Senate Standing Committee on Business, Professions and Economic Development

We're going to wait for a quorum until we secure additional members, but we do have an author. Senator Allen, you have one bill today. Please proceed when ready.

I do. Thank you so much, Mr. Chair.

I guess I should say this is Senate Bill 285, item number one.

Yes. Well, thank you, Mr. Chair, and members. And I do want to give a special thanks to the staff for the hard work on pulling together the very excellent analysis that I read at the park yesterday with my son. Under existing law, local jurisdictions are allowed to authorize the smoking, vaporizing and ingesting of cannabis and cannabis projects on the premises of a licensed retailer or a micro business, which is what's referred to as a cannabis consumption lounge. Now, current state regulation prevents these lounges from preparing and selling freshly made food and beverages.

They're allowed to have prepackaged items, but they can't be fresh, even if their local jurisdiction would otherwise allow them to. So the idea is that we're going to try to change the rules. These freshly made items would be non cannabis infused, they'd be nonalcoholic, essentially nothing more than the kinds of foods that you might find in a bar, like a burger and fries.

This has created costly and cumbersome workarounds to provide guests with the expected experience by either taking out two property leases or having food items delivered from outside vendors. And actually, my witness from the West Hollywood Chamber of Commerce can speak to some of the bizarre hoops that businesses are having to go through in order to comply with the law.

To address this, the bill would allow for a local jurisdiction to allow for these consumption lounges to prepare and serve fresh made items, while additionally extending the ability to sell prepackaged items to any cannabis retailer. Once again, this just gives the power to the local jurisdiction to make that judgment call. There's been some claims made that this reverses previous agreements with regards to local control, and it's just not the case. This is the local jurisdiction.

The local jurisdiction will still have the power to make the decision here. It would allow them to allow for the preparation and serving of fresh food at these lounges. It doesn't legalize indoor smoking, as existing statute provides locals with the ability to authorize operation of consumption areas. Already, the bill doesn't do anything beyond providing local authorities with the decision making power over food and beverage sales nonalcoholic by licensed retailers in their jurisdiction. These are developing small businesses.

This bill is seeking to support them in operating as intended, while retaining the respect for local control provided through Prop 64. And it's for that reason that the bill has garnered broad support from the cannabis industry, but also local governments. And I respectfully ask your aye vote. And with me here today, I have Jackie Subeck, who's come from our sponsor, the West Hollywood Chamber of Commerce.

Please proceed.

Thank you. Good morning, Chair Rothman and committee members. My name is Jackie Subeck. I'm a cannabis policy advocate based in West Hollywood. I'd like to first take a quick second to thank Senator Allen for his dedication to this bill, as well as the West Hollywood Chamber of Commerce for their unwavering commitment to helping our small businesses. Cannabis launchers are still a very new and pioneering concept here in California.

With the passing of Prop 64 legalizing cannabis in the state, the right to establish consumption launchers was handed over to local jurisdictions to decide what was best for their community. Some chose to have small smoking rooms adjacent to their retail stores, while others, such as West Hollywood, San Francisco, Oakland, and the Coachella Valley, desired a more experiential business model for licenses to create a restaurant lounge similar to a bar restaurant situation where a customer can enjoy a meal, a beverage, and consume cannabis all under the same roof. SB 285 will open up the viability for this to happen.

As it stands today, a lounge licensee who is seeking out a lease for their future business does not even know if they need a kitchen or not, ultimately making it quite challenging to develop a realistic business plan that offers the ability to thrive and hopefully prosper. This bill will allow these lounges to determine the right lease for their business ahead of time and if they choose, hire a chef to prepare fresh non cannabis food and nonalcoholic beverages for their hungry and thirsty customers.

Currently, state regulations prevent any legal cannabis sales after 10:00 p.m.. SB 285 will make it feasible for lounges to remain open until 02:00 a.m., without cannabis sales, but will offer them four additional hours each night to sell food and beverage. That's 28 hours of additional revenue each week, which is a literal game changer.

Additionally, this bill will enhance the abilities of our cannabis retailers, who are struggling daily to make ends meet, to be able to sell prepackaged food and nonalcoholic beverages to customers who will be able to purchase a kombucha or a bag of chips or even a grab and go sandwich alongside their cannabis purchases.

Simply put, adding additional revenue streams in the food and beverage category promotes economic viability across the board to our retail stores and lounges, giving them more reliable revenue streams, as well as opportunities to participate in the nightlife of their community by not having to shut their doors early because they have nothing else they're legally allowed to sell. Thank you very much.

Thank you. Are there any other witnesses in the hearing room who wish to testify in support of Senate Bill 285? Name, affiliation and position, please.

Good morning, chair and members. Andrea Deveau, on behalf of the California Cannabis Manufacturers Association, in support.

Thank you. Any other witnesses in support? Seeing none, let's move to any lead opposition witnesses. Any lead opposition witnesses in the room. Any other, please step forward.

Mr. Chair, Members Andrew Antwee here today on behalf of the American Heart Association, and frankly, we have great respect for the author. It's very thoughtful. But we just disagree on exactly how this would be implemented and whether or not it violates the intent of Proposition 64. Under the basis of our opposition, we point out that in 2016, California passed Prop 64, legalizing adult use, in an effort to continue worker protections. Our groups and others worked closely with proponents of 64 to ensure that the same safety guidelines were put in place. However, this measure will undermine these protections and put thousands of workers, we're concerned, at risk by allowing the preparation and sale of non cannabis food in buildings where smoking and vaping cannabis and cannabis products is allowed. So on this basis, we're opposed.

Thank you, sir. Any other opposition to the bill? Let's turn to witnesses waiting to testify via the teleconference service. Moderator please prompt any individuals waiting to testify in support or opposition to Senate Bill 285. We'll begin with them.

Thank you, Mr. Chair. If you are in support or opposition to SB 285, please press one followed by zero at this time. One followed by zero. And we will begin with line 14. You are open.

Good Morning. this is Jonatan Cvetko, Executive Director of the United Cannabis Business Association, also representing the San Francisco Cannabis Retailers alliance, as well as the Long Beach Collective Association, all in support of this bill. Thank you.

Thank you. Next, please.

Next we'll go to line 34. You are open.

Hello, this is Dr. Lynn Silver from the Public Health Institute speaking in opposition to this bill.

Thank you, ma'am. Next, please.

We'll go to line 29, please go ahead. Line 29, you are open. Are you muted? Line 29.

Yes, here I am. This is Michael Long. On behalf of Angeles Emeralds, Social Equity, LA and California Minority alliance, all in strong support. Thank you.

Thank you. Next, please.

Line 11, please. Go ahead.

Hello, this is Armin Fronian. I'm calling on behalf of Coachella Valley Cannabis Alliance Network, and I'm in support of this bill. Thank you.

Thank you. Next, please.

Line 16, please go ahead.

Hi, this is Genevieve Morril President and CEO of the West Hollywood Chamber of Commerce, in full support of SB 285 on behalf of 40 license holders.

Thank you. Next, please.

Hello. Hi, my name is Adam Hijazi. I'm with the Long Beach Collective Association. We just wanted to voice our support for this bill. Thank you.

Line 32, you are open.

Hello, this is Carlos De La Torre from Cornerstone Wellness and the UCBA Trade Association in support of this bill.

Thank you. Next, please.

We'll give one final reminder. One, followed by zero if you are in support or opposition to SB 285, and line 37, please go ahead.

Thank you. Next, please.

Mr. Chair, we have exhausted the queue.

Thank you. Let's now bring the conversation back to my colleagues on the dais. Colleagues, any questions or comments?

Question for the author.

Please proceed.

Senator, a lot of support. No doubt. My concern would be additional drinking or alcohol or loitering. Do you see any of that? Did you look into that? I know the chamber is behind you, which is great. And I'm going to support the bill. As a matter of fact, when it's appropriate, I'll move it. I'm just concerned about the activities in the milling around, when normally it's in buy the product and gone. Okay, that would be my concern.

So you're talking about dispensaries. These are lounges, and these exist right now, where people go and they hang out. This is totally different than a dispensary. It's a lounge that's specific to cannabis consumption. And the idea is that right now, they're allowed to give you packaged food, but they can't give you fresh food. They're allowed to give you. So we would allow fresh food and non alcoholic drinks at the lounge. Just at the lounge.

In fact, if anything, let's be honest, having a little bit of food when you're ingesting cannabis actually leads to safer behavior, ultimately, than no food. Okay, but these are not dispensaries. These are lounges. These are cannabis consumption.

Thanks for clarifying. Thank you. I'll still move the bill.

We don't quite have a quorum yet, but any other questions or comments? Okay, Senator Allen, would you like to close?

Yeah, I appreciate the question. Appreciate the discussion. We just got the letter from Andrew's folks and certainly want to talk to him and engage with him and see what we can do to get any issues resolved. But once again, this just gives the local jurisdiction the right to allow for fresh food. Right now it's packaged and it's just at these lounges. So thank you to the chamber, thank you to the city and all the folks who've supported. I certainly ask for an aye vote when the time comes.

Thanks, Senator.

As soon as we have a quorum, we'll take it up.

Thank you. Thank you, Mr. Chair.

I don't see any other authors who were not Committee Members, so Senator Alvarado-Gil, you're on deck. Item number 10, Senate Bill 820, cannabis enforcement seizure of property. Senator Allen. I'll let you borrow the Committee Member if she wishes. Proceed when ready.

Thank you, Mr. Chair and Members of the Committee, I'm here to present on Senate Bill 820, cannabis enforcement seizure of property. The illegal cannabis ecosystem has caused major economic and environmental damage here in California. Many of the state's estimated 50,000 illegal cultivation sites have been found using banned pesticides that can poison wildlife and water supplies and are believed to account for hundreds of millions of gallons of water stolen from farms and neighboring communities each year.

Senate Bill 820 simply adopts the same civil asset forfeiture processes currently applicable to unlicensed manufacturing of alcoholic beverages, known as moonshining, to apply to unlicensed commercial cannabis activities. So, in summary, same civil asset forfeiture procedures currently applicable to unlicensed manufacturing of alcoholic beverages will apply to unlicensed commercial cannabis activities. The purpose of this bill is to act as a deterrent to other illicit operators and promote entrance into the legal regulated cannabis market.

This bill would, upon a judgment in favor of the forfeiture, allow these assets to be sold at public auctions by the Department of Cannabis Control or by the local jurisdiction. The remaining funds would be deposited into the Cannabis Control Fund, which is used to carry out provisions of the California Cannabis Equity Act.

Based on a public hearing that we had here in Committee, I saw the need to have more funds allocated towards our social equity programs and to help enhance the ability of our small business owners that are doing it the right way, that are pursuing legal businesses to have access to those social equity funds. So a portion of these funds would be dedicated to funding that program.

It's vital to not only shut down the bad actors, but to support licensed cannabis businesses that enhance reliable access to regulated, tested cannabis in the legal market. I have here to testify is Sarah Dukett from our Rural County Representatives of California.

Ms. Duckett, please proceed.

Good morning, Chair, Committee Members. Existing law authorizes the seizure of property used in conjunction with unlicensed manufacturer of hard liquor. Unlike drug seizures statutes, these laws are adapted to the fact that alcoholic beverages are not inherently unlawful. No criminal conviction is required, and anyone with an interest in the property is given an opportunity to prove in civil proceedings that the property was not used unlawfully. SB 820 proposes to adopt similar provisions for unlicensed cannabis activities.

A recent reason report stated that two thirds of all sales of cannabis in California are conducted in the illegal market. The consequences of the immense problem have been highlighted in recent articles in LA Times, as well as Cal Matters. Rural communities, even the ones with the most expansive allowances for legal operators, have been inundated with unlicensed and unregulated cannabis activity that is undermining the health and safety of residents and our regulated cannabis businesses.

Frequently, counties are getting calls within 24 to 48 hours after enforcement actions that these bad actors are up in business, back in business. The reality, unfortunately, is that many illicit cannabis operators are able to recover quickly following enforcement actions due to the complicit landlords, exploitation of workers and remaining specialty equipment used for cultivation and manufacturing of cannabis. The provisions of this bill provides important tools to dismantle these illegal businesses by disrupting the financial resources of operators.

In addition, SB 820 would invest enforcement proceeds in the cannabis control fund to support equity programs. It's vital to not only shut down the bad actors, but to support licensed cannabis businesses that enhance reliable access to regulated tested cannabis in the marketplace. Our focus is to address the large scale unlicensed cannabis activities that are undercutting the legal operators, to create an environment that allows those that stepped into the legal market to actually have a chance to compete.

And we are committed to working with stakeholders to put in place guardrails and Senate Public Safety to address any of their concerns. In conclusion, local jurisdictions are a critical partner to the success of the legal marketplace in California, and adequate and effective enforcement is a key pillar to that success. SB 820 provides an additional tool for both the state and local government to utilize. For those reasons, we respectfully ask for your aye vote. Thank you.

Thank you, ma'am. Are there any other supporters in the room who wish to testify in support of Senate Bill 820? Seeing none. Are there any witnesses in opposition? Lead witnesses first, in opposition to this measure? Seeing none. Let's move to witnesses waiting to testify via the teleconference service. Moderator, if you would, please prompt those sitting on the teleconference line in support or opposition to Senate Bill 820.

Thank you, Mr. Chair. Excellent. As he said, if you are in support or opposition to SB 820, please press 1-0 at this time. One followed by zero. Reminder, if you are in opposition or in support of SB 820 please press one followed by zero. Nobody is queuing up, Mr. Chair.

Thank you, Moderator. Now bring it back to the dais and my colleagues. Questions or comments? Seeing none, would you like to close, Senator?

Yes. Thank you. I believe this bill has been dual-referred, and if the Committee deems it eligible, we'll move forward to Public Safety. I just want to underscore that revenues from forfeitures will be appropriated by the Legislature to be carried out the provisions of the California Cannabis Equity Act. This is a social equity piece of legislation that would allow money from illegal cannabis businesses to be forfeited to benefit our social equity programs. So I respectfully ask for an aye vote.

Thank you, Senator. Let's establish quorum.

[Roll call]

We have a quorum. Do we have a motion on Senate Billy 820? Okay, so we have a motion by Senator Ashby. The motion is due passed to Senate Public Safety. Please call the roll.

[Roll call]

Matter has six votes. We'll hold the roll open for absent Members. Let's now call the roll on item number one, which was moved by Senator Archuleta.

Motion is due pass the Senate Floor. [Roll call]

This is item number one, Senate Bill 285. Senator Allen.

[Roll Call].

Matter has eight votes. We'll hold the roll open for absent members. Let's now call item number four. Senate Bill 524, Senator Caballero, pharmacist furnishing prescription medications. Senator, proceed when ready.

