Recommendation to adopt resolution of the City Council of the City of Long Beach opposing bills or ballot measures that would weaken the Medical Injury Compensation Reform Act (MICRA).
Clinical read item is a report from the city attorney with the recommendation to adopt a resolution of the City Council of the City of Long Beach, opposing bills or ballot measures that would weaken the Medical Injury Compensation Reform Act. Mr. JOHNSON. Well, thank you, Mayor. I believe we have some folks who've come out tonight to speak both. I think we have some people from the medical community and the legal community. Can we go ahead and hear from the speakers? Would you like a motion, Mr.. Mayor, of a statement as to what way? Oh, sure. Well, you know, this is a very controversial issue. I know we've discussed it in the past. This is a state issue that's been debated for 39 plus years, will continue to be debated for many years to come. So I personally think that because there's no initiative that's qualified, there's really no reason for the city take a position . And I think we should just stay neutral, see if something qualifies and if it does qualify, we can come back, take the position. So with that, I go ahead and make a motion just to receive and file this item at this time. Moving. Seconded. Please come up. Those who wish to make a comment, please identify yourself. When you see the yellow light, it means you have 30 seconds to conclude. Thank you. Good evening, Mayor Foster. Council members, thank you for the opportunity to speak tonight. My name is Tammy Smick and I am here to speak to you about our experience with Micra and to urge you to oppose any resolution that would support micra. This is our 20 year old son. Alexander Smick. He was born here in Long Beach in 1991. Alex died due to medical negligence on February 23rd, 2012, at an Orange County hospital under the care of Dr. Daniel Hedrick. Alex was prescribed and administered a lethal combination of medications that caused his death within hours of admission. Shockingly, after Alex was administered the combination of medications, he was left unmonitored without even a blood pressure check for over 7 hours. When he was finally checked on during morning rounds, Alex was found dead already in rigor mortis. After nearly six months, the Orange County coroner determine the cause of death poly acute drug intoxication. When we received the coroner's report, we thought that some governmental agency would leap to action and hold to account those responsible for our son's death . We were very wrong. What we discovered was that doctors and hospitals are very insulated from accountability. And we learned that if we wanted to hold the doctor and hospital accountable, we would have to seek legal action. We are not litigious people, but we wanted to make sure this horrific treatment would not happen to another innocent victim. And that's when we learned about micra. Alex was a college student studying to be a surgical technician. He wanted to work in the medical industry. Erotically the very industry that caused his death because he was not a wage earner. Michael limits the value of Alex's life at $250,000. Michael also limits access to the legal system because of the high cost of litigating a malpractise case. My husband and I have invested thousands of dollars to ensure we have our day in court and to fight for justice for Alex. Our fight is not with the many wonderful doctors who responsibly treat patients and save lives every day. But our fight is with this system that would rather protect dangerous doctors than protect patient safety. I implore you protect patient rights and oppose any resolution that would support my micra. Thank you. Thank you. Sorry for your loss. Thank you very much. And next, please. My name is Tim Smith. And I'm a very angry father. Alex was my son. And I'm here to urge you to oppose oppose any resolution that would support micra. I'm a father who grieves every single day over the loss of my son. I suffer constantly from the image of my son's cold, stiff and purple body as he lay dead in the hospital bed where he sought help. Alex died a preventable death at the hands of the medical professionals from whom he sought help as Alex was dragged to death in a hospital. And we are fighting to stop this tragedy from happening to another innocent victim. We only lost we not only lost our beloved son, but we have been victimized by micra. Micra has made our access to the legal system very difficult. Doctors take an oath to do no harm but when they do negligently harm patients they need to be held accountable. Patients and their families should not have to fight against an archaic law such as micra and multibillion dollar insurance companies when seeking accountability. Please do not rush to judgment in support of Micra. I urge you to contemplate this. Have $250,000. Was fair in 1975. How can that same amount be fair in 2014? Thank you. Thank you, sir. Next. Thank you, Mr. Mayor. You didn't council when it was Peter Mackler, who is the executive director of the Government of Communications and Public Policy for the Memorial Care Health System, which Long Beach Memorial, Miller Children's Hospital, Long Beach and Commune Hospital members. And I applaud Mr. Johnson in his