SENATE COMMITTEE ON HEALTH. THIS
IS YOUR TEN SECOND WARNING.
SENATE COMMITTEE ON HEALTH WILL
COME TO ORDER. GOOD AFTERNOON,
EVERYONE. THANK YOU FOR BEING
HERE. WE CONTINUE TO WELCOME ALL
OF YOU AND MEMBERS OF THE PUBLIC
HERE IN PERSON. WE'RE GOING TO
ALLOW SIX MINUTES FOR TESTIMONY
PER SIDE. FOR THOSE OF YOU WHO
WISH TO SPEAK, FEEL FREE NOT TO
USE ALL THAT TIME, BUT WE'LL
CERTAINLY ALLOW EVERY BIT OF IT.
IF YOU HAVE SOMETHING TO SAY AND
WANT TO SAY IT. WE HAVE 18 BILLS
ON TODAY'S CALENDAR, PLUS ONE
SPECIAL ORDER ITEM, EIGHT OF THE
BILLS ARE BEING ARE ON OUR
PROPOSED CONSENT CALENDAR. ITEM
NUMBER TWO, SENATE BILL 910 WITH
AMENDMENTS. ITEM NUMBER FOUR,
SENATE BILL 963 WITH AMENDMENTS.
ITEM NUMBER SIX, SENATE BILL
1082, AMENDMENTS WILL BE TAKEN
IN HUMAN SERVICES. ITEM NUMBER
11. SENATE BILL 1252, ITEM
NUMBER 12. SENATE BILL 1257,
WITH AMENDMENTS. ITEM NUMBER 13.
SENATE BILL 1319. ITEM NUMBER
14. SENATE BILL 1320, WITH
AMENDMENTS AND ITEM NUMBER 16.
SENATE BILL 1442. WITH THAT, WE
HAVE AN ITEM ON SPECIAL ORDER.
IT'S ITEM NUMBER ONE, SENATE
BILL 12 NINE ZERO BY ME, BY ROTH
. HEALTH CARE COVERAGE,
ESSENTIAL HEALTH BENEFIT. I'M
GOING TO TURN THE GAVEL OVER TO
MY VICE CHAIR, SENATOR NGUYEN.
THANK YOU, MR. CHAIR. AT THIS
TIME, WE WILL, START WITH OUR
SPECIAL SUBCOMMITTEE. SINCE WE
DON'T HAVE A QUORUM AND WE, I'M
ASKING FOR SENATOR ROTH TO
PLEASE PRESENT SB 1290. THANK
YOU, MADAM CHAIR. THIS BILL
SUNSETS CALIFORNIA'S CURRENT
ESSENTIAL HEALTH BENEFITS
BENCHMARK PLAN. THE BENCHMARK
PLAN IS THE PLAN THAT IS THE
MARKER FOR THE HEALTH PLAN AND
INSURANCE POLICIES THAT ARE SOLD
IN CALIFORNIA'S INDIVIDUAL AND
SMALL GROUP HEALTH INSURANCE
MARKETS, ACCORDING TO THE
AFFORDABLE CARE ACT, WHICH
INCLUDES THE PLANS AVAILABLE
THROUGH COVERED CALIFORNIA
FEDERAL RULES ALLOW STATES TO
UPDATE THEIR BENCHMARK PLAN
AFTER UNDERGOING A STAKEHOLDER
PROCESS. FEDERAL RULES ALSO
ESTABLISH A CEILING AND FLOOR
FOR THE CHANGES THAT CAN OCCUR.
THIS BILL IS MEANT TO KICK START
THE STAKEHOLDER PROCESS. MÁS. MY
HOPE IS THAT AT THE END OF THE
PROCESS, WE WILL BE ABLE TO
AMEND THIS BILL TO INCORPORATE
THE CHANGES THAT COME OUT OF
THAT PROCESS IN TERMS OF
EXPANDING OR CHANGING ESSENTIAL
HEALTH BENEFITS IN THE BENCHMARK
PLAN, I HAVE WITNESSES WHO WILL
BE PROVIDING TECHNICAL
ASSISTANCE AND WHO CAN EXPLAIN
MORE ABOUT THIS PROCESS. OUR
FIRST WITNESS IS KAREN CORBETT.
CALIFORNIA HEALTH BENEFITS
REVIEW PROGRAM, AND OUR SECOND
WITNESS IS MARY WATANABE,
DIRECTOR OF THE DEPARTMENT OF
MANAGED HEALTH CARE, AND SARAH
REAM, CHIEF COUNSEL TO DMHC. WE
THANK YOU. WHO WOULD LIKE TO GO
FIRST, KAREN. GOOD AFTERNOON.
GOOD AFTERNOON. CAN YOU HEAR ME?
YES. THANK YOU FOR HAVING ME,
AGAIN. MY NAME IS KAREN CORBETT.
I'M THE DIRECTOR OF THE
CALIFORNIA HEALTH BENEFITS
REVIEW PROGRAM. I'VE BEEN
DIRECTOR SINCE 2011. AGAIN, I'M
HAPPY TO BE HERE AS A TECHNICAL
RESOURCE. SO BACK WAY BACK IN
THE MIDST OF TIME, BACK IN 2011,
EACH STATE WAS NOTIFIED BY THE
FEDERAL GOVERNMENT TO CHOOSE THE
RESPECT THEIR RESPECTIVE HB,
THEIR HB BENCHMARK PLAN THAT
WOULD DEFINE THE STANDARD SET OF
BENEFITS THAT MUST BE COVERED BY
PLANS IN THAT STATE MOVING
FORWARD. STARTING IN 2014,
INSURERS IN EVERY STATE WERE
REQUIRED FOR THE VERY FIRST TIME
TO OFFER PLANS THAT WERE WITH
BENEFITS THAT WERE SUBSTANTIALLY
EQUAL TO THOSE FOUND IN THE
STATE'S BENCHMARK PLAN, AND,
IMPORTANTLY, THE HB BENCHMARK
DEFINED ONLY WHAT BENEFITS MUST
BE COVERED, NOT WHAT THE COST
SHARING LEVELS WERE TO BE
ANYWAY. STATES HAD TO SELECT
THEIR FIRST HB BENCHMARK BY THE
END OF SEPTEMBER OF 2012, WHICH
WOULD AGAIN DEFINE EACH STATE'S
EAP FOR 2014 AND 15. THIS
BENCHMARK INCLUDED COVERAGE FOR
STATE MANDATES THAT WERE ENACTED
BEFORE DECEMBER 31ST OF 2011,
AND COMPLIED WITH THE MENTAL
HEALTH PARITY AND ADDICTION LAW
OF 2008. THESE COMMENTS ARE
BASED ON MY NOTES OF
CONVERSATIONS WITH LEGISLATORS
AND KEY LEGISLATIVE STAFF AT
THAT TIME. SOME OF THE KEY
CONSIDERATIONS IN THE PREVIOUS
DELIBERATIONS WERE ONE. BEING
QUITE MINDFUL OF WHICH REGULATED
MARKET THE STATE WAS SELECTING
ITS BENCHMARK PLAN FROM, GENERAL
CONSENSUS WAS THAT IT WAS
IMPORTANT THAT CALIFORNIA CHOOSE
A PLAN REGULATED BY DMHC. WHY
DMHC REGULATED PLANS WERE
SUBJECT TO THE KNOX KEAN HEALTH
CARE SERVICE ACT OF 1975 THAT
REQUIRES COVERAGE OF MEDICALLY
NECESSARY BASIC HEALTH CARE
SERVICES. THEREFORE, MEDICALLY
NECESSARY BASIC HEALTH CARE
SERVICES ARE INDEED A PART OF
THE AHP COVERAGE REQUIREMENT IN
CALIFORNIA. NOW, THE LANDSCAPE
IS DIFFERENT TODAY. AT THE TIME,
THE COMPREHENSIVENESS OF DMHC
PLANS FELT MEANINGFUL FOR THE
PURPOSES OF ESTABLISHING
CALIFORNIA'S BENCHMARK PLAN. FOR
EXAMPLE, DMHC HAD LONG STANDING
REQUIREMENTS THAT ABORTION HAD
TO BE COVERED BY HEALTH PLANS.
THAT SAID, THERE WAS ALSO
CONSIDERATION OF AFFORDABILITY
AND WIDESPREAD SUPPORT OF
COVERED CALIFORNIA BECAUSE THE
BENEFITS PROVIDED BY THE
BENCHMARK WOULD BECOME MANDATED
BENEFITS. THERE WERE DISCUSSIONS
AND TRADE OFFS AT THAT TIME THAT
WERE EVALUATED AND CONSIDERED
ABORTION, AND A FEW OTHER AREAS
WERE PRIORITIZED OVER THINGS
LIKE CHIROPRACTIC CARE, FOR
EXAMPLE, AND PEDIATRIC HEARING
AIDS. SO CALIFORNIA SELECTED AHP
BENCHMARK, THE BASE BENCHMARK
PLAN, CALIFORNIA, SELECTED FOR
2014 WAS THE KAISER SMALL GROUP
HMO 30. THAT WAS THE LARGEST
PLAN BY ENROLLMENT IN ONE OF THE
THREE LARGEST SMALL GROUP
INSURANCE PRODUCTS. CALIFORNIA
CHOSE TO SUPPLEMENT THIS PLAN
WITH THE PEDIATRIC DENTAL
BENEFIT FROM ITS SEPARATE CHIP
PROGRAM, AND THE PEDIATRIC
VISION BENEFITS FROM THE FEDERAL
EMPLOYEE VISION PROGRAM AND TO
CREATE THE OVERALL AHP BENCHMARK
PLAN FOR CALIFORNIA. WE ALSO,
HERE IN CALIFORNIA, CHOSE TO
DEFINE HABILITATIVE SERVICES
UNDER THE SAME TERMS AND
CONDITIONS APPLIED TO
REHABILITATIVE SERVICES. WHEN WE
AGAIN REVISITED THE BENCHMARK IN
2015 FOR THE 2017 YEAR, THE
BROWN ADMINISTRATION HAD
FEELINGS THAT WE SHOULD NOT
CHANGE THE PLANS AT THE TIME,
AND THE LEGISLATURE AGREED.
MEDICAL TREND WAS RUNNING AT
ABOUT 7% THAT YEAR. IN PLAN
YEARS 2014, 15 AND 16, THE BASE
BENCHMARK PLAN WAS A PLAN THAT
WAS SOLD IN 2012. WHILE IN PLAN
YEARS 2017 THROUGH 2024, THE
BASE BENCHMARK PLAN WAS A PLAN
THAT WAS SOLD ON THE MARKET IN
2014, AS NO NEW BASE, BENCHMARK
PLAN OR SUPPLEMENTS WERE
SUBMITTED TO CMS, THE KAISER
HEALTH PLAN, SMALL GROUP 30, OR
THE HMO 30 PLAN PLUS THOSE
IDENTIFIED SUPPLEMENTS CONTINUE
TO SERVE AS CALIFORNIA'S
BENCHMARK PLAN TODAY. NOW, GOING
FORWARD, HHS ESTABLISHED NEW
RULES PROVIDING STATES WITH NEW
FLEXIBILITY FOR SELECTING A
BENCHMARK PLAN. CALIFORNIA MAY
CHOOSE NOW CHOOSE TO DO ONE OF
THREE THINGS. SELECT THE
BENCHMARK PLAN FROM ANOTHER
STATE. USE FOR THE 2017 PLAN
YEAR, OR CALIFORNIA CAN REPLACE
ONE OR MORE CATEGORIES OF SSBS
UNDER ITS BENCHMARK PLAN USED
FOR THE 2017 PLAN YEAR, WITH THE
SAME CATEGORY OR CATEGORIES OF
HB FROM THE BENCHMARK PLAN THAT
ANOTHER STATE USED FOR THE 2017
YEAR, OR OPTION THREE.
OTHERWISE, SELECT A NEW SET OF
BENCH OF BENEFITS THAT WOULD
BECOME THE STATE'S NEW HB PLAN
BY SELECTING SOME OR ALL
CATEGORIES FROM ANOTHER STATE'S
BENCHMARK PLAN, OR ADDING TO THE
BASE OF BENCHMARK TO THE BASE
BENCHMARK PLAN. CALIFORNIA COULD
INCLUDE NEW SERVICES NOT
CURRENTLY COVERED UNDER OUR
BENCHMARK PLAN, THERE ARE THREE
SPECIFIC BENEFITS THAT ARE
COVERED BY THE MAJORITY OF OTHER
STATE BENCHMARK PLANS, BUT THAT
ARE NOT INCLUDED IN THE CURRENT
KAISER SMALL GROUP 30 PLAN.
CHIROPRACTIC CARE SERVICES,
HEARING AIDS, AND INFERTILITY
SERVICES AND TREATMENTS. THE
COMMITTEE'S ANALYSIS OF SB 1290
IS EXCELLENT AND COMPREHENSIVE.
I WISH TO CLOSE WITH A BRIEF
CALLOUT OF A COUPLE OF COMMENTS
TO REMIND COMMITTEE MEMBERS OF
SOME IMPORTANT CONSIDERATIONS
AND CONTEXT TO THE STATE
SELECTION OF ITS HB BENCHMARK
PLAN. THE ACA REQUIRES COVERAGE
OF, FOR ALMOST ALL ENROLLEES IN
THE INDIVIDUAL AND SMALL GROUP
MARKETS, BOTH INSIDE AND OUTSIDE
OF COVERED CALIFORNIA. IN INSIDE
COVERED CALIFORNIA, ALL
QUALIFIED HEALTH PLANS, KNOWN AS
SHPS, ARE REQUIRED TO PROVIDE
COVERAGE OF HCBS WHILE OUTSIDE
COVERED CALIFORNIA NON
GRANDFATHERED PLANS AND POLICIES
IN THE INDIVIDUAL AND SMALL
GROUP MARKET ARE REQUIRED TO
COVER THE ABS. HOWEVER, LARGE
GROUP SELF-INSURED AND
GRANDFATHERED PLANS AND POLICIES
ARE EXEMPT FROM HB REQUIREMENTS
FOR 2024. SHE ESTIMATED THAT
12.1% OF CALIFORNIANS ARE
ENROLLED IN COMMERCIAL HEALTH
INSURANCE THAT MUST COVER HB,
MEDI-CAL, CALIFORNIA'S MEDICAID
PROGRAM IS ALSO REQUIRED BY THE
ACA TO COVER A SET OF BENEFITS
REFERRED TO AS NPS, BUT THOSE
ARE SEPARATE FROM AND FUNCTION
INDEPENDENTLY FROM THE NPS THAT
COMMERCIAL HEALTH INSURANCE CAN
BE REQUIRED TO COVER UNDER THE
ACA. SO IN CLOSING, A REMINDER
THAT CALIFORNIA MUST SUBMIT ANY
PROPOSED MODIFIED BENCHMARK PLAN
IT SELECTS BY THE FIRST
WEDNESDAY IN MAY, TWO YEARS
PRIOR TO THE EFFECTIVE DATE OF
THE NEW BENCHMARK PLAN. SO IN
EARLY MAY 2024 FOR PLAN YEAR
BEGINNING IN 2026 AND EARLY MAY
2025 FOR PLAN YEAR BEGINNING
JANUARY 1ST, 2027. THANKS FOR
HAVING ME HERE TODAY. THANK YOU
SIR. NEXT PLEASE. MISS WATANABE,
THERE WE GO. ALL RIGHT. GOOD
AFTERNOON. MY NAME IS MARY
WATANABE. I'M THE DIRECTOR OF
THE DEPARTMENT OF MANAGED HEALTH
CARE. WITH ME, I HAVE SARAH
REAM, OUR GENERAL COUNSEL, IS
HERE TO HELP ANSWER SOME OF THE
MORE TECHNICAL QUESTIONS IF
NEEDED, JUST TO PROVIDE SOME
QUICK BACKGROUND ABOUT THE
DEPARTMENT, THE DEPARTMENT OF
MANAGED HEALTH CARE, OUR MISSION
IS TO PROTECT CONSUMERS HEALTH
CARE RIGHTS AND ENSURE A STABLE
HEALTH CARE DELIVERY SYSTEM. WE
CURRENTLY LICENSE 143 PLANS THAT
PROVIDE COVERAGE TO NEARLY 30
MILLION CALIFORNIANS IN THE
STATE, THIS MEANS THAT WE
REGULATE ABOUT 96% OF STATE
REGULATED COMMERCIAL AND
GOVERNMENT INSURANCE OFFERED IN
THE STATE, MY COLLEAGUE DID A
REALLY GOOD JOB PROVIDING SOME
OVERVIEW OF THE PROCESS IN THE
BACKGROUND. I THINK I'LL REALLY
FOCUS ON THE TIMELINE HERE, SO
BEFORE WE SUBMIT THE FILING TO
CMS WITH OUR THE LEGISLATURE'S
NEW SELECTED BENCHMARK PLAN, IF
WE GO DOWN THAT OPTION, WE
REALLY NEED TO SELECT CONSIDER
SOME OF THE OPTIONS. AND THE
LEGISLATURE WOULD NEED TO
CONSIDER AND ADOPT THE NEWLY
SELECTED BENCHMARK PLAN BY
AMENDING STATE STATUTES, WE
FORESEE THE ADMINISTRATION
PARTNERING WITH THE LEGISLATURE
TO HIRE A CONSULTANT TO ASSIST
WITH THE ANALYSIS OF
CALIFORNIA'S BENCHMARK PLAN AND
EVALUATING THESE OPTIONS TO
INCLUDE ADDITIONAL BENEFITS. THE
CONSULTANT WOULD ALSO PREPARE
THE ACTUARIAL ANALYSIS TO
SUPPORT THE SELECTION OF A NEW
BENCHMARK PLAN, AND THE
APPLICATION TO CMS. WE ARE
CURRENTLY EXPLORING OPTIONS FOR
FUNDING THIS WORK PRIMARILY WITH
SUPPORT FROM A FOUNDATION. AND
ANTICIPATE THIS ANALYSIS WILL
TAKE APPROXIMATELY 6 TO 8
MONTHS. ONCE WE HAVE IDENTIFIED
SEVERAL OPTIONS FOR A POSSIBLE
NEW BENCHMARK PLAN, WE
ANTICIPATE A STAKEHOLDER PROCESS
TO PROVIDE INPUT ON THE OPTIONS.
IN ADDITION, THERE WILL LIKELY
BE ADDITIONAL OPPORTUNITIES FOR
STAKEHOLDER INPUT THROUGH THE
INFORMATIONAL HEARINGS OR OTHER
HEARINGS RELATED TO THE
LEGISLATION CODIFYING THE NEW
BENCHMARK PLAN AT A LATER DATE.
AND AGAIN, JUST A REMINDER ABOUT
THAT CRITICAL DATE THAT WE DO
NEED TO FILE BY MAY FOR IT TO
TAKE EFFECT TWO YEARS IN THE
FUTURE. SO IT WOULD BE MAY OF
2025 FOR THIS TO TAKE EFFECT IN
THE 2027 BENEFIT YEAR. SO I
THINK I'LL PAUSE THERE. AND
SARAH AND I OF COURSE, WOULD BE
HAPPY TO ANSWER ANY QUESTIONS.
THANK YOU. COMMENTS. ANY
QUESTIONS FOR THE MADAM CHAIR, I
THINK THERE MAY BE SOME
STAKEHOLDERS IN THE AUDIENCE WHO
WISH TO COMMENT BEFORE THEM,
THOUGH. CAN I CALL AND ASK IF
THERE'S ANY WITNESSES TO SUPPORT
OR OPPOSE? WITNESSES TO SUPPORT
AND OPPOSE, NOT THE
STAKEHOLDERS. DIANA. WITH HEALTH
ACCESS AND WE ARE IN SUPPORT.
THANK YOU. WE ARE IN SUPPORT OF
SB 1290 AND, BELIEVE THAT THIS
REEXAMINATION OF THE BENCHMARK
PLAN IS TIMELY, NECESSARY, HAS A
POTENTIAL TO REDUCE HEALTH
INEQUITIES AND INCREASE ACCESS
TO CARE. THANK YOU FOR
AUTHORING. THANK YOU. ANY OTHER
WITNESSES TO SUPPORT OR OPPOSE
SEEING NONE NO MORE, AT THIS
TIME, I WANT TO CALL FOR THE
STAKEHOLDERS, IF YOU CAN COME
UP, DO YOU WANT ME TO CALL
EVERYBODY BY NAME OR YOU KNOW
WHO YOU ARE? YOU WANT TO COME
UP, PLEASE STATE YOUR NAME AND
THE ORGANIZATION THAT YOU'RE
WITH AND YOU HAVE ONE MINUTE
EACH, PLEASE. OH, AWESOME. ONE
MINUTE, I THOUGHT I HAD 15
SECONDS. I AM CASEY KANE, FIVE
NOW. I MEANT FIVE MINUTES. JUST
KIDDING. I AM A PARENT OF A DEAF
AND HARD OF HEARING CHILD. I'M
ALSO A AUDIOLOGY GRADUATE
STUDENT AND THE BOARD PRESIDENT
FOR CALIFORNIA HANDS AND VOICES.
I HIGHLY SUPPORT THIS BILL. AND
YOUR NAME CASEY KANE. THANK YOU.
MRS. NICOLETIS THANK YOU, MADAM
CHAIR, AND SENATOR ROTH, MR.
CHAIR AND MEMBERS, NICK LOUISOS
WITH THE CALIFORNIA ASSOCIATION
OF HEALTH PLANS. WE ISSUED A
SUPPORT AND CONCEPT LETTER ON
THIS BILL, AND WE'RE SUPPORTIVE
OF THE BILL MOVING FORWARD.
CERTAINLY CALIFORNIA'S CURRENT
ESSENTIAL HEALTH BENEFITS OR
IRBS, AS, AS, AS YOU HEARD A
MOMENT AGO, WERE DETERMINED
AFTER A PRETTY ROBUST DISCUSSION
AND ANALYSIS, BALANCING CONSUMER
ACCESSIBILITY TO HEALTH CARE
SERVICES AND AFFORDABILITY OF
THAT PROCESS AND THE PROCESS
THAT'S ENVISIONED BY SB 1290, IS
ENCOURAGING AND CERTAINLY
PREFERABLE TO THE CURRENT
APPROACH, AT LEAST IN OUR VIEW
OF HAPHAZARD IDLY. CONSIDERING
ONE OFF BENEFIT COVERAGE BILLS,
AS IN THE POLICY COMMITTEES THAT
INFLATE HEALTH CARE PREMIUMS FOR
ALL CALIFORNIANS, YOU KNOW, JUST
TO CONTEXTUALIZE THAT, LAST YEAR
, CALIFORNIA LAWMAKERS
INTRODUCED A BATCH OF MANDATE
BILLS THAT WOULD HAVE INCREASED
PREMIUMS IN THE FIRST YEAR BY
NEARLY $1 BILLION, AND WE ARE
GRATEFUL THAT AT LEAST ON THE
SENATE SIDE, THERE ARE MINIMAL
NUMBER OF MANDATE BILLS THAT
HAVE BEEN INTRODUCED, BUT
SEVERAL HAVE BEEN REINTRODUCED
THIS YEAR NONETHELESS, WHILE
REOPENING CALIFORNIA'S ESSENTIAL
HEALTH BENEFITS IS NOT WITHOUT
ITS CHALLENGES AND PITFALLS, IT,
YOU KNOW, IT OFFERS POLICYMAKERS
THE OPPORTUNITY TO ENGAGE IN A
MORE THOUGHTFUL DISCUSSION OF
COVERAGE, AGAIN, BALANCING
AFFORDABILITY AND ACCESSIBILITY.
IF WE DO GO DOWN THIS PATH, YOU
KNOW, WE WOULD STRONGLY SUGGEST
THAT A MORATORIUM BE PLACED ON
THE CONSIDERATION OF ANY NEW
INDIVIDUAL. AND ONE OFF BENEFIT
MANDATE BILLS WHILE THIS PROCESS
PLAYS OUT, WE WOULD ALSO ASK
POLICYMAKERS TO KEEP IN MIND
THAT THERE IS WORK BEING DONE AT
THE OFFICE OF HEALTH CARE
AFFORDABILITY, WHICH IS
CURRENTLY CONSIDERING A
STATEWIDE SPENDING TARGET. CAP
IS IN SUPPORT OF A MULTI YEAR
SPENDING TARGET AND IN ANY CASE,
THIS. THIS SHOULD NOT CONFLICT
WITH WHATEVER WORK IS BEING DONE
AT THAT LEVEL. WE'D LOVE TO BE
AN INTEGRAL PART OF THE
CONVERSATION. THANK YOU, THANK
YOU. NEXT. STEPHANIE WATKINS, ON
BEHALF OF THE ASSOCIATION OF
CALIFORNIA LIFE AND HEALTH
INSURANCE COMPANIES. IN THE
INTEREST OF TIME, I WILL ALIGN
MY COMMENTS WITH MY COLLEAGUE AT
CAP. WE ARE SUPPORT AND CONCEPT
AND LOOK FORWARD TO THE
CONVERSATION AS IT MOVES
FORWARD. THANK YOU. THANK YOU,
GOOD AFTERNOON, CRAIG PULSIFER.
ON BEHALF OF EQUALITY
CALIFORNIA, I STRONGLY SUPPORT
EFFORTS TO ENSURE THAT NOT ONLY
LGBTQ, BUT ALL CALIFORNIANS CAN
ACCESS THE HEALTH CARE SERVICES
THEY NEED. I'M ALSO HERE TODAY
REPRESENTING A COALITION OF
ORGANIZATIONS WORKING TO EXPAND
COVERAGE FOR INFERTILITY
TREATMENT. WE RECOGNIZE THAT
INFERTILITY IS A DISEASE AS
DEFINED BY THE AMA, THE WHO AND
THE AMERICAN SOCIETY FOR
REPRODUCTIVE MEDICINE. AS SUCH,
WE BELIEVE TREATMENT FOR
INFERTILITY SHOULD BE COVERED IN
THE STATE'S BENCHMARK PLAN. JUST
LIKE ALL OTHER DISEASES FOR
WHICH TREATMENT IS MEDICALLY
NECESSARY. UNFORTUNATELY, WHILE
THE STATE'S CURRENT BENCHMARK
PLAN COVERS A WIDE ARRAY OF
REPRODUCTIVE HEALTH SERVICES, IT
DOES NOT INCLUDE COVERAGE FOR
FERTILITY CARE, A GLARING
OMISSION GIVEN THAT THIS CARE IS
AN ESSENTIAL COMPONENT OF
REPRODUCTIVE HEALTH CARE. AT THE
SAME TIME, THE CURRENT BENCHMARK
PLAN LEAVES OUT LGBTQ PEOPLE WHO
RELY ON ACCESS TO FERTILITY
TREATMENTS TO START A FAMILY.
JUST LAST YEAR, THE ASRM
PUBLISHED A NEW, MORE INCLUSIVE
DEFINITION OF INFERTILITY THAT
REFLECTS THE LIVED EXPERIENCES
OF LGBTQ PEOPLE, AND WE STRONGLY
SUPPORT EFFORTS TO ENSURE THAT
CALIFORNIA'S BENCHMARK PLAN
INCLUDES EQUITABLE AND INCLUSIVE
COVERAGE FOR STANDARD FERTILITY
SERVICES, INCLUDING DIAGNOSTICS,
MEDICALLY INDICATED
PRESERVATION, ARTIFICIAL
INSEMINATION, AND IVF. LASTLY, I
WOULD JUST NOTE THAT CALIFORNIA,
WHICH HOLDS ITSELF OUT AS A
LEADER IN REPRODUCTIVE FREEDOM,
IS CURRENTLY LAGGING BEHIND
SEVERAL OTHER STATES THAT
ALREADY INCLUDE FERTILITY
SERVICES AS AN IRB AND AT A TIME
WHEN IVF IS UNDER ATTACK ACROSS
THE COUNTRY, IT'S NOW MORE
IMPORTANT THAN EVER TO ENSURE
THAT CALIFORNIANS HAVE ACCESS TO
THE FULL SPECTRUM OF
REPRODUCTIVE HEALTH CARE. THANK
YOU, THANK YOU. NEXT SORRY. GOOD
AFTERNOON, JESSICA MORAN WITH
THE CALIFORNIA DENTAL
ASSOCIATION. APPRECIATE THE
OPPORTUNITY TO GIVE COMMENT ON
SB 1290. THIS IS ESPECIALLY
TIMELY AS JUST LAST WEEK, CMS,
FINALIZED AND PUBLISHED THEIR
RULE FOR 2025 PLAN DESIGNS,
WHICH INCLUDE THE OPPORTUNITY
FOR STATES TO OPEN UP THEIR AHP
BENCHMARKS TO INCLUDE, ROUTINE
NON PEDIATRIC DENTAL SERVICES.
WHILE DATA INDICATES THAT 88% OF
CALIFORNIANS HAVE SOME FORM OF
DENTAL COVERAGE, WITH ABOUT 50%
OF THAT BEING EMPLOYER SPONSORED
COVERAGE, THERE IS SIGNIFICANT
VARIATION ACROSS THE DENTAL
MARKET FOR SERVICES THAT ARE
COVERED, AND PLANNED POLICIES,
FOR EXAMPLE, THERE'S NO MINIMUM
STANDARD OR FLOOR REQUIRED FOR
DENTAL COVERAGE. MOST DENTAL
PLANS HAVE ANNUAL ANNUAL
MAXIMUMS AND NO CAP TO PATIENT
OUT-OF-POCKET SPENDING, THESE
FACTORS LEAVE CONSUMERS TO
PURCHASE INADEQUATE DENTAL
COVERAGE COVERAGE THAT'S
INAPPROPRIATE FOR THE DENTAL
NEEDS OR SIMPLY RECEIVING LOW TO
NO VALUE FOR THE PREMIUM DOLLARS
THAT ARE BEING SPENT. I ASK YOU
TO WRAP IT UP, PLEASE. WE URGE
THE COMMITTEE TO AMEND SB 1290
TO INCLUDE ADULT DENTAL
SERVICES. AND ADDITIONALLY, WHEN
DESIGNING THE BENEFIT, WE
REQUEST THE LEGISLATURE TO
INCLUDE A SEPARATE DENTAL
DEDUCTIBLE FOR EMBEDDED DENTAL
SERVICES. NØ ANNUAL LIFETIME
MINUTES NÓ ANNUAL LIFETIME
LIMITS ON DENTAL COVERAGE
SERVICES AND ARE REASONABLE
OUT-OF-POCKET MAXIMUM.
CALIFORNIA HAS THE OPPORTUNITY
TO BE THE FIRST STATE TO
IMPLEMENT THIS, SO WE LOOK
FORWARD TO CONTINUE WORKING WITH
THE LEGISLATURE. THANK YOU,
THANK YOU. AND IF I JUST AS A
REMINDER, ONE MINUTE, PLEASE, SO
THAT WE CAN ALLOW EVERYBODY ELSE
TO HAVE SOME TIME TO SPEAK, MY
NAME IS STUART CONNOLLY. I'M A
BOARD MEMBER FOR THE HEARING
LOSS ASSOCIATION OF AMERICA AND
FATHER OF TWO YOUNG GIRLS WHO
SHARE MY HEARING LOSS. I WANTED
TO GIVE A PERSONAL EFFECT TO
WHAT THIS BILL MEANS TO A LOT OF
US. AS YOU PROBABLY KNOW,
THERE'S AN EPIDEMIC OF UNTREATED
HEARING LOSS IN THIS COUNTRY DUE
TO THE COST. FAMILIES CHOOSE TO
LIVE WITH POOR HEARING OR THE
WRONG EQUIPMENT FOR FAR TOO
LONG, WHICH LEADS TO OTHER LOST
OPPORTUNITIES. RECENTLY, MY TWO
GIRLS AND I NEEDED TO UPGRADE
OUR AGING HEARING AIDS. OUR BILL
WAS OVER $20,000 AFTER OUR TOP
TIER INSURANCE DEDUCTED ONLY
1500 PER HEARING AID BECAUSE
THEY DEEMED OUR UPGRADES AS AN
ELECTIVE AND NOT THE TRUE
MEDICALLY NECESSARY EQUIPMENT
THEY ARE. WE HAD TO PASS ON
KEEPING THOSE HEARING AIDS THAT
WERE ALREADY FITTED TO THEM.
THIS IS THE REALITY FOR MYSELF
AND FOR THOUSANDS OF FAMILIES
LIKE MINE IN CALIFORNIA. THE
HACCP PROGRAM THAT WAS SUPPOSED
TO FIX THIS IS WOEFULLY ILL
EQUIPPED TO HANDLE THE TRUE NEED
OF OUR COMMUNITY. THERE ISN'T A
SINGLE PROVIDER ON YOUR SITE
THAT SERVES SACRAMENTO WITH
WITHIN 100 MILES, AND THE
INSURANCE COMPANIES THAT ARE
SUPPOSED TO COVER OUR EQUIPMENT
FOR WHAT WE PAY THEM. BUT THEY
WON'T BECAUSE THEY NEED TO SAVE
A PROFIT. PLEASE HOLD THEM
ACCOUNTABLE BY PASSING THIS
BILL. THANK YOU. HELLO, I'M NORA
LIN WITH CHILDREN NOW AND I'M
HERE WITH OUR PARTNER, MICHELLE
MARCINIAK FROM LET CALIFORNIA
KIDS HERE TO SPEAK STRONGLY IN
SUPPORT OF A POLICY SOLUTION
THAT WILL PERMANENTLY CLOSE THE
COVERAGE GAP FOR CHILDREN IN
NEED OF HEARING AIDS, ACCORDING
TO PEDIATRIC EXPERTS, FAILURE TO
GIVE APPROPRIATE EARLY
INTERVENTION TO DEAF AND HARD OF
HEARING CHILDREN LEADS TO SPEECH
, LANGUAGE, COGNITIVE,
EDUCATIONAL AND SOCIAL EMOTIONAL
DEFICITS, AND PERMANENT AND
PREVENTABLE DELAYS. 32 STATES
HAVE RECOGNIZED THIS AND REQUIRE
HEALTH PLANS TO COVER CHILDREN'S
HEARING AIDS, BUT CALIFORNIA IS
NOT ONE OF THEM. OVER 20,000
CHILDREN IN CALIFORNIA ARE STUCK
IN THIS COVERAGE GAP, AND THEIR
FAMILIES FACE DIFFICULT CHOICES
ABOUT AFFORDING HEALTH CARE.
IT'S TIME TO FIX THIS, AND I
WILL PASS TO MICHELLE. FOR OVER
THE PAST TWO DECADES AND MORE
RECENTLY UNDER THE THIS
ADMINISTRATION, SEVERAL ATTEMPTS
HAVE BEEN MADE TO ADDRESS THIS
DEVELOPMENTAL CRISIS, ALL OF
WHICH GOVERNOR NEWSOM HAS
BLOCKED DUE TO THE PRECEDENT IT
WOULD SET TO GO ABOVE AND BEYOND
THE ESSENTIAL HEALTH BENEFITS.