Thank you very much, Mr. Chair and members, I'm pleased to present SB 524, which will allow pharmacists to provide direct treatment to patients following a positive test result for a select number of common, easily treatable diseases. Health care is not equal all over the state, and in rural California it is inaccessible for many Californians. Rural residents are confronted by many obstacles, including a shortage of physicians and primary care providers, lack of transportation, hospital closures, and limited access to treatments for various viral illnesses.

Many rural Californians face expensive emergency room visits or long wait times in order to be treated for diseases like Covid-19 or strep throat. The limited number of healthcare facilities serving rural areas are often burdened with more patients than they have the capacity to serve. This was particularly the case during a recent triple demic of COVID, influenza, and RSB. Meanwhile, millions of Californians benefit from testing vaccines and treatment from pharmacists.

Nearly nine in 10 Californians live within 5 miles of a community pharmacy, and the role of pharmacists in orchestrating patient care is underused. For many patients, community pharmacies can provide a quick primary access point to healthcare. Two years ago, I authored a bill that allows pharmacists to perform several FDA approved or authorized tests, allowing pharmacists to screen for Covid-19 and several common illnesses. And you all know what those tests are like.

We take them ourselves in order to show up on Sunday, in order to show up on Monday and Thursday. And what that bill did was allow pharmacists to be able to conduct those tests. However, pharmacists cannot currently prescribe treatment for most of the common healthcare conditions for which they currently perform the testing, limiting access to treatment for Californians. For example, a person who goes to a pharmacy and tests positives for the flu would not be able to then be furnished a treatment by a pharmacist.

They would apt to go to a Doctor or a healthcare facility. Recognizing the essential role of pharmacies in combating the Covid-19 pandemic, the Department of Consumer affairs gave pharmacists the authority to prescribe a Covid-19 treatment, paxlovid, directly to patients. This waiver is set to expire soon, meaning that pharmacists will no longer be able to administer that particular treatment. Building on the groundwork laid by pharmacist testing authority and the DCA waiver for paxlovid, SB 524 would allow pharmacists to prescribe treatment for five common conditions.

These diseases are Covid-19 Influenza, Influenza, sexually transmitted infections, strep throat and conjunctivitis. These conditions, and that's pink eye. I mean, if you've ever had pink eye, when you get it again, you will know it's pink eye and it takes a treatment in order to be able to stop it. Otherwise, it goes crazy. These conditions were selected because they were common diseases that plague communities and healthcare facilities and are easily treatable with commonly prescribed medications. Pharmacists are rigorously trained to provide treatments to patients.

Furthermore, the bill requires the State Board of Pharmacy and the California Medical Board to create procedures and protocols relating to the furnishing of treatments. These procedures and protocols would include training requirements for pharmacists administering test and treat, and will generate the involvement of a variety of healthcare professionals who can ensure that treatment for common diseases is safe and achievable. For many patients, community pharmacies are their primary access points for health care.

Getting tested and treated directly may often be the fastest way for an individual to get treatment and stop the spread of the disease. Pharmacists can already provide the test for many diseases, so the ability to furnish simple treatments is a natural next step. By giving pharmacists the authority to prescribe treatments after they've tested positive for these five common diseases, the bill reduces burdens for healthcare facilities and expands healthcare accessibility for all Californians.

With me today to testify is Rob Geddes, the pharmacist with Albertsons and Safeway, and Clint Hopkins with Pucci's Pharmacy, or Lindsay Gullahorn with Capitol Advocacy.

Okay, lead witnesses, please step forward.

Good morning, Mr. Chair, Committee Members. My name is Lindsay Gullahorn, here today on behalf of the California Community Pharmacy Coalition, and we are proud to support SB 524. We see this as a practical measure that will authorize pharmacists, who are some of the most readily accessible healthcare providers, for Californians, to quickly, safely, and effectively administer treatments to Californians who may otherwise have to wait to get in to see their primary care provider. There is a shortage of primary care providers in California. Millions of Californians live in areas of the state with healthcare professional shortages and a lack of available primary care providers. And I think we all know this is especially true in the rural parts of the state. On the other hand, the vast majority of Californians live within just a few miles of a community pharmacy. This is where they get their medications, consultations, vaccinations, testing, and a number of other services.

Unfortunately, when a patient has symptoms for conditions like the flu or strep, they have to wait to see their primary care provider to receive treatment. Even though pharmacists can test for these conditions, for many people, getting an appointment can take days or longer. And if their symptoms develop in the evening or over the weekend, as we know they often do, patients face waiting even longer to receive treatment or visiting urgent care, and potentially waiting for hours to get the care they need. SB 524 is a, I think, simple, common sense solution to this problem. It'll give patients the option to visit their local neighborhood pharmacy to receive both testing and treatment in a matter of minutes for just five conditions, Covid, flu, strep, pink eye, and sexually transmitted infections. So we really see this bill as a modest expansion of pharmacist services that will have a dramatic positive impact on access to care and patient health outcomes.

As the Senator mentioned, in 2021, legislation was enacted in California that gave pharmacists the authority to perform CLIA Waived testing. And last year, pharmacists were given the authority, emergency temporary authority, to provide tax livid to patients upon a positive test result for Covid. So this bill simply codifies that authority, narrowly expands it to allow pharmacists to furnish straightforward treatment for four other common conditions. And for this reason, we're proud to support the bill. Thank you.

Thank you. Any other lead witnesses in support?

Hi, my name is Rob Geddes, and I'm with Albertson's companies. I'm the Director of pharmacy, legislative and regulatory affairs. I'm also a pharmacist, and I'm here in strong support of SB 524. This will expand health care access to health care for Californians by allowing pharmacists to directly provide treatment for the five common conditions that both the Senator and Lindsay have outlined. Nearly half the states across the country have, in some capacity, allowed pharmacists to furnish medications related to a test. In these states, they're safely providing services to the patients. As far as Albertsons goes, we do offer these services to patients in states where it is allowed. It has been a great service for those patients in rural healthcare areas, as well as individuals who may not have established care with a primary care provider and are in need of that access point to health care.

Point of care testing and treatment is fast, efficient and safe way to diagnose and care for patients, and pharmacists in California already have experience and authorization to do this under their current scope of practice. For example, pharmacists can administer treatment for HIV via post exposure or preexposure prophylaxis. In addition, during the state of emergency related to Covid-19, pharmacists were able to independently administer Paxlovid to patients who tested positive for Covid. SB 524 is a natural next step to increasing access to pharmacy services for Californians.

Pharmacists provide testing and consultations as well as training and education to patients about drug therapy, disease management and disease prevention. Pharmacists in California also administer immunizations, furnace self administered birth control, nicotine replacement products, and standard travel medications. Pharmacies are one of the most easily accessible healthcare access points for patients. Typically most accessible for patients, more accessible for patients than their primary care providers. This bill does help your constituents in the rural areas, in any areas that are in need of access to health care, and these are treatments that can be furnished via a quick and easy test that pharmacists can be trained and effectively can provide that treatment to those patients. Albertson's companies does stand in favor of this bill and would ask for an aye vote from the Committee. Thank you very much.

Thank you, sir. Any other witnesses in the hearing room in support of this measure? Excuse me? Any other witnesses in support? Let's turn to lead witnesses in opposition. Are there any lead witnesses in opposition? Try to keep the total. If there's more than one, try to keep the total presentation to four minutes.

Good morning, chair and Committee Members. My name is Jassy Grewal, Legislative Director with the United Food and Commercial Workers Western States Council, testifying today with an opposed uness amended position on Senate Bill 524. UFCW represents thousands of pharmacists and pharmacy technicians in the grocery and drug retail settings or otherwise called chain community pharmacies.

SB 524 would significantly expand a pharmacist scope of practice to allow for a test to treat model without any additional protections for pharmacists working in this setting. Our concerns lie squarely in the fact that pharmacists currently do not have adequate staffing to complete their current workload and do not have autonomy over workflow decisions. Pharmacists in the retail setting have been sounding the alarm bells for years about their current working conditions.

These cries for help have been confirmed by a recent workforce survey conducted by the California State Board of Pharmacy, the survey results were alarming. 91% of chain pharmacists said that staffing in their primary work site is not appropriate to ensure adequate patient care. 35% of pharmacists in the chain setting indicated that they have, on average, three to five medication errors in a month and another 45% they said they have one to two medication errors in a month.

That is 80% of chain pharmacists sharing that at least one medication error is happening in a month. Medication errors which can cause severe patient harm and potentially death, the last thing any California patient expects to happen when they leave the pharmacy with a prescription.

Furthermore, 83% of pharmacists said that they do not have time to provide appropriate patient consultations, patient consultations which are the basics of pharmacy, but also the last check to make sure patients are getting the right medication. As it relates to the ancillary services pharmacists provide, 78% of chain pharmacists said that they do not have time to provide adequate screening before the administration of an immunization. The reality is pharmacists who are overworked and understaffed are not able to offer the best patient care to Californians.

It is for these reasons, UFCW is requesting an amendment to SB 524 that would require an additional pharmacist in the pharmacy to provide only the clinical services authorized by this bill. This ensures that pharmacists who are overworked and understaffed on their current workload duties do not need to break workflow to assist patients and offer treatment on the illnesses and conditions which are time extensive under this proposal. This amendment will ensure that pharmacies can provide the highest level of patient care and services delivered by pharmacists whose sole focus will be testing and treating illnesses and conditions under this bill. We appreciate the author's willingness to engage in discussions with UFCW and look forward to receiving feedback on our proposed amendments and updated opposed unless amended position thank you.

Thank you, ma'am. Are there any other individuals who wish to testify in opposition? Name affiliation.

Good morning chair and members. My name is George Sores with the California Medical Association. We do appreciate the Committee staff's analysis on this bill and the author's willingness to meet and discuss our significant concerns on this measure. CMA's concerns are primarily focused on treatments that pharmacists would be allowed to prescribe to individuals at retail pharmacies.

Under this bill, the treatments are too expansive and a one size fits all approach to treating illnesses can be dangerous for our communities. We are aware that this bill has been amended recently to include tests to treat for Covid Influenza, strep throat, sexually transmitted infections and pink eye. However, treatment plans for those illnesses are not always the same, and this Bill does not consider individuals who have preexisting conditions. An individual's primary care physician should not be removed from the treatment process.

Additionally, it is unclear how complicated medical cases would be referred to an appropriate medical provider. This bill would also allow for pharmacists to prescribe antibiotics, which could have far reaching and unintended consequences to the healthcare delivery system. We understand and appreciate the author's intent around access to health care, but this measure would not achieve access. And furthermore, we don't believe that this approach achieves health equity in our most underserved areas.

Our underserved communities deserve to have access to a primary care physician and should not have to rely on getting their health care at a Walgreens or CVS. We look forward to continuing to be part of the solution on access to care, but this measure is not the right approach. Senators, we respectfully ask that you vote no on SB 524 today at the appropriate time. I'm happy to answer any questions from the Committee. Thank you.

Thank you. Any other witnesses in opposition? Name, affiliation and position on the bill.

Thanks, chair members. Tim Madden, representing the California Chapter at the American College of Cardiology in opposition.

Thank you, sir. Any other opposition witnesses?

Ryan Spencer, on behalf of the American College of OBGYN's district nine, in opposition.

Any other opposition witnesses? Let's now move to the teleconference service. Moderator, if you would, please prompt any individuals waiting on the teleconference service to testify in support or opposition to this measure. Senate Bill 524.

Thank you, Mr. Chair. If you are in support or opposition to SB 524, please press one followed by zero. One followed by zero. And we will begin with line 12 you are open.

Short on behalf of Loma Linda University health and support.

Thank you. Next, please.

We have one more reminder there, Mr. Chair. One followed by zero. If you are in support or opposition to SB 524, 524.

And nobody is queuing up at this time.

Thank you. Moderator let's bring the matter back to the dais and my colleagues. Colleagues, questions or comments? Senator Wahab, followed by Senator Alvarado-Gil.

Thank you Chair I do want to say, Senator Caballero, you have always introduced a big focus on rural communities and those that are under served. I will say that staff and I had discussed this Bill, and the big concern is obviously providing more medical providers, doctors in these areas.

But the honest truth is that if it hasn't happened in several years already, knowing that there is underserved communities, this Bill is maybe not exactly what everybody wants, but it is a step in the right direction to provide the needs of these individuals. And it's limited in scope, and these are common things that happen with a lot of people. So I will be supporting this, and I do appreciate your leadership on this. Thank you.

Thank you, Senator. Senator Alvarado-Gil.

Senator, thank you for your presentation today. My conflict with this Bill is around the sexually transmitted infections, and I was wondering if you can say a little bit more about how those tests would be conducted and how the people would be counseled around prevention or mental health in these circumstances.

Thank you very much for that question. The way that the testing that's been approved, in other words, the testing can happen right now if it's a CLIA approved test, which means it's a test that it shows up as a positive or a negative for that specific disease, and so the sexually transmitted diseases show up as a positive or a negative. And once you get that diagnosis, then it's a question of what kind of treatment modality you use in order to get rid of the disease.

And so the pharmacists would have the same opportunity as the doctors to determine the medication that would be approved. And the medication is -drawing a blank here. It's an antibiotic that will start to reduce the disease. And so my expectation is that the pharmacist would take the patient through a series of questions and advise them as to what kind of behavior is risky for that particular disease and what are the conditions under which they should have sex while they're undergoing their treatment.

So it's one of the reasons that we put in the Bill that there would be a protocol that would be established so that everybody's doing the process the same way. And the Bill requires that the pharmacists undergo a training specific to those particular diseases so that they know how that protocol works and what it is that's advisable to recommend to a patient. So it's not, you get to do anything.

Yes, I would certainly agree, and thank you for the explanation. So I think for me, I'm still stuck on this sexually transmitted infections because there is quite a variety of them absent of a full pelvic exam or a health screening or even counseling. And I'm going to focus on women here for a moment.

There would be very structured and educational opportunity, as well as protocols for how to be able to treat the specific sexually transmitted disease because there are a variety of them.

I would be concerned about specific sexually transmitted infections that are lifelong or can then lead to other things, such as cervical cancer. The other thing that concerns me here is with sexually transmitted infections, the assumption is that that person had sex, had intercourse, and with intercourse can come pregnancy. And if there's not a follow up in terms of whether or not the woman is pregnant, there may be danger to the unborn fetus through prescribed medications.

So all in all, this Bill for me is a step in the right direction. But I can't get over the sexually transmitted disease or sexually transmitted infection portion. And I would encourage that aspect to stay within the OBGYN world, not only to protect women, but to protect the unborn child.

