OUR THE SENATE COMMITTEE ON
HEALTH WILL COME TO ORDER HI
GOOD AFTERNOON AND THE SENATE
CONTINUES TO WORK IN THE PUBLIC
IN PERSON AND BE OUR
TELECONFERENCE SERVICE WE WILL
ALLOW FOR SIX MINUTES OR IN
PERSON TESTIMONY PER SIDE EXTRA
CREDIT FOR NOT TAKING THAT FULL
AMOUNT OF TIME- IF NECESSARY
WILL CAP PHONE TESTIMONY FIFTY
MINUTES TOTAL FOR INDIVIDUALS
WISHING TO PROVIDE PUBLIC
COMMENT TODAY PARTICIPANT NUMBER
IS. 877-226-8163 AND THE ACCESS
CODE. IS. SEVEN THREE SIX TWO
EIGHT THREE FOUR WE HAVE FIFTEEN
WELL NOW FOURTEEN BILLS ON THE
AGENDA TODAY THREE OF THOSE
BILLS ARE ON PROPOSED CONSENT
AND THAT IS S. B. TEN SB FIVE OH
TWO SB SIX THIRTY NINE THREE
BILLS WERE PULLED FROM TODAY'S
COMMITTEE HEARING THAT IS SB
SIXTY SEVEN SB FIVE FIFTY ONE
AND SB SEVEN SEVENTY FOUR. OKAY
HAVE AN ESTABLISHED ALL THOSE-
WE ARE NOT WE'RE NOT RUNNING
WITH A FULL- COMMITTEE SOUL
START AS A SUBCOMMITTEE- DON'T
WE HAVE OUR FIRST OFF AUTHOR
HERE I SEE. CENTER PORTANTINO.
GOOD AFTERNOON MADAM CHAIR AND
MEMBERS- I'M HERE TO PRESENT. SB
TWO THREE FOUR- I'D LIKE TO
BEGIN BY ACCEPTING THE AMENDMENT
BE OUTLINED ON PAGE SIX OF THE
COMMITTEE ANALYSIS AND THANK
YOUR COMMITTEE STAFF AND MY
STAFF FOR WORKING. SO DILIGENTLY
ON THE BILL SO HAPPY TO TAKE A
MOMENT B. I'D ALSO LIKE TO THANK
SENATORS WIN ROSS AND THE MOANS
WERE ON THE COMMITTEE WERE ALSO
CO AUTHORS OF THE BILL. SB TWO
THREE FOUR WOULD REQUIRE SCHOOLS
COLLEGE CAMPUSES STADIUMS
CONCERT VENUES IN THE MUSEUM IN
PARKS IN THE STATE TO MAINTAIN.
AN EXPIRED DOSES OF NAXAL NAXAL
ON HYDRO CHLORIDE ALSO KNOWN AS
NOR CAN WE SAW SPIKE
UNFORTUNATELY. IN ADOLESCENT
DEATH RATES FROM OPIOID
OVERDOSES FROM TWO THOUSAND
NINETEEN TO TWO THOUSAND TWENTY.
NEARLY DOUBLING IN THE NUMBER
AND HAVE CONTINUED TO SEE AN
ALARMING INCREASE WITHIN THE
PAST YEAR. IT WAS ALSO FOUND
THAT 20% OF FORTY TWO BAY AREA
SCHOOL DISTRICTS REPORTED NOT
HAVING OUR CAN READILY AVAILABLE
ON THEIR SCHOOL CAMPUSES. IT'S
CRUCIAL THAT WE PLACE IN OUR
CANTON SPACES FREQUENTLY S. S.
S. ACCESS BY CALIFORNIANS GIVEN
THE SEVERE RISK POSED BY OUR
STATE'S GROWING OPIOID CRISIS.
NOR CAN IS A MEDICATION THAT
WITH WITH WITH THAT HAS THE
POTENTIAL TO SAVE LIVES FROM
ENDING IN DEATH AFTER AN OPIOID
. EXPLOSION EXPOSURE. WE THAT
STATE THAT HAVE IN DISTRIBUTION
PROGRAMS HAVE SEEN A SIGNIFICANT
REDUCTION IN DEATH RATES BY
FOLLOWING THIS APPROACH THIS
BILL WILL HELP EQUIP SCHOOLS AND
OTHER VENUES WITH THE RESOURCES
THEY NEED. TO PROTECT STUDENTS
AND KEEP OUR COMMUNITIES AT
LARGE SAFE I WISH WE DIDN'T HAVE
THIS CRISIS WHICH WE DIDN'T HAVE
AN OPIOID CRASHES I MEAN IT IT
BREAKS MY HEART EVERY TIME. A
CONSTITUENT FAMILY OR YOU SEE
SOMEBODY ON THE NEWS I MEAN IT'S
JUST. IT'S HEART WRENCHING AND
TO KNOW THAT WE HAVE. SOMETHING
THAT CAN HELP IN THAT EMERGENCY-
WE SHOULD TRY TO MAKE IT READILY
AVAILABLE. I'VE BEEN AT- PLACES
IN MY DISTRICT WHERE IT'S GIVEN
OUT TO. HOMELESS WHICH IT SHOULD
BE- WE TRY TO PUT IT. PUT IT OUT
IN CIRCULATION AS MUCH AS
POSSIBLE AND WHAT THIS BILL
SEEKS TO DO. IS TO MAKE IT
AVAILABLE TO THOSE VENUES THAT
WE KNOW OUR YOUNG PEOPLE GO AND
SELL- WITH ME TODAY I HAVE ADRIN
CHILDREN FROM THE CALIFORNIA
ALLIANCE OF CHILD. CHILD AND
FAMILY SERVICES AND CAME STONE
FROM THE CALIFORNIA DISTRICT
ATTORNEYS ASSOCIATION. THE
TESTIFYING IN SUPPORT AND I
WOULD RESPECTFULLY ASK FOR AN
AYE VOTE WHEN APPROPRIATE. THANK
YOU VERY MUCH FIRST WHAT IS
PLEASE. THANK YOU GOOD AFTERNOON
SHERRY MEMBERS ADRIAN SHELTON
WITH THE CALIFORNIA ALLIANCE OF
CHILD AND FAMILY SERVICES. WE
REPRESENT ONE HUNDRED SIXTY
NONPROFIT COMMUNITY BASED
ORGANIZATIONS ACROSS THE STATE
SERVING CHILDREN YOUTH AND
FAMILIES. SO WE'RE PROUD TO
SUPPORT SB TWO THIRTY FOR TODAY.
OUR MEMBERS US SERVE STUDENTS IN
A VARIETY OF SETTINGS ACROSS THE
STATE AND RECOGNIZE. THE NEED TO
HAVE THESE LIFE SAVING
MEDICATIONS SUCH AS NALOXONE.
AVAILABLE ON SCHOOL CAMPUSES. WE
ALREADY HAVE EXISTING LAN OR
STATE WHICH AUTHORIZES EACH
PUBLIC AND PRIVATE ELEMENTARY
AND SECONDARY SCHOOLS TO
DETERMINE WHETHER TO MAKE.
EMERGENCY NALOXONE AND TRAINED
PERSONNEL AVAILABLE AFTER SCHOOL
SITE. HOWEVER DUE TO THE
AVAILABILITY OF OPIOIDS AND
THEIR IMPACT ON YOUTH ACROSS THE
STATE. WE BELIEVE THAT WE MUST
TAKE FURTHER PRECAUTIONS. THE
OPIOID CRISIS HAS BEEN
HEIGHTENED AND WE ARE SEEN
TRAGIC FEST LINKED TO OPIOID
OVERDOSES. ALARMING RATE SO FOR
EXAMPLE THE CALIFORNIA
DEPARTMENT OF PUBLIC HEALTH. HAS
REPORTED A TOTAL OF OVER SIX
THOUSAND. THAT'S RELATED TO ANY
OVERT OVERDOSE IN THE LAST YEAR.
THAT'S UP. FROM FIFTY FIVE
HUNDRED AND TWENTY TWENTY. SO
BELIEVE THAT WE MUST HAVE KNOWN.
MORE COMMONLY KNOWN AS DARK CARE
MORE READILY. IN SCHOOLS AND
OTHER VENUES- TO REDUCE THESE
OPIOID RELATED DEATH. THE WE
BELIEVE THAT OUR SPEED TO THIRTY
FOUR WILL BETTER EQUIP
CALIFORNIA TO DEAL WITH OUR
OPIOID CRISIS AND SO WE ARE
PLEASED TO SUPPORT SB TWO THIRTY
FOR TODAY. THANK YOU VERY MUCH.
NEXT PERSON PLEASE GOOD MORNING
KIM STONE STONE ADVOCACY ON
BEHALF THE CALIFORNIA DISTRICT
ATTORNEYS ASSOCIATION. I WASN'T
GONNA START MY REMARKS WITH MY
ALLERGIES BUT I HAVE SUBSTANTIAL
. SEASONAL ALLERGIES AND FINE
NOW USE FLOW NEEDS YEAR ROUND
WHICH I HIGHLY RECOMMEND TO ANY
OF THE REST OF YOU WHO HAVE IT.
AND EVERY MORNING I WAKE UP.
IT'S NOT EXACTLY A SNORTS LIKE A
REALLY KIND OF EASY PLUNGE PUSH
AND INHALE AT THE SAME TIME.
WHICH IS VERY SIMILAR TO HOW ONE
WOULD ADMINISTER NALOXONE IT'S
EXTREMELY SIMPLE- AND I THINK
YOU HAVE ALL HEARD FROM MANY
OTHER WITNESSES AND MANY OTHER
BILLS THE- PROBLEM OF- OF
OPIOIDS. IN TWENTY TWENTY ONE.
IN CALIFORNIA- WE HAD TWO
HUNDRED AND TWENTY FOUR PHENYL
RELATED OVERDOSE DEATHS IN TEENS
AGES FIFTEEN TO NINETEEN FOR THE
CALIFORNIA. DEPARTMENT OF PUBLIC
HEALTH AND IN THE UNITED STATES-
PER. PER THE CDC. OUR MINORS
AGES TWELVE TO EIGHTEEN OVERDOSE
THIS IS ALL DRUGS NOT JUST-
OPIOIDS AT A RATE HIGHER THAN
THE REST OF THE UNITED. STATES
AND THEN FOR ADULTS EIGHTEEN AND
UP FENTANYL KILLS MORE PEOPLE
EACH YEAR THAN AUTO CRASHES
GUNSHOTS A SUICIDE AND MORE EVEN
THAN DIED BY COVERED NINETEEN IN
TWENTY TWENTY ONE. MY CLIENTS
THAT DISTRICT ATTORNEYS DON'T
BELIEVE THAT THIS IS THE ONLY
PART OF THE SOLUTION THEY'VE GOT
A BUNCH OF OTHER BILLS THEY
SUPPORT BETTER ACTUALLY UNLIKELY
TO PROCEED. BUT THIS IS ONE BUT
IT MIGHT ACTUALLY BE ABLE TO DO
SOMETHING AND SO WE URGE YOUR
SUPPORT. THANK YOU VERY MUCH
WHAT ELSE THAT WOULD BE THE TIME
JUST NAME AND AFFILIATION.
LITERATURE BOB ZERO AND WE HAVE
OF PINNACLE TREATMENT CENTERS WE
HAVE FORTY FOR MEDICALLY
ASSISTED TREATMENT CENTERS
THROUGHOUT CALIFORNIA AND WE.
SUPPORT THE BILL THANK. THANK
YOU MIL CORTES WOULD COVER
ADVOCATE ON BEHALF THE SANFORD
FOUR NINERS WILL. FOR NOT HAVING
OUR LETTER AND WE ARE WORKING ON
THAT I WANT TO THANK THE AUTHOR
IN A STAFF FOR WORKING WITH US
ON TECHNICAL AMENDMENTS AROUND
STADIUMS AND CONCERT VENUES.
THANK YOU. GOOD AFTERNOON SOME
ARE PALCA CALIFORNIA CATHOLIC
CONFERENCE IN SUPPORT. THANK YOU
. PURCELL JUST ON BEHALF OF THE
CITY OF. SANTA MONICA AND
SUPPORT THANK YOU. MALAYSIAN
WITH THE CATHOLIC CONFERENCE IN
SUPPORT THANK YOU THANK YOU.
UNDERCUT KIRBY WITH THE
CALIFORNIA COUNCIL OF COMMUNITY
BEHAVIOR HEALTH AGENCIES IN
STRONG SUPPORT THANK YOU. KOREA
SHE TO WITH THE STEINBERG
INSTITUTE IN SUPPORT. THANK YOU
VERY MUCH- WE HAVE NO LISTEN
OPPOSITION TO THIS BILL IF
THERE'S ANY OPPOSITION THAT YOU
COME FORWARD NOW. SEEING NONE-
ANYONE JUST IN THE ROOM. HI
SEEING NONE WILL GO TO THE
PHONES FOR- PEOPLE- JUST NAME
AFFILIATION AND FEAR FOR THE
BILL OR AGAINST THE BILL.
MODERATOR PLEASE. HELLO LADIES
AND GENTLEMEN IF YOU HAVE-
OPPOSITION OR FOR THE BILL.
PRESS ONE IF ZERO ON YOUR
TELEPHONE KEYPAD. DEMOCRATIC WE
ARE CALLING FROM LINE NUMBER
FORTY NINE YES GO AHEAD. GOOD
AFTERNOON SURE MEMBERS SEND US
ON BEHALF OF LOS ANGELES COUNTY
SUPERINTENDENT SCHOOL DR DEBORAH
DARO. SUPPORT THANK YOU THANK
YOU VERY MUCH NEXT CALLER PLEASE
. THANKS CALLER FROM NINE FIFTY
TO PLEASE GO AHEAD. MEDICARE
TONY TOOK A ROW ON BEHALF OF THE
CALIFORNIA TEACHERS ASSOCIATION
IN SUPPORT THANK YOU THANK YOU
VERY MUCH NEXT CALLER PLEASE.
THE MIX COLORS OF MY NUMBER
FIFTY FIVE PLEASE GO AHEAD.
AFTERNOON MADAM CHAIR LAWRENCE
INSPECTED HERE ON BEHALF OF
GOVERNMENT FOR CALIFORNIA IN
SUPPORT. THANK YOU VERY MUCH TAX
COLOR PLEASE. WE ARE NO FURTHER
OUR OR FOR ME PROCEED. OKAY
THANK YOU VERY MUCH- NOW WOULD
BE THE TIME TO BRING IT BACK TO
THE DAYS FOR ANY QUESTIONS AND
OR COMMENTS. SENTIMENT FOR.
THANK YOU MANAGER- YOU KNOW I
APPRECIATE THE WITNESS WHO
SHARED THAT YOU KNOW SHE
COMPARED IT TO PUTTING. WITH THE
FLOW NAYS HOW EASY IT WAS YOU
KNOW I WORKED AS AN EMT AND MY
SCOPE OF PRACTICE I WOULD
QUESTION MIKE BUT IT'S SO EASY I
CAN JUST GIVE SOMEONE TIME AND-
I CAN JUST GIVE SOMEONE THIS BUT
IT WASN'T WITHIN MY SCOPE OF
PRACTICE. EVEN THOUGH IT WAS
REALLY EASY TO DO- AN MP PEN IS
NOT WITHIN THE SCOPE OF PRACTICE
FOR AND AN EMT TO DO IN EVERY
SINGLE COUNTY JUST BECAUSE
THAT'S WHAT THE WHAT THE SCOPE
OF PRACTICE. I DO HAVE SOME
HESITANCY TO MOVE FOR WITH A
BILL THAT GOES AGAINST THE
STANDING ORDER THAT REQUIRES
TRAINING FOR THIS- AND I DO KNOW
WE HAVE A BILL LATER ON THAT
TOOK THE AMENDMENTS FOR TRAINING
I KNOW IT'S IMPORTANT. BUT I PUT
ON MY HEAD OF HOW THE NAME T. R.
E. I KNOW THESE THESE LAWS THESE
ORDERS ARE IN PLACE FOR A
CERTAIN REASON- TO PROTECT.
SOMETIMES THE UNINTENDED
CONSEQUENCES OUT OF THAT SO. I'M
I'M STILL VERY HESITANT WITH
THIS- RECOGNIZE THE IMPORTANT
BUT THAT TRAINING PART IS WHAT
I'M REALLY WORRIED ABOUT. GIVE
RESPOND SENATOR YEAH I MEAN THE
FOOD AND DRUG ADMINISTRATION IS
MAKING IT AVAILABLE OVER THE
COUNTER AND IT'S GOING TO BE
AVAILABLE ONLINE- EXISTING LAW
ALLOWS THE TRAINING TO BE
PERMISSIVE ON CAMPUSES- I JUST
DON'T WANNA OVER BURDEN- THE
SCHOOL DISTRICT WITH THE- WITH
THE MANDATE OF THE TRAINING
WHEN. THIS PARTICULAR PRODUCT IS
SO SIMPLE TO IMPLEMENT I
RESPECT- THE- THE ISSUE WITH MP
PENS. THAT'S A LITTLE BIT
DIFFERENT A LITTLE BIT MORE
COMPLICATED THAN. THAN NOR CAN I
MEAN I'VE BEEN AT THIS. HOMELESS
SHELTER. AND SWEAR. WE JUST GIVE
IT AN ENEMY FOR GIVING IT TO ONE
SEGMENT OF THE POPULATION AND-
WITH THE UNDERSTANDING THAT
THEY'RE CAPABLE OF ADMINISTERING
AND I THINK. ON A SCHOOL SETTING
OR IN A CONCERT VENUE. WE
SHOULDN'T HAVE TO BE THE SAME SO
I JUST THINK THE MANDATING
TRAINING FOR SOMETHING THIS
SIMPLE IN THIS REGULARLY
AVAILABLE PRODUCT JUST MAKES IT
OVER BURDENSOME SO THAT'S THAT'S
- YOU KNOW IT'S A JUDGMENT CALL
I RESPECTED THAT THE DISCUSSION
PIECE BECAUSE THE QUESTION IS
DOES IT MAKE IT MORE EFFICIENT.
OR DOES IT MAKE IT MORE
BURDENSOME AND THAT'S WHAT WE'RE
REALLY TALKING ABOUT HERE. I AM
CITING ON MAKING IT. LESS
BURDENSOME AND THINK THAT ON
BALANCE WILL. GET TO MORE PEOPLE
AND HELP MORE PEOPLE IN THIS
TRAINING SIDE YOU CAN MAKE THAT
ARE AYE SO. I THINK IT'S JUST
WHERE WE SEE ON THE SPECTRUM OF
THAT CONVERSATION SO I REALLY
RESPECT. THE QUESTION BUT I JUST
THINK ON BALANCE WE'RE GOING TO
HELP MORE PEOPLE IF WE MAKE IT
MORE READILY AVAILABLE AND
THAT'S THAT'S WHERE I'M AT
AIRING ON THAT SIDE. OKAY
ANYBODY ELSE. DR THANK YOU
VENTURE YOU KNOW I'M- I JUST
STEPPED I AGREE WITH THE
TRAINING ASPECT AND IN SOME
CASES I JUST WONDER. IN THIS
PARTICULAR SITUATION GIVEN THE
NATURE OF THIS EPIDEMIC IF YOU
CAN CALL THIS AN EPIDEMIC. IF WE
SHOULDN'T ERR ON THE SIDE OF
PUTTING MORE OF THIS OUT.
EVERYWHERE AND TO. HAVE SOMEONE
THINK THAT SINCE THEY HAVE BEEN
TRAINED THEY CAN'T. ADMINISTER
THAN OUR CAN. HELLO LUCK SOON- I
THINK. IT CREATES A OF A PROBLEM
THAT WE MAY WANT TO TRY TO AVOID
BECAUSE- THE CONSEQUENCES OF.
NOT DOING IT ALL I THINK THAT
ALL. ARE CERTAINLY GREATER THAN
THE CONSEQUENCES OF. NOT FULLY.
ADMINISTERING THE PLUNGER OR- OR
OR THINGS LIKE THAT I. I'M
CERTAINLY NO EXPERT- I DEFER TO
PEOPLE WHO. ARE EXPERTS
INCLUDING MY COLLEAGUE WHO IS A
LICENSED CLINICAL SOCIAL WORKER
AND HAS EXPERIENCE AS AN EMT AND
PROBABLY IN A VARIETY OF OTHER
HEALTH CARE. MARINAS ON THE
SUBJECT BUT I JUST WANT TO THROW
THAT OUT THERE IS MY TWO CENTS I
OBVIOUSLY WILL BE SUPPORTING THE
MEASURE THANK YOU MANAGER. THANK
YOU VERY MUCH- AND I CAN I WILL
. I WILL SAY THAT WITHIN YOU AND
I HAVE HAD CONVERSATIONS THAT I
THINK THE TRAINING IS IMPORTANT-
THE LAST BILL THAT WE WERE- KIND
OF WORKING OFF. AB THREE EIGHTY
ONE IT HAS TRAINING AS A
COMPONENT OF THAT BILL. THAT
WOULD ALLOW SCHOOLS TO BE ABLE
TO DO THIS NOW WE'RE GOING TO
MANDATE IT- AND MOST PEOPLE GET
THEIR THEIR- THE DOSAGE FROM THE
DEPARTMENT HEALTH CARE SERVICES
THAT'S WHERE THEY GET IT FROM.
AND THERE'S A FREE ONLINE
TRAINING THAT DOES NOT SEEM TO
BE OVERLY BURDENSOME AT ALL. WE
LIVE IN A LITIGIOUS WORLD I JUST
I WORRY ABOUT EDUCATORS HAVING
TO A RECOGNIZE THE SIGNS AND
SYMPTOMS OF AN OVERDOSE VERSUS A
SEIZURE VERSUS SOMETHING ELSE.
AND THEN FEELING COMFORTABLE
ENOUGH TO ADMINISTER IT- AND
THEREBY POTENTIALLY STANDING BY
AND DOING NOTHING. AND THEN I
ALSO THAN WORRY ABOUT IF WE'RE
GOING TO HAVE IF THE PEOPLE
GONNA BE. AGAIN BUT ALSO
SOMEBODY WHO HAS WORKED IN THE
HEALTHCARE FIELD. THE SCOPE OF
PRACTICE IS IMPORTANT AND A
TRAINING. I'M I WENT THROUGH
THIS MORE AND IT WAS PRETTY
PRETTY. FUN UNBURDEN SOME. TO DO
THE TRAINING MYSELF THIS
MORNING- AND THOSE THINGS IN
THERE THAT THAT I DIDN'T KNOW-
SO I JUST LIKE AND I'VE BEEN
I'VE SHARED WITH YOU I WILL BE
SUPPORT HIS BILL TODAY I'M NOT.
I THINK THERE IS AN EPIDEMIC I'M
NOT GONNA STAND IN THE WAY OF
IT- BUT THE TREE DOES NOT SEEM
TO BE BURDENSOME AND IF WE'RE
REQUIRING AND MANDATING IT ALL
THESE PLACES. AT SOME POINT DO
WE THEN RUN INTO A- A PROBLEM
WITH SUPPLY WHEN WE DON'T KNOW
THAT AND WE DON'T KNOW IF IT
WOULD NOT THEN HAVE ENOUGH FOR
FOLKS WHO ARE. OUT ON THE STREET
YOU USING- AND THE FUN I WOULD
ARGUE THAT THE FOLKS IN THE
HOMELESS CAMPS OR GIVING IT OUT
HAVE BEEN TRAINED THAT'S- THEIR
JOB IS TO GO OUT. AND CONTACT
FOLKS WHO ARE IN THE CAMPS. AND
AS YOU'VE ALREADY SAID IT'S
GOING TO BE OVER THE COUNTER
NOW. AND I WOULD IMAGINE THOSE
WHO ARE BUYING IT OVER THE
COUNTER OR THOSE WHO ARE. USERS
AND OR KNOW PEOPLE WHO ARE
USING- I COULD POTENTIALLY. SO
THAT'S THEIR OWN THEIR OWN
PERSONAL CHOICE BUT WHAT WE'RE
TELLING SCHOOLS THAT THEY HAVE
TO DO IT. WHICH THEN I THINK
JUST WE JUST GET INTO. MORE GRAY
AREAS- SO I. I WILL HOPE THAT
YOU'LL MAYBE CONTINUE. THINKING
ABOUT TAKING SOME AMENDMENTS AND
I CAN SUPPORT THIS WHEN IT'S ON
THE FLOOR. WOULD YOU LIKE CLOSER
I WOULD TO- AND AS I SAID THIS
IS A REALLY. A CONVERSATION
ABOUT. PHILOSOPHICALLY WHAT WE
THINK WILL. HELP THE MOST PEOPLE
IN A TIME OF CRISIS AND I AGREE
WITH THE GENERAL THAT JUST
HAVING MORE OF AN IN CIRCULATION
HAVING MORE OF AN AVAILABLE. I
THINK IT'S GOING TO SAVE MORE
LIVES THAN THAN. THEN A
PROCEDURAL ISSUE AND- I ALSO
THINK IT IT. ATTENTIVELY MAKES
THE BILL HARDER TO GET A
SIGNATURE DOWN THE ROAD TO AND
SO I JUST. ONE ERROR ON THE SIDE
OF A FREE TRAINING MAKES IT HARD
TO GET A SIGNATURE. THE MANDATE
PART ON THE TRAINING MAKING ONLY
APPLICABLE TO A SCHOOL THAT HAS
THE TRAINING IT'S THAT'S THE
PIECE NOT THE TRAINING ITSELF
IT'S THAT IT'S THE- SAME TO.
THAT YOU HAVE TO HAVE THE
TRAINING IN ORDER TO HAVE THE
PRODUCT THAT'S THE PIECE IT'S
NOT THE TRAINING IT'S THE-
BURDEN THAT THAT PUTS ON THAT
SCHOOL DISTRICT AND SO. I THINK
THAT THAT MAKES THE BILL HARDER
TO PASS. SO WITH THAT I
RESPECTFULLY ASK FOR AN IPHONE
RESPECTFULLY DISAGREE WITH THE
CHAIRS ANALYSIS OKAY WELL THANK
YOU VERY MUCH. WELL WE HAVE A
QUORUM WILL TAKE A VOTE. THANK
YOU CENTER DRAWS OF. READY THANK
YOU CHAIR AND TO THE COMMITTEES
. FOR THEIR THOUGHTFUL AND- I
WILL ACCEPT THE COMMITTEE
AMENDMENT ON PAGE SEVEN. OF THE
ANALYSIS. AS BEFORE TO FOR THE
CALIFORNIA CHILDREN'S SERVICES
MODERNIZATION ACT WILL HELP MAKE
LIFESAVING MEDICAL CARE FOR
CRITICALLY ILL CHILDREN.
ACCESSIBLE AND AFFORDABLE FOR
MORE FAMILIES. ESTABLISHED IN
NINETEEN TWENTY SEVEN THE
CALIFORNIA CHILDREN'S SERVICES
PROGRAM. SHARES FOR CHILDREN
WITH COMPLEX AND OR LIFE
THREATENING CONDITIONS SUCH AS
CANCER BUT NEEDS MODERNIZING.
THIS BILL WILL ALIGN THE CCS
CALIFORNIA CHILDREN'S SERVICES
MEDICAL ELIGIBILITY WITH BEST
PRACTICES ADDITIONALLY IT WILL
UPDATE FINANCIAL ELIGIBILITY FOR
MODERATELY MIDDLE CLASS FAMILIES
WITH CRITICALLY ILL CHILDREN.
CAN AVOID FINANCIAL CATASTROPHE
. THE THIRD THIS BILL WILL MAKE
REIMBURSEMENT FOR CCS PROVIDERS
MORE SUSTAINABLE AS RATES HAVE
NOT BEEN UPDATED SINCE TWO
THOUSAND AND TWO. CHILDREN'S
ACCESS TO LIFESAVING DRUGS IN
HOSPITALS IS JEOPARDIZED SINCE
THE DEPARTMENT OF HEALTH CARE
SERVICES DOESN'T COVER THESE
EXPENSIVE DRUGS THE SAME WAY AS
OUTPATIENT SO THIS BILL WOULD
EQUALIZE DRUG ACCESS WE ALSO
WANT TO PRESERVE THE PROVEN CCS
EXPERT CASE MANAGEMENT. AND
SUPPORT BY MAINTAINING THE
SEPARATION FROM MEDIC CAL
MANAGED CARE THE CHILDREN IN
THIS PROGRAM HAVE COMPLEX AND
EXPENSIVE MEDICAL NEEDS WHICH
NON SPECIALIZED HOSPITALS HAVE
DIFFICULTY CARRYING FOR OFTEN
THEY REFER PATIENTS TO
CHILDREN'S HOSPITALS WHERE THEY
CAN GET THE SPECIALIZED CARE.
THIS LEAVES CHILDREN'S HOSPITALS
AND THEIR PEDIATRIC PROVIDERS
DEALING WITH A HUGE SHARE OF THE
LOW MEDI CAL REIMBURSEMENT RATES
FOR PEDIATRIC CARE. MOST
CHILDREN IN THIS PROGRAM ARE
ELIGIBLE FOR MEDICAL 70% ARE
CHILDREN OF COLOR AND MANY
RESIDE IN RURAL AND UNDER
RESOURCE COMMUNITIES THERE ARE
SOME OF THE STATE'S BOTH
MEDICALLY FRAGILE. WITH
CONDITIONS LIKE CANCER SICKLE
CELL DISEASE CYSTIC FIBROSIS
SEVERE BURNS CEREBRAL PALSY AND
CONGENITAL HEART DISEASE AS
BEFORE TWENTY FOUR WILL HELP
THESE BABIES AND CHILDREN. MY
WITNESSES TODAY ARE NANCY
ANOTHER LENT PARENT OF TWO
CHILDREN AND FOUNDER OF KIDS IN
CARE GIVERS. SHE WILL BE
INTRODUCED BY AND LOUISE KUHNS
PRESIDENT AND CEO OF THE
CALIFORNIA CHILDREN'S HOSPITAL
ASSOCIATION WILL ALSO BE
AVAILABLE TO ANSWER TECHNICAL
QUESTIONS. AND DR CARLOS LEARNER
MEDICAL DIRECTOR FOR THE
PEDIATRIC MEDICAL HOME PROGRAM
AT UCLA MATTEL CHILDREN'S
HOSPITAL. THANK YOU MA'AM SHARE
. THANK YOU VERY MUCH NEXT
PERSON HER. THING A IN COULDN'T
A PRESIDENCY CALIFORNIA HOLDEN
HOSPITAL SO SAY- AS THE CENTER
SAID I'M HERE TO ANSWER
QUESTIONS AND I'D LIKE TO YIELD
MY TIME TO ANSWER ANOTHER LUNCH
AS A PARENT OF TWO CHILDREN WHO
CONCERT BY THE CCS PROGRAM.
THANK YOU. WELCOME THANK YOU
GOOD AFTERNOON. EGGMAN MEMBERS
OF THE SENATE COMMITTEE MY NAME
IS NANCY NO AND I'M THE MOTHER
OF TWO CHILDREN LIVING WITH
MEDICAL COMPLEXITIES. I ALSO
SERVED AS THE DIRECTOR OF A CARE
GIVER AND PARENT ENGAGEMENT
PROJECT FOR THE CALIFORNIA
CHILDREN'S TRUST. AND I SIT ON
THE CALIFORNIA MEDICAID
CHILDREN'S HEALTH ADVISORY AND
SHOP AND THE CCS MONITORING AND
OVERSIGHT COMMITTEE. I WANT TO
THANK YOU FOR THE OPPORTUNITY TO
EXPRESS MY SUPPORT FOR SB FOUR
TWENTY FOUR. THE IMPORTANCE OF
SB FOUR TWENTY FOUR IN CCS IS
FRONT OF MIND LAST FRIDAY WE
SPENT THE ENTIRE DAY WITH
PEDIATRIC SPECIALIST. A GASTRO
ENTOMOLOGIST A RHEUMATOLOGIST
IMMEDIATELY FOLLOWED BY
EXTENSIVE LABS AND A FIVE HOURS
A DAY IN THE UCSF PEDIATRIC
OUTPATIENT INFUSION CENTER. I
WAS ONCE AGAIN DEEPLY GRATEFUL
THAT MY DAUGHTER EMILY S. CARE
WAS COVERED BY CCS. HE WAS BORN
WITHOUT PRENATAL CARE AT THIRTY
TWO WEEKS OPIATE EXPOSED WITH
CARDIAC AND PULMONARY PROBLEMS.
SHE SPENT THE FIRST WEEKS OF HER
LIFE IN THE NICK YOU. WHAT ARE
SOCIAL WORKER CALLED TO SAY THAN
MILLION NEEDED A FOSTER TO ADOPT
HOME TO CARE FOR PREMATURE
INFANT WITHDRAWING FROM OPIATES.
PRESUMED TO BE BLIND AND
SEVERELY DEVELOPMENTALLY
DISABLED WE SAID YES. WE SAID
YES IN PART BECAUSE WE KNEW THAT
CCS WOULD ENSURE ACCESS TO AN
AUTHORIZATION. OF THE
SPECIALIZED CARE AND MILLION
NEEDED. TODAY MILLIONS FIFTEEN.
SHE LOVES HORSES ANIME AND
RAMAN. AND LIVES WITH A RARE
COMPLEX SYSTEMIC AUTO
INFLAMMATORY DISEASE AS WELL AS
AB DE ASTHMA INTRACTABLE
MIGRAINES BUT SHOTS DISEASE
EIGHTY D. AND LEARNING
DISABILITIES. AMALIA WAS
INCIDENTLY NOT BLIND IN PLANS TO
ATTEND COLLEGE HAS A CARE TEAM
THAT INCLUDES OVER TWENTY FIVE
MEDICAL SUBSPECIALISTS. EMILY
REQUIRES MONTHLY INFUSIONS
REGULAR HOSPITAL STAYS EXTENSIVE
AND EXPENSIVE HOME MEDICATION
REGIMES REGULAR LABS FREQUENT
SPECIALTY CARE VISITS ET
ADMISSIONS. B. NUTRITION
SERVICES INTEGRATIVE PAIN
MANAGEMENT. AT A LOT OF
PROCEDURES ALL REQUIRING TIMELY
ACCESS TO SPECIALIST THE KEEPER
HEALTHY WE'RE LUCKY WE'RE LUCKY
BECAUSE CCS IN THE QUALITY OF
CARE MILLION RECEIVED. HAS
ALLOWED HER TO EXPERIENCE MANY
MOMENTS OF WELLNESS AND WITHOUT
THE MAGIC OF CHILDHOOD INCLUDING
THE RECENT DELIGHT OF BEING WELL
ENOUGH TO SHOP FOR A DRESS FOR
HER FIRST HIGH SCHOOL DANCE.
WITH THE PASSAGE OF SB FOUR
TWENTY FOUR AND GREATER
INVESTMENT IN THE SYSTEM OF CARE
SHE SHE OTHER CHILDREN RELY ON
THEY'LL BE BETTER ACCESS TO
BREAK THROUGH DRUGS AND A TIMELY
AND SPECIALIZED CARE. SB FOUR
TWENTY FOUR CANNON WILL ENSURE
ACCESS TO THE SPECIALIZED CARE
COORDINATION SUPPORT SERVICES
AND PEDIATRIC SPECIALTY CARE
FAMILIES LIKE MINE DEPEND ON
THANK YOU SO MUCH THANK YOU
THANK YOU FOR SAYING YES. THANK
YOU SO MUCH GOOD AFTERNOON THAT
TERROR EGGMAN A MEMBERS OF THE
COMMITTEE I'M DOCTOR CARLOS
LEARNER AND MY CALIFORNIA-
CHILDREN SERVICES PANEL DECISION
NINE PROFESSOR AND VICE CHAIR OF
PEDIATRICS AT MATTEL CHILDREN'S
HOSPITAL UCLA. I ALSO HAVE THE
HONOR OF SERVING AS PRESIDENT OF
THE CHILDREN'S SPECIALTY CARE
COALITION WHICH IS A NONPROFIT
ADVOCACY ASSOCIATION. THAT
REPRESENTS EIGHTEEN PEDIATRIC
SPECIALTY MEDICAL GROUPS. OUR
MISSION IS TO ENSURE THAT
CHILDREN WITH COMPLEX HEALTH
CARE NEEDS HAVE TIMELY ACCESS TO
EQUITABLE HEALTH CARE. THERE ARE
OVER THREE HUNDRED FIFTY
THOUSAND CHILDREN IN CALIFORNIA
ARE CONSIDERING MEDICALLY
COMPLEX CHILDREN LIKE AMELIA
THAT ARE EXPECTED TO DOUBLE OVER
THE NEXT DECADE. THE MAJORITY OF
THEM DEPEND ON CCS ON THAT
SPECIAL IS FOR THEIR CARE. I
WANT TO SHARE WITH YOU WHAT OUR
MEMBERS HAVE BEEN EXPERIENCING
UP AND DOWN THE STATE REGARDING
ACCESS TO SPECIALTY MEDICAL
CARE. THIS YEAR ORGANIZATION
COMPLETED A SURVEY OF OUR
MEMBERS TO HELP DEVELOP A FULL
PICTURE OF THIS TAXES CRISIS. IN
TWELVE OF THE FIFTEEN
SPECIALTIES WE ASKED ABOUT THE
AVERAGE WEIGHT FOR NEW PATIENTS
EXCEEDED THAT NETWORK ADEQUACY
STANDARDS. FOR SOME SPECIALTIES
THE WAIT IS EVEN MORE EXTREME.
FOR A DEVELOPMENTAL SPECIALIST
THE AVERAGE WAIT IS OVER THREE
MONTHS. FOR A GENETIC SPECIALTY
LIST IS OVER FOUR MONTHS. IN
SOME REGIONS SUCH AS RURAL AREAS
TO WHICH CAN BE MUCH LONGER.
THIS LONG WAITS TO SEE A
SPECIALIST CAMBIADO NICE THING
FOR FAMILIES AND A HEALTH HAZARD
TO THEIR CHILDREN. I'VE
WITNESSED IS DIRECTLY INPUT MY
OWN PATIENTS. AT THE ROOT OF
THESE TAXES CHALLENGES OR
DIFFICULTIES IN RECRUITING AND
RETAINING PEDIATRIC SPECIALTY
PHYSICIANS. MEDICAL ISSUE
INSURANCE FOR THE MAJORITY OF
CHILDREN ACROSS THE STATE. BUT
IT PAYS FAR LESS TO MEDICARE FOR
COMPARABLE SERVICES. GREAT FOR
CCS PHYSICIAN SERVICES HAVE NOT
BEEN ADJUSTED IN OVER TWO
DECADES. THE EFFECTS OF THIS LOW
REIMBURSEMENT IS INEQUITABLE
CARE FOR OUR CHILDREN. WITH
FEWER AND FEWER DOCTORS CHOOSE
CHOOSING CAREERS IN PEDIATRIC
SPECIALTIES. IN OUR CALIFORNIA
SURVEY OUR. PHYSICIAN GROUPS
REPORTED AN AVERAGE RECRUIT AND
ABOUT LEASE ONE YEAR FOR NOW PM
BUT- WITH SOME POSITIONS. FOR
OVER YEARS. WITH US OF SPECIALTY
AND INCREASING CARE NEEDS MANY
OF OUR SPECIALTY PHYSICIANS ARE
OVERBOOKED AND OVERWORKED
LEADING TO BURNOUT AND FURTHER
LOSSES TO OUR SPECIALTY
WORKFORCE. ADDITIONALLY MANY OF
OUR ORGANIZATIONS EXPECT A HIGH
NUMBER OF SPECIALIST RETIREMENT
IN THE NEXT FEW YEARS. IN SOME.
CHRONIC UNDERFUNDING HAS SLOWLY
ERODED THE ABILITY OF CCS
PROVIDERS TO ENSURE AN ADEQUATE
NETWORK TO MEET THE DEMAND FOR
SERVICES OF OUR CHILDREN. SB
FOUR TWENTY FOUR IS VITAL TO
ENSURE THAT THE CCS PROGRAM
CONTINUES TO MEET THE NEEDS OF
CCS CHILDREN AND THEIR FAMILIES.
I RESPECTFULLY ASK FOR YOUR I.
BOATS THANK YOU THANK YOU VERY
MUCH- AND THEN LET'S TAKE A
QUICK PAUSE AND I THINK WE HAVE
A CORPSMAN ESTABLISH A QUORUM
SECRETARY IF YOU CALL THE ROLL.
SAN EGGMAN. A HERE WHEN HERE
GLAZER. GONZALEZ HERE FROM
DOLLARS HERE. GROWTH APARTADO.
LIMON END OF OUR- RANGE OF OUR
HERE ROSS. ROTH HERE RUBIO. BOB
BOB HERE WINNER. THEIR WINNER
HERE. THANK YOU MUCH WE HAVE A
QUORUM ALL RIGHT ANYBODY ELSE
HERE TO SPEAK IN SUPPORT. OF
THIS BILL S. B. FOR TWENTY FOUR
PLEASE COME FORWARD NOW JUST
NAME AFFILIATION PLEASE. KELLY
BROOKS ON BEHALF OF THE
CALIFORNIA ASSOCIATION OF PUBLIC
HOSPITALS AND HEALTH SYSTEMS
HERE IN SUPPORT. NORTHLAND WITH
CHILDREN NOW IT'S SUPPORT THANK
YOU. FOR THE BILL AND PARENTS
APART THANK YOU. AARON TAYLOR ON
BEHALF OF THE MORIAL CARE HEALTH
SYSTEM IN SUPPORT THANK YOU.
