Senate Standing Committee on Health

So I think we'll just go ahead and begin. And I will ask my Vice Chair to take the gavel. And I see our witnesses are here.

Madam Chair, at this time, SB 326 by item three.

Thank you very much, Members. And as you recall, we had a very long informational hearing on this topic earlier. And I'm glad to say this Bill passed Assembly yesterday with strong bipartisan support, overwhelmingly. And so 20 years later, we're back to redo the MHSA. And as everyone knows, in 20 years, a lot of things changes. In fact, we went to over just over 20% uninsured now to less than eight. And so with that, and then the situation can also continue to change on our streets.

We continue to see those suffering. And so as we have this Fund, which also has grown substantially since we began it, when we first passed this back in 20 years ago, it was probably just a few million every year. The last couple of years, it's been over 3 billion every single year that goes into counties to be able to Fund these services. This is a redo redoing the pots one, to be able to use it for housing interventions.

We know that's one of the key things and really focusing and also including subs abuse is another huge issue. We know initially we were just talking about alcoholism and we've seen that transform. So to be able to really focus on these things, also really focusing on outcomes and accountabilities not just how much the counties have spent, but actually what the outcomes, what levels of funding there are.

So a lot of very exciting changes and a great, huge help from the Administration in their work and their vision. As I've said before, we have never had a Governor who has focused so much on mental health. But as we know, we've never had the crisis that we continue to see on our streets and in our communities and in the hearts and minds of our public who look around and say, surely we could spend our money better.

So this is a way to be able to spend our money better. And again, we go to the voters to see if they're going to agree with us. And with that, I would invite Director Baass up to talk a little bit more and answer any questions you may have.

Good morning. Michelle Baass, Director of the Department of Healthcare Services. Really just wanted to quickly thank Senator Eggman in partnership in this proposal. SB 326 really modernizes and reforms the Mental Health Services Act expands services can be provided to individuals with only substance use disorders, prioritizes care for those who are most vulnerable, and prioritizes housing interventions and workforce and continues investments in prevention, early interventions and innovative pilot programs.

Just quickly, some of the key changes with regard to the BHSA or the Behavioral Health Services Act modernizes the county allocations 30% to housing interventions, 35% to full service partnership programs, and 35% to behavioral health services and supports. Also provides flexibility to our counties to move dollars between those buckets up to 14% to meet the local needs and have kind of a conversation with their local communities on the best way to use those dollars. Create some new statewide led investments, including prevention 4% for prevention dollars.

Really recognizing the ability to state to efficiently develop statewide community wide and regional prevention programs workforce 3% of total dollars. Really leveraging these dollars to also draw down significant federal funds under our BH Connect waiver, leveraging over about 2.4 billion in investments over the five-year waiver program.

And then with regard to some of the oversight and accountability, really revising the three-year MHSA planning process to be a more comprehensive, integrated planning process for community behavioral health, not just Including Our Mental Health Services Dollars, but also our realignment, our MediCal dollars and all of the different system partners and contributors to the community behavioral health system.

And then finally, with regard to accountability, having counties and the state report on an outcomes and transparency report yearly, which will include information on utilization dollars, used dollars unspent, and outcomes achieved with those investments. With that, thank you and happy to answer any questions.

Thank you. Any other supporters? If you can, please state your name and affiliation and position.

Good morning, Madam Chair and Members. Karen Lang, on behalf of San Francisco Mayor London Breed in support. Thank you.

Good morning, chair and Members. Kira Ross on behalf of Mayor Lincoln in the City of Stockton, in support. Thank you.

Andrew Dawson, the California Housing Partnership in support.

Nico Molina on behalf of the Silicon Valley Leadership Group, in support.

At this time, we're asking for any opposition. Seeing none, we'll go on to the teleconference and if we can mad anybody on the call. Moderator please.

Ladies and gentlemen, if you wish to speak in support or opposition, please press 1 and 0. We'll be going to line 16. Please go ahead.