Well, I appreciate that. And the only comment I would make is that we're talking about an initial diagnosis. Anytime you go in to see a doctor and you've scheduled an appointment, which has become more and more difficult, I have to say, to do, they're going to end up doing the exam that was originally scheduled. If there is follow up, they will then set up a follow up exam, and it may be with an OBGYN, it may be with a specialist. And so this is not intended to take away all of that from another medical professional.

It's to just deal with the issue that is presented to the pharmacist. Suffice it to say that that exam, that testing for that particular disease would happen at a medical doctor's office, but there would need to be follow up in any case. So in my mind, it's the same. You're not going to get a full pelvic exam unless you go in and that was what the original appointment was for. So I understand your concern, and I appreciate it very much.

Thank you, Senator. Senator Wilk.

Thank you, Mr. Chair. The last time I checked, 16 out of 58 counties had an insufficient ratio of doctors to patients. So I'm always looking for ways to safely expand access to health care for my constituents. And when we hear opposition, I always ask myself, is it because they are concerned for patients, or is it because they're concerned about market share? I'll share a personal story. Took my wife to Italy for our 25th wedding anniversary.

About halfway through, she contracted pink eye, and we were freaking out because we had no idea what we're going to do. We went to a pharmacy. Boom. Immediately subscribed it, addressed it, got rid of it. So this, to me, is a very limited common sense approach to increase access. So I will be supporting your Bill today and happy to make the motion when appropriate.

Thank you, sir.

Thank you, Senator. Senator Ashby.

Yeah. I just wanted to join my colleague from Hayward in first noting that you're a huge champion of access to healthcare in rural areas across the State of California. I can't imagine this state without your leadership in that area. And I can see what you're doing here. It fits right in with the rest of the package of the body of your work this year, which is trying to make sure that people have access. I originally had some concerns.

I know you have been working with the opponents already. Right. Senator, you've already made several changes to limit some things.

Yes. That's the reason it's limited to these five, because there was a very robust discussion and it made sense to me.

Right. I appreciate that you did that. I still have a few questions about it in my own mind that I just want to see how it progresses as you go through here, these various committees. I know you're working really hard on it. What I think is special and important and a little bit different about you is you're working on it across several bills that are trying to do other things, too.

And all of them work towards one goal, which is making sure that rural people in California have access to care. And so I'm definitely going to vote yesterday, give the opportunity to keep working on it and keep moving in concert with the other efforts that you're putting together. That is a much larger package. I also just wanted to express appreciation for the changes that you made that makes it easier to support, and I assume there will be additional changes as you go along. So thank you.

Thank you very much.

Thank you, Senator. Senator Archuleta.

Yes. Thank you, Mr. Chair. I can appreciate your concern about the underserved because you and I both worked on those issues, especially with our community hospitals. So I'm in total agreement that we have to address this. Are we asking these pharmacists for additional training? Are they doing it voluntarily because is it additional training needed, or are they under their license able to do it and it's done, or tell me about the additional training.

That's the whole issue, is that the allegation from the medical profession is they don't have the training. And so to make sure that everybody has consistent and recent training, the Bill requires that they would have to go through a training program to understand what the protocols are so that it would be under their license. They are allowed to do this, but then they have to do the training in order to be able to actually do the work.

So that's the reason for the training in the Bill, is to give them, they go through extensive educational background, to be a pharmacist. And much of the training, much of the education is exactly the same as a medical doctor would get. What's different is the medical doctors go into a practical setting and get trained in a hospital, and that's the residency program. But they have the same background, the same classes, if you will, that a medical doctor has when they graduate from the school.

So the additional training is specific to these diseases and would give them the background they need. And obviously they're pharmacists, right. They understand these drugs, but the background they need to be able to put it together to be able to actually treat.

And I'll be supporting the Bill. Thank you.

Thank you, Senator. Seeing no other questions or comments. Senator, would you like to close?

Thank you very much. I think this has been a really robust discussion. I appreciate it very very much. Just know that I'm working very hard with the opposition. Some of it has been very new, as in Friday, and so I take very seriously their concerns. And this is the First Committee. I expect it's going to change over time to make sure that we take into consideration the issues that have been raised by the opposition. Respectfully ask for your aye vote, too.

Thank you, Senator. We have a motion, motion by Senator Wilk. The motion is do passed to Senate Health. Please call the roll.

[Roll call].

The vote is eight to two. We'll hold the roll open for absent members. Next up, item number five, Senate Bill 785. Senator Caballero, consumer protection ticket sellers.

Thank you very much, Mr. Chair and members. SB 785 would protect consumers, empower athletic teams and artists, and address real issues affecting the live events ticketing systems. The bill would require transparent upfront pricing on all platforms that sell tickets. And this is a consumer protection bill.

Too often, consumers go on platforms and find tickets they think will fit within their budgets, only to find out that at the checkout page that fees must still be added to the order or that the ticket has increased significantly in price. And it's increased significantly in price because of the manipulation of the system so that people believe that the tickets have almost sold out or that the price is going higher and higher, and people need to react immediately in order to be able to buy a ticket, when in reality there's lots more tickets to sell. SB 785 will end the hiding game and force all platforms to list prices up front and that protect consumers so that they know that the price that they see on the platform is the price that they're actually going to pay.

What we found in doing our research and working on this bill is that there are a number of different ways that tickets are sold, and that it goes as far as to a site which allows you to say that you want to buy a ticket, but also they'll finance it so that you don't have to put money up front, but that you owe them. It's like a loan and it's not regulated in any way.

And so the problem with it is that you think you're buying a ticket, but in reality, you're paying like a payday lender type of program when the interest rates or the charge or what you're going to end up paying is not disclosed to you specifically. And so it's kind of the wild, wild west in ticket sales. And who ends up getting hurt are the consumers who think that they need to buy a ticket off a particular site.

And actually, that site may not have the ticket, they're going to get it, but they don't have it, or they end up buying. So it's speculative as to whether they're actually going to get a ticket or not, or they're buying something that's being resold over and over and over again and increasing the price of the ticket.

So what we're trying to do in this bill is to establish some guidelines to protect the consumers and to make it very clear what it is that they're purchasing, how much they're purchasing it from, and not allow scalpers and bots to play games with the system to be able to increase the price of the tickets beyond what it was original.

And you've probably heard some very famous incidents where the ticket sales went within minutes and they went within minutes because the bots have been gaming the system and snatching up tickets and then selling them on a retail market and then ripping off customers. And so this bill, this is the First Committee for the bill, expect it to see some changes over time.

But the whole purpose is to protect consumers and to protect the integrity of the sports teams and the artists that are the ones performing and that aren't seeing the benefit of the pirated tickets going up really high. They don't see the benefit of it. It's middle people that are taking advantage of the situation. So I respectfully ask for your aye vote today. Here to testify is Willie “Prophet” Stiggers with the Black Music Action Coalition and Dan Wall with Live Nation entertainment.

Gentlemen, two minutes each. Please proceed.

Peace. I am Willie “Prophet” Stiggers. I'm the co founder and co chair of the Black Music Action Coalition. I am also here today representing music artist advocacy groups to express our collective and strong support of SB 785. I want to thank all of you for hearing from the artists. There are a lot of people discussing concert tickets and music fans. No one knows and appreciate music fans more than the artists.

We represent those artists, they work very hard with the venues to provide the best live experience to as many fans as possible. Unregulated scalpers and secondary platforms do not care about artists or fans. In fact, they prey on the fans. Scalpers and secondary platforms have been going from state to state promoting thinly disguised legislation that aids scalpers and strips artists from their ability to control their relationship with the fans.

We are thankful for Senator Caballero, who took the time to really understand the issue and sponsor SB 785. This bill empowers artists and protects their fans. Artists and their fans have a special relationship, and the fans are best served when artists have that control. SB 75 recognizes that. SB 75 explicitly protects artists ability to control how their tickets are sold, resold and the technologies that utilizes to keep the prices down. Giving control back to the artists will prevent unregulated scalpers from taking advantage of passionate fans.

These scalpers deceptively procure tickets and then sell them at exorbitant prices. These fans buy from the secondary platforms for these exorbitant prices. None of that value goes back to the artists or the venues. Artists are trying to prevent this price gouging by scalpers. They are using new innovations and technology like face value exchange, where tickets can be sold for the original price. Before exchange of this work, artists must have the ability to attach resale terms and conditions to the tickets.

SB 785 will explicitly protect these rights for artists in California. There is another bill in the California Assembly, AB 8, that incorrectly strips artists of their rights, which will inadvertently benefit the scalpers who make no investment to these artists or venues. SB 75 also bans speculative ticketing and deceptive websites. Scalpers advertise tickets that they don't possess, sometimes before the tickets are even on sale. They use bots to procure tickets and prevent fans from buying the tickets at face value.

SB 785 cleans up the ticketing ecosystem by simply requiring resellers to have possession of the ticket before listing it for sale. Fans will be able to purchase the tickets with confidence. There are other important aspects of the bill, like all in pricing, but I have limited time today, so I want to emphasize it is vital to give artists back the control and prevent unregulated scalpers from gouging fans. Thank you for taking time to listen. On behalf of the artists and their fans, I ask you to support SB 785.

Thank you. Two minutes, please, sir.

Mr. Chair, members of the committee, my name is Dan Wall. I'm the Executive Vice President for corporate and regulatory affairs at Live Nation Entertainment, which is the parent company of Live Nation and Ticketmaster. I'm here today to testify in support of SB 785. We regard it as common sense ticketing reform that will, as Willie just indicated, clean up much of the nefarious activity that we see in the live event ticketing ecosystem.

It's particularly important to protect the rights of the people who create the events, the artists, the teams, and the venues, who should be the ones who are determining the rules for not only the initial ticket sale, but the ticket resale. While there are many provisions of this bill that we support, I want to focus on three. First of all, Live Nation entertainment supports the basic principle that the first price a consumer sees should be the final price that they pay.

That's the so called all in price that includes all fees. For many years, we have advocated for the industry to turn to an all in pricing model, and we're pleased to see that Senator Caballero has included language to this end in this bill. But all-in pricing only works if everyone adopts it, because otherwise the drip price is the one that looks cheapest and it prejudices the honest person. Honesty is punished.

It also requires effective enforcement because we have all in pricing legislation in some other states, New York, for example, and we do not see other resale sites complying with it. So we need all-in pricing legislation, and we need effective enforcement live nation also fully supports the ban on speculative ticketing that Senator Caballero described. This is just an indefensible practice where on other resale sites, not Ticketmaster, sellers will post tickets that they don't have.

They don't have them physically, and they have no right to buy them. It's not like they're seasoned ticket holders that are going to get them someday. They do this to take advantage of the initial enthusiasm around a show and try to get a very high price, which will then they'll go try to cover by sometime between then and the show, buying a ticket, saying, gee, I actually couldn't get you the ticket that you thought you bought. But here, take this one.

Not disclosing that they're making a huge profit on that. There is no justification for that practice. AB 8, which was mentioned, purports to try to regulate it, but in a way that actually preserves the practice. Senator Caballero's bill is what we need. It makes it unlawful under all circumstances. Period, end of sentence. And finally, we fully support the language in this bill that protects the rights of event presenters to manage how tickets are sold, resold and transferred.

We have a serious problem in this country with ticket scalpers and certain resale sites frustrating efforts by artists and sports teams to keep prices reasonable and to have the proceeds of ticket sales go to the artist. Instead, scalpers who are interlopers are making huge profits on the sale. We can give artists tools, technologies, to manage this, tools that artists from Pearl Jam to Eric Church and to many others have utilized.

I'm going to have to ask you to wrap it up, sir.

I will, sir. But there is legislation that the scalping community is seeking all over the country to ban this. Instead, this bill makes it clear that these are the artists' rights. They should be in control, not any ticketing company. Thank you.

Perfect. Thank you. Are there any other witnesses in support of this measure? Name, affiliation and position on the measure only, please. Thank you.

Tim Lynch, on behalf of the Golden State warriors, and we're in support of the bill. Thank you.

Next, please.

Alex Torres with the Bay Area Council, representing 300 employers, from the sports teams to independent venues, in support.

Thank you. Next, please.

Thank you. Melissa Cortez. On behalf of the San Francisco 49 ers in support.

Good morning. Silvio Ferrari on behalf of the National Football League, in support.

Thank you. Next, please.

Thank you. Any other support witnesses in the room? Okay, now let's hear from any witnesses lead witnesses in opposition. Are there any lead witnesses in opposition in the room? Okay, since there are two of you, let's see if we can try this again. Two minutes each.

Thank you. My name is Brian Hess. I'm the Executive Director of Sports Fan Coalition. We're a national nonprofit dedicated to preserving the rights of fans wherever public policy impacts the games we love. That includes advocating for equal pay for women athletes, problem gambling protections for those at risk of addiction, as well as ticketing rights for consumers. Thank you for the opportunity to testify on 785 and how it negatively impacts the fan experience. While 785 is well intentioned, it falls short in protecting consumers and will only exacerbate the issues fans are seeing in their ticket buying experience.

The bill regulates one side of the marketplace most concerning. The bill preserves an existing exemption in statute for primary contractors such as Ticketmaster or AXS, which raises the question whether the new provisions of 785 even apply to them. This would include provisions inquiring retailers to disclose the tickets all in price, creating two different consumer experiences which will lead to confusion and consumer harm.

Secondly, 785 proposes to codify the ability of event presenters to unilaterally set terms and conditions that exert total control over consumers rights once the ticket is obtained, included after purchase. Unfortunately, consumers have no bargaining power or ability to influence these terms, which are often unfair and used to limit consumer choice and stifle competition. Sadly, we've seen many examples of consumers being used as pawns by event presenters and original ticket sellers in their effort to ingrain existing monopolies and exercise control of tickets that have already been purchased. In 2019, media reported that hundreds of customers that purchased legitimate tickets for an event at the Wiltern Theater in LA were denied admission to the event solely because they had purchased tickets on secondary ticket marketplaces. Imagine that happening on the scale of a Sacramento Kings game.

Unfortunately, this provision fortifies the ability of our presenters to act in this manner. Perhaps what is most telling with respect to 785 is what's missing from it. State and national consumer groups have called for increased transparency about tickets and how they're allocated and distributed to consumers. Yet 785 includes no new transparency requirements for event organizers or primary ticket sellers. It's also concerning that 785 provides event presenters and original ticket sellers a private right of action against their competitors, essentially privatizing enforcement, but fails to give that same express right to consumers. It is particularly egregious oversight in a legal environment. While Live Nation Entertainment and its subsidiary Ticketmaster are utilizing mandatory arbitration provisions in their terms and conditions to force consumer based lawsuits into arbitration.

