Good afternoon, assembly member. >> Good afternoon, Mr. Chair, colleagues. I want to start by thanking the Chair and his staff for their hard work on this important issue, and appreciate the partnership between our two houses in moving this critical waver forward. AB 1568 Is a companion measure to the chair's SB 815. And together these bills enact the Medical 2020 waiver, which is a five year, $6.2 billion demonstration that provides California the opportunity to leverage federal funds to advance key initiatives. The waiver has four key pillars from the global payment program, which allows public hospitals to receive funding for services provided to the uninsured.

To the public hospital redesign and incentives in Medi-Cal or PRIME program, which uses a pay-for-performance and value based approach to the whole person care. An initiative which has a greater coordination of care across different disciplines and service areas. And finally, to the dental transformation initiative, which provides us an opportunity to improve the oral healthcare of our most vulnerable children. I think that this bill embodies the shared commitment of California and the federal government, to invest in a performance-based healthcare delivery system. And to continue improving the quality of healthcare that we provide to our most valuable Californians. So I appreciate the opportunity to be here with you today. And respectfully ask for your aye vote. I have witnesses as well. Terry Thomas and Kelly Brooks from CSAC, who are prepared to testify in support. >> Thank you, welcome, and present. >> Thank you, Mr. Chair and members. Terry Thomas on behalf of the California Association of Public Hospitals and Health Systems. CAPH strongly supports this measure, which is one half of the bill that you heard before this committee a short time ago and passed out of this committee unanimously.

This bill contains the Whole Person Care Pilot Programs and the Dental Transformation Initiatives. CAPH is public hospitals. There are 21 public hospital systems left in this state. They play a critical safety net role and deliver care to everyone regardless of ability to pay. We have over 2.85 million patient visits a year. And provide a wide range of speciality services as well as train over half of the physicians in this state. We strongly supported the earlier bill, and we testified previously on that, and we support this bill as well. Just a few comments about the Whole Person Care Pilot Program. Under that program, the Department of Health Care Services will select pilot projects on the basis of competitive applications. Which are focused on identifying frequent high users, particularly of the emergency room, Many of whom are homeless. We certainly hope that while this is open to counties around the state, we certainly hope a number of our public hospital systems will apply and will be awarded grants under this program. The people that are awarded grants, the counties will then collaborate with other agencies in the county such as behavioral health, alcohol and drugs, jail services, housing programs.

And they will work together to test care innovations to try to both improve the physical healthcare of their patients as well as produce greater efficiencies in the system and reduce the unnecessary utilization of services. The work of the housing coalitions is a key ingredient here as the link between homelessness and poor healthcare status has been demonstrated repeatedly. So we strongly support this component. I am not going to spend any time on the Dental Transformation Initiative except to say because we don't provide those services but, except to say it is a very important and critically necessary part of the waiver and others can speak to that program better than me.

But we urge your support. Thank you. >> Thank you. Anyone else in support? >> Kelly Brooks on behalf of the California State Association of Counties, also pleased to be here today in support. AB 1568 provides the statutory framework to implement California's Medi-Cal 2020 waiver. And it's particular to the components related to whole person care, which will provide $1.5 billion to California over the next five years. And the dental transformation initiative, which will provide $750 million, specifically to children's dental care in California. The counties are very supportive of both provisions in the bill, speaking in particular to whole person care, this is the first time that a Medicaid waiver in California has addressed the social determinants of health. And we think this is very crucial piece to the waiver and are really looking at this as an opportunity to break down silos between county departments, health plans, mental health plans, providers, public hospitals, and community-based providers.

In addition to providing better care coordination, it's an opportunity to share data and improve health outcomes. So far, the Department of Heath Care Services has received 29 letters of interest from counties across the state, counties with hospitals, counties without, very small counties, very large urban counties, a real mix. Which I think is an indication of the high level of interest and the interest amongst counties in trying to address very vexing social problems such as homelessness. In addition to testifying today on behalf of SESAC I also want to register support for the Los Angeles County Board of Supervisors, the Santa Clara Board of Supervisors, and the County Health Executives Association of California. Thank you. >> Kathryn Austin Scott, originally District Hospital Leadership Forum. We are supportive of all the four pieces of the waiver, the whole person care and dental piece.