Good morning, Madam Chair and Members. Moira Topp, on behalf of San Diego Mayor Todd Gloria, as well as the Big City Mayors Coalition, which is the coalition of mayors of the 13 largest cities, all in unanimous support. Thank you.

And next we'll go to line 28. Please go ahead.

Good morning. Anastasia Kovalchuk with California Advisors on behalf of Sacramento. Mirage Steinberg in support. Thank you.

And several more have just queued up at this moment one moment while their line number is taken real quick.

Thank you.

Next, we'll go to line 19. Please go ahead.

Good morning. Sharon Gonzalez, on behalf of Mayor Karen Goh, the City of Bakersfield, and the City of Colorado in support. Thank you.

Next, we will go to line 23. Please go ahead.

Leah Barros on behalf of California Hospital Association in support.

Next, we will go to line 15. Please go ahead.

Good morning, this is Jason Minsky with the Association of California School Administrators just thanking the Administration and the author and we have withdrawn our opposition with the latest amendments. Thank you. Thank you.

Next, we will go to line 27. Please go ahead.

Good morning. Rachel Bhagwat on behalf of ACLU California Action, respectfully, in opposition, with a need for more time to work this through. Thank you.

Next, we will go to line 26. Please go ahead.

Yes, good morning. Karen Schmelter with Nossaman on behalf of the County of Monterey. The County of Monterey still echoes the California State Association of County's position on SB 326. We still have some concerns with this measure, but really thank the author for putting the amendments that she has forward.

And there's currently no one else in this queue at this time. Madam Chair.

Thank you. Madam Chair, if I may, I'm going to establish a quorum. Thank you, Madam Clerk. Please call roll.

Senator Eggman here. Nguyen here. Glazer. Gonzales here. Grove here. Hurtado. Limon. Menjivar here. Roth here. Rubio here. Wahab. Wiener. We have seven, so we have a quorum.

We have established a quorum at this time. Members. Questions, comments? Senator Roth?

Thank you, Madam Chair. Just want to while it's not directly related to this Bill and before this Committee, I just wanted to thank the Governor and the Administration and Dr. Galley specifically for the assistance with the acute care inpatient psychiatric issue and improving mental health services and delivery in our underserved areas. So thank you very much for that. Thank you, Madam Chair.

Please. Thank you, Madam Chair. I just want to recognize the author you have worked so hard on, especially mental health issues and trying to provide care for those out in the street. So I really do want to commend the author on this. It's not just this Bill and working with the Governor and thank you to the governor's office, but you specifically.

I know you've actually toured also California, so a lot of credit is due here and I want to thank you for that and once again, the Administration for bringing this forward. Thank you. Thank you. Please, I'm going to add on to the kudos. Thank you again.

I know we cannot top you in terms of the work that you've done in mental health, but I know some of our Latino community members have had issues specific with talking about how vague this might be and really wanting deep connections with this Bill as it pertains to mental health and behavioral health. So what is your response? And I know you'll continue to do that, I know you will, but would you?

Yeah, we continue to work on it. And a lot of our communities who say we're going to focus more on black and brown, well, those are the ones who are suffering the most, right? So those are the ones who need a lot of help. And I will say that we did a lot of amendments to be able to take some of that into account. And as we talked before about when we first started, it was over a 20% uninsured rate.

That is down to less than seven now. So there is so much more that we can Bill for now that wasn't possible to Bill for earlier. And so we're going to not maybe do as much of that in the community outreach just because those things can already be billed for now and be able to use the Mental Health Services Act that comes directly from the taxpayers, really, to be able to address those who are most in need.

Yes. And I look forward to working with you on that. Thank you so much. Any other comments? Question. Is there a motion? There's a motion. Would you like to close?

Just I want to thank all of you so much. You've all been along on the journey with me and I appreciate it. As your mayors, your county supervisors, our community groups. When we introduced this, we knew we still had work to do to negotiate, which is why you don't hear much opposition now, because we've really gone very far to negotiate with communities of color, with children's advocates, and with counties themselves to provide that flexibility, understanding one size doesn't fit all.