If you truly want to protect fans, you should consider introducing and passing our model ticket buyer Bill of Rights, which was included in your committee report today. In the wake of a disturbing trend of poor fan experiences during the ticket buying process, Sports Fans Coalition, the National Consumers League, Consumer Federation of America, Fan Freedom, Consumer Action, Public Knowledge, and the National Association of Consumer Advocates developed a set of principles to protect fans known as the ticket buyer Bill of Rights.

These include the right to transferability, the right to transparency, the right to set the price, the right to a fair marketplace, and the right to recourse. We are all familiar with the adage, what's good for the goose is good for the gander. Well, this bill flips that on its head and says, what's bad for the goose is good for the gander. Our ticket buyer Bill of Rights, on the other hand, prioritizes consumers and equally regulates both sides of the industry. It shifts the balance of control from the ticket sellers to the ticket buyers and calls for heightened transparency across the entire industry. I encourage you to consider these consumer protections before moving forward with the bill. Thank you.

Thank you, sir. Next, please.

Thank you, Mr. Chair and members. Ignacio Hernandez, on behalf of the Consumer Federation of California in opposition. I'm going to adjust my comments a little bit based on the prior. Let me just mention the consumer Federation of California. When we come at this issue, we recognize that the ticket ecosystem needs some major overhaul. We've seen that over the last few years. We've seen so many problems, and in particular, we need to focus on what's going to be best for the individual consumer.

There are a couple of provisions in here that have some merit that still need work, but we are concerned that the balance of the bill, the overwhelming majority of the bill, is focused on not imposing certain requirements on the original sellers of tickets. The committee analysis has made clear, for example, that the requirement that the seller of a ticket indicates a specific seat where in the venue, the map, all that information that is critical for consumers.

The requirement to provide that information is only on a reseller and not on the original ticket seller. That is a major gap that needs to be addressed. There are a number of other gaps that the committee analysis rightly points out, rightly points out that are only imposing requirements on resellers and not on the original ticket sellers. We need to see the same type of requirements on original sellers, and then we can have a much better discussion on the bill.

Let me point out that the author I have a lot of respect for, worked on bills and worked out amendments with her over the years, pointed out about the financing. Let's keep in mind, I believe, as I understand this bill, current practices, that there are original sellers that do say buy now, pay later, and that this bill would not have any kind of mandates or regulations on that practice. So we see a lot of gaps here in this bill.

We see a little bit too much of a thumb on the scale for original sellers. We think those issues need to be addressed before it should be supported and always willing to sit down, talk with the author going forward. Thank you.

Thank you, sir. Any other opposition witnesses in the hearing room? Name, affiliation, position on the measure, please?

Mr. Chairman and members Courtney Jensen, on behalf of Seatgeek and tickpick in opposition.

Thank you. Next, please.

Hello, my name is Sean Auyash on behalf of Stubhub, headquartered here in California and New York City. We are opposed unless amended. Our concerns align with many of the issues raised in the Committee analysis. We look forward to working with the Committee and the author on language that treats all ticket sellers equally, as well as incorporating other meaningful consumer protections mentioned by the prior.

Thank you, sir. Next, please.

Good morning. Andrea Deveau on behalf of vivid seats, we'll just align ourselves with the comments made previously opposed unless amended.

Thank you. Any other opposition witnesses in the room? Let's now move to the teleconference service. Moderator, if you would, please prompt. Anyone on the teleconference service who wishes to testify in support or opposition to this measure will take them now.

Thank you. Mr. Chair, if you are in support or opposition to SB 785, please take this opportunity and press one, followed by zero. One followed by zero. We'll begin today with line nine. You are open.

My name is John Breyault, and I am the Vice President of public policy, telecommunications and fraud with the National Consumers League. NCl respectfully opposes SB 785.

Next, we are going to go to line 19. You are open. Line 19.

In opposition of SB 785.

Thank you. Next, please.

Thank you. Line 22, please. Go ahead.

Good afternoon. President, Fan Freedom Project, in opposition.

Thank you. Next, please.

Line 38, you are open.

Mr. Chair Members Shane Gusman, on behalf of Sagaftra, the Screen Actors Guild, American Federation of Television and Radio Artists in support.

Thank you. Next, please.

Line 27, please. Go ahead.

Good morning, Mr. Chair and members of the committee. Victoria Von Feliski from access tickets registering our strong support for this bill and thanks capital for her leadership.

Thank you. Next, please.

Line 42, you are open.

This is Aaron Whitty I'm the Director of Consumer Protection for Consumer Federation of America, and CFA opposes this Bill. Thank you.

And we'll give one more reminder here. If you are in support or opposition, please press one followed by zero at this time. And that is Bill SB 785. Line 46, please. Go ahead,

Mr. Chairman. My name is Bruce Morris, Director of government affairs for Ticket Network, strong opposition to this bill.

Thank you. Next, please.

Mr. Chair. We have cleared the queue.

Thank you very much. Let's bring the discussion back to my colleagues on the dais colleagues questions, comments, Senator Niello followed by Senator Becker.

Thank you, Mr. Chair. For reasons that have been articulated, but from a personal perspective, especially because of the provision of private right of action, I can't support this bill as it exists. But I know that the good Senator is a collaborator and I know this bill is going to change. So for that reason, I'm just going to lay off.

Thank you.

Thank you, sir. Senator Becker?

Yeah. I was just going to say I appreciate you tackling this issue, and obviously, it's very important and complicated and a lot of comments. I do appreciate the approach where performers and teams are going to have control over the ticketing, and the people who make the product will have control, and I appreciate that. Again, I know there's all in pricing and a lot of things you mentioned, so I know there's a lot to work through, but I will be supporting the bill today and look forward to continued discussions.

Thank you very much.

Thank you, Senator. Senator Ashby.

So let me just start with the serious part, which is I know you're working really hard on this bill, and I know you have opposition that you're still working with. So, again, First Committee, I know it'll look different next time we see it, and I know you. You'll work hard on addressing their problems. I was prepared to vote yes on this today when I came in until I heard the warriors support it.

And now every bit of my Sacramento King's heart is like, why would I do that? You guys are with me on this, right? Sacramento people in the room. Okay. That's making me feel a little bit better. If you cheer for the kings tonight, maybe. Okay. All right. Better.

Senator Alvarado-Gil.

I will say that I'm one of those consumers that gets discouraged because I look forward to seeing my favorite artist or going to a sports event and not being in the first five or 15 minutes and being blown out of the water to be able to purchase something. So I abhor the bots and the whole system that you're looking to help regulate. I really commend you on, because as a consumer, it's very frustrating to be lost in this labyrinth.

The question that I have, and this is for clarification, is speaking on the note or the point of the opposition. Why is there the differentiation between the original sellers, ticket resellers, ticket marketplaces, event presenters? Like, why the secondary but not the primary market?

Not sure I understand the question, but let me just say that the Ticket Buyer Bill of Rights was identified. And there's almost nothing on that that doesn't make sense to me. In other words, it's a question of writing it up and getting everybody to agree that it's the direction we should go in.

Let me just say that the original ticket sellers are the ones that are going to get the tickets, and the bots are being used to buy up these big blocks, and then they end up on some of the other platforms. And so there's this competition, and the competition is what you saw here today. It's that we want to have a seat at the table. Yeah, but you didn't get the tickets originally, right?

So it's part of the challenge of trying to figure out how do we do this so that there is protection for the consumer. So when you go on, you know that you're buying from an original site and there are URLs that also are very similar, but don't really have access to the tickets and are going to try to buy them off the secondary market. So what it's doing is inflating the cost for everything. And so the question becomes, where do we cut it off?

So that, where do we say the tickets should reside? So that, you know you're getting the ticket and that you're getting the all in pricing. It's going to force some of the models to change out of existence because it's a scam, is really what it is.

It's some sites that are saying they have tickets, but they don't have tickets, and they're going to see if they can get the tickets, and so they're putting them up for sale and people are sending them money or signing a loan document that now requires them to pay them a whole heck of a lot of money for tickets that nobody has, the site doesn't have, and the purchaser may never get.

They may get a ticket, but it may not be the one they wanted or even close to where they wanted to sit. And so the challenge is where do you make the line so that you can't do it, you can't utilize an illegal system? The bots, if this bill passes, becomes an illegal system. Right now, it's part of the ecosystem and there's nothing you can do about it. And it's a frustrating experience, as you said.

Indeed. Thank you.

Sir Wahab.

Thank you. So I'm a person who does enjoy going to concerts, and obviously we want to see the legends kind of play. It has been very problematic purchasing tickets just for an average person who can't compete with the bots, can't purchase one if their high speed Internet doesn't hit that market. And it's not just concert tickets and gaming events, but it's also, as Senator Ashby and I were chatting, you know, shoes, sneakers, things like that. I think all of us know when the latest kicks kind of drop.

You can't compete, right? You know, I'm always a little thrown off when there's a lot of advocates in the room that are supporting this bill from the institutions that do break down these bills. You pay for your parking separately when it's sent via email to your phone, you pay for a convenience charge. You just keep paying for way too many things, right? Things that 10 years ago you didn't have to pay for.

And so that is always my concern when folks come in talking about this, I just wanted to understand a little bit more as to the Ticket Buyer Bill of Rights that was referenced, and obviously in the analysis. How does your bill incorporate some of their concerns, and then potentially, how do you plan on incorporating future concerns?

Well, there are a number of things. The Ticket Buyer Bill of rights, and I don't have a copy of that in front of me, but I have the analysis. So all in upfront pricing, no price fees at checkout? Well, that's part of the bill, mandating primary ticket selling companies to report all ticket bought activity to the appropriate authorities. Frankly, don't remember if that's in the bill or not, but we've made it illegal.

And so if reporting is required or if reporting is something that the primary company can do, then by all means. I'm not familiar with how bots operate, but that's one of the things that's kind of a no brainer. Clear and conspicuous disclosure, when a ticket seller does not have a ticket in their possession or a contractual right, that's part of the bill. Some of these may not be part of the bill, but could be included very easily, like a guarantee of unrestricted transfer of all tickets.

If you buy a ticket and you can't go in the end and you want to give it to your family member or sell it to a family member because you're cheap, then there shouldn't be any restriction on that either. I don't think we address that in the bill, but it's certainly something that I would agree with. Prohibition on deceptive URLs and other fraudulent reseller practice. That's the bill. So the point is that I think we're pretty close.

It's just a question of figuring out some of the language that's going to be necessary in order to make sure that we're really protecting consumer. My goal, as I said at the beginning, is to protect consumers. And so it's disturbing to me to have consumer organizations not supporting it. But I think we can get there eventually. They may just think I need to go further, so we need to talk.

I will also say one of the things that the reason why this bill, it's important, and I think that it's running rampant across, as I said, in multiple different arenas. One of the things that I always love this argument and slightly disagree with it is when they say that it further limits competition. We hear that often when we talk about the free market, and it's not accurate because there has to be some safeguards specifically for people, and the opponents of this bill kind of highlight that.

But the reality is that because of bots being in play, because there are resellers that are buying this and have the time at 10:00 a.m. on a Friday or special privileges that they can purchase the tickets ahead, they're actually jacking up the price. Is there any provision in this bill that states for reporting in particular when, let's say you have an arena, you have 1000 seats, supposedly it's sold out, but only 500 people showed up.

Or are there any type of reporting mechanisms to be a little bit more transparent as to what is going on, how many people really showed up and anything like that?

What's the interest that you're trying to protect?

Specifically, because the tickets are being fakely sold or like at $1,000, like Beyonce tickets, Madonna tickets, all the people that we should be paying max 250 for, they're being resold and resold and resold, right. So I just kind of wanted to understand a little bit, like is there transparency as to, yes, we had 1000 seats. It was only to capacity at 12%. And when we're talking about reporting and kind of potentially getting more data to kind of curb this behavior.

So, the reason I asked the question is because there's reporting ahead of time, what's going on with the ticket sales, and then there's reporting afterwards. What I understand is that there are many times that artists will maintain control of some of the tickets because they have altruistic motives in terms of how they're going to distribute those tickets. They may give them to a boys and girls club and say, you can raise money selling these tickets.

Or what they do is they bring in a group and say, you're in for free. And so part of the transparency is after the fact, transparency becomes real easy because then you can say, here's what we did with the tickets.

And in that situation, if 500 tickets were sold out of 1000 and the rest didn't sell, the team that has the game that's going to be played or the artist now has no control over those tickets because they've been sold on a secondary market, but there's no buyer for them. In other words, they've been jacked up so high that people can't afford them anymore. And so now all of a sudden they don't have control over their own tickets anymore.

And that's part of the problem is that the way the system has been set up, the artist loses their ability to be able to control what's happening with the fan experience. And absolutely the last thing they want is to do a concert and then find out that half the venue is empty because they got jacked up so much. And so that's part of what we're trying to avoid here.

Okay. And Senator, I will be supporting this in this Committee. I obviously have concerns because I care to your point as well, about the consumer in particular. And I think that you are definitely in the right direction. And I hope that eventually there can be an agreement on both ends. But I do just want to say I appreciate your efforts on this. And this is actually a real problem for people who want to enjoy their lives and family members and have experiences. So thank you.

Thank you very much.

Thank you, Senator. Senator Wilk.

Thank you, Mr. Chair. Thank you for taking on this very important and complicated issue, because it's something that cries out for reform. Going through the bills, one of the challenges I see with it is that it's not a level playing field. You're not treating all actors the same. Live Nation came up here and was crying poor. They control Ticketmaster, Live Nation, 90% of the live entertainment market, and they have the Ticketmaster resale. They play in the secondary market as well.

And from everything I've read, they get the tickets before anybody else does. So I'm going to lay off the bill today only because, I have serious concerns with the bill, but I trust you and hopefully we get there. Again, my staff pulled out some figures last year on secondary market. Consumers paid $4.5 billion. That's $4.5 billion that should have been in their pockets and instead went to wherever, but it's not right. Cries out for reform, and I'm hoping you get there.

Thank you. Appreciate it.

Thank you, Senator. Senator, I will be supporting the bill to give you an opportunity to continue to work on this. We had a very good conversation. I was able to express to you the view that I thought the bill, frankly, strikes original seller from language that prior to this bill, if enacted, exists. So I think there is some value in taking a look at putting at reinserting the phrase original seller in some of the provisions of your bill.

We discussed the penalties and the amount of the penalties and the application of the penalties as the bill provides. I think that you need to take a look at that. I think with respect to the civil action, we discussed the concept of prevailing party with regard to the recovery of attorneys fees and costs in order to give the civil action and the recovery some balance, among other things.

And I know you'll take a look at those issues and the other ones we discussed, and I look forward to seeing the product at the end. With that, would you like to close? Senator Dodd?

I am so sorry, Chairman. I just won't speak. That's fine. I'm okay with that.