THE GOVERNOR'S ALTERNATIVE
PROGRAM. AFTER THREE YEARS AND
MILLIONS INVESTED, IS NOT
WORKING, WITH LESS THAN 2%
SERVED BY ADDING HEARING AIDS TO
THE ÁP. THIS BILL ADDRESSES THE
GOVERNOR'S STATED CONCERNS AND
ADDRESSES THIS DEVELOPMENTAL
EMERGENCY. THAT'S BEEN UNFOLDING
FOR YEARS IN THE STATE OF
CALIFORNIA. AS A MOM WITH A
CHILD WHO IS HARD OF HEARING,
THE STORY THAT HAUNTS ME MOST IS
CHILDREN SHOWING UP AT CENTERS
ACROSS THE STATE AT THE AGE OF
FIVE, UNABLE TO SAY THEIR NAME
BECAUSE THEY HAVE NEVER HAD
ACCESS TO SOUND. I URGE THE
ADMINISTRATION TO ACT WITH
URGENCY ON THIS. IT'S TIME TO
LET CALIFORNIA KIDS HEAR. THANK
YOU. GOOD AFTERNOON, LLOYD
FRIESEN, REPRESENTING THE
CALIFORNIA CHIROPRACTIC
ASSOCIATION, ALSO KNOWN AS CAL
CHIRO. AND WE SUPPORT THE
PROVISION OF SB 1290 TO REVIEW
THE ESSENTIAL HEALTH BENEFITS
AND BENCHMARK PLAN,
SPECIFICALLY, WE'RE ASKING THAT
THE NEW BENCHMARK PLAN INCLUDE
CHIROPRACTIC SERVICES,
SPECIFICALLY AS IT RELATES TO
CHIROPRACTIC MANIPULATIVE
THERAPY, THAT THERAPY HAS BEEN
SHOWN TO BE ONE OF THE TOP,
TREATMENT INTERVENTIONS WITH THE
CONSERVATIVE MANAGEMENT OF,
NECK, BACK AND HEADACHES,
CALIFORNIA IS ONE OF ONLY FOUR
STATES THAT DOES NOT INCLUDE
CHIROPRACTIC SERVICES AS A
BENEFIT. AND SO AGAIN, WE WOULD
ASK THE STATE OF CALIFORNIA IN
THEIR REVIEW OF THE BENCHMARK
PLAN, INCLUDE THAT, AGAIN, THE
SCIENTIFIC LITERATURE SHOWS THE
IMPORTANCE OF THAT SERVICE. AND
AGAIN, WE SUPPORT THE ACTIVITY
OF THIS, OF THIS LEGISLATION.
AND THANK YOU, SENATOR ROTH, FOR
YOUR LEADERSHIP ON THIS. THANK
YOU. THANK YOU. NEXT THANK YOU,
MADAM CHAIR. THANK YOU, SENATOR
ROTH. I'M RYAN SPENCER, ON
BEHALF OF THE CROHN'S AND
COLITIS FOUNDATION. OVER THE
PAST SEVERAL YEARS, THE
FOUNDATION HAS BEEN WORKING ON
IMPROVING COVERAGE BENEFITS FOR
PATIENTS WITH INFLAMMATORY BOWEL
DISEASE, IBD. SPECIFICALLY,
THEY'VE BEEN WORKING TO ENSURE
COVERAGE OF DIETARY ENTERAL
FORMULAS FOR PATIENTS DIAGNOSED
WITH CROHN'S DISEASE. THESE
DRINKS HAVE BEEN CLINICALLY
PROVEN TO TREAT PATIENTS AND TO
KEEP THEM IN REMISSION, IN THE
SAME WAY AS A MORE AGGRESSIVE
AND MORE EXPENSIVE BIOLOGIC
DRUGS. IRONICALLY, THE BIOLOGIC
DRUGS ARE TYPICALLY COVERED. THE
INTERNAL DIETARY FORMULAS ARE
NOT AVOIDING MORE EXPENSIVE
BIOLOGICS, AND USING ENTERAL
FORMULA CAN REDUCE OVERALL COST
OF HEALTH CARE SYSTEM AND STILL
EFFECTIVELY KEEP IBD PATIENTS,
PARTICULARLY CHILDREN, IN
REMISSION. LAST YEAR, AB 1620 BY
SEJM MEMBER CONNOLLY, WHICH
WOULD HAVE REQUIRED COVERAGE OF
DIETARY FORMULAS, WAS VETOED BY
THE GOVERNOR, CITING THE BELIEF
IT WAS NOT INCLUDED IN THE
BENCHMARK PLAN AND THEREFORE
EXCEEDED THE DEFINITION OF BS.
THERE WAS NO DISPUTE ON THE
TREATMENT OR ITS EFFICACY, IT
WAS MERELY BECAUSE IT WAS NOT IN
THE BENCHMARK. SO I ASKED WHEN
THE STATE DOES IMPLEMENT A NEW
BENCHMARK PLAN, PLEASE ENSURE
THE INCLUSION OF COVERAGE OF ALL
DIETARY ENTERAL FORMULAS
PRESCRIBED TO TREAT DIGESTIVE
DISORDERS. THANK YOU. THANK YOU.
SEEING NO SEEING NO MORE. NO
OTHER WITNESSES. OUR
STAKEHOLDERS AT THIS TIME, I
WOULD LIKE TO PAUSE TO ESTABLISH
A QUORUM. MADAM CLERK, CAN WE
PLEASE CALL ROLL? SENATOR ROTH
HERE. ROTH HERE. WHEN HERE. WHEN
HERE. GLASER. GLASER HERE.
GONZALEZ. GROVE. HURTADO HERE.
HURTADO. HERE. LIMÓN. MENGIBAR
MENGIBAR. HERE. RUBIO. SMALLWOOD
CUEVAS. SMALLWOOD. CUEVAS. HERE.
WIENER THANK YOU. THAT'S SIX
MEMBERS. WE HAVE A QUORUM, AT
THIS TIME, I'M GOING TO BRING IT
BACK, COLLEAGUES, MEMBERS, ANY
QUESTIONS? COMMENTS SENATOR
MANCHIN, THANK YOU SO MUCH,
MADAM VICE CHAIR. I AM REALLY
EXCITED ABOUT THIS BILL. SENATOR
ROTH, THERE ARE TWO ITEMS THAT
I'M ESPECIALLY EXCITED ABOUT.
THE POTENTIAL OF, INCLUDING AS A
BENEFIT, ONE OF THEM, YOU HEARD
A LOT FROM STAKEHOLDERS TODAY,
LET CALIFORNIA CHILDREN HEAR AN
EFFORT THAT A STAKEHOLDERS HAVE
BEEN WORKING ON FOR OVER 20
YEARS THAT SOMEHOW WE CAN'T GET
IT RIGHT HERE, IN CALIFORNIA,
WE'VE ATTEMPTED VARIOUS TIMES
AND I ATTEMPTED LAST YEAR AS
WELL, AND UNFORTUNATELY GOT
VETOED, WE ARE FAILING OUR KIDS
WHO ARE UNABLE TO HEAR HARD OF
HEARING AND THE STORY YOU HEARD
OF ONE OF THE STAKEHOLDERS IS A
FAMILIAR STORY TO SO MANY
INDIVIDUALS. I WANT TO ECHO THE
URGENCY BEHIND ENSURING THAT WE
SUBMIT A PLAN. AND MY QUESTION
IN ALL THIS IS, SENATOR ROTH, DO
WE THINK WE CAN GET THERE BY MAY
OF NEXT YEAR AND SUBMITTING
THAT? I MEAN, IF IT WAS UP TO
ME, I WISH WE COULD DO IT IN
THIS MAY IN LESS THAN A MONTH.
BUT WHAT DO WE NEED TO DO TO
ENSURE THAT WE SUBMIT BY NEXT
MAY? WELL, YOU HEARD THE
TIMELINE OUTLINED, BY THE
WITNESSES. THE KEY IS THAT IF
WE'RE GOING TO MAKE A CHANGE IN
THE ESSENTIAL BENEFIT, ADOPT A
PLAN, MAKE THE CHANGE IN THE
ESSENTIAL BENEFITS, AND WANT IT
EFFECTIVE IN THE 2027 POLICY
YEAR. WE HAVE TO HAVE THE. I
WON'T BE HERE. YOU ALL WILL HAVE
TO HAVE THIS DONE BY MAY 2025.
SO IT WOULD CERTAINLY BE, I
WOULD THINK, IF YOU'RE
INTERESTED, SIGNIFICANT FOR
THOSE HERE THIS YEAR TO MOVE
THIS ALONG AS FAR AS POSSIBLE.
IF NOT, GET IT DONE DURING THIS
SESSION. THERE'S SOME ACTUARIAL
WORK THAT NEEDS TO BE DONE. YOU
KNOW, THE ACTUARY NEEDS TO
COMPARE OUR CURRENT PLAN AGAINST
OTHER PLANS. THEN WE NEED TO DO
AN ACTUARIAL ANALYSIS AND COST
ANALYSIS OF THE INDIVIDUAL
BENEFITS OPTIONS THAT COULD BE
INCLUDED IN THE PLAN, AND THEN
MAKE SOME DECISIONS AS TO WHAT
SHOULD ULTIMATELY BE INCLUDED AS
ESSENTIAL BENEFITS. PUT THAT IN
A BILL. GET THE BILL THROUGH.
AND IF I CAN, MADAM CHAIR, MAY I
USE THIS AS AN OPPORTUNITY TO
SORT OF EXPLAIN THE PROCESS?
THIS IS NOT YOUR TYPICAL BILL
WHERE WE THE BILL IS FILLED UP
AND WE ALL KNOW WHAT WE'RE
VOTING ON. THIS IS A BILL TO
START THE PROCESS AND HAVE A
CONVERSATION. BUT THAT'S HOW WE
HAVE TO DO THIS. WE HAVE TO HAVE
A CONVERSATION. OAN AS THE
ACTUARIAL ANALYSIS IS MOVING
FORWARD, AS TO WHICH BENEFITS TO
PUT IN THE BILL. SO IF IT LEAVES
HERE AND IT GOES TO THE SENATE
FLOOR, IT'S GOING TO GO OVER THE
ASSEMBLY. AND ALL THROUGH THAT
PROCESS, YES, THE ACTUARIAL WORK
CONTINUES. DECISIONS ARE MADE
WORKING WITH STAKEHOLDERS AS TO
WHICH BENEFITS, ESSENTIAL
BENEFITS SHOULD BE INCLUDED.
WHAT SHOULD BE CHANGED? BILL
TAKES FORM, VOTED ON OVER THERE,
COMES BACK HERE. IN THE
MEANTIME, I WILL BE SCHEDULING
ANOTHER INFORMATIONAL HEARING TO
KEEP YOU APPRIZED OF
DEVELOPMENTS AND THE TIMELINE
AND HOW WE'RE MOVING FORWARD.
AND IF WE GET IT DONE THIS YEAR,
WE'LL COME BACK HERE TO THE
SENATE COMMITTEE FOR A VOTE ON
THE BILL WITH EVERYTHING FLESHED
OUT, BECAUSE I KNOW THOSE ARE
TYPICALLY SOME OF YOU ARE
TYPICALLY CONCERNED ABOUT THAT
BEFORE IT MOVES FORWARD. THAT
COULD CONCEIVABLY HAPPEN BEFORE
WE END SESSION THIS YEAR. IF IT
DOES NOT HAPPEN, THE ACTUAL
AERIAL WORK CAN CONTINUE AND THE
WORK OUTSIDE THE BUILDING HERE
CAN CONTINUE. BUT YOU'LL START
OVER WITH A NEW BILL IN JANUARY
OF 2025, AND YOU'LL NEED TO MOVE
THAT BILL THROUGH BOTH HOUSES OF
THE LEGISLATURE FOR, BEFORE MAY
2025, IN ORDER TO PROVIDE THE
APPROPRIATE NOTIFICATION TO
HEALTH AND HUMAN SERVICES. SO I
SHARE YOUR INTEREST, IF THAT'S
AN INTEREST OF YOURS, AND IT'S
THE INTEREST OF OTHER COLLEAGUES
IN THE LEGISLATURE, THEN MAYBE
WE CAN SPEED UP THE PROCESS.
DOES THAT ANSWER YOUR QUESTION,
SENATOR? THAT DOES MY SHARE. I
HAVE ANOTHER QUESTION FOR THE
WITNESS, SIR, I FORGOT YOUR
NAME. YOUR NAME? BUT, GARREN.
GARREN, CORBETT, YOU GAVE SOME
OPTIONS THAT WE CAN TAKE. AND I
THINK THERE WERE THREE OPTIONS.
THERE WERE TWO THAT I WANTED.
CLARIFICATION. WE CAN SUBMIT A
NEW SET OF BENEFITS, OR WE CAN
JUST REPLACE SOME OF THEM.
CORRECT? YES. USING OTHER STATES
, IS THERE A MAX AMOUNT OF
BENEFITS WE CAN INCLUDE? THAT'S
A FANTASTIC QUESTION. I DON'T
THINK SO. BUT I'LL TURN IT OVER
TO I'M SARAH REAM. I'M THE CHIEF
COUNSEL FOR THE DMHC, SO THERE'S
NOT A MAXIMUM AMOUNT OF
BENEFITS, BUT THERE'S A
GENEROSITY LIMIT. THERE'S A THE
SET OF BENEFITS WHEN TAKEN
TOGETHER, THERE'S A FLOOR WHICH
IS SET BY LOOKING AT THE LEAST
GENEROUS PLAN, IN TYPICAL PLAN
IN THE STATE. AND THEN THERE'S A
CEILING, WHICH IS THE MOST
GENEROUS TYPICAL PLAN. SO THE
VALUE OF YOUR BENEFITS HAS TO
FALL WITHIN THAT RANGE. YOU
CAN'T, YOU KNOW, AND THE PURPOSE
OF THAT CONGRESS DID NOT WANT A
STATES ADOPTING A PLAN THAT IS
GOING, NOR DID THEY WANT. THEY
WERE MINDFUL OF COST AND
PREMIUMS AND PREMIUMS RISING. SO
THEY ALSO DID NOT WANT A BENEFIT
PLAN THAT JUST WAS THE SKY'S THE
LIMIT. SO YOU HAVE PARAMETER
DÍAS AND YOU HAVE MOVEMENT
WITHIN THOSE PARAMETERS. BUT YOU
HAVE TO STAY WITHIN THOSE
PARAMETERS OKAY. AND THEN YOU
MENTIONED KAISER. IS THAT ONE OF
THE LOWER. IT'S A IT'S A FAIRLY
GENEROUS PLAN. BUT THAT'S OUR
CURRENT BENCHMARK. IT'S BEEN OUR
BENCHMARK. GOT IT. OKAY. WELL I
JUST YOU KNOW FOR THE RECORD, I
KNOW I MENTIONED HEARING AIDS,
INFERTILITY SERVICES. I WOULD WE
NEED TO INCLUDE THAT. WE'RE SO
BEHIND. IT'S DISCRIMINATORY.
WE'RE BEHIND 14 OTHER STATES ON
COVERAGE EXPANSION OF COVERAGE
OF THIS, SO THREE THINGS I WANT
TO SAY THAT I, I WOULD PUSH FOR
AND ARE THE THREE ITEMS THAT YOU
MENTIONED TODAY THAT ISN'T
COVERED BY KAISER, IT'S CAIRO
HEARING AIDS AND FERTILITY
SERVICES, BUT IF I WOULD RANK
THEM, HEARING AIDS WOULD BE
NUMBER ONE. AND THEN INFERTILITY
AND THEN CAIRO, THOSE ARE THE
THINGS I WOULD PUT MY HAT ON TO
ENSURE THAT WE INCLUDE IN
BENEFITS. THANK YOU. ANY OTHER
COMMENTS? MEMBER COLLEAGUES
SEEING NONE, SENATOR. MR. CHAIR,
WOULD YOU LIKE TO CLOSE? WELL,
LET ME JUST SAY I'M COMMITTED AS
WE MOVE THROUGH THE PROCESS AND
WE HAVE THE STAKEHOLDER
CONVERSATIONS AND CONVERSATIONS
WITH THE ADMINISTRATION AND THE
ASSEMBLY ON THE CONTENTS OF THIS
BILL TO KEEP MEMBERS OF THIS
HEALTH COMMITTEE, SPECIFICALLY
APPRIZED OF WHAT'S GOING ON AND
WHAT THE TIMELINE IS, WE WILL
HAVE AN INFORMATIONAL HEARING
ASSUMING THE BILL MOVES FORWARD
AND THERE'S SOMETHING TO REPORT.
AND AT THE END OF THE PROCESS,
IF IT'S DURING MY TIME HERE, WE
WILL BRING THE BILL BACK TO THIS
COMMITTEE SO THAT YOU'LL HAVE
ANOTHER LOOK AT IT WITH MORE
INFORMATION IN IT, AND YOU'LL
HAVE ANOTHER OPPORTUNITY TO VOTE
EITHER UP OR DOWN OR NOT VOTE.
AND THAT'S MY COMMITMENT. SO AT
THIS POINT, SENATOR MENJIVAR,
SHE'S GOING TO MAKE MY CLOTHES
FOR ME. I THINK, MADAM CHAIR, I
JUST I JUST THINK I WANT TO MAKE
SURE WE ALL UNDERSTAND HOW
IMPORTANT THIS IS, THIS IS SO
HUGE. I THINK, NICK, YOU KNOW,
MENTIONED THIS, THAT WE ALWAYS
BRING UP BILLS OF ADDED MANDATES
AND ONE OFFS. THIS IS OUR
OPPORTUNITY TO REALLY LOOK AT
ALL THESE ISSUES THAT WE'VE
LOOKED TO CREATE MANDATES AND TO
GROUP UNDER THIS, NEW, HB Â. HB
YES, I JUST WANT TO MAKE SURE
EVERYONE REALLY UNDERSTAND. I
WISH THE WHOLE COMMITTEE WAS
HERE TO REALLY HEAR THIS,
BECAUSE THIS IS A GREAT
OPPORTUNITY FOR US TO CLOSE THE
GAPS ON A LOT OF BENEFITS. I
JUST WANT PEOPLE TO REALLY
UNDERSTAND HOW IMPORTANT THIS
MATTER IS, IS THAT YOU'RE CLOSE,
MADAM CHAIR? I COULD NOT HAVE
DONE A BETTER JOB OF CLOSING.
THAT'S WHY I LOVE MY BUDGET.
SUBCOMMITTEE CHAIR. RESPECTFULLY
ASK, CAN I VOTE AT THE
APPROPRIATE TIME? THANK YOU. DO
I, IS THERE A MOTION? A MOTION
BY SENATOR MENGIBAR. THIS IS Dð
PASS AND REFER TO THE COMMITTEE
ON APPROPRIATION. PLEASE CALL
FOR A VOTE. SENATOR ROTH, A ROTH
. AYE. WHEN I WHEN I GLASER I
GLASER I GONZALEZ. GROVE
HURTADO. HURTADO I LIMÓN
MENGIBAR I MENGIBAR I RUBIO.
SMALLWOOD CUEVAS I SMALLWOOD.
CUEVAS I WIENER. SO 60160 WILL
KEEP THE ROLL CALL OPEN. THANK
YOU, MADAM CHAIR. AND MEMBERS.
I'M SORRY. I FEEL LIKE YOU LIKE.
GET THAT OUT OF.
LET'S GO AHEAD AND, TAKE THE
TAKE UP THE CONSENT CALENDAR,
CONSENT CALENDAR IS ITEM NUMBER
CONSISTS OF ITEM NUMBER TWO,
SENATE BILL 910 WITH AMENDMENTS.
ITEM NUMBER FOR SENATE BILL 963
WITH AMENDMENTS. ITEM NUMBER
SIX. SENATE BILL 1082 AMENDMENTS
BEING TAKEN IN HUMAN SERVICES.
ITEM NUMBER 11. SENATE BILL
1252. ITEM 12. SENATE BILL 1257
WITH AMENDMENTS. ITEM 13. SENATE
BILL 1319. ITEM NUMBER 14.
SENATE BILL 1320, WITH
AMENDMENTS AND ITEM NUMBER 16.
SENATE BILL 1442. IS THERE A
MOTION? CONSENT CALENDAR.
SENATOR GLAZER MOVES THE BILL.
PLEASE CALL THE ROLL. HURTADO.
OH, EXCUSE ME. LET'S CORRECT IT.
SENATOR HURTADO MOVES THE BILL.
THEY'RE FIGHTING OVER IT NOW.
PLEASE CALL THE ROLL. SENATOR
ROTH. AYE. ROTH. I WHEN I WHEN I
GLASER. GLASER I GONZALEZ.
GROVE. HURTADO HURTADO I LIMÓN.
MENGIBAR MENGIBAR. I RUBIO.
SMALLWOOD CUEVAS. SMALLWOOD.
CUEVAS I WIENER. CONSENT.
CALENDAR. THE VOTE IS SIX ZERO.
WILL HOLD THE ROLL OPEN FOR
ABSENT MEMBERS AS. SENATOR
UMBERG, YOU ARE HERE ON ITEM
NUMBER THREE. SENATE BILL 913,
SUBSTANCE USE DISORDER TREATMENT
FACILITIES. PLEASE PROCEED WHEN
READY. THANK YOU, MR. CHAIR AND
MEMBERS. AND A SPECIAL THANK
YOU. YOU AND I HAVE ENGAGED ON
THIS AND TO REYES DÍAS ALSO FOR
YOUR ASSISTANCE. LET ME BEGIN BY
SAYING THAT WE ARE TAKING
SIGNIFICANT AMENDMENTS. MOST
SIGNIFICANTLY, THE PORTIONS OF
THE BILL THAT RESPOND TO SOBER
LIVING HOMES AND FACILITIES THAT
HAS NOW BEEN STRUCK FROM THE
BILL, WE ARE COMMITTED TO TAKING
OTHER AMENDMENTS AS THIS BILL
SHOULD PROCEED OUT OF THIS OUT
OF THIS COMMITTEE WITH RESPECT
TO, FOR EXAMPLE, WHO CAN MAKE A
SITE VISIT. WE ORIGINALLY SAID
CITY ATTORNEYS. AS DISTRICT
ATTORNEYS, WE ELIMINATE DISTRICT
ATTORNEYS AS, THESE AMENDMENTS
ARE TAKEN IN RESPONSE TO
CONCERNS RAISED BY THE COMMITTEE
. SO WHAT THIS BILL NOW CONCERNS
US ARE SUBSTANCE USE DISORDER
TREATMENT FACILITIES. THIS IS A
PARTICULARLY ACUTE ISSUE IN
SOUTHERN CALIFORNIA IN AN AREA
KNOWN AS THE REHAB RIVIERA. I
THINK MEMBERS MAY BE FAMILIAR
WITH THE ISSUE CONCERNING REHAB
FACILITIES THAT ENGAGE IN
PATIENT BROKERING, ENGAGE IN
RECRUITING FOLKS TO COME TO THAT
TREATMENT FACILITY. AND ONCE
THEIR INSURANCE RUNS OUT, GOING
AHEAD AND RELEASING THEM
BASICALLY TO THE STREET, SB 913
WOULD AUGMENT SUBSTANCE ABUSE
TREATMENT REGULATION EFFORTS BY
LICENSING EFFORTS, LICENSED
LICENSING BY REQUIRING THE
DEPARTMENT OF HEALTH CARE
SERVICES TO ADOPT A PROCESS THAT
WOULD ALLOW CITIES TO REQUEST
APPROVAL TO CONDUCT SITE VISITS.
IN OTHER WORDS, THE DEPARTMENT
OF HEALTH CARE SERVICES WOULD
NEED TO PROVIDE ITS CONSENT FOR
A CITY ATTORNEY TO MAKE A SITE
VISIT TO SEE WHETHER OR NOT THAT
FACILITY IS ENGAGED IN UNLAWFUL
ACTIVITY. FOR EXAMPLE, PATIENT
BROKERING, IT WOULD ALSO ALLOW A
SITE VISIT SO THAT THE CITY
ATTORNEY AND OR DCH, C.H, CAN
DETERMINE WHETHER OR NOT THERE
ARE OTHER VIOLATIONS, WE WOULD
NOT PERMIT THE CITY ATTORNEY TO
INSPECT, SEARCH ANY AREA WHERE
AN INDIVIDUAL RESIDENT HAS AN
EXPECTATION OF PRIVACY. THIS
DOES NOT GRANT ANY ADDITIONAL
AUTHORITY TO A CITY ATTORNEY
THAT IS NOT ALREADY HELD BY THE
DEPARTMENT OF HEALTH CARE
SERVICES, WE'LL CONTINUE TO WORK
ON AMENDMENTS. AND WITH THAT, I
URGE AN AYE VOTE. WE HAVE, OUR
WITNESS, SENATOR, AS SHE IS
COMING FORWARD, YOU KNOW, MY
POLICY HERE IS THE COMMITTEE
VOTES ON THE BILL IN PRINT. SO
IS YOUR OPENING DESCRIBING THE
BILL IN PRINT, OR IS IT
DESCRIBING WHAT YOU'RE GOING TO
DO WITH IT? IT'S DESCRIBING
AMENDMENTS THAT WE ARE
COMMITTING TO TAKE SHOULD THIS
BILL MOVE OUT OF COMMITTEE. OKAY
AND, YOU KNOW, THE LET ME LET ME
JUST SAY THIS. WHAT WE VOTE ON
HERE IS THE BILL IN PRINT. BUT
IT'S OKAY TO TELL PEOPLE WHAT
YOU'RE GOING TO DO WITH IT. AND
THAT'S FINE. IT'S TOUGH TO
ANALYZE IT WHEN WE DON'T HAVE A
OPPORTUNITY TO LOOK AT IT, BUT
YES, AND I UNDERSTAND THAT. AND
I, I'M GRATEFUL FOR THE
COMMITTEE'S STAFF AND THEIR
FLEXIBILITY. TÊ I RECOGNIZE THAT
WE MAY HAVE CONFUSED, CREATED
SOME CONFUSION. AND TO THE
EXTENT THAT WE HAVE CREATED ANY
CONFUSION BY REFERENCE TO, FOR
EXAMPLE, SOBER LIVING HOMES THAT
ARE LICENSED OR UNLICENSED AS
YOU POINT OUT, MR. CHAIR,
EARLIER TODAY THAT BY DEFINITION
, SOBER LIVING HOMES ARE NOT
LICENSED. THANK YOU. I DIDN'T
MEAN TO INTERRUPT. MA'AM, PLEASE
IDENTIFY YOURSELF FOR THE
RECORD, AND PLEASE PROCEED WHEN
YOU'RE READY. THANK YOU. SO
MUCH. GOOD AFTERNOON, CHAIR AND
MEMBERS. MY NAME IS CAROLINE
GRINDER, AND I'M HERE ON BEHALF
OF THE LEAGUE OF CALIFORNIA
CITIES, WHICH IS PROUD TO
SPONSOR SB 913 RESIDENTIAL
RECOVERY HOUSING PROVIDES A WIDE
RANGE OF BENEFITS TO SOME OF
CALIFORNIA'S MOST VULNERABLE
RESIDENTS, AND IT'S CRITICAL
THAT THEIR NEEDS ARE PRIORITIZED
OVER PROFITS. THAT'S WHY
COMPLIANCE WITH STATE LICENSING
LAWS ADMINISTERED THROUGH THE
DEPARTMENT OF HEALTH CARE
SERVICES IS ESSENTIAL TO
SAFEGUARDING RESIDENTS
WELL-BEING AND MAINTAINING
QUALITY CARE. SB NINE THIRTEEN'S
INTENT IS TO ENHANCE THE
OVERSIGHT AND ENFORCEMENT OF
STATE LICENSING LAWS FOR ALCOHOL
AND DRUG TREATMENT FACILITIES,
WITH CITIES AS PARTNERS,
SPECIFICALLY, 913 WOULD AUGMENT
STATE LICENSING EFFORTS BY
REQUIRING DCS TO ADOPT A PROCESS
THAT WOULD ALLOW CITIES TO
REQUEST APPROVAL, TO CONDUCT
SITE VISITS AND ENFORCE EXISTING
STATE LICENSING LAWS. CITIES
WOULD BE ABLE TO REQUEST THIS
APPROVAL BASED ON THE CITY'S
REASONABLE BELIEF THAT THE
FACILITY IS OPERATING OUT OF
COMPLIANCE WITH STATE LICENSING
LAWS. TO BE REALLY CLEAR, SB 913
WOULD ESTABLISH A PROCESS FOR
CITIES TO WORK WITH THE
DEPARTMENT TO ENSURE COMPLIANCE
AND WOULD REQUIRE THE
DEPARTMENT'S APPROVAL PRIOR TO
ANY INSPECTION OR ENFORCEMENT
ACTION. IN NO WAY DO WE INTEND
FOR SB 913 TO ALLOW CITIES TO
CONDUCT THESE SITE VISITS OR
TAKE ENFORCEMENT ACTION WITHOUT
THE DIRECTION AND APPROVAL OF
THE DEPARTMENT. THIS MEASURE
ALSO DOES NOT CREATE A NEW
PROCESS OUTSIDE THE SCOPE OF
WHAT DCS IS ALREADY AUTHORIZED
TO DO. CITIES ARE THE CLOSEST
LEVEL OF GOVERNMENT TO THE
CONSTITUENTS THEY SERVE AND ARE
THEREFORE WELL POSITIONED TO
RESPOND PROMPTLY TO EMERGING
ISSUES AND CONCERNS IN THEIR
COMMUNITIES, ALLOWING CITIES TO
PARTNER WITH THE STATE TO
CONDUCT THESE SITE INSPECTIONS
AND ENFORCE STATE LICENSING LAWS
WILL ENSURE SWIFT ACTION TO
ADDRESS VIOLATIONS, ENSURE
COMPLIANCE, AND PROTECT PUBLIC
HEALTH AND SAFETY BY
COLLABORATING WITH CITIES, THE
STATE CAN SUPPLEMENT ITS
REGULATORY EFFORTS BY LEVERAGING
LOCAL RESOURCES. ACCORDING TO
DHCS, THE AVERAGE AMOUNT OF TIME
IT TAKES TO CLOSE A SINGLE
COMPLAINT IS AROUND FOUR MONTHS,
AND THEY RECEIVE NEARLY 600 OF
THESE PER YEAR. AS THE NUMBER OF
FACILITIES CONTINUES TO RISE IN
CALIFORNIA. IN RESPONSE TO THE
STATE'S SUBSTANCE USE CRISIS,
THE DEPARTMENT FACES A MAJOR
HURDLE IN BEING ABLE TO MONITOR
AND REGULATE THESE FACILITIES.
CITIES CAN BE A VALUABLE PARTNER
IN ENSURING THAT THE DEPARTMENT
IS AWARE OF VIOLATIONS, AND
ENSURING SWIFT ACTION IS TAKEN
FOR THOSE REASONS, WE BELIEVE
913 WOULD HELP MEET OUR SHARED
GOALS OF ENSURING TREATMENT
FACILITIES MEET STANDARDS FOR
PATIENT CARE, WHICH IS A CENTRAL
PART OF EFFECTIVE TREATMENT
OUTCOMES AND COMMUNITY
WELL-BEING. CAL CITIES HAS A
LONG HISTORY OF ATTEMPTING TO
PASS LEGISLATION TO ADDRESS THE
CONCERNS RAISED BY CITIES ABOUT
THE NEED FOR INCREASED
OVERSIGHT, TRANSPARENCY AND
ACCOUNTABILITY FOR DRUG AND
ALCOHOL RECOVERY FACILITIES.
CITIES ARE FOCUSED ON ENACTING
LEGISLATIVE SOLUTIONS THAT
SAFEGUARD EVERY PERSON'S
WELL-BEING AND CARE. WE BELIEVE
THAT 913 IS A STEP FORWARD IN
PROTECTING RESIDENTS AND
UPHOLDING THE INTEGRITY OF
TREATMENT FACILITIES. WE COMMIT
TO CONTINUING TO WORK WITH THE
AUTHOR AND ANY OPPOSITION TO
ADDRESS ANY CONCERNS THAT ARE
RAISED. I THINK WE SHARE THE
SAME GOAL OF ENSURING THAT BAD
ACTORS ARE UNABLE TO SUBVERT
STATE OVERSIGHT, TO TAKE
ADVANTAGE OF VULNERABLE
POPULATIONS. SO WITH THAT, WE
URGE THE COMMITTEE SUPPORT OF
THIS LEGISLATION SO WE CAN
CONTINUE TO HAVE THOSE
CONVERSATIONS THIS YEAR. THANK
YOU. BEFORE WE START WITH THE
OTHER SUPPORT WITNESSES, LET ME
JUST GET SOME CLARIFICATION. I
REALIZE I SAID WE'RE GOING TO
VOTE THE BILL IN PRINT AND WE
ARE IN THE BILL IN PRINT
INCLUDES SOBER LIVING
FACILITIES. BUT FOR THE MOMENT,
I'M GOING TO IGNORE THAT. DOES
THE LEAGUE CONTEND THAT THAT
SINCE WE'RE AUTHORIZING AS A
STATE IN OTHER WORDS, DELEGATING
, ENFORCEMENT AUTHORITY TO LOCAL
OFFICIALS, THE CITY ATTORNEY OR
A DISTRICT ATTORNEY, WHATEVER,
OF HEALTH FACILITIES? BECAUSE
THAT'S WHAT WE'RE TALKING ABOUT
HERE, THAT IF WE HAVE
NEIGHBORHOOD OR CLIENT CUSTOMER
PATIENT COMPLAINTS ABOUT SNFS
SKILLED NURSING FACILITIES, OR
PATIENT COMPLAINTS ABOUT
HOSPITALS, THAT THAT THE NATURAL
COURSE OF ACTION HERE WOULD
EXTEND ALSO TO AUTHORIZING CITY
ATTORNEYS OR DISTRICT ATTORNEYS
TO CONDUCT ENFORCEMENT
INSPECTIONS OF OTHER TYPES OF
HEALTH FACILITIES. I THINK OUR
INTENTION HERE IS THAT THAT
PROCESS WOULD BE THROUGH THE
DEPARTMENT. RIGHT. SO I DON'T
THINK WE'RE ANTICIPATING THAT
CITIES WOULD WANT TO TAKE ON
THAT ENFORCEMENT ACTION FOR ALL
TYPES OF DIFFERENT KINDS OF
GROUP HOME FACILITIES, BUT THAT
CITIES COULD PARTNER WITH THE
DEPARTMENT WHERE THERE IS A
ENFORCEMENT PROBLEM TO ENSURE
THAT WE'RE RESPONDING SWIFTLY
AND ENSURE THAT WE ARE AVAILABLE
AS A RESOURCE TO THE DEPARTMENT
WHEN THERE'S DIFFICULTY DOING
THESE INSPECTIONS AND PROVIDING
THAT OVERSIGHT. WE FEEL THERE'S
AN ACUTE PROBLEM WITH ALCOHOL
AND DRUG TREATMENT FACILITIES.
