GOOD AFTERNOON, UM, THE SENATE
HEALTH COMMITTEE WILL COME TO
ORDER. I APOLOGIZE FOR THE DELAY
. THERE WAS A ANOTHER COMMITTEE
IN HERE. THAT WAS, UM, HAD A
LONG AGENDA AND, UH, THEY WERE
CLEARING THE AGENDA. I ACTUALLY
CAME IN THE BACK DOOR SAW MY
COLLEAGUES THOUGHT I'D BEEN
REASSIGNED. I GUESS THAT'S NOT
THE CASE. SO THIS IS THE HEALTH
COMMITTEE. UM AS YOU KNOW, WE
WELCOME THE PUBLIC IN PERSON AND
LOOKS LIKE SEVERAL OF YOU ARE
HERE. WE ALLOW SIX MINUTES OF
TESTIMONY PER SIDE. OBVIOUSLY,
BREVITY IS APPRECIATED. WE DO
HAVE NINE BILLS ON TODAY'S
AGENDA. TWO OF THEM ARE GOING TO
BE OUR HONOR. PROPOSED CONSENT
CALENDAR ITEM NUMBER FIVE SENATE
BILL 1428 AND ITEM NUMBER SIX
SENATE BILL 1258 WITH AMENDMENTS
NOW THAT WE'VE HAD THAT OUT OF
THE WAY, WE'RE GOING TO FUNCTION
AS A SUB COMMITTEE, BUT WE'RE
GOING TO START WITH ITEM NUMBER
ONE SENATE BILL 909 BY SENATOR
UMBERG. IT'S MY UNDERSTANDING,
SENATOR NEWMAN WILL BE
PRESENTING PROCEED WHEN READY,
SIR. THANK YOU AND MR CHAIR WITH
YOUR PERMISSION. I'M THE SECOND
ITEM IS THE SECOND BILL. IF WE
COULD REVERSE THOSE ONE OF MY
WITNESSES HAS TO CATCH A FLIGHT.
YOU ABSOLUTELY CAN APPRECIATE
THAT. WE'RE REVERSING ITEM
NUMBER TWO SENATE BILL 1119 BY
SENATOR NEWMAN HOSPITAL SEISMIC
COMPLIANCE AND LET ME ADD I SAW
YOU COME IN IN THE MIDDLE OF THE
EQ MEETING. I THOUGHT YOU
HANDLED IT WITH GRACE AND
DIGNITY WHEN YOU LEFT, UM M
CHAIR MEMBERS. THANK YOU FOR THE
OPPORTUNITY TO PRESENT S¼ P 1119
COME ON. UH, WHICH WOULD
AUTHORIZE A LIMITED NUMBER OF
NARROW CASE SPECIFIC EXTENSIONS
OF THE 2025 SEISMIC COMPLIANCE
DEADLINES MANDATED BY A B 21 94
3 HOSPITALS, WHICH ARE ALL PART
OF THE PROVIDENCE HEALTH GROUP,
EACH OF WHICH IS ACTIVELY IN THE
PROCESS OF WORKING TO ACHIEVE
COMPLIANCE PER A B 2190. MORE
SPECIFICALLY, 1119 WOULD
AUTHORIZE EXTENSIONS OF TWO
ADDITIONAL YEARS FOR PROVIDENCE
ST JUDE MEDICAL CENTER IN
FULLERTON AND PROVIDENCE, ST
JOSEPH HOSPITAL IN EUREKA AND AN
EXTENSION OF ONE ADDITIONAL YEAR
FOR PROVIDENCE CEDARS TARZANA
MEDICAL CENTER IN LOS ANGELES
COUNTY. AS YOU'LL RECALL A B
2190 AUTHORED BY ASSEMBLY MEMBER
REYES IN 2018 REQUIRED ALL
CALIFORNIA HOSPITALS TO
SEISMICALLY PROTECT THEIR
BUILDINGS TO PROPERLY ENSURE THE
SAFETY OF PATIENTS AND STAFF
UNDER THE PROVISIONS OF THE BILL
, THE DEADLINE FOR FINAL SEISMIC
COMPLIANCE FOR HOSPITALS
EXECUTING A REPLACEMENT OR
RETROFIT PLAN WAS JULY 1ST 2022
AND FOR HOSPITALS SEEKING
EXTENSIONS BASED ON A REBUILD
PLAN. THAT DEADLINE IS JANUARY
1ST. 2025 AS IN SO MANY OTHER
AREAS. UH, THE COVID-19 PANDEMIC
CAUSED SUBSTANTIAL CHANGES IN
THE FINANCIAL PRIORITIES AND
CONDITIONS, UH OF HOSPITALS ALL
ACROSS THE STATE, REQUIRING MANY
HOSPITALS TO FOCUS ON ENSURING
ADEQUATE CAPACITY IN PATIENT
CARE IN MANY CASES AT THE
EXPENSE OF OTHER PRIORITIES, OR
MANDATES OR ONGOING WORK LIKE
THE RETROFIT PROCESS. THIS WAS
THE CASE WITH RESPECT TO THE
THREE PROVIDENCE FACILITIES
COVERED BY THIS BILL WITHOUT THE
EXTENSIONS PROVIDED FOR BY THIS
LEGISLATION AS A RESULT, OF
FAILING TO MEET THE PRESCRIBED
DEADLINES. THESE HOSPITALS WILL
LOSE THEIR LICENSURE AND THE
COMMUNITIES THEY SERVE WILL LOSE
ACCESS TO VITAL CARE. HAVING
SAID THAT, LET ME ADDRESS THE
VALID AND VERY REASONABLE
CONCERNS EXPRESSED BY THE
OPPOSITION. IT IS IMPERATIVE AS
WE ALL AGREE THAT STAFF AND
PATIENTS HAVE THE ASSURANCE THAT
HOSPITAL FACILITIES ARE SAFE AND
UP TO DATE IN COMPLIANCE WITH
ALL PREVAILING SEISMIC STANDARDS
. I WANT TO ASSURE YOU AS MY
WITNESSES WILL DO THAT THE THREE
HOSPITALS COVERED IN THIS
LEGISLATION CONTINUE TO WORK
ACTIVELY TOWARD COMPLIANCE AND
ARE IN THE MIDST OF ONGOING
CONSTRUCTION PLANS ALL THE WHILE
BALANCING THAT NEED WITH THE
OPERATIONAL COSTS AND
REQUIREMENTS OF OPERATING A
HOSPITAL INADEQUATELY SERVING
THE NEEDS OF THEIR PATIENTS. THE
LIMITED EXTENSION IS PROVIDED
FOR BY THIS BILL ARE NARROWLY
TAILORED TO ENSURE THAT NONE OF
THESE THREE IMPORTANT AREA
HOSPITALS WILL BE FORCED TO
CLOSE VITAL INFRASTRUCTURE WHILE
MAINTAINING THE REQUIREMENTS OF
THIS LEGISLATURE HAS RIGHTFULLY
PLACED ON CALIFORNIA HOSPITALS.
THE LEGISLATURE HAS PREVIOUSLY
RECOGNIZED THAT SUCH EXCHANGES
ARE REASONABLE AND WILL ALLOW
FOR THE COMPLETION OF THIS TYPE
OF ESSENTIAL INFRASTRUCTURE WORK
WHILE ENSURING CONTINUOUS
PATIENT CARE AT EACH FAC. IN
COMMUNITIES WHERE THAT CARE IS
DESPERATELY NEEDED WITH ME TO
TESTIFY TODAY IS LAURA RAMOS,
UH, THE èC E Ó OF PROVIDENCE
SAINT JUDE MEDICAL CENTER IN
FULLERTON, AND RYAN BARRY,
EXECUTIVE DIRECTOR OF
CONSTRUCTION SERVICES FOR
PROVIDENCE, CALIFORNIA I AM
RESPECTFULLY ASKING FOR YOUR I
VOTE TODAY. THANK YOU, SENATOR.
PLEASE PROCEED. THANK YOU. GOOD
AFTERNOON. MY NAME IS LAURA
RAMOS AND I AM THE CHIEF
EXECUTIVE OF SAINT JUDE MEDICAL
CENTER IN FULLERTON. I'M HERE
TODAY REPRESENTING ALL THREE OF
OUR PROVIDENCE MINISTRIES IN
NEED OF A SEISMIC EXTENSION AS
OUTLINED IN S¼ 1119. I WANT TO
EXPRESS MY SINCERE GRATITUDE TO
SENATOR JOSH NEWMAN AND THE
OTHER CO AUTHORS FOR CHAMPIONING
CHAMPIONING THIS LEGISLATION TO
ENSURE WE CAN MAINTAIN CRITICAL
ACCESS TO CARE IN COMMUNITIES.
ACROSS THE STATE. FOUNDED BY THE
SISTERS OF PROVIDENCE AND
SISTERS OF SAINT JOSEPH
PROVIDENCE, INCORPORATES OUR
MISSION OF SERVING THOSE WHO ARE
POOR AND VULNERABLE AND TO ALL
ELEMENTS OF OUR WORK AND
DECISION MAKING. LAST YEAR,
PROVIDENCE INVESTED
APPROXIMATELY $700 MILLION INTO
THE COMMUNITIES. WE SERVE IN THE
FORM OF GRANTS AND SERVICE
SUPPORTING MENTAL HEALTH ACCESS
TO HOUSING AND ACCESS TO MEDICAL
CARE. WHILE WE ARE STEADFAST AND
CONTINUING TO SUPPORT THE
COMMUNITIES THAT WE SERVE, WE
ARE IN DIRE NEED OF A LIMITED
EXTENSION TO REACH SEISMIC
COMPLIANCE AT OUR THREE HOSPITAL
CAMPUSES PROVIDENCE, SAINT
JOSEPH AND EUREKA. PROVIDENCE
CEDAR SINAI IN TARZANA AND
PROVIDENCE SAINT JUDE MEDICAL
CENTER IN FULLERTON. WORK HAS
BEEN UNDERWAY AT THESE THREE
MINISTRIES. BUT UNFORTUNATELY
PROVIDENCE, LIKE MANY OTHERS IN
THE HOSPITAL FIELD, IS STILL
RECOVERING FINANCIALLY FROM THE
PANDEMIC AND DID NOT HAVE THE
CASH ON HAND TO COMPLETE THESE
REQUIREMENTS BY THE LOOMING 2025
DEADLINE. I AM PLEASED TO SHARE
THAT WE ARE EXTREMELY CLOSE AT
THE TARZANA CAMPUS. IN FACT, WE
JUST CELEBRATED THE GRAND
OPENING OF A NEW PATIENT CARE
TOWER JUST LAST OCTOBER. AGAIN
WE NEED JUST A SHORT EXTENSION
ONE YEAR TO A LOT IS ENOUGH TIME
TO BECOME FULLY COMPLIANT WITH
THE RELOCATION OF UTILITIES AT
TARZANA. THE ST JOSEPH CAMPUS IN
EUREKA WAS PAUSED DURING COVID
AGAIN, SOMETHING OTHER HOSPITALS
WERE FORCED TO DO IN ORDER TO
SHIFT PRIORITIES TO GIVE CARE
FOR PATIENTS IN THEIR
COMMUNITIES. UPON RESUMING ITS
APPARENT WE ARE IN NEED OF TWO
ADDITIONAL YEARS TO REACH
COMPLIANCE AT THIS CAMPUS. THIS
CAMPUS IS UNIQUE AS THERE ARE
LIMITED MEDICAL OPTIONS IN THE
RURAL COMMUNITY OF HUMBOLDT
COUNTY. LASTLY SAINT JUDE THE
CAMPUS I OVERSEE. ON AVERAGE. WE
ARE EXCEEDING 100% CAPACITY
EVERY DAY. WE'RE IN PLANNING AND
SCOPING STAGES AND NEED THE TWO
YEAR EXPANSION TO ENSURE WE
MINIMIZE ANY ACCESS IMPACTS TO
THIS VERY IMPACTED CAMPUS. FOR
THESE THREE CAMPUSES. THE
REALITY IS NÓ CONSTRUCTION TEAM
CAN COMPLETE THE WORK BY THE
DEADLINE. WE ARE IN CLOSE
CONTACT WITH HÌ Kò, AND
UNFORTUNATELY, HÌ Kò IS LIMITED
IN THEIR STATUTORY AUTHORITY TO
PROVIDE ANY FURTHER EXTENSIONS.
WHICH IS WHY I AM HERE TODAY
SEEKING YOUR SUPPORT. FACED WITH
FINANCIAL PENALTIES AND ULTIMATE
REVOCATION OF LICENSURE. IF
THESE SEISMIC DEADLINES ARE NOT
MET, PROVIDENCE NEEDS YOUR
SUPPORT TO ENSURE WE CAN BECOME
SEISMICALLY COMPLIANT WHILE
MAINTAINING ACCESS TO CARE IN
BOTH URBAN AND RURAL COMMUNITIES
THAT WE SERVE. THANK YOU FOR
YOUR TIME. THANK YOU NEXT,
PLEASE, SIR. ARE ARE YOU
SPEAKING? I WAS TECHNICAL
ASSISTANT THE BARRY HERE JUST
FOR TECHNICAL. WE NEED A LOT OF
TECHNICAL ASSISTANCE HERE. UM
ARE THERE ANY OTHER SUPPORT
WITNESSES IN THE ROOM? IF SO,
PLEASE? STEP UP. NAME
AFFILIATION AND POSITION ON THE
MEASURE, PLEASE. GOOD AFTERNOON
CHAIR AND MEMBERS ALFREDO MEDINA
HERE ON BEHALF OF CEDAR SINAI IN
SUPPORT OF THE MEASURE, AND FOR
ALL THE REASONS ALREADY
ELOQUENTLY OUTLINED BY THE
AUTHOR AND THE WITNESSES, WE
ASKED RESPECTFULLY FOR I VOTE.
THANK YOU. THANK YOU, SIR. NEXT
PLEASE CLIFTON WILSON ON BEHALF
OF THE HUMBOLDT COUNTY BOARD OF
SUPERVISORS AND SUPPORT. THANK
YOU. THANK YOU NEXT. IN A SET
SHORT ON BEHALF OF THE ALLIANCE
OF CATHOLIC HEALTH CARE AND
SUPPORT. NEXT. VANESSA GONZALEZ,
WITH THE CALIFORNIA HOSPITAL
ASSOCIATION REPRESENTING OVER
400 HOSPITALS AND HEALTH SYSTEMS
IN CALIFORNIA. HERE IN SUPPORT.
THANK YOU, MA'AM, ANY OTHER
SUPPORT WITNESSES HERE IN THE
HEARING ROOM, SEEING, NOT ANY
OPPOSITION WITNESSES IN THE
HEARING ROOM, LEAD OR OTHERWISE?
SEE THERE'S. ONE GOOD AFTERNOON,
MATT WAS ON BEHALF OF S¼, A U,
CALIFORNIA WE ARE NOT REGISTERED
AND OPPOSED. WE JUST HAVE A
CONCERNED POSITION ON THIS BILL.
THESE ARE HOSPITALS THAT ALREADY
GOT EXTENSIONS TO MEET THE 2020
EXTENSION. AND, UM, GIVEN THE
REALITIES OF WHAT JUST HAPPENED
IN TAIWAN, AND, YOU KNOW, JUST
REALLY UNDERSCORES THAT IT
REALLY IS A, UH, NOT A IF
EARTHQUAKES GONNA HAPPEN, IT'S A
WIN AND SO REALLY JUST ENCOURAGE
CONTINUED THOUGHTFULNESS ON THIS
BILL THAT I KNOW THE AUTHOR AND
SPONSOR WILL HAVE TO MAKE SURE
THAT WE ARE COMING INTO
COMPLIANCE TO PROTECT BOTH
WORKERS AND THE SERVICES.
COMMUNITIES NEED, UM JUST WANT
TO STRESS THAT THE EXTENSION ON
THE 2025 EXTENSION IS REALLY SO
THAT THEY'RE LAYING THAT PATHWAY
TO 2030. HOW IMPORTANT THAT IS,
SO THAT ONCE AGAIN NOT OPPOSED.
JUST WANT TO MAKE SURE THAT
THOSE HOSPITALS ARE STILL
GETTING TO THAT 2030 COMPLIANCE
AND MEAN THAT 2020 STANDARDS AS
WELL. THANK YOU. THANK YOU.
THANKS FOR THOSE COMMENTS, UH,
ANY OTHER WITNESSES IN
OPPOSITION? SEEING NONE. LET ME
BRING IT BACK TO THE DAIS. MY
COLLEAGUES TO OFFER ANY
QUESTIONS, COMMENTS OR CONCERNS
COLLEAGUES ANYTHING. IT'S BEEN
WELL AT THE APPROPRIATE TIME OF
GOT YOU DOWN. SENATOR. ANY
QUESTIONS? CONSIDER ME THANK YOU
SO MUCH, UM MAYBE I MISSED HIS
ANALYSIS. SENATOR CAN YOU
CLARIFY? BECAUSE I HEARD FROM
PROVIDENCE THAT YOU'RE ASKING
FOR SPECIFIC DIFFERENT
EXTENSIONS FOR EACH CAMPUS, SO
THEY'RE NOT ALL GROUPED IN. I
HEARD TARZAN. IT'S JUST ONE
YEAR. CORRECT OK? UM I MEAN, I
THINK SO. IT'S IMPORTANT RIGHT?
THAT'S THE ONE HOSPITAL. THAT
WAS IT IN THE VALLEY, WHERE THE
NORTHRIDGE HOSPITAL WHERE THE
NORTHRIDGE EARTHQUAKE HAPPENED.
AND WHICH IS WHY WE HAVE ALL
THESE SEISMIC. UM ROSE. I AM
GLAD TO HEAR THIS. JUST ONE YEAR
I'M WONDERING IS. ARE THESE THE
ONLY ONES? I KNOW THERE ARE TWO
OTHER PROVIDENCES IN MY DISTRICT
THAT ARE WITHIN MILES OF THE
TARZAN HOSPITAL. UM, ARE THOSE
OTHER, UM, LOCATIONS? IN LINE TO
MEET THE DEADLINES. THANK YOU
GUYS FOR HAVING US TODAY. MY
NAME IS RYAN. BARRY I'VE BEEN IN
THE HEALTHCARE CONSTRUCTION
INDUSTRY FOR OVER 25 YEARS. SO
FOR THE A B 2100 AND 90
COMPLIANCE, I BELIEVE YOU EVER
SEE HOLY CROSS AND ST JOSEPH
BURBANK, AND THEY DO NOT HAVE
ANY BUILDINGS ON THOSE CAMPUS
THAT QUALIFY FOR THAT BILL. AND
IS IT TRUE THAT I KNOW YOU SHARE
THE CONSTRUCTION? I DRIVEN BY
THE ONE ON ONE. I'VE SEEN THE
CONSTRUCTION THE PAST COUPLE OF
YEARS. IT LOOKS BEAUTIFUL. THE
CAMPUS LOOKS GREAT. THAT PART OF
THE CONSTRUCTION WAS ALSO IN
LINE TO ME. UH, THE SEISMIC, UH,
COMPLIANCE YES, THAT'S CORRECT.
SO THE ONLY PIECE THAT'S LEFT IS
THE EXISTING TOWER THAT WE JUST
STARTED TO DECOMMISSION IN
OCTOBER. YEAH, CORRECT, OK.
MISTER PRESIDENT. I GUESS I JUST
HAVE ONE QUESTION. OBVIOUSLY
WE'RE INTERESTED HERE IN MAKING
SURE THAT SEISMIC RETROFIT
OCCURS BECAUSE IT'S A CRITICAL
ISSUE. I KNOW YOU RECOGNIZE THAT
TOO, IN THE HOSPITAL INDUSTRY
AND THOSE WHO SPOKE, UH WE DON'T
WANT ANOTHER SITUATION WHERE
HOSPITALS COLLAPSE AND WE ALSO
EVEN THOUGH THEY DON'T COLLAPSE,
WE WANNA MAKE SURE THAT
HOSPITALS ARE ABLE TO CONTINUE
TO PROVIDE HEALTH CARE TO THE
PATIENTS THAT ARE IN THEM
FOLLOWING A MAJOR INCIDENT AND I
KNOW YOU'RE WORKING TOWARD THAT
AS WELL. BUT MY ONLY AND I'M
GLAD I YOU HERE, SIR. FOR
TECHNICAL ASSISTANCE ON
CONSTRUCTION. MY ONLY QUESTION
WAS THE EXTENSIONS. THE LATEST
ONE GOES OUT TO JANUARY OF 2027,
WHICH IS REALLY ONLY A LITTLE
OVER TWO YEARS AWAY AND GIVEN
CONSTRUCTION AND HÌ Kò, AND ALL
OF THAT GOES INTO YOUR BUSINESS.
