILL SOME
LAG BECAUSE IT TAKES TIME TO
AUTOMATE AND OUR SYSTEM ON ALL
OF OUR PROGRAMS THAT WE OPERATE
CALFRESH. AND CAL WORKS AS WELL
AS MEDICARE ALL THEY WERE
TALKING ABOUT TODAY. REALLY
HIGHLY AUTOMATED AND SO MOST
CHANGES IF NOT ALL DO REQUIRE
SOME LEVEL OF AUTOMATION. AND
THE WORKAROUNDS CAN BE VERY
DIFFICULT TO DO MANUALLY SO WHAT
WE DO IS TRY TO. PROVIDE THAT
INPUT AS YOU ALL THROUGH BILLS
OR THE BUDGET PROCESS OR
THINKING ABOUT CHANGES TO SAY
THIS ONE IS BIGGER THAN A BREAD
BOX IS GOING TO TAKE AWHILE OR-
THIS IS ONE THAT WE LOOK IT
LOOKS LIKE. WE CAN MAKE A
RELATIVELY QUICK CHANGE OR MAYBE
THERE'S EVEN A MANUAL WORK
AROUND THAT WE COULD DO IN THIS
CASE SO WE WANT TO BE THERE AND
BE THAT RESOURCE- SHE BILL IN
ORDER TO BE ABLE TO GIVE YOU
HONEST FEEDBACK AND INFORMATION.
AS YOU'RE CONSIDERING CERTAIN
CHANGES SO THAT YOU KNOW HOW
LONG IT WOULD TAKE. ON THE OTHER
THING TO NOTE CHU- IS THAT IT IS
IMPORTANT THAT WE COORDINATE
VERY CLOSELY. AS COOPER NOTED.
ON THE STAKEHOLDER INPUT IT. AND
GET FINAL INSTRUCTIONS TO OUR-
I. T. STAY. BEFORE THEY TO PER.
THE REASON BEING A MANY MANY
YEARS AGO DECADES AGO WHEN WE
FIRST AUTOMATED EVERYTHING AND-
HOW TO STARTED GOING. SOMETIMES
THE SYSTEMS WOULD GET GOING ON
CHANGES. AND THINGS WOULDN'T
REALLY BE FINALIZED YET AND THEN
CHANGES WOULD BE MADE AND THEY'D
HAVE TO STOP AND KIND OF GO
BACKWARDS. AND IT TOOK LONGER
THAN IT NEEDED TO. SO NOW WE DO
HAVE AN AGREEMENT THAT WE REALLY
THAT FINAL IN ORDER TO BE ABLE
TO PROCEED. AND SO ALL THE
POLICY QUESTIONS WHICH REALLY
THE POLICY SHOULD DRIVE
AUTOMATION IT SHOULD BE THE
OTHER WAY AROUND. AND SO WE WORK
REALLY CLOSELY TO TRY TO PUT.
COUNTY STAFF ON THOSE GROUPS
**** OUR TEAM ON THE GROUP
STAKEHOLDERS LIKE THE ONES
YOU'RE GOING TO HEAR FROM. TODAY
TO MAKE SURE THAT WE'RE REALLY
HAMMERING OUT THOSE QUESTIONS SO
THAT WHEN WE GET THAT
INSTRUCTION WE HANDED OVER TO
THE- I. T. FOLKS. IT'S FINAL AND
WE CAN GET GOING AND FEEL
CONFIDENT THAT WHAT THEY'RE
STARTING TO PROGRAM IS WHAT THEY
REALLY NEED A PROGRAM TO MAKE IT
WORK. SO I HOPE THIS IS BEEN
HELPFUL AND OF COURSE HAPPY. TO
ANSWER QUESTIONS AT THE
APPROPRIATE TIME. THANK YOU SO
MUCH CRAPPIE. YEAH I WAS. WHAT
QUESTIONS UNTIL THE OF THE- LAST
PANELIST WE'RE GONNA MOVE ON
OVER TO OR ZUMA- PANELISTS SARAH
DARK. WAS THE DIRECTOR OF HEALTH
AND PUBLIC BENEFITS POLICY AT
THE IMMIGRANT POLICY CENTER
WELCOME. HEY I'M GOOD MORNING
TERRY MEMBERS THANK YOU SO MUCH
FOR HAVING ME TODAY- SO I'VE
BEEN ASKED TO SPEAK TO THE-
MEDIC CALYX PENSION FOR
DOCUMENTED INDIVIDUALS. CIPC THE
CALIFORNIA IMMIGRANT POLICY
CENTER HAS ACTUALLY BEEN- IN THE
PROCESS OF REACHING OUT TO OUR
GRASSROOTS NETWORKS TO SEEK. OUR
INPUT ABOUT HOW TO BE BEST
PREPARED FOR THIS EXPANSION AND
WHAT- THEY ANTICIPATE THE
GREATEST CHALLENGES BEING AND-
BEST PRACTICES FOR GETTING
AROUND THOSE AND SAID LIKE TO
SHARE SOME OF OUR KEY TAKE AWAYS
AND WHAT WE'VE LEARNED SO FAR-
AND- THEY'RE ALL CONSIDERATIONS
I THINK THAT THE STATE CAN. KEEP
IN MIND WHEN THINKING ABOUT HOW
TO DO ITS OWN- OUTRAGE AND HOW
TO BEST SUPPORT CBO PARTNERS
THAT WILL BE ON THE FRONT LINES
OF GETTING THE WORD OUT ABOUT
THIS EXPANSION AND MAKING SURE
THAT PEOPLE ARE ENROLLING- SO
SOME OF THE THINGS WE'VE LEARNED
IN OUR CONVERSATIONS WITH OUR-
PARTNERS WHO ARE. WELL CONNECTED
IN THESE IN THESE YOU KNOW NEWLY
NEWLY ELIGIBLE COMMUNITIES- IS
THAT IT WILL TAKE ONE ON ONE
CONTACT WITH TRUSTED MESSENGERS
AND ONE ON ONE ENROLLMENT
ASSISTANCE TO REACH AND ENROLL
PEOPLE WHO ARE UNDOCUMENTED- AND
- BASED. FACE IS MUCH MUCH MORE
PREFERABLE THAN OTHER METHODS OF
TRYING TO GET IN TOUCH WITH
PEOPLE I'M IN START IN SOME
PARTS OF THE STATE'S THESE
TRUSTED. MESSENGERS THAT DO HAVE
THE DEEPEST REACH AND
RELATIONSHIPS IN THESE
COMMUNITIES MAY NOT NECESSARILY
BE AND ROLLERS THEMSELVES AND
SO- THEY'RE VERY WILLING TO DO
THE OUTREACH- THEY HAVE THE
CAPACITY THEY HAVE THE REACH AND
TRUST IN THESE COMMUNITIES BUT
WILL NEED. TO BE CONNECTED TO
ADDITIONAL PARTNERS THAT CAN
PROVIDE ENROLLMENT ASSISTANCE
AND- A LOT OF THEM HAD SAID HAD
SAID THAT THE MOST IDEAL THING
WOULD ACTUALLY BE. EIGHT TO
BRING ENROLLMENT ASSISTANCE
PARTNERS ON SITE TO WHERE THEY
DO THEIR WORK- AND TO BE
CONNECTED TO THOSE INTO THE TO
HELP THAT TODAY CAN BE A BRIDGE
TO CONNECT OF THAT ENROLLMENT
ASSISTANCE DIRECTLY TO COMMITTEE
MEMBERS- OBVIOUSLY THESE GROUPS
NEED. ADDITIONAL RESOURCES IN
ORDER TO DO THIS WORK- AND- YOU
KNOW A LOT OF THE ISSUES THAT
THEIR STAFF OR DEALING WITH IT
INCLUDES- JUST BURN OUT AND A
LOT OF- THE PAST ANY STRAIN AND-
PARTICULARLY IN RETAINING PEOPLE
WITH LANGUAGE SKILLS AS THAT'S
GOING TO BE A HUGE NEED TO SO IT
MAY TAKE. TIME TO BUILD UP THE
CAPACITY FOR ALL OF THAT WORK-
HAS ALWAYS LANGUAGE ACCESS IT IS
A MAJOR BARRIER FRENCH GENERAL
MEANT. AND TO EVEN JUST KNOWING
ABOUT THE MEDICAID EXPANSION.
PARTICULARLY FOR- LIMITED
ENGLISH PROFICIENT PEOPLE WHO
ARE API OR INDIGENOUS- WORK
SCHEDULES AND TRANSPORTATION IT
WILL MAKE IT VERY DIFFICULT FOR
MANY PEOPLE WHO ARE UNDOCUMENTED
GENERAL AND MEDICARE OUT AND
SUBSEQUENTLY SEEK CARE- COMMON
TYPES OF WORK THAT. ARE SOME OF
OUR GRASSROOTS PARTNERS HAVE
SHARED WITH US THAT THE
COMMUNITIES THEY WORK WITH ARE
ENGAGED IN INCLUDE FARM WORK
DOMESTIC WORKERS HOME CARE
WORKERS. WAREHOUSE WORKERS- DAY
AND DAY LABORERS- THERE ARE SEE
DEALS ON THE GROUND WHO. HAVE
VERY SUCCESSFULLY FOUND WAYS TO
MEET ALL OF THESE INDIVIDUALS AT
THEIR- HOMES OR PLACES OF WORK
OR OTHER GATHERING POINTS- IN
THE COMMUNITY- TO DO. OTHER
TYPES OF OUTREACH AND SERVICE
PROVISION AND COMMUNITY
EDUCATION SO A LOT OF THE CBO'S
DROPPED EVERYTHING TO DO COVAY
WITHOUT REACH AND TO- TAKE.
TESTING AND- BACKS IN. ON SITE
AT PLACES OF WORK OTHER PLACES
LIKE THAT AND SO THEY HAVE- THE
INFRASTRUCTURE. TO SORT OF REACH
THESE PEOPLE- BUT AGAIN IT'S
ABOUT- AND THEY COULD BE
DEPLOYED THESE THIS
INFRASTRUCTURE COULD BE DEPLOYED
TO EDUCATE COMMUNITIES ABOUT
MEDIC HOW- BUT HOWEVER AS AS
NOTED EARLIER THEY'RE USUALLY
NOT ENCRYPTED TO ENROLLMENT AND
SO THEY WOULD NEED ROLLER
PARTNERS ON SITE- OR SOME OTHER
WAY TO CONNECT INTO A WARM HAND
OFF TO AN ENROLLMENT ASSISTER-
THE TRANSIENT NATURE OF THE JOBS
MANY UNDOCUMENTED ADULTS HAVE-
COULD ALSO MAKE MAKE CONTINUITY
OF- ENROLLMENT IN ACCESS TO CARE
A CHALLENGE SO PEOPLE MIGHT BE.
WORKING IN DIFFERENT COUNTIES AT
DIFFERENT TIMES OF THE YEAR AND
THAT PRESENTS A CHALLENGE
OBVIOUSLY FOR THE OBVIOUS
REASONS- BECAUSE OF MEDICAL
BEING ADMINISTERED AT THE COUNTY
LEVEL IN PEOPLE HAVING TO CHANGE
THEIR CASE OVER FROM COUNTY TO
COUNTY. THAT'S SOMETHING I THINK
TO THAT THE STATE SHOULD JUST
ANTICIPATE BE PREPARED FOR AND
FIGURE OUT HOW TO REDUCE THAT
TYPE OF BARRIERS TO THAT TYPE OF
MOVING AROUND. IMPACTING
PEOPLE'S CONTINUITY OF CARE- AND
FOR SOME PEOPLE IT'S EVEN THE
CROSSING STATE LINES YOU KNOW
THERE ARE TRANSIT WORKERS WHO
MIGHT. SPEND ONE PART OF THE
SEASON IN CALIFORNIA AND ANOTHER
PART YOU KNOW DOING AGRICULTURAL
WORK IN ARIZONA OR SOMEWHERE
ELSE SO. THESE ARE THE THINGS
THAT I THINK WE CAN FOR PROBABLY
TRY TO FIND WORK AROUND SO THAT.
IT DOESN'T DISRUPT PEOPLE'S
ABILITY TO GET CARE WHEREVER
THEY ARE- GROUPS THAT IN ROLL
PEOPLE- SO WE DID SPEAK WITH YOU
KNOW BOTH. GRASSROOTS
ORGANIZATIONS THAT HAVE REALLY
DEEP REACH INTO THESE
COMMUNITIES THAT DON'T DO
ENROLLMENT BUT ALSO. WE DID
SPEAK WITH ENROLLMENT
ORGANIZATIONS AS WELL. AND A LOT
OF THOSE ORGANIZATIONS ARE- THE
ONE THAT AGAIN PARTICULARLY WORK
WITH UNDOCUMENTED COMMUNITIES
AS- MANY NAVIGATOR ENROLLMENT.
ORGANIZATIONS STILL YOU KNOW
THERE ARE A SMALL NUMBER OF THE-
CLIENTS THAT THEY SERVE ARE
DOCUMENTED BUT THERE ARE SOME
WHO REALLY- SPECIALIZE IN
WORKING WITH THAT COMMUNITY AND
FOR THOSE- ORGANIZATIONS. THEY
ARE USED TO HOW DIFFICULT IT IS
THEY'VE COME UP WITH THEIR OWN
WORK. AROUNDS- AND MANY OF THEM
WILL US THAT THEY THINK IT WOULD
BE ALMOST AND- TO. ANYWAY WHO'S
UNDOCUMENTED APPLYING WITHOUT
SOME TYPE OF. ONE ON ONE
ASSISTANCE- SO. AGAIN JUST THE
NEED FOR DIRECT ASSISTANCE IS
GOING TO BE- HUGE YOU KNOW AND
POTENTIALLY AN INSURMOUNTABLE
BARRIER TO ACTUALLY GETTING AND
ROLLED IF PEOPLE DON'T HAVE
SOMEONE THEY CAN SIT DOWN WITH
THEM THAT'S CHALLENGING ENOUGH.
A RURAL PART OF THE STATE OR
PART OF THE STATE WHERE- THERE
YOU KNOW THERE AREN'T AS MANY
CBO'S ARE ASSISTANCE AROUND AND
ESPECIALLY FOR AGAIN PEOPLE WHO
ARE IN- LINES OF WORK WHERE THEY
CAN'T. TAKE THAT TIME OFF TO GO
MAKE AN APPOINTMENT AND SIT DOWN
IN THE OFFICE OF YOU KNOW THEIR
LOCAL C. B. L. M. SO JUST
THINKING OF WAYS TO SORT OF
REACH PEOPLE WHERE THEY'RE AT-
AND THEN OBVIOUSLY. THE
ENROLLMENT PROCESS IS
CHALLENGING- DOCUMENTING
IDENTITY INCOME AND OTHER
ELEMENTS IS REALLY DIFFICULT
WITHOUT THAT INDIVIDUAL HELP
FROM AN EXPERT ENROLLMENT
ASSISTER. SO YOU KNOW THIS MIGHT
LOOK LIKE PEOPLE HAVING. NEAR
DEATH I DON'T HAVE A OF A WEEKLY
PAY STUB- I GET PAID VARYING
WAGES EVERY WEEK- AND SO IT MAY
BE YOU KNOW- UNDER THE TABLE OR-
YOU KNOW IN A WAY THAT'S HARD TO
CAPTURE DOCUMENT AND SO WHAT IS
MY MONTHLY INCOME I DON'T KNOW
IT FLUCTUATES RIGHT IN THERE ARE
WAYS THAT ENROLLMENT A SISTERS
KNOW. HOW TO. CALCULATE THAT
COME UP WITH AVERAGES AT CETERA
BUT- PEOPLE NEED THAT TYPE OF
GUIDANCE ON HOW TO DO THAT- SAME
THING WITH YOU KNOW AS YOU CAN
IMAGINE TRYING TO PROVIDE.
INFORMATION ABOUT YOUR IDENTITY.
EVEN SOMETIMES WHERE YOU LIVE
CAN BE CHALLENGING IF YOU'RE
MOVING AROUND. SO GATHERING ALL
THAT INFORMATION AND FIGURING
OUT THE BEST WAY TO PROVIDE ALL
THE NECESSARY DOCUMENTATION IS
GOING TO BE. EXTREMELY
CHALLENGING AND REQUIRE. AGAIN
DEDICATED ONE ON ONE ASSISTANCE
FOR PEOPLE- SOME OF THESE
ENROLLMENT ORGANIZATIONS THAT
MENTIONED THAT THERE COUNTIES
ARE WORKING VERY WELL WITH THE
CBO'S THERE. AND THAT'S HELPED
REDUCE BARRIERS AND LIGHTEN THE
LOAD OF CBO'S OTHER. OTHERS YOU
KNOW HAVE AND HAVE NOT HAD THAT
EXPERIENCE SO- I THINK WHAT. ALL
OF THE GOES TO SHOW IS JUST-
THERE'S A NEED FOR THIS. TO I
THINK HOW MORE OF A FOCUS AND
CAPACITY AND RESOURCES DEDICATED
TO OUTREACH. AND THAT MAY NOT
NECESSARILY BE THE STATE AND
COUNTY IS DOING THE OUT REACH-
ALTHOUGH THAT'S PART OF IT
CERTAINLY- BUT IT ALSO MEANS. A
MUCH MORE ROBUST SUPPORT
ENGAGEMENT AND CAPACITY AND
RESOURCES FOR CBO'S THAT AGAIN.
ARE ALREADY MEETING THESE
INDIVIDUALS DOING COMMUNITY
EDUCATION'S PROVIDING SERVICES-
AND REACHING THEM AND OUR ARM
YOU KNOW MANY OF THEM. HAVE SAID
IN A WE JUST LIKE PICKED UP SOME
MEDICAL APPLICATIONS AND TOOK
THEM OUT YOU KNOW ONCE WE ONCE
THE YOUNG ADULT AND OLDER ADULT
EXPANSION PAST WEEK WE HONESTLY
DON'T KNOW THE BEST WAYS TO FILL
OUT THIS APPLICATION BUT WE'RE
JUST TRYING OUR BEST TO SORT OF.
MAKE SURE COMMUNITIES ARE AWARE
WE DON'T WANT THEM TO MISS OUT
SO. THAT THE WORK- IS BEING DONE
AND PEOPLE ARE- WILLING TO DO
THE WORK BUT THERE'S JUST SOME
SUPPORT NEEDED IN TERMS OF LIKE
TECHNICAL ASSISTANCE. IN ROMAN
ASSISTANCE AND CONNECTING- THE
GROUPS THAT HAVE THE REGION TO
THE COMMUNITY WITH THE GROUPS
THAT HAVE THE LIKE SKILL SET TO
GET THEM THROUGH THE APP VERY
COMPLICATED APPLICATION PROCESS
AND THEN. I'VE I'VE HARDLY EVEN
TOUCHED ON ALL THE ISSUES ONCE
PEOPLE ARE ENROLLED AND YOU KNOW
ALL THE SUPPORT THAT COULD
POTENTIALLY BE NEEDED TO MAKE
SURE PEOPLE ARE. UNDERSTANDING
WHAT IT MEANS TO HAVE COVERAGE
AND UTILIZING IT- AND SO I THINK
THERE'S I DON'T HAVE- YOU KNOW A
SPECIFIC AMOUNT OF DOLLARS THAT
I'M YOU KNOW RECOMMENDING- BE
ALLOCATED OR ANYTHING LIKE THAT
BUT JUST. AS THE STATE IS MOVING
CLOSER AND CLOSER TO THIS
IMPLEMENTATION DATE- I WOULD
JUST ENCOURAGE THAT THE STATE
REALLY THINK. ABOUT IN.
OPPORTUNITIES FOR WHETHER IT'S
NAVIGATOR FUNDING WHETHER IT'S-
JUST ANY ANY SORT OF TRAINING
AND TECHNICAL ASSISTANCE ANY
SORT OF OPPORTUNITIES TO. HELP
THE CBO'S- BUILD UP THE CAPACITY
TO DO THE WORK THAT THEY'RE SO
WELL EQUIPPED TO DO IF THEY JUST
HAD SOME SUPPORT- BECAUSE IT'S
COULD BE JUST ABUNDANTLY CLEAR
THAT. THIS IS NOT A COMMUNITY I
MEAN IF. YOU KNOW WE ALL
UNDERSTAND IT IN MOST CASES HAS
NEVER INTERFACE WITH THE HEALTH
CARE SYSTEM BEFORE ANYWAY. NEVER
GIVEN THEIR INFORMATION TO THE
GOVERNMENT FOR YOU KNOW PUBLIC
BENEFITS APPLICATION OR THE
LIKE- THERE'S JUST SO MANY. SO
MANY BARRIERS AND- IT WOULD BE A
REALLY UP A MISSED OPPORTUNITY
NOT TO TAKE ADVANTAGE OF. THE
CBO'S IN THE INFRASTRUCTURE
THAT'S ALREADY REACHING THESE
COMMUNITIES- AND JUST YOU KNOW
USE THAT AS A CONDUIT FOR
GETTING OUT INFORMATION ABOUT
MEDIC CAL- HEADS. THAT'S- THAT'S
THAT CONCLUDES MY REMARKS TODAY
THANK YOU SO MUCH HAPPY ANSWER
QUESTIONS AS WELL. IS THERE ARE
REALLY APPRECIATE THAT- AND I
WANT TO ECHO THAT I USED TO WORK
AS A DIRECTOR NONPROFIT IS CBO
IN MY DISTRICT ARE- WORKS WITH
PREDOMINANTLY MONOLINGUAL
SPANISH SPEAKER BUT I'M-
PREDOMINANTLY. A FILIPINO
INDIVIDUALS AND WE HELPED DURING
THE KOBE IT RENTAL ASSISTANCE
AND OTHER. PUBLIC BENEFITS RIGHT
AND THE NUMBER ONE THING THAT WE
WOULD HEAR WE PHYSICALLY HELP
PEOPLE FILL OUT THE APPLICATION
WAS THAT. IT WAS SO DAUNTING. IT
WAS LANGUAGE BARRIERS WE CAN SAY
YOU PRESS SCHOOL FOR A CHANGE OF
LANGUAGE I MANY TIMES. AS WE
WANT. IT'S STILL A BARRIER ON
THE SO THERE'S TECHNICAL WORDS
WITHIN AND WE SAW A HUGE
INCREASE AND- PEOPLE WANTING OR
FEELING COMFORTABLE TO APPLY
BECAUSE THEY SAT NEXT TO
SOMEONE. WHO REALLY WALK THEM
THROUGH THAT SO I JUST WANTED TO
ECHO THAT BEFORE WE GO ON TO THE
NEXT PANELIST IF WE CAN
ESTABLISH A QUORUM PLEASE.
SENATORS MANY OF OUR HERE AND
OVER HERE. EGGMAN EGGMAN HAIR
GROWTH. OFF ROTH HERE. GREAT
THANK YOU SO MUCH WE'RE GONNA
MOVE ON TO- KIM A CELLPHONE.
FROM THE MEDIC CALLIN I HSS
POLICY SPECIALIST THANK YOU SO
MUCH WELCOME. GOOD MORNING.
THANKS FOR HAVING ME HERE TODAY
MY NAME IS KIM CELL FONG. I MET
A ADVOCATE ABOUT STATIC LEGAL
SERVICES I APPRECIATE THE
OPPORTUNITY TO LEAD ME TO SPEAK
TODAY. I'VE WORKED ABOUT SETBACK
FOR OVER TWENTY YEARS AS A
MEDICAL ADVOCATE SERVING THE LA
COMMUNITY. MY CLIENTS ARE OLDER
ADULTS WHO ARE SEVERELY IMPACTED
BY DISABILITY AND NEED HELP WITH
THEIR ACTIVITIES OF DAILY
LIVING. ALL MY CLIENTS ARE ON
MEDICARE AND I HSS I CAN'T
EXPRESS HOW EXCITED LIKE TRULY
EXCITED ADVOCATES ARE WITH ALL
THESE MEDICARE REFORMS. THEY
IMPROVE THE HEALTH AND WELLBEING
OF OLDER ADULTS IN OUR COMMUNITY
AND PEOPLE WITH DISABILITIES WHO
NOW HAVE GREATER ACCESS TO
MEDICO. I WANT TO THANK THE
DEPARTMENT OF HEALTH CARE
SERVICES AND THE LEGISLATURE FOR
THESE HISTORIC MEDIC CAL
INVESTMENTS. TODAY I'D LIKE TO
ADDRESS SEVERAL CHALLENGES I SEE
IN ACCESSING. WE ALL KNOW THAT
MEDIC CAL ASSET LIMIT CHANGE
FROM TWO THOUSAND TWO HUNDRED
AND THIRTY THOUSAND DOLLARS IN
JULY. HOWEVER THIS SEEMS TO BE A
CLOSELY HELD SECRET. ALMOST ALL
MY CLIENTS ARE UNAWARE OF THIS
MONUMENTAL CHANGE. THE PEOPLE
MOST SURPRISED OUR MEDICARE
PARTICIPANTS WHO HAD NO IDEA THE
LAW CHANGED. ONE WOMAN I SPOKE
WITH HAS NOT COLLECTED A TWELVE
THOUSAND DOLLAR LIFE INSURANCE
POLICY BECAUSE SHE DON'T WANT TO
LOSE HER MEDICAL BENEFITS.
ANOTHER WOMAN WAS HAPPY TO LEARN
SHE CAN FINALLY START SAVING FOR
A POWER WHEELCHAIR. THE ASSET
LIMIT INCREASE IS ALMOST
MEANINGLESS WHEN PEOPLE DON'T
KNOW ABOUT IT. IT'S VITAL THAT
CURRENT MEDICARE RECIPIENTS ARE
INFORMED OF THE ASSET LIMIT
CHANGED SO THAT THEY CAN BENEFIT
FROM IT AND SAVE FOR THE FUTURE
. WE URGE THE DEPARTMENT OF
HEALTH CARE SERVICES TO FOLLOW
THROUGH ON ITS RECENT
COMMITMENT. TO SEND A MAILER TO
CURRENT MEDICARE PARTICIPANTS
AND INFORM THEM OF THIS
WONDERFUL CHANGE THE PROGRAM. WE
HOPE THE DEPARTMENT CAN COMMIT
TO A TIME FRAME TO SEND THE
MAILER AND THE STAKEHOLDER
REVIEW PROCESS LET'S SPREAD THIS
GOOD NEWS. LOOKING TO THE FUTURE
. I URGE SHARE OF COST REFORM BE
IMPLEMENTED. THE SHARE OF COST
BASE LEVEL MUST BE CHANGED FROM
SIX HUNDRED DOLLARS A MONTH TWO
HUNDRED AND 38% OF FEDERAL
POVERTY LEVEL. I ASK EACH ONE OF
YOU. COULD YOU LIVE ON SIX
HUNDRED DOLLARS A MONTH TO PAY
YOUR RENT YOUR UTILITIES YOUR
FOOD YOUR PHONE YOUR OTHER BILLS
. IT'S IMPOSSIBLE YOU SAY.
THAT'S EXACTLY WHAT MEDICARE NOW
AND CALIFORNIA REQUIRES OF OLDER
AND DISABLED ADULTS IN THE
MEDICARE'S SHARE OF COST
PROGRAM. THEY ARE ONLY ALLOWED
TO HAVE SIX HUNDRED DOLLARS IN
INCOME. AND THE REST MUST GO
TOWARDS THEIR MONTHLY MEDICARE'S
SHARE OF COST. NO ONE SHOULD
HAVE TO LIVE ON SIX HUNDRED
DOLLARS A MONTH ESPECIALLY OUR
MOST VULNERABLE CITIZENS.
CHANGING SHARE OF COST TWO
HUNDRED AND 38% OF FEDERAL
POVERTY LEVEL IS AN EQUITABLE
REMEDY TO OUR CURRENT IN
EQUITABLE SYSTEM. FINALLY WE'RE
CONCERNED ABOUT THE END OF THE
PUBLIC HEALTH EMERGENCY AND
POTENTIAL MEDICAL TERMINATIONS.
MANY PEOPLE HAVE MOVED SINCE
TWENTY TWENTY I HAVE NOT UPDATED
THEIR ADDRESSES WITH MEDICA. A
CLIENT EMAIL ME IN JANUARY
STATING QUOTE. I HAVE BEEN
TRYING TO CONTACT MEDICAL FOR
DAYS WITH NO SUCCESS TO CHANGE
YOUR ADDRESS AND PHONE NUMBER.
EVERY TIME I CALL AFTER A THIRTY
MINUTE WAIT THE MESSAGE SAYS
THEY'RE TOO BUSY AND TO CALL
BACK LATER AND I'M DISCONNECTED
. I DID FIND A MEDIC CAL CONTACT
UPDATE FORM BUT IT HAD NO
MAILING ADDRESS. SHE WAS
PROACTIVE BUT SHE COULD NOT
OVERCOME THE BARRIERS TO
COMPLETE WHICH SHOULD BE A
SIMPLE TASK OF CHANGING HER
ADDRESS. I AM CONCERNED PEOPLE
WILL BE TERMINATED BECAUSE THEY
COULD NOT UPDATE THEIR ADDRESSES
OR CONTACT MEDICARE TO PROVIDE
OTHER NECESSARY INFORMATION. WE
SUGGEST A SAFETY NET BE CREATED
TO CATCH PEOPLE WHOSE MEDICAL
SERVICES ARE TERMINATED. SOME
OPTIONS ARE. CHINESE COULD
CREATE A DEDICATED PHONE LINE TO
ASSIST WITH THE MEDICAL
TERMINATIONS ONLY. THIS CALL
SHOULD BE PRIORITIZED AND PEOPLE
SHOULD HAVE AN OPTION TO LEAVE A
MESSAGE OR CALL BACK BECAUSE
PEOPLE CAN. OFTEN NOT GET
THROUGH ON THE CUSTOMER SERVICE
SITE LINE IN LA AND I KNOW
THAT'S NOT JUST SPECIFIC TO L.
A. COUNTY. COUNTIES COULD CREATE
SPECIALIZED WORKERS TO ASSIST IN
CURING THE MEDICAL TERMINATION
CASES. AND IN ORDER TO QUICKLY
REINSTATE ELIGIBILITY COUNTY
SHOULD ENCOURAGE WORKERS TO
ALLOW PEOPLE TO SUBMIT STORE
INSTATEMENT OVER THE PHONE OR
ONLINE WHICH ELIMINATE THE DELAY
OF PROVIDED DOCUMENTS THROUGH
THE MAIL. WE MUST PROTECT OUR
MOST VULNERABLE CITIZENS FROM
LOSING VITAL HEALTH CARE. SHARE
PARTNERSHIP AND LOOK FORWARD TO
OUR CONTINUED WORK TOGETHER
THANK YOU. THANK YOU KIM FOR
SHARING THAT MOVING ON TO OUR
NEXT PANELIST WE HAVE LIVED AWAY
FROM THE WESTERN CENTER ONLINE
PROPERTY WELCOME. GOOD MORNING
CHAIR MEMBERS LINDA WAY WITH
WESTERN CENTER ON LAW AND
POVERTY FIRSTLY WE WANT TO
COMMEND THE ADMINISTRATION AND
THE LEGISLATURE'S RECENT META
CALYX PENSION THAT WILL MAKE
CALIFORNIA THE FIRST IN THE
NATION TO COVER ALL LOW INCOME
ADULTS REGARDLESS OF IMMIGRATION
STATUS. TOGETHER WITH THE END OF
THE SENIOR PENALTY AND THE
SCHEDULED ELIMINATION OF THE
ASSET TEST ALL ADULTS UNDER A
HUNDRED AND 38% OF THE FEDERAL
POVERTY LEVEL WILL BE ELIGIBLE
FOR FREE FULL SCOPE MEDI CAL
AFFECTED JANUARY TWENTY TWENTY
FOUR. ENROLLMENT INTO FULL SCOPE
MEDICARE IT'S EASY FOR SOME FOR
EXAMPLE THE DEPARTMENT SAID
MAILERS TO PEOPLE WHO ARE DENIED
MEDICARE OUT DUE TO BEING OVER
INCOME OR ABOVE ASSET INVITING
THEM TO RE APPLY. THE DEPARTMENT
ALSO AUTOMATICALLY MOVED YOUNG
ADULTS AND PEOPLE FIFTY AND
OLDER FROM RESTRICTED EMERGENCY
SCOPE TO FULL SCOPE. BUT AS
GREAT AS THESE ENROLLMENT
PATHWAYS ARE FOR SOME MORE IS
NEEDED. MANY LOW INCOME PEOPLE
AREN'T AWARE OF THESE EXPANSIONS
THEY SOON THAT THEY ARE ELIGIBLE
SO DON'T EVEN BOTHER APPLYING
FOR MEDICARE. THE ASSET TEST IS
A DECADES OLD RULE THE BEFORE
JULY IT REMAINED UNCHANGED
DESPITE INFLATION. SO WHEN THE
ASSET TEST EXCUSE ME SO WHEN THE
ASSET LIMIT INCREASE WE EXPECTED
A MUCH LARGER GROUP OF
INDIVIDUALS TO BE NEWLY
ENROLLED. MR ARE HIGHLIGHTED THE
NEED FOR TRUSTED PARTNERSHIPS TO
OUT REACH FOR HEALTH FOR ALL
EXPANSION SO WILL ALSO SHARE THE
NEED TO UPDATE. APPS TO UPDATE-
SOME FORMS OF BIRTH THE INSTANCE
THE MCV THIRTEEN FORM STILL USES
THE TERM ALIENS STATING THAT
ONLY THOSE ALIENS WITH STEP
SATISFACTORY IMMIGRATION STATUS
ARE ELIGIBLE FOR FULL SCOPE MEDI
CAL. THIS IS DESPITE THE NOT SO
RECENT EXPANSIONS. TO
INDIVIDUALS REGARDLESS OF
IMMIGRATION STATUS. WITH THE
IMPLEMENTATION OF ALL THESE
EXPANSIONS THE MEDIC CALIFORNIA
TWENTY FOUR IS NOT THE MEDIC
KALIFAT STE. THIS SHOULD BE SUB
CELEBRATED AND PUBLICIZED SO
URGES THE DEPARTMENT TO WIDELY
SHARE THIS NEWS THROUGH OUTREACH
AND PARTNERSHIPS WITH COMMUNITY
BASED ORGANIZATIONS. EXISTING
RESOURCES LIKE THE TWENTY FIVE
MILLION DOLLAR CONTRACT WITHOUT
REACH VENDOR GMM BE FOR
UNWINDING COULD ALSO ENCOURAGE
PEOPLE TO SIGN UP FOR MEDICARE
OUT. WE RECOMMEND THE DEPARTMENT
EXPLORE SUSTAINING THE CAMPAIGN
BEYOND MAY TWENTY TWENTY FOUR TO
ENCOURAGE CONTINUED ENROLLMENT.
I ALSO WANT TO PUBLICLY THANK
THE DEPARTMENT FOR TO WORK TO
MINIMIZE COVERAGE INTERRUPTIONS
FOR SENIORS AND PERSONS WITH
DISABILITIES ONCE RENEWALS
RESUME THIS APRIL AND BEFORE THE
ASSET TEST IS COMPLETELY
ELIMINATED NEXT JANUARY. WITHOUT
THIS MANY SENIORS AND PERSONS
WITH DISABILITIES WOULD HAVE HAD
THEIR MEDICARE HEALTH TERMINATED
FOR FAILURE TO VERIFY OR FOR
BEING ABOVE THE CURRENT ASSET
LIMIT. HOWEVER COVERAGE
TERMINATIONS WRITTEN UP HOWEVER
COVERAGE TERMINATION CONCERNS
REMAIN. ADVOCATES FROM ACROSS
THE STATE ALAMEDA SANTA BARBARA
LA AND SACRAMENTO TO NAME A FEW
REPORT COUNTY CALL WAIT TIMES IN
EXCESS OF THIRTY MINUTES.
DISCONNECTS AND DROPPED CALLS
AND OTHER BARRIERS THIS IS PRIOR
TO UNWINDING AND BEFORE THE
EXPECTED SURGE IN CALL VOLUMES
WE WORRY THAT INDIVIDUALS WILL
BE TERMINATED NOT BECAUSE THEY
ARE NO LONGER ELIGIBLE BECAUSE
THEY CANNOT REPORT THEIR NEW
ADDRESS CHANGE OR OTHER CHANGES.
L. A. COUNTY CALL ABANDONMENT
RATE AVERAGE 20% LAST YEAR
MEANING OVER A HUNDRED THOUSAND
PEOPLE A MONTH. GOT TIRED OF
WAITING AND HUNG UP. EVEN WORSE
AN ADDITIONAL HUNDRED FIFTY
THOUSAND CALLS PER MONTH WE'RE
SIMPLY DISCONNECTED BECAUSE CALL
VOLUME WAS TOO HIGH. IT'S
UNCLEAR HOW MANY PEOPLE GAVE UP
COMPLETELY OR TRIED AGAIN BUT
THIS DEMONSTRATES A DISCOURAGING
PROCESS THAT IS EXPECTED TO
BECOME EVEN MORE CHALLENGING. WE
APPRECIATE FEDERAL GUIDANCE
REQUIRES COUNTIES TO CHECK OTHER
SOURCES LIKE THE MEDICARE PLAN-
AND REQUIRE CONTACT BEYOND A
MALE BUT WE FEAR PEOPLE WILL
LOSE THEIR MEDICAID OUT EVEN
THOUGH THEY DID EVERYTHING
RIGHT. INCLUDING TRYING TO
PROACTIVELY CONTACT THE COUNTY.
IN LIGHT OF COUNTY OFFICE
STAFFING SHORTAGES THE COUNTY
COMPUTER SYSTEMS AUTOMATIC CUT
OFF FUTURE LOOMS LARGE.
BASICALLY IF A CASE IS NOT
TOUCHED THEN THE MEDICARE WILL
AUTOMATICALLY END. WHEN COUNTIES
ARE OVERWORKED AND THERE'S NO
GUARANTEE THAT SUBMIT IT FOR NEW
INFORMATION WILL BE MARKED AS
RECEIVED IN TIME. THOUSANDS AT
RISK ARONIE IS TERMINATION
STUPID THE AUTO TERMINATION
FUNCTIONALITY. WE RECOMMEND
SAFEGUARDS TO PROTECT MEDICARE
ENROLLEES FROM BEING UNDULY
TERMINATED. THERE NEEDS TO BE
SOME SORT OF HOLD FUNCTION ONE
MEDIC HOW CUT OFF EXCEED
EXPECTATIONS AS WELL AS DATA
MEASUREMENTS IN PLACE TO KNOW
WHEN TO STOP TERMINATIONS. THIS
MAY INCLUDE MONITORING CALL
CENTER VOLUMES REQUEST FOR STATE
HEARINGS VOLUME OF TO-
TERMINATIONS COUNTY STAFFING
READY MISS REPORTS AND MORE.
BOTTOM LINE GIVEN THE CURRENT
DIFFICULTIES THE DEPARTMENT
SHOULD BE PLANNING FOR SAFETY
FILE. THANK YOU. I REALLY
APPRECIATE THAT LINDA AND OUR
FINAL PANELIST IS GOING TO BE
KRISTIN GOLDEN TESTER- FROM THE
CHILDREN'S PARTNERSHIP. THANK
YOU. I'M I'M HERE TO TALK ABOUT
THE A MULTI YEAR CONTINUOUS
COVERAGE PROPOSAL FOR CHILDREN
WERE VERY PLEASED THAT-
CALIFORNIA HAS IT ENACTED THIS
POLICY- THE EVIDENCE IS QUITE
CLEAR THAT STABLE COVERAGE IS
GOING TO INCREASE- WELL CHILD
VISITS DENTAL CARE. AND BETTER
HEALTH OUTCOMES CONVERSELY GAPS
IN COVERAGE ARE GOING TO LEAD TO
DELAYS IN CARE UNMET NEED AND
RISKS OF HOSPITALIZATION- THE
AIM OF THIS POLICY AND WHEN IT
WAS IMPLEMENTED WAS INTENDED TO
CONTINUE TO PROTECT CHILDREN
WHEN THE FEDERAL CONTINUOUS
COVERAGE PROPOSAL ENDED- THE
ABSENCE OF THE CONTINUOUS
COVERAGE PROPOSAL WILL MEAN.
THAT ABOUT EIGHT HUNDRED TO A
MILLION CHILDREN WILL BE LOSING
COVERAGE DURING THE UNWINDING OF
THIS IS A GREAT RISK AND A BIG
STEP BACKWARDS IN OUR ENROLLMENT
OR AGAIN AS YOU HEARD- HAS
ALREADY ADOPTED AND IS GOING TO
BE OPERATING IT'S CONTINUOUS
COVERAGE PROPOSAL. AT SO THAT IT
WILL SEAMLESSLY- BACK UP ON THE
UNWINDING THAT THEY'RE GOING
THROUGH SO THEIR CHILDREN WILL
NOT HAVE TO LOSE COVERAGE
UNFORTUNATELY CALIFORNIA IS NOT
ON TRACK TO BE ABLE TO BE
PREPARED- TO IMPLEMENT THE
CONTINUOUS COVERAGE WHEN DO F.
GIVES THE GREEN FISCAL LIGHT- TO
DO SO AND- TWENTY TWENTY FOUR.
IN LAST YEAR'S BUDGET- DH CS HAD
SAID THAT- IT WAS GOING TO HAVE
THERE WERE SOME LENGTHY
PREPARATIONS NECESSARY ONE IS TO
SUBMIT A LEVIN FIFTEEN WAIVER.
TO IT AS YOU HEARD FROM KATHY
IS- THE COUNTY GUIDANCE AND
DEVELOPING THAT POLICY AND THREE
IS THAT LINK THE AUTOMATION TIME
IT TAKES- FOR THE SYSTEM CHANGES
WE ARE DEEPLY CONCERNED THAT THE
DEPARTMENT IS NOT DOING THESE
PREEMPTIVE- FREE- IMPLEMENTATION
STEPS. TO BE READY TO GO LIVE
WHEN THE DEPARTMENT OF FINANCE
GIVES THE FISCAL GREEN LIGHT
AND- SPRING OF TWENTY TWENTY
FOUR- IT WHAT WE'RE HEARING IN
AND THAT YOU HEARD IN THE
TESTIMONY THAT- THAT THE THEY
ARE WAITING UNTIL THE DEPARTMENT
OF FINANCE OFFERS THAT BEFORE
STARTING WITH THE WAIVER. WE
HAVE BEEN URGING- THE THEM TO
NOT DELAY IN FACT IT WAS VERY
CLEAR IN THE BUDGET LAW THAT
THERE WAS SUPPOSED TO BE THIS IS
THE TRIGGER LANGUAGE IN THE
BUDGET LANGUAGE THAT SAYS THEY
ARE SUPPOSED TO BE SUPPORTING
AND PREPARING FOR THESE FUTURE
PROGRAMS- AND SO WE'RE ASKING
THAT THE DEPARTMENT EXPEDITE.
THE PREPARATION SO THIS POLICY
CAN GO LIVE ON WE GET THE
FISCAL- GREEN LIGHT FROM
DEPARTMENT OF FINANCE. MS WE
CONTINUE TO URGE THEM TO OF
IMMEDIATELY BEGIN THESE LIKE THE
PREVIOUS ADMINISTRATION-
PLANNING. PARTS FOR EXAMPLE WE
WANT THE WAIVER TO BE SUBMITTED
AS SOON AS POSSIBLE NOW TO THE
HAVE STE CONVERSATIONS NOW ON
THE POLICY DEVELOPMENT GIVEN THE
LONG A LENGTH OF TIME IT TAKES.
TO IMPLEMENT THEM AND THEN ALSO
AS YOU HEARD IT'S A VERY LENGTHY
PROCESS FOR AUTOMATION SYSTEM
MODIFICATIONS SO WE'D LIKE TO
BEGIN THAT PROCESS OF PLANNING
AS SOON AS POSSIBLE. AND WE URGE
THE COMMITTEE- TO INSTRUCTED THE
DEPARTMENT TO START THOSE PRE
PLANNING PREPARATIONS NOW. THERE
ARE SEVERAL THINGS THAT CAN BE
DONE IN ORDER TO MAKE IT AS
SEAMLESS AS POSSIBLE WITH THE
UNWINDING AND CHILDREN NOT
FALLING THROUGH THE GAPS- YOU'VE
HEARD THAT- THERE WAS A OF AN
APPROVAL FROM A E. FOURTEEN MAX-
FLEXIBILITY WAIVER- FOR OTHER
POPULATIONS WE HOPE THAT
CALIFORNIA WILL CONSIDER THAT.
FOR CHILDREN THAT WOULD INCLUDE
DE PRIORITIZING CHILLED YOUNG
CHILDREN'S APPLICATIONS OR
RENEWALS SO THAT IT COULD BE AT
THE FURTHER END OF THE UNWINDING
PERIOD AND HOPEFULLY IN TIME FOR
IF PREPARED IN ADVANCE. THE
IMPLEMENTATION OF THE- OF THE
CONTINUOUS COVERAGE PROPOSAL FOR
KIDS. REALLY IS A CRITICAL TIME
FOR CHILDREN- THE REASON WHY
THIS POLICY IS A DIRECTED AT
CHILDREN YOUNG CHILDREN IS
BECAUSE IN THOSE FIRST FEW YEARS
A LIFE 90% OF THEIR BRAIN
DEVELOPMENT IS OCCURRING. AND
SMALL GAPS IN COVERAGE CAN BE
VERY DISRUPTIVE BECAUSE CHILDREN
BEFORE THE AGE OF FIVE HAVE
ABOUT FOURTEEN WELL CHILD VISITS
AND SCREENINGS THAT OCCUR IN
THOSE TIMES- WE KNOW THAT
CONTINUOUS COVERAGE CAN MAKE A
BIG DIFFERENCE AND MAKING SURE
THAT THE GAPS- THAT THEY DON'T
HAVE AS MUCH GAPS AS WE'VE SEEN
IN THE LAST. FEW YEARS OF THE
FEDERAL CONTINUOUS COVERAGE
PROPOSAL THAT IT HAS REDUCED
CHILDREN'S- GAPS IN COVERAGE BY
ABOUT SEVENTY FIVE PERCENT. AND
WE HOPE TO PROTECT THOSE
CHILDREN BY ASKING THAT THE
IMPLEMENTATION AND THE
PREPARATIONS ARE- HAPPENING
RIGHT NOW TO PREPARE FOR OUR
CONTINUOUS COVERAGE IN
CALIFORNIA THANK YOU. THANK YOU
SO MUCH- BEFORE WE TURN TO
QUESTIONS UP HERE WOULD LIKE TO
ASK A LEO. OR DEPARTMENT OF
FINANCE IF THEY HAVE ANY
COMMENTS. MCLEISH MORROW AT THE
LA- WE DO NOT HAVE ANY COMMENTS
FOR THIS PANEL THAT ARE
AVAILABLE FOR QUESTIONS GREAT
GIFTS. DEPARTMENT OF FINANCE I
WELCOME YOU UP. HI A DETAIL OF
THE DEPARTMENT OF FINANCE NO
FURTHER COMMENTS AT THIS TIME A
WELCOME QUESTIONS. GREAT THANK
YOU SO MUCH. I HAVE TO REMEMBER
THAT MY COLLEAGUES HAVE PROBABLY
HAVE QUESTIONS AS WELL SO I
WON'T TAKE UP TOO MANY OF MY
QUESTIONS HERE I'M DON'T START
OFF ACTUALLY WITH THE MOST
RECENT TOPIC BECAUSE YOU YOU.
MISS KRISTIN. MENTIONED A LOT OF
QUESTIONS AND I HAVE MYSELF TELL
START UP HERE THIS COOPER WITH
QUESTIONS REGARDING THIS
CONTINUOUS OF CARE AND WONDERING
YOU KNOW I HEARD. THE ELEVEN
POINT FIVE WAIVER YOU'RE WAITING
FOR THE GREEN LIGHT FOR- FUND
DEAN. AND IF I HEARD CORRECTLY
SHOULD BE BEGINNING IN FALL BUT
YOU TALK TO ME A LITTLE BIT MORE
ABOUT HOW YOU'RE LOOKING AT
THOSE THREE THINGS OF SUBMITTING
THE WAIVER AND THE GUIDANCE FOR
COUNTIES IN THE ROMAN SYSTEM
MEDICATIONS WHY CAN'T THAT BE
DONE BEFORE. THE ALLOCATION OF
FUNDS SURE SO HAPPY TO WALK
THROUGH SOME OF THAT AS YOU
PROBABLY ARE AWARE IN THE BUDGET
ACT TO- LAST YEAR ON THIS WAS
APPROVED TO GO LIVE NO SOONER
THAN CHEN ONE OF TWENTY TWENTY
FIVE- AND- WITH THE ENDING OF
THE PUBLIC HEALTH EMERGING.
EMERGENCY AS YOU WOULD IMAGINE A
LOT OF OUR TIME ENERGY AND FOCUS
HAS BEEN ENSURING THAT WE
CONTINUE TO HAVE COVERAGE FOR
THE FIFTEEN. POINT THREE MILLION
PEOPLE THAT ARE CURRENTLY IN OUR
PROGRAM TO ENSURE OUR SYSTEMS
ARE READY OUR COUNTIES ARE
READY- IN OUR ADVOCATES AND
NAVIGATORS ON THE GROUND READY
TO ENSURE PEOPLE THAT HAVE
COVERAGE MEANING MAINTAIN
COVERAGE- AND SO I THINK THAT IS
ONE THING THAT WE HAVE BEEN VERY
FOCUSED ON. WE ARE VERY
COMMITTED TO STAKEHOLDER
ENGAGEMENT AS WE DO ON ALL OF
OUR COVERAGE EXPANSIONS- A
INCLUDING THIS PARTICULAR
COVERAGE EXPANSION. WE HAVE HAD
CONVERSATIONS WITH HER
COLLEAGUES IN OREGON TO
UNDERSTAND THEIR MODEL THEIR
PROCESS THEIR PIECES. I'M FROM A
STATE TO STATE CONVERSATION
WHICH IS IMPORTANT FOR US TO
GROUND OURSELVES IN THAT TYPE OF
POLICY FIRST. I'M AND HAVE
SOMETHING FOR PEOPLE TO RESPOND
TO AND REACT TO WHEN WE DO GO
OUT TO PUBLIC ENGAGEMENT AND
STAKEHOLDER ENGAGEMENT- IN THE
FALL THE WE DO IMAGINE WE WILL
START ROLLING UP OUR SLEEVES
EVEN MAYBE LATE SUMMER. ROLLING
UP OUR SLEEVES WITH A PROPOSAL
FOR PEOPLE TO RESPOND TO HAVE ON
FEEDBACK TO WE USUALLY DO
MULTIPLE MONTHS OF ENGAGEMENT
AND REGARDS TO THAT SO STARTING
EVEN IN TWENTY TWENTY THREE FOR
SOMETHING GOING I. IN TWENTY
FIVE- WILL START THOSE
CONVERSATIONS THAT WOULD INCLUDE
OUR FULL POLICY PIECES HOW WE
PLAN TO IMPLEMENT. IT INCLUDES
HOW WE WILL I'M DESIGN OUT REACH
AND ENGAGEMENT MODALITIES AND WE
HAVE A NUMBER OF STAKEHOLDER
WORKGROUPS THAT WE DO THESE
DESIGN CONVERSATIONS WITH. WE
ALSO DID A FULL ASSESSMENT
ORIGINALLY ON THE SYSTEMS THAT
NEEDED TO HAPPEN. ONE OF THE
REASONS WHY WE ALL. A
RECOMMENDED IN ADDITION TO THE
BUDGET PROTECT A POTENTIAL
IMPLICATIONS. IS THE SYSTEM
MIGRATION THAT BOTH KATHY AND I
MENTIONED EARLIER MAKING SURE
THAT WAS BEYOND US IN REGARDS TO
THE GO LIVE TIME BECAUSE THIS
WILL BE A PRETTY LARGE SYSTEM
IMPLEMENTATION. AS KATHY
MENTIONED- AND I DID IN MY
OPENING COMMENTS WE HAVE TO HAVE
THE POLICY NOW DOWN TO BE ABLE
TO EVEN DO THOSE SYSTEM PIECES
WHICH IS WHY WE'RE STARTING TO
ENGAGE IN THOSE POLICY
CONVERSATIONS IN TWENTY TWENTY
THREE. I WE ARE VERY VERY
COMMITTED TO THAT. HOWEVER WE DO
ALSO WANT TO MAKE SURE THAT WE
HAVE- APPROPRIATION TO MOVE
FORWARD BEFORE WERE OFFICIALLY
GOING TO THE FEDERAL GOVERNMENT
WITH ASKS LIKE WAIVERS. OF
COURSE WE WILL START BUILDING
THE WAIVER WE WILL START DOING
THOSE VARIOUS PIECES. BUT WE
TYPICALLY UNTIL WE HAVE SOME-
EITHER PREPARATION BUDGET OR
PROPOSAL IN THE BUDGET.
TYPICALLY DON'T GO TO SEEK
FEDERAL APPROVAL FOR VARIOUS
PIECES AND TELL WE HAVE THAT
RELATIVELY. GREEN LIGHT WHICH IS
WHY I MENTION THAT IN MY
COMMENTS YOU KNOW ONCE WE GET
THAT GREEN LIGHT HOPEFULLY IN
THE SPRING OF TWENTY FOUR FROM
THE DEPARTMENT OF FINANCE THAT
WE CAN PROCEED. I'LL BE WOULD
IMMEDIATELY MOVE TO THOSE TO
THOSE ACTIONS. ARE BUT AGAIN
FULLY COMMITTED BETWEEN NOW AND
THAT PERIOD OF TIME TO ENGAGE
WITH STAKEHOLDERS AND HAPPY TO
ANSWER ANY OTHER QUESTIONS I THE
OTHER THING I WOULD JUST OUT IF
I COULD- WE ALSO ARE WORKING. ON
THREE OTHER ELEVEN FIFTEEN
WAIVERS AT THIS TIME WITH THE
FEDERAL GOVERNMENT TO- WE ARE
DOING A LOT IN CALIFORNIA. IN
MEDIC CAL AND SO WE ALSO HAVE TO
BE- SENSITIVE AND AWARE OF THAT
WITH OUR FEDERAL PARTNERS IN
REGARDS TO THAT ENGAGE AND SO I
JUST WANTED TO MENTION THAT. I
APPRECIATE YOU KNOW. DOING THE
LEGWORK BEFORE PUTTING SOMETHING
OUT YOU KNOW I'M A FIRM BELIEVER
THAT WOULD WORK FORWARD NOT
BACKWARD SETTING SOMETHING UP SO
I. I HEARD A LOT OF GOOD REASONS
REGARDING NUMBER TWO AND THREE
ON THE GUIDANCE TO COUNTIES AND
THE SISTER MY- I GUESS I STILL.
