Assembly Budget Subcommittee No. 1 on Health

Good afternoon. I'm going to call this hearing to order and welcome everyone to the Assembly Budget Subcommitee No. 1 on Health. Today is our second hearing reviewing the Governor's May Revision proposal. It's actually this Committee's 10th hearing overall and I want to thank our Sub 1 Committee Members and other Assemblyembers who guested in last night.

We were here very late until about 9:30 last night going over proposals related to DHCS and similar to yesterday, today's hearing is informational and it's open to every member of the State Assembly.

And so we want to welcome Assemblymember Zbur who has interest in some of the items on the agenda today and any other of our colleagues that come, obviously we welcome them. First and foremost, we are here to be strong and transparent fiscal stewards for California's taxpayers and California's people.

And so yesterday we established ground rules to sort of keep us moving along with professionalism and courtesy. We know that disagreement is part of the process.

And as Members come in, I will remind them that this is about a respectful process where we are going to refrain from interrupting witnesses or one another and refrain from any kind of personal attack or accusatory or inflammatory language. And I will say I think we did very well with that yesterday.

So for those watching want to thank all of the Members that were with us yesterday for their decorum and ask that anybody who's on the dais keep to specific questions as opposed to lengthy speeches, knowing that there's a lot of people here in the audience who wait a very long time to be able to have their say at the mic.

So today's hearing will focus on the remaining healthcare proposals included in the Governor's May Revision. Since its release, we have received extensive feedback from a wide range of stakeholders and I want to thank members of the public and stakeholders who have engaged in this process.

We have heard particular concern regarding the reversion of unspent funds from various programs and contracts administered by the California Department of Public Health, including potential impacts on initiatives under the Office of Gender Health Equity. And so this hearing is an opportunity to further examine the effects of those proposals along with the many other changes.

As I did yesterday, I'm going to continue to ask the Administration to work closely with us to develop balanced fiscal solutions that also reflect the values and the health care needs of all Californians. So I know that Assemblymember Zbur is short on time and has an issue that he wanted to speak on before we get into having our witnesses up to the dais-- up to the table.

Thank you, Chair Addis. Really appreciate the indulgence. I have something that I've got to leave for at 3 o' clock and then I'm going to try to come back later. So I just wanted to get a couple issues on the table in case I'm gone when these areas-- when it's the appropriate time to discuss this.

In particular, wanted to raise concerns about the California Reducing Disparities Project, which was a part of a $58 million authorization in the 2021 budget. 15.8 million I think would have actually been authorized this year and that looks like it was cut completely.

The Reducing Disparities Project is a statewide initiative that's housed within CDPH's Office of Health Equity and is designed to reduce mental health disparities among historically underserved populations. It funds community defined culturally responsive prevention and early intervention strategies through grants to grassroots organizations serving African American, Latino, Latinx, Asian Pacific Islander, Native American and LGBTQ+ communities.

In the fiscal year 24-25, CRDP supported 41 community-based organizations across California and that's been recognized as a national model for equity driven behavioral health investment.

The Governor's May Revise for 25-26 proposes to eliminate the program entirely, cutting $15.8 million from the including funding for active multi-year contracts that were not disclosed in the public budget summary. So the first question I think I'd ask at the appropriate time is, is this cut really there? Because it does--

It looks like that cut was left out of the programmatic documentation. So the first question is are we focused on something in which the cut was not really made? Which is what I'm hoping. The second though is I think really highlighting the fact that this cut is going to be really devastating.

That you know, many of the 40 organizations that received funding through this, they were their grantees that are in mid-contract, they're delivering critical health programming and these were active contracts with trusted community partners. And this abrupt cutting of funding I think is going to have a devastating impact on some of these programs.

It's also-- I just sort of question why the disproportionate impact. When you look at HHS and CDPH overall they took a modest reduction of about 3.9%. Well, HHS actually saw an increase of 2.82%. It looks like the Office of Health Equity overall took a decline of 50%.

And of course the particular programs that affect these communities were cut completely. So that was something that I was concerned about, wanted to raise. The second issue is related to the Gender Health Equity section, which was CDPH request General Fund expenditure authority for 15.5 million.

It was originally again authorized in 2019 and it's about to expire. On that-- Actually going back to the other one, one of the things that at least some of the advocates and some of the community partners had mentioned was that they believe that this was being cut back because of non-application on the funds.

And they've sort of, a number of the applicants have told me that they, you know, that the contract dates have been really delayed. They've applied on time. It took a long time for the contracts to get out. Even after the contracts were awarded, a lot more time to--

And so they have actually, I think done their part and many of them have hired staff already in reliance on these contracts. So the hardships are going to be pretty significant.

Then going back to the other one that, the Gender Health Equity section in that one, I understand there's more than 30 organizations who've been told their grants are being eliminated within the Gender Health Equity section of the Office of Health Equity, in addition to the GBQ Fund, that includes six Planned Parenthood Affiliates of California that reported they were funded through the RJ Fund for Reproductive Justice.

Again, that was not mentioned in the documentation that came out. So again, a question is, is this fund-- is this actually being cut? But it looks like it is.

And of course you have the same sort of sets of issues on sort of delays, you know, sort of the recipients of the grants sort of-- and I don't want to use charged language, but being held responsible for sort of the delay in getting the money out when in fact there's been delays in getting the money out from the administrator side.

So those are the two things that I wanted to raise, raise concern about the cuts just having how disproportionate they are. They are programs that disproportionately affect underserved-- help underserved communities, the LGBTQ community in particular, LGBTQ women in particular, and LGBTQ people of color.

And so I just wanted to thank you for giving me an opportunity to raise concerns about these cuts.

Absolutely. Thank you Assemblymember. And I know that CDPH is here and hopefully listened to your comments and concerns and maybe can address them when they-- when we address those issues on the agenda. So thank you so much for coming and we hope you'll come back if you have time to.

But just in terms of housekeeping today, we're going to cover six issues for six departments, including the Commission for Behavioral Health, the Emergency Medical Services Authority, the California Department of Public Health, the Department of State Hospitals, the Department for Healthcare Access and Information, and the Department of Managed Health Care. And the agenda is online on our Committee's website and physical copies are available in the hearing room.

After we conclude a panel presentation on each issue, we will have questions from the dais and then comments from the public. All public comment will be taken in person at the end of each issue and comments should pertain to the specific presentation.

We'll open up public comment for items not on yesterday or-- not on yesterday or today's agenda at the end of the hearing.

Because there's a large number of people here, I am going to ask you, just as we did yesterday, to keep your public comment to name, organization, specific issue and position on the issue, and if you're unable to attend this hearing in person, you may submit your comments via email to [email protected].

And so with that, we will start our first issue, the Commission for Behavioral Health, and I'll invite presenters up to the table. The background for this item is on page two of the agenda. We're first going to receive an overview of the May Revision proposals and welcome additional comments from Department of Finance and the LAO. And please go ahead and get started when you're ready.

Good afternoon, Chair and Committee Members. Paula Fonacier-Tang with the Department of Finance. As our colleagues noted yesterday, we want to begin by offering some opening remarks ahead of discussing the proposed budget solutions as a whole and then before going into our remarks specific to the first issue. At the Governor's budget, both the administration and the LAO noted that baseline expenditure growth was outpacing revenues.

With the release of the 25-26 May Revision, we are addressing the state's third consecutive deficit budget, which is 12 billion in the coming year. For context, the past two budgets addressed approximately 30 billion and 50 billion deficits, respectively.

These previous budgets, however, were solved largely by eliminating significant one-time funds, special fund transfers and loans, withdrawing from reserves and attempting to cut spending in our own departments. Amidst our third consecutive deficit, these solutions have been largely exhausted. We are now forced to look deeper and make more difficult decisions.

While we acknowledge these proposals may be met with concerns, the administration would like to reiterate that the May Revision is a starting point. To the extent that members of the legislature have alternative solutions or approaches to address the budget deficit, we will continue to engage with the legislature as we work together towards a final budget agreement.

Thank you and I'll now hand it off to my colleague who will be providing some remarks about the proposed elimination to the Commission on Behavioral Health.

Hello, everyone. Lizbeth Castillo with the Department of Finance. So the May Revision proposes to eliminate Mental Health Wellness Act funds administered by the Behavioral Health Services Oversight and Accountability Commission by 20 million Behavioral Health Services Fund in 25-26.

And ongoing, given the state's fiscal outlook, as my colleague mentioned, the May Revision proposes the elimination to utilize available Behavioral Health Services Fund to offset General Fund costs.

And although we are cutting the funding, we would like to note that the Behavioral Health Services Act passed in 2023 provides a maximum of 20 million over five years for the commission beginning in 2026-27 from the Behavioral Health Services Act Innovation Partnership Fund.

The 20 million is available for five years, after which the funding shall be subject to the annual state budget process. Per statute, the commission is required to use the funding to award grants to private, public and nonprofit partners to promote the development of innovative and substance use disorder programs and practices. And that concludes my comments.

Great. Oh, am I on? So, good afternoon and thank you for the opportunity to be here today. My name is Brenda Grealish and I'm the Executive Director for the Commission on Behavioral Health. And I'll start first with a couple reappropriation proposals that are in the May Revision.

One is the extension of liquidation of $430,000 for the Early Psychosis Intervention Plus program. Essentially this is just a one year extension for one grantee who started one year later as a result of a previous grantee not choosing to move forward.

So this essentially gives Sacramento County's Early Psychosis Intervention Plus Program the same three years that the rest of the grantees in the program had to complete their implementation. And this is to expand the provision of high quality evidence-based early psychosis and mood disorder detection and intervention services.

The second reappropriation proposal is to do a two year extension for the liquidation for 7,768,000 for six grantees of the emergency psychiatric assessment, treatment and healing teams or units which streamline emergency department assessment of the health needs of mental health consumers experiencing psychiatric emergencies to quickly transition them out of emergency departments into a calming space that allows for rapid assessment of support and linkages to continued services to address their behavioral health needs.

And then moving along, I think for those-- those were the two reappropriations, but I think moving along with what the Department of Finance team had mentioned in terms of the proposed elimination of the $20 million in Mental Health Wellness Act funds, essentially the Mental Health Wellness Act is part of the Commission's local assistance budget, meaning that it's designed to serve the unmet needs in local communities.

So transferring these funds to the General Fund would strip critical resources away from California's most vulnerable populations. And the immediate impact of this cut is the elimination of three projects which are just about ready to launch, which would remove essential supports for people that rely on these services every day.

However, the long term impact of this cut is the effective elimination of all Commission grant programs. So while the new $20 million innovation grant related program funded by Prop 1 will begin next year, it's limited to five years. After which the Commission will have to try to secure additional funding.

So if this cut is enacted, then by fiscal year 3031 the Commission will no longer have any permanent ongoing grant programming and without this grant funding, the Commission will be unable to fill critical gaps necessary to support the state's behavioral health transformation goals and more importantly, to support those most in need.

In terms of the immediate impacts, the three launch-ready grants that the Commission has right on the-- or is right on the cusp of implementing were developed in close partnership with other state departments and community stakeholders and address major gaps in our systems.

So our first is a $20 million grant focused on children ages 0 to 5 that's about to be awarded to six community-based organizations and one technical assistance provider. Eliminating these funding would pull resources-- this funding would pull resources directly from organizations who serve birthing people during pregnancy, infancy and early childhood.

Their goal is to connect families with vital supports through our public health delivery systems and achieve access to services that are available through recent efforts-- recent ongoing efforts and recent efforts such as CalAIM and BH-Connect and to our knowledge, no other state department or other entity is doing this work at the state level.

Our second grant that we have that we're on the cusp of implementing is our $20 million Full Service Partnerships grant which is focused on implementing performance-based contracting and this would derail major efforts to strengthen our behavioral health systems and fulfill the promises of Proposition 1.

And this grant, like others, were developed in collaboration with state and local partners to ensure alignment and add technical assistance capacity. So eliminating this grant again puts both progress and people at risk.

And finally, our third most immediate grant is a $20 million peer respite grant which is set to launch later this year and would contradict the state's crisis response goals as outlined in the 988 strategic plan and peer respites offer dignified voluntary alternatives to hospitalization and incarceration, providing people in crisis with the compassionate care that they deserve.

So it's important to note that the Commission's $20 million Innovation Partnership Grant, under Prop 1, is not a replacement for this Mental Health Wellness Act funding again as it's time-limited to five years and then thereafter would be contingent on state budget conditions.

Furthermore, the Innovation Fund also has an entirely different scope as it's designed for public private partnerships and can public, private and nonprofit entities. So all funded initiatives under the Innovation Partnership Fund must be innovative and system level in nature as defined by the Commission.