IS THAT A LONG ENOUGH A LENGTHY
ENOUGH EXTENSION IN ORDER TO GET
THE JOB DONE, GIVEN THE FACT
THAT WE'RE TALKING ABOUT DESIGN
TEAMS IN GENERAL CONTRACTORS AND
ALL OF THAT. YEAH SO IT IS SO IN
LIEU OF ASKING FOR A BLANKET
EXTENSION, WE ASKED FOR THE
EXTENSIONS, KNOWING THAT WE HAD
MILESTONES TO MEET ASSUMING THEY
WERE GRANTED AND WE ALREADY HAVE
GENERAL CONTRACTORS HIRED OR
ALMOST HIRED AT EVERY CAMPUS AND
ARCHITECTS AND DESIGN TEAMS AND
THEIR ENGINEERING TEAMS ARE
ALREADY ON. UH CONTRACTED AS
WELL. I MEAN, DID YOU BUILD IN?
UM CONTINGENCY TIME FOR THINGS
THAT HAPPEN, PARTICULARLY IN
YOUR BUSINESS HOSPITAL BUSINESS
WITH HOSPITAL CONSTRUCTION, SO
THAT, UM, SHOULD THIS BILL MOVE
OUT, WHICH I ASSUME IT WILL AND
BE SIGNED THAT WHAT WE SEE IS
FINALITY AND WE WON'T SEE YOU
BACK AGAIN. WE DID. WE TOOK ALL
THAT INTO ACCOUNT BECAUSE WE'VE
HAD CONSTRUCTION GOING IN
PROGRESS BEING MADE FOR THE LAST
SEVERAL YEARS. SO REALLY, WHAT
WE DID IS WE BUILT A SCHEDULE
BASED ON THE UNKNOWNS AS WELL.
WHICH ACCOUNTS FOR THE
CONTINGENCY IN THE SCHEDULES
THAT WE'VE ASKED FOR EXTENSIONS,
BUT I THINK IT'S AN EXCELLENT
QUESTION AND ONE THAT I DID
EXPECT AS WELL. I THINK THAT THE
TIME FRAME THAT WE ARE ASKING,
REALLY, UM, I HOPE UNDERSCORES
OUR COMMITMENT TO THE PRIOR
COMMENT THAT WAS MADE TO
SEISMIC. COMPLIANCE WELL, WE
CERTAINLY APPRECIATE SHORTER
RATHER THAN LENGTHIER, BECAUSE I
THINK MY PERCEPTION IS WE GIVE
THESE LONG EXTENSIONS AND THEN
OUT OF SIGHT OUT OF MIND AND
LIFE IN THE HOSPITAL BUSINESS
TAKES OVER AND THINGS HAPPEN,
AND THEN WE SEE THE SAME
FACILITIES BACK AGAIN. WE'RE
TRYING TO LIMIT THAT WE'RE GOING
TO TRY TO RESTRUCTURE. SO WE
PROVIDE GUIDELINES AND
MILESTONES MUCH AS WHAT YOU ARE
DOING SO THAT EXTENSIONS ARE
TIED DIRECTLY TO THE TEST THAT
NEEDS TO BE ACCOMPLISHED,
ULTIMATELY GETTING THE FACILITY
TOWARD FULL COMPLIANCE ON BOTH
THE NONSTRUCTURAL AND THE
STRUCTURAL SIDE. UM THAT IS ALL
I HAVE. IN TERMS OF QUESTIONS,
SENATOR MEN. ANOTHER ONE. I JUST
WANNA CLARIFY BECAUSE EVEN IN
THE ANALYSIS, THERE'S BEEN A
COUPLE OF POINTS. UM, SENATOR
AND MAYBE OUR DIRECT MY QUESTION
TO PROVIDENCE, WHERE COMPLIANCE
MILESTONES HAVEN'T EVEN BEEN
MET. SO I'M JUST THINKING IN
GOOD FAITH IF THEY HAVEN'T EVEN
BEEN MET UP TO THIS POINT HOW
YOU KNOW, GOING BACK TO THE
CHAIRS? POINT DO YOU ASSUME IT
WILL BE COMPLETED BY 2027. SO WE
TOOK THAT INTO ACCOUNT WHEN WE
BUILT THE SCHEDULES AND ASKED
FOR THE ONE YEAR AND TWO YEAR
EXTENSIONS, SO WE'VE OUTLINED
THOSE MILESTONES WHICH WILL WORK
WITH HÌ Kò. IN IDENTIFYING IF
THIS BILL DOES GET EXTENDED WE
HAVEN'T MET THEM. WE HAVEN'T WE
HAVE BUT WE WILL MEET THEM NOW
WE WILL MEET THEM NOW. SO WE'RE
TAKING THAT INTO ACCOUNT AS WE
BUILT THE NEW MILESTONES INTO
OUR SCHEDULE BEFORE WE WON'T BE
HERE NEXT YEAR, BUT I WILL
COMMITTEE OR THE NEXT COUPLE OF
YEARS. SHOULD Y'ALL COME BACK
AND ASK FOR ANOTHER EXTENSION?
OK? YEAH, DULY NOTED. YES THANK
YOU. SENATOR MENZ. SENATOR
NEWMAN WILL BE HERE TOO, SO WE
CAN PUT HIM BACK AT THE PODIUM
WHEN YOU ASK YOU KNOCK ON WOOD,
SIR. ANY OTHER QUESTIONS,
COMMENTS OR CONCERNS? COLLEAGUES
ANYTHING SEEING NONE. LET'S UM
LET'S ESTABLISH A QUORUM FIRST.
SENATOR ROTH ROTH HERE. WHEN
WHEN? HERE GLASER GONZALEZ
GONZALEZ HERE, GROVE. HURTADO
LIMÓN. THE MOON. HERE. THE BEJAR
BEJAR RUBIO, SMALLWOOD CUEVAS
WIENER. WE ARE PRESENT. WE HAVE
A QUORUM. SENATOR NEWMAN. WOULD
YOU LIKE TO CLOSE? THANK YOU. SO
THANK YOU TO MY WITNESSES. AS
YOU'VE HEARD. THE PROVIDENCE
HOSPITALS THAT ARE COVERED BY
THIS BILL ARE ARE ARE
DELIBERATELY WORKING TOWARD
MEETING THE COMPLIANCE
OBLIGATIONS. THAT'S WHY THERE
ARE DIFFERENT SPECIFICATIONS FOR
ONE THAN THE OTHER TWO. I KNOW
OF TWO OTHER BILLS THAT THIS
COMMITTEE WILL HEAR ON THE SAME
SUBJECT, SO THIS IS A PROBLEM
THAT IS NOT UNIQUE TO PROVIDENCE
. IT'S FAIRLY CONSISTENT ACROSS
THE BOARD. UH, BUT, I KNOW I
SPEAK FOR THE WITNESSES AND FOR
THE PROVINCE CHANGE. GENERALLY,
THEY'RE VERY COMMITTED TO DOING
THE WORK TO RENDER OF THEIR
FACILITIES SEISMICALLY SAFE AND
WHEN GRANTED, THIS EXTENSION
WILL LET THEM DO THAT. I
RESPECTFULLY ASTRONAUT VOTE.
THANK YOU, SIR. UM IT'S BEEN
MOVED BY SENATOR NGUYEN. THE
MOTION IS TO PASS AND RE REFER
TO THE COMMITTEE ON
APPROPRIATIONS. PLEASE CALL THE
ROLL. SENATOR ROTH ROTH, I WHEN
I WHEN I GLAZER GONZALEZ
GONZALEZ, I GROVE HURTADO. LIONE
LIMÓN I MENJIVAR MENJIVAR. I
RUBIO SMALLWOOD CUEVAS WIENER
WIENER. I SIX VOTES WILL HOLD
THE ROW OPEN FOR ABSENT MEMBERS.
SIR NEWMAN, WOULD YOU LIKE TO
PRESENT YOU? ITEM NUMBER ONE
SENATE BILL NINE. I WOULD THANK
YOU, MR CHAIR AND THANK YOU TO
MS RAMOS. MR. BARRY. I HOPE YOU
MAKE YOUR FLIGHT. THANK YOU.
AYE. SO SO THANK YOU AGAIN. MR
CHAIR COMMITTEE. UH, MEMBERS?
UH, I AM ACTUALLY I'M PRESENTING
S¼ B 909 ON BEHALF OF SENATOR
UMBER, WHO WAS TAKEN AWAY FOR A
FAMILY ISSUE. S¼ B 909 IS A BILL
THAT STRENGTHENS OUR HEALTH CARE
WORKFORCE BY REMOVING THE
NATIONAL LOAN REPAYMENT LIMIT OF
105,000 FOR THE STEPHEN M
THOMPSON PHYSICIAN CORPS LOAN
REPAYMENT PROGRAM, CALIFORNIA'S
HEALTH AND HUMAN SERVICES AGENCY
DESIGNATES 172 REGIONS IN THE
STATE AS MEDICALLY UNDERSERVED
AREAS. AND THAT COVERS ROUGHLY
11 MILLION CALIFORNIANS IN THOSE
AREAS, UH, WHO LIVE WITH A
SHORTAGE OF PRIMARY HEALTH CARE
PROVIDERS NEARBY TO COMBAT THIS?
THE STEPHEN M THOMPSON PHYSICIAN
COURT LOAN REPAYMENT PROGRAM
PROVIDES PHYSICIANS WITH UP TO
$105,000 IN LOAN DEBT
FORGIVENESS IN EXCHANGE FOR
THREE CONSECUTIVE YEARS OF
SERVICE IN A MEDICALLY
UNDERSERVED AREA. UNFORTUNATELY
THIS LIMIT OF $105,000, WHICH
WAS ESTABLISHED IN THE YEAR,
2002 IS CURRENTLY TOO LOW.
ACCOUNT FOR MEDICAL STUDENT DEBT
TRENDS, ACCORDING TO THE
ASSOCIATION OF AMERICAN MEDICAL
COLLEGES. THE AVERAGE MEDICAL
STUDENTS DEBT HAS RISEN BY OVER
$150,000 IN THAT TIME FRAME TO
AN AVERAGE OF ROUGHLY $240,000
EACH ACCORDINGLY, THE FINANCIAL
INCENTIVE THAT MAY HAVE WORKED
IN 2002 AT THE START OF THE
PROGRAM IS OBVIOUSLY LESS
EFFECTIVE TODAY. BY REMOVING
THIS LIMIT, S¼ B 909 ENABLES
PARTICIPATING PHYSICIANS TO BE
ELIGIBLE FOR REPAYMENT. UH, THAT
BETTER REFLECTS MODERN DEBT
AVERAGES AND DOING SO WILL
BOLSTER THE OFFERED BY THE
PROGRAM, IMPROVING QUALITY
HEALTH CARE ACCESS IN THE
COMMUNITIES THAT NEED IT. THE
MOST. I THANK YOU FOR YOUR
CONSIDERATION AND ON BEHALF OF
SENATOR UMBERG, ASK FOR YOUR I
VOTE TODAY. THANK YOU, SENATOR,
WITNESSES AND SUPPORT IF YOUR
LEAD YOU MAY TAKE THE TABLE, IF
NOT YOUR CALL. THANK YOU. CHAIR
TIM MADDEN, REPRESENTING THE
CALIFORNIA CHAPTER OF THE
AMERICAN COLLEGE OF EMERGENCY
PHYSICIANS. THAT CALIFORNIA
CHAPTER OF THE AMERICAN COLLEGE
OF CARDIOLOGY AND THE CALIFORNIA
RHEUMATOLOGY ALLIANCE, ALL IN
SUPPORT FOR THE REASONS OUTLINED
BY SENATOR NEWMAN. THANK YOU.
THANK YOU, SIR. NEXT, PLEASE. I
KNOW THAT IT'S UNUSUAL TO SEE ME
HERE ON A HEALTH CARE BILLS
WHENEVER, BUT STEVE THOMPSON WAS
VERY COMMITTED TO THIS PROGRAM.
I Ó IN MANY WAYS MY
PROFESSIONAL, NOT MY ECONOMIC
CAREER TO STEVE. THE ORIGINAL
PROGRAM WAS ACTUALLY AUTHORED BY
MARCO FIREBUG AT THE DRIVING
FORCE FOR THE PROGRAM WAS STEVE
PEACE, JOHN BURTON AND THE WHITE
LOU PIN. AND BECAUSE THEY
REPRESENTED UNDESERVED
COMMUNITIES AND WITH THE WAY
MEDICAL DEBT IS NOW GETTING
PEOPLE TO ACTUALLY USE, THIS
PROGRAM IS ALMOST IMPOSSIBLE,
GIVEN THE CURRENT ECONOMIC
SITUATION, SO IT'S VERY CRITICAL
AND I WANT TO COMMEND THE PRO
TEM FOR MAKING THIS A PRIORITY
TO EXPAND THIS PROGRAM, SO ALL
CALIFORNIANS HAVE ACCESS TO
QUALITY HEALTH CARE. THANK YOU,
SIR. NEXT, PLEASE. MR CHAIR.
MEMBERS OF THE COMMITTEE BRANDED
MARCH WITH THE CALIFORNIA
MEDICAL ASSOCIATION AND SUPPORT
THANK YOU ANY OTHER WITNESSES IN
SUPPORT? WITNESSES IN OPPOSITION
ANYONE IN THE ROOM. SEEING NONE
OF US BRING THE MATTER BACK TO
MY COLLEAGUES ON THE DAIS FOR
QUESTIONS, COMMENTS OR CONCERNS,
COLLEAGUES ANY QUESTIONS,
COMMENTS OR CONCERNS. WHO MOVED
IT, SENATOR MENJIVAR MOVED THE
BILL SEEING NÓ OTHER QUESTIONS.
SENATOR NEWMAN. WOULD YOU LIKE
TO CLOSE ON BEHALF OF SENATOR?
RESPECTFULLY ASKING FOR YOUR OWN
VOTE? PLEASE CALL THE ROLL.
SENATOR ROTH. AYE, ROTH. I WHEN
I GLAZER GONZALEZ. GROWTH.
HURTADO LIMÓN I MENJIVAR
MENJIVAR. I RUBIO SMALLWOOD
CUEVAS WIENER. I THANK YOU. BILL
HAS FIVE VOTES WILL HOLD THE ROW
OPEN FOUR ABSENT MEMBERS. LET'S
SENATOR RAZA WAS HERE. ITEM
NUMBER THREE SENATE BILL 1132
COUNTY HEALTH OFFICERS, PLEASE
PROCEED WHEN READY, SENATOR
THANK YOU, MISTER. PRESIDENT
MEMBERS 11 S¼ P 1132 CLARIFIES
THE AUTHORITY OF COUNTY HEALTH
OFFICERS TO ENTER AND INSPECT
PRIVATE DETENTION FACILITIES
OPERATING IN OUR STATE. EXISTING
LAW DOES NOT EXPLICITLY COVER
PRIVATE DETENTION FACILITIES,
INCLUDING CIVIL DETENTION
FACILITIES USED TO DETAIN
IMMIGRANTS. TODAY THERE ARE SIX
PRIVATE FACILITIES OPERATING IN
OUR STATE THAT CAN HOLD AS MANY
AS 7000 INDIVIDUALS AT A TIME.
THESE FACILITIES HAVE NOW HAVE
UNTIL NOW FALLEN INTO A GRAY
AREA UNDER OUR HEALTH AND SAFETY
CODES, SO THAT WHILE PUBLIC
HEALTH OVERSIGHT LAWS EMPOWER
INSPECTIONS OF PUBLICLY OPERATED
DETENTION FACILITIES AND ALL
PRIVATE WORK FURLOUGH FACILITIES
, THEY DO NOT EXPLICITLY COVER
PRIVATE DETENTION FACILITIES.
UH, WE WANT TO CHANGE THIS, UM,
AND INCLUDE EXPLICIT
AUTHORIZATION FOR COUNTY HEALTH
OFFICIALS TO ENTER AND INSPECT
FACILITIES WHENEVER NECESSARY.
PRIVATE DETENTION FACILITIES
OPERATED BY FOR PROFIT COMPANIES
OFTEN FAIL TO MEET MINIMUM
STANDARDS OF HEALTH, SAFETY AND
SANITATION. IMPROVING
TRANSPARENCY IN THESE FACILITIES
IS NOT ONLY GOOD FOR PUBLIC
POLICY, BUT NECESSARY FOR THE
SAFETY OF OUR STATE, UM IN 2020,
THREE, KOSHA ENTERED AND
INSPECTED ONE OF THESE
FACILITIES FOLLOWING THE PASSAGE
OF A B 263 THAT REQUIRED PRIVATE
FACILITIES. TO ABIDE BY
WORKPLACE SAFETY REGULATIONS.
THE INSPECTION FIND THE PRIVATE
OPERATOR $100,000 FOR SIX
VIOLATIONS OF STATE CODE,
FAILING TO PROVIDE WORKERS WITH
EFFECTIVE INFORMATION AND
TRAINING ON HAZARDOUS MATERIALS.
THERE MUST BE ACCOUNTABILITY AND
OVERSIGHT OF THESE FACILITIES
WITH ME. I HAVE RONALD COLEMAN
BAESA, MANAGING POLICY DIRECTOR
TO THE CALIFORNIA PAN ETHNIC
HEALTH NETWORK, UM TO SPEAK AND
SUPPORT AND HAMID WAS YES. WANNA
COME UP. UM HE HAS DONE ADVOCACY
DIRECTOR FOR THE IMMIGRANT
DEFENSE ADVOCATES TO HELP ANSWER
QUESTIONS. THANK YOU. GENTLEMEN,
PLEASE PROCEED. GOOD AFTERNOON,
MR CHAIR AND MEMBERS. MY NAME IS
RONALD COLEMAN VALA, MANAGING
DIRECTOR OF POLICY AT THE
CALIFORNIA PANE AND HEALTH
NETWORK. èC P. I'M PLEASED TO
BE HERE TODAY TO OFFER TESTIMONY
IN SUPPORT OF S¼ B 1132. THIS
BILL CONCERNS THE PUBLIC HEALTH
OVERSIGHT FOR PRIVATE FOR PROFIT
DETENTION FACILITIES THAT
OPERATE THROUGHOUT OUR STATE FOR
PROFIT DETENTION FACILITIES
CONSISTENTLY FALL SHORT OF THE
STANDARDS OF CARE THAT SHOULD IT
BE IN EXISTENCE IN CONGREGATE
SETTINGS WHERE HUMAN BEINGS ARE
JAILED. WHILE CALIFORNIA NÓ
LONGER HAS PRIVATE JAILS OR
PRISONS. THERE ARE SIX PRIVATE
DETENTION FACILITIES IN OUR
STATE THAT ARE USED FOR CIVIL
DETENTION OF IMMIGRANTS. THESE
FACILITIES ARE PRIVATELY OWNED
AND OPERATED AND HAVE THE
CAPACITY TO HOUSE MORE THAN 7000
PEOPLE AT ANY GIVEN MOMENT.
ALTHOUGH THE ENFORCEMENT OF
IMMIGRATION LAWS IS A FEDERAL
ISSUE, THE OPERATION OF
IMMIGRANT DETENTION FACILITIES
HAS HISTORICALLY DELEGATED TO
STATE AND LOCAL ENTITIES,
PARTICULARLY WITH RESPECT TO
ISSUES RELATED TO HEALTH AND
SAFETY. DESPITE THESE
REQUIREMENTS, OVERSIGHT,
ACCOUNTABILITY AND TRANSPARENCY
HAS BEEN DIFFICULT TO ENFORCE OR
OBTAIN IN PRIVATE DETENTION
FACILITIES. PART OF THE
CHALLENGE HAS BEEN THAT PRIVATE
FACILITIES HAVE OPERATED UNDER A
GRAY AREA IN CALIFORNIA LAW AS
IT STANDS COUNTY. OFFICERS ARE
DIRECTED TO INSPECT PUBLIC
DETENTION FACILITIES AND PRIVATE
WORK FURLOUGH FACILITIES.