PRICE DOUGHERTY IN BEHALF OF THE
AMERICAN ACADEMY OF PEDIATRICS
CALIFORNIANS SUPPORT. THANK YOU
VERY MUCH. OKAY NOW'S THE TIME
FOR OPPOSITION. YOU HAVE SIX
MINUTES TOTAL. GOOD AFTERNOON
TERRY COMMITTEE MEMBERS WHEN
THEY EXCITEMENT AT THE LOCAL
HEALTH PLANS OF CALIFORNIA WHICH
REPRESENTS THE SIXTEEN LOCAL
MEDIC HOW MANAGED CARE PLANS
INCLUDING THE COUNTY ORGANIZED
HEALTH SYSTEMS THAT PROVIDE
INTEGRATED CARE TO CCS ELIGIBLE
CHILDREN THROUGH THE WHOLE CHILD
MODEL. L. H. B. C. HAS IT OPPOSE
UNLESS AMENDED POSITION ON THIS
BILL BECAUSE IT PROHIBITS
EXPANSION OF WHOLE CHILD MODEL
INCLUDING INCLUDING FOR COUNTY
ORGANIZED HEALTH SYSTEMS THAT
WILL BE EXPANDING INTO NEW
COUNTIES IN TWENTY TWENTY FOUR.
THE WHOLE CHILD MODEL BEGAN AS A
SMALL PILOT PROGRAM THAT
EXPANDED TO OTHER COAST COUNTIES
THROUGH SB FIVE EIGHTY SIX AND
TWENTY SIXTEEN. ONE OF THE GOALS
OF SB FIVE EIGHTY SIX S. IMPROVE
COORDINATION AND INTEGRATION OF
SERVICES FOR CHILDREN ENROLLED
IN THE CCS PROGRAM TO TREAT THE
WHOLE PERSON OR THE WHOLE TILED
INCLUDING CARE FOR THEIR CCS
ELIGIBLE CONDITION OTHER HEALTH
AND BEHAVIORAL HEALTH SERVICES.
AND TO ADDRESS SOCIAL DRIVERS OF
HEALTH. SINCE SB FIVE EIGHTY SIX
WAS PASSED NEARLY SEVEN YEARS
AGO COUNTY ORGANIZED HEALTH
SYSTEMS THAT OPERATE A WHOLE
CHILD MODEL. DEVELOPED EXPERTISE
IN SERVING THE CCS POPULATION
MAINTAINED CLOSE CONNECTIONS
WITH THE FAMILIES OF CCS
CHILDREN TO BOTH CASE
MANAGEMENT. AND REGULAR FAMILY
ADVISORY COMMITTEE MEETINGS
SUCCESSFULLY CONTACTED
CONTRACTED WITH THE PROVIDERS
THAT SERVE THESE CHILDREN
INCLUDING THE CHILDREN'S
HOSPITALS AND SPECIALTY CARE
CENTERS. THAT CONTINUE TO
COORDINATE CLOSELY WITH THEIR
COUNTIES HAVE BEEN ONGOING ROLE
IN WITH RESPECT TO CCS
ELIGIBILITY. AN INDEPENDENT
EVALUATION OF THE WHOLE CHILD
MODEL PROGRAM WHICH ASSESSES THE
OVERALL IMPACT OF THE
IMPLEMENTATION OF WHOLE CHILD
MODEL WAS RECENTLY RELEASED BY
DH CS. THE RESULTS OF THE
EVALUATION ARE CLEAR THAT THE
WHOLE CHILD MODEL MEETS THE
GOALS OF MAINTAINING ACCESS TO
PRIMARY AND SPECIALTY CARE FOR
THE CCS POPULATION. HAS
MAINTAINED OR IMPROVED MEMBER
SATISFACTION. AS WITH ANY
PROGRAM THE EVALUATION ALSO
IDENTIFIES OPPORTUNITIES FOR
IMPROVEMENT FOR FURTHER AN
INVESTIGATION BOTH AND WHOLE
CHILD MODEL COUNTIES. AND CCS
CLASSIC COUNTIES WHERE CCS IS
NOT CARVED INTO THE PLAN. BUT
THE OVERALL FINDINGS DEMONSTRATE
. THE EARLY SUCCESSES OF WHOLE
CHILD MODEL. SB TO FOUR AND MANY
TO KIND. TO MY THE CS AND
ADDRESS PROVIDER FINANCIAL
CONCERNS. L. A. T. C. DOES NOT
OBJECT TO THOSE PROPOSED
CHANGES. ARE OPPOSITION IS
PREDICATED ON SECTIONS EIGHT AND
NINE OF THE BILL WHICH WOULD
PROHIBIT ANY EXPANSION OF FULL
TILE MODEL. LOOK FORWARD TO
WORKING TO CONTINUING TO WORK
WITH AUTHOR AND SPONSORS TO
ADDRESS OUR CONCERNS THANK YOU
THANK YOU VERY MUCH. NEXT PERSON
PLEASE. THANK YOU MADAM CHAIR
MEMBERS TRENT SMITH ON BEHALF OF
TWO OF THE L. H. P. C. MEMBERS.
CALIFORNIA ALLIANCE FOR HEALTH
IN PARTNERSHIP HEALTH- SO SEAT
ARE REMARKS OF THE PREVIOUS
SPEAKER THANK YOU. THANK YOU
VERY MUCH ANYBODY ELSE HERE TO
SPEAK IN SUPPORT OR OPPOSITION
OF THIS BILL PLEASE COME FORWARD
NOW. SEEING NONE. LET'S GO TO
THE PHONE LINES MODERATOR. THERE
ANY CALLERS IN THE QUEUE. THANK
YOU IF YOU WOULD LIKE TO TESTIFY
I THINK WE ON SB FOUR TWENTY
FOUR SO. JUST BEFORE TWENTY FOUR
THAT'S CORRECT. OKAY OKAY
ANYBODY FOR SB TWO FOUR TWENTY
FOUR IF YOU'D LIKE TO TESTIFY AT
THIS TIME. BURKE PLEASE PRESS
ONE FOLLOWED BY ZERO ONE FIVE
EIGHT ZERO POINT FORTY ONE
PLEASE GO AHEAD. GOOD AFTERNOON
MADAM CHAIR AND MEMBERS NICOLE
WORTMAN ON BEHALF OF THE
CHILDREN'S PARTNERSHIP IN
SUPPORT. THANK YOU VERY MUCH TAX
COLOR PLEASE. FIND FIFTY SIX YOU
ARE OPEN. THE THIRTY SIX PLEASE
GO AHEAD. THANK YOU MADAM CHAIR
HERE GONZALEZ ON BEHALF OF THE
HAEMOPHILIA COUNCIL OF
CALIFORNIA AND STRONG SUPPORT.
THANK YOU VERY MUCH TEXT COLOR
PLEASE. FIVE SIXTY ONE YOU ARE
OPEN. HELLO SANCHEZ CHILDREN POP
LOS ANGELES IN SUPPORT OF SB
FORTY FOUR THANK YOU. FOR THANK
YOU VERY MUCH FOR A FUN ROOM.
PLEASE PRESS ONE ZERO IF YOU ARE
IN. SUPPORT OR OPPOSITION TO SB
FOUR TWENTY FOUR AND LINE. WE
HAVE ONE MORE WITH AN OPERATOR
ONE MOMENT VENTURE. OVERLYING
FORTY THREE LINE FORTY THREE.
THANK FORTY THREE CAN YEARS.
LOOKING IN THE PROPOSAL CITING
THEM SUPPORT. THANK YOU VERY
MUCH THANKS CALLER IF THERE IS
ONE. FIFTY EIGHT PLEASE GO AHEAD
. BY FIFTY EIGHT YOU ARE OPEN. I
FIFTY EIGHT ONE MORE SHOT WOULD
YOU LIKE TO TESTIFY. YOUR LINES
OPEN. THEY'RE NOT RESPONDING
THAT HAS EXHAUSTED THE QUEUE.
THANK YOU VERY MUCH OKAY NO WE
WOULD BRING IT BACK TO THE
COMMITTEE FOR ANY QUESTIONS AND
OR COMMENTS CENTER US. THANK
YOU- THE MANAGER I GUESS MY
QUESTION MAY BE. COULD BE
DIRECTED TO THE LOCAL PLANS THAT
WERE OPPOSING AT LEAST IN PART
UNLESS AMENDED. AND MY FIRST ONE
IS HOW HOW DO YOU ENSURE.
NETWORK AT ADEQUACY IN IN THIS
WHOLE. CHILD MODEL SITUATION
CRAP YOU COVERED IT BUT- I'M
CONCERNED ABOUT GIVEN THE-
POLITICAL NATURE OF THE CHILDREN
THAT ARE SERVICED BY THE CCS
PROGRAM- I ASSUME MANY OF THE
CONDITIONS REQUIRE HIGHLY
SPECIALIZED. AND TRAINED-
HEALTHCARE PROVIDERS INCLUDING.
PHYSICIANS AND SOME OF THE
COUNTY'S SITTER IN THE WHOLE
CHILD MODEL. MAY OR MAY NOT HAVE
OF THOSE KINDS OF A FACILITIES
IN THOSE TYPES OF HIGHLY SKILLED
PROVIDERS AVAILABLE. YES I'LL
I'LL FOCUS MY COMMENTS ON- THE
WHOLE CHILD MODEL PLANS AND THAT
CURRENTLY OPERATE IN THE PROGRAM
AND WILL BE EXPANDING INTO
TWELVE ADDITIONAL COUNTIES IN
TWENTY TWENTY FOUR SO- PRIOR TO
THE IMPLEMENTATION OF WHOLE
CHILD MODEL WHICH WAS STAGGERED
BEGINNING IN IN TWENTY EIGHTEEN-
THERE IS A VERY RIGOROUS READING
THIS PROCESS- THAT OCCURRED WITH
DH CS AND WHERE NETWORK AT ISC
ADEQUACY HAD TO BE DEMONSTRATED.
INCLUDING CONTRACTS WITH CCS
PANEL PROVIDERS THAT PROVIDE
THIS HIGHLY SPECIALIZED CARE TO
YOUR POINT- SO THERE IS NETWORK
ADEQUACY THAT SOMETHING THAT
THAT DTS MONITORS ON AN ONGOING
BASIS AND I THINK ONE DATA POINT
TO PULL OUT FROM FROM THE WHOLE
CHILD MODEL EVALUATION. IS THAT
ACTUALLY 90% OF- SPECIALTY CARE
VISITS FOR HOLD TIGHT FOR
CHILDREN RULED IN WHOLE CHILD
MODEL WHERE WITH CCS PANELED
SPECIALTY CARE PROVIDER SO-
EIGHT EIGHT I HOPE THAT ANSWERS
YOUR QUESTION BUT IT IS THAT A
PROCESS THAT DHS I'M GOES
THROUGH WITH THE PLANS TO ENSURE
THAT THERE IS AN ADEQUATE
NETWORK TO SERVE THOSE. THOSE
LITTLE CHILDREN. THANK YOU MAY
BE THE ANSWER TO THIS QUESTION
IS WRAPPED IN MINIATURE TO THE
PREVIOUS ONE BUT- IF NOT YOU
COULD. HIGHLIGHTED FOR ME.
REALLY THERE WAS A RECENT STUDY
THAT CAME OUT OF NOT AN
OPPORTUNITY TO REVIEW IT HE YOU
REFERENCED IN YOUR EARLIER
COMMENTS. AND SO WITH REGARD TO
THAT STUDY WHAT WHAT DOES THE
STUDY OR DO THE STUDIES REFLECT.
REGARDING THE PERCENTAGE OF
CHILDREN. ENROLLED IN THE CCS
PROGRAM ARE RECEIVING CARE. THE
BY CCS PROVIDERS. IN THE WHOLE
CHILD MODEL COUNTIES. WHAT IS
THAT PERCENTAGE VERSUS THE
PERCENTAGE AND NONE. WHO YEAH I
THINK- I'LL AND I'LL TO GET BACK
TO YOU ON THAT ONE ACTUALLY IS
PROBABLY A GOOD QUESTION FOR DH
CS. THE EVALUATION WAS PREVIEWED
WITH- A NUMBER OF STAKEHOLDERS
AND I AND I KNOW ALSO WITH WITH
THE LEGISLATURE PRIOR TO ITS
RELEASE AND SO WE GOT SOME HIGH
LEVEL DATA POINTS. BUT IT THE
FULL EVALUATION WAS JUST
RELEASED A FEW WEEKS AGO AND IS
OVER SIX HUNDRED PAGES SO. I CAN
I CAN FOLLOW UP WITH THAT
QUESTION ARE YOU CAN DIRECT IT
TO THE DEPARTMENT THAT I DON'T.
DO YOU THINK ANSWER TO THAT
QUESTION THAT WOULD BE RELEVANT
TO. THE DECISIONS THAT WE'RE
MAKING TODAY. YEAH I DO I MEAN I
THINK THE THAT TOP LINE
CONCLUSION OF THE EVALUATION. IS
REALLY THAT- THE CHILDREN
ENROLLED IN COUNTIES WITH WHOLE
CHILD MODEL- KIND OF THE
EXPERIENCING CARE AND ACCESS TO
CARE WHAT SORT OF EQUIVALENT OR
BETTER THAN THAT IN CCS CLASSIC
COUNTIES- AND I THINK YOU KNOW
COULD POINT TO A NUMBER OF KIND
OF THE- FINDINGS FOR ERROR
CONCLUSIONS FROM THE EVALUATION-
TO ILLUSTRATE THAT AND- LIKE I
MENTIONED I THINK THERE'S ALSO A
NUMBER TO BE TO BE CANDID
THERE'S A NUMBER OF. AREAS
WHERE- THE EVALUATED EVALUATOR
INDICATED THAT THERE SHOULD BE-
A GREATER AND GREATER LOOK AT
FROM BOTH DH CS AND- ON BOTH THE
WHOLE CHILD MODEL SIDE AND CCS-
IN THE CCS PROGRAM SO- HAPPY TO
HAVE A FOLLOW UP CONVERSATION.
WITH YOU IN MORE DETAIL TO KIND
OF TALK THROUGH SOME OF THOSE
RESULTS BUT- YOU KNOW I THINK AT
A HIGH LEVEL. WE FEEL LIKE IT
DEMONSTRATES THE SUCCESS AT
LEAST EARLY SUCCESSFUL CHILD
MODELS- I THINK THE REASON I'M
ASKING IS SOME OF US OBVIOUSLY
WANT TO MAKE SURE THAT THERE'S A
CONTINUED EMPHASIS. ON MOVING
THESE FAMILIES IN THESE
VULNERABLE CHILDREN. TO CCS. ALL
FIGHTER OR SPECIALIZED. AND A
DISINCENTIVE TO KEEPING. THE
FAMILIES AND THE CHILDREN BACK
INSIDE THE SYSTEM- IN IN SOME
OTHER WAY CARING FOR THEM IN
SOME OTHER WAY. AND THAT'S WHY
THE REPORT WILL BE I'D BE VERY
INTERESTED IN READING THE REPORT
WHEN I RECEIVE IT. AND TAKING A
LOOK AT THE ONE PERCENTAGE
COMPARED TO THE OTHER PERCENTAGE
BECAUSE THAT MAY IN FACT. TELL
THE TALE I'M NOT GOING TO
DOMINATE THE QUESTIONING ANYMORE
APPRECIATE YOUR RESPONSES THANK
YOU VENTURE THANK YOU. THANK YOU
VERY MUCH ANYBODY ELSE WISHING
IT WEIGH IN ON THIS. OKAY
CONTINUED CENTER FOR WORKING
WITH THE COMMITTEE AND IT WAS
ONE AMENDMENT YOU DIDN'T TAKE
BUT I UNDERSTAND THAT YOU'RE
GOING TO CONTINUE TO WORK ON
THIS ISSUE AND I KNOW YOU TO BE
A THOUGHTFUL PERSON WHO WILL.
CONTINUE TO GET THIS RIGHT
BECAUSE WE ARE TALKING ABOUT THE
STATE'S MOST VULNERABLE
CHILDREN. AND WE REALLY NEED TO-
AND AGAIN MY SPOUSE IS NOT A
CHILD BUT- INCREDIBLY COMPLEX
MEDICAL NEEDS AND I KNOW WHAT
IT'S LIKE TO HAVE TO TRY TO WORK
WITH. THE WHOLE TEAM OF
SPECIALTIES AND HOWL- FROM.
CHALLENGING IT IS TO BE ABLE TO
FIND HELP IN A IN A- IN A VERY
COMPLEX SYSTEM. OKAY THANK YOU
THIS BE THE TIME FOR A MOTION.
SO SUNDARBANS IS. A HIS BEFORE
FOUR MOVED PRICE RAWSON THAT IS
A DO PASS A MANAGER REFER TO
COMMITTEE ON APPROPRIATIONS
SECRETARY. TO CLOSE SENATOR.
THANK YOU VERY MUCH MANAGER AYE
I APPRECIATE YOUR COMMENT AND-
THE PROPOSED- AMENDMENT AND I.
WANT TO KEEP WORKING ON THAT
ISSUE OF COURSE- BUT ALL IN ALL
WE JUST WANT TO MAKE SURE THAT.
THESE CHILDREN GET THE
SPECIALIZED ATTENTION THAT THEY
NEED AND THAT THEY DESERVE AND-
THAT'S OUR GOAL SO APPRECIATE IN
AN URGENT AYE VOTE THANK YOU
THANK YOU VERY MUCH. SECRETARY
PLEASE CALL THE ROLL. SENATORS
EGGMAN. HI EGGMAN AYE WHEN I.
GLAZER GONZALEZ. GONZALEZ I.
GROWTH HER TADO. LIMÓN CHANGE OF
OUR- MENJIVAR I. ROTH OF ROTH I
. RUBIO WAHAD. BOB I WIENER ALL
RIGHT WINNER HI. SEVEN NEWS. ALL
RIGHT THAT PHIL HAS ENOUGH TO
GET UP WILL HOLD THE ROLE OPEN
FOR ABSENT MEMBERS THANK YOU
VERY MUCH THANK YOU MADAM CHAIR
AND MEMBERS. ALL RIGHT. THEY
THINK I SEE SENATOR BECKER IN
THE ROOM. HE IS HERE FOR SB.
FIVE EIGHTY TWO. PRESS ONE TO
CONSENT. YEAH SURE PLEASE WE CAN
DO IT OKAY YOU CAN DO IT. ALL
RIGHT AFTER MEN CHAIRMEN. ONLY
FOR STARBASE EXCEPT ALL THE
COMMITTEE AMEND. THIS DESIGNED
TO PROTECT HEALTH CARE PER
INCLUDING DOCTORS. IN Q. CLINIC
FROM PRICE GET BY THEIR
TECHNOLOGY VENDORS. IT'S A
LITTLE TECHNICAL COMMITTEE- SOME
EXPLANATION BACK IN TWENTY
TWENTY ONE FIFTY ONE THIRTY
THREE ESTABLISH THE CALIFORNIA
HEALTH AND HUMAN SERVICES DATA
EXCHANGE FRAMEWORK WHICH IS
INTENDED STABLE REAL TIME
EXCHANGE A PATIENT'S MEDICAL
DATA BETWEEN PHYSICIANS AND
OTHER HEALTHCARE ENTITIES. IN
ORDER TO IMPROVE PATIENT CARE
AND REDUCE COSTS WITHIN THE
HEALTH CARE SYSTEM. THEY DID
CHANGE FOR BUILT ON FEDERAL
RULES. WHICH REQUIRE ALL ACTORS
IN HEALTH CARE SYSTEM TO ALLOW
THEIR ACCESS TO PATIENT DATA TO
OTHER PROVIDERS AND PREVENT ANY
OF THESE ENTITIES FOR
INTERFERING OR DISCOURAGING
EXCHANGE OF PATIENT DATA.
UNFORTUNATE WE'RE SEEING
EXAMPLES WERE ELECTRONIC HEALTH
RECORD VENDORS BECAME BARRIERS
TO ACHIEVING THIS REAL TIME
EXCHANGE BY CHARGING A
REASONABLE FEES. HEALTH CARE
PROVIDERS ARE HEAVILY RELIANT ON
THE TECHNOLOGY VENDORS TO ENABLE
THESE DATA EXCHANGE INTERFACES.
INTERSTELLAR BY THE SUPPORTER
CHARGING EXCESSIVE AMOUNT FOR IT
THE VERY LIMITED OPTIONS.
BECAUSE IT'S VERY AN EXPIRATION
SEVEN TIME CONSUMING TO SWITCH
TO A DIFFERENT VENDOR.
TECHNOLOGY VENDORS CAN'T TAKE
ADVANTAGE OF THE JUSTICES THIS
DEPENDENCE BY CHARGING.
UNREASONABLE FEES INCLUDING
CASES WHERE VENDORS HAVE
REQUIRED PIECES HIS TENS OF
THOUSANDS OF DOLLARS PER
POSITION POSITION FOR THE
REQUIRED SUPPORT. HIS COMPLIANCE
IS REQUIRED IN STATE LAW
PHYSICIANS FACE A DAUNTING
CHOICE TO PAY THE FEES. FOR
COMPLAINTS WERE TAKEN A HUGE
PROJECT COST TO SWITCH IT WOULD
ACHIEVE THE BENEFITS OF SEAMLESS
SHARING OF DATA WHEN YOU MAKE
SURE IT'S EASIER FOR HEALTHCARE
PROVIDERS TO COMPLY. WITH ANY
UNFAIR PRACTICES. NO I'M NOT
AGAINST TECHNOLOGY VENDORS TO-
MAKING A FAIR PROFIT ME MANY OF
THEM IN MY DISTRICT. ON WHICH
ONE WE SHOULD OWN CHURCH ON
REASONABLE FEES- BUT WHAT IS
UNREASONABLE FORTUNATELY THE
FEDERAL GOVERNMENT IS ALREADY
DEFINED. RULES OF FOR OF
GOVERNING WHAT KINDS OF FEES ARE
REASONABLE OR NOT. FOR
TECHNOLOGY RELATED TO THE
FEDERAL HEALTH DATA SHARING
REQUIREMENTS. AND THIS BILL JUST
REQUIRES THE SAME RULES APPLY TO
ADDITIONAL DATA SHARING
REQUIREMENTS FROM THE STATE'S.
DATA EXCHANGE FRAMEWORK. I THANK
THE COMMITTEE FOR HELPFUL
AMENDMENTS. THAT CLARIFY HOW THE
FEDERAL REGULATIONS RELATED TO
REGIONAL FEES WOULD APPLY TO
CALIFORNIA'S DATA SHARING
REQUIREMENTS. PROVISIONAL BILL
TWENTY TWENTY ONE ALSO REQUIRED
THE MAIN PARTIES INVOLVED DATA
SHARING TO SIGN A DATA SHARING
AGREEMENT TO GOVERN HOW DATA
SHARED. HE DID NOT INCLUDE
TECHNOLOGY VENDORS IN THIS LIST
OF PARTIES REQUIRED TO SIGN THE
AGREEMENT. EVEN THOUGH
TECHNOLOGY VENDORS ARE CRUCIAL
TO IMPLEMENTING DATA SHARING AND
OFTEN HAVE CONTROL OVER SHARED
DATA. I JUST MORE HELPFUL
COMMITTEE MEMONS THE OTHER PART
A BILL PASSED THE STAKEHOLDER
GROUP. THAT WAS SET UP TO
DEVELOP THE DETAILS ISSUE AN
AGREEMENT TO DETERMINE WHETHER
AND HOW IT WOULD BE APPROPRIATE
TO REQUIRE VENDORS BE PART
DISAGREEMENT. IF SO IT WILL
REQUIRE THE TECHNOLOGY VENDORS
TO BE SIGNATORIES AGREEMENT
WITHIN TWELVE MONTHS. OF THOSE
REQUIREMENTS BEING FINALIZED.
WITH THESE TWO FIXES SB FIVE
EIGHTY TWO WILL WILL ENSURE THE
AND REASONABLE BENEFITS DO NOT
BECOME A BARRIER. TO SUCCESSFUL
INVITATION THE DATA SHARE
EXCHANGE FRAMEWORK. AND TO THE
GAINS IN PAY TO CARE PATIENT
CARE THAT MEDICAL DATA SHARING
WILL UNLOCK AND WITH THAT. I
STRICTLY AS FOR AYE VOTE TODAY
WE HAVE DAVID FORD FOR THE CMA
HERE TO TESTIFY. THANK YOU
MISTER FORD. THANK SIX MINUTES
SE. THANK YOU MADAM CHAIR
MEMBERS AS A STATED MY NAME IS
DAVID FOR THE VICE PRESIDENT
HEALTH INFORMATION TECHNOLOGY
FOR THE CALIFORNIA MEDICAL
ASSOCIATION- WE ARE THE SPONSORS
OF SB FIVE EIGHTY TWO. LIKE TO
THANK THE AUTHOR FOR BRING IT
FORWARD AND THE COMMITTEE STAFF
AS WAS REFERENCE FOR DOING SOME
PRETTY EXTENSIVE WORK ON THIS
BILL TO HELP US REFINE THE
LANGUAGE- ON THAT NOTE WE KNOW
THERE ARE STILL SOME CONCERNS
OUT THERE ABOUT. SOME OF THE
DEFINITIONS IN THE BILL
UNFORTUNATELY WE HAVE
STAKEHOLDERS THAT HAVE GIVEN US
DIRECTLY CONFLICTING INPUT ON
HOW TO FIX THAT PROBLEM SO- WE
COULDN'T QUITE SIX SEVEN TIME
FOR THIS HEARING BUT THIS BILL
HAS IT. ANOTHER STOP IN
JUDICIARY AND THEN OF COURSE
WE'LL CONTINUE MOVING ON AFTER
THAT SO WE WANT TO KEEP WORKING
ON THAT ONE PIECE. THAT'S
IMPORTANT- SO JUST A PICKUP OF-
FOR WHAT'S UNDER PACKER SAID.
WE'VE SEEN THIS OVER AND OVER
AGAIN ACTUALLY WAS NOT PRACTICES
THROUGH. MEANINGFUL USE INTO
MIPS INTO AND FEDERAL
INFORMATION BLOCKING- AND NOW TO
THE DATA EXCHANGE FRAMEWORK WE
CONTINUE TO PUT THESE
REQUIREMENTS ON PHYSICIANS THAT
AND- REQUIRE THEM TO USE OUR
ELECTRONIC HEALTH RECORDS TO
MAKE DATA AVAILABLE TO PATIENTS
AND TO OTHER PROVIDERS. AND WE
ALWAYS STOP SHORT OF LOOKING AT
THAT THE TECHNOLOGY ITSELF AND
IT DOES CREATE PROBLEMS- AND
I'LL JUST QUICKLY USE ONE DATA
POINT TO CENTER BACKER COVER THE
BILL VERY WELL. JUST BEFORE I
CAME OVER HERE FOR ABOUT TEN
MINUTES BEFORE I WALKED OVER
HERE. I SEE I GOT THE RESULTS OF
A PHYSICIAN SURVEY THAT CMA JUST
DID. OUT SMALL PRACTICES IN
UNDERSERVED COMMUNITIES ASKING
ABOUT THEIR CONCERNS ABOUT DATA
EXCHANGE. IT LIKELY COMES AS NO
SURPRISE THAT. TWO THIRDS OF THE
PHYSICIANS LISTED AS THEIR TOP
CONCERN ABOUT DATA EXCHANGE IT'S
COST PROHIBITIVE. THIS IS AN
ISSUE IT'S AN ISSUE THAT COMES
UP OVER AND OVER AND OVER AGAIN.
AND AS WE ARE TELLING POSITIONS
YOU MUST DO DATA EXCHANGE. WE
HAVE TO REALLY LOOK AT THE
IMPEDIMENTS THAT ARE KEEPING
THEM FROM DOING SO. AND THAT'S
WHAT THIS BILL IS TRYING TO DO
IS CREATE A PROCESS WHERE AS WE
CREATE THIS GOVERNANCE STRUCTURE
ON THE STATE LEVEL. OVER HEALTH
INFORMATION EXCHANGE WE'RE
GIVING THEM SOME ABILITY TO
REVIEW THESE COSTS AND REALLY
GET PHYSICIAN SOMEWHERE TO GO TO
LOOK FOR HELP. THOUGHT ASK YOUR
EYES UP. THANK YOU VERY MUCH.
NOBODY ELSE IN THE ROOM HERE TO
SPEAK IN SUPPORT OF THE BILL.
KIM STONE STONE ADVOCACY ON
BEHALF OF CALIFORNIA ORTHOPEDIC
ASSOCIATION IN SUPPORT. THANK
YOU. PERSONAL CHAOS ON BEHALF OF
THE CALIFORNIA STATE ASSOCIATION
OF PSYCHIATRISTS AND SUPPORT.
THANK YOU. GOOD AFTERNOON I.
KATIE AND I DON'T HAVE ACCESS
CALIFORNIA AND WE DON'T HAVE A
POSITION WITH A BILL THAT
APPRECIATE WORKING WITH THE
COMMITTEE AND THE AUTHOR ON
AMENDMENTS TO CLARIFY THAT THE
REASONABLE FEES WILL BE. AND
WILL BE SUFFICIENT TO COLLECT
AND EXCHANGE THE DATA REQUIRED
BY THE HEALTH INFORMATION
EXCHANGE IN A DATA SHARING
AGREEMENT THANK YOU THANK YOU
VERY MUCH. OKAY SEE NOBODY ELSE
APPROACHING THE MIGHT.
OPPOSITION. THANK YOU MADAM
CHAIR AND MEMBERS OF AN ADVOCATE
ON BEHALF OF OCEAN AND
CALIFORNIA TENNELL TELEHEALTH
NETWORK AND RESPECTFUL
OPPOSITION. THANK YOU VERY MUCH
ANYBODY ELSE BEGIN A POSITION
TODAY. OKAY THEN WE'LL GO TO THE
PHONE LINES. MODERATOR FEAR
THEY'RE OPEN UP THE PHONE LINES
FOR ANYONE SUPPORT OR OPPOSITION
TO SB FIVE EIGHTY TO JUST NAME
AND POSITION. THANK YOU MADAM
CHAIR AND ISSUE STATED IF YOUR
SUPPORT OR OPPOSITION TO SB FIVE
EIGHT TWO. PLEASE PRESS ONE
FOLLOWED BY ZERO ONE VOEPEL ZERO
AT THIS TIME. ONE MORE REMINDER
IF YOU ARE IN SUPPORT OR
OPPOSITION TO SB FIVE EIGHT TWO.
PLEASE TAKE THIS OPPORTUNITY
PRESS ONE FOLLOWED BY ZERO. I'M
SURE NOBODY'S GOING UP OKAY
THANK YOU- WILL NOW BRING THIS
ISSUE BACK TO THE COMMITTEE ANY
QUESTIONS COMMENTS. THE BILL'S
BEEN MOVED BY SENATOR ROSS- AND
WE THANK YOU FOR YOUR WORK ON
THIS CENTER BAKER AND IT SOUNDS
LIKE YOU'RE STILL BE CONTINUE TO
WORK WITH THE OPPOSITION TRY TO.
HAMMER OUT SOME OF THOSE LESS
DETAILS TO MAKE SURE. PEOPLE CAN
GET HAVE THE EXCHANGE AND THE
BILLING NOT BE ONEROUS WOULD YOU
LIKE TO CLOSE. WITH EXACTLY AND
WITHOUT RESPECT LAST FOR A VOTE
FOR MUCH SECRETARY PLEASE CALL
THE ROLL. AND THE MOTION IS TO
PASS AS AMENDED AND RE REFER TO
THE COMMITTEE ON JUDICIARY.
SENATORS EGGMAN. EGGMAN AYE WHEN
I GLAZER. GONZALEZ FIVE GONZALEZ
I GROWTH. FURTADO LIMÓN. END OF
OUR- RANGE OF OUR AYE ROTH. ROTH
AYE RUBIO. WHAT HAN. BOB I
WINNER. WIENER AYE. THE BILL HAS
. HAVE SEVEN VOTES ENOUGH TO GET
IT UP WILL HOLD THE RULES OPEN
FOR MEMBERS TO ADD ON THANK YOU
VERY MUCH- OUR NEXT BUILT UP. IS
SENATOR SKINNER WITH SB FIVE
NINETY EIGHT IF YOU'RE READY
MA'AM. IT THERE'S A MOTION FOR
THE CONSENT CALENDAR WE COULD.
WITH THE CENTER ROTH MOVE THAT
AGAIN HE'S QUICK ON THE DRAW
SHERMAN. MAYBE NEXT TIME SOME
AND AGAIN TO REPEAT THE MEASURES
ON CONSENT THAT SB TEN CORTESE
SB FIVE OH TWO ALLEN AND SB SIX
THIRTY NINE. LOAN THIRTY PLEASE
CALL THE ROLL. SENATORS EGGMAN
HI YOU MAY I WENT BY WHEN I
CLICK. GONZALEZ AND I GROWTH.
HER TADO LIMÓN MENJIVAR MENJIVAR
I ROTH. ROTH I RUBIO. WHAT HAAB
. BOB I WINNER. WINNER I. SEVEN
SEVEN ZERO THAT HAS ENOUGH TO
GET IT OUT BUT WILL THE ROLE FOR
ABSENT. CENTER PLEASE PLAYING
YOU SOME TO MEMBERS I AM. S. B.
FIVE NINETY EIGHT. AND BEFORE I
JUST THE BILL I WILL AND THAT I
HAPPY TO TAKE THE COMMITTEES
MANY THAT ARE OUT IN THE
ANALYSIS SO I'M TAKING ALL OF
THOSE AND WE THANK YOU FOR
WORKING WITH THE COMMITTEE AND
WE WANT TO THANK THE COMMITTEE
STAFF FOR THEIR VERY HARD WORK.
ON THIS BILL ABSOLUTELY
ABSOLUTELY APPRECIATED. HELP
INSURANCE COMPANIES. COMMONLY
MAYBE NOT COMMONLY BUT- THE
TIMES REQUIRE A MEDICAL PROVIDER
TO GET PRIOR AUTHORIZATION
BEFORE THEY CAN DELIVER CARE OR
TREATMENT TO THEIR PATIENTS NOTE
CERTAIN TIMES THAT'S
APPROPRIATE. BUT THERE IS AN
OVER USE OF IT IT IS NOW
BASICALLY WE'RE ALMOST ANY
ACTIVITY THAT THE- DOCTOR WANTS
TO ENGAGE IN FOR THEIR PATIENT
REQUIRES THIS PRIOR
AUTHORIZATION. THAT PRACTICE CAN
HARM PATIENTS WHY BECAUSE YOU
CAN DELAY NECESSARY AND OFTEN
TIME SENSITIVE CARE WHICH THEN
IF IT DOES CAN RESULT IN AN
OTHERWISE UNNECESSARY
HOSPITALIZATION OR OTHER OFT
COMPLICATION OF THE TREATMENT.
ADDITIONALLY PATIENTS WILL OFTEN
GET FRUSTRATED BECAUSE THEY'VE A
YOU KNOW WHAT THERE ARE DOCTORS
RECOMMENDED TO THEM THEY CAN'T
FOLLOW YET AND SO THEY CAN GIVE
UP ON TREATMENT SO SOMETIMES
THIS PRIOR AUTHORIZATION IS EVEN
JUST WHEN YOU'RE CONTINUING
SOMETHING THAT WAS PREVIOUSLY
APPROVED. BUT SINCE THEN IN
LIMBO THE- IN THE COURSE
LIMBAUGH I DON'T THINK THE A
CHURCH'S LE THAT THE DEBT FREE
SURPRISE THROWN OUT BUT ALL USE
IT ANYWAY- THE PATIENT WILL
THEN- IN EFFECT TO GET
FRUSTRATED AND GIVE UP ON THEIR-
ABANDONED THEIR TREATMENTS WHICH
OF COURSE CAN ALSO ADD
COMPLICATIONS. OF THE AMERICAN
MEDICAL ASSOCIATION SURVEYED
THEIR MEMBERS AND WHAT THE
RESULTS OF THAT SURVEY AROUND
THIS PRACTICE IS THAT 94% OF THE
PHYSICIANS REPORTED DELAYS IN
CARE. 80% REPORTED ABANDONMENT
OF TREATMENT BY THEIR PATIENTS
25% REPORTED IT UNNECESSARY
HOSPITALIZATIONS BECAUSE OF THE
DELAY. ANY GOOD OTHER NUMBER
REPORTED DIFFERENT TO. OTHER
IMPACTS TO THE PATIENT'S HEALTH
AND NEGATIVE OUTCOMES. SO SB
FIVE NINETY EIGHT MAKES TWO KEY
CHANGES IT GIVES A IT RESPECTS
THE FACT THE PRIOR
AUTHORIZATIONS CAN BE VERY
NECESSARY AND HELPFUL IN TERMS
OF KEEPING COSTS DOWN AND IT
GIVES A ONE YEAR PRIOR
AUTHORIZATION EXEMPTION. TO
PROVIDERS WHO PRACTICE WITHIN AN
HEALTH PLANS GUIDELINES AND
FOLLOW THE REQUIREMENTS FOR
TREATING PATIENTS 90% OR MORE AT
THE TIME. IT ALSO REQUIRES
INSURANCE PER AUTHORIZATION
REVIEWERS TO HAVE THE SAME
MEDICAL EXPERTISE AS THE
PROVIDER THEY ARE REVIEWING SO
NOW. LET ME BRING MY WITNESSES
IN SUPPORT I'VE GOTTEN GOOD. WHO
WROTE A OP ED AND MATTERS FOR
HER PERSONAL EXPERIENCE WITH HER
FATHER HAD CANCER AND PRISCILLA
CORROSIVE WHO IS FROM THE
ASSOCIATION OF CHILD AND
ADOLESCENT PSYCHIATRY. THANK YOU
VERY MUCH GO AHEAD. THANKS. GOOD
AFTERNOON MADAM CHAIR AND
MEMBERS OF THE COMMITTEE. THAT
WAS IT I DID TO GET IT WITH SOME
OF. MY NAME IS THAT IN GONZALEZ
THIS ONE BUT THERE'S GONZALEZ.
WE LOST HER FATHER TO METASTATIC
MELANOMA THE FIGURES FORMA
CANCER APRIL TWENTY SEVENTH
ALMOST A YEAR AGO. WHEN DOCTORS
IDENTIFIED A TUMOR GROWING MY
DEADLINES IN AUGUST WE KNEW THAT
ANY CHANCE WE HAD A BEATING HAS
CANCER WOULD BE ROOTED IN THE
TEAM OF SPECIALISTS HANDLE IN
THIS CARE. AND T. SWIFT ACTION.
MY DAD'S HEALTH PLAN MADE THAT
IMPOSSIBLE FOR TO MEET EVERY
TREATMENT TEST HIS DOCTOR SAID
HE NEEDED REQUIRED PRIOR
AUTHORIZATION. BEFORE MY DAD'S
TREATMENT COULD EVEN BEGIN HIS
DOCTORS STRUGGLE TO GET APPROVAL
FOR A BIOPSY THAT WOULD DETECT
EARLY SIGNS OF CANCER. CAN
PROVIDE MORE ACCURATE DIAGNOSIS
. FINALLY AFTER RECEIVING
APPROVAL AND GETTING AN
APPOINTMENT SCHEDULED TEN WEEKS
LATER. DIAGNOSTIC TESTING SHOWED
THAT MY DAD. HAD METASTATIC
MELANOMA. HE WAS REFERRED TO AN
ONCOLOGIST SPECIALIST WERE AGAIN
THERE WAS A DELAY IN OBTAINING
APPROVAL FOR FURTHER DIAGNOSTICS
AND TREATMENT. SINCE I DID IT
THE BILL LEE REMEMBERS SPENDING
THREE HOURS. AND A HALF ONE DAY
IN MARCH TRYING TO REQUEST THE
PILLS OF THE INSURANCE DENIALS
OF AN MRI. AND PET SCANS
REQUESTED BY YOUR DOCTOR SO.
THIS IS MY FOLDER OF ALL MY
COMMUNICATIONS BACK AND FORTH
WITH THAT. FOUR WEEKS LATER A
PET SCAN FINALLY RECEIVED SHOULD
AS LONG SHOT THE CANCER HAD
SPREAD INTO HIS ADRENAL GLAND
HIPS AND FURTHER INTO HIS LUNGS
. HIS TEAM OF DOCTORS KEPT THEIR
SPIRITS HIGH AND DEVELOPED AN
IMMUNOTHERAPY TREATMENT PLAN.
