OKAY THE SENATE HEARING ON
HEALTH WILL COME TO ORDER. OR
OUR FIRST MEETING OF OUR 2024
HAPPY 2024 TO EVERYBODY. GOOD TO
SEE FOLKS BACK ALL READY TO GO.
WE HAVE OUR FIRST AUTHOR HERE.
WE HAVE THREE MEMBERS HERE. AND
SO WE WILL START AS A
SUBCOMMITTEE IF THAT'S OKAY WITH
THE SENATOR AMBERG. WILL ALLOW
FOR SIX MINUTES OF TESTIMONY ON
EITHER SIDE DON'T FEEL COMPELLED
TO USE IT. AND AS OF 2024, WE'RE
NOT HAVING ALL OUR OUR PHONE IN
PEOPLE AND SUPPORTERS AND
OPPOSITION CAN GET RIGHT UP HERE
WITH US. SO WELCOME TO 2024.
HAMBURG WOULD YOU LIKE TO BEGIN?
THANK YOU, PLEASE. SB 26. LET'S
BE 26 BUILDS ON THE WORK AND THE
LEADERSHIP OF THE CHAIR
CONCERNING CARE COURTS, ALTHOUGH
IT'S BROADER THAN JUST CARE
COURT ONE OF THE GREAT
CHALLENGES WE HAVE IN TERMS OF
MAKING SURE THAT THOSE THAT ARE
IN NEED PROFESSIONAL BEHAVIORAL
HEALTHCARE, UM HAVE THE ABILITY
TO RECEIVE IT, AND THEN WE HAVE
THE CAPACITY TO PROVIDE IT AND
ONE OF THE KEY CHALLENGES IN
TERMS OF CAPACITY IS JUST THE
NUMBER OF QUALIFIED HEALTH CARE.
BEHAVIORAL HEALTHCARE
PROFESSIONALS WITH THIS BILL
DOES IS THIS BILL PROVIDES A
SCHOLARSHIP FOR THOSE WHO WISH
TO BECOME BEHAVIORAL HEALTH CARE
PROFESSIONALS, AND IT'S IN
EXCHANGE FOR THEIR AGREEMENT TO
BE ABLE TO CONTINUE TO WORK IN
THE FIELD FOR A PERIOD OF TIME.
I RECOGNIZE THAT YOU KNOW, WE
ARE SHORT SOME MONEY HERE IN THE
STATE. UM AND IS THIS BILL
PROGRESSES THAT WE WILL HAVE TO
FIND WAYS TO FUND THIS BILL, BUT
I THINK IT'S INCREDIBLY
IMPORTANT SO MUCH OF WHAT WE DO
IN MENTAL HEALTH IS THE CHAIR
NOSE IS DEPENDENT UPON OUR
CAPACITY PROVIDE THOSE SERVICES
AND SO WITH THAT, I WOULD ASK
FOR AN I VOTE. I HAVE NO
WITNESSES. I'M THE WITNESS.
OKAY. OKAY. WELL, THAT MAKES IT
EASY. WE LIKE THAT. AND THE
SENATOR UNDERPLAYS HIS
ENGAGEMENT IN THE CARE COURT AS
WELL AS THE PRIMARY AUTHOR. OKAY
AT THIS POINT, WE'RE ANY MEMBERS
LIKE TO HAVE ANY QUESTIONS,
COMMENTS ABOUT THE CARE COURT.
SCHOLARSHIP PROGRAM. AND OF
COURSE, THIS IS ALL GOING TO BE,
OF COURSE, DEPENDENT UPON
APPROPRIATION AND THE DEPARTMENT
SETTING UP SOME PARAMETERS AND
EVERYTHING FOR THIS. MAY I MAKE
A COMMENT, ACTUALLY. WELL, FIRST
OF ALL, I JUST WANT TO THANK YOU
FOR THAT, BECAUSE I THINK IT'S
IMPORTANT TO HAVE THIS PROGRAM
AND HOPEFULLY WE COULD GET
FUNDING. BUT I'D LIKE TO BE
ADDED AS A CO AUTHOR, SINCE, UM
COOPERATE TO YOUR OTHER BILL.
THANK YOU. THANK YOU. WELCOME
IT. THANK YOU, SENATOR RUBIO.
OKAY SEEING NO OTHER MEMBERS.
SENATOR WAHAB, MOVE ONE
APPROPRIATE. OKAY THANK YOU VERY
MUCH. WE DON'T HAVE A CORNER AT
THIS TIME, BUT WOULD YOU LIKE TO
CLOSE HER? WOULD URGENT I VOTE.
ALL RIGHT. THANK YOU VERY MUCH.
WE WILL TAKE THAT UP. AS SOON AS
WE GET A QUORUM AGAIN. I WOULD
ENCOURAGE MEMBERS TO COME DOWN
ON ANY OPPOSITION. ANY
OPPOSITION. ALL RIGHT NOW, BUT
THANK YOU VILLAGE. OKAY URGENT.
I VOTE. THANK YOU VERY MUCH.
ALRIGHT ALRIGHT. THANK YOU. SEE
YOU DISMISSED IT ALRIGHT, MOVING
ON. TO BY ITEM NUMBER THREE. SB
294 SENATOR WIENER. HAVING TO DO
WITH HEALTHCARE COVERAGE AND THE
. INDEPENDENT MEDICAL REVIEW. TO
OUR FRIENDS FOR BEING HERE.
WAIT. ABSOLUTELY. OKAY? HMM. I'M
GETTING OUT OF THIS AND AGAIN IF
I COULD ASK OTHER SENATORS TO
COME SO WE CAN ESTABLISH A
QUORUM. THANK YOU VERY MUCH.
WHENEVER YOU'RE READY, SENATOR,
OKAY. THANK YOU VERY MUCH. MADAM
CHAIR AND COLLEAGUES. I'M HERE
TODAY TO PRESENT SP 294, WHICH
IS SIMILAR TO BILL THAT PASSED
OUT OF THIS COMMITTEE LAST YEAR,
WHICH WAS SP 238, WHOSE GOAL IS
TO EXPAND ACCESS TO MENTAL
HEALTH TREATMENT FOR YOUNG
PEOPLE. SPECIFICALLY THE BILL
PROVIDES THAT IF INSURANCE
COMPANY IF A HEALTH PLAN DENIES
OR DELAYS OBSTRUCTS COVERAGE FOR
BEHAVIORAL HEALTH TREATMENT FOR
SOMEONE UNDER THE AGE OF 26,
THERE WILL BE AN AUTOMATIC
INDEPENDENT MEDICAL REVIEW.
INSTEAD OF THE NORMAL PROCESS
WHERE YOU HAVE TO GO THROUGH AN
ADMINISTRATIVE PROCESS AND THEN
SEEK AND I AM ARE WE KNOW THAT
WHEN I AM RS DO HAPPEN FOR THIS
CATEGORY OF YOUTH SEEKING
BEHAVIORAL HEALTH TREATMENT
OVERWHELMINGLY, THEY WIN THEIR
IMAR, SO WE KNOW THEY'RE
ENTITLED TO THIS COVERAGE. WE
ALSO KNOW THAT THERE ARE A LOT
OF FAMILIES THAT DO NOT EVEN
KNOW THAT THEY CAN SEEK AN
INDEPENDENT MEDICAL REVIEW, AND
THEY'RE JUST PROPORTIONATELY
LOWER INCOME. FAMILIES WERE
ENGLISH IS AT THE FIRST LANGUAGE
AND SO FORTH. SO THIS IS AN
EQUITY ISSUE AS WELL. UM AND SO
WE THINK THAT THIS BILL WILL
ENSURE THAT PEOPLE CAN ACTUALLY
ACCESS THEIR THEIR HEALTH
INSURANCE WHEN THEIR CHILDREN
ARE. AH, YOU KNOW. NOT YET IN
CRISIS HOPEFULLY TO ALL TOO
OFTEN IN OUR SYSTEM. WE PROVIDE
MENTAL HEALTH TREATMENT. WHEN
PEOPLE ARE ALREADY IN CRISIS. WE
WANT TO HELP PEOPLE BEFORE THEY
ARE IN CRISIS. AND WE KNOW THAT
OUR YOUNG PEOPLE ARE REALLY
STRUGGLING RIGHT NOW WITH MENTAL
HEALTH CHALLENGES, SO I
RESPECTFULLY ASK FOR YOUR I VOTE
AND WITH ME TODAY TO TESTIFY. IS
ADRIAN SHELTON, VICE PRESIDENT
OF PUBLIC POLICY AND STRATEGY
WITH THE CALIFORNIA ALLIANCE OF
CHILDREN AND FAMILY SERVICES,
AND NORLAND WITH CHILDREN NOW
THANK YOU, MS. SHELTON WOULD YOU
LIKE TO GO FIRST OR WHO'S GOING
FIRST? MADAM CHAIR MEMBERS. MY
NAME IS NORLAND AND I'M HERE ON
BEHALF OF CHILDREN NOW STATE
BASED RESEARCH AND ADVOCACY
NONPROFIT ORGANIZATION FOCUSED
ON CHILDREN'S HEALTH, EDUCATION
AND WELFARE, WHERE THE SPONSORS
OF SB 294 AS THE COMMITTEE'S
ANALYSIS LAYS OUT THROUGH ITS
DEPARTMENT OF MANAGED HEALTHCARE
AND DEPARTMENT OF INSURANCE. THE
STATE REGULATES HEALTH PLANS AND
DISABILITY INSURERS ISSUE
GUIDANCE FOR PLANS TO USE AND
PROVIDING MEDICALLY NECESSARY
MENTAL HEALTH AND SUBSTANCE
ABUSE DISORDER CARE. THEY HAVE
GRIEVANCE SYSTEMS TO WHICH CARE
DENIALS CAN BE APPEALED, AND
THEY ARE REQUIRED TO
EXPEDITIOUSLY REVIEW CASES
SUBMITTED FOR INDEPENDENT
MEDICAL REVIEW AND IMMEDIATELY
NOTIFY ENROLLEES OVER THEIR
DECISION. I AM ARE STATISTICS
PAINT A CLEAR PICTURE THAT
HEALTH PLANS ARE FAILING TO
ENSURE MENTAL HEALTH SERVICES
FOR YOUNG PEOPLE, AND THE STATE
HAS YET TO IMPLEMENT A NEW
SYSTEM TO ADDRESS THIS ISSUE. WE
KNOW BASED ON THE DMH SEE DATA
THAT SENATOR WIENER REFERENCED
THAT BETWEEN 2, 2017 AND 2022.
MOST MENTAL HEALTH DENIALS FOR
YOUTH WERE LATER OVERTURNED BY
THE IMAR. THE INCREASING NUMBERS
OF YOUTH FAILING TO GET THE
MENTAL HEALTH TREATMENT THEY'RE
PRESCRIBED IN A TIMELY MANNER
SPEAKS TO THE NEED FOR REFORM,
WHILE MORE YOUTH ARE ACCESSING
THE INDEPENDENT MEDICAL REVIEW
PROCESS, CARE CONTINUES TO BE
DENIED IT AN ALARMING RATE. THE
STATE HAS A ROLE TO PLAY WHEN
PRESCRIBED MENTAL HEALTH CARE IS
DENIED, AND SP 294 WILL ENSURE
STATE OVERSIGHT OF HEALTH PLANS
BY REQUIRING HEALTH PLANS TO
AUTOMATICALLY SUBMIT ANY DENIALS
OF MENTAL HEALTH CARE FOR YOUTH
UP TO AGE 26 TO THEIR GRIEVANCE
PROCESS. IF A PLAN CONTINUES TO
DENY CARE FOLLOWING THE
GRIEVANCE, THE CASE WOULD BE
AUTOMATICALLY SUBMITTED TO THE
IMAR. FOR DENIALS IN LIFE
THREATENING AND SERIOUS CASES.
THE APPEAL TO M R WOULD BE
DIRECT. CALIFORNIA'S MENTAL
HEALTH CRISIS HAS BECOME A FULL
BLOWN EMERGENCY AND THE SYSTEM
WE HAVE IN PLACE TO PROVIDE
MENTAL HEALTH CARE FOR OUR YOUTH
IS BROKEN. PLANS TOO OFTEN FAIL
TO PROVIDE THE MENTAL HEALTH
CARE NEEDED. AND WHEN THAT
HAPPENS TO CHILDREN, THE RESULTS
ARE DISASTROUS. FOR THESE
REASONS. WE REQUEST YOUR I VOTE
ON SB 294. THANK YOU VERY MUCH.