HOWEVER THE FACILITIES IN
QUESTION DO NOT CLEANLY FIT INTO
EITHER CATEGORY, BUT ARE CLEARLY
FACIL FACILITIES THAT DO NEED TO
BE ACCOUNTED FOR AS IT RELATES
TO OUR PUBLIC HEALTH OVERSIGHT.
S¼ B 1132 ENSURES THAT ALL
FACILITIES THAT DETAIN
INDIVIDUALS IN CALIFORNIA,
INCLUDING JAILS, PRISONS AND
PRIVATE DETENTION FACILITIES ARE
SUBJECT TO PUBLIC HEALTH
OVERSIGHT AND TRANSPARENCY. THIS
BILL CLARIFIES THAT COUNTY
PUBLIC HEALTH OFFICIALS CAN
INSPECT PRIVATE DETENTION
FACILITIES WHEN NECESSARY, BUT
IT DOES NOT IMPOSE AN ANNUAL
INSPECTION REQUIREMENT. THE
COVID-19 PANDEMIC SHOWCASED THE
POTENTIAL PROBLEMS POSED BY
THESE FACILITIES, PARTICULARLY
WHEN THE OT MESA DETENTION
FACILITY BECAME THE SITE OF THE
LARGEST OUTBREAK OF COVID-19 IN
ANY CIVIL DETENTION FACILITY.
THE OUTBREAK SPREAD TO MORE THAN
200 INDIVIDUALS IN THE FACILITY,
NOT ONLY THOSE DETAINED BUT ALSO
THE WORKERS. TRAGICALLY ONE MAN
DETAINED THERE LOST THEIR LIFE
DURING THIS COVID OUTBREAK.
EMAILS LATER OBTAINED THROUGH
APR REQUEST INCLUDED EMAILS FROM
PUBLIC HEALTH OFFICIALS TO THE
WARDEN ASKING FOR EMPLOYEES TO
BE TESTED FOR COVID, THE WARDEN
FOR THE PRIVATE FACILITY
RESPONDED THEY HAD NÓ INTENTION
OF TESTING THEIR EMPLOYEES FOR
COVID, AND THIS IS PART OF A
PATTERN THAT OPERATORS BELIEVE
THAT THEY ARE ABOVE THE LAW IN
2020, THREE, CAL OSHA LEVIED
$104,510 IN FINES AGAINST THE
PRIVATE PRISON OPERATOR, GE Ó
GROUP FOR WILLFUL AND SERIOUS
HEALTH. AFTER DETAINED IMMIGRANT
WORKERS AT THE GOLDEN STATE
ANNEX IN CENTRAL CALIFORNIA
COMPLAINED ABOUT UNSAFE WORKING,
UNSAFE CONDITIONS. THIS FUND WAS
THE RESULT OF A SINGLE
INSPECTION, BUT THE IT CERTAINLY
DOCUMENTS THE SYSTEMIC ISSUES
PRESENT IN ALL FACILITIES. S¼ P
1132 EMPOWERS COUNTY HEALTH
OFFICIALS TO CONDUCT INSPECTIONS
OF PRIVATE DETENTION FACILITIES
AS NECESSARY AND WHEN
APPROPRIATE, AND ENSURES THAT NÓ
FACILITY IN CALIFORNIA IS
ALLOWED TO SLIP THROUGH THE
CRACKS ANY LONGER. THANK YOU.
THANK YOU, SIR. NEXT, PLEASE.
HAPPY TO ANSWER ANY QUESTIONS.
PERFECT IS THERE ANY OTHER
SUPPORT WITNESSES IN THE HEARING
ROOM SUPPORT WITNESSES, PLEASE
STEP UP NAME, AFFILIATION AND
POSITION ON THE MEASURE ONLY
PLEASE. THANK YOU FOR COMING.
AND WITH PLANNED PARENTHOOD,
AFFILIATES OF CALIFORNIA IN
SPORT. THANK YOU NEXT, PLEASE
CYNTHIA VALENCIA WITH THE A èC
LU, CALIFORNIA ACTION AND
SUPPORT. THANK YOU. CHLOE STUCK
WITH THE CALIFORNIA IMMIGRANT
POLICY CENTER PROUD CO SPONSOR
IN SUPPORT. THANK YOU NEXT GOAL.
POLICY DIRECTOR AT IMMIGRANT
DEFENSE ADVOCATES PROUD CO
SPONSOR AND SUPPORT ALSO HERE
FOR OUR COSPONSOR NEXT GEN
POLICY. THANK YOU. THANK YOU FOR
JOINING US NEXT, PLEASE. APRIL
NEWMAN WITH THE CALIFORNIA
COLLABORATIVE FOR IMMIGRANT
JUSTICE, COSPONSOR AND IN STRONG
SUPPORT. THANK YOU. YOU NEXT,
PLEASE. WITH THE CALIFORNIA
COLLABORATIVE FOR IMMIGRANT
JUSTICE, COSPONSOR AND HERE WITH
A LOT OF SUPPORT. THANK YOU.
THANK YOU ANY OTHER SUPPORT
WITNESSES IN THE HEARING ROOM,
SEEING NONE. LET CALL FOR
OPPOSITION WITNESSES, LEAD OR
OTHERWISE, ANY OPPOSITION
WITNESSES IN THE HEARING ROOM.
SEEING NONE. LET'S BRING THE
MATTER BACK TO THE DESK AND MY
COLLEAGUES FOR ANY QUESTIONS,
COMMENTS OR CONCERNS, QUESTIONS,
COMMENTS OR CONCERNS. A COMMENT
SENATOR RUBIO I KNEW I COULD
COUNT ON YOU. THANK YOU. I'D
LIKE TO KEEP YOU OCCUPIED. UM
JUST WANTED TO SAY THANK YOU TO
THE AUTHOR. I THINK THE
INFORMATION YOU SHARE IS VERY
COMPELLING. AND I THINK IT WAS
OVERDUE. SO THANK YOU FOR THAT.
I JUST WANNA MOVE THE BILL IN
APPROPRIATE. THANK YOU. BILL
MOVED BY SENATOR RUBIO. SEEING
NÓ OTHER QUESTIONS OR COMMENTS.
UM SENATOR IT WOULD YOU LIKE TO
CLOSE? THANK YOU ALL. THANK YOU
TO OUR INCREDIBLE ORGANIZATIONS
THAT DO THIS EVERY SINGLE DAY
AND ASK FOR YOUR HIGH VOTE.
THANK YOU. BILL HAS BEEN MOVED
BY SENATOR RUBIO. THE MOTION IS
TO PASS AND RE REFER TO THE
COMMITTEE ON PUBLIC SAFETY.
PLEASE CALL THE ROLL. SENATOR
ROSS ROSS. I WHEN, WHEN NÓ.
LASER GONZALEZ. GROWTH. HURTADO.
LEMON. HØI SHE SAID. AYE LAMON,
I MANJAR MENJIVAR I RUBIO RUBIO
I SMALLWOOD QUAS. WIENER. VOTE
IS 4 TO 1 WILL HOLD THE OPEN FOR
EPSOM MEMBERS. THANK YOU,
SENATOR. THANK YOU, MR CHAIR.
LET'S TAKE THE CONSENT CALENDAR.
UM ON THE PROPOSED CONSENT
CALENDAR. ITEM NUMBER FIVE
SENATE BILL 1028 BY SENATOR
ATKINS HEALTH CARE COVERAGE,
TRIGGERING EVENTS AND ITEM
NUMBER SIX SENATE BILL 1258 BY
SENATOR DOLLY ME UNRECOVERED
PAYMENTS INTEREST RATE. MOVED BY
SENATOR MENJIVAR PLEASE CALL THE
ROLL. SENATOR ROSS I, I WHEN I
WHEN I GLAZER GONZALEZ GROVE
HURTADO LIMÓN. THE MO. I
MENJIVAR MENJIVAR, I RUBIO RUBIO
I SMALLWOOD QUAS WIENER. FULL
TIME. VOTE IS 50. WE'LL HOLD THE
DOOR OPEN FOR ABSENT MEMBERS ON
THAT ONE. SENATOR LAMONE WOULD
LIKE TO PRESENT ITEM NUMBER FOUR
SENATE BILL 1213 FOR SENATOR
ATKINS HEALTH CARE. OH, I DIDN'T
SEE SENATOR TIZI. OH RIGHT THERE
. I APOLOGIZE, SIR. ANY GLASSES?
LET'S TAKE ITEM NUMBER SEVEN.
SENATE BILL 1300 SENATOR CORTESI
HEALTH FACILITY CLOSURE PUBLIC
NOTICE.
PROCEED WHEN READY, SIR. THANK
YOU, MR CHAIR AND SENATORS. I'M
PLEASED TO PRESENT S¼ P 1300.
THE BILL WAS SPONSORED BY NAMI,
CALIFORNIA. LET ME BEGIN BY
SAYING THAT I'M ACCEPTING THE
AMENDMENTS THAT ARE BEING PASSED
OUT TO ADDRESS THE POLICY
COMMENT IN THE ANALYSIS. THE
AMENDMENTS ELIMINATE THE
REQUIREMENTS THAT HÌ èC A. I
CERTIFY THE IMPACT ANALYSIS. IT
GIVES CDPH THE ABILITY TO PERMIT
A CLOSURE WITHOUT THE EXTRA 30
DAYS' NOTICE IF KEEPING THE
SUPPLEMENTAL SERVICE OPEN
THREATENS THE STABILITY OF THE
HOSPITAL AS A WHOLE. AND
HOPEFULLY I'VE STATED THAT
VERBATIM. I WANT TO THANK THE
COMMITTEE STAFF FOR THEIR WORK
ON THE AMENDMENTS. I MEAN THAT
SINCERELY THESE THIS IS AN
IMPORTANT BILL. I BELIEVE, BUT
ONE THAT WE WANT TO GET EXACTLY
RIGHT. UM THIS THIS BILL WILL
HELP COMMUNITIES PREPARE FOR
CLOSURES OF PSYCHIATRIC UNITS
AND MATERNITY WARDS IN HOSPITALS
. WE PURPOSELY BROUGHT BOTH OF
THOSE THINGS, EVEN IF THEY MIGHT
SEEM SOMEWHAT INCONGRUOUS IN
TERMS OF TYPES OF HEALTH CARE IN
MY DISTRICT ALONE, I'VE
EXPERIENCED CLOSURES OF BOTH A
MATERNITY WARD AND A PSYCHIATRIC
UNIT IN LESS THAN FIVE YEARS.
THESE UNITS CLOSED DESPITE THE
HOSPITAL AS A WHOLE REMAINING
PROFITABLE. THIS PROBLEM ISN'T
UNIQUE TO MY COUNTY. IT EXTENDS
ACROSS CALIFORNIA, ACCORDING TO
A RECENT CAL MATTERS. REPORT
WE'VE LOST 27 MATERNITY WARDS IN
THE PAST THREE YEARS ALONE.
THESE CLOSURES RESULT IN
MATERNITY CARE, DESERTS AND
PREDOMINANTLY LOW INCOME
OFTENTIMES LATINO COMMUNITIES
AND RURAL COMMUNITIES AS WELL.
THE NEGATIVE IMPACTS ON FAMILIES
INCLUDE DECREASED ACCESS TO
PRENATAL AND POSTPARTUM CARE.
INCREASED TRAVEL DISTANCE
WORSENING MATERNAL MORTALITY
RATES AND INCREASED EMERGENCY
DELIVERIES WHEN A PSYCHIATRIC
UNIT CLOSES. IT PLACES
ADDITIONAL STRAIN, OF COURSE ON
OUR BEHAVIORAL HEALTH SYSTEM.
CALIFORNIA IS ALREADY IN A
PSYCHIATRIC BED SHORTAGE, WHICH
I THINK WE'RE ALL FAMILIAR WITH.
I KNOW THE CHAIR IS IN THAT
OVERBURDENS OUR EMERGENCY ROOMS,
PROLONGED STAYS IN CORRECTIONAL
DETENTION AND PUSHES PEOPLE INTO
HOMELESSNESS. AND THIS IS WHY
IT'S IMPERATIVE FOR LOCAL
COMMUNITIES TO HAVE AN
UNDERSTANDING OF THE IMPACT THAT
A PSYCHIATRIC UNIT CLOSURE IS
GOING TO HAVE. S¼ P 1300 WOULD
REQUIRE A HEALTH FACILITY TO
PROVIDE 120 DAY PUBLIC NOTICE OF
THE ELIMINATION OF A INPATIENT
PSYCHIATRIC OR MATERNITY WARD
UNIT. IT ALSO REQUIRES A HEALTH
FACILITY TO PREPARE A REPORT
THAT ANALYZES THE IMPACT OF A
CLOSURE ON THE SURROUNDING
COMMUNITY'S HEALTH SYSTEM.
REPORT WILL ALLOW THE COUNTY
BOARD OF SUPERVISORS TO ASSESS
THE CLOSURES, IMPACT ON THE
PUBLIC HEALTH SYSTEM AND
IDENTIFY HOW BEST TO MITIGATE
THE LOSS AGAIN. IT WILL ALLOW
THEM TO DO SO THERE'S NÓ
REQUIREMENT THAT THEY DO SO
FINALLY, THE BILL INCREASES
PUBLIC TRANSPARENCY BY STRONGLY
ENCOURAGING THE COUNTY BOARD OF
SUPERVISORS TO POST THE REPORT
ONLINE AND HOLD A PUBLIC HEARING
TO PROVIDE THE COMMUNITY. AN
OVERVIEW OF THE IMPACT REPORT.
JOINING US TODAY TO TESTIFY. WE
HAVE MICHAEL FITZGERALD,
PRESIDENT OF Z GROUP, AND FRANK
ATO, MEMBER OF THE HUR COUNTY,
NAY LEGISLATIVE COMMITTEE, AND
UNAPPARENT OF SOMEONE WITH A
MENTAL HEALTH CONDITION. HE
ASKED US TO SHARE THAT WITH THAT
. I'LL TURN IT BACK OVER TO YOU,
MR CHAIR AT THE APPROPRIATE
TIME. I RESPECTFULLY ASK FOR
YOUR EYE BONE. THANK YOU,
SENATOR. GENTLEMEN, YOU MAY
PROCEED. AND YOU PUSH. WELL,
CHECK IT OUT HERE, OK? UH,
MICHAEL FITZGERALD, PRESIDENT
AND GROUP HEALTH CARE
ORGANIZATION THAT CONSULTS WITH
BEHAVIORAL HEALTH AND BEHAVIORAL
HEALTH ISSUES. PAST EXECUTIVE
DIRECTOR FOR EL CAMINO HOSPITAL
IN MOUNTAIN VIEW WAS THERE FOR
MANY YEARS COMPREHENSIVE MENTAL
HEALTH SERVICES AS PART OF THE
GENERAL CARE HOSPITAL, AND THAT
REMAINS OPEN, IN FACT, BUILT A
NEW FACILITY. UH, THIS IMPACT OF
A CLOSURE THAT OCCURRED IN SANTA
CLARA COUNTY. UH, IT WASN'T JUST
THAT WE LOST PSYCHIATRIC BEDS.
WE LOST PSYCHIATRIC BEDS THAT
WERE PART OF GENERAL ACUTE CARE
HOSPITAL AND THAT'S THE PLACES
THAT ARE CLOSING. THESE PLACES
TAKE PATIENCE BECAUSE THEY HAVE
AN EMERGENCY DEPARTMENT THAT
MENTAL HEALTH FACILITIES
GENERALLY RUN BY FOR PROFIT
ORGANIZATIONS, FREESTANDING
PSYCHIATRIC HOSPITALS, UH, RUN
BY ORGANIZATIONS SUCH AS U, S¼,
ACADIA OR SIGNATURE HEALTH THAT
ARE CONSTANTLY IN TROUBLE WITH
èC M S¼ VERY MUCH HIGH PROFIT
ORGANIZATIONS TO TAKE
PSYCHIATRIC PATIENTS ON A BOLD
BASIS. THEY DON'T TAKE PATIENTS
WITH MEDICAL COMORBIDITIES, AND
THEY ARE NOT APPROPRIATE PLACES
FOR PATIENTS WITH NEW DIAGNOSIS.
OLDER ADULTS OR PEOPLE THAT NEED
ACCESS TO OTHER COMPREHENSIVE
SERVICES AT ALL, MAJOR GENERAL
ACUTE CARE HOSPITAL CAN PROVIDE.
THE PROBLEM IS THAT THE GENERAL
ACUTE CARE HOSPITALS ARE CLOSING
THESE BEDS BECAUSE THE COST
IMPACT COST OF PROVIDING THESE
SERVICES EVEN THOUGH THEY MAY BE
HIGHLY PROFITABLE IN OTHER AREAS
OF CARE. THIS THIS BILL IS MINOR
. IT DOESN'T PROVIDE A WHOLE LOT
, EXCEPT FOR MORE TIME FOR
COMMUNITY DISCUSSION THAT IS
IMPORTANT IN THAT 120 DAY PERIOD
. IT TAKES IT TAKES A LONG TIME.
IT DID IN THIS CASE, JUST SO YOU
UNDERSTAND. IT'S EVEN CLOSING,
GETTING PEOPLE TOGETHER, TALKING
ABOUT THE ISSUE. WE NEED THAT
MORE TIME. THERE'LL BE AN
ARGUMENT MADE TODAY BY THE
OPPOSITION THAT WILL SAY THAT IT
MAY IMPACT CLOSURE QUICKLY. OR
THAT ALL THE STAFF WILL LEAVE.
THIS IS NOT ACCURATE IN MY
EXPERIENCE, AND I SPEAK AS
SOMEONE WHO'S BEEN EXECUTIVE
DIRECTOR AT A HOSPITAL AND HAS
WORKED WITH èC A IN THE PAST AS
PAST CHAIR AND HAVE A LOT OF
SUPPORT FOR THE HOSPITAL
ASSOCIATION, WHAT THEY'RE TRYING
TO DO. WE NEED MORE LEGISLATIVE
ACTIVITY DOWNSTREAM SO THAT WE
CAN OR DOWN DOWN THE ROAD SO WE
CAN AFFECT US ON AN UPSTREAM
RATHER THAN DOWNSTREAM BASIS AND
TRY TO SUPPORT HOSPITALS IN
MAKING THIS DECISION INITIALLY,
RIGHT NOW IT IS WHAT IT IS. AND
I THINK THAT ADDITIONAL TIME
WILL BE HELPFUL TO, UH TO, UH,
HAVE THAT DISCUSSION IN THE
COMMUNITY AND TRY TO HAVE THAT
ARE RESPONSIBLE. THANK YOU FOR
YOUR TIME. THANK YOU, SIR. CAN
YOU HEAR ME? YES OK. MY NAME IS
FRANK ALIOTO. I AM THE
LEGISLATIVE CHAIR FOR NAMI,
SANTA CLARA COUNTY. AND, UH, I
AM. HERE I'M ALSO A MEMBER OF
THE SANTA CLARA COUNTY MENTAL
HEALTH COMMITTEE, WHICH REPORTS
TO OUR BOARD OF SUPERVISORS. I
AM HERE TODAY, THOUGH NOT AS
MEMBERS OF THOSE TWO
ORGANIZATIONS, BUT I'M HERE AS A
PARENT. AND I. I CAN'T TELL YOU
HOW DIFFICULT IT IS TO FIND A
PLACE. FOR A MENTALLY UH,
INCOMPETENT PERSON WHEN PLACES
ARE CLOSING ON SHORT NOTICE. I
MEAN, EVEN 120 DAYS IS GENERALLY
NOT ENOUGH TIME. UM THESE, UH I
THINK I THINK THE REAL ISSUE OR
ONE OF THE REAL ISSUES HERE. IS
THE CLOSURE OF MENTAL HEALTH
FACILITIES AND THE LOSS OF BEDS.
