GOOD AFTERNOON, THE SENATE
COMMITTEE ON HEALTH WILL COME TO
ORDER I AM YOUR CHAIR, RICHARD
ROTH. AND THIS IS SENATE HEALTH.
WE CONTINUE TO WELCOME THE
PUBLIC TO PROVIDE IN-PERSON
COMMENT AT THE APPROPRIATE TIME.
WE'RE GOING TO ALLOW SIX MINUTES
FOR TESTIMONY PER SIDE TODAY,
BUT DON'T FEEL OBLIGATED TO USE
ALL THAT TIME. IF YOU DON'T NEED
TO. ONE BILL WAS PULLED FROM
TODAY'S HEARING. SENATE BILL
999. WE HAVE EIGHT BILLS ON
TODAY'S AGENDA, WITH THREE OF
THEM BEING ON OUR PROPOSED
CONSENT CALENDAR. SENATE BILL
945, SENATE BILL 1333 AND SENATE
BILL 112. AT THE APPROPRIATE
POINT IN TIME. WE WILL. CALL FOR
THE QUORUM. IN THE INTERIM, WE
WILL CONTINUE TO FUNCTION AS A
SUB COMMITTEE AND I WILL PUT OUT
THE REQUEST FOR AUTHORS TO
REPORT TO THE SENATE HEARING
ROOM FOR THE SENATE HEALTH
COMMITTEE TO START PRESENTING
BILLS A S¼ A P THANKS FOR THOSE
OF YOU WONDERING, WE'VE HAD A
TELEPHONE OUTAGE IN THE BUILDING
. AND SO WE'RE UNABLE TO SUMMON
MEMBERS BY TELEPHONE, SO
HOPEFULLY THEY'RE WATCHING ON
THE TELEVISION AND THEY SEE ME
CALLING FOR THEM TO COME DOWN
AND START THIS PROCESS.
SENATOR MENJIVAR. ARE YOU
PREPARED TO PRESENT SENATE BILL
950 THREE. ITEM NUMBER SEVEN.
THAT WAIT FOR MY ENOUGH SAID,
THANK YOU.
OK PLEASE FUNCTIONING AS A
SUBCOMITTEE STILL, BUT WE'RE
GOING TO CALL ITEM NUMBER SEVEN
SENATE BILL 950 THREE, SENATOR
MENJIVAR ME MENSTRUAL PRODUCTS.
PLEASE PROCEED WHEN READY. HERE
WE GO. WE WILL MAKE DO HERE. HØI
GOOD AFTERNOON. UH, FELLOW
COMMITTEE MEMBERS, I'M HERE TO
TALK TO YOU ABOUT S¼ B 953 A
SIMILAR BILL THAT I PRESENTED IN
THIS COMMITTEE LAST YEAR. IT IS
THIS YEAR'S PERIOD EQUITY NOW.
FIRST I ACCEPT THE COMMITTEE'S
AMENDMENTS, AS STATED IN THE
BILL ANALYSIS ON PAGE FOUR. SO
LET'S GET INTO IT. LET'S TALK
ABOUT PERIODS PERIOD. EQUITY IS
A PUBLIC HEALTH ISSUE. IT IS
CRUCIAL FOR THE WELL BEING
MENTAL AND PHYSICAL HEALTH OF
MENSTRUATING PEOPLE. ESPECIALLY
OUR MOST VULNERABLE ON ME,
RECOGNIZING IT AS A HEALTHCARE
NECESSITY ALIGNS WITH THE
BROADER PUBLIC HEALTH GOALS,
PREVENTING REPRODUCTIVE HEALTH
ISSUES. SEPSIS CERVICAL CANCER
AND OVARIAN CANCER. THIS BILL
WILL HELP ADDRESS THE DANGERS IN
EQUITY OF PERIOD. POVERTY
AMONGST CALIFORNIANS ON MEDI BY
REQUIRING THE DEPARTMENT OF
HEALTH CARE SERVICES SEEK THE
NECESSARY FEDERAL WAIVERS TO
IMPLEMENT MEDICAL COVERAGE FOR
MENSTRUAL PRODUCTS. THIS WILL
THEN REMOVE THE FINANCIAL BURDEN
FROM ME. RECIPIENTS THAT
SOMETIMES IS ATTACHED AND
PURCHASING THESE ITEMS. WE HAVE
SOME FEDERAL PRESIDENT IN THIS
WITH THIS WITH THIS BILL. IN
2020, THE FEDERAL GOVERNMENT
CLASSIFIED MENSTRUAL PRODUCTS AS
MEDICAL EXPENSES. THEN IN 2020
THREE, OUR OWN, UH, STATE PUT
OUT A REPORT LOOKING TO ADDRESS
PERIOD POVERTY. UM TO ADDRESS
PEER POVERTY AND IS ASKING FOR
DEPARTMENT OF HEALTH A Dð HÌ èC
S¼ TO EXAMINE POTENTIAL OPTIONS
FOR SUBMITTING A WAIVER FOR
REIMBURSEMENT NOW, THE REPORT
ASKED THE DEPARTMENT THAT THEY
LOOK INTO, UM, A WAY TO INCLUDE
MEDIC, UH, MENSTRUAL PRODUCTS AS
A REIMBURSEMENT. MY BILL IS
SAYING THAT WE SHOULD SUBMIT A
WAIVER TO HAVE THIS BE
REIMBURSED UNDER MEDI CAL. THIS
WOULDN'T BE THE FIRST THING THAT
THE STATE HAS ASKED FOR A WAIVER
, A WAIVER THAT IS OFTEN KNOWN
AS THE, UM 1115 WAIVER. WE HAVE
ASKED FOR OTHER WAIVERS TO
ADDRESS THE WHOLE PERSON OF
INDIVIDUAL A STATE AS A WHOLE IS
MOVING TOWARDS ADDRESSING THE
ENTIRE NEEDS OF THE PERSON SOME
EXAMPLES OF WAIVERS THAT WE'VE
HAD FOR ME ARE STRAIGHT OUT OF
OUR èC AIM INITIATIVE WHERE WE
CAN NOW REIMBURSE FOR HOUSING.
NAVIGATION. UM, HOUSING, UM DOWN
PAYMENTS AND SO FORTH. WE ARE
TAKING THE SAME APPROACH THAT
THE STATE HAS TAKEN IN OTHER
ITEMS TO REIMBURSE WITH THIS
BILL S¼ B 9553. BECAUSE I
STARTED EARLY. I DON'T KNOW IF
MY WITNESSES ARE THEY SHE IS
HERE. ONE WITNESS IS UNABLE TO
BE HERE. UH, MR CHAIR WITH YOUR
PERMISSION, I'D LIKE TO NOW TURN
TO MY, UM, WITNESS. PLEASE
PROCEED. AFTERNOON CHAIR
MEMBERS. MY NAME IS JENNIFER
ROBLES. OH, OK. YES WE, UH, WE
HAVE A NEW PROCESS HERE. WE
ALLOW YOU TO SIT DOWN. WELCOME.
THANK YOU. UM DO I JUST PUSH THE
BUTTON? YES, MA'AM. SHOULD BE ON
IF YOU STATE YOUR NAME AGAIN. UM
I'LL START OVER GOOD AFTERNOON
CHAIR MEMBERS. MY NAME IS
JENNIFER ROBLES WITH HEALTH
ACCESS CALIFORNIA, THE STATE
WIDE HEALTH CARE CONSUMER
ADVOCACY COALITION, DESPITE
CALIFORNIA'S PREVIOUS EFFORTS IN
TACKLING PERIOD POVERTY, IT'S
ESSENTIAL TO RECOGNIZE THE
ONGOING FINANCIAL BARRIERS THAT
CALIFORNIANS FACE IN AFFORDING
PERIOD PRODUCTS. S¼ B 953,
SEEKING TO INCORPORATE MUNSTER
PRODUCTS AS IT COVERED BENEFIT
UNDER ME, HELPS CLOSE THE
DISPARITY IN MENSTRUAL INEQUITY
BY RELIEVING THE FINANCIAL
STRAIN ON MANY LOW INCOME
INTRATOR, PARTICULARLY AS
MEDICAL HAS ZERO COST SHARING OR
DEDUCTIBLES. THIS LEGISLATION
WOULD PROVIDE BENEFITS TO A
BROAD SPECTRUM OF MEDICAL
BENEFICIARIES SPANNING FROM
CHILDREN, TEENAGERS AND ADULTS
EARNING LESS THAN $20,000 A YEAR
. RESEARCH SUGGESTS THAT
MARGINALIZED AND LOW INCOME
INTRATOR FACE INCREASED HEALTH
RISKS BECAUSE OF INADEQUATE
AVAILABILITY OF PERIOD PRODUCTS
AS THEY ARE COMPELLED TO WEIGH.
THE COST AGAINST ESSENTIALS LIKE
FOOD, WITH MULTIPLE BARRIERS
ALREADY HINDERING THEIR ACCESS
TO CARE. THESE HEALTH RISKS
WOULD ONLY WORSEN THEIR
DIFFICULTIES. HEALTH ACCESS HAS
LONG ADVOCATED FOR CALIFORNIA TO
LEAD THE WAY AND INNOVATIVE
POLICIES SUCH AS THESE TO
IMPROVE THE HEALTH OF OUR MOST
VULNERABLE COMMUNITIES, AND IF
OUR STATE PROGRAMS COVERED BASIC
MENSTRUAL PRODUCTS AND THUS
RELIEVE MENSTRUATES FROM THIS
FINANCIAL BURDEN, CALIFORNIA
WOULD BOLSTER THE ONGOING
NATIONAL INTEREST AND
RECOGNIZING THAT MENSTRUAL
HEALTH IS HEALTHCARE. THANK YOU,
AND HEALTH ACCESS IS PROUD TO
SUPPORT S¼ B 953. THANK YOU FOR
JOINING US TODAY. ARE THERE ANY
OTHER SUPPORT WITNESSES IN ROOM
1200? PLEASE STEP FORWARD. GOOD
AFTERNOON, LINDA WAY WITH
WESTERN CENTER ON LAW AND
POVERTY AND SUPPORT. THANK YOU.
ANYONE ELSE? CRAIG PATRA ON
BEHALF OF EQUALITY, CALIFORNIA
IN SUPPORT. THANK YOU FOR
JOINING US NEXT, PLEASE. JOE
SIGNS ON BEHALF OF COUNTY HEALTH
EXECUTIVES ASSOCIATION AND
SUPPORT THANK YOU. GOOD
AFTERNOON CHAIR MEMBERS MARY
LOVAS WITH THE CALIFORNIA NURSES
ASSOCIATION IN SUPPORT. THANK
YOU ANY OTHER WITNESSES IN
SUPPORT? SEEING NONE. LET'S TURN
TO ANY WITNESSES IN OPPOSITION
ANY LEAD WITNESSES. SEEING NONE
ANY OTHER WITNESSES IN
OPPOSITION TO THIS MEASURE? OK
LET'S BRING THE CONVERSATION
BACK TO MY COLLEAGUES ON THE
DEUS COLLEAGUES ANY QUESTIONS,
COMMENTS OR CONCERNS? SO I JUST
WANNA THANK THE AUTHOR FOR
BRINGING THIS FORWARD. I KNOW
IT'S IMPORTANT FOR LOW INCOME
FAMILIES AND WHEN APPROPRIATE, I
LIKE TO MOVE IT. THANK YOU,
SENATOR. THANK YOU. ANY OTHER
QUESTIONS, COMMENTS OR CONCERNS?
NONE. WOULD YOU LIKE TO CLOSE?
THANK YOU COLLEAGUES FOR THAT
ROBUST CONVERSATION ON MY BILL.
THIS BILL SIMPLY IS DOING THE
FIRST STEP. WE ARE JUST GOING TO
THE FEDERAL GOVERNMENT TO
REQUEST A WAIVER, PLAIN AND
SIMPLE AS THAT. THANK YOU AGAIN
AND EVERY RESPECT TO ASK FOR AN
I VOTE. THANK YOU VERY MUCH.
SENATOR WE DO HAVE A QUORUM. IT
LOOKS LIKE SO LET'S CALL FOR THE
QUORUM. SENATOR ROSS. BROTH
HERE. WHEN HERE, GLAZER.
GONZALEZ. GROWTH. HURTADO
HURTADO HERE, LIMÓN. BEAR BEAR
HERE, RUBIO RUBIO PRESENT
SMALLWOOD CUEVAS WIENER. AND
PRESENT. OK COLLEAGUES. WE HAVE
A MOTION BY SENATOR RUBIO. THE
MOTION IS TO PASS AS AMENDED,
AND WE REFER TO THE COMMITTEE ON
APPROPRIATIONS. PLEASE CALL THE
ROLL. SENATOR ROSS ROTH. I WHEN
GLAZER. GONZALEZ. GROWTH.
HURTADO. FOR TAO. I LIMÓN MEN,
MEN I RUBIO RUBIO, I SMALL WOOD
QUAS WIENER. WIENER. I A THE
VOTE IS 50. WE'LL HOLD THE ROLL
OPEN FOR ABSENT MEMBERS. WHAT
HAPPENED? YOU HAVE ITEM NUMBER
TWO SENATE BILL 980 0. WOULD YOU
LIKE TO PROCEED? PLEASE PROCEED
WHEN READY. WHICH. RIGHT? GOOD
AFTERNOON, MR CHAIR AND MEMBERS.
I JUST WANT TO START OUT BY
SAYING I ACCEPT THE COMMITTEE
AMENDMENTS AND THANK YOU TO YOUR
COMMITTEE STAFF FOR HELPING US
WITH THIS BILL. MORE
SPECIFICALLY THE FACT THAT IT'S
ALREADY BEEN MORE THAN SIX
MONTHS THAT THEY'VE BEEN WORKING
WITH ME ON THIS BILL. SO THANK
YOU. UH S¼ B 980, BETTER KNOWN
AS THE SMILE ACT IS A BIPARTISAN
STEP TOWARD FAIR AND EQUITABLE
ACCESS TO DENTAL SERVICES FOR
ALL CALIFORNIANS, THE SMILE ACT
DOES TWO THINGS FIRST. IT'S
SIMPLY ALIGNED STATUTE TO
REGULATIONS FOR LAB PROCESS
CROWNS BY LOWERING THE STATUTORY
AGE OF 21 TO THE AGE OF 13 AS
LISTED IN REGULATIONS SECOND,
AND MORE IMPORTANTLY, THIS BILL
ENSURES DENTAL PLANTS ARE
COVERED BENEFIT UNDER THE
MEDICAL DENTAL PROGRAM. IN FACT,
ONE THIRD OF THE STATE'S
POPULATION, WHICH IS ROUGHLY 13
MILLION PEOPLE, IS ENROLLED IN
MEDI CAL, AND IN ORDER TO
QUALIFY FOR MEDICAL. A FAMILY
MUST BE AT 138% OF THE POVERTY
LEVEL. ACCORDING TO THE CENTERS
FOR DISEASE CONTROL AND
PREVENTION. THERE ARE
DISPARITIES IN EQUAL ACCESS TO
ORAL HEALTH. FOR INSTANCE, THE
MEDICAL DENTAL PROGRAMS CURRENT
POLICY MIGHT ALLOW FOR DENTAL
IMPLANTS IN VERY EXTREME CASES,
THOUGH PRIOR AUTHORIZATION MUST
BE GIVEN, AS WELL AS DOCUMENTED
PROOF PROVIDED OF AN EXCEPTIONAL
MEDICAL CONDITION. MEDICAL'S
DENTAL PROVIDER HANDBOOK
OUTLINES THESE CONDITIONS AS
CANCER OF THE MOUTH. SEVERE LOSS
OF UPPER AND LOWER JAWBONE.
SKELETAL DEFORMITIES ARE
TRAUMATIC DESTRUCTION OF THE JAW
, FACE OR HEAD. THAT'S WHAT YOU
NEED TO QUALIFY CURRENTLY. ASIDE
FROM THE EXTREME CASES I JUST
LISTED FOR YOU. DENTAL IMPLANTS
ARE NOT A COVERED BENEFIT IN THE
MEDI MEDICAL DENTAL PROGRAM.
HOWEVER THE PROGRAM DOES COVER
THE REMOVAL OF TEETH. AS WELL AS
EXISTING DENTAL IMPLANTS, BUT
PATIENTS DO NOT HAVE AN OPTION
FOR REPLACING THEM. ONE OF THE
CONSEQUENCES OF NOT HAVING A
MISSING TOOTH REPLACED IS
PERMANENT BONE LOSS BECAUSE THE
JAW IS NOT GETTING THE
STIMULATION IT NEEDS TO STAY
HEALTHY. MISSING A TOOTH CAN
LEAD TO ORAL DISEASE, POOR
NUTRITION AND IS LINKED TO
SYSTEMIC DISEASES LIKE DIAB
DIABETES AND CORONARY HEART
DISEASE. ACCORDING TO THE CENTER
FOR DISEASE CONTROL AND
PREVENTION, BILLIONS OF DOLLARS
ARE LOST IN PRODUCTIVITY IN THE
UNITED STATES EACH YEAR DUE TO
ORAL DISEASE, AND MILLIONS MORE
ARE SPENT ON THE CONSEQUENCES OF
AND HOSPITAL VISITS DUE TO ITS
NEGATIVE EFFECT ON OVERALL
HEALTH. ALTHOUGH CALIFORNIA HAS
MADE STRIDES IN ADDRESSING THE
ISSUES OF EQUITY AMONG ITS MOST
VULNERABLE COMMUNITIES, WE STILL
HAVE A LOT OF WORK TO DO TO
EFFECTIVELY ADDRESS THE NEEDS OF
THESE COMMUNITIES, ESPECIALLY
THE STATE'S GROWING AGING
POPULATION. AS I CALL IT THE
SILVER TSUNAMI. THE PUBLIC
POLICY INSTITUTE OF CALIFORNIA
TELLS US THAT CALIFORNIA WILL
EXPERIENCE AN EXPLOSIVE GROWTH
IN ITS AGING POPULATION IN THE
NEXT 30 YEARS, AND BY 2030,
WHICH IS SIX YEARS FROM NOW, ONE
IN EVERY THREE CALIFORNIANS WILL
BE OVER THE AGE OF 50. THIS
POPULATION MAKES UP THE
COMMUNITIES THAT CANNOT AFFORD
TO PAY OUT OF POCKET FOR DENTAL
CARE OR DO NOT HAVE PRIVATE
DENTAL INSURANCE. THEY ARE ON
FIXED INCOMES. THE SMILE ACT IS
A STEP TOWARD ENSURING FAIR AND
EQUITABLE ACCESS TO DENTAL
SERVICES. IT SAVES MILLIONS IN
HEALTHCARE COSTS THROUGH ITS
PREVENTATIVE AND EARLY
INTERVENTION EFFORTS AND ALLOWS
FOR A BETTER QUALITY OF LIFE FOR
ALL CALIFORNIANS WITH ME TODAY
IN SUPPORT IS ANGELA GARDNER,
BOARD MEMBER OF HEALTHY
CALIFORNIA NOW AND MEMBER OF
CALIFORNIA ALLIANCE FOR RETIRED
AMERICANS. GARNER WELCOME.