WE'RE THRILLED WHEN MY DAD'S. IT
WAS TRANSFERRED TO THE STATE OF
THE ART HOSPITAL. OFFERING
SPECIALTY CARE AND TRIALS FOR
METASTATIC MELANOMA. I'M SORRY
OKAY. GET OFF THANK YOU. BUT
EVERY NEW TREATMENT
RECOMMENDATION ARE SCANNED WITH
MET WITH OPTICAL AN OBSTACLE
COURSE A PRIOR AUTHORIZATION
DONE ELSE WHICH WE APPEALED AND
UP TO ULTIMATELY APPROVED THAT
WERE APPROVED BY THE INSURANCE
COMPANY. THIS LED BY FAMILY AND
LIKE TO BELIEVE THAT THEIR GOAL
WAS NOT TO PROVIDE MY DAD WITH
THE CARE THAT HE NEEDED BUT TO
DELAY HIS TREATMENT AND PROTECT
THE PROFITS. IT CERTAINLY WASN'T
TO PROVIDE MY DAD WITH THE CARE
HE NEEDED TO FIGHT HIS CANCER.
TIME IS YOUR MOST PRECIOUS
RESOURCE WHEN IT COMES TO CANCER
AND I WAS SPENDING MY TIME THE
LAST FEW MONTHS OF MY FATHER'S
LIFE. FIGHTING WITH THIS
INSURANCE COMPANY. WE HELD OUT
HOPE WITH HIS DOCTORS TRIED TO
GET HIM INTO CLINICAL TRIALS
THAT WE CAN GET IMMEDIATE
TREATMENT RATHER THAN TRUTH. GO
THROUGH THESE AUTHORIZATION
DELAYS WE HAD EXPERIENCE BUT THE
MRI. OF HIS HEADS. IN THE REBEL
THAT HAD MADE TO HIS. WHICH
WOULD ALLOW CALL HIM FOR THE
CLINICAL TRIAL. WE DIDN'T GIVE
UP. WE GOT A REFERRAL AGAIN. FOR
HIM TO BEGIN RADIATION THERAPY.
REFERRAL WAS DENIED. APPEALED
AND OVERTURNED. IT WAS ALREADY
TOO LATE. MY DAD ENDED UP
PASSING AWAY APRIL TWENTY
SEVENTH. NINETY TWEET IN TWENTY
TWENTY TO. NOBODY COULD HAVE
EXPERIENCED THE STRESS
FRUSTRATION AND PAIN WE WENT
THROUGH. THAT IS WHY SB FIVE
NINETY EIGHT IS SO IMPORTANT IT
ALLOWS PATIENTS LIKE MY DAD TO
GET TREATMENTS THAT URGENTLY
NEED WITHOUT UNNECESSARY DELAYS.
WILL FIX THE PROCESS TO ALLOW
PHYSICIANS TO PROVIDE TREATMENT
AND SERVICES BASED ON WHAT WE
THE PATIENTS STATE WHAT THEY
NEED IT. PART THREE PRIOR
AUTHORIZATION LAKES HINDER MY
FATHER'S CARE OPTIONS WITH
HEALTH. PLEASE PASS SB FIVE
NINETY EIGHT STOP THIS TERRIBLE
PRACTICE. PLEASE VOTE YES. ON SB
FIVE NINETY EIGHT THANK YOU
THANK YOU VERY MUCH FOR
TESTIMONY IN VERY SORRY FOR YOUR
LOSS I KNOW ANNIVERSARIES ARE
HARD. FOR THEM I'M JIM I SEE BY
YOUR FOLDER THAT YOU ARE DID
EVERYTHING YOU COULD AND YOU'RE
STILL FIGHTING FOR YOUR DAD
ABSOLUTELY THANK YOU THANK YOU
VERY MUCH. THIRD OF THE WITNESS
PLEASE. ABOUT TWO MINUTES LEFT.
A PERSONAL KIDDOS HERE ON BEHALF
OF THE CALIFORNIA ACADEMY OF
JOURNALISTIC HIGH TREE A PROUD
CO SPONSORS AND SB FIVE NINETY
EIGHT. UP PRIOR AUTHORIZATIONS
HAVE EXPANDED NEW AND BRAND NAME
MEDICATIONS GENERIC MEDICATIONS
CAUSING INCREASED DAILY BURDEN
ON THE ENTIRE MEDICAL SYSTEM
INCLUDING FAMILIES PROVIDERS
HAVE HAD TO HIRE STAFF TO
PROCESS PRESCRIPTION PRIOR
AUTHORIZATIONS INCREASING HEALTH
CARE COSTS WHICH ULTIMATELY.
LIMITS THE DELIVERY OF HEALTH
CARE AVAILABLE FOR ALL IN
ADDITION NOW PRIOR
AUTHORIZATIONS ARE FREQUENTLY
FOR GENETIC. GENERIC MEDICATIONS
THAT COST LESS THAN TWENTY FOUR
MONTHS ALTHOUGH THAT MEANS SOME
WILL BUY OUT OF- OUT OF POCKET
NOT ALL CAN DO SO. IS AN ABUSE
OF STALLING PROCESS THAT LIMITS
THE CARE PROVIDED TO EVERYONE
PSYCHIATRIC AT- ACCESS TO CARE
IS A HUGE PROBLEM THROUGHOUT
CALIFORNIA CHILDREN ADOLESCENTS
FACE SERIOUS. AND DANGEROUS WAIT
TIMES TO ACCESS TO CARE. THEN
FACE FURTHER DELAYS IN
INITIATING CARE DUE TO PRIOR
AUTHORIZATIONS IN ADDITION EVERY
YEAR INSURANCES REQUIRE. A
RENEWING AUTHORIZATIONS FOR
NECESSARY MEDICATIONS THAT HAVE
SAFELY BEEN TAKING FOR A LONG
TIME. EXCESSIVE PRIOR
AUTHORIZATIONS LEAD TO WORSENING
OF CRISIS HOSPITALIZATIONS
CHILDREN MISSING SCHOOL- PARENTS
. MISSING WORK AND HARM TO
PATIENTS. I AUTHORIZATION TO.
AFFECT LOWER AND INDIVIDUALS
BECAUSE CLINICS THAT SERVE
POPULATIONS DO NOT HAVE FUNDING
TO HIRE STAFF TO PROCESS PA'S.
IN THOSE FAMILIES DO NOT HAVE
FUNDS TO PURCHASE EVEN GENERIC
MEDICATIONS OUT OF POCKET.
INSURANCE COMPANIES USE
ARTIFICIAL CRITERIA FOR
REQUIRING PA'S FOR THE PEDIATRIC
POPULATION THEY FREQUENTLY CITE
THAT MEDICATION ISN'T FTA
AUTHORIZED FOR TREATMENT.
UNFORTUNATELY MOST MEDICATIONS
ARE NOT AUTHORIZED FOR CHILDREN
ESPECIALLY CONSIDERING
PSYCHIATRIC- PSYCHOTROPIC
MEDICATIONS. FOR CHRONIC PAIN TO
CHILDREN AND TREATMENT FOR RARE
CONDITIONS THIS LACK OF
AUTHORIZATION IS NOT RELATED TO
SAFETY OR EFFECTIVENESS BUT
RATHER A LACK OF FUNDING TO
COMPLETE FTA AUTHORIZATIONS
ESPECIALLY FOR GENERIC
MEDICATION. AUTHORIZATION OUR
PRIOR AUTHORIZATIONS BEGIN AS A
COST CONTROL BUT HAD BEEN ABUSED
BY THE POINT OF INCREASING
HEALTH CARE COSTS AND BECOMING A
DANGEROUS BURDEN. YOUR TO CARE
FOR THESE REASONS WE
RESPECTFULLY ASK AND URGE YOUR
AYE VOTE TODAY AND ON BEHALF OF
THE CALIFORNIA STATE ASSOCIATION
OF PSYCHIATRISTS ARE ALSO STRONG
SUPPORT THANK YOU VERY MUCH OF
THE SPEAKING IN SUPPORT TODAY
JUST NAME AND AFFILIATION PLACE
NOW. MADAM CHAIR MEMBERS OF THE
COMMITTEE BRAND IN MARCH YOU
WITH THE CALIFORNIA MEDICAL
ASSOCIATION PROUD SPONSOR BILL
THANK YOU TO THE COMMITTEE AND
STAFF AND YOU FOR WORKING SO
HARD. KIM STONE STONE ADVOCACY
ON BEHALF OF THE CALIFORNIA
ORTHOPEDIC ASSOCIATION IN
SUPPORT THANK YOU. STAFF ANYMORE
ON BEHALF OF THE ADVANCED
MEDICAL TECHNOLOGY ASSOCIATION
HERE IN SUPPORT THANK YOU. BRENT
SPENCER PATH THE CALIFORNIA
PODIATRIC MEDICAL ASSOCIATION IN
SUPPORT THANK YOU. TEMAT
MURPHY'S IN THE CALIFORNIA
CHAPTER OF THE AMERICAN COLLEGE
OF CARDIOLOGY AND CALIFORNIA'S
SOCIETY PLASTIC SURGEONS IN THE
CALIFORNIA RHEUMATOLOGY ALLIANCE
PHONE SUPPORT THANK YOU. DO YOU
FEEL ABOUT THE CALIFORNIA LIFE
SCIENCES IN SUPPORT THANK YOU.
UNDER CLICK HARVEY AND BEHALF OF
THE CALIFORNIA ACCESS COALITION
AND SUPPORT THANK YOU. REYES
DOUGHERTY ON BEHALF OF THE
CALIFORNIA AMBULATORY SURGERY
ASSOCIATION THE CALIFORNIA
ACADEMY OF FAMILY PHYSICIANS.
CALIFORNIA SOCIETY OF
ANESTHESIOLOGISTS ON SPORT THANK
YOU THANK YOU. KATEY LEIGHTON ON
BEHALF OF THE CHILDREN SPECIALTY
CARE COALITION AND SUPPORT.
THANK YOU VERY MUCH. OKAY I SEE
NO OTHER SUPPORTERS IN THE ROOM
AND NOW IT'S TIME FOR OPPOSITION
PLEASE COME FORWARD. GOOD
AFTERNOON CHAIR MEMBERS BILL
BARCELONA WITH AMERICA'S
PHYSICIAN GROUPS INTRODUCING OUR
BOARD MEMBER ADAM SOLOMON THANK
YOU. GOOD AFTERNOON CHAIR AND-
MEMBERS MY NAME IS ADAM SALAMON
I'M A BOARD MEMBER OF AMERICA'S
PHYSICIAN GROUPS AND THE CHIEF
MEDICAL OFFICER OF THE
MEMORIALCARE MEDICAL FOUNDATION.
PART OF AN INTEGRATED HEALTH
SYSTEM IN SOUTHERN CALIFORNIA
WHICH TAKES RESPONSIBILITY FOR
THE QUALITY AND COST OF CARE FOR
OVER A QUARTER MILLION
CALIFORNIANS I'M ALSO A BOARD
CERTIFIED INTERNAL MEDICINE
PHYSICIAN. ONE OF THE THINGS
THAT I NOTICED AT THE START OF
MY PRACTICE TWENTY SIX YEARS AGO
WITH THE VARIATION IN THE
APPROACH TO CARE BY SPECIALISTS.
NOW YEARS LATER EVEN WITH THE
DRAMATIC INCREASE IN HIGH
QUALITY RESEARCH IN THE GROWTH
OF EVIDENCE BASED MEDICINE I SEE
THIS ISSUE PERSIST. TO ME THE
NORTH STAR SHOULD ALWAYS BE WHAT
IS BEST FOR THE PATIENT. MANY
PATIENTS ASSUME THAT WHEN A
DOCTOR TELLS YOU THAT YOU NEED A
PROCEDURE IT REALLY NEEDS TO BE
DONE. BUT A TWENTY FOURTEEN
STUDY BY THE HARVARD MEDICAL
SCHOOL IN THE COMMONWEALTH FUND
FOUND THAT IN ONE YEAR BETWEEN
TWENTY FIVE AND 42% OF MEDICARE
SENIORS. RECEIVED ONE OF TWENTY
SIX TESTS OR TREATMENTS THAT
HAVE BEEN DETERMINED. TO HAVE NO
BENEFIT OR TO BE OUTRIGHT
HARMFUL. PRIOR AUTHORIZATION IS
A TOOL TO HELP REDUCE THE
LIKELIHOOD THE PATIENTS RECEIVE
SUCH UNNECESSARY OR HARMFUL CARE
. I WANT TO CLEAR UP SOME COMMON
MISPERCEPTIONS ABOUT PRIOR
AUTHORIZATION. FIRSTLY
PRIVATIZATION RARELY CAUSES
DELAYS. THERE ARE STRICT AND
SPECIFIC TIME LIMITS THAT
ORGANIZATIONS MUST COMPLY WITH.
IN ORDER TO FINALIZE THEIR
REQUESTS. WHOSE TURN AROUND
TIMES ARE REGULARLY AUDITED
CAREFULLY MONITORED AND MUST BE
REPORTED AT LEAST BIANNUALLY
WITH SOME PLANS AUDITING THIS
MONTHLY. WE PROCESS ABOUT SEVEN
HUNDRED FIFTY THOUSAND PRIOR
AUTH REQUESTS PER YEAR. WITH ONE
THIRD APPROVED WITHIN A DAY. IN
OUR AVERAGE TURNAROUND TIME IS
BELOW TWO AND A HALF DAYS.
SECONDLY THE NUMBER OF DENIALS
IS VERY VERY LOW. IN MOST CASES
THOSE TRIALS TEND TO BE FOR
SPECIFIC PROCEDURES THAT HAVE
BEEN FOUND TO BE OF MARGINAL
VALUE TO THE PATIENT. OR THAT
CATCH A REFERRAL TO PROVIDER OR
LOCATION THAT IS NOT IN THE
NETWORK SAVING THE PATIENT FROM
UNDERGOING UNNECESSARY
PROCEDURES. OR BEING IMPACTED BY
HIGH OUT OF NETWORK COSTS. JUST
AS YOU WOULD EXPECT THE
PHARMACIST TO CATCH AN ERRANT
PRESCRIPTION WITH THE WRONG
STRENGTH PRIOR TO OFF A- PRIOR
AUTHORIZATION PROVIDES A SECOND
LOOK. TO CONFIRM THAT THE
SERVICE BEING REQUESTED MATCHES
THE EVIDENCE. WITH THE
IMPLEMENTATION OF THE OFFICE OF
HEALTH CARE AFFORDABILITY WE
ALSO HAVE THE SUBJECT WE ALSO
ARE SUBJECT TO GROWTH. CAPS COST
GROWTH CAPS ESTABLISHED BY THE
STATE GOVERNMENT. AUTHORIZATION
OF YOU IS A KEY ELEMENT IN
MEETING THE STATE MANDATED GOALS
SO WE CAN ENSURE THE PATIENTS
ARE RECEIVING THE MOST COST
EFFECTIVE AND EVIDENCE BASED
CARE. IS YOUR FAMILY MEMBER
BETTER OFF GOING TO A DOCTOR
THAT WANTS TO AVOID ANOTHER
DOCTOR REVIEWING THE
RECOMMENDATIONS. TO ME THE
PATIENT SHOULD COME FIRST. THANK
YOU BOTH MISTER BARCELONA WILL
BE AVAILABLE FOR QUESTIONS THANK
YOU VERY MUCH IMPERIAL SPEAK IN
OPPOSITION TO THIS BILL TODAY
PLEASE COME FORWARD. MADAM CHAIR
MEMBERS THANK YOU VERY MUCH
STEPHANIE WADKINS ON BEHALF OF
THE ASSOCIATION OF CALIFORNIA
LIFE AND HEALTH INSURANCE
COMPANIES FIRST I'D LIKE TO
THANK. THE COMMITTEE STAFF AND
YOURSELF AS WELL AS THE AUTHOR
AND SPONSORS WE'VE HAD MULTIPLE
CONVERSATIONS IS THIS BILL WE'VE
SEEN BEFORE. UNFORTUNATELY WE
ARE HERE TODAY IN OPPOSITION. SB
FIVE NINETY EIGHT IS A
COMPLICATED BILL THAT WILL
REGRETTABLY INCREASE THE COST OF
HEALTH CARE LEAD TO POOR PATIENT
OUTCOMES CONSUMER CONFUSION AN
INCREASE ADMINISTRATIVE COSTS.
THIS BILL CONTAINS A NUMBER OF
MAJOR PROVISIONS THAT WILL
PRIMARILY BE ADDRESSING THE
PROVISIONS RELATED TO PRIOR
AUTHORIZATION. THE PRIOR
AUTHORIZATION COMPONENT OF THE
BILL WILL OBSTRUCT THE ABILITY
OF MY MEMBERS TO PLAY
COMMONSENSE CHECKS AND BALANCES
AND HEALTH CARE. HEALTH PLANS
AND INSURERS WORKED DILIGENTLY
TO ENSURE THAT AND RELEASE AN
INSURANCE ARE GETTING THE RIGHT
CARE AT THE RIGHT TIME FROM THE
RIGHT PROVIDER. PRIOR
AUTHORIZATION IS A KEY COMPONENT
TO THAT. AND RECOGNITION OF THE
NEED TO STREAMLINE THE PROCESS
MANY HEALTH PLANS AND INSURERS
ARE CURRENTLY IMPLEMENTING THEIR
OWN ENHANCE PRIOR AUTHORIZATION
PROGRAMS TO HELP EASE THE BURDEN
OF PROVIDERS A RELEASE.
UNFORTUNATELY THE ONE SIZE FITS
ALL MANDATE OUTLINED IN SB FIVE
NINETY EIGHT WILL DISRUPT THOSE
EFFORTS AND HARM THE GOOD WORK
THAT HAS BEEN DONE TO DATE TO
THOSE. IN A SAFE AND LOGICAL
MANNER. THE SCOPE OF FIVE NINETY
EIGHT IS CONCERNING THIS BOOK IS
SPECIFIED PROVIDERS A FREE PASS.
FOR IN ANY OVERSIGHT OF CLINICAL
DECISIONS FOR A PERIOD OF ONE
YEAR. AT THE END OF THAT ONE
YEAR HEALTH PLANS AND INSURERS
WOULD ONLY BE ALLOWED TO REVIEW
A MAXIMUM OF TWENTY FIVE CASES
ACROSS ALL PRODUCT TYPES. THIS
IS HARDLY REPRESENTATIVE SAMPLE
TO ENSURE OUR ENROLLEES IN
INTERESTS ARE RECEIVING THE
RIGHT CARE. UNDER FIVE NINETY
EIGHT PRIOR AUTHORIZATION IS
WAIT FOR ALL SERVICES AND MOST
TRACKS. RENDERED BY THE PROVIDER
THE WAIVER WOULD EVEN APPLY TO
SERVICES THAT ARE ASSOCIATED
WITH HIGH RISK FRAUD WASTE AND
ABUSE THE NEGATIVE SIDE EFFECTS.
SB FIVE NINETY IT OFFERS VERY
LITTLE TO ENSURE THAT THE RATE
OF FRAUDULENT WASTEFUL CARE DOES
NOT INCREASE DURING THE ONE YEAR
LOOK BACK PERIOD. ALSO IN OUR
ESTIMATION WE BELIEVE THE SB
FIVE NINETY EIGHT WILL ACTUALLY
INCREASE THE COST OF HEALTHCARE
BY INCREASING THE NUMBER OF
UNNECESSARY SERVICES THAT WILL
FLOW THROUGH THE SYSTEM. IT
SHOULD BE NOTED THAT THE BILL
ALLOWS FOR WRITER TO COUNT ANY
MODEL. OF PRIOR AUTHORIZATION.
IT IS ULTIMATELY APPROVED AS A
PART OF THEIR 90% APPROVAL RATE
WHICH IS A STANDARD FOR THEM
CALL THING FOR THE PROGRAM. THIS
ISN'T THIS IS ESPECIALLY
CONCERNING BECAUSE YOU COULD
HAVE A PROVIDER WHO'S PRIOR
AUTHORIZATIONS ARE OFTEN
MODIFIED. BASED ON COMPLIANCE
WITH CLINICAL CARE GUIDELINES.
YEAH BECAUSE THE PEAS ARE
ULTIMATELY APPROVED AFTER THE
CHANGES ARE MADE THE PROVIDER
CAN USE THAT AS A PART OF THEIR
90% STANDARD TO QUALIFY FOR GOLD
CARD. ULTIMATELY THAT MEANS ON A
GO FORWARD BASIS NONE OF THOSE
MODIFICATIONS WOULD BE
IDENTIFIED LEAVING US TO WONDER
HOW MANY PATIENTS WILL BE PUT AT
RISK. HOW MANY UNNECESSARY
SERVICES WILL BE PERFORMED. AND
HOW WILL ENROLLEES IN INSURERS
HANDLE THE POTENTIAL INCREASE IN
PREMIUMS. DUE TO THE ADDITIONAL
COST INTO THE SYSTEM. AND TO
THAT POINT WE CURRENTLY DO NOT
HAVE A SUBURBAN HOUSES ON THIS
BILL. SO IT'S INCREDIBLY
DIFFICULT TO QUALIFY WHAT THE
EXACT COST INCREASE THE PREMIUMS
WOULD BE FOR PAYERS. FOR THOSE
REASONS WE OPPOSED SB FIVE
NINETY EIGHT WELL WE THINK THERE
IS A PATHWAY TO HAVE A
PRODUCTIVE POLICY CONVERSATION
WE LOOK FORWARD TO POTENTIALLY
HAVING THAT. AT THIS POINT IN
TIME WE THINK THIS BILL BECAUSE
TOO FAR. THANK YOU VERY MUCH.
OTHER SPEAKING IN OPPOSITION AT
THIS POINT NOT JUST NAME AND
AFFILIATION. BENTOR MEMBERS JOHN
WHEN YOU'RE ON THE AMERICA'S
HEALTH AND- PLANS IN OPPOSITION
. MANAGER MEMBERS NICK LOUISE US
ON BEHALF OF THE CALIFORNIA
ASSOCIATION HEALTH PLANS IN
OPPOSITION THANK YOU. ALISON
RAINY ON BEHALF OF THE
PHARMACEUTICAL CARE MANAGEMENT
ASSOCIATION AND OPPOSITION.
THANK YOU. AT THIS POINT WILL GO
TO THE PHONE LINES. MODERATOR OF
THEIR ANY CALLS AND IN THE QUEUE
AND AT THIS POINT JUST NAME
AFFILIATION AND POSITION. ON THE
BILL. PAUL CAN ONCE AGAIN PRESS
ONE AND ZERO. CALIFORNIA OF.
OPPOSITION OUR APPROVAL FOR THIS
BILL. ONE MOMENT. WE'RE GOING TO
LINE NUMBER. FIFTY SIX. PLEASE
GO AHEAD. YOUR IT AFTERNOON
MADAM CHAIR HERE TEN DOLLARS ON
BEHALF OF MY CLIENT. YES THEY
CREATION OF NORTHERN CALIFORNIA
ONCOLOGISTS OTHERWISE KNOWN AS
AND CAL AS WELL AS THE MEDICAL
ONCOLOGY EXPECTATION OF SOUTHERN
CALIFORNIA OTHERWISE KNOWN AS
MILAN IN SUPPORT. YOU CAN. THANK
YOU VERY MUCH NEXT CALLER PLEASE
. RUDOLFO TO LINE NUMBER SIXTY
SIX PLEASE GO AHEAD. THANK YOU
MADAM CHAIR AND MEMBERS ALEX
CALLING ON BEHALF OF THE
CALIFORNIA CHRONIC CARE
COALITION FOR THANK YOU. NICE
COLOR PLEASE. NEXT CALLER IS A
LINE FORTY FIVE PLEASE GO AHEAD
. THANK YOU MADAM CHAIR AND
MEMBERS THIS IS SAUNTER POOL ON
BEHALF OF WESTERN CENTER ON LAW
AND POVERTY IN SUPPORT. THANK
YOU NEXT COLOR PLEASE. OUR NEXT
CALLER COME FROM FINE NUMBER
FIFTY THREE PLEASE GO AHEAD.
MADAM CHAIR MEMBERS OF THE
COMMITTEE RANDALL ACRE
PSYCHIATRIC PHYSICIANS OF
ALLIANCE CALIFORNIA- STRONGLY IN
SUPPORT. THANK YOU VERY MUCH
NEXT CALLER PLEASE. CALLER FROM
LINE NUMBER SIXTY NINE PLEASE GO
AHEAD. AND YOUR MEMBERS BOB
ACTIVE IN BEHALF OF CALIFORNIA
GREYLOCK KHOSLA IN CALIFORNIA
SCIENTOLOGIST IN SUPPORT THANK
YOU. THANK YOU VERY MUCH. THAT'S
ALL THE CALLS MODERATOR. THAT'S
CORRECT NO FURTHER CALLS OKAY
THANK YOU VERY MUCH AT TIME
WOULD BRING THE BILL BACK TO THE
COMMITTEE QUESTIONS COMMENTS
SENATOR GROWTH. THANK YOU MADAM
CHAIR. THAT TOUGH ISSUE. FOR ME
I THINK THE PENDULUM SWUNG- WHEN
WE DID PRIOR AUTHORIZATION IF
YEARS AGO THERE WERE- MEDICAL
FIGHTERS THAT WERE OBVIOUSLY
TAKING ADVANTAGE OF CERTAIN
THINGS AND GETTING CARTE
BLANCHE- AND- WHEN YOU BROUGHT
THIS BILL FORWARD I'VE HAD
SEVERAL- MEDICAL WRITERS CONTACT
ME IN MY DISTRICT- REQUESTING MY
AYE VOTE ON THIS BILL. AND THEN
I'VE HAD SEVERAL OF- MY PLANS
AND- PHARMACY SAYING PLEASE
DON'T DO IT THIS CAUSES CHAOS SO
ON AND SO FORTH. AND I THINK
THERE'S A HAPPY MEDIUM
SOMEPLACE- BUT I DO WANT TO TELL
YOU THAT- I HAVE I HAVE CONCERNS
I DO THINK THAT WE NEED THE
PRIOR AUTHORIZATION- IN SOME
CASES BUT THEN I ALSO KNOW THAT.
DOCTOR SICK ENOUGH TO DO NO HARM
AND THAT THEY SHOULD MAKE SURE
THAT THE PATIENT IS CARE- TAKEN
CARE OF AND- AND ESPECIALLY LIKE
THE WITNESS TALKED ABOUT HER
FATHER THAT DID NOT GET THE- THE
TIMELY- MEDICATION NEEDED FOR
CANCER TREATMENT WHICH IS
SOMETHING THAT DESPERATELY NEEDS
TO BE TREATED IN A TIMELY
MANNER- I HAVE A FEW CONCERNS
AND I JUST WANT TO DRESS THEM
WITH YOU TO SEE IF IT'S
SOMETHING THAT COULD BE WORKED
OUT. SO LET'S JUST SAY THE BILL
PASSES AND A DOCTOR ISSUES A
PRESCRIPTION. THAT DOCTOR ISSUES
A PRESCRIPTION THE PATIENT OR
THE MEMBER TAKES IT TO THE
PHARMACY IN THE PHARMACY ISSUES
THE PRESCRIPTION BASED ON THAT
PRESCRIPTION ISSUED BY THE
DOCTOR. AND THEN I REALIZE IT'S
ONLY 10% BECAUSE 90% OF THE OF
THE- PRESCRIPTIONS ARE
AUTHORIZED EVEN FOR PRE YOU
KNOW. PRE AUTHORIZED BY THE
INSURANCE COMPANY- WHO'S
RESPONSIBLE FOR THAT DOES THE
PHARMACY EAT THAT COST. IS THE
PLANS AREN'T GOING TO PAY FOR
THAT. OR DOES IT GO BACK TO THE
DOCTOR THERE'S I THINK THERE'S A
GAP THERE- IF THAT MAKES SENSE
UNLESS THERE'S SOMETHING IN THE
BILL THAT I'VE MISSED. WELL
THERE IS. THIS DOESN'T DIRECTLY
ANSWER THE QUESTION DOT COME
BACK TO YOUR QUESTION THERE'S-
TEARS OF THE OF PRESCRIPTIONS
AND THEY ARE HERE FOR IN THE
BILL IS EXEMPTS TIER FOUR TENDS
TO BE THE MOST EXPENSIVE. AND
SPECIALTY DRUGS. AND IT IS
EXEMPT IN THIS ERA. NOW IF AN
INSURER. REFUSES TO COVER THE
COST OF THE PRESCRIPTION.
USUALLY THE PHARMACY LET'S SAY
YOU'RE A I'D- HATE. LET'S USE
THE EXAMPLE OF THE REFUSED TO
COVER THE COSTS THE POSITION
MOST OF US WE GO TO THE DOCTOR.
WE GET EIGHT EIGHT ABA. WE GET
SOMETHING IN ADVANCE FROM THE
DOCTOR INDICATING THAT YOU THE
PATIENT ARE RESPONSIBLE FOR THE
COSTS THAT INSURANCE DOESN'T.
COVER IN THAT IN EFFECT YOU ARE
YOUR AGREEMENT TO THAT IS PART
OF YOUR OUT. AGREEMENT TO TAKE
SERVICES FROM THAT DOCTOR. NOW I
CAN'T SIT TO STAND BEFORE YOU
AND TELL YOU THAT EVERY PHARMACY
DOES THE SAME THING BUT I WOULD
IMAGINE THAT MOST PHARMACIES.
WOULD THEN BILL THE- THE
RECIPIENT IN OTHER WORDS THE
PERSON WHO RECEIVED THE
MEDICINE. OKAY THANK YOU FOR
THAT THERE WERE THERE WAS A
CLARIFICATION OF PHARMACIES WERE
ASKING FOR LIKE WHO WOULD BE
RESPONSIBLE FOR THE BILL AND SO.
IF THE INSURANCE COMPANIES.
DATA
PROVIDED
ICYMI-STATE-SHOULD-FOCUS-ROADS-INSTEAD-CREATING-RETIREMENT-PLANS
HAS YOU SIGN SOMETHING NEW NEW
GREEN WITH THE TREATMENT THAT.
THERE IS AN ESTIMATE OF WHAT
INSURANCE WILL COVER BUT THERE'S
NOT A GUARANTEE AND THAT SHE
WOULD BE RESPONSIBLE FOR THE
DIFFERENCE. THANK YOU MA'AM THE
OTHER QUESTION THAT I HAD
RECEIVED THANK YOU. SENATOR IS-
YOU KNOW SEVEN SOME MEMBER
COMPANIES- SOME PLANS ARE MEMBER
COME HAVE A THOUSAND MEMBERS AND
TENS OF THOUSANDS OF MEMBERS- I
THINK THAT EVEN ON A GOLD CARD
PROGRAM. AT TWENTY FIVE AUDIT
YOU KNOW TO PULL TWENTY FIVE
RECORDS OUT OF THEM AT
ORGANIZATION HAS TENS OF
THOUSANDS OF MEMBERS. IS A
PRETTY LOW NUMBER AND IT WAS AT
A CONSIDERATION THAT WAS TAKEN
WHEN YOU LOOKED AT THIS OR WOULD
IT BE SOMETHING THAT YOU'D BE
WILLING TO LOOK AT A PERCENTAGE
POINT SO THAT THERE COULD BE AN
ADDED COULD AUDIT PROGRAM WHAT I
DON'T WANT TO DO IS GO BACK TO.
WHERE WE WERE BEFORE RIGHT I
WANT THE PLANS TO BE ABLE TO SAY
LOOK YOU'RE DOING THIS WRONG AND
THEY HAVE TO HAVE A ADEQUATE
AUDIT PROGRAM TO DO THAT- SO
THAT WE DON'T THE PENDULUM
DISCHI DOESN'T KEEP SWINGING
FROM RIGHT TO LEFT BECAUSE THIS
IS A DELICATE BALANCE IN THE
MIDDLE AND- AND OBVIOUSLY LIVES
DEPEND ON IT- ED REALLY
CONSIDERED WHETHER THERE SHOULD
BE. A VOLUMETRIC CHORUS YOU
INDICATED A PERCENT WE YOU KNOW
WE SETTLED ON A NUMBER BUT IT'S
CERTAINLY SOMETHING THAT I CAN
TALK TO THE SPONSORS ABOUT
WHETHER THAT WOULD BE
INAPPROPRIATE- MODIFICATION.
OKAY THANK YOU I APPRECIATE THAT
I KNOW YOU'RE WILLING TO WORK
WITH THE OPPOSITION- I BUT LIKE
I SAID MY CONCERN IS IT IF
YOU'VE GOT I DON'T KNOW FIFTY
THOUSAND MEMBERS AND YOU GET TO
AUDIT TWENTY FIVE. NOT TWENTY
FIVE HUNDRED TWENTY FIVE THAT'S
KIND OF IT- A POOR AUDIT- TO ME
IT'S A POOR AUDIT AT CAPTURE
THERE. AND WHAT DO WE HAVE MAYBE
THE SPONSOR ADDRESS THAT BECAUSE
I DON'T THINK THAT'S QUITE
RIGHT. OKAY ABSOLUTELY I THOUGHT
IT WAS BY DOCTOR BUT THAT'S OKAY
WE'LL GO. GET A MANAGER AT
CENTER GROVE- SO THE FIFTEEN TO
TWENTY FIVE IS BASED ON A REVIEW
OF THE PHYSICIANS UTILIZATION
DURING THAT COLD. THE GOLD CARD
PROGRAM FOR A YEAR- THE REASON
WHY AND THE BILL STARTED OFF AS
TEN TO TWENTY WE TOOK AN
AMENDMENT- UPON INTRODUCTION- TO
MOVE FROM FIFTEEN TO TWENTY
FIVE- THE REASON IS THAT BECAUSE
THOSE. ARE IN DEPTH REVIEWS THAT
REQUIRE MEDICAL RECORDS AND SO
ON AND SO FORTH SO. IF WE START
TO INCREASE THAT NUMBER THAT
BURDEN THAT WE'RE TRYING TO
ADDRESS HERE- WITH TOP OF FOR
PHYSICIAN PRACTICES REALLY
DOESN'T GET ADDRESSED BECAUSE-
THAT WOULD REQUIRE SIT DOWN.
REVIEW OF MEDICAL RECORDS SO ON
AND SO FORTH AND THAT IS
CERTAINLY TRUE. UPON APPEAL SO
THE FIFTEEN TO TWENTY FIVE IS
BY. POSITION RIGHT NOT. BY IF
NOT MY NUMBERS AND I THIS IS.
OKAY YEAH MA'AM I'M SORRY
MISUNDERSTOOD THAT I AM. THANK
YOU CLEAR. THAT AND I. THINK THE
LAST QUESTION I- THE LAST
QUESTION I IS- OBVIOUSLY. THE
MOST IN. THING IS ADDRESSED. IS
LIFE THREATENING. DISEASE OR
LIFE THREATENING ILLNESS- I
DON'T THINK ANYBODY WHO
STRUGGLING WITH THE TIMELINE OF
CANCER SHOULD BE DENIED ANYTHING
UNTIL THEY GET YOU KNOW.
OBVIOUSLY AND THAT'S I AM VERY
SORRY THAT THAT HAPPENED TO YOUR
FATHER- BUT- THERE'S THAT STORY
WHICH IS VERY SIGNIFICANT AND
MAKE SURE OTHER STORIES LIKE IT.
BUT THERE'S ALSO STORIES ON THE
OTHER SIDE WHERE. YOU KNOW THAT
THE INSURANCE COMPANIES HAVE
FOUND OUT THAT THERE HAVE BEEN
PRESCRIPTIONS AND IN THAT HAVE
CAUSED HARM ADDICTION- AND OTHER
THINGS. AND SO JUST RIGHT I AM I
KNOW YOU'RE GOING TO DO WHAT
YOU'RE GONNA DO WITH THIS BILL
BUT I WOULD LIKE YOU TO CONSIDER
A BALANCE. IN THE MIDDLE SO THAT
BOOK BECAUSE I THINK THE PLANS
ARE MAKING SURE THAT THEY HAVE
ADEQUATE HEALTH CARE FOR THEIR
MEMBERS BECAUSE- IF THEY DIDN'T
THEIR MEMBERS WOULD LEAVE THEIR
PLAN. BUT I ALSO THINK THAT
DOCTORS HAVE IN ARE ISSUING
PRESCRIPTIONS TO MAKE SURE THEIR
PATIENTS ARE TAKING CARE OF AND
LIKE I SAID THEY TAKE AN OATH TO
DO NO HARM. BUT I ALSO THAT
THERE ARE DOCTORS OUT THERE THAT
MAY NOT. AND THAT MAY JUST
CONTINUALLY RE ISSUE
PRESCRIPTIONS AND THE PLANTS
FIND- THAT THOSE THINGS ARE
CAUSING MORE HARM WHICH ARE
CREATING OTHER. AND HEALTH CARE
COST BECAUSE OF THOSE
PRESCRIPTIONS BEING ISSUED SO I
GET IT FROM BOTH SIDES. AND BOTH
INDIVIDUAL BOTH SIDES ARE- ARE
AT I THINK LOOKING OUT FOR THE
BEST INTEREST OF THEIR MEMBERS
AND THE PATIENT WHICH IS THE
SAME PERSON. AND WE GOT A STRIKE
A HAPPY MEDIUM SO I WOULD JUST
ASK YOU IF YOU WOULD PLEASE LOOK
AT THE FACT OF. YOU KNOW
CATASTROPHIC OR OR DEATH OR YOU
KNOW IN AN IMMINENT DEATH OR
ILLNESS AND- TERMINAL ILLNESS
STEPS TO MAKE SURE THAT. WE'RE
NOT JUST TERMINAL BUT YOU KNOW
DISEASE THAT CAN BE TREATED YOU
KNOW THERE'S A TIME SENSITIVE
SITUATION LIKE WE HAVE IN THE
TESTIMONY. THE BUT THEN ALSO
ADDRESSED THE ISSUE THAT THE
PLANS HAVE WITH REGARDING TO-
THE AUDITING TO BE ABLE TO MAKE
SURE THAT DOCTORS ARE DOING WHAT
THEY'RE SUPPOSED TO BE DOING.
AND THEN ADDRESSING THE ISSUE
WITH THE PHARMACIES HAVE BECAUSE
PHARMACY SOME OF THEM ARE
OPPOSED BECAUSE- YOU KNOW THEY
FEEL LIKE THEY'RE GOING TO BE
STUCK WITH THE BILL AND THERE'S
NOTHING THEY CAN DO AND- TO GO
AFTER SOMEONE ELSE FOR
PERSONALLY. PAID PRESCRIPTION IS
NOT. A VERY GOOD AFTERNOON. SO
THANK YOU FOR LISTENING. MY
COMMENTS. THE COURAGE CENTER US
. THE MANAGER. YOU KNOW I ASK MY
STAFF TO. TRY TO. PROVIDE ME
WITH THE- THAT INSURERS SO PPO
PRE AUTHORIZATION LIST AND- MY
STAFF DID SO. X. TO ME LIKE IT'S
ABOUT A HUNDRED TWO HUNDRED AND
TWENTY FIVE PAGES FAIRLY SMALL
PRINT. ONE OF THE- ITEMS ON THE
FIRST PAGE IS- ANNECY EASIER FOR
A HEART TRANSPLANT. I ASSUME
THERE'S SOME OTHER ISSUES
ASSOCIATED WITH THAT- BUT- I
GUESS MY QUESTION GOES TO- THE
PLANS. SINCE THIS OBVIOUSLY IS A
IS AN ACTIVE INSURERS. PPO
THROUGH STATION LIST. WHAT
WHAT'S WRONG WITH. GOLD CARDING-
THE POSITION HEALTH PROFESSIONAL
WHO HAS AN APPROVAL RATE OF NOT
LESS THAN 90% THANK YOU SENATOR.
I THINK THE QUESTION FOR US
REALLY IS THE DETAILS OF HOW
THAT DETERMINES AND I KNOW THAT
WHEN YOU LOOK AT IT FROM THE
PERSPECTIVE OF 90% WHEN YOU LOOK
AT IT AT 10% OF PEOPLE WILL GET
POTENTIALLY- CARE THAT'S NOT
APPROPRIATE THAT SHOULDN'T HAVE
OTHERWISE BEEN AUTHORIZED. AND
OUR MEMBERS HAVE DONE A LOT IN
THE WAY OF LOOKING AT PRIOR
AUTHORIZATION I KNOW THAT IT
FEELS LIKE THERE'S A LOT BUT
SOME OF THEM ARE SIMPLE THINGS
LIKE YOU MAY HAVE A DRUG THAT'S
COUNTER INDICATED FOR SOMEONE
WHO'S PREGNANT. SO THERE'S A
PRIOR AUTHORIZATION ON THAT DRUG
AND IT'S GOING TO GO THROUGH A
SIMPLE EDIT PROCESS AND A QUICK
REVIEW BUT THAT'S A PART OF IT
TO CATCH THOSE INSTANCES WHERE
THERE'S HARM TO THE PATIENT THAT
MAY NOT BE ANNA MAY BE UNKNOWN
TO THE PROVIDER. THERE'S ALSO
ISSUES ON THE PPO SIDE WHERE YOU
REALLY SAID AS THE PRIMARY USE
THAT AS YOUR OWN PRIMARY CARE
PHYSICIAN YOU ARE MANAGING YOUR
OWN CARE. SO YOU MAY NOT BE
AWARE OF ALL OF THE LABS THAT
WERE DONE BY ONE SPECIALIST ARE
NOW BEING RE ORDERED BY ANOTHER
SPECIALIST BUT CAN BE SHARED I
MEAN ALL OF THOSE ADDITIONAL
COSTS. WOULD BE BORNE BY THE
SYSTEM. AND THAT'S NOT TO SAY
ANY NEFARIOUS REASON ON BEHALF
OF THE PROVIDERS IT'S JUST A
SIMPLE MANAGEMENT AND SO MANY
TIMES. PRIOR AUTHORIZATION IS
NOT MEANT TO BE PUNITIVE IT'S
MEANT TO MANAGE THE SYSTEM I
THINK ONE OF THE MOST-
CONCERNING PARTS ABOUT THE BILL
AT LEAST FOR ME. IS THAT IT
CONSIDERS YOUR MODIFICATIONS OF
YOUR PROVIDER YOU'VE REQUESTED-
PRIOR AUTHORIZATION THE PLAN IS
HAS AN ADDED OR IS CAUGHT
SOMETHING YOU SHOULD START WITH
FIVE MILLIGRAMS INSTEAD OF TEN
MILLIGRAMS YOU SHOULD START WITH
P. T. INSTEAD OF BACK SURGERY. I
CATCH THAT USE OF PHYSICIAN
MODIFY THAT MAKE THAT CHANGE
RESUBMITTED AND ARE APPROVED YOU
GET TO CONSIDER THAT IS A PART
OF YOUR 90% APPROVAL RATING. I
MEAN THERE IN LIES THE REAL
MEDICAL MANAGEMENT WHERE I THINK
WE PROVIDED SOME OF YOU WITH
SOME NUMBERS. MORE ON THE HMO
SIDE BUT- THERE'S ABOUT 30% OF
THOSE MODIFICATIONS THAT ARE
SIGNIFICANT BUT VERY HELPFUL TO
THIS IS THEN. I THINK OUR
CONCERN IS THIS NO LONGER
CAUGHT. SO WHICH YOU POSITION
WITH THE PLANS POSITION ON THE
BILL CHANGES THE LANGUAGE IN THE
BILL. PROVIDES ESSENTIALLY THAT.
