Senate Budget and Fiscal Review Subcommittee No. 3 on Health and Human Services

Good morning and welcome back to our last session for budget sub three on Health and Human Services. Today the run of show is we're going to do public comment for our final thoughts, prayers, comments, concerns for the budget, our hopes and dreams. Right. And then we're going to do three votes only.

The first one will be where we all agree. The second will be where three of us agree and then no. Yes. And the final one will be also. Three of us agree and then an abstention. So we're going to kick off with public comment.

If we can line up here and then wrap around the back for me. Yeah, you're fine. Yeah. It's gonna be very difficult.

Yeah. Yeah. Sorry. Good morning, Madam Chair, and thank you. It's good to be back. Russel Dawson-Rawlings, community organizing manager at California Foundation for Independent Living Centers.

We appreciate your commitment to protecting programs for seniors and people with disabilities, particularly protecting the vital services in home, supportive services for undocumented individuals, and critical funding for food, nutrition programs and restoring funding for critical services for people with intellectual and developmental disabilities. We know this is a hard time. We encourage you to stay steadfast as negotiations continue, and we'll be a resource of support and information if needed. Thank you.

Thank you. Thank you, Madam Chair and Senator Roth. And I want to thank Elizabeth, who's been just an absolute wonderful person to work with, with questions and answers and all that. I want you to know that we really appreciate her work.

Also, just want to say thank you for all of you, what you've done, and what you're hopefully going to continue to do with the developmentally disabled population. Just one note in the upcoming funding sessions that are in front of us, that we work on a stabilization for revenue for this population.

And look at that as a get away from this rollercoaster of funding going forward. Due to the Lanterman act that we instigated about 55 years ago, that we did say that we would care for this population, we just didn't say how well. And let's make sure that we do. Thank you so much again for all of your time and consideration for the population. Thank you.

Thank you, Madam Chair. Senator Roth, Carl London here today. I have two quick items to mention. The first is on behalf of the Sickle Cell Disease Foundation and Center for Inherited Blood Disorders, in support of the inclusion of the $5 million in the Senate and Assembly budget proposals you put forth to support the sickle cell centers of excellence that were made possible by the Legislature and Governor Newsom in the 2019 budget.

Just briefly to report on that, those 12 clinics throughout California that serve 10,000 patients with sickle cell disease have made a profound difference. And data conclusively demonstrate that the preventive care by these clinics saves the State of California close to $100 million annually through reduced hospitalizations and visits to the emergency room. So thank you on that.

For helping on that. Second, as a parent board member of a nonprofit and as an advocate for people with intellectual and developmental disabilities, thank you. Thank you for pushing to restore the rate increases that we need so profoundly throughout the State of California. Without these, I will tell you that this system is on the absolute verge of collapse. Thank you, sir. So thank you for your effort. Thank you.

Thank you, Madam Chair Members Andrew Shane from Grace and child poverty California, on behalf of the 75,765 CalWORKS moms who couldn't be here today, just so deeply grateful.

You know, I'm personally grateful for the wins, a program that doesn't get enough attention, but that one I would just lift up as a sign of the commitment across the board of this Committee. And we know it's not a lack of shared commitment by the Administration. This Governor has been a champion for children. This has just been a matter of resources, and we stand ready to support in the final negotiations. Thank you so much.

Eileen Kubanski with the County Welfare Directors Association, echoing the gratitude of those that have come before us. Thank you to you all and to your staff for all of the hard work and the championing on behalf of families in deep poverty, adults with and our foster youth especially as well. We stand ready to fight with you as we enter into the next phase and are just grateful for all your restorations. Appreciate it.

Thanks, Eileen.

Echoing Eileen's comments, Kim Rothschild with the California Association of Public Authorities for in home supportive services, thank you for all the restored cuts to IHSS.

Thank you Madam Chair Members Darby Kernan. On behalf of Nourish California, we support the Subcommittee's action on maintaining the Calfresh minimum benefit pilot and your action on the CFAB expansion. On behalf of First Five Association, we support your action on rejecting the CalWORKS home visiting cuts and your actions on adding the child care slots.

And lastly, leading age California would like to express our support for the Legislature's budget proposals that reject many of the governor's proposed cuts to the home safe program, multiple multifamily housing and the other older Californians act. Thank you.

Thank you Chair and Members Kathy Mossberg, on behalf of a few different clients, on behalf of the Public Health Institute, really want to thank you for helping us salvage the California Cancer Registry and also the California Bridge Center Funding on behalf of the San Francisco AIDS Foundation, APLA Health.

I want to really thank you and your staff for all the support on that package, and we'll continue to work with you to keep all of that in. And then finally, on behalf of the area agencies on aging and meals on, well, California, really thank you tremendously for saving us from that, from the cut in senior nutrition. Thank you. Thank you.

Chair Members of the Committee, Kelly Longo Flores with the California Association of Food Banks. We work alongside 41 food banks across the state with a mission to end hunger. We're here with a resounding thank you for your actions.

I think it shows the commitment and it shows that you were listening to us hearing after hearing as we went through these, just a couple of specific ones I want to point out. Thank you for permanently authorizing the state emergency Food Bank Reserve. That's huge for us.

That allows food banks to react really quickly in times of crisis. Thank you for rejecting the elimination of the Calfresh minimum benefits pilot, as we know that would have been, that's $23 up to 50 for supporting CalWORKS and rejecting the elimination of wins, as Andrew mentioned.