MY OWN LEARNING HERE AS A NEW
MEMBER OF. NOT UNDERSTANDING WHY
WE COULDN'T WHY WE CAN START
WORKING ON GETTING THIS FEDERAL
EVER READY TO GO. FOR WHEN WE
HAVE THE GREEN LIGHT WE CAN JUST
SUBMIT IF YOU COULD JUST GO A
LITTLE BIT MORE ON THAT FIRE. SO
WE WILL WE WILL DO A FULL WE
WILL. FIRST HAVE TO DECIDE THE
POLICY WHEN YOU SUBMIT A FEDERAL
WAIVER THERE'S A NUMBER OF
PIECES WE WILL HAVE TO HAVE A
FULL. ON EXPENSES CALL BUDGET
CHARITY SUPER JOAQUIN. NOT
NECESSARY. BUT WE WILL HAVE TO
WORK ON ALL OF THOSE VARIOUS
ASSUMPTIONS IN REGARDS TO THE
SUBMISSION. THERE SO WE WILL
START ALL OF THAT WORK FAR IN
ADVANCE- AND THOSE ARE THE TYPES
OF STAKEHOLDER ENGAGEMENTS WE
WILL START THIS LATE SUMMER AND
FALL. WE'LL START TALKING TO THE
POLICY DESIGN. HOW IT IT YOU
KNOW- IMPROVES- ACCESS WE WILL
HAVE TO COME UP WITH AN
EVALUATION DESIGN. THAT IS
REQUIRED WHEN WE SUBMIT A WAIVER
TO THE FEDERAL GOVERNMENT
HOWEVER WE CAN EVALUATE.
INCREASED ACCESS. YOU HAVE TO
HAVE HYPOTHESES. WE WILL ENGAGE
IN ALL OF THOSE CONVERSATIONS
STARTING THIS SUMMER AND FALL.
BECAUSE WE WILL HAVE TO HAVE ALL
OF THAT READY FOR IT. ULTIMATELY
A SUBMISSION WE'RE HOPING THAT
THERE'S AN APPROPRIATION IN THE
BUDGET AS WE ALL DO. I WHICH IS
WHY WE COMMITTED TO IT LAST
YEAR. I'M AS SOON AS WE GET THAT
WE WOULD SUBMIT SO WE WOULD BE
DOING. ALL OF THAT WAIVER BUILD
ALL OF THOSE POLICY
CONVERSATIONS DECISIONS THAT
NEED TO BE MADE HYPOTHESES ON
THE EVALUATION. WHAT WE'RE
TRYING TO ACHIEVE. AS WELL AS
OUR A FORMAL PROPOSAL THAT WILL
ALL HAPPEN THIS FALL. AND EARLY
SPRING IN HOPES WITH THAT WE GET
THAT GREEN LIGHT WE WOULD
IMMEDIATELY POST FOR A THIRTY
DAY PUBLIC COMMENT PERIOD- WHICH
IS FEDERALLY REQUIRED WE WOULD
HAVE TO HAVE TO PUBLIC HEARINGS
ONCE WE GET THAT GREEN LIGHT.
IT'S ALSO FEDERALLY REQUIRED.
AND THEN WE WOULD SUBMIT AND
THEN CMS ALSO DOES A FORMAL
FEDERAL PUBLIC COMMENT PERIOD.
SO THERE ARE A LOT OF PROCEDURES
THAT DO YOU HAVE TO HAPPEN- BUT
WE WILL. DO EVERYTHING WE CAN TO
BE READY AND ABLE TO OPPOSED FOR
THAT OFFICIAL PUBLIC COMMENT
PERIOD. IN ANTICIPATION OF THAT
APPROVAL FROM THE DEPARTMENT OF
FINANCE. WOULD YOU BE
COMFORTABLE IN SAYING COME FILE
YOU HAVE A LITTLE BIT MORE.
TANGIBLE THINGS THAT WE CAN. YES
THAT IS WHAT WE ARE PLANNING FOR
HER NEXT. MY SECOND QUESTION
THEIR TURN TO MY COLLEAGUES HERE
IS THAT KATHY. YOU KNOW WE- SOME
OF THE ISSUES REGARDING- THE
NEED FOR WORK FOURS OR JUST THE
LONG WAIT BUT IN YOUR- REPORT. I
DIDN'T HEAR MUCH CONCERNS
REGARDING WORKFORCE. HOWEVER YOU
DID. THIS YOU KNOW MENTIONED.
THE FORTY FOUR POINT FIVE
MILLION FOR STOP TIME IS THAT
OVER TIME IS THAT NEW EMPLOYEES
AND IS THAT WHAT YOU'RE THINKING
IS GOING TO DRESS SOME OF THE
CONCERNS WE ARE TODAY. FOR A
COMPLETE START. IT WAS ON. DID
I- NOT THANK YOU SORRY- MATTER
IT'S NOT ME. TO THAT OKAY- SO.
IT'S BEING TEMPERAMENTAL YOU
KNOW- IT WHAT'S SO INTERESTING
THAT YOU ASK I HAD A WHOLE
LITTLE SECTION OF WORKFORCE
CHALLENGES AND I THOUGHT. WELL I
DON'T KNOW IF WE'RE REALLY
TALKING SO MUCH ABOUT. THE RE
DETERMINATIONS HERE TODAY. AND
SO I'M GOING TO SAVE THAT AND
MAKE SURE THEY REALLY WANT TO
HEAR IT. GIVEN THAT I FEEL LIKE
I'M GOING TO WALK SO I WILL. I
WILL ADDRESS THAT WE ARE
ABSOLUTELY FACING SUCH AS THE
SAME WORKFORCE CHALLENGES THAT
REALLY EVERYBODY IS ACROSS. I
THINK ALL SECTORS NOT JUST IN
THE GOVERNMENT- COUNTIES ARE
CONTINUALLY HIRING. AND A LOT OF
TIMES- WHEN WE ARE HIRING PEOPLE
WE ARE ALSO TRAINING OUR
EXISTING STAFF BECAUSE THE L.
MANY OF IN SOME COUNTIES MOST.
HAVE NEVER DONE A
REDETERMINATION A MEDIC CAL I
MEAN WE'VE HAD THREE YEARS A LOT
OF TURNOVER DURING THE PANDEMIC
A LOT OF PEOPLE WHO GOT HIRED AT
THIS POINT WHERE WE WERE DOING
CONTINUOUS ELIGIBILITY. AND SO-
IN ADDITION TO HAVING THE
CHALLENGES AND THAT THE CONSTANT
RECRUITMENT OCCURRING WE ALSO
KNOW THAT WHEN PEOPLE ARE
TRAINED THEY COULD PULL OFF THE
LINE. AND SO THAT COULD BE
EXACERBATING SOME OF THINGS LIKE
THE CALL CENTER WAIT TIMES THE
PEOPLE ARE EXPERIENCING. THAT
SAID OUR COUNTIES ARE MONITORING
THEIR CALL CENTERS- PLEASE
REMEMBER THE CALL CENTERS ARE
NOT JUST MANTA CAL THEY'RE ALSO
CALFRESH AND CAL WORKS- IN MOST
CASES TO HANDLE EITHER INITIAL
OR ONGOING ELIGIBILITY FOR
THOSE. AND SO THOSE TWO PROGRAMS
LIKE I MENTIONED IN MY- OPENING
REMARKS ARE ALSO GOING THROUGH
THEIR OWN FUNDING AND WORKFORCE
CHALLENGES AS WELL SO- IF
ANYONE'S LISTENING NEEDS A JOB
PLEASE GO UP- APPLY TO YOUR
NEAREST COUNTY I'M NOT JOKING- I
WILL I WILL SAY- THAT WE
APPRECIATE VERY MUCH THE DH CS.
HAS WORKED WITH COUNTIES TO HAVE
THEM DO YOU- READY THIS PLANTS
REALLY TO THIS- READ OF TERM-
GETTING GOING AND- THE PLANS
COVER ALL OF THE TYPES OF TOPICS
THAT YOU'D HOPE WHICH IS. HOW
YOUR CALL CENTER HOW'S YOUR
FRONTLINE STAFF- HOW ARE PEOPLE
COMING IN TO YOU KNOW JUST GET
GREETED ARE THERE PEOPLE TO
GREET WHAT'S YOUR LOBBY
MANAGEMENT PRACTICE LIKE SO WE
CAN. HANDLE PEOPLE WERE ALSO-
WORKING VERY HARD TO MAKE SURE
THAT PEOPLE ARE AWARE OF THE
ONLINE POSSIBILITIES- I KNOW NOT
EVERYONE IS ABLE TO DO ONLINE-
THEY MAY NOT HAVE CAPACITY- OR-
BECAUSE OF DISABILITIES ARE.
WITH THE SYSTEMS THEY MAY NOT
FEEL COMFORTABLE DOING THAT BUT
FOR PEOPLE WHO ARE ABLE TO
CREATE AN ACCOUNT ONLINE THEY
CAN ACTUALLY DO THE RE
DETERMINATIONS ONLINE. AND SO
THAT IS- A HELPFUL THING THAT
WE'RE DEFINITELY MAKING SURE AS
PART OF THE MESSAGING THE WE'VE
WORKED VERY CLOSELY WITH OUR GM
BB WHO WAS MENTIONED BY ONE OF
THE OTHER SPEAKERS THAT. THE
OUTRAGE CONSULTANT THE DH CS
HIRED PART OF THE MESSAGING IS
GO CHECK YOUR ONLINE ACCOUNT
MAKE SURE YOUR PASSWORDS UP TO
DATE. BUT CHECK YOUR ADDRESS
MAKE SURE THAT'S UP TO DATE- AND
WE'RE ALSO TRYING IN THE
MESSAGING TO BE VERY CLEAR. IF
YOUR ADDRESS HASN'T CHANGED IT'S
OKAY YOU DON'T HAVE TO CALL
COUNTY YOU KNOW DON'T EVERYBODY
CALL JUST BECAUSE YOU HEAR
SOMETHING'S HAPPENING IF YOU
HAVE STAYED PUT. AND HAVE NOT
RECENTLY MOVED OR IF YOU MOVED
AND YOU TOLD US AND WE'VE BEEN
GETTING THE MATERIALS WE KNOW
THAT YOU'VE MOVED AND SO REALLY
TRYING TO DO WHAT SOME OF THESE
MESSAGES SO THAT WE CAN HAVE.
PEOPLE WHO REALLY NEED THAT HELP
VIA PHONE OR IN PERSON OR WHO
REALLY NEED TO TELL US THAT
SOMETHING HAS CHANGED AND HAVE
IT YET ARE THE ONES THAT WE CAN
DEDICATE THEIR STAFF TO. KNOWING
THAT WERE EXPERIENCING THE
STAFFING ISSUES ONE MORE THING I
DO WANT TO ADDRESS- AND THAT WAS
THE COMMENT RELATED TO- AUTO
DISCONTINUANCE IS OF INDIVIDUALS
WHEN. THEY COUNTIES HAVE NOT YET
TAKEN ACTION ON THEIR RE
DETERMINATIONS. SO- I ASSUME
YOU'RE PROBABLY. GONNA GET INTO
THIS IN MORE DETAIL IN A FUTURE
HEARING. BUT WHEN A READER TERM.
IS DONE AS COOPER NOTED THE
FIRST WE DO WE TRY TO DO IT ON
AN- EX PARTE BASIS. MEETING WE
LOOK AT WHAT WE ALREADY HAVE IN
THE PERSON'S FILE. IF THEY'RE ON
CALFRESH OR CAL WORKS WE LOOK AT
THAT AS WELL. AND WE ALSO GO OUT
AND WE- MATCH UP TO DATABASES
FEDERAL DATABASES. TO SEE WHAT'S
THEIR INCOME AND IF THEY'RE ALL
COMPATIBLE AND THEY LOOK
ELIGIBLE WE JUST RENEW THEM. AND
SO IN THAT CASE THE PERSON WE
GET A LETTER. THAT SAYS
CONGRATULATIONS YOU'VE BEEN
RENEWED ITS BASED ON THAT. THEY
DON'T NEED TO DO ANYTHING. SO
IT'S THOSE PEOPLE WHO WHO WE
CANNOT DO THAT WITH. IF WE ARE
UNABLE TO SAY YES YOU'RE
ELIGIBLE. THEN WE SAY TO THEM WE
COULDN'T FIND YOU ELIGIBLE HERE
IS WHAT WE HAVE. AND HERE IS
WHAT WE NEED YOU TO DO AND SO
IT'S VERY TARGETED IT IS PRE
FILLED OUT. OF A BIG CHANGE WITH
THE AFFORDABLE CARE ACT A FEW
YEARS AGO. IT'S NOT JUST THE BIG
BLANK PACKET AND THAT TELLS THEM
WHAT WE NEED. BUT THEN THEY DO
NEED TO SEND IT BACK OR CALL OR
GO ONLINE. ONE THING THAT IT'S
IMPORTANT UNDERSTAND IS. ON ALL
OF THOSE THINGS ARE BAR CODED
NOW. AND SO WHEN THEY ARE
RECEIVED AT THE COUNTY. IF THE
BAR CODE IS SCANNED IT IS PUT
INTO THE SYSTEM AS HAVING BEEN
RECEIVED. EVEN IF WE DON'T HAVE
A WORKER TO GOING TO BE ABLE TO
PROCESS THAT BEFORE THAT
REDETERMINATION DATE. IT WILL BE
SHOWN AS RECEIVED. AND THEY WILL
NOT BE AUTO AUTOMATICALLY
DISCONTINUE. WHETHER THEY'RE
ELIGIBLE OR NOT IF WE HAVEN'T
WORKED AT BUT IT SHOWS IS
RECEIVED. SO I DID JUST DOUBLE
CHECK THAT REAL QUICK- TO MAKE
SURE THAT I COULD EXPLAIN THAT-
AND SO. THINKING ABOUT WAYS TO
MANAGE WORKLOAD IN SITUATIONS
WHERE COUNTY MIGHT BE A LITTLE
BEHIND. MAKING SURE THAT WE'VE
MARKED EVERYONE THAT IS CENTER
PACKET SAID. AS YES I RECEIVE
THESE YOU KNOW JUST GETTING THAT
IN THE SYSTEM. AND THEN WILL BE
PROCESSING THAT AND EVERYTHING'S
GOING TO REPORTER THERE'S A LOT
OF DATA AGAIN YOU'RE GONNA HEAR
ABOUT ALL THAT I'M ASSUMING IT.
FUTURE HEARING- SO WE CAN TRACK
THE WORKLOAD- BUT TO THE EXTENT
THAT WORK WITH THAT THAT IF WE
GET BEHIND BASED ON SOME OF
THESE ISSUES. PEOPLE DON'T. GET
HARMED BY THAT WOULD BE OUR GOAL
THIS WALL AND I'M HOPEFUL THAT.
HELPFUL AND WILL. TO WORK WITH
ADVOCATES YOU ALL. AND OF COURSE
THE STATE PARTNERS TO. TARGET
THINGS LIKE THAT TO MAKE SURE
THAT WERE REALLY. THINKING ABOUT
HOW CAN WE- SHIFT YOU KNOW IF WE
HAVE LIMITED STAFF HOW DO WE
MAKE SURE WE COVER THE CALL
CENTERS. THE IDEA OF HAVING A
DEDICATED LINE HOW DO WE LOOK
INTO THAT YOU KNOW THINGS LIKE
THAT SO. I THINK WE'RE ALWAYS
COLLECTING THAT BEST PRACTICE.
IS SPECIALLY THE SITUATION THAT
WE'RE- FACING WITH- YOU KNOW
WE'VE DONE RE DETERMINATIONS
WE'VE RUN THIS ON BEHALF OF THE
STATE OF THE WAS CREATED. BUT WE
ARE IN A UNIQUE SITUATION NOW
WITH THIS HUGE NUMBER OF PEOPLE.
AS WELL AS THIS- REALLY. JUST
DIFFERENT FROM WHAT ANY OF US
HAVE EVER SEEN KIND OF LABOR
FORCE- DYNAMIC SO. THANK YOU MY
LAST FOLLOW UP TO THAT KATHY IS-
NO WE HEARD SOME SUGGESTIONS
ROUTE. ARE REGARDING
COLLABORATION WITH CBO'S. YOU
TALK A LITTLE BIT MORE ABOUT
THAT YOU KNOW THESE ARE THE
TRUSTED MESSENGERS IN
COMMUNITIES. YOU KNOW THAT IT
WORKED FOR THE KOBE NINETEEN
VACCINES IN AWARENESS THERE. IS
THERE ANY CONVERSATIONS
REGARDING PARTNERING IN THIS
AREA OH ABSOLUTELY I KNOW AT A
LOCAL LEVEL WE TEND TO WITH
LOCAL CBO'S IN ORGANIZATIONS-
EITHER. MATTHEW KIND OF MATCH UP
AND INTRODUCED IF THEY'RE HAVING
A DIFFICULT TIME. GETTING AND SO
FOR EXAMPLE THERE WAS A COMMENT
WHERE SOME. I THINK FROM SADNESS
STAR THAT YOU KNOW SOME OF OUR
FOLKS ARE HAVING REALLY GOOD
LUCK SOME OF THEM NOT SO MUCH.
WELL I'D LOVE TO KNOW WHAT THE
BEST PRACTICES ARE. AND I'D LOVE
TO KNOW WHERE THEY TRY TO HAVE
IT. MADE THOSE CONNECTIONS
BECAUSE WE'RE HAPPY TO TRY TO
HELP WITH THAT- IT REALLY IS
GOING TO TAKE EVERYBODY WORKING
TOGETHER I THINK TO MAKE SURE
THAT WE GET THROUGH. NOT JUST
THE READER TERMINATIONS BUT ALSO
SUCCESSFUL IMPLEMENTATION OF
THINGS LIKE THAT UNDOCUMENTED
EXPANSION. THE WE SUPPORT IT I
MEAN WE WANT THAT TO HAPPEN AND
I KNOW- FOR EXAMPLE IN LOS
ANGELES COUNTY I BELIEVE THEY
HAVE REGULAR MEETINGS. WITH A
LARGE GROUP OF THEIR ADVOCATE
PARTNERS- AND SO I CAN. KIND OF
CHECK IN WITH THAT IF THERE'S
SOMEBODY WAS NOT INCLUDED- HOW
DO THEY GET INCLUDED- IN OUR OF
FORMER OUR COMMUNITY. I KNOW
THAT THOSE COUNT- ARE IN. IN A
OF THE LOCAL COLLABORATIVES.
THEY'VE GOT SOME- I THINK SORT
OF. A HALLMARK SORTS OF PROGRAMS
WHERE THEY DO GET IN AS WELL
WITH THEIR PUBLIC HEALTH
PARTNERS AND WITH OTHER
ORGANIZATIONS. SO I FEEL LIKE
THOSE THINGS AREN'T THERE AND
MAKING SURE THAT THEY'RE REALLY
DIALED IN IN A SITUATION LIKE
THIS AND WE CAN TRY TO HELP PLAY
THAT CONNECTIVE IN SUPPORT OF
ALL. THANK YOU SO MUCH TURN OVER
TO MY COLLEAGUE CENTER EGGMAN.
THANK YOU- NICE TO SEE EVERYBODY
HERE IN PERSON. AND FOR JUST M.
IN THANK YOU ALL FOR YOUR WORK
RIGHT THIS IS BEEN A HUGE
UNDERTAKING THAT EVERYBODY IS
ENGAGED IN. OF AND AS I HEAR
THE- ARE STAKEHOLDERS TALKING
YOU KNOW THEY THEY POINT TO
PROBLEMS AND YOU GUYS ARE TWENTY
TO SOLUTION SO. I SO MY HOPE IS
THAT. EVERYBODY'S TALKING AND
LISTENING TO EACH OTHER- AND
MAKING SURE THAT WE'RE ABLE TO
ADDRESS. SOME OF THE ISSUES THAT
ARE GOING TO BE INHERENT IN IT
INCLUDING A WHOLE BUNCH OF
PEOPLE IN A NEW SYSTEM. DURING A
PANDEMIC. RIGHT SO LET'S JUST
START THERE- I GUESS MY QUESTION
IS AROUND. AND I WAS CONCERNED
ABOUT THE CALL TIMES IN THE HANG
UPS AND ALL OF THAT. BUT IT
SOUNDS LIKE PERCENT REELING
YOU'VE GOT. YOU'VE GOT SOME
CONTINUOUS QUALITY IMPROVEMENT
GOING ON WITH THE OFFICES IN.
YES THAT'S THE- THAT'S THE
INTENT LIKE I SAID I KNOW WHY-
WE HAD- A VERY. I THINK
PRODUCTIVE IN DEPTH CONVERSATION
WITH DIRECTOR BOSS RELATED TO
THE ISSUE A COUPLE OF MONTHS
AGO- AND GAVE US AN OPPORTUNITY
TO REACH OUT TO. THE DIRECTORS
AND MAKE SURE THAT THEY HAVE THE
CAPACITY IN THEIR CALL CENTER
STRUCTURES TO MONITOR- THINGS
LIKE THAT CALL TIMES- AND THEY
DO. I THINK ONE OF THE CHOICES
THAT IS MADE SOMETIMES IS HOW
MANY PEOPLE AM I GOING TO PUT ON
THE PHONES. AND HOW MANY PEOPLE
I'M GOING TO HAVE IN THE OFFICE
AND THEY TRY TO. YOU KNOW SHIFT
AROUND BASED ON THE DEMAND THAT
THEY THINK THAT THERE MIGHT BE.
AND IT CAN BE DIFFICULT TO TURN
ON THE FLY. SO I THINK AS WE SEE
WHAT THE PREFERENCES MAYBE FOR
PEOPLE COMING OUT OF THE
PANDEMIC FOR SO YOU KNOW COMING
IN PERSON VERSUS CALLING- AND
TRY TO. AS WELL LIKE I SAID DR.
AS MANY PEOPLE WHO ARE CAPABLE
OF SELF SERVING ONLINE. TO DO SO
BUT NOT ABANDON THOSE WHO CANNOT
DO THAT OR DO NOT WANT TO DO
THAT- MAKING SURE THAT WE HAVE
THAT DOOR TO WALK IN OR THE
PHONE TO BE ANSWERED. ARE VERY
CRITICAL COMPONENTS AND SO ON
WITH I KNOW THAT OUR DIRECTORS
TAKE IT VERY SERIOUSLY AND SO-
I'LL BE REPORTING BACK AND-
WE'LL PROBABLY DO SOME
ADDITIONAL TROUBLESHOOTING
THROUGH OUR- COMMITTEES AND WITH
OUR BOARD. ON TO SORT OF HELP
THEM THINK THROUGH OTHER. THINGS
AND IF THERE'S THINGS THAT THEY
NEED. I MEAN CERTAINLY MORE
STAFF IS A HUGE PART OF THIS
AND- WE ALSO ARE IN SOME
CONVERSATIONS RIGHT NOW WITH
CALLIE CHAR. WHICH DOES-
RECRUITMENT UNDER THE MERIT
SYSTEM PRINCIPLES FOR A NUMBER
OF OUR SMALLER AND RURAL
COUNTIES. THAT ARE SAYING A
PARTICULAR ISSUE RIGHT NOW
RECRUITING PEOPLE- WE'RE WORKING
WITH THEM TO TRY TO MAKE SOME
POTENTIAL CHANGES. TO THOSE
PROPHECIES THAT MIGHT- ENABLE
EITHER A QUICKER PROCESS OR
PROCESS WHERE. PEOPLE WHO WE
KNOW CAN DO THAT JOB DO YOU END
UP GETTING ADVANCED IN THE
PROCESS AND SO. THAT'S ALL AN
AREA THAT WE- FOR IS WHILE WE'VE
GOT A FEW THINGS GOING ON TO TRY
TO. INCREASE RESOURCES IN THE
FORM OF PEOPLE AND YOU KNOW
HUMAN CAPITAL- BUT ALSO ANY
OTHER ISSUES THAT WE SEE- WILL
CERTAINLY BE WORKING WITH THAT
DEPARTMENT ON THAT AS WELL. OKAY
AND HOW ABOUT THE ISSUE AROUND
NOTIFICATION THAT A LOT OF
PEOPLE DON'T KNOW THEY'RE
ELIGIBLE AND OR DON'T KNOW.
ABOUT THE INCREASED AMOUNT OF
PEOPLE WHO ARE ABLE TO HAVE. IT
YET. SO THE- THE DEPARTMENT'S
ACTUALLY IMPLEMENTING- WE GET
TWENTY FIVE MILLION DOLLARS IN
THE BUDGET LAST YEAR TO DO A
STATEWIDE MEDIA CAMPAIGN. THAT
LAUNCHED LAST MONTH I'M AND WILL
CONTINUE THROUGH MAY OF TWENTY
TWENTY FOUR REALLY WORKING ON
HOW DO WE GET STATEWIDE
MESSAGING OUT TO MAKE SURE
PEOPLE UNDERSTAND. YOU KNOW
WHO'S ELIGIBLE- THE MESSAGING
AROUND LOOKING FOR THE YELLOW
ENVELOPE WILL BE DOING ALL
THINGS IN YELLOW ENVELOPE SO
THAT YOU KNOW THEY CAN KIND OF
SEE THAT WHEN IT COMES IN THE
MAIL- WE'RE TRYING TO DO
TRAINING MODALITIES WE HAVE
EVERYTHING ALL THRESHOLD
LANGUAGES WE HAVE CREATED.
CUSTOMIZABLE FLYERS FOR A
CLINICS FOR ANYONE TO USE I WILL
WORK ON LEDGE PACKETS OF FOR OUR
MEMBERS TO HAVE AVAILABLE I'M SO
ALL REALLY IMPORTANT THINGS TO
REALLY GET THE WORD OUT ACROSS
THE ENTIRE STATE OF CALIFORNIA.
WE ALSO GOT SIXTY MILLION FOR
HEALTH ENROLLMENT NAVIGATORS IN
THE BUDGET LAST YEAR WE JUST
ANNOUNCED OF THOSE AWARDS WERE
REALLY EXCITED THAT'S FOR
COMMUNITY BASED ORGANIZATIONS
CAN REALLY PLAY. A LARGE ROLE OR
COUNTY PARTNERS OF REALLY
GETTING THAT INFORMATION OUT TO
TRUSTED PARTNERS IN THE
COMMUNITY ACROSS THE STATE OF
CALIFORNIA. THEY WERE REALLY
TRYING TO WORK WITH THAT AS WELL
AS MANY OF OUR- AND CONSUMER
ADVOCATES WHO HELP US GET THE
WORD OUT ON AS WELL AND THEY
ALSO ARE VERY GOOD AT GETTING US
INFORMATION WHEN THINGS AREN'T
GOING RIGHT ON. ON THE GROUND WE
ALWAYS APPRECIATE HEARING WHEN
SOMETHING IS STARTING TO SLIP.
THE ONLY THING I'D OTHER POST AS
WE WILL BE. POSTING ALL REPORTS
BY COUNTY A PUBLICLY DURING THE
ENTIRE WE DETERMINATION SO WE
HAVE AN UNDERSTANDING ENGAGE
BOTH FOR THEM AND FOR US. TO
BETTER UNDERSTAND WHERE WE MAY
NEED TO STEP IN AND HELP AS
PARTNERS TO FIGURE OUT HOW WE
CAN MITIGATE THINGS OR OR FIND
SOLUTIONS TOGETHER. OKAY AND ON
THE ISSUE OF MEAN. WE ALL BEEN
TALKING A LOT RECENT. THAT OUR
SENIOR ARE NUMBER ONE POPULATION
FALLING INTO HOMELESSNESS RIGHT
SOMETHING THAT WE CERTAINLY WE
WANT TO BE ABLE TO KEEP PEOPLE
HOUSE AS LONG AS WE POSSIBLY
CAN. SO CAN YOU TALK ABOUT THAT
MOVING TO A HUNDRED THIRTY
EIGHT- DO LEVEL FEDERAL POVERTY
IS THAT POSSIBLE AT ALL OR IS IT
JUST A BUDGETARY ISSUE. YES SO
THAT HAS ALREADY GONE LIVE SO
WE'VE ALREADY EXTENDED TO THE
HUNDRED THIRTY EIGHT OKAY THE
OTHER THING THAT WE DID DURING
THE PUBLIC HEALTH EMERGENCY- IS
WE ARE ANYONE WITH ZERO INCOME
WILL BE AUTOMATICALLY. ON
APPROVED. WE GOT A FEDERAL.
FLEXIBILITY WAIVER FROM THE
FEDERAL GOVERNMENT SO THAT
PEOPLE EXPERIENCING HOMELESSNESS
WILL HAVE A VERY EASY
REDETERMINATION PROCESS. DURING
THIS. NEXT YEAR AND THAT WAS A
HUGE WIN FOR US IN REGARDS TO
MAKING SURE PEOPLE EXPERIENCING
HOMELESSNESS WILL CONTINUE TO
HAVE COVERAGE AND THEN OF COURSE
FOR OLDER. ADULTS AS WELL SO ALL
OF THOSE PIECES ARE IN PLACE AND
WILL BE ENACTED FOR THIS
REDETERMINATION PERIOD OKAY. AND
THEN ON THE ASSET TEST I MEAN
WE'RE GONNA DO IT ONE MORE TIME
WE MOVED UP TO A HUNDRED THIRTY
THOUSAND. AND WE'RE WERE.
STRUGGLING FOR STAFF. WHY WHAT
WE WERE GONNA DO IT ONE MORE
TIME IF EVERYONE'S GOING TO BE
ELIGIBLE. AND THERE'S NOT GONNA
BE AN ASSET TEST NEXT YEAR
RIGHT- SO WE- WE- WERE ABLE TO
SUBMIT TO THE FEDERAL GOVERNMENT
TO GET A WAIVER BETWEEN. APRIL
ESSENTIALLY ACTUALLY WILL HAVE
EFFECTIVE MARCH FIRST. THROUGH
THE END OF THIS YEAR SO THAT
PEOPLE THAT- ESSENTIALLY WOULD
BE WAIVING THE ASSET THROUGH THE
END OF THIS YEAR FOR RENEWAL SO
PEOPLE THAT HAD WOULD. MAYBE GO
OVER THE 131% THEY WILL BE ABLE
TO MAINTAIN THEIR COVERAGE
BECAUSE THAT WOULD BECOME AN
ACTIVE JANUARY ONE OF TWENTY
FOUR. WE'RE WORKING FOR CMS TO
GET THAT APPROVED SAID THAT THAT
WOULD CONTINUE. WE JUST
ANNOUNCED THAT YESTERDAY SO NOW
WE ARE YOU'RE NOT A DOCKING HAS
GOT. BECAUSE IT REMINDED ME YES
WE JUST ANNOUNCED THAT WE ARE
REALLY EXCITED ABOUT THAT WE'VE
BEEN PARTY RECEIVED A LITTLE
DANCE WHEN IT. BROUGHT TO US BY
AT THE KIDS TO FIND A SOLUTION
AND WE WERE ABLE TO FIND ONE AND
OUTSIDE JUST YESTERDAY WERE VERY
HAPPY ABOUT IT GOOD THAT'S
FANTASTIC AND JUST A BIT. AS A
FORMER PRACTICING SOCIAL WORKER
TRYING TO THAT WHOLE ASSET
TESTING JUST. WAS INSANE TO TRY
TO GET HELP FOR PEOPLE. SO
YOU'RE SAYING AS WE MOVE FROM
THE FEDERAL POVERTY LEVEL UP
THAT IT'S MORE THAN SIX HUNDRED
DOLLARS A MONTH THAT PEOPLE ARE
ALLOWED TO LIVE ON. THE
PARTICULAR PIECES STILL ON THAT
PART IS STILL. IF YOU'RE TALKING
ABOUT THEM. THE SHOW THE SHOW
CAR COST SURE BECAUSE THE PART I
MEAN THERE'S DIFFERENT PARTS
BECAUSE THAT THERE'S DIFFERENT
PIECES SO WE HAVE THE- THE
SENIOR PENALTY FOR AGE I'M GOING
TO DISABLED. INCREASE FROM A
100% A HUNDRED THIRTY EIGHT
PERCENT. IN DECEMBER OF TWENTY
TWENTY. THERE ARE OTHER PIECES
AROUND MAINTENANCE NEEDED OTHER
PIECES THAT HAVE HAD PREVIOUS
PROPOSALS THAT HAVE BEEN MOVED
FORWARD. SO IT JUST DEPENDS ON
WHICH ONE YOU'RE YOU'RE
REFERRING TO- AND SO THAT WAS.
SOMETHING THAT'S BEEN CONSIDERED
PREVIOUSLY BUT HAS NOT BEEN
APPROVED IN A BUDGET I'M TO THIS
POINT ON EXPANSION- BUT BUT THE
OTHER PIECES HAVE. HAVE MOVED
FORWARD AND HAPPEN APPROVED- AS
WELL. I WILL KNOW ON THE SHARE
OF COST REFORM ON THE RAISING
THE SIX HUNDRED DOLLAR TWO
HUNDRED THIRTY EIGHT PERCENT.
WAS APPROVED IN LAST YEAR'S
BUDGET JET. FIVE TO BE INTO
EFFECT SIMILAR TO THE CONTINUOUS
ELIGIBILITY TWENTY TWENTY FIVE.
AND CONTINGENT UPON-
APPROPRIATIONS SO- WITH WITH
STRESS THE NEED TO. TO CONTINUE
TO MOVE TOWARD THAT TWENTY
TWENTY FIVE IMPLEMENTATION DATE
IT BROUGHT IT UP TO HOW MUCH. UP
FROM OF A SIX HUNDRED DOLLARS
210038% OF THE FEDERAL POVERTY
LEVEL SO THAT- INDIVIDUALS WHO
ARE A DOLLAR ABOVE THE 138% HAVE
A- A DOLLAR SHARE OF COST
INSTEAD OF. OVER HALF THEIR
INCOME. AND I DON'T HAVE THAT
HUNDRED THIRTY EIGHT RIGHT OFF
THE TOP OF MY HEAD BUT IT'S
AROUND. THIRTEEN HUNDRED A MONTH
FOR AN INDIVIDUAL EXCUSE ME IN
ARTFUL WAY OF TRYING TO ASK. IS
A LOT OF NUMBERS THERE'S A LOT A
LOT A LOT AND WE'VE DONE A
HONEST. YEAH OKAY THANK YOU.
WELL JUST ONE LAST NUMBER
QUESTION- MISTER BREAK YOU
MENTIONED ANTICIPATED I THINK
WAS A SEVEN HUNDRED THOUSAND.
NEW PEOPLE MEDICARE THOUGHT THE
GOAL THAT WE HAVE CAPACITY FOR
THIS IS HOW MUCH- PEOPLE HAVE
ALREADY SIGNED UP SO IT'S A
COMBINATION BUT DOMINANTLY THOSE
ARE PEOPLE WHO WE HAVE A- LITTLE
LESS BUT AROUND SEVEN HUNDRED
THOUSAND ADULTS WHO ARE
UNRESTRICTED SCOPE COVERAGE
RIGHT NOW BETWEEN THE AGE OF
TWENTY SIX AND FORTY NINE. WHO
ARE UNDOCUMENTED THAT WOULD BE
AUTOMATICALLY SWITCHED OVER
JANUARY ONE TWENTY TWENTY FOUR
TO RECEIVE FULL SCOPE MEDICAL
COVERAGE- I'M IN SO. I'M IT DOES
ALLOW FOR A LITTLE BIT OF AN
ESTIMATE OF ADDITIONAL
INDIVIDUALS- WITHIN THE
COMMUNITY THAT WOULD ALSO BE
ELIGIBLE. AMEND IT IS THE
LARGEST EXPANSION THAT WE'VE HAD
IN A PRETTY LONG TIME AND SO WE
ARE REALLY WORKING TO ANTICIPATE
THAT. ON YOUR WE HAVE EXPERIENCE
WITH THIS FOR EXAMPLE WITH THE
ACA WOULD BE TOOK ON A LARGE
NUMBER PEOPLE WHO HADN'T
PREVIOUSLY HAD- FULL COVERAGE.
ON AND SO WE'RE BRINGING UP A
LOT OF THOSE BEST PRACTICES AND
LESSONS LEARNED SAYS WELL SO
IT'S NOT CALCULATING PEOPLE WHO
AREN'T EVEN. IN THE RESTRICTIVE
SCOPE WHATSOEVER. NO SO WHERE
DID THE THAT SEVEN HUNDRED
THOUSAND INCLUDES PEOPLE WHO ARE
CURRENTLY IN RESTRICTED RIGHT-
THAT WOULD WHO. HAVEN'T EVEN
SIGNED UP FOR MEDI CAL THAT IS
CORRECT NOT ACCOUNTING FOR THAT
THAT IS AND THEY SHOULD THEY
ALSO AMOUNT TO SEVEN OR THOUSAND
DO WE HAVE THAT CAPACITY TO YES
BRING ON FOURTEEN. OKAY YEAH
YEAH WE WILL WE WILL HAVE
CAPACITY- AT THIS POINT WE ARE
WE ARE PREPARING FOR. I'M ALL OF
THE VARIOUS COVERAGE EXPANSIONS
OF FOR NETWORK ADEQUACY VIOLENCE
WHICH IS ESSENTIALLY WHAT OUR
MANAGED CARE PLANS HAVE TO BE
ABLE TO HAVE NETWORKS FOR- IN
REGARDS TO ANTICIPATING THOSE
NUMBERS- I. AT THIS TIME PERFECT
THANK YOU SO MUCH WELL AS WE-
CLOSE OUT THIS PANEL I WANT TO
THANK EVERYONE BOTH IN PERSON
AND SOON YOU KNOW SOME OF THE
TAKE AWAYS HERE AS- YOU KNOW.
KATHY YOU'RE GONNA LOOK TO SEE
SOME A DEDICATED LINE. YOU KNOW
MAKE CITED FOR SOME OF THE FUNDS
COMING TO HELP WITH THOSE AT THE
NAVIGATION AND- THE TRUSTED
MESSENGERS AND- AND I LOOK
FORWARD TO AND FALL. TO SEE IF
WE HAVE MORE INFORMATION
REGARDING THE CONTINUOUS
COVERAGE FOR AGES ZERO TO FIVE
AND GETTING READY FOR JANUARY
TWENTY TWENTY FIVE SO WE'LL
DEFINITELY BE IN TOUCH. A MORE
ON THAT SO THANK YOU SO MUCH.
WE'RE GONNA LOVE SOME OF THE
WILL REMAIN HERE AS WE CONTINUE
ON TO. OUR DEPARTMENT OF HEALTH
CARE SERVICES. IT SHOULD TO ON
OUR AGENDA IS AN OVERVIEW OF
DEPARTMENT OF HEALTH CARE
SERVICES WELCOMING BACK. A MISS
COOPER AND THEN HELLO. MICHELLE
BUS I AM GOOD MORNING. MADAM
CHAIR. AND MEMBERS OF THE
SUBCOMMITTEE MICHELLE BOSS
STRUCTURE OF THE DEPARTMENT OF
HEALTH CARE SERVICES. OFFER
ISSUE TO GOING TO PROVIDE A
BRIEF OVERVIEW OF THE DEPARTMENT
AND ITS PROGRAM AND BUDGET. OF
THE DEPARTMENT HEALTHCARE
SERVICES HELPS MILLIONS OF
CALIFORNIANS GAINS ACCESS TO
AFFORDABLE INTEGRATED EQUITABLE
AND HIGH QUALITY PHYSICAL AND
BEHAVIORAL HEALTH CARE.
INCLUDING MENTAL. MEDICAL DENTAL
PHARMACEUTICAL SUBSTANCE USE
TREATMENT SERVICES AND LONG TERM
SERVICES AND SUPPORTS. THE
GOVERNOR'S BUDGET PROPOSES ABOUT
A HUNDRED FORTY FOUR BILLION
DOLLARS TOTAL FUNDS FOR THE
DEPARTMENT ABOUT THIRTY NINE
BILLION GENERAL FUND TO SUPPORT
THE DEPARTMENT'S PROGRAMS. OF
THAT AMOUNT ABOUT ONE POINT
THREE BILLION FUNDS DEPARTMENT
OPERATIONS INCLUDING ABOUT FORTY
SEVEN HUNDRED POSITIONS FOR THE
SUPPORT OF THE DEPARTMENTS
PROGRAMS. DH CS IS. PROGRAM IS
MEDIC. THE MEDICAL PROVIDES
HEALTH CARE SERVICES FOR MORE
THAN FIFTEEN MILLION INCOME
ELIGIBLE I CALIFORNIANS
INCLUDING FAMILIES WITH CHILDREN
SENIORS PERSONS WITH
DISABILITIES FOSTER CARE YOUTH
AND CHILDREN. PREGNANT WOMEN AND
OTHER INDIVIDUALS. ONE IN THREE
CALIFORNIANS ARE ENROLLED IN
MEDICARE ALL WITH MORE THAN
SIXTY FIVE OF OUR MEMBERS
IDENTIFYING AS PEOPLE OF COLOR.
MEDI CAL COVERS 50% OF ALL
BIRTHS IN CALIFORNIA WITH ABOUT
TWO THIRDS OF CHILDREN ENROLLED
IN MEDI CAL IDENTIFYING ITS
BLACK AND LATINO. AND THEN MORE
THAN TWO IN THREE PATIENT DAYS
IN CALIFORNIA LONG TERM CARE
FACILITIES ARE COVERED BY
MEDICAL. CALIFORNIA IS
TRANSFORMING THE MEDI CAL
PROGRAM TO ENSURE CALIFORNIANS
GET THE CARE THEY NEED TO LIVE
HEALTHIER LIVES THIS INCLUDES
CAL AIM OUR LONG TERM COMMITMENT
TO OUR FOR PERSON CENTERED CARE
THAT GOES BEYOND THE DOCTOR'S
OFFICES. HOSPITAL AND ADDRESSES
THEIR PHYSICAL AND MENTAL HEALTH
NEEDS. ARE COMPREHENSIVE QUALITY
STRATEGY WHICH INCLUDES SPECIFIC
METRICS AND GOALS FOR ALL
DELIVERY SYSTEMS INCLUDING
MANAGED CARE DENTAL BEHAVIORAL
HEALTH. AS PART OF OUR QUALITY
STRATEGY WE'VE LAUNCHED OUR BOLD
GOALS FIFTY BY TWENTY TWENTY
FIVE INITIATIVE WHICH FOCUSES ON
CHILDREN'S PREVENTIVE CARE
BEHAVIORAL HEALTH INTEGRATION
AND MATERNITY CARE FOCUSING
PARTICULARLY ON HEALTH EQUITY
WITHIN THESE DOMAINS. ARE NEW
MANAGED CARE CONTRACTS FOR
TWENTY TWENTY FOUR CREATES MORE
TRANSPARENCY ACCOUNTABILITY
EQUITY QUALITY AND VALUE AND
REALLY INCREASES OUR-
EXPECTATION OF OUR MEDICAL
MANAGED CARE PLANS. ADDITIONALLY
THE RECENT ADDITION OF BENEFITS
SUCH AS THE COMMUNITY HEALTH
WORKERS DULAS PEER SUPPORT
SPECIALIST AND DYADIC HERE. AND
EXPANSIONS TO NEW POPULATIONS
WHICH WE JUST COVERED IN THE
FIRST PANEL. ONE I THINK THE
LEGISLATURE FOR IT'S A SUPPORT
AND PARTNERSHIP OVER THE LAST
FEW YEARS WOULD BE SIGNIFICANT
INVESTMENTS IN THE MEDICAL
PROGRAM. THE DEPARTMENT ALSO
ADMINISTERS PROGRAMS FOR SPECIAL
POPULATIONS AND SEVERAL OTHER
NON MEDICAL PROGRAMS INCLUDING
THE GENETICALLY HANDICAPPED
PERSONS PROGRAM THE CALIFORNIA
CHILDREN'S SERVICES PROGRAM. I'M
A NEWBORN HEARING SCREENING
PROGRAM FOR LOW INCOME FOR
CHILDREN AND ADULTS WITH
SPECIFIC GENETIC DISEASES. OUR
OFFICE OF TRIBAL AFFAIRS IS
RESPONSIBLE FOR COORDINATING AND
DIRECTING THE DELIVERY OF HEALTH
CARE TO CALIFORNIANS IN RURAL
AREAS AND UNDERSERVED
POPULATIONS THROUGH THE INDIAN
HEALTH PROGRAM. AMERICAN INDIAN
MATERNAL SUPPORT SERVICES AND
OUR TRIBAL EMERGENCY
PREPAREDNESS PROGRAM. LICENSING
AND CERTIFICATION MONITORING AND
COMPLAINTS FOR DRIVING UNDER THE
INFLUENCE PROGRAMS NARCOTIC
TREATMENT PROGRAMS PSYCHIATRIC
HEALTH FACILITIES MENTAL HEALTH
REHABILITATION CENTERS AND
OTHER. RESIDENTIAL BEHAVIOR
HEALTH TREATMENT PROVIDERS. OUR
COMMITMENT TO HEALTH COUNTY
MENTAL HEALTH SERVICES AND
SUBSTANCE USE DISORDER TREATMENT
SERVICES FUNDED BY BLOCK GRANTS
THE MENTAL HEALTH SERVICES ACT.
OUR BEHAVIORAL HEALTH CONTINUUM
INFRASTRUCTURE PROGRAM WHICH
PROVIDES GRANT FUNDING TO
DEVELOP THE CONTINUUM OF
BEHAVIOR HEALTH FACILITY
FACILITIES. AT OUR PUBLIC HEALTH
PREVENTION AND TREATMENT PROGRAM
PROGRAMS PROVIDED BY THE EVERY
WOMAN COUNTS PROGRAM PROSTATE
CANCER TREATMENT PROGRAM AND THE
FAMILY PLANNING ACCESS AND CARE
TREATMENT PROGRAM. HAPPY TO
ANSWER ANY QUESTIONS. NO
QUESTION ON MY END. GREAT FOR
DIED IN ISSUE NUMBER THREE. IS
ON THE NOVEMBER TWENTY TWENTY
TWO MEDICARE LOCAL ASSISTANCE
ESTIMATE. SUGGESTED BACKGROUND
OUR MEDIC CAL ESTIMATE WE I'M
TWO TWO YEAR ONE FOR THE
GOVERNOR'S BUDGET AND ONE FOR
MAY REVISION AND- THE THAT I
PICKED AT ME REVISION WILL
REFLECT UPDATED CASELOAD
UTILIZATION I'M AND PAYMENT TIME
MEAN OUGHT TO REFLECT THE LATEST
INFORMATION WE HAVE. FOR THE
CURRENT YEAR THE GOVERNOR'S
BUDGET PROJECTS A FOUR POINT TWO
BILLION DOLLAR I'M LESS GENERAL
FUND WILL BE NEEDED TO SUPPORT
THE MEDICAL PROGRAM AS COMPARED
TO THE TWENTY TWENTY TO BUDGET
ACT. YOUR GENDER DOES A GREAT
JOB- DETAIL IN A LIST OF THE
FACTORS CONTRIBUTING TO THIS
CHANGE IN THE BUDGET I WILL JUST
FOCUS ON THE MOST SIGNIFICANT
ITEMS. IN THE CURRENT YEAR
THERE'S A TWELVE POINT 9%
DECREASE IN GENERAL FUND
EXPENDITURES COMPARED TO THE
BUDGET YEAR. SOME OF THIS IS A
RESULT IN THE STATE'S PROJECTED
REVENUE FORECASTS AND- AS AS
SUCH WERE DILLANE ROUND SIX OF
OUR BEHAVIORAL HEALTH
INFRASTRUCTURE CONTINUE PROGRAM
FOR ABOUT FOUR HUNDRED AND
EIGHTY MILLION DOLLARS. AND
WE'RE DELAYING THREE HUNDRED AND
SEVENTY MILLION- THE FOR A
PREVIOUSLY APPROVED A BUYBACK OF
A LONG OUTSTANDING- TWO WEEK
HOLD ON FEE FOR SERVICE PAYMENTS
SO THAT'S JUST A TECHNICAL SHIFT
IN WHERE THE DOLLARS GET
ACCOUNTED FOR. AND THEN OTHER
CHANGES I REALLY MORE RELATED TO
TECHNICAL CHANGES RELATE TO A
DELAY OF PAYMENTS OF ABOUT TWO
POINT FOUR BILLION TO. THE
FEDERAL CMS RELATED TO STATE
ONLY POPULATIONS. I SEVEN
HUNDRED SEVENTY FOUR MILLION A
NET REDUCTION IN COSTS. RELATED
TO COPE AT NINETEEN. AND THEN IN
TERMS OF THE BUDGET YEAR WE
PROJECT- HUNDRED THIRTY EIGHT
NINE. HUNDRED THIRTY EIGHT POINT
NINE BILLION DOLLARS TOTAL FUNDS
AND ABOUT THIRTY EIGHT BILLION
FOR A GENERAL FUND FOR THE
MEDICARE PROGRAM. THIS IS A ONE
POINT ONE. BILLION TOTAL FINE
INCREASE AND A SIX POINT FOUR
BILLION GENERAL FUND INCREASE
COMPARED TO THE CURRENT YEAR. I
BEG THE FACTORS INFLUENCING THIS
CHANGE IS A SIX HUNDRED THIRTY
FIVE MILLION. TO FIND PREVIOUSLY
IMPROVED EXPANSION OF THE FULL
SCOPE MEDI CAL PROGRAM TO
ELIGIBLE INDIVIDUALS. AGE SIX
TWENTY SIX OR THIRTY NINE WHICH
WE JUST SPOKE ABOUT. A THREE
HUNDRED SEVEN MILLION ON A ONE
TIME BASIS TO INITIALLY FUND THE
NON FEDERAL SHARE OF A
BEHAVIORAL HEALTH SERVICES I'M-
KIND OF A FUN TO FACILITATE CAL
A BEHAVIORAL HEALTH. PAYMENT
REFORM. A SAVINGS OF ABOUT THREE
HUNDRED SEVENTEEN MILLION. I
PROPOSE FROM ANY MANAGE KERR TAX
TO TAKE EFFECT. IN TWENTY TWENTY
FOUR AND I KNOW WE'LL BE
DISCUSSING THAT MORE AT LEADER
HEARINGS. I'M AND ABOUT SIX
HUNDRED SIXTY FOUR MILLION
RELATED TO THE GROWTH IN MANAGED
CARE COSTS. SEVERAL OTHER
TECHNICAL ADJUSTMENTS I REALLY
RELATE TO A THREE POINT. FOUR
BILLION IN REPAYMENTS TO CMS
RELATED TO STATE ONLY
POPULATIONS. I TWO POINT SEVEN
BILLION DOLLAR INCREASE RELATED
TO COST REALLY TO COBIT
NINETEEN. LARGELY REFLECTING
THAT IS SEEM TO END OF ENHANCE
FEDERAL FUNDING AVAILABLE DURING
THE PANDEMIC- IN ABOUT- SOME
OTHER OFTEN BEEN REDUCTIONS OF
ABOUT TWO POINT EIGHT BILLION
DOLLARS. THAT'LL TAKE ANY
QUESTIONS. DOES THE PROGRAM
FINANCER LES ALL HAVE ANY
COMMENTS. DEPARTMENT OF PLANNING
FOR THE COMING. LUCRECE MORROW
THE L. A. O. WE DO WANT TO NOTE
THAT AT THE TIME THE
MINISTRATION PUT TOGETHER THE
BUDGET THAT WAS CONSIDERABLE
UNDER THIRTY CERTAINTY AROUND
THAT. FEDERAL ACTIONS FOR COVER
NINETEEN POLICIES INCLUDING WHEN
ELIGIBILITY DETERMINATIONS WOULD
RESUME AND AVAILABILITY OF
ENHANCE FEDERAL FUNDING THAT'S
BEEN PROVIDED. JOIN THE PUBLIC
HEALTH EMERGENCY SHORTLY BEFORE
THE BUDGET WAS RELEASED THE
FEDERAL GOVERNMENT. ANNOUNCED
THAT- A FEW CHANGES TO THE
POLICIES ONE WE NOW KNOW THAT
ELIGIBILITY DETERMINATIONS WILL
BE AGAIN SOONER THAN THAT
MINISTRATION ANTICIPATED GETTING
ONE MONTH EARLIER IN APRIL OF
TWENTY TWENTY THREE. WE ALSO NOW
KNOW THAT THE ENHANCE FEDERAL
FUNDING RATHER THAN ENDING-
IMMEDIATELY UP RG. AT THE END OF
THE QUARTER THAT THE PHD
WOULD'VE ENDED WE NOW WILL HAVE
A RAMP DOWN PROCESS FOR THAT
FUNDING THROUGH CALENDAR YEAR
TWENTY TWENTY THREE WITH IT
DECLINING. AS A PERCENTAGE OF
THE SHERIFF COSTS- THROUGH THE
YEAR UNTIL IT REACHES ZERO AT IN
JANUARY- AS A RESULT OF THESE
CHANGES AS WELL AS AN ASSESSMENT
OF CASELOAD TRENDS. WE FOUND
BASED ON MORE RECENT CASE LAW
DATA WE FIND THAT ON THAT THAT
WOULD BE IT I NEED FOR ONE
BILLION DOLLARS LAST GENERAL
FUND AND TWENTY THREE TWENTY
FOUR. WE ARE NOT RECOMMENDING
SPECIFIC ACTIONS AT THIS TIME
OTHER WE RECOMMEND WITHHOLDING
ACTION ON THESE ADJUSTMENTS AND
TOLD ME A REVISION. THIS WILL
ALLOW THE ADMINISTRATION TIME TO
REFLECT THE CHANGES TO FEDERAL
POLICIES AS WELL AS MORE RECENT
CASE LOAD DATA INTO OUR
ESTIMATES. AND THEN WILL PROVIDE
ANOTHER ASSESSMENT OF THOSE
ESTIMATES AT THAT TIME AND
PROVIDE A FINAL RECOMMENDATION
I'VE BEEN THEIR VISION THANK
YOU. THANK YOU SO MUCH I DON'T
HAVE ANY. QUESTIONS COLLEAGUES
CENTERED WITH. THANK YOU I'M SO
I'M ASSUMING AFTER THE REVISE
AND NOW THAT WE KNOW MORE YOU'RE
GOING TO BACK SOME UP. BECAUSE I
WE HAD A HEALTH HEARING
YESTERDAY AND PRETTY LOUD AND
CLEAR PEOPLE DON'T THINK THAT
ROUND SIX SHOULD BE DELAYED
PEOPLE DON'T THINK WORKFORCE
FUNDING SHOULD BE DELAYED. SO
I'M SURE YOU'LL TAKE ALL THOSE
THINGS INTO CONSIDERATION WHEN
YOU COME BACK WITH WITH WITH THE
NET NEXT UPDATED BUDGET YES.
OKAY. TO I. SEE NO OTHER
QUESTIONS WERE GOING TO HOLD
THIS ITEM OPEN AND MOVE ON TO
ISSUE NUMBER FOR. THE NOVEMBER
TWENTY TWENTY TWO FAMILY HEALTH
LOCAL ASSISTANCE TESTAMENT.