APPROVED NOT LESS THAN 90% OF
THE PRIOR. UNMODIFIED
AUTHORIZATION REQUESTS. I THINK
WE STILL HAVE CONCERNS I THINK
THERE'S AN INTERESTING AMENDMENT
THAT WAS TAKEN. HAS PLANS LOOK
AT. M. SERVICES THAT HAVE A 95%
APPROVAL RATING THAT WAS THE
MOST RECENT AMENDMENT. THAT WAS
IN CONJUNCTION IN KIND OF IN
LINE WITH A HIP WHICH IS OUR
NATIONAL ORGANIZATION AN AMA.
BUT THAT STILL INVOLVES
MODIFICATIONS POTENTIALLY WHAT
I'M SAYING IS. YOU HAVE A
SITUATION WHERE THE BILL SAYS
INSTEAD. 90% OR MORE PRIOR ON
MODIFIED. AUTHORIZATION REQUESTS
TO GIVE A POSITION THAT MORE 90%
OR MORE THE TIME. IS IN COMPLETE
AGREEMENT A MIND MELD WITH THE
PLAN ON WHAT SHOULD BE
AUTHORIZED AND WHAT NOT SHOULD
BE A AND WHAT SHOULDN'T BE
AUTHORIZED. COULD NOT CHANGE
YOUR POSITION. I THINK WE
FUNDAMENTALLY STILL HAVE
CONCERNS WITH GOLD CARTING.
PERCENT OF AT IT'S AN ADDITIONAL
SERVICES THAT ARE DRIVEN INTO
THE SYSTEM AND THE POTENTIAL
COST I THINK WHAT WE WANT TO SEE
IS A CHIPPER ANALYSIS TO TELL US
WHAT THAT POTENTIALLY COULD DO.
I MEAN ON THE PPO SIDE
ESPECIALLY I MEAN WE'RE ALREADY
THE MOST EXPENSIVE INSURANCE
THAT YOU'RE PROBABLY GOING TO BE
ABLE TO ACCESS. IF WE ARE
DRIVING ADDITIONAL COST INTO
THAT ESPECIALLY FOR RURAL AREAS
WHERE THEY DON'T HAVE AN
ALTERNATIVE AND THE PPO IS THE
ONLY OPTION THAT THEY HAVE. WE
WERE CONTINUING TO LOOK AT
MAKING HEALTH CARE LESS
AFFORDABLE. WE ARE ABSOLUTELY
OPEN TO HAVING A CONVERSATION
BUT I THINK JUST MAKING THAT
MINOR MODIFICATION BUT STILL
HAVING GOLD CARTING I THINK WE'D
LIKE TO SEE SOME NUMBERS- AND
ABOUT A GREATER ANALYSIS THAN
WHAT WE'VE SEEN. WE'VE HAD BILLS
AND THIS COMMITTEE AND OTHERS
THAT JUST MAKE MINOR TWEAKS TO
PRIOR AUTH THAT HAVE GONE TO
CHIPPER. AND SO I THINK WE'RE WE
ARE. WORKING A LITTLE BIT BLIND
ABOUT WHAT THE ACTUAL NUMBERS
ARE ANY THINK THIS COMMITTEE
ESPECIALLY SHOULD. SHOULD LIKELY
BE ASKING THE SAME QUESTION FOR
THE REASON I'M ASKING IS SO IF
YOU HAVE A POSITION. IN A TWELVE
MONTH PERIOD IT SUBMITS ONE
HUNDRED REQUESTS FOR. A PRIOR
AUTHORIZATION REQUEST FOR
APPROVAL. AND CONSISTENTLY
NINETY OF THOSE REQUEST.
REQUESTS ARE APPROVED BY YOU
WHAT WE CAN DISCUSS WITH THEIR
MODIFIED OR UNMODIFIED. AND TEN
OR NOT. WITHOUT THIS BILL YOU
ARE REQUIRING THE PHYSICIAN TO
HAVE AUTHORIZATION. GET
AUTHORIZATION ON ALL ONE HUNDRED
OF THE REQUEST. IF THEY'RE THE
SAME THE NEXT YEARS THAT MAKE
SENSE NO IT THAT AND I
APPRECIATE WHERE YOU GUYS ARE
TRYING TO FIND A MIDDLE GROUND
OF WHETHER OR NOT. I THINK WE
WOULD BE OPEN TO CONVERSATIONS
ABOUT REVIEWING PRIOR
AUTHORIZATIONS SETTING UP. AT A
SPECIFIC GOAL I THINK THE OTHER
ISSUE IS. WANTING TO LOOK AT A
SPECIFIC SERVICE VERSES HOLD. A
PHYSICIAN COULD DO A LOT A
PRIMARY CARE PHYSICIAN CAN DO A
LOT OF DIFFERENT THINGS UNDER
THEIR DAY TO DAY. ACTIVITIES I
THINK WE'RE LOOKING AT MOST OF
OUR MEMBERS OF LOOKED AT
SPECIFIC TIMES SERVICES. AND
DETERMINED BASED ON A SPECIFIC
SERVICE TO REMOVE PRIOR
AUTHORIZATION VERSES- THAT
PROVIDER NO LONGER HAS PRIOR
AUTHORIZATION OVER. ANY SERVICE
OR DRUG THEY PROVIDE I THINK
THAT'S THE GREATER CONCERN
BECAUSE THOSE EDITS WOULD NO
LONGER BE CAUGHT WHEN IT COMES
TO SAFETY. AND THAT'S THE OTHER
ISSUE OKAY DO WE WANT TO HAVE WE
DO HAVE. TO BURN IN THE I THINK
IN THE ROOM SOMEBODY HERE.
DARREN. JOHN LEWIS. WOULD YOU
LIKE TO COMMENT ON THIS INCIDENT
WITH THERE'S A LOT OF QUESTIONS
ABOUT THE- PROCESS. REVIEW THIS.
BILL SO WE HAVEN'T HAD THE TIME
TO BLOCK OUT YOUR ACTUARIES YOU
WANT TO COME UP AND COME TO THE
MIKE. AND LIKE. HE'S LIKE OKAY.
THEY CAN'T AFFORD. SENATOR
EGGMAN WE WANNA TO REVIEW BILL
SO NOT AT THE TO OUR AD. AND
FACULTY TO LOOK AT IT. THOUGH IT
IS A BIT COMP QUESTION- QUITE
DIFFERENT FROM MANY OF THE KINDS
OF BILLS THAT WE HAVE BEEN ASKED
ANALYZE. OKAY THANK YOU THE END.
BE THAT MEAN THAT MEANS
GENERALLY ALTHOUGH LOOK AT
SOMETHING HAS NEED TO WITH WITH
PRIOR AUTHORIZATION AND FIGURE
OUT HOW MUCH IT'LL ACTUALLY
COST. WHAT HE'S SAYING IS THAT
BECAUSE- BECAUSE THIS IS A GOLD
CARD SO WHAT IT TAKES INTO
ACCOUNT MANY PROCEDURES. MANY
DIFFERENT AYE PRESCRIPTIONS.
THAT IT'S A VERY COMPLICATED TO
TRY TO FIGURE THAT OUT. LIKE THE
REGULARS CHARACTERIZE I
CORRECTLY JUST. THANK MAY I JUST
SENATORS QUESTION. THE THANK YOU
SO. AS AN EXAMPLE SO THEY
BROUGHT UP WAS WAS- BACK PAIN
SAYS EXAMPLE OF BACK PAIN
PATIENT- MOST OF PATIENTS WITH
BACK PAIN THAT GETS SENT TO A
SPECIALIST DON'T GET SURGERY.
BUT THE CITY'S SPECIALIST WHO
THEN ORDERS PHYSICAL THERAPY
ORDERS A FOLLOW UP ORDERS AN
EXTRA. ORDERS ATTENSITY SOME
LABS. ORDERS MORE PHYSICAL
THERAPY ORDERS AN MRI SOON WE'RE
NOW OUT SIX SEVEN EIGHT
DIFFERENT REFERRAL REQUEST PRIOR
AUTHORIZATION REQUESTS IN THE
END THE PATIENT MAY NOT GET
SURGERY AND LIKELY WON'T. THAT
NEXT PERSON COMES AND SEES A
PATIENT REPEAT THIS FOUR TIMES.
EASILY MORE THAN 90% APPROVAL
RATING ON ALL OF THE REQUESTS
NOW THE SURGEON ASKS FOR A
FUSION MULTI LEVEL FUSION THIS
PATIENT COMPLETELY INAPPROPRIATE
REQUEST IS DENIED. YOU DO A
RANDOM AUDIT OF THIS PATIENT OR
THIS SURGEONS THOUSANDS OF
REQUESTS OVER THE COURSE OF THE
YEAR OF TWENTY FIVE. THEY'RE
THEY'RE LIKELY ALL GOING TO BE
FINE IN THAT POSITION WILL BE
GOLD CARD AND YET THE FINAL
SURGERY THAT HE RECOMMENDED WAS
COMPLETELY INAPPROPRIATE AND
DANGEROUS FOR THAT PATIENT. I
UNDERSTAND THEN YOU NEED TO THEN
YOU NEED TO FIGURE OUT A WAY TO
DEAL WITH THE TEN PERCENT. AND
NOT HAVE US HAVE PRE
AUTHORIZATION FOR A 1100% OF THE
CASES THAT THE PHYSICIAN SUBMITS
TO YOU. THAT'S MY TAKE ON IT BUT
THAT'S JUST ME THANK YOU I HAVE
SOME QUESTIONS I NEED TO ASK.
WITH THE TEARS PERMISSION
CLEARED UP TO THE GROUPS. IF WE
HAVE THE GROUP STILL HERE. I WAS
SO. WHAT I UP THE PEOPLE PRO
AUTHORS HOW DOES THE BILL.
IMPACT MULTI SPECIALTY GROUPS
THAT ARE CAPITATED IN THE SAME
WAY FOR THE MOST PART- THE
GROUPS ARE DELEGATED BY THE
HEALTH PLANS TO DO THIS
FUNCTION. THEY'RE ALSO
FINANCIALLY RESPONSIBLE FOR THE
COSTS. AND SO IF THEY WERE. D.
DELEGATED UNDER THIS BILL. THEY
WOULD STILL BE ON THE HOOK
FINANCIALLY FOR ALL THE CHARGES.
THAT THESE POSITIONS WOULD BE
RACKING UP CONSIDERABLE I MEAN
WE LOSE THE MEDICAL MANAGEMENT
AND WE LOSE THE COST CONTROL IN
THE SYSTEM. WE JUST BOIL THAT
DOWN TO MY UNDERSTANDING OF
CAPITATION WHICH IS PROBABLY
AROUND HISSING YOU'LL CORRECT ME
I'M SURE. IS IT A MULTI
SPECIALTY MEDICAL GROUP LIKE A
HOSPITAL I SUPPOSE. WE WILL
RECEIVE LET'S SAY TEN MILLION
DOLLARS TO TAKE CARE OF A
THOUSAND LIVES. CAPITATED
PAYMENT. BLOW UP SOME RECORDS
EARLIER HOWEVER IT'S PAID. AND
YOU GET THAT MONEY. TO TRY TO
KEEP THEM HEALTHY BECAUSE THAT'S
IN YOUR BEST INTEREST BUT WHAT
DO YOU KEEP THE THOUSAND LIVES
THOUSAND PEOPLE HEALTHY OR NOT.
YOU HAVE TO SERVICE THEM PROVIDE
MEDICAL CARE HEALTH CARE FOR THE
TEN MILLION DOLLARS RIGHT SO
IT'S INCUMBENT ON THE MULTI
SPECIALTY MEDICAL GROUP. TO
MANAGE THAT MONEY AND MANAGE
THAT CARE SO THE LINES CROSS OR
MEET. THE PATIENTS GET THE CARE
THEY NEED AT THE TIME THEY NEED.
HOPEFULLY YOU MAINTAIN THEM
HEALTHY CONDITION. AND THE
MEDICAL SPECIALTY MULTI
SPECIALTY MEDICAL GROUP
CONTINUES TO REMAIN IN OPERATION
BECAUSE YOU'VE NOT SPENT MORE
THAN TEN MILLION DOLLARS SO YOU
DO YOUR OWN. UTILIZATION REVIEW
INSIDE THE FOUR WALLS OF YOUR
MULTI SPECIALTY MEDICAL GROUP
CORRECT YES THAT'S WHY WE HAVE
THE CALIFORNIA DELEGATED MODEL
WHICH IS DIFFERENT FROM OTHER
STATES TO POSITIONS. MANAGING
THE CARE OF OTHER PHYSICIANS AND
WHAT I'M CONCERNED ABOUT IS I'M
TRYING TO MAKE SURE THAT THIS
BILL AVOIDS. DICTATING TO THOSE
INSIDE THE FOUR CORNERS OR WALLS
OF THE MULTI SPECIALTY. MEDICAL
GROUP FOR MEDICAL CLINIC. HOW OR
HOW NOT TO DO UTILIZATION REVIEW
BECAUSE WE'RE DICTATING TO YOU
HOW YOU MANAGE. HEALTH CARE
MONEY YOU RECEIVE AND HOW YOU
DELIVER HEALTH CARE TO THOSE
LIVES THAT YOU'RE RESPONSIBLE
FOR RIGHT AND SO HOW DOES THIS
BILL IF I IF I COULD ADDRESS
THAT YES MA'AM. SO IF YOU LOOK
AT SECTION THIRTEEN SIXTY SIX
POINT. SEVEN NINE FEET STATE
IT'S THAT A PLAN SHALL NOT DEL.
THREE IN THIS ARE TO DELHI
PROVIDE UNLESS THE PARTY AGREE.
INCREASED UPON A NEW PROVISION
TO THE PARTIES CONTRACT SO IT.
IT RETAINS THE ABILITY OF
DELEGATED PROVIDER TO DO WHAT
YOU DESCRIBED. AND. THE QUESTION
THE QUESTION. MA'AM IS CENTER
IS. THE POWER IS IT IS INHERENT
IN THE PLAN NOT THAT MIGHT MULTI
SPECIALTY MEDICAL GROUP CLINIC
TO TEMPTING TO PROVIDE HEALTH
CARE AND SO IF THE CONTRACTING
IT'S AN UNEQUAL CONTRACTING
POSITION. AND IF WE'RE EXPECTING
THE PLAN NOT TO ATTEMPT TO
PRESSURE THE MULTI SPECIALTY
MEDICAL CLINIC OR GROUP. NOT TO
AGREE. TO A CONTRACT PROVISION I
I'M NOT SURE THAT THAT'S GOING
TO WORK. THAT'S CORRECT SENATOR
AND RESPECTFULLY- I'M SUPPORT.
I'M SUPPORTING THIS BILL I JUST
I AM CONCERNED ABOUT THIS
ELEMENT OF IT. YEAH I'VE BEEN
DOING HEALTHCARE CONTRACTING
WORK FOR TWENTY YEARS NOW. THE
PROVIDER BILL OF RIGHTS. GIVES
DELEGATING GROUP THE ABILITY TO
TERMINATE THEIR CONTRACT. WITH
THE PLAN. IF A PROVISION A
MATERIAL CHANGE. IS UNACCEPTABLE
TO THEM THAT'S THE ONLY REMEDY
UNDER THE PROVIDER BILL OF
RIGHTS SO YOU TERMINATE THE
RELATIONSHIP. OVER A LINE IN THE
SAND IF YOU WILL IN THE
NEGOTIATION. THAT REALLY DOESN'T
HELP ANYBODY IN THIS SITUATION
DOES IT WE LOSE THE MEDICAL
MANAGEMENT OF THE GROUP. IN THE
DELEGATED RELATIONSHIP THE PLAN
GOES BACK TO RETAINING THIS-
THIS. ADMINISTRATIVE FUNCTION
AND THERE'S LESS OVERSIGHT BY
PHYSICIANS OR PHYSICIANS IN THE
SYSTEM SO THAT'S THE PROBLEM.
WHAT WE SEE AT THE GROUP LEVEL
WHERE WE TAKE RESPONSIBILITY FOR
THIS CARE IN A NETWORK IS A
TREMENDOUS VARIATION IN PRACTICE
WITH DOCTOR SOLOMON SEES IN HIS.
DAILY REVIEW OF THOUSANDS OF
THESE. IS THAT. WELL ONE SURGEON
DOES IT A CERTAIN WAY. HILL C.
TWENTY WHO ARE IN THE SAME
SPECIALTY. DOING IT IN A
DIFFERENT WAY. THIS IS WHERE
THIS EXTRA LAYER REVIEW IS SO
IMPORTANT BECAUSE WE KNOW IN
AMERICAN HEALTH CARE 40% OF THE
CARE. IS SUBJECT TO VARIATION IN
PRACTICE AS HE STATED
OVERTREATMENT UNSAFE PROCEDURES-
THAT'S WHY THIS IS SO IMPORTANT
TO HAVE THIS LINE OF REVIEW AT
THE MEDICAL GROUP LEVEL. FROM
PHYSICIAN TO PHYSICIAN. THANK
YOU THANK YOU KNOW I SEE A
DIFFERENCE BETWEEN PPO RESIN.
AND MANAGED CARE SITUATION
APPRECIATED APOLOGIZED TO THE
CHAIR. PROJECTS THE AUTHOR THANK
A CLARIFICATION I'LL BE A
SUPPORTING THE BILL BUT I AS THE
BILL MOVES FORWARD. FROM MY
PERSPECTIVE WE NEED TO TAKE WE
NEED TO DEAL WITH THIS
CAPITATED. MULTISPECIALTY
MEDICAL GROUP- ISSUE AND I DON'T
THINK WE CAN LEAVE IT TO THE
HEALTH PLANS TO DO WITH THE BY
CONTRACT BECAUSE I THINK THERE'S
AN UNEQUAL BARGAINING
RELATIONSHIP BETWEEN POWER
HEALTH PLANS AND MANNING AND
MEDICAL GROUPS. THAT IS NOT
SOLVED BY THIS BILL. RESHAPED
THE DISTINCTION ON I READ THE
SECTION BECAUSE OUR INTENTION IN
THE SECTION WAS TO TRY TO
PROTECT THOSE DELEGATE GROUPS.
BEYOND BUT I'M CERTAINLY WILLING
AND- PERHAPS THE SPONSORED COULD
ALSO SPEAK TO THIS IF THEY HAVE
A PERSPECTIVE ON IT TO LOOK AT.
YOU KNOW TO LOOK AT THE POINT
YOU MADE BECAUSE OF COURSE OR
INTENT IN DOING THAT SECTION WAS
TO PROTECT THEM. BUT IF THERE'S
AN ISSUE ABOUT THAT WE'D BE
HAPPY TO LOOK AT IT SO BRANDON
ON. THAT SAID ROTH. SO THE
PREVIOUS OF THE BILL AGAIN DID
NOT THIS EXEMPTS AFTER A TWENTY
TWENTY TWO IN THAT SESSION WE
MET WITH DELEGATED GROUPS A LOT
OF THOSE MEDICAL GROUPS ARE OUR
MEMBERS AS WELL. AND WE
UNDERSTOOD THE ACTUAL PROBLEM
WHICH IS WHY WHEN YOU GET BACK
TO THE FUNDAMENTAL ISSUE TO YOUR
POINT. THESE MEDICAL GROUPS OUR
DOCTOR OWNED OPERATED AND
CONFIGURED RIGHT SO WHEN WE
UNDERSTAND AND UNDERSTOOD THE
PROBLEM THE EXEMPTION WENT INTO
THE LANGUAGE. AND YOU HAVE OUR
COMMITMENT TO ATTEMPT TO ITS
TIGHT NOT MORE AND PROTECT THAT
DELEGATED BOTTLE. RIGHT THEY ARE
IN THE THEY ARE CLOSEST TO THE
PATIENT THAT ISN'T WITHOUT IS
NOT SOMETHING THAT WE WANT TO
BLOW UP WITH THIS BILL AND THAT
IS THE INTENT OF THE EXEMPTION.
THAT WE CAN. TAKE BACK AND
STRENGTHEN- IN ORDER TO MAKE
THAT CLEAR. THURMOND THANK YOU.
I APPRECIATE THE CONVERSATION A
DIALOGUE AND MINE IS MORE OF A
COMMON AND AM A COMMENT THAT
LEADS TO I THINK A STRUGGLE THAT
I'VE HAD OVER THE LAST SEVEN
YEARS BECAUSE OVER THE LAST
SEVEN YEARS WE'VE BEEN HAVING
DISCUSSIONS ABOUT PRIOR.
AUTHORIZATION AND I'VE SEEN IT
APPROACH- REALLY ON A ONE ISSUE
BY A WHEN ISSUED BASIS AND I AM
PART OF THAT LIKE I'VE HAD BILLS
I HAVE BILLS ARE GOING TO SEE A
BILL- THAT DEALS WITH ONE
SPECIFIC THING- AND IT'S REALLY
DIFFICULT BECAUSE THIS IS SUCH A
BIG PROBLEM. AND I THINK THAT
YOU KNOW ONE OF THE COMMENTS I
HEARD. THAT WAS THAT YOU KNOW
THERE'S NOT A WHOLE LOT OF
EVIDENCE- THAT THIS ACTUALLY
LEADS TO. A DELAY IN CARE. AND I
HAVE TO TELL YOU THAT THE MORE
USE TALK TO CONSTITUENTS. THAT
IS VERY DISCONNECTED FROM THE
LIVED EXPERIENCE OF CONSTITUENTS
SO I EAT I I'VE STRUGGLED WITH
HOW DO WE ADDRESS THIS AS A
SYSTEM. I THINK WANT TEEN- SOME
COST CONTROL IS REASONABLE I
TRULY BELIEVE IT'S REASONABLE. I
HEAR EXAMPLES OF WE KNOW IF THE
LAB TESTS ARE ALREADY BEING DONE
HERE WEEK PERHAPS YOU CAN USE
THEM I GET THAT AND I WOULD
AGREE. WITH THE PROCESS THAT.
CONSIDERED THAT AND WE DON'T
WANT TO HAVE DOUBLE YOU KNOW WE
DON'T WANT A SYSTEM THAT
DUPLICATES A LOT OF THE SAME
WORK I MEAN YOU DON'T WANT THAT
IN ANY PUT. PARTICULAR SPACE IF
IT'S NOT NEEDED. BUT IT IS VERY
DIFFICULT TO UNDERSTAND WHAT
IT'S GOING TO TAKE TO SAY LOOK
WE'VE HAD. AT LEAST A DECADE OF
HAVING A CONVERSATION IN THIS
LEGISLATURE ABOUT PRIOR
AUTHORIZATION WE'VE PIECE MAILED
IT- AND IT'S BEEN VERY
DIFFICULT. AND SO YOU HAVE A
BILL LIKE THIS THAT ATTEMPTS TO
GO BROADER AND NOT JUST DO IT
FOR ONE PARTICULAR THING- AND-
YOU KNOW WE WANT TO BE SENSITIVE
TO THE ISSUES. AS THE MANAGEMENT
OF CARE BUT THIS IS BECOME VERY
DIFFICULT AND I THINK THAT I AM
NOT I AM NOW AT A PLACE FOR I'M
NOT CONVINCED WHILE I AM THE
AUTHOR AND I THINK THAT WE HAVE
TO DO WHATEVER WE CAN. I'M NOT
CONVINCED THAT THE- LONG TERM
SOLUTION IS TO ONLY DO IT. BY
PIECEMEAL- AND THAT MEANS ONE.
AT PIECE OF CARE AT A TIME I
THINK THAT THAT AT A NECESSITY
YOU HAVE AUTHORS LIKE ME THAT
HAD TO DO IT. BUT I'M NOT SURE
THAT THAT IS THE ULTIMATE LONG
TERM SOLUTION- SO. YOU KNOW I
SHARE THESE THOUGHTS IN THIS
FEEDBACK SIMPLY BECAUSE IT'S
SOMETHING THAT KEEPS COMING UP
AND I DON'T KNOW WHEN WE'RE
GOING TO REACH- SOME KIND OF
UNDERSTANDING. OF WHAT THE
SYSTEM NEEDS IN ORDER. TO BRIDGE
WHATEVER EVIDENCE THERE IS THAT
THIS DOESN'T DELAYED CARE TO THE
LIVED EXPERIENCES OF SO MANY
PEOPLE WE REPRESENT THAT SAYS IT
DOES. THERE IS A REAL GAP THERE
THAT I THINK I FEEL NEEDS
BRIDGING. AND I STRUGGLED WITH
WHAT THE ANSWER IS AS A YOU KNOW
I'VE ATTEMPTED TO DO IT ON ONE
WAYS AND I'M NOT SURE THAT'S THE
ULTIMATE WAY SO- I LOOK FORWARD
TO MORE CONVERSATIONS. ABOUT
THIS BECAUSE I THINK WE ARE ALL
INTERESTED IN GETTING IT RIGHT
WE ARE ALL INTERESTED IN HAVING
A HEALTH CARE SYSTEM THAT DOES
MORE AXES- AND DOESN'T DUPLICATE
SOME OF- THE COST IF NOT NEEDED-
BUT- BUT CERTAINLY. I THINK
ACCESS TO IMMEDIATE CARE IS AT
THE CORE OF WHAT WE'RE ALL
TRYING TO ACHIEVE. THANK YOU.
ANYBODY ELSE. OKAY I'LL SAY IT
AGAIN JUST TO THINK THE
OPPOSITION AND THE SPONSORS AND
THE AUTHOR AND STAFF FOR WORKING
SO HARD ON THIS IS. THIS IS- IF
YOU CAN SEE IT DID PROMPT A LOT
OF CONVERSATIONS HERE CERTAIN
PROMPTED A LOT OF CONVERSATIONS
EVEN I WAS OVERSEAS WERE HAVING
CONVERSATIONS ABOUT THIS- AND WE
WOULD AND THERE ARE PLANS TO ASK
THAT DIVERSITY TO DO THAT- LOOK
AT. PRIOR AUTH OVERALL- SO I
KIND OF WANT TO HOLD BACK ON A
LOT OF THESE PIECEMEAL BILLS
BECAUSE IT DOES GET VERY.
TECHNICAL WE HAVE ANOTHER ALSO
HERE WITH ONE TODAY ALSO AND FOR
EVERY TIME WE DO THAT IT'S LIKE
WELCOME ALL RIGHT YOU. TRY TO
HELP THIS GROUP AND THEN IT
COSTS MORE FUN THE DEDUCTIBLE OR
ON THE OTHER GROUP BROWN TOLD
BUT INTO THE PLANTS SO. OUR
HEALTH CARE SYSTEM IS INCREDIBLY
COMPLICATED- AND SO WE THANK YOU
FOR REALLY TRYING TO DIG DOWN
AND WORK ON THIS- I WILL ALSO
SAY I HAVE BEEN- THAT I SO I CAN
SEE BOTH SIDES OF THIS. BUT ON
THE SIDES OF AGAIN I LIVE WITH A
SICK PERSON I KNOW THE PRIOR US
EVERY SINGLE TIME THAT WE HAVE
TO RENEW THE PHYSICAL THERAPY.
RIGHT THANK YOU KEPT GOT BRAIN
CANCER AND NEUROLOGICAL ISSUES
IT'S NOT IT'S NOT GOING AWAY SO.
IT'S ALWAYS APPROVED BUT IT'S
ALWAYS A WAITING PERIOD- AND M.
AND TO SAY THAT THE PREVIOUS
WORKS ALL THE TIME BECAUSE THIS
WEEK WE KNOW WE DON'T PEOPLE
HAVE PROCEDURES THAT ARE
NECESSARY. UNDER THE PREVIOUS
SYSTEM RIGHT UP WITH THAT THAT
ALREADY HAPPENS. AGAIN WE'RE
TALKING ABOUT PHYSICIANS WHO
HAVE THE TONIGHT NINETY PERCENT.
THAT THAT ARE RECEIVED
AUTHORIZATION SO- I'LL BE
SUPPORTING THIS BILL. WOULD YOU
LIKE TO CLOSE. THANK YOU- LOOK.
OUR HEALTH SYSTEM DOES COME. ALL
OF US TO. IT DOES. AND SO. AM
VERY SO. OF TO BRING COSTS. BUT
I WILL. ASSERT THAT. ELTINGE
INTERESTS AND BRING DOWN CO
DOESN'T NECESSARILY BRING DOWN
THE COST TO YOU AND I. THE
BRINGS DOWN THE COST WHAT
THEY'RE PAYING OUT NOT TO
EUROPE. AND I. WOULD ALSO- I
DON'T KNOW ANYONE. WHO'S
TREATMENT WAS IMPROVED DID IT
THEIR INSURANCE COMPANIES
INTERVENTION. AND FOR MANY OF US
WHEN THE PRE AUTHORIZATION IS
DENIED. THE YOU KNOW I WAS VERY
IMPRESSED TO HEAR FROM OUR
WITNESSES THAT THEY- THAT THEY
TOOK THE TIME TO APPEAL BECAUSE
FOR. FOR MANY OF THE PLANTS B.
THE PROCESS FOR APPEALING YOU
GOING TO THE WEBSITE TO FIND IN
THE FORM IS NOT READILY
AVAILABLE. THERE'S LIKE A ONE
EIGHT HUNDRED NUMBER YOU MIGHT
HAVE TO CALL YOUR PUT ON HOLD
FOR HOWEVER LONG OF A TIME
YOU'RE THEN DIRECTED THIS THAT
YEAH I MEAN IT'S BASICALLY
DESIGNED. FOR YOU TO NOT BE ABLE
TO SUCCESSFULLY SUBMIT AN APPEAL
AND THEN OF COURSE YOU WAIT
FOREVER TO GET ANY ANSWER ON
THAT APPEAL. AND THERE'S GOOD
DOCUMENTATION OF THAT THE
INSURANCE COMPANIES ARE QUITE
THE THEY KNOW THIS AND SO THEY-
SOME SOME PORTION OF THEIR PRIOR
AUTHORIZATION REQUIREMENT IS TO
HOPEFULLY. DISCOURAGE EITHER THE
PATIENT OR THE HEALTH PROVIDER
FOR PURSUING IT AND THEN OF
COURSE THAT SAVES THEM THE COST.
AND BUT IT DOESN'T NECESSARILY
IMPROVE THE OUTCOME FOR THE
PATIENT AND I WILL ALSO SAY THAT
I WAS A BIT. TAKEN ABACK BY THE
COMMENT THAT WILL YOU KNOW THIS
PRIOR AUTHORIZATION IS GOING TO
HELP ENSURE. THAT STATE IF
YOU'RE PREGNANT WOMAN THAT THE
PRESCRIPTION THAT YOU WERE
PRESCRIBED DOESN'T CONFER
DOESN'T ISN'T COUNTER INDICATIVE
TO YOUR PREGNANCY WELL. BOTH THE
PHARMACIST AND THE DOCTOR HALF
THE LIABILITY RESPONSIBLE
RESPONSIBILITY FOR IF THEY-
PRESCRIBE A PRESCRIPTION OR
DISPENSING PRESCRIPTION DOES
COUNTER INDICATIVE TO THAT.
PATIENT SIX SO WHAT ADDED
BENEFIT I MEAN THAT THE- THE
INSURER WOULD NECESSARILY HAPPY
EVEN ALL OF THE KNOWLEDGE OR THE
RECORDS ON THE PATIENT IN TERMS
OF THAT ONE CONCERT THAT WE
JUST. I'M SORRY THAT ONE I FELT
WAS JUST NOT EVEN A CREDIBLE
THERE MAY BE OTHER CIRCUMSTANCES
WHERE FOR EXAMPLE IF THERE'S TWO
DIFFERENT SPECIALISTS THAT
EXAMPLE THAT WAS GIVEN OKAY FINE
I CAN SEE WHERE THAT. IS
POTENTIALLY RELEVANT BUT SOME OF
THE EXAMPLES NO- ANYWAY- I
DIDN'T INTEND TO ADD THOSE
THINGS IN THE CLOSE BUT IT
HAPPENS SOMETIMES WHEN YOU'RE
PRESENTING A BILL AND THINGS ARE
BROUGHT FORWARD BUT- I. COMMIT
AS WAS INDICATED TO WORK WITH
THE SPONSORS TO TRY TO ADDRESS
THIS ISSUE OF THE- A DELEGATED
GROUPS BECAUSE IT IS NOT OUR
INTENTION FOR THEM. TO BE PUT AT
THAT DISADVANTAGE. AND TO
CONTINUE TO WORK ON IT BUT I
THINK THAT WHAT WE OF WHAT THE
SYSTEM THAT WE HAVE NOW IS NOT.
PER SE DELIVERING THE BEST CARE
AND THE BEST OUTCOMES FOR
PATIENTS WITH THAT AYE ELSEVIER
AYE VOTE. THANK YOU VERY MUCH-
AND THIS MOTION IS TO PASS AND
REFERRED TO THE COMMITTEE ON
APPROPRIATIONS. AS AMENDED.
SECRETARY PLEASE CALL THE ROLL.
SENATOR EGGMAN BY. EGGMAN AYE
WHEN. GLAZER GONZALEZ. GONZALEZ
I GROWTH. FURTADO LIMON. LIMON
AYE MENJIVAR. ROTH ROTH AYE.
RUBIO HAN. BOB WINNER. WINNER I
. SIX SIX AND LEAVE THE ROLE OF
THANK YOU VERY MUCH SENATOR-
AND- I BELIEVE SENATOR GONZALEZ
WHO'S NOT SURE IN THIS COMMITTEE
IS NEXT UP TO PREVENT FOR
SENATOR STERN.
HE. THANK YOU MADAM CHAIR AND
MEMBERS I'M PRESENTING SP SEVEN
SEVEN NINE ON BEHALF OF SENATOR
STERN WHICH WILL GUARANTEE
QUALITY CARE AND QUALITY JOBS
AND HEALTH CARE. AND INCREASED
PUBLIC TRANSPARENCY BY UPDATING
ANNUAL DATA REPORTING FOR
NONPROFIT PRIMARY CARE
FACILITIES CLINICS BEFORE I
BEGIN I WOULD LIKE TO STATE THAT
THE AUTHOR IS ACCEPTING THE
AMENDMENTS WORKED OUT IN THE
COMMITTEES- WITH THE COMMITTEE
STOP THAT ARE BEING PASSED OUT
BUT ALSO LIKE TO THANK COMMITTEE
STAFF FOR THEIR HELP DEVELOPING
THESE AMENDMENTS ON BEHALF OF
THE SENATOR- THESE AMENDMENTS
REMOVE THE CIVIL PENALTY THAT
WAS PREVIOUSLY IN THE BILL
ADDITIONALLY. THE AMENDMENT
SIGNIFICANTLY NARROW THE DATA
REPORTING SOME DATA ELEMENTS ARE
REMOVED COMPLETELY FALL IN OTHER
CASES DISCRETION IS GIVEN TO THE
DEPARTMENT THE RECENTLY RELEASED
CALIFORNIA PRIMARY CARE
ASSOCIATION COMPENSATION AND
BENEFITS SURVEY REPORT INDICATED
THAT STAFF TURNOVER RATES
CONTINUE TO CLIMB WITH RATES IN
TWENTY TWENTY TWO OVER THREE
TIMES HIGHER THAN THOSE OF
TWENTY TWENTY. THESE CONDITIONS
HAVE A DEVASTATING IMPACT ON
PATIENT CARE EXPOSING
VULNERABILITIES IN OUR STATE'S
SOCIAL SAFETY NET AND FURTHER
EXACERBATING DISPARITIES IN
HEALTH CARE DELIVERY SYSTEM KERN
REPORTS DO NOT PROVIDE THE LEVEL
OF DETAIL NEEDED TO UNDERSTAND
LABOR TRENDS WORK FORCE
DEVELOPMENT ACTIVITIES AND
IMPLICATIONS FOR QUALITY. AND
EQUITY THERE SB SEVEN SEVEN NINE
WILL FOCUS ON MODERNIZING DATA
COLLECTION ON CLINIC WORK FORCE
AND THE QUALITY OF PATIENT CARE.
BUT TODAY I HAVE HERE TO TESTIFY
ON BEHALF OF THE SENATOR BETH
MELANAU SKI. IS WHICH IS THE
GOVERNMENT AFFAIRS ADVOCATE WITH
THAT S. CI YOU CALIFORNIA AS
WELL AS ANGELA MILAN. A PATIENT
ACCESS REPRESENTATIVE WITH
GOLDEN VALLEY HEALTH CENTER AND
A PROUD MEMBER OF SEIU LOCAL
FIVE TO ONE I RESPECTFULLY ASK
FOR MY VOTE THANK YOU VERY MUCH
PLEASE GO AHEAD AND CHAIR
MEMBERS STUFF ON ASZKI AND I'M
HERE TODAY AGAIN ON BEHALF OF
THE STATE CALIFORNIA SEVEN
THOUSAND MEMBERS. IF YOU CALL
FOR IS A PROUD SPONSOR OF SB
SEVEN SEVEN NINE WITH OVER
SENATOR STERN'S LEADERSHIP- AND
SOONER GONZALEZ FOR DIPPING 2%
THANK YOU. AZER NOTED WE HELP
THE COMMITTEE AGREE IS THAT
WE'VE TAKEN SIGNIFICANT
AMENDMENTS TO REFINE THE BILL. I
WANT TO GET AND APPLAUD THE
GUIDING HAND OF THE COMMITTEE ON
THAT NOTE TO I WOULD LIKE TO
BRIEFLY SHARE THE U. S. CASE
PERSPECTIVE. ON THIS IMPORTANT
BILL. THE BILL COMES DOWN TO A
FEW THINGS CLINICS ARE GROWING
BUT THEIR DATA LAGS BEHIND.
ACCURACY OF CONNECT DATA WILL
GET WORSE WITHOUT ACTION AND WE
NEED TO COLLECT NEW DATA TO
BETTER RECOGNIZE THE ENVIRONMENT
WE'RE IN TODAY. THE DEPARTMENT
OF HEALTH CARE ACCESS
INFORMATION AND ITS PREDECESSOR
US BUT IS A LONG HISTORY OF
ANNUALLY COLLECTING. FROM EACH
LICENSE CLINIC SITE. A PRIMARY
CARE CLINIC AND YOU LOSE ASIAN
REPORTER THE A YOU ARE. FOR THE
PAST DECADE THE NUMBER OF
CLINICS AND COMPANIES GO
SIGNIFICANTLY WITH MUCH OF THE
GROWTH BEING IN INTERMENT CLINIC
SITES. TODAY INTERMENT A CLICK
CLICK SITES DO NOT REPORT
DIRECTLY BUT UNDER THEIR LICENSE
CLINIC THERE FLAYED WITH. THIS
MEANS DATA ACROSS TWO OR MORE
LOCATIONS. IS AGGREGATED
TOGETHER THIS IS RESULTING IN A
OR DATA SAID THAT NO LONGER
PROVIDES ACCURATE INFORMATION.
OF LOCAL EXPERIENCE AND CAN NO
LONGER MEET THE NEEDS OF
POLICYMAKERS AND STAKEHOLDERS.
BECAUSE THE SIGNIFICANT GROWTH
IN A GERMAN SITES A TREND THAT
CONTINUES OUR DATA SET WILL GET
WORSE. THE PERCENT OF CLINIC
SITES COMPLETING THE A WAR IS
DECREASING. EACH YEAR. LESS DATA
I MEAN TO LESS COMPLETE PICTURE
OF PRIMARY AND UNDER
COMMUNITIES. SB SO SEVEN NINE
GET TO BACK ON TRACK BURKE DATA.