opening comments a few moments ago that this is certainly a complex and difficult issue and telling our thoughts and prayers go out to the previous speakers. I am here actually to ask for your vote on the resolution on 14 to 8085 to oppose any changes to the Michael Law. The Act has served to keep health care costs in a state down and it does indeed stand as a national model. The nonpartisan Legislative Analyst's Office estimates that the projected changes could cost local and state governments tens of millions of dollars if they attempt to quadruple the noneconomic damages becomes a reality. As severe a domino effect would take effect and affect. Each of our shared constituencies are bound to be affected at a time when every hospital an integrated health system such as memorial care, is facing unprecedented challenges due to considerable reductions in our reimbursements from Medicare and Medicaid and the prospect of higher health care costs due to an increased insurance premiums and more complex claims will certainly take its toll on communities to the cuts from the Affordable Care Act. Across the board sequestration reductions due to the sustainable growth rate, the memorial care health system is facing almost half a billion dollars in reduced payments over the next ten years. And despite these challenges, the three Long Beach based medical centers provided our communities, our shared constituents, with over $67 million of quantifiable community benefits in fiscal year 2015. And that includes over $17 million in charity care for the uninsured and the under-insured. And this also includes $33 million in local breast cancer screenings and prostate screenings and neonatal classes and such other community based programs. I mentioned the domino effect. If our rates were to increase, which they surely will, coupled with the federal and state decreases, no health care system in the state will be able to sustain community services at the current levels. If nothing else, if the cap goes up, so do our attorney's fees and the time needed to negotiate. And this is money that is desperately needed in the communities as memorial care health system. And every health care provider in the country is working hard to truly transform the way we deliver care in our communities . It is critically important that might not be changed. May Council I thank you for your time and I do ask for I vote on resolution 1485. Thank you. Thank you. Next. Good evening. I'm Tina Kim, assistant director of policy at the Community Clinic Association of Los Angeles County. Khaleesi represents 53 federally qualified health centers, community clinics and free clinics throughout Los Angeles County. Our members operate nearly 200 clinical sites throughout the county, providing medical, dental, mental health and pharmacy services to over 1 million and duplicate patients every year. The majority of whom are uninsured or underinsured. In Long Beach alone, eight clinical sites operated by three of our members alone serve over 38,000 patients annually and provided over 106,000 medical encounters in 2012. The vast majority of patients served by the clinics are low income. 69% live below the poverty line and 58% are uninsured. I'm here to urge the Council to adopts the resolution before you today with an eye vote. The trial lawyers push for a potential November ballot measure to change Medicare would significantly undermine clinics local efforts to continue providing much needed high quality care to the underserved. CCRC has been a longtime member of the coalition Californians allied for patient protection. We strongly support micra. It is fair and allows clinics to focus on the important task of providing health care to all of those who walk through the doors regardless of their insurance status or ability to pay. As the largest regional association of nonprofit community clinics and health centers in California, we do have a stake in the game when it comes to Micra. Surely changes in the law proposed by the trial lawyers will greatly impact the clinic's ability to keep doors open if the trial lawyers are successful. Increased lawsuits and higher attorney payouts come with a hefty price tag that not only affects local and state governments, but also affects the very patients clinics serve. Michael would be altered in a way that makes it easier to sue health care providers and triple lawyers legal fees in the process. Meanwhile, clinics will be forced to offset higher health care costs and medical liability rates by cutting expenses elsewhere, such as reducing hours, cutting staff or reduced services. This will only make us further out of reach to the people who need the health care our clinics provide. Therefore, it is important that you vote in support of the resolution. Thank you very much. Q Next, please. Good evening, Mr. Mayor. Honorable Councilman. My name is David Kim. I'm a family physician in the medical director of the New America Medical Group Clinic off of Bellflower and Stearns in the former Borders bookstore. And I'm here tonight because we are in a time where, as a primary care doctor who is managing other primary care doctors, we're having a difficult time drawing primary care doctors into the field. And if this proposal to change micro limits goes through, it