We'll talk afterwards.

Well, I guess just real quickly, I bought four tickets last night to the game tonight and the Ticketmaster, I'm a co-author of this Bill and I'm okay with it. I'm going to support it today. But I'll tell you, to Senator Wilk's point, it's not a level playing field as I get charged $800 for extra fees over exorbitant. Now look at supply and demand. I decide to buy them. Great. So I'm all in. But this just kind of hit home this morning here on this issue, as I listen to some of the opposition.

Go kings. I forget, did I ask you, Senator Caballero, would you like to close?

I really appreciate all the discussion. I appreciate the attention paid to this bill. This was going to be a very simple bill, and I got into it, and it's one of those things that you realize is much more complicated. I'm interested in protecting the consumer, having a good consumer experience, but I also want to be fair. And so my commitment is I'll continue to work on the bill.

Thank you, Senator. I'm certain we have a motion somewhere on the bill. Colleagues, Senator Ashby moves the bill. The motion is due pass to Senate Judiciary. Please call the roll.

[Roll call]

The vote is five to one. We'll keep the roll open for absent Members.

Thank you very much, Mr. Chair.

We're going to take pause.

Let's open roll on- While we're waiting on our next author, let's open the roll on items we've already voted on. Item number one, Senate Bill 285, Senator Allen. Current vote is eight to zero. Chair voting aye.

[Roll call]

Vote is nine to one. We'll hold the roll open for absent members. Let's go to item number four, Senate Bill 524. Current vote is eight to two. Chair voting aye.

[Roll Call]

Current vote is nine to two. We'll hold the roll open for absent members. Item number five, Senate Bill 785, Senator Caballero. Current vote is five to one.

[Roll Call]

Vote remains five to one. We'll hold the row open for absent members. And the last item is item number 10, Senate Bill 820. Current vote is six to zero. Chair voting aye.

[Roll Call]

Current vote, eight to zero. Hold the roll open for absent members. Item number two. Senator Atkins, floor is yours. Senate Bill 447.

Chairman, please forgive me for coming in the back door. I was trying to get here quickly. I should not have done that. And thank you, Chairman and colleagues. I am here and appreciate the opportunity to present SB 447. This bill would lift the travel ban and create in its place the bridge project, which would be used to promote nonpartisan marketing in other states that would emphasize the value of inclusion and acceptance of the LGBTQ plus community.

The travel ban, AB 1887 from 2016, was certainly well meaning. I know that I surely meant well when I voted for it twice in the Assembly, but things have changed significantly and I believe a different approach is warranted. It's important that we acknowledge the meaningful impact the ban has had, particularly in the early days of its implementation. AB 1887 helped raise awareness regarding LGBTQ discrimination. It even gave states like North Carolina and Georgia some pause about their discriminatory laws.

Unfortunately, since the travel ban's passage, states have continued to enact discriminatory laws, and the list of banned states has grown to 23. In many instances, the travel ban has inadvertently caused California to isolate our own services and citizens in a time when we are leading the nation in ensuring inclusivity and freedoms. Researchers, many of whom are seeking to better understand the discrimination in states subject to the travel ban, are unable to travel to states on the banned list with state funds.

To continue their important research, several state University athletic programs have had to adjust to AB 1887 securing private funds for out of state travel. Banning travel to these states could jeopardize opportunities for intercollegiate athletes to compete in games that determine post season eligibility. And then there's the impact on California's efforts to be a beacon of reproductive freedom and help those in other states obtain care.

Last year, with reproductive rights facing unprecedented threats and the rollback of Roe v. Wade, we had to explore and take swift action to ensure that Californians and all who need to come here could continue to get the critical care that they need. One thing we discovered was that while we could pay for people's plane tickets to California, we couldn't pay for their tickets to go home because of the travel ban. SB 447 rethinks our approach.

It would lift the current travel ban and put in its place the bridge project. The bridge project would be a new program within the governor's Office of Business and Economic Development, or GO-Biz, to encourage acceptance of the LGBTQ-plus community. The intent of the bridge project campaign is to target audiences in states that have established discriminatory laws with compelling messaging regarding antidiscrimination issues that we know the LGBTQ-plus community are facing in real-time.

One thing that is really important to note, the bill prohibits bridge project marketing campaigns from promoting a political purpose or featuring any elected official or candidate for elected office. It would focus on issues, not politics or politicians. This is not about gaining a political edge or promoting a political purpose. It's about people and helping us connect with one another.

Despite our differences, I've had several positive conversations with other legislators and advocates who actually supported AB 1887, who agree it might be time to lift the ban and replace it with a different approach. These discussions are ongoing, and I look forward to working with stakeholders as the bill moves through the process. And again, we call this bridge project.

We call it that because we need to build bridges with good people in other states and we need to help build bridges that reach all those in the LGBTQ plus community in other states who are looking for hope and a path that they can follow safely and in real equality. So SB 447 is a positive approach and a positive tool that I think we need. I respectfully ask for your aye vote.

Thank you, Senator. Are there any lead witnesses in support of this measure?

Yes, Mr. Chairman, if I might, I have John Perez, UC Regent, speaker emeritus, of course, of the Assembly, and Craig Pulsifer, who is a Legislative Director for Equality California.

Speaker emeritus, please proceed.

Thank you, General Chairman. Committee, it is great to be back here with you. It's nice to be in the Senate supporting such a wonderful piece of legislation. As a region of the University of California, we respect the goals behind AB 1887 and the initial travel ban, but think the time is right to change course, and SB 447 addresses exactly the right issues. The travel ban has created a range of challenges for us.

University personnel have to make difficult decisions to avoid student, faculty, and staff travel to targeted states even when their professional or academic pursuits necessitate that travel. This has led to bureaucratic shell games, with extraneous efforts being made to ensure that even the most basic costs are not covered by state funds. The University is aware of circumstances where the University could pay for a prospective faculty member to be recruited to come to California as we tried to bring them into our employ.

Yet we could only pay for them to return to adjacent states because the recruit's home state was on a banned list. In 2021, when UCLA qualified for the Sweet 16 being held in Memphis that year, UCLA's men's basketball leadership had to locate non-state funds and noted that they would not deny any student-athlete the right to participate in postseason play. But not every athletic program has the ability to find those nonstate resources.

Similarly, numerous students and faculty had had learning and advancement opportunities curtailed by the ban, and not all faculty and students have been able to raise or access private, non-state funds to effectuate the travel that was important for their advancement or research. SB 447 would allow our University to continue their important work while providing for a way to reach into states who've passed cruel anti-LGBTQ laws with a strong message of inclusion and support. And I would note, as the author of the legislation creating GO-Biz that I think the bridge project really does have a proper home within GO-Biz. I urge your support.

Thank you, sir. Next lead witness in support.

Good afternoon, Chair and members. Craig Pulsipher on behalf of Equality California. I'm very proud to be here today in support of SB 447. As you all know, we're seeing attacks on the LGBTQ community across this country like we've never seen before. Right-wing politicians and extremists are demonizing Trans people, in particular, for political gain and threatening even their very right to exist.

In 2016, Equality California was proud to cosponsor AB 1887 by Assemblymember Evan Low, which banned nonessential state-funded travel to states that discriminate against LGBTQ people. California's travel ban served an important purpose, sending a clear message that taxpayer dollars would not be used to fund bigotry and hatred. But the sad reality is that anti-LGBTQ legislation is continuing to spread across this country at a pace like we've never seen.

According to the ACLU, more than 400 anti-LGBTQ bills have been introduced in legislatures this year alone, the majority of which target Trans people, in particular, their right to access life-saving medical care. It's time for a shift in strategy to be even more proactive and vocal about combating anti-LGBTQ hate in states with these bigoted and discriminatory laws.

We are appreciative of pro tem Atkins for bringing this Bill forward, which will repeal the state's travel ban and establish a new program to spread inclusive messaging in states with anti-LGBTQ laws. At a time when our community is quite literally under attack, being on offense and proactively combating hate is now more important than ever. And I respectfully urge your aye vote.

Thank you, sir. Are there any other witnesses in support in the hearing room? Step forward. Name, affiliation, and position on the measure, please.

Good afternoon, Mr. Chair. Satinder Malhi here on behalf of the California State University, in support.

Thank you. Thank you, sir. Any other support witnesses? Now let's turn to any lead witnesses in opposition. Are there any lead witnesses in opposition in the hearing room? Any other opposition witnesses in the hearing room? Seeing none, let's move to the teleconference service. Moderator, if you would, please prompt any individuals waiting to testify in support or opposition to Senate Bill 447, we'll move forward with them.

Thank you, Mr. Chair. If you are in support or opposition to SB 447, please press one followed by zero at this time. One followed by zero. Give another reminder if you are in support or opposition to SB 44 7, go ahead and hit one zero. And nobody is queuing up, Mr. Chair.

Thank you, Moderator. Let's bring the discussion back to my colleagues on the dais. Colleagues, any questions or comments? Does that mean you have a question, Archuleta?

I do.

Please proceed. Please proceed.

Thank you. Thank you, Madam Pro Temp, for bringing this forward. California is always trying to be first. We're always trying to promote our equality, our opportunities, and to bring people in to California. I think this bill will reach out across other states and know we will welcome you. We will bring in the bright minds that are out there, regardless of your background or your beliefs. And I think it's a great Bill for equality, and I will definitely support it. And I thank you once again for bringing it forward.

Thank you, Senator. Senator Wahab.

Thank you. Thank you for this. I do just want to highlight that over the course of several weeks now, not only years, we've not only seen the attack against the LGBTQ community but also women's rights, including this past week. It is very important to be proactive, as was mentioned, and kind of see what else can we do to kind of help support activists that are really actually trying to do the job that we in California kind of almost sometimes forget about. Right? Because we're very privileged here in this state. So I really want to thank you for your leadership, and I'll move the Bill when appropriate. Thank you.

Thank you, Senator. Senator Atkins, would you like to close?

I appreciate your time and thank you for the support. And while obviously this talks about the LGBTQ-plus community, there's no room for hate anywhere. And I think we can do a campaign. I will bespeak my age here, but the kind of campaign I envision, those of you who remember it was a Coca-Cola commercial. But I still to this day, think of I'd like to teach the world to sing and live in perfect harmony. I mean, that is really what I'm trying to accomplish here. Regardless of where you are on a political spectrum or your personal beliefs, I think there is room for all of us to coexist, and I think this is a more positive step. I appreciate your support. Ask for an aye vote.

Thank you, Senator. The bill has been moved by Senator Wahab. The motion is do passed to the Senate Appropriations Committee. Please call the roll.

[Roll Call]

Vote is six to two. Will hold the roll open for absent members. Senator Wilk, would you like to present your bill? Senator Dodd has three bills. I thought I'd give you the opportunity.

I thought you might be shorter.

Yeah. Hopefully this is a very simple bill, as the late, great Wykowski used to say. Anyway, thank you, Mr. Chair and Members, I present to you SB 829, which will take a small step in protecting consumers from the monopoly that Congress mistakenly allowed when approving the Ticketmaster Live Nation merger in 2010. Artists from Taylor Swift to Depeche Mode have expressed outrage at the Ticketmaster Live Nation business model that has overcharged fans or completely slammed the door of fans seeing their favorite artists.

According to the Senate Judiciary Committee, Ticketmaster Live Nation has as much as 90% of the live entertainment market. In order to have access to Live Nation's entertainment roster, venues are forced to sign exclusivity agreements. In return, those venues receive a kickback from Ticketmaster. Obviously, these costs are passed on to fans through Ticketmaster's outrageously high ticket service fees. Where's Senator Dodd when you need him? SB 829 will prohibit exclusivity clauses and contracts between a primary ticket seller and an entertainment venue in the State of California.

SB 829 is based on a legislative proposal going through the New York State Legislature. Ticketmaster Live Nation has already signed a stipulated agreement with the government of Ireland to end the practice. Teddy Roosevelt said, "where a trust becomes a monopoly, the state has an immediate right to interfere". SB 829 is a modest reform that will hopefully provide some economic relief for our constituents from monolithic corporate greed. And with that, I respect an aye vote.

I did have some primary witnesses, but they are a victim of Coachella. They were not on the flight this morning, so no primary witnesses at this time.

Well, let's ask if there are any witnesses in the hearing room in support of this measure.

Hi. Brian Hess, Sports Fans Coalition. Strong support of his bill.

Thank you, sir. Any other witnesses in support? Let's turn to any lead witnesses in opposition? Any lead witnesses in opposition to this measure in the hearing room? Any witnesses in opposition to this measure in the hearing room? Seeing none, let's move to the teleconference service. Moderator, if you would, please prompt any individuals waiting to testify, either in support or in opposition to this measure, we'll take them.

To provide public comment, in support or opposition to SB 829, please press one, then zero at this time. And we have no comments. Perfect. Thank you, Mr. Moderator. Bring the matter back to the dais and my colleagues. Colleagues, any questions or comments? Seeing none. Senator Wilk, would you like to close?

Sure. They didn't testify today. There is some opposition. I think they didn't testify because we've had really good discussions. Again, I'm not looking to put anybody out of business. I'm just looking for a level playing field and for consumers to get the best price possible. I will continue to work with them and strengthen the area that they're concerned about. And with that, I respectfully ask for an aye vote.

Thank you, Senator. The bill has been moved by Senator Dodd. The motion is due passed to Senate Judiciary. Please call the roll.

[Roll Call]

Bill has eight votes. We'll hold the roll open for absent Members. Senator Dodd will be presenting three bills. He will be presenting for Senator Gonzalez. Item number three, Senate Bill 517. And we will start with that one.

Mr. Chair, with all due respect, could I start with SB 667? Because we have witnesses that have to leave.

We can start with whatever you'd like. Item number eight, Senate Bill 667 by Senator Dodd, healing arts.

Thank you very much, Mr. Chair and members. I would like to begin by thanking you and your staff for their hard work on the bill, and I'll be accepting the Committee's recommended amendments beginning on page 12 of the analysis. SB 667 builds upon legislation I authored in 2020 that removed physician supervision requirements for certified nurse midwives, that's CNMs, and established parameters for collaborative care and transfer for moderate and high-risk pregnancies.

Since this passage, unnecessary restrictions have come to light that limit the potential for certified nurse midwives to care for patients at the full extent of their training and education. In the face of persistent maternity deserts and OBGYN shortages statewide, it is critical that we continue to address barriers that limit access to highly qualified, qualified providers. The bill will reduce the redundancies in existing law and expand upon the ability of certified nurse midwives.