OF SITES ADDITIONALLY SB SEVEN
SEVEN SEVEN NINE TAKES US A STEP
FURTHER WITH NEW DATA
REQUIREMENTS WILL BE ABLE TO
BETTER UNDERSTAND THE LABOR
PICTURE ON THE GROUND. WILL
BEGIN TO COLLECT DATA ON NOTABLE
BUT NOT WELL DOCUMENTED TREND OF
CLINIC MERGERS AND ACQUISITIONS.
ALASKA WE WANNA MAKE SURE THE
QUALITY EQUITY MEASURES AT THE
LOCAL SITE LEVELS ARE PUBLICLY
DOCUMENTED. ALTERNATELY WITH
GREATER TRANSPARENCY AND
ACCOUNTABILITY WE CAN BETTER
INFORM PUBLIC FUNDING PUT POLICY
DECISIONS THAT IMPROVE ACCESS TO
CARE. WHY IS HE IS PROUD TO
SUPPORT S. B. AND THE SPONSOR SB
SEVEN SEVEN NINE THANK IN
ADVANCE YOUR AYE VOTE I'M GOING
TO HAND IT OVER NOW TO AND LET
ME LINE TO SPEAK ABOUT THE
CLINIC WORKERS. IN CENTRAL VERY
MUCH. GOOD AFTERNOON SENATORS
THANK YOU FOR THIS OPPORTUNITY
FOR ME TO SHARE MY STORY WITH
YOU IN MY CLINIC WORKERS LIKE ME
SUPPORT SB SEVEN SEVEN NINE. MY
NAME IS ANGELA ME ON I AM YOUR
DENTAL SCHEDULER AND OUT WATER A
GOLDEN VALLEY HEALTH CENTERS.
LIKE SO MANY OTHER CLINIC
WORKERS IN MY STATE I LOVE MY
JOB AND I LOVE WHAT I DO. BUT
THAT'S NOT WHY THAT'S WHY I'M
HERE TODAY BECAUSE IT LIKE A
COMMUNITY. CLINICS NEED HELP TO
DELIVER ON PROMISES OF OUR
HEALTHCARE ACCESS FOR ALL. BUT
THE WAY THINGS ARE NOW LAWMAKERS
AND OTHERS WHO CARE ABOUT
HEALTHCARE JUSTICE ARE GETTING
THE COMPLETE PICTURE OF WHAT'S
REALLY GOING ON. ACTS AS A STATE
ACROSS THE STATE THERE ARE MORE
THAN THREE THOUSAND CLINIC
CLINIC. STATE SITES BUT NEARLY
HALF OF THE SITE ARE REQUIRED TO
REPORT INFORMATION OR WHETHER.
THEY HAVE SIGNIFICANT STAFFING
WORK. FORCE DEVELOPMENT AND
HEALTHY SERVICES ARE BEING MET.
THE LACK OF SERVICE INFORMATION
IS MISLED. THE MILLIONS OF
CALIFORNIA'S THAT RELY ON OUR
CLINICS EACH YEAR. THE CLINICS
ARE OPENING UP FASTER THAN
LEVELS OF STAFF THAT WE CAN BE
MATH. WE CAN'T KEEP. PROVIDERS
OF OUR FACILITIES WE CAN'T
RETAIN RECEPTIONIST DENTAL
ASSISTANCE MEDICAL ASSISTANCE
BUT WE NEED TO HAVE MORE WORKERS
TO MEET RAISING. PATIENTS CALL
NEEDS. ARE CLINICS IT JUST
OPENED UP URGING KEROPPI AND
PATTERSON CALIFORNIA BUT IN THE
FACE OF HIGH STAFFING TURNAROUND
INSTRUCTIONS. FOR KIDS FOR.
CHURCHES OF WORKERS I WORRY WE
WILL BE WE WILL BE ABLE TO FILL
THE PATIENT'S NEEDS. MANY OF THE
NEW STAFF. LEAVE AFTER SUFFERING
AND WITH THE HAVE- LOOK WORK
LOAD AND RELOAD WAGES IS THAT WE
HAVE AT THE MOMENT. SB SEVEN
SEVEN NINE WON'T SOLVE ALL THESE
PROBLEMS WE ARE FACING IN OUR
CLINICS TODAY. BUT THEY WILL BE
A MAJOR STEP IN HELPING FIND THE
SOLUTION. WE WILL BE ABLE TO.
SEE WHICH CLINICS HAVE ENOUGH
STAFF WHAT CLEMENT CLINICS ARE
DOING WHAT TO ADDRESS SHORTAGE
OF STAFF AND HOW THE CLINICS.
ARE SURROUNDING. WILL HELP THE
SURROUNDING COMMUNITIES AROUND
US I URGE YOU TO STAND WITH
CLINIC WORKERS IN THE MILLIONS
OF PATIENTS WHO RELY ON THE
SUPPORT AND CARE WE PROVIDE EACH
YEAR. I ASK YOU TO VOTE YES ON
SB SEVEN SEVEN NINE THANK YOU
THANK YOU VERY MUCH ANGELA.
ANYBODY ELSE NOW WANTING TO COME
FORWARD JUST NAME. AND
AFFILIATION PLEASE. GET OUT
MADAM CHAIR COMMITTEE MEMBERS
AND STAFF CHRISTOPHE MAIRE WITH
THE AMERICAN FEDERATION OF STATE
COUNTY AND MUNICIPAL EMPLOYEES.
IN SUPPORT OF SB SEVEN SEVEN
NINE THANK YOU. CHRIS MYERS AT
THE CALIFORNIA SCHOOL EMPLOYEES
ASSOCIATION IN STRONG SUPPORT
THANK YOU THANK YOU. GOOD
AFTERNOON MY NAME IS FRANK ABOUT
THIS THAT WE'RE COLLECTING NIKA
IN OAKLAND AND I'M A PROUD
MEMBER OF LOCAL TEN TO ONE AND
I'M TO SPEAK IN SUPPORT OF SB
SEVEN SEVEN NINE. THANK YOU
THANK YOU. GOOD AFTERNOON MY
NAME IS TINA GIVE I'M FROM. EAST
BAY FOR MORE INFORMATION HEALTH
SERVICES AT MY COMPANY HELP
ADVOCATES ALSO I'VE MEMBER SEIU
TEN TWENTY ONE AS FOR SB SEVEN
SEVEN NINE THANK YOU. THANK YOU.
SEE THREE. PLAN COMMITTEE
MEMBERS MY NAME TO KEEP THE
MAMODO WITH CALIFORNIA ALLIANCE
FOR RETIRED AMERICANS AND
SUPPORT THE BILL. THANK YOU.
TODAY MY NAME IS MEDIA HOLDER I
AM AGING LAND SPECIALISTS FIVE
OR FIVE. PROCESS REFERRALS AND
THE WATSON CENTER- ON MEMBER
WITH A AECOM IS HUGE AS STFU
SEVEN TO ANYONE. AND SUPPORTING
. SEVEN SEVEN NINE THANK YOU
VERY MUCH. HELLO MY NAME IS
LUCKY SHE CAN'T I WORK FROM
FAMILIES TOGETHER OF ORANGE
COUNTY IN THE CITY OF TUSTIN I'M
A MEDICAL ASSISTANT. AND I
SUPPORT SB SEVEN SEVEN NINE
THANK YOU. HI GOOD AFTERNOON MY
NAME IS VALERIE D. THEM WHITE
PEOPLE AND I'M A IS CSU SEVEN
TWO ONE. AND A FULL BOTTOM IS
FROM SOUTH CENTRAL LA FROM
WHAT'S THE UP HERE AND I'M HERE
TO SUPPORT SB SEVEN TWO TWO
NINE. THANK YOU. SEVEN NINE.
HELLO AFTERNOON MY NAME IS MABEL
BIT MORE THIS CHEN. I AM A
BEHAVIOR HEALTH WORKER-
COMMITTEE HEALTH WORKER AT
LIFELONG MEDICAL CARE TO DOUBLE
CALIFORNIA. ENERGY TO PASS SB
SEVEN SEVEN NINE THANK YOU THANK
YOU. ALICIA WALKER FROM LIFELONG
MEDICAL CARE IN OAKLAND I'M A
CLINICAL COORDINATOR AND I'M
HERE SUPPORT SB SEVEN SEVEN NINE
THANK YOU. MY NAME IS JESSE
KOCHER FROM LIFELONG MEDICAL
GROUP A MEMBER OF YOU H. W. AND
I'M HERE IN SUPPORT OF SB SEVEN
SEVEN NINE THANK YOU THANK YOU.
HELLO MY NAME IS PERLA MARTINEZ
I AM A MEDICAL ASSISTANT ON THE
FAMILY HEALTH AND LAW SCHOOL-
MOST PROUD MEMBER OF SEIU AND I
SUPPORT SB SEVEN SEVEN NINE
THANK YOU. A NUMBER OF THIS
PRODUCT OF THE YEAR- DESTROYED
BY SEN THEY- IQAMA BY SEN THE
YOUR FOR YOUR SUPPORT IN PLACE
FOR THAT. AT THIS IN. SAID THAT
NINE. BE BANGLA MODEST YES YES
THIS. THE NUMBER IS IDEA HASSLES
LARA YOU BECOME A BUS THAT THEY
THIS BILL UP FOR YOU. IS CAPITAL
BLISS QUE LES. BEST THANK YOU.
HI MY NAME IS MIKE CAL I'M UP
CARE. ELIGIBLE SPECIAL IN SAN
PABLO CAL LIFELONG KERR- SCO U.
U. H. W. AND I SUPPORT SB SEVEN
SEVEN NINE THANK YOU. MY NAME IS
EMMA MOUNT AGAINST MEDICAL
ASSISTANT ABOARD COUNTY BOARD TO
US BECAUSE KILL SENT THAT IN
UNION CD AND I SUPPORTER SB
SEVEN SEVEN NINE. THANK YOU. MY
NAME IS AS FOR THE CONNECTED
CARDIO I AM A CONSUMER RELATIONS
COORDINATOR WITH NORTHEAST
VALLEY HEALTH CORPORATION. OF
THAT OUR SUPPORT SB SEVEN SEVEN
NINE THANK YOU. HI MY NAME'S
MIKIE SURETIES AND I AM A
PERINATAL SUBSTANCE USE DISORDER
COUNSELOR FOR CLINICAL MERYL
AMBLE HEIGHTS LOS ANGELES. I AM
A MEMBER OF THE S. AND SORRY AS
HE I YOU ON SEVEN TWO ONE AND
I'M SPEAKING IN SUPPORT OF SB
SEVEN SEVEN NINE THANK YOU. HI
MY NAME IS LYDIA CONNELL FOR
NORTH VALLEY HILL CORPORATION
SOME IT MENTAL HEALING FOR BOTH.
SB SEVEN SEVEN NINE THANK YOU
THE- GOD YOU. HELLO MY NAME IS
FERNANDO VERONICA NORTH ISRAELI
MEMBER OF S. E. I. U. SEVEN
TWENTY ONE HERE TO SUPPORT SB
SEVEN SEVEN NINE THANK YOU.
HELLO MY NAME IS SONIA- SOME I'M
A MEDICAL ASSISTANT AND DENTAL
ASSISTANT AND BENEVOLENT CELL
CENTER LOS ANGELES CALIFORNIA
AND I STRONGLY SUPPORT SB SEVEN
SEVEN NINE THANK YOU. HELLO MY
NAME IS TERRY EVAN SOME A
REGISTERED DENTAL ASSISTANT FOR
THE WHAT'S HEALTHCARE
CORPORATION AND YES FOR SB SEVEN
SEVEN NINE THANK YOU. HI MY NAME
IS DESTINY PARKS I'M A MEDICAL
ASSISTANT AT BENEVOLENCE HEALTH
CENTER IN ANAHEIM CALIFORNIA AND
I SUPPORT SB SEVEN SEVEN NINE
THANK YOU. GOOD AFTERNOON MY
NAME IS SADDAM MEDINA- FROM
SUNNY SEATTLE HEALTH IN A SPORT
SB SEVEN SEVEN NINE THANK YOU.
GOOD AFTERNOON MY NAME IS JUDITH
VALENZUELA I'M A CNA CERTIFIED
NURSING ASSISTANT IN TWENTY ZERO
HILL CENTER IN SAN DIEGO AND I'M
SUPPORT THE SEVEN SEVEN NINE
THANK YOU. HI GOOD AFTERNOON MY
NAME'S MARIA MCCARVEL I'M FROM
FROM SAN DIEGO I SUPPORT THIS IS
FAR FROM YOU COULD SIGNAL. A AND
E'S C. V. S. B. SEVEN SEVEN
NIGHT THANK YOU THANK YOU. HELLO
MY NAME IS TROY DEPARTMENT THE
PHARMACY TECHNICIAN FROM SAN
DIEGO FROM SAN YSIDRO HEALTH
CENTER AND I SUPPORT SB SEVEN
SEVEN NINE THANK YOU. GOOD
AFTERNOON I AM BRANDON DAWKINS I
MAY HELP WORK WITH THE SAN
FRANCISCO DEPARTMENT OF PUBLIC
HEALTH I AM ALSO A MEMBER OF
SEIU LOCAL TEN TO ONE AND I'M
HERE SUPPORT OF S. B. SEVEN
SEVEN NINE THANK YOU YOU WERE
ANY KINGS HAD. ELEVEN SAN
FRANCISCO- IT PLEASE. GOOD
AFTERNOON MR WITH CAL LABOR
FEDERATION ALSO IN SUPPORT THANK
YOU. GOOD AFTERNOON MY NAME IS
LOUISE MODEL I AM A MEDICAL
ASSISTANT I WORK FOR CLINIC OF
THE COMMUNITY AND OVER IN OXNARD
CALIFORNIA AND I SUPPORT SB SIX
SEVEN SEVEN NINE THANK YOU. HI
MY NAME IS LESLIE I AM A HEALTH
EDUCATOR AT CLINIC AS A
COMMINGLED ALLEN OXNARD AND I'M
HERE TO SUPPORT SB SEVEN SEVEN
EIGHT THANK YOU. HELLO MY NAME
IS SAYS MARILYN AT THE I'M A
MEDICAL ASSISTANT AT CLINIC AT
THAT COMING OUT AND- AND I
SUPPORT THEM SB SEVEN SEVEN
NINE. THANK YOU VERY MUCH. OKAY
HAVING EXHAUSTED THE YESS ANY
OPPOSITION. TO SPEAK ON THIS
BILL PLEASE COME FORWARD. GOOD
AFTERNOON MADAM CHAIR AND
MEMBERS DENNIS CLASS FROM MEADOW
REPRESENTED REPRESENTING THE
CALIFORNIA HEALTH PLUS ADVOCATES
WE REPRESENT THE COMMITTEE
HEALTH CENTERS IN THE STATE OF
CALIFORNIA- ONENESS. EXPRESS OUR
PREPAID APPRECIATION TO THE
COMMITTEE AND STAFF FOR A VERY
THOUGHTFUL ANALYSIS AND- FOR THE
PROPOSED AMENDMENTS NARROW IN
THE BILL- WE'RE GOING TO TAKE
THIS BACK TO OUR OUR- OUR- I
JUST. COMMITTEE FOR REVIEW THE
AMENDMENTS- JUST WANT TO MAKE A
COMMENT IN TERMS OF. MAKING SURE
THAT ANY ADDITIONAL POINTS
REALLY GET TO THE HEART OF I
THINK WHAT ARE OUR COLLECTIVE
HOPE IS TO IMPROVE PATIENT CARE
FOR ALL OUR COMMUNITIES
SPECIALLY ARE UNDERSERVED
COMMUNITIES SO REALLY APPRECIATE
THE AUTHOR AND THE SPONSOR AND
THE COURT TO CONTINUE WORK.
THANK YOU. MADAM CHAIR MEMBER
THE COMMITTEE BRANHAM ARCHER THE
CALIFORNIA MEDICAL ASSOCIATION-
AN OPPOSE UNLESS AMENDED STILL
REVIEWING THE AMENDMENTS FROM
THE COMMITTEE BUT I APPRECIATE
THE DIALOGUE THUS FAR AND LOOK
FORWARD TO WORKING WITH THE
OTHER. THANK YOU. ANYBODY ELSE
NOT JUST GOING TO SPEAK OKAY.
VENTURE MEMBERS DUNCAN
MCFETRIDGE ON BEHALF OF ALL TO
MED HEALTH CLINICS- WE TO OUR
OPPOSE UNLESS AMENDED WE THANK
THE AUTHOR AND SPONSORS. FOR THE
MEMPHIS WERE REVIEWING RIGHT NOW
AND- TAKE A LOOK AT HIM THANK
YOU VERY MUCH. ANYBODY ELSE NOW
THIS COME UP NAME AND
AFFILIATION. SEEING NONE WILL GO
TO THE PHONE LINES MODERATOR OF
THEIR ANY CALLS IN THE QUEUE.
LADIES AND GENTLEMEN IF YOU'LL-
HAVE OPPOSITION OR SUPPORT FOR
THIS BILL OF. S. B. SEVEN SEVEN
NINE. PRESS ONE ZERO YOUR
TELEPHONE KEYPAD. BROUGH TO LINE
FOR TWO. PLEASE GO AHEAD. IN A
MODERN CHAIRS SET BRAMBLE HERE
CALLING ON BEHALF OF THE
CALIFORNIA TEACHERS ASSOCIATION
CLEARANCE STRONG SUPPORT OF
SENATE BILL SEVEN SEVEN NINE
THANK YOU THANKS CALLER PLEASE.
ONE MOMENT HERE WE GATHER THEIR
LINE NUMBER HF Q. IT UP.
AGAIN IF YOU HAVE OPPOSITION OR
SUPPORT FOR THIS BILL PRESS ONE
AND ZERO YOU TELEPHONE KEYPAD.
YES ONE MORE MOMENT HERE.
OKAY. IT IS FROM LINE SIXTY
SEVEN PLEASE GO AHEAD. GO AHEAD
PLEASE INDIVISIBLE. HI THERE
THIS IS REALLY DARN FROM THE
CLINIC ASSOCIATION OF LAST DAM
COUNTY ALLEN ECHO MICHAEL THAT
WITH THE CALIFORNIA COASTAL
ADVOCATES AS WELL AS OKAY AND
JUST REALLY THE HERE TODAY WE
CAN I REVIEW AT THE AMENDMENT-
THAT REALLY WANT TO APPRECIATE
THE PROPER IN THE MADE THANK YOU
THANK YOU VERY. OKAY SO I THINK
WILL NOW BE IT BACK TO THE COULD
. QUESTIONS COMMENTS. THURMOND.
FOR THANK YOU CHAIR- I DO
APPRECIATE- YOU KNOW THE INTENT
OF THIS BILL MY ONLY QUESTION IS
THE COMMUNITY CLINICS ARE HERE
TO SERVE THE VERY SAME PEOPLE
THAT WE HEARD SAY YES- FOR THIS
I'M GOING TO MAKE SURE WINNER
HERE IF THERE'S ANY RESPONSE ON-
THE ADDITIONAL BURDEN THAT WOULD
BE PLACED ON COMMUNICANT X. ARE
READY OR STRUGGLING TO FUNCTION
AND PROVIDE THE SERVICES
NECESSARY. THANK YOU CENTER
APPRECIATE THE QUESTION-
ABSOLUTELY WITH YOUR MARKS RIGHT
AT THE HEART OF THIS ARE. AT ALL
OF THE WORKERS HE THOUGHT TODAY
LIVE IN THE COMMUNITY WHICH THEY
SERVE PROBABLY SO- AND WE WANT
TO MAKE SURE THIS COMMUTING THE
CARE THEY DESERVE. IN TERMS OF
BURDEN ON THE HEALTH CENTERS
THAT SOME OF THAT I THINK WE
TOOK INTO CONSIDERATION AFTER
WALKING THREE MINUTE PROCESS-
WITH THE COMMITTEE- AND
APPRECIATED- THE CONCERNS
EXPRESSED AROUND THIS. THE
REALITY IS OUR CLINICS ARE DOING
SIGNIFICANT- REPORTING ALREADY
AND WE BELIEVE THAT HAD A POINT
THAT WE ARE ASKING FOR HERE ARE
CONSISTENT WITH THINGS THEY
READY MAINTAINING FOR OTHER DATA
REPORTING THEY MIGHT BE DOING.
SO FOR EXAMPLE IS LEADS TO SOME
QUALITY DATA QUALITY
CONVERSATION WE WANT TO BRING
FORWARD HERE THERE'S AN
OPPORTUNITY FOR US TO SIMPLY BE
LIFTING UP DATA THERE A
PROVIDING SEMANTICALLY PLANS FOR
THE PURPOSES REPORTING PUBLICLY
IN A WATER. AND SEWER CONFIDENT
AS WE KIND OF MOVE FOR THIS
PROCESS EXCEEDED DIALOGUE WILL
CONTINUE TO FIND AREAS LIKE THIS
WHERE. AGAIN WE'RE NOT LOOKING
TO HAVE YOU DO COMPLICATED
CALCULATIONS THAT WILL TAKE YOUR
STAFF AWAY FROM PATIENT CARE. OR
IMPACT IN OTHER WAYS THAT MIGHT
HARM YOUR BUSINESS MODEL THAT
WOULD AGAIN TAKE YOU AWAY FROM
DIRECTING THEIR FOR. YOUR
DOLLARS THE WAY WHICH THEY
SHOULD BE DIRECTED BACK TO THE
PATIENTS. BUT IN FACT OUR GOAL
HERE TO MAKE SURE WE'RE ONLY
COLLECTING THE DATA WE NEED TO
COLLECT. THAT INFORMATION HERE
ABOUT HOW WE CAN MOVE FORWARD
FUTURE POLICY AND EVEN FUTURE
FUNDING. TO UPLIFT HIS COMMUNITY
IS NOT PLUS THESE HEALTH CENTERS
ON THE WORK THAT WE'VE DONE THE
WORK. BY THE WORK FORCE THAT WAS
HERE TODAY SO. VERY MUCH
APPRECIATE THIS COMMENT I THINK
IT'S IN ORDER TO GET YOU TO TAKE
IN MIND. AS WE WORK WITH THE
AUTHOR'S OFFICE. AND MOVE
FORWARD IN THIS JOURNEY THANK
YOU. THANK YOU SO MUCH IF YOU
EVER GO TO THE AUTHOR- THAT I
WILL BE. THIS OUT YOU COULD
COME. WORK WITH THE CAN HEALTH.
ON A- COMMON GROUND THERE THANK
YOU. THANK YOU AND- I KNOW
YOU'RE NOT THE AUTHOR BUT WE
WANT TO THANK THE AUTHOR AND
THE- PROPONENTS AND ANY
OPPOSITION AND BEGIN. AGAIN THE
HARDEST WORKING STAFF IN THE
BUILDING REALLY DIGGING IN ON
THIS AND- TRYING TO GET DOWN TO
THE MEAT OF WHAT WAS ACTUALLY. I
REQUEST YOU KNOW WHAT WOULD
ACTUALLY HELP. AND NOT BE SO
ONEROUS THAT THEY HAD A HIGHER
WHOLE NEW HR DEPARTMENT TO. GET
THE DATA SO WITH THAT WOULD YOU
LIKE TO CLOSE RESPECTFULLY ASK
FOR EITHER. OKAY AND THIS IS A-
DO PASS AS AMENDED AND RE REFER
TO THE COMMITTEE ON JUDICIARY.
SECTOR PLEASE CALL THE ROLL.
SENATORS EGGMAN BY. EGGMAN AYE.
WHEN GLAZER. GONZALEZ GONZALEZ
I. GROWTH FURTADO. LIMÓN RIGHT
LIMONIIDAE. MENJIVAR MENJIVAR
AYE. ROTH ROTH AYE. RUBIO WAHAD
. WIENER THANK WIENER AYE. RIGHT
AS SIX WILL LEAVE IT OPEN FOR.
MISS MEMBERS- NOW. SIR WIENER.
TWO BILLS IN FRONT OF US.
TWO TWO EXCELLENT DOES NOT
ANSWER. TO S. TO ACCIDENTAL THAT
NEITHER ONE OF THOSE. PRIOR
AUTHORIZATION. AND WHILE THE
FIRST ONE DOESN'T SAY PRIOR
AUTHORIZATION IS KIND PRIOR ALL
THREE. FILMS ARE WHICH ONES THE
FIRST ONE TO START WITH SEVENTY
. GREAT THANK YOU. MADAM CHAIR
FIRST I WANT TO REALLY THANK THE
COMMITTEE FOR WORKING WITH US
AND I'M HAPPY TO ACCEPT THE
COMMITTEES AMENDMENTS AS
OUTLINED IN THE ANALYSIS.
COLLEAGUES ARE FOR THOSE WHO
WERE ON HEALTH COMMITTEE LAST
SESSIONS THIS BILL LOOK FAMILIAR
BECAUSE THE BILL PASSES
COMMITTEE I BELIEVE UNANIMOUSLY
LAST YEAR UNFORTUNATELY IT WAS
HELD IN SOME WAY APPROACH SO WE
ARE BACK WITH A NARROWER.
VERSION OF IT- SO- IS THIS- SB
SEVENTY- STRENGTHENS
CALIFORNIA'S PROHIBITION ON NON
MEDICAL SWITCHING WHICH IS WHEN
A HEALTH PLAN FORCES A PATIENT
TO SWITCH FROM PRESCRIBED DRUGS
TO DIFFERENT DRUGS FOR NON
MEDICAL REASONS SUCH AS COST. SB
SEVEN SEVENTY ONE- TO THAT
EXISTING PROHIBITION- DOSE LEVEL
OR DOSAGE FORM- SO HEALTH PLANS
AND NOT BE ABLE TO FORCE A
SWITCH TO A DIFFERENT DOSAGE
FORM OR DOES LEVEL- FOR COST
REASONS- THE BILL IT IS A
PERSONAL FOR ME AS I DESCRIBED
WHEN I PRESENTED THE BILL LAST
YEAR- I LIVE WITHOUT CROHN'S
DISEASE AND- AND SO I KNOW FIRST
HAND- WHAT IT MEANS ONE.
INSURANCE COMPANIES SOMETIMES
TRY TO PUSH YOU ON THE ONE DRUG
OR ANOTHER- EVEN THOUGH YOUR
DOCTOR HAS BEEN CLEAR THAT A
PARTICULAR DRUGS IS THE CORRECT
TERM FOR YOU AND THAT DRUGS ARE
COULD BE THE DIFFERENCE BETWEEN
LEADING- THE HEALTHY AND STABLE
LIFE AND NOT. SKIVE FROM. TO THE
GUILTY WILL BENEFIT NOT WITHOUT
PRIOR AUTHORIZATION. WE KNOW
THAT SO MANY CALIFORNIANS LIVE
WITH CHRONIC ILLNESS AND RELY ON
THEIR PHYSICIAN'S JUDGMENT IN
TERMS OF WHAT MEDICATIONS BEST
FOR THEM WHAT DOES WHAT DOES
SUCH FORM- AND THE WE NEED TO
ENSURE THAT THEY ARE NOT-
DISRUPTED- ESPECIALLY WHEN A
PATIENT IS SWITCHING INSURANCE
COVERAGE- THERE IS SIGNIFICANT
RISK. OF DISRUPTION- ORDER
FORCED CHANGES AND WE NEED TO
AVOID THAT- SO SB SEVENTY
STRENGTHENS PENSION STABILITY
AND WELL BEING AS FOR ITS
CONTINUITY OF CARE- I
RESPECTFULLY ASK YOUR AYE VOTE
AND WITH ME. TODAY TO TESTIFY-
IS AMY BROUGH CORDELIA CROHN'S
PATIENT AND MEDICAL STUDENTS
STANFORD. AND RYAN SPENCER ON
BEHALF OF OUR SPONSOR- THE
CROHN'S AND COLITIS FOUNDATION
WHO WILL BE HERE FOR TECHNICAL.
QUESTIONS THANK YOU VERY MUCH
PLEASE. BUT I'M MA'AM THANK YOU
SO MUCH FOR HAVING ME HERE
TODAY- MY NAME IS AMY BICKEL
IDEA I AM A MEDICAL STUDENT AT
STANFORD UNIVERSITY SCHOOL OF
MEDICINE AND I'VE ALSO LIVED
WITH ALL SORT OF COLITIS WHICH
IS A TYPE OF INFLAMMATORY BOWEL
DISEASE OR IBD FOR SHORT. FOR
OVER FOURTEEN YEARS NOW AS A
PHYSICIAN IN TRAINING AND AS A
LONG TIME PATIENTS I AM HERE
TODAY TO SHARE FIRSTHAND THE
LIFE CHANGING POSITIVE IMPACT
THE SB SEVENTY WOULD HAVE. WHEN
I WAS DIAGNOSED WITH IBD AT THE
AGE OF TEN IN THE MIDST OF FIFTH
GRADE I WAS TOLD THAT THIS WAS A
CHRONIC DISEASE WITH NO KNOWN
CORE MEANING THAT I WOULD BE
HAVE TO BE MANAGED ON MEDICATION
FOR THE REST OF MY LIFE. BECAUSE
OF THE COMPLEX WAY THAT I. B. D.
MANIFESTS FOR EACH AND EVERY
PATIENT EACH TREATMENT PLAN IS
ALSO UNIQUE. AND ONCE YOU FIND
THAT MEDICATION THAT FINALLY
WORKS MEANING THAT YOU NO LONGER
HAVE TO BE RUNNING TO THE
RESTROOM IN THE MIDDLE OF CLASS.
YOU NO LONGER HAVE TO USE UP ALL
YOUR SIXTIES AT WORK AND YOU CAN
FINALLY SAY YES I CAN GO TO THAT
PM LEE GATHERING INSTEAD OF
BEING IN THE HOSPITAL. YOU OF
COURSE WANT TO STAY ON THAT
MEDICATION AS LONG AS POSSIBLE.
BECAUSE THE REALITY IS THAT
THERE ARE NOT MANY CLASSES OF
MEDICATION THAT CAN BE USED TO
TREAT DIABETES. AND SO WHEN A
PATIENT STARTS FAILING ON A
MEDICATION NUMEROUS STUDIES HAVE
SHOWN THAT ALTERING THE DOSE OF
DOTS THE MEDICATION CAN ACTUALLY
ALLOW THE PATIENT TO ACHIEVE
REMISSION ONCE MORE. SO INSTEAD
OF HAVING TO GO THROUGH THE
TUMULTUOUS PROCESS OF SWITCHING
TO A NEW MEDICATION THEY CAN
INSTEAD JUST STAY ON THEIR
CURRENT ONE. JUST OUT AND
OPTIMIZE DOSE. FOR EXAMPLE ONE
OF THE MEDICATIONS THAT I TAKE
FOR MY I. B. D. IS AN INJECTION
I TAKE IT HOME ONCE EVERY TWO
WEEKS. IF I WERE TO GET SICK
AGAIN WHICH FOR ME WOULD MEAN AN
EXCRUCIATING AMOUNT OF PAIN AND
INABILITY TO KEATS AND FATIGUE
AMONG. MANY OTHER SYMPTOMS. MY
PHYSICIAN MAY DECIDE. THE BEST
COURSE OF ACTION IS JUST TO
INCREASE MY DOSE TO ONCE EVERY
WEEK. THIS WOULD BE PREFERRED
FOR SO MANY REASONS. MY BODY'S
ALREADY USED TO THE MEDICATION-
IT'S VERY CONVENIENT TO FIT INTO
MY SCHEDULE AS A MEDICAL STUDENT
TAKING THE INJECTIONS AT HOME.
AND THIS. PARTICULAR MEDICATION
DOESN'T CAUSE THE SEVERE SIDE
EFFECTS THE OTHER MEDICATION.
TOP FOR ME IN THE PAST. BUT IF
MY INSURANCE. DECIDE TO DELAY
THEIR PRE. OF THE INCREASED
DOSE. OR IF THEY DECIDE TO DENY
THIS ALL TOGETHER THAT I WOULD
BE LEFT WITH NO OTHER OPTION TO
THEN SWITCH TO ANOTHER
MEDICATION WHICH- MAY NOT EVEN
WORK. AND THE PROBLEM WITH THIS
IS THAT ONCE WE SWITCH TO A
DIFFERENT MEDICATION PATIENTS
CAN NEVER GO BACK TO THAT
ORIGINAL. CLASS THE MEDICATION
WHICH MEANS THE WHOLE THING IS
ELIMINATED FOR THEM AND IS NO
LONGER AN OPTION. SO AS A RESULT
PATIENTS START TO RUN OUT OF
OPTIONS. BUT WHEN WE'RE ABLE TO
KEEP PATIENTS STABLE IN THE
CURRENT MEDICATION WE DECREASE
THE RISK OF THEM HAVING TO GO TO
THE ER OR THE URGENT CARE. FOR
HIGH COST PROCEDURES WE DECREASE
THE LIKELIHOOD OF THEM HAVING TO
GO ON DISABILITY. AND WE
DECREASE THE RISK OF THEM HAVING
TO UNDERGO EXPENSIVE SURGICAL
TREATMENTS. THE REALITY IS THE
DOSE ESCALATION IS ACTUALLY VERY
COMMON AND MEDICALLY SAFE
PRACTICE. AND ENSURES ULTIMATELY
AGREE THAT DOING SO IS
ACCEPTABLE. IN FACT IN TWENTY
TWENTY ONE EIGHTY SEVEN POINT 5%
OF IBD PATIENTS WHO APPEALED.
THEIR INSURANCE MEDICATION
DENIALS TO CALIFORNIA'S
DEPARTMENT OF MANAGED HEALTHCARE
INDEPENDENT MEDICAL REVIEW
PROCESS. EVENTUALLY HAD THEIR
REQUEST APPROVED WHICH MEANS
THAT IN THE VAST MAJORITY OF
THESE CASES ALL WE'RE CURRENTLY
DOING IS JUST DELAYING THE CARE
THAT THESE PATIENTS DESPERATELY
NEED. IN ORDER TO SURVIVE AND
THRIVE. WE IN CALIFORNIA SENATOR
WIENER MENTIONED HAVE ALREADY
PASSED REFORM FOR STEP THERAPY
AND FOR NON MEDICAL SWITCHING
WHICH IS AN INCREDIBLE STEP
FORWARD FOR CHRONIC DISEASE
PATIENTS. BUT PRESCRIPTION
DOSAGE IS A HUGE GAP IN COVERAGE
WHICH IS WHY SB SEVENTY SIX TO
CLOSE. I DECIDED TO GO TO
MEDICAL SCHOOL BECAUSE I WAS
INSPIRED BY MY OWN I. B. D.
JOURNEY TO WORK HARD TO SEE THE
LIVES OF CHILDREN AND ADULTS WHO
LIVE WITH CHRONIC DISEASE AS-
BUT THE WAY THAT THE SYSTEM IS
CURRENTLY SET UP. NO MATTER HOW
MUCH OF RESEARCH I DO ON
OPTIMIZING THE EXACT DOSE OF MY
PATIENTS MEDICATION NO MATTER
HOW MUCH I BELIEVE MY PATIENT
COULD BENEFIT FROM A DOSE
INCREASE ON THE CURRENT
MEDICATION. THERE WILL ALWAYS BE
A SILENT PARTNER THE INSURANCE
COMPANY WHO MAY DELAY OR DENY MY
PATIENTS RIGHT TO THEIR EVIDENCE
BASED DOES OPTIMIZE MEDICATION.
THE REST- YOU TO SUPPORT SB
SEVENTY TO MAKE SURE THAT
PATIENTS WITH CHRONIC DISEASES
INCLUDING INFLAMMATORY BOWEL
DISEASE HAVE THE CONTINUITY AND
QUALITY OF CARE THAT THEY
DESERVE. THANK YOU THANK YOU
VERY MUCH. THE WHAT ELSE WAS
SPEAKER THE SUPPORT. NAME
AFFILIATION NOW. GOOD AFTERNOON
SMILE HER ON BEHALF OF THE
CALIFORNIA CHILDREN SPECIALTY
CARE COALITION IN SUPPORT. KIM
STONE STONE ADVOCACY I'M HAPPY
CALIFORNIA ORTHOPEDIC
ASSOCIATION IN SUPPORT. I'M SURE
MEMBERS TO MADDEN REPRESENT THE
CALIFORNIA RHEUMATOLOGY ALLIANCE
IN SUPPORT. CHRIS MYERS AT THE
CALIFORNIA SCHOOL EMPLOYEES
ASSOCIATION IN SUPPORT. BANTER
PLEASE LOOK DON'T GET TIRED OF
MY FACE JUST YET BRAND IN MARCH
OF THE CALIFORNIA MEDICAL
ASSOCIATION IN SUPPORT. OF.
JENNIFER SENATOR REPRESENTING
THE CALIFORNIA LIFE SCIENCES IN
SUPPORT. FOR HIS SHEET WITH
STEINBERG AND STUDENT SUPPORT.
RATABLY TOUR WITH THE CALIFORNIA
PHARMACISTS ASSOCIATION IN
SUPPORT. THUNDERCRACKER WITH THE
CALIFORNIA ACCESS COALITION
SUPPORT. THANK YOU. OKAY HAVING
EXHAUSTED SUPPORT US TURNED
OPPOSITION. GOOD AFTERNOON MADAM
CHAIR MEMBERS OF THE COMMITTEE
HAD GEN ANTI WHAT THE CALIFORNIA
ASSOCIATION OF HEALTH PLANS
REPRESENTING FORTY THREE KNOCKS
KEEN LICENSE HEALTH PLANS
COVERING OVER TWENTY SEVEN
MILLION CALIFORNIANS.
REGRETTABLY WE ARE HERE TODAY IN
OPPOSITION TO THE SP SEVENTY- IT
WHICH WOULD. INDEFINITELY LIMIT
HEALTH PLANS OR INSURERS ABILITY
TO REVIEW ANY CHANGES THAT ARE
MADE TO AN INCREASE IN THE
MEDICATION OR CHANGE THE DOSAGE
FORM OF AN EXISTING MEDICATION
OR EXISTING PRESCRIPTION FOR OUR
EMPLOYEES HOLIDAYS FOR THE DELAY
I DO WANT TO THANK THE AUTHOR
THE SPONSORS AND IN THE
COMMITTEE STAFF WE'VE HAD
SEVERAL ROBUST AND- I THINK
THOUGHTFUL CONVERSATIONS ABOUT
THIS BILL. GOING BACK TO LAST
YEAR AND MOVING INTO THIS YEAR
SO WE CERTAINLY APPRECIATE
HAVING THOSE CONVERSATIONS-
MOVING FORWARD- AS IT'S PROBABLY
NO SURPRISE CONSIDERING SOME OF
THE OTHER BILLS UP FOR
DISCUSSION TODAY. YOU HEALTH
PLANS RELY ON SEVERAL CRITICAL
UTILIZATION MANAGEMENT PROTOCOLS
TO ENSURE THAT PATIENTS RECEIVE
THE RIGHT CARE AT THE RIGHT TIME
THE RIGHT PROVIDER THESE
PROTOCOLS ARE CRITICALLY
IMPORTANT IN PROMOTING SAFE
EFFECTIVE AND AFFORDABLE CARE.
FOR OUR PLAN RELEASED.
UNFORTUNATELY SB SEVENTY WOULD
REMOVE OUR ABILITY TO REVIEW
CLINICALLY APPROPRIATE USE OF
PRESCRIPTION DRUGS IF THE DOSAGE
OF THE MEDICATION IS INCREASED.
OR THE DOSAGE FORM IS CHANGED
WHICH WE BELIEVE MAY LEAD TO
SEVERAL UNINTENDED CONSEQUENCES.