We'll allow our hospitals to participate, hopefully, in some of those programs in our rural areas. So we're looking forward to working with the Department and the local counties, and support the bill. Thank you. >> Barbara Blazer with the California Hospital Association, also here today in strong support of this bill. >> Thank you, anyone else in support? >> Amber Cain with the Association of California Healthcare Districts in support. >> Nicole Wardelman on behalf of the Ventura County Board of Supervisors and San Bernardino Supervisors in support. >> Beth Capel on behalf of Health Access in support. >> Greg Herner on behalf of Alameda Health System in support. >> Joanna [UNKNOWN] on behalf of the Urban Counties of California in support. >> Devin Anderson on behalf of San Mateo County in support. >> [UNKNOWN] on behalf of the University of California in support.

>> Elizabeth Lansburg with the Western Center on Law and Poverty. We're in support, we had suggested a few amendments. As someone who worked in legal aid with low income Medi-Cal beneficiaries, it's hard to imagine two more important things in improving dental care and have the Whole Person Care Pilots who are very supportive of the Whole Person Care Pilot. On the potential transformation, it's great to see. We, of course, want to improve access for children. We're also very concerned about access for adults, and so not something that can be addressed in this bill, but something for us to consider moving forward. We did suggest that the incentive payments that are going to dentists will also go to dentists in GMC dental plans.

I think the committee is well aware of quality problems with the GMC plans and so we had suggested language making sure that the incentive payments to those dentists not be offset by the plans because, again, there have been some access problems. So I urge your support today and would love to work on those pieces. Thank you. >> Thank you.

Anyone in opposition? Questions, comments? Pan? >> No, thank you sir, very much. I know this a very important part of waiver. I'm sure it would be easy to clarify because there's always some. The Whole Person Project, which is, I think, is a great idea, is not going to use this, in any way supplant the CSS for children with special needs in any of the counties, right? >> Correct.

>> Thank you. >> Could we have a motion by, yeah, Senator Winn, would you like to close? >> Thank you for your consideration, I respectfully ask for your aye vote. >> Thank you. We're at item number four, AB 1568 do pass to appropriations. Call the members, please. >> Hernandez? >> Aye. >> Hernandez, aye. Nguyen? >> Aye. >> Nguyen, aye. Hall, Mitchell, Monning? >> Aye. >> Monning, aye. Nielsen? >> Aye. >> Nielsen, aye. Pan? >> Aye. >> Pan, aye. Roth? >> Aye. >> Roth, aye. Wolk? >> Currently has six, enough to get out. We're going to place that bill on call, thank you. >> Thank you Mister Chair, staff, and colleagues. >> We're at item number 9, AB 2750, Gomez, tissue banks.

Good afternoon, Assemblymember, welcome. >> Thank you Mr Chair and Senators, I'm presenting Assembly Bill 2750, which will exempt a person from tissue bank licensure if they're storing certain types of allograft tissue. Currently without a tissue bank license, you cannot store allograft tissue for use. This creates a situation where hospitals and surgery centers order tissue for same day usage. When tissues go unused in that day, they are required to return tissues on that same day. AB 2750 creates a narrow exemption for hospital or outpatient clinic to store allograft tissue, as long as they maintain a log of when the tissue was received, when it expires, among other information.

The stored tissue must also be obtained from a licensed tissue bank, be individually boxed and have a unique identification code. If not intended for further distribution and is registered with the FDA. I have entered Governor, I almost made you Governor. And a Governor representing his client, Andrew. >> When Andrew governed on our behalf- >> Could you get somebody more suited to present other than Andrew Governor? >> I know.