And again, like just to reiterate, if the funding is immediately eliminated, then that would immediately impact those three launch-ready programs and would result in those three launch-ready programs having to compete for the Innovation Partnership funds in which they'd be competing against private entities, including tech and behavioral health startups.

And they'd also have to prove that they are sufficiently innovative to qualify. So in contrast, the Mental Health Wellness Act does not have such innovation requirements. It supports crisis prevention, early intervention and crisis response strategies with input from peers, county behavioral health agencies, community-based organizations and state partners.

And just to give an example of some of the other types of programs that have been funded under the mental health grants, they include programs to address the needs of older adults, psychiatric emergency rooms, substance use disorders, and then one pilot, recent pilot, focusing on access to medication-assisted treatment is just a good example of what the state could potentially scale and help with SUD integration as elevated by Prop 1.

And again, these might not necessarily be considered innovative, but they are filling gaps. So really the Mental Health Wellness Act is the Commission's largest and most impactful ongoing grant program.

And cutting these grants would abandon the promising pilots midstream, sever those partnerships and undermine the success of our California Behavioral Health Report reforms at a time when stability and continuity are crucial.

So with that, you know, just want to stress those long-term impacts that, you know, really essentially it's a total elimination of the Commission's grant-making ability beyond 3031 and then it would be subject to the Budget Act. And I'll turn it over to Commissioner Chambers just to add a little bit more from your perspective.

Thank you. And thank you for this. My name is Rayshell Chambers and I'm here to speak on behalf of the black and brown individuals that were not here and able to travel all the way to Sacramento to advocate for our services that are going to be lost.

I'm speaking for families that have birthing mothers and families that are 0 through 5 like myself who suffered from post traumatic stress as a result of having a child. I'm here because I was appointed by Gavin Newsom to represent the clients and consumers.

This money, if cut, will impact my niece who's right now in Riverside County, FSP program who needs peer support, who Prop 1 is not able to help sufficiently yet. This money will help mothers like me who lost their mind after having a baby. Women don't talk about that.

The Commission is meeting needs with maternal health that are imminent right now, not with DHCS and Health and Human services. And also this money will also eliminate peer respite. As someone that's been hospitalized four times, I did not need to go to emergency room every time.

I should have had the opportunity to go to a respite that gave me 30 days stay and the tools needed. And they say, zero, the state is funding that. This bond money does not allow nonprofits that are black and brown to compete with big CBOs. That money, we cannot meet those investments.

The Commission was providing investments for black and brown communities to compete in this new system of Prop 1 so that we can provide trauma-informed grassroots services.

And I'm also speaking because, as I noted, I'm a person with serious mental illness and I also run a mental health forensic treatment program and I'm implementing, as I said, CalAIM and ECM right now.

And as the Commissioner-- I'm also a Commissioner and I want to let you know that FSP is not going to be completely sustained by the Prop 1. We need these mental health wellness funds to be able to support the gaps. We know that the retention rate is high. It is one of the most effective programs, FSP.

However, we do not have investments to fill in those gaps. And so FSP is needed and the funding by the Commission is needed so that we can suffice the budget money that's being left off the table.

Additionally, as a CBO, this capital investment money, we're not able to compete, as I noted, with the CBOs and the large corporations for Prop 1. So we need the money for peer respites. As I noted, I've been hospitalized and other individuals do not need to go to a hospital.

I believe the system is bridging individuals to go to emergency rooms and psychiatric facilities. The Commission has made investments already to be able to support with peer respites and diverting from those programs.

So essentially I want to close and say that if you don't leave hearing anything I said, mothers and parents and fathers, individuals who are birthing children 0 through 5 need these additional supports.

I can tell you anybody that's birthed a child in this room knows that, anybody right now with FSP got a parent or family member in an intense program. The state resources are needed amongst multiple programs and additionally our peer respites, we need to be able to divert people not into long term treatment.

And as I noted in the Senate yesterday, they said it's never the IT people that are coming up here or the government bureaucrats saying to save their budgets.

It's the individuals in the back that look like me that are black and brown that scraped up their coins to come here to tell you to please not cut our program. Please, please, please check on the people from racial, ethnic diverse communities. Our programs are important and we need to be funded. Thank you.

Thank you, Commissioner. And anything from the LAO?

Yes, Will Owens with the Legislative Analyst Office. So first, just broad comments, believe you heard from my colleague yesterday on the kind of state's overall budget condition. And so again, just to kind of echo those comments of the ongoing structural deficit and the need to address that.

However, you know, the Legislature should look at the specific mix of solutions proposed by the Governor and kind of consider those in deciding its priorities broadly across the proposals you'll hear today, there are a number of proposals that we are still waiting on specific either trailer Bill Language on or budget proposal information on at that.

At this time we're unable to kind of evaluate those proposals. But as we get more information we'll be sure to reach out to the Committee with any concerns we may have as it relates to this specific proposal. You'll note that this is funding from the Behavioral Health Services Fund account, formerly the mental health Services Fund.

So from the millionaires tax, the state receives a certain portion of that funding to allocate as it kind of is fit to kind of implement the provisions of the actual. To the degree that the Administration is using some of this funding to help address the overall General Fund budget shortfall, we are aware that it is.

However, we are still waiting for backup documentation on the total scope of the amount of this behavioral health services Fund that is available. So until that time comes, we're unable to say, provide a definitive analysis on this proposal. Like I said, that being said, available for questions. Thank you.

Thank you. I do have questions. I think first and foremost we went through three hours of hearings yesterday where we heard time and again very similar comments to what the Commissioner has just expressed that there seems to be a trend of trying to balance California's budget on the backs of those most most in need.

And so you know, for Department of Finance, I would ask that you, number one, react to what you've heard from the Commission and the Commissioner about how devastating this proposal is and just your initial reactions to that.

And then if you could talk about why this particular funding is on your list to eliminate and what alternatives you've looked at to be able to provide, preserve this funding. And we'll open up to other Committee Members as well.

Thank you for the question, Chair. On behalf of the Administration, we recognize that this is not a situation that we want to be in in terms of a fiscal situation. As you recall from last year's budget cycle, we, we rolled back a lot of one time and temporary funding. It was largely exhausted.

There were solutions that were included in that budget. And so that means that going forward, decisions to balance the budget will involve more difficult trade offs. And so we acknowledge that eliminating funding can be an interruption. But we also see there's an opportunity with these new Innovation Partnership grant funds.

And to our understanding, per statute, the Commission is required to use the funding to award grants to private, public and nonprofit partners to promote the development of innovative and substance use disorder programs and practices.

And so While the funding, the 20 million is proposed to be eliminated, the Commission will also be receiving this additional funding 20 million starting in 26-27.

And I think the Administration will also like to note that as a requirement under the new Behavioral Health Services act, the Commission is required to consult with HHS agency, dhcs and other entities on the allowable uses of these funds.

And we think that, you know, to the extent that the Commission can explore using these funds to support programs that achieve similar goals as those currently funding, funded with a mental health wellness act and work in collaboration with other health entities to ensure that the services are aligned with the state's overall behavioral health transformation strategy and is not duplicative of those other efforts.

I guess I'll ask the question more specifically. Where else have you looked for this 20 million besides cutting these services?

Yes. I can't speak to the deliverative process in the budget, but I can say that overall the goal was to close the budget shortfall, reduce ongoing expenditure growth and while preserving as many programs and services as possible.

Got it. Thank you. Assemblymember any questions on this item. With that, then we will open to public comment for this specific issue and we will ask you to please keep your comment to name, organization and position on this specific issue. And we will.

I am going to have to hold to that because I understand we have hundreds of people waiting to give public comment in different areas for this hearing.

Good afternoon, Dixie, with the California Alliance of Child and Family Services. Our Members are concerned about the Mental Health Wellness Grants cuts and the $20 million cuts for full service partnerships, a. Cornerstone of Prop 1, and the $20. Million cuts to the peer Respite initiative. Thank you so much.

Stacie Hiramoto with REMHDCO, the Racial and Ethnic Mental Health Disparities Coalition Planning. Please do not cut these funds. The Commission has just turned over a new leaf. They have a new Executive Director. The staff is open. I would not have come up to support this about six months ago, but we do now. They want to work with the community. Please don't cut these funds.

Good afternoon. Susan Gallagher with Cal Voices, our oldest peer run organization in California. And we oppose these cuts to the Commission. I think that you don't understand the level of community involvement that has been involved in developing these programs.

And the Commission really has done their due diligence in reaching out to communities like ours and many of the other folks here to develop and create these programs. And so when you just yank it back like that, these are not fungible things. They just can't be replaced with another 20 million. That is different. Thank you. I just.

Thank you. Just a quick reminder, if you can keep to name organization and position. We do. You can't see them in this room, but there are hundreds of people coming to this hearing today and we need, we do need to move quickly.

Darby Kernan, on behalf of the First 5 Association of, California, we oppose the $20 million cut. We associate our comments with that of the Commission and the Executive Director. Thank. You.

Good afternoon, chair and Committee Members. I'm Barbara Schmitz. I work for First Five California. And we obviously are hoping to reject the proposed $20 million cuts. And we also associate ourselves with some of the Commission comments and witness testimony. Thank you.

Nora Angeles. With Children Now, we oppose the $20 million BHSA reduction. Thank you.

Seeing no other public comment, we'll say thank you to everyone who's given testimony on this issue. Point well taken, Commissioner. I do hope Department of Finance will go back and really identify what else could be done for this $20 million and come back to the table with some ideas on this. But thank you all for coming.

We are going to move on to issue two, which is Emergency Medical Services Authority. And background for this item is on page three of the agenda. We will first have an overview of the May revision proposals and then welcome additional comments from LAO and Department of Finance. And you're welcome to start.

Thank you, Madam Chair and Members. I'm Gabrielle Santoro, Chief. Oh, is it not on? Is that better? Oh, this one. Is that better? Yeah. Okay. Thank you. Apologies. I'm Gabrielle Santoro, Chief Deputy Director of the Emergency Medical Services Authority, or EMSA. As noted, we were asked to provide a brief overview of our may revision proposals.

First, we propose a $1.1 million General Fund Expenditure Authority increase and a $1.6 million Reimbursement Expenditure Authority increase to support the increased costs for the California Poison Control system that the UC operates via contract with EMSA.

Next, we propose a $5.5 million General Fund expenditure authority increase to correct an erroneous reduction made to EMSA's expenditure authority in the previous Budget Act. And finally, we propose the reappropriation of $3.6 million General Fund originally appropriated in the 2021 Budget act to support the continued planning and implementation of the Enterprise Services and Data Management System.

That concludes my comments, but happy to answer any questions.

Thank you. Anything from Department of Finance or L. A? Kayla Knott, Department of Finance. Nothing further to add.

Oh, sorry, Will Owens LAO, Nothing to add, but available for questions

Will.

And I actually don't have questions on this issue. Assembly Member, do you have any questions? Assembly Member. All good. Do you have any questions on this issue? Okay, then we are going to move to public comment for items on. For number issue number two on Emergency Medical Services Authority. Is there any public comment on this particular issue?

Looks like we may have public somebody walking in for public comment. We'll give them a moment.

Or at least we're searching.

Okay, seeing—almost. Okay, seeing and hearing no public comment for Issue 2, we are going to move on to our third issue with the California Department of Public Health. Background for this Item is on Page 4 of your agenda.

We will first receive an overview of the May Revision proposals and then welcome additional comments from the Department of Finance and the LAO. I am going to ask our presenters to be as brief as possible.

I know that—I believe we have a number of people who are going to want to make public comment on this issue, and we want to make sure that everybody gets their time.

Well, welcome and please do feel free to start as soon as you're ready.

Okay. Thank you. Madam Chair and Members, Brandon Nunes, Chief Deputy Director for Operations at the Department of Public Health. The agenda lays out a number of proposals for us here at CDPH. Would you like me to just go through each one and just do a high level or?

Let's do—I think there may be a number of people who want to comment and have questions on this. So, let's do a brief, high-level overview, then we'll turn it over to Department of Finance and the LAO to see if they have additional comments and then there will be comments from the dais and then public comment.

So, thank you.

You're welcome. So, just at a very high level for us this year at May Revision, not a large change dollars-wise from Governor's Budget for '25-'26, 5.5 billion even in total funds supported, supported with $742 million General Fund, a slight increase in our General Fund of 2%, and an overall reduction of 1.25% from Governor's Budget to May Revision.

As far as proposals go, I'll hit just a couple of the high-level proposals and then, if you want details on some of the others, we can jump into those.