BUT I THINK THAT WE FORESEE THAT
IF THERE WERE OTHER PROCESSES TO
WORK WITH DEPARTMENTS, WE'D BE
OPEN TO THAT. AND TO THE AUTHOR,
SINCE WE'RE TALKING ABOUT
RESIDENTIAL TREATMENT FACILITIES
WHERE TREATMENT IS ONGOING AND
IT'S A HEALTH FACILITY, DON'T
YOU ANTICIPATE PROBLEMS
ASSOCIATED WITH HIPAA
VIOLATIONS? YOU'RE DEALING WITH
PATIENTS AND PATIENT RECORDS AND
THE WHOLE PURPOSE FOR GOING IN,
I ASSUME, WOULD BE DETERMINED TO
BE TO DETERMINE THE NATURE AND
THE SCOPE OF THE TREATMENT
PROVIDED AND WHETHER IT'S WITHIN
THE LICENSE. AND IN DOING SO,
WOULDN'T YOU BE OF NECESSITY
REQUIRED ACQUIRING THE LOOK OF
THE USE OF AND THE REVIEW OF
PATIENT RECORDS IN THESE
TREATMENT FACILITIES? SO A
COUPLE OF POINTS. ONE IS THAT
WHATEVER AUTHORIZATION IS, THE
AUTHORIZATION THAT THE
DEPARTMENT OF HEALTH CARE
SERVICES CURRENTLY HAS. SO TO
THE EXTENT THE DEPARTMENT OF
HEALTH CARE SERVICES PROHIBITED,
FOR EXAMPLE, FROM EXAMINING
PATIENT RECORDS, EXAMINING AREAS
WHERE THERE'S AN EXPECTATION OF
PRIVACY THAT THOSE PROHIBITIONS
WOULD APPLY TO THE CITY
ATTORNEY, FOR EXAMPLE, ON A SITE
VISIT. WELL, THAT'S THE WHOLE
THAT'S EVERYTHING INSIDE THE
RESIDENTIAL TREATMENT FACILITY
OTHER THAN THE ADMINISTRATIVE
OFFICE, BECAUSE YOU'RE DEALING
WITH PATIENTS, RIGHT. PATIENT
IDENTITY, PATIENT SITUATION,
PATIENT TREATMENT COURSE OF
ACTION. SO IF, FOR EXAMPLE, YOU
SEE THAT THAT THERE ARE, YOU
KNOW, 20 PATIENTS IN A PLACE
THAT'S AUTHORIZED TO TREAT SIX
THAT'S NOT AN INVASION OF FOR
EXAMPLE, AN INDIVIDUAL'S PRIVACY
INTEREST IS CONTAINED IN HIPAA
NUMBER ONE. NUMBER TWO, IF YOU
SEE, FOR EXAMPLE, THAT THERE'S
DRUG USE, THAT THERE'S NEEDLES
BEING STREWN ABOUT THAT IS YOU
HAVE NO EXPECTATION OF PRIVACY
IF YOU LEAVE NEEDLES SOMEWHERE
ON THE PREMISES. SO IF YOU SEE
THAT THAT FOLKS ARE ACTIVELY
USING DRUGS, YOU DON'T NEED TO
INVADE THEIR PRIVACY. BUT IF YOU
CAN SEE THAT THAT'S GOING ON,
THEN THAT BEARS FURTHER
INVESTIGATION. AND SO I TAKE
YOUR POINT AND WE'LL MAKE SURE,
MR. CHAIR, THAT THAT ANY SITE
INSPECTION IS WITHIN THE BOUNDS
OF WHAT'S CURRENTLY AUTHORIZED
BY DCS TO INSPECT OR VISIT. AND
I ASSUME THEN YOUR BILL, WHETHER
THE ONE IN PRINT OR THE ONE THAT
YOU THINK IS GOING TO BE IN
PRINT, WOULD BE PERMISSIVE. SO
IF YOU MADE A REQUEST, I ASSUME
THE DEPARTMENT OF HEALTH CARE
SERVICES COULD DENY THE REQUEST
WITHOUT RECOURSE. THAT'S CORRECT
. OKAY. WELL, LET'S CONTINUE THE
PROCESS. I'M SORRY, COLLEAGUES,
LET'S TAKE THE SUPPORT
WITNESSES, I APOLOGIZE. SUPPORT
WITNESSES, PLEASE. NICOLE
WORTMANN, ON BEHALF OF THE
ORANGE COUNTY BOARD OF
SUPERVISORS IN SUPPORT OF THE
BILL IN PRINT. AND THEY WILL
EVALUATE THE BILL AS IT MAY BE
IN PRINT AT A FUTURE DATE. THANK
YOU. MA'AM. ANY OTHER SUPPORT
WITNESSES? ANY OPPOSITION
WITNESSES?
GOOD AFTERNOON, HONORABLE CHAIR
AND MEMBERS, SHERRY DALEY WITH
THE CALIFORNIA CONSORTIUM OF
ADDICTION PROGRAMS AND
PROFESSIONALS HERE TODAY IN
RESPECTFUL OPPOSITION TO SB 913,
WHICH AIMS TO SHARE STATE
AUTHORITY FOR REGULATING ALCOHOL
AND DRUG TREATMENT PROGRAMS WITH
LOCAL GOVERNMENTS. HAPPY TO HEAR
THAT THERE HAS BEEN SOME
MOVEMENT ON CHANGING THE
DIRECTION OF THE BILL. HAVEN'T
SEEN ANYTHING IN PRINT, SO
UNFORTUNATELY I WILL HAVE TO GO
WITH WHAT IS IN PRINT REGARDING
MY COMMENTS TODAY, AFTER WHAT I
CONSIDERED A FRUITFUL, FRUITFUL
CONVERSATIONS WITH THE BILL'S
SPONSORS, WE WERE UNABLE TO COME
TO A CHORD REGARDING HOW TO
IMPROVE ENFORCEMENT AGAINST
UNLICENSED PROVISION OF
ADDICTION TREATMENT SERVICES IN
THE ORANGE COUNTY AREA. ALTHOUGH
WE PROVIDED SEVERAL SPECIFIC
SETS OF LANGUAGE TO REMEDY SOME
OF THE LOOPHOLES, WE SEE IN
STATUTES WITH REGARD TO
LICENSING OF TREATMENT PROGRAMS
TO THE LEAGUE, NONE WERE
ACCEPTED. WE BELIEVE THAT ALL
THOSE SENATOR UMBERG HAS SAFETY
AND CONSUMER PROTECTION AT
HEART. WE DO NOT BELIEVE THE
SPONSORS DO. WHAT THEY WANT IS
TO APPEASE NIMBYS IN ORANGE
COUNTY, WHO HAVE WAGED A LEGAL
AND PUBLIC RELATIONS BATTLE
AGAINST RECOVERY RESIDENCES,
OTHERWISE KNOWN AS SOBER LIVING,
FOR OVER TEN YEARS. IN DECEMBER,
THE LEAGUE OF CITIES ANNOUNCED
IT SUPPORTED THE GOVERNOR'S
PROPOSITION ONE, WHICH AIMS TO
EXPAND WRAPAROUND SERVICES,
INCLUDING HOUSING FOR PEOPLE
WITH MENTAL HEALTH AND SUBSTANCE
USE DISORDER DIAGNOSES.
FOLLOWING THE LEAGUE'S SUPPORT
OF PROP ONE, ELECTED OFFICIALS
AND NEWPORT BEACH, HUNTINGTON
BEACH AND ORANGE OPTED TO
WITHDRAW THEIR CITY'S MEMBERSHIP
IN THE LEAGUE, AND OTHERS ARE
CONSIDERING DOING SO AS WELL. LO
AND BEHOLD, WE NOW HAVE A RASH
OF ANTI SOBER LIVING BILLS PUT
FORWARD BY THE LEAGUE TO APPEASE
THEIR MEMBERS AND BEND TO THE
WILL OF THOSE WHO STRIVE TO
DISCRIMINATE AGAINST THOSE IN
RECOVERY. THE VERY PEOPLE WHO
HAVE DONE THE HARD WORK OF
LEARNING HOW TO LIVE DIFFERENTLY
AND TO BECOME CONTRIBUTING
MEMBERS OF THEIR COMMUNITIES. MY
ORGANIZATION ADVOCATED FOR CLEAR
GUIDANCE FROM THE DEPARTMENT OF
HOUSING AND COMMUNITY
DEVELOPMENT CONCERNING GROUP
LIVING HOMES AND THE INCREASING
HARASSMENT WE ARE SEEING FROM
THE ENTITIES WHO ARE NOW HERE
TODAY ASKING YOU TO GIVE THEM
UNPRECEDENTED AUTHORITY TO
INVADE PEOPLE'S HOMES AND IMPOSE
JUDGMENT ON WHAT THEY THINK THEY
HAVE FOUND WITHIN THEM. THAT
GUIDANCE WAS RELEASED IN A
TECHNICAL ADVISORY THAT IS
REFERENCED IN THE ANALYSIS FOR
THE BILL. IT SPECIFICALLY STATES
THAT LOCAL GOVERNMENT CANNOT
REQUIRE RECOVERY RESIDENCES TO
OBTAIN PERMITS TO BE REGULATED
IN ANY MEANS THAT IS NOT APPLIED
TO OTHER SINGLE FAMILY
HOUSEHOLDS IN A JURISDICTION.
ESSENTIALLY, THIS GUIDANCE
BARRED LOCAL GOVERNMENT FROM
REGULATING RECOVERY HOUSING OUT
OF EXISTENCE. IN RESPONSE, SB
913 PROPOSES A NEW WAY TO ALLOW
LOCAL GOVERNMENT TO INFRINGE ON
THE HOUSING RIGHTS OF PEOPLE
PROTECTED BY THE AMERICANS WITH
DISABILITIES ACT. IT WOULD ALLOW
LOCAL GOVERNMENT OFFICIALS TO
MAKE UNANNOUNCED VISITS TO
PRIVATE RESIDENCES. THEY BELIEVE
ARE IN VIOLATION OF LICENSING
LAWS. THIS WOULD BE EQUIVALENT
TO ALLOWING WARRANTLESS SEARCHES
OF PEOPLE'S HOMES. HCD HAS BEEN
VERY CLEAR ON WHAT CANNOT BE
DONE WITH REGARD TO GROUP HOMES.
YET THESE LOCAL GOVERNMENTS
THROUGHOUT ORANGE COUNTY
CONTINUE TO HARASS CITIZENS AND
THUMB THEIR NOSES AT STATE LAWS
AND THE CONSTITUTION SIMPLY PUT,
THEIR TRACK RECORD ON THIS ISSUE
PROVES THAT THESE ENTITIES WOULD
IGNORE ANY RULES PRESENTED TO
THEM AND CONTINUE DOWN A PATH OF
DISCRIMINATION. BUT WITH THE
STATE'S BLESSING, SHOULD THIS
MEASURE PASS? IN ADDITION TO THE
INHERENT DISCRIMINATORY NATURE
OF THIS POLICY LAST YEAR'S
BUDGET ACTIONS MAKE IT
UNWARRANTED. THE DEPARTMENT OF
HEALTH CARE SERVICES ASKED FOR
AND RECEIVED 12 ADDITIONAL
PERMANENT POSITIONS FOR ONGOING
AND CORRESPONDING STATUTORY
CHANGES TO STRENGTHEN COMPLIANCE
OVERSIGHT FOR SUBSTANCE USE
DISORDER LICENSURE ENFORCEMENT.
JUST LAST YEAR, THIS INCLUDED.
THE REQUEST INCLUDED AN ADDITION
OF A FIELD OFFICE IN SANTA ANA,
WHICH ADDS ADDITIONAL STAFFING
TO WORK IN THE IN SOUTHERN
CALIFORNIA, ENHANCE OVERSIGHT IN
THE REGION. IT INCLUDES AN AGPA
IN THE NEW OFFICE TO SPEED THE
COMPLAINT RESPONSE AND FUNDING
TO POST ALL COMPLAINT AND
COMPLIANCE REPORTS ON THE DHCS
WEBSITE. THE NEW OFFICE WILL
ACHIEVE THE STATED GOALS OF THE
BILL WITHOUT CREATING INVASIVE
LOCAL GOVERNMENT INVOLVEMENT
OVER LICENSING INVESTIGATIONS.
AS ALWAYS, I THANK SENATOR FOR
HIS CONTINUOUS EFFORTS TO MAKE
ALCOHOL AND DRUG TREATMENT MORE
ACCESSIBLE AND HIGHER QUALITY,
AND I LOOK FORWARD TO WORKING
WITH HIM AND HIS STAFF ON FUTURE
LEGISLATION IN THIS AREA IN THE
COMING MONTHS. WE ARE TOTALLY ON
BOARD TO WORK ON ANY LEGISLATION
THAT ADDRESSES THE ACUTE PROBLEM
OF PATIENT BROKERING.
UNFORTUNATELY THIS BILL DOES NOT
IN ITS CURRENT FORM. THANK YOU.
THANK YOU MA'AM. ANY OTHER
OPPOSITION WITNESSES? JOHN
DREBINGER WITH THE STEINBERG
INSTITUTE IN RESPECTFUL
OPPOSITION. ANY OTHER OPPOSITION
WITNESSES? SEEING NONE. WE'LL
BRING IT BACK TO THE DAIS. AND
MY COLLEAGUES, LET ME JUST START
OFF WITH THE LEAGUE, YOU KNOW,
AND THE AUTHOR, SINCE 2021, IT
APPEARS TO ME LOOKING AT BUDGET
CHANGE PROPOSALS THAT WE AS THE
STATE HAVE INVESTED, ABOUT $5
MILLION OR MORE, IN ADDITIONAL
RESOURCES, REYES, I ASSUME,
PRIMARILY DIRECTED TO ORANGE
COUNTY, MY TO DEAL WITH
INVESTIGATION OF COMPLAINTS,
LICENSING ISSUES. WE DON'T
LICENSE SOBER LIVING FACILITY,
BUT WE DO RESPOND TO COMPLAINTS
OF UNLICENSED ACTIVITY. THERE
AND ANYWHERE ELSE. FRANKLY, IN
THIS SPACE, IS IT THE LEAGUE'S
POSITION THAT THE AND IT'S ALSO
MY UNDERSTANDING THAT THERE IS A
SATELLITE OFFICE OF DHC, THE
DEPARTMENT OR DCS. RIGHT.
DEPARTMENT OF HEALTH CARE
SERVICES. I'M TIRED, IN SANTA
ANA WITH INSPECTORS THERE. DOES
THE LEAGUE CONTEND THAT THE
INSPECTION OF LICENSED
RESIDENTIAL TREATMENT FACILITIES
IS HAS BEEN INADEQUATE AS
OPPOSED TO THE CONTINUING DEBATE
AND CONCERN OVER SOBER LIVING
FACILITIES? I THINK WE BELIEVE
THAT THOSE INVESTMENTS AND THE
OPENING OF THAT OFFICE ARE IN
RESPONSE TO THE FACT THAT THERE
IS A DISPROPORTIONATE AMOUNT OF
THESE FACILITIES WITHIN ORANGE
COUNTY AND SOUTHERN CALIFORNIA
GENERALLY. THE FACT THAT A LOT
OF THESE STAFF ARE LOCATED IN
SACRAMENTO FOR YEARS CREATED
REAL INEFFICIENCIES IN THE
PROCESS. WE'RE HAPPY TO SEE THAT
THERE'S A RECOGNITION OF THAT IN
THIS INVESTMENT, BUT I THINK IT
DOESN'T CHANGE THE FACT THAT IN
2023, WE'RE STILL FACING THESE
REALLY LENGTHY TIMINGS TO CLOSE
OUT THESE INSPECTIONS. AND I
THINK THAT THAT CONTINUES TO
ALLOW PEOPLE TO FLY UNDER THE
RADAR. AND OUR GOAL IS JUST HOW
DO WE ENSURE THAT THAT
ENFORCEMENT IS ADEQUATE. BUT ONE
OF THE ISSUES IS IF THE CITY
ATTORNEY'S OR THE DISTRICT
ATTORNEY'S ARE LIMITED IN TERMS
OF WHAT THEY CAN LOOK AT,
PATIENT RECORDS, TREATMENT, YOU
KNOW, PROFILES AND THE LIKE,
BECAUSE OF HIPAA, WHICH THEY ARE
, WE RECOGNIZE THAT WE HAVE NO
INTENTION OF CITIES BEING IN ANY
KIND OF VIOLATION OF HIPAA. OUR
GOAL IS THAT THE DEPARTMENT
WOULD SET UP A PROCESS THAT
CITIES WOULD HAVE TO ADHERE TO.
SO WHATEVER THE DEPARTMENT WOULD
DETERMINE THAT CITIES WERE OR
WERE NOT ALLOWED TO DO, WE WANT
CITIES TO HAVE TO COMPLY WITH
THAT. AND THE GOAL IS NOT TO, AS
THE SENATOR MENTIONED EARLIER,
SET CITIES UP IN A POSITION TO
BE IN VIOLATION OF INDIVIDUAL'S
RIGHTS. WELL, AND THE AUTHOR AND
I AND I'LL DIRECT THIS TO THE
AUTHOR HAVE HAD THIS
CONVERSATION, I'M NOT ON THE
JUDICIARY COMMITTEE, BUT I ONCE
WAS A LAWYER. IT SEEMS TO ME
THAT IF THE STATE, THROUGH THE
DEPARTMENT OF HEALTH CARE
SERVICES, DESIGNATES AND
AUTHORIZES SOMEONE TO ACT ON ITS
BEHALF, THAT THEY BECOME THE
AGENT. AND SO THE AUTHOR IS
GOING TO HAVE TO WORK OUT IF
THIS BILL MOVES SOME SORT OF
IMMUNITY SITUATION. SO IF THE
LOCAL AGENTS, WHETHER IT'S A
CITY ATTORNEY OR A DISTRICT
ATTORNEY, VIOLATE THE RULES,
WHETHER THEY'RE FEDERAL OR STATE
, AND SOMEBODY GETS SUED, IT'S
ORANGE COUNTY OR THE CITY OR
BOTH, NOT THE STATE OF
CALIFORNIA, IF THAT'S A REQUEST.
YES. MR. CHAIR, IT IS TO THE
EXTENT THAT SOMEONE WHO IS
CONDUCTING A SITE VISIT EXCEEDS
THEIR AUTHORITY. IT IS MY VIEW
THAT THEY SHOULD BE ON THE HOOK,
AND THE STATE SHOULD NOT BE ON
THE HOOK FOR IT, WE'LL MAKE THAT
CLEAR. IF YOU'D LIKE, I'D
RESPOND TO SOME OF THE OTHER
POINTS THAT HAVE BEEN RAISED.
PLEASE FEEL FREE. AND I WANT TO
MAKE SURE I ALLOW QUESTIONS BY
MY COLLEAGUES. SURE. STOP
DOMINATING THE CONVERSATION.
WELL, I'LL. THAT'S ME. STOP
DOMINATING THE CONVERSATION.
I'LL I'LL RESPOND. SO FIRST OF
ALL, LET ME ADDRESS THE POINT
WITH RESPECT TO SOBER LIVING
HOMES AND FACILITIES AND THE
OPPOSITION DID NOT HAVE AN
OPPORTUNITY TO, BE ABLE TO
RESPOND AS TO THE AMENDMENT
BECAUSE THIS IS OF RECENT
VINTAGE NUMBER ONE, NUMBER TWO
IS THAT THERE MAY BE SOME
FACTUAL DISPUTE AS TO WHAT THE
EXISTENCE IS OF THE DEPARTMENT'S
FACILITY IN SANTA ANA. WE'RE
INFORMED THAT THERE'S BEEN NO
PERMIT ISSUED IN THE LAST COUPLE
OF YEARS FOR ANY FACILITY. AND
WE'RE INFORMED THAT THAT WHILE
THERE MAY BE ADDITIONAL
PERSONNEL TO ADDITIONAL
PERSONNEL, THEY'RE LOCATED HERE
IN SACRAMENTO. BUT I DON'T THINK
THAT ANYONE WOULD DISPUTE THE
ISSUE THAT THAT THERE'S BEEN
VIRTUALLY NO ENFORCEMENT. I
THINK THAT THE DEPARTMENT WOULD
AGREE THAT THE RESOURCES ARE
COMPLETELY INADEQUATE, AT LEAST
AS TO OUR PART OF THE STATE,
THAT THERE'S BEEN VIRTUALLY NO
SITE VISITS, AND ALSO, JUST TO
BE CLEAR, THIS DOESN'T JUST
PERTAIN TO ORANGE COUNTY. THIS
IS THIS THIS WOULD BE A
STATEWIDE, ENFORCEMENT. AND IT
WOULD APPLY STATEWIDE. WELL,
THAT'S EVEN MORE CONCERNING TO
ME, BUT THAT'S OKAY. I MEAN,
WE'RE DEALING WITH A
DEMONSTRATED NEED AND THAT'S ONE
FOR THE STATE TO DELEGATE
AUTHORITY IN A PARTICULAR AREA.
THAT'S ONE THING. BUT TO PASS A
BILL AND I DON'T KNOW WHAT BILL
WE'RE PASSING, BUT TO PASS A
BILL THAT THAT AUTHORIZES
STATEWIDE CITIES AND COUNTIES TO
COME TO THE DEPARTMENT OF HEALTH
CARE SERVICES AND REQUEST
AUTHORITY TO TAKE OVER THE
STATE'S AUTHORITY FOR
ENFORCEMENT OF STATE LAWS AND
REGULATIONS. THAT'S PROBLEMATIC,
BUT THAT'S OKAY. WELL TO
RESPOND, MR. CHAIR, IS THAT,
IT'S NOT THE INTENT THAT THAT
THE CITIES, FOR EXAMPLE, TAKE
OVER THE RESPONSIBILITY. THE
DEPARTMENT HAS RESPONSIBILITY TO
THE EXTENT THAT THE DEPARTMENT
IS DOES NOT HAVE ADEQUATE
CAPACITY, AND THEY PROVIDE THEIR
CONSENT TO, FOR EXAMPLE, A CITY
ATTORNEY TO MAKE MAKE A SITE
VISIT WITH THE PROPER DIRECTION
FROM THE DEPARTMENT THAT THAT
THAT IS THE THAT IS THE INTENT.
SO THAT WE'RE ALL CLEAR, AND
THIS IS AN ISSUE THAT DOESN'T
JUST PERTAIN TO ORANGE COUNTY.
I'M INFORMED THAT THERE ARE MANY
AREAS OF THE STATE WHERE THERE
ARE ISSUES WITH RESPECT TO THESE
TREATMENT FACILITIES. DOES YOUR
BILL PROVIDE A PROCESS? IN OTHER
WORDS, WHAT HAPPENS WHEN THE,
LET'S SAY, A CITY ATTORNEY
EXCEEDS THE CITY ATTORNEY'S
AUTHORITY UNDER THE DELEGATION?
OAN. WHAT'S THE REMEDY? WELL
THE REMEDY WOULD BE JUST LIKE
ANY OTHER, YOU KNOW, FOR EXAMPLE
, 1983 ACTION IF FIRE THEM IF
THE IF WELL, IT'S JUST LIKE ANY
OTHER 1983 ACTION. IF A
GOVERNMENTAL ENTITY INVADES THE
CIVIL RIGHTS OF AN INDIVIDUAL,
THAT INDIVIDUAL HAS A CERTAINLY
RECOURSE. AND AS I INDICATED
BEFORE, WE'LL MAKE CLEAR THAT
THAT RECOURSE WOULD PERTAIN TO
THE ENTITY THAT'S CONDUCTING THE
SITE VISIT. SO FOR EXAMPLE, TO
YOUR POINT, WHETHER THE STATE
WOULD BE RESPONSIBLE FOR A ROGUE
CITY ATTORNEY, THEY SHOULD NOT
AND WOULD NOT BE RESPONSIBLE. IT
WOULD BE THE CITY'S
RESPONSIBILITY. OKAY COLLEAGUES,
I'M GOING TO, SHUT MY MOUTH AND
ALLOW YOU ALL TO HAVE QUESTIONS,
COMMENTS OR CONCERNS. PLEASE
DIRECT THEM TO THE AUTHOR OR THE
LEAD WITNESS. SENATOR NGUYEN.
THANK THANK YOU, MR. CHAIR, I
WANT FIRST SAY THANK YOU TO
SENATOR UMNOT FOR PUTTING
FORWARD THIS BILL. THIS HAS BEEN
AN ONGOING DISCUSSION, NOT JUST
IN ORANGE COUNTY, ORANGE COUNTY
OF, OF THE 200 PLUS FACILITIES
IN CALIFORNIA, 61 OF THEM ARE IN
ORANGE COUNTY, 61 OF THEM ARE IN
LOS ANGELES COUNTY AS WELL. SO
YOU'RE LOOKING AT TWO COUNTIES
IN ORANGE COUNTY IS ONLY 3.2
MILLION PEOPLE, THIS HAS BEEN
THE NUMBER ONE ISSUE THAT LOCAL
GOVERNMENT IN MY DISTRICT. I
REPRESENT HALF OF ORANGE COUNTY
CITIES. THIS IT COULD BE
COASTAL, IT COULD BE INLAND.
DOESN'T MATTER. THIS IS BECOME A
SATURATED PROBLEM IN ORANGE
COUNTY, WE CANNOT GET THE
DEPARTMENT TO LISTEN TO US, TO
HEAR FROM US. THEY'RE NOT COMING
OUT. WE CAN COMPLAIN. WE CAN
COMPLAIN. I MEAN, EVEN THE FACT
THAT, YOU KNOW, WHEN YOU'RE
TALKING ABOUT THE HEALTH CODE
SECTION 15. OH TWO A STATES
THAT, YOU KNOW, THE WHOLE IDEA
OF OVERCONCENTRATION WITHIN
300FT, THAT'S NOT EVEN BEEN
LOOKED AT. THERE'S FACILITIES
WITHIN AND THERE'S MULTIPLE
FACILITIES. AND SO THESE
FACILITY HAS BEEN THIS THIS
ISSUE HAS BEEN AN ONGOING FOR
ALMOST 20 YEARS, NOT JUST IN
ORANGE COUNTY. AND SO, YOU KNOW,
BRINGING THIS FORWARD, WE ALLOW
A FULL DISCUSSION IN THE STATE
LEGISLATIVE BODY THAT HAS NEVER
BEEN THAT HAS NOT HAPPENED FOR
US. AND SO I URGE A SUPPORT OF
THIS SO THAT WE CAN CONTINUE
THAT DISCUSSION, YOU KNOW, I DO
ALSO WANT TO MAKE ANOTHER
COMMENT IS THAT I KNOW THAT ONE
OF THE OPPOSITION WITNESSES SAID
SOMETHING ABOUT THE LEAGUE OF
CITIES, AND I'M NOT HERE TO
DEFEND THE LEAGUE OF CITIES. BUT
YOU MENTIONED MY CITIES. NEWPORT
BEACH, HUNTING BEACH HAVE ALL
JUST LEFT. LEAGUE OF CITIES.
LET'S STICK TO ONE ISSUE AT A
TIME. THAT WAS BECAUSE OF
SOMETHING ELSE. IT'S NOT BECAUSE
OF THE REHAB. BECAUSE IF IT WAS
THE REHAB, ALL THE CITIES WOULD
HAVE LEFT 20 YEARS AGO, YOU
KNOW, THERE'S SO LET'S STICK TO
THAT REASON. AND THAT'S WHAT
THOSE CITIES HAVE STATED WAS
BECAUSE OF PROP ONE ISSUE, NOT
BECAUSE OF NOT DOING THE REHAB,
SO I THINK THAT'S REALLY UNFAIR
TO MAKE THAT COMMENT, AGAINST
THE LEAGUE OF CITIES, THE, SO I
ASK YOU MY QUESTION, MR. CHAIR,
IS TO THE LEAGUE OR OR THE
AUTHOR OR THE SENATOR IS CAN YOU
KIND OF GIVE US A RUNDOWN OF
WHAT HAPPENS WHEN A CITY FILED A
COMPLAINT? BECAUSE I WANT PEOPLE
TO KNOW, WHAT ARE WE DOING?
WHAT? WHY DO WE EVEN NEED TO
HAVE THIS DISCUSSION HERE? WHAT?
I MEAN, IF GARDEN GROVE,
STANTON, WHATEVER CITY FILES A
COMPLAINT TO THE DEPARTMENT,
WHERE DOES THAT GO? AND WHAT
DOES THAT HAPPEN? I REALIZE THIS
SOUNDS FACILE, BUT PRETTY MUCH
NOTHING. THANK YOU. CAN SOMEBODY
TELL ME WHAT WHAT TYPE OF
COMPLAINT? I MEAN, I THINK WE
NEED WE'RE TALKING ABOUT
RESIDENTIAL TREATMENT
FACILITIES. AT LEAST IN WHAT YOU
PROPOSE TO BE THE AMENDED BILL.
AND SO IS THE COMPLAINT THAT
WHAT WHAT'S GOING ON THAT
THERE'S SOMETHING OTHER THAN
LICENSED RESIDENTIAL DRUG
TREATMENT GOING ON IN THE
FACILITY, SENATOR? OR IS IT
SOMETHING ELSE? WELL, I THINK
THERE'S A VARIETY OF COMPLAINTS.
ONE IS, IS THAT THAT THERE
RECRUITING, FOR EXAMPLE,
PATIENTS FROM BEYOND 125 MILES,
WHICH IS CURRENT STATE
REGULATION AND RECRUITING THEM
TO COME TO THE FACILITY TO
BASICALLY USE UP ALL THEIR
INSURANCE AND THEN THEY BOOT
THEM OUT. I THINK THAT'S THE
MOST COMMON COMPLAINT. THERE ARE
OTHER COMPLAINTS ABOUT ABOUT THE
FACILITY HAVING WAY BEING WAY
OVER CAPACITY. THAT'S ANOTHER
COMMON COMPLAINT, OTHER ISSUES
ARE, FOR EXAMPLE, BESIDES THE
MARKETING, THE FALSE MARKETING
COMPLAINTS, FOR EXAMPLE, DRUG
PARAPHERNALIA BEING LEFT AROUND
THE AREA, THERE ARE BECAUSE
THESE ARE TREATMENT FACILITIES,
THESE ARE NOT NEEDLE EXCHANGE
FACILITIES. THERE SHOULD NOT BE
ANY DRUG USE IN AND AROUND THE
AREA. SO IF NEEDLES ARE FOUND IN
THE NEIGHBORHOOD, THEN THERE'S
REASON TO BELIEVE THAT THERE'S
SOMETHING GONE AWRY IN THE
FACILITY. QUÊ, I JUST THANK YOU.
AND THAT'S WHAT I WANTED PEOPLE
TO HEAR. IS THAT WHAT DOES
HAPPEN TO THESE COMPLAINTS AND
WHY WE ARE WHERE WE ARE TODAY?
BECAUSE IF YOU THINK ABOUT IT IN
YOUR OWN NEIGHBORHOOD, I HAVE 11
YEAR AND A 13 YEAR OLD. I DON'T
HAVE A FACILITY IN MY
NEIGHBORHOOD, BUT I DON'T WANT
MY CHILDREN TO BE SURROUNDED BY
NEEDLES ALL OVER THE
NEIGHBORHOOD OR EVEN INCIDENCES
IN NEWPORT BEACH WHERE SOMEONE
AT AT 2:00 IN THE MORNING RAN TO
SOMEONE'S HOME BECAUSE THEY WERE
DELUSIONAL. THEY NEEDED THE
HELP. AND WE'RE NOT HERE. ANY OF
OUR CITIES AND THE LOCAL ELECTED
ARE NOT HERE TO NOT SUPPORT
THIS. THE PEOPLE NEED HELP AND
WE ARE HERE AND READY TO HELP.
BUT THERE NEEDS TO BE ORDER.
THERE NEEDS TO BE SOME HELP FOR
ALSO NEIGHBORHOODS AND RESIDENTS
WHO'VE LIVED THERE, WHO HAS
YOUNG CHILDREN WHO ARE OLDER,
WHO NEEDS TO HELP THEMSELVES IN
OTHER WAYS. AND SO THIS IS
REALLY GOING TO IS HAVING THAT
DISCUSSION AND ALLOWING CITIES
TO WORK WITH THE STATE, NOT TAKE
OVER THE STATE, BECAUSE I KNOW
NONE OF THE CITY WANTS TO TAKE
OVER THE STATE'S RESPONSIBILITY
AND THE HEALTH CARE FACILITIES,
BUT THIS IS ABOUT ALLOWING LOCAL
GOVERNMENT TO RESPOND TO THEIR
CONSTITUENTS, JUST LIKE ANY OF
US. WHEN THEY CALL THEIR CITY
THE CITY SAYS, I CAN'T DO
ANYTHING ABOUT IT. THE CITY
CALLS US. LET'S SLATER. AND WE
GO, WELL, WE TRY. WE CALL Tê.
WE'RE NOT HEARING. AND THAT'S
WHY WE ARE WHERE WE ARE TODAY.
AND SO, YOU KNOW, I THINK, GOING
BACK TO IS I JUST WANT TO SAY
THANK YOU FOR ALLOWING US TO
HAVE THIS DISCUSSION, BECAUSE
THIS IS HAPPENING ALL OVER THE
STATE. A LOT OF IT IS
CONCENTRATED IN ORANGE COUNTY,
MAINLY BECAUSE WE HAVE 41 MILES
OF THE COAST. BUT LIKE I SAID,
THOUGH, IT'S NOT JUST THE COAST
ANYMORE. IT'S NOW ALSO
FACILITIES WHO ARE INLAND AND
NEXT DOOR TO THE COAST AND ALL
OF ORANGE COUNTY. SO WITH THAT,
THANK YOU, MR. CHAIRMAN. THANK
YOU. SENATOR. ANY OTHER
QUESTIONS? COMMENTS? SENATOR
INGVAR? I RECOGNIZE THAT WE DO
NEED TO HAVE ACCOUNTABILITY, BUT
, SENATOR UMBERG, THAT'S EXACTLY
WHAT I'M WORRIED ABOUT. THE
COMMENTS FROM SENATOR, NGUYEN,
THAT'S WHERE WE'RE GOING TO BE
HEARING. AND IT'S GOING TO BE
WEAPONIZED JUST LIKE THAT. THAT
IS MY BIGGEST CONCERN. THE
NIMBYS ARE GOING TO COME OUT
EVEN MORE. THE FEAR MONGERING
THAT YOU JUST HEARD IS WHAT'S
GOING TO HAPPEN IF WE DON'T
AMEND THIS BILL. AND THAT WAS A
PERFECT EXAMPLE OF MY NUMBER ONE
CONCERN OF THIS BILL, BECAUSE I
HEAR IT TOO. IN MY DISTRICT. I
HAVE SOME IN THE RESIDENTIAL
AREAS OF MY DISTRICT, BUT, YOU
KNOW, WE HAD A CONVERSATION THAT
I'M WORRIED THAT THIS AVENUE
WILL BE WEAPONIZED. AND I
UNDERSTAND THAT WE ARE HERE TO
ADHERE TO OUR CONSTITUENTS, BUT
AT TIMES WE ARE, ARE ARE BOXED
IN. WE DON'T WANT THESE IN OUR
NEIGHBORHOODS, BUT WE ALSO DON'T
WANT HOMELESSNESS. WE NEED A WE
HAVE TO BALANCE THAT. AND I'M
NOT HERE TO SAY THAT WE SHOULD
HAVE INDECENT XYZ HAPPENING IN
OUR IN OUR NEIGHBORHOODS, I'D
LIKE TO TAKE WALKS AROUND MY
NEIGHBORHOOD, AND I WANT TO MAKE
SURE THAT IT'S CLEAN. GREAT BUT
WE'RE SEEING THAT ALL OVER
CALIFORNIA, RIGHT? AND IF WE'RE
PUSHING THEM OUT OF CERTAIN
AREAS, ONE, THEY'RE GOING TO BE
CONCENTRATED IN OTHER
COMMUNITIES, PREDOMINANTLY THAT
LOOK LIKE MINE OR WE'RE JUST NOT
GOING TO HAVE THESE ENTITIES,
AND THEN WE'RE GOING TO BE GOING
BACKWARDS INSTEAD OF FORWARDS.
AND HOW WE'RE GOING TO ADDRESS
THE DIFFERENT KIND OF ISSUES
WE'RE HAVING IN CALIFORNIA. THE
NEW SATELLITE OFFICE, HOW LONG
HAS IT BEEN IN PLACE FOR US TO
EVEN SEE IF IT'S HAD AN IMPACT
ON SOME OF THESE ISSUES? DO WE
KNOW I DON'T KNOW HOW LONG. SO
THAT MAY BE WITH I'LL ADDRESS
THE FIRST PART OF YOUR QUESTION.
BUT AS TO THE SECOND PART OF
YOUR QUESTION, I AM NOT AWARE OF
ANY PERMIT BEING ISSUED IN SANTA
ANA FOR A SATELLITE OFFICE. LET
ME ASK MISS GRINDLE GRINDER.