will make it even more difficult for us to draw quality care, primary care doctors to practice in the very areas of Southern California that we most need into practice and we are already experiencing. A real need and a dearth of primary care doctors to serve the communities, to be able to keep patients healthy, to keep them from becoming ill in the first place. And that's really a transition that we are feeling and moving toward in America. And I think anything that will make it more difficult for us to incentivize or to create an environment in which to allow those physicians to practice in the way they desire. And why we went into medicine, I think, will really hurt our cause and hurt our community to keep them healthy. I think the the very the increase in cost that any change in micro will bring will ultimately lead to a decrease in service to the very public that I think that this measure or this change to micro is proposing to protect. I think the fact that it. Comes across in a way that I think lacks integrity by throwing in this bill to measure and screen doctors for drug abuse and then kind of funneling in this change to make her afterwards. I was leaving a target the other day and someone asked me, would you want do you want to sign a petition to screen doctors for drugs and alcohol? Please sign this petition. And I said, no, thank you. But I think that there's such a more profound conversation behind that, that the public, I think, deserves to be engaged in. And I think for them to hide behind this initial sort of tagline and then expect it to be passed and slide this migraine behind the change in Medicare, behind it, I think, really is disingenuous. And so I really urge you to consider this thoughtfully and on behalf of the constituents that you serve and and the patients that I tried to keep healthy to really oppose any change to Micra. Thank you. Thank you, doctor. Thanks, blue. Thank you. Good evening, Mr. Mayor. Council members. My name is Barry Thorpe. I've been a resident of Long Beach for 49 years, a resident of the fifth District for the past 23. I'm I'm here not to talk about what may or may not happen with Micra as it's changed or not. I'm I'm here to talk about what's happening in Long Beach today something that some of you may or may not be concerned be aware of other and that I'm I'm here because 119 days ago my sister Laura was a patient at Pacific Hospital in Long Beach. She was there on a non-threatening, non-surgical stay. And over the course of a few days, over repeated acts of negligence and neglect, she was given an overdose of medication. And over the next few days, went to multiple organ failure and died. At the time of my sister's death, two state lawmakers both expressed concerns about patient safety at Pacific Hospital. One of them, state Senator Labus, specifically stated that he was concerned about the mismanagement and mistreatment of patients and the potential for that. And it's not a potential because it happened. Now, the nice gentleman offered thoughts and prayers to some other people that spoke about their loss and thoughts and prayers and concern to lawmakers. I suggest do not substitute for viable legal remedy and you don't have that currently in a Micra with a $250,000 cap which is 25 years old . The amount of of deterrent value that this offered to the numerous people at Pacific that watched my sister decline and die and did nothing to stop it. It's meaningless. It's almost a cruel joke. It's an illusion of a remedy because we immediately encountered problems to even get an attorney that would be able to represent us and address the problems at Pacific because of the limitations of Micra and we worked hard to find one and we found a very good one and we were very lucky because we had the ability to do that. I'm sure other I'm sure other people are not as lucky. I would ask that there is no haste to, to to weigh in on this resolution, on this initiative before it's even qualified. Let the process work out. Let people hear both sides in Long Beach about whether or not it's appropriate to adjust micra for purposes of patient safety. I'm asking you to do that as as a citizen of the city and as a person who knows firsthand just very recently why this is something that really does need to be considered at length. Thank you. Thank you. Next, please. Hi. My name is Eric Andras. I actually sent you all an email this past week with a lot of. Information, and I hope you all were able to. Take a look at it. My sister, Cali Andrus. Was mentally. Retarded. She had the learning ability of a four year old, and I took her to the E.R. one night because she had a terrible stomach ache, and two days later she was dead from medical negligence. The hospital refused to give her any pain medication for 15 hours. The poor thing just sat and suffered in. Horrendous pain for 15. Hours. When they finally gave her medication, they gave her a drug called Dilaudid, which is seven times stronger than morphine. Even though she had only been. Prescribed a low dose of morphine shortly before they gave her the Dilaudid, they gave her a radioactive beverage to drink for an unnecessary CT scan. Because of the sedative effect of the Dilaudid, she ended up aspirating that radioactive beverage into her lungs, which caused pulmonary edema and sent her into cardiac arrest. The hospital was under the wrong assumption that my. Sister was a DNR. A do not resuscitate. So while she was laying there in cardiac arrest, they were standing there doing nothing. When they finally realized that they were wrong. They called a code blue and they were able to bring her back 17 minutes later. But it was too late. She was nearly. Brain dead by that time. This is when I finally learned about Michael. I had never heard of such a thing. 