REACHED A SO FOR THE BUDGET YEAR
THE GOVERNOR'S BUDGET ESTIMATES
EXPENDITURES OF EIGHTY SEVEN
MILLION TOTAL FINES FOR THE
CALIFORNIA CHILDREN'S SERVICES
PROGRAM. A THREE MILLION DOLLAR
INCREASE COMPARED TO THE CURRENT
YEAR AND JUST FOR CONTEXT THAT
THAT CALIFORNIA CHILDREN'S
PROGRAM PROVIDES DIAGNOSTIC
TREATMENT SERVICES. TO CHILDREN
UNDER AGE TWENTY ONE A WITH CCS
ELIGIBLE MEDICAL CONDITIONS. ARE
AT A HUNDRED AND THIRTY SIX
MILLION TOTAL FUNDS FOR THE
GENETICALLY HANDICAPPED PERSONS
PROGRAM WHICH IS A FOUR MILLION
DOLLAR INCREASE COMPARED TO THE
CURRENT YEAR. AND THAT
GENETICALLY HANDICAPPED PERSONS
PROGRAM IS A HEALTH PROGRAM FOR
ADULTS WITH SPECIFIC GENETIC
DISEASES. AND THEN FINALLY A
THIRTY SEVEN MILLION- TOTAL
FUNDS FOR THE EVERY WOMAN COUNTS
PROGRAM WHICH IS A ONE MILLION
DOLLAR INCREASE COMPARED TO THE
CURRENT YEAR. AND EVERY WOMAN
COUNTS PROGRAM PROVIDES FREE
BREAST AND CERVICAL CANCER TREAT
SCREENING AND DIAGNOSTIC
SERVICES TO CALIFORNIA'S
UNDERSERVED POPULATIONS- THE
GOVERNOR'S BUDGET FAMILY HEALTH
ESTIMATE PROJECTS SIXTEEN
MILLION I'M SORRY EXCUSE ME
FORTY MILLION LESS GENERAL FUND
IS NEEDED TO SUPPORT FAMILY
HEALTH PROGRAMS IN THE CURRENT
YEAR COMPARED TO THE TWENTY
TWENTY TO. ACT WITHOUT WILL TAKE
ANY QUESTIONS ELEVEN THEN SORRY
ONE MORE QUESTION HERE ON THE-
THE CHILD HEALTH AND DISABILITY
PREVENT. PREVENTION PROGRAM
TRANSITION. LAST YEAR'S BUDGET
SUNSET THAT C. H. D. P. PROGRAM
BY JULY ONE TWENTY TWENTY FOUR
AND PRESERVES PRESUMPTIVE
ELIGIBILITY ENROLLMENT
ACTIVITIES CURRENTLY OFFERED
THROUGH THIS PROGRAM- AS WELL AS
OTHER ACTIVITIES CURRENTLY
PERFORMED BY C. H. BTP COUNTY
AND UNDER THE CHILDHOOD. LEAD
POISONING PREVENTION PROGRAM. AS
PART OF THIS TRANSITION THE
DEPARTMENT IS CONVENED A
WORKGROUP COMPRISED OF
GOVERNMENT AND NON GOVERNMENTAL
STAKEHOLDERS INCLUDING PUBLIC
HEALTH NURSES. MANAGED CARE
PLANS COUNTY SOCIAL SERVICES
REPRESENTATIVES FROM THE HEALTH
CARE PROGRAM FOR CHILDREN IN
FOSTER CARE PROGRAM AND CONSUMER
ADVOCATES AND OTHERS. A WE
KICKED OFF THIS STAKEHOLDER
WORKGROUP LAST OCTOBER AND I
HAVE A ALSO CONVENED IN JANUARY
IN FEBRUARY AND I HAVE THREE
MORE MEETING SCHEDULED FOR MARCH
MAY AND JUNE. THE WORK GROUP IS
REALLY THINKING THROUGH THE
ELEMENTS OF THE TRANSITION PLAN-
AS SPECIFIED IN THE TRAILER BILL
INCLUDING CHILDREN'S PRESUMPTIVE
ELIGIBILITY. MONITORING AND
OVERSIGHT ACTIVITIES TRANSITION
IT ALLOCATION OF CHD P.
RESOURCES CHILDHOOD LEAD
POISONING PREVENTION PROGRAM
ACTIVITIES AND ESTABLISHING THE
HEALTH CARE PROGRAM FOR CHILDREN
IN FOSTER CARE AS A STANDALONE
PROGRAM. THE DEPARTMENT IS
SOLICITING FEEDBACK FROM THE
WORKGROUP TO DEVELOP THE UPDATED
TRANSITION PLAN AND WE PLAN TO
FINALIZE IN RECENT LEASE THE
TRANSITION PLAN BY THE END OF
THIS CALENDAR YEAR- AND WE PLAN
TO INCLUDE THIS TRANSITION PLAN
IS PART OF OUR TWENTY TWENTY
FOUR TWENTY FIVE I GOT. A
GOVERNOR'S BUDGET PER FOR
CONSIDERATION BY THE LEGISLATURE
. THANK YOU A DEPARTMENT OF
FINANCE CERTAINLY- ANY COMMENT.
A TILE RAY DEPARTMENT FINANCE
THE THING THAT. LUCHAR THAT LEÓN
NO COMMENTS ON THIS ITEM HAPPY
TO ANSWER QUESTIONS THANK YOU
KNOW COMES QUESTIONS ON MY END.
C. NINE THAT WE'RE GOING TO HOLD
THIS ITEM OPEN TO MOVE ON TO
ITEM ISSUE NUMBER FIVE. THE POST
ELIGIBILITY TREATMENT OF INCOME
ON A TRAILER BILL LANGUAGE. YES
HAPPY TO PRESENT ON THIS ITEM
OTHER DEPARTMENT IS PROPOSING
TRAILER BILL LANGUAGE TO ALIGN
OUR POLICIES WITH FEDERAL
GUIDELINES OF THE TEAR THEIR
BILL- ADDRESSES HOW THE
DEPARTMENT DESCRIBES THE COST
SHARING PROVISIONS. FOR
INDIVIDUAL SUBJECT TO POST
ELIGIBILITY TREATMENT IN INCOME
THE SPEND DOWN OF EXCESS INCOME
REQUIRED FOR INDIVIDUALS TO
BECOME ELIGIBLE FOR THE MEDIC
HOW- THROUGH THE MEDICALLY NEEDY
PROGRAM. THE TRAILER BILL IS
MEANT TO CLEAN UP OUR LANGUAGE
IN STATE STATUTE TO ALIGN WITH
FEDERAL GUIDELINES ON THIS WAS
RAISED TO US DURING THE PUBLIC
HEALTH EMERGENCY THAT SOME OF
OUR LANGUAGE IN TERMS AND STATE
STATUTE ON A LINE WITH THE
FEDERAL GUIDELINES AND SO WE'RE
REALLY JUST ALIGNING. AND
THEY'LL BE NO IMPACT INDIVIDUALS
WERE NOT CHANGING ANY OF THE
RULES OR GUIDELINES AROUND THESE
PIECES IT'S REALLY AROUND THE
WORDS THAT WERE USING- IN
REGARDS TO IT IN STATE STATUTES
SO THAT WE COMPLY. A BUT WE DO
KNOW THAT WE WILL ALSO RECEIVE
FEEDBACK FROM STAKEHOLDERS THAT
WE NEED TO UPDATE SOME OF OUR
MESSAGING ON NOTICES OF ACTIONS
AND OTHERS TO MAKE SURE IT'S NOT
CONFUSING TO OUR ADVICE. OUR TO
OUR MEMBERS SO. HOW DO WE MAKE
SURE THAT WE'RE COMMUNICATING
WHAT THIS MEANS- IN TO MAKE SURE
THAT OUR MEMBERS UNDERSTAND WHAT
WERE- WERE TELLING OF THEM.
ESSENTIALLY THE DEPARTMENT HAS
USED THE TERM SHARE OF COSTS TO
DESCRIBE. THIS POST- IN ROMAN
TREATMENT OF INCOME RULES FOR
MANY YEARS- WHEN INDIVIDUALS
MOVE INTO LONG TERM CARE OR HAVE
APPLIED FOR ON WHAT'S CALLED
POST ELIGIBILITY TREATMENT OF
INCOME RULES CORRECTLY. I'M IN
ACCORDANCE WITH THE RIGHT SINCE
WE'RE REALLY JUST GONNA BE
WORKING ON FINE TUNING SOME
LANGUAGE. SO PEOPLE UNDERSTAND
THAT THEY'RE NOT LOSING ANY OF
THEIR ACCESS AND WHAT IT MEANS
WHEN THEY TRANSITION FROM ONE TO
ANOTHER- CMS- ALSO. IS LOOKING
FOR US TO DO THIS AS SOON AS
POSSIBLE WHICH IS WHY WE PUT IT
FORWARD IN THIS BUDGET I MISS
BOB AND HAPPY TO ANSWER ANY
QUESTIONS. THANK YOU A
DEPARTMENT FINANCIALLY- ANY
COMMENT. HER SKIPPED OVER THE
PART OF FINANCE NOTHING AT THIS
TIME. WE HAVE NOT RAISED
CONCERNS THIS PROPOSAL THANK
YOU. THANK YOU. ANY QUESTIONS
CENTER EVENT. I JUST THIS FOR
AGAIN FOR MY OWN EDUCATION SO
WE'RE NOT CAUGHT SHARE OF COSTLY
MORE WE'RE GOING TO CALL IT. AND
HOW DO WE SAID ALWAYS SAYING
MAGGIE MEGABYTE WHAT WE SAYING.
WHY ARE WE SAYING THAT. I WOULD
I REFRAIN FROM CALLING IT PETTY
WHICH IS WHAT IT WOULD BE
BECAUSE THIS POST IN OUR HOME
COUNTRY. OF IF NOT THE BEST
TERMS YOU KNOW I'M WHICH IS WHY
ACTUALLY ADVOCATES HAVE COME TO
SAY THAT'S PROBABLY NOT THE
RIGHT TERM TO PUT IN A NOTICE-
EVEN IF IT'S THE CORRECT FEDERAL
TERM. SO WE WILL WE'RE UPDATING
ON STATE STATUTE TO REFLECT KIND
OF FEDERAL GUIDELINES BUT WILL
WORK ON THE MESSAGING TO ACTUAL
MEMBERS. I'M SO THAT IT IS IT IS
NOT CONFUSING- AT TO THEM- BUT
WE AGREE I THINK AT THE END OF
THE DAY IT'S NOT THE BEST- YOU
KNOW TERMINOLOGY. OKAY I MEAN
EVERYONE KNOWS SHARE COSTS. BUT
I. OKAY I THINK THE PROBLEM IS
WE DON'T WANT THEM TO THINK
THERE IS. A SHERIFF RIGHT YES
IT'S AN ASSESSMENT ON THE
INCOME. NOT NECESSARILY SHARE
COSTS AND SO IT'S CREATING
CONFUSION. WHEN PEOPLE MOVED
INTO THIS CATEGORY THEY THOUGHT
THERE WAS SOMETHING CHANGING OR
THERE YOU KNOW AND SO WE HAVE
THAT WE HAVE TO CORRECT THAT FOR
OUR MEMBERS SO THERE'S NO
CONFUSION. NAMES HAVE CHANGED.
TO PROTECT THE- WE'RE GONNA HOLD
ITEM OPEN TO MOVE ON TO ISSUE
NUMBER SIX HEALTH COVERAGE.
HEALTHCARE COVERAGE
CONTRACEPTIVES CONTRACEPTIVES
RELATED TO SB. FIVE TWENTY
THREE. THE DEPARTMENT IS
REQUESTING THREE PERMANENT
POSITIONS- AND EXPENDITURE
THIRTY OF ABOUT FOUR HUNDRED
FIFTY FIVE THOUSAND DOLLARS TO
AT TO IMPLEMENT. SB FIVE TWENTY
THREE HEALTH CARE COVERAGE
CONTRACEPTIVES. THEIR RESEARCH
REQUESTED RESOURCES WILL BE USED
TO LEAD POLICY DEVELOPMENT AND
IMPLEMENTATION. CONDUCT ONGOING
MONITORING ACTIVITIES. AND
ANALYZE COVERAGE COVERED
SERVICES TO DETERMINE WHICH
CONTRACEPTIVE SERVICES MAY NEED
TO BE CARVED OUT FOR FEE FOR
SERVICE. SB FIVE TO THREE A
PROHIBITS LIMITATIONS ON
COVERAGE OF CONTRACEPTIVE
COVERAGE SO FOR EXAMPLE THEM AT
THE BILL REQUIRES MANAGED CARE
PLANS TO PROVIDE COVERAGE- FOR
VOLUNTARY TUBAL LIGATION AND
OTHER SIMILAR STERILISATION
PROCEDURES. AS WELL AS FOR
CLINICAL SERVICES RELATED TO THE
PROVISION OR USE OF
CONTRACEPTION CONTRACEPTION
PATIENT EDUCATION REFERRALS AND
COUNSELING. MEDICARE CURRENTLY
COVERS FAMILY PLANNING
COUNSELING EXCEPT MAYES AND
TUBAL LIGATION AND TREATMENT FOR
COMPLICATIONS RESULTING FROM FOR
OUR FAMILY PLANNING PROCEDURES
HOWEVER THERE ARE CERTAIN
FEDERAL REQUIREMENTS THAT APPLY.
I'M WHICH MUST WHICH MAY BE
CONSTRUED AS RESTRICTIONS I'M SO
THESE RESOURCES WILL HELP US
IMPLEMENT AT THAT THE BILL. I'M
BERNARD FINANCIALLY ON THE
QUESTIONS. DIGITAL ADDED A
PERMANENT FINANCE NOTHING
FURTHER TO ADD. WE HAVE NOT
RAISED CONCERNS OF THIS PROPOSAL
THANK YOU. I'M JUST A QUICK
QUESTION OR NO IF YOU WOULD KNOW
THIS. OUR PLANS ARE READY
IMPLEMENTING THIS COVERAGE. SO
AND MEDICARE WE ARE TO COVER ALL
FDA APPROVED ON DRUGS OR
SERVICES IN THE ONE EXCEPTION
IS- STERILIZATION ON THAT MAY
NOT BE COVERED UNDER CERTAIN
FEDERAL GUIDELINES DEPENDING ON
IF IT IS ON VOLUNTARY ON BEHALF
AND NOT MEDICALLY NECESSARY. IN
WHICH CASE WE WILL BE CREATING A
PATHWAY IN P. FOR SERVICE CARVED
OUT OF THE RESPONSIBILITY FOR
MANAGED CARE PLANS I'M SO THAT
WE CAN PAY A 100% GENERAL FUND
FOR ANYTHING THAT WOULD NOT
OTHERWISE DRAW DOWN FEDERAL
FUNDS AND I THINK THAT'S THE
ONLY ONE EXCEPTION THAT WE
IDENTIFY DURING THE BILL
ANALYSIS IN THE LANGUAGE THAT WE
IDENTIFIED WHICH IS WHY WE NEED
THE STAFF TO BE ABLE TO BUILD.
ON THAT S. EXCEPTION OTHER THAN
THAT MEDICARE COVERS ALL FDA
APPROVED DRUGS AND SERVICES- AS
LONG AS IT'S MEDICALLY NECESSARY
AND WITHIN FEDERAL GUIDELINES
THANK YOU. ANY OTHER QUESTIONS.
THEY WERE GONNA HOLD ITEM OPEN
ONE ISSUE NUMBER SEVEN
CALIFORNIA CANCER CARE EQUITY
ACT RELATED TO S. B. NINE EIGHT
SEVEN. TO THE DEPARTMENT IS
REQUESTING A THREE PERMANENT
POSITIONS ONE LIMITED TERM
EQUIVALENT. POSITION IN SOME
CONTRACT RESOURCES TO IMPLEMENT
SB NINE EIGHTY SEVEN- THE
CANCER- X. CENTER EQUITY ACT.
THE RECESSES ARE NEEDED TO
DEVELOP AND IMPLEMENT GOOD FAITH
EFFORT CONTRACTING REQUIREMENTS
FOR MEDICAID MANAGED CARE PLANS.
DEVELOP AND IMPLEMENT A CANCER
CENTER REFERRAL PROGRAMS FOR
ENROLLEES WITH COMPLEX CARE.
COMPLEX CANCER DIAGNOSIS.
DEVELOP A PROCESS IN
CONSULTATION WITH APPROPRIATE
STAKEHOLDERS TO CONTINUALLY
UPDATE AND FURTHER DEFINE
COMPLEX CANCER DIAGNOSIS FOR
PURPOSES OF REFERRAL FOR THIS
PROGRAM. AND THEN CONDUCT
ONGOING MONITORING AND OVERSIGHT
OF OUR MANAGED CARE PLANS AND
TAKE CORRECTIVE ACTION WHEN
NECESSARY. DOES THE PERMANENT
FINANCER LES- HAVE ANY COMMENT
ON THIS. DIGITAL ADDED
DEPARTMENT OF FINANCE SOMETHING
FOR TODAY FURTHER TO ADD. DHISAN
CONCENTRATE SOLELY- WE HAVEN'T
RAISED CONCERNS WITH THIS
PROPOSAL. QUESTIONS WE'RE GONNA
HOLD THE ITEM OPEN WE'RE GOING
TO MOVE ON TO. THE ITEM NUMBER
EIGHT MATERNA PANDEMIC RELATED
MENTAL HEALTH CONDITIONS AS IT
RELATES TO SB TWELVE OH SEVEN.
OTHER DEPARTMENT IS REQUESTING
TO PERMANENT POSITIONS- AND
EXPENDITURE THIRTY OF THREE
HUNDRED AND TEN THOUSAND DOLLARS
ON THE BUDGET YOU'RE AN ON GOING
THE POSITIONS ARE NEEDED TO
IMPLEMENT THE REQUIREMENTS FOR
MANAGED CARE PLANS TO DEVELOP-
MATERNAL MENTAL HEALTH PROGRAM
THAT IS ALIGNED WITH OUR
COMPREHENSIVE QUALITY STRATEGY.
AND GOALS TO DRIVE IMPROVEMENTS
IN MATERNAL AND CHILD HEALTH
OUTCOMES MANAGED CARE PLANS MUST
DEVELOP THE MATERNAL MENTAL
HEALTH PROGRAM BY JULY OF TWENTY
TWENTY THREE. THE REQUESTED
RESOURCES ARE NEEDED TO YOU LIED
ABOUT AND POLICY DEVELOPMENT AND
IMPLEMENTATION DESIGN I PROVIDE
TECHNICAL ASSISTANCE TO MANAGED
CARE PLANS OVER THE COURSE OF
IMPLEMENTING THESE VARIOUS
MEASURES AS WELL AS DEVELOPING
MONITORING- TOOLS AND PROTOCOLS.
A RESOURCES WILL ALSO BE USED TO
WORK WITH THE DEPARTMENT OF
MANAGED- MANAGE HELP- TO ENSURE
THAT WE ARE ALIGNING IN REGARDS
TO IMPLEMENTATIONS HERE A WE
ALSO WILL BE A MONITORING THE
COMPLIANCE VARIOUS QUALITY
METRICS THAT WOULD BE NEEDED.
EDUCATION TRAINING AND MEMBER
EDUCATION THAT WOULD COME INTO
OUR THE FUTURE IS WELL- AND SO
HAPPY TO ANSWER ANY QUESTIONS.
DOES LA- OR DEPARTMENT FUNDS
HAVE ANY COMMENTS. THE DETAIL OF
THE DEPARTMENT OF FINANCE
NOTHING FURTHER TO ADD. WE
HAVEN'T RAISED. CONCERNS OF THIS
PROPOSAL FOR PERFECT THANK YOU.
SALAS INCLUSIONS. GONNA HOLD
ITEM OPEN AND WE'RE GOING TO
MOVE ON TO ISSUE NINE THE WHOLE
CHILD MODEL. THE TRAILER BILL
LANGUAGE. THE DEPARTMENT OF
HEALTH CARE SERVICES IS
PROPOSING TO IMPLEMENT THE
CALIFORNIA CHILDREN'S SERVICES
OR WHAT'S KNOWN AS CCS WHOLE
CHILD MODEL. I'M IN FIFTEEN
COUNTIES CONVERTING TO THE I'M
COUNTY ORGANIZED HEALTH SYSTEMS
OR WHOSE- AND SINGLE PLAN MODELS
AS A PART OF THE COUNTY MODEL
CHANGES THAT ARE GOING LIVE
JANUARY ONE OF TWENTY TWENTY
FOUR- IT WILL BE A PHASED
IMPLEMENTATION WHICH I'LL GET TO
IN A IN A SECOND. WE'RE ALSO
PROPOSING TO MANDATORILY AND
ROLE OF FOSTER CHILDREN I'M IN
SINGLE AND PLAN COUNTIES- TO
ALIGN WITH THAT INCIDENT VERY
MANDATORY ROLL THEM INTO MANAGED
CARE PLANS. TO ALIGN WITH THE
POLICY IN CODES COUNTIES ACROSS
THE ENTIRE STATE OF CALIFORNIA-
THERE ARE PROBABLY A HUNDRED AND
SEVENTY THREE THOUSAND CHILDREN
IN CCS WITH A LITTLE. UNDER
THIRTY ONE THOUSAND OR 18% IN
THE WHOLE CHILD MODEL TODAY A
THIS WOULD BRING THE TOTAL OF
WHOLE CHILD MODEL COUNTIES TO
THIRTY SIX IN AROUND FORTY SEVEN
THOUSAND CHILDREN OR TWENTY
SEVEN PERCENT. OF THE CHILDREN
THAT ARE CCS ELIGIBLE I'M INTO
THE WHOLE CHILD MODEL. UP WITH
EXISTING WHOLE CHILD MODEL
MANAGED CARE PLANS ARE SCHEDULED
TO EXPAND TO NEW COUNTIES IN
TWENTY TWENTY FOUR- WE ARE
HOPING TO ALIGN THE POLICY FOR
THOSE MANAGED CARE PLANS. FOR
EXAMPLE PARTNERSHIP WILL BE
ADDING A LARGE NUMBER OF
COUNTIES TO ON THEM AS A CLOSE
PLAN- AND WE DO THINK IT'S
IMPORTANT THAT OUR MANAGED CARE
PLANS ARE TREATING ALL OF THEIR
VARIOUS COUNTIES AND MEMBERS
CONSISTENTLY- AND CCS IS CARVED
INTO THE MANAGED CARE PLANS
RESPONSIBILITY IN THOSE
COUNTIES- AND SO THAT IS WHY WE
ARE MOVING FORWARD TO
STANDARDIZE THIS WHERE- MANAGED
CARE PLANS HAVE EXPANDED AND
WE'RE COUNTIES HAVE CHOSEN-
THROUGH ORDINANCE BEING PASSED.
A TO MOVE INTO THESE CODES
MODELS ACROSS THE INSTEAD OF A
STATE OF CALIFORNIA ON THERE WAS
EVERY I COUNTY THAT ELECTED TO
MOVE INTO THESE BECAUSE MODELS
WENT THROUGH A PUBLIC HEARING
PROCESS THEY HAD A PASSED LOCAL
ORDINANCES TO MOVE INTO CODES
MODELS. IN THE STATE OF
CALIFORNIA FOR A CLOSE INCLUDING
THE PARTNERSHIP MODEL ON CCS IS
CARVED IN UNDER. THE WHOLE CHILD
MODEL IN THOSE PARTICULAR COUNTY
SAID THAT IS WHY WE'RE MOVING
FOR WITH OUR- I'M REGARDING
THAT. IT WILL BE A PHASED
APPROACH THOUGH BECAUSE WE HAVE
CONSULTED WITH THE COUNTIES-
IT'S IN IT AND TWENTY TWENTY TWO
TO UNDERSTAND WHAT THIS WOULD
LOOK LIKE. ON THE FIRST PHASE
WILL BE FOCUSED ON DEPENDING
COUNTIES A DEPENDING COUNTY AS
SOMEONE WITH THE STATE OF
CALIFORNIA ACTUALLY DOES THE
AUTHORIZATION FOR C. C. SERVICES
OR THE COORDINATION OURSELVES.
ON THOSE WHICH TRANSITION FIRST
ON IN THE SECOND PHASE WOULD BE
INDICATED INDEPENDENT COUNTIES-
AND THAT IS WHERE THE COUNTY.
THEMSELVES DO THOSE CCS
COORDINATION- PIECES- AND AN
ELIGIBILITY PIECES. I'M SO PHASE
ONE IS BEING PROPOSED IN TEN
CODES EXPANSION COUNTIES. ON
THAT HAVE A DEPENDING COUNTY
DESIGNATION IN THE CCS PROGRAM
BY TWENTY TWENTY FOUR- AND THOSE
TEN COUNTIES- INCLUDE- THE
VARIOUS COUNTIES IN PARTNERSHIP
HEALTH PLAN SO COLUSA. GLENN
NEVADA PLUMAS SIERRA- SUTTER A
TO HUMANA AND YUBA AND THEN IN
OUR ALLIANCE COUNTIES IN
MARIPOSA AND SAN BENITO. PHASE
TWO WOULD IMPLEMENT A WHOLE
CHILD MODEL EXPANSION INTO CLOSE
EXPANSION COUNTIES THAT HAVE
INDEPENDENT COUNTY. DESIGNATION
IN THE CCS PROGRAM I'M AS WELL
AS THE THREE NEW SINGLES. PLAN
COUNTIES BY G. AND ONE OF TWENTY
TWENTY FIVE SO TWO FACED
APPROACH HERE- WITH OUR PARTNERS
AND THAT WAS BASED ON FEEDBACK
WE RECEIVED FROM OUR COUNTY
PARTNERS IN REGARDS TO HOW TO
YOU. I'M TRANSITION THIS- AND
ALLOW FOR CAPACITY POLICY
BUILDING- AND- TRANSITION.
REGARDING THE WHOLE CHILD MODEL
INDEPENDENT EVALUATION OF THE
DEPARTMENT OF HEALTH CARE
SERVICES AIMING TO RELEASE THE
INDEPENDENT EVALUATION OF THE
WHOLE CHILD MODEL BY THE END OF
MARCH- DUE TO DELAYS ON EIGHTY A
AND D. IDENTIFICATION WE HAVE
KNOCK ON THAT REPORT OUT
PUBLICLY. HOWEVER WE HAVE GONE
AND MADE SURE WE ARE- EDUCATING
PEOPLE ABOUT THE OUTCOMES OF THE
EVALUATION WE ACTUALLY JUST
ALLEGE BRIEFING FOR LEAD STAFF
YESTERDAY ON THE FULL EVALUATION
OUTCOMES. WE ALSO HAVE BRIEFED
ON OUR CCS ADVISORY COMMITTEE WE
HAVE BRIEFED MANAGED CARE. PLANS
GEAC IN MANY OF OUR OF AT THE
AND WILL CONTINUE TO EDUCATE
PEOPLE ON THE EVALUATION
OUTCOMES. THE DEPARTMENT
CONTRACTED WITH THE UNIVERSITY
OF CALIFORNIA SAN FRANCISCO
INSTITUTE FOR HEALTH POLICY
STUDIES TO CONDUCT THIS
INDEPENDENT EVALUATION THE
EVALUATION IS ORGANIZED BY
RESEARCH QUESTIONS THAT
ADDRESSES EACH EVALUATION
QUESTION THAT WAS IDENTIFIED IN
THE ORIGINAL SB FIVE EIGHTY SIX
WHICH WAS NEGOTIATED BETWEEN THE
ADMINISTRATION AND THE
LEGISLATURE AT THAT TIME- THE
DEPARTMENT'S. DECISION TO
PROCEED WITH PROPOSING THE
IMPLEMENTATION OF WHOLE CHILD
MODEL IN THESE COUNTIES WORDS IS
BANDED REALLY- WAS SUPPORTED BY
THE RESULTS AND CONCLUSIONS
IDENTIFIED IN THE INDEPENDENT
EVALUATION BY UCSF. THE
EVALUATION REPORT IDENTIFIED
THAT THE WHOLE CHILD MODEL HAD
SIMILAR OR SAME RESULTS ON AS
THE SEAT OF THE CLASSIC CCS OR
AN IMPROVED IMPACT. ON TO THE
MAJORITY OF THE CCS CLIENT
PARTICIPANTS ACROSS THE MAJORITY
OF THE VALUATION MEASURES AS
COMPARED TO THE CLASSIC CCS
PROGRAM. EVALUATION CONCLUDED
THAT THE CCS WHOLE CHILD MODEL
MAINTAIN SERVICES AND PROVIDED
CCS LEVEL QUALITY OF CARE FOR
THE MAJORITY OF CCS CLIENTS IN
THE WHOLE CHILD MODEL. IT
INCREASE ACCESS TO CCS PANEL
PROVIDERS HAD LOWER GRIEVANCES
STREAMLINED DME REFERRALS
SATISFACTION WAS EITHER
UNCHANGED FOR IMPROVED FOR THE
MAJORITY OF MEMBERS AS REPORTED
BY THE INDEPENDENT EVALUATOR.
QUALITY WAS MAINTAINED INCLUDING
AND HE DOES MEASURES WHERE MOST
OF THEM WERE IMPROVED OR STAYED
THE SAME AND CONSISTENT WITH
CLASSIC CCS- AND SO THERE WERE
SOME ALSO SOME AREAS OF
IMPROVEMENT WHICH WE NOTED IN
REGARDS TO YOU OF THE EVALUATION
WHICH WE WILL TAKE VERY
SERIOUSLY TO LOOK AT. ONE OF
WHICH IS THE CCS ENROLLMENT
WHERE ON AVERAGE THE ABSOLUTE
DIFFERENCE BETWEEN THE WHOLE
CHILD MODEL AND CLASSIC CCS
COUNTIES FOR NEW REFERRALS WAS
ABOUT A 122% DIFFERENCE. I KNOW
THAT'S A SMALL PERCENT BUT ONE
OF THE CORE FACTORS THAT WE
WANTED WITH WHOLE CHILD MODELS
TO HAVE NO DISRUPTION OF THIS AN
INDIVIDUAL WHO IS CCS ELIGIBLE
FROM BEING DESIGNATED AS CCS
BECAUSE AS AGREED TO IN SB FIVE
EIGHTY SIX THERE WERE CERTAIN
PROTECTIONS THAT COME ALONG.
WITH BEING A CCS INDIVIDUAL AND
SO WE WILL WORK WITH OUR MANAGED
CARE PLANS TO ENSURE THAT THERE
ARE PROCESSES IN PLACE TO MAKE
SURE THEY ARE IDENTIFYING CCS
CHILDREN IN REFERRING THEM TO BE
FORMALLY ENROLLED IN THE CCS
PROGRAM SO THEY CAN HAVE THOSE
ADDITIONAL PROTECTIONS.
INCLUDING OF A PROVIDER BUMP.
THAT IS GOOD- CORRELATED TO THAT
WOULD ALSO NOTE THAT THE OF.
PERIOD WAS DURING PUBLIC
EMERGENCY- SO WE ALSO SOUGHT IS
PROMISING THAT THE EVALUATION
ALSO STILL SHOWED- YOU KNOW
PRETTY HIGH IMPROVEMENT. AND OR
CONSISTENT WITH THE CLASSIC CCS
AND WE DID SEE THE VARIATION- IN
REGARDS TO THAT AGAIN FOR THE
MAJORITY OF THE MEASURES NOT ALL
BE MENTIONED SOME OF THE AREAS
WERE WANTING TO SEE SOME
CONTINUED IMPROVEMENT- THEY ALSO
IT NOTED THAT CARE COORDINATION.
NEEDED SOME IMPROVEMENT FOR BOTH
THE CLASSIC CCS AND THE WHOLE
CHILD MODEL SO WE'LL CONTINUE TO
WORK WITH OUR CCS. I'M PARTNERS
IN THE COUNTY AS WELL AS OUR
MANAGED CARE PLANS TO REALLY
IMPROVE. THE CARE COORDINATION
FOR THESE INDIVIDUALS. WHEN IT
COMES TO CCS REIMBURSEMENT- WHEN
IT COUNTY TRANSITIONS FROM FEE
FOR SERVICE TO THE WHOLE CHILD
MODEL. EXISTING LAW REQUIRES
THAT MEDICARE MANAGED CARE PLANS
PAY PHYSICIANS AND SURGEONS A
PROVIDER BONTA SO THERE WAS A
NEGOTIATED SB FIVE EIGHTY SIX
THAT ANYONE WHO TRANSITION OVER.
HAS TO MAINTAIN THAT POSITION
BUMP IN REGARDS TO THESE
SERVICES AND THAT IS REQUIRED
FOR THESE INDIVIDUALS AS WELL.
WHEN IT COMES TO THE HOSPITAL
QUALITY ASSURANCE FEE AS WE HAVE
HEARD SOME OF OUR CHILDREN'S
HOSPITALS ARE ANXIOUS AROUND
THIS TRANSITION. OF WE HAVE HAD
CONVERSATIONS WITH THEM- IN
THOSE PAYMENT PROGRAMS THE
METHODOLOGY TO DETERMINE THE
AMOUNT OF SUPPLEMENTAL PAYMENTS
TO HOSPITALS AND P. FOR SERVICE
DELIVERY SYSTEM. INCLUDES
FACTORS TO ACCOUNT FOR HIGH
ACUITY STAYS OR SERVICES-
HOWEVER UNDER MANAGED CARE THE
DIRECTED PAYMENT PROGRAMS THAT
WE USE- IT IS THE SAME PER DIEM
OR OUT ON REGARDLESS OF THAT
ACUITY AND SO THEY HAVE SOME-
SOME QUESTIONS ABOUT WHAT THIS
TRANSITION MEANS. OF FOR THEM
THE DEPARTMENT IS COMMITTED TO
WORKING WITH OUR HOSPITAL
PARTNERS TO MODIFY THE STRUCTURE
OF THE MANAGED CARE DIRECTED
PAYMENTS. AMID TO HAVE THOSE
CONVERSATIONS- TO ACCOUNT FOR
THE DIFFERENCES- MORE
APPROPRIATELY FOR FUTURE
PROGRAMS. THE NEXT ITERATION OF
THE HOSPITAL QUALITY FEW THAT
WOULD BE SUBMITTING WOULD BE FOR
CALENDAR YEAR TWENTY TWENTY
FIVE. HOWEVER I WOULD NOTE THAT
UNDER THE FEE FOR SERVICE
PROGRAM THE PAYMENTS ARE BASED
ON HISTORICAL UTILIZATION. WHICH
MEANS THE IMPACTS OF THE TRAILER
BILL ON UTILIZATION FOR OUR
HOSPITAL PARTNERS WOULD NOT BE
REALIZED UNTIL AT LEAST CALENDAR
YEAR TWENTY TWENTY SIX. SO WE
HAVE TIME TO FIND THE SOLUTIONS
FOR OUR HOSPITAL PARTNERS. AS WE
CONTINUE TO HAVE CONVERSATIONS
WITH THEM AND IN FACT IN
CALENDAR YEAR TWENTY TWENTY FOUR
FOR COUNTIES WERE WHOLE CHILD
MODELS EXPANDED HOSPITALS WOULD
RECEIVE SUPPLEMENTAL PAYMENTS
UNDER THE FEE FOR SERVICE
PROGRAM. BASED ON CALENDAR YEAR
TWENTY TWENTY ONE UTILIZATION
BEEN CCS REMAINED IN FEE FOR
SERVICE. AND THEY WOULD ALSO
RECEIVE SUPPLEMENTAL PAYMENTS
UNDER THE MANAGED CARE DIRECTED
PAYMENT PROGRAM FOR CALENDAR
YEAR TWENTY TWENTY FOUR
UTILIZATION. WHEN THE MEMBER WAS
IN WHOLE CHILD MODEL SO
ESSENTIALLY AN ENHANCED PAYMENT
FOR A TWO YEAR PERIOD OF TIME
FOR THOSE HOSPITALS AS WE
TRANSITION AND FIND SOLUTIONS
MOVING FORWARD. ON THE
DEPARTMENT IS VERY COMMITTED TO
WORKING WITH ALL ADVOCATES OR
INDIVIDUALS WHO ARE CONCERNED
AROUND THIS EXPANSION OF WHOLE
CHILD MODEL TO HOPEFULLY FIND A
PATHWAY FORWARD WHERE WE CAN
CONTINUE TO STANDARDIZED.
SERVICES IN THOSE CLOSE COUNTIES
WHERE A WHOLE CHILD MODEL IS
ALREADY CARVED IN A TODAY. DOES
THE DEPARTMENT FINANCER LA OR
HAVE ANY QUESTIONS. COMMENTS
START. AT THE TABLE A DEPARTMENT
OF FINANCE NO FURTHER COMMENTS.
ADDRESSING CONCENTRATE SOLELY- A
BEFORE DIVING IN YOUR COMMENTS
YOUR SON MIGHT BE HELPFUL JUST
TO POINT OUT SOME PARTS OF YOUR
AGENDA THAT MIGHT BE HELPFUL TO
FOLLOW- ON PAGE THIRTY YOU'LL
SEE THE- A LIST OF THE-
PARTICIPANTS. JUSTIN COUNTIES
THAT PARTICIPATE IN WHOLE CHILD
MODEL THAT'S WORDS AS
PARTICIPATING COUNTIES AND THEN
PARTICIPATING HEALTH PLANS ARE
THE HEALTH PLANS THAT OPERATE IN
THOSE. HOTEL MODEL IN THOSE
COUNTIES. TURNING TO PAGE THIRTY
ONE. ARE YOU CAN SEE A LIST OF
ALL OF THE- IN A MANAGED CARE
MODEL CHANGES. AND UP ALL THE
WAY UP TO YUBA YOU CAN SEE THE A
LIST OF COUNTIES THAT ARE
TRANSITIONING TO SINGLE PLAN OR
THAT THE CODES MODEL. WHICH ARE
THE COUNTY SERVED IMPACTED BY
THIS PROPOSAL. AND THEN ARE
MOVING TOWARDS THE BOTTOM OF
PAGE THIRTY ONE YOU CAN SEE THE
TWO PHASES THERE AND EAT. THE
COUNTIES AFFECTED BY EACH PHASE
. NO WE THINK THIS PROPOSAL
RAISES A FEW- KEEP POLICY
CONSIDERATIONS FOR THE
LEGISLATURE. OFFERS WE
UNDERSTAND THE DEPARTMENT'S
RATIONALE OF WANTING TO ALIGN
WITH- THE- MANAGED CARE MODEL
CHANGES. AND ALSO TO FURTHER
STANDARDIZE THE WAY SERVICES ARE
DELIVERED ACROSS THE STATE AND
WE THINK THAT RATIONAL WARRANTS
CONSIDERATION. WE ALSO NOTE THAT
STAKEHOLDERS OVER THE YEARS HAVE
RAISED CONCERNS ABOUT THE
POTENTIAL IMPACT OF WHOLE CHILD
MODEL ON ACCESS AND QUALITY OF.
CCS SERVICES WE UNDERSTAND THE
EVALUATION WAS AND TENDED TO
SHED LIGHT ON A LOT OF THOSE
CONCERNS. I THINK THIS RUSSIAN
NOTED. IT DID BRIEF LEGISLATIVE
STAFF INCLUDING OUR OFFICE ON-
SOME OF THE KEY CONCLUSIONS OF
THAT EVALUATION. ANTICIPATES
RELEASING THE FULL EVALUATION
LATER THIS MONTH WE RECOMMEND
WITHHOLDING ACTION UNTIL THAT
FULL EVALUATION IS RELEASED
LATER THIS MONTH- WHEN THAT
EVALUATIONS RELEASED WE'RE WE'RE
HAPPY TO WORK WITH THE COMMITTEE
FURTHER ON- PERSON THROUGH THAT
EVALUATION. WE THINK THERE ARE A
COUPLE OF KEY ISSUES A LET THE
LEGISLATURE WANNA KEEP AN EYE
OUT IN THAT EVALUATION NO ONE OF
COURSE IS THAT THE DIFFERENCES
AND ACCESS AND QUALITY OF
SERVICES AND WHOLE CHILD MODEL
COMPARED TO TRADITIONAL CCS. THE
ADMINISTRATION WALK THROUGH SOME
OF THOSE KEY DIFFERENCES
ALREADY. WE ALSO THINK IT WILL
BE IMPORTANT TO NOTICE WHERE
THOSE DIFFERENCES WERE LARGEST
IN AND HOW NOTABLE THOSE
DIFFERENCES WERE- SOME OF THAT
INFORMATION IS. STILL SER
FORTHCOMING IN THE EVALUATION.
AND FINALLY IN WHICH CAL THOSE
THE WERE MOST KNOWN. AND WHAT
THAT MIGHT SUGGEST ABOUT THE
IMPACTS OF EXPANDING HOTEL MODEL
TO THE PROPOSED COUNTIES IN IN
THIS PROPOSAL. WE ALSO THINK THE
LEGISLATURE WANT TO CONTINUE TO
WORK WITH THE ADMINISTRATION TO
UNDERSTAND THE FINANCING
IMPLICATIONS OF THIS PROPOSAL
AND ENSURE IT'S COMFORTABLE WITH
THOSE IMPLICATIONS. I'M
DEPENDING ON THESE FACTORS THE
LEGISLATURE HAS OPTIONS HERE IF
IT IF IT SATISFIED WITH THE
TRADE OFF WITH THE PROPOSAL. IT
COULD APPROVE ALL OR PARTS OF
THE PROPOSAL OR IT TO THE EXTENT
THAT IT NEEDS MORE TIME TO
DELIBERATE ON THESE ISSUES ARE.
IT ALSO COULD FOR SOME OF THESE
DECISIONS AND DISCUSS THEM IN
CONCRETE AND FURTHER. SO AGAIN
HAPPY TO HAPPY TO BE AVAILABLE
FOR QUESTIONS. GREAT THANK YOU
AND MISS COOPER REALLY
APPRECIATE GIVEN SOME HIGHLIGHTS
TO THIS BUT YOU KNOW. YOU KNOW
I'M ON BOARD WITH THAT TOO I
REALLY WANT TO READ THIS REPORT.
AND MAKE A DECISION ON THAT
BECAUSE I AM A LITTLE HESITANT.
YOU KNOW THAT THEIR VALUATION
TOOK NO TIME TO COME OUT AND I
DON'T WANT TO JUMP HERE BEFORE
GETTING. THINGS ARE EVIDENCE
BASED THAT ARE ACTUALLY GOING TO
WORK. FOR THEM ALL THE EVERY
SINGLE COUNTY I TO BE HAS A
TENANT PASSES SOMETHING THAT
LEAVES OUT JUST EVEN ONE COUNTY.
BECAUSE THAT COULD BE
DETRIMENTAL TO A LOT OF-
PATIENTS. NO NO QUESTIONS ARE
WHICH IS A COMMON I'LL TURN TO.
MY COLLEAGUE CENTER UP HERE
THANK YOU A MADAM CHAIR- YOU
KNOW I'M PROBABLY A LITTLE OUT
OF DATE MY RECOLLECTION OF
MANAGED CARE. IS IT WORKS BEST
WHEN ITS BALANCES ACUITY. WHAT
WORKS BEST FOR PROVIDERS WHEN IT
BUT WHEN THE ACUITY IS BALANCED.
RIGHT AND HERE ARE MY WRONG.
THAT'S BIG QUESTION WHETHER.
LOOKING ABOUT CAPITATED PAYMENTS
INNOCENTS ARE WE RIGHT BUT
THEY'RE DIFFERENT RATES PAID BY
DIFFERENT YOU CUTIE LEVELS THAT
YOU GET PAID PER LIFE AND- THE-
ADJUSTED BY ACUITY IF YOU
ADJUSTED BUT IT'S A IT'S A-
SERVE A GLOBAL THING WHEN YOU
SIGN UP TO THIS HERE WE'RE
TALKING ABOUT. KIDS BASICALLY
AND SOME YOUNG SOME NOT QUITE SO
YOUNG. WAS VERY HIGH ACUITY'S-
IN A MEDICAL FIELD IN THE STATE
OF CALIFORNIA WHERE- MANY
HOSPITALS ARE HAVE PEDIATRIC
BEDS CERTAINLY WHERE I COME
FROM. IF THEY DON'T HAVE
PEDIATRIC SPECIALISTS. THOSE
TEND TO BE LOCATED IN IN VERY
SPECIFIC FACILITIES. AND YET
WE'RE TAKING A PROCESS THAT HAS
SEEMED TO WORK FAIRLY WELL FEE
FOR SERVICE- AND WE'RE CHANGING
THAT. AND SO I GUESS I HAVE A
COUPLE QUESTIONS THE FIRST ONE
IS WHY ARE WE DOING THIS ARE WE
DOING THIS TO SAVE MONEY. I'M SO
NO AND I JUST WANT TO REMIND
EVERYONE WE ALREADY HAVE THIRTY
AROUND THIRTY ONE THOUSAND
CHILDREN IN THE WHOLE CHILD
MODEL PROGRAM TO DAY- ACROSS
FIFTEEN COUNTIES IN THE IN IN.
IN CALIFORNIA- AND SO AS WE ARE
EVALUATING THAT INITIAL
TRANSITION THAT TOOK PLACE
BETWEEN TWO THOUSAND EIGHTEEN
OVER MULTIPLE MONTHS IN MULTIPLE
COUNTIES ACROSS THE STATE SO
THIS WE HAVEN'T SEEN THE
EVALUATION WE WILL BE RELEASED
AND YET I AM WHEN I'M I'M
CONCERNED ABOUT THE DIFFERENCES
IN TREATMENT. THE DIFFERENCES IN
OUTCOME AND YOU TELL ME THAT
UCSF IS DONE A STUDY AND THEN
ENTER NO SIGNIFICANT DIFFERENCES
WELL I'D LIKE TO SEE THAT.
BECAUSE WE'RE TALKING ABOUT
PUTTING PEOPLE IN A MANAGED CARE
SITUATION. THAT MAY OR MAY NOT
PROVIDE CARE AT DEDICATED HIGHLY
SPECIALIZED CHILDREN'S HOSPITALS
YES THEY HAVE TO SIGN UP TO THE
PROGRAM DON'T THEY- WE ACTUALLY
THERE'S A NUMBER OF PROTECTIONS
THAT WERE NEGOTIATED WITH THE
LEGISLATURE OM I'D ORIGINALLY
AROUND SB FIVE EIGHTY SIX. TO
PUT MANY OF THOSE PROTECTIONS
FOR EXAMPLE- EVEN ENROLLED IN
MANAGED CARE ALL CCS KIDS STILL
NEED TO SEE CCS PANEL PROVIDERS
OR THEY ARE REQUIRED TO ALSO
COORDINATE ANY OUT OF NETWORK
HERE WHAT WE ARE ALSO SAWS THAT
MOST MANAGED CARE PLAN
SIGNIFICANTLY INCREASE THEIR
NETWORK TO HAVE BETTER ACCESS.
FOR THESE VARIOUS CCS PANEL
PROVIDERS- I DON'T HAVE THE
STAND FOR ANY BUT I BELIEVE
INDEPENDENT EVALUATOR SAID CLOSE
290% WE'RE ALL SEEING CCS PANEL
PROVIDERS- IN THEIR NETWORKS IN
MOST WERE EXPANDED THEIR
PROVIDER NETWORKS. I'M
SIGNIFICANTLY TO MEET THE NEEDS
I MEAN COORDINATE THOSE SERVICES
SOCIAL VALUATION LOOKS AT THOSE
TYPES OF THINGS AND THEN POINTS
OUT ANY DIFFERENCES BY MANAGED
CARE PLAN SO YOU CAN SEE THE
DIFFERENCES ACROSS THOSE VARIOUS
AND I GUESS BACK TO MY- ORIGINAL
QUESTION WHY ARE WE DOING THIS.
I REALIZE WE'VE I REALIZE YOU
HAVE IT WORKING IN OTHER
COUNTIES THEY DIDN'T ADDRESS THE
QUESTION YEAH WHY ARE WE DOING
IT YEAH I HAVE TO DO WHICH I WAS
THE GOAL AND THE OBJECTIVE IN
DOING THIS. IN THE OFFICE AND I
WAS HERE. I WAS PROBABLY A ONE
OF THESE. BUT I JUST DON'T
REMEMBER SO I'M HAPPY TO WALK
THROUGH THAT SO THE REASON MY
WORD- WE ARE RECOMMENDING TO ADD
IS I'M TIED TO THE MANAGED CARE
PROCUREMENT- THAT WE HAVE A
LARGE UP HE'S GOING LIVES
JANUARY TWENTY TWENTY FOUR- WE
ALLOWED ALL COUNTIES TO DECIDE
IF THEY WANTED TO CHANGE THEIR
MODEL. OF MANAGED CARE IN THEIR
COUNTY- AND SO A STARTING IN
TWENTY TWENTY WE WERE WORKING
WITH COUNTIES ACROSS THE STATE
OF CALIFORNIA TO SAY IF YOU WANT
TO MOVE WE HAVE DIFFERENT MODELS
OF MANAGED CARE IN CALIFORNIA
SOME COUNTIES ONLY HAVE ONE
MANAGED CARE PLAN. SOME COUNTIES
HAVE TO MANAGED CARE PLAN AND
SOME COUNTIES HAVE MULTIPLE
MANAGED CARE PLANS FOR MEDICARE
ALL. ON BUT COUNTIES HAD COME TO
US SAYING WE WANT TO CHANGE OUR
MODEL OF CARE AND WE WANT YOU TO
CONSIDER THAT BEFORE YOU DECIDE
WHO YOU'RE COMMERCIAL PLANTS ARE
GOING TO BE ACROSS THE STATE OF
CALIFORNIA. WE THOUGHT THAT WAS
REASONABLE. SO WE GAVE COUNTIES
AN OPPORTUNITY TO GO TO THEIR
BOARDS OF SUPERVISORS- AND
ESSENTIALLY IT PASSED AN
ORDINANCE THAT THEY WANTED TO
CHANGE THEIR- MANAGED CARE MODEL
FOR MEDIC CAL. AND WE HAD A
SIGNIFICANT NUMBER OF OUR
COUNTIES CHANGE THEIR MODEL. A
MANY OF WHICH CHANGE FROM WHAT'S
CALLED THE TWO PLAN MODEL TO A
SINGLE PLAN. AND WE CALL THOSE
CODES IN CALIFORNIA- COUNTY
ORGANIZED HEALTH SYSTEMS- IN AND
THAT'S WHERE CENTURY YOU HAVE
ONE MANAGED CARE PLAN FOR THAT
COUNTY- AND- EGGS. PARTNERSHIP
IS A GOOD EXAMPLE PARTNERSHIP IS
A WHOLE CHILD MODEL COUNTY WHERE
THEIR EXISTING COUNTIES. HAVE
CCS CARVED IN- AND SO WHEN THOSE
COUNTIES MADE THAT CHANGE TO GO
TO A CODES. ON THE MADE THAT TO
CHOOSE GOING INTO THE
PARTNERSHIP MODEL OF CARE AND
INTO THE COUNTY ORGANIZED HEALTH
SYSTEM MODEL OF CARE- AND IN
THIS EXAMPLE WE HAD CARP CCS IN-
AND SO WE ARE RECOMMENDING TO A
LINE THAT POLICY FOR. ALL OF THE
FUTURE- COUNTIES THAT WILL NOW
BE IN PARTNERSHIP HEALTH PLAN.
SO THE PARTNERSHIP HEALTH PLAN
THAT IS CAN TREATING ALL OF THE
CHILDREN IN THEIR MANAGED CARE
PLAN CONSISTENCY CONSISTENTLY
ACROSS ALL OF THEIR COUNTIES-
OTHERWISE THEY WILL HAVE TO
ESSENTIALLY TO READ. SOME OF
THEIR- WITH CC BEING. IN THERE
RESPONSIBLE FOR DOING THESE
VARIOUS PIECES AND SOME IT WOULD
BE CARVED OUT TO THE COUNTY TO
CONTINUE TO PROVIDE SERVICES.
ONLY FOR THE CCS SERVICES I MEAN
THAT'S ONE OF THE COMPLEXITIES
AROUND CCS. IT'S NOT THAT THE
COUNTY DOES ALL OF THAT ARE ALL
OF THE CHILDREN SERVICES ARE IN
FEE FOR SERVICE THOSE
INDIVIDUALS ARE ACTUALLY
ENROLLED IN MANAGED CARE TODAY.
IT'S JUST THEIR CCS CONDITION
THAT IS CARVED OUT TO FEE FOR
SERVICE AND THIS HAS CREATED
REALLY COMPLICATING FACTORS
AROUND. COORDINATION IN PIECES
HISTORICALLY WHICH IS WHY WHOLE
CHILD MODEL AND SB FIVE EIGHTY
SIX ME FORWARD TO TEST AND
EVALUATE WHETHER WE COULD SEE.
THAT ACCESS AND QUALITY AND
MANAGED CARE FOR CHILDREN WITH
COMPLEX MEDICAL CONDITIONS
BECAUSE I THINK WE ALL AGREED WE
WANTED TO MAKE SURE. THAT THAT
WAS SUCCESSFUL BEFORE MOVING
FORWARD WITH ANY EXPANSIONS IT'S
REALLY THE TWENTY FOUR CHANGE OF
MODEL CHANGES THAT'S DRIVING.
THIS EXPANSION OF THIS WAR WELL
OTHER THAN THE COMPLEXITY IN
MANAGING IT AT THE COUNTY LEVEL.
BUT LOTS OF THINGS ARE COMPLEX
WHAT'S THE INCENTIVE FOR A
COUNTY. TO SELECT THE MANAGED
CARE MODEL FOR THE CCS SERVICES
. SO THE COUNTIES SELECTED
THROUGH ORDINANCE TO MOVE INTO A
CLOSE MODEL OR THE SINGLE PLAN
MODEL- AND- AND THAT WAS DONE
BECAUSE THEY CHOSE THEY WANTED
HOW THEY WANTED TO PICK THEIR
MANAGED CARE PLAN MY PARTNER.
AND IN THOSE COUNTIES ARE THEY
CHOSE PARTNERSHIP THAT THEY
WOULD PREFER PARTNERSHIP TO BE
THEIR THEIR PARTNER VERSUS
HAVING A COMMERCIAL PLAN AND
MAYBE ANOTHER PLAN. ON IT WE LET
THE LOCAL PEOPLE DRIVE THAT
RECOMMENDATION SO THEY CHOSE
KIND OF THAT THEIR MANAGED CARE
MODEL. THIS PARTICULAR CHANGES
REALLY AROUND I'M WITHIN THAT
MODEL IN CALIFORNIA IN
CALIFORNIA WE HAVE CCS CARVED
IN- IS THE RESPONSIBILITY OF
THAT MANAGED CARE PLAN- AND SO I
THINK THAT'S WHAT WE'RE NOW
PROPOSING IS TO A LINE THAT
POLICY- FOR THOSE COUNTIES AS
WELL. OMITTING THOSE ARE THE
CONVERSATIONS THAT WILL HAVE TO
HAVE- WITH THOSE INDIVIDUALS WE
DO COMMIT TO IT WITH EXPERIENCE
NOW HAVING. GONE LIVE IN THE
OTHER COUNTIES- BUT THAT IS
ESSENTIALLY WHAT WE'RE
PROPOSING. ANYTHING NO I JUST
WANTED A YOU ALREADY SAID IT BUT
REALLY THE GOAL WITH KIND OF
PUTTING IT TOGETHER IS THAT YOU
HAVE ONE PLAN THAT COORDINATES
ALL SERVICES FOR THE CHILD IT'S
NOT THE CCS PIECES CARVED OUT.