WE ARE CONCERNED THAT SHIPPING
PLANS OUR ABILITY TO PROVIDE
THIS CLINICAL OVERSIGHT. NGUYEN
AN INCREASE IN A POTENTIALLY
ADVERSE REACTIONS- FROM-
INCREASE- IN A DRUG OR DOSAGE
FORM OF THE DRUG- COULD HAVE
SIGNIFICANT IMPACTS- IS A SAFETY
IMPACTS- MOVING FORWARD. I WOULD
HEALTH INSURERS TO LIMIT THE
DOSE OF THE DRUG OR THE DOSAGE
FORM OF THE DRUG IT'S USUALLY
FOR SAFETY REASONS- THE SAFETY
REASONS INCLUDE CONSISTENCY WITH
FDA APPROVED LABELING. AND
PRESCRIBED DOSES THAT HAVE BEEN
STUDIED ARE SHOWN TO BE
EFFICACIOUS. HELLO WE APPRECIATE
THAT THE BILL ATTEMPTS TO
CONSTRUCT A FRAMEWORK TO ENSURE
THAT THESE CHANGES AND DOSE AND
DOSE AND FORMER PRESCRIBE
SAFELY. BUT WE ARE CONCERNED
THAT THIS BILL DOES NOT CONSIDER
THE FULL CLINICAL COMPENDIA
RECOMMENDATIONS AROUND SUPPORTED
OFF LABEL USES- THAT IS IN-
INCREASES IN OFF LABEL USES OR
DOSAGE FORM CHANGES FOR OFF
LABEL USE OF THESE PRESCRIPTION
DRUGS. ADDITIONALLY WE ARE
CONCERNED THE TAKING WHERE
ABILITY TO PROVIDE CLINICAL
OVERSIGHT COULD ENCOURAGE THE
USE OF EXPENSIVE SPECIALTY AND
BRAND NAME DRUGS. WHEN A GENERIC
OR LOWER COST BRAND EQUIPMENT IS
AVAILABLE AND CLINICALLY
APPROPRIATE- LASTLY WE LEAVE
THAT SB SEVENTY COULD LEAD TO
SOME DRAMATICALLY INCREASED
COSTS IN THE HEALTHCARE DELIVERY
SYSTEM. I WOULD THINK THAT
CALIFORNIA HEALTH BENEFIT REVIEW
PROGRAM ANALYSIS MADE SEVERAL
KEY ASSUMPTIONS IN THE ANALYSIS
THAT MAY CONFLICT. WITH SOME OF
THOSE QUESTIONS THAT WE'VE HAD
WITH THE AUTHORS OFTEN THE
SPONSORS ABOUT THE INTENT OF THE
BILL. IN OUR CONVERSATIONS- WITH
BOTH- CHIPPER. AND THE AUTHOR'S
OFFICE WE WERE UNDER THE
IMPRESSION THAT THAT. THAT THIS
BILL WAS INTENDED TO REMOVE OUR
ABILITY TO USE- UTILIZATION
REVIEW- WHEN LOOKING AT AN
INCREASE IN INDO SIR OR CHANGE
IN DOSAGE FORM- YOU KNOW- FROM
THE TRIP ANALYSIS THEY DID NOT
TAKE THAT INTO CONSIDERATION-
AND INSTEAD ASSUME THAT THE
PLANT WOULD BE ABLE TO RETAIN
THEIR ABILITY. TO UTILIZE THESE
PROTOCOLS WHICH AGAIN BELIEVE IS
INCOMES. WITH THE CONVERSATION
THAT WE HAD PREVIOUSLY.
ADDITIONAL KNOW ARE
UNDERSTANDING. WAS THAT THE
INTENT OF THIS BILL IS TO FREEZE
COST SHARING. PROVISIONS
INDEFINITELY- AND I BELIEVE THE
TRIP ANALYSIS MADE THE
ASSUMPTION THAT THOSE COSTS.
WOULD BE FROZEN KIND OF ON A
YEAR OVER YEAR BASIS SOMEONE
RENEW WITH THE PLAN POLICY YEAR.
WE DO UNDERSTAND THERE ARE SOME
AMENDMENTS ARE BEING DISCUSSED
THAT ADDRESS SOME OF THOSE
ISSUES SO WE ARE WE ARE HAPPY TO
REVIEW THOSE AND COME BACK TO
THE COMMITTEE- BUT- THOSE ARE
JUST SOME OF THE KIND OF THE
ISSUES I THINK WE- OR SEEKING
DEATH TED TO GETS MORE ALIGNMENT
ON SO. OVERALL WE BELIEVE THAT
THAT THIS AND BILLS IMPACT MAY
BE MUCH LARGER THAN THE TWENTY
SEVEN MILLION DOLLARS AND
PREMIUM INCREASES OUTLINED BY
THE TRIP ANALYSIS. WHICH WE
BELIEVE WILL ULTIMATELY HARM
AFFORDABILITY MOVING FORWARD SO
AGAIN APPRECIATE- YOU KNOW THE
CONVERSATIONS THAT WE HAD WITH
IT WITH THE DOLLARS OFFICE AND
THE COURTS AT CONTINUOUS
CONVERSATIONS MOVING FORWARD.
SEVEN ELECTIONS ON THE HAVE A
DISSERTATION CALIFORNIA LIFE AND
HEALTH INSURANCE COMPANIES WE
TWO WERE IN OPPOSITION TO THE
BILL I WILL THANK- AS MY
COLLEAGUE MENTIONED WE'VE HAD.
REALLY GREAT CONVERSATIONS WITH
THE COMMITTEE. COMMITTEE STAFF
WITH THE SPONSORS- AND CONTINUE
THOSE CONVERSATIONS
UNFORTUNATELY FOR THE REASONS
STATED WE ARE OPPOSED. I THINK
AS WE EARLIER HAD A CONVERSATION
IN GENERAL ABOUT PRIOR
AUTHORIZATION. THERE IS A
CONCERN ABOUT RESTRICTING A
PLANT'S ABILITY ON AND ON ON
GOING BASIS. TO REVIEW. CURRENT
PRESCRIPTIONS AND THE POTENTIAL
HARM FOR PATIENTS OF FOR THOSE
REASONS REMAIN OPPOSED WE LOOK
FORWARD TO CONTINUING THOSE
CONVERSATIONS- AS THE BILL MOVES
FORWARD THANK YOU. THANK YOU
VERY MUCH ANYBODY ELSE IN
OPPOSITION NOW'S THE TIME TO
COME FORWARD. NE'EMAN FILIATION.
SIGNAL OVER THE PHONE LINES. A
MODERN TO EVERYBODY IN THE QUEUE
. YES PLEASE EXAMINE A FEW OF
SUPPORTER OPPOSITION TO STILL AT
THIS MOMENT IN TIME PRESS. ONE
IF ZERO YOU TELEPHONE KEYPAD.
THE FIRST GOAL TO LINE SEVEN
FIVE. THE GO AHEAD. TO OPEN THE
HALF OF THE CAL STATE ASIAN
THANK HIGHEST IN THE PART THANK
YOU THANK NICE COLOR. WE NOW TO
LINE SEVENTY SIX. WE'VE GOT.
THANK YOU MADAM CHAIR MEMBERS.
CALLING ON THE OF THE CALIFORNIA
CHRONIC COOLEY SUPPORT. THANK
YOU COLOR. ALASKA COMMENTING Q.
IS LINES. THREE GO AHEAD.
SACRAMENTO THANK YOU THE COUNTY
AND PART.
AND I'LL JUST SAY- ALSO THANK
YOU TO THE COMMITTEE STAFF FOR
ALL THEIR HARD WORK ON THIS AND-
SENATOR FOR BEING AMENABLE. TO
TRYING TO GET THIS JUST RIGHT
AND WE DO HAVE DIVERT IN THE
AUDIENCE IF ANYBODY HAS ANY
QUESTIONS ALTHOUGH THEIR WORK
WAS ALREADY SHADED ON- THEY'RE
HERE WELL AS- SO WITH THAT
CENTER WOULD YOU LIKE TO CLOSE-
THANK YOU MANAGE RESPECTFULLY
ASK FOR I GO THANK YOU FOR MUCH
AND THE MOST IS TO AS A MAN. AND
RE REFER TO THE ON APPROVED
SECRETARY CALL THE ROLL.
SENATORS EGGMAN EGGMAN WHEN.
GLAZER GONZALEZ GONZALEZ GROWTH
FURTADO LIMÓN HI LIMÓN AYE
MENJIVAR MENJIVAR AYE ROTH ROTH
AYE RUBIO BOB HI BOB HI WINNERS
BY WINTER I THANK YOU VERY MUCH
AND LET ME JUST CHECK WITH
AMOUNT IS HOW'S YOUR TIME. EVEN
THOUGH WITH. SHE HAS A FLAT
THREE HAS A FLIGHT YOU CAN. IF
YOU CHANCE GET A SNACK CENTER.
THE BILL SO OR WOULDN'T EVEN
CALL. SHADED THANK I APPRECIATE
THE FOR WEEK WE HAVE SOMEONE
HERE THAT'S GOING TO CATCH A
FLIGHT SO YOU AB THANK YOU TURN
MEMBERS S. B. THREE TWO FOUR.
HEALTH PLAN AND PAUL FROM PER
AUTHOR SOMETHING EVEN HEARD OF-
OTHER YOU TO. REVIEW FOR ANY
CALL AND IT- INTO TREATMENT FOR
ENTERED. ENDOMETRIOSIS IS A TO
THE MAIN DE A- BY THE CENTER
FOR. REPRODUCTION RESEARCH DUE
TO ITS VARIED SYMPTOMS BY
PATIENTS AND INCONSISTENT
DIAGNOSES BY MEDICAL
PROFESSIONALS AN ESTIMATED ONE
IN TEN WOMEN IN THE UNITED
STATES BETWEEN THE AGES OF
TWENTY FIVE AND FORTY ARE
AFFECTED BY ENDOMETRIOSIS. ON
AVERAGE WOMEN IN THE UNITED
STATES WILL SUFFER FROM
ENDOMETRIOSIS FOR TEN YEARS
BEFORE RECEIVING THE PROPER.
DIAGNOSIS CURRENTLY UNDER MOST
PLAN. LEOPARD LEPER AS SPEAK. OR
IS IT THE RIGHT- AND OTHER DAY.
STUDIES FOR ENTRY REQUIRE AUTH.
B. BEING A WHICH CAN TAKE WEEKS
OR MONTHS BEFORE A PURSE DAY IS
SET FOR THE PATIENT SB THREE TWO
WILL. THE PROCESS FOR WOMEN TO
THE PRIZE DATE VENTURA AND
SECURITY YOU'RE. FOR TO AND OF
LIFE WITH. TO WE HAVE A DOCTOR
SON J. R. WALL A CLINICAL
CLINICAL. AND DIRECTOR FOR
SURVEY THAT YOU SAN DIEGO HEALTH
AND RIGHT SPENCER A
REPRESENTATIVE EIGHT. WHO WILL
PROVIDE HAS- IT'S A OF SB TO
FOUR THANK YOU MUCH CHRIS
WITNESS FOR STOCKED. MADAM CHAIR
AT MEMBERS. I DO WANT MAKE IT
CLEAR THAT I'M REPRESENTING
EMPLOYER TODAY THE UNIVERSITY OF
CALIFORNIA. THANK YOU FOR YOUR
WORK ON THIS BILL WHICH HAS THE
POTENTIAL TO MAKE A HUGE
DIFFERENCE TO HUNDREDS OF
THOUSANDS OF WOMEN IN CALIFORNIA
. AND TO BE TRESSES AS YOU HEARD
IS A COMMON DISEASE. IT STEALS
THE PEAK LIVES. OF WOMEN OF
REPRODUCTIVE AGE THEY HAVE TO
TROUBLE WITH PAIN. I'M QUITE
DEBILITATE PAIN I CAN'T
DIFFICULTY WITH FERTILITY. AS A
CONSEQUENCE OF THE PAIN. THEY
HAVE DIFFICULTY SCHOOL BECAUSE
CAN START TO NOT. ALL THE WAY UP
TO MENOPAUSE THEY CAN HAVE
DIFFICULTY WITH SCHOOLING
DIFFICULTY HOLDING DOWN A JOB
MAINTAINING RELATIONSHIPS
BECAUSE OF PAIN WITH SOCIAL
FUNCTIONING. AS A MANY ASPECTS
OF THEIR LIFE CAN BE SUBOPTIMAL
. S. B. THREE TO FOUR. IS AS YOU
HAVE IT GET TOWARDS IMPROVING
ACCESS TO DIAGNOSIS AND
MANAGEMENT OF THIS CHRONIC
DEBILITATING DISEASE. DECREASING
BARRIERS TO ACCESS. THERE ARE
TWO ASPECTS. OF ENDOMETRIOSIS
THAT NEED ATTENTION MOST ONE IS
ACCESS TO DIAGNOSIS. AND THE
OTHER IS TO EFFECTIVE MANAGEMENT
. I WOULD LIKE TO SHOW SOME
FACTS TEND TO BE. THAT'LL HELP
PUT THIS BILL IN PERSON I HOPE.
YES THIS IS A COMMON TO WE HEARD
THE THEY CAN BE HUGE IN
DIAGNOSE. A COCKTAIL A SICK TO
TWELVE YEARS FROM THE ONSET PAIN
COULD DIAGNOSIS OF END. THIS IS
AN AFFRONT ON WOMEN. MEN WOULD
NOT TOLERATE SIX TO TWELVE YEARS
IN PAIN WITHOUT A DIAGNOSIS
RIGHT. DIMITRIS IS A FAX. ALL
ASPECTS OF A WOMAN'S LIFE HER
WORK HER HOME HER EDUCATION.
CREMIN DEFENDER OF ENDOMETRIOSIS
. IS LIMITED BY ACCESS SO THAT
MANY WOMEN WHO HAVE A DIAGNOSIS
OF ENDOMETRIOSIS STILL DON'T
RECEIVE. APPROVED TREATMENTS FOR
THAT DISEASE TREATMENTS THAT UP
BASED ON NATIONAL MEDICAL
GUIDELINES EVIDENCE BASED
GUIDELINES WE'RE NOT TALKING
ABOUT MAVERICK SUGGESTIONS OF
EXPERIMENTAL OPTIONS WE'RE
TALKING ABOUT BREAD AND BUTTER
STANDARD OPTIONS THEY DON'T HAVE
ACCESS TO IT AND AS A- AS A
PHYSICIAN THAT SCENE OVER A
HUNDRED THOUSAND WOMEN. AND
SPENT THIRTY YEARS RESEARCHING
ENDOMETRIOSIS. MY JOB
DESCRIPTION IS TO MAKE A
DIFFERENCE TO THE PATIENT
SITTING IN FRONT OF ME. AND
EVERY TIME I'M NOT ABLE TO DO
THAT BECAUSE OF LIMITED ACCESS
TO DIAGNOSIS OR MANAGEMENT I
FAIL. OF COURSE THIS DISCUSSION
IS NOT ABOUT ME. IT'S ABOUT THE
PATIENT BUT WHEN I FELT THE
PATIENT THE PATIENT'S NOT HAPPY
AND DOESN'T DO WELL EITHER. WE
HAVE TO REMEMBER WITH
ENDOMETRIOSIS THERE'S A FACILITY
BUTTON AND SOAP FERTILITY
PRESERVATION IS AN ASPECT THAT
WE SHOULD THINK ABOUT AS WELL.
WITH THIS BILL THEY WILL BE COST
SAVINGS. WITH EARLY DIAGNOSIS
EARLY MANAGEMENT DATA MANAGEMENT
. THEY'LL BE FEWER ER VISITS.
LESS OPIOID ADDICTION. LESS
RUINED LIVES. LESS UNNECESSARY
PROCEDURES BECAUSE PEOPLE WILL
BE DIAGNOSED EARLIER WHEN THE
SYMPTOMS A MORE STRAIGHTFORWARD
ROBIN LATER WHEN IT CAN BE MORE
COMPLEX. AND THEY WILL BE LESS
LOST PRODUCTIVITY. WE IN
CALIFORNIA I'M NOT THE ONLY ONES
FIGHTING ENDOMETRIOSIS ABOUT
FOUR FIVE YEARS AGO THE HEALTH
MINISTER OF AUSTRALIA APOLOGIZE
TO THE WOMEN OF AUSTRALIA FOR
THE COOL PUT CARE OF WOMEN WITH
ENDOMETRIOSIS. I SEE THIS BILL.
AS CALIFORNIA JOINING THE FIGHT
AGAINST ENDOMETRIOSIS. THANK YOU
VERY MUCH. THANK YOU VERY MUCH.
ARRANGEMENTS ARE. THANK YOU
MA'AM CARE- I THINK THE DOCTOR
SUMMARIZED- THE ISSUE QUITE WELL
AS WELL AS THE CENTERS OPEN
TESTIMONY SAW JUST EMPHASIZE TO
BREED RULE REGARDLESS OF THE
TREATMENT TYPE- THE DECISION
WHETHER TO BE SURGERY MEDICATION
SHOULD BE LEFT UP TO THE
PROVIDER AND THE PATIENT WHAT IS
CLINICALLY ETIQUETTE. COMMITTEE
INDICATED AND WHAT IS EVIDENCE
BASED AND THAT'S WHAT THIS BILL
SEEKS TO DO SO WITHOUT A
NECESSARY PREPARATION KERR
MISSING ACTION BY THE TREATMENT
OF THE PATIENT SERVICE THAT'S
WHY WE SUPPORT THE BILL THANK
YOU THANK YOU VERY MUCH. OKAY
ANYBODY ELSE TO GET IN RIGHT
SPEND ABOUT THE AMERICAN COLLEGE
OBGYN NINE THANK YOU VERY MUCH
RIGHT. RIGHT OTHER PEOPLE
SPEAKING IN SUPPORT COME. TO THE
MIKE NAME AND AFFILIATION.
BRANDON MARCH WITH THE MEDICAL
IN SUPPORT THANK YOU FOR TELLING
. ANYBODY ELSE BEGINS. OKAY UP
AS WHEN I COME BACK COME ON BACK
UP. MADAM CHAIR MEMBERS THE
COMMITTEE HAD AT HAND TO THE
CALIFORNIA ASSOCIATION OF HEALTH
PLANS I THINK IN THE INTEREST OF
TIME AND- THE ROBUST DISCUSSION
THAT WE'VE HAD AROUND PRIOR
AUTHORIZATION TODAY INCLUDING
THAT THAT COMES FROM THE CENTER
EARLIER TODAY- YOU KNOW I THINK
WE'VE WE'VE- KIND OF SUMMARIZE
SOME OF OUR OUR OUR POSITION
AROUND AROUND THE ISSUE. LARGE
LOOK FOR TO WORKING WITH THE
CENTER'S OFFICE MOVING FORWARD
THANK YOU. THANK YOU. STEPHANIE
WHAT CAN SOMEBODY AFTER THIS
SESSION OF CALIFORNIA LIFE AND
HEALTH INSURANCE COMPANIES I
THINK WE THOUGHT SOMEONE WE WERE
JUST GONNA SAY DITTO SOMEONE TO
GO WITH THAT EIGHT GET. THANK
YOU VERY MUCH ANYBODY ELSE BEING
IN A POSITION TODAY. NAME AN
AFFILIATE. ALL RIGHT SAYING
THAT- BECAUSE THE PHONE LINES
MODERATOR ANYBODY IN THE QUEUE.
I'LL TAKE THAT AS A NO- NOW'S
THE TIME WE WOULD BRING IT BACK
TO COMMITTEE MEMBERS SENATE WHAT
. THANK YOU- FIRST I WANT TO
THANK THE SENATOR FOR BRINGING
THIS BILL FORWARD I REALLY DO
APPRECIATE IT I ALSO WANT TO
THANK- THE FIRST LEAD WITNESS
TO. ALL STATEMENTS YOU'VE MADE-
SO WHAT'S INTERESTING IS I HAVE
ACTUALLY PERSONALLY SUFFERED
FROM ENDOMETRIOSIS AND-
EVERYTHING YOU SAID IS A 100%
FACTUAL- ET PEOPLE TAKE TIME OFF
DAY AFTER DAY AFTER DAY NOT
KNOWING EXACTLY WHAT IS WRONG
WITH THEM. AND IF THE GO TO OF A
LOT OF DOCTORS IS PAIN
MANAGEMENT. RATE AND THEY GIVE
YOU AN UNLIMITED SUPPLY OF
MEDICINE THAT JUST SUPPRESSES
YOUR PAIN- SO YOU CAN GRIT YOUR
TEETH AND GO BACK TO WORK RIGHT
OR GO BACK TO CLASS- IT IS NOT
FAIR- THERE ARE MANY WOMEN THAT.
END UP GOING TO THE ER REGULARLY
. ALL THE SCANS AND THEY STILL
DON'T KNOW AND- IT IS A VERY
INVASIVE PROCEDURE TO EVEN CHECK
IF YOU HAVE ENDOMETRIOSIS AND
TWO HUNDRED CENT DIAGNOSE IT-
SOME DOCTORS INCLUDING MY OWN
SAID THAT TO IN ORDER TO ONE
HUNDRED SAN CONFERMENT WE WOULD
HAVE TO DO IT INVASIVE SURGERY.
JUST TO EXPLORE WHETHER OR NOT
YOU HAVE ENDOMETRIOSIS THIS IS A
100% NOT FAIR- THE TOOLS AND
THE- PROCEDURE AS WELL AS THE
MEDICATION AS WELL AS THERE IS
THERE'S NO RIGHT WAY. I TO SAY
THAT THE WAY THAT INTO MUTUAL
AND DO ME TRIPS IS ACTUALLY
BEING HANDLED PROPERLY. IN
TODAY'S SCIENCES- SO THIS BILL
IS ONE STEP CLOSER TO AT LEAST
GIVING- SOME WOMEN AT LEAST US
SOME RELIEF. AND I THINK THAT
IT'S INCREDIBLY IMPORTANT TO
HIGHLIGHT WOMEN'S ISSUES THAT GO
BEYOND THE BASICS RIGHT SO I
REALLY WANT TO THANK THE SENATOR
FOR BRING THIS FORWARD AND
EVERYBODY THAT IS IN SUPPORT OF
THIS SO I'LL ALSO MOVE THIS.
THANK YOU VERY MUCH SENATOR.
ANYBODY ELSE. OKAY AND I'LL SAY
JUST AS WE'VE ALL SAID ABOUT A
PRIOR AUTHORIZATION SET YOU KNOW
IT'S WE- DIDN'T. LOWER THE COST
HERE IT INCREASES THE COST
SOMEWHERE ELSE SO I THINK WE'RE
ALL AWARE OF THAT- AND CERTAINLY
DON'T WANT TO HAVE. POLICIES IN
PLACE THAT ARE AN AFFRONT TO
WOMAN. WOULD YOU LIKE TO CLOSE I
RESPECTFULLY ASK FOR A VOTE
THANK YOU VERY MUCH SECRETARY
PLEASE CALL THE ROLL AND THAT
MOTION IS TO PASS AND REFERRED
TO THE COMMITTEE ON
APPROPRIATIONS. SENATORS EGGMAN
HI EGGMAN ICE WHEN. GLAZER
GONZALEZ HI GONZALEZ I. GROWTH
FURTADO LIMON I LIMON HI
MENJIVAR. BINGE OF OUR AYE ROTH.
ROTH AYE RUBIO. BOB HI BOB I
WINNER. WINNER HI. SEVEN SEVEN
ZERO AND I BELIEVE THE ROLE OPEN
FOR OTHER MEMBERS THANK YOU VERY
MUCH AND HAVE A SAFE JOURNEY
BACK TO SAN DIEGO DR- AND AGAIN.
COULD YOU STEP WE'RE GOING TO
ASK YOU TO BIRD DO AN OVERALL
ANALYSIS ON ALL THE PRIOR
AUTHORIZATIONS OVER THE BREAK
AND HOPEFULLY THAT'LL GIVE US.
SOME MORE DATA TO BE ABLE TO DO
REALLY APPROACHES IN A
THOUGHTFUL MANNER TO. CORRECT
CENTER WINNER YOU BACK UP. WITH
. THE SPEED TO THIRTY EIGHT.
THANK YOU VERY MUCH MADAM CHAIR
I'M HERE TODAY TO PRESENT THE
STREET TWO THIRTY EIGHT I WANT
TO AGAIN THANK THE HEALTH
COMMITTEE YOURSELF IN YOUR
STAFF- FOR WORKING WITH US TO
BUILD HAPPY TO ACCEPT THE
COMMITTEES AMENDMENTS AS LISTED
IN THE ANALYSIS- BECAUSE OVER
THE LAST FEW YEARS. I THINK WE
ALL KNOW SOME MENTAL HEALTH
CHALLENGES FACING. YOUNG PEOPLE
IN CALIFORNIA AND ACROSS THE
COUNTRY- LARGEST HAVE EXPLODED-
SO MANY OF OUR YOUNG PEOPLE ARE
SUFFERING WITH MENTAL HEALTH
CHALLENGES- WE KNOW EVEN BEFORE
THE PANDEMIC- IT WAS A PROBLEM
50% OF MENTAL HEALTH. PROBLEMS
MANIFEST BY AGE FOURTEEN AND 75%
BY AGE TWENTY FOUR AND YET WE
HAVE PRETTY CONSISTENTLY FAILED
TO YOUNG PEOPLE AND AGRI GIVING
ACCESS TO MENTAL HEALTH
TREATMENT SO WE CAN GET AN-
EARLY AND HELP THEM GET BACK ON
TRACK. SB TWO THIRTY EIGHT- WILL
HELP- AND ENSURE THAT- HEALTH
PLANS ARE ACTUALLY PROVIDING-
MENTAL HEALTH COVERAGE THAT
THEY'RE REQUIRED. TO PROVIDE AND
WE KNOW BECAUSE THE MENTAL PART
OF IT ARE REQUIRED AND IF
THERE'S A BAD HISTORY OF HEALTH
PLANS. REFUSING TO PROVIDE
MENTAL HEALTH COVERAGE- WE WANT
TO MAKE SURE THAT THAT COVERAGE
HAPPENS IN A TIMELY MANNER. AS
WELL AND SPECIFICALLY- WITH THIS
BILL WILL DO- IS WHEN HEALTH
PLAN DENIES- COVERAGE FOR MENTAL
HEALTH TREATMENT FOR A YOUNG
PERSON ANYONE UNDER THE AGE OF
TWENTY SIX. AN AUTOMATIC
INDEPENDENT MEDICAL REVIEW OR I
AM ARE WILL BE TRIGGERED A
CURRENTLY THERE'S A GRIEVANCE
PROCESS IT'S A MULTI STEP
PROCESS THAT CAN END UP TAKING
MONTHS. IN ADDITION WE KNOW THAT
YOU KNOW EVERYONE IS ENTITLED TO
AN INDEPENDENT MEDICAL REVIEW
AND I AM OUR. OB BUT MANY PEOPLE
DO NOT. YOU THOUGH THAT THEIR
ENTITLED TO I AM ARE AND THEY
JUST INVOKE IT. AND IN FACT WE
KNOW THE FROM THE- IS CENTERED
FOR YOU MENTAL. OVER ONE THERE
IN SPEAKERS SO IT'S NOT ENGLISH
OR THE FOR. NOT SEEKING A AM
MARS- AND THAT IS A HUGE EQUITY
PROBLEMS- WE ALSO KNOW THAT WHEN
I AM OURS ARE REQUESTED RELATING
TO YOUTH MENTAL HEALTH COVERAGE.
OVERWHELMINGLY THE CARD THE
HEALTH PLAN IS OVERTURNED AND
THE COVERAGE IS GRANTED. SO AS
WE HEARD EARLIER THIS IS PARTLY
ABOUT TIMING AND WHEN IT COMES
TO MENTAL HEALTH WE KNOW THAT
TIME IS ABSOLUTELY OUR ENEMY. IN
TERMS OF EFFECTIVE. TREATMENTS
SO THIS BILL I THINK IS. COMMON
SENSE IT'S NOT EXPANDING WHAT
THE COVERAGES IT'S A PROCESS
BILL DESIGNED TO EXPEDITE
GETTING THESE KIDS. YOUNG PEOPLE
THE HEALTH THAT THEY NEED SO I
RESPECTFULLY ASK YOUR AYE VOTE-
WITH ME TODAY IS- DR CLARK
HARVEY- WITH- WITH THE
CALIFORNIA COUNCIL OF COMMUNITY
APRIL HEALTH AGENCIES. AND THE
SHAUN FRANCIS WHO IS THE SENIOR
DIRECTOR BEHAVIORAL. HEALTH AT
CHILDREN'S NOW. THANK YOU GO
AHEAD PLEASE GOOD AFTERNOON
CERTAINLY UNDER HER CAR WITH
THE- WERE STATE ADVOCACY OR-
RIGHT MIDDLE AND SO USE DISORDER
CLINICS ACROSS THE STATE TWO
THIRDS OF HIM- PROVIDE SERVICES
TO CHILDREN YOUTH AND YOUNG
ADULTS. AS A PSYCHOLOGIST AND AS
A PATIENT ADVOCATE I HAVE
WITNESSED FIRST HAND THE MIDDLE
HEALTH CRISIS THE CALIFORNIA'S
YOUTH ARE FACING AND THE
IMPORTANCE OF THESE SERVICES FOR
OUR KIDS. MIDDLEMAS IS KILLING
CALIFORNIA'S YOUTH SUICIDE IS
THE SECOND LEADING CAUSE OF
DEATH IN YOUTH BETWEEN FIFTEEN
AND TWENTY FOUR YEARS OF AGE
SUICIDE RATE AMONG BLACK YOUTH
DOUBLED BETWEEN TWENTY FOURTEEN
AND TWENTY TWENTY. PRIOR TO THE
PANDEMIC CALIFORNIA WAS RANKED
FORTY EIGHTH IN THE NATION WHEN
EXAMINING CHILDREN'S ACCESS TO
MENTAL HEALTH CARE. THE PANDEMIC
ONLY EXACERBATED DIRE CONDITIONS
AMONGST OUR YOUTH AND MANY
CHILDREN LOST PARENTS CARE
GIVERS THEY FELT ISOLATED FROM
THEIR PEERS AND WE'RE EXPOSED TO
UNSTABLE HOME ENVIRONMENTS YOUTH
WITH POOR MENTAL HEALTH OFTEN
STRUGGLE WITH SCHOOL GRADES
ABSENTEEISM. ACTING OUT BEHAVIOR
AND SUBSTANCE USE ABUSE. THIS
CAN INCREASE THE RISK OF
SEXUALLY TRANSMITTED INFECTIONS
EMERGENCY ROOM VISITS
NEUROLOGICAL IMPAIRMENTS THE
DEVELOPMENTAL DELAYS AND THE
LIST GOES ON. SO WHAT AS LONG
BEEN A CRISIS HOME HAS NOW
MORPHED INTO A FULL BLOWN
EMERGENCY YET MANY HEALTH PLANS
CONTINUE TO DENY CARE AT AN
ALARMING RATE. A CHILD COMES TO
OUR PROVIDERS THEY OFTEN ARE
STRUGGLING WITH CHRONIC ANXIETY
ADHD THAT'S UNMANAGEABLE
DEPRESSIVE EPISODE OR BIPOLAR
DISORDER. THEY WORK TO
UNDERSTAND THEIR ILLNESS AND
PRESCRIBE CULTURALLY. CONGRUENT
CARE THAT TAKES INTO
CONSIDERATION THEIR FAMILY
HISTORY AND THEY'RE VERY UNIQUE
NEEDS SO IT IS EXTREMELY
FRUSTRATING WHEN THEY'RE PLANTED
NICE SUCH CARE. OFTEN BECAUSE OF
MEDICAL NECESSITY DISPUTES. TO
NAVIGATING OUR HEALTH CARE
SYSTEM TO ACCESS KERR IS ALREADY
CHALLENGING ENOUGH FOR YOUTH AND
THEIR FAMILIES. AND FOR THE FEW
THAT HAVE THE TIME AND THE
RESOURCES TO PERSIST. THE
TENTING COUNTERBALANCE WHEN
ATTEMPTING TO FILE A GRIEVANCE
OR APPEAL A DENIAL THROUGH THE
INDEPENDENT MEDICAL REVIEW
PROCESS. SB TWO THIRTY EIGHT
WOULD PUT THE POWER BACK IN THE
HANDS OF PROVIDERS AND CLIENTS
TO DECIDE WHAT KIND OF CARE IS
RIGHT FOR THEM WITHOUT PLACING
THE BURDEN ON FAMILIES TO FIGHT
THE SYSTEM THANK YOU. THANK YOU
VERY MUCH. FOR THIS NEXT PERSON
PLEASE. THANK YOU MADAM CHAIR
AND MEMBERS. MY NAME IS LUSHAN
FRANCIS AND I'M WITH CHILDREN
NOW AND WE ARE PROUD SPONSORS OF
SENATE BILL TWO THIRTY EIGHT. WE
HOPE THE CASE STORIES THAT WE
PROVIDED YOU TODAY GIVE YOU A
SENSE OF HIGH BE I AM OUR
PROCESS CAN BE USED TO SETTLE
CONCERNS THAT ARE IMPORTANT TO
FAMILIES. REGARDING THEIR
CHILDREN'S MENTAL HEALTH. THOSE
CASES HIGHLIGHT WHEN THE MRI I
AM OUR PROCESS WAS UTILIZED AND
A POSITIVE OUTCOME WAS DECLARED
. ARBIL IS ABOUT WHAT HAPPENS
WHEN FAMILIES DON'T UTILIZE THE
PROCESS BECAUSE THEY DON'T KNOW
HOW OR THEY DON'T SPEAK ENGLISH
OR THEY ARE SIMPLY OVERWHELMED
PARENTS WERE TRYING TO KEEP
THEIR HEAD ABOVE WATER. THAT IS
WHY I WANTED TO TAKE THE TIME TO
SHARE ONE STORY FROM ONE OF OUR
PROVIDER FRIENDS. WHO WAS KIND
ENOUGH TO SEND ME A VERY
DETAILED EMAIL ABOUT THEIR
EXPERIENCE. THEY WROTE. RECENTLY
WE REFERRED A TEN YEAR OLD BOY
WITH LARGE COMMERCIAL INSURANCE
COVERAGE TO RESIDENTIAL
TREATMENT. DUE TO DIFFICULTIES
REGULATING MOOD AND INCREASE
PHYSICAL AGGRESSION AT HOME. HE
STRUGGLED WITH A HISTORY OF
BEING BULLIED AT SCHOOL AND HAD
PREVIOUSLY ENGAGED IN SELF HARM
TWICE BY CUTTING HIMSELF WITH A
KNIFE. AFTER TWO WEEKS OF
TREATMENT IS INSURANCE COVERAGE
FOR THE RESIDENTIAL TREATMENT
PROGRAM WAS DENIED. WE REQUESTED
A PEER TO PEER REVIEW AT WHICH
TIME ANOTHER WEEK OF TREATMENT
WAS APPROVED. AFTER THAT WEEK
WAS COMPLETE ANOTHER DENIAL WAS
ISSUED. IN THESE DENIALS HE WAS
BEHAVING AGGRESSIVELY WITH PEERS
AND STAFF AND WE WERE ACTIVELY
CHANGING HIS MEDICATION HOPING
FOR A DIFFERENT OUTCOME. THE
FAMILY AGREED TO PAY OUT OF
POCKET HOPING THEY WOULD BE ABLE
TO CONVINCE THEIR SCHOOL
DISTRICT. TO COVER SOME OF THE
COST TO THEIR SON'S IEP PROCESS
. WITH THIS CASE NO APPEAL WAS
FILED BECAUSE THE FAMILY WAS
FOCUSED ON OBTAINING FUNDING TO
THE SCHOOL DISTRICT. VAIDER
NOTED THAT IF THIS HAD BEEN
REFERRED AUTOMATICALLY TO THE
IMR PROCESS A MORE THOROUGH
REVIEW OF THE MEDICAL NECESSITY
CRITERIA MAY HAVE YIELDED A
DIFFERENT RESULT. WELL IN THIS
CASE WE CAN'T KNOW IF THIS WOULD
HAVE BEEN APPROVED ONE THING
THAT WE CONSISTENTLY SEE IS THAT
FAMILIES ARE COVERED WITH THE
COMMERCIAL INSURANCE TO THEIR
JOBS. OFTEN RELYING ON PUBLIC
FUNDS TO PAY FOR THINGS THAT BE
A RADICALLY THEIR HEALTH
INSURANCE SHOULD COVER. YOU'VE
HEARD A LOT TODAY ABOUT HOW
PATIENTS STRUGGLE TO GET THE
CARE THEY NEED FROM HEALTH
PLANS. SB TWO THIRTY EIGHT IS
ACTUALLY PRETTY SIMPLE THING
PAUL. ELIMINATES THE REQUIREMENT
FOR A PARENT OR CARE GIVER TO
PICK UP THE PHONE AND FIGHT WITH
THEIR PLAN. FOR THOSE REASONS WE
REALLY HOPE IT'LL SUPPORT SB TWO
THIRTY EIGHT. THANK YOU VERY
MUCH. FOR THE PEOPLE OF THE
PEOPLE SPEAKING IN SUPPORT NOW
THE TIME TO COME FORWARD JUST
NAME AND AFFILIATION PLEASE.
ORLAND WITH CHILDREN NOW ON
BEHALF OF THE CALIFORNIA
PSYCHOLOGICAL ASSOCIATION IN
SUPPORT. VETERANS WITH HEALTH
ACCESS CALIFORNIANS STRONG
SUPPORT THANK YOU. THE MANAGER
MEMBERS PRICE DOUGHERTY ON
BEHALF OF THE AMERICAN ACADEMY
OF PEDIATRICS CALIFORNIA IN
SUPPORT. THIS MADAM CHAIR
MEMBERS TO MADDEN REPRESENT THE
CALIFORNIA CHAPTER OF THE
AMERICAN COLLEGE OF EMERGENCY
PHYSICIANS IN SUPPORT. THANK YOU
. THANK YOU MADAM CHAIR AND
MEMBERS AMBER SHE'D WITH THE
COUNTY BEHAVIOR HEALTH DIRECTORS
ASSOCIATION OF CALIFORNIA IN
SUPPORT THANK YOU THANK YOU.
THANK YOU MELISSA CORTEZ ON
BEHALF OF AUTISM SPEAKS IN THE
CENTER FOR AUTISM AND RELATED
DISORDERS IN SUPPORT. THANK YOU
. UNDER CLICK HARVEY ON BEHALF
OF THE CALIFORNIA ACCESS
COALITION IN SUPPORT. THANK YOU
. ALL RIGHT- AND NOW WOULD BE
THE TIME FOR OPPOSITION. COME
BACK ON UP. I WOULD LIKE TO
ECHOED MY COLLEAGUES COMMENTS
ABOUT GETTING SICK OF SEEING MY
FACE TODAY BUT- I ONCE AGAIN
JEFF HANSON WITH THE CALIFORNIA
STATE ASSOCIATION HEALTH PLANS-
CORRECTLY HERE IN OPPOSITION SB
THIRTY EIGHT FIRST AND FOREMOST
DO WANT TO THANK THE AUTHORS
OFFICE AND THE SPONSORS ARE ONCE
AGAIN WE APPRECIATE YOUR OF YOUR
OPEN UP OUR OPEN DOOR POLICY
CENTER AND- WORKING WITH. THE
SPONSORS OF THE BILL WE'VE HAD
SOME SOME VERY GOOD
CONVERSATIONS- REGARDING THIS
BILL MOVING FORWARD AND WE
CERTAINLY SHARE THE GOAL IN THE
AIM A WITH THIS BILL TRYING TO
ACCOMPLISH AND THAT WE ARE
SERVING- THE MIDDLE HEALTH AND
SUBSTANCE USE NEEDS OF OUR YOUNG
PEOPLE AND IN THE STATE SO WE'RE
FULLY COMMITTED THAT WE TRULY
APPRECIATE THAT INTENT-
REGRETTABLY HOWEVER- YOU KNOW.
THIS BILL IS IGNORING SOME KEY
CONSIDERATIONS FROM FROM OUR
VANTAGE POINT IN THE CLAIMS THE
TERMINATION PROCESS THAT COULD
ULTIMATELY. LEAD ACTUALLY THE IN
CARE WHICH IS WHAT WE'RE WE'RE
PRIMARILY CONCERNED ABOUT. OUR
PRIMARY CONCERN IS THAT THE BILL
COMPLETELY REMOVES THE HEALTH
PLANS EXISTING SECONDARY REVIEW
PROCESS AFTER AGREEMENT HAS BEEN
FILED. THAT OFTEN ALLOWS THE
PLANTS TO RESOLVE INITIAL TO
MILES AND MODIFICATIONS QUICKLY.
A TYPICALLY WHEN A PLAN- ISSUES
A DENIAL OR MODIFICATION. YOU
OFTENTIMES THAT'S GENERALLY
BECAUSE THERE'S MISSING CLINICAL
INFORMATION AND CHART
DOCUMENTATION OR THERE'S
GENERALLY A MISCOMMUNICATION
BETWEEN THE PLAN AND THE
PROVIDER- OFTENTIMES DURING THE
SECONDARY. REVIEW PROCESS ONCE
AGREEMENT HAS BEEN FILED WE CAN
WE CAN OFTENTIMES GO BACK TO
THAT PROVIDER THAT INDIVIDUAL
CLEAR UP THE MISCOMMUNICATION
GET THE DOCUMENTATION CHARGE
THAT WE NEED. AND THEN PROCEED
WITH WITH OVERTURNING THAT CLAIM
AND MOVING FORWARD AND GETTING
THAT INDIVIDUAL THE CARE THAT
THEY NEED QUICKLY- HOWEVER ONCE-
YOU KNOW THIS BILL WOULD WOULD.
WOULD AUTOMATICALLY SUBMIT THOSE
CLAIMS- TO THE I AM A PROCESS
AND ONCE THAT ONCE THE- ONCE
CONSERVANCY MINUTE DIÆN MARK-
THAT'S- OBVIOUSLY ADMINISTERED
BY A THIRD PARTY. HEALTH PLANS
HAVE NO ABILITY THEN TO RESOLVE
THOSE GRIEVANCES IN THOSE
COMPLAINTS QUICKLY- AND
THEREFORE WERE. ESSENTIALLY
TAKEN OUT OF THE PROCESS- BY
THIS BILL AND WE WERE CONCERNED
THAT ACTUALLY IS GOING TO LEAD
TO DELAYS IN CARE- MOVING
FORWARD SO. YOU KNOW I MAGICALLY
TRIGGERING THE I AM A PROCESS
WITHOUT THE ABILITY OF HEALTH
PLANS TO INTERNALLY REVIEW THE
INITIAL REQUEST AGAIN ONCE AGAIN
COULD LEAD TO DELAYS IN CARE.