I know it's only dollar 10, but that makes a difference for a lot of people. And lastly, for your support in rejecting the IHSS cuts. All Californians should live in the least restrictive environment possible. Thank you. Thank you.

Good morning. Sara Bachez with Children Now and the ECE Coalition. So appreciative and thankful for all of your leadership in preserving the family urgent response system, the Emergency Child Care Bridge program, the CalWORKS Home Visiting program, all of the child care packages, a complete package.

And also adding that on the implementation plan on the alternative methodology ensuring that livable wages is included as part of lifting up the rates for child care providers. Thank you so much.

Good morning. Erin Levi, representing the Congregate Living Health Facility Association, The Cliffs. We are deeply appreciative for the $7.7 million General Fund inclusion. This will be the first increase these providers have had in 40 years, the first increase ever. To remind you, these are young adults for the most part, that are mainly quadriplegic on ventilators.

They are less acute than hospitals, but more acute than nursing homes. They are living in a residential setting. This money will allow the health healthcare workers to get the rage that they deserve. Thank you so much. Thank you.

Hello. Monica Kirkland, on behalf of Senior Services Coalition of Alameda County, we just want to thank you all for just being partners with all of this. We want to thank you specifically for the rejections for home safe.

We really do appreciate that our most vulnerable population for the older California act, the nutrition is very important, just protecting those who need it most, right? And then also for the AP's as well as IHSS, something that does not go unrecognized, as a lot of our colleagues has already mentioned. But we just want to thank you so much for that.

Thank you Madam Chair and Members, my name is Danita Stromgren and I'm a volunteer with AARP representing 3.2 million California members. First, we'd like to thank you for rejecting these specific proposals in the May budget revision, the rejection of the 111 million over three to the older California Seniors nutrition program through the Department of Aging, the proposed cuts of the 40 million in 2425 and ongoing for adult protective services, as well as the proposed 4.8 million reduction for the AP's training and for the rejection of the delay to the home safe program.

Thank you also for the inclusion of the budget proposal to enhance the long term care ombudsman program. But we are disappointed that the proposal to implement the MediCal Sheriff Cost Reform was not included in the proposal and we'd urge your reconsideration of this program. Thank you very much. But thank you for all of your efforts. Thank you.

Good morning. Nora Lynn on behalf of Children Now, thank you to the Committee Members and staff for your hard work on this year's budget. We appreciate the difficult decisions that must be made, but when things get tough and tight, it is even more important that we prioritize children.

Unfortunately, the budget presented before you is not one that prioritizes kids. For example, it is damaging that California will continue to allow thousands of eligible young children to lose their MediCal coverage every month because of paperwork mistakes and administrative errors.

It is unconscionable that in an environment where youth suicidality is at an all-time high, we are reducing funds for youth suicide prevention activities. And we remain concerned that while so many new behavioral health initiatives are unfolding and fundamentally change the funding structure of our community-based organizations, we are cutting CYBHI evidence-to-base practice grants, a one-time grant program that could provide relief and stability for CBOS serving our kids.

Good morning. Chair and Members, Adrienne Shilton with the California alliance of Child and Family Services. We'd like to extend our huge Thanksgiving thanks to all of you for the tough work that you have done on the proposals before us.

That impact our most vulnerable youth and families, and specifically wanted to call out a few specific programs that we're thankful that you restored. One is the restoration offers, which is a literal lifeline for our foster youth and their caregivers.

We're grateful for the restoration of some of the proposed workforce reductions, especially to those individuals who have already been awarded. Also grateful for the restoration of the CalWORKS home Visiting program, and we appreciate the work that you have done on the Department of Social Services permanent rates proposal as well, and we look forward to continued engagement. Thank you.

Thank you.

Kelly Brooks I'm here on behalf of several clients. First, on behalf of the California Association of Public Hospitals and Health Systems. We truly appreciate the restoration of the provider rate increases from the MCO tax revenue. This funding will help public health care systems address our three to $4 billion deficit and avoid potential service reductions.

CPH has also been working with DHCs to address our deficit through significant increases in our state direct payments, which use local dollars to draw down federal funds. Large increases to these programs is particularly important in light of the uncertainty around the MCO tax funding and the new administrative fees proposed by the Administration.

Second, on behalf of the urban counties of California, the Rural County Representatives of California, the boards of supervisors of Los Angeles, Ventura, Riverside, Santa Cruz, thank you very much for all the work you did to avoid the drastic cuts in human services and in the future of public health funding.

On behalf of the California Community Living Network, thank you for rejecting the Developmental Services rate reform delay. And then finally, on behalf of the Association of Diaper Banks, we're obviously disappointed and folks may be eliminating or significantly curtailing disbursement of diapers, but we'll be back next year to work with you some more. Thanks.

Good morning. Christine Smith with Health Access California. Health access appreciates the Legislature's rejection of the administrator administration's elimination of IHSS benefits targeted at undocumented Californians, continuing the goal for all to have access to this essential service and care. We also appreciate the Legislature's continued commitment to protect the individual mandate penalty funds collected from the uninsured.

And we support the Legislature's rejection of the ongoing sweeping of 109 million annually in favor of a one time loan. Funds collected from those who are uninsured should be preserved to make coverage more affordable and accessible for all, including over the half million uninsured undocumented who are excluded from the Covered California marketplace. But thank you for all your work. Thank you.

Good morning, Madam Chair and Members Jolie Onodera with the California State Association of Counties representing all 58 counties. CSAC is extremely grateful for the Legislature's rejection of the numerous proposed cuts to the critical health and human services programs, including the public health infrastructure.