Wouldn't we all like to go back 20 years later and be able to redo something that we did in our personal life or in our home, to put on a new roof or whatever? I just see this as a reasonable update 20 years later to how we spend our money, actually meeting the moment that we find ourselves in. I respectfully ask for your aye vote and your thanks again for all your partnership.

Thank you. The motion is which one's? That one that the Assembly amendments be concurred in. Please call for the vote.

Senator Eggman. Aye. Eggman. Aye. Nguyen. Glazer. Gonzalez. Gonzalez. Aye. Grove. Grove. I aye. Hurtado. Limon. Menjivar. Menjivar aye. Roth. Roth aye. Rubio. Rubio aye. Wahab. Weiner. Thank you. And we'll hold the call open. Does she need this back?

Sorry. No, you're totally fine. I bring a spare just in case. Thank you.

Thank you. We're prepared to go with Senator Menjivar, but we are waiting for our ALS interpreter. So we're going to hold on a minute. All right, we have our next Bill up. We have before us SB 635 by Senator Menjivar concerning healthcare coverage of hearing aids.

Thank you, Madam Chair. Good morning, everyone. I'm here to present to you SB 635, the Let California Kids hear, act. You've probably seen little kids with this white shirt on their front saying, Let them hear. This Bill has enjoyed bipartisan support, and it's a Bill to rectify a program that hasn't been working for the past couple of years. A previous Assembly Member was looking to ensure that our kids, our youth, got coverage for their hearing aids because they were screened.

A Bill had been passed for kids to be screened for hearing loss or hard of hearing, but that's as far as it went. As a parent with a newborn, you're told that your child is hard of hearing or won't be able to hear, but then you're not offered the support to purchase these hearing items that can range up to $3,000. There was a previous Bill attempting to rectify. However, we rerouted to see if the Department could address this issue.

The Department has gotten so much money to address this and yet has only been able to serve in the low hundreds out of the tens of thousands, children and youth who are eligible to get coverage for hearing aids. On top of that, there are so minimal providers, little providers, who participate in this because of the lack of reimbursement for this service.

So to ensure that the children you see today get the coverage, to get hearing aids, to be able to address what experts have called a developmental emergency, we need to ensure that we get SB 635 passed to that. I want to turn it over to my witness who can speak a little bit more.

A mom who stopped everything to start a nonprofit to dedicate her time to ensuring that her child and the rest of the thousands of children in California have access to hearing AIDS. So, Madam Chair, with your permission, I'd like to introduce Michelle what is Michelle your last name? Michelle Marciniak. I'm really bad. I'm so sorry, Michelle. We've worked so hard on this. A co-chair and co-founder of Let California Kids Hear and co-sponsor. Of SB 635 Good morning. Please go ahead.

Good morning. My name is Michelle. I'm co-founder of Let California Kids Hear and a co-sponsor with Children Now of SB 635. I want to thank the 50 organizations who have signed on, the Parent Advocates here, and all the Legislature who has always stood with our children. My husband and I found ourselves in a support group in LA one evening, grieving that our daughter hadn't heard us say I love you in six months, or the bedtime stories we read at night.

We were quickly humbled, as we could afford hearing aids, and every mom's story thereafter was about devastating financial decisions that they were making. The fourth mom said, I have five kids our family's not going down. He'll go without. I started interviewing more people and went to the no Limits for Deaf Children Center, and they said children were showing up at the age of five, right before they were supposed to go to kindergarten, unable to say their name because they had never heard it.

I was working at Children's Hospital Los Angeles at the time and went on to the cancer unit. And the drug that saved a child's life also took their hearing. And then, as they called their health plans were told, it is elective for your child to hear. Hearing AIDS cost $6,000. It puts a tremendous strain on so many hardworking families to find thousands of dollars to pay for the hearing aids, delay time-sensitive treatment, or forego them altogether.