38 years this law has been on the books and I've never even heard of Micra. When I tried to get a lawyer it took me over eight months to get a lawyer to take my case and it only I only ended up getting one because I started advocating for patient safety. Over a dozen lawyers turned our case down. And this is what everybody that's that's going through medical negligence these days is going to. My sister had no husband. She had no work. She had no children. So she only qualifies for the $250,000 cap. So what lawyer is going to take that? It costs sometimes $100,000 and in fees to bring a court case. Then you've got $75,000 in lawyer fees. You've got to take that out of the 250,000 before a victim can even see any more money. And then that's in 1970 $5. By the time $75,000 is left in 1970 $5, it works out to about $17,000. That's what a medical negligence victim gets these days because of micra. It's a horrible law. I've actually been in contact with senator barry keene who wrote the law in 1975. He has come out and he has written a statement and I sent you all the link to this and he is also for raising the cap. He wrote the law and he's for raising the cap. So I beg of you all please do not support anything that has to do with with promoting Micra. It's a terrible law and it's really affecting a lot of people who are suffering from medical negligence. Thank you. Thank you. Next please. Hello. My name's Betty Brown. I'm here because of my sister, Tamara Walter. That passed away four years ago from medical negligence. She went into the went into the clinic for a minor procedure and 20 minute procedure. And never came out. They ended up putting her in a room. A recovery room, forgot her, and she suffocated. As the other gentleman said, too, I wasn't even aware of my crew if we went out to try and get help to see attorneys to to make some changes and couldn't get any help. I happened to have the opportunity to go to Sacramento a couple of years ago and work on the SB 100 and we bill and we got it passed, which is to improve the standards at the clinics and hospitals, which I hope helps because of the limitations with Medicare. It's very hard to get any type of, you know, help with attorneys. And my sister also was single, had no children. So her life wasn't worth much either. You know, the last two, the rest of the families just horrendous. Please. You know, a. You know, we have to make change to make. We have to see people, you know, in the future. And the only way that's going to do it is if we are able to hold the doctors and whoever accountable. And unfortunately, the only way to hold them accountable is financially they don't care. You know, it's and there's a lot of great doctors out there, you know, just the few that don't care. Hopefully if we make changes that will affect them anyways. I mean, other than just being a victim of the medical negligence, we're also you know, we're a victim with with with the micro, you know, with not being able to to do anything. So. Thank you. Thank you, Miss Byrne. Next with. My name is Dr. Carlos Martinez. I'm a local ophthalmologist. I have been in practice here for the last 13 years, and I have served as chairman of ophthalmology at Memorial. I have served a quality assurance on memorial quality assurance in Los Alamitos at Reagan Street Surgery Center. So I am interested in taking the bad apples out of the community, and I have done everything I can. And the truth is that every one of our colleagues and every one of the cases that I've reviewed have always been about caring doctors, trying to do their best in a field that is incredibly difficult. But the answer to the problem is not changing. Micro. Micro. There are no caps for gross negligence. There are no caps or economic damages. So the idea that raising the cap for pain and suffering would lead to a resolution or would lead to taking those who have made mistakes or acts of negligence out of the field is just not the case. If I thought that that would solve that issue, I would support changes to micro, but I don't think that's actually a factor in the whole equation. So I support the resolution that you have come up with supporting micro, and I invite everybody to have a discussion about how to solve the issues. Thank you. Thank you. Next, please. Good evening, Mr. Mayor. Members of the council. My name is Victor Christie. With Californians Allied for patient protection. I'm here to urge your support of the resolution to support micro micro works. Any change to Micra will only jeopardize the citizens of Long Beach and all Californians ability to access quality health care. It is wrong to increase health care costs for every citizen of this state, especially now at a time when we are implementing the Affordable Care Act. We cannot return to the