An evaluation of the commitment of almeda county hospital

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An evaluation of the commitment of almeda county hospital

I'd like to welcome them and my colleague from the Senate who is the Chair, Senator Bozek and my co-chair Representative Eberle.

Do you have any remarks before we start our public hearing? Thank you Madam Chairman, I have a few remarks. I want to thank the members of Insurance Committee who are taking the time to participate and to share the time with the Public Health.

This for the public's benefit, this particular hearing that we're going to participate in, the infant nutritional formula mandate is both a public health issue and a mandate for the Insurance Committee to put forward. I want to also thank and remind some of the people that last year, Representative Frey proposed this measure to us in Insurance Committee and at that time it needed a life of its own so it worked its way over this year.

I want to thank the members who have submitted the bill from our committee, that is Senator McDermott and Representative Amann and I wanted to also submitted us a bill to us -- just had two of them already -- so we have his name on it and that is Attorney General Richard Blumenthal, it's one of his proposals this year.

So I want to thank those members for having submitted those bills on this issue and I think it's an important enough issue that we can do together and kill two birds with one stone.

Thank you very much Madam Chairman. Thank you Representative Eberle is going to begin the hearing.

An evaluation of the commitment of almeda county hospital

Thank you, I'll call this public hearing to order. The first hour of all public hearings according to our rules is reserved for legislators and state agency officials. At the end of that hour we move into the public testimony on the bills and with one exception we will be hearing the bills in the order they're listed on the notice of the public hearing.

After the legislators and the state agency officials we will have a panel presentation briefly on the clinical trials bill and then we will move into the public testimony. So I understand that our first two speakers on the officials list are Senator Kevin Sullivan, President Pro Tempore of the Senate and Attorney General Richard Blumenthal that they want to testify together, so I would invite you up please.

Chairman, members of the joint committee, I'm very proud to be accompanied this morning by President Pro Tempore Kevin Sullivan, by Doctor Barbara Kaye who is a pediatrician and most important by Skyler Austin who probably is the wisest and most articulate member of the public.

Notice I'm excluding all of us who are public officials and legislators who appear certainly on behalf of this cause.

Skyler obvious has been integral, has been instrumental to this cause and I want to give full credit to Skyler's parents, Laura and Don Austin who came to my office with this problem.

An evaluation of the commitment of almeda county hospital

It isn't their problem and shouldn't have been anyone's problem, it never should have been a problem for anyone. But Skyler was born with a digestive disorder.

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I'm going to try to describe it to you as best I can in layman's terms, since I'm here with Doctor and Kaye and we're also accompanied by Louis Mendelssohn who is a pediatric allergist, I know that I will be corrected if I misstate any of the essential medical facts.

Essentially, Skyler is unable to digest protein, in fact he has very severe reactions bordering on anaphylactic shock, which is life threatening to contact with any kind of protein, even close proximity to milk products will precipitate this kind of reaction.

So naturally he can't digest milk products, nor can he even use the kind of milk substitutes that many of us as parents have come to know well. The kind of stuff you buy on the shelves and you don't need prescriptions for.

He needs particular formulas, they are in effect medical foods. They are nutritional substitutes that contain the amino acids in protein but do not contain proteins themselves. And so the body will not reject the amino acids if they are contained in for example Neocate, which is what he is able to use.

The problem that Don and Laura Austin brought to me essentially is that Anthem, their insurer, would not provide coverage for these kinds of specialized formulas that are regulated by the FDA, that generally are prescribed, that cannot be bought over the counter or on the shelves, but are medically necessary and more accurately prescribed by their doctor.

The denial of that coverage is what brings us here today and makes necessary this kind of measure. But my office now has 18 to 20 of these cases right now.

Where insurers are refusing to pay for this medically necessary formula. And that is the watch word, medically necessary. We're not asking you to provide coverage for stuff you can buy on the supermarket shelves, even the kinds of protein substitute formulas that can be bought without a prescription.

We're asking for mandatory coverage for this particular kind of formula necessary where children have this very serious kind of allergic reaction to protein. In effect, we're asking you to clarify law.The Community Assessment, Planning, and Evaluation (CAPE) unit of the Alameda County Public Health Department has prepared a story map focusing on trends in prescribing practices and opioid outcomes—emergency department visits, hospitalization, and mortality—among residents of Alameda County.

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