We're asking for your renewed support to adopt the original solution a pediatric mandate to address a developmental emergency that's been unfolding for 25 years in the State of California. These costs are not only devastating the child and the family, but they're costly to society. It costs $1 million for every child that doesn't get early intervention in special education, other medical complications, and other costs. The state is currently spending 400 million a year to educate deaf and hard of hearing children.

The absence of a solution is costing taxpayers billions of dollars by failing to provide early intervention. In 2019, the Legislature passed the Let California Hear Act. By unanimous consent, Governor Newsom pulled the Bill back and offered an alternative program. I'm so sorry.

And we'll need to wrap up. Okay.

Okay. 30 states cover it. We are trailing Southern states now. SB 635 is a responsible deployment of state resources. The potential $11 million costs will be offset by the 13.4 million for the HACCP program that you guys allocated. It is a fix that would address this developmental emergency that's been unfolding for years in the State of California. It would help 20,000 children. California's children and families are struggling, and they can't wait any longer. I want to thank my daughter who told me this morning, this isn't done until every child is covered in the State of California. Thank you very much.

Thank you very much for your advocacy and passion. Anybody else speaking in support of this Bill, now would be the time just to come forward.

New Orleans with Children Now proud co sponsor in support.

Thank you.

Nikki Feinstein, mother of a six year old hard of hearing girl who wears hearing AIDS. We've been fighting this since she was one. So I ask you to please let California kids hear.

Thank you.

Good morning, Madam Chair and Members. Nick Brokaw from Sacramento advocates on behalf of the California Academy of Ideology and Support.

Thank you.

Dr. Aditi Bhuskute UC Davis Medical Center, pediatric ENT in support of this Bill.

Thank you.

My name is Elijah Schuler, and my California kids hear. Thank you. Bye.

Hi, my name is Avery and it's time to let California kids hear.

We agree, Avery.

Hi, I'm Caprice Shuler, a mom of Avery, and I support SB 635.

Thank you for coming.

My name is Johanna Wonderley, mother of four, heart of hearing children. It's time to let California kids hear. You want to say something? Let California kids hear. I'm Kayden and let California kids hear. Let California kids hear. Yay go ahead. I'm Cassie, and let California kids hear.

Thanks, Cassie.

I am Carrie and let California kids hear.

Yeah.

Hi, good morning. My name is Maricella and I'm a hard-of-hearing adult. Most importantly, I was a hard-of-hearing child whose parents, unfortunately, did have to bypass those hearing aids. And so I know the struggle. This is my son, Mateo. He's hard of hearing as well and needs both hearing aids, and I refuse for history to be repeated.

Thank you.

Hi, I'm Mateo, and let California kids hear.

Thank you, Mateo.

Hi, Alex Smith, a mother of a hard of hearing son, sayer he needs. His hearing aid to thrive and it's. For his safety as well. So please let California kids hear.

Thank you.

Hello, I'm Denise Kyles Jensen, mom of. Two deaf boys, 14 and 10 years old, and this is her fourth.

Thank you.

Hi, I'm a mom of a deaf and hard of hearing child. I'm an audiology student and President of California Handed Voices hearing support, please. Let California kids hear.

Thank you.

Hi. My name is Lauren Ding. I am a mother of a five year old son who is hard of hearing. Please let California kids hear.

Thank you. Okay, anybody speaking in opposition to this Bill? Anybody not want California kids to hear? All right, seeing none, we'll go to the phone lines.

Ladies and gentlemen, if you wish to speak in support or opposition, you may press one, then zero. At this time. We'll be going to line 24. Please go ahead.

Good morning. Sandra Poole on behalf of Western Center on Law and Poverty. In support.

Thank you.

Next we'll go to line 33. Please go ahead.

Madam Chair, Members of Committee, Brandon Martu with the California Medical Association in support.

Thank you.

Next we go to line 15. Please go ahead.

Good morning. This is Ivette Mitsubi with the Association of California School Administrators and strong support. Thank you.

Thank you.