CalWORKS, AP's, IHSS and child welfare very much appreciate the Legislature's understanding of how vital this funding is for county administered programs and services that our most vulnerable populations rely on every day. Thank you. Thanks.

Good morning. Michelle Gibbons with CHEAC representing local health departments throughout the state. I want to thank you to this Subcommittee, to your staff for your leadership in protecting the future of public health funds. Every day have come into this room there's been a new case of something that these dollars are being put to use to prevent.

So protecting these funds is protecting Californians. And so we stand with you. We'll do whatever it takes to help make sure that this makes it into the final budget package.

Also, just want to express appreciation on the syndromic surveillance trailer Bill and the interoperability with our existing systems, appreciation for the CHDP transition and HCPCFIC, and the flexibility that's being provided in there, and for retaining the CalWORKS home visiting program. Thank you.

Good morning. Kristin Power with the Alliance for Children's Rights and we want to express our appreciation to the Subcommittee and the Legislature for your very thoughtful work in this difficult year, particularly in the areas of supporting children in foster care and their caregivers, by rejecting the elimination of the family or term response system and the resource family approval, funding and protecting the emergency child care bridge and home visiting programs.

We also appreciate the rejection of the trigger for the proposed permanent foster care rate and the proposed reporting at milestones toward implementation and urge your continued oversight as that proposal moves forward. Thank you. Thank you.

Hello Chair and Members. My name is Justina Erpelding. I'm with Every Child California ECE Voices and we're a member of the ECE Coalition. We want to thank you for all your hard work and dedication to early childhood education and especially the 11,000 slots that were awarded that you have requested to be honored.

I got to see their faces yesterday when we had people here advocating that represented a thousand of those spots that you're asking to be restored. We also ask that you codify the remaining 200,000 promised slots so that we have a timeline of when they will be released. But we also ask that the DSS to create a report through January of 2026 on the alternative methodology, implementation progress, and that hold harmless through 24 and 25, will be part of that. So thank you. Thank you.

Good Morning Chair and Members. Malik Bynum with UDW, AFSCME Local 3930 and Child Care Providers United, a partnership between UDW and SEIU on childcare. We're appreciative of the Senate's plan to continue funding the over 11,000 slots from spring 2024.

However, we know that there is still work to be done, so we urge the Legislature and the Administration to continue working towards that goal of 200,000 slots as soon as possible, as well as ensuring progress towards reform based on the true cost of care as it relates to home care. We're absolutely grateful to see these rejections to the cuts to IHSS, specifically the expansion to undocumented individuals and the elimination of the provider backup system, both critical pieces of the program for consumers and providers alike.

We do, however, continue to urge the Committee to adopt trailaberal language relating to the state participation cap for local negotiations in San Diego and Riverside. Without this language, home care providers in these counties, Low income women of color will essentially receive a pay cut cut in 2025, and that will be absolutely devastating for our workers. So we appreciate the actions to come today and request your support for that proposal. Thank you.

Thank you.

Good morning, Madam Chair and Members Ronald Coleman Baeza here with the California Pan Ethnic Health Network, CPEHN. We very much appreciate the rejection of the proposal to eliminate in-home support services to the undocumented.

A proposal like that should have no place in the debate in California, and so we appreciate not having a discriminatory proposal codified in state law. We also appreciate the rejection of the future of public health funding and also the elimination of the Indian health program.

We also appreciate that there may be modest adjustments to the MCO tax and hope that there can be consideration of raising reimbursement rates for chws, community health workers, promoters and health representatives, which would be a small, very tiny percentage of any funding with that revenue. Thank you.

Good morning. Yasmin Pilot, on behalf of Justice and Aging, thank you for rejecting many of the harmful cuts to health and human services programs from the mayor vision that would impact older adults.

Specifically, I want to thank the Subcommittee for rejecting the proposal to eliminate IHSS benefits for undocumented Californians and maintaining the IHSS backup provider system. We also appreciate the rejections of the cuts to AP's Homesafe, Calfresh and Senior Nutrition Programs. We urge the Legislature to maintain these programs in the final budget deal with the Administration.

And finally, as the Legislature considers the modifications to the MCO tax, we encourage timely implementation of sheriff cost reform, which currently leaves older adults and people with disabilities trapped in poverty. Thank you. Thank you.

Good morning. Jessica Moran with the California Dental Association. We are greatly appreciative of the Legislature for rejecting both the elimination and the delay in funding for the specialty clinic grant program. Really hoping to see this reflected in the final budget agreement on the Office of Oral Health Funding.

Totally understand that cuts need to be made in difficult budget years. We are looking forward to work in the Subcommittee on restoring that continuous funding in future budget years. Thank you.

Thank you, Madam Chair, Members of the Committee, Brandon Marchy with the California Medical Association. We appreciate the time and the effort that the Subcommittee and the Legislature has put to the MCO proposal.

As you know, billions went to the MediCal provider and increased MediCal provider rates, and also billions more went to the General Fund in order to address budget deficits such as this one. We would respectfully request and are happy to work with the Legislature and the Subcommitee to make sure that that money goes out on time and as was agreed to in 2025 instead of 2026. Thank you.

Thank you. Good morning. Molly Robeson with Planned Parenthood affiliates of California. We appreciate the proposal rejects elimination of investments in Medi Cal. However, these investments cannot be delayed to 2026.

We urge the Legislature to restore the targeted rate increases originally proposed to begin in 2025 to start in 2025 to protect funding for family planning and abortion services and make an impact in the medic health system. But really appreciate the work on this. Thank you. Thank you, Molly.