WE'VE BEEN UNABLE IN OUR OUR
LOCAL AREA AND REGIONAL
REPRESENTATIVES TO BE ABLE TO
ENSURE THESE PEOPLE ARE ACTUALLY
THERE AND HAVE NO EVIDENCE OF
THAT YET, BUT I'M HAPPY TO
CONTINUE TO TRY TO FIND THAT.
YEAH. AND MR. CHAIR, IF I MIGHT
RESPOND, ALL RIGHT. SO YOUR
CONCERNS ARE LEGITIMATE AND WE
HAVE A STATE INTEREST IN MAKING
SURE THAT THERE ARE ADEQUATE OR
AT LEAST AS BEST AS WE CAN DO
RECOVERY FACILITIES, AND WE ALSO
HAVE AN INTEREST IN, FOR
EXAMPLE, MAKING SURE THAT A
ROGUE CITY ATTORNEY DOESN'T JUST
BECOME THE AGENT OF A FEW
DISGRUNTLED NEIGHBORS. AND
THAT'S WHY WE, WILL AMEND THE
BILL TO MAKE IT VERY CLEAR THAT
THE CITY ATTORNEY MAY ONLY
OPERATE UNDER THE AUTHORITY AND
WITH THE CONSENT OF THE
DEPARTMENT. SO TO THE EXTENT
THAT THE DEPARTMENT, WHICH STILL
HAS PRIMARY RESPONSIBILITY,
FEELS AS THOUGH THERE ARE EITHER
, COMPLAINTS THAT ARE NOT WORTH
INVESTIGATING OR UNWARRANTED
COMPLAINTS, THEY WITHHOLD
CONSENT. SO WE'RE NOT WE'RE NOT
RELINQUISHING OUR
RESPONSIBILITY. WE'RE SIMPLY
ADDING ANOTHER COMPONENT TO THE
DEPARTMENT TO BE ABLE TO ENFORCE
THE LAW. WHAT WOULD BE THE FIRST
STEP? THE DEPARTMENT ASKED THE
CITY TO STEP IN, OR THE CITY ASK
THE DEPARTMENT FOR THEM TO STEP
IN. WELL, I SUPPOSE TO GO EITHER
WAY, BUT MY GUESS IS THAT THAT
THE CITY WOULD BE ASKING. THE
DEPARTMENT MOST OFTEN DOES THE
BILL OR FUTURE PRINT. WOULD IT
BE SPECIFIC TO SAY THAT THE
STATE CAN COME? I WOULD, AND I
DON'T KNOW IF THAT'S IN PLACE
RIGHT NOW, THAT IF A DEPARTMENT
DOES NEED HELP, WHICH WE
RECOGNIZE ARE, YOU KNOW, OVER
CAPACITY AND SEVERAL ISSUES THAT
THEY REACHED OUT TO THE CITY ON
ISSUES, SO THE BILL DOES NOT
PRECLUDE THE DEPARTMENT FROM
ASKING A CITY AND GIVING
AUTHORIZATION AND CONSENT TO A
CITY. AND IT CAN GO EITHER WAY
RIGHT NOW, EVEN WITHOUT THIS
BILL, CAN THE CITY CAN THE
DEPARTMENT ASK FOR CITY FOR
ASSISTANCE? WELL, I'M SURE THE
DEPARTMENT CAN ASK THE CITY FOR
ASSISTANCE. THE DEPARTMENT RIGHT
NOW CANNOT. SO FAR AS I KNOW,
DEPUTIZE THE CITY TO MAKE A SITE
VISIT. DOES YOUR BILL ALLOW FOR
THAT? WILL THAT YOUR BILL ALLOW
FOR THAT, WE CERTAINLY CAN DO
THAT. I WOULD EXPECT THAT TO THE
EXTENT THAT THE DEPARTMENT WANTS
TO GIVE CONSENT AND AUTHORITY
THAT THAT THEY CERTAINLY COULD
AND WILL MAKE SURE THAT THAT'S
INCLUDED IN THE BILL. I AS I
SAID AT THE OUTSET, I THINK THE
MOST COMMON OCCURRENCE IS GOING
TO BE A CITY ASKING THE
DEPARTMENT TO PROVIDE CONSENT
AND AUTHORITY. AND THE
DEPARTMENT CAN CERTAINLY,
PRESCRIBE THAT AUTHORITY IN
WHATEVER WAY IT SEES FIT. AND,
SENATOR, CAN YOU CLARIFY IN THE
BEGINNING, YOU SAID YOU'RE GOING
TO BE ONLY DOING, RESIDENTIAL
FACILITY TREATMENTS. NO LONGER
SOBERING CENTERS, NO LONGER
SOBER LIVING HOMES. THAT'S
CORRECT. OKAY. AND YOU KNOW,
SENATOR, YOU KNOW, I'LL ECHO
WHAT WE TALKED ABOUT A LOT OF
CONCERNS WITH THE BILL. RESPECT
YOU AS AN AUTHOR. AND I KNOW
YOU'RE DEDICATED TO ENSURING
THAT YOUR WORK IS, FLUFFED OUT.
I WILL BE VOTING THIS BILL OUT,
BUT I WILL BE RESERVING MY RIGHT
BECAUSE I STILL HAVE SOME
OUTSTANDING CONCERNS. AND
HOPEFULLY BY THE TIME IT GETS TO
US AGAIN. IT'S FLUSHED OUT.
THANK YOU. THANK YOU, SENATOR.
THAT'S RIGHT, SENATOR LIMON,
THANK YOU FOR KEEPING ME ON
TRACK. THANK YOU, SO THANK YOU
TO THE AUTHOR AND TO THE CHAIR.
I THINK THAT THIS BILL HAS
GENERATED A LOT OF ROBUST
CONVERSATION. SO FOR CLARITY OF
AMENDMENTS AS THIS MOVES
FORWARD, NO SOBER LIVING
FACILITIES, PERIOD. SOBER LIVING
HOME HOMES. RIGHT CORRECT. NO
SOBER LIVING HOMES. BUT YOU ARE
INCLUDING RESIDENTIAL. WELL,
WHAT IS INCLUDED ARE I JUST WANT
TO KNOW ALL OF THE RIGHT LIKE
YOU'RE MOVING FORWARD. RIGHT.
SORRY. LICENSED SUBSTANCE USE
DISORDER TREATMENT FACILITIES
WHICH ARE SOMETIMES REFERRED TO
AS RECOVERY CENTERS. BUT THESE
ARE NOT. SO TO DISTINGUISH, IT
IS MY UNDERSTANDING THAT A SOBER
LIVING HOME IS NOT NECESSARILY
IS NOT A LICENSED FACILITY. AND
IT IS A PLACE WHERE INDIVIDUALS
RESIDE AND WHERE THEY MAY BE
GETTING TREATMENT SOMEWHERE
ELSE. AND SO TO THE EXTENT THAT
A SOBER LIVING HOME WISHES TO
ESTABLISH ITSELF IN VIRTUALLY
ANY NEIGHBORHOOD, THIS BILL DOES
NOT PROSCRIBE THAT OR PROHIBIT
THAT, AND NOR DOES IT AUTHORIZE
A CITY ATTORNEY TO MAKE A SITE
VISIT. OKAY, SO IT WILL INCLUDE
RECOVERY CENTERS, BUT NOT THE
UNLICENSED SOBER LIVING HOMES.
YES. AND I AND I CREATED SOME
CONFUSION, I THINK, BY
DESIGNATING THEM AS UNLICENSED
SOBER LIVING HOMES BECAUSE, AS
THE CHAIR POINTED OUT TO ME
EARLIER TODAY, BY DEFINITION, A
SOBER LIVING HOME IS UNLICENSED.
OKAY, BUT THOSE AS YOU MOVE
FORWARD WILL BE AMENDED OUT,
CORRECT FROM THIS AND ANY OTHER
THINGS THAT YOU CAN SPEAK ON.
SORRY, I JUST WANT CLARIFICATION
ON WHAT THE AMENDMENTS ARE. IN
ADDITION TO THIS, THERE ARE NO
AMENDMENTS. WELL, WHAT I'M JUST
I WANT TO REMIND EVERYONE THAT
THIS COMMITTEE DOES NOT
NEGOTIATE AMENDMENTS FROM THE
DAIS AND WILL NOT RECESS TO DO A
BULLET POINT, THE BILL COULD
HAVE BEEN PUT OVER TO CLARIFY
AMENDMENTS. SO WHEN YOU VOTE,
YOUR VOTING ON WHAT'S IN PRINT,
AND IF FOR SOME REASON IT
DOESN'T WIND UP ULTIMATELY THAT
WAY IN THE FINAL VERSION OF THE
PRINT IN ANOTHER COMMITTEE. YOU
JUST WANT TO MAKE SURE YOU
UNDERSTAND. THANK YOU. SORRY.
AND I JUST I WANTED JUST TO TAKE
THE WORD OF THE AUTHOR IN TERMS
OF WHAT THE I GUESS I SHOULDN'T
USE THE WORD AMENDMENTS, BUT I
APPRECIATE THE CLARITY,
AMENDMENTS OR AMENDMENTS. I
SHOULD USE THE WORD OF JUST KIND
OF THE ISSUES YOU'RE GOING TO
WORK ON. IS THERE ANYTHING ELSE
THAT YOU ARE GOING TO BE WORKING
ON AS THIS BILL MOVES FORWARD?
SO THAT WHEN I DO TAKE A VOTE,
I'M JUST CLEAR THAT THESE ARE
THE ISSUES YOU'RE GOING TO BE
WORKING ON, BUT THEY ARE NOT
AMENDMENTS. SURE. LET ME JUST I,
AS CHAIR POINTS OUT, I I'M
INFORMED THAT THERE'S NO HEARING
NEXT WEEK IN SENATE HEALTH. IS
THAT ACCURATE? WE'RE NOT GOING
TO HEAR WE DON'T HAVE A HEARING
ON THE 17TH. WE HAVE A HEARING
ON THE 24TH AND ON THE 20 Ó AND
I'M SORRY. AND ON THE 22ND,
ACTUALLY, WE HAVE A MATTER
SPECIALLY SET ON THE 22ND.
UNFORTUNATELY THIS IS DOUBLE
REFERRED. SO IN THAT THERE'S NOT
A HEARING NEXT WEEK. THERE'S NOT
AN OPPORTUNITY THEN FOR THE BILL
TO BE HEARD. THEN IN SENATE
JUDICIARY BEFORE IT CAN PASS ON
TO THE TO APPROPRIATIONS. I'M
NOT OBJECTING TO THE
CONVERSATION. I JUST WANT TO
MAKE SURE THE RECORD IS CLEAR
BECAUSE OF PROBLEMS THAT WE'VE
HAD IN OTHER COMMITTEES IN PRIOR
YEARS. THAT RIGHT. I'M TRYING TO
RESPOND TO YOUR CONCERN AS TO
WHY WE WOULDN'T PUT IT OVER. AND
I THINK THAT'S A REASONABLE
SUGGESTION. IT JUST DOESN'T
BECAUSE OF THE TIMING AND
BECAUSE OF THE FACT IT'S DOUBLE
REFERRED, IT DOESN'T WORK. THAT,
IN ESSENCE, PUTTING IT OVER
KILLS THE BILL, AND SO, WELL,
THAT WASN'T MY INTENT. NO, I
UNDERSTAND THAT, MR. CHAIR. THEN
IN RESPONSE TO SENATOR LEMON'S
QUESTION. YES, WE WANT TO MAKE
IT CLEAR THAT IN THE BILL WHAT
IT PERTAINS TO, WHAT IT DOES NOT
PERTAIN TO, TO ADDRESS THE
QUESTIONS OF THE CHAIR THAT THIS
WHOMEVER IS CONDUCTING THE SITE
VISIT IS THE ENTITY THAT IS
RESPONSIVE, ABLE TO OPERATE
WITHIN THE BOUNDS OF THE LAW. SO
TO THE EXTENT THAT SOMEBODY
OPERATES OUTSIDE THE BOUNDS OF
THE LAW AND SUBJECTS THEMSELVES
TO, YOU KNOW, CIVIL RIGHTS
ACTIONS AND THOSE KINDS OF
THINGS THAT THAT WOULD OBTAIN
TWO TO, TO USE THE MOST COMMON
EXAMPLE TO THE CITY, NUMBER ONE.
NUMBER TWO IS THAT THIS IS ONLY
WITH THE CONSENT OF THE
DEPARTMENT AND ONLY WITHIN THE
BOUNDS AUTHORIZED BY THE
DEPARTMENT. IF THE DEPARTMENT
SHOULD REFUSE TO CONSENT, THEN
THEN THERE IS NO AUTHORITY TO
MAKE A SITE VISIT. AND SO, TO BE
CLEAR, THE RESPONSIBILITY FOR
THAT CONSENT IN THE PRIMARY
RESPONSIBILITY FOR THE
ENFORCEMENT OF THE LAW IS THE
DEPARTMENT. RIGHT. SO IF THE
DEPARTMENT POTENTIALLY SAID WE
DO NOT CONSENT TO X, BUT WE
CONSENT TO Y, THAT WOULD BE
ADHERED BY THROUGH THE CITY,
POTENTIALLY THIS CITY ONLY WOULD
BE AUTHORIZED TO OPERATE WITHIN
THE BOUNDS OF THE CONSENT AND
THE AUTHORIZATION OF THE
DEPARTMENT, SHOULD THEY EXCEED
IT AND CAUSE HARM. THEN THAT
WHATEVER REMEDY WOULD BE
ENFORCED UPON THE CITY. OKAY, SO
ALONG THOSE LINES, IF THERE IS A
DISCREPANCY IN WHAT AN
INSPECTION, THE INTERPRETATION
OF SOMETHING THAT IS SEEN OR
HEARD OR DONE OR EXPERIENCED IN
AN INVESTIGATION, AND IF THE IF
THERE IS A DISAGREEMENT BETWEEN
THAT INTERPRETATION BETWEEN THE
CITY OR THE STATE, WHICH
SUPERSEDES IF THEY ARE NOT
ALIGNED WELL, THAT WOULD BE A
FACTUAL QUESTION FOR A COURT. SO
FOR EXAMPLE, IF THE CITY
ARGUABLY, EXCEEDED ITS BOUNDS IN
TERMS OF AUTHORIZATION. SO JUST
TO USE AN EXAMPLE, AS THE CHAIR
POINTED OUT, HIPAA SO LET'S SAY
THE CITY INSPECTED A SITE AND
THEN ENTERED INTO ONE OF THE
ROOMS AND DECIDED THAT THEY
NEEDED TO GO THROUGH AN AREA
THEY THOUGHT WAS A PUBLIC AREA.
IT TURNS OUT TO BE A PRIVATE
AREA. IT'S A FOOT LOCKER OR
SOMETHING LIKE THAT. IT TURNS
OUT IT'S A FOOT LOCKER AND THAT
THERE'S AN INVASION OF PRIVACY
AND THAT THE INDIVIDUAL WHOSE
PRIVACY IS INVADED, THEN SUES
THE CITY AND THE STATE FOR THIS
INVASION OF PRIVACY THAT THE
COURT WOULD HAVE TO DETERMINE
WHAT THE BOUNDS WERE OF THE
AUTHORIZATION, WHETHER THE CITY
EXCEEDED THOSE BOUNDS. IF THE
CITY EXCEEDED THOSE BOUNDS, THEN
THEY WOULD BE RESPONSIBLE. IF
THE STATE WAS NEGLIGENT, THAT
DIDN'T ACTUALLY, USE DUE
DILIGENCE IN IN AUTHORIZING THE
CITY, THEN THERE COULD BE OTHER
LIABILITY. BUT BUT THAT'S TRUE
OF ANYTHING. I MEAN, THAT'S
BASICALLY TRUE OF ANY. SO FOR
EXAMPLE, IN LAW ENFORCEMENT,
THERE ARE OFTEN JOINT TASK
FORCES BETWEEN THE STATE, THE
FEDERAL GOVERNMENT AND THE LOCAL
CITY. AND IF THERE'S A
VIOLATION, IF SOMEONE COMMITS A
CIVIL RIGHTS VIOLATION, THEN
IT'S UP TO A COURT TO IN A IN A
FINDER OF FACT, A JURY TO, FOR
EXAMPLE, MAKE A DETERMINATION AS
TO WHO IS RESPONSIBLE. AND I
APPRECIATE THAT. AND I THINK ONE
OF THE CONCERNS I HEARD FROM,
FROM, THE CHAIR AND THAT I SHARE
AS WELL, IS IF THERE ARE WAYS
THAT THIS LAW CAN, YOU KNOW,
SHOULD IT MOVE FORWARD, BE
WRITTEN IN SUCH A WAY THAT IT
MAKES IT EASIER FOR THE COURT TO
DETERMINE AND NOT HOLD THE STATE
LIABLE FOR, YOU KNOW, WE FOR
APPROPRIATE BETWEEN, YOU KNOW,
THE ISSUES BETWEEN THE CITY AND
THE STATE. AND I THINK THAT
THAT'S ONE OF THIS AND I
APPRECIATE THAT PART OF THIS
DISCUSSION HAS GENERATED THAT
THERE IS A HIGHER CONCENTRATION
IN, IN CERTAIN PARTS OF OUR
STATE. THEREFORE, YOU SEE A LOT
MORE ENGAGEMENT AND FEEDBACK.
AND REALLY, YOU KNOW, I THINK
WE'VE GIVEN ORANGE COUNTY AS THE
EXAMPLE. AND SO THERE'S JUST
MORE EXPERIENCES THERE. BUT AT
THE SAME TIME, THIS IS STATEWIDE
AND THIS WILL HAVE STATEWIDE
IMPLICATIONS. AND MY CONCERN IS,
NOT, YOU KNOW, NOT JUST PUTTING
IT ON THE STATE, BECAUSE THE
BALANCE AND THE WEIGHT OF WHAT
IT FEELS LIKE, IS PROBABLY
DIFFERENT IN ALL 58 COUNTIES. I
MEAN, THE EXAMPLES THAT WERE
GIVEN IS THAT TWO COUNTIES
PRIMARILY ARE BEARING, YOU KNOW,
KIND OF THE BRUNT OF THIS OR, OR
HALF. RIGHT, AND SO I WANT TO BE
RESPECTFUL OF SOMETHING THAT'S
THAT, THAT'S, YOU KNOW, AGAIN,
GOING TO HAVE AN IMPLICATION FOR
THE ENTIRE STATE. AND I WOULD
AGREE THAT IF THERE ARE WAYS
THAT THIS LAW CAN BE WRITTEN TO
MAKE THAT CLARITY AND MAKE IT
EASIER FOR THE COURT TO
DETERMINE THAT THE INTENT WAS
FOR IF A CITY DOES IT, A CITY
HAS TO TAKE KIND OF OWNERSHIP OF
THIS. RIGHT, THAT THAT WOULD BE
SOMETHING THAT WOULD BE, OF
COURSE, THAT, THAT I WOULD
SUPPORT. BUT, YOU KNOW, I DON'T
KNOW HOW OTHERS WILL WEIGH IN.
SO TO MR. CHAIR, IF I MAY
RESPOND. OF COURSE. SO WE WILL
MAKE IT CLEAR THAT THE CITY OR
WHATEVER ENTITY IS AUTHORIZED,
IS ONLY AUTHORIZED TO PERFORM
ITS DUTIES WITHIN THE BOUNDS OF
THAT AUTHORIZATION AND SHOULD
THEY EXCEED IT, THAT THEY WILL
BEAR RESPONSIBILITY. I ALSO
WOULD EXPECT, ALTHOUGH THIS IS A
LAW THAT APPLIES STATEWIDE, THAT
IN COUNTIES THAT DON'T HAVE ANY
OF THESE FACILITIES, YOU'RE NOT
GOING TO HEAR THERE'S NOT GOING
TO BE COMPLAINTS. AND SO TO THE
EXTENT THAT THAT THERE ARE
COUNTIES THAT HAVE ZERO
FACILITIES, YOU WILL HAVE ZERO,
ISSUES, RIGHT? YES. SO I WILL BE
SUPPORTING THIS TODAY. I THINK
IT'S AN IMPORTANT ISSUE,
CERTAINLY. I HEARD FROM YOU AS
THE AUTHOR HOW IMPORTANT THIS
IS, I THINK, LIKE OTHERS
SUPPORTING IT WITH SOME CONCERNS
AND SOME PAUSE AND NOT KNOWING
IF THIS WAS THE RIGHT STEP, I
SHARE, YOU KNOW, THE, SOME OF
THE CONCERNS THAT OUR CHAIR HAS
EXPRESSED, AND I HOPE THAT AS IT
MOVES FORWARD, THERE'LL BE
ONGOING CONVERSATION. I KNOW,
YOU KNOW, YOU'RE GOING TO WORK
ON THAT, BUT THIS IS A DIFFICULT
ONE, TO BE ABLE TO VOTE ON TODAY
. BUT I UNDERSTAND HOW IMPORTANT
IT IS TO AT LEAST ATTEMPT TO DO
SOMETHING AND HAVE A BILL IN
PRINT THAT REQUIRES A
LEGISLATIVE CONVERSATION WITH
INPUT, WITH ANALYSIS FOR
PURPOSES OF THE DISTRICT. THANK
YOU. SENATOR RUBIO. THANK YOU,
MR. CHAIR, AND THIS IS VERY
DIFFICULT FOR TWO REASONS, LET'S
JUST START WITH THE AUTHOR AND
THE CHAIR. I RESPECT THE CHAIR
SO MUCH. AND, YOU KNOW, AND I
KNOW IT'S VERY THOUGHTFUL EVERY
TIME WE COME HERE, YOU KNOW, THE
AMENDMENTS HE TAKES ON ANY BILL,
I TEND TO ALMOST AGREE 100%
BECAUSE, YOU KNOW, THAT'S HOW
MUCH TIME HE TAKES TO GET TO A
GOOD PLACE. AND AT THE SAME
TIME, I RESPECT THE AUTHOR. I
KNOW THAT YOU KNOW THAT WHEN YOU
ENGAGE IN LEGISLATION, YOU'RE
ALWAYS LOOKING AT IT NOT ONLY AS
A LEGISLATOR, BUT YOU KNOW YOUR
YOUR LEGAL MIND AS WELL. AND AND
SO IT'S DIFFICULT BECAUSE WE
WERE TOLD NOT TO, AS HE, AS THE
CHAIR PUT IT, NEGOTIATE FROM THE
DAIS AND I'M ACTUALLY HAVE
PERSONAL EXPERIENCE OF LETTING A
BILL OUT AND SOMEONE NOT KEEPING
THEIR COMMITMENTS. THAT WAS VERY
I THINK YOU ALL REMEMBER THAT.
AND, THERE WAS, YOU KNOW, I HAD
TO PAY A PRICE FOR IT IN MY
DISTRICT, BUT BECAUSE IT IS
DIFFICULT, IT IS DOUBLE REFER. I
KNOW YOU'RE TRYING TO GET TO A
GOOD PLACE, BUT I WANT TO
CONSIDER IT. BUT I HAVE A COUPLE
OF QUESTIONS. AND I'M SORRY. I
DID WALK IN A LITTLE LATE. I WAS
WORKING ON ANOTHER COMMITTEE,
YOU HAVE LANGUAGE HERE THAT SAYS
, UNANNOUNCED SITE VISITS. CAN
YOU TELL ME IF YOU ADDRESSED
THAT? IS THERE ANY CHANGE IN
THAT LANGUAGE? SO CURRENTLY, THE
DEPARTMENT CAN MAKE ANNOUNCED OR
UNANNOUNCED SITE VISITS. AND TO
THE EXTENT THAT THEY ARE
CONFERRING AUTHORITY AND
PERMISSION ON A CITY ATTORNEY,
THEY CAN RESTRICT THAT IF THEY
WISH. THE DEPARTMENT CAN SAY
ONLY ANNOUNCE VISITS OR BOTH.
BUT RIGHT NOW WE'RE GIVING A
LITTLE BIT MORE, I GUESS,
AUTHORITY TO THE CITIES, RIGHT?
WE'RE LETTING THEM SORT OF TAKE,
CONTROL OF THIS ISSUE AS THEY
WERE PUTTING IT. RIGHT. WE ARE
NOT GIVING ANY ADDITIONAL
AUTHORITY TO CITIES AT ALL. THE
AUTHORITY THAT EXISTS IS NOT
EXPANDED BY THIS BILL. THE
AUTHORITY THAT EXISTS CURRENTLY
RESIDES IN THE DEPARTMENT. SO TO
THE EXTENT THE DEPARTMENT, IN
ESSENCE, PROVIDES SOME AUTHORITY
AND SOME CONSENT, THEY CANNOT
GIVE MORE AUTHORITY THAN THE
AUTHORITY THEY CURRENTLY HAVE.
SO, FOR EXAMPLE, IF THE
DEPARTMENT, THE DEPARTMENT DOES
NOT HAVE THE RIGHT TO INVADE
SOMEONE'S HIPAA, HIPAA, INVADE
HIPAA RIGHTS, THE DEPARTMENT
DOESN'T HAVE THAT RIGHT. AND IF
THE DEPARTMENT SAYS CITY HAVE AT
IT, GO THROUGH ANY RECORD YOU
LIKE, THAT WOULD BE THAT WOULD
BE BEYOND THE AUTHORIZATION. AND
TO SENATOR LAMONT'S QUESTION,
YES, IF THE DEPARTMENT DID THAT,
THEY WOULD PROBABLY BE ALSO
JOINTLY AND SEVERALLY LIABLE
WITH THE CITY IF THEY SIMPLY
AUTHORIZED THE CITY TO DO
SOMETHING THAT THEY WEREN'T
AUTHORIZED TO DO. YOU KNOW, AND
I'M TRYING TO UNDERSTAND THE
ISSUE. THIS IS NOT SOMETHING
THAT I DEAL WITH EVERY SINGLE
DAY, BUT I DO HAVE A LITTLE BIT
OF RESERVATION IN TERMS OF
SOMETHING THAT I SAW IN MY OWN
DISTRICT. YOU KNOW, WHERE, THE
NEIGHBORING CITY, NEIGHBORHOOD
WAS COMPLAINING ABOUT CERTAIN
FACILITIES, AND IT ALMOST BECAME
ALMOST LIKE A MOB MENTALITY
WHERE THEY KEPT HARASSING, YOU
KNOW, PEOPLE IN THESE FACILITIES
. AND SO I ALMOST, YOU KNOW,
WHEN I HEAR THINGS LIKE, YOU
KNOW, UNANNOUNCED SITE VISITS,
YOU KNOW, I JUST REMEMBER HOW
HARD MY COMMUNITY WORKED TO TRY
AND GET THESE SOME OF THESE
FACILITIES OUT. AND IT WAS JUST
CONSTANT HARASSMENT. SO I WANT
TO SORT OF CLARITY AND PERHAPS
I'M NOT UNDERSTANDING THE B¢O.
SO THAT'S PROBABLY MY FAULT THAT
I NEED TO I WOULD LIKE TO SEE I
DO WANT TO SUPPORT IN THE SENSE
THAT I KNOW IT NEEDS TO HAPPEN.
I REALLY HESITATE BECAUSE I, YOU
KNOW, ALWAYS DEFER TO THE CHAIR.
AND I KNOW HOW STRONGLY WE FEEL
ABOUT HAVING THINGS DONE BEFORE
THEY COME TO COMMITTEES, BUT
THIS ISSUE KIND OF IS DOESN'T
SIT WELL WITH ME BECAUSE I JUST
REMEMBER THE HARASSMENT OF THESE
FACILITIES CONSTANTLY BY SOME OF
MY COMMUNITY MEMBERS. THEY JUST
THEY COULD HAVE DONE ANYTHING,
BUT THEY JUST WANTED THEM OUT.
SO THEY WERE ALWAYS BEING
HARASSED. AND WHEN IT SAYS
UNANNOUNCED SITE VISITS, I'D
LIKE TO SEE SOME KIND OF,
GUIDANCE OR SOME REASONABLE
CAUSE TO VISIT AND CONTINUE TO,
YOU KNOW, TO BE PRESENT. THAT'S
BECAUSE THERE'S REASONABLE CAUSE
TO BELIEVE THAT SOMETHING IS
NOT, YOU KNOW, IN THE UP AND UP.
SO I DON'T WANT TO REPEAT WHAT
EVERYONE SAYS. I, YOU KNOW, I'VE
HEARD THE ENTIRE DEBATE AND
PIECES AND I JUST GO BACK TO
WHAT SENATOR LIMÓN IS STATED. WE
NEED A LITTLE BIT MORE CLARITY
BECAUSE YOU'RE TRYING TO POINT
THE FINGERS AND SEE WHO'S AT
FAULT OR WHO YOU BLAME, AND
THAT'S AN AREA THAT YOU NEED TO
TACKLE. BUT, I DO WANT MORE TIME
TO TALK TO YOU ABOUT IT. I KNOW
WE ATTEMPTED SEVERAL TIMES AND
IT'S JUST BEEN CRAZY. AS WE CAN
ALL ATTEST, WE'RE JUGGLING 3 OR
4 DIFFERENT COMMITTEES, BUT I
WILL SAY, YOU KNOW, AGAIN WITH
HESITATION, SUPPORT THE BILL.
AND MY APOLOGIES TO THE CHAIR
BECAUSE I ALWAYS DEFER TO THE
CHAIR, BUT I WANT TO MORE IN
DEPTH CONVERSATION, AND I HOPE
THAT WE COULD GET TO A PLACE
THAT ALL THE CONCERNS ARE
ANSWERED AND IF YOU'RE OKAY WITH
THAT, I WILL BE SUPPORTING. LET
ME. I'M SORRY. THANK YOU,
SENATOR RUBIO. NO APOLOGY
NECESSARY. I DON'T. ASK PEOPLE
TO VOTE ANY PARTICULAR WAY. AND
I THOUGHT I MADE THAT CLEAR. SO
DON'T WORRY ABOUT IT. SENATOR
YOU HAD SOMETHING TO SAY. I WAS
GOING TO SAY THAT THESE ARE FAIR
POINTS. AND TO THE EXTENT THAT,
FOR EXAMPLE, THERE APPEAR TO BE
HARASSMENT BY INDIVIDUAL
NEIGHBORS, BY MULTIPLE
COMPLAINTS, CERTAINLY THE
DEPARTMENT SHOULD TAKE THAT INTO
CONSIDERATION. I WOULD EXPECT
WOULD TAKE THAT INTO
CONSIDERATION IN GRANTING,
CONSENT AND AUTHORIZATION. TO
THE EXTENT THE DEPARTMENT SAYS,
LOOK, YOU CAN MAKE, ONLY
ANNOUNCED VISITS, OR YOU CAN
MAKE AN UNANNOUNCED VISIT
BETWEEN THE HOURS OF 10 A.M. AND
2 P.M. THEY CERTAINLY THEY HAVE
THE ABILITY TO DO THAT. THIS
BILL DOESN'T GIVE ANY ADDITIONAL
AUTHORITY. SO THEY THEY CAN DO
THAT. AND, YOU KNOW, JUST LIKE
IN ALL CASES WHERE WE EXPECT THE
STATE LAW ENFORCEMENT OR, OR
OTHER STATE ENTITIES TO ACT WITH
REASON, WE WOULD EXPECT THEM TO
ACT WITH REASON. AND IF THEY
DEMONSTRATE STATE THAT THEY
DON'T HAVE JUDGMENT, THEN IT'S
OUR RESPONSIBILITY TO COME BACK
IN AND RESTRAIN THEIR JUDGMENT.
YEAH AND THANK YOU FOR THAT. AND
MY APOLOGY TO THE CHAIR. HE
NEVER DOES TELL US HOW TO VOTE,
BUT JUST OUT OF RESPECT, I, YOU
KNOW, I, I DO VALUE HIS
THOUGHTFULNESS. AND I KNOW THAT
WHEN HE SPEAKS, IT MEANS
SOMETHING. AND WHEN HE'S NOT ON
BOARD ON SOMETHING, THERE'S A
REALLY GOOD REASON. SO I DO TAKE
THAT VERY SERIOUSLY. SERIOUSLY.
BUT THANK YOU FOR ANSWERING MY
QUESTIONS AND I WILL BE
SUPPORTING IT TODAY. THANK YOU.
SENATOR. SENATOR GROVE, YOU'RE
UP AT BAT, THANK YOU, MR. CHAIR.
FIRST, JUST ON A SIDE NOTE, I'D
LIKE TO THANK THE CHAIR, THAT
SPEAKS VOLUMES FOR INTEGRITY,
BECAUSE THAT IS NOT ALWAYS WHAT
HAPPENS IN COMMITTEES WHEN THE
CHAIR SAYS NO, IT'S A NO GO. AND
SO THAT IS A MAN OF HONOR
SITTING TO MY RIGHT THAT ALLOWS,
OPPOSING CONVERSATION TO TAKE
PLACE IN HIS COMMITTEE AND
SUPPORT OF A BILL THAT HE IS
OPPOSED TO. AND I JUST I WANT TO
RECOGNIZE THAT, I, I, I'VE BEEN
LISTENING TO THE CONVERSATION. I
UNDERSTAND WHERE MY COLLEAGUES
ARE COMING FROM IN THE, IN THE
QUESTIONS THAT THEY WANT
ANSWERED. I THINK THE CHAIR
BROUGHT UP SOME REALLY GOOD
QUESTIONS, BUT THE WAY I READ
THIS AND I'M JUST AND I WENT
THROUGH IT BECAUSE I HEARD
HEARD, YOU KNOW, NOT THE
SCUTTLEBUTT BUT THE YOU KNOW,
THE, THE WAY THE COMMITTEE COULD
GO. SO MY UNDERSTANDING IS AND
AGAIN, JUST CORRECT ME IF I'M
WRONG, YOU'RE ALIGNING, YOU'RE
ALIGNING THESE FACILITIES WITH
ADULT TREATMENT COURT. BEST
PRACTICE STANDARDS. NO, I Þ, I
DON'T, I DON'T KNOW, I SUPPOSE I
CAN ASK IF IT IF IT IS ALIGNED
EXACTLY WITH ADULT TREATMENT
COURT. IS THAT OKAY? GOT IT. I
GOT IT, OKAY, I APOLOGIZE, I WAS
LOOKING DIFFERENT, BILL. OKAY.
ALL RIGHT, I OKAY I'M I WASN'T
HERE I HAD SEPARATE COMMITTEES.
NO NO NO I LISTEN I DO THAT ALL
THE TIME I OKAY. YOU KNOW AND
I'M JUST GRATEFUL WHEN I PRESENT
THE RIGHT BILL WHEN CALLED UPON.
SO. OKAY. THAT'S OKAY. I HAVE MY
NOTES ON THIS ONE TOO. SO I'M
LIKE LOOKING AT BEST PRACTICES,
BUT I APOLOGIZE, AND I
APOLOGIZE, MR. CHAIR, FOR NOT
HAVING THAT, SO I HAVE A
TREATMENT FACILITY IN THE
CENTRAL VALLEY AREA. NOT I ONLY
HAVE 1 OR 2. I DON'T HAVE A LOT.
SO I HAVE A TREATMENT FACILITY,
AND I DO GET CALLS FROM MY
OFFICE. LOOK THERE IN MY FRONT
YARD. IT'S 3:00 IN THE MORNING.