crisis that led to the passage of micra where the san jose mercury news then stated that insurance rates will peril medical care in the Los Angeles Times stated then that doctors face an insurance crisis which will affect 8000 in the Southland. Yes, regrettably, there are individual tragic cases of medical negligence that no one ever, ever wants to see. But this is not the way to do it. Changing Micra is not the solution. That is why we have a broad based coalition of community health centers, public safety positions, labor, the Department of Public Health of Los Angeles County and more than a thousand others to support micra. I respectfully urge and I vote please protect access to health care. Thank you. Thank you. Next please. Good evening, Mr. Mayor and council members. My name is James Ah Christie. No relation to the last speaker. I have been a resident of Long Beach for over 20 years. I'm an attorney and my law firm represents victims of medical negligence. One case that we to give you an example of the kinds of cases that I that I see. I represented the parents of a 25 day old baby who went to the hospital with sepsis and high fever and five days later was about to be released. The physician said he's he's going to be okay. Let's release him. The mother said, I'm not going to take him home. You can see he's jittering. The baby had symptoms of seizure all these five days that he was in the hospital on that last day that the physician decided he would needed an emergency MRI of this infant rushed him down to the MRI room. The baby went into cardiac arrest and resulted in brain death at 30 days old. We won that arbitration. But the most that it was available to that family, those those parents was 250,000, not apiece, but for both of them together. And this is a couple they still go to the park every birthday with a birthday cake to commemorate Jayden's birth. But I'd really like to speak about the people who can't get a lawyer who are victims of medical negligence. And I see them all the time and my heart really goes out to them. They can't get a lawyer because the cap is too low and the economics don't work out. Is so expensive to litigate the medical negligence case, they cannot find a lawyer to represent them. That's why it's socially responsible to lift the microcap. It's going to provide access to justice. It's going to make physicians more responsible for the care they give. And I respectfully urge a no vote on this resolution. Thank you. Thank you. My name is Nicholas Domingo. I did not know that this issue was on the agenda today, and I'm not prepared to talk about it. I am in the medical care field and. I make my living by that. Also, I had a mother who died in a local hospital. She stated in front of witnesses that she wanted to live and that she wanted treatment. And despite that fact, a DNR was placed on her without authorization. The only person that could. In the world. Agreed to that DNR was me and I didn't even know about it was placed without authorization. And then she was denied treatment even. Which would have been given to a deranged patient. She needed to be on a ventilator. And she died. And there were many, many other gross and embarrassing mistakes. I don't know any of these people here. I don't know these two people who suffered the loss of their son. I've never seen them before. But the things that they experienced I encountered ten years ago. I don't have an agenda at this time. I do not have a lawsuit. That was years ago. I do know that that hospital probably spent over $1,000,000 on attorney's fees. And they're saying there's no money. There is money. Like in most other aspects of the world. Businesses are money driven. Anyway, at the very end, I watched my mother suffocate. And. The nurse at this hospital knew that that was happening and didn't even stand up because at that point she was a legitimate DNR because there was no more treatment for her. And she suffocated. And then they tried to usher me out of the room so that they could withdraw the medical devices and carry me out so they could get on with business. It's very, very difficult to obtain an attorney because of money. But the hospitals can afford high priced attorneys. And they do. And again, I get no penny for this. I have no agenda, no lawsuit. Thank you. Thank you. Next. Mr. Mayor, council members, I thank you for a brief minute. My name is John Hinman. I live in Long Beach. I live in the second district. I'm a small business owner in the third district. I employ two employees who live in the second district and I believe the fifth District. I practice medical malpractise defense for four years in Long Beach at a prominent defense firm and I now practice medical Malpractise plaintiffs work along with Social Security, disability, employment, and a variety of other things. I have to tell you that I urge you strongly to get all of the opinions of all of your constituents and the people who really know what's going on about this before you make a decision. I think that's most important. I have two brief comments. First of all, I think that the bar to filing medical malpractise cases is the fact that you need experts to come out and say that there was medical negligence. That is a huge bar to filing these cases. And I think to claim