Good afternoon, Madam Chair and Members. My name is Tyesha Watts with the California Academy of Family Physicians. We are super appreciative of the restoration of the 74.1 million to the Song Brown Residency Programs. This funding was crucial in order for us to build up our primary care workforce.

We ask also that as budget decisions are being made, we know that it's a tough budget decision, but the song Brown program is consistently on the chopping block because it doesn't have a stable funding source. So we ask that this funding be preserved so that we can continue to build up our primary care workforce and provide care to those rural and HPSA areas.

And I would like to align my comments with my colleagues from CMA and Planned Parenthood regarding the provider rates for primary care provider rates for the primary care physicians in the MCO tax. Thank you. Thank you.

Hi, good morning. Jason Sullivan-Halpern from the California Long term Care Ombudsman Association. And I just want to say on behalf of California's 35 local long term care ombudsman programs. We sincerely appreciate you, including our proposal to increase funding for those programs from two special funds controlled by CDPH.

The need for this funding was incredibly urgent, and we think this is going to provide those programs with the support they need to keep older adults and adults with disabilities living in long term care safe, happy and healthy over the next few years.

And we can work on a more long term permanent solution that doesn't require cobbling together special funds from different agencies. And we just are tremendously grateful and also for your rejection of the cuts for our partners at AP's. Thank you.

Good morning, Madam Chair Members. Susanna Meyer, Executive Director for Empowered Aging, offering Ombudsman Services for Alameda, Contra Costa and Solano counties. We would like to thank you for your rejection of the mabry vise for the critical safety net support services that are keeping seniors in their home longer.

We already know that there's a crisis mode in direct care workforce. There's a huge amount of growth in senior homelessness, and of course, the senior population is expanding rapidly. So whatever we can do to keep people in their homes longer will keep them safe and protected. Thank you so much for your protection.

Thanks, Beth hi, good morning Chair and Members. Beth Malinowski, the SEIU California, as a proud partner of the California Can't Wait Coalition, want to thank you for rejecting the mayor vision proposal to cut 300 million from the future of public health funding.

Additionally, I want to thank you for your investments in physician workforce and your restoration of cuts to the song Brown program and the Legislature's commitment to lifting up healthcare workforce more broadly through commitment to fund the healthcare minimum wage. Lastly, our labor partners want to thank you for your commitment to striking workers and healthcare coverage for them through Covered California. Thank you. Thank you.

Buenos Dias, Madam Chair and Committee Members. Just, Maria Romo, on behalf of Child Care Resource Center, just want to extend gratitude for rejecting and modifying the cuts to CalWorks, the home visiting program, emergency child care foster bridge program, and also for restoring childcare slots for all of our families and our children.

As these proposals make their way to the governor's desk, we strongly ask you to please protect them and keep them in mind as they're coming across this desk. The Administration cannot afford to cut these programs and reduce funding long term as it impacts the most vulnerable communities and families in our districts. We just want you to keep them in mind and know that you are affecting a lot of families. Thank you. Thank you.

Good morning. Nico with the Mesa Verde Group here on behalf of Immigrant Legal Defense in the Loyola Law School Immigrant Justice Clinic. We'd like to thank the Legislature for rejecting the governor's proposed cuts to immigration legal services for the CSU and TPS recipients and funding them in the Legislature's budget. Thank you. Thanks.

Good afternoon. Barry GiarDiNI, California Disability Services Association I want to thank the Legislature for agreeing to a proposal, I think, that reflects the needs of vulnerable Californians everywhere, particularly the rejection of the governor's proposal to delay the rate model implementation for individuals with intellectual and developmental disabilities.

It's a massive win for today, and we are hopeful that we can hold strong in the final budget negotiations. Just a final note, this Committee has been a pleasure to watch work this year. It's very tough year, and you've done an incredible job, Madam Chair and Members, in being considerate and thoughtful in light of very difficult news. So thank you. So thank you.

Good morning. Member and Chair. Lydia Missaelides. I'm the Executive Director for the California Association for Adult Day Services. I'm here to express our hopes, dreams and prayers on behalf of the almost 40,000 participants served by our amazing almost 300 community-based adult services programs who are really struggling with inflationary costs that have, have not only gone up, but are, in addition to recovering from the pandemic still.

And I know you personally saw with your own eyes, Senator Menjivar, what that impact has on people's lives when they can receive these services. So that we hope that you can continue to keep Seabass in the mix as you pursue your final closing days of these negotiations, and we greatly appreciate your support thus far. Thank you.

Thank you.

If cut the medical acupuncture benefit, those vulnerable communities don't have access to acupuncture. Acupuncture has been proved to be very effective for pain management and anti opioid crisis, and I hope it will keep as Los Angeles, we know a lot of movie stars acupuncture and they post on TV, social media.

And meanwhile, Los Angeles has a lot of medical patients and they cannot so just neighborhood somebody can access acupuncture and some other people. Thank you. Don't have access. Thank you so much.

And we rejected that proposal. If you don't. Okay.

Madam Chair and Senators, I'd just like to associate my remarks with the previous speaker. Acupuncture under Medi Cal gives our most vulnerable populations and our most underserved populations access to this important medicine, which is both effective and cost effective, non opioid and non pharmaceutical.

And we appreciate very much your work on this Committee and hope you'll continue to stay strong in working to maintain full funding for acupuncture under Medi Cal for these key populations. Thank you.