WHAT CAN I DO? AND BECAUSE
THEY'RE THERE, SOBER LIVING
HOMES, UNLICENSED, THAT ARE
CONSTITUTIONALLY PROTECTED UNDER
THAT, THAT ISSUE, OR THAT
STANDARD, THERE'S NOT A LOT THAT
CAN BE DONE, AND THEN THERE WAS
ONE TIME WHERE I TALKED TO THE
LAW ENFORCEMENT INDIVIDUALS AND
THEY'RE SAYING THERE WAS A HUGE
ALTERCATION BECAUSE THE NEIGHBOR
HAD JUST HAD ENOUGH. SO I GET
WHAT YOU'RE TRYING TO DO. AGAIN,
I DON'T HAVE THE MAJORITY. MY
COLLEAGUE, THE VICE CHAIR, SAID
THAT THEY HAVE 61 OF THESE
FACILITIES IN ORANGE COUNTY. I
DON'T HAVE THOSE, BUT I DO THINK
THAT, OBVIOUSLY LOCAL ORDINANCE,
THEY ALLOW THESE THESE HOMES TO
BE THERE. I THINK THESE HOMES
ARE SIGNIFICANT. THEY NEED TO DO
THAT. WE USED TO HAVE THEM GO TO
I MEAN, REALISTICALLY, BEFORE
PROPOSITIONS WERE PASSED IN THIS
STATE, THEY'D BE ARRESTED, YOU
KNOW, PUT IN JAIL FOR 30 DAYS,
GET WRAPAROUND TREATMENTS.
THEY'D SOLVE THE PROBLEM IN AN
ISOLATED FACILITY THAT DIDN'T DO
THIS. BUT NOW WE HAVE A
DIFFERENT, COMPASSION, I GUESS,
FOR INDIVIDUALS IN THIS. AND
CORRECT ME IF I'M WRONG, BUT I
DO THINK THAT THE PEOPLE WHO
LIVE NEXT DOOR TO THEM ARE DOWN
THE STREET FROM THEM OR ON THE
WAY TO THAT FACILITY HAVE RIGHTS
AS WELL. AND I THINK BRINGING
SOME CLARITY INTO THE REGULATORY
PIECE OF THIS, MAKES SENSE,
SPECIFICALLY JUST FROM LIFE
EXPERIENCES WHERE I'VE HAD
PEOPLE CALL MY OFFICE REGARDING
THIS, AGAIN, NOTHING AGAINST THE
CHAIR I LOVED. I UNDERSTAND WHAT
HE'S SAYING. I LISTENED TO THE
ARGUMENTS HERE, BUT, I, I JUST
WANTED TO MAKE THAT STATEMENT
THAT THAT'S WHAT I THOUGHT IT
WAS. IS THAT ACCURATE? LIKE.
WELL, YES, IT IS ACCURATE THAT
THAT WE'RE FOCUSED ON, THE
LICENSED SUBSTANCE. I WANT TO BE
SURE THAT I DON'T CREATE
ADDITIONAL CONFUSION HERE. THE
LICENSED USE DISORDER TREATMENT
FACILITIES, SOMETIMES REFERRED
TO AS RECOVERY CENTERS. SO THE
CONFUSION THÀNH, I HOPE I'VE
ELIMINATED AT LEAST SOME OF IT
BY ELIMINATING THE PORTION OF
THE BILL THAT MADE REFERENCE TO
SOBER LIVING HOMES. YES. SO THIS
DOESN'T DEAL WITH SOBER LIVING
HOMES. THAT MAY BE AN ISSUE FOR
ANOTHER DAY, BUT THIS DOESN'T
THIS DOESN'T DEAL WITH THOSE.
YES, IT'S LICENSED TREATMENT
FACILITIES IN A NEIGHBORHOOD.
THAT'S RIGHT. BASICALLY. WELL,
WHEREVER THAT'S CORRECT.
WHEREVER THAT'S OKAY. THANK YOU
SIR. YES. THANK YOU, SENATOR
GROVE. SENATOR MENGIBAR, ON THAT
SAME POINT, SENATOR, RECOVERY
CENTERS, I THOUGHT WE HAD HEARD
A BILL HERE. RECOVERY CENTERS
AREN'T ALL LICENSED, SO THIS
WOULD ONLY APPLY TO THOSE THAT
ARE LICENSED. GOT IT. THANK YOU,
AND WHO CURRENTLY INSPECTS THESE
FACILITIES UNDER DCS? NO ONE. I
MEAN, THAT'S THE I CAN I CAN
DEFER TO THE LEAGUE, BUT THERE'S
VIRTUALLY NO ENFORCEMENT GOING
ON. SO THAT'S WHAT THE CHALLENGE
IS THERE. THERE IS A WAY TO FILE
COMPLAINTS WITH THE DEPARTMENT.
AND THEN THEY HAVE INSPECTORS
WHO WILL DO INSPECTIONS, DO
UNANNOUNCED SITE VISITS AND TAKE
ENFORCEMENT ACTION. WHAT TITLE
DO THEY HAVE OR BACKGROUND? I'M
NOT AN EXPERT ON MEANING. WE'RE
ASKING ATTORNEYS OR TO INSPECT.
DO THEY HAVE THE EXPERTISE LIKE
THE INSPECTORS UNDER THE
DEPARTMENT TO INSPECT? DO THEY
KNOW WHAT THEY'RE LOOKING FOR?
IS THIS GOING TO REQUIRE EXTRA
TRAINING OF THESE ATTORNEYS. SO.
WELL, ONE, IT DOESN'T
NECESSARILY NEED TO BE AN
ATTORNEY. NUMBER ONE, IT WOULD
BE, THE BILL WOULD ENVISION
THAT, FOR EXAMPLE, A CITY
ATTORNEY'S OFFICE WOULD HAVE
THEN BEEN AUTHORIZED TO PERFORM
A CERTAIN SITE VISIT. AND YOUR
POINT IS WELL TAKEN IS THAT THE
DEPARTMENT IS REQUIRED TO
BASICALLY ESTABLISH THE POLICY
AND THE QUALIFICATIONS OF THOSE
WHO WOULD BE CONDUCTING THE SITE
VISIT. SO IT WOULD BE AND I WAS
A BIT FACILE BEFORE, BUT THE
ENFORCEMENT IS NEGLIGIBLE. SO
WHEN I SAY NONE, IT'S JUST
NEGLIGIBLE. BUT IN THEORY, IF
THE PROGRAM WAS WORKING WELL,
WELL, THE PROGRAM IS, I DON'T
BELIEVE THE ONE THING I DO
BELIEVE IS THE PROGRAM THAT THE
DEPARTMENT IS DOES NOT HAVE THE
CAPACITY TO BASICALLY ENFORCE
THE LAW TODAY. AND THUS, IF IT
IS BEING ENFORCED, IT IS IT IS
NEGLIGIBLE. I KNOW, I KNOW,
SENATOR, WE'VE GIVEN YOU A
LAUNDRY LIST OF THINGS THAT YOUR
STAFF IS JOTTING. AND I'D LIKE
TO ADD ONE MORE FINAL THING. IF
WE CAN LOOK AT THE TITLES OR THE
EXPERIENCE OF THE INDIVIDUALS,
SHOULD THIS BILL MAKE IT, OF WHO
IS GOING TO INSPECT AND WHAT
KNOWLEDGE THAT INDIVIDUAL IS
GOING TO HAVE OF THESE
FACILITIES. SO TO YOUR POINT, I
AM NOT AN EXPERT IN THIS AREA. I
BELIEVE THAT THE DEPARTMENT,
THEY SHOULD AND I THINK THEY DO
HAVE EXPERTISE IN THIS AREA. SO
I WOULD REQUIRE THEM TO ACTUALLY
DEVELOP THE CRITERIA AND THE
QUALIFICATIONS FOR BOTH THE SITE
VISIT AS WELL AS THE CRITERION
QUALIFICATION FOR THOSE WHO
CONDUCT THE SITE VISIT. WE WOULD
EXPECT TO THE CHAIR'S POINT
EARLIER IF THE DEPARTMENT SIMPLY
SAYS, YOU KNOW, YOU CAN HAVE
ANYBODY CONDUCT A SITE VISIT AND
IT TURNS OUT THAT YOU HAVE
UNQUALIFIED PEOPLE WHO ARE
RUNNING ROUGHSHOD OVER PEOPLE'S
RIGHTS, THAT, THAT COULD INERT
TO THE STATE'S LIABILITY. BUT I
DO HAVE CONFIDENCE THAT THE
DEPARTMENT COULD CREATE THE
GUIDELINES SO THAT THE CITY
ATTORNEY, THEN OAN COULD
ENFORCE THOSE GUIDELINES. SO,
FOR EXAMPLE, IF THE DEPARTMENT
SAYS EVERYONE MUST HAVE THE
FOLLOWING QUALIFICATIONS AND THE
CITY SIMPLY IGNORES THAT AND
OPERATES AS A ROGUE AGENCY, THAT
THEY THEN ASSUME WHATEVER
LIABILITY MIGHT, MIGHT OCCUR.
OKAY. THANK YOU. ANY OTHER
QUESTIONS? COMMENTS SENATOR
NGUYEN THANK YOU, MR. CHAIR,
THERE WAS A COMMENT FROM MY
COLLEAGUE IN LOS ANGELES,
EARLIER IN RESPONSE TO MY
COMMENTS, I JUST WANT TO MAKE IT
CLEAR WE ARE NOT HERE FROM
ORANGE COUNTY SAYING WE DON'T
WANT ANY. THAT'S NOT IT. WE KNOW
THAT EVERY ONE OF US ARE
RESPONSIBLE AND NEED, AND
THERE'S INDIVIDUALS OUT THERE
WHO NEEDS THE HELP. FACILITIES
SHOULD BE OPEN. WHAT WE'RE
ASKING FOR IS JUST TO ALLOW US
TO PARTNER WITH THE STATE AGENCY
TO GIVE US THEIR GUIDELINES, TO
HELP US WORK WITHIN OUR
COMMUNITIES. THAT'S IT. WE'RE
NOT ASKING FOR ANYTHING MORE.
WE'RE NOT ASKING, YOU KNOW, TO
COMPLETELY SAY SHIELD ORANGE
COUNTY FROM EVER HAVING
FACILITIES AGAIN. NO, THAT'S NOT
THE COMMENT THAT I MADE AT ALL.
THIS IS ABOUT BEING GOOD
NEIGHBORS AND ALSO BEING GOOD
CITIZENS WORKING TOGETHER IN THE
COMMUNITY, WHETHER THAT'S THE
FACILITIES AND THE NEIGHBORS.
AND THAT'S WHAT IT REALLY COMES
DOWN TO RIGHT NOW. CITIES FEEL
THAT THEY'RE HANDICAPPED. THEY
CALLED AND CRY AND SCREAM AND NO
ONE IS HEARING AND THE STATE'S
NOT HEARING. THERE'S NO
ENFORCEMENT, NO RESPONSE, AND IF
THERE IS, YOU KNOW, AS THE,
SENATOR, THE AUTHOR STATED THAT
IT'S PROBABLY VERY SPARSE AND.
OR NONE IN EXISTENCE. AND SO,
YOU KNOW, I JUST WANT TO MAKE IT
CLEAR THAT, AGAIN, WE IN ORANGE
COUNTY WANT TO BE THERE. WE'RE
HERE TO HELP. BUT BUT WE ALSO
WANT SOME HELP. WE NEED TO BE
ABLE TO WORK WITH THE DEPARTMENT
AND ALLOW US TO ANSWER TO OUR
CONSTITUENTS AS WELL. THANK YOU,
SENATOR, JUST FOR THE RECORD,
THE STATISTICS THAT HAVE BEEN
PROVIDED TO ME BETWEEN FISCAL
YEAR 2018 AND 2022, DHS AVERAGED
595 COMPLAINTS ANNUALLY FOR
ABOUT 1750 SUBSTANCE ABUSE
TREATMENT FACILITIES, AND THE
AVERAGE TIME TO CLOSE A
COMPLAINT HAS DROPPED IN THE
LAST TWO YEARS, FROM 245 DAYS TO
114 DAYS. JUST FOR THE RECORD,
FOR PEOPLE WHO DON'T THINK THE
DEPARTMENT OF HEALTH CARE
SERVICES IS DOING ANYTHING, YOU
KNOW, SENATOR, AS YOU MOVE YOUR
BILL FORWARD AND I'M SURE
THERE'LL BE A MOTION AND IT'LL
MOVE FORWARD, IN LOOKING AT YOUR
BILL, WHAT HAPPENS AFTER THE
SITE VISIT? SO FOR, FOR EXAMPLE,
IF THERE'S AN ENFORCEMENT
ACTION, THEY FIND OUT THAT THAT
THERE'S A VIOLATION OF THE LAW
AT THAT POINT IN TIME, AGAIN,
OPERATING WITHIN THE AUTHORITY
OF THE DEPARTMENT, THEN WHETHER
THE DEPARTMENT AUTHORIZES THE
CITY ATTORNEY, FOR EXAMPLE, TO
TAKE THAT FACILITY TO ENACT
EXACT WHATEVER REMEDIES
CURRENTLY ARE AVAILABLE IN THE
LAW, THAT'S WHAT WOULD HAPPEN.
OR THE DEPARTMENT COULD DO THAT.
BUT BUT AGAIN, ULTIMATELY IT
RESIDES IN THE DEPARTMENT TO
ENFORCE THE LAW. WELL THE WAY
THE BILL IS CURRENTLY DRAFTED,
AS I READ IT IN SECTION 11 834
.01, IT AUTHORIZES NOTHING
BEYOND A SITE VISIT. SO SHOULD
THIS PASS IN ITS CURRENT FORM,
ALL THAT'S AUTHORIZED IF THE
DEPARTMENT AUTHORIZES IT PER A
REQUEST, IS TO ALLOW A CITY OR
COUNTY TO CONDUCT AN UNANNOUNCED
OR ANNOUNCED SITE VISIT, AND
FRANKLY. THE BILL CURRENTLY
AUTHORIZES THAT IT LOOKS LIKE
ONLY WITH RESPECT TO UNLICENSED,
SOBER LIVING HOMES. SO I GUESS
WHAT I'M TELLING YOU, OR
SUGGESTING OR SAYING IS, TO THE
EXTENT THAT THIS BILL IS
SUBSTANTIALLY CHANGED IN THE
JUDICIARY COMMITTEE, I DON'T
KNOW WHAT THE HEALTH COMMITTEE
MAY CHOOSE TO DO, BECAUSE IF
THERE'S SUBSTANTIAL CHANGE FROM
THE CURRENT LANGUAGE IN THE BILL
THAT ENHANCES THE ACTIVITY OF A
CITY ATTORNEY OR A DISTRICT
ATTORNEY BEYOND A SITE VISIT,
SINCE WE HAVEN'T SEEN ANY
LANGUAGE, WE MAY HAVE TO LOOK AT
IT AGAIN IN. AND I UNDERSTAND
THAT, MR. CHAIR. AND LET ME
AGAIN SORT OF UNDERLINE A POINT
THAT WAS EARLIER MADE. I KNOW
THAT YOU, MR. CHAIR, AND I KNOW
YOUR STAFF TAKES A GREAT DEAL OF
PRIDE IN THE WORK THAT THEY DO,
AND WHEN THERE ARE SIGNIFICANT
CHANGES MADE WITHOUT THE
OPPORTUNITY TO FULLY ANALYZE, IT
PUTS YOU IN A BIND AND PUTS YOUR
STAFF IN A BIND. AND I AM, I AM
SORRY FOR THAT, ONE OF THE
REASONS IS THAT WE COULD NOT PUT
THE BILL OFF NUMBER TWO IS THAT
MANY OF THESE CHANGES ARE
RESPONSIVE EITHER TO THE
COMMITTEE'S CONCERNS, WHICH WERE
LEGITIMATE, OR TO INDIVIDUAL
MEMBERS CONCERNS. AND SO, AGAIN,
OAN, TO THE EXTENT THAT THE
CHAIR LOOKS TO SEE WHAT THE BILL
LOOKS LIKE IN PRINT WHEN IT
COMES TO JUDICIARY COMMITTEE,
THEN IF THE CHAIR HAS CONTINUING
CONCERNS AND WISHES TO BRING IT
BACK, OF COURSE, YOU KNOW, WE
DEFER THE CHAIR'S PREROGATIVE. I
HAVE A GOOD RELATIONSHIP WITH
THE CHAIR OF JUDICIARY, AND I
THINK I CAN COMMIT THAT
COMMITTEE TO MAKE SURE THAT WE,
PROVIDE YOU WHATEVER INFORMATION
I JUST WANTED TO POINT OUT TO
YOU. I DON'T THINK YOUR LANGUAGE
DOES WHAT YOU'RE TALKING ABOUT,
AND YOU MAY WANT TO TAKE ANOTHER
LOOK AT IT. NO, I THINK YOU'RE
RIGHT. I MEAN, BECAUSE YOU'LL BE
BACK IN THE 114 DAYS TO
COMPLAINT RESOLUTION. I THINK
YOU ARE CORRECT THAT WE THAT THE
BILL HAS SIGNIFICANT AMENDMENTS
AND SIGNIFICANT CHANGES AND WHAT
I'VE TRIED TO DO IS I'VE TRIED
TO EXPRESS TO THE COMMITTEE
BEFORE THE COMMITTEE VOTES WHAT
MY INTENT IS IN TERMS OF THOSE
FUTURE AMENDMENTS. I UNDERSTAND
THAT, IT'S CERTAINLY APPROPRIATE
FOR YOU AND YOUR STAFF TO REVIEW
IN WRITING WHAT THOSE AMENDMENTS
ARE SO THAT YOU CAN ANALYZE
WHETHER IT'S CONSISTENT WITH
YOUR, YOUR CONCERNS. OKAY. ANY
OTHER QUESTIONS? COMMENTS? WE
HAVE CERTAINLY TAKEN THE TIME
WITH THIS ONE, BUT IT DESERVES
THE TIME. SO SENATOR, GREAT
PRESENTATION. MAY I HAVE A
MOTION, PLEASE? IT'S BEEN MOVED
BY SENATOR NGUYEN, PLEASE CALL
THE ROLL. Þ. THE MOTION ON THE
BILL IS TO PASS AND RE REFER TO
THE COMMITTEE ON JUDICIARY.
SENATOR ROTH NOT VOTING WHEN I
WHEN I GLAZER GONZALEZ. GROVE.
GROVE. I HURTADO. LIMON. LIMÓN I
MENGIBAR MENGIBAR I RUBIO I
RUBIO I SMALLWOOD. CUEVAS
WIENER. BILL HAS FIVE VOTES WILL
HOLD A ROLL UP FOR ABSENT
MEMBERS SEN. THANK YOU, MR.
CHAIR.
SENATOR BECKER, ITEM NUMBER TEN,
SENATE BILL 1120. GOOD
AFTERNOON, CHAIR AND MEMBERS.
I'M HERE TODAY TO PRESENT SB
1120. THE PHYSICIANS MAKE
DECISIONS ACT, THIS BILL THAT
TAKES A CRITICAL STEP FORWARD IN
ENSURING FAIR AND ACCURATE
HEALTH CARE DECISIONS FOR
PATIENTS IN CALIFORNIA. I'D
FIRST LIKE TO THANK THE CHAIR
AND COMMITTEE STAFF FOR THEIR
WORK ON THE BILL. I WILL BE
ACCEPTING MINOR TECHNICAL
AMENDMENTS FROM THE COMMITTEE
TODAY, PUT SIMPLY, THIS BILL
REQUIRES PHYSICIAN OVERSIGHT
WHEN ALGORITHMS ARE USED TO
DECIDE ON HEALTH CARE PROVIDERS
REQUESTS TO OFFER MEDICAL
SERVICES, THIS IS A NECESSARY
SAFEGUARD TO ADDRESS THE GROWING
USE OF ARTIFICIAL INTELLIGENCE
IN HEALTH INSURANCE PROCESSES,
SUCH AS CLAIMS AND PRIOR
AUTHORIZATION, PRIOR
AUTHORIZATION REQUESTS. AND WITH
ME TODAY I HAVE DOCTOR ANNA YAP
AT UC DAVIS HEALTH EMERGENCY
MEDICINE, AND WE ALSO HAVE
GEORGE SOROS FROM THE CMA
AVAILABLE FOR ANY TECHNICAL
QUESTIONS. THANK YOU. THANK YOU
SIR. PLEASE PROCEED. GOOD
AFTERNOON. GOOD. GOOD AFTERNOON.
CHAIR MEMBERS. I AM DOCTOR ANNA
YAP HERE TODAY REPRESENTING THE
CALIFORNIA MEDICAL ASSOCIATION
AS THE PROUD SPONSOR OF SB 1120,
RELATING TO ARTIFICIAL
INTELLIGENCE AND HEALTH CARE. WE
WANT TO THANK THE COMMITTEE FOR
HEARING THIS BILL TODAY, AND A
SPECIAL THANK YOU TO SENATOR
BECKER FOR AUTHORING THIS
IMPORTANT MEASURE. ARTIFICIAL
INTELLIGENCE IS A POPULAR TOPIC
THAT HAS GROWN IMMENSELY OVER
THE PAST COUPLE OF YEARS, BUT IN
THE PRACTICE OF MEDICINE, WE
HAVE BEEN USING AI FOR YEARS TO
ASSIST WITH DIAGNOSIS AND
TESTING, WHICH IS WHY THE
PHYSICIAN COMMUNITY OFTEN REFERS
TO ARTIFICIAL INTELLIGENCE AS
AUGMENTED INTELLIGENCE. IN
GENERAL, PHYSICIANS ARE
ENTHUSIASTIC ABOUT THE POTENTIAL
OF AI IN HEALTH CARE, BUT WE
ALSO WANT TO GUARANTEE IT'S DONE
IN A SAFE, RESPONSIBLE, AND
ETHICAL MANNER FOR OUR PATIENTS.
SB 1120 TAKES A STEP IN THE
RIGHT DIRECTION BY REQUIRING
THAT ANY DENIAL OR MODIFICATION
OF CARE IN A HEALTH PLAN, PRIOR
AUTHORIZATION PROCESS MUST BE
OVERSEEN BY A HUMAN PHYSICIAN,
AND THAT I ANY AI TOOL THAT IS
USED TO SUPPORT PHYSICIANS IN
UTILIZATION REVIEW PROCESSES
MUST COMPLY WITH FEDERAL
STANDARDS FOR FREEDOM FROM BIAS.
THIS INCLUDES EXCLUDING BIASES
THAT DISCRIMINATE AGAINST AN
INDIVIDUAL BASED ON THEIR GENDER
, RACE, OR OTHER IDENTITIES. I
CAN BE A POWERFUL TOOL FOR
SUPPORTING PHYSICIANS IN MAKING
CLINICAL DECISIONS, BUT WE MUST
BE AWARE THAT THEY CAN BE DEEPLY
FLAWED. I MODELS USED BY
PHYSICIANS TO DETECT DISEASES
SUCH AS CANCER, OR SUGGEST THE
MOST EFFECTIVE TREATMENT, ARE
EVALUATED BY THE FOOD AND DRUG
ADMINISTRATION, BUT THE AI TOOLS
TARGETED IN THIS BILL, WHICH ARE
USED BY INSURERS IN DECIDING
WHETHER THOSE LIFE ALTERING
TREATMENTS SHOULD BE PAID FOR,
ARE NOT SUBJECTED TO THE SAME
SCRUTINY AND HAVE LITTLE
INDEPENDENT OVERSIGHT, EVEN
THOUGH THEY ALSO INFLUENCE THE
CARE OF OUR NATION'S SICKEST
PATIENTS. NO MATTER HOW SMART
THE TECHNOLOGY IS, IT IS
DEPENDENT ON THE UNDERLYING DATA
SOURCES THAT IT LEARNS FROM. IF
THOSE UNDERLYING SOURCES ARE
FLAWED OR BIASED, IT CAN CREATE
DISASTROUS OUTCOMES FOR OUR
PATIENTS. THAT'S WHY WE NEED THE
KNOWLEDGE AND EXPERIENCE OF A
PHYSICIAN TO MAKE THE FINAL
DECISION. THIS BILL BUILDS ON
OTHER SIMILAR EFFORTS AT THE
STATE AND FEDERAL LEVEL. IN A
FINAL RULE ISSUED EARLIER THIS
YEAR CALLED T I ONE, THE FEDERAL
GOVERNMENT PUT RULES IN PLACE
FOR CERTIFIED HEALTH INFORMATION
TECHNOLOGY TOOLS TO ENSURE THAT
THEY ARE FREE FROM BIAS. SEVERAL
BILLS CURRENTLY IN THE ASSEMBLY
CALL FOR TRANSPARENCY AROUND
DATA SOURCES AND ALGORITHMS, AND
DATA SOURCES. SB 1120 GUARANTEES
THAT INCREDIBLY IMPORTANT AND
SENSITIVE DECISIONS ARE MADE BY
HUMAN PHYSICIAN. THIS IS A KEY
PIECE OF LEGISLATION TO ALLOW US
TO PROVIDE SOME IMPORTANT
SPECIFIC RAIL GUARDS AS AI
DEVELOPS IN HEALTH CARE. AS THE
LEADERS OF THE HEALTH CARE TEAM,
WE BEAR THE ULTIMATE
RESPONSIBILITY FOR THE
TREATMENTS THAT ARE
ADMINISTERED, AND IT IS
IMPORTANT THAT PHYSICIANS, NOT
COMPUTERS, CAN MAKE SURE THAT
OUR PATIENTS GET THE CARE THAT
THEY NEED. THUS, I RESPECTFULLY
REQUEST AN AYE VOTE ON SB 1120
THE PHYSICIANS MAKE DECISIONS
ACT. THANK YOU ALL AND I'M HAPPY
TO ANSWER ANY QUESTIONS. THANK
YOU VERY MUCH. NEXT, PLEASE.
JUST HERE TO ANSWER ANY
TECHNICAL QUESTIONS. JORGE
SUAREZ WITH THE CALIFORNIA
MEDICAL ASSOCIATION. PERFECT
PERFECT. ARE THERE ANY OTHER
WITNESSES IN SUPPORT? NAME
AFFILIATION AND POSITION ON THE
MEASURE, PLEASE? THANK YOU.
CHAIR AND MEMBERS TIM MADDEN
REPRESENTING THE CALIFORNIA
RHEUMATOLOGY ALLIANCE IN THE
CALIFORNIA CHAPTER OF THE
AMERICAN COLLEGE OF CARDIOLOGY
IN SUPPORT. THANK YOU SIR. NEXT
PLEASE. GOOD AFTERNOON, CHAIR
AND MEMBERS, KIM STONE. STONE
ADVOCACY ON BEHALF OF THE
CALIFORNIA ORTHOPEDIC
ASSOCIATION IN SUPPORT. THANK
YOU. THANKS FOR COMING NEXT.
PLEASE LEAH BARROWS, ON BEHALF
OF CALIFORNIA HOSPITAL
ASSOCIATION IN SUPPORT. THANK
YOU. NEXT, PLEASE. GRACE COPLAN,
ON BEHALF OF PROVIDENCE HEALTH
IN SUPPORT. THANKS FOR COMING
NEXT, PLEASE. JENNIFER SNYDER
WITH CAPITAL ADVOCACY ON BEHALF
OF THE CALIFORNIA LIFE SCIENCES
IN SUPPORT. THANK YOU. NEXT,
SARAH, ON BEHALF OF THE ALS
ASSOCIATION AND SUPPORT. THANK
YOU MA'AM. NEXT. YES, SIR.
RANDALL HAGER, ON BEHALF OF THE
PSYCHIATRIC PHYSICIANS ALLIANCE
OF CALIFORNIA IN SUPPORT. THANK
YOU. ANY OTHER WITNESSES IN
SUPPORT? OKAY, LET'S MOVE TO
WITNESSES IN OPPOSITION FIRST.
ANY LEAD WITNESSES? SORRY. OUR
POSITION IS A CONCERNS POSITION
RIGHT NOW, SO, ROBERT BOYKIN,
GOOD AFTERNOON, CHAIR. MEMBERS
OF THE COMMITTEE, ROBERT BOYKIN
WITH THE CALIFORNIA ASSOCIATION
OF HEALTH PLANS HERE TODAY IN A
CONCERNS POSITION. WE WOULD LIKE
TO THANK THE AUTHORS OFFICE FOR
EARLY ENGAGEMENT ON THE BILL.
HOWEVER, THE BILL HAS CHANGED
SUBSTANTIALLY SINCE IT WAS
INTRODUCED IN FEBRUARY, WE ARE
STILL REVIEWING THE MOST RECENT
AMENDMENTS AND MAY UPDATE OUR
POSITION SHOULD THE BILL MOVE
FORWARD. TODAY, OUR MAIN CONCERN
IS THAT THE CURRENT LANGUAGE
APPEARS TO BE OVERLY BROAD AND
NOT EASILY APPLICABLE, AND IN
THE HEALTH CARE SPACE.
ADDITIONALLY, WE ARE CONCERNED
WITH THE PROVISION OF THE BILL
REQUIRING THAT OUR AI SYSTEMS
AND SOFTWARE BE OPEN TO
INSPECTION. OUR CONCERN HERE IS
THAT THE BILL DOES NOT CLEARLY
DEFINED WHO COULD ACCESS AND
INSPECT THESE SYSTEMS, WHICH
COULD CREATE POTENTIAL PRIVACY
AND PROPRIETARY CONCERNS. BUT
LET'S BE CLEAR, WE WANT TO NOTE
THAT CURRENTLY HEALTH PLANS USE
AUTOMATED TOOLS TO ASSIST IN
DECISION MAKING, REDUCE
ADMINISTRATIVE BURDENS AND
INCREASE EFFICIENCY, AND DO NOT
SOLELY RELY ON THESE TOOLS TO
MAKE HEALTH CARE DECISIONS.
THERE IS AND WILL ALWAYS BE
HUMAN INVOLVEMENT WHEN MAKING
THESE DECISIONS. WE LOOK FORWARD
TO FURTHER CONVERSATIONS AS THE
BILL MOVES FORWARD WITH THE
AUTHOR'S OFFICE AND OTHER
STAKEHOLDERS. THANK YOU FOR YOUR
TIME TODAY. THANK YOU. NEXT,
PLEASE. STEPHANIE WATKINS, ON
BEHALF OF THE ASSOCIATION OF
CALIFORNIA LIFE AND HEALTH
INSURANCE COMPANIES, I'D ECHO MY
COLLEAGUES COMMENTS. IN THE
INTEREST OF TIME, WE DO HAVE A
CONCERNS POSITION ON THE BILL.
WE DO HAVE SOME ADDITIONAL
POINTS THAT WE'D LIKE TO DISCUSS
WITH THE AUTHOR ABOUT SOME OF
THE MOST RECENT AMENDMENTS
REGARDING WHAT PROVIDERS CAN
REVIEW THE PRIOR AUTHORIZATION
REQUESTS, AND LOOK FORWARD TO
THOSE CONVERSATIONS IF THE BILL
MOVES FORWARD TODAY. THANK YOU.
THANK YOU. NEXT, PLEASE. MR.
CHAIR MEMBERS, JOHN WENGER, ON
BEHALF OF AMERICA'S HEALTH
INSURANCE PLANS, ALSO HAVE A
CONCERNS POSITION, BUT LOOK
FORWARD TO THE CONVERSATIONS.
THANK YOU. THANK YOU SIR. ANY
OTHER WITNESSES IN OPPOSITION OR
CONCERNED? OKAY. SEEING NONE,
LET'S BRING THE MATTER BACK TO
THE DAIS AND MY COLLEAGUES FOR
QUESTIONS, COMMENTS OR CONCERNS.
SENATOR GROVE, THANK YOU, MR.
CHAIR, YOU KNOW, I TECHNOLOGY IS
PRETTY COOL WHEN YOU USE IT AND
SCARY AT THE SAME TIME. AND I
KNOW THAT IT SAVED US TIME IN
THE REAL WORLD. I'M A BUSINESS
OWNER AND WE WRITE POLICIES A
LOT, AND YOU CAN PLUG SOME STUFF
IN AND THE POLICIES COME OUT AND
THEY'RE, YOU KNOW, WE HAD THEM
FIRST CHECKED BY OUR LEGAL TEAM
AND THEY'RE LIKE, YEAH, THEY'RE
PERFECT. AND IT SAVED HOURS AND
HOURS OF TIME. THAT'S WAY
DIFFERENT THAN HAVING A DOCTOR,
A COMPUTER TALK TO YOU ABOUT
YOUR PHYSICAL OR YOUR MEDICAL
ISSUES OR ANYTHING LIKE THAT.
SO, JUST LIKE, YOU KNOW, SELF
DRIVING CARS, I THINK THAT'S A
GREAT NEW TECHNOLOGY. BUT I WANT
SOMEBODY BEHIND THE WHEEL, I
WANT I, I LIKE THE AI SITUATION.
I THINK IT'S, IT'S PRETTY
BENEFICIAL IN SOME AREAS. BUT I
WANT A DOCTOR LOOKING AT ME, MY
FAMILY AND I'M ASSUMING, YOU
KNOW, OVERSEEING WHAT'S GOING
ON. SO, HONORED TO SUPPORT THE
BILL TODAY. I THINK IT'S COMMON
SENSE. AND I THINK THAT NEXT
YEAR WE'LL PROBABLY SEE A LOT OF
AI BILLS, AS FAST AS THAT PIECE
OF TECHNOLOGY IS MOVING. THANK
YOU, SIR. THANK YOU, MR. CHAIR.
THANK YOU. SENATOR. ANY OTHER
QUESTIONS, COMMENTS OR CONCERNS?
OKAY, SENATOR, YOU MAY CLOSE. I
APPRECIATE THOSE COMMENTS FROM
THE SENATOR AND RESPECTFULLY ASK
FOR AN AYE VOTE. OKAY. THE
MOTION IS TO PASS AS AMENDED. WE
REFER TO THE COMMITTEE ON
APPROPRIATIONS. PLEASE CALL THE
ROLL. SENATOR ROSS. AYE. ROTH.
AYE. WHEN GLAZER. GONZALEZ,
GROVE. GROVE. AYE. HURTADO.
LIMÓN MENGIBAR. MENGIBAR. AYE
RUBIO. AYE. RUBIO. AYE.
SMALLWOOD. CUEVAS WIENER. BILL
HAS FOUR VOTES. WE'LL HOLD THE
ROLL OPEN FOR ABSENT MEMBERS.
THANK YOU, SENATOR BECKER.