SHELTON GOOD AFTERNOON SHARE
EGGMAN AND HONORABLE MEMBERS OF
THE SENATE HEALTH COMMITTEE. MY
NAME IS ADRIAN SHELTON AND WITH
THE CALIFORNIA ALLIANCE OF CHILD
AND FAMILY SERVICES, AND WE
REPRESENT 167. NONPROFIT
COMMUNITY BASED PROVIDERS ACROSS
CALIFORNIA SERVING VULNERABLE
CHILDREN, YOUTH AND FAMILIES IN
OUR SAFETY NET. WE ARE PROUD
SUPPORTER OF SP 294. FROM OUR
VANTAGE POINT REPRESENTING THESE
NONPROFIT ORGANIZATIONS WORKING
WITH THE CHILDREN, YOUTH AND
FAMILIES WITH MENTAL HEALTH
NEEDS, WE SEE AN URGENT NEED FOR
THIS BILL. REMEMBERS REPORT TO
US ALMOST DAILY THE FAMILIES
THAT HAVE BEEN DENIED COVERAGE
BY THEIR INSURANCE COMPANY, AND
THIS IS DEVASTATING AS SYMPTOMS
CAN WORSEN FOR THEIR CHILDREN.
SO WHEN THEY WHEN YOU GET
APPROPRIATE LEVEL OF CARE, THE
APPROPRIATE AMOUNT OF TIME
THERE'S SYMPTOMS GET
DRAMATICALLY BETTER. THAT'S BEEN
OUR EXPERIENCE, SO I WANTED TO
SHARE ONE STORY FROM ONE OF OUR
MEMBER AGENCIES TO MAKE THIS
POINT. WE CHANGED THE NAME AND
DETAILS TO PROTECT HIS PRIVACY.
MATTHEW IS A 14 YEAR OLD BOY WHO
CAME TO ONE OF OUR MEMBER
AGENCIES RESIDENTIAL PROGRAMS.
LAST YEAR, HE HAD THREE BACK TO
BACK HOSPITALIZATIONS AND
ATTEMPTED SUICIDE. BEFORE HE WAS
ADOPTED BY A RELATIVE AT THE AGE
OF FIVE. HE HAD BEEN TERRIBLY
ABUSED BY BY HIS BIOLOGICAL
PARENTS. HE SUFFERED PTSD AND HE
WAS ON FIVE DIFFERENT
MEDICATIONS AFTER THREE WEEKS
AND OUR MEMBER AGENCIES PROGRAM,
HOWEVER, MATTHEWS INSURANCE
COMPANY DENIED ANY ADDITIONAL
DAYS STATING THAT HE NO LONGER
MET MEDICAL NECESSITY. UM THIS
WAS DESPITE HIS PSYCHIATRIST
RECOMMENDING FURTHER TREATMENT.
SO HOPING THE APPEAL PROCESS
WITH HER INSURANCE COMPANY WOULD
CHANGE THE RESULTS. MATTHEW'S
MOM TOOK OUT ALONE WHILE SHE
AWAITED THE OUTCOME. HOWEVER
AFTER TWO WEEKS THE MOTHER HAD
EXHAUSTED HER FINANCIAL
RESOURCES AND WITHOUT OTHER
OPTIONS, SHE TOOK MATTHEW HOME.
SO AFTER WAITING ANOTHER WEEK,
MATTHEW'S MOTHER LEARNED THAT
THE APPEAL WAS UNSUCCESSFUL, AND
ONLY THEN COULD COULD. MATTHEW'S
MOM FILED A COMPLAINT WITH
DEPARTMENT OF MANAGED HEALTHCARE
. SO MEANWHILE, DURING THIS TIME
HE HAD BEEN RE HOSPITALIZED AND
ANOTHER ATTEMPT OF SELF HARM.
THIS IS ALSO UNNECESSARY. WE ARE
IN THE MIDDLE OF A DEVASTATING
BEHAVIORAL HEALTH CRISIS AMONG
OUR YOUTH, AS ALL OF YOU KNOW.
STORIES LIKE THIS ARE
UNFORTUNATELY NOT UNCOMMON IN
THE MENTAL HEALTH FIELD, SO OUR
MEMBERS ARE FREQUENTLY YOU KNOW,
SEEING PARENTS FACED WITH THIS
AWFUL AWFUL CHOICE AFTER DENIAL,
WHICH IS TO END TREATMENT AND
TAKE THE RISK OF THEIR CHILD'S
CONDITION, WORSENING OR TAKE ON
FINANCIAL HARDSHIP TO CONTINUE
THE TREATMENT, SO PLACING THIS
THE ENTIRE RESPONSIBILITY ON THE
FAMILY TO INITIATE THE EMR, FROM
OUR PERSPECTIVE IS JUST A RECIPE
FOR FAILURE. AND SO, REALLY, IN
ALL, BUT THE MOST RARE
EXCEPTIONS, AT LEAST WITH THE
CLIENTS THAT WE ARE SERVING
FAMILIES IN CRISIS THAT JUST DO
NOT HAVE THE RESOURCES. WE
BELIEVE THAT SP 294 WAS
REPRESENTS ONE SOLUTION THAT
WILL HAVE, YOU KNOW A DIRECT AND
POSITIVE IMPACT ON CHILDREN LIKE
MATTHEW. SO WE URGE YOUR SUPPORT
TODAY. THANK YOU. THANK YOU VERY
MUCH. ANYBODY ELSE SPEAKING IN
SUPPORT OF THIS MEASURE TODAY,
JUST NAME AND AFFILIATION NOW?
LINDA WAY WITH WESTERN CENTER ON
LAW AND POVERTY IN SUPPORT.
THANK YOU. EVEN DINES WITH
HEALTH ACCESS CALIFORNIA AND
SUPPORT. THANK YOU. THANK YOU.
ANDREA RIVERA ON BEHALF OF THE
CALIFORNIA PEN, ETHNIC HEALTH
NETWORK AND SUPPORT THANK YOU.
CHANDRA BINGER WITH THE
STEINBERG INSTITUTE AND SUPPORT
AND ALSO HERE IN SUPPORT ON
BEHALF OF THE KENNEDY FOR HIM.
THANK YOU. I WOULD GET ONLY WITH
THE CALIFORNIA CHILDREN'S
HOSPITAL ASSOCIATION IN SUPPORT.
JOSH HASNI WAS SANTA CLARA
COUNTY IN SUPPORT. GOOD
AFTERNOON CHAIR AND MEMBERS
BRIAN MIRAMONTE IS WOULD ASK ME
AND SUPPORT THANK YOU VERY MUCH.
OKAY SEE NOBODY ELSE. SPEAKING
OF SUPPORT, WILL TAKE OPPOSITION
NOW. VERY WELL.
MADAM CHAIR MEMBERS, STEPHANIE
WATKINS ON BEHALF OF THE
ASSOCIATION OF CALIFORNIA LIFE
AND HEALTH INSURANCE COMPANIES
HERE IN OPPOSITION. DID SP 294
TODAY. FIRST AND FOREMOST, I'D
LIKE TO THANK THE AUTHOR,
SPONSOR AND STAFF. WE HAVE BEEN
WORKING CLOSELY WITH THEM OVER
THE LAST YEAR TO TRY TO FIND
SOME PATHWAY FORWARD TO ADDRESS
THIS IMPORTANT ISSUE.
UNFORTUNATELY WE ARE IN
OPPOSITION TODAY. IT GOES
WITHOUT SAYING THAT MENTAL
HEALTH IS A KEY COMPONENT TO
PERSONS OVERALL WELL BEING, AND
HEALTH PLANS AND INSURERS REMAIN
STEADFAST IN OUR EFFORT TO
PROVIDE SELF SAFE EVIDENCE BASED
BEHAVIORAL HEALTHCARE AND
ACCORDANCE WITH EXISTING STATE
AND FEDERAL REQUIREMENTS. WHILE
WE APPRECIATE THE OVERARCHING
GOAL OF ENSURING ENROLLEES
INSURANCE HAVE ACCESS TO
IMPORTANT, MEDICALLY NECESSARY
MENTAL HEALTH SERVICES. WE
BELIEVE THAT THIS BILL IS
MISSING KEY CONSIDERATIONS IN
THE DETERMINATION PROCESS. THAT
WOULD INTERFERE WITH THE
PATIENT'S ABILITY TO GET THAT
CARE. THEY NEED SPECIFICALLY
CONCERNED THAT THIS BILL WILL
SUBSTANTIALLY ALTER A HEALTH
PLAN INSURERS INTERNAL REVIEW
STRUCTURE BY CREATING A NEW
BIFURCATED PROCESS FOR THE
PURPOSE OF REVIEWING YOUTH
MENTAL HEALTH SERVICES. AS
DRAFTED, THE BILL CREATES A
UNIQUE TWO TIERED REVIEW SYSTEM,
WHICH REQUIRES THE HEALTH PLAN
AND ENSURED AUTOMATICALLY REVIEW
ALL HEALTH RELATED MEDICAL
HEALTH SERVICES ON THE PLANS
HAVE ISSUED A NATIONAL DENIAL OR
MODIFICATION. IT ALSO REQUIRES
PLANS AND INSURERS DECIDE STEP
THE PLANET INSURERS INTERNAL
PROCESS AND AUTOMATICALLY
ASSISTANT SUBMIT SPECIFIED CASES
TO THE M R PROCESS, WHILE MANY
INITIAL DENIALS AND
MODIFICATIONS CAN BE RESOLVED
THROUGH A PLANET OR INSURERS
INTERNAL REVIEW PROCESS, IT
WOULD BE AN OVERSTATEMENT TO
SUGGEST THAT EVERY MODIFICATION
OR DENIAL SHOULD AUTOMATICALLY
BE SUBMITTED. THE SUCCESS OF
THESE CASES AND THE REVIEWS ARE
LARGELY DEPENDENT ON THE
ENGAGEMENT OF THE INDIVIDUAL
PATIENT OR PHYSICIAN WITHOUT
THEIR INVOLVEMENT. THE SECONDARY
REVIEW PROCESS WILL LIKELY THE
RESULT IN AN INCREASE OF
UNNECESSARY ADVERSE BENEFIT
DETERMINATIONS. WHICH WILL HAVE
THE NEGATIVE, EFFECTIVE, FURTHER
DELAYING CARE. ADDITIONALLY
WHILE THE SPONSORS HAVE
ATTEMPTED TO ADDRESS THE PRIVACY
CONCERNS WE HAVE RAISED WE
REMAIN TROUBLED THAT THE PROCESS
OUTLINED PUTS BOTH PLANS AND
INSURERS IN THE STATES. I AM OUR
PROCESS AND UNTENABLE SITUATION.
THE BILL REQUIRES AS A PAWN IN
ISSUING A MODIFICATION OR DENIAL
OF SERVICE TO IMMEDIATELY SUBMIT
THE GRIEVANCE ALONG WITH ALL
RELEVANT INFORMATION TO THE
STATES. I AM OUR SYSTEM. WITHOUT
THE PATIENT'S INFORMED CONSENT
THAT PLAN AND ENSURE LACKS THE
AUTHORITY TO RELEASE CRITICAL
PATIENT INFORMATION NECESSARY
FOR THE REVIEW TO MAKE A
JUDGMENT AS TO THE
APPROPRIATENESS OF CARE. WHILE
THE BILL REQUIRES A PLAN ENSURED
TO COORDINATE WITH ENROLLING IN
PROVIDER FOR THE COMPLETION OF
ASSIGNED, I AM OUR APPLICATION
THAT COULD TAKE DAYS OR WEEKS
WITH THAT IN MIND WHILE WE SHARE
THE BILL, SPONSORS VIEW THAT
CHILDREN WITH MENTAL HEALTH AND
SUBSTANCE USE DISORDERS RECEIVED
THE MEDICALLY NECESSARY CARE
THAT THEY NEED. WE BELIEVE THAT
SP 294 AS DRAFTED MAY HAVE
NUMEROUS AND INTENDED
CONSEQUENCES AND COULD ACTUALLY
DELAY CARE WHILE SIMULTANEOUSLY
BUILDING IN MORE UNNECESSARY
COST OF THE SYSTEM, FOR THOSE
REASONS REMAIN OPPOSED. THANK
YOU. GOOD AFTERNOON, MADAM CHAIR
MEMBERS OF THE COMMITTEE JET
HAMPTON WITH THE CALIFORNIA
ASSOCIATION HEALTH PLANS
REPRESENTING 44 LICENSE PLANNED
REPRESENTING 27 MILLION
CALIFORNIANS ACROSS THE STATE.