Next we go to line 22. Please go ahead.

My name is Raquel Lipset. I am a parent of a hard-of-hearing daughter that was not able to get hearing aids until two and a half, and I saw the detriment of that. I support SB 635, let California kids hear.

Thank you. Next caller.

Next we'll go to line 13. Please go ahead.

Hello, go ahead, please.

It's on Mercedes Montalvo, physician and parent advocate in support.

Thank you. Next caller, please.

Next we go to line 25. Please go ahead. 25. Your line is open. Next. And we'll go to line 31. Please go ahead.

Hi, Erica Lopez, parent of a daughter who is hard of hearing in support.

Thank you.

Next we go to line 14, please go ahead.

Hello, Janelle Ocampo, proud parent of two hard-of-hearing girls, age is eight and 16. And both of them who have hearing aids, one did not receive them until later in life and one was provided hearing aids earlier in life. And I have seen the great.

Thank you, ma'am.

Thank you.

Okay, thank you. Next caller, please.

Next we'll go to line 12, please go ahead.

Hi, Holly Gale, grandmother of a hard-of-hearing child let California kids hear.

Thank you.

Next we'll go to line 29, please go ahead. 29, your line is open. Next caller then. Moderator moving on to the next one. They did just queue up. So one moment while our line number is given and we will be going to line nine. Please go ahead.

Hello, this is Amy Garcia, mother of a hard-of-hearing boy, and I support this Bill.

Thank you. Thanks, caller.

There's currently no one else in the queue at this time. Madam Chair.

Thank you very much. Now would be the time to bring it back to the Committee. I saw Senator Rubio and Senator Grove wanted to speak. Senator Rubio.

Thank you, Madam Chair. Yes, I'm very proud to be a co-author of this measure. I know we've tried it in the past and I want to just commend all the young little ones who came to speak here. We're very proud of you for being able to come up and speak to the adults here. But I wanted to add my voice to a lot of the comments that the author made and it's really important that we not see this just as a financial issue.

And I know it was stated that the class is 1 million in early intervention, but I want to share that when I was a teacher, I had a fourth grade student who had a record that was very long of incidents with the principal in the yard. I mean, it went on and on and on. It wasn't until we figured out that the little boy could not hear. And he also had he needed glasses and the system did not catch it early enough.

So he spent a lot of time in the principal's office and always misunderstood. Everything that he did was again, misunderstood as behavior issues. But the reality is the little boy could not hear and he could not see. And so without that kind of education early on in Kinder, 1st, second, and third, by the time he got to fourth grade, he really didn't stand a chance.

So we were so fortunate to be able to catch that early on, when we got him glasses, we got him the hearing aids, he was a completely different child. By the time he left my classroom, he was really performing where he needed to be. And I'm just sorry we didn't catch that soon enough. And so to all the children out there struggling, this is going to be a life-changing moment.

And I also think for parents, it's again, not just financial, the stress that parents have to deal with. I only imagine that parent every time the principal called to come in because the child was in trouble again. And so with that, you can put a price on the peace of mind of the parents, making sure that the child has the education it needs early on. I mean, the benefits go on and on and on.

So I just want to thank the author and everyone here for advocating on behalf of our kids, our students. And with that, I will move the Bill when it's appropriate. Thank you.

Thank you, Senator Grove.

Thank you, Madam Chair. I'd like to thank Michelle for know standing up for. I'd like to thank the author for bringing it forward. I do have questions, though, because I'm very concerned about the analysis and what it says. Obviously, we passed AB 598, which required health plans to cover hearing aids for children. It died. And then the Governor Institute another program Hearing Aid Coverage for children program. The HACCP program to date.

They've gotten $16 million has been allocated and they've only issued hearing AIDS to 225 children. That's a problem and it's not a good use of money. Who is going to administer this program? Please don't say the same.

No, it wouldn't. That's why we would retrieve from that program.

Okay.