HANDLED BY THE COUNTY YOU KNOW
CCS PROGRAM IT'S ALL COORDINATED
UNDER ONE MANAGED CARE PLAN. FOR
EXAMPLE ONE OF THE THINGS THAT
WE'RE SEEING INCREASES THAT
CHILDREN ARE GETTING HIGHER
REFERRALS TO BEHAVIORAL HEALTH
SERVICES NOW THAT THEY'RE
ENROLLED IN MANAGED CARE BECAUSE
MANAGED CARE PLANS RESPONSIBLE
FOR COORDINATING. ALL OF THEIR
SERVICES NOT JUST THE CCS THAT'S
CARVED OUT FOR JUST THE CCS
CONDITION. SO SAY YOU HAVE
SOMEONE WITH A COMPLEX MEDICAL
CONDITION CARVED OUT TO THE
COUNTY. THEY'RE ONLY RESPONSIBLE
FOR THE CARE COORDINATION OF
THAT PARTICULAR DIAGNOSIS AND
SYSTEM. BUT THE MANAGED CARE
PLAN WHEN THEY'RE ABLE TO LOOK
AT ALL OF IT THEY CAN MAKE SURE
THEY'RE GETTING THAT CRITICAL
CARE WHICH IS VERY IMPORTANT.
BUT MAKING SURE THEY'RE ALSO
GETTING THOSE REFERRALS TO
BEHAVIORAL HEALTH AND WE'VE SEEN
THAT IMPROVE WHEN THEY'RE
RESPONSIBLE FOR COORDINATING ALL
OF THE SERVICES FOR THE KIDS
INSTEAD OF IT BEING A KIND OF
SILO TO. AND DEVIDED
RESPONSIBILITY AT THIS TIME WELL
THIS WILL CERTAINLY BE SOMETHING
I'M GONNA BE WATCHING VERY
CLOSELY BECAUSE OBVIOUSLY
BEHAVIORAL. IS VERY VERY
IMPORTANT. BUT THE CONDITIONS
THAT. YOUNG PEOPLE TO BE IN THE
CCS PROGRAM ARE VERY VERY VERY
SERIOUS AND SO THE QUESTION IS
THE- IS THE MANAGER HEALTHCARE
PLAN. UNDER THIS PROGRAM GOING
TO BE ABLE TO GET THE
APPROPRIATE LEVEL OF CARE AND
DELIVER THE APPROPRIATE LEVEL OF
SERVICE. TO THOSE INDIVIDUALS
WHO ARE IN THE CCS PROGRAM FOR
THE CCS CONDITION. AND I GUESS
YOU KNOW SOME MANAGED HEALTH
PLANS PROBABLY MANAGED CARE
PLANS PROBABLY DO WELL WITH
BEHAVIORAL HEALTH BUT WE ALSO
KNOW THERE ARE SOME WHO. ARE NOT
DOING QUITE SO WELL WITH PAVE
YOUR HOUSE FOR A WHOLE VARIETY
OF REASONS INCLUDING WORK FORCE
SO. SOMETIMES IT WORKS AND
SOMETIMES IT DOESN'T SO. LOOK
FORWARD TO TAKING A LOOK AT THE-
VALUATION REPORTS AND- I'M SURE
WE'LL BE TALKING ABOUT THIS-
MORE THANK YOU VERY MUCH FOR
WHAT YOU DO THOUGH. THANK YOU
MANAGER. CENTER EGGMAN. THANK
YOU. SOME I'LL ALSO BE VERY
INTERESTED IN READING THE REPORT
BECAUSE AS- YOU KNOW. DURING THE
BRIEFING IT SOUNDS LIKE IT MAY
HAVE THAT HASN'T BEEN UP A
FLAWLESS. PLAN AND THEN TO
EXPAND IT MAKES PEOPLE LITTLE
BIT ANXIOUS. CAN YOU TALK A
LITTLE BIT ABOUT. ARE THERE ARE
THERE ARE PARTICIPANTS IN. SEE
SEE. SEE FOR DIAGNOSIS ALSO HAVE
PRIVATE INSURANCE COMMERCIAL
INSURANCE AND HOW ARE WE HOW ARE
WE BRING IT ALL OF THAT. IN TO
OFFSET SOME OF THE MEDICAL
BURDEN. YES THE CCS IS ONE OF
THOSE PROGRAMS WHERE WE HAVE-
CCS MEDICAL- AND INDIVIDUALS ON
MEDICARE CAN ALSO HAVE OTHER
HEALTH COVERAGE. ON MEDICAID AND
MEDICARE- IN CALIFORNIA IS
ALWAYS A PAYER OF LAST RESORT-
AND SO OUR MANAGED CARE PLANS
AND US AS THE DEPARTMENT
HEALTHCARE SERVICES ARE USED TO
COORDINATION OF BENEFITS IN THAT
REGARD- WE HAVE A LOT OF
EXPERIENCE WITH. WITH THAT WE
ALSO IN CALIFORNIA HAVE WHAT WE
CALL CCS STATE ONLY WHERE- A
HIGHER THRESHOLD FOR INCOME
SOMEONE BE CAN BECOME ELIGIBLE
FOR CCS BUT WE PAY A 100% STATE
GENERAL FUND. OF FOR THOSE
SERVICES I'M SO WE HAVE
EXPERIENCE WITH BOTH INTO
USUALLY SOMETIMES IN THE HIGHER
WERE THE COORDINATION OF CARE IS
NEEDED. I'M BUT OFTEN TIMES IF
THEY NEED THAT ADDITIONAL
COVERAGE AND THEY'RE ELIGIBLE
WITHIN THE INCOME THEN WE JUST
WORK ON THE COORDINATION OF
BENEFITS WITH THEIR PRIVATE
INSURANCE. THANK FOR REFERRALS
TO BEHAVIOR HEALTH OR SOMETHING
IF SOMEBODY HAD A PRIVATE. WHICH
IS NOT THEIR DIAGNOSIS THAT THEY
WERE IN CCS FOR. THEN THEY COULD
THEY COULD BE OUT OF THE SYSTEM
YES SO IT COULD BE SOMETHING
WHERE WE COVER SOMETHING THAT
THEIR INSURANCE DOESN'T COVER
FOR EXAMPLE OR ON THE HAVE TO
MAXIMIZE THEIR YOU KNOW PRIVATE
INSURANCE BEFORE WE WOULD- PAY
IN THE END WE DO THAT. THAT ON A
REGULAR BASIS. YES THE- THANK
YOU WERE GONNA HOLD THAT ITEM
OPEN TO MOVE ON TO THE LAST ITEM
IN THIS DEPARTMENT THIS
PROPOSALS FOR INVESTMENT.
FIGURE LIKE TO WELCOME THE
PRESENTER OF THIS PROPOSAL IT'S
GOING TO BE- LUCY. I'M MAYBE
GONNA TRY. I'M SO SORRY SHE- YES
. WE HAVE THIS. CHILD HEALTH
AXES. LOU QUEUE WORKS. OKAY
AFTERNOON THAT MIGHT. MA'AM LOSE
TRIED TO ALL ON BEHALF OF THE-
AND TO. HEALTH WHICH IS A CAN.
BASED IN LOS ANGELES SERVING.
LITERALLY THOUSANDS OF FAMILIES
INDIVIDUALS EVERY MONTH AND ALSO
ENGAGE IN STATEWIDE POLICY WORK.
WE APPRECIATE THIS OPPORTUNITY
TO ADDRESS SUCH AN IMPORTANT
ISSUE. LOW INCOME PEOPLE IN
CALIFORNIA DURING PREGNANCY WHO
HAVE MEDICARE I'LL BEAR A
DISPROPORTIONATE BURDEN OF
SOCIAL FACTORS THAT CAN HARM
THEIR HEALTH AND THAT IS
ACCORDING TO DATA FROM THE
CALIFORNIA DEPARTMENT OF PUBLIC
HEALTH EVEN BEFORE THE COVERED
NINETEEN PANDEMIC HISPANIC AND
AFRICAN AMERICANS WITH MEDICAL
DURING PREGNANCY WERE
SIGNIFICANTLY MORE LIKELY TO
EXPERIENCE HARMFUL SOCIAL
CONDITIONS. AND THE PANDEMIC HAS
ONLY MADE THOSE CONDITIONS WORSE
EXAMPLES FROM THE PUBLIC HEALTH
DEPARTMENT OF PUBLIC HEALTH
SURVEY INCLUDE SIGNIFICANTLY
GREATER RATES OF FOOD INSECURITY
DURING PREGNANCY HOMELESSNESS OR
NO REGULAR PLACE TO SLEEP HAVING
TO MOVE DUE TO PROBLEMS PAYING
RENT OR THEIR MORTGAGE JOB LOSS
AND THIS LAST ONE I THINK IS
REALLY PROFOUND. NO PRACTICAL OR
EMOTIONAL SUPPORT. THE
CONDITIONS DON'T JUST DISAPPEAR
AT THE END OF THE INITIAL SIXTY
DAY POST PARTUM PERIOD THE
PROPOSAL THAT'S REQUESTED IS TO
ALIGN MEDIC CAL'S COMPREHENSIVE
PERINATAL SERVICES PROGRAM
BENEFIT WHICH CURRENTLY ENDS AT
SIXTY DAYS POSTPARTUM WITH MEDI
CAL'S NEW TWELVE MONTH. POST
PREGNANCY ELIGIBILITY AND THAT
TOOK EFFECT IN APRIL OF TWENTY
TWENTY TWO. THE FIRST YEAR IS
CRITICAL NOT ONLY FOR MOTHERS
AND NEWBORNS BUT ALSO FOR PEOPLE
WHO EXPERIENCE MISCARRIAGE OR
STILLBIRTH. A KEY COMPONENT OF
MEDICAL CPS P. BENEFIT IS
INTEGRATING NON CLINICAL
SUPPORTS WITH MEDICAL CARE BASED
ON ASSESSMENTS IN EACH TRIMESTER
AND POSTPARTUM SERVICES LIKE
SUPPORT GROUPS PEER COUNSELING
HELP OR REFERRALS WITH
TRANSPORTATION FOOD HOUSING
IMMIGRATION STATUS CONCERNS.
THESE THINGS HELP FAMILIES AVOID
MITIGATE OR RESOLVE HARMFUL
SOCIAL CONDITIONS BEFORE THEY
DEVELOP OR MAKE THE PERSON'S
HEALTH WORSE REQUIRING
INTERVENTIONS LIKE THOSE
AVAILABLE UNDER CALTRAIN.
RESEARCH SHOWS THAT TRACKING PRE
DIAGNOSIS STRESS OR ANXIETY
EARLY WITH LOW LEVEL
INTERVENTIONS CAN HELP PREVENT
MORE SERIOUS MATERNAL DEPRESSION
AND EVEN SUICIDE WHICH
TRAGICALLY IS THE LEADING CAUSE
OF MATERNAL DEATHS IN THE LATER
POST PARTUM PERIOD WILL BE ON
THE FIRST SIXTY DAYS. CPS P.
ALSO REQUIRES WARM HANDOFFS TO
HIGHER LEVELS OF CARE SUCH AS TO
PSYCHIATRISTS WHEN THAT IS
NEEDED. BREASTFEEDING SUPPORT IS
OFTEN ESSENTIAL WELL BEYOND THE
FOR SIXTY DAYS AND CPS P. IS THE
MAIN WAY THAT PROVIDERS CAN BILL
FOR THESE ESSENTIAL SERVICES FOR
FAMILIES. CBS P. ALSO REQUIRES
THAT FAMILIES BE GIVEN
INFORMATION ABOUT NEWBORN
DEVELOPMENTAL SCREENINGS
IMMUNIZATIONS AND OTHER HEALTH
ISSUES AS WELL AS OFFERED
ASSISTANCE WITH SCHEDULING
PEDIATRIC VISITS AND
TRANSPORTATION IF THAT IS
NEEDED. SO C. P. S. P. FOR
TWELVE MONTHS POSTPARTUM COULD
BE PART OF AN EFFECTIVE STRATEGY
FOR COMBATING MEDICALS VERY LOW
RATES OF PEDIATRIC PREVENTIVE
CARE THERE SOMEWHERE AROUND 25%
COMPREHENSIVE PERINATAL HEALTH
WORKERS ARE PART OF THE C. P. S.
P. CARE TEAM. THEY PROVIDE NON
CLINICAL SUPPORTIVE SERVICES AS
PART OF THE TEAM SO THAT.
DOCTORS NURSES AND OTHER MEDICAL
PROVIDERS CAN WORK AT THE TOP OF
THEIR LICENSES WHILE THEIR
PATIENTS GET HELP WITH SOCIAL
NEEDS FROM THE INTEGRATED CARE
TEAM. THE STATE'S RULES IN OUR
VIEW NEED TO BE UPDATED SO THAT
THESE COMPREHENSIVE PERINATAL
HEALTH WORKERS CAN BE MOST
EFFECTIVE BY ASSISTING PEOPLE IN
THEIR HOMES AND ELSEWHERE IN THE
COMMUNITY NOT JUST AT A MEDICAL
FACILITY. THE BUDGET REQUEST
WOULD ALSO INCLUDE THIS CHANGE
CALIFORNIA HAS DONE SOME
AMAZINGLY WONDERFUL IMPROVEMENTS
AND EXPANSIONS AND REFORMS IN
MEDICAL IN RECENT YEARS WHICH MY
CLIENT MATERNAL AND CHILD HEALTH
ACCESS HAS VERY VOCALLY
SUPPORTED. UP ONE OF THESE IS
THE COMP IS THE COMMUNITY HEALTH
WORKER BENEFIT THE DOULA BENEFIT
AND OTHERS. THOSE MAY OVERLAP IN
SOME WAYS WITH C. P. S. B. BUT
THEY DO NOT MAKE CPS P.
IRRELEVANT THEY DO NOT
COMPLETELY TAKE THE PLACE OF CPS
P. THEY MAY RESULT IN THE NEED
FOR LESS UTILIZATION CPS P. AND
THAT WOULD BE FINE IF PEOPLE'S
NEEDS ARE BEING MET ELSEWHERE.
BUT THERE ARE THINGS THAT CPS P.
DOES WITH AN INTEGRATED HEALTH
TEAM UTILIZING EXPERIENCE
TRAINED COMPREHENSIVE PERINEAL
HEALTH WORKERS THAT NONE OF
THESE OTHER REFORMS THAT WE
SUPPORT. WOULD REPLACE. BEST
PRACTICE MODELS IN CALIFORNIA
EXIST THROUGHOUT THE STATE THEY
USE THE CPS P. APPROACH. FOR
EXAMPLE HERE IN SACRAMENTO BLACK
. MOTHERS UNITED WAS FOUNDED.
OVER A DECADE AGO BY A PERSON
WHO IS BOTH A DOULA AND A FORMER
CPS P. WORKER BECAUSE SHE FELT
THE NEED TO DELIVER THESE
SERVICES IN THE COMMUNITY IN AN
INTEGRATED WAY. THE RESPECT
INITIATIVE IN SAN FRANCISCO ALSO
RELIES ON C. P. S. B. BELOVED
BLACK CENTERING AND ALAMEDA WEST
COUNTY CLINICS AND RULES SO NO
MY COUNTY AND THERE ARE MANY
OTHER EXAMPLES. PROGRAMS LIKE
THESE COULD EXTEND THEIR REACH
AND SERVICES DURING PREGNANCY
AND THE FIRST YEAR AFTER IF THE
BUDGET REQUEST WERE APPROVED I
JUST LIKE TO MAKE ONE FINAL
POINT IN MEDICAL I THINK THE
DEPARTMENT INDICATED EARLIER
THAT APPROXIMATELY 50% OF
CALIFORNIA'S BURSAR COVERED BY
MEDICARE. I THINK MAYBE NOW THAT
NUMBER IS A LITTLE LOWER
ACCORDING TO THE DEPARTMENT OF
PUBLIC HEALTH IT MAY BE MORE
LIKE 43% BASED ON RECENT DATA.
AND YET IN MANY COUNTIES IT'S
SIGNIFICANTLY HIGHER FOR EXAMPLE
AND SAN JOAQUIN 55% OF BIRTHS
ARE COVERED BY MEDICAID ALL IN
KERN 69% IN KINGS 58% OF BIRTHS
ARE COVERED BY MEDICAID. TULARE
70% MADERA 74% RIVERSIDE NEARLY
49% AND LOS ANGELES COUNTY WITH
ITS LARGE LARGE POPULATION FORTY
FIVE POINT FIVE PERCENT. SO
MAKING MORE OF THESE PRE
DIAGNOSIS PREVENTIVE SERVICES
AVAILABLE TO FAMILIES IN THE
FIRST YEAR AFTER PREGNANCY ENDS
WOULD CONTRIBUTE SIGNIFICANTLY
TO AVAILABLE RESOURCES SO WE
DON'T HAVE TO GO TO THE HIGHER
LEVELS OF CARE. SO THAT WHEN
THEY DO LET ISN'T AVAILABLE WHEN
THE WORK FORCE FOR THE COMMUNITY
HEALTH WORKER ISN'T AVAILABLE
WHEN THE EXPERTISE THE TRAINING.
THAT THE HEARING AID THE
COMPREHENSIVE PERINATAL HEALTH
WORKERS ISN'T OTHERWISE
AVAILABLE IN A PRACTICE WE HAVE
C. P. S. P. TO RELY ON. THANK
YOU VERY MUCH AND HAPPY TO
ANSWER ANY QUESTIONS. THANK YOU
SO MUCH RISK YOU DOES THE
DEPARTMENT OF FINANCE OR HAVING
COMMENT. THANK I CAN TO TELL THE
DEPARTMENT OF FINANCE NO
COMMENTS AT THIS TIME GREAT I'M
QUICK QUESTION I THINK
CLARIFICATION ON MY I NEED IN
THE BEGINNING YOU MENTIONED THIS
PROGRAM COULD SIT. IN THE
CURRENT PROGRAM WITHIN THE
DEPARTMENT IS THAT CORRECT- I
SHOULD HAVE BEEN MORE CLEAR
MADAM CHAIR THE COMPREHENSIVE
PERINATAL SERVICES PROGRAM IT'S
A LITTLE CONFUSING IT'S CALLED
THE COMPREHENSIVE PERINATAL
SERVICES PROGRAM. BUT IT'S
ACTUALLY IN OUR STATE STATUTE
AND PART OF OUR STATE MEDICAL
PLAN APPROVED BY THE FEDERAL
GOVERNMENT AS A MEDIC CAL
BENEFITS SO FOR EXAMPLE OR STATE
MEDICAL PLAN HAS POSITION
SERVICES AS A COVERED BENEFIT WE
HAVE PRESCRIPTION DRUGS AS A
COVERED BENEFIT WE HAVE
CHIROPRACTORS SERVICES AS A
COVERED BENEFIT WE HAVE. A
MENTAL HEALTH IS GO ON AND ON
AND ON CPS P. EXIST AT THE SAME
STATUTORY LEVEL AND AT THE SAME
LEVEL INTERSTATE PLANT SO IT'S
AS IF WE'RE SAYING IN CALIFORNIA
HAVING FAILED TO EXTEND THIS
PARTICULAR BENEFIT. FOR THE FULL
TWELVE MONTHS AFTER PREGNANCY
AND SHUTTING IT OFF THAT SIXTY
DAYS IS IF WE'RE SAYING WELL
WE'RE GOING TO STOP THE
PHYSICIAN SERVICES ORGANISED UP
PRESCRIPTION MEDICATIONS WE
SHOULD HAVE. THE FULL RANGE OF
WHAT CALIFORNIA LEGISLATURE HAVE
DECIDED IS NECESSARY TO SUPPORT
FAMILIES IN A PREVENTIVE SPACE
AVAILABLE THROUGHOUT THAT YEAR.
THERE YOU KNOW IS- A REAL NEED
FOR THIS AGAIN I GO BACK TO THE
LACK OF JUST PRACTICAL AND
EMOTIONAL SUPPORT YOU DON'T NEED
A PSYCHIATRIST TO DEAL WITH
THAT. AND YOU KNOW THE OB IN THE
GENERAL PRACTITIONER IS PROBABLY
NOT THE BEST PERSON TO BE
WORKING WITH A FAMILY TO MAKE
SURE THAT GLUE HAPPENS THAT THE
FAMILY THAT NEEDS THESE KINDS OF
SOCIAL SUPPORTS. GETS TO THE
RIGHT PLACE AND HAS THE
APPROPRIATE LEVEL OF
COORDINATION FOR THOSE NON
CLINICAL SUPPORTS AND YET AT THE
SAME TIME THE MEDICAL CARE TEAM
. NEEDS TO BE AWARE OF WHAT'S
GOING ON. THANK YOU HAVE.
SENATORS THERE ARE REALLY
PASSIONATE ABOUT BEHAVIOR HEALTH
TWO OF WHICH ARE SOCIAL WORKERS
UP HERE I'M IN TWO WEEKS AGO I
GOT A BRIEFING ON JUSTICE THE
MATERNAL DEATH AND HOW IT'S-
RISING IN THE STATE OF
CALIFORNIA AND- LATINAS MAKE
ABOUT 48% OF PEOPLE. GIVING
BIRTH IN THE STATE. AND THEIR
RATES FOR MATERNAL DEATH HAS
INCREASED AND YOU POINTED OUT
SOMETHING THAT I THINK YOU KNOW
ISSUE SO WHAT DOES THAT TO MOST
OF OUR MATERNAL MATERNAL DEATHS
HAPPENED POST SIXTY DAYS. AND
IT'S VERY PREVENTABLE- YOU KNOW
I DON'T. I DON'T HAVE TO REPEAT
WHAT YOU SAID- BUT I'D LIKE TO
FIRST TURN TO THE DEPARTMENT OF
JUST ANY KIND OF RESPONSE IN
THIS AREA- YOU KNOW JUST CURRENT
BOUGHT YOU I'M NOT SURE IF YOU
KNEW THIS QUESTION WAS COMING
YOUR WAY BUT- I. APPRECIATE
LUCY'S PASSION ON THIS TOPIC
WE'VE BEEN IN DISCUSSIONS ON
THIS FOR. ABOUT A YEAR OR SO-
AND ALSO JUST WANT TO RECOGNIZE
AS PART OF OUR BOLD GOALS
TWENTY. BY TWENTY TWENTY FIVE
MATERNITY CARE AND KIND OF
IMPROVING MATERNAL OUTCOMES IS
ONE OF OUR CLINICAL FOCUS AREAS
WE SEE THE DATA WE KNOW THAT
THIS IS SOMETHING WE NEED TO
ADDRESS. AND A LOT OF OUR
INITIATIVES ARE ALIGNED TO
ADDRESSING THIS THIS PARTICULAR-
ISSUE AND WE KNOW WE WANT TO DO
BETTER HERE. COLLEAGUES CENTER
EGGMAN. AND JUST A THANK YOU FOR
THE CLARIFICATION BECAUSE WHEN
YOUR FIRST TALK ABOUT I THOUGHT
WELL HOW'S THAT DIFFERENT FROM
THE DOULA SERVICES THAT WE'VE
TALKED ABOUT RECENTLY. SO HOW
HOW ARE WE GOING TO IN YOUR MIND
MAKE SURE THAT THERE'S NOT A LOT
OF OVERLAP AS WERE ALL TALKING
ABOUT. OUR WORKFORCE CRISIS NOT
HAVING A PEOPLE HOW WE CAN HELP
MAKE SURE THERE'S NOT THREE
PEOPLE TREATING ONE PERSON. I
THINK THAT'S A GREAT QUESTION
IT'S SOMETHING WE'VE GIVEN A LOT
OF THOUGHT TO- WE KNOW THE
DEPARTMENT IS EXPERT ON MANY
THINGS AND ENSURING THAT THERE'S
NO DUPLICATE PAYMENT. IS ONE OF
THE THINGS THAT THEY'RE REALLY
GOOD AT SO YOU KNOW THIS IS NOT
THE ONLY PLACE IN MEDICINE WHERE
THERE'S THE POTENTIAL FOR
OVERLAPPING SURFACE SO. OF
COURSE WE WOULD WANT TO WORK
WITH THE DEPARTMENT- AND YOU
KNOW IF THEY HAVE THE EXPERTISE
TO SET UP THE RIGHT SYSTEMS
CONTROL THAT- THE OTHER THING
THAT I. WOULD REALLY LIKE TO
EMPHASIZE THOUGH IS THAT- ON THE
WORK FORCE ISSUE THIS IS WHAT'S
SO- MOTIVATING TO US. THIS
BENEFIT IN THE MEDICAL PROGRAM
AND IN OUR FEDERALLY APPROVED
STATE PLAN HAS EXISTED
LITERALLY. FOR DECADES AND SO WE
HAVE IN CALIFORNIA DEVELOPED. A
WORKFORCE THESE COMPREHENSIVE.
PERINATAL HEALTH WORKERS WHO ARE
PART OF THESE TEAMS. NOTE THE
REQUIREMENTS TO BE A C. PH W. A
COMPREHENSIVE. PERINATAL HEALTH
WORKER- ARE ACTUALLY. MORE
STRINGENT THAN THE REQUIREMENTS
THAT HAVE BEEN ADOPTED FOR
COMMUNITY HEALTH WORKERS WE HAVE
NO PROBLEM WITH THAT WE THINK
THE STANDARDS FOR C. H. W.'S
COMMUNITY HEALTH WORKERS. ARE
EXCELLENT WE WORK WITH THE
DEPARTMENT IN THE STAKEHOLDER
GROUPS- TO DEVELOP THOSE WE
THINK THEY'RE FINE. BUT I WANT
TO UNDERSCORE THAT WE HAVE THIS
VERY EXPERIENCED AND EXPERT WORK
TEAM OF YOU KNOW PEOPLE WHO
SPEAK MISSED TACKLE WHO SPEAK
THE NON SPANISH INDIGENOUS
LANGUAGES WHO ARE ALSO IN MANY
CASES PROMOTE TAUGHT US- WHO
WORK IN THE AFRICAN AMERICAN
COMMUNITY. AND TO ARE ACCUSTOMED
TO WORKING WITH THE GENERAL
PRACTITIONER THE FAMILY DOCTOR
THE- AS PART OF THE CLINICAL
CARE TEAM WHY ARE WE NOT TAKING
ADVANTAGE OF THAT RESOURCE WHY
ARE WE LEVERAGING IT WHILE WE
BUILD UP THE DO A WORK FORCE
WHILE WE BUILD UP THE C. H. W.
AND- THE OTHER POINT THAT I
WOULD EMPHASIZE IS THAT NOT.
EVERY PRACTICE IS GOING TO FOCUS
ON THEIR COMMUNITY HEALTH WORKER
SERVICES IN THE PERINEAL SPACE
AND SO WE HAVE THIS READY MADE
MEDIC CAL BENEFIT THAT
COMPLIMENTS COMPLETELY THE
PUBLIC HEALTH. THE OR THE
POPULATION HEALTH MANAGEMENT
STRATEGIES THAT I THINK THE
DIRECTOR HAS BEEN REFERRING TO.
A QUALITY ASSURANCE STRATEGY ON
PUBLIC HEALTH OR POPULATION
MANAGEMENT I'M SORRY- OLD HABITS
DIE HARD POPULATION YOU KNOW
MANAGEMENT THAT'S A QUALITY
ASSURANCE. STRATEGY THE
CONFERENCE A PERINATAL SERVICES
PROGRAM BENEFIT CAN WORK WELL
WITH THAT STRATEGY JUST LIKE THE
POSITION BENEFIT IS GOING TO
HAVE TO WORK WELL WITH
POPULATION HEALTH MANAGEMENT
JUST LIKE DENTAL AT CENTER AT
CENTER. SO WE'D REALLY LIKE TO
BE ABLE WE FEEL THAT THESE
MATERNAL DEATHS ARE. IN MANY
CASES PREVENTABLE TRAGEDIES. AND
SOMETIMES THE LOWER LEVEL
INTERVENTIONS CAN MAKE A
SIGNIFICANT CONTRIBUTION IN THE
COMMUNITY RESOURCE IN THE
VILLAGE TO PRODUCE. BURKE
PREVENT THINGS FROM GETTING
WORSE WE NEED TO THROW
EVERYTHING WE'VE GOD AT THIS
PROBLEM ON THE WAY IN TODAY I
WAS LISTENING TO THE LATEST
REPORT AT THE NATIONAL LEVEL.
THE US IS EVEN WORSE NOW THAN IT
WAS IN PREVIOUS NATIONAL REPORTS
ON MATERNAL DEATHS- IT'S
SOMETHING LIKE THIRTY TWO PER
THOUSAND COMPARED TO ONLY TWO.
THOUSAND IN OTHER. YOU KNOW
ECONOMICALLY DEVELOPED NATIONS
SO THIS IS AN OPPORTUNITY TO
WORK WITH PEOPLE AT THE FIRST
SIGNS TO TAKE ADVANTAGE OF THE
SUPPORT GROUP STRUCTURE AGAIN
YOU DON'T NEED THE PSYCHOLOGIST
WHO MAYBE DON'T EVEN NEED THE
LICENSED CLINICAL SOCIAL WORKER.
BUT IT'S PROFOUND THE IMPACT
THAT HAVING THOSE COMMUNITIES
SUPPORTS CAN BRING. SO YOU'RE
SUGGESTING THERE'S A THE MASSIVE
WORK FOR OUT THERE WAITING FOR
US TO PASS THIS AND THEN THAT
WILL BE ALL FUNDED LET ME LET ME
JUST CLARIFY- YOU KNOW I DON'T
MEAN THAT THERE'S A MASSIVE WORK
FORCE OUT THERE OF COMPREHENSIVE
PERINATAL SERVICES WORKERS. BUT
YOU BETCHA SENATOR IN THESE
PROGRAMS BECAUSE IT'S A MEDICARE
BENEFIT DURING PREGNANCY IN
SIXTY DAYS RIGHT AND THESE
PEOPLE MY PHONE IS RINGING OFF
THE HOOK IT'S LIKE WHY CAN'T WE
CONTINUE DOING THIS. AND KNOW
THAT THERE'S COMPENSATION. AFTER
THAT INITIAL SIXTY DAYS WE HAVE
BUILT A RELATIONSHIP WITH THIS
YOU KNOW PERSON WHO HAS BEEN
SUBSTANCE INVOLVED FOR EXAMPLE
DURING THE PREGNANCY AND NOW
SHE'S STABLE AND SHE TRUSTS US.
AND WE WANT TO KEEP HER STABLE
AND THIS SUPPORT GROUP THAT
SHE'S COMING TO EVERY WEEK YOU
KNOW IS WORKING FOR HER SO WE
DON'T WANT TO SHUT THAT OFF OVER
SIXTY DAYS AND WE REALLY DON'T
HAVE THE FUNDING RESOURCES. TO
CONTINUE IT BEYOND SIXTY DAYS.
IT'S A SITUATION THAT WE CAN
DEAL WITH IF WE MAKE MORE
RESOURCES AT THAT LEVEL OF CARE
AVAILABLE IN THE COMMUNITY WITH
THIS LEVEL OF PRACTITIONERS WHO
WORK THEN WITH THE LICENSE
FOLKS. OKAY THE DIRECTOR MUSTARD
OR HERBS COVERED AND- I WORKED
ON SIMILAR JUST IN IT KIND OF
HAPPENED THROUGH THE BUDGET
THANK TWO YEARS AGO TO EXPAND.
MEDICAL A POST PARTUM FOR A YEAR
CORRECT SO THAT'S ALREADY DONE.
THAT'S DONE OKAY- OKAY AND I
GUESS I JUST WANT TO SAY AS WERE
ALSO FACING A CRISIS WITH OUR
HOSPITALS AND TRYING TO KEEP
THEM AFLOAT. WHEN WE THINK ABOUT
A MEDIC CAL BURSTS IT'S
APPROXIMATELY EIGHTEEN THOUSAND
DOLLARS. IT IS SO. TO FOR THE
FOR. FOR US TO TRY TO. STOP THE
BLEED ON OUR ON OUR HOSPITALS IT
MAKES ALL THE KINDS OF SENSE TO
ME IN THE WORLD TO BE ABLE TO
MAKE SURE PEOPLE STAY HEALTHY
AND DON'T HAVE TO HAVE RETURN
TRIPS BACK. AS WE FACE A
REDUCTION IN ACUTE CARE
SERVICES. THANK YOU. ONE LAST
QUESTION- THE DEPARTMENT SAY WE
GET THE TWO POINT FOUR MILLION
FROM THE STATE. IS THAT
SOMETHING THAT YOU KNOW CLOSE TO
WHAT CENTER EGGMAN THAT- **** WE
HAVE THE MONEY IN THAT SAID THE
PROGRAM IS READY TO GO. AS YOU
CAN YOU BE ABLE TO JUST EXPAND
IT. OR WOULD MORE BE NECESSARY
SO I MEAN WE WOULD HAVE TO AS AS
AS MENTIONED ALL OF THE SERVICES
COVERED IN THE PROGRAM ARE ALSO
SEPARATELY AVAILABLE FOR MEDIC
CAL INDIVIDUALS TO RECEIVE IN
THE- POST PARTUM EXPANSION THAT
WAS MENTIONED- SO I THINK WE
WOULD HAVE TO LOOK AT THE
DUPLICATION PROCESS SEASON. I'M
ALSO AS MICHELLE MENTIONED WE
ARE WORKING ON A COMPREHENSIVE
QUALITY STRATEGY I'M
SPECIFICALLY ON MATERNAL
OUTCOMES AS WELL AS DISPARITIES
IN MATERNAL COMES IN WE ARE
LAUNCHING. A VERY LARGE
WORKGROUP IN REGARDS TO WHAT ARE
THE BEST CLINICAL CARE
GUIDELINES FOR MATERNITY HOW ARE
WE GOING TO TARGET WERE SEEN
DISPARITIES TODAY IN THE
MATERNAL OUTCOMES TO DO MORE
TARGETED INTERVENTIONS BECAUSE
WHAT WE ARE DOING IN OUR PROGRAM
TODAY. IS NOT CLOSING THOSE
GAPS- AND WE ARE LOOKING ACROSS
THE NEW DO THE BENEFIT COMMUNITY
HEALTH WORKER IN ALL OF THE
DYADIC SERVICES THAT WERE JUST
ADDED WITH IN PARTNERSHIP WITH
THE LEGISLATURE. ALL OF THESE
MOVING PIECES TONS WE HAVE ALL
THE BENEFITS YOU NEED IF YOU
LOOK AT THE CHECK YOU OUT THERE
CALIFORNIA. ON PAPER WE HAVE
EVERYTHING YOU NEED TO HAVE
GREAT MATERNAL OUTCOMES BUT WE
NEED TO MAKE SURE THAT WE'RE
BRING IT ALL TOGETHER AND I
THINK THAT'S WHERE WE REALLY
PARTNER IN REGARDS TO WORKING ON
THOSE THINGS SO IF. IF THIS WERE
TO BE. A FUNDED WE WOULD HAVE TO
PARTNER A TO FIGURE OUT WHAT
THAT LOOKS LIKE WHAT IS THAT
MODEL OF CARE WHAT ARE THE
VARIOUS PIECES WERE PULLING
TOGETHER. BUT IT HAS TO ALL BE
IMPROVING HEALTH OUTCOMES. AND
ALL THE VARIOUS PIECES THAT
WE'VE HAD IN CALIFORNIA WE'RE
STILL NOT MOVING THE MARK ON
ACTUAL QUALITY OUTCOMES FOR
INDIVIDUALS AND THAT'S WHAT
WE'RE TRYING TO GET TO THE CORE
AT THE DEPARTMENT HEALTHCARE
SERVICES TODAY. I'M AND WE ARE
LAUNCHING THIS YEAR VERY LARGE
STAKEHOLDER PROCESS. OVER CONNOR
BIRTH EQUITY A PATHWAY TO REALLY
FOCUS ON THAT PARTICULAR. WORK
WITH OUR ADVOCATES AND OUR
PARTNERS. JUST TO UNDERSCORE HOW
IT'S AND- TO COORDINATE ALL OF
THIS IS THAT THERE'S NOT ALL
THESE INDEPENDENT- DELIVERY
SYSTEMS ARE PROGRAMS THAT AREN'T
ALL PULL TOGETHER I THINK THAT'S
WHAT WE'RE REALLY TRYING TO DO
IS TO COMPREHENSIVELY LOOK
WHAT'S OUT THERE AND HOW DO WE
PULL TOGETHER SO THAT. NOT ONLY
FROM THE MEMBERS PERSPECTIVE BUT
FROM OUTCOMES PERSPECTIVE YOU
KNOW FOLLOW UP VISITS HAPPEN
WHATEVER IT MAY BE OUR IS
COORDINATED. GREAT THANK YOU SO
MUCH THANK YOU FOR- PRESENTING
THE PROPOSAL I DO WANNA KNOW
UNDER THIS ISSUE ISSUE TEN
PROPOSALS FOR INVESTMENT. IN THE
SUBCOMMITTEE DID RECEIVED THREE
PROPOSALS FOR INVESTMENT IN THE
DEPARTMENT TO WE ONLY HEARD FROM
ONE. BUT I JUST WANT TO.
PUBLICLY SAY THAT THE OTHER TWO
WERE THE MEDIC COW HEALTH AND
ROMAN NAVIGATORS PROJECT BUDGET.
AUGMENTATION ASKING FOR SIXTY
MILLION. TO SUPPORT THE MEDICAL
HEALTH AND ROMAN NAVIGATORS AND
THE SECOND ONE WAS FOR THE
HOUSING PRESERVATION FOR LONG
TERM CARE. RESIDENTS ASKING
FORTY. FORTY FOUR MILLION.
ANNUALLY TO SUPPORT INCREASING
THE HOME UPKEEP ALLOWANCE H.
AWAY FROM TWO OH NINE PER MONTH
TO ACTUAL HOUSE. HOUSING COSTS
ABOUT 210030% OF THE FEDERAL
POVERTY LEVEL. JUST TO KNOW.
THANK YOU SO MUCH FOR YOUR
PARTICIPATION. SO WE'RE GONNA
HALL AT. THE HALL- LEAVE THOSE
ITEMS OPEN. AND MOVE ON TO THE
NEXT APARTMENT. THE EMERGENCY
MEDICAL SERVICES AUTHORITY.
LIKE TO WELCOME THEN
REGISTRATION JOIN US IN PERSON
AND ONLINE. WE'RE GONNA START
OFF WITH ISSUE NUMBER ONE WHICH
IS AN OVERVIEW OF EMSA. HI GOOD
AFTERNOON MY NAME'S RICHARD
TRUCKS ON THE CHIEF OF
ADMINISTRATION AT THE EMERGENCY
MEDICAL SERVICES AUTHORITY WHICH
OVER FOR TO US MS- AS REQUEST
WILL PROVIDE A BRIEF OVERVIEW OF
THE DEPARTMENT AND OUR CURRENT
MS OF PROPOSALS UNDER
CONSIDERATION- MS WAS FORMALLY
ESTABLISHED BY THE EMS SYSTEM
ACT IN NINETEEN EIGHTY IS THE
STATE LEAD AGENCY- AND
CENTRALIZE RESOURCE OVERSEE
EMERGENCY DISASTER MEDICAL
SERVICES IN THE STATE OF
CALIFORNIA. MS IS CHARGED WITH
PROVIDING LEADERSHIP IN THE
INNOVATION IN THE ADMINISTRATION
OF THE EMERGENCY MEDICAL
SERVICES OR EMS SYSTEM
THROUGHOUT THE STATE WHICH
INCLUDES SETTING STANDARDS FOR
THE TRAINING AND SCOPE OF
PRACTICE FOR VARIOUS LEVELS OF
EMS PERSONNEL. WERE ALSO
RESPONSIBLE FOR PROMOTING
DISASTER MEDICAL PREPAREDNESS
THROUGHOUT THE STATE AND WHEN
REQUIRED COORDINATING SUPPORTING
THE SAVE CALIFORNIA'S MEDICAL
RESPONSE TO MAJOR DISASTERS. AND
THE WORKS CLOSELY WITH MANY
LOCAL STATE FEDERAL AGENCIES
PRIVATE ENTERPRISES IN THOSE AND
DISASTER MEDICAL SERVICE ROLES
TO PROMOTE QUALITY IMAGE
SERVICES STATEWIDE. THE A
SUPPORTERS PROGRAM FUNCTIONS
ORGANIZED INTO THREE SEPARATE
DIVISIONS THE M. S. PERSONAL
DIVISION THE M. S. SYSTEMS
PLANNING AND DEVELOPMENT SKEWS
ME M. ASSISTANCE PLANNING AND
DEVELOPMENT DIVISION AND
DISASTER MEDICAL SERVICES. THE
EMS PERSONNEL DIVISION DEVELOPS
AND IMPLEMENTS REGULATIONS THAT
SET STANDARDS FOR TRAINING
CERTIFICATION LICENSING AND
SCOPE OF PRACTICE FOR EMERGENCY
MEDICAL PERSONNEL INCLUDING.
EMTS ADVANCED EMTS PARAMEDICS
MOBILE INTENSIVE CARE NURSES
FIREFIGHTERS POLICE OFFICERS AND
LIFEGUARDS THE EMS PERSONNEL
DIVISION LICENSES AND
DISCIPLINES PARAMEDIC STATEWIDE
FOR CIVIL AND CRIMINAL
VIOLATIONS OF THE CALIFORNIA
HEALTH AND SAFETY CODE. REQUIRED
FOR CHILDCARE PROVIDERS AND
SCHOOL BUS DRIVERS. THE EMS
SYSTEMS DIVISION COORDINATES
LOCAL EMS SYSTEM STATEWIDE
TRAUMA SYSTEM IN THE CALIFORNIA
POISON CONTROL SYSTEM- THIS
DIVISION ESTABLISHES REGULATIONS
AND GUIDELINES FOR LOCAL EMS
AGENCIES AND REVIEW AND APPROVE.
LOCAL EMS PLANS TO ENSURE THAT
THEY MEET THE MINIMUM STANDARDS
THIS DIVISION ALSO MANAGES THE
STATE'S DATA COLLECTION EMS DATA
COLLECTION QUALITY ASSURANCE
DISPATCHING COMMUNICATION
STANDARDS IN EMS FOR CHILDREN
EFFORTS. THE LAST DIVISION OF
THE THIRD IS A DISASTER MEDICAL
SERVICES DIVISION WHO FULFILLS
MS ROLE AS THE LEAD AGENCY
RESPONSIBLE FOR COORDINATING
CALIFORNIA'S MEDICAL RESPONSE TO
DISASTERS. THE DIVISION
ORGANIZES A STATEWIDE NETWORK TO
PROVIDE MEDICAL RESOURCES TO
LOCAL GOVERNMENTS IN SUPPORT OF
THEIR DISASTER RESPONSE THIS MAY
INCLUDE THE IDENTIFICATION
ACQUISITION AND DEPLOYMENT OF
MEDICAL SUPPLIES. AND EMERGENCY
RESPONSE PERSONNEL FROM
UNAFFECTED REGIONS OF THE STATE
TO MEET THE NEEDS OF DISASTER
VICTIMS. RESPONSE ACTIVITIES MAY
ALSO INCLUDE- ARRANGE FOR THE
EVACUATION OF INJURED VICTIMS.
TO HOSPITALS IN AREAS REGION'S
NOT IMPACTED BY THE DISASTER AND
THE DISASTER MEDICAL RESPONSE
DIVISION MAINTAINS STAFFS AND
DEPLOYS THE STATE'S MOBILE
MEDICAL ASSETS PROGRAM- THAT'S
THE END OF OVERVIEW. KEPT A
BRIEF. THANK YOU I APPRECIATE WE
WILL I'M AN COMMON ALL RIGHT
WERE GONNA DIE INTO A ISSUE
NUMBER TWO. YOU MISSED HUMAN
TRAFFICKING TRAINING
IMPLEMENTATION AS RELATES TO AB
TWENTY ONE THIRTY. MS REQUESTING
EIGHTY FOUR THOUSAND DOLLARS IN
GENERAL FUND IN 232-424-2520
FIVE TWENTY SIX TO RECRUIT HIRE
TEMPORARY STAFF TO COORDINATE
AND SUPPORT THE IMPLEMENTATION
OF AB TWENTY ONE THIRTY. WHICH
REQUIRES EMERGENCY MEDICAL
TECHNICIANS ADVANCED EMERGENCY
MEDICAL TECHNICIANS AND
PARAMEDICS UPON INITIAL
LICENSURE TO COMPLETE AT LEAST
TWENTY MINUTES OF TRAINING ON
ISSUES RELATED TO HUMAN
TRAFFICKING. THE UNITED STATES
DEPARTMENT OF HOMELAND SECURITY
IDENTIFIES HIM AS PROVIDERS IS
ONE OF THE SERVICE PROVIDERS
MOST LIKELY TO ENCOUNTER HUMAN
TRAFFICKING VICTIMS. IN TWENTY
TWENTY CALIFORNIA BOTH THE
LARGEST YOU MUST PROVIDER
POPULATION IN THE US AND THE
HIGHEST NUMBER OF REPORTED HUMAN
TRAFFICKING INCIDENTS AT NEARLY
TEN PERCENT. OF ALL REPORTED
INCIDENTS NATIONWIDE. SUFFICIENT
COORDINATION AND SUPPORT IS
ESSENTIAL TO MEET MS
RESPONSIBILITIES TO TRAIN
PERSONNEL THROUGHOUT CALIFORNIA
YOU CAN RECOGNIZE AND REPORT
POTENTIAL HUMAN TRAFFICKING
INCIDENTS. ALTHOUGH MANY
TRAINING PROGRAMS INCLUDE HUMAN
TRAFFICKING IN THEIR CURRICULUM
AB TWENTY ONE THIRTY REQUIRES
MS- IN THE LIMBS AS TO DETERMINE
THAT ALL INITIAL TRAINING
PROGRAMS. PROVIDING TRAINING
RELATED TO THESE ISSUES WITH
HUMAN TRAFFICKING. TO MEET THESE
REQUIREMENTS AND SO WILL REQUIRE
REGULATORY UPDATES TO
INCORPORATE THE NEW STANDARD FOR
ALL PROGRAM TYPES. AND
CONFIGURATION UPDATES TO OUR
CENTRAL REGISTRY. RUVO THIS FOR
SO MS ABILITY TO LEADERSHIP
TRAINING STANDARD REQUIREMENTS
AND ENHANCE THE CENTRAL REGISTRY
LICENSING AND CERTIFICATION
SYSTEM. BY ESTABLISHING
WORKGROUPS AND COORDINATING
OUTREACH AND EDUCATION OF LENSES
AMSEL TRAIN CENTRAL REGISTRY
LICENSING AND CERTIFICATION
USERS AND THE SUCCESSFUL REVIEW
AND APPROVAL OF THIS NEW INITIAL
APPLICATION TRAINING
REQUIREMENTS. MS USE EXISTING
POSITION OF AUTHORITY TO
ESTABLISH THE STAFF SUPPORT.
DOES THE TOP DEPARTMENT FINANCER
LA- HAVE ANY COMMENT. GREAT WILL
LOANS L. A. L. NO CONCERNS WITH
THIS PROPOSAL. I- I WORKED AS AN
EMT FOR FIVE YEARS- SO I'M VERY
EXCITED TO HAVE FUTURE EMPTIES
BE PARDONED RECEIVE THIS
TRAINING BECAUSE YOU ARE RIGHT
YOU KNOW WE GO TO THE NOOKS AND
CRANNIES. OF CITIES AND COUNTIES
AREAS IS SOMETIMES ARE. IN THE
DARK FOR THE REST OF THE PEOPLE
IN THE- WE'RE EXPOSED TO A LOT
OF THINGS SO. I'M EXCITED FOR
THE POTENTIAL IMPLEMENTATION OF
THIS. THE BREAK WE'RE GONNA HOLD
THE ITEM OPEN AND MOVE ON TO
ISSUE NUMBER THREE DIVERSITY
EQUITY AND INCLUSION STRATEGIC
PLAN DEVELOPMENT. MS IS
REQUESTING A HUNDRED THOUSAND
GENERAL FUND AT TWENTY THREE
TWENTY FOUR TO CONTRACT WITH A
CONSULTANT. TO ASSIST IN THE
DEVELOPMENT OF A DIVERSITY
EQUITY AND INCLUSION STRATEGIC
PLAN THAT ALIGNS WITH THE
CALIFORNIA HEALTH AND HUMAN
SERVICES INITIATIVES TO REDUCE
HEALTH INEQUITIES AND
DISPARITIES. AND TO SUPPORT MS
AS EMERGENCY MEDICAL SERVICE
SYSTEM STRATEGIC PRIORITIES.
HEALTHEQUITY HAS BEEN A KEY
FOCUS OF THE ADMINISTRATION AND
THE COVERT NINETEEN PANDEMIC
ACCELERATED THE NEED. FOR
ADDITIONAL ACTION IS CRITICAL
THE CALIFORNIANS OF ALL AGES
ABILITIES AND BACKGROUNDS HAVE
EQUITABLE ACCESS TO THE
CONDITIONS THAT OPTIMIZE HEALTH.
THIS IS ESPECIALLY CRITICAL FOR
COMMUNITIES THAT HAVE
EXPERIENCED SOCIO ECONOMIC
DISADVANTAGE HISTORICAL
INJUSTICE ANOTHER AVOIDABLE
SYSTEMIC INEQUITIES. TO DO THIS
AS A MUST COORDINATE WITH CALLIE
CHURCH SO THAT IS POLICIES AND
PROGRAMS ARE STRATEGICALLY
ALIGNED. TO FURTHER STATEWIDE
EQUITY GOALS- HEALTHEQUITY
WORKFORCE DIVERSITY INCLUSION
ARE CRITICAL ELEMENTS THE CAL
HHS MISSION TO IDENTIFY AND
ADDRESS LONG STANDING BARRIERS.
TO HEALTH AND WELLNESS OF
DIVERSE POPULATION STRUCK
CALIFORNIA. APPROVING THE
REQUEST RESOURCES WILL RESULT IN
THE FOLLOWING SUPPORT MS AS
MISSION AND GOALS IMPROVE
SUSTAINABILITY OF PRE HOSPITAL
EMS EQUITY AND SOCIAL JUSTICE
SUFFERS WITH STATE LOCAL
PRIVATE. AND COMMUNITY BASED
ORGANIZATIONS IMPROVE MS PATIENT
OUTCOMES AND DISADVANTAGED AND
DESPAIR COMMUNITIES ACROSS THE
STATE AND ALIGN WITH CALLIE
TEACH US MISSION OF CREATING
PATIENT FOCUSED PROGRAMS.
ADDRESSING ACCESS TREATMENT AND
WORKSTREAMS TO COMBAT M. S.
HEALTHCARE DISPARITIES. IN THE
WORK FORCE INEQUITIES. THANK
YOU- TURNING TO OF FINANCE EARLY
OR FOR ANY COMMENTS FOR THE
HOTEL DEPARTMENT. AN OFFICE HELD
APARTMENT OF FINANCE LEVINE
ADDED. WE HAVE NO CONCERNS WITH
THIS PROPOSAL. ANY COMMENTS SEE
NON WE'RE GONNA HOLD ITEM OPEN
MOVE ONTO ISSUE NUMBER FOR
CALIFORNIA POST EVEN JUST READ
ACT TRAILER BILL LANGUAGE JOIN
US ON ZUMA'S DEPUTY DIRECTOR
LORNA. SB THANK YOU- MS
PROPOSING STRIKE THROUGH
STATUTORY REQUIREMENT TO
INTEGRATE THE ADVANCE HEALTH
CARE DIRECTIVE REGISTRY INTO THE
PULSE RATE HE REGISTRY. THE
POLLS FORMS A MEDICAL ORDER
SIGNED BY BOTH THE PATIENT AND A
PHYSICIAN NURSE PRACTITIONER
PHYSICIAN ASSISTANT THAT GIVE
SERIOUSLY ILL PATIENTS MORE
CONTROL OVER THEIR CARE BY
SPECIFYING THE TYPE OF MEDICAL
TREATMENT THEY WISH TO RECEIVE
TOWARDS THE END OF LIFE. CHAPTER
ONE FORTY THREE STATUTES OF
TWENTY TWENTY ONE OR ASSEMBLY
BILL ONE THIRTY THREE ENACTED
THE CALIFORNIA POLLS HE REGISTRY
WHICH REQUIRES AND THE TO
ESTABLISH. A STATEWIDE
ELECTRONIC POLLS REGISTRY SYSTEM
FOR THE PURPOSE OF COLLECTING
PATIENT POST INFORMATION
PROVIDING REAL TIME ELECTRONIC
ACCESS TO THE FORM BY EMS AND
MEDICAL PROVIDERS. AB ONE THIRTY
THREE ALSO REQUIRES INCIDENT
CORPORATE THE ADVANCE HEALTH
CARE DIRECTIVE REGISTRY-
ESTABLISH PURSUANT TO PART FIVE
OF DIVISION FOUR POINT SEVEN OF
THE PROBATE CODE AND OVERSEEN BY
THE SECRETARY OF STATE. INTO THE
POLLS THE REGISTRY- AS THERE IS
NO EXISTING ELECTRONIC REGISTRY
FOR THE H. C. D. INTEGRATION OF
THE H. C. D. OR ADVANCED
HEALTHCARE DIRECTIVE DATA. AND
MS ELECTRONIC REGISTRY IS NOT
FEASIBLE WITHOUT SIGNIFICANT
DELAYS TO THE IMPLEMENTATION OF
THE POLLS YOU REGISTRY AND
ADDITIONAL FUNDING. ELIMINATING
THE REQUIREMENT TO INCORPORATE
THE HCD REGISTERING IN THE POLLS
REGISTRY WILL ALLOW- THE SYSTEM
TO BE IMPLEMENTED IN A MUCH MORE
TIMELY MANNER. THERE'S A FOLLOW
UP QUESTION A U. S. IN A MINUTE-
PASS THAT OFF TO LARA ABBY OF
THE OFFICE OF SYSTEMS
INTEGRATION WHO IS THE PROJECT
LEAD AS WE WENT THROUGH THE
POWER PROCESS ON THIS. I A GOOD
AFTERNOON MADAM CHAIR ON A BOOK
COMMITTEE MEMBERS AND I THINK
YOU. MISTER TRUSSELL I WILL
ADDRESS QUESTION NUMBER TWO-
WHICH IS PLEASE BRIEFLY DESCRIBE
THE OPERATIONAL CHALLENGES TO
INCLUDING DATA FROM THE ADVANCE
HEALTH CARE DIRECTIVE IN THE
POLLS REGISTRY. A BEGINNING IN
ABOUT FEBRUARY OF TWENTY TWENTY
TWO AS PART OF THE PROJECT
PLANNING FOR THE POST REGISTRY
AMSTERDAM COLLABORATION WITH OUR
SIDE. BEGIN DISCOVERY ON THE
CURRENT STATUS OF THE H. C. D.