IN THE INTEREST OF TIME I WILL
ASSOCIATE AN ECHO MUCH OF MY
COMMENTS TO MY COLLEAGUE FROM
THE ASSOCIATION OF CALIFORNIA
LIFE AND HEALTH INSURANCE
COMPANIES I DO AGAIN WANT TO
THANK THE AUTHOR AND STAFF AND
SPONSORS FOR WORKING WITH US, AS
MY COLLEAGUE HAD MENTIONED, HAVE
DONE QUITE A BIT OF WORK AND HAD
QUITE A FEW CONVERSATIONS AROUND
THIS BILL IN THE LAST YEAR, SO
WE ARE REALLY APPRECIATIVE AND
GRATEFUL FOR THOSE
CONVERSATIONS. AGAIN. OUR
CONCERNS ARE FAIRLY SIMILAR TO
MY COLLEAGUES FROM A CLICK AND
HER TESTIMONY THAT SHE
HIGHLIGHTED. I WOULD ALSO POINT
OUT THAT WE DO HAVE SOME
QUESTIONS AND POTENTIAL CONCERNS
AROUND THE TIMING OF THE BILL,
AS THERE IS A CONSIDERABLE
AMOUNT OF WORK THAT'S BEING DONE
IN THIS AREA, AS YOU ALL KNOW,
WITHIN THE LAST COUPLE OF YEARS.
SPECIFICALLY WE ARE LOOKING AT
THE REQUIREMENTS FOR PLANS.
INSURERS COVER SERVICES. THAT
ORIGINATE FROM 1988 CALLS IN
LEGISLATION THAT WAS PASSED
RECENTLY, AS WELL AS CARE COURT
AS WELL AS THE IMMINENT
IMPLEMENTATION OF THE CHILDREN
AND YOUTH BEHAVIORAL HEALTH
INITIATIVE, WHICH WILL ALTER THE
WAY THAT CHILDREN YOUTH ACCESS
CARE, AND THESE MANDATES REQUIRE
PLANS INSURERS TO COVER A
VARIETY OF MENTAL HEALTH AND
SUBSTANCE USE SERVICES WITHOUT
PRIOR AUTHORIZATION, OR ZERO
COST SHARE. SO ALL OF THESE
VARIOUS PROGRAMS ARE COMING
TOGETHER RELATIVE TO THE
DELIVERY OF MENTAL HEALTH
SERVICES FOR CHILDREN AND YOUTH.
I THINK WE WANT TO BE SURE THAT
WE'RE MINDFUL OF ALL OF THOSE
PROGRAMS, IN ADDITION TO
POTENTIAL OTHER CONSIDERATIONS
GOING FORWARD, SO WITH THAT
BEING SAID, WE ARE OPPOSED TO
THE BILL, BUT AGAIN LOOK FORWARD
TO CONTINUING TO WORK WITH THE
AUTHOR AND SPONSORS ON A PATH
FORWARD. OKAY THANK YOU VERY
MUCH AND WHAT WE HAVE HERE. I'M
GOING TO ASK THE SECRETARY TO
CALL THE ROLL, PLEASE, SO WE CAN
GET A QUORUM. SENATORS EGGMAN
EGGMAN HERE WHEN? WHEN? HERE,
GLASER. GONZALEZ SALAS HERE,
GROVE. HER TAITO LIMÓN. MENJIVAR
MENJIVAR HERE, ROSS RUBIO.
PRESENT PRESENT A HOB HOB HERE,
WIENER HERE. WE HAVE A QUORUM.
THANK YOU VERY MUCH. OKAY.
ANYBODY ELSE SPEAKING IN
OPPOSITION TODAY, PLEASE. JACKIE
AMERICA'S HEALTH INSURANCE PLANS
AND RESPECTFUL OPPOSITION. THANK
YOU. THANK YOU VERY MUCH.
ANYBODY ELSE? OKAY THANK YOU
VERY MUCH. WOULD YOU LIKE TO
ADDRESS THE ISSUE OF MULTIPLE
PROGRAMS ALL COMING ONLINE RIGHT
NOW? I MEAN, EVERY POLICY AREA I
MEAN, WE HEAR FROM THE
OPPOSITION THAT WE PASSED SOME
OTHER BILLS, SO DON'T PASS MORE
BILLS IN THIS AREA. THIS IS A
VERY SPECIFIC ISSUE OF CHILDREN
WHOSE FAMILIES HAVE HEALTH
INSURANCE. AND THEY HAVE A
MENTAL HEALTH. PROBLEM AND THE
INSURANCE COMPANY IS DENYING
COVERAGE AND THEY DON'T EVEN
REALIZE THAT THEY CAN INVOKE AN
INDEPENDENT MEDICAL REVIEW. ALL
THIS DOES IS INVOKE IT, AUTOM
AUTOMATICALLY. WE ACTUALLY MADE
AN AMENDMENT IN RESPONSE TO
FEEDBACK TO DISTINGUISH BETWEEN
LIFE THREATENING AND NON LIFE
THREATENING DIAGNOSES FOR THE
NON LIFE THREATENING, THEY WILL.
IT WILL BE AN AUTOMATIC FRUIT
PRELIMINARY REVIEW BY THE
INSURANCE COMPANIES SO THAT THEY
CAN CORRECT ANY ERROR THAT THEY
WANT TO CORRECT AND FOR LIFE
THREATENING. WE WANTED TO GO TO
THAT REVIEW QUICKLY, SO THIS IS
A VERY SPECIFIC ISSUE THAT DOES
NOT IN ANY WAY CONFLICT WITH
OTHER POLICIES WE'VE ADOPTED.
OKAY THANK YOU. IF THERE ARE NO
OTHER QUESTIONS FROM ANY OTHER
MEMBERS, WOULD WE TAKE THAT AS
YOUR CLOSE, SENATOR? OKAY? THANK
YOU, AND WE HAVE A MOTION BY
SENATOR GONZALEZ. IF SECRETARY
COULD CALL THE ROLL. READ THE
MOTION, PLEASE. AND UH, THERE
WERE AMENDMENTS THAT YOU
ACCEPTED TO DO PASS AS AMENDED
AND RE REFER TO THE COMMITTEE ON
APPROPRIATIONS EXCEPT THE
COMMUNITY MOMENT. MY APOLOGIES
FOR THAT. THANK YOU. OKAY THAT
IS ON CALL AGAIN. WE ENCOURAGE
SENATORS TO COME AS RAPIDLY AS
POSSIBLE, AND SENATOR WUHAN
WANTED TO MAKE THE MOTION ON
SENATOR UM BERG'S ON 2940. NO,
NO, NO, I'M SORRY. I THOUGHT WE
VOTED. NO, YOU'RE GOING TOO
FAST, TOO FAST, TOO SLOW DOWN.
THE MORNING LAST DOWN THE
COBBLED SENATORS EGGMAN I WHEN.
GLASER GONZALEZ GONZALEZ. AYE.
GROVE. HURTADO LIMÓN. MENJIVAR
BRA, RUBIO RUBIO I HAB HI. HI
WIENER. WHERE I THAT'S UNCALLED
THAT BILL IS ON CALL AGAIN. WE
ENCOURAGE MEMBERS TO COME. AND
ON SB 26 NUMBER SENATOR WILL
HAVE MADE THE MOTION AND THAT
MOTION IS DUE PASSES AMENDED AND
REFERRED TO THE COMMITTEE ON
APPROPRIATIONS. SECRETARY PLEASE
CALL THE ROLL. SENATORS EGGMAN
EGGMAN I WHEN GLASER GONZALES
GONZALES, I GROVE HER TAITO.
LIMÓN MENJIVAR. ROTH RUBIO. BY
RUBIO HOB HOB I WIENER WIENER. I
CALL OKAY. THAT BILL IS ALSO ON
CALL AND NEXT UP. WE HAVE
SENATOR WAHABI WITH SB 402
.
ALL RIGHT. THANK YOU. CHAIR AND
MEMBERS. I FIRST WANT TO THANK
THE HEALTH COMMITTEE FOR WORKING
WITH OUR TEAM ON THIS PARTICULAR
BILL, I DO JUST WANT TO SAY THAT
WE WILL BE ACCEPTING THE MINUTES
. UM, AUMENTO EXCUSE ME
AMENDMENTS AS DISCUSSED WITH THE
COMMITTEE. UM AND SPECIFICALLY,
DO YOU WANT TO HIGHLIGHT THAT S
BEFORE OH, TO THE APPROPRIATE
RESPONSE TO MENTAL HEALTH
CRISIS. UM ADDRESSES
DEFICIENCIES IN THE CURRENT LAW
RELATED TO MENTAL HEALTH CRISIS
INTERVENTIONS AND SPECIFICALLY
THE ISSUE INITIATION OF 51
FIFTIES. UM SPECIFICALLY THE
DECISION MAKING PROCESS PHASE OF
INITIATING A 5150 OR 72 HOUR
HOLD DOES NOT ALWAYS INCLUDE THE
ACTIVE INVOLVEMENT OF MENTAL
HEALTH EXPERTS, WHICH LEADS TO
POOR OUTCOMES FOR THE
INDIVIDUALS IN CRISIS IN THEIR
COMMUNITIES. IN FACT, IF YOU
TAKE A LOOK PROPS, 63 WAS PASSED
IN CALIFORNIA BY VOTERS AND
RESULTED IN COMMUNITY BASED
ORGANIZATIONS BEING ABLE TO
PROVIDE PREVENTION AND EARLY
INTERVENTION CARE SPECIFICALLY
TO MAKE IT MORE ROBUST THAT YOU
KNOW COMMUNITIES OF COLOR CAN
ADDRESS SOME OF THEIR COMMUNITY
NEEDS MORE DIRECTLY, RATHER THAN
GOING THROUGH A HOSPITAL AND SO
FORTH. MANY OF THESE AGENCIES
HIRED LICENSED AND MARRIAGE,
MARRIAGE AND FAMILY THERAPIST AS
WELL AS SOCIAL WORKERS AND L P.
C C S TO DO THE WORK FOR MENTAL
HEALTH AND EARLY INTERVENTION.
THESE INDIVIDUALS DEVELOP A
RAPPORT WITH THE INDIVIDUAL
COMMUNITY MEMBERS, THEIR
FAMILIES AND MUCH MORE. MANY OF
THEM OPERATE AS A CASEWORKER AND
PROVIDE SERVICES TO THEM AND
UNDERSTAND, YOU KNOW WHEN THEY
HAVE TO GO TO A DOCTOR, WHAT
TYPES OF MEDICATION THEY'RE
TAKING, AND MUCH MORE WITH PROP
63 WE HAVE DISCOVERED, INCLUDING
MYSELF AS A BOARD MEMBER OF ONE
OF THE AGENCIES THAT DID A LOT
OF THIS TYPE OF CASE WORK. WAS
THAT THERE WAS A LIMITATION WHEN
AN INDIVIDUAL WAS BECOMING A
LITTLE BIT MORE UNSTABLE THAT
THE MARRIAGE AND FAMILY
THERAPIST OR THE SOCIAL WORKER
SO FORTH WOULD HAVE TO CALL 911
OR POLICE OFFICER TO INITIATE
THE 5150 HOLD. THIS IS OBVIOUSLY
VERY PROBLEMATIC AND IN MANY
WAYS SPECIFICALLY OR CURRENT
FRAMEWORK PLACES UNDUE PRESSURE
ON LAW ENFORCEMENT TO INITIATE
5150 HOLDS. RESULTING IN
POTENTIAL DELAYS, AS WELL AS
POLICE OFFICERS MAKING MENTAL
HEALTH ASSESSMENTS WITHOUT THEIR
BACKGROUND CASE WORKING
KNOWLEDGE OF THAT PARTICULAR
INDIVIDUAL. S. B. 402 SEEKS TO
ADDRESS THESE ISSUES BY
EXPANDING THE CATEGORY OF
AUTHORIZED INITIATORS OF 5150,
ALLOWING LICENSED MENTAL HEALTH
PROFESSIONALS LIKE LICENSED
MARRIAGE AND FAMILY THERAPIST
LCS AND LP CCS TO INITIATE THE
5150. LICENSED MENTAL HEALTH
PROFESSIONALS WITHIN THESE
ORGANIZATIONS ARE LIMITED IN
THEIR ABILITY TO FULLY SUPPORT
THEIR CLIENTS. AS IS THIS
HOPEFULLY ADDRESSES THAT
PARTICULAR CONCERN. WE'RE
TALKING ABOUT HAVING MORE
PROFESSIONALS WHO HAVE
ESTABLISHED TRUST WITH THE
CLIENTS AND COMMUNITIES AS
BEFORE AIMS TO SUPPORT THESE
FRONTLINE LICENSED MENTAL HEALTH
PROFESSIONALS AND THEIR CLIENTS
WITH THE STRATEGIC EXPANSION. OF
WHOM MAY INITIATE THE 5150 IF
IT'S REALLY NEEDED, ADDITIONALLY
WITH THESE AMENDMENTS, AS BEFORE
, TWO WILL ALSO IMPROVE AND
INCREASE REPORTING REQUIREMENTS
REGARDING 51 FIFTIES AS L. M. H
P S REPORT AND POLICE DO NOT
REPORT NECESSARILY THE 51
FIFTIES. I RESPECTFULLY ASK FOR
AN EYE BOAT. OKAY ANYBODY
SPEAKING IN SUPPORT OF THIS BILL
TODAY, SEEING NONE. ANYBODY
SPEAKING IN OPPOSITION TO THIS
BILL TODAY?