SENATOR. MEN, YOU ARE HERE ON
ITEM NUMBER FIVE, SENATE BILL
1078, LANGUAGE ACCESS. PLEASE
PROCEED WHEN READY. MAY I
PROCEED, CHAIR? MR. CHAIR. THANK
YOU. CHAIR. ROTH. COMMITTEE
MEMBERS, BEFORE I START, I JUST
WANT TO MAKE CLEAR THAT I'M
ACCEPTING THE PROPOSED COMMITTEE
AMENDMENTS AND WANT TO THANK THE
COMMITTEE STAFF FOR THEIR WORK
ON THE BILL. SB 1078 WOULD
CREATE AN OFFICE OF LANGUAGE
ACCESS WITHIN THE CALIFORNIA
HEALTH AND HUMAN SERVICES
AGENCY. CAL HHS. THIS OFFICE
WOULD PROVIDE OVERSIGHT,
ACCOUNTABILITY AND COORDINATION
ACROSS CAL HHS DEPARTMENTS AND
OFFICES TO ENSURE INDIVIDUALS
WITH LIMITED ENGLISH PROFICIENCY
HAVE MEANINGFUL ACCESS TO ITS
PROGRAMS AND SERVICES. FOR THE
NEARLY 6.4 MILLION CALIFORNIANS
WHO HAVE LIMITED ENGLISH
PROFICIENCY, LANGUAGE BARRIERS
POSE A SIGNIFICANT CHALLENGE
THEIR ABILITY TO HAVE ACCESS TO
QUALITY HEALTH CARE COVERAGE AND
SERVICES. STUDIES SHOW THE
ABSENCE OF CULTURALLY AND
LINGUISTICALLY APPROPRIATE
HEALTH CARE SERVICES, HAVE
NEGATIVE HEALTH CARE OUTCOMES
FOR INDIVIDUALS IN THIS
SITUATION, INCLUDING LONGER
HOSPITAL STAYS AND HIGHER
LIKELIHOOD OF HOSPITAL
READMISSIONS. THESE AVOIDABLE
CLINICAL COSTS CAN BE
SIGNIFICANTLY REDUCED WITH
IMPROVING INTERPRETATION AND
TRANSLATION SERVICES. AND WHILE
CALIFORNIA HAS LONG RECOGNIZED
THE IMPORTANCE OF PROVIDING IN
LANGUAGE RESOURCES, THIS OFTEN
DOESN'T GET TRANSLATED WITHIN
OUR SIGNIFICANT BUREAUCRACY AND
HAVE NOT BEEN IMPLEMENTED IN AN
EFFECTIVE WAY. SB 1078 WOULD
HELP ENSURE IMPLEMENTATION AND
MONITORING OF EXISTING FEDERAL
AND STATE LANGUAGE ACCESS LAWS
AND CLOSE AN EXISTING GAP FOR
THOSE SEEKING ACCESS TO THE
BROAD SPECTRUM OF HEALTH
SERVICES, TODAY I HAVE WITH ME
JULIA LAO FROM ASIAN HEALTH
SERVICES AND DORINA WONG FROM
ASIAN RESOURCES, INC. TO TESTIFY
IN SUPPORT. PLEASE PROCEED. GOOD
AFTERNOON. CHAIR ROTH AND SENATE
HEALTH COMMITTEE MEMBERS, MY
NAME IS JULIA LEE. I'M THE CEO
OF ASIAN HEALTH SERVICES AND ONE
OF THE CO-SPONSORS OF SB 1078.
ASIAN HEALTH SERVICES WERE A
COMMUNITY HEALTH CENTER THAT
PROVIDES MEDICAL, DENTAL AND
BEHAVIORAL HEALTH CARE SERVICES
TO 50,000 LOW INCOME PATIENTS IN
14 ASIAN LANGUAGES. WE STARTED
50 YEARS AGO BECAUSE WE SAW THAT
LANGUAGE WAS A KEY BARRIER TO
HEALTH CARE ACCESS. MANY OF OUR
PATIENTS, THEY TRAVEL 30 TO 50
MILES JUST TO ACCESS OUR
SERVICES BECAUSE OF THE LANGUAGE
BARRIERS THAT THEY EXPERIENCED.
MY OWN GRANDFATHER WAS ALSO A
COMMUNITY HEALTH CENTER PATIENT,
RECEIVED SERVICES IN IN HIS OWN
LANGUAGE, AND AVOIDED A LOT OF
ER VISITS BECAUSE OF THAT,
BECAUSE OF HIS HEALTH ISSUES.
WHEN WE SAW THAT CALIFORNIA
EMBARKED ON THE BROADEST
DISTRIBUTION OF COVID
VACCINATIONS, WE SAW HOW
LANGUAGE BARRIERS REALLY
HINDERED COMMUNITY MEMBERS WITH
LIMITED ENGLISH PROFICIENCY FROM
ACCESSING LIFE SAVING VACCINES.
THE STATE'S VACCINE WEBSITE HAD
A LOT OF TRANSLATIONS FULL OF
ERRORS. MASS VACCINATION SITES
PROMISED TRANSLATIONS FOR
LANGUAGES BEYOND SPANISH, BUT
OUR OWN STAFF AND OUR OWN
COMMUNITY MEMBERS WERE
UNSUCCESSFUL IN GETTING
INTERPRETERS IN ASIAN LANGUAGES,
WE WERE ABLE TO STAND UP OUR
MULTILINGUAL, MULTICULTURAL
TESTING SITE IN TEN ASIAN
LANGUAGES, BUT WE SAW OVERALL
HOW THE IMPACT OF LACK OF
LANGUAGE ACCESSIBILITY HAD
REALLY JUST REALLY CHALLENGES
WITH INDIVIDUALS. WITH LEP, THEY
WERE THREE TIMES MORE THAN
LIKELY TO TEST POSITIVE FOR
COVID, AND THOSE WHO ARE
HOSPITALIZED FOR 35% MORE LIKELY
TO SUFFER HEALTH OUTCOMES
COMPARED WITH ENGLISH SPEAKERS.
THESE HEALTH INEQUITIES COULD
HAVE BEEN MITIGATED. THERE'S
BEEN A LOT OF CHALLENGES AND
WE'D LIKE TO AVOID THAT MOVING
FORWARD. WE'VE BEEN VERY
ENCOURAGED BY THE GOVERNOR'S
2022 EXECUTIVE ORDER THAT
DIRECTS CAL HHS TO DEVELOP
LANGUAGE ACCESS PLANS TO IMPROVE
ACCESS TO THEIR SERVICES. YET
THERE'S NO MECHANISM OR ENTITY
CHARGED WITH OVERSIGHT AND
ACCOUNTABILITY FOR THE
DEVELOPMENT AND IMPLEMENTATION.
IMPLEMENTATION OF THESE PLANS
THERE LACKS TRANSPARENCY FOR THE
PUBLIC TO KNOW HOW AND WHEN
THESE PLANS ARE DEVELOPED, AND
WHAT PROGRESS HAS BEEN MADE,
WITH RECENT DATA INDICATING THAT
29% OF INDIVIDUALS WITH LIMITED
ENGLISH PROFICIENCY DO NOT HAVE
A USUAL SOURCE OF CARE, IT'S
EVEN MORE CRITICAL THAT SB 1078
BE PASSED TO ENSURE GREATER
ACCOUNTABILITY AND ACCESSIBILITY
TO CAL HHS PROGRAMS AND
MEANINGFULLY REDUCE RACIAL AND
ETHNIC HEALTH DISPARITIES IN OUR
STATE. SB 1078 CURRENTLY HAS
OVER 70 ORGANIZATIONS
REPRESENTING ASIAN AMERICAN,
NATIVE HAWAIIAN, PACIFIC
ISLANDER, AFRICAN AMERICAN, AND
LATINX COMMUNITIES IN SUPPORT OF
THIS BILL. THANK YOU. CHAIR ROTH
AND MEMBERS OF THE COMMITTEE FOR
YOUR TIME TODAY. THANK YOU. NEXT
PLEASE. YES. HI. GOOD AFTERNOON,
CHAIR ROTH AND COMMITTEE
MEMBERS. MY NAME IS DORINA WONG.
I AM THE POLICY DIRECTOR AT
ASIAN RESOURCES, INC. WE ASK FOR
YOUR SUPPORT OF SB 1078, WHICH
WE WILL IMPROVE LANGUAGE ACCESS
FOR LIMITED ENGLISH PROFICIENT
OR LEP. CALIFORNIANS SINCE 1980,
ARI HAS PROVIDED OVER 30,000
DIRECT SERVICES TO ASIAN
AMERICANS, NATIVE HAWAIIAN
PACIFIC ISLANDERS, IMMIGRANTS
LIMITED ENGLISH SPEAKERS EVERY
YEAR IN OUR OFFICES IN
SACRAMENTO AND LA, WE ALSO
ADVOCATE FOR INCREASED CULTURAL
AND LINGUISTIC ACCESS TO HEALTH
AND SOCIAL SERVICES PROGRAMS. AS
LIKE AS WE HAVE SEEN FIRSTHAND,
THE SERIOUS LANGUAGE BARRIERS
THAT OUR CLIENTS FACE, OUR STAFF
HAS SEEN LONG WAIT TIMES.
SOMETIMES OVER AN HOUR OR MORE,
WHEN THEY TRY TO TALK TO THE
COUNTY ELIGIBILITY WORKERS
DURING THE MEDI-CAL RENEWAL
PROCESS, ESPECIALLY DURING THE
DEPARTMENT OF HEALTH CARE
SERVICES PUBLIC HEALTH
UNWINDING. SO THIS HAS CAUSED
MEDI-CAL TERMINATIONS AND LOSS
OF HEALTH CARE COVERAGE AND
SERVICES. SO THESE LANGUAGE
BARRIERS, IF YOU HAVE, AS YOU
HAVE HEARD, YOU KNOW, CAN CAUSE,
CAN CAUSE HEALTH DISPARITIES,
ADVERSE EXPERIENCES AND
SIGNIFICANT HARM AND HAS CAUSED
SIGNIFICANT HARM TO OUR LEP
COMMUNITY MEMBERS. SO SB 1078
WILL CONTRIBUTE TO IMPROVED
COMMUNICATION. AND AS SENATOR
MIN AND JULIA HAS POINTED OUT,
CAN AVOID COSTLY, COSTLY, HEALTH
CARE COSTS. THE BILL WOULD ALSO
BOLSTER THE STATE'S FEDERAL AND
STATE STATUTORY LANGUAGE
REQUIREMENTS BY CODIFYING CAL
HHS, LANGUAGE ACCESS POLICY AND
THE LANGUAGE ACCESS PLANS.
CURRENTLY AS JULIA POINTED OUT,
THERE IS NO MECHANISM TO REQUIRE
OR MONITOR THE PLANS TO
COORDINATE THE LANGUAGE SERVICES
ACROSS THE AGENCY OR ENFORCING
THE PROVISIONS OF THE PLANS. SO
THIS WILL CREATE A CENTRALIZED
OFFICE THAT WOULD MONITOR THE
EFFECTIVE IMPLEMENTATION OF
THOSE PLANS AND ISSUE CORRECTIVE
ACTION PLANS FOR THOSE
NON-COMPLYING. IT WOULD ALSO
PROVIDE AN INFORM LEP
COMMUNITIES ABOUT CRITICAL HHS
CAL HHS RESOURCES ON ITS PUBLIC
WEBSITE, AND ALLOWS SMALLER
LANGUAGE POPULATIONS TO REQUEST
THE TRANSLATION OF VITAL
DOCUMENTS UPON A WRITTEN
REQUEST. AND THEN FINALLY, THERE
WOULD BE INCREASED
ACCOUNTABILITY OF CAL HHS BY
REQUIRING REGULAR REPORTS TO THE
LEGISLATURE ABOUT ITS PROGRESS
AND ALSO TO CREATE A LANGUAGE
ACCESS ADVISORY STAKEHOLDER
GROUP. SO THAT THEY COULD
PROVIDE COMMUNITY INPUT. SO, IN
CONCLUSION, FOR ALL THOSE
REASONS, WE THINK THAT THE 1078
WILL IMPROVE, WILL ADDRESS THE
CURRENT SYSTEMIC BARRIERS THAT
MANY COMMUNITIES FACE AND URGE
YOUR SUPPORT OF SB 1078. THANK
YOU. MA'AM. ANY OTHER WITNESSES
IN SUPPORT? NAME AFFILIATION,
AND POSITION ON THE MEASURE,
PLEASE? ABBY ALVAREZ WITH THE
REGIONAL PACIFIC ISLANDER TASK
FORCE, THE CENTER FOR ASIAN
AMERICANS AND ACTION, AND THE
ORANGE COUNTY ASIAN PACIFIC
ISLANDER COMMUNITY ALLIANCE.
THANK YOU. NEXT, PLEASE. REBECCA
GONZALEZ, WESTERN CENTER ON LAW
AND POVERTY AND SUPPORT. THANK
YOU. HELLO. FAITH LEE WITH ASIAN
AMERICANS ADVANCING JUSTICE,
SOUTHERN CALIFORNIA, WE'RE IN
SUPPORT. THANK YOU. THANK YOU
VERY MUCH. NEXT, PLEASE. HI. MÀ
VELEZ WITH THE LATINO COALITION
FOR A HEALTHY CALIFORNIA AND
STRONG SUPPORT. THANK YOU. NEXT
AFTERNOON, MR. CHAIR MEMBERS
DENNIS CUEVAS ROMERO WITH THE
CALIFORNIA PRIMARY CARE
ASSOCIATION ADVOCATES AND
SUPPORT. THANK YOU. YES, SIR.
KEVIN AZLYNN, COALITION
CALIFORNIA REPRESENTS
ORGANIZATION STRONG SUPPORT.
THANK YOU. THANK YOU SIR. ANY
OTHER WITNESSES IN SUPPORT?
LET'S TURN TO WITNESSES AND
OPPOSITION. ANY OTHER
OPPOSITION. ANY WITNESSES IN
OPPOSITION, LEAD OR OTHERWISE.
SEEING NONE. LET'S BRING THE
MATTER BACK TO THE DAIS. MY
COLLEAGUES, QUESTIONS, COMMENTS,
CONCERNS ANYONE? SENATOR NGUYEN
THANK YOU, MR. CHAIRMAN.
SENATOR, I APPRECIATE THE BILL
AND I WILL BE SUPPORTING IT. ONE
THING I HOPE THE NEW OFFICE OF
LANGUAGE ACCESS ALSO CONSIDER, I
MEAN, CONSIDER THE DIFFERENT
LANGUAGES WITHIN THAT COMMUNITY,
FOR EXAMPLE, WITHIN THE
VIETNAMESE AMERICAN COMMUNITY,
THOSE WHO WERE EDUCATED PRIOR TO
1975, NO UNDERSTANDS DIFFERENT
LANGUAGE AND DIFFERENT WORDING
AND SO WE ACTUALLY HAVE BEEN
HAVING A LOT OF DIFFICULTY WITH
A LOT OF STATE, BOOKLETS AND
MANUALS OF DIFFERENT LANGUAGES
OF VIETNAMESE THAT A LOT OF OUR
OLDER GENERATION CANNOT
UNDERSTAND. VERSUS BECAUSE
THEY'RE THE TRANSLATION RIGHT
NOW THAT'S BEING USED TEND TO BE
MORE OF A GOOGLE TRANSLATION. IT
IS SO NOT THE SAME. AND THOSE
WHO ARE EDUCATED AFTER 75 HAS A
DIFFERENT, EDUCATION. AND IN
TERMS OF THE LANGUAGE OF THE
VIETNAMESE LANGUAGE THAN THOSE
WHO ARE OLDER. AND SO I HOPE
THAT THE, THE NEW, THE NEW
OFFICE WOULD TAKE THAT INTO
ACCOUNT. AND MAKING SURE THAT WE
HAVE THE LANGUAGE SO THAT PEOPLE
CAN THOSE WHO MOST LIKELY NEED
IT OR THE OLDER GENERATION,
WOULD BE ABLE TO READ AND
UNDERSTAND WHAT OUR INTENT IS,
OR TRYING TO EXPLAIN WHATEVER
THAT PROGRAM IS, OR IF THERE'S A
TEST TO IT AS WELL, SO I WILL BE
SUPPORTING AND I HOPE THAT AS WE
MOVE FORWARD THAT THAT'S TAKEN
INTO CONSIDERATION. I DON'T KNOW
ABOUT THE OTHER LANGUAGES, I'M
JUST MORE FAMILIAR WITH THE
VIETNAMESE LANGUAGE. SO THANK
YOU. THANK YOU FOR THE COMMENTS,
SENATOR. AND I THINK ONE OF THE
REASONS WE'RE TRYING TO PUT THIS
TOGETHER IS TO ENSURE THAT THERE
IS CULTURAL, AS THEY SAY,
CULTURALLY COMPETENT PROGRAMING
AVAILABLE. IT'S NOT JUST GOOGLE
TRANSLATE AT THE END OF THE DAY.
THANK YOU. THANK YOU, SENATOR.
SENATOR SENATOR, THANK YOU SO
MUCH. I KNOW THAT THE DEPARTMENT
HAS TRIED, AND PUT SOME ACTION
PLANS TOGETHER IN YOUR BILL IS
GOING TO BE IT'S GOING TO
COMPLEMENT THE EFFORTS OF THE
DEPARTMENT. I REALLY APPRECIATE
YOU BRINGING THIS BILL FORWARD.
THANK YOU, SENATOR. THANK YOU.
SENATOR ANY OTHER QUESTIONS
COMMENTS, CONCERNS SEEING NONE.
SENATOR. AMENDMENT YOU LIKE TO
CLOSE I RESPECTFULLY ASK FOR
YOUR I VOTE. AND WHO MOVED
SENATOR MENGIBAR MOVED THE BILL.
THE MOTION IS TO PASS. WE REFER
TO THE COMMITTEE ON HUMAN
SERVICES AMENDMENTS BEING TAKEN
IN HUMAN SERVICES. PLEASE CALL
THE ROLL. SENATOR ROTH, A ROTH I
WHEN I WHEN I GLASER GONZALES
GROVE. GROVE I HURTADO. LIMÓN
MENGIBAR MENGIBAR I RUBIO
SMALLWOOD. CUEVAS WIENER. THE
LAST FOUR VOTES WILL HOLD THE
ROLL OPEN FOR ABSENT MEMBERS.
LET ME ASK SENATOR EGGMAN.
SENATOR WAHHAB'S BEEN SITTING
HERE FOR A WHILE. YOU YOU HAVE
MORE THAN ONE BILL. WOULD YOU
MIND IF WE TAKE SENATOR WAHAB?
IT'S WHY DON'T YOU FLIP A COIN?
THANK YOU, MA'AM. ROCK PAPER
SCISSORS. SO, SENATOR WAHAB, I
GUESS THAT MEANS YOU HAVE TO
SPEAK QUICKLY. THIS IS ITEM 15,
SENATE BILL 1355, MEDI-CAL
IN-HOME SUPPORTIVE SERVICES.
REDETERMINATION. READY? PLEASE
PROCEED WHEN READY. YES. THANK
YOU. THANK YOU TO SENATOR EGGMAN
FOR GIVING UP HER SPOT REAL
QUICK. CHAIR ROTH, COLLEAGUES
AND MEMBERS OF THE PUBLIC. I
THANK THE COMMITTEE FOR THEIR
AMENDMENTS AND THANK CHAIR ROTH
FOR HIS SUPPORT OF THE BILL. I'M
HERE TO PRESENT SB 1355, WHICH
EXTENDS THE ELIGIBILITY OF
MEDI-CAL BENEFITS FOR IN-HOME
SUPPORT SERVICES RECIPIENTS TO
EVERY THREE YEARS INSTEAD OF
ANNUALLY. EVERY YEAR. THE MOST
VULNERABLE OF AN ALREADY
VULNERABLE POPULATION LOSE
BENEFITS BECAUSE THEY DID NOT
SUBMIT THEIR INFORMATION IN TIME
OR LACK KNOWLEDGE, ACCESS, AND
ASSISTANCE WITH AN
ADMINISTRATIVE PROCESS THEY MAY
FIND INTIMIDATING AND CUMBERSOME
, ESPECIALLY MONOLINGUAL
INDIVIDUALS, IMMIGRANTS, AND
OTHERS. EXTENDING THE
ELIGIBILITY PERIOD WILL ENSURE
THAT THE POPULATION WHO RELY
MOST ON IT WILL SEE FEWER
INTERRUPTIONS OF THEIR BENEFITS.
LONG TERME CARE AND AGING
EXPERTS AGREE THAT THAT ANY
CHANGES IN INCOME FOR MEDI-CAL
BENEFICIARIES ON IHSS ARE TOO
SIGNIFICANT TO WARRANT YEARLY
APPLICATIONS. SB 1355 IS MODELED
AFTER EXISTING LAW, WHICH ALLOWS
CONTINUING MEDI-CAL ELIGIBILITY
FOR CHILDREN UP TO FIVE YEARS OF
AGE WITHOUT CONDUCTING
REDETERMINATIONS DURING THAT
PERIOD. IT ITS USE WITH OTHER
MEDI-CAL POPULATIONS HAS ALREADY
PROVEN IT IS POSSIBLE TO CONDUCT
REDETERMINATION WITHOUT YEARLY
APPLICATIONS BY MEDI-CAL
BENEFICIARIES ON IHSS. I
SPECIFICALLY WANT TO SAY THAT
IHSS HAS THE LOWEST THRESHOLD
FOR PEOPLE TO BE ABLE TO PARTAKE
IN THAT PROGRAM, SPECIFICALLY
SELECTING SOMEBODY THAT CAN
PROVIDE CULTURALLY COMPETENT
CARE, ESPECIALLY TO OUR
IMMIGRANT COMMUNITIES OR LOWER
INCOME COMMUNITIES. AND WE
AGAIN, HAVE AN AGING POPULATION,
AND THIS IS ONE OF THE SAFETY
NET PROGRAMS THAT SO MANY PEOPLE
RELY ON. SO I WOULD LIKE TO
INTRODUCE MY WITNESS, KEVIN
ASLANIAN, EXECUTIVE DIRECTOR
WITH THE COALITION OF CALIFORNIA
WELFARE RIGHTS ORGANIZATION
MEANS. PLEASE PROCEED, SIR. GOOD
AFTERNOON. MY NAME IS KEVIN
ESTÁN, COALITION OF CALIFORNIA
WELFARE RIGHTS ORGANIZATION. AND
WE WORK WITH A LOT OF HHS
CLIENTS WHO HAVE VERY OFTEN HAVE
PROBLEMS WITH WITH THIS MEAN
ENROLLMENT AND THE CHAIR, THE
DSS AND THE PRIVATE HEALTH CARE
SERVICES PUBLISHES REPORTS ABOUT
ENROLLMENT. AND IN DURING
JANUARY OF THIS YEAR, 108,000
MEDI-CAL RECIPIENTS WERE
DISENROLLED. AND BECAUSE THEY
DID NOT COMPLETE THEIR RENEWAL,
42% OF THOSE DISENROLLED SAID,
DURING A SURVEY DONE BY THE
DEPARTMENT OF HEALTH CARE
SERVICES, SAID THAT THEY NEVER
GOT THE RENEWAL FORM, SO HOW
COULD THEY'RE ENROLL? 64% OF
THEM COMPLETED THE FORM AND SENT
IT BACK TO THE TO THE SYSTEM. IT
GOT LOST IN THE SYSTEM. IT'S
KIND OF NUTTY, 35% OF THEM TRIED
TO CALL UP AND GO THROUGH THE
RENEWAL SYSTEM, AND THEY
COULDN'T GET THE CALL CENTER
JUST DROPPED THEIR CALL. AND THE
MAJOR, MAJOR VICTIMS OF THESE
ARE MOSTLY HISPANICS THAT THIS
HAPPENS TO. SO THIS BILL
BASICALLY WOULD JUST GIVE PEOPLE
THREE YEARS, IN MOST OF THE MOST
OF THE PEOPLE ON FIXED INCOME,
YOU KNOW, EXACTLY WHAT THEY
HAVE. AND THE MED SYSTEM SHOWS
IF THERE'S A IF THERE'S A COLA
INCREASE, IT'S THERE. THE
GOVERNMENT KNOWS THAT THERE'S NO
THERE'S NOTHING TO LOOK AT. AND
I URGE AND I VOTE THANK YOU.
THANK YOU VERY MUCH, SIR. ANY
OTHER WITNESSES IN SUPPORT
PLEASE STEP FORWARD. NAME AND
AFFILIATION AND POSITION ON THE
MEASURE, PLEASE. CHAIR KATHY
MOSSBERG WITH THE LOCAL HEALTH
PLANS OF CALIFORNIA IN SUPPORT.
THANK YOU. ANY OTHER WITNESSES
IN SUPPORT? NOW LET'S TAKE
WITNESSES IN OPPOSITION. ARE
THERE ANY OPPOSITION WITNESSES
IN THE HEARING ROOM SEEING NONE.
BRING IT BACK TO MY COLLEAGUE.
MOVE THE BILL. SENATOR GROVE
MOVES THE BILL. SENATOR WAHAB,
WOULD YOU LIKE TO CLOSE? I
RESPECTFULLY ASK FOR AN AYE VOTE
. THE MOTION IS TO PASS, AS
AMENDED. WE REFER TO THE
COMMITTEE ON GOVERNMENT
ORGANIZED GOVERNMENTAL
ORGANIZATION. PLEASE CALL THE
ROLL. SENATOR ROTH, A ROTH I.
WHEN GLASER. GONZALEZ GROVE.
GROVE I. HURTADO. LIMÓN DE
MENGIBAR. RUBIO. SMALLWOOD.
CUEVAS. WIENER BILL HAS TWO
VOTES. WE'LL HOLD A ROLL OPEN
FOR ABSENT MEMBERS. SEN. EGGMAN,
THANK YOU VERY MUCH FOR YOUR
PATIENCE. THANK YOU. YOU'RE HERE
ON TWO MEASURES. FIRST IS ITEM
NUMBER SEVEN. SENATE BILL 1238
LANTERMAN PETRIS SHORT ACT
DESIGNATED FACILITIES. THANK YOU
VERY MUCH. I HOPE IT WASN'T
SOMETHING I SAID THAT ALL THE
MEMBERS LEFT OUT, IT WAS
SOMETHING I SAID, SENATOR. WAS
IT ON? AND THIS HAS TO DO WITH
THE, SUBSTANCE USE DISORDER
TREATMENT CENTERS, BUT NOT
RELATED TO THE EARLIER ONE,
WHICH WAS PRESENTED HERE, I'M
PRESENTING SB 1238, WHICH YOU
MIGHT REMEMBER LAST YEAR WE
PASSED, SB 43, WHICH REDEFINED
WHAT IT MEANS TO BE GRAVELY
DISABLED IN THE STATE OF
CALIFORNIA, SINCE THEN, WE'VE
BEEN, YOU KNOW, WELL, WELL,
REALIZING THAT THERE'S GOING TO
BE SOME, SOME CLEAN UP
LEGISLATION THAT'S GOING TO HAVE
TO HAPPEN. AND SO WE'RE HERE
TODAY WITH THE FIRST THING THAT
WE'VE HEARD THAT HAS BECOME A
REAL ISSUE IS, THE ISSUE AROUND
FACILITIES OF COURSE. AND WE
KNOW WE'RE BUILDING THEM OUT. WE
HAVE OUR SIX ROUND, I THINK, OF
B CHIP PROP ONE PASSED. MORE
WILL BE COMING, BUT OFTEN BEING
ABLE TO DESIGNATE WHICH ONES
THAT PEOPLE CAN GO TO. SINCE A
STANDALONE SUBSTANCE USE
DIAGNOSIS IS NOW ELIGIBLE FOR
THAT KIND OF ADMISSION, THE
CRITERIA AT THE FACILITIES AND
WHAT IS ALLOWED THROUGH THE
DEPARTMENT DOES NOT QUITE TRACK
WITH THAT. SO WHAT THIS IS, IS
GOING TO ALLOW DIFFERENT SORTS
OF FACILITIES THAT THE COUNTY
CAN DESIGNATE IN EACH COUNTY. NØ
COUNTY WILL BE REQUIRED BECAUSE
LIKE A SNIFF MAY BE ABLE TO DO
IT IN ONE COUNTY, BUT IN ANOTHER
COUNTY, THAT MIGHT BE TOTALLY
INAPPROPRIATE. SO THIS ALL GOES
TO THE COUNTY DESIGNATION OF
WHICH FACILITIES THEY THINK WILL
BE THAT PLACE THAT WILL TAKE
THAT PATIENT WHO MIGHT HAVE A
STANDALONE SUBSTANCE USE
DISORDER DIAGNOSIS, TRYING TO
COME OUT OF THE ER TO BE ABLE TO
GET THEM INTO OUR SYSTEM. WITH
ME HERE TODAY IS THE HEAD OF THE
POSITION OF EMERGENCY ROOM
ASSOCIATE DOCTOR GERTZ. LIKE
HERS, SIR. DOCTOR, PLEASE
PROCEED. HI, I'M MICHAEL GERTZ.
THANK YOU FOR HAVING ME. I'M AN
EMERGENCY PHYSICIAN IN THE
ANTELOPE VALLEY. I'M ALSO THE
PRESIDENT OF CALIFORNIA ASAP. A
CO-SPONSOR OF THE BILL. THIS
BILL IS ABOUT CREATING OPTIONS
AND FLEXIBILITY TO COUNTIES TO
IDENTIFY AND DEVELOP SAFE,
THERAPEUTIC PLACES FOR PEOPLE
WITH SEVERE SUBSTANCE USE
DISORDER TO RECOVER. AS NOTED BY
SENATOR EGGMAN, THE POPULATION
ELIGIBLE FOR INVOLUNTARY
TREATMENT HAS EXPANDED IT NOW
INCLUDES PEOPLE WITH JUST
SUBSTANCE USE DISORDERS AND NO
COMORBIDITY OF MENTAL HEALTH
DISEASE. OTHERWISE, THIS
POPULATION DESERVES ACCESS TO
DEDICATED TREATMENT FACILITIES.
THE ED SHOULD NOT BE THE ONLY
OPTION FOR PEOPLE AT HIGHEST
RISK FOR SUBSTANCE USE DISORDER.
OUR EDS HAVE DONE A LOT OF WORK
OVER THE PAST FEW YEARS TO
BECOME A WELCOMING PLACE FOR
PATIENTS WITH SUBSTANCE USE
DISORDERS TO BEGIN TREATMENT AS
EMERGENCY PHYSICIANS, WE ARE
PASSIONATE AND DEDICATED TO
PROVIDING 24 OVER SEVEN OPEN
DOOR ACCESS TO EVERYONE IN OUR
COMMUNITIES. BUT RECOVERY TAKES
TIME AND SPACE. 72 HOURS IS TOO
LONG FOR ANYONE TO STAY IN AN
EMERGENCY DEPARTMENT. WE ARE
ALWAYS OPEN, WHICH MEANS THE
LIGHTS NEVER GO OFF, THE ALARMS
NEVER STOP RINGING, AND THE
AMBULANCES NEVER STOP ROLLING IN
SLEEP DEPRIVATION,
OVERSTIMULATION, NONE OF THESE
ARE HELPFUL FOR PEOPLE LOOKING
TO FIND RECOVERY WITH SERIOUS
SUBSTANCE USE DISORDERS.
COUNTIES NEED THE FLEXIBILITY TO
IDENTITY TO IDENTIFY OPTIONS SO
PATIENTS CAN HAVE A SAFE, QUIET
SPACE TO RECOVER AND SO THAT WE
CAN KEEP OUR EMERGENCY
DEPARTMENTS OPEN 24 OVER SEVEN
AND HAVE ACCESS TO EVERYONE.
THANK YOU. THANK YOU SIR. AND
ALSO TODAY WITH ME IS RANDALL
HAGAR WITH THE PSYCHIATRIC
PHYSICIANS ALLIANCE OF
CALIFORNIA. SURE THANK YOU,
SENATOR EGGMAN. THANK YOU,
CHAIR, FOR ALLOWING ME TO GIVE
TESTIMONY TODAY. WHEN ABBY. I'M
SORRY. SB 43 WAS ENACTED, WE DID
A SURVEY OF OUR MEMBERSHIP
ACROSS THE STATE. AND WE DO HAVE
MEMBERS WHO ARE MEDICAL
DIRECTORS AND FACILITIES OF ALL
SORTS. AND THE FEEDBACK WE
STARTED GETTING WAS THAT THERE
WAS A PARTICULARLY VEXATIOUS
ISSUE IN THE LOCAL COUNTIES,
WITH THE PASSAGE THEY WERE KIND
OF FREAKING OUT, IF YOU WILL,
ABOUT THE WHOLE ISSUE OF HOW YOU
DEAL WITH SUBSTANCE USING
INDIVIDUALS WHO HAVE BECOME
GRAVELY DISABLED, YOU KNOW,
LOCAL OFFICIALS WERE NOT SURE
WHERE TO SEND THEM. WHAT KIND OF
AUTHORITY, WOULD BE FOUND
LOCALLY TO, AFFECT TRANSPORTS
AND TREATMENT, BUT WHAT WE DID
FIND IS THAT MANY OF THE
LICENSED FACILITIES THAT ARE
CURRENTLY CERTIFIED BY COUNTIES
AND APPROVED BY THE STATE IN
LOCAL JURISDICTIONS, AS, ARE
ALREADY TREATING THIS POPULATION
IN IN A VERY SPECIAL RESPECT. IN
THAT RESPECT IS THAT THEY HAVE
CO-OCCURRING DISORDERS, THEY
HAVE A SEVERE MENTAL ILLNESS,
AND THEY ALSO HAVE THEIR
SUBSTANCE USE ISSUE ON BOARD.
AND THOSE PEOPLE DO GET ACCESS
TO THE TREATMENT FACILITIES THAT
ARE CERTIFIED TO, ALLOW
TREATMENT AND EVALUATION FOR
PEOPLE WITH SEVERE MENTAL
ILLNESS, SO IN A SENSE, THAT
GAVE US THE IDEA THAT MAYBE WHAT
WE NEEDED TO DO BECAUSE THERE IS
STILL A POPULATION OUT THERE
THAT HAS A SOUL DIAGNOSIS OF
SEVERE, SUBSTANCE USE DISORDER.
AND WHAT WE NEEDED TO DO IS
CREATE THE CAPACITY FOR COUNTIES
TO BE ABLE TO CERTIFY FACILITIES
FOR THE TREATMENT OF THEM. WHAT
WE DID FIND IN OUR, EFFORTS TO
LOOK FOR A SOLUTION WAS THAT
THERE ARE SEVERAL KINDS OF
FACILITIES WHERE REGULATIONS
SPECIFICALLY PROHIBIT, THE
ADMISSION OF PEOPLE WITH A SOLE
SUBSTANCE USE DISORDER AND SO IT
SEEMS SIMPLEST TO, BASICALLY TO
THINK ABOUT CONFERRING
DISCRETIONARY AUTHORITY ON
COUNTIES TO DO DESIGNATION OF
THOSE KINDS OF FACILITIES. IT IS
PERMISSIVE. THEY'RE NOT, FORCED
TO DESIGNATE ANY PARTICULAR
FACILITY. BUT IF THEY DEEM THAT
THAT'S APPROPRIATE, THEY CAN DO
THAT, WE THINK THAT THIS IS A
VERY MODEST START TO ADDRESS THE
ISSUES AS SOME OF THE FACILITIES
AND TREATMENTS THAT WILL BE
ENABLED BY PROPOSITION ONE, CAN
COME ONLINE IN THE INTERVENING
YEARS, BUT THIS DOES MOVE US
FORWARD A BIT. IT DOES ADDRESS
THE INSTITUTIONAL ISSUE OF THE
DOOR IS CLOSED TO YOU IF YOU'RE
SOLELY, SUBSTANCE USE DISORDER,
DIAGNOSED. THANK YOU. THANK YOU.
SIR. OTHER WITNESSES IN SUPPORT,
NAME, AFFILIATION, POSITION ON
THE MEASURE ONLY. PLEASE GOOD
AFTERNOON, MR. CHAIR. MEMBERS.
DYLAN ELLIOTT, ON BEHALF OF THE
CALIFORNIA STATE ASSOCIATION OF
PSYCHIATRISTS, ADDITIONAL
CO-SPONSOR AND IN SUPPORT. THANK
YOU, THANK YOU. NEXT, PLEASE.