BY HOSPITALS AND ORGANIZATIONS
THAT RUN FROM OR PROFITABLE AND
DECIDE THAT THEY ARE GOING TO,
UH, YOU KNOW, CUT A CUT BEDS OR
CUT SERVICES TO ENHANCE THEIR
BOTTOM LINE AT THE TIME THAT,
UH, GOOD SAMARITAN HOSPITAL IN
LOS GATOS PRIVATELY OWNED
HOSPITAL WAS CLOSING A CRITICAL
CARE PSYCHIATRIC FACILITY. THE
WEBSITE IS BRAGGING CORPORATE
SITE IS BRAGGING ABOUT NEAR
RECORD INCOME AND YOUR RECORD
PROFITABILITY. AND IF YOU DUG
FURTHER, YOU GOT A èC E Ó,
WHO'S MAKING $34 MILLION A YEAR,
AND THEY'RE CLOSING AN 18 BED
CRITICAL CARE PSYCHIATRIC UNIT.
IN LOS LOS GATOS AND SAN JOSE,
CALIFORNIA. UM THIS. I AM A
FORMER èC E Ó OF A PUBLICLY
TRADED COMPANY ON NASDAQ, AND I
GOT TO TELL YOU THIS. THIS IS
IMMORAL. ME AND THE STATE OF
CALIFORNIA NEEDS TO STEP UP AND
PROTECT US. FROM THESE THINGS
HAPPENING. THAT'S THAT'S WHY TWO
CENTS AS A AS A PRIVATE CITIZEN,
UM WE HAVE GOT MORE CLOSURES
COMING UP RIGHT NOW SCHEDULED. I
MEAN, REGIONAL IS CLOSING AND,
AS WAS MENTIONED EARLIER, IT'S
GOING TO PUT A PARTICULAR
HARDSHIP TO GET TO VALLEY
MEDICAL CENTER FROM THE EAST
SIDE, WHICH IS HIGHLY HISPANIC.
AND UH, NOT NECESSARILY, UH, THE
WEALTHIEST PART OF THE SILICON
VALLEY. UH AND IT'S GONNA TAKE
WHEN ONCE THAT CLOSES, YOU'RE
GONNA HAVE A CRITICAL CARE
PSYCHIATRIC PATIENT WHO NEEDS
INSTANT HELP. IT'S GOING TO ADD
8 TO 15 MINUTES, DEPENDING ON
TRAFFIC TO GET THAT PERSON TO
THE EMERGENCY WARD. AT VALLEY
MEDICAL AND I HAVE TO TELL YOU
PEOPLE WHO ARE FAMILIAR WITH
THAT END OF THE BUSINESS. UH, UH
, CRITICAL CARE AND MOVING IT TO
EMERGENCY WARS. 8 TO 15 MINUTES
IS THE IS THE DIFFERENCE BETWEEN
LIFE AND DEATH. ALL RIGHT, SO
THAT'S WHAT THESE CLOSURES MEAN
AND I THINK THAT NOTICE AND
EXTENDING NOTICE OF NOTIFICATION
BY 30 DAYS IS MINIMUM THAT CAN
BE DONE TO HELP FAMILIES. SO
THEY CAN LOOK FOR OTHER OPTIONS
FOR THEIR LOVED ONES AND THEIR
CHILDREN. THANK YOU. THANK YOU
BOTH. THANK YOU, SIR,
PARTICULARLY FOR COMING TO OFFER
TESTIMONY AT CIVIL. IT'S A
CRITICAL ISSUE. CAN I MAKE ONE
OTHER COMMENT, AND THIS IS I
JUST QUICKLY THIS IS A PERSONAL
OPINION WHEN I WHEN I GO TO A
WEBSITE, AND I LOOK AT A
CORPORATION, A HOSPITAL
CORPORATION THAT IS PRINTING
MONEY AND BRAGGING ABOUT YOU
KNOW THE SUCCESS AND THEY
DEPRIVE CARE FROM THOSE PEOPLE
WHO ARE SO DESPERATE AND NEEDY.
I AM TELLING YOU TO ME AND MY
BENEDICTINE EDUCATION, OK? THAT
BORDERS ON A CRIME AGAINST
HUMANITY. THAT'S HOW UPSET I AM.
THANK YOU. WE APPRECIATE YOU
COMING TO TESTIFY TODAY. ARE
THERE ANY OTHER SUPPORT
WITNESSES IN THE HEARING ROOM,
PLEASE STEP FORWARD NAME,
AFFILIATION AND POSITION ON THE
MEASURE, PLEASE. KATIE VAN DYNE
IS WITH HEALTH ACCESS CALIFORNIA
AND SUPPORT. THANK YOU. THANK
YOU, MA'AM. NEXT, PLEASE.
BANNING OFFER WAS THE NATIONAL
ALLIANCE ON MENTAL ILLNESS, ALSO
KNOWN AS NAMI, CALIFORNIA WHERE
THE SPONSOR OF THIS BILL, ASK
YOUR SUPPORT. THANKS. THANK YOU
FOR JOINING US TODAY. YES,
MA'AM. AND POOL WITH WESTERN
CENTER ON LAW AND POVERTY AND
SUPPORT. THANK YOU NEXT, PLEASE,
SIR. DAVID CAMPOS ON BEHALF OF
THE COUNTY OF SANTA CLARA IN
SUPPORT. THANK YOU. BEING A
PEARL ON BEHALF OF THE AMERICAN
FEDERATION OF STATE, COUNTY
MUNICIPAL EMPLOYEES AND STRONG
SUPPORT. THANK YOU, SIR. NEXT,
PLEASE. I AND WITH PLANNED
PARENTHOOD AFFILIATES OF
CALIFORNIA WERE IN SUPPORT.
THANK YOU FOR JOINING US. GOOD
AFTERNOON CHAIR MEMBERS OF MARRI
LOPEZ WITH THE CALIFORNIA NURSES
ASSOCIATION IN SUPPORT. THANK
YOU ANY OTHER SUPPORT WITNESSES
CONCERN TO WITNESSES IN
OPPOSITION, IF ANY, IN THE
HEARING ROOM, OPPOSITION
WITNESSES PLEASE STEP FORWARD.
IF YOU'D LIKE. PLEASE JOIN US AT
THE TABLE. WE'LL FIGURE THIS
OUT. THE MICS ON THIS END OVER
HERE.
HØI GOOD AFTERNOON CHAIR. ROTH
AND MEMBERS. MY NAME IS KIRSTEN
BARLOW. I'M HERE WITH THE
CALIFORNIA HOSPITAL ASSOCIATION.
UM WE UNFORTUNATELY HERE TODAY
TO SHARE OUR OPPOSITION TO THE
BILL, AS IT'S CURRENTLY WRITTEN.
AND WHILE WE APPRECIATE
AMENDMENTS THAT WERE DEVELOPED
BY THE COMMITTEE, WE THINK
THERE'S STILL MORE WORK TO DO
AND HAVE BEEN TRYING TO HAVE
SOME CONVERSATIONS WITH NAI
CALIFORNIA TO SEE IF THERE ARE
SOME WAYS THAT WE MIGHT AS THE
BILL MOVES FORWARD, UM FIND SOME
THINGS THAT WOULD ADDRESS OUR
CONCERNS. WE DO WANT TO SAY THAT
WE DO SHARE THE AND NAMIS
CONCERNS ABOUT ENSURING ACCESS
TO INPATIENT PSYCHIATRIC CARE
AND LABOR AND DELIVERY SERVICES.
BUT WHILE IT MIGHT SOUND LIKE A
SIMPLE POLICY TO JUST ADD 30
EXTRA DAYS, UM OF PUBLIC NOTICE
BEFORE A HOSPITAL HAS TO MAKE
THE TOUGH DECISION TO CLOSE A
SERVICE. THIS WILL NOT ACTUALLY
PREVENT THOSE SERVICES FROM
ULTIMATELY CLOSING AND IN SOME
CASES COULD EVEN MAKE THE
SITUATION WORSE. UM HOSPITAL
STAFF REACT THE SAME WAY ANY ONE
OF US WOULD. IF WE FOUND OUT OUR
JOB MIGHT BE IN DANGER, AND THEY
BEGIN TO LEAVE ESSENTIALLY
IMMEDIATELY TO LOOK FOR OTHER
WORK. AS A RESULT, HOSPITALS
SOMETIMES END UP NEEDING TO
START TO RAMP DOWN THE NUMBER OF
PATIENTS THEY CAN ACCEPT IN THAT
UNIT, OR EVEN CLOSE THE SERVICE
DOWN ALTOGETHER WAY BEFORE THE
90 DAYS IS EVEN HIT TODAY. UM
AND WHILE WE AGAIN APPRECIATE
THE HARD WORK OF THE CHAIR AND
THE COMMITTEE ON THE AMENDMENTS,
THERE ARE STILL SOME CONCERNS
THAT WE HAVE, UM, FOR EXAMPLE,
UM, ALLOWING A HOSPITAL TO CLOSE
ITS SERVICE 90 DAYS AFTER
PROVIDING COULD BE HELPFUL. BUT
REALLY, BY DOING SO, THE AUTHOR
OR THE COMMITTEE IS SORT OF
ACKNOWLEDGING THAT GIVING THAT
LONGER PERIOD OF 120 PROBABLY
MEANS THAT STAFF WILL LEAVE AND
YOU MIGHT ACTUALLY NEED THAT, UM
, NEED TO CLOSE DOWN SOONER. UM,
ADDITIONALLY, THERE'S A
PROVISION THAT WOULD ALLOW US A
HOSPITAL, UM, TO HAVE SOME
FLEXIBILITY IF THE DEPARTMENT OF
PUBLIC HEALTH HAS CITED IT FOR
NOT PROVIDING SAFE CARE
HOSPITALS SIMPLY WOULD NOT TAKE
ON MORE PATIENTS IF THEY FOR
INSUFFICIENT. WE WOULDN'T NEED
TO GET TO THAT POINT TO BE CITED
BEFORE TAKING ACTION. UM,
ADDITIONALLY, THERE ARE SOME
PIECES OF THE IMPACT ANALYSIS
THAT WE FIND ARE PROBLEMATIC, IN
PARTICULAR ASKING THE HOSPITAL
TO ESTIMATE THE EFFECT OF
CLOSING A SERVICE ON THE COUNTY.
UM, IS PROBLEMATIC FOR SEVERAL
REASONS. IN SOME CASES, IT'S
BECAUSE THE INFORMATION WE
WOULDN'T HAVE, FRANKLY, UM, IN
TERMS OF YOU KNOW WHAT'S THE
COUNTY GOING TO DO IF THE
SERVICE GOES AWAY? WHAT
ADDITIONAL COST? WOULD IT INCUR
TO REPLACE THE BEDS, FOR EXAMPLE
, THAT ARE LOST? UM THE OTHER
DIFFICULTY, I THINK, UM, WITH
MENTIONING THE COUNTY
SPECIFICALLY IS THAT IT KIND OF
RE REAFFIRMS THE PRESSURE. WE'VE
ALL COLLECTIVELY PLACED ON
COUNTIES IN OUR STATE TO SOLVE
THE PUBLIC BEHAVIORAL HEALTH
CRISIS, UM, AND DOESN'T REALLY
REFLECT THE FACT THAT MANY OF
THESE PATIENTS HAVE PRIVATE
INSURANCE, AND IT'S NOT THE
COUNTY'S ROLE NOR AUTHORITY TO,
YOU KNOW, SORT OF STEP IN AND DO
ANYTHING IN PARTICULAR ABOUT
MAKING, UM IMPATIENT PSYCH, OR
LABOR AND DELIVERY AVAILABLE TO
THE BROADER COMMUNITY. UM IN THE
FEW HOSPITALS THAT HAVE CLOSED,
INPATIENT PSYCHIATRIC CARE IN
THE LAST DECADE, UM THEY'VE
MOSTLY CITED WORKFORCE
CHALLENGES AND MEDICAID
REIMBURSEMENT PROBLEMS. AND SO
YOU KNOW, AGAIN, PROVIDING 30
EXTRA DAYS OF NOTICE. I THINK WE
ACKNOWLEDGE WOULD NOT
NECESSARILY SOLVE THE PROBLEM OF
PROTECTING OR PRESERVING BEDS.
BUT WE ARE VERY INTERESTED IN
WORKING WITH NAMI, UM AND THE
AUTHOR ON SOME OF THE KIND OF
REAL POLICY SOLUTIONS THAT, UM,
AS MR FITZGERALD SAID, GET
FURTHER AHEAD OF THAT FROM
HAPPENING IN THE FIRST PLACE. UM
FOR EXAMPLE, UM, ADDRESSING THE
MEDICAID REIMBURSEMENT RATES IS
SOMETHING THAT WE'RE AWARE
DEPARTMENT OF HEALTH CARE
SERVICES IS STARTING TO WORK ON
AND WE'RE SUPPORTING THEIR
EFFORTS IN THAT ARENA. UM, WE
ALSO THINK THAT WE HAVE NOT
REALLY RAISED OUR EXPECTATIONS
ENOUGH FOR HEALTH PLANS IN
COUNTIES TO SHOW THEY HAVE AN
ADEQUATE ACCESS TO THOSE
SERVICES. SO, FOR EXAMPLE, OUR
COUNTY MENTAL HEALTH DEPARTMENTS
ARE ASKED TO PROVIDE PROOF
ESSENTIALLY TO THE STATE THAT
THEY'VE SUFFICIENT OUTPATIENT
MENTAL HEALTH CARE AVAILABLE TO
MEDICARE BENEFICIARIES. WE HAVE
NOT ASKED THEM TO PROVE THEY CAN
PROVIDE INPATIENT PSYCHIATRIC
CARE, WHICH IS PART OF WHY WE
HAVE 24 COUNTIES OUT OF 58 WITH
ZERO IN PATIENT PSYCHIATRIC BEDS
TODAY, SO WE THINK THAT THERE
ARE OTHER SOLUTIONS THAT SORT OF
GET TO THE UNDERLYING ISSUE HERE
AND HOPE TO BE ABLE TO WORK
THROUGH THOSE ISSUES WITH THE
AUTHOR AND SPONSORS. AND WITH
THAT I WILL TURN TO MY
COLLEAGUES. THANK YOU. GOOD
AFTERNOON SHARING. MY NAME IS
JIM SILVER, AND I'M THE èC E Ó
OF RIDGECREST REGIONAL HOSPITAL.
THANK YOU FOR ALLOWING ME TO
DISCUSS MY CONCERNS IN
OPPOSITION TO SB 1000 THREE 100
TODAY. THE WAY OF BACKGROUND
RIDGECREST IS A SMALL, CRITICAL
ACCESS HOSPITAL. WE ARE
COMMUNITY NONPROFIT BASED. WE
HAVE A CAPACITY OF 25 BEDS.
RECENTLY I HAD TO MAKE THE
AGONIZING DECISION TO CLOSE OUR
LABOR AND DELIVERY PROGRAM.
RIDGE CREST DELIVERED ITS LAST
BABY ON FEBRUARY 29TH. SO AND
UNFORTUNATELY I AM ALL TOO
FAMILIAR WITH THE CLOSURE
PROCESS. I SHOULD ALSO LET THE
COMMITTEE KNOW THAT OUR DAY IS
CASH ON HAND IS NOW AT 25 DAYS,
AND AFTER THAT THERE IS NÓ MORE
CASH IN MY FACILITY TO KEEP
OPERATIONS. WHILE PROVIDING
ADDITIONAL NOTIFICATION AS WELL
INTENDED. I'M AFRAID IT'S GOING
TO HAVE THE OPPOSITE EFFECT AND
WILL ACTUALLY FORCE HOSPITALS TO
CLOSE SERVICES LONGER. LONGER OR
SOONER, LONGER NOTICE PERIODS
AND IMPACT ANALYSIS REQUIRING
HOSPITALS TO PROVIDE INFORMATION
THAT THEY HAVE NÓ ACCESS TO WILL
NOT STOP SERVICE CLOSURES. WE
SHOULD BE WORKING TO ADDRESS THE
UNDERLYING CHALLENGES THAT ARE
CAUSING CLOSURES TO STOP THEM
FROM HAPPENING IN THE FIRST
PLACE RATHER THAN FURTHER
REQUIREMENTS. ONCE THE HOSPITAL
HAS DETERMINED THAT THEY ARE
GOING TO CLOSE THE SERVICE IN MY
HOSPITAL'S CASE, WE KNEW THAT
LABOR AND DELIVERY UNIT WAS AT
RISK. AND WE DELIBERATED FOR
ALMOST TWO YEARS, REPEATEDLY
POSTPONING MAKING A DECISION
WHILE WE CONDUCTED EXTENSIVE
ANALYSIS OF DEMOGRAPHICS. ENGAGE
COMMUNITY AND POLICY LEADERS AND
ADVOCATED FOR INCREASED
REIMBURSEMENT RATES AND
INCORPORATED INPUT FROM OUR
MEDICAL STAFF LEADERS.
EXASPERATING THE PROBLEM IS A
DECLINING BIRTH RATE IN OUR
COMMUNITY, WHICH FURTHER
STRESSES FINANCIAL, LABOR AND
DELIVERY PROGRAM AS WELL AS
MAKES QUALITY MORE OF A
CHALLENGE. MEANWHILE INCREASING
COSTS DUE TO STAFFING CHALLENGES
IN BOTH THE NURSING AND
PHYSICIAN FIELDS CREATED MORE
FINANCIAL DISTRESS. ULTIMATELY,
THE DECISION BECAME CLEAR. CLOSE
OUR LABOR AND DELIVERY PROGRAM
OR CONSIDER DOWNGRADING OUR
EMERGENCY DEPARTMENT, WHICH
WOULD HAVE HAD POTENTIALLY
DEADLY IMPACT TO OUR COMMUNITY
RESIDENTS. OUR BOARD LIBERATED
OVER BOTH POTENTIAL ACTIONS VERY
CAREFULLY. WE CANNOT ADDRESS THE
CHALLENGES THE PATIENTS AND
PROVIDERS ARE FACING WHEN
MAINTAINING AND INCREASING
ACCESS IF WE DON'T HOLD ALL
STAKEHOLDERS ACCOUNTABLE BY
ENSURING REIMBURSEMENT RATES FOR
BOTH COMMERCIAL AND GOVERNMENT
PAYERS COVERS COST REQUIRING
ADEQUATE NETWORKS, CONSIDERING
TIME AND DISTANCE STANDARDS
COULD HELP RURAL PROVIDERS MEET
THE NEEDS OF OUR COMMUNITIES.
FIXING THESE PROBLEMS REQUIRES
BUY IN AND OWNERSHIP FROM ALL
INVOLVED, NOT JUST THOSE OF US
THAT ARE ON THE FRONT LINE
STRUGGLING TO MAINTAIN SERVICES.
NOW ONLY OF THESE CHALLENGES
THAT MY HOSPITAL CONTINUES TO
FACE OR ADDRESSED IN S¼ B 1000
THREE, 100 IS UNLIKELY TO
BENEFIT PATIENTS AS SERVICE
COULD TELL ME IT'S LIKELY TO
COME EVEN SOONER. IN MY
HOSPITAL'S CASE. IF I HAD THE
ADVANCE NOTICE REQUIREMENT, I
WOULD HAVE MADE THE DECISION TO
CLOSE THE LABOR IT SOONER. DUE
TO CONCERNS ABOUT FRANKLY
RUNNING OUT OF CASH. I DELAYED
THE DECISION AS LONG AS I COULD.
UP UNTIL THE DAY I HAD TO GIVE
THE OFFICIAL 90 DAY NOTICE,
HOPING THAT THERE WERE SOME
INCREASES GOING TO OCCUR TO THE
REIMBURSEMENT RATES, BUT
UNFORTUNATELY THAT DID NOT
HAPPEN. I WOULD ASK THAT WE
FOCUS ON NECESSARY FINANCIAL
SUPPORT TO HOSPITALS FOR
OBSTETRICAL PROGRAMS, ESPECIALLY
UNREIMBURSED STANDBY EXPENSES TO
STOP THE EVER GROWING MATERNAL
CARE DESERTS OCCURRING IN OUR
STATE. CHANGE NOTICE PERIODS AND
COLLECTING ADDITIONAL
INFORMATION DOES NOT ADDRESS THE
UNDERLYING CHALLENGES THAT ARE
LEADING TO CLOSURES. THANK YOU
VERY MUCH AND VERY HAPPY TO
ANSWER ANY QUESTIONS. THANK YOU,
SIR. ANY OTHER OPPOSITION
WITNESSES IN THE HEARING ROOM?