Thank you, sir.

Good morning, Madam Chair Members. Dennis Cuevas-Romero with the California Primary Care Association advocates appreciate the thoughtful consideration by this Committee in a tough budget year. I want to speak briefly on the MCO tax. Appreciate the approach by the Legislature for health centers. As you know, targeted rate increases aren't going to be reaching the health centers.

However, specialty care is really important for us to be able to refer our patients. So we would urge the targeted rate increases to be moved to this budget year.

Also want to express our appreciation for the Committee's rejections of the various programs, specifically the Health enrollment navigator for Clinics program, the optional medical cut for acupuncture, the Indian health program, and various healthcare workforce programs, particularly Song -Brown, the California Medicine Scholars program, and the Health Career Opportunities program. So really appreciate all the work. Thank you.

Thank you,

Madam Chair. Tony Anderson, Association Regional Center Agencies. Thank you for your leadership. From you and the rest of the Committee. This is, you know, we've been telling you about the impact and the need in our community, and you clearly listen. A lot of people come to me and say, why should I tell my legislators this?

Thank you.

They're not going to listen to me. You all clearly listen to the what would the impact of the delay in the rate reform be? And we really appreciate that and anything we can do to continue that fight. Thank you very much.

Philip Yang from California University, Silicon Valley. I'm representing all the schools in California for acupuncture to thank you all the Senate Members for your effort for the rejection of the reduction and elimination for acupuncture budget in the medical program. Thank you so much.

Thank you.

Good morning, Chairmembers and Senators. I come from Ukiah, Mendocino County. I'm an acupuncturist. I do a lot of free treatment for the communities, even the temple where people they are really need medical and to release the pain, which I do in more than 20 years, then I know acupuncture can help a lot of people release the pain. And I would like to know or to thank you guys and to reject, but even if they have opportunity to open this case to consider about it, we are really appreciated. Thank you very much. Thank you.

Good morning, Madam Chair, Members of the Committee, Jordan Lindsay with the ARC of California, the ARC and United Cerebral Palsy California Collaboration, and on behalf of the Lanterman Coalition, we want to thank you for your leadership across the health and human services sectors in protecting services for individuals with disabilities across the state. We're incredibly grateful for what has come out of this Committee and the actions that are about to occur. Thank you so much.

Thank you.

Good morning. Linda Wei with Western center on Law and Poverty want to echo all our appreciation for preserving critical safety net programs that benefit Low income Californians.

Specifically, we appreciate preserving the critical CalWORKS programs and the authority to apply for the federal pilot that allows us to implement some family centered changes, as well as appreciate foster care programs, nutrition benefits, as well as the safety net being preserved. Also want to thank the Legislature for stopping discriminatory cuts to the IHSS program.

Thank you.

And finally, as the Legislature considers modifications to the MCO tax, would urge timely implementation of the share of cost reform so that seniors and persons with disabilities can access mediCal. Thank you and we stand ready behind you.

Hello Mari Rogers from Childcare Law Center. We urge the Legislature to release the spaces as soon as possible, and we support the proposal to put the 200,000 space expansion in trailer bill language. We also support the child care reversion account. Until child care providers have a fair pay, we will not have an equitable society.

We support the proposal for placeholder trailblanguage that includes reporting deadlines and protective policies for the implementation of rate reform paying providers based on the full cost of enriching carers is a critical step to righting historical wrongs.

Thank you.

We thank the Legislature for minimizing cuts to cow works, but we urge the Legislature to cut all the to reject all the cuts to the Cal works program. Thank you.

Thank you. Madam Chair and Members Cathy Senderling Mcdonald for the County of Alameda, here to express thanks and support for the restorations and rejections to cut of the future of public health funding the Older Californians Act and related funding housing programs such as HAP, bringing families home and home safe, as well as the rejections to the sweeping and really devastating cuts proposed to numerous county administered human services programs serving children, adults and families, including those who are undocumented California residents.

Thank you so much.

Madam Chair and Members. Tiffany Whiten with SEIU California just really wanted to thank you for your commitment to protect our families, our children, our aging and our foster youth by rejecting the proposals to CalWORKS and in particular family stabilization, child welfare specifically. FERS.

Also appreciate the commitment to the pilot and continued discussion there, the rejection to IHSS, AP's, the delay to the DD rate study and for immigration legal services, and appreciate maintaining funds in the safety net reserves. Thank you.

Thank you.

Madam Chair Members Tim Madden, representing the California chapter of the American College of emergency physicians. We're very appreciative of the action to reject the governor's proposal as it relates to the MCO tax, specifically for the 24/25 year of the Legislature's plan.

We would ask that you keep in mind the emergency physicians as you're looking at those and additional investments. Unfortunately, with all the other cuts that may have to move forward, we're anticipating a heavy flow of medical patients coming into the emergency Department.

So we think it's a good time to buttress and support the emergency Department from that perspective. And then quickly, I also represent the Grossmont healthcare district, and they're looking at establishing a new song Brown primary care residency program. So we're very appreciative of restoring some of those monies.

It's a little bit unclear on how it relates to new programs. I know the intent was to really focus on those existing programs, which we completely appreciate, but just want to mention that for you all. Thank you.

Thank you.

Good morning. Jackie Gonzalez, Policy Director at immigrant defense advocates it's nice to be here and feel happy. Thank you to the chair and the staff. I think today we feel like the voices of the people that came to Sacramento were heard. And we're deeply grateful for the rejection of the cuts to IHSS, CSU and TPS.