JEFF NEAL, REPRESENTING THE
COUNTY OF SAN DIEGO, ALSO IN
SUPPORT. NEXT, PLEASE. THANK
YOU. SIR LEAH BARROWS, ON BEHALF
OF CALIFORNIA HOSPITAL
ASSOCIATION IN SUPPORT. THANK
YOU, MR. CHAIR. AND MEMBERS,
MOYAMOYA, ON BEHALF OF SAN DIEGO
MAYOR TODD GLORIA, AS WELL AS
THE FULL BIG CITY MAYORS
COALITION, WHICH IS THE
COALITION OF MAYORS OF THE 13
LARGEST CITIES IN CALIFORNIA,
ALL IN STRONG SUPPORT. THANK YOU
, MR. CHAIR. MEMBERS OF THE
COMMITTEE, BRANDON MARTY WITH
THE CALIFORNIA MEDICAL
ASSOCIATION IN SUPPORT. THANK
YOU. ANY OTHER WITNESSES IN
SUPPORT? WITNESSES IN
OPPOSITION, PLEASE. ANY
WITNESSES IN OPPOSITION? IF YOU
LEAD, YOU MAY STEP UP AND TAKE A
MICROPHONE.
PLEASE IDENTIFY YOURSELVES FOR
THE RECORD AND YOU MAY PROCEED
WHEN READY. THANK YOU, MR. CHAIR
AND MEMBERS. MICHELLE CABRERA
WITH THE COUNTY BEHAVIORAL
HEALTH DIRECTORS ASSOCIATION OF
CALIFORNIA, WITH AN OPPOSING MÁS
AMENDED POSITION ON THIS BILL.
FIRST, WE WANT TO APPRECIATE THE
SENATOR FOR HER WORK IN TRYING
TO ADDRESS WHAT IS INDEED A
CONUNDRUM THAT WE FACE IN TRYING
TO IMPLEMENT SB 43 COUNTY
BEHAVIORAL HEALTH DEPARTMENTS
WERE IMMEDIATELY GETTING TO WORK
ONCE THIS BILL WAS SIGNED TO TRY
TO IDENTIFY WHAT KINDS OF
CHANGES WOULD BE NECESSARY IN
OUR SYSTEM TO FAITHFULLY
IMPLEMENT SB 43 AND THE LPS
SYSTEM, AS WE KNOW IT HAD
HISTORICALLY FOR THE, SINCE ITS
INCEPTION, BEEN BUILT AROUND A
SYSTEM OF CARE TO ADDRESS MENTAL
HEALTH CONDITIONS AND THE
TREATMENT OF THOSE CONDITIONS
AND ALCOHOLISM, AS WELL AS
ALCOHOLISM. HOWEVER, WITH WITH
RESPECT TO ALCOHOLISM, WELL, I
WON'T TAKE FOR MY TIME IN
ADDRESSING THAT, BUT I'M HAPPY
TO IN THE Q&A, SO WHAT WE'RE
CONCERNED ABOUT HERE IS THAT
THIS BILL ACTUALLY DOES NOT
SOLVE THE PROBLEM THAT IT
PURPORTS TO TRY TO ADDRESS IN,
IN A WAY THAT WE BELIEVE
SUPPORTS THE WELFARE, THE SAFETY
AND THE TREATMENT OUTCOMES OF
THE EXPANDED POPULATION THAT WE
NEED TO SERVE UNDER SB 43, AND
IT WOULD CREATE A PERCEPTION
THAT COUNTIES HAVE VIABLE
OPTIONS TO TREAT SUBSTANCE USE
DISORDERS ONLY WITHOUT ACTUALLY
MAKING THE NECESSARY CHANGES TO
THE TREATMENT FACILITIES TO DO
SO, AND, AND THAT THAT WILL
CREATE BOTH PUBLIC PRESSURE AND
CONCERN AT THE LOCAL LEVEL AS
WELL AS CONFUSION AS TO WHY
WE'RE NOT USING THE AUTHORITY
THAT'S GRANTED TO US UNDER THIS
BILL TO THEN DESIGNATE, FOR
EXAMPLE, A PSYCHIATRIC HEALTH
FACILITY FOR SUBSTANCE USE
DISORDER ONLY TREATMENT. LET ME
GIVE YOU AN EXAMPLE, THE
REGULATIONS FOR PSYCHIATRIC
HEALTH FACILITIES TODAY SAY THAT
WE MAY NOT TREAT SUD ONLY. WHY
IS THAT IT? BECAUSE THOSE
FACILITIES ARE NOT REQUIRED TO
HAVE THE KINDS OF SERVICES OR
STAFFING THAT WOULD ENSURE THAT
THOSE NEEDS WOULD BE ADEQUATELY
MET? THEY ARE APPROPRIATE FOR
INDIVIDUALS WITH CO-OCCURRING
CONDITIONS AND SO IN THE SHORT
RUN, DHS HAS ALREADY CLARIFIED
IN GUIDANCE THAT THEY MAY BE
USED AS SUCH. WE BELIEVE THAT A
MORE HELPFUL TRACK AND THIS IS
THE AMENDMENT THAT WE'VE
PROPOSED, WOULD BE TO HAVE DHS
CONVENE STAKEHOLDERS TO IDENTIFY
WHAT KIND OF STAFFING SERVICES
WOULD BE NECESSARY TO ADAPT OUR
CURRENT LOCKED LPS FACILITIES TO
SAFELY AND APPROPRIATELY TREAT
THEIR SUBSTANCE USE DISORDER OR
CO-OCCURRING MEDICAL NEEDS, AND
THEN TO PUT US ON A TRACK TO
MAKE CHANGES TO LICENSING AND
REGULATION STANDARDS, WHICH
WOULD ALSO REQUIRE POTENTIALLY
CHANGES IN REIMBURSEMENT. BUT
THAT'S GOING TO TAKE SOME TIME
TO FIGURE OUT. AND SO WE'RE
ASKING FOR AN AMENDMENT TO PUT
US ON TRACK TO MAKE SOME OF
THOSE CHANGES. WITHOUT THAT,
WE'RE CONCERNED ABOUT THE SAFETY
OF THESE FACILITY TYPES FOR
INDIVIDUALS WITH SUD ONLY IN
PARTICULAR AND THE QUALITY OF
CARE, WE THINK THAT THE BILL
WON'T RESULT IN THE OUTCOMES
THAT THE AUTHOR AND THE SPONSORS
ULTIMATELY WANT. FOR THESE
REASONS, WE RESPECTFULLY OPPOSE.
UNLESS AMENDED. AND AGAIN, THANK
YOU TO THE AUTHOR FOR BEING OPEN
TO DISCUSS OUR CONCERNS. THANK
YOU. MA'AM. SIR THANK YOU, CHAIR
AND MEMBERS, FOR ALLOWING ME TO
SPEAK IN OPPOSITION OF SB 1238,
MY NAME IS SAMUEL JAN, AND I'M
WITH DISABILITY RIGHTS
CALIFORNIA. WE'RE THE DESIGNATED
PROTECTION ADVOCACY SYSTEM FOR
OUR STATE, SB 1238 IS A FOLLOW
UP TO SB 43 LAST YEAR, WHICH
EXPANDED CIVIL COMMITMENT
CRITERIA TO INCLUDE INDIVIDUALS
WITH SUBSTANCE USE DISORDER FOR
THE FIRST TIME IN OVER 50 YEARS.
SB 1238 SEEKS TO ANSWER THE
QUESTION OF WHERE THESE
INDIVIDUALS WILL BE HELD, WE
CONTINUE TO RAISE CONCERNS WITH
THE EXPANSION OF AN INVOLUNTARY
COMMITMENT AND THE SPECIFIC
IMPACT ON THE SUBSTANCE USE
DISORDER POPULATION. WE ALSO
ECHO THE CONCERNS OF THE
BEHAVIORAL HEALTH DIRECTORS
ASSOCIATION, THAT THE MANNER IN
WHICH SB 1238 IMPLEMENTS THE
TREMENDOUS CHANGES STEMMING FROM
SB 43 IS NOT COMPREHENSIVE AND
COULD LEAD TO SIGNIFICANT
ISSUES. INVOLUNTARY COMMITMENT
IS EXTRAORDINARILY EXPENSIVE AND
OFTEN CAUSES INCREASED HARM. IT
PULLS RESOURCES FROM UPSTREAM
AND DOWNSTREAM SERVICES THAT
COULD BE USED TO AVOID
HOSPITALIZATION AND KEEP PEOPLE
STABLE LONG TERME THE RESEARCH
ON INVOLUNTARILY COMMITTED OF
INDIVIDUALS WITH SUBSTITUTE
SUBSTANCE USE DISORDER IS CLEAR.
IT'S LESS EFFECTIVE THAN
VOLUNTARY TREATMENT, AND IT
SIGNIFICANTLY INCREASES RISK OF
POST COMMITMENT OVERDOSE. SB
1238 WOULD ALLOW FULL
IMPLEMENTATION OF SB 43 IN A
MANNER THAT WILL HARM
CALIFORNIANS WITH SUBSTANCE USE
DISORDER. OUR STATE SHOULD
INSTEAD FOCUSING FOCUS ON
INCREASING ACCESS TO VOLUNTARY
SUBSTANCE USE DISORDER TREATMENT
SERVICES, PARTICULARLY IN
UNDERSERVED COMMUNITIES. SB 1238
IS A MISTAKE FOR CALIFORNIA, AND
WE URGE YOUR NO VOTE. THANK YOU
SIR. ANY OTHER WITNESSES IN
OPPOSITION SEEING NONE, LET'S
BRING THE MATTER BACK TO THE
DAIS AND QUESTIONS, COMMENTS,
CONCERNS. SENATOR MENGIBAR. MR.
CHAIR, IF WE COULD ALLOW THE
SENATOR TO RESPOND TO SOME OF
THE ISSUES THE OPPOSITION HAS
BROUGHT UP. YES, THANK YOU VERY
MUCH, YOU KNOW, AND I, I THANK
THE FEDERALLY FUNDED DISABILITY
RIGHTS FOR COMING HERE TODAY TO
OBJECT TO THE WORK WE DID LAST
YEAR AND CONTINUE ON THIS YEAR,
WE HAVE A DIFFERENCE OF OPINION.
AND THEN, I APPRECIATE AND WE
HAVE BEEN WORKING AND YOU'RE
GOING TO SIT UP HERE ON MY ON MY
NEXT BILL. WE'RE GOING TO
CONTINUE THIS RELATIONSHIP. BUT
IT SOUNDS TO ME LIKE BASICALLY
WHAT YOU'RE ASKING US TO DO IS
NOT DO THIS BECAUSE IT WOULD PUT
PRESSURE ON COUNTIES. WE FEEL
PRESSURE EVERY SINGLE DAY TO BE
ABLE TO GET SOMETHING DONE. I MY
OFFICE HAS HAD SO MANY
CONVERSATIONS WITH LOCAL
COUNTIES, WITH HOSPITALS ABOUT
THE NEED TO CLEAR UP THESE
REGULATIONS AS THE NEED TO BE
ABLE TO DESIGNATE CERTAIN
FACILITIES SO THAT THE ERS
AREN'T BACKED UP. I UNDERSTAND
THAT IT'S GOING TO BE MORE WORK.
I UNDERSTAND COUNTIES ARE GOING
TO HAVE TO LOOK AT THEIR OWN
WHAT THEY NEED AND AGAIN, WHAT
WHEN WE JUST ALSO PASSED PROP
ONE AND THAT SAID, WE'RE GOING
TO DO A REAL INVENTORY OF
EVERYTHING WE HAVE. AND WE KNOW
THAT WE DON'T QUITE HAVE ENOUGH.
THAT'S WHY WE'RE PUTTING IT ALL
ON, THAT'S WHY IT'S ALL BEING
BUILT. AND WE ALSO KNOW THAT
THERE ARE FACILITIES THAT ARE
ELIGIBLE NOW TO BE ABLE TO DO
THIS KIND OF TREATMENT. AGAIN,
DIFFERENT FACILITIES HAVE
DIFFERENT CAPACITIES. WE ARE
FORCING NOBODY TO DO ANYTHING.
WE'RE SAYING COUNTIES WHO WOULD
LIKE TO DO IT CAN DESIGNATE
OTHER FACILITIES THAT THAT THEN
ADDRESS THAT ISSUE FROM THE 1967
RULE ABOUT MENTAL HEALTH ISSUES,
ONLY. GOOD ANSWER FROM SENATOR.
FURTHER QUESTIONS. SENATOR. ANY
OTHER QUESTIONS? MEMBERS, SEEING
NONE. SENATOR, YOU MAY CLOSE.
THANK YOU VERY MUCH. AGAIN, THIS
IS AN IMPORTANT PIECE OF FOLLOW
UP. AGAIN LAST YEAR, AND I THANK
YOU ALL FOR YOUR SUPPORT IN
PASSING SB 43. WE KNOW THAT WE
DIDN'T GET A LOT OF COOPERATION
FROM A LOT OF DEPARTMENTS
BECAUSE FOLKS DIDN'T THINK WE
COULD DO IT. THEY DOUBTED YOU
ALL. WE DID IT. AND NOW WE JUST
REALLY NEED TO BE ABLE TO FIX
THE LITTLE PROBLEMS THAT MIGHT
EXIST, BECAUSE WE, YOU KNOW, WE
HAD TO PASS IT WITHOUT A LOT OF
GUIDANCE BEFORE, WE'RE SURE
GETTING IT NOW, AND WE'RE TAKING
ALL OF IT IN AND PUT IT INTO
POLICY. AND I ASK FOR YOUR I
VOTE. THANK YOU. SENATOR, IS
THERE A MOTION? SENATOR GROVE
MOVES THE BILL. PLEASE CALL THE
ROLL. AND THE MOTION IS. THANK
YOU. THE MOTION IS TO PASS. AND
WE REFER TO THE COMMITTEE ON
JUDICIARY. SENATOR ROTH, A ROTH
I WHEN I, WHEN I GLASER.
GONZALEZ. GROVE. GROVE AYE.
HURTADO. LIMON. MENGIBAR
MENGIBAR. AYE. RUBIO. SMALLWOOD
CUEVAS. WIENER. AYE. WIENER.
AYE. BEALL ES. BILL HAS FIVE
VOTES. WILL HOLD A ROLL OPEN FOR
ABSENT MEMBERS. SENATOR, YOU
HAVE ONE MORE ITEM. ITEM NUMBER
NINE, SENATE BILL 1397,
BEHAVIORAL HEALTH SERVICES
COVERAGE. THANK YOU VERY MUCH.
MR. CABRERA THANK YOU. THANK YOU
TO THE CHAIR AND COMMITTEE FOR
HEARING THIS. BILL. I WANT TO
START BY SAYING I'LL BE
ACCEPTING THE COMMITTEE
AMENDMENTS. SB 1397 WILL REQUIRE
HEALTH PLANS AND INSURERS TO PAY
THE GREATER OF THE MEDI-CAL
SPECIALTY MENTAL HEALTH RATE FOR
A CONTRACTED SERVICE THAT THE
COUNTY HEALTH AGENCY IS
PROVIDING. SO, AGAIN, YOU KNOW,
WE'VE DONE A LOT OF WORK TOWARDS
PARITY OF MAKING SURE THAT,
PRIVATE INSURANCES PAY THEIR
FAIR SHARE IN TREATING FOLKS,
ESPECIALLY IF THEY'RE COVERED
UNDER THEIR PLAN, TREATING
MENTAL HEALTH ISSUES. WE ALSO
KNOW AND WE HEARD LAST YEAR
THROUGH THE PASSAGE OF SB 326
AND, REDOING OF THE MENTAL
HEALTH SERVICES ACT THAT A LOT
OF TIMES COUNTIES ARE JUST
PROVIDING THIS WITHOUT GETTING
REIMBURSED. SO THIS BILL SAYS
COUNTIES OR, PRIVATE HEALTH CARE
INSURANCES ARE WELCOME TO LET
COUNTIES PROVIDE THE SERVICE.
THE SPECIALTY SERVICE, AND OF
COURSE, THIS IS A FULL SERVICE
PARTNERSHIP WE'RE TALKING ABOUT.
BUT IF THEY ASK THE COUNTIES TO
DO THAT, THEN THEY MUST BE
REIMBURSED AT THE MEDI-CAL RATE
TO SAID COUNTY. THAT WAY WE'RE
SAVING OUR COUNTY DOLLARS FOR
THOSE WHO REALLY NEED IT, WHO
ARE ON MEDI-CAL. WE ARE PULLING
DOWN THE DOLLARS FROM PRIVATE
INSURANCES WHO SHOULD BE
COVERING THIS AND MAKING SURE
THAT THERE'S NO THERE'S NO BREAK
IN SERVICES. AND WITH ME HERE
TODAY, I HAVE MICHELLE CABRERA,
WHO IS THE EXECUTIVE DIRECTOR OF
THE COUNTY BEHAVIORAL HEALTH
DIRECTORS ASSOCIATION, AS WELL
AS SUSAN HOLT COUNTY BEHAVIORAL
HEALTH DIRECTOR OF FRESNO.
PLEASE PROCEED. MR. CHAIR,
MEMBERS MICHELLE CABRERA
RECEIVED A AND WE ARE PROUD TO
SUPPORT THIS BILL, WHICH WOULD
REQUIRE COMMERCIAL INSURANCE
PLANS TO REIMBURSE COUNTY
BEHAVIORAL HEALTH FOR
INDIVIDUALS WHO ARE SERVED IN
OUR FULL SERVICE PARTNERSHIPS.
AND I WOULD LIKE TO TAKE THE
REMAINING TIME THAT I MAY HAVE
AND GIVE IT TO OUR COUNTY
BEHAVIORAL HEALTH DIRECTOR FROM
FRESNO. THANK YOU. MA'AM, PLEASE
PROCEED. THANK YOU VERY MUCH.
MR. CHAIR. MEMBERS, MY NAME IS
SUSAN HOLT AND I AM REPRESENTING
MY COLLEAGUES WITH THE COUNTY
BEHAVIORAL HEALTH DIRECTORS
ASSOCIATION. I'M THE BEHAVIORAL
HEALTH DIRECTOR IN FRESNO COUNTY
AND AS YOU AS YOU HEARD FROM OUR
AUTHOR, SENATOR EGGMAN, THIS
BILL IS QUITE IMPORTANT TO US
BECAUSE IT WOULD REQUIRE THAT
REIMBURSEMENT FROM THE
COMMERCIAL INSURANCE PLANS FULL
SERVICE PARTNERSHIPS. ALSO, WE
CALL THESE FULL FSPS. THEY
PROVIDE A WHATEVER IT TAKES
UNIQUE APPROACH TO BEHAVIORAL
HEALTH CARE, AND THEY PROVIDE
HIGHLY INTENSIVE MENTAL HEALTH
SERVICES WITH MULTIPLE SERVICE
ENCOUNTERS PER WEEK. THIS
INCLUDES TWO POPULATIONS,
RANGING FROM CHILDREN ALL THE
WAY TO OLDER ADULTS. RECENT
POLICY CHANGES WILL REQUIRE
COUNTY BEHAVIORAL HEALTH
AGENCIES TO FOCUS OUR RESOURCES
ON THOSE MEMBERS WHO ARE
MEDI-CAL BENEFICIARIES,
INCLUDING FOCUSING OUR FSP
EFFORTS. AND THAT REQUIRES US
NOW TO REALLY, CAREFULLY
CONSIDER AND REEVALUATE WHEN AND
HOW WE CAN PROVIDE SERVICES TO
THE BROADER COMMUNITY IN FRESNO
COUNTY. WE HAVE SEEN
CONSISTENTLY MANY REQUESTS FOR
FSP SERVICES FROM INDIVIDUALS
WITH COMMERCIAL INSURANCE.
TYPICALLY, THESE REFERRALS COME
THROUGH OUR CRISIS CONTINUUM,
BUT ALSO SO THESE REFERRALS EVEN
COME FROM THOSE COMMERCIAL
PLANS. AND THEIR NETWORK OF
PRIVATE PROVIDERS. THERE'S A
VARIETY OF REASONS FOR THIS. ONE
OF THOSE REASONS IS THAT FSPS
THROUGH COUNTY BEHAVIORAL HEALTH
SYSTEMS PROVIDE PSYCHOSOCIAL
INTENSIVE MENTAL HEALTH
TREATMENT SERVICES THAT ARE
COMMUNITY BASED, MEANING THAT WE
QUITE LITERALLY GO WHERE PEOPLE
ARE. WE MEET THEM WHERE THEY'RE
AT. WE ALSO ASSIGN A PERSONAL
SERVICES COORDINATOR TO EVERY
SINGLE PERSON IN A IN A FULL
SERVICE PARTNERSHIP PROGRAM, AND
THAT CLIENT HAS ACCESS 24 HOURS
A DAY, SEVEN DAYS A WEEK, TO A
MEMBER OF THEIR
MULTIDISCIPLINARY TEAM WHO KNOWS
THEM PERSONALLY SO THAT THEY CAN
NOT RELY ON THE PUBLIC CRISIS
SYSTEM WHEN THEY HAVE AN EPISODE
THAT NEEDS ATTENTION. POST
PANDEMIC, WE ARE SEEING
INCREASED ACUITY ACROSS ALL
PAYER SOURCES. INDIVIDUALS
ACROSS CALIFORNIA, WHETHER THEY
HAVE MEDI-CAL OR NOT, ARE SEEING
HIGHER AND HIGHER LEVELS OF
ACUITY THAT'S HITTING THE COUNTY
BEHAVIORAL HEALTH CRISIS
CONTINUUM AND INPATIENT
SERVICES. SO BECAUSE OF THAT, WE
ANTICIPATE INCREASED REFERRALS
TO THE COUNTY BEHAVIORAL HEALTH
SYSTEM FOR THE FULL SERVICE
PARTNERSHIP LEVEL OF CARE.
SADLY, IN MY COMMUNITY, NUMEROUS
INDIVIDUALS WHO HAVE PRIVATE
INSURANCE HAVE REACHED OUT TO ME
TO TELL ME THEY FEEL THAT THEY
NEED TO QUIT THEIR JOB SO THAT
THEY CAN ENTER INTO POVERTY SO
THAT THEIR LOVED ONE WILL
QUALIFY FOR MEDI-CAL SO THAT
THEY CAN HAVE ACCESS TO THESE
VERY IMPORTANT FULL SERVICE
PARTNERSHIP PROGRAMS WE HAVE IN
FRESNO COUNTY. ATTEMPTED TO BILL
COMMERCIAL INSURANCE, AND THE
VAST, VAST, VAST MAJORITY OF THE
TIME, THOSE CLAIMS ARE DENIED.
AND OVERALL, WE RECEIVE LESS
THAN 1% OF THE COST OF THE CARE
FOR THOSE PRIVATELY INSURED
INDIVIDUALS. WE'RE QUITE
GRATEFUL TO THE LEGISLATURE FOR
YOUR COMMITMENT TO PARITY, IN
PARTICULAR. SENATOR WIENER AND
OTHERS WHO HAVE BEEN PUSHING FOR
EXPANDING PARITY LAWS AND
ENFORCEMENT TO ENSURE GREATER
COVERAGE AND VERY GRATEFUL TO
SENATOR EGGMAN FOR AUTHORING SB
1397. ON BEHALF OF MY
COLLEAGUES, COUNTY BEHAVIORAL
HEALTH DIRECTORS ACROSS THE
STATE, AND WE STRONGLY SUPPORT
SB 1397 TO ENSURE ACCESS TO FULL
SERVICE PARTNERSHIP CARE AND WE
RESPECTFULLY REQUEST AN AYE
VOTE. THANK YOU. MA'AM. ANY
OTHER WITNESSES IN SUPPORT,
NAME, AFFILIATION AND POSITION
ON THE BILL, PLEASE? GOOD
AFTERNOON, MR. CHAIR, AND
MEMBERS. JOLIE ONODERA, ON
BEHALF OF THE CALIFORNIA STATE
ASSOCIATION OF COUNTIES, AS WELL
AS THE RURAL COUNTY
REPRESENTATIVES OF CALIFORNIA
AND THE URBAN COUNTIES OF
CALIFORNIA IN STRONG SUPPORT.
THANK YOU VERY MUCH. NEXT,
PLEASE, CHAIR AND MEMBERS SAMUEL
CHAN WITH DISABILITY RIGHTS
CALIFORNIA. WE'RE IN SUPPORT.
THANK YOU. ANY OTHER WITNESSES
IN SUPPORT IN THE HEARING ROOM?
OKAY. HOW ABOUT WITNESSES IN
OPPOSITION? ANY WITNESSES IN
OPPOSITION ON LAST CALL? OKAY.
SEEING NONE BACK TO THE DAIS.
COLLEAGUES, QUESTIONS, COMMENTS,
CONCERNS BEEN MOVED BY SENATOR
MENDEZ BAR. SENATOR EGGMAN,
WOULD YOU LIKE TO CLOSE? I WOULD
JUST THANK YOU ALL VERY MUCH AND
THANK OUR WITNESSES FOR
TESTIFYING AND REALLY LAYING
OUT, I THINK, THE PERVERSE
INCENTIVE THAT WE'VE MADE FOR
PEOPLE TO LEAVE THEIR JOB IN
ORDER TO BE ABLE TO GET
COVERAGE, THAT'S THAT'S WRONG.
THAT'S WRONG. LET'S TRY TO FIX
IT. I ASK FOR YOUR AYE VOTE.
OKAY GREAT JOB. MOTION IS TO
PASS AS AMENDED. WE REFER TO THE
COMMITTEE ON APPROPRIATIONS.
PLEASE CALL THE ROLL. SENATOR
ROSS ROTH. AYE. WHEN I, WHEN I
GLASER. GONZALEZ. GROVE. HURTADO
LIMÓN. MENGIBAR. MENGIBAR I.
RUBIO. SMALLWOOD. CUEVAS. WIENER
WIENER I HILL HAS FOUR VOTES.
WILL HOLD THE ROLL OPEN FOR
ABSENT MEMBERS. THANK YOU.
SENATOR GONZALEZ. DO I SEE
SENATOR GONZALEZ? NOPE OKAY.
HE'S NOT HERE. HE WANTED TO DO
YOUR BILL. WE'LL DO. GO BACK TO
YOU. WE'LL DO MY BILLS 18 AND
19. IF SHE COMES, WE'LL STOP.
OKAY AT THIS TIME, WE WILL MOVE
INTO THE, BILL, SB 1042 FROM
SENATOR ROTH.
THANK YOU, MADAM CHAIR. MEMBERS.
THE BILL REQUIRES ALL NURSING
PROGRAMS IN THE STATE OF
CALIFORNIA TO REPORT THEIR
CLINICAL PLACEMENT NEEDS TO THE
BOARD OF REGISTERED NURSING. THE
BILL WILL ALSO REQUIRE HEALTH
FACILITIES AND CLINICS TO REPORT
ON CLINICAL PLACEMENT SLOTS FOR
NURSING STUDENTS TO THE
DEPARTMENT OF HEALTH CARE ACCESS
AND INFORMATION, HCI. THE BILL
WOULD ALSO AUTHORIZE THE BOARD
OF REGISTERED NURSING UPON
REQUEST BY A NURSING SCHOOL OR
PROGRAM, TO ASSIST IN FINDING
AND SECURING CLINICAL PLACEMENT
SLOTS TO MEET THE CLINICAL
PLACEMENT NEEDS OF THAT
PARTICULAR SCHOOL OR PROGRAM. AS
YOU MAY KNOW, ONE OF THE MAJOR
BOTTLENECKS TO GROWING CAPACITY
IN OUR NURSING PROGRAMS IS THE
CHALLENGE OF LOCATING AND
SECURING THE CLINICAL PLACEMENT
SLOTS NECESSARY TO PROVIDE THE
CLINICAL TRAINING REQUIRED TO
OBTAIN A NURSING DEGREE. THERE
WAS A 2020 STATE AUDITOR REPORT
ON THE BOARD OF REGISTERED
NURSING THAT FOUND THAT DUE TO A
LACK OF RELIABLE DATA, THE BOARD
LACKED CRITICAL INFORMATION
ABOUT THE LOCATION AND
AVAILABILITY OF CLINICAL
PLACEMENT SLOTS TO MAKE
ENROLLMENT DECISIONS. THEREFORE,
THE STATE AUDITOR RECOMMENDED
THAT THE BOARD REQUIRE NURSING
PROGRAMS TO ANNUALLY UPDATE
INFORMATION ABOUT THE CLINICAL
FACILITIES THEY USE FOR STUDENT
PLACEMENTS, AND THAT COMPILING
THIS INFORMATION AND COMPARING
IT WITH OTHER AVAILABLE
INFORMATION ABOUT EXISTING
FACILITIES WOULD ALLOW THE BOARD
TO IDENTIFY CLINICAL FACILITIES,
CLINICAL FACILITIES THAT
PROGRAMS DO NOT CURRENTLY USE
FOR PLACEMENTS, WHICH COULD HELP
NURSING PROGRAMS FIND ADDITIONAL
SLOTS FOR THEIR STUDENTS. THIS
BILL DOES JUST THAT BY
COLLECTING DATA ON NURSING
PROGRAMS, CLINICAL PLACEMENT
NEEDS, AND COLLECTING DATA FROM
HEALTH FACILITIES AND CLINICS ON
THEIR CLINICAL PLACEMENT SLOTS.
THE BOARD WOULD THEN HAVE THE
NECESSARY INFORMATION TO
PROPERLY MATCH SCARCE CLINICAL
PLACEMENTS WITH THE NURSING
STUDENTS THAT NEED THEM. THE
INFORMATION WILL ALSO ASSIST THE
BOARD IN WORKING TO IDENTIFY
ADDITIONAL CLINICAL PLACEMENT
SLOTS IN A BROADER RANGE OF
HEALTH CARE FACILITIES AND
CLINICS, NOT JUST HOSPITALS. THE
APPROPRIATE TIME I'D
RESPECTFULLY ASK FOR YOUR VOTE.
THANK YOU, MR. CHAIRMAN. DO WE
HAVE ANY WITNESSES IN SUPPORT?
PLEASE COME FORWARD. HELLO,
DANIEL PEARL, ON BEHALF OF THE
AMERICAN FEDERATION OF STATE
COUNTY MUNICIPAL EMPLOYEES, AS
WELL AS THE UNITED NURSES
ASSOCIATION OF CALIFORNIA, UNION
OF HEALTH CARE PROFESSIONALS AND
STRONG SUPPORT. THANK YOU.
SAMUEL CHEN WITH DISABILITY
RIGHTS CALIFORNIA. WE ARE IN
SUPPORT. THANK YOU, MATT LÀ WITH
SEIU CALIFORNIA IN SUPPORT.
THANK YOU, DO WE HAVE ANY
WITNESSES IN OPPOSITION OR
ANYONE IN THE ROOM WHO WANTS TO
VOICE AN OPPOSITION? SEEING
NONE. BRING IT BACK TO MY
COLLEAGUES. QUESTIONS, COMMENTS?
THERE'S NONE. WOULD YOU LIKE TO
CONCLUDE? CAN WE ASK FOR AN AYE
VOTE? THANK YOU, MADAM CHAIR.
THANK YOU. IS THERE A MOTION?
OH, SENATOR, MOTION BY SENATOR
WIENER, THIS IS, DO PASS TO
REFER TO THE COMMITTEE ON ON
BUSINESS, PROFESSIONS AND
ECONOMIC DEVELOPMENT. PLEASE
CALL FOR THE VOTE. SENATOR ROTH.
AYE. ROTH AYE. WHEN I WHEN I
GLASER. GONZALEZ. GROVE. HURTADO
LIMÓN. MENGIBAR. MENGIBAR I.
RUBIO. SMALLWOOD. CUEVAS. WIENER
WIENER. I. NAZARIAN WILL HOLD IT
OPEN, THE VOTE IS FOUR ZERO.
WILL HOLD A ROLL CALL OPEN.
THANK YOU, MADAM CHAIR, AND
WE'LL GO NOW ON TO SB 1385.
THANK YOU, MADAM CHAIR. THIS
BILL HAPPENS TO BE PART OF THE
SENATE. SENATE, DEMOCRATIC
CAUCUSES SAFER CALIFORNIA POLICY
PLATFORM, WHICH INCLUDES BILLS
TO ADDRESS BOTH RETAIL THEFT AND
THE FENTANYL CRISIS. THIS
PARTICULAR BILL ALLOWS THE
SUBSTANCE ABUSE NAVIGATOR PLACED
IN EMERGENCY DEPARTMENTS TO
BUILD A MEDI-CAL PROGRAM UNDER
THE NEWLY IMPLEMENTED COMMUNITY
HEALTH WORKER BENEFIT, THE
CALIFORNIA BRIDGE PROGRAM. CAL
BRIDGE RECOGNIZED THE IMPORTANT
ROLE THAT HOSPITAL EMERGENCY
DEPARTMENTS CAN PLAY IN LINKING
PATIENTS WITH OPIOID USE
DISORDER TO TREATMENT, AND IN
PREVENTING FENTANYL OVERDOSE
DEATHS. CAL BRIDGE ACCOMPLISHES
THIS BY COMBINING IMMEDIATE
ACCESS TO MEDICATION FOR
ADDICTION TREATMENT WITH SUPPORT
. FROM A SUBSTANCE ABUSE
COUNSELOR OR NAVIGATOR WHO LINKS
THE PATIENT TO ONGOING CARE.
WHAT BEGAN AS A PILOT PROGRAM
USING FEDERAL FUNDING IN 52
HOSPITALS IS NOW A PROGRAM THAT
HAS BEEN IMPLEMENTED ACROSS 276
HOSPITAL EMERGENCY DEPARTMENTS.
IN ORDER TO SUSTAIN THESE
PROGRAMS, HOWEVER, A FUNDING
SOURCE IS NEEDED AND THIS BILL
CREATES THE FUNDING SOURCE BY
ALLOWING THE SUBSTANCE ABUSE
NAVIGATORS PLACED IN EMERGENCY
DEPARTMENTS TO BUILD A MEDI-CAL
PROGRAM WITH ME TODAY TO SPEAK
TO THE SUCCESS OF THE PROGRAM IS
DOCTOR AMY MULLEN, AN ER DOCTOR
AT UC DAVIS, AND ONE OF THE
PRINCIPAL FOUNDERS OF THE CAL
BRIDGE PROGRAM. HOPE I DIDN'T
BUTCHER YOUR NAME, DOCTOR. YOU
DID A FANTASTIC JOB. THANK YOU
VERY MUCH. PLEASE DOCTOR, I AM
EXCITED TO HAVE AN OPPORTUNITY
TO TALK TO YOU ABOUT THE
TRANSFORMATIVE POWER OF OUR
SUBSTANCE USE NAVIGATORS. WE
LITERALLY CALL THEM SUNS BECAUSE
THEY BRING THE SUN INTO OUR
EMERGENCY DEPARTMENTS. WE
STARTED AT UC DAVIS WITH A
SINGLE SUBSTANCE USE NAVIGATOR
WHO WAS GRANT FUNDED. HIS NAME
IS TOMMY TREVINO. HE HAS CHANGED
THE WAY THAT WE TAKE CARE OF
PATIENTS IN THE EMERGENCY
DEPARTMENT FROM A FAST A PROBLEM
THAT WAS INTRACTABLE AND
UNSOLVABLE TO A PLACE WHERE WE
CAN HAVE A HUGE OPPORTUNITY TO
CHANGE PEOPLE'S LIVES. THAT IS
WHAT HE DID. WE HAVE NOW
SUBSTANCE USE NAVIGATORS IN
EMERGENCY DEPARTMENTS ACROSS
CALIFORNIA DOING SIMILAR WORK,
BUT THEY ARE GRANT FUNDED. THIS
PROGRAM NEEDS TO BE EMBEDDED IN
THE MEDI-CAL PROGRAM BECAUSE
ONE, IT NEEDS TO CONTINUE BUT
EXTEND. IF YOU CAN IMAGINE THE
TRANSFORMATIVE POWER THAT ONE
HUMAN CAN HAVE IN AN EMERGENCY
DEPARTMENT THAT SEES OVER
100,000 PEOPLE ANNUALLY, IMAGINE
I NEED AN ARMY OF SUNS IN MY
EMERGENCY DEPARTMENT WHO CAN
IDENTIFY THE UNMET SOCIAL NEEDS
IN MY PATIENT POPULATION, HELP
OVERCOME THEM, AND LINK THEM TO
TREATMENT. I APPRECIATE SO MUCH
SENATOR ROTH'S BRINGING THIS
FORWARD BECAUSE IT HAS BEEN A
TRANSFORMATIONAL PROGRAM FOR OUR
EMERGENCY DEPARTMENTS, AND
PATIENTS IN CALIFORNIA. THANK
YOU VERY MUCH. THANK YOU. AT
THIS TIME, LET'S HEAR FROM OTHER
SUPPORTERS. THANK YOU. CHAIR AND
MEMBERS, TIM MADDEN,
REPRESENTING THE CALIFORNIA
CHAPTER OF THE AMERICAN COLLEGE
OF EMERGENCY PHYSICIANS. AND WE
RECENTLY JUST COME ON AS A
SPONSOR OF THIS BILL. SO PROUD
TO SUPPORT THE EFFORT. THANK
YOU. THANK YOU. GOOD AFTERNOON,
GLENN BACCHUS, FOR THE ELLA
BAKER CENTER FOR HUMAN RIGHTS
AND THE PROSECUTORS ALLIANCE OF
CALIFORNIA IN SUPPORT. THANK
YOU. ANY OTHER DO WE HAVE ANY,
WITNESS IN OPPOSITION SEEING
NONE, BRING IT BACK TO MY
COLLEAGUES COMMENTS, QUESTIONS.