HI. GOOD AFTERNOON, MADAM CHAIR
MEMBERS, MICHELE CABRERA WITH
THE COUNTY BEHAVIORAL HEALTH
DIRECTORS ASSOCIATION OF
CALIFORNIA, AND FIRST I WANT TO
ACKNOWLEDGE AND THANK THE CHAIR
AS WELL AS THE COMMITTEE STAFF
FOR THE AMENDMENTS, WHICH WE ARE
STILL IN THE PROCESS OF
REVIEWING WITH OUR MEMBERS. WE
THINK THAT THE PROVISIONS TO
REQUIRE THAT INDIVIDUALS ELEMENT
UM UH, LICENSED MENTAL HEALTH
PROFESSIONALS THAT THEY BE, UM
STILL BE, UM, UH OFF. AUTHORIZED
BY THE COUNTY IS AN IMPORTANT
ONE COUNTY DESIGNATION ENSURES
SEVERAL THINGS THAT I WANT TO
EMPHASIZE AND UNDERSCORE. THE
FIRST IS THAT NOT ALL MENTAL
HEALTH PROFESSIONALS WHO ARE
LICENSED IN THE STATE OF
CALIFORNIA ARE CURRENTLY
ACTIVELY PRACTICING, AND THIS
WOULD IN ITS ORIGINAL VERSION
HAS GIVEN THE ABILITY TO PLACE
HOLDS. REGARDLESS THEY ALSO
DON'T ALL WORK IN CRISIS AND SO
THEY DON'T UNDERSTAND
NECESSARILY THE SPECIFIC
COMPONENTS OF CRISIS. THE REASON
WHY WE THINK THAT THE
DESIGNATION PROCESS IS SO
IMPORTANT IS WE REQUIRE TRAINING
AS WELL AS IN MOST CASES,
PASSAGE OF A TEST AND THEN WE DO
CONSISTENT OVERSIGHT AND
MONITORING OF THESE CLINICIANS
IN L. A COUNTY, FOR EXAMPLE, WE
HAVE 4200 INDIVIDUALS WHO ARE
ALL LICENSED CLINICIANS WHO HAVE
BEEN DESIGNATED BY THE COUNTY OF
LOS ANGELES. TO PUT PEOPLE ON
HOLT'S THEY ALL HAVE TO GO
THROUGH TRAINING. THEY ALL NEED
TO PASS THE TEST. AND SO IT'S
REALLY IMPORTANT BOTH FOR OUR
OWN SAKE TO ENSURE THAT THOSE
INDIVIDUALS UNDERSTAND THIS
POWER AND AUTHORITY BUT ALSO FOR
THE REPORTING PROVISIONS.
SENATOR AND CHAIR YOU. YOU
PASSED A BILL THAT RECENTLY THAT
UPS THE ANTE THAT REQUIRES
COUNTIES TO REPORT CERTAIN
INTERIM INFORMATION OR ELSEWHERE
. PENALIZED IF INDIVIDUAL
CLINICIANS ARE NOT UNDER COUNTY
DESIGNATION. AND UNDER THE
OVERSIGHT OF COUNTIES. WE HAVE
NO MEANS TO ENSURE THAT THOSE
INDIVIDUALS ARE TRACKING BECAUSE
WE MAY NOT KNOW WHO THEY ARE,
AND THAT THEY'VE EVER PLACED A
HOLD, AND SO IT CREATES A BIGGER
PROBLEM. THERE WERE ALSO
CONCERNED ABOUT POTENTIAL
LIABILITY FOR PROVIDERS AND THEM
NOT UNDERSTANDING THAT THEY IF
SOMEONE, UM YOU KNOW DIETS BY
SUICIDE OR HURT SOMEONE ELSE
THAT THEY COULD POTENTIALLY BE
LIABLE IF THEY PUT DID OR DID
NOT PUT SOMEBODY ON THE WHOLE
DISTANCE. SO FOR ALL OF THOSE
REASONS, WE ORIGINALLY OPPOSED
THE BILL. WE'RE STILL LOOKING AT
THE AMENDMENTS TO ENSURE THAT
THEY HAVE THAT SORT OF SAFETY.
NET OF COUNTY DESIGNATION AND
APPRECIATE SO MUCH THAT
COMMITTEE'S WORK AND HELPING TO
MOVE THIS BILL TO A BETTER
PLACE. THANK YOU. THANK YOU.
THAT'S RIGHT. THIS AFTERNOON,
MADAM CHAIR COMMITTEE MEMBERS,
UM DEBRA DISABILITY RIGHTS.
CALIFORNIA AH. WE ARE HERE IN
RELUCTANT OPPOSITION. WE THINK
THE AUTHOR IS WORKING ON
SOMETHING VERY IMPORTANT WITH AN
INTENT THAT WE SUPPORT. WE
DEFINITELY THINK CRISIS
RESPONSIBLE WORK BETTER IF THE
ROLE OF LAW ENFORCEMENT IS
REDUCED. WE THANK THE AUTHOR FOR
MEETING WITH DRC TWICE. AND WE
LOOK FORWARD TO CONTINUED
MEETINGS IN THE FUTURE. THIS
MORNING, SENATOR WAHABI AGREED
TO CONVENE A STAKEHOLDER GROUP
TO WORK ON THE VACCINE ISSUES
PRESENTED BY THE BILL. UM
GENERALLY SPEAKING, WE OPPOSE
ANY BILL THAT EXPANDS
INVOLUNTARY TREATMENT AND
UNFORTUNATELY WITH THIS BILL AH!
AS A SENATOR SAID, YOU KNOW, YOU
END UP HAVING TO CALL 911 AND
THAT'S ONE OF THE THINGS SHE
WANTS TO CHANGE. AND WE THINK
THAT EVEN WITH THIS BILL, UM
THERE WILL STILL BE CAUSED TO
911. AND IF THE PERSON IF
THROUGH THE TRUST IN THAT
RELATIONSHIP THAT THERAPIST HAS
WITH THE CLIENT THE CLIENT CAN
BE CONVINCED TO GO VOLUNTARILY.
THEN YOU DON'T NEED AN
INVOLUNTARY HOLD. DON'T NEED
THAT 5150. BUT THE DEFAULT UNDER
THE BILL IN EXPANDING THE 5150
AUTHORITY, THE DEFAULT THEN
BECOMES 5150. BUT THEN WE'RE
THINKING THAT WE THINK IT'S
UNCLEAR JUST HOW THIS IS GOING
TO PLAY OUT IN REAL TIME BECAUSE
WE THINK A THERAPIST TO
THERAPIST THINKS A CLIENT IS IN
CRISIS, AND THAT THERAPIST HAS A
HISTORY WITH THE CLIENT.
HOPEFULLY, THERE'S TRUST IN THAT
THERAPIST CLIENT RELATIONSHIP.
IT WILL LEAD TO THE CLIENT BEING
ABLE TO GET CARE. ON A VOLUNTARY
BASIS. IF THE THERAPIST THINKS
IT HAS TO GO DOWN THE ROAD OF A
5150. WE DON'T SEE HOW THEY'RE
GOING TO TRANSPORT A PERSON WHO
DOES NOT WANT TO GO TO THE
HOSPITAL TO THE HOSPITAL, AND WE
THINK LAW ENFORCEMENT IS GOING
TO GET CALLED AND THAT'S HOW IT
WILL PLAY OUT IN REAL TIME. UM
WE RAISED THE ISSUE WITH SENATOR
WAHAB THIS MORNING ABOUT JUST
WHEN A THERAPIST WOULD BE ABLE
TO EXERCISE THIS AUTHORITY,
ALTHOUGH IT IS TRUE THAT
THERAPISTS ARE MANDATED
REPORTERS FOR THINGS THEY
WITNESS AT ANY TIME. I THINK THE
SENATOR AGREES THAT THIS PERSON
OCULAR 5150 AUTHORITY SHOULD BE
LIMITED TO SITUATIONS WHERE THE
THERAPIST IS PERFORMING THEIR
USUAL BUSINESS FUNCTIONS. SO WE
ARE NOT PREPARED TODAY TO
SUGGEST ANY LANGUAGE, BUT WE
LOOK FORWARD TO PARTICIPATING IN
A STAKEHOLDER CONVENING. WE
WOULD BE REALLY HAPPY IF WE
COULD NOT ONLY REMOVE OUR
OPPOSITION BUT ALSO MOVED TO A
SUPPORT POSITION. THANK YOU VERY
MUCH. THANK YOU VERY MUCH.
OTHERS SPEAKING IN OPPOSITION
COME FORWARD THIS TIME. HMM.
CALIFORNIA'S IS IN RESPECTFUL
OPPOSITION AND CONVERSATION WITH
THE AUTHOR. THANK YOU. ANDREA
RIVERA ON BEHALF OF THE
CALIFORNIA PEN ETHNIC HEALTH
NETWORK. WE ARE OPPOSED TO THE
VERSION OF THE BILL. IT IS
IMPRINTING ARE REVIEWING THE
AMENDMENTS. THANK YOU. THANK YOU
VERY MUCH. OKAY? UM WELL AS AS
WE'VE HAD A LOT OF
CONVERSATIONS. WE'VE WORKED A
LOT ON THIS ON THIS BILL, AND SO
WHAT IT NOW DOES IS SAY, RAISE
THE COUNTY IS THAT DESIGNATE
DECIDE WHO THOSE PEOPLE ARE
EXCITED 4200, AND I THINK YOU'RE
GOING TO WORK ON SOME MORE
INFORMATION FOR ME FOR SOME
OTHER COUNTIES, AND I RESPECT
WHERE THE SENATORS TRYING TO GET
THAT IS A CONVERSATION THAT WE
NEED TO CONTINUE TO HAVE
ONGOING. ABOUT TRYING TO GET LAW
ENFORCEMENT OUT AND LICENSED
PROFESSIONALS IN BUT AT THIS
POINT, THE BILL WILL SAY THAT
THE COUNTIES HAVE THE AUTHORITY
TO DESIGNATE PEOPLE. ANY OTHER
QUESTIONS AT THIS TIME,
SENATE-ROOM. THANK YOU, MADAM
CHERRY. I DO HAVE A QUESTION A
COUPLE OF QUESTIONS OF THE
AUTHOR TO GO DIRECTLY TO THE
WITNESS. SURE, OKAY. THROUGH THE
CHAIR. YOU TALKED A LITTLE BIT
ABOUT HOW THAT PLAYS OUT ON THE
GROUND. I GET WHERE THE AUTHOR
IS TRYING TO GO. WE HAVE PEOPLE
ON THE STREETS HAVE SEEN BILLS
COME THROUGH THIS BUILDING IN
THIS VERY COMMITTEE WHERE
PARENTS ARE PLEADING WITH US TO
ALLOW THEM TO BE ABLE TO PROVIDE
MEDICAL, YOU KNOW, MANDATED
MEDICAL BUT MANDATED MEDICAL
BECAUSE THEY WOULD SHOW US
PICTURES WHERE THE INDIVIDUALS
LUCID IN NORMAL AND HAD A JOB,
AND NOW THEY'RE ON THE STREET
NAKED AND THEY CAN'T FUNCTION.