We understand it's a difficult budget year. We were saddened to not see chirp included the children's holistic immigration representation project. But we will continue to fight for ways to make sure that the unaccompanied children have have a safety net here. Thank you again. Thanks.

Good morning. Hamid Yazdan, on behalf of Luma Action, echoing the comments of my colleague, thank you for protecting immigration legal services, the TPS, and the CSU program, and also emphasizing a need to find a replacement for the CHRP program for unaccompanied minor children. That program's funding is not being renewed, but the issue remains. These children need support services. They need legal services and social services. Thank you.

Thank you,

Madam Chair Members. Sara Flocks, California Labor Federation I'm going to echo one of the prior speakers. It's good to be here and feel happy and hopeful, and that is because of your leadership. And we thank you and your staff for all of the work you've done.

We're particularly supportive of the budget proposal language for healthcare, for striking workers to continue and give that program stability. We also are very supportive of your actions to protect public health and the public health workforce by rejecting the cuts to the public health program.

And we would like to see more restoration, but very supportive of the child care slots as well. And we thank you for your hard work.

Thank you.

Good afternoon, Madam Chair and Members. Nick Brokaw from Sacramento, advocates here on behalf of the California Academy of Audiology, here to express our appreciation for your efforts to push for the restoration and funding for Medi Cal reimbursement rates for audiologists.

And just note that in addition to the impact this has on deaf and hard of hearing individuals, certainly this Committee's focus on the the hearing aid coverage for children program, really critical just to recognize that the rates for audiologists medi Cal space is inextricably linked to the rates that are provided for services for the hearing aid coverage for children program.

Thank you.

Good afternoon. Jamie Miner, on behalf of Vertex Pharmaceuticals, want to echo some of the comments made by the Sickle Cell Disease foundation. We are in support of the $5 million for the sickle cell disease clinics. We think it will save the state over $100 million a year due to reduced hospitalization and time within hospitals. So thank you so much.

Thank you.

Hi, Madam Chair and Members of the Committee, my name is Mark Diehl and I'm the CEO of California Coverage and health Initiatives and a Member of the Medi Cal for Older Adults Coalition.

I'm here to ask again for your continued support for that program, for the funding renewal, reauthorization, and support for the request submitted by Senator Dodd. That program helps up to 1.6 million Californians who are in need of healthcare navigation services in some communities where they live.

They have about 165 different Medi Cal and Medicare options to choose from, and our folks who work at CBOS counties community clinics help them navigate into the best program to meet their needs. This program draws down federal funds and provides a lot of jobs in the communities we serve and serves the most vulnerable California residents.

Thank you.

Good morning, Madam Chair Members. Janice O'Malley with AFL-CIO California. Thank you so much for your remarkable work, along with Committee staff on attempting to craft a proposal that really tries to mitigate the severe cuts to core services and programs that many folks in the state rely on.

Just want to uplift the comments that were made by our AFL-CIO affiliate, UDW Local 3930, and also many of our labor partners who came and spoke before me also want to uplift the thank you so much for protecting the $300 million for public health and want to also emphasize, just really thank you for respecting the negotiated agreement on the MCO tax.

Thank you.

In particular, we were focused on the $50 million for ground emergency transportation where the reimbursement rates aren't as on par with public emergency services. So thank you so much. And as these conversations continue to move on in negotiations, let us know how we can help preserve this proposal. Thank you.

Good morning Madam Chair and Members. Mark Farouk with California Hospital Association. We appreciate the out year restoration of the MCO tax funding, understand the extremely challenging circumstances of the state budget.

However, we are disappointed with the lack of funding in the current budget budget year for rate increases to protect and expand access to healthcare for medi Cal patients. As you know, many hospitals remain in severe financial distress from the Covid-19 pandemic and rising medical inflation for pharmaceuticals as well as medical supplies. So appreciate your continued consideration.

Thanks Mark.

Good morning. I'm Jung Hu for America, Association of Chinese Medicine and Acupuncture. So please keep acupuncture service in medcal because it is effective and safe and Low cost treatment. Thank you.

Good morning. My name is Jin Jiao Xia. I have a practice acupuncture clinic in downtown Sacramento. I only want to say if cut the Medicare budget for the patient for sure. Then it's unnecessary. Emergency service and surgery will cost more. Thank you. Thank you so much for coming.

Thank you.

Hi. Morning. I am Wenzhou Zhong from American Association of Chinese Medicine and Acupuncture. I'm here to voice for keeping acupuncture in the Medi Cal system. But I just heard great news. You turned down the proposal, so I'm very grateful to you keeping the acupuncture in the Medicare system. Thank you.

Good afternoon, Madam Chair Members. Christopher Sanchez with the Mesareda group here on behalf of CARSE and the Central American Resource center, an inclusive action for the city, echoing the comments from my colleagues related to immigration legal services, including the chirp program, and also the comments related to undocumented Californians who are receiving IHSS. Thank you, Madam Chair.

Thank you.

Good morning. Kelly Larew, with resilient advocacy on behalf of PHI Air ambulance and the air ambulance industry. We appreciate the hard work of the Committee restoring the MCO tax and are hopeful to be considered as part of the additional rate increases that the Legislature will prioritize as the Special Fund Fund the supplemental air ambulance payment for Medi Cal Members is no longer.

There's no money in there anymore, and the reimbursement rate is about 20% of the cost of a transport. PHI serves the rural north. So as you can imagine, this is a really challenging situation for us. Thank you.

Thank you.