CAN YOU HEAR ME? YES, MA'AM.
PERFECT. THANK YOU, SENATOR.
GOOD AFTERNOON CHAIR ROTH AND
MEMBERS OF THE COMMITTEE. MY
NAME IS ANGELA GARDNER. I
CURRENTLY SERVE ON THE BOARD OF
DIRECTORS OF THE HEALTHY
CALIFORNIA NOW COALITION. AND
I'M A PROUD MEMBER OF THE
CALIFORNIA ALLIANCE FOR RETIRED
AMERICANS. AS AN ADVOCATE FOR
HEALTHCARE REFORM FOR MANY
YEARS. MY DESIRE TO ACHIEVE
HEALTH EQUITY IS ROOTED IN MY
OWN STRUGGLES TO ACCESS AND
AFFORD HEALTH CARE AS A PERSON
WITH A DISABILITY. IN 2006. I
HAD TO STOP WORKING DUE TO MY
DISABILITY, WHICH MADE ME
FORFEIT MY HEALTH CARE. DURING
THIS TRANSITIONAL PHASE OF MY
LIFE. I RETURNED HOME TO LIVE
WITH MY MOTHER WHO I STILL LIVE
WITH TODAY. BUT DESPITE THE
HEALTH CARE ADVANCES NATIONALLY
AT THE TIME, I WAS UNABLE TO
OBTAIN DENTAL COVERAGE UNTIL
2014 WHEN I WAS ACCEPTED INTO ME
NEARLY EIGHT YEARS LATER. FOR
EIGHT YEARS. I WENT WITHOUT ANY
DELL COVERAGE IN MY ORAL HEALTH,
DECLINED. MEDICAL DENTAL
BENEFITS HAVE HELPED ME IN MANY
WAYS I HAVE RECEIVED TEETH,
CLEANINGS, FILLINGS AND X RAYS
AND OTHER SERVICES AS COVERED
BENEFITS AND I AM GRATEFUL FOR
BUT AS I GET OLDER I MAY NEED
MORE SIGNIFICANT DENTAL WORK,
SUCH AS REQUIRING IMPLANTS,
WHICH IS NOT A COVERED BENEFIT
UNDER ME. S¼ B 980 WILL GIVE ME
THE PEACE OF MIND. OF KNOWING
THAT DESPITE THE GAPS IN DENTAL
COVERAGE AND CARE, DENTAL
IMPLANTS WILL BE COVER COVERED
BENEFIT FOR ME AND THE MILLIONS
OF CALIFORNIANS WHO DEPEND ON
MEDI CAL FOR THEIR DENTAL
COVERAGE, ESPECIALLY FOR SENIORS
AND PEOPLE WITH DISABILITIES.
ABOVE ALL THESE EXPERIENCES HAVE
TAUGHT ME THAT ORAL HEALTH IS
TRULY THE FOUNDATION OF OVERALL
HEALTH. I RESPECTFULLY ASK THIS
COMMITTEE TO TAKE A BOLD STEP
FORWARD TO ACHIEVE HEALTH EQUITY
AND EXPAND ACCESS TO AFFORDABLE
ORAL CARE. BYPASSING S¼ B 980
TODAY. THANK YOU. THANK YOU FOR
JOINING US. ARE THERE ANY OTHER
SUPPORT WITNESSES IN THE ROOM
SUPPORT WITNESSES IN SUPPORT OF
THIS MEASURE. S¼ B 980. YES
MA'AM. GOOD AFTERNOON, LINDA WAY
WITH WESTERN CENTER ON LAW AND
POVERTY IN SUPPORT. THANK YOU
FOR JOINING US. NEXT PLEASE.
KATIE VAN DYNES WITH HEALTH
ACCESS CALIFORNIA AND SUPPORT.
THANK YOU. THANK YOU. HELLO,
MONICA KIRKLAND OF SENIOR
SERVICES COALITION IN SUPPORT.
THANK YOU. THANKS, PLEASE. HELLO
JOE SIGNS WITH COUNTY HEALTH
EXECUTIVES ASSOCIATION IN
SUPPORT. THANK YOU. MAY I ASK A
GUY FOR THE CALIFORNIA
ASSOCIATION OF ORTHODONTISTS AND
SUPPORT DIANA MESHI PLASTER
COUNTY CONSTITUENT SUPPORT OF
THIS BILL, THANK YOU FOR COMING
DOWN WONG FROM KIRA. I'M FROM
SACRAMENTO AND I SUPPORT S¼ B
980. THANK YOU, SIR. NEXT,
PLEASE. I'M RON MARTIN OF THE
FRESNO, CALIFORNIA ALLIANCE OF
RETIRED AMERICANS AND I SUPPORT
980. THANK YOU, SIR. YES, MA'AM.
ARLENE HARRISON RETIRED
DEPARTMENT OF HUMAN ASSISTANCE
ME WORKER AND I SUPPORT THE
BILL. THANK YOU. YES, MA'AM AND
NOEL FELICE SMITH. I'M A RETIRED
REGISTERED NURSE AND I SUPPORT
THIS BILL. THANK YOU FOR JOINING
US NEXT, PLEASE. PATRICIA
CHADWICK WITH ONE PAIR STATES
AND I SUPPORT THIS BILL. RANDY
HICKS, CALIFORNIA'S DISABILITY
RIGHTS IN CAR AND STRONG
SUPPORT. THANK YOU, SIR. NEXT,
PLEASE. WEBER KA STRONG SUPPORT.
THANK YOU. KOTO RETIREE FROM S¼
IU 721 IN SUPPORT. THANKS.
FRANCIS CORNA, A RETIREE FROM
FRESNO COUNTY PROBATION AND S¼,
èC, IU AND 521 AND CARA AND I
SUPPORT THIS BILL. THANK YOU,
MA'AM. THANKS. PLEASE, SIR.
JAMES HACKETT, RETIREE FROM
FRESNO COUNTY. I WORKED WITH THE
DEPARTMENT OF SOCIAL SERVICES
FOR 31 YEARS AND I SUPPORT THIS
BILL. THANK YOU FOR YOUR
SERVICE. NEXT, PLEASE. HØI. MY
NAME IS RICHARD. I'M WITH KARA
AND I AM IN SUPPORT. THANKS. HØI
GOOD AFTERNOON, UM, CHAIR AND
MEMBERS BRIANNA PITMAN SPENCER
WITH THE CALIFORNIA DENTAL
ASSOCIATION. I'M HERE AS A
LITTLE BIT OF A TWEENER. WE
ACTUALLY HAVE A SUPPORTIVE
AMENDED POSITION. UM I REALLY
WANT TO APPLAUD THE SENATOR FOR
BRINGING THIS BILL FORWARD AND
THE TOPIC OF MEDICAL DENTAL
BENEFITS AND PARTICULARLY FOR
HER ADVOCACY FOR SENIORS OR
SENIORS, ORAL HEALTH CARE, UM,
AS WRITTEN IN OUR LETTER, WE DO
HAVE SOME CONCERNS WITH THE
STATE'S ABILITY TO ACTUALLY
IMPLEMENT A BENEFIT AS
COMPLICATED AND EXPENSIVE AS
IMPLANTS, JUST GIVEN SORT OF THE
STATUS OF THE PROGRAM AND THE
CHALLENGE THAT THEY HAVE, AND
SOME OF THE ADMINISTRATIVE
BURDENS THAT ARE IN PLACE ON
OTHER, LESS EXPENSIVE, LESS
COMPLEX PROCEDURES. UM IN
PARTICULAR, AS WE MENTIONED THE
CROWN'S RATE THAT EXISTS NOW IS
SO LOW THAT WE ONLY CAN ASSUME
THE INTENT IS TO DISCOURAGE
UTILIZATION. THAT'S DEFINITELY
SOMETHING WE THINK REALLY NEEDS
TO BE INVESTED IN, AND IF WE
WERE TO DO IMPLANTS, WE REALLY
WOULD NEED TO MAKE SURE THAT THE
RATE WAS SUFFICIENT. WE èC Dð
REALLY DOES STRONGLY SUPPORT THE
IDEA OF LOOKING AT THE MEDICAL
DENTAL PROGRAM AND THE BENEFIT
STRUCTURE AND MAKING SURE THAT
IT MEETS THE ORAL HEALTH NEEDS.
I THINK, AS THE SENATOR SAID, WE
AGREE WITH EVERYTHING, ALL OF
THE VOICES YOU HEARD? WE NEED TO
MAKE SURE THAT OUR ADULTS AND
SENIORS WHO ARE ON MEDI CAL ARE
ABLE TO MAINTAIN THEIR TEETH
GOING FORWARD. THERE ARE A LOT
OF HOLES IN THAT'S DENTAL
COVERAGE, IN ADDITION TO THE
IMPLANTS, SO THINGS THAT REPLACE
TEETH LIKE BRIDGES, PARTIAL
DENTURES, THE COVERAGE IS NOT
GREAT, AND WE REALLY WOULD LIKE
TO SEE THOSE THINGS CONSIDERED
ALONGSIDE, UM, IMPLANTS OR SO
YOU KNOW, SORT OF LOOKING AT
THIS SORT OF COMPREHENSIVELY. SO
WE HAVE REACHED OUT TO THE
SENATOR'S OFFICE. AND WE WOULD
REALLY LIKE THE OPPORTUNITY TO
WORK ON THIS AND TO LOOK AT
MEDICAL DENTAL BECAUSE WE THINK
THIS IS REALLY IMPORTANT,
PARTICULARLY WE'VE DONE A LOT OF
WORK ON KIDS. THERE'S A LOT OF
WORK LEFT FOR ADULTS AND IN
PARTICULAR ARE VULNERABLE
SENIORS. THANK YOU. THANK YOU,
MA'AM. NEXT, PLEASE. MR. CHAIR
GARY COOPER, REPRESENTING
CALIFORNIA ASSOCIATION OF ORAL
AND MAXWELL FACIAL SURGEONS. AND
WE HAVE MET WITH THE SENATOR AND
HER STAFF. WE'RE A BIT OF A
TWEENER AS WELL. WE'RE VERY
CONCERNED ABOUT THE CITIZENS
THAT SHE IS TRYING TO HELP. BUT
AS YOU KNOW, OUR DOCTORS DO MOST
OF THE IMPLANT WORK AND WE'RE
VERY CONCERNED ABOUT THE
EXPANSION OF THE IMPLANTS. IF
THERE ARE OTHER TYPES OF THINGS
THAT CAN BE DONE, AS OPPOSED TO
IMPLANTS, BUT WE'VE COMMITTED TO
THE SENATOR THAT WE WILL WORK
WITH HER AND HER STAFF. EVEN AS
OF YESTERDAY, I SPOKE WITH YOUR
STAFF AND WE'VE COMMITTED THAT.
WE WILL CONTINUE TO WORK WITH
YOU. AND SO AT THAT POINT, WE
STILL REMAIN NEUTRAL. BUT WE
WILL HOPE THAT THE BILL WILL
MOVE FORWARD. THANK YOU. THANK
YOU, SIR. ANY OTHER WITNESSES IN
SUPPORT, SAYING NONE. LET'S TAKE
ANY WITNESSES IN OPPOSITION
FIRST LEAD OPPOSITION WITNESSES.
SEEING NONE. ANY OPPOSITION
WITNESSES? I SEE NONE. SO LET'S
BRING THE DISCUSSION BACK TO MY
COLLEAGUES ON THE DAY COLLEAGUES
ANY QUESTIONS, COMMENTS OR
CONCERNS, SENATOR RUBIO, YOU
LOOK LIKE YOU. I THANK YOU, MR
CHAIR. UM, WELL AGAIN, THANK YOU
FOR THE ALTERNATE HERE. SOME OF
THE CONCERNS THAT THAT Tð IS NOT
OPPOSITION BUT TWEENERS
EXPRESSED AND THERE IS ALWAYS A
COST AND CONCERN IN TERMS OF
ADMINISTRATIVE ADMINISTRATIVELY
BEING ABLE TO PUT THIS FORWARD
AND YOU KNOW, I'M SURE THE
AUTHOR WILL CONTINUE TO WORK ON
SOME OF THESE ISSUES THAT I
THINK SHE'S ALREADY EXPRESSED.
BUT I DO THINK THAT YOU KNOW, I,
I THINK BESIDES THE OBVIOUS
ISSUES ALREADY MENTIONED, FOR
EXAMPLE, THE PERMANENT LOSS OF
BONE ORAL DISEASES AND JUST THE
POTENTIAL OF OTHER HEALTH ISSUES
THAT COME ALONG WITH IT. UM YOU
KNOW, I. I LIKE TO ALSO FOCUS ON
THE SOCIAL EMOTIONAL ASPECT OF
IT. YOU KNOW, I'VE SEEN SOME OF
MY SENIORS OR SENIOR CENTERS
SOMEWHAT WITH DRY AS SOON AS
THEY DON'T FEEL CONFIDENT, AND I
THINK AS A SENIORS BECOME OLDER,
WE WANT THEM TO CONTINUE TO BE
ACTIVE AND PARTICIPATE AND BE
PART OF THE SENIOR COMMUNITY.
BUT YOU KNOW WHEN THEY'RE HAVING
ISSUES, UH, DENTAL ISSUES OR
THEY LOSE THEIR Tð. AND THINGS
LIKE THAT ARE REALLY, UM RENTS
THEIR CONFIDENCE AND AGAIN IF WE
WANNA PRESSING TO BE HEALTHIER
AND LATER IN LIFE, THEN WE NEED
TO MAKE SURE THAT THEY HAVE
EVERY OPPORTUNITY TO CONTINUE TO
BE CONFIDENT AND PARTICIPATE IN
FULLY AND ACTIVITIES, UH, IN OUR
COMMUNITIES, SO I DO WANNA MOVE
THE BILL FORWARD AND I WILL BE
ADDING AS A CO-AUTHOR. THANK
YOU. THANK YOU, SENATOR, SENATOR
MJ. THANK YOU, MR PRESIDENT.
SENATOR I HAVE TWO QUESTIONS. MY
FIRST ONE IS, UH, IN IN THE
POLICY ANALYSIS IS SPOKE ABOUT
ENSURING THERE'S SOME KIND OF
LANGUAGE TO UTILIZE THIS AS A
LAST FORM OF RESORT THAT THERE
WERE OTHER OPTIONS STATED FROM
SOME PROVIDERS THAT COULD BE
BETTER FIT FOR THAT. DO WE SEE
SOME OR DO YOU SEE SOME CONCERN
IN UTILIZING THIS AS A GO
STRAIGHT TO THIS PROCEDURE.
THERE HAS BEEN A LOT OF
CONVERSATION AS YOU'VE HEARD
FROM EVEN FOLKS THAT YOU KNOW
SOME WOULD ASSUME WOULD BE IN
OPPOSITION, BUT CLEARLY THEY'RE
NOT, UH, ORAL HEALTH IS A
PRIORITY FOR A LOT OF PEOPLE
WHEN WE TALK TO, UH, LET'S SAY
SOME OF THE PROVIDERS AND THE
ORAL SURGEONS AND SO FORTH. UH,
BEFORE WE GET TO THE POINT OF A
LEGITIMATE IMPLANT, THERE ARE
SOME STEPS THAT WE COULD TAKE
WHICH WE ARE CONSIDERING. WE'RE
IN THE MIDST OF A CONVERSATION
IF YOU WILL. TO WHAT THAT LOOKS
LIKE, CLEARLY I'M NOT A DENTIST,
RIGHT? SO I DON'T KNOW EVERY
SINGLE CAVEAT. UM BUT, UH FOR AN
IMPLANT. OBVIOUSLY THEY HAVE TO
GO TO AN ORAL SURGEON AND, YOU
KNOW, HAVE TO SEE WHETHER THE
BONES CAN TAKE IT AND SO MUCH
MORE AND EVEN BEFORE THEY HAVE
TO REPLACE OR REMOVE A TOOTH.
YOU KNOW THERE'S POTENTIAL
PROCEDURES THERE. I THINK ONE OF
THE BIGGEST CONCERNS THAT YOU
HAVE HEARD IS THAT THE
REIMBURSEMENT RATE IS JUST
FAIRLY TOO LOW, RIGHT? UM AND
THAT'S PROBLEMATIC. WE WANT TO
BE ABLE TO ADVOCATE FOR
INCREASED RATES. WELL UM, BUT,
UH, THERE ARE SOME SOME SMALLER
STEPS BEFORE THAT THAT WE ARE
LOOKING INTO AS WELL. THAT WAS
GONNA BE MY SECOND PART. AS YOU
KNOW, YOU AND I HAVE TALKED
ABOUT THIS RIGHT? HOW CAN WE
BETTER INCREASE OUR MEDICAL
RATES FOR AN ARRAY OF THINGS AND
, YOU KNOW, HAVING PROVIDERS BE
PARTICIPANTS OF THE MEDICARE
PROGRAM UNDER DENTAL CARE IS
ALREADY VERY DIFFICULT. AND I
HOPE YOU AND I WILL CONTINUE
TALKING ABOUT HOW WE CAN BE
CREATIVE IN THAT SENSE, BUT
HAPPY TO SUPPORT YOUR BILL HERE.