But for the most part, a couple of proposals that I would mention, we've talked about the California Vaccine Management System in this Committee quite a bit. There is funding included at the May Revision for the Vaccine Management System of $31.5 million one-time in '25-'26.

We do have some solutions that go towards solving the $12 billion budget deficit that the state is currently facing. Most of those solutions come in the form of reversions to various General Fund appropriations that we've had throughout the past few years, the largest of which comes from the California Reducing Disparities project.

Of the $30 million, roughly $15.8 million comes from a reversion that was provided to us in the '21 Budget Act. It would have gone through 2026 and said this reversion will end it.

At the end of this fiscal year, we have some, some $4 million in reversions related to capacity training and care for LGBTQ foster youth. In the Budget few years back, we also received funding for workforce development dollars, roughly $65 million over four years.

The budget includes, in total, about a $9.2 million reversion from those workforce development dollars, related to public health, workforce development and engagement, Public Health Pathways Training Corps, microbiologist training, the Lab Aspire Program, and our California Epidemiological Investigation Service, or Cal EIS, Fellowship.

Part of the solutions related to workforce development too, along with those reversions, we had $3.2 million that was going to be included in the '25-'26 Budget for workforce development, related to upskilling, that is now being withdrawn as part of the May Revision. But that's all part of the packages related to workforce development.

And then, to round out the reversions, STD prevention, there was a million dollars coming—being reverted—related to that that we received in the '23 Budget Act; some funding related to HEP C prevention and HEP C testing kits, $1.3 million in reversions there; Hospice Task Force, a million dollars that came to us in the '22 Budget Act, and then, $900,000 related to extreme heat.

So, as I mentioned, in total, one of the larger issues that we're carrying in May Revision is the reversion of the funding. Would you like me to keep going with other items or I can? Those are some of the larger highlights.

There's obviously a lot of other budget change proposals throughout the centers, as well as some ledge proposals. I can continue to.

I think that's good for the moment, but I know there's a ton of interest in this topic and I have, you know, some questions and I know my colleague—colleagues on the dais—and Assemblymember Zbur was here earlier and had quite a bit of concern and comments on this topic.

But is there anything else from Department of Finance or the LAO?

Nothing to add. Thank you.

Yeah, just echoing comments. Will Owens, the LAO, echoing comments from before. A number of these proposals, we're still waiting for a little more detail from the Administration, at which time we can flag any concerns that we may raise for the Committee.

Just one proposal in particular I just wanted to flag, maybe not necessarily about the proposal itself, but more broadly, there is a proposal for the Generative AI, Gen AI Project, pilot project for health facilities.

So, our Office released a report shortly ago kind of providing some overall recommendations on maybe the state's approach to both the Gen AI projects and some IT kind of processes more broadly.

Just kind of consistent with recommendations there that we just note that more legislative oversight over the state's Gen I—Gen AI—projects, whole, is needed and are that our Office is available to assist the Committee, as needed, on developing additional oversight tools for these projects. Happy to answer any questions.

Thank you. I do have questions around—and this was raised by Assemblymember Zbur earlier, but he had to leave—the California Reducing Disparities Project.

And what was brought up earlier, and I've, I've had conduct on this as well, is that there are more than 40 organizations funded through the CRDP and that many of these grantees are mid, mid-contract, and that their contracts will have to end.

And just wondering how CDPH is justifying abruptly cutting funding right in the middle of these contracts.

That's correct. There's roughly—CRDP did support roughly 33 grants and nine contracts. So, I think that's roughly the 40 that you mentioned. I think, you know, it goes towards the particular budget situation that we're facing this year.

You know, this starts a conversation of course with the Legislature, but this is an area that was available to be reverted early and was considered as part of General Fund solutions, given the budget situation.

Okay. So, it's funding that was promised but funding that now will be slashed, even though it's mid-contract?

There were—the contracts were available through the 2026, through the June of 2026, as well as the funding most of the last year would have been, not that it wouldn't have supported program, but evaluation of the program would have occurred in that last year primarily.

So, that's I think the main thing that would be foregone in by reverting early.

Got it. And just because we have additional Members that have arrived, I'll just remind all of us of our, sort of, conduct on the dais and conduct for folks that are in the room that we're going to treat each other with kindness and respect.

We may not always agree with what's being presented, particularly those on the dais may not always agree with what's being being presented, but that it's our commitment to listen, to be inquisitive, to represent the taxpayers and the people of California, to not interrupt, and to move through the agenda as quickly as we're able, so that we can get the public's input on this.

I have like one or two other questions on this. One of them is if you can talk about the percent of total funds that were cut from the Office of Health Equity and how you decided, you know, to target those funds over others.

As far as percentage of total funds, a lot of the, again, a lot of the reversion amounts were one time in nature, so they would have expired either at the end of this year or 2026. As far as what proportion that is to total funds of the Office of Health Equity, I would have to take that back.

But we can get that very quickly for your staff. Make sure you get that.

Okay. That would be helpful. And then there's questions around if this funding is going to affect reproductive care in California, specifically how that's going to play out for reproductive care as well. So, I'm going to turn it over to my colleagues on the dais. So, we are on Issue 3 and—I think.

Hope I got that right. And it's CDPH, and you've seen a number of budget proposals. And if you have any questions, Assemblymember Schiavo and Bonta and Mr. Patterson, if you have questions, just let me know.

Thank you. So, on the CRDP programs, I, you know, echo the Chair's concerns around these cuts, particularly in the middle of their contract—contracts and grants—that we've already approved to them. And, you know, it really feels like breaking a promise and a commitment that we have made. My understanding is that, you know, these programs have really made a big difference.

Do you have any information or knowledge about how successful these programs have been in accomplishing their goals?

I don't know.

I'll help. Yeah. Good afternoon. Christine Chador. Yes, we have an evaluation of our CRDP programs, and they have been quite successful in providing mental health services to underserved communities.

Okay. Well, knowing that, knowing that we're in the middle of a mental health crisis, it seems like that would not be something we would want to cut. We don't want to cut incredibly successful programs. We want to cut programs that are not really producing the results that we would like to see.

So, I hope that you know that that'll be taken back and reconsidered in terms of focusing on where we can—it's been confusing.

I just have to say it's, you know, it's difficult in these hearings to really get a strong sense of why these cuts are being made and what the kind of criteria is behind some of these cuts.

Because if we have a successful program that is making a difference in communities that have been underserved for too long, then that seems like something that we would want to continue to support and bolster. And—but it's continually hard to get an understanding of where programs are not really making the impact that they should be.

And I think that, you know, you all have a lot more staff resources to be able to kind of figure this out. And you also get the reports directly to you on programs that are being successful or not.

And so, you know, I hope in this time when we're going back and forth, would encourage departments and the Department of Finance to really look at the programs that are not delivering on what they have promised and that those are the areas that we particularly focus on first, instead of programs that we know are making a difference.

So, another, you know, concern I wanted to raise is that there has been the Reproductive Freedom and Abortion Access Unit under the Gender Health Equity section of CDPH—was established to address issues related to reproductive freedom, justice, abortion, and focus on California's communities that are historically and systematically experience inequities related to access to related services.

So, this includes providing grants for community-based organizations that conduct medically accurate and culturally competent outreach and education on sexual health and reproductive health issues.

The unit administers abortion.ca.gov, a website that is a really critical resource to make sure that we cut through the noise of fact and fiction around medically appropriate and you know, and medical abortion care that is available and providers that are available in the state.

And so, does this Revise eliminate that website—eliminate any support of that website or eliminate that website?

No, the May Revision does not propose to eliminate abortion.ca.gov. There was a million dollars, I think provided in a previous budget that was set to expire this year, that helped us kind of stand up the infrastructure of the website. And then, I think most of the maintenance of the website was done through OHI. I think that's correct.

Okay. So, we expect that website to be continuing?

So, just speaking to the website. So again, there are dollars associated with the website. I'm sorry, Riley Thompson, Department of Finance. Apologies for not starting with that. So, there are dollars associated with the website that do expire as of June 30th, 2025, and those—so those dollars will expire.

I cannot speak as to whether that is the totality of the resources needed to keep on the website. And I'll defer to the Department.

Yeah, I think we're on the same page that there was some one-time funding that kind of helped stand it up, but really kind of the maintenance, the staff work that goes into the—we were never, we kind of always absorbed that. So, there would be no plans in the May Revision to abolish that site.

Okay. Because I also have a Bill related to this, where we wanted to bolster that website and include information that's been taken down by the Federal Government, related to abortion and women's health care, to make sure that it was more robust and resourceful.

And so, I'm concerned and raising a flag and concerned about that being jeopardized in any way.

And then, I'll just, you know, mention—we talked about this a lot last night—but want to flag, you know, concerns about Prop 56 funds, defunding Planned Parenthood and women's health organizations and also wanted to raise concerns about the ADAP program that that reduces it $50.5 million.

But I know other Members want to ask questions, so I'll leave it at that.

Thank you. Assemblymember Bonta.

Thank you. This is in reference to the CDEPS and the CRDP Program. So, my understanding is that the CDEPs are included throughout the various funding categories of Prop 1. What's the rationale for pulling back funding to the programs that provide these interventions a year before the programs in Prop 1 take effect?

Specifically, sorry, to the CRDP funding?

Yes.

I think I'd reiterate again that it's just, again, towards a difficult budget season solving towards the $12 billion in this particular situation. These were solutions that were identified in our budget. So, ending the program a year early was part of helping to solve for that solution—solve for that issue.

So, solving for a couple of numbers. So, 33 community-based organizations are a part of the CDEPs. Have you, also in thinking about proposing this, done any analysis around how many providers will lose their jobs or how many Californians would lose, lose services through these programs?

We would have to get back to you on that.

Yeah, that's—I really do hope that you get back to us on that. I think it's very challenging to make any diligent analysis on these kinds of budget cuts when we actually don't understand or aren't able to be shared what the impact of those, of those cuts are.

I think we're able to enter into a robust conversation about what needs to happen. But if we're only given partial information, it's just not, not fair to this Legislature. So, I'd encourage us to have those kinds of answers going forward. Has there—in the past DPH has received MHSA funds for the CRDP through Offices of Health Equity—has there been any consideration around any alternative funding sources rather than simply cutting off services?

For instance, can the MHSA set aside, or state admin be used to support these community-based programs instead?

We have not looked at those alternatives.

I think that is a—we've been called on to provide alternatives in helping to address the budget shortage that we know we have. I think looking at State Admin is a very reasonable potential solution. And I would encourage, through the Chair, for us to be able to have some analysis around that. I don't have any other questions.

Thank you, Chair.

Thank you. Assemblymember Patterson.

Great, thanks. Just a couple questions. The AIDS Drug Assistance Program, it says here, "Decreases expenditures by $50 million and ongoing," but it says to reflect decreased caseload. Is that—that's because we expect less people to take advantage of the program?

That's primarily true, yeah. There's—we take a look at the caseload trends between Governor's Budget and May Revision, and those adjustments were made here for caseload primarily.

All right, thank you. And then, California Syndromic Surveillance Program Reappropriation, as regarding from the Opioid Settlement Fund, tracks overdoses and things like that. According to the information I have here, reappropriates $2.5 million, but is that basically because it's not spent yet and we'll just reappropriate it to this year?

Correct. It'll roll from this year to the '25-'26 year.

Okay, thank you. There's one more question I had here. Oh, yes, just something that caught my eye. Generative artificial intelligence, $8 million one-time from Internal Departmental Quality Improvement Account to support the development of a generative artificial intelligence minimum viable product. Can you talk a little bit about what on God's good green earth that is?

We can, yes. Susan Finelli.

Hi. I'm also a Chief Deputy in Public Health. Susan Finelli. It is a generative AI project for our Center for Health Care Quality, and what it would do is allow us to use generative AI to look at once a survey is conducted in a healthcare facility, the nurses and other surveyors have to come back and write a long report about any deficiencies, and they have to map it to the appropriate regulations.

This would use generative AI to look at those regulations, compare the notes, and really cut down on the time it takes to write those reports, so that our surveyors can spend their time in the facilities making sure that people are compliant, rather than writing those reports and spending a lot of time doing that.

Okay. And what exactly is the Internal Departmental Quality Improvement Account? What other items are eligible to use that particular Fund?

We've generally used that for other quality improvement type efforts, whether that be, you know, modern technology, modernization, like moving to some of our new systems for having like on an iPad, the ability for surveyors to fill that out.

So, it's really meant to be an improvement account to make sure that the work that we do in our health care facilities is continuously improving.