REGISTRY IN CALIFORNIA AND
REQUIREMENTS FOR ITS INCLUSION.
I SHOULD NOT AT THIS TIME THE
OVERSIGHT PROVIDES- OF PROJECT
MANAGEMENT OPPORTUNE MEN AND
ONGOING SYSTEM TO SUPPORT TO
DEPARTMENTS WITHIN GUY
CALIFORNIA HEALTH AND HUMAN
SERVICES AGENCY. AND THAT HAS
THE CAPACITY IN WHICH I AM A
ASSURING THESE OBSERVATIONS. ON
THE FOLLOWING OPERATIONAL
CONSIDERATION AND CHALLENGES
WERE IDENTIFIED. AS PREVIOUSLY
MENTIONED THERE IS NO EXISTING
ELECTRONIC REGISTRY FOR THE H.
C. D. IN CALIFORNIA SO IT NEED
TO BE DEVELOPED FROM SCRATCH
WHICH MEANS INCORPORATION OF AGE
CD DATA IS NOT FEASIBLE WITHOUT
SIGNIFICANT DELAYS TO INCLUDE.
THE IMPLEMENTATION OF THE POST
REGISTRY. THE POST FORM IS
MATERIALLY DIFFERENT AND BOTH
FOREMAN IN TOWN FROM THE H. CD.
THE PULSE FARMERS A BRIEF TWO
PAGE STANDARDIZED MEDICAL ORDER
DESIGNED FOR PERSONS WHO MEET
SPECIFIC HEALTH CARE CRITERIA
SUCH AS ADVANCED DISEASE OR
ILLNESS OR FRAILTY. IT SPECIFIES
VERY SPECIFIC LIFE SUSTAINING
TREATMENT AND WISHES. AND IT IS
IMMEDIATELY ACTIONABLE AND
USABLE IN THE FIELD BY EMS
PERSONNEL. THE POST FORM HAS
DEFINED DATA FIELDS AND SPECIFIC
ORDERS THAT ARE DIRECTLY
RELEVANT TO CARE PROVIDED BY EM
AUS AND LENDS ITSELF TO
CONVERSION INTO AN ELECTRONIC
FORMAT. THE POST FORM IS
COMPLETED AND SIGNED BY A
MEDICAL PROFESSIONAL AND LENDS
ITSELF TO DIGITAL SIGNATURES.
AND IS INCLUDED AS PART OF A
PATIENT'S HEALTH CARE RECORD. AN
H. C. D. MUST BE SIGNED BY TWO
WITNESSES AND OR NOTARIZED. AND
SO HAS CLEAR AUTHORITY FOR POST
. AND OF WHEREAS A FORTY FOR THE
H. C. D. RESTS WITH THE
SECRETARY OF STATE CURRENTLY BY
STATUTE. ONE IMPORTANT NOTE IS
THAT SECTION D. OF THE POST
WHERE DOES ALLOW THE PATIENT TO
INDICATE IF THEY HAVE AN H. C.
D. AND WHO THEIR AGENT AS
REPRESENTING THEM. AS MENTIONED
WHILE MANY HEALTH CARE PROVIDERS
PROVIDE H. H. C. D. FORMS FOR
PATIENTS IT IS NOT STANDARDIZED
AND PROBATE CODE PERMITS IN H.
C. D. FORM TO BE MODIFIED IN ANY
WAY NECESSARY. AND ALTERNATIVE
FORMATS TO BE USED AS A RESULT
MANY PROVIDERS HAVE CREATED
THEIR OWN VERSIONS OF THE FORM
AND ALL VERSIONS CAN BE MODIFIED
BY THE PATIENT. WILL OPPOSE
FORMS OF MEDICAL ORDER DESIGNED
TO AND UP PUT IN PLACE BETWEEN A
MEDICAL PRACTITIONER AND
PATIENT. THE H. C. D. IS A LEGAL
DOCUMENT IT IS UNIQUELY
DEVELOPED BY AN INDIVIDUAL OFTEN
WITH THEIR ATTORNEY. AND UNLIKE
THE POST FORM IT COVERS AN ARRAY
OF END OF LIFE WISHES THAT GO
BEYOND LIFE SUSTAINING
TREATMENTS. IN EMERGENCY
SITUATIONS. THE FOR MAYBE MANY
PAGES LENGTH. IN LENGTH. AND
THIS CREATES CHALLENGES AND
DIGITIZING H. CD DOCUMENT AS
WELL AS CHALLENGES WITH
USABILITY BY EMS PERSONNEL.
UNLIKE A POST FORM WHICH IS
TARGETED FOR SPECIFIC PATIENT
POPULATION ANY COMPETENT ADULT
CAN HAVE AN AGE CD. WE KNOW THAT
THE SECRETARY OF STATE HAS
APPROXIMATELY TEN THOUSAND AGE
CD'S ON FILE BUT WE DO NOT KNOW
THE FOR THE TOTAL NUMBER OF
ADVANCE DIRECTIVES THAT MAY
EXIST WITHIN CALIFORNIA. AT THIS
TIME. ALSO BECAUSE OF THE NATURE
OF THE H. C. D. IT IS A COMEBACK
CURRENTLY ON THE PATIENT BY
PROCESS OR THE INDIVIDUAL I
SHOULD SAY BY PROCESS. TO ENSURE
THAT THEY ARE. WARM IS
MAINTAINED IN THE CURRENT STATE-
IN THE REGISTRY. BECAUSE THE H.
C. D. IS NOT STANDARDIZED IT CAN
EXPRESS GENERAL AND OR SPECIFIC
HEALTH CARE WISHES. SUCH AS
DESIGNATING A POWER OF ATTORNEY
AND PAIN MANAGEMENT AND IT IS
NOT NECESSARILY ACTIONABLE BY
EMS PERSONNEL. BECAUSE OF THE
BREADTH AND SCOPE THAT AN H. C.
D. MAY TAKE MAINTAINING THE H.
C. BURKE H. C. D. REGISTRY. AND
RESPONDED TO QUESTIONS FROM
PATIENTS AND HEALTHCARE
PROVIDERS MAY FALL OUTSIDE OF MS
AS MISSION WITH ALREADY
INCURRING EXPERTISE. THE H. C.
D. ISSUES BY FAR BROADER CROSS
SECTION OF HEALTH PROVIDERS IN A
VARIETY OF SETTINGS INCLUDING
LONG TERM CARE AND SKILLED
NURSING. NOW IT SHOULD BE NOTED
THAT SECURITY REQUIREMENTS FOR
YOU POST MAY BE DIFFERENT FROM
H. C. D. REGISTRIES DO TO EAT
POLLS BEING A MEDICAL ORDER AND
SUBJECT TO PH I'D- AS PREVIOUSLY
MENTIONED IT DOES CONTAIN OF THE
PATIENT'S MEDICAL RECORD. WE
WOULD NEED A THOROUGH
UNDERSTANDING OF HIPAA AND OTHER
SECURITY REQUIREMENTS OF REACH
FOR. THE COUPLING OF THE AGE CD
WITH A POST INTRODUCES
COMPLEXITY FROM A LEGAL POLICY
AND TECHNOLOGY PERSPECTIVE. THAT
WOULD HAVE TO BE RESOLVED BEFORE
THE E. PULLS REGISTRY COULD MOVE
FORWARD. BECAUSE THE POST FORM
IS A WELL DEFINED STANDARDIZED
MEDICAL ORDER THAT CURRENTLY. IS
AN EXISTING RESPONSIBILITY OF
EMSA THE COUPLING THE
REQUIREMENT FOR M. SUCH WILL
COOPERATE THE H. C. D. REGISTRY
AND TO THE POST REGISTRY WILL
ALLOW THAT YOU POST REGISTRY TO
BE IMPLEMENTED UNDER THE CURRENT
TIME FRAMES AND BUDGET. AND
WITHOUT I WILL TAKE A POTS.
THANK YOU SO MUCH FOR STRAINING
TO- DEPARTMENT FINANCE IN LA-
FOR COMMENT. NOTHING TACTIC YOU
. NOTHING BAD. AT TWO QUESTIONS
ON MY END- YOU KNOW DEPUTY
DIRECTOR LEARN ARE YOU MENTIONED
YOU DON'T EMS ITS LIFE
SUSTAINING TREATMENT WHERE THEIR
ADVANCE DIRECTIVE DOESN'T ALWAYS
COME INTO PLAY. SO IF YOU TALK
TO A LITTLE BIT MORE- IT. HE
SURE A LITTLE BIT MORE REGARDING
HOW. THIS IS THE REASON WHY IT
SHOULDN'T BE CONNECTED AND THEN
SECOND THE POST NOT EVERYONE HAS
A POST EITHER THAT YOU CAN
REFERENCE AND ONE OF THAT
INDIVIDUAL YOU TREATING. HAS
DIRECTIVE IN THE ADVANCE RIGHT
TO FOR- DO NOT RESUSCITATE HOW
DO YOU THINK COMBAT THAT. THOSE
TWO QUESTIONS. YES I WILL I WILL
BE GLAD TO TAKE AN OPPORTUNITY
TO ADDRESS UP AND I WILL ALSO
INVITE- MISTER TRUSSELL TO WAY
DOWN FROM A PROGRAMMATIC
STANDPOINT- AND PLEASE HELP ME
MAKE SURE THAT I AM. DRESSING
YOUR QUESTION AS AS PHRASED- SO
OPPOSE FORM IS- IN MANY WAYS
COULD BE IS CONSIDERED A SUBSET
OF AN ADVANCE CARE DIRECTIVE IT
IS TARGETED TO A VERY SPECIFIC
POPULATION IT IS. TWO PAGES IN
LENGTH AND SECTION B. OF THE
FORM OUTLINES VERY SPECIFIC-
MEDICAL INTERVENTIONS THAT A
PERSON MAY OR MAY NOT WANT TO
HAVE. BY UP HEALTHCARE PERSONNEL
EMS PERSONNEL IN EMERGENCY
SITUATION SO IT DIFFERS- FROM A
HEALTHCARE DIRECTIVE AN ADVANCE
DIRECTIVE IN THAT REGARD WHEREAS
HEALTHCARE CARE DIRECTED CAN
TAKE ON MANY FORMATS AND CAN
ADDRESS AN ARRAY OF DIFFERENT.
TYPES OF END OF LIFE WISHES THAT
MAY OR MAY NOT INCLUDE- POLLS.
ON ANY A COMPETENT ADULT CAN
HAVE AN ADVANCE CARE DIRECTIVE
AGAIN VERSUS ANY POST OR FORCES
OPPOSED FORM WHICH IS DESIGNATED
FOR SPECIFIC POPULATION BASED ON
MEDICAL CRITERIA THAT IS- NOTED
THAT DEVELOPED. BETWEEN NATION
AND THEIR POSITION. ALLEN'S ARE
SO I WILL UPON THERE TO SEE IF I
MISSED ANY L. OF YOUR CALL-
MADAM CHU. AND I MAY NEED- TO
AND I'M A TRUSSELL WAY AND THE
DM- QUESTION. THANK YOU. CAN YOU
REPEAT THE QUESTION YEAH I'M
WONDERING YOU KNOW I GUESS THIS
WAS. BEFORE MY TIME AS TO WHY IT
WAS IMPLEMENTED TO TRANSFER THE
INFORMATION FROM THE ADVANCE
DIRECTIVE INTO POST. IF YOU KNOW
YOU'RE IN AN EMERGENCY SITUATION
ITS LIFE SUSTAINING TREATMENT
HOW DOES THAT COME INTO PLAY
THAT YOU NEED THAT DOCUMENT
RIGHT THEN AND THERE. WELL I
THINK IT'S PART OF- THE OVERALL
GOAL OF YOU FROM- MEDICAL
RECORD- HI THAMES WERE THE
HEALTH INFORMATION EXCHANGE. IS
THAT THE DMS PERSONNEL WOULD
HAVE DIRECT ACCESS TO THIS FORM
SO THEY CAN EITHER PROVIDE THE
MEDICAL TREATMENT OR NOT PROVIDE
THE MEDICAL TREATMENT AT THE
SCENE AND H. C. D. HOWEVER COULD
BE A HUGE DOCUMENT. WHERE THEY
DON'T REALLY HAVE THE ABILITY TO
GO THROUGH THE DOCUMENT AND KNOW
EVERYTHING WALL THEIR RES WATER
PROVIDING THE- EMERGENCY.
SUPPORT SERVICES SO TO HAVE
EIGHT CD RIGHT NOW THERE'S
REALLY NO- STREAMLINE HCD
PROCESS YOU KNOW WHERE THESE
ITEMS CAN BE BROUGHT UP IN
SINCE. RIGHT NOW MY
UNDERSTANDING IS THE H. C. D. IS
ESSENTIALLY SUBMITTED BY AN
INDIVIDUAL THERE'S NO PROOF THAT
IT'S BEEN SUBMITTED BY AN
ATTORNEY OR- IT'S BEEN
VALIDATED. THAT IT IS AN H. CD.
AND SO IT'S JUST SITTING THERE
FOR ACCESS FROM DOCTORS
PROVIDERS THAT THEY CALL UP IN
THE ACCESS IT THROUGH THE
SECRETARY OF STATE'S OFFICE. SO
REALLY THE POST REGISTRY IS
BEING DESIGNED TO BE AN
EMERGENCY SERVICES TOOL IN
PROVIDING TREATMENT. THANK YOU.
SONORA WHAT ARE YOU SAYING THAT
IF THERE'S AN ADVANCE. DIRECTIVE
PREPARED APPROPRIATELY. THE
FORMALITIES DONE AT A HEALTH
CARE PROVIDER CAN IGNORE IT WHEN
A PATIENT IS PRESENTING- I'M NO
I'M NOT SAYING THAT BUT- THE- HE
POLLS REGISTRY FORM WOULD BE
PART OF THE PATIENT RECORD.
RIGHT NO I UNDERSTAND SO LET ME
AS SISSY WE'RE DESIGNING IS
STATEWIDE. ELECTRONIC REGISTRY
SYSTEM TO COLLECT INFORMATION
AND IN THIS CASE IT WAS
PRIMARILY TO. TO DEAL WITH THE
POST- ISSUE. BUT IT WOULD SEEM
TO ME THAT. WHAT YOU REALLY NEED
TO KNOW IF YOU'RE IN THE FIELD.
IS WHETHER THERE'S AN ADVANCE
DIRECTIVE THAT SAYS DO NOT
RESUSCITATE. RIGHT CORRECT ALL
THE REST OF THE STUFF AT THAT
POINT PROBABLY RELEVANT TO THE
PROCESS RIGHT. CORRECT SO
INSTEAD OF WORRYING ABOUT
WHETHER WE CAN. EXPORT THIS
ENTIRE FORM INTO SOME ELECTRONIC
SYSTEM OF FORM THAT APPARENTLY
DEALS WITH A LOT OF OTHER THINGS
BESIDES THE DO NOT RESUSCITATE.
THINGS TO ME ALL WE NEED TO HAVE
ADDED TO YOUR STATEWIDE
ELECTRONIC REGISTRY SYSTEM. IS
WHETHER THERE IS A FORM. THAT
THAT THE SECRETARY OF STATE HAS
BEEN INCLUDES A DO NOT
RESUSCITATE RIGHT. CORRECT YES
SO WHAT WHY ARE WE TALKING ABOUT
THAT BECAUSE IF. IF I'M A
PATIENT AND I'VE SIGNED AN
ADVANCE DIRECTIVE WITH ALL THE
FROM LEGAL FORMALITIES THAT
PROBATE CODE REQUIRES AND MAYBE
HAS SENT TO THE SECRETARY OF
STATE I DON'T KNOW. AND I'M I
HAVE A AN EMS UNIT THERE WAS A
PARAMEDIC AND EMT. AND THEY'RE
READY TO PADDLE ME. BUT THEY CAN
LOOK UP ON WHATEVER YOU PUT IN
THE UNITS THAT SAYS I MAY NOT
HAVE A PULSE BUT I HAVE A
ADVANCE DIRECTIVE THAT SAYS.
RICHARD ROTH DO NOT RESUSCITATE
. AND IT'S COMING FROM SOME
GOVERNMENT REPOSITORY THAT SAYS
AT. WOULDN'T THAT BE HELPFUL. IT
WOULD BE HELPFUL. YES UP SO.
COMMENTS I'M EXCUSE ME SENATOR
MAY I ADD COMMENT OF TO THE ON
RAMP TO THE CHAIR SHARES GO
AHEAD. BOTTOMED HERE MAY I AM
COMMENTING QUESTION. GO AHEAD.
THANK YOU I. YOUR THE POLLS
PHARMACY AT MUCH IS A VERY BRIEF
TWO PAGE FORM AND SECTION BE ON
THE VERY FIRST PAGE ABOUT FORM-
IT. OUTLINES THE MEDICAL
INTERVENTIONS THAT A PERSON IF
THEY ARE FOUND WITH THE PULSE
AND OR BREATHING ON SCENE THAT
THEY WOULD WANT BY EMS PERSONNEL
INCLUDING FULL TREATMENT
SELECTIVE TREATMENT OR KOMPAS
COMFORT FOCUSED TREATMENT ONLY.
SO THAT ALLOWS AND EMS PERSONNEL
TO VERY QUICKLY SCALE NOT FORM
AND AS LONG AS THE FORM IS FULLY
COMPLETE ALL SECTIONS ARE
COMPLETED AND IT IS SIGNED THEY
CAN TAKE THAT ACTION IMMEDIATELY
IN THE FIELD. OF VERSES AN
ADVANCE DIRECTIVE WHICH BECAUSE
OF ITS BREADTH AND SCOPE IT MAY
OR MAY NOT CONTAIN- THESE TYPES
OF DIRECTIONS- IT COULD HAVE. A
POWER OF ATTORNEY FOR EXAMPLE IT
COULD HAVE OUR MORE LIMITED
ORDERED MORE EXPANSIVE-
DIRECTIONS ON THE FULL SCOPE OF
END OF LIFE VERSES LIFE
SUSTAINING INTERVENTIONS SO I
THINK THAT IS ONE OF THE
MATERIAL DIFFERENCES THAT AGAIN
PART OF WHAT WE'RE SAYING IS
WOULD REQUIRE THAT MORE DEEPER
DISCOVERY- AND BECAUSE THE FORM
OF THE POST FORM ITSELF HAS
THIS. VERY UP FOCUSED AND AGAIN
BY EMS PERSONNEL OR EMERGENCY
PERSONNEL ON THAT COULD INCLUDE
DOCTORS AND EMERGENCY ROOM
SITUATION AS WELL- BECAUSE IT
HAS THAT AGAIN VERY DEDICATED
AND SPECIFIC FOCUS FOR SPECIFIC
POPULATION- AGAIN BUT THEY WOULD
HAVE THAT WOULD ALLOW- AGAIN A
READILY USE AND UNMEDIATED
INVENTION BY EMS PERSONNEL- AND
CERTAINLY- I THINK WE- ARE ALL
IN AGREEMENT THAT- YOU KNOW IN.
ADVANCE DIRECTIVE DOES CONTAIN
IMPORTANT INFORMATION AS WELL-
WE ARE TRYING TO OUTLINE THE
CHALLENGES AND THE ADDITIONAL
DISCOVERY AND- AND CONVERSATION
THAT WE NEED TO BE HAD TO MAKE
THAT FORM AS USABLE- FOR THIS
TYPE OF. NOT JUST REGISTRY BUT
ALSO ELECTRONIC FORMAT THAT WERE
SPEAKING TO WELL LISTEN I
UNDERSTAND THE DIFFERENCES
BETWEEN THE TWO FORMS BUT I ALSO
UNDERSTAND IF SOMEONE. EXECUTES
AN ADVANCE DIRECTIVE THE TO AS
NOT PROCESS. THE EXPO MEDICAL
PER RESPONDING FOR MAKE ITS WAY.
I AND PROPERLY DISPOSE OF WERE
THAT DISPOSITION IS THEY EXPECT
MEDICAL PERSONNEL TO IT HERE TO
THE- TO THE REQUEST SO WHAT
YOU'RE SUGGESTING IS. PERHAPS WE
NEED TO REOPEN THE PROBATE CODE
IN ADDITION TO THE ADVANCE
DIRECTIVE FORM THAT WE CURRENTLY
PROVIDE FOR. I GUESS WE NEED TO
PROVIDE THE- THE SIMPLIFIED
VERSION. IF YOU NEED A FORM IN
YOUR SYSTEM AS OPPOSED TO AN
ENTRY OF SIMPLIFIED FORM SO YOU
CAN ADD IT TO THE- TO THE POST
REQUIREMENTS SO I GUESS FROM.
THIS IS JUST MY OPINION FROM MY
PERSPECTIVE YOU PROBABLY OUGHT
TO KEEP THE- STOVE WARM ON THE
STATE WIDE ELECTRONIC REGISTRY
SYSTEM SO WE'RE ABLE TO GET A
SIMPLIFIED FORM THROUGH THE
LEGISLATURE IN THROUGH THE
GOVERNOR'S OFFICE THAT YOU'RE
ABLE TO IMPLEMENT IT BECAUSE- I
MAY NOT HAVE A POST BUT WHEN
THE- EMTS SHOW UP IN THE
PARAMEDICS SHOW UP AT OF. AT MY
HOUSE IF I SEE A DO NOT
RESUSCITATE I DON'T WANT TO SEE
PATIL'S ASSUMING I CAN SEE RIGHT
. SO LET'S SEE IF WE CAN COME UP
WITH A- SEE WE CAN COME UP WITH
SOME SUGGESTIONS AND TAKE SOME
ACTION TO MAKE SURE THAT. THAT
WHATEVER'S IN THE DIRECTIVE IF
IT PERTAINS TO DO NOT
RESUSCITATE IS IN YOUR SYSTEM IF
THAT'S WHAT WE'RE TELLING.
PARAMEDICS IN EMTS THAT THEY
NEED TO LOOK AT TO DECIDE WHAT
THEY NEED TO DO WITH RESPECT TO.
THE TREATMENT. WITHIN THE
PROTOCOL THANK YOU THANK YOU
MANAGER. FIGURES IN IRAQ CENTER
EDMUND. THANK YOU AND I MY
COMMENTS ARE ALONG THE SAME
LINES AS AS- SENATOR ROSS. SO IT
AND YOU GOT TO OLD SOLDIERS AND
ONE YOUNG SOLDIER UP HERE- THEN
IT SOUNDS LIKE. WHAT YOU'RE- A
MARINE RAIN SORRY SORRY SORRY IT
SOUNDS LIKE- IT SOUNDS LIKE AT
LEAST TWO OF US UP HERE HAVE
ADVANCE DIRECTIVES WITH OUR
WISHES KNOWN THAT WE DON'T WANT
THE PETALS. BECAUSE WE ARE IN
ELIGIBLE TO HAVE A POST. ORDER
BECAUSE WE DON'T HAVE A CERTAIN
DIAGNOSIS THAT WOULD INELIGIBLE
MAKE US ELIGIBLE TO HAVE A POST
CERTIFICATE- REFORM FILLED OUT.
SO I WOULD AGREE THAT WE NEED TO
FIND SOME WAY TO BLEND THOSE
TWO. SYSTEMS OTHERWISE WE'RE
DEVELOPING. WE'RE DEVELOPING UP
A SYSTEM FOR A VERY SMALL
POPULATION. THAT FIRST
RESPONDERS ARE RESPONDING TO FOR
PEOPLE WHO ARE ALREADY VERY ILL
. RIGHT THERE THESE ARE ALREADY
VERY ILL PEOPLE YOU'RE GONNA GO
SEE VERSES THE GENERAL PUBLIC.
WHO ALSO WANT TO BE INCLUDED IN
OUR WHICH IS BEING KNOWN
ESPECIALLY IF WE'VE GONE THROUGH
THE TROUBLE. AND LIKE. LIKE THE
GENERAL HOPING I. TURN INTO THE
SECRETARY STATUS NOT JUST IN MY
FILE CABINET. BUT AS A HOSPICE
SOCIAL WORKERS AS A WE WOULD
TELL PEOPLE YET TAPE IT TO THE
REFRIGERATOR SO I'M VERY GLAD
WERE NOT KEEPING THINGS THE
REFRIGERATOR ANYMORE- BUT WE
NEED TO FIND A WAY TO COMBINE
THESE TWO SYSTEMS SO THAT
PEOPLE'S WISHES. ARE ABLE TO BE
RESPECTED AT THE END OF LIFE.
THANK YOU SO MUCH- FOR NOW WE'RE
GONNA HOLDEN HOLD THIS ITEM OPEN
AND MOVE ON TO ISSUE NUMBER
FIVE. THE M. THE DIRECTOR AND
CHIEF MEDICAL OFFICER TRAILER
BILL LANGUAGE. ASSEMBLY TELL
DEPARTMENT OF FINANCE. THE
ADMINISTRATION IS PROPOSING TO
REMOVE THE MEDICAL DOCTOR
REQUIREMENTS AS A PART OF THE
ELIGIBILITY CRITERIA TO SERVICE
THE DEPARTMENT STRUCTURE. AND TO
APPOINT A CHIEF MEDICAL OFFICER.
AN EXISTING LAW REQUIRES AND
SAYS DIRECTOR TO BE A LICENSED
PHYSICIAN AND SURGEON WITH
SUBSTANTIAL EMERGENCY MEDICINE
PRACTICE. AND THESE REQUIREMENTS
HAVE LIMITED THE ELIGIBLE
CANDIDATE POOL AND MADE IT VERY
CHALLENGING TO RECRUIT FOR THIS
LEADERSHIP ROLE IN THE PAST.
THEREFORE REMOVING THE MD
REQUIREMENT FOR AND SAYS
DIRECTOR WILL ASSIST THE
DEPARTMENT TAPPING INTO A
BROADER CANADA POOL WHILE AT THE
SAME TIME FOCUSING ON THE
APPROPRIATE SKILLS THAT WITH
REGARDS TO PUBLIC ADMINISTRATION
FOR THE DIRECTOR. AND ALSO
RESPOND TO THE SECOND QUESTION.
IN TERMS OF THE BIFURCATION OF
DUTIES BETWEEN THE DIRECTOR AND
THE CMO ON THE ADMINISTRATION'S
PERSPECTIVE IS THAT BY REMOVING
THE REQUIREMENT FOR THEM SAID
DIRECTOR AND ADDING AS MEDICAL
OFFICER. THIS REALLY ALLOWS FOR
THE DIRECTOR TO CONTINUE TO
FOCUS ON THE DAY TO DAY
OPERATIONAL ADMINISTRATIVE AND
STRATEGIC PLANNING ACTIVITIES
THAT ARE REALLY NECESSARY FOR
THE CHIEF ADMINISTRATOR OF THE
DEPARTMENT. ON THE OTHER HAND
THE CMO WOULD HAVE OVERSIGHT OF
CLINICAL FUNCTIONS THAT HAVE A
DIRECT IMPACT ON PATIENT CARE
PATIENT SAFETY AND PATIENT
OUTCOMES- AS A COUPLE OF
EXAMPLES OF WHAT THE CMO WOULD
HAVE LEADERSHIP OVER THAT WOULD
INCLUDE APPROVING REVISIONS. TO
STANDARD SCOPES OF PRACTICE FOR
EMS PROVIDERS. THAT WOULD ALSO
INCLUDE FINAL APPROVAL ON LOCAL
EMS AGENCY EMS PLANS- OVER WHICH
THERE IS A CLINICAL CARE
COMPONENT- SPECIFICALLY THOSE
AREAS INCLUDE- EMERGENCY MEDICAL
DISPATCH AS WELL AS SPECIAL- EMS
CLINICAL PROGRAM PLANS. ANOTHER
POTENTIAL DUTY OF THE CMO WOULD
BE OVERSIGHT OF- AND SO WHEN
THEY'RE IN THE FIELD THEIR
RESPONSE ACTIVITIES AS IT
RELATES TO THE DISASTER MEDICAL
SERVICES. ANY COMMENT. NO
COMMENTS ON THIS PROPOSAL. NO
COMMENTS FROM ME. WE'RE GOING TO
HOLD THE ITEM OPEN AND THAT WAS
THE LAST ISSUE WENT IN THE
DEPARTMENT OF EMSA. THANK YOU.
THE LAST APARTMENT WILL BE
HEARING FROM TODAY'S THE
DEPARTMENT OF PUBLIC HEALTH. I
WILL COME THE ADMINISTRATION
WILL BE PRESENTED TO. COME ON UP
.
WELCOME THANK YOU THE FIRST
ISSUE HERE'S JUST GONNA BE AN
OVERVIEW TRUST BUT WILL BE AN
OVERVIEW OF THE DEPARTMENT OF
PUBLIC HEALTH. THANK YOU MADAM
CHAIR. SO MY JOURNEY ALSO. OKAY
GOT IT BEFORE WE MOVE FORWARD
GOING TO DO- A STATE OF THE
STATE'S PUBLIC HEALTH. OKAY
ABOUT THAT WOULD BE ME. GOOD
AFTERNOON MY NAME IS- DOCTOR
THOUGHT MY THOUGHT ON. I AM THE
STATE PUBLIC HEALTH OFFICER AND
DIRECTOR OF THE CALIFORNIA
DEPARTMENT OF PUBLIC HEALTH.
IT'S AN HONOR TO BE HERE TODAY
TO PRESENT ON THE STATE OF
PUBLIC HEALTH IN CALIFORNIA. AT
CDPH OUR MISSION IS TO ADVANCE
THE HEALTH AND WELL BEING OF
CALIFORNIA'S DIVERSE PEOPLES AND
COMMUNITIES WITH THE VISION THAT
ALL CALIFORNIANS ENJOY HEALTHY
COMMUNITIES WITH THRIVING
FAMILIES AND INDIVIDUALS. HEALTH
IS NOT THE ABSENCE OF DISEASE OR
INJURY. IT'S A STATE OF COMPLETE
PHYSICAL MENTAL AND SOCIAL WELL
BEING. THE INSTITUTE OF MEDICINE
DEFINED A PUBLIC HEALTH. AS WHAT
WE AS A SOCIETY COLLECTIVELY DUE
TO ENSURE THE CONDITIONS IN
WHICH PEOPLE CAN BE HEALTHY.
PUBLIC HEALTH IS OUR COLLECTIVE
ENDEAVOR TO PROTECT AND PROMOTE
AND IMPROVE THE HEALTH OF OUR
COMMUNITIES. UNFORTUNATELY THE
FIELD OF PUBLIC HEALTH IS OFTEN
MISUNDERSTOOD AND SOMETIMES
CONFUSE WITH HEALTH CARE. WHICH
IS THE PROVISION OF MEDICAL
SERVICES TO A PREDEFINED
POPULATION. HERE IS A PUBLIC
HEALTH APPROACH IT HAS FOUR
PILLARS. FIRST THE ECOLOGICAL
SOCIAL ALSO CALLED EAGLE SOCIAL.
WHICH IS A RELATIONSHIP OF
PEOPLE WITH THEIR FAMILY AND
SOCIAL NETWORKS AND WITH THEIR
NEIGHBORHOOD AND ENVIRONMENT. IN
OTHER WORDS IN OTHER WORDS
HEALTH HAPPENS WHERE WE LIVE
WORK LEARN PLAY AND PRAY. THINK
FOR EXAMPLE OF THE COVE IN
NINETEEN PANDEMIC AND IT'S WIDE
SPREAD IMPACTS. THINK OF THE
HEALTH IMPACTS FROM CLIMATE
CHANGE. THE SECOND PILLAR IS
LIFE COURSE AND
INTERGENERATIONAL PROCESS THESE.
THANK OF ADVERSE CHILDHOOD
EXPERIENCES AND TOXIC STRESS. IN
THE INTERGENERATIONAL
TRANSMISSION OF THE SOCIAL AND
BIOLOGICAL EFFECTS OF ADVERSITY
AND TRAUMA. THE THIRD PILLAR IS
EQUITY AND HEALTH EQUITY. THANK
A LOW INCOME COMMUNITIES AND
ESSENTIAL WORKERS WITH HIGHER
RATES OF COVERT NINETEEN
EXPOSURE ILLNESS HOSPITALIZATION
AND DEATH. THINK OF THE
DISPROPORTIONATE IMPACTS OF
VIOLENCE AND MENTAL HEALTH OF
COMMUNITIES OF COLOR ESPECIALLY
BLACK AFRICAN AMERICANS. AND
FINALLY THE FOURTH PILLAR OF
PUBLIC HEALTH IS A PREVENTION
FOCUS IS SPECIALLY PRIMARY
PREVENTION. THINK OF LAWS
REDUCING AVAILABILITY OF TOBACCO
PRODUCTS AND EXPOSURE TO
SECONDHAND SMOKE. THINK OF
SMARTER ST DESIGN VEHICLE
STANDARDS SEAT BELTS AND CHILD
SAFETY SEATS AND ROBUST SAFETY
MOBILITY OPTIONS TO REDUCE ROAD
FATALITIES. WELL WHAT HAVE WE
ACCOMPLISHED COLLECTIVELY. OVER
THE LAST TWENTY YEARS PUBLIC
HEALTH HAS CONTRIBUTED TO
SIGNIFICANT IMPROVEMENTS IN
HEALTH AND WELL BEING FOR ALL
GROUPS IN CALIFORNIA FOR
EXAMPLE. THE DEATH RATE FOR LUNG
CANCER HAS DECREASED BY 57%
SINCE TWO THOUSAND ONE. THANKS A
COMPREHENSIVE TOBACCO CONTROL
EFFORTS CREATING A SOCIAL AND
LEGAL CONTEXT IN WHICH TOBACCO
IS LESS DESIRABLE ACCEPTABLE AND
ACCESSIBLE. THE HIV DEATH RATE
DECREASED BY 71% BETWEEN TWO
THOUSAND AND ONE AND TWENTY
TWENTY ONE FOR ALL GROUPS AND BY
73% FOR BLACK INDIVIDUALS. BIRTH
RATES AMONG ADOLESCENTS
DECREASED BY 78% BETWEEN TWO
THOUSAND AND TWENTY TWENTY. DUE
TO IMPROVED ACCESS TO PUBLIC
HEALTH PREVENTION STRATEGIES
INCLUDING COMPREHENSIVE SEXUAL
HEALTH EDUCATION CLINICAL
SERVICES AND PROMOTION OF
HEALTHY RELATIONSHIPS AND
COMMUNICATION PRACTICES. DESPITE
DECLINES IN MORTALITY FOR ALL
GROUPS IN CALIFORNIA SIGNIFICANT
RACIAL AND ETHNIC. HEALTH
DISPARITIES CONTINUE FOR EXAMPLE
OVERALL LIFE EXPECTANCY IS TEN
TO TWELVE YEARS LEFT. FOR BLACK
INDIVIDUALS COMPARED TO ASIAN
INDIVIDUALS WITH THE HIGHEST
LIFE EXPECTANCY. THE RATE FOR
ALCOHOL RELATED DEATHS IS
FOURTEEN TIMES HIGHER FOR
AMERICAN INDIAN AND ALASKA
NATIVE INDIVIDUALS COMPARED TO
ASIAN INDIVIDUALS AND IS THE
FOURTH LEADING CAUSE OF DEATH
FOR THIS GROUP. THE PREGNANCY
ASSOCIATED MORTALITY RATE IS
ABOUT THREE POINT FIVE TIMES
HIGHER AMONG BLACK WOMEN THAN
AMONG WHITE WOMEN. HIV STD DEATH
RATE IS ELEVEN TIMES HIGHER FOR
BLACK INDIVIDUALS AND ASIAN
INDIVIDUALS. PUBLIC HEALTH WORKS
TO REDUCE THESE THESE
DISPARITIES BY INFORMING
POLICIES THAT ADDRESS THE
UNDERLYING SOCIAL ENVIRONMENTAL
AND BEHAVIORAL DRIVERS OF HEALTH
AND BY REGULATING SELECTED
SECTORS WITH HIGH IMPACTS ON
HEALTH FOR EXAMPLE WE LICENSE
AND CERTIFY INSPECTED OVER TEN
THOUSAND HEALTH FACILITIES
ACROSS CALIFORNIA. EQUITIES A
FOUNDATIONAL GUIDING PRINCIPLE
IN PUBLIC HEALTH BASED ON NEED
EVERY CALIFORNIAN SHOULD HAVE
THE RESOURCES AN OPPORTUNITY
OPPORTUNITIES TO BE HEALTHY AND
THRIVE. THIS REQUIRES
PRIORITIZING INVESTMENTS IN
COMMUNITIES WITH CONTINUING
HEALTH INEQUITIES. TODAY
CALIFORNIA FACES SOME OF THE
TOUGHEST PUBLIC HEALTH
CHALLENGES IN DECADES. THESE
CHALLENGES INCLUDE COVERT
NINETEEN CHRONIC DISEASES LIKE
CARDIOVASCULAR DISEASE AND
ALZHEIMER'S MENTAL ILLNESS AND
SUBSTANCE USE DISORDER FIRE ARM
RELATED DEATH AND INJURY. AND
HEALTH IMPACTS FROM CLIMATE
CHANGE AND EXTREME WEATHER. CDPH
IS BUILDING CAPACITY TO TACKLE
FEES PUBLIC HEALTH PRIORITIES.
CLIMATE CHANGE IS A MAJOR FORCE
IMPACTING THE PUBLIC'S HEALTH
AFFECTING ALL ASPECTS OF OUR
HEALTH AND WELL BEING AFFECTING
ACCESS TO CLEAN AIR FOOD WATER
SHELTER IN PHYSICAL SAFETY.
HEATWAVES DROUGHTS WILDFIRES AND
WILDFIRE SMOKE IN FLOOD RESULT
IN ILLNESS INJURIES AND DEATHS
AS WELL AS LOSS OF LIVELIHOODS
CONTRIBUTING TO UNEMPLOYMENT
POVERTY AND HOUSING INSTABILITY
. DIRECT AND INDIRECT IN A FAX.
BUT AFFECTS INCREASE CHRONIC AND
INFECTIOUS DISEASES MENTAL
HEALTH CHALLENGES AND HEAT AND
SMOKE RELATED ILLNESSES. THE
IMPACTS HAVE THE GREATEST TOLL
ON THE ON THE HEALTH OF THOSE
ALREADY EXPERIENCING HEALTH
SOCIAL AND ECONOMIC INEQUITIES.
PUBLIC HEALTH MONITORS
POPULATION HEALTH IMPACTS AND
PARTNERS WITH STATE AND LOCAL
GOVERNMENT AND IN THE PRIVATE
SECTOR TO EMBED PULLED THE
PUBLIC HEALTH APPROACH IN
EFFORTS TO ADDRESS THESE
CHALLENGES. LIFE EXPECTANCY
STEADILY INCREASE FOR TWENTY
YEARS PRIOR TO TWENTY TWENTY BUT
DUE TO IMPACTS OF COVER NINETEEN
PAN THAT COVER NINETEEN PANDEMIC
WE EXPERIENCED A SHARP DROP IN
LIFE EXPECTANCY. IN TWENTY
TWENTY ONE COVERT NINETEEN WAS
THE LEADING CAUSE OF DEATH AND
YEARS OF LIFE LOST WITH OVER
FOUR FORTY THREE THOUSAND
CALIFORNIANS LOSING THEIR LIFE
IN THE YEAR TWENTY TWENTY.
MILLIONS MORE EXPERIENCED SEVERE
ILLNESS HOSPITALIZATION
DESTRUCTION TO EDUCATIONAL WORK
AND SOMETIMES LOSS OF JOBS OR
HOUSING. KOVEN NINETEEN
HIGHLIGHTED AND EXACERBATED
EXISTING HEALTH INEQUITIES. THE
COVER NINETEEN DEATH RATE WAS
SIGNIFICANTLY SIGNIFICANTLY
HIGHER FOR NATIVE NATIVE
HAWAIIAN AND PACIFIC ISLANDERS
BLACKS AND LATINOS. COMPARED TO
THE STATEWIDE RATE. LOW INCOME
COMMUNITIES SUFFER
DISPROPORTIONATELY. THEY LIVE IN
CROWDED CONDITIONS WORK IN
ESSENTIAL FRONTLINE JOBS AND HAD
MORE EXPOSURE TO COVE IN
NINETEEN. THEY HAVE LESS ACCESS
TO RESOURCES CREATING GAPS IN
HEALTH CARE INFORMATION HOUSING
AND ECONOMIC SECURITY. THROUGH
OUR COLLECTIVE ACTIONS PROVIDING
TESTING VACCINATION TREATMENT.
AND PUBLIC HEALTH GUIDANCE CASES
HOSPITALIZATIONS AND DEATHS
DROPPED SIGNIFICANTLY BETWEEN
TWENTY TWENTY AND TWENTY TWENTY
ONE. IN TWENTY TWENTY TO COVE IN
NINETEEN DROPPED TO BE THE THIRD
LEADING CAUSE OF DEATH NOW IN
TWENTY TWENTY THREE WE HAVE
REACHED THE LOWEST LEVELS OF THE
PRE PANDEMIC PERIOD. ENABLING
ACTIVITIES OF DAILY LIFE TO
RESUME MORE SAFELY. COVERED
NINETEEN WILL REMAIN WITH US FOR
THE FORESEEABLE FUTURE INCLUDING
THE UNCERTAIN BURDEN OF LONG
COATED. USING LESSONS LEARNED
FROM THE PANDEMIC OF THE
CALIFORNIA SMARTER PLAN ENABLES
US TO MANAGE CODE NINETEEN TODAY
AND TO PREPARE FOR FUTURE
SEARCHES INVARIANCE. AS WELL TO
RESPOND TO EMERGING INFECTIOUS
DISEASES. LAST YEAR CDPH
LEVERAGE THE COVERT RESPONSE
INFRASTRUCTURE AND A SMARTER
PLAN TO RESPOND TO THE M. POX
OUTBREAK. WE WERE ABLE TO
ACTIVATE SYSTEMS FOR
SURVEILLANCE VACCINATION AND
TREATMENT TO HIGHLY IMPACTED
COMMUNITIES. FOURTEEN DAY
AVERAGE CASE RATES HAVE FALLEN
FROM MORE THAN NINETY PER DAY IN
AUGUST TWENTY TWENTY TWO. TO
LESS THAN ONE CASE PER DAY. CDPH
DISTRIBUTED VACCINE AND
ANTIVIRAL TREATMENT STATEWIDE
SUPPORTED VACCINATION EVENTS AND
PROVIDED DISEASE PREVENTION
MESSAGING. ALMOST THREE HUNDRED
THOUSAND VACCINE DOSES HAVE BEEN
ADMINISTERED TO MORE THAN ONE
HUNDRED AND EIGHTY THOUSAND
PEOPLE WITH OVER ONE HUNDRED
THOUSAND PERSONS RECEIVING TWO
DOSES. AGAIN AT THE END OF
TWENTY TWENTY TWO WE LEVERAGE
NEW THE NEW COVERT RESPONSE
INFRASTRUCTURE TO WOULD ADDRESS
SUCH THE SIMULTANEOUS SURGE OF
KOBE NINETEEN. INFLUENZA AND
RSV. WE TRACKED IS THESE LEVEL
IN REAL TIME AND PROJECTED
IMPACTS ON THE HEALTH CARE
SYSTEM CDPS PROVIDED DATA TO
LOCAL PARTNERS. AND POLICY
MAKERS TO GUIDE THE RESPONSE TO
THIS TROUBLED EMIC. THE
GOVERNOR'S TWENTY TWENTY THREE
BUDGET PROPOSAL CONTINUES
INVESTMENTS TO SUPPORT THE
STATE'S EFFORT TO PROTECT
AGAINST COVER NINETEEN AND
OTHER. PUBLIC HEALTH IMPACTS.
CAL'S FOR CALIFORNIA'S
POPULATION IS GROWING OLDER. BY
TWENTY THIRTY ONE IN FOR
CALIFORNIANS WILL BE OVER THE
AGE OF SIXTY. THE SKIMMER CARD
DISEASE AND ALZHEIMER DISEASE
CONTINUES TO BE THE TOP LEADING
CAUSES OF DEATH FOR
CALIFORNIANS. CARDIOVASCULAR
DISEASES CONTRIBUTED TO THE MOST
DEATHS IN TWENTY TWENTY ONE.
THIS CONDITION GROUPS INCLUDE
ISCHEMIC HEART DISEASE STROKE
AND HYPERTENSIVE HEART DISEASE
ALL OF WHICH ARE THE FIVE
LEADING CAUSES OF DEATH. DURING
THE PANDEMIC PERIOD RACES
ISCHEMIC HEART DISEASE INCREASE
CALTRAIN THE LONG TERM TREND OF
DECLINE. THE DATA FOR TWENTY
TWENTY ONE SHOWS THAT THE
DOWNWARD TREND HAS RETURNED
REACHING AN ALL TIME LOW. MOST
CARDIOVASCULAR CONDITIONS CAN BE
PREVENTED BY IDRISS ADDRESSING
BEHAVIORAL RISK FACTORS SUCH AS
TOBACCO USE. UNHEALTHY DIET AND
OBESITY PHYSICAL IN ACTIVITY AND
HARMFUL ALCOHOL CONSUMPTION.
HOWEVER RECOGNIZING THAT DEEPLY
ROOTED SOCIAL E. ANY ECONOMIC
INEQUITIES ARE THE DRIVERS OF
MANY HEALTH BEHAVIORS. PUBLIC
HEALTH INFORMS POLICIES THAT
IMPROVE COMMUNITY CONDITIONS SO
ALL PEOPLE CAN ENJOY SAFE
WALKABLE NEIGHBORHOODS AND
ACCESS TO HEALTHY FOODS AND
AFFORDABLE HOUSING. DEATHS FROM
ALZHEIMER'S DISEASE HAVE MORE
THAN DOUBLED SINCE. THE YEAR TWO
THOUSAND AND ABOUT ONE IN TEN
ADULTS IN CALIFORNIA EXPERIENCE
OBJECTIVE COGNITIVE DECLINE OR
MEMORY LOSS. CITY PREACH
COLLABORATES WITH STAKEHOLDERS
TO SUPPORT THE MASTER PLAN FOR
AGING TO PREVENT AND PREPARE FOR
THE GROWING NUMBER OF
ALZHEIMER'S ALZHEIMER'S CASES.
IN FORTY PATH FORWARD FOR
FAMILIES. SEVERAL CONDITIONS
OTHER THE COCOPAH NINETEEN SHOW
SUBSTANTIAL INCREASES IN DEATH
RATES OVER THE PAST TWO YEARS.
THESE INCLUDE DEATHS RELATED TO
ALCOHOL. ROTICH INJURING AND
DRUG OVERDOSE DRUG OVERDOSE HAS
BY FAR BECAUSE THE LARGEST
INCREASE WITH DEATHS INCREASING
BY OVER 2100% BETWEEN TWENTY
ELEVEN AND TWENTY TWENTY ONE.
THIS BEGAN WITH WITH A 63%
INCREASE IN THE PRE PANDEMIC
PERIOD. THIS INCREASED SURGE
DRAMATICALLY DURING THE PANDEMIC
PERIOD WITH AN ADDITIONAL 79%
INCREASE IN JUST TWO YEARS.
ENGINE IN JUST TWO YEARS AND
OVER TEN THOUSAND DEATHS IN
TWENTY TWENTY ONE. IN TWENTY
NINETEEN DRUG OVERDOSE DEATHS
OVERTOOK ISCHEMIC HEART DISEASE
AS A TOP UP BECAUSE OF YEARS OF
LIFE LOST. BETWEEN TWENTY
NINETEEN AND TWENTY TWENTY ONE
THERE WAS ALSO A 38% INCREASE IN
HOMICIDES. AFTER MANY YEARS OF
DECREASING OR LEVEL RATES. THIS
WAS DRIVEN BY AN INCREASE IN
FIREARM RELATED HOMICIDES.
EXPOSURE TO GUN VIOLENCE
DRAMATIZES SURVIVORS AND
COMMUNITIES IMPACTING MENTAL
HEALTH AND SOCIAL WELL BEING.
MANY PUBLIC HEALTH CHALLENGES
START EARLY IN LIFE AMONG
CHILDREN YOUTH AND YOUNG ADULTS
IMPACTING THEIR LIFE COURSE
TRAJECTORY OF PHYSICAL MENTAL
AND EMOTIONAL HEALTH AND
WELLBEING. CHILDREN YOU ARE
DEALING WITH UNPRECEDENTED
CHALLENGES DUE TO THE COVE IN
NINETEEN PANDEMIC. AS OF
SEPTEMBER TWENTY TWENTY TWO.
ALMOST THIRTY EIGHT THOUSAND
CHILDREN. CALIFORNIA'S CHILDREN
UNDER THE AGE OF EIGHTEEN HAVE
LOST A PARENT OR CARE GIVER
GIVER DUE TO COVERT NINETEEN.
THIS TYPE OF LOSS HAS LONG TERM
HEALTH CONSEQUENCES AND
CONTRIBUTES TO ADVERSE CHILDHOOD
EXPERIENCES OR TALK OR ACES.
TOXIC STRESS OVER TIME FROM ACES
CAN ALTER BRAIN DEVELOPMENT AND
AFFECT OUR BODIES RESPONSE TO
STRESS. ACES ARE LINKED TO
CHRONIC HEALTH PROBLEMS MENTAL
HEALTH ISSUES AND SUBSTANCE
MISUSE IN ADULTHOOD IN
CALIFORNIA ABOUT SIX IN TEN
ADULTS REPORT EXPERIENCING AT
LEAST ONE ACE BEFORE THE AGE OF
EIGHTEEN. PUBLIC HEALTH WORKS
WITH THE WITH THE DEPARTMENT OF
SOCIAL SOCIAL SERVICES AND THE
OFFICE OF THE SURGEON GENERAL TO
PROMOTE POLICIES THAT PREVENT
ACES AND BUILDER BUILDS A SAFE
STABLE AND NURTURING
RELATIONSHIPS. AND ENVIRONMENTS
TO PROGRAMS LIKE HOME VISITING.
MENTAL HEALTH CONDITIONS AFFECT
MORE THAN HALF OF U. S. PEOPLE
OVER THEIR LIFETIME AND
CONTRIBUTE TO WORSE OVERALL
HEALTH. AND RISK OF DEATH BY
SUICIDE. IN CALIFORNIA'S SEVERE
MENTAL ILLNESS AND SUBSTANCE USE
DISORDERS HAVE A SIGNIFICANT
IMPACT ON YOUNG ADULTS WITH MOOD
DISORDERS AND SCHIZOPHRENIA. AS
THE FIRST AND LEADING CAUSE
LEADING CAUSES OF AND THIRD A
SORRY THE FIRST AND THIRD
LEADING CAUSE OF
HOSPITALIZATION. RESPECTIVELY
FOR CALIFORNIANS AGE FIFTEEN TO
TWENTY FOUR. MENTAL HEALTH
CONDITIONS ARE THE SECOND
LEADING CAUSE OF YEARS OF LIVED
WITH DISABILITY FOR CALIFORNIANS
AND THE LEADING CAUSE FOR
CHILDREN BETWEEN THE AGES OF
FIVE TO FOURTEEN EMPHASIZING THE
NEED TO STRENGTHEN PREVENTION.
EARLY IDENTIFICATION AND
COMPASSIONATE CARE. UNTREATED
MENTAL HEALTH PROBLEMS OR
SUBSTANCE USE AND ADDICTION CAN
RESULT IN INJURY AND PREMATURE
DEATH. IN TWENTY TWENTY ONE OVER
FOUR THOUSAND CALIFORNIANS DIED
BY SUICIDE. THE OVERALL NUMBER
OF SUICIDE DEATHS HAS DECREASED
SINCE TWENTY EIGHTEEN. BECAUSE
OF DECREASES IN OLDER PERSONS.
IN CONTRAST SUICIDE AND SELF
HARM ARE AMONG THE TOP FIVE
CAUSES OF DEATH. FOR FIFTEEN TO
FORTY FOUR YEAR OLD AND RATES
HAVE BEEN RISING IN RECENT YEARS
AMONG BLACK AND LATINO
CALIFORNIANS. HOSPITALIZATIONS
AND EMERGENCY DEPARTMENT VISITS
FOR MENTAL HEALTH RELATED
CONDITIONS ARE HIGHER AMONG
BLACK INDIVIDUALS THAN FOR ANY
OTHER RACE OR ETHNIC GROUP. THE
GOVERNOR'S PROPOSED BUDGET
DEMONSTRATES A STEADFAST
COMMITMENT TO ADVANCING THE
HEALTH AND WELL BEING. OF ALL
CALIFORNIANS COMMUNITIES WHILE
PRIORITIZING THE MOST VULNERABLE
THROUGH CRITICAL INVESTMENTS IN
THE BEHAVIORAL HEALTH SYSTEMS
SOCIAL SYSTEM. SOCIAL SAFETY NET
PROGRAMS AND PUBLIC HEALTH
INFRASTRUCTURE. RECENT PUBLIC
HEALTH EFFORTS AIM TO PROVE TO
PREVENT ADDICTION AND OVERDOSE
THROUGH HARM REDUCTION
STRATEGIES PUBLIC AWARENESS AND
EDUCATION RECOVERY AND SUPPORT
SERVICES AS WELL AS INNOVATIVE
APPROACHES TO MAKE NALOXONE AND
FENTANYL TEST STRIPS MORE WIDELY
AVAILABLE. THE CALIFORNIA YOUTH
BEHAVIOR HEALTH INITIATIVE AN
INTER DEPARTMENTAL COLLABORATIVE
ARE FOR TO TRANSFORM THE
BEHAVIORAL HEALTH SYSTEM TO BE
MORE RESPONSIVE TO THE CURRENT
NEEDS. OF OUR CHILDREN AND YOUTH
IS A MAJOR FOCUS FOR US. CDPH IS
LEADING AN EDUCATIONAL CAMPAIGN
TO NORMALIZE SEEKING SUPPORT FOR
MENTAL HEALTH CHALLENGES AND TO
DE STIGMATIZE BEHAVIOR HEALTH IN
COMMUNITIES. THE BUDGET PROVIDES
PROVIDE SUPPORT FOR CORE PUBLIC
HEALTH INFRASTRUCTURE THROUGH
THE FUTURE PUBLIC HEALTH
INITIATIVES THE STATE INVESTED
THREE HUNDRED MILLION DOLLARS TO
MODERNIZE STATE AND LOCAL PUBLIC
HEALTH INFRASTRUCTURE INTO
TRANSITION TO A MORE RESILIENT
SYSTEM. CENTERED ON EQUITY WE
ARE BUILDING OUR CAPACITY AND
CAPABILITIES IN LONG TERM
STRATEGIC PLANNING AND POLICY
DEVELOPMENT. WORKFORCE
DEVELOPMENT DATA MODERNIZATION
DATA SCIENCE IN DECISION
INTELLIGENCE EMERGENCY
PREPAREDNESS OUR RESPONSE.