THANK YOU. YOU WANNA ADD AS A
CO-AUTHOR? NOT AS A SUB THREE
CHAIR, YOU KNOW, RIGHT? YOU LOOK
AT THAT MONEY PART. THANK YOU
ANY OTHER QUESTIONS, COMMENTS OR
CONCERNS? SING NAN THE BILL HAS
BEEN MOVED BY SENATOR RUBIO. THE
MOTION IS TO PASS AS AMENDED. WE
REFER TO THE COMMITTEE ON
APPROPRIATIONS. WOULD YOU LIKE
TO CLOSE SENATOR BOB? I
RESPECTFULLY ASK FOR AN I VOTE
FOR THE SMILE ACT AS I'M
SMILING. OK? NICE PRESENTATION.
THANK YOU. PLEASE CALL THE ROLL.
SENATOR ROTH ROTH, I WHEN I AYE.
GLAZER GONZALEZ GROVE HURTADO
HURTADO. I LIMÓN LIMÓN I
MENJIVAR MENJIVAR. I RUBIO RUBIO
I SMALLWOOD QUAS WIENER WIENER.
I FOR A 70. WE HOLD THE DOOR
OPEN FOR ABSENT MEMBERS BEFORE I
CALL UP OUR CHAIR EMERITUS
SENATOR EGM FOR HER TWO BILLS.
LET'S TAKE THE CONSENT CALENDAR.
THERE ARE THREE BILLS ON THE
PROPOSED CONSENT CALENDAR.
SENATE BILL 945, SENATE BILL
1333 AND SENATE BILL 1112. IS
THERE A MOTION MOVE THE BILL
WHO? SENATOR RUBIO SENATOR MANAR
SENATOR MENJIVAR HAS MOVED THE
CONSENT CALENDAR. PLEASE CALL
THE ROLL. SENATOR ROTH. AYE,
ROTH. I WHEN LIKE WHEN I GLAZER
GONZALEZ? GROWTH HURTADO HURTADO
EYE LEMON, I LI I MENJIVAR
MENJIVAR. I RUBIO I RUBIO I
SMALLWOOD QUAS. WIENER. WE? I
CODE IS 70. WE'LL HOLD THE DOOR
OPEN FOR ABSENT MEMBERS. THAT DO
YOU? YEAH. SENATOR WELCOME. YOU
HAVE TWO ITEMS. THANK YOU. HELLO
FRIENDS. I'VE MISSED YOU. WE
MISS YOU. YOU ITEM NUMBER FOUR
IS 1017 17. THANK YOU, CHAIR AND
COMMITTEE MEMBERS HERE. UM
YOU'VE HEARD ABOUT THIS BILL
BEFORE? BECAUSE IT'S BEEN
ANOTHER ONE OF MY PRIORITIES.
I'VE WORKED ON AND WORKED ON AND
WORKED ON IT, AND WE USED TO
CALL IT A BED REGISTRY. BUT WE
ARE NOW GOING TO CALL IT A BED
SOLUTION. AS YOU KNOW, WHEN
PEOPLE ARE YOU KNOW OUR ER S¼
ARE ALL PACKED UP. PEOPLE COME
IN WITH A MENTAL HEALTH ISSUE.
THEY NEED TO MOVE TO A DIFFERENT
PLACE. DIFFERENT LEVEL OF CARE,
AND PEOPLE ARE GOING THROUGH
THEIR PAPER AND CALLING
DIFFERENT PLACES TO SEE IF THEY
HAVE A BED. A BED FOR A 75 YEAR
OLD, SUICIDAL, SUICIDAL FEMALE
WITH HEALTH ISSUES. BEDS CAN BE
VERY SPECIFIC VERSUS UH,
SOMEBODY WHO'S COMING IN WITH AN
OVERDOSE OF OXY. UM SO THIS
WOULD HAVE WOULD HAVE ALL THE
BEDS THAT ARE AVAILABLE AND DO A
WHOLE INVENTORY OF THEM AND THEN
HAVE A REGISTRY. WHERE WE HAVE A
PATIENT BEFORE A CLIENT BEFORE
YOU. THEY NEED TO BE MOVED TO A
BED. UM AND YOU'LL BE ABLE TO
FIND SOMETHING ONLINE ON TIME.
WHERE THAT NEXT PLACE WILL BE
REALLY IMPORTANT ISSUE, AND I
THINK IT'S ONE OF THE LAST
PIECES THAT WE NEED TO DO TO
REALLY ENSURE THAT OUR CONTINUUM
OF CARE IS UP AND FLOWING AS IT
SHOULD BE THAT PEOPLE CAN MOVE
UP AND DOWN THE CONTINUUM OF
CARE AS NEEDED WITHOUT HAVING TO
SEARCH FOR HOURS AND SOMETIMES
DAYS TO FIND A PLACE THAT IS
WILLING TO ACCEPT A PERSON. YOU
STILL HAVE TO GO THROUGH THE
WHOLE INTAKE PROCESS. BUT AT
PROVIDERS WOULD THEN KNOW WHERE
THERE WAS CAPACITY TO BE ABLE TO
SEND FOLKS UM, WITH ME TODAY TO
TESTIFY IS RANDALL HAGAR,
LEGISLATIVE ADVOCATE WITH THE
PSYCHIATRIC PHYSICIANS
ASSOCIATION ALLIANCE. PLEASE
PROCEED, SIR. THANK YOU,
CHAIRMAN ROTH AND MEMBERS OF THE
COMMITTEE RANDALL HAGER,
REPRESENTING THE PSYCHIATRIC
PHYSICIANS ALLIANCE IN
CALIFORNIA. EXCUSE ME A LITTLE
HORSE HERE. UM I HAVE
REPRESENTED PSYCHIATRISTS FOR
OVER 20 YEARS, AND THIS HAS BEEN
A CONTINUING PROBLEM. WHAT TO DO
WITH THE PATIENT WHEN YOU'RE
SITTING THERE AND THERE'S NÓ.
THERE'S NÓ ROOM AT THE END AS
FAR AS YOU KNOW, AND YOUR
IMMEDIATE NETWORK OF FACILITIES,
UM IT'S ALL 100% FULL. IT'S AT
CAPACITY. SO, UM, IT'S AMAZING
TO ME THAT AT THIS POINT TIME
WITH THE TECHNOLOGY THAT WE HAVE
IN THIS STATE WHEN YOU CAN
ACTUALLY PULL UP A RIDE FROM THE
AIRPORT TO YOUR HOTEL IN ABOUT
SEVEN OR EIGHT MINUTES WHERE YOU
CAN GET A CHOCOLATE MILKSHAKE
DELIVERED TO YOUR DOORSTEP. UM,
THOSE KINDS OF ALGORITHMS, AND
THAT KIND OF TECHNOLOGY IS OUT
THERE, BUT WE STILL CAN'T FIND
PSYCHIATRIC BEDS WHEN WE NEED
THEM. AND THEY CAN, AS SENATOR,
AMAN SAID, RUN THE GAMUT.
SOMETIMES THEY'RE GOING TO BE
DRUG AND ALCOHOL BEDS. SOMETIMES
IT'S IN PATIENT PSYCHIATRIC BEDS
FOR THOSE KINDS OF BEDS. WE ARE
TALKING ABOUT PEOPLE WHO ARE
VERY SICK, WHO PROBABLY ARE IN
AN ACUTE CRISIS AND THEY NEED TO
GO AND THEY NEED TO GO NOW AND
BEING ABLE TO DOWNLOAD A P Dð F
OFF THE DHCS SITE, UH, GO
THROUGH IT. PAGE BY PAGE. DO
COLD CALLING, UM, IS NOT AN
EFFICIENT PROCESS, AND IT
CERTAINLY DOESN'T ADVANTAGE. THE
PATIENT SO THAT'S WHY WE'RE HERE
TODAY. THIS IS WHAT THIS BILL IS
ABOUT. IT WILL CONNECT THE RIGHT
BED WITH THE RIGHT. AT THE RIGHT
TIME. UM AND I COULD GIVE YOU A
MORE EXAMPLES OF THAT. IF YOU'D
LIKE TO ASK ME QUESTIONS ABOUT
THAT LATER. WE HAVE REAL WORLD
EXAMPLES. BUT I WILL THINK, I. I
THINK I'LL LEAVE IT AT THAT AND
TURN IT OVER TO MY COLLEAGUE
HERE. THANK YOU. CHAIR. PLEASE.
STATE YOUR NAME FOR THE RECORD.
THANK YOU, MR CHAIR AND MEMBERS
DANNY OFFER WITH THE NATIONAL
ALLIANCE ON MENTAL ILLNESS ALSO
KNOWN AS NAMI, CALIFORNIA. UM
WE'RE THE STATEWIDE AFFILIATE OF
THE COUNTRY'S LARGEST MENTAL
HEALTH ADVOCACY ORGANIZATION. WE
HAVE OVER 100, 10,000 MEMBERS
AND 58 AFFILIATES, WHO INCLUDE
MANY PEOPLE LIVING WITH A
SERIOUS MENTAL ILLNESS, AS WELL
AS THEIR FAMILIES AND THEIR
SUPPORTERS. WE ADVOCATE ON THEIR
BEHALF, PROVIDING EDUCATION AND
SUPPORT TO OUR MEMBERS AS WELL
AS THE BROADER COMMUNITY. UM
LENGTH OF STAY. OUR LOVED ONES
WHO END UP IN THE ER WITH A
BEHAVIORAL HEALTH CRISIS
EXPERIENCED SOME OF THE LONGEST
LENGTHS OF STAY OUT OF ANYBODY
WHO ENDS UP THERE. A NATIONAL
SURVEY OF OVER 6000 FOUND THAT
MORE THAN 70% OF THESE HELD A
PSYCH PATIENT, NOT JUST FOR
HOURS, BUT FOR DAYS WHILE TRYING
TO FIND A BED. UM I KNOW THAT
OFTEN, UM, BEHAVIORAL HEALTH
CRISIS. JUST THE TERM CAN SEEM A
BIT ABSTRACT, UM, PARTICULARLY
WHEN READ OFF A PIECE OF PAPER
BY A GUY WITH A NASAL MONOTONE.
BUT IMAGINE WITH ME IF YOU'RE
YOU'RE HAVING THE WORST DAY OF
YOUR LIFE. YOU'RE SCARED. UM,
YOU MIGHT BE HEARING OR SEEING
THINGS. AND NOW YOU'RE TOLD THAT
YOU NEED TO WAIT HERE IN THIS
EMERGENCY ROOM AND WE DO NOT
KNOW WHEN WE WILL HAVE A BED FOR
YOU. UM OUR LOVED ONES JUST
CAN'T WAIT THAT LONG. BY
DEVELOPING A SYSTEM TO TRACK BED
AVAILABILITY. THIS BILL WILL
HELP OUR LOVED ONES ACCESS CARE
MUCH QUICKER. WHERE MINUTES
REALLY DO COUNT? UM AND AS MR
CHAIR SO ASTUTELY POINTED OUT
LAST YEAR IN LAST YEAR'S
ITERATION OF THIS BILL, WE ARE
LUCKY ENOUGH THAT WE DO HAVE
MORE BEDS COMING ONLINE, THANKS
TO THE BEHAVIORAL HEALTH
CONTINUUM INFRASTRUCTURE PROJECT
AS WELL AS PROP ONE SHOULD IT
PASS, AND IT'S IMPERATIVE NOW,
MORE THAN EVER THAT WE'RE ABLE
TO HAVE A SYSTEM IN PLACE TO
THESE BEDS WHEN THEY ARE NEEDED
THANKS VERY MUCH. THANK YOU
OTHER WITNESSES IN SUPPORT OF
THE MEASURE. AS CHAIRMAN OF
MEMBERS, PAUL OTA ON BEHALF OF
THE CALIFORNIA STATE ASSOCIATION
OF PSYCHIATRISTS AND OTHER CO
SPONSOR YOUR IVO. THANK YOU.
THANK YOU. THANKS FOR ATTENDING
NEXT, PLEASE. GOOD AFTERNOON, MR
CHAIR MEMBERS, USHA MACHE ON
BEHALF OF THE CALIFORNIA STATE
SHERIFFS ASSOCIATION IN SUPPORT
OF SENATE BILL 1017. THANK YOU.
THANK YOU FOR ATTENDING NEXT,
PLEASE. THANK YOU. CHAIR MEMBERS
TIM BAD AND REPRESENT THE
CALIFORNIA CHAPTER OF THE
AMERICAN COLLEGE OF EMERGENCY
PHYSICIANS IN SPORT. THANK YOU.
YES, SIR. GEORGE SOROS,
CALIFORNIA MEDICAL ASSOCIATION
AND SUPPORT. THANK YOU. THANK
YOU, SIR. NEXT PLEASE. JOHN
DINGER WITH THE STEINBERG
INSTITUTE AND STRONG SUPPORT.
THANK YOU, SIR. ANY OTHER
WITNESSES IN SUPPORT? SING NONE.
WITNESSES IN OPPOSITION FIRST
LEAD WITNESSES IN OPPOSITION IF
THERE ARE ANY YOU A LEAD
WITNESS, SIR.
WE HAVE ROOM AT THE END, BUT
THAT'S OK. WELCOME, SIR. PLEASE
STATE YOUR NAME FOR THE RECORD.
GOOD AFTERNOON CHAIR MEMBERS. MY
NAME IS AMBER RASHID AND I AM
HERE ON BEHALF OF THE COUNTY
BEHAVIOR HEALTH DIRECTORS
ASSOCIATION OF CALIFORNIA, THE
LEADERS OF THE PUBLIC BEHAVIOR,
HEALTH AGENCIES THAT SERVE THE
MENTAL HEALTH AND SUBSTANCE USE
DISORDER NEEDS OF THE MEDICAL,
UNINSURED AND UNDERINSURED
POPULATIONS. WE RESPECTFULLY
HAVE AND OPPOSE UNLESS AMENDED
POSITION ON THIS BILL, WHILE CB
COMMENDS THE AUTHOR FOR SEEKING
TO ADDRESS THE DELAYS THAT THOSE
IN PSYCHIATRIC CRISIS TOO
FREQUENTLY EXPERIENCE WHEN
ATTEMPTING TO ACCESS VITAL
SERVICES. WE BELIEVE THAT ANY
APPROACH TAKEN MUST BE FEASIBLE,
REALISTIC AND GUIDED BY
PARTNERSHIPS WITH STAKEHOLDERS
RATHER THAN PUNITIVE APPROACHES.
èC B HÌ Dð APPRECIATES THE
APPROACH OUTLINED IN S¼ B 1017,
WHICH INCLUDES CONFERRING WITH
STAKEHOLDERS TO INFORM THE
DEVELOPMENT OF THIS DATABASE.
RECOGNIZING HOW CRITICAL
STAKEHOLDER BUY IN IS FOR
ENSURING EFFECTIVENESS OF A
REGISTRY AS THE LEADERS OF THE
PUBLIC BEHAVIOR HEALTH AGENCIES
IN CALIFORNIA WE RECOMMEND AN
AMENDMENT, WHICH INCLUDES COUNTY
BEHAVIOR HEALTH AS A PART OF
THEY HOLD THEIR BUY IN THE VÆ HÌ
G IS ALSO CONCERNED WITH THE
PUNITIVE PROVISIONS IN S¼, B,
S¼, 10 AND 17, WHICH ULTIMATELY
ALLOWED DHCS TO ASSESS A PLAN OF
CORRECTION OR PENALTIES AGAINST
A FACILITY FOR FAILING TO SUBMIT
DATA IN A TIMELY MANNER WHEN THE
SCOPE OF THE DATABASE HAS NOT
YET BEEN DEVELOPED. THIS EXPOSES
OUR COUNTY BEHAVIOR, HEALTH
AGENCIES AND CONTRACTED
PROVIDERS TO UNKNOWN LIABILITY.
IT WOULD ALSO POTENTIALLY DIVERT
RESOURCES AWAY FROM MUCH NEEDED
TREATMENT AND SERVICES. IT IS,
FOR THESE REASONS, REQUESTS THE
REMOVAL OF THE PUNITIVE
PROVISIONS IN S¼ B 1017. THANKS
TO YOU FOR YOUR TIME AND FOR
YOUR CONSIDERATION, AND FOR THE
AFOREMENTIONED REASONS, HAS AN
OPPOSING AMENDED POSITION AND
LOOKS FORWARD TO CONTINUED AND
FURTHER CONVERSATIONS WITH THE
AUTHOR'S OFFICE. THANK YOU FOR
JOINING US TODAY, SIR. YOU'RE
NEXT, PLEASE STATE YOUR NAME FOR
THE RECORD. RANDY HICKS CLIENT.
AS WELL AS GOOD INTENTION AS
THIS SOUNDS AND FINDING MORE
BEDS FOR PEOPLE AND GETTING THEM
OFF THE STREETS, THAT'S ALL WELL
AND GOOD. YOU AS A CLIENT, I
SUGGEST WE TRY OUTPATIENT. AND I
AM ALSO BELIEVE THAT WHEN NEW TO
SPORTS TREATMENT ON THE PEOPLE,
THEY'RE NOT NECESSARILY GONNA
TAKE IT, AND THE OTHER THING IS
YOU GUYS ARE GUARANTEEING THAT
THEY'RE GOING TO HAVE A MENTAL
HEALTH ISSUE WHEN THEY COULD
SIMPLY HAVE A DRUG AND ALCOHOL
ISSUE. HOW ABOUT A TREATMENT FOR
THAT, INSTEAD OF DECIDING THAT
THEY'RE CRAZY? WE'RE GONNA LOCK
THEM UP. THEIR CRAZY WE WILL PUT
SOME MORE BEDS OUT THERE AND
THAT'S WHAT YOU GUYS ARE DOING.