Thank you to the Committee and to the chair. I have a little sign here that says, I like acupuncture and I vote. I'm a Doctor of acupuncture. I'm a teacher, and I've been a MediCal provider for my patients since 1988 at a reimbursement of $16.

At the time, I'd like to say that we've talked about pain and the effectiveness for opioids, but we are primary care in the State of California and we have former Governor Jerry Brown to thank for that.

And we would like to encourage Gavin Newsom to keep with his understanding of providing medical care for the undocumented, the underserved, the seniors of which I am one, and that he has promised in his earlier campaigns to do that and to follow the legacy of former Governor Jerry Brown, who created the acupuncture laws in California, and that we treat more than pain, we work with infertility, everything. Thank you.

Thank you.

Good morning. My name is Cindy Vasalo and I'm a student of traditional Chinese medicine at five branches University in Santa Cruz. On behalf of our patients and our students becoming future acupuncturists, I'd like to express our gratitude for protecting and restoring acupuncture benefits for our medi Cal patients. Thank you so much for your hard work.

Good morning. Henry Cohen, also a student at five branches University in Santa Cruz and aspiring acupuncturist, just wanted to thank the Committee for restoring and rejecting the proposed cuts to acupuncture.

And as somebody who aspires to go into acupuncture as a public health servant using Medi Cal, I'm just very grateful for that preservation you guys are providing, and just working with communities on the margins, watching people get off of opiates. Using acupuncture is a very powerful experience, personally, for me. I'm sure as many people have experienced here.

So just want to remind everyone the acupuncture does work and thank you for valuing it.

Thank you.

Morning. John Drebinger with the Steinberg Institute wanted to thank the Committee for your efforts to preserve critical behavioral health funding. And just to express we remain concerned about the cuts to behavioral health workforce.

Thank you.

Funding estimates indicate that we need 375,000 new behavioral health providers to come online over the next 10 years to meet the demand for our behavioral health crisis, and those dollars often take years to see an impact on the actual availability of those providers in the workforce. So thank you for your continued attention to the issue.

Thank you.

Hi, good morning, madam chairs and Members. Di Wu with Northeast Medical services in support of legacy Legislature's restorations of acupuncture services in medical, and please continue this support in the budget for future years. Thank you.

Thank you. Now, make sure to tell the Administration. Okay.

Madam Chair Member Vivian Liang with Northeast Medical Services in support of the Legislature's restoration of acupuncture services and Medi Cal. I also just want to thank you for the rejection of cuts to Song Brown, Indian health medicine scholars health enrollment for navigators for clinics and other tests at HTI. Thank you.

Hi, Sumayana Hara, on behalf of rescare community Living, we just want to express our thanks for rejecting the governor's proposal to delay the provider rate reform, but also wanted to express that we remain significantly concerned about the three categories of the intermediate care facilities that have not received an adjustment since 2022.

Thank you.

And as a 100% medi Cal provider, it is extremely difficult for us to meet all the costs to employ providers without the 1.5% adjustment. So thank you.

Good morning, Madam Chair and Members. Pamela Gibbs, representing the Los Angeles County office of Education. It's a pleasure to see the work that the Committee has been doing. Briefly, briefly, just two items today. We appreciate your proposals to reject cuts to childcare and the restoration of funding for CalWORKS.

Thank you.

We look forward to working with you in the coming days and weeks on concluding the budget process, and we'll follow up with the letter. Thank you very much, and good luck with the process in the next coming weeks.

Hello, Madam Chair Members Kat De Berg with the health Officers Association of California thanking you for keeping the future of public health funding in your version of the budget. As you know, this funds not just preparedness for future public health activities, but for work that's being done on the ground right now. So thank you very much. And we will be telling the Administration. Thank you.

Thanks.

Hello. My name is Elba Gonzalez Mares. I'm the Executive Director of community Health Initiative. I'm here as a Member of the older adult coalition here respectfully requesting the continuation of such a vital program that helps older adults navigate really complex public programs. One of those, of course, being Medi Cal.

In my 20 years of doing this work, this is the only space where I have been able to really meaningful address in helping seniors access services by, of course, a way of having insurance, but most importantly, being able to continue to meet their needs at such a critical stage of their lives and having that be done with a whole full coalition.

So we do receive, respectfully ask that you continue that very important work for our most vulnerable, aged, blind and disabled in California. Thank you.

Hi, Madam Chair and Members Brandon Tate with the Youth Mental Health Equity Coalition. I just want to thank the Members and the staff of this Committee for the Hard work that went into this.

Thank you for the rejection of the cuts to the Office of Health Equity, particularly the public education and change program, as well as the future of public health program. These are really essential programs to our youth in the state investing in our future, particularly for our LGBTQ youth, who are the most disproportionately impacted.

I just want to thank you. If there's anything our coalition can do as you continue to work through this, please let us know.

Thank you.

Good morning, chair Members Trent Murphy with the California Association of Alcohol and Drug Program Executives. First off, we want to express our gratitude on the reversal of the proposal on the MCO tax and reinstating those provider rate increases.

Also the reduction or the change from the elimination of the CalWORKS substance use disorder services from an elimination to a reduction. Thank you very much for that modest proposal. Also want to restate the Steinberg Institute.

Thank you.

Madam Chair Members. Rand Martin, on behalf of Aviana Healthcare, after weeks and weeks of asking, asking, asking, I'm here today to say thank you for your very profound commitment to private duty nursing, as well as your protection of the rate reform for Developmental Services.