that the $250,000 cap is the real bar to filing these cases is not necessarily the reality. Second of all, I want you to know that I have, in my short four months of representing plaintiffs, have had to have several tearful conversations with folks who have clear liability cases. But because of the complexity of their situation and the 250 cap, I was unable to represent them. These folks had consulted with five, ten, 15 lawyers. I was literally their last line of somebody who could potentially take the case, and I had to, through my own tears in theirs, tell them, no, this is real. This is the real situation that's happening all the time. Please get all of the facts before you make a decision. Thank you very much. Thank you. Next. Mayor Foster, members of the council. My name is John Blumberg. I've been an attorney in this city for 39 years, and my office has been across the street in Long Beach for all of that time. And before that, my father's law firm was in this city since 1955. I'm on the Long Beach Symphony Executive Committee. Your children, your wives, your husbands, your family. They've been calling me for medical malpractise advice for many years. And there are many, many, many terrible stories that I hear every day, every week. This is an issue which is a complex issue. Medical malpractise law is among the most difficult to practice. Expert witnesses are necessary before a case can ever get past the first step. The medical the medical lobby, the insurance companies would be much better off if there are artificial limitations on the compensation that people can receive from medical malpractise cases. However, those who are victims of medical malpractise cases should have the right to be compensated in an amount which is commensurate with what they have suffered. This is neither frivolous nor is it meritless. It is simply a matter of what is appropriate compensation and what was appropriate compensation 38 years ago is not appropriate compensation now . If it was fair 38 years ago to set a $250,000 limit on the recovery of a life of pain, of suffering, of misery, if it was fair 38 years ago, it could not be fair now. And so you are the representatives of the city of Long Beach, of the citizens of the city of Long Beach. And I think that it would be most prudent, since there is no initiative at this time, most prudent not to take a position and never to take a position because this is a matter to be debated. It's a matter to be discussed. And it's a matter that perhaps if an initiative ultimately does qualify for the ballot to allow the political, nonpolitical and sociological debate to take place in the city, with the city council not taking a position where the citizens of the city of Long Beach essentially are told that this is how your representatives feel about the issue. And I would join those who say it is appropriate not to take a position at this time. Thank you. Thank you. Councilmember Lowenthal. Thank you, Mr. Mayor. And I want to thank everyone that's come to speak on this issue today. It is very heart wrenching, all of your experiences. And I'm sorry I can't see you over there, but I do want to thank you for coming. Where I'm coming from on this issue and certainly where I believe seven of our council members we had eight council members here last week. Seven of the eight are coming from on. This is really an access to to health care issue. The Medical Injury Compensation Reform Act has protected patients and our health care network for over 35 years in California. We've heard from our medical professionals right here from Long Beach coming to speak on that. And I'm asking our council colleagues, my council colleagues to consider that Long Beach memorial while Molina health care was not here. They are a home based health care provider here serving health care to really the less visible among us, serving those that aren't able to afford the health care that each of us here are able to. And so we have to consider that micros original purpose is still relevant today to ensure that injured patients are fairly compensated, medical liability rates are kept in check, and physicians and clinics can remain in practice treating patients, driving physicians out of the practice, especially those that are good physicians, the ones that intend to do right every single day does not serve our families, does not serve Californians. The Troy and Alana Park Patient Safety Act of 2014 is a ballot measure that is attempting to qualify for the November ballot with potentially significant impacts to the community and our city. California's own Legislative Analyst's has reviewed the proposed ballot measure and determined that the likelihood of cost. Increases to state and local governments is substantial by eroding micro's protections to increase lawsuit payouts. The ballot measure will hurt community clinics. We have many community clinics here. It will hurt doctors and hospitals and for the purposes of this council's consideration. Also, increased costs and lower sales tax revenue to the city as the costs of employer malpractise suits and health care policies go up and our residents expendable consumer income goes down. Small percentage increases in our cost of doing business could have an exponential impact on our future budgets. As