NÓ I'LL BRING THE CONVERSATION
BACK TO THE DAIS AND MY
COLLEAGUES FOR QUESTIONS,
COMMENTS AND CONCERNS I. I DO
WANT TO NOTE ONE ISSUE OR POINT
AND THAT IS THERE WERE SOME
AMENDMENTS PROPOSED WITH THE
AUTHOR, THE AUTHOR HAS AGREED TO
ACCEPT AND ONE IN PARTICULAR
GIVES CDPH THE ABILITY TO ALLOW
A HOSPITAL TO CLOSE THE
MATERNITY PSYCHE AND PSYCHE OR
PSYCHIATRIC UNIT. WITHOUT
WAITING FOR THIS ADDITIONAL 30
DAYS IF IT FINDS THAT THE
CLOSURE AND THE NOTICE PERIOD
RATHER WILL THREATEN THE
HOSPITAL AS A WHOLE OF MIRRORING
THE LANGUAGE THAT CURRENTLY
EXISTS FOR EMERGENCY DEPARTMENTS
AND WHERE THE STABILITY OF THE
HOSPITAL AS A WHOLE IS
THREATENED, SO YOU ALREADY HAVE
A 90 DAY NOTICE PERIOD THAT'S
REQUIRED AND THIS IS TO ADD 30
TO GO TO 120 IN THE 30. UM CAN
BE ERASED BY CDPH IF IT FINDS
THAT THE ADDITIONAL NOTICE
PERIOD WILL THREATEN THE
STABILITY OF THE HOSPITAL. WE
CAN DEBATE THE ORIGINAL 90 DAYS.
BUT THAT'S NOT THE ISSUE HERE.
THE ISSUE IS THE ADDITIONAL THE
ADDITIONAL 30 DAYS. UM OBVIOUSLY
THIS IS A DELICATE SITUATION.
THOSE OF YOU WHO ARE SMALL
HOSPITALS IN RURAL AREAS OR
SMALL HOSPITALS IN URBAN AREAS
DOESN'T SEEM TO BE. THERE'S A
DIFFERENCE IN SOME CASES THAT
ARE ON THE CUSP OF FINANCIAL
DISASTER. THAT'S AN ISSUE THAT'S
MUCH BROADER THAN THE SPILL THAT
WE ARE GOING TO HAVE TO GRAPPLE
WITH IN THE STATE. HOPEFULLY
SOON WITH A MORE ROBUST BUDGET.
IT DEALS WITH REIMBURSEMENT
RATES FOR MEDI CAL AND VARIOUS
PROCEDURES. IT DEALS FOR A WHOLE
HOST OF ISSUES, INCLUDING
SEISMIC THAT WE'RE CURRENTLY
GRAPPLING WITH. BUT AGAIN,
THAT'S NOT THIS PARTICULAR BILL.
UM SEEMS TO ME THAT NOTICE AN
ADDITIONAL NOTICE PERIOD. AND
ASIDE FROM THE FINANCIAL
DISTRESSED HOSPITALS AND
ADDITIONAL NOTICE PERIOD COULD
CAUSE SOME ISSUES FOR HOSPITALS
WITH RESPECT TO STAFFING, BUT
I'M WONDERING IF THE OPPORTUNITY
FOR FURTHER PUBLIC DISCUSSION
AND INVESTIGATION OF OPTIONS
DURING THAT 30 DAYS MIGHT BE
WORTH THE ADDITIONAL NOTICE
PERIOD TO HOSPITALS. WE ALSO
HAVE TRANSITION IN CONTINUITY OF
CARE, AND IN PARTICULAR IN THE
MENTAL HEALTH FIELD. I DON'T
KNOW WHEN A WHEN A WHEN A
HOSPITAL THAT IS ONE OF A FEW IN
AN AREA SHUTS DOWN A ACUTE CARE
INPATIENT PSYCHIATRIC UNIT. WHAT
PEOPLE WHO NEED THAT UNIT DO UH
AND THAT'S AN ISSUE WE'RE GOING
TO HAVE TO GRAPPLE WITH, UM IN
THIS STATE AND IN THIS BUILDING
FAIRLY QUICKLY, WE HAVE A
BEHAVIORAL HEALTH BOND THAT
THERE WAS A VARIETY OF OPINIONS
ON THAT. I'D BE INTERESTED TO
TAKE A POLL IN THIS ROOM TO SEE
WHO SUPPORTED AND OPPOSED. BUT
WE CAN'T ASK THOSE QUESTIONS.
BUT HOPEFULLY THAT ADDITIONAL
MONEY ONCE IT ROLLS OUT, WILL
ENABLE WILL SUPPORT ADDITIONAL
BED CAPACITY AND SUPPORT THOSE
THAT HAVE TRIED TO MAINTAIN
CAPACITY OVER TIME. AND RATHER
DIFFICULT. CONDITIONS. SO I JUST
WANTED TO NOTE THE AMENDMENT.
THE REST WAS COMMENTARY. SO I'M
GOING TO TURN TO MY COLLEAGUES
FOR QUESTIONS, COMMENTS OR
CONCERNS. I'M SURE SENATOR GROVE
HAS SOME SENATOR GROVE. MISTER
PRESIDENT. MY APOLOGIES. I HAVE
A DUAL COMMITTEE DUTY. I WAS IN
RULES. RULES JUST ADJOURNED AND
I MADE MY WAY DOWN. TO THE FIRST
FLOOR, I BELIEVE IS SECOND FLOOR
FOR RULES. UM I. I DO HAVE A
COMMENTS AND THE REASON I'M
MAKING THIS COMMENT IS BECAUSE,
UM, YOU KNOW, ONE OF YOUR
OPPOSITION WITNESSES IS ONE OF
MY PRESIDENTS OF A HOSPITAL THAT
WE HAVE IN A VERY RURAL
COMMUNITY THAT IS THE LIFE BLOOD
TO THE CHANNEL LINK NAVAL AIR
WARFARE CENTER, WHICH IS A SOUTH
CHINA SEA PROTECTOR, WHICH IS
BENEFICIAL TO ALL OF US IN THE
STATE, INCLUDING CONSTITUENTS IN
EVERYBODY'S DISTRICT THAT'S
STANDING THERE AND ON THE DÍAS.
UM IT'S A FINANCIALLY STRESSED
HOSPITAL AND I. I HATE THAT WE
STILL ARE PUTTING BAND AIDS ON
THE REAL SITUATION BECAUSE THE
SITUATION IS DEFINITELY WE NEED
TO INCREASE MEDICAL RATES. UM WE
KEEP INCREASING SMALL
PERCENTAGES, MAKING NEGOTIATIONS
WITH HEALTH PLANS AND OTHER
ORGANIZATIONS WHO CAN OFFSET
SOME OF THE COST. AND THESE ARE
ALL JUST MINIMAL BANDAIDS IF
EVEN BANDAIDS ON SITUATIONS THAT
ARE DASTARDLY, UM, UH, NOT
SUBSTANTIAL ENOUGH TO FIX THE
PROBLEM THAT WE HAVE. BUT ON THE
FLIP SIDE, WE'RE INCREASING
COSTS BY A 30 DAY NOTICE. WE'RE
NOT ADDRESSING THE SEISMIC ISSUE
THAT'S COMING UP LIKE A
WHIRLWIND. THEY HAVE TO START
PLANNING NOW FOR THE TIME LIMIT
FOR SEISMIC. WE'RE NOT
ADDRESSING THE $25 INCREASE IN
WAGES FOR EVERY PERSON IN A
HOSPITAL. WE KEEP ADDING
EXPENSES UP TO HERE, FIXING A
BAND AID TO THIS LEVEL, AND
YOU'RE PUTTING FINANCIALLY
DISTRESSED HOSPITALS IN A
POSITION WHERE THEY CAN'T
PROVIDE ADEQUATE HEALTHCARE
SPECIFICALLY TO OUR RURAL
COMMUNITIES. AND I DESPISE WITH
EVERY BIT OF MY BEING THIS
RESPONSE THAT I GET FROM SOME OF
MY COLLEAGUES, UH, FOR INSTANCE,
LIKE, UM WE'LL JUST GO TO THE
NEXT HOSPITAL. WELL THE NEXT
HOSPITAL FOR MR FROM JIM'S
HOSPITAL IN RIDGECREST, MISTER
SERVER'S HOSPITAL IS A 55 TO 60
MILES AWAY, BUT THINK ABOUT IT.
IT'S NOT LIKE TRAVELING DOWN I
FIVE YOU'RE TRAVELING DOWN A
CANYON ROAD WITH A 50 FT. DROP
TO A RIVER ON ONE SIDE AND A TWO
LANE ROAD AND A CANYON WALL. THE
OTHER SIDE AND VERY WINDY
CONDITIONS. IT'S NOT IN THE SAME
CIRCUMSTANCES THAT YOU DEAL WITH
IN LARGE METROPOLIS AREA. UM
THIS IS A RURAL HOSPITAL, AND IT
ALSO HAS A ABILITY TO AFFECT OUR
RECRUITMENT FOR OUR NAVAL AIR
WARFARE CENTER, WHERE WE EXPECT
THE BEST OF THE BEST TO SHOW UP
AND PROTECT US FROM CYBER
SECURITY ISSUES FROM UM YOU
KNOW, IT'S THE LARGEST RESEARCH
AND DEVELOPMENT ARM IN THE
UNITED STATES MILITARY AND I
JUST SAY ALL THAT THAT, UM WE
CAN'T AFFORD TO LET THIS
HOSPITAL FAIL. UM AND I HAVE
HUGE CONCERNS. OVER THAT I AM
GOING TO OPPOSE THE BILL TODAY
BECAUSE I CAN'T JUST SEE ADDING
ANOTHER. UM ANOTHER BRICK WALL
TO A HOSPITAL THAT'S ALREADY
STRUGGLING TO KEEP THEIR DOORS
OPEN IS UNDER THE LIST OF
FINANCIALLY DISTRESSED HOSPITALS
HAS ADDRESSED THE MATERNITY WARD
ISSUE IS EITHER GOING TO AND I
APOLOGIZE FOR NOT BEING HERE FOR
THE ENTIRE TESTIMONY. STAND BY
EMERGENCY ROOM. HAVE YOU DONE
THAT ALREADY? ARE THINKING ABOUT
DOING THAT THAT'S IS ON OUR
TRIGGER LIST. IF OUR FINANCIALS
DO NOT IMPROVE, WE WILL
DOWNGRADE FROM A BASIC TO A
STANDBY, STANDBY EMERGENCY ROOM.
THINK ABOUT RECRUITING SOMEBODY
AND THE SERVICES THAT THAT RURAL
COMMUNITY WILL GET WHEN YOU
CAN'T EVEN TAKE YOUR KID TO THE
HOSPITAL FOR A BROKEN ARM FOR AN
EMERGENCY OR SOMETHING LIKE
THAT. NOT TO MENTION CARDIO CARE
, CARDIOVASCULAR CARE AND
PULMONARY CARE. UM SO I JUST I
CHALLENGE ALL MY COLLEAGUES TO
UNDERSTAND THAT RURAL CALIFORNIA
DOESN'T OPERATE LIKE YOU. I
DON'T HAVE A FOUNDATION LIKE MY
COLLEAGUE IN SAN FRANCISCO,
WHERE YOU CAN JUST SET UP A
FOUNDATION IN SOME MILLIONAIRE
BILLIONAIRE CAN GIVE YOU
MILLIONS OF DOLLARS IN THE
FOUNDATION TO MAKE OFFSET THAT.
I DON'T HAVE THOSE PEOPLE IN MY
DISTRICT. I HAVE HARD WORKING
WHITE COLLAR JOBS, RESEARCH AND
DEVELOPMENT JOBS, ESPECIALLY IN
THIS AREA SCHOOL TEACHERS, AND
THEY DESERVE ADEQUATE AND
SUBSTANTIAL MEDICAL CARE. AND I
JUST THINK, ADDING THESE
CONTINUOUS MANDATES AND EXTENDED
COST. UM ON HOSPITALS. THERE ARE
ALREADY FINANCIAL TO STRETCH
WHICH WE TRIED TO ADDRESS LAST
YEAR WITH THE LOAN PROGRAM. UM
IS NOT A GOOD THING FOR ALL OF
US IN THE STATE, SO I
RESPECTFULLY OPPOSE THE BILL
TODAY. THANK YOU. THANKS. THANK
YOU, SENATOR. UM ANY OTHER
QUESTIONS? COLLEAGUES COMMENTS
CONCERNS. IT'S SENATOR MENJIVAR
HAS MOVED THE BILL, SENATOR
CORTESI, WOULD YOU LIKE TO
CLOSE? THANK YOU AGAIN. UM MR
CHAIR. I REALLY APPRECIATE YOUR,
UM FAIRNESS. NOT THAT YOU NEED
TO HEAR THAT FROM ME OR MASTERY
OF EACH OF THESE TOPICS THAT
COME BEFORE YOU IN HEALTH
COMMITTEE AND BEFORE US AS AS
THE SENATE. I'M VERY HAPPY THAT
WE'VE BEEN ABLE TO CREATE AN
OPPORTUNITY TODAY FOR FOLKS TO
TALK ABOUT ISSUES THAT REALLY
DON'T HAVE ANYTHING DIRECTLY TO
DO WITH THE BILL, BUT I THINK
IT'S A PERFECT EXAMPLE OF WHAT
WE ARE TRYING TO DO WITH THE
BILL IN TERMS OF CREATING PUBLIC
HEARING PROCESSES, WHERE ISSUES
LIKE THIS THAT ARE ARE DRIVING
DECISIONS. TO CLOSE PSYCH UNITS
AND TO CLOSE MATERNITY UNITS
COME TO PUBLIC HEARING AT THE
BEHEST OF EACH COUNTY. EACH OF
THE 58 COUNTIES, NOT JUST MINE.
UH BUT EACH OF THE 58 COUNTIES
IN INCLUDING CURRENT AND OTHERS,
THOSE BOARDS OF SUPERVISORS,
WHICH ARE SUBDIVISIONS OF THE
STATE OF CALIFORNIA, DIRECT
SUBDIVISIONS OF OUR GOVERNMENT,
WHICH HAVE THE SAME RIGHTS TO
HOLD PUBLIC HEARINGS, AS WE DO
RIGHT HERE WOULD HAVE THE
OPPORTUNITY TO HEAR TESTIMONY
LIKE THIS. VERY COMPELLING
TESTIMONY LIKE THIS FROM THE
OPPOSITION WITNESSES IN THEIR
LOCAL COUNTY WITHOUT HAVING TO
DRIVE 24 OR FIVE OR GET ON AN
AIRPLANE FROM LOS ANGELES AND
COME TO SACRAMENTO. THAT'S WHAT
SHOULD BE HAPPENING INSTEAD, WE
HAVE AN OPAQUE SITUATION WHERE
THESE UNITS ARE CLOSED. THE
COUNTIES DON'T HAVE DIRECT
JURISDICTION OVER THE HOSPITALS,
BUT MOREOVER, THEY DON'T EVEN
HAVE THE OPPORTUNITY BY STATUTE
TO CALL A HEARING TO INVITE
PEOPLE IN TO ASK THEM. WHAT THE
HELL HAPPENED. WHAT HAPPENED?
CAN WE HAVE YOU COME IN AND TELL
US IN A PUBLIC HEARING, SO OUR
CONSTITUENTS BLACK, WHITE, BROWN
AND OTHER CAN COME FORWARD AND
HEAR WHAT JUST HAPPENED? WHY
WOULD WE STOP THAT FROM
HAPPENING IN KERN OR SILICON
VALLEY OR ANY COUNTY? ANY OF THE
58 COUNTIES IN CALIFORNIA?
THAT'S ALL THIS BILL DOES. AND
THAT'S WHY THE SUPPORT,
WITNESSES SAID. MY SUPPORT,
WITNESSES SAID, THIS IS REALLY A
VERY SIMPLE BILL. IT DOESN'T DO
MUCH. IT CREATES A PUBLIC
HEARING OPPORTUNITY AT THE LOCAL
LEVEL, UH, TO DEAL WITH ISSUES
THAT ARE I AGREE WITH YOU
SENATORS ABSOLUTELY VITAL TO THE
SURVIVAL OF OUR CONSTITUENTS IN
MY COUNTY. SILICON VALLEY AND
IMAGINE IT'S LIKE THIS HAVE
VISITED LOS ANGELES A FEW TIMES,
UH IN LOS ANGELES COUNTY WHEN
YOU CLOSE DOWN A MATERNITY UNIT
ON ONE SIDE OF THE VALLEY.
ESPECIALLY ON THE SIDE OF THE
VALLEY, WHICH IS DOMINATED BY
PEOPLE OF COLOR. AND YOU TELL
THEM THAT YOU NOW HAVE TO
COMMUTE. IN HIGH TRAFFIC
SITUATIONS AT PEAK HOURS. UH, TO
GO TO MATERNITY UNIT. THAT BY
THE WAY WE OWN AS A HOSPITAL
SYSTEM ALL THE WAY ACROSS THE
VALLEY. IT'S JUST AS DIFFICULT
AS GETTING ACROSS KERN COUNTY.
IT MAY BE MORE DIFFICULT WITHOUT
A HELICOPTER. IT TAKES SOMETIMES
AN HOUR AND 15 MINUTES AN HOUR
AND 30 MINUTES TO GET 12 MILES
ACROSS OUR VALLEY IN A CAR.
THAT'S WHAT I THINK ONE OF OUR
COLLEAGUES WHO IS IN THE
COMMITTEE ROOM YESTERDAY,
TALKING ABOUT REPARATIONS WOULD
CALL MODERN DAY REDLINING.
THAT'S MODERN DAY REDLINING, AND
THAT'S WHY SOME PEOPLE FEEL THAT
THAT'S IMMORAL. UH, WHEN YOU
CLOSE DOWN A PSYCH UNIT, WE KNOW
WHAT THE IMPACT OF THAT IS. I
KNOW THAT I THINK MOST OF OUR
COLLEAGUES HERE KNOW THAT. BUT
TO HAVE, IN EFFECT, AN OBSTACLE
IN OUR STATUTORY TEAM THAT
DISALLOWS AGAIN ONE OF OUR OWN
SUBDIVISIONS OF GOVERNMENT
COUNTY GOVERNMENT TO CALL A
HEARING IN IN AND FIND OUT
EXACTLY WHAT HAPPENED. AND
PERHAPS PERHAPS BRING TO BEAR
SOME REMEDIES, PERHAPS BRING TO
BEAR SOME HELP. SOME COUNTY
GRANTS SOME COUNTY ASSISTANT
SOME LOBBYING EFFORTS AT THE
STATE OF CALIFORNIA. WHY WE
WOULD CUT THAT OFF. I HAVE NÓ
IDEA. I RESPECTFULLY ASK FOR
YOUR I VOTE. THANK YOU, SENATOR.
THE BILL S¼ B 1300 ITEM NUMBER
SEVEN HAS BEEN MOVED BY SENATOR
MENJIVAR. THE MOTION IS TO PASS
AS AMENDED AND REREFER TO THE
COMMITTEE ON APPROPRIATIONS. WE
ARE READY TO CALL THE ROLL.
PLEASE CALL THE ROLL. SENATOR
ROSS ROTH. I WHEN GLAZER
GONZALEZ. GROWTH NÓ GROWTH NÓ
HURTADO LIMÓN. I MENJIVAR
MENJIVAR. I RUBIO SMALLWOOD QUAS
SMALLWOOD QUAS I WIENER WIENER.
I THE VOTE IS. 5 TO 1 WILL HOLD
THE DOOR OPEN FOR EPSOM MEMBERS.