And do you think that—I'm sorry, I'm just very, I've never seen state IT project cost anything less than like a billion dollars. So, when I see $8 million in generative AI, I'm just trying to get an understanding of—cause, you know, we're making cuts in a lot of places.

And so, that's why I asked the question about—or the Governor, sorry, not we're making cuts, the Governor's proposing cuts in certain places that are pretty detrimental to, you know, I think a lot of things. But in this particular case, we're spending $8 million on something a little suspicious whether or not it will only cost $8 million.

But exactly how will the Department move forward with procuring this product? Is it in-house? Is it going to be contracted out?

It will be contracted out. We did a pilot, the RFI Squared Project, where the governors had different pilot projects for a dollar where they came and looked at whether they could create a viable product and did some pre-work. And then along with that ability to contract with one of those vendors, came along with that process.

Okay. Yes.

Yes. Will Owens with the LAO. So, maybe just—it might be helpful to provide a little context again. So, this Gen AI project is one of a number of Gen AI projects across the state that the Administration is piloting, using a new kind of procurement process for IT projects.

And so, our Office released a report shortly ago kind of evaluating this process as a whole.

And so, while not maybe specific to this proposal, within that report we did recommend a number of opportunities for the Legislature to provide oversight for these projects, again, relating to reporting language to understand maybe some of the outcomes from this, these initial round of pilots, that way so the Legislature could better evaluate maybe some of the outcomes in this process, moving forward.

Our Office would be happy to, again, follow up with the Committee or Members to kind of describe in detail some of those oversight opportunities.

Okay, well, thank you for that. And just I don't know if this is better for the LAO or for the Department, or maybe both can answer. But this would be run through an RFI process, right?

Where maybe the Department makes some kind of qualitative analysis on the best vendor to use, rather than sort of an open bidding process.

So, right now, it's a contract that follows the pilot and you're able to choose one of the vendors that were in the pilot and so, it's not a separate RFI process.

Okay. All right. Well, I'll definitely be interested to see how that works out in the future. I'd love to see from the LAO recommendations on that. Like I said, you know, been around here for a long time.

I've only been in the Legislature for two years, but I used to be a staff person here over two decades ago. And I still feel like we're working on technology projects from two decades ago that still haven't exactly rolled out or went overrun. So, I carry a lot of suspicion that we can meet that goal.

But admittedly, I don't know a lot about it. I just—it just sort of stuck out as an expenditure for me. I want the Department to be efficient, but you know, when we're making such draconian proposed cuts from the Governor that, you know, just kind of stuck out as a, as an expenditure there.

So, look forward to kind of keeping an eye on that. So, thank you.

Yeah. And there is a BCP that will be posted by Finance that sort of details this.

Assemblymember Bonta, yeah.

Want to thank Assemblymember Patterson for bringing up the generative AI. Have you all produced a proof of concept or any?

We have and we can share that with you.

Okay. I think it would be helpful for all of us to have that before we think about taking our one-time dollars for another $8 million investment.

I had a question about the Women Infants and Children May Revision estimate. It decreases federal funding by $20.2 million ongoing and decreases the WIC Manufacturer Rebate Fund by $176,000 ongoing. Does that mean that we are deciding not to leverage $20.2 million in federal funding?

No. It, it, it means that basically the caseload is increasing year over year. It's not increasing as quickly as we anticipated at Governor's Budget. And so, that—and there's also some impacts related to the cost of food within the program. So, those drive the changes to the federal funding and the rebate funding.

But we, we have the ability though still to fully fund the program at its need.

Okay, thank you.

Seeing no other questions up here. We're going to open up public comment and we'll remind folks, if you could please state your name, your organization. I know there are a number of items on this agenda, so if you can be specific and then please state your position on the issue.

Thank you, Chair and the Assembly Members. My name is Iraj Firoz, and I am here on behalf of Muslim American Society Social Service Foundation, funded by CRDP. Please, please do not cut the funding for the California Reducing Disparities Project under the Department of Public Health in the Mid-Advising Division. Thank you.

Stacey Hiramoto with REMCO, the Racial and Ethnic Mental Health Disparities Project, a partner in the CRDP Project. You are going to hear from people all over the state who have just found out on Thursday that their program may be slashed unexpectedly in the middle of their contracts. Please listen to them.

But I also want you to pay—if you have questions, we have a distinguished Researcher from Loyola Maramont University today that will be speaking. She can give you proof that this program is cost effective and saves the taxpayers monies, as well as does improvements for all the participants.

Thank you.

Hello everyone. My name is Hamid Bahrami. I'm talking on behalf of Mass Social Services Foundation. I have received services from this entity on mental health. I am against this Proposition. I am asking kindly you to reject this Proposition and keep on going. Thank you.

Hello, everyone. My name is Cesar Gonzalez Garcia. I'm here with the California Rural Indian Health Board. We represent 70 federally recognized tribes in California, along with 20 tribal health clinic systems. We're here to urge the Subcommitee to oppose the cut to the California Reducing Disparity Project. Thank you.

Thank you to giving me opportunity to speak, committee member. So, my name is Amanullah Shinwari, here on behalf of Mass SSF, Social Service Foundation, funded by CRDP. I reject the proposal, $15.8 million to cut the California Reducing Disparity Project, under the Department of Public Health, in the May Revise. Thank you so much.

Good afternoon. Goshen Issavzam, the Executive Director with the Muslim American Society Social Services Foundation. You'll hear us as MAS-SSF, or MAS Social Services Foundation. The name is very long.

We are here—we're funded under the CRDP for nine years and we're going on to our last year in 2026, and we reject the proposal of $15.8 million to the CRDP funds. Thank you so much.

Good afternoon. My name is Josefina Alvarado Mena. I'm the CEO of Safe Passages and I signed the CRDP contract on behalf of my organization. We have been serving African American students in Oakland for the last three years. We have served over 350 students, and they are all still alive.

And right now, we have 126 participants in our program, and it would be unconscionable to end services in about a month's time. Thank you.

Good afternoon. My name is Rachel Guerrero, and I am a consultant to this project. I actually was the architect of this project. I worked for 22 years at the Department of Mental Health.

The original design of this project was to fund services and evaluate them and to go to those communities who are most adversely impacted by healthcare disparities and ask them for the solutions. They have done that. We have evaluated this program. We have one more year to complete.

There's thousands of people who are in the middle of getting care and I strongly urge you to reject the recommendations to reduce the $15.8 million. Thank you.

Thank you.

Hello.

I'm bending. Okay.

Hello. My name is Sonia Young-Adam. I am the CEO of the California Black Women's Health Project. And the 1.2 million black women and girls in California are the reason why we live and breathe and the work that we do at the California Black Women's Health Project.

We have a project that is under the CRDP and for nine years we have served our community incredibly well every day.

I'm gonna ask you to please state your name, your organization, the issue, and your position on the issue. We have it up a lot of people that want to have their voices heard.

Good afternoon, I'm Dr. Roland Moore from the Pacific Institute for Research and Evaluation in Berkeley. And recognizing the tremendous evaluation of the CRDP, I urge you to preserve it. Thank you.

Good afternoon. My name is Regina Mason. I am the Co-Founder of the Village Project, the only African American based mental health clinic in Monterey County, and I oppose the cut. Thank you.

Hello. My name is Katherine Ferry. I work for UC Davis Center for Reducing Health Disparities. However, I'm speaking as a private citizen and do not represent the University of California in my remarks. I urge you to oppose the elimination of the California Reducing Disparities Project and cut contracts for over 35 agencies. Thank you.

Good afternoon. My name is Carla Ornellis. I am a Project Coordinator at UC Davis Center for Reducing Health Disparities. I am here as a private citizen. I do not represent UC Davis Health, and I kindly ask that you reject the proposed cuts to the CRDP project. Thank you.

Hello. My name is Yaneli Odesma and I'm part of the California Reducing Disparities Project. I am the Community Outreach Coordinator at the Center for Reducing Health Disparities at UC Davis Health. However, I'm also here as a private citizen and do not represent the University of California.

And I strongly urge the Subcommitee to reject the proposed $15.8 million cut to the center—to the California Reducing Disparities Project. Thank you.

Good afternoon. Dixie with the California Alliance of Child and Family Services. Our members are concerned with the proposed $15.8 million in cuts to the Reducing Disparities Project. Thank you so much.

Hi, y'all. My name is Sophia Tupuola. I'm a mama, a published author, and illustrator, and I'm a community servant. Also, I'm a recipient of the Essence of MANA Services. I'm in opposition to any cuts to the California Reducing Disparities Project that funds Essence of MANA Program.

Hello, my name's Oshun.

Good afternoon. My name is Donastasio Flores with Asian American Recovery Services. I oversee the CRDP funded Essence of MANA Program serving Asian American, Native Hawaiian, and Pacific Islanders communities. I'm in opposition to any cuts to the California Reducing Disparities Project.

Hi, my name is Felicia Chan and I'm a counselor at the East Bay Asian Youth Center here in Sacramento. I'm here to respectfully ask that you do not cut funding for the California Reducing Disparities Project, since it does fund our counseling program, which allows me to serve Asian youth that normally do not seek help due to mistrust and stigma. So, thank you.

Thank you.

Hello, my name is Jonathan Brumfield. I am the Executive Director for Youth Development Workforce Development at Safe Passengers in the open. Based on 100% graduation rate, 90% reduction in truancy, and a 0% recidivism rate, I strongly urge you not to cut our funding for CRDP. Thank you.

Hey, how's it going? My name is Nimrod Kane. I'm a Life Coach at Safe Passages in Oakland. Came up through the program, you know, through the pipeline. Some of us actually live in the communities we serve. So, you know, we're working with the students right now. So, please, kindly, reject it.

Good afternoon, Chair and Members. My name is Abit Stanikzai, and I am working with Muslim American Society Social Services Foundation. So, I'm working—so, state that you rejected the proposal $15.8 million to cut to the California Reducing Disparity Project under the Department of Public Health in the May Revise. Thank you.

My name is Loeni Marsina, and I am the Project Coordinator for the Essence of MANA Program with Asian American Recovery Services, the only CDEP that serves the Pacific Islander population, under the CDRP.

I come to you all with a humble heart asking that you reject the proposed cut to the CRDP under the Department of Public Health. Please do not just hear us, but stand with us and protect and invest in our communities. Thank you.

Hello, my name is Alex Filippelli. My pronouns are they and he and I'm with the Center for Applied Research Solutions. We support six LGBTQ-serving grantees across the State of California, with the California Reducing Disparities Project. Please reject these cuts. Thank you.

Laurel Ben Hamida, Sacramento County. Please do not cut the funding for MAS Social Services Foundation, which is part of the California Reducing Disparities Project, which is important because it has grown organizations that can now fill gaps in the system. When my husband, an immigrant engineer, had the same cancer as Steve Jobs.

Thank you.

Now we can get it.

Thank you.

Hello, my name is Andre Smith, and I am a Manager with the Sweet Potato Project Two. I oppose this cut and I urge you to do as well. Please save our CRDP. Thank you.

Hello, my name is Patrick Hamilton. I'm the Project Coordinator for the Sweet Potato Project Two under the CRDP. Over the years, I mentored over 300 students. Please, I oppose and reject that of the budget cut.

Hi. Yolanda Randos, Director of West Fresno Family Resource Center, our CRDP has a Sweet Potato Project, and on behalf of the 300 plus youth that have completed our program, in addition to the 50 plus youth that are currently enrolled, we encourage you please, please reject this budget cut. Thank you.

Good afternoon. My name is Dr. Patito from the Samoan Community Development Center and we are connected with the Essence of MANA project through Asian American Recovery Center, and we want to just ask you to just please do not cut the programs that the Pacific Islander community has very little resources.

I urge you to please consider not to cut this program. Thank you.

Good afternoon, everybody. Tino Felice, from the Samoan Community Development Center, also in support and partnership with Asian American Recovery Services, the program Essence of MANA. Please do not cut the funding and we oppose the funding cuts. Thank you.

...Whole Systems Learning, African American Hub. We operate the only agency in LA County that addresses trauma for gang-impacted African American male youth. The elimination, not the cut, but the elimination of this program will devastate us because it's in the final year of 14 years, 2009, that we will evaluate.

If we cannot evaluate our program, it guts all of the progress and successes we have achieved so far.

Good afternoon. My name is Kendra Brown. I'm a Community Health Worker for Whole Systems Learning and I oppose the budget cut. Thank you.

Good afternoon, I'm Kerry Hughes. I'm a Program Manager with Whole Systems Learning. I oppose the cut and if you cut this money, you will be destroying hundreds, if not thousands, of lives down in LA County. Thank you.