I commented at our January meeting, yes, it was our January meeting. I believe that our city should join the more than 800 organizations including hospitals, community clinics, county and city governments, business and taxpayer groups, labor unions and members of public safety that support Micra and oppose any changes. As I said earlier, I'm coming at this in order to protect access to health care for all but really for those of us who are less visible in our communities. And it's important to restate what was said earlier by one of our speakers that there is no cap here for gross negligence. We are still allowed unlimited economic damages for past and future medical costs, unlimited damages for lost wages, lifetime earning potential, and any other economic losses. Micro only impacts. The punitive I'm sorry, the noneconomic damages and caps. The noneconomic damages. That to 50, there's unlimited punitive damages. And so with that, I ask my colleagues to stay the course from our direction and our action last week and vote no on this receive and file motion. Thank you, Mr. Mayor. Council membership scheme. Thank you, Mr. Mayor. I want to thank the people who came forward and talk today. And I'm extremely sorry for your losses. You know, I'm a registered nurse practitioner, an attorney, so I kind of work in both worlds. I also am on the California Medical Board, and I would urge you and anyone here, because a lot of people don't know this, that if you have if you believe that a physician has been negligent, please file with the medical board, make a complaint. I spend roughly about three days a week reviewing cases that are given to the medical board. We do them online about physicians that are being disciplined. So the board is extremely active. We take it very seriously. And when a hospital senses an 805 report, which they're required under law to give us when a physician has been negligent , we take that very seriously as well. So I encourage the public to use that venue. But that being said to individuals, I think the point that I would like to support is that they have this kind of issue on a consent agenda without really having a lot of public input. I don't think serves as well at all about this initiative. What I would like to do is make a substitute motion that we send this issue to our state legislation committee so that we can have further public comment and review, and then the ledge committee can make a recommendation to the full city council on it. And by that time, hopefully we will have a clarification about the language, the potential language or what is moving forward. And the city council can actually take a more informed position. So I make that motion. It's been moved and seconded. Mr. DELONE Thank you, Mr. Mayor. It's my understanding the original motion was to receive a file and now we have a substitute to send it to state. Loj Is that correct? Well, I know that there's a second meeting now. We've had some pretty significant discussion on this and I think what I'd like to do is make a substitute substitute to support the original recommendation to adopt the resolution. Second. Okay. That's in order. Mr. JOHNSON. Well, thank you, Mayor. I want to thank everyone from both sides this very heated argument for coming tonight. But I think the question that has not been answered, that's been asked over and over again, I ask this question and many of you have asked the question is simple. If $250,000 was the right number in 1975, why is it the right number today? How long are we going to wait? Are going to wait 50 years when $203,000 buys 10% of what it does today, or he does not believe in pain and suffering damages. If that's the case, let's just say it. Let's just say that there should be no pain and suffering damages. But to basically let inflation do what we're not willing to do ourselves, which is to help victims and their families, that you have no access to justice is wrong. I think, simply put, we know in all of our policy areas, we constantly look at CPI adjustments. There's no reason not to do it here. So I oppose the motion because while I think we should kill this outright, I think Councilwoman Shipley has a good point, which that this does deserve more consideration from all sides and from all perspectives. And I would certainly support going to the legislative committee. All right, members, we have a motion on the floor to support the original motion. Members, cast your votes on that motion. You know, in this day and age community. They want it in the state budget committee. The motion carries five votes. Three votes no. All right. Thank you. Thank you all who testified and appreciate that the motion has passed. Your Honor, my name is Mark Werth. I'm sorry. I'm here for the first time. I did not see what the recorded vote was. Five three. Right there, right on the board. Okay. And that motion is to approve the original? That is correct. Thank you. Okay. You're out of order. So if you have a question, you can do it offline. Okay. All right. Thank you. And we have you have a question. See that gentleman right at the end right there? Mr. Barkin, I'm happy to do that. That means the original motion, I guess, to support the microphone position has been adopted by the council. Thank you. Item 23, Will.