AND FORCE THEM INTO A PROCESS
THAT DOESN'T NECESSARILY LEAD TO
A MORE TIMELY OUTCOME WHICH. WE
THINK- IS CERTAINLY IMPORTANT.
IT'S IMPORTANT TO NOTE THAT
HELPED A ARE STATURE REQUIRED
WAS GRIEVE. UNDER THREE DAYS FOR
EXCITED APPEALS AND THIRTY DAYS
FOR STANDARD APPEALS. GENERALLY
THESE DISPUTES ARE RESOLVED MUCH
MORE QUICKLY THAN THE STASHED
RETIREMENT REQUIRE. WHICH IS
OFTENTIMES COMPLETED MORE
QUICKLY THAN IF THE CASE WERE
ACTUALLY SENT TO AYE. BUT WE'RE
ALSO CONCERNED ABOUT THE
POTENTIAL IMPACT THAT SB TWO
THIRTY EIGHT MIGHT HAVE ON THE
INTEGRITY OF THE CURRENT I AM
OUR SYSTEM. AUTOMATICALLY
REFERRING TO NILES OR
MODIFICATIONS THE I'M OUR
PROCESS REGARDLESS OF ITS-
MERITS WILL CERTAINLY LEAD TO A
MASSIVE INFLUX- IN CASES OTHER
BY. COMPROMISING THE ABILITY OF
THE CURRENT SYSTEM TO WORK
EFFICIENTLY AND EFFECTIVELY. AND
RESOLVING THESE CASES IN A
TIMELY MANNER. WE CERTAINLY
AGREE AGAIN WITH THE INTENT OF
THIS BILL- WITH THE AUTHOR AND
SPONSORS- THAT INDIVIDUAL
SUFFERING MENTAL HEALTH AND
SUBSTANCE USE DISORDER SHOULD
RECEIVE. MEDICALLY NECESSARY
CARE THAT THEY NEED- BUT WE
BELIEVE UNFORTUNATELY THE SB TWO
THIRTY HAS SOME UNINTENDED
CONSEQUENCES. THAT ACTUALLY
MIGHT BUILD MORE COST INTO THE-
HEALTHCARE DELIVERY SYSTEM. SO-
ONCE AGAIN FOR THESE REASONS WE
ARE OPPOSED SB TWO THIRTY EIGHT
I LOOK FORWARD TO CONTINUING
THIS CONVERSATION WITH THE
AUTHOR AND SPONSORS. THANK YOU.
FIFTY SEVENTY ONE ON BEHALF OF
THE AS A AND- LIFE AND HEALTH
INSURANCE COMPANIES REGRETTABLY
WE ARE TO OPPOSED WE HAD. REALLY
GREAT CONVERSATIONS WITH THE
AUTHOR AND SPONSOR I THINK
THERE'S BEEN A LITTLE BIT OF AN
EDUCATION PROCESS ABOUT. THE
INITIAL APPROVAL HOW THAT WORKS
AND THE SECONDARY LEVEL OF
GRIEVANCES AND HOW IT FUNCTIONS
AND MOVED THE IMR. I THINK OUR
CONCERN IS AN ESPECIALLY ON THE
ARE EXCITED WHICH IS ON THE
PHARMACY SIDE WE HAVE TWENTY
FOUR SEVENTY TWO HOURS TO
APPROVE OR DENY THOSE FOR THEIR
AUTOMATICALLY APPROVED. SO ONE
OF THE CONVERSATIONS THAT WE'VE
HAD IS AND I KNOW IT'S NOT THE
INTENT IS TO MOVE THINGS THAT
ARE SIMPLY MISSING PAPERWORK OR
LAB WORK. KIND OF SIMPLE FIXES
TO MOVE TO APPROVAL THAT YOU
WOULD BE MOVING THOSE TIME ARE
BUT UNDER THE CURRENT STRUCTURE
OF THE BILL THAT'S EXACTLY WHAT
WOULD HAPPEN. MOST LIKELY WHAT
YOU WOULD SEE IS. THOSE BEING
MOVED DIRECTLY TO IMR AND THEN
POTENTIALLY CANCELLED LATER BY
THE PHYSICIAN OUR CONCERN IS AS
THOSE MOVE INTO THE I AM OUR
PROCESS SO DOES THOSE PUT. THOSE
I AM OUR REVIEWER START TO DO
THEIR WORK. AND DOES THAT THEN
CREATE FUTURE DELAYS FOR OTHER
THINGS THAT REALLY DO OR SHOULD
GO THROUGH AYE MAR SO I THINK
WE'RE HOPEFUL THAT WE CAN
CONTINUE THOSE CONVERSATIONS WE
DO SEE- THE GRIEVANCE PROCESS.
AS OF FUNCTIONING M. ASSISTANCE
TO MOVE THINGS QUICKLY AND MOVE
THEM TO APPROVAL ESPECIALLY FOR
THOSE INSTANCES WHERE WE'RE
MISSING PAPERWORK OR- APPROVALS-
LAB WORK SO FOR THOSE REASONS
REMAIN OPPOSED WE LOOK FORWARD
TO CONTINUING THOSE
CONVERSATIONS. THANK YOU THANK
YOU VERY MUCH. ANYBODY ELSE
WISHING TO SPEAK IN OPPOSITION
OF THIS BILL THAT WAS TIME. NAME
AND AFFILIATION. SIGNAL GO TO
PHONE LINE MODERATOR ANYBODY IN
THE QUEUE FOR THIS. BILL IF
DETERMINES TO ITUNES COMMON IN
OPPOSITION OR SUPPORT IN THE
PRESS ONE ZERO. I WILL GO TO
LINE AT THE FLAT. ONE EIGHTY
YOUR LINE IS OPEN. I WANT TO
LINE FORTY ONE THESE CALL AT. IF
. FIND FORTY ONE YEAR LINES
OPEN. OKAY. MOHON TWO ONE
SEVENTY SEVEN. UP THANK GOD. I.
FORTY ONE. I WOULDN'T WANT TO
LINE SEVENTY SEVEN. IT'S BAD.
ANDREA RIVERA ON BEHALF OF THE
CALIFORNIA PAN ETHNIC HEALTH
NETWORK IN SUPPORT THANKS THANK
YOU. THANKS CALLER PLEASE. BONTA
LINE SEVENTY EIGHT HE'S GLAD. ON
BEHALF OF THE CALIFORNIA ACADEMY
OF CHILD AND ADOLESCENT
PSYCHIATRY AND THE CALIFORNIA
STATE FIFTY SHOULD TAKE HIGH
TRUST AND SUPPORT THANK YOU.
THANK YOU NEXT CALLER PLEASE.
THANKS FOR THE TWO LINES FORTY
SIX PLEASE GO AHEAD OF. GOOD
AFTERNOON LINDA WAY WITH WESTERN
CENTER ON LAW AND POVERTY IN
SUPPORT THANK YOU. THANK YOU
NICE COLOR PLEASE. THANKS TO THE
TIMELINE EIGHTY ONE PLEASE GO
AHEAD. HELLO THIS IS KEVIN INFO
FRIENDS COMMITTEE ON LEGISLATION
OF CALIFORNIA AND STRONG SUPPORT
THANK YOU THANK YOU NICE COLOR
PLEASE. THIS IS A TO LINE
SEVENTY PLEASE GO AHEAD. HEY
LORI THANK YOU WITH THE COUNTY
FOR A MINUTE THE POOREST AMENDED
PETITION OUR APPRECIATE OF THE
NUMBER OF THE JUST A MOMENT THE
AUTHOR I SPONSORS AGREED TO TAKE
IN THIS COMMITTEE AND BELIEVE ME
IT'S THE BILL CLOSER TO CONTENT
HOWEVER WE STILL HAVE REMAINING
CONFERRING THAT. WILL CONTINUE
TO WORK WITH THE AUTHORS AND
SPONSORS UNDER INSURED CONSUMERS
ARE PROTECTED RAFI I'M OUR
PROCESS THANK YOU. THANK YOU
VERY MUCH THIS CALL PLEASE.
LINES SEVEN PLEASE GO AHEAD. THE
GREAT FALLS OPERABLE FROM THE
HAPPENED THE NATIONAL CENTER FOR
YOU FOUGHT IN SUPPORT OF THE
BILL THANK YOU THANK YOU NICE
COLOR PLEASE. AT THE TIME
SEVENTY TWO PLEASE GO AHEAD.
LOCAL COUNTY WITH THE NATIONAL
ASSOCIATION OF SOCIAL WORKERS
CALIFORNIA CHAPTER AND YOU'RE IN
FOR QUITE A BIT STYLE THANK YOU
NEXT CALLER PLEASE. THANKS TO
THE TIMELINE FIFTY THREE PLEASE
GO AHEAD. MADAM CHAIR MEMBERS OF
THE COMMITTEE RENTAL ANGER ON
BEHALF OF THE PSYCHIATRIC
PHYSICIANS ALLIANCE OF
CALIFORNIA IN STRONG SUPPORT.
THANK YOU THANKS CALLER PLEASE.
THANK TO THE LINE EIGHTY PLEASE
GO AHEAD. HELLO MADAM CHAIR AND
MEMBERS JENNIFER MILEY WITH THE
AMERICAN FEDERATION OF STATE
COUNTY AND MUNICIPAL EMPLOYEES
AND PART. THANK YOU. CALLER
PLEASE. NEXT TO THE TO LINE
EIGHTY SIX IF I HAD. CENTER
MEMBERS JOHN WHEN YOU'RE ON THE
MARKET HEALTH INSURANCE PLANS IN
OPPOSITION. THANK YOU THANKS
CALLER PLEASE. HELLO MY Q. THAT
HUMID MANAGER OKAY THANK YOU
VERY MUCH JUST TELL BRING THEM
BACK TO THE COMMITTEE. SENATE
AND HOUSE. I JUST WANT TO SAY
THANK YOU TO SENATOR WIENER FOR
BRINGING THIS FORWARD- AND TO
YOUR SPONSORS I THINK IT'S AN
INCREDIBLE BILL I'D LOVE TO BE
ADDED ON AS A CO AUTHOR HAVING.
A SIXTEEN YEAR OLD STEPSON- AND
HIS MANY FRIENDS WHO HAD- A LOT
OF INSTANCES WHERE YOU KNOW WE
NEED WE NEED THE HELP AND HAPPEN
TONIGHT I THINK THIS IS ANOTHER
OPPORTUNITY IN THE- YOU KNOW FOR
US TO BE ABLE TO TAKE CARE OF
THESE THESE THESE YOUTH SO WITH
THAT I THANK YOU VERY MUCH THANK
YOU CENTER. AND CAPITAL OF THE
BILL ON APPROPRIATE. THANK YOU
HAVE OF THE HAVE YOU IN THE BILL
THAT BILLS BEEN APPROVED BY
SENATOR GONZALEZ- IN BILLS.
OKAY- WOULD YOU LIKE TO CLOSE.
IT'S A WANT TO. THANK YOU THIS
IS BEEN A- COALITION BEHIND THIS
BILL AND I THINK THIS WILL
REALLY- HELP GET THESE KIDS SELF
IN NEED I RESPECTFULLY ASK FOR
AN AYE VOTE THANK YOU VERY MUCH-
THE MOTION IS TO PASS AS AMENDED
AND REFERRED THE COMMITTEE ON
APPROPRIATIONS SECRETARY PLEASE
CALL THE ROLL. SENATORS EGGMAN.
EGGMAN AYE WHEN. GLAZER GONZALEZ
HI GONZALEZ I GROWTH. FURTADO
FURTADO I AM ON. THE MON HI
MENJIVAR. ENGINE ARE AYE ROTH.
ROTH AYE RUBIO. WHAT HAN I BOB
HI WINNER. WINNER I. IT HAS
EIGHT VOTE AND WE'LL LEAVE IT
OPEN FOR MEMBERS TO ADD ON
CENTER HURTADO. BE PRESENTING SB
. FOUR SEVENTY TWO. I AND WE
THANK YOU IN ADVANCE FOR
ACCEPTING THE PROPOSED
AMENDMENTS.
GOOD AFTERNOON CHAIR MEMBERS OF
COURSE ARE YOU'RE WELCOME I'M
HAPPY TO SET THE AMENDMENTS ARE
TODAY I'M HERE TO PRESENT SP
FOUR SEVEN TWO- WHICH CREATES
THE NALOXONE SCHOOL
ACCOUNTABILITY ACT. FIRST I
WOULD ONCE AGAIN START BY
THINKING THE COMMITTEE AT
CONSULTED REYES THE DS FOR
WORKING. WITH ME IN MY OFFICE
ON- ON AMENDMENT TO NOT BE
ACCEPTING THEM. WHICH ARE FOUND
ON PAGE THREE OF THE ANALYSIS.
AS WE KNOW THERE'S AN OPIOID
CRISIS HERE IN THE US AND
CALIFORNIA OF COURSE. OF THE
NEARLY THREE THOUSAND
CALIFORNIANS TO DIE FROM OPIOID
OVERDOSE IN TWENTY NINETEEN FOUR
HUNDRED FOUR WERE BETWEEN
FIFTEEN AND TWENTY FOUR YEARS
OLD. BILL THE LOCKS ON THE
SCHOOL ACCOUNTABILITY ACT WILL
ALLOW US TO HAVE A BETTER
UNDERSTANDING OF THE OPIOID
CRISIS IN OUR YOUTH WHILE ALSO
ALLOWING SCHOOLS TO SHARE
RESOURCES TO PARENTS FROM THE
STATE DEPARTMENT OF PUBLIC
HEALTH ABOUT NALOXONE. THIS BILL
IS ONE OF MANY ONGOING EFFORTS
IN THE OPIOID CRISIS IN THE
STATE SB FOUR SEVEN TWO WILL
REQUIRE EACH SCHOOL DISTRICT
COUNTY OFFICE OF EDUCATION TO
HAVE TWO DOSES OF NALOXONE ON AT
SCHOOL CAMPUS AND TO REPORT TO
THE STATE DEPARTMENT OF
EDUCATION AND THE STATE
DEPARTMENT OF HEALTH CARE
SERVICES. ON OR BEFORE JULY
THIRTY FIRST TWENTY TWENTY FOUR
AND ANNUALLY THEREAFTER ABOUT
CERTAIN INFORMATION REGARDING
OPIOID ANTAGONIST UNFORTUNATELY
MY WITNESS COULD NOT MAKE IT
HERE TODAY. BUT THANK YOU FOR
YOUR TIME AND I RESPECT PLUS
PRINTABLE THANK YOU. HERE
SPEAKING UP SUPPORT. ALL RIGHT
ANYBODY SPEAK IN OPPOSITION. ALL
RIGHT GOING TO GO TO OUR CALLERS
. ANYBODY IN THE QUEUE. PRESS
ONE OF THE EARTH'S. WE HAVE NO
ONE IN Q. OKAY. THANK YOU VERY
MUCH OF THIS TIME WE DO WE CAN
BRING IT BACK TO THE COMMITTEE.
IT'S BEEN REMOVED BY MULTIPLE
PEOPLE PICK ONE US SECRETARY- WE
THANK YOU FOR AGAIN WE THANK YOU
FOR THIS IS A GOOD BILL. WE'RE
GOING TO HAVE NO LOCKS ON CAMPUS
WE HAVE TRAINED PEOPLE TO
ADMINISTER IT IF IT AND WE'RE
GONNA HAVE REPORTING DONE. ABOUT
THE OUTCOMES. SO I THINK IT'S A
GREAT BILL AND I'M I'D LIKE TO
EVEN BE ADDED AS A CO AUTHOR-
AND SECRETARY PLEASE CALL THE
ROLL THE MOTION IS TO PASS AS
AMENDED AND RE REFER TO THE
COMMITTEE ON APPROPRIATIONS AND
WE THANK THE CENTER FOR GETTING
US BACK ON TIME. SENATORS EGGMAN
FIVE EGGMAN AYE WHEN. I WHEN I
GLAZER. GONZALEZ I GONZALEZ I
GROWTH. FURTADO FURTADO I MOAN.
MOAN I. MENJIVAR. MENJIVAR AYE
ROTH RUBIO. WAHAD BOB HI WINNER
. WINNER I. IT HAS EIGHT VOTE TO
LEAVE IT OPEN FOR ABSENT MEMBERS
LARRY SEE OUR NEXT SENATOR UP
READY TO GO CENTER MENJIVAR THIS
TALK ABOUT SEXUAL HEALTH
CONTRACEPTIVES YES THANK YOU SO
MUCH GOOD AFTERNOON I'M- MY
HAPPIEST YEAH AWARENESS WEEK SO
I THINK IT'S JUST SO APPROPRIATE
TO BRING UP THIS BILL. THAT WE
ARE IN A CRISIS RIGHT NOW AND S.
CI CRISIS IN SB FIVE FOR ONE IS
A STEP FORWARD TO HELP ADDRESS
THIS CRISIS. I'M SB FIVE FOUR
ONE SIX TO ADDRESS THIS EPIDEMIC
AMONG CALIFORNIA AS A WHOLE IN
IS LOOKING TO DO- FOR SPECIFIC
THINGS FIRST. MAKES BANG THE
ACCESS TO CONDOMS IN OUR PUBLIC
SCHOOLS TO BE LOCATED IN TWO
DIFFERENT LOCATIONS FOR CHILDREN
TO BE ABLE TO UTILIZE THEM I TO
BARS SCHOOLS SERVE MEAN. SEVENTH
THROUGH TWELFTH GRADE- A FROM
PROHIBITING THE DISTRIBUTION OF
CONDOMS IN THE CONTEXT OF
EDUCATIONAL AND PUBLIC HEALTH
PROGRAMS AND INITIATIVES THREE
IT'S GOING TO PROHIBIT
PHARMACIES AND- WE'LL TELL
RETAILERS FROM ASKING PROOF OF
AGE RIGHT NOW THERE IS NO LAW
REQUIRING SOMEONE WHO IS LOOKING
TO PURCHASE. CONTRACEPTION TO
ASK FOR AN ID BUT IT'S HAPPENING
AND IT'S NOT DETERMINE OUR YOUTH
FROM HIGH- ENGAGING TO SEXUAL
ACTIVITY IT'S IMPACTING- HAVING
THEM- HAVE SEXUAL ACTIVITY. OF
INTERCOURSE WITHOUT PROTECTION.
MY BILL IS ALL LOOKING TO ENSURE
THAT THERE NO WRONG DOOR FOR THE
HPV VACCINE IT CURRENTLY OUR
FAMILY PACKS ARE- UNABLE TO
SERVE IN THE MINORS WERE LOOKING
TO GET THE VACCINE- AND I'M
LOOKING TO ENSURE THAT
INDIVIDUALS TWELVE TO EIGHTEEN
CAN GO TO THEIR LOCAL FAMILY
PACKED. IN OBTAIN THE HPV
VACCINE HPV IS RIGHT NOW IS THE
LEADING S. CI A MOST COMMON S.
CI IN THE NATION. WE ARE SEEING
RIGHT NOW THAT ONE IN FIVE
PEOPLE NATIONWIDE HAVE CONTACTED
S. C. ARE YOU HERE IN CALIFORNIA
OVER 50% OF THAT OUR PEOPLE
BETWEEN THE AGES OF FIFTEEN AND
TWENTY FOUR YEARS OLD. THESE
THAT YOU THOUGHT WERE TALKING
ABOUT I UNDERSTAND THAT PARENTS
WILL CONTINUE TO HAVE
CONVERSATIONS WITH OUR YOUTH BUT
WE CANNOT BE WITH THEM TWENTY
FOUR SEVEN AND SHOULD A YOUTH-
MAKE THAT PERSONAL DECISION I
WANT TO MAKE SURE THEY HAVE THE
NECESSARY. RESOURCES TO STATE
SAFE AND HEALTHY. THE COMING
VERY STARTING ABOUT INCURRING
NOW IS SOMETHING I'VE ALREADY
MENTIONED- WE HAVE INDIVIDUALS
AT STORES THAT ARE ASKING FOR A
D. THEY'RE ASKING FOR PROOF OF
AGE I PUT THESE THINGS BEHIND
CLOSED- BARRIERS. AND AGAIN IT'S
NOT DETERMINE OUR YOUTH IT SHOWS
INCREASE. IN OUR RATES ARE S. CI
. PROVIDING IN OUR SCHOOL
ENSURES THAT OUR YOUTH- STAY
SAFE AND HEALTHY I'M PROUD THAT
THIS BILL IS BEING USED TO LET-
ARTS THAT YOU THOUGHT BROUGHT
THIS FORWARD IN OR SEEN. THAT
THAT'S THAT THEY FIND AT THE
SCHOOL THEIR SCHOOLS HAVE A
RESPONSIBILITY TO PROVIDE THIS
TO THEM THERE WAS A STUDY DONE.
IN LATE LAST YEAR DECEMBER
TWENTY TWENTY TWO THAT SHOW THAT
55% OF TEENS AGREED THAT THEY
WOULD USE THE CONDOMS OVERSEAS
YOU TO OBTAIN 60% AGREED THAT
SCHOOLS SHOULD MAKE THEM. MORE
AVAILABLE. LASTLY LIKE I
MENTIONED THE LAST PART THAT
THIS BILL WOULD DO WOULD BE
FOCUSING ON THE HPV. VACCINE
CURRENTLY NOT EVERY SINGLE
FAMILY PACKED HAS THE VACCINES
FOR CHILDREN PROGRAM WHICH- IS
ALLOWING THIS FAXING TO BE-
DISTRIBUTED SO WANT TO MAKE SURE
WE'RE CLOSING THAT GAP HERE WITH
ME TODAY IN SUPPORT OF THIS
BILL. ARE TWO OF THE CO SPONSORS
A SYLVIA GARCIA WITH THE CENTRAL
AXIS HOW AND KIM ROBINSON WITH
BLACK WOMEN FOR WELLNESS. THANK
YOU. THANK YOU PLEASE GO AHEAD.
TRIBUNE CHAIR COMMITTEE MEMBERS
AND AGAIN HAPPY STI AWARENESS
WEEK MY NAME IS SYLVIA CAST YEAR
AMENDED RIGHT DIRECTOR OF
GOVERNMENT AFFAIRS AT ESSENTIAL
ACCESS HEALTH. BUT WE ADVANCE
HEALTH EQUITY AND PROMOTE
QUALITY SEXUAL AND REPRODUCTIVE
HEALTH CARE FOR ALL. WE WORK IN
CLOSE PARTNERSHIP WITH THE STATE
COUNTY HEALTH DEPARTMENT'S
COMMITTEE PROVIDERS AND OTHER
STAKEHOLDERS TO INCREASE ACCESS
TO REPRODUCTIVE HEALTH CARE.
INCLUDING STI PREVENTION TESTING
AND TREATMENT. WE'RE PROUD CO
SPONSOR THIS BILL ALONG WITH OUR
OTHER PARTNERS. AS A STANDARD
MENTIONED WE ARE LIVING. THROUGH
AN STI ADAMIC HERE IN CALIFORNIA
ACROSS THE NATION WHICH HAS RATE
REACHED CRISIS LEVELS. JUST
YESTERDAY THE CDC RELEASED THE
MOST RECENT DATA ON NATIONWIDE
STI RATES WHICH IS FROM TWENTY
TWENTY ONE AND THE PICTURE IT
PAINTS IS NOT VERY PRETTY.
ACROSS THE BOARD STI RATES
CONTINUE TO RISE THERE WERE ONE
POINT SIX MILLION CASES OF
CHLAMYDIA REPORTED IN TWENTY
TWENTY ONE AND GOING TO REOCCUR
RATES INCREASED ONE HUNDRED AND
18% OVER THE LAST TEN YEARS.
SYMBOLISE CASES SAW THE STEEPEST
RISE WITH THE TWENTY EIGHT POINT
SIX INCREASE FROM TWENTY TWENTY
TO TWENTY TWENTY ONE. SINCE MOST
STI'S ARE A SYMPTOMATIC THEY ARE
OFTEN LEFT UNDETECTED AND
COMPOSED SERIOUS LIFE
THREATENING HEALTH PROBLEMS
LATER IN LIFE. IN TWENTY
EIGHTEEN THE CDC ESTIMATED THE
STI'S COST THE U. S. HEALTHCARE
SYSTEM APPROXIMATELY SIXTEEN
BILLION DOLLARS IN DIRECT A
LIFETIME MEDICAL COSTS. ABOUT
36% OF THAT COST ACCOUNTED FOR
CARE PROVIDED TO YOUTH AGES
FIFTEEN THROUGH TWENTY FOUR.
THIS IS WHY YOU NEED AND DESERVE
EQUITABLE ACCESS TO CONDOMS AND
THE HPV VACCINE. CONDOMS ARE AN
EFFECTIVE TOOL TO REDUCE STI
TRANSMISSION AND IT'S ONE PART
OF A MULTI PRONGED PUBLIC HEALTH
STRATEGY TO ADDRESS STI'S.
HOWEVER CONDOM USE AMONG
SEXUALLY ACTIVE TEENS HAS
DECLINED OVER THE LAST DECADE.
MANY TEENS FACE SIGNIFICANT
BARRIERS TO ACCESSING CONDOMS
THIS INCLUDES STATE MONTH
JUDGMENTAL. PROVIDERS AND RETAIL
STAFF LIMITED HAS. AND COST
AMONG OTHERS THIS IS WHY SOME
SCHOOLS HAVE ALREADY BEEN
DISTRIBUTING CONDOMS NOW WE NEED
TO MAKE THIS EQUITABLE ACROSS
ALL PUBLIC HIGH SCHOOLS IN OUR
STATE. THE HPV VACCINES AND
OTHER VITAL TOOL HEALTH TOOL TO
REDUCE INCIDENCES OF HPV RELATED
CANCERS- WHILE 80% OF CALIFORNIA
TEAMS RECEIVE THE FIRST FAX THE
FIRST OF THE THREE DOSES OF THE
VACCINE IN TWENTY TWENTY. THE
VAST MAJORITY DO NOT COMPLETE
THE FULL VACCINATION SERIES
LEAVING THEM WITHOUT MAXIMUM
PROTECTION. AND WHILE WE WERE
THRILLED WHEN THE CALIFORNIA
FAMILY PACK PROGRAM BEGUN
COVERING THE VACCINE. WE WERE
DISMAYED THAT THE BENEFIT WAS
ONLY EXTENDED TO THOSE WHO WERE
NINETEEN AND OLDER BECAUSE IN
THIS THE ISSUE IS THAT WHILE
MOST MINERS CAN GET THIS VACCINE
THROUGH THE V. AT B. C. B. S. C.
PROGRAM. NOT ALL TWO THOUSAND
PLUS AFTER PROVIDERS ARE
ENROLLED FOR THAT PROGRAM AND
THEY HAVE SHARED WITH US THAT
THEY'VE HAVE HAD TO TURN AWAY
SOME TEAMS BECAUSE THERE WAS NO
WAY TO GIVE IT TO THEM. WITHOUT
COVERAGE FOR TO PROMOTE HEALTH
EQUITY AND CONTINUITY OF CARE WE
NEED TO ENSURE THERE IS NO WRONG
DOOR FOR TEENS SEEKING THE HPV
VACCINE. FOR THESE REASONS WE
URGE YOU TO VOTE YESTERDAY THANK
YOU THANK YOU VERY MUCH NEXT
WITNESS PLEASE. GOOD AFTERNOON
AND THANK YOU MADAM CHAIR AND
COMMITTEE MEMBERS. MY NAME IS
KEN ROBINSON AND I'M THE
COMMUNITY LIAISON WITH BLACK
WOMEN FOR WELLNESS AND BLACK
WOMEN FOR WELLNESS ACTION
PROJECT. WE ARE STATEWIDE
REPRODUCTIVE JUSTICE COMMUNITY
BASED ORGANIZATION COMMITTED TO
IMPROVING THE OVERALL HEALTH
STATUS AND WELL BEING OF BLACK
WOMEN AND GIRLS. I'M READING
THIS TESTIMONY ON BEHALF OF ONE
ELSE TO LEARN. WHO SERVES AS THE
PROGRAM LEAD FOR BLACK WOMEN FOR
WELLNESS GET SMART BEFORE YOU
GET SEXY PROGRAM. OUR
COMPREHENSIVE SEX ED PROGRAM
DEDICATED TO ELIMINATING HEALTH
DISPARITIES THAT PERSIST IN OUR
COMMUNITY. BLACK WOMEN FOR
WELLNESS ACTION PROJECT IS PROUD
TO CO SPONSOR SB FIVE FOUR ONE.
THE USE HEALTH EQUITY AND SAFETY
ACT BECAUSE IT IS A HUGE STEP IN
ELIMINATING HEALTH DISPARITIES
AND IT REMOVES BARRIERS THAT
LIMIT YOUTH ACCESS TO CRITICAL
RESOURCES. THIS BILL WILL
ADVANCE HEALTH EQUITY IMPROVE
HEALTH OUTCOMES AND SUPPORT
SAFER SEX BEHAVIORS AMONG TEENS
BY REQUIRING THAT CALIFORNIA
PUBLIC AND CHARTER HIGH SCHOOLS
MAKE INTERNAL AND EXTERNAL
CONDOMS ARE READILY AVAILABLE TO
STUDENTS. PROHIBITING RETAILERS
FROM ASKING FOR ID FOR CONDOM
PURCHASES AND INCREASING ACCESS
TO THE HPV VACCINE. AS PROGRAM
LEAD FOR GET SMART A LARGE
PORTION OF MY WORK IS TO TRAIN
PEER EDUCATORS FROM HIGH SCHOOLS
ACROSS L. A. COUNTY. TO LEAD
COMPREHENSIVE SEX ED WORKSHOPS
IN SCHOOLS AND IN THE COMMUNITY
WE EDUCATE AROUND FIFTEEN
HUNDRED TO THREE THOUSAND YOUTHS
AND YOUNG ADULTS BETWEEN THE
AGES OF TWELVE AND THIRTY YEARS
OLD. ON SEXUAL HEALTH TOPICS
LIKE CONSENT BODY IMAGE SEXUALLY
TRANSMITTED INFECTIONS BIRTH
CONTROL GENDER IDENTITY AND
EXPRESSION TO NAME A FEW LAST
WEEK AFTER HOSTING AN EVENT ON
HEALTH ADVOCACY ONE OF OUR PEER
EDUCATORS THAT THE TEN KINGS
DREW MEDICAL MAGNET HIGH SCHOOL.
THANKED ME FOR DOING THIS WORK
SHE SAID THAT BEFORE JOINING GET
SMART SHE HAD NOT RECEIVED ANY
SEX ED IN SCHOOL AND CONSIDERED
HERSELF TO BE CLUELESS. SO WHEN
HER BOYFRIEND WANTED TO TAKE
THINGS FURTHER NEITHER OF THEM
KNEW WHERE TO GET CONDOMS FROM
OR WHO TO ASK. SHE SAID SHE
SUPPORTS BILLS LIKE SB FIVE FOUR
ONE BECAUSE SHE RECALLS THE FEAR
AND STIGMA SHE FELT AFTER
EXPERIENCING A PREGNANCY SCARE
AND NOT FEELING LIKE SHE HAD
ANYONE TO TALK TO OR WHERE SHE
COULD GO FOR HELP. SHE WISHED
HER SCHOOL PROVIDED SEX
EDUCATION AND MADE SURE THAT
CONDOMS WERE ASSESSABLE. SO THAT
SHE AND HER PARTNER WOULD BE
EQUIPPED TO MAKE BETTER
DECISIONS FOR THEMSELVES. GET
SMART OUR MISSION IS TO ENSURE
YOU HAVE THE KNOWLEDGE AND TOOLS
TO MAKE SURE MAKE THE MOST
INFORMED DECISIONS ABOUT THEIR
HEALTH. THE ADVANTAGES OF
MOBILIZING RESOURCES IS WHY I
IMPLORE YOU ALL TO VOTE YES ON
SB FIVE FOR ONE. THING WE ARE
FIGHTING AROUND THE CLOCK TO
ENSURE WE'RE MAKING PROGRESS IN
ADDRESSING THE STD ECOT
EPIDEMICS THANK YOU VERY MUCH
THANK YOU ANYBODY ELSE BECAUSE
SUPPORTERS. NAME AND AFFILIATION
AT THIS POINT. MADAM CHAIR BRAND
IN MARCH WITH THE CALIFORNIA
MEDICAL ASSOCIATION IN SUPPORT.
ERIN EVANS ON BEHALF OF NARAL
PRO CHOICE CALIFORNIA AS WELL AS
THE CALIFORNIA NURSE MIDWIVES
ASSOCIATION IN SUPPORT THANKS.
RUTH DAWSON WITH ACLU CALIFORNIA
ACTION IN SUPPORT THANK YOU. AT
THE MOST PROGRAMS IN THE SAN
FRANCISCO AIDS FOUNDATION AS
WELL AS ANY UPDATE MIX COALITION
IN SUPPORT. BRENT SPENCER WITH
AMERICAN COLLEGE OF OBGYN
STRYCHNINE IN SUPPORT. THANK YOU
FOR BEING HERE TODAY TO SPEAK IN
OPPOSITION. NO LEAD. OKAY ANYWAY
JUST WANT TO GET UP AND SAY THEY
OPPOSE. OKAY LET'S GO TO PHONE
LINES THERE ANYBODY IN THE QUEUE
. IF YOU'RE ALREADY OPPOSITION
OR SUPPORT AT THE MOMENT PRESS
ONE THEN ZERO ON YOUR TELEPHONE
KEYPAD. WE'LL GO TO LINE NUMBER
FORTY TWO. PLEASE GO AHEAD. THE
NAME OF THE INSURANCE OF BRAMBLE
CALLING ON BEHALF OF THE
CALIFORNIA TEACHERS ASSOCIATION
WE ARE IN SUPPORT THANK YOU VERY
MUCH NEXT CALLER PLEASE. THANKS
CALLER KLEIN NUMBER NINETY ONE
PLEASE GO AHEAD. WE HAVEN'T
CALIFORNIA FACULTY ASSOCIATION
IN SUPPORT. THANK YOU NICE COLOR
PLEASE. OUR NEXT CALLER FROM MY
NUMBER EIGHTY THREE PLEASE GO
AHEAD. GENERATION UP AND BEING
YOUR IT BYE BYE BYE FOR CALLING
IN. THANK YOU VERY MUCH THANKS
PLEASE. OUR NEXT CALLER FROM
NINE NINE NUMBER NINETY PLEASE
GO AHEAD. HI MY NAME IS DONNA
AND I'M A SENIOR I DON'T KNOW
HOW OLD ARE BY UNIFIED AND ALSO
IT'S AN UNCONTROLLED COURT.
THANK YOU VERY MUCH TAX COLOR
PLEASE. OUR NEXT CALLER IS FROM
NINE NUMBER EIGHTY SEVEN PLEASE
GO AHEAD. EIGHTY SEVEN LINE IS
OPEN. THE COMMISSION A FIFTY
MINUTE. WE'LL GO TO OUR LAST
CALLER IN. IN WHICH IS LINE
NUMBER EIGHTY EIGHT PLEASE GO
AHEAD. COMPLETELY WELL I'M
CURRENTLY A SENIOR UC BERKELEY
AUTHOR WITH JONATHAN REA IN
STRONG SUPPORT OF THE BILL THANK
YOU THANK YOU VERY MUCH. OKAY
HAVE YOU TO OTHER PEOPLE QUEUED
UP SO ONE MOMENT. PERFECT WE'LL
GO TO LINE NUMBER. NINETY TWO
PLEASE GO AHEAD. THE GREAT BURKE
FOR THE CALIFORNIA FAMILY
COUNCIL IN OPPOSITION. THANK YOU
NEXT CALLER PLEASE. THE LAST
CALL THEIR QUEUED UP AS LINE
NUMBER NINETY THREE PLEASE GO
AHEAD. WHEN THE FAMILY- UNLESS
YOU KNOW YOU SEE BERKELEY AND I
AM OF THE CELL THANK YOU VERY
MUCH OKAY HAVE BEEN WITH US A
LOT OF PEOPLE. DO WELL IT ONE
OTHER PERSON JUST QUEUED UP BUT
ONLY OKAY. LOOK AT WHAT WE'RE
GOING TO THE LINE NUMBER OF
EIGHTY FIVE PLEASE GO AHEAD.
ONLY HIGH SCHOOL IN ON IMPORTED
SB FIVE FOUR ONE THANK YOU. THAT
IT. FROM WHAT I CAN TELL THAT
WAS THE LAST PERSON ALL RIGHT
LET'S CUT IT OFF THANK YOU VERY
MUCH BUT NOW THE TIME TO BRING
IT BACK TO THE COMMITTEE.
QUESTIONS COMMENTS. MOVE THE
BILL BY SENATOR ROSS- WHAT. I
DON'T HAVE IT TEARS LAW CENTER
WHILE IN SECONDARY MADE THE
DECISION. OKAY HERE'S CLOSER
OVER THERE OKAY- THANK YOU FOR
BRINGING THIS BILL FORWARD AND
HAPPY STD WEEK TO YOU TOO WOULD
YOU LIKE TO CLOSE- YEAH I KNOW
THIS ISN'T A SEXY TOPIC
SOMETIMES IT CAN BE
UNCOMFORTABLE. THIS IS A CRISIS
THAT IN IT'S A TOOL TO COMBAT
THIS CRISIS OUR RESPECT TO THE
FBI ABOUT THANK YOU VERY MUCH-
SECRETARY PLEASE CALL THE ROLL
AND THE MOTION IS. TO PASS AND
REFERRED TO THE COMMITTEE ON
APPROPRIATIONS. SENATORS EGGMAN
HI EGGMAN AYE WHEN. WHEN NO
GLAZER GONZALEZ GONZALEZ I
GROWTH HER TADO. FURTADO I
LIMÓN. SIMONE I MANAGE OF OUR-
END OF OUR AYE ROTH. OFF THE ICE
RUBIO. WHAT HAN. BOB HI WIENER.
WINNER I. I WILL LEAVE THE BILL
ON CALL AND NOW THE NEW CHAIR
FOR JUST ONE MORE BILL HELLO YOU
CAN HEAR WHEN YOU MAY PERCENT
FIT THANK YOU MADAM CHAIR I'M
HERE TODAY TO PRESENT SB SIX TO
FIVE WHICH SEEKS TO BRING. ABOUT
MORE TRANSPARENCY TO THE PROCESS
SURROUNDING. SURROUNDING THE
COLLECTION STORAGE AND USE OF
NEWBORN GENETIC DATA THAT IS
CURRENTLY COLLECTED IN STORE AS
PART OF CALIFORNIANS NEWBORN
SCREENING PROGRAM. I WOULD LIKE
TO THINK THIS BILL SPONSORED
CALIFORNIA HEALTH COALITION
ADVOCACY AND THE HEALTH
COMMITTEE STAFF FOR WORKING WITH
MY STAFF ON THE MIMIDS AND I'M
AGREED TO- TAKE THOSE AMENDMENTS
AS WELL. R. SB TWO SB SIX TO
FIVE IS THE FIRST AND FOREMOST A
BILL ABOUT INDIVIDUAL RIGHTS.