Good afternoon. My name is David Tripp. I'm a Peer Support Specialist with Whole Systems Learning and I oppose the cuts.

Hello. How you guys doing today? My name is Marcus Benz. I'm a Community Health Worker for Whole Systems Learning. I definitely oppose the cut. If people don't have places to come for resources, they'll continue to go for what they know. So, please don't—oppose the cuts.

Hello, my name is Juwan Rollins. I work with Whole Systems Learning as well, out of Long Beach, California, and I am against the cuts.

How you doing? I'm Wes Charles, Jr. I'm a Community Health Coach here at Whole Systems and I oppose it because everything we do is for the youth and for those that's been impacted by the system. And without us, it's a lot of people that'd be affected. Thank you.

Hi, I'm Jason Edmonds. I'm the Director of Business Development and Communications at Whole Systems Learning, and I wanted to thank you all for asking the questions that you did. Those are very important questions. Thank you very much.

Hello, I'm Sean Richardson. I'm a Peer Support Specialist with Whole Systems Learning, and I traveled all this way from Long Beach, California, to request that you oppose the cuts.

My name is Tanya Kerso. I'm the Program Assistant over at Whole Systems Learning and I ask that you guys really consider rejecting the cuts because it'll greatly impact not only the youth, but the community as well.

Good afternoon. My name is Tiffany Thomas. I am a Program Manager over at Whole Systems Learning. We did drive all the way up here, six hours, just to you guys, to request that you guys reject this cut. Thank you.

Hi, my name is Kimiko Crutcher. I'm coming from Whole Systems Learning, and I'm here to ask that you reject the, the proposal to cut funding for CDEP.

Hello, my name is Ronaldo Henry Allah. I'm the Executive Director of Whole Systems Learning, and I oppose the cuts. And if we do have these cuts, I have 179 kids in my program that will be hurt if this happens.

My name is JJ Nonu with Asian American Recovery Services and I oppose any cuts to the CRDP. Because of essence of mine, I was able to get custody of my daughter and break generational curses. Thank you.

Elle Chen, on behalf of Drug Policy Alliance, opposed to any clawbacks to the California Overdose Prevention and Harm Reduction Initiative, responsible for almost 60% of overdose reversals and AIDS Drug Assistance Program. Thank you.

Wesley Saver, Health Right 360. Strongly opposed to any cuts to the California Reducing Disparities Project, AIDS Drug Assistance Program and California Overdose Prevention and Harm Reduction Initiative. Thank you.

Thank you.

Laura Thomas with the San Francisco AIDS Foundation and the Epidemics California asking you to reject any cut in opioid settlement funds to the California Overdose Prevention and Harm Reduction Initiative, as well as asking for the state to speed up the repayment of the AIDS Drug Assistance Program rebate Fund to help us address pending federal cuts in HIV prevention.

From the CDC. Thank you.

Talo Falava Malo and good afternoon. My name is Leah Potano Famavai. I'm someone in Tongdan, 21 year old young woman who has been positive and heavily impacted by program under Asian American Recovery Services since I was 13 years old. I'm in opposition to any cuts to the California Reducing Disparities Project. Thank you.

Greetings. My name is Epi Leonel Malvai of nonprofit organization Samoan Solutions. I'm here both as a community partner of the Essence of Mana program and as a Samoan double parent to two daughters who have been positively impacted by the Essence of Mana Program.

This is one of the only programs that is directly focused on reducing disparities in the Native Hawaiian, Pacific Islander Asian communities which is funded by the California Reducing Disparities Projects. I ask for your support in opposing any cuts to the California Reducing Disparities Project. Thank you.

Hello. I'm Elena from Round. I'm a drug. I'm a Round Valley tribal Member. I'm a senior ambassador at Two Feathers, a youth leader. Four years ago I was suicidal and hospitalized. Then I got connected to Feathers along with the ACORN program and coming a long ways, that really helped me with my mental health.

I'm so sorry to interrupt you, but it's name, organization, issue and your position on the issue. It's not that we don't want to hear your story, it's just the number of people that also want to be heard. So name organization, issue and position on the issue. Okay?

Okay.

I oppose the cuts.

Down, please. Thank you.

Hello everyone. My name is Keisha Ann Daniels. I'm a Yurok Tribal Member here from Humboldt County. Today I'm here on the behalf of Two Feathers Native American Family Services, specifically our ACORN program. For many youth, including myself, these programs aren't activities, they are lifelines.

The loss of funding through the CRPD grant would be devastating for myself and countless youth in my community. It would mean losing a vital source of support, identity and hope. With that being said, I urge you to view this not as an expense, but a vital investment for our future. I'm opposed to the cut. Thank you.

Hello, my name is Yvonne Guido. I work for Two Feathers Native American Family Services. I am a substance abuse counselor. I oppose these cuts. Please listen to us.

Good afternoon, Subcommitee Members. My name is John Alita. I am the Executive Director of the San Joaquin Pride Center serving Stockton and San Joaquin County. And I urge you to please do not let these cuts to CRT programs occur. Thank you.

Good afternoon. Craig Pulsar. On behalf of Equality California, we are strongly opposed to the cuts to the Office of Health Equity, including the complete elimination of the Gender Health Equity Section and complete elimination of the California Reducing Disparities Project. Thank you.

Good afternoon. My name is Ari Lozano. I'm a licensed marriage and family therapist and the at the Gender Health Center, a trans, queer, black, indigenous and brown serving organization here in Sacramento. I urge you to maintain 100% of the funding for CRDP.

In this moment of budget decisions, do not balance the state's books on the backs of Trans, queer, indigenous, black and Brown Californians. Protect 100% of CRDP funding. Thank you.

Good afternoon. My name is Alberto Perez Rendon. I'm with La Clinica De La Raza Cultura Bienestar out of Oakland, California.

I'm here with my partners from Tiburia Vasquez Health center and La Familia Counseling to urge you to please do not leave behind the thousands of indigenous, immigrant, Latinx, monolingual, Spanish speaking and indigenous speaking families that rely on our services for preventive mental health services. Please restore the funding for crtp. Thank you.

Good afternoon. My name is Monica Suniga, supervisor at Tiburcio Vasquez Health Center in Alameda County. We serve hundreds of at risk Latinx families with the support of the California Reducing Disparities Parties Project. So please, please, please reject this card. Thank you.

Hello, my name is Nawid Gyasi. I'm on behalf of Muslim American Society Social Service Foundation, funded by crdp. Please do not cut the fund for crdp. Thank you.

Good afternoon. Thank you. Madam Chair and Assembly Members, I am Idrisa Dering. I am here on behalf of Muslim American Society Social Service foundation funded by CRDP that was rejected in the proposal of $15.8 million to cut the California Reducing Spirit Project under Department of Health in the middleweiss. Please do not cut the CRD budget.

This is a real need for our community. Thank you.

Hello. Hello. Thank you for giving us this opportunity. Aseela Sadiqi, on behalf of Muslim American Society Society Social Services Foundation funded by CRDP stated that you rejected the proposal of 15.8 million to cut off the California Reducing Disparities Project under the Department of Public Health and may revise. Please revise it again. Thank you.

This is. I'm here on behalf of Muslim American Social Service foundation funded by CRDP Estate that the project proposed a 15.8 million cut to the California Reducing Disparity Project under Department of Public Health. It may revise that. Thank you.

Good afternoon. Thank you. Hasna Taslim here on behalf of Muslim American Society Social Service Foundation founded by CRDP state that you reject the proposal of 15.8 million to cut the California Reducing Disparities Project under the Department of Public Health and Media Bias. Thank you.

Hi, My name is Elia De La Crusto Ledoji. I'm a senior researcher at Loyola Marymount University. I'm part of the statewide evaluation team for CRDP and the lead for CRDP's cost benefit analysis. I strongly oppose the budget cuts for CRDP and I want to say that there is proofness of effectiveness.

Our statewide evaluation showed that CRDP has already served over 15,000 participants and for every taxpayer funded dollar invested in CRDP, there was a return of up to $5 in current and future benefits to the State of California. Please do not cut crdp.

Hello. Thank you for this opportunity. My name is Lupita Rodriguez, Director at the Health Education Council, local nonprofit in the Sacramento region. We are funded by the CRDP and we oppose the proposed cuts to the project. We are saving lives. Please allow us to continue doing that.

Good afternoon. I'm Jesse Damon with Special Service for Groups in Los Angeles. I urge you to honor California's commitment to equity by restoring funding for the crdp. Thank you.

I'm Noemi Tungui from Ixteco Indigena, Community Organizing Project Program Manager for the Viviendo con Amor or Living with Love Program, a direct prevention and early intervention mental health and domestic violence program led in Mixteco and Spanish that serves the migrant, indigenous, Mexican and Latinx community Members. On behalf of CRDP. I oppose the 15.8 budget cut proposal.

Thank you.

Good afternoon, Committee Members. Thank you so much for this time and for allowing us to give public comment. My name is Erica Jun and I'm with the California Reducing Disparities Project. And I urge you to vote to reject the cuts to the CRDP. Thank you.

Good afternoon. I'm Dr. Robin Battle and I am a consultant to the Asian American Recovery Services Program who houses Essence of Mana, one of the CRDRP recipients. And I've spent the last eight to nine years helping them document the success of their program for the clients as well as the community at large.

I implore you to please explore not cutting this program.

Good afternoon, Madam Chair, and also all the Members. My name is the Director of Monoculture center in Butte County. I'm here to reject the $15.8 million for the CRDP, our program called the Zhongxia, and for the Senior program. Please save the underserved and unserved community.

Hi, my name is Lu Chao Zong. I am from the MO Cultural Center of Butte County. I am the program analyst for our elderly program. And I strongly urge that we do not cut our fundings to our California Reducing Disparity Project because we are the bridge to our communities.

Hello, my name is Winston Tsang. I'm the external evaluator for the Hmong Cultural Center of Butte County's Zone Shop Happy Program serving Hmong refugee older adults. And they really. The program has documented evaluative giving hope, giving them happiness instead of the nightmares they had and suicidal ideation. I urge you to reject this CRDP cuts. Thank you.

Hello, my name is Kristin Vang and I am a youth counselor from IBEXI East Bay Asian Youth Center of Sacramento. We are funded by a CRDP and we've created programs to help students with their mental health, bring families together and overall helping the underserved communities.

Southeast Asian students in Sacramento, so I hear today respectfully ask that you continue funding that you don't defund crdp. Thank you.

Hi, good afternoon. Thank you for listening to us. My name is Jesse Armenta. I'm the Clinical Director of La Familia Counseling Center here in Sacramento County. We are one of the guarantees that are serving the Latino community here in our counties of Sacramento. I oppose the cuts, the budget cuts, and I urge you to do the same.

There are thousands of individuals that are being affected. Thank you.

Hi, Dr. Esther Chung. I'm an epidemiologist with RTI International based in Oakland, California. I asked the Committee to reject Any cuts to the California Overdose Prevention and Harm Reduction Initiative and fully restore the $8.4 million budget concordant with the 2023 Budget Act. Thank you.

Good afternoon. My name is Claudia Del Rio. I work at La Familia, Alameda County, and I oppose these cuts. Thank you.

Good afternoon. My name is Caitlin Cruz and I am a clinical supervisor at La Clinica De La Raza Program. I oversee the team of health educators and I am urging you to please refuse these cuts that you're proposing to CRDP.

Good afternoon. I'm Dr. Juliet Lee. I work with the Native American Technical Assistance Provider Team. We serve seven grantees in the CRDP project who are establishing the evidence base of what they know, that culture is healing, culture is prevention, and culture is wellness. We're doing that with evaluation.

It's very important that we have this final year of our funding to maintain that. So I urge you not to cut this very important program. Thank you so much for your time.

Hi there. My name is J.M. Jaffe. I use they and them pronouns. And I'm the Executive Director of Lyon Martin Community Health Services in San Francisco. We are a federally qualified health center providing primary care and mental health services tailored to queer and Trans people. Over 3,000 clients across the state.

We are in a queer and Trans public health crisis and we need your help. Yet this proposal cuts over half $1.0 million per year for our clinic. Please, please stand up for our people during this critical time and reject this revision.

Hi, my name is Nick Gordon. I'm the Medical Director at Lyon Martin Community Health in San Francisco where I've been a physician for about two decades. And I can guarantee you that if these cuts go through, some of my patients are going to die.

And so I would really strongly urge you to vote no on any of the CDPH Gender Health Equity Grant cuts and not be responsible for this and and many other deaths. Thank you.