THEY'RE NOT FUNCTIONING IN WHAT
THEY WHAT IS A SAFE PLACE FOR
SAFETY, HUMAN HUMANITY PLACE. UM
SO I UNDERSTAND WHERE THE AUTHOR
IS TRYING TO GO. BUT I GUESS THE
QUESTIONS THAT I HAVE I WANT TO
KNOW HOW IT PLAYS OUT BECAUSE
THE WAY I SEE IT, I'M NOT A
LICENSED PROFESSIONAL, BUT THE
WAY I SEE IT IS YOU'RE TREATING
SOMEONE YOU THINK THERE IS AN
IMMINENT THREAT OR THERE'S
SOMETHING THAT HAPPENS AND YOU
ARE GOING TO RISK THIS MAN
BECAUSE HE'S YOUR YOU KNOW, NO
OFFENSE, BUT YOU KNOW WHAT I
MEAN. YOU'RE IS THAT WHAT WOULD
HAPPEN OR ARE YOU GOING TO PICK
UP AND CALL LAW ENFORCEMENT 911,
AND YOU CAN CALL ENFORCEMENT 911
. NOW I UNDERSTAND OR NOT, SO,
UM, YES, YOU'RE YOU'RE VERY X,
NOT A THREAT VERY CLOSE TO IT. I
THINK THAT WAS OUR INITIAL
QUESTION. WHEN WE SAW THE
ORIGINAL VERSION OF THE BILL WAS
WHAT NEXT, RIGHT? ONCE YOU'VE
THEORETICALLY PUT SOMEBODY ON A
HOLD, AND THIS GOES TO
DISABILITY RIGHTS, CALIFORNIA'S
COMMENTS YOU'VE YOU'VE
DETERMINED THAT THIS PERSON IS
THAT SUCH A HIGH RISK THAT THEY
NEED TO BE EVALUATED FOR BY A
TRAINED CLINICIAN TO DETERMINE
WHETHER THAT TEMPORARY HOLD
NEEDS TO BE EXTENDED AND WHETHER
INVOLUNTARY TREATMENT IS NEEDED
ON A LONGER BASIS, BECAUSE
SOMETIMES THESE EPISODES ARE
SPORADIC AND OR TEMPORARY, RIGHT
, SOMEONE MAY ANY ANY PERSON
COULD HAVE SUICIDAL IDEATION
RIGHT? IT'S NOT JUST THE PERSON
WHO ENDS UP ON THE STREET, 51
FIFTIES ARE FAR MORE COMMON.
RIGHT PEOPLE. PEOPLE HAVE
TERRIBLE MOMENTS WHERE THEY
CONTEMPLATE DEATH BY SUICIDE.
AND SO IT IS. IT IS ASSUMED THAT
THERE IS A BROADER CATEGORY OF
PEOPLE WHO MIGHT FALL INTO THAT
DANGER TO SULFUR, OTHERS
CATEGORY. AND THEN THERE IS A
MUCH SMALLER SUBSET WHO MAY NEED
MORE SIGNIFICANT, ONGOING
INVOLUNTARY TREATMENT IN ORDER
TO MAKE A DETERMINATION ABOUT
WHICH CATEGORY YOU FIT INTO. YOU
NEED TO BE TRANSPORTED TO WHAT'S
CALLED A DESIGNATED FACILITY
PLACE WHERE THOSE PROFESSIONALS
WHO CAN DO THAT MORE THOROUGH
EVALUATION WHO HAVE BEEN TRAINED
AH ARE AND TO DRC'S POINT YOU
NEED TO BE ABLE TO PHYSICALLY
TAKE A PERSON TO THAT PLACE. AND
SO THE REAL UNDERLYING PROBLEM
IS AROUND THAT RESTRAINT AND
TRANSPORTATION ISSUE. UM WHICH
IS WHY THE LAW ENFORCEMENT
QUESTION IS CHALLENGE
CHALLENGING ONE RIGHT? THERE ARE
VERY FEW INDIVIDUALS AND
ENTITIES THAT HAVE BEEN IMBUED
WITH THE POWERS AND THE
AUTHORITY TO RESTRAIN SOMEONE
AGAINST THEIR WILL, AND
PHYSICALLY MOVE THEM FROM ONE
PLACE TO THE OTHER. SO
UNFORTUNATELY, THAT IS STILL A
PROBLEM IF WE WIDELY EXPAND THE
NET OF WHO'S GIVEN THE AUTHORITY
TO PUT SOMEONE ON A HOLD THOSE
PEOPLE THEN HOW DO HOW AND IN
WHAT WAY? DO THEY DO SOMETHING
ABOUT THAT HOLD? I GUESS MY
QUESTION IS, IS IT THE
EXPECTATION? IF YOU ARE A
LICENSED PROFESSIONAL, IS THAT
THE EXPECTATION THAT YOU DO IT
UNDER THIS BILL? YOU TRANSPORT
THEM. THIS BILL LEAVES THAT
QUESTION ENTIRELY OPEN. OKAY
THERE ARE ONLY SO MANY PEOPLE
WHO CAN DO THAT RIGHT? SO IT'S
ENFORCEMENT AND CERTAINLY MTS
WHO ARE TRAINED IN THAT WAY,
EVEN MOST OF OUR MOBILE CRISIS.
TEAMS CAN'T DO THAT, IF IT DOES
GO TO THE COUNTY DESIGNATION
UNDER THE CHAIRS, ASSUMING THE
COMMITTEE'S AMENDMENTS IS THERE
A LIKE A STANDARD OPERATING
PROCEDURE? WHO THE COUNTY CAN
DISEASE? THAT ALREADY IN PLACE?
YES SO THAT'S SOMETHING THAT'S
PART OF THE TRAINING. IT'S
UNDERSTANDING. WHAT ARE YOU
DOING WHEN YOU PUT SOMEBODY ON A
HOLD? WHAT DOES THIS PUT INTO
MOTION? WHAT DOES IT MEAN FOR
YOU AS A PROFESSIONAL? WHAT DOES
IT MEAN FOR THE INDIVIDUAL? AND
WHAT DO YOU DO NEXT? WHAT ARE
THE STEPS THAT FOLLOW
UNDERSTANDING ALL OF THAT IS
REALLY IMPORTANT WHEN IT COMES
TO THIS KIND OF VERY HIGH RISK
SITUATION, AND IT IS HIGH RISK
FOR EVERYONE FOR THE
INDIVIDUALS. EVOLVED AND FOR THE
COMMUNITY. THANK YOU. THE LAST
QUESTION I HAVE, MADAM CHAIR IS
I LOOK AT IT FROM Tð CAUSES. I
MEAN, I'M SURE YOU'RE VERY
CAPABLE IN YOUR JOB. IF YOU HAVE
A £200 CLIENT, THAT'S A MAIL IT
I DON'T SEE HOW YOU'RE GOING TO
APPREHEND THAT CLIENT AND TAKE
HIM IN. THAT'S WHERE I SEE THIS
GOING. BUT I COULD BE WRONG. I
THINK YOU PICK UP THE PHONE AND
CALL 911 THAT WE WANT TO
ELIMINATE 911 AND LAW
ENFORCEMENT. SO I SEE THAT I SEE
THE CONFLICT. WHAT ABOUT THE
LIABILITY PIECE? WHAT IF THIS
BILL PASSES IF THE BILL PASSES
AND IT GETS SIGNED WHERE IS THE
LIABILITY LIE? DOES IT LIE LIE
WITH THE INDIVIDUAL? THERAPIST.
YES THEY MAKE A DETERMINATION
THAT THEY SHOULD GO. AND THEN
SOMETHING HAPPENS TO THAT
INDIVIDUAL OR WHERE DOES IT LIE
NOW? MURKY LIABILITIES TIED UP
IN THIS IN THE SENSE THAT IF
YOU'RE A CLINICIAN, S¼ AND
PATIENT IN THE COURSE OF YOUR
VISIT, SAYS SOMETHING AND YOU
DETERMINE OKAY. THEY MAY HAVE
MENTIONED I WANT TO DIE. BUT DO
I THINK THAT THIS IS CREDIBLE?
NO AND THEN THAT PERSON DIES BY
SUICIDE. YOU KNOW, THE FAMILY
COULD SAY YOU. YOU HAD THE
AUTHORITY. YOU HAVE THE POWER TO
PUT THIS PERSON ON A HOLD. BUT
YOU DIDN'T. AND NOW MY LOVED ONE
IS DEAD SO THEY COULD GO AFTER
THAT PERSON INDIVIDUALLY. OKAY
THANK YOU. SO CAN I ADDRESS SOME
OF THE QUESTIONS? YOU HAVE TO
YOU NEXT, MA'AM? SORRY. THANK
YOU. SO YOU RAISE A COUPLE OF
GOOD QUESTIONS, RIGHT? AND I
WANT TO BE VERY FRANK. THE
ORIGINAL BILLS INTENT ONE. THIS
DOES NOT ELIMINATE POLICE
OFFICERS FOR MAKING A 5150 CALL
AT ALL RIGHT, EXPANDS IT TO
PROFESSIONALS WHO ARE ALREADY
DEALING WITH THESE INDIVIDUALS.
THEY ARE DESIGNATED BY THEIR
INDIVIDUAL COUNTIES THROUGH
WHETHER THAT CERTIFICATION
TRAINING AND SO FORTH, RIGHT? SO
WE WANT TO MAKE SURE THAT WE ARE
ENSURING THAT THE INDIVIDUALS
WORKING WITH THESE COMMUNITIES
OR A STRAINED AS POSSIBLE IN
FOLLOWING THE GUIDELINES, NUMBER
ONE NUMBER TWO IS THAT IN THE
CITY OF HAYWARD, WE HAVE
INITIATED A LOT OF EFFORT AROUND
THIS SPECIFICALLY TO HAVE AN
APPROPRIATE RESPONSE TO CRISIS
CALLS. AND I WANT TO BE VERY
CLEAR. I HAVE WORKED ON THIS
PARTICULAR ISSUE FOR A NUMBER OF
YEARS. ONE WE DID A SURVEY
WITHIN OUR OWN INTERNAL POLICE
FORCE. POLICE OVERWHELMINGLY DO
NOT WANT TO HANDLE MENTAL HEALTH
CALLS NOR HOMELESS CALLS. IT IS
THEY ARE NOT SOCIAL WORKERS.
THEY DO NOT HAVE THE QUALIFIED
TRAINING TO DEAL WITH A MENTAL
HEALTH OF VALUATION OR ANYTHING
LIKE THAT. THEY ARE USUALLY
CALLED AND THEN WORK WITH
SOMEBODY TO MAKE THAT ASSESSMENT
, INCLUDING THE NEGOTIATION
TEAMS, THE CRISIS RESPONSE TEAMS
AND MUCH. MORE, UM HOWEVER, THE
INDIVIDUALS THAT ARE WORKING AT
COMMUNITY BASED ORGANIZATIONS
INDIVIDUALS THAT HAVE THEIR
OTHER TYPES OF ORGANIZATIONS
THAT WORK IN THIS SPACE OR
HAVING A SIGNIFICANT AMOUNT OF
DIFFICULTIES, SO TO YOUR
REFERENCE OF A FAMILY MEMBER
BEGGING SOMEBODY TO PLEASE MY
MOTHER, MY FATHER, MY BROTHER,
MY SISTER. MY LOVED ONE IS
STRUGGLING. I KNOW THAT THEY
HAVE ISSUES, BUT THEIR
MEDICATION IS OFFER. THEY'RE NOT
TAKING IT ANYMORE OR ANYTHING
LIKE THAT. PLEASE HELP THAT IS
HAPPENING TODAY. AND WHEN THEY
CALL 911 BECAUSE 911 HAVE OTHER
ISSUES TO TAKE CARE OF ROBBERIES
, RAPES, MURDERS THAT ARE
CONSIDERED PRIORITY ONE CALLS
RIGHT. THEY WILL TRIAGE THAT AS
TO WHAT THEIR PRIORITY IS. I
HAVE GONE ON THE NUMBER OF RIDE
ALONGS WITH MY POLICE AS WELL.