Altogether, the changes that are made have the potential to significantly improve access to maternity care and midwifery, particularly in rural communities and areas where CNMs might seek to open up birth centers. Lastly, I'd like to highlight that the bill before you today represents a significant work in collaboration with the stakeholders that began before the bill was even introduced, and I'm committed to continuing to work through all the remaining issues and concerns as the bill moves forward. With me today to speak in support of the measure is Holly Smith, policy chair for the Certified Nurse Midwives Association, and Dr. Zoe Tilton.

Please step forward.

Chair Roth and Committee, thank you for having me today. My name is Holly Smith and I have been a nurse midwife for 23 years and have been doing public health policy for the last 10 years. And I am also the health policy chair for the California Nurse-Midwives Association. Thank you also to Senator Dodd for carrying this bill and working to finish up what we started in 2020 with SB 1237. SB 1237 was a landmark bill for nurse-midwives in California.

The intent, as you know, was to create independent practice for nurse-midwives so that cnms could fill geographic access gaps, improve outcomes for birthing people who need it most, and help to close the racial disparity gap for maternal mortality and morbidity in California. And thanks to this committee and the Legislature, I have never been prouder to say that the decision to enact SB 1237 is working.

I field regular calls from cnms who are making the most out of this new law and opening practices across the state. But now, in our third year since enactment of that law, we have had ample time to hear from our members about remaining barriers, some of which put new burdens on patients. I have personally heard from CNMs in far northern counties, the North Bay, Sacramento area, Central Coast, La, Inland Empire, Antelope Valley, and San Diego, and others who are trying to utilize the new law but are running into challenges. For example, CNMs can only send someone out on disability during limited times in their pregnancy. But there are clear examples of normal events during the course of pregnancy that require some time off of work.

When a CNM cannot certify disability for something within their scope, this puts the burden on the patient to find a doctor, explain the issue again to someone new, pay an additional copay, or find childcare in the process, and of course, waste time. This doesn't make sense and SB 667 corrects this. Another example to collaborate on the care of a moderate-risk patient, meaning a patient outside of our defined low-risk scope, CNMs and physicians have to sign two agreements.

This wasn't really intended by SB 1237, but is how the law has bore out. This is confusing to CNMs and doctors alike. This bill keeps all of the same safeguards, but does so through one signed, mutually agreed upon policy and protocol. CNMs also need the ability to prescribe pain medications in very limited instances and in limited quantities. Imagine if you are a person who has seen a nurse midwife your entire course of care.

Can you imagine being in pain the first or second day after an uncomplicated delivery of your third child but now need to find a physician to treat your pain or incur the cost and time of dragging yourself and your new baby to the urgent care or the emergency room for something that easily could have been solved by your midwife. Other states have figured this out, and I believe California can as well.

Finally, to see patients and to make appropriate treatment and care management decisions, CNMs need the ability to perform and interpret a small number of laboratory tests that are within our scope. In fact, SB 1237 did address this to some degree. But as the laboratory code in California still stands, you or I could pick up a pregnancy test at CVS, for example, and interpret the result.

But a CNM who owns a birth center cannot do that in the course of patient care unless they have a physician lab director. Nor can they do simple microscopy to diagnose something like whether a person's bag of water has broken, which, of course, is a key part of diagnosing labor and managing labor. These arbitrary rules are contrary to the goal of expanded access. Removing these barriers will allow CNMs to practice as envisioned by this Committee and the Legislature in passing our law in 2020. Thank you, and I respectfully ask for your aye vote.

Thank you. Next, please.

Good afternoon, Chairman and Senators. I'm Dr. Zoe Tilton. I've been practicing OBGYN for 30 years, including most of that time in Davis and Sutter in Sacramento. I support the provisions of SB 667, which expand certified nurse-midwives ability to provide care for common gynecologic conditions within their scope and training, prescribe medications, order lab tests, authorize medical disability, and to continue care for moderate-risk women during labor within a model of collaboration with a physician.

As SB 1237 in 2020 intended, a specific example occurs with disability certification. Women are impacted negatively when they need temporary time off during the course of an otherwise normal pregnancy, like severe nausea and vomiting. But the nurse midwife cannot authorize their disability. This means that in some cases, the patient has to hunt for a physician while in the midst of their discomfort, potentially delaying what they're meeting their need by days or weeks.

The physician is also burdened, taking time to see a patient for what is an otherwise unnecessary appointment. In my experience, low-risk women receive excellent care from nurse-midwives, and optimal outcomes are sustained when midwives care for women of moderate risk. Involving obstetricians for high-risk consultation or transfer of care is a sound model of care. Midwives are able to spend more time. Their care is cost-effective. This is particularly important in the labor process.

Care for midwives reduces medical complications and cesareans. Midwives also provide better outcomes after birth, where more frequent visits improve outcomes for issues such as postpartum depression, breastfeeding difficulties and high blood pressure. In summary, midwives can improve access and reduce maternal morbidity and mortality, which is especially impactful in low-resource communities. I urge your support for SB 667.

This bill simply cleans up the policy implications left over from SB 1237, ensuring that women who seek nurse-midwifery care get the full benefit of their care without unnecessary roadblocks. Your support will help to expand access for pregnancy and gynecologic care for California women. Thank you and I would appreciate your aye vote.

Thank you, ma'am. Are there any other witnesses in support of the measure in the hearing room? Please step forward. Name, affiliation, and position on the measure.

Thank you, Mr. Chair. Erin Evans on behalf of NARAL Pro-Choice California in support of this measure, I've also been asked to convey support from an additional co-sponsor, that's Black Women for Wellness Action Project, as well as support from four individual midwives from around the state. Thank you.

Thank you, ma'am. Any other witnesses in support in the hearing room? Seeing none, let's turn to lead opposition witnesses. Are there any lead opposition witnesses? Please step forward.

Thank you, Mr. Chair. Ryan Spencer on behalf of the American College of OBGYN's District Nine, in respectful opposition unless amended to Senator Dodd's SB 667. I'd first like to thank the author and the sponsors for reaching out to us early to discuss their intent to possible pathways forward. This relationship, as the Senator pointed out, stems from our work in 2020 on SB 1237, and we appreciate this relationship.

However, for SB 667, we were able to come to an agreement on some key elements, but two significant ones still remain. First and foremost is the issue of furnishing scheduled drugs. When we negotiated 1237, one of the first issues that come off the table was controlled substances such as narcotics. This made sense as nurse midwives were seeking Independence to provide low-risk care, and there seemed to be very little reason to utilize high-risk, highly addictive drugs be part of this care.

In other times, when not low-risk, nurse midwives may still furnish scheduled drugs but may do so through mutually agreed-upon protocols with the physician. Such protocols, which to be queer, allow CNMs to continue to care for that patient, are in place. In those cases when a low-risk pregnancy or birth turns to high-risk, or when care necessitating treatment outside their scope is warranted, including the use of high-risk drugs.

We've heard the rationale that after the use of non-scheduled drugs or nonpharmacologic treatments have failed, nurse-midwives should be able to provide scheduled drugs, including narcotics, as a person is still, quote, Low risk. This based on an assumption that the condition of the patient receiving in narcotics still qualifies as low risk. How do we know it's not something more serious? Serious enough to warrant a narcotic?

Serious enough to warrant physician collaboration as SB 1237 intended, at a time when physicians are working to reduce the utilization of narcotics and obstructive care, this provision goes in completely opposite direction and should not be taken lightly. ACOG also has concerns with the provision authorizing nurse-midwives to become laboratory directors. I acknowledge the Committee's amendments and will not spend too much time on this matter.

However, it's important to note our concern that these carveouts diminish the value of a lab director's very important purpose to ensure a high quality system approach to testing that provide accurate and reliable test results. Again, we do appreciate the dialogue with the author and sponsor, and depending on today's outcome, we look forward to continuing our discussion. However, until these important issues are addressed, ACOG must continue to remain opposed unless amended.

Thank you. Thank you, sir. Are there any other witnesses in opposition to the measure in the hearing room who wish to speak? Seeing none, let's turn to the teleconference service. Moderator, would you please prompt any individuals waiting to testify either in support or in opposition to Senate Bill 667, and we'll take them?

To provide public comment in support or opposition to SB 667, please press one, then zero at this time. And we do have one comment coming through. One moment, please, while we provide them with their line number. I'll take it after this. And now we'll hear from line 51.

Hello, my name is Mary Kathryn Phillips, and I am a certified nurse-midwife in California. I support Senate Bill 667 as it is written, and I would like to express my additional support for the two items regarding laboratory testing and the prescription of narcotics. There are.

Thank you, ma'am.

Many instances.

Ma'am.

Thank you.

Thank you. Next, please.

We have no further comments at this time.

Thank you, Moderator. I believe we have someone in the room. We're at the point where it's name, affiliation, and position on the measure.

Sir, George Soares of the California Medical Association. Respectfully opposed unless amended. Looking forward to continuing conversations.

Thank you, sir. Now let's bring the matter back to my colleagues on the dais. Colleagues, any questions? Comments? I see Senator Wahab and Senator Alvarado-Gil. Senator Wahab.

Thank you. Thank you, Senator Dodd, for bringing this. I just wanted to highlight that I know that especially in the healthcare industry, we always kind of look at having more security and protections and so forth, but in particular, more people are opting out to kind of dictate kind of how they want to do things for their health and their safety. And I really do appreciate some of the support, especially for, as we talk about women kind of making their own choice, number one.

And number two, also just the protections around black women. Also we have higher mortality rates with them giving birth and much more. So I really do appreciate this bill. I know that you're probably going to most likely work with opposition to see if you can clean up anything else that is needed. But overall, I do support this and I will be voting yes. Thank you.

Thank you, Senator. Senator Alvarado-Gil.

Senator Dodd, thank you for bringing this forward. I am a big fan of nurse-midwives and am happy to see this piece of legislation in front of me. My question is a point of clarification, and I think this is for staff. So page 11, second paragraph. I just want to confirm, California Academy of Family Physicians, are they in support or in opposition?

Because you have it under the opposition. See here, it's under the opposition category.

Maybe, Senator, maybe. You know, I don't think they're in the room. California Academy of Family physicians in the room.

Are you in support or opposition, sir? But first, your name?

I'm Bryce Docherty on behalf of the California Academy of Family Physicians. We're in a supportive amended posture as well. I think the committee analysis was perhaps there was an error there on what the position was.

So you are in support?

We are opposed unless amended.

Okay. Opposed unless amended. Okay.

So they're opposed unless it's amended. Any other questions?

Okay, point of clarification. Still fuzzy, but all right. Thank you.

Thank you, Senator. Any other questions or comments? Seeing none. Senator Dodd, would you like to close?

Yes, I appreciate the comments. Just real quickly, I just think, particularly in the home setting, that women that are having birth should have the same type of care that they would have in the hospital. Oftentimes there's just not the time to be able to do some of these things. And I would also say that nurse-midwives share the goal on not overprescribing any type of drugs with the rest of the medical community. Respectfully ask for your aye vote.

Thank you. Do we have a motion on this bill? Moved by Senator Wilk. Thank you. The motion is do pass as amended to Senate appropriations. Please call the roll.

[Roll Call]

Bill has eight votes. We'll hold the roll open for absent members. Which bill would you like to take up?

I think we're going to take up item number two now.

Just item number three.

People that are waiting there as well.

Yes. Item number three. Senator Gonzalez's bill?

Yes.

Senate Bill 517, economic development. Please proceed.

Hi, Mr. Chair and members. I'm here today to present SB 517, which will advance the coordination and economic vitality of the state's freight sector. The freight sector drives one-third of California's economy, generating millions of jobs and moving trillions of dollars through the state. However, the 2021 supply chain crisis made it clear that the complex multimodal freight sector needs better high level coordinating and planning. A clear example of losses California incurred because of lack of freight sector economic planning is that we are foregoing federal dollars.

West Coast ports have received only 10% of the federal dollars for port infrastructure in recent years. SB 517 will address this gap in planning by creating a freight and supply chain coordinator within the governor's Office of Business and Economic Development. This coordinator will facilitate the coordination of the industry by engaging with relevant stakeholders and state agencies to plan for the economic competitiveness of the freight sector. Testify in support of the bill, I have Martha Miller with the California Association of Port Authorities and Mike Jacob with the Pacific Merchant Shipping Association.

Ms. Miller.

Hi there. My name is Martha Miller. I'm the executive director of the California Association of Port Authorities, which consists of the 11 commercial seaports in California here today due to our strong support of SB 517 by Senator Gonzalez. The California ports are responsible for handing 38% of all containerized imports and 28% of all exports in the US. Additionally, over 3.1 million jobs are supported by the trade that moves through California ports.

While we saw an increase in cargo during the pandemic, these numbers actually signify a 2% dip in cargo coming into and leaving the state with beneficial cargo owners choosing to divert cargo to other ports of entry on the eastern Gulf coast. Despite the critical importance of freight to California's workforce and economy, the recent COVID induced supply chain challenges have shown that California's freight sector is in need of better planning and coordination across agencies. In response to the supply chain crisis, the Biden Administration appointed a port envoy to meet across sectors with stakeholders from the national supply chain to mitigate congestion in real time. We saw the effectiveness of this approach, and while GO-Biz and CalSTA have both taken leadership roles in facilitating coordination, there's currently no state entity, office or position with the authority and capacity to coordinate across all of the different agencies.

Kappa, along with other key stakeholders in the goods movement sector, including ports, labor importers, environmental advocates and exporters, participated in the California Supply Chain Success Summit in 2021. The summit was hosted by Go-Biz, CalSTS, Food and AG, and a key finding from the summit was this exact solution was to create a supply chain coordinator within GO-Biz and within state government. SB 517 directly addresses this recommendation by establishing a freight and supply chain coordinator to be the primary resource for this critical industry within state government. Steer competitiveness and sustainability across the freight sector. As we look to the future and continue to work on solutions that will help get goods moving efficiently, we believe accountability and smarter coordination within state leadership is critical. Thank you, and happy to answer any questions.

Thank you. Jacob.

Good afternoon, Chairman Roth and members. Mike Jacob with the Pacific Merchant Shipping Association, represent ocean carriers and marine terminal operators. Reports and given the hour, be very brief. We've really been blessed with a state that has taken focus and made the effort to address our issues, but those issues are siloed. So we have a goods moving action plan, we have a sustainable freight action plan. We have a California freight mobility plan.

We have a goods movement emission reduction plan, but we don't have one entity, as Ms. Miller just said, to bring those together. And that fragility in our planning and coordination working together was really highlighted during the recent supply chain crisis, during the pandemic. So we appreciate the focus on this bill and ask for your aye vote.

Thank you, sir. Now let's turn to any other witnesses in support in the room. Name, affiliation, and position on the measure, please.

Good afternoon, Mr. Chair and committee members. Jonathan Clay here, on behalf of the Port of San Diego, in support.