Good afternoon. My name is Ana Sita Miller. I'm here to represent the Indian Health Center of Santa Clara Valley. I'm our Prevention Services Program Director where our focus is really on prevention and early intervention. I'm here today to express Indian Health center of Santa Clara Valley's strong opposition to the 15.8 million cut to California Reducing Disparities Project.

Thank you for hearing us today.

Hello. My name is Dr. Malachi Cote. I use he, they, fam pronouns. And I am a licensed psychologist and the Executive Director of the Gender Health Center here in Sacramento, California. We strongly oppose the cuts. We are a CRDP funded organization, so please follow this lead and keep us funded.

Hi, I am Dr. Paul Masadi. I'm with the Native American Health Center. I'm also a health service and policy researcher. I have to tell you, in 30 years of health services and policy research, I have never seen anything as powerful as the crdp.

It's the ability to be assistance level change, a paradigm shift to increase capacity and patient satisfaction.

If you could give you an example, we've conducted three State your position on the issue.

My position is that the CRDP is powerful and we should keep going.

Thank you. Thank you.

Good afternoon, Assembly Members. My name is Saadia Zaidi and I'm, I'm here on behalf of Muslim American Society Social Services Foundation funded by crdp. I urge you to reject the proposal to cut the 15.8 million to California Reducing Disparities project under the Department of Public Health in the May revise. Thank you so much.

Thank you, Assembly Members. My name is Kamala Emiri. I am here on the behalf of Muslim American Society Social Service Foundation funded by CRDP. I reject the proposal 15.8 million to cut on the California Reducing Disparities project under the Department of Public Health in the May revise.

Hola. Buenas tardes. Pronouns. They. Them. We. Us. With the San Gabriel Valley LGBTQ center where the Trans and queer suburbs of LA County with 120,000 LGBTQ population, that's 20% of LA County. Trans and queer people are experiencing national erasure and we can't allow it to happen in California.

We have yet to see Trans and queer allyship reflected in our California budget. We stand to lose the very little that we have. And we urge you not to cut the Gender Health Equity Unit and continue LGBTQ funding. Gracias.

Thank you.

Good afternoon you all. My name is Camila Cam. I'm the Director of Policy at California Latinas Reproductive Justice and the President at the San Gabriel Valley LGBTQ Center. We are strongly opposed to the cuts with the Office of Health Equity, primarily the Gender Health Equity section.

We are two entirely different projects that are funded by the Office of Health Equity, the Reproductive Justice Fund and the LBTQ Health Equity Initiative. The San Gabriel Valley LGBTQ center represents 120,000, an estimated 20% of the LGBTQs population of Los Angeles County. So we oppose any puts to the California Reducing Health Disparities Act. Thank you.

Good afternoon. Angela Pontus on behalf of Planned Parenthood Affiliates of California in opposition to the proposed budget solution to sweep funding from the Office of Health Equity, including the Reproductive Freedom and Abortion Access Unit. This unit Supports reproductive health grants that the Planned Parenthood affiliates use for valuable community health education. Thanks.

Good afternoon. Michelle Gibbons with the County Health Executives Association of California. First here to support the additional funding from ICA vaccine. I thank the leadership of this Committee in hearing it on the rescissions to public health workforce funding. There is one called career ladder upskilling funding.

They are cutting 2526 funds which means that folks that were originally in like an educational upskill skilling program, they went back to school, they are relying on some of the reimbursements in order to complete their education.

So we would just ask for a model that the Legislature adopt a modified proposal which would allow for those funds to still be paid out on the local side.

It's roughly it's between 300 to 400,000 and then I assume that there would be state folks doing the same thing and so potentially a small cost on the state side as well. So we just asked for the Legislature to adopt that modification. Thank you.

Thank you, Madam Chair. Members, Megan Subers on behalf of the Los Angeles LGBT Center, I'm here to urge you all to reject the proposal that eliminates funding for the LBTQ health equity initiative. Would be extremely harmful to the center and the other grantees. Thank you.

Good afternoon everybody. Thank you so much for your time today. My name is Samia Malik here from MASSSF, Muslim American Society Social Services Foundation. On the tablet of our Lady Liberty are the words give me your tired, your poor, your huddled masses yearning to breathe free.

And CRDP programs are doing just that for the communities that are here representing themselves today. It is allowing them to breathe free and flourish and thrive in their communities. I'm against this funding cut of $15.8 million to CRDP programs. Thank you so much.

Hello, my name is Siham Tlili. I'm part of MAS Social Services Foundation, as part of Arab Muslim community. We do oppose to this cut to the CRDP fund cutting and would love that you take our voice into your actions. Thank you.

Hello, my name is Heval Adli and I'm here on behalf of Muslim American Society Social Service Foundation and we encourage you not to—not to do the cuts, the $50 million that's proposed. We are the only agency in the state of California who provides this kind of service for mental health for this population. Thank you.

Good afternoon, Assembly Members. My name is Zarifaya Kobe. I'm here on behalf of Muslim American Society Social Service Foundation, funded by CRDP. I reject the proposal, $15.8 million to cut the California Reducing Disparities Project under the Department of Public Health in the May Revise.

Thank you, Assembly Members. My name is Al Taf. I am here on behalf of Muslim American Society Social Service Foundation, founded by CRDP. State that you reject the proposal, $15.8 million to cut to the California Reducing Disparities Project, under the Department of Public Health in the May Revise. Thank you.

Hello. Thank you, Assembly Members. My name is Camila. I'm here on behalf Muslim American Society Social Service Foundation, founded by CRDP. State that you reject the proposal, $15.8 million to cut to the California Reducing Disparities Project under the Department of Public Health and May Revise it. Thank you very much.

Thank you, Assembly Members. I'm Lalima Noorzad. I'm from Afghanistan. I'm here on behalf of Muslim American Society Social Service Foundation, funded by CRDP. State that you reject the proposal, $15.8 million to cut to the California Reducing Disparities Project, under the Department of Public Health, in the May Revise. Thank you for.

Hi. Good evening. Thank you, Assembly Member. My name is Rita Ramesh. I am here on behalf of Muslim American Society Social Service Foundation, funded by CRDP. I reject the proposal, $15.8 million to cut to the California Reducing Disparities Project, under the Department of Public Health, in the May Revise. Thank you so much.

Thank you, Assembly Members. My name is Karima. My last name is Mobaruz Bayhakim. I'm from Afghanistan. I'm here on behalf of Muslim American Society Social Service Foundation, funded by CRDP State. Did you reject the proposal, $15.8 million to a cut to the California Reducing Disparities Project, under the Department of Public Health, in the May Revise? Thank you so much.

Hello, everyone. Good afternoon. My name is Naji Alavi. I'm here on behalf of Muslim American Social Society Service Foundation, funded by CRDP. I reject the proposal, $15.8 million to the cut of the California Reducing Disparities Project, under the Department of Public Health, in the May Revise. Thank you.

Hi, I'm Danny Munoz. My pronouns are they/them. I'm currently the Executive Director at the Center for Sexuality and Gender Diversity. We serve hundreds of youth, young adults, and adults in Bakersfield, in Kern County, by providing free and affirming mental health services through counseling and support groups.

And I ask that you keep CRDP funded as previously stated, 100%. Thank you.

Hello. My name is Fry Friend. My pronouns are he/him. I'm here from Bakersfield, also with the Center for Sexuality and Gender Diversity. We are part of CRDP. We provide lifesaving mental health services to rural community members. Please do not cut CRDP funding. Thank you so much.

My name is Alyssa and I'm here on behalf of the Center for Sexuality and Gender Diversity as part of the California Reducing Disparities Project. And I would like to urge the Subcommitee to reject the $15.8 million cut to the CRDP in the May Revision and because that provides lifesaving services to underserved communities across California and historically disadvantaged groups. Thank you.

Hi, my name is Riley Williams Pierce. I'm here on behalf of the Center for Sexual—Sexuality—and Gender Diversity. I urge you to maintain your promise to these historically underserved communities and reject any funding cuts to the CRDP and the critical proven services that the CRDP provides. Thank you.

Good afternoon. My name is Ace Moody, and my pronouns are they/he. I am here with the Center for Sexuality and Gender Diversity in Kern County, as a part of California Reducing Disparities Project, the CRDP. I would like to urge the Subcommitee to reject the $15.8 million cut to CRDP because it is our lifeline.

The program is a lifeline for everybody who are in the LGBTQIA2S community in Kern County and would leave zero services available if it is defunded. I have been a volunteer with the Center for a decade as of this November and can speak directly about the positive impacts that exist to this program. It is a necessity.

It acts as the hub for education and services for our community. It is a place where we have that community. It saves lives by its own existence. It gives hope, even in a time where hope is a hard thing to find. Thank you.

Good day. My name is Michael Moody. My pronouns are he/him. I'm here today with the Center for Sexuality and Gender Diversity, as part of the California Reducing Disparities Project. I would like to urge the Subcommitee to reject the cut to the program. This program is a lifeline for the LGBT plus community in Kern County and would leave zero services available if defunded.

I have heard the firsthand testimony from younger people supported by the program on how it changed their lives or saved their lives. Please consider the value of the program. Thank you for your time.

Hello, my name is Janelle Butler and I'm with San Francisco Community Health Trans Thrive. I'm the Associate Director and the CRDP funding has been life changing for folks in our community and we just ask that you don't cut it.

Please. Thank you.

Good afternoon. I'm Commissioner Khilynn Fowler in Alameda County. I also serve as the Community Relations Manager at San Francisco Community Health Center. I just want you to all to take in consideration when you're cutting this Fund. We created innovative ways to have to connect people, especially trans women, into healthcare. And just take in consideration before you do budget cuts, because that will put all the work that we've put in to make a better, healthier San Francisco that will roll back all our activities. Thank you.

Hello, my name is Christopher Bode. I'm from the San Francisco Community Health Center. I am here to urge you to reject the cut to CRDP programs like this that are aimed at reducing disparities and helping to save lives. Save the state money and cutting them will only cost more. Thank you.

Good afternoon. Ryan Souza, on behalf of APLA Health and Essential Access Health, members of the End the Epidemics Coalition, we continue to be opposed to any funding shift from the California Overdose Harm Prevention and Harm Reduction Initiative to naloxone distribution.

Additionally, we want to support the AIDS Drug Assistance Program Rebate Fund emergency backfill from the federal cuts, presented by the End the Epidemics Coalition. And then lastly, on behalf of the Public Health Institute, we urge this body to reject any cuts to the CRDP program. Thank you so much.

My name is Matthew May. I just wanted to say that harm reduction programs save lives, and it saved my life. So, thank you.

Good afternoon, Committee Members. My name is Genevieve Flores-Haro. I'm the Associate Director for the Mixteco/Indigena Community Organizing Project, or MICOP and I'm also a Member of the Ventura County Behavioral Health Advisory Board. Not representing the BHAB in this moment, just sharing for identification purposes. MICOP received our CRDP funds my second week.

And in those nine years, we've served thousands of indigenous farm working women with our CDEP. So, we urge you strongly to reject the proposed cuts to CRDP. Thank you.

My name is—my name is...Director of Community Organizing with MICOP. Part of my job is work with farm workers community and on behalf of the indigenous Mexican community, I reject the proposed cuts to the CRDP project. Thank you.

Good afternoon, Chair Addis and Members. My name is Vanessa Teran. I'm the Director of Policy with the Mixteco/Indigena Community Organizing Project. Our Living with Love Project was one of the first indigenous Mexican culturally responsive curriculum moving towards a community evidence-based practice.

We strongly reject the Governor's proposed $15.8 million to the California Reducing Disparities Project under CDPH and the May Revise. Thank you so much.

Good afternoon, Madam Chair and Members. Gregory Kramer on behalf of Disability Rights California. We oppose any asset limits to Medi-Cal. Any type of means testing requirements that are in addition to existing ones under Medi-Cal. We also urge you to reject the Governor's proposed elimination of $20 million for the Mental Health Wellness Act.

These funds provide at timely behavioral health care and would immediately cut three critical initiatives already in motion. Finally, we are concerned with the proposed changes to the Self Determination Program. We fundamentally reject that the concept that if expenditures in SDP have been escalating that something is wrong, it's a reflection of the broader system. Thank you.

Seeing no other public comment, we'll turn it back to the dais for any closing comments. Assembly Member, did you have anything you wanted to close with and then I may have a comment?

Thank you, Chair. I just wanted to thank and appreciate all of the people who came to speak in public comments, particularly on the CRDP Funds item and the Gender Health Equity section savings.