AND OFTEN TIMES WE WERE ON A
CALL WHERE POLICE STATED THAT
THERE WAS AN INDIVIDUAL THAT WAS
ON THE TRAIN TRACK. THAT'S
RIGHT. YOU DON'T KNOW EXACTLY
WHAT'S HAPPENING ON THOSE TRAIN
TRACKS IN THE MIDDLE OF THE
NIGHT WAS MIDNIGHT. UH AND THE
CALL WAS I DON'T KNOW IF THEY'RE
TRYING TO COMMIT SUICIDE OR DO
SOMETHING WEIRD, AND POLICE ARE
AFRAID OF THAT INDIVIDUAL THAT
THEY'RE RESPONDING TO IS
INTERESTED IN COMMITTING SUICIDE
BY COP RIGHT? WHICH MAKES THE
POLICE OFFICER SCARED A LITTLE
BIT, TOO, AND HAVE A HEIGHTENED
A LITTLE ANXIETY. WHEN THEY'RE
APPROACHING THOSE CALLS. WE ALSO
KNOW DOMESTIC VIOLENCE CALLS OR
THE RISKIEST CALLS AND SO IN OUR
CITY, WE ENSURE THAT POLICE WERE
STILL RESPOND. ENDING DOMESTIC
VIOLENCE CALLS. I WILL SAY THAT
THIS DOES WORK. IT'S SO FAR IN
THE CITY OF HAYWARD, IT'S IN ITS
THIRD YEAR. AS FAR AS
TRANSPORTATION. I DO WANT TO BE
VERY CLEAR. WE ARE FOCUSED ON
POLICY HERE BUT AS A PROCEDURAL
MOVE, UM WE HAVE INITIATED A LOT
OF THINGS AND WE'VE SEEN WHAT
WORKS AND WHAT DOESN'T WORK.
FIREFIGHTERS ARE ABLE TO
TRANSPORT PEOPLE AS WELL. THEY
DO NOT CARRY A WEAPON, THEY ARE
ABLE TO RESPOND IN A LOCAL CITY
A LOT FASTER THAN POLICE BECAUSE
THEY ARE NOT. ON AS MANY CALLS
61% OF 911 CALLS IN THE CITY OF
HAYWARD ARE ACTUALLY ABOUT
HEALTHCARE. SO WHEN YOU CALL 911
YOU'RE SAYING I HAVE A HEART
ATTACK? I'M NOT FEELING WELL.
THINGS LIKE THAT, AND 39% ARE
RELATED TO CRIME RIGHT OR SOME
TYPE OF ISSUE THAT A POLICE
OFFICER ATTENDS. SO I WANT TO
PRIORITIZE THAT AND JUST
EXPLAINED THAT THE COMMUNITIES
THAT ARE LARGELY AFFECTED DO NOT
GO TO THE DOCTOR AS A REGULARLY
DO NOT HAVE THERAPY AS REGULARLY
MAY NOT. EVEN KNOW THAT THEY
HAVE OPTIONS OR EVEN IMMIGRANT
COMMUNITIES WHERE MENTAL HEALTH
STIGMA AND MENTAL HEALTH ACROSS
THE BOARD IS NOT REALLY WELL
UNDERSTOOD, APPROPRIATELY
DISCUSSED OR ANYTHING LIKE THAT,
INCLUDING IN MY COMMUNITY. THERE
HAVE BEEN CONVERSATIONS THAT YOU
KNOW WE HAVE TO BE CULTURALLY
APPROPRIATE AND SO FORTH. BUT
THERE ARE COMMUNITIES THAT
BELIEVE THAT IF YOU HAVE
DEPRESSION, YOU SHOULD TOUGHEN
UP. THERE ARE COMMUNITIES THAT
BELIEVE THAT IF YOU'RE
SCHIZOPHRENIC, YOU WERE
POSSESSED BY THE DEVIL. THERE
ARE COMMUNITIES THAT ARE NOT
WELL EQUIPPED TO HANDLE THIS AND
THE TRUST THE COMMUNITY BASED
ORGANIZATIONS THAT THEY MAY HAVE
A RELATIONSHIP WITH IN THEIR
INDIVIDUAL CITIES OR COUNTIES
AND SO FORTH THAT SPEAK THEIR
LANGUAGE. SO FORTH. A LOT OF
THESE THERAPISTS OF DIFFERENT
BACKGROUNDS USUALLY WANT TO WORK
AND SUPPORT THEIR OWN
COMMUNITIES. THAT'S ONE PIECE TO
THE COMMENTARY THAT WAS MADE
ABOUT LICENSED CLINICAL SOCIAL
WORKERS OR LFTS, THAT
POTENTIALLY DO NOT NECESSARILY
HAVE THE TRAINING ACROSS THE
BOARD. THERE'S ABOUT 3000 HOURS
THAT THEY HAVE TO HAVE TO GET
LICENSED BY THE STATE. SO THEY
DO HAVE A SIGNIFICANT AMOUNT OF
TRAINING. AND OF COURSE, WE HAVE
STATED THAT FROM THE COUNTY
PERSPECTIVE, WHATEVER OTHER
TRAINING OR CLARIFICATION THEY
WANT, OF COURSE, WE WILL OBLIGE
AS HAPPILY AS POSSIBLE. UM
HOWEVER, POLICE OFFICERS DON'T
HAVE THE SAME AMOUNT OF TRAINING
REGARDING MENTAL HEALTH. AS FAR
AS NON PROFITS, THEY CAN SIMPLY
GET A GRANT AND RETROFIT A
VEHICLE. A BUS VAN SOMETHING
LIKE THAT. BUT WE HAVE ALSO SEEN
A LOT OF COLLABORATION WITH THE
HOSPITALS WITH THE AMBULANCE
SERVICE WITH MUCH MORE. SO I
THINK THAT AGAIN. THIS IS A
START TO AN ISSUE THAT WE
CLEARLY SEE FOR FAMILIES THAT
ARE STRUGGLING THAT ARE REACHING
OUT THAT DO HAVE THEIR
INDIVIDUAL LOVED ONE IN SOME
TYPE OF AGENCY THAT HAS ACTUALLY
SPENT A YEAR WITH THEM TWO YEARS
WITH THEM SEEING THEM. DO WELL
AND MAYBE THEIR MEDS ARE OFF OR
SOMETHING LIKE THAT, UM AND THE
PEOPLE THAT VOLUNTARILY COME.
THEY VOLUNTARILY COME TO THE
INDIVIDUAL THAT THEY TRUST THAT
THEY HAVE BEEN WORKING WITH, UM
AND AGAIN WHEN WE TALK ABOUT
PARANOIA OR SCHIZOPHRENIA OR
ANYTHING LIKE THAT, UM, SOME OF
THESE INDIVIDUALS HAVE A NATURAL
OPPOSITION TO AUTHORITY AND
THAT'S WHAT IF LAW ENFORCEMENT
COMES INTO PLAY. NOT THAT THEY
SHOULDN'T COME INTO PLAY. UM IN
SOME INSTANCES, THEY ARE A
LITTLE BIT MORE AGITATED,
WHEREAS WITH THEIR THERAPIST,
THEIR CASEWORKER, THEIR SOCIAL
WORKER, THINGS LIKE THAT. THEY
MAY WILLINGLY AND CALMLY
ACTUALLY GO. SO EVEN IF THEY ARE
£200 300 POUNDS, 6 FT. 5 6 FT
FOUR. SO WE HAVE SEEN THIS WORK.
I WOULD LIKE TO INITIATE THIS ON
A STATEWIDE LEVEL AND OBVIOUSLY
HAVE TO DO IT THROUGH AN
UMBRELLA. TEAR TEAR TEAR TEAR TO
GET TO EXACTLY WHAT I NEED IN
THE STATE. BUT I WILL SAY THAT
THIS HAS BEEN LARGELY SUCCESSFUL
. IT IS CALLED THE HEART PROGRAM
IN THE CITY OF HAYWARD. I URGE
EVERYBODY TO TAKE A LOOK AT IT,
OR FIREFIGHTERS FULLY SUPPORTED
AS WELL AS OUR THERAPIST, SO I'M
HAPPY TO ADDRESS ANY OTHER
CONCERNS. SENATOR DAHLE SORRY.
THANK YOU VERY MUCH. I DO. I
REALLY I THINK EVERYBODY ON THIS
DIOCESE REALIZES THAT WE HAVE A
PROBLEM. I TOOK A CALL YESTERDAY
FROM ORANGE COUNTY RESIDENT WHO
IS OUR SON IS SUFFERING FROM
PSYCHOSIS AND THEY CAN'T DO
ANYTHING ABOUT IT BECAUSE HE'S
20 YEARS OLD. YES SO I THINK WE
ALL REALIZE THE PROBLEM. I'M
JUST NERVOUS ABOUT THE UM, WE
MAKE DECISIONS ON A 10,000 FT
LEVEL, BUT IT'S HARD FOR ME TO
DIGEST HOW THIS IS GOING TO WORK
ON THE GROUND. SO I DO WANT TO
LOOK AT YOUR PROGRAM THAT YOU
HAVE THE HEART PROGRAM. THANK
YOU AGAINST AN AGRO OF THIS BILL
JUST SIMPLY SAYS THE COUNTY IS
RESPONSIBLE FOR DESIGNATING
PEOPLE. THANK YOU. THANK YOU
VERY MUCH, MADAM CHAIR AND THANK
YOU FOR BRINGING THIS FORWARD. I
THINK WHAT HAS BEEN SAID IS WHAT
I AGREE WITH AS WELL,
ABSOLUTELY. WE SEE A PROBLEM
WITH THE LAW ENFORCEMENT ASPECT
OF IT. HOW DO WE LESSEN THAT?
THAT'S WHAT WE ALL AGREE ON. I
ALSO TO HAVE A HEART PROGRAM IN
THE CITY OF LONG BEACH. IT'S A
PILOT PROGRAM, AND WE KNOW THAT
IT'S GOING TO HAVE AN END DATE.
YOU KNOW VERY SOON, SO I'M GLAD
WE'RE HAVING THIS DISCUSSION.
BUT MAYBE THIS IS FOR YOUR
WITNESSES. OR IF YOU HAVE THE
INFORMATION WHAT COUNTY OUTSIDE
OF THOSE SORT OF HODGEPODGE
PILOT PROGRAMS THAT WE HOPE
WOULD BE SUSTAINABLE. THE
COUNTIES WERE DEFAULTING WITH
THESE AMENDMENTS WITH THE COUNTY
DESIGNATION. ARE THERE ANY GAPS
CURRENTLY? I MEAN, YOU TALKED
ABOUT THE TYPES OF OBVIOUSLY
THERE ARE LOTS OF GAPS. I KNOW,
RIGHT? BUT DO YOU TALKED ABOUT
THE TYPES OF LICENSES LICENSED
THERAPISTS, SOME THAT MIGHT NOT
BE ACTIVE. DO WE STILL SEE THAT
WITHIN THE COMPANY, SO I WILL
SAY THAT EVEN FOR EXAMPLE, A
PERSON CAN GET LICENSED AND
GRADUATE AND, YOU KNOW, GO
THROUGH THE GRADUATE PROGRAM,
BUT SOME PEOPLE WANT TO EARN
MORE MONEY RIGHT? AND SO THEY
HAVE THEIR LICENSE AND THEY END
UP BEING AN ELECTED OFFICIAL
INSTEAD OF, YOU KNOW, WORKING IN
SOCIAL WORK OR THERAPY. I WILL
SAY THAT OFTEN TIMES AND WE ARE
WORKING ON AN AMENDMENT TOGETHER
. WE HAD THIS CONVERSATION
EARLIER TODAY IS TO WE ARE NOT
TAKING IT IN THIS PARTICULAR
COMMITTEE BECAUSE IT'S A
DIFFERENT AMENDMENT. UM TO
CLARIFY THAT LANGUAGE AS TO WHEN
CAN THESE INDIVIDUALS
POTENTIALLY DO IT? SO THERE ARE
PLENTY OF GAPS IN MENTAL HEALTH
SPACES. WHEN WE TALK ABOUT
POLICY, THE COUNTY, THE CITY'S
EMERGENCY HEALTH AND SO FORTH,
BUT SPECIFICALLY WITH THIS
COUNTY DESIGNATION, BECAUSE
OBVIOUSLY THIS IS WHAT WE'RE
DOING. IT MAY CHANGE LATER,
OBVIOUSLY, AS YOU'RE DISCUSSING
AND GOING TO HAVE MEETINGS WITH
EVERYBODY, THAT'S THE CURRENT
STRUCTURE AS IT STANDS TODAY.
YES, BUT PERHAPS CAN I ASK
WITNESSES AS WELL? NOT MY
WITNESSES. THE CHAIR. I'M SORRY.
THE OPPOSITION APOLOGIES. IT'S
BEEN A LONG DAY. UM DO YOU HAVE
ANY ADDITIONAL FEEDBACK ON THAT?