Thank you, sir. Next, please.

Sarah Pollo Moo, on behalf of the California Retailers Association, in support.

Thank you, ma'am. Next, please.

Bernice Jimenez Creager, on behalf of the California Trucking Association, in support.

Thank you. Any other witnesses in support? Now let's turn to lead witnesses in opposition. Are there any lead witnesses in opposition in the hearing room who wish to testify? Seeing no movement. Any other witnesses who wish to testify in opposition? Seeing none. Let's go to the teleconference service. Moderator, would you please prompt any witnesses who wish to testify in support or opposition to this measure, and we will hear from them.

To provide public comment in support or opposition to SB 5117, please press one, then zero at this time. And we'll hear from line 55.

Nate Solov on behalf of the Port of LA, in support. Thank you.

Thank you. Next, please.

And we have no further comments at this time.

Thank you, Mr. Moderator. Bring the matter back to my colleagues on the dais. Colleagues, any questions or comments?

I'll move the bill.

The bill has been moved by Senator Archuleta. Any questions?

No, I just wanted to say I really do appreciate Senator Gonzalez for bringing this forward and you for presenting this, so thank you.

I'm sure Senator Gonzalez would respectfully ask your aye vote.

Senator Dodd, would you like to close?

I just did.

Was that your close? You get a gold star. The measure has been moved by Senator Archuleta and the motion is do pass to Senate transportation. Please call the roll.

[Roll Call]

Bill has eight votes. We'll hold the roll open for absent Members. And now, Senator Dodd, item number seven. Senate Bill 271.

Thank you very much, Mr. Chair and Members. SB 271 will empower powered wheelchair users by offering them a viable alternative to costly and time consuming repairs by allowing consumers and independent repair providers access to parts, documentation, and software necessary to repair their own devices, while also protecting manufacturer trade secrets. When a powered wheelchair breaks down, it can be a serious problem that requires prompt repair.

The limited number of CRT, that's Complex Rehab Technology service providers in the state means that individuals who use powered wheelchairs often have no other option but to rely on the manufacturer for repairs. This can result in delays of several weeks or even months before the repairs can be completed. During this time, individuals may be unable to leave their homes and participate in their communities and attend work or school.

This bill also includes important safeguards for consumers by clearly defining the scope of repairs that can be safely carried out by independent repair providers for chairs that fall under complex rehab technology classification and provide written notice to consumers about their warranty rights. Lastly, 271 improves access to this life changing technology by removing prior authorization requirements and reoccurring prescriptions for complex rehabilitation technology. These barriers can delay care for patients with significant and often lifelong disabilities.

Removing this requirement will allow individuals with disabilities to obtain the critical equipment they need in a reasonable time frame. This legislation also ensures that only safe parts are made available to independent repair shops or individuals. Protecting the quality of life of individuals with disabilities. We must prioritize the needs and rights of vulnerable communities, and SB 271 is an important step towards achieving that goal.

I have with me today Dan Okenfuss, the public policy manager at California Foundation for Independent Living Centers, and the Sacramento Disability Rights Activist and wheelchair user Alexa Guerrero from Placer to speak in support of the bill.

Thank you, sir. You may proceed.

Thank you, Mr. Chair and Senators. My name is Dan Okenfuss.

I'm the public policy manager for the California Foundation for Independent Living Centers, and we're here as a co sponsor of SB 271, granting power wheelchair users the ability to conduct maintenance and repair services on their own mobility devices. A bit about CFILC we're a statewide disability rights organization that serves as the membership body for California's 25 independent living centers, and we provide services and supports for thousands of individuals with disabilities so they can live comfortably in their own homes.

SB 271 will require manufacturers of power chairs to provide access to items necessary to facilitate repairs on equipment owned by a consumer and therefore making it easier for our consumers to fill the repair needs on their devices. And I just want to add one more thing here about powered wheelchairs are crucial to the well being and Independence of many of our members with a wide variety of medical conditions and mobility impairments.

And however, the shortage of licensed repair shops in the state and long wait times can cause serious difficulties for individuals who need them for their daily activities. And with me today is my friend, Alexa Guerro.

Yes, ma'am. Please proceed.

My name is Alexa Guerrero. I've been a lifetime user of a power chair. When my power chair breaks, I have to wait up to four weeks. Which means I have no independence at all. So this bill will improve the quality of life for power chair users. Thank you.

Thank you for coming to testify. Are there any other support witnesses in the room who wish to testify? Now, let's move to lead witnesses in opposition.

Liv Butler, Californians Against Waste in support.

Okay. Any other support witnesses? Are there opposition witnesses in the hearing room?

Mr. Chair and members, John Winger, on behalf of the National Coalition for Assistive and Rehab Technology, were the manufacturers and providers of complex rehab technology. First wanted to, to thank the Senator and his staff for all the hard work on the Bill. The amendments have gotten us to a really good place. We currently still have an opposed unless amended position, but we think it's moving in the right direction.

The removal of prior authorization is going to go a long way in getting rid of some of these delays that we've been seeing. Obviously, we want to provide timely repairs for our patients, and so we've had a very good dialogue.

There's just a couple small cleanup things, and I think we want to have a conversation around the penalty provisions, just ensuring that nobody's getting inadvertently penalized for some of the requirements in the Bill that are, some of the requirements that are in complex rehab technology code section that are a little bit vague. And so we just need to have a little bit more dialogue on that.

But with all the amount of work that's gone on to get this far in the First Committee is much appreciated, and so we're really hopeful that we can get to a support position here shortly.

Good. Thank you for working with the author. Any other opposition witnesses in the hearing room? Seeing none. Let's go to the teleconference service. Moderator, if you would please prompt any individuals waiting to testify either in support or in opposition to the measure, we will hear from them.

To provide public comment in support or opposition to SB 271, please press one, then zero at this time. And first we'll hear from line 57.

Good afternoon, Chair and members. Rebecca Marcus, on behalf of CalPIRG in support.

Thank you. Next, please.

Line 50.

Good afternoon, Chair and members of the Committee. My name is Russell Rawlings. I am a resident of Sacramento and a lifelong power chair user. I have experienced many difficulties in obtaining repairs for my own power chair.

In fact, I think that it's the experience of employed people like myself that access to repair and maintenance, wheelchair maintenance actually becomes more of a burden because of the personal costs borne by the individual and the lack of comprehensive insurance policies that cover wheelchair repairs. So I am in full support of SB 271, that will provide greater access to repair and also the ability to maintain our chairs through access to the necessary software that controls our devices and effective for us to use. Thank you, sir.

Just a reminder to those on the line, this is the time where it's name, affiliation and support or opposition to the measure, please. Next, please.

Next, we'll hear from line 62.

Hi, Laurel Lehman here on behalf of Consumer Reports. We're a proud co-sponsor of SB 271 and also in strong support.

Thank you. Next, please.

25.

Hello, my name is Beck Levin. I am Systems Change Advocate for the Dayle McIntosh Center for the Disabled in Orange County, California, and I would like to express my support.

Thank you, ma'am. Next, please.

28.

Hello, Sheri Burns with Silicon Valley Independent Living Center and the Aging Services Collaborative at Santa Clara County. I am calling in support of Senate Bill 271.

Thank you. Next, please.

Line 21.

Good afternoon. I'm Kate Laddish, chair of the Yolo County In-Home Supportive Services Advisory Committee and a wheelchair user. Yolo County IHSS Advisory Committee supports this Bill. Thank you.

Thank you. Next, please.

64.

Mr. Chair and members, Bob Ackerman, on behalf of the California Association of Medical Product Suppliers, which are durable medical equipment providers, appreciate Senator Dodd's amendments to the Bill, working with staff in a much better place. So we're opposed, unless amended now, working to get the support. Thank you.

Thank you. Next, please.

Line 63.

Hello, this is Sheila Allen, Executive Director of Yolo Healthy Aging Alliance. Our organization and board have voted to support SB 271.

Thank you, ma'am. Next, please.

Line 10.

This is Christine Fitzgerald, community advocate, Silicon Valley Independent Center, and a wheelchair user, in support of 271.

Thank you. Next, please.

Line 44.

This is Jillian Foster. On behalf of DCRC Independent Living Center in Los Angeles, California, in support.

Thank you. Next, please.

Line 20.

Good afternoon. Roger Acuna, with Independent Living Resources of Contra Costa and Solano Counties in support.

Thank you. Next, please.

Mr. Chair. We have no further comments at this time.

Thank you, Mr. Moderator. Let's bring the matter back to my colleagues on the dais. Colleagues, any questions or comments? Senator Wilk.

Yeah I just have a. So I'm supporting the Bill. On the penalties, they seem high. How did you guys come up with that number?

There's another Bill in Colorado that used that number that did pass. I spoke with my staff about that this morning, and we're really interested in looking at that because I agree with you.

Okay, great. Thank you. Again, no one should have to go four weeks without a wheelchair. That's outrageous. So thanks for doing the Bill.

Any other questions, comments? Seeing none. Is there a motion on this Bill? Senator Wilk moves the Bill. Would you like to close, Senator Dodd?

Respectful ask for aye vote.

The motion is do pass to Senate Judiciary. Please call the roll.

[Roll Call]

Bill has eight votes. We'll hold the roll open for absent members. Senator Becker, Item number 9, Senate Bill. I see Mr. McGuire here. Where?

Mr. Chair? Mr. Chair, Senator Becker was at Coachella this weekend as well, and I did not see him on the flight this morning, so I don't know if he came in last night.

Well, we're going to take Senator McGuire, the majority leader, first, since he's first on the list. Sorry, Senator Becker. This is item number six, Senate Bill 601. Senator McGuire, professions and vocations contractors. Please begin when ready, sir.

Thank you so much, Mr. Chair, and to Members and I'll be brief, I want to first and foremost say thank you so much to the Chair and to the incredible staff of the Committee for their work on this. I also want to say thank you to the Contractor State Licensing Board for their partnership. SB 601 will protect homeowners struggling to better rebuild their homes and lives from fraudulent contractors.

In particular, after some of the worst disasters that this state has seen in generations, we continue to see mega-fires and earthquakes, and floods, and thousands of Californians have lost their homes in these devastating disasters. And what we know is losing a home is one of the worst experiences one can face in their life. But ending up with an inexperienced contractor, or worse, a contractor who intentionally takes a job knowing that they cannot finish it, has made the rebuilding process, the healing process, incredibly traumatic.

And that's why we are in front of you today. Since 2018, the State Licensing Board has received an average of 180 disaster-related complaints each year, a significant increase from the previous four years, where they averaged about 24. So we've gone from 24 since, mostly the fires, to 180 a year. And most of these complaints are from consumers in declared disaster areas who were harmed by unscrupulous contractors.

Disaster recovery often takes years, but under current law, the statute of limitations for this, an unlawful use of a license is just one year. So here's what this Bill will do. 601. SB 601 will increase the statute of limitations for the unlawful use of a license from one year to three years. And I want to be very clear, Mr. Chair, the vast majority of contractors in this state, they are advancing with rebuilds, and they're doing right by their customers. The vast majority.

But as Senator Dodd and I have seen firsthand, there are a handful that do not. And there are some road contractors who charge fire survivors full price for rebuilds that include shoddy work, windows on background that are backwards, roofs that leak, doors that don't fit, or they simply walk off the job and are never to be heard from again. Now, I'd like to acknowledge an amendment that we're going to take in a future Committee.

Mr. Chair, we have heard from concerns from the California Surety Federation on the payment performance bond piece of this legislation. We will be removing this section from the Bill and are currently working with the licensing board to ensure unscrupulous contractors are held accountable through a potential penalty proposal. We'll have more to report here, but we are going to be taking that portion of the Bill out.

I'm grateful that we have the chief of legislation for the contractor State Licensing Board with us here today, and I'm grateful, Mr. Chair, for being able to present with you today.

Okay, I see a lead witness at the microphone. Please proceed, ma'am.

Thank you, honorable Chair and Committee Members. My name is Yeaphana La Marr. I'm the Chief of Legislation from the Contractor State License Board. Thank you, Senator McGuire, for authoring this Bill. SB 601 would increase the statute of limitations for misdemeanor violations pertaining to unlawful use of a license issued by a program within the Department of Consumer Affairs from one year from the date of occurrence to three years from the date of discovery.

California continues to experience severe fire or severe weather events that result in damage to residential property. CSLB conducts outreach at local assistance centers operated by the California Office of Emergency Services to educate homeowners about contractor licensing requirements. However, a consumer cannot protect themselves by checking the license if the unlicensed contractor is unlawfully using the valid license of another contractor. Consumers who are recovering from a disaster often don't file a complaint immediately as their priorities are on other important matters.

Consequently, CSLB is often prevented from pursuing criminal action, making the only option administrative disciplinary action, which is not as effective a deterrent as a misdemeanor prosecution. Thanks again. Thank you again, Senator McGuire. CSLB is in support of this Bill and appreciate your support as well.

Thank you, ma'am. Are there any other witnesses in support of the measure in the hearing room? Seeing none. Let's turn to any witnesses, lead witnesses in opposition or any other opposition witnesses. Please step forward.

Good afternoon, Mr. Chair and Members. Bret Gladfelty with Apex Group on behalf of the California Surety Federation. I had a long speech here about what we were going to oppose, but we'll be removing our opposition with those promised amendments. So thank you.

Thank you, sir. Any other opposition witnesses seeing none. Let's turn to the teleconference service. Moderator if you would, please prompt any individuals waiting to testify, either in support or in opposition to this measure, Senate Bill 601. We will take their testimony.

To provide public comment in support or opposition to SB 601 please press one then zero at this time. And we have no comment.

Thank you, Mr. Moderator. Bring the matter back to my colleagues on the dais. Senator Niello?

Thank you, Mr. Chair. I know firsthand that this problem exists because I had a house fire quite some time ago, almost 20 years ago, but my house burned down. And very shortly after that, I started getting phone calls from interesting characters. Frankly, I found them fairly easy to identify, almost on the surface of it but then if you check them out, you quickly learn. But it is a real issue. I was prepared not to support this because of the surety requirement.

Obviously, that was a fatal problem which you took out. So I'll be supporting the Bill.

Thank you, Senator. Senator Arcelleto.

Yes, thank you, Senator, for bringing this forward. We've got the contractor and the subcontractor, and often the subcontractor run out and get business, and you get five or six, eight, ten jobs going and bring in subcontractors and they fall to the wayside. And I think the issue always, we look to the contractor, but how do we ensure that the subcontractors are working more diligently when we're addressing things that we just mentioned when the disaster hits or just anyone remodeling their home or doing whatever?

It is not always a contractor that shows up day after day. It's a subcontractor. Would you comment?