THANK YOU, SIR. SENATOR MO IS
PRESENTING ITEM NUMBER FOUR
SENATE BILL 1213 FOR SENATOR
ATKINS HEALTH CARE PROGRAMS.
CANCER THANK YOU, CHAIRMAN AND
MEMBERS. I HAVE MORE OF A VOICE
TODAY THAN I DID YESTERDAY. I'M
HERE TODAY TO PRESENT S¼ B 1213
ON BEHALF OF SENATOR ATKINS,
WHICH WOULD EXPAND ACCESS TO
BREAST AND CERVICAL CANCER
SCREENINGS, DIAGNOSTIC SERVICES
AND TREATMENT FOR LOWER INCOME
CALIFORNIANS. OTHER THAN SKIN
CANCER. BREAST CANCER IS THE
MOST COMMON CANCER IN WH FOR
WOMEN IN THE UNITED STATES AND
THE SECOND LEADING CAUSE OF
CANCER DEATH IN WOMEN. THE
AMERICAN CANCER SOCIETY
ESTIMATES THAT THERE WILL BE
ABOUT 13,820 NEW CASES OF
CERVICAL CANCER IN 2024 AND
ABOUT 4360 WOMEN WILL DIE FROM
THIS DISEASE DETECTING AND
TREATING BREAST AND CERVICAL
CANCER EARLY CAN SAVE LIVES AND
IMPROVE HEALTH OUTCOMES.
CURRENTLY MANY LOWER INCOME
WOMEN WHO ARE UNINSURED OR
UNDERINSURED WITH AN INCOME OF
ABOVE 200% OF THE FEDERAL
POVERTY LEVEL AND WHO ARE NOT
ELIGIBLE FOR ME ARE UNABLE TO
AFFORD OR PURCHASE INSURANCE.
AND UNDOCUMENTED INDIVIDUALS ARE
NOT ELIGIBLE FOR SUBSIDIES TO
REDUCE PREMIUMS. TO ENSURE THAT
LOWER INCOME CALIFORNIANS GET
THE TREATMENT THEY NEED. EVERY
WOMAN COUNTS PROGRAM PROVIDES
FREE BREAST AND CERVICAL CANCER
SCREENINGS TO ELIGIBLE
CALIFORNIANS AND THE BREAST AND
CERVICAL CANCER TREATMENT
PROGRAM PROVIDES TREATMENT
BENEFITS TO ELIGIBLE
CALIFORNIANS DIAGNOSED WITH
BREAST OR CERVICAL CANCER. S¼ B
1213 WOULD INCREASE THE
ELIGIBILITY THRESHOLD FOR THE
EVERY WOMAN COUNTS PROGRAM AND
THE BREAST AND CERVICAL CANCER
TREATMENT PROGRAMS. 200% OF THE
FEDERAL POVERTY LEVEL TO 300% OF
THE FEDERAL POVERTY LEVEL,
MEANING MORE WOMEN WOULD BE ABLE
TO ACCESS LIFE SAVING MEDICAL
CARE. HERE TO TESTIFY IN SUPPORT
OUR AUTUMN. ROAD IN SMITH FROM
THE AMERICAN CANCER ACTION
NETWORK, AND CONNOR SWEENEY WITH
THE SUSAN G KOMEN FOUNDATION AS
WELL AS COURTNEY QUINN FROM THE
A. I BE AWARE BREAST CANCER
FOUNDATIONS. PLEASE PROCEED. UH,
THANKS. THANK YOU. CHAIR MEMBERS
. I'M OTTO OGDEN SMITH WITH THE
AMERICAN CANCER SOCIETY CANCER
ACTION NETWORK HERE IS A PROUD
CO SPONSOR OF THIS BILL. EVERY
WOMAN COUNTS AND THE BREAST AND
CERVICAL CANCER TREATMENT. UH,
PROGRAMS ARE CRITICAL LIFELINE
TO WOMEN AND CALIFORNIA WHO ARE
UNINSURED AND UNDERINSURED SINCE
THE AFFORDABLE CARE ACT,
CALIFORNIA HAS BEEN AT THE
FOREFRONT OF ACHIEVING UNIVERSAL
COVERAGE THROUGH A VARIETY OF
EXPANSIONS AND SUBSIDIES.
EXPANDING EVERYONE COUNTS IN THE
BCC TP TO THREE 100% WILL BRING
US IN ALIGNMENT WITH 80% OF
OTHER STATES. WILL MORE
IMPORTANTLY, TAKE A MODEST NEXT
STEP IN PROVIDING ACCESS TO
CANCER CARE TREATMENT TO THE
WOMEN WHO NEED IT THE MOST AS
CALIFORNIA MOVES FORWARD TOWARDS
UNIVERSAL COVERAGE. IT IS
CRITICAL THAT WE TAKE THE NEXT
STEP IN ENSURING THAT MORE
PEOPLE HAVE ACCESS TO CRITICAL
CANCER CARE. THANK YOU. AS FOR
YOUR I VOTE, THANK YOU, MA'AM.
SURE. THANK YOU, MR CHAIR
MEMBERS. CONNOR SWEENEY WITH THE
SUSAN G KOMEN FOUNDATION. ALSO A
PROUD COSPONSOR OF THIS BILL.
EVERY WOMAN COUNTS IN THE BRETON
CERVICAL CANCER TREATMENT
PROGRAM HAVE A STRONG TRACK
RECORD OF SAVING LIVES BY
PROVIDING FREE CANCER SCREENINGS
AND, UH, TREATMENT, PROVIDING
PUBLIC EDUCATION, OUTREACH,
PATIENT NAVIGATION AND CARE
COORDINATIONS FOR THOSE
DIAGNOSED WITH CANCER THROUGH
èC EW èC PROVIDES THOUSANDS OF
SCREENINGS TO WOMEN EVERY SINGLE
YEAR. IS A SPECIAL EMPHASIS ON
WOMEN WHO ARE LESS LIKELY TO BE
SCREENED FOR CANCER, INCLUDING
THOSE WITH LOW INCOME AND WHO
ARE WITHOUT ACCESS TO AFFORDABLE
HEALTH COVERAGE OPTIONS AND
THOSE FROM RACIAL AND ETHNIC
MINORITY GROUPS. BUT DESPITE
THEIR STRONG TRACK RECORD OF
SUCCESS IN THIS CRITICAL MISSION
, E èC AND THE TREATMENT
PROGRAM ARE ONLY ABLE TO PROVIDE
THESE SERVICES TO CALIFORNIANS
MAKING UP TO 200% OF THE FEDERAL
POVERTY LEVEL, WHICH IS JUST
$30,120. THIS IS, IN FACT AMONG
SOME OF THE LOW COVERAGE LEVELS
FOR THESE TYPES OF PROGRAMS IN
THE U S¼. PATIENTS WITH INCOMES
HIGHER THAN THIS BAR ARE UNABLE
TO GET ACCESS TO THESE TREATMENT
AND SCREENING PROGRAMS. THEY'RE
INELIGIBLE FOR MEDI BENEFITS.
AND YET AT THE SAME TIME, THOSE
FOLKS MAY BE WITHOUT FULL HEALTH
CARE COVERAGE THROUGH THEIR
EMPLOYER, OR THEY MAY BE
ENROLLED IN A HIGH DEDUCTIBLE
HEALTH PLAN WITH ANNUAL
DEDUCTIBLES AS HIGH AS $10,000
BY ALLOWING THESE PROGRAMS TO
COVER CALIFORNIANS UP TO THREE
100% OF THE FEDERAL POVERTY
LEVEL, OR $45,000 45,180 DOLLARS
WHEN ENSURE THOSE ADDITIONAL
CALIFORNIANS ARE ABLE TO GET
SCREENED AND, IF NECESSARY,
TREATED FOR BREAST OR CERVICAL
CANCER WITHOUT DELAY OR
FINANCIAL HARDSHIP. WHEN IT
COMES TO TREATING CANCER TO
MAXIMIZE A PATIENT'S CHANCES OF
SURVIVAL. EVERY SECOND COUNTS.
YET THERE ARE STILL MANY WOMEN
OUT THERE WHO WILL DELAY OR
COMPLETELY SKIP THESE CRITICAL
HEALTH SERVICES BECAUSE THEY
CAN'T AFFORD IT. THIS BILL WILL
REDUCE THE NUMBER OF
CALIFORNIANS WHO LOSE THEIR LIFE
, LIVELIHOOD OR LIFE SAVINGS TO
THIS TERRIBLE DISEASE. THANK YOU
AGAIN FOR THE OPPORTUNITY TO
COMMENT. WE RESPECTFULLY ASK FOR
YOUR I VOTE. THANK YOU, SIR. MY
NAME IS COURTNEY QUINN. I AM A
BREAST CANCER SURVIVOR AND THE
EXECUTIVE DIRECTOR FOR THE I BE
AWARE BREAST CANCER FOUNDATION.
WE'RE THE LARGEST NONPROFIT
ORGANIZATION DEDICATED SOLELY TO
BREAST CANCER IN THE GREATER
SACRAMENTO AREA. UM, AS OUR
REACH IS MORE THAN 2.5 MILLION
INDIVIDUALS IN THE IN THE MONTH
OF OCTOBER ALONE AS BREAST
CANCER AWARENESS MONTH WE ARE
OFTEN THE FIRST POINT OF CONTACT
WHEN SOMEBODY LOCALLY REALIZES
THAT THEY NEED A MAMMOGRAM, OR
THEY'VE DISCOVERED A LUMP SO AS
BREAST CANCER SURVIVOR I HAVE
THE HONOR OF TELLING YOU ABOUT
SOME STORIES OF SOME INDIVIDUALS
WHO HAVE BEEN SAVED FROM EVERY
WOMAN COUNTS. AND THE BCC Tð P,
UM, PROGRAM AND WHY THEY'RE NOW
CANCER SURVIVORS. UM AND SOME
ARE NOT CANCER SURVIVORS. THEY
JUST NOW KNOW THEY'RE COMPLETELY
HEALTHY. UM AND NÓ LONGER HAVE
THAT HEALTH CONCERN. SO UM,
FIRST STORY I'M GONNA SHARE IS
WE RECEIVED A PHONE CALL FROM AN
INDIVIDUAL WHO HAD NEVER HAD A
MAMMOGRAM. SHE DIDN'T HAVE
INSURANCE I SHARED ABOUT THE
EVERY WOMAN COUNTS PROGRAM, AND
I STATED THE INCOME. SHE LET OUT
A HUGE SIGH AND SAID, I MAKE
$100 MORE EVERY SINGLE MONTH, SO
I'M NOT ELIGIBLE. SO HOW DO I
GET A MAMMOGRAM? AND BECAUSE I
TOLD HER THAT BECAUSE SHE LIVED
IN THE GREATER SACRAMENTO AREA,
OUR ORGANIZATION WOULD PAY FOR
HER SCREENING. BUT THAT'S SADLY
NOT TRUE. FOR MANY OF THE
INDIVIDUALS THAT LIVE IN THE
AREAS YOU REPRESENT. UM SO I
CHECKED WITH THE LOCAL HOSPITAL
AND I CHECKED TO SEE HOW MUCH
THE CURRENT OUT OF POCKET COSTS
FOR AN INDIVIDUAL NEEDED
SCREENING. MAMMOGRAM IS IT'S
MORE THAN $750. SO IF YOU'RE AN
INDIVIDUAL MAKING MINIMUM WAGE,
UH, PRETA, YOU'D HAVE TO WEAR
WORK 47 HOURS TO PAY FOR THIS
EXAM. SO THAT'S PART OF THE
IMPORTANCE OF WHY WE WANT TO SEE
THIS PASSED. UM THE SECOND STORY
I'LL SHARE IS THERE WAS A SMALL
BUSINESS OWNER WHO HAD EMERGENCY
INSURANCE ONLY WHEN SHE FOUND
HER LUMP. UM, AS A BUSINESS AS
HER BUSINESS WAS STRUGGLING, SHE
WAS BARELY ABLE TO PAY THE
EMERGENCY INSURANCE PREMIUMS SO
SHE WAS ELIGIBLE FOR EVERY WOMAN
COUNTS. HER LUMP WAS INDEED
BREAST CANCER, AND SHE'S ALIVE
TODAY BECAUSE OF EVERY WOMAN
COUNTS IN THE BCC èC Tð P
PROGRAM. AND THEN THE OTHER ONE
I'M GONNA SHARE WITH YOU IS
IMAGINE BEING THIS INDIVIDUAL
WHO IS HAVING A BLOODY DISCHARGE
FROM HER NIPPLE. AND SHE DOESN'T
KNOW WHAT'S HAPPENING WITH HER
BODY, AND SHE'S FEARFUL IT'S
CANCER. AND SHE DOESN'T HAVE THE
FINANCIAL MEANS TO PAY THE
THOUSANDS OF DOLLARS FOR A
BREAST MRI YET FORTUNATELY, SHE
LIVES IN THE STATE OF CALIFORNIA
, WHERE THE STATE RECEIVES
FEDERAL FUNDS TO PAY FOR THIS
BREAST MRI AND THE TREATMENT
THAT SHE NEEDED. SO THE STATE OF
CALIFORNIA CAN TURN TO THE
FEDERAL GOVERNMENT FOR THESE
FUNDS, WHEREAS THESE INDIVIDUALS
OFTEN HAVE NÓ ONE TO TURN TO SO
ON BEHALF OF THE ORGANIZATIONS,
BREAST AND CERVICAL CANCER
SURVIVORS AND THOSE THAT WILL BE
SAVED BY THIS LEGISLATION. I
ASKED FOR AN A AN IVO. SORRY UM
ON, UM SENATE BILL 1213. THANK
YOU VERY, VERY MUCH OTHERS IN
SUPPORT OF THIS MEASURE, NAME,
AFFILIATION AND POSITION ON THE
BILL, PLEASE. MR CHAIR MEMBERS
OF THE COMMITTEE, BRANDON MARCH
WITH THE CALIFORNIA MEDICAL
ASSOCIATION IN SUPPORT. THANK
YOU, SIR. NEXT, PLEASE. MR CHAIR
MEMBERS CHAD MAYS, CAPITAL
ADVOCACY WITH THE CITY OF HOPE,
AND ALSO ACCOMPANY LIFE SCIENCES
AND SUPPORT. WELCOME BACK. THANK
YOU NEXT, PLEASE. KATIE VAN DYNE
WITH HEALTH ACCESS CALIFORNIA
AND SUPPORT. THANK YOU, PLEASE.
MÀ WAS WITH S¼ èC IU,
CALIFORNIA AND SUPPORT. THANK
YOU NEXT, PLEASE. MARK FAROOQ,
CALIFORNIA HOSPITAL ASSOCIATION
IN SUPPORT. THANK YOU, SIR. YES,
MA'AM. GOOD AFTERNOON, WHITNEY
FRANCIS WITH THE WESTERN CENTER
ON LAW, POVERTY IN SUPPORT.
MOLLY ROPES AND PLANNED
PARENTHOOD AFFILIATES OF
CALIFORNIA IN SPORT. RYAN
SPENCER WITH THE AMERICAN
COLLEGE OF Ó. BGY N S¼
DISTRICT NINE IN SUPPORT. THANK
YOU, MR SPENCER. NEXT, PLEASE.
CHRIS MYERS WITH THE CALIFORNIA
SCHOOL EMPLOYEES ASSOCIATION AND
SUPPORT JOSH GAR WITH THE COUNTY
HEALTH EXECUTIVES ASSOCIATION OF
CALIFORNIA IN SUPPORT. MR CHAIR
MEMBERS. MY NAME IS FRED. NOT
REPRESENTING STANFORD. HEALTH
CARE AND SUPPORT. THANK YOU,
SIR. I AM NEXT, PLEASE. CHERRY
ANDREW, TWO TIME BREAST CANCER
SURVIVOR AND VOLUNTEER WITH L,
BE AWARE BREAST CANCER
FOUNDATION AND SUPPORT. THANK
YOU FOR WHAT YOU ARE DOING. YES,
PLEASE. MELISSA MANZO WITH I'LL
BE AWARE BREAST CANCER
FOUNDATION AND SUPPORT. THANK
YOU. YES, SIR. DOUG CARSON,
FOUNDER OF THE AL BEWARE BREAST
CANCER FOUNDATION IN SUPPORT.
THANK YOU ANY OTHER WITNESSES IN
SUPPORT? NOW LET'S TURN TO
WITNESSES IN OPPOSITION. IF
THERE ARE ANY WITNESSES IN
OPPOSITION, PLEASE STEP FORWARD.
SEEING NONE. LET'S BRING THE
MATTER BACK TO THE DEUS AND MY
COLLEAGUES FOR QUESTIONS,
COMMENTS AND CONCERNS ANY
SENATOR RUBIO THANK YOU. WELL
FIRST, I WANNA THANK OTTO. I
KNOW THAT WE'VE HAD THE
OPPORTUNITY TO WORK A LOT ON
ISSUES OF CANCER, AND I MEAN, IT
ALMOST AFFECTS EVERYONE IN ONE
WAY OR THE OTHER. YOU KNOW, I
HAVE A LOT OF FAMILY MEMBERS,
AND THAT'S WHY I'VE WORKED ON
SEVERAL PIECES OF LEGISLATION.
AND I THINK THIS IS SO
IMPORTANT. THERE'S ALWAYS THIS
MISCONCEPTION OF YOU KNOW THAT
IT'S SO EASY TO GET COVERAGE. I
MEAN, I JUST REMEMBER GOING BACK
TO A HO CHURCH WHEN I WAS A
TEACHER, AND EVEN AS TEACHERS,
WE HAD COVERAGE AND WE HAD TO
STRUGGLE TO GIVE OUR SICK LEAVE
TO TEACHERS WHO HAD COUNSEL AND
IT JUST SEEMS LIKE A NEVER
ENDING STORY. SO THIS IS JUST
VERY BASIC. YOU KNOW, SOMETHING
THAT STRUCK ME IS WHEN YOU JUST
TALKED ABOUT THE 300% RIGHT,
WHICH IS $45,000. IT'S JUST IT
JUST SEEMS INCREDIBLE. I MEAN, I
CAN'T IMAGINE YOU KNOW WHO CAN
AFFORD ANYTHING. KIND OF
SALARIES, ESPECIALLY WITH THE
FAMILY. AND SO I KNOW OUR AUTHOR
IS NOT HERE AND THANK YOU FOR
PRESENTING THE BILL, BUT IT'S WE
JUST HAVE TO DO IT. IT IS
EXTREMELY IMPORTANT THAT WE
SUPPORT WOMEN AND I BECAUSE I'VE
WORKED ON ISSUES OF CANCER. UM,
YOU KNOW, YOU HEAR THE STORIES
WHERE WOMEN JUST KEEP WAITING
AND WAITING AND IT'S TOO LATE
AND THE IMPACT NOT NOT ONLY JUST
FOR THEM THEIR FAMILIES OR
COMMUNITIES AND EVERYONE THAT
GATHERS AND TRIES TO SUPPORT
THEM, SO JUST THANK YOU FOR
BRINGING THIS FORWARD AND I
STRONGLY SUPPORT IT. AND I WANT
TO MOVE A BILL. BUT THANK YOU.
FOR PRESENTING THE BILL AS WELL.
APPRECIATE YOU. ANY OTHER
QUESTIONS, COMMENTS OR CONCERNS
COLLEAGUES. NÓ MOMENT. WOULD YOU
LIKE TO CLOSE? I JUST WANT TO
THANK THE AUTHOR FOR BRINGING
THIS FORWARD BUT ALSO FOR GIVING
ME THE OPPORTUNITY TO PRESENT ON
IT. BECAUSE IN THE AUDIENCE, WE
HAVE, UH, STUDENTS HERE FROM
OXNARD COLLEGE THAT ARE
WITNESSING THEIR VERY FIRST BILL
BEING PRESENTED AND HERE IN THE
CAPITAL FOR THE FIRST TIME WITH
THAT, I RESPECTFULLY ASK FOR AN
I VOTE IN STUDENTS HAVE AN
EXCELLENT AUTHOR TO WATCH. SO
THERE YOU GO. THE BILL HAS BEEN
MOVED BY SENATOR RUBIO. THE
MOTION IS DUE PASS AND REREFER
TO THE COMMITTEE ON
APPROPRIATIONS. PLEASE CALL THE
ROLL. SENATOR ROSS ROSS, I WHEN
LASER GONZALEZ. GROWTH AYE,
GROVE A HURTADO LIONE. I LI I
MENJIVAR MENJIVAR I RUBIO RUBIO
I SMALLWOOD CUEVAS SMALLWOOD
QUAS I WIENER WIENER. I THE VOTE
COUNT IS 70. WE'LL HOLD THE OPEN
FOR ABSENT MEMBERS. THANK YOU.