I WOULD JUST LIKE TO GET SORT OF
A LARGER PICTURE ON WHAT THAT
AND I WILL SAY, JUST IN WORKING
ON THIS BILL. WE'VE ASKED MR
CABRERA. IF WE CAN GET A NUMBER
OF EVERY COUNTY. HOW MANY DID
THEY HAVE THAT ARE DESIGNATED?
SHE SAID L, A COUNTY 42. AND SO
WE'VE ASKED FOR THAT INFORMATION
FOR EVERY COUNTY 4342 144,200
CLINICIANS DESIGNATED DESIGNATED
IN IN L A. YEAH. UM BILLY COUNTY
COUNTY. YEAH SO THOSE ARE ALL
COUNTY WORKERS OR NON COUNTY
WORKERS, SO IT'S A COMBINATION
OF COUNTY AND NON COUNTY. UM BUT
THEY WOULD BE CONTRACTED
PROVIDERS NONETHELESS, AND THE
CONTRACT IS ACTUALLY IMPORTANT
BECAUSE AGAIN THAT GOES TO HOW
WE CAN ASK, COMPEL THEM TO
REPORT TO US OR GIVE US WHAT WE
NEED TO BE COMPLIANT UNDER LPS
IF IT'S AN INDIVIDUAL
PRACTITIONERS, SOLO PRACTITIONER
HAS THEIR LICENSES, MAYBE SEEING
PEOPLE PRIVATE PAY OR WHATEVER
OUR RELATIONSHIP TO THAT
PROVIDER IS NIL. WE DON'T HAVE
ANY IDEA HOW WE CAN THAT THEY
EXIST THAT THEY'RE PUTTING
PEOPLE ON HOLD. SO WHAT? WE HAVE
NO LEVERAGE TO SAY HEY, IF YOU
DON'T REPORT THIS, THEN WE'RE
GOING TO GET FINED. BUT THEY
DON'T HAVE ANY YOU KNOW, NEED OR
DESIRE NECESSARILY TO REPORT TO
US, SO THOSE KINDS OF VERY LIKE
PRACTICAL ISSUES LOOM LARGE FOR
US, ASIDE FROM THE RISK AND
LIABILITY CONCERNS, I WOULD SAY,
YOU KNOW, IN TERMS OF THE
BACKGROUNDS OF PEOPLE WHO ARE
DESIGNATED BY COUNTIES, IT DOES
VARY, AND SO DOES THE
AVAILABILITY OF THESE CLINICIANS
COUNTY BY COUNTY AS WELL. SO IN
SOME COMMUNITIES, WE JUST DON'T
HAVE VERY MANY LICENSED
CLINICIANS PERIOD SO YOU'LL SEE
VERY LOW NUMBERS. AND THOSE
CLINTON YEAH, 42. 200 FOR A
COUNTY THAT HAS 10 MILLION
PEOPLE. YEAH SO WE'RE TRYING TO
HOPEFULLY EXPAND AND DO MORE
OUTREACH AND I'M ALSO LOOKING UP
GO, HOWEVER, THAT'S IN. THAT'S
JUST INDIVIDUALS. THEY ALSO HAVE
60 HOSPITALS THAT HAVE
DESIGNATION STATUS, SO IT'S A
BIGGER NET. I WOULD SAY IN L A
COUNTY. YES AND I'M ALSO LOOKING
AT SOME OF THEIR LPS CRITERIA
THAT'S HASN'T BEEN UPDATED SINCE
2016. SO WE'VE GOT SOME WORK.
WE'RE UPDATING A LOT OF INTO
YOUR POINT ALSO, WE HAVE OKAY.
SO FOR EXAMPLE, EACH COUNTY
HANDLES IT VERY DIFFERENTLY.
THERE'S NO UNIFORMITY COUNTY TO
COUNTY. I REPRESENT MULTIPLE
COUNTIES. THEY DON'T HANDLE IT
THE SAME WAY AND AT THE SAME
TIME, THOSE MEDICAL FACILITIES
IT'S BASED ON THE DELEGATION OF
AUTHORITY OF THEIR PSYCHOLOGIST,
SO IT'S NOT EVERY SINGLE
INDIVIDUAL THAT WORKS THERE EVEN
WITH THE CREDENTIALS THAT THEY
HAVE, SO IT'S LIMITED IN SOME
COUNTIES SIGNIFICANTLY, MAYBE
EXPANDED IN SOME COUNTIES
SIGNIFICAN INTEREST AND I WOULD
JUST SAY AS THE ONLY LICENSE
PERSON SITTING UP HERE. AND WHO
DID HAVE 3200 OF SUPERVISED
HOURS AND SET FOR ALL THE TESTS.
DON'T GO OVER STEP BY STEP FROM
5150. IT'S A DIFFERENT KIND OF
WORK, RIGHT? MELANIE IS A MSW
RIGHT? SHE PROBABLY HASN'T
WORKED IN DIRECT PRACTICE FOR A
VERY LONG TIME. RIGHT SO JUST TO
SAY EVERYBODY WHO'S GOT ONE CAN
DO. IT IS RIGHT AND THAT'S WHY
THE COUNTY IT'S NOT. IT'S NOT
COVERED IN SCHOOL. IF YOU HAVE A
PLACEMENT IN WHICH YOU DO THAT
KIND OF CRISIS WORK. THEN YOU'LL
GET EXPERIENCE AT IT. BUT IF YOU
DON'T THEN YOU'RE NOT GOING TO
GET THAT KIND OF EXPERIENCE.
WHICH IS WHY THIS BILL KIND OF
AGAIN UNDERSTANDING THAT THERE'S
A BIGGER ISSUE OUT THERE. BUT
THIS BILL JUST NARROWS IT DOWN
TO SAY. WHICH IS EXISTING THAT
COUNTIES ARE THE DESIGNATED
PERSON TO AUTHORIZE WHO CAN DO
IT AND WHO CAN'T ONE LAST THING
I WILL JUST ADD JUST TO THINK
ABOUT AS YOU'RE DISCUSSING THIS.
THE CITY OF LONG BEACH HAS ITS
OWN HEALTH DEPARTMENT, SO EVEN
MORE CUMBERSOME FOR US TO GET
MENTAL HEALTH DATA. AND SO AS
YOU'RE THINKING ABOUT THE
COUNTIES. YOU SHOULD THINK ALSO
ABOUT THE JURISDICTIONS LIKE THE
FOUR CITIES ACROSS THE STATE
THAT HAVE HELPED DEPARTMENTS AND
THAT ALSO HAVE TO WORK DIRECTLY
WITH THE COUNTIES THAT MAY NOT
BE SUPPORTED AS MUCH AS THEY
SHOULD BE IN MENTAL HEALTH. AND
IN THIS REALM, SO YEAH, AND
SADLY, WE ALSO KNOW COUNTIES
DON'T NECESSARILY NOT ALL OF
THEM PRIORITIZE MENTAL HEALTH AS
WELL. SO THERE ARE SOME COUNTIES
THAT LITERALLY IT'S VERY MINIMAL
FUNDING AND MUCH MORE. SO WE
HAVE SIGNIFICANT CONCERNS THAT
WE HAVE TO ADDRESS MOVING
FORWARD. HEY, SENATOR MENJIVAR.
THANK YOU, MADAM CHAIR. I MISSED
A BIG CHUNK OF THIS CONVERSATION
. I DON'T KNOW IF THIS IS
REPETITIVE, BUT I HAD INITIAL
CONCERNS AS SUSSEX. A LOT OF THE
PEOPLE IN THE DAYS HAD SOME OF
THE SIMILAR CONCERNS OR SOME OF
THE CONCERNS FOR ME IS THE
UNINTENDED CONSEQUENCES IN TERMS
OF WHO? WHAT HAPPENS IN REAL
LIFE. DON'T KNOW AGAIN. IF THIS
IS TALKED ABOUT IF A THERAPIST
THEN PUTS ME ON A WHOLE DRY,
THEN WAY ON THE SOFA. WHO COMES
IN. DOES THE PET TEAM GET CAUGHT
FOR THIS? THERE'S NOT ENOUGH
PEOPLE IN THE PET TEAM. THAT WAS
SOME OF THE THINGS I'M SO
CONCERNED ON IN THE SHORT
CONVERSATION THAT I'VE HEARD, I
HAVEN'T HEARD ANYTHING THAT'S
ADDRESSING ANYTHING LIKE THAT
AGAIN. I AGREE WITH EVERYBODY
HERE THAT I TO WANNA REMOVE LAW
ENFORCEMENT FROM THESE KIND OF
CALLS. I DO WANT TO MAKE SURE I
DON'T KNOW IF THERE'S CAPACITY
IN THIS BILL LATER ON. TO ADD
THIS JUST THE PROCESS OF WHAT IT
WOULD LOOK LIKE, UM, AFTER
SOMEONE PUT SOMEONE ON A HOLD TO
THE THERAPIST. I KNOW THEY
DON'T. BUT DOES THE THERAPIST
THEN DRIVE THIS INDIVIDUAL TO
THEIR LOCAL E R. SENATOR? WE DID
TALK ABOUT THIS. I FIGURED JUST
VOICING IT. I I'M GOING TO BE
VOTING FOR THIS BILL BY
RESERVING MY RIGHT THAT ONCE WE
GET IT TO THE FLOOR, IT'S MORE
ROBUST, SO THIS BILL SIMPLY
EXPANDS THE DESIGNATION OF WHO
CAN YEAH, INITIATIVE 5150 RIGHT
NOW, EVEN WITH LAW ENFORCEMENT,
SO, FOR EXAMPLE, THERE IS A CASE
OF AN INDIVIDUAL WHO HAD
SCHIZOPHRENIA. UM, AND THEIR
FAMILY MEMBERS WERE WORKING WITH
THE STRIKE TEAM IN L A AND THEY
WERE UNABLE TO GET THEM TO HAVE
A HOLD AND PLACED ON HOLD RIGHT,
EVEN THOUGH THE THERAPISTS AND
SO FORTH THAT WERE ON THAT TEAM
SPECIFICALLY SAID, YES. THIS
INDIVIDUAL IS NOT STABLE AND SO
FORTH. IT TOOK ROUGHLY TWO WEEKS
BECAUSE THE STRIKE TEAM HAD TO
GO OUT MULTIPLE TIMES AND STILL
COULDN'T PLACE THEM ON A 5150
HOLD. THEY KEPT CALLING LAW
ENFORCEMENT BY THE TIME LAW
ENFORCEMENT CAME AN HOUR AWAY
TWO HOURS AWAY, HAD OTHER
PRIORITIES BECAUSE LAW
ENFORCEMENT HANDLES MOSTLY CRIME
RELATED ISSUES. UM THIS
INDIVIDUAL WOULD LEAVE. YOU KNOW
YOU CAN'T HOLD THEM THERE RIGHT
NOW, HOWEVER, WE HAVE SEEN OTHER
TYPES OF EFFORTS WHERE, IF A
5150 IS PLACED ON AN INDIVIDUAL,
AND THEY ARE ONE WILLING TO WORK
WITH THEIR PARTICULAR PERSON
THAT THEY'RE TALKING TO THAT
THERAPIST THAT THEY HAVE A
RELATIONSHIP WITH OR THERE IS NO
SENSE OF AUTHORITY OVER THAT
PERSON, FOR EXAMPLE, A LAW
ENFORCEMENT OFFICER WITH THE
POLICE AND YOU KNOW, UM, A GUN
AND SO FORTH. THEY ARE MORE
WILLING TO GO WITH THE
INDIVIDUAL. WE'VE ALSO TALKED
ABOUT DEFINITION OF 5150 IS
SOMEONE THAT DOESN'T WANT TO GO?