No, you're absolutely right. I'm going to comment through the Chair, if it's all right with Senator Archuleta and Senator Niello. I think Senator Niello is right that on the face, if you have a devastating event and it's one home, you're able to weed out those potential bad actors. The challenge that we have faced, and I'll talk about the Tubbs Fire, where we saw about 6,300 homes burn, is that you have contractors flooding in from across the state, in the west.

Many aren't qualified, including subs who come to a job and are in it for the money and not for the people that they work for. So I'm going to turn it over to the State Licensing Board if they'd like to better talk specifically in regards to subs. But for us, it's the contractor who is on the book of business and signs the contract with the homeowner, which is why we're going after that individual company who is responsible for the overall rebuild.

They're ultimately the responsible party to follow through with a contractual obligation. And that's why you're seeing that from a one-year to a three-year and through. The Chair would welcome Senator Dodd, because I know this is an issue that we've worked on closely. I think that's been our biggest issue, especially in the Tubbs, has been those individual general contractors are responsible for garnering those other subs, plumbers, electricians, drywallers, et cetera.

Thank you, Senator. Let me just make sure I'm clear. So the three year, the move from one year to three years on a statute of limitations is more than just somebody using a fake license or not having a license. This move will deal with any sort of customer complaint having to do with the contractor's work performance or lack thereof.

Work performance or lack thereof. That's in particular what this Bill is focused. So if you have shoddy contract, excuse me, shoddy work done by a contractor, if you have a contractor that's worked off the job, if you have a contractor that has not followed through with the obligations that are within the embedded contract signed by that general and the homeowner, you're absolutely right. It's all-encompassing.

And you have three years to file your complaint and have it taken care of.

Yes, sir, you're absolutely right. And what we have found, especially after times of disaster, that 12 months simply flies by. Right? And with the homeowner rebuilding their life, they don't have time. And this three years allows that homeowner to be able to go after the worst of the worst. And I want to be very clear, Mr. Chair, the vast majority of contractors would not be caught up within this accountability net in the Bill. It would be those worse are the worst.

But you have hit the nail on the head, Mr. Chair.

Certainly, as amended, I'm supporting, or as you propose to amend it, I'll be supporting the Bill. Senator Alvarado-Gil.

Senator McGuire, I want to thank you for bringing this Bill forward. As a freshman Senator myself, your reputation has permeated in my district. You've been a strong advocate not only for rural communities, but for all consumers in wildfire and natural disasters. So I want to thank you for this piece of legislation. I currently have 11 of my 13 counties that are recovering from natural disasters.

And over and over again, I hear that fear from some of our most vulnerable consumers about predatory contractors, particularly in the mountain communities where it is very limited access to high-quality contractors. So I think this piece of legislation is due, and I think this is something that will be very supportive of what a lot of my constituents are dealing with. So thank you for continuing to be that voice for the rural communities.

Senator, I'm grateful. I'm grateful to be able to work with you, and you are tenacious in the pursuit of holding folks accountable for those who are harming your constituents. And I'm grateful for your partnership. And thank you so much. And I look forward to working with you on this. Thank you.

Thank you, Senator. Seeing no other hands in the air, Senator McGuire, would you like to close?

Would respectfully ask for an Aye vote, and thank you for your time. We'll keep you in the loop, sir, on these upcoming amendments. Thank you, Mr. Chairm.

Thank you. We have a motion.

Move the Bill.

Senator Archuleta moves the Bill, and the motion is do pass to Senate Public Safety. Please call the roll.

[Roll call].

Bill has 11 votes. We'll hold the roll open for absent Members. Senator Becker, our final item, item number nine. Senate Bill 784, health care districts employment. You're going to bring us across the finish line, Senator.

All right. Good afternoon. I'm here to present SB 784. California's public district hospital serves some of California's most diverse and underserved populations and are the most local form of public hospital. But despite being the sole closest source of health care for many families and seniors, district hospitals are the only public hospitals not allowed to directly employ physicians. This hurts their ability to provide services to their largely underserved patients.

As district hospitals are either rural and struggle to recruit physicians, or in urban areas where high cost of living make it difficult to recruit and retain physicians, direct employment provides a way to compete in or with larger labor markets to offer physicians benefits that make working at a public hospital more attractive.

Allowing physicians to choose direct employment is particularly attractive to doctors coming out of residency or who are relocating from other states where direct employment of physicians is more common and would prefer to receive set salary, benefits, and hours while still having their clinical autonomy as physicians. Respected.

Absent this change, digital hospitals must continue to rely solely on contracting with physician groups or individual doctors, making it increasingly difficult to ensure they can provide essential care to those who need it most with me testify today in support is Sarah Bridge with the Association of California Healthcare Districts and Dr. Shreyas Mallur, El Camino Health Associate Chief Medical Officer. Thank you.

Yes, ma'am. Please proceed.

Thank you. Chair Roth and Members, Sarah Bridge, on behalf of the Association of California Healthcare Districts here is proud sponsors of SB 784. Want to thank the Senator for his leadership on this. I will defer most of my time to Dr. Malore, but want to touch on a couple of quick points. There are 33 district hospitals in the State of California. 17 of them, by way of their critical access designation, already enjoy the ability to directly employ physicians.

This Bill aims to bring parity to the 16 remaining district hospitals that do not enjoy the ability to directly employ physicians unlike their other public counterparts.

As the Senator mentioned, UC and county hospitals have long enjoyed the ability to directly employ physicians, and for the past seven years, the critical access hospitals, the 28 in this state, and the 17 district hospitals have successfully piloted a program to show that direct employment of physicians allows district hospitals to recruit and retain physicians to their areas where they have continued difficulties. District hospitals service large portions of MediCal and Medicare patients as opposed to their commercial counterparts.

This makes them less attractive to contracting with physician groups, and so being able to employ physicians directly allows them to offer set salaries, benefits, hours that make them a more attractive employment opportunity for those coming out of residency and from out-of-state. One point that I'd mention is that the Bill aims to protect clinical judgment and ensure that doctors make clinically appropriate decisions and to protect against corporate interests and influence.

With that, I would respectfully urge your Aye vote and thank the Senator for his leadership.

Thank you. Doctor, you're up.

Thank you Chair and Members of the Committee, thank you for the opportunity to speak today in support of Senate Bill 784. My name is Shreyas Mallur. I'm the Associate Chief Medical Officer for El Camino Health, co-sponsor of the Bill. I am an internal medicine physician. I specialize in hospital medicine. I've been in practice for two decades. I've worked both in independent group and a large medical group for 20-plus years. I'd like to tell you about public district hospitals.

We focus on what is best for our patients, high-quality clinical care, and also respecting clinical judgment. We are locally governed, publicly accountable, and we are responsive to our community's health needs. During the public health emergency, El Camino Health, which is district hospital, was one of the first organizations in the state offering robust COVID-19 testing and vaccinations when they became available. We set up pop-up testing and vaccination sites because they were needed in the community.

While other healthcare organizations across the country, to be frank, have reduced mental health services, El Camino has expanded mental health services by increasing the number of inpatient beds. We have 21. We are up to 36 inpatient beds. And we also launched new programs. Our perinatal, which is the mom. We call it the Moms program. Inpatient Psychiatry Program for Moms is one of three in the entire nation. Senate Bill 784 is about health equity and access.

People from all walks of life, physicians, everybody ask me what keeps me up at night in my role. I can tell you that the biggest concern I have is that our district hospital will not be able to provide care for someone who walks through our doors in clinical need. Somebody in need because we have, because of lack of clinical specialty, clinical resources.

SB 784 would be just one tool for district hospitals to recruit and retain high-quality specialty and primary care physicians to provide care to those most in need. A concern is often raised that nonclinical administrators or board members would direct clinical care or interfere with clinician judgment. I would like to dispel that myth. As a practice and physician myself, physicians practice medicine based on evidence and guidelines that are set by their societies.

And the parameters for clinical practice in the State of California and across the nation are not set by non-clinical administrators or board members, but by self-governing, independent medical staff bodies. In a hospital, a medical staff body is the ultimate arbiter of what clinical care should be provided at the hospital. It would be very difficult, if not impossible, for a non-clinical administrator to direct clinical care by physicians or interfere with their clinical judgment. The structure of a district hospital would not allow that.

There are multiple checks and balances to prevent that from happening. Senate Bill 784 is a modest Bill that would give public district hospitals an option that other public hospitals, such as UCs and University of California hospitals currently enjoy. That would strengthen our ability to provide local essential clinical services to increase healthcare access to those in need in our districts. Thank you for your time.

Thank you, Doctor. Any other witnesses in support of this measure? Name, affiliation.

Mr. Chair and Members. Connie Delgado on behalf of the District Hospital Leadership Forum in support.

Thank you for coming. Any other witnesses in support?

John Cowan from El Camino Health in support.

Fine. Any other witnesses in support? Now let's turn to any opposition witnesses. First lead opposition witness and then any other opposition witnesses.

Thank you, Mr. Chair, Members of the Committee, Brandon Marchy with the California Medical Association. We have the utmost respect for the Senator, the author. We appreciate his work and our conversations thus far. Unfortunately, this Bill is the wrong Bill at the wrong time. The Bill does not solve the stated problem of getting physicians into these communities that need care.

Instead, SB 784 would wipe away some long-standing protections for patients and providers from ulterior motives such as profits, shifting cultural and political pressures, and faith-based beliefs. With current attacks to cut abortion and other reproductive care, gender-affirming services, and corporations acquiescing to political culture wars, it is more important than ever to defend patients' ability to get the quality care they need and deserve. It is our understanding that the Senator introduced the Bill to allow El Camino Hospital to district to employ physicians.

However, the exemption is not just limited to El Camino. In fact, it applies to any hospital district that is structured in this way. Additionally, it's not clear that the conditions on the ground in the case of El Camino in particular, warrant this permanent exemption. The area has physicians, both independent and in medical groups. They are ready to contract with the hospital to provide care in their communities and around their communities.

A hospital district's inability to come to a negotiated contract with those doctors is not a reason to come to the Legislature to undermine long-standing law that provides patients with the peace of mind that when they walk in to see a doctor, that doctor has their best interests and their care at heart, not the interests of their employers.

The safeguards in SB 784 are also not strong enough to protect physicians from undue influence from a hospital that holds their privileges, their credentials, and their ability to practice medicine. These interferences are difficult to prove and are even harder to arbitrate in court, which is the only way the corporate bar is enforced to this day.

At a minimum, the Bill should require a report from a Department to see how often the exemption is used, the recruitment and retention rate of physicians at the hospitals, and to assess the impact on patient and physician decision-making. To really address the issue of physician recruitment and retention in rural and underserved communities, California must address its public payer reimbursement rates.

The ability of a hospital and physician to be payer agnostic and to not lose money on a MediCal visit is crucial to the viability of both hospitals and medical groups up and down the state. Decisions about patient care, regardless of the service, should be insulated from profiteering political or religious entities. SB 784 would eliminate that bulwark that ensures that care decisions are made in the best interests of the patient and not encumbered by ulterior motives. I respectfully request you're No vote.

Thank you. Any other opposition witnesses in the room? Seeing none. Let's turn to the teleconference service moderator. If you would, please prompt. any individuals waiting to testify either in support or opposition to Senate Bill 784, we'll take them.

To provide public comment in support or opposition to SB 784. Please press one than zero at this time. And Mr. Chair, we have no comments.

Thank you. Let's bring the matter back to the dais and my colleagues for any questions or comments. Colleagues, any questions or comments? Senator Ashby.

I know we're at the end of a long hearing, but I'm willing to vote for it today. But I just want to ask you what you're doing to work with the opposition, because some of the things that he shared are pretty concerning, and I just want to make sure that you're planning on working on those. I noticed you didn't accept any amendments here, but it is going to Health, so maybe there'll be some opportunity for some more discussion there.

I'm not working with Brandon. I'm kidding. No, I have a great relationship with the CMA. We are continuing to have conversations. I think some of his broader points are very valid around public payer and all the things that. They're probably beyond the scope of this Bill, but I absolutely agree with. But we will continue to work going forward.

Okay. Thank you.

Anything else, colleagues? If not. Senator Becker, would you like to close?

Yeah Thank you. I appreciate the question and the concern. Again, I think, just to restate that this does mirror the protections in existing code, ensuring clinical judgment rests solely with the physician. So I just want to really reassure folks on that point, we'll continue to work on it, and I respectfully request your Aye vote.

Thank you, sir. I need a motion. Senator Niello moves the Bill. The motion is do pass to Senate Health. Please call the roll.

[Roll call].

Bill has 12 votes. At this point, we'll hold the roll open for absent Members. If we have Members who wish to add on to the roll on the Business, Professions, and Economic Development Committee, I suggest that you beat feet down here to the hearing room 2100. Thank you. Okay, we're back in action. We're going to open the roll with item number 1, Senate Bill 285, Senator Allen. The current vote is 9 to 1. Chair voting aye.

[Roll Call]

Vote is 12 to 1, that matter is out. Item number 2, Senate Bill 447, Senator Atkins. Current vote is 6 to 2. Chair voting aye.

[Roll Call]

Vote is 10 to 3, that matter is out. Item number 3, Senate Bill 517, Senator Gonzalez. Current vote is 8 to 0. Chair voting aye.

[Roll Call]

Current vote 13 to 0. That matter is out. Item number 4, Senate Bill 524, Senator Caballero. Current vote is 9 to 2. Chair voting aye.

[Roll Call]

Vote is 10 to 2. That bill is out. Item number 5, SB 785, Senator Caballero. Current vote is 5 to 1. Chair voting aye.

[Roll Call]

Vote is 9 to 1. That measure is out. Item number 6, SB 601, Senator McGuire. Current vote is 11 to 0. Chair voting aye.

[Roll Call]

Current vote 13-0. That measure is out. Next item is item number 7, Senator Dodd, SB 271. Current vote is 8 to 0. Chair voting aye.

[Roll Call]

Current vote 13-0. That matter is out. Next item, item number 8, SB 667, Senator Dodd. Current vote is 8 to 0. Chair voting aye.

[Roll Call]

Current vote 12 to 0. That matter is out. Next item, item number 9, Senator Becker, Senate Bill 784. Current vote is 12 to 0. Chair voting aye.

[Roll Call]

12 to 0, that matter is out. Item number 10, Senator Alvarado-Gil. Current vote is 8 to 0. Chair voting aye.

[Roll Call]

Current vote 11 to 0. That matter is out. Last item, item number 11, Senate Bill 829, Senator Wilk. Current vote is 8 to 0. Chair voting aye.

[Roll Call]

Current vote is 11 to 0. That matter is out. Thank you all for who participated in today's hearing. The Senate Business, Professions, and Economic Development Committee is adjourned.