NEXT ITEM. UM, SENATOR MENS.
LOOKS LIKE YOU'RE UP TO BAT WITH
TWO OR WHICH IS 11. ITEM NUMBER
EIGHT. YOU DIDN'T KNOW I WAS
GIVING YOU ANOTHER ONE. ITEM
NUMBER EIGHT SENATE BILL 959
TRANS INCLUSIVE CARE RESOURCES
AND SUPPORT SERVICES. PROCEED
WHEN READY THANK YOU, MR CHAIR
COMMITTEE MEMBERS. I AM THE ONLY
ONE THAT STANDS BETWEEN. US
GETTING OUT OF HERE. WELL,
ACTUALLY, SENATOR GONZALEZ, JUST
KIDDING THAT I WOULD TAKE MY
TIME. UH CHAIR, MR MR CHAIR.
WE'LL BE TAKING THE COMMITTEE
AMENDMENTS, AS NOTED ON PAGE
FIVE. AND SIX OF ANALYSIS. THANK
YOU SO MUCH TO THE COMMITTEE. UM
STAFF FOR THE BEAUTIFUL ANALYSIS
. S¼ B 959 ESTABLISHED A WEBSITE
RESOURCE FOR TRANSGENDER, GENDER
, DIVERSE AND INTERSEX PEOPLE
AND THEIR FAMILIES TO SUCCESS
ACCESS RELIABLE INFORMATION
ABOUT ACCESS TO TRANS INCLUSIVE
HEALTH CARE, EXISTING LEGAL
PROTECTIONS FOR PATIENTS AND
HEALTH CARE. AND OTHER AVAILABLE
SUPPORT SERVICES. WE HAVE ALL
WITNESSED THE SIGNIFICANT RISE
IN ANTI TRANS HATE ACROSS THE
COUNTRY, FUELED BY LEGISLATION,
RESTRICTIVE HEALTH POLICIES AND
MISINFORMATION. AND DESPITE OUR
STATE'S STRONG LAWS, PROTECT
PROTECTING TGI PEOPLE'S ACCESS
TO ESSENTIAL HEALTH CARE, Tð J
PEOPLE AND A YOUTH ESPECIALLY
CONTINUE TO HAVE SIGNIFICANT
DIFFICULTY FINDING PROVIDERS FOR
ROUTINE CARE. IDENTIFYING
HEALTHCARE PROVIDERS WHO OFFER
GENDER FROM CARE WITHIN THEIR
HEALTH PLAN CAN BE EVEN HARDER.
THIS ACCESS ISSUES EXACERBATE
EXISTING HEALTH DISPARITIES
AMONG Tð G I CALIFORNIANS WHO
ARE MORE LIKELY TO EXPERIENCE
CHRONIC HEALTH CONDITIONS AND
EXPERIENCE HIGHER RATES OF
HEALTH CONCERNS RELATED TO HÌ. I
VÆ SUBSTANCE USE MENTAL ILLNESS
AND SEXUAL PHYSICAL VIOLENCE.
THAT IS, WHY SHOULD S¼ P 959
PASS? CALIFORNIA HÌ HÌ S¼ WOULD
RECREATE THIS WEBSITE THAT WILL
SHOWCASE A COUPLE OF THINGS.
IT'S GOING TO SHOW EXISTING
LEGAL PROTECTIONS FOR PATIENTS
IN HEALTH CARE PROVIDERS. IT'S
GOING TO SHOW HOW TO ACCESS
HEALTH PLAN PROVIDER DIRECTORIES
FOR GENDER AFFIRMING CARE. IT
WOULD SHOWCASE PAYMENT SUPPORT
RESOURCES, INCLUDING COVERAGE,
OPTIONS AND FINANCIAL ASSISTANCE
PROGRAMS. SUPPORT SERVICES,
INCLUDING TRANSPORTATION AND
FAMILY ENGAGEMENT SUPPORT IN.
ADDITIONALLY IT WILL HAVE
REFERENCES AND LINKS TO OTHER
RELATED INFORMATION AND
RESOURCES. THERE ARE TOO MANY Tð
G I INDIVIDUALS WHO
UNFORTUNATELY, ARE LOSING THEIR
LIFE EITHER THROUGH SUICIDE,
BULLYING MENTAL HEALTH AND SO
FORTH. I DO NOT WANT TO HEAR
ANOTHER NAME LIKE WE'VE HEARD OF
NEXT BENEDICT, WHO DIED EARLIER
THIS YEAR. A 16 YEAR OLD
TRANSGENDER IN INDIGENOUS, NON
BINARY INDIVIDUAL ALEX TAYLOR
FRANCO, WHO DIED ALSO EARLIER
THIS YEAR AT 21 YEAR OLD TRANS
MAN WHO WAS SHOT AND KILLED IN
UTAH. OR ARE ARIANNA MITCHELL, A
70 YEAR OLD BLACK TRANS GIRL?
THERE ARE MANY BARRIERS TO EXIST
TO ENSURE THAT THAT THE Tð G I
POPULATION FEELS SECURE AND SAFE
, AND THIS IS ONE OF THE THINGS
A SMALL EFFORT THAT WE CAN MAKE
TO ENSURE THAT THEY CAN HAVE A
FOCAL POINT WHERE THEY CAN PULL
ALL THE AVAILABLE RESOURCES THAT
THE GREAT STATE OF CALIFORNIA
HAS TO THAT MR CHAIR I'D LIKE TO
THEN NOW TURN OVER TO TWO
WITNESSES WHO ARE HERE TO SPEAK
AND SUPPORT OF THIS BILL. MOLE
AND EVE, BENI VENICE. BUTCHER IT
PLEASE. PLEASE PROCEED. GOOD
AFTERNOON. MY NAME IS KATHY MULL
SHE HER MY PRONOUNS. I'M THE
FOUNDER AND EXECUTIVE DIRECTOR
OF TRANS FAMILY SUPPORT SERVICES
AND TRANS YOUTH LIBERATION. WE
HAVE SERVED OVER 5000 TRANS
INDIVIDUALS IN THEIR FAMILIES.
UM FIRST AND FOREMOST, THIS BILL
IS ESSENTIAL TO ACKNOWLEDGE THE
LONG STANDING DISCRIMINATION AND
PREJUDICE THAT THE Tð G
COMMUNITY HAS ENDURED WITH THE
HEALTHCARE SYSTEM. FAR TOO OFTEN
TGI INDIVIDUALS HAVE FACED
DISCRIMINATION. MEDICAL AND
MENTAL HEALTH PROFESSIONALS
LEADING TO DISPARITIES IN CARE
AND ADVERSE HEALTH OUTCOMES.
THIS DISCRIMINATION NOT ONLY
UNDERMINES THE TRUST BETWEEN
PATIENTS AND HEALTH CARE
PROVIDERS, BUT PERPETUATES A
CYCLE OF MARGINALIZATION AND
NEGLECT. MOREOVER ONE OF THE
OVERWHELMING CHALLENGES Tð G
INDIVIDUALS IS THE DIFFICULTY IN
FINDING HEALTHCARE PROVIDERS WHO
ARE ADEQUATELY TRAINED AND
KNOWLEDGEABLE ABOUT THEIR HEALTH
CARE NEEDS. MANY PROVIDERS LACK
THE NECESSARY EXPERTISE OR
CULTURAL COMPETENCE TO PROVIDE
AFFIRMING AND INCLUSIVE CARE FOR
TRANSGENDER PATIENTS. THIS LACK
OF TRAINING AND AWARENESS
CONTRIBUTES TO SIGNIFICANT
BARRIERS IN ACCESSING ESSENTIAL
HEALTH CARE SERVICES. IN
ADDITION TO THESE CHALLENGES WE
CAN'T IGNORE AS WE'VE ALREADY
HEARD THE ALARMING RISE OF ANTI
TRANS RHETORIC AND MOVEMENTS
THAT SEEK TO UNDERMINE THE
RIGHTS AND DIGNITY OF ALL Tð G
INDIVIDUALS ACROSS THE COUNTRY.
AND HERE IN CALIFORNIA, WE HAVE
WITNESSED A DISTURBING TREND OF
LEGISLATION TARGETING THESE
RIGHTS. THIS HOSTILE ENVIRONMENT
NOT ONLY EXACERBATES THE MENTAL
HEALTH CHALLENGES FACED BY THE
Tð COMMUNITY, BUT ALSO
REINFORCES THE STIGMA AND
DISCRIMINATION THEY EXPERIENCE
IN THE HEALTH CARE SETTING. S¼ B
959 SEEKS TO ADDRESS THESE
CHALLENGES. AND AS YOU HEARD
THIS WEBSITE WILL SERVE AS A
CENTRALIZED RESOURCE HUB WHERE
THE PUBLIC CAN ACCESS UP TO DATE
INFORMATION ABOUT TRANS
INCLUSIVE HEALTH CARE SERVICES
AND SUPPORT RESOURCES BY THE
STATE. THE IMPORTANCE OF THIS
WEBSITE CANNOT BE OVERSTATED. IT
WILL SERVE AS A LIFELINE TO Tð G
I INDIVIDUALS OFFERING CRITICAL
INFORMATION ON HEALTH CARE
PROVIDERS, SUPPORT GROUPS, LEGAL
RESOURCES AND MORE. THIS
INITIATIVE ALIGNS WITH
CALIFORNIA'S LONG STANDING
COMMITMENT TO EQUITY DIVERSITY
AND INCLUSION IN HEALTH CARE,
ENSURING THAT ALL RESIDENTS,
REGARDLESS OF GENDER IDENTITY,
HAVE EQUAL ACCESS TO QUALITY
CARE AND SUPPORT SERVICES ON
BEHALF OF THE Tð G èC COMMUNITY
THAT WE SERVE ACROSS CALIFORNIA.
I URGE YOU TO SUPPORT THIS
IMPORTANT LEGISLATION AND TAKE A
STAND FOR HEALTH AND WELL BEING
OF ALL CALIFORNIANS. THANK YOU
NEXT, PLEASE. GOOD AFTERNOON
CHAIR. ROTH AND MEMBERS OF THE
COMMITTEE. MY NAME IS EVE
BANNERS WITH THE SACRAMENTO L GB
Tð COMMUNITY CENTER, HAPPY TO BE
HERE TODAY TO SPEAK IN SUPPORT
OF SENATE BILL 959. AS WE HAVE
HEARD, WE HAVE SEEN A STARTLING
RISE IN ANTI L GB Tð Q PLUS
LEGISLATION ACROSS THE COUNTRY.
WITH A SIGNIFICANT PORTION
TARGETING TRANSGENDER, NON
CONFORMING AND INTERSEX FOLKS.
IN ADDITION TO THIS HOSTILE
POLICY, LANDSCAPE, Tð G I FOLKS
EXPERIENCE HEIGHTENED RATES OF
CHRONIC HEALTH ISSUES, SUBSTANCE
USE MENTAL ILLNESS, SEXUAL
VIOLENCE, UNEMPLOYMENT, HOUSING
DISCRIMINATION, AND THE LIST
GOES ON. THIS GREATER ILL HEALTH
IS UNFORTUNATELY PAIRED WITH
SIGNIFICANT BARRIERS TO QUALITY
AFFIRMING CARE. MANY OF THE
COMMUNITY MEMBERS WHO COME TO
THE SACRAMENTO L GB Tð COMMUNITY
CENTER DO SO BECAUSE THEY HAVE
STRUGGLED TO FIND OTHER
AFFIRMING RESOURCES. RESOURCES
THAT THEY NEED TO LIVE HAPPY AND
HEALTHY LIVES. ADDRESS THIS
ISSUE. THE CENTER OFFERS MANY
RESOURCES INCLUDING FREE S¼ Tð.
I HÌ I VÆ SCREENINGS. MENTAL
HEALTH SERVICES, HARM REDUCTION,
SUPPORT, RESPITE EMPLOYMENT
RESOURCES AND SAFE COMMUNITY
SPACES. THIS SUPPORT IS
ABSOLUTELY ESSENTIAL TO Tð G. I
FOLKS BUT UNFORTUNATELY IT IS
INACCESSIBLE TO MANY Tð G. I
CALIFORNIANS TO ADDRESS THIS
LACK OF ACCESSIBLE RESOURCES. S¼
B 8 959 WILL CREATE A WEBSITE
DETAILING ACCURATE INFORMATION
THAT WILL CONNECT PEOPLE AND
THEIR FAMILIES TO LIFE SAVING
CARE. SACRAMENTO L GB Tð
COMMUNITY CENTER BELIEVES THAT
SENATE BILL 959 IS MUCH NEEDED
AND WE URGE YOU TO SUPPORT THIS
POLICY. UM I RESPECTFULLY URGE
YOU TO VOTE YES. ON SENATE BILL
959. THANK THANK YOU. THANKS FOR
JOINING US ANY OTHER WITNESSES
IN SUPPORT OF THIS MEASURE? NAME
AFFILIATION AND POSITION ON THE
MEASURE ONLY PLEASE. YES MA'AM.
GOOD AFTERNOON SYMPHONY BARBIE
ON BEHALF OF PLANNED PARENTHOOD
AFFILIATES IN CALIFORNIA. PROUD
COSPONSOR AND SUPPORT. THANK
YOU. THANK YOU NEXT, PLEASE. Kò
P FOR QUALITY CALIFORNIA PROUD,
COSPONSOR STRONG SUPPORT. THANK
YOU NEXT. YES, MA'AM. NICOLE
MORALES ON BEHALF OF CHILDREN
NOW AND SUPPORT. THANK YOU NEXT,
PLEASE. BRANDON MARCH WITH THE
CALIFORNIA MEDICAL ASSOCIATION
IN SUPPORT. THANK YOU. WELCOME
BACK. YES, MA'AM. AFTERNOON
DARCY TOTTEN, WITH THE
CALIFORNIA COMMISSION ON THE
STATUS OF WOMEN AND GIRLS AND
STRONG SUPPORT. THANK YOU ANY
OTHER WITNESSES IN SUPPORT IN
THE HEARING ROOM? ABOUT
WITNESSES IN OPPOSITION, LEAD OR
OTHERWISE ANY WITNESSES IN
OPPOSITION. SEEING NONE WILL
BRING THE MATTER BACK TO THE
DEUS AND MY COLLEAGUES FOR ANY
QUESTIONS, COMMENTS AND CONCERNS
ANY QUESTIONS, COMMENTS OR
CONCERNS? THANK THE AUTHOR FOR
BRINGING THE BILL AND I'M HAPPY
TO MOVE IT. THANK YOU, SENATOR
SMALLWOOD CUEVAS. SOMETIMES. NÓ
OTHER QUESTIONS. SENATOR. WOULD
YOU LIKE TO CLOSE? NICE JOB.
WERE THERE. OTHER QUESTIONS? I'M
SORRY. YES, I GUESS. THANK YOU.
THANK YOU. SO TRYING TO CREATE
BALANCE HERE, UM DO I THINK THAT
, UM, OBVIOUSLY, EVERYONE,
INCLUDING MY PEOPLE IN
RIDGECREST DESERVE ADEQUATE
HEALTH CARE AND ANY TGI KIDS
WHEREVER THEY'RE AT, RIGHT. I
DON'T CARE WHERE THEY'RE AT IN
CALIFORNIA. MY DISTRICT, YOUR
DISTRICT. I GUESS THE ISSUE THAT
I HAVE. I'M GOING TO BORROW
THIS. MY COLLEAGUES. OH, IT
COMES OFF IN BORROW MY
COLLEAGUES. IPAD HERE. UM I
UNDERSTOOD. IT'S JUST A WEBSITE
A WEBSITE. THAT'S WHAT THE BILL
DOES. OK, BUT I GUESS THE ISSUE
OR THE SENTENCE. THAT BRINGS US
TO A PLACE WHERE IT'S UM THE
QUESTION. I GUESS THAT WE'RE
ASKING. OR I AM ASKING NOT
ASKING ON BEHALF OF MY
COLLEAGUE. UM UH, IT SAYS HERE,
IT SAYS IT IS GOING TO PROVIDE
TGI INDIVIDUALS AND FAMILIES
ACCESSING TRANS HEALTHCARE. THIS
IS RIGHT OFF YOUR BILL SUPPORT
SERVICES IN STATE, INCLUDING BUT
NOT LIMITED GENERAL DESCRIPTION
OF TRANS INCLUSIVE HEALTH CARE,
WHICH IS FINE INFORMATION ON HOW
TO ACCESS DIRECTORIES. BUT IT
SAYS A PROVIDERS FOR PROVIDING
GENDER FOR MAIN CARE SERVICES IS
THAT TOO MINORS UM, SO IS THERE
PUBERTY BLOCKERS? IS THERE
SURGERY? IS THERE ALL THOSE
THINGS INCLUDED IN THAT THAT
THEY WOULD BE REFERRED TO AS A
MINOR? THAT'S WE'RE NOT BEING
SPECIFIC ON THE EXACT UM,
PROCEDURE. IT'S MORE ON WHO'S
ACCEPTING AND WHO CAN GO WHERE
THE INDIVIDUAL CAN GO SEEK.
GENDER AFFIRMING CARE, SO
CORRECT ME IF I'M WRONG? IT'S
NOT GONNA THE WEBSITE IS NOT
GONNA HAVE THIS IS WHERE YOU GO
FOR HORMONE TREATMENT. THIS IS
WHERE YOU GO FOR THIS. THIS IS
WHERE WE GO FOR THAT. IT'S JUST
OVER ARCHING. WHAT DO YOU MEAN
BY OVER, LIKE, JUST GENDER
AFFIRMING CARE AS A WHOLE, LIKE
THESE ARE THE PROVIDERS THAT
ACCEPT, UM, YOU AS AN INDIVIDUAL
. THESE ARE THE PROVIDERS THAT,
UM YOU CAN GO IN AND HAVE A
CONVERSATION RELATED TO WHAT YOU
LOOK AT AS GENDER AFFIRMING CARE
. IS IT FOR MINORS OR NOT FOR
MINORS FAMILY AND THIS IS THE
WEBSITE IS NOT GONNA ASK. ARE
YOU 18 YEARS OR OR OLDER TO
ACCESS THIS WEBSITE? THIS
WEBSITE WOULD BE JUST LIKE THE,
UH, ABORTION DOT CæA DOT GOV
WEBSITE THAT WE HAVE RIGHT NOW.
THAT IS A WEBSITE ACCESSIBLE BY
ANYONE? UM SO WE DO NOT HAVE ANY
PARENTAL CONTROLS IN TERMS OF
AGES. UM ANYONE WOULD BE ABLE TO
GO THERE. UM JUST ALSO REMINDING
YOU, UM, NOT REMINDING JUST ALSO
NOTING THAT, UM, IN CALIFORNIA,
WE DO HAVE CERTAIN LAWS ALREADY
IN PLACE. THIS ISN'T LOOKING TO
CHANGE ANY SINGLE LAW RELATED AT
WHAT AGE AN INDIVIDUAL CAN SEEK
XY OR Z, UM, CARE AND THOSE LAWS
ARE NOT BEING TOUCHED OR
ADDRESSED IN THIS BILL. IT'S
JUST A WEBSITE JUST A WEBSITE.