HEALTH CARE PARTNERSHIPS TO
IMPROVE POPULATION HEALTH
MANAGEMENT. COMMUNITY ENGAGEMENT
AND PARTNERSHIPS AND RECRUITMENT
AND RETENTION OF I'D OF A
DIVERSE WORKFORCE THAT REFLECTS
THE COMMUNITIES WE SERVE. THIS
FUNDING IS ALREADY AT WORK WITH
MANY NEW STAFF HIRED ACROSS THE
STATE TO SUPPORT THIS
TRANSFORMATION. CDPH IS AN
AGENCY WITH OVER TWO HUNDRED AND
TWENTY PROGRAMS AND OVER FOUR
THOUSAND STAFF BUT PUBLIC HEALTH
IS WHAT WE DO COLLECTIVELY. TO
ENSURE THE CONDITIONS IN WHICH
EVERY CALIFORNIANS CAN BE
HEALTHY AND THRIVE. THANK YOU
FOR YOUR LEADERSHIP AND SUPPORT
. THANK YOU SO MUCH FOR THAT YOU
KNOW SOMETIMES HEARING THESE
STATS THANK YOU FEEL. IT'S A YOU
KNOW WEIGHS HEAVY ON NEWMAN AYE
PRECIADO SO TIME IN THE GUN
VIOLENCE WITH PUBLIC HEALTH THAT
OFTENTIMES ISN'T LOOKED AS IT
BEING LINKED TOGETHER SIR
APPRECIATE THAT ANY COMMENTS
BEFORE WE DIVE IN. JUST ONE
QUESTION ALWAYS NICE TO SEE A
DOCTOR TO CURRENT- HOW HOW IS IT
GOING WITH COLLECTING ART THE
SOCHI DATA NO NOW SPEAKING AS
THE CHAIR OF THE L. G. B. T. Q.
CAUCUS- BUT ALSO HAS TO DO WITH
BUDGET- SO SOME OF THAT DATA
THAT WE HAVE BEEN ASKING FOR
IT'S BEEN. SLOW TO COME YES- THE
FUNDING FOR THE M. PARKS THAT WE
PROVIDED NEVER WENT OUT- AND I
FELL AND WE GOT WE GOT THE
CRISIS UNDER CONTROL- BUT CAN
YOU AND I KNOW THERE'S BEEN A
PANDEMIC REYES ALL RIGHT- RIGHT
BUT BUT BUT THERE'S ALSO ANGST.
AMONGST SOME OF MY MEMBER GAS SO
THE FOR THE FOR THE SOCHI AUDIT-
WE JUST COMPLETELY JUST
COMPLETED AN AUDIT. AND WE JUST
HAVE TO REVIEW WITH THE TEAM ON
MONDAY AND SO WE WILL BE COMING
WILL BE HAVING A DETAIL WITH THE
DETAIL RECOMMENDATIONS IN THE
AUDIT. AND WE DEFINITELY AN AREA
OF IMPROVEMENT FOR THE FOR THE
DEPARTMENT PUBLIC HEALTH AND SO
WE'RE COMMITTED TO MAKING THOSE
IMPROVEMENTS OKAY. IN THE INBOX
BUT I HAVE TO FOLLOW UP I HAVE
TO FOLLOW UP ON THE DETAIL OF
THAT OKAY BUDGET MY
UNDERSTANDING IS THAT THE MONEY
DID GO OUT IN. WHEN ARE THE REST
OF OUR TEAM COMES OUT UP THEY
MAY THEY MAY HAVE MORE
INFORMATION OKAY BECAUSE MY
UNDERSTANDING WAS WEEK WE
ALLOCATED FOR THAT BUT THAT IT
DIDN'T GO OUT. MAYBE MAYBE I
THINK- MINDEN SO WE HAD TO RE
THREE ALLOCATED SOMEWHERE ELSE.
YEAH AND I THINK WHEN WE START
TO TALK ABOUT SOME OF THE COBIT
ISSUES APOLOGIES BROWN INDUSTRY
DEPUTY FOR OPERATIONS AT THE
DEPARTMENT- PROBABLY THAT TEAM
WILL BE ABLE TO HAVE SOME
DISCUSSIONS WITH YOU ABOUT THE-
THE MONKEY POX- AT THE END PARKS
RATHER. INVESTMENT. SOMEONE OUT.
THANK. THINKCENTRE M. AMBER MOVE
IN A NO OR- SAME OF. THE OF
PUBLIC HEALTH. HE SAID READ. YES
WELCOME THANK YOU- YES. IN A TO
STEP PROPER- SINCE THE GRAHAM
MUCH GAVE UP PRO OVERVIEW ALL
JUST YOU A REALLY HIGH LEVEL
BUDGET OVER. FOR DEPARTMENT. AND
YOUR GENDER DOES A GREAT JOB OF
HIGHLIGHTING IT FOR US BUT
OVERALL FOR OUR DEPARTMENT FOR
TWENTY THREE TWENTY FOUR WE HAVE
A BUDGET OF FIVE POINT FIVE
BILLION. ON THAT'S BROKEN DOWN
BY A ONE BILLION DOLLARS GENERAL
FUND TWO POINT TWO BILLION
FEDERAL FUNDS AND TWO POINT
THREE BILLION FROM ABOUT. FIFTY
DIFFERENT SPECIAL FUNDS IN THE
DEPARTMENT WE ALSO PROVIDE-
THREE POINT FIVE BILLION IN
LOCAL ASSISTANCE FUNDING AND
THEN TWO BILLION OF THAT STAYS
WITH THE DEPARTMENT- AS DOCTOR
ARE. MENTIONED ARE BUDGET DOES
INCLUDE THE INVESTMENT FROM LAST
YEAR TO THREE HUNDRED MILLION
FOR FUTURE PUBLIC HEALTH- ONE
HUNDRED MILLION OF THAT STAYED
HERE WITH THE DEPARTMENT IN TWO
HUNDRED MILLION WAS PROVIDED TO-
THE LOCAL HEALTH JURISDICTIONS
FOR THEIR INFRASTRUCTURE AS
WELL- OUR BUDGET DOES ASSUME
REDUCE COVERT RESPONSE COSTS-
THAT'S IN PART DRIVEN BY
REDUCED- RESPONSE ACTIVITIES
SINCE THE PEAK OF THE COVERT
RESPONSE- AS A RESULT ARE TWENTY
TWO TWENTY THREE- PROJECTED
EXPENDITURES. ARE BEING REDUCED
BY SIX HUNDRED AND FOURTEEN
MILLION IN THE CURRENT YEAR. AND
THEN WE DO HAVE INVESTMENT OF A
HUNDRED AND SEVENTY SIX MILLION
IN THE IN THE BUDGET YEAR TWENTY
THREE TWENTY FOUR- TO
IMPLEMENTS- COVERT RESPONSE
ROUGHLY A HUNDRED MILLION FOR
THAT AND THEN. IMPLEMENTATION OF
OUR SMARTER PLAN ABOUT SEVENTY
FIVE AND A HALF MILLION ROUGHLY
IS FOR THAT PRIMARILY DUE TO
POOR MAINTENANCE AND OPERATIONS
OF SOME OF OUR SYSTEMS THAT WERE
SET UP- DURING THE COVERED
RESPONSE AND WE'RE PREPARED TO
CHAT WITH YOU A LITTLE MORE WHEN
WE GET ISSUE NUMBER TWO TODAY.
ON THOSE WITH OUR TEAM- WE DO
HAVE A COUPLE AREAS IN OUR
BUDGET THAT ARE PART OF THE
ADMINISTRATION'S STRATEGY TO
ADDRESS THE BUDGET SHORTFALL-
ONE OF THESE AREAS IS RELATED TO
THE PIPE PUBLIC HEALTH CLIMATE
AND HEALTH RESILIENCE- PLANNING
GRANTS THAT WERE PROVIDED LAST
YEAR. THIS DOES FALL INTO THE
CATEGORY THE ADMINISTRATION'S
TRIGGER REDUCTIONS SO TO THE
EXTENT THERE'S FUNDING IN THE
TWENTY FOUR TWENTY FIVE BUDGET
THIS PARTICULAR AND- REDUCTION
WOULD BE RESTORED. AND THEN WE
DO HAVE A PARTIAL PUBLIC HEALTH
WORK FORCE REDUCTION THAT WILL
BE TALKING TO YOU ABOUT TODAY IN
ISSUE FOR I BELIEVE- ROUGHLY- OF
FORTY NINE- SORRY THE BUDGET
REDUCE FUNDING FOR VARIOUS
PUBLIC HEALTH WORKFORCE TRAINING
AND DEVELOPMENT PROGRAMS BY
ROUGHLY FORTY NINE POINT EIGHT
MILLION. THIS IS SPLIT OVER- FOR
FISCAL YEARS WITH ABOUT FIVE
MILLION COMING OUT OF CURRENT
YEAR. AND ABOUT TWENTY POINT
EIGHT MILLION IN EACH OF BUDGET
YEAR AND BUDGET YEAR PLUS ONE-
AND THEN FINALLY- WE DO HAVE A
NUMBER OF DIFFERENT BCPS IN
PROPOSALS WOULD BE TALKING TO
YOU ABOUT- OVER THE BUDGET
SEASON. THE GOVERNOR'S BUDGET
INCLUDED ABOUT FOURTEEN MILLION
THAT'S TOTAL FUNDS TO SUPPORT
ABOUT FIFTEEN PIECES OF
LEGISLATION THAT PASSED LAST
YEAR- WE HAVE ABOUT THREE POINT
TWO MILLION DOLLARS IN INCREASES
THAT COME FROM OUR PROPOSITION
NINETY NINE IN OUR PROPOSITION
FIFTY SIX OUR TOBACCO- TAX FUNDS
TO SUPPORT A TOBACCO CESSATION
PROGRAMS. AND THEN FINALLY
THERE'S ABOUT A TWO HUNDRED
MILLION DOLLAR INCREASE IN THE
CURRENT YEAR AND ROUGHLY A TWO
HUNDRED- AND TWENTY OR SO
MILLION DOLLAR INCREASE IN THE
BUDGET YEAR TO SUPPORT OUR
PUBLIC ASSISTANCE PROGRAMS SUCH
AS OUR AIDS DRUG ASSISTANCE
PROGRAM- OUR GENETIC DISEASE
SCREENING PROGRAMS AND OF COURSE
OUR WOMEN INFANTS AND CHILDREN
PROGRAM SO IT'S A VERY HIGH
LEVEL OVERVIEW OF OUR BUDGET WE
OF COURSE HAVE OUR TEAM HERE TO
TALK ABOUT A LOT OF THESE ISSUES
BUT- HAPPY TO STOP THEIR INTAKE
ANYTHING WHICH I HAVE A
QUESTION- AND I THINK MAYBE.
EITHER OF YOU DOCTORS ON YOU
MENTIONED A LITTLE BIT ABOUT
ESCAPES I APOLOGIZE BUT- I MISS
THIS. YOU KNOW THE CDC JUST CAME
OUT WITH- SOME STATISTICS ON
YOUTH STA- RATES HAVE GONE UP IN
OUR OUR OUR YOUTH I'M TO KERR-
HAVE DECREASED THE USAGE OF
CONDOMS. ESPECIALLY IN A ROW
AREAS JUST RAN OFF YOU'VE YOUR
TEAM HAS BEEN ABLE TO LOOK INTO
THAT MOST RECENT CDC REPORT.
EARLY CONVERSATIONS REGARDING
THAT- I IT. LATER ON JAMES WHITE
WILL BE WILL BE I THINK HE'S
GONNA BE PERCENT LATER ON FROM
THE CENTER FOR INFECTIOUS
DISEASES I THINK HE CAN TELL YOU
THAT THE LATER. THAT WILL BE
PREPARED FOR THE SOMEONE PERFECT
OKAY THERE WERE GONNA MOVE INTO
A ISSUE TO COMMON. WERE THANK
YOU.
THE SIGN OKAY. A GOOD AFTERNOON
MADAM CHAIR AND MEMBERS OF THE
SUBCOMMITTEE MY NAME IS MELISSA
ELLIS I'M THE ASSISTANT DEPUTY
DIRECTOR OF OUR EMERGENCY
PREPAREDNESS OFFICE AT THE
CALIFORNIA DEPARTMENT OF PUBLIC
HEALTH. I AM SO FOR BUDGET YEAR
TWENTY THREE TWENTY FOUR C. PH
IS REQUESTING ONE HUNDRED AND
ONE POINT THREE MILLION DOLLARS.
TO CONTINUE THE STATE'S PUBLIC
HEALTH AND SAFETY RESPONSE
EFFORTS AGAINST COVERT NINETEEN.
THE FUNDS WILL SUPPORT PRIORITY
PANDEMIC RESPONSE EFFORTS THREE
JUNE OF TWENTY TWENTY FOUR.
SPECIFICALLY CDPH IS REQUESTING
A TWENTY EIGHT MILLION DOLLARS
TO PURCHASE TEST KITS FOR
VULNERABLE POPULATIONS. WE'VE
INCLUDED FIFTEEN MILLION DOLLARS
FOR OPERATIONS SUPPORT WHICH
INCLUDES CONSULTANTS AND
REDIRECTED STATE STAFF IN ORDER
TO SUPPORT CITY PH IS CONTINUED
RESPONSE FOR ACTIVITIES THAT
INCLUDE VACCINES THERAPEUTICS
TESTING AND DISTRIBUTION OF
SUPPLIES. CDPH WILL CONTINUE
SERVICE AGREEMENTS FOR THE
MEDICAL HEALTH COORDINATION
CENTER AND THE CDPH WAREHOUSE TO
SUPPORT RESPONSE TO AND RECOVERY
FROM THE PANDEMIC AND FINALLY
ONGOING LEGAL SETTLEMENT
SETTLEMENTS FOR COPING NINETEEN
RELATED LITIGATION. INCLUDING
CHALLENGES TO STATE PUBLIC
HEALTH ORDERS AND GUIDANCE. ALSO
INCLUDED IS FIVE MILLION DOLLARS
TO PROVIDE GRANT INCENTIVE
PROGRAMS THAT SUPPORT PEDIATRIC
PROVIDERS FOR ADMINISTERING
VACCINES TO CHILDREN UNDER FIVE
AND THREE MILLION DOLLARS FOR
THE PROVIDER CALL CENTER AND
TECHNICAL ASSISTANCE FOR LOCAL
HEALTH DEPARTMENTS AND PROVIDERS
. THERE'S ALSO THREE THREE
HUNDRED THOUSAND DOLLARS TO
SUPPORT IT INFRASTRUCTURE AND
FINALLY IT SHOULD IT BE NEEDED
CDPH IS REQUESTING FIFTY MILLION
DOLLARS IN EMERGENCY CONTINGENCY
FUNDS TO SUPPORT PANDEMIC
RESPONSE EFFORTS THAT EXCEED THE
ALREADY IDENTIFIED AREAS OF NEED
. AND I CAN PAUSE THERE I CAN GO
RIGHT INTO THE QUESTION. PLEASE
GO INTO THE QUESTION OKAY. I'M
SO THE RATIONALE FOR THE
REDUCTIONS- ALTHOUGH CDPH
RECEIVE NEARLY ONE POINT EIGHT
BILLION DOLLARS IN THE CURRENT
YEAR FOR COVERT NINETEEN
RESPONSE ACTIVITIES WE ARE
REFLECTING A PROPOSED BUDGET
ADJUSTMENT REDUCTION OF SIX
HUNDRED AND FOURTEEN MILLION
DOLLARS. TO MEET THIS BUDGET
ADJUSTMENT AND CURRENT YEAR CDPH
PLANS TO REDUCE SPENDING IN MANY
AREAS OF THE COVERT NINETEEN
RESPONSE. INCLUDING PUBLIC
TESTING ACTIVITIES THERAPEUTICS
AND STATE OPERATIONS SUPPORT.
ADDITIONALLY CDPH NO LONGER
PLANS TO UTILIZE THE M. TWO
HUNDRED AND FIFTY MILLION DOLLAR
CONTINGENCY FUNDS THAT WE WERE
AUTHORIZED TO SPEND THIS YEAR.
AND IN ADDITION THE CURRENT YEAR
BUDGET INCLUDES OVER FOUR
HUNDRED MILLION DOLLARS FOR THE
BORDER RESPONSE EFFORTS IN
SOUTHERN CALIFORNIA WHICH IS NOT
IN THE CDPH REQUEST FOR FUNDING
AND BUDGET YEAR. AND FOR THIS
REQUEST CDPH IS REQUESTING AGAIN
ONE HUNDRED AND ONE POINT THREE
MILLION DOLLARS AND TWENTY THREE
TWENTY FOUR. AS WE ANTICIPATE
MANY OF THE ONGOING COVERT
NINETEEN RESPONSE EFFORTS TO
EITHER WIND DOWN SUCH AS THE
GRADUAL DEMOBILIZATION OF
COMMUNITY TESTING SITES. THE
PUBLIC TESTING LAB NETWORK
STAFFING DEPLOYMENTS AND MANY
OTHER ACTIVITIES TO TRANSITION
TO THE HEALTHCARE SYSTEM SUCH AS
THERAPEUTICS AND VACCINE
ADMINISTRATION. CDPH ALSO PLANS
TO REDUCE OUR COVERT NINETEEN
RESPONSE ACTIVITIES BY REDUCING
OUR WASTE WATER SURVEILLANCE
FOOTPRINT. THE IMPACTS OF LONG
COVE IT AND OTHER LONG TERM
IMPACTS OF THE PANDEMIC.
REDUCING OUR CASE INVESTIGATION
AND CONTACT TRACING TEAMS
TRAINING AND ABILITY TO SEARCH
WITH DEPLOYED STAFF. ONE OF THE
MOST SIGNIFICANT REDUCTIONS IS
TESTING. PREVIOUSLY THE TESTING
EFFORT FOCUSED ON SUPPORTING
COMMUNITY TESTING SITES SCHOOLS
AND OTHER OUTBREAK RESPONSE
NEEDS AS WELL AS PURCHASING OVER
THE COUNTER ANTIGEN TEST. THIS
REQUEST SCALES ARE TESTING
RESPONSE TO PURCHASING A SMALLER
AMOUNT OF OVER THE COUNTER
ANTIGEN TEST FOR VULNERABLE
POPULATIONS. CDPH AS
SURVEILLANCE AND EPIDEMIOLOGY
CAPACITY WILL ALSO SCALE BACK
WITH THE REDUCTION AND REPORTING
FREQUENCY LESS DETAILED
EPIDEMIOLOGY INFORMATION. AND
LESS HOSPITAL IN VACCINE DATA
REPORTING IN ADDITION TO
DECREASING OUR AUTOMATION AND
DATA INTEGRATION CAPACITY. AS
WELL AS GOING BACK FOR MODELING
AND ADVANCED ANALYTIC CAPACITY.
THIS REQUEST FOR BUDGET YEAR
PRIORITIZES THE MOST CRITICAL
ACTIVITIES THAT NEED TO CONTINUE
SO THAT CALIFORNIA'S MOST
VULNERABLE POPULATIONS ARE
PROTECTED AND TO MAINTAIN A
STATE OF READINESS. TURNING OVER
TO OUR DEPARTMENT THERE LA
OPENING COMMENT. HI YES- WILL
LOANS- LMAO SO WE JUST WANT TO
NOTE THAT YOU KNOW WE BELIEVE
THAT ENSURING THAT APARTMENT HAS
SUFFICIENT RESOURCES TO RESPOND
TO ANY DEVELOPMENTS IN THE KOBE
NINETEEN PANDEMIC IS PRUDENT-
HOWEVER WE WOULD NOTE THAT THE
LEGISLATURE. MAY WANT TO
CONSIDER AND WEIGH THE NEED FOR
DEDICATED CONTINGENCY FUNDING
ESPECIALLY IN THE ERA OF UP
BUDGET SOLUTIONS- YOU KNOW WE
WOULD BE HAPPY TO WORK WITH THE
LEGISLATURE TO. YOU KNOW
CONSIDER ALTERNATIVE BUT BUDGET
LANGUAGE- TO ALLOW FOR THE
SPENDING OF FUNDS FOR
DEVELOPMENTS AS WELL AS TO
STRENGTHEN LEGISLATIVE OVERSIGHT
OF THOSE ADDITIONAL FUNDS. THANK
YOU SO MUCH I'M JUST
CLARIFICATION ON THE STOP HIM IN
THIS IS THE FIRST TIME WE TALK
ABOUT WORKFORCE. IS THE FIRST
LINE ITEM I SEE ZERO DOLLARS
HERE IS A BUTTE SPOKE ABOUT THE
OUTREACH TEAMS IS THAT WAY
BECAUSE YOU'RE PULLING THEM BACK
IN. YOU NO LONGER NEED THAT. THE
SECTION. SO WE'RE LOOKING AT I'M
SORRY NOTHING. OKAY RIGHT THAT
WAS OUR MEDICAL- MED SURGE
STAFFING. AND SO- WE'VE WE'RE
SIGNIFICANTLY SCALING OPERATION
BACK. SENATE WHAT DO YOU MEAN BY
YOUR MED SURGE LIKE PEOPLE WHO
ARE ON THE WARDS AND STUFF OR
PEOPLE IN HOSPITALS HEALTH CARE
. OKAY THAT WAS JUST FOR THAT
PART OKAY. ALL RIGHT DOES I
WOULDN'T AND I WOULD JUST LIKE
YOU KNOW TO THE CHAIR TO MAKE
SURE WE WORK WITH THE L. A. I'M
ALSO UNCOMFORTABLE WITH LIKE WE
I MEAN WE WERE CAUGHT A LITTLE
FLAT FOOTED AND I KNOW PUBLIC
HEALTH THAT THEY'RE GONNA GET A
WHOLE LOT MORE MONEY THAN. THAN
THAN THE BUDGET ALLOWED FOR YOU
AND SO IT DOESN'T SEEM TO ME TO
BE PRUDENT TO BE PULLING BACK
ANYTHING FROM PUBLIC HEALTH WHEN
WE KNOW WE STILL HAVE. S. T. D.
ISSUES WE STILL HAVE SUICIDE
ISSUES WE STILL HAVE A LOT OF
ISSUES THAT DIRECTLY RELATE TO
PUBLIC HEALTH- SO IT JUST
DOESN'T SEEM TO ME AT TO BE
PRUDENT FOR THIS TO BE AN AREA.
THAT THAT WOULD CUT BACK ON I
DON'T AND I DON'T KNOW IF THE
DEPARTMENT HAS FOLLOWED YOU
PROBABLY HAVE. SOME OF THE FIRST
ROUND. THEY'RE DOING. YOU KNOW
MASSIVE ASSESSMENTS OF. YOUNG
PEOPLE AND THEIR BEHAVIOR HEALTH
NEEDS AND WHAT THEY WOULD LIKE
TO SEE AND SOME OF THE THINGS
ARE JUST MORE. YOU KNOW LIKE
LIKE THINGS THAT WE TAKE FOR
GRANTED LIKE FRESH AIR. HAVING
PLACES TO PLAY OUTSIDE HAVING
ACTIVITIES SO THOSE KIND OF
THINGS THAT I SEE MUCH MORE
RELATED TO PUBLIC HEALTH. SO I
CERTAINLY HOPE THERE'S A ROLE
FOR THE PUBLIC HEALTH
DEPARTMENT- AS WE GO FORWARD
WITH NEW PLANS OF STANDING UP
THE WHOLE PLATFORM- FOR OUR
YOUNG PEOPLE'S MENTAL HEALTH
NEEDS. THANK YOU WE'RE GONNA
LEAVE THIS ITEM OPEN AND WE'RE
GONNA MOVE ON TO ISSUE NUMBER
THREE MAINTENANCE AND OPERATIONS
OF INFECTIOUS DISEASE DATA
CENTER. SYSTEMS SMARTER PLAN.
WE'RE JOINED ON ZOOM. BY JAMES
WHAT THE ASSISTANT DEPUTY
DIRECTOR FROM THE CENTER OF
INFECTIOUS DISEASE DEPARTMENT
PUBLIC HEALTH. GOOD AFTERNOON
MADAM CHAIR AND COMMITTEE
MEMBERS CAN YOU HEAR ME ALRIGHT
. YES THANK YOU VERY MUCH- I'M
GLAD TO PRESENT YOU THIS
AFTERNOON. THE CALIFORNIA
DEPARTMENT OF PUBLIC HEALTH
REQUESTS TO SEVENTY FOUR POINT
FOUR MILLION DOLLARS IN GENERAL
FUND. IN TWENTY TWENTY THREE
TWENTY FOUR FOR THE MAINTENANCE
AND OPERATIONS A CRITICAL
INFECTIOUS DISEASE STATUS
DOESN'T SYSTEMS ESTABLISHED
DURING THE COVER NINETEEN
PANDEMIC. THAT WILL CONTINUE TO
SUPPORT THE STATE'S EMERGENCY
PREPAREDNESS AND RESPONSE
EFFORTS AND DISEASE CONTROL WORK
FOR COVER NINETEEN AND OTHER
INFECTIOUS DISEASES. THIS
FUNDING WILL SUPPORT MAINTENANCE
AND OPERATIONS ARE TOO IMPORTANT
SYSTEMS THE CALIFORNIA CODE
REPORTING SYSTEM OR CC R. S.
WHICH HAS BEEN RENAMED SAPPHIRE.
AND HELP CONNECT THE STATE
SYSTEM FOR DISEASE INVESTIGATION
AND CONTACT TRACING. AS WELL AS
IT INFRASTRUCTURE AND SECURITY
COSTS. SO I WILL BRIEFLY
DESCRIBE THESE THREE ITEMS.
FIRST CDPH REQUESTS THIRTY POINT
NINE MILLION DOLLARS IN TWENTY
THREE TWENTY FOUR FOR
MAINTENANCE AND OPERATIONS OF
SAPPHIRE WHICH STANDS FOR THE
SURVEILLANCE AND PUBLIC HEALTH
INFORMATION RECORDING AN
EXCHANGE. SAPPHIRES A CORE
ELEMENT OF THE SYSTEM THAT CDPH
USES TO COLLECT DATA ON ALL
REPORTABLE DISEASES. SAPPHIRE
ENABLE CDPH TO RECEIVE
ELECTRONIC DATA MESSAGES FROM
LABORATORIES AND OTHER DATA SAID
MATTERS. THIS SYSTEM IS CRITICAL
TO DISEASE PREVENTION AND
CONTROL EFFORTS FOR COVERT
NINETEEN AND OTHER INFECTIOUS
DISEASES. AS WELL AS
PREPAREDNESS FOR FUTURE PANDEMIC
EMERGENCY RESPONSE. MORE THAN
THREE HUNDRED AND FIFTY DATA
SUBMITTERS ARE CONNECTED
DIRECTLY TO THE SYSTEM AND
SUBMITTING RESULTS ON BEHALF OF
THOUSANDS OF ENTITIES. CDPH
RECEIVED AN APPROPRIATION OF
TWENTY SIX POINT THREE MILLION
DOLLARS IN TWENTY TWO TWENTY
THREE TO PROVIDE ONE YEAR
FUNDING TO SUPPORT AND OPERATE
THE SYSTEM. THE ONE YEAR FUNDING
STRATEGY WAS DESIGNED TO ALLOW
CDPH TO OBTAIN UPDATED
MAINTENANCE AND OPERATIONS COSTS
THROUGH A RE COMPETITION FOR THE
SYSTEM. TWENTY TWENTY TWO CDPH
AND ENGAGED IN A NEW CHALLENGE
BASED PROCUREMENT PROCESS
RESULTING IN A CONTRACT WITH A
NEW VENDOR. THE TRANSITION
BETWEEN THE OLD AND NEW VENDOR.
WAS COMPLETED BY DECEMBER THIRTY
FIRST TWENTY TWENTY TWO AND IS
PART OF THE TRANSITION THE
SYSTEM WAS RENAMED TO SAPPHIRE
TO RECOGNIZE THAT IT RECEIVES
DATA FOR ALL REPORTABLE
CONDITIONS NOT JUST COVER
NINETEEN. SECOND CDPH REQUEST
THIRTY NINE POINT SEVEN MILLION
DOLLARS FOR TWENTY TO TWENTY
THREE. FOR TWENTY TWENTY THREE
TWENTY FOUR FOR MAINTENANCE AND
OPERATIONS OF CAL CONNECT. HOW
CONNECT IS CALIFORNIA'S SYSTEM
FOR CASE AN OUTBREAK
INVESTIGATION CONTACT TRACING.
MONITORING OF EXPOSED
INDIVIDUALS AND COMMUNICATION
WITH AFFECTED PERSONS. HOW
CONNECT WAS DEVELOPED DURING THE
PANDEMIC AND HAS NOW BEEN
EXPANDED TO SUPPORT THE M. PARKS
RESPONSE. IT HAS ALSO BEEN
UTILIZED FOR MONITORING PERSONS
EXPOSED TO AVIAN INFLUENZA AND
EBOLA VIRUS DISEASE. CDPH PLANS
TO LEVERAGE THE COW CONNECT
FUNCTIONALITY TO ADDRESS OTHER
PRIORITY CONDITIONS THAT REQUIRE
CASE INVESTIGATION AND CONTACT
TRACING. SUCH AS TUBERCULOSIS
HIV SYPHILIS PERINATAL HEPATITIS
B. AND MEASLES. CDPH RECEIVED AN
APPROPRIATION OF THIRTY NINE
POINT SIX MILLION DOLLARS IN
TWENTY TWO TWENTY THREE. TO
PROVIDE ONE YEAR FUNDING TO
SUPPORT MAINTENANCE AND
OPERATIONS OF CAL CONNECT. BUT
WHEN YOU'RE FUNDING STRATEGY WAS
DESIGNED TO ALLOW US AGAIN TO
UPDATE OUR COSTS FOR CAL CONNECT
THROUGH RE COMPETITION. WHICH WE
DID IN TWENTY TWENTY TWO
RESULTING IN A NEW CONTRACT WITH
THE EXISTING VENDOR. THIRD TO
SUPPORT DATA SYSTEM
MODERNIZATION EFFORTS CDPH
REQUEST THREE POINT EIGHT
MILLION DOLLARS IN TWENTY THREE
TWENTY FOUR. FOR LICENSING
MAINTENANCE AND SUPPORT OF THE
INFRASTRUCTURE AND SECURITY
PROTOCOLS NEEDED TO SUPPORT THE
PUBLIC HEALTH SURVEILLANCE AND
RESPONSE SYSTEMS AND
DEPARTMENTAL DATA INCLUDING
CONFIDENTIAL PROTECTED HEALTH
INFORMATION. THE FUNDING
REQUESTED IS IN THIS PROPOSAL IS
NEEDED TO MAINTAIN AND OPERATE
CDPH TECHNOLOGY INFRASTRUCTURE
IN ITS CURRENT STATE. SUPPORT
CRITICAL PUBLIC HEALTH SERVICES
STATEWIDE PREPARE FOR AND
RESPOND TO FUTURE PUBLIC HEALTH
EMERGENCIES AND TO LEVERAGE THE
TECHNOLOGY DEVELOPED FOR GROUP
COVERAGE NINETEEN. TO ADDRESS
OTHER CONDITIONS THAT IMPACT THE
PEOPLE OF CALIFORNIA. THANK YOU
. AND THERE WAS ONE QUESTION
THAT I'M HAPPY ANSWERS WELL OR
IF THERE ARE OTHER QUESTIONS NOW
I CAN PAUSE. GOOD AN ANSWER THAT
LAST QUESTION. GREAT THANK YOU
SO THE QUESTION WAS- THE
REQUESTED MAINTENANCE AND
OPERATIONS RESOURCES ARE ONLY
FOR TWENTY THREE TWENTY FOUR.
WHAT IS THE PLAN FOR ONGOING
MAINTENANCE AND OPERATIONS OF
THE SYSTEMS. SO THESE TWO
SYSTEMS ARE IN MAINTENANCE AND
OPERATIONS NOW IN THEIR PLAN TO
BE AN ONGOING PART OF THE CDPH
PORTFOLIO OF IT SYSTEMS. USED TO
MONITOR AND CONTROL REPORTABLE
DISEASE AS- WE PLAN TO REFINE
FUTURE COST ESTIMATES AS WE ARE
WORKING ON A DEPARTMENT WIDE IT
STRATEGIC PLANNING PROCESS IN
CONJUNCTION WITH THE FUTURE
PUBLIC HEALTH PLANNING. SO WE DO
ANTICIPATE SUBMITTING A FUTURE
FUNDING REQUEST BASED ON THESE
REFINED COST ESTIMATES. THANK
YOU- FROM THE FINANCE LA- ANY
COMMENT. HE HAS AN OPT OUT
DEPARTMENT OF FINANCE NOTHING
BAD RIGHT NOW. HE WILLANS LMAO
NO COMMENTS ON THIS PROPOSAL
OKAY- JAMES QUESTION HERE. I'M
ON THE REQUEST YOUR DO YOU HAVE
THE WORKFORCE IN PLACE TO MEET
THE MAINTENANCE FOR THE YEAR.
FOR THE FOR THE TWO SYSTEMS YES
- WE DID RECEIVE- FUNDING FOR
THE WORK FORCE FOR THE SYSTEMS
IN A PREVIOUS- PROPOSAL AND SO
WE ARE IN THE PROCESS. OF
BRINGING THOSE PEOPLE ONLINE
WE'VE ALREADY RUN ON A NUMBER OF
FOLKS AND WE'RE CONTINUING THAT
PROCESS. CENTER EGGMAN. GREAT
THANK YOU SO MUCH JAMES WE'RE
GONNA HOLD THIS ITEM OPEN AND
WE'RE GONNA MOVE ON TO ISSUE
NUMBER FOR THE PUBLIC HEALTH
WORKFORCE INVESTMENTS REVERSION
. WELCOME. HI GIVE A QUICK
SUMMARY OF THE CHANGES TO THE
VILLAGE CHIEF DEPUTY WITH PUBLIC
HEALTH- THIS CURRENT THE
PROPOSAL ELIMINATES FIVE MILLION
DOLLARS IN CURRENT YEAR FUNDING
OF THE TWENTY POINT EIGHT
MILLION FOR THESE PIPELINE
PROGRAMS IT DOES NOT INCLUDE THE
FIRST ONE ON THE LIST WHICH IS
THE PUBLIC HEALTH NURSE
CERTIFICATION FEES THAT'S NOT
PART OF THIS ONE. BUT IT DOES
INCLUDE THE PIPELINE PROGRAMS
INCLUDING THE UP SKILLING CAREER
LADDER FUNDING THE- PATHWAYS
PROGRAM THE MICROBIOLOGIST
TRAINING- THE LAB DIRECTOR
TRAINING AND THE EPIDEMIOLOGIST
KELLY I ASKED PROGRAM. AND SO
AND WE ARE IN THE PROCESS AND
CURRENT YEAR OF ADEN ALLOCATING
THESE FUNDS OUT WE HAVE PLANS
FOR THE CURRENT YEAR FUNDING BUT
IT DOES ELIMINATE FUNDING FOR
THE PIPELINE PROGRAMS IN THE
COMING YEAR- UPCOMING YEARS THAT
WAS PROMISED OVER THE- INTERNET
THE REGIONAL- RECOMMENDATION WAS
TWENTY POINT EIGHT MILLION IN
FUNDING. OVER- TWENTY THREE
TWENTY FOUR AM AND THEN TWENTY
FOUR TWENTY FIVE AND AGAIN A
SMALLER AMOUNT IN THE FOURTH
YEAR AND SO THIS WOULD ELIMINATE
THAT FUNDING AND THAT. A LOT
FINANCED TALK ABOUT SORT OF THE
TOUGH CHOICES THAT HAD TO BE
MADE WITH PRIORITIZATION OF ON
THE ON GOING FUTURE PUBLIC
HEALTH FUNDING- THE THREE
HUNDRED MILLION. BUT HAPPY TO
TAKE ANY QUESTIONS. TURNING OVER
. GOOD AFTER MADAM CHAIR NEXT TO
OF HIGH- I KEEP. OF THE
ADMINISTRATION'S APPROACH TO
ADDRESSING THE BUDGET PROBLEM
WITH HER PRIORITIZE ONGOING
COMMITMENTS APPROVED IN PREVIOUS
BUDGETS INCLUDING THOSE
COMMITMENTS FOR PUBLIC HEALTH
INFRASTRUCTURE AND STAFFING
RESOURCES. OF COURSE INCLUDE
THREE HUNDRED MILLION GENERAL
FUND ONGOING FOR STATE AND LOCAL
HEALTH DEPARTMENTS- A LARGE
PORTION OF WHICH WAS FOR NEW
STAFF- AS WELL AS ONGOING WORK
FORCE NOT SKILLING PROGRAMS
INCLUDED IN. LAST YEAR'S TWENTY
FIRST CENTURY PUBLIC HEALTH IT
PROPOSAL. GO AHEAD. YES- WILL
OWNS OHIO- SO WE WANT TO NOTE
THAT THE LEGISLATURE MAY WISH TO
EVALUATE HOW REDUCTION AND
PUBLIC HEALTH WORKFORCE
INITIATIVES- MAY ACTUALLY IMPACT
ITS BROADER GOALS OF ADDRESSING
THE STATE'S PUBLIC HEALTH
INFRASTRUCTURE. PARTICULARLY IN
LIGHT OF THE ONGOING THREE
HUNDRED MILLION. WE BELIEVE THAT
THE BUDGET SOLUTION MAY
UNDERCUT- THE STATE'S RECENT
EFFORTS IN THIS REGARD- IN
SUPPORTING THIS ONGOING-
INFRASTRUCTURE. THANK YOU SO
MUCH. COULD YOU SPEAK A LITTLE
BIT MORE ABOUT. HOW IMPACTFUL
THESE THESE- POSITIONS ARE WHAT
THEY DO HOW THEY HELP DURING THE
PANDEMIC AND- TWENTY NOTED OKAY
SACRAMENTO SO- I'LL TALK FIRST
ABOUT THE PATHWAYS PROGRAM WHICH
BRINGS IN PEOPLE FROM A VARIETY
OF BACKGROUNDS AND DIVERSE
BACKGROUNDS AND REALLY SERVES AS
A PIPELINE AND SOME OF. THE
FOLKS THAT COULD APPLY WOULD
INCLUDE SOME OF OUR CONTACT
TRACERS AND OTHER PEOPLE WHO
HAVE BEEN ASSISTING US
THROUGHOUT THE PANDEMIC- WE'VE
RECEIVED HUNDREDS OF
APPLICATIONS- FOR THE PATHWAYS
PROGRAM AND WERE ABLE TO- WITH
THE DOLLARS THAT WE GOTTEN
CURRENT YEAR. I AM FINE TWENTY
FIVE FELLOWS THAT WILL BE PLACED
ACROSS THE STATE- AND THEN KELLY
I **** FOR EPIDEMIOLOGISTS THAT
WOULD BE TRAINED ACROSS THE
STATE- AND WE HAVE ALREADY
ALLOCATED THAT MONEY FOR CURRENT
YEAR THE THREE POINT TWO
MILLION. THE CAREER LADDER AND
UPSKILLING IS MEANT TO YOU
REALLY HELP THE PEOPLE WHO ARE
ALREADY IN PUBLIC HEALTH BOTH
STATE AND LOCAL TO YOU- PROMOTE
AND GET TRAINING AND ADVANCEMENT
SOME OF WHICH- BE ABLE GO OUT
AND LOCAL ALLOCATIONS AND RIGHT
NOW WE GOT. A AND MANY MORE
APPLICANTS FOR TRAINING AND
EDUCATION SUPPORT AND FOR THE
CAREER LADDER AND FUNDING WE'VE
GOT I'M MORE THAN TWELVE POINT
SIX MILLION AND REQUESTS. I'M IN
THE CURRENT YEAR- AND WILL BE
ABLE TO AWARD TWO POINT TWO
MILLION UP THAT. I'M THE
MICROBIOLOGIST CERTAINLY A
SHORTAGE NO SHORTAGE THROUGHOUT
THE PANDEMIC IN TERMS OF THE
NEED FOR WITH LABORATORY- STAFF-
ONE OF OUR HARDEST POSITIONS TO
FILL ARE BOTH LAB-
MICROBIOLOGISTS AS WELL AS
LABORATORY DIRECTORS. WE HAVE A
LOT OF REQUIREMENTS FOR
LABORATORY DIRECTORS IN THE
STATE- THIS FUNDING ALLOWS ABOUT
TEN ALLOW DIRECTORS TO GO
THROUGH THE PROGRAM THE LAB
DIRECTOR TRAINING IT IS MULTI
YEAR. AND SO THIS WOULD ONLY
FUND THE FIRST YEAR OF- THAT
WAS- CANDIDATES. THAT WE POINT
TO WIN ONLY FUN FOR ONE YEAR.
YES I'M AT RIGHT NOW BECAUSE WE
RECEIVED A FIVE MILLION
REDUCTION IN CURRENT YEAR WE
HAVE TO POINT TO ALLOCATE. IT TO
THE LAB DIRECTORS. THANK YOU IN
CAN YOU CLARIFY ON WHY THE FIRST
ONE IS AN INCLUDED THE PUBLIC
HEALTH NURSE CERTIFICATION FEES
. I'VE I'VE OF WHAT FINANCE
COMMENT ON THAT ONE I THINK THAT
MIGHT BE H. KIND DONORS- THAT IS
CORRECT EVAN ALLEYS COMMON IS
THAT CORRECT- THAT WAS MONEY
THAT WAS INCLUDED IN THE
DEPARTMENT OF HEALTH CARE ACCESS
AND INFORMATION BUDGETS AS A
LIMITED TERM INVESTMENTS. THANK
YOU CENTERMAN. I JUST LIKE TO
SAY THAT I DON'T THINK THIS IS A
GOOD IDEA AT ALL- WORKFORCES ALL
WE'VE BEEN TALKING ABOUT THE
LACK OF- OUR PIPELINE SO
SOMETHING WE WANT TO CLOSE OUR
PARK LANE WE WANT TO RIP THE
RUNS OFFER A LADDER. ALL THE
THINGS THAT WE'VE WORKED TO- TO
DEVELOP. THAT WE'RE JUST GONNA
UNDO SO. I WOULD JUST SUGGEST
THE PARTNER FINANCING MIGHT BE
SOME OTHER PLACES THAT WE CAN
CUT BUT I DON'T THINK WORKFORCE
AND PROMOTING. RIGHT BECAUSE IT.
AND WE DID ALL THIS BECAUSE OF
MORE PATHWAYS PEOPLE HAVE MORE
OPPORTUNITIES THEY HAVE THE MORE
TRAINING THEY GET. THE MORE
THEY'RE HAPPY IN THEIR JOBS AND
THEY STAY THEY DON'T GET BURNED
OUT THEY DON'T LEAVE THEY DON'T
LEAVE BECAUSE THEY HAVE NO
OPPORTUNITIES. WE WERE DESPERATE
TRYING TO FIND. AT THESE
NAVIGATORS IN THESE CONTRACTS
RACERS AND NOW WE HAVE THEM AND
WE WANT TO CUT HIM LOOSE DOES IT
MAKES NO SENSE TO ME. AT ALL SO
I VOTE FOR REVERSION OF THE
REVERSION. YOU KNOW SAY YOU KNOW
THE FIRST THAT WE HAVE THROUGH
WEEKS AGO I STARTED WITH OPENING
REMARKS ON THE INTENT OF THE
BODY HERE IN STEP THREE. THIS
YEAR WE PROTECT THE WORK FORCE
AND REALLY LOOK INTO THE DELAYS
AND POTENTIAL CUTS IN THE
SITUATION. OF THE OF JANUARY
BUDGET AND I TOLD MY COLLEAGUE
INSANE THAT'S EXACTLY. EXACTLY
WHAT WE'LL DO AND ENSURE THAT WE
PROTECT THIS PIPELINE AND WILL
HAVE FOR THE CONVERSATION ON
THAT. FOR NOW WE'RE GOING TO
LEAVE THE ITEM OFTEN CONTINUE TO
ISSUE NUMBER FIVE. UNCOVER
NINETEEN WEBSITE INFORMATION.
TECHNOLOGY RESEARCH RESOURCES.
THANK YOU. THANK YOU SEE A
PERSON IS FINALLY.
GOOD AFTERNOON MADAM CHAIRWOMAN.
COMMITTEE MEMBERS MY NAME IS
TONY TRAN AND I WILL BE. I'LL BE
COVERING ISSUE FIVE- FROM- CDPH
IGST. WE ARE ASKING FOR A
CONTINUATION OF FUNDING FOR
PUBLIC HEALTH RESPONSE EFFORTS.
THAT SUPPORT SECURITY AND
TRANSLATION SERVICES TO OPTIMIZE
THE MAINTENANCE. OPERATION OF
THE COBIT NINETEEN WEBSITE. THE
COBY NINETEEN WEBSITE PROVIDES
THE ABILITY TO MAKE IMPROVE DATA
DRIVEN DECISIONS. BY STATE
DEPARTMENTS AND LEADERSHIP.
IMPROVE ACCESS TO KOBE NINETEEN
DATA BY CALIFORNIANS. THE
ABILITY FOR CALIFORNIANS TO
ACCESS PUBLIC HEALTH SERVICES.
FUNDING REQUEST GEN THREE
GENERAL FUND THREE LIMITED TERM
IT POSITIONS NINE HUNDRED
THOUSAND DOLLARS ANNUALLY FOR
PHYSICAL YEARS. TWENTY THREE
TWENTY FOUR TWENTY FOUR TWENTY
FIVE AND TWENTY FIVE TWENTY SIX.
WHICH INCLUDES LICENSING AND
OPERATING COST. YEAH THANK YOU
SO MUCH L. A. O. D. O. F. ANY
COMMENT. WE HAVE NO OTHER
COMMENTS ON THIS PROPOSAL THREE
I DON'T HAVE ANY COMMENTS OR
QUESTIONS. THANK YOU SO MUCH
WE'RE GONNA LEAVE THAT ITEM OPEN
AND MOVE ON TO ISSUE NUMBER SIX
AIDS DRUG ASSISTANCE PROGRAM
ESTIMATE THANK YOU THANK YOU SO
MUCH. WE'RE GOING TO BE
WELCOMING ON SOUMYA SURE REESE
CAP. WE JUST WANNA MAKE SURE YOU
ALL CAN HEAR ME OKAY YES PERFECT
GOOD AFTERNOON MADAM CHAIR
MEMBERS OF THE SENATE MY NAME IS
SIRIS CAMP AND I AM THE BRANCH
CHIEF WHO OVERSEES THE AIDS DRUG
ASSISTANCE PROGRAM. I AM GLAD TO
BE BEFORE YOU TO PROVIDE AN
OVERVIEW OF THE MAJOR CHANGES IN
THE AIDS DRUG ASSISTANCE PROGRAM
NOVEMBER ESTIMATE PACKAGE. JUST
FOR CONTEXT THE AIDS DRUG
ASSISTANCE PROGRAM MOST COMMONLY
REFERRED TO AS FEET APP PROVIDES
ACCESS TO LIFE SAVING
MEDICATIONS FOR ELIGIBLE
CALIFORNIA RESIDENTS LIVING WITH
HIV. WE ALSO PROVIDE ASSISTANCE
WITH COSTS RELATED TO PRE
EXPOSURE PROPHYLAXIS FOR CLIENTS
AT RISK FOR ACQUIRING HIV AND
POST EXPOSURE PROPHYLAXIS FOR
CLIENTS WHO MAY HAVE BEEN
EXPOSED TO HIV. EIGHT UP IS
FUNDED THROUGH THE FEDERAL TRUST
FUND AND THE EIGHT APPLE REBATE
FUND. FOR CURRENT YEAR THE
BUDGET ACT OF TWENTY TWENTY TWO
INCLUDED EIGHT OUTLOOK
ASSISTANCE FUNDING FOR FOUR
HUNDRED AND FIFTY FIVE POINT ONE
MILLION. THE REVISED CURRENT
YEAR BUDGET IS FOUR HUNDRED AND
FORTY POINT FIVE MILLION WHICH
IS A DECREASE OF FOURTEEN POINT
FIVE MILLION WHEN COMPARED TO
THE BUDGET ACT OF TWENTY TWENTY
TWO. THIS DECREASE IS DRIVEN
PRIMARILY BY LOWER LOWER
MEDICATION EXPENDITURES AND
PREMIUMS FOR ENSURE CLIENT
GROUPS CLIENT GROUPS THAN
PREVIOUSLY ESTIMATED. CHANGES TO
EIGHT APPS BUDGET AUTHORITY WHEN
COMPARED TO THE BUDGET ACTIVE
TWENTY TWENTY TO INCLUDE AN
INCREASE OF EIGHT POINT ONE
MILLION AND FEDERAL FUNDS. AND A
DECREASE AND TWENTY TWO POINT
SEVEN MILLION AND EIGHT AFTER
REBATE FUNDS. FOR BUDGET YEAR
PROPOSED EIGHT OUTLOOK
ASSISTANCE FUNDING FOR THE
BUDGET YEAR IS FOUR HUNDRED
FORTY POINT ONE MILLION WHICH IS
A DECREASE OF FOURTEEN POINT
NINE WHEN COMPARED TO THE BUDGET
ACT OF TWENTY TWENTY TWO. THIS
DECREASE IS DRIVEN PRIMARILY BY
A MEDIC CAL EXPANSIONS AND LOWER
MEDICATION EXPENDITURES AND
PREMIUMS FOR THE INSURED CLIENT
GROUPS THAN PREVIOUSLY
ESTIMATED. CHANGES TO THE EIGHT
APPS BUDGET AUTHORITY WHEN
COMPARED TO THE BUDGET ACT OF
TWENTY TWENTY TO INCLUDE AN
INCREASE OF TWENTY SIX POINT ONE
MILLION IN FEDERAL FUNDS AND A
DECREASE. OF SEVENTEEN POINT
FIVE MILLION AND EIGHT AFTER
REBATE FUNDS. I AM HAPPY TO
ADDRESS ANY QUESTIONS. THANK YOU
FOR QUESTIONS TURNED INTO A LEÓN
DEPARTMENT FINANCE FOR COMMENTS
NOTHING TO ADD THANK YOU. WE
HAVE NO COMMON ON THIS SITE. I
HAVE NO CLUE. CENTER EGGMAN HAS
ONE I WOULD JUST BE REMISS I
DIDN'T SAY HELLO TO SURGERIES
CAN. MY FORMER STUDENTS NICE TO
SEE YOU DOING GOOD WORK A NICE
TO SEE YOU. EGGMAN THAT'S
AWESOME. THANK WE'RE GONNA HOLD
THAT ITEM- OPEN WE'RE TO MOVE ON
TO ISSUE A SEVEN. CALIFORNIA
MOON IN THEY SAY SHE REGISTER AS
RELATED TO AB. SEVENTEEN NINETY
SEVEN. HI GOOD AFTERNOON MY NAME
IS ROB SCHECTER FROM CALIFORNIA
DEPARTMENT PUBLIC HEALTH
MUSICIAN BRANCH AND THANK YOU
FOR THE TIME TODAY- CALIFORNIA
HAS LONGSTANDING IMMUNIZATION
REGISTRY. A DATABASE OF BOTH
CHILDHOOD AND ADULT LIFE SPAN
IMMUNIZATION RECORDS- THAT HAS
BEEN LARGELY VOLUNTARY OVER THE
LAST DECADES- IN ITS EXISTENCE.
A FEW- A FEW PARTIES ARE
REQUIRED. TO REPORT BY LAW
INCLUDING PHARMACIES IN
CALIFORNIA AND- BOB FROM A
FEDERAL REQUIREMENT- COBEN
NINETEEN VACCINE DOSES ARE ALSO
REQUIRED TO GO IN EACH STATE'S
IMMUNIZATION REGISTRY.
CALIFORNIA'S IMPOSITION RAISE
YOUR CARE AS THAT WOULD IMPLY IS
SIMILAR TO IMMUNIZATION SYSTEMS
IN MUSICIAN PERMISSION SYSTEMS
AROUND THE COUNTRY- BIG OF. LAST
YEAR ASSEMBLY BILL ONE SEVEN
NINE SEVEN. WAS PASSED IN
CHAPTER WHICH AS ONE PROVISION
REQUIRES- IN IMMUNIZING
CALIFORNIA WEATHER IMMUNIZING
CHILDREN ADULTS REPORT THIS IS
INTO. IMITATION REGISTRY.
BECAUSE UP UNTIL NOW IT'S BEEN
LARGELY VOLUNTARY THERE ARE
STILL THOUSANDS OF PROVIDERS.
THANK WHO ARE NOT YET ON THE
SYSTEM. AND SO THE REFUND
REQUEST RELATED TO THE BILL IS
FOR ADDITIONAL STAFF AT CDPH TO
SUPPORT- A TO ON BOARD- THESE
PROVIDERS- NOW SUBJECT TO THE
REQUIREMENTS OF AB ONE SEVEN
NINE SEVEN SO A COMBINATION OF
SOME PART- SOME BAR TIME AND
FULL TIME STAFF OVER THE NEXT
YEARS. TO BUILD UP THIS
IMPORTANT INFORMATION SYSTEM-
SOME OF THE VALUE OF WHICH WAS
EVIDENT- HAS BEEN EVIDENT DURING
THAT THE CODEPENDENT MAKE SOME
OF YOU MAY HAVE SEEN OR HEARD OF
THE DIGITAL VACCINE RECORD.
WHICH INDIVIDUALS ONLINE CAN GET
PROOF RAPID PROOF OF THEIR
COMMON VACCINES FOR VARIOUS-
INTENT FOR OCCUPATIONAL OR TO
ATTEND EVENTS ARE FOR VARIOUS
PURPOSES AND THAT WAS TAPPING
INTO- TO THE DATA WITHIN WITHIN
THE DATABASE AND- EXAMPLE OF
WHAT. MORE CAN BE A CALL AS AS
MORE AND MORE DATA ENTERS THE
SYSTEM TO ADD TO THE HUNDREDS OF
MILLIONS OF RECORDS THAT ARE IN
THERE. THANK YOU FOR YOUR
ATTENTION AND HAPPY TO ANSWER
ANY QUESTIONS THANK YOU ROBERT
DEPARTMENT FINANCE ANY COMMENT.
AT THIRTY NOTHING TO HAVE A LEÓN
ACCOUNT- WE HAVE NO CONCERNS
WITH THIS PROPOSAL THANK YOU
ROBERT QUICK QUESTION I GOT MY
VACCINE AT A BA. AND I WOULD MY
INFORMATION WAS SENT UP BY AND
WAS IN ABLE TAXES THE DIGITAL
CARD IT WAS NEVER ENTERED IN.