And it'd be just a mandate on health plans because we've put so much money. You saw how much money and we didn't get a bang for our buck, basically, if you will. So it isn't working under the Administration, the Department. So we're going to reroute that to be a coverage under a health plan.

Thank you.

Okay.

Thank you.

Thank you. See no other Members wishing to speak. Let's bring it back to the author. And you have a motion.

Zero, thank you so know I would say, Senator Rubio, the chapter analysis also included coverage for MediCal beneficiaries. However, in the State of California, MediCal covers hearing aids. So that number is skewed a little bit. And I'm very thankful for the support that I've received so far getting respect glass for your aye vote so that California kids can hear.

Thank you very much. And thank you to all the advocates and the parents and everybody who came out today to make a compelling case. And so with that, there is a motion. And the motion is that the Assembly amendments be concurred in. I'll have the secretary call the roll.

Senator Eggman aye. Nguyen aye. Glazer. Gonzales aye. Grove aye. Hurtado aye. Limon aye. Menjivar aye. Roth aye. Rubio aye. Wahab aye. Wiener aye. Hold it open for Glazer.

That's 11 to zero. We'll keep the roll open for a little while. Next up, we have Senator Becker on SB 582 concerning health information. Welcome, Senator.

Good morning, chair and Members.

Okay.

I rise to present SB 582. This is a Bill designed to protect healthcare providers, including small doctors practices and community clinics from price gouging by their technology vendors. Increasingly, we see electronic health record vendors charging excessive fees, which prevents these offices from being able to comply and participate in sharing data. So this Bill applies the existing federal rules governing reasonableness of fees to our state level data sharing requirements.

The amendments in the Assembly reflect feedback from industry stakeholders, resolve a chaptering conflict, and revise minor provisions of SB 1419, the Bill I authored last year, than with the application programming interfaces and electronic disclosure of test results. With that, I have a witness here, George Soares from the California Medical Association.

Please, Mr. Soares.

California Medical Association is proud sponsors. As the Senator said, these were predominantly cleanup amendments from SB 1419 from last year, and respectfully asked for an aye vote and can answer any questions. Thank you.

Thank you very much. People speaking in support. Just the me too's now.

Izzy Swindler on behalf of California State Association of Psychiatrists in support. Thank you.

Wonderful. Thank you. Okay. Seeing none, now is the time for people in opposition to come forward. Seeing none. We'll go to the phone lines. Moderator if there are any calls in the queue?

Ladies and gentlemen, if you wish to speak in support or opposition, please press one, then zero. There's no one queuing up, Madam Chair.

Okay, bringing it back to the Committee. All right, we have a motion. Senator, would you like to close?

Respectfully ask for an aye vote.

Wonderful. The Clerk will call the roll. And the motion is the Assembly amendments be concurred in.

Senator Eggman aye, Nguyen aye, Glazer, Gonzalez, Grove aye, Hurtado aye, Limon aye, Menjivar aye, Roth aye, Rubio, Wahab aye, Wiener aye.

You have enough for that to get out? We'll hold it open, 9-0.

Bill to get out. We'll hold the roll open a little bit. Nine to zero. Thank you very much. Thank you. Okay, that concludes our business for the day. I will hold the roll open for a little while for Senator Glazer to arrive, if you would, and we'll open the roll on the other ones. Yes, sir. Okay. All right, let's start with AB 326, or SB 326 by Eggman secretary called the roll. The motion again is that the Assembly amendments be concurred in.

Senator Nguyen aye, Glazer, Hurtado aye, Limon aye, Wahab aye, Wiener aye. And Senator Glazer aye.

Okay, moving on to...12-0. That Bill is out. Moving on now to SB Five or 635 by Senator Menjivar again that the Assembly amendments be concurred in. Secretary call the roll.

Senator Glazer aye.

12 to 0. That Bill is out. SB 635. Menjivar 582. Benjivar, or Becker. Jeez. Please call the roll.

Senator aye, Gonzalez, Rubio.

10-0. That Bill is out. The roll is closed. All the amendments have been concurred in motion is adjourned.