I think we just saw such a beautiful representation of what California is, come through these doors, to beg for a very simple thing which is to ensure continuity of care.

I know that it takes so much to be able to stand up these programs and make sure that they are culturally relevant, resonant, and connected, in the middle of a mental health care crisis for our children, adults, and seniors.

And I'm just really struggling with the idea that we would know that we are—have made a promise and commitment and are cutting that funding, disrupting the infrastructure for these critical services, knowing that we have the ability to continue the funding and support through Prop 1.

And I think a year would be devastating to have to wait to be able to make that bridge. So, through the Chair, I would encourage us to think about not making that cut. It is counterproductive and quite destructive, in my estimation, and I just want to thank everybody for coming forward.

And also, on the Gender Health Equity section savings in particular, we heard the same thing there, that there have been an opportunity to provide very specific opportunities for our trans community, for our LGBTQ community, for people to be able to get gender-affirming care and care that supports their reproductive health access.

And there are some, some cuts that are too close to the bone I think, for us to be able to withstand, especially within the context of recognizing that we're just disrupting something that would then have to be rebuilt. When we're leaving everybody to their own devices right now at the state level, there's something to be said for enabling people to be able to take care of our own.

And I ask that you consider that, Chair.

Thank you, Assemblymember, and I'll just, one, I want to say apologies to anybody who didn't get to tell their full story and that remind you that if you didn't get to say everything you wanted to say at the microphone, that you are welcome to email us at [email protected] and certainly did not mean to silence anybody, but wanted to get to hear everybody that was in line to make comments on this incredibly important issue.

I did a tiny bit of math as we were sitting here listening to folks who literally were begging for this program to continue for its duration, which I believe is just about one more year to finish out for the CRDP Project, and we're talking about 0.13% of the budget, budget shortfall that we're facing.

So, not 1%, but 0.13%, that the CRDP cut represents. And I think it should be noted, Department of Finance and Department of Public Health, I hope you're noting the amount of pain that this causes to make up that size of a budget gap and really consider if you can find this funding a different way.

I've noticed some things in the budget that I think are questionable in terms of expenses and I'm sure that you could have brought us something that wouldn't have caused this much pain, but would have achieved these goals for that kind of a percentage of a gap that you're trying to fill in the short term, knowing that there is other funding coming.

And I will say that one of my constituents texted me and said, basically if you do this, we will be completely wiped away. You've heard that message over and over and over again.

And so, I would just ask, ask that you come back with a little bit, a bit more thinking on this issue and truly hearing the folks that showed up in the room today who need us, they need these programs, and I don't think they're asking for that much. So, I do want to thank you.

I know this is hard work. I know that you don't enjoy making these cuts or proposing these cuts, but I do think you could do a better job at it. And so that's what we're asking you to do is come back with a better proposal for us.

With that, we'll say thank you and move on to Issue 4 and the Department of State Hospitals. Back—as folks are switching out, I'll share that background for this Item is on Page 12 of the agenda and we are first going to receive, excuse me, an overview of the May Revision proposals and then welcome additional comments from the Department of Finance and the LAO. And please go ahead and start when you're ready.

Good afternoon, Chair and Members. Stephanie Clendenin, Director for the Department of State Hospitals, and I'm joined by Chief Deputy Director, Brent Houser, and together, we will provide an overview of the May Revision adjustments. The May Revision reflects an overall reduction of $191.5 million from the Governor's Budget, bringing DSH's total proposed budget down to $3.2 billion, and includes an additional reduction of 100.8 positions.

The May Revision includes several General Fund solutions for the Department of State Hospitals to assist with aligning General Fund expenditures—program expenditures—to available revenues. These solutions include a reduction of $4.8 million in fiscal year 2025-'26, $5.9 million in '26-'27, and $2.3 million in '27-'28 and ongoing, related to various operational efficiencies that the Department plans to implement.

The Department also proposes to implement a prior authorization and utilization management software for certain specialty care services, to confirm medical necessity of referrals of patients to specialty medical providers and specialists. This will result in savings of $250,000 in fiscal year '25-'26, $500,000 in '26-'27, and $1 million in '27-'28 and ongoing.

The Department proposes to reduce 124.1 positions and $22 million in General Fund across these five state hospitals for isolation unit staffing, to reflect current isolation unit utilization for isolating patients with COVID-19, as required.

We also propose trailer bill language and a reduction of 3.1 positions and $1.5 million in '25-;26 and ongoing, and this is to modify the requirement for reporting to the Court from semiannually to annually for the "not guilty by reason of insanity" population.

This change will align the reporting requirements for this population with that of other longer-term commitments that we serve. There are also several General Fund budget solutions related to our IST Solutions programs.

These proposals include right sizing the IST Solutions' overall appropriation by reducing a total of $161.1 million in fiscal year '25-'26, $238.8 million in '26-'27, and $157.33 million in '27-'28 and ongoing.

This reject—reduction—adjusts the funding for early access and stabilization services, community-based restoration and diversion, and County Collaborative Workgroup Grant funding, and this adjustment reflects current contract and expenditure levels with private providers in the counties and provides funding to maintain, on an ongoing basis, the current service levels in these programs.

For community-based restoration and diversion, we also proposed an additional reduction of $12.3 million in budget year and ongoing to right size the existing contract with LA County to the current year funding levels, to reflect current enrollment rates which are trending lower than we initially assumed when the contract was executed.

The Department also proposes to revert $232.5 million in unused IST Infrastructure Grant funding, originally appropriated in fiscal year '22-'23, which had encumbrance availability through '26-'27.

And lastly, as part of the IST General Fund Solutions, DSH proposes to revert $4.6 million in unused funding, originally appropriated in '23-'24 and $4.5 million in '24-'25, for the Judicial Council to develop training for court-appointed evaluators. The Judicial Council contracted with an expert to develop, and they did deliver training. However, not all funds were utilized.

Lastly, regarding IST solutions, I would just note that these adjustments right size the funding for these solutions related to programs to meet the current IST referral levels and current program expenditure and services levels. We do not anticipate any negative impacts to delivery of services for incompetent to stand trial individuals.

As a result of these adjustments, we have made great strides in implementing the IST programs and accomplishing reducing our wait list and meeting the court mandated 28-day timelines, and the remaining funding levels will continue to support the Department and its partners in these current endeavors.

I will now turn it over to Chief Deputy Director Houser to provide a brief overview of our other May Revision adjustments.

Good afternoon, Chair and Members. Brent Houser, Chief Deputy Director of Operations for the Department of State Hospitals. I'll just go through the remaining proposals as listed in the agenda.

Starting with the Electronic Health Record, DSH proposes to reappropriate $7.5 million General Fund for the cost of 26.4 positions, independent verification, validation costs, and Department of Technology contract execution costs for an electronic health record project.

This will allow the Department to complete the remaining planning activities and initiate project implementation by being able to successfully procure an electronic health record. DSH also requests budget bill language to allow DSH to seek Department of Finance and legislative approval for one-time, mid-year funding under specified conditions to avoid project delays and implementation.

DSH also requests provisional budget bill language for Training and Education Partnership contract exemption to be able to support the Department of State Hospital's employment pipeline. This language would specifically exempt DSH partnerships with educational institutions and hospitals focused on providing clinical training opportunities to state hospitals and the exemptions from specific contract and procurement roles.

This action will increase our partnerships with educational institutions and hospitals to support our recruitment efforts for hard to fill positions.

It will increase the number of trainees, fellows, and residents, and otherwise interns that serve in a direct care patient capacity with the Department of State Hospitals. Specific to the County Bed Billing Reimbursement Authority Adjustment, DSH requests reimbursement authority of $13.4 million in '25-'26 and $21 million in '26-'27 and ongoing, due to a projected increase in Lantrum Patient Petra Short Patient Census and negotiated rate increases with the counties.

DSH also plans to increase capacity for LPS patients by about 69 beds, through the utilization of existing bed capacity and repurposing one of the units associated with the DSH Metropolitan Increased Secure Bed Capacity Project. For the DSH Metropolitan Increased Secure Bed Capacity Project, DSH reports a onetime current year savings of $5.9 million.

For the Patient-Driven Operating Expenses and Equipment Adjustment, DSH reports a reduction of $1.5 million General Fund in current year and request for an additional $290,000 in the budget year. Specific to the DSH Coalinga Telepsychology Pilot, DSH historically has experienced recruitment challenges, particularly for hospitals in more rural areas such as DSH Coalinga.

The use of telepsychiatry services has been a successful program to increase access for treatment for patients and modeled off of this program, DSH is requesting to pilot telepsychology at DSH Coalinga. Specifically, DSH proposes to redirect for existing vacant psychology positions at DSH Coalinga to provide telepsychology services for a three-year pilot program.

This comes with a $474,000 request in budget year and a $342,000 request through '27-'28 to pilot this program. For the conditional release program for non-sexually violent predators, DSH reports a one-time savings of $3.3 million in '24-'25, as a result of reduced census and program closure.

For the IST Solutions Program as a regular adjustment, aside from General Fund solutions, DSH proposes an additional savings of $10.9 million in the current year, $37.8 in the budget year, and $39 million in '26-'27, related to the early access destabilization services and jail-based competency treatment programs.

And then moving to DSH's last two proposals in the capital outlay space, DSH proposes a reappropriation of $21.6 million General Fund for the construction phase of the Patent Fire Alarm System Upgrade Project.

Last, DSH proposes a reversion of $26.2 million General Fund in a new appropriation of $34.4 million for the construction phase of the Coalinga Hydronic Loop Replacement Project. This new system will provide hot and cold-water distribution, a loop connecting six existing buildings and nine connection points. That concludes the Department's overview—brief overview of the May Revise.

Happy to take any questions.

Thank you. Is there anything from Department of Finance or the LAO?

Victoria Rappleye, Department of Finance, nothing further to add.

Will Owens, LAO, nothing to add but available for questions.

I do have a couple quick questions. For the incompetent to stand trial, I just want to make sure I heard you correctly that even with a reduction in funding, you expect the wait list improvements that you've had to be maintained. We won't see any changes there?

Correct.

Okay.

The funding that we retained in the program is to continue funding the existing programs and services at their current levels, which are meeting the current demand.

Great. Okay. And then you mentioned the grant program and $232.5 million reversion to the IST Infrastructure Grant Program because funds weren't used. Do you know why counties—it sounds like counties didn't take advantage of the grant program, but do you know why that is?

Are they——are the funds too difficult to access or the Grant too complicated, or what happened?

There's a couple of challenges with respect to it. I would note that we had 15 applications for a total of 1,674 beds and initially, we received funding to be able to fund up to 5,000 beds.

That funding envisioned—the funding levels were enough for residential type funding, but in working with the county, some had desires to develop higher level funding, and we weren't funded at that level for that type of program.

We also—the program requires a 30-year covenant to continue serving ISTs for 30 years and for some programs, that was also a deterrent for partnering in the program, and then, generally, the way the funding was structured, it wasn't enough funding to fund the entire build of the program.

And so, you know, we envisioned that when we developed this program that it would fund like the initial portion of the construction, but there would be an ongoing debt service that would be paid for through the contract for services through us. And that structure isn't necessarily working out for some programs.

So, it's a myriad of challenges that we've had.

Thank you. Thank you. Any other questions from Members? Assemblymember Bonta.

Apologies. I had a question about the Coalinga Hydroponic Loop Replacement Program, appropriating $34.35 one-time General Fund for construction phase. So, does that mean that the project—well first of all, what is it? And second of all, can you be clear about what stage of the project this is in?

Yes. So, the hydronic loop system is essentially how water is transported throughout the system. It distributes hot and cold water to our patients. That supports around 13,400 patients on a daily basis. And the current loop system is deteriorated and well beyond its loose—useful—life.

So, the project has been completed on preliminary plans, working drawings, and send the, this, the proposal to fund the construction phase of the project.

How much has already been invested in that project?

The working drawings are around hundreds of thousands of dollars already. And the preliminary plans—let me just see if I have that detail available at my fingertips. Apologies for the delay. For the preliminary plans, it is 3—$539,000—for preliminary plans and $744,000 for the working drawings, which has already been invested in this project.

I would just note, not moving forward with the project would challenge the Department, since we do have to shut down the water when there are leaks with the current piping system, which impacts unit operations, treatment, daily living activities, such as showers.

So, we do view this project as very essential to the daily living activities of serving our patients.

I can add to that. Matt Schuller, Department of Finance...unit. So, your—one of your questions also the status. So, we had put this out to bid and we were unable to award it because we did not have enough construction funding.

So, this proposal, if funded, would be—enable us—to award the construction contract in July because the bidder was willing to hold the bid for us.