THE GOVERNOR'S LOTTERY. BECAUSE
OF THAT- WOULD THIS IN FACT
CHANGE THAT. WOOD THE V. A. ALSO
BE A PART OF THE SYSTEM-
SEPARATE FROM THE ASSEMBLY BILL
AND THE CONSEQUENCES OF THE NEW
LAW. NEW STATUTES- THE- C. PH WE
ARE WORKING WITH THE VETERANS
ADMINISTRATION AND OTHER FEDERAL
PARTNERS TO- TO GET MORE MORE OF
THOSE FEDERAL SYSTEM DATA IS
INTO THE SYSTEM MILITARY. AND
FEDERAL SYSTEMS TO- SO PROVIDERS
HAVE ACCESS TO THOSE IS. AS YOU
OTHERS- TRAVEL AROUND THE STATE
ARE LOOKING FOR LOOKING FOR
RECORDS YOUR PROVIDERS ARE
LOOKING FOR THOSE RECORDS. I
WOULD BE REALLY INTERESTED IN
AND OUT WOULD LIKE TO KEEP IN
MIND THIS BECAUSE I WOULD LOVE
THE MY VETERAN PEERS TO ALSO BE
THEIR DATA. TO BE INCLUDED IN
HERE. SENATE WENT. WELL IT JUST
IT IN ADDITION TO THE CHAIR I
ALSO WASN'T ELIGIBLE TO WIN IN
THE LOTTERY EVEN THOUGH I PICKED
A BALL ONE DAY- BECAUSE MY WHOLE
COUNTY WASN'T WASN'T ENTERED AND
SO I THINK IN ADDITION TO
VETERANS SOME OF OUR MORE RULER.
OR- AREAS WITHOUT THIS SAME KIND
OF TECHNOLOGY. WE'RE NOT AND NOT
NOT THAT WE CARE ABOUT WINNING
THE BALL BUT JUST THAT EVERYBODY
NEEDS TO GO. TO THE DATA SYSTEM
SO AGAIN AS WE TALK ABOUT
REDUCING STAFF MEMBERS THIS IS I
THINK A GREAT EXAMPLE OF WHY WE
NEED TO CONTINUE TO KEEP OUR
PUBLIC HEALTH SYSTEM. AS HEALTHY
AS POSSIBLE. THANK YOU
APPRECIATE THE COMMENT AND OVER
THE LAST YEAR THROUGH THE
PANDEMIC WE'VE WE'VE WORKED TO
INTEGRATE ALL COUNTIES INTO THE
CENTRAL DATABASE. SO SORRY FOR
YEAH EVEN IF THEY DON'T HAVE A
FAX MACHINE. THANK YOU ROBERT
WE'RE GONNA HOLD THIS ITEM OPEN
WRITTEN AND MOVE ON TO ISSUE
EIGHT THE SENTINEL PROGRAM
GRANTS RELATED TO AB TWENTY
THREE SIX FIVE AND AVAILABILITY
OF FEDERAL TEST STRIPS. AND THE
LOCSIN. WE HAVE ONLINE ALEXANDER
ROTH. FROM THE HARM REDUCTANT
REDUCTION UNIT CHIEF DEPARTMENT
OF HEALTH. HI VERY MUCH. I WITH
THE CENTER FOR INFECTIOUS. AND I
CENTER AS WELL AS CENTER FOR
CAN. WERE FOR NOW. OVER FOUR
YEARS. FROM THE OPIATE
SETTLEMENTS TO SUPPORT TO
PROJECTS THAT WILL ADDRESS THE
OPIOID CRISIS. THE FIRST WILL
ISSUE SIX ONE TIME COMPETITIVE
GRANTS. TO REDUCE FEDERAL USE AN
OVERDOSE FOLLOWING THE
REQUIREMENTS OF THE AB TWENTY
THREE SIXTY FIVE. WHICH WAS
SIGNED INTO LAW LAST YEAR TO
ESTABLISH THIS PROJECT. THE
GRANTS WILL BE ALLOCATED BY
REGION TWO IN NORTHERN
CALIFORNIA TO AND CENTRAL VALLEY
TO IN SOUTHERN CALIFORNIA. WITH
THE GOAL OF SUPPORTING LOCAL
EFFORTS IN EDUCATION TESTING
RECOVERY AND SUPPORT SERVICES.
THE SECOND PROPOSAL WILL BUILD
ON TWO OF THE TOOLS THAT ARE
AVAILABLE TO HELP STEM THE
OVERDOSE CRISIS AND SAVE LIVES.
FIRST EXPAND THE NALOXONE
DISTRIBUTION WORK THAT'S
CURRENTLY BEING DONE BY THE
SIXTY EIGHT SYRINGE SERVICES
PROGRAMS IN CALIFORNIA. AND THEN
SO I CAN INCREASE ACCESS TO
MONTEZ STRIPS. THE CENTER FOR
INFECTIOUS DISEASES WILL ISSUE A
REQUEST FOR INFORMATION TO
EXPLORE INNOVATIVE APPROACHES TO
THAT WORK AND THEN USE THAT
INFORMATION TO ISSUE TWO ONE
TIME COMPETITIVE GRANTS. TO
ESTABLISH A LOW COST NALOXONE
SUPPLY FOR SYRINGE SERVICES
PROGRAMS AND EXPAND ACCESS. TO
FINAL TEST STRIPS THROUGHOUT THE
STATE. I'M HAPPY TO ANSWER ANY
THAT PEOPLE HAVE ABOUT THESE
PROPOSALS THANK YOU DEPARTMENT
OF FINANCE AND INCOMING. MAILS
BERMAN FINANCE SOMETHING FURTHER
TO ADD. HELLO WE HAVE NO
COMMENTS ON THIS PROPOSAL. GREAT
HAVE ANY QUESTIONS OR COMMENTS.
NONE ON OUR END. THANK YOU SO
MUCH WE'RE GOING TO HOLD THE
ITEM OPEN AND MOVE ON TO ISSUE
NUMBER NINE THE BABY BIG INFANT.
BODY WITH SOME TREATMENT AND
PREVENTION PROGRAM. GOOD
AFTERNOON MADAM CHAIR NOT A BOOK
COMMITTEE MEMBERS THANK YOU FOR
AT THAT TIME TO CONSIDER THIS
PROPOSAL THE CALIFORNIA
DEPARTMENT OF PUBLIC HEALTH IS
REQUESTING AUTHORITY TO. BURKE A
TOTAL OF SIXTY SEVEN POINT EIGHT
MILLION OF THE INSTANT BOXES AND
TREATMENT AND PREVENTION
PROGRAMS SPECIAL FUNDS OVER THE
NEXT FIVE YEARS WITH THE
MANUFACTURE AND DISTRIBUTION. A
BABY BIG CD PH IS UNIQUE FDA
APPROVED TREATMENT FOR IN THE
BOXES. THIS PROPOSAL IS SPECIFIC
TO THAT A BIT BOTULISM TREATMENT
AND PREVENTION PROGRAMS SPECIAL
FUNDS. WHICH HAS A HEALTHY
BALANCE ON GOING REVENUE AND
DOES NOT AFFECT THE GENERAL
FUND. BECAUSE IT'S PROVIDE A
BRIEF OVERVIEW OF THE PROPOSAL
IT'S A BACKGROUND THAT INTO
BOXES AND TREATMENT AND
PREVENTION PROGRAM IN A SPECIAL
FUNDS CAN COST YOU TO STOP
CONTAINED. STATURE IN. IN NINETY
SIX BY. EIGHTY SEX. OF YOU.
SEVEN TO SEVEN TWO NINE. AND
I'LL VERY THE BOX AND THIS THIS
COME FORM OF IN BOX IN THE NINE
STATES OF POTENTIALLY LIFE
THREATENING DISEASE. INCENTIVIZE
AND WAS FACT AS A NOVEL FOR IF
YOU HAVE AND CAL NINETEEN SIX.
PAGES LET IN. THIS DISEASE AND
FIND STATE STREET FOR- MANY
YEARS OF WORKING OCTOBER TWO
THREE- ALMOST TWENTY YEARS AGO.
THANK THE BOXES AND TREATMENT
AND PREVENT PROGRAM YOU SEE U.
S. FDA LICENSE STARTS. IN THE
PUBLIC'S ARE DRUG UNIT FIVE.
IMMUNOGLOBULIN AUSTIN AND AB.
FOR THE TREATMENT OF INFANT.
RECEIVED REDUCED OSCAR. STATE
TIME AND COST BABY FIVE THAN
NINE THOUSAND PER PIECE AND I
YOU TO BABYSIT TURNER. WITH
THEIR PARENTS ALMOST FOUR WEEKS
SOONER. I PEACHES ONLY SO OF
THIS. DRUG IN BIG BIG THE WHOLE
. ADDRESS OF INTO AND- INCREASE
UTILITY OF BABY BIG TREATMENT
ALSO. AND THIS CALLIN YEAR TO
TWENTY TWO YOU. KNOW.
ACTION DISTRIBUTION AT THE STATE
BIG. STFU CHEAP EXPENSIVE
BOTULISM. AND ADICIONAL
COMMENCES IN EXPENDITURES
REQUESTED AN INCREASE FROM THE
PREVIOUS REQUEST ARE YOU TAKE
INTO ACCOUNT INFLATION RELATED
INCREASES IN PERSONNEL OPERATING
AND REGULATORY COSTS AND THE
PRESIDENT THIRTY DOESN'T GET
SENT OVER ESTIMATES DOING TO THE
ON GOING MISALIGNMENT
MANUFACTURING. CALENDAR YEARS
WITH AGENCY FISCAL YEARS TO
PROVIDE SUFFICIENT AUTHORITY FOR
EXPENSES MOVING FROM MADE MAJOR
TO JULY AUGUST TIME FRAME.
ACOSTA BIG MAN FACT LEVY YOUR
CHARGED FOR TREATMENT WHICH I
PAID FOR HOUSE AND SIR BUT BY
THE SAID. THIS REASONS OF BIG
HAVE KIDS WE INCREASE AS MORE
CASE OF INTO BOX READY WRECKED.
THE NO FEE NEED THAT TIME
HOWEVER LET'S SEE MY THE TO
MANUFACTURE AND DISTRIBUTE
EXCEPT INCREASE THE TEACH YEARS
AS NEEDED TO OFFSET AND
INCREASES IN. IN. THANK YOU-
BERMAN FINANCING COMING NOTHING
TO ADD LEÓN TO COME WE HAVE NO
CONCERN WITH THIS. BECAUSE SHE'S
THE MET MAGIC PHRASE DOES NOT
AFFECT THE GENERAL HE GOT THANK
AND WENT. JUST ASK AND I'M- I
DON'T QUITE REALIZE WE HAVE THIS
BABY BIG BACHELORS EITHER WHICH
WHICH SPENT- DO WE ALSO DO WE DO
WE SELL IT WITH THE- ONLY MAKER
IN THE SO WONDERING IS- IS THERE
A WAY THAT IT CAN BE- TO SELL
SUSTAIN WITHOUT WITHOUT US COULD
TO A- YES PROGRAM IS A- IS BEING
. SO THE REVENUE THAT'S OF THE
C. CHARGED FOR THAT YOU ARE YOU
TO SYSTEM THE- OCCUR. IT JUST
REQUEST TO PULL OUT OF THAT BUT
NOT FOR TO BE ABLE TO FUND IT
OKAY. THANK YOU WHICH ASKING
FOR. AND IS HEALTHY THANK YOU
THANK YOU THANK YOU SO MUCH
WE'RE GONNA MOVE ON TO OUR NEXT
IS- LICENSURE OF CLEAN LAB JANET
. NOT GONNA PROJECT MICE TONGUE
. IT'S NICE TO- NOT TO ME WELL
HERE- IN CLINICAL REPORT.
BIOLAGE AS RELATED TO S. B.
TOXIC SEVEN. GOOD MANAGER IN-
HONORABLE CA MEMBERS ON BROWN
THOMAS. AND THE BRANCH BROUGHT
OF US. IN THE NEW SAN FOR LAB SO
. AND I'LL BE A IS YEAH. THE
GOVERNOR BUDGET WITH A MIND
INCREASE. IN SPENDING UP UP
HUNDRED TEN THOUSAND. OR FISH
YEAR TWENTY THREE TWENTY FOUR
FOR A SPECIAL FUNDED POSITION
WOOD MISTER TO LICENSE
CATEGORIES RATED BY SENATE BILL.
TWELVE SIXTY SEVEN. THE NEW
CATEGORIES OR CLINICAL
LABORATORY GENETICS. AND
CLINICAL REPRODUCTIVE BIOLOGY.
JUNE LABORATORY FIELDS THAT WERE
NOT PREVIOUSLY RECOGNIZED IT
STATE LAW. EACH CATEGORY WILL
HELP RENEW LICENSES. FOR
TRAINEES SCIENTIST DR LEVEL
DIRECTORS AND CONSULTANTS. THIS
BILL EXPANDED THE WORK SCOPE OF
LABORATORY GENETICISTS. WHO
INCLUDES STARTED GENETICS
GENETIC MOLECULAR BIOLOGY. AND
ALSO BIOCHEMICAL GENETICS THE
NEW LICENSES WILL REDUCE
TRAINING TIME. REQUIRED FOR
LICENSURE FOR LABORATORY
GENETICISTS AND EXPEDITE MOVING
TRAIN GENETICIST. INTO THE
LABORATORY WORKFORCE. THE BILL
ALSO ON LICENSURE REPORT FILE.
THESE ARE LABORATORY CHRIS. WHO
PROVIDE DIED NOT TESTS. NEEDED
TO DIE AND TREAT IN FOR TELL.
ENTERED PATIENTS DURING THE OF
THE SYSTEM REPRODUCTION. INTEL
THIS NEW CATEGORY WAS JUST. AS
SYSTEM REPRODUCTION FACILITIES
AT THE HIGHER GENERALIST
CLINICAL LAB SCIENTIST- PERFORM
THE ROBERT TESTING THIS REDUCE
THE AVAILABILITY OF CLINICAL LAB
SCIENTIST TO DO GENERAL AN
INFECTIOUS DISEASE TESTING AND
OTHER LABORATORIES. THE ADDITION
OF THESE LICENSE CATEGORIES
HOPES TO ADDRESS THE LABORATORY
WORK FOR SHORTAGE AND INCREASED
LABORATORY TESTING CAPACITY.
THIS BILL REQUIRES THE PROGRAM
TO ADMINISTER SIX NEW LICENSE
CHARGE IN THE TWO NEW LICENSE
CATEGORIES IN ORDER TO DO THIS
THE PROGRAM IS REQUESTING
FUNDING AUTHORITY FOR ONE P. Y.
YOU'RE HIRING EXAMINER WILL
HANDLE ADDITIONAL APPLICATIONS.
EXPECTED TO BE AROUND FIVE
HUNDRED FIFTY IN THE FIRST YEAR
THE EXAMINER WILL OVERSEE
PROCESSING OF LICENSURE
APPLICATIONS OR TRAINEES
CLINICAL LAB SCIENTIST DOCTOR
WOULD AGREE SPECIALIST. OVERSEE
APPROVAL OF CRAZY PROGRAMS AND
CERTIFICATION EXAMINATIONS. AND
BE THE OUTLOOK FOR LICENSURE
RENEWAL. EXAM ARE WILL ALSO WITH
THAT THE- OF. AFFORDABLE NEW PA
IN PROCEDURES AND REGULATIONS
AND PROVIDE ONGOING SUPPORT FOR
THE PROGRAM AND THE REGULATED
COMMUNITY. ON COMPLAINTS AND
QUESTIONS RELATED TO THE BILL
LICENSE CHARACTERS. THE PROGRAM
FORM THE REQUESTED PI OUT OF THE
ALL OUT THAT SPECIAL BOND. HELLO
THIS IS A PIECE PROGRAM AND THE
NEW POSITION WILL NOT BE FUNDED
OUT OF THE GENERAL FUND. THE
PROGRAM IS ONLY REQUESTING
SPENDING AND POSITION OF
AUTHORITY TO CREATE THE NEW
POSITION. PROGRAM DOES NOT
ANTICIPATE THAT IMPLEMENTATION
OF THIS BILL WILL REQUIRE
ADDITIONAL FUNDS TO COVER
ONGOING NINETY COSTS. IF THERE
ARE ANY THE PROGRAM EXPECTS THEM
TO BE MINIMAL. WE HAVE AN ONLINE
SYSTEM FOR ALL A LICENSE
CATEGORIES AND WE'VE ALREADY
CONVERTED IT TO ADD AND INCLUDE
THESE NEW. LICENSE CATEGORIES
AND PARKS. QUESTIONS PLEASE. THE
PROGRAM FINANCING COMING NOTHING
TO ADD HELLO- WE HAVEN'T
CONCERNS THIS PROPOSAL. I HAVE
NO QUESTIONS OR COMMENTS
ENTERTAINMENT SCENE ON HERE
WE'RE GONNA MOVE ON TO THE LAST
ISSUE IN THIS DEPARTMENT. IT'S
THE CALIFORNIA INTEGRATED BY TO
RECORD SYSTEM UPGRADES FOR DEATH
CERTIFICATE CONTENT AS IT
RELATES TO AB TWENTY FOUR THIRTY
SIX. WELCOME.
OKAY THANK GOOD AFTERNOON DAM
I'M THE STATE REGISTRAR THE
DEPUTY DIRECTOR FOR THE CENTER
FOR HEALTH STATISTICS AND
INFORMATICS. CDPH IS REQUESTING
GENERAL FUND EXPENDITURE
AUTHORITY OF FIVE HUNDRED AND
THIRTY SIX THOUSAND DOLLARS IN
TWENTY TWENTY THREE TWENTY
TWENTY FOUR TO MAKE CHANGES ON
INFORMATION. ON DEATH
CERTIFICATES PURSUANT TO AB.
TWENTY FOUR THIRTY SIX. ASSEMBLY
WE WILL BE REQUESTING EIGHTY
EIGHT THOUSAND DOLLARS TO
SUPPORT WIDENING UNIVERSITY OF
CALIFORNIA SAN DIEGO PROGRAMMER
AND ANALYST FOR A PERIOD OF
THREE MONTHS TO FOCUS SOLELY ON
THE SYSTEM UPDATES REQUIRED TO
MEET THE CHANGES IN STATUTE.
INCLUDING CHANGES TO THE
CERTIFICATE TEMPLATE AND USER
INTERFACE AND UPDATES TO DATA
FILE MAPPING. ADDITIONALLY WE
WOULD REQUEST FOUR HUNDRED AND
SEVENTY FIVE THOUSAND DOLLARS TO
SUPPORT FOR INDEPENDENT CONTRACT
STUFF FOR PERIOD OF FOUR AND A
HALF MONTHS TO ASSIST CDPH STAFF
WITH REQUIREMENTS GATHERING USER
ACCEPTANCE TESTING TRAINING
OUTREACH EMPLOYMENT PUT
IMPLEMENTATION PLANNING. AND
TRACKING AS THE STATE REGISTRAR
CDPH IS RESPONSIBLE FOR
REGISTERING EACH LIVE BIRTH
DEATH FETAL DEATH IN MARRIAGE.
KERR'S IN CALIFORNIA AND FOR
PROVIDING CERTIFIED COPIES OF
VITAL RECORDS TO THE PUBLIC.
CDPH ADMINISTERS VARIOUS
ELECTRONIC SYSTEMS THAT MAINTAIN
VITAL RECORDS INCLUDING THE
CALIFORNIA INTEGRATED VITAL
RECORDS SYSTEM IN COLLABORATION
WITH THE UNIVERSITY OF
CALIFORNIA SAN DIEGO. UCSD
PROVIDES REGULAR MAINTENANCE AND
OPERATIONS FUNCTIONS AND
SCHEDULE SYSTEMS ENHANCEMENTS
FOR FUNCTIONALITY AND
EFFICIENCY. UNDER CONTRACT WITH
CDPH. THIS BILL REQUIRES THE
CERTIFICATE OF DEATH TO INCLUDE
THE CURRENT FIRST AND MIDDLE
NAMES. BIRTH LAST NAMES AND THE
BIRTHPLACES OF PARENTS WITHOUT
ANY REFERENCE TO THE PARENTS
GENDERED RELATIONSHIP TO THE
DECEDENT. THE BILL WOULD REQUIRE
THE STATE REGISTER TO A
ELECTRONICALLY CAPTURE
INFORMATION ON THE PARENT'S
RELATIONSHIP TO THE DECEDENT.
AND ANY ADDITIONAL LAST NAMES
USED BY THE PARENTS WHICH WOULD
NOT BE TRANSCRIBED ON THE ACTUAL
HARD COPY OF THE DEATH
CERTIFICATE. BUT WOULD RATHER BE
COLLECTED ELECTRONICALLY. THE
BILL REQUIRES THE REGISTRAR TO
IMPLEMENT THE CHANGES NO LATER
THAN JULY FIRST TWENTY TWENTY
FOUR ANY QUESTIONS. DEPARTMENT
OF FINANCE IN THE COMING. A NOTE
NOTHING TO ADD. LA O. ANY
COMMENT WE HAVE NO CONCERNS WITH
THIS PROPOSAL. I JUST FOR.
BECAUSE I THOUGHT I UNDERSTOOD
AND THEN WHEN I LISTEN TO IF I
HAVE IT RIGHT CHECK. CURRENTLY
DEATH CERTIFICATES DON'T. THEY
DON'T HAVE A SECTION FOR MOM
MOTHER AND FATHER. BUT THEY DO
HAVE A SECTION CURRENTLY I
CALIFORNIA'S DEATH CERTIFICATES
IS A GENDERED LABEL OF MOTHER
AND FATHER THOU ART THERE IS
ALSO A SLASH AND IT SAYS PARENT
OR PARENTS- BUT I THE REVERSAL
DESIGNATION OF MOTHER AND FATHER
IN THIS WOULD JUST REMOVE THAT
JUST PUT FIRST LAST NAME.
CORRECT FINNERAN. RIGHT I MEAN
THE YOU KNOW TWO LESBIANS UP
HERE SO THIS WOULD BE VERY
HELPFUL. MAKE SURE ALL RIGHT.
WELL GREAT THANK YOU SO MUCH OF
PRESENTATION- WE'RE GONNA HOLD
THAT ITEM OPEN AND MOVE ON TO. I
LIED BEFORE THAT WAS IN THE LAST
THING THIS IS THE LAST THING
ISSUE TWELVE I'M PROPOSALS FOR
INVESTMENT- THE SUB COMMITTEE
HAS RECEIVED. THE FOLLOWING
PROPOSAL FOR INVESTMENT. IF WE
RECEIVED JUST ONE. AND THEN
WE'RE GOING TO BE HERE IN A
PRESENTATION ON THE HEPATITIS C.
VIRUS EQUITY ACCESS TO THE CARE
. ACCESS TO THE CARE AND
PRESENTING THIS PROPOSAL IS
GOING TO BE DAVID KILBURN
EXECUTIVE DIRECTOR OF THE AXIS
SUPPORT NETWORK HE WILL BE
ACCOMPANIED BY JESSICA HOPE. WHO
WAS CURED OF HCV. THROUGH A S.
AN AXIS THROUGH A SENSE SERVICES
AND WORKS AS AN H. C. B.
NAVIGATOR. FOR A PERFECT.
WELCOME GOOD AFTERNOON MY NAME
IS DAVID GILBERT HE SAID FROM
ACCESS SUPPORT NETWORK- THE AND
WE ARE REPRESENTING THE IN THE
EPIDEMICS COALITION AND I'M AS
YOU SAID EXECUTIVE DIRECTOR OF
ACCESS SUPPORT NETWORK WE SERVE.
SAN LUIS OBISPO MONTEREY AND
SANTA BARBARA COUNTIES- THANK
YOU FOR LETTING US BE HERE- IT'S
TALK ABOUT HEPATITIS C. NOW WE
HAVE A SIMPLE COST EFFECTIVE
CURE FOR HEPATITIS C. INTO SHORT
OF EIGHT TO TWELVE WEEKS RIGHT
NOW. IT'S BEEN AVAILABLE SINCE
TWO THOUSAND FOURTEEN BUT THE
EPIDEMIC CONTINUES TO GROW. CDC
REPORTED THAT IN TWO THOUSAND
TWENTY NEW CASES OF PEPSI AMONG
YOUNG PEOPLE BETWEEN TWENTY AND
THIRTY NINE WERE FOUR TIMES AS
HIGH AS THEY WERE TEN YEARS AGO
. AN ESTIMATED 40% OF PEOPLE
LIVING WITH PEPSI STILL ARE
UNAWARE THAT THEY HAVE IT.
BECAUSE LACK OF ACCESS TO
TESTING CARE AND TREATMENT HELPS
HE CONTINUES TO BE RESPONSIBLE
FOR MORE DEATHS. THAN THE SIXTY
REPORTABLE COMMUNICABLE DISEASES
COMBINED EXCLUDING COKE. THERE
ARE SIGNIFICANT DISPARITIES IN
NEW INFECTIONS AND BURDENS OF
UNTREATED HEPATITIS C. AMONG
THOSE. WHO ARE TRADITIONALLY NOT
CONNECTED TO OUR HEALTH CARE
SYSTEMS ESPECIALLY YOUNG PEOPLE
USING DRUGS. THE BY PARK
COMMUNITIES PEOPLE EXPERIENCING
HOMELESSNESS AND PEOPLE WITH
CARPOOL EXPERIENCE. WHAT PEOPLE
ARE DIAGNOSED THEIR SERIOUS
INEQUITIES IN WHO GETS TREATED.
ONE OF THREE INSURED PEOPLE GET
. ONLY ONE IN THREE INJURED
PEOPLE GET HI C. TREATMENT-
PEOPLE ENROLLED IN MEDICAID OR
46% LESS LIKELY TO GET TREATMENT
THAT THOSE WITH PRIVATE
INSURANCE. ARE MEDICAID
BENEFICIARIES- OF OTHER RACES
27% LESS LIKELY TO- GET
TREATMENT THAN WHITE RECIPIENTS.
IT'S CLEAR THAT WE'RE NOT DOING
ENOUGH RIGHT NOW. THE THIS
DISPROPORTIONATELY AFFECTS THE
VULNERABLE COMMUNITIES AND
SUPPORT AND SUPPORT PEOPLE
KNOWING THEIR HIV. STATUS IN
CURING THEM EVIDENCE BASED-
STRATEGIES ARE CLEAR THE
CALIFORNIA HEPATITIS C.
DEMONSTRATION PROJECTS-
HIGHLIGHTED THE NEED FOR
TARGETED OUTREACH. ARLINGTON
APPLICATION SERVICES FOR
PRIORITY POPULATIONS AT SITES
WHERE THEY'RE ALREADY GETTING.
CARE THOSE MIGHT INCLUDE SYRINGE
EXCHANGE PROGRAMS MOBILE HEALTH
VANS JAILS AND EMERGENCY ROOMS
AND MEDICATION ASSISTED
TREATMENT PROGRAMS. WE HAVE THE
OPPORTUNITY RIGHT NOW TO BUILD
ON THE WORK THE LOCAL HEALTH
JURISDICTIONS AND COMMUNITY
BASED ORGANIZATIONS LIKE A SAND
ALREADY YOU'RE DOING AN X. WITH
EXTREMELY LIMITED RESOURCES-
THAT ARE AVAILABLE RIGHT NOW.
BUT MORE RESOURCES ARE NECESSARY
TO MAKE SIGNIFICANT IMPACT PEPSI
HAS BEEN HISTORICALLY
UNDERFUNDED AT THE FEDERAL AND
STATE LEVEL THIS PROPOSAL WOULD
STRENGTHEN EXPAND PUBLIC HEALTH
SERVICES THAT CENTER AND SUPPORT
THE MOST VULNERABLE COMMUNITIES
AND INDIVIDUALS IN ACCESSING
CARE AND TREATMENT. THAT ARE CO
LOCATED AT PLACES WHERE PEOPLE
ARE ALREADY RECEIVING SERVICES
THIS IS A MINIMAL INVESTMENT
WOULD ALLOW US TO LEVERAGE
EXISTING SERVICES AND STRATEGIES
REDUCE INEQUITIES IMPROVE HEALTH
SAVE LIVES AND ULTIMATELY MOVE
CALIFORNIA CLOSER TO- ENDING THE
HABSI DEPUTY EMIC. I THINK THE
TIME IS NOW TO MOVE ON. OPERATIC
KIDDING HEPATITIS C. WE HAVE THE
CURE AND WE HAVE THE MEANS- WE
JUST NEED FUNDING. LET LIKE TO
ASK YOU JUST A CUT. EIGHT HI
CRUSH- MY NAME IS JESSICA AND
I'M WORKING I WORK AT ACCESS
SUPPORT NETWORK WITH DAVID. AND
I JUST WANTED TO SHARE MY STORY
AND- IN TWO THOUSAND TEN I WAS
DIAGNOSED WITH PEPSI I WOULD I
HAD. ONLY BEEN USING DRUGS FOR
SIX MONTHS AND I TESTED POSITIVE
AT THE TIME I WAS TWENTY TWO
YEAR OLD AND HOUSE MOTHER OF TWO
CHILDREN. AGES THREE AND SIX
MONTHS. AT THAT TIME I HAD LOST
CUSTODY OF MY CHILDREN AND I HAD
BEEN. WORKING ON REUNIFICATION
WITH THEM THE ONLY TREATMENT AT
THE TIME WAS INTERFERE ON. I HAD
HEARD IT WAS HORRIBLE IN MY
GIVING UP A YEAR OF MY LIFE
PUTTING PLANS OF REUNIFICATION
ON HOLD I WAS ON HOUSE WHERE
WOULD I. LIVE WHERE I COULD GO
THROUGH THIS. PEOPLE I KNEW WERE
ALMOST TIME FOR TREATMENT ON A
LOAN. AND AT THE END OF HEROES
AND NOT GUARANTEED. I WAS SO
YOUNG AND HAS SO MUCH MORE LIFE
TO LIVE. I FELT LIKE MY ONLY
OPTION WAS TO JUST CONTINUE
LIVING MY LIFE UNTIL I ACTUALLY
HAD NO CHOICE BUT TO TRIED
INTERFERON TREATMENTS. I MADE
SEVERAL OTHER TIMES TO ACCESS
TREATMENT EACH TIME IT WAS A
MONTHS LONG PROCESS TO GO TO
NOWHERE. EVERY TIME I ATTEMPT TO
THE AWKWARD CONVERSATION I WAS
SPACE THE JUDGMENT AND STIGMA.
NOT BEING ABLE TO TALK TO
MEDICAL PROVIDERS. OKAY ANSWERS
ROBBIA BREAST FEEDING MIGHT AT
YOUNGEST DAUGHTER. BECAUSE I WAS
SCARED OF TRANSMISSION. FINALLY
ANSWERED WORKING LIKE ACCESS
SUPPORT NETWORK. A LOCAL
COMMUNITY BASED AGENCY PROVIDING
HARM REDUCTION SERVICES AND HIV
INITIATIVE HCV SUPPORT SERVICES.
THEY HAD HCV TELL HEALTH CLINIC
I DID MANAGE INITIAL INTAKE A
MONTH LATER I HAD. MEDS IN EIGHT
WEEKS LATER I WAS HAVE SEEK A
FREE. THIS PROCESS IS NOT ONLY
CONVENIENT BUT IT DIDN'T HAVE
THE JUDGMENT STIGMA AND
BERRYESSA FACE SO MANY TIMES.
I'M NOT ADVOCATE FOR CLIENTS IN
A VARIETY OF SITUATIONS AND
LIVING WITH TYPE C. FREE. THANK
YOU FOR SHARING YOUR STORY YEAH.
WE'RE GOING TO TURN OVER TO
DEPARTMENT OF FINANCE FOR ANY
COMMON- NICK MILLS DEPARTMENT
FINANCE- FINANCES NOT EVALUATE
THIS REHEARSAL SO WE HAVE NO
POSITIONAL AND AT THIS TIME.
OKAY AND THEY'LL. I DON'T HAVE
ANY QUESTIONS CENTER I'M EGGMAN
. I JUST WANT TO SAY THANK YOU
TO BOTH YOU AND THINK YOU JUST
GO FOR TURN YOUR LIFE AROUND.
AND GETTING THE TREATMENT AND
THEN BEING BRAVE ENOUGH TO COME
UP HERE AND TESTIFIED TODAY- IT
MATTERS AND WE APPRECIATE IT-
ALL SHARE MY SPOUSE CONTRACTED.
HIV OR HEPATITIS C. WHILE
SERVING THE AS A MEDIC IN IN THE
MILITARY AND HAD IT FOR YEARS.
DIDN'T KNOW SHE HAD IT AND GAVE
BLOOD ROUTINELY EVERY SIX WEEKS
UNTIL THEY DEVELOP THE TEST SO
WHO KNOWS HOW MANY PEOPLE SHE
PASSED IT TO. BUT ALSO. REFUSE
TO TAKE THE INTERFERE ON DIDN'T
WANT ANYTHING TO DO WITH THAT.
UNTIL THE NEW TREATMENT CAME
ALONG AND LIKE YOU. IT IS JUST
IT'S GONE AWAY SHE GOT A LOT OF
OTHER MEDICAL PROBLEMS BUT THAT
NO LONGER REMAINS ONE OF A SO.
THANK YOU VERY MUCH FOR ADVOCACY
THANK YOU THANK YOU. REALLY
APPRECIATE IT. WE'RE GONNA. HOLD
THAT ITEM OPEN. NOW WE ARE GOING
TO BE MOVING ON TO PUBLIC
COMMENT. WILL NOT AS A REMINDER
TODAY'S PARTICIPANT NUMBER FOR
THOSE WHO ARE NOT IN PERSON WITH
US TODAY IS ONE EIGHT SEVEN
SEVEN. TWO TWO SIX. EIGHTY ONE
SIXTY THREE AND THE ACCESS CODE
ONCE AGAIN AT SEVEN THREE SIX
TWENTY EIGHT THIRTY FOUR. WILL
BEGIN FIRST WHAT WITNESSES HERE
IN ROOM A TWELVE HUNDRED. GO
AHEAD. GOOD AFTERNOON LINDA WAY
WITH WESTERN CENTER ON LAW AND
POVERTY REGARDING DEPARTMENT OF
HEALTH CARE SERVICES ITEMS WE
HAVE CONCERNS WITH THE POST
ELIGIBILITY TREATMENT AND INCOME
TVL. SPECIFICALLY CHANGING THE
TERM SHARE OF COST TO SPEND DOWN
OF EXCESS INCOME. IT'S A BIT
PREMATURE AND RECOMMEND WAITING
UNTIL A NEW TERMINOLOGY HAS BEEN
USER TESTED AND REVIEWED BY THE
WORK GROUP THAT WE APPRECIATE
THAT DEPARTMENT HAS ALREADY
COMMITTED TO DOING. WE ALSO
SUPPORT EXTENDING THE
COMPREHENSIVE PERINATAL SERVICES
PROGRAM BENEFIT WHICH PROVIDES
IMPORTANT SUPPORTIVE SERVICES
DURING PREGNANCY AND POST. AND
FINALLY SUPPORT FUNDING TO
INCREASE THE HOME UPKEEP
ALLOWANCE TO HELP LONG TERM CARE
RESIDENTS RETURNED TO THE
COMMUNITY THANK YOU. Q. GOOD
AFTERNOON BETSY ARMSTRONG ON
BEHALF OF THE COUNTY HEALTH
EXECUTIVES ASSOCIATION ON EMSA
ISSUE NUMBER FIVE REGARDING THE
EMS AUTHORITY DIRECTOR. AT CHECK
SUPPORTS THE TRAILER BILL IF
AMENDED- AND TO UPDATE EXISTING
STATUTE THAT ASSIGNS ANY
CLINICAL OR MEDICAL
RESPONSIBILITIES TO THE CHIEF
MEDICAL OFFICER AS WELL AS
LANGUAGE REQUIRING THAT THE
DIRECTOR. I CAN HAVE EXTENSIVE
EMS HEALTH OR PUBLIC HEALTH
EXPERIENCE WE THINK THIS IS AN
EQUITY OPPORTUNITY- TO FIELD A
BROADER AND MORE DIVERSE FIELD
OF CANDIDATES FOR THIS POSITION.
I'M ALSO HERE TODAY ON BEHALF OF
THE EMS ADMINISTRATORS
ASSOCIATION THEY ARE SUPPORTING
CONCEPT BUT SHARE- THE
AMENDMENTS THAT WE'VE SUGGESTED
THANK YOU THANK YOU. GOOD
AFTERNOON MICHELLE GIVENS AT THE
COUNTY HEALTH EXECUTIVES
ASSOCIATION AS WELL- ON ISSUE
FOR UNDER CD P. H. CHECK
RESPECTFULLY OPPOSES THE
ADMISSION ADMINISTRATION'S
PROPOSAL TO CUT ROUGHLY FIFTY
MILLION DOLLARS FROM PUBLIC
HEALTH WORKFORCE TRAINING AND
DEVELOPMENT PROGRAMS. A LOCAL
HEALTH DEPARTMENTS CONTINUE TO
EXPERIENCE DEPARTURES AND WE'RE
EXPERIENCING HIRING CHALLENGES
IN TERMS OF GETTING PEOPLE INTO
THE FIELD OF PUBLIC HEALTH AS
WELL WE CAN'T WAIT TO PREPARE
FOR THE NEXT CRISIS AND THAT
NEXT AT TO BE PREPARED IT. IS
DEPENDENT ON A WORK FORCE SO IF
WE DON'T HAVE A PIPELINE WE
DON'T HAVE ANY LEVEL OF
PREPAREDNESS AND SO WE WOULD
HOPE THAT THE LEGISLATURE WOULD
JOIN US WE APPRECIATE THE
COMMENTS- IN REJECTING THE
PROPOSAL THERE. AN ISSUE NINE
UNDER DH CS RELATED TO THE WHOLE
CHILD MODEL. CHECK RESPECTFULLY
OPPOSES THE ADMINISTRATION'S
PROPOSAL TO EXPAND. THE PRIOR
LEGISLATION IMPLEMENTED THE
WHOLE CHILD MODEL IS VERY CLEAR
AND EVALUATION WOULD NEED TO
COME FORTH THAT EVALUATION WILL
DETERMINE WHETHER THE EXPANSION
WOULD CONTINUE. THE EXPANSION
WAS NOT CONTINGENT ON ADDITIONAL
JURISDICTIONS ENTERING INTO A
COUNTY ORGANIZED HEALTH SYSTEM
MODEL OF CARE. IT WAS NOT
CONTINGENT ON SINGLE PLAN YOU
KNOW WOOD COUNTY OPTING FOR A
SINGLE PLAN MODEL SO WHEN THE
ADMINISTRATION SAYS. YOU KNOW WE
ARE DOING THIS TO BE CONSISTENT
THAT IS NOT THE NATURE OF WHAT
THAT IMPLEMENTING LEGISLATION
WAS FORCED TO WE HAVE CONCERNS
THERE. WE ALSO JUST WANNA REMIND
FOLKS AT THIS IS IT THIS
INVOLVES CUTS TO OUR COUNTY
STAFF FOLKS WHO ARE PUBLIC
HEALTH NURSES WHO HAVE BEEN
WORKING HAND IN HAND CASE
MANAGING THESE VERY VULNERABLE
KIDS. THAT EXPERTISE WOULD BE
LOST IS THAT TRANSITION HAPPENS
AS WELL. AND THE OTHER THING
THAT I WOULD JUST MENTION IS ON
ISSUE FOR UNDER DH CS WE ARE
CONCERNED ABOUT THE STATE'S
CALCULATION OF THE CCS
ADMINISTRATIVE RATE THAT COMES
TO COUNTIES. AT WE JUST RECENTLY
WERE BRIEFED ON THIS AND WHAT WE
HAVE DETERMINED IS THAT THERE'S
A FORECASTING METHODOLOGY THAT
DOESN'T REALLY TAKE INTO ACCOUNT
THE ACTUAL EXPERIENCE AT THE
COUNTY LEVEL. SO THE COST I'M
JUST THROWING OUT NUMBERS
HUNDRED DOLLARS BUT THE FISCAL
FORECASTING METHODOLOGY SAYS
THERE'S FIFTY DOLLARS
EVERYBODY'S PROPORTIONATELY
TAKING A HIT. AT JUST TO GET TO
THE FIFTY DOLLAR LEVEL AS THE
STARTING POINT OF WHAT'S
AVAILABLE ACROSS THE STATE
THAT'S REALLY PROBLEMATIC
BECAUSE IT'S NOT RIGHT SIZING TO
WHAT IT ACTUALLY COSTS TO DO AS-
SO. YOUR TIME THANK YOU THANK
YOU SO. GOOD AFTERNOON MADAM
CHAIR AMY BLOOMBERG ON BEHALF OF
THE CALIFORNIA CHILDREN'S
HOSPITAL ASSOCIATION. ALSO
TESTIFYING IN OPPOSITION TO DH
CS AGENDA ITEM NINE. THE TRAILER
BILL TO EXPAND THAT CALIFORNIA
CHILLIN CHILDREN SERVICES WHOLE
CHILD MODEL. THE CALIFORNIA
CHILDREN'S SERVICES PROGRAM
TREATS CALIFORNIA'S MOST
VULNERABLE CHILDREN AND YOUTH.
WITH CONDITIONS LIKE EPILEPSY
SICKLE CELL DISEASE CYSTIC
FIBROSIS AND CANCER. AND SETS
IMPORTANT QUALITY STANDARDS FOR
SPECIALTY CARE. WE REALLY
APPRECIATE THE COMMITTEE'S
COMMENTS- AND QUESTIONS THAT
THEY REYES DURING THIS
DISCUSSION. THE WHOLE TOLD
MODELS BEEN IN OPERATION AND
TWENTY ONE COUNTIES OVER THE
PAST FOUR YEARS AND HAS NOT
LIVED UP TO THE PROMISE. OF
EITHER EXCEEDING OR PROVIDING
COMPATIBLE SERVICES TO THAT OF
THE CLASSIC CCS PROGRAM. KEY
CONCERNS INCLUDE A DECREASE IN
ENROLLMENT CCS WHERE WHOLE CHILD
MODEL HAS GONE INTO EFFECT. THE
LOSS OF EXPERT CCS CASE
MANAGEMENT SERVICES AND THE
SIGNIFICANT NEGATIVE FINANCIAL
IMPACT TO CHILDREN'S HOSPITALS
UNDER THIS MODEL. WHICH
THREATENS ACCESS TO CARE FOR
THIS FRAGILE PATIENT POPULATION.
UNDER WHOLE CHILD MODEL
HOSPITALS RECEIVE LESS FUNDING
UNDER THE STATE'S HOSPITAL
QUALITY ASSURANCE FEE YOUR
PROVIDER FEE. UNDER THE FEE
HOSPITAL'S TAX THEMSELVES TO
DRAW DOWN FEDERAL MEDICAID FUNDS
REVENUE FROM THE PROGRAM IS USED
TO HELP OFFSET MEDIC HOUSE
EXTREMELY LOW REIMBURSEMENT
RATES. AND FUNDS ARE TARGETED
TARGETED TO HIGH VOLUME
HOSPITALS HI MEDIKAL VOLUME
HOSPITALS OF WHICH CHILDREN'S
HOSPITALS ARE SOME OF THE
HIGHEST. IMPORTANTLY THE FEE
INCLUDES AN ACUITY ADJUSTMENT
FOR OUTPATIENT SERVICES BUT THIS
ADJUSTMENT GOES AWAY WHEN THE
OUTPATIENT CCS SERVICES ARE
PROVIDED AND MANAGED CARE.
ALREADY AN EXISTING WHOLE CHILD
MODEL COUNTIES ARE HOSPITALS ARE
BEGINNING TO FEEL THE LOSS OF
REVENUE CHOC CHILDREN'S IN
ORANGE COUNTY ESTIMATES THE
ANNUAL IMPACT A WHOLE CHILD
MODEL WILL RESULT IN A LOSS OF.
TWENTY MILLION DOLLARS STARTING
THIS YEAR. AT THE TRAILER BILLS
APPROVED OAKLAND CHILDREN'S
CONCEDED CUT OF TWENTY MILLION
DOLLARS ANNUALLY. CHILDREN'S
HOSPITALS. CANNOT ABSORB THESE
CUTS. WELL DH CS AS GUESTS YET
TO RELEASE WHOLE CHILD MODEL OF.
MANDATED UNDER SB FIVE EIGHTY
SIX A PREVIEW OF RESULTS
SUBSTANTIATES MANY OF THE
QUALITY AND ACCESS CONCERNS WE
HAVE. THIS PROPOSAL DOES NOT
RESULT IN ANY COST SAVINGS TO
THE STATE AND EXPANSION OF THE
WHOLE CHILD MODEL IS PREMATURE.
FOR THESE REASONS WE URGE THE
COMMITTEE TO REJECT THE PROPOSAL
THANK YOU THANK YOU VERY MUCH.
GOOD AFTERNOON MADAM CHAIR YES
MEAN COLORED WITH JUSTICE IN
AGING I'M HERE TO UPLIFT OUR
STAKEHOLDER PROPOSAL AN ISSUE
TEND TO INCREASE THE HOME UPKEEP
ALLOWANCE TO ACTUAL HOUSING
COSTS OF TWO HUNDRED THIRTY
EIGHT PERCENT. OF THE FEDERAL
POVERTY LEVEL. RIGHT NOW LONG
TERM CARE RESIDENTS RISK LOSING
THEIR HOW THEIR HOMES BECAUSE
THEY'RE ONLY ALLOWED TO KEEP TWO
HUNDRED NINE DOLLARS A MONTH TO
PRESERVE THEIR HOUSING. GIVEN
CALIFORNIA'S HIGH COST OF LIVING
THE CURRENT AMOUNT IS NOT
SUBSTANTIAL ENOUGH TO UPKEEP OF
THE HOME AND RESIDENTS RISK
LOSING THEIR HOUSING AND
THEREFORE BEING PERMANENTLY
INSTITUTIONALIZED OR HOMELESS.
INCREASING THE HOME UPKEEP
ALLOWANCES A COMMON SENSE
APPROACH TO PRESERVING HOUSING
FOR NURSES NURSING HOME
RESIDENTS SO THEY CAN RETURN
HOME AFTER SIX MONTHS. I'D ALSO
LIKE TO THANK THE DEPARTMENT FOR
THEIR GREAT WORK IN IMPLEMENTING
THE EXPANSION OF MEDICAL TO
OLDER ADULTS AGE FIFTY. AND
OLDER REGARDLESS OF IMMIGRATION
STATUS AND THE LEGISLATURE'S
CONTINUED COMMITMENT TO THIS
EXPANSION. I'D ALSO LIKE TO
THANK THE DEPARTMENT OF THE
LEGISLATURE FOR THE COMMITMENT
TO REFORMING THE SHARE OF COST
PROGRAM. TO IMPROVE
AFFORDABILITY OF MEDICO AS MISS
CELLPHONE TESTIFIED. WHO IN
CALIFORNIA CAN LIVE ON SIX
HUNDRED DOLLARS A MONTH AND I'D
URGE THAT WE REALLY. MAKE SURE
THAT WE CAN IMPLEMENT THAT
STARTING IN TWENTY TWENTY FIVE
AS THE BUDGET- SAID LAST YEAR.
HOWEVER WE DO HAVE CONCERNS
ABOUT THE T. B. O. AN ISSUE FIVE
REGARDING CHANGING THE NAME OF
THE SHARE OF COST PROGRAM AND WE
LOOK FORWARD TO WORKING WITH THE
DEPARTMENT- TO COME TO A
MUTUALLY AGREEABLE. NAME AND
FINALLY WOULD LIKE TO THANK THE
DEPARTMENT FOR THEIR WORK- AND
THE LEGISLATURE ON ELIMINATING
THE ASSET TEST AND THE
ANNOUNCEMENT THAT JUST CAME OUT
YESTERDAY. ON LIMITING THE TURN
IN THE REDETERMINATION PROCESS
THANK YOU VERY MUCH THANK YOU.
GOOD AFTERNOON MADAM CHAIR
JENNIFER SNYDER ON BEHALF OF
CITY OF HOPE. AND WE'RE HERE AT
TODAY IN SUPPORT OF A DH CS
ISSUE ITEM NUMBER SEVEN- WHICH
PROVIDES- IT'S A B. C. P. FROM
THE DEPARTMENT OF HEALTH CARE
SERVICES REGARDING
IMPLEMENTATION OF SB NINE EIGHT
SEVEN. I'M CITY OF HOPE ALONG
WITH TWELVE OTHER ORGANIZATIONS
AS STRONGLY SUPPORTED SENATOR
PORTANTINO'S BILL WHICH WAS SB
NINE EIGHT SEVEN LAST YEAR. WHAT
IT DOES IT DOES TWO THINGS IT
MAKE SURE THAT- HEALTH CARE
MANAGED CARE PLANS IN THE
MEDICARE PROGRAM. A MAKE GOOD
FAITH EFFORTS TO CONTRACT WITH
AN NCI DESIGNATED COMPREHENSIVE
CANCER CENTER. AND THEN IT ALSO
MAKE SURE THE MEDIC HELP
RECIPIENTS CAN ACCESS FOR
REFERRAL TO THOSE CANCER CENTERS
WHEN THEY HAVE A COMPLEX CANCER
DIAGNOSIS. WE WERE THRILLED TO
SEE THAT THE DEPARTMENT IS VERY
INTERESTED IN MAKING SURE THAT
THEY MONITOR THIS PROGRAM. AND
THE FUNDS THAT THEY HAVE-
REQUESTED WE THINK WILL ENSURE
THAT THEY CAN MAKE SURE THAT
MANAGED CARE PLANS MAKE THOSE
GOOD FAITH EFFORTS. ON THAT
MEDICARE PATIENTS WILL. GET
ACCEPTED REFERRALS AND THEY WILL
GET ACCESS TO THESE NCI
DESIGNATED COMPREHENSIVE CANCER
CENTERS FOR CLINICAL TRIALS FOR
GENETIC GENETIC GENOMIC TESTING-
CUTTING EDGE- DISEASE
MANAGEMENT- AND WE JUST REALLY
ARE ARE WANT TO BE SECURE IN
SUPPORT TODAY ON BEHALF OF. OUR
ENTIRE COALITION SENT THANK YOU
VERY MUCH GREAT THANK YOU.
VENTURE MEMBERS RAND MARTIN HERE
ON BEHALF OF ARYANA HEALTH CARE
WHICH IS ONE OF THE LARGEST
PROVIDERS OF IN HOME. HEALTH
CARE FOR- FOR CHILDREN'S COMPLEX
MEDICAL CONDITIONS I'M HERE FOR
YOUR CONSIDERATION AS YOU WORK
THROUGH THE CUT THROUGH THE
MEDIC CAL BUDGET. I'M FOR THE
PROPOSAL TO INCREASE THE MEDIC
CAL RATE- FOR PDN SERVICES BY
ABOUT FORTY PERCENT. I'M WE'RE
FACING A MAJOR CRISIS IN THAT
INDUSTRY BECAUSE KIDS ARE STUCK
IN THE HOSPITAL ARE NOT ABLE TO
MOVE INTO THE HOME BECAUSE THERE
ARE NOT ENOUGH AUTHORIZED HOURS
AND NOT ENOUGH NURSES OUT THERE.
TO PROVIDE THOSE SERVICES- WE
THINK THAT WITH AN INCREASE IN
THE RATE THAT I'M HAS BEEN
STATIC NOW FOR ABOUT FIVE YEARS.
AND THAT WILL BE ABLE TO- DEAL
WITH THE NURSES SHORTAGE- GET
MORE KIDS OUT INTO- GET GET THEM
OUT OF THE INSTITUTIONS AND INTO
THE- INTO THE HOME WHERE WHERE
THEY BELONG- WANT TO POINT OUT
THAT UNLIKE MOST BUDGET
PROPOSALS THIS ONE ACTUALLY
COMES WITH A SAVINGS TO THE
STATE. WHEN YOU'RE TALKING ABOUT
IN STE INSTITUTIONAL CARE AT TEN
THOUSAND DOLLARS A DAY AS
OPPOSED TO. IN HOME CARE WHICH
IS MAXES OUT AT ABOUT FIFTEEN
HUNDRED DOLLARS A DAY YOU'RE
SAVING A LOT OF MONEY IF YOU GET
THE KIDS OUT OF THE INSTITUTION
AND INTO THE HOME. ENCOURAGE YOU
TO CONSIDER THAT AS YOU'RE
MOVING FORWARD THANK YOU THANK
YOU. THANK YOU MADAM CHAIR MEGAN
SUPERS ON BEHALF OF TWO
DIFFERENT CLIENTS THAT WOULD
LIKE TO MAKE COMMENTS TODAY A
FIRST ON BEHALF OF THE
CALIFORNIA PRIMARY CARE
ASSOCIATION CALIFORNIA HEALTH
PLUS ADVOCATES THE COMMUNITY
CLINICS AND HEALTH CENTERS.
WOULD LIKE TO ACKNOWLEDGE- WHEN
THE ADDITIONAL PROPOSALS FOR
INVESTMENT UNDER ITEM NUMBER TEN
UNDER THE DEPARTMENT OF HEALTH
CARE SERVICES. TO RE TO INVEST
AN ADDITIONAL SIXTY MILLION
DOLLARS TO THE HEALTH NAVIGATION
PROGRAM. BETWEEN NOW AND ABOUT
JUNE OF TWENTY TWENTY FOUR THERE
ARE OVER FIFTEEN MILLION MEDIC
CAL PATIENTS THAT ARE EITHER
GOING TO. NEED TO RECERTIFY DUE
TO THE- EXPIRATION OF THE PUBLIC
HEALTH EMERGENCY OR WILL BE
NEWLY. ELIGIBLE BECAUSE OF
HEALTH CARE. FOR ALL EXPANSION
WHICH WERE VERY SUPPORTIVE OF
THE HEALTH NAVIGATION PROGRAM AS
WE UNDERSTAND IT HAD SIXTY
MILLION ALLOCATED LAST YEAR. AND
THE STATE RECEIVED OVER TWICE
THAT AMOUNT OF REQUESTS SO THAT
INITIAL SIXTY MILLION HAS BEEN
USED IN VENUES FOR VERY GOOD
PURPOSE- THE HEALTH NAVIGATION
PROGRAM ALLOWS HEALTH CENTERS TO
PARTNER WITH COUNTIES TO. ACT AS
AN AUTHORIZED REPRESENTATIVE OF
THE PATIENT AND REALLY I WORK
HAND IN HAND WITH THE COUNTY TO
MAKE SURE THAT FOLKS. UNDERSTAND
THE APPLICATION PROCESS CAN BE
LINKED TO LEGAL SERVICES THAT
THEY HAVE QUESTION ABOUT THEIR
IMMIGRATION STATUS. I'M AND
REALLY MAKE SURE THAT NOBODY IS
LOSING COVERAGE- DO DUE TO THE
EXPIRATION OF THE PUBLIC HEALTH
EMERGENCY AND THE ADDITIONAL
FOLKS THAT ARE GOING TO BE
ELIGIBLE- OTHER SECOND KLEIN ON
BEHALF OF THE CALIFORNIA
PROFESSIONAL FIREFIGHTERS WANT
TO EXPRESS OUR STRONG SUPPORT
FOR. I'M ISSUE NUMBER FIVE UNDER
AND STUFF- AND THE CHANGES TO
THE QUALIFICATIONS FOR THE
DIRECTOR OF EMSA- WE THINK THIS
MAKES SENSE- TO THE POINT RAISED
EARLIER THIS WILL EXPAND THE
POOL OF CANDIDATES THAT WOULD BE
ELIGIBLE. REALLY LUPIN THAT
PUBLIC HEALTH ADMINISTRATION
PERSPECTIVE WHILE COUPLING IT
WITH THE CHIEF MEDICAL OFFICER.