THE RIGHTS TO PRIVACY AND
ENSURING INFORMED CONSENTS
AROUND THE USE OF VERY PERSONAL
AND SENSITIVE INFORMATION. THE
NEWBORN SCREENING PROGRAM HAS
BEEN A FANTASTIC NET AND
NATIONALLY RECOGNIZED PROGRAM
THAT WE HAVE HERE IN CALIFORNIA
HAS CERTAINLY HELPED WITH THE
RESEARCH AND STUDY OF MANY
DIFFERENT GENETIC DC DISEASES OR
CONDITIONS. THERE'S NO DENYING
THAT THERE IS THERE'S BEEN A
GREAT NET BENEFIT TO THE
SCIENTISTS AND RESEARCHERS HAVE
BEEN ABLE TO LEARN ABOUT THROUGH
SAMPLES PROVIDED BY THIS
PROGRAM. HOWEVER AS A PARENT OF
TWO. CALIFORNIA BORN CHILDREN I
NEED TO UNDERSTAND WHAT IS BEING
DONE WITH THESE INFORMATION. AND
THE INFORMATION TAKEN FOR THE
BLOOD SPOTS COLLECTED AT THE
TIME OF BIRTH. NATIONAL BE
HONEST BEFORE. I WAS EVEN DOING
THIS BILL I DIDN'T KNOW THAT WE
WERE DOING THIS. BECAUSE I HAD
NO CLUE I REMEMBER THE CARDS HE
MEMBER WHEN YOU GAVE BIRTH THIS
IS CARD THAT'S GIVEN. THAT HAS
THE BABY'S FROM PIT FINGERPRINT
AND- FOOTPRINT. AND THEN A DABBA
BLOOD FASTER COLLECTION THAT'S
BEEN COLLECTED. AND THAT
COLLECTS DATA THAT INFORMATION
THOUGH IT GETS TO THE STATE DATA
AND IT'S- AND I DIDN'T KNOW THAT
IT WAS DEEP. I WAS NOT INFORMED
TO ME I THOUGHT THAT WAS JUST A
PROCESS THAT EVERY BABY HAD TO
GO THROUGH- CALIFORNIA PARENTS
ARE NOT BEING PROPERLY INFORMED
OF THEIR RIGHTS REGARDING THE
COLLECTION STORAGE. AND USE OF
THESE BLOOD SAMPLES OR OTHER
GENETIC MATERIALS COLLECTED BY
THE STATE. FOR THE NEWBORN
SCREENING PROGRAM. AS A MOM WHO
REMEMBERS MOST EVERYTHING ABOUT
MY PREGNANCY- AGAIN I CANNOT
RECALL SIGNING OR KNOWLEDGE OF
ANY RELEASE. FORM OR CONSENT
FORM INFORMING. ABOUT THE BLOOD
COLLECTION STORAGE AND USE OF
THE COLLECTED SAMPLES FOR MY TWO
CHILDREN. AFTER SPEAKING WITH
MANY PARENTS IN THE COMMUNITY
AND AROUND MY DISTRICT I'VE
LISTENED TO THE SAME STORIES
FROM PARENTS. MOST OF THOSE
PARENTS I SPOKE TO. WILL HAVE NO
PROBLEM WITH THE SAMPLES OR THE
COLLECTION OF THE CHILDREN
SAMPLES BUT I THINK WE SHOULD BE
INFORMED AND BEING ALLOWED TO
GIVE CONSENT. THERE'S NO DENYING
THE PORTS OF THE WORK BY THE
RESEARCHERS WHO HAVE ACCESS TO
THESE SAMPLES BUT CALIFORNIANS
SHOULD BE PROBABLY INFORM AND
HAVE A CHOICE IN HOW THE GENETIC
DATA. INTO AN INFORMATION IS
BEING USED AND ACCESS. IT'S A
GARDEN SHOULD BE FULLY INFORMED
ABOUT THE PROCESS OF COLLECTING
ANALYZING AND STORING THESE
GENETIC INFORMATION COLLECTED
FROM NEWBORN INFANTS. WITH ME
TODAY IS STEVEN O'CONNOR STAFF
ATTORNEY FROM THE NONPROFIT
NATIONAL HEALTH FREEDOM ACTION
TO SHARE HIS TESTIMONY ANY AND
EXPERTISE ON THE SUBJECT. THANK
YOU. THANK YOU GOOD AFTERNOON
CHAIR AND COMMITTEE MEMBERS AS
NOTED MY NAME IS STEVEN O'CONNOR
I'M A STAFF ATTORNEY WITH THE
NATIONAL WITH NATIONAL HEALTH
FREEDOM ACTION AND WE'RE A FIVE
OH ONE C. FOR. THAT HELPS TO
PROMOTE HEALTH RIGHT MEDICAL
RIGHTS AND HEALTH FREEDOM AROUND
THE UNITED STATES. WE HELP STATE
LEVEL GROUPS IN REVIEWING
DRAFTING AND PROMOTING BILLS
SUCH AS CAL SUCH AS THE
CALIFORNIA COALITION HEALTH
COALITION ADVOCACY. WE'VE WORKED
WITH THEM ON THIS BILL AND WE DO
SUPPORT IT. NOW FIRST OFF THE
MANDATORY GENETIC SCREENING IS
AN IMPORTANT PUBLIC HEALTH
MATTER AND THIS BILL DOES
SUPPORT THAT PROCESS. I WANT TO
NOTE THAT THE GENETIC DATA IN
NEWBORN BLOOD SAMPLES IS HIGHLY
DISTINGUISHABLE AND CANNOT BE
TRULY DE IDENTIFIED. BECAUSE THE
SAMPLES ARE STORED INDEFINITELY
AND THIRD PARTIES ARE GIVEN
ACCESS TO CONSUMERS ARE
CONCERNED ABOUT GENETIC PRIVACY.
AT PRESENT PARENTS ARE POORLY
INFORMED IF AT ALL ABOUT THE
STORAGE OF. AND MEDICAL RESEARCH
OF THE NEWBORN SAMPLES AND ARE
NOT ABLE TO WITHHOLD CONSENT. BY
COMPARISON CALIFORNIA ALREADY
REQUIRES CONSENT FOR PREGNANCY
BLOOD SAMPLES TO BE USED FOR
RESEARCH IN THIS BILL SIMPLY
APPLIES A SIMILAR STANDARD TO
NEWBORN SCREENING SAMPLES-
NEWBORNS AND PARENTS SHOULD HAVE
A CLEAR. AND UNAMBIGUOUS RIGHT
TO PRIVACY IN FULL KNOWLEDGE OF
THE FUTURE IMPACT OF MEDICAL
PROCEDURES. THE NEW SUBSECTIONS
I. N. K. AGYNESS TWELVE FIVE
THOUSAND CODIFY THE KNOWLEDGE
AND CONSENT THAT PARENTS
DESERVE. THE NEW SECTION. TWELVE
FIVE THOUSAND THREE EIGHT FIVE
PROVIDES THAT THE WRITTEN
BROCHURE PROVIDED TO PARENTS
GIVE NOTICE OF THE RIGHT TO
WITHHOLD CONSENT. AT THE NEW
SECTION AT. TWELVE FIVE THOUSAND
AND FIVE V. ONE ENSURES THAT
PARENTS ARE INFORMED OF THEIR
RIGHTS AT LEAST FOUR WEEKS PRIOR
TO THE ESTIMATED DELIVERY. WE'RE
MOVING IT WE ARE IN A WORLD IN
WHICH SCIENTIFIC PROGRESS WILL
BRING CHALLENGES FOR CIVIL
LIBERTIES ESPECIALLY OUR RIGHTS
TO PRIVACY. FOR EXAMPLE
CONVICTED FELONS IN CALIFORNIA
MUST PROVIDE A DNA SAMPLE FOR
FUTURE USE IN THAT CASE THERE'S
A REASONABLE NEXUS BETWEEN THE
DNA REQUIREMENT AND THE
UNDERLYING CONVICTION. UNDER
CURRENT LAW NEWBORN BABIES ARE
EFFECTIVELY BEING TREATED AS
SUSPECTS TO THE DEGREE THAT
POLICE CAN ATTEMPT TO ACCESS THE
BIOBANK DATA EVEN MANY YEARS IN
THE FUTURE. THE BENEFIT FROM
REAL TIME TESTING FOR GENETIC
DISORDERS IS CLEAR AND THIS BILL
IN NO WAY HINDERS THAT BENEFIT.
AND AS A NO THE SIDE NOTE THE
PROPOSED BILL SAYS THAT IF THE
PARENTS UNABLE TO COMPLETE THE
FORM THE SAMPLE WILL BE TAKEN
AND WILK AND MAY BE USED FOR
RESEARCH THAT'S TWELVE FIVE
THOUSAND AND FORTY. THE NEW A
SECTION. BUT THE STORAGE OF
SAMPLES FOR MEDICAL RESEARCH IS
A COMPLETELY DIFFERENT USE ONE
THAT'S IN THE PUBLIC COULD.
BEFORE OUR PARA PARA TRADE SOME
OF THEIR NEWBORNS PRIVACY. THAN
WHAT IS INITIALLY DONE TO HELP
FOR A PERSONAL BENEFIT BEFORE
THEY TRADED FOR PUBLIC BENEFIT
THEY SHOULD HAVE A CLEAR
NOTIFICATION AND A CLEAR RIGHT
TO OPT OUT. LIKEWISE POTENTIAL
USED BY LAW ENFORCEMENT IS
ANOTHER PUBLIC BENEFIT. AND
SINCE THE RESEARCH IS SECONDARY
TO THE- CARE OF THE NEWBORN AND
ANY LAW ENFORCEMENT AXIS IS THEN
SECONDARY TO THE STORAGE FOR
MEDICAL RESEARCH. IT'S FRANKLY
TOO FAR REMOVED TO BE ALLOWED.
THIS ISSUE IS CURED BY THE NEW
SUBSECTION J. OF TWELVE FIVE
THOUSAND HEALTH AND SAFETY CODE
WHICH PRECLUDES THE USE OF THE
BIOBANK BY LAW ENFORCEMENT. IN A
JULY TWENTY SIX TWENTY TWENTY
TWO- PIECE FROM THE L. A.
ARTICLE FROM THE ACLU'S
TECHNOLOGY FELLOW CRYSTAL GRANT.
THEY NOTED THAT POLICE ACCESS TO
THESE BIOBANKS ENDANGERS PUBLIC
TRUST IN THE PROCESS AND QUOTE
THREATENS ALL AMERICANS RIGHT TO
GENETIC PRIVACY. AND JUST TO
FINISH UP QUICKLY FOLKS- A
COUPLE NOTES ON THE LEGISLATIVE
ANALYSIS IN THIS CASE. AT PAGE
SEVEN PARAGRAPH EIGHT. THE
OPPONENTS COMPLAIN THERE'S THREE
MAIN COMPLAINT SEEMS TO BE THAT
IT SAID THAT. IT'S CHANGING IT
TO AN OPT IN BUT MY
UNDERSTANDING IS THAT AMENDMENTS
THAT ARE BEING ACCEPTED WILL
CREATE THIS INTO AN OPT OUT SO
THAT SOME OF THAT PROBLEM IS
SOLVED. THE SECOND PARAGRAPH ON
PAGE SIX IS QUOTED THAT IT'S NOT
USED TO CREATE A DATABASE YET
LAW ENFORCEMENT CAN GET ACCESS
TO THE SEARCH WARRANT SO THAT'S
INCORRECT. AT PAGE SEVEN
PARAGRAPH EIGHT. THE OPPOSITION
INDICATES THAT THIS WOULD NOT
PROVIDE ANY NEW RIGHTS BUT IT
DOES BY PRECLUDING LAW
ENFORCEMENT ACCESS. AND FINALLY
AT PAGE EIGHT PARAGRAPH NINE
THEY NOTE THAT THE BIOBANK HAS
THIRTY YEARS OF STORED DATA
WITHOUT EXPRESS CONSENT. THAT'S
PART OF THE PROBLEM AND THIS
BILL WILL FIX THAT YOU'RE
PUSHING YOUR SIX MINUTES SIR
THANK YOU. THAT'S THAT'S ALL I
HAVE TO SAY I WANT TO SAY THANK
YOU SO MUCH FOR YOUR ATTENTION
AND ASK YOU TO VOTE ON A ON THIS
MEASURE THANK YOU VERY MUCH.
OKAY SO THAT NO MORE. WITNESSES
BUT NOW EVERYONE JUST WANTS TO
SPEAK IN SUPPORT OF THE BILL NOW
IS THE TIME FOR YOU TO COME UP
AND DO THAT. CLINTON LACK ON
BEHALF OF CALIFORNIA OF
COALITION ADVOCACY PROUD SPONSOR
OF THE BILL AND AMERICAN NURSES
ASSOCIATION IN SUPPORT THANK YOU
VERY MUCH- ANYBODY SPEAKING IN
OPPOSITION TO THE BILL TODAY.
PLEASE COME FORWARD. SIX GOOD
AFTERNOON TERRY COMMITTEE
MEMBERS VANESSA GONZALEZ WITH A
CALIFORNIA HOSPITAL ASSOCIATION
WITH AND OPPOSE POSITION ON SB
SIX TWENTY FIVE. CALIFORNIA'S
NEWBORN SCREENING PROGRAM IS
EXTREMELY IMPORTANT AND TEST NEW
BORN BABIES FOR ABOUT SEVENTY
RARE AND SERIOUSLY DISABLING
DISEASES IF IDENTIFIED EARLY
AFTER BIRTH MANY OF THESE
CONDITIONS CAN BE TREATED BEFORE
THEY CAUSE SERIOUS HEALTH
PROBLEMS. ONLY A SMALL SPOT OF
BLOOD IS TAKEN FROM THE BABY'S
HEEL FOR TESTING AFTER TESTING
THE SMALL SPOT OF BLOOD IS
SECURELY STORED BY CDPH AND
OCCASIONALLY USE FOR IMPORTANT
RESEARCH IT IS IMPORTANT TO
EMPHASIZE THAT PARENTS CURRENTLY
HAVE THE ABILITY TO OPT OUT. OF
THE TESTING STORAGE AND RESEARCH
COMPONENTS OF THIS PROGRAM ALL
PARENTS ARE ALREADY GIVEN
INFORMATION BY THEIR DOCTOR
ABOUT HOW THEY CAN OPT OUT.
UNFORTUNATELY THE AGREED UPON
AMENDMENTS TO ADDRESS CONCERNS
AS PARENTS WOULD NOT BE REQUIRED
TO COMPLETE A CONSENT FORM AT
LEAST FOUR WEEKS BEFORE THEIR
DUE DATE THE CONSENT FORM WOULD
HAVE FOUR DIFFERENT SIGNATURE
LINES FOR THE PARENT TO
ACKNOWLEDGE RECEIPT OF THE
INFORMATION OR OPT OUT OF
VARIOUS. COMPONENTS OF THE
PROGRAM THE CONCERN WITH THIS
FORM IS THAT MANY MOMS WILL
INADVERTENTLY NOT FILL OUT THE
FORM. AND THE BILL IS UNCLEAR
WHETHER THE BABY CAN BE TESTED
IF THIS FORM IS NOT FILLED OUT.
BECAUSE PARENTS ALREADY HAVE THE
ABILITY TO OPT OUT OF THE
NEWBORN SCREENING PROGRAM AND
NEWBORN BABIES MAY INVERT
INADVERTENTLY NOT GET TESTED FOR
SERIOUS CONDITIONS WE
RESPECTFULLY REQUEST YOUR NO
VOTE. ON SB. SIX TWENTY FIVE
THANK YOU THANK YOU NEXT
WITNESS. CRISTINA ELSE JUST
WANTS SPEAK THE- TO ME TOO. OKAY
SEEING NONE WILL GO TO THE PHONE
LINES. MODERATOR BULLETED IN
GERMAN IF YOU OF OPPOSITION OR
SUPPORT THAT IS MOM MOMENT PRESS
ONE AND ZERO YOUR TELEPHONE
KEYPAD. ONE PERSON IS KILLED UP
ONE MOMENT.
ALL RIGHT THEY'RE NOT QUICK.
OKAY SO ONE MOMENT HERE.
OKAY THE SECOND LINE NINETY FOUR
PRESCHOOL OR HEAD. BUT I'M SURE
MEMBERS A NEED LUMBERED WITH THE
CALIFORNIA CHILDREN'S HOSPITAL
ASSOCIATION AND OPPOSITION THAT
THAT LIVE. WITH A CALIFORNIA
HOSPITAL ASSOCIATION. THANK YOU
VERY MUCH THIRD OF THE CALLER.
WE HAVE NO FURTHER CALLERS OKAY
YOU VERY MUCH. NOW IT'S TIME TO
BRING IT BACK TO THE COMMITTEE
QUESTIONS COMMENTS. THE NEW UP.
TWENTY FOUR MANAGER. FOR I'M
GONZALEZ YOUR. BLAND'S A LONG
DAY- I JUST WANNA CLARIFICATION
THE WIND IS IN OPPOSITION
MENTIONED THAT YOU CAN CURRENTLY
AKTAU. THEN WHAT WOULD BE THE
PURPOSE ALSO YOU CAN CURRENTLY
OPT OUT BUT NO ONE INFORMS THE
PARENTS ABOUT IT ALL. SO WHEN
YOU GO WHEN WE'RE NOT IN FORM I
DON'T REMEMBER GETTING ANYTHING
AT ALL WHEN I GAVE BIRTH TO BOTH
OF MY BOYS I DON'T EVEN KNOW
THIS COLLECTION WAS EVEN
HAPPENING- AND SO YOU'RE NOT I
MEAN IF I WAS INFORMED. THAT YOU
KNOW WHEN YOU'RE PRESIDENT YOU
GET LOTS OF FORMS- AND THERE'S A
LOTS OF FORMS FOR OPT OUT AS
WELL SO IT'S NOT JUST ONE FORM
AND SO MOST OF US PARENTS WOULD
GO THROUGH ALL THOSE FORMS BUT
IF YOU JUST HOLD OF SOMETHING- I
DON'T REMEMBER IT I DON'T- SO.
EVEN IF WE HAD EVEN IF YOU CAN
OP OUT TODAY YOU'RE NOT IN FOR
ABOUT IT AT ALL. DID YOU WANT TO
ASK THE CJ WHAT. YES- AT THE
CURRENT WORK REQUIREMENT IS- AT
LEAST FOUR MONTHS TO BIRTH. I'M
SORRY FOR FOUR WEEKS PRIOR TO
BIRTH AS THAT THE PREGNANT MOMS
AT POSITION IS REQUIRED TO GIVE
THEM A PAMPHLET THAT'S BEEN
CREATED BY CDPH AND GIVE THEM
ALL THE INFORMATION. ABOUT THE
NEWBORN SCREENING PROGRAM AND
ALSO HAS THE INFORMATION ON HOW
THEY CAN OPT OUT OF THE TEST AS
WELL AS THE STORAGE AND RESEARCH
. AND EVERY AND EVERY MOM
RECEIVES THAT- THAT PAMPHLET.
FOR YOUR BILL- SENATOR IF A
PARENT OPTS OUT. DOES REQUIRE
THEM TO GIVE A REASON IS JUST
OFF DOWN IT'S JUST A IT'S JUST A
FORM JUST TO ABOUT. IT'S IT ALSO
ALLOWS AN INDIVIDUAL ONCE THEY
REACH AGE TEEN TO ALSO. ASK FOR
THEIR INFORMATION BACK AS WELL.
BECAUSE RIGHT NOW WE HAVE NO
ACCESS TO KNOWING IF IT'S STILL
THERE OR NOT. AND NOT EVEN
KNOWING WHETHER. OF WHERE THAT
DATA IS GOING. AND THAT WAS
WHERE THE AMENDMENTS WE TOOK
THIS OUT OF MITCHELL BILL WAS
TWO PEOPLE HAVE THE RIGHT TO OPT
IN. AND SO WE SAID NO THEY HAVE
TO SEND OUT SO MAKES IT EASIER
FOR. AMID THIS CALL RUBIO. THIS
THANK YOU- SO WHEN THE HOSPITALS
TAKE THE SAMPLE. AND THERE IN
PARTICULAR LIKE LET'S SAY- YOU
HAVE TO KEEP IT IN SOME TYPE OF
DATABASE CORRECT. RIGHT THE
RESULT NOW. HI HARD WORK. IS
THAT A CARDBOARD CAR THAT I
MEANT YEAH THERE'S BUT I GOT A
BLOOD IN A ON A CO THERE'S NO
DNA DATABASE. CARD DOES NOT HAVE
THE BABY'S NAME HAS AN ID NUMBER
AND THEN THERE IS A COMPUTER
THAT IS NOT HOOKED UP TO THE
INTERNET THAT. THAT MATCHES THE
NUMBER ON THE CARD WITH THE
BABY'S NAME AND BIRTH DATE IN
CASE SOME FOLLOW UP TESTS TO BE
DONE OKAY BUT NO DNA INFORMATION
OF ANY KIND CORRECT KNOW THAT
NAME NOPE JUST A SORT OF WHAT
ARE WE ASKING BACK SO WHEN THE
KID TURNS EIGHTEEN THEY WANT
THEIR CARD THAT CARD BACK. THEY
CAN ASK FOR TO BE DESTROYED
TODAY THE CHILD WHEN IT'S
EIGHTEEN CASPER TO BE DESTROYED
TODAY THEY WOULDN'T GET THEIR
CARD BACK IT WOULD BE DESTROYED
IF THEY ASKED FOR IT HOW DO YOU
DESTROY IT. HOW DOES I DON'T
KNOW HOW CDPH IT OVER BUT I
DON'T KNOW. REDDIT RENDON UP I
DON'T KNOW. VACANCY IS THIS IS
THAT THIS DATA RIGHT NOW IT'S
BEEN SOLD TO THIRD PARTIES NO IT
HAS NOT. IF YOU WERE TO A
QUESTION OF. NOT ASKING A
QUESTION- SO- ALL WE'RE ASKING
FOR IS AS A MOM OR DAD. YOU'RE
ALLOWED TO BE GIVEN AN
OPPORTUNITY TO OPT OUT AND BE
INFORMED. AND NOT HIS HAND PILES
OF PAPERS I UNDERSTAND THAT SO
I'M I'M VERY INTERESTED IN WHY
THE LOOK TRONG FRONTIER. GROUP
IS INTERESTED IN THIS WHERE IS
THE- TRONIC COMPONENT THAT'S
KIND OF WHAT I'M MORE CURIOUS
ABOUT. YEAH THE ONE. WITH THE
WANTED HIM TO ADDRESS IS NOT
PART ELECTRONIC FRONTIER FORCE
THE L. CHINA COMPONENT OF IT.
BASICALLY THEIR CONCERN IS WITH
GENETIC PRIVACY AND THE
STATEMENT THAT THERE'S NO
DATABASE IS IN ALL PRACTICAL
REALITY NOT TRUE. THE POLICE
AROUND THE NATION OF YOU SEARCH
WARRANTS TO GET INTO THESE THESE
DATA BANKS. AND IT AND IT IS
THAT IT'S VERY EASY TO DE
IDENTIFY. IT IS A DATABASE IN
PRACTICAL EFFECT. OTHERWISE
THERE WOULD BE NO BUT IT IT IS A
DATABASE AND CURRENTLY HAS AS IT
WAS NOTED IN THE ANALYSIS
THERE'S THIRTY YEARS OF DATA
STORE. INFORMATION AND SAMPLES
WITH NO EXPRESS CONSENT SO IT'S
ONE THING TO SAY WE'RE GONNA
NOTICE NOTIFY YOU WHERE YOU CAN
CALL AND LEARNED THAT YOU MIGHT
BE ABLE TO HAVE IT DESTROYED.
IT'S VERY DIFFERENT TO GET
AFFIRMATIVE POSITIVE CONSENT FOR
A MEDICAL PER USE OF. A CHILD'S.
BLOOD SAMPLE FOR RESEARCH OKAY
SO OKAY SO THIS IS I HAVE A
COUPLE MORE QUESTIONS AND I
DON'T KNOW IF IT'S FOR YOU- SO
THE QUESTION. IS WHY IS THIS
EVEN DONE. IT'S DONE IN ORDER TO
CHECK FOR GENETIC DISORDERS THAT
CAN BE TREATED AND HELPED. WITH
A NEWBORN IT'S DONE INITIALLY IT
WAS CREATED FOR THE BENEFIT OF
THE NEW BORN AND THE FAMILY. THE
RESEARCH COMPONENT IS TOTALLY
DIFFERENT IT'S BASICALLY THAT
THE MEDICAL SYSTEMS AND WE HAVE
ALL THIS INFORMATION SO NOW
MAYBE WE CAN USES FOR RESEARCH.
OKAY THEN AND AGAIN LOG SO MY
CONCERN. WITH THIS- YOU KNOW
WHEN WE CAN DEBATE YOU KNOW
WHETHER OR NOT DOES NOT EXIST.
IS THAT IF THERE IS A DATABASE
RIGHT WHICH I DO BELIEVE THERE
HAS TO BE SOME VERSION OF IT
GREAT INCLUDING- YOU KNOW JUST.
CONNECTING DATA TO. INDIVIDUALS
IS THE REDUNDANCY SO IN TECH WE
HAVE TO HAVE REDUNDANT
WAREHOUSES OF DATA DATA
WAREHOUSES IN PARTICULAR RATE.
THESE REDUNDANCIES HAVE A
STANDARD THAT WE'RE SUPPOSED TO
KEEP IT IN MULTIPLE WAREHOUSES
IN CASE ONE BURNS DOWN
ESPECIALLY FOR HOSPITALS-
BECAUSE OF THE FACT THAT IT'S
LIFESAVING AND SO FORTH RATE. IS
THERE ANY CLAUSES IN WHERE THE
DATA WAREHOUSES ARE. PLUS THE
INFORMATION BEING SHARED. PLUS
THE CONSENT OF THE PARENT-
SPECIFICALLY ALL TIED INTO EACH
OTHER THAT THERE WILL BE NO
SHARING OF ANY INFORMATION
THAT'S THE QUESTION I JUST I
CENTER I THINK THAT WOULD HAVE
TO GO DEPARTMENT PUBLIC HEALTH
BECAUSE YOU'RE THE ONE TO
MAINTAIN THAT. THAT DATA SO I
THINK THAT'S YOUR QUESTIONS ARE
FASCINATING BUT I THINK THERE
BEYOND THE SCOPE OF THIS BILL. I
YOU KNOW IF THE HOSPITAL FEELS
LIKE THERE IF THEY DON'T KEEP
THE DATA AND THERE'S OKAY SO
AGREED I MEAN THIS IS A HOSPITAL
SO SHE'S NOT NOT YET THE PUBLIC
HEALTH NO I COMPLETELY
UNDERSTAND BUT THE HOSPITALS
DON'T. WILL KEEP IT IN ONE
LOCATION AND THAT'S KIND OF IN
HOUSE AND IT'S NOT NECESSARY
PUBLIC ALL THE SO ANYWAY NO THE
HOSPITAL'S A KEY IS OFFERING
KEEP IT ALL THE DEPARTMENT OF.
PUBLIC HEALTH KEEPS IT IT GETS
SENT TO THE- STATE. READ BUT THE
DATA WAREHOUSE ITSELF IS NEVER
THE DEPARTMENT OF PUBLIC HEALTH
CARE SYSTEM IF THEY DO YOU'RE
RIGHT I DON'T KNOW WHAT THAT IS.
WE CAN ASK THE DEPARTMENT OF
PUBLIC HEALTH FOR THAT
INFORMATION AND GET BACK TO YOU-
ON WHERE THEY STORE IT. SO I
APPRECIATE THAT MY LINE OF
QUESTIONING THANK YOU. GET THE
COURTS TO ENGINES THE CARD TO
KEPT IN FREEZERS AND YOU KNOW
WHAT AND WHEN THE BILL FIRST
CAME FORWARD LIKE. IT WOULD BE
NICE IF THERE WAS A DATABASE WE
TALKED THERE REALLY ISN'T A
DATABASE- SO I THINK PART OF
THIS IS AROUND PRIVACY AND
PEOPLE WORRY ABOUT PEOPLE
GETTING THEIR INFORMATION. THESE
ARE CARDS IN A WAREHOUSE IN UP
IN FREEZERS. THAT AGAIN YOU TAKE
A SAMPLE TO CHECK FOR THAT THE
CHILD WAS DECIDED WHAT WE SHOULD
PROBABLY KEEP ALL THE SAMPLES
BECAUSE AT SOME POINT AND GO
BACK. AND THERE IS SOME RESEARCH
DONE. THROUGH MUSIC THIRD PARTY
PEOPLE ARE PAYING TO GET YOUR
DATA. IT'S JUST RESEARCHERS WHO
ARE LOOKING. TO RESEARCH
SOMETHING THEY CAN PROVE THEY
CAN GET SOME OF THAT DATA. AND
SOMEONE STAGES A REGULAR PROCESS
. THE STUDY GOES BRING THE
PROCESS TO BE ABLE TO ATTAIN THE
RESEARCH NOT GETTING. SENATE
RUBIO. THE THIS. I'M SORRY MY
VOICE IS STILL STRUGGLING. I
JUST HAVE A CONCERN THERE SEEMS
TO BE A LITTLE BIT OF
DISCREPANCY. I'D LIKE TO WRITE
THAT THE LADY WHO IS TALKING
ABOUT. THE AGE WHERE THEY CAN
COME AND- ASK FOR THE CARD BACK
TO CLARIFY WHAT SHE WAS SAYING.
I BELIEVE IT WAS A YOUNG. I
THINK THE ONE SITTING DOWN YOU
SAID SOMETHING ABOUT. THE CARD
ASKED FOR THE CARD TO GET IT.
BACK RIGHT AWAY UNDER CURRENT
LAW- THAT YES UNDER CURRENT LAW
TODAY ONCE THE BABY YOU ARE I.
IF YOU'RE BORN IN CALIFORNIA WE
CAN. OPT OUT WE CAN SEND IT WE
CAN REQUEST THE CDPH GO FIND OUR
BLOOD SPOT CARDS AND DESTROY IT.
SO THAT IS SEPARATELY THE LAW.
THE OTHER CLARIFICATION IS AND I
THINK I HEARD YOU SAY THAT
THERE'S NO. IDENTIFYING MARKERS
OTHER THAN THE BLATANT LIKE THE
NAME READ MORE. SO WITH SOMEONE
ELSE FOR IT BACK THAT'S WHAT I'M
TRYING TO UNDERSTAND SO HOW DO
THEY KNOW IT BELONGS TO THAT
PARTICULAR. THE THAT'S FILLING
OUT THE FORM FOR CITY PH IT'S A
ONE PAGE FORM IT'S VERY VERY
EASY- ASKS FOR THE BABY'S BIRTH
DATE. AND ADDRESS AT THE TIME OF
BIRTH AND HOSPITAL OF BIRTH AND
THAT'S AND THEY THERE'S A
COMPUTER WITH THE CARD NUMBER.
AND THEN THAT INFORMATION. WHICH
IS NOT HOOKED UP TO THE INTERNET
AND THEN THEY LOOK IT UP THEY
FIND THEY IF I SENT IN THE FORM
THEY LOOK UP. MY CARD NUMBER
THEN THEY'D GO FIND THE CARD
NUMBER. AND THEY- DESTROYED.
OKAY THANK YOU THE TOPIC. TO
VOTE LEARNED A LOT TODAY ABOUT
GENETIC TESTING AND DATABASE.
ANYBODY ELSE- CENTER WINNER
PLEASE. I THANK YOU YOU KNOW I
APPRECIATE THE- IMPETUS BEHIND
THE BILL I THINK THAT. CURRENT
LAW HAS- PLENTY OF PROTECTIONS
IN PLACE THIS IS A- THIS IS NOT-
I DON'T THINK THIS IS COMPARABLE
TO THE PREVIOUS- BILLS THAT HAVE
DEALT WITH LIKE PRIVATE-
INDIVIDUALS OR ORGANIZATIONS
HOLDING THIS DATA THIS IS A
PUBLIC. HEALTH A IT'S A DATABASE
BUT IT'S TIME HOOKED UP TO
INTERNET A PUBLIC HEALTH.
INFORMATION PUBLIC HEALTH
INFORMATION THEY'RE ALREADY
PROTECTIONS I DON'T SEE THE NEED
FOR THOSE RESPECTFULLY. AND SO
I'M NOT GOING TO BE SUPPORTING
THE BILL TODAY. THANK YOU VERY
MUCH. WHAT ELSE. ALL RIGHT.
THANK YOU FOR WORKING WITH THE
COMMITTEE AND ACCEPTING THE
AMENDMENTS WOULD YOU LIKE TO
CLOSE I RESPECTFULLY ASK FOR
YOUR I. BOATS OKAY AND THAT. IS
OUR MOTION. SENATOR TOTAL MOVES
THE BILL. AND THE MOTION IS TO
PASS AS AMENDED AND REFERRED TO
THE COMMITTEE ON JUDICIARY. THE
COUNTRY FISCAL. SENATORS EGGMAN
EGGMAN AYE WHEN HIGH WINDS ICE
LASER. GONZALEZ GROWTH. HER
TADO. FURTADO I LIMÓN. MENJIVAR
MENJIVAR I. ROSS RUBIO. BOB
WIENER. THAT WINNER NO. FAURIA
SAYS ONE NOW OKAY THAT'S A FOUR
YESES I WILL HOLD THE ROLE OPEN
FOR ABSENT MEMBERS. OKAY AND
THIS WOULD BE THE TIME FOR
ABSENT MEMBERS TO COME ON DOWN.
WE'LL LEAVE THIS OPEN ANOTHER
FIVE MINUTES AND THEN WILL BE
CLOSING THE RULES. THE MOTION-
THAT'S RIGHT WE STILL HAVE A
MOTION ON CENTER PORTANTINO'S
BILL. TWO THIRTY FOUR TO THIRTY
FIFTY TO THIRTY FOUR. SEVEN
THIRTEEN AND WINNER OF THE BILL
. A SURGICAL THE ROLE IN THAT
ONE AND THAT THE MOTION IS TO
PASS AND AMEND AND REFERRED TO
THE COMMITTEE ON APPROPRIATIONS
. SENATORS EGGMAN. EGGMAN NO.
WHEN GLAZER. GONZALEZ GROWTH
FURTADO FURTADO I LIVE MY OWN HI
LIMÓN I PLEDGE OF OUR- ROTH THIS
WOULD BE- OWES FOR THREE. WILL
BE I THIS FIGHT HOPS I HOP OFF.
WINNER WINNER AT. YES FIVE YESES
AND- FIVE YESES AND ONE AND SO
WILL THAT ROLE OPEN. WHEN I.
OKAY SICKNESSES WE CAN. SO. IN
ORDER. TO OKAY SO THAT WILL MOVE
ON TO. S. B. FOUR TWO FOUR TO
RUN. FOR THE MOTION IS TO PASS A
CEMENT REFER TO THE CA AND
APPROVED SECRETARY YOU COULD
CALL THE- I'M SORRY FOR FOUR.
YES GLAZER. GROWTH HER TADO
FURTADO I THE MONTH THANKS THE
MON I. RUBIO RUBIO I. THE TEN
YES TEN. YES WELL HOLD IT OPEN
FOR JUST A FEW MORE MINUTES-
NEXT UP IS ABOUT THE CONSENT
CALENDAR. THANK YOU ON THE
CONSENT CALENDAR AGAIN AS S. B.
TEN SB FIVE OH TWO SB SIX THIRTY
NINE SECRETARY PLEASE CALL THE
ROLL. SENATORS GLAZER. GROWTH
FURTADO HER TADO AYE LIMÓN HI
LIMÓN I RUBIO. RUBIO I. HEY
KRISTI ALLEY. THIS THAT'S TEN.
HEY THAT SETTLED OPEN A FEW
MORE. SENATOR TO COME ON DOWN.
SB FIVE EIGHTY NINE SENATOR
SKINNER DO OF MEN AND REFER TO
THE COMMITTEE ON APPROPRIATIONS
SECRETARY PLEASE CALL THE ROLL
FIVE NINETY EIGHT FIVE NINETY
EIGHT. SENATORS WHEN. GLAZER
GROWTH HER TADO FURTADO I
MENTIONED ARE BINGE OF OUR AYE
RUBIO. RUBIO I. NINE OKAY NINE
LEAVE IT OPEN AGAIN CALLING
CENTER GLAZER S. B. SEVEN
SEVENTY NINE STERN. THE JUNGLE.
SENATORS THE BILL PULLED OF. NO
TAPE ON TICKET YES THEY ARE AT
SEVEN SEVEN NINE CAN BE UPSET
SEVEN. HI PAUL. SEVEN SEVEN NINE
STERN. EVERYTHING FROM. WELCOME
CENTER GLAZER. SENATORS WHEN.
WHEN NO GLAZER. SEVEN SEVENTY
NINE STERN PRESENTED BY GONZALEZ
. NO NO NO. GLAZER NO GROWTH
FURTADO HER TADO I. RUBIO RIGHT
RUBIO I. OKAY LET'S GO BACK IN.
IT'S A NICE. NINETY LET'S GO DO
US SENATOR BAKER SO WE DON'T
WANT. THAT WENT OUT WE GET BILLS
OUT WHERE ONE BILL OUT FOR THE-
THREE DIFFERENT FOR. A LOT OF A
LOT OF IT COULD IN THIS KITCHEN
. SB FIVE EIGHTY TWO BECKER. HI
CAN. THANK YOU. SENATE GLAZER.
EASIER I THINK GROWTH FOR TWO-
FOR TODD II THE MON LEMON I
RUBIO. RUBIO I. HELLO ZERO CAN
HELP UP AT LEVELS ARE THAT OUT
ROLES CLOSE. SB SEVENTY WIENER.
SECRETARY PLEASE CALL THE ROLL.
SENATORS WHEN THE WHEN NO GLAZER
GLAZER EYEING GROWTH HER TADO
HER TADO I. RUBIO RUBIO I. IT'S
TEN TO ONE TEN TO ONE THAT BILLS
OUT ROSE CLOSED SB TWO THIRTY
EIGHT WIENER. THREE HM SENATORS
WHEN. GLAZER GLAZER EYEING
GROWTH RUBIO. THE OKAY IT TAKES
. I HAVE A K. NINE OKAY THAT IS
UP AS NINE VOTES AND IT IS- OUT
ROSE CLOSED SB THREE TWENTY FOUR
LOAN. MEDICARE WE JUST HEARD
THIS GROUP WAS COMING BACK JUST
TRYING TO HIT THAT. SHE'S SAID I
KNOW I CAN'T MISS RECALL NOTES
NOW TO TELL US YES. THE ONES
THAT CLOSE OKAY CLOSE TO CLOSE.
THE IS WHAT PUT ANY SENATE LAMAR
. SB TWENTY FOUR. SENATE WHEN
YOU WHEN. GROWTH FURTADO FOR
TODD- I RUBIO. RUBIO I. NOBODY
YES GLAZER. ALL RIGHT DID YOU
WANT TO VOTE. NOW I. YES GLAZERS
. GLAZER AYE. TEN OF IT'S OPEN
I'LL CHECK. TEN TEN TEN ONE THE
BILL IS. YEAH. THREE FOUR TO
TWENTY BUT WE JUST HEARD SENATOR
. BACK WITH HER SHE WAS NOT CAN
WORKS THE AFTER. THAT THANKS.
OKAY SO I WAS CLOSE AND RULED BY
MINUTES. TO TWO THIRTY FOUR. FOR
THOSE THAT BECAUSE. FILE ITEM.
SB TWO THIRD FOUR THIS CALL THE
ROLL AGAIN ON THAT ONE. SENATORS
GLAZER. RELATED WILL BE WITH
THEM OTHER NINE GLAZER AYE
GONZALEZ BY THE I. GROWTH
MENJIVAR. THIS ROTH RATHER. ROTH
I. ANY UPDATE ON CENTER GROVE.
NEGATIVE WHAT WE'RE GOING TO
CLOSE ROLE NINE NINE ONE TWO
NINETY FOUR OUT- WHAT NUMBER ARE
WE ON SECRETARY LEARN. SENATE
FOR FIFTEEN. SENATOR OR TITLES
BILL SB FOUR SEVENTY TWO
SECRETARY PLEASE CALL THE ROLL.
NUMBER. FIFTEEN SENATOR GLAZERS
GLAZER EYEING GROWTH BROTH AYE
ROSS AYE RUBIO. RUBIO I. ELEVEN
ELEVEN ZERO THAT ROLE THAT IS
ELEVEN ZERO THAT BILLS OUT. S.
B. FIVE FIVE FORTY ONE MENJIVAR
S. T. D.'S. SENATORS GLAZER. AS
ARE EYEING GROWTH RUBIO. RUBIO I
. OKAY TEN ONE TEN ONE OF BILLS
OUT SB. SIX TWENTY FIVE. WHEN
SENATORS GLAZER GLAZER AYE
GONZALEZ. GROWTH FOR THE MON.
ROTH THIS. RUBIO WAHABI. WHAT HI
THIS IS ROB. ROTH I. COULD I
HAVE A. THE NEW YORK. TIMES OKAY
SO THAT BILL HAS SIX ONE SIX
APPROACH IT DOES NOT HAVE ENOUGH
TO GET OUT. BUT THE SELECTORS
ROOM YES THE CONSIDERATION ALL
RIGHT THE BILL FAILS
RECONSIDERATION HIS GRANTED OKAY
LET'S GO. SURE IT WILL. SEVEN
THAT IS A BIGGER FIVE EIGHTY
TWO. YES I HAVE A YES. ALL RIGHT
NOW WHAT IS THE WITH MICHAEL.
CLOSE THE MOST I DON'T THINK THE
GREEN. NOT FOR FINANCE WE DO NOT
CLOSE- FOR TWENTY FOUR HOURS A
FOR TWENTY FOURTH OKAY SLICER
SENATOR GLAZERS DO YOU CARE TO
VOTE ON AS BEFORE SEVENTY FOUR
TO ROSA. THREE FOUR TWENTY FOUR.
NUMBER GLAZER GLAZER AYE
FACILITIES ELEVEN ZERO THAT
BILLS OUT. THAT'S JUST ONE
SECOND. ONE THING SHE RECALLED.
NINE SORRY. BUT TWO THIRTY EIGHT
WIENER NUMBER. SIX TWO SIX NINE
EIGHT. WHAT IS. SHE WANTS TO
VOTE YES YOU WANT TO GO IN.
ONLINE BECAUSE- SO I THINK WE
HAVE THE PHONE I DON'T KNOW WHAT
TO DO.
LET'S CALL THE CONSENT CALENDAR
SENATOR GLAZERS. GLAZER AYE.
CONSENT CALENDAR IS OUT. EVEN ON
. YEAH. THE BECAUSE ROSA. EIGHT
FIVE NINETY EIGHT AND NINE WAS
PULLED OFF THE 8598 DEGREES ZERO
FOR THAT ONE. B. FIVE NINETY
EIGHT GLAZER. PLEASE YOU'RE A-
SENATOR WHEN. TO GROW. THAT'S
TENTH ZERO TEN TEN ZERO THAT
BILL IS OUT.
MICHAEL BAKER THE DALLAS OUT.
ALL RIGHT THAT CONCLUDES OUR
HEARING FOR THE DAY SHOULD THE
STAFF WHO WHO DID THE PHONES AND
EVERYTHING ELSE- AND THANK YOU
ALL VERY MUCH FOR YOUR
PARTICIPATION THIS MEETING IS
ADJOURNED. OVER.