And on behalf of the AIDS Healthcare foundation, appreciate your rejecting the $300 million in public health cuts. Thank you so much.

Thank you. Thank you so much. For those who came, for the final public comments of sub three of this year. Before we go into our votes, let's establish our quorum. If we can, please call the roll.

[Roll Call] We have a quorum.

Thank you. Quorum is present. This past two years have been so educational, frustrating, emotional, a lot of heartburn and so forth. But no white or gray hairs came out. So I am thankful for that. I don't know what next year will bring. I've been so honored and blessed to be on this sub three Committee.

I want to thank my first, my two colleagues to the right who are leaving us at the end of this year. Thank you so much for holding down the fort with me, and it's been an honor to work alongside you. These are two of my favorite Senators in the Senate that I've learned so much from.

You know, Senator Eggman has been in this space for a long time, will continue to be in this space following her tenure here. General Roth is a trustworthy man who stands firm to his beliefs. And I think we saw a good exit from last weeks. And the questioning he provided, it was a good way to go out.

Senator Grove, thank you so much for also being a huge champion, champion for our youth, our foster kids and so forth, for doubling down on the many questions that I had to Department of Finance departments who came in. I really appreciate you honing in on that as well. It's been a great honor to the advocates.

Thank you so much for continuing to be loud in all these issues. As you heard, the votes we're taking today are because of everything that we heard from our advocates, the endless amount of lobbying that came. I will say some of the things that we.

Some of the things I changed my mind on because I heard of the impact that it was going to cause. So a lot of your advocacy really really, really does work. And so thank you so much.

And I'm hoping that for the next couple weeks, he will continue just a little bit more to ensure that what we pass today is as close as possible to what we get in the next couple of weeks. Weeks. So with that, I'd like to give an opportunity to any Members. Senator Roth.

Thank you so much, Senator Roth.

Well, Madam Chair, just let me say this with apologies to your predecessors. Best chair ever.

Yeah. As one of those former not quite adequate chairs, I would concur with that. Yeah. I think your clarity, your courage, your compassion at this moment in time provided everything that we need. I appreciate and admire your strength, your courage, and again, your moral clarity when it comes to these very important issues.

Thank you so much.

And I also want to thank the LAO, a huge help for me, too, really being able to provide context for things as we grappled.

It's been an honor to watch you work. As leaving Members, we sat in awe.

Thank you. Thank you, Madam Chair, I echo my colleagues comments. My colleague from Stockton used to be my favorite chair of this Committee, but having been able to serve on you and see your passion, your tenacity.

And again, apologies to the Governor, but Senator Menjivar is a force to be reckoned with, and she's going to defend this population to the death she is. And she's a Marine Corps veteran. I don't mean that, like, literally, but she's going to fight for the people that she serves.

And so maybe next year, the Administration will take a look at, you know, challenging these things at first and looking at other measures to make cuts and nothing against what the Administration is doing.

I realize we're trying to balance a budget, but you don't start with the most vulnerable Members of society, and you definitely don't start with the most vulnerable Members of society when you got a Marine Corps veteran as a chair that advocates with her whole heart for these issues. So applaud the chair. Thank you for your service.

Thank you, Senators. I really appreciate your sentiments. My North Star are to my left and to my right. Elizabeth and Scott, if you haven't met them, are just beyond amazing. Their knowledge of this is the reason why I've been able to be so prepared, because they prepare me so, so well.

They're so passionate about everything under health and human services, because without really passionate staff, I don't think we could do the work that we can do. So I want to thank them so much. For the past two years. It's been amazing to work with them, alongside them so with that, we're doing three votes on.

I'm going to read off every single item, and then I'm going to need a motion, and then we'll vote. So we're first voting on group a. Consent.

Items Items 1-3,10,12 -23,25,29,31,34 -39,43,44,46,48,49.56 -58,61,62,65,67 through 71,74,76,77,83,85 through 87,89 through 91,94 through 98,102,104,106,108,110,112,115,117,119 through 122,133 through 138,140,142,154,158 through 167,173 through 175,177 through 180,182 through 186,188 through 196,199,200,202 through 205,207 through 209,215 through 218,220 and 223 through 229,231,233 through 238,240 through 242,244,246 through 258,260 through 264,270 through 273 and 276 through 279.

I didn't read all these so I can be number one as who talks the most legislators. I had to read all these numbers. I'm looking for a motion on those consent items moved by Senator Grove. Please call the roll.

[Roll Call]

On a vote of four to zero, those consent items are approved. Moving on to our group b of votes, we are now going to be voting on items 6,7,26,27,30,40,50,52,53,64,72,81,84,92,99,105,113,116,123-132,156,157,168,169,172,265,268-269. . Looking for a motion so moved so moved by Senator Roth. Please call the roll.

[Roll Call]

Our final vote is on group c.

We're going to be voting on items 4,5,8,9,11,24,28,32,33,41,42,45,47,51,54,55,59,60,63,66,73,75,78,80,82,88,93,100,101, 103,107,109,111,114,118,139,141,155,170,171,176,181,187,197,198,201,206,210-214,219,221-222,230,232,239,243,245,259,266-267,274-275,280-281 Looking for a motion so moved moved by Senator Roth. Please call the roll.

[Roll Call]

On a vote of three to zero, that group section passes. Those are our final votes. Your task now is to continue advocacy to ensure that the three party deal stays as close as possible to this. My hat's off to you. Thank you so much, and hopefully we'll see each other next year.

Budget Subcommitee number three on health and human Services has adjourned.