>> Where's Jim Gross when you need him? >> Pardon for the interruption. >> Andrew President. >> Please proceed. >> I'm Andrew Governor on behalf of My Medex, one of the world's leading global processors marketer and distributors of human amniotic tissue. We ask your support of the bill. Due to the burdens of licensure right now, many hospitals and ASCs are opting not to obtain a tissue bank license. Rather than enter into agreements with the tissue bank suppliers to deliver tissues, as Mr. Gomez says, on a daily basis, we are actually having courier services deliver tissue in the morning. >> And whatever unused tissue was available at the end of the day, under current law, they actually have to ship it back. Two years ago, this legislature unanimously passed a bill that would've exempted hospitals and ASCs to store tissues under certain circumstances.

Unfortunately, the governor vetoed that bill, and in his veto message, he talked about striking a balance between safety and the economy. We believe this bill actually strikes that balance. All this does is it narrowly adds an exemption to the current lists of exemptions in the tissue bank licensing law, that says that products that can be maintained at ambient room temperature with no refrigeration. Our client, My MedX has developed a product for many of their competitors which actually can be stored at room temperature for up to five years. >> And so we believe this simple, narrowly drafted bill will actually reduce cost and help ensure that patients get access to tissues they need, and we ask for your support.

>> Thank you. Anyone else in support, opposition, questions? Senator Monning. >> Thank you, just a quick question. Your final comment, your client, My MedX, would benefit from this. You said others have also developed this technology? >> Yeah, there's many competitors around the globe. >> Who would also benefit from this? >> Correct, and we actually put in, and it's a two year ambient requirement versus a five year to take into account all the other products. >> Great, thank you.

Appreciate it. >> And seeing no other questions, would you like to close? >> Ask for your aye vote. >> Thank you. We're at item number 9, AB 2750. We have a motion? >> Move. >> Move by Senator Pan, do pass to appropriations. Call the members. >> Hernandez? >> Aye. >> Hernandez, aye. Nguyen? >> Aye. >> Nguyen, aye. Hall, Mitchell, Monning? >> Aye. >> Monning, aye. Nielsen? >> Aye. >> Nielsen, aye. Pan? >> Aye. >> Pan, aye.

Roth? >> Aye. >> Roth, aye. Wolk? >> Currently have six, enough to get out. We'll place that bill on call, thank you. >> Thank you, Senator. >> Thank you. One and all. >> Okay, we're going to go ahead and open the roll. We're going to first start off with the >> Thank you. Thank you. >> First, start off with the consent calendar. That's item number one and number six. Call the absent members, please.

>> Paul Mitchell. >> Aye. >> Mitchell, aye. >> Currently has seven to zero, that vote is out. Item number two, AB59, Waldron. Call the absent members. >> Call. Mitchell? >> Aye. >> Mitchell, aye. Manning? >> That's 6-0, that bill is out. Item number three, AB1386, Low. Call the absent members. Hall, Mitchell? >> Aye. >> Mitchell, aye, Wolk? >> Current vote count is 7-0. >> [INAUDIBLE] about why the liability [INAUDIBLE] >> [INAUDIBLE] >> Item number 4. Item number four, AB 1568 Bonta, call the absent members. >> Paul, Mitchell. >> Aye. >> Mitchell, aye, Wolk. >> 7-0 that bill is out. Item number five, AB 1931 Rodriguez, call the absent members. Hall. Mitchell. >> Aye. >> Mitchell, aye. Wolk. >> Current vote count 7-0, that bill is out. Item number eight, AB 2568 Atkins. Call the absent members. >> Hall. Mitchell. >> Aye. >> Mitchell, aye. Wolk. 7-0, that bill is out.

Item number nine AB 2750, Gomez. Call the absent members. >> Hall, Mitchell. >> Aye. >> Mitchell aye. Wolk. >> 7-0, and that bill is out. That concludes the business of the day, and we're adjourned. You're welcome.



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