I SIR. SENATOR, CAN YOU CLARIFY
SOMETHING FOR ME, PLEASE? THE
BILL, THE WAY I UNDERSTAND IT,
IS FOR MENTAL HEALTH SERVICES IN
IN THE CAPACITY OF THE FENTANYL
DRUG ADDICTION AND THINGS LIKE
THAT. LIKE SIMILAR TO THAT, IT'S
MENTAL HEALTH SERVICES THOUGH,
RIGHT? IT'S SUBSTANCE ABUSE.
SUBSTANCE ABUSE, SUBSTANCE
ABUSE. SO TO THE EXTENT THAT I
GUESS THAT INVOLVES MENTAL
HEALTH, I SUPPOSE, BUT IT'S
PRIMARILY IT'S SUBSTANCE ABUSE
COUNSELORS TO TRANSITION
INDIVIDUALS WITH SUBSTANCE ABUSE
FROM THE EMERGENCY DEPARTMENT ON
A CONTINUUM OF CARE BASIS. SO I
THINK I DID I SAY THAT
CORRECTLY, DOCTOR? YES YOU DID.
HOWEVER, I WILL SAY, YOU KNOW,
PEOPLE WITH SUBSTANCE USE
DISORDERS RARELY HAVE AN
ISOLATED SUBSTANCE USE DISORDER.
THERE'S OFTEN CO-OCCURRING PTSD,
DEPRESSION, ANXIETY, AND OUR
SUBSTANCE USE NAVIGATORS HELP
NAVIGATE PEOPLE WITH THOSE
ISSUES AS WELL TO SERVICES.
EXACTLY. YEAH. THEY LOOK THEY'LL
LOOK AT THE WHOLE PERSON, LOOK
AT THOSE NEEDS AND ADDRESS THEM
AS THEY COME. OKAY? OKAY. THANK
YOU. NO MORE COMMENTS. WOULD YOU
LIKE TO CLOSE? YES FOR AN AYE
VOTE? THANK YOU FOR YOUR
PATIENCE. IS THERE A MOTION.
MOVE BY SENATOR MENGIBAR. MADAM
CLERK, PLEASE CALL THE ROLL. OH.
I'M SORRY. AND IT'S. Dð PASS AND
REFER. WE REFER TO THE COMMITTEE
ON APPROPRIATIONS. SENATOR ROTH,
A ROTH. AYE. WHEN GLAZER,
GONZALEZ. GROVE. GROVE. AYE.
HURTADO LIMÓN. MENGIBAR.
MENGIBAR AYE. RUBIO. SMALLWOOD.
CUEVAS. WIENER WIENER. AYE.
TECHNICALLY IT IS. OH. I'M SORRY
. 440 WILL KEEP THE ROLL CALL
OPEN. I'M SO SORRY, MR. CHAIRMAN
. MY GOD TELLS ME IF YOU WENT UP
ON IT, THERE'S LITTLE DOWNSIDE.
BUT TECHNICALLY, YOU'RE RIGHT.
AND AT THIS TIME, I'M. WE'RE
GOING TO. WE'RE WAITING FOR
SENATOR. WE'RE WAITING FOR ONE
MORE AUTHOR
.
OKAY. WE'RE WAITING FOR SENATOR
GONZALEZ
.
WE'RE GOING TO OPEN THE ROLL UP
FOR THOSE MEMBERS WHO HAVE
JOINED US. WE'RE GOING TO START
WITH THE CONSENT CALENDAR. AND
ON THE CONSENT CALENDAR, WE
HAVE. I WANT TO USE YOUR SEAT.
NUMBER TWO, SB 910 WITH
AMENDMENTS. NUMBER FOUR, SB 963,
WITH AMENDMENTS NUMBER SIX, SB
1082. AMENDMENTS ARE GOING TO BE
TAKEN IN HUMAN SERVICES NUMBER
11, SB 1252, NUMBER 12, SB 1257
WITH AMENDMENTS. ITEM 13. SENATE
BILL 1319. ITEM 14. SENATE BILL
1320 WITH AMENDMENTS AND ITEM
16. SENATE BILL 1442 CURRENT
VOTE ON THE CONSENT CALENDAR IS
SIX ZERO. CHAIR VOTING AYE.
PLEASE CALL THE ROLL. GONZALEZ.
GROVE GROVE. AYE. LIMÓN. LIMÓN
AYE. RUBIO. WIENER WIENER. AYE.
Ã. CURRENT VOTE IS NINE ZERO
WILL HOLD A ROLL OPEN FOR ABSENT
MEMBERS. CALLING ITEM NUMBER
ONE, SENATE BILL 12 NINE ZERO.
HEALTH CARE COVERAGE. ESSENTIAL
BENEFITS. CURRENT VOTE IS SIX
ZERO. CHAIR VOTING AYE. PLEASE
CALL THE ROLL. GONZALEZ.
GONZALEZ. AYE GROVE NUMBER ONE.
WHICH 011. YES. HI. SORRY GROVE.
AYE LIMÓN. LIMON. AYE. RUBIO
RUBIO. AYE. WIENER. AYE. WIENER
AYE. CURRENT VOTE IS 11 ZERO.
AND JUST. THAT'S OUT. RIGHT?
YEP. THAT ONE'S OUT. THAT MATTER
IS OUT. ONE NUMBER. YOUR AYE.
CALL ITEM NUMBER THREE, SENATE
BILL 913 UMBERG. SUBSTANCE USE
DISORDER TREATMENT FACILITIES.
CURRENT VOTE IS 5 TO 0. CHAIR
NOT VOTING. PLEASE CALL THE
ROLL. SENATOR ROTH. GLASER.
GLASER. AYE. GONZALEZ GONZALEZ.
AYE. HURTADO SMALLWOOD. CUEVAS.
WIENER WIENER. AYE CURRENT VOTE
IS 8 TO 0. WILL HOLD THE ROLL
OPEN FOR ABSENT MEMBERS. NEXT
ITEM IS ITEM NUMBER FIVE. SENATE
BILL 1078 BY SENATOR MENDOCINE.
WHICH ACCESS CURRENT VOTE FOR
ZERO. CHAIR VOTING AYE. PLEASE
CALL THE ROLL. GLASER. GLASER
AYE. GONZALEZ. GONZALEZ. AYE.
HURTADO LIMÓN. LIMÓN. AYE. RUBIO
RUBIO. AYE. SMALLWOOD. CUEVAS
WIENER. WIENER. AYE CURRENT VOTE
IS NINE ZERO. HOLD OPEN FOR
ABSENT MEMBERS. NEXT ITEM. IS
ITEM NUMBER SEVEN, SB 1238.
SENATOR EGGMAN
LANTERMAN-PETRIS-SHORT. ACT
DESIGNATED FACILITIES. CURRENT
VOTE IS FIVE ZERO. CHAIR VOTING
AYE. GLASER. GLASER. AYE.
GONZALEZ AYE. GONZALEZ. AYE.
HURTADO LIMÓN. LIMÓN. AYE. RUBIO
RUBIO. AYE. SMALLWOOD. CUEVAS
SMALLWOOD. CUEVAS. AYE PUTS US
AT TEN. WE'RE MISSING. HURTADO
CURRENT VOTE IS TEN ZERO. WE'LL
HOLD THE ROLL OPEN FOR THE
ABSENT MEMBER. NEXT ITEM, ITEM
NUMBER EIGHT. SENATE BILL 1274.
OOPS. BEEN DROPPED. ITEM NUMBER
NINE. SENATE BILL 1397 BY
SENATOR EGGMAN BEHAVIORAL HEALTH
SERVICES COVERAGE. CURRENT VOTE
FOUR ZERO CHAIR VOTING AYE.
PLEASE CALL THE ROLL. GLASER.
GLASER. AYE. GONZALEZ GONZALEZ.
AYE. GROVE. GROVE AYE. HURTADO.
LIMÓN LEMON. AYE. RUBIO. AYE.
RUBIO. AYE SMALLWOOD. CUEVAS.
SMALLWOOD. CUEVAS. AYE. CURRENT
VOTE IS TEN ZERO. WILL HOLD THE
ROW OPEN FOR ABSENT MEMBERS.
ITEM NUMBER TEN. SENATE BILL
1120 SEN. BECKER. HEALTH CARE
COVERAGE UTILIZATION REVIEW.
CURRENT VOTE IS FOUR ZERO. CHAIR
VOTING AYE. PLEASE CALL THE
ROLL. WHEN I WHEN I. GLASER.
GLASER AYE. GONZALEZ. GONZALEZ.
AYE. HURTADO LIMÓN. LIMÓN. AYE
SMALLWOOD. CUEVAS. SMALLWOOD.
CUEVAS AYE. WIENER. WIENER. AYE
CURRENT VOTE TEN ZERO WILL HOLD
THE ROW OPEN FOR ABSENT MEMBERS.
ABSENT MEMBERS. ITEM NUMBER 11.
SENATE BILL 12. THAT'S ON
CONSENT. CONSENT ITEM NUMBER 15.
SENATE BILL 1355. SENATOR WAHAB,
MEDI-CAL IN-HOME SUPPORTIVE
SERVICES REDETERMINATION CURRENT
VOTE TWO ZERO. CHAIR VOTING AYE.
PLEASE CALL THE ROLL WHEN.
GLASER. GLASER. AYE. GONZALEZ
GONZALEZ. AYE. HURTADO LIMÓN.
LIMÓN. AYE. MENGIBAR MENGIBAR.
AYE. RUBIO. RUBIO. AYE
SMALLWOOD. CUEVAS. AYE.
SMALLWOOD. CUEVAS. AYE. WIENER
AYE. WIENER. AYE. CURRENT VOTE
NINE ZERO WILL HOLD THE ROW OPEN
FOR ABSENT MEMBERS. ITEM NUMBER.
WE'RE GOING TO PICK THAT UP IN A
SECOND ITEM NUMBER 18. SENATE
BILL 1042 BY SENATOR ROTH.
HEALTH FACILITIES AND CLINICS.
CLINICAL PLACEMENTS. CURRENT
VOTE FOUR ZERO. CHAIR. VOTING
AYE. PLEASE CALL THE ROLL.
GLASER. GLASER AYE. GONZALEZ.
GONZALEZ. AYE. GROVE GROVE. AYE.
HURTADO LIMÓN. LIMÓN. AYE. RUBIO
RUBIO. AYE. SMALLWOOD. CUEVAS
SMALLWOOD. CUEVAS. AYE. CURRENT
VOTE TEN ZERO. HOLD. WILL OPEN
FOR ABSENT MEMBERS. ITEM NUMBER
19. SENATE BILL 1385 SEN. ROTH.
MEDI-CAL SUPERVISING PROVIDERS.
CURRENT VOTE FOUR ZERO CHAIR.
VOTING AYE, PLEASE CALL THE ROLL
WHEN. GLASER. GLASER. AYE.
GONZALEZ GONZALEZ. AYE. HURTADO
LIMÓN. LEMON. AYE. RUBIO AYE.
RUBIO. AYE. SMALLWOOD. CUEVAS.
SMALLWOOD. CUEVAS. AYE. CURRENT
VOTE. NINE ZERO WILL HOLD THE
ROLL OPEN FOR ABSENT MEMBERS.
FEW SENATOR GONZALEZ, ITEM
NUMBER 17. SENATE BILL 1016.
LATINO AND INDIGENOUS
DISPARITIES REDUCTION ACT.
PLEASE PROCEED WHEN READY. THANK
YOU, MISTER CHAIR. AND MEMBERS,
I WANT TO BEGIN BY ACCEPTING THE
COMMITTEE AMENDMENTS DESCRIBED
ON PAGES FIVE AND SIX BY OF THE
ANALYSIS, AND WOULD LIKE TO
THANK THE COMMITTEE STAFF FOR
THEIR WORK ON THIS. I'M HERE TO
PRESENT SB 1016, WHICH WILL HELP
UNCOVER TRENDS AND DISPARITIES
THAT ARE OFTEN HIDDEN IN
AGGREGATED HEALTH DATA FOR
LATINOS AND INDIGENOUS
MESOAMERICANS LATINOS MAKE UP
40% OF CALIFORNIA'S POPULATION.
HOWEVER WITHIN THE COMMUNITY,
THERE ARE SEVERAL ETHNIC GROUPS
THAT HAVE DIVERSE HEALTH
OUTCOMES. SB 1016 WILL ADDRESS
THESE SHORTCOMINGS BY REQUIRING
THE DEPARTMENT OF PUBLIC HEALTH
TO COLLECT AND RELEASE
DISAGGREGATED DATA FOR SPECIFIED
LATINO SUBGROUPS, INCLUDING
MEXICAN, SALVADORAN, GUATEMALAN,
EACH MAJOR MESOAMERICAN
INDIGENOUS NATION, AS WELL AS
OTHERS TESTIFYING IN SUPPORT OF
THIS MEASURE. TODAY I HAVE
GENEVIEVE FLORES WITH THE MÉXICO
INDIGENA COMMUNITY ORGANIZING
PROJECT, AS WELL AS ERIKA
LIBRADO WITH CENTRO NACIONAL
PARA EL DESARROLLO INDIGENA
PEQUENO. AND WITH THAT, I
RESPECTFULLY ASK FOR AN AYE VOTE
ON SB 1016. THANK YOU. PLEASE
PROCEED. BUENAS TARDES. MIEMBROS
DEL COMITÉ GÂY OAN ERIKA
LIBRADO JOHNMYERS GÂY DE MILANO.
CHANOMI INGLÉS SOLA DE PROGRAMAS
IN GREENFIELD. CONSENTRATE
BINACIONAL PARA EL DESARROLLO
INDIGENA. JOAQUIN. UNA
ORGANIZATION CRIADA POR PARA LAS
COMUNIDADES INDIGENAS PARA
ORGANIZAR Y GARANTIZAR QUÊ LA
CULTURA LOS IDIOMAS Y EL
CONOCIMIENTO DE NUESTRAS
COMUNIDADES SE HAN RECONOCIDOS Y
RESPETADO POR LOS SISTEMAS
INSTITUTIONS CAN IMPACTA
NUESTRAS VIDAS. CUIDADO ES UN
CURIOSO PRACTITIONER DE SEVE DE
66, ESCRITA POR LA SENADORA LENA
GONZALEZ, APOYO A NUESTRO
PROGRAMA DE SALUD MENTAL
MATERNA, DON DE LOS GRUPOS DE
APOYO QUÊ LLAMAMOS PLATICAS PARA
MADRES INDIGENAS AND MR. KHÎI
TRIQUI HEMOS TENIDO A MADRES CON
ANOS DE TRAUMA DESPUÉS DE
EXPERIENCIAS MIGRATORIAS
DIFICILES ABUSOS PASADOS Y OTROS
PROBLEMAS DE SALUD MENTAL. SIN
EMBARGO, CUANDO LAS MADRES
ACUDEN A NOSOTROS EN CRISIS NO
PODEMOS ENCONTRAR ASISTENCIA
PARA ELLAS, ESPECIALMENTE
ASISTENCIA QUÊ PUEDE IN SUS EN
SUS LENGUAS. POR EJEMPLO, UNA
MADRE TÊ Kò NOS AYUDA CON SU
CASO DE CALFRESH LÀ LOS
BENEFICIOS PORQUE NO PODIA
PAPELES Y NO PODIA COMUNICARSE
CON LA TRABAJADORA SOCIAL EN
ESPANOL Y LA OFICINA DEL
CONDADO. NO UN INTERPRET SI
NUESTRA AYUDA DE Ã INTERPRETER
Y SUS HIJOS NO RECIBIDO COVERAGE
SI LOS DATOS QUÊ DE NUESTRA
NUESTRA, PRESENCIA ES LO
IMPORTANTE QUÊ ES TENER
SERVICIOS EN IDIOMAS INDIGENAS
NUESTRAS MADRES DE FAMILIAS
SERIAN SUFRIENDO POR ESO, ESTOY
AQUI HOY PARA NUESTROS PADRES Y
FAMILIAS INDIGENAS. CREO C¯ ES
IMPORTANTE CÁC LA PRESENCIA DE
LAS COMUNIDADES INDIGENAS Y QUÊ
NUESTRAS VOCES Â NECESSIDADE SE
HAN ESCUCHAR TODAS AS BETWEEN 16
IS THE FIRST STEP IN MAKING THAT
POSSIBLE AT THE STATE AND LOCAL
LEVELS. THEREFORE, I
RESPECTFULLY ASK FOR YOUR VOTE
IN FAVOR OF SB 1016. THANK YOU
MA'AM. NEXT PLEASE. AND I'LL
JUST BE REPEATING THE FIRST PART
OF MY COLLEAGUES COMMENTS IN
ENGLISH, SO GOOD AFTERNOON,
MEMBERS OF THE COMMITTEE. MY
NAME IS ERIKA LIBRADO. I'M FROM
THE TRIQUI COMMUNITY. MY FAMILY
IS FROM CRUZ CHIQUITO, OAXACA,
AND I SPEAK SPANISH AND ENGLISH.
I'M THE GREENFIELD PROGRAM
MANAGER WITH CENTRO NACIONAL
PARA EL DESARROLLO INDIGENA, AN
ORGANIZATION CREATED BY AND FOR
INDIGENOUS COMMUNITIES TO
ORGANIZE AND TO MAKE SURE OUR
COMMUNITIES, CULTURE, LANGUAGES
AND KNOWLEDGE ARE RECOGNIZED AND
RESPECTED BY SYSTEMS AND
INSTITUTIONS THAT IMPACT OUR
LIVES. CBDO IS A PROUD
CO-SPONSOR OF SB 1016, AUTHORED
BY SENATOR LENO GONZALEZ, ONE OF
THE TEAMS THAT I SUPPORT IS OUR
MATERNAL MENTAL HEALTH PROGRAM.
WE'RE CDVA. Þ PROVIDES SUPPORT
GROUPS THAT WE CALL PLATICAS FOR
INDIGENOUS MOTHERS IN MEXICO AND
TRIQUI IN OUR PROGRAM. WE HAVE
SEEN MOTHERS WITH YEARS OF
TRAUMA AFTER DIFFICULT MIGRATION
EXPERIENCES, PAST ABUSE AND
POSTPARTUM DEPRESSION, OR OTHER
MENTAL HEALTH ISSUES. YET WHEN
MOTHERS COME TO US IN CRISIS, WE
STRUGGLE TO FIND ASSISTANCE FOR
THEM, ESPECIALLY ASSISTANCE THAT
CAN BE PROVIDED IN THEIR
LANGUAGES. FOR EXAMPLE, A MOTHER
ASKED US FOR HELP WITH HER
CALFRESH CASE. SHE HAD BEEN
DENIED BENEFITS BECAUSE SHE
COULD NOT READ THE PAPERS THEY
SENT HER, AND SHE COULD NOT
COMMUNICATE WITH THE SOCIAL
WORKER IN SPANISH AT THE COUNTY,
AND THE COUNTY OFFICE WOULD NOT
PROVIDE HER ASSISTANCE WITH AN
INTERPRETER. WE TRANSLATED THE
DOCUMENT FOR HER AND HELPED HER
CALL THE OFFICE. WITHOUT OUR
HELP, THOUGH, SHE AND HER
CHILDREN WOULD HAVE BEEN DENIED
CALFRESH WITHOUT THE DATA TO
SHOW OUR PRESENCE AND HOW
IMPORTANT IT IS TO PROVIDE
SERVICES IN INDIGENOUS
LANGUAGES, OUR MOTHERS AND
FAMILIES WILL CONTINUE TO
SUFFER. AND THAT'S WHY I'M HERE
TODAY. FOR OUR INDIGENOUS
MOTHERS AND FAMILIES, I BELIEVE
THAT IT IS IMPORTANT THAT THE
PRESENCE OF INDIGENOUS
COMMUNITIES ARE COUNTED, AND
THAT OUR VOICES AND NEEDS ARE
HEARD. SB 1016 IS THE FIRST STEP
IN MAKING THAT POSSIBLE AT THE
STATE AND LOCAL LEVELS, AND
THEREFORE I RESPECTFULLY ASK FOR
YOUR VOTE IN FAVOR OF SB TEN,
AND THEN I'LL JUST SWITCH OVER
TO MY COMMENTS. THAT'S FINE.
THANK YOU. THANK YOU. AND THEN,
FOR ME. SO GOOD AFTERNOON, CHAIR
AND MEMBERS OF THE COMMITTEE, MY
NAME IS GENEVIEVE FLORES, AND AS
WAS MENTIONED, I'M THE ASSOCIATE
DIRECTOR FOR THE MIXTECO
INDIGENA COMMUNITY ORGANIZING
PROJECT, OR MAYKOP MAIKOP IS A
PROUD CO-SPONSOR OF SB 1016,
AUTHORED BY SENATOR LENA
GONZALEZ. SB 1016 AIMS TO
COLLECT DEMOGRAPHIC AND LANGUAGE
DATA FOR CALIFORNIA'S LATINO
SUBGROUPS AND INDIGENOUS
MESOAMERICAN NATIONS. THIS DATA
WILL BE DISAGGREGATED TO PROVIDE
A MORE DETAILED UNDERSTANDING OF
THE NEEDS AND EXPERIENCES OF
THESE COMMUNITIES. CALIFORNIA
HAS A RICH DIVERSITY OF
INDIGENOUS MESOAMERICAN
COMMUNITIES, EACH WITH OUR OWN
LANGUAGES, OUR OWN CULTURES, AND
OUR OWN CUSTOMS. HOWEVER THESE
COMMUNITIES HAVE OFTEN BEEN TOLD
THAT WE'RE TOO SMALL TO BE
COUNTED. THOUGH THE 2010
INDIGENOUS FARMWORKER STUDY
INDICATED THAT MORE THAN 60% OF
FARMWORKERS ON THE CALIFORNIA
CENTRAL COAST ARE INDIGENOUS,
OUR COMMUNITIES CONTINUE TO BE
IGNORED. SINCE THAT REPORT'S
RELEASE OVER TEN YEARS AGO, SB
1016 AIMS TO IDENTIFY AND
DECREASE HEALTH DISPARITIES
AMONG LATINO AND INDIGENOUS
COMMUNITIES IN CALIFORNIA.
RESEARCH INDICATES THAT
COLLECTING MORE DETAILED AND
ACCURATE DEMOGRAPHIC DATA IS
CRUCIAL TO EFFECTIVELY
ADDRESSING THE HEALTH NEEDS OF
DIVERSE POPULATIONS. IN 2023,
MAIKOP, IN COLLABORATION WITH
THE LOCAL HEALTH PUBLIC HEALTH
DEPARTMENT, RESEARCHERS AND OUR
COMMUNITY MEMBERS CONDUCTED THE
SAN LUIS OBISPO INDIGENOUS
DEMOGRAPHIC STUDY. THE STUDY
REVEALED THAT SAN LUIS OBISPO
COUNTY, IN PARTICULAR, IS HOME
TO OVER 8000 INDIGENOUS
COMMUNITY MEMBERS. OF THOSE
SURVEYED, 57% SPEAK ONLY THEIR
INDIGENOUS LANGUAGE. MISTIKO
OTHER INDIGENOUS GROUPS THAT WE
FOUND IN THE COUNTY ARE NACO,
AMUZGO, TRIQUI AND NAWAT. 95%
WORK IN AGRICULTURE, 87% OF
CHILDREN UNDER FIVE, 64%
STRUGGLE TO FIND A STRUGGLE TO
FIND FOOD. IN THE LAST YEAR, 85%
LACK HEALTH INSURANCE AND ONLY
46% REPORTED EVER RECEIVING A
PHYSICAL EXAM. THE STUDY
HIGHLIGHTS THE IMPORTANCE TO
INCLUDE ALL COMMUNITY MEMBERS IN
DATA COLLECTION, TO UNDERSTAND
THEIR NEEDS, AND TO CREATE
SYSTEMS THAT CAN BE MORE
RESPONSIVE. LATINOS ARE NOT A
HOMOGENOUS GROUP, AND LATINIDAD
DANGEROUSLY ERASES INDIGENOUS
MESOAMERICAN IDENTITIES. SB 1016
IS A STEP TOWARDS RECOGNIZING
AND VALUING OUR DIFFERENCES AND
ENSURING HEALTH EQUITY FOR
INDIGENOUS AND LATINO
COMMUNITIES IN CALIFORNIA, AND
WE RESPECTFULLY REQUEST YOUR AYE
VOTE. THANK YOU. THANK YOU,
THANK YOU BOTH FOR COMING. ANY
OTHER WITNESSES IN SUPPORT,
NAME, AFFILIATION, POSITION ON
THE MEASURE, PLEASE? REBECCA
GONZALEZ, WESTERN CENTER ON LAW
AND POVERTY IN SUPPORT. THANK
YOU. MA'AM. NEXT, PLEASE. KARINA
WONG, ASIAN RESOURCES INC. AND
STRONG SUPPORT OF SB 1016. THANK
YOU. NEXT, PLEASE. THANK YOU.
BUENAS TARDES. MY NAME IS
MARICELA RAMIREZ. I'M YO HABLO
ESPANOL. I ESTOY APOYO DE LA
DÍAS. GRACIAS THANK YOU.
GRACIAS. BUENAS TARDES. MY NAME
IS SARA SALLY. HABLO ESPANOL. Y
ESTOY EN APOYO DE LA DÍAS. THANK
YOU. MÀ VELEZ WITH THE LATINO
COALITION FOR A HEALTHY
CALIFORNIA, A CO-SPONSOR AND IN
STRONG SUPPORT. THANK YOU. GOOD
AFTERNOON. JERONIMO AGUILAR HERE
ON BEHALF OF ALL OF US OR NONE
TODOS EN SACRAMENTO CHAPTER IN
STRONG SUPPORT. THANK YOU. THANK
YOU. ANY OTHER WITNESSES IN
SUPPORT, ANY WITNESSES IN
OPPOSITION? SEEING NONE. LET'S
BRING THE MATTER BACK TO THE
DAIS. COLLEAGUES, QUESTIONS,
COMMENTS, CONCERNS. SENATOR
LIMON, THANK YOU. AND I JUST
WANT TO THANK THE AUTHOR AND THE
PRESENTERS ALSO FROM THE
DISTRICT THAT I REPRESENT. SO
GREAT TO SEE THE WORK THAT YOU
ARE ADVOCATING FOR WITH THE
AUTHOR AND RESPECTFULLY MOVE THE
BILL WHEN APPROPRIATE. THANK
YOU, SENATOR LIMON. ANY OTHER
HANDS UP? NO OTHER SENATOR. SAY
THANK THE AUTHOR FOR BRINGING
THIS. AND THANK YOU SO MUCH FOR
SHARING YOUR STORIES AND MAKING
THIS IMPORTANT DEMAND, WE NEED
TO RESPECT OUR INDIGENOUS
COMMUNITIES WHO ARE FEEDING OUR
FAMILIES ACROSS THE STATE. AND,
NO, MY COPS WORK VERY WELL, AND
I'M EXCITED TO SEE YOU ALL HERE
REPRESENTING ON THIS ISSUE.
THANK YOU. OKAY. WOULD YOU LIKE
TO CLOSE, SENATOR? I WOULD JUST
LIKE TO THANK GENEVIEVE AND
ERICA, AS WELL AS THE MANY
ORGANIZATIONS WHO'VE BEEN
WORKING ON THIS. THIS IS OUR
SECOND YEAR, CONDUCTING THIS
ORGANIZATION AND PUSHING THIS
BILL. AND I WOULD LIKE TO
RESPECTFULLY ASK FOR AN AYE
VOTE. OKAY. THE MOTION IS BY
SENATOR LIMON. THE MOTION IS TO
PASS, AS AMENDED. WE REFER TO
THE COMMITTEE ON APPROPRIATIONS.
PLEASE CALL THE ROLL, SENATOR
ROTH. AYE ROTH. AYE. WHEN I WHEN
I GLASER. GLASER I GONZALEZ I
GONZALEZ I GROVE. HURTADO
HURTADO I LIMÓN I LIMÓN I
MENGIBAR I MENGIBAR I RUBIO I
RUBIO I SMALLWOOD. CUEVAS I
SMALLWOOD CUEVAS I WIENER.
WIENER Ó. I HAVE TO VOTE. GROVE
OKAY. WIENER. I CURRENT VOTE IS
TEN ZERO. AM I MISSING ANYBODY?
GO OUT AND VOTE. BUT SHE'S NOT
COMING BACK. SO NO CLOSE UP VOTE
IS TEN ZERO. THAT MATTER IS OUT.
THAT CONCLUDES THE RUN OF BILLS.
WE'RE GOING TO GO BACK THROUGH
AND SEE IF WE CAN PICK UP ANY
ABSENT MEMBERS. WE'RE GOING TO
START WITH, WE'RE GOING TO START
WITH ITEM NUMBER TWO. THE
CONSENT CALENDARS AND THE
CONSENT CALENDAR FOR THOSE WHO
ARE INTERESTED IS NUMBER TWO,
SENATE BILL 910 WITH AMENDMENTS.
ITEM NUMBER FOR SENATE BILL 963
WITH AMENDMENTS. ITEM SIX,
SENATE BILL 1082, WITH
AMENDMENTS BEING TAKEN IN HUMAN
SERVICES ITEM 11. SENATE BILL
1252. ITEM 12. SENATE BILL 1257,
WITH AMENDMENTS. ITEM 13. SENATE
BILL 1319. ITEM 14. SENATE BILL
13, 20, WITH AMENDMENTS AND ITEM
16. SENATE BILL 1442. CURRENT
VOTE IS NINE ZERO. CHAIR VOTING
AYE. PLEASE CALL THE ROLL. THIS
IS THE CONSENT CALENDAR.
GONZALEZ GONZALEZ I RUBIO I
RUBIO I VOTE IS 11 ZERO. THAT
MATTER IS OUT STARTING WITH ITEM
NUMBER ONE SENATE BILL THAT'S
OUT. ITEM NUMBER THREE SENATE
BILL 913. SENATOR UMBERG
SUBSTANCE USE DISORDER TREATMENT
FACILITIES. CURRENT VOTE IS 8 TO
0. CHAIR. NOT VOTING, PLEASE
CALL THE ROLL. ROTH HURTADO.
HURTADO I SMALLWOOD. CUEVAS
SMALLWOOD. CUEVAS I VOTE IS TEN
ZERO. THAT MATTER IS OUT. NEXT
ITEM. ITEM ITEM NUMBER FIVE.
SENATE AMEND SENATE BILL 1078.
LANGUAGE ACCESS. CURRENT VOTE 9
TO 0. PLEASE CALL THE ROLL ON.
HURTADO. HURTADO I SMALLWOOD.
CUEVAS. ROBLES I DON'T KNOW.
THIS IS ITEM NUMBER FIVE. SENATE
BILL 1078. SENATE AMEND LANGUAGE
ACCESS. SMALLWOOD. CUEVAS. WHICH
NUMBER IS THIS? FIVE FIVE SENATE
AMEND. ITEM I SMALLWOOD. CUEVAS
I VOTE IS 11 ZERO. THAT MATTER
IS OUT. NEXT ITEM IS ITEM NUMBER
SEVEN. SENATE BILL 1238. SENATOR
EGGMAN LANTERMAN-PETRIS-SHORT
ACT DESIGNATED FACILITIES.
CURRENT VOTE TEN ZERO CHAIR
VOTING AYE. PLEASE CALL THE ROLL
. HURTADO. HURTADO I VOTE IS 11
ZERO. THAT MATTER IS OUT. NEXT
ITEM IS ITEM NUMBER EIGHT, SB
1274. SENATOR. THAT'S EXCUSE ME,
THAT'S WITHDRAWN. ITEM NUMBER
NINE, SENATE BILL 1397. SENATOR
EGGMAN, BEHAVIORAL HEALTH
SERVICES COVERAGE. CURRENT VOTE
TEN ZERO. CHAIR VOTING I HURTADO
. HURTADO I VOTE COUNT 11 ZERO.
THAT MATTER IS OUT NEXT ITEM IS
ITEM NUMBER TEN. SB 1120.
SENATOR BECKER, HEALTH CARE
COVERAGE UTILIZATION REVIEW VOTE
TEN ZERO CHAIR VOTING AYE.
PLEASE CALL THE ROLL. HURTADO
HURTADO I DIDN'T HAVE A MOTION
NOTED ON THAT ONE. SOMEBODY THAT
MOVED IT. GROVE. GROVE. OKAY.
THANK YOU. VOTE 11 ZERO. THAT
MATTER IS OUT. NEXT ITEM. ITEM
NUMBER 15. SENATE BILL 1355.
SENATOR WAHAB, MEDICAL IN-HOME
SUPPORT SERVICES
REDETERMINATION. CURRENT VOTE
NINE ZERO CHAIR VOTING AYE.
PLEASE CALL THE ROLL WHEN OAN
HURTADO. HURTADO I WITH WINDS
NOT COMING BACK, VOTE IS TEN
ZERO. THAT MATTER IS OUT. DID WE
CLOSE THAT OUT? 1016? YES AND
WE. I THINK WE JUST HAVE YOUR
THE 18 CLOSED OUT ITEM 17 SB
1016. LET'S CHECK ITEM NUMBER
18. SENATE BILL 1042 HEALTH
FACILITIES AND CLINICS. CLINICAL
PLACEMENTS. NURSING VOTE TEN
ZERO. CHAIR VOTING AYE. HURTADO.
HURTADO, A CURRENT VOTE 11 ZERO.
THAT MATTER IS OUT. AND OUR
FINAL ITEM ON THIS CALL, ITEM
NUMBER 19, SENATE BILL 1385.
ROTH MEDI-CAL SUPERVISING
PROVIDERS. CURRENT VOTE NINE
ZERO. CHAIR. VOTING I. WHEN
HURTADO. HURTADO I. CURRENT VOTE
TEN ZERO. THAT MATTER IS OUT.
MISS ANYTHING. LOOKS LIKE WE'VE
CONCLUDED OUR AGENDA TODAY.
THANK YOU FOR YOUR
PARTICIPATION. THIS SESSION OF
THE SENATE HEALTH COMMITTEE IS
ADJOURNED