And what, you said that it said, it said an end-of-life stage. The current system?

Yes, the current system is completely deteriorated, so we do have to conduct emergency repairs on it since it is leaking. So, a new system is eminent in—which is why we're putting the proposal before you.

And would people have to be displaced during the construction phase?

No. Patients are not anticipated to be displaced during the construction phase. Most of the work is done below ground. But I would say there is work that's being conducted behind the secure treatment area.

So, where our patient residential units are, which is actually what is contributed to some of the feedback we received from bidders and needing to request additional funding.

And then, I think, Chair, you asked a question about the incompetent to stand trial program. Just another—so, the right sizing of Community-Based Restoration and Felony Diversion Program resources, you're decreasing funding by $12.3 million ongoing, to align program resources with current utilization trends. What is that?

I'm sorry, I missed the question.

What is it?

Oh, that one. For community-based restoration diversion, that is a reduction of $12.3 million for our contract with LA County, specifically.

So, this is for them to provide services for individuals who are incompetent to stand trial and who would otherwise be served within our state hospitals, who are being able to be served in community-based programs instead.

And ultimately, when we entered into the contract with LA County, we assumed that they would serve approximately 70% of their IST individuals, that courts would approve that high level of individuals to be served in these community programs. But ultimately, the referrals are coming in lower, and you know, so we do not—so we are proposing to adjust the contract down to the level that we're currently seeing, as far as utilization.

Thank you.

Assembly Member Schiavo.

Thank you, Madam Chair. So the Department of State Hospitals, you're looking at decreasing it 195 or 191.5 million. And that's 233 physicians that are being reduced. Correct. And so are these already vacant positions or what. What are these positions?

Yes. So 233 reflects the totality of some adjustments that were also made at Governor's Budget associated with the vacancy reduction drill. There's an additional 108 being proposed at May revision, which is primarily related to our isolation unit staffing. Right. Sizing General Fund solution.

To adjust, we have to still continue isolating patients that are positive for COVID 19, but the positive rates are trending a lot lower. So right now those isolation units are remaining vacant. So we're proposing to reduce the vacant staffing level positions as a General Fund solution and wouldn't impact kind of our baseline services.

And we'll still be able to continue to isolate patients when appropriate in accordance with CDPH guidelines. And it's just that those units right now are remaining vacant for most of the year. So we are able to give up the vacant positions that may revise and those.

So those positions specifically are the 108 that you talked about?

Primarily the 108, yes.

And what else is. So when you say the 108, is that included in the 233 or is that on top of.

Yes, yes, it is. It's inclusive.

Okay. And what are the other positions that are included there?

There's also a reduction of three positions associated with one of the General Fund solutions that is adjusting reporting requirements with not guilty by reason of insanity patients.

There's trailer Bill Language to report annually instead of biannually for this particular patient population, which would reduce workload such that we can get back three vacant positions and out of the 233.

So other than the 108 that you just explained, what are those positions there?

The 108. So the COVID 19 isolation proposals actually 124 positions, and this was three. So there's an offset going on with positions we're actually asking for. So that's why the math isn't netting out, because some of these proposals do also request for position authority. So I think for the reductions, those are the primary two proposals.

But Director, if I'm missing one, please.

Yeah, I think if you're asking for the totality of the over the over 200 positions, some of those were proposed in Governor's Budget and they were related to the Vacancy, position reduction. And the positions that we primarily gave up were positions associated with units that we had been able to close. And the positions were vacant.

So they were vacant positions.

How many of these are not vacant positions?

I don't. We won't be giving up any positions that are not vacant.

Okay. Okay. Okay. Thank you.

Any other questions? No other questions. Then we will open up to public comment for item four and we'll ask you to please state your name, organization, specific issue and position on the issue that you are speaking to. So this is for Department of State Hospitals. Welcome.

Good evening, Madam Chair Members. George Osborne for the Union of American Physicians and Dentists. I have a general comment on the budget has to do with the subject that's been a sore spot with state workers for many, many years and that's contracting out of state jobs.

UAPD is currently sponsoring AB393 in the Legislature this session, which, if enacted, would save the state overall probably $1.0 billion a year in contracting out fees. We think if the Budget Committee were to include the language in AB393 in a trailer Bill and enact it in this year's budget, that would accomplish what we're looking for.

That would provide continuity of care to the patients. It would reduce the state budget by about $1.0 billion.

I have to ask you to wrap up. I've been. So. I have to ask you to wrap up. I've been very stringent with other commenters today. So if you could please state your position on this item and we will take comments for items not on the agenda after. After we hear the next couple.

Thank you, Madam Chair. I'll close by saying that we. We don't believe that the solution, the budget solution that the Governor has proposed to put a lot of the budget problems on the back of state workers is appropriate. Thank you.

So I'll just ask you state name, organization, issue and your specific position on the issue or you're welcome to save your comment for items not on the agenda.

Yeah, thank you. I may very well do that at the end. Madam Chair Members, Kobe Pizotti, on behalf of the California Association of Psychiatric Technicians, we represent 4300 total budgeted positions. Only 3000 of them are filled at DSH and there's 38% vacancy rate at Department of State Hospitals, Atascadero. In your area.

This is a big issue for us. The reason why there's the ability to close down certain units is, is because you don't have enough staff to do that job. Although, by the way, there's 2,500 assaults on staff last year and my Members worked 1.4 million hours of overtime.

I just wanted to make that Good afternoon Madam Chair, Members of Committee Al Austin with AFSCME. We represent several hundred mental health professionals, pharmacists, chaplains within the state hospitals and I would echo the comments of previous commenters. There are serious staffing challenges.

We would ask this Committee and the Legislature to take a hard look at contractors personal service contracts that are currently pretty prevalent amongst within this Department as well as other areas to trim the fat. We also would oppose any cuts to any mental health positions within the Department of State Hospitals. Thank you.

Seeing no other public comment, we'll say thank you to our presenters and move on to issue five. The Department of Healthcare Access and Information background is on page 16 of your agenda. We're first going to receive an overview of the May revision proposals and welcome additional comments from Department of Finance and the LAO.

And please go ahead and start whenever you're ready.

Thank you very much Madam Chair and Members Elizabeth Landsberg, the Director of HACI, the Department of Healthcare Access and Information so I will just start with our presentation of our May revision specific agenda items. The first is a proposal regarding pharmacy benefit manager licensure and data requirements.

HCAI requests six positions and $6.2 million to support enhanced oversight of pharmacy benefit managers or PBMs to improve transparency and accountability in the prescription drug market.

This initiative would require PBMS to report data to gain a better understanding of costs and HCAI has collaborated with the Department of Managed Healthcare who is responsible for the PBM licensure portion of the proposal. HCAI would be responsible for data reporting and cost transparency requirements.

To implement these new Data requirements for PBMs, HCAI will build upon the successful implementation of the HPD the Healthcare Payments Data Program, California's All Payer Claims Database, and require PBMS to be mandatory submitters to the hpd. HCAI has extensive experience in collecting and reporting prescription drug data.

The HPD is currently getting prescription drug data from health plans and insurers, including pharmacy claims, and will begin collecting non claims payment. But what we don't have is the specifics about the PBMS themselves. We're currently also collecting price and other data from prescription drug manufacturers pursuant to Senate Bill 2017, including Wholesale Acquisition costs.

In this budget proposal, the Department of Managed Health Care would replace the current registration requirement for PBMS with a licensure mandate and that licensing requirement would include the requirement for PBMs to submit data to HCAI PBMs would provide HCAI information about the pharmacy benefits they manage, including drug pricing data such as wholesale acquisition costs and average wholesale prices and national average drug acquisition costs, prescription drugs and Member counts, the fees paid to PBMS by manufacturers, plans and pharmacies, discounts or rebates to or from PBMs.

And then this information would be grouped by national drug code, therapeutic category, manufacturer and generic product identifier to allow analysis. It would also be grouped by by pharmacies owned and not owned by the pharmacy benefit manager. There's been an incredible amount of vertical integration of health plans, owning PBMs, owning pharmacies, and so on.

This data is important to meeting the state's goals of lowering health care costs. HCAI researchers and the public would use this information to evaluate the efficacy of PBM policy reforms and comprehensively monitor the prescription drug system to support informed policy decisions. Madam Chair, would you like us to go through all of our budget change proposals?

No, I think this is good. And if there's specific questions, Members can ask them. Okay, yeah. Thank you.

Great. Scott Crisman, Chief Deputy Director at HCA. I'll take the next item which is the health Care Payments Data Program funding adjustment. The May revision actually revises the Governor's Budget proposal for the health care payments data based program from $22 million in 25-26 and ongoing down to $181,000,001 time in 2020. 25-26.

The Administration will continue to evaluate the program's funding needs through the annual budget process. The Administration is also withdrawing the Governor's Budget trailer Bill Language allowing for the revenue transfer from managed care Administrative Fines and penalties Fund in lieu of provisional language authorizing a one time transfer in fiscal year 25-26.

Next item is withdrawal of resources for rent adjustment. The Administration is withdrawing the budget request as is no longer necessary for operational need. Previously planned HCI move has been canceled. Next item is long term care staffing.

HCAI is requesting 597,001 time from the California Health Data Planning Fund Position Authority for three positions to implement new healthcare data reporting requirements related to a federal rule from Cms including minimum staffing standards for long term care facilities and Medicaid Institutional Payment Transparency Reporting final rule so those resources will be used to make adjustments to data reporting as required.

And then our next budget change proposal is for the BHCONNECT proposal and the workforce proposals therein.

Thank you very much. Libby Abbott, Deputy Director for Health Workforce Development as part of a combined BH Connect BCP HKAI requests expenditure and reimbursement authority of up to 1.9 billion over five years and 57 positions to implement and administer the behavioral health community based organized networks of equitable care and treatment.

That's BH Connect Workforce Initiative and Senate Bill 326 Prop 1. HCI also requests public contract code exemption authority for these funds to implement the workforce programs within the required timeframe.

In addition, we propose statutory language authorizing the use of third party administrators to manage the Administration of workforce development programs under BH Connect Workforce initiative and SB326 Prop 1 to ensure that we're compliant with timelines and able to take advantage of this historic funding opportunity.

And then I think our last agenda item deals with our CALRX program.

I'm back. Last item is caloric reduction. So the 2425 budget included a one year deferral of $50 million initially appropriated to the Calrex program for a California based insulin manufacturing facility.

The May revision proposes to redirect 5 million of these funds to support CALRX initiatives for public health priority drugs that are at risk of drug market failure here in California. The remaining $45 million of the Calorex in state insulin manufacturing funding is proposed to be reverted as a solution to solve for the 25-26 budget deficit.

I believe those are our items.

Madam Chair. Thank you. Is there anything. Is that right? You look like maybe you had more.

There's a technical adjustment to chapter legislation. It's a minor technical proposal.

Okay. We'll see if we have questions on it. Certainly. Thank you. Thank you. Anything from DOF or Lao?

Albert Benin, Department of Finance Nothing further to add.

Yes. Good evening, Madam Chair Members. Mark Newton with the Legislative Analyst Office. We'd like to speak briefly on three issues related to this budget and the first is the pharmacy benefit manager proposal which cuts across this budget as well as the next item.

With the Department of Managed Healthcare at its heart, we think this is a significant policy proposal. It is a policy area that the Legislature has considered the last few years with introduced legislation.

Our office's recommendation is that policy proposals that have relatively limited budgetary implications really should be deferred for consideration to the policy process or at least later in the year. We think that the focus at the budget time should be on the fiscal picture.

There are some very, very difficult fiscal trade offs that the Legislature will need to consider. And without prejudice to the merits of this proposal, we would recommend it be deferred just to give a sense for maybe some other ones in the budget.

What we're talking about there a Major proposal to accelerate conveyance in the Delta, a major proposal to create a new housing agency. This is the type of sort of policy driven proposals that we recommend be deferred for consideration later in the year.

Then on the second issue, just staff mentioned sort of continued interest sort of in the diaper Axis initiative, which was a January budget proposal, continues to be in the budget. It's a discretionary spending proposal, thus one that we think sort of is subject to a relatively high bar in determining whether it should go forward.

We did raise in analysis earlier this year a number of concerns with the proposal. If the Legislature has interest in this policy area of increasing access to.

To diapers, we think there are alternative approaches, perhaps using leveraging existing state programs such as the CalWORKS sort of subsidy for diapers as well as diaper diaper banks to perhaps address some implementation issues that we had and perhaps even reduce costs. So be happy to work with the Subcommitee on that if interested in proceeding.