NO TECHNICALLY, IT'S A LITTLE
BIT OF BOTH IN THE SENSE OF I'M
TALKING ABOUT THE PROCESS THE
PROCESS SO YOU ASKED, SO WE'RE
TALKING ABOUT POLICY OF
INITIATING 5150. BUT I ALSO WANT
TO SAY THAT THE QUESTION SO FAR
HAVE BEEN ABOUT PROCESS SO WHAT
DOES THE NONPROFIT DO? WHAT IS
THE THERAPY? THERAPISTS DO SO
FORTH? RIGHT QUESTION LIKE, IF
YOU'RE THE STRIKE TEAM IS ON THE
STREET. AND IF THEY HAD THE
ABILITY RIGHT THERE AND THERE TO
PUT THEM ON HOLD, THEY WOULD
STILL HAVE TO WAIT TWO WEEKS
BECAUSE THEY THEMSELVES CAN'T DO
ANYTHING PAST THAT. RIGHT? NO SO
THEY HAVE NOT BEEN ABLE TO
INITIATE THE 5150. THAT IS THE
PROBLEM IF THEY DO, EVEN IF THEY
SAID IN THE MOMENT I HAVE THE
AUTHORITY, I AM NOW PLACING YOU
AT 5150. HMM. THAT'S AS FAR AS
IT WOULD GO. NOT NECESSARILY
BECAUSE FROM A PROCESS
PERSPECTIVE AGAIN, THIS WOULD BE
PROCESSED. THE ORGANIZATION THAT
EMPLOYS THE STRIKE TEAM COULD
ALSO HAVE THE TOOLS FOR THEIR
PARTICULAR EMPLOYEES TO BE ABLE
TO CARRY OUT THEIR JOB, SO THAT
COULD MEAN AND WE'VE TALKED
ABOUT THIS. FOR EXAMPLE, IN THE
CITY OF HAYWARD, FOR US
INTERRUPT YOU FOR A SECOND,
BECAUSE I THINK WHAT THE
SENATORS IS SAYING. YOU HAVE
BEEN TOLD US THAT REPEATED THAT
THOSE ARE PRACTICE ISSUES. WHAT
SHE IS SAYING IS BEFORE THIS.
THIS BILL WOULD NEED MORE WORK
TO BE ABLE TO ADDRESS MORE OF
THOSE THINGS BEFORE PEOPLE WOULD
FEEL COMFORTABLE WITH IT. THIS
BILL SIMPLY SAYS THE COUNTY IS
THE DESIGNATED ASIDE. WHO CAN
INSTITUTE OF 5150 WHO CANNOT IF
WE'RE SEEING THAT NOT OLD
COUNTIES LOOK AT MENTAL HEALTH.
AS A DIRE SITUATION AND WE'RE
GIVING THEM THE ABILITY TO THEN
DESIGNATE. WHOEVER THEY WANT TO
DESIGNATE. ISN'T THERE A PLACE
TO BE WORRIED ABOUT THAT? IT'S
EXISTING LAW, SENATOR OH, THAT'S
RIGHT. THAT IS TRUE. THAT'S HOW
4200 PEOPLE ARE DESIGNATED. IF
YOU DON'T MIND MY ANSWER. I MEAN
, THE EVERY SINGLE COUNTY IS
RESPONSIBLE FOR THE DELIVERY OF
SPECIALTY MENTAL HEALTH AND
SUBSTANCE USE DISORDER SERVICES
UNDER CONTRACT WITH THE STATE OF
CALIFORNIA. AND SO EVERY COUNTY,
OF COURSE, HAS A SIGNIFICANT SET
OF SERVICES FOR PEOPLE WITH
SEVERE PERSISTENT MENTAL ILLNESS
AND, UM, SO I WOULD SAY THE
DEGREE TO WHICH EACH OF THOSE
COUNTIES HAS EXTRA COUNTY
GENERAL FUND THAT THEY'RE ABLE
TO ADD ON TOP OF THE FUNDING
THAT THE STATE AND FEDERAL
GOVERNMENTS PROVIDE IS VARIABLE,
AND SOME COUNTIES ARE VERY CASH
STRAPPED. AND SO THERE IS NOT
THAT MARGIN. YOU KNOW, WE DO SEE
SOME COUNTIES ARE IN A POSITION
POLITICALLY TO PASS TAXES, FOR
EXAMPLE, THAT HELPED AUGMENT
THEIR MENTAL HEALTH SERVICES.
THOSE TEND TO BE IN THE BAY AREA
AND THOSE SORTS OF PLACES SO
THERE ARE DIFFERENCES ACROSS THE
STATE AND A LOT OF THAT HAS TO
DO WITH RESOURCES THAT SOME OF
THE WORK THAT WE'VE BEEN DOING
THE LAST COUPLE OF YEARS AS
REQUIRING MORE DATA REQUIRING
MORE TRANSPARENCY AND
INFORMATION ON 51 FIFTIES AND
WHAT THE TREATMENT WAS WHAT THE
OUTCOME WAS A LOT OF THOSE
THINGS THAT WORK THAT WE THAT WE
WEREN'T WE WEREN'T COLLECTING IN
A GOOD WAY BEFORE AND DOING
ANYTHING WITH THAT DATA. THAT'S
SOME OF THE THINGS THAT WE'VE
BEEN WORKING ON THE LAST COUPLE
OF YEARS TO MAKE THAT PROCESS OF
WHICH IS WHAT SCARBOROUGH SAID
WHICH, DESIGNATING ANYBODY WOULD
MAKE IT MORE DIFFICULT BUT TO BE
ABLE TO GET REAL NUMBERS AND
OUTCOMES ON HOW EVERY COUNTY IS
DOING THIS AND WHO NEEDS HELP?
AND WHO DOESN'T? IF THERE ARE NO
OTHER QUESTIONS. WOULD YOU LIKE
TO CLOSE, SENATOR SENATOR RUBIO?
SORRY THIS IS JUST BASED ON
EVERYTHING THAT I HEARD HERE
BECAUSE I THINK THAT WE ALL HAVE
THE SAME INTENTION OF TRYING TO
TAKE CARE OF THOSE THAT ARE YOU
KNOW, OUR FAMILY MEMBERS ARE
STRUGGLING, BUT I THINK I HEARD
YOU SAY YOU HAVE A PROGRAM AND
HAYWORTH AND I HEARD THE SENATOR
FROM LONGVIEW TO SAY THAT SHE
HAS A PROGRAM AND HER
JURISDICTION. I THINK WE JUST
SHARED YOU HAVE 500,000, WHICH
IS A BIG COMMUNITY. YOURS IS
ABOUT 160,000. I'D LIKE TO SEE
AND I KNOW WE'RE TALKING ABOUT
DATA COLLECTED, LIKE FOR SOMEONE
THAT HAS SMALLER COMMUNITIES. UM
AND I THINK I HEARD YOU SAY THAT
IT WORKS. WELL, I'D LIKE TO SEE
MAYBE IN THE FUTURE AWAY TO
CONDENSED LIKE THIS INFORMATION
FOR LIKE LOCAL AGENCIES,
JURISDICTIONS, COUNTIES TO BE
ABLE TO GO AND SEE WHAT THE BEST
PRACTICES ARE BECAUSE I YOU KNOW
FROM HEARING YOU AS WELL AS
HEARING THAT THE SENATOR FROM
LONG BEACH IT FEELS LIKE THERE'S
A THE ANSWER. IS THERE
SOMEWHERE, RIGHT? BUT FOR
SOMEONE JUST DRIVING FROM
SCRATCH MAY BE DIFFICULT. SO
JUST THE THOUGHT OF YOU KNOW,
MAYBE THE FUTURE MAKING SOME
KIND OF WEBSITE WHERE WE CAN GO
TO FOR INFORMATION SO THAT WE
CAN, YOU KNOW, REFER OUR LOCAL
COMMUNITIES TO GO GET DATA, BUT
THANK YOU. I WAS GONNA SAY I HAD
A LOT MORE QUESTIONS. BUT GIVEN
THAT IT'S THE SENATOR'S
BIRTHDAY, I DECIDED I'M GOING TO
GO EASY ON HER. NOT HAPPY. HAPPY
BIRTHDAY SOON. THANK YOU. OKAY
ANY OTHER QUESTIONS OR COMMENTS
SEEN ON SENATOR WOULD YOU LIKE
TO CLOSE AND CENA RUBIO HAVE
ASKED SCARBOROUGH FOR THAT
INFORMATION NOT FOR THE WEBSITE.
BUT JUST FOR LIKE, TELL US WHAT
EVERY COUNTY IS DOING. BUT I
WOULD ENCOURAGE EVERYBODY TO
CALL YOUR LOCAL COUNTIES AND
SAY, HOW MANY PEOPLE DO YOU HAVE
DESIGNATED? CAN I SEE YOUR
PROCESS BECAUSE THEY ALL HAVE TO
HAVE A PROCESS FOR IT. OKAY
WOULD YOU LIKE TO CLOSE? THANK
YOU. WELL, ONE. I JUST WANT TO
THANK THE WITNESSES HERE. WE
HAVE BEEN IN CONVERSATION AND WE
WILL CONTINUE OUR CONVERSATIONS.
I WILL SAY PERSONALLY, MENTAL
HEALTH IS INCREDIBLY IMPORTANT
TO ME. I HAVE STATED TO EVEN THE
OPPOSITION THAT YOU KNOW, I WILL
CONTINUE TO WORK IN THIS AREA.
WE DO HAVE A LOT OF DIFFERENT
GAPS. AT THE STATE SIDE AT THE
COUNTY SIDE, EVEN THE CITIES AND
EMERGENCY RESPONSE IT. THERE'S
NOT ONE THING THAT CAN SOLVE
EVERY SINGLE PROBLEM AND I THINK
THAT FOR ME, THIS BILL IS A
START TO AT LEAST EXPAND, WHO
ARE ON THE FRONTLINES, WORKING
WITH COMMUNITIES IN NEED, AND I
RESPECTFULLY ASK FOR AN I THANK
YOU VERY MUCH AND THE MOTION. DO
WE HAVE A MOTION TO MOVE THE
BILL? SUMMER SENATOR REMOVED BY
SENATOR LIMÓN AND THE MOTIONS DO
PASS AND REFER THE COMMITTEE ON
JUDICIARY. SECRETARY, WOULD YOU
CALL THE ROLL? SENATORS EGMOND
EGMOND, I WHEN, WHEN? NO GLASER
GLASER, I, GONZALEZ GONZALEZ. I
GROVE. HER TAITO TAITO? AYE
LIMÓN. MENJIVAR MENJIVAR. AYE,
ROTH. RUBIO. BY RUBIO I HOB HOB
BY WINNER WINNER AYE. 1010 1
WILL HOLD THE ROAD OPEN FOR ANY
ABSOLUTE MEMBERS. AND NOW LET'S
MOVE BACK UP TO 99 SP 26TH,
SENATOR AMBERG MENTAL HEALTH
PROFESSIONS CARE SCHOLARSHIP
PROGRAM SECRETARY. PLEASE CALL
THE ROLL. SENATOR WEN. SB 20
SCHOLARSHIP WHEN I GLASER.
GLASER I GROVE. HER TAITO. HER
TATO. I LIMÓN LIMÓN I MENJIVAR
RI ROTH. OKAY THAT'S 10 0 10
YEAR OLD. HOLD IT OPEN FOR A
MINUTE AND THEN FINALLY SP 294,
SENATOR WIENER. THE PASS AND
REFERRED TO THE COMMITTEE ON
APPROPRIATIONS. FIRST SECRETARY.
PLEASE CALM DOWN. SENATOR WEN.
WIENER AM ARE 294. I DON'T KNOW.
YEAH. NO, NO. WHEN NO. GLASER
GLASER, I GROVE HER TAITO. HER.
TATO AYE. LIMÓN LIMÓN. AYE
MENJIVAR MENJIVAR. AYE ROTH. 91.
OKAY I'M ALREADY VOTED ON THAT
ONE. RIGHT? AH, I'M GOING CRAZY.
OKAY WE'LL LEAVE THAT ONE OPEN
AND ENCOURAGE CENTER GROVE TO
COME ON BACK. HE'S ON OUR WAY, I
THINK, BUT THEN I WOULD THINK
THE REST OF YOU FOR OUR FIRST
HEALTH COMMITTEE HEARING OF
2024TH. EXACTLY. WOW MANY YEARS
WHAT'S THAT, SAYING? THAT'S WHAT
SHE TRIED GETTING INTO HER
PHONE.
NUMBER 26 HAMBURG SENATOR GROVE
GROVE. I YOURSELF THROUGH THE
ROTH. FROM 11 0 11 0. THAT BILL
IS OUT. THE ROLE IS CLOSED. SP
294 WINNER SENATOR GROVE GROVE,
WHO? NO NO, NO. AND ROTH 9 TO 92
. NO WAS THERE TUNA 92. THAT
BILL IS OUT. THE ROLE IS CLOSED
AND ON SB 4021 HOB SENATOR GROVE
ENOUGH, SENATOR ROTH 9191. THAT
BILL IS OUT AND THE ROLE IS
CLOSED AND THIS CONCLUDES THE
HEALTH COMMITTEE HEARING. HUESO.