OK AND THERE IS THERE'S NÓ
DIRECTION TO SPECIFIC PROVIDERS
OR THERE IS A DIRECTION SPECIFIC
WRITERS. THERE WILL BE A
DIRECTORY. A DIRECTORY. YES OK,
BUT WE, IF FROM NOT MISTAKEN
WILL BE PROTECTING THE NAMES OF
PROVIDERS. THERE'S NÓ ACTUAL
NAMES OF PROVIDERS ON THIS
WEBSITE. YES SO I KNOW THERE'S A
DIFFERENCE OF OPINION BETWEEN
ALL OF US. YOU KNOW, PEOPLE OF
ALL OF IT. WELL I MEAN, JUST
THERE'S A DIFFERENCE OF OPINION
WITH WITH LEGISLATORS, SO I
GUESS MY THING IS IF I HAD A
CHILD THAT WAS GOING THROUGH
GENDER, IDENTITY OR GENDER CARE
ISSUES AND MY CHOICE FOR MY 14,
YEAR OLD OR 15 YEAR OLD WHATEVER
THE AGE UNDER AGE 18 AND I WAS,
UM AND ACCEPTING AND LOVING AND
YOU ALWAYS SUPPORT YOUR
CHILDREN. BUT I WOULDN'T I AS A
AS A PARENT, I COULD SEE THAT I
WOULD NOT WANT MY CHILD TO HAVE
SURGERY, THINGS THAT WOULD THAT
COULD POSSIBLY HARM THEM
PHYSICALLY IN THE FUTURE. SO I
GUESS MY THING IS, IS THAT IS
THAT GOING TO DO THAT? IS THIS
WEBSITE GOING TO DIRECT A CHILD
WITHOUT PARENTAL CONSENT TO GO
AND HAVE A SURGERY DONE, AND
THEN THE CHILD'S IN THE HOSPITAL
AND YOU FIND OUT ABOUT IT THAT
WAY. IS THAT AGAIN AND PLEASE
CORRECT ME. IF I'M WRONG ON
THIS. I TRIED AS MUCH AS I WOULD
TURN TO MY WITNESS. I WANNA TRY
AS MUCH. MY, UH, BE ABLE TO
RESPOND TO THAT QUESTION MYSELF.
UM CURRENTLY RIGHT NOW, UM THOSE
WHO SEEK TO BE PLACED ON XYZ
UNDER THE AGE OF 18 ARE DOING
THAT WITH PARENTAL THERE IS
THERE IS NÓ DOCTOR IN THE STATE
OF CALIFORNIA. THERE IS NÓ
DOCTOR ANYWHERE IN OUR COUNTRY
THAT WILL BE PROVIDING ANY KIND
OF GENDER AFFIRMING CARE TO A
MINOR WITHOUT PARENTAL CONSENT.
THAT'S WHAT I NEEDED TO KNOW. IT
DOES NOT HAPPEN. OK, THANK YOU,
MA'AM. SORRY. THANK YOU FOR THE
QUESTION ANY OTHER QUESTIONS?
HAS BEEN MOVED BY SENATOR
SMALLWOOD CUEVAS. THE MOTION IS
TO PASS AS AMENDED AND REREFER
TO THE COMMITTEE ON
APPROPRIATIONS. PLEASE CALL THE
ROLL. SENATOR ROTH ROTH, I WHEN
BLAZER. GONZALEZ GONZALEZ, I
GROVE HURTADO. THE MO. LIONE I
MENJIVAR AY MANJAR AY, RUBIO
RUBIO I SMALLWOOD CUEVAS I
SMALLWOOD QUAS I WIENER. WEINER.
I ABSTENTION TO NÓ, PLEASE.
EXCUSE ME. PARDON ME. CAN YOU
CHANGE MY YES. WHEN NÓ. LET ME
JUST CLARIFY SHE DIDN'T VOTE,
DID SHE? I HAVE NOT NÓ. SHE
DIDN'T VOTE SO IT WASN'T A
CHANGE. IT WAS A NÓ VOTE, SO THE
VOTE IS SEVEN. EYES AND ONE KNOW
WILL HOLD THE ROW OPEN FOR
ABSENT MEMBERS. THANK YOU. THANK
YOU, SENATOR. SENATOR GONZALEZ.
ITEM NUMBER NINE S¼ B 1131. IF
YOU ARE READY, MEDI PROVIDERS,
PLEASE PROCEED. THANK YOU. GOOD
AFTERNOON, MR CHAIR AND MEMBERS.
I WANT TO BEGIN BY ACCEPTING THE
COMMITTEE AMENDMENTS DESCRIBED
ON PAGES FOUR THROUGH FIVE OF
THE ANALYSIS AND WOULD LIKE TO
THANK THE COMMITTEE FOR THEIR
HELP. UM I'M HERE TO PRESENT S¼
B 1131, WHICH WILL ENSURE ACCESS
TO ESSENTIAL FAMILY PLANNING
SERVICES FOR LOW INCOME
CALIFORNIANS ACROSS THE STATE.
SINCE 1997, CALIFORNIA HAS BEEN
PROVIDING FAMILY PLANNING
SERVICES, SUCH AS CONTRACEPTION,
PREGNANCY TESTING AND HÌ. I VÆ
TESTING TO LOW INCOME
INDIVIDUALS AT NÓ COST THROUGH
FAMILY PLANNING, ACCESS CARE AND
TREATMENT PROGRAM, ALSO KNOWN AS
THE FAMILY PACT. IN ORDER FOR A
HEALTH CLINIC TO PROVIDE THESE
SERVICES IN THEIR COMMUNITY. THE
CLINIC MUST BE CERTIFIED
CERTIFIED. EXCUSE ME BY A
DESIGNATED HEALTH CARE
PROFESSIONAL. DESPITE A HEALTH
CARE WORKFORCE SHORTAGE, THE
STATE CONTINUES TO LIMIT WHO CAN
CERTIFY CLINICS FOR FAMILY
PACKED SERVICES TO ONLY
PHYSICIANS, CERTIFIED NURSE
MIDWIVES OR CERTIFIED NURSE
PRACTITIONERS. S¼ P 1131 WILL
ADDRESS THIS SHORTCOMING IN THE
LAW BY EXPANDING WHO CAN CERTIFY
A CLINIC TO INCLUDE PHYSICIAN
ASSISTANTS REQUIRING AT LEAST
SIX MONTHS FOR A PROVIDER TO
COMPLETE ORIENTATION AFTER
ENROLLMENT AND REQUIRING DHCS TO
OFFER TRAININGS VIRTUALLY AND ON
A MONTHLY BASIS. THESE CHANGES
ARE CRITICAL, OF COURSE TO
ENSURING THAT EVERY CALIFORNIAN
ACROSS THE STATE HAS ACCESS
TESTIFYING IN SUPPORT OF THE
MEASURE. TODAY I HAVE KELBY LIND
WITH PLANNED PARENTHOOD
AFFILIATES OF CALIFORNIA AND
JEREMY MILES, A PHYSICIAN
ASSISTANT AT WELLS SPACE HEALTH.
I RESPECTFULLY ASK FOR MY VOTE.
THANK YOU, SENATOR. PLEASE
PROCEED. MR CHAIRMAN, MEMBERS.
GOOD AFTERNOON. MY NAME IS
JEREMY MEES, PRESIDENT ELECT OF
THE CALIFORNIA ACADEMY OF
PHYSICIAN ASSOCIATES. AFTER
TRAINING AT UC DAVIS' FAMILY
NURSE PRACTITIONER AND P A
PROGRAM I'VE BEEN PRACTICING
ADULT PRIMARY CARE LOCALLY FOR
THE LAST 12 YEARS. I'M CURRENTLY
THE ASSOCIATE MEDICAL DIRECTOR
OF PRIMARY CARE AT WELLS SPACE
HEALTH, FEDERALLY QUALIFIED
NETWORK OF HEALTH CENTERS,
PROVIDING A VARIETY OF SERVICES
TO UNDERSERVED POPULATIONS. I'M
HERE TODAY IN SUPPORT OF SB 1131
, WHICH SEEKS TO IMPROVE THE
FAMILY PLANNING, ACCESS CARE AND
TREATMENT PROGRAM, ALSO KNOWN AS
FAMILY PACT. FAMILY PACT IS A
LIFELINE TO ESSENTIAL SERVICES
FOR OVER 1 MILLION CALIFORNIANS.
MANY OF THE PATIENTS I SERVE,
UTILIZE FAMILY PACT AND ARE
UNHOUSED UNINSURED, IMPOVERISHED
, UNDOCUMENTED AND
DISENFRANCHISED. WHILE FREE
ACCESS TO F Dð. A APPROVED
CONTRACEPTION IS THE BREAD AND
BUTTER OF THE FAMILY PACK
PROGRAM. THE PROGRAM ALSO
PROVIDES OTHER CRUCIAL SERVICES
SUCH AS SCREENING FOR S¼ Tð. I
S¼ MEN, WOMEN AND MINORS AND
CERVICAL CANCER SCREENING FOR
FEMALES. INDICATED FOLLOW-UP
TESTING AND TREATMENT IS
COVERED. SHOULD ANY OF THESE
SCREENINGS COME BACK? POSITIVE
THESE SERVICES CATCH EARLY,
ASYMPTOMATIC ILLNESS LIMIT
SPREAD AND VULNERABLE
POPULATIONS. AND IT'S NOT AN
OVERSTATEMENT TO SAY THAT THEY
SAVE LIVES. IT'S ALSO IMPORTANT
TO NOTE THAT MANY OF THE CLINICS
PROVIDING FAMILY BACK SERVICES
ARE FEDERALLY QUALIFIED,
REQUIRING THAT THEY REFUSE
SERVICE TO NÓ ONE. WHEN A
PATIENT HAS NÓ INSURANCE,
FEDERALLY QUALIFIED CLINICS
PROVIDE SERVICES ON A SLIDING
FEE SCALE. THIS ENTAILS A
NOMINAL, PERHAPS $10 FEE. FOR
THOSE ABLE TO PAY IT WHILE THE
SERVICES ARE OFFERED FOR FREE
FOR ANYONE WITHOUT A SOURCE OF
INCOME. FAMILY PACK PROGRAM
ALLOWS FQ HÌ èC S¼ TO SERVE
MORE PATIENTS WHILE SUSTAINING
OUR CLINICS. MR. CHAIR MEMBERS.
THIS IS A GOOD PROGRAM. BUT DUE
TO A HANDFUL OF THE PROGRAM'S
PRACTICES, INCLUDING CURRENT
POLICY, NOT PERMITTING PAS LIKE
ME TO CERTIFY THE CLINIC. MANY
HEALTH CENTERS ACROSS THE STATE
THAT TREAT THESE UNDERSERVED
POPULATIONS CAN'T DO SO UNDER
THE FAMILY PACK PROGRAM AS THEY
ARE UNABLE TO BECOME CERTIFIED.
THIS MEANS THAT PATIENTS EITHER
HAVE TO FOREGO NEEDED CARE OR
PAY OUT OF POCKET. BY PASSING
THIS LEGISLATION LIVES OF
CALIFORNIANS WILL BE SAVED,
NEEDLESS SUFFERING AVOIDED AND
THE MOTIVATING AIM OF ENACTING
THE FAMILY PACT PROGRAM
FULFILLED. NEXT, PLEASE. GOOD
AFTERNOON CHAIR ROTH AND MEMBERS
OF THE COMMITTEE. MY NAME IS
KELBY LAND, AND I'M, THE VICE
PRESIDENT OF REGULATORY AFFAIRS
FOR PLANNED PARENTHOOD
AFFILIATES OF CALIFORNIA,
REPRESENTING SEVEN AFFILIATES
THAT PROVIDE COMPREHENSIVE
SEXUAL AND REPRODUCTIVE HEALTH
CARE ON BEHALF OF THE FAMILY
PACT PROGRAM THROUGHOUT
CALIFORNIA. WE ARE PROUD
COSPONSOR OF SENATE BILL 1131,
AND I WANT TO BEGIN BY THANKING
THE AUTHOR FOR HER DEDICATION
AND LEADERSHIP ON FAMILY
PLANNING SERVICES. PLANNED
PARENTHOOD IS THE STATE'S
LARGEST FAMILY PACK PROVIDER
WITH HALF A MILLION ANNUAL
VISITS THROUGH THE PROGRAM.
FAMILY PACK PROVIDES CRITICAL
COVERAGE FOR CALIFORNIANS WHO
NEED AFFORDABLE FAMILY PLANNING
SERVICES, PARTICULARLY PATIENTS
WHO HAVE CONFIDENTIALITY
CONCERNS OR WHOSE FAMILY INCOME
EXCEEDS THE MEDICAL LIMIT.
PLANNED PARENTHOOD SUPPORTS THE
INTENDED PURPOSE OF THE FAMILY
PACK SITE CERTIFIER PROGRAM TO
ENSURE THAT ALL FAMILY PACK
PROVIDERS ARE UP TO DATE ON THE
POLICIES AND BENEFITS OF THE
FAMILY PACK PROGRAM. HOWEVER
THERE IS A NEED FOR
CLARIFICATION AND UPDATES THAT
THE PROGRAM REFLECTS HOW THE
FAMILY PACK PROVIDERS PROVIDE
CARE AND FACILITIES, THEIR
ABILITY TO PROVIDE THE NECESSARY
OVERSIGHT AS REQUIRED. WE SHARE
THE STATE'S GOAL OF IMPROVING
AND MAINTAINING PROGRAM
INTEGRITY, ENSURING CLINICAL
QUALITY AND COMPLIANCE WITH THE
FAMILY PACK STANDARDS AND
MAINTAINING ACCESS TO TIME
SENSITIVE FAMILY PLANNING
SERVICES FOR PATIENTS.
GRANDPARENT HAD PRIORITIZES
PROVIDING THE HIGHEST QUALITY OF
CARE TO ALL PATIENTS, INCLUDING
FAMILY PACK PATIENTS. THIS BILL
WILL CLARIFY AND STREAMLINE THE
FAMILY PACK PROGRAM, IMPROVE
REQUIREMENTS TO SUSTAIN AND
EXPAND THE PROGRAM FOR FUTURE
YEARS AND REDUCE HEALTH CARE
DISPARITIES FOR FAMILY PACKED
PATIENTS ACROSS THE STATE.
FAMILY PACK PROGRAM IS CRITICAL
TO PLANNED PARENTHOOD'S PATIENT
POPULATION. AND THAT IS WHY
PLANNED PARENTHOOD IS A PROUD
SPONSOR OF A B 1131. AND I
RESPECTFULLY URGE YOUR I VOTE.
THANK YOU. THANK YOU. ARE THERE
ANY OTHER WITNESSES IN SUPPORT
IN THE HEARING ROOM WITNESSES IN
SUPPORT? NAME, AFFILIATION AND
POSITION ON THE MEASURE, PLEASE.
THANK YOU, MISTER. CHAIR
MEMBERS. I'M ERIN EVANS ON
BEHALF OF REPRODUCTIVE FREEDOM
FOR ALL FORMERLY N PRO CHOICE,
CALIFORNIA IN SUPPORT. THANK
YOU. THANK YOU. THANKS FOR
JOINING US. YES PLEASE, BOSS
WITH THE CENTRAL ACCESS HEALTH
AND STRONG SUPPORT. THANK YOU.
ANY OTHER SUPPORT WITNESSES
SEEING NONE LETS WITNESSES IN
OPPOSITION SEEING NONE. LET'S
BRING THE MATTER BACK TO THE
D¯ÚI DEUS AND MY COLLEAGUES FOR
QUESTIONS, COMMENTS AND
CONCERNS. YOU SEE NÓ HANDS
SENATOR MENUS MOVED THE BILL.
THE MOTION IS DO PASS AS AMENDED
AND REREFER THE COMMITTEE ON
APPROPRIATIONS, BUT SENATOR
GONZALEZ, YOU MAY CLOSE. I JUST
WANT TO THANK OUR WITNESSES, MR
MEESE AND MR LIN FOR THEIR
TESTIMONY, AND I RESPECTFULLY
ASK FOR NE OK, PLEASE CALL THE
ROLL. SENATOR ROSS ROTH. I WHEN
BLAZER. GONZALEZ GONZALEZ. I
GROVE NOT VERY HURTADO HURTADO.
I LIONE THE MO. I MENS. MEN OF
OUR I, RUBIO RUBIO, I SMALLWOOD
CUEVAS. I SMALLWOOD QUAS I
WIENER. WE OR I BILL HAS EIGHT
VOTES HOLD THE ROLL OPEN FOR S¼
MEMBERS.
OH, WE'RE GOING TO OPEN THE ROLE
ON ITEMS THAT WE'VE HEARD TODAY,
STARTING WITH ITEM NUMBER ONE SO
THAT COLLEAGUES ARE NOT HERE.
PLEASE COME DOWN TO THE HEARING
ROOM START WITH ITEM NUMBER ONE
SENATE BILL 909, SENATOR UMBERG.
THE ROLE IS OF 50 CHAIR VOTING.
I PLEASE CALL THE ROLL. SENATOR
GLASER. GONZALEZ GONZALEZ. I
GROVE I GROVE I HURTADO HURTADO.
I RUBIO RUBIO I SMALLWOOD CUEVAS
SMALLWOOD QUAS. I THE VOTE IS 10
0 THAT ITEM IS OUT. ITEM NUMBER
TWO SENATE BILL 1119 CURRENT
VOTE IS 60 CHAIR VOTING. I
PLEASE CALL THE ROLL. SENATOR
GLASER. GROWTH I HURTADO
HURTADO, I RUBIO HØI RUBIO I
SMALLWOOD CUEVAS. THAT VOTE IS
90 THAT MATTER IS OUT. ITEM
NUMBER THREE SENATE BILL 1132
CURRENT VOTE IS 4 TO 1 CHAIR
VOTING. I PLEASE CALL THE ROLL.
SENATOR GLASER. GONZALEZ.
GONZALEZ I GROVE, NOT FOOD.
HURTADO. HURTADO I SMALLWOOD
QUAS. SWALLOWED CUEVAS. I
WIENER. WINNER. AYE. CURRENT
VOTE IS 8 TO 1 THAT MATTER IS
OUT. NEXT ITEM ITEM NUMBER 4
1212 13. CURRENT VOTE IS 7 TO 0
CHAIR VOTING. I PLEASE CALL THE
ROLL. SENATOR WYN I WHEN I
GLASER. GONZALEZ GONZALEZ, I,
HURTADO HURTADO. I CURRENT VOTE
IS 10 0 THAT MATTER IS OUT. THE
CONSENT CALENDAR ITEMS NUMBER
FIVE AND SIX ITEM FIVE. SENATE
BILL 1428 AND ITEM NUMBER SIX
SENATE BILL 1258 CURRENT VOTE IS
5 TO 0, PLEASE CALL THE ROLL.
SENATOR GLASER. GONZALEZ
GONZALEZ, I GROVE WHAT 1300
GROVE EYE HURTADO. HURTADO I
SMALLWOOD QUAS SMALLWOOD QUAS I
WIENER. WEENER. I VOTE. 10 0
THAT MATTER, THOSE MATTERS ARE
OUT. ITEM NUMBER SEVEN SENATE
BILL 1300 BY SENATOR CORTESE.
CURRENT VOTE IS A 5 TO 1 SHARE
VOTING. I PLEASE CALL THE ROLL.
SENATOR WEN NÓ WHEN NÓ. GLAZER.
GONZALEZ GONZALEZ. I HURTADO.
HURTADO. I RUBIO. HØI RUBIO. I
THINK. SORRY ABOUT THIS, TOO. I
CURRENT VOTE IS 8 TO 8 TO 2.
THAT MATTER IS OUT. ITEM NUMBER
EIGHT. SENATE BILL 959 CURRENT
VOTE IS 7 TO 1 SHARE VOTING. I
PLEASE CALL THE ROLL. SENATOR
GLASER. GROWTH. HURTADO.
HURTADO. I. Kò CURRENT VOTE IS 8
TO 1 THAT MATTER IS OUT. AND OUR
FINAL MATTER. ITEM NUMBER NINE
SENATE BILL 1131 CURRENT VOTE IS
8 TO 0. SURE VOTING AYE. PLEASE
CALL THE ROLL. SENATOR WEN
GLASER. GROWTH. VOTE IS 8 TO 0
THAT MATTER IS OUT. AND THAT
CONCLUDES THE HEARING OF THE
SENATE COMMITTEE ON HEALTH FOR
APRIL THREE. 224. WE ARE
ADJOURNED.