TO ENSURE THAT THE MEDICAL
PROTOCOLS ARE ALSO- TAKEN CARE
OF ON THAT SIDE TO- AND SO WE
ARE SUPPORTIVE OF THAT TRAILER.
BILL LANGUAGE THANK YOU THANK
YOU MAKE IT. MADAM CHAIR BRUCE
PALMER REPRESENTING THE
CALIFORNIA ASSOCIATION OF PUBLIC
HEALTH LABORATORY DIRECTORS THE
TWENTY EIGHT LOCAL PUBLIC HEALTH
LABORATORIES IN OUR STATE. LIKE
SHE ACT WE AGREE WITH THEIR
TESTIMONY OPPOSING. THE
REVERSION TO RELATED TO PUBLIC
HEALTH WORKFORCE WE APPRECIATE
YOUR SUPPORT. OF THIS- WORKFORCE
DEVELOPMENT AND SPECIFICALLY WE
LOOK AT IN ITEM NUMBER FOR THE
CALIFORNIA MICROBIOLOGISTS
TRAINING AND PUBLIC HEALTH LAB A
SPIRE. THE TRAINS ARE DIRECTORS
IN THE LAPS. IF YOU KNOW THE
PUBLIC HEALTH LABS OF THE FIRST
LINE OF DEFENSE. IN AN OUTBREAK
ONCE THAT DISEASES THE-
IDENTIFIED THEN ACTION CAN BE
TAKEN TO CONTROL THE SPREAD OF
DISEASE WHICH THEN IN TURN.
LIMITS THE AMOUNT OF. PEOPLE WHO
ARE SICK OR DIE FROM A
PARTICULAR OUTBREAKS WE'RE ON
THE FRONT LINES IN ORDER TO DO
OUR JOB PROPERLY WE'D HAVE TO
HAVE A ROBUST WORK FORCE TO DO
THAT. AND THAT'S WHY THE
TRAINING CONTAINED. IN THIS ITEM
IS SO IMPORTANT AND AGAIN THANKS
FOR YOUR SUPPORT THANK YOU. GOOD
AFTERNOON MADAM CHAIR REBECCA
SULLIVAN WITH LOCAL HEALTH PLANS
CALIFORNIA REPRESENTING THE
SIXTEEN LOCAL MEDIC HOW MANAGED
CARE HEALTH PLANS OF THE STATE-
THIS IS TO ISSUE NUMBER NINE
UNDER DH CS. LHP C. SUPPORTS THE
WHOLE CHILD MODELS WILL CHILD
MODEL AND ITS GOAL OF IMPROVING
COORDINATION AND INTEGRATION FOR
THE CCS POPULATION ACROSS ALL
HEALTH AND SOCIAL SERVICES AND-
NEED ACCESS TO THE HIGH QUALITY
SPECIALTY CARE. WE BELIEVE THAT
COAST PLANS HAVE DELIVERED ON
THE GOALS OF WHOLE CHILD MODEL
BY BUILDING EXPERTISE IN WORKING
WITH THE CCS POPULATION AND
THEIR FAMILIES MAINTAINING
SPECIALTY CARE NETWORKS THAT
PROVIDE THIS CRITICAL CARE. AND
CLOSE PARTNERSHIP WITH OUR
COUNTY IS. WE'RE SUPPORT OF THE
ADMINISTRATION'S PROPOSAL TO
BUILD ON THE SUCCESS BY
EXPANDING WHOLE CHILD MODEL TO A
PHASED APPROACH THAT IT
KNOWLEDGE IS THE EXPERIENCE AND
READINESS OF EXISTING BECAUSE
PLANS AND ADDITIONAL TIME NEEDED
FOR COUNTIES THAT ARE
TRANSITIONING TO A SINGLE PLAN.
WE LOOK FORWARD TO CONTINUE
DISCUSSIONS WITH THE LEGISLATURE
AND ADMINISTRATION ABOUT THIS
PROPOSAL TO ENSURE A SMOOTH AND
SUCCESSFUL TRANSITION OF WHOLE
CHILD MODEL THANK YOU THANK YOU
. MADAM CHAIR MEMBERS JOHN
LINGER ON BEHALF OF THE NATIONAL
COALITION FOR ASSISTIVE AND
REHAB TECHNOLOGY ALSO SPEAKING
THE ISSUE NINE I THINK WE WOULD
SHARE THE CONCERNS OF THE
CHILDREN HOSPITALS ASSOCIATION.
ON THE EXPANSION- OF OUR OUR
MEMBERS ARE PROVIDERS AND
MANUFACTURERS OF COMPLEX REHAB
TECHNOLOGY WHICH IS INDIVIDUALLY
CUSTOMIZED EQUIPMENT FOR. ADULTS
AND CHILDREN OF SIGNIFICANT
PHYSICAL DISABILITY SO- LARGE
POPULATION OF CCS. ATIONS AND
SO. WE CONTINUE TO HAVE
REIMBURSEMENT CHALLENGES WITH T.
H. C. S. WE HAD AN ONGOING
DIALOGUE THERE AND CONTINUE TO
DO SO BUT- THE MAJORITY OF OUR
LABOR COSTS ARE NOT REIMBURSED
AT THE MOMENT AND OUR
TRANSPORTATION COSTS ARE
REIMBURSED AND SO IT'S A VERY
DIFFICULT BUSINESS MODEL- FOR US
OVER A LITTLE BIT CONCERNED
ABOUT SEEING MORE PATIENTS BE
SHIFTED INTO THE MANAGED CARE
MODEL AND GO THROUGH RATE
REVIEW. IF OUR RATES ARE ARE
STILL AN ADEQUATE AND SO WE'D
LIKE TO SEE THE RATES FIXED
BEFORE WE- START BUILDING NEW.
MANAGED CARE RATES ON TOP OF IT
THANK YOU THANK YOU. GOOD
AFTERNOON MADAM CHAIR NORTHLAND
WITH CHILDREN NOW- CHILDREN NOW
WILL BE COMMENTING ON A FEW OF
THE DH CS AGENDA ITEMS TODAY.
GUARDING ISSUE ONE ON MEDICAID
EXPANSIONS WE CONTINUE TO
STRONGLY SUPPORT THE AGREEMENT
MADE IN LAST YEAR'S BUDGET. TO
EXPAND CONTINUOUS COVERAGE FOR
MULTIPLE YEARS TO CHILDREN UNDER
FIVE. AND WE APPRECIATE THE
DEPARTMENT'S COMMITMENT TO THIS
POLICY. WE LOOK FORWARD TO
GETTING DOWN TO WORK WITH T. H.
C. S. ON THE IMPORTANT PRE
IMPLEMENTATION PLANNING
NECESSARY TO ENSURE SYSTEM READY
NEXT TO KEEP KIDS CONTINUOUSLY
COVERED. REGARDING ISSUE FOR ON
FAMILY HEALTH SERVICES WE
APPRECIATE THE SUBCOMMITTEE'S
QUESTION ABOUT THE CHILD HEALTH
AND DISABILITY PREVENTION
PROGRAM STAKEHOLDER PROCESS. AND
DEVELOPMENT OF THE TRANSITION
PLAN. CHILDREN NOW SERVES ON THE
NEWLY REVAMPED ADVISORY
WORKGROUP DH CS HAS CONVENE TO
DEVELOP THIS PLAN AND
APPRECIATES THE EFFORTS MADE TO
IMPROVE THE PROCESS. ONLY THREE
MEETINGS REMAIN ONE NEXT WEEK
ONE IN APRIL AND THE LAST ONE IN
JUNE AND STAKEHOLDERS ARE
INTERESTED TO LEARN HOW INPUT
PROVIDED IS BEING TAKEN INTO
ACCOUNT AND REFLECTED IN THE
PLAN. WE STRONGLY RECOMMEND THAT
THIS SUBCOMMITTEE CONVENE AN
OVERSIGHT HEARING THIS BUDGET
SEASON FOR A STATUS UPDATE AND
ALLOW FOR STAKEHOLDERS ENGAGED
IN THE PROCESS AND AFFECTED BY
CHD P. SUNSET. TO SHARE THEIR
PERSPECTIVE ABOUT THE PLAN.
REGARDING ISSUE NINE ON THE
WHOLE CHILD MODEL. WE OPPOSE THE
PROPOSED EXPANSION OF THE CCS
WHOLE CHILD MODEL BECAUSE IT IS
INCONSISTENT WITH SB FIVE EIGHT
SIX AUTHORIZING THE WHOLE CHILD
MODEL PILOTS IN TWENTY SIXTEEN.
AND GIVEN THE EXPERIENCE AND
EXPANSION OF THE WHOLE CHILD
MODEL IS UNNECESSARY WOULD
RESULT IN THE LOSS OF IMPORTANT
CASE MANAGEMENT EXPERTISE. MAY
RESULT IN FEWER ELIGIBLE
CHILDREN BEING IDENTIFIED IN
OFFERED SERVICES. AND WOULD BE
DEVASTATING TO THE PEDIATRIC
SPECIALTY CARE DELIVERY SYSTEM
IF IMPLEMENTED AFTER MANY
DECADES OF LOW REIMBURSEMENT AND
MORE RECENT CUTS. WE BELIEVE THE
NEEDED SUBSTANTIVE AND IN DEPTH
POLICY DISCUSSION ABOUT CCS IS
MORE APPROPRIATE AS PART OF THE
POLICY COMMITTEE PROCESS. AND
LAST REGARDING ISSUE TEN ON
PROPOSALS FOR INVESTMENT. WE
SUPPORT A BUDGET INVESTMENT TO
EXTEND MEDIC HOUSE EXISTING
COMPREHENSIVE PERINATAL SERVICES
PROGRAM. BENEFIT AND COVERING
SUPPORTIVE SERVICES DURING THE
TWELVE MONTH POSTPARTUM
ELIGIBILITY PERIOD. THIS BUDGET
REQUEST WILL HELP ADDRESS SOCIAL
CONDITIONS AFFECTING INFANT AND
MATERNAL HEALTH EARLY ON TO HELP
PREVENT HEALTH CONDITIONS OR
STOP THEM FROM BECOMING WORSE
THANK YOU FOR YOUR TIME. THANK
YOU. MADAM CHAIR TRENT SMITH I'M
COMMENTING ON- ISSUE NINE OUT OF
THE DEPARTMENT HEALTHCARE
SERVICES THE WHOLE CHILD MODEL
EXPANSION. I'M SPEAKING ON
BEHALF OF OUR CLIENTS
PARTNERSHIP HEALTH PLAN AND
CENTRAL COAST ALLIANCE FOR
HEALTH BOTH OF WHICH ARE COUNTY
ORGANIZED WHOLE SYSTEMS. PUBLIC
NONPROFIT MEDICAL MANAGED CARE
PLANS WHO HAVE SUCCESSFULLY BEEN
IMPLEMENTING THE WHOLE CHILD-
MANAGED CARE MODEL IN THEIR
COUNTIES- THEY SUPPORT THE-
DEPARTMENT'S TRAIL ABOUT TRAILER
BILL LANGUAGE TO ALLOW THEM TO
PROVIDE THE SAME SERVICES IN THE
COUNTIES THAT WILL SOON AT- BE
ADDED TO THEIR PLAN. DANCE IN WE
WOULD OFFER THAT ONCE THE
VALUATION REPORT COMES OUT OUR
CLIENTS BE HAPPY TO MEET WITH
STAFF FOR ANY OF THE MEMBERS
STAG ANSWER YOUR QUESTIONS
DIRECTLY ON THEIR EXPERIENCES
AND CAPABILITIES- TO ANSWER A
COUPLE QUESTIONS THAT SENATOR
ROTH PRESENTED- THE COUNTIES
CHOSE TO AND TO JOIN THE COUNTY
ORGANIZED HEALTH SYSTEM. AND
WHAT THAT MEANS IS NOT JUST THE
BOARD OF SUPERVISORS BUT THE
BOARD OF SUPERVISORS IN
CONSULTATION WITH THEIR PROVIDER
COMMUNITY IN THEIR CONSTITUENTS
WHO WANTED THIS LEVEL OF
COORDINATED AND INTEGRATED CARE
SO AGAIN WE'RE HAPPY TO SHARE
THAT INFORMATION DIRECTLY ONCE
THE VALUATION REPORT COMES OUT.
THANK YOU THANK YOU. MADAM CHAIR
PETER CALLOUS NOT BE HALF THE
CALIFORNIA ASSOCIATION FOR
HEALTH SERVICES AT HOME THE
ASSOCIATION FOR. HOME HEALTH
AGENCIES SPEAKING TO THE
PROPOSAL ARTICULATED BY ARYANA
HEALTH WHICH IS ONE OF OUR
MEMBERS OTHER STAKEHOLDERS ARE
PART OF THE COALITION AS WELL.
PROPOSING THE RATE STABILIZATION
FOR PRIVATE DUTY NURSING DON'T
WANT TO SPEND MORE TIME I WILL
JUST ADD TO THE POINT OF WHY WE
ARE HERE IS IT IN THE LAST TWO
TO THREE YEARS. THE WORK FORCE
FOR THIS PROGRAM HAS DECREASED
BY ABOUT FIFTY PERCENT. BECAUSE
INSTITUTIONAL CARE SETTINGS CAN
PART PAY WAGES THAT ARE ABOUT A
THIRD HIGHER 32% HIGHER. COST OF
CARE FOR- FOR A DAY FOR UP-
MEDICALLY COMPLEX CHILD AT HOME
IS ONE THOUSAND FOUR HUNDRED
EIGHTY TWO DOLLARS PER DAY IN A
HOSPITAL IS BETWEEN SEVEN TO TEN
THOUSAND DOLLARS PER DAY. SO THE
COST BENEFIT AND RETURN IS
MANIFEST NAVIDAD THANK YOU THANK
YOU SO MUCH. MODERATOR IF YOU
WOULD PLEASE PROMPTLY AND- I'M
JUST GONNA I'M I'M I GOT WELL
I'M NOT. I DO NOT THINK IT WOULD
GO AHEAD NORI THAT'S OKAY AS A
GAME MANAGER. HOURS ABOUT GOOD
AFTERNOON GOOD AFTERNOON SCOTT-
JOSE TOWARDS WITH HEALTH ACCESS
CALIFORNIA ON ISSUE ONE WITHIN
DCS WE APPRECIATE THE CONTINUED
SUPPORT FROM THE LEGISLATURE TO
INSURE THAT THE MEDICAL
EXPANSION FOR UNDOCUMENTED
INDIVIDUALS. H. TWENTY SIX FORTY
NINE REMAINS ON TRACK TO BEGIN
JENNY FIRST TWENTY TWENTY FOUR
AND THEN ON ISSUE TEN OF THE ACS
HOW THE ACCESS IS ALSO IN
SUPPORT OF EXPANDING MEDIC HOUSE
EXISTING. C. P. S. P. BENEFIT AS
IT DOES TAKE A VILLAGE TO
SUPPORT FAMILIES DURING AND
AFTER PREGNANCY AND PEOPLE
REALLY NEED THIS PROGRAM FOR THE
FULL TWELVE MONTHS OF POST
PARTUM. AND I THINK YOU FOR YOUR
TIME. THANK YOU. NO I DON'T OKAY
. RIGHT NOW MODERATOR IF YOU
WOULD PLEASE PROMPT INDIVIDUALS
WAITING TO PROVIDE PUBLIC
COMMENT. AND THEN KINDLY LET ME
KNOW HOW MANY PEOPLE WE HAVING
Q. THANK YOU MEDICARE IT LOOKS
LIKE. WE HAVE- BUT FIFTEEN OR
SO. BUT I'LL GIVE A QUICK
REMINDER IF YOU WOULD LIKE TO
OPT FOR A PUBLIC COMMENT ON
TODAY'S. SESSION PLEASE PRESS
ONE FOLLOWED BY ZERO POINTS ONE
FILED BY ZERO AND WE WILL BEGIN
WITH ONE TWENTY NINE PLEASE GO
AHEAD. THAT AFTERNOON TERM AND
OF OUR INSIDE COMMITTEE MEMBERS
MY NAME IS KATIE LEE AND I'M
TESTIFYING ON BEHALF OF THE
CHILDREN SPECIALTY CARE
COALITION. TO EXPRESS THEIR
OPPOSITION TO AGENDA ITEM NINE
B. EIGHT YES AS PROPOSED TRAILER
BILL TO EXPAND THE WHOLE CHILD
MODEL. THE CALIFORNIA CHILDREN'S
SERVICES PROGRAM TREATS
CALIFORNIA'S MOST MEDICALLY
COMPLEX CHILDREN AND YOU
ENSURING THAT THEY GET THE RIGHT
CARE FROM THE RIGHT PROVIDER AT
THE RIGHT TIME. WE HAVE SEVERAL
CONCERNS WITH THE WAY THE WHOLE
CHILD MODEL HAS PERFORMED
INCLUDING A STATISTICALLY
SIGNIFICANT DECREASE IN
ENROLLMENT AND CCS. WHERE IT'S
GONE INTO A FACT MEANING THAT
FEWER CHILDREN ARE BENEFITING
FROM THE PROGRAM. WE ALSO KNOW
THAT MANY FAMILIES MISS THE DEEP
EXPERTISE IN RELATIONSHIP WITH
THEIR CCS NURSE CASE MANAGER.
AND WE ARE ALSO CONCERNED ABOUT
THE NEGATIVE FINANCIAL IMPACT
THE CHILDREN'S HOSPITALS WHICH
THREATENS AN ALREADY
DESTABILIZED PROVIDER NETWORK
THAT TREAT A- DISPROPORTIONATELY
HIGH VOLUME OF MEDIC HELP
PATIENT. SO AND SO WE HAVE MORE
DETAILS ON THE WAY WHOLE CHILD
MODEL HAS PERFORMED. INCLUDING
THE FULL EVALUATION AND A BETTER
UNDERSTANDING OF THE ROOT CAUSES
OF THESE CONCERNING ISSUES I
FEEL THAT EXTENSION OF WHOLE
CHILD MODEL IS PREMATURE AT THIS
TIME SO. WE WOULD URGE THE
COMMITTEE TO REJECT THE PROPOSAL
UNTIL STRONGLY THAT IT BELONGS
IN A POLICY COMMITTEE. THANKS
FOR LISTENING. THANK YOU NEXT
CALLER. ONE FORTY SIX YOU ARE.
YEAH CAN YOU MIND CHAIR BY
REQUIRED THE HELP ON. IT OUT.
WHICH REPRESENTS THE HOW OFFICER
AND CAL. YOUR ACTIONS. WE'RE
ASKING THE COMMITTEE WHICH THE
GOVERNOR PROPOSED TO CUT MONTHLY
. WHICH IS AN ACTOR NOT YEAR'S
BUDGET PUBLIC HEALTH OF PUBLIC
HEALTH WORKFORCE. WHEN THE COACH
THAT WE WOULD IMPACTED AS THE
PUBLIC HEALTH LAB ARTICLE. EVEN
ASK CALIFORNIA POPULATION HAS
BEEN THE NUMBER OF LOCAL PUBLIC
HEALTH LAB THREE. BUT A LOT
LOCAL LOCK. NIGHT NINETY LOS DUE
TO A LACK OF QUALIFIED FOR THE
HEALTH BY HEATERS. I'M THE
FUNDING HELP UNPREPARED AND TO
CONNECT ENDEMIC. AND THEN UNDER
- THE AND- FIVE BILLION TO THAT-
THE WHOLE. APPROVED LIVING
POSITION LEADERSHIP AND THAT
COULD AGENCY UNLESS PLEASE NOT A
OFFICER DR. IN BACK. WITH ALL MY
TO A THREE AND A BUSINESS MAKING
. WE HOPE THAT WILL WORK US ON
BOTH OF THESE IMPORTANT ISSUES
THANK THANK YOU NEXT.
THANKS A SIGNIFICANT WORK WORKS
CHALLENGES WHICH ARE
PARTICULARLY USED CAR COUNTY
HEALTH AND HUMAN SERVICES AGENCY
WHETHER IT'S ME TRANSEXUAL ARE
CURRENT AND COMMUNITY HEALTH
WORKERS. ON BEHALF OF THE
CHILDREN'S PARTNERSHIP WE OPPOSE
THE GOVERNOR'S TRAILER BILL
LANGUAGE TO EXPAND THE WHOLE TOP
MODEL FOR CALIFORNIA CHILDREN'S
SERVICES. THE EXPERIENCE OF THE
WHOLE CHILD MODEL MEDICATION
OVER THE PAST FOUR YEARS
INDICATES THAT MODEL COMPRISED
SIX YES CHILDREN. ACCESS TO BOTH
SPECIALIZED MEDICAL CARE AND
EXPERT CASE MANAGEMENT SERVICES
AND THE TRANSITION WILL RESULT
IN EVEN DEEPER MET CAL CUTS THE
PCS OUTPATIENT PROVIDERS. THANK
YOU. THANK YOU NEXT COLOR. NINE
SIX TWO PLEASE GO AHEAD. GOOD
AFTERNOON ACTUALLY BURKE HERE
BEHALF OF THE RIVER COUNTY OF
PAPER AND URBAN COUNTY THE
CALIFORNIA OPPOSITION THE PUBLIC
HEALTH WORKFORCE CUTS- IN
RIVERSIDE COUNTY A POLITICAL
HEALTH. DIRECTOR THEY GET AND
RECRUITMENT FOR THREE RIGHT I
COUNTY THE VALERIE TO BE MORE
COMBAT WITH OTHER DISPOSITION OF
HAITI'S GOLDEN TECHNICAL AND
THEY'RE VERY FEW KENNEDY TO MEET
THE MINIMUM. TO SERVE THAT
CAPACITY AN ADDITIONAL REPLAY
CAL ABOUT THAT THAT EMAIL.
PUBLIC HEALTH AND THERE SAID A
MICROBE AT THE PRIVATE SECTOR WE
ARE VERY- WHEN YOU CONSIDER THE
ISSUE AGAIN LATER THIS YEAR TO
PLEASE REJECT- AT THE PUBLIC
HEALTH WORKFORCE. YOU HAVE THAT
CENTER NEED THANK YOU. THANK
NEXT COLOR. PLEASE GO AHEAD
LYSYK FIVE. GOOD MY TREATMENT
GET EVEN NEED TO BUT IT'S
CORNISH'S THANK YOU THE PUBLIC
TO FOR CALM. THE CHILDREN
CORNISH TRONG THE BOY SIXTY THE
HAS BRING SERVICE PROGRAM
BENEFIT. BOTH FOR THEM AND WITH
LOOKING. IN HOPE AND CORPORATE
APPROACH CARING FOR MY HELP SO
BEFORE. TO BOTH BOREDOM THE VET.
THE REQUESTED IN. LOOKS A WEEK
OF FUND THAT FAMILIES ARE HELP
PRO THAT THEM IN THE FIRST PLACE
. BUT BELIEVE THAT ACTED SERVICE
EARLY MY OR THREE HEALTH. VOICE
AND EXPANDING MEDICAL THE TWENTY
P. BEN AND OF AFTER FOR PEOPLE.
THE OTHER COUNTRIES TO COME WITH
. IT'S PARTNERSHIP AS A THE
LEGISLATURE PLEASE AND PRO THAT
YEAR AND YOU. THANK YOU NEXT
COLOR. MOGELIJK SIX THREE YEAR
ARE OPEN. SIXTY THREE PLEASE
CALL. GO AHEAD AFTERNOON ANDREA
. WITH THE CALIFORNIA PAN ETHNIC
HEALTH NETWORK CALLING IN
REGARDS TO ISSUE TEN FEET KIND
OF SUPPORTIVE OF THE BUDGET
REQUEST TO EXTEND THE EXISTING
MEDICAL COMPREHENSIVE PERINATAL
SERVICES PROGRAM THROUGH THE
TWELVE MONTH POST PARTUM. PERIOD
CPF HE IS ALREADY AVAILABLE
THROUGH PREGNANCY THROUGHOUT
PREGNANCY AND SIXTY DAYS
POSTPARTUM THE CALIFORNIANS AND
ESPECIALLY COMMUNITIES OF COLOR
NEED CPSC THROUGHOUT THE TWELVE
MONTHS ELIGIBILITY PERIOD TO
PROVIDE IMPORTANT PREVENTION
CARE SERVICES. BUDGET REQUEST
WILL HELP ADDRESS SOCIAL
CONDITIONS WHICH IMPACT HEALTH
OUTCOMES AND HELP PREVENT HEALTH
CONDITIONS FROM BECOMING WORKS
WHICH THEN REQUIRE INTENSIVE AND
COSTLY CARE. WE URGE THE
LEGISLATURE TO SUPPORT THIS
REQUEST AND WHAT WE WOULD ALSO
LIKE TO EXPRESS OUR GRATITUDE
FOR THE LEGISLATURE CONTINUED
SUPPORT TO EXPAND MEDIC HOW
ACCESS TO ALL CALIFORNIANS
REGARDLESS OF IMMIGRATION
STATUS. WE LOOK FORWARD TO
CONTINUED PARTNERSHIP AS WE LOOK
TO IMPLEMENT BY JANUARY FIRST
TWENTY TWENTY FOUR THANK YOU.
THANK YOU NEXT COLOR. THANK
FORTY FIVE PLEASE GO AHEAD. THAT
SHORT REPRESENTING RADY
CHILDREN'S HOSPITAL IN LOMA
LINDA UNIVERSITY HEALTH WOULD
LIKE TO EXPRESS OPPOSITION TO
ITEM NUMBER NINE HUNDRED THE
DEPARTMENT OF HEALTH CARE
SERVICES I DID I DON'T.
REGARDING THE PROPOSED EXPANSION
OF THE WHOLE CHILD MODEL I'D
LIKE TO LINE MY COMMENTS WITH
THOSE OF THE CALIFORNIA
CHILDREN'S HOSPITAL ASSOCIATION
THANK THE CHAIR AND THE MEMBERS
FOR THEIR REALLY THOUGHTFUL
COMMENTS AND QUESTIONS DURING
THIS ITEM THANK YOU. THEY YOU
NEXT CALLER. I FIFTY SEVEN
PLEASE GO AHEAD. GOOD AFTERNOON
MY AND HER ON BEHALF OF THE
CALIFORNIA DENTAL ASSOCIATION-
HUH YOUR COMMENTS ON THIS ISSUE
FOR UNDER DH YEAH. FIRST MEDIAN
PARTISAN OVERSIGHT PANEL ON THAT
C. H. D. P. TRANSITION DURING
THAT THE BUDGET CYCLE AS IT IS
CRITICAL TO EXAMINE THIS C. H.
D. P. SUNSET IN GREAT DETAIL
SINCE HER IT DIDN'T CHARGE AT.
THERE ARE NO GAPS IN CARE OR
REDUCE QUALITY OF CARE
ESPECIALLY IN ORAL HEALTH FOR
CALIFORNIA CALIFORNIA'S MOST
VULNERABLE YOUTH. SECOND PDF
SUPPORTS CALIFORNIA'S-
RECOMMITMENT TO ORAL HEALTH BY
USING GENERAL FUND. DOLLARS TO
SUPPORT MEDICARE HEALTH
SUPPLEMENTAL PROVIDER PAYMENTS.
THE CONTINUED. USE OF GENERAL
FUND DOLLARS IS CRITICAL TO
MAINTAINING PROP FIFTY SIX
FUNDING LEVEL. WELL WHICH
PROVIDE. MUCH NEEDED STABILITY
FOR THEM HELD PRO. THANKS FIFTY
SIX TOOK A FAIR THEIR HAS BEEN A
25% INCREASE IN DENTAL PROVIDER
ENROLLED IN MEDI CAL. WHICH IN
TURN- INCREASED- DIGITALIZATION
FOR ENROLLEES THANK YOU FOR YOUR
TIME. THANK YOU NICE COLOR.
WE'LL GO TO LINE SIXTY ONE YOUR
OPEN. THANK YOU FOR TAKING MY
CALL MY NAME IS LINDA I'M
CALLING FROM NINETEEN
CALIFORNIA'S X. FACTOR COUNTY. I
HAD A COUPLE THINGS FIRST AYE
OPPOSED ANY MANDATORY OR
MANDATED. ITEMS NEXT AYE OPPOSED
TO MAKING A TACKLE RACIAL MATTER
WHEN THERE'S NO DIFFERENCE IN
PEOPLE IT'S A DIFFERENT COLOR WE
ALL BLEED THE SAME. I'M GOING- I
PERSONALLY DON'T ANY TAX DOLLARS
GO TO ANY CITIZENS OF THE UNITED
IN PERSON I READ IT CALIFORNIA.
AND SORRY IF I MEAN BUT I DON'T
KNOW IF HE'S INDIVIDUALS MY CAT
WITH THE PENN. PARTY I DO WANT
TO SUPPORT THEM AND ANY WAY AND
I'M VERY IF I. WILSHIRE GAVE
APRIL YOUR THANK YOU THANK YOU
NEXT CALLER. ONE SIXTY SIX
PLEASE GO AHEAD. AFTER RONALD BY
ON BEHALF OF SETON CAL SENATE I
THINK HELP WE ARE VERY OF THE
CAR OF SAN DARTS YET YOU SEE THE
IMPORTANCE OF RESEARCH COMMUNITY
ON. THIS OUTREACH EDUCATION
EFFORTS THE MEDICAL. FOR
UNDOCUMENTED BEGINNING TO TWENTY
FOUR INTERESTINGLY THE MEDIC OUT
OF YOUR PROGRAM BEEN THE MAIN
THE- UP LIST AS IT RELATES TO
SUPPORTING ENROLLMENT EFFORTS
FOR THE EXPANSION TO THE
UNDOCUMENTED POPULATION JUST
LAST YEAR'S EVEN HAD A BILL IN
BUDGET PROPOSAL TO TRY TO
PRIORITIZE FUNDING TO CBO TO
ENSURE. READINESS TO SUPPORT
EXPANSION BUT IT WAS NOT
SUPPORTED BY THE ADMINISTRATION
DESPITE WHAT WE KNOW ABOUT THE
NEEDS. OF THIS POPULATION AS
SHARED BY CIPC THE LEGISLATURE
FUNDED NAVIGATORS FOR SIXTY
MILLION FOR FOUR YEARS IN THE
LAST BUDGETS. AND THE MOST LOOK
DOLLARS ARE GOING OUT THE DOOR
ONLY TWO HUNDRED THOUSAND
DOLLARS REMAINS DESPITE THIS THE
PROGRAM ISN'T STATEWIDE THAT
THERE'S ROOM FOR IMPROVEMENT AS
IT RELATES TO FIOS FILLING THE
GAP ON THE GROUND- IN
INFORMATION IS UNAVAILABLE RIGHT
NOW ABOUT WHO SOME OF THE CBO
CONTRACTORS MAY BE CURRENTLY
FUNDED. AND SO WE CAN'T
NECESSARILY TELL AND DON'T KNOW
WHAT THEIR CAPACITY LOOKS LIKE
TO APPROPRIATELY OUTREACH TO
IMMIGRANT COMMUNITIES WE ARE TO
THE LEGISLATURE TO INCLUDE MORE
FUNDING IN THE NAVIGATORS
PROGRAM EARMARKED FOR CEOS. AND
OR PARTNERSHIPS WITH THE DEALS
TO MEET THIS CRITICAL NEED
ADDITIONALLY WORKING TO OPPOSE
CUTTING FORTY NINE TWENTY
BILLION DOLLARS DEDICATED TO
REBUILDING. CALIFORNIA'S LOCAL
PUBLIC HEALTH WORKFORCE WE URGE
YOU TO REJECT THE COTTON ENSURE
THAT WE SUSTAIN TWENTY MILLION
DOLLARS FOR LOCAL INFRASTRUCTURE
AND WORKFORCE HOWEVER WE ALSO
BELIEVE THE CRITICAL. COMMUNIQU
COMMUNITY COMPONENT IS MISSING A
PART OF THE COMPREHENSIVE PUBLIC
HEALTH INFRASTRUCTURE AND WE
URGE THE LEGISLATURE TO INVEST
FIFTY MILLION OVER TWO YEARS FOR
THE HEALTH EQUITY AND RACIAL
JUSTICE FUND. THANK YOU. THANK
YOU NEXT CALLER. THANKS SEVEN
CALL. SIXTY SEVEN. CAN YOU HEAR
IS. YOUR OPEN. SIXTY SEVEN. ONE
MORE SHOT SIXTY SEVEN ARE YOU
MUTED. KAPANEN'S GO WITH THE
FRIENDS COMMITTEE ON LEGISLATION
OF CALIFORNIA. IN STRONG SUPPORT
OF EXPANDING MEDICARE OF THE
LISTING C. P. S. T. BENEFIT TO
TWELVE MONTHS. POSTPARTUM THANK
YOU. THANK YOU NEXT COLOR. WHY
SIXTY EIGHT PLEASE GO AHEAD. HI
GOOD AFTERNOON MADAM CHAIR AND
MEMBERS THAT'S NOT OUT. YEAH YOU
CALIFORNIA OR THE AVERAGE SEVEN
HUNDRED THOUSAND MEMBERS I'D
LIKE TO OFFER. THE MARKET A
NUMBER OF ITEMS FOR HIM TO START
BREAKING OUT IN THE TREMENDOUS
WORK ABOUT PUBLIC SECTOR
WORKFORCE IN THE LEGISLATURE AND
TO BRING THAT THE I MEAN IF I
LOOK BACK IN THE HEALTH CARE
COVERAGE. AND THE CRITICAL. BACK
TO BE WE WANT CAN. WE APPRECIATE
COMMITTEE HOLDEN OVERSIGHT HI ON
THE TECHNOLOGY INCOME NEXT PART
OF CONVERSATION FAN. YOU GET
YOUR PAPER ON THE ARE DONE.
GUARD YOU INTERNET NINE ON YEAH
HOLD MODEL. AS HER CAN ABOUT A
FURTHER OF HIGHWAY- AND THE
IMPORTANTLY. WE'RE GOING TO LOOK
WHAT IT MEANS FOR LOCAL ARE THEY
THE SCALE AMERICAN COUNTY
RECORDER COULD NOT BE IN THE
RUBBLE AND WILL BE LOST IN ALEX
. THAT WERE FROM LOCAL
JURISDICTIONS MEDICARE. YOU'RE
GETTING DEREK NETWORK THAT YOU
NEEDS EACH BAND WILL A LOT YEAH
CANNOT SEPARATE THAT FROM A
DIFFERENT TRIBE THAT. COMMITTED
TO FY TWO TWENTY THREE BY. WITH
THE HD TREND AND WE APPRECIATE
THE COMMITTEE DO YOU THE OUT FOR
AN UPDATE ON THE TRANSIT AT- IN
KEEPING THE F. 2220% WE WOULD
WELCOME. PANEL ON THE TRANSITION
OF LATER HEARING WE CANNOT BUT
YEAH. TURNING.
WELL BACK A LATE ROUGHLY COULD
DENY INVESTMENT FOR PUBLIC
HEALTH WORKFORCE AS WE ALL KNOW
THE PROPOSAL MOVE BACKWARD AND
FELT REALLY RECOGNIZED
EVERYTHING WE'VE LEARNED FROM
THE UNDER INVESTMENTS WE'VE MADE
IN PUBLIC HEALTH FOR DECADES.
AND THAT IMPACT AND UNDERMINE
OUR PANDEMIC RESPONSE ARE WE
REALLY THINK THE LEGISLATURE-
FOR TAKING THESE ISSUES ON AND
LOOK FORWARD TO WORKING WITH YOU
ALL AND REJECTING THE PROPOSAL.
THANK YOU NEXT CALLER. RIGHT
SEVENTY FOUR PLEASE GO AHEAD.
THANK YOU THANK YOU MADAM CHAIR
AND MEMBERS THIS IS ROBBIE
GONZALEZ NOW WITH THE CALIFORNIA
BREASTFEEDING COALITION I'M
CALLING TO EXPRESS OUR SUPPORT
FOR ISSUE TEN UNDER DH CS. TOOK
STANDARD CPS FEED SERVICES TO
THE TWELVE MONTHS IT'S AN
EXTREMELY VALUABLE PROGRAM IN
IT'S A MINIMAL BUDGET REQUEST OF
INVESTMENT TO HAVE LONG TERM
POSITIVE OUTCOMES FOR FAMILIES
AS THEY NAVIGATE. BEING NEW
PARENTS AND IT'S ONE OF THE ONLY
WAYS THAT LOW INCOME FAMILIES
CAN ACCESS LACTATION SUPPORT
WHICH- IN THE ISSUE COME UP YOU
THE YEAR WITH- EARLY ON AND THEN
GOING BACK TO WORK. HAVE THOSE
FIRST SIXTY DAYS SO THANK YOU
VERY MUCH THANK YOU NEXT CALLER
. ONE FORTY FOR YOUR OPEN. I'M.
FORTY FOUR. OH ONE MORE SHOT
LIKE FORTY FOUR YOU MUTED ALONE
YOU YEP WE HEAR. YOUR MOUTH-
GOOD AFTERNOON MADAM CHAIR AND
SUBCOMMITTEE MEMBERS MY NAME IS
STEPHANIE DANCE KERR BOARD
MEMBER OF THE TEAM THE FAILURE
COUNCIL OF CALIFORNIA AS WELL AS
A PARENT OF A SON WHO IS COVERED
BY CCS FOR HIS ENTIRE CHILDHOOD.
I AM TESTIFYING IN OPPOSITION TO
AGENDA ITEM NINE DCHS PROPOSED
TRAILER BILL TO EXPAND THE WHOLE
CHILD MODEL THAT STATED BEFORE
HE MOVED TO- THIS. COVERS
CHILDREN WITH RARE AND CHRONIC
CONDITIONS INCLUDING HIM FOR YET
AND OTHER INHERITED BLEEDING
DISORDERS- ALONG THE OTHER
CONCERNS THAT PEOPLE MENTIONED
THE- REFERRAL TO SPECIALISTS WHO
MAY NOT BE AVAILABLE IN A
MANAGED CARE MODEL SYSTEM. AND
ALSO THE APPROPRIATE REFERRALS
FOR DIAGNOSTICS WHICH IS
EXTREMELY COMPLEX FOR RARE
CONDITIONS AND COULD BE ENOUGH
MISHANDLED BY THOSE WHO
PROVIDERS WHO DO NOT. KNOW HOW
TO TREAT THESE CONDITIONS OR HOW
TO IDENTIFY THEM SO THIS WOULD
DISRUPT THE SYSTEM THAT HAS BEEN
WORKING VERY WELL AND WE ARE
STRONGLY. OPPOSED TO THIS. MODEL
THANK YOU THANK YOUR NEXT CALLER
- NEXT. PERSON Q. WILL BE ONE
MOMENT PLEASE WAS GO TO LINE
SIXTY YOU ARE OPEN PLEASE GO
AHEAD SIXTY. THANK YOU GOOD
AFTERNOON MADAM CHAIR AND
COMMITTEE MEMBERS AND THE LEAVE
IN BALM ON BEHALF OF THE CEO OF
LOS ANGELES COUNTY AND TODAY
SPEAKING FOR OUR LOS ANGELES
COUNTY DEPARTMENT. OF PUBLIC
HEALTH WE'RE DIRECTING OUR
COMMENTS TO DPH ITEM NUMBER FOR
THE ALIGN OUR COMMENTS TO THOSE
OF RIVERSIDE ORANGE COUNTY'S IN
THE UCC WE OPPOSE THE FIFTY
MILLION DOLLARS IN REVERSAL OF
PUBLIC HEALTH WORKFORCE
DEVELOPMENT TRAINING PROGRAMS.
HEALTH WORK DEVELOPMENT AND
TRAINING PROGRAMS APPROVED IN
THE TWENTY TWENTY TO BUDGET ACT
REPRESENTS A FEW INITIATIVES
DEDICATED TO SUPPORTING
CALIFORNIA'S PUBLIC HEALTH
WORKFORCE HI FLY. WITHOUT
CULTIVATING A WELL TRAINED
PUBLIC HEALTH WORK FORCE
PARTICULARLY FOR HARD TO RECRUIT
PROFESSIONALS LIKE LABORATORY
SPECIALISTS AND EPIDEMIOLOGISTS.
CALIFORNIA REP FURTHER
JEOPARDIZING THE PUBLIC HEALTH
SYSTEMS CAN. EXCUSE ME CAPACITY
AND CAPABILITY TO RESPOND
EFFECTIVELY AND RAPIDLY TO OUR
COMMUNITIES MANY PUBLIC HEALTH
CHALLENGES NOT TO MENTION THE
NEXT PANDEMIC OR OTHER MASSIVE
HEALTH CRISES RELATED TO FOR
EXAMPLE NATURAL DISASTERS. WE
APPRECIATE THE LEGISLATURE
SUPPORT AND COMMITMENT TO
REBUILDING AND STRENGTHENING
CALIFORNIA PUBLIC HEALTH
INFRASTRUCTURE AND WORKFORCE
DURING THE PANDEMIC AND BEYOND
FOR CRITICAL PUBLIC HEALTH
NEEDS. THE PROPOSED CUTS
UNDERMINE THE HARD EARNED
PROGRESS IN ADDRESSING THE
PUBLIC HEALTH SYSTEMS
LONGSTANDING VULNERABILITIES IN
RESPONDING TO PRESSING AND
EMERGENT PUBLIC HEALTH
CHALLENGES. AND IT STATED BY
SENATOR EGGMAN PLEASE REVERSE.
THESE REVERSALS THANK YOU. THANK
YOU NEXT CALLER. LINE FORTY
SEVEN PLEASE GO AHEAD. AFTERNOON
MADAM CHAIR AND COMMITTEE
MEMBERS. MY NAME'S AND DONLEY
I'M REPRESENTING THE SAN
FRANCISCO AIDS FOUNDATION AND
WE'RE CALLING THE STRONG SUPPORT
OF ISSUE TWELVE UNDER. THE H.
WHICH IS ETP AND ACADEMIC SORRY
CREDIT THE EQUITY IN ACCESS
BUDGET REQUEST. WE ALSO JUST
WANTED TO THANK SENATOR LARRY
AND L. G. B. T. Q. CAUCUS FOR
THEIR SUPPORT OF THIS ITEM AND
JUST A BRIEF EXAMPLE OF HOW
IMPORTANT THE FUNDING IS AT THE
AT THE LOCAL LEVEL AT THE SAME.
AID FOUNDATION IT WITH THE COURT
HUGE INSIGNIFICANT EXPANSION THE
HOURS THAT WE CAN PROVIDE
HEPATITIS C. TESTING AND ACCESS
TO CARE AND TREATMENT KARENGE
EXCHANGE SITE. CURRENTLY OUR
HOURS AREN'T SUFFICIENT TO SERVE
ALL THE CLIENTS WHO REALLY NEED
THE SERVICES OUT. WE THANK YOU
FOR CONSIDERING US AND WE LOOK
FORWARD TO WORKING WITH THE
COMMITTEE IN THE BUDGET BY TRUMP
WHAT YOU REQUEST THANKS. SO MUCH
THANK YOU NEXT CALLER. FIVE
SEVENTY ARE OPEN. AFTERNOON
MADAM AND COMMITTEE MEMBER MY
NAME ELENA THE LION AND I'M FROM
OF THE NETWORK A NONPROFIT OR-
SERVING MY- DAMAGE THAT- ANTENNA
BARBECUE. WE'RE GOING TO OUR
STRONG SUPPORT FOR THE AND THE
UPDATE HEPATITIS B. EQUITY AND
ACCESS TO CARE ABOUT YOUR
REQUEST. THANK YOU. THANK YOU
NEXT CALLER. PLEASE GO AHEAD
LIKE SEVENTY NINE. GOOD
AFTERNOON THIS IS CONNOR SWEENEY
WITH THE SUSAN G. KOMEN BREAST
CANCER FOUNDATION CALLING IN
SUPPORT OF THE NHS. ISSUE NUMBER
SEVEN REGARDING THE
IMPLEMENTATION OF SB NINE EIGHT
SEVEN THE CATCHER CARE ACT THE
ACT THANK YOU. THANK YOU NEXT
COLOR. LINE SEVENTY ONE YOU ARE
OPEN. GOOD AFTERNOON MADAM CHAIR
AND COMMITTEE MEMBERS MY NAME IS
ANDREAS MADA I'M CALLING FROM
SAN DIEGO I AM REPRESENTING THE
CALIFORNIA HEPATITIS A LINE
ABOUT THE KNOWN AS CALLAHAN. WE
ARE CALLING REGARDING ISSUE
TWELVE PROPOSAL FOR INVESTMENTS
AND ARMSTRONG REPORTED THE END
THE EPIDEMIC HEPATITIS THE
EQUITY AND ACCESS SECURE BUDGET
REQUEST. EIGHT EITHER REALLY OF
MORTALITY AMONG NATIVE AMERICANS
AND BLACK POPULATION IS THREE
AND 2% GREATER IS THAT
RESPECTIVELY THAN AMONG WHITE
AMERICANS. THIS REQUEST TO
ENSURE LOCAL HEALTH
JURISDICTIONS ARE SUPPORTED IN
THEIR EFFORT TO ADDRESS
DISPROPORTIONATELY AFFECTED
NATIVE AMERICAN AND BLACK
POPULATION. AND THOSE
EXPERIENCING HOMELESSNESS LIVING
WITH HCV AND MAKING SURE THEIR
PRIOR TRIED FOR TESTING LINKAGE
. TO CARE AND TREATMENT THANK
YOU. THANK YOU NEXT. MY SEVENTY
EIGHT YOU ARE OPEN. THANK YOU
GOOD AFTERNOON MADAM CHAIR AND
COMMITTEE MEMBERS MY NAME IS
JORDAN A CURLY ON THE TOP AND
THE SAN FRANCISCO. WE ARE
CALLING BY CALLING ON ISSUE
TWELVE UNDER CDPH WE OFFER
STRONG SUPPORT AND THAT THE
NEXT. IN EQUITY ACCESS SECURE
BUDGET REQUESTS ONLINE I CALLED
AND DONNELLY AFTER DISCOURAGED.
AND ENCOURAGE A LOT OF US AGO.
THIS FUNDING WOULD ALLOW COUNTY
COMMUNITY TO STRENGTHEN ACT THAT
THE APPLICATION THE ENTERED A
TREATMENT TO PRIORITIZE POP THE
CORK. MOBILE POPULATION THAT
DISPROPORTIONATELY BEAR THE
BURDEN OF HEPATITIS YOU BREATH.
AND DISPARITIES IN HEALTH
OUTCOMES FUNDING INFORMATION
APPLICATION SERVICES IT'S
CRITICAL TO PROGRESS ON THE
TICKET YOUR LIMITATION IN
CALIFORNIA THANK YOU FOR THE.
OPPORTUNITY TO PROVIDE COMMENT
ON THIS YEAR. THANK YOU NEXT
CALL. MY EIGHTY TWO YEAR OPEN.
AFTERNOON THAT IS REBECCA
GONZALEZ THE NOW THAT THE OF
WORKERS. CHAPTER I WANTED JOHN
DURING WHO ASKED TO EXPAND THAT
ACCOUNT COMPREHENSIVE PERI
SERVICES PROGRAM BENEFITS COVER
THE NEW TWELVE MONTH POST PART
IN ELIGIBILITY. THANK YOU. THANK
YOU NICE COLOR. I AM EIGHTY ONE
PLEASE GO. BUT I THINK ON BEHALF
THE NURSE AND PARTNERSHIP ONE OF
THE CDPH OFFERED EVIDENCE BASED
HOME VISITING PROGRAMS AND A FEW
SERVICE FIRST TIME PREGNANT
PEOPLE AND THEIR BABIES UP TO
AGE TO- PLEASE TO SUPPORT UNDER
DH CS ISSUE TEND TO EXTEND THE
CPSC PROGRAM TO TWELVE MONTHS.
POSTPARTUM THANK YOU. THANK YOU
NEXT COLOR. MY NAME FIVE PLEASE
GO AHEAD. THANK YOU GOOD
AFTERNOON MADAM CHAIR GILLIANA
DERA WITH THE CALIFORNIA STATE
ASSOCIATION COUNTY REPRESENTING
ALL CITY COUNTY. I'D LIKE TO
COMMENT ON ISSUE THE BEFORE
UNDER THE DEPARTMENT OF PUBLIC
HEALTH WHICH PROPOSED TO REDUCE
INVESTMENT IN PUBLIC HEALTH
WORKFORCE DEVELOPMENT FOR NEARLY
FIFTY MILLION DOLLARS AT A TIME
WHEN HEALTHCARE WORKFORCE
CHALLENGES COMPUTER BY. ASETEK
PURPOSES THIS PROPOSED REVERSION
OF THE FORTY NINE POINT EIGHT
MILLION DOLLARS PREVIOUSLY
APPROVED IN THE TWENTY TWENTY TO
BUDGET ACT. I REQUEST THE
COMMITTEE REJECTED PROPOSAL TO
CUT THESE WORKFORCE DEVELOPMENT
FUNDS THAT. ARE STILL CRITICALLY
NEEDED THANK YOU. THANK YOUR
NEXT CALLER. WE WANT FINAL
PLEASE PRESS ONE FOLLOWED BY
ZERO AT THIS TIME IF YOU WOULD
LIKE TO COMMENT ON TODAY'S
AGENDA- LINE EIGHTY SIX PLEASE
GO AHEAD. HELLO IS IT ME. YES GO
AHEAD ACT- EXCELLENT I AM
CALLING- TO COMMENT ON. THE
ISSUE NUMBER TWO ABOUT THE CALL
MID NINETEEN RESPOND- THE
SMARTER PLAN GOVERNOR'S BUDGET.
AND ALSO THAT TIES INTO NUMBERS
TO READ ABOUT- THE INFECTIOUS
DISEASE. DATA SYSTEMS- I AM
CALLING- TO REPRESENT THE
MILLIONS OF PEOPLE WHO ARE A
PART OF THE- WHO OWNS YOUR BODY
IF THE WHO OWNS YOUR BODY IN THE
WHO OWNS YOUR BODY THAT MAKES
YOU A SLAVE ORGANIZATION SO
READING FROM THE DEFENDER
CHILDREN'S HEALTH DEFENSE. AND
YOU CONTINUE TO PERPETUATE THIS
SMARTER PLAN OF SHOT MATH
ETCETERA. REFLECTED IN THE
DEFENDER INFANTS AND CHILDREN
SIX MONTHS THROUGH AGE FOUR WHO
RECEIVED THE THREE DOSE PRIMARY
SERIES OF THE FIGHTER. BIO AND
TECH CO WITH NINETEEN VACCINE
ARE NOW ELIGIBLE FOR A FORCE
GHOST. WRITERS BIVALENT BLISTER
SHOT. THE US FOOD AND DRUG
ADMINISTRATION FTA ON TUESDAY
AMENDED THE EMERGENCY USE
AUTHORIZATION YOU WAY OF FIVE
THERE BY FAILING COULD NINETEEN
BOOSTER VACCINE FOR THE YOUNGER
AGE GROUP BUT ONLY FOR THOSE
CHILDREN WHO RECEIVED THE THREE
DOSE SERIES. BEFORE THE FDA
AUTHORIZED FIGHTERS BIVALENT
MAKAN MR THE THIRD SHOT IN THE
PRIMARY SERIES. UNDER THE
AMENDED AUTHORIZATION CHILDREN
CAN RECEIVE THEIR FOURTH SHOT
TWO MONTHS AFTER COMPLETING THE
THREE DOTS PRIMARY SERIES. OUR
ANDY T. H. DIRECTOR OF THE FDA'S
CENTER FOR BIOLOGICS EVALUATION
AND RESEARCH SAID THE
AUTHORIZATION GIVE PARENTS THE
OPPORTUNITY TO UPDATE THEIR
CHILDREN'S PROTECTION HOWEVER
CRITICS INCLUDING PETER
MCCULLOUGH MD AND PH AND
INTERNIST. CARDIOLOGISTS THAT
THE SHOT CLOSE LONG TERM SAFETY
CONCERNS FOR CHILDREN I AM
GREATLY CONCERNED ABOUT THE LONG
TERM SAFETY OF ACCUMULATING
NOVEL MRNA AND LUKHAN SPIKE
PROTEIN IN PREVIOUSLY HEALTHY
CHILDREN MCCULLOUGH TOLD THE
DEFENDER. CONTINUED SHOP ARE NOT
NATURAL AND CANNOT MAKE THEIR
BODIES HEALTHIER MARY HOLLAND
PRESIDENT AND GENERAL COUNSEL OF
CHILDREN'S HEALTH DEFENSE SAID.
IF ONE EVER NEEDED PROOF OF
WHICH SIDE SB AVON FARMERS OR
THE PEOPLE'S ONE NEED LOOK NO
FURTHER THAN IT AUTHORIZATION OF
THE FORCE KOPEN SHOP FOR
CHILDREN UNDER FIVE. WITH
KNOWLEDGE THAT EACH SHOT DON'T
WORK AND THAT THEY CAN CAUSE
SEVERE HARM INCLUDING DEATH.
THIS DECISION IS SIMPLY. OBSCENE
DR MICHELLE THE P. WITH MORE
THAN FOUR YEARS EXPERIENCE IN Q.
AND IN A MEDICINE THE FOR.
MEDICAL LOGIC AND REASON HAVE
TAKEN A BACK SEAT TO
UNFATHOMABLE POLICY BASED ON THE
FICTION. FOR CALLING IN IF YOU
COULD LEGALLY ROUNDUP OF
INFORMATION NOW WITH. ZERO AND
I'M GLOBAL REPORTING SYSTEMS
WHICH- TWO CHILDREN. I LEARNED
THAT WE SHOULD IT WE'RE GOING TO
GO ON TO THE NEXT CALLER. I WE
HAVE EXHAUSTED THE Q. MADAM
CHAIR. GREAT SEE NO MORE NO ONE
KNOWS LOOKING TO PROVIDE A
PUBLIC COMMENT IF YOU DIDN'T
HAVE THE OPPORTUNITY TO COME IN
PERSON ARE CALLING AS A REMINDER
YOU CAN STILL SUBMIT A WRITTEN A
PUBLIC COMMENT- TO THE BUDGET
AND FISCAL REVIEW COMMITTEE AND
OR VISIT OUR WEBSITE. THANK YOU
FOR EVERYONE'S PATIENT
COOPERATION THAT CONCLUDES THE
AGENDA AND WITH THAT THE SENATE
BUDGET SUB COMMITTEE NUMBER
THREE ON HEALTH AND HUMAN
SERVICES HAS EARNED.