IT'S NOT. WE GET MORE BEDS TO
PUT MORE PEOPLE TO LOCK THEM
AWAY THAN HAVING PEOPLE COME OUT
AND BE ON THEIR OWN AND HAVE NOT
FORCED TREATMENT AND OUTPATIENT
AND THE OTHER THING, PSYCHIATRY
IS ALL WELL AND GOOD J DRUGS,
BUT SOMETIMES PSYCHOLOGY WORKS,
TOO. SOMETIMES IT HURT TO TALK
TO SOMEBODY. OK, SO AS A CLIENT,
I UNDERSTAND HER. SHE'S GOT WELL
INTENTIONED. YES I UNDERSTAND
WHAT SHE'S DOING. AND YES, WE
PROBABLY NEED MORE BEDS. BUT WE
SHOULD ALSO LOOK AT OTHER
ALTERNATIVES BEFORE WE JUST LOCK
THEM AWAY. HM. THANK YOU FOR
ATTENDING, SIR. THANK YOU, BOTH
FOR YOUR TESTIMONY. ANY OTHER
WITNESSES IN OPPOSITION HERE IN
THE HEARING ROOM ROOM, 1200.
JING NAN, LET'S BRING THE
CONVERSATION BACK TO MY
COLLEAGUES ON THE DEUS
COLLEAGUES. ANY QUESTIONS?
COMMENTS OR CONCERNS, SENATOR
WYNN SENATOR, I GOT A COUPLE OF,
UM, QUESTION. UM JUST FOR MY
UNDERSTANDING. SO IF DOES THIS
FORCE A PARTICULAR LET ME STEP
BACK. SO MY CONCERN IS THIS IS
THAT IF ONE COUNTY DOESN'T HAVE
TO FACILITY, THEN IT FORCES ALL
THE OTHER COUNTY TO HAVE TO BEAR
THE BURDEN DOES THAT SO IF I'M A
FACILITY, SAY A COUNTY I HAVE
PLENTY OF BEDS BECAUSE WE'VE
WORKED HARD. WE MADE SURE WE'RE
IN COMPLIANCE. WE'RE HELPING OUT
AND YES, I DO HAVE 25% OF MY
FACILITIES. OPEN BUT ANOTHER
COUNTY DECIDE I'M NOT DOING
ANYTHING. I'M NOT GONNA HAVE ANY
BEDS. I'M NOT GONNA CARE, SO I'M
JUST GONNA SEND IT TO L, A
COUNTY OR ORANGE COUNTY. I
REPRESENT BOTH. SO, UM DOES IT
FORCE THOSE COUNT TO HAVE TO
ACCEPT? OR BE IT IN COMPLIANCE
WITH THAT, OR CAN THEY DENY I
APPRECIATE THAT QUESTION IS A
REALLY GOOD QUESTION. UM THE
POINT OF ANOTHER ANOTHER, I
THINK BENEFIT OF HAVING THE BED
SOLUTION IS THAT THEN WE HAVE
BETTER TRACKING RIGHT AND WE'RE
AND WE THINK PROP. ONE PAST AND
PART OF THAT IS REALLY DOING AN
EVALUATION OF WHERE THERE ARE
RESOURCES. AND SO THIS WILL ALSO
LEND TO LET US KNOW WHERE THE
BEDS ARE. AND SO IF WE GET THE
REPORT BACK THAT EVERYBODY IN A
CERTAIN COUNTY IS HAVING TO
TRAVEL TO A DIFFERENT COUNTY.
THAT IS A REAL PROBLEM. BUT
RIGHT NOW WE DON'T HAVE ANY, UH
DATA ABOUT THAT. WE JUST HAVE
ANECDOTAL THINGS, SO THE IDEA IS
TO HAVE EVERY COUNTY HAVE THEIR
RESOURCES BUILT OFF FOR EVERY
LEVEL OF CARE. WE'RE NOT JUST
TALKING ABOUT INPATIENT, BUT
EVERY LEVEL OF CARE AND SO
PEOPLE SHOULDN'T HAVE TO GO OUT
OF COUNTY. THAT'S THE WHOLE
POINT. I THINK OF ANOTHER PART
OF BEING ABLE TO DO THIS BOTH
WITH THE EASE OF GETTING
SOMEBODY SOMEPLACE, BUT ALSO
IDENTIFYING WHERE ARE THE GAPS
IN SERVICES. AND HOW DO WE GO
ABOUT FILLING THAT SO THERE'S
AYE, BUT NOBODY'S EVER FORCED TO
TAKE ANYBODY. OK THAT'S THAT'S
THAT'S MY ANSWER. EVER FORCED TO
TAKE ANYBODY BUT IF YOU HAVE,
YOU KNOW 75% OF BED OPENINGS, WE
WERE PROBABLY GOING TO WANT TO
KNOW WHY YOU'RE NOT USING IT.
YEAH, NÓ. AND AND I'M I MEAN,
I'M I'M SUPPORTIVE OF THE IDEA
AND THE DATA. WE NEED THAT
INFORMATION. THERE'S NÓ DOUBT. I
JUST DON'T WANT YOU KNOW, ONE
COUNTY YOU YOU HEAR THIS A LOT
MICE IS TAKING THE BURDEN FOR
THE OTHER CITY OR MY COUNT IS
TAKING THE BURDEN FOR THAT
COUNTY BECAUSE THEY'RE NOT. THEY
DON'T WANNA DO IT AND SO THAT
THAT'S JUST MORE OF THE
CONCERNS. THAT THEY STILL HAVE
THAT LOCAL CONTROL. I THINK
THAT'S I THINK THAT'S A GREAT
QUESTION AND A AND A GREAT
POINT. THANK YOU AND AGAIN THIS
WAY. THIS HELPS US ACTUALLY
IDENTIFY IF THERE IS A PROBLEM,
BECAUSE RIGHT NOW, WHEN YOU CALL
SOME PLACE, AND YOU SAY, I HAVE,
SO OH NÓ NÓ BEDS WE DON'T REALLY
KNOW IF THAT'S EVEN TRUE OR NOT.
YEAH, PERFECT. THANK YOU.
EDIFICATION THAT THERE IS NÓ
OBLIGATION CREATED BY THIS JUST
BECAUSE A BED IS IDENTIFIED.
THERE'S THE MISINFORMATION OUT
THERE IS THAT IT CREATES AN
OBLIGATION BECAUSE THERE'S AN
OPENING. YOU GOT TO TAKE THE
NEXT PATIENT WHO SHOWS UP THAT'S
NOT TRUE. WHAT THIS IS REALLY
ABOUT IS IDENTIFYING A PLACE TO
MAKE A PHONE CALL SO YOU CAN
CONNECT AS A PROVIDER TO THE
HOSPITAL PEOPLE AND YOU CAN TALK
ABOUT WHETHER YOUR PATIENT FITS
AND WHETHER OR NOT THE RECEIVING
FACILITY WANTS TO TAKE THEM. SO
HAS THE CAPACITY TO TAKE THEM AT
THAT TIME DUE TO STAFFING OR
WHATEVER OTHER ISSUES. THANK
YOU, SENATOR, SENATOR M. SENATOR
I THINK. TWO WEEKS AGO WE HEARD
ABOUT JUST SOME OF THE, UH,
DIFFICULTIES IN CAPTURING SOME
CODING AND BILLING THROUGH èC,
A Dð ANTICIPATE SOME OF THOSE
DIFFICULTIES AS WE'RE COLLECTING
ON THAT DATA FROM 58 COUNTIES.
UM WE DO IN SOME RESPECTS, AND
THAT'S WHY WE ALSO LOOKING AT
SAMA'S GOT, LIKE A LIKE A. HOW
IS THE BEST WAY TO DO THAT? AND
SO WE'RE TRYING TO INCORPORATE
ALL THAT WITH STAKEHOLDERS? BUT
THERE'S ALWAYS GOING TO BE SOME
KIND OF ISSUES, BUT WE DON'T
KNOW WHAT THEY ARE, UNTIL WE
ACTUALLY RUN INTO THE ISSUES
THAT WE HAVE TO BE ABLE TO SAY.
OH HERE IS A PROBLEM HERE WITH
CAL LÀ. THIS IS WHAT WE NEED TO
DO TO FIX IT, OK? THANK YOU,
SENATOR. ANY OTHER QUESTIONS?
COMMENTS CONCERNS SEEING NONE.
IS THERE A MOTION FOR THIS BILL?
SENATOR TAO MAKES THE MOTION
SENATOR. WOULD YOU LIKE TO CLOSE
? YES THANK YOU VERY MUCH. AND
AGAIN. THANK YOU FOR HEARING
THIS, AND I APPRECIATE THE
COUNTIES COMING FORWARD, AND I
APPRECIATE THEM WORKING WITH US
AS WE CONTINUE TO MOVE FORWARD,
AS MANY OF US KNOW, ONE OF THE
ISSUES IN DOING SOMETHING LIKE
THIS IS THAT EVERYBODY HAS TO
PARTICIPATE. WE'VE HAD THAT WE
PASSED OTHER POLICIES AND SOME
WHOLE BIG SECTIONS DON'T INPUT
INTO THE DATA. AND SO IT'S BEEN
SAID. IF YOU IF YOU MAKE A LAW
WITHOUT ANY PENALTIES, IT'S JUST
A SUGGESTION. UM SO THIS IS $100
A DAY FOR PEOPLE WHO DON'T BUT
THERE IS AN APPEAL PROCESS.
THERE IS A HOW ARE YOU GOING TO
REMEDY PROCESS? IT DOESN'T JUST
MOVE TO FINES RIGHT AWAY. I
THINK THIS IS A REALLY IMPORTANT
ISSUE TO BE ABLE TO STREAMLINE
ALL OF OUR SERVICES, AND I WOULD
ASK FOR YOUR VOTE. THANK YOU.
PLEASE CALL THE ROLL. IT'S BEEN
MOVED BY SENATOR TAO AND THE
MOTION IS TO PASS AND REREFER TO
THE COMMITTEE ON JUDICIARY. NOW
WE CAN CALL THE ROLL. THANK YOU.
SENATOR ROSS ROTH. I WHEN? WHEN
I GLAZER GONZALEZ? GROWTH.
HURTADO HURTADO. I LIMÓN LIMÓN I
MENJIVAR MENJIVAR. I RUBIO RUBIO
I SMALLWOOD CUEVAS WIENER.
WEENER. I BILL HAS SEVEN VOTES.
7 TO 0 WILL HOLD THE OPEN FOR
ABSENT MEMBERS. SENATOR EDMAN
NUMBER FIVE SENATE BILL 184.
THANK YOU VERY MUCH, UM, MEMBERS
. THIS HAS TO DO WITH THEIR RE
HEARING. I DON'T KNOW IF
EVERYBODY KNOWS WHAT A REHEARING
IS. BUT WHEN SOMEBODY IS 5150
BROUGHT IN AGAINST THEIR WILL
YOU HAVE TO HAVE A COURT ORDER
AND JUDGE SAY YES. THIS PERSON
IS INCAPABLE OF MAKING THEIR OWN
DECISIONS. SO WE'RE GOING TO BE
ABLE TO TREAT THEM WITH
MEDICATION. UM SO CURRENTLY
RIGHT NOW, IF YOU GO FOR A 5150
THAT REES HEARING IS OBTAINED,
AND IT IS CONSIDERED THAT IT
LAST THROUGH THE 5200 AND 50 AS
SOMEBODY HAS TO STAY THAT
ADDITIONAL TWO WEEKS WE HAVE
FOUND AND PROFESSIONALS HAVE
FOUND AND BROUGHT THIS TO US
THAT IF PEOPLE THEN HAVE TO GO
FOR A 30 DAY OR THE ADDITIONAL,
UH, THE 30 DAY, UM THAT OFTEN
TIMES THEIR TREATMENT, THEN IS
THE MEDICATION IS STOPPED BEING
GIVEN BECAUSE THERE ARE SOME AND
IT'S SUPPOSED TO BE. THE REESES
HEARING IS IN IN IN EFFECT UNTIL
CAPACITY IS REACHED, BUT THERE
HAS BEEN SOME DISAGREEMENTS
ABOUT THAT. SO WE THINK THIS LAW
IS IMPORTANT SO THAT IF THE
PERSON IS STILL ACETATED THAT RE
HOLDING HOLDS OVER THEIR ENTIRE
TIME IN TREATMENT UNTIL THEY
HAVE, UH, RESTORED CAPACITY SO
THAT THEY DON'T GO OFF
MEDICATIONS AND THEN
DECOMPENSATE BEFORE ANOTHER
RECENT HEARING IS HEARD FOR THEM
TO BE ABLE TO BE DECLARED AGAIN.
THERE'S ALWAYS A PROCESS FOR
APPEAL. THERE'S ALWAYS A PROCESS
FOR THE PUBLIC DEFENDER, BUT WE
REALLY THINK THIS HELPS PEOPLE
BE ABLE TO MOST EFFECTIVELY
RESTORE THEMSELVES WITHOUT
HAVING TO TAKE BACKWARD STEPS
BECAUSE OF A SIMPLE TECHNICALITY
OF A RES. AND WITH ME TODAY IS
DR ERIC CHEN AND RANDALL HAGAR.
GENTLEMEN PLEASE PROCEED.
IDENTIFY YOURSELVES FOR THE
RIGHT FIRST. HØI GOOD AFTERNOON.
THANK YOU. CHAIRMAN ROTH. THANK
YOU, SENATOR EGGMAN ERIC CHUNG
I'M A PSYCHIATRIST, ASSOCIATE
PROFESSOR OF PSYCHIATRY AT U èC
L, A AND CHIEF MEDICAL OFFICER
OF ULA'S RESNICK
NEUROPSYCHIATRIC HOSPITAL. SB
1184 FIXES A CRITICAL GAP IN
ACUTE CARE TREATMENT OF
PSYCHIATRIC PATIENTS. WE HAVE
SEEN THIS FOR DECADES AS A
PROBLEM THAT PLAYS OUT IN OUR
HOSPITALS ACROSS THE STATE. UM
FIRST TO BE CLEAR ABOUT WHICH
PATIENTS WE ARE TALKING ABOUT.
FREQUENTLY THIS APPLIES TO
PATIENTS WHO HAVE SEVERE FORMS
OF PSYCHOSIS, INCLUDING
SCHIZOPHRENIA. THEY HAVE FIRST
OF ALL BEEN INVOLUNTARILY
HOSPITALIZED UNDER CURRENT LAW
DUE TO THE ACUTE SEVERITY OF
THEIR ILLNESS. THEY HAVE
SECONDARILY BEEN CLINICALLY AND
JUDICIALLY EVALUATED TO LACK
CAPACITY TO MAKE DECISIONS ABOUT
THEIR PSYCHIATRIC MEDICATION
TREATMENT. DUE TO THE SEVERE
NATURE OF THEIR ILLNESS. THE WAY
THE LAW CURRENTLY EXISTS,
CREATES ARTIFICIAL AND NEGATIVE
CLINICAL TREATMENT INTERRUPTIONS
AND THERE ARE FIVE OF THEM. I
WANT TO CALL TO YOUR ATTENTION.
THE FIRST IS OBVIOUS. IT IS A
LIKELY WORSENING OF THEIR
CLINICAL STATUS, MEANING THEY
BECOME MORE PSYCHOTIC WHEN THEY
ARE TAKEN OFF THEIR MEDICATIONS.
THEY HAVE POTENTIAL ADVERSE
EFFECTS AND RISK OF ABRUPT
DISCONTINUATION OF THE
MEDICATIONS, WHICH CAN INCLUDE
NAUSEA, SWEATING, INSOMNIA,
AGITATION, MOOD VOLATILITY,
CATATONIA, MUSCLE RIGIDITY AND
POTENTIALLY SEIZURE. THERE IS A
POSSIBILITY OF INCREASED PATIENT
AND STAFF HARM AND SAFETY RISKS.
WHEN PATIENTS DECOMPENSATE LIKE
THIS WITH AGITATED BEHAVIOR OR
VIOLENCE OCCURRING IN THE
HOSPITAL, SETTING THE POTENTIAL
NEGATIVE IMPACT OF USE OF
RESTRAINTS, SECLUSION AND
PHYSICAL HOLDS, AND, IRONICALLY,
INVOLUNTARY INJECTED MEDICATION
WHEN THEY GO OFF MEDICATIONS DUE
TO THE GAP IN THE RE PROCESS.
THIS LIKELY PROLONGS THE LENGTH
OF STAY OF INPATIENT,
INVOLUNTARY HOSPITALIZATION OR
ON THE FLIP SIDE. IT CAN LEAD TO
PREMATURE DISCHARGE IF HOSPITALS
AND PHYSICIANS ARE FRUSTRATED BY
THE PROCESS AND END THE
INVOLUNTARY HOLD. THERE'S LITTLE
TO NÓ CLINICAL VALUE FOR
PATIENTS IN DETAINING THEM
INVOLUNTARILY IN THE HOSPITAL
WHEN THEY LACK CAPACITY WITHOUT
PROVIDING THEM TREATMENT.
PATIENTS DO RETAIN RIGHTS. THEY
HAVE THE RIGHT TO FILE TO WIN
THEIR PROBABLE CAUSE HEARING AT
EACH PHASE OF THE HOLD. THEY
HAVE THE RIGHT TO FILE A WRIT AT
EACH PHASE OF THE HOLD. AND AS
WAS MENTIONED BY SENATOR EDMAN,
PSYCHIATRIST AND THE MEDICAL
STAFF MUST RESTORE THE ABILITY
FOR A PATIENT TO MAKE DECISIONS
ABOUT THEIR CARE WHEN THEY HAVE
REGAINED CAPACITY, WHICH IS WHAT
WE REALLY HOPE FOR. UH, WE ARE
DEVOTED TO BEST PATIENT CARE,
AND WE WOULD DO THIS WITH NÓ
OTHER CONDITION IN MEDICINE IN
ACUTE CARE, SETTING TO START A
MEDICATION FOR A PATIENT WHO IS
INCAPACITATED. STOP IT FOR A
PERIOD OF FIVE OR SIX DAYS
WAITING FOR SOMETHING TO HAPPEN,
RESTARTING IT FOR ANOTHER 17
DAYS AND STOPPING IT AGAIN. WE
SIMPLY WOULD NOT DO THAT IN
MEDICINE. THIS IS ALSO ABOUT
RESOURCE CONSUMPTION DURING THIS
ENTIRE GAP PERIOD OF TREATMENT.
WE ARE PROVIDING 24 7 NURSING
AND SUPPORT. IN THE HOSPITAL,
BUT NÓ TREATMENT IS BEING
RENDERED. UH PHYSICIANS AND
HOSPITALS MUST DEVOTE ADDITIONAL
RESOURCES TO ENGAGING IN THE
CORE PROCESSES, WHICH CAN BE
USED OTHERWISE FOR PATIENT CARE.
AS I MENTIONED BEFORE, UH, THIS
GAP LIKELY LENGTHENS INPATIENT
STAYS AND IS NOT IN THE BEST
INTEREST OF PATIENTS. THERE ARE
PLENTY OF OTHER PATIENTS WAITING
AT EMERGENCY DEPARTMENTS ALL
ACROSS THE STATE WHO NEED
HOSPITALIZATION WHILE WE ARE
WASTING THIS PRECIOUS TIME.
THANK YOU. THANK YOU, SIR. MR
CHAIR MEMBERS OF THE COMMITTEE,
RANDALL HAGER, AGAIN FOR A
PSYCHIATRIC PHYSICIANS ALLIANCE
OF CALIFORNIA IS GOING TO
EMBROIDER A LITTLE BIT AROUND
THE EDGES. THAT WAS EXCELLENT
TESTIMONY FROM A RULE EXPERT. I
ACTUALLY LEARNED ABOUT THIS FROM
HIM. AND SO I WILL JUST SAY THAT
WE HAVE A REAL ISSUE ON OUR
STREETS TODAY WHERE PEOPLE HAVE
BEEN UNTREATED WITH SEVERE
MENTAL ILLNESSES LIKE
SCHIZOPHRENIA OUT ON THE STREETS
FOR MONTHS, IF NOT YEARS, AND
IT'S SORT OF AXIOMATIC THAT THE
LONGER THAT YOU GO WITH YOUR
UNTREATED ILLNESS, THE LONGER
AND HARDER IT'S GOING TO BE TO
BRING YOURSELF INTO SOME SORT OF
A STABILITY WITH THE HELP OF
YOUR DOCTORS. SO WHAT WE'RE
TALKING ABOUT HERE IS MAYBE
AVOIDING THREE HEARINGS AND 45.
IN ORDER TO CONTINUE MEDICATION.
AS WE KNOW ADMINISTRATIVELY,
THINGS HAPPENED. THERE MAY BE
GAPS AND YOU'VE HAD A
DESCRIPTION OF WHAT HAPPENS WHEN
PEOPLE ARE ALLOWED TO MISS THEIR
MEDICATIONS, PARTICULARLY PEOPLE
WITH PSYCHOTIC DISORDERS. UM AND
SO THIS BILL IS REALLY ABOUT
THAT AS MUCH AS ANYTHING ELSE,
BUT IT'S REALLY ALSO A NEED TO
MAKE SURE THAT IN THE QUICKEST
AND THE SUREST WAY POSSIBLE THAT
PATIENTS ARE ABLE TO STEP ONTO
THE ROAD TOWARDS RECOVERY. AND
THAT'S WHY WE BRING THIS BILL
FORWARD. WE WANT, YOU KNOW TO
INCENTIVIZE THAT IN FACILITIES
AND THROUGHOUT THE STATE, AND
WITH THAT, I'LL ANSWER ANY
QUESTIONS. THANK YOU FOR YOUR
TESTIMONY, ANY OTHER SUPPORT
WITNESSES IN THE HEARING ROOM?
MR CHAIRMAN MEMBERS PAUL YOU ON
BEHALF OF THE CALIFORNIA STATE
ASSOCIATION OF PSYCHIATRISTS,
THE SPONSOR OF THIS BILL REALLY
APPRECIATE DR CHEN COMING UP TO
TESTIFY IN THERE AS A WITNESS TO
YOU IN PERSON OR DRY VOTE.
THANKS FOR JOINING US NEXT,
PLEASE. MR CHAIR MEMBERS OF THE
COMMITTEE, BRANDON MARCH WITH
THE CALIFORNIA MEDICAL
ASSOCIATION IN SUPPORT. THANK
YOU ANY OTHER SUPPORT WITNESSES
IN THE HEARING ROOM? SEEING NONE
. ANY OPPOSITION WITNESSES IN
THE HEARING ROOM IF THERE ARE
ANY LEAD OPPOSITION WITNESSES
WHO HAVE BEEN IDENTIFIED. PLEASE
STEP FORWARD. WE'LL TAKE YOUR
TESTIMONY FIRST. YOU'RE WELCOME
TO JOIN US. AT THE LEAD.
OPPOSITION WITNESSES ARE WELCOME
TO JOIN US AT THE TABLE. JUST
TOO PLEASE. THANK YOU VERY MUCH.
SIT WHEREVER YOU ARE COMFORTABLE
AND IDENTIFY YOURSELVES FOR THE
RECORD BEFORE YOU START HØI. UM
THANK YOU. CHAIR MEMBERS. UH, MY
NAME IS SAMUEL JAN AND I'M WITH
DISABILITY RIGHTS CALIFORNIA AND
I'M A SENIOR MENTAL HEALTH
POLICY ATTORNEY. UM WE ARE THE
FEDERALLY DESIGNATED PROTECTION
ADVOCACY SYSTEM FOR THE STATE OF
CALIFORNIA. UM I'LL NOTE THAT WE
DID SEE THE COMMITTEE AMENDMENTS
. THEY DO ALLEVIATE OUR CONCERNS
ABOUT VAGUE LANGUAGE THAT COULD
BE INTERPRETED TO ALLOW ONE
INVOLUNTARY MEDICATION ORDER TO
LAST INDEFINITELY. HOWEVER WE
ARE CONCERNED THAT ANOTHER HOLD
WAS ADDED TO THE BILL, WHICH
WOULD EXPLICITLY LENGTHEN THE
DURATION. UM A SINGLE IN
INVOLUNTARY MEDICATION ORDER
COULD LAST. WE ARE STILL OPPOSED
TO THIS BILL AND WE HAVE SERIOUS
CONCERNS IT WOULD ELIMINATE DUE
PROCESS RIGHTS OF FOR PATIENTS
WHICH ALLOW THEM TO CONTEST
INVOLUNTARY MEDICATION ORDERS.
UNDER CURRENT LAW, THESE RIGHTS
ALIGN WITH THE RIGHT TO CONTEST
INVOLUNTARY DETENTION. FOR
EXAMPLE, IF YOU GET PLACED ON A
NEW INVOLUNTARY HOLD, YOU HAVE
THE RIGHT TO CONTEST THAT NEW
HOLD AND THE FACILITY NEEDS TO
OBTAIN A NEW COURT ORDER IN
ORDER TO ADMINISTER INVOLUNTARY
MEDICATIONS. THIS BILL WOULD
DECOUPLE THESE RIGHTS AND ALLOW
ONE INVOLUNTARY MEDICATION ORDER
TO LAST THE DURATION OF AN
INVOLUNTARY DETENTION. PATIENTS
CAN HAVE VERY GOOD REASONS FOR
REFUSING PSYCHIATRIC MEDICATIONS
. THESE ARE POWERFUL, MIND
ALTERING DRUGS THAT CAN HAVE
EXTREME SIDE EFFECTS. FOR
EXAMPLE, ONE STUDY FOUND THAT
BETWEEN 15 AND 30% OF PATIENTS
OVER THE AGE OF 45 DEVELOPED A
CONDITION CALLED TARDIVE
DYSKINESIA AFTER JUST ONE YEAR
OF TREATMENT FROM PSYCHIATRIC
MEDICATIONS. THIS CONDITION IS A
SEVERE AND PERMANENT MOVEMENT
DISORDER. UM ONE ARGUMENT THAT
WE'VE HEARD FROM THE AUTHOR AND
FROM THE PROPONENTS IN SUPPORT
OF THIS BILL IS THAT CURRENT LAW
CREATES A TREATMENT GAP WHICH
CAN DISRUPT MEDICATION TITRATION
. I'LL NOTE THAT THIS IS NOT AN
ACTUAL ISSUE IN PRACTICE IF A
FACILITY PLANS TO PLACE A
PATIENT ON A NEW HOLD AND
CONTINUE A RACE, THEY WILL TIME
THE FILING OF THE NEW HOLD WITH
THE RE PETITION ON A DAY WHEN
THE RE PETITION CAN BE HEARD BY
THE COURT. THIS PRACTICE
ELIMINATES ANY GAP IN
INVOLUNTARY MEDICATION TREATMENT
THAT WOULD OTHERWISE OCCUR, AND
IT'S A WIDELY UTILIZED PRACTICE
THROUGHOUT THE STATE. UM THESE
HEARINGS ARE CRITICAL IN
DETERMINING WHETHER PATIENTS
HAVE SUFFICIENT REASONS TO
REFUSE PSYCHIATRIC MEDICATION,
SUCH AS SERIOUS MEDICAL
COMPLICATIONS. WE URGE THIS
COMMITTEE NOT TO ROLL BACK THESE
IMPORTANT DUE PROCESS
PROTECTIONS WE ASK FOR YOUR NÓ
VOTE ON SB 1184. THANK YOU.
THANK YOU FOR JOINING US, MA'AM,
YOU ARE NEXT. HELLO, CHAIR AND
MEMBERS. MY NAME IS RACHEL BOG,
AND I'M A LEGISLATIVE ADVOCATE
WITH A èC LU CALIFORNIA ACTION.
THE A. èC LU OPPOSES SB 1184
BECAUSE IT TAKES AWAY AS SAM
MENTIONED DUE PROCESS JUST DUE
PROCESS PROTECTIONS DURING A
SCARY MEDICAL PROCESS WITH NÓ
REASONABLE JUSTIFICATION. UM
WHEN A PERSON IS TAKEN FOR AN
INVOLUNTARY PSYCH HOLD, IT'S
WELL UNDERSTOOD THAT YOU CAN'T
JUST HOLD THEM INDEFINITELY
BECAUSE PEOPLE SHOULD ONLY HAVE
THEIR CIVIL RIGHTS DEPRIVED AS
LONG AS IT'S ABSOLUTELY
NECESSARY, AND THAT'S WHY THERE
ARE INTERIM HEARINGS AND SUCH
BETWEEN DIFFERENT CONSECUTIVE
HOLDS TO CREATE CHECKPOINTS
ALONG THE WAY. UM, WHERE A
PERSON COULD PROVE THEY'RE NÓ
LONGER, A DANGER TO THEMSELVES
OR OTHERS. SIMILARLY WHAT THIS
BILL COVERS IS A SEPARATE SET OF
HEARINGS THAT DETERMINE WHETHER
A PERSON IS MENTALLY WELL ENOUGH
DURING AN INVOLUNTARY HOLD TO
MAKE THEIR OWN MEDICAL DECISIONS
ON LIKE IF A DOCTOR CAN OVERRIDE
THEM, REFUSING PSYCHIATRIC
MEDICATIONS. IF A SHORT-TERM
FORCED MEDICATION ORDER IS
PLACED UNDER CURRENT LAW, A
PERSON IS ENTITLED MULTIPLE
OPPORTUNITIES ALONG THE WAY TO
PROVE IF THEY'VE REGAINED THE
ABILITY TO MAKE THEIR OWN
DECISIONS. THIS BILL WOULD
ELIMINATE THOSE CHECKPOINTS AND
WOULD MAKE IT SO AS SAM
MENTIONED SINGLE INVOLUNTARY
MEDICATION ORDER COULD LAST AS I
READ IT ABOUT 47 DAYS IN THE
CURRENT TEXT, OR 77, WITH THE
POTENTIAL AMENDMENTS AS
CIRCULATED WITHOUT A PERSON
BEING ENTITLED TO THOSE STANDARD
LEGAL PROTECTIONS ALONG THE WAY.
IS NOT HERE TO CONTEST THE IDEA
OF INVOLUNTARY MEDICATION. WHAT
WE'RE OPPOSING IS THE IDEA THAT
THROUGH SEVEN OR 11 WEEKS OF
FORCED DRUGS, TAKING AWAY
SOMEONE'S RIGHT TO GET THE
CHANCE TO PROVE WHETHER THEY'VE
RECOVERED OR STILL NEED FORCED
ANTIPSYCHOTICS SO THAT NOBODY
ENDS UP IN ONE FLEW OVER THE
CUCKOO'S NEST. CHECKPOINT
HEARINGS AND PETITIONS ARE DUE
PROCESS, AND IT'S REALLY
CONCERNING TO SEE THE FACT SHEET
FOR THE BILL DESCRIBED DUE
PROCESS AS REDUNDANT. ALSO IT IT
SAYS THAT THE BILL IS NEEDED TO
REDUCE ADMINISTRATIVE BURDEN ON
PSYCHIATRISTS WITH GREAT CONCERN
AND EMPATHY FOR THE CAPACITY AND
STAFFING ISSUES AND OUR MENTAL
HEALTH FACILITIES. AND EVEN IN
THE COURTS, A èC LU HAS TO
EMPHASIZE THAT THOSE ISSUES
CAPACITY STAFFING, IT'S NOT
CONSTITUTIONAL TO JUST REMOVE
LEGAL PROTECTIONS IN ORDER TO
FIX THEM. I URGE YOU TO REJECT
THE PREMISE OF THIS BILL. THANK
YOU. THANK YOU FOR JOINING US
ANY OTHER OPPOSITION WITNESSES,
PLEASE STEP FORWARD RANDY.
HECK'S CLIENT OPPOSED. THANK
YOU, SIR. ANY OTHER OPPOSITION
WITNESSES? SEEING NONE. LET'S
BRING THE CONVERSATION BACK TO
MY COLLEAGUES ON THE DAY AS
COLLEAGUES ANY QUESTIONS,
COMMENTS OR CONCERNS. I JUST
HAVE A QUESTION. UM MADAM
SENATOR WITH THE PROPOSED
AMENDMENT. WHAT IS THE LONGEST
TIME THE INITIAL MEDICATION
ORDER CAN STAY IN EFFECT? I
BELIEVE WE'RE TALKING ABOUT 72
DAYS. IS THAT CORRECT WITH THE
INITIAL WITH THE WITH THE
AMENDMENT THAT'S GOING FORWARD
RIGHT NOW AND AGAIN. THAT'S THE
LONGEST BUT IT IT'S AS SOON AS
SOMEBODY'S CAPACITY IS RESTORED,
THEN THAT THAT ORDER GOES
PERFECT. THANK YOU. ANY OTHER
QUESTIONS? SENATOR GROVE
COMMENT. THANK YOU, MR CHAIR. I
HAVE A COMMENT. I KNOW THIS IS A
REALLY TOUGH BILL, AND I KNOW
THAT, UM I UNDERSTAND BOTH SIDES
OF THE ARGUMENT, BUT I CAN TELL
YOU THAT I HAVE TALKED TO
PARENTS OF ADULT CHILDREN. UM
THAT HAVE SAID SHOWED ME
PHOTOGRAPHS. THIS IS MY SON WHEN
WE REQUIRED HIM TO TAKE
MEDICATION, AND HE'S WORKING AT
ALBERTSON'S, AND HE'S THE
MANAGER OF THE MEAT DEPARTMENT
AND HIS LIFE IS NORMAL, AND HIS
WIFE AND HIS KIDS ARE HAPPY. AND
THEN WHEN HE DOESN'T HE'S ON THE
STREET. THEY'RE TRYING TO FIND
HIM. UM, YOU KNOW, MAKE SURE
SAFE, MAKE CONTACT. IT IS A VERY
HARD THING FOR I THINK NOT ONLY
PARENTS, BUT FAMILY MEMBERS. UM
AND I THINK THE LIMITED SCOPE
THAT YOU PUT IN THIS, UM AGAIN.
I'M NOT FOR THINGS LIKE THIS.
BUT BECAUSE OF THE LIMITED SCOPE
AND I DRIVE DOWN 12TH STREET,
AND I SEE NAKED PEOPLE IN THE
STREET THAT DON'T EVEN KNOW
THEY'RE ON THE STREET, RIGHT?
THEY DON'T EVEN KNOW THEY'RE
THERE. UM THE LADY IN THE COSTCO
PARKING LOT. UM SHE DOESN'T EVEN
KNOW SHE'S IN THE COSTCO PARKING
LOT. AND IF WE COULD GET HER ON
THE MEDICATION THAT SHE NEEDS SO
SHE CAN BE SELF AWARE AND GO
BACK TO WHAT WOULD BE A NORMAL
LIFE. UM MAYBE AT HER HOME. UM
THEN I'M ALL IN AND SO I
APPRECIATE NUMBER ONE VETERAN TO
VETERAN AND YOU WORK IN THIS
AREA. FOR I WOULD SAY, 30 YEARS
AT LEAST, AND I THANK YOU FOR
BRINGING THIS FORWARD. THANK YOU
VERY MUCH. THANK YOU. COLLEAGUES
ANY OTHER QUESTIONS OR COMMENTS,
SENATOR MEN? SENATOR UM OR MAYBE
THIS QUESTION MIGHT BE FOR THE
EXPERT. BUT NOT SAYING YOU'RE
NOT THE EXPERT. YOU'RE THE
EXPERT 100% NOT 100. YOU'RE
RIGHT. UM HOW MUCH TIME IS. ARE
WE GIVEN A PATIENT, UM, TO BE
ABLE TO PROVE THAT THEY CAPABLE
TO WEAN OFF OUR OUR OR GONE TO A
GOOD STATE OF MIND ON THAT POINT
BEFORE GIVING ANOTHER DOSE. I
WOULD I WOULD DEFER TO DR CHUNG
AS IS HE WORKS WITH THIS EVERY
DAY. UH DID YOU MAKE JUST TO BE
SURE THAT I UNDERSTAND YOUR
QUESTION, SENATOR? IS IT A
QUESTION ABOUT HOW LONG DOES IT
TAKE FOR A PATIENT TO REGAIN
BECAUSE I THINK WHICH IS
CAPACITY LOOK LIKE BUT IN
ADDRESSING SOMETIMES THE
CONCERNS THAT WE'RE JUST GONNA
BE SHOVING TREATMENT DOWN A
PATIENT'S THROAT CONSTANTLY
WITHOUT REALLY GIVING. UH UH, AN
ABILITY FOR THAT. TO PROVE THAT
THEY NÓ LONGER NEED TO BE ON
MEDICATION. IS THERE? UM A
STANDARDIZED TIMELINE OF HOW
MUCH WE HAVE TO WAIT AND BEFORE
DETERMINING IF THAT PATIENT
NEEDS MORE MEDICATION OR NOT?
WELL LET ME ANSWER IT THIS WAY.
THE TREATMENT OF SCHIZOPHRENIA,
PARTICULARLY WITH ORAL
MEDICATIONS, IS CUSTOMARILY A
DAILY TREATMENT IN THE ACUTE
SETTING. SO EVERY DAY A
MEDICATION IS INDICATED TO BEGIN
TO CHIP AWAY AT THE SEVERITY OF
THE PSYCHOTIC ILLNESS, THE TIME
FRAME OF IMPROVEMENT CAN BE VERY
GRADUAL. UNFORTUNATELY IT CAN BE
VERY SLOW FOR INDIVIDUALS WHO
HAVE REACHED THIS POINT WHERE
THEY HAVE BEEN BROUGHT IN
INVOLUNTARILY AND THEN LACK
CAPACITY TO MAKE DECISIONS OVER
THEIR TREATMENT. SO AT IN BEST
CASE SCENARIO, THEY WILL REGAIN
THAT CAPACITY EARLY WITHIN
BEFORE YOU EVEN HIT A 30 DAY OR
A 2ND 30 DAY HOLD, BUT IN MANY
CASES THEY DO NOT, AND THEY
REMAIN TOO ILL TO MAKE THAT
DECISION TOO ILL TO LEAVE THE
HOSPITAL AND HAVE CONTINUED TO
BE EVALUATED BY A COURT HEARING
OFFICERS TO BE ABLE TO BE
DETAINED IN THE HOSPITAL. THEY
HAVEN'T BEEN ABLE TO STATE THE
REASON WHY THEY SHOULD BE ABLE
TO LEAVE THE HOSPITAL AND
PREVAIL ON THEIR P èC HEARING
PROBABLE CAUSE HEARING AND THEY
CALL FOR A WRIT. THEY HAVE A
SECOND CHANCE TO BE ABLE TO
PROVE IN FRONT OF A JUDGE WHY
THEY SHOULD BE ABLE TO BE
RELEASED FROM THE HOSPITAL THAT
WOULD DISCONTINUE ALL TREATMENT
ENTIRELY, AND THEY WOULD BE ABLE
TO LEAVE. AND THE PATIENT
THEMSELVES IS THE ONE THAT GOES
AND TRY ATTEMPTS TO PROVE THAT
POINT WITH AN ADVOCATE WITH A
COURT APPOINTED ADVOCATE, OR ANY
ONE OF THEIR CHOICE. OK, THANK
YOU, AND AS A LEAD, ONE OF THE
LEAD OPPOSITION PEOPLE POINTED
OUT, THERE IS A PROCESS ALREADY
TO GO TO SAY IF YOU STILL NEED
TO BE HELD, RIGHT. WHAT WE'RE
DOING IS SAYING YOU DON'T HAVE
TO GO FOR THE SECOND PROCESS TO
SAY, SHOULD YOU RE HEARING STILL
CONTINUE THAT THAT BEING FOUND
THAT YOU'RE STILL INCAPABLE OF
HAVING CAPACITY SHOULD BE YOU
SHOULDN'T HAVE TO DO BOTH EVERY
SINGLE TIME. SOMEBODY IS GOING
TO BE HELD ANOTHER TWO WEEKS
WITHOUT MEDICATION, WHICH THEN?
OF COURSE, CAUSES DISRUPTION FOR
THE WHOLE UNIT. OK THANK YOU.
WOULD IT BE OK IF I REPLIED TO
THAT, BECAUSE THAT WAS MY
COMMENT, UM UM, I'LL I'LL ALLOW
IT. I APOLOGIZE. FENDER MANJAR.
I THINK YOU'RE ASKING REALLY
IMPORTANT QUESTIONS, AND I JUST
WANT TO HIGHLIGHT THAT FROM A
DIFFERENT PERSPECTIVE, THE
SEPARATENESS OF IT'S IMPORTANT
TO UNDERSTAND THE SIGNIFICANCE
OF THE SEPARATENESS OF THESE TWO
SETS OF HEARINGS BECAUSE, I
DON'T BELIEVE THAT IT FOLLOWS
THAT JUST BECAUSE YOU'VE BEEN
FOUND TO NEED TO STAY IN THE
HOSPITAL LONGER THAT YOU SHOULD
AUTOMATICALLY AND IT DOESN'T
REALLY FOLLOW KIND OF THE
CONSTITUTIONAL PRECEDENT ON
THIS, EITHER. IT IT DOESN'T
FOLLOW THAT YOU SHOULD BE ON,
YOU KNOW, FOUND TO BE INCAPABLE
TO REFUSE PSYCHIATRIC MEDICATION
. THE STANDARD FOR KEEPING
SOMEONE IN THE HOSPITAL UNDER
INVOLUNTARY HOLD IS TYPICAL,
TYPICALLY DANGER TO SELF AND
OTHERS RIGHT, AS OPPOSED TO, I
COULD BE A DANGER TO MYSELF AND
OTHERS. THAT DOESN'T MEAN THAT I
HAVE AM IN A MENTAL PLACE WHERE
I SHOULDN'T BE ABLE TO MAKE MY
OWN MEDICAL DECISIONS. AND SO
IT'S JUST NOT THAT BINARY. IT'S
NOT LIKE I IF A PERSON IS FOUND
TO BE ABLE TO MAKE THEIR OWN
MEDICAL DECISIONS, IT DOESN'T
MEAN OH, THEY GO OFF MEDICATION.
IT MEANS THAT IF A PSYCHIATRIST
IS MAKING A CLAIM ABOUT WHAT
THEIR MED REGIMEN SHOULD BE.
IT'S WHETHER THE PERSON HAS THE
ABILITY TO SAY YES, NÓ, OR COULD
I TRY SOMETHING DIFFERENT?
OBVIOUSLY THERE CAN BE THAT
CONVERSATION RIGHT? BUT AS
SOMEONE WHO TAKES SIGNIFICANT
PSYCHIATRIC MEDIC IN MEDICATION,
SOMETIMES I'VE HAD SITUATIONS
WHERE I HAVE EXPERIENCED SIDE
EFFECTS THAT MADE ME FEEL LIKE
THIS WASN'T THE BEST COURSE OF
MEDS IN A PSYCHIATRIST WASN'T
LISTENING TO ME AND WASN'T
TAKING THAT SERIOUSLY. RIGHT SO
I JUST WANNA SEPARATE OUT THOSE
TWO ISSUES AND JUST SHARE THAT
LIKE THIS IDEA THAT BECAUSE A
PERSON IS BEING HELD, THEY
THEREFORE SHOULDN'T NEED ANOTHER
HEARING TO DETERMINE WHETHER
THEY CAN REFUSE PSYCHIATRIC MEDS
. IT'S JUST IT'S A LITTLE BIT
DICEY, BOTH CONSTITUTIONALLY AND
IN PRACTICE. UM WHEN YOU'VE GONE
THROUGH THIS, RIGHT, SO I JUST
WANT TO SHARE THAT. OK AND AGAIN
. WE'RE NOT TALKING ABOUT PEOPLE
WHO ARE SEEING THEIR
PSYCHIATRIST ON AN OUTPATIENT
BASIS AND GOING IN FOR THE
ADJUSTMENT. WE'RE TALKING ABOUT
PEOPLE WHO HAVE BEEN FOUND TO BE
INCAPACITATED. SO I THINK THAT
IS THE DISTINCTION. AND I THINK
USING EXAMPLES LIKE ONE FLEW
OVER THE CUCKOO'S NEST IS A
LITTLE BIT INFLAMMATORY. IT'S
NOT. WE'RE NOT TALKING ABOUT
GOING BACK IN TIME. WE'RE
TALKING ABOUT TRYING TO THE
SERVICES THAT PEOPLE NEED RIGHT
NOW. AND I KNOW THE A èC LU IS
ALSO OPPOSED TO S¼ P 43 THAT WE
DID LAST YEAR THAT WILL ALSO
EXPAND THE DEFINITION OF WHAT IT
MEANS TO BE GRAVELY DISABLED AND
TO BE ABLE TO MAKE YOUR OWN
HEALTH CARE DECISIONS. BE
BEFORE. BEFORE I TURN TO SENATOR
RUBIO. I'M JUST CURIOUS. I MEAN,
IS THE STANDARD REALLY DIFFERENT
? I MEAN, THERE HAS TO BE A
LEGAL STANDARD HERE. WE'RE
DEALING WITH THE LAW, AND WE'RE
DEALING WITH DECISIONS THAT THE
COURT MAKES WITH ADVICE AND
ASSISTANCE BY MENTAL HEALTH
PROFESSIONALS IN THIS CONTEXT
AND THE CONSTITUTION AND THE
CONSTITUTIONAL RIGHTS OF
INDIVIDUALS HAVE SO CAN ONE BE
INCAPACITATED TO THE POINT WHERE
THEY HAVE TO BE DETAINED AND
VOLUNTARILY IN IN A IN A MENTAL
HEALTH FACILITY AND STILL HAVE
THE CAPACITY TO DECIDE WHETHER
OR NOT THEY SHOULD TAKE THEIR ME
THEY WANT TO TAKE THEIR
MEDICATION. THAT'S A REALLY GOOD
QUESTION. UH, CHAIR ROTH AND THE
ANSWER IS, YES. THE RIGHTS ARE
DIFFERENT. THERE'S ACTUALLY A
DIFFERENT EVIDENTIARY STANDARD.
SO THE EVIDENTIARY STANDARD TO
BE HELD IN A PSYCHIATRIC
FACILITY IS PROBABLE CAUSE
COURTS HAVE HELD THAT THE RIGHT
TO REFUSE MEDICATION IS ACTUALLY
MORE PROTECTED THAN THE RIGHT
TO, UH, ONE'S LIBERTY. UM
BECAUSE PSYCHIATRIC MEDICATION
IS SUCH AN INVASIVE THING NOT
ONLY IS IT? UM COMPROMISE BODILY
AUTONOMY. IT ALSO COMPROMISES
ONE'S MIND. IT'S A THEY'RE VERY
POWERFUL MEDICATIONS, SO IT IS.
IT IS A DIFFERENT EVIDENTIARY
STANDARD AND COURTS HAVE HELD
THAT THE RIGHT TO REFUSE
MEDICATION IS ACTUALLY MORE
PROTECTIVE. YOU HAVE MORE RIGHTS
IN THAT SPACE THAN YOU DO TO BE
INVOLUNTARILY, BUT IN A
PRACTICAL CONTEXT, WE ACTUALLY
HAVE CASES AND DECISIONS WHERE
THE COURTS HAVE HELD AN
INDIVIDUAL INVOLUNTARILY IN A
FACILITY. BUT RULED THAT THE
PERSON DOES NOT HAVE HAS THE
RIGHT NOT TO TAKE MEDICATION.
YES I. I AM A FORMER PATIENTS
RIGHTS ADVOCATE. I'VE
REPRESENTED HUNDREDS OF
INDIVIDUALS IN THESE PETITIONS.
AND YOU KNOW, WE WIN THESE
HEARINGS FOR PEOPLE WHO ARE
INVOLUNTARILY DETAINED, BUT HAVE
THE RIGHT UM, YOU KNOW, THE
COURT DETERMINES THAT THEY STILL
HAVE THE RIGHT TO REFUSE
MEDICATION, SO IT'S A DIFFERENT
LEGAL STANDARD. IT'S A HIGHER
EVIDENTIARY STANDARD. AND UM,
YOU KNOW THIS BILL ROLLING BACK
THOSE RIGHT? IT'S SO NOT UM, YOU
KNOW, ELIMINATING THESE DUE
PROCESS PROTECTIONS IS REALLY
CONCERNING. BUT IN THE IN THE
CASE WHERE SOMEONE IS HELD AND
IS BEING FORCED TO TAKE
MEDICATION INVOLUNTARILY AND
INDIVIDUALS SUCH AS YOURSELF OR
YOUR ORGANIZATION FEEL THAT
THAT'S INAPPROPRIATE OR A LOCAL
ADVOCATE RIGHTS ADVOCATE, WOULD
THEY NOT HAVE ACCESS TO THE
COURTS TO BE A MOTION TO HAVE
THE COURT RECONSIDER THE ISSUE?
SO WHAT? WHAT THIS BILL WOULD DO
IS CONSIDER THE ISSUE THIS BILL
WOULD ELIMINATE DUE PROCESS
PROTECTION. SO CURRENTLY, IF
YOU'RE IN A FACILITY, YOU WOULD
HAVE THE RIGHT TO CONTEST AN
INVOLUNTARY MEDICATION ORDER
DURING THE DURATION OF THAT
DETENTION. LET'S SAY, FOR
EXAMPLE ABOUT I THINK ABOUT FIVE
TIMES SO THIS BILL WOULD MAKE IT
SO THAT IT WOULD ELIMINATE THREE
OF THOSE FIVE TIMES SO YOU WOULD
ONLY HAVE THE RIGHT TO CONTEST
THAT INVOLUNTARY MEDICATION
ORDER IN THE INITIAL HEARING,
AND THEN YOU WOULD HAVE THE
RIGHT TO FILE AN APPEAL, SO IT
MAKES IT SO THAT YOU HAVE LESS
RIGHTS TO CONTEST INVOLUNTARY
MEDICATION ORDERS THAN YOU DO TO
CONTEST YOUR CONFINEMENT EVEN
THOUGH COURTS HAVE HELD THE
OPPOSITE WELL, DOESN'T THIS BILL
ONLY IMPACT THE TIMING OF
HEARINGS THAT WE SET? WE DON'T
WE CAN'T INTERFERE WITH
SOMEONE'S CONSTITUTIONAL RIGHTS.
SO IF SOMEONE IS A
CONSTITUTIONAL RIGHT CAN'T YOU
GO TO COURT AND FILE A MOTION
AND HAVE A JUDGE? HEAR THE CASE?
YOU HAVE ONE RIGHT TO APPEAL
BOTH FOR THE INVOLUNTARY
DETENTION AND FOR THE PETITION.
SO WHAT THIS BILL DOES IS IT IS
IT ROLLS BACK ADDITIONAL
PROTECTIONS THAT YOU HAVE TO
CONTEST THE INVOLUNTARY
MEDICATION ORDER. ALL THIS BILL
DOES. IT DOESN'T GET PEOPLE OFF
THE STREETS. IT ELIMINATES DUE
PROCESS PROTECTIONS FOR PEOPLE
TO CONTEST THESE ORDERS. I DON'T
WANT TO BELABOR THIS. I'M NOT
SURE I UNDERSTAND THAT IF IT'S A
CONSTITUTIONAL RIGHT. I'M SURE
SOMEONE OUGHT TO BE ABLE TO
FIGURE OUT A WAY TO GET INTO
COURT. TO CHALLENGE THE
CONSTITUTION. CONSTITUTIONALITY
OF WHAT THE GOVERNMENT OR SOME
GOVERNMENT AGENCY IS DOING VIS A
VIS THE PERSON BEING IMPACTED.
BUT I'M GONNA CALL ON SENATOR
RUBIO TO ANSWER. ASK HER
QUESTION, SENATOR RUBIO. THANK
YOU, MR CHAIR. I THINK MY
CONCERN QUESTION AND ALONG THE
LINES THAT OF THE CHAIR, UH,
BECAUSE YOU'RE SAYING THAT IT
ELIMINATES DUE PROCESS, SO I'M
JUST GONNA TURN IT OVER TO THE
AUTHOR TO GO DOWN. AND YOU KNOW
WHAT I'M HEARING IS ELIMINATING
ELIMINATING DUE PROCESS. CAN YOU
GO OVER AND HIGHLIGHT AT THE
RIGHTS AND HOW WE COME TO THIS?
THAT DOESN'T VIOLATE JUST
ELIMINATING DUE PROCESS
COMPLETELY BECAUSE THAT'S KIND
OF WHAT I HEAR WHEN I HEAR THE
LAST STATEMENT. SO WE'RE TALKING
AND PEOPLE ALWAYS HAVE. THE
RIGHT TO FILE HABEAS CORPUS
WITHOUT RIGHT DOES NOT DISAPPEAR
IN ANY FORM. WHAT THIS DOES, IF
A PERSON HAS NOT BEEN RESTORED
TO CAPACITY. IT ALLOWS NOT TO
HAVE ANOTHER RE HEARING. AND
AGAIN. THIS IS THE PHYSICIAN WHO
IS TREATING THAT PERSON SAYING
THAT YOU STILL DON'T HAVE THE
CAPACITY. WE ALL JUST HEARD A
CASE SOMEBODY WAS IN HELD FOR,
LIKE, THREE MONTHS AND THEN JUST
DISCHARGED WITH NÓ AFTERCARE,
AND I DIDN'T LOOK AT IT
SPECIFICALLY, BUT I WOULD GUESS
THAT THE MEDICATION WASN'T
CONTINUED BECAUSE THEY WERE
NEVER ABLE TO RETURN TO CAPACITY
AND THEN EVENTUALLY JUST
RELEASED SO AGAIN, WE ARE NOT
AND WE CAN CONTINUE TO WORK ON
IT. WE NEED TO MAKE IT MORE
CLEAR ABOUT HABEAS CORPUS. WE'RE
NOT TRYING TO INTERFERE WITH
THAT AT ALL. JUST THE AUTOMATIC
THAT REQUIRES IT THAT SOMETIMES
CAN'T GET ON THE DOCKET AND THEN
PEOPLE GO FOR DAYS WITHOUT
HAVING THEIR MEDICATION. AND
THEN AGAIN, THE CONSEQUENCE OF
THAT IS TO GO BACKWARDS. THE
CONSEQUENCE OF THAT IS TO
DECOMPENSATE FURTHER AND THEN
NEED LONGER TO STAY IN ORDER TO
GET CAPACITY BACK. WELL I KNOW A
GUEST TO BE CLEAR WHAT I'M
HEARING, YOU KNOW, YOU SAY AND
BUT IS COUNTER TO WHAT HE'S
SAYING IS THAT, UH, THE RIGHT IS
STILL THERE. BUT THE OTHER PART
FOR ME IS THAT RESTRAINT TO
CAPACITY AND THAT IS, I IMAGINE
THERE'S PROFESSIONALS LOOKING AT
THIS INDIVIDUAL AND SEEING WHAT
THEIR CAPACITY IS, SO IT'S NOT.
THEY'RE JUST AUTOMATICALLY
SAYING LET'S DO IT THERE, SEEING
THAT THEY ARE RESTORED TO
CAPACITY. IF NOT, YOU KNOW, THEN
THAT'S WHEN THIS KICKS IN RIGHT,
SO I KNOW IT'S A LITTLE
CONFUSING, BUT I JUST FROM MY
SECURITY, I SEE AUTHOR'S POINT.
I'D LIKE TO PROVIDE SOME CONTEXT
THAT MIGHT HELP IF I COULD
PLEASE OK. SURE SO THERE IS A
CONTINUOUS DAILY EVALUATION FOR
CAPACITY. RIGHT START WITH THAT
45 DAYS, 12 DAYS, WHATEVER. UM
THAT'S THE CONTEXT. THE OTHER IS
THAT THERE ARE MULTIPLE
OPPORTUNITIES FOR DUE PROCESS.
SO YOU HAVE PROBABLE CAUSE
HEARINGS. YOU HAVE CERTIFICATION
HEARINGS. YOU'VE GOT THE REESE
HEARING AND THEN YOU'VE GOT THE
RED HERRING. SO WHILE WE'RE
DOING IS ALTERNATING, ALTERING
ONE OF THOSE HEARINGS, THE OTHER
OPTIONS ARE STILL AVAILABLE. THE
WAY YOU EXPLAIN IT TO ME RIGHT
NOW. I CAN SEE BECAUSE AGAIN IF
YOU WAS HERE AND WITHOUT RESPECT
, I HEAR THAT I FEEL LIKE ALL
RIGHTS ARE OUT THE WINDOW. BUT
THE WAY YOU EXPLAIN IT, THERE'S
MULTIPLE OPPORTUNITIES, RIGHT?
AND THERE'S A REAL BIG CONFLICT,
UH, FOR ME IN PARTICULAR, BUT
BECAUSE WE SEE I YOU KNOW, I HAD
A YOU KNOW, VERY AFFLUENT WOMAN.
COME TO ME TO SAY THAT HER
MOTHER WAS ON THE STREET AND
THEY NEEDED HELP. AND THERE'S
ALWAYS THIS THIS CONFLICT WHERE
YOU WANT PEOPLE TO HAVE THEIR
RIGHTS. BUT THEN, ON THE OTHER
HAND, YOU CAN'T HELP THESE
INDIVIDUALS THAT ARE ON THE
STREET OR THEY'RE SICK OR
PERHAPS NOT BEING ABLE TO TAKE
CARE OF THEMSELVES THAT WE DON'T
HAVE THESE TYPE OF, UH, TWO
BILLS IN PLACE. SO WITH THAT, I
JUST WANT TO MOVE THE BILL WHEN
IT'S SECURE. THANK YOU. THANK
YOU, UM SENATOR RUBIO COLLEAGUES
ANY OTHER QUESTIONS, COMMENTS OR
CONCERNS? SEEING NONE. SENATOR
WOULD YOU LIKE TO CLOSE? THANK
YOU, MR CHAIR, AND I APPRECIATE
THE CONVERSATION AND I
APPRECIATE THE ONGOING
OPPOSITION FROM DISABILITY
RIGHTS AND A èC LU AND I GET IT
AND I THINK AS A HEALTHY
CONVERSATION WE NEED TO CONTINUE
TO HAVE, UM AND BUT I DO BELIEVE
THAT WE NEED TO BE ABLE TO
PROVIDE TREATMENT AT THE IN THE
BEST WAY THAT WE CAN IN ORDER TO
GET PEOPLE BACK INTO A PLACE
WHERE THEY CAN MAKE THEIR OWN
DECISIONS AGAIN. THIS IS ALWAYS
TO MOVE PEOPLE TO A LOWER LEVEL
OF CARE. IT IS NOT TO CONTINUE
TO HOLD PEOPLE. IT'S TO MOVE
THEM TO A LOWER LEVEL OF CARE,
SO THEY BE RESTORED TO CAPACITY
AND GO ON ABOUT THEIR LIVES, AND
I RESPECTFULLY ASK FOR YOUR VOTE
YOU SENATOR, SENATOR RUBIO HAS
MOVED THE BILL. THE MOTION IS TO
PASS AS AMENDED. WE REFER THE
COMMITTEE ON JUDICIARY. PLEASE
CALL THE ROLL. SENATOR ROSS ROTH
. I WHEN I WHEN I GLAZER
GONZALEZ GROWTH GROVE. I
HURTADO. LIONE LIMÓN I MENJIVAR
MENJIVAR. I RUBIO I RUBIO I
SMALLWOOD QUAS I SMALLWOOD QUAS
I WIENER WIENER. I THANK YOU
MEMBERS VOTE IS 8 TO 0. WE'LL
HOLD THE OPEN FOR ABSENT
MEMBERS. THANK YOU ALL FOR
PARTICIPATING. UM OUR FINAL ITEM
. UM THIS AFTERNOON IS ITEM
NUMBER NINE. SENATE BILL 957
SENATOR WEINER DATA COLLECTION.
SIR. PLEASE PROCEED WHEN READY.
THANK YOU VERY MUCH, MISTER.
CHAIR IT'S YOU AND YOUR STAFF
FOR WORKING WITH US ON THIS
BILL, PRESENTING SENATE BILL 957
, WHICH WILL WHICH SEEKS TO
ADDRESS A VERY SIGNIFICANT GAP
IN OUR HEALTH CARE SYSTEM
RELATING TO L GB Tð Q PEOPLE,
WHICH IS A PROFOUND LACK OF DATA
COLLECTION. I'M GOING TO BE
PERFECTLY HONEST WITH YOU, UH,
COLLEAGUES, UM, I REALLY WISH
THAT I COULD HAVE USED THIS BILL
VEHICLE FOR SOMETHING ELSE. I
WISH I DID. NOT HAVE TO
INTRODUCE THIS BILL. THE
CALIFORNIA DEPARTMENT OF PUBLIC
HEALTH SHOULD BE JUST
AUTOMATICALLY COLLECTING THIS
DATA, AND IT'S FRANKLY
DISAPPOINTING THAT I HAD TO
INTRODUCE THIS BILL AFTER I
INTRODUCE ANOTHER BILL IN 2020
THAT WAS PASSED AND AFTER FORMER
ASSEMBLY MEMBER TWO PASSED A LAW
A NUMBER OF YEARS AGO. IT HAS
BEEN VERY CLEAR THAT THIS
LEGISLATURE WANTS DATA
COLLECTION ON SEXUAL ORIENTATION
AND GENDER IDENTITY SO THAT WE
CAN HAVE A FULL PICTURE OF THE
NEEDS AND THE DISPARITIES
RELATING TO L, GB Tð Q COMMUNITY
AND, SADLY, THAT SIMPLY HASN'T
HAPPENED. AND SO WE ASKED FOR AN
AUDIT OF CDPH IN THIS ISSUE
SEVERAL YEARS AGO, THAT AUDIT
CAME BACK WITH SOME VERY CLEAR
DEFICIENCIES IN THE LION'S SHARE
OF CDPH FORMS. IT DOES NOT ASK
FOR VOLUNTARY INFORMATION ABOUT
A PERSON'S SEXUAL ORIENTATION
AND GENDER IDENTITY. WE KNOW
THAT CDPH IS NOT COLLECTING THIS
DATA FROM FROM OTHER ENTITIES
LIKE COUNTY HEALTH DEPARTMENTS,
AND SO IT IS, UH, WE SIMPLY DO
NOT HAVE THE COMPLETE PICTURE OF
THE HEALTH AND HEALTH
DISPARITIES RELATING TO L GB Tð
Q PEOPLE, UH, AND THIS IS A
MATTER OF LIFE AND DEATH. IT'S
NOT JUST INFORMATION FOR THE
SAKE OF INFORMATION WHEN YOU
THINK ABOUT EARLY IN THE
PANDEMIC WHEN WE WERE STILL
LEARNING ABOUT THE VIRUS. WE
KNEW THAT, UH, BLACK PEOPLE WERE
MUCH MORE LIKELY TO DIE OF COVID
. WE KNEW THAT LATINO PEOPLE
WERE MUCH MORE LIKELY TO BE
INFECTED BY COVID. WE KNEW THAT
OLDER PEOPLE WERE MUCH MORE
LIKELY TO GET BECOME SEVERELY
ILL AND TO DIE THAN YOUNGER
PEOPLE WERE WE AND THE QUESTION
IS HOW HOW DID WE KNOW THESE
THINGS? WE DIDN'T JUST MAGICALLY
KNOW THESE THINGS? IT WASN'T
ANECDOTAL. IT WAS BECAUSE IN OUR
HEALTHCARE SYSTEM, WE VERY
CONSISTENTLY ASK PEOPLE TO ALL
VOLUNTARY. NONE OF THIS IS
MANDATORY. BUT MOST PEOPLE
ANSWER WHAT IS YOUR GENDER? WHAT
IS YOUR AGE? WHAT IS YOUR RACE,
AND THAT DATA ALLOWED US TO KNOW
QUICKLY. WAS MOST AT RISK OF
COVID, UH AND WE DON'T HAVE THAT
INFORMATION FOR L GB Tð Q PEOPLE
BECAUSE WE DO NOT ASK IT. AND WE
DON'T ASK, AND I'M GOING TO BE
HONEST WITH YOU. IT'S BECAUSE WE
TOO MANY PEOPLE IN OUR HEALTH
CARE SYSTEM ARE STILL IS THIS
PERCEPTION THAT IS SO DATED AND
OLD THAT THE THAT YOUR SEXUAL
ORIENTATION WHETHER YOU'RE GÂY
OR LESBIAN OR TRANS OR BI IT
SOMEHOW A DIRTY LITTLE SECRET.
IT'S QUOTE UNQUOTE PRIVATE, AND
SO WE CAN'T POSSIBLY ASK ANYONE
FOR THAT. MAYBE THAT WAS THE
ATTITUDE MANY YEARS AGO. THAT
SHOULD NOT BE THE TO TODAY AGAIN
. NÓ ONE IS REQUIRED TO ANSWER
JUST LIKE YOU DON'T HAVE TO SAY
WHAT YOUR RACE IS, OR YOU DON'T
HAVE TO ANSWER ANY OF THAT. BUT
WE SHOULD BE ASKING THE QUESTION
AND MOST PEOPLE WILL PROVIDE
THAT DATA, AND IT WILL ALLOW US
TO FOCUS RESOURCES TO FOCUS. UH,
EDUCATIONAL CAMPAIGNS TO ADDRESS
ANY KINDS OF DISPARITIES OR
SHORTCOMINGS. AND SO THIS BILL
FULLY IMPLEMENTS THE STATE
AUDITORS AUDIT RECOMMENDATIONS.
THIS WILL, I THINK, FINALLY PUT
A STOP TO THESE DEFICIENCIES.
AND I RESPECTFULLY ASK FOR YOUR
EYE VOTE WITH ME TODAY TO
TESTIFY IS CRAIG PULSIFER, THE
LEGISLATIVE DIRECTOR WITH THE
EQUALITY CALIFORNIA AND EVE
BANNA FROM THE SACRAMENTO L GB
Tð CENTER. MS FOER, PLEASE
PROCEED. GOOD AFTERNOON CHAIR
AND MEMBERS. CRAIG POLSTER ON
BEHALF OF EQUALITY, CALIFORNIA
PROUD COSPONSOR AND, UH,
APPRECIATE SENATOR WEINER
BRINGING THIS BILL FORWARD TO
MAKE SURE THAT èC P WAS
COLLECTING ACCURATE AND COMPLETE
DATA TO IMPROVE PROGRAMS AND
SERVICES FOR L GB Tð Q PEOPLE.
EFFORTS TO COLLECT SOJI DATA
HAVE BEEN UNDERWAY FOR QUITE
SOME TIME. BUT AS THE SENATOR
NOTED, THE URGENCY BEHIND
COLLECTING THIS DATA WAS REALLY
MADE CLEAR DURING THE COVID
PANDEMIC. WHEN MEMBERS OF THE
COMMUNITY ESPECIALLY WERE
ESPECIALLY VULNERABLE TO THE
IMPACTS OF COVID AND SOCHI DATA
WAS NOT BEING ROUTINELY
COLLECTED. MOST RECENTLY IN 2022
SOJI DATA COLLECTION BECAME EVEN
MORE CRITICAL DURING THE OX
OUTBREAK, WHEN THE VAST MAJORITY
OF CASES WERE ON GÂY AND
BISEXUAL MEN AND ACCURATE DATA
WAS ESSENTIAL TO EFFECTIVELY
TARGET VACCINES AND OTHER
RESOURCES TO THIS COMMUNITY.
UNFORTUNATELY DESPITE PREVIOUS
LEGISLATION MANDATING CDPH AND
OTHER STATE DEPARTMENTS COLLECT
VOLUNTARY SOJI DATA WHEN
COLLECTING OTHER DEMOGRAPHIC
DATA, THE AUDITOR'S REPORT
REVEALED THAT THEY ARE STILL
GLARING ISSUES RELATED TO THE
COLLECTION AND REPORTING OF THIS
DATA BOTH WITHIN AND AMONG THE
PROVIDERS AND LABS THEY WORK
WITH. NOTABLY THE REPORT FOUND
THAT èC Dð P COLLECTS COMPLETE
SOJI DATA ON A VERY SMALL NUMBER
OF FORMS ONLY 17 OUT OF 100.
NINE. LAST WEEK. èC Dð P SHARED
AND, UH, A BUDGET SUBCOMITTEE
HEARING THAT IT'S WORKING
DILIGENTLY TO IMPLEMENT THE
RECOMMENDATIONS FROM THIS REPORT
, S¼ 957 WILL HELP TO ENSURE
THAT THE DEPARTMENT FOLLOWS
THROUGH ON THAT STATED
COMMITMENT AND IMPORTANTLY, THE
BILL WILL REQUIRE èC Dð P TO
PROVIDE AN ANNUAL REPORT TO THE
LEGISLATURE AND TO THE PUBLIC
ABOUT ITS PROGRESS IN
IMPLEMENTING THE RECOMMENDATIONS
FROM THE AUDIT, INCLUDING THE
STEPS IT IS TAKING TO IMPROVE
PROGRAMS AND SERVICES FOR L GB
Tð Q PEOPLE AND AGAIN THANK THE
SENATOR FOR HIS WORK ON THIS
ISSUE OVER THE PAST SEVERAL
YEARS AND RESPECTFULLY REQUEST
YOUR VOTE. THANK YOU, SIR. GOOD
AFTERNOON, MR CHAIR AND MEMBERS.
MY NAME IS EVE BANNA AND I'M
WITH THE SACRAMENTO L GB Tð
COMMUNITY CENTER. HAPPY TO BE
HERE TODAY TO SHOW MY SUPPORT
FOR SENATE BILL 957, WHICH SEEKS
TO IMPROVE THE COLLECTION OF
SEXUAL ORIENTATION AND GENDER
IDENTITY DATA. AT THE CENTER. WE
OFTEN HEAR FIRSTHAND ACCOUNTS
ABOUT THE LACK OF AFFIRMING
RESOURCES AVAILABLE TO L GB Tð
COMMUNITY MEMBERS. L GB Tð
PEOPLE ARE OFTEN LEFT TO RELY ON
EACH OTHER FOR SUPPORT.
INFORMATION AND CARE, UM, TO
MAKE UP FOR A LACK OF AVAILABLE
RESOURCES FOR THEM. THIS LACK OF
SUPPORT CAN BE ATTRIBUTED TO
MANY THINGS, INCLUDING PERVASIVE
STIGMA, MISINFORMATION AND AN
INCOMPLETE UNDERSTANDING OF THE
NEEDS OF L GB Tð Q, PLUS
COMMUNITY MEMBERS. L GB Tð Q.
PEOPLE SHOULD NOT HAVE TO FILL
IN THESE GAPS BY THEMSELVES AND
ONE IMPORTANT WAY TO ADDRESS
THESE ISSUES IS BY PRIORITIZING
BETTER SEXUAL ORIENTATION AND
GENDER IDENTITY DATA COLLECTION.
FOR L GB Tð COMMUNITY
EXPERIENCES, EXTENSIVE HEALTH
DISPARITIES. UM, THIS INCLUDES
HEIGHTENED RATES OF ANXIETY,
DEPRESSION, CERTAIN TYPES OF
CANCER SUBSTANCE USE
CARDIOVASCULAR DISEASE AND
DISABILITY. OVERALL, UM TO
REDUCE THESE HEALTH DISPARITIES.
WE NEED TO UNDERSTAND COMMUNITY
MEMBERS UNIQUE EXPERIENCES AND
NEEDS. UM AND PARTICULARLY THOSE
WHO HAVE MULTIPLE MARGINALIZED
IDENTITIES AND TO DO THIS, WE
NEED COMPLETE SOJI DATA. UM IF
WE DO NOT PRIORITIZE THIS TYPE
OF DATA WE RISK PERPETUATING THE
SAME PROBLEMS THAT HAVE BEEN
IMPACTING. L GB Tð COMMUNITIES
FOR GENERATIONS. SO GIVEN ALL OF
THIS, THE SACRAMENTO L GB Tð
COMMUNITY CENTER STRONGLY
RECOMMENDS SENATE BILL 957 AND
WE ARE DUE TO SUPPORT THIS
IMPORTANT LEGISLATION. QUEER AND
TRANS FOLKS NEED US TO DO BETTER
. UM AND WE BELIEVE THAT SENATE
BILL NINE AND 57 IS A MUCH
NEEDED SOLUTION TO ADDRESS THESE
EXISTING HEALTH DISPARITIES. SO
THANK YOU SO MUCH FOR YOUR
CONSIDERATION. THANK YOU FOR
JOINING US ANY OTHER SUPPORT
WITNESSES HERE IN THE HEARING
ROOM IN SUPPORT, PLEASE. RANDY
HICKS, A MEMBER OF THE L GB Tð
Q. AND CITIZEN OF THIS STATE AND
STRONG SUPPORT. THANK YOU, SIR.
NEXT, PLEASE. NICOLE MOLES ON
BEHALF OF CHILDREN NOW IN STRONG
SUPPORT. THANK YOU NEXT, PLEASE.
JENNIFER ROBLES WITH HEALTH
ACCESS CALIFORNIA AND SUPPORT
THANKS FOR JOINING US NEXT,
PLEASE. MEMBERS OGDEN SMITH WITH
THE AMERICAN CANCER SOCIETY
CANCER ACTION NETWORK. ALSO IN
SUPPORT. THANK YOU. NEXT,
PLEASE. GOOD AFTERNOON, RYAN
SOUZA WITH THE SAN FRANCISCO
AIDS FOUNDATION AND ÁP HEALTH
AND SUPPORT. THANKS FOR JOINING
US, SIR. NEXT, PLEASE. GOOD
AFTERNOON, WHITNEY FRANCIS WITH
THE WESTERN CENTER ON LAW AND
POVERTY IN SUPPORT. M FRANCIS,
PLEASE. THEY NEED A STRAND
VOLUNTEER WITH A ARP, CALIFORNIA
IN SUPPORT. THANK YOU ANY OTHER
WITNESSES IN SUPPORT? OK SEEING
NONE. LET'S START WITH THE LEAD
OPPOSITION WITNESSES. ANY
OPPOSITIONS, ANY OPPOSITION
WITNESSES LEAD OPPOSITION. OTHER
OPPOSITION. OK SEEING NONE.
LET'S BRING THE DISCUSSION BACK
TO MY COLLEAGUES ON THE DAY AS
COLLEAGUES ANY QUESTIONS,
COMMENTS CONCERNS SENATOR
MENJIVAR JUST TO COMMENT. YOU
KNOW THE CHAIR AND I JUST LAST
WEEK WERE TALKING ABOUT THIS IN
SUB THREE AND THE SENATOR, UH,
WHO'S BRINGING THIS FORWARD? I
WANT TO THANK YOU SO MUCH
BECAUSE YOU'RE SO RIGHT. THE
EXCUSE WE GOT FROM THE
DEPARTMENT WAS PRIVACY LAWS,
PRIVACY LAWS, PRIVACY LAWS, AND
THAT'S THE ONLY EXCUSE FOR THIS
DEMOGRAPHIC. NOT FOR RACE, NOT
FOR SEX. EVERYTHING ELSE CAN BE
CAPTURED EXCEPT EXCEPT SOJI AND
A SMALLER STORY WHEN I WAS A
LITTLE STAFFER IN THE CITY OF L
A DURING COVID. I SAW YOUR BILL
PASS FROM 2020 OR SOMETHING LIKE
THAT. AND I WAS PUSHING THE CITY
OF L A. IT'S LIKE, HEY, THIS
BILL PASSED A WIDE. WHY AREN'T
WE DOING THIS AND WOULD GET THE
SAME PUSH BACK. WE CAN'T ASK
THAT QUESTION. WE CAN'T ASK THAT
QUESTION. SO I'M SORRY YOU HAD
TO TAKE UP A SPOT IN YOUR BILL
PACKAGE ON THIS, BUT I ALSO
THANK YOU FOR TAKING UP A SPOT
ON THIS ISSUE. SO WITH THAT MR
CHAIR WHEN APPROPRIATE, LIKE TO
MOVE THE BILL. THANK YOU,
SENATOR. ANY OTHER COMMENTS?
QUESTIONS OR CONCERNS BY MY
COLLEAGUES ON THE DAIS? I JUST I
HAVE A I HAVE A QUESTION, MR
CHAIR. THANK YOU, UM HOW DO WHAT
IS THERE AN ENFORCEMENT PIECE
HERE? HOW DO WE? I MEAN, THIS IS
HOW MANY YEARS IN THE MAKING.
WHAT WHAT? WHAT IS THE
OPPORTUNITY TO HAVE SOME
ACCOUNTABILITY ON THIS? SO YEAH,
AND I'VE I'VE LEARNED AND NOW MY
EIGHTH YEAR IN THIS BODY, LIKE
GETTING A BILL SIGNED INTO LAW
IS ONLY STEP ONE. YOU HAVE TO.
WE ALL HAVE TO SORT OF. REALLY
UH, MONITOR IMPLEMENTATION AND
MAKE SURE DEPARTMENTS ARE
IMPLEMENTING. AND WE DID, UM YOU
KNOW WE OUR L GB Tð Q CAUCUS
MET. EARLY ON WITH èC TO
EXPRESS OUR SERIOUS CONCERN
ABOUT THE LACK OF DATA
COLLECTION, AND SO WE'VE BEEN
MONITORING IT. I THINK THEY'RE
NOT NECESSARILY VIOLATING THE
LAW THERE, BUT THEY ARE
CERTAINLY DOING AT BEST. THE
BARE MINIMUM AND SO THIS, UH,
THIS BILL WILL FINALLY REQUIRE
THEM TO JUST DO IT
COMPREHENSIVELY, AND THEY SAY
THEY WANT TO DO THAT. AND AGAIN,
I WORK. I'M NOT. I'M NOT TRYING
TO DISPARAGE A LOT OF GREAT
PEOPLE AT THE DEPARTMENT OF
PUBLIC HEALTH. IT IS THAT IT'S
JUST THAT FOR WHATEVER REASON
REASON THE AGENCY HAS NOT.
OCCUPIED THE FIELD HERE AND JUST
GOTTEN IT DONE. UH AND WE I. I
WOULD HAVE HOPED WE DIDN'T NEED
A BILL. BUT WE DO AND THIS
HOPEFULLY WILL BE THE END OF IT.
THANK YOU FOR YOUR WORK ON THIS.
I AM HAPPY TO SUPPORT. THANK
YOU, SENATOR. I THINK ITS FINAL
CALL FOR QUESTIONS. OK UM THE
BILL HAS BEEN MOVED BY SENATOR
MENS SENATOR WEINER. WOULD YOU
LIKE TO CLOSE? RESPECTFULLY ASK
FOR AN I VOTE. THIS IS ITEM
NUMBER NINE. SENATE BILL 957 THE
MOTIONS BY SENATOR MINAR. IT'S
DUE PASS TO REFER TO THE
COMMISSION ON COMMITTEE ON
JUDICIARY. PLEASE CALL THE ROLL.
SENATOR ROSS ROTH. I WHEN, WHEN
NÓ. GLAZER GONZALEZ GONZALEZ, I
GROVE HURTADO HURTADO EYE LIMÓN
LIMÓN I MENJIVAR MENJIVAR, I
RUBIO RUBIO I SMALLWOOD QUAS
SMALLWOOD QUAS I WIENER WIENER.
I DID? YES. YOU WERE FIRST. OK
THE VOTE IS 8 TO 1. WE'LL KEEP
THE ROLL OPEN FOR ABSENT
MEMBERS. THANK YOU VERY MUCH.
THANKS FOR JOINING US. I'M GONNA
START AT THE TOP OF THE CONSENT,
ESPECIALLY WHEN WE GO THROUGH
THE CONSENT. YEAH, I'M GOING TO
START WITH. I'M JUST GONNA DO
ONE, WHICH IS CONSENT ITEM,
WHICH IS GO ONE THROUGH NINE.
WE'RE GOING TO, UM, FOR THOSE
WHO WEREN'T HERE. WE'RE GOING TO
OPEN THE ROLE TO MAKE SURE THAT
WE HAVE YOU CAPTURED. WE'RE
GOING TO START WITH, UM ITEM
NUMBER ONE IN THE CONSENT
CALENDAR, AND THE CONSENT
CALENDAR IS HAS THREE ITEMS ON
IT. ITEM NUMBER ONE SENATE BILL
945 ITEM NUMBER SIX SENATE BILL
1333 AND ITEM NUMBER EIGHT
SENATE BILL 112. THE CURRENT
VOTE IS 70 CHAIR VOTING. I
PLEASE CALL THE ROLL. SENATOR
GLASER. GONZALEZ GONZALEZ, I
GROVE SMALLWOOD CUEVAS.
SMALLWOOD CUEVAS? AYE. 9029 TO
0, RIGHT? VOTE IS 9 TO 0. WE'LL
KEEP THE ROLL OPEN FOR ABSENT
MEMBERS. NEXT IS, UM ITEM NUMBER
TWO. SENATE BILL 980 BY SENATOR
WAHAB. CURRENT VOTE IS 70 CHAIR.
VOTING. I PLEASE CALL THE ROLL.
SENATOR GLASER. GONZALEZ
GONZALEZ, I GROVE SMALLWOOD
CUEVAS. I SMALLWOOD QUAS. I
CURRENT VOTE IS 90. WE'LL HOLD
THE ROLL OPEN FOR ABSENT
MEMBERS. NEXT ITEM IS ITEM
NUMBER FOUR SENATE BILL 1017 BY
SENATOR EDMUND CURRENT VOTE IS
70 CHAIR VOTING. I SENATOR
GLASER. GONZALEZ GONZALEZ, I
SMALLWOOD QUAS IY SMALLWOOD
QUAS. I CURRENT VOTE IS 90.
WE'LL HOLD THE OPEN FOR ABSENT
MEMBERS. THE NEXT ITEM IS ITEM
NUMBER FIVE SENATE BILL 1184 BY
SENATOR EDMAN CURRENT VOTE IS 8
TO 0 CHAIR VOTING. I COLOR ROLE.
SENATOR GLASER GLASER, I,
GONZALEZ GONZALEZ. I HURTADO.
HURTADO. I THAT WAS YOUR HOME.
VOTE IS 11 0. IT RIGHT. THAT
MATTER IS OUT THAT MATTER IS
OUT. UM NEXT ITEM ITEM NUMBER
SEVEN S¼ B 953 BY SENATOR MANJAR
CURRENT VOTE IS 5 TO 0 CHAIR
VOTING, AYE. PLEASE CALL THE
ROLL, SENATOR W. GLAZER GLAZER,
I GONZALEZ GONZALEZ. I GROVE
LIMÓN LIMÓN I SMALLWOOD CUEVAS
SMALLWOOD QUAS. I. DO WE KNOW
WHETHER THE OTHER PEOPLE ARE
COMING BACK? CEDRIC GIRLS COMING
BACK. OH, SHE IS OK, SO WE'LL
HOLD IT OPEN. CURRENT VOTE IS 9
TO 0. WE'LL HOLD THE ROW OPEN
FOR ABSENT MEMBERS. AND THE LAST
ITEM ITEM NUMBER NINE. SENATE
BILL 957 BY SENATOR WEINER. THE
CURRENT VOTE IS 8 TO 1 CHAIR
VOTING. I PLEASE CALL THE ROLL.
SENATOR GLASER. HØI GLAZE YOUR
EYE GROVE. SORRY. 9 TO 1. THE
CURRENT VOTE IS 9 TO 1. WE'LL
HOLD THE ROLE OPEN FOR ABSENT
MEMBERS. THANK YOU ALL. LET'S
CALL THE ROLE ON THE CONSENT
CALENDAR AGAIN. ITEM NUMBER ONE
CONSENT CALENDAR CONSISTS OF
THREE BILLS. SENATE BILL 945
ITEM NUMBER ONE ITEM NUMBER SIX
SENATE BILL 1333 AND ITEM NUMBER
EIGHT. SENATE BILL 1112 CURRENT
VOTE ON THE CONSENT CALENDAR IS
9 TO 0 CHAIR VOTING. I PLEASE
CALL THE ROLL. SENATOR GLASER
GLAZER. I GROVE. VOTE IS 10 0
WILL HOLD OPEN FOR ABSENT
MEMBERS. AND DO WE WANT TO GET
TO SENATOR GLASER? WHAT IS HE
MISSING? HE'S MISSING ITEM 2980.
AND HE'S MISSING A COUPLE AND
ITEM. 4 1017. THANK YOU. OK
SENATOR GLASER. WE'RE GONNA CALL
THE ROLL FOR YOU ON THE, UM OPEN
ITEMS. THE NEXT ONE IS ITEM
NUMBER TWO SENATE BILL 980 BY
SENATOR WAHAB CURRENT VOTE IS 90
CHAIR VOTING I PLEASE CALL THE
ROLL. SENATOR GLASER GLASER. I
GROVE. VOTE IS 10 0. WE'LL HOLD
THE ROAD OPEN FOR ABSENT MEMBERS
NEXT ITEM. IS ITEM NUMBER FOUR
S¼ B 1017 BY SENATOR MON CURRENT
VOTE IS 90 SURE VOTING I SENATOR
GLASER GLASER. I GROVE CURRENT
VOTE. 10 0 WILL HOLD THE OPEN
FOR ABSENT MEMBERS. NEXT ITEM
ITEM NUMBER FIVE SENATE BILL
1184 BY SENATOR EDMUND CURRENT
VOTE IS THAT'S OUT. UH, GLAZER
IS ON EVERYTHING ELSE. OK THAT'S
IT FOR YOU, SENATOR. AND WE LET
HER KNOW AGAIN, SIR. SENATOR
GROVE. WE JUST WE JUST GROVE IS
ALL NEEDS TO VOTE ON CONSENT AND
SHE'S ON HER WAY, SHE SAYS.
SHE'S ON HER WAY, A FEW OF THEM
WELL, I HAVE TO CLOSE THEM OUT
ANYWAY, EXCEPT FOR SO SHE SHOULD
BE HERE MOMENTARILY, SIR. THANK
YOU. FOR THE FIRST IT WAS A
LITTLE LONG. THAT REALLY.
I'M SORRY, NÓ. IT'S OKAY. WE'RE
JUST GOING TO ROLL THROUGH.
WE'RE GONNA OPEN THE FILE ON ALL
OF THE ITEMS, EXCEPT FOR THE ONE
THAT'S OUT, SO WE'RE GOING TO
FIRST TAKE THE CONSENT CALENDAR,
STARTING WITH ITEM NUMBER ONE.
THERE ARE THREE ITEMS ON THE
CONSENT CALENDAR. S¼ B 945 ITEM
NUMBER THAT'S ITEM NUMBER ONE
ITEM. SIX SENATE BILL 1333, AN
ITEM NUMBER EIGHT. SENATE BILL
1112 CURRENT VOTE IS 10 0 CHAIR
VOTING. I PLEASE CALL THE ROLL,
SENATOR. GROSS. AYE, OTIS 11 0.
MATTER. THAT ITEM, WHICH IS A
CONSENT CALENDAR IS OUT. NEXT IS
ITEM NUMBER TWO SENATE BILL 980
0 BY SENATOR WAHAB CURRENT VOTE
IS 10 0 CHAIR VOTING. I PLEASE
CALL THE ROLL, SENATOR GROVE
GROVE. AYE CURRENT VOTE 11 0.
THAT ITEM IS OUT. NEXT ITEM IS
ITEM NUMBER FOUR SENATE BILL
1017 BY SENATOR EGM CURRENT VOTE
IS 10 0 CHAIR VOTING. I PLEASE
CALL THE ROLL, SENATOR GROVE
GROVE. I IS ONE THAT ITEM IS OUT
. ITEM NUMBER FIVE IS OUT. SEND
A BILL 184 NEXT ITEM ITEM NUMBER
SEVEN. SENATE BILL 953 BY
SENATOR MEN BAR. UH, CURRENT
VOTE IS NÓ IT'S 90 WEDNESDAY,
90. UH, CHAIR VOTING. I PLEASE
CALL THE ROLL SENATOR WHEN
SENATOR GROVE, NOT VOTING. FINAL
VOTE IS 90. THAT ITEM IS OUT.
AND THE FINAL ITEM IS ITEM
NUMBER NINE. SENATE BILL 957 BY
SENATOR WEINER. UM CURRENT VOTE
IS 991 CHAIR VOTING, AYE.
SENATOR GROVE. NÓ NÓ FINAL VOTE.
IS 9 TO 2. THAT ITEM IS OUT. AND
THIS CONCLUDES THE SENATE
COMMITTEE ON HEALTH HEARING FOR
TODAY, WHICH IS MARCH 2020 24.
WE ARE